- Izzie wrestles with her ghost, Torres uses a ground-breaking procedure to get her mind off of Hahn, and the interns continue teaching themselves spurred on by a new cohort.
- Meredith's best friend from college shows up on her doorstep and Cristina feels threatened by it. Meredith thinks Sloan is putting the moves on her half-sister and asks Derek to intervene, while the interns practice sutures on each other and Izzie still feels Denny's presence. Hahn is suddenly gone from Seattle Grace and everyone immediately feel at odds over her replacement.—Moviedude1
- Hahn is gone: Meredith's voiceover talked about the unbreakable, family-like bond that's formed between surgeons when Cristina barged into her bedroom, waking Derek up, to announce that "Hahn is gone." Just then, Meredith's old friend, Sadie, knocked on the door and came in and giggled incessantly with Meredith, kicking Cristina out the bed. Derek then welcomed Cristina to his world of getting kicked out of bed by someone Meredith would rather be with.
Sadie said Meredith was the reason she gone into medicine in the first place. Izzie stood outside and didn't want to talk about the complications of Hahn's case making her think about Denny again. Alex was understanding, but when Izzie walked in, Denny's ghost walked alongside her. Lexie had cuts on her arms and Cristina sent her away to plastics. Alex told Cristina that a famous doctor was at the hospital to do a heart transplant, and he was going to piggyback on it. Cristina wondered why she wasn't on it.
Callie said she didn't know why Hahn was gone and didn't want to talk about it. Callie wanted to be distracted by a surgery when a "human pretzel" came in. The man had been sleeping in a dumpster and was mangled so badly that he was impaled by his own limbs.
The chief wanted the staff to impress Dr. Dixon, but warned them that "she's off" and "a little different." Dr. Dixon showed up and was very socially awkward, almost robotic, in explaining why she was there. "OK, then, she's a little off," Bailey said.
Cristina kept telling Sadie, a new intern, to get out of the way and stop asking stupid questions as the team treated the mangled guy. They had to remove his femur, which was impaling him. He was unconscious until the femur came loose, then he screamed in agony. He wanted everyone to get their hands off him and Dr. Hunt demanded they listen. They all took their hands off him and Hunt asked the patient his name: Timothy Miller. He said he had to be able to walk.
Bailey gave a tour of the hospital to Dr. Dixon, who recited facts about surgery as she and Bailey walked. Izzie and Alex talked to the patient, a Navajo Indian, who didn't want a new donor heart because he thought his transplanted heart was haunting him. He just wanted the doctors to take the old heart out, without accepted a new one. Denny's ghost said, "that's just stupid" and said he should take the heart. Dr. Dixon told the patient if he didn't accept the heart, he'd be kept alive for a short time by machines before a sudden and agonizing death. "That's what I'm talking about," Denny's ghost said.
George barged into a room where the interns were cutting each other to practice stitches. Lexie told him to leave because the room was for interns only. Timothy, the mangled man, explained that he's homeless and has to be able to walk around town. He said if the surgery wasn't going to allow him to walk, he didn't want it. Hunt called off the surgery.
The Navajo patient wanted to keep the old heart, but Dr. Dixon explained "there are rules and rules are rules." Derek and Sloan explained to Hunt that they couldn't just let Timothy die without having surgery. "We save lives here," Derek told Hunt. "We don't just patch up patients and leave them to die. If you can't handle that, go back to the desert and leave us here to do our jobs." Hunt left, and Derek asked Callie to figure out a way to build Timothy some legs.
Callie tried to figure out how to make Timothy a new leg, and she asked for every piece of titanium in the hospital. Bailey went to the chief and asked him to make a rule declaring the hospital's position of respecting patients' religious beliefs. He said it's just common sense, but Bailey needed him to make a rule because Dr. Dixon doesn't do "common sense" she only does rules. He agreed.
Cristina introduced herself to Dr. Dixon, who wondered why Cristina was talking to her when the other residents were still on her case. Cristina left. Cristina suddenly wanted Hahn back. Callie told Cristina she and Hahn had a fight and Cristina said, "It's not like she was your girlfriend." Then Cristina learned the truth.
Derek made Meredith talk to Lexie about whether she was a secret cutter. She didn't respond, then Sloan walked up and called Lexie "Little Grey" and told her he needed her for surgery. Hunt went to Timothy and heard Timothy's "story." He said his life took and turn and he "just couldn't connect." Hunt seemed a bit shaken. (This is the point when we remember that Hunt 's entire platoon was killed in Iraq).
Lexie told the Secret Intern Society that they had to shut it down for a few days because of Meredith's suspicion. Sadie, the newest member, said they just had to be more careful -- as in, not cutting each other where their cuts were visible. She took off her shirt, sliced herself near her shoulder blade and asked, "Who wants to stitch me up?" Everyone raised their hands.
Meredith told Derek to tell Sloan "to keep his Little Sloan out of Little Grey." Callie told Sloan that Hahn didn't say goodbye to her. Izzie asked the Navajo patient if Derek's ghost could be bringing heart patients to her. He asked if Denny was "here right now?" He asked her not to be in his surgery because he didn't need any extra ghosts in his operating room.
Derek and Hunt convinced Timothy to let them operate. During the heart surgery, Bailey explained to Dr. Dixon the new rule allowing the doctors to give the old heart back to the patient after surgery based on his religious beliefs. Izzie, watching from the gallery, had a conversation with Denny, telling him he wasn't real. He wanted her to touch his hand to prove it. She refused and asked him why he was there. "I'm here for you, Izzie Stevens," he said. She said nothing.
After the donor heart was separated, it started beating on its own. The doctors couldn't figure out what was happening. The patient's original heart seemed to be functioning and Dr. Dixon explained the heart had six years to rest and might have had enough time to repair itself.
The chief came in to check on the surgery and Sloan bragged about Lexie's stitching skills. The chief congratulated Lexie, and congratulated Cristina for teaching Lexie well. He told her if she kept up that level of teaching, she'd be the "one to watch" for the solo surgery.
Izzie gave the Navajo patient the old heart and he said his tribe's medicine man would burn it. He said they can cleanse metals and jewelry, but fabrics, clothing, books that were read by the dead, are all burned. "You don't still have any of his clothes, do you?" he asked.
Timothy died in surgery and Callie broke down, blaming the other doctors for not keeping him alive while she built his bones from scratch. She cried and Hunt cleared the room.
Dr. Dixon told Bailey that she likes the heart and its regularity. She asked Bailey if she was familiar with Asperger's Syndrome. She said she doesn't understand cues of sarcasm, "but I know when I'm being manipulated and I know when I'm being made fun of." Dr. Dixon said she doesn't like Seattle Grace, and left.
Alex watched as Izzie said her final goodbye to Denny's ghost, telling him he'll always be with her, but she had to let him go. Back at home, Alex told Izzie to let him help her. She handed him Denny's sweater and asked him to burn it for her.
Cristina discovered the interns' arms, where they'd stitched themselves. She told them she'd never taught them the parallel pulley stitch, she could barely do that stitch herself. She told them practicing on themselves was insane and told them to "shut it down."
Derek wanted Meredith to tell him one of the stories she wouldn't let Sadie tell him. Back at the bar, Cristina chased Hunt down after he left and he was upset about the patient. He yelled at her, saying he doesn't need her to feel sorry for him, and just doesn't need her. Then he kissed her. They said nothing and she left.
Denny's sweater cracked in the fireplace as Izzie watched, but when she went to her bedroom, Denny was sitting there. She freaked out, repeating, "You're not real," but he told her he came back for her. He asked her to touch him, and she did. And her hand didn't go through him. She touched his chest and he held her hand said, "See?"
"Some ties that bind us," Meredith's voiceover said, "are meant to be."
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