Katherine Heigl (Izzie Stevens) doesn't appear in this episode.

Meredith: (opening voiceover) In order to get a good diagnosis, doctors have to constantly change their perspective. We start by getting the patients point of view, though they don't often have a clue what's going on. So we look at the patient from every possible angle. We rule things out. We uncover new information trying to get to what's actually wrong. We're asking for second opinions hoping we'll see something others might have missed. For the patient, a fresh perspective can mean the difference between living and dying. For the doctor, it can mean your picking a fight with everyone who got there before you.

Meredith: Are the Mercy West people that bad?
Cristina: They're everywhere and there are more of them than us, and they're kicking our asses. God, I miss Izzie. We need more 'uses', so get back here.
Meredith: I have to be discharged first. You want to forge Bailey's signature?
Cristina: No, that'll get me fired. Ooh, ask one of the new ones to do it. Get them fired.

Derek: (to Webber) Maybe it's not one doctor. Maybe it's too many doctors who don't know each other and who don't trust each other. When I got to that room, it was chaos, because that's the system now, chaos. That has been the system that has been in place since this merger was put in place. Your system. I'm saying you should look again at who's responsible.

Meredith: (closing voiceover) When we're heading towards an outcome that's too horrible to face, that's when we go looking for a second opinion. Sometimes, the answer we get just confirms our worst fears but sometimes, it can shed new light on the problem. Make you see it in a whole new way. After all the opinions have been heard and every point of view has been considered, you finally find what you were after, the truth. But the truth isn't where it ends, that's just where you begin again with a whole new set of questions.

Episode Title: I Saw What I Saw

"I Saw What I Saw" is the title of a song by Sara Groves.