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As Addison works with Rebecca, a pregnant woman who needs to have a C-section but wants to give birth naturally, she begins to doubt her abilities as a doctor. The interns work with Shawn Sullivan, a car salesman who wants to return to his normal routine after he has surgery. However, when Shawn lights a cigarette that catches his face on fire, Derek and Mark argue over how they should procede with his burn treatment. Meanwhile, Burke continues to rehab his injured hands with the help of Cristina, gradually progressing from operating on chickens to operating on a corpse. Meredith goes into surgery after her appendix bursts and after surgery, she finally makes a decision between Derek and Finn. Elsewhere, Callie and George continue to discuss their relationship and Izzie meets a man who gives her the surprise of her life.
Mark: How's my favorite dirty mistress?
Meredith: Haven't you heard? Now I'm an adulterous whore.
(on the voice message Denny left for his parents)
Denny: Dad, Mom, it's me. I'm calling from Seattle Grace Hospital where the beautiful, talented, and incredibly stubborn Doctor Isabel Stevens has just given me a brand new heart and promised to marry me. I know we've had our differences, and I'm sorry we've been out of touch. Believe it or not, I was trying to make everything better. I know you're angry, but I hope you'll forgive me. Turns out sometimes you have to do the wrong thing. Sometimes you have to make a big mistake to figure out how to make things right. Mistakes are painful, but they're the only way to find out who you really are. I know who I am, now. I know what I want. I've got the love of my life, a new heart, and I want you guys to get on the next plane out here and meet my girl. Everything's gonna be different now. I promise. From here on out, nothing's ever gonna be the same. I love you, bye.
Derek: How's Dr. Grey?
Cristina: Oh, she's not pregnant ... with anyone's baby.
Meredith: Now all my boys are here. You're all so handsome and such good kissers.
George: Oh God!
Finn: Excuse me?
George: She's on drugs.
Meredith: (pointing at George) He's an excellent kisser.
Finn: You two dated?
Derek: You didn't know?
Meredith: It wasn't a date so much as a ... disastrously ... uncomfortable ... sexual experience.
George: Oh ... I ... I can't be here.
Bailey: None of you can be here, this woman is being prepped for surgery, which means you all need to leave.
Bailey: Now! (Derek, Finn and George turn to leave) Not you O'Malley!
Derek: You deserve to be with somebody who makes you happy. Somebody who’s not going to complicate your life. Somebody who won’t hurt you. He’s the better guy. Meredith, Finn’s the better guy.
Derek: I’m walking away.