Determined to reverse Seattle Grace's slide into mediocrity, the chief lays down some new rules for interns and residents with which no one's happy. Derek asks Meredith for further changes in her living arrangements. Lexie challenges Cristina's diagnosis for a patient with a persistent headache, and the chief's preoccupation with reputation blinds him to problems with the physical plant.
There is a huge problem affecting the whole hospital including patients too. Richard is trying to do his best to solve the problem.
- Previously on...: Seattle Grace was ranked 12th among teaching hospitals in the country, down from second, and the chief was crackin' skulls. Lexie denied Sloan that George is her boyfriend, but she totally has the hots for George. And Cristina told Meredith that she and Derek wouldn't work, but Meredith insisted that Cristina cheer her on.
A change would do you good?: Meredith's "wiser than she is" voiceover said that surgeons are trained to fix what's broken. Real Meredith told her therapist that she was done with therapy. The therapist told her she isn't finished. Mere thought it was over because she was now happy and Derek was moving in. Meredith then rushed off to a big meeting the chief had called.
Derek was taking measurements in Meredith's house and broke the news to Izzie that she was moving out when Derek moved in. Izzie told Alex, and they, along with Derek, gave Meredith an earful at the hospital. Meredith didn't think they had to move out, but Derek wanted them out so they could build their life together.
Everyone waited to hear what the chief's "new rules" were. The chief took first- second- and third-year residents off "de facto" specialties because it interferes with a well-rounded education. That meant Cristina couldn't focus only on heart patients anymore. She was instead placed on a case with Derek, instead of Meredith. "Personal relationships, personal loyalties and personal favorites will no longer be a factor in our training program," the chief said. He also wanted a new focus on bedside manner, which either meant treating them with humanity (see: Alex) or becoming less emotionally involved (see: Izzie).
George finally sat to retake his exam. He was ready to go when the ceiling started leaking water on him. A sign? Alex had a patient in a wheelchair that was working. The patient decided to get up and walk and, slipped on water and lost consciousness.
The ceiling was leaking all over the floor because a pipe burst. Hahn was bothered that Sloan new about her blossoming relationship with Callie, but Callie was the one who'd told him. Izzie saw an ad for an apartment and took it. Derek asked Cristina if she'd also want the roommates out if she were him. She didn't answer, but when he offered her a specialized part of a surgery, she said, "Fine, I'd want them out. Whatever." Derek told Meredith what Cristina said.
Meredith had a cancer patient who wanted to hear some kind of gossip, anything. So Meredith told her about Derek and tried to cheer up the patient.
Izzie tried to get Alex to share the apartment with her. She told him it had an "honest-to-God fireplace," but he said he wasn't interested. "I'd rather live in my honest-to-God car." Alex was doing an CT scan on the guy who slipped and hit his head. The chief wanted to know if they were "looking at a lawsuit" and Alex told him the guy "didn't seem like the lawsuit type." Just then, the leak dripped water onto the CT machine, which short-circuited and exploded, cutting the power in the room with the guy still in the machine. "Hello?"
The guy was convinced that God hated him. His wife left him. His accountant had stolen from him. In surgery with Meredith's cancer patient, Bailey tried to teach with enthusiasm, per the chief's orders, but she took a look inside the patient and grew serious. Meredith looked stunned.
The chief asked George to help him out because of all that was going wrong at the hospital, but George hadn't even found a room to take his exam. George volunteered to continue as the chief's intern for at least one more day.
Lexie, who was helping on Derek and Cristina's brain patient as they were trying to figure out what was causing pain in his head. Lexie had tried to tell Cristina about an idea she had, but Cristina didn't listen. Lexie instead went to Sloan, who's an ear, nose and throat specialist in addition to being a plastic surgeon, and told him the idea. He thought it made sense, so he went to Derek and Cristina and tried it out. It involved sticking something up the guy's nose. It worked. The guy ached when Sloan did the test and confirmed that it was the same pain. Sloan told Derek that a simple procedure should fix it. "Unless you still want to chop out the front of his brain," he said.
Meredith's cancer patient woke up and they told her that her tumor was bigger than they expected and had wrapped around a major blood vessel. She would have to start another round of chemo. She immediately asked Meredith if she'd decided what to do about her roommates.
Hahn asked Callie why she was talking to Sloan about their relationship instead of her. The gang sat down for lunch and shared all their problems. George laid his head on the table and whined about his test. Bailey warned the chief that the leak might be a bigger problem than he thought. She said Tucker flushed a toy down the toilet at home and a few days later her house was flooded with "poop water." Meredith, Cristina, Izzie and Alex rode an elevator up a floor and when the doors opened, water rushed in.
Chaos set in, patients were being moved and water was all over the place. Bailey suggested they shut down and get the problem fixed. The chief got frustrated and yelled at Bailey to go to the clinic. Sloan offered Lexie a spot in the surgery for the guy with the head pain, but she turned it down because she promised George she'd help him with the stuff for the chief so he could take his exam. Sloan called her pathetic.
Alex's patient was down in the dumps about how his life was terrible and he should just skip his surgery, but Alex told him there's always something to live for -- or at least the possibility of something. He looked up and saw Izzie as he said it. Izzie asked Cristina to think about moving in with her in the new apartment.
Alex and Hahn were operating on the guy who feels like he has a dark cloud hanging over him ... when the ceiling started to leak and promptly collapsed, bringing water splashing down on him as his abdomen was cut open.
Alex had to tell Sloan to clear out of the OR he was using for the head pain patient. The chief couldn't believe the news about the ceiling collapse. The chief decided to close the surgical floor and send patients to other hospitals. He asked Bailey not to gloat, and she didn't. Back in surgery, it turned out Alex's "dark cloud" patient had a big tumor that they found because they had to explore his abdomen more thoroughly than they would have.
Cristina went to Meredith's therapist and said that Derek and Meredith weren't going to work. She said that Meredith lives in constant pain and Derek doesn't understand that. He said that he didn't get Meredith because he wanted her to kick her roommates out of the house. The therapist told Cristina it must be painful for her to lose Meredith to Derek. Cristina called her "a terrible shrink" and walked out.
Meredith's cancer patient said she was "dying and you can't let me die without knowing what you decided." Meredith didn't say anything, and the girl assumed that meant she was breaking up with Derek. She said that's "no fair" because she was dying and Meredith was "casting all that hotness into the wind." Then the patient cried.
Alex's "dark cloud" laughed at his bad luck when Alex told him about the tumor, but Alex told him the ceiling collapse actually saved his life, because pancreatic tumors are never found that early.
George reported back to the chief about all that he'd done. Back at the bar, Lexie showed off her photographic memory for Sloan, while Cristina and Callie talked about the apartment Izzie found. They loved it. When they told Izzie that, she got mad because it was for her and Cristina, not for Cristina and Callie. Cristina had already put a deposit down and told Izzie she should've been clearer. Callie told Hahn that she told Sloan about them because he's her friend. Hahn said she probably just hates Sloan because he's seen Callie naked.
Meredith was in the elevator with her shrink and asked what the point was of all their hours of therapy because the world is a horrible place. The shrink said horrible things happen, and happiness in the face of those things isn't the goal. "Feeling" life is the goal. She told Meredith that she's not done with therapy because she was just started to talk about her feelings.
Izzie was sad while sitting on the porch of the house and told Meredith "I don't have anyone." Alex showed up and just said "hello" before going inside.
Meredith went in and told Derek that her friends are "my family" and that he doesn't get to assume she'd kick them out, and he doesn't get to announce to them that they're moving out. He said, "OK."
The chief, saying he had to start with himself if he wanted to run a successful teaching hospital, stayed late to give George his three-hour test.