Medicine has a way of exposing the lies. It might take a while but, eventually, our bodies will betray our deepest secrets. Within the walls of the hospital, the truth is stripped bare. How we keep our secrets outside the hospital, well... That's a little different.
George is in the bathroom, examining himself while looking at a book called "Rashes, Hives, and Skin Eruptions." Izzie, waiting to get in the bathroom, thinks he's doing something else to himself. George insists he wasn't doing that. He's got a girlfriend. She doesn't believe him.
The nursing home keeps calling Meredith, wondering why she doesn't come to their family dinners. Derek is getting calls of his own that he doesn't want to talk about.
At the hospital, Bailey lets Cristina and Izzie perform a procedure to remove excessive fluid from a man's abdomen all by themselves. George and Alex work with Burke on one of Burke's old college buddies. Their incredible discovery? Burke's male friend has an ovary. And Richard is having troubles performing a simple surgery that gets Derek's and Bailey's attention.
George asks Alex to take a look at a rash, to help diagnose it. Alex does, confirming that it is, in fact, Syphilis. At least Izzie now believes him that he's got a girlfriend.
Derek finds a tumor near Richard's optic nerve and wants to operate immediately. Richard agrees, but wants it to be kept a secret. Bailey and Meredith will assist as part of the secret team.
George isn't the only with syphilis in the hospital (obviously he got it from his new nurse girlfriend). There's an outbreak, with multiple residents, nurses, and interns all contracting the sexually transmitted disease. Everyone in the hospital who's having sex with anyone else in the hospital must get tested.
Cristina and Izzie's simple procedure hits a giant complication the patient dies. Bailey tells them they did everything by the book, the death was most likely the result of the man's poor physical health (big drinker). But Cristina and Izzie aren't satisfied with that. They want an autopsy. But the man's family namely his daughter over his mother's objections doesn't want one. The daughter would rather let things rest and move on, and she convinces the mother not to consent to an autopsy.
Derek, Bailey and Meredith close off an OR to do Richard's operation covertly. Izzie and Cristina take it upon themselves to their own secret procedure an autopsy against the family's wishes. They need to know what really went wrong.
After Richard's operation if over though, first thing Bailey does is look for Izzie and Cristina. And she catches them literally red handed, the body wide open on the table. Bailey is fuming. This autopsy is illegal and can get them all fired if not put in jail. But Izzie picks up the man's heart. "It's huge" Bailey notes. And there's something really wrong with it sedimentary material has built up in it, making the heart quite heavy.
Richard's operation to remove the tumor was a success, but they won't know the extent to which his vision will recover until he wakes up. Meredith finally tells Derek her secret about her Mother. Derek wants to be there for her. He embraces her warmly and kisses her. And Richard opens his eyes and sees everything. And he doesn't approve.
Bailey, Izzie, and Cristina tell the family of the autopsy patient what they found that the man has a genetic condition that could affect the daughter too. That's why he died, and that's why she should get tested for it. Izzie and Cristina get what they want, and so does Bailey she gets them to finally sign the consent form (making the surgery retroactively quite legal).
Olivia tries to tell George she's sorry, that she was seeing someone when he asked her out, but it's over between them. It's George she wants to be with now. And then George finds out who the other guy was. The guy that gave Olivia syphilis was Alex. An enraged George tackles Alex on the spot in the locker room. The other interns have to separate them.
Meredith agrees to a steak dinner with Derek. Derek has something he wants to tell her. They meet in the lobby, all ready to go out on their first official date. And then a woman arrives, the mere sight of her causing Derek to say to Meredith "I'm so sorry." And then the woman says to Meredith: "You must be the woman screwing my husband."