Gossip is all the rage at SGH, with Meredith feeling the brunt it. And, medically, one case has peaked the curiosity of the doctors a man who presents as pregnant. Even his home pregnancy test is positive. Izzie and Cristina try to steal this case from psych to cheer Meredith up. As the patient becomes as much as a hospital fascination as her love life, Meredith begins to sympathize with him, and eventually kicks everyone out of his room to give the patient his privacy. Burke wants to come clean to the chief about his relationship with Cristina, but Cristina disagrees. When Cristina starts getting a ton of crappy scut assignments she assumes Bailey has figured things about between her and Burke and this is her punishment Bailey doesn't know, though. Izzie is pissed at Alex for being so emotionally withdrawn from her all of a sudden he wins her over at the end when he finally kisses her quite publicly and quite spectacularly.
George is still "Burke's guy" after his elevator heroics and he works with Burke on a female heart patient who shouldn't be alive. She's had several heart surgeries over the last few years, and no one is more surprised that she's still around than her battered husband. During this surgery, the woman's heart actually catches on fire, but Burke saves her, and she lives to batter her husband another day Which prompts him to finally leave her. Derek after couples' counseling with Addison works with Alex on a paralyzed girl who is a candidate for a procedure that can ease her life. Her overprotecting mother won't let her have the procedure, but Derek and Alex know it's the best thing, so it's up to Alex to somehow convince the girl to want the procedure for herself. Richard offers Addison a full time position at SGH.