The attendings choose Cristina for the solo surgery, but the Chief has put her on probation and orders her to select another resident to take her place. The residents all plead their cases to her: George insists he's grown the most, Meredith believes she's the most qualified but tells Cristina to "do what she has to do," while Alex calmly recites the surgical procedure to her.
Izzie, meanwhile, is not even trying to win the surgery, she's far too occupied with Denny, who is now with her at the hospital. Izzie hasn't been at the clinic all week and makes excuses why she can't work when she does show up. George notices her talking to herself and tries to tell Alex he thinks there's something wrong with her. Alex just snaps at him, "Never talk to me about Izzie again."
Mark advises Callie not to flirt with "hot, crazy intern," Sadie, and to channel all her frustrated sexual energy into surgeries. Mark himself is trying to avoid Lexie: Ever since Derek ordered him to stay away from her, he can't stop thinking about her, but she's helping him wiht a patient whose voice box he is rebuilding.
Watching the residents scuffle for the solo surgery reminds Miranda when she was "young, gifted black, and everyone knew it." Hearing about Mark's cutting-edge surgery, she asks to scrub in, but asks him so many questions he wants to know if she'd rather just do the surgery herself.
Besides punishing Cristina by not allowing her to operate, Richard also makes her baby sit Dr. Virginia Dixon. "At the end of the day, I want that woman to be my next head of cardio. If she's not, I know who to blame." Virginia tells Cristina she should award the solo surgery based on science, not on feelings. At the end of the day, Virginia decides to stay on.
Cristina finally chooses Alex for the solo surgery. Alex eagerly tells Izzie and wants her to scrub in with him. In his excitement, he blurts out that he loves her and he knows she's been scarce because of the patient who reminded her of Denny. "I'm not going to die, Izzie," he tells her, assuming that her being so distant is fear of commitment.
He panics when she doesn't show for the surgery. He asks Meredith to scrub in instead and calls himself an idiot for telling Izzie he loved her. "You have to kick ass in there, Alex. You have no choice," she tells him, just as Izzie shows up and tells the Chief, "He's ready."
Cristina tells a hurt Meredith that choosing Alex over her wasn't a personal decision. "Unlike you, I can separate my personal life from my job." She angrily tells the other residents watching Alex operate, "None of you said anything. They were all our interns. I won this. They picked me. If I don't deserve this solo surgery, then none of us do."
Cristina is on the verge of tears after leaving the O.R,. so Owen tells her to follow him. He shows her his favorite place in the hospital: a ventilation shaft that he likes to stand on to clear his head. "Anything can happen on a vent," he says. "Like what?" she asks and they kiss.
Sadie tells Lexie to stop feeling guilty about the intern surgery ring --- and that Mark likes her. "You haven't noticed his eyes on your ass?" she asks. Lexie tells her she's "delusional," but that night, she goes to Mark's apartment to tell him his vocal reconstruction voice was a success. She starts stripping, saying, "Teach me." Mark tries to get her to leave, but when she asks, "Am I really so bad," he answers, "No, I am," and kisses her.