Now that Izzie realizes that she's ill, she tries testing herself at the clinic, but doesn't get far before her interns arrive. When she has to show Sadie the right way to take blood from a patient, she demonstrates the technique on herself, then tells Sadie to run both tests. Under the guise of training, Izzie has Sadie run more tests on her. Sadie's only discovery: Izzie is anemic.
Derek is ready to propose to Meredith, but wants to wait until the right moment, because, as he tells Mark, "she spooks easily." Mark advises Derek to wait, Cristina tells him to keep it simple, while the Chief advises Derek to go all out. Derek is surprised when Meredith mentions how cute their kids will be, so he takes it as a sign he should go ahead and propose.
Miranda or Dr. Dixon Miranda asks Richard not to put her on another case of a dying kid. She's shocked but happy when he tells her he wants to promote her from a resident to an attending.
Cristina prepares a couple whose daughter needs heart surgery for dealing with the very odd Dr. Dixon. Miranda translates Dr. Dixon's technical terminology into lay terms, but worries about bonding with another child who might not make it. When the girl needs immediate surgery, Miranda asks Dr. Robbins to scrub in instead. Robbins tells her the girl will be fine, and so will Miranda. But during surgery, they discover that the girl's heart is irreparable and she'll need a transplant. Dr. Dixon turns to Miranda to help talk the parents through it, but she's gone to spend time with her son in the nursery.
Dr. Dixon tells the parents that the girl will need medicine every three minutes and won't be able to leave the hospital, but Miranda arrives with a backpack that can deliver the medicine, meaning the girl can go about her daily life. The ecstatic parents hug Dr. Dixon, who immediately freaks out. The only way she can calm down is if someone -- which ends up being Miranda and Cristina -- holds her tight.
Miranda confides to Dr. Robbins that after her son's health scare last year, she doesn't want to live through anything similar, but Dr. Robbins believes Miranda's devotion to children makes her "uniquely qualified" to be a pediatric surgeon.
Meredith asks Cristina to pre-read her mother's ninth journal, the one where Ellis detailed her affair with Richard. "Yeah, you'll go blind reading that," says Cristina and takes on the task. She tells Meredith the diary is all about "longing looks," so far, the kind that Cristina is currently having with Owen. Until, that is, a woman arrives who causes Owen to panic and run. Cristina follows him and delivers the same kind of huge hug she just gave Dr. Dixon.
Meredith finds Cristina in an on-call room, with Owen fast asleep. "He's planning to propose," she tells Meredith, but she's talking about Richard in the diary, not Derek.
Lexie pours out her feelings for Mark to Callie, who doesn't want to hear it. "Alone people don't like to hear about together people. It's sort of like bringing a six-pack to an AA meeting," Callie tells her.
When Meredith asks Lexie what's going on with her and Mark, since she's been working with him for a week, she lies and says she's thinking about specializing in plastics.
Mark is convinced he needs to break up with Lexie, especially now that Derek is proposing to Meredith. Lexie gives Mark an ultimatum: She needs to be able to tell Meredith and Derek about their relationship, and if he won't, "Then, I can't do this."
Derek's odd behavior after her baby comment makes Meredith think he doesn't want to have children with her. "My babies will have Alzheimer's and suicidal tendencies and split ends," she tells Cristina. Lexie, Cristina, and a patient who are all in on the secret tell her not to worry.
"You have been acting like a basket case," Meredith tells Derek as he prepares to leave the hospital for the day, "If you don't want babies or you don't want babies with my crappy DNA, just say so." "Meredith, I want your crappy babies, all of them," he tells her, but insists he has to go.
With Mark's help, Derek has decorated their bedroom with dozens of roses, candles and teddy bears, but after he gets a call, thinks better of it. The only evidence of his romantic gesture: A single rose Meredith finds under her pillow.
Lexie goes to Joe's and finds an emotional Callie sitting at the bar. When she asks her if she's okay, Callie shakes her head and runs into the bathroom.
Dr. Robbins follows her and tells her that she knows what's going on with her since people at the hospital talk, but she assures her that plenty of people will be waiting in line for Callie as soon as she's ready to date again. "You want to give me some names?" Callie laughs, and Dr. Robbins kisses her. "I think you'll know," she says.
At the hospital, Justin wordlessly comforts Izzie after she shows him a medical file.