Addison delays her return to Los Angeles to help with Derek's pregnant patient, Jen, who's suffering mini-strokes and needs another surgery. The husband tells them, "If it comes down to a choice, save my wife," and not the baby. The first surgery goes well but then Jen crashes again and Derek insists that he can save her, even if it means taking out her temporal lobe and eventually her frontal lobe. He can't control the bleeding, however and Addison announces she has no choice but to deliver the baby. "I can save her," he tells Addison, ordering her to wait.
"This has gone too far," Addison insists, "Even if she does live, you are creating a monster. You don't get to play God here." She picks up her scalpel to begin the C-section and Derek shouts at her to put it down. The rest of the O.R. watches the tense standoff in disbelief. Addison tells Alex to go get the Chief and Derek orders, "Do not touch my patient, Addison." Addison appeals to Meredith, who has been assisting Derek. She tells him that it's too late to save Jen, but they can still save the baby. When Richard arrives, he gently tells Derek it's over.
Alex, Addison and Derek break the news of Jen's death to her husband and he wants to know the details. All a guilt-stricken Derek can say is, "I'm sorry." "You killed her, you're a murderer," the man yells at Derek.Previo
When Callie and Cristina examine a patient's recent stitches, they see evidence of a botched surgery, thanks to Dr. Campbell, the legendary first female surgeon at Seattle Grace. Owen wants to page Dr. Campbell, as it's her patient, but Cristina says, "What? And have her maim the guy again? We page someone who actually knows how to operate instead of some dinosaur who refuses to put down her scalpel and go join her friends in Boca." Unfortunately, Campbell is standing right behind her at the time and announces, "The dinosaur is here. No need to page me."
Owen thinks Cristina's too hard on people, but she insists that Campbell is "old and out of touch." In examining the patient's X-rays, Cristina sees evidence of a major error, and presents it to the Chief. Richard informs Campbell's patient that a complication during surgery -- his bowel was nicked -- requires a second surgery. Richard advises the patient that he can request a different surgeon, but he wants to stick with Campbell.
Cristina insists that the patient doesn't understand the situation but Richard barks at her to "Back down." However, he makes a point to watch the operation. While she's operating, Campbell criticizes Richard, her former pupil, for his soft teaching methods and Cristina for her lack respect. When Cristina calmly states that the current surgery was only due to Campbell's mistake, Campbell orders her out of her O.R.
After the surgery, Campbell admits to Richard that she made a mistake, but it's not until Owen tells her of his discharge from the Army that she decides to give up surgery. "They knew it was my time, even if I didn't. I'm grateful to them for that," he says.
Owen tells Cristina that today she was in the right, but that she was also a "bully to someone who needed compassion." He says she's a lot like Dr. Campbell. "Forty years from now, I'm going to have to pry that scalpel out of your hand, too," she agrees she won't want to give it up, but he says she's missing the point: He still wants to be there for her forty years from now.
An angry patient confronts Izzie: She'd been told she has cancer. In reality, she's only anemic, and she's convinced that someone at the clinic mislabeled her blood sample. "Don't apologize to me, I'm just anemic," says the woman, "You apologize to that dying person." Izzie realizes "that dying person" must be her.
She takes out the paperwork on her own blood test: It reads "anemic." She does a self exam and finds a suspicious-looking spot on her back. Izzie makes an appointment with dermatology, where the doctor insists that it's probably nothing.
Callie asks Arizona out on a date, but Arizona turns her down when she realizes that Callie's only dated one other woman before her. "I spend my entire day around newborns, so I try not to in my personal life," she explains. Callie approaches Arizona at Joe's and insists she has lots of experience in other areas, but she makes the announcement in front of Arizona's date for the evening.
Miranda needs a letter of recommendation from the Chief so she can specialize in pediatrics, but when he finally hands it to her, it's just a form letter, with words such as "serviceable" and "fine." "I am better than fine," she storms. Miranda confronts Richard about his less-than-glowing letter and he snaps that he's wasted his time grooming her to become "the next me," if she wants to "leave him" and become a pediatric surgeon. "I am not your son or daughter. You don't get to pin all your hopes and dreams on me, sir," she protests.
Mark picks the absolute wrong time to tell a shattered Derek he's sleeping with Lexie and Derek hauls off and punches him. The two get into a violent free-for-all and Owen has to pry them apart. Lexie arrives to comfort Mark and he tells her, "It was worth it."
Izzie chews out her interns for the labeling mix-up, but tells them they're lucky because they get to save lives. She presents them with a case of a "29-year-old female who we misdiagnosed with anemia. Let's not make the same mistake again," she says.