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Alex: I need you to not talk medicine to me ok. Talk to me like I'm your friend. Like I'm the guy whose cereal you eat in the morning, and tell me what to do.
Derek: Karev, I can't tell you what to do.
Alex: What if it was Meredith? What would you do if you had to choose between spending a few more months with Meredith knowing she was gonna die. Watching her... watching her sick. Or spending the rest of your life with someone who looked like Meredith, but wasn't her anymore? (Der looks at him saddened, thinking about it) She is the one good thing that happened to me. The one good thing. So I need to know what to do. I need you to tell me, what if it was Meredith.
Derek: I would ask her to have the surgery.