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Fight or flight. Run from your problems, or stay and tough it out. When faced with stressful situations, people tend to react in one of these two ways, as many Seattle Grace staffers will soon demonstrate.
In the first 10 minutes of this heart-stopper (pun not intended), Derek examines Burke do determine the extent of his injuries, and is faced with the difficult task of operating on a friend. A bullet caused an aneurysm near Preston's spine, and is limiting the motion in his left hand. Since he'd be finished as a surgeon without his hand at 100 percent, Burke has two options: wait it out and see if the condition improves, or have Derek attempt a risky operation that could cause further, permanent nerve damage.
When he asks Cristina's advice, she walks away, unable to see Burke in such a vulnerable state. After much soul searching, Derek agrees to attempt it.
Richard is then greeted by his wife, Adele. Their niece, Camille, is rushed to the hospital. She fainted after her senior prom. In the act of losing her V-Card. Richard? Not happy. Camille is diagnosed with terminal ovarian cancer -- she survived a bout with it three years prior -- which devastates Richard. After he sends Camille's fellow prom-goers home, Adele becomes enraged and criticizes his lack of respect for family, outing his affair with Ellis Grey in the process. Richard agrees to throw a senior prom at Seattle Grace in honor of Camille, which the whole staff will attend.
Later, Richard tells Derek that he though the relationship with the elder Dr. Grey had been clandestine the entire time.
The interns, meanwhile, are all battling to save Denny. Burke sent Cristina to check on them, and George paged Meredith, so it's a fearsome foursome keeping Denny's heart pumping. Izzie's plan appears to be working as Denny deteriorates quickly without his LVAD. Right before passing out, he asks for her hand in marriage. Alex is unable to buy more time at Mercy West as Dr. Burke's counterpart, Dr. Han, harvests the donor heart for her own patient's use. Bailey discovers what the interns are up to, furiously stripping Izzie of her duties at the hospital and asking Richard for his "hypothetical" advice on what to do about the transplant.
However, because no intern will specifically admit responsibility, there is no proof, and by maintaining silence they plan to keep their jobs.
When Richard learns what happened, he is equally furious, but says their responsibility is to the patient, who is going to die without a transplant. A phone call later, Alex brings both the heart and Dr. Han -- who will do the surgery with Burke out of commission -- to Seattle Grace. The interns refuse to turn Izzie in, even during Richard's tirade. After a period of intense flat-lining, Dr. Han successfully completes the heart transplant while Derek is forced to wake Preston up during his operation when concerns arise over possible nerve damage.
For our Episode Guide to part two of the season finale, Losing My Religion, follow the link.