Derek and Addison, whose personal relationship is already strained, must cope with additional professional stress when two of their closest friends -- married couple Savannah and Weiss -- visit them in Seattle. Savannah is determined not to receive breast and ovarian cancer that are hereditary in her family and seeks a radical, preemptive operation (a total mastectomy and hysterectomy). As conflicted, reluctant and disappointed as Weiss is, he decides to support Savannah in her request to have the surgery after a talk with Derek.
Meanwhile, George witnesses a man fall five stories and survive. As happy as George is about it, the man does not share that sentiment. In fact, he wishes he had died right then and there. When he tells George about a former girlfriend who he still harbors feelings for -- and who works in Seattle Grace's billing department -- George sets out to find her and learns that maybe there is no such thing as fate.
An elderly gentleman makes a difficult decision and does not tell his wife that she only has a few months to live. Meredith decides to intervene, to the best of her ability. At the same time, the young Dr. Grey continues to fight her own whirlwind of emotions pertaining to Derek, who spurned her as soon as Addison came back to Seattle.
Richard continually presses Dr. Bailey about a fellowship Seattle Grace is offering her, and she remains standoffish until he accuses her of shopping her services around to other hospitals. At that point, she reveals the true reason for her reluctance -- the fact that she is pregnant.
Lastly, Cristina and Preston decide to take their relationship outside the hospital and go on an actual date. Which may have gone down as the most awkward date in history had a man across the room not suffered a heart attack in the middle of dinner. Drs. Yang and Burke save the day.