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We all make mistakes... but some of us don't remember them.
Izzie is wracked with guilt and confusion over the fact that she and George slept together. He probably would feel the same way, if he remembered.
As for Mrs. O'Malley, she tells George to forget about their argument (the one that drove him into Izzie's arms). They have to put on a good show, as Callie's dad has just found out about their marriage and is on his way to Seattle to meet George.
Speaking of fractured relationships, Cristina tells Meredith she's going to try to forget the flap over Colin Marlow, and get things back the way they used to be with Preston. She brings Burke coffee at the hospital, like the old days. But he's interested in moving forward, not backwards.
After just one day at SGH, Marlow draws up a 10-year plan for the hospital. The attendings hear that and scramble to come up with their own long-term agendas. Mark tries to pick Miranda's brain in advance of his meeting with the board, but she snaps at him, insisting she doesn't have time for this since she's got patients who need to be helped. Right now.
Thus, unintentionally, Mark stumbled onto a brilliant idea - he channels Miranda's idea for "right now" plan for Seattle Grace and impresses the board of directors. He's looking - shockingly - like he may have a shot at Richard's position now.
With no idea who she is or what she used to look like, a recovering Jane Doe needs to select a face for herself. Literally. Mark is set to perform reconstructive plastic surgery on her, and Alex presents several computer images of faces for her to pick. She worries, understandably, that her unborn baby's father won't recognize her if she picks the wrong one.
Alex helps her by inventing a persona for each of the three different face options. Reassured, she picks the last one, which Alex named "Ava."
Izzie wants to avoid George and Cristina wants to avoid Burke and Marlow, so the both volunteer to work in the clinic. With George still shaky over the previous night, Callie won't let him near a patient with an incredibly rare disease which turns muscle into bone.
Izzie gets stuck helping Callie. The patient, Cathy, has internal bleeding, probably caused from overdosing on painkillers. She knows she'll die from this disease eventually, and asks what happens if she refuses surgery. She will bleed to death, Callie says. Her daughter, Nina, is incensed, unable to accept her mother giving up, and insists on the surgery.
She bleeds out on the operating table, but would also have died if they opened her up. Izzie comforts Nina, saying her mother was ready to go.
Cristina treats construction worker with type II diabetes complaining of a sore foot... but the sore foot is severely injured and has to be cut off. He is devastated, begging her to find a way to save it. Compassionate, she pores over her medical textbooks, clearly equating the hapless limb with her own wounded relationship.
In the end, she can't save the foot - but before his presentation to the board, she tells Burke he's still the same man the Chief originally chose. Comforted, he says he knows he's not... but he hopes he's grown, for the better, since then. Later, after some unexpected advice from Colin, Yang agrees to marry Burke, as long as it's low-key and not religious.
Sloan is going to let Meredith harvest bone from her Jane Doe's by herself. Derek is concerned that Mark is using her to impress Richard - if she gets in over her head, Mark looks good by saving the day, whereas if she does a great job, Mark still gets the credit as a strong leader.
Meredith is not thrilled at Derek being overly protective, but tells Mark that she won't do it just to serve his ends. Mark doesn't deny he has his own reasons - but says that the Chief has been looking at Mer like a lost puppy, and if she does the surgery and does it well, he'll treat her like she's a surgeon again.
She agrees to do it, and comes through with flying colors.
"My dead Mommy would be proud," she tells Derek.
His board presentation, meanwhile, was a bomb. What he doesn't tell Mer is that he was distracted, since thinking about 10-year plans only got him thinking of the only 10-year plan he really cares about: with her.
Still wracked with guilt, Izzie asks Addison for advice about sleeping with the wrong person - is it wrong, even if it feels right? Surprised, Addison tells her to simply stop... and it's clear that's not the advice that Dr. Stevens was hoping for.
Callie's dad meets George and he is not pleased. The eloping, for one. The fact that he's broke, for two. But George wins points when he freaks out - Mr. Torres talked about buying a house and car for them, and O'Malley is having none of it, insisting he'll provide for her on his own.
Mr. Torres later finds George and says he respects him wanting to provide for Callie on his own. But he warns him to never hurt Callie. But by this time, it's of little consolation to George, since he's had flashbacks to what he did with Izzie the night before.
He rushes to find her and they share awkward silence. Izzie wants to tell Callie, but George insists he can't... it would hurt her too much, she's stood by him all along, and it has to remain their secret. He won't clear his conscience at the expense of the pain it will cause Callie.
Back at the hotel, Callie and George are lying in bed. She says she still smells his clothes from the night before, even though they're over in the closet. He tells her he's sorry, she says she'll learn to live with it. At Meredith's house, Izzie strips the sheets off her bed and begins to cry.