Adele is back. And not for personal reasons. The Chief's wife rushes their niece, Camille, to Seattle Grace, the hospital where she had her prom. She can't breathe and Izzie and Alex perform an emergency tracheotomy to keep her alive. It turns out Camille's cancer has spread all over, to her throat and beyond, and she doesn't want to continue fighting. She's too tired and wants to spend her last days at home with her friends.
Adele wants Richard to do everything he can to save Camille's life, but in the end, Richard gives her the options of treatment, but decides to honor his niece's wishes and discharge her. Adele says this is the one time she asked Richard to put his job first, and he didn't, not even to save his niece - the closest thing they have to their own daughter. It doesn't look good for the future prospects of Richard's marriage.
Miranda has a patient named Ruthie whose ankle is swollen and blue from a bad fall on the treadmill. Ruthie is osteoporotic, despite being only 28, because she's been working out while starving herself in order to lose 40 pounds. Callie tells Ruthie and her boyfriend that she can repair her leg, but she's going to be in a cast for a very long time.
They begin to argue when Ruthie starts to vomit up blood. The doctors then operate and find a bleeding ulcer. All the ibuprofen she's been taking to relieve her aches from working out too much made it much worse. Callie can't believe someone would willingly ruin their body, but Bailey says people are stupid and only want to be loved - that's they only reason why they do anything. Callie - who's had a brutal day (more on that in a few moments) - almost fights the boyfriend outside. Bailey intervenes.
After George's confession to Callie, she simply says she forgives him. He made a mistake, but they took vows, so she forgives him. It's over.
Hearing this, George frantically looks for Izzie, but Callie has found her first. She tells Izzie, â€œCafeteria. Noon. You, me. Be there.â€ This makes Izzie fear she's going to get beaten up and all the other doctors excited there's going to be a fight. The only one not excited is, who after hearing she slept with George, is furious at Izzie. Maybe he still has feelings for her? Maybe he just can't believe he got rejected and George didn't?
In any case, everyone gathers around Izzie as she prepares for Callie to fight her in the lunchroom. Noon arrives, Callie finally approaches, and Izzie puts up her dukes. But Callie just wanted to talk, and is now much more humiliated by this debacle. Later, Izzie tries to apologize and Dr. Torres loses it, telling her â€œDon't you dare come to me for forgiveness, you traitorous bitch.â€ Yikes.
Izzie goes home and spends the night crying in bed. Alex, though, who is now living at the house remember, comes in with a box of tissues, and not so seriously tells her to keep it down. George finds Callie in the rain outside the hospital. He doesn't want her to just say that she forgives when she's angry. Callie breaks down and admits he's right - she furious and she doesn't forgive him.
Derek wants to take Meredith away to wine country for 48 hours of hot sex. She is so in, but has to get Alex to cover her shift and thus take Norman, the world's oldest intern, off his hands in the meantime. Problems happen immediately when Norman informs one of Mark's patients, Ms. Bitzer, that she's terminally ill and going to die. Only she isn't. He read the wrong chart.
Cristina, meanwhile, treats a high school football player who was paralyzed in a game. The boy's father is a crazy and pretty much berates his son for getting hurt. Derek drills holes into his head and stretches his body out so that the spinal cord can fit back in. Lexie, or simply 3 in Cristina's eyes, tries to assist, but Yang sternly corrects her every move.
Later, after some urging from Derek, Cristina becomes a better teacher to 3, helping her out in the boy's second operation. Derek and Lexie have now started to get to know each other, bonding over their common ground - Mer - which she's less than thrilled about. She gets mad at him for getting to know Lexie, but Derek says he talks to Lexie about things he can't talk to Meredith about. He also has canceled their weekend.
What things? How about how he wants to marry Meredith, have kids with her, settle down and grow old with her. As usual, Mer freezes up, but Derek, he says he understands why she can't or won't talk about it. He says that he knows she's not ready. He says he will wait for her, but ... even though he's waiting, if there's someone else who gives him what he wants before Meredith is ready, there are no guarantees.