Grey's Anatomy begins with the second-year residents anxiously awaiting the decision on who gets the first solo surgery.
Richard and the attendings have made their decision. The vote is unanimous: everyone agrees that Cristina should do the first solo surgery.
However, since she is still in trouble over her interns secretly cutting themselves, she is no longer in the running. Richard decides then that Cristina must choose who among her colleagues gets to do the job.
Since all of the interns are still grounded, the person Cristina picks will get to choose one fellow resident to scrub in.
The first surgery will be a below-the-knee amputation.
Another thing Cristina must do to make good with the Chief is make sure that Dr. Virginia Dixon (Mary McDonnell) is still impressed by the hospital so that she'll accept a position there as the new head of cardio.
All the residents suck up to Cristina, except for Izzie, who doesn't really plead her case; only telling Cristina that she is currently enjoying mind-blowing sex (with Denny of course).
Dixon advises Cristina to make a system, ranking each of her colleagues by their various merits. However, Major Hunt tells her to trust her gut, 'cause that's the way they do it in war - and that's how he chose her.
Bailey needs a challenge to rediscover her passion for surgery and wants in on Mark's surgery in which a woman, Kathleen, can't talk because she had a laryngectomy years ago. Mark will be reconstructing a larynx for her.
Kathleen is pissed off, ignoring her husband and her doctors, communicating curtly in one-word responses on Post-it notes. Lexie is still on probation, but Mark lets her be on cappuccino duty.
This week's trauma case involves two sisters, Emma, the younger, and Holly, the older. Holly was driving Emma to a Future Leaders of America meeting when she crashed the car.
The sisters get on the doctors' nerves with their bickering.
Emma tells her sister that she hopes she dies, as sisters are wont to tell each other. Holly has sustained a head injury, though, so there's a chance that that might actually happen.
Sadie failed to notice that Holly might have a brain injury and instead goes off to find Callie in the x-ray room. Callie finds Mark to ask his opinion on whether Sadie was actually flirting with her.
She realizes that it was probably all in her head because she's lonely but she finds the intern incredibly hot. Mark says Sadie lives on the wrong side of the diagonal on the Hot-Crazy scale.
Alex and Derek bring Holly to get a CT brain scan, but she crashes in the middle of it. They pull her out of the machine and she looks blue-skinned with blood running out of her facial orifices.
Derek says that she has brain matter in her blood.
In Holly's surgery, Derek asks Alex to perform a surgical technique, but as soon as he starts, Holly's brain starts hemorrhaging. She's still alive, but effectively brain dead.
Dixon, who is also in the OR, comments how fortunate that such a young girl should lose her brain function because that makes her a good candidate to become an organ donor. Crickets.
Because of all the sex Izzie is having in the on-call room, she's blowing off all of her clinic duties all week, leaving George to cover them.
Concerned something is wrong, George asks Alex to look for Izzie, but Alex doesn't want to help George at all. Izzie is getting it on with fake Denny in the on-call room again at this time.
In Mark's surgery, Bailey regains her passion because of Mark's amazing work. Instead of getting annoyed with all of her questions, Mark seems willing to teach Bailey.
In the gallery, Sadie and Lexie discuss sex. Sadie says the attendings at Seattle Grace are only interested in their underlings. Lexie takes note.
Meredith brings Emma to see Holly. Emma wants to know whether her sister will ever wake up, but Dixon announces matter-of-factly that although Holly's body is working, she is dead and her organs must be harvested.
Meredith, with compassion for the family, asks Dixon to leave.
Sadie approaches Richard and says she was responsible for the unauthorized surgery, and that she should be punished instead of Cristina.
It turns out Sadie's father is some sort of big shot donor or board member because he's the only reason she is still employed at Seattle Grace.
Cristina picks Alex to do the solo surgery because he proved to her to be the most prepared. He goes to find Izzie, who's in post-coital bliss with Denny in an on-call room bunk bed.
Alex announces that he loves her. He promises that he'll never leave her and he'll always be there for her, and he chooses her to scrub in. When he leaves, Denny says, "I'm really starting not to like that guy."
Meredith is hurt that Cristina didn't pick her, so at Derek's prompting, she confronts her about it. Cristina gets upset because her decision to choose Alex had nothing to do with Meredith, just business.
Major Hunt, noticing Cristina's distress, leads her down to some crazy room in the basement. He stands her over a vent from which steam comes up and they start making out. Hot scene!
Mark's larynx patient refuses to even try to talk after the surgery. Her husband is frustrated and upset, but later, Lexie convinces her to.
Lexie is truly amazed at Mark's prowess... but will that be in more ways than one? Later that night, she goes over to Mark's.
She strips down to her underwear and asks him to "teach" her because he did something amazing by making his patient speak again. Mark gives in, despite the promise he made to Derek about Little Sloan and Little Grey.
Still anxious to hire Dixon, Richard wants to know whether she likes Seattle Grace any better. After she gets him to admit that he was torturing Cristina by making her choose among her peers, Dixon hints she might take the job if the board makes her a better offer.
Before his surgery, Alex asks Meredith to scrub in, since he's now freaking out about telling Izzie he loves her, and she's nowhere to be found.
Izzie shows up at the last minute. As Alex does his first solo surgery, some residents take bets that he'll screw up.
Meredith says simply, "He's one of us."
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