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Picking up where "Here's to the Future" left off, part two of the two-hour season finale begins with Bailey in the Chief's office, joined by Arizona, who breaks the news to her that she was accepted into the peds fellowship program.
Izzie, recovering from surgery, starts making sounds or talking. Alex yells "Shepherd!"
Cristina wants to know why Owen was hugging O'Malley and he says he was able to sleep last night because Cristina came with him to see his mom.
He says he can now be a better man, and he kisses her. He also says that O'Malley has some amazing news but he will let him relay it.
George breaks the news to Bailey: He joined the Army, and he's reporting to duty tomorrow. She is understandably shocked.
Mer tells Cristina that she's going to city hall to get married. She gives Mer her post-it and favorite pen. They think about hugging but pass.
A trauma patient arrives.
A woman, slightly injured herself, comes in and says a now- unconscious guy jumped in front of a bus to save her life.
The face of the man is revealed - and there is no face. He is messed up that bad. The woman vomits and is taken out.
Derek asks Izzie a bunch of questions and she answers everything right - her name, etc - and she's talking about the surgery, apparently quite lucid.
A few seconds later, however, Izzie asks the same questions about the tumor - did Derek get it all out? Ten seconds later, she repeats herself again.
Yang, Alex, and Derek exchange confused, concerned looks because the surgery has obviously done some something to Izzie's brain.
After the third time Izzie asks how the surgery went, with absolutely no idea that she just did twice before, she asks them what's wrong.
Outside her room, Alex panics, asks Derek if he screwed up her brain. Derek shuts him up and says freaking her out won't help.
The faceless patient starts coding again, as Derek and Mark join the fray. Mer screws the guy's skull as a last-ditch procedure and his blood starts oozing out.
The man wakes up and opens an eye beneath the carnage that is his face.
Lexie is suturing the woman the guy saved. Mark enters the picture and the two talk about their previous conversation and Lexie says she's OK with sharing power in the relationship.
Mark completely ignores her.
Of course, when Mark talks to the patient, she talks about what she just heard and shares her opinion on the matter.
"It sucks being the girl," she tells Mark, to which he disagrees.
When the patient enumerates the things that describe a girl, and they agree Mark is the girl in the relationship because he can't wait to move in.
Bailey confronts Owen for convincing George to join the army. He says he was just offering him an option. Bailey tells - no orders him - to get George out of there.
Arizona tells Bailey that she looks pretty dark for someone pursuing peds. Callie, meanwhile, comes in and tells Bailey that she has plans to stop George from joining the army.
Arizona makes a big deal out of it, and tells Callie that she thinks it's "awesome" that George joined the army.
Callie and Bailey brief Meredith, Alex and Yang about doing an intervention that they're going to do to stop George. Izzie will do cancery eyes. Karev will pull the harsh childhood card, etc., at 6 tonight to stop him.
Meredith tries to comfort the faceless, mangled patient by telling him that he's a hero. The guy tries to write something and was given a pen.
The woman, Amanda, says she and faceless guy had 30 seconds of interaction before the bus came. She says the "ordinary-looking" guy smiled at him and she never gives him a second look.
She proceeds to call the guy her prince, and a hero for doing what he did. She says she was too busy looking for hot guys.
Bailey is not as determined to pursue the peds fellowship, and Arizona is giving her a hard time for it. Bailey drops the bomb - if she indeed goes for it, her husband will divorce her.
Arizona is dumbfounded.
Mark and Derek talk about their respective relationships. Mark says he's buying a house, Derek says they're going to city hall.
The two hug, and Meredith comes in.
Arizona is once again bugging Callie for all the wrong reasons. The two continue to argue about George.
When Arizona calls her by her real name, Callie replies "Don't Calliope me because you called George joining the army awesome."
Meanwhile, the guys continue to operate on the faceless patient. Owen says he thinks George will do well, Mark says he'll be back on a body bag.
Alex is writing post-its on Izzie's bed to remind her of everything that she's supposed to but doesn't.
Cristina and Alex argue about what Alex is doing. Alex says he wants her to practice the little memory that she has, and Cristina wants him to calm down and leave her alone for a while.
Alex yells at Cristina and says she's only looking after Izzie's welfare. Cristina assures him that she'll be better.
Amanda asks Meredith if the faceless guy is going to be OK. Meredith asks Yang if Izzie is doing better. Meredith says she's going to city hall.
She points out the things that are happening in Seattle Grace - Izzie not knowing Alex is working very hard, the faceless guy maybe dying, and the girl not having the chance to tell him she loves him.
Meredith thinks that if you love someone, you have to say it, while they can hear you.
Taking her own advice, Mer tells Cristina she loves her. Cristina tells Meredith that she has changed, in a good way. The two hug.
Arizona comes up to Callie and reiterates that she thinks George joining the army is awesome. She offers some rhetoric in defending the war.
She tells her that her brother died in Iraq because there are not enough doctors in there. Callie grabs her hand and apologizes.
Down in the underground vent, Yang is thinking about something when Owen comes in and acts like it's an occupied restroom.
Inspired by Meredith, Yang tells Owen that she loves him. She narrates the two's love story and tells him that "I can't breathe without you."
Owen assures her that all she has to do is say yes.
Alex continues to berate Izzie for not remembering stuff. She says she wants a break, and Alex tells him to suck it up.
Alex is very pissed at what's happening. After an outburst that included the hypothetical thought of smothering her with a pillow, he apologizes. She said it's OK, just give her a minute and she'll forget anyway.
Bailey, meekly, tells the Chief that she changed her mind about the peds fellowship and asks if there's still a spot in general surgery.
Trying to contain tears, Bailey tells the chief that it's very hard, trying to make a choice between her marriage and the fellowship, says that a marriage that gives her an ultimatum is not a marriage.
Bailey finally breaks down, citing George and Izzie.
Lexie drops in with Mark scouting for houses. Being a girl, Lexie says he's only doing that to make her feel bad that he's moving on.
He tells her that he's a better woman than her.
Meredith and Derek are trying to find a way to juggle their busy surgical schedule to make time to go to city hall and get married.
Derek wants to reschedule, understandably, but Meredith insists that today is the time. Derek wants to write vows on a piece of paper, and Meredith gives him the post-its from Yang.
The two brainstorm about their vows. They came up with the following:
The two sign the post-it, and Meredith declares this is the wedding. A post-it note. The two kiss, and you can tell it's more real than any big ceremony in some big church.
Izzie complains to Cristina that Alex marched in earlier and told her that being married to him is the worst thing ever. Once again inspired, Cristina rushes out, looks for Owen, and kisses him full on the lips.
She tells him yes, and shuffles off - still smiling.
The Chief tells Bailey and Callie that George took the day off. Uh oh.
Meredith and Derek - newly married - tell Owen that they're OK with spending their honeymoon on the OR, as they prep up for operating on faceless guy.
Meredith tries to comfort the guy and tell him it's OK. He writes something on her hand - 007 - and Meredith yells "Oh God oh God!"
The faceless patient is George O'Malley.
Alex is happy that Izzie remembers something, even if it is his outburst. The two hug, but then she loses consciousness.
Meredith comes running down the hall and yells, "It's George!" And at about the same time that they figure it out, Izzie crashes.
Knowing that it's George, everybody - Derek, Owen, and Meredith - tells him to hang in there.
Izzie flatlines and despite signing a DNR, Karev tries to revive her.
The Chief goes, "Screw the DNR" and grabs on the defribillator to revive her, too. Everybody goes to work.
A montage follows of the Chief trying to revive Izzie and people working on George. We see her on a dress in the elevator (the same dress she wore when Denny died, it appears), and suddenly the elevator opens and it's George, in an army uniform. The two smile.
Izzie is not responding to the efforts of everyone. Alex sobs.
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