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Mark must perform a face transplant for a man who lost half of his face when he was hit by a car.

As with most big surgeries on this show, this one acts more as a metaphor for all of the drama to orbit rather than providing much drama itself.

To summarize the patient's story, though, he freaks when his online friends – who were supposed to meet him for the first time after the surgery – show up before the surgery to offer moral support.

He panics and tells them to get the hell out because he doesn’t want them to see his face. Mark explains to him that he’ll need his friends to get him through the psychological trauma after the surgery.

In fact, Sloan can’t ethically perform the surgery if the man doesn’t have that support. The man finally calls them and asks them to come back where we’re treated to an analogy of his face and an orchid that looks ugly at first glance, but is beautiful because of what it has been through.

The surgery proceeds. Mark picks Lexie and Izzie to assist him, but Izzie keeps ripping into the interns whenever they make fun of the face patient, and Mark finally decides she’s too edgy to scrub in.

It's just him and Lexie.

The other interns continually mutter under their breaths about Lexie getting ahead by sleeping with Mark. It starts to get to them until Lexie decides she doesn’t care what they think - she kisses him in front of everyone.

Meanwhile, three interns have their own drama going on. While Meredith and George are examining patients and trying to get through their paperwork in time to watch Mark's transplant, one intern is running around with a black eye, another with a bloody hand, and a third (a woman) sobbing.

Meredith and George stop trying to ignore the drama and decide to find out what was going on. The guy with the bloody fist and the crying girl were dating, but broke up for a while. During the time they were broken up, she slept with the dude now walking around with a black eye.

The rest is pretty much history.

Meredith and George basically tell them all to grow up ... only the crying girl is also pregnant.

Elsewhere, Chief can’t pay attention to Mark's surgery or anything else because he’s so caught up in worrying about if and when Derek is coming back, so Bailey takes it upon herself ... to send Callie to see him.

Unfortunately, that plan backfires as Derek just brings her down into his depression. When she doesn’t come back and her phone goes straight to voicemail, Bailey freaks out ... and gets Owen to go out and retrieve both Torres and Derek at the trailer, which backfires in the exact same way.

Bailey finally goes to the Chief and tells him what’s happened, so he goes out to smack some sense into all of them. Derek blasts him for telling Meredith about the ring and tells Chief that he ruined him.

Richard refuses to be blown off, though, and tells Derek that he’ll be there when Derek decides to come out of his hole. The Chief also advises Derek to call Meredith.

Back at the hospital, Cristina is so caught up in trying to find Izzie treatment that she can’t focus on her work. It doesn’t help that Izzie doesn’t seem interested in getting any treatment.

Yang doesn’t understand why Izzie told her about the cancer if she doesn’t want help and doesn’t want anyone else to know. Finally, when Yang can’t even focus on her first solo surgery – a hernia removal – she decides to tell Alex and Bailey, knowing that they’ll tell everyone else.

Rather than being upset with Yang for telling everyone and verbally smacking some sense into her, Izzie is grateful and thanks Cristina.

As everyone gathers around to help Izzie and get her admitted as a patient, Meredith goes to see Derek and they have a tender moment where they say how they love each other, but Meredith is on a mission.

She wants Derek to operate on Izzie’s tumor. He's one of the few who can. She leaves the films with him and goes back to help Izzie.

The group checks Izzie into the hospital and begin running tests while Derek sits at his trailer and examines Izzie’s brain scan results.

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Grey's Anatomy Season 5 Episode 18 Quotes

Miranda: I've lost Hunt and Torres, see I sent them to get Shepherd and ... never heard from them again ... I was trying to solve the Shepherd situation for you sir, but it appears that I somehow made it three times worse.
Richard: [stares]
Miranda: So I'm telling you and my next move I believe is that I'm gonna call the police because I'm half convinced that they're all dead ... on a spit ... with an one armed man turning them into shish kabob sir ... It's my mind it just goes there.

Miranda: Do I look like a therapist?!
Richard: You asked!