"The Heart of the Matter"
Written by Allan Heinberg; directed by Randy Zisk

As Meredith voices over that everyone makes mistakes and hurts people no matter what, George tries to get Callie to talk to him in the wake of his revelation about his affair with Izzie (see “Let the Truth Sting”). She surprises him by announcing that she forgives him. He made a mistake, but they took wedding vows and agreed to stay together until they die. Later, George rushes around the hospital, trying desperately to get in touch with Izzie. He runs into Meredith, who then meets up with Derek. He wants to go away with her for the weekend, and she points out that they never went away together when they were dating, so why should they start now? She agrees when she realizes that they’ll just be having sex for 48 hours. Cristina spots the two of them and complains that Meredith is having a great time while she’s stuck working in the pit with the interns. She’s also confused as to whether they’re still hating Lexie. Meredith says they’re hating the idea of Lexie, but not Lexie herself, since they don’t have a reason to hate her. Cristina disagrees, since Lexie being an intern is enough reason. “You may be the new Nazi,” Meredith tells her. She asks Alex to work for her over the weekend, and he agrees if she’ll look after Norman for him for the day. George runs by again, still looking for Izzie, and Meredith warns that he’ll have to work in the clinic if he’s late for rounds. This just gives George an idea of where Izzie might be.

In the clinic, Bailey meets a woman named Ruthie who hurt her ankle while working out on her treadmill. She wants a shot of cortisone for the pain since she has to go meet her trainer. George runs in and asks Lexie if she’s seen Izzie. She hasn’t, and she wants to know if he’s seen Cristina. She’s ready for rounds and vows to answer all her questions correctly and not let Cristina give her crap anymore. Derek tends to a teenager named Adam whose spine was injured while he was playing football. His father Stanley isn’t too sympathetic. George finally learns Izzie’s location from Webber - and learns that Callie is looking for her, too. As Izzie lectures her interns about penmanship, Callie finds her and tells her they need to talk in the cafeteria at noon. Later, George finally finds Izzie, who’s surprised to hear that Callie forgave him. She suspects that Callie is saving all of her “rage and bloodshed” for their confrontation in the cafeteria. She vows not to go down without a fight. Cristina and Lexie join Derek in tending to Adam, and Lexie says she can’t believe how Stanley treats his son. Cristina tells her to focus on the medicine, calling her Three, and Derek asks if that’s her nickname. He’s impressed with her medical knowledge and wonders how she and Meredith have been getting along. Lexie thinks Meredith still hates her, but Derek is sure she doesn’t.

Meredith introduces Mark to Norman, who proves that he’s been listening to the other doctors’ conversations, since he’s now spouting “seriously” all the time. He also asks what Mark’s McNickname is. Meredith tells Norman that one of their patients is being discharged to hospice and they have to tell her there’s nothing else they can do. Norman isn’t thrilled about having to do so. He suddenly realizes that Mark is A/K/A McSteamy. Bailey pages Callie to consult on Ruthie’s case, and Callie determines that she needs surgery and is osteoporotic. Bailey tells her that Ruthie isn’t as old as most people who are osteoporotic. Callie seems more concerned with getting away from George as soon as possible. George tells Bailey he’s not going to discuss the situation with her. Meredith gives Norman a few guidelines to telling a patient she’s dying, like being detached and polite but not cold. He needs to show that he cares without getting too emotional, because that will make the patient emotional. She tells him that even though things are more difficult for him because he’s older than the others, he can still do well if he focuses on the medicine. Cristina approaches to tell Meredith that Derek and Lexie are bonding over their relationship with her. Norman reminds Meredith that she just told him to focus on medicine.

Back in Adam’s room, Derek, Cristina, and Lexie tell him he’ll need traction to fix his spine. Stanley is, again, not very sympathetic. In the room of the patient Norman has just told is dying, and Meredith chastises him for not remembering what she told him about remaining unemotional. Norman apologizes again and he and Meredith “slowly and respectfully back out of the room.” Izzie tracks Alex down in the clinic and asks what he’s doing at lunch. He’s heard about her and Callie’s confrontation from his interns and is looking forward to it. He wants to know what Izzie did, but she won’t tell him. Suddenly Adele arrives with Camille (last seen in “Losing My Religion” but now played by Camille Winbush) and Camille’s mother Arlene; Camille is having trouble breathing and Izzie and Alex have to perform an emergency procedure to help her. Later, Webber, Alex, and Izzie perform surgery on Camille and discover a mass. Webber is sure that Camille can beat her cancer again. Norman and Meredith approach Cristina, and Meredith tells her they just had to inform a 48-year-old woman that she’s going to die. “I wish I could tell a 24-year-old woman she’s gonna die,” Cristina replies, looking at Lexie, who’s talking to Derek. Lexie approaches (Norman greets her with, “‘Sup, Lexie?”) and tells an unresponsive Cristina that Derek wants to meet them in Adam’s room in a few minutes. Cristina accuses her of using Meredith to get in good with Derek, but Cristina won’t put up with it, so Lexie will be observing for the rest of the day. Lexie finally stands up to her, telling her her name is Lexie, not Three or Grey.

Bailey, George, and Callie learn from Ruthie’s boyfriend Will that she’s been dieting and recently lost 40 pounds. Ruthie explains that they made a deal - if she got down to a size four, they’d move in together. His part of the deal was to quit smoking. Bailey warns that even if Bailey repairs Ruthie’s fracture, she’s not going to get better if she doesn’t take better care of herself. Will doesn’t care about the stipulations and tells the doctors to fix Ruthie’s ankle. Meredith and Norman rejoin Mark at the nurses’ station and are shocked to learn that the patient they were supposed to tell was dying is a man, and definitely not the woman they talked to. Norman misread the room number and told a woman who came in for mole removal that she’s going to hospice. Back in Adam’s room, Stanley tries to motivate Adam by telling him that traction is like being in the weight room. Cristina reminds Lexie to stay against the wall, but Derek points out that they’re at a teaching hospital and allows Lexie to move closer so she can see what’s going on. As Adam’s traction begins, Alex and Izzie scrub out of Camille’s surgery and discuss how hard it must have been for her to hear that she had cancer when she was just 14. Alex is still interested in the upcoming fight, and Izzie asks him to pull Callie off of her if the fight actually occurs. She finally agrees to tell him why they’re fighting, as long as he promises not to tell anyone. When Alex learns that Izzie slept with George, he tells her he’s embarrassed for her.

Meredith chastises Norman more for screwing up his one responsibility, and he invites her to yell more since Bailey says that’s how interns learn. They go looking for their non-dying patient, Gretchen, and learn that she’s left the hospital. “Feel like yelling now?” Norman asks. Webber tells Camille, Arlene, and Adele that Camille’s cancer has returned and spread to her chest, throat, and lungs. Camille just wants to go home and refuses to have any treatment. Adele doesn’t think Camille is old enough or capable of making such an important decision, despite the fact that she’s 18. Camille replies that she doesn’t want to spend the little time she has left in the hospital. She asks Webber to be her uncle instead of her doctor right now. Adam’s traction continues, but he’s not sure he can take it much longer. Stanley tries to coach him, but he annoys Adam to the point where Adam throws him out of the room. Lexie tries to comfort Adam but Cristina yells at her for touching him. Derek observes the situation and pulls Cristina aside to remind her that she’s supposed to be teaching Lexie, not yelling at her. Until she can figure out how to be less selfish and competitive, Derek won’t let her assist with his surgeries.

Arlene agrees with Camille that she’s not going to get any better, but Adele thinks she’ll agree to be treated if Webber talks her into it. She begs him to try to help the closest thing they have to a child of their own. Meredith tries to call Gretchen again, and Mark blasts her and Norman for not being able to find her. Meredith takes responsibility for the screw-up, admitting out that she was distracted. Norman tells her that Lexie is a nice girl and wouldn’t say anything “untoward…or uncool.” Meredith goes back to making calls, and when she starts to address Norman again, she sees that he’s disappeared. Later, in the cafeteria, Cristina complains to Meredith about what Derek said about her and Meredith complains that she lost both a patient and Norman. The two join Alex and a nervous Izzie, who’s waiting for Callie to arrive. Meredith wants to know what the fight is about and Alex tells her she doesn’t want to know. He also doesn’t think the fight is worth it. Izzie disagrees. George goes to get Ruthie’s labs and a tech lets him know that Izzie and Callie are supposed to fight in the cafeteria. There, Izzie stretches and boasts that she was raised in a trailer park and learned how to fight dirty. Callie approaches and Izzie quickly realizes that she wants to talk, not fight. She leaves and someone announces that that means she’s forfeiting. “You were very ghetto fabulous,” Cristina taunts Izzie. George arrives and learns that the fight didn’t happen. “Guess they realized they were fighting over nothing,” Alex tells him.

Derek finds Mark in an office and asks his advice on weekend getaway destinations. “I hope you don’t mind if I kill your girlfriend,” Mark replies, telling him about the Gretchen situation. The two disagree on how interns should behave - Mark thinks they should be seen and not heard, but Derek thinks they learn better through interacting with patients. Mark notes that that means he has to teach, then clean up their messes. Derek says Meredith doesn’t screw up that much and isn’t an intern. Mark recommends Sonoma for the weekend, then says that Meredith is still an intern and the only difference between her and Norman is that Derek isn’t sleeping with Norman. Callie rejoins Bailey in Ruthie’s room, where Ruthie is learning that she’ll be in a cast for 8 to 12 weeks following her surgery. Callie chastises her again for not eating well, then gets into an argument with Will, which ends when Ruthie starts vomiting blood. She’s quickly taken to surgery to treat an ulcer, and Bailey tells George that she did this to herself because she wanted to be loved. In Adam’s surgery, Derek lets Lexie do some cauterizing, then puts Cristina in a position where she has to teach Lexie. Norman returns to the nurses’ station and tells Meredith that he went to Gretchen’ s apartment and got her to come back to the hospital by telling her she had an outstanding bill. She’s kind of excited to be dying because it’s forced her to quit her job, dump her boyfriend, and take a trip to Iceland. She’s not so happy to learn that she’s not dying after all.

Callie finds Will smoking outside and blasts him for not keeping up his end of his deal with Ruthie. She announces that Ruthie didn’t survive the surgery and blames him for pushing her too hard. Will says he wanted her to be healthy and claims that he loved her. Callie disagrees, saying that people don’t destroy the people they love. George separates the two of them but Callie eggs Will on to hit her, since she didn’t get to have a fight earlier. Bailey defuses the situation and asks Callie what’s wrong, telling her that the “nothing” she claims almost cost her her career. Webber visits Camille and asks her why she waited so long to come to the hospital. She knows her cancer is never going to be cured, and she was hoping it would kill her before she had to come back to the hospital. Webber has come up with a plan to treat her, and as her uncle, he wants her to agree to it, but as her doctor, he’ll do whatever she wants. Camille just wants to go home, so Webber keeps his word and says she can go.

Izzie approaches Callie and apologizes for everything that’s happened. Callie blasts her for taking advantage and making her think she was seeing a situation that wasn’t there. She was humiliated by Izzie’s affair with George, and then she was humiliated again by the situation in the cafeteria. Though Callie is upset with George for breaking his vows, she’s also upset with Izzie for disrespecting her as a woman and stealing something from her. She thinks Izzie should be the one who’s humiliated, and she shouldn’t be asking for forgiveness. Later, Alex encounters Izzie and she asks if he hates her now, too. He still can’t believe she slept with George, and that she claims she fell in love with him when he’s already married. Izzie points out that he’s still in love with Rebecca, who’s also married, so he shouldn’t be allowed to judge her. Alex reminds her that she said she wasn’t ready for a relationship after Denny’s death, but then she slept with George and told Alex about it like he’s “one of [her] chick friends.” Mark tells Meredith and Norman that Gretchen has settled her potential lawsuit with the hospital, which will be paying for her apartment in Iceland. He announces that he’s writing them up, but Meredith wants to be the one who’s blamed because Norman was her responsibility. Mark says she’s noble, though dumb.

Adele blasts Webber for not convincing Camille to get treatment, and for once again not choosing his family over his job. George finds Callie outside in the rain and says she can’t just forgive him because what he did was unforgivable. He knows she’s furious and can’t just forget what happened. She agrees. Meredith tells Derek she got Alex to cover her for the weekend, but he backs out of it, assuring her that it has nothing to do with anything Lexie said. He tells her he gets to say things to Lexie that he can’t say to Meredith. He wants to marry Meredith and have a family with her, and not just have 48 hours alone with her. She takes a step back and he notes that that’s what’s wrong with their relationship - “I say things like that and you fight the urge to run in the opposite direction.” He’s fine with it now, but he’s been doing this a while and she’s still an intern, so she’s not ready. Meredith agrees but says that if things stay the way they are, she could get ready. Derek agrees to wait until she is but notes that while he’s waiting, he could meet someone who’s ready now. As Meredith voices over about forgiving, revenge, and forgetting, Stanley visits Adam and Lexie thanks Cristina for helping her out in surgery. Cristina calls her Three again, and this time Lexie doesn’t argue with her. At home, Izzie cries alone in her room and Alex throws her some tissues, telling her to be quiet. Callie is also alone in her own room and no happier than Izzie.


MEMORABLE QUOTES: Meredith: “I have gone out of my way to be nice to her, and this is what she does, talks about me behind my back?”
Cristina: “When were you nice to her?”
Meredith: “I was nice…once.”

Norman: “You want to yell at me some more? You can, because I am an intern and according to Dr. Bailey, yelling is how we learn.”
Meredith: “Well, I’m not a very good yeller.”
Norman: “Oh, I’m sure it just takes practice. Perhaps Ms. Bitzer will show us how it’s done.”

Cristina: “What is wrong with these interns? We weren’t like this.”
Meredith: “We were great interns.”
Cristina: “I was great. You were…you were good.”

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