Lexie spies on Webber who is announcing the doctor who will be doing the next surgery solo. The interns all say different names of who it will be which angers the doctors.
Webber gathers all the doctors together and tells them that the person chosen for the solo surgery is purely based on trust. He says that everyone picked Dr. Yang, but since she is out of the running, she has to pick the next surgeon. Since Dr. Yang's interns are banned also, Yang will allow a second doctor to assist.
The doctors all try to flatter Cristina but she tells them all to leave so she can think about it. George and Alex talk to Izzy, but when she replies she also adds comments to Denny, who still haunts her.
Lexie goes to Sloan and tells him that she would like to learn. After a joke about sex, Sloan gets angry. He says that he is her superior and that it was improper but she reassures him that she just wants to learn medicine and that the sex remark was just a joke.
Lexie, Bailey, and Sloan meet with their patient who needs a new voice box. Sloan asks her if she has any questions and the patient holds up a post it note that says "No."
There are two sisters fighting loudly in the hospital. The younger sister, Emma, argues with the older sister, Holly, about crashing a car when she wasn't even supposed to be driving.
George tells Cristina that he has grown a lot since he started and tells her that that is why he is the best choice for the surgery. Cristina says thanks and continues to brush her teeth.
Callie and Meredith attend to the arguing girls. Alex walks in and looks at Holly and thinks that she may have a skull fracture. They take her away and Emma tells her sister that she hopes she dies.
Izzy notices the clinic is locked and tells everyone she'll be back with keys. She leaves with Denny while talking to him. George watches Izzy walk and talk with the imaginary person.
Cristina meets with Dixon and she asks if she can help with the amputation. Cristina says that she has to pick one of her peers to do the surgery.
Lexie asks her patient's husband if they can fill out some forms. He tells Lexie that the post it notes are not a good system of communication.
Callie and Sadie closely examine Holly's x-rays. Sadie brushes up against Callie.
Derek and Sloan see that Holly is not doing so well. Meredith tells Emma that Holly is going into surgery. Emma is disturbed that the last thing she said to her sister was that she hoped she died.
As Holly's skull is opened up, she starts to crash. They wonder what went wrong. Holly ends up dying and Dixon explains that there was nothing they could have done. Dixon says that Holly will make an excellent candidate for organ donation since she is young.
Callie goes to Sloan, concerned about the signals that she received from Sadie. Callie realizes she made up the affection. He yells at her, saying she should not sleep with the interns. Lexie looks over Sloan's shoulder and asks what he is working on. He yells at her for intruding his space.
Meredith goes to Cristina and tells her she deserves the surgery, but Cristina should do what she needs to do. Alex tells Cristina that she was robbed. He then explains in detail what he would do if he was operating. He also notes that he had done four amputations in the past. Cristina, confused, talks to Hunt about the choice she has to make and he gives her the advice to go with her gut.
George tells Alex that something is wrong with Izzie. Alex tells him never to talk to him about Izzie again. In the meantime, Izzie is in bed with Denny.
Sadie goes to Lexie in the observation room and says that she is not sorry about what they did. Sadie says that it was a good way to learn. Lexie says that Sloan taught her medicine earlier; it was not about sex.
Bailey assists Sloan with the voice box surgery. Afterward, Sloan asks his patient, Mrs. Anderson, to try to talk. She goes for her post it notes and her husband stands up and tells her "no." He tells her to talk to him.
Emma is brought to Holly. Emma asks if Holly can come out of the coma and Dixon tells her coldy that that it is unlikely. Dixon asks about the fate of Holly's organs and her parents ask for more time o think about it. Emma tells Dixon to get out.
Izzie approaches Cristina and asks if she's ever had mind blowing sex. She explains that she is currently having the best sex she has ever had. She also says that she is sure that Cristina will give the surgery to Meredith. She says that she does not care because she is having great sex.
Dixon tells Cristina that it is not fair that people are dying and he tells her that Holly's organs could save these peoples' lives. Cristina leaves and goes to the surgery board. She grabs a marker and as all the doctors look on, she writes Karev. Meredith tells him congratulations. Webber tells Cristina she made an interesting choice.
Alex goes to Izzie and lets her know that he won the surgery. He tells her that he loves her and explains that he went to find her to tell her the good news but she was not there. He says that she is never there. But he thinks that she might love him too. He says that he understands what she went through with Denny, but he thinks that she makes him want to be a better person. He tells her she can be scared, but she should be scared with him. He asks her to join him with his first solo surgery. He kisses her and leaves and Denny tells Izzie that he does not like Alex.
Emma tells Meredith that she did not mean what she said to Holly. Meredith tells Emma to tell Holly what she really wanted to say. She tells Holly that she's sorry and that she loves her. Meredith says that Holly loves her too despite what may have been said.
Lexie goes to her patient and tells her that since it's just the two of them, she should try to talk. She starts to say "hi" and as she does, her husband walks in and hears his wife. Full of tears, he says "hi" back and they hug.
Meredith goes to Cristina and tells her that she knows she didn't choose her because she was mad. Cristina gets annoyed and says she gave the job to Alex because he was actually better suited for the job. She reassures her that she can separate her job from her personal life unlike her. Cristina stands up, yells at all the doctors about how she deserved the solo surgery more than all of them, and then she leaves.
George tells Meredith he is worried about Izzie and Meredith is then paged by Alex. Meredith goes to Alex who is freaking out because he had told Izzie that he loved her and she hadn't shown up for the surgery. Meredith tells him to stop worrying about it because he needs to be focused. Webber walks in and asks if Alex is ready. Alex doesn't say anything and Izzie walks in and says she's ready.
Hunt takes Cristina to the boiler and a rush of air blows up. He tells Christina that it will clear her head and they kiss.
Lexie goes to Sloan's house and tells him that he made Mrs. Anderson speak. She tells him that she respects him and asks him to teach her. He tells her to stop but she doesn't. She starts taking off her clothes and keeps asking him to teach her. She asks him if she is really all that bad and he tells her no. He kisses her and they make love.