Meredith says, "Intimacy is a four syllable word for "Here are my heart and soul - please grind them into hamburger and enjoy."
It dawns on George that Izzie and Meredith treat him more like a sister than, well, a man, and that's troubling for him. But even more troubling for George is that Alex has picked up on George's "sister role" and won't let him forget it. Cristina's aggressive pre-pre-rounds (arriving to the hospital at least a half hour before the other interns) gets her on a patient with pancreatic cancer (and its corresponding "whipple" surgery). That patient is Liz Fallon, a scrub nurse of 20 years for Dr. Ellis Grey. Despite working with Meredith's mom for that length of time, though, she's never met Meredith. George isn't the only one annoyed by Alex. Izzie feels the brunt of his machismo whenever he mockingly calls her "Dr. Model" because of how she earned her way through college and med school, a past that directly conflicts with her present when she gets assigned to a patient (with prostate cancer) who's familiar with her work (in a Bethany Whisper lingerie ad). The prostate patient doesn't want her working on him. And Meredith works with Derek (with a little help from Alex and George) on the case of a construction worker with six nails embedded in his head.
Friction forms between George and Izzie when he passive-aggressively "forgets" to buy the tampons she asked him to buy. Cristina finds herself playing "cruise director" for Liz, taking her around the hospital to all the old services she used to work with, but not setting up any actual surgery. Derek asks Meredith out for a meal together, but she declines.
Meredith finally meets Liz, admitting for the first time to someone else that her mom is in a nursing home, with Alzheimer's, and that she is the only one allowed to see her or know of her condition. Meredith also visits her mother, who is unable to recall Meredith's childhood or even her own husband. But her old co-worker Liz, though, Ellis recalls with complete clarity, which devastates Meredith.
Once Alex gets wind of Izzie's lingerie ad, it's just more fuel for him. He copies and hangs up her half-naked photos all over the hospital. The subject of momentary ridicule, Izzie puts Alex (and the others amused by the photos) in their place by angrily stripping down to her underwear to show them - quite convincingly - that she has no problem with her body and them seeing it, while simultaneously reminding them that this body is why she completely lacks the debt that plagues them.
Meredith suspects there is more to the construction worker's ails than just nails in his head. After Derek removes the nails successfully, she believes the reason why he had the accident with the nail gun in the first place was because of an undiagnosed brain disease. And she's right. He has a tumor. This puts Derek and Meredith at odds with each other for the first time, when she disagrees over the proper course of treatment for the tumor. Derek lets the patient and his wife make the decision - to have surgery that will prolong his life, but potentially wipe out his personality and many memories. Meredith, reeling from her responsibility to take care of Ellis, oversteps her bounds as a doctor and chastises them for their decision, saying they should go for the option that will preserve his memories and personality, even if it means fewer years.
Cristina learns that there isn't going to be a whipple. There isn't going to be any surgery for Liz and there never was. Liz came to the hospital to die, and Cristina was merely giving her a chance to say good-bye to everyone, but not without imparting much wisdom to the hardened intern. When Liz finally crashes, despite Do Not Rescusitate orders, Cristina won't let her go. But to no avail, as Burke and Richard have to practically pull her off the dying Liz. Liz becomes Cristina's first "time of death." This isn't easy for Cristina, and Burke is there for her in the end.
Meredith finally agrees to get some breakfast with Derek…