Synopsis - Derek begins his new role. Meanwhile, Bailey and Meredith's patient awakens from anesthesia mid-surgery; Teddy refuses to place Cristina on her service while Arizona tests Alex in pediatrics; and Mark refuses to speak to a heartbroken Lexie.
Derek (Patrick Dempsey), aka McDreamy, has become the interim chief of surgery. It wasn't a big surprise after the last epsiode, "I Like You So Much Better When You're Naked," when the former chief, Dr. Webber (James Pickens Jr.) is found to be hitting the bottle after 17 years of sobriety. Dr. Webber is faced with two options: early retirement or rehab. He chooses rehab, after agonizing about the decision for the entire hour, but who can say they didn't know that wasn't going to happen.
When a patient wakes up in the middle of the surgery it disrupts Bailey's (Chandra Wilson) surgery and she goes off on the anesthesiologist, who is quite quickly turning into what I believe is her new love interest. The woman is obviously traumatized and won't let Bailey touch her to repair the incision when it breaks open after the surgery when she is freaking out in her recovery bed. Turns out it was no one's fault and the anesthesiologist (who is so far unnamed) is bringing the heat and intensity when he comes to tell Miranda
In the whom is sleeping with whom front: There is tension between Mark Sloan (Eric Dane) and Lexie Grey (Chyler Leigh) through the entire episode. Okay, maybe it's not tension when Mark won't talk to Lexie, but both of them seem equally tense and annoyed at everyone. Owen Hunt (Kevin McKidd) and Cristina Yang (Sandra Oh) both end up with sex-related injuries, though having sex on a hot vent will burn your ass. Cristina finally opens up to Owen after she is berated by Teddy Altman (Kim Raver). Callie Torres (Sara Ramirez) and Arizona Robbins (Jessica Capshaw) barely talk in the whole episode. I guess a lesbian kiss gets you no airtime in the next episode.