In last week’s episode of Grey’s Anatomy [abc], officially named after a Belle & Sebastian song, Seattle Grace Hospital gets a visit from a dehydrated runner and an escaped Amish. George deals with his dad’s death, the senior doctors scramble upon hearing rumors of the Chief’s retirement, and Bailey has a dream. All of this in the unsurprisingly delayed recap. After the jump.

Meredith’s voice tells us what the episode is about over a busy hospital scene. In the middle of it all, Bailey stands, staring bleakly off into the middle distance, looking awfully distressed. “No one believes their life will turn out just kind of o.k. We all think we’re going to be great. And from the day we decide to be surgeons, we are filled with expectation. Expectations of the trails we will blaze, the people we will help, the difference we will make. Great expectations of who we will be, where we will go. And then we get there.”

Fly past the Space Needle, over downtown, and into the Burkeatorium. In his finest purple shirt & sweater, he’s hosting a dinner party with Grey and Dempsey. In the kitchen, Sandra Oh tosses bites of cereal into her mouth. Despite the silent treatment, they’re still living together. Meredith tries to convince him to talk to her, or at least give her food. Changing the subject, Dempsey brings up a rumor about the Chief’s imminent retirement. Burke plays dumb, but Sandra Oh’s loud scoff reveals the truth. She elaborates, saying that he’s taking himself out of the running, blaming her for being “part of the team”. We can only assume that the offer of dessert does little to diffuse the awkward tension of Dempsey’s surprise.

Back at the Grey House, Meredith wants to talk about the Oh–Burke domestic tension and prospects for a successful relationship. Dempsey just quietly stews about not being asked to be Chief.

Izzie tries to bring a plate of baked goods to George’s room. But her knock is answered by a barely-dressed Callie making her escape. It seems that having a dead dad puts George in the mood for acrobatic sex. Three times tonight and gearing up for a fourth. Callie’s legs are too bent out of shape to continue. She hastily dresses, imploring Izzie to take over GeorgeWatch2007. {Neat how it’s now 2007 even though that doesn’t really fit with the show’s internal chronology. Maybe it was 2007 from the start? Because there’s been only one xmas episode and it seems like they’re all still first year interns.} Callie runs off and Naked!George opens the door looking for her. Mouth agape, Izzie stares at his man parts, smiles, and asks if he’s hungry. {Here, our internal Valerie Cherish begs for an I don’t need to see that!}

Sunrise over the sound brings us back to Seattle Grace. A week has passed and Addison has been weirdly avoiding Alex. She claims otherwise, but this pretty obviously awkward kiss aftermath. Passing Callie on the steps, she confesses about her Alex kiss, but she counters with a “George has become a sex machine.”

Izzie repeats the unexpected phrase of the week in the locker room, but fails to capture the attention of the other interns. Meredith is too tired from being kept awake by Dempsey’s rantings, concern for the Sandra Oh and Burke’s wordless relationship, and Alex’s unknown problems (he insists that he’s all good.). Izzie pulls the “recovering from the death of her fiance, demise of her surgical career, indignity of depositing an 8 million dollar check” card, saying that she could blow at any minute and needs some assistance on the George front. Enter George, on the hunt for Torres.

In a walk and talk, she says that perpetual sex isn’t a form of grief, he claims to have blacked out her seeing him naked (denial!), and they run into Addison. Asking about sex as a form of denial throws her for a loop, but they save her from herself by responding to her “what do you know” with gossip about a case and not her extracurriculars.

Entering the Elevator of Awkward (and otherwise) Meetings, the Chief has abandoned his every day is casual Friday wardrobe and shows up in a suit and tie. Dempsey and Bailey chase after him, jockeying for prime elevator position. He invites them both in, but tells them that they’ll need to keep it short. Since Dempsey’s issue is “epic”, Bailey gets the room to herself. She wants Seattle Grace to open a free clinic. He’s confused. This isn’t even surgical {it’s just a mandatory hospital drama plotline. Hasn’t it come up a few times in the hundred year history of E.R. alone.} and she’ll need to get support from department heads, jump through hoops, and find funding {even the monkeys in the home audience can guess the answer to this hurdle}. He says he’ll consider it, but doesn’t really see why she’s taking it on.

George and Izzie drop in on Addison’s patient. She (with her very protective friend in tow) is in for a pelvic exam. The patient, a young twenty something is incredibly upbeat and accepting of having interns in the room and doing the exam. While Izzie’s warming up the speculum, the patient and her girl friend {not girlfriend} talk about their strong bond. Born two days apart, they’re b.f.f., using the phrase “cradle to grave” repeatedly. The word “grave” on a hospital soap can’t be a good sign at all. Sure enough, Izzie sees something pretty scary down there. {Probably more upsetting than what George showed her last night.} The patient insists that George should also get a look since it’s a teaching hospital. The friend interprets their shock as a sing that her pal might be pregnant, but that’s not it at all. The grim music that takes us to the opening title lets us all know that it’s not a happy discovery.

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Outside the room, George and Izzie talk about the shocking discovery: the largest cervical tumor ever, visible to the naked eye. Friend wants to know if it’s cancer so that she can prepare and not cry. They say that the biopsy will take hours, but she should call in the parents. Now. Not going to happen, the girls left home at 16 and they don’t talk to them anymore. It’s complicated, but they’re each others family now. She’s not contacting her parents and neither are they.

McSteamy assigns Grey and Alex to tend to a patient’s bedsores as a going away present for the nurses. He’s doing one last rhinoplasty before leaving Seattle Grace; it’s his little gift to all of us, leaving the city prettier than he found it.

Bailey chases down Dempsey to try to get his support for her pipe dream free clinic. Like the Chief, he doesn’t see the point and is still bitter about not being chosen to be the replacement Chief {ah, remember the good old days when we just called them Chief Wannabe #1 & #2?}

In yet another hallway, Sandra Oh asks Callie how George is doing. She brings up his sexual appetite and Oh stops to remind her that they aren’t friends and that is Too Much Information. Torres thought she’d care, but whatever. She doesn’t like her either. Patient time: this one’s a runner with a dislocated knee. He blacked out during a race. Callie makes small talk and snaps his leg back into place, leaving S.O. to do some tests to rule out dehydration.

Izzie wonders if George will be O.K. working on the giant tumor girl, on account of his dad having died of cancer a week ago. But he’s cool with it. At the end of the hall, he sees Callie and nearly attacks her. So great is his incredibly manly and heterosexual drive for her. But she escapes, leaving Izzie to confront him about the non-normalness of his grieving. We’re treated to the phrase “your girlfriend’s vagina is broken.” On cue, a couple of Puritans show up.

They rush over and sure enough, two straight-out-of the Crucible puritans! A couple, she in her bonnet and he in his crazy beard. When they ask if they need help, he responds by speaking in his own weird Puritan language before remembering that he’s not in Amish Country anymore. They’re at the hospital to see their daughter. You know, the one with the freaky tumor growing out of her cervix.

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Just as the girls are talking about how they’ll deal with their restaurant schedules if this big scary tumor thing turns out to be serious, they’re interrupted by a visit from the Old Country. Healthy friend freaks out, angry that they’re there. Izzie says that she didn’t call them, tumor girl says it’s o.k. When the angry one confronts the parents in their native tongue, they won’t respond. Why? Because she’s been shunned. Awesome.

Enter Addison with the test results. Even the Amish can guess the results: the cancer. The Shunned freaks out but the unshunned (let’s just call her Goodie from now on) says it’s O.K. She asks her parents to leave, saying it was a bad idea to have them come.

Elsewhere, Meredith chats up McSteamsalot about his departure. He explains by saying that he hates it here: the weather, the mean unforgiving people. Grey wonders whether he’s talking about the good people of Seattle or Dempsey and Addison. He says that since his contract with the Chief was oral and non-binding, it shouldn’t be a big deal to skip town early. {they’re really running a tight ship over there at SGH, aren’t they?} When Meredith drops the rumor about the Chief stepping down, it piques his interest.

In another hallway of hospital gossip, Patrick Dempsey asks Addison what the Chief promised her to get her to come to Seattle. She trots out the old “foremost neonatal unit west of Manhattan” schtick. He wonders if she was told anything about being Chief. No, but now she’s curious too. {enter Chief Wannabe #4} Leaving, she again brushes off Alex who stops her by yelling that when she gets a minute, he’d like to talk about the kissing.

But before that, he’s back to bedsore watch with Meredith. Sandra Oh drops in to talk about her Running Man case, complaining that she didn’t even get a fracture out of it. Enter Burke, asking if anyone wants to assist on a trunkusarteriosaurus surgery, saying that the first eager intern to describe the condition gets to scrub in. Grey and Alex are stumped, Oh is furious with them for not knowing and exasperated that her vow of silence kept her out of the fancy rare surgery.

Scrubbing in, Burke apologizes to Dempsey about the whole Chief bombshell. It wasn’t the first time. He didn’t know who to trust about his hand. Dempsey snaps that now that he’s all fixed up he could even run for Chief. Burke’s out of the running, he’s looking for answers, and it wouldn’t be right. Not that it matters much in this place, grumps Dempsey.

In the hallway of the Two Union Square photo, Sandra Oh tells the running man that he’s seriously dehydrated, but his bones look o.k. At first all he cares about is the next race {his purpose on this episode is to teach us about winning}. Then he mentions that his legs hurt. Oh peeks under the sheets to find two seriously swollen legs. She calls Callie for the gross-out surgery of the week. They spill betadyne all over him and slice his calves open. While he’s still awake and screaming

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The Chief wonders why he’s progressing so quickly. Callie figures out that it has something to do with the aspirin and the dehydration. Up to an O.R. stat.

In the waiting room, Izzie tries to get George to grieve a little, but he’s still hot for Callie. They notice that the Amish are still around.

Alex finally confronts Addison, pulling her into a supply closet. Not to make out (does she think he wants to be just another intern sleeping with an attending). He tells her to lay off the avoidance and the assuming that he wants her. He kissed her back because she’s his boss; all of this avoidance is keeping him out of cool surgeries. It doesn’t need to happen again.

McDempsey and McSteamy in the hallway: each has heard good news about imminent departures. Good news travels fast. Except that McSteamy isn’t leaving now that he’s heard about the race for Chief from a certain “chatty girlfriend”.

In the O.R. with cut up Running Man, Sandra Oh and Callie express their admiration for each other and the leg slicing. Not that they’re friends. But still, Oh asks about George. Callie says that they don’t talk about anything (Oh: talking’s overrated). The last thing they talked about was Burke and Oh’s not talking to each other. (Torres: Silence is overrated).

Izzie talks to the cancer-ridden good Amish girl. The Shunned is out of the room. Izzie tells her that her parents are still waiting and that she knows who called them. Goodie confesses that she called after her tumor was discovered in at an E.R. visit a few weeks prior. She didn’t have the money to pay the bills, got scared, and called home. And now for the backstory on the shunning: her friend decided to leave the community after she was baptized. She followed her out into the world, but because she hadn’t been baptized, she remains unshunned. {I need to brush up on my Rumspriga rulebook, but this doesn’t make much sense. If they’re the same age, wouldn’t they have had coincident wild times and baptisms?} Basically, she can still go back. She thinks about it. It’s her home, and if she’s dying she wants an Amish funeral with the white dress and everyone there. But she made a promise (cradle to grave!) to the Shunned.

In her surgery, Addison bemoans the preventability of giant tumors. If only they’re caught in time. This is a perfect reason for Bailey to bring up her crazy free clinic scheme. No one’s really sold on it. When they open her, she’s all full of cancer and they have to closer her up. Here, George quietly loses it. Since, you know, his dad died last week. And they didn’t close him up even though he was full of cancer.

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Izzie looks for George. In the background, the Amish Parents hug.

In Running Man’s surgery, the Chief thinks that you have to be crazy to have run 12 miles before passing out. Callie says that he should have sat down when he felt dizzy. Sandra Oh defends him, saying that he couldn’t have expected that a head cold and a couple of aspiring would do him in. She sympathizes with his determination: he was in it to win it and she gets that. Surgery is the most competitive field in medicine, they should all understand. Time for a Chiefly lesson: “it’s a long road. When you get to the end of it you’re not going to care about winning. You’re just going to be relieved you made it to the finish line.”

Patrick Dempsey angrily comes into some sort of little office where Meredith is working on paperwork to yell at her about telling McSteamy about the Chief’s resignation. Now he’s staying, and Dempsey is pissed. So angry at her for giving him an excuse to stay that he slams the door and leaves.

Bailey tries to get Burke to sign off on her clinic, guilt tripping him about keeping her out of surgeries and filling her with self-doubt while he was hiding his tremor. He says that she needs someone who can provide direction and leadership; he’s not that man. She replies: Not anymore; if that’s what he wants to believe.

Post-Op. Goodie is still asleep; so Izzie briefs the Shunned friend on her prognosis. It’s not good and no amount of talking to doctors and experts will prepare her to deal with this all by herself. She tells her that Goodie called home because she wants to go back, but won’t do it without her friend’s blessing. Izzie says she’s dying and that if she loves her it’s possible that the best thing to do for her is to let her go.

All of the Chief Wannabes find themselves hanging around outside the Chief’s office to squabble. They mob him until he asks for an explanation. McSteamy says that they all want to be Chief. He shuts them up, telling them that he’s had a perfect day, retiring, saving a life, and now he’s off to see his wife. Now they’ve ruined the possibility of a happy day of retirement with all of them acting like fools and hovering around like vultures trying to pick his bones. Bailey interrupts, surprised to hear that he’s stepping down. He explains that his agreement was to stay on until he finds a replacement.

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Later. Bailey confronts the Chief about his omitting the part about retiring when she was hitting him up about the free clinic. He explains that she needs one of those fools to sign-off on it since one of them might be Chief of Surgery in the next month. He admits that it’s hard for him to imagine, but since she’s not ready for the job, one of them will need to do it for the next few years. She’s surprised. He says that it will eventually be her, that’s who she is. {It seems highly unlikely that one of them would happily hand over the job after a couple years, but what do I know about hospital power dynamics}. He wasn’t sending her on a wild goose chase, he was trying to get her into the habit of doing things without him.

The four wannabes are still camped out on the skybridge to the Chief’s office, stunned at the reality of his retirement and the possibility that one of them could soon take his place. The thought of McSteamy as Chief of Surgery makes Addison throw up a little in her mouth. Bailey attacks with letters of support for them to sign. Burke and Dempsey ask why she wants it so much — she’s a surgeon. She explains that she needs something more. They all have their messy love lives and their secrets and their silliness. She needs something to hold on to; a reason to believe that medicine can not only save lives, but change lives. She needs to believe in something the way she used to believe in them. {I hate to harp on the timeline again, but the only one of them who’s been around with her for more than a year is Burke. And when did she ever “believe” in McSteamy?}. She yells at them to sign and they comply. Dempsey reminds her that she still needs funding {I wonder where she’ll find that…}

As she leaves, Dempsey says something about the Nazi being back. {Whatever. A little gruffness in support of a sappy cause isn’t particularly convincing, is it?}

Back in Amish land, the Shunned tells her friend to go home to her parents who love her {and presumably don’t believe in chemo- or radiation-therapy}. Goodie says that she can’t leave her. Shunned says not to worry, she’ll be living it up in the 21st century while she’s back home getting baptized and dying Amish style. Goodie says that she can’t shun her; but Shunnie says that she will and she won’t take no for an answer. Amish parents come in, and Shunnie slowly backs away. Amish mom breaks the shun: saying that she will tell Shunnie’s parents that she’s well and has grown into a fine woman. They hug, and Shunnie exits while Izzie listens to pick up a lesson for later.

Seattle at night from the waterfront brings us to the Chief’s house. He knocks on the door with flowers to find his surprised wife. He tells her that he has finally retired and now he feels relieved. She breaks the bad news: when she told him that she didn’t have any more time to wait, she meant it. That was months ago and she’s moved on. In fact, there’s another man in his house right now. Klassy. She’s so sorry, but what did he expect? {Probably not being left out in the cold while his wife entertains another gentleman caller. Just a guess.}

In a dark conference room, Izzie finds George and sits down to say that she’s sorry. She asks if having a lot of sex makes him feel better. and says that maybe you’re not supposed to feel better. He says that she can’t help him and she realizes that {just like the Amish drama that conveniently played out only moments ago} she has to let him go. {They’ve been friends for almost a year, and he’s not dying, or being shunned, but it’s totally the same thing.} She hugs him, saying that life is short and it sucks a lot of the time. If being with Callie makes him happy, he should go for it.

Just as he leaves, Bailey arrives and Izzie asks her about the clinic. She says that she has her signatures; so the Seattle Grace Free Clinic will exist. Izzie smiles, and the lightbulb we saw going off an hour ago finally lights up. She corrects Bailey, “the Denny Duquette Memorial Clinic.” She has eight million dollars. Bailey just replies with a surprised “Izzie Stevens”.

Back at the Grey House, Dempsey walks into Meredith’s bedroom and says that she left without him and now she isn’t talking to him. He admits that he was a jerk, but that doesn’t mean you stop talking to him. He asks if he gets that she’s saying he’s sorry. She says that he yelled at her for no reason and walked away and now he shows up. He explains that of course he showed up: you fight sometimes and somebody apologizes. She wonders how she was supposed to know that and he realizes that she’s never done this before. He walks closer and tells her to expect that he will show up no matter what. She says O.K. and they kiss. She says that he’ll make an excellent Chief.

And, it’s voiceover time: “. . . we all think we’re going to be great. And we feel a little bit robbed when our expectations aren’t met . . .”

Addison invites Alex to scrub in for an emergency surgery. He agrees.

“. . . but sometimes our expectations sell us short . . . ”

At the Burkeatorium. Sandra Oh tells Burke that she was right. She really believed that what she did was right, but she doesn’t want him to forgive her. She’d find it patronizing because he thinks she was wrong. It doesn’t matter. She’s in this for the long haul, to finish the race {thank goodness for patients who bring lessons with their swollen legs!}, so it’s fine if she doesn’t win this one. He wins; she’s talking first.

“… sometimes the expected simply pales in comparison to the unexpected ..”

Burke asks her to marry him.

At Callie’s. George says that he can’t wait another minute. She says no more sex. He says that ever since his dad died, his stomach feels full of asphalt and he laughs whenever he remembers that he’s not going to talk to him again because it sounds so stupid. Every time he looks at her, he feel better. He’d be happy to look at her from across the room. Any piece of her, hopefully all of her would be the best thing. He loves her. A wide eyed, “George” is all she can say before he gets down on his knee and asks her to marry him.

“. . . you’ve gotta wonder why we cling to our expectations. Because the expected is just what keeps us steady, standing, still. The expected’s just the beginning. The unexpected is what changes our lives.”

Scenes of proposals alternate with neither woman responding and both guys repeating their pleas.