Cristina surprises Meredith and Derek in bed to announce that Erica Hahn has left Seattle Grace. Just then, one of Meredith's oldest friends, Sadie arrives, flinging herself into Meredith's arms. "I've never even heard of this woman. How good a friend can she be?" Cristina protests. "Good enough to kick us both out of bed. Welcome to my world," says Derek.
Sadie says that Meredith is the reason she went to med school, but she postponed her residency to work in a morgue. Now, she says she craves "flowing blood."
"She's your pre-Cristina Cristina," Derek comments to Meredith and wants to know where the nickname "Deth" came from. "Oh no, the adventures of Deth and Die are better left untold," she replies.
Izzie is reluctant to go to work after having had to face the man whose heart she stole for Denny, and when she does enter the hospital, Denny is right there, waiting for her.
His ghost stays with her all day, as she sits with a man who has a "piggyback" heart transplant that is too small for him. The patient, who is a Navajo, believes that he is haunted by the young girl whose heart he received, and he wants it removed, even if it means he'll die. He realizes that Izzie is haunted by her own ghost and tells her, "I don't need any more ghosts in the operating room."
After the girl's heart is removed, the man's heart starts beating on its own and Izzie believes, as does he, that he is no longer haunted. He tells her he's going to burn the heart, so she decides to burn her last possession of Denny's, the sweater she made him.
When she spies mysterious scratches on Lexie's arm, Cristina suspects that she's a secret "cutter," not realizing that the cuts come from Lexie practicing techniques with the other interns.
Derek hears Cristina's suspicions about Lexie and urges Meredith to step in and help. "She's your family," he tells her. Meredith asks Lexie if she's okay, and that she's "just wondering if you're channeling your tragic pain into self-mutilation."
Lexie tells the interns that they need to shut down for a while, but newcomer Sadie suggests they keep going. She tells Lexie, "You're only going to learn so much by being careful,"and -- to the shock of the other interns -- takes off her shirt, and cuts herself on the shoulder. "Who wants to stitch me up?" she offers.
"I want to rock a surgery and I don't want to talk about Hahn," Callie tells Cristina when she asks what happened with Erica. Fortunately, for her, a highly complicated case arrives: a homeless man who was crushed in a dumpster, and who is now impaled on his own leg.
He tells them if they can't save his leg, which looks very unlikely, he doesn't want to live. Owen tells Cristina to make the patient comfortable, and that the surgery is off.
Derek asks Callie, "Please tell me you can figure out a way to build this man some legs." She consults the X-rays and decides she can rebuild the leg, which she does, but the homeless man dies on the operating table. Callie breaks into sobs, saying that she did her part and that everyone else let her down. Mark stays to comfort her as she cries out her grief.
Richard asks Miranda to show the visiting heart specialist Dr. Dixon around, but warns her that she is a "little off," as Miranda finds out when Dixon keeps reciting historical trivia about heart surgery. It turns out she has Asperger's Syndrome and has difficulty interacting with others, preferring to stick to the laws of medicine.
Lexie demonstrates amazing skill with a "pulley stitch" and Richard, assuming that it was Cristina who taught it to her, tells the resident, "You're my one to watch," for the solo surgery.
Cristina discovers the underground intern surgery ring and orders them to shut it down. "Do not practice on yourself," she says. "That is insane."
Izzie tells Denny's ghost that she will always love him and that she'll never forget him. But even though she's said goodbye and burned the sweater, he is still there. "Touch me," he urges her and when she reaches out her hand, she can feel his heart beating. 'I told you I was real," he says and kisses her.
Mark, Cristina, and Callie drink their sorrows over being single away, but Callie drifts over to Sadie and offers to buy her a drink. Owen runs into Cristina outside the bar, visibly upset about losing a patient, and then he kisses her unexpectedly.
[Edit]
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