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Addison (Kate Walsh) is caught in the middle when her old friend Esme Sorrento (Janet Rotblatt) wants to have her uterus removed to prevent cancer, while Esme's husband Joe (Shelley Berman) is dead set against the operation. Elsewhere, George (T.R. Knight) is saddled with another eccentric patient, this one a suicidal window washer (Geoffrey Rivas); try though she might, Meredith can't avoid running into Derek (Patrick Dempsey); and Cristina (Sandra Oh) prepares for an important date with Burke (Isaiah Washington). The episode's pivotal moment occurs when Dr. Bailey discovers why she has been so unusually lethargic (a plot twist dictated by actual events in the life of actress Chandra Wilson, who plays Bailey).