Last week Izzie Stevens found out that Ava/Rebecca Pope is not really pregnant like she told Alex Karev. She asks Miranda Bailey "If I can't get ahold of my patient, is it okay to give her test results to her friend?" You know Bailey, she shoots down the proposal right away due to patient privacy rules. So here Izzie is stuck. She's already broken hospital rules in the past and we all know what messes that has gotten her. Alex has told her that he and Ava are planning to get an apartment together and she's leaving her husband and everything for him. We all know this is going to end badly and Alex just thinks Izzie is being unsupportive and maybe even jealous.

Meanwhile Alex is trying to prepare for fatherhood. He's helping a heart surgery patient, who due to infection control has been in a plastic chamber for 6 weeks away from her daughters. The girls ask what happens to their mom when they take her heart out. Alex explains, "We'll have her on a heart-lung machine. It's like Snow White. She eats the apple and dies for a while, but she's not really dead, you know. " The small girls freak out that they're mom's going to die, did Snow White die? Thinking he was so smart with his explanation to the kids turns on him and the mom condescendingly says, "It's okay, you don't have kids. You wouldn't know." It's hard on Alex who isn't ready, but is trying so hard now to get ready for his new baby. Then on top of it, he has a slight temperature and is kept out of the surgery. He is able to redeem himself when he saves the mother's life after her lung collapses and although it puts her back into isolation (because of his temp), he is able to get her daughters "clean" to come and see and touch her. That is something she hasn't been able to do in 6 weeks.

Meanwhile, Izzie has run into Alex dozens of times - wanting to tell him - not being able to tell him. She can't get ahold of Ava to give her the results either. During one of the confrontations Alex gets upset saying to Izzie, "You can't pass a baby on the street without stopping. The only fricking baby in the world you're not happy about is mine." And still, she hold her tongue and doesn't tell him. By the end of the day, she's exhausted sitting outside with Miranda Bailey where she is questioned on whether she told the friend or not. She tells her that "even though it killed me" she didn't tell. "You're growing" Bailey tells her. "I wish it would stop" Izzie says.

Good things may come for Izzie from this in her Seattle Grace career, but chances are that it's going to come back to bite her with Alex eventually, too. Izzie is growing, though. I'll give her props for steps in the right direction at least.

more from this episode. . .