Amidst all of the kidney surgeries of the day, Alex Karev and Isobel Stevens have a moral struggle with their patient.  It turns out that their patient had offered his son $10,000 as a "early Christmas present" if he participates in the kidney donating.  The young man is bitter to be there and obviously not excited to be there.  Turning to Bailey in fear of the unethical nature of this arrangement, the two interns pose it as a hypothetical.  Bailey firmly explains that if their patient withdraws from the surgery, it crumbles all of the others.  It's all 6 or nothing.  They decide to keep it to themselves.  The situation is infuriating to Izzie who thinks the soncares too much about the money and not enough about his dying father. Alex tells her, "This is your problem.  You're too wrapped up and involved and you start caring about these people."  She throws it back at him and is insulted by his remark. She ends the argument telling him he can't keep being a great guy one second then a jerk the next, "It's getting old."

Later the patient starts to make excuses for his son saying how he knows that his son can be selfish and rude, but he's been through a lot.  His mother died and he, as father, worked late and wasn't really there for him.  Izzie tells him that he can't blame himself - "some people are just broken."  The patient breaks down saying "I'm sorry, I'm so sorry," to a son who isn't even there with him.  All the patients go in for surgery and come out successfully, but Izzie and Alex's patient is not doing well and will probably die.  Alex can't stand to watch as the patient's son hasn't even come to check on his father.  He storms into the son's room and yells at him for not caring, telling him that his father is probably dying and he'll never know that his son cares for him.  "Do you want to live with that," he yells as Izzie pulls him out of the room.  

The next thing we see is a sobbing son holding his father's hand as he dies.  At least they were there for eachother in the end.  Back at home, Izzie is full of emotion.  She goes to Alex's room and tells him "I care about you and I'm not going to go crazy and I'm not going to try to kill myself and I'm not going to stop caring no matter how hard you try to push me away."  "Shut up  and get out of my room," Alex responds. Izzie's not going to give up that easy, "I care about you and I know you care about me.  Admit it!"  She urges on even though he keeps telling her to jsut leave him alone.  She begins to reapeat herself, over and over telling him "I care about you, I care about you," until finally Alex gives in and they begin kissing.           

more from this episode . . .