Miranda Bailey shares with Derek Shepard that she and Tuck are going to marriage counseling.  When he walked up, she was on her phone arguing over not going in the mornings because its too hard for her to get to work on time.  When Derek asks how it was going, she tells him, "Tucks arguing about the counseling, how do you think it's going. . ." She notices how tired he is this morning and he better not be because he's doing a craniotomy on her patient today.  Derek explains how he's tired because Meredith and Cristina were on the phone all night and kept him up.  "Did you tell her Yang goes or I go?" she asks.  "I don't think I'd win that one," Derek admits.  He tells  her that it was at least a little better when she had Burke, then tells her "Addison and I did counseling."  "Right before you got divorced," Bailey calls after him as he walks away.  She's not entirely convinced that's a good thing.  

Derek soon runs into Mark Sloan.  "I need you to have sex with Cristina Yang. . . distract her, engage her. . .give her something to do after midnight besides call my girlfriend and wake me up."  "Yang?  No," Sloan knows she is not the type - too "serious," "unfun" and "not his type."  Derek explains how she should be his type.  She's complicated, intense and intelligent.  "She's a single malt scotch and you're used to beer bongs."   "Callie Torres is no beer bong," Mark replies.  Then Derek appeals to his pride.  "Oh, you probably don't think you have a shot,"  he teases.  Sloan gets defensive.   Finally he asks it as a favor to him.  "I'm not your stud horse," Mark begins, "You slept with my wife" Derek finishes.  And Sloan suddenly agrees.

While Derek and Miranda explain the surgery to their elderly patient, they are making sure she is full aware that this particular surgery will be much "dicier" than any of the previous surgeries she's had.  They make sure she is aware that she can live several months with this tumor if she wants.  The patient explains that the pain is just too bad.  She couldn't live like this.  The patient and her husband agree that they want to sign the "do not rescusitate" form.  "I just hate lying around" she says explaining that she would hate to be on life support.  The couple says a very sweet goodbye to one another before she heads of into surgery.  A goodbye as if they'll never see one another again.  "Sorry, we do this every time.  She signs the paper, we kiss and hug goodbye, then after the surgery, we say 'hello' again."  As Bailey and Shepard walk away, Bailey tells him, "That there is the holy grail of marriages."   "Mmm.  Something to aspire to," Derek agrees.

"Dr. Yang, you paged me?" Mark asks.  "Yes," and she tells him about the patient they have.  "Oh, I was hoping you wanted to see me."  "I did," she tells him matter-of-factly and she again gives him the run down about the patient.  A confused Sloan does what he's told.

In surgery with their patient, Derek announces that he took care of his Cristina problem and it was easy.  "If it doesn't feel like work, it's not going to work."  Derek asks if she learned that in counseling and she jsut laughs.  She begins to marvel that this couple probably never had to go to counseling.  "They just took the bad with the good."  Things start to go wrong with the surgery.  "Lets make sure these two get a chance to say 'hello' again."   

After surgery Derek explains to the patient's husband, "It has been a difficult surgery, especially for her at her age."  "Oh sure," the husband says, "the waiting is always the hard part."  "Ed, she may not make it through the night," Derek explains.  "I know. I know," the second time not quite as confident.  He sits down to hold her hand.  

Soon the patient's machines start beeping because she's in distress.  The husband becomes frantic because no one is helping her.  Bailey calmly tries to explain that they are keeping her comfortable but because they signed the "DNR" they're not going to do any heroics.  The patient is still upset when Derek walks up to find out whats wrong.  He reiterates what Bailey has been saying and explains that even if they rescusitate her, she probably will not wake up.  The man starts to plead with his wife to come back.  At first gently then more and more frantic.  Her heart stops.  He scans the room to see no one getting up to help before starting compressions himself.   Bailey tries to stop him, but he refuses her help. After multiple attempts to stop the man and after letting much time pass, he admits he can't be theone to let her go.  Bailey takes over the compressions for him as Derek eases him to sitting down.  Soon Bailey realizes that she can't let go either.  Derek steps in and takes over the compressions.  He gives a few pumps and slows until he stops and the heart stops, too.  

In one last feeble attempt Mark Sloan asks Cristina to bring him some paperwork after her shift.  "I'm sorry did you say something?" is all Cristina replies. "Yang what is wrong with you,"  "Sir?" she says unwittingly.  "I've had women opt for needless elective buttock enhancement surgery just for another chance to be flirted with by me, so what's your deal?"  Still confused she says, "I have no idea what you're talking about."  "Ive been hitting on you all day," he admits.  She just laughs. "REally?" and excuses herself.  "It wasn't even my idea.  It was Shepard's idea," he calls after her.  Derek walks up to see the trail end.  "That woman is not a single malt scotch, my friend.  She is bad, cheap wine that gives you a headache you can feel in your teeth, " Mark declares and storms off.

Derek returns home to Meredith and finds Cristina and her are reading another diary.  "Sloan, seriously?" Meredith asks and they start laughing.  "What did you think we'd double date?" Cristina asks.  He says, "Look, I'm going to take my pants off so unless you wanted to stay here and see. . ." "Nope," she quickly replies and she leaves. "I'm going to see it later," Meredith says, "I'm going to go downstairs."

 more from this episode . . .