Izzie Stevens wakes up early and goes to the closet to get a sweater down from the closet.  She holds it close to her face to get a good smell of who once wore it – Denny.    As they are walking in to work this morning, she stops outside for a moment.  Alex Karev stops to make sure she’s alright – knowing that Hahn’s case has brought up old feelings about Denny.  .   “That’s stuff in the past, stuff in the past, Izz,” he remind her.  “You don’t understand,” she tells him.  “ I might if you talk to me,”  but after a silent pause he says, “Fine,” gives her a smooch and heads in.  Izzie waits a minute more before walking in alone.  She is immediately greeted by Denny inside.  He’s talking to her now, trying to get her to talk to him, asking how she’s doing.  Izzie’s doing her best to ignore him, but it’s hard.  She reminds herself out loud that she is alone several times.

 Meanwhile Chief is giving Miranda Bailey the instructions that she needs to be his “ambassador today.”  He’s trying to woo Dickson over to joining their team and he needs Bailey to help.  “But she’s a little different, she’s a little off,” he tells her, “so we’re wooing today.”  “I can woo with the best of them,” Miranda tells him.  Alex is sarcastically asking if she’s going to be crazy cause he’s had his share of crazy this year.  Bailey quickly puts him in his place and reminds him their job is to impress her today before an eager Izzie Stevens arrives with the chart.   The three are introduced to Dr. Dickson – a woman who stands out like a sore thumb dressed all in red in a hospital full of white-clad doctors and nurses.  While Bailey tries to introduce herself, Dr. Victoria Dickson stiffly extends an arm saying, “I brought my own lab coat, I’m here to perform a heart transplant today, a new heart, a procedure invented by Christian Barnet in 1967.  I do hearts.”  She never made eye contact once and they are uncomfortably aware of what “a little off” means.

Bailey soon takes Dr. Dickson for a tour of the surgery area, telling about the latest equipment, etc., but Dr. Dickson just starts spouting out random facts about surgery back to her.  Soon Alex joins them and Bailey asks him to give her an update.   He begins to explain what is going on with the patient’s heart - was too small so they transplanted another heart in on top of  it – a “piggyback” surgery, but Dr. Dickson corrects him, “heterotopic transplant, ‘piggyback’ is the colloquial name for the procedure.  Don’t do that.”  After the awkward silence is finished, they take her to meet the patient.

Isobel Stevens has been in meeting with the heart patient.  He tells her all about how he never should have taken the heart in the first place.  The man is  a Navajo Indian and his people believe that you should never touch a dead body let alone accept an organ from one.  He believes that he’s been haunted ever since for having another person’s heart in his body.  All the while, Denny is there in the room haunting Izzie and interjecting his thoughts on the case.  The patient tells her that he doesn’t want the heart anymore.  He wants them to take it out and if that means he dies, at least he will no longer be haunted.  Just as he’s saying this, Dr. Dickson enters the room to over hear his request.  She explains, “Are you aware that without a new heart, you will live a short life attached to a machine before dying a sudden and agonizing death?”  Denny says, “That’s what I’m talking about.”   The man respects her opinion (which she assures are facts) but reasserts that he doesn’t want another heart.  “What he’s trying to say,” Izzie explains, “is that he’d rather live a shorter life that’s unhaunted than a longer one that that is.(long silent pause) Not that I agree, I’m just saying.”  No one is sure how to respond so Izzie excuses herself to stand at the back of the room (by Denny).   The patient begins asking what is going to happen to the heart after it’s removed from his body.  Dr. Dickson explains that there are very strict rules about how the hospital disposes of the heart.  Bailey steps in  and proposes a compromise – give the patient the old heart and let Dickson put in a new heart – but they both quickly say no.  Bailey takes a step back.  “There are rules,” Dickson says,  “There are laws and rules.  No,” and she walks out of the room.

Bailey finds her way to the Chief and begins asking him about rules.  She wants him to assert for her that if the patient has cultural or religious beliefs, the hospital can make accommodations.  Richard knows that it is common courtesy to practice this way.  He doesn’t understand why she’s asking him to declare a rule of something that they already do.  “Dr. Dickson doesn’t do common courtesy, but she understands rules, so if it’s a rule, we’re golden, if not we have a pissed of patient, an apoplectic surgeon, and none of those things makes for a successful procedure on a faulty heart.  Not to mention the failure to woo.”  She doesn’t care how he does it, but he finally declares, “It’s a rule.” Bailey thanks him and leaves.

Meanwhile, Cristina has finally found a moment to come and introduce herself to the new Dr. Dickson.  She is eager and polite and tells her she is honored to meet her before Dickson asks, “Are the other ones taken off my case?”  Cristina confused asks, “What other ones?”  “The black one, the male one, the woman with yellow hair?”  “Not that I’m aware of,” Cristina tells her.  “Then why are you talking to me?” Dickson questions.  Cristina, left speechless leaves and Dickson continues reviewing the chart of her patient.

Izzie is in with the heart patient and begins to ask more questions about the unhaunting process in his culture.  Denny is still there with her interjecting his comments until finally the patient asks why she is so interested in his haunting.  She finally asks what she really wanted to know.  She asks if ghosts can do thing, make things happen because there have been a lot of things lately in the hospital to remind her of her dead fiancée.  He asks her if the ghost is there now and she realizes that he now will not want her in his surgery.  “I just don’t need any extra ghosts in my surgery,” he tells her.

While Alex is marveling at the efficiency of Dr. Dickson’s technique in surgery, Bailey seizes the opportunity to explain the ‘rule’ to her.  “There is a rule about giving medical waste to a patient.  There is an official, very, very specific rule  that in the event a patient asks for their organ or body part back for any reason or involving their cultural beliefs, we must respect that patients wishes and return that organ to the patient.  That is the rule I forgot to tell you about.”  “If I walked out to pathology and asked them about that rule right now, would they tell me?” Dickson asks.  Bailey assures her that the Chief would know about the rule because it’s the Chief’s rule.  Dickson turns to Karev and tells him to make sure he follows the rule and gets the heart to the patient after surgery.  They continue on.

Up in the observation deck, Izzie is having her own personal struggle with Denny.  He keeps trying to have conversations with her.  “Do you know what I wished every day after you died,” she asks, “I wished that I could see you again.  I’d have given anything just to see you one more time.  Looking at you and knowing I can’t touch you . . .it’s killing me.”  “Izzie, you can touch me,” Denny says.  “You’re not real!”  She insists.      She goes on insisting he’s not real and something must be wrong with her while he goes on insisting that she just reach out and touch him.  She refuses.

Dr. Dickson finishes up the surgery and they remove the transplanted heart from his chest.  They begin preparing to set him up on bypass when all of the sudden Bailey asks, “What the heck is that?”  The patients heart – his original heart is beating again.  Dickson is bewildered “That’s not right, this is not normal.  That heart is beating. It shouldn’t be beating, it shouldn’t be beating.”  But now there’s nothing left to do but close him up.  

Trying to explain this anomaly to the patient they really have no real explanation.  He’s finally free - no longer haunted.  Dr. Dickson begins to explain how she’s read of cases before where this has happened – after years of rest, the heart picks up and beats again.  She’s never seen it herself before.  “You have your beliefs, I have mine,” he explains.  “I don’t have beliefs,” Dickson explains, “I have science.”  “Science is a belief,” he tells her, “A belief in only what you can see and touch.  I believe in more.”  She has nothing more to say.

Izzie returns to the heart patient to learn more about his beliefs on haunting.  She asks what will be done with the heart.  He explains that the medicine man of the tribe will burn it.  They believe in burning all of the belongings of the deceased to cleanse it away.  “The spirit can cling to anything.”

Dr. Bailey gets on the elevator with Dr. Dickson at the end of the day.  “Excellent job. . . excellent rule following,” Bailey says.  There is a pause before Dr. Dickson begins, “I only have one real area of interest - the human heart I love it.   I like it’s regularity. I know everything there is to know about it.  I like it’s predictability.  It has rules.  Everything about it has a purpose.  Every chambers has a function, every function has a movement.  I like the color.  It’s comforting.  Are you familiar with Asperger’s Syndrome, Dr. Bailey?”  “Of course I do, significant impairment in social situations,” and the light goes on for Bailey.  Dickson continues, “I’m not good at social cues like sarcasm or condescension, but I do know when I’m being manipulated and I know when I’m being made fun of.  I don’t think I like this hospital very much.  I don’t think I like this hospital at all.”

As Izzie leaves the hospital, she is still not alone, “I love you.  I will always love you.  You own a piece of me, so even though you are gone, you will never be forgotten. Not by me.  I’m sorry we never got our chance.  I’m sorry we never got to get married or have children, or grow old together.  I wanted that so much.  I wanted to be your wife, more than anything.”  “Why are you telling me this,”  Denny asks.  “I’m trying to let you go, so that your soul can be at peace.”  “I am at peace,” he tells her, “I’m here for you.”  “Goodbye Denny, I love you, but goodbye.”  She walks away and you see Alex Karev standing behind watching her the whole time.

Alex comes home to Izzie and says “I see you.  I’ve seen you all day.  You’re struggling with something.  Let me help you.”  She asks him to burn  Denny’s sweater for her.  Alex burns it while she watches from afar before retreating to her room alone.  She closes the door behind her and opens her eyes to the startling sight that Denny is there.  She begins freaking out.  She said goodbye and burned the sweater and thought he’d be gone.  Denny jokingly says thanks because he loved the sweater then explains again, “I’m here for you.  Izzie, look at me.  .  . touch me.”  She’s very hesitant to try, but when she does, she can feel him.  “See, told you I was real,” he says.  She smiles and they embrace in a kiss.  The voiceover saying “The ties that bind us are sometimes impossible to explain.  They connect us even after it seems like the ties should be broken . . . because some ties are meant to be.”              

more from this episode. . .