To hide her own medical crisis, Izzie enlists the interns to diagnose "Patient X" as a competition, not revealing that the life-threatening test results they are analyzing are actually her own.
Derek's confidence is severely shaken when he and Addison clash over the treatment of Jen, a dying pregnant patient with a brain aneurysm. After Jen passes away, her husband publicly labels Derek a murderer, triggering a deep professional and personal spiral for the neurosurgeon.
Dr. Bailey is devastated to receive a generic "form letter" recommendation from the Chief for her pediatric fellowship. Webber eventually admits his lack of effort stemmed from his disappointment that she was "abandoning" his dream of her one day taking over as Chief.
Cristina Yang identifies a major surgical error made by the hospital's first female surgeon, Dr. Margaret Campbell (guest star Faye Dunaway). After initially dismissing Cristina, Campbell realizes she is no longer at her peak and decides that this surgery will be her last.