Meredith tells her therapist that she's done with her sessions. The therapist tells her that she's not finished and has more work to do. Meredith tells her that she's moving in with Derek and her problems are over.
Derek runs into Izzy at the house and asks when she's moving out. Izzy flips out and asks the rest of the roommates if they knew they were getting kicked out. Izzy asks Meredith about their living arrangement and Meredith tells him she needs to think about it. Derek tells her that he wants them to start their life together.
The staff is assembled to hear Dr. Richard Webber's new rules. Meredith asks Cristina what she thinks she should do about her roommates, but Cristina doesn't want to talk about it. Mark, who is also at the meeting, teases Dr. Hahn about her relationship with Dr. Torres.
Dr. Richard Webber lays out the new rules: first second, and third year members will no longer get to be de facto experts, there will be no office relationships, the doctors will focus on their bedside manner either becoming nicer or less chummy, and they need to nurture their interns, if the intern fails then the doctor fails too.
The new rules has Meredith replaced by Cristine to assist a patient suffering from chronic pain. He's had the pain for seven years and has never been correctly diagnosed. Derek suggests that they perform a lobotomy. While discussing the operation, Derek asks Cristina if she agrees with his position on having the roommates move out. He tells her that if she answers, she can do the surgery to which she responds that she agrees with him. Dr. Lexie Grey, Cristina's intern, approaches them with information she read in an old medical journal that would suggest the patient needs an ENT. Cristina sends her away.
Lexie then goes to Mark and tells him about her patient. She asks him to look at him since he's an ENT. Mark enters the room and asks permission to see the patient. Derek allows it, but Cristina is angry. Mark sticks a poker up the patient's nose and is able to identify the pain. Lexie's diagnosis was correct and the lobotomy is called off.
Dr. Webber sets Dr. George O'Malley, his intern, up in an office to take his medical exam. Just as he's about to start the test, drops of water fall through the ceiling. He goes to Dr. Webber who tells him to find another room.
Dr. Alex Karev is escorting his patient, Jack O'Brien, in a wheelchair when the wheel gets stuck. Alex leaves him to get another wheelchair, but Mr. O'Brien gets up and walks. He then slips and falls and is carted off on a gurney. Mr. O'Brien explains to Alex that God hates him. His wife left him, his accountant stole from him, and now he's sent to a hospital for surgery and it's crumbling all around him.
Dr. Webber sees that the ceiling is leaking in several places and asks the maintenance guys what the problem is. They tell him a pipe burst and they need to shut off the water to fix it. He tells them the OR needs water and to fix the problem with the water left on.
Hahn goes to Torres and asks if she told Mark about their relationship. Torres says she tells him everything and Hahn gets upset.
Izzy's too chummy relationship with Shelly, a girl with liver cancer, gets her removed from the the case and Meredith put in her place. Shelly asks Meredith to give her some details about her life. Meredith asks if she wants to hear about her dumb boss or dumb boyfriend, to which Shelly responds boyfriend.
Dr. Miranda Bailey is showing Meredith how to perform the cancer removal operation, but they find the tumor is much larger than they had thought. They tell Shelly she'll need more chemotherapy. Upon hearing the news, Shelly asks Meredith if she's decided what to do about her roommates.
While examining Mr. O'Brien, Izzy takes out an ad for an apartment and asks Alex if he wants to move in with her because she can't afford it on her own. He tells her no, then the lights in O'Brien's examining room go out, leaving him