Derek (Patrick Dempsey) spent the greater part of the episode trotting around a diamond ring for Meredith (Ellen Pompeo), but he hadn't the faintest clue of how he was going to pop the question. Because it is a Grey's Anatomy cliche for Meredith to be the last to know about anything pertaining to her, everyone else found out about his plans to propose, and everyone had an opinion or two to share.
Richard was all about the Grand Gesture. He wanted Derek to procure flowers, candles, exotic foods, live musicians and a rowboat. Skywriting is not out of the question. To his credit, Derek seemed reluctant to go grand with his plan, saying that Meredith is not a grand gesture kind of woman.
At the other end of the spectrum, Meredith and Lexie's (Chyler Leigh) pregnant aneurysm patient Jen advised him to go the opposite route. Her husband proposed to her between the cat food and the tampons at the grocery store, and that ended up being very romantic.
In the end, Derek decided to take stupid Mark Sloan's (Eric Dane) advice on how to propose. (Thankfully, the proposal didn't actually occur, so Derek effectively gets a do-over. Who wants to bet that he'll blurt it out spontaneously at Joe's bar?) At Mark's urging, Derek trucked in tons of roses, candles and a white stuff bear and decorated their premarital bed with a heart-shaped pile of rose petals because chicks dig this stuff. This is the most sucktacularly hackneyed and completely un-Meredith route he could possibly have taken. Has he met Meredith? Her nickname is Death, for crying out loud. She is dark and twisty, not shiny and happy. For her sake, I'm so glad the proposal didn't happen this way.
I'm sure there are some people out there whose hearts melt at this kind of proposal in fact, I believe my own brother did something similar when he proposed to his wife but for my money, you should keep it simple, throw in a few jokes, maybe quote Monty Python and the Holy Grail in the middle of it. It should be personal and sincere. It should be your own personal version of what's romantic, not what you think you're supposed to think is romantic. In fact, when I get to that point in my life with my partner, I might do the proposing myself so as to have exactly what I want. My BuddyTV colleague, Kim Wetter, tells me that this is very lesbian of me, but I just want what I like.
As for the rest of the episode, there are two key lessons to take away: (1) group hugs involving three socially awkward people are awesome, and (2) always be careful when putting things in your butt.