An exhausted Meredith thinks she may have made a mistake during surgery, which could jeopardize her career. Alex deals with a patient who is addicted to painkillers, and very stubborn about getting them. George’s patient’s complaints stem not from continued smoking but from a mistake made in surgery five years ago at Seattle Grace. Meredith and Derek have sex in a car, and are caught by Dr. Bailey. Cristina and Burke also have sex in the on-call room.