Number one rule of surgery is limit exposure. Keep your hands clean, your incisions small, and your wounds covered. Number two rule of surgery is when rule number one stops working, try something else. Because sometimes you can't limit exposure, sometimes the injury is so bad you have to cut, and cut big. In surgery, the healing process begins with a cut, an incision, the tearing of flesh. We have to damage the healthy flesh in order to expose the unhealthy. It feels cruel and against common sense, but it works. You risk exposure for the sake of healing, and when it's over, once the incision has been closed, you wait. You wait and hope that your patient will heal. That you haven't in fact, just made everything worse.

I Like You So Much Better When You're Naked is the twelfth episode of the sixth season and the 114th overall episode of Grey's Anatomy.

Short SummaryEdit

After learning of Richard's drinking problem, Derek confronts him for the sake of his friend and the hospital, Izzie returns, hoping to reconcile with Alex, and tensions run high between Teddy, Cristina, and Owen in the aftermath of Cristina's startling confession.

Full SummaryEdit

Bailey is performing a hot chemo lavage and explains the procedure to everyone in the crowded gallery. As Callie notices that Bailey's seen her, she wants to go. She had a headache and needs coffee, but Arizona whispers she has a cure for headaches that doesn't involve coffee. They leave and Teddy takes Callie's seat next to Cristina. Cristina thought Teddy was leaving, but she has to finish out her contract, which has a few more weeks. Cristina says she didn't mean what she said about Owen. Teddy agrees to forget about it.

Meredith and Derek are arguing in their bedroom. He wants to report Richard, but she doesn't want him to as it'll end Richard's career. She thinks he's only doing this because he wants the Chief's job. Derek is going to report Richard anyway, because it's wrong. She calls post-it, because she told the secret about her friend to her husband, not the head of neuro, so the laws of post-it prevail. He thinks it's wrong, but she keeps calling post-it. He angrily agrees not to tell, and kisses her. They start making out until her pager goes off. Izzie's coming home, so she has to tell Alex. Even though he's not going to the board, he wants Meredith to think about what she said.

Meredith walks into Alex's room to tell him about Izzie, but then sees Lexie's in Alex's bed too.

Meredith is giving Alex and Lexie a speech. Alex doesn't care, but Lexie feels really guilty. Meredith says they're all gone keep their mouths shut about this. Izzie's coming home and no one needs to know. "Know what?" Izzie suddenly asks from the doorway.

Derek storms into Richard's office. There were no sterile supplies last night, making surgery come to a full stop for a complete hour. Richard knows, it's being taken care off. Having noticed Richard's strange behavior, Derek says he wants to help, but Richard says he can only help by doing his own job and letting him do his. Derek leaves, distraught.

Izzie went to the trailer first, but she noticed Alex doesn't live there anymore. There's an awkward silence and Izzie brings up that Meredith mentioned he's moving on. She realizes now she was wrong blaming him for getting fired. She apologizes. He interrupts and says he doesn't want to have a big talk. He needs to leave for work. She brings up she has a PET scan at the hospital later, so she might see him there. She has applied for some residency programs, so she's having the scan to make sure she's stable. One of these programs is in Tacoma, so they can be okay if she takes it. He really needs to leave. She jokes he's gonna be jealous when she'll be working in Tacoma then.

Richard is writing his name on the OR board, taking Bailey's whipple. Jackson and Meredith are gonna assist. Jackson can open up, so Meredith is fresh when she gets to disect the neck of the pancreas from the portal vein. That's the hardest part, Meredith remarks. And a fifth-year procedure, Jackson adds. It's what they've been practicing, so Richard is sure she can handle it. 

Some guy is singing loudly in the ER. Alex asks Hunt if he can help out in the trauma room. By making the guy shut up, Hunt says. 

Alex walks up to the patient and yells to stop. The man is singing to make them understand the seriousness of the problem. He's lost his upper register completely. Alex starts examining and Aaron says his boyfriend gave him bronchitis, which is the cause of the problem. Jeffrey says he didn't give it to him, but Aaron insists he did. Aaron's gonna need an X-ray, but Alex tells nurse Tyler to page an intern for that, as he doesn't have time himself. He returns to the trauma room, but Hunt's already taken up his patient to the OR. "Got time now?" Tyler asks, and as Alex takes the chart, Aaron starts singing again.

Arizona and Callie are making out in an on-call room. Arizona feels Callie is hot, as in fever. She then sees Callie has chicken pox.

In a conference room, Cristina tells Meredith all about Teddy and Owen and what happened. Cristina is finally feeling like herself again now that she has Teddy, and she loves Owen but she also loves Teddy, so she has no idea if she meant it when she said Teddy could have Owen. Meredith tells her not to talk about stuff like this, but Cristina wonders what Meredith would choose gun to her head: surgery or Derek. 

Arizona brings Lexie to Callie's patient room. Arizona snooped through Lexie's personal file, so she knows Lexie's already had the chicken pox, whereas she hasn't. Callie wants to leave, but Arizona doesn't allow it as she's highly contagious. As she scratches, Callie tells Arizona she's gonna kill her. Arizona replies to stop scratching, as it only makes it worse and it'll give her scars.

As Meredith is practicing in the skills lab, Izzie tells Meredith she needs to get her hands in a body again. She really wants this Tacoma thing. A call from Derek Shepherd would help with that, Izzie whispers as Derek walks in. As she leaves, Meredith informs him on Izzie's request. Derek saw that Richard is doing a whipple. This worries him, as a whipple is a difficult procedure and Richard hasn't operated in months. He doesn't trust Richard anymore, but Meredith calls post-it again. Derek kisses her and leaves. Meredith tells herself that Richard is fine.

Teddy, Cristina, and Alex are in Aaron's room. Teddy shuts Cristina up to let Alex talk, as he made the diagnosis. There's a chance it's cancer. Aaron worries they might have to take out his lung, which can't happen, because singing is his whole life. Besides me, Jeffrey adds, but Aaron doesn't seem to agree.

Bailey catches up with Derek. She says Richard took her whipple, only to let Meredith do the pancreatic dissection. She performed that procedure for the first time just last year. The Chief's judgment is not clear and rational, she concludes. Derek says there's nothing he can do, but she replies he's the only one who can. She performed her first hot chemo lavage this morning. It was a big deal for her, but the Chief was not even there to see it and she doesn't even know why she thought he would show. The truth is he's gone, and he's been gone a long time. She walks away, leaving Derek to overthink the matter.

Lexie walks into Callie's room with some work, as Arizona thought it might take her mind off the itching. Callie desperately tries to get Lexie to take off her gauze paws, but Arizona anticipated everything Callie would try, so she instructed Lexie on how not to bend. As Callie continues to complain about the pain, Lexie blurts out that she's had sex with Alex, which she regrets as she loves Mark, but she's afraid she can't handle everything that's going on in his life. She's telling Callie to show her that she's in pain too. Callie doesn't find it comparable and throws her out.

The residents are having lunch while Meredith is practicing on a corpse. Cristina brings up the love/surgery dilemma. Izzie comes in with lunch too, as her PET scan got pushed back. Cristina continues to pressure them to choose. Meredith admits she'd choose surgery, which makes Cristina happy. Izzie thinks it's crazy. Surgery is a job, the thing you come home from, not the thing you come home to. "If you lose your job, you can always get another one, but if you start losing your love, suddenly nothing else matters," she says as she looks at Alex. Alex replies that it's love that comes and goes, surgery doesn't. Alex and Cristina take off as Meredith finishes dissecting successfully.

Teddy, Cristina, and Alex tell Aaron that he has lung cancer in his left lung. The worst case scenario is that they have to resect the lung. Jeffrey understands it's also possible they won't have to remove any lung tissue, but Aaron is not interested in the optimistism. Losing a lung would mean that his life is over, as he can no longer sing then. He explains that because he's too big, physically and emotionally, he spends all day making himself smaller. On stage, at night, is the only time he can stop doing that. He doesn't want to live if he's gonna have to spend all day making himself smaller.

Owen sneaks into a lounge to hide sterile supplies in a closet. Derek witnesses it, and he understands why Owen's doing it. Derek says wants to do something that he feels he needs to do because of his responsibility, but Meredith is stopping him. The other half of the twisted sisters, Owen remarks. Derek explains he'd come out pretty bad, like he did it for the wrong reasons, for himself. Owen learned in the army that doing the right thing is when it's the best for the most people.

Izzie is lying in the scanner and Alex is with her. Izzie wants to know if he's really moved on. He admits he slept with someone, but she thinks they can get through it. He holds her foot to let her know he's still there with her.

Derek enters Richard's office and puts down a bottle of booze on the desk. He takes a glass and pours Richard a drink. He doesn't want Richard to drink it, but he knows Richard is gonna drink it anyway. He also believes this won't be Richard's first drink today.

Teddy, Cristina, and Alex are operating on Aaron. It turns out removing the lung offers the best chance of survival, but she decides to remove the visible tumor and treat the lung with intrapleural hot chemo therapy. She sends Alex to find out what Bailey used in her procedure this morning. She understands Aaron needs his lung.

Callie wakes up with Mark by her side. He says he's had them when he was 6 and climbs into bed with her. He tells her Addison did the surgery and that Sloan and the baby doing good. And he slept with Addison. She advises him not to tell Lexie. Mark starts rubbing her to ease her pain, which she enjoys, and it won't give her scars. 

Alex informs Jeffrey that they saved the lung, so Aaron's gonna be fine. Jeffrey is a little disappointed, as he thought Aaron was finally going to be like the rest of them, doing the things he now finds so demeaning. What really is demeaning, Jeffrey says, is loving and taking care of a man who thinks so little of you. Alex suggests he can walk out, but Jeffrey loves him too much to walk away.

Meredith and Jackson are in the OR, waiting for the Chief. However, instead, Bailey shows up as Webber got caught up. Bailey refuses to let Meredith perform the pancreatic neck dissection. Meredith sighs and leaves.

As Meredith leaves the scrub room, Derek says he's sorry that she didn't get to do the procedure, but it's not a surprise to him that Richard got caught up. She refuses to turn him in. Derek informs her that Tacoma passed on Izzie beause of her history. If he can go the board, the first thing he's gonna do as the Chief is hire Izzie back. The choice is up to her, but she walks off angrily.

Arizona and Lexie are watching Callie and Mark cuddle. They know not to be jealous. Arizona reveals she's had the chicken pox already, but she told Callie she hadn't because she was afraid it would take them out of the sexy part of things. And now Mark is making scratching look sexy. 

Cristina and Teddy are watching Aaron. Cristina knows that Teddy gets that Cristina would choose surgery over a guy. She won't apologize for it, especially to Teddy, as she understands the patient's desire not to live without his gift. Cristina chooses her gift too, and she wants to learn from Teddy to be great.

Izzie walks into Meredith and asks her if Derek has talked to Tacoma yet. Meredith pretends not to know. Izzie is happy because she got her scans back and they're really good, so Derek could mention she's officially not dying of cancer when he talks to them. Izzie feels good about getting the job, and then getting Alex back and becoming herself again. She can feel it. Izzie wants to go show Derek her scans, but Meredith says she'll go tell Derek so that Izzie can go tell Alex.

Meredith finds Derek and allows him to go to the board, although she kind of hates him for it.

Owen sits down with Teddy at Joe's. Teddy's already drunk and she mentions how Beth was not good enough for him as Beth told her once that as soon as she and Owen got married, she'd stop teaching and just raise their kids. Teddy knew Owen doesn't like someone with zero ambition. And then there's Cristina, who's the exact opposite. She keeps on rambling that she gets why he loves her, and she blurts out that she was willing to trade him for her. Owen is shocked.

Izzie sits down with Alex in the residents' lounge. She shows him the scans. They hug. He's genuinely happy for her. She says it's like it never happened, but he says it did happen. They got through it, and he's on the other side now. He loves her so much, and he used to think he wasn't a good guy before he met her. Now, after all of it, he knows he's good guy and he thanks her for that. However, he now also knows he's good enough not to deserve this, loving her so much it hurts. He deserves someone who's gonna stay for him. He's genuinely happy for her, but he wants her to go and be happy and not come back, because he's finally happy again.

Richard is sleeping on the couch in his office. He wakes up with Meredith by his side. Outside of the office, Larry Jennings and two other board members are waiting to come in. He starts apologizing for not showing up for the surgery, but she tells him he doesn't have to apologize for anything. She leaves, and then Richard sees the board members, knowing what's gonna happen.

Owen shows up at Cristina's. She didn't know where he was and left him messages. He walks in and passionately kisses her. She stops him and asks what's going on. She makes him sad by thinking a successful career is gonna make her happy.  He wants her to know that people and other things do matter too. He matters. They matter. So she doesn't get to toss him aside, and he won't let her. She starts crying and kisses him.

Lexie runs after Mark as he's on his way out. She asks him about Sloan's surgery, but all he says is that he slept with Addison. She reveals she slept with Alex, so it's good that he slept with Addison, because then they're even. He's shocked to hear that while he was dealing with his sick daughter and hurting, she slept with Alex. She mentions he wasn't exactly hurting as he slept with Addison, but he replies that she broke up with him, left him. He can't even look at her right now.

Izzie is packing her stuff. Meredith says she has no idea what it took from her, but Izzie really doesn't want to stay. Meredith says she can't just throw people away, but Izzie can't stay here. She needs Meredith to understand that she needs to start over. "Please don't go. This is your home," Meredith says. Izzie replies it's not her home anymore. It's just a place she worked and she can do that anywhere. Meredith walks away.

Arizona climbs into bed with Callie, who doesn't understand what Arizona is doing. "So I get the chicken pox," Arizona says as she starts cuddling.

Meredith and Derek are lying awake in bed. Meredith asks if he saw Richard before he left. Derek didn't, as he didn't think it'd make things easier. He's sure it's the best thing for Richard, and he knows that Meredith knows it too. "Let's not pretend you did this for him," Meredith says. She knows he did it for himself. In the choice between surgery and love, he chose ambition. He bounces back that she did so too. She knew he wasn't ready to do that surgery, but she wanted to do it so bad that she was willing to overlook it. Derek concludes they're the same and tries to go to sleep as Meredith lies awake beside him.


  • Meredith Grey
  • Cristina Yang
  • Izzie Stevens
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Owen Hunt
  • Arizona Robbins
  • Derek Shepherd
  • Teddy Altman
  • Larry Jennings
  • Jackson Avery
  • Jeffrey
  • Aaron Mafrici
  • Nurse Tyler Christian
  • Trauma Nurse and Alex Karev

Main CastEdit

Guest StarsEdit


Medical NotesEdit

Bailey's PatientEdit

  • Diagnosis:
    • Cancer
  • Treatment:
    • Tumor resection
    • Intraperitoneal hyperthermic chemotherapy

Bailey did a hot chemo lavage on a patient after resecting a tumor.

Izzie StevensEdit

  • Diagnosis:
  • Doctors:
  • Treatment:

Izzie said she was having a PET scan so she could show the hospitals she was stable when she applied to residency programs. She later said the scan results were really good.

Webber's PatientEdit

  • Diagnosis:
    • Pancreatic cancer
  • Treatment:
    • Whipple

Webber was going to do a whipple on a patient of Bailey's, but he ended up having Bailey do it.

Aaron MafriciEdit

  • Diagnosis:
    • Pleural mesothelioma
  • Treatment:
    • Tumor resection
    • Intrapleural hyperthermic chemotherapy

Aaron came into the hospital and believed he had bronchitis. However, scans revealed that he actually had lung cancer. They said that best case, they'd only have to remove the tumor and wouldn't have to remove any lung tissue. However, in surgery, they discovered that the cancer was widespread. The safe treatment was to remove his lung, diaphragm, and pericardium. However, because Aaron didn't want that, they removed the visible tumor and use hot chemo lavage to treat the rest.

Owen's PatientEdit

  • Diagnosis:
    • Car accident injuries
  • Treatment:
    • Surgery

Owen had a patient who was in a car accident. He took the patient to surgery.

Callie TorresEdit

  • Diagnosis:
    • Chicken pox
  • Treatment:

Callie developed chicken pox. She was admitted to the hospital.

Callie's PatientEdit

  • Diagnosis:
    • Various
  • Treatment:

Lexie brought Callie the case files for several of her patients so she could work and get her mind off the itching. She had a tibial plateau fracture in room 2240 and a Lisfranc fracture in 2211.


Song Performer Scene
"Everybody" Ingrid Michaelson
  • Bailey explains the procedure she is doing in the O.R. while the gallery is filled with doctors observing.
  • Callie has a headache, so she and Arizona leave to have sex..
  • Cristina and Teddy talk in the gallery about what Cristina said.
"Something Bigger, Something Better" Amanda Blank
  • Callie and Arizona make out until Arizona realizes Callie has chicken pox.
"Oh Dear" Brandi Carlile
  • Owen is shocked to hear what Cristina said.
  • Izzie shows Alex her scans.
  • Alex tells Izzie that he deserves better and lets Izzie go.
"Your Side Now" Trent Dabbs
  • Meredith wakes the chief while the board waits. 
  • Owen won't let Cristina trade him.
  • Lexie runs to catch up with Mark.
"Better" Matthew Mayfield
  • Mark and Lexie talk outside the hospital. He walks away.
  • Izzie packs her stuff and is leaving. Meredith tries to talk her into staying.
  • Arizona climbs into bed next to Callie, even though Callie has the chicken pox.
  • Meredith and Derek are in their bed, talking about choosing ambition over love.

Notes and TriviaEdit

Grey's Anatomy 6x12

Grey's Anatomy 6x12

  • This episode's title originated from the song I Like You So Much Better When You're Naked, originally sung by Ida Maria.
  • This episode scored 12.70 million viewers.
  • This episode marks the last appearance of Katherine Heigl as doctor Izzie Stevens. It was supposed to be Katherine's last episode before her maternity leave, but she didn't return to set afterwards and asked to be released from her contract.
  • This episode marks the 100th voice over to be narrated solely by Meredith Grey.
  • When Dr. Webber is writing his name on the O.R Board for Bailey's whipple, the camera zooms out so the audience can see the whole O.R Board. And a Ramirez, S. is scheduled to have a Transesophageal Echocardiogram. Ramirez, S. = Sara Ramirez (Callie Torres)
  • Callie's chicken pox storyline originated from a story Sara Ramírez told the writers about being quarantained in college when she had chicken pox herself.


Episode StillsEdit


Meredith: (catching Alex and Lexie in bed) Izzie leaves and Mark gets a kid, and you two decide the best way to deal is to get drunk and mash your genitals together?
Alex: No freaking way you get to judge us or give relationship advice. Besides you were a total dirty mistress like two weeks ago.
Lexie: Are you calling me a dirty mistress?
Meredith: That was two years ago and his wife didn't have cancer!
Lexie: Because I've been with like six guys in my whole life. Alex and I, we've done it before. I was recycling, it was like good for the environment.
Alex: Izzie's gone. I was horny. She was there.
Lexie: Oh crap, I am a dirty mistress. Oh god, you're gonna tell Derek and then Derek's gonna tell Mark that I'm a whore.

Callie: Okay, she saw me. Now I can go.
Cristina: She's just getting started.
Callie: Yeah, I have a headache. I need coffee.
Arizona: I have a cure for a headache that doesn't involve coffee.

Cristina: Where have you been? You just disappeared. I left you, like, ten messages. Are you drunk? (Owen grabs her and kisses her, she pulls away) Wait, what? What? What?
Owen: You make me sad. You think that surgery is going to make you feel, you think a successful career is gonna make you happy, you think you know things, you know things and nothing else matters. No one else matters. People do matter. I matter. We...we matter. So you don't get to toss me aside. I won't let you.

Izzie: It's like it never happened.
Alex: Yeah, but it did. It all happened, Iz. You got cancer, and we got married, and you died and you lived again. And you left, then you came back. And we got through it. I got through it. And I'm on the other side. Iz, I love you so much, and I... Till I met you, I used to think I just wasn't a good guy. Growing up with my family, I mean, that's what they told me. But now, after all of it, I know that I'm a good man. And I thank you for that, Because I know now that I'm good enough not to deserve this... Not to have to feel like this... Not to love you so much that I almost hate you. I deserve someone who will stay. I'm happy you're okay. And I'm happy about your job. And I want you to go... And be happy and not come back.

Meredith: Do you know what it took for me to make this happen?
Izzie: Please tell Derek I'm really sorry.
Meredith: This isn't about Derek. It's about me. It's about us. You don't just walk away from people. You don't just throw people away.
Izzie: I can't, Meredith. Okay? I can't be here. Please. Please try to understand. I have to start over. I need to start over, okay?
Meredith: Please don't go. This is your home.
Izzie: No, it's not, not anymore. It's just a place I worked, and I can do that anywhere.

Owen: You make me sad. You think that surgery is gonna make you feel. You think that a successful career is gonna make you happy. You think you know things. You know things, and nothing else matters, no one else matters. People do matter. I matter. We matter. So you don't get to toss me aside. I won't let you.

Cristina: So you get it. You didn't have to do that, but you did. You get it.
Teddy: What are you talking about?
Cristina: I choose surgery over a guy. I'm not gonna apologize for it, especially to you. You didn't have to save his lung. The right thing would've been to remove it. But the patient was clear that he didn't want to live without his gift, and you get that. I choose my gift. I want to be great, and I want to learn from you. I choose my gift.

See AlsoEdit

A complete overview of this episode's crew can be found here.

The Grey Matter blog post on this episode can be found here.

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