Grey's Anatomy: Didn't We Almost Have It All

The fourth hiker arrives at the hospital with an axe in his head. The other hikers first say it was an accident, but then admit that they did it on purpose. Adele has a miscarriage, but reveals it was Richard's baby and they reconcile. Rebecca's husband, Jeff, arrives. Rebecca asks Alex if there is any reason that she shouldn't leave with Jeff. He says there isn't, but later regrets it. Callie and George decide to try to have a baby. Richard has meetings with all the attendings. He selects Derek to succeed him, but Derek turns it down, saying he wants Richard to continue with the job. Callie is chosen as Chief Resident over Miranda. Izzie tells George that she loves him and hopes he loves her too. Derek tells Meredith that he loves her but needs to know if she sees a future with him. She doesn't answer. The interns' first exam results arrive and everyone passes except for George, who doesn't know what he's going to do. He goes into the locker room where he meets the new set of interns. One of them, the same girl who asked Derek for a drink, introduces herself as Lexie Grey. At Cristina and Burke's wedding, she hesitates to walk down the aisle when she realizes she forgot her vows. After a noticeable delay, Preston goes to talk to her. He says he knows she doesn't want to do this, but that she was only doing it because she loves him. And that if he really loves her for who she is, instead of whom he wants her to be, he wouldn't be waiting for her at the altar, he would be letting her go. Meredith informs the guests that the wedding is off.