'Grey's Anatomy' season finale: Izzie survives surgery -- or does she?

Tonight's two-hour "Grey's Anatomy" season finale was jam-packed with revelations -- about love, healing, fighting cancer, DNR orders, Bailey's marriage, and the fates of Izzie Stevens and George O'Malley.

And time's a-wastin', so here are spoilers galore...

Izzie's surgery: The first hour focused on whether or not Izzie would let Derek remove her brain tumor. It's an incredibly hard decision, since the tumor's in a place where her entire personality and functioning lives. A test to gauge how she'd fare with surgery in that part of her brain shows huge problems. Dr. Swinder (Kimberly Elise) argues against surgery; Derek, unsurprisingly, favors it. Swinder's had good results with drug therapy on another patient, Allison (Liza Weil), that made the tumor disappear. Initially, after careful consideration and a heartfelt and totally over the line talking-to from Meredith, Izzie decides against the surgery. Which forces Alex to abandon his "whatever you want" stance and lay down the law, telling her that not having surgery is not an option; it's his life too, and he wants her to have it.

But then Allison codes and goes south in surgery, leaving her on life support -- a heartbreaking turn of events that leaves even hard-core Swinder reeling. Izzie, who's having hallucinations about discussing her situation on a beach with Denny, finally finds solace with George, who assures her she already knows what to do. She finally  agrees to the surgery, but makes it clear she does not want to end up on a ventilator. She'll do the surgery, but she's signing a DNR (Do Not Resuscitate) order. Which makes Alex crazy -- until she explains that now she understands why Denny signed a DNR. If it comes down to it, she says, let me go.

Hour two opens with Izzie finally waking up from surgery, and thankfully being able to communicate, see, hear, and speak. She's Izzie. But for the time being, at least, she has no short-term memory -- her mind resets every five minutes. Mortified and determined to rescue her future, Alex works with her over and over to exercise her memory, first barking questions and then posting notes all over her room -- which was charming in "50 First Dates" but staggeringly sad and anxious here. She knows something's up and urges him to get it off his chest -- and boy does he unload. You made me promise you wouldn't live like this, he says. So now what do I do? Smother you with a pillow? Give you an overdose of morphine? Leave you?

Naturally, Izzie's upset -- it's never good to hear from your husband that being married to you is awful. Later she relays the story to Cristina -- and she can actually remember it on her own. Alex rushes back, thrilled that she's improving, and she goes limp in his arms. Alex insists that they save her despite the DNR -- and ultimately the Chief agrees, saying screw the DNR. How that one would make it past hospital counsel, I'll never know. Izzie flatlines, and while we can hear them working on her, we see her go into the elevator with her prom dress on. The doors close. They open again, and the voices get louder -- did they bring her back?

George's decision: George works a case with Hunt and Callie -- Charlie, a young Army Lieutenant who served in Iraq (Zach Gilford), wants them to amputate his lower leg, which seems healthy but is causing him incredible pain that doesn't respond to any kind of treatment. His commanding officer sent him to Hunt at Seattle Grace, knowing that Hunt would understand Charlie's feelings about not fitting into civilian life and the need to go back to war. But to do that, Charlie needs to rid himself of this pain and get a prosthetic leg. Callie's horrified at the thought of cutting off a healthy limb, but Hunt sympathizes -- and eventually George does too.

But it's more than that. George really seems to have found his calling in trauma surgery, and in a switcheroo that's designed to make us think it's Hunt going back to Iraq (Hunt tells Cristina he needs to go back because his work there isn't finished), George enlists to be a trauma surgeon in the Army. His relatively short trauma experience, combined with the fact that he's just a second-year resident, seems suspect to me, but OK. Everyone spends a large part of the second hour panicked and plotting an intervention to talk George out of enlisting. Except for Arizona, who thinks he's brave and awesome for signing up -- which totally appalls Callie. Turns out that Arizona's brother died in Iraq, so she supports anyone willing to go there and help.

George is supposed to be spending his last day at SGH in surgery, and they really could've used his help with a horrible trauma that comes in -- a John Doe pushed a woman out of the way of an oncoming bus, was hit and dragged for half a mile. He's just broken into pieces with massive injuries, and the woman who he saved becomes convinced he's her prince charming. Barely hanging on before his second surgery, John Doe signs a message on Meredith's hand: 007. John Doe is George O'Malley. And when Izzie's elevator doors open, he's standing there in his uniform -- on the other side. Which I'm interpreting as... he's on the other side. If so, RIP, Dr. O'Malley. And great work, T.R. Knight.

Derek and Meredith: There's work friction, of course -- particularly over Meredith's role in Izzie's surgery decision. But after they watch Izzie and Alex on the way to Izzie's surgery, they decide to get married at city hall, because Meredith says she doesn't want to spend another day not married to Derek. As a newlywed myself, I definitely understand the impulse -- both to take that plunge and avoid the wedding.

Just as they're leaving for city hall, Meredith gets a page. Derek concedes that today might not be the best day to do this, but Meredith points out that every day is like this. There's never going to be time to get married and have their lives unless they make time. And so, on a Post-It note from Cristina's "something old, something new" offering, they have a very sweet conversation about what they want to promise each other... wait, is that a slowed-down cover of FLASHDANCE playing in the background? Good grief. My brain just cleaved in two, and I can't decide: is that horrifying or awesome?

Not every set of vows contains the word "smelly," and this allows them to declare themselves married. The pressure is off -- the moment has been seized, love has been expressed, and amazingly, they're the healthiest people in the place.

Bailey's career: The Chief and Arizona are going head-to-head in a battle over Bailey (Arizona's speech to the chief about fighting him and winning made me fall in love with her a little bit. And I cry when I get angry at authority figures too.), and the Chief plays dirty by wooing her with a whiz-bang surgery robot that is admittedly cool and finds Bailey making lightsaber noises. Her heart seems to be increasingly in peds, though -- Arizona's speech about seeing the joy must've broken through -- and she gets the prestigious pediatric surgery fellowship.

But Bailey's husband tells her that if she takes the fellowship, he'll divorce her. When she asks the Chief if there's still space in general surgery for her, he assumes she's chosen her marriage over work. But nope -- she's leaving Tucker, because marriages shouldn't come down to ultimatims. Right on, Bailey -- be true to yourself. But she's not sure she can handle the dissolution of her marriage and a new specialty all at once. Brilliant performance by Chandra Wilson, as always.

Cristina and Owen: Owen's making progress in therapy, but he gets the notion into his head that he needs to go back to Iraq to finish his work. Cristina's having none of it -- patients still die, she says, and pushes him to deal with his life here. Namely, that he should tell his mother he's home. With Cristina in tow, he goes to see his mom, and finally he can sleep -- and without nightmares. He asks Cristina to make a go of it with him, and after watching Meredith, she finally believes that people can change, and that therapy can help. In a couple of very touching scenes in the boiler room and hallway, she takes a massive leap of faith and tells him she loves him. That is awesome.

Sloan and Little Grey: The gist: Mark asks Lexie to move in with him, a notion she completely blows off. Maybe in 10 years, she says. So in an effort to move on, he starts shopping for houses. It's much-needed comic relief, and much less annoying than it sounds. And yes, he is a better woman than Lexie.

What did you think? Did you see George's death coming, or did it hit you out of the blue? What do you think of the way they left Izzie? Can you imagine a Grey's with two semi-well-adjusted couples at its core?

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