Alex uses Izzie's modeling against her, and her last ad causes a patient to reject her care. Meredith finds parallels between a patient and her mother, and Christina must deal with a hospital-savvy patient.
George feels less masculine when Izzie and Meredith treat him like a sister. When Izzie's last modeling shoot is published Alex decides to play a cruel joke on her, and a patient recognizes her. Meanwhile, Derek treats a patient who has several nails stuck in his head, and a woman who knew Meredith's mother arrives in the hospital.—Alex