January 23, 2009 12:00 AM

Thursday’s Grey’s Anatomy was the kind of gut-wrenching episode fans live for, but don’t get very often. It was tense and emotional as the serial killer and dying kid cases both came to an end. But lest you forget that these folks like to walk a fine line between comedy and drama, they threw in some broken man bits for good measure. — Carrie Bell

Right to Die: Meredith (Ellen Pompeo) ignored the convict’s suicide attempt and subsequent seizure as long as possible and didn’t tell Derek (Patrick Dempsey) what had happened. But when Yang (Sandra Oh) checked in, the patient changed his mind and Der was paged. He was livid with his girlfriend and forced her to watch him undo her mistakes.

Bailey’s (Chandra Wilson) attachment to her case sent her into the O.R., begging McDreamy to stop working on the murderer so she could get the organs for the dying kid. Der reminded her about the oath they took and asked, “Am I an executioner or a surgeon?” She relented and Der and Yang saved him, which Mer called “a waste.” Der charged that the killer was playing her all along, a claim he tried to make himself when he awoke, but Mer said she knew he was just scared of death because she would have been too. He asked Mer to be the friendly face at his execution. She complied and found Der waiting for her at the gate. “I wanted to show him compassion,” she said. “And it was horrible.” Despite their differences, Der offered a shoulder to cry on and when she still wouldn’t stop, he went to Yang for reinforcements.

The Chief (James Pickens, Jr.) found a patient who was being taken off life support that day and convinced his wife to donate his organs in the knick of time. Bailey came clean about “crossing a line” and the Chief surprised her by admitting he had too, which led to her tearful breakdown.

Blunder Down Under: It’s all fun and games until someone winds up with a bent penis! McSteamy (Eric Dane) and Lexie’s (Chyler Leigh) hot and heavy session was cut short when she broke his junk. Torres (Sara Ramirez) and Hunt (Kevin McKidd) operated on him. Lexie felt awful, but Sloane pushed her away and the other interns kept bugging her about whodunit. She was about to crack when Sadie took the fall. She also guarded the door while Lexie refused to abandon him. Lexie climbed into his bed and stroked his hair like she was his girlfriend.

A Kiss Before Dying: Despite breaking up with him last week, Izzie’s (Katherine Heigl) phantom lover went all stalker and wouldn’t leave her side even when she demanded it. He kept saying he was there for her and she should use her medical training to figure out what was going down. She had the same theories fans have been tossing around for weeks. Her “a-ha!” moment came when she was talking to Jackson’s mom when he was on the brink of death. She ran outside and had a final confrontation and kiss with Denny. She told him that she hated him for fooling around instead of telling her that she was dying.

Second Chances : Hunt tried to apologize to Yang, but she stonewalled him and preferred to act like nothing happened in the shower, the passing out in her bed or the revelations about the horrors of war. He didn’t give up. He described the date he had planned to watch the Northern Lights and asked for another chance. She hesitated because of his “big problems” but eventually agreed to try again despite them.

Tell us: What’s going to happen to Izzie? Did Derek do the right thing with the serial killer? What if there hadn’t been an extremely convenient donor?

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