Meredith: "You didn't say goodbye this morning."
Derek: "I had a surgery. I didn't wanna wake you."
Meredith: "No, you were starting your clinical trial and you feel guilty that I'm not on it so you snuck out."
Derek: "You're right, but I don't feel guilty, and I didn't sneak out." (Alex walks over)
Alex: "Patient number two, Daniel Cobb, admitted and in his room. His wife has some questions for you."
Meredith: "I can't believe. He picked you for this thing instead of me?"
Alex: "Well, Dr. Shepherd didn't want to leave anything to chance."
Meredith: "Now you can both go to hell."
Derek: "Meredith, it was open to all the residents, Karev just did better job at pitching me."
Meredith: "It was open for all the residents expect for one!!!" (Derek leaves and blows her a kiss)

Derek: "My next Alzheimer's surgery is tomorrow at seven. Put your name on the board."

Doctors practise deception all the time. We give vague answers to hard questions. We don't talk about post-op pain. We say you'll experience some discomfort. If you didn't die, we tell you that surgery went well. But the placebo has to be the doctors greatest deception. Half of our patients we tell the truth, the other half, we pray that the placebo effect is real. And we tell ourselves that they'll feel better anyhow. Believing help is on the way, when in fact, we're leaving them to die.

Doctors practise deception every day. On our patients, on their families... But the worst deception we practise is on ourselves. Which is why sometimes it takes us a while to realize that the truth has been in front of us the whole time.