<P> Dr. Meredith Grey's (Ellen Pompeo) love interest Dr. Finn Dandrige (Chris O'Donnell), the vet of Doc--the dog she shares with Shepherd--informs her that Doc has had several seizures due to his bone cancer and that she and Shepherd have to make a decision . Webber interrogates the interns individually about Duquette's LVAD wire, but only learns about their personal problems instead . Dr. Izzie Stevens (Katherine Heigl) finally accepts Duquette's marriage proposal . At Dandridge's office, Grey and Shepherd, joined by Dr. Addison Montgomery - Shepherd (Kate Walsh), decide to put Doc to sleep . </P> <P> The hospital staff begins to arrive at the prom and Dr. Callie Torres (Sara Ramirez) and Dr. George O'Malley (T.R. Knight) discuss the status of their relationship, which leads to the former admitting her love and commitment . During the dance, Grey and Shepherd escape Dandridge and Montgomery to have a heated argument that leads to sexual intercourse . In the meantime, as Duquette waits for Stevens alone in his room, he experiences a sudden sense of pain, and unexpectedly dies . While Webber is sitting in the operating room gallery and reflecting on his career, Dr. Miranda Bailey (Chandra Wilson) announces Duquette's death . </P> <P> News of the death spreads, and the interns hurry to his room to find a shocked Stevens, lying on the bed, clinging to his still form . As they each try to comfort her, the cause of his death is revealed to have been a blood clot that led to a fatal stroke . Stevens says that if she had taken less time to dress, she would have arrived at his room sooner and could have been with him while he died . Dr. Alex Karev (Justin Chambers) then talks to Stevens, picking her up and hugging her . Afterward, Dr. Cristina Yang (Sandra Oh), who did not know how to handle Burke's situation, goes to his room and puts her hand on his to show him her support . As the episode ends, Stevens confesses to Webber that she was the one responsible for the LVAD wire cut, and claiming she cannot be a surgeon, quits the program . After everyone begins going their separate ways, Grey remains torn on who she should follow: Shepherd or Dandridge . </P> <P> The episode was written by series creator Shonda Rhimes and directed by filmmaker Mark Tinker, while Ed Ornelas edited it . It was the last episode to feature Sara Ramirez as a guest star, as she began receiving star billing in the season three premiere . Morgan, Ramirez, Thompson, Smith, Utterback, Devine, and O'Donnell reprised their roles as Duquette, Torres, Travis, Hahn, Harper, Adele, and Dandridge, respectively, while Hirsh and Hines made their first and only appearances as Claire and Natalie, respectively . The soundtrack of the episode consisted of Pete Droge's "Under the Waves", Dressy Bessy's "Side 2", Amos Lee's "Colors", Masha Qrella's "Destination Vertical", Kate Havnevik's "Grace", and Snow Patrol's "Chasing Cars". The American profile of Northern Irish band Snow Patrol increased after their single was used in this episode . Lead singer Gary Lightbody was initially uncertain about licensing a song for the soundtrack, but has since admitted that the publicity had a positive effect . </P>

What episode does izzy cut the lvad wire
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