 The night before her internship begins , Lexie meets Derek Shepherd ( Patrick Dempsey ) at Joe 's Bar , mirroring his initial meeting with Meredith . The pair flirt , but Derek makes his excuses and leaves . On her arrival at the hospital , Lexie meets George O 'Malley ( T.R. Knight ) who quickly realizes her identity . Lexie promises to keep George 's secret that he is repeating his internship after failing his intern exam and the pair strike up a friendship . Lexie is assigned to be Cristina Yang 's ( Sandra Oh ) intern , and is dubbed " three " by Cristina , who doesn 't take the time to learn her name . Lexie is eager to get to know her half @-@ sister Meredith , but receives a hostile response when she introduces herself , and her later frequent attempts to bond with Meredith are similarly rebuffed . Lexie begins a brief sexual relationship with Alex Karev ( Justin Chambers ) , who discovers that Thatcher has descended into alcoholism following Susan 's death . When Meredith scolds Lexie for not looking after Thatcher , she finally retaliates and decides to stop pursuing a relationship with Meredith . Lexie bonds with patient Nick Hanscom ( Seth Green ) , and is present when his exposed artery blows , causing him to suffer massive blood loss . She manages to stop the bleeding , but is distraught when Nick later dies anyway . Feeling sympathy for Lexie , Cristina invites her to join her and Meredith in drinking and dancing , causing the sisters relationship to begin to thaw . The following morning , Meredith goes out of her way to make Lexie breakfast , which she politely eats despite an allergy to eggs , resulting in her having to be treated at the hospital . Lexie and George agree to move in together , but they can only afford a dilapidated apartment which Lexie attempts to improve by stealing decorations from the hospital . She begins to develop romantic feelings for George , and discovers that he had only failed his intern exam by one point , encouraging him to try and convince the Chief that he deserves a second chance . 
