When does Nicholas realize his chances of being chief of surgery are probably ruined?

Nicholas arrives at the meeting with Max in his arms and a splitting headache. Before Alistair can even begin the meeting, Nicholas announces that he is taking a leave of absence for a week and when he returns, his situation with Max will be resolved. Alistair is not happy about this, and Nicholas suddenly realizes he has probably just lost his chance of being chief of cardiothoracic surgery. However, Nicholas knows that he has no other choice.