When famous surgeon Dr. Harper Avery is rushed to Seattle Grace-Mercy West, the staff is surprised to discover that one of their own is related to this legend, and his unorthodox request for his surgery causes tensions t between Derek and Richard. Meanwhile Callie and Arizona try to help Teddy and Sloan move on from their pasts and find greener pastures.
When Avery's grandfather comes to the ER, Webber's wish for a stress-free first day back is lost after the surgeon requests an awake surgery. Elsewhere, Cristina and Teddy attempt a hand-me-down lung transplant for a cancer survivor.
- Lexie laid in Alex's bed, naked, waiting for him to come into the room. Derek walked in, though, looking for Alex. He left, and Lexie admitted to Meredith that she was still sleeping with Alex. Meredith warned Lexie not to have feelings for him because he's like Meredith three years ago. "Your heart lives in your vagina," Meredith told her.
At the hospital, Derek walked in on Sloan having sex in a storage closet and wondered why this was his morning. Cristina, meanwhile, was sharing a story about Teddy with Hunt and he seemed a bit uncomfortable with them being friends. Cristina told Hunt he could be friends with Teddy, too. He thanked her.
A trauma patient came in after a motorcycle accident. He had a head injury and as the patient was being wheeled away from the ambulance, the paramedic slipped and the patient fell to the ground, hitting his head again.
Cristina wanted in on the case, but had to talk to the hospital's lawyer about the paramedic's fall. Charles got the case instead. Teddy was staring at Hunt and Arizona caught her. She suggested Teddy become friends with her to stop obsessing over Hunt.
Arizona had a lung transplant case and Alex wanted in on it, but she didn't want to work with him because he'd slept with Callie years before. Derek met with Sloan to lay down the law: No screwing drug reps in the hospital. The chief stopped by with a urine sample, which was part of his rehab. The chief asked for a light schedule of surgeries and the ability to go home by 5. He and Derek shook hands.
Avery brought in a patient who he seemed to know. Turned out the man was his grandfather, and a legendary doctor. Cristina had come over to help and misdiagnosed Dr. Harper Avery (as in "the Harper Avery Award"). She was mortified.
Cristina and Meredith had some fun at Lexie's expense. After Meredith told Cristina about Lexie and Alex, Cristina said the same things Meredith had said (that Alex was like Meredith three years ago, and that Lexie's heart was in her vagina).
Harper Avery was getting annoyed and wanted an experienced surgeon to treat him. He asked for Dr. Grey, meaning Ellis, but Meredith told him Ellis had died. Then he asked whether Dr. Webber still worked there. Derek started to say Dr. Webber wasn't available, but things started going very wrong with Hunt and Cristina's motorcycle patient, so Derek paged Dr. Webber.
Harper immediately asked Dr. Webber who he was "slipping it to," because he was no longer the chief of surgery. Harper had abdominal obstructions and demanded that Dr. Webber do his surgery. He also wanted to watch.
Teddy and Arizona's lung transplant patient was told that he was too high-risk to get a lung. Lexie remembered a program in which the hospital was taking lungs that would otherwise be discarded and repairing them on bypass. Cristina wanted to get on the case. She thought it would be awesome for winning awards if the procedure could be done while Harper Avery was in the hospital.
Harper was getting geared up for his awake surgery, but Derek said he couldn't authorize it. Before he could say anything else, Dr. Webber said, "We can do this." Harper told Derek that Webber's move was what a good chief would do and that he should "take note."
Derek told Dr. Webber he didn't support the decision. Webber apologized and Derek said it was up to him.
Sloan had just finished having sex with a nurse when Callie asked him to look at her patient's brain scans. Her patient was an elderly woman who was deaf and Sloan spotted this by looking at the scans. Derek had just told Sloan he might fire him for having sex in the hospital, but Sloan said he was such a good doctor he could cure the patient's hearing problem. Then he asked Derek, "You still want to fire me?"
Harper watched as the doctors poked around in his abdomen. Harper asked Meredith a hypothetical question (Young Avery had been whining earlier about the pressure he felt being Harper's grandson): He asked Meredith whether she would have worked at a different hospital if her mother was still alive and working at Seattle Grace, in order to avoid working in her mom's shadow. Meredith didn't answer.
In the gallery, Charles came in and told Cristina that their motorcycle accident guy's heart function was maintained and "now he's an organ donor." She left. Meanwhile in the surgery, Harper started bleeding out.
Sloan told Callie's elderly patient that he'd be able to restore her hearing. The woman's daughter thanked him and called him a miracle worker, and Sloan found this to be a bit of a turn on. Callie told him he'd better not sleep with the woman.
Dr. Webber fixed Harper's bleeder and things were back on track. Meanwhile, Cristina was working on the fancy lung procedure she'd talked about earlier. Lexie decided to help. Charles saw this through the window.
Teddy and Hunt were chatting and he invited her to come over to have dinner with he and Cristina some day. She agreed. Charles then came to her and told her that he'd like to be involved in the use of the lungs of his former patient. Teddy was upset and yelled at Cristina for going rogue and stealing the lungs. They argued about Cristina's motivation (winning awards) and Cristina tried to convince Teddy that she could pull off the surgery. As they yelled, Lexie noticed that the lungs were inflating on the bypass machine.
Teddy talked to the lung patient about the risks with the lung transplant. His sister, who was argumentative, wanted to wait for something other than some "hand-me-down lungs." The patient wanted to try it. He asked Arizona if it was his best shot. She deferred to Teddy, who said, "It's your only shot." He agreed to undergo the surgery.
Sloan, who'd been yelling at Alex every time he got a chance (because Alex hooked up with Lexie), yelled at Alex to get out of the O.R. in preparation for the surgery on the elderly woman's ear. Callie told Sloan he was out of line and that he needed to decide what kind of person he was going to be in the aftermath of Little Sloan leaving and taking her baby away: He could grow up, find a woman he loved and have a baby, or just screw anything that walked into the hospital.
Alex and Charles were among the doctors asking Avery for some face time with his grandfather. He then whined to Meredith about how hard it was to have a famous last name. His grandfather paged him so they could finish their talk. He'd been saving a spot for Avery at his hospital, but Avery didn't want it. They argued and Harper's pulse dropped.
There was a complication in Harper's surgery. He wanted to be awake again, but Derek wouldn't allow it and said he would declare Harper unfit to make his own medical decisions if he didn't cooperate. "That's how a chief does things," Derek said. "Take note."
Webber asked Derek to let Bailey do Harper's surgery. He didn't want to risk doing anything wrong. He said he wanted a drink, not to be holding another man's life in his hands. Derek told him Bailey could assist, but he believed in Dr. Webber.
Sloan talked to the elderly woman's daughter, who was relieved that she'd no longer have to take care of her mother. She gave a little speech about how much of her life had been wasted caring for her, but her mother woke up and said she'd been the one taking care of her daughter. She moved back home after getting divorced and her mother never kicked her out. They both realized that the her hearing was back and celebrated.
Teddy and Cristina were working on the patient and the lung tissue was falling apart. Teddy was upset, saying that awards only motivate doctors to be competitive, rather than make good decisions. They agreed on a different approach.
Back in Harper Avery's surgery, Webber and Bailey figured out that Harper was allergic to the type of suture they'd used the first -- the one he specifically requested. No one could have known, so Webber hadn't actually messed anything up the first time. They worked on replacing the suture with another kind.
Teddy and Cristina wrapped up their transplant and decided to test the transplanted lungs off bypass. They waited.
Teddy, Cristina and Lexie told the guy's sister that her brother was going to be OK. The transplant worked.
Meredith told Avery that his grandfather was going to be fine, then she basically told Avery to stop whining. She said that if her mother was still around, she would definitely want to learn from her, and he should take advantage of the opportunity to learn from his grandfather.
Lexie proudly told Alex about the transplant, but he was upset that she'd told Sloan about them hooking up to make him jealous. She told him he made her not feel, so if he couldn't handle being used for sex he should let her know. He told her he had a free 20 minutes if she wanted to go "not feel" somewhere.
Teddy and Hunt talked about the transplant and how great Cristina was in surgery. Hunt asked her if she wanted to get a beer, but she said she had to go to girls' night.
Sloan saw Alex in the hallway and told him that the yelling and kicking him out of ORs was over. Then Lexie walked out of the on-call room, breathless. Sloan looked at her and said, "Hey." Then he shook his head and turned and walked away.
Harper asked Dr. Webber how his regenerative research was going, and Dr. Webber said he'd put it on the shelf a few years back. Harper told Webber that his research put him on the short list for his award several times, and encouraged him to "dust it off." Webber said it might be a good time to do that.
Sloan and Hunt were shooting baskets in Derek's office and Sloan admitted he had sex with his patient's daughter, but only after he repaired her mother's hearing. Webber came in and apologized to Derek for agreeing to the awake surgery in the first place. He said he just had to feel something other than the humiliation of peeing into a cup that day. Derek said he understood.
Girls night ended up at the softball field where they took batting practice. Cristina told Meredith she loved Teddy.