The Chief makes a career-changing decision that shocks Seattle Grace Hospital; Cristina and Owen try to find normalcy in their relationship; April continues to struggle in her new role; and the 5th year residents are given their first solo surgeries, only to find out that even the most routine procedures aren't always easy.
The chief makes a decision that shocks everyone at Seattle Grace.
- We start with a disclaimer that "No animals were harmed in the production of this episode." So... hope you're all done with dinner!
Meredith talks about working and studying and preparing months and years for the day you step up. This is the day when fifth-year residents rotate in as lead surgeons. Attendings are to observe and stay silent, only helping if they absolutely have to. The chief also announces that he's resigned as chief of surgery but will stay on the surgical staff. He hands his duties over to Dr. Owen Hunt. Everyone seems to have questions, Teddy is excited for hunt, and Bailey is stunned.
Meredith is anticipating her first aneurysm surgery and tells Alex she hasn't heard anything about Zola. The surgeons wait to see where they're assigned. Kepner mentions something about having an office, which catches everyone off guard. She shows them her new digs and they all start to claim their spots in the her office. They're all fighting over who is going to teach skills labs, even though April has made a schedule, when Avery gets the news on his phone that the chief resigned and Owen is the new chief of surgery. They're all stunned.
Derek is still reeling from the news, but talks to the chief about why he's taking the fall. Webber says he just wanted to know if Derek had heard anything about Zola, and Derek says he hasn't.
Cristina gets a chance to congratulate Owen, and they have an extremely awkward exchange. Meredith notices.
Arizona mocks Alex for taking a bowel resection surgery, calling him for trying to pad his board with good outcomes. She tells him he's going to low-ball himself out of a fellowship.
Meredith explains the aneurysm surgery to her patient and his wife and when they ask what her success rate is, she admits this will be her first. Derek, standing in the doorway, steps in and says that after this one her success rate will be 100 percent, and he assures them he'll be there the whole time. This comforts them. Outside the room, Meredith thanks him and they talk about Zola. He doesn't want to talk about it, and when Meredith asks if he wants to stay together if they don't get Zola back, he says they should focus on the surgery.
Cristina is teaching some interns while preparing for her patient's surgery. Teddy watches and seems uncomfortable with Cristina's somewhat harsh approach, especially when she asks them if they're in "the slow class." She tells she's "all about not skipping the basics," referring to Teddy's teaching approach last week.
Avery is preparing for a cleft palette surgery on an infant. He assures the baby's mother and explains what he's going to do. Arizona, observing from the doorway, tells him he did a great job but that Sloan is going to do the procedure. Avery seems shaken.
April prepares her patient, Sam Kenton, a longtime patient of Dr. Webber's, for his surgery. Alex stands next to April while she has a pleasant, conversational exchange with Sam and his son, but Alex cuts it off and just wants the facts about the case. April recites them and is clearly upset by the turn of events.
Arizona, Bailey and Teddy lounge around wondering what Webber's "deal" with Meredith is, since he's clearly taken the fall for her actions. He seems too cherry, though, and is talking to his sandwich. Everyone thinks it's weird and awkward.
April is drowning in her work, telling Callie she has to push back a surgery because she's teaching skills lab and assisting Alex on the bowel resection. Owen tells her to delegate that stuff.
Bailey is clearly agitated when she comes up to Owen and asks for her call schedule. Callie tells Owen to be careful not to make Bailey an enemy.
Cristina reports back to Teddy that her patient really just needs an appendectomy and says she's going to hand the patient off to general surgery. Teddy tells her she should do the appie herself and Cristina says it's too basic of a surgery for her to do. Teddy tells Cristina that the patient will still need her heart monitored and reminds her that she loves the basics and is "all about the fundamentals."
The son of the bowel resection patient asks April some private questions about his dad's recovery. She says the answers will depend on what Alex finds during surgery and that he'll be able to answer any questions. The son asks about how "cool" Alex is, and adds that he seems "a little douchey." April agrees that he can be that way but is a good doctor.
Webber comes to Meredith and she apologizes to him, but he doesn't let her finish. He just wants to wish her luck on her aneurysm surgery. She tells him she doesn't know which clip to use and Webber says she can't know until she sees the aneurysm. He says it's a big deal and Derek leads the whole O.R. in a round of cheers when it's done. She says she doesn't think he'll do that this time. Webber asks if they're OK, and she says they're fine. He says they'll need to be, otherwise they have no business being in a surgery together.
All the surgeons want to practice their surgeries on a pig. Alex is practicing his bowel procedure and Cristina isin a panic because she hasn't thought about an appendectomy in three years. No one is sure about whether a pig even has an appendix. April asks Alex to go talk to his patient and he says that's not his job. Cristina heads to the skills lab to talk to first-years about an open appendectomy.
Owen goes to Bailey to deliver her call schedule and says he wants to give her the time she needs to work on Webber's clinical trial. She thinks he's trying to say she doesn't manage her time well.
Callie gives a frustrated April a little pep talk on how to be a better chief resident, even though Callie admits she sucked at the job.
Avery shows Arizona a successful cleft-palette procedure and says he deserve to operate on the baby. She tells him he can.
Cristina, meanwhile, is grilling first-years in the skills lab about how to do an appendectomy, nearly bringing on of them to tears when she can't remember how to finish the procedure.
When Cristina tells Owen she's now working on an appie, he asks if she'll be home for dinner and wonders whether he should pick something up. It's so awkward as they debate what to eat, Meredith suggests Chinese food. When Owen leaves, she tells Cristina that she needs to talk about things with Owen.
April is telling Alex about Sam, their patient, and when he asks why she's telling him all this, she says talking to patients is his job. He says his job is fixing the patient when he opens them up because it's all on him at that point. April realizes Alex is nervous and that's why he didn't want to operate on a kid. She tells him he'll be fine as he anxiously scrubs his hands.
In another O.R., Meredith and Derek are scrubbing their hands and Meredith says he should do the surgery because they're not a team. He tosses three quick-fire questions at her about the aneurysm procedure and she answers them just as quickly. He walks into the O.R.
Meanwhile, Alex is still nervous and tries to stand on the wrong side of the patient, unaccustomed to taking the surgeon's position. When Alex moves to the other side, April whispers to him, "You practiced it the other way, didn't you?" Webber, who's observing, asks if there's a problem and Alex says no. He asks for a 10 blade.
Cristina is doing her appie and Teddy is questioning her every step of the way.
Avery is about to start the cleft-palette surgery on the baby when Arizona launches into a speech about how the procedure is going to change the baby's whole life -- either for better or worse. He stops, and she asks him if he wants to postpone.
Meredith selects her clip for the aneurysm and Derek tells her to use a smaller one, and she says no. They go back and forth and Derek finally tells her, "Put the clip down."
Cristina, responding to each of Teddy's questions in a lightly annoyed fashion, gets to the point where the first-year student wasn't sure how to finish and she realizes she, too, doesn't know what to do next. She admits this to Teddy.
Meanwhile, Alex sees something in his patient's bowel that makes him anxious, and Webber takes notice.
Back in Cristina's O.R., she's trying to talk herself through the procedure while Teddy is lecturing her and she finally tells Teddy to shut up.
Alex changes course and implements a procedure using dye and a black light (which he was practicing earlier on the pig).
Meredith is going toward her patient's aneurysm with Derek still demanding that she use a smaller clip. Derek is not pleased and is giving Meredith some seriously angry looks. Meredith apparently completes the process successfully, but there's no applause.
Alex keeps working, and Cristina again tells Teddy she can't remember the next step. Teddy says she might remember this the next time she's screaming at an intern for skipping the fundamentals. Cristina tries to hand Teddy the tools and tells her to just finish it. Teddy's slightly nervous look reveals that she also doesn't know what to do next, and Teddy tells Cristina she should know what to do. The nurse makes a suggestion.
Elsewhere, Sloan wraps up Avery's cleft-palette surgery and tells him not to worry. "You're still the goober," Sloan says, intentionally mislabeling Avery, who is "The Gunther," based on last week's events.
Alex is beginning to panic and asks Webber what he should do. Webber says nothing and goes back to reading his book. Alex decides to close the patient up.
Avery's name is erased from the board as the cleft-palette baby's mother gives Sloan and hug to thank him.
Cristina's name is also erased, and she and Teddy walk out of the O.R. vowing to never speak of this surgery again.
Alex's name is erased from the board and April give shim some encouragement as he braces himself to go tell Sam's son that he did everything he could.
Meredith finishes up her aneurysm procedure and others in the room wait for Derek to lead the applause. He doesn't, but an anesthesiologist does and everyone else joins in. Eventually, even Derek reluctantly claps his hands a couple of times. Meredith rolls her eyes.
Cristina and Meredith commiserate about how neither of them wants to go home. April's serving shots in her office, and Avery wants to know who got the worst results to settle their wager. Meredith reports that her surgery was flawless, and Cristina says her appie went great, but Avery knows that it was "finished by a nurse."
Avery then mocks Alex for sending his patient into septic shock, and Cristina says that blowing a bowel resection is "like misspelling your own name." April gets upset, and Avery says it's Alex who lost. April then points out that Avery "never even touched his patient" and that Sloan had to do the whole thing. She says this means he loses by forfeit. She offers him a rematch and says they can go again tomorrow. "And the next day," Cristina adds. "And the next day," says Meredith.
Owen goes to Bailey and tells her he needs her on his side. She asks him if she's done something wrong or if he just needs him to like her. He leaves.
Bailey shares an elevator with Webber and she says "everyone knows who to be mad at." Webber tells her Meredith just tried to give him more time with his wife, and he plans on enjoying it. He says he's happy and he wants her to be happy for him. She says she'll try.
Cristina and Owen finish dinner and awkwardly volunteer to do the dishes. Owen then says he's been feeling terrible. Cristina starts the "do you want to talk about it" conversation when Owen darts to the bathroom to throw up, blaming it on the spring rolls.
At home, Meredith tells Derek that they shouldn't have been in the O.R. together because they're not a team and they need to figure out if they can be one before they get Zola back. She tells him to say whatever it is he needs to say. He tells her she's never faced a consequence in her life and even now everyone around her is losing jobs and losing trials because of her actions. She says she's changed, and he reminds her she stole Zola last week and refused to listen to her in surgery today. She tells him to trust her and he says he has no reason to trust her.
She asks why he's with her, and he points at the post-it note. He says he promised he wouldn't run. She tells him not to keep the promise if he doesn't want to, and if he can't trust her with Zola. He says that's not what he said.
He says what he loves about her is also what he hates about her -- that she took Zola to protect her, she tampered with the trial for Webber, and she stood in front of a bullet for him. She realizes he can't trust her at work, so she says she won't work on his service anymore. That's her consequence.
Back at Owen and Cristina's place, they're both now laying on the bathroom floor regretting the spring rolls, comforting each other.