The scene opens with Webber's big day, with his equal-parts happy and sad storyline. He launched the episode with the revelation of his 10,000th surgery, asking Bailey about whether the hospital would be commemorating the event in any way. "I mean, you'll do something?" he asked, seeming jovial and grinning. "I mean, it is my 10,000th surgery. That's a lot of surgery." Thankfully, Bailey had planned a conference room party, complete with red velvet cake, speeches, a banner, and sparkling cider. For his 10,000th Webber got a pair of surly sisters, one of which was giving the other a part of her liver. Marcy wouldn't give her sister a break about having to give her a slice of her liver.
Meanwhile, Webber’s wife Adele resurfaced. Adele was confused and disturbed as before; she was found wandering toward the hospital, nearly seven miles from the Webber home. Kepner tried to keep her at bay while Webber was in surgery, but she eventually made her way into the observation gallery above her husband's surgery. "Ellis! You let him go" she yelled at Meredith, thinking that she was her mother. "What kind of a woman would break up a marriage?"The scene then turned from merely heartbreaking to completely haunting, as Webber began singing "My Funny Valentine" through the intercom to the observation gallery to try to calm her down. Apparently, the pair's first dance as a couple was to the song. "You were the most beautiful bride I've ever seen," he told his distraught wife. There is nothing worse than watching someone descend slowly into madness.
Because that's what happened right before everybody’s eyes. Adele finished the show tune with tears streaming down her face, making the moment more tragic than the death of Henry. Speaking of Henry, his still-recent death was still coloring activities at Seattle Grace, mostly the actions of Altman and Cristina. After last week's odd interactions between the pair, they seemed to have mended fences for the most part and were using back-to-back surgeries to ease the pain of the recent passing, even with all the "widow casseroles" still piling up. Altman and Cristina actually stole a heart surgery from Dr. McQueen and didn't tell Owen, which sent him into a rage when he discovered what had happened. Owen wasn't only mad at Altman, whom he tired to reconcile with, but it set off a fight between him and Cristina, too, as he eventually told her he could fire her.
"Her husband's dead!" she told him. "She's taking it out on you. You've just got to deal with it." Derek and Lexie, are handling the episode's Case of the Week, a little boy needing brain surgery that eight other surgeons had already refused to do. It was a truly unfortunate situation that found the mother hiding the truth from her afflicted 11-year-old son to protect him, but he knew his damage all the while and was really just protecting her from finding out that he knew. It does make sense. Ultimately, Derek and Lexie took the case; went in for surgery; and had to close up without taking out the tumor because it was too risky, ensuring that the kid would die in about three months. After Lexie made an impassioned play to attempt the surgery anyway, Derek offered his own wisdom to the younger Grey: "They're not called lost causes because they're fun."
The only comforting part, really, was thinking about the poor little guy getting to go to Pearl Harbor in Hawaii before he died -- he loved battlefields so; and when he told his mom not to worry because he was going to be in heaven with his father. The other important storyline of the night was that Meredith finally decided on her specialty -- general surgery -- after being prodded by Chief Hunt. "You ditched neuro," he said. "You wasted time in OB. You're my only fifth year that doesn't know where they're going. You're drowning." It seems that Bailey might have been the person to finally convince her to follow in both the footsteps of herself and her mother, Ellis Grey. "There's nothing wrong with knowing one organ and knowing it well," she said, about to extol the virtues of general surgery and knowing all the organs.
"Just like there's nothing wrong with being fifth chair viola in the back of the orchestra. But it's a hell of a lot more fun being the conductor." Finally, when she was about to decide, Meredith talked to the ex-chief; bringing up the worry that if she chose general surgery she'd be like her mother. "I don't want to be like my mother," she whined to her mother's ex-lover. "You don't have to ever worry about being anything like your mother," he assured her, referencing how good of a mother she was to Zola. "I knew her, and you're nothing like your mother. You have a gift. Don't waste it." Kepner, Avery, and Karev decided they're moving out of Meredith and Derek's house; and Arizona and Callie pushed Mark to take things to the next level with his new girlfriend Julia.
But they saw a crack in that possibility. "Oh no. No, no, no, no, no," Callie said, upon realizing why he wasn't telling his likeable new gal "I love you." "This is classic Mark. He found out Lexie and Jackson broke up and now suddenly he's getting cold feet about Julia. You and Lexie are over, okay? That ship has sailed. And sank." Elsewhere, Hunt walked into Zola's birthday party and saw his wife Cristina playing tenderly with the tyke of honor. He was none too happy to witness that. What began as a fight about her taking the surgery without asking and mocking him with Dr. Altman turned into a battle about control and the abortion that Cristina had demanded earlier. Cristina tried telling him that he has to let Altman be and allow her to do whatever she wants, after what happened with Henry. "You have no idea what's going on here, do you?" she said, while in the kitchen at Zola's birthday party. "You let me operate on her husband and now he's dead. She gets whatever she wants. Do you understand? Anything she wants from you. Ever." And then she added: "It's not my fault Teddy hates you.
But don't take your guilt out on me!" That's when Hunt finally blew up, and took the fight or possibly the break-up -- to the next level. "This is not one surgery!" he roared, clearly referring to the abortion. And Cristina, in a rage: "It was a horrible situation, but it's over," she screamed. "Is it too much to ask that we just try and forget it?" And, finally, Hunt again: "You killed our baby. You don't ever forget that!" The whole of Seattle Grace heard this in next room over, where Zola's birthday party was happening. And this is where Meredith Grey's voice over came into play. "When do you throw in the towel?" she asked, as Cristina and Owen fought just before the episode ended. "Admit that a lost cause is just that? There comes a point when it all becomes too much. That's where the real work begins -- to find hope where there seems to be absolutely none at all." The episode ends.