The episode begins and Meredith and Derek are having sex. Cristina's too is having sex with her boss. April and Jackson too just had sex. But they agree it's "the last time" just like the previous last times. Arizona meets David, her prosthetist. He says they'll be working together for a while "until one of us dies, or your leg grows back". Meredith's intern brings her a scan that shows a rare mass in a patient. Webber brings Catherine to meet a patient, Brian. He appears to have basketballs in his pockets but they aren't basketballs. Catherine doesn't understand why he let his condition get this bad before seeking treatment. He says a few months earlier everything just "blew up".
He's nervous about going to his 10-year reunion. Cristina's boss asks her if she recommended to Dr. Thomas a quicker, more efficient approach on a patient of theirs who needs two procedures done during one operation. She says she did and reports to her boss that Dr. Thomas said they're a hospital not a pizza delivery service they don't need it done in 30 minutes or less. Her boss tells her to enjoy her time with Dr. Thomas while she can. She asks what that means, but there's no clear answer. Alex meets David, the prosthetist, and asks how soon Arizona will be back on her feet. David doesn't know yet and offers to tell Arizona that Alex stopped by. Alex tells him not to.
In his class, Derek's eager student is wowed by Derek's approach, but makes what would have been a fatal mistake on a model. Bailey looks at the scans of Meredith's patient and says it is a mess. Bailey tries to steal the surgery, but Meredith won't let it go. Jackson asks Webber why his name is on the board for the scrotal lymphedema surgery the next day. Webber covers his tracks by telling Jackson that his mom wanted him to do a consult on the skin flap. Jackson agrees to do it. Cristina and Meredith talk on the phone and Meredith explains that she's hesitating to tell Derek about her "impossible" tumor removal because he's not operating anymore and that he's trying to be cheery about teaching. Derek gets home and tells Meredith he hates teaching. Meredith doesn't tell Derek about the tumor. Cristina goes to her boss' house and asks him what the deal is with Dr. Thomas.
She asks what he meant when he said, "Enjoy him while you can". Cristina asks if they're firing Dr. Thomas, and her boss explains they can't fire him but they can force him to retire. He says Dr. Thomas hasn't made a mistake, but he will and when he does his age will make it a malpractice suit that the hospital will lose. She tells her boss he should've told her earlier. He says he never thought she'd have a problem with it. Alex and Jackson are stunned when they see the swollen scrotum guy. April tells Jackson that his mom keeps asking her why she looks so tired. Meredith asks April why she looks so tired, and April just smirks, looks at Jackson and walks away.
Meredith and Jackson are left looking through the hospital room window at Catherine and Webber inside talking and laughing, and she says they look cute together. She asks Jackson if he thinks they look tired. In Minnesota, Cristina asks Dr. Thomas why they aren't doing her proposed surgery. He says he's capable and she asks him to prove it. Brian asks about his recovery time and wonders if there's any chance he won't be able to walk for a while. Bailey is still trying to negotiate to take Meredith's tumor. Meredith's intern, on the other hand, is chasing her patient through the halls. He gets all the way outside. Meredith talks to him and he says that the intern was in the hall bragging about the "once-in-a-career" tumor, and that Meredith didn't even know where she was going to start.
Meredith says that's the way it goes sometimes. They have a quick heart to heart, the man says the intern has a big mouth and Meredith agrees. David is trying to help Arizona with her prosthetic leg and she yells at him after he tries to help lift her so she can take a few steps. He tells her she's going to need help and adds that she's lucky to have people in her corner who care. She insults him and he leaves. Derek goes to teach her class and his students ask if they can go watch Meredith remove that rare tumor. Derek is surprised to learn this. Cristina's boss comes into her O.R. and asks what she told Dr. Thomas. He says he could be in trouble if she told Dr. Thomas too much. She says she was surprised that Dr. Thomas agreed to take the challenge of going with the more modern approach.
Her boss says it might work out just fine, if and when Dr. Thomas "craps out" in surgery. In surgery, Meredith's intern apologizes for having said too much to their patient. Derek barges into the gallery, where Hunt is the only one watching. He tells Hunt that Meredith is "bubble wrapping" him. Hunt tells him he's got a reputation for needing to be bubble wrapped. Meredith opens up the patient and sees the tumor and they now have to figure out where they start. Bailey is in the scrotal surgery, having a great time. She's giddy and says April volunteered her spot in the surgery. Cristina is in her surgery with Dr. Thomas and he struggles with threading the catheter.
He nearly gives up and hands it over to Cristina, but she gives him one tip and he's off and running. Cristina's boss says it went well with Dr. Thomas. She can tell he's disappointed, but he says that on the bright side, she's out early. He proposes they hook up, but she says she's meeting a friend for drinks, and walks away. Derek's eager student shows him that he's "visualizing the anatomy" better now, and demonstrates how he can now do the procedure he messed up earlier. Derek smiles and congratulates him. Hunt asks Derek if he has a minute to talk. Catherine tells Brian that his procedure went just as planned, and that Amy Miller's got a lot to look forward to. Jackson comes back to talk with Webber.
He gives him a whole manly speech. Jackson tells Webber that if he hurts his mom, he'll get hurt. Webber says he won't hurt her because he likes her. "And I don't like that you like her" Jackson says. Webber steps up to him and says, "Well, man to man, you're just going to have to deal with it. You don't want a piece of this. Not today". Jackson warns, "I'm watching you," and walks away. Webber says, "I hope you like the view". Bailey sees all this. Webber goes over to her and says he knows she’s thinking about the fact that he's married. Bailey says she was actually thinking that what Webber just did took "some pretty big balls".
Derek asks Meredith how the tumor went. She says it was no big deal, but he tells her he's not going to run off to the woods and grow a beard. If she has a good day, he wants to hear about it. She then starts spilling how excited she was and explains everything she did and how she was able to figure it out. At home, Callie is about ready to leave when Arizona invites her to sit with her and watch TV. She does. Catherine gives Jackson a kiss goodbye as she leaves the hospital with Webber. April is there. She asks Jackson how he is, and he says he's fine. She asks if he wants to have sex, and he does. So they do. Dr. Thomas and Cristina are having drinks at a bar. He says he knows they're trying to push him out.
He shows her a watch they gave him at a "surprise retirement party" four years earlier. He says it's a piece of junk, but he wears it "just to screw with them". He tells her everyone there is so polite that they don't dare say anything directly. He tells Cristina, "It's been a while since I've had anyone who cared enough to give me grief". She orders a drink and insists that Dr. Thomas gets something with actual alcohol. Hunt on the other hand, heads out to the woods and sits outside Derek's trailer. The episode ends at this point.