The episode begins and Cristina is back, and she's sleeping in the bed in her loft in Seattle, where she's apparently been for two days. Meredith is with her. Jackson and April have sex, again, much to April's puzzlement. Meredith and Alex get a 17-year-old patient named Brian who's cramping and looks jaundiced. And some of his hair falls out when Meredith puts her hand on the back of his head. Wilson treats a apparently homeless man with a long, white beard that the interns have taken to calling Santa Claus. He insists he hasn't been drinking but his blood-alcohol level is high, and he throws up on her again.
Hunt gives Cristina a job and tells her she can thank Jeff Russell, who pushed to get her there. He's the new cardio chief. Hunt tells her there's a meeting of the crash survivors later and she should attend. He says he'll be there to support his staff, not as her proxy. Bailey tells a mother about some more tests she wants to run on the woman's daughter before sending her home. Bailey calls Arizona. She tells her about the 13-year-old girl with a persistent fever and other symptoms after having an appendectomy. Arizona reluctantly agrees to take a look at the patient's chart. Cristina tells Meredith that "the husband formerly known as Owen is now just my employer". Jackson asks Alex if he can move in when Alex buys Meredith's house and Alex says, "no roommates".
Cristina heads off to meet "this Jeff schmuck". Wilson goes through Santa Claus's tests and sees there's nothing wrong with him. Cristina meets Jeff Russell, the cardio chief. He welcomes her and tells her to "go, have fun, see patients". He doesn't have time to talk. He tells her to go run his service and make him look great. He tells her to assign her own cases. Cristina meets her interns. They're already scared of her. Meredith and Alex tell Brian's parents that his symptoms are consistent with the use of anabolic steroids. He denies it at first, but then admits he's been taking them for two years to try to impress girls. Wilson tells Hunt about Santa Claus, who tells her to send him on his way. He says Santa Claus has been coming to the hospital for years with the same symptoms, always drunk.
He tells her to discharge him. She goes to discharge him and he asks for a blanket. Bailey tells Arizona the scans for her patient are outside her door because the intern she sent to bring them didn't knock on her door. The lawyer wants Callie to say that Derek won't be able to operate again as a result of the injury he sustained in the crash. Derek hears this and asks to take a break. Arizona opens the door and there's no case file there. Bailey apologizes to Arizona on the phone and assures her she'll find out what happened with the chart. She then pulls out the chart and gives it to an intern. A lawyer asks Cristina if she's suffered any injuries or trauma and she refuses to cooperate. Cristina then gets a new patient with a possible fistula. She tells her two interns she's going to let them scrub in. Suddenly, they love her.
Hunt asks Wilson why she ordered an abdominal CT on Santa Claus when he was discharged an hour earlier. She says she didn't discharge him. She cleaned him up and shaved his beard, she says, because maybe if he looked cleaner he wouldn't get blown off by his next doctor. Callie asks Derek if he wished they'd just taken the settlement, and she goes on to say they didn't because Derek pushed everyone else not to, even though they'd already decided, they would. She tells him he did the same thing with his hand surgery. She didn't want to do it, but he pushed her, so she did it. Derek says he thought she could do it, but she couldn't. He tells her not to blame herself because it's his own fault. Arizona calls Bailey again. She's now pacing around her apartment, saying she wants to see the chart.
Cristina is in surgery with her interns. Cristina is loving her new role as a teacher in the O.R., and is even using some "old-fashioned" techniques. Meredith and Alex are arguing over the house when a nurse comes back with test results for Brian. He has cancer. Wilson goes back to her freshly shaven Santa Claus and tells him his test results came back clear. She asks him to be honest about whether he comes in looking for drugs. He says he does. He asks for aspirin. He tells her about raging headaches he gets. He says he was going to tell her, but then he vomits. Meredith tells Brian's parents they got all the cancer out but there's a chance of recurrence if he continues to use the steroids.
Alex sees Wilson with another vomit-stained shirt and when he tells her to change the shirt again she goes off on him about how frustrated she's been trying to treat a patient who keeps vomiting and she can't figure out why. Cristina and her interns are celebrating their successful surgery when Hunt comes up and yells at her about tearing into one of Dr. Russell's patients without telling him. Bailey confesses to Callie that she may have "pushed a thing a little too far" with Arizona. Callie asks Bailey what she did, and then she sees Arizona walking through the hospital. Bailey sends Callie so as not to scare her away. Bailey never sent the chart, knowing that Arizona would come looking for it. Arizona acts annoyed, at first, telling Bailey that if she says she's going to do something she should do it.
But as soon as she starts reading the chart, Arizona diagnoses the case as Lumiere's Disease. They walks together to go do an ultrasound. Alex explains the diagnosis to Santa Claus and gives him medication to treat his migraines, which are causing the vomiting. Hunt is again berating Cristina for cutting into Russell's patient without his authorization while they wait for Russell to show up and go over the case. Russell arrives, looks over the chart and tells Cristina she made a "great save". He thanks her, then thanks Hunt and says, "Now I know why you pushed so hard for her". Russell leaves and Cristina just looks at Hunt. Callie and Derek come back to meet with the lawyers. She wants to retract her earlier statement. She says she does believe that Derek will operate again.
She goes over the many options that are still available to them. Derek listens and asks her why she didn't mention this before. Callie cries and says she was scared and felt like she failed him. She tells Derek he wasn't wrong to push her and he should've pushed her harder. She says they've haven't tried everything and they shouldn't stop until they do. Back with the lawyers, it's announced that the next step is to file a complaint against the parties. The doctors ask for the pilot to be left out of it. The lawyer asks Hunt to step out, and he does. After Hunt is gone, she explains that they aren't going after the pilot. They'll investigate him to make the case, but they'll be seeking damages far greater than what the pilot or even the charter company can cover.
The other lawyer says they'll be going after the bigger fish Seattle Grace. "The people who put you on that plane," the lawyer says. The doctors fall silent. Cristina gets home to her loft and packs up her sleeping bag. Alex gets home to Meredith's place, which he's buying, and finds Cristina inside. She wants to rent a room. He gives it some thought, finds it funny that Cristina needs his help, and then tells her the master bedroom is his and rent is due on the first of the month. The episode ends at this point.