The episode begins at a staff meeting; Hunt announces that its Arizona's first day back, but Callie says the doctors should all just not make a big deal of it. Hunt then announces that some people may have heard that some of the hospital's doctors have filed a lawsuit against the hospital and he ensures it doesn't affect anyone there. Arizona shows up and Callie has an intern following her around with a wheelchair in case she needs it. Cristina is telling Meredith about how she wishes Hunt was as gracious with her as he's being with the doctors who are suing the hospital.
April comes around frantically looking for Avery and Cristina asks, "Why, are you look for some action Jackson?" Cristina cracks herself up, but April isn't amused. Callie walks Derek through the finer points of the surgery she wants to do on his hand. He isn't impressed. He tells her to "keep trying". Bailey is waiting for a liver transplant patient. Meredith checks out a patient who grabs and squeezes her butt. She hands him off to Avery, who is quickly pulled away by April. She tells him she's late with her period. She's never been four days late in her life. Avery is stunned. They decide to do a blood test to see if she's pregnant. They leave the on-call room and April gets a 14-year-old patient who was in a horseback riding accident.
Avery in the meantime is asked by Callie to help with Derek's hand. Derek tells Meredith he's wondering why he should do the surgery at all. He says there's no good solution, and the best he can hope for is that his hand is half fixed. Bailey gives Cristina grief over letting an intern practice on her liver transplant patient, who has been waiting for years for his liver. April and Alex are treating the kid who was trampled by a horse. April moves the kid to an operating room sooner than Alex would have liked. He wanted to wait for Arizona. The liver transplant patient's liver is running about an hour late. He thinks there's a perfectly good reason, but his partner is upset, saying he doesn't want to sit back and wait for the one thing that could get him their 30 years together.
Meredith is about to discharge her grabby patient when she realizes that he's got some kind of grasping reflex issue, not just an impulse to grab butts and this time breasts. She tells her intern that she thinks the patient has a brain tumor. Callie has some Christmas-themed ideas for Bailey's wedding. Arizona drops by and says she's going to do an exploratory surgery, which Bailey thinks might involve a lot of standing. Then she tries to backtrack and say that Arizona might get bored after all that standing. April cries while telling Meredith that she "had a plan," and now she thinks she's pregnant. Avery is on his way to meet with her. Meredith tells her "plans don't mean anything". Avery shows up and he and April walk away.
The lawyers tell Hunt that the charter airline he used had a record of mechanical problems. The lawyers tell him that in the last round of budget cuts, the decision was made to go with this airline. He is upset and asks someone whose decision it was to go with an airline without checking its safety records. Then one of the lawyers hands Hunt the form with his own signature on it. He doesn't remember making the decision, but confirms it's his signature on the approval. Roberta Thompson, a new board member, introduces herself and tells Hunt that "a mistake was made" but the board has his "full support" in this lawsuit. Avery draws April's blood for the test and they ask each other whether they're OK.
She tells him she can do it himself if he wants her to. Alex walks in and pulls April away. In her surgery, Arizona steps away for a moment to stretch and the intern who's been following her with a wheelchair comes toward her with a rolling chair. Arizona snaps at her, telling her to get away. Wilson confirms for Meredith that their patient does, indeed, have a brain tumor. Cristina asks her intern to close up the liver patient, despite Bailey's objection. But the patient starts bleeding. After her surgery, Arizona turns to walk away and trips and falls. Alex orders everyone out. Arizona seems to cry and tells Alex she'd been so proud of herself for getting through the day.
She thought she was such a big shot and went to put her weight on her left foot and she doesn't have a left foot. She laughs it off and asks Alex to help her up. The bleeding on Bailey's liver patient still won't stop. The liver is patching. His body is rejecting it. Callie and Avery are going over plans for Derek's hand, but Avery's attention is elsewhere. He says Derek is just going to shoot it down, but Callie tells him it's their job to come up with a plan that will make it ok. Avery leaves to "go do something". Meredith shows Derek the scans on her brain tumor patient after another neuro surgeon has said it is inoperable. Derek agrees that it isn't inoperable and he agrees to page Clemens and walk him through how to do it.
Meredith tells Derek that Clemens won't do it as well as Derek and that's why he needs to get his hand fixed. Avery goes to April and tells her he's "all in," and they should have the baby, get married and be awesome parents. They cheerily go over their plans for their future life together. Hunt goes to Webber and wonders why the board would have his back and not just fire him. Webber realizes that Hunt is married to someone on the other side. Hunt seems inspired and leaves. Bailey has to report to her patient and his partner that the liver didn't match. She's made calls for another liver, "but, given Graham's condition" she starts to say. But Graham understands its better that they give another liver to someone who can make it last. He turns to his partner and tells him, "It's not 30 years, but it's better than nothing".
Outside the hospital, April has the test results and brings them to Avery. She takes a deep breath and sees that she's not pregnant. She goes on to profusely thank the Lord above for how she doesn't have to marry Avery, who seems upset. She tells him she didn't mean it that way and says she should just go on the pill so she doesn't have to worry every time, but Avery tells her not to bother and says it might have been a sign that they shouldn't be together. Cristina asks Meredith whether she's changed. Meredith tells Cristina that she seems to want Hunt back, which might mean she's changed. Cristina agrees. Hunt goes back to the lawyers and Roberta Thompson and questions why his conflict of interest doesn't seem to concern them.
He tells them all that he thinks they're hoping that because he's married to Cristina, the judge will throw the whole case out. Ms. Thompson begins to reiterate, "let's not over think this, the board supports you 100 percent" but one of the lawyers shakes his head and Hunt sees this. She stops. The lawyer reminds Hunt that the confidentiality agreement his signed is punishable by termination and considerable financial penalties. Hunt says he understands and leaves. Derek gets home and tells Meredith that Clemens referred the brain tumor patient to another surgeon at Seattle Presbyterian. Meredith shows Derek a new shirt she got for Zola.
It says, "World's Greatest Big Sister." Meredith warns that "it's only three weeks," and she has a hostile uterus and hasn't even told Cristina. Derek is thrilled that they're going to have another baby. They hug. Cristina is waiting for Hunt at the loft. She wants to talk. She starts to talk, but Hunt says, "We should get a divorce". She asks him if that's what he wants and he says, "Yeah". The episode ends at this point.