Cristina Yang has little sympathy for Constance Ferguson (special guest star Rosanna Arquette), a prison inmate who jeopardizes her health just to get out of solitary confinement. Meanwhile the interns all keep careful watch on the family of premature quintuplets with a variety of serious health challenges, Izzie's anger at Alex reaches boiling point, and Dr. Addison Shepherd decides to teach Izzie a very painful lesson.

When Isaac has an inoperable tumor wrapped around his spine, he wants Derek to do the impossible. Derek tests the Chief's authority when Richard objects to moving forward with the risky surgery.

A patient who needs an extremely difficult surgery comes to Seattle Grace, and it's Richard and Owen who vie for the opportunity to tackle it. But the decision lies in the hands of Derek, who deems that Owen should take on the surgery, leaving Richard bitter. Meanwhile, Bailey deals with her own personal struggles when she nervously prepares for another date with Ben.

As part of their training, Seattle Grace's residents are put in charge; the attending surgeons compete for a million-dollar grant.

As Callie and Arizona's wedding approaches, the couple quickly realize that the day they've been looking forward to is not turning out the way they'd envisioned. Meanwhile Alex continues to make the other residents jealous as he appears to be the top contender for Chief Resident, Meredith and Derek make a decision that will change their lives forever, and Dr. Perkins presents Teddy with a very tempting proposition.

The chief makes a decision that shocks everyone at Seattle Grace; Owen and Cristina attempt to find normalcy; April struggles in her new role; the 5th-year residents receive their first solo surgery assignments.

After eight years of practice, the residents head to San Francisco for their oral boards; sparks fly between Catherine and Richard when they bump into each other at the hotel; Bailey intervenes after Owen and Teddy get into a heated argument about their young car crash patient; and Mark tries to recruit Lexie for one of his cases. Meanwhile, Alex feels guilty for being away from the hospital when Tommy's health begins to fail.

As the doctors continue with their lawsuit, they’re forced to confront the realities of their injuries. Meanwhile, Bailey tricks Arizona into helping her with a pediatric case, and Cristina tries to find normalcy in her new environment.

The discord and chaos created by the hospital's new management team causes one physician to question his future at Seattle Grace. Meanwhile, the doctors and the interns must juggle several transplant surgeries at once, each coming with its own set of obstacles.

Callie makes a decision about her relationship; the doctors receive devastating news.

Cristina imagines the two routes her life can take based on one decision she makes. Meanwhile one of the hospital’s patients decides whether or not to live.

April stays optimistic as Arizona begins testing on her baby; Dr. Herman plans out a crash course in fetal surgery; and Owen and Callie encourage each other to get back into the dating scene. Meanwhile, Meredith, Maggie and Bailey use the 3D printer to gain a better understanding of their patient's tumor.

Meredith, rattled by the latest events, tries to figure out what to do about Derek. Meanwhile, Owen is shocked when his mother is admitted to the hospital.

A patient from Meredith's very first surgery as an Intern is readmitted to Grey Sloan Memorial with a new aneurysm, and Amelia takes her case. Meanwhile, Maggie suspects that Richard knows about her relationship with Andrew, and Arizona debates dating again.

Meredith goes on an ambulance ride with Owen and Nathan to pick up a heart for a transplant patient. Musician & MS patient Kyle Diaz is admitted to Grey Sloan Memorial with a tremor in his hand, and the residents apply for the Preminger Grant. Meanwhile, Catherine continues to insert herself into Jackson and April’s business against Richard’s wishes.

Meredith and Bailey are at odds when both of their patients need a liver transplant, Owen seeks help from the other doctors when he is charged with babysitting baby Harriet for the day, and Amelia struggles with telling Owen some important news.

Meredith and Nathan have to confront their feelings when they are are stuck sitting next to each other on a plane.

Harper Avery arrives at Grey Sloan, putting Bailey on edge. A familiar face from Meredith’s past returns as a patient, and Amelia tries to manage a secret.

Maggie's relationship with Clive starts to progress; she invites him over for a game night to meet Meredith and Amelia; Meredith and Jo meet with the owner of the patent to the polymer they need for their project, who is a friend of the family.

Meredith reaches out to Teddy and helps her talk through some of her personal struggles. Owen and Amelia hide out near Betty’s school after she becomes a flight risk. Meanwhile, Jo wants to get to work on the fellowship, but Bailey’s attention is elsewhere.

When Jackson throws a party to celebrate Catherine’s surgery and those who worked to save her, literally nothing goes as planned. Meanwhile, Helen pays Alex and Jo a surprise visit.

Meredith has a court hearing after skipping out on community service, while Bailey and Jo have a patient that Jo realizes is from the treatment facility. Richard and Gemma grab breakfast together and things go awry.

Seattle’s favorite redhead returns and graces the Grey Sloan halls with her experience and expertise as she attempts to help Richard teach the newest crop of residents. Meanwhile, Meredith has a decision to make, and Link confides in Teddy.

A dinner party is thrown at the sister house in Nick's honor. Meanwhile, Grey Sloan Memorial receives a victim of a brutal hate crime.

A bull rider shows up at Grey Sloan with severe injuries, forcing Maggie, Amelia, Owen and Blue to examine their own biases. Elsewhere, Simone can’t find anyone to be her maid of honor, and Mika takes drastic measures to pay down her student debt.