All eyes are on Derek as he is set to perform his first surgery after his breakdown; attention is also set on Izzie, whose medical condition requires her to undergo a difficult surgery; and Owen has another PTSD episode that injures Cristina and traumatizes both of them, throwing the future of their relationship into question.

The hospital staff is left to deal with the aftermath of George's passing. Hitting the staff hard, they all find unique ways to get through the various stages of grief. George's mom returns, faced with the difficult task of deciding what to do with his organs.

An elderly patient admitted into the E.R. for a heart condition sees a familiar face, a long lost love who happens to be in the E.R. as well for a fractured arm, and the staff find themselves caught up in their love story. Meanwhile, Karev treats a troubled teenage patient (guest star Demi Lovato) whose parents brought her in for schizophrenia, and Meredith can't help but tell Cristina about her suspicions of Owen -- which inevitably messes with Cristina's head.

Derek and Meredith visit the obstetrician and receive disturbing news; Lexie notices April and Meredith growing closer; Jackson tries to get ahead in the operating room.

Richard is desperate for Derek and Meredith to accept Adele into their Alzheimer's trial, but will Adele stand in her own way? Meanwhile Mark and Arizona have conflicting ideas of the kind of baby shower Callie wants, Teddy is freaked out when Henry has another health complication -- leaving them both a little exposed -- and the competitiveness amongst the residents for the Chief Resident position is amplified when Richard receives the green light for his diabetes clinical trial.

Derek encourages a hesitant Meredith to work with him again in neurology; Jackson's mother, Catherine Avery, returns to Seattle Grace with a urology fellow and develops an interest in Richard; and Cristina becomes increasingly suspicious of Owen's every move. Meanwhile, Alex tries to deny the fact that Morgan may be falling for him.