Meredith opens a box in the living room and finds Anatomy Jane. Derek reminds her the plan was to take the boxes to the attic, but Meredith’s too busy with the detachable organs from the doll, for which she made up fake names as a kid.
Izzie wakes up in Alex’s bed. Alex asks if they’re screwing other people or not. She rolls her eyes and calls him an ass.
Callie and Erica are laughing in bed. It was amazing. Erica says her whole life, she’s been with men and it always felt fine, but she never felt like this. This is like needing glasses. When she was a kid, she would get headaches and it turned out she needed glasses, which she didn’t understand because she could see fine. When she got glasses, suddenly, she noticed the big green blobs on trees weren’t blobs, they were leaves. She didn’t know she was missing the leaves, she starts crying and tells Callie she is like glasses. Erica calls out that she’s so, extremely gay, but Callie seems overwhelmed and says she has to go. Erica knows she crossed a line.
Richard introduces Derek and Mark to Owen, the new head of trauma. Owen tells them they now have a chance to steal his patients. Richard is happy, because thanks to Owen, they’re a level 1 trauma center again. Meredith and Cristina enter the hospital, talking about Anatomy Jane, until Cristina sees Owen. She grabs Meredith and drags her away down a corridor.
They stop around a corner and Cristina explains she saw Owen, whom they thought was in Iraq, and that they kissed. It was a stupid nothing, but Meredith thinks she fears Owen thinks otherwise. He obviously likes her and now he’s back. Meredith says it’d be romantic if he quit the military for her, but Cristina doesn’t want to get involved with another Attending.
Bailey paged Richard to the helipad. She pulled off a domino surgery. That’s the kind of thing that shows him she’s going to be a great surgeon someday. He wants her to be the best, and if she’s going to succeed him as the best general surgeon of this hospital, they have to start now. She can take point on any surgery she wants and she can solve problems without his approval. She can be him. She says she can do that, but she wonders why they came up here for that. A helicopter arrives and Richard explains they’re bringing in a 10-year-old with an inoperable abdominal leiomyosarcoma. He instructs Bailey to put together a team and finds a solution. It’s not easy being him.
Izzie wonders why Alex is already bored with her after one week. Alex is not bored. He was asking if she’s all-in. She calls him barbarian, so she can’t be all-in. He tells her he’ll tap a girl from radiology next.
Lexie is ignoring George. Meredith tells George she wouldn’t reject him as they enter the residents dressing room. Bailey enters and tells them they have a mandatory skills lab, except for the one who gets to assist her to remove an inoperable tumor. George is out as he has a lot of delinquent charts. Alex wonders how Bailey can operate on an inoperable tumor, so he’s out, too. Cristina is also out as she wasn’t supportive of a fellow resident. Bailey then sees Meredith is holding Anatomy Jane, which means Meredith is in.
At the skills lab, Cristina finds out she has a new intern, Ryan Spalding, whom Cristina nicknames 4.2. Owen enters the skills lab as they’re getting gowned. Cristina hides behind Lexie. Owen says he’ll teach them to save lives quickly and efficiently in bad circumstances. He asks if anyone has a problem working with live tissue, because then they have to leave. Everyone stays. Owen opens a curtain, revealing anesthetized pigs. He stabs them one by one as the residents and interns watch in horror. He then instructs the residents and interns to save their lives.
Izzie tells Owen he’s a monster. Owen says they didn’t fell any pain. Izzie says they can practice on surgical mannequins. She’s out. Owen then asks if anyone wants two pigs.
Meredith is presenting Tori’s case. Her leiomyosarcoma is wrapped around several arteries. It’s considered unresectable. Since Tori didn’t understand, Meredith uses Anatomy Jane to explain to her where her tumor is and why it’s so difficult to resect it. Ruth, Tori’s grandmother, says the plan has to include Dr. Hahn, as they came here from Seattle Pres because Richard stole her from there. If Erica’s not on Tori’s team, they’re leaving for San Francisco.
Mark meets Callie in an on-call room. He starts undressing as Callie just wants sex without any talking. She explains she’s testing a theory.
Owen is looking around at the residents’s work. Lexie is petting the pig, but Cristina tells her to stop. Owen asks Cristina what her name is, as she’s spending a lot of time on her anastomosis. Owen tells her to look at George, who stopped the bleeding and moved on to the liver lac. Cristina says sloppy work can lead to complications. Owen says he can always return to make things pretty when the pig is stable, but Cristina’s pig is acidotic and hypothermic. A kid would be dead by now. “Quick and dirty, Cristine,” Owen says. She says it’s Cristina.
Meredith and Bailey are working on Tori in the cath lab. Tori’s aunt and uncle appear in the gallery, as they like to make sure Tori is not lonely. Bailey allows them to stay. Meredith injects the dye, which reveals the tumor. Meredith and Bailey are shocked to see how much it has extended.
Izzie tells Derek that Owen is stabbing pigs. Derek tells her she should roll with it since he is the new head of trauma. Do no harm applies only to humans. She’s saying this to him as her roommate: he disgusts her.
Callie tells Mark it was nice, but swears anyway. She walks out.
Bailey paged Erica to show her Tori’s angio. Bailey has ideas, but Erica tells her to try them on someone with a chance. Bailey stresses she would like Erica on her team.
Lexie is now talking to her pig. Cristina tells her to cut it. Owen gets paged to the ER as there are multiple incoming victims. He calls off the skills lab so the residents can help him, but he orders Cristina to stay behind and save the pigs. The pigs better be alive when they get back.
The victims arrive in the ER. Mark and Derek arrive for a head injury and burns on Alex’s patient, but Owen tells them they got it. The residents won’t learn as much or fast about trauma if they stand back and have to watch attendings do it, unless that attending is Owen.
Erica thinks they should send Tori away, since they can’t help her. Meredith suggests they take out the stomach and the kidneys, but Erica doesn’t think that’s a good idea since those are two completely different blood supplies. Tori’s family is gathered around the conference room. Richard gets paged away. Erica asks Meredith to close the blinds.
Derek paged Richard to tell him that Owen is out of his mind. Richard says he has no time for this.
Richard returns to the conference room, where Meredith is playing with her Anatomy Jane. Erica knows Richard wants to be #1, but this a waste of resources. Meredith used Anatomy Jane to come up with an idea. What if they took out each organ where the tumor interferes with the blood supply one by one? Erica says they don’t have the time for that. Richard wonders if they could make the time. He asks Bailey to throw some stuff up on the board.
Alex tells Owen his patient has a subdural hematoma and he wonders if they should go to an OR. Owen reminds him his patient’s scalp is bleeding, and he asks Alex to take care of that without Shepherd and with supplies that are in the trauma room only. Alex decides on skin glue.
Owen moves to the other trauma room, where Izzie is working on Charles Hiott. The ultrasound indicated free fluid, so she’s going to take him to CT to confirm, but Charles is pretty much OR-bound. Izzie gives Charles a tetanus shot, and Owen tells her they have to thank horses for that.
Tori’s surgical team explains to her family that they want to take out all of her abdominal organs. They’ll put the organs on ice and while they resect the tumor, and then use synthetic grafts to reconnect the vessels to put the organs back in. Richard admits it’s never been done before, so there are a lot of things that can go wrong. Bailey says they don’t have time for another round of chemo. This is their only shot. The family consents.
Cristina finds Bailey and says her education is compromised working on pigs, while there are human victims to take care of. Her interns are babysitting the pigs now. Bailey doesn’t have time now as she has to go operate on Tori. She tells Cristina to return to her pigs.
Meredith meets Richard in the scrub room. She wonders why they’re not taking out the kidney since the left renal artery is involved. Richard says they can remove the tumor without doing that. She asks why he won’t look at her. Richard hasn’t looked at her all day. She doesn’t think she’s imagining things. Richard gets angry and tells her to focus on Tori.
The surgeons are operating on Tori. Tori’s father wants to be put through on the phone, but Richard says no. There’s a bleeding and they rush to fix it. They hang another unit of blood. Erica hopes Tori’s aorta is not as friable, or there won’t be enough blood in the world to save Tori.
Lexie is closing up her pig. She’s worried. Cristina reminds her interns that the pigs aren’t pets; they’re subjects. They need to keep them alive so Owen can choke on his words by the end of the day. Lexie’s pig starts crashing. Cristina rushes to her side. She has to open the pig back up.
In the OR, the surgeons remove Tori’s organs from her body. While they’re put on ice, the surgeons stare at the empty body cavity. A nurse informs Richard that Tori’s dad has called 18 times. Bailey tells Richard to go talk to them, reminding him he put her in charge.
In another OR, Mark and Derek can’t believe Alex used skin glue. Alex defends himself, saying Owen told him to act as if he was in the field. Mark says their hospital doesn’t qualify as war zone.
Richard meets up with Tori’s dad. Richard says they’re resecting the tumor right now, which he should be helping with. Richard says the most important thing is that the doctors are focused on Tori, and interruptions don’t help with that. Randy apologizes. They have been to a lot of hospitals and they are not easy places to get information. A lot of times, it’s impossible to get to talk to a doctor. He doesn’t know if that’s neglect or their egos getting in the way, but he doesn’t care. They’re just trying to take care of Tori and doing whatever they can. Richard tells him to not ever stop taking care of Tori like that.
In another OR, Owen will let Izzie use a stapler if she answers questions about vaccines and the animals they were tested on. Izzie points out there are possible differences between an animal’s physiology and a human’s. Owen says it’s possible, but not necessarily true. She tells him to keep his stapler as it’s not worth it.
While Cristina’s working on the the pig, she asks about the other pigs. They are stable. Cristina’s pig starts deteriorating and she decides open him up further.
In the OR, the surgeons have come to realize they can’t reconnect the organs to the vessels, which means they’ll die. It’s also too late for a transplant.
Erica shoots down everyone’s ideas. Bailey asks what her idea is. Erica says her idea was not to do this from the beginning. Richard tells them to shut up and get over themselves. He tells them to talk to each other. Bailey suggests to use a human umbilical vein. Erica says it could work and says she’s on board if Bailey wants to do it. Bailey says go.
Owen and Izzie are scrubbing out. He explains he was just trying to teach her. She says they have labs for that with dummies. His mentality was fitting before he came here, but they have technology here. He refuses to be accused of torture as those animals felt no pain. Izzie says he doesn’t know that. He doesn’t know what they felt. Animals are sensitive and intelligent, which is simply the truth. If he wants her to learn from her, he’ll have to use the technologies they have. She refuses to be called less of a doctor for walking away from those pigs.
The pig’s heart is not filling. Cristina orders Lexie to massage it with both her hands, and then sees the knife went through the diaphragm, into the pig’s spleen.
Richard says there’s a bleeding, and Bailey sees it’s coming from a graft. They clamp it.
At the same time, Cristina is fixing her pig.
After a while, the graft starts pulsating.
The pig’s heart also starts beating in its own.
All of the surgeons, those in the skills lab and those in the OR, are relieved.
Mark says he never failed to let women finish, but Callie did finish and she’s sad. He says she’s a conundrum. Callie says Erica cried this morning after sex. Mark tells her to take that as a compliment, but Callie says she was a revelation. The sex was awesome, but it’s also awesome with Mark. Callie thought there would be a difference. Mark says the difference is that he knows she had sex with Erica, but Erica doesn’t know Callie had sex with him. He asks if she wants to be a cheater, because he’s fine with it. Question is if she is. Derek barges in and tells Mark he’s going to yell at Owen. Mark says he’ll be right there. Derek greets Callie, who tried to hide, before walking out.
Derek and Mark approach Owen and tell him he almost maimed a guy for life. Owen’s lucky Derek managed to save the blood supply. Owen asks what he would have done. Mark says he would have asked the two fine surgeons to step in. Owen asks if there’s a better way to do it, medically, because he’d genuinely like to hear that. He’ll listen.
Richard compliments Erica and Bailey, who laughs. She finds it hard to believe Erica is accepting congratulations when she was against the surgery at first and then fought Bailey every step of the way. Erica says she still had a world-class heart surgeon by her side. Bailey knows that, but today Erica was a bullying pain in the ass. At no point, she encouraged Bailey. Erica made it as hard as possible for all them. They did a great job today, but that wasn’t thanks to Erica.
Cristina updates Owen on the pig. All the pigs survived. Owen compliments their work and asks to put the pigs out and write up their work. Cristina is shocked to hear she has to kill the pigs.
Owen finds Cristina, who refuses to kill the pigs. He can kill the pigs if he wants to. Owen lists all the things she got to practice and learn today. Keeping those pigs alive after all the procedures, for months of recovery, that is not humane. Cristina can’t believe he didn’t remember her name. He did, but that was before. He tells her about his latest tour, where they landed in an ambush. There were 20 people in his unit, including him, and everyone but him died. Then he got discharged. He’s not in the before anymore. He knew her name in the before, but now he’s living in the after.
Callie finds Erica in a lounge and confesses she slept with Mark Sloan. Erica says she sucks at apologies. Callie says Erica was crying and seeing leaves, but Callie wasn’t. She doesn’t know what the future holds. She wants to be with Erica, and in order to do that, she needs to be honest. She slept with Mark twice today. Erica says okay.
Richard paged Meredith to ask her about Tori, who’s stable. Richard tells her she wasn’t imagining things. He says young Meredith used to take Anatomy Jane everywhere. Seeing Anatomy Jane was a reminder of how he was to blame for Meredith not having anybody as a kid. It reminds him of all his mistakes. That’s not her fault. If he thought an apology would mean anything for Meredith, he’d apologize a thousand times a day.
Cristina is looking at the pigs. Lexie joins her. Cristina tells her she can’t kill the pigs. Lexie says they’ll suffer otherwise. They take the meds to put them down.
Callie and Mark have agreed: no more on-call room. Mark says he’ll see her around. Callie asks if he wants to get a drink. They can still hang out and be friends. He’s good for more than sex. He agrees to that drink. Callie hopes the crying will pass.
Richard watches Tori’s family celebrate and thank Bailey. He smiles.
George comes home. Lexie made them mac and cheese. She says she named the pigs today. George doesn’t know what that means. Lexie takes things personally and she gets too emotional. There’s no place for that at work, so she apologizes for earlier.
Izzie is lying in bed as Alex comes in. She asks him to leave her alone, but he doesn’t leave. He’s not good at relationships or talking about feelings, but she is. Maybe she can teach him. He wants to know what he did wrong. She realizes he doesn’t want them to see other people and that’s how he tried to tell her. She laughs. They share a kiss. He wants lessons. She tells him to start by complimenting her, and then to ask her if she wants to go steady with him. They share another kiss. Izzie asks him if he wants to go steady with her. He says yeah. They fall down onto the bed.
Meredith opened another box and finds the hat she used to wear to elementary school. Derek opens another box. It contains more diaries. Meredith is surprised to see how many there are.
