Meredith shows a set of diseased lungs to her anatomy class, saying that according to the patient’s family, the man never smoked. However, he’d secretly smoked two packs a day in his car for 20 years. Sometimes, a patient’s shame is the elephant in the room. They try to hide things from their surgeons, and it doesn’t work because the body doesn’t lie. The truth is there for everyone to see.
Maggie, Meredith, and Amelia are riding to work. Meredith and Amelia are completely silent as Maggie tries to encourage conversation by talking about how she and DeLuca are barely talking. They say hi, but there’s no talking, even after the sex. She points out that Penny’s starting that day and asks if they want to talk about that, because they should. It doesn’t burn when she pees anymore.
Penny gets on an elevator with Callie. Callie starts to talk to her, but Penny says it’s okay. She doesn’t have to do that.
Penny enters the residents’ locker room and asks how she finds out which service she’s one. Jo says she should ask Stephanie because she’s probably not qualified to answer that. Stephanie tells her to check her email and leaves.
Bailey tells Meredith that transfer residents generally do their first rotation in general surgery and Penny is starting that day and is on Meredith’s service. She says that either she or Richard could take over, but Meredith says it’s fine. She’ll take Blake. It’s the job.
Nathan Riggs pulls into the ambulance bay. Isaac says he can’t park there. Nathan says he’s just stopping for a second. He has a patient. He opens the back door and shows him Kamal Aboud. They’re late, but they’re here.
Jackson shows Ben a case he worked on with tumors on someone’s fingers. He’s going to be working on Kamal, whom April had brought over from Jordan to have surgery. Ben’s shocked that Jackson’s going to let him dissect the tumors. April comes in and asks if they’re ready. Jackson sends Ben to peds to get ready. April thanks Jackson and says Kamal’s a great kid. He’s been living in the hospital since his family died. Jackson says to stop selling. He’s doing the surgery. They go to see Kamal.
Penny finds Meredith. Penny says she doesn’t want it to be awkward or uncomfortable, so Meredith tells her not to make it that way, like she’s doing right now. Meredith gets paged and tells her they’re doing a consult in the pit.
They go see Robert Matthews, who fell down two flights of stairs and had abdominal pain. Meredith does an ultrasound. Robert wakes up and panics, saying he needs to leave. He did something bad. He was trying to get up to the choir loft. He accidentally attached a sex tape to an email bulletin instead of a video of kids playing volleyball.
Kamal is telling April about his trip to Seattle. She introduces him to Jackson. Just then, Nathan comes in and hugs April. She thanks him for bringing Kamal. They worked together on her last tour. They go to look at Kamal’s hands and Jackson sees that they’re much worse than he anticipated. Kamal asks if he can fix them. Jackson says that’s the plan.
In the hallway, Jackson yells at April about not telling him how bad they were. She pretended the scans got lost so Jackson wouldn’t see how bad the case was. She wanted him to meet Kamal and says they need to help him.
Owen asks Callie about Penny being on Meredith’s service. Callie says they haven’t spoken since the party, since Penny thinks she’s on Meredith’s side, which she is, but she’s also on Penny’s side. And now Meredith’s not talking to her either.
Robert has 78 new messages. Everyone knows. Outside the curtain, Meredith has Penny do an assessment. She skips type and crossmatch for blood. Meredith tells her not to skip steps. She needs to know what Penny knows from Dillard. She tells Andrew to take him for a CT.
April says she didn’t lie. She bent the truth. Jackson hasn’t been wanting to try things she’s suggested lately. He says the tumors has probably destroyed any bone this kid had. There might not be anything resembling hands in there. His case is more serious than others that have been successful. Nathan says they’ll keep going until they find someone. Jackson says they’ll all say the same thing. He agrees to do some biopsies so they get a complete picture of what they’re dealing with.
Richard comes into the ER and razzes his friend, Paul James for being a bad driver. He and his daughter, Angela were in a car accident. He was driving and hit a tree. He says he hit the break and they just kept going. Richard and Paul have known each other since before he and Adele were married. Paul call Richard Bumpy, which Maggie wonders about. Angela has a broken clavicle and a weak pulse in her right arm. Richard sees Paul rub his thigh and asks if he’s okay. He says he’s fine, but Richard wants to do a workup anyway.
They are looking at Robert’s CT results and Meredith asks Penny what she sees. Penny sees fluid and Meredith says it’s around the kidney when Penny can’t tell. It’s a serious injury, so they need to do an exploratory laparotomy. Amelia and Stephanie come in. Amelia looks at the CT. She says he has a mild concussion. She’ll examine him, but he’s cleared for surgery. Stephanie asks if it’s the pastor who gave his congregation a special blessing. Word’s all the way around the hospital. Penny says she bets the pews will be full on Sunday, but gets silence. Amelia says to monitor for neuro deficits and she’ll do another check post-op. Amelia has Stephanie show Penny where to take Robert. Once they’re gone, Amelia berates Meredith for having Penny on her service. Meredith says she’s trying to rise above and Amelia should to. Amelia says she should have ended it the night of the party. Then she says it was better when they weren’t talking and leaves.
Jackson says the biopsy showed pre-cancerous cells on both sides. He officially recommends amputation of both hands. It’s his best shot before it progresses to cancer. Nathan says he won’t have a chance to survive in Jordan like that. April implores Jackson to try. Nathan tells them he’s going to leave and take Kamal because it’s not about them. It’s about Kamal, who saw his family get murdered and his house get burned down. He’d have been taken as a child soldier, but his hands were deformed. It’s not about them working out their crap. He’s going to make sure Kamal gets help. He leaves. Jackson asks why April brought Kamal to him. She says she doesn’t believe it’s hopeless. Jackson says there’s nothing there to save.
As Meredith preps for surgery, she asks Penny what the most difficult part of a partial nephrectomy is. Penny explains and Meredith says she should know the surgery inside and out. Penny’s going to talk her through the surgery. Her hands are Meredith’s hands.
Maggie tells Paul that Angela’s going into surgery for a subclavian bleed. She asks him again about the name Bumpy, but before he can explain, Richard comes in. He sees Paul massaging his foot and asks about it. He says it’s fine, but Richard says he has diabetes and he figures Paul already knew that. The pins and needles pain in his foot is diabetic nerve pain. Paul says he hasn’t told Angela. He doesn’t want to tell her. Richard says it might have caused the accident and he needs to tell Angela. Paul asks Richard if he has any children. Richard says he doesn’t and Paul says he can’t possibly understand. Maggie says she’ll let him know when Angela’s out of surgery and leaves.
April rants to Arizona about Jackson giving up. Arizona asks why April brought Kamal in the first place. The scans were so bad that she had a lie about them. She lied about a child. Arizona says she understands what it’s like when things feel like they’re coming apart and needing something to pull it together. She gets it.
Nathan’s on the phone with a friend. He wants them to show Kamal’s scans to someone. Owen comes out and is shocked to see him. Nathan explains that he worked with April and brought a kid to have surgery. Owen says after the surgery, he has to leave.
Penny’s still dictating the surgery. Richard comes in to check on them. He says Penny’s being very thorough. But Meredith says she missed a step. She didn’t tell Meredith to clamp the hilum. Meredith did it on her own. Meredith tells Penny to hand over her suction because if she’d been in charge, the patient would have died. She tells Penny to step back from the table.
Callie passes Penny in the hospital. She asks her what’s wrong. Penny tells her about Meredith. She says she let Meredith in her head and she froze. Callie offers to talk to her, but Penny says no. She’ll figure it out. It’s not Callie’s problem.
Jackson, Ben, and Nathan look at Kamal. Nathan says he checked with three other guys and they all said no. Jackson says he knows April can be intense. Nathan says she’s The Machine. She keeps working and doesn’t let anything get to her. She encourages others to keep working as well. Nothing’s going to stop her once she’s started. Jackson says that’s true. She’s usually right, though. Jackson sends Ben to find out what Callie is doing.
Maggie gets out of surgery and tells Richard in went well. She repaired the artery. He can tell Paul she’ll be fine. Richard tries to explain why he didn’t tell Paul about Maggie. He’s not sure what to tell people. Maggie starts to tear up and wants to pretend it’s allergies. She gets that he doesn’t want to admit that he cheated on his wife. It won’t help anyone. She doesn’t know what they are. Richard says he doesn’t know either. Maggie says it’s fine and leaves.
They tell Kamal they’re going to amputate his hands. He asks if he can still carry things. Jackson says they’ll talk about that.
They take Kamal to surgery. April says she’ll be there afterward. Jackson says he’s not sure, but they’re going to do it anyway. Nathan tells Kamal they’ll have a soda waiting for him when he’s done. An emotional April tells kisses Kamal on the forehead. They take Kamal inside. Once Kamal’s in the OR, Callie comes over and they start talking about their plans to remove the tumors and save the hands. They didn’t want to give Kamal hope, because it might end up being the world’s slowest amputation. April’s upset that Nathan lied to her, but he says it was a good lie. She’s happy that Jackson’s going to try.
Richard wants to talk to Meredith. He thought she was stepping up, but she was hazing Penny. Meredith defends herself. Richard says she was at the top of her class at Dillard. Her references were impeccable. Meredith realizes he knew that Penny was on Derek’s case. She was an excellent candidate. Meredith was the only reason not to hire her. Meredith wonders why that wasn’t reason enough.
Penny’s doing a post-op exam of Robert. He’s upset because he’s everywhere. He’s been fired. Someone’s threatening charges as a sexual predator. He’s finished. They were supposed to be a community and they’ve all turned their backs on him. She tells him to put his phone away. His mother saw the video and her friends won’t talk to her. They’re trying to figure out who the woman is, as if it’s their business. At least her life isn’t ruined, too. People put their faith in clergy and when they break it, it ends things. Penny says she believes he can fix it. Robert has pain and she finds blood in his urine bag. He has a clot in his catheter. She asks a nurse to page Meredith.
April and Nathan watch Kamal’s surgery. April says Jackson’s talking about divorce, but that’s not what she wants. She doesn’t think Jackson or God wants it for them either. Nathan says God probably has bigger things on his mind than that.
In the OR, Jackson and Callie are hunting for any usable bones. Callie’s not really finding anything. Jackson implores her to keep going. A nurse turns on the bone saw and Jackson tells her to put it down until they’re sure there’s nothing more they can do. Callie finds a bit of usable bone.
Meredith comes into Martin’s room. Penny hasn’t been able to place a new catheter. Meredith’s upset at Penny for not noticing the problem right away. She asks if there’s any part of the job that Penny can handle. Meredith then kicks her off the case and her service.
In Kamal’s surgery, they’re able to find enough bones to reconstruct his hands. Because he’s young, some bone might regenerate and then can use rib grafts. They have enough bones to make a hand. In the gallery, Nathan says he didn’t believe it, but April did.
Maggie tells Paul that Angela will be fine. Richard comes in and encourages him again to talk to Angela. He’s not sure he can. Richard admits to the affair and having a daughter, but doesn’t say that it’s Maggie. He says Adele lived with the pain alone, protecting him. He made a mess, but some good did come of it and he’s proud to know her.
Meredith comes into the bathroom where Amelia is washing her hands and says that Amelia’s right. Penny doesn’t belong there. Amelia asks her to say it again, that she was right. Meredith tried to rise above, but Penny’s made mistakes and she’s impossible. In a stall, Callie clears her throat and then comes out to wash her hands. Meredith says it’s the truth. Callie says Meredith wasn’t teaching, she was bullying. It was mean and small.
Meredith is sitting in the chapel. Alex comes in and she asks him to leave her alone. He asks her since when does she pray. She says she’s not. She’s talking to Derek. She’s trying to rise above, but she’s not sure she can. She thought Derek might know what she should do and why she’s there. So she’s waiting for divine intervention or something.
They remove Kamal’s bandages and show him his hands. He’s amazed that they look like hands. Nathan tells him they’re his hands. Jackson says he’ll need a few more surgeries, but they’re his hands. He high fives Kamal.
Richard watches Paul talk to Angela in his room. Maggie comes up and asks why Paul calls him Bumpy. He says there was a dance called The Bump and he excelled at it. Maggie asks why he didn’t tell Paul that it was her. He says he figures it’s up to her to tell him if she wants to. But he’d be fine with it if she did. She says that’s noted and walks away. Richard then starts to dance for a few seconds.
April’s leaving when Jackson comes up to her. He thanks her for bringing Kamal. She apologizes for lying and says he has no idea what he did for Kamal. She brought him because she knew he could do it. They did it. They hug and April starts to ask if he wants to talk, but Nathan comes up and asks if she’s ready. They’re going to get drinks with Bailey before he leaves. April says she doesn’t have to go, but Jackson tell her to go celebrate. They invited Jackson, but he tells them to have fun.
Richard tells Meredith he didn’t want Penny there. He fought it, but allowed it because he has been accused of coddling Meredith and he didn’t want that. And he tells her he didn’t want Meredith there in the first place because of what had happened with Ellis. He didn’t want her to remind him of the best and worst times of his life. He decided it wasn’t fair to her and put aside his feelings and rose above. He’s glad he did. Meredith says Derek would have said the same thing. He probably would have even liked Penny.
Astrid comes to the desk looking for Robert. Meredith asks if she’s his family. She says no, she’s the choir director at the church. Meredith knows she’s the girl in the video. Astrid says it’s not fair that this one mistake is all everyone will remember about him. She wants him to know that he at least has her.
Meredith watches Robert and Astrid in his room and then pulls the door shut.
Callie finds Penny sitting on a bench outside the hospital. Penny says it was a mistake to come there. She’s not sure she wants to do it. Callie says she went off on Meredith about her and Penny asks why she’s making it harder. Callie says it’s what she should have done at the party. Penny says she gets it. They’re her friends. Derek was. Callie says she’s a surgeon. They make mistakes. They need to be forgiven. She will if Penny will. And she’s here if Penny’s here. Penny says she is and they kiss. Penny gets paged. Meredith has requested her on her service for the rest of the week. Either she wants to work with her or wants to torture her more. It’s one of those. They leave together.
Meredith continues to teach her anatomy class. Penny has joined the class and Meredith tells the class not to let their shame kill them.
