Jackson meets Cristina, April, and Meredith outside of the hotel. Meredith says it was hell, while Cristina admits she went a lot overboard. None of them think it went well. Meanwhile, Meredith’s voice over criticizes the carpe diem motto. Meredith says the next test will be in June 2013, disappointing them all. Jackson suggests they don’t even talk about anymore and they all happily agree. Meredith asks if anyone knows how Alex did it. “Anyone know if Alex made it?” April replies, surprising the two of them, as they don’t know he flew back to Seattle.
Richard meets Catherine. He asks if she’s okay, but she’s not sure. She’s not worried about last night. She’s worried because she checked with some of her friends on the committee and one of the Seattle Grace doctors didn’t pass. She has no idea who, but if it’s Jackson, he’ll blame her forever.
Six Hours Earlier
Session One
The doctors are welcomed by their examiners. They’ll get 4 separate scenarios in 3 30-minute sessions with 10-minute breaks in between. To pass the test, they must pass two of the three sessions, so they can fail a session and still pass. Examiners are not permitted to indicate whether or not they failed each sessions. They’ll be rated on their ability to diagnose, manage treatment, handle the unexpected. So, basically, the strength of their constitution in crisis.
In contrast to the others’ examiners, Cristina’s old examiner is talking really slowly. He explains that once a scenario’s passed, there’s no doubling back. He wants to explain this, but Cristina interrupts him, saying she gets it. He asks her if she’s in a hurry. No, just ready when he is. He starts reading the first scenario. Cristina starts replying fast.
Meredith is also answering to her first scenario, trying to ignore her illness. Jackson is replying without difficulties, while April is nervous, so she has to ask certain information twice. In Alex’s exam hotel room, the two examiners watch the empty chair, agreeing to give this Karev 15 more minutes. Cristina finishes up. Her examiners remarks her treatment was aggressive. She takes a step back. He asks if she’s okay with that. She is. Meanwhile, Meredith has to take a pause from time to time to hold back vomit.
Alex is putting on a tie in cab that’s stuck in traffic. He suggests the driver take the bus lane, but the driver refuses. They’re about 20 blocks away from his destination. Alex throws money and then gets out of the car. While he runs towards the hotel, his examiners talk about the game last night.
Back in Seattle, Mark serves pancakes to Julia and Sofia. He’s nervous because Jackson is taking the test right now. Julia thinks that’s cute and paternal. He’s a natural father. She says they should have a baby. She sees his shocked face and tells him not to freak out. She likes this whole situation and he doesn’t have to say anything. As she grabs her stuff, she says he can go back to worrying about Jackson and they can talk about it later. She would say no rush, but actually her FSH levels suggest that rushing a little may not be the worst thing in the world. She kisses him and leaves.
Callie reads Mark’s text about what just happened, but Arizona can’t deal with it right now. She says she should’ve picked him up herself. Callie thought he was her brother’s best friend, but Arizona says they were all very close. He flew in from Tibet and he has cancer and still, she let him take a cab. Callie calms her down, but his type of cancer is very slow growing and he found out six months ago. He could be fine. Arizona is not worried with Callie in the OR and says they’ll love each other. “I’m taking his tumor out, it’s the least he could do,” Callie jokes as they meet Nick in the waiting room. Arizona hugs him and asks what’s up with the cane. He says walking hurts. That is soon, Arizona says, but he then confesses he found out about his tumor 6 years ago, not months. Arizona is shocked as Callie and Nick shake hands.
Mark tells Derek that Julia wants his baby. He thought it was crazy, but when you think about it, it’s actually genius. He loves Julia and he wants siblings for Sofia. He and Derek discuss if he should do it when Lexie comes over. Derek makes up the excuse that they were talking about the cranioplasty, about which she’s excited. They walk to their patient’s room.
In the room, Lexie presents the case. Charlie fell off the roof six months. He’s in now for a repair of a skull bone defect that occurred secondary to the surgical removal of part of his skull. They waited for the swelling to go down. Lexie asks what he was doing anyway. “Being an idiot,” his wife replies. They start arguing over the matter until Derek explains they created a custom titanium plate that they will secure to the bone. Mark will take fat from his belly to pull his face into shape. Charlie has a garage and has all the tools needed to attach the titanium plate to his skull, so he suggests they do it there to save him money, but his wife firmly disagrees.
Owen asks Bailey for a favor. She has to really woo the candidates today. After the boards, they may lose very good doctors to other programs, and if that happens, they need to make sure they have fresh talent ready and waiting to take their place. For that, he needs her to woo their socks off. Bailey agrees to as Teddy comes over. She asks Owen if he has any idea on what Cristina’s plans are for next year, but he hasn’t. She asks him to keep him posted, which he will do.
The doctors get out of their hotel exam rooms. Meredith runs off to the housekeeping cart to vomit in it. Cristina comes over and gives her some tissues. She thinks the first session was easy. “I wanna punch your face,” Meredith says in between vomiting. Cristina gets her some more tissues.
Alex finally arrives in his hotel exam room. He apologizes and introduces himself. He says he was stuck with a patient, but one of the examiners says they all have patients. Yet, they were there. He asks if he just fails then. The first of three sessions, yes, which means he needs perfect scores in the next two sessions.
Catherine finds Jackson, knowing he must be shocked. He’s more irritated that she seems to be everywhere he goes. She says she’s a woman, she has needs. He acts disgusted, but she says he shouldn’t bring it up if he can’t talk about it like an adult. He reminds her he didn’t bring it up and asks her to leave him alone as he’s in the middle of his boards. She follows him because she’s the examiner in the room next to his. They get into their rooms.
Session Two
A nervous April is answering to a scenario. When she’s finished, the examiner says the patient died. They move on to the next scenario, but she wants to go back to clarify things.
Meredith is still doing her best to ignore her illness while answering, but the examiner notices she’s squeamish.
Alex is explaining his course of treatment to a scenario as well. He perfectly deals with a mentioned complication.
April has gone back to the previous situation and is clarifying her course of treatment, even though she knows she can’t do that. As the examiners get ready to move on, she just can’t let it go and goes back to the previous scenario. She asks them to hold on for a second and takes off her jacket, revealing her shirt is soaked with sweat. The doctors are embarrassed for her as she tries to cover up the sweat marks. The examiner asks if she would allow them the courtesy of moving on. As the examiners starts reading the next scenario, April once again returns to the previous scenario. She yells at her examiners to please tell her why the patient would die and that she can’t answer correctly if she doesn’t have the full information. She’s a really good doctor, but she just needs all the information.
While looking at the scans that accompany this scenario, Jackson is distracted by the laughter of his mother next door. He says the noise is distracting, but this makes the examiners question his ability to function in a high-volume OR. As he tries to talk it down, they mock him while the laughter continues.
Cristina’s examiner is getting a cup of coffee. Cristina herself is always ahead of the questions and already deals with possible complications. The examiners calls her decision a risky move, but she visibly disagrees with that. However, when he asks her if she wanted to add something, she says no.
Callie is examining Nick and she reproaches him for having waited six years before seeking treatment. Nick says he’s been working with naturopath. It helped at first, but when the pain kicked up, he saw a real doctor, who was gonna refer him to an orthopedic surgeon. He then decided to visit Arizona, as she just married one of those. “Not that it was a real wedding,” he jokes, offending Callie. He’s serious, but not in the way Callie is thinking. He meant Arizona is already married to him. They were 10, did the wedding in a treehouse with rings made out of crabgrass. It was a beautiful ceremony, officiated by Tim, and Nick was probably the last guy she ever kissed. Callie returns to the medical part and goes to order new scans, as the ones they’re looking at are 12 months old. He spent the last year fighting through the pain. As Callie leaves, Nick asks if he’s dying, because Callie’s attitude makes it seem so. Arizona assures him he’ll be fine and that Callie is a genius with a scalpel. They talk a little. He forgot how much he missed her, and same goes for her. They hug.
Bailey is guiding the candidates. One of them asks if he’d have to share an office. She wants to say they don’t have offices, but corrects herself and says she’ll have to check on that. Another candidate asks if parking spaces are assigned for attendings. She’ll have to check on that too. The tour continues.
Derek and Lexie are in the skills lab. Mark told Lexie she’ll get to graft the fat. He agrees that’s cool and then decides to be her big brother for 30 seconds. He tells her Julia wants to have a baby with Mark. As she asks more about his reaction, Derek walks off to go check on a patient.
Cristina and Meredith are in the bathroom of the hotel. Meredith thinks all of her questions are gross with all the bowels and bloody stools. Cristina says her examiner is a fossil. Meredith thinks about living in the toilet stall until she dies. April knocks on the door, but Cristina tells her to go away as there’s a sick woman in there. April says she really needs to get in. “Sorry! Closed for maintenance!” Cristina then says. April begs her to let her in, but Cristina tells her to come back later.
Bailey starts talking to Derek about the applicants. He asks her when he became the advice columnist. He apologizes, but no one seems to be able to make up their own mind today. Bailey says people do make up their own minds, but they just need help getting there. When someone comes to her with a problem, she gives them a metaphor. The beauty of it is that the people seeking advice will draw some meaning from it and it’ll help them to make the decision they were gonna make in the first place. Derek thinks he’s just gonna stick with being honest. Bailey says that honesty can bite him in the ass when people take his advice but it doesn’t work out.
April is drying her shirt in the men’s restroom. The men remind her it’s a men’s restroom, but she yells they’re all doctors. Jackson comes in. They’re both failing and start panicking. April says Jesus in the only one who can calm her down, but she broke her promise and he won’t talk to her now. Jackson asks her why she let him do it then, but she doesn’t know. As they’re yelling about it, he says that being the guy who made her break her promise is very unbecoming, especially for an Avery. April can’t believe he’s comparing breaking her promise to Jesus to putting a tiny dent in his family’s crest. They calm down and he apologizes. He’s worrying about his mother and what she’ll say when he fails. She says that’s not pathetic, as it’s the most important relationship of one’s life. April says it’s not the problem that she broke her promise, the problem is that it felt good. They talk about how it happened. He locks the door while they keep on recapitulating the previous night, soon ending up kissing again. He picks her up and takes her into a stall.
In the cafeteria, one of the candidates sniffs a roll, disgusting the attendings. Bailey says they need to keep their people and everyone agrees. They talk about their resident’s options and Bailey says her contact in Boston said that Meredith said that their program is her top choice. Mark looks at Derek and says he’s building a house. Derek says Harvard has a really good neuro department and there are really nice houses there too. He walks out of the cafeteria, frustrating Mark.
Derek is on the phone with Meredith. She confesses she’s not okay. She’s failing and she doesn’t think she can go back in. She asks if he would still love her if she fails. He asks if she wants him to yell at her or tell her to come home. She wants him to tell her what to do. “The test is a mirror,” he says. Like Bailey predicted, Meredith draws a conclusion: she won’t be able to look herself in the mirror if she gives up. He says he’ll love her whatever she decides, but she says nobody loves a quitter. He wishes her good luck and she hangs up the phone. She gets out of the stall, while he smiles because Bailey’s trick worked.
Final Session
Instead of answering medically to the scenario, April says she would pray for the patient. She knows it’s not the right answer, but it’s what she would do first. Or at least if they had asked her yesterday, now she’s not so sure anymore that Jesus is listening. The examiner says this is highly inappropriate, but she replies so is having premarital sex in the men’s room with a really good friend, but that just happened. April says she spent a decade, surrounded by scientists, holding back her true feelings about God because of the fear of being mocked or considered less of a doctor. She was hiding, ashamed to admit she loves God, but this is the one relationship she can count on. She’s not sure what happened to that relationship now, but she’s sure she’s done hiding. The examiners snaps her back to reality and she gives him a medical reply now.
Jackson is very focused, even correcting his examiner’s scenario and thereby impressing them.
Bailey and Callie are operating on Nick while Arizona is talking about something Nick did for orphan girls in Calcutta. Bailey tells Arizona that they’re not going to kill her friend and Callie asks if he saves puppies too. Arizona demands less sarcasm and more focus. Callie and Bailey then encounter a complication. Callie claims she forgot to bring snacks to daycare today and sends Arizona out to do it. Bailey knows she didn’t forget snacks. No, Callie saw mets in the vessels, and if they’re there, they can be everywhere.
In surgery, Derek asks Lexie a question about an atrophied muscle. She explains why it’s atrophied. Derek meaningfully says it’s too late for the muscle, it’s missed its chance to attach. Mark asks why they’re talking about the muscle, but Derek claims it’s just a teacher moment. He continues to talk metaphorically about the muscle, trying to send Lexie a message, but Mark suddenly says he received the message loud and clear, thinking it’s about Julia and the baby.
Arizona meets Callie, Bailey, and Teddy in an X-ray viewing room. The kids already had snacks. She asks why Teddy’s there. Callie tells her they did a PET scan, which showed Nick has intradural mets. They even spread into his heart. Bailey says there’s very little they can do. Arizona takes a moment to let it all sink in and then leaves in anger.
Meredith is answering a question, but has to pause to vomit in the bin.
Cristina starts bickering with her examiner over the use of endoscopic procedures. She says opening the patient up would be more invasive, but fine too.
Meredith finishes throwing up. The examiners want to call it done and say she can retake the test next year, but she asks if they can’t handle a little vomit as doctors. She resumes and finishes her answer, but asks them to ask her something else, as she’s known the answer since she was 12 because her mother invented the technique. “Keep ’em coming, but don’t go easy on me,” she says. As the examiner starts reading the next scenario, Meredith vomits again.
Cristina’s examiner comments she seems awfully sure of herself. He thinks it makes her feel threatened. “Have we moved on to psychology?” she asks. He finds her hostility curious. She’s curious as to why he finds her hostile. He wishes she would voice her issues if she disagrees with his approach. She claims not to have issues with his approach, but he doesn’t believe her. They stare at each other and she then confesses she wasn’t okay with the open procedure earlier. With this being the new century and all, she would’ve treated it endoscopically. He concludes she lied then. She says she can answer his questions any way he wants, using medical techniques from any era. She tells him to pick a decade he’s comfortable with and go from there. He sees it’s been a pleasure to have been a witness to such a genius as he can know finally retire, knowing such advanced and creative minds are at work in the surgical field. He starts packing his stuff, so Cristina asks if that’s it. Yes, he thinks they’ve had enough of an education for the day. She brings up there are still 20 minutes left, but he wishes her the best of luck and walks out.
Alex gives a reply to the scenario, but then realizes it was a trick question. He can’t believe he’s going to fail because of a trick question and starts arguing about it, but his examiner says he’s lucky to even be getting this chance as he missed his first session. For the best freakin’ reason, Alex defends himself, and he gives them his patient history. He had to be there, and all he missed here was a few more hypothetical trick questions. He yells they’re staring and that they are doctors, deciding if he can become a doctor too, questioning how they can do that if they can’t even understand why he was late. The examiners close their folders. He asks if they can at least tell him if he passed.
An angry Alex storms into the hallway and throws away his bag. He sits down against the wall as he tries to hold back his tears.
Richard and Catherine walk out of the hotel. She better go in order not to miss her flight. She kisses him goodbye and says she doesn’t regret last night even a bit. Neither does he, but it’s just bad timing since they live in different cities. She agrees. He asks her to call him if she knows more about the boards, and she asks him to call her to let her know he got home safe. Before getting in a cab, she asks if he’s going to a certain conference in May. He’s speaking there. They start comparing agendas.
Charlie is admiring his head in a mirror. His wife tells Lexie and Derek that they’re miracle workers. He wants to know when he can get back on the ladder. His wife asks Derek to talk some sense into him. Derek says that’s not his place, but if she wants to do it, she should. She says he is clumsy and she can’t stand the thought of losing him again, so she asks him to take a second and what’s left of his brain to think about how she felt about it, how scared she was to lose him forever. He understands and apologizes, saying he can find a new hobby they can do together. They start arguing about bowling.
Lexie walks into Mark outside the hospital. She thanks him for letting her graft the fat. He says she did a good job and asks if she’s okay. She blurts out she loves him. She loves him and she’s been trying not to say it. Jackson is a great guy, but it was never going to work out, because she loves him. He’s in her, like he’s a disease and she’s infected by Mark Sloan. She can’t think about anything or anybody, she can’t sleep, she can’t breath or eat and she loves him all the time. She finishes and says she feels so much better, finally having said it. He doesn’t respond. Suddenly, Julia appears. She greets Lexie and says she thought she was supposed to meet Mark in the lobby. She asks if he’s ready, but he’s speechless.
Arizona walks into Nick’s room. He claims to be feeling okay due to the drugs. She then says he’s an idiot. He should’ve called her and asks why he didn’t. He tries to keep it light, but she’s dead serious because he’s dying. She says they both barely made it through the hell when Tim died, so she doesn’t understand why he didn’t do something for six years and then come when it’s too late. He knows she’s feeling. She yells he’s an idiot. She couldn’t help Tim, but she could’ve helped him. She then storm off past Callie, who is standing in the doorway.
In the ambulance bay, the shuttle with the residents arrives. April runs inside as she has to pee. Jackson, Meredith, Cristina, and Alex are checking their phones for the results, which are 4 minutes late. They all keep refreshing the page. They all think they failed. A nurse comes outside to ask if any of them is on call, because she has trauma. They yell no. Jackson is the first to find out he passed. Cristina and Meredith find out too soon after. Alex’s phone won’t refresh. Jackson gives him his phone. He passed too and they all hug and dance happily. Jackson asks about April, who’s just come back outside. She’s watching her phone and then looks at them with teary eyes.