For the first time in quite a while, the day starts out rather happily at Seattle Grace: Richard is performing his 10,000th surgery, Teddy and Cristina are getting along and working brilliantly together, and it’s Zola’s first birthday. Meredith actually bakes a cake for Zola’s party that night, though the kitchen is a little crowded with April, Jackson, Alex, and Alex’s latest Flavor of the Week. April finally realizes that she and Jackson really should move out, and so she sets about finding a place for them. Unfortunately, the one she wants is too expensive so she finally offers that Alex can move out with them. I mean, it is for hardwood floors and a washer/dryer. I can’t really blame her.
The Chief’s milestone surgery is a liver transplant between two sisters, played by Peri Gilpin and Nia Vardalos. Nia is the sis in need of a liver and Peri (who will forever be Roz Doyle to me) cannot stop being a total bitch reminding Nia just how much she’s doing for her and how grateful she should be. Nia eventually tries to back out but it’s too late, and so Mere and Bailey remove a portion of Roz’s liver and Richard transplants it into Nia. It’s not the easiest surgery for Richard, though it’s not for any surgical reason — Adele wandered out of the house and tried to walk to the hospital to find him, but fortunately a neighbor saw her. The woman brings her to Seattle Grace but because Richard is in the middle of surgery April winds up having to watch after Adele, who becomes agitated once again thinking that Richard has left her. When April takes her to the gallery to assure her that he is just working, she sees Meredith and, thinking she is Ellis, has a meltdown crying and yelling at her to leave Richard alone. April puts Adele on the intercom so that Richard can talk to her and Mere advises him to talk to her about a nice memory, so he winds up singing “My Funny Valentine,” which was their wedding song, and she joins in for an incredibly touching, sad duet. Bailey had organized a party to celebrate the surgery but he cancels it so that he can take his wife home. While all of this is happening Mere is also trying to figure out what specialty she is going to declare and everyone thinks that it should be general surgery for a number of reasons, not least of which is that her mother was pretty much the best and most famous general surgeon in the history of the world.
Lexie is still kind of living Meredith’s old surgical life working with Derek, who is still on his kick of taking difficult cases. Their patient is a boy with a spinal tumor, whose mother has been told by eight doctors that it is inoperable. Because the kid is going to die within three months anyway, she wants someone to take a stab at it, and so finally Derek agrees. One little complication is that she hasn’t actually told her son that he has a tumor. When Lexie is alone with the boy he admits that he knows what it is since he overheard one of his last doctors talking, and she promises that Derek is the best and they’ll do what they can. Unfortunately, once they are in there it really is inoperable and Derek finally makes the decision to close him up. Lexie tries to fight him on it to the point where he excuses her from the OR, and later that night at Zola’s party they have a conversation where he admits that sometimes these things truly are inoperable and asks if she wants out. But despite how horribly sad it was to get through the day (including after the surgery, watching the boy admit to his mom that he knew he was going to go see his dad in heaven soon) she tells Derek she is still totally on board for all of these crazy cases.