Ellis is pacing. She is rambling about Richard going back to Adele.

Meredith attempts to calm her down. She tells Ellis this happened

a long time ago. Ellis doesn’t respond. She then says he must have left

her because of her daughter as Richard never wanted children.

She never should have had a kid.

Bailey, Cristina, Burke, and Derek are gathered in Richard’s office. Bailey wants to know how Burke and Cristina will be punished. Richard says technically, they have done nothing wrong, so Richard still has not decided. Richard says Cristina will go back on the floor with Bailey. Bailey objects, but since the situation didn’t directly harm her, she has to suck it up. Once the two of them are gone, Richard tells Derek and Burke they need to get together to deal with the tremor. Derek says Burke does not want his help. Richard says that hand is worth 2 million dollars, so they have to figure it out.

Harold wants George to know that if things go wrong, the life insurance papers are in his night stand drawer. And his magazines are in the garage. George is a bit disgusted, but Callie clears her throat from the doorway. She wanted to check up on Harold’s collarbone. George gets up and leaves, completely ignoring Callie.

Derek tells Burke there’s likely just a compression around the site of injury. Burke doesn’t want another surgery. Derek is confident he can do this, but Burke points out that he said that last time.

The other interns are discussing possible punishments for Cristina, with Meredith being the only one on her side. George points it out it was not just a mistake. Cristina comes in and they all go silent. Everyone but Meredith leaves. Meredith asks about her and Burke. Cristina says they are existing in total silence. Neither of them wants to talk. Bailey comes in and says rounds started 30 seconds ago. If she’s late again, Cristina can find another resident.

Addison comes up and asks if she can have Meredith. Bailey agrees. Addison tells Meredith that her sister Molly was admitted for an emergency C-section. Meredith says Molly is not her sister, and Susan Grey is definitely not her mother. She doesn’t need to know this. Addison says she does as Susan comes up behind her. She greets Meredith, who just tries her best at a smile.

Bailey and her interns enter Harold’s room, where Louise has set out some breakfast for them. However, Bailey makes it clear they are not to touch anything. George’s brothers come in and immediately go at the food. Erica also enters, determined to make this fast. She asks which intern’s hers. Alex says it must be his case given the others’ situations. However, Bailey chooses Yang. Cristina presents the case. Harold is scheduled for aortic valve replacement.

Izzie, Alex, and George follow Bailey as they complain about Yang getting a case. Bailey turns around and tells them to stop whining, or else she won’t show them what’s behind the door behind her. And she’s certain they really want to see it. She opens the door, revealing adult male conjoined twins. One of them has to pee, which annoys the other one. The interns are in awe. Bailey asks which one of them thinks Yang got the better case. No one replies.

Bailey tells the interns the patients are Peter and Jake Weitzman. Derek, Mark, and Richard have also joined the team. Richard says the Weitzmans came in for a separation procedure. Six months ago, Pete chickened out because of the risks. Alex says they came back at the right time since Mark has joined the staff. George asks why now. The reason then walks in: Elena, the love of Jake’s life. Elena stresses they don’t have to do this for her. Derek is still serious about the risks. Jake is completely done being attached to another person. Pete doesn’t want to be attached to someone who doesn’t want to be attached to him.

The three interns are arguing who gets to be on the case, but they are all on. However, Izzie is still only to observe. Mark requests an intern and chooses Izzie.

As they walk off, Izzie thanks Mark for picking her. She asks if he’ll be working on both the neural graft and skin reconstruction. He will, and he thinks he’ll be better with some caffeine in his system. He gives Izzie money and tells her his order. She directs him to the cafeteria or the coffee cart. She does not do coffee. She then proceeds to ask questions.

Richard and Derek are discussing the case. Richard is thinking about the press, but Derek would rather not do the surgery. The spines are fused together from L4 down and their blood flow is intricately connected. They could end up paralyzed or dead. Richard wonders why Derek is backing out. They are moving forward unless there is irrefutable evidence that it can’t be done.

Susan tells Meredith that her father is not here. He’s at Harvard Med visiting Lexie. They’ve been working with Addison to buy time, but apparently the baby is ready to come out. Addison could use an intern, so she asks Meredith to ask Bailey. Meredith volunteers. Susan likes that she’ll have a familiar face in the OR. Meredith says it’s her job and asks if Molly knows. Susan confesses Thatcher thought it was better not to tell her. Meredith agrees. Addison thinks Molly should be about ready, so Susan needs to get into scrubs and find a cap. Susan realizes she’s about to be a grandmother.

Cristina is explaining the procedure to Harold and his family. It’s good they are doing the surgery today because Harold had a lot of irregular heart rhythms this morning. Suddenly, George enters and points out that his father’s potassium is borderline low. Hahn says they got this and wants to kick him out when he starts bickering with Cristina, but George insists on staying and points out he’s the one who hired Erica.

In the OR, Addison is a few minutes away from delivering the baby. Susan is comforting her daughter. Addison delivers the baby and has Meredith cut the cord. The baby’s not crying. Addison says they need to get this baby to an OR and get it stabilized. Molly starts panicking so Addison asks Susan to stay with Molly. As she works on the baby, she asks Meredith to explain what’s going on to Susan. However, it takes a while for her to get through to Meredith. Meredith then tells Susan the baby’s not breathing.

As she’s scrubbing, Addison scolds Meredith for having left her hanging. Meredith apologizes and offers to scrub in on the baby, but Addison needs her to keep Molly and Susan updated. The baby has jejunal atresia, which puts her life at risk. Addison has consent to operate, but she does not have time for updates. She has decided not to let Meredith into an OR with her family again and asks her to come check with her every hour.

Bailey is yelling at George for his behavior to Hahn. She orders George to stay 50 feet away from his father and he better not make her tell him again. George sees Burke at the nurses’ station. Hahn and Cristina also come up to the nurses’ station. Hahn tells Burke Cristina has proven herself to be quite the asset. He trained her well. Burke agrees she’s very professional.

Richard finds Burke researching neurosurgeons. He does not want Derek. Richard has not yelled, because he was supporting a guy in trouble. But now, he’s yelling. He wants to retire and he wants his wife back. He passed the torch to Burke and he blew it out. Burke realizes he let Richard down. Richard says he’s tired of men acting like boys. If he doesn’t let Derek fix his hand, he’s also letting himself down.

The surgical team consisting of 22 surgeons is practicing on a model in the OR. Each one of them is aware what to do. A critical point comes when Derek cuts a certain artery, because after that, it’ll only be 2 minutes before all sensation to a certain set of nerves are gone. Mark says they have enough spare nerves to cover the deficit. He’s confident they can do this. Derek says the body is much more fragile than this model. He insists this is not worth the risk since both men are doing fine. He leaves the room.

Meredith goes to Susan and Molly and tells them about the baby’s intestinal obstruction. Molly says she can’t do this. Susan says she’s right here and her dad’s on the way, too. Molly wants to call Eric. Susan tells Meredith that he’s Molly’s husband, who’s in Iraq. Molly needs to tell him so they can name the baby together.

Izzie and Alex are preparing Jake and Peter. Jake shares the real reason they are having the surgery. They have rules. When one of them is on a date, the other one has to sit there and be quiet. Elena says she likes how Pete stood up for her. Also, Jake says Pete touched Elena when they were having sex. Pete says it was an accident. Elena says she was fine with it. It wasn’t a big deal. It was sweet. Jake then realizes she liked it. Elena says she’s in love with Jake. It’s great when they make love, but after Jake falls asleep, she and Pete talk. She loves that, too. Jake says she can’t have the both of them and demands that she make a choice. She remains silent for a while and then apologizes. Pete then wants to talk to her, but Jake hits him in the face. The doctors break up the fight.

The interns gather in Really Old Guy’s room for lunch. Alex is surprised that Cristina hasn’t been kicked out of the program yet. Alex wonders how Cristina managed to pull it off without the nurses noticing. Izzie and George join in. Meredith tries to defend her, but Cristina tells her to cut it out. She leaves the room.

George enters Harold’s room, prompting Callie to leave. Harold stops her and asks George to make nice with Callie. He’s noticed that George is very angry, picking fights every chance he gets, and that’s not like him. Harold wants to know why George is so mad at Callie. Harold lists all the people George is angry at. It’s a long list. Especially when the person he’s really angry at is him. He drank, and smoked, doesn’t exercise, and eats all the wrong things. Now he has cancer and George has to take care of everything. George claims he doesn’t mind, but Harold knows he does. It’s okay for George to be mad at him, because he’s mad at himself. He doesn’t want to die and leave his boy in charge. George assures him he won’t die. George’s mother and brothers enter, and they mock their brother again. As George yells at them, his father starts gasping for air.

George’s family thinks Harold’s having a heart attack, but George clarifies he’s just tachycardic. George tells his father to stop resisting the oxygen mask. He orders meds as Burke comes in. Burke checks out the chart and changes the medication George ordered. He gives George the syringe. Erica and Cristina come in as George administers the lidocaine. Burke updates them. Erica needs everyone to leave. She takes a listen.

Izzie finds Mark following his page. He wants coffee. He tells her she needs to learn how to fetch and stay if she wants to stay on his service. She agrees to get him one cup of coffee, but she tells him he better does something that commands respects if he wants her to respect him.

Derek is still practicing on the model with Bailey by his side. She tells him she started to think she shouldn’t be operating after the Duquette M&M. She let the whispers in and started doubting herself. Surgeons put a life at stake every time they hold a scalpel, so it interfered with her job. She tells Derek he fixed Burke’s hand as he had promised. It’s Burke’s fault for not having been honest about the tremor. There’s no telling what Derek could have done to prevent it, but she’s sure he can pull this surgery off.

Harold is taken to the OR and asks if George is coming. George says they don’t allow family in there, but he assures him he’ll be taken good care of. Louise is crying, wondering what she’s gonna do if Harold dies.

George enters the OR as the conjoined twins are brought in. He requests Bailey take him off the case so he can be with his mother. She deems that the right choice. Jake asks Bailey to make sure that Pete’s ass is bigger than his once they are separated.

Meredith is back in Addison’s OR. It’s going to take a long time and she’s doing the best she can. She doesn’t know what Meredith can tell Molly and Susan.

Mark tells Bailey that he’d like Izzie to come down from the gallery so she can have a better view. Bailey says okay. Richard reminds her Izzie is without privilege right now. Bailey bounces back that Cristina also made a mistake, yet she’s in OR 2 right now. Bailey then tells Izzie to come down and scrub in. Derek finds that the vessels are even more fragile than in the model. Mark suggests a microvascular bypass graft. He can harvest the saphenous vein. Derek doubts that approach, but Richard says they need a decision now and it’s Derek’s call. Derek looks at Bailey and decides it’s a go.

George is watching his father’s surgery from the scrub room. Burke comes in. George tells him they just started. He turns around as Hahn saws through the sternum. Burke then walks him through the procedure as it goes on. Burke himself also watches Cristina.

The saphenous vein graft is in place. They are all ready for the moment of truth. They remove the clamps. Bailey handles the nerve stimulator. It takes a while, but they manage to make muscles twitch in both twins. That means they have four functioning legs. The staff applauds. The surgeons are relieved. They separate the twins. Derek jokes it would be nice if every love triangle could be fixed with a scalpel. Mark realizes he would’ve stabbed him a long time ago, then.

Meredith approaches Susan, who needs good news. Meredith says Addison is on her way to explain everything. Susan tells her Molly has named the baby Laura. Meredith says Laura will need some recovery time, but she should come through. Susan is very relieved. She hugs Meredith. Susan tells her this is her niece. Meredith tells her they both seem very nice, but she doesn’t know them. They are not her family.

As they are operating, Hahn tells Cristina she reminds her of herself as an intern. She’s focused, intense, and cold, which is not a bad thing. Friends, family, dating, it’s all overrated. There’s a lot of bleeding around the aortic suture line, which they rush to fix. Cristina tells Hahn she can put the aortic cannula in the right atrium by herself. Hahn tells her to do it.

George has turned around and he’s wondering what Cristina is doing. Burke tells him that she’s doing a running whip stitch, but it’s okay since she’s done it on her own before.

The fix holds. Hahn compliments Cristina’s work.

Burke tells George he wouldn’t have done anything differently himself. You just never know how the body is going to respond. Every surgery and every body is different. But it’s okay now, they are in the home stretch. Burke goes to leave and George thanks him.

Bailey tells Richard that Yang and Burke going without punishment undermines everything. Richard tells her to take a step back and gain some perspective. If he fires them, their career is over. They made a terrible judgment call. Bailey says that is what happened with Denny. Richard says Yang and Burke didn’t kill anybody. He also doesn’t want to hear Bailey saying she killed Denny. Bailey says she was responsible for Izzie. She is also responsible for Cristina. She is the common thread here. She lost Cristina and Izzie. Richard says they are not the same. Richard says she raised them like children. Some of them make mistakes and disappoint you. Richard says it must have taken a great strength for Yang to come to him and report her attending and boyfriend. Cristina has grown a lot, and that is on Bailey. Some of her interns turned out just like her.

Elena is with Pete. She wants to talk, but he says it’s been a long day. She tells him she’ll come back tomorrow. She kisses him and leaves.

Alex and Izzie put Pete and Jake in the same room. They hold hands.

Meredith is standing outside the NICU as Addison talks to Susan and Molly about Laura’s surgery. Susan notices Meredith watching them. She leaves the room and invites Meredith to come in. Meredith just wants to know if she’s okay. Susan says she’s beautiful. Meredith goes to walk off, but Susan tells her they can be her family. She knows Meredith has a mother, but they can be her family, too.

The interns are getting ready to go home in silence. Meredith then raises her voice and says she can’t take this anymore. They have to let Cristina off the hook. She reminds Izzie that Cristina stood by her after she cut the LVAD wire, and that Cristina helped Alex study after he failed his exam. She goes to say something about when everybody was calling George 007, but he says Cristina was the one who was calling him 007. He leaves and Meredith sighs. George leaves, but Izzie and Alex decide to forgive Cristina. They leave. Cristina wonders why Meredith just can’t seem to mind her own business. Meredith says Cristina is her sister, her family, and she’s all she’s got. Cristina admits she’s so tired and lets her head rest on Meredith’s shoulder.

Callie runs into George in the hallway. She wanted to check up on his dad. He tells her he’s resting and doing good.

Meredith and Cristina pass Derek and Burke on their way out. Derek and Meredith greet each other while Burke and Cristina just share a tense look. Derek tells Meredith he’s going back with Burke to examine the tremor and their options. Cristina then gets on the elevator with the men.

Ellis is rambling. She couldn’t stay with Thatcher. She didn’t care that he was Meredith’s father. And then Richard didn’t leave Adele. She breaks down. Meredith stands up to hug her. Ellis initially resists, but then realizes who Meredith is and hugs her back.