Everybody is pissy, angry, and crabby. It's just like Thanksgiving with my family. Meredith's half-sister arrives at the hospital for an emergency c-section. Meredith works with Addison on the surgery, but panics when the baby seems to be failing. After a long day of surgery, Addison saves the baby. But Meredith finishes the day by telling her father's wife that, as nice as she seems, she's not Meredith's family. But Meredith's resistance crumbles a bit when she sees her beautiful new niece.
In the aftermath of Cristina's confession to the Chief, he's angry with Burke for hiding his tremor. And Bailey is furious with Cristina for being yet another intern to royally screw up, and for contributing to Bailey's own crisis of confidence. As punishment, Bailey assigns Cristina to work with Dr. Hahn on George's father's heart surgery. This doesn't sit well with George, who's angry himself at Cristina for being willing to allow Burke's shaky hand into his dad's chest cavity. A temper tantrum from George causes a cardiac crisis for his dad, but Burke's quick response helps him regain some of George's confidence. And that confidence is further restored when Burke watches the surgery with George and helps him remain calm when there's a problem. George's anger at Cristina is also reduced because the work she did while helping Burke hide his tremor enables her to step in and help save Mr. O'Malley's life during the surgery.
And you're asking, why was it "punishment" for Cristina to be assigned to George's dad's case? That's because the other interns all get assigned to the surgery separating two adult conjoined twins (who have decided to go ahead with the surgery because one of them has a girlfriend, who seems to have a crush on the other one). The surgery is incredibly complex, with the Chief handling the cardiothoracic stuff, Mark on the plastics, and Derek on the very complicated neuro portion. Izzie is assigned to Mark, and he treats her like shit -- but she stands up to him and earns his respect. Things don't go so well for Derek, who blames himself for Burke's tremor and doubts his own skill. In the end, the surgery is a success.
After an episode of everyone holding everyone else at arm's length, we finish with some forgiveness. Burke gets over his anger at Derek and consults with him about further surgery to relieve the tremor. And he tacitly invites Cristina to join in that conversation as the woman who loves him. And Meredith has a very moving scene with her mother in which she comes to grips with some of her own anger at her mother's abandonment of her family. It's pretty weepy, and pretty sweet.
Dear ABC Promo Department: You're probably not going to win new viewers for this show with promos that make it seem that the episode is about some revolutionary cutting edge surgical procedure. You've got hot doctors having inappropriate sex -- stick with that.
Previously, on Grey's Anatomy, Meredith kissed McDreamy, George's dad was admitted with what eventually turned out to be cancer and a heart problem, Meredith learned that she had a half-sister she never knew about, George was an ass to Callie, the Chief stopped seeing Meredith's mother in order to focus on his own marriage, and the truth about Burke's tremor came out when George asked Dr. Hahn to perform his father's heart surgery.
We're at Ellis's nursing home, where she's freaking out over the fact that the Chief has decided he can no longer visit her. There's an incredible amount of pain and rage in her voice as she rants on about the Chief leaving her for his own wife (the nerve!). Meredith tries to calm her down by bringing her into the present: "Mom. Mom, look at me. This happened a very long time ago. This is not happening now." Ellis seems to comprehend for just a second, and then she tells Mere, "It's because I have a daughter, isn't it? He always said he didn't want kids. I should never have had a kid." Ouch.
The Chief's office. Bailey, Cristina, Burke, Derek, and the Chief are all sitting silently. It's like someone put them in a time-out. Bailey stands and walks to the door, but before she leaves, she turns and asks the Chief, "What's going to happen to them?" She's pointing at Cristina and Burke. She wants to know what their "punishment" is going to be, declaring, "There's a need for justice." The Chief: "Justice has no definition within the four walls of a hospital." Well, certainly not within the four walls of this hospital. The Chief declares that Cristina and Burke have done nothing wrong, "legally and technically." What about ethically? Morally? Medically? Do any of those words ring a bell, Weber? Bailey is not happy about this shit, but she doesn't press the point. That is, until the Chief tells Cristina to go back to work with Bailey. The Chief doesn't understand why she's so angry, and asks, "Am I not understanding this? Does this situation directly harm you in some way?" She tells him it doesn't, and he orders her and Cristina to get back to work. Once they leave, the Chief tells Derek and Burke to get together to find a solution for the tremor right away. Derek: "He doesn't want my help." The Chief doesn't understand this, and then Burke tells him, "I don't want his help." The Chief is not pleased: "That hand is worth two million dollars. I want it fixed!" I bet Burke is just thrilled to have his human worth reduced to a dollar figure on the hospital's balance sheet.