While Alex tries to study, Mere finds Bailey and tells her that a gastric perforation just came in. Bailey curses and tells George to take Nadia back to her room. George howls in protest, but Bailey tells him to shut up; they'll get to her later this afternoon. Mere explains to Bailey about Alex: he's retaking his boards, and without some help, he's going to fail. Bailey gives Mere permission to go help him, and tells George to get back there and scrub in after he returns Nadia to her awful family.
Justin's surgery. He's still complaining that he doesn't want the stupid new heart, so why are they doing this? Cristina says it's because he needs it, and until he's eighteen, his mother calls all the shots. Justin: "My mother's a liar. You heard her. She said the heart came from Santa Claus. She shouldn't get to decide anything." Cristina tells him he could make a run for it, but the heart he has won't get him very far. Burke asks Justin if he's ready. Justin asks Burke to give this heart to some other kid if he dies in surgery. Burke tells Justin that's not gonna happen -- not on his watch. Please excuse me while I go into HOTTIAC ARREST. They put Justin under, and we fade into the next scene.
Tim's two adorable little girls are sitting on his bed, adorably retelling a Christmas story. Izzie and McDreamy walk in, and McDreamy asks if they could talk more privately. Tim's wife, who is just as overly into her kids as Tim, says just to tell them now, and asks if it's bad. McDreamy says Tim's fall caused a subdural hematoma. One of Tim's girls: "I don't even know what that means!" McDreamy says it means their dad's...well, his brain is bleeding. Little girl: "GREAT." Hee. McDreamy is not nearly as amused, and turns to Tim and his wife to say that they need to operate quickly, before the bleeding gets worse. The boy child says they don't need an operation. Tim says he thinks they do, as Izzie and McDreamy exchange "Weirdos!" looks. Tim's wife tells the kids that it's all going to be fine, because they have a doctor named "Shepherd," isn't that wonderful, and a total sign from God? Wow, they really are weirdos.
Back in Justin's surgery, Burke has replaced the heart. He says it's a beautiful fit, and all they need to do now is figure out why Justin is so angry. Cristina says if she had his mother she'd be angry, too. Burke says his mother isn't the problem; she loves him, and never leaves. Cristina says she also never listens. Burke just hopes Justin changes his mind before it's too late: with all medical realities being equal, why does one patient live, and another die? "I believe there's a mind-body-spirit connection. And if Justin really doesn't want this heart, his body will reject it." Cristina doesn't understand this crazy non-scientific talk, and says, "So, let me get this straight. You not only celebrate Christmas...you actually believe in Santa Claus?" Oh, shit. Burke has finally had enough of Cristina's grinchiness, and tells her to go schedule a psychiatric consult for Justin. Cristina: "But we're not done here." Burke: "YOU are." Hooray! Smackdown! Thank Santa. The other people in the room all stand there uncomfortably as Cristina leaves in a huff. See ya, Crissy! Commercials.
Mere is pretending to be a patient for Alex. She says it hurts "here, and here, and here." Alex: "Any chance you got hit by a truck?" Hee. Mere tells him he's judged on bedside manner, and she wouldn't be surprised if that's why he failed the last time. Alex says it's not like he even asked for her help in the first place, neener neener, et cetera. Mere's like, "Enough with the ego, you big baby! I gave up a surgery for this! Now. Like I said, it hurts here, and here, and back here. Oh, and this morning? I noticed my poop was a funny greyish color." Alex gives her a nasty look, and also wonders why she's using that crazy Boston accent.
Bailey and George are in surgery with the gastric perforation. The guy apparently had gastric bypass surgery, and then ate too much. Bailey says eating is what he lives for, and they should just put him out of his misery. George tries to make a funny: "Paging Dr. Karevian, heh heh heh." Bailey lays into him. She holds up her scalpel: "You see this, O'Malley? I make one mistake with this scalpel, this man's dead. My husband? He makes mistakes at his job all the time. As far as I know he's never killed anyone, but I have. And YOU WILL. And Alex did. He made a math mistake, and a man died for it. Run that past your accountant; see how he'd feel if, every mistake he made, someone ended up dead." Aaaaaaaaawesome. Bailey's not done yet, though: she tells George he doesn't have to like Alex, but he damn well has to be on his side. George is stunned into silence, as he should be in the presence of such greatness.
Tim's surgery. Izzie goes on and on about what a great family Tim has, with their Hanumas and Christmakkah and how cute are those kids and blah blah blah vomit-cakes. McDreamy is finally like, "Really, Dr. Stevens. Christmakkah?" Izzie thinks it's sweet, of course. McDreamy shuts her down, saying brain injuries pile up around the holidays every year, with people falling off their roofs stringing up lights, or skating for the first time in a decade. "And every year, people drive through blizzards to get to parties where they kiss germ-infected strangers under poisonous mistletoe, and then they get so drunk that they smash their heads through their windshield on their way home." Well. Merry Christmas! It does get Izzie to shut up, so that's something.
Cristina busts Alex, uh, "assessing" Mere's chest, and tells them if they're that desperate, she has an excellent vibrator catalog. Mere has to tell her that Alex failed his boards, and she's helping him study. Alex is like, "Way to keep a secret, MEREDITH." Mere ignores him and tells Cristina he needs their help. Cristina says it's too bad, but she's not helping. Mere jumps up and says she has to go. She begs Cristina to do it for her, and leaves. Cristina sighs and jumps up on the gurney. "I'm a fifty-five-year-old man, and I'm nauseous and I can't stop throwing up." Alex tells her to just forget it; he doesn't need her bitchy help. He sure doesn't need a lot of people's help for someone about to not be a doctor anymore. Cristina tells him to shut up and diagnose her. Alex asks if she has any abdominal pain. Cristina: "Yes. From my giant fat belly all the way to my back. Oh, and I'm drunk. Hiccup hiccup." Ooh, I know this one! She's every southern dad on Christmas Day! Well, except for the Baptists.
Bailey tells Mere and George about a new patient who's just come in: a man who gave himself a hernia trying to wrap a big-screen TV for his wife. Bailey: "And you know his wife doesn't even like TV." She asks Mere if that "other project" is covered. Mere says she thinks so. Bailey tells her to scrub in, then tells George, "O'Malley, go tell Nadia she's off the schedule 'til tomorrow." Poor George.
Cut to Nadia's family going berserk. GOD. George promises them that tomorrow, Nadia will be in surgery as early as possible. Nadia's mom starts screaming, then her dad starts screaming, and now the GameBoy is at top volume. George asks Nadia's son if he could please turn it down, and he brats, "Who are you, my DAD?" No, your dad is the other extremely loud man in the room. Nadia's mom tells George they've ruined Christmas. George tries to apologize. The woman bursts into tears. I hate them.
Alex has his hand all UP on Cristina's boob. She tells him what he's doing right now is assault, and turns his hand around. "