So fifth year really is starting to get competitive -- Alex has to hand over some of his surgeries to Arizona, who is courting some super crazy impressive resident who is in the running for her fellowship. Alex spends the day being a depressed jerk but that night when he is at the bar the girl comes in to get a drink and he overhears her on the phone complaining that Arizona could only talk about Alex and how awesome he is.

Meredith and Bailey are pulled off of mouse duty for a day when a VIP patient comes to the hospital, and that patient turns out to be none other than Mrs. O'Malley. She had a surgery done at Seattle Presbyterian but they botched it and so she sucked it up and came to Seattle Grace to have them fix it. She's obviously a little bit scared and is very emotional, especially when she sees Callie for the first time in years. Callie decides not to drop the bomb about her sexuality and new wife but Mrs. O saw her wedding ring and peppers Mere with questions. Meredith tells Callie that she thinks that whether Callie tells her the truth or not, she thinks Callie should be there for her after her surgery since Mrs. O loved her so much. They're doing surgery because Mere figured out what was wrong with her, but in the process pissed Bailey off because she ran extra tests that weren't what Bailey had ordered. Mere finally confronts her as they get ready to scrub in and reminds her that she may have screwed things up and not have a lot of control over certain things, but she is a good surgeon. Bailey finally swallows her pride and lets Mere do the surgery, and while they are working says it's hard for a parent or similar person to see a child they raised do something stupid and screw up their lives, even if they did that something for a good reason. Having said that, she offers an olive branch in the form of advising Meredith on what she should wear in her court hearing so that she looks like a warm and loving mother.

When Mrs. O wakes up from surgery Callie is there and just blurts out everything about her life now. When she sees her former mother-in-law crying she thinks she disappointed her but it turns out that she is crying with happiness to hear that Callie had a baby and they re-bond while looking at cute pictures on her phone.

Henry is at the hospital to observe Teddy kicking ass in the OR, and he's so excited by it all that after a romp in the on-call room (she's making this day in the hospital as authentic as possible) he admits that he wants to go to med school. She's totally against it, finally admitting that she likes life as-is and doesn't want to be married to a med student for the next ten years. Henry's pretty offended since he thinks that she just wants him to be the adoring husband while she gets the glory, so he cuts his day short and leaves. When she gets home she seems to have mellowed and wants to talk about their first fight but it's quickly forgotten when she finds him coughing up blood. Please, can we not kill off another likeable, hot non-surgeon love interest?? We won't know the answer to that this week, though.

The surgery that Henry did see was Teddy and Cristina harvesting a heart for transplant, but the recipient dies before they send it away, so they leave it hooked up to a nifty machine that keeps it warm and beating until a team from a new hospital can arrive. Cristina's having a bitch of a time coming up with her surgical bucket list because she is writing down every surgery that pops into her head, interesting or not. Richard takes a look at this list and tells her that the beating heart is the key to her making the list. Finally, Cristina has the realization that if something isn't as cool as the heart in a box, it's not worth going on the list. With that, she makes an edited version of the list that Richard heartily endorses.

Derek has decided that his next project is to find patients with hopeless, inoperable conditions and to try to fix them, and it's basically as obnoxious as it sounds. He also has a lot of time because he has a patient (played by the always-awesome Alfre Woodard) with three aneurysms, and one has sprung a leak and needs to be fixed. But the patient is an author who is trying to finish her book and refuses to go into surgery until it is done. Derek orders Lexie to convince her to do it now, and Lexie winds up taking dictation and typing up the rest of the book and getting really, really into it. Let's face it, this sounds like something I'd totally read too -- a sort of time-travel love triangle.

If you think this sounds conveniently like it might parallel what's going on in Lexie's life with Mark and Jackson, then you've definitely watched TV before. Jackson spends the day avoiding Mark and a really cool surgery because he's so uncomfortable about Lexie's obvious jealousy and lingering feelings for him. Mark freaks out because he senses that Jackson is leaving but he truly does like working with him and wants to continue teaching him. Also, he seems to have no clue about Lexie's feelings even though she did just hit his girlfriend with a softball. Jackson goes to talk to the all-knowing heart in a box and finally tells Lexie that she's obviously still got feelings for Mark but that he wants to keep working with the guy, which means that he's got to break up with her. Lexie had just come from a fight with Alfre about the end of the book, and how the girl in the middle should end up with the guy who is sweet and wonderful and good for her, but Alfre insists that the guy may be good, but the heroine's soulmate is the good-for-nothing pickpocket character. Lexie kind of breaks down when she seems to realize that while Jackson is sweet and wonderful and good for her, her soulmate might just be the equivalent of a French pickpocket.