The time has come for each of the Chief Resident hopefuls to interview with Owen, and at the same time everyone is doing what they need to do out of the interview room as well. Jackson actually knocks himself out of the running early when he inexplicably resigns from the Chief's diabetes clinical trial. Owen's actually kind of pissed about it since he thinks Jackson has a history of quitting when things get hard, and then he wonders if the trial is flawed. But when Owen investigates the trial, he finds that it's actually so awesome it could potentially win awards, such as the very one named after Jackson's grandfather. Owen realizes that Jackson quit because he realized that if he was on the trial it would never win said award, and he tells Jackson he respects the decision but also warns him not to let the name hold him back. Jackson isn't too worried that he's out of the running because he still has his loving girlfriend Lexie -- though she spends most of the episode mooning over Mark and Sofia, who are hanging out during Callie's first day back at work. It seems the image of Mark with an infant isn't as horrifying as she had anticipated, and in fact is turning out to be her own personal catnip.
Meredith is finding that she's pretty into the baby idea as well. She and Derek are still working to try and adopt Zola, but Meredith is fretting about all the ways things could go wrong and the adoption could fall through. Zola has to have routine surgery for a hernia, and Mere worries during the entire procedure while watching through the window, but things go totally fine. She then has a meeting with someone from the adoption agency to see how suitable she might be as a parent, and she's crazy nervous and awkward during the interview. Once she calms down a bit and just speaks honestly, she winds up doing a great job showing the woman how much she cares about Zola in her own way. The other thing adding to Mere's stress level is that she's terrified that Alex is going to spill the beans about her switcheroo in the trial, but he keeps it to himself, even though he's pretty bitter about it.
As part of her interview, April shows Owen how well her checklists work to make sure the doctors follow protocol in treating every patient. But her plan is messed up when Cristina swoops in and takes one of the patients herself instead of calling Teddy to consult as the list told her to do. Cristina discovers that the guy has a tiny little tree that is growing in one of his lungs and decides that she's going to do the surgery to remove it herself. April is totally against it until Cristina offers to put in a good word for her with Owen if she keeps her mouth shut. April seems tempted, but ultimately she blows the whistle on Cristina, and Richard, Teddy and Owen are all livid. The patient, however, is so grateful for Cristina figuring out what was wrong with him that he insists she do the surgery herself. It seems like Teddy's head might explode from seeing Cristina totally flaunt the rules and yet save the day once again. Once Cristina has her own Chief Resident interview with Owen, he tells her point-blank that she's not getting the job, but it's not because of the stunt she pulled -- instead, he points out that the job entails a ton of managerial bullshit, scheduling, dealing with other residents' problems, and all sorts of other things that Cristina would hate. He tells her that she's a brilliant surgeon and should just focus on surgery. She's completely pissed off, but once she has time to think about it (time, and a few drinks at the bar) she realizes he's right and that he's looking out for her, and they make up.
After the showdown with Cristina, Teddy seems to be thinking a life on the other side of the world with a hot man might not be the worst thing ever. She kind of breaks Henry's heart when she tells him about the possibility of her moving, and it's made worse when he realizes that she hasn't even told Andrew that they are married. Henry decides he has to start taking care of himself, so he manages to convince Richard to accept him into the diabetes trial, and then that helps Henry get his old job back, too, since he won't be falling sick all the time like he had been. He hopes that this will give him a fighting chance against Andrew, but Teddy ultimately decides to move to Germany, and Henry asks her for a divorce.
Shockingly, Alex and Lucy (remember her?) now appear to be dating, or at least sleeping together. Lucy tells him she's been offered a position at Baylor and he thinks that's great and she could take it, which hurts her feelings since she thought he'd fight at least a little bit to have her stay for the sake of their budding relationship. Alex is still treating some of his African patients and he seems to really care about them, as more than just an edge in the Chief Resident race. The older sister of one of his patients falls ill, and the docs discover that not only is she pregnant, but she's got complications of the highest order, with the baby growing outside her uterus. Lucy delivers the baby and then hands him over to Alex, who continues to be awesome and gets the baby breathing and doing well. He makes a comment to Arizona afterward about how sad it is to know that all these patients still won't necessarily get the long-term follow-up care that they need, so Arizona suggests he go to Africa and take over the position in the clinic which she vacated. He makes some inquiries about it, which makes Lucy even madder, and Cristina has to point out for him that Lucy is mad because he didn't take her into consideration when thinking about the job. He finally does and decides he wants to see where the relationship might go, but when he goes to tell her that, she admits that she swiped the job in Africa out from under him. He goes to the bar to drown his sorrows, and while talking to Cristina she babbles that she thinks Mere will win Chief Resident on account of how organized and trustworthy she is. This is the last straw for a hurt and pissed-off Alex, so he does what he does best -- lashes out -- by drunkenly announcing to Owen that Meredith messed with the Alzheimer's trial.
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"No sex." Cristina has decided that she's got to play hardball in the Chief Resident game, and she thinks that, with formal interviews later that day, Owen shouldn't have his judgment clouded by thoughts of the hot sex he had with his beautiful wife the night before. Owen is incredibly skeptical about the plan, but Cristina won't budge. She also managed to work her way onto Owen's service for the day, claiming that since she can't work with Teddy and show what she's got, she has to then show it to Owen directly and prove what an amazing candidate she is. Of course, she hasn't totally thought this through as she might be ensuring that her boss is rather frustrated and cranky, but we'll see. Mere's VO for the day reminds us that we all know the saying, "Adapt or die."
Sometimes, when one is adapting, they have to attack or kill. Meredith tries to convince herself that Alex wouldn't attack but she's clearly unsure, so she actually asks him if he's going to say anything about her in his meeting. Alex oozes contempt as he points out he thought that she was going to just wish him luck, but now he knows it's every man for himself in this race. He walks out of the room leaving Mere aghast and even more scared than she was before. Is she new? Does she not remember that it's best not to poke a grouchy Alex with a stick lest he bite?
Lexie and Avery are brushing their teeth, both clad in towels just out of the shower. Now that's a view I'd like every morning. She coaches him about all the awesome things he needs to say about himself and the trial, adding that the trial is going to win every award there is. This seems to push some button and he goes from just silent and slightly nervous to full-on grouch who cuts her off, saying he knows what to say, and then shuffles out of the bathroom. Ooh, but what a view as he leaves. I've decided I'm not in love with his slightly longer hair, but I'll take that trade for those back muscles any day. Holy lats, Batman!
When Alex gets back to his room, Lucy is there in bed, checking her email. Really? These two are still happening? I never believed that Alex would moon around after this girl like a puppy. Stop trying to make Lucy happen, show. She is stunned to find out she got into some program at Baylor, but when Alex is excited for her she immediately starts hedging and talking about everything she has to consider before leaving Seattle. Alex doesn't pick up at all on the fact that she's trying to say that he is one of those factors, so she takes a different approach, saying that if he gets Chief Resident and she's still around, at least he'll have one friend. Alex just brushes that off, saying that all the docs know that this competition isn't personal, and sometimes you have to be a shark. He then congratulates her and takes off to get ready for his interview with Owen while she sits in bed, miffed, and I start inspecting my cuticles since I find them more interesting than her bruised feelings.