Alex and Arizona sprint down the hall toward whatever emergency paged Alex, and both are panicked about what might have happened and if anyone else knows. They have good reason to be freaked out because they open the door and see Janet there with Zola, who has had a seizure.
Ryan's brother Chad has traveled with him to Seattle, and while he means well, he's doing a better job of embarrassing Ryan than standing naked in front of a lecture hall did. But he wants for his brother is to have some big business going on down there and finally Jackson tactfully tells them he thinks Ryan will be happy. Chad then also wants to make sure that it will "stand up" and do everything it's supposed to, and Catherine points out that this is why they are, in fact, doing a transplant. Mark throws out the less risky reconstruction option once again, but Ryan explains that he knew for months something was wrong before he saw a doctor and by the time he finally went, they said it was cancer that was too advanced and he'd have to lose his penis. He's tired of looking down and being reminded that he was a coward, and also thinks that if the medical world can learn from him and help someone else then he can at least feel good about what happened. I'm impressed that actually losing his most treasured organ seems to have matured Ryan into more of a man. Catherine gives Mark a pointed look and Mark seems to finally back down and accept the transplant idea as Catherine tells Ryan she'll see him in surgery.
As Arizona and Alex frantically treat Zola, Janet explains that the foster family said she was running a fever and wouldn't stop crying. Alex then tells everyone he'll page Meredith and Derek, but in response there is the proverbial record scratch and Janet tells him that he can't because their custody was suspended. Alex seems to think this is insane but Arizona adds that it would be a breach of confidentiality. For all intents and purposes, right now Meredith and Derek are just a third party. Alex is appalled, especially as they are right there in the hospital, but Arizona insists that the last thing they need right now is to put the adoption in jeopardy by breaking the rules. Seriously, though, if this were real life, I can't believe they'd even bring Zola to this hospital; it just feels like Janet is trying to set everyone up for failure (though I totally don't think that is actually her intent within this storyline). Yes, Zola was originally treated at this hospital but since Derek was one of her original doctors, it's not like he'd be able to work on her now. Alex seems to find this whole situation ridiculous but Arizona ignores him and just works on Zola.