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.
As the Averys, Meredith and Mark get ready for surgery, Catherine compliments Meredith and asks about her specialization; Mere is smoother than I expected when she says that she was thinking about neuro but it now making a change. Mark, now 100% the proud mentor, brags that Jackson had a chance to go into neuro but turned it down for plastics. Unfortunately, this has the same reaction as if he told her that Jackson turned down Harvard for Partytown Technical Night School. She admonishes Jackson for turning down an opportunity to work with Derek Shepherd in favor of plastics and adds, "Who raised you when I wasn't looking?" Seriously, you'd think he just announced his dream of becoming the underwater basket weaving champion of Seattle. Even Mark yelps, "I'm standing right here!" Everyone is saved when Ryan is wheeled up and Catherine goes from irate mother to gentle surgeon. Chad is told that this is as far as he can go, so the brothers have a touching goodbye in which Chad tells Ryan he's going to take him to test out his new functionality at a strip club. Ryan stops him there, tired of always talking about his anatomy rather than talking about, say, basketball. He asks Catherine to promise this will go well so that he gets his brother back. Catherine tells him it will work and then merrily heads off to "harvest the donor organ." The boys opt not to think about that too hard (sorry, couldn't resist) and Ryan just warns Chad that once this is done, they are never to discuss his johnson ever again. Chad happily makes that promise and then they have a really sincere hug before doing the manly back-clapping and nod that says, "Don't worry, we weren't that into that hug, we're dudes." Chad watches them take Ryan away and instead of looking sad or worried like most family members, just raises his hands in victory for his little brother.