A scowling Lucy goes in to the gallery to watch the transplant and finds Alex already there. After a moment he finally apologizes but maintains that she was overreacting, and that he deserves to be in there with his patient. Lucy isn't impressed by his feelings of entitlement and tells him about how she had another patient, who had a 40-hour labor and a baby stuck at a bad angle. She deliberately explains to Alex just how hard it is for a woman to go through that much pain, and how she kept the woman going by promising her that she'd have a beautiful baby when it was all done... except that then there was something wrong and she was the person who then had to tell the woman that after that, her baby didn't make it. Even Alex seems to understand just how awful an experience that would be, and when Lucy concludes by telling him she doesn't care about what he thinks he deserves he wisely keeps his mouth shut for once.
Lexie finds Meredith studying a vending machine and announces that Thatcher indeed has kidney stones, and Bailey is taking him to the OR. She's still astride her high horse and tells Mere that Thatcher deserves this pain for what he's done, and that she now understands that this is how he works -- he finds a new family and stops talking to the old one, which is just what he did to Meredith. Mercifully, Meredith finally turns and tells Lexie to get a grip. She explains that their situations were totally different -- Ellis cheated on him and then took Meredith across the country, while in Lexie's case her mom died, Thatcher was sad, and then he found someone that made him happy. She implores Lexie to give her blessing and just let him be happy, but Lexie seems not to have absorbed anything her big sister said, and tries to get Meredith to hate him along with her. Meredith just tells her that she loves her, but Lexie has to grow up; she then walks away leaving Lexie with her mouth gaping open.
Alex and Lucy are both worried watching the tiny surgery and they have good reason to be as things seem to be going wrong. Down below, the surgeons figure they need to do somethingamajig which usually takes 45 minutes, but Teddy tells them they have 30, and she instructs a nurse to start the clock. Which they do, starting an actual, big, digital timer in the middle of the room for all to see. Alex is agitated and swears and Lucy looks over at him, maybe realizing that the Grinch has a heart after all.
It's too much for her to bear, and she finally turns around and faces the wall while below, the docs work into their 27th minute. Teddy says that they are ready and again they take off the tiny clamp; Alex assures Lucy that they've got it but his face betrays him and Lucy calls him on it. Fortunately, though, we have a happy ending as the baby's vitals begin to climb and the surgeons all breathe a sigh of relief. Up in the gallery, Alex and Lucy both do triumphant fist pumps but then when they happen to lock eyes, they both awkwardly turn away like kids in a schoolyard.