It's good to be Chief of Surgery. Because not only are you Chief, but it means that when you admit to messing with a clinical trial, you don't get fired. But while the Board doesn't fire Richard, he does decide to step down as Chief of Surgery and just go back to a regular old garden-variety surgeon so that he can spend more time with Adele. He hands the reins over to Owen, who has some big shoes to fill and a lot of skeptical surgeons to lead. None more so than Bailey, who is furious about the situation and refuses to give Owen an easy time as leader. Because people always want what they don't have, Owen becomes desperate to have her on his side. His chances of this happening, though, so far look about as likely as a snowball's chance in the Sahara. She still thinks that Richard lied just to save Meredith, but Richard tries to convince her that what Meredith did gave him extra time to be with Adele, so he wanted to step down in order to enjoy that time. She's still pissed but concedes that maybe one day, far, far in the future, she might be able to get over being angry at him.
Owen and Cristina are having an awkward day themselves because they now have no idea what to say or how to interact with one another. They are both overly chipper and somehow both awkward and yet formal, and Meredith's theory is that it's because they haven't actually talked to one another about the abortion. She thinks that they will have to talk and clear the air in order to get back to normal, but Cristina has no idea how to go about this. She and Owen wind up ordering Chinese food for an awkward dinner at home but then both come down with food poisoning, and while holding each other on the bathroom floor, the ice is broken and they seem to finally fall back into acting like themselves without having to sit down for A Conversation. Note to self: if I ever have a hard subject to bring up, just have some bad spring rolls instead and everything will work itself out.
In addition to it being Owen's first day as Chief, it's also the first day that the fifth-year residents will have their own surgeries. April still can't control them at all and when she tries to assign them all skills labs to teach, the others turn it into a contest where the person who does the worst at their surgery has to teach all of the labs. Callie finds April having a frustrated moment and they talk about it a little bit; Callie tells her she was an awful Chief Resident but can at least advise her that the best thing she can do is get them on her side and then she'll have a better chance of them listening to her.
For her first surgery, Cristina thinks she's doing a fancy cardio procedure but winds up with an appendectomy. The problem with this is that Teddy is right -- Cristina knows how to do the fancy procedure but the appendectomy not so much. She pretends to quiz the interns so that they'll remind her how it's done but once she's in the OR, she forgets the steps halfway through. Teddy crows that this is exactly why she's trying to teach Cristina the basics but when Cristina does finally ask for guidance, it turns out Teddy also don't remember how to do the procedure. Fortunately for them, the surgical nurse does know and she tells them what to do to finish the job. Jackson is supposed to be repairing a cleft palate on a baby, but Arizona wants Mark to do the job since it's a complicated surgery. Jackson finally convinces her he can do it but once they are in the OR and she starts talking about how this surgery will ultimately determine the course of the boy's life, Jackson finds he's not as confident as he thought and has Arizona call Mark to do the job after all. Alex has a bowel surgery that presumably he thinks will be simple, but as he prepares for it he also forsakes any trace of a bedside manner and April realizes that his bad attitude is because he's kind of terrified. She gives him a pep talk, and when it turns out the patient is beyond help and there's nothing Alex could have done she at least tells him she knows he did all that he could. At the end of the day when they compare notes they decide Alex lost the contest but April helps protect him by calling Jackson out for not even doing a surgery. They all decide that Jackson loses by default and while he's pissed, it's a good first step for April towards figuring out how to work with and lead the others.
The person who turns out to be a rock star is Meredith, who takes on an aneurysm as her first surgery. She tells Derek she thinks he should do it since the two of them aren't acting like a team, and that's a bad idea for her first go at this alone, but he declares that she's ready. Of course once inside the OR, he questions her choices and yells at her a whole lot though she sticks to her guns and does what she thinks is best. It turns out perfectly, which seems to make Derek even angrier, especially when she gets a round of applause from the rest of the surgical team. That night they finally have it out and he admits he can't trust her at all, but points out that he meant what he wrote on the Post-It so he won't leave her. He also grudgingly admits that he knows she did all of the crazy things including messing with the trial and taking Zola because she was trying to help the people she loves, but he's still angry that she's had no real consequences at all. I guess losing Zola doesn't count because it's not just her that's going through that pain? I don't quite know. They finally realize that the biggest problem they have is that he can't trust her at work, and so she says that they will stop working together and that being off of his service will then be her consequence. That seems to work for Derek and while he still seems fairly livid they at least fall asleep on the same bed with their hands nearly touching, so maybe the Post-It will usher them through this mess after all.
Mere's VO started a moment before my DVR did so I missed the very beginning, but she seems to be talking about all one's life leading to one particular day. It's a particular day all of the residents have been looking forward to but the attendings, not so much. Richard reminds them that today is the day that the fifth year residents rotate in as lead surgeons. How quickly these doctors forget this own day in their lives, even though for Bailey and Callie it wasn't that long ago. They all make suitably disparaging remarks as Richard reminds them that they will stay silent and step in on a surgery only if they have to. Basically, now every day is one big Gunther exercise, then. Then, as casually as if he was announcing a change on the cafeteria menu, Richard tells them that effective that morning he resigned as Chief of Surgery and that Owen is taking over the position while Richard stays on staff as a regular surgeon. He turns the meeting right over but his audience doesn't care about Owen and just wants to know what happened. Meredith VO's that you can't prepare for the day when you step down. Well... yes, you can. You might now know totally how it will feel until you get there but in many -- or most, really -- cases you can absolutely plan for stepping down. This VO is really pushing it today. Arizona asks what happened while Derek asks bitchily if the Board is forcing him to step down. Teddy chooses the awkward lull that follows to even more awkwardly excitedly to call out to Owen, "You're the new Chief of Surgery! Nice!" That good sex must be affecting her ability to judge a room. Bailey doesn't say anything because she's in utter shock, her face a complete blank like she can't actually comprehend what is going on.
Mere and Cristina are walking and talking and Mere tells her and us that she hasn't heard anything about Zola yet. Cristina wonders if she is okay but Mere points out that she has to be okay because she is clipping first aneurysm that day. May your patient not find out you're in the middle of emotional turmoil when doing this highly specialized and risky procedure that basically either ends in success or death. Cristina is doing a valve replacement and is reveling in the fact that Teddy isn't allowed to say a word to her while she's working. Eventually April falls in step with them and then Alex -- they all ask about Zola and ask if "it" is up yet. "It" turns out to be the board with their names written on as lead surgeons. Alex is mocked for taking an "easy" bowel resection instead of a pediatric case. Jackson is mocked for doing plastics until he boasts that it's a kid with a cleft lip. April gets mocked for fixing someone's knee. Basically, it sounds like some of them are aiming higher than others today. But all is forgotten when April reminds them that they all have to start teaching skills labs, and the schedule is up in her office. Their notice is less about the labs and much more about her having an office.