Mere, Cristina and Derek are in the elevator, musing about what they could do with all of their money, while Alex sneers at them from behind. Mere muses about buying a house but this gets upgraded by the others until somehow they are buying multiple football teams. Clearly none of them are actual football fans if they think $15 mil each is going to get them a team. Stick to the houses, kids. Maybe they can pool their money to get Troy Polamalu to be their pool boy for a season. Alex finally can't take all this talk of their buckets of money and gripes as he gets off the elevator that he should have been on the plane. Ah yes, how easy it is to forget that if he'd been on the plane, he might be dead right now, or at least short an appendage.
Jackson's facial reconstruction patient is a teenager named James with a condition that prematurely fused his skull bones together as a kid and resulted in what James calls a "weird-looking face" that is all out of proportion. His mom admonishes him but James seems to be pretty awesomely well-adjusted and at ease with his condition, more than most teenagers would be. Mark had been his doctor for most of his life and he and his parents adored and miss him now, but since they know Jackson was his "guy" they trust him. Jackson throws them for a bit of a loop, though, when he suggests a more radical surgery than what Mark had planned which involves moving all of the bones of James' face forward, rather than just his jaw. He and Stephanie can't help but be flirty as they explain everything, and Leah is not blind and sees the sparks. James' parents seem a little nervous at the idea of a new plan but Jackson explains how James' development went differently from what Mark expected and the family seems open to it. Arizona then comes in and greets them all but when she hears that about the new surgery, she calls him into the hall to "discuss."
She thinks he's nuts, but Jackson argues that this could give James a more normal appearance. She can't get over that Mark knew the kid for 16 years and had a plan that now Jackson is ripping to shreds. (I thought I'd been a smartypants who caught a mistake by the writers when I was all, "Mark wasn't in Seattle for 16 years!! Except that later they totally mention that James was originally Mark's and Derek's patient in New York.) Jackson finally tires of Arizona's nagging and tells her that he'd be happy to argue with Mark if he were there but he's not, and as plastics is not Arizona's specialty she needs to hear him out. He adds that he'd be happy to walk her through his thought process as a courtesy, and it goes over just about as well as you'd think -- she can only gape and marvel at his impertinence.