The Chief has finally come to terms with the idea that Adele probably has Alzheimer's, and so his way of dealing with it is to pressure Derek to accept her into the study. When a patient unexpectedly drops out, a spot opens up, but when Mere runs the test to see if Adele is eligible, Adele doesn't score low enough to qualify. When Richard finds out that she only failed (passed?) by a single point, he hits the roof, but Mere makes Derek hold firm since the whole study could be ruined if they make one exception to the standard protocol. Adele is thrilled to be rejected since she wants to believe she doesn't have Alzheimer's but when Meredith tells her about the things she got wrong on her test and Adele finally has to admit she's sick; the reason she was in denial is that she and Richard finally found happiness and now this is threatening to tear them apart once again.
As part of his effort to get Derek to bend the rules for Adele, the Chief decides to try out his experimental diabetes procedure on a patient, even though it hasn't yet actually been approved. Granted, the woman needs it, since nothing else has worked, but in order for the Chief to do the surgery he needs a waiver from the FDA to try it out before the approval. The patient turns out to be in such bad shape that they can't wait to see if they are given the waiver, so Richard performs the surgery anyway. Fortunately for him, he's granted the waiver after the fact. Also fortunately for him, it goes perfectly and the results are what he had been hoping for. Bailey is thrilled, too, having helped on the case despite Eli sort of undermining her in front of the patient. The two get into a bit of an argument over it, but after work, outside the hospital, Eli turns Neanderthal as he tells Bailey to come home with him so that he can do all sorts of things to make her forget the day. While I thought she was going to let him have it she seems to actually like his caveman act and ultimately decides to go home with him.
On the opposite end of the Neanderthal spectrum we have Henry. He passes out while jogging and is brought into the hospital, where they discover he has a tumor that needs to come out ASAP. Richard is skeptical about Teddy doing the procedure, but she insists their relationship is nothing more than a business arrangement and she's fine. Once Henry is hopped up on morphine, however, he very sweetly spills his true feelings, which are that he thinks the two of them could be great together. Richard pulls her from the surgery and Cristina gets it instead, but Teddy is allowed to be in the OR to supervise. When things go wrong, Teddy starts to freak out, and it's pretty obvious this is more than a business arrangement for her, too; Cristina has to yell at her to shut up so she can work, and then of course winds up doing an awesome job removing the tumor. Teddy and Henry have a talk afterward, and she tells him that she's thought about their being together but insists she doesn't feel any spark and so they can't. That doesn't seem to be entirely true, given her actions, but maybe she's trying to get herself to believe it. Cristina is so impressed with herself that she orders pizza for dinner for her and Owen -- no cereal tonight! -- but her good mood is dashed when Owen tells her that Richard handed him the task of picking the next Chief Resident, and she realizes this means she probably won't get it since if she did everyone would think Owen was just favoring his wife.
Alex and Lucy are still doing their mating dance -- he awkwardly and defensively pines for her while she treats him like dirt. Lucy finally asks Meredith if she's missing anything about him, since Alex must be a better person than he lets on, given how many friends he has that care so much about him. Mere gives Lucy his romantic backstory in the tiniest of nutshells and it's enough to make Lucy kiss him when she runs into him after work.
April and Stark seem to be getting on well, but April is convinced that whatever they are doing is definitely not dating, since it sounds like they haven't gotten physical at all. When he invites her over to watch From Here to Eternity the other docs point out that this isn't just a movie between friends and is a viewing that probably would take place in the bedroom. Freaked out, she breaks things off with him, but that night she watches the movie by herself and seems to be more upset than relieved about ending it, whatever "it" was.
Jackson and Lexie are still together and hooking up everywhere they can, as often as they can. Of course it's only a matter of time before Mark realizes what's going on. Fortunately he doesn't realize it until after he's thrown Callie a huge, girly baby shower. Arizona fights him every step of the way, sure that Callie doesn't want a shower with games and onesie decorating, but it turns out he got it all totally right, and Arizona sulks in a corner for most of the time. At the end of the party Callie gives Arizona a present -- she's whisking her off to a weekend getaway to thank her for going along with all this even though Callie knows she hates it. As they are driving they get in yet another fight over Mark, and Arizona is in a right state, since she feels like Mark gets way more of Callie than she does. Callie asks what would help and a light goes off above Arizona's head -- she asks Callie to marry her. She's so wrapped up in convincing Callie she's serious and that this is exactly what she wants that she doesn't see the truck in the road ahead of them, and the episode ends with the sickening crunch of their vehicle plowing right into it.
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Meredith kicks us off this week with a voiceover that says that while doctors like to think of themselves as sexy renegades, it turns out they are basically sheep who always follow protocol. No matter how much he follows protocol, Jackson has no worries about also looking sexy; he takes off his shirt to sneak up and seduce Lexie as she does laundry and they start to make out. April walks in wanting to use the washer for some unsexy laundry and is ticked to find them there, asking if there is anywhere left in the house that they don't hook up. She storms off and Lexie briefly entertains the idea of their going upstairs but she's quickly distracted by more making out with a half-naked man and they get down to business right there.
Alex has bucked the trend and actually moved OUT of Mere's house, though all he's done is move into Derek's trailer, which he has positioned in the hospital parking lot. Bailey's ticked that he's blocking her parking spot, and not very impressed by Alex's explanation that this way he's able to get surgeries first since he's so close -- something important for a possible future Chief Resident. I'm going to try and forget that he just spits his toothpaste onto the pavement as he brushes his teeth, because it's revolting.
Mere's VO reminds us that not following protocol can lead to people dying. I suppose that puts most other professions into perspective for a moment. She and Derek are examining Adele who is asking them when they are going to just get married, already. Richard tells her gently that they are married, in a tone that says they have had this conversation before, but he'll be gentle because he thinks her mind is going. Adele isn't having any of that and says that she knows about the post-it but she's talking about a real live, actual, white-dress, marriage-licensed wedding, and that has nothing to do with her potential Alzheimer's. I suspect she is just voicing what much of the viewing audience still thinks of the Mere-Der union, though truth be told I think the post-it works for these two and we're not going to see anything else for a long time, if ever. Derek changes the subject and tells her she's got symptoms that can be early onset Alzheimer's, but she doesn't want to hear it and counters by reminding him that she was a nurse and she knows that 20% of all Alzheimer's diagnoses turn out to be wrong. Richard is obviously worried and doesn't believe her when she insists she is fine.
Outside, Meredith and Derek remind him gently that it takes a lot of patients a long time to come to terms with the diagnosis, but Richard isn't any patient and he wants to get things done; he orders Derek to get Adele into the trial. The first problem Derek points out is that they need Adele's consent, which currently seems unlikely, and then he reminds Richard that both the trial and the wait list are totally full. Richard isn't interested in what he sees as excuses and just tells Derek pointedly that he knows Derek will do whatever he can to help Adele.