The doctors receive bad news from Jackson, Amelia arrives in Seattle for an unexpected visit, and Bailey makes a bold decision.
Owen and Meredith return on the plane from the awards without Cristina, who disappeared after not winning the Harper Avery.
Derek receives a surprise visit at home from his sister Amy, who tells him she may be facing the prospect of a life like his and Meredith's. He leaves her with the kids.
At home, Alex is stressed over the private practice offer, which he has to decide on by day's end. He says Arizona will be pissed, so Jo tries to talk him through what to say.
At Callie and Arizona's place, they are in bed and April is talking to them about their efforts to conceive. Callie tells her to get out of her vagina and then comments to Arizona that it's only been two days, but it feels like ten.
Richard surprises Catherine at her office out of town. She teases that she thought he might show up to try and find out why Yang didn't win. He insists he planned the trip before. They kiss. Richard gets to talking about Yang's loss - he says it makes no sense and the committee clearly wasn't impartial. Catherine points out the conflict of interest considering which hospital Yang works for and says she could never win that award. They argue. Catherine snarks about him coming across the country because his prize pony didn't win a ribbon. She admits Cristina had the votes. Richard tells her he actually came to propose, but now he's leaving.
At the hospital, Cristina's patients are asking for her. Shane learns that no one has heard from her. Alex corners Arizona and smiles. She asks what he did to his face. He tells her about his offer. By the nurses' station, Derek presses Jackson to support his clinical trial. Nearby, Meredith snaps at April when she asks about Cristina. In the bubble room, Bailey soothes the parents of the boy with no immune system who is very sick. Later, Cristina shows up in the OR to operate on her patient. She tells everyone it was an honor just to be nominated. In the corridor, Jackson runs into April. She tells him she needs to come over tonight. Jackson says he's stressed because they can't keep all the research projects. April snipes that it's classy that they deny Yang the award and then look at shutting down her research. In the x-ray room, Meredith rants at Derek about Cristina's loss and subsequent disappearance until she learns she's in the OR. Derek tells Meredith that Amy's with the kids. In Cristina's OR, the heart they are transplanting is a lemon so Alex and Arizona must fly to pick up another one in Portland.
On the flight to Portland, Alex talks to Arizona about the decision he is facing about the private practice.
At Grey-Sloan, Meredith and Derek go into surgery together after Meredith tries unsuccessfully to talk to Cristina about her loss in the hall. Jackson sticks his head into the OR and receives a rant from Meredith about Cristina not getting the Harper Avery. Meanwhile, Bailey's bubble boy's mother gets frightened and calls a halt to all procedures on him. Cristina continues to juggle the three siblings in heart failure. She coaches Ross and Murphy by speakerphone while she works on the sister. She then tells the parents a choice must be made as to which sibling gets the donor heart. They want her to choose. In the other OR with Owen, April breaks down about her fight with Jackson. He tells her they'll get past this. In the lab, Bailey shows off her research to Jackson, but he needs something concrete. She says she's doing the procedure today. Stephanie appears with news the parents won't allow it.
In Portland, Alex and Arizona harvest the donor heart. She tells him she'll miss him and she's proud of him. He says he'll still have hospital privileges so he'll see her around. She tells him to shut-up. They talk more about the decision. Alex says it's a big paycheck. Arizona muses that it's a big decision then.
At Grey-Sloan, Cristina decides to put an artificial heart in one child - his sister will get the donor heart. Meanwhile, Mer and Derek sneak into the on-call room to make love. Later, Cristina and Owen tell the parents of the heart transplant siblings that the one with the artificial heart didn't make it. In the boardroom, Jackson tells the doctors to look at his decision. Alex appears and tells Jackson he's giving his notice. In the corridor, Owen phones around looking for Cristina. Richard appears and says they need to talk.
Alex arrives at home and tells a very happy Jo that he went with the private practice. Derek and Meredith get home to find their children broke his sister. Amy cries that she sucks at this. Jackson gets home to discover April there. They both apologize. He implores her to stay and push through this problem. She tells him she's pregnant. Bailey and Stephanie observe the bubble boy. Once alone, Bailey pulls out a baggie and looks at the boy. Owen finds Cristina standing clothed in the shower. She assures him she stands by the decision about the heart. She says she did it all perfectly, but what was the point? Owen tells her she won the Harper Avery - Richard told him she got the most votes but never stood a chance due to politics. Cristina walks right out of the hospital...
Spoilers for Next Week on Grey's Anatomy:
Cristina seeks guidance from Meredith as she makes a decision about her future.
Derek and Amelia join forces to operate on conjoined twins.
Jo takes on too many cases.
Stephanie uncovers the truth about Bailey's bubble-boy case.
Wow, so Alex took the private practice deal and Cristina is totally disillusioned. April and Jackson are at odds and expecting a child together, Richard appears to have split up with Catherine, and Bailey seems to be contemplating making a very risky move. So it was a bit of a downer episode. Derek Meredith, and broken Amy were my favorites tonight, along with Jo being so happy for Alex.
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- Candace Young