Cristina is awarded the first solo surgery among the residents, but she is forced to give it up and choose her replacement; Lexie is impressed when Mark performs a cutting-edge procedure; Callie doesn't know if Sadie is friendly or flirtatious.

All eyes are on Derek as he is set to perform his first surgery after his breakdown; attention is also set on Izzie, whose medical condition requires her to undergo a difficult surgery; and Owen has another PTSD episode that injures Cristina and traumatizes both of them, throwing the future of their relationship into question.