Meredith goes to visit her mother, and finds she hasn't been eating. Richard shows up and brings her a box of chocolates, because he knows she hasn't been eating regular food.
Her announcement to the other interns that she's now "bright and shiny" because of getting back together with Derek takes a bit of a setback when she finds out that George's dad is in the hospital. He passed out and broke his clavicle in a fall.
When George and Bailey check on Mr. O'Malley, Callie is in the room, having popped his bone back into place. George's brothers are also there and they won't take George's word for anything, but only listen to Bailey. Bailey forbids George from working on his own father's case. She tells him he can pick one of the other interns for the case, and he picks Cristina.
When George goes to find Cristina, he observes her performing a complicated procedure by herself as Burke looks on. Later, she insists she merely assisted. He tells her he saw Burke having a hand spasm but she brushes off his concerns. He asks Burke if he's doing okay and Burke tells him everything is fine.
Callie and George's brothers are debating the merits of various cars when George checks back in on his father and he tells her he can handle his family on his own.
George has trouble breaking the diagnosis to his father, so Cristina tells him he has cancer in his esophagus and stomach and that he needs surgery to remove it.
George confides to Izzie and Meredith that he can't handle the news, or the way his brothers are treating him, or that Callie slept with Mark. He also says he's been worried about Burke.
A scan reveals that Mr. O'Malley needs an aortic valve replacement before he can undergo the cancer surgery. George tells Cristina he wants Burke to do it but demands to know if Burke is really okay. She says he is, but he knows she's lying.
George's brothers argue with him when he tells them they need to do the heart surgery before the cancer surgery. Callie steps in and compares their dad to a vintage car, talking engines instead of hearts, and they suddenly get it.
Addison is surprised that Derek is being so friendly. Because they're getting along so well, she asks him if he'll come talk to Richard with her because she thinks he's depressed. He says Adele wants him to step down as Chief of Surgery. Instead of listening to what he's saying, they're soon bickering about their own issues.
Richard calls Meredith in to tell her that he can't keep seeing her mother anymore since he's going to try to make his marriage work. He tells her that she's an extraordinary woman who worked very hard and sacrificed a lot.
Bailey assigns Izzie to shadow Alex and reminds her of the rules of her probation, which includes no talking to or touching patients. Alex is still assisting Mark, who tells him and Izzie to pick up his dry cleaning and to get him a sandwich. Addison finds out and and reminds him that Seattle Grace is a teaching hospital. So he brings them in to see Frank, a pec implant surgery patient who needs to be monitored after some swelling.
Frank, who refers to himself in the third person, says he got the implants because his girlfriend started seeing a physical trainer. He invites Izzie to feel the implants. She does and then he says she should compare them to real ones. Mark walks in to find her with one hand on Frank's chest and one on Alex's and sighs in disgust, "This is why I don't work with interns."
To the annoyance of the other interns, Alex and Izzie start talking about themselves in the third person. Frank senses the "vibes" between Alex and Izzie and tells him to go for her, even though Alex says it's complicated. To make a grand gesture like Frank did, he lets Izzie take out Frank's drainage tube. Izzie is so happy after the procedure, Alex goes in for a kiss. She freezes and tells him she can't.
They both end up at Joe's, where she says she didn't know that he still felt that way about her. But she asks, "Can Izzie buy Alex a drink?" A little girl, Mia Hanson, is brought in after being run over with an SUV by her devoted nanny, Anna. Mrs. Hanson, a high powered attorney, and her husband argue who's to blame for the accident. When Anna says she just didn't see Mia in the SUV's blind spot, Mrs. Hanson fires her. Mia won't stay still during a head scan and her mother's attempts to soothe her don't work. "I want Anna," she keeps saying.
Bailey and Meredith operate on Mia and Meredith thinks that the Hansons are lousy parents because they don't know their child's blood type or her favorite song, the way the nanny does. Bailey tells her that all parents just do the best they can.
After the surgery, they tell her Mia is doing fine, but keeps asking for Anna. Mrs. Hanson says she that she's good at her job, but not at the "mom stuff." So they bring Anna back.
Miranda sees Anna singing to Mia and calls home and insists her husband wake the baby up so she can sing to him over the phone.
Meredith tells her mother Richard isn't coming to visit anymore and, in her Alzheimer's confusion, laments having to raise her daughter alone. Meredith tells her she did the best she could.
Meredith and Derek decide that they can't keep up "bright and shiny" but that just being together is enough.