Remember how Cristina quit at the end of "That's Me Trying"? Well, it wasn't a joke. Not many know about the resignation until Teddy is forced to mention it during a med case presentation. A stunned Mark disrupts the proceedings while an angry Derek makes it clear that he blames Teddy for pushing Cristina too hard.
Now it's time for some RANDOM RELATIONSHIP UPDATES! April is crushing on Alex and Jackson's been leering at Lexie. Callie's hurting after Arizona's departure. She stops by to visit a disturbingly giddy Cristina, who convinces Callie to let her cut her hair. It doesn't go well. Callie needs to see a professional stylist before Cristina's firehouse-warming party, which she decides to have on whim. Better clean up all that hair!
You know that movie The Hangover? Well, Dr. Alex Karev may have lived it. He's feeling the effects of a wild weekend in Vegas, but gains no sympathy from the new Pediatrics Attending, Dr. Phil Stark (guest star Peter MacNicol). Stark's cavalier attitude during liver transplant surgery on an infant is surprising. Alex and April are truly stunned by Stark's decision to leave the baby opened up with a sponge in her until the swelling of the new liver goes down. April wonders how this is a solution. Alex says, "It's not."
Alex comes up with a viable alternative to help the baby, but Stark's not having any of it. Well, he's not having any of it as far as Alex knows. Stark operates while implementing Alex's concept. The Chief congratulates Stark on the great idea, but April asks just who came up with the solution first. Glad to see she has Alex's back.
Later, April finds the recently-dissed doc and things take a passionate turn. Alex loses it when April asks to slow down. He says she's a big girl and he's not going to hold her virgin hand through all this. Alex storms off, leaving April alone and stunned. It's all pretty harsh.
The Chief hustles Owen and Teddy into the VIP wing of the hospital. There's a lot of activity as a top political figure from the Middle East is wheeled down the hallway. He's crashing. An official in charge, Ronald Lace, says no one can know this man is being hospitalized. No one can even know he's in the country. And from a global perspective, Lace says it would be a really great if this guy didn't die.
Teddy manages to quash the mini-political firestorm surrounding the news that the world leader needs open heart surgery. Meredith learns the patient once had an aneurysm that has now burst. That means Teddy and Derek will have to operate simultaneously. There are multiple complications during the surgery and multiple discussions about Cristina. Derek ultimately apologizes to everyone. Without Cristina, he wouldn't be standing there. Obviously, he's personally invested in what's happening with her.
The VIP surgery goes well and the world leader is whisked out of the country before Teddy has a chance to do her post-op exam. Lace thanks Teddy for all that she did. He also says he enjoyed meeting her. Teddy responds, "I'd say the same, but you were never here." She just can't catch a break in the guy department, can she?
Jackson doesn't think anyone wants to work with him. When a patient takes a bad turn, an unavailable Bailey orders him to get her into an OR and start cutting. You heard us. She wants Jackson to operate solo. The patient dies on his table. When Bailey arrives, Jackson screams that it wasn't his fault. He won't let Bailey get a word in. That's too bad because Bailey later tells the Chief that Jackson was great on the case.
It seems like everyone is at Cristina's housewarming party except for Cristina. Derek warned her that she was about to be bombarded by a bunch of folks asking her to come back to work, so the two of them hide on the roof to chat about home improvements. Seriously, they're drinking wine and discussing bathroom tiles. Meanwhile, down at the party…
A wild-haired Callie asks Mark if she can move in with him. That'll work. And when Jackson finds out what happened with April, he punches Alex in the face. Then he punches him again. And again. Later, Meredith learns that Alex didn't go to Vegas at all. He was in Iowa having his schizophrenic brother committed for trying to kill his little sister. It was rough. So, now you know how this episode got its title.