A young boy, Wes, has a tumor on his spine. The best doctors in the world have deemed it inoperable. So, it makes perfect sense that Dr. Derek Shepherd is going to operate, right? The mom says her son has no idea he has a tumor. He believes he's being treated for a bad backache. In truth, Wes is totally hip to his illness. He just doesn't want his worried mom to know he knows. He swears Lexie to secrecy.
Derek does his best to remove the tumor, but it turns out all the other doctors were right. It's inoperable. Lexie pleads with him to try, but this is truly a hopeless case. They have no choice but to close him up without removing the tumor. Wes later tells his mom not to worry because he'll soon be in heaven with his dad. It's a heartbreaking moment, but one that's not going to stop Lexie from assisting Derek on more hopeless cases in the future.
There are two big parties in the works. The first is Zola's birthday bash. The second gala is to celebrate Richard's 10,000th surgery. The former chief nixes the idea of confetti because it might get in the cake. The man didn't get to do all those surgeries without looking at the big picture.
Richard's operation involves a kidney transplant between a couple of bickering sisters (guest stars Peri Gilpin and Nia Vardalos). Things are going well until a confused Adele shows up after being found wandering the streets. Meredith suggests that Richard recall a happy memory to help ground her, so he sings "My Funny Valentine" because they were married on February 14th. This works wonderfully, but Richard knows his celebratory party must now be canceled.
Now that Mer-Der have Zola, April thinks it's time to move out. She wants Jackson as a roomie, but would prefer to ditch Alex. That's not gonna happen. They need rent from all of them to get a decent place. In other news, Meredith needs to declare a specialty. General surgery seems to make the most sense, but Meredith worries that will make her just like Ellis. Richard assures her that she's nothing like her mother.
Callie and Arizona believe Mark is afraid to say "I love you" to Julia because Lexie broke up with Jackson. They try to convince him that the Lexie ship has sailed (and sank). The two ladies aren't subtle in their attempts to get him to say those three little words to Julia. But Mark refuses to rush into things like he did with Addison and Lexie. Just call him McMaturity.
Teddy has been receiving lots of sympathy casseroles from her colleagues. She's also been doing lots of surgeries with Cristina right by her side. Owen wants them both to get some rest. He orders them away from the latest trauma case which involves a man who has part of a fence lodged near his heart. Owen is also trying to find a way to get Teddy to stop hating him. Somehow we don't think another casserole will do the trick.
Teddy and Cristina go behind Owen's back to scam their way into operating on Fenceman. When the Chief of Surgery learns of their deception, he demands that they both report to him after the operation. Owen overhears Cristina and Teddy laughing at him on his way out of the OR.
Meredith swipes some of Teddy's widow casseroles for Zola's party. She also makes use of her baby girl's birthday cake to celebrate Richard's 10,000th surgery. Still no confetti though. But there are fireworks once Owen shows up. He and Cristina get into a loud shouting match in the kitchen. It starts out about the surgery then segues into other issues. Owen believes their lives revolve around Cristina getting whatever she wants. He says, "You killed our baby. You don't ever forget that!" Suddenly no one is in much of a party mood.