The Chief announces that he's stepping down from his post, though he'll stay on as a member of the staff. Owen takes over as Chief of Surgery. Needless to say, just about everyone is stunned. Teddy his very happy for Owen, but Bailey looks like her head is about to explode. You know the look we're talking about, right? In other news, the time has come for the fifth year residents to rotate in as lead surgeons. Should make for an interesting shift!
Meredith is tasked with clipping an aneurysm. Alex is doing a bowel resection. Jackson is to work on a baby with a cleft lip. Cristina is scheduled for a mitral valve replacement. As for April, she's still having trouble gaining the respect of her colleagues. They invade her office where a contest is proposed. Whoever has the worst outcome of the day teaches the skills lab for the month. April doesn't like it, but she's overruled.
Alex doesn't have time for small talk as April chats with the bowel resection patient and his concerned son. He barks for the bullet points of the case. The exchange doesn't exactly put the family at ease. April assures the son that Alex is a very good surgeon. But even top docs need practice. That's why Alex operates on a big pig first. His friends also want dibs on the practice porker in order to hone their skills for their impending procedures.
Cristina berates her first year charges when they skip a basic step while examining a patient. As it turns out, the lady has appendicitis. Teddy wants Cristina to do this very "basic" procedure. That's not as easy as it sounds, as Cristina has little appendix experience. She tricks her first years into talking her through the procedure, but still chokes during the actual surgery. Unfortunately, Teddy doesn't know what to do either. A nurse has to bail them out. They agree to never speak of this incident ever again.
Arizona informs Jackson that Mark is going to do the cleft surgery on the young baby. After performing the procedure on Alex's pig, Jackson proves to Arizona that he deserves to do it. She agrees. But some last minute doubts force Jackson to hand over the scalpel to Mark. That's cool. Jackson's still the Gunther.
April realizes the reason Alex was so abrupt earlier is because he's really nervous about his first go as lead surgeon. Richard is in the room, but he doesn't step in when things go south. That's because he knows Alex did everything he could. April does, too. That won't make it any easier when Alex has to explain what happened to the patient's son. No one said being lead surgeon was going to be easy.
There's been no word about Derek and Meredith's fate with Zola. Mer's very first aneurysm clip is certainly daunting, but her big concern is the fact that she and Derek aren't a team right now. This becomes evident when he demands she use a certain clip. But Meredith is lead surgeon. She uses the clip she deems best. It works and there's applause from everyone in the room, with Derek joining in only at the end.
Even though the contest idea wasn't her own, April realizes it actually worked. She deems Jackson to be the biggest loser of the day because he didn't even operate on his patient. He can redeem himself during a rematch tomorrow. Say what you want about April's leadership skills, she's smart enough to roll with what works.
Owen realizes that he needs Bailey on his side if he's going to be an effective Chief. Repeated failed efforts to be nice to her assure him this won't be easy. Bailey is also ticked at the Chief (we mean the old Chief, not the new one). Richard wants her to be happy for him. That'll take some time. No prob. Richard will wait.
Owen and Cristina haven't talked about the whole abortion issue-not once. She believes her hubby is finally opening up when he admits to feeling terrible. But he's not talking about his feelings. He's illin' over some bad springs rolls. Hey, at least their sudden bout of food poisoning is enough to get them talking again.
As for Meredith and Derek, he's upset because the things he hates most about his wife are also the things he loves about her. But Derek promised he wouldn't run. He promised he would love her. The proof of this is that blue post-it hanging on their wall. Derek trusts his wife completely when it comes to Zola, but things are different at the hospital. Meredith suggests they stop working together. Hey, we're all for this initiative if that's what it takes to keep them together at home.