Alex is one of the candidates Alana would like to see become a Grand Ambassador for the hospital. He's extremely uncomfortable taking part in a photo shoot. Things are also awkward at home. Jackson and Stephanie are making out on the couch while Cristina and Owen are making love upstairs. Jo helps alleviate things by making loud animal noises. Now everyone else feels uneasy. Jo is a cool lady, but Alex swears there's nothing romantic happening here.
PR folks follow Alex around snapping photos of him as grateful patients hug him for his life-saving work. Jackson is also in the running for the Grand Ambassador gig. The two competing docs team up on a young transgender patient. The patient's father is upset about his daughter's impending operation. It leads to a shoving match with Alex and a heated confrontation with the patient. Nevertheless, the operation is a go.
Pegasus Horizons is the group interested in buying Seattle Grace Mercy West. Callie and Richard check out another hospital they've purchased in the past. They go undercover as the married Calliope and Julio Plantain, with Richard playing the part of a patient. They later use their real names while saying they are reps from Pegasus. They find a lot of unhappy docs who have been forced into toeing the company line.