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.