Arizona's best childhood friend, Nick, is in town from Tibet. He was her rock after her brother died. The guy has cancer, but Callie is optimistic because it's been slow-growing for six months. Nick clarifies that he's actually had cancer for six years. The guy's in a lot of pain. There's a good reason for that. Callie discovers that Nick's cancer has spread. There's very little they can do for him. Needless to say, Arizona is devastated. She's also furious at Nick for not calling her sooner. She couldn't help her brother, but she could have helped him.
Derek, Mark and Lexie treat a man who fell off a roof. They are fixing a bone defect that occurred after the initial operation. They secure a titanium plate onto his skull. During the operation, Derek tries to subtly deliver a message to Lexie about her situation Mark. Later, Lexie repeatedly tells Mark that she loves him during a sweet, rambling speech. It ends abruptly when Julia pops by. As for Mark, he just stands there speechless.
Back in Seattle, the fifth years learn their fate one by one. Jackson is the first to find out he passed his boards. Cristina and Meredith have also made it through. Even though he missed the first session, Alex has passed the boards, too. But we said earlier that one of our favorite docs didn't make the grade. By the devastated look on April's face, we now know who it is.