Jackson is now the big boss at Seattle Grace Mercy West. He lays out the foundation's plans as far as moving forward. They conflict with the plans that have already been formulated by some of our favorite docs. The biggest newsflash is the thought that new leadership would be good for morale. Jackson says the recommendation is that they find a new Chief of Surgery. When Owen learns he may be on the outs, he makes thinks easy for the board. He quits.
It's a perfect storm of transplants at the hospital. Alex has a new kidney on the way for a 16-year-old girl if she can pull herself away from kissing a fellow dialysis patient. Cristina is doing a heart and lung transplant. The third case involves Brad Parker, a former Mercy West resident with ALS. April remembers him as an amazing guy who never gave up. That's why she's shocked to learn that he wants to be taken off his ventilator so that he can donate his organs once his heart stops.
Cristina's elderly patient, Mr. Schultz, has a beef with another elderly patient, Mr. Crump. The two old guys are neighbors who were involved in a love triangle that ended bad for both men. Cristina wants to transfer Schultz's heart into Crump so the first man can get a heart/lung combo from the same donor. Too bad Crump would rather croak. He's rejecting the heart out of spite. Cristina eventually convinces him to take the heart so he can outlive his nemesis.