A young boy is desperate need of a transplant and the only organ donor around is also a serial killer. And Meredith meets McMommy!
Derek’s mom, Carolyn (guest star Tyne Daly), comes to town. This has Meredith a bit of a nervous wreck. Izzie tells her she should just try to put on a chipper face. But what exactly makes for a chipper Meredith? Apparently, it involves things like ponytails, forced smiles and not really talking much. Yeah, it’s as weird as it sounds.
Mer’s change-for-the-chipper doesn’t make the impression she was hoping for. Fortunately, she’s saved from a prolonged conversation with McMommy when she has to treat convicted murderer William Dunn. Who says there’s never a serial killer around when you need one?
Miranda is fighting as hard as she can for Jackson, a little boy who desperately needs a liver transplant. She’s fighting so hard that she’s getting on Arizona’s nerves. Finally, Dr. Robbins snaps.
It comes out that William, the murderer, would be willing to donate his organs. It’s not an option despite him being a match. Luckily, another donor comes through for Jackson. But as the organ transplant is underway, Sadie sees a suspicious spot. The organs are no good. Jackson needs a new donor, and soon.
Carolyn has known Mark Sloan ever since he was a little McSteamy, so it doesn’t take her long to figure out that Mark is having a relationship with Lexie. Mark expects disapproval, but Carolyn says she’s happy for him. She tells him he needs a younger woman to compensate for his perpetual immaturity. We’re still not sure if that’s a compliment or not. Carolyn agrees not to tell Derek but warns Mark about keeping secrets from his friend. Was anyone else thinking “Addison” when she said that?
William is crashing, but he begs Meredith not to let him be executed. Derek needs another doctor's signature to okay the surgery, but she freezes. Cristina signs it instead, so Derek asks her to scrub in. William survives the surgery and tells Derek, that they're exactly alike as they both choose when, or whether, someone else dies. Derek insists they're nothing alike, and repeats that he's not going to let William die in the hospital.
Izzie tells Denny that she's tired of the secrecy of carrying on a relationship with a dead man. "I want you alive," she says. "Are you breaking up with me, Izzie Stevens?" he asks. She is. Dr. Robbins advises Alex not to get hung up on the bad cases and to make plans. He takes this advice to heart and asks Izzie if she'll go visit his mother with him.
Owen asks Cristina out on a date, but he shows up late and drunk. Hey, he never said it would be a good date. Cristina orders him to take a shower. He does. Unfortunately, he steps into her shower while still wearing all his clothes. He then goes on to tell her the details of his first, incredibly traumatic, case during the war. Cristina listens. Then she gets into the shower with him.
Meredith can’t keep up the charade any longer. She shows Carolyn her true self, without the forced smiles and ridiculous ponytail. Meredith’s sure she’s blown it. As Derek speaks with his mother alone, she tells him she's no longer angry about his father's murder. She notes that that he sees things in black and white, but that Meredith doesn't. "You need a spoonful of that," she tells him, adding, "She's the one." We wish we had a McMommy like that.
Meredith learns that Jackson still needs organs, so she tells William that his skull is very vulnerable post-surgery. If he damages it, he’ll surely die. He (and we) knows why she’s saying this. Meredith steps out of the room. William takes a deep breath. He slams his head against the bed frame.