As Izzie deals with the aftershocks of her night of passion with George, her world is rocked once again when the daughter she gave away 11 years ago comes into Seattle Grace.
George promises an exhausted Callie, who's worked all night, that he'll meet her later for coffee. In walks Izzie, carrying a rosary. Alex is surprised she's doing penance and says, "You did something bad." She and George exchange guilty looks. Things get more intense for Izzie when a couple, the Kleins, come in because their adopted daughter has leukemia. The young girl, Hannah, is actually the baby Izzie gave up for adoption 11 years ago. Can you say “curveball?!”
The Kleins need Izzie to be a bone marrow donor. Izzie agrees to be tested but also wants to meet Hannah. She’s crushed when Hannah is too tired to see her. But she opts to do the testing anyway. Bailey has the other interns cover for Izzie. George wants to know what's going on, but Bailey tells him it's none of his business.
George discovers what’s happening and stays with Izzie through the painful testing. He admires her for what she's doing. They walk by Hannah's room and he tells her she can sneak a peek, since Hannah can't see her. She's overwhelmed at seeing her daughter for the first time. George, meanwhile, completely blows off his coffee date with Callie. He lies saying he was busy in the clinic. Callie knows something is off about his story but doesn't press it, saying she's tired and is going home. Does anyone else hear the sound of a ticking relationship time bomb?
Derek confronts Richard about his promise to name him as his replacement. The Chief tells him he knows he and Meredith are happy together and that if he became Chief, he would lose her, just as Richard lost his wife. He swore an oath to Ellis to look out for Meredith. Derek confides in Miranda, who says being Chief doesn't mean anything if you’re alone.
Meredith's stepmom, Susan, feels guilty for not encouraging Thatcher to visit Meredith more often when she was young. Meredith is simply not used to this kind of overprotective mothering. The Chief, on the other hand, is not used to flirting. Sloan offers to help him improve his game with the ladies. Addison does, too. But the Chief declines. Hey, at least he’s not dying his hair anymore!
A photo of Jane Doe’s new post-op face is released to the police and the media for help in identifying her. A couple, the Malones, comes forward thinking she's their daughter, Shannon. The characteristics match: pregnancy, height, hair, blood type, a lack of tonsils, even if the face doesn't quite fit. The Malones tell Alex and Addison that Shannon has been missing for months after her husband left because he didn't want the baby.
Mr. Malone and Jane Doe are bonding beautifully when Mrs. Malone tells Alex she's sure that this woman is not her daughter. Her husband is just more desperate to believe than she is. Alex tries to break the news to Jane. He calls her "Ava," the name they picked out before her surgery, but she insists he call her Shannon. She doesn't want to believe him and says he's being selfish and that he just doesn't want to let her leave.
Colin Marlow asks Cristina to assist him on a "piggyback" heart transplant and grudgingly says that Burke can also scrub in. Cristina decides she must treat Colin's continued pursuit of her like a chess match, and outflank him. She plays up her affection for Burke in front of him, holding hands, showing off the nail colors she's trying out for the wedding. We know. It’s weird.
Colin sees right through her little game. It's only when he catches her asking Burke a surgical question that he knows she already knows the answer to, that he realizes he's seeing their true relationship. The Cristina he knew would never stoop to building up a man's ego. He says there's no point in pursuing the Chief position here since the woman he knew is gone. Back at home, Burke says he's relieved she can now go back to "the real Cristina," but it's obvious that Cristina isn't so sure who that is.