Derek's little sister, Amelia, comes to Seattle Grace asking Derek for help, to operate on her friend Erica. he refuses to do it. Lexie convinces Derek to help Amelia out. They need to do the procedure in under 90 seconds for any chance of Erica to live. They end up nailing the procedure in 86 seconds.
The fifth year residents spend their time preparing for the oral boards. Jackson and April pair up. Alex uses his intern to quiz him on questions. Cristina and Meredith should be studying together, but Cristina is too busy trying to repair her marriage with Owen. After talking with Richard, Callie thinks about telling Meredith about her secret study method, but she wants Meredith to prove herself first. Meredith succeeds and Callie lets her in on her secret.
Patient Carrie Rissler was told she had six months to live, over eight years ago. She thanks Bailey for this. The women is back to have a lymph node transfer. Bailey makes Mark and Jackson read through every line of her medical records before they operate. In the OR, Bailey drives everyone crazy and Mark has Jackson to tell Bailey to leave.
Morgan, who is 24 weeks pregnant, has a heart attack. The Teddy operates immediately and the baby needs to be delivered now. Alex freaks out and feel guilty for how he's worked Morgan - he didn't know she was pregnant. Cristina and Owen go to marriage therapy and it does not end well.