Derek and Meredith are thrilled with the prospect of possibly adopting a child. Since Alex let it slip that Meredith fudged with the Alzheimer's trial, her job is now on the line. Richard was appreciative of her trying to help Adele. Derek on the other hand did not understand how Meredith could that, disregarding the millions of Alzheimer's patients that could have benefited from a successful trial. He begins to rethink raising a child with her.
Cristina and Owen discuss her candidacy for chief resident. She withholds sex for him to see her solely as a doctor, and nothing else. Cristina notices that her period is late and finds out that she is pregnant. She tells Owen that she is pregnant and that she had scheduled for an abortion. He kicks her out of the house and she is back at Meredith's.
Alex was originally the frontrunner to become chief resident but because of his intoxicated leaking of Meredith's secret, Owen changed his opinion of Alex. It turns out that April is the new chief resident, although it doesn't seem like she is prepared for the role.
Marks decides to back down and let Jackson have Lexie. Teddy finally admits that she is falling in love with her husband, Henry.