Amelia arrives at Seattle Grace to beg Derek to help with the gliosarcoma case; Cristina and Owen have heated arguments during marriage counseling; Alex realizes he needs to improve his people skills in order to be a good doctor.

As Adele's condition continues to deteriorate, Richard considers altering their living situation; an explosion at a local coffee shop results in a busy day in the ER for the doctors; Callie takes Meredith under her wing by helping her study for her boards; Lexie joins Arizona and Alex in peds, as they continue to care for intern Morgan's premature son; and when Jackson snaps at a patient, Mark encourages him to find ways to relieve his stress. Meanwhile, Cristina lets her suspicions get the best of her.

Derek encourages a hesitant Meredith to work with him again in neurology; Jackson's mother, Catherine Avery, returns to Seattle Grace with a urology fellow and develops an interest in Richard; and Cristina becomes increasingly suspicious of Owen's every move. Meanwhile, Alex tries to deny the fact that Morgan may be falling for him.

A lion breaks loose in Seattle, leaving a couple's lives and relationship at risk; Lexie overhears Mark's discussion about moving in with Julia; Teddy begins to take steps towards coming to terms with Henry's death; Callie grills Arizona on her past lovers; and Alex requests to be taken off Morgan's preemie case when she becomes too dependent on him. Meanwhile, Meredith tries to be a support for Cristina as the tension between her and Owen hits a boiling point.

After eight years of practice, the residents head to San Francisco for their oral boards; sparks fly between Catherine and Richard when they bump into each other at the hotel; Bailey intervenes after Owen and Teddy get into a heated argument about their young car crash patient; and Mark tries to recruit Lexie for one of his cases. Meanwhile, Alex feels guilty for being away from the hospital when Tommy's health begins to fail.