Derek's mother visits, the death row patient starts angling for death in the hospital, Izzie craves more in her relationships, and Jackson's need for organs becomes critical.
Derek refuses to let a death row inmate die from injuries sustained in a prison riot, Miranda refuses to let a little boy die because he can't get the badly-needed transplant, Denny refuses to let his relationship with Izzie die, Lexie won't let her budding relationship with Mark die, and Derek's visiting mother puts everyone's mother first on priority lists.
- Arizona was annoyed with Bailey for calling her in the middle of the night to chat about Jackson's transplant.
Derek told the convict that his brain contusion could kill him if it went untreated. He said he might as well take his chances with the "brain thing" than facing execution.
Sloan was looking for a way to sneak out of Lexie's room when he found out Derek's mom was going to show up. He was afraid she'd find out that he was hooking up with "forbidden fruit." Meredith was also nervous about the arrival of Mama Shepherd. The group was all around Meredith helping her brace for meeting Derek's mom. Sloan walked out of the house at 4 a.m., just as Derek was walking in. Meredith even changed her hairstyle.
Derek again suggested surgery for the death-row inmate. Derek refused to let him cheat the system and insisted that they would perform the surgery after he fell asleep.
Callie had a patient who had surgery in Hong Kong to get his legs lengthened. It was pretty ugly and the bottom half of his leg was gone. Bailey told Sadie she didn't trust her and told Sadie to stay out of her way when dealing with Jackson. She told Sadie not to talk to her patient without raising her hand and asking permission to speak.
William, the death-row inmate, found out from Jackson that he needs a new liver and new intestine. "Yeah," William said. "You want mine?"
Derek's mom made a surprise arrival at the hospital. She spotted Sloan, who quickly tried to avoid her. Meredith showed up and put on her best smile. Derek's mom wanted to meet Meredith for lunch. "I can't wait to dive in and learn everything about you," Mama Sloan said.
Dr. Hunt asked Cristina out on a date. She didn't respond. Denny, meanwhile, was giving Izzie top reasons for dating a dead guy. One was "no awkward dates." Bailey told Jackson that what William offered was "definitely against the rules." William was trying to convince Meredith that he should be allowed to give Jackson his organs. "Let me save a life before I go," he said.
The short guy, Chuck, was upset that the doctors suggested they could save him, but he'd lose the two inches he was supposed to grow as a result of his experimental surgery.
Bailey suggested a tips procedure on Jackson instead of waiting for donor organs. Arizona said the tips procedure was like putting a band-aid on a bullet hole. Bailey said she was tired of waiting. They shouted at each other for a few minutes before Alex came in and told them to shut up because they might have found the organs.
Arizona and Alex were on a plane to get the organs and Arizona suddenly started grilling Alex about Izzie and he got impatient with her.
Izzie was giving Cristina tips about what she should talk to Hunt about on their date. Meredith, meanwhile, was having her first "date" with Mama Shepherd across the cafeteria. Lexie came up and sat with Sloan and he asked what she was doing. She said, "You sleep with me, you lunch with me. New rule." Then, the rest of the interns showed up and Sloan got up to leave.
Derek's mom found Sloan and confessed that he was sleeping with Meredith's sister, who happened to be drinking a juice box when Mama Shepherd looked over.
Meredith had a bit of a light moment with William, when he told her that he was given a choice of hanging or lethal injection. He asked her what would be her choice, medically speaking. She explained that hanging would prolong his death after breaking his neck and the injection would be given after he was anesthetized. He asked if he was a match for Jackson. "Yes, you were," Meredith told him.
Derek's mom found Lexie and asked her if she's "a good girl." She asked how many sexual partners she'd had. "Kinda six, kinda seven," Lexie said.
Callie told Sloan about how she "used to walk tall" -- as a metaphor for the poor guy who was trying to get his legs stretched a couple of inches.
Back in the plane, Alex asked Arizona, "What is wrong with you?" because she wouldn't stop talking about "relationships and rainbows and crap" despite the fact that they just went to get organs from a dead kid for their patient.
Bailey was starting to operate on Jackson when Sadie raised her hand and asked Bailey to call on her. Sadie noticed a spot on one of Jackson's organs.
Meanwhile, William crashed. Derek wanted Meredith to sign the form that needed to be signed by two doctors to consent for William's operation. She froze and Cristina took the chart from Derek and signed it.
The chief told a frantic Bailey that Jackson would die if they kept his dying organs inside him. Sadie asked Bailey not to be mad at her for being there.
Cristina talked to Meredith for the first time in a while, just to say her pony tail looked ridiculous. Derek's mom told Sloan that Lexie was "a lovely girl."
Callie told Chuck she had to shave off a quarter inch of his leg to save him. The man was even more upset by this, and his six-foot-tall brother finally went off on him, telling him he should stop complaining about being short.
Derek told William he wasn't going to let him die in the hospital. William tried to tell Derek that they weren't so different, because Derek decides who lives or dies in the hospital.
Meredith confessed to Derek's mom she was a fraud and that she was not the kind of girl mothers like. She said she was "dark and gloomy" and that she was "the kind of person who feels bad for serial killers." Derek's mom simply replied, "It was very nice to meet you, Meredith," and walked away. Izzie saw this and shook her head. Izzie then told Denny she wanted to meet his mother, but she couldn't. She went on to say all the other things she wanted, like walking down the street with him, telling her friends about him. She finally said, "I want you alive." He asked if she was breaking up with him. "I think I am," she said.
Sloan met Lexie outside the elevator and turned to Callie, who was in the elevator with him and said, "Walk tall."
Hunt showed up to Cristina's house late and drunk. He said he was nervous because he hadn't been on a date in five years. She told him to shower, so he went into her bathroom.
Derek's mom said it's easier to have compassion for a good person than a murder. She said she knew Derek was still angry for what happened to his dad. She said she still couldn't sleep on his side of the bed, but said she wasn't angry anymore. She told Derek he sees things in black and white, and Meredith doesn't. "You need a spoonful of that," she said. "You need her. She's the one."
Hunt was in Cristina's shower -- completely clothed in his suit -- and started telling Cristina about his best surgery. It sounded wildly complicated, but he saved a soldier who then sent him a letter for saving his life, "then he shot himself."
Alex asked Izzie if she'd like to take a road trip to Iowa to meet his mom. She didn't respond right away, but then kissed him. Denny sat on the bed next to Alex after Izzie left the room to get tequila. Denny said, "Alex, we gotta talk."
Bailey told Jackson's mother they had to wait for a miracle. Meredith went into William's room and told him Derek removed a piece of his skull that left a bit of his brain somewhat exposed. She said any damage to that area would result in his brain swelling and cause brain death. She advised him, as his doctor, to make sure nothing damaged that area. Meredith knew William was ready to give his life to save Jackson. She left the room and William proceeded to slam the back of his head against the headboard of his hospital bed. He repeated this a few times before his hand went limp and the screen cut to black.