As Thanksgiving, Christmas and New Year's pass, Miranda is visited by her father, William, who disapproves of her choices in life; meanwhile, Mark and Lexie must cope with the shocking arrival of a woman from his past, and Thatcher Grey questions the Chief's recent behavior as Meredith comes to his defense.

When Owen recruits his fellow Iraqi War vet, Dr. Teddy Altman, as the new cardiothoracic surgeon, Cristina questions Teddy's abilities in the OR and the nature of their past relationship. Meanwhile Izzie returns to Seattle Grace with her high school mentor seeking treatment for his dementia, and the stress of Richard's responsibilities, post-merger, are taking their toll.

A generous donation is offered to Seattle Grace by the parents of Arizona's 10-year-old patient. however, when his condition worsens, she finds herself in a conflict of interests. Meanwhile, Cristina tests her boundaries with Owen at the hospital, and adding insult to injury, Alex is left with all of Izzie's hospital bills to contend with.

When Isaac, the hospital lab tech, has an inoperable tumor wrapped around his spine, he turns to Dr. Derek Shepherd to do the impossible, and Derek tests the Chief's authority when Richard objects to moving forward with the risky surgery.

After a burn victim unexpectedly dies in the midst of a chaotic ER, the Chief and board member Jennings interrogate the residents to find the culprit, as all the Mercy West and Seattle Grace residents defend their actions in an effort to save their jobs.

As Mercy West merges with Seattle Grace, battle lines are drawn between the two hospital's residents over the patients.

Thatcher is hospitalized with liver failure, and Meredith fights anger and guilt while deciding her responsibility. Sloan treats an octogenarian who wants an implant. Izzie's interference in Hunt's cancer case may have deadly consequences.

Several weeks after her near-death experience, a recovering Izzie returns to work. Meanwhile, nervous that there will be layoffs in the hospital in the wake of an announcement from the Chief, the Seattle Grace residents compete to survive the cuts, including Cristina, who attempts to work alongside Arizona in pediatrics. And Bailey and Alex's patient's already complex case is further complicated by her schizophrenic son.

The Seattle Grace staff has to deal with the aftermath of George’s tragic death. As the news hits the staff hard, they all must find a way to get through the stages of grief. Later, George’s mother arrives at the hospital to decide what to do with his organs.