Sadie and Meredith Grey are both awake in the middle of the night.  Sadie can’t sleep because she’s uncomfortable on the sofa, Meredith is up reading her mother’s diary.  The same mother they used to hate as she is reminded by Sadie.  Meredith is now able to admit, “You know, I kinda think now that if I wasn’t her daughter, I would have liked her.  She was funny, intense. . . She was a lot like Cristina.”  Sadie makes a snide comment about Cristina not being funny.  Meredith suggests Sadie get to know Cristina Yang, but instead, Sadie asks her about her sister, Lexie.  Meredith quickly shoots down the idea saying that Lexie grew up with “parents and rules,” so they wouldn’t be good together.  Cristina pages her to the hospital for the “appy” (appendectomy) and Sadie decides to come, too, to go to the Skills Lab she says.   As they leave, Derek Shepard tells Meredith “No, more strays,” realizing that she has invited Sadie, too, into the house.  She agrees. 

At the hospital, Miranda Bailey arrives for her surgery confused as to why all the 2^nd years are there.  They quickly begin sucking up and giving the patients vitals to her in preparation.  She gets it – they’re all there because they’ve heard that the past two years the solo surgery has been an appendectomy and they’ve come to watch the “master” to get the practice.  An emergency patient comes in with Owen Hunt and he asks for one of the residents.  “Me mine, I’m on call,” George O’Malley shouts.  She gives it to him.  Then a nurse comes up asking  for a resident for a patient with abdominal pain.  Bailey sends Meredith and Cristina to prep her surgery, then sends Alex to the abdominal pain patient pointing out that you never know what it may turn into.

In another part of the hospital, the interns are still practicing.  This time, one of them is laying in a hospital bed when Sadie comes in and tells them that all of the residents are there in the hospital tonight.  They begin discussing how they gave one intern an epidural when they realize that they forgot to give him a catheter.  Sadie is upset she missed it.  Sadie tells Lexie Grey that she’s proud of her and she’s not a “priss” like Meredith said she was.  Lexie resents that comment.  Sadie jokes about doing a c-section  and Lexie suggests an appendectomy.  The others think she’s being funny, but she’s serious.  They all start to put it together and talk about how they can pull it off.  The intern on the bed starts to get nervous – he didn’t sign up for this.  Sadie says, “Fine, do me . . .as long as I can do one of you next.”  “Done,” Lexie tells her and they shake hands.

Mark Sloan comes into a supply closet looking for I.V. kits and runs into Lexie laden with supplies.  He asks if she knows where kits are and where all the interns are.  She gives him a lame excuse about them all being busy and Derek Shepard walks up.  “Needed some medical supplies and found the intern in the supply closet,” Mark defends (as Derek previously told him to stay away from “Little Grey”), “Did not invite the intern in the supply closet.”  She leaves and Mark says, “Don’t look at me that way, I didn’t do anything.”  “Don’t,” Derek tells him.  “I didn’t,” says Mark.

The interns are ready with Sadie.  She’s all numbed up and they’re scrubbed in.  Lexie begins to prepare for the incision.  She tells another intern to bring the book closer so she can see.  She draws the incision line on Sadie’s stomach and before she cuts, but starts to get nervous.  She tells them that  maybe they shouldn’t go through with it, there are other ways they can learn.  Sadie grabs the scalpel and cuts her own stomach open.  “Or you can just take out my appendix,” Sadie tells her.  They find the appendix and start to get nervous that it looks a little enflamed.  They begin to discuss how to procede and one intern explains that this no longer makes it a routine surgery.  They should get a resident to help.  “Listen I’m the one laying here on the table,” Sadie tells her, “The last thing I need is you getting nervous.  If you can’t handle it, leave.”  So she does.  Lexie resumes the surgery.

Meredith is confused why the interns aren’t answering their pages today.  She and Cristina soon stumble upon the intern who backed out of the surgery, her arms full of candy bars and she swears she doesn’t know where the others are.  Cristina takes the candy bars and the intern leaves.  Alex joins them in wondering where they are.  Meredith suggests they check the skills lab.  Alex comments that he’s not sure what is there, but his interns are certainly showing some progress recently.  “No they’re just idiots,” and Cristina leaves to find them.  She knows something is up.  Alex leaves as well and Meredith is left behind, but she’s not alone long.  Lexie Grey is approaching tenderly behind her.    “Meredith, do you have a sec?” Lexie asks, but judging by her terrified look Meredith knows it’s something serious.

Moments later Cristina finds her intern in the basement laying in a hospital bed reading his medical books.  When she asks him to go with her, he is forced to admit he has an epidural and catheter in that prevents him.  Something definitely is going on. 

Meredith and Cristina arrive at the same time to find Sadie cut open on the table.  She is now unconscious. The intern left in the room says, “ I think she’s dying.”   The two get to work immediately.  Meredith send the interns to go get the Chief and Bailey.  She instructs them to tell them it is an emergency – no more. 

Derek and Mark are in the hallway briefly discussing their patient when Mark confesses, “It’s your fault, you know.  I never thought about Little Grey that way until you told me not to.  Now I can’t help it.  You planted a seed.”  “Unplant it,” says Derek.

The intern finds Bailey and tells her there is an emergency.  She starts to brush it off and say, “What kind of emergency?”   When he repeats that it’s an emergency she looks up and sees the fear on his face.    Bailey walks in asking, “What the hell is going on?”  Lexie says, “We were trying to take out her appendix.”  “Well, who’s foolish idea was that?”  Bailey insists.  “Mine,” says Lexie.  They frantically begin working to stop the bleeding.  Crisitina and Meredith are nervous, but Bailey helps them get through.  They stabilize her and suture her up.  Bailey lets them make the decisions. 

The interns are all outside sitting against the wall wondering if they will go to jail for their wrong-doings. George O’Malley comes up to them, having just heard and says to Lexie, “What the hell happened?  We live together, you should have come to me.”   Lexie gets upset at him because he couldn’t have done anything about it and because this is the one thing she’s done in the last few months that had nothing to do with impressing him.  She walks away.  The other intern  clears up any further misunderstanding by telling George, “Dude, she’s like in love with you.  How did you miss that?”  but he has no words.

Lexie watches as the Chief Webber arrives and takes Meredith and Cristina into his office.

Chief is not happy to be awoken from his sleep and starts to lay into Cristina and Meredith.  They are speechless and he says, “Don’t beat yourself up about it too much. I’ve seen a lot of material from you two through this whole mess.  You handled the crisis, you handled the surgery, you saved that girl’s life and you called for help right away.  There was a time not long ago that you would have reached a different conclusion.”  He explains how they could  have tried to hid it, but they didn’t..  Just as things looked good for them, Lexie came barging in and insisting they not get in trouble for it.  It was her fault and Dr. Yang tried to tell her to shut it down yesterday and she didn’t listen.  Chief turns more sour on Cristina disappointed that she knew before and didn’t do anything sooner.  Meredith knew nothing. 

Outside his office the girls begin fighting.  Meredith can’t believe Cristina knew and didn’t do anything.  Cristina admits that she only knew about them practicing sutures on each other.  The argument continues and even gets personal.  Cristina is mad,  “Who are you to lecture me about doing the right thing, are you kidding me?  You’re not an attending, Meredith.  You might be sleeping with one, but you’re not one yet.”  She questions how this can be about Derek.  Cristina admits, “Okay it’s not about you and Derek. It’s about you not having my back in there. . . you should have said anything.  You have a relationship with the Chief.  You have his ear and you didn’t say anything to defend me.  Because this isn’t just about me.  You just sat there and watched him take me out of the running for the solo surgery.  You let me take the blame, but the fact is that we all had interns in that room.  We all failed to supervise them.  And if your friend had died in there, if we hadn’t saved her life, that would have been on all of us, too.  You should have said that.”

As Dr. Bailey is leaving, all of the residents are there waiting for her direction.  They’re wondering what they should do about their interns.  In a way only Bailey can, she tells them,   “They are your babies.  Do you really need a speech from me. At this point after all this time.  Because if you do, you shouldn’t be here.”   They lead all of the interns into Sadie and make them present the case to her.  They make them all stand there and tell Sadie to her face what went wrong and what happened in the surgery.  They also have to personally apologize for the mistakes that were made.  Effective immediately they are all put on probation and taken out of all surgeries .

Meredith takes a moment alone to lecture Sadie about how reckless and irresponsible she is being “as her boss.”  Then says, “as your friend, what the hell is going on with you?”  Sadie simply says, “I don’t know.”

Derek sees Lexie sitting in the lobby all alone.  Mark reminds him of the times that  Derek’s mom used to make him take Mark home because he was all alone.  He says, about Lexie, “Either you take her home or I’m taking her.”