Chapter Summaries

After Mr. Herman’s teratoma was removed, Adam visited Barney, who blamed Adam for his bad luck after a viper bit him. Marshall and Lily asked Adam to help deal with a flying Roach-Rat in their apartment, and Adam agreed to investigate.

• Mr. Herman’s teratoma was removed, and the doctors accepted his objection to displaying it as an exhibit.
• Marshall and Lily visited Barney after a Golden Eyelash Viper bit his butt, and Barney blamed Adam for his misfortunes.
• Marshall and Lily told Adam that a monster had appeared in their apartment and asked him to subdue it.
• Adam identified their description as a Roach-Rat and joked that it could fly.
• Adam agreed to go with Marshall and Lily to see the Roach-Rat, suspecting it was the first of its kind.

Adam, Marshall, and Lily searched Marshall's apartment for the Roach-Rat while Ted explained why he planned to visit Singles' End Station. Ted left determined to try the matchmaking service, though he still hoped to meet the Slut Pumpkin Girl again.

• Adam suggested capturing the Roach-Rat alive and sending it to Columbia University for study, while Lily proposed killing it with a bat before changing her mind.
• Ted told Adam, Marshall, and Lily that a coworker had persuaded him to try Singles' End Station, whose owner, Allen Parshell, supposedly matched people with a perfect success rate.
• Ted said he still hoped to find the Slut Pumpkin Girl, the woman he had met at a Halloween party years earlier, and imagined that a match through the service might prove they were destined for each other.
• Adam questioned whether someone as wonderful as the Slut Pumpkin Girl would use Singles' End Station and told Ted that finding her there would mean they were destined to be together.
• Ted decided to visit Singles' End Station, compared his search for love to a rat and a cockroach finding each other, and left after Adam teased him about finding his mother rat.

Lily and Marshall helped Adam capture a mutated Roach-Rat, which Marshall agreed to deliver to his biology contact at Columbia University. At the hospital, Meredith said goodbye to Derek, but she refused Adam’s bet that she could truly end their relationship.

• Lily and Marshall found the Roach-Rat in Marshall’s apartment and called Adam over.
• Adam caught the Roach-Rat and sealed it in a glass jar, then asked Marshall to take it to his friend at Columbia University.
• Adam returned to the Medical Center and saw Meredith and Derek solemnly say goodbye to each other.
• Meredith told Adam she was done with Derek, and Adam offered to bet a rare surgery that she would not stay away from him.
• Meredith refused the bet and hurried back into the hospital.

Adam and Cristina discussed her strained romance with Dr. Burke and how to turn his dates into medical study sessions. The next morning, Meredith's bar hookup Steven came to the Medical Center with a problem that left Adam laughing.

• Cristina attended the private study session alone because Meredith went to a bar, Liz was working overtime, and Bianca was upset with Adam for neglecting her.
• Cristina said she had turned down Dr. Burke's date to study Ellis Grey, and Adam encouraged her to invite Burke to a lecture instead.
• Adam hoped Cristina would persuade Burke to join the study sessions so he could learn from the renowned surgeon.
• The next morning, Meredith told Cristina she had sent her bar hookups home, and Adam said the men were uncomfortable because they were unused to women treating them casually.
• Steven, Meredith's hookup from the previous night, arrived at the Medical Center and revealed his problem, making Adam struggle to hold back his laughter.

Adam examined Steven for persistent priapism after Meredith’s hookup arrived at the hospital with the problem, while Meredith feared the incident would worsen the gossip about her. When Steven’s condition returned after treatment, Adam suspected a neurological cause, possibly a tumor, and went to investigate.

• Steven showed Adam and the other doctors his condition outside the medical center, and Meredith panicked about the gossip spreading.
• Adam examined Steven and explained that persistent priapism was often caused by erectile dysfunction medication, but Steven insisted he had taken none.
• Adam ordered Steven admitted for tests and told Meredith and Cristina to handle his treatment while he left for other work.
• Steven’s tests came back normal, and an enema failed before needle aspiration temporarily resolved his condition.
• Meredith told Adam that Steven’s condition had returned, so Adam suspected a neurological problem such as a tumor and went to examine him.

Dr. Bailey reprimanded Meredith and Cristina for bringing Adam to examine Steven, then called Neurosurgery to assess his injury. Dr. Shepherd arrived and, after Steven asked Meredith when he last had sex, realized the man’s problem was tied to Meredith and lost his cheerful mood.

• Dr. Bailey scolded Meredith and Cristina for seeking Adam’s help and warned that Steven’s condition might become necrotic.
• Dr. Bailey told Meredith that she had called a Neurosurgery specialist, leaving Meredith mortified because she had injured Steven during sex.
• Dr. Shepherd arrived in high spirits after reconciling with his wife and began examining Steven.
• Dr. Shepherd asked Steven when he had last had sex, and Steven turned to Meredith for the answer.
• Dr. Shepherd stopped writing and stared at Meredith in disbelief as his good mood vanished.

Adam took over Steven Warden’s surgery after Meredith left the room amid tension with her ex-boyfriend, Dr. Shepherd. Dr. Shepherd made Adam the lead surgeon, and Adam prepared to remove Steven’s spinal tumor.

• Cristina tried to leave the room, but Adam stayed as Meredith and Dr. Shepherd awkwardly faced each other over Steven’s surgery.
• Adam examined Steven’s CT scans and identified a tumor compressing the nerve responsible for his sexual function.
• Steven held Meredith’s hand and revealed that they had met at Joe’s Bar the previous night, upsetting Dr. Shepherd; Meredith left and Adam agreed to take over.
• Dr. Shepherd asked Adam about his confidence in the operation, then appointed him lead surgeon after Adam answered confidently.
• Adam realized Dr. Shepherd had yielded the surgery to avoid risking an emotional lapse while operating on his romantic rival.

At lunch, Cristina tried to bargain with Adam over a surgery and a favor, while Meredith faced gossip about her successful surgery and an unwelcome invitation from Stu. Adam learned the men had nicknamed Meredith “Rock Queen” and warned Stu that his shameless flirting could get him beaten.

• Cristina asked Adam to count her work on a rare case toward a surgery or favor, but Adam refused because she had given up the surgery.
• Meredith came to ask about the surgery, and Adam told her it had succeeded as gossip about her spread through the hospital.
• Liz, George, and Stu joined Adam and Cristina at lunch, where Stu invited Meredith to Joe’s Bar and she left in anger and embarrassment.
• Stu told Adam that male staff privately called Meredith “Rock Queen” and admitted he was unafraid to ask her out because of his low center of gravity.
• Adam warned Stu to tone down his flirting or someone in the real world would beat him to death.

Adam mentored John Carter at the hospital while building his reputation with the Duncan-Adler formula, then returned home on Halloween to find Alice Kidman waiting in a striking costume. The chapter left Alice inside Adam’s apartment after she revealed her fish-scale uniform.

• Adam left the cafeteria and taught John Carter to report to supervising doctors while following them on the way to the Operating Room.
• Carter offered Adam braised pork hocks, and Adam called them too sweet before Nurse Know-It-All encouraged Carter to learn Eastern cooking and gave him the contact information for Adam’s favorite restaurant’s chef.
• Several weeks later, Paige gave birth to the Duncan-Adler formula, and Adam published a paper that helped raise his standing in the medical field.
• Adam worked overtime on Halloween, returned to his apartment, and completed his usual math study session.
• Alice Kidman arrived wearing an Eyes Wide Shut-style robe and mask, then revealed a white fish-scale uniform after Adam let her in.

Alice and Agent Hill fought after arriving at Adam’s apartment at the same time, and Adam ended up restraining both of them. The next morning, Alice told Steven Murphy that she had been injured by a woman she believed was cosplaying S.H.I.E.L.D. deputy director Maria Hill.

• Alice visited Adam to discuss a surgical case, then Agent Hill arrived at his apartment without warning.
• Alice and Agent Hill argued and fought, and Adam pinned them both down when they attacked him.
• Agent Hill left in borrowed clothes after threatening Alice, while Adam joked that Howard would be jealous.
• At the Medical Center, Alice told Steven Murphy that a woman pretending to be Maria Hill had shoved her and injured her forehead.
• Steven offered to get even, but Alice said she had hurt Hill too and suspected Hill was in worse shape.

Adam, Cristina, and Liz discussed Dr. Montgomery’s arrival and the Medical Center’s new pediatric case: a woman carrying quintuplets. After Liz recommended reducing the pregnancy to three fetuses, Adam questioned her reaction and suspected she had a personal history involving pregnancy.

• Cristina teased Adam about his unusually cheerful mood while the interns discussed Dr. Montgomery joining the Medical Center’s staff.
• Liz told Adam and Cristina that Mrs. Rusebin was carrying quintuplets, and they joked about the sensational pregnancy and the strain of raising eight children.
• After examining Mrs. Rusebin at thirty-two weeks, Liz said the mother should consider giving up two fetuses so the remaining babies could develop longer.
• Adam reminded Liz that the decision belonged to the patient, then wondered whether her strong reaction came from her own past pregnancy and whether she might be Juno Buno.

Dr. Montgomery invited Adam to help manage Mrs. Rusebin’s quintuplet pregnancy, hoping to recruit his talent for Neonatology. Adam agreed to work with Dr. Stevenson, and Dr. Montgomery left him with the suggestion that his presence could help Mrs. Rusebin, who was showing signs of depression.

• Dr. Montgomery approached Adam in the hospital hallway and invited him to join Mrs. Rusebin’s quintuplet case.
• Adam accepted the assignment but asked about Dr. Stevenson, and Dr. Montgomery said they would be jointly responsible.
• Dr. Montgomery considered Adam a stronger recruit than Liz but recognized that he was unlikely to choose pediatrics.
• Dr. Montgomery told Adam that Mrs. Rusebin showed signs of depression and suggested his presence might help her feel more at ease.

Adam joined the consultation for Mrs. Rusebin’s quintuplet pregnancy and discovered serious problems affecting three of the fetuses. The doctors reassured Mrs. Rusebin that the conditions could be treated, but she was left grieving and regretting her decision not to reduce the pregnancy.

• Dr. Montgomery left after Adam reminded her that the Chief of Surgery had put the staff at Dr. Shepherd’s disposal.
• Dr. Montgomery considered cultivating Liz instead, since Adam was talented but difficult to direct.
• Adam examined Mrs. Rusebin and found that the third fetus showed signs of cerebral edema, while two others had additional abnormalities.
• Adam asked Liz to call both Dr. Shepherds and Dr. Burke, then explained Lucy’s condition to Mrs. Rusebin.
• The Dr. Shepherds confirmed Adam’s findings and helped calm Mrs. Rusebin by explaining that all three conditions could be treated.
• Mrs. Rusebin accepted that three of her daughters had problems, while Adam recognized her deep regret over refusing to spare any of the fetuses.

Adam presented a treatment plan for three fetuses with serious conditions and answered the department chiefs’ questions about rare surgeries. Richard agreed that Adam could assist, but Adam’s greater familiarity with the procedures left him poised to lead the operation, with Burke supervising.

• Richard summoned Adam and the department heads to consult on the pregnant woman’s three fetuses.
• Adam identified Lucy’s cerebral edema, Emily’s hypoplastic left heart syndrome, and Julie’s organs developing outside her body, then proposed monitoring Lucy and timing surgery around the other fetuses.
• Burke challenged Adam’s knowledge of the Norwood and Fonton procedures, but Adam answered his questions with detailed surgical explanations.
• Adam said he knew the procedures from discussing them with Ellis Grey, prompting Richard to refuse Burke’s suggestion to invite her because of her Alzheimer’s Disease.
• Richard said Adam could assist with the surgery, and Adam concluded that he would need to lead while Burke supervised and assisted.

Adam and Liz coordinated care for Mrs. Rusebin as her quintuplet delivery approached, and Adam went to the ER to treat patients. The chapter ended when an angry familiar woman called out to Adam.

• Dr. Montgomery explained the urgent surgery planned for Mrs. Rusebin, and Adam and Liz agreed to monitor her in alternating shifts.
• Adam reviewed Mrs. Rusebin’s scans with Ellis Grey and discussed how to improve the surgery.
• Adam examined Mr. Patrick, diagnosed why his whole body seemed to hurt, and treated his broken finger.
• Adam freed a child whose head was trapped in an antique tiger mount by removing the teeth caught around his neck.
• A familiar woman angrily called out to Adam as he treated the child’s neck.

At the medical center, Lily confronted Adam about Robin’s injuries, but he refused to explain what had happened. He prescribed ointment and persuaded Lily to visit Robin instead, while he stayed behind to watch the quintuplets.

• Adam treated a child whose neck had become stuck in a tiger-head opening, then took Lily outside when she arrived at the emergency department.
• Lily demanded to know what Adam had done to Robin, but Adam denied causing her injuries and said Robin wanted the details kept private.
• Lily told Adam that Robin was too hurt to wear underwear and had missed work, and Adam realized how badly he had overlooked her needs.
• Adam offered to prescribe ointment for Robin and urged Lily to apply it, citing Robin’s dogs and guns as reasons he should not visit.
• Lily considered Adam’s suggestion, and Adam decided she could comfort Robin while he stayed at the hospital to keep watch over the quintuplets.

Adam agreed to visit Robin and apologize after Lily insisted he take responsibility, then arrived at Robin’s apartment, where she confronted him with a handgun and five barking dogs. Adam claimed the gun had no bullets, subdued the dogs with a glance, and entered as they whimpered.

• Lily refused Adam’s suggestion that she treat Robin in his place and persuaded him to apologize to Robin himself.
• Adam arranged for the hospital to cover his shift, then drove to Robin’s apartment without Lily.
• Robin opened the door holding five dogs’ leashes and aiming a handgun at Adam.
• Adam said he bet Robin’s gun had no bullets, silenced the dogs with a glance, and stepped inside.

Adam made peace with Robin after their fight, while Robin remained angry about losing to Alice and asked Adam to help her challenge her again. Adam left for the hospital, leaving Robin’s five dogs desperate to go outside.

• Robin put away her gun, but told Adam she had not decided whether to forgive him.
• Robin blamed Adam for her loss to Alice and demanded another chance to fight her; Adam said he would try once Robin recovered.
• Robin told Adam that Lily was her warmest friend and that she thought of them as best friends.
• Adam asked Robin how Lily and Marshall were doing, then answered a call from the hospital and left.
• Robin’s five dogs huddled on the sofa, afraid to approach her while Adam was there and unable to go outside.

Adam coordinated an emergency delivery after Mrs. Rusebin’s placenta tore, then led surgery on her newborn daughter, Emily. When he opened the infant’s heart, he found a complication that made his preparations useless.

• Adam examined Mrs. Rusebin and confirmed that she and the babies were stable while Liz went to rest.
• At two thirty in the morning, Mrs. Rusebin’s water broke and Adam diagnosed a torn placenta, called Dr. Montgomery, and summoned the surgical teams.
• Dr. Montgomery led the cesarean section as Liz assisted, while Adam and Dr. Burke prepared to operate on Baby Number Two, Emily.
• Adam took the lead in Operating Room Two and discovered a problem in Emily’s left ventricle.

After Emily’s Norwood Procedure was halted because her aorta was too narrow, Dr. Montgomery arranged for Liz to care for her alone, hoping the crisis would prepare Liz to become a stronger doctor. Adam stayed away while Liz repeatedly paged him through the night, leaving her to face Emily’s worsening condition by herself.

• Adam and Dr. Burke discovered that Emily’s aorta was only one millimeter wide, so Dr. Montgomery ended the Norwood Procedure and Adam closed Emily’s chest.
• Dr. Montgomery asked Adam not to tell Liz that Emily was unlikely to survive and wanted Liz to handle her care without help so she could learn to withstand the emotional pressure.
• Adam agreed to Dr. Montgomery’s plan and avoided Liz during the day, then left the hospital to tend to Robin’s injury that night.
• Liz repeatedly paged Adam in desperation while he stayed at Robin’s apartment, explaining the situation and Dr. Montgomery’s intentions to Robin.