Chapter Summaries

Adam arranged care for Tatiana, a young girl with AIDS, after Nurse Carol admitted she wanted to adopt her but feared her past suicide attempt would prevent approval. He planned for Caroline to adopt Tatiana instead, then discussed the idea with Juno, who suggested Heather as another possibility, leaving Adam surprised.

• Adam visited Tatiana and learned from Nurse Carol that the girl's fever and cough had improved.
• Nurse Carol said she wanted to adopt Tatiana, but Adam warned that Child Protective Services might reject her because of her history.
• Carol cried over Tatiana's likely future in foster care, and Adam promised to arrange a better home for her.
• Adam reassured Carol and let her stay with Tatiana, then told Juno he planned to have Caroline adopt the girl.
• Juno teased Adam about Caroline and suggested he consider Heather, prompting him to ask, "Are you kidding?"

Adam and Juno debated whether Heather should adopt Tatiana, weighing Heather’s devotion against the possibility that Tatiana might die young. Juno urged Adam to trust Heather and promised he could help her through any loss, leaving them playfully teasing each other over the phone.

• Juno argued that Heather could give Tatiana the devoted family love Caroline could not, while Adam worried Heather might not survive Tatiana’s death.
• Adam recalled that Heather had firmly decided not to have children and had even gotten an IUD, but admitted he trusted Juno’s judgment.
• Juno explained that Heather had gained financial security through investments and could afford the best care for Tatiana.
• Juno said medical advances might protect Tatiana and that Adam could comfort Heather if the worst happened.
• Adam and Juno teased each other about being paranoid women’s favorites and continued their playful phone conversation.

Liz joined Dr. Burke to retrieve a heart for Danny, but the donor died and another patient had priority for the second available heart. Desperate to secure it for Danny, Liz used Dr. Burke’s phone to call Adam for help.

• After a former restaurant employee shot several people, Adam criticized both the shooter and the manager whose firing had sparked the attack.
• Adam warned Liz not to get Danny’s hopes up and questioned whether her career or love mattered more to her, angering her.
• Liz accompanied Dr. Burke to retrieve a heart for Danny, but he learned the donor had died and the heart could not be used.
• Liz interrupted Dr. Han’s preparations for another transplant, and the transplant center confirmed Dr. Han’s patient ranked seventeen seconds ahead of Dr. Burke’s patient.
• Liz secretly used Dr. Burke’s phone to call Adam and demanded his help getting the heart for Danny.

Liz tried to manipulate Danny Duggett’s transplant priority to secure him a donor heart, but Adam refused and warned her that her fraud could cripple the hospital. After Adam reported her, Dr. Burke agreed to follow the Transplant Center’s testing procedures, and Richard said he would fire Liz.

• Liz asked Adam to falsify Danny’s condition so Danny could receive the last available heart, but Adam refused and demanded to speak with Dr. Burke.
• Liz hung up on Adam, switched off Dr. Burke’s phone, and enlisted George O’Malley to help falsify the data.
• Adam confronted George, sent him away, and reported Liz to Chief of Surgery Richard.
• Liz told Dr. Burke that Danny’s condition was deteriorating, and the Transplant Center allowed an hour for tests to determine whether Danny qualified for priority.
• Dr. Burke restarted his phone and spoke with Adam and Richard, agreeing to follow the proper procedures and give up the heart if tests did not confirm Danny’s deterioration.
• Adam and Richard warned Liz to stay quiet and wait for the test results, while Richard declared that he would fire her.

After a second shooting at the Medical Center, Adam found Liz wounded and learned that a bullet lodged in her spinal nerves could end her career as a doctor. He warned George to keep Liz’s earlier request secret as she faced a dangerous operation.

• Cristina saw the previously injured couple reconcile, but the boyfriend again used his girlfriend as a shield when gunfire erupted outside the hospital.
• Adam went to investigate while Chief of Surgery Richard stayed behind to guard the ward and watch for Liz.
• Adam found the gunman dead by suicide, along with the dead manager and a badly wounded Liz, whom he revived and rushed to emergency treatment.
• Dr. Shepherd assessed Liz and explained that the bullet was lodged in her spinal nerve bundle, making surgery risky and her future as a doctor uncertain.
• Adam rebuked George for defending Liz and warned him not to reveal the request she had made, lest he bring the Medical Center down with her.

Liz woke after being shot and learned that her right hand might lose some function, while Adam told her the heart she had nearly jeopardized was being transplanted into a father of two. During surgery, the doctors woke Liz without anesthesia so she could help determine whether her arm’s nerves still worked, leaving her convulsing in agony as George tried to keep her focused.

• Liz woke in the emergency room, and Adam explained her shoulder injury and the uncertain prospects for her right hand.
• Adam told Liz that Danny was safe and that the heart had gone to Dr. Han’s patient, who was undergoing a transplant.
• During surgery, Dr. Shepherd and Adam found no clear nerve damage but could not get a response from Liz’s arm, so they decided to wake her for an awake test.
• Dr. Shepherd asked for someone close to Liz to help her through the pain, and Adam suggested George because Danny could not leave his bed.
• George came to the operating room, and the team stopped Liz’s anesthesia as he called for her to wake up.
• Liz regained consciousness and convulsed from the pain while Adam and the nurses restrained her.

During Liz’s operation, Adam and Dr. Shepherd insisted that George let her decide whether to continue the painful wake-up test, and Liz chose to stop. After the surgery, Chief of Surgery Richard gathered Adam, Dr. Burke, and George to discuss Stevenson’s attempted heart theft.

• Adam argued that Liz should be woken and asked whether she wanted to continue the test, and George admitted he could not decide for her.
• When Liz woke, George explained the situation, and she chose to stop; Dr. Shepherd had the anesthesiologist put her under again.
• Adam said Liz’s choice showed she was not wholly devoted to medicine and suggested she might be less devastated if the surgery’s outcome was bad.
• Dr. Shepherd continued the operation cautiously because he did not know whether Liz’s arm nerves were damaged.
• After the surgery, Chief of Surgery Richard summoned Adam, Dr. Burke, and George and began discussing Stevenson’s attempt to steal a heart by falsifying records.

Adam explained that Liz would be forced to leave the Medical Center rather than be publicly fired, but the Chief’s negative evaluation and ban on recommendation letters would make finding another hospital difficult. He then continued arranging Tatiana’s treatment and potential adoption by Heather.

• Cristina, Meredith, and George learned that Liz would be asked to leave the Medical Center because the hospital could not publicly disclose the reason for firing her.
• Cristina argued that Liz’s punishment was justified because her actions could have led to Danny’s death, while Meredith hoped Liz would behave less impulsively at another hospital.
• Adam visited the VIP ward, where he had arranged for Caroline’s foundation to adopt Tatiana before transferring her to Heather, and had found Tatiana an English teacher.
• Cristina suspected Adam intended to block Liz from starting over, and Adam revealed that the Chief would give Liz a bad evaluation and forbid her former supervisors from writing recommendation letters.

Adam exposed a diner who faked a seizure to avoid paying his restaurant bill, then attended a laparoscopic surgery seminar with Cristina and outperformed her and Richard. After lunch, Cristina celebrated beating Richard but challenged Adam to compete again, and he said he did not need more practice.

• Adam recognized that an elderly diner was faking a seizure, caught him when he ran, and had hospital security hand him over to the police.
• Adam and Cristina attended a laparoscopic surgery seminar, where Cristina tried the instruments and Richard struggled with his grip.
• Cristina learned that Adam had already completed the exercise and was repeatedly practicing it with greater speed and precision.
• Richard joined Adam, Cristina, George, and Meredith at lunch, admitted his hands were rusty, and left after Adam praised his fundamentals.
• Cristina challenged Adam to compete again in the afternoon, but Adam said he would not attend because he no longer needed the practice.

A month passed as Danny received a new heart, while Liz struggled with regret and the loss of her ability to operate. Tatiana was adopted by Heather and welcomed into a loving family, while Adam reflected on the people who had left his life.

• Cristina asked Chief of Surgery Richard how he could suture with his eyes closed, and he explained that years of operations had built muscle memory, though she still needed practice.
• Danny received a new heart after the patient ahead of him recovered, while Liz's injuries healed but her right hand continued to tremble and she frequently broke into tears.
• Danny learned what Liz had done, visited her after recovering, and proposed; Liz resigned from the Medical Center and married him.
• Adam doubted Danny and Liz's relationship would last, but accepted that Liz had left his life along with Alex.
• Caroline's Ellis Charity Foundation orphanage adopted Tatiana, and Heather later adopted her; Juno and Karen celebrated with them.

Adam told Lily how Robin threw him out after he accidentally enraged her, and he decided not to pursue her or apologize while she was angry. Lily then hinted that she and Marshall had problems as their wedding approached.

• Lily asked Adam about being thrown out of Robin's house, and Adam explained that his careless remark during their argument about humanity's continuation provoked Robin's fury.
• Adam recalled that Robin had searched for a weapon and chased him out, while he realized that Heather's recent visit had made him too careless.
• Lily warned Adam that Robin was possessive and would not simply get over the insult, urging him to apologize and make things right.
• Adam said Robin would not accept an apology unless he offered her a committed relationship, which he could not give, so he planned to let matters cool.
• Adam changed the subject to Lily and Marshall, and Lily's expression stiffened when he asked if they had problems.

At Friends Bar, Adam helped Lily examine her doubts about marrying Marshall and her teenage dreams of traveling, becoming an artist, and having a romance with a woman. He offered to arrange an honest assessment of her artistic talent, leaving Lily uneasy but considering whether to pursue the dream.

• Adam asked Lily whether she feared marriage would make her abandon her unfulfilled dreams.
• Lily explained that she had once left a high-school boyfriend to pursue her ambitions, but later fell in love with Marshall and was now about to marry him.
• Lily said Robin had comforted her with a kiss, though she dismissed it as no great lesbian romance.
• Adam argued that Lily could travel with Marshall and questioned whether she truly wanted to become an artist or merely romanticized an artist's life.
• Adam offered to introduce Lily to a master painter to judge her talent and warned her against dishonest art teachers, while Lily said she feared he would undermine her confidence.

Adam urged Lily to test her artistic ambitions by painting her wedding with Marshall, while Robin remained furious with him over their encounter and threatened him with a gun. The next day, Adam froze when he saw a familiar face during hospital rounds.

• Adam challenged Lily to paint her wedding with Marshall and urged her to focus on the wedding preparations.
• Lily told Adam that she and Marshall had secured a booking at Vance Mout after beating Todd and Valerie to the venue.
• Lily accompanied Adam to apologize to Robin, but Robin answered the door with a gun and loaded its magazine as Adam left.
• Adam understood that Robin was angry because he had ignored her objections, and he chose not to reveal that she could not get pregnant.
• Adam entered a hospital room during the interns' morning rounds and froze when he saw a familiar face.

Adam discovered that Beatrice, Mary Cooper’s cousin, had advanced lung cancer and wanted to meet Mary and her family before undergoing surgery. As Mary, Sheldon's Grandma, and Missy traveled to see her, Beatrice’s hopes of finding support for her daughter Emilia began to grow.

• Adam recognized Beatrice’s resemblance to Mary and learned that Beatrice had terminal lung cancer.
• Beatrice introduced her daughter Emilia, and Adam told them about Mary’s children and offered to arrange a meeting with Missy.
• Adam took responsibility for Beatrice’s case and explained that surgery could ease her symptoms but could not cure her cancer.
• Dr. Burke told Beatrice that surgery might give her a year in the best case, though she could die at any time.
• Beatrice asked to see Mary and her family before surgery, so Adam contacted Mary and booked flights for her and Sheldon's Grandma while Missy traveled from Philadelphia.

Missy arrived at the hospital and reunited with her mother’s cousin Beatrice and Beatrice’s daughter, Emilia, while Adam and the family gathered around them. As Beatrice prepared for surgery, she told Emilia that she was gravely ill and made her promise not to grieve for too long if she died.

• Missy met Beatrice and Emilia at the Medical Center, and Mary Cooper and Sheldon’s grandma arrived soon afterward.
• Missy took Emilia aside and warned her to stay away from Adam, then regaled her with stories about his romantic exploits.
• Adam confronted Missy about what she had told Emilia, and Missy teased him about his past with Paige.
• Beatrice told Emilia that she was very sick and might not survive surgery, then urged her daughter to remember that a child’s happiness mattered most.
• Emilia promised not to grieve for too long, while Mary and Sheldon’s grandma supported Beatrice.

Adam and Missy discussed Sheldon's cold response to news about Beatrice, while Beatrice prepared for surgery and hoped to attend Emilia's birthday in the hospital. During the operation, Adam and Dr. Burke discovered the cancer had spread more severely than scans showed, leaving Beatrice at most a month to live.

• Missy told Adam that Sheldon had replied only, “So?” when she asked him to visit Beatrice, and Adam explained that Sheldon’s family attachments differed by their roles and relationships.
• Beatrice finished comforting Emilia and said she hoped to attend her birthday party the day after tomorrow.
• Adam told Beatrice and Mary that surgery could not wait, but that she might recover enough to celebrate Emilia’s birthday in her hospital room.
• Adam opened Beatrice’s chest and found the metastatic tumors were more extensive than the scans had shown.
• Dr. Burke said Beatrice had at most a month to live even if they removed all the tumor they could, and Adam agreed they would try to win her that time.

After Beatrice’s successful surgery, Adam told the family that her widespread cancer left her about a month to live. Mary planned a large birthday and farewell party for Emilia, and Sheldon reluctantly agreed to attend.

• Adam announced that Beatrice’s surgery had removed the bronchial tumor, but her metastases gave her about a month to live.
• Mary, Missy, and Grandma comforted Emilia and discussed how they would spend Beatrice’s remaining time with her.
• Mary arranged to stay with Emilia, while Missy planned to return for Emilia’s birthday and visit on her days off.
• Mary asked Adam to help make Emilia’s birthday party a larger celebration for her family and friends, and Adam agreed to speak to the chief.
• Mary called Sheldon and ordered him to attend the party and prepare a gift for Emilia, and Sheldon reluctantly agreed.

Adam finished tutoring Ellis Grey and checked on Beatrice, who thanked him for helping the Cooper family and learned that Paige would attend Emilia’s birthday party. During hospital rounds, Dr. Burke discovered a mass around Kev Paulus’s heart, while Adam’s colleagues questioned whether his closeness to Emilia could be inappropriate; Adam explained the birthday party was for Beatrice.

• Adam checked Beatrice’s condition and encouraged her to rest, and Mary praised him while warning that he was already with Paige.
• Mary told Beatrice about Paige and confirmed that she would attend Emilia’s birthday party with Sheldon.
• Dr. Burke informed Kev Paulus and his fiancée that scans showed a large mass around his heart and assigned Cristina to oversee his angiogram.
• Cristina, George, and Meredith warned Adam about dating Emilia, and Adam denied romantic intentions and said the party was a favor for Beatrice.

Adam debated freedom and private property with George, Meredith, and Cristina before discussing a patient's dangerous Coronary Artery Aneurysm. The patient's fiancée left him just before the aneurysm ruptured, and Dr. Burke and Cristina took him to surgery.

• Adam argued that the Medical Center's board controlled the rights and freedoms on its property, while George rejected his explanation.
• Cristina told Adam that the patient had a Coronary Artery Aneurysm but wanted to postpone surgery until after his wedding.
• Amy told Cristina that Cave had agreed to surgery, then said she could not face it and ended their engagement.
• The patient's alarm sounded, and Adam rushed in, warning that the aneurysm might have ruptured as Dr. Burke and Cristina prepared to operate.
• Adam said the breakup could have triggered the rupture, while Meredith questioned whether love was real.

Adam and the others prepared for Emilia’s birthday party, where Emilia met her cousins Georgie Jr. and Sheldon for the first time. Sheldon gave her an awkwardly personal gift, prompting Mary to roar at him.

• Adam explained to Emilia that the hospitalized patient’s survival and his former fiancée’s betrayal might eventually feel like good fortune.
• Adam told Emilia that Georgie Jr. and Sheldon would attend her birthday party and warned her that Sheldon could be blunt and irritating.
• Paige and Lisa left to pick Sheldon up, and Cristina, Meredith, and George learned that Paige was the young mathematician Dr. Adler and teased Adam about her age.
• Georgie Jr. and Veronica warmly welcomed Emilia and gave her a birthday gift.
• Sheldon reluctantly greeted Emilia, secretly sanitized his hands after shaking hers, and gave her a collection of Wonder Woman comics because the heroine shared Emilia’s family circumstances.
• Mary shouted Sheldon’s full name after he explained that Wonder Woman’s mother had died too.