Chapter Summaries

Adam operated on a baby boy whose health had been damaged by passive amphetamine addiction, then took over Cristina’s patient, a man suffering repeated cardiac arrests and severe cravings after becoming addicted to amphetamines. At lunch, Adam defended George’s decision to sit with his fellow interns and discussed the lonely neighbor injured in an explosion.

• Adam and Shorty operated on a one-year-old boy, and Dr. Shepherd asked Lexie to take responsibility for the child’s mother.
• George chose to sit with Lexie, Shorty, and Carter rather than join Meredith’s table, and Adam said that staying with his colleagues was the right choice for him.
• Cristina described how Ouyang Feng’s amphetamine cravings triggered repeated cardiac arrests, and Adam offered to take over his care so he could hear his story.
• Cristina said Kelly was treating the neighbor injured in the explosion, while Meredith and Cristina explained how he had cared for his neighbors’ children and wrongly believed they were family.
• Adam argued that the neighbor had good reason to believe he was close to the parents, then imagined how Penny might react if Leonard and Sheldon were evil.

Adam comforted Mrs. Christ after learning that her son had suffered a stroke and her husband had been arrested, then set Lexie a demanding exercise to teach her to deliver news with compassion and objectivity. A call from Rachel stunned Adam, and he rushed to the emergency department.

• Adam handed Ouyang Feng’s care to Carter and told him to page immediately if anything happened.
• Adam calmed Mrs. Christ’s breathing and explained that her son would be placed in his grandmother’s custody.
• Adam instructed Lexie to distribute diagnostic results with Melendez until she could remain polite and objective without sharing patients’ emotions.
• Adam considered how poor habits could endanger doctors and reflected on Lexie, George, Melendez, and Carter.
• Rachel called Adam with startling news, and he rushed to the emergency department.

Adam met Phoebe and Brooke at the medical center after the two women injured each other in a two-day contest to win a dream wedding. They remained locked together and refused to release the wedding dress, leaving their friends facing off around them.

• Paramedics brought the injured Phoebe and Brooke to the medical center, where Adam learned they had fought over a wedding dress.
• Adam and Carrie tried to calm the women and separate them, but both insisted they would not let go first.
• Rachel, Ross, Joey, and Mike arrived to support Phoebe, while Samantha, Miranda, and Charlotte arrived to support Brooke.
• The referee explained that the store contest awarded a dream wedding worth up to one hundred thousand dollars to whoever held the dress longest.
• The referee revealed the women had been holding on for two days, and both rejected the suggestion to split the prize.

Adam stopped Phoebe and Brooke’s wedding-dress fight by proposing that their prize money go to charity, then ended their struggle and sent Brooke for emergency tests after spotting signs of internal bleeding. Ross recognized Phoebe as the burly figure who had frightened him when they were children.

• Adam challenged Phoebe and Brooke to donate the $100,000 prize to the New York Children's Charity Fund, and both insisted they did not care about the money.
• Adam tried to end the fight by warning the injured brides about their wedding-day injuries, but Phoebe and Brooke resumed arguing over whose name would appear on the donation list.
• Adam reset Phoebe’s dislocated shoulder, making her release the dress and allowing Brooke to claim victory.
• Adam examined Brooke, suspected internal bleeding, and sent her into the hospital for urgent tests while Kelly treated Phoebe.
• Ross realized that Phoebe was the burly figure who had once yanked his ear and demanded money outside St. Mark's Comic Book Store.

After Brooke won the contest and received her prize, Adam treated her injuries and urged the Four City Sisters to get medical examinations. The women left for checkups, while Brooke believed Adam had only used health warnings to discourage their flirting.

• Doctors found that Brooke had intracranial bleeding from Phoebe's abuse, treated her with medication, and kept her under observation.
• Brooke celebrated her victory, received the hundred-thousand-dollar check, and told Adam she would donate the money to charity.
• Samantha flirted with Adam and asked him to examine her, but he sent her with Shorty for a checkup and warned her about breast cancer risks.
• Adam urged Kelly to get a comprehensive physical examination, leaving the Four City Sisters worried as they followed Shorty to arrange their tests.
• Brooke suggested Adam had scared the women away to stop them pestering him, but Adam insisted regular checkups were important.

Adam told the group that Phoebe’s fight with Brooke had caused a small intracranial bleed, but Brooke was expected to recover. Phoebe agreed to be more careful and considered delaying her wedding until Monica had given birth, leaving Adam to recommend a date at least ten weeks away.

• Adam reported that Brooke had a minor intracranial bleed and was unlikely to face serious complications, then warned Phoebe that she had been too brutal.
• Adam urged Phoebe to be more careful for Mike’s sake, and Phoebe agreed to hold back in the future.
• Adam examined Phoebe and found that Kelly had treated her injuries well.
• Phoebe said she might postpone her wedding until after Monica’s baby arrived so Monica could attend.
• Adam advised Phoebe to wait at least ten weeks, suggesting Monica could help direct the wedding, and everyone joked about Monica’s obsessive planning.

Adam checked on George O'Malley and Ouyang Feng at the hospital before helping Samantha and the Four City Sisters understand her possible breast cancer diagnosis. Samantha still needed a biopsy, but Adam said the scans suggested that any cancer was early-stage and treatable.

• Adam left Phoebe after she agreed to postpone her wedding so her stepfather might be able to attend.
• Adam found George O'Malley enduring awkward examinations at the Free Clinic under Dr. Bailey's guidance.
• Adam checked on Ouyang Feng, who had remained stable under Carter's care, and left without disturbing them.
• Adam met Kelly and Samantha outside Brooke's hospital room after Kelly was stopped from smoking.
• Adam reviewed Samantha's CT scans and said a biopsy was needed to confirm the diagnosis, though any breast cancer appeared to be early-stage and treatable.

After Adam explained Samantha’s breast cancer treatment options, an expedited biopsy confirmed an exceptionally early-stage cancer. Samantha chose breast-conserving surgery, which Adam arranged for the next day, while he reflected on the strain illness could place on love.

• Kelly asked Adam how Samantha’s breast cancer would be treated if confirmed, and Adam explained surgery, chemotherapy, and other treatment options.
• Kelly, Miranda, and Charlotte encouraged Samantha by emphasizing that early detection gave her a good chance of treatment.
• Samantha thanked Adam and asked him to be her doctor, and he agreed to arrange a biopsy.
• Adam performed an ultrasound-guided biopsy, which confirmed exceptionally early-stage breast cancer, then consulted an oncology attending physician.
• With Samantha’s consent, Adam arranged her admission and preoperative examinations, and Samantha chose breast-conserving surgery for the following day.
• Adam thought about Dr. Montgomery’s friend and her husband, wondering whether love could withstand a life without the possibility of children.

After the interns finished their first 36-hour shift, Adam offered Shorty, Carter, and Lexie recordings and reading lists from his study group to prepare for joining. George left feeling pressured to study too, while Adam headed out for a date.

• Adam dismissed George, Carter, Lexie, and Shorty after their first 36-hour shift and invited the three eager interns to join his study group after preparing.
• George said he had plans with Kelly, but followed the others to Adam's office after they left for the study group materials.
• Adam gave the interns videotapes and reading lists, crediting Cristina Yang for organizing them.
• Shorty asked whether mastering the recordings would qualify him to join the study group, and Carter and Lexie also vowed to do the work.
• Adam told the interns not to pressure themselves and said the materials were optional, then left for a date.

Sandra visited Adam and spent the next day searching his apartment for evidence of his secrets, but found nothing. Adam had secretly recorded her search and planned to study her behavior with Juno, leaving Sandra determined to return.

• Sandra visited Adam after arranging a date, and she stayed overnight in his apartment.
• Sandra woke late, noticed the imprint of a book title on her back, and searched Adam’s study for clues.
• Sandra searched the rows of books for a hidden safe or secret chamber but found nothing before leaving.
• Adam watched recordings of Sandra through hidden cameras and planned to analyze her behavior with Juno.

Adam urged Cristina to treat the interns under her as a teacher and warned that her harsh behavior was damaging her reputation. He then explained why Kelly was so happy about George, who had begun trying to improve himself and had received Adam’s study tapes.

• Cristina said George and the other interns had taken Adam’s Study Session Tapes and complained that her four assigned interns were fishing for information about a secret manual.
• Adam told Cristina that, as a resident at a teaching hospital, she needed to teach her interns patiently and warned that attendings could punish her for poor teaching conduct.
• Adam said people were calling Cristina the new The Nazi and criticized her for answering questions meant for the interns.
• Kelly arrived in the locker room in high spirits, prompting Cristina to ask whether Adam had slept with her.
• Adam attributed Kelly’s good mood to George’s charm and his new efforts to improve, while Cristina said Kelly was happy because she had received Adam’s sought-after Study Session Tapes for free.

Adam supervised rounds, performed Samantha Jones's breast-conserving surgery, and teased George about his relationship with Dr. Torres. Afterward, he joined the attendings outside the Chairman of the Board's room and helped mock Mark Sloan, leaving Sloan furious.

• Adam had Lexie present Samantha Jones's condition during rounds and assigned her to prepare the patient for surgery.
• Cristina stopped answering Dr. Burke's questions herself and called on Dr. Gant, who described a patient's condition.
• Adam, Lexie, and George successfully performed Samantha's breast-conserving surgery, while Adam teased George about studying with Dr. Torres.
• Adam found Dr. Burke, Dr. Shepherd, Dr. Montgomery, and Dr. Sloan gathered outside the Chairman of the Board's room.
• Adam and Dr. Montgomery joked that Mark Sloan could become a circumcision elder, leaving Mark furious.

Adam went with Chief of Surgery Richard to treat Medical Center chairman Larry, while several attendings followed, hoping to compete for Richard’s successor. Larry’s arrival exposed the group’s rivalry, and the chapter ended when he pulled down his pants in front of them.

• Adam left the attendings outside the VIP ward after his pager summoned him to Richard’s office.
• Richard told Adam to keep a special patient’s condition confidential, but Adam revealed that the attendings already knew Larry had arrived.
• Adam and Richard discussed Mark Sloan’s rivals and the Nurses Anti-Sloan Alliance, along with Barney Stinson’s deceptive dating schemes.
• Richard tried to send Dr. Burke and the other attendings away from Larry’s VIP ward, but they refused to leave.
• Larry greeted Richard, complained about the four attendings’ presence, and then pulled down his pants in front of everyone.

Adam diagnosed chairman of the board Larry’s swollen, obstructed genitals as a likely candiru parasite after learning he had urinated in the Amazon River. The doctors prepared to confirm the diagnosis and remove it urgently because it could cause sepsis.

• Dr. Montgomery left after mistaking Larry’s condition for the result of sexual misconduct, and Larry threatened Mark Sloan over his smirk.
• Adam examined Larry, who said he had been unable to urinate for three days and had recently gone rafting in the Amazon River.
• Adam asked whether Larry had urinated in the river and concluded that a candiru had likely entered his urethra.
• The Chief of Surgery ordered immediate tests and surgery if the parasite was confirmed, warning Larry that it could cause sepsis.

Adam prepared the Medical Center’s surgeons to operate on Chairman of the Board Larry, who had a Candiru parasitizing him. Larry chose Chief of Surgery Richard to lead the risky surgery, with Adam as first assistant, and the doctors assembled in the Operating Room.

• Adam arranged an examination for Larry’s female secretary and asked whether Larry wanted Nancy examined too; Larry said she had not gone with him to the Amazon.
• Cristina saw the Candiru on Larry’s X-ray and eagerly asked to join the surgery, while Adam warned her not to draw Larry’s attention.
• Adam told Melendez to book an Operating Room, and Larry decided to notify Nancy after learning that the surgery carried risks.
• Larry appointed Richard as lead surgeon and Adam as first assistant; Richard invited the other attending physicians, including Mark Sloan, to participate.
• Carter reported that Larry’s secretary had no abnormalities and asked to enter the Operating Room, but Adam turned him down because it was already crowded.

Adam removed the parasitic catfish lodged inside hospital chairman Larry after the Chief of Surgery failed to grasp it with an endoscope. The surgery ended with the writhing fish on display and several people volunteering to take it.

• Chairman Larry agreed to an endoscopic attempt to remove the parasitic catfish before the surgeons resorted to open surgery.
• The Chief of Surgery located the catfish but repeatedly failed to grip its slippery body with the endoscopic forceps.
• Adam took over and used his precise control to catch the catfish and slowly pull it out.
• Adam displayed the wriggling, ten-centimeter fish, and Cristina, the anesthesiologist, and a nurse volunteered to keep it.

Adam and the Chief of Surgery successfully removed the parasitic catfish from Chairman Larry, while Nancy revealed she had long known about her husband’s affair. At lunch, Mark Sloan angrily confronted Adam over a medical chart, leaving the cause of his accusation unclear.

• Adam and the Chief of Surgery finished the surgery, and Nancy thanked them for saving Larry.
• Nancy asked Sophia to retrieve the catfish so she could have it turned into an artwork for Larry’s office as a reminder not to fool around.
• Nancy’s remarks about affairs reminded Adam that the Chief of Surgery’s wife had also known about his relationship with Alice Grey and had chosen to endure it.
• Adam, the Chief of Surgery, and Meredith went their separate ways, and Adam later ate lunch with Cristina and Meredith.
• Mark Sloan slammed a medical chart onto Adam’s table and accused him of failing to handle a simple task, prompting Adam to ask what had happened.

Meredith was reprimanded after she mistakenly told the wrong patient she was dying, and she rushed out to find and apologize to the patient. Adam refused to excuse her mistake, then challenged Mark Sloan’s humiliating attack and left Mark facing a possible confrontation with the Chief of Surgery.

• Mark Sloan blamed Meredith for telling a woman in Room 5513 that she was dying when the intended patient was a man in Room 5512.
• Adam recognized that Mark’s sloppy handwriting contributed to the confusion but stayed silent, while Cristina held back from defending Meredith.
• Meredith accepted responsibility for the intern she had sent with the chart and ran out to find the patient, who had already left the hospital.
• Mark Sloan mocked Meredith and challenged Adam to give his opinion, and Adam agreed that her mistake showed she was not ready to be a professional resident.
• Adam warned Mark Sloan that the Chief of Surgery and the Chairman of the Board could turn against him, prompting Mark to leave after Adam reminded him about their seminar the next day.

After Adam Duncan warned Mark Sloan that they would meet at the upcoming Patient Mortality Conference, Mark became consumed with worry about defending a fatal surgery case. Unable to sleep, he returned to the hospital in the early morning to review the case again.

• Cristina eagerly left to buy snacks and drinks for the conference after Adam explained that he planned to challenge Mark only if he had made a mistake.
• Mark spent the afternoon reviewing his fatal surgery case and convinced himself that he had done nothing wrong.
• Mark returned to his apartment, listened to voicemails from several women, then deleted them after Adam's warning resurfaced in his mind.
• Mark worried that Adam's medical knowledge could leave him unable to answer questions at the conference, even if his surgery had been sound.
• Mark drank himself to bed but could not sleep, so he returned to the hospital before dawn to review the case again.

Adam warned the interns after Norman quit following a disastrous misdiagnosis that forced the hospital to compensate a patient. As Adam headed to a Patient Mortality Conference, the Chief of Surgery pulled him aside, leaving Cristina to suspect the anticipated confrontation with Sloan would not happen.

• Adam explained that Norman had left the internship after misdiagnosing a patient, whose losses the hospital compensated with a house and cash.
• Norman accepted responsibility, asked to leave, and decided to pursue psychology; Meredith also faced responsibility as his supervisor.
• Adam urged the interns to take their work seriously, and Cristina invited them to the Patient Mortality Conference where she expected Adam to challenge Sloan.
• The Chief of Surgery stopped Adam outside the conference room and asked to speak with him, prompting Cristina to conclude that the showdown probably would not happen.