Chapter Summaries

Adam discovered that George's father had aortic valve insufficiency and planned a valve replacement before the tumor surgery. Later, he took Jessie and FBI recruit O'Connor for a high-speed drive, gave O'Connor criminal evidence to study, and warned Jessie that the rookie might be tempted to join the carjacking gang he was meant to infiltrate.

• Adam told George and his family that George's father needed an artificial valve replacement before his tumor resection, and scheduled the operation for the next day.
• Adam reassured George that he would do his best but could not guarantee the outcome, and told him to bring his mother in.
• At two thirty in the morning, Adam picked up Jessie and O'Connor, demonstrated his driving skills, and offered to teach O'Connor if he studied the materials Adam provided.
• Adam gave O'Connor documents and videos about carjacking crimes, then drove off with Jessie and explained that the materials were meant to guard against the recruit being drawn into the gang.
• Jessie defended O'Connor's screening, but Adam warned that the gang's leader could use charisma and the appeal of criminal success to turn the undercover recruit against the FBI.

Adam confronted George after George questioned the planned surgery without understanding the relevant medical details, then operated on Mr. O'Malley with Shorty and Carter. When severe bleeding complicated the procedure, Adam guided Shorty through sutures and the operation stabilized.

• George questioned Adam's plan for his father, but could not explain how the potassium level affected the surgery, and George's father apologized for him.
• Adam rebuked George for his impulsiveness and lack of preparation, then took Shorty and Carter into the Operating Room to replace Mr. O'Malley's aortic valve.
• Adam mentored Shorty and Carter during the operation while Carter flattered him and talked about his family's Halloween and Christmas traditions.
• The ascending aorta began distending and bleeding, so Adam ordered the team to reestablish bypass and asked Shorty to perform continuous horizontal mattress sutures.
• Shorty followed Adam's guidance with steady hands, stopping the bleeding and restoring the operation to normal, while Carter resolved to improve his skills and remain in Adam's favor.

After George's father's successful aortic valve replacement, Adam argued with Cristina and Meredith over the Surgical Holy Grail, an award that gave its winner access to surgeries for three months. They persuaded him to hold the competition immediately, and he set a two-week contest to begin after George's father's surgery was over.

• Adam told George's mother that the aortic valve replacement had succeeded and that George's father would be monitored before tumor resection.
• Cristina confronted Adam about the Surgical Holy Grail, and he explained that Bailey had given him the pager intended for the first-year resident competition.
• Cristina and Meredith pressed Adam to let them compete now instead of waiting until the next year, and Adam agreed.
• Cristina explained the competition's point system, which awarded points for procedures, observing, assisting, leading surgeries, and solving difficult cases.
• Adam scheduled the two-week competition to begin a couple of days later, after George's father's surgery was over.

The Four Interns learned about the Surgical Holy Grail Competition and prepared to compete, while Adam looked forward to Shorty challenging Cristina. Adam then met Jessie Paige and rookie undercover agent Brian O'Conner, agreed to teach Brian to drive, and revealed his unusual approach to racing.

• George vowed to defeat Cristina and Meredith in the competition, while Shorty and Carter saw it as a chance to prove themselves and Lexie struggled with her wish to beat her sister.
• Adam doubted that Cristina would easily win the competition and hoped Shorty would outdo her.
• Adam met Jessie Paige and Brian O'Conner, who analyzed a criminal gang leader by comparing him to Song Jiang from Water Margin.
• Adam agreed to teach Brian to drive and explained that racing skill came from practicing cornering and drifting.
• Adam told Brian that he calculated racing maneuvers with a mathematical model and joked that he could do the calculations in his head.

Adam trained Brian in high-speed drifting while caring for George’s father, Harold, whose upcoming tumor surgery might be canceled if the cancer had spread too far. He left Harold and George to discuss the risks and reach a shared decision before surgery.

• Adam used his driving skills to coach Brian through drifting, and Brian quickly learned to perform the maneuvers on his own.
• After several nights of training Brian, Adam returned to the hospital, where the O’Malley family celebrated Harold’s condition before his scheduled surgery.
• Shorty explained that the doctors would assess the cancer during surgery and might close Harold up instead if the disease had spread too far.
• Harold insisted that the doctors remove the tumor regardless, but Adam warned him about the risks and urged him to discuss the decision with George.
• Harold agreed to talk with George after realizing that a secret decision could provoke his son and damage George’s future.

Adam's surgery on George's father revealed widespread cancer, so he closed the incision after explaining that surgery could no longer help. Dr. House then asked Adam to persuade a hopeless preschool teacher to accept treatment, and Adam suggested House appeal to her by acting like a pleading child.

• George's father agreed to let Adam decide whether to continue the surgery, and Adam began the operation.
• Adam and Carter found cancer throughout George's father's stomach, abdominal lymph nodes, and liver, so Adam ended the procedure and sutured him up.
• Dr. House called Adam about a preschool teacher who refused treatment despite House's diagnosis.
• Adam proposed that Dr. House act cute and plead with the preschool teacher, arguing that she would not ignore a child's plea.
• Foreman supported Adam's idea, and Dr. Wilson began explaining the patient's condition so they could discuss what to do next.

Adam reviewed the preschool teacher’s worsening neurological symptoms with Dr. House and identified neurocysticercosis as a likely diagnosis. He proposed confirming it with a thigh X-ray, leaving House surprised by a test that could verify the diagnosis without medication or MRI.

• Dr. Wilson recounted the patient’s seizures, language loss, and failed treatments as Adam challenged Dr. House’s diagnostic reasoning.
• Adam rejected Dr. Foreman’s psittacosis theory because the preschool’s children had shown no signs of infection.
• After learning ham had been found in the patient’s home, Adam connected the pork exposure to neurocysticercosis and its neurological symptoms.
• Dr. House proposed treating the patient with albendazole, while Dr. Foreman remained skeptical of the diagnosis.
• Adam suggested taking an X-ray of the patient’s thigh to look for tapeworm cysts and confirm the diagnosis.

Adam spent Halloween at the hospital, reflecting on his recent success with Dr. House and turning down a patient's daughter’s flirtation. He helped a clever boy seeking ear surgery find Dr. Sloan, where the child revealed that Mark was his father.

• Adam explained to Juno how he had helped Dr. House and discussed their Halloween plans, while Juno planned to celebrate Tatiana’s first Halloween in Texas.
• Adam made rounds with The Four Interns and politely declined Erin’s Halloween invitation, then reprimanded Carter for staring at her costume.
• A boy with a deformity in his ears asked Adam for help getting charity surgery and explained why he had chosen Halloween to approach him.
• Adam agreed to help the boy on the condition that the boy help him first, then brought him to Mark Sloan.
• The boy stepped from behind Adam, called Mark “Dad,” and left Mark stunned.

Adam arranged a free surgery for a boy born with deformed ears, then rushed to stop a chainsaw from endangering people in the emergency room. He found an African American patient sawing into his own calf and welcomed Carter to Halloween at the Medical Center.

• Mark panicked when the boy implied he was his son, then agreed to perform the boy's ear surgery for free after Adam arranged an operating room and staff.
• Adam sent George and Nurse Know-It-All to handle the surgery preparations and went to the emergency room.
• Adam found the chubby boy had severed his index finger while carving a pumpkin, and ordered Carter to find the chainsaw stuck in the patient's finger.
• When a chainsaw started up in a ward, Adam stopped Cristina and entered alone to investigate.
• Adam pulled back the curtain and found an African American man sawing into his own calf as Cristina, Carter, and the others watched in shock.

At the Medical Center, Adam treated a man who had deliberately severed his healthy leg and then tried to save Eileen Shawley after a brick struck her car. Eileen was declared brain-dead, and Adam left warning his family and friends to stay alert during Halloween.

• Adam took the chainsaw from Leatherface, examined the man's wound, and learned that the patient had deliberately severed his healthy leg to get an amputation.
• Adam ordered a psychiatrist and Dr. Torres, then reflected on selling his investments before the approaching market crash.
• An ambulance brought in Eileen Shawley with a severe brain injury after a brick hit her windshield while children played on an overpass.
• Adam and the medical team operated on Eileen, but she was ultimately declared brain-dead.
• Adam repeatedly warned his family and close friends to be careful around reckless children during Halloween.

Adam informed Mr. Shaw that his brain-dead daughter, Erin, could donate her heart, but Mr. Shaw chose to give her organs to others rather than receive her heart himself. After a brutal Halloween shift, Adam returned home and summoned the Black Widow to continue investigating his secrets.

• Adam revived Mr. Shaw after the news of Erin's condition triggered a heart attack, then explained that Erin's heart could be transplanted into him if he agreed to withdraw her life support.
• Mr. Shaw visited Erin and, after trying to reach her with memories of their life together, accepted that she was gone and agreed to donate her organs to others, but not to receive her heart.
• Adam declined Lexie's suggestion to have George O'Malley persuade Mr. Shaw, deciding to respect his choice and let Erin's heart save someone else.
• Adam treated a series of Halloween victims, including a homeless man saved from arson by his dog and a child seriously injured in a hit-and-run, and worked past one in the morning.
• Adam returned to his apartment and called the Black Widow, making Sandra continue her mission to investigate his secrets.

Nurse Know-It-All told Adam about her mother losing her pension after being transferred to the emergency room and about her own frustration at being mistaken for a doctor, leaving her uncertain whether to remain a nurse. Adam encouraged her to consider medical school, then moved ahead with the clinical research and selected a participant for the third surgery.

• Nurse Know-It-All told Adam that hospital management had transferred her mother and other near-retirement nurses to unfamiliar emergency departments, and her mother resigned after making mistakes and losing her pension.
• Nurse Know-It-All recounted treating her former chemistry teacher during an emergency, only to feel slighted when he reacted with surprise that she was a nurse.
• Adam suggested that Nurse Know-It-All take time off and consider medical school if she wanted to become a doctor, and she began reflecting on the choice.
• Adam told Shorty that preparations for the third surgery were complete and reviewed the updated clinical research application list.
• Adam checked one name on the list and selected that person for the clinical research.

Adam prepared to operate on Gryda Berry’s aggressive brain tumor, but she asked to wait for her boyfriend, Andre, before deciding. After discovering that Andre was real and reuniting the couple, Adam agreed to proceed with the risky surgery, leaving Gryda on the operating table.

• Gryda asked Adam to delay the operation until her boyfriend Andre arrived, and Adam agreed to wait three hours despite Lexie’s objections.
• Gryda’s sister told Adam she believed Andre was a hallucination caused by Gryda’s tumor and described Gryda’s Cinderella-like story of meeting him in Santorini.
• Adam investigated and confirmed that Andre existed, then helped bring him to the hospital to reunite with Gryda.
• After Gryda and Andre reunited and both pleaded for the surgery, Adam agreed to operate, and Gryda lay down on the operating table.

Adam performed surgery on Cinderella for Malignant Glioma and feared his jinxing would turn against him, but the operation succeeded and her next-day scans showed the tumor shrinking. The Medical Center celebrated his breakthrough, and the Chief of Surgery declared the hospital could rise to the top of the American and world rankings.

• Adam rallied the surgical team with jinxing declarations before beginning Cinderella’s operation.
• Adam managed Cinderella’s rising intracranial pressure during surgery, and the procedure ended successfully.
• Adam sent Shorty and Lexie to update Cinderella’s family while he waited anxiously for her to make it through the night.
• Shorty presented Cinderella’s postoperative MRI scans, and Adam confirmed that the tumor had shrunk and the serum was working.
• Lexie, Shorty, Carter, George, and the hospital staff celebrated Adam’s breakthrough as the Chief of Surgery congratulated him and praised the Medical Center’s chances of becoming the top teaching hospital.

Adam celebrated the breakthrough in his cancer research and explained that Paige deserved to share credit for the Duncan-Adler Method. Meredith and Cristina compared his recognition of Paige with how their own relationships might handle similar honors, leaving to confront their partners about it.

• Adam gave Cristina the Surgical Holy Grail pager because his interns would be too busy with George's father's illness and the research follow-up to compete.
• Adam insisted the new surgical method be called the Duncan-Adler Method and credited Paige's mathematical modeling for enabling the breakthrough.
• Cristina and Meredith called Adam's decision true love and joked about whether Burke and Derek would share credit with them.
• Cristina left to visit Burke, and Meredith said she would ask Derek about the issue, prompting Adam to worry about the trouble he had caused.

Adam learned Cinderella’s tumor had shrunk enough to make surgery possible, and he prepared to publish his research in The Lancet after the operation. Meanwhile, Cristina and Meredith remained at odds with their partners over research authorship, and Meredith’s old friend Sadie arrived as a new intern.

• Adam told Cinderella’s sister and Prince Charming that her tumor had shrunk and that surgery could be possible around Thanksgiving.
• Adam decided The Lancet was the right journal for his neurosurgery research and continued organizing the data for his paper.
• Cristina and Dr. Burke stayed estranged over whether Cristina deserved authorship, while Meredith and Dr. Shepherd continued arguing over the same issue.
• Adam spent the next few weeks focusing on Cinderella’s treatment and nearly finished preparing the data for his paper.
• Meredith introduced her college friend Sadie, a new intern, to Adam, and Cristina watched the two friends leave together.
• Adam told Cristina that Meredith and Sadie’s hundred days traveling around Europe had made their bond impossible for her to join.

Adam questioned Sadie’s medical knowledge after the Chief of Surgery asked him to take her on, then sent her to learn the ropes with Meredith. Meredith and Cristina later pressed him about Sadie, and his teasing about Meredith’s past in Europe made Meredith furious.

• The Chief of Surgery asked Adam to take Sadie on as an intern, citing her experience in the morgue and her friendship with Meredith.
• Adam tested Sadie on pulmonary embolisms and appendectomies, found her knowledge lacking, and suggested Meredith show her around instead.
• The Chief of Surgery admitted Sadie’s father was the reason for the favor, and Sadie left to find Meredith.
• Cristina teased Adam about persuading Sadie not to join him, while Meredith asked him to give Sadie another chance.
• Adam joked about Meredith’s hundred days in Europe, angering her, and then apologized.

Adam and Paige successfully removed Cinderella’s shrunken malignant glioma after the experimental immune serum reduced it enough for surgery. Adam celebrated Thanksgiving with his family and told Ted that the treatment could not help Anna’s primary brain cancer yet, while promising to follow related research.

• Adam confirmed that Cinderella’s tumor had shrunk and that her condition remained stable despite mild symptoms from the serum.
• Adam and Paige examined the eroded tissue during surgery and successfully removed Cinderella’s tumor, earning applause from the hospital staff.
• Ted asked Adam whether the treatment could help Anna, but Adam explained that it targeted inoperable malignant gliomas and could not yet treat primary brain cancer.
• Adam arranged for Shorty to watch Cinderella and returned home to celebrate Thanksgiving with Monica and Little Adam.
• Adam and Paige worked on their paper, and Adam hoped The Lancet would publish it before Christmas.

Adam, Paige, and Juno discussed how their forthcoming paper might push Sheldon to work harder, then Adam left their Thanksgiving gathering to treat Mark Sloan for a serious fracture. Mark revealed that Sadie had caused his injury, and Adam joked about her being a devil to him.

• Adam, Paige, and Juno agreed that their paper might pressure Sheldon to reduce his hobbies and pursue greater achievements.
• Adam received an urgent call from Mark Sloan and left the Thanksgiving dinner to perform surgery at the hospital.
• Adam examined Mark and warned that his fracture could cause lasting complications without surgery.
• Adam asked whether Meredith or Lexie had injured Mark, and Mark said Sadie had done it.
• Adam teased Mark about Meredith and Sadie's nicknames, calling Sadie a devil to him.

Adam treated Mark’s minor fracture after Sadie broke it, while Meredith and Cristina learned what had happened. Adam also set a cautious pace for expanding his clinical research, and George stayed away after his father died.

• Adam operated on Mark’s tiny fracture as hospital nurses celebrated the news that someone had broken it.
• Meredith denied breaking Mark’s fracture, and Adam revealed that Sadie had done it; Sadie later confirmed the details to Dr. Shepherd.
• Adam realized Sadie had used the Three Kingdoms Compendium and yoga to break Mark’s fracture.
• George missed work after his father died on Thanksgiving night.
• Adam agreed to expand his clinical research cautiously, limiting it to two surgeries a month.