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Are we still in high school or what? It's all about growing up - or at least trying to - on Grey's Anatomy. Miranda Bailey posts a sign announcing herself as Chief Resident, and she's immediately put to the test when her high school crush - along with a ton of kids from California, who are in the area visiting colleges - lands in the ER.
The man, Marcus, calls her Mandy, and they flirt while she stitches up his cuts. Bailey is giddy like never before. She used to do Marcus' homework for him back in school, when Miranda was a brainiac band geek and he was a track star. George notices that there might be something wrong with his heart, and they page Hahn, who tells Miranda she could have figured this out on her own and was too busy being smitten with Marcus.
A girl named Tricia whose face is bleeding and has broken bones, insists that nobody is going to touch her face but the head of plastic surgery. A cheerleader, this is, like, her life. But she's got it good compared to Danny, who has a pencil going all the way through his eye into his brain.
Tricia learns she has a broken leg and a broken coccyx. Mark assures her she will find no one better than him anywhere. Secretly (or not so much), Mark relishes the opportunity to work on a hot cheerleader. Of course, as two other high schoolers tell Mark they remind him of a dad, his ego gets knocked down a few pegs.
It turns out Danny is a bit of a loner, but has a girl friend, Marissa, who is also a loner. Lexie doesn't understand how to relate, but Izzie does, as the outcast trailer park girl who got Knocked Up. Callie also relates well to a patient today, telling Tricia the cheerleader that once she recovers, she can still be a cheerleader - which she loves - and that being captain isn't all it's cracked up to be anyway.
During Danny's surgery, Derek catches the eye of an attractive nurse in the OR as he talks about cliques. Then he pulls the pencil out of Danny's eye, which causes an artery to burst and his brain to swell, instantly leaving him in a coma from which he'll never wake up. Almost in tears himself, Derek tells Marissa the news.
Richard sees Bailey filling out Marcus' forms, a violation of protocol. At that point Marcus starts seizing up and requires immediate surgery. Marcus makes it through his surgery fine, and afterwards, tells Bailey that she's always been his angel and thanks her for getting him through this ... would she finish his paperwork for him? George is upset Marcus has the gall to take advantage of Mandy after she saved his life.
Bailey eventually sees George's point, and has a meltdown to Derek in which she let's it all out. She complains how Marcus does not see her as anyone but someone to do his work. Miranda laments that Marcus didn't ask her to the homecoming dance. A nice Derek says that in high school, he was a band geek too... with acne, an afro and weighing 110 pounds. He puts his arm around her and they share a nice heart-to-heart.
Later, the nurse who talked to Derek about cliques in the OR finds him in the hallway and says she admires how seriously he takes his patients, but he has no idea who she is, confirming her claim that there are cliques in the workplace just as they were in high school. Derek is intrigued by her as they part ways.
Cristina tells Callie that things aren't going well in the land of George and Izzie. Callie admits this gives her slight satisfaction. Cristina has been kissing Hahn's ass, but Callie advises her to back off. Yang then freaks when Hahn is doing a pulmonary embolectomy on Marcus, but can't go help because that'd be brown-nosing. The second Hahn pages her, though, she goes running. The inner brown-noser wins!
Thatcher is admitted to the hospital, needing stitches after putting his hand through a window while wasted. He asks Alex to go get his daughter, Dr. Grey. But Lexie is still embarrassed that Alex witnessed the drunken outburst from the other night, and blows him off. So Alex finds Meredith deal with Thatcher.
While she stitches her father up, he apologizes for blaming Susan's death on Meredith. He tells her today is Susan's birthday and apologizes for not knowing her when she was in high school and speculates that maybe that's why she turned out so strong... stronger than Lexie for sure. Lexie overhears and is not thrilled.
Meredith later tells Lexie she should keep a better eye on Thatcher. Lexie responds with a tirade about how Meredith she doesn't know the first thing about what it's like to have to deal with that drunk. Meredith is hurt by Lexie's speech, and Richard - the principal, only nicer - asks her if she needs to come in and sit down for a moment. He promised Ellis he'd take care of Meredith and the Chief makes good.
Izzie finds George sitting in the foyer at home. They have had a very bad day. He says that for some reason, he can't talk to her anymore. She can't talk to him, either, and both agree that they miss having best friends.
Derek again finds the OR nurse, Rose (Lauren Stamile), leaving the hospital. He apologizes that he should have noticed her during their three-hour surgery. She says that she's worked with him 36 times, but today's was the only one in which he made eye contact. Derek and Mark go have drinks at the bar.
Sydney, who Derek had accepted a date with earlier, comes over to let Derek down easily - she is a complex woman has needs which must be fulfilled. As Derek gets "dumped," he catches Meredith's eye across the room. He walks up to her and they immediately leave together, smiling. Once again, on his way out the door, he catches the eye of Rose, who waves to him and smiles.
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