Cristina and Derek are going fishing because Owen is afraid to leave Cristina alone. Mark propositions Callie for more sex in the shower, and then Callie and Mark discuss how having sex with each other actually makes them miss Arizona and Lexie, respectively.
Cristina and Meredith are still awkward and not talking.
Bailey starts a research contest aimed at eliminating fistulas and offers the winner the opportunity to pull a gall bladder out of a mouth.
Teddy meets a patient named Henry in the elevator while he is on the way to propose to his girlfriend.
Mark tells Lexie he misses her, and she blows him off.
Meredith and Owen have a conversation outside while waiting for trauma patients, and Meredith asks how he plans on keeping Cristina busy all the time.
The trauma patients are newlyweds who were mountain hiking on their honeymoon. The wife, Trina, landed on her husband Jason when the two fell, and Jason is rushed to the OR with internal bleeding while Trina just has a lacerated ear.
Another patient, Mr. Cherkofsky needs a new hip, and his neurotic wife makes Callie crazy. Callie tells them to get a second opinion since she is confident that they will come back to her for her cutting edge surgery.
Jackson, Lexie, and April all get very competitive with their post-op protocols in order to win Bailey's contest.
Henry, the patient that Teddy met in the earlier, tells her that his girlfriend didn't accept his marriage proposal and that he’s run out of insurance. He is going to be discharged that day despite the dangerous tumor on his adrenal gland.
Cristina admits while fishing with Derek that she can't turn her mind off. Derek repeatedly tells her to try to be quiet, and she finally succeeds.
Teddy asks the Chief to do Henry's surgery pro bono and convinces the Chief to set up a meeting with the review board despite his reservations.
Lexie wants to put a drain back in one of her fistula patients since a male nurse, Eli, took it out prematurely, but Eli won't let her. Lexie gets Mark to smooth things over with Eli, and Mark convinces her to get drinks with him in exchange for the favor.
After Owen and Meredith constantly bicker during Jason's surgery, Owen kicks Meredith out of his OR.
Meredith calls Derek to complaint about being kicked out of the OR and about Cristina refusing to talk to her. Cristina finally catches a fish and gets incredibly excited. Mr. Cherkosky, the hip patient comes back to Callie, and Callie gets to do the surgery with Alex and offers to take Alex under her wing and steal him from Dr. Stark.
Meredith goes back to talk to Owen, who accuses her of being reckless with patients, her own life, and Cristina. Meredith blames Owen for marrying Cristina and letting her totally fall apart.
While looking at Eli's charts, Bailey discovers that removing the drain during day 3 in the post-op process reduces fistulas by 30%.
At the review board, Teddy advocates for Henry.
The fish that Cristina catches turns out to be record-setting, and she and Derek share a moment while she proudly holds her fish. Cristina then starts to break down and cry while posing for a picture with her prize fish.
Jason gets out of surgery, but is still in critical condition. Alex decides to go back to work with Dr. Stark, which annoys Callie.
The Chief sets Henry up with some free medication and access to the free clinic and tells him the hospital will see him through this. Teddy apologizes for failing Henry and offers to marry him to save him.
Bailey is excited that the fistula mystery is solved, and then accepts when Eli asks her on a date. Lexie meets Mark at the bar and says it's unfair for both of him if she actually stays for the date. Mark kisses her.
Jackson sees them together and comes to save Lexie as they had planned, but she decides to stay with Mark. Cristina brings 21 pounds of trout home to Owen and doesn't tell him much about her day, but posts the tearful picture of her holding the fish.
Arizona knocks on Callie's door late at night crying and says that she left Africa because she misses her, and Callie shuts the door on Arizona's face.