Claire practices for her first day leading surgery. She practices talking to the patient, saying the surgery went well, etc. She pours out most of her alcohol while practicing but keeps a bottle for celebrating with. She is interrupted by her mom giving her a urine sample for drug testing.
Shaun thinks a patient may need a lap chole, which would be a great first surgery for Claire, and Claire tells him not to get ahead of himself, let's find out what's wrong first.
The patient is a foster child who has pain consistent with gall bladder needing to be removed. Shaun excitedly announces it is Claire's first surgery.
Melendez thinks the surgery wil be difficult because of scarring. Shaun suggests an open procedure. He and Claire go to observe Andrews doing one and discuss Shaun's date with Carly. Shaun asked Carly 83 questions such as whether she wants children. Claire thinks it's too soon for such heavy topics. Shaun is confused. As long as she answered his questions, what difference does it make? But she didn't ask for a third date -- is that a bad sign? The conversation is interrupted by Andrews announcing he made an error and showing Claire how he corrects it. Claire seems freaked out.
Shaun is upset about the mistake he made. Talking to Carly might make things worse. Claire offers to talk to Carly after the surgery. Shaun says that will be soon. There was just a cancellation and the surgery is in 45 minutes.
Claire nervously walks down the hall, practicing what she will say to Michelle's parents. She is interrupted by a different patient screaming. She goes to see what is going on. It is a fisherman who has a huge fish stuck in him and won't let Morgan break the fish because he wants a picture of his catch. The fish starts flopping around and Claire has to help contain it. The guy says it's a post mortem response. Anyway he won't get an MRI without the fish.
Claire goes to talk to her patient. The mom is on the phone and hangs up. How long will Michelle be in the hospital? Claire says a week. Mom sas that's too long, she needs her to watch the other kids after school. Claire says Michelle has been sick for a while... all of a sudden Michelle's chest hurts and she looks very sick.
Claire says in the next scene that Michelle had a pulmonary embolism --e.g. a blood clot in her lungs. SHe asks her if she was lying about not b eing on birth control. Michelle admits she was. She didn't want to say it in front of her little sister. SHe freaks out when Claire goes to insert a catheter. Claire sees cuts on her leg.
Michelle says the cuts were from a fence. Claire tells her later she nows that's not true. She says kids cut themselves when they are in a lot of pain. Michelle doesn't want to talk about it. Claire sits and watces her. Michelle eventually admits that her mom b rought in three foster kids and made her take care of them. She never leaves the house without a kid attached.
Claire tries to talk to the mother who says Michelle's home life is fine and that "they" (black people) do not talk to psychiatrists. Claire thinks that should change. The mother walks off and Melendez warns Claire not to get overinvolved and just focus on the surgery.
Claire tries to practice but Shaun interrupts to ask her to talk to Carly and won't stop telling her things that could go wrong. She leaves and runs into Morgan, who starts quizzing her on the surgery because she thinks Claire will be Chief Resident someday.
The fish has metal in it which causes the MRI to go badly and the fisherman to get impaled and require emergency surgery.
Claire must apply pressure and gets blood all over her hands. They also cramp up.
Lim tells her later that the patient is negative for HIV and other STDs so she doesn't need meds. Claire admits she is nervous but Lim tells her not to verbalize that. As a non-white woman she has too much pressure to succeed and can't afford to be insecure. Besides, she's had to work twice as hard as others to get here.
Claire is studying and her mom asks her about her patient. She tells her that the patient is young and taking care of foster siblings. During the conversation, she admits she was only restrained and serious as a kid because she was worried about her mom falling apart.
Claire talks to Michelle's mom who insists Michelle was only cutting because of peer pressure and is just mad that her mom won't let her hang out with her friends. She thinks it's typical teen drama. Claire tries to tell her Michelle needs help. The mother says Michelle needs to have surgery and get out of the hospital.
Claire talks to Michelle, who says her mom wouldn't listen to her. Claire tells Michelle about her own mom being bipolar. Michelle agrees to talk to a therapist.
Morgan and Park discuss the marlin guy in front of Claire, who is trying to concentrate. She suggests the guy might have an infection.
Lim calls Claire in. The mother says Claire made a referral to a psychiatrist against her wishes. She wants to report her to the medical board. Lim asks if Michelle was a danger to herself. Claire says yes. Lim says Claire did the right thing but should have informed her. She's taking her off Michelle's case.
In therapy with her mom, Claire doesn't want to talk about what happened but eventually does. She's embarrassed and doesn't understand how she can be scared of something she wants. Her mom says things that matter are scary. She's scared of going to therapy but does it anyway because Claire is not scared of anything.
Later, Claire asks to talk to Carly but Carly has to see a patient who has cancer first. Claire realizes that's what's wrong with Marlin Guy. Morgan says she will remember this when she is Chief Resident.
There is a problem. Michelle refuses to have surgery if Claire doesn't perform it. She doesn't want to get better. Her mom says don't say that. Claire tells Michelle that getting the surgery is a priority, not who does it, and promises she will observe from the gallery.
Lim tells Claire she had to pull her off because if she made any mistakes during surgery that mother would sue. Claire understands. Melendez comes along and says that he convinced the mother to let Claire do the surgery.
Claire runs into Carly, who tells her she likes her but she should mind her own business and stop interfering in her relationship with Shaun. And by the way she hates small talk and liked Shaun's questions.
Claire takes a selfie before heading to the OR and sends it to her mom.
In the OR the patient begins to bleed out. Claire figures out what to do. She is proud of herself afterwards.
Michelle's mom says Michelle wants to be a doctor now and asks for the therapist's card.
Claire answers a call from her mom all happy but it's the police. Her mom drove drunk and killed herself.
She had a voicemail from her saying she was proud of her and made dinner and was getting dessert to celebrate.