The race between the attending physicians for the Chief of Surgery position heats up after a new competitor enters the fray. They soon realize that the new surgeon, Colin Marlow, was Cristina's professor in medical school and they used to have a long-term relationship. He begins to lie to Burke in order to protect her secret, but is soon faced with the realization that their relationship is on the rocks. George finds out that Callie's family is rich, but she had previously hidden the fact in order to find out whether George loves her for who she really is. Derek treats his former colleague from New York, and forces her to have surgery for brain cancer in order to save her future, no matter what the post-surgery risks are. Alex continues to work with Jane Doe, whose memory doesn't seem to come back. He moves in with Meredith and they have a dinner with her father and stepmother. She seems to connect with Susan, but her relationship with Thatcher seems to be irreparable. Izzie wakes up, realizing that she has slept with George while they were both drunk.

In the aftermath of Izzie's affair with George, he doesn't seem to remember anything. Callie lets him know that they will be having dinner with her father, but George does not make a good impression, being hung over after last night's events. Alex helps Jane Doe choose how her face will look like after Mark Sloan performs reconstructive surgery on her. He also gives her a new perspective on how the world will see her from then on. The hospital board begins interviewing the candidates for the Chief's position, and Colin Marlow intimidates everyone with his ten-year plan. However, after taking advice from Bailey, Mark seems to have convinced the board that he is appropriate for the job, despite continuous efforts from Derek, Burke and Addison, whose careers in the hospital outlast his. Izzie seeks advice from Addison about her affair, telling her sleeping with George felt right, despite him being married. Mark takes Meredith as his intern for the day in order to impress the Chief, something that Derek doesn't approve of, feeling that Mark has become manipulative.

Colin Marlow continues to try to get in the way of Cristina and Burke's relationship. The daughter that Izzie gave up for adoption needs something from her. This episode features a pro chess player, a flirtatious woman, and a mother named Mrs. Malone. Mr. and Mrs. Malone haven't talked to their daugther in a while because of their son-in-law. Someone goes to see a priest.