Bailey heads up a team of surgeons performing a "domino procedure" in which each surgery hinges on the one preceding it; Derek gets sole credit for the brain tumor study he did with Meredith; Lexie goes to great lengths to have George notice her romantically, and Sloan counsels a desperate Callie on the ways of love.

The Chief announces to the residents that a solo surgery will be awarded, and the news sends them into a competitive frenzy. Meanwhile Derek turns to Bailey for advice when he feels Cristina is interfering in his relationship with Meredith, and Erica discovers a shocking connection between one of her surgical residents and a longtime patient.