Owen, Cristina and George operate on Maddie's dad. Owen tells Cristina to back off. The man crashes. Owen tells Cristina to go grab something out of his truck. Later, Cristina returns with a canister containing a powder. Owen sprinkles the powder on the wound of Maddie's dad and tells George that it will help with blood clots.

A woman asks to see her sister Karen. Karen hears her sister, Julie, and says that her name is Willow now. Julie tells her that she told her to get down from the tree. Later, Karen and Julie argue about what she did. Callie tells Julie that what Karen did was brave. Karen crashes and is taken into surgery.

Izzie tells her mom she has stage 4 melanoma. She says her cancer spread to her organs. Izzie says she is dying like her grandma did. Ronnie says she doesn't know why she is sick then starts to cry. Izzie comforts her mom.

Arizona visits Callie while she operates on Karen. Callie says Karen lived in a tree and crapped in a bucket. Arizona tells Callie she will keep loving her even if she returns to her family.

Bailey tells Izzie that she thinks her test is going to go well. Izzie says she wants to give her mom good news. Bailey admits she called Izzie's mom. Bailey says she would want her mom if she was in situation. After the test, Bailey tells Ronnie that Izzie's cancer is practically gone. Ronnie says she knew nothing could happen to her daughter then leaves the room. Izzie asks Bailey to tell her the truth. Bailey says there is new cancer in her body. She says she will operate on her later.

Webber tells Derek that Meredith treats her as if he is her father. Derek tells Webber he acts like he considers her as family. George tells Meredith that the patient who was shot will survive. Meredith tells Maddie's mom she needs to protect her daughter. Meredith sees that Webber caught her talking to Maddie and her mom and says she will pack her stuff. Later, Webber meets with Meredith. He says he saw she was neglected when she was a kid and should have fought for her. He says he is proud she stood up for Maddie. Webber apologizes for letting her down and she gives him a hug.

Callie tells Julie that her sister will survive. Julie says the forestry company weighed the costs of bulldozing Karen and did it anyways. Karen wakes up and Julie tells her she will file a lawsuit. Callie tells Sloan she needs her family.

Izzie tells her mom she is fine and she should fly back home. Cristina sees Owen outside of the office. He tells Cristina, 'nice work tonight'. Cristina says she is upset he asked her to run to the truck during surgery. Owen says George doesn't know what his truck looks like. He says George wants to be a trauma surgeon. Cristina tells Owen she is angry he is only saying short phrases to her. Owen says he and his psychologist came up with three word phrases to replace the three words that he can't say to her. Cristina tells Owen, 'Take care now,' then leaves.

Maddie and her mom visit her dad. Her mom tells him that they are leaving him. Maddie tells Meredith goodbye, then leaves.

Sloan meets with Thatcher and Lexie for dinner. Thatcher thinks Sloan is Lexie's teacher, but Lexie says Sloan is her boyfriend. Back at the hospital, Alex samples the food that is going to be served at the wedding and tells Izzie how it tastes. Bailey walks in and takes Izzie into surgery. At the house, Meredith tells Derek they need to move the wedding for Izzie.