The final Grey's Anatomy episode of 2009 takes us on a journey through the holiday season. While Derek attempts to build a prototype to save a child's life and Teddy tries to sustain a heartless patient, Sloan's world is rocked by the arrival of a new family member. Also, the Teddy-Owen-Cristina love triangle takes a new twist.
On the eve of Thanksgiving, the Chief pulls Meredith aside to explain that he hasn't fallen off the wagon. He's going through "situational depression," which escalated his drinking. In what appears to be bribery, the Chief offers to be her mentor. Derek finds this new situation odd, but Meredith hasn't been able to get on a surgery since the merger and she's not going to give up this advantage.
Elsewhere, Cristina and Owen are getting hot and heavy in the on-call room. They're interrupted by a page from Teddy, but it's Cristina who goes running to her. Someone's hot for teacher, especially when Teddy decides to actually remove the heart of their patient. The now heartless Kelsey was brought in earlier by her brand new boyfriend, whose heart is big enough for the two of them. He decides to stay by her side.
In a phone conversation with Bailey's mother, we learn that the doc hasn't told her family that she and Tucker are getting divorced. Callie overhears this exchange and calls her out: "How long can you keep that a secret?" she asks. Bailey replies, "When you started dating woman, how long did you keep that secret from your family?"
Just when you thought the doctors of Seattle Grace didn't have enough problems to deal with, in walks a hot blonde looking for Dr. Sloan. For a split second, Mark does a double take of the girl, but those thoughts are quickly driven out of his mind when she reveals that he's her father. Getting down to brass tax, Callie brings in the paternity test kit.
Over in the O.R., Derek finds himself unsurprised by this news, explaining to Lexie that there could be "a gaggle of Sloans" out there. Unfortunately, the news just keeps on getting worse. Derek, Lexie and Arizona cannot go any further in surgery on their young patient - who has a cluster of tangled blood vessels in his brain - without killing him. "Happy Thanksgiving, Jacobson family," says Arizona.
Owen and Teddy find themselves alone in the ambulance bay. (Awkward, party of two.) With the slow melodic music playing in the background, you can just feel Teddy's heart actually breaking. She cuts Owen off before he can explain, preferring not to actually have the dreaded follow up conversation that will just lead to more heartbreak.
Back to the baby daddy drama (well, she's not a baby, that's for sure). Mark is having trouble even speaking, let alone comprehending the severity of his situation. "Dude, are you like high or something?" asks Little Sloan (yes, I called her that). Derek saves Mark from his crisis, needing help with Nicholas' case. Unfortunately, the only way to operate on the little tyke is to create instruments small enough to fit in his nasal cavity. Can Big Sloan save the day?
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