Plot

In this Maggie-centric episode, she continues to try to make a positive impression at the hospital but finds herself in extremely unfortunate situations. Meanwhile, Richard continues to hold onto his secret and the doctors work with a dying woman who is being kept alive by her daughter.—Anonymous

Pierce is still getting to know Seattle, but spends a lot of time on the phone with her parents. She tells her mom she doesn't need to make friends, and she says she hasn't talked with Meredith, saying she doesn't need a sister. She gets a page and has to run. She finds a woman with nurses around her who is crashing and quickly revives her. It's the kind of puzzle she can easily solve, but Pierce -- who is providing the voiceover -- says people are a different kind of puzzle. Just then, she avoids stepping into an elevator that Meredith is in. Webber is there, too, and follows Pierce to the stairwell to tell her she can't keep avoiding Meredith.

Pierce tries to get Jo's attention, impatiently calling her "Dr. Willis" (it's Dr. Wilson). Jo corrects her and they go see a patient, a 22-year-old man named Robbie who is in agonizing pain trying to pass a kidney stone. Robbie says his chest hurts, too, after Pierce asks. Pierce tells Jo that he's at risk for sudden cardiac death. Her next patient is a 35-year-old woman named Rita, who is 33 weeks pregnant and on bed rest. Arizona comes in to catch up on what the baby will need. Pierce tells Jo in the hallway that there's a good chance Rita will die having the baby. Back to 88-year-old Marjorie, the woman she revived earlier, who pulls Pierce close and tells her she wants to die, adding, "Oh, please, please let me die."

Marjorie laments that her life was "beautiful" and she's forgetting it. She says her daughter, Jeanie, won't let her sign any forms that would allow doctors to stop treatment. Outside of the room, Jo suggests to Pierce that she should talk to the daughter. When Jeanie shows up, Jo tries to talk her into letting her die, but Jeanie isn't having it. She tearfully tells the doctors to do everything they can to save her mother. Afterward, Pierce gets in Jo's face and tells her she is never to talk to patients unless she's told to, and should not counsel a patient's family on care. Jo apologizes, then Pierce says she just "had to bring the thunder." It's something she does to ensure people that just because she's young and pretty doesn't mean she shouldn't be taken seriously.

Their other patient, Robbie has a cardio myopathy. Pierce wants to send out Robbie's test results for genome testing. Bailey says she can do it in the hospital's genome lab, to which she still has a set of keys even though the board voted to shut it down. She then imparts some not-so-kind words about the board, on which she was promised a seat but it's been given to Karev instead. Pierce gets a page from Alex and asks Pierce who "Dr. Karev" is. Jo explains that Alex Karev is the doctor who got Bailey's seat on the board and will be coming back to the hospital. She doesn't reveal that they're together.

Rita is having some lower back pain. Pierce forgets Jo's name again.

Pierce goes to Alex's O.R., where is operating with his boss, who likes to play loud music and encourages dancing around the O.R. during surgery. Pierce doesn't seem amused. She congratulates Alex on getting the seat on the board and, despite his efforts to quiet her down, his boss gets upset, stops the music and asks Alex is he's quitting the practice. Alex says he "might be." Pierce slips out of the room while Karev's boss says he's going to fire him.

Pierce angrily comes to Jo and tells her she was "indiscreet and stupid" and kicks her off her service. She says Jo shouldn't have shared confidential information about Alex's career. Pierce says she can't trust her.

Hunt comes to Pierce and asks her why she pulled Cristina's chart on the McNeil family, which had three kids with cardio myopathy. He doesn't want to get the family's hopes up and tells her to leave them alone. She concedes.

In the cafeteria, Zola gets Pierce's attention and leads her back to the table where Derek and Meredith are sitting. She brings up Derek's NIH appointment in Washington, D.C., but he tells her he isn't going because he wants to stay close to his family. Derek invites her to join them for lunch, but she goes to look for another table and runs into Webber and Amy Sheppard sitting and talking. Pierce asks if everyone in the room is somehow related and after a brief awkward silence, Amy gets up to leave with a laugh. Pierce sits down with Webber and gets annoyed when Webber explains that Meredith adopted a "beautiful, surgically-needy African orphan." She asks Webber if he thinks she should talk to Meredith about it. Pierce is in awe of the coincidence that Meredith adopted a kid after her mother gave one up. She asks Webber if he knows the backstory and he says that based on what he knows about Ellis Grey, giving her up would've been "the most difficult decision of her life." Pierce asks how well he knew her, but they're interrupted by Jo who brings bad news about Rita.

Pierce interrupts Callie and Arizona arguing about their personal lives and stands outside the room. They go to Rita's room and tell her the baby needs to come out. Rita insists that they make sure the baby is OK. Her husband is upset and tells his wife he knew something like this would happen. Pierce asks him to leave the room. Outside, Pierce tells him that his wife needs his support. He explains that they lost a child after a freak accident at age 2 and now Rita blames herself. Pierce says they're going to do their best to keep them both alive.

They bring Rita into surgery and quickly get the baby out. Arizona takes the baby to another room while Pierce starts working on Rita's heart. Pierce gets Rita's heart going, then asks Jo if she can close. She excitedly says she can. Pierce runs to check on the baby and Arizona says she's losing her.

Pierce and Arizona work together to try something to save the baby. Pierce again tells Jo she's off her service. Alex shows up and is upset with Pierce for blabbing about the board spot, but Jo steps in to take the blame and Alex turns his anger toward her. Pierce slips away to respond to a page from "Dr. Sheppard." It's Amy waiting for Pierce and she loves the new doctor when she asks Amy if the consult is for her or "the other Dr. Sheppard." She says no one has ever referred to her brother as "the other Dr. Sheppard" before. The patient is a woman in her early 20s named Tracy who had a minor stroke after sex with a guy she just met at the gym. He's there and wants to know if he was the reason she had a stroke.

Pierce gets another page and leaves. She goes to Marjorie's room and finds Hunt and Jackson there. Bailey is there, too, and admits they caught her trying to run the genome test on Robbie. Bailey tells Pierce she threw her under the bus. Pierce says shutting the genome program is "stupid" and "makes your board look like a bunch of morons." Bailey is loving it and introduces Jackson, who Hunt clarifies is a voting member on the board. Pierce confronts Meredith about putting a central line in her patient without notifying her. Meredith says she doesn't need her permission to keep a patient from dying. Hunt hears this and says Meredith is right.

Pierce chases Meredith down and demands to be taken seriously. That's when a ukelele-playing guy in a sturgeon costume comes in and sings a congratulatory song to Pierce as a gift from her parents. Everyone stands around and takes in the scene and laughs while Pierce stands there mortified.

Pierce tells her parents on the phone and tries to hold back tears as she thanks them for the "incredibly cheesy" gift, even though the timing could've been better. She cries and says it might have been a mistake to come to Seattle because she doesn't feel like she can be herself.

Amy and Pierce compare notes on Tracy's stroke. Amy's focus fades for a bit as she considers what kind of sex she'd need to have in order to get close to having a stroke. She laments not having had sex in a long time and Pierce says she's "preaching to the choir." Pierce realizes there was a clot in Tracy's leg that travels through her heart and to her brain. Amy congratulates Pierce and they start to bond over their family backgrounds. Amy says "it wasn't until I met Meredith I had a sister I could relate to." Pierce is surprised and Amy explains that Meredith is hard to get to know at first, but "she's worth knowing, really."

Jo comes in and tells Pierce that Bailey wants to see her. Bailey found the problem with Robbie with a genome test. This wasn't know until a week ago. We next see Pierce explaining to the McNeils that a genetic mutation is what caused their children's cardio myopathy. Pierce explains that she kept look because "when I find a puzzle it's very hard for me to put it down."

Pierce gets another page and runs to find Meredith pumping Marjorie's chest. She moves Meredith out the way and takes over the chest pumping, telling Meredith that Marjorie's heart can't take the defibrillation. Pierce talks to Marjorie while Meredith insists that Pierce is letting her die. Marjorie asks Meredith to call the time of death, but Meredith doesn't respond and just leaves angrily.

Hunt stops Pierce in the hallway and thanks her for giving the McNeils some peace. Meredith walks up and tells Hunt that Pierce "slow coded" a patient right in front of her, deliberately withholding care. Pierce looks Meredith in the eye and says she did everything she could. Meredith walks away. Pierce stops Meredith before she can get to Jeanie, Marjorie's daughter. Pierce explains that Marjorie begged her "in no uncertain terms" to end her suffering but her daughter wouldn't allow her to. Pierce says she did what she and her patient decided was best. Pierce tells Meredith to look her in the eye and tell her she wouldn't have done the same thing.

Jeanie walks up and Pierce starts to tell Jeanie that her mother's heart stopped again, but she can't bring herself to say she did everything she could. Meredith steps in and says, "Dr. Pierce did everything in her power, despite all our efforts and capabilities we were unable to save your mother. I am very sorry for your loss." Jeanie cries, Meredith walks away and Pierce hugs Jeanie.

Pierce goes to see Rita's baby, who is doing well. She hears Callie tell Arizona that she should go for the fellowship if it makes her happy.

Pierce then goes to Rita's room and is there when she wakes up. She tells Rita that the baby is fine.

Pierce then overhears Jo telling Stephanie that Pierce figured out the McNeils' kids heart problem. Stephanie takes off when Pierce says hi. Jo tells Pierce that she finished her post-ops, and Pierce tells her she's insubordinate on top of everything else. Jo stands up and defends herself, saying she's not insubordinate or untrustworthy. She apologizes for the mistake, but she came to the hospital to learn and she learned a "crap ton" and gave herself a second chance. Pierce asks if this is Jo's "thunder," and Jo says it is. Pierce invites her back to her service.

Pierce catches Meredith on the way out of the hospital and tells her that her mother was Ellis Grey. She says she was put up for adoption in Boston and was raised by a nice couple, but she found out a year ago that her mother was Ellis Grey. Meredith suspiciously asks Pierce what she's after. Meredith says that because Pierce is five years younger, she would have know if her mother was pregnant. She tells Pierce she's either wrong or lying and walks away after telling her to "stay away from me."