Callie walks in the room and sees Mark and Sloan staring at each other while they wait for the paternity test.

During surgery, Lexie tells Derek that Sloan is almost as old as her. Derek says since he can't get to the brain, he has to send Nicholas home to die. Afterwards, Derek and Arizona explain to his parents there are no instruments small enough to fix their son.

Derek walks in the room and asks Sloan for help. Sloan says he is too young to have an eighteen year old doctor. Derek asks him to make his patient operable.

Alex suggests to talk about what they are not grateful for. Cristina says she is not happy about the merger. Cristina is jealous that Meredith is getting private lessons from Webber.

After work, Lexie, Callie and Arizona cook Thanksgiving dinner. They are surprised when Sloan brings in Riley. After Sloan informs Lexie that since they discovered Riley is his daughter and is going to move in, Lexie cuts off the tip of her finger.

The show jumps to Christmas Eve. While Webber instructs Meredith, he says she reminds him of her mother. Meredith advises him to make it up with Derek.

Lexie asks Sloan to talk to his daughter. When he attempts to talk, she calls him an old perv

Bailey's dad Bill arrives at her house and asks if it is true she is getting a divorce.

Kelsey tells Cristina and Teddy it is weird she doesn't have a heart beat. She says she feels like she is getting tired. Cristina tells her she needs to hang on until New Years Eve since they will probably get a flood of new organs after people get into accidents. Kelsey asks to go outside to see the snow since she might die at any time. Cristina starts to say no, but Teddy says they can do that.

While talking to Derek, Mark says he is considering running to Arkansas so no one can find him. He admits he knew Sloan's mother was pregnant, but he thought she would get an abortion.

Callie introduces himself to Bill Bailey. She explains they get a lot of holiday related injuries this time of year. She confesses she recently started dating women which her family is having a hard time accepting. She says Bailey is making a tough decision with her divorce.