Meredith tells Derek that she thinks he will make a great chief At the hospital, the staff wonders what is going on with the leadership or if the doctors from Mercy West will be let go.

Bailey operates on a patient named Leslie who starts to crash. Bailey looks for a nick, then realizes that the patient is awake. Bailey orders her anesthesiologist Ben to put her patient back under. Derek calls a full staff meeting. He tells the doctors that he has been appointed as the interim chief of surgery. Derek states he wants to bring the hospital back to its former glory. After Webber and Larry arrive, Derek becomes nervous before he ends his announcement. Since Teddy is still jealous at Cristina, she asks Avery to help her with surgery. Arizona tells Alex that she heard that he is the future of pediatrics. Lexie asks Mark for an update on Sloan, but he ignores her.

Larry tells Webber that he can either retire early or enter a rehab program that Derek insists he go through with. Webber says he needs some time to think. Derek is told that there is a situation that he needs to attend to. Bailey and her team tells him about Leslie's situation. Derek says he hopes Leslie doesn't remember or they will get sued. Derek meets with Leslie and tells her they were able to remove her tumor. Leslie says she remembers when she woke up on the table and smelled her own flesh. She says she was awake and couldn't move while they butchered her insides.

Ben suggests a plan to Bailey, but she says it is his fault they are going to get sued. She scolds him for reading a magazine instead of staying focus on the patient.

Arizona and Alex consult with a patient named Brad. Brad tries to describe his pain, but his father cuts him off. After Alex suggests they conduct a CT scan, Brad's father tells him the test will be expensive. Brad insists he is not faking his pain.

Cristina asks Teddy for more time under her mentorship, but Teddy says she can't spare any more time.

After Bailey visits her, Leslie tells her not to touch her. Leslie says she remembers when Bailey panicked during surgery. Leslie's heart rate increases while blood pours through her wound. Meredith works on patching her up.