The angst of the episode kicks off immediately in different sectors of the Grey Sloan Memorial doctors' personal lives. It seems that Amelia's (Caterina Scorsone) happiness to return the Grey abode is short-lived as Meredith (Ellen Pompeo) has already taken to nitpicking Amelia's habits. The residents in the interim are competing for the Preminger Grant, a prestigious fellowship awarded by the Chief of Surgery, Dr. Bailey (Chandra Wilson), based on the recommendations of the attendings. Stephanie (Jerrika Hinton) and Jo (Camilla Luddington) are both going for it but Penny (Samantha Sloyan) is hesitant about applying.
At the Webber household, Katherine (Debbie Allen) and Richard (James Pickens Jr.) are in the midst of a drag-down dirty fight about Katherine manipulating April (Sarah Drew) into giving her the information she needs to sue for full-custody of the baby for Jackson (Jesse Williams). Richard is not pleased that his wife would stoop so low and meddle, especially when Avery and April were just starting to figure it out. To be fair, Jackson is also against the idea of suing his ex-wife and refuses to hire a family lawyer that would push the case forward.
April is dealing with a huge heaping of irony in the ER when a 14-year old pregnant patient shows up. Jenny (Morgan Lily) is suffering from extreme abdominal pain that turns out to be an aneurism that needs to be clipped before it kills her and her baby. The problem is that Jenny's mom doesn't know she's pregnant and so April and Robbins (Jessica Capshaw) must find a way to treat her without letting the cat out of the bag. Robbins is staunchly against telling the mom but April thinks its imperative - they've switched sides of their own war.
Meredith decides to avoid her own drama by taking a remote transplant pick-up with Owen (Kevin McKidd) and Riggs (Martin Henderson). She's stuck in the back of the ambulance as the mediator and attempts to use small talk to diffuse the tension. Unfortunately, small talk leads to Amelia, and Riggs admits that he bought her a drink months ago, not knowing that she's an alcoholic. The reveal sets Hunt into an angry tantrum, which sets a great tone for how the rest of the trip will go.
Jenny isn't the only star patient of the week! Wilder Valderrama makes her first appearance as Kyle, a guitar virtuoso who has unstoppable hand tremors. Amelia, Stephanie and Penny team up to perform a brain surgery with Kyle awake to test if the electrodes they are putting in his brain are fixing the tremor. Kyle immediately takes a liking to Stephanie, which puts her in charge of monitoring him during the surgery instead of assisting Amelia. That does not go down well. She decides to vent to Jo about Penny taking her slot and puts her down for being from a sub-par medical school. Of course, it's a small hospital so Penny was standing there to hear all of it and she has to re-evaluate who are her friends and whether she should just lay down while her friends apply for fancy grants and leave her behind.
To make matters worse, Penny isn't the only one overhearing things. April is preparing for surgery with Jenny when she overhears Katherine yelling at Richard that she is not going to let up. Suddenly, April knows everything about the Avery plan to sue her for full-custody and she must prepare a game plan to keep her baby.
Meanwhile, Meredith, Riggs and Hunt finally arrive at the hospital where they are picking up a new heart and liver but the patient's heart is going out before they can get the liver which makes both organs not viable for their patient. Riggs tries to resuscitate the patient but it's no use and they lose both of the organs. That's strike two for him and Hunt for the day. Meredith tries to calm the storm by reminding Hunt that not everything is Riggs' fault. That's when Hunt lays down that Riggs wasn't even around when Hunt's sister got on the helicopter ride that killed her. He allegedly was sleeping with someone else and Megan got on the helicopter because she was leaving him. The question remains, is Riggs' or Hunt's story the right one?
It's a better day for the patients of the week. April does tell Jenny's mom that she's pregnant, which causes a huge fight between mother and daughter. The aneurism begins to rupture, which sends Jenny to surgery prematurely. The time in the OR gives Arizona and April time to talk and Arizona manages to show April how similar this situation is to their own fight, and April finally understands how Arizona could have been tempted to tell Jackson about her pregnancy. The ice finally starts to break. Jenny's spleen is removed, but overall she's okay and her mother comes around to the idea of being a grandmother as well.
Kyle keeps up his flirt game during his own open brain surgery. There's a scary moment when Amelia and Penny spot a brain bleed, but Stephanie is able to keep Kyle calm as Amelia fixes it. The surgery also fixes his tremor and he plays guitar so beautifully, every girl in the operating room seems to melt, even the ones that aren't attracted to men. It goes the furthest with Stephanie, of course.
Let the good feeling of smooth recoveries fill you up, because the last act of the show was all about breaking hearts. Jo and Stephanie find out that Penny decided to apply for the grant after all, and they turn on her just after apologizing for talking crap about her. To make matters worse, Stephanie goes after Amelia for backing Penny after promising Stephanie she'd have her back. A scorned Edwards is a nasty Edwards as she throws Amelia's alcoholism in her face. Amelia kicks her out of the room before it can become even more of a disaster, but it's obvious that the words leave a sting. The salt in the wound is that Penny gets the grant, proving she's as worthy as the rest of the residents but will cause some tension between her and Callie (Sara Ramirez) in the near future.
There's a brief respite in the pain for Maggie (Kelly McCreary) to realize that Meredith and Amelia's nitpicking is just how they communicate. Sisters fight, especially adult sisters and once again the Grey house is a happy place to be.
The good feeling lasts all of a few moments as Katherine apologizes to Jackson for trying to force his hand. She'll try not to meddle, but Jackson assures her that he's done something to get his power back, which makes everyone pretty nervous. However, it's April who's pulled the premature trigger. She cracks and tells Arizona that she knows about the Avery plan and she "won't be the victim." There's a series of cuts back and forth that reveal Jackson's "power" move was to buy April a crib - because he could hurt her but his power is in not doing so. He's appealing to her kinder nature. That makes getting served a restraining order taken out by April sting even more. The kind Jackson vanishes before everyone's eyes and April has a tearful look of "Oh no" as she reads the note on the crib in her apartment.
If this is the Avery and Kepner war has commenced and this is the first shot fired. Whose side are you going to be on?
Grey's Anatomy airs Thursdays at 8/9c on ABC.