Patients include Meredith's half-sister in labor that puts a strain on her personal needs in the family department. George's needs in the family department include a couple of brothers who don't respect him. Richard's needs in the family department include his desire to retire, but Preston's tremor and deception puts the ability to satisfy those needs on hold. Izzie needs to face up to Mark or become his personal slave. And Miranda tries to help Derrick get back in the surgeon saddle when he questions his ability, thinking he failed Burke.