A young boy needs a heart transplant but doesn't seem to want it, and his treatment causes Burke and Yang to have philosophical differences. Meanwhile, when the interns rally to help Alex prepare to re-take his exam, Meredith has to remind Izzie of the true spirit of the Christmas holiday; and despite a reconciliation with his wife, Derek isn't in a festive mood.
A recent gang shooting reconnects Rush to her first homicide case. The latest victim is the brother of the first murder victim whose case Rush worked. The mother of the victims, Maeve, has lost four out of five sons to gang violence, and Rush is determined to stop the cycle and save Patrick, Maeve's youngest.
In the series finale, David finally embraces a demon; Keith gives 'tough love'; Nathaniel talks to his younger son; Brenda delivers and fights Nate's negativity; Claire gets an exciting call; Ted inspires sexy photos; Margaret is impressed to see Olivier's nurturing side; George's limitations eclipse his intentions; and Claire drives into her future.
David and Keith struggle to create parent-child boundaries; When Brenda and Nate get some ambiguous news, it confirms their views on life and death; Ruth fills her schedule with activities, but has trouble unwinding; Claire meets an interesting guy at work, and makes an effort to fit in; Margaret lets a cat out of the bag; and George drops a bomb on Ruth.
Nate and Brenda discuss giving Maya a 'coherent narrative'; David and Keith await news from Mary, and meet a special little boy; Vanessa is shocked when Julio gets into trouble at school--and mortified when Rico schmoozes things over; Billy invites Claire to dinner, but has no appetite; Margaret helps stage an ambush; and Maggie brings George to a tense meal.
