All eyes are on Derek as he is set to perform his first surgery after his breakdown; attention is also set on Izzie, whose medical condition requires her to undergo a difficult surgery; and Owen has another PTSD episode that injures Cristina and traumatizes both of them, throwing the future of their relationship into question.

Earl helps Randy find his first love, Pinky.

Chloe discovers how the other half lives when she wishes out loud for a peaceful life like her cousin Lois... and a sorceress places her consciousness in Lois' body. Meanwhile, Clark receives a wish of his own.

The contestants find out who is safe and who will be sent home on the American Idol results show.

Jane's week alone with Sophie turns out to be more stressful than she had hoped. Meanwhile, Rosemary tries to unionize Horatio's fellow nannies in order to get them better perks; and Emily and Jason's children don't like their "stay-cation" concept.

Andrea has a new boyfriend and Sam wants the couple to actually go on a real date for once. Todd doesn't like being just the roommate. Dena has a new penpal in Iraq, but she wonders if it means she's cheating on Chase.

As his new boss becomes even more watchful, Michael's behavior becomes increasingly careless, Pam deals with a difficult copier, and Kelly has a new crush.

Sam and Dean both work at a ironworks company. Dean is in sales and marketing, Sam in tech support. They don't remember each other, or their lives as Hunters. However, when a ghost starts causing suicides among the employees, the brothers have to learn quickly who and what they are, or die trying.

Chef Ramsay challenges the team's palates in a blind taste testing. In a packed dinner service, anxiety is higher than usual when celebrities Eric McCormack and Robert Patrick stop by.

Addison is having a difficult time dealing with her feeling for Dr. Noah and Violet starts getting jealous when she finds out that Pete is going out with a single mother.

Jack plans a perfect party for his 50th birthday, including recreating one of his favorite moments from his childhood. Kenneth and Pete unite to make Tracy's childhood dream come true. Meanwhile, Dennis Duffy admits to Liz an addiction he has, which causes friction between her and Jenna.

Doctors and nurses from the ER help out at a camp for children who have had open heart surgeries. A woman returns to County for the baby she previously abandoned there.

Barker and Ellis infiltrate a high-stakes poker game to sniff out the assassin who's after an informant who's about to enter the witness protection program. Barker and Ellis have three tough jobs--protect the informant, figure out which player is the assassin, and not lose their $3 million buy-ins.

One more wreck is explored before winter.