When a homeless woman goes missing from a shelter linked to a previous case, Jack suspects Rick Knowles -one of two identical twins--who manipulated his brother, Greg, into confessing to the murders of several other homeless women.
The surgeons work as a team to free a boy from a hardening block of cement; Izzie helps Alex care for an ailing Rebecca; Meredith and Derek have one last chance at a positive result in their clinical trial.
Jack is torn between Emily and the new woman in his life, while Nolan and Louise bring Southern charm to East Hampton.
Violet files for joint custody of Lucas, but Pete hires an attorney and fights back, dragging everyone at the practice into the trial.