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During his life as a dog, Fluke gets to know his family better and bitterly realizes, much to his regret, that he had been a distant workaholic.As more memories return, Fluke suspects that his human death was caused by his former business partner Jeff Newman (Eric Stoltz).Brian tells Carol that he heard Fluke tell him in a vision that Fluke had to leave them. Instead, Fluke digs away at the snow in front of his tombstone to show Carol who he really is by uncovering the word "forever" at the bottom, a phrase he often said to her as a human.
Fluke is then abducted by a man named Sylvester (Ron Perlman) to be used in makeup experiments at a cosmetics company.After Rumbo's death, Fluke seeks out his surviving wife Carol (Nancy Travis) and son Brian (Max Pomeranc) and reunites with them by becoming their new family dog.Though Carol, implied to be afraid of dogs, is apprehensive about adopting Fluke, she caves in seeing how Brian has quickly bonded with Fluke.Meredith's best friend from college shows up on her doorstep and Cristina feels threatened by it.Meredith thinks Sloan is putting the moves on her half-sister and asks Derek to intervene, while the interns practice sutures on each other and Izzie still feels Denny's presence. Rehn performed the world's first successful heart surgery (not transplant) on September 9, 1896.