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The Chief has finally come to terms with the idea that Adele probably has Alzheimer's, and so his way of dealing with it is to pressure Derek to accept her into the study. When a patient unexpectedly drops out, a spot opens up, but when Mere runs the test to see if Adele is eligible, Adele doesn't score low enough to qualify.
When Richard finds out that she only failed (passed?) by a single point, he hits the roof, but Mere makes Derek hold firm since the whole study could be ruined if they make one exception to the standard protocol. Adele is thrilled to be rejected since she wants to believe she doesn't have Alzheimer's but when Meredith tells her about the things she got wrong on her test and Adele finally has to admit she's sick; the reason she was in denial is that she and Richard finally found happiness and now this is threatening to tear them apart once again.
Watch the full episode below: