Richard throws everyone for a loop when he switches the resident and attending pairings, and Arizona takes a huge risk on a woman who is pregnant with quadruplets. Meanwhile, April is faced with a difficult decision.

Meredith takes a step forward with Will but quickly regrets it; Maggie senses a disconnection with Andrew; and Amelia reevaluates her relationship with Owen. Meanwhile, Catherine comes into town and really shakes things up with April and Jackson.