Derek lands the grant he needs for his clinical trial and all the attendings take him out to Joe's Bar to celebrate, but they get a surprise when they see someone they know already at the bar. Meanwhile, Meredith and Alex have to fend for themselves during the night shift with a nine-year-old patient who's experiencing post-surgical complications and his very pushy mother.

News of the incoming mass causalities after a gunman opens fire at a local college hits the staff hard when they must spring into action, even while their own wounds are still fresh; and Arizona does not receive a warm welcome home at the hospital.