After weeks of concealing the fact she was pregnant and miscarried, Meredith at last tells Derek and is finally cleared to return to her surgical duties in the wake of the hospital shooting spree; Cristina experiences post-traumatic stress disorder in the midst of an operation; and Bailey refuses to let Alex operate until he agrees to have the bullet in his chest removed.

Things are hostile on all fronts when a visit to the obstetrician results in some disturbing news for Meredith and Derek, and Lexie loses it when she notices Meredith and April getting closer. Meanwhile a car crash brings in multiple traumas and Jackson tries using his physical attributes to get ahead in the operating room, while Cristina's self-doubt carries outside of the hospital and into her house hunting with Owen.