The discord and chaos created by the hospital's new management team causes one physician to question his future at Seattle Grace. Meanwhile, the doctors and the interns must juggle several transplant surgeries at once, each coming with its own set of obstacles.

Gas tanker explodes on a Seattle highway, causing multiple injuries -- including paramedic Matthew; Meredith and Jo help a frantic mother whose child is suffering from a mysterious illness; and Owen bonds with a young boy whose parents are in critical condition. Meanwhile true colors are revealed when Alex is forced to work with Jo's boyfriend on an ailing patient.