By Lauren S
It's Jackson's first day on the job, and what greets him is a group of colleagues pissed that he's now their overlord, understaffed ORs, an overworked Chief of Surgery, and a mom who still calls him "Sweetheart" in front of the Board. When he and the survivors have their first meeting he is really just a mouthpiece for the Harper Avery Foundation, and the rest of them have no patience for it at all and no respect for him. The last straw for all of them is when he suggests that they might need to start fresh with new leadership, meaning Owen would be fired as Chief. No one else wants to even consider it and they shut down the meeting. Meanwhile, Owen is out of his mind trying to coordinate the surgery schedule considering that they don't have enough nurses to actually have all of the ORs up and running at once. It's extra tricky because there wind up being multiple organs that need transplanting at the same time.
Cristina is done keeping secrets from Owen so she goes to him and tells him that he might be fired. Owen confronts Jackson but while he's screaming at him, Derek comes up and gets in the middle. He and Owen wind up screaming at each other with Derek once again alluding to the crash being Owen's fault so Owen lobs back that Derek didn't have to sue and consequently bankrupt the hospital. That said, he then quits.
Alex is still in an extra-bad mood because he both feels left out and because Princess has a hot new boyfriend and he was too dumb to tell her his feeeeelings. He has a kid who is having a kidney transplant but as he goes through all of the possible side effects of the meds she'll need to take, the girl freaks out and locks herself in the bathroom. Alex finally manages to get her to talk to him and somehow relates her situation to his own mistake of not telling Princess how he feels about her. Because he's a pediatrics god, that somehow gets the girl to agree to the surgery after all.
Cristina has one patient who is getting both a new heart and lungs, and another patient who flies off the handle when he hears that that guy is getting a heart before he is. It turns out the two men have a history -- one's wife left him for the other guy, though a while after that she left him too. Cristina realizes that she can do a domino procedure, giving heart/lungs' old heart to the other guy (yadda yadda lung heart stress medical reasoning yadda) but he refuses to accept it. She manages to talk him into it by convincing him he'll be able to use the new ticker to dance on the other guy's grave one day. (It's actually really cute.)
The last organ-related activity is April's patient, a friend of hers who was a resident with her at Mercy West until he was diagnosed with ALS and couldn't work anymore. He made the decision that he's going to go off his ventilator and let himself die so that his organs can go to others, but April can't bring herself to let him do this and keeps trying to talk him into other options to try and live longer. He finally fires her as his doctor, but she eventually comes to respect his decision and actually helps him convince his mother that this is truly what he wants to do. April takes him and his family to the OR where they'll disconnect him and then once he dies, they'll take the family out and harvest the organs within five minutes.
Jackson, meanwhile, is busy trying to participate in a Board meeting but obvious he's in over his head. Richard is concerned for him and tries to tell Catherine that it's too much. But she's convinced Jackson will figure it out, and finally yells at Richard for overstepping his bounds and acting like a parent. She immediately recants, though, because she realizes that they are awesome together and Richard really did mean the best for Jackson.
All of the organ hoo-ha converges at once, with April and her guy in one OR and Cristina and Alex fighting over the other and trying to shove each of their patients' beds through the door first. Jackson manages to finally take some control and figures out the OR schedule (heart and lungs get priority over kidney) and the others seem to find a bit of respect for him, at least for a moment.
Cristina tells Derek that he has to stop blaming Owen so Derek chases him down with his car and finally admits he doesn't blame him, while Owen admits he blames himself. Derek admits he's just pissed off at the world, and also at Mark, and he and Owen bond and counsel each other on getting over it all.
Finally, Jackson calls a new meeting with the survivors and this time, he's ready to be a leader. He tells them that they will reopen the ER (he'd been waffling about it earlier) and that they are going to hire Owen back, which Owen has already agreed to. Finally, he says that he thinks that they need to remember that they are now a hospital run by doctors and they should be even more awesome because of it. In honor of this, and of a fresh start, and most importantly in honor of the two doctors who died in the crash, he proposes that they rename the hospital Grey Sloan Memorial Hospital. The idea is met with full support by the others, and they realize maybe this crazy harebrained plan of theirs might work after all.