Wind of Change

S09E12

While Arizona is doing much, much better emotionally, she now has a new issue to deal with: phantom pain in her missing leg. It's a very real and I've heard an absolutely excruciating thing, and she's having nightmares about it when she sleeps and pain as well when she's in the OR, to the point that she has to leave a surgery on an African orphan because it is too much. Cristina and Alex are able to finish the surgery but Alex is worried. He doesn't actually know that she's having the pain; the only person who figures out what's going on is Owen, so he tries to help her out with a therapy that involves picturing herself slowing down waves on the beach. When that doesn't help, she has Alex finally stab her in her prosthetic foot with a scalpel and that somehow gets her brain to calm down so that the pain subsides.

Everyone at the hospital is kind of on edge because a consultant has been called in to observe and figure out where they can cut expenses since they now have tens of millions of dollars to pay out to the crash survivors. No one wants her around because they are sure she's going to fire them and/or cut their pet programs. It turns out Richard actually knows her as she was a student of his years earlier, and he keeps trying to have coffee with her so that they can catch up but she avoids him at every turn. Princess goes so far as to lie about the time of a complicated brain surgery that Derek is doing so that they can keep her out of the OR. (Because of course Derek wouldn't start back operating again with anything less than a crazy scary complicated surgery.) The consultant, Alana, finds out the surgery is going on and tries to go observe but Derek sticks up for Princess' lie and kicks Alana out of the OR so that he can finish up his 23-hour procedure. Happily for him (and for Callie, since it's "her" wrist doing the work) the surgery winds up totally successful.

Bailey and Mere have a pregnant patient who comes in fearing she's in early labor, but then she winds up falling unconscious and they realize that she's actually in liver failure. Smash is on Mere's service and he can't seem to do anything right, screwing up lab orders and whatnot. Mere finally orders him to sit by the phone and wait for UNOS since they need to do a transplant. When a liver comes through, he goes with Mere and assists in the harvest… and winds up cutting a crucial artery and rendering the donor liver useless. Mere is a complete emotional mess because of all of the pregnancy hormones and can barely keep it together when he keeps screwing up. The day they are lucky enough to get another liver but it's in Portland and requires a flight to go pick it up. Smash is to go and be the Keeper of the Cooler, and because Mere can't bring herself to get on a plane Bailey offers to go along to do the harvesting. But at the last moment, Mere sucks it up and takes Bailey's place on the plane. This time there's no crash, though the liver they harvest turns out to have a mass on it. Mere almost loses it again but after a biopsy, it turns out to be benign and they get it back to Seattle and into their patient after all.

April is not happy to have Jackson's current fling Stephanie helping her out in the ER for the day, and she puts her through her paces in return. She's so busy riding Stephanie that she doesn't notice that one of the (very cute) paramedics seems to be hanging around for a few extra moments each times he brings in a patient. Stephanie is so nervous and working so hard that she actually puts off sex with Jackson (gasp!) but all is rewarded when, after two days, she's totally on top of all of the patients and is congratulated by April for doing a good job. Right about this moment, Cute Paramedic Matthew shows back up and works up the nerve to ask a shocked April out for coffee.

Alana then calls all of the doctors together to talk about what she observed over the two days -- she's impressed with the African orphan program and thinks it's great PR and totally worth saving. But she reminds them that they do have to cut costs and so the first thing she suggests they do is shut down the ER. She points out that it's not bringing in any money and they are wasting surgical interns by having them work in there on non-emergent cases. Almost everyone grabs their pearls at the suggestion, and Derek gets especially uppity with her about it. But Bailey then speaks up to say that they have to do something so they'd better start listening to the woman and considering her suggestions since some of them don't have millions in the bank to fall back on. Afterwards, Richard finally catches up with Alana and tries to schedule coffee; she turns him down, but pointedly tells him that he logged the fewest hours in the OR of any surgeon the month. Dun dun duuuuuuuun.

On a beautiful Seattle morning, Arizona is jogging... with two fully intact legs. Mere's VO teaches us about Phantom Limb Syndrome -- people who have lost a limb can experience sensations where the limb used to be and most of the time, what they feel is intense pain. I've read about this before and it sounds horrifying, as the pain is usually incredibly strong and can be debilitating. She gets a page and runs straight to the hospital where a blonde female patient has been brought after a plane crash, with a broken femur and massive infection. Arizona tries to follow the gurney but she's struck with crippling pain in her own left femur and then all of a sudden, her leg begins to crumble into cartoony CG glass, finally shattering to a million pieces and sending her falling to the floor.

She sits up in bed, gasping in pain, and a sleepy Callie asks if she's hurting again. But why tell your orthopedic surgeon wife that you're having pain when you can just suffer in silence alone? She convinces Callie to go back to sleep and then gasps silently as she rubs at the bed in the spot where her leg used to be.

At the real hospital later, Callie frowns while reading something on her phone and then when she runs into Derek, lays into him for starting back on surgery with a complicated, long, difficult brain surgery with a huge margin for error and/or death. He's Derek, why do something sensible? Though it turns out he has a decent reason for it -- this is a patient he was supposed to operate on around the time of the crash, and if he doesn't go in soon it will be too late for the guy. Callie concedes that if he can do this, then she'll know "her hand" can do anything. Derek argues back that it's "his hand," but she takes no notice.

Owen gathers the surgical staff together and then gets up on the stairs to announce that, on account of the "financial setback" that has befallen the hospital, the administration is working to cut costs and they have hired a Physician Advisor to help them out. He claims this person will help them figure out how to maximize efficiency while cutting costs where they can. Bailey dryly points out what everyone is thinking, which is that this person will be figuring out who can be fired. Owen plays this down and tries to sound confident as he says that this person is just there to help, but he is convincing absolutely no one. He was supposed to introduce her at this meeting but she's late, and Cristina cracks that that isn't very efficient; it's certainly setting her up to be received even less warmly than she would have anyway. Derek is miffed to hear that she'll be observing even inside the OR but Owen explains that she is a trained surgeon and repeats again that she's going to help. Even he doesn't sound convinced by his own words, though.

When the meeting breaks up Meredith tells Derek she needs to see him about something urgent; it turns out that the urgency is a pregnancy-hormone-fueled fire in her loins for her husband. When she gets a page for a consult, though, she bursts into tears and explains with a tragedy mask face that she cries now whenever she's mad, and she's mad because she can't have sex. Smash knocks on the door and calls to Derek that he's supposed to be working with Meredith but he wants to scrub in on the brain surgery, so could Derek speak to his wife? Blotchy, angry Mere opens the door and hollers at him that they have a consult on a pregnant woman with abdominal pain, so he's to do the workup and meet her there and to not even give Derek's surgery a second thought. She slams the door in his face and kisses Derek, who notes to himself that he actually is quite a fan of these pregnancy hormones.

Stephanie is trying to work the ER but she's in over her head which we can tell because she can't even hold on to a stack of charts. She runs up to April and asks her to do a consult, guiltily adding that she's sure April has better things to do. Few things are more uncomfortable than having to ask your boss and current fling's ex-girlfriend for help. April isn't too pleased to have Stephanie on her service and when she realizes Stephanie doesn't even know the bed numbers she declares that she's going to whip her into shape and teach her how to actually run the pit.

They walk up to the patient and April apologizes for the wait, but the woman just smarms back that if she'd really had shortness of breath she'd be on the verge of death now, so thanks a lot. Meet Alana Cahill, the Physician Advisor. It turns out she missed the meeting because she was waiting to see how long it took to get help in the ER, and Stephanie is horrified and tries to take the blame but an unimpressed Alana just wants to be taken to meet Owen.

Mere's pregnant patient, Brie, is in a ton of pain; her wife Heidi holds her hands and babbles nervously that this must just be early labor. Mere reports that it's not contractions but assures them the baby is okay and the lab results will help them figure out what's going on. Well, they would if Smash had ordered the right test, which he didn't. He falls over himself apologizing and high-tails it out to correct his mistake; Mere manages not to cry this time in front of the patients even though she's plenty pissed off.

Arizona and Alex have one of their African patients in for an operation, and Cristina is helping out since the little girl needs heart surgery. The girl's guardian tells them how relieved she was to find out that the program wasn't moving to UCLA after all, since Alex and Arizona are so good with the kids. Arizona assures her that she had been gone but now she's back, and the program isn't going anywhere now -- this feels awfully heavy-handed and like the program will wind up in Alana's sights soon enough.

That's exactly what Cristina thinks, at least, and when she and Alex are out in the hall she tells him as much. She figures that flying kids halfway around the world for pro bono surgery isn't the kind of expense that will be deemed acceptable. Alex gets defensive about it but Cristina is unmoved and she seems to have hit quite a nerve, putting Alex on edge. Hitting nerves really is her second specialty, after cardio.

When Smash gets back to Brie's room he's horrified to see that she's unconscious and intubated, and Bailey and Mere are working on her frantically. He hands over the test results which show that she's in liver failure to the point where she won't live more than a week with her bum organ. Heidi walks in with balloons and is panicked to see what happened just in the time she took to run to the gift shop.

Outside, Bailey explains to her that Brie's liver has stopped working, and she needs a transplant pretty much immediately. The good news is that the baby is totally fine for now, and that because she's an emergent case her name is on the top of UNOS's list for a new liver. She then takes Heidi in to see her wife, leaving Mere to freak out on Smash. She growls at him not to say a word but he can't help himself and begins to apologize profusely. She tries to control her lunatic pregnancy angry tears as she yells at him to leave and not come back until he has a liver for her. Her level of crazy gets ratcheted so high that Smash finally turns and runs off to Liver Duty.

Derek and Princess greet their patient, Jimmy, and his awesome brassy sister, Carla. The two happily tease each other and she puts on a good show but you can see the fear behind her eyes regarding her brother's health especially when he tells Derek that after the crash he looked around for another surgeon but no one else would even consider trying to do the operation. Derek keeps his tone light as he says that they'll run some tests and see if the tumor has progressed and tries to ease some of Carla's worry while they wait to see what's what.

When he and Princess get to the hall, he tells her matter-of-factly to go see if she can switch services with Smash and of course she freaks out thinking that once again she's the Disappointing Intern. He explains that she's fine but Smash knows what he wants before he asks for it and he won't have time during this surgery to teach her. For all of her bravado about how she was only ever crying on command, she looks cut to the core as she slumps off. Mercifully, though, there are no actual waterworks because I might blind myself rolling my eyes too hard if we had to witness that again. As she leaves, Owen walks up and with Alana and introduces her to Derek. She immediately starts in on the fact that Jimmy has been admitted a full day before his surgery and asks if that happens in all of the departments but Derek snips prissily that she can take that up with Owen. When she tells Derek she'll see him in the OR his eyebrows nearly fly off his forehead and he informs her that typically someone needs to be invited to be in the OR. She can match him sass-for-sass, though, and retorts that if things were running typically, she wouldn't be there. Owen just watches the exchange with a guilty, mortified air about him as Derek storms off.

By Lauren S

April and Stephanie meet an ambulance staffed by an extremely cute paramedic named Matthew. April takes no notice of him and just talks Stephanie through receiving a patient which she manages to screw up. She wants a do-over but April yells at her that there is no time. There's also no time for her to take any notice of just how good-looking Matthew really is.

Alana is lecturing Owen about how long she had to wait in the ER as they walk down the hall, but is cut off when Richard recognizes her and calls her name. It turns out she was a student of his and he's happy to see her and figures she must be there for a job. His smile falters when he finds out she's actually the advisor, and she seems mighty uncomfortable around him as well. He wants to catch up but she claims she's too busy, and can't seem to get away from him fast enough.

By Lauren S

Our new interns have for some reason continued to hang out at their disgusting dumpster oasis and that's where Princess finds Smash, staring at his phone. She tells him that she's there to trade places with him but he's living in fear of the pregnancy hormones and refuses to give up Liver Duty. Princess is still bent out of shape that Derek doesn't want to work with her and she berates him and steals his phone, holding it out of reach like she is a bully stealing his lunch on the playground. She's then shocked when the phone actually rings.

Cristina, Alex and Arizona are in the OR, and Cristina gets really excited when she realizes that their patient might have some crazy rare condition that she's only ever read about before. Arizona is fidgeting with pain while Cristina and Alex talk, barely able to hear anything for the pain in her leg. Cristina is suddenly much more supportive of the program when she realizes that these kids are bringing new and fantastical diseases that she hadn't dreamed she'd ever really get to see in person. When it's time to send something for a biopsy, Arizona offers to take it to the lab and ducks out of the room as fast as possible, to Alex's confusion. Once she gets out the doors and out of sight, she leans on a gurney and gasps in pain, rubbing her leg.

Owen and Alana walk in to the break room where Arizona is sitting with her head in her hand, clearly upset. Alana zeroes in on the pastries and bagels and asks if they are in every room; Owen doesn't actually know if they are and sounds shocked that she'd be looking at things like that. Oh Owen, come ON. We've all read those Yahoo! articles about how we aren't supposed to get coffee at Starbucks every morning and this is totally the workplace equivalent of that. You aren't that clueless. I realize that Alana isn't there to be their friend but the woman has absolutely no sense of humor, either, and her stilted manner isn't helping Owen or anyone else feel comfortable. (Nor is it making them want to help her out, either.) When he introduces her to Arizona he realizes Arizona is upset and asks for a moment so Alana leaves. He immediately realizes that she's having phantom pain and tries to convince her that it's a very real problem and not just her being crazy, which is what she's beating herself up about. He's worried for her when he hears that it's getting worse, and he goes and pulls a mirror off of a cupboard door and brings it over to her. He sets it down so that she sees a reflection of her good leg, as if her other leg is still whole.

By Lauren S

She thinks he's nuts but he explains that they have to rewire the brain and remind it of what happened. He tells her there are different treatments but for each person it's personal -- one guy he knew in the army had to stab his prosthetic with a screwdriver. She finds this all insane but when he asks if the pain is better she realizes, shocked, that it actually is. He asks what Callie thinks and is disappointed when she admits that she hasn't told her what's going on, given that she is an orthopedic surgeon and could really help with this kind of thing. Arizona freaks out that she was just starting to feel like a wife again, rather than a patient, and that she can't go back to being a patient especially over something that isn't even real. Owen actually does understand, so he tells her that he will work with her to help her figure it out.

Now that Cristina realizes the African orphans might have all sorts of different cardiac conditions she'd never see otherwise in the US, she thinks they are the greatest thing since sliced bread and tells Meredith all about her new love. "They're exotically diseased, beautiful little train wrecks." She's on a high from the fancy surgery she just did, and is so excited that she doesn't notice that Mere looks barely able to hold her face together as she walks down the hall with a cooler. She's on her way to go pick up Brie's new liver, but she asks Bailey if she can get a different intern to go with her. Bailey is unimpressed that she's ready to give up on Smash already and reminds Mere that she often wanted to kill all of them when they were interns and that they actually pulled serious crap like cutting LVAD wires without getting dumped from the program. She just tells Mere she's got to suck it up.

Derek goes in to Jimmy's room and finds him and Carla exclaiming of a cookie the size of a pizza that someone sent him, but since he can't eat now he's just staring at the thing. I think the not eating beforehand really is one of the worst things about surgery and it's during those hours you also realize how every single commercial on TV is for some kind of food or food-related thing. Everything's all hunky dory giant cookie jokes until Carla realizes how serious Derek's face is, and he admits that the tumor has progressed. All of the risks -- little things like Jimmy possibly going deaf, half of his face basically melting, death, etc. -- are bigger now. Derek tells him to take time and think about what he wants to do but Jimmy says that he already waited months while Derek was recovering and he wants to try it. Carla can't handle it anymore, and she runs out of the room.

Meredith and Smash are in the OR, removing the liver for transport, and Mere is talking Smash through the steps to disconnect it. But as he makes a cut, blood begins to spurt everywhere and Mere starts to wail. The local doctors are watching from afar at the train wreck in front of them while Mere screams at Smash that he just cut the artery that was absolutely not supposed to be cut. The surgeon observing turns to his own intern and tells him never to do what Smash just did, while Mere whimpers and tries to save the liver. I get it, Smash is a screw-up and Mere is emotionally fragile... but to be fair, she said cut, and he cut and followed her instructions. He did screw up, but it wasn't like he did something totally out of the question, willy-nilly dicing up the organ while disregarding his boss just for fun.

Arizona heads up to the ICU to see her patient and finds Alex and Alana outside the room, discussing the surgery. Alana manages to act human enough to act if she is okay and Arizona apologizes for her having to see her upset like that. Alana just replies that she was having a moment, everyone has them and it just sucks when they are at work. I would have thought Alana would also have seen that Arizona had her scrubs rolled up in there and was clearly going through a pain issue to do with her amputated leg, but I guess she couldn't see past the pastries. Alex thanks Arizona for letting him finish up the surgery, and Alana rather pointedly says it was impressive for her to let a fellow do that. Arizona says that he's qualified, and Alana asks about their surgery the day since she'll be observing. Arizona immediately assures her that she'll be in charge and working with Cristina. Once Alana leaves, Alex asks what's going on but Arizona insists everything is fine. She tries to leave but Alex offers, kind of self-consciously, to do the surgery if she wants to sit it out. He's sincere, but she's taken aback by the suggestion. He continues that he's worried about the program since Cristina keeps making cracks, and so he wants to make sure everything goes perfectly for Alana. She refuses to even engage him on the subject and just tells him that she'll see him there in the morning.

Yet it's shown to be nighttime when the three of them gather in the OR and Arizona asks for a scalpel. As she reaches to make a cut, though, she yelps in pain and blood appears on the leg of her scrubs. Cristina and Alex stare at her impassively as she struggles and tries again, but she then slips in a puddle of her own blood, looks down, and finally tears off her scrubs to show grotesque open gashes in her leg. Cristina and Alex continue to just stare at her and the patient's stats start to drop, so she grabs a scalpel and starts cutting off her own leg at the thigh, screaming while looking up at them. Finally, she wakes up with a gasp from her nightmare.

The morning she wakes up sitting on the floor of the bathroom, with a long mirror propped up reflecting her still-whole leg like Owen did earlier. Because she totally just happened to have an extra 3-foot long mirror lying around that she could bring into the room without waking her sleeping wife, like we all do. Callie tries to open the door and join her for a shower but Arizona calls a quick excuse that she's running late, and they make plans to do a movie that night after work. Callie is obviously disappointed, while Arizona is relieved that Callie doesn't realize that she's working on her phantom pain.

Back at the hospital, Mere has the unhappy task of telling Heidi that there was a complication with the donor liver and it's no longer viable. She works to keep herself sounding realistic but positive and it's all going as well as possible if you ignore Smash hanging in the doorway like a wounded puppy. Mere assures Heidi that they'll keep Brie on life support and doing transfusions to buy her some time until they can hopefully get a new liver. Heidi pleads with them to make Brie okay again; as Bailey talks to her Mere finally bolts for the door like she can no longer stand to be trapped in the room.

Outside, she rests her head in her hands when Smash comes up and has the absolute gall to say, dejected, that he hopes she won't mention his massive screw-ups to Derek since Derek still thinks he's amazing. Mere orders him to shut right up and tells him he's not allowed to feel sorry for himself since he did destroy a good liver and that's all Mere can see now when she looks at him. His phone rings and Mere almost starts angry crying again when he looks to see who it is but finally he is able to interject that he thinks it's UNOS, so she grabs the phone and answers it herself.

Alana is in scrubs, studying the surgery board, when Richard walks up to greet her. She clearly has no interest in talking to him and is instead trying to figure out her schedule to observe surgeries that day. She is especially interested in Derek's surgery; Princess is nearby and overhears this so she manages to walk up to the board and wipe off part of the 8 so that it looks clumsily like the surgery is at 3:00 instead if you had no idea what actual handwritten numbers were supposed to look like. Princess smiles sweetly as she says that the surgery was pushed back and so Alana thanks her and adjusts her schedule accordingly. Richard excitedly thinks that maybe this gives them time for coffee but she shoots him down again and finally he makes the comment that he always expected to see her in the OR. She dryly replies, "One way or another, right?" It seems like he finds this position to be a step down from being an actual surgeon, and she is so self-conscious and prickly that I suspect deep down she agrees.

By Lauren S

Princess and Derek are in the OR, and he explains to her that there is a timer set to ding every 10 minutes and when that happens she's to drench Jimmy's brain tissue. Derek is also going to be periodically using a probe to stimulate Jimmy's facial muscles and so Princess' job will be to look at the screen and make sure he is twitching. As long as he's twitching, they haven't accidentally killed off his facial function. And with that, they are off and cutting.

Smash has a face of stone as he holds on to his cooler on the jet, and Bailey demands to know why they haven't taken off yet. A moment later, the question is answered when Mere pokes her head in the door and says that she can go after all. Bailey's doubtful, but Mere's face is all grim determination -- the first time she's looked anything but teary and insane all day -- and she takes her seat and tells Bailey she'll call when they have the liver ready. She buckles herself in and then grabs a hold of the seat, twitching and drumming her fingers nervously. Smash is obviously worried and keeps glancing at her, but he has finally learned when he should and shouldn't speak around Medusa and he keeps quiet. As the plane lifts off, Mere lets out a huge breath.

The plane successfully makes it to Portland and Mere makes sure that she's doing all of the actual surgery herself. The only thing she'll actually allow him to do is to hold the basin where she places the liver. As she does, though, he notices that there's a mass on there and she winds up even closer to waterworks as she moans that they have to have it biopsied.

While Arizona, Alex and Cristina work, Alana is up in the gallery quizzing Owen about the cost of the Africa program. He makes it sound pretty good but she has a comeback for his various points and isn't concerned at all about sounding remotely impressed. They are interrupted when Arizona gasps in pain and knocks a basin to the floor. Owen jumps up to the intercom and tells her to imagine a wave, while Alana demands to know what's going on, thinking Arizona is having a panic attack. They all ignore her and after Arizona admits that this is especially bad, Owen finally turns to Alana and sends her off to go watch Derek's surgery; she's shocked to find out that it began that morning as originally planned. Alex keeps offering to take over for Arizona but Cristina yells that no one can move because Arizona currently is holding something crucial and any movement would be catastrophic. Arizona tells Alex to shut up, she's at the beach. He has no idea what she's talking about and seems even more alarmed when it sounds like she's talking gibberish.

By Lauren S

Stephanie and Jackson are in an on-call room breathing heavy and getting set for a horizontal mambo when she whispers some medical gobbledygook into his ear. He actually finds it strangely sexy but it turns out she didn't know she said it out loud since her mind is full of all the info April has given her on her patients. She insists she's not too busy for some fun with the chiseled god in front of her but after a few more kisses, she realizes she is in fact too busy. She takes off, thanking him for understanding, but the look on his face says that there are certain parts of his anatomy as blue as his scrubs right now.

Bailey and Smash watch Mere while she talks on the phone, and try to figure out if it's good news. She's not crying, which is kind of a miracle, and turns out to be awesomely because they have another compatible liver waiting in Portland. She informs Smash he's flying to pick it up, and even Bailey seems to think that this might not be the best idea. But Meredith reminds them that she can't get on a plane, so they are going to let the docs in Portland harvest the organ and give it to Smash to carry back in his cooler. She maintains that if Smash has been to a picnic before, that means he should be able to be trusted to get the liver back in one piece. Bailey reminds her that they like to do the harvesting themselves, but Mere declares that she can't fly and walks off. Finally, with a sigh, Bailey tells Smash that she's going to Portland with him. I don't quite get why this is such a big deal for Bailey especially given Mere's history, but it makes things nice and tense while Smash freaks out about ruining something yet again.

By Lauren S

Bailey and Heidi both knew that the liver retrieval was supposed to be quick, so Heidi is panicking now that too much time has passed. Bailey tries to calm her down and finally, the phone rings. Happily, it's Meredith calling to say the liver is okay and they will be there in 50 minutes.

Despite having told her he wouldn't have time to teach her during the surgery, Derek is actually walking Princess through everything he's doing. So far, Jimmy's face keeps twitching on command, and the mood is cautiously optimistic until Alana bangs in, demanding to know the status of the surgery. Derek plays dumb and refuses to work with her which just makes her madder and she tells him pointedly that Princess gave her the wrong time. Princess plays innocent and calls it an intern mistake but Derek actually speaks up and defends her, saying that she was following his orders not to allow visitors. He and Alana snap at each other a bit more until Derek yells that anyone not surgically necessary isn't welcome in the OR. She's completely unimpressed by his attitude, but she does turn and stomp out.

By Lauren S

Arizona is gently trying to adjust her leg and pleads that she has to switch out but Cristina absolutely won't allow it since she's holding the little girl's heart valve in place. Finally, with no other options, Arizona tells Alex to stab her in the foot with a scalpel. Alex doesn't even know what to think but definitely doesn't think she's serious until Owen jumps on the OR and orders him to do so. Of course Alana walks back in as this is going on but Owen manages to ignore her. Alex seems doubtful but finally takes the blade and drives it into Arizona's shoe, so that it goes straight through to her prosthetic foot. Owen cringes as Alex does it, but when Arizona looks down and sees the instrument sticking out of her foot, she finally starts to breathe deeply and it appears the pain begins to subside.

Things are not going so well in Derek's ER; he tries the probe again, but this time there is no movement in Jimmy's face. Princess asks what it means, as if this complication was not already explained multiple times to the patient and to her, so Derek can answer dramatically that they may have lost Jimmy the ability to move half his face and they won't know for sure until he wakes up.

Meredith and Smash bring the cooler into the OR, and Mere sees that the baby has been delivered and is being wheeled away in an incubator. She tears up again and Smash panics, thinking something is going wrong, but it turns out that she also cries when she's happy. She's not so happy that she doesn't threaten him to keep his eyes on the liver, though, rather than on her teary face.

Stephanie looks a little bit like a zombie at the ER desk when April walks up and begins to quiz her about patients and beds. Stephanie is able to nail everything, though, and April smiles and congratulates her on a job well done. Cute Paramedic Matthew is walking by and, seeing April actually smiling and not maniacally shooting instructions at her intern, he pauses. She still has not picked up on anything at all so she's shocked when he admits he's been watching her for two days and wonders if she'd ever like to have a cup of coffee with him. He immediately stutters when she just kind of gapes at him and apologizes for sounding creepy -- at the desk, Stephanie works hard but ultimately fails to hide her amusement at the awkward exchange in front of her. Finally, though, April breaks into a grin. So... I guess that means she says yes?

By Lauren S

Alex and Cristina are in with their young patient, whose heart is now ticking as it's supposed to. The woman thanks them, and Cristina can't help herself and practically salivates as she asks sweetly what other potential patients the woman might have with obscure cardiac maladies. Alex jumps in and cuts her off, telling the woman that they are simply happy the program is up and running again.

Derek and Princess go to visit Jimmy as he wakes up and find Carla amid the crumbs of the giant cookie, which she ate out of nerves. As she yells at her brother for worrying her, he winces, and the docs notice happily that the wince covers both sides of his face. Derek checks him out while Carla shrieks in joy, and then she grabs him in a hug and kisses his totally working face while the doctors grin at the scene.

Alana then calls a meeting with all of the docs and surprisingly begins by telling them sincerely how impressed she is by what she saw over the past three days. She begins to talk about the Africa program when Cristina jumps out of her seat and yells that she can't cut the program because it's so full of interesting surgeries that she wants. Cristina manages to catch herself and unconvincingly say that the orphans really need the help so that it doesn't sound all about her; Alana assures them that the program is great PR for the hospital and she would never cut it. But she does have one suggestion that she's sure will shock everyone though it makes a lot of sense in the long run, cutting costs while having only a nominal effect on the core hospital and the staff. No one is prepared for what she actually suggests, though, which is to shut down the ER.

Everyone in the room gasps; Owen argues that they are a Level 1 trauma center and Richard points out that they are a hospital, implying that a hospital with no ER is just insanity. She argues that the ER is not bringing in any money and that most of the patients who came in were underinsured and had ailments that could have been handled by a primary care doctor. She also points out that having surgical interns staff the place is a complete waste of their skills. She then also reminds everyone that overall she's working to try and keep the hospital itself open. Derek speaks up and dismisses the idea as ridiculous but Bailey interrupts him to ask if he has a better idea. Rather harshly she points out that Alana is trying to keep the hospital open and keep all of them employed, which seems important since most of them don't have millions of dollars to fall back on. Derek's face turns to stone, while everyone else looks shocked, crash victims and other docs alike, that she would really go there. Bailey says that unless anyone has a better idea, they should probably hear Alana out. Jackson gives her an impressed smile, while everyone else just sort of silently gapes at what just happened.

By Lauren S

After the meeting, Richard trails after Alana to the elevator and tries to sound casual as he suggests that she might have judged things a little bit harshly, and maybe with his years of experience there they could work together to try and figure out some solutions. She just tells him that being a harsh judge is necessary for her job, and then adds that she knows he's disappointed in her but it's not his job to judge her anymore, either. All of their interactions have been a little bit strange and I am curious what the history is and if we're actually going to get to find out one during of these episodes. She reminds him of something he said during her intern year, which is that medicine is constantly changing and they need to be a part of that change or get out. She's there to make changes, and thinks he should be proud. As she gets on the elevator she adds, almost as an afterthought, that Richard logged the fewest OR hours of any surgeon the past month. "Good night!"

To be fair, that is because his WIFE JUST DIED, but it seems that giving details to Alana such as that, or the fact that Arizona is still learning how to manage with a new prosthetic leg, isn't a big concern to anyone. I totally think that if they are back at work they should then be ready to get back to work, but I also think that these details help put particular events and choices into a much more meaningful context.

By Lauren S

Arizona is already in bed while Callie gets ready to join her and rants about Alana's proposed changes. She adds that it should have been a good day, too, because Derek was able to do a 23-hour surgery with his fancy fixed hand. Arizona tells her that they should go to sleep, but Callie is too angry to do it yet. So instead, Arizona asks if she wants to go to the beach with her. Callie is so confused she laughs as she asks what on earth Arizona means. Mere tells us that the body can be stubborn about accepting change; it likes to hold out hope that it will be whole again.

Actual Meredith is pretty livid at Bailey for calling Derek out in the meeting but Derek for once is the more understanding one, reminding Mere that Bailey is nervous, just like everyone else. Mere argues that it isn't their fault, but Derek concedes that right now it feels like it is. And that truly sucks -- they really have wound up in a completely horrible position because they really are victims, but now they look like the causes of the downfall of the hospital, too, which isn't fair to them. She decides to change her focus to the good that happened that day, which is that Derek got his hand back. She then tells him proudly that she flew on a plane; he's shocked, and she still seems kind of freaked out by it, but she's also proud of herself.

She VOs that the body will fight until it can understand its new reality, accept what is gone, and move on. We see Callie and Arizona sitting in lounge chairs on a fake beach (I suspect this might even be Izzie and Dead Denny's fake beach), sipping margaritas. Awesomely, we see that in this daydream Arizona has her prosthetic, though it's propped up against the chair while they relax and enjoy the waves. In their bedroom, holding hands with their eyes closed, Callie happily says that this really kind of works. I feel all warm and fuzzy that Arizona has finally accepted her new self and that she and Callie are finally back on track.

Lauren S is a writer who lives and works in Atlanta and loves virtual margaritas on a virtual beach almost as much as she likes the real thing. She wants everyone to know: "The views expressed in my recaps and anything else I might write on TWoP are my own and do not necessarily reflect the views of my employer."