Alana gets to work immediately implementing changes to streamline the hospital's processes and increase efficiency. Most of what she does is to make things more uniform, like standardizing the supplies in all of the ORs, but some of the things are a little more out there -- like installing cameras in all of the CCU rooms so that a remote doctor can presumably help with cases. Cristina winds up with a doctor named Bob "helping" her and Leah, and she butts heads with him and refuses to listen to his suggestions about preferred medications. They then wind up with a teenage patient who was in a horrible accident, but he's a Jehovah's Witness which means they can't give him any blood whatsoever. Leah had no idea that there was an actual law in place that forces doctors to obey these wishes, but Cristina knows and does all she can to try and help the kid sans blood even though he lost about half of his own in the accident. She does make a plea to the family to allow the blood but they stick to their guns, and Leah gets up in arms about their decision to the point where she goes into the kid's room and tries to sneak him some through his IV drip. Unfortunately for her, she forgot about Bob, who catches her in time and busts her with Cristina. Unfortunately for the patient, he winds up dying and Leah is left struggling with her inability to understand or respect the family's choices, and her confusion that Cristina was so calmly able to handle it.
Another streamlining measure is to start standardizing certain surgeries; today the lesson for the general surgeons is regarding hernia repair and Alana brings in a guy to teach his method which has been deemed the best. Bailey is still all for playing along with these changes since the alternative is watching the hospital close, but Richard is adamant that his personal method is better and he's going to just go ahead and stick with it, thankyouverymuch. He finally gets in a fight with the guy about it and Richard accuses him of trying to turn the hospital into an assembly line. Unfortunately, as the guy is yelling back, trying to defend himself, he slips and actually yells that the patients don't matter -- this gives all of the surgeons who witnessed the outburst some pause.
Alana doesn't hear this because she wound up helping Owen with a surgery on account of she was standing to a patient when his carotid artery blew and was the one to patch it up with her own hand. As she's a trained surgeon she knows the best chance of the guy surviving is to not try and switch her out for another person so she winds up helping out with the whole surgery. While they work she admits to Owen that she's used to being the villain because everyone needs someone to blame when faced with all of this change, but that she's saved a bunch of hospitals already and while no one thanks her, she at least knows she helped them. After the surgery she goes with Owen to talk to the patient's family and is profusely thanked and hugged for saving his life, and seems to have a moment where she turns back into a person and remembers that some of being a surgeon can be awesome and actually getting thanked for your job is kind of a wonderful feeling.
Callie, Arizona and Alex are working together on a 13-year-old who had to have a double hip replacement and whose elite gymnastics career is over as a result. The girl is a monster to all of them; she thinks her life is over now and refuses to get out of bed. Alex is the first one to try and talk her out, but she manages to chase him off and leave him depressed about life in general. Callie and Arizona have been fighting all day about how Callie always winds up playing Bad Cop to Arizona's Good Cop when they have to deal with an issue with Sofia. This of course comes into play with their patient, and Callie tries her Bad Cop routine on the girl only to have the girl basically send her into a black hole of depression about the futility of life. Arizona mocks them both and finally goes in to play Good Cop. When that doesn't work, she pulls up her pant leg, shows the girl her prosthetic, and points out that she actually does know what she's going through. But even that doesn't work, so she finally goes full-on Livid Scary Cop and orders the girl out of bed in a raging fury. The girl is so stunned -- almost like someone threw her into a shower fully clothed -- that she finally gets up and actually looks happy when she can start taking baby steps.
April and Derek come up with a plan to ask all of the different departments to cut their budgets a little bit and if it all works, they should have enough money to keep the ER open. When Derek gets called into surgery, April has to do the pitches herself and ends up with everyone hating her and no one agreeing to the plan but Derek goes back to everyone afterward and she gets a lesson in how to finesse people; they are able to get everyone to agree to the cuts and triumphantly find Owen and Alana and declare that now the ER can stay open. Alana's surgical high is quickly wiped out as she tells them that they have misunderstood and no amount of budget cuts will reopen the ER because they are going to be selling the hospital and she's basically there to spruce things up and make it attractive for potential buyers. Apparently buyers don't want ERs in their hospitals these days.
Grey's at first appears to have cut their own budget as it looks like home video as Cristina and Mere stand in an empty hospital room and stare straight up at the camera. But no, it turns out that we are seeing the vantage point from a camera that was installed in the room, and Cristina reports that they have been put all over the CCU. Both of their fears are that they will be installed elsewhere, including on-call rooms. After a moment contemplating this sexy horror, Cristina muses about what evil could be behind the camera; a very cheerful male voice says hello and calls Cristina by name. Mere realizes that Big Brother can read Cristina's nametag.
Alana gathers the attendings in the OR and there, she claims that the cameras aren't meant to spy but rather they are staffed by a remote physician who can help out the doctors. Everyone looks highly skeptical as she says that an extra set of eyes will help reduce mistakes. We tune Alana out for Mere's VO about all of those horrible buzzwords: streamline, optimize, integrate, adapt. Mere wonders if all of the tools that are supposed to make one's life easier actually help. Personally, I hate those buzzwords (and the term "buzzword") so much that it makes me not want to do any of those things. Alana's voice comes back as she sums up how everything she's talking about will ultimately help reduce "costly litigation." Read: "Dear God, this hospital can't afford another lawsuit." She's had the ORs all rearranged so that the supplies in each one are in uniform locations; her goal is to reduce the time it takes to change over from one surgery to another. Callie and Arizona run in late and are bickering about Arizona taking too long to get Sofia ready. She was talking Sofia into putting on her tights by herself while Callie thinks she should have just done it and gotten out the door to get to work and daycare on time. She's also angry that she always gets painted as the bad cop. Just then, Alana tells the room that every second counts and you need the most efficient approach, which Callie thinks supports her method of just pulling tights onto a toddler.
The interns, minus Heather who is off filming a new pilot, are hanging around outside the door trying to hear what is going on. Princess watches through the window and then reports that they are talking about new hospital procedures and OMG they weren't invited and this means they are totally getting fired. And of course, her tone of voice says she is taking this utterly personally. I should create a drinking game based on the number of times per episode that I have the active thought that she sucks, but then I'd wind up so incapacitated you'd just get pages of gibberish until I passed out and the drool shorted out my keyboard. The others think she's nuts but she pulls open overflowing drawers in a nearby supply cabinet and says that this is evidence that the nurses are stockpiling supplies and the end is nigh.
Alana is still going on about OR turnover time and hopes to see them cut in half; with that goal set she dismisses everyone. As they walk off, Cristina bitches that closing the ER is going to help with turnover time as they will no longer have any patients. When asked she reports that Owen isn't doing anything about the ER closing until it actually happens but Alex is sure that a trauma surgeon with no ER has no point and wants to know if he's leaving and if Cristina will go with him. He's not grown a heart, rest assured, but he claims he is depending on Cristina's rent check. This from the same guy who had to be strong-armed into having a roommate. Mere declares that the ER won't close because Derek spent the night with April... devising a plan.
The two are completely manic both from what they deem their brilliant plan and probably also from sleep deprivation -- they figured out how to cut a little bit from each department's budget and the savings should be enough to keep the ER open. April thinks Cardio is going to be mad that they have to miss the TED conference. Derek agrees, but he's confident they can get this to work. He's surprised they don't have any responses to their email until he sees that April sent it out with the totally even-toned and not at all panic-inducing subject line "PROPOSED BUDGET CUTS." He's aghast and realizes they'll have to pitch their idea in person instead, but concedes that is probably a better idea anyway. They both then realize that their breath could wilt flowers and run off to clean themselves up.
Richard, Bailey and Mere are in the skills lab with a number of other surgeons, all sitting in front of naked rubber Ken-doll-esque torsos. Alana is standing at the front of the room and introduces Dr. Darryl Nessbaum who is there to standardize the way they repair hernias. Bailey applauds him and whoops, and at Mere and Richard's looks she explains that all of Alana's other "fixed" hospitals cut 30% of their staff so she's not above ass-kissing to keep hers. Mere figures she's safe because they can't fire a pregnant lady. Alana gets a page and leaves them to Dr. Darryl who asks with far too much enthusiasm, "Are you reading to rock some hernias?" Bailey lets out a "WOO!" like she's at the Super Bowl and they just fixed a power outage.
Callie, Arizona and Alex are all staring through the window at their patient -- a sullen-looking 13-year-old named Simmi who is listening to her headphones. Arizona and Alex think she's the devil incarnate, but Callie tells them to cut her a break, because she's just angry and scared after a double hip replacement. She then reminds them, merely for the sake of the viewing audience, that Simmi had surgery three days before and she needs to get up and moving immediately or she's at risk for blood clots and an overall crappy recovery. Of course she and Arizona begin squabbling again over the best way to make her do this, and Arizona petulantly asks Callie to show them the Bad Cop Way. Callie thinks a moment and then takes advantage of their seniority by ordering Alex to go in and do it for them.
Alana seeks out Owen when she hears that he turned away the contractors who had arrived to measure the ER. What, are they turning it into a game room? Is there really no hope that the hospital could recover financially and it would be open again one day? This, I suppose, is why I write recaps about a fictional hospital and don't run a real one -- the finances are beyond me. Owen just tells her he doesn't want workmen in the way while they are still treating patients and he doesn't give a rat's ass about her tight schedule. As he talks he gowns up and heads for the elevator and she follows him on to continue their conversation, though she seems a little nervous in there. Owen reminds her that in the Army, the guys on the front line save the most lives because they are closest to the patients at the moment of injury and therefore have the best chance to fix it; in this case the ER is on their front line. Alana finally asks where they are going and when she hears that they are meeting a medevac, she begins to stutter and tries to get herself excused. But it's too late, and the doors open and immediately the paramedics push in a gurney with a logger who got into an unfortunate tousle with a chainsaw -- he's got deep cuts all over and pretty much no nose left. While Alana tries to stay calm she notices that blood is starting to seep through a bandage on his neck and then after a moment, his carotid artery blows open all over her. She reaches out and plugs it, assuring Owen she's got it. "I was closest." How poetic.
Alana keeps her fingers in the guy's artery all the way to the OR and Owen tells her that as soon as they find another surgeon they will switch her out. But being a trained surgeon herself -- a point that's very easy to forget with her current position -- she tells Owen she's got it and points out that with injuries such as this it's better to just have one person plugging the neck with a finger as it lowers the chance of the victim stroking out. Owen seems to have doubts about her being there but knows she's right, so he orders the staff to get a gown on her.
Derek and April are wriggling like puppies as they walk down the hall planning their presentation. Unfortunately, April is a numbers geek so that's all she wants to talk about. Derek realizes this is not the right approach and they decide that she'll be Vanna White to his Pat Sajak and will hold up the charts when he needs them. Just as they finalize this plan, though, he gets a page to go consult on Chainsaw Logger, so he tells April she'll have to start without him. She's under no illusions and reminds him desperately that no one likes her, but Derek orders her to forget the numbers and talk from the heart, confident she can do it. Or at least, he says that to her in hopes that she believes it.
Dr. Darryl finishes up a video on something called The Varner Technique and proudly tells them it took him years to develop this. Wouldn't it be called the Dr. Darryl technique, then? If this thought has crossed his mind it's not bothering him as he excitedly drones on about the mighty hernia. But Richard isn't on board and raises his hand, telling Dr. D nicely that this is all well and good, but he's developed his own technique and he's going to go ahead and keep using that. Dr. D has just a mildly patronizing tone as he says that they all need to use the new method so that they are, "Quick. Clean. Efficient." Bailey turns around and mocks Richard for being an old dog who can't learn new tricks. Dr. D then announces that they will run a competition -- first one to 20 perfect hernia repairs wins a Seattle Grace Mercy West hoodie. Mere can't help but make some fun but Bailey is in it to win it, sure that what they are actually winning is job security. She then declares, "Tributes, may the odds be ever in your favor." She's been doing some quality reading on her nights when Ben is in California; I applaud her great taste.
Alex goes in to talk to Simmi and from the moment mocks his trying to get her to take her earbuds out you can tell she's even surlier than the average teen. He tells her she has to get out of bed and if she doesn't her hips won't heal right, but she haughtily declares she doesn't care. When he has the nerve to tell her that her life isn't over at 13, she snarls her life story to him: she was an elite gymnast whose mom worked double shifts to support her training, and the year before she came in first at the Future Stars Nationals. She was basically all lined up to go to the Rio Olympics. Her hips started hurting and she trained through it which, given where she is now, seems to have made whatever it was worse. Now, she declares, she has nothing to live for. When Alex insists this isn't the case, she gets even nastier with him and finally tells him he might understand her feelings if he had ever been the best at something. She's pretty much getting off on her righteous anger and finally says that all she has left to do is to wait to die. Defeated, Alex finally trudges out of the room.
Leah is on Cristina's service and she walks out of a patient's room to report that the Big Brother Doctor is arguing with her about what medicine to give a patient and it's gotten so bad it's freaking the patient out. Cristina thinks about this a minute and then walks in to an empty room, looks at the camera, and commands, "Open the pod bay doors, HAL." I would have only liked that more if she'd called the camera "Mother." It turns out that Big Brother Doctor is actually named Bob, and when Cristina tells him to be a silent observer and not argue with her choices, he cites some trial results at her. She mocks him for having time to read off in his cozy pod or wherever he actually lives and then starts to argue about the very same trial, which she's actually familiar with. But she's cut off when Leah reports they have a trauma on the way in. Cristina turns back to Bob and orders, "Just make sure my idiot interns don't screw up."
April's first victim is Dr. Jeff in cardio, but since he already got her email with it's scary, all-caps subject line he has no interest in hearing it. She falls back on what she's comfortable with and tries to cite figures to him but he cuts her off to talk about how amazing the TED conference is. He figures that hearing speakers talk about innovation is much more useful in trying to keep the hospital open than scrimping and saving from the overall budget; he then leaves the room while she's still struggling for coherent words.
Back in the OR, Owen asks Alana to take a look at something in the guy's neck and after she does, it's like she broke the seal and found some of her surgical mojo again -- we know this because she hums while she works. She and Owen talk about how exciting surgery is and he finally asks the million dollar question: why did she stop in the first place? She's saved from answering when Derek comes in, and he recoils just a bit when he sees her there and makes a snide comment about how she's now just going ahead and doing their jobs. Owen is feeling more generous and insists she saved the guy's life, but Alana tries to brush it off. Derek tells her that this dude is lucky he cut himself in the neck with his chainsaw today and not tomorrow, when the ER would be closed and he'd just be dead already. Now, way to make a point, but also... they'd just go to a different hospital/ER with him. I don't believe for a second this is all there is in Seattle first because it's crazy, and second because I think the city wouldn't have let them shut down literally the only emergency room around. But we get it, Derek hates her and thinks he's better than her.
Cristina and Leah's patient is a 19-year-old who was slaloming on his skateboard with a buddy when he got run over by a car. And look, I'm not wishing death on people, but I have often thought there are few stupider pastimes than that, and this is EXACTLY WHY. His buddy follows them in so they learn the kid's name is Rich, but don't have any other info. Cristina calls for supplies including blood and then when it takes a few moments, pointedly yells at someone about the blood again. As they are about to hook him up, though, a medical ID tag falls to the ground and Leah exclaims, horrified, and shows it to Cristina. Cristina quickly yells at everyone to stop and explains that he's a Jehovah's Witness, so they can't give him any blood. Just in case we missed what a big deal this is, the camera lovingly lingers on the two bags they were about to use.
As they rush the kid to the ER Cristina explains how they are going to try a bloodless surgery, which involves recirculating his blood and lots of some fancy-sounding saline solution. Leah is indignant that Cristina would consider something so crazy and then scoffs when Cristina says that if they use blood, they could be arrested for assault and battery. Unfortunately, Cristina's being totally serious and says that there are protocols in place for people who won't or can't take blood. She reminds Leah that they do bloodless surgeries all the time but Leah snaps back that they don't do it for really major cardiac procedures. She doesn't seem too worried about the breaking the law part and still seems incredulous that they really aren't going to use any blood.
Callie and Arizona walk back to pediatrics and are shocked to see Alex at the computer and Simmi still sulking in bed. He warns them that she is so dark she turned him into a suicide risk; Callie thinks he's being ridiculous and decides to go in and force her. She and Arizona argue AGAIN about her approach and then this dissolves back into an argument about Sofia and her tights. Alex finally tells them he's going to go lie down.
When Cristina gets Rich into the OR she shouts instructions and demands various supplies, but when she finally gets the scalpel in her hand, she decides that cutting will cause him to lose too much blood. She decides on another way to do the repair and then orders everyone to reconfigure the ER for that as fast as possible.
Back in the skills lab, Bailey is still trash talking while Richard is swearing as he fumbles with the new procedure. Dr. D couldn't be more patronizing if he patted the two of them on the head while assuring them that they will get it, and a whopping twelve other hospitals in the country have already started using this standardized approach and a few more might be considering it. With stats like those, who needs an individual, thought-out approach? He compliments Mere on a job well done but when he checks Bailey's work he tells her she's not quite there and she should look to Meredith's awesome job. Meredith gives Bailey a smug smile and continues her work while Bailey pouts.
Leah comes out from the OR to update the family, but first she runs into Unnamed Friend and reports that Rich is touch-and-go, and they are taking him back to the CCU. Are you really allowed to tell non-family even that much? Well, Leah has already shown that she's not actually that familiar with protocol and it's not that damning of an update, so we'll let it slide. Unnamed Friend (IMDB tells me his name is Brock, but damned if they ever actually said it on-camera) (also: Brock? His role is not nearly soapy enough for a splendid moniker like that) gestures to a huge group that is praying and tells Leah that is Rich's family. He then voices his concern that in all of their time working at the skate shop and flirting with death on their skateboards, Rich never once mentioned that he was a Jehovah's Witness. He asks Leah, if she believed in something so hard she would die for it, wouldn't she tell her friends? Leah manages to pack a lot of defiance into a couple of words when she agrees that she would. Brock decides he can't take waiting there anymore and gives Leah his number so that she can call him with an update, conveniently leaving her as the only doubting Thomas in the hospital.
Meanwhile, Alana is really starting to get into her surgery and when she comes up with a solution to fix the artery, Owen has her do it. Jackson and Stephanie come in so that he can get to work on what's left of the guy's nose, but his headlamp isn't where it usually is and this starts him on a sarcastic tirade against Alana and her methods since now he's just actually wasted time trying to find something. As he rants that it feels like they are working in a fast-food restaurant, Alana is starting to look uncomfortable behind her surgical mask and finally Stephanie notices that she is there. Both she and Owen keep trying to gently get Jackson to stop, but he rants about Alana's lack of OR experience, saying he can tell she hasn't been in one in years. Finally, she speaks up: "Until today." As Owen glares at him, Jackson catches himself and tells them brightly that he can repair the nose post-op, so he'll just be on his way. He and Stephanie then flee the OR, and Owen apologizes to her. She takes it fairly well in stride and says that people need a bad guy when things like this happen and she's used to it being her. And while he's upset about the ER and the docs are upset about everything, this is how the hospital will survive and in her heart, she'll know she's the one who saved it. She does sound like she's fishing for a kind word, though, when she tells him she's saved a dozen hospitals before this one and no one thanked her then, either. Boo hoo.
Leah is still in a fury over the blood ban on Rich, because he's not doing well at all. When Cristina calmly tells her that they have to respect his wishes, she has a fit because of what Brock said; Cristina snaps back that buddies don't usually talk about their religion at the skate park. Leah just asks how he can know what he believes at age 19, saying she was a completely different person at 19. She also is someone who has clearly never been religious in any way -- I get why she's upset, and it would be so hard as a doctor to do this, but she still needs to back off about the kid's faith. She's so worked up that she actually cops attitude with Cristina, horrified that she's fine with it. Cristina tells her that it doesn't matter what they think since his alert was clear, and it's not for them to have an opinion. But she does tell Leah they will try to talk to the family, and Bob wishes them luck from above as they leave.
It's Callie's turn to try and get Simmi out of bed, and she just orders the girl to do it. But the girl out-sasses her and declares that she doesn't give Callie permission to touch her, and she'll scream. Callie decides to try another approach -- the "Fine, do it, see if I care when your hip rots and you can't walk again" approach. Simmi is not impressed and finally sneers at Callie as she talks about how much it would suck for her if she did all she could to fix Simmi, training hard to be a surgeon, doing the operation perfectly, and then it didn't help anyway. Dramatic piano starts up so we know that she's getting to Callie as she gripes that it doesn't matter how hard someone tries, or how much they want something, because everything is out of their control. Once she has Callie good and defeated, she gloats.
Bailey has finally gotten the hang of the hernia repairs; Dr. D compliments her on a job well done and then blathers on about how much he loves hernias and executing things perfectly. Bailey is gloating when Mere takes a deep breath and pulls off her gloves, and quickly she realizes that something is wrong. Mere tries to play it off but she's obviously upset, and she runs out. Bailey, totally serious now, follows her into the hall where she finds Mere pacing, holding her stomach, and theorizing that she got too happy and complacent and now the universe is smacking her down again. Just when we think she's gone, Dark and Twisty Meredith rises up from the deep and rears her head. Bailey makes her stop and explain what's going on, but when Mere says it's a flutter, Bailey puts her hand on Mere's stomach. Gently, she tells her what's going on is actually a really, really good thing -- the baby is kicking. They both break out in grins.
Cristina explains to Rich's parents that he's lost at least half of his blood volume, and his mom breaks down in scared tears at the news. But even though she and Rich's dad are heartbroken and terrified, they are very firm in their beliefs and maintain that he not be given more blood. They explain that they believe life is a gift from God, and you don't try to sustain it by taking in blood. Cristina tells them, gently but bluntly, that Rich is in critical condition and that without blood, his organs will shut down and that will basically be the end. As his surgeon, she implores them to give him a chance. But they are adamant and his mom says that they have seen miracles through prayer before, and if it's God's will that he live... Leah finally freaks out and starts yelling at them, but Cristina shuts her up quickly. Rich's dad doesn't get mad, because he knows that they are doing all they can, but explains that giving him blood would condemn him and he knows that it would be better for Rich to die without it than live with it. Cristina tells them that they understand and will do everything they can to keep the boy alive. Leah glares at them for a while, but finally turns and follows Cristina.
When April comes back to Derek with a report on her presentations, she admits she was basically yelled at by everyone and totally failed. Derek pretty quickly realizes that she did actually go into the numbers with everyone, and says that he'll try and fix what she did. He then sees one doc from dermatology and runs after him, making conversation about their kids in daycare. He talks about how Zola is at the age where she tries to swallow magnets, LEGOs, and any other choking hazard she can find, so this is what that doc has to look forward to soon. He then comments happily that it's a relief that there is an ER just downstairs in case anything ever happens. The other doc agrees and then stops and asks, hang on a second, isn't that closing? With that, Derek smoothly works into his suggestions about what they might cut to save the ER. April follows behind them, hopefully soaking up some of the personable magic.
Leah's hair is suddenly much curlier than it was before as she takes notes and Cristina taps at a computer and glares at her. Mere comes over and Cristina gripes that she hates Leah's mopey face and thinks it's ridiculous because they never moped when they were interns. The cold in Minnesota must have frozen the part of her brain that contains those memories; Mere looks confused because she's still clearly got them. She then excitedly reports that the baby kicked, and then the two of them take off to go get some snacks. When they are gone, Leah goes all shifty as she picks up a bag of saline, goes into Rich's room, and dramatically pulls the curtain. Aaaaaaah, so her curly hair is SCHEMING curly hair -- she reaches into her coat where she has hidden a blood bag, and switches it out for the saline. She then reaches over and starts to set it up in his IV but Bob's voice rings out from above and warns her to stop immediately.
When we rejoin them Cristina is hollering at Leah, and her hair is defeated and only mildly wavy again. Leah isn't actually very sorry, though, and she just mocks the family for praying. Cristina is livid, telling her that she's barely a doctor yet and knows nothing; she's also never to give a patient anything without Cristina's orders. Leah STILL doesn't back down, saying she wanted Rich to have a chance. Which is nice and all, and Cristina understands that she is passionate, but she still has to follow orders. And, you know, laws. She then dismisses Leah from her service and Leah finally apologizes as she walks out. Cristina then turns to Bob and asks if he's going to get her fired but Bob says that Leah didn't actually do anything, so there is nothing to tell. Cristina concedes that Leah was right that Rich is circling the drain -- seriously, if that fight that just took place over his body didn't wake him then he's in a really bad state.
Owen and Alana have reached the moment of truth but when they let go, the sutures have held and Chainsaw Logger's carotid is back in business. She's relieved and kind of overjoyed, grinning as she experiences the high of a successful surgery. She then sees the time and tries to leave, worried that she lost a whole day. But Owen tells her she has to stay and finish so that then she can go along and tell the family he'll survive and actually have someone say thank you. She ponders this and then agrees, smiling as she asks for a scalpel to keep working.
The interns, still minus Heather, head out to the garbage oasis with Princess still yelling that they are all going to get fired. Stephanie tries to get her to stop and reminds them of the obvious point -- that if these changes don't work the hospital will close and then yes, none of them will have jobs any more. Leah then gets a page that Rich is coding, so she runs back inside. Stephanie starts to work up a head of inspirational steam as she cheers that they are the future and of course Alana will realize that! Just as she raises the others' hopes, though, they hear a dry chuckle come from around the corner and Callie steps out holding a cup of coffee. She's been affected by the Simmi Curse and says that they can work hard, but the future is out of their control. She then pours out her coffee and crushes the cup before dropping it to the ground in desperation. With that, the wind is completely taken out of all of the interns' sails.
Derek seeks out Dr. Jeff, but leaves April behind for this negotiation. Jeff tries to shut him down immediately but Derek persists and doesn't bend to Jeff's argument that going to TED is about the networking, not just the talks. Finally, when Derek won't let up, Jeff says coolly that he might be more receptive to the idea if Derek gives up his parking space. This only confuses Derek, since their spots are to each other, but Jeff wants the space in addition to his own so Derek will stop dinging his doors. He wants to spread out over both spaces and then presumably dance around in glee in all of the open, door-free space on either side of his car. Derek crosses his arms and then asks pointedly, "How's your sister, Jeff?" Jeff asks if he's really, truly going there, but underneath it all he is amused. Apparently Derek clipped his sister's aneurysm, so Jeff said if there was anything he could ever do, name it. Both are smiling at each other as a result of this ridiculously awesome manipulating. Jeff finally gives up, but tells Derek that he still wants his parking space. I now want the Derek/Jeff buddy comedy spinoff.
Bailey is knocking out hernia repairs left and right and sings that Richard should go ahead and swallow his poison berries now because she is the girl on FIRE. I'd like to see Bailey in the Hunger Games. I think she'd kick some serious ass. Richard then calls over Dr. D to check his work and he's at first impressed and then put out because Richard didn't use his method. Richard cheerfully says that he wanted Dr. D to see his method and how well it could work, and Dr. D has to try and control his temper as he tries to smile and remind Richard that this method won't be used there anymore. I would think as long as they have material to do sutures it wouldn't make a difference -- if Richard's method works for him, it actually uses fewer supplies than the other. Richard also gets pretty ticked off as he mocks this new mindset, which just turns the hospital into an assembly line. Dr. D thinks all patients deserve the same standard of care but Richard demands to know what standard that is if the doctors are just trying to shuffle them in and out as fast as possible. Bailey looks uncomfortable, like she wants Richard to save himself and stop making a scene, but as Richard goes on Dr. D finally loses his cool and screams, "You're missing the point; the patients don't matter!" He pretty immediately tries to smile and backtrack but by now all of the surgeons are staring at him and Bailey is glaring skeptically. She doesn't even gloat when he tells Richard he should follow her lead.
Leah gets to the door of Rich's his room and watches as Cristina and a team repeatedly shock him and do compressions. Cristina is grasping for other ideas but sad music starts to play which tells us this is the end for the poor kid. He is also completely grey, which is another good indicator that it's all over. Cristina finally calls time of death. After everyone files out Leah says that he didn't have to die, he just needed his family to allow him some blood, but Cristina points out that patients who get blood die all the time too, so they don't know for sure how he would have turned out. She plans to give Leah a very long lecture about how horribly wrong her actions were, but she says sadly that first she has to go notify his family. She then looks up at the camera and tells Bob that the show is over, he can change the channel.
Arizona goes back up to pediatrics and is disgusted when she finds out that Callie also failed to get Simmi out of bed, though she does gloat a little that the Bad Cop routine didn't work. She then walks in and gently but firmly tells the girl she has to get up, and she knows it's hard but she knows she wants it. When Simmi spits that Arizona knows nothing, Arizona leans down and rolls up her pant leg to show off her prosthetic. She tells Simmi about how she lost her leg less than a year earlier and thought it was over, but now she's doing everything she used to do including operating on this good-for-nothing wretch. Simmi smarms that they sent the cripple in to talk to her, oh boy. That's the last straw for Arizona, so she finally decides it's time to out-Bad-Cop Callie. She lowers the bed and get things ready as she yells that Simmi can be scared and angry but she's not allowed to be an asshole and bring everyone around her down. She's to treat people with kindness and respect, and she's to start with herself. She then says that she's counting to three. Simmi looks so bewildered that on the count of three, she actually moves to try and stand up. Arizona is shocked and immediately grabs her to help her up while Callie and Alex rush in with a walker and tons of encouragement. Simmi actually looks pleased as she takes a few steps and they cheer her on.
In the ICU, Owen tells Chainsaw Logger's family that he's going to live, and they have Alana to thank. A woman who I presume is his wife screams with joy and grabs Alana in a huge hug as she cries and thanks her, and Alana grins back at Owen, her heart having grown three sizes that day.
Bailey is wearing her newly-won hoodie when she and Richard get on the elevator to go home. Dr. D then rushes to catch it and it takes him a moment before he realizes who else is in there. He tries to make small talk but they ignore him, so finally he says he knows change is rough but one day they'll get used to it. He then compliments Bailey on her sweatshirt but she just informs him that it's itchy, and the two doctors walk off. Dr. D watches them in surprise, as if he had no idea that they could really withstand the magic of hernias.
Alana is walking down the hall with Owen, talking about how she'd forgotten about the amazing rush of a successful surgery, and he half-jokes that she could do it again the day if they had an ER. On cue, April and Derek run up and declare that they came up with a plan to save the ER and hand over a binder for her to review. But with that, her heart shrinks three sizes back down and she apologizes that they misunderstood -- nothing is going to save the ER or the hospital. Derek is the first to get it and he says that she's getting them ready to sell. The other two, especially Owen, are shocked, but Alana admits it and says that she is there to make it "presentable" for the possible buyers. Owen says that she's staging it like she's selling a house and she agrees, saying the ER is the shag carpet that has to go. I still don't understand this at all, but I'm sure we'll learn more about it in the coming weeks. Does that mean they'll close after all? As they all stare at her, she apologizes, thanks Owen for a good day, and walks off.
Later, Owen walks through the OR and sadly and slowly turns off all of the lights before walking outside. As the doors close, we see a sign in the window telling people that the ER is closed and giving them the address of where they should go instead. Mere VO's that to be efficient you have to eliminate what doesn't work while holding on to the things that matter the most. Cristina is waiting outside for him and asks what he is going to do. He has no idea past that he's going to drink a whole lot that night. She smiles sadly and offers to buy the first round. With that, they walk off arm in arm.
At the McMansion, Derek and Mere are sitting in bed and he has his hand on her stomach; they both grin and exclaim excitedly when he feels a tiny kick.
Lauren S is a writer who lives and works in Atlanta and wishes she had two parking spots to herself. 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."