In the wake of the shooting at Seattle Grace-Mercy West, the doctors find themselves in a frenzy: Christina and Owen will be getting married, and others are trying to deal with the recent blood bath. Derek is arrested for speeding!

Meredith finally tells Derek about her pregnancy and miscarriage; during a surgery, Cristina experiences PTSD; Bailey won't let Alex operate until he has the bullet in his chest removed.

Issues surface when Derek's estranged sister, Amelia (Caterina Scorsone), visits unexpectedly; Meredith and Derek continue to try to ease Cristina back into surgery.

Everyone pulls together to help Callie and baby Sofia on their painstaking journeys to recovery in hopes of allowing mother and baby to finally meet; the sudden death of a clinical trial patient has Derek proceeding with more caution while Meredith makes a calculated and risky move; Alex treats a cranky old rich woman dying of cancer and gets an idea for a grandiose endeavor that is sure to get him the Chief Resident spot; and Teddy is pleasantly surprised by the return of a familiar face.

As Callie and Arizona's wedding approaches, the couple quickly realize that the day they've been looking forward to is not turning out the way they'd envisioned. Meanwhile Alex continues to make the other residents jealous as he appears to be the top contender for Chief Resident, Meredith and Derek make a decision that will change their lives forever, and Dr. Perkins presents Teddy with a very tempting proposition.

Personal and work pressures are adding up and have Meredith visibly on edge, Owen conducts formal interviews for the Chief Resident position, Cristina grows increasingly defiant, Alex and Lucy's undefined relationship gets tested, and Jackson suddenly backs out of the Webber's diabetes trial.

News of Meredith's dishonesty in the clinical trial comes to light, leading to unanticipated consequences for her and others; Cristina finds herself in a compromising situation, which forces her to decide between her career and her relationship; Owen posts his decision for Chief Resident, and Teddy makes a surprising choice regarding her love life -- and her future.