Owen stresses teamwork and moves his leadership role over to the baseball field when he signs the doctors up for a baseball league, pitting them against their biggest competition, Seattle Presbyterian; Lexie tries to hide her jealous rage when she sees Mark with a new woman, but her emotions get the better of her; Alex fights to keep Zola at Seattle Grace after it is suggested that she be moved to another hospital due to a conflict of interest with Meredith and Derek; and Richard scolds Meredith and Bailey for their feud

A severe car crash involving an entire family results in an all-hands-on situation in the ER, as the eldest daughter is left to make the toughest decision of her life. Meanwhile Teddy, still in the dark about Henry's death, calls upon Cristina to help with her patient in the O.R., and Lexie finds herself working alongside Mark's new girlfriend, Julia, during an eye surgery.

Richard performs a monumental surgery in his career; Derek and Lexie attempt to work miracles for a patient with an inoperable tumor

The residents agonize over their oral boards, reliving every answer they gave during their exams; Arizona's close childhood friend comes to Seattle Grace for medical help; the doctors work on a patient who is missing one third of his skull; and Julia asks Mark to start a family with her. Meanwhile Catherine tells Richard that one of his residents has failed.

In this flashback episode, return to the site of the plane crash and watch as each doctor tries to cope with the heartache and injuries caused by the crash. Meanwhile, back at Seattle Grace, everyone struggles to find a bit of normalcy amidst the chaos.