- Seattle Grace Hospital is hit with a crisis like no other in its history.
- Meredith started the night by talking about how a hospital, for most people, is a scary place where bad things happen. But for her and the doctors, the hospital is a sanctuary. Cristina and Callie, meanwhile, started the episode crying over their breakups and Meredith took a pregnancy test that was positive. Meredith's voiceover said she loves it at the hospital -- then, after passing by Mr. Clark (the man who's been distraught over his wife's death at Seattle Grace and is suing the hospital), she corrected herself and said she "loved it here."
Meredith told Cristina she wasn't trying to get pregnant, but was happy nonetheless. Cristina told Meredith that she was over the Owen-Teddy thing. Mr. Clark was looking for Derek.
Arizona got a little girl who needed an appendectomy. Teddy was mad at Hunt and told him she wanted a little bit of peace. Bailey and Charles were treating a young woman (played by Mandy Moore) who wanted her follow-up surgery so she could get rid of her colostomy bag.
Hunt and Teddy were treating a man who'd been in a car accident and was then shot by the guy in the other car. His wife was distraught and Hunt gave her a moment to say goodbye to her husband before surgery, just in case it was the last time she'd see him. Cristina and Hunt had a little run-in before Hunt took off for surgery. Teddy asked Cristina to cover her post-ops.
Mr. Clark continued looking for Derek and when he'd been blown off by a few different doctors he found Reed and asked her where Derek's office was. She told him she wasn't a tour guide and he pulled out a gun and shot her in the head. Alex came around the corner to see what happened and Mr. Clark shot him in the chest.
Alex dragged himself, bleeding and unseen by anyone, into an elevator. No one else was aware of anything having happened. Meredith talked to Derek and told him she had some stuff to tell him over dinner that night. She went to run Sloan's post-ops. She then told Derek to look forward to a lot of "dirty sex" that night.
Hunt asked Cristina to scrub in on his surgery with Teddy but she refused. Hunt went after her. Christina asked Hunt if he loved her or Teddy and he hesitated, so she said she was done. Dr. Kepner was in a storage closet when she slipped on the pool of blood from Reed's gunshot. She went to Derek in a panic and eventually was able to tell him Reed had been shot and was dead.
Mr. Clark and Cristina were in an elevator together and he asked where Derek's office was. She gave him fairly precise and polite directions (obviously not knowing he had a gun) and he thanked her. He got off the elevator and told her to "have a nice day."
"You, too," she said.
Alex was losing blood and struggling to breathe, but no one had found him. Derek scrambled to figure out the protocol for locking down the hospital. In a restaurant nearby, Webber was having breakfast when he saw a bunch of police cars speed by. Arizona got word of the lockdown and sealed the pediatrics floor. It just so happened that Callie was there too and couldn't leave.
Derek went into Hunt and Teddy's surgery and pulled Avery aside to tell him about the shooter. He told him not to say anything about the shooter until the patient was stable and that no one could leave. Christina and Meredith were stuck in a quiet hallway when the lockdown happened. Meredith decided to tell Derek right away about the pregnancy. Then Cristina told her about her breakup.
Sloan was getting flirty with Lexie when a nurse saw Mr. Clark going up a flight of stairs. She shouted to him that he couldn't leave the area and he turned around and shot her, setting off a frenzy on the floor. Sloan grabbed Lexie and took her toward an elevator for safety and when the doors opened they saw Alex laying motionless and bloody.
Webber got to the hospital and a cop told him what happened but wouldn't let him inside. Sloan and Lexie took Alex into a meeting room and started working on him.
Christina and Meredith walked around the empty wing of the hospital talking about the baby situation. Derek found them and told them about the shooter. He locked them in a room and told them not to move.
Bailey was trying to tell her patient about the "situation" in the hospital when Charles burst into the room and said the shooter was on their floor. Bailey told Charles to hide and told her patient to play dead and covered completely with a blanket. Mr. Clark walked into the room, found Charles hiding, and asked if he was a surgeon. When Charles said he was a surgeon, Mr. Clark shot him. Then he saw the patient laying on the bed and pulled down the blanket. When he realized he was looking at a dead woman he got very upset. He then dragged Bailey out from under her patient's bed and asked her at gunpoint if she was a surgeon. Bailey, shaken, said she was a nurse and Mr. Clark said he was sorry for the trouble. He reloaded his gun and walked out of the room.
Sloan and Lexie kept working on Alex, who was screaming in pain. and Lexie had to shut him up so Mr. Clark wouldn't hear them.
Callie and Arizona were arguing about their breakup when her appendicitis patient began screaming in pain. Bailey was trying to treat Charles' gunshot and she talked Mary, her patient, through the steps to help her.
When Hunt's surgery was done, Avery told them they couldn't leave and Hunt was angry with Avery for not having said anything earlier. Hunt had to get his patient to the ICU so he decided to take the man by himself and Teddy came along. Meredith was on the verge of throwing up in the room where she was locked with Cristina when Cristina saw Mr. Clark out of the small window. She realized he was the shooter and he was looking for Derek. Meredith puked.
Mr. Clark found Derek on the bridge and Derek told him to get somewhere safe because of the situation in the hospital. He didn't want Mr. Clark to get hurt. Mr. Clark told Derek he was already hurt. "You hurt me when you decided to kill my wife," he said, raising his gun and pointing it at Derek.
Sloan realized Alex needed a transfusion and Lexie said she'd go get the blood. She told Alex not to die. Cristina and Meredith went looking for Derek and across the atrium they saw Mr. Clark pointing his gun at Derek. Mr. Clark was telling Derek he was "a man," and he wasn't a man when he let Derek decide his wife should die. "I wasn't a man then, but I'm a man now," he said.
Bailey was working on Charles and he asked her to be honest with him about whether or not he was dying. She lied and said no.
Mr. Clark told Derek that someone had to protect people from him and told him he didn't get to play God. Derek began telling Mr. Clark about how he understood his loss because he watched robbers kill his father for his watch. He said he didn't become a doctor so he could be a god but so that he could save lives. Derek asked Mr. Clark to look him in the eye and he poured his heart out to him, telling him he was a human being and made mistakes. He was flawed. Derek told Mr. Clark that he could see in his eyes he was a good man.
"Can you see it in mine?" Derek asked.
Mr. Clark lowered his gun, but Dr. Kepner came running up behind Derek and when Derek turned to look at her, Mr. Clark raised his gun again. In a slow-motion sequence, Mr. Clark pulled the trigger and hit Derek in the chest, Dr. Kepner panicked, and Meredith screamed.
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