begins with Meredith (Ellen Pompeo
) standing in her house of candles that she made for McDreamy. She is ready to begin her fairytale life with Derek, her "happily ever after," but she voiceovers that happily ever after doesn't happen. We cut to her rushing to the hospital where Derek is dying on an operating table after being hit by a bus. She screams and cries, but suddenly, we find out that it was all just a dream. Real-life Meredith jumps up from a nap in the on-call room, as her voiceover curses the person who invented "happily ever after." She rushes to a computer where Bailey, Derek, Hahn and the residents are all hovering. The national rankings for teaching hospitals is about to be released, and everyone is on edge to find out where Seattle Grace landed this year. Everyone is shocked and saddened to learn that they fell down to number 12 in the rankings, behind Cleveland Clinic of all places.
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It is an unseasonably cold autumn in Seattle this year, and freak snow storm is causing havoc in the streets. There are car accidents all over the city, but unfortunately, Mercy West is now the only level one trauma center in Seattle, so Mercy West is getting all of their bloody trauma victims.
Hahn (Brooke Smith
) spends the episode trying to improve her teaching skills, and avoiding all contact, eye or otherwise, with Callie (Sara Ramirez
Meredith tells Cristina (Sandra Oh
) about her Derek dying dream, which is a dream that she's been having many times since the season finale. She's going to ask Derek to move in with her, but Cristina, distracted with the fact that she is now the top resident at a second-rate hospital, tells Meredith to stop talking about Derek. Lexie (Chyler Leigh
) overhears the conversation and figures out that Meredith slept with George. Lexie is hugely disappointed because she is in love with George. (Of course, George being George, he's blissfully unaware of Lexie's feelings, even as she makes eyes at him while helping him study for his second try at the intern exam.)
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(Image courtesy of ABC)