Competition heats up as several of the doctors fight to become the new face of Seattle Grace; April brings in an emergency case, and Jackson and Alex work with a transgender teen couple. Meanwhile, the hospital implements new policies which test the patience of the staff.
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The doctors of Seattle Grace are faced with the aftermath of last season's plane crash. As they try to move on with their lives, they must learn to adapt to the changes, cope with their losses and move forward with their relationships and careers.
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The residents determine their future as they make their final decisions regarding post residency positions; Mark admits to Derek that he is torn between his love for Lexie and the fact that Julia can give him everything he's ever wanted; Ben plans something extra special for Bailey, but she is preoccupied with her work; and Arizona encourages her childhood friend, Nick, to have surgery. Meanwhile a couple on their third honeymoon come to the hospital complaining of mysterious symptoms.
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A lion breaks loose in Seattle, leaving a couple's lives and relationship at risk; Lexie overhears Mark's discussion about moving in with Julia; Teddy begins to take steps towards coming to terms with Henry's death; Callie grills Arizona on her past lovers; and Alex requests to be taken off Morgan's preemie case when she becomes too dependent on him. Meanwhile, Meredith tries to be a support for Cristina as the tension between her and Owen hits a boiling point.
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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.
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The doctors of Seattle Grace are called upon to man up when a stampede at a comic book convention causes an influx of colorful characters in the OR-blurring the lines of fantasy and reality; Mark shows his softer side with baby Sofia when Arizona and Callie go out of town, but at work he continues to give Jackson a hard time; Ben returns to the OR, only to find that Nurse Eli has moved in on Bailey; and the male doctors bond over their frustrations with women.
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In the first hour of the two-hour season six finale, Meredith receives life-changing news just as Seattle Grace Hospital is hit with a crisis like no other in its history.
This is the first hour of a 2-hour season finale. Two episode entries have been created. The 10pm EST marker will mark to beginning of the second episode.