It's the final year of residency, but the Chief still warns them not to kill anyone. Meanwhile, Meredith is fired for what occurred during the Alzheimer's trial. Meanwhile, Susannah and Danny, a married couple, are suddenly caught up in a gigantic sinkhole that opens up below their car. Susannah's leg is trapped under the car, and Owen and Callie are on the scene. They talk Danny through amputating his own wife's leg. But Danny can't finish, so Owen has to climb down into the hole to help.
Meanwhile Alex is at the sinkhole and tends to a boy who has been buried alive. Meanwhile Jackson has decided that he wants to go into plastic surgery, which upsets Mark.
The adoption counselor has found out about Meredith and Derek's breakup, even though Meredith tried to keep it quiet. The counselor has also found out that Meredith doesn't have a job anymore. Derek is understandably frustrated.
Cristina hasn't gotten the abortion yet, but Meredith reminds her how bad it was to be an unwanted child. She will resent her child just as Meredith's mom resented her. Meanwhile, Teddy is happy with all the time she's been spending with Henry, and she offers to teach Cristina.
Bailey nearly performs surgery on the wrong patient, but Lexie catches the mistake just in time. Bailey thinks that the surgery team needs a Gunther, something to force them to work together.
Meredith fears losing Zola permanently, but the counselor doesn't want to discuss their options until Derek gets out of surgery. Meredith offers to get him, but instead she grabs Zola and hurries off.