After last season's gunman rampage, a lot of the staff at Seattle Grace is shaken up. Dr. Perkins is brought in to help with the recovery since many physicians are still mentally distraught. He assesses whether or not each doctor is ready to return to work.
Dr. Bailey has a flashback to the day of the incident. She flees the city with her son to stay with her parents for a month. Meredith is seen getting Derek from jail, where he was put in for reckless endangerment. But, the police do not end up charging him because "they worship him". Derek steps down as the chief of staff and gives the position back to Dr. Weber.
In another flashback, Lexie is trying to help a patient, but she loses it and goes crazy, due to PTSD coupled with sleep deprivation. She turns to Alex for help but he walks away from her, but Mark is there to console her. Because of this breakdown, Mark had to commit Lexie to the psych ward.
Cristina keeps herself occupied with planning her and Owen's wedding. Meredith thinks that Cristina maybe rushing things and that it is a sign she is not ready to head back into the operating room. Dr. Bailey is still affected by the incident and she breaks up with Ben, because she feels that she is too much of a mess for him, who was golfing during the shooting and has not suffered the same PTSD as most of the other doctors.
All of the doctors have been given the okay to perform surgery, except Meredith, who sees Dr. Perkins and Teddie kissing. Dr. Perkins could tell that Meredith was holding something back and he was right. She still hasn't told Derek about the miscarriage because she doesn't want to stress him out more than necessary. Later, Derek is pulled over for speeding and taken to jail, but this time Meredith refuses to bail him out. Because of this, he misses Cristina and Owen's wedding.