A old case from Ducky's past seems to be returned when similar murder happens. Ducky has always had quite special way of dealing with dead people but this time it is even more out of the usual. That scene when the girl wakes up and tells him to give closer to her family. It's probably how Ducky sees his dead bodies on morgue.
But also.. the way they met the murderer so early on the episode and she looked so sweet and innocent and you would expect anyone else but not her. That was quite a shock.. as McGee had stunning expression when he realized. Poor him..