Alana is still going on about OR turnover time and hopes to see them cut in half; with that goal set she dismisses everyone. As they walk off, Cristina bitches that closing the ER is going to help with turnover time as they will no longer have any patients. When asked she reports that Owen isn't doing anything about the ER closing until it actually happens but Alex is sure that a trauma surgeon with no ER has no point and wants to know if he's leaving and if Cristina will go with him. He's not grown a heart, rest assured, but he claims he is depending on Cristina's rent check. This from the same guy who had to be strong-armed into having a roommate. Mere declares that the ER won't close because Derek spent the night with April... devising a plan.
The two are completely manic both from what they deem their brilliant plan and probably also from sleep deprivation -- they figured out how to cut a little bit from each department's budget and the savings should be enough to keep the ER open. April thinks Cardio is going to be mad that they have to miss the TED conference. Derek agrees, but he's confident they can get this to work. He's surprised they don't have any responses to their email until he sees that April sent it out with the totally even-toned and not at all panic-inducing subject line "PROPOSED BUDGET CUTS." He's aghast and realizes they'll have to pitch their idea in person instead, but concedes that is probably a better idea anyway. They both then realize that their breath could wilt flowers and run off to clean themselves up.
Richard, Bailey and Mere are in the skills lab with a number of other surgeons, all sitting in front of naked rubber Ken-doll-esque torsos. Alana is standing at the front of the room and introduces Dr. Darryl Nessbaum who is there to standardize the way they repair hernias. Bailey applauds him and whoops, and at Mere and Richard's looks she explains that all of Alana's other "fixed" hospitals cut 30% of their staff so she's not above ass-kissing to keep hers. Mere figures she's safe because they can't fire a pregnant lady. Alana gets a page and leaves them to Dr. Darryl who asks with far too much enthusiasm, "Are you reading to rock some hernias?" Bailey lets out a "WOO!" like she's at the Super Bowl and they just fixed a power outage.
Callie, Arizona and Alex are all staring through the window at their patient -- a sullen-looking 13-year-old named Simmi who is listening to her headphones. Arizona and Alex think she's the devil incarnate, but Callie tells them to cut her a break, because she's just angry and scared after a double hip replacement. She then reminds them, merely for the sake of the viewing audience, that Simmi had surgery three days before and she needs to get up and moving immediately or she's at risk for blood clots and an overall crappy recovery. Of course she and Arizona begin squabbling again over the best way to make her do this, and Arizona petulantly asks Callie to show them the Bad Cop Way. Callie thinks a moment and then takes advantage of their seniority by ordering Alex to go in and do it for them.