Jackson then sits with April in an empty exam room as she tries to get a hold of herself and admits she's not sure why this particular patient death is hitting her so hard, but we all know, and I'm sure Jackson knows, that it's tearing her up that something that seems meant to be has been so cruelly destroyed. She tries to pull herself together so that she can tell Vince, knowing it's not fair if she's upset when she does. But she breaks down in sobs and leans against Jackson, who puts his arm around her shoulder and holds her for a long time. She finally pulls her heads back, and her eyes start darting between his eyes and his lips. But just as she starts to lean forward a bit, Alex comes in to try and get an update on Elyse and the two are snapped apart. Jackson tells him and April starts crying again as she tries to say she can do the notification. Alex offers that "Chest Pecwell's" name is still on the file, so shall he make him do it? Both April and Jackson jump at that, and when Alex leaves they seem to realize that they were just kind of saved from themselves.
Mere is helping Cristina pack Paul's body in ice in the CCU while they muse about what could be wrong with Parker. Mere still respects Casey's instincts but since it seems to fit strep and he tested positive... she thinks that's what it has to be. Owen then runs in, all atwitter because Cristina didn't wake him when Paul coded. She points out that this is her patient, so why would she? Especially since I don't think she's realized that Owen has been watching out for Ethan all day and night. Owen is freaked out about the therapeutic hypothermia that Cristina is implementing and despite Cristina's calm explanation of how it could help, he throws out all of the things that could go wrong. It's obvious that he's overreacting because of Ethan, because every surgery in the history of medicine has risks. Owen asks if Jeff agreed with the treatment but Cristina just points out that she didn't ask him since this is her patient. Fed up, Owen storms out while Mere giggles that she thinks Owen is going to tell Cristina's teacher. I do seriously think that this is leading to another showdown about wanting children, sooner than later.
Oh ew, we get the sound of a bone saw as Smash opens up a chunk of Rachel's skull. Derek compliments his work, and Smash manages somehow to suck up even just in the way he says thanks. But then Derek calls Heather over to take Smash's place and help out with the surgery. Derek loves her quick hands (thankfully not a euphemism), and is too excited to notice that Smash's head is about to explode.