As we all saw in the billion promos, the Very Special Event of the season is that one ambulance crashes into another in the bay. The good news is, this V.S.E. is done so much better than last season's that there's no comparison. No doctors nearly dying is a good thing. The bad news is that all four of the paramedics involved are in bad shape. One ambulance flipped over, pinning both of its occupants -- Ray and Stan -- inside. Stan is clearly going to die when they move the vehicle, so they wait to do so until Meredith can get his wife, an x-ray technician, over to say goodbye. After that, the firefighters start to move it until Stan starts yelling for them to stop, since he can now see that Ray has an oxygen tank (or oxygen something else metal) embedded in his back, and if they move him, they'll kill him. Richard tells Stan he's a hero, but sadly, he doesn't hear it, because he's dead. Richard and Meredith realize that they need to work on Ray inside the vehicle, hanging upside down, and skinny Meredith can fit in there, so she needs to crawl over Stan's body to help him, and that's where we leave off on that story for the week. The patient that they were bringing in is a guy who has gotten a chest infection after major heart surgery, and needs his sternum removed. Things go from bad to worse with him when a piece of shrapnel from the accident pierces his leg. Callie, Izzie, and Cristina are all working on him, Izzie and Cristina fighting for face time with Hahn. They don't end up working together for long, however, because Bailey requests Cristina's help. The male paramedic in the other ambulance, Shane, clearly has internal injuries, but doesn't want a female, black, or (worst of all) female black doctor working on him. Bailey grabs Cristina to help her out, so Cristina is the first one who gets to see the giant swastika tattooed on Shane's abdomen, even though he's still mad that Cristina's not a white male. Bailey decides that she's a better person than Shane is, so she gets George to talk him into signing his consent form, and slices straight through the tattoo to begin his surgery, and announces that no one is ever to call her "the Nazi" again. As if this wasn't bad enough, because of the surgery, Bailey's going to miss lunch with her husband. He's mad that she's never home, and this was where they were going to talk it out, so you know this is going to get ugly and awful, because no relationships on this show can be functional. The cause of the accident is that the fourth paramedic, Mary, had a seizure while driving into the ambulance bay and lost control. It turns out that she's got a brain tumor, so Derek goes in with a scope, after a long explanation about how the computer will help guide the scope through her brain to fix everything. He gets in some good flirting with Rose throughout the day leading up to the surgery, so it's a bummer for her when the very computer showing him the way through Mary's brain crashes and she can't control-alt-delete it back to life for him. He's left standing with a scope in Mary's brain waiting for a technician. Also a bummer is that Meredith thinks she's ready to tell Derek not to see other people, but chickens out of doing it first thing that morning, so of course this is going to get sticky. Meanwhile, in the other OR, Alex is working with Sloane on the sternum removal. He's got a special guest watching in the gallery -- Ava, who showed up to surprise him and got him to break the rules so that she could see him work. It's bad timing, since that morning Alex was making out with Lexie and acting like they might maybe sorta be a couple. Lexie ends up talking to Ava, who tells her that she is seeing Alex, so Lexie heads back, dejected, to her patient. That would be Seth Green, who has spent the day hitting on Lexie. Just when he's laughing, realizing that she's suddenly single and maybe he has a chance, an artery in his neck bursts, covering Lexie with blood. So in summary -- it's a seriously, seriously no good, very bad day for everyone.