If you came here looking for an uplifting hour... this is not your episode. We pick up just a few moments after where we left off last week -- Teddy has gotten Henry to the hospital bed and a CT reveals some big horrible tumor in his lung. Teddy gets called into an emergency surgery herself on another patient so she can't be there at Henry's side through everything. She instead has to operate on a woman Callie just released from the hospital after a spine fusion -- she collapses, and they can't figure out what's wrong until, in surgery, they find a screw from her spine that has come loose and ripped up part of her heart. Callie is completely freaked out and only admits to Bailey the depth of why she is so scared, which is that she let Jackson do the surgery himself while she read a magazine. Judging by the other attendings this seems to be the standard, but regardless she knows she could be held responsible. But as of the close of the episode, it's not clear if the woman is going to survive or not.
Richard does discuss Henry's treatment with Teddy and he wants to open him up to pull out the lung, take out the tumor, and put the rest of the healthy lung back in. Teddy thinks this is far too invasive and wants him to use a laser, but he's never done the procedure with a laser and is adamant that his first go at it not be on his colleague's wife. Teddy knows that Cristina can do it since she just did an identical surgery, but Owen (and Bailey and Richard) all argue that it's too much to put on her shoulders. Teddy thinks that they can just cover Henry's face and not tell Cristina his name and that she won't figure out who it is, and her ability to just be a surgical machine will then work to everyone's advantage. Owen finally reluctantly agrees, and away they go. Unfortunately, as the surgery goes on things start to go wrong and they have to open up his chest anyway; once inside they find that the tumor has eaten through his pulmonary artery and there is no hope for him. Despite Richard's best efforts to keep his heart pumping, he dies on the table. Cristina finally realizes that everyone is acting a little bit strangely and Owen, who has come in to see how things are going, calls her into the scrub room and tells her that it was Henry. We don't hear her reaction because she's on the other side of the window, but basically -- it's horrible and she completely melts down to learn that her mentor's husband just died on her watch. Owen's heartbreaking duties aren't over because he has to tell Teddy, but Teddy is wrist-deep in her own patient and is the only one who can really finish the job. Richard convinces Owen that whether he likes it or not, he has to keep the news about Henry from her long enough for her to finish the surgery so that they don't have another patient die on the table in front of them. He's still pretty tortured but the fact that all are wearing surgical masks helps, and he manages to smile and nod along with Teddy's conversation well enough that she truly thinks Henry is hanging out in recovery somewhere, and the episode ends before we see him finally tell her the awful news.
The day isn't going much better for Derek and Meredith, though at least they are both alive (for now). Meredith gets a call from Janet saying that the court cancelled the hearing and that the way it happens basically means that they are not going to give Zola to them. She actually tells Meredith it's time to move on, so this doesn't really leave a ton of room for misinterpretation. She's heartbroken and when she talks to Derek about it, declares that she doesn't want another baby. She's then called away with Alex to go pick up a newborn that was born unexpectedly in a facility not at all set up for all of the complications she appears to have. When they go to take her away in her incubator they run into her mom, who is predictably distressed. The doctor insists that she can't go along since she just had surgery herself and it would be too much, so Meredith goes to her and promises that she will take care of her baby. Naturally, this means that something is going to go wrong, and that something is that their ambulance breaks down at night (of course), in the pouring rain (of course), on a curvy mountain road with no shoulder, just around a bend so no driver will see them until it's too late (of COURSE). Oh, and the ambulance is filled with oxygen tanks so if they DO get hit, it will blow sky-high. The driver runs to go get help and they manage to call Arizona, who is doing a surgery with Derek and Mark, to tell her what happened. While she has them on speaker phone, they hear a loud noise and then the phone goes dead. What we see is that they get hit by a car and roll over. Alex and Mere seem to be okay (though she has a nasty gash on her forehead) but she decides that they have to get out with the baby. When they finally open the doors and go outside, they see that the road is now littered with bodies and an overturned truck that that is on fire, and we are left with some cliffhangers for at least the next few weeks.
We, as a people, tend to say we had a terrible day when we get in a fight with our boss or have the flu, but nothing truly terrible has actually happened. So starts Meredith's voiceover as we see Henry having what could actually be classified as a terrible day (well, night): coughing up large quantities of blood into a bucket while Teddy (her shirt covered in his blood) frets and Bailey and Owen try to figure out what is wrong. Teddy tells them that Henry hasn't had a new tumor since June, and since Webber did that full workup Bailey has him paged to come help out. Owen decides they have to put in a central line so Teddy automatically grabs the kit and starts to open it. Owen goes to her and gently tells her that they've got it, and she nods and tries to hold back her tears, feeling helpless and hating it.
It's obviously going to be One Of Those Nights in the ER. Arizona gets a call that a child is coming who had his face half ripped off by a dog so she goes to get ready for that but then gets a phone call and she asks whoever it is, "Where?"
Mere, Cristina and Alex are still at the bar (this episode picking up approximately ten minutes or so after the last one left off) having a good time that seems sure to be cut short if the tone of the first couple of scenes is anything to go by. Alex walks back to their table and they mock him for being rejected by a girl, but Alex (preferring to look like an ass rather than a loser) admits that he got rejected because it turns out he had actually hooked up with her before and she didn't take it so well that he didn't remember that. Hey, at least his taste is consistent. The girls mock him and he defends that this is George's fault, because talking about dead people throws him off of his game. Meredith's phone rings and she sees that it's Janet, so she runs off to take it, asking Cristina to cover the tab. Alex gets a page and has to go so he tries to get Cristina to spot him some dough but she makes him pay, adding that since Meredith is on the phone with a social worker, he can find $20 to cover her bill.
Callie is in the process of discharging a patient and reminds the woman that since they just put a bunch of screws in her back, she'll need to take it easy with her little boy. The woman is flinching with each move and Callie wants to keep her there another day, but she insists she has to go home to be with her son. Is it normal to discharge someone when they are still in this much pain? Something about it seems to warrant more than just Callie mildly suggesting she hang around. But they're interrupted when the woman's husband and son come in to see her and Callie doesn't push it. Instead, she kneels down and tells the little boy that he has to be very gentle with his mommy the next few days. She then reminds the woman to call her if she has any problems and she and her husband thank Callie; all of them are cheerful but the woman is clearly trying to cover up some pain and surely this isn't going to end well.