After the cliffhanger ending of last season's finale, it's a bit of a surprise that this season begins at the hospital, three months or so after the accident. It comes to light at some point that they were in the forest for almost a week before being found, though there are no specifics about their experience out there. The episode takes a while to reveal just what happened to everyone, but the biggest news is that Mark is on life support and has been on it for 30 days. According to his living will, when 30 days are up (which will be at five that evening) they are to unhook him from the machines and let him go.

Meredith and Derek are still in Seattle, working at the hospital. He decides that today is the day he's finally going to operate again; he's been medically cleared for weeks but not able to bring himself to do it. He gets to the OR and is greeted by a ton of the staff giving him a round of applause and Callie makes him announce, "It's a beautiful day to save lives," which he does rather reluctantly. Halfway through the surgery he drops a tool and after a momentary pause, flees and has Callie finish up alone. Afterward, he admits in a fury that his hand went numb. As if that wasn't crappy enough, it's then time to go turn off Mark's ventilator. Callie seems to be holding up fairly well but refuses to talk about Arizona and we're left wondering if Arizona is even alive when a new pediatric attending is hired. At one point, Callie dissolves into sobs in a supply closet but no one has yet actually said Arizona is dead, and both Joe R and I decided we'd believe it only when the words were spoken.

There's a new batch of interns whose names I refuse to memorize until I know they are going to stay for a while, and they are all terrified of one particular attending… Meredith, or "Medusa," as they have christened her. Mere has taken over Bailey's old role of the gruff, no-nonsense, terrifying teacher while Bailey has become the butt of jokes and has a new nickname of her own: "BCB," or "Booty Call Bailey," since Ben has been sneaking up for 12 hour visits when he can and they spend most of their time together giggling in on-call rooms.

Alex has been putting off Hopkins and has been using the time in Seattle to try and sleep with every one of the female interns before he leaves. When he meets the new peds intern he's immediately up in arms when the guy announces that he's sending Alex's African orphan program down to be continued at UCLA since he isn't interested in it himself.

Cristina is the only one who actually went to her new job and she's freezing her ass off at the Mayo in Minnesota. She and Meredith spend all of their free time FaceTiming on their iPads and we learn that Cristina hasn't been able to get herself back on an airplane to come back to Seattle even on this day when Mark is going to die. She is happy to just do her work and be a perfect surgeon but it turns out that all of the surgeons there work as a team, with no egos or superstars, and her boss notices that this isn't really in Cristina's wheelhouse. He orders her to take a few days off to mellow out and obviously knows nothing about her if he thinks that will work. Jackson is handling all of the duties of the Plastics Posse but he still goes in and updates Mark a few times a day on all of "their" cases and has conversations as if Mark is there giving him advice.

Finally, Avery tells Mark quietly that he knows he has things covered and that he will carry on the Posse's work. He goes and waits outside of the room as Richard walks Callie and Derek through the steps and then takes Mark off of life support. Mere eventually joins Avery, Bailey, Ben, and Richard and they all wait for the inevitable until Mere can no longer stand it and she takes off for the airport to go visit Cristina.

At the airport she runs into Alex who didn't even bother to say goodbye and from their argument we learn he's suffering from a whole heap of survivor's guilt. They each leave to go to their respective planes and we see Owen run up and just barely catch a flight as well. Once Mere's plane is pulling away from the gate, however, she can't go through with it and she gets up and demands in a blind panic to be let off. She goes to the airport bar and does shots while FaceTiming with Cristina and then Alex walks up and admits that he couldn't get on his plane either, and he apologizes for being an ass. He also wants to stay in Seattle so that the new peds attending doesn't totally screw everything up. While it was assumed that Owen was running to catch a plane to go see his estranged wife, it turns out he flew to see April on her parents' farm. He apologizes for not being a good teacher to her and for firing her, and begs her to come back to work again.

Throughout the hour there have been various "home videos" of Mark being a great best friend to both Derek and Callie and a great dad to Sofia and a loving member of the Sloan-Torres-Robbins nontraditional family, so that when his heart finally does stop it's all the more tragic. The question still remains, though -- what became of Arizona? We finally learn that she is still alive when Callie gets home, bursts through the door to their bedroom and tells the back of Arizona's head that she needs to suck it up and get out of bed and back into her life because Callie needs her, especially now that Mark is dead. Arizona slowly turns to face her with a look of pure malice as she snarls that it's not that easy to just deal with the fact that Callie… cut her leg off. And with that, she pulls back the blankets to reveal that she lost her leg above the knee as a result of the crash.