At the hospital, the docs all gather around a table for a staff meeting, and the first major change we notice is that Addison is there, very pregnant, and still married to Derek; the two of them smile and laugh as he helps her sit down. Bailey has the long braided hairdo we saw in her first year flashbacks.

Callie rushes down the hall pushing blonde twin toddlers in a stroller while their older sister walks alongside; Callie tells the girl to sit and wait while she goes in to the meeting. She doesn't like this much but she does like when her daddy Owen shows up. Hmm, I didn't guess that little twist in Elttaes. They have a mildly tense conversation because he's shocked that she has them there for a meeting, while Callie points out that if Ellis is going to schedule a meeting before daycare opens, she has no choice. The two then sweep into Ellis' office and join the others.

Bailey doesn't just have her first-year braids, she has her first-year nerves even though she is an attending. Ellis launches right in, saying she thinks they can absorb Seattle Presbyterian just like they did Mercy West. Won't this city be down to one fictional hospital? What will people across town do? And what is this fictional hospital inside a fictional show going to be called? Elttaes Grace Mercy West Presbyterian? I suppose then it's good there will just be one hospital in town since no one will be able to remember that entire name. Addie then pipes up to congratulate Ellis on her third Harper Avery, and Ellis is very bad at acting modest or shy. After letting them fawn all over her she does admit that there will be press there to talk to her that day. She then goes around the table asking the doctors what they have going on. When Derek says his one surgery, she mocks him for not having more than that and then reminds everyone, "If you're not innovating, be generating!" Derek gives a very tight smile. Elttaes Callie is head of cardio, and she has Cristina doing a solo procedure while she handles a kid with an artificial lung who is waiting for a transplant. Arizona pipes up to state for the record that she doesn't agree with this method of treatment and the two bicker a while until Ellis sides with Callie declares it's great because it is innovative, which should be an example to Derek. Hmm, I wonder if somehow the adversarial relationship between the two women might come around and evolve into something else? That would be surprising.