Steph walks out of her patient's room and when she sees Smash, does some serious gloating about her awesome ability to do a post-op dictation on her own. So... the pagers that make the bonking noise and which they all now wear around their necks are also recorders? This is a strange new world. Smash just pulls out a cup of pink slime which he's taking to the lab and argues that his goo is cooler than her dictation. She asks if he has seen Leah and when she hears that Leah just ran off to answer a 911 page her haughty attitude drops and she sprints off to see what just happened.
The issue in the NICU is that Reece has gone totally downhill and needs to be taken right into surgery to fix something with his shunt. Noah is completely freaking out but the interns don't seem to really care. Instead, Leah just gloats in Steph's face that she won the right to scrub in.
Heather walks into the OR and gazes happily at the big, disgusting surgery going on until Richard notices her and Mere claims Heather as her own. Mere asks about the calls and Heather reports that Kathy and Amy got messages, Nancy hung up on her twice and Lizzie said she might be up for it but she's way more interested in learning about what's going on with Zola these days. Derek then storms in because apparently Lizzie called him as soon as she was off the phone with Heather. He and Mere yell at each other about his care, since he didn't want his family involved, but she argues back that they have to do the surgery ASAP since the longer they wait, the less chance it has of being successful. That seems like a completely reasonable argument and Bailey chimes in that it's a no-brainer, but Derek is too worked up and yells at Heather to call all his sisters back and undo everything. This is very classic Derek equal-opportunity boorish asshole behavior today. As soon as he leaves, though, Mere yells at Heather not to undo anything.
Alex walks Princess through the procedure of getting the baby hooked up to the machine until an alarm starts to ring and he takes over right away. He actually seems like a decent teacher as he does his thing; he has Princess do compressions on the baby's heart while he works quickly to try and finish up the surgery before the baby bleeds out or some other horrible thing happens.