Picking up almost immediately where we left off in December, we learn that April and Jackson ran out of her beautiful wedding hand in hand, grins on their faces. Once in the car, however, April starts to panic. She pulls herself back together and is sure that she wants to be with Jackson, but later freaks out again and gets out of the car on the side of the road to have an anxiety attack.
At the same time, we see that James isn't dead, but he's in a really bad way, and the docs piece together that Smash was hallucinating that James was Heather because he hadn't gotten any sleep. Alex isn't going to forgive this, though, and also fully blames Cristina for turning Smash into a surgical monster. Other pertinent post-wedding happenings: Mere is incensed to learn that Derek told the president that he'd continue his research, and Arizona finally snaps and yells at Callie that she doesn't want to be fixed because she's not broken, but she's pretty sure their relationship is.
Cut to three weeks later -- James is dying, and Alex lies to his wife, telling her James is dead so that she'll come to Seattle to pick up his things. When she arrives Alex introduces Jo as his fiancée, which Jo finds awfully confusing since she doesn't remember him asking her to marry him. Alex takes Mrs. James to his room, and she's furious to realize that James is still alive. All she then wants to do is take back his guitar, which was her father's and which James stole. When James wakes up, he's desperate to see the family and tells Alex he wants to give back the guitar, so Alex lies that they haven't arrived yet and then sits vigil by James' bedside. Smash goes to him and tries to apologize, and Alex loses it and starts to beat him to a pulp. Fortunately, Cristina and Mere (who finally are doing a surgery together and mending their friendship!) find him and pull him off; Mere holds Alex in a hug, in a surprisingly touching moment, while Cristina goes and stitches up Smash's face. He's had a hard day with Owen trying to humiliate him in the name of teaching, and is convinced he's a mess. Cristina acknowledges that he's made mistakes, but reminds him that he helped save Baby Nathan's life so he should remember that he's not a complete waste. Sadly, James does end up dying, but only after Alex assures him that his family is on the way and that Alex told Mrs. James about how badly James wanted to return the guitar.
During another fight, Ben admits to Bailey that he didn't quit surgery because he wanted to do so and that he still loves it. Someone seems to finally remember that there's an opening in the program in Seattle since Heather died, so he joins as the newest resident and he and Bailey seem to finally be getting along better even if she does embarrass him by packing his lunch every day like his mom. She was hoping he'd provide some gossip, especially about what is going on with Jackson and April, since no one knows what happened between them after they ran out on the wedding, but he knows nothing.
Somehow, Callie and Arizona go from Arizona saying that their relationship isn't working to buying a house together three weeks later. Callie is nervous about it, but Arizona assures her that this house is a new start, without all of the memories of hospital beds and emotional meltdowns in the shower. She basically admits that she still doesn't know what's going to happen, but that she wants to make the best go if it that they can and this house is the way to do it.
Stephanie is understandably gutted about her boyfriend running off with the bride at the wedding they were attending. She hides out for a couple of weeks and avoids him, but when she winds up with a patient who could use some serious pro bono surgery to help undo his turning himself into a cat (yep) she finally approaches him to ask him to do the surgery and also tells him to not even try to apologize. Leah tries to comfort her and as she does, she works herself into a lather over the failed resident/attending hookups and declares that she, Stephanie and Smash were all taken advantage of by their bosses who used them and threw them away. Not long after this, Owen is called into a meeting with HR and then calls an emergency board meeting to announce that one of the residents filed three official complaints, and as a result they are putting a policy into place that bans any workplace relationships other than existing marriages.
And this is how we find out what happened after April got out of the car: she can't believe that they've just destroyed Matthew and Stephanie's lives just so that she and Jackson can date. While she's panicking, Jackson breaks in to point out that she's right, he doesn't want to date her -- he wants to marry her. They run off and get secretly married, but he comes home from the board meeting and admits they may have to finally admit what they did given the changes that are about to go into effect. The other couple this is bound to affect is Jo and Alex; she finally realized that his desperate, pre-wedding declaration of love was a proposal, and freaks out because she doesn't want to get married. He seems to forgive this when his dad dies and she goes to comfort him, but it's going to become a very big issue very soon.
The second half of the season is kicked off with an excruciatingly slow version of Total Eclipse of the Heart which only has the effect of making me go to watch this version, which is possibly one of the best things the Internet has ever given us. No, seriously, I'll wait for you to check it out. Done? Excellent, though it's going to make this hour seem awfully boring by comparison. Anyhow, we see a slow-motion shot of the barn doors opening and a giddy Jackson and April running out, hand in hand, her veil flying. The two get into his car and we see that her excited, "Oh my God!" begins to turn into a horrified, "OH MY GOD," when she starts to really think about what they've done. In real time, Jackson asks if she's sure and after a moment, she takes a breath, mauls him with kisses, and tells him to drive. Mere VO's that it's often hard to tell the difference between very good and very bad decisions when we are making them.
And after all of the drama of Mere and Cristina having their dresses altered, Mere shoves hers unceremoniously into her bag while she packs up to leave. Derek has told her about his phone call from Mr. President, and she's livid that he's now going to continue his research, which means that he's also not going to be able to give her all of the time in the world to work on her own. And while Derek has a valid point, which is that you can't really say no to the leader of the free world, Mere isn't really in the mood to hear it. Cristina comes in and reports that April's sisters have wept their way through every tissue in the building; she loves this drama even more than that at the bridal shower and she's a full-on fan of crazy April now. Mere storms out, and Cristina is relieved when Derek reports that this time she's mad at him and not her hopefully soon-to-be-again bestie. She's also in awe to hear that the President actually called Derek personally.
Back at the hospital, Alex is hollering at Owen that he wants Smash fired and/or arrested while Jo, Leah and Richard look on. James is still alive and stable, but barely. Owen asks Richard what the hell happened, and after Richard reports that Smash was hallucinating that James was Heather, Leah realizes this is probably related that time Smash showed her how to fudge one's hours so that they could work without that pesky, mandatory sleep. Owen literally smacks his palm to his head over the ridiculous mess that is unfolding while Leah runs to try and find her exhausted friend. Owen assures Alex that Cristina is on her way but Alex says he doesn't want her touching James since she's the one who turned Smash into a monster in the first place. When Owen tells him to wait until they have all the facts, Alex hollers back that Cristina is screwing Smash, and Owen looks rather like Alex just punched him in the face.