The hospital sale seems to be moving ahead; Alana has a bunch of people there for a tour from a potential buyer company called Pegasus, while she also works to figure out which of the ridiculously good-looking doctors will be the new "face" of the hospital. Alex and Jackson are the front runners, and Princess and Stephanie get a little too into trying to make their own personal candidates the winner.

Callie is disturbed by the idea of the sale, especially because she can't actually find any useful information about Pegasus on their website. She and Richard decide to take a little trip down to Portland to visit a hospital there which has already been bought by them. They pose as a married couple and Richard pretends to have chest pain to check things out in the ER. (Also: Wait, they got to keep their ER?) The doctor they see is very nice but they realize pretty quickly that he has to follow a specific protocol on an iPad which dictates the questions he will ask and makes sure that the exam is kept to under 15 minutes. Once Richard has been deemed to be fine, the two decide to meander the halls and eventually talk to a group of doctors while pretending to be Pegasus reps looking for feedback. The doctors there hate it because they can no longer think for themselves and they have to follow a lot of protocols that don't even make sense or seem best for the patients. They finally meet Portland General's own "face" who recognizes Callie since he is an orthopedic surgeon too. Since he thinks she now works for Pegasus, he asks if there is a spot open at Seattle Grace since he hates it in Portland where he does very little actual surgery anymore. When they finally return to Seattle, Richard admits that the early retirement package he's been offered is looking pretty appealing right now.

April has started hanging out with Hot Paramedic Matthew and since she has basically nothing to do at the hospital with all of the traumas gone, she goes for a ride along with him. They go pick up a kid who has been hit by a car and conveniently, Seattle Pres is too crowded to take him, the next closest ER is over an hour away, and but he's too hurt so April is sure he'll die if they try that. She calls Jackson and they decide to sneak him into the pretty much stripped room that used to be Seattle Grace's ER. Along the way they wind up enlisting the help of all of the interns, Meredith, Alex, Cristina, and finally Derek since Mere realized they need someone who can actually get them the medications they will need. He also proves useful when he diverts Alana's tour away from the ER -- which, by the way, apparently is being remodeled to be a hernia clinic. I guess that explains the skills lab from last week, though I had no idea there was such a rampant hernia problem in Seattle. When the tour finally does make it down there, they have managed to sneak out the kid but Alana sees drops of fresh blood on the floor and realizes that there has been monkey business. She and Owen pull all of the docs in one by one to interrogate them to try and get to the bottom of what happened.

In addition to helping this poor kid, Alex and Jackson are working together on a transgender teenager, Brian, in the process of a female-to-male transition. He's there for surgery to remove his breasts, and is being supported by his male-to-female transgendered girlfriend, Jess. Brian's dad shows up before surgery, having received an email about it, and he's so distraught by what is going on that he almost comes to blows with Alex. Alex manages to calm him down, but he still can't really deal with the decisions his child is making. When the docs come out after surgery to report to Jess how it went, Brian's dad shows up and they realize he was there the whole time, wanting to make sure it went okay. Jess admits she sent the email because she knows how much Brian loves his dad; He finally comes around enough to gruffly offer Jess some cash as rent money but can't bring himself to be there when Brian wakes up.

Once Jackson and Alex find out about the staff interrogations they walk into the room and take total responsibility for everything, pointing out that it was the right thing to do and that neither of them has any interest anymore in being the face of the hospital anymore given everything that is going on. Alana is aghast when Owen dismisses them without punishment and insists yet again that everything she's doing is the only way to save the hospital. She also calls in Derek to yell at him since they realize he assisted the docs in their actions but yet later we see that he still winds up becoming the "face" anyway. And it's kind of scary because his face now graces the inside of the elevator doors. That's a whole lot of Derek, right there.

Finally, Callie calls a meeting of the crash survivors (though Cristina isn't there because she can't hear her phone during her on-call room hookup with Owen) to tell them that they have to do something. And her idea of something is that they should band together and buy the hospital themselves.