Cristina, of course, then goes running away to Meredith. She sees that Mere is in a conference room with Richard and Derek and peeks through the window. Mere sees her and gives an infinitesimal head shake which Richard doesn't notice on account of all of his yelling. He still wants answers that Mere is still not giving up, and he warns her that once they get all of the info from Alex they'll figure out the dates on which this happened and what patients were involved. Seriously, Richard? No tiny pang of uncertainty that you might realize what possibly happened? Meredith again maintains that nothing she did changes the trial, SIGH. That line has gotten very old, very fast. But the worst thing about this situation is that it's brought Self-Righteous Derek back with a vengeance. He yells at Meredith that she doesn't get to choose which patients get what and when Meredith tries to say that the trial is still blind since he doesn't know who got what, Derek haughtily spits that the trial is over. He then decides to get personal and yells that she screwed him and the hospital. As Derek rants, Alex knocks on the door and hands his report to Richard, who looks it over and then pulls out his own datebook and starts to flip through. Quietly, he finally says something but Derek can't hear over the sound of his own voice, which is growling at Mere that he did this whole trial for her, to cure her disease. I'd say this whole "treating the spouse like a colleague" has failed rather spectacularly at this point. Richard speaks up and tells Derek that Meredith's shenanigans were for Adele. Meredith remains silent; Derek is gobsmacked.
As the doctors are all waiting around in the ER, reality seems to have set it for everyone but April, who is still thinking of things she can prepare for the potential onslaught of patients. Mark is the one to finally say out loud that if no one has been brought in thus far, it means no one survived the crash. It looks like April is the only one who hadn't realized this already, and she's crushed.
We managed to have so much of this season be blissfully free of Derek's self-righteousness, but he's got his holier-than-thou pants hiked up and secured tight with his superiority belt; he demands to know what Richard is going to do about it the situation. When Richard sighs and admits he doesn't know, Derek sneers that the protocol for this is clear. Mere asks, aghast, if Derek is actually encouraging Richard to fire her. I guess these two should really have just stuck with the post-it considering how things are going now that they have actual legal marriage paperwork. Richard admits his own role in the whole mess and says that he basically pressured Mere into doing what she did, so they'd have to both be fired. It's not the answer Derek wanted, so he storms out in a huff. Richard tells Meredith that he has to suspend her so that it doesn't look so bad, and then sighs that he'll hand the whole thing over to the FDA to figure out. There's a knock at the door and Owen nods, which sends a silent message that seems to say that everyone is dead and Richard is needed for the next phase of notifying everyone. But before Richard leaves the room, he says to Meredith with a voice a bit husky with emotion, "I don't know how to..." Mere doesn't make him finish the sentence but just tells him that she knows. Despite all the crap that has just hit the fan, she still seems totally at peace with what she did.