Derek has found momentary refuge in the gallery and is watching surgery when Mark finds him, and he says slightly bitterly that this is the closest he's been to the OR in a week. He's not terribly in love with the brunch/glad-handing side of being Chief, which I get but it's also a not-so-secret reality and one he might have considered. Mark decides to change the subject by announcing that he's adopting Sloane's baby, and then he tells Derek (and I think himself) that it's the right thing to do. Derek nods as Mark explains his reasons for why this will work and then congratulates his friend when Mark grins and says he's having a baby. Mark congratulates him back on his Chiefdom and says that this is always what he wanted. Right? Derek mumbles yes but the fact that he can't take his eyes off of the surgery below says he's not so sure.
Bailey is nearly done working on Mr. Banks, and Arizona delightedly points out that it is just in time for dinner, maybe even dancing. Bailey finally responds to what she's been listening to for hours, and puts it in terms of her patient -- that he'll be fine, he won't be dancing anytime soon, but that when he wants to dance and the time is right he'll be able to make the decision on his own. She then dismisses Arizona, who slumps out of the OR a sad, unsuccessful cupid. Dr. Warren starts to make conversation but Bailey shuts him down too, and he counters that he wasn't the one that said anything about dancing. "Although..." He can't finish the thought because Bailey shushes him just as blood starts gushing into the open wound from a torn artery that Bailey missed.
Alex goes to check on Emile but he's gone, and Tyler pops up long enough to suggest that he just left. Alex seems a little down about that, and when he walks into the room he goes to take the $50 off his clipboard but it flutters out of his hand and to the ground. Unsurprisingly, if you've ever watched a medical drama before, once he bends down to retrieve it he sees Emile collapsed on the floor on the opposite side of the bed, terrified and convulsing, and Alex yells for help.
Derek is increasingly agitated at his non-doctor-ish day, and when April runs up with his clothes for the brunch as well as notecards for his speech, Derek tells her to go home. April again chirps that she's there if he is and Derek turns on her and asks if she wants to be an assistant or a surgeon, as all he wants to do right now is surgery. April starts to tremble and admits that she's not sure that she can be a surgeon, that she's grateful he hired her back but that it's easier to help him out than to be the doctor who killed someone. She then says that if Derek doesn't need her to be an errand girl, she should maybe not be there at all. I totally understand it but also -- didn't Derek think to talk to this girl before he rehired her the second he became Chief? Alex runs up before Derek can reply and when he says that he's got an epidural bleed, Derek tells April to come with him.
Frankie is out of surgery, and the doctors are all gathered around as he sees that he's still only got a stump coming from his shoulder. He logically and sadly assumes they couldn't do it, but Trauma Barbie is the one to tell him that they could save his arm, and he just has to prepare himself as they took extraordinary measures. She's already working around the clock!! Sorry, I think for the rest of my life that's going to be my knee-jerk reaction to the term on account of Harrison Ford's recent pathetic return to the big screen. As Lexie rolls back the sheet, Hunt explains that the arm needed a blood supply to keep it viable until they could reattach it, so they had to relocate it for a bit. The big reveal is then that his arm is attached... to his thigh. Frankie is horrified, and demands to know why they would do this to him. Lexie is hurt that her effort is being received so badly, and assures him it's only temporary and that this is what he wanted -- his arm. Frankie yells that he wanted his arm in the right place, which... is fair. He also reminds her that he didn't want to be a freak, and he can't believe they didn't just leave him as he was.
Callie gets home from work only to catch Sloan trying to sneak out of Mark's apartment with her suitcase in hand. She's disgusted at the younger girl and asks if she even told Mark she's leaving, but Sloan just defends that she only wanted a place to stay and some money, and didn't expect Mark to care so much. She was horrified to get home and see the crib, and she takes off with Callie running after her trying to assure her that Mark is a good guy and that Sloan could know the baby this way. That, however, is the whole issue -- Sloan wants a clean break like Mark got with her. The soulful guitar starts up as she asks if she deserves that, and Callie is moved by the strings and pulls out her wallet. With a fistful of cash she orders Sloan to take her vitamins, go to all her doctor appointments, and to call if she gets into any trouble. She then hands over the wad -- seriously, I only ever had that many bills in my purse on the day I sold my car for cash -- and Sloan seems both happy and appreciative of the gesture, which is clearly a first. She thanks Callie sincerely and then leaves.
Mrs. Banks is awake after her scare and asks about her husband; Mere answers that there were complications but that Bailey is doing all she can to fix him. She then asks about Emile, and Meredith has to admit that he is in surgery for bleeding in his brain. Mrs. Banks is horrified, and after a moment she tells Mere that Emile didn't say a word to her for 15 years. Mere asks if she knew, and she did, which is why she kept going back. Instead she met her husband, Emile never made a move, and so she made her choice. Mere can't quite get a grip on things and prods gently that she kept going back to the restaurant, but Mrs. B. says sincerely that Bob liked it and she loved Bob, so it became their place. She then says with a fond smile that he orders for her because he knows what she likes, and that they have reached the point where it's comfortable to not talk sometimes. She seems utterly at ease with her choice, which she says she keeps making every day. Mere is left to some serious thinking about relationships and what she perceived earlier as Mrs. B. tells her that's what marriage is.
While she's calm, though, her two men are not faring well in surgery -- Bailey can't get Bob's bleeding under control, while Derek is cursing at the discovery of a severed artery in Emile's brain. Alex is beating himself up, wondering what he missed, but Derek assures him that this kind of thing has no symptoms and the CT was negative, so it's the kind of thing that you don't find until it's too late. He asks if it's too late and Derek admits he doesn't know. Both Bailey and Derek beg their respective patients to stay alive.
Emile did not listen to Derek's begging, and April watches in tears as they zip him into a body bag. She tries to cry quietly and not give away that she's falling apart, but Alex knows she's upset and says harshly that Emile watched his life happen without him and is probably better off. His tone is very obviously trying to cover up that he had gotten fond of the guy over the course of the night. April can't take it and lets out a sob as Derek comes in, and she cries that she can't be a surgeon and watch people die. He practices yet another Chiefly role -- comforting an upset employee -- and pats her on the shoulder as she sobs that she should never have come back. He admits to making his own mistake last year and almost walking away, but assures her that if you don't feel the losses you aren't cut out to be a surgeon. Wait a second; aren't you supposed to not feel for your patients so that you can work more efficiently? I'm confused. But Derek assures her that he hired her back because he knows she can be a good surgeon, and she fights to get a hold of herself.
Dr. Warren approaches Bailey, who is updating the surgical board, and it see