While Arizona is doing much, much better emotionally, she now has a new issue to deal with: phantom pain in her missing leg. It's a very real and I've heard an absolutely excruciating thing, and she's having nightmares about it when she sleeps and pain as well when she's in the OR, to the point that she has to leave a surgery on an African orphan because it is too much. Cristina and Alex are able to finish the surgery but Alex is worried. He doesn't actually know that she's having the pain; the only person who figures out what's going on is Owen, so he tries to help her out with a therapy that involves picturing herself slowing down waves on the beach. When that doesn't help, she has Alex finally stab her in her prosthetic foot with a scalpel and that somehow gets her brain to calm down so that the pain subsides.
Everyone at the hospital is kind of on edge because a consultant has been called in to observe and figure out where they can cut expenses since they now have tens of millions of dollars to pay out to the crash survivors. No one wants her around because they are sure she's going to fire them and/or cut their pet programs. It turns out Richard actually knows her as she was a student of his years earlier, and he keeps trying to have coffee with her so that they can catch up but she avoids him at every turn. Princess goes so far as to lie about the time of a complicated brain surgery that Derek is doing so that they can keep her out of the OR. (Because of course Derek wouldn't start back operating again with anything less than a crazy scary complicated surgery.) The consultant, Alana, finds out the surgery is going on and tries to go observe but Derek sticks up for Princess' lie and kicks Alana out of the OR so that he can finish up his 23-hour procedure. Happily for him (and for Callie, since it's "her" wrist doing the work) the surgery winds up totally successful.
Bailey and Mere have a pregnant patient who comes in fearing she's in early labor, but then she winds up falling unconscious and they realize that she's actually in liver failure. Smash is on Mere's service and he can't seem to do anything right, screwing up lab orders and whatnot. Mere finally orders him to sit by the phone and wait for UNOS since they need to do a transplant. When a liver comes through, he goes with Mere and assists in the harvest… and winds up cutting a crucial artery and rendering the donor liver useless. Mere is a complete emotional mess because of all of the pregnancy hormones and can barely keep it together when he keeps screwing up. The next day they are lucky enough to get another liver but it's in Portland and requires a flight to go pick it up. Smash is to go and be the Keeper of the Cooler, and because Mere can't bring herself to get on a plane Bailey offers to go along to do the harvesting. But at the last moment, Mere sucks it up and takes Bailey's place on the plane. This time there's no crash, though the liver they harvest turns out to have a mass on it. Mere almost loses it again but after a biopsy, it turns out to be benign and they get it back to Seattle and into their patient after all.
April is not happy to have Jackson's current fling Stephanie helping her out in the ER for the day, and she puts her through her paces in return. She's so busy riding Stephanie that she doesn't notice that one of the (very cute) paramedics seems to be hanging around for a few extra moments each times he brings in a patient. Stephanie is so nervous and working so hard that she actually puts off sex with Jackson (gasp!) but all is rewarded when, after two days, she's totally on top of all of the patients and is congratulated by April for doing a good job. Right about this moment, Cute Paramedic Matthew shows back up and works up the nerve to ask a shocked April out for coffee.
Alana then calls all of the doctors together to talk about what she observed over the two days -- she's impressed with the African orphan program and thinks it's great PR and totally worth saving. But she reminds them that they do have to cut costs and so the first thing she suggests they do is shut down the ER. She points out that it's not bringing in any money and they are wasting surgical interns by having them work in there on non-emergent cases. Almost everyone grabs their pearls at the suggestion, and Derek gets especially uppity with her about it. But Bailey then speaks up to say that they have to do something so they'd better start listening to the woman and considering her suggestions since some of them don't have millions in the bank to fall back on. Afterwards, Richard finally catches up with Alana and tries to schedule coffee; she turns him down, but pointedly tells him that he logged the fewest hours in the OR of any surgeon the previous month. Dun dun duuuuuuuun.
On a beautiful Seattle morning, Arizona is jogging... with two fully intact legs. Mere's VO teaches us about Phantom Limb Syndrome -- people who have lost a limb can experience sensations where the limb used to be and most of the time, what they feel is intense pain. I've read about this before and it sounds horrifying, as the pain is usually incredibly strong and can be debilitating. She gets a page and runs straight to the hospital where a blonde female patient has been brought after a plane crash, with a broken femur and massive infection. Arizona tries to follow the gurney but she's struck with crippling pain in her own left femur and then all of a sudden, her leg begins to crumble into cartoony CG glass, finally shattering to a million pieces and sending her falling to the floor.
She sits up in bed, gasping in pain, and a sleepy Callie asks if she's hurting again. But why tell your orthopedic surgeon wife that you're having pain when you can just suffer in silence alone? She convinces Callie to go back to sleep and then gasps silently as she rubs at the bed in the spot where her leg used to be.
At the real hospital later, Callie frowns while reading something on her phone and then when she runs into Derek, lays into him for starting back on surgery with a complicated, long, difficult brain surgery with a huge margin for error and/or death. He's Derek, why do something sensible? Though it turns out he has a decent reason for it -- this is a patient he was supposed to operate on around the time of the crash, and if he doesn't go in soon it will be too late for the guy. Callie concedes that if he can do this, then she'll know "her hand" can do anything. Derek argues back that it's "his hand," but she takes no notice.
Owen gathers the surgical staff together and then gets up on the stairs to announce that, on account of the "financial setback" that has befallen the hospital, the administration is working to cut costs and they have hired a Physician Advisor to help them out. He claims this person will help them figure out how to maximize efficiency while cutting costs where they can. Bailey dryly points out what everyone is thinking, which is that this person will be figuring out who can be fired. Owen plays this down and tries to sound confident as he says that this person is just there to help, but he is convincing absolutely no one. He was supposed to introduce her at this meeting but she's late, and Cristina cracks that that isn't very efficient; it's certainly setting her up to be received even less warmly than she would have anyway. Derek is miffed to hear that she'll be observing even inside the OR but Owen explains that she is a trained surgeon and repeats again that she's going to help. Even he doesn't sound convinced by his own words, though.