Alex and Cristina are in with their young patient, whose heart is now ticking as it's supposed to. The woman thanks them, and Cristina can't help herself and practically salivates as she asks sweetly what other potential patients the woman might have with obscure cardiac maladies. Alex jumps in and cuts her off, telling the woman that they are simply happy the program is up and running again.
Derek and Princess go to visit Jimmy as he wakes up and find Carla amid the crumbs of the giant cookie, which she ate out of nerves. As she yells at her brother for worrying her, he winces, and the docs notice happily that the wince covers both sides of his face. Derek checks him out while Carla shrieks in joy, and then she grabs him in a hug and kisses his totally working face while the doctors grin at the scene.
Alana then calls a meeting with all of the docs and surprisingly begins by telling them sincerely how impressed she is by what she saw over the past three days. She begins to talk about the Africa program when Cristina jumps out of her seat and yells that she can't cut the program because it's so full of interesting surgeries that she wants. Cristina manages to catch herself and unconvincingly say that the orphans really need the help so that it doesn't sound all about her; Alana assures them that the program is great PR for the hospital and she would never cut it. But she does have one suggestion that she's sure will shock everyone though it makes a lot of sense in the long run, cutting costs while having only a nominal effect on the core hospital and the staff. No one is prepared for what she actually suggests, though, which is to shut down the ER.
Everyone in the room gasps; Owen argues that they are a Level 1 trauma center and Richard points out that they are a hospital, implying that a hospital with no ER is just insanity. She argues that the ER is not bringing in any money and that most of the patients who came in were underinsured and had ailments that could have been handled by a primary care doctor. She also points out that having surgical interns staff the place is a complete waste of their skills. She then also reminds everyone that overall she's working to try and keep the hospital itself open. Derek speaks up and dismisses the idea as ridiculous but Bailey interrupts him to ask if he has a better idea. Rather harshly she points out that Alana is trying to keep the hospital open and keep all of them employed, which seems important since most of them don't have millions of dollars to fall back on. Derek's face turns to stone, while everyone else looks shocked, crash victims and other docs alike, that she would really go there. Bailey says that unless anyone has a better idea, they should probably hear Alana out. Jackson gives her an impressed smile, while everyone else just sort of silently gapes at what just happened.