Meredith and Smash are in the OR, removing the liver for transport, and Mere is talking Smash through the steps to disconnect it. But as he makes a cut, blood begins to spurt everywhere and Mere starts to wail. The local doctors are watching from afar at the train wreck in front of them while Mere screams at Smash that he just cut the artery that was absolutely not supposed to be cut. The surgeon observing turns to his own intern and tells him never to do what Smash just did, while Mere whimpers and tries to save the liver. I get it, Smash is a screw-up and Mere is emotionally fragile... but to be fair, she said cut, and he cut and followed her instructions. He did screw up, but it wasn't like he did something totally out of the question, willy-nilly dicing up the organ while disregarding his boss just for fun.
Arizona heads up to the ICU to see her patient and finds Alex and Alana outside the room, discussing the surgery. Alana manages to act human enough to act if she is okay and Arizona apologizes for her having to see her upset like that. Alana just replies that she was having a moment, everyone has them and it just sucks when they are at work. I would have thought Alana would also have seen that Arizona had her scrubs rolled up in there and was clearly going through a pain issue to do with her amputated leg, but I guess she couldn't see past the pastries. Alex thanks Arizona for letting him finish up the surgery, and Alana rather pointedly says it was impressive for her to let a fellow do that. Arizona says that he's qualified, and Alana asks about their surgery the next day since she'll be observing. Arizona immediately assures her that she'll be in charge and working with Cristina. Once Alana leaves, Alex asks what's going on but Arizona insists everything is fine. She tries to leave but Alex offers, kind of self-consciously, to do the surgery if she wants to sit it out. He's sincere, but she's taken aback by the suggestion. He continues that he's worried about the program since Cristina keeps making cracks, and so he wants to make sure everything goes perfectly for Alana. She refuses to even engage him on the subject and just tells him that she'll see him there in the morning.
Yet it's shown to be nighttime when the three of them gather in the OR and Arizona asks for a scalpel. As she reaches to make a cut, though, she yelps in pain and blood appears on the leg of her scrubs. Cristina and Alex stare at her impassively as she struggles and tries again, but she then slips in a puddle of her own blood, looks down, and finally tears off her scrubs to show grotesque open gashes in her leg. Cristina and Alex continue to just stare at her and the patient's stats start to drop, so she grabs a scalpel and starts cutting off her own leg at the thigh, screaming while looking up at them. Finally, she wakes up with a gasp from her nightmare.