We pick up almost immediately after that shocking fall finale, with the car crash just by Meredith and Alex's ambulance. A whole family is injured - except for teenager Lily, who's emerged relatively scot free - and it's all hands on deck.
Meredith hands Lily the baby the ambulance was transporting, teaching her how to keep the oxygen going, so she can focus on the crash. Naturally this has mixed results - Lily's kind of preoccupied by her brutally injured family members and keeps forgetting to count.
Meredith manages to keep it going, though, and she and Alex begin attending to the victims. The grandmother doesn't make it, but Lily's sister is still alive (albeit with a shard of glass right through her eye), and brother Michael is hanging on, despite being trapped under the car.
When another car rounds the bend, it's too late to pull Michael out - Meredith has to hope for the best and stand in the middle of the road, waving. Luckily, it works...
They arrive back at Seattle Grace, and there's chaos as everyone starts to treat the survivors. Alex wants to help with the baby from the ambulance, but Arizona thinks he's done enough - he's exhausted and needs to sit this one out.
The only problem is that he just can't. Justin Chambers is wonderful at showing just how fidgety he is - eventually, Alex jumps up and forces Arizona to let him help, yelling that he didn't go through hell to just back off. Arizona doesn't have much of a choice but to allow it.
Everything goes well (hurrah, a bright spot!) but later Alex rushes in, worrying that he didn't perform a certain procedure. But Arizona reminds him that he did do it after all. Let's just hope this was tiredness and/or concussion and/or shock and not something more worrying...
Elsewhere, Lily's sister is in the hands of Mark, Lexie and Derek, who need some extra help. Unfortunately, loads of people are too far away or unavailable. The only person left to call just happens to be Mark's new girlfriend Julia. You know, the one whom Lexie launched a baseball at. Awkwaaard.
Anyway, Julia turns out to be brilliant and manages to get the shard of glass out whilst also saving the girl's eye. Pretty spectacular. What's worse is that afterwards, Julia admits to Lexie that she was nervous the entire time - she was working with Derek, for goodness' sake! So Lexie can't even hate her... ("Dammit," she groans when she realises.)
Bailey, Ben and Meredith are treating Michael, but there's a diversion when Lily's mum has complications. Meredith rushes over, but there's nothing she can do - Lily has seen both her mother and grandmother die. Not a good night.
But there's no time for Meredith to feel bad - she's got to ask a grief-stricken Lily all the questions about medications, allergies... and whether her parents ever talked about "extraordinary measures" (Lily doesn't know anything). Then it's time to take Michael into surgery.
All seems to be going well, but then Michael runs into complications - malignant hypothermia! Ben (who's been bothering Bailey by bringing up the death of Henry) catches it and they manage to fix the problem, but Meredith has to run around warning all the other doctors in case the other family members have the same issue.
Michael makes it through, but things are looking bad for Lily's dad. She begs him to wake up, but instead he keeps coding. The doctors revive him over and over again, but it's clear he's in dire straits.
Lily watches it all, refusing to leave her father's side, and asks Meredith exactly what's going on. Then she makes a tough decision - they have to stop reviving him. Meredith points out that it's not her decision - she's just a child - but Lily reveals that she turned 18 four hours ago - and she's been watching them "torture" her dad for six. She begs Meredith to let her dad die in peace.
She signs the form, and her dad's life support is switched off. Meredith offers to leave, but Lily asks her to stay - and hugs her and cries as her dad passes away. Then she has to go and see her siblings and tell them about their parents' deaths. What a heartbreaking, grim, devastating story.
Of course, that's not all. Teddy's still operating on Callie and Jackson's patient, and has no idea about Henry's death. April wants to help with the car crash, but Owen tells her to return to Teddy - she needs to let him know as soon as she's out of surgery. But when April hears about Henry, she's too distraught to go into surgery, and has to settle for the gallery.
Later, Teddy pages Owen and reveals that she needs Cristina's help. Of course, Cristina's just been in surgery and seen Henry die, but Teddy doesn't know that, and she's insistent. Owen doesn't have much choice, and though Cristina is resistant, she eventually agrees. A patient's life is at stake, after all. (Incidentally, seeing Cristina taking a deep breath and putting her game face on before entering the OR was great.)
This entire storyline is devastating, because we know that Teddy is going to find out about Henry eventually. So seeing her thanking Cristina for operating on Henry, or seeing Cristina deflecting questions about Henry by mocking April (who watches sadly in the gallery), or seeing Teddy whoop excitedly to keep herself awake - everything is given another layer, another devastating meaning.
The surgery is a success - even though they have to take the heart out of the body to repair it - but as soon as they're done Cristina calls up to April to close, and takes Teddy outside. Yes, you guessed it - she tells her about Henry's death.
It is awful (heartbreaking, I mean - the scene is wonderful television). I defy you not to cry as the realisation dawns on Teddy and she urges Cristina to spell it out - forcing Cristina to say: "Henry is dead."
Teddy is devastated and can barely move as she cries, but she thanks Cristina and goes to sit with Henry's body. Horrible. And Cristina's devastated too, and doesn't want to talk to Owen about it. It's like a big fat punch in the stomach.
Oh, and Bailey tells Ben the truth about Henry - that he was a friend - and apologises to him for being rude earlier. But Ben comes to sit with her and takes her hand. It's another touching little moment.
Anyway, Jackson's feeling awful since it was his mistake that caused the problems with Teddy's patient in the first place. He wants to take the fall, and Callie would like that too - but hey, she's the resident. Maybe Jackson will learn something and not make the same mistakes again...
In other words, it was almost an unremittingly grim episode - brilliant and emotional, but grim. But then we end on a lovely note. Meredith and Derek are at home and being cute together (after all their problems earlier this season).
And then there's a doorbell, and they think it's pizza, but it's not pizza, because it's the social worker and Zola. ZOLA! Yes, Meredith and Derek are getting Zola, so we end on a wonderful moment and it's all smiles. For now, at least!
What did you think of the episode? Leave your comments below!