The roof of a fancy restaurant caves in, causing huge casualties.
A and her husband both suffer rough injuries. He's having a tough time of it in surgery, she's faring better, and in the next bed is Emil, the head waiter at the restaurant who's secretly been in love with her for 15 years.
He slipped Alex $50 to share the room with her. When he thinks she's asleep, he tells Alex and Meredith about how he's known her for years, watched her with her husband, and loved her from afar.
He knows they're unhappy because their conversation has dwindled. He can see she's scared that her husband will die and she'll be alone, but she'll never have to be alone if she doesn't want to be.
She's awake and she's heard everything he said.
Meredith and Alex take bets on whether they'll tell another they love each other, as Alex, Meredith and Cristina snark about marriage while eating the chocolates Alex took from a guy in a coma.
Unfortunately, the wife has complications, then Emil has to go to surgery with a brain bleed as her husband runs into some hairy complications on Bailey's surgical table.
In the end, she survives and her husband survives, but Emil does not. She explains to Meredith that she chose her husband over Emil and made a choice, and she continues to do so every day in her happy marriage, she's still heartbroken.
A dishwasher's arm was also amputated in the wreck. He desperately wants them to save it, and makes the case to the newly blonde Lexie and Avery.
Lexie's gone "Trauma Room Barbie," as Avery puts it, in an effort to move on after the breakup with Mark, and he bucks her up and basically pushes her into becoming more assertive so she'll be treated differently.
He does this with a speech about how tough he's had it, being so good looking that his family never expected anything from him.
Lexie talks Mark and Owen into reattaching the guy's arm even though both the arm and the amputation site were damaged and contaminated and they keep the blood supply flowing by attaching it temporarily to his torso.
But Lexie talks him down from feeling like a freak,and then goes and sleeps with Alex again.
Bailey comes into the scene trailed by Callie and Arizona, who are all about Valentine's Day and their gifts for one another. They're mostly forgivable, though, until they see Bailey get all flustered with the cute anesthesiologist when he asks her out to dinner.
It continues when Arizona dives headlong into not at all subtle hinting about them dating while they're all in surgery, and finally Bailey confesses to him that she goes stupid around him because she likes him.
And that she'd be cool with going to dinner.
Mark's all excited about being a granddad, and buys a crib. Then Sloan turns up, interested only in getting official proof that the baby is healthy so she can move forward with giving the baby up for adoption.
Callie forces her hand, and she confesses her plans to Mark, saying that she's not ready to be a mother. He offers to adopt the baby, and Callie pledges her help in raising him.
So Sloan agrees to at least discuss the idea and work it out. But Callie catches her sneaking out of Mark's apartment, and she admits that she only wanted money and a place to stay for a while.
She didn't expect Mark to start caring. She wants the baby to be someone else's, she says - her father got a clean break, she feels she deserves the same chance.
Callie sends her off with some stern warnings about taking care of herself and a wad of cash, and then has to break the news to Mark about what happened.
Teddy's trying her hardest, but Owen won't even look at her - and what breaks her heart is that he's her best friend and she misses him. She misses her friend and that - along with the job and the amazing student - is more important.
She'll deal with the rest. She's going to be fine, and they're going to be friends, Teddy tells Owen. We'll see.
Derek's learning that being the chief of surgery is a lot more than being in the OR. It's also a lot of administrative work, talking to the press, fundraising efforts.
He's rehired April Kepner, but instead of doing surgery she's focused on helping him with administrative duties. Which includes calling Meredith "Mrs. Derek Shepherd" which is weird.
April is really doubting that she's cut out for surgery, but Derek steps up and gives her a great pep talk about her abilities.
Meredith, predictably, gets all twitchy about the idea of having to play Derek's wife occasionally, but does a little manning up of her own and shows up for him.
And after she's appalled by the placard announcing the reception honoring "Dr. and Mrs. Shepherd," tells Derek he's got some serious making up to do. Sex style.