Meredith's hormones kick in, Arizona experiences phantom pain, and an adviser looks to make cuts.
At the hospital, Callie questions Derek's plans to do a long surgery. They join the staff. Owen tells everyone an adviser has been appointed to find ways to cut costs. Meredith drags Derek into the on-call room to have sex - her hormones make her want it all the time. When she gets paged, she cries. Shane knocks on the door and finds himself confronted by a furious Meredith.
At the nurses' station, Stephanie asks April for help. April takes her to the ER, where their patient turns out to be Dr. Cahill, the adviser, who's upset about the wait time.
Alex, Arizona, and Christina consult with an African orphan with a heart problem. After, Christina warns Karev the adviser could cut his orphan program. Later, in surgery, Christina is excited about the girl's rare heart disorder. Arizona leaves suddenly.
Meredith and Shane are treating a pregnant woman who winds up unconscious - her liver shut down. Meredith orders an apologetic Shane to go and not to come back until he's found a liver. Meredith tells Bailey she wants to kill him.
Derek and Jo meet with the tumor patient. He tells Jo he wants Shane to assist. Owen and Dr. Cahill appear. She questions pre-op patients staying overnight and then complains about the ER wait time. Richard appears - apparently he knows Dr. Cahill. Meanwhile, Shane, waiting on a liver, tells Jo he can't assist Derek. Later, Derek has to tell his patient the tumor has progressed. He agrees to let Jo assist.
Owen and Dr. Cahill find Arizona in the lounge. Owen realizes she has phantom limb pain and assures her it's very real. He uses a mirror to re-route her brain. Arizona feels slightly better. She's angry to feel pain from a leg that's not there. Owen vows to help. Arizona meets with Karev about tomorrow's surgery. He offers to let her sit out - he doesn't want anything to jeopardize the program. Arizona insists she'll operate.
Meredith and Shane travel by ambulance to get a liver. Shane rambles about her pregnancy until she snaps. Once at the other hospital, Shane's mistake costs them the liver.
In the ER, Matthew, a paramedic, watches as April yammers away at Stephanie.
At home, Arizona has a nightmare about having leg pain in surgery and cutting her own leg with a scalpel. In the morning, she pretends to Callie that she's fine.
Back at Seattle Grace, Shane listens as Meredith and Bailey discuss waiting for another liver to become available. Meredith is reaming Shane out when the call comes. She says he'll have to fly to get the liver - all he has to do is carry a cooler. Bailey decides to go with him.
In a room, Owen teaches Arizona biofeedback with ocean waves. Later, he and Dr. Cahill observe the African girl's surgery. Arizona yells out. Owen tells her to picture the waves and sends Cahill to Derek's surgery. Derek kicks her out. She returns to find Owen ordering Alex to stab Arizona in the foot. It works - the phantom pain stops.
Stephanie is reciting medical terminology while making out with Jackson in the on-call room. She admits she's too busy and leaves.
At the airport, Shane and Bailey are surprised when Meredith shows up determined to fly. Bailey disembarks. They take off.
In the Portland hospital, Meredith is upset to see a mass on the harvested liver. They do a biopsy and it's fine.
In surgery, Jo tells Derek there is no face twitch. He says they may have lost the tumor patient the ability to move half his face. Later, they learn he is okay.
Back at Seattle Grace in the liver surgery, Shane is alarmed when Meredith cries, apparently from happiness.
At the nurses' station, April grills Stephanie, who passes the 'test'. Matthew, the paramedic, appears and asks April out.
Dr. Cahill holds a staff meeting and mentions the African orphan program. Christina surprises everyone by defending it. Cahill's proposal is actually that the hospital close the ER. Arguing ensues. Derek gets confrontational. Bailey snaps that not all of them have millions to fall back on, so unless he has a better idea, he should listen to what she has to say.
Near the elevator, Cahill talks to Richard about when he was her teacher. She says she'll be making changes - he should be proud. She notes that he logged the least amount of surgery hours last month.
At home, Meredith and Derek discuss Seattle Grace. Meredith congratulates Derek on his surgery and says she flew on a plane today.
In bed, Callie and Arizona visualize being on a beach.
I loved that Derek operated again and Meredith flew. The bit with the pregnancy hormones was pretty funny. Owen helping Arizona was also cool - but what a gory nightmare she had! So glad Alex's program wasn't on the chopping board. Christina was hilarious defending the orphans! The hot new paramedic is very intriguing and the actor playing him used to be one of my favorites on "All My Children." Yum! Dr. Cahill seems scary - yikes!
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