Over some tense guitar music, there's a montage of the ambulance crash and Meredith and Cristina's dancing while Mere revisits the theme she started last week: "At the end of the day, the experience of practicing medicine bears little resemblance to the dream." Alex is down to his tank top, making out with Ava. Because her priorities are clearly out of whack, she keeps stopping their making out to ask him if he's okay, and does not seem to be grasping the "even if I'm not, I don't want to talk about it with you" that he's conveying by brushing her off and kissing her again. Instead she reminds him about how intense and awful the day was, and asks, "How can you be okay after a day like that?" But he doesn't answer, so we're left to wonder just how awful it was as Meredith reminds us, "We go into medicine to save lives."