Its the first day at work for Derek Shepherd in the the much coveted role of (Interim) Chief after a self righteous opportunity arose to have the board remove Richard Webber. Richard can either opt for retirement or rehab with his job waiting for him. Derek insists on the latter option. As Webber takes his time deciding his options there is much speculation as to the exact reason of his removal from office. Derek and he have a heated exchange where Webber forces Derek to admit he wanted his job but Derek after admitting it says he didn't want Webber to lose his.
Karev makes the Mercy West people feel like their jobs are at risk now as Shepherd was never in favour of the merger. This is further evidenced in Shepherds speech where he intends to right all the wrongs. Arizona says Peds is hardcore to Avery when he tries to belittle it to Karev by calling him 'the best babysitter'. In her teaching she says peds have to advocate for their patients but don't berate or judge the parents. Karev once again shows promise in this field.
Bailey has a possible lawsuit against her and the hospital as a patient she operated on awoke in the middle of surgery. She can't trust Bailey and refuses to let her touch her anymore. Bailey blames the Mercy West anesthesiologist in a fit of anger and it seems possible there might be chemistry between them in the future. He figures out the patient's body fights the anesthetic faster than normal and there was no way of knowing that prior to surgery. Bailey excuses her anger by explaining she was scared.
Mark is convinced Lexi is in the wrong for breaking up with him and sleeping with Karev so is ignoring her while she tries to make small talk even though Mark himself went and slept with Addison - twice!
Owen ignores Teddy who in turn appoints Avery instead of Christina as her intern. Owen is overly passionate with Christina. (noticeably so even for Christina) - leaving her with burns on her butt. This was my favourite scene with Karev labelling them 'hot cross buns' and Lexi while treating Christina gets nostalgic about her own sex injuries with Mark which prompts Christina to snap "Please don't cry on my ass!"
Owen has a revelation about Christina nearly walking down the aisle with Burke. Christina doesn't respond to page from Teddy as Owen tells her not to leave their tryst. When Christina figured out whats happening she is furious. Owen confronts her and she finally talks to him about Burke and tells him she loves him more than she did Burke but won't allow him to take control of her like Burke used to.
Meredith and Bailey also convince Richard to go rehab.
Bailey advises Derek that apology is key to being a chief something she shows she is unable to do herself (to 'the gas man').
Derek rehires 2 previously fired interns.