The entire staff is down after learning that a publication ranked Seattle Grace as the 12th best Teaching Hospital in the nation.
Dr. Meredith Grey has reoccurring dreams that she interprets as her fear of having a happy ending in her life. She wants to conquer her fear and tells Dr. Cristina Yang that she is wanting to ask Derek Shepherd to move in together.
Dr. Erica Hahn and Dr. Callie Torres are uncomfortable even looking at each other after having kissed last season.
It's snowing and the conditions in Seattle are perfect for the formation of dangerous black ice, which may lead to more hospital patients.
The team wait in front of the hospital, eager to see an inflow of patients. They start to lose hope due to their recent loss of their regional Level 1 Trauma status. Just before they all come in, a badly damaged car swerves in, carrying three women dressed in evening gowns with their driver in the back bleeding profusely.
The driver is dead on arrival, two of the ladies, Sarah Beth (played by Bernadette Peters) and Anna, are okay after treatment. The third woman, Betty, is in a condition where she loses her memory every thirty seconds.
During treatment, the ladies try to call their husbands, but get no response. Miranda Bailey gets word that a group of men were in an accident and convince the women that they might be their husbands. Bailey advises that the women should insist to reroute the treatment of their husbands to Seattle Grace Hospital.
Ambulances pull in with the ladies' husbands on board and an army doctor, Major Hunt, who was involved in the accident and gave care, including giving one man an emergency tracheotomy using a pen.
Yang is instantly swept off her feet by Major Hunt's display of manliness.
The extent of the injuries include the man with a trach, a man losing feeling in his lower body, and one of the husbands having a depressed skull fracture that looks fatal.
Angry and looking for redemption after hearing the news about the drop in ranking, Chief Surgeon Richard Webber is determined to save the most likely doomed man's life.
While waiting at the hospital, Anna, one of the wives, talks to Meredith about her long marriage. Anna says that the duration and the life of compromises continues to chip away her true self. She tells the Grey that she had an affair with her best friend Sarah Beth's husband.
The woman's story puts a crack in Grey's vision of living happily ever after.
In between the time of operations, Derek advises Rose, his scrub nurse that he had a relationship with, to request a transfer due to the awkward and sometimes angry interactions during surgery. She initially says no, but finally agrees after accidentally cutting him with a scalpel.
Derek has more issues during tonight's episode when Dr. Torres makes the decision to attempt an experimental procedure to restore one of the husband's spinal cord functions. Torres takes the lead confidently at first, but freezes up at the first sign of problems. She, however, recovers and succeeds in restoring the husband's functions with the encouragement of Dr. Hahn.
Later, Torres shares her feelings of freaking out at her discovery of attraction with Hahn. Hahn says she is also scared, but that they should explore their new experiences together.
Intern Lexie Grey is also looking for a new relationship and finds herself attracted to George O'Malley, but can't find the courage to let him know about it.
Dr. Mark Sloan sees the attraction and teases Lexie by bullying George around while pressuring her to open up. When Lexie and George are finally alone, she first starts the conversation asking about his love affair with her older sister, Meredith. George comes clean and says that sleeping with Meridith was a mistake. George then says that he sees Lexie as one of his best friends, which discourages Lexie from telling him that she wants more from him.
Another relationship is strained after Dr. Izzie Stev