George and Derek work together, Denny still doesn't have a heart, and Meredith gets paired with Callie. A 12-week pregnant girl dies in the O.R. and her parents try to keep the baby alive. This causes tension between Derek and Addison. One doctor's overreaction unites two bickering patients. Finn is still treating Doc for medical problems.

Denny needs a heart or else. Izzie and George go crazy trying to get him one. Derek has the life of a friend in his hands as he operates on Burke who has been shot. Burke cannot operate on Denny after Denny's heart stopped and now Denny is in a dire condition. Cristina gets put in charge of the ER and she is worried about Burke.

This episode is the second part of a two-hour season finale. Richard tries to get information from Addison about a family member's condition. Callie and George have a talk about his feelings. Meredith and Derek have a talk about Doc.

A traumatic car accident fills the ER. Izzie pushes the boundaries of her probation. Cristina has a crisis of conscience about her deceptive teamwork with Burke.

Recent events strain Burke and Cristina's relationship. Mark and Derek must work together when two close-knit brothers seek medical help. One of Meredith's half sisters is admitted to the hospital.

It's Halloween at Seattle Grace! There may be jokes, pranks, and/or scare tactics. Some of the women form a club based on an experience they all share. A man volunteers for what most of the doctors believe is an unnecessary surgery. One of the patients is in the hospital because they tried to carve a pumpkin in an unconventional manner.

A patient comes to the ER with a dream and a condition which may prevent him form realizing it. Two patients are competing to win something big. One of them convinces an intern to take their place.

Izzie and George's new-founded relationship results in them having bad sex. Callie's Chief Resident position is taken away from her, and Bailey is the humble replacement. Meredith can barely handle it with Lexie anymore.

There has been a bus crash and the patients are in the ER. Meredith and Derek's relationship gets more complicated when he dates a fellow doctor. Meredith's dad goes to visit her at the hospital.

An ambulance crash endangers the lives of the paramedics involved, as Meredith and the Chief work on-site to save them, Bailey treats a patient who refuses her help, and Ava returns for Alex and meets his other girlfriend in the process.

Meredith works furiously to save a paramedic trapped in an ambulance; Lexie holds the life of a patient in her hands; Derek must rely on a nurse to save a patient; Bailey struggles to balance her personal life with her work.

George has a surprise visitor. Bailey's family is falling apart. Derek sorts through what kissing Rose means. Meredith discovers something that doesn't inspire hope or happiness in her. Alex treats a faith healer.

Time has passed but not much has changed. Sexual angst still runs rampant in the halls of Seattle Grace. Derek and Rose have been dating and Meredith has noticed the activities of her current off-again ex-boyfriend. The doctor's are in the midst of a competition.

Addison visits Seattle Grace because they need skills that only she has. Rebecca/Ava returns with news for Alex. Meredith and Derek's clinical trial experiences one or two developments.

The clinical trial continues to make progress. The anti-McSteamy club creates new initiatives but that isn't enough to stop one woman from spending time with him. Christina is affected by Burke's career developments.

Dr. Wyatt refuses to let Meredith give up on therapy. Alex learns something else about Rebecca. The Chief wants Erica to perform a daring surgery. Christina continues to act strangely.

A couple undergoes surgery. Derek and Meredith's clinical trial gets a second shot from a new patient. Izzie helps Alex. McSteamy hooks up with someone.

A couple undergoes surgery. Derek and Meredith's clinical trial gets a second shot from a new patient. Izzie helps Alex. McSteamy hooks up with someone.

As Meredith and Derek begin to find that their "happily ever after" is anything but easy, Cristina develops a crush on a military doctor who brings in a trauma patient. Meanwhile, the Chief and his staff cope with the news that Seattle Grace is no longer considered a top-tier teaching hospital.

Alex is offended when Izzie talks about how great a man Alex is to Meredith. Derek is stabbed with the scalpel in the palm of his hand by Rose, while the Chief is stunned over Mercy West's increase in the number of patients, a deadly ice storm ravages Seattle.

When the plumbing springs a leak, chaos breaks out at Seattle Grace as the Chief tries to put in place new teaching methods. Meanwhile, George takes his residency exam; and Derek attempts to get Meredith's roommates to move out, much to their surprise.

Meredith is sent into a state of panic when Derek finds her mother's diary in the house. Meanwhile, Callie stresses while preparing for her first date with Erica. Later, Cristina stumbles across a part of the hospital no one has ever seen before.

Bailey heads up a "domino procedure" in which each surgery hinges on the one preceding it. Meanwhile, Derek gets sole credit for the brain-tumor study he did with Meredith; Lexie tries to get George to notice her romantically; and Sloan counsels a desperate Callie in the ways of love.

The chief gives Bailey new power and responsibility. He also gives her a very difficult surgical assignment: remove a girl's inoperable tumor. Meanwhile, new trauma chief Owen (Kevin McKidd) challenges the attendings' methods and the residents' skills.

When the Chief makes an announcement that a solo surgery is up as an award, the residents are sent into a frenzy all trying to get an edge over one another. Meanwhile, Derek asks Bailey for advice after Cristina continues to interfere in his relationship with Meredith. Elsewhere, Erica uncovers a shocking connection between a resident and a patient.