The episode begins and it's the last day of Meredith's first trimester, and it's also a potentially big day in the plane crash suit. Hunt rushes to catch Derek in the elevator and mentions that there might be a judgment that day. Jackson comes around to the group of interns and Stephanie says she's available to help with his case. He pretends it’s "fine" for her to help, but it is shown they're just acting indifferent to each other because they don't want anyone to know they're hooking up. Callie sets up Derek's first "real" day back, but it's not what anyone thinks it'll be. She's having him play ping pong for eight hours to simulate the hand movements he'd be doing in surgery.
Bailey gets a husband and wife couple injured in a stripper pole accident. Phones start ringing and all the doctors from the crash are being asked to go to the courthouse. They get there and learn that they've won. Callie gets there and hears the news; the judge is giving the doctors $15 million each. The hospital's insurance company will be issuing each of them "a big check," their lawyer tells them. Bailey's patient later tells her she was doing a "sexy flexy" on the stripper pole when she fell on her husband. Bailey goes to April to have her check on Mr. Olson. In an elevator, Meredith, Cristina and Derek talk about the houses and football teams they could buy with their money.
Alex is in the elevator getting annoyed and says he "should've been on that damn plane". Jackson shows Leah and Stephanie their patient; James, who was born with Crouzon syndrome. Sloan had operated on James five times to "try to make me less weird looking" James says. Jackson explains that Sloan's plan called for one last operation, but Jackson has a new plan that could be more complicated. Arizona shows up and hears about the new plan. She pulls Jackson into the hall and questions his choice to do something new, but Jackson says he isn't going to argue with her about it. Meredith and the rest of the doctors are about to leave when Heather asks Meredith to check on a 19-year-old college student who's nauseated with a distended stomach and claiming she isn't pregnant.
Meredith goes to check. Cristina overhears this and after Meredith leaves Cristina turns to Derek and says she knows Meredith is pregnant. She explains that Meredith hasn't told her "but she knows I know". Cristina says Meredith will tell her when she's ready to be happy about it. Heather goes to check on the 19-year-old, who is named Taylor. She has an overbearing mother who is answering all of Heather's questions and not letting her daughter speak for herself. Meredith gently ushers the mother out of the room. Meredith comes back in tells Heather she needs to let the patient speak. Derek is playing ping pong and talking to Jackson about James, the patient Sloan had been working on for years. Derek recommends sticking with Sloan's plan. Jackson comes to Arizona, upset that she called Derek in on his surgery plan for James.
Arizona tells Jackson that he's like the new babysitter on Sloan's patient and that he "doesn't even know where we keep the wipes". Jackson, insulted tells Arizona he just wanted to let her know that he's going to proceed with the surgery Sloan recommended. Bailey tells Mrs. Olson that her husband's ribs punctured his diaphragm when she landed on him. She's headed off to radiology for an X-ray and asks whether it's OK that she's "vag-azzled" her vagina. She's put sparkles on it. Catherine shows up at the hospital to see Webber. He says he's been busy and tries to walk away. Catherine tells him she's worried about him. Webber angrily tells Catherine she's not his wife. "My wife died" he tells her, "while I was carrying on with another woman". He tells her that he hasn't returned her calls because he doesn't want her there.
Cristina tells Derek he has to forgive Hunt and stop holding a grudge. She tells him they won and he needs to move on, and let Hunt move on. "He put us on that plane" Derek says. Cristina reminds Derek that he was chief once and made budget decisions based on what he knew at the time. "It's not that easy" Derek says. "I know," Cristina says. "Forgive him anyway" she adds. Bailey is operating on Mr. Olson. Meredith and Webber are in Taylor's surgery and Meredith pulls out a giant hairball from Taylor's stomach. Bailey tells Mrs. Olson she's going to be fine and her husband will be alright, as well. Bailey tells her to "stay off the pole" but Mrs. Olson says Bailey just got back from her honeymoon, but she's made it through 45 years of marriage and having kids.
She's humiliated because her husband looked embarrassed for her when it all happened. Jackson is about to begin James's surgery and Arizona comes in. They have another verbal confrontation about Jackson's plan. He's changed back to his own plan, but Arizona again makes a case for Sloan's plan. Jackson reminds her that Sloan isn't there and he's going to do what he thinks is best. At dinner, everyone is eating in silence. Derek asks Arizona how James's surgery went. She tells him about Jackson's change of plans. Callie demands a toast and insists that everyone drink champagne. Meredith says she can't. Callie insists that she try, and Meredith announces that she can't because she's pregnant. "And I'm happy, so let's celebrate" she says. All smiling, they clink their glasses.
Webber shows up at a bar and finds Catherine sitting alone. He tells her that he should've been there with Adele. He says he failed her when she needed him the most. He tells her he feels like he can't breathe. She tells him he is breathing, so he might as well not do it alone. She asks if she can just hold his hand. He reaches out for her hand. Jackson in the meantime tells James and his parents that his surgery went well and he's "just going to be another pretty face" now. He tells James' parents that Sloan did most of the work and he just got them into the end zone. Stephanie and Leah are watching through a window and Stephanie starts referring to Dr. Avery as "Jackson." Leah starts to mock Stephanie about it and pretends she knows that Stephanie is sleeping with Jackson."How did you know?" Stephanie asks. "I didn't," Leah says. "But I do now" she adds.
Heather on the other hand tells Taylor that she's going to have to start standing up to her mother. Taylor's mother comes in and Heather explains to her that Taylor has a condition that causes her to want to eat her own hair. She says Taylor will need to see a therapist. Taylor's mother snaps back that Taylor will "just stop" like she did when she wanted to stop eating carbs. Taylor stands up for herself and says it's not the same kind of thing; it's a real medical condition and demands that her mother take her to see a therapist. Jackson finds April and tells her that he's "kind of sleeping with Stephanie". April says ok, but starts crying. She tells him she misses him and thought they could still be friends. He says they can still be friends, but she says she's just thinking about kissing him.
She says she's not ready to be his friend. He asks if she's sure and she says yes. From the restaurant, Derek calls Hunt and encourages him to join them and have a drink. Hunt says he can't. Derek passes the phone to Cristina and asks her to get Hunt to join them. She tries to woo Hunt on the phone but he says nothing. Cristina passes the phone back to Derek, who tries once more but Hunt insists he'll join them "another time". Hunt is at the hospital outside the conference room. After getting off the phone, Hunt goes back into the conference room. The hospital's lawyer says the insurance company found a loophole.
Turns out, no more than two attending are allowed on a medi-plane, so when Arizona took Alex's place on the flight, that happened. The insurance company says it isn't going to pay."So, who pays?" Hunt asks. "We do" the lawyer tells him; in other words the hospital. "We don't have that kind of reserve" Hunt says. The lawyer says it means "we go bankrupt; the hospital closes its doors". Back at the hospital, the group of survivors is blissfully celebrating. The episode ends at this point.