Dr. Alana Cahill (guest star Constance Zimmer) is a physician adviser who has been hired to help Seattle Grace Mercy West avoid bankruptcy. She was Richard's student a long time ago. Alana is concerned from the get-go when it takes 45 minutes for someone to finally treat her fake ailment in the ER. That's not very efficient. April gives Stephanie a crash course on how to keep things moving in the pit. While this is happening, a handsome paramedic named Matthew observes April from afar until he dials up the courage to ask her out for coffee.
Meredith is having a serious bout of raging pregnancy hormones. She cries constantly, especially when she's angry. This has Shane on edge. He screws up an assignment involving a pregnant woman who goes into liver failure. The patient needs a transplant pronto. Shane tries to chat with Meredith about her pregnancy during their ambulance ride to find a new liver. It doesn't go well. Neither does the donor surgery. Shane makes a mistake that causes the liver to no longer be viable. Meredith is furious. She's also a blubbering mass of tears.
Another liver becomes available in Portland. Meredith still can't get on a plane, so she wants Shane to serve as delivery man. Bailey doesn't want this job left in the hands of an intern, so she goes along for the ride. There's a delay before takeoff. Meredith lets Bailey know that she's ready to fly again. She boots her off the plane. Later, Shane discovers a mass on the new donor liver. Not good. Thankfully, further testing indicates that it's still viable. Back to Seattle they go!