Twelfth place? Twelfth?! We can’t believe it, and neither can the doctors of Seattle Grace when our favorite hospital winds up ranked number 12 in the country. The Chief takes the ranking extremely personally and, after steaming for a good long while, starts to think about how to get SGH back on track. We can’t have patients going to Mercy West!
Now that Meredith and Derek are back together, she keeps dreaming that he's dead, which is pretty odd, Mer. She decides to ask him to move in with her and he accepts. Derek’s still got a little issue with a bitter and jealous Nurse Rose, who refuses to transfer out of his department and is making all of his surgeries a nightmare.
It's snowing, but now that Seattle Grace's ranking has slipped, ambulances are taking accident victims to other hospitals. The residents are just about to give up on patient arrivals when a battered limo drives up: Three women on their way to a formal event have gotten into an accident which seriously wounded their driver. One of the women, Betty, appears to have a concussion since she keeps asking where she is. Sarah Beth and Anna are not seriously hurt, but are concerned about their husbands.
Miranda hears that a limo with three men -- the women's husbands -- is on its way to another hospital, so she informs the women they can ask for the men to be taken to Seattle Grace instead. When the men arrive, they're accompanied by Major Owen Hunt, a military doctor who performed triage on the scene -- including using a pen for a tracheotomy. Awesome! Hunt is hurt himself, but insists on checking on "his" patients. Cristina is impressed when he suggests a radical freezing technique to save Philip, who will be paralyzed otherwise. She's even more impressed when Hunt staples shut his own wound without any local anesthesia. This guy is manly!
Sarah Beth doesn't know what to do when she's told that her husband's insurance expires at midnight and that all his credit cards have been canceled. Anna confesses to Meredith that she's been having an affair with Sarah Beth's husband, Michael. Even the patients have this kind of drama at SGH!
Alex insists he's fine and Izzie tells him she still expects to see Denny around the corner, so it's okay if he needs some time to get over Ava. He regrets having broken down in front of her, however, and tells her to leave him alone. Looks like Alex is in defensive mode.
Lexie scolds Sloan for being mean to George and the surgeon correctly guesses that she has a crush on him. He says he'll stop being cruel to George if she'll confess how she feels, but she can’t handle coming out with her feelings like that. George misunderstands the situation and thinks that Lexie is sleeping with Sloan. Get a clue, O’Malley!
Meredith has been talking Cristina's ear off about her anxieties over having Derek move in and finally Cristina snaps and yells at her to shut up, saying that the whole thing is a terrible idea. Cristina slips on some ice outside and before Meredith can help her up, a sharp icicle falls, stabbing Cristina in the chest. Icicle Impaled! Yikes!