- An earthquake leaves Maggie trapped in an elevator and threatens Meredith's streak of successful surgeries; Owen gives medical advice over the phone; Ben opens up Jackson.
- An earthquake hits and the whole staff treats people who're affected by it. Callie and Maggie are treating a 70 year old woman who's hip was injured in the earthquake but actually was injured while having sex. Callie thinks she can fix her hip but Maggie doesn't think her heart can take it so they try to find another way because the woman doesn't want the sex to end. Which makes Maggie reconsider starting a relationship. Meredith treats a group of people who were injured while on vacation. They consist of a man and his daughter and his girlfriend and her son. The daughter doesn't like it because she doesn't like the girlfriend. Jackson wants Ben to join him in surgery and they talk about what's bothering him and driving a wedge between him and Miranda. And a girl calls the hospital and says she and her mother are trapped because of the earthquake and her mother is not breathing. It'll be some time before someone can get to her so Owen tries to talk to her and tell her what she has to do to keep her mother alive.—rcs0411@yahoo.com
- Meredith seems to be avoiding visiting Derek in Washington, D.C., and she's asking Alex why Jo is "stalking" her. Jo tells Stephanie that Meredith hasn't lost a single patient since November. Suddenly, an earthquake hits.
Pierce gets stuck in an elevator with Ethan from radiology. He's been stuck in an elevator after an earthquake before and says it's a safety feature. After an awkward introduction, the elevator opens and they walk out.
Bailey suggests to Ben that he call his sister but he wants her to stay out of his family business. Jackson comes over and suggests to Ben that he could join "the plastics posse."
April is back to work and apparently trying to keep busy. Meanwhile, Callie gets a 75-year-old woman named Jean who's pretty sure she broke her hip in a fall during the earthquake -- and she goes into detail about how she was having sex with her neighbor Herb when it happened.
More patients start to come in after the earthquake, including a soon-to-be blended family where the siblings are arguing -- the older sister annoyed that her stepbrother-to-be ruined the trip by falling and hurting himself, and taking her dad down with him.
Hunt is frustrated with the phone in the E.R. ringing repeatedly and finally answers. It's an 11-year-old girl named Ruby calling from a cabin in the mountains and saying that her mother is unconscious. Hunt tells April to call 911 and get the call traced, but assures Ruby he will help.
The middle of the E.R. is too loud -- April yells at a woman to quiet down after the woman ignored Hunt's first request -- so Hunt decides to transfer the call to a trauma room. It's the most dramatic and epic phone call transfer in history, but Hunt manages to complete it successfully. Amelia is now standing with Hunt and they determine the mother's airway is obstructed. Ruby tells Hunt that her lips are turning blue.
The father from the ski accident confides in Meredith that he's worried his family won't survive the adversity presented by the kids not getting along.
Ben and Jackson present some breast augmentation options to a woman and her boyfriend and she chooses a larger option after looking to her boyfriend for a nod. Jackson says they're not going to do anything right away and they can come back in six weeks. Jackson later tells a confused Ben that it will take the woman six weeks to realize that she's trying to fulfill her boyfriend's dream, not her own.
Hunt and Amelia walk Ruby through some attempts to clear her airway, but they don't work. Amelia stops Ruby from lifting her mom's neck, which was Hunt's suggestion, because she doesn't want to paralyze her.
Jean wants to know what kind of surgery will give her full "flexibility." She wants to keep living it up and having creative sex, and Callie gets it. Afterward, Pierce tells Callie she's concerned that Jean's heart can't take the long surgery that would be required.
With Ruby holding the phone to her mom's chest, Hunt and Amelia realize that she has air trapped in her chest and will need a chest tube to clear it. Hunt decides to try walking Ruby through putting in a chest tube -- but the cell phone Ruby is using starts to beep. The battery is dying.
Micah -- the boy from the skiing accident -- starts to crash and Meredith and Alex try to save him. Jo and Stephanie watch to see what Meredith is going to do -- the streak is on the line. Meredith says it's too late for the crash cart. She gives Micah a solid punch in the middle of the chest, and his heart beat rhythm gets back to normal.
Hunt pauses, realizing that he's asking an 11-year-old kid to cut her mother open, but he has to move forward. Ruby is afraid, but willing to do what she has to do. Webber, who has joined in on the phone call, helps describe for Ruby where she needs to stick a skewer into her mother's chest. She does it, panics a bit, then follows Hunt's instructions to put a straw into the hole and release the trapped air. It helps for a moment, but then Ruby's mother's heart stops. Hunt has to teach her CPR over the phone.
Callie and Pierce look at Jean's X-rays with Ethan in radiology -- who is happy to see Pierce again. They agree to take a less invasive route with Jean. Callie leaves and Ethan asks Pierce out for coffee and she awkwardly turns him down.
Alex and Meredith tell Micah's mother and soon-to-be stepfather about his condition and Karen, Micah's mother, gets upset with him for talking her into the ski trip.
Hunt and Amelia talk Ruby through pumping her mom's chest, telling her to push to the beat of "Staying Alive." They sing it for her and all sing along. The phone is nearly dead, but April reports that the call has been traced and paramedics are on the way by helicopter. Hunt Ruby to keep pumping her mom's chest until help arrives, then asks her to call him back when the medics arrive. Ruby sings "Staying Alive" while crying, and the phone call is dropped.
In surgery, Meredith talks to Alex about how her marriage is perfectly happy and that she's just focusing on her work while Derek focuses on his.
In another surgery, Callie starts asking Pierce about Ethan. Pierce says Ethan isn't her type -- adding that she doesn't date at work. Callie gives her a hard time for implying that she doesn't "date down" after Pierce notes that Ethan is "a radiologist."
Ben's issues with his sibling's gender reassignment start to emerge when he and Jackson are working on a nose job and Jackson explains that he knows the patient is doing the right thing because he talked to her a long time and listened to her reasons for getting the surgery.
Finally, the phone rings again. Ruby's mother comes to the hospital by helicopter. She's wheeled in and Ruby steps out of the helicopter, sees Hunt and runs to hug him, telling him she did exactly what he said until help came.
Amelia is operating on a blood clot in Ruby's mother's head.
Jackson and Ben continue to talk about their patient's nose job in terms of how it relates to Ben's siblings gender reassignment.
Pierce gets defensive with Callie and explains that she just doesn't date. She says there's a "gap" between her and most people. She says she's always been too "different" and things "always get awkward and weird" and fall apart. Callie listens to all of this and says it's "a bunch of crap." She tells Pierce she's just being scared.
Meredith fixes up Micah and Jo sighs and says, "The streak's alive." After some prodding Jo goes into detail about the streak since Nov. 14. Meredith notices the date. She leaves and asks Stephanie to close Micah up. Meredith tells Alex that Nov. 14 is the date that Derek left and she's been perfect since. She wonders if Alex is right -- that she's better off without him.
The ski dad again confides in Meredith that all he wanted was for his whole family to be happy, but now Karen won't talk to him.
Amelia comes out of surgery and tells Ruby that her mom is going to be fine.
Ben comes to Bailey and says he called his sister and "she's fine." His choice of pronoun is notable, but Bailey doesn't react much until he apologizes for having told her to stay out of his business. She also wants him to make her dinner.
Jean isn't wild about waiting eight weeks recovering before having sex, and she encourages Callie and Pierce to enjoy their functioning hips while they have them. Pierce goes to Ethan and accepts his invitation for coffee.
Hunt and Amelia hug in the hallway -- and the hug turns into some more intense action in an on-call room.
Meredith tells Alex that she's doing great and that Derek's journey to D.C. gave her a chance to remind herself who she is without him, but she still wants to share it with him. She wants to tell him that she is -- no, they are -- on a streak. She goes to call Derek -- and a woman answers the phone. Meredith asks who it is and there's no response.
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