Plot

Meredith keeps herself busy while Derek prepares for his move; Jackson and April get difficult news; Arizona and Amelia talk about how best to approach Dr. Herman.

Everyone is dealing with the tragedies they left behind before the winter break. Derek is preparing to leave for Washington, D.C., after telling Meredith that he resents her because he gave up everything for her. Jackson tells April the news that something is wrong with their baby. Amelia and Arizona are figuring out what's going on with Dr. Herman brain tumor. Through all this, Derek looks at a framed Post-It note from the vows he and Meredith made to each other. The framed one is about loving each other even when they hate each other. "No running," Derek says in a brief flashback. After Derek is gone, Meredith throws the frame in the trash.

The doctors are getting ready for potentially many casualties after a woman drove into a bunch of cars intentionally and drove off a bridge with her two kids in the car.

The apparent driver and her two kids arrive in ambulances and Meredith seems worried that other doctors are jumping to conclusions about the woman's actions. When the woman's husband arrives, Hunt tell him that his wife "was the driver" who drove off the bridge, and Meredith doesn't seem to like that.

Arizona is nervous about telling Dr. Herman that she's been examining her case with Amelia. She needs to figure out how and when to tell her, but they walk into the room with her scans on the screens and Dr. Herman is there. She is not happy. Amelia tries to save the day by telling Dr. Herman that she can remove the tumor. Dr. Herman walks out to a surgery.

Jackson tells Hunt that April shouldn't be operating, asking him to trust him. Hunt goes to tag April out of surgery, but she refuses to leave. She knows Jackson went to him and she's upset that others are deciding what's best for her. He finally has to tell her it's an order, and she leaves.

In surgery, Meredith breaks the news that Derek left for D.C. and asks Hunt if he's going to kick her out surgery, too, so she can go paint her nails or "have a good cry." Stephanie pipes in and says the news is about their baby and "it's bad."

April does seem to be struggling a bit as she walks through the E.R. The younger child of the alleged driver tells the police and his father about the moments leading up to the crash. April unloads on Jackson about letting the police "interrogate" the boy. She's also upset that he had Hunt take out her out of surgery. Webber walks in on Jackson in a supply room and Jackosn breaks down crying after Webber asks him if everything is OK. "No," he says. "Everything is not OK."

A teenager and his younger brother have been getting examined by Alex, Jo and Bailey, but they refuse to give their names because the teenager is worried his parents will be upset that he was driving. Bailey and Alex butt heads about how to treat the teenager, but Alex pulls ranks and Bailey doesn't like it.

April is checking on another patient when Pierce asks her if she's having a boy or girl. April freezes for a moment. She then pulls Stephanie aside and berates her for not telling her about her own baby before she went and told Jackson.

The husband of the woman who drove off the bridge confides in Stephanie that his wife is stressed and juggling a lot of things, and he doesn't help enough.

Dr. Herman tells Arizona she's tired of getting her hopes up for a cure because it's happened too often. She says all she can do is embrace what she knows, which is that this thing is going to kill her.

Meredith guesses that the woman has a tumor on her pancreas, and that might explain her low blood-sugar levels and might have caused her to drive off the bridge.

Bailey is grilling the young brother about his identity, but he won't budge, repeating his brother's orders by saying, "I'm a brick wall."

Alex and Jo are checking out the teenager when he crashes and Alex decides he has to cut him open.

April again loses it, this time talking to Callie, about how "this woman" who drove off the bridge hurt her own kids and all those other people.

The husband again beats himself up over not having noticed his wife's stress. He cries and wonders why he couldn't have been more prepared. Jackson goes to Arizona and asks if she can talk to him about their baby's situation.

Meredith pokes around the woman's pancreas in search of a tumor, which Hunt doubts she'll find. But she does.

Bailey finally gets the younger brother to hand over his cell phone, so that she can contact their parents. He cries and says it's all his fault because he asked his older brother to drive him to get ice cream.

Meredith and Hunt explain to the woman's husband that her tumor was causing the distractedness, forgetfulness and likely the accident.

Arizona, who'd previously walked out of surgery with Dr. Herman, tells Dr. Herman she's blowing a chance she has to be cured. Herman goes into a bathroom and cries alone for a moment.

A nanny Meredith is interviewing reminds her that she's been waiting for hours to talk, and Meredith tells her that she needs someone who can support her.

Dr. Herman comes to Arizona and Amelia and says, "Let's talk."

Amelia presents her plan to Herman and Hunt. Herman agrees to let Amelia operate, but only if and when the tumor starts to threaten the optic nerve.

Alex and Bailey have a little heart to heart and Bailey laments that she's also missing her child's life.

April and Jackson start talking and April says the disease that their baby seems to have won't end up well. April gets upset when she learns that the woman with the car had a tumor that left her with no control. She wonders why God would do this to someone. She then breaks down and tells Jackson that they were having a boy.

Meredith and Derek talk on the phone just as he's boarding his flight, which has been delayed all day, and they apologize to each other and promise to try to make it work. Meredith takes the framed Post-It note out of the trash and hangs it back on the wall -- leaving the cracked glass as is.