On this week's Grey's, Meredith's first patient is back, meaning we get reminded how young and happy she once was. Look at the light in her eyes! It's almost as if she hasn't just seen an enormous amount of loved ones die untimely deaths. In present day, the interns are fooling around in the cadaver room, and Meredith wants them to show respect. April still hasn't told Jackson she's pregnant. She explains to Arizona that telling him will burst her happiness bubble. No, April, it will bring you back together in love! Haven't you ever seen Grey's Anatomy before?! It seems like Maggie and Amelia are back to being buddies, even if Meredith isn't ready to completely repair the sister trio. Amelia is missing a boot because she left it at Owen's after some amazing sex — all to avoid getting caught by Webber (too late, by the way). Maggie and DeLuca haven't been having sex. Hers is a life of pain and suffering. You'd think working on life-and-death cases would give them some perspective, but the one thing that unites the Grey's doctors is looking at both a tumor and a mild sex drought with the same look of pain in their eyes. When Edwards complains that she and Amelia are in a rut of aneurysms (#doctorproblems, but actually probably more of a problem for the people with BLEEDING BRAINS), Amelia promises she can clip the next one herself.
And in rolls the next aneurysm, Katie Bryce, Meredith's first patient from the Grey's Anatomy pilot: This patient marks the first time she and Derek looked at each other with meaning in their eyes over an unconscious patient. It seems like Katie hasn't grown up at all in the last decade (though her lipstick game has improved considerably), and now Amelia is filling in for Derek. Which feels like it could be... a metaphor! Meredith insists she's still her patient, and she's still on the case. Could this be the surgery that has Mer and Amelia back to braiding each other's hair? Meredith and Penny are discharging a now cancer-free patient who's one month from getting her diploma as an older college student, who hasn't called a mysterious "David," as she promised Mer she would. Luckily she needs to be kept in the hospital so the docs can investigate a possible problem with her chemo port, because she still has things to learn — or something! Jo confronts Alex about the engagement ring still in the drawer, and when pushed for an answer on their possible nuptials, she bolts from their shared elevator. As one does. Arizona and Richard now constitute our favorite friendship on Grey's, with Richard taking the responsibility of being Arizona's wingman very, very seriously. In his downtime, he's torturing DeLuca because he's having sex with Richard's recently discovered daughter. It's antiquated and inappropriate, but he does have to make up for years of glaring at middle school boys.
Meredith's cancer patient has a huge bleed when they try to remove the port, meaning cardio has to be brought in — the massively unpopular Riggs. While Mer holds a bunch of paper towels over the wound on her patient's chest, which seems troublingly similar to how a complete nonmedical person like myself would deal with the situation, Penny plays carrier pigeon for Meredith and Amelia as Mer tries to get info on Katie Bryce. Instead of Penny clearly explaining exactly why Meredith doesn't chat up Amelia herself, she keeps things vague, until Amelia and her sister-in-law are basically in a new fight. Communication, people — it's what could have saved Romeo and Juliet. April is surprising everyone with how calm she is post-divorce, but at least no one has accused her of having a "glow" yet. And Maggie and DeLuca are off to fit in some on-call-room sex. But the hookup is disturbed by the revelation that DeLuca didn't know that Maggie is Webber's biological daughter. Honestly, don't these docs have a private Facebook page or an email chain or something to keep them up to date on the gossip that runs rampant among their group? Maggie tries to chat up dear old dad about her non-boyfriend, but she ends up just accidentally introducing a lot of innuendos.
Amelia tells Katie the giant aneurysm surgery will be risky but necessary. Meanwhile, cancer patient Daphne might need surgery because she's suffering from septicemia. Riggs wants to operate, but Grey puts it off, just like Daphne is putting off calling her son David, whom she left six years ago. Looks like the start of another doctor metaphor.
Amelia's freaking out over the giant aneurysm, but Hunt gives her a pep talk, which is nice of him considering she's implied she's not ready to give him any more boot-losing sex. Daphne calls her son and wraps up her phone call just as the docs realize they need to get the profusely bleeding woman into surgery — ASAP. As Meredith stays on the gurney to keep pressure on the bleed, she passes Katie, triggering a flashback to Derek and his catchphrase (the one part of McDreamy I totally don't miss). Post-surgery, Katie survived, but poor Daphne died. Her passing prompts a very tense heart-to-heart between Meredith and Riggs when we learn the mystery of Riggs and Hunt's feud. Riggs and Hunt's sister were working together overseas, and when she insisted she go with her patient on a risky helicopter ride, he let her. So Hunt's anger is just as unjustified as you might have guessed. Jo tells Alex to keep the engagement ring in the drawer, which is basically saying keep the marriage proposal on ice, which seems massively unfair to him, but he rolls with it. And after seeing a crushing moment of civility between Jackson and April (he pays his half of their phone bill because he doesn't want "to leave anything undone"), Alex becomes another person urging her to tell her ex she's having his baby.
Katie's okay, but she'll never learn the story of her two surgeons falling in love, having babies and crazy elevator sex, so is she really okay? Maggie and Webber come to an understanding about his dad-style protectiveness over her. And poor David comes to see his mother one last time. And, once again, Grey's ends on a predictably sad note.