The storm that led to Grey-Sloan Memorial Hospital being overrun with patients rages on. Owen wants to assemble the board to possibly shut down the ER. The members are dealing with many personal issues. Meredith and Derek just had a baby. Arizona just revealed her affair to Callie, who then clues in all of their fellow docs in on this breaking news. An engaged April confronts an injured Jackson about the status of their relationship, while Alex and Jo look for an original place to get intimate. It seems the adventurous Dr. Karev has had sex in every on-call room in the land. Bailey is trying to track down Richard, but no one knows he's been electrocuted in the generator room.
Cops and firefighters roll into the hospital with injuries from a mudslide. There are civilian casualties as well. There's no way the ER can close now. Owen works on a firefighter captain named Lenny. The guy's in bad shape. Also hurting is a woman named Lydia. She's worried about the fate of her house. Bailey worries about not having enough general surgeons around. She orders Shane to find Richard. That never happens. Shane tricks Heather into doing the search. So off she goes. Heather reaches the area where Richard is hurt. One step into a pool of water has her being electrocuted, too. THWACK! Heather slams her head while crashing to the floor.
Shane finds Richard and Heather. Both are in bad shape. Cristina works a balloon pump into Richard as Bailey talks her through the fact that she didn't rupture his aorta. The patient has a steady heartbeat. Cristina Yang isn't a hugger, but that doesn't stop Bailey from forcing one on her. Richard isn't out of the woods though. Bailey wants to open him up. Cristina believes that's the wrong move. The decision on what to do doesn't belong to either one of them though. Richard made Meredith his go-to person for situations such as this.
Sasha, a cop with a nasty neck laceration, worries that her fiance, Brian, hasn't come in from the storm yet. She believes he's okay though. Someone at the mudslide scene used a Sharpie to write down vital signs on the skin of those who were injured. Sasha thinks it had to be Brian. It wasn't. The on-the-scene triage Sharpie-wielder was actually a patient, Lydia. If Stephanie had known that, she probably wouldn't have yelled at her for worrying about her house. Lydia takes a turn for the worse.
Lenny the fire chief takes a turn for the worse, too. Owen and April can't save him. His crew gives the order to escort his wife into the hospital with full lights and sirens. Sasha lets everyone know that there's still a missing man out there. They need to bring him home. They need to do it for Lenny. Alex tries to keep the firefighters safe inside by convincing them to give blood. The missing man is found. That's the good news. The bad news is a flesh-eating bacteria is attacking Sasha. Jackson needs to operate pronto.
In random updates, things are tense between Callie and Arizona as they are forced to work together. April leads Chief Lenny's wife in to say goodbye to her beloved husband. Meredith makes the call to operate on Richard. Cristina says she made the right decision even that may not be what she truly believes. The swelling in Heather's brain is bad. There's no way she's getting out of this situation without major deficits. Shane believes this is his fault, but he promises Derek that he'll be okay to assist. The lives of Dr. Richard Webber and Dr. Heather Brooks hang in the balance as their colleagues prepare to do whatever it takes to save them.