Train wreck victims come to Seattle Grace and all staff gets called in. Derek okays Webber for surgery. Addison and Izzie work with a woman who is pregnant and badly burned. Izzie must make a decision that is the equivalent of choosing between her friendship with Meredith and her career's future. Cristina searches for a patient's leg and Alex gets annoyed and wonders if he should be a doctor. Two people are caught in a coin flip situation when they get impaled by the same pole. Finally, a slightly buzzed Meredith waits on Derek's decision.