Meredith struggles to stay afloat and eventually begins drowning, but nobody is around to notice. Derek finds her coat on a man she had helped, and starts looking for her and, much to his shock, the little girl Meredith took care of indicates that she is in the water. Derek saves her, but she is almost dead, due to hypothermia. The little girl gets reunited with her mother. Izzie has to perform brain surgery on a man stuck between cars, as he begins to experience seizures. She drills holes into his head, to relieve the pressure on his skull and ultimately saves his life before he is rescued and transferred to Seattle Grace Hospital; this leads to Webber allowing her back into surgeries. George lies to the woman whose son he had been looking for, in order to get her to surgery, and eventually finds Callie operating on the son. Alex is unsuccessful in searching for the pregnant Jane Doe's family as she undergoes surgery, and at the same time he also has to deal with the families of the victims. The interns find out about Meredith's situation and express their hopelessness. She wakes up in what appears to be limbo and meets her deceased acquaintances.