Grey's Anatomy Episode 11.09 Where Do We Go from Here

Derek and Meredith recall the past milestones of their rollercoaster relationship as he prepares for a move to DC. Once he's gone from the house, the framed blue Post-It is removed from its place above their bed and deposited into the trash by Meredith.

A woman, Brooke, rammed a bunch of cars before taking a sharp turn off a bridge with her two kids, Mia and Parker, also in the vehicle. Police believe this was an intentional act. There are many casualties coming into the hospital from this incident. Many of them are children. Word of all this comes moments after Jackson tells April of their unborn baby's dire health issues. He asks Owen to pull his wife from all surgeries.

April is ordered out of her OR. She ends up wandering through a sea of casualties, including the kids with the suicidal mom. April orders Jackson to help and protect those children. That won't be easy. Jackson is barely able to hold it together when Richard asks if everything is okay. As for April, she lays into Stephanie for not telling her something was wrong with her baby when she had the chance.

Two young brothers refuse to give up their names when they are brought in to the hospital. The older sibling was driving even though he's underage. He's also in bad shape. Alex and Jo work on him while Bailey works to get info from his younger brother. She eventually gets what she needs. Bailey also begins to question her own parenting skills. Her busy work life is causing her to miss things going on with Tuck.

Amelia forces Arizona to tell Dr. Herman that they've been looking for ways to attack her tumor. Too late! She already knows. Dr. Herman refuses to believe there is any hope. This infuriates Arizona. She berates Herman for wasting a chance to live. Her words hit home. Dr. Herman decides that the operation will take place just before there's a point of no return. Until then, Arizona will continue to absorb her knowledge.

Meredith is disappointed to learn that the suicidal mother didn't have anything in her system. She was hoping there would be something to explain her actions. Owen asks Meredith if she's talked to Cristina. It's been awhile. It's because of what Cristina said about her and Derek before she left. Meredith knows she was right, and she doesn't want her to be right. As for the mom, Brooke, she may not be suicidal after all. A tumor on her pancreas may have dictated her behavior.

Mia and Parker's dad blames himself for missing the signs with his wife. He breaks down in front of Jackson, who then asks Arizona to help him prepare for what's ahead. As for April, she rants to Callie at how furious she is that a mother could do such a thing to her own children. Meredith knows the answer to that one. Against all odds, she finally finds the tumor she suspected was on Brooke's pancreas. Time to take it out!

Owen lets Meredith know that he told Cristina to leave. It's not exactly the same situation as the one with Derek, but it's pretty close. Meredith meets with Lynn, a woman who has been waiting around all day for a possible nanny position. She says needs help. She needs support. She needs a person who is in it with her. Meredith breaks down in tears. Lynn tells her all will be okay as she gives her a hug.

Richard steps out of the hospital to call to Catherine. The two of them need to talk. Back inside, Owen thanks April for her work, for work is just what she needed on this day. When April finds out about Brooke's tumor, she questions why God would let something like that happen. Jackson has no answer for this. After fighting it for so long, April finally breaks down in tears. She tells Jackson that their baby is a boy.

At the end of a long day, Meredith makes a phone call. She catches Derek as he's preparing to board his flight to DC. They both admit that they don't want things to end this way. Meredith encourages Derek to go, but in a good way. They can do this. They will make this work. Meredith doesn't hear this last declaration as the cell phone signal dies. She likely felt it though. Meredith fishes the framed blue Post-It note out of the trash. It's placed back on the wall over their bed-back where it belongs.