Still haunted by the horrific shooting rampage at the hospital, the staffers struggled to rebuild their lives, and flashback-filled sessions with trauma counselor Andrew Perkins (James Tupper) – a requirement before returning to surgical duty – revealed just how much one day irrevocably changed everything.
Derek survived a bullet to the chest and became a seize-the-day adrenaline junkie, racing his car down the Seattle freeways like Mario Andretti (which frequently landed him in jail) and impulsively resigning as chief in order to try and save a teen from a massive, life-threatening tumor.
Bailey, who left town with her son to stay with her parents after the tragedy, broke up with her boyfriend upon her return.
Alex refused to have the bullet removed from his side and abandoned a newly brunette Lexie when she had a breakdown and wound up in the psych ward.
And while Dr. Weber was so thrilled to be reinstated as chief that he busted a move in his old office, even he admitted he was still rocked by nightmares and attending twice-a-day AA meetings.
The only one who seemed to have escaped the ordeal relatively unscathed was Teddy, who'd managed to move on from Owen by hooking up with Perkins.
All of the doctors got the go-ahead to return to work except "twisted sisters" Meredith – who refused to tell Derek about her miscarriage, even when he suggested making a baby – and the recently engaged Cristina.
Still unnerved by having a gun held to her head while operating on Derek, Cristina couldn't even look at an OR and kept herself preoccupied by frantically flipping through bridal magazines, fascinated by the images of the "simple girls" whose biggest concern seemed to be trying to find the right shoes to wear to walk down the aisle.
In one of the episode's most heartbreaking scenes, she told Perkins, "I want to be the person who gets happy over finding the perfect dress. I want to be simple because no one holds a gun to the head of a simple girl."
Also incredibly moving: The moment when Derek tried to reassure his young patient and his mom – and clearly himself – that the post-surgery trauma was "not a dying pain. It's a healing pain. You won. We won."
The hour ended with notes of hope. Meredith finally gave her bestie her blessing to marry Owen, Callie asked Arizona to move in with her, Lexie stood up to Alex, and the whole gang – save Derek, whom Mer had decided not to bail out of jail after his latest arrest – gathered for Cristina and Owen's low-key ceremony. "I do," vowed the bride, wearing the perfect red dress, before sealing her union with a kiss. She was talking to Owen but, in making a commitment to start anew, she was really speaking for all of Seattle Grace.
Tell us: What did you think of the premiere? Were you happy Cristina, once left at the altar by Burke, finally got married? And what should new hottie Perkins's McNickname be?