Credit: Ron Tom/ABC Family Channel © 2010 Disney ABC Television Group Photo: Alex Karev on Grey's Anatomy February 24, 2011

This week's episode could best be described as Grey's Anatomy meets 24. It chronicled an hour of Meredith's work day, and yes, events did occur in real-time. The backstory is that Mer volunteered to help run the ER one evening in the hopes of improving her standing in the Chief Resident race. But she was not prepared for the influx of cases both critical and crazy she was about to receive.

Big boobs and little pricks: Mer starts out the episode flying high as high as a kite because she's hopped up on hormones as part of her fertility treatment. Cristina mentions that she's considering being Callie's baby's godmother, but Meredith doesn't want her to be — because, in Mer's (admittedly irrational) mind, doing so would be a vote of no-confidence in her baby-making abilities — so Cristina declines. Later, Derek steals Meredith away for what seems like a quickie, but the on-call room is occupied by Bailey and Eli who are "napping" together, so Mer and Der go to the elevator. He tells her to drop her pants and turn around, and we all brace for some X-rated content, but Derek merely injects her with more drugs. Close call!

Oliver's twist: One patient, Oliver, is complaining of chest pains when he's admitted. Mer schedules test after test as time allows, but the dude suddenly codes. She's able to revive him long enough to solicit Teddy's help, and they rush him into surgery because his aorta is dissecting. Unfortunately, it's a next-to-impossible operation, and Oliver dies on the table. Mer then has the unfortunate duty of breaking the news to his wife and son. (Daddy's not exactly gonna be able to make the basketball game, Little Max.) After the surgery, Teddy is finally able to go on a date with this guy William, but Henry has been talking to him in the waiting room and deems him not good enough. A fake husband makes for a great wingman, apparently.

Mitch and his terrible horrible no good very bad girlfriend: Another patient, Mitch, comes in with what Lexie describes a glorified migraine and a girlfriend from hell. Lexie eventually sends him home, but Meredith catches him in the parking lot as he's just on the cusp of a stroke. The docs fix him up, though, and when he wakes up, he dumps his cold-hearted girlfriend.

Wrist management: Richard's wife Adele comes in with an injured wrist. She claims she fell from a ladder while trying to get Christmas decorations down after work. Mer is worried because it's February and because Adele is retired. But the Chief denies anything is wrong and takes her home, not listening to Meredith's concerns.

Knife? Meet brain: The craziest case of all is that of Stewart, who arrives at this hospital drunk with his drunk buddy and a knife sticking out of his head. He and his friend are totally chill with the situation, though, and they even pull out the knife themselves. (We expected lots of red spurts just then.) Luckily for Stewart, the knife caused absolutely zero damage to the brain: it's just a flesh wound. If only we were all so lucky whilst inebriated.

Karev cares: And the sweetest storyline is that involving Nathan, a 4-year-old with a fractured femur. Mer promises his family that she'll get him an OR as soon as she can, but by the time she's able to, another doctor has taken over. It's Alex, who gave up his floor-seat basketball tickets to operate on Nathan. He impresses Lucy with both this noble deed and with his passion for college b-ball, so they flirt the whole episode. Total 180, right? Jackson, having been bequeathed the tickets, takes Lexie to the game. New romance alert!