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One of Meredith’s oldest friends, Sadie, becomes an intern at Seattle Grace, but Mer’s friends are less than welcoming to her. Lexie leads her fellow interns in secretive, unorthodox surgical training sessions; and a new surgeon, Harriet Dixon, brings rules and order to the OR.

Sam is targeted by a demon revolution that ultimately leads to a revelation that can have serious effects on his future.

After realizing that the latest escaped soul keeps surfacing back to Earth, the Devil informs Sam that a leak has sprung in Hell and tells his bounty hunter to find out how the souls are escaping back to Earth.