The episode, along with its second part, earned Rhimes a nomination for the Primetime Emmy Award for Outstanding Writing for a Drama Series.
[2] The episode opens with a voice-over narration from Meredith Grey (Ellen Pompeo) about the inevitability of death and the importance of pursuing one's dreams before it is too late.
In a dream sequence, George O'Malley (T. R. Knight) imagines himself in the shower with Izzie Stevens (Katherine Heigl), Cristina Yang (Sandra Oh) and Meredith Grey (Ellen Pompeo).
One of the paramedics, Hannah Davies (Christina Ricci), has her hand inside the man's chest cavity to stop the bleeding.
Dr. Preston Burke (Isaiah Washington) quickly takes charge of the case, and Alex Karev (Justin Chambers) is assigned to calm down the hysterical wife, which he successfully does by yelling back at her, shocking her into composure.
Richard Webber (James Pickens Jr.), struggling to maintain order amidst the chaos, does his best to keep the hospital functioning despite the escalating danger.