Part two of the two-hour season finale. Meredith and Cristina wheel Derek to the OR to find Teddy, but Jackson tells them she and Owen already left with their patient, so Cristina and Jackson decide to perform the surgery instead, while Meredith and April wait in the other room. Mark tries to keep Alex alive while Lexie sets out to retrieve blood for Alex and runs into Clark, who reveals he's after Derek, Richard and Lexie, because they are the ones who decided his wife should die. A sniper shoots Clark in his shoulder and Lexie escapes. Bailey and Mary try to help Percy, but are unable to get him to an OR because the police shut off the elevators; Percy eventually dies in Bailey's arms. Richard, who is outside, hears all the emergency calls from the doctors who are still inside and sneaks past the cops into the hospital, much like Owen once he realizes Cristina is still in the hospital, marking this as his final decision between Teddy and Cristina. Mark and Lexie (who also says she loves Alex) are able to stop the bleeding in Alex's chest and while delirious, Alex calls out for Izzie and begs her to come back. Owen finds everyone else in the OR and, unbeknownst to Meredith and April, so has Clark. Owen tries to calm Clark down while he is holding a gun to Cristina's head trying to make her stop operating on Derek. Meredith realizes Clark is in the OR and tries to sacrifice herself instead of Derek since she is his wife, is like a daughter to Richard, and is Lexi's sister. Owen lunges for Clark and gets shot. Jackson tricks Clark into believing Derek is dead by removing the leads on Derek's heart monitor, so Clark leaves. They continue surgery while Meredith helps tend to Owen and then suffers a miscarriage. The SWAT team enter the hospital while Richard finds Clark, who then decides to shoot himself with his last bullet. The hospital turns into a crime scene and Meredith silently mourns the death of her unborn baby.