In real life, getting on a plane is a normal, fairly risk-free thing to do. On Grey’s Anatomy, getting on a plane is like playing Russian roulette - and somehow, Meredith always gets the loaded chamber.
This time around, she’s flying to a conference and ends up sitting next to Riggs, who she didn’t know was also going to the conference. This is a bad shock to Grey, but a pleasant surprise to Riggs: He quickly points out that they’re about to have three days alone together without anyone around (or rather, anything they know around) to bother them and get in their way. It sounds pretty nice. Meredith, though, is busy acting like they’re over. She tells Riggs she wants some alone time and then goes to the bathroom... where he also goes, thinking she made inviting eyes at him. She didn’t. But now he’s there and she’s there and, well, airplane bathrooms are very, very small.
At first, there’s some more back-and-forth. Meredith tells him she’s simply ignoring her feelings toward him, partly because she doesn’t want to hurt Maggie. He responds that Maggie isn’t there, and somehow, that kinda works. He’s about to leave, realizing that Meredith is serious when she says she doesn’t want to do anything with him, but then, it turns out, Meredith isn’t that serious. She’s standing in front of the door, his only exit. Instead of moving to let him out, she leans in to kiss him. Meredith is in a lot of clubs - ones for people with dead parents and dead husbands and dead sisters, for example - but she just joined the most fun one yet.
And she doesn’t want to talk about it. After they leave the bathroom, she wants to pretend like it never happened. This is all good and fun until turbulence strikes. Like, bad, pop-a-Xanax-and-say-your-prayers turbulence. Luggage and people go flying, and once it calms down a little, Meredith notices Max, a friend she made on the way out of her bathroom romp, is on the floor, seemingly unconscious. Never get on a plane with Meredith Grey!
At this point, Meredith is having flashbacks to that time she was on a plane that crashed. But she’s one of only a few doctors on the plane - Riggs and a very cute pediatric dentist are the only other two - so she can’t let these get to her. Not now, at least. So she doesn’t: She’s immediately in doctor mode, trying to figure out if Max has a brain bleed. Together, she, Riggs, and Cute Dentist go around doing their best to fix up people with the few tools they have. No matter how qualified they are, there are some things they just can’t do in the air. Once Max starts vomiting and seizing, Meredith demands the captain make an emergency landing to save this guy’s life. The captain says no - they’re between two storm systems, and landing now could put everyone’s lives in danger. Meredith doesn’t like this answer, but she has no choice but to accept it, so she gets to work.
But it’s not all saving lives. After Max seems stable for a moment, Grey and Riggs take a seat, and she regales him with stories of the plane crash. “Sometimes I feel like I’m cursed,” she says. “A lot of people die around me. Sometimes I just feel like I’m waiting for my turn.” Well, yeah.
After Max’s seizure, Meredith realizes they have to do something with him or else he’s going to die. So she enlists Riggs, a passenger, and Cute Dentist to help her stick a needle in Max’s brain. She seems confident, but, unfortunately, confidence doesn’t prevent turbulence. Her attempts to do the procedure keep getting interrupted by the rocking plane, though she’s ultimately successful. And right when the turbulence worsens and it seems like they’re all about to die, the plane lands. They’re safe.
On the ground, the pretty flight attendant hits on Riggs. He rejects her flirtation, thinking of Meredith the whole time. Again, he’s excited by the prospect of them getting some time alone together, while she’s stressed out by it. He doesn’t understand how she can be so strong and brave, like the way she just was on the plane, but be scared to be with him; she’s insistent that she’s making a choice to prioritize her family, her sister. Then he brings out the big guns: “You’re scared of letting him go,” he says, referring, of course, to Derek. And maybe he’s right.
The episode ends with Meredith agreeing to go find a hotel with Riggs, where she will, presumably, prioritize herself. And honestly, after the flight she just had? She deserves it.