After Derek's death Amelia has been struggling to cope, in this book she will go through drug relapse, alcohol relapse, self harm, suicidal thoughts (along with possible suicide attempts), eating disorder and other mental health issues while her family and friends fight to help her. Please take this as a trigger warning about what will be covered in this book.

After the death of Ryan Kerrigan, Amelia Shepherd decided to get sober, and eventually found out she was pregnant with a baby girl. After getting sober she moved back to Seattle, Washington with her daughter Charlotte. Flash forward 15 years later, and Amelia falls in love with the cute pediatric attending at work, but Amelia isn't sure if shes comfortable with her sexuality. Her daughter doesn't know her crush. Could she keep it a secret? Would Charlotte accept her mother?

Alex and Jo Karev's 16 year old daughter, Katie, is found to be pregnant. The problem is telling her parents.

Jo and Alex have their first child with no problems, or were there?

After Jo and Alex separated, he came back and so do some of the classic characters, all with incredible reasons and lots of intense drama. After finding out about life changing events, does he stick around or leave, for a second time. Mainly Jo and Alex, but includes Callie and Arizona also, with some other ships.

Four siblings get bounced around from foster home to foster home, sometimes together, but most of the time apart. Until one day one of them ended up in the hospital after getting into a fight at school and a doctor decides to take him in after his current foster parents kicked him out.