Yvette Cruise

The BAU travels to Mexico to aid in the capture of a serial killer who has targeted elderly women.

When a family arrives at Seattle Grace Hospital after a serious car accident, Alex learns that their injuries are only the beginning of their problems. Meanwhile, as Dr. Webber recovers from brain surgery, it seems that his wife (guest starring Loretta Devine as Mrs. Webber) has some concerns about the state of their marriage.

As Meredith nervously awaits a final decision from Derek, her angst is interrupted when a train crash brings several seriously injured patients to the hospital, including Bonnie and Tom, a pair of passengers who've been impaled on a metal pole. And Addison Shepherd sees great potential in Izzie, who must decide whether her loyalty as Meredith's friend outweighs professional gain.

Cristina scrubs in on the rare "humpty dumpty" procedure, much to the envy of her fellow doctors, Alex questions his future medical specialty, George and Addison work with a pregnant woman with an unusual dilemma, and Derek receives a surprise visit from his sister.

Earl (Jason Lee) realizes that he had been cheating the government by failing to pay his taxes in the past. After adding, "cheating the government" to his list, Earl becomes determined to pay the government what he owes, but apparently they don't want his money. Earl's attempts to settle his debt leads him to conjuring up unconventional payback methods. Ethan Suplee, Jaime Pressly, Nadine Velazquez, and Eddie Steeples also star.