Could trouble be brewing in paradise for Owen Hunt and Amelia Shepherd already? During Season 13, episode 6 of “Grey’s Anatomy,” after learning that the two were not expecting a baby yet, Derek Shepherd’s sister makes a shocking revelation to Alex that could spell disaster in the future.

Amelia (Caterina Scorsone) is assigned to look after a young boy involved in a car accident with his father. The boy appears OK, with the exception of a large cut to the head, and is checked out, stitched up and sent along. He stands by his father’s bedside, discussing the frightening details of their brush with death, which appears to have been caused by road rage. Away from his father, the boy admits to Amelia that he’s shaken up from the incident, confiding in her that his father was driving extremely fast — so fast, in fact, that he thought the car was going to go off the road.

During their conversation, Amelia’s patient takes a turn for the worse. He faints and is unable to squeeze her hand or respond to simple questions. He’s rushed to surgery, but she and the hardworking team of surgeons are unable to save him. Despite Ben’s (Jason George) insistence that he’s dead, Amelia wants to continue trying to heal him. She finally accepts his fate, slamming a small metal table holding surgery tools with her hands.

Outside of the operating room, Amelia finds herself alone with Alex (Justin Chambers), who has just been dealt a difficult hand himself. She confides in him that she once had a child who was born with a condition that left him with only hours to live. She told no one in her family about the child, and was the one and only person who held him before he died. Amelia admits, for the first time, that her first child’s death is the reason she was so relieved when the pregnancy test she took in episode 5 came up negative. She tells Alex that she isn’t ready for kids and while she knows she needs to share this information with her husband, she also knows that it will break his heart.

Meanwhile Alex’s patient — who he first encountered while waiting in line at the courthouse earlier in the episode — has learned that she’s got pancreatic cancer. The diagnosis leaves her with a tough decision to make. She can either terminate the pregnancy and move forward with treatment, which will give her only a few months to a year to live, or continue on and potentially die before the child is even born. Alex presents her with a non-traditional surgical option, much to the dismay of Bailey (Chandra Wilson), who is already frustrated with him because of outside pressure from Catherine (Debbie Allen) to fire him. In time she realizes that he was right, but isn’t willing to let him perform the procedure.

She and a group of surgeons bring Alex’s patient into the operating room and are able to remove the tumor, buying her more time. In addition to struggles in the clinic, Alex has finally received a date from the court in regards to a trial for the assault charges against him. He is not feeling confident about the case and it’s causing tension in the hospital.

DeLuca (Giacomo Gianniotti) is waiting on baited breath to hear when he and Alex will have to face one another in court and is also grappling with jealousy after seeing Jo (Camilla Luddington) and Alex talking. He confronts her, suggesting that they stop talking about the case for fear that she’ll share information with Alex, and learns that the two were just teaming up on the clinic case. Could a romance be budding between the pair?

Tune in to “Grey’s Anatomy” next Thursday at 8 p.m. EDT on ABC to find out.