Grey's Anatomy s08e10 Episode Script
Suddenly
Previously on "Greys' anatomy" Zola was our baby, and she's gone, and I don't want another baby.
You and I broke up.
You basically told me to wait for you.
What the hell happened? That's the screw that I just pulled out of her heart.
I supervised you inserting pedicle screws and a plate.
She's half dead.
Dr.
Altman's repairing her heart right now.
So who's gonna be operating on me? Cristina.
It's her mentor's husband.
Cristina doesn't have to know that it's Henry.
Meredith and Alex are trapped in an ambulance in the middle of the highway.
We think they got hit.
They're sitting in a powder keg.
We gotta get outta here before this thing blows.
It's not right.
If she finds out that I waited, she will never forgive me.
Her husband just died in our O.
R.
She'll never forgive any of us.
Victims of a sudden impact are some of the hardest to treat.
It's not just the collision that injures them.
It's everything after.
The centrifugal force keeps them moving, tossing them from vehicles, throwing them through windshields, slamming their internal organs into the skeleton.
Their bodies are injured over and over again.
So there's no way to know how much damage has actually been done Until they stop.
Sir? Can you move? We need to get you off this road.
Honey.
Jessica.
Answer me.
Mom, wake up! Help them, please.
You have to help! My mom, my dad, The van and I just stepped in blood.
- I-I just stepped in blood.
- Hey, what's your name? Lily.
Okay, Lily, I need you to calm down and take the baby.
- Hold the baby.
- I don't even babysit.
- I can't hold a baby.
- Lily, do you want me to help your family or not? Hold the baby.
Okay, I need you to squeeze.
One, two, squeeze.
What if I mess up? You're not gonna mess up, Lily.
One, two, squeeze.
Count out loud so I can hear you.
Okay, one, two, squeeze.
One, two, squeeze.
No matter what you do, don't stop squeezing.
One, two, squeeze.
One, two, squeeze.
Ma'am, ma'am, I'm a doctor.
Can you hear me? I don't know.
Three or four hours I think.
Yeah, you know what? Hang on a second.
The doctor's back.
This is Laura's mom.
She wants to know how long the surgery should take.
Uh, that depends.
Dr.
Altman is working on the repair right now.
Did you hear that? Um, he says Dr.
Altman's still - No, Altman.
- Mm-hmm.
No, for the heart.
Y-you know, c-can you talk to her? Uh, yeah.
Hi, this is Dr.
Avery.
She's a cardiothoracic surgeon.
No, no, this this is the heart.
No, it's really hard to tell at this point.
Oh, no.
This is cruel.
Her husband is dead, and she has no idea.
She's sewing a woman's heart back together.
Come on.
There's gotta be a better way to handle this.
There's no good way to handle it, Bailey.
This is an impossible decision.
So you land on the side of what is best for the patient, the one who's still alive.
Teddy will understand.
You think so? You got any tape in there? I have to do an adhesive dressing.
Probably.
I just grabbed whatever.
Is my mom okay? Mom? Lily, keep counting.
Why isn't why isn't she talking? Lily! How's she doing? Not good.
I may have to intubate.
Don't you have to do a pressure dressing? Ugh.
I see gray matter.
Brains are on the ground.
Wait.
That's Nana.
- That's my Na - There's nothing we can do.
Oh, crap.
This kid's got a shard of glass in her eye.
She's unconscious.
Her pulse is low.
- That's my sister.
That's Abby.
- Lily Just see the blinker on the van? Just watch that blinker and keep counting.
One, two, squeeze.
One, two, squeeze.
- Lily.
- The kids.
The kids.
Your girls are okay, all right? I just helped one and the other one's right over there.
And Michael? What about Michael? There's another kid? Oh, crap.
- There's no pulse.
- Michael? Dad! Dad! Lily, keep counting! One, two, squeeze.
One, two, squeeze.
One, two, squeeze.
- Michael? - Help.
- Help.
- Michael? Michael? Help.
Help.
Okay.
Um, I'm-I'm gonna check your pulse.
Pulse is a little weak.
All right.
I'm gonna try to free your legs, okay? One, two, squeeze.
One, two, squeeze.
One, two, squeeze.
Meredith, there's a car coming! Oh, crap.
Can you feel your legs? - You gotta get outta there! - Michael! He's trapped.
I have to get his legs free! - There's not time! - Oh, my god! Kid, just keep counting.
Meredith! - Oh, my god.
- You gotta get off the road! Come on.
- Come on! - Oh, my god.
- Help me.
- Meredith! - Squeeze.
- No, don't leave me.
What the hell are you they're not even gonna see you! Meredith, what are you doing?! Stop! Please! Son of a It's okay.
You're okay.
All right? Just breathe.
Just breathe.
Help is here.
Help is here.
One, two, squeeze.
One, two, squeeze B.
P.
's down and she's tachycardic.
We gotta get her up to the NICU.
intubated in the field.
Multiple facial fractures.
Foreign body to the eye.
You're bleeding you need stitches.
No, I'll be okay.
I'm gonna take care of it.
Take the mom to trauma two.
And we need to staff as many O.
R.
s upstairs as possible.
What do we got? Abdominal pain.
Last vitals show a B.
P.
of 100 over 80 and a pulse of 120.
Grey, you need someone to take a look at that? It's fine.
Where do you want me? - Bailey needs hands on bed four.
- Wait.
Is that my mom? - Could you get her back in the bed? - But that-that's my mom.
She needs to be checked out.
Dr.
Hunt, how can I help? What are you doing here? Is Altman out of surgery? Uh, almost.
She's about to take her off bypass, but our pagers kept going off, so she figured, maybe you need some extra help.
Dr.
Webber, I could use you on this.
You, too, Hunt.
- I w - Okay.
Okay, go back into Altman's surgery and tell her that I didn't need you.
I was really hoping to log some more trauma hours.
Kepner Altman's husband died in surgery, and she doesn't know, so I need you in the O.
R.
and page me the moment that she's d Wait, wait.
I'm sorry.
W-what? - Kepner.
- Henry's Kepner, can you handle this? Um, yeah, yes.
No.
No, no, no.
You can't go into her surgery like that.
So go to the gallery and watch the surgery from there.
Okay? She went about two hours with no antibiotics and an unknown amount of fluids 'cause we didn't have a pump.
All right.
Careful with that suction.
We weren't able to suction for a while.
Her pneumonia may be getting worse.
She probably needs another X-ray.
Well, that's great.
You did extraordinary work tonight, Karev.
I've got it from here.
No.
What? No.
Yes.
You were in a major accident.
You need to go get yourself checked out.
Take a breath.
You're gonna sit this one out.
I'm not sitting anything out.
Yes, you are.
Good-bye.
Okay, what do we got? His pelvis is dust.
must be massive internal bleeding.
Can't keep his systolic above 68.
Okay, there's definitely free fluid in his abdomen.
It's just hard to define where the bleeding's coming from.
Where do you want to start? - Pelvis.
- Abdomen.
Abby couldn't wait to sleep in a tent.
Sir, I'm Dr.
Hunt.
B.
P.
's still dropping we're gonna be taking you up to surgery.
Lily didn't even want to come.
Okay, if we don't stabilize this pelvis, there won't be any surgery.
There's no time for fixators.
She wanted to spend her birthday with friends, not-not camping with us.
I said no.
I made her come.
Oh, my god, I I did this to them.
I did this.
You didn't harm your family.
You didn't mean for this to happen.
You didn't do this.
Okay, sir, I am really sorry, but even with the painkillers, this is gonna hurt.
Aah! That should hold for now.
Okay, let's get him to surgery.
Okay.
Altman paged.
9-1-1.
Is everything okay? Uh, uh, we got this.
Go.
Scrub in when you can.
You paged? Yeah, the patient's got a flail mitral valve.
The sutures for the patch caught on the valve when we went on bypass.
Uh, what can I do? You can tell me where Cristina is.
I've been paging her, but she won't answer.
Damn it.
Why won't this hold? Okay, you need a resident? I'll get you a resident.
No, not a resident.
Yang.
This is I need another me, and she is the closest thing.
Don't tell her I said that.
She just got out of surgery.
She's exhausted.
All right, well, splash some water on her face and get her in here.
She can handle it.
All right, sponge stick.
Let's get an irrigation tray and start cleaning this up.
Craniofacial lac? Oh, it's worse than that.
We're a need a retinal-vitreous surgeon.
Yeah.
I've got Lexie calling around for one right now.
Pand Waldman is gonna be at least another hour.
Try Jassy.
Jassy? No, I got someone who will run circles around Jassy.
Hey, babe.
Your girlfriend? Hold on, Julia.
She's great.
You'll love her.
Um, you know, it's gonna take at least 45 minutes to get here from Seattle Pres.
She's not at Seattle Pres.
She's at my place.
It's five minutes away.
Hey, how'd you like to operate with me and Derek tonight? It-it hurts.
My stomach really hurts.
Okay, Michael, we gave you something for the pain.
It should kick in in a minute.
Abdomen feels rigid.
Yep.
Free fluid in the right upper quadrant.
So that could be a liver lac.
We should order a C.
T.
No, keep trying! - That's my mom! - Okay, Michael, I need you to stay still, please.
At what-what's going on? You can't just give up.
You have to keep trying.
She already watched the grandmother die.
Yeah, go, go.
How long you been going? What have you given her and what have her rhythms been? She has been coding for thirty minutes.
She's already gotten lidocaine and amiodarone.
Okay, her kid's outside the window watching.
We need to go again.
Charge to 360.
Clear.
- Push another of epi.
Let's charge again.
- Please.
Dr.
Grey.
Damn it.
Charge again.
Clear.
Damn it.
Come on.
Come on.
Mom.
Time of death 2:27.
Hand me the ultrasound and get me a kit.
We're doing a bedside gastrostomy.
What do you think you're doing? We need to decompress her stomach so she doesn't get more reflux into her trachea.
Karev, you're not on this case.
Look, I've been with this baby since yesterday.
Okay? She almost died.
I almost died.
I didn't go through hell with this kid to just back off.
Then slow down.
Okay? We don't need to rush through this.
Yeah, I know.
Just suction, please.
Cristina, just stop for one minute - and listen to what I have to - No.
I said no.
I know you're exhausted.
This is a mitral valve re I am not operating now! She requested you.
- Now if you don't go in there - Teddy requested me? Oh, my god.
You haven't told her.
You haven't told her yet? What are you no, no.
No, I am not no, - I'm not going in - Cristina, if that patient dies on the table, this will all have been for nothing.
This has this has to be worth something.
Saving a life is worth something.
I can't.
I can't.
I can't.
I can't do it.
You have no choice.
She's waiting.
So go.
How much trauma has your girlfriend done? A lot.
She's told me about a bunch of her cases.
Oh, so we're just going off your pillow talk? If I get a hint that your girlfriend is in over her head, I'm gonna boot her out of my O.
R.
You know what your problem is? You don't think anyone who sleeps with me can be talented or have half a brain.
- That is not true.
- It's mostly true.
Yeah.
Yeah, it's mostly true.
Your ex-wife is brilliant, and she slept with me.
Well I'm not trying to start a fight.
I'm just sayin'.
Ah, Dr.
Canner, thank you very much for showing up on such short notice.
No problem.
Fastball here just updated me about your patient.
Again, I am I'm really sorry for hitting you in the I'm fine.
My breast made a quick recovery.
Mm.
It did.
Okay, Mark.
The glass penetrated the globe through to the orbit.
So she's gonna lose the eye? Normally, yes.
I was thinking, if you used a temporal approach to expose the orbit and decompress the eye, we could save it.
Well, if you do that, there's more risk of bleeding.
That's true.
I could get control of the blood supply first, then enucleate the eye.
But I think the eye is salvageable.
Either way, it's your call.
Let's save the eye.
Agreed.
Lily.
I'm so sorry about your mom.
Yeah.
Your dad and your sister are in surgery.
And I'm about to take your brother up to repair a tear in his liver.
Okay.
Do you know if anyone in your family is on any medications? I don't know.
What about allergies? Has has anyone had surgery? I don't think so.
Do you remember your parents talking about what they would do if someone got really sick? Would they want extraordinary measures taken? I'm sorry.
I know it's a difficult question, but anything you could tell us would help.
No.
We don't talk about stuff like that.
We just talk about normal things, so I don't I don't know anything.
Well, is there anyone we can call? Who takes care of you when your parents go out of town? My grandma.
But she's dead now, so Okay, I've got the bleeding under control.
It's your turn, Dr.
Canner.
All right, pull up my microscope, please.
Okay, 4 by 4.
Speculum.
Saline.
Dr.
Shepherd.
Thank you.
- Damn it.
- Did you just push the glass in deeper? You must have speared a branch of the ophthalmic artery.
Cautery.
All right.
Let me get in there.
It's kind of hard right now.
My hand is in her eye.
- Forceps.
- Canner.
Hold on.
There.
Bone fragment.
Thank you.
I'll be needing that.
A little bleeding is natural, Dr.
Shepherd.
I'm not gonna find any more little presents in there, am I? Mm.
Okay, everyone, here comes the fun part.
Clamp.
All right.
Looks like a grade 4 liver lac.
Grey, do you want to do an omental pedicle repair? - Absolutely.
- Okay.
Heard you lost one of your clinical trial patients today, Dr.
Bailey.
I'm sorry to hear It wasn't my trial that killed him.
The man suffered from Von-Hippel Lindau.
That's what killed him.
Well, I wasn't implying that your trial Let's focus on the living patients, and not the dead ones, okay? Wh-what'd you do? Nothing.
I'm just irrigating.
His temp spiked.
C-o levels are through the roof.
- Well, what's the problem? - Uh, he's tachycardic.
Increased heart rate.
Patient's burning up.
I didn't use sux, but I did use sevoflurane.
Ice.
We need ice.
Wait.
Now this is my patient - Run.
Get ice, now.
- Right away, doctor.
Kid's about to go into organ failure.
I'm pushing dantrolene.
- Let's get some cooling blankets.
- On it.
And turn the thermostat down in here as low as it will go.
Right away, doctor.
Oh, my god.
Malignant hyperthermia.
Where's that ice? What do we got? Oh, good.
I got a flail mitral valve when I took her off bypass.
Just put her back on and cooled her down again.
I need your hands.
Okay.
Oh, and, um thank you for Henry.
I am so sorry that we had to lie to you, but you were the only one that I trusted to do it.
You get it, right? Right.
You're not mad at me? No.
No.
Good.
Okay.
Go get scrubbed.
Gown me.
What did Altman want? How's the patient? She'll be fine now that I put Cristina in there.
You You what? You put Yang in the same O.
R.
with Teddy with my patient on the table? What the hell made you think that was a good idea? I believe it was your mistake that put everyone in this position in the first place, so you're really not one to point fingers right now.
Catch me up.
I can't get visualization of the mitral valve.
The-the left atrium's too small.
What about superior pulmonary vein exposure? Yes, good.
Let's do that.
Scissors.
What is she doing up there? Sorry? Kepner.
She's been sitting up there like a gargoyle.
I thought there was a big trauma.
Oh, yeah.
Um, I don't know.
Did you get a chance to check on Henry post-op before I pulled you in here? I bet no one wanted her.
What? Kepner.
Probably because her voice can peel paint off walls.
Charge to 200.
Clear! I mean, a trauma is stressful enough.
Who needs that? You're you're horrible.
Push 100 of lidocaine.
Am I wrong? - I'm right.
- Would you stop? Stop it.
- Kind of.
- You agree with me.
I can tell - Would you stop? - By your eyes.
Okay, stop.
Oh.
How are they doing? Uh, still trying to repair the valve.
Well, and making fun of me.
What? Cristina doesn't want to talk about Henry's surgery, so instead she's making fun of me.
I'll turn off the intercom.
No, it's I have to know everything that's going on.
It's okay.
I can handle it.
Still bad visualization.
There is a lot of unexpected fibrosis.
We're just increasing our chances of rupturing her heart.
We can't get in there.
There's too much tension on the walls.
All right.
We need to do this right.
We're gonna do an ex vivo.
You want to take the heart out? Can we can we try to Oh, come on, Yang.
A cardiac autotransplantation for an ex vivo valve reconstruction? If that's not on your bucket list, it should be.
Are you up for this? You bet.
Great.
Okay.
We're gonna start with the atrium to explant the heart.
And let's get some music in here.
What do you want to listen to? You pick? Let's get another cooling blanket in here.
Grey, let's repack this liver.
Gelfoam.
What's next? We gave him dantrolene to relax his muscles and lidocaine to calm his heart.
He's on ice inside and out.
Only thing left to do now is wait.
All right, well, settle in.
Could be a while.
Dr.
Warren isn't malignant hyperthermia genetic? - You gotta warn them - Already on it.
How's she doing? She's a little full of herself if you ask me, but she's getting the job done, I guess.
No, the kid.
Abby.
You gotta watch her temp if you gave her any sux or inhalation anesthetics because our kid had a reaction.
Meredith, did you get your stitches? I will.
Fill them in.
Oh, pelvic stabilization's not holding.
- Get me more lap pads.
- More.
- Do it.
Yeah.
I got that.
- You need something? You haven't used any sux or inhalation anesthetic, have you? 'Cause our kid had a reaction.
Oh, damn it.
This hematoma's expanding.
I'll occlude the internal iliac.
Try and get some temporary control.
All right.
I need more lap sponges here.
Just watch his temp.
We got it, Grey.
Thank you.
Hemoclip.
Yeah, hold it right over there.
Yep.
Okay, one more.
Come on.
Let's pack it.
Yep.
Heart rate's coming down.
His temperature's starting to stabilize.
Usually about the time you realize it's malignant hyperthermia, it's too late.
That's a nice catch.
You probably saved this kid's life.
Figured you didn't need another patient dying on you today.
- Oh, so you did it for me? - Oh, yeah.
Any other doctor, I probably wouldn't have said anything.
It's freezing in here.
Well, why don't you jump up and down? That'll warm you up? I think I'll repair the liver.
That'll warm me up.
Suction.
We have to go back in.
What? On the baby.
I forgot to place the tension-free anastomosis.
Do you hear me? I forgot to place it.
Whoa, whoa, whoa, whoa.
Look at me.
You did the anastomosis.
I watched you do it.
You used the double-layer technique.
You remember? I Okay.
You need to sit down.
You need to sit down.
You are overtired and probably experiencing some residual shock.
And you're gonna take a break this time, for real.
Yeah, but No.
Don't argue with me, Karev.
Deep breath.
Beautiful.
Nice work.
All right.
Let's prepare for reimplantation.
You know, you-you're gonna think that I'm crazy, but there is this thing that we used to do in med school to try and stay awake.
And after this many hours of surgery, you need to stay awake.
I'm, uh, I'm pretty awake, actually.
Whoo! Give me a "Whoo!" Whoo.
Oh, come on.
Give me a "Whoo!" Whoo.
That's no, that's not good.
Come on.
You gotta wake up.
Whoo! Whoo! Oh, okay, that's a little better.
Whoo! Whoo! Whoo! They still going? Whoo! - What the hell are they doing? - Come on.
- I - Whoo! Think they're having fun.
Whoo! You gotta be okay.
'Cause we need you right now.
So if you can hear me, I'm s-sorry for being such a jerk on the camping trip.
I'll try to be better.
Just please wake up.
You gotta wake up, and I'll be nicer.
I'll help Michael with his homework and I'll babysit.
You won't even have to pay me.
Just please, dad, just open your eyes.
Lily I just came to tell you that your brother is out of surgery, and he's doing okay.
- And so is your sister.
- Okay.
Okay? Can you make sure that nobody else tells them about my mom? Sh I should be the one to tell them.
Of course.
Of course.
He's coding! Push 1 of epi, 1 of atropine.
Charge paddles to 200.
Charging.
Charged.
Clear.
Cardio tech, trauma one.
They're almost finished.
Now they did have to take her heart out of her body to repair the valve, but the procedure went smoothly.
It's over.
They're putting the heart back in right now.
It's good.
It's good? My wife's body is in pieces on some O.
R.
table, and you're telling me that it's good? - What is wrong with you? - I'm sorry.
- I didn't - Dad? Hey, my man.
I'm here.
Go back to sleep.
Okay, buddy? Ow! I thought peds surgeons were supposed to be gentle.
Yeah.
You look like hell.
You should go home.
Me? You smell bad.
You go home.
How's the baby? - Good.
Actually, really good.
- Aw.
Good.
How are the other kids? Oh, well, the oldest daughter, I mean, she watched her mother die, now her father keeps coding, and she won't leave his side.
Daddy? Daddy! - Dad, please.
- Lily, I'm sorry.
- You can't be in here.
- Wait.
Wait.
- Charge the paddles to 300.
- Charging.
Charged.
Clear.
I was paged.
Code blue? He keeps going into V-fib.
Okay, let's start compressions.
Lily you can't be in here.
- She can't see this again.
- Come on.
Let's go.
- No, I'm not leaving.
I'm not gonna leave.
- Meredith.
Lily, please.
Stop it! It's my dad.
Please.
I have a right to be here, - and I'm not gonna leave him.
- Charge again.
Clear.
Come on.
All right.
That's the last suture.
In that case, gentlemen, I am all done.
Nice work, Dr.
Canner.
It was a pleasure, Dr.
Shepherd.
All right.
I can trust you two to finish this? You're not gonna ruin all the good work I just did? Well, I wouldn't bet on it.
Follow me out, Dr.
Grey.
I need to talk to you for a second.
Me? Why? I-I mean, uh, of course, if-if-if you Don't worry.
I'm not gonna throw a ball at you.
It's about her post-op instructions.
Her eye needs to be covered 24/7.
She can watch tv all she wants, but she can't read a book for the first three days.
Whoa.
Okay.
Oh, thank god that is over.
Did I seem nervous in there? Just be-be honest with me.
Oh, you-you seemed more than okay.
That is Derek Shepherd in there, one of the best neurosurgeons in the country, And Mark's best friend.
And the whole time I was in there, all I could think about was my high school cross-country team.
Coach would always say, "Don't look back," "never look back, because if the kid behind you sees that," "he knows you're weak, and he will run you down.
" The whole surgery that that's all I was thinking about.
Don't look back.
Well, you didn't.
Thanks.
Yeah.
Thank you, Dr.
Grey.
Damn it.
Now I like her.
Um, that's, like, the fourth time you've had to revive him tonight.
Is that normal? His body has been through a lot.
What are those tubes for? Uh, his body is filling with fluid, and those tubes are draining it.
And that thing That's making noise? It's a ventilator.
It's breathing for him.
Is he gonna wake up? You can tell me.
I can take it.
I have no way to know that.
What do you know? I know that we haven't been able to take him off of the life support.
And I know that it's very hard on his body every time we try and revive him and that it's taking longer and longer each time we try.
And his kidney tests are elevated.
Which means what? Which means that His-his organs are starting to fail, one by one.
You asked me about extraordinary measures before, if my parents ever talked to me about them.
What you're doing to my dad, - are those extraordinary me - They are.
I think you should stop.
It's not that simple.
And it's not your call.
You're his child I'm not a child, not anymore.
I turned 18 4 hours ago.
Today is my birthday.
And I've watched you torture my dad for the past six.
So I'm the head of the family now, and it's my job.
If you take him off the machines and he lives, then he lives.
But if you don't then at least we let him go in peace.
You gotta stop.
Please.
Okay, time to close.
Would you like to do the honors? Kepner can close.
What? Kepner, can you close? Uh, I-I can, but Yang.
Kepner, close.
Cristina Can I speak to you privately, please? What's up? You okay? When we brought your husband into the O.
R.
, we originally thought we could go in with a bronchoscope and a laser, however, there was a lot of bleeding, so we had to open him up.
Wait.
You-you wait.
No.
Owen said that When we opened him up, we saw that his tumor had eroded his pulmonary artery.
Dr.
Webber and I both used extraordinary measures - No.
Uh, no, no.
No.
- But we We used extraordinary measures, but his heart could not tolerate - the excessive bleeding.
- No.
He did not survive the surgery.
I'm sorry.
You're saying you're saying, he's dead.
Yes.
Say it.
Teddy When you inform the family, you have to say it so that they know that it's really happening.
It's the first thing that you're taught.
I never really thought about it But now I get it, and, um Cristina I need you I need you to say it.
Henry is dead.
Thank you.
Where's Teddy? I don't know.
Wait.
You told her? Of course I did.
You shoulda let me.
I should've been the one Oh, my god.
This is not about you.
Who cares who told her? Okay, I told her, because you made me stand there and talk and joke and-and lie to her for hours, for hours.
I am sorry.
I had to No, I know, I know.
I don't wanna I don't wanna hear it.
And neither will she.
Oh, um Give me the chart.
Uh Just give me the chart.
Thank you.
Get out.
I'll give you your privacy.
So what happens now? His heart rate will slow down, and that's gonna make the alarm sound, but I'll I can turn the sound off.
And then his breathing is going to get slower and slower.
And then his organs will start to fail because they need oxygen to survive.
And then when there's no breathing and no pulse, that's when he's gone.
Is this it? This is it, sweetie.
I'll wait outside.
No, please.
Please wait.
Okay, okay.
I really should be taking the fall for this.
I agree.
All right.
Well, then I'm just gonna walk in there and I'm gonna tell him.
Look, let me let me spell it out for you, Avery.
This is on me.
Yes, it was your mistake, and, yes, you should feel like crap, but I'm your attending, you're a fifth year, which means that I'm responsible for what happens in my O.
R.
- and you get a free ride.
- I don't want a free ride.
Well, I don't want to give it to you, but I will, because you're still young and inexperienced and hopefully, you' learn something here.
You'll start double-checking your work, and the work of your residents when the time comes, because otherwise, you'll be me, walking in to apologize to a family that hates me almost as much as I hate myself right now.
Dr.
Torres, there you are.
I need to talk to you.
I know.
I know, Mr.
Lewis.
I want to talk, too.
Yeah, you owe me an explanation.
Okay? A real explanation.
What happened to Laura this is totally unacceptable.
I, uh, I understand.
I was rude to you before when you mentioned Henry.
I'm used to it.
It's kinda your thing.
Look, when bad things happen to you, you lash out.
You want space.
That's why I'm sitting way over here at my own table.
I'm I'm giving you space.
I didn't just lose a patient today.
I lost a friend.
I'm sorry.
I wouldn't mind if you didn't give me quite so much space.
Canner did a good job.
Yeah, she did.
Don't screw this one up.
I like her.
She's a keeper.
I'll be close by if you need me.
You can't prepare for a sudden impact.
You can't brace yourself.
It just hits you out of nowhere.
And suddenly the life you knew before is over forever.
Ohh.
What's wrong? There's no food, and I'm hungry.
I just ordered pizza.
For breakfast? We've been up for 39 straight hours.
It's dinner.
It's a very, very late dinner.
Oh, that cheese is old.
I'm hungry.
I might die.
Don't eat the old cheese.
Come and sit down by me.
Put your head down.
I'd like to put a little salt on your nose and eat a bite.
The pizza will be here any minute.
Mm-hmm.
We'll be okay if it's just the two of us if that's what you want.
I love you.
Pizza.
Don't start eating that pizza without me.
Meredith? - Derek.
- Yes? Is that our baby? Yes.
Yes, it is.
She's yours.
Hi.
Hi.
Come here.
You and I broke up.
You basically told me to wait for you.
What the hell happened? That's the screw that I just pulled out of her heart.
I supervised you inserting pedicle screws and a plate.
She's half dead.
Dr.
Altman's repairing her heart right now.
So who's gonna be operating on me? Cristina.
It's her mentor's husband.
Cristina doesn't have to know that it's Henry.
Meredith and Alex are trapped in an ambulance in the middle of the highway.
We think they got hit.
They're sitting in a powder keg.
We gotta get outta here before this thing blows.
It's not right.
If she finds out that I waited, she will never forgive me.
Her husband just died in our O.
R.
She'll never forgive any of us.
Victims of a sudden impact are some of the hardest to treat.
It's not just the collision that injures them.
It's everything after.
The centrifugal force keeps them moving, tossing them from vehicles, throwing them through windshields, slamming their internal organs into the skeleton.
Their bodies are injured over and over again.
So there's no way to know how much damage has actually been done Until they stop.
Sir? Can you move? We need to get you off this road.
Honey.
Jessica.
Answer me.
Mom, wake up! Help them, please.
You have to help! My mom, my dad, The van and I just stepped in blood.
- I-I just stepped in blood.
- Hey, what's your name? Lily.
Okay, Lily, I need you to calm down and take the baby.
- Hold the baby.
- I don't even babysit.
- I can't hold a baby.
- Lily, do you want me to help your family or not? Hold the baby.
Okay, I need you to squeeze.
One, two, squeeze.
What if I mess up? You're not gonna mess up, Lily.
One, two, squeeze.
Count out loud so I can hear you.
Okay, one, two, squeeze.
One, two, squeeze.
No matter what you do, don't stop squeezing.
One, two, squeeze.
One, two, squeeze.
Ma'am, ma'am, I'm a doctor.
Can you hear me? I don't know.
Three or four hours I think.
Yeah, you know what? Hang on a second.
The doctor's back.
This is Laura's mom.
She wants to know how long the surgery should take.
Uh, that depends.
Dr.
Altman is working on the repair right now.
Did you hear that? Um, he says Dr.
Altman's still - No, Altman.
- Mm-hmm.
No, for the heart.
Y-you know, c-can you talk to her? Uh, yeah.
Hi, this is Dr.
Avery.
She's a cardiothoracic surgeon.
No, no, this this is the heart.
No, it's really hard to tell at this point.
Oh, no.
This is cruel.
Her husband is dead, and she has no idea.
She's sewing a woman's heart back together.
Come on.
There's gotta be a better way to handle this.
There's no good way to handle it, Bailey.
This is an impossible decision.
So you land on the side of what is best for the patient, the one who's still alive.
Teddy will understand.
You think so? You got any tape in there? I have to do an adhesive dressing.
Probably.
I just grabbed whatever.
Is my mom okay? Mom? Lily, keep counting.
Why isn't why isn't she talking? Lily! How's she doing? Not good.
I may have to intubate.
Don't you have to do a pressure dressing? Ugh.
I see gray matter.
Brains are on the ground.
Wait.
That's Nana.
- That's my Na - There's nothing we can do.
Oh, crap.
This kid's got a shard of glass in her eye.
She's unconscious.
Her pulse is low.
- That's my sister.
That's Abby.
- Lily Just see the blinker on the van? Just watch that blinker and keep counting.
One, two, squeeze.
One, two, squeeze.
- Lily.
- The kids.
The kids.
Your girls are okay, all right? I just helped one and the other one's right over there.
And Michael? What about Michael? There's another kid? Oh, crap.
- There's no pulse.
- Michael? Dad! Dad! Lily, keep counting! One, two, squeeze.
One, two, squeeze.
One, two, squeeze.
- Michael? - Help.
- Help.
- Michael? Michael? Help.
Help.
Okay.
Um, I'm-I'm gonna check your pulse.
Pulse is a little weak.
All right.
I'm gonna try to free your legs, okay? One, two, squeeze.
One, two, squeeze.
One, two, squeeze.
Meredith, there's a car coming! Oh, crap.
Can you feel your legs? - You gotta get outta there! - Michael! He's trapped.
I have to get his legs free! - There's not time! - Oh, my god! Kid, just keep counting.
Meredith! - Oh, my god.
- You gotta get off the road! Come on.
- Come on! - Oh, my god.
- Help me.
- Meredith! - Squeeze.
- No, don't leave me.
What the hell are you they're not even gonna see you! Meredith, what are you doing?! Stop! Please! Son of a It's okay.
You're okay.
All right? Just breathe.
Just breathe.
Help is here.
Help is here.
One, two, squeeze.
One, two, squeeze B.
P.
's down and she's tachycardic.
We gotta get her up to the NICU.
intubated in the field.
Multiple facial fractures.
Foreign body to the eye.
You're bleeding you need stitches.
No, I'll be okay.
I'm gonna take care of it.
Take the mom to trauma two.
And we need to staff as many O.
R.
s upstairs as possible.
What do we got? Abdominal pain.
Last vitals show a B.
P.
of 100 over 80 and a pulse of 120.
Grey, you need someone to take a look at that? It's fine.
Where do you want me? - Bailey needs hands on bed four.
- Wait.
Is that my mom? - Could you get her back in the bed? - But that-that's my mom.
She needs to be checked out.
Dr.
Hunt, how can I help? What are you doing here? Is Altman out of surgery? Uh, almost.
She's about to take her off bypass, but our pagers kept going off, so she figured, maybe you need some extra help.
Dr.
Webber, I could use you on this.
You, too, Hunt.
- I w - Okay.
Okay, go back into Altman's surgery and tell her that I didn't need you.
I was really hoping to log some more trauma hours.
Kepner Altman's husband died in surgery, and she doesn't know, so I need you in the O.
R.
and page me the moment that she's d Wait, wait.
I'm sorry.
W-what? - Kepner.
- Henry's Kepner, can you handle this? Um, yeah, yes.
No.
No, no, no.
You can't go into her surgery like that.
So go to the gallery and watch the surgery from there.
Okay? She went about two hours with no antibiotics and an unknown amount of fluids 'cause we didn't have a pump.
All right.
Careful with that suction.
We weren't able to suction for a while.
Her pneumonia may be getting worse.
She probably needs another X-ray.
Well, that's great.
You did extraordinary work tonight, Karev.
I've got it from here.
No.
What? No.
Yes.
You were in a major accident.
You need to go get yourself checked out.
Take a breath.
You're gonna sit this one out.
I'm not sitting anything out.
Yes, you are.
Good-bye.
Okay, what do we got? His pelvis is dust.
must be massive internal bleeding.
Can't keep his systolic above 68.
Okay, there's definitely free fluid in his abdomen.
It's just hard to define where the bleeding's coming from.
Where do you want to start? - Pelvis.
- Abdomen.
Abby couldn't wait to sleep in a tent.
Sir, I'm Dr.
Hunt.
B.
P.
's still dropping we're gonna be taking you up to surgery.
Lily didn't even want to come.
Okay, if we don't stabilize this pelvis, there won't be any surgery.
There's no time for fixators.
She wanted to spend her birthday with friends, not-not camping with us.
I said no.
I made her come.
Oh, my god, I I did this to them.
I did this.
You didn't harm your family.
You didn't mean for this to happen.
You didn't do this.
Okay, sir, I am really sorry, but even with the painkillers, this is gonna hurt.
Aah! That should hold for now.
Okay, let's get him to surgery.
Okay.
Altman paged.
9-1-1.
Is everything okay? Uh, uh, we got this.
Go.
Scrub in when you can.
You paged? Yeah, the patient's got a flail mitral valve.
The sutures for the patch caught on the valve when we went on bypass.
Uh, what can I do? You can tell me where Cristina is.
I've been paging her, but she won't answer.
Damn it.
Why won't this hold? Okay, you need a resident? I'll get you a resident.
No, not a resident.
Yang.
This is I need another me, and she is the closest thing.
Don't tell her I said that.
She just got out of surgery.
She's exhausted.
All right, well, splash some water on her face and get her in here.
She can handle it.
All right, sponge stick.
Let's get an irrigation tray and start cleaning this up.
Craniofacial lac? Oh, it's worse than that.
We're a need a retinal-vitreous surgeon.
Yeah.
I've got Lexie calling around for one right now.
Pand Waldman is gonna be at least another hour.
Try Jassy.
Jassy? No, I got someone who will run circles around Jassy.
Hey, babe.
Your girlfriend? Hold on, Julia.
She's great.
You'll love her.
Um, you know, it's gonna take at least 45 minutes to get here from Seattle Pres.
She's not at Seattle Pres.
She's at my place.
It's five minutes away.
Hey, how'd you like to operate with me and Derek tonight? It-it hurts.
My stomach really hurts.
Okay, Michael, we gave you something for the pain.
It should kick in in a minute.
Abdomen feels rigid.
Yep.
Free fluid in the right upper quadrant.
So that could be a liver lac.
We should order a C.
T.
No, keep trying! - That's my mom! - Okay, Michael, I need you to stay still, please.
At what-what's going on? You can't just give up.
You have to keep trying.
She already watched the grandmother die.
Yeah, go, go.
How long you been going? What have you given her and what have her rhythms been? She has been coding for thirty minutes.
She's already gotten lidocaine and amiodarone.
Okay, her kid's outside the window watching.
We need to go again.
Charge to 360.
Clear.
- Push another of epi.
Let's charge again.
- Please.
Dr.
Grey.
Damn it.
Charge again.
Clear.
Damn it.
Come on.
Come on.
Mom.
Time of death 2:27.
Hand me the ultrasound and get me a kit.
We're doing a bedside gastrostomy.
What do you think you're doing? We need to decompress her stomach so she doesn't get more reflux into her trachea.
Karev, you're not on this case.
Look, I've been with this baby since yesterday.
Okay? She almost died.
I almost died.
I didn't go through hell with this kid to just back off.
Then slow down.
Okay? We don't need to rush through this.
Yeah, I know.
Just suction, please.
Cristina, just stop for one minute - and listen to what I have to - No.
I said no.
I know you're exhausted.
This is a mitral valve re I am not operating now! She requested you.
- Now if you don't go in there - Teddy requested me? Oh, my god.
You haven't told her.
You haven't told her yet? What are you no, no.
No, I am not no, - I'm not going in - Cristina, if that patient dies on the table, this will all have been for nothing.
This has this has to be worth something.
Saving a life is worth something.
I can't.
I can't.
I can't.
I can't do it.
You have no choice.
She's waiting.
So go.
How much trauma has your girlfriend done? A lot.
She's told me about a bunch of her cases.
Oh, so we're just going off your pillow talk? If I get a hint that your girlfriend is in over her head, I'm gonna boot her out of my O.
R.
You know what your problem is? You don't think anyone who sleeps with me can be talented or have half a brain.
- That is not true.
- It's mostly true.
Yeah.
Yeah, it's mostly true.
Your ex-wife is brilliant, and she slept with me.
Well I'm not trying to start a fight.
I'm just sayin'.
Ah, Dr.
Canner, thank you very much for showing up on such short notice.
No problem.
Fastball here just updated me about your patient.
Again, I am I'm really sorry for hitting you in the I'm fine.
My breast made a quick recovery.
Mm.
It did.
Okay, Mark.
The glass penetrated the globe through to the orbit.
So she's gonna lose the eye? Normally, yes.
I was thinking, if you used a temporal approach to expose the orbit and decompress the eye, we could save it.
Well, if you do that, there's more risk of bleeding.
That's true.
I could get control of the blood supply first, then enucleate the eye.
But I think the eye is salvageable.
Either way, it's your call.
Let's save the eye.
Agreed.
Lily.
I'm so sorry about your mom.
Yeah.
Your dad and your sister are in surgery.
And I'm about to take your brother up to repair a tear in his liver.
Okay.
Do you know if anyone in your family is on any medications? I don't know.
What about allergies? Has has anyone had surgery? I don't think so.
Do you remember your parents talking about what they would do if someone got really sick? Would they want extraordinary measures taken? I'm sorry.
I know it's a difficult question, but anything you could tell us would help.
No.
We don't talk about stuff like that.
We just talk about normal things, so I don't I don't know anything.
Well, is there anyone we can call? Who takes care of you when your parents go out of town? My grandma.
But she's dead now, so Okay, I've got the bleeding under control.
It's your turn, Dr.
Canner.
All right, pull up my microscope, please.
Okay, 4 by 4.
Speculum.
Saline.
Dr.
Shepherd.
Thank you.
- Damn it.
- Did you just push the glass in deeper? You must have speared a branch of the ophthalmic artery.
Cautery.
All right.
Let me get in there.
It's kind of hard right now.
My hand is in her eye.
- Forceps.
- Canner.
Hold on.
There.
Bone fragment.
Thank you.
I'll be needing that.
A little bleeding is natural, Dr.
Shepherd.
I'm not gonna find any more little presents in there, am I? Mm.
Okay, everyone, here comes the fun part.
Clamp.
All right.
Looks like a grade 4 liver lac.
Grey, do you want to do an omental pedicle repair? - Absolutely.
- Okay.
Heard you lost one of your clinical trial patients today, Dr.
Bailey.
I'm sorry to hear It wasn't my trial that killed him.
The man suffered from Von-Hippel Lindau.
That's what killed him.
Well, I wasn't implying that your trial Let's focus on the living patients, and not the dead ones, okay? Wh-what'd you do? Nothing.
I'm just irrigating.
His temp spiked.
C-o levels are through the roof.
- Well, what's the problem? - Uh, he's tachycardic.
Increased heart rate.
Patient's burning up.
I didn't use sux, but I did use sevoflurane.
Ice.
We need ice.
Wait.
Now this is my patient - Run.
Get ice, now.
- Right away, doctor.
Kid's about to go into organ failure.
I'm pushing dantrolene.
- Let's get some cooling blankets.
- On it.
And turn the thermostat down in here as low as it will go.
Right away, doctor.
Oh, my god.
Malignant hyperthermia.
Where's that ice? What do we got? Oh, good.
I got a flail mitral valve when I took her off bypass.
Just put her back on and cooled her down again.
I need your hands.
Okay.
Oh, and, um thank you for Henry.
I am so sorry that we had to lie to you, but you were the only one that I trusted to do it.
You get it, right? Right.
You're not mad at me? No.
No.
Good.
Okay.
Go get scrubbed.
Gown me.
What did Altman want? How's the patient? She'll be fine now that I put Cristina in there.
You You what? You put Yang in the same O.
R.
with Teddy with my patient on the table? What the hell made you think that was a good idea? I believe it was your mistake that put everyone in this position in the first place, so you're really not one to point fingers right now.
Catch me up.
I can't get visualization of the mitral valve.
The-the left atrium's too small.
What about superior pulmonary vein exposure? Yes, good.
Let's do that.
Scissors.
What is she doing up there? Sorry? Kepner.
She's been sitting up there like a gargoyle.
I thought there was a big trauma.
Oh, yeah.
Um, I don't know.
Did you get a chance to check on Henry post-op before I pulled you in here? I bet no one wanted her.
What? Kepner.
Probably because her voice can peel paint off walls.
Charge to 200.
Clear! I mean, a trauma is stressful enough.
Who needs that? You're you're horrible.
Push 100 of lidocaine.
Am I wrong? - I'm right.
- Would you stop? Stop it.
- Kind of.
- You agree with me.
I can tell - Would you stop? - By your eyes.
Okay, stop.
Oh.
How are they doing? Uh, still trying to repair the valve.
Well, and making fun of me.
What? Cristina doesn't want to talk about Henry's surgery, so instead she's making fun of me.
I'll turn off the intercom.
No, it's I have to know everything that's going on.
It's okay.
I can handle it.
Still bad visualization.
There is a lot of unexpected fibrosis.
We're just increasing our chances of rupturing her heart.
We can't get in there.
There's too much tension on the walls.
All right.
We need to do this right.
We're gonna do an ex vivo.
You want to take the heart out? Can we can we try to Oh, come on, Yang.
A cardiac autotransplantation for an ex vivo valve reconstruction? If that's not on your bucket list, it should be.
Are you up for this? You bet.
Great.
Okay.
We're gonna start with the atrium to explant the heart.
And let's get some music in here.
What do you want to listen to? You pick? Let's get another cooling blanket in here.
Grey, let's repack this liver.
Gelfoam.
What's next? We gave him dantrolene to relax his muscles and lidocaine to calm his heart.
He's on ice inside and out.
Only thing left to do now is wait.
All right, well, settle in.
Could be a while.
Dr.
Warren isn't malignant hyperthermia genetic? - You gotta warn them - Already on it.
How's she doing? She's a little full of herself if you ask me, but she's getting the job done, I guess.
No, the kid.
Abby.
You gotta watch her temp if you gave her any sux or inhalation anesthetics because our kid had a reaction.
Meredith, did you get your stitches? I will.
Fill them in.
Oh, pelvic stabilization's not holding.
- Get me more lap pads.
- More.
- Do it.
Yeah.
I got that.
- You need something? You haven't used any sux or inhalation anesthetic, have you? 'Cause our kid had a reaction.
Oh, damn it.
This hematoma's expanding.
I'll occlude the internal iliac.
Try and get some temporary control.
All right.
I need more lap sponges here.
Just watch his temp.
We got it, Grey.
Thank you.
Hemoclip.
Yeah, hold it right over there.
Yep.
Okay, one more.
Come on.
Let's pack it.
Yep.
Heart rate's coming down.
His temperature's starting to stabilize.
Usually about the time you realize it's malignant hyperthermia, it's too late.
That's a nice catch.
You probably saved this kid's life.
Figured you didn't need another patient dying on you today.
- Oh, so you did it for me? - Oh, yeah.
Any other doctor, I probably wouldn't have said anything.
It's freezing in here.
Well, why don't you jump up and down? That'll warm you up? I think I'll repair the liver.
That'll warm me up.
Suction.
We have to go back in.
What? On the baby.
I forgot to place the tension-free anastomosis.
Do you hear me? I forgot to place it.
Whoa, whoa, whoa, whoa.
Look at me.
You did the anastomosis.
I watched you do it.
You used the double-layer technique.
You remember? I Okay.
You need to sit down.
You need to sit down.
You are overtired and probably experiencing some residual shock.
And you're gonna take a break this time, for real.
Yeah, but No.
Don't argue with me, Karev.
Deep breath.
Beautiful.
Nice work.
All right.
Let's prepare for reimplantation.
You know, you-you're gonna think that I'm crazy, but there is this thing that we used to do in med school to try and stay awake.
And after this many hours of surgery, you need to stay awake.
I'm, uh, I'm pretty awake, actually.
Whoo! Give me a "Whoo!" Whoo.
Oh, come on.
Give me a "Whoo!" Whoo.
That's no, that's not good.
Come on.
You gotta wake up.
Whoo! Whoo! Oh, okay, that's a little better.
Whoo! Whoo! Whoo! They still going? Whoo! - What the hell are they doing? - Come on.
- I - Whoo! Think they're having fun.
Whoo! You gotta be okay.
'Cause we need you right now.
So if you can hear me, I'm s-sorry for being such a jerk on the camping trip.
I'll try to be better.
Just please wake up.
You gotta wake up, and I'll be nicer.
I'll help Michael with his homework and I'll babysit.
You won't even have to pay me.
Just please, dad, just open your eyes.
Lily I just came to tell you that your brother is out of surgery, and he's doing okay.
- And so is your sister.
- Okay.
Okay? Can you make sure that nobody else tells them about my mom? Sh I should be the one to tell them.
Of course.
Of course.
He's coding! Push 1 of epi, 1 of atropine.
Charge paddles to 200.
Charging.
Charged.
Clear.
Cardio tech, trauma one.
They're almost finished.
Now they did have to take her heart out of her body to repair the valve, but the procedure went smoothly.
It's over.
They're putting the heart back in right now.
It's good.
It's good? My wife's body is in pieces on some O.
R.
table, and you're telling me that it's good? - What is wrong with you? - I'm sorry.
- I didn't - Dad? Hey, my man.
I'm here.
Go back to sleep.
Okay, buddy? Ow! I thought peds surgeons were supposed to be gentle.
Yeah.
You look like hell.
You should go home.
Me? You smell bad.
You go home.
How's the baby? - Good.
Actually, really good.
- Aw.
Good.
How are the other kids? Oh, well, the oldest daughter, I mean, she watched her mother die, now her father keeps coding, and she won't leave his side.
Daddy? Daddy! - Dad, please.
- Lily, I'm sorry.
- You can't be in here.
- Wait.
Wait.
- Charge the paddles to 300.
- Charging.
Charged.
Clear.
I was paged.
Code blue? He keeps going into V-fib.
Okay, let's start compressions.
Lily you can't be in here.
- She can't see this again.
- Come on.
Let's go.
- No, I'm not leaving.
I'm not gonna leave.
- Meredith.
Lily, please.
Stop it! It's my dad.
Please.
I have a right to be here, - and I'm not gonna leave him.
- Charge again.
Clear.
Come on.
All right.
That's the last suture.
In that case, gentlemen, I am all done.
Nice work, Dr.
Canner.
It was a pleasure, Dr.
Shepherd.
All right.
I can trust you two to finish this? You're not gonna ruin all the good work I just did? Well, I wouldn't bet on it.
Follow me out, Dr.
Grey.
I need to talk to you for a second.
Me? Why? I-I mean, uh, of course, if-if-if you Don't worry.
I'm not gonna throw a ball at you.
It's about her post-op instructions.
Her eye needs to be covered 24/7.
She can watch tv all she wants, but she can't read a book for the first three days.
Whoa.
Okay.
Oh, thank god that is over.
Did I seem nervous in there? Just be-be honest with me.
Oh, you-you seemed more than okay.
That is Derek Shepherd in there, one of the best neurosurgeons in the country, And Mark's best friend.
And the whole time I was in there, all I could think about was my high school cross-country team.
Coach would always say, "Don't look back," "never look back, because if the kid behind you sees that," "he knows you're weak, and he will run you down.
" The whole surgery that that's all I was thinking about.
Don't look back.
Well, you didn't.
Thanks.
Yeah.
Thank you, Dr.
Grey.
Damn it.
Now I like her.
Um, that's, like, the fourth time you've had to revive him tonight.
Is that normal? His body has been through a lot.
What are those tubes for? Uh, his body is filling with fluid, and those tubes are draining it.
And that thing That's making noise? It's a ventilator.
It's breathing for him.
Is he gonna wake up? You can tell me.
I can take it.
I have no way to know that.
What do you know? I know that we haven't been able to take him off of the life support.
And I know that it's very hard on his body every time we try and revive him and that it's taking longer and longer each time we try.
And his kidney tests are elevated.
Which means what? Which means that His-his organs are starting to fail, one by one.
You asked me about extraordinary measures before, if my parents ever talked to me about them.
What you're doing to my dad, - are those extraordinary me - They are.
I think you should stop.
It's not that simple.
And it's not your call.
You're his child I'm not a child, not anymore.
I turned 18 4 hours ago.
Today is my birthday.
And I've watched you torture my dad for the past six.
So I'm the head of the family now, and it's my job.
If you take him off the machines and he lives, then he lives.
But if you don't then at least we let him go in peace.
You gotta stop.
Please.
Okay, time to close.
Would you like to do the honors? Kepner can close.
What? Kepner, can you close? Uh, I-I can, but Yang.
Kepner, close.
Cristina Can I speak to you privately, please? What's up? You okay? When we brought your husband into the O.
R.
, we originally thought we could go in with a bronchoscope and a laser, however, there was a lot of bleeding, so we had to open him up.
Wait.
You-you wait.
No.
Owen said that When we opened him up, we saw that his tumor had eroded his pulmonary artery.
Dr.
Webber and I both used extraordinary measures - No.
Uh, no, no.
No.
- But we We used extraordinary measures, but his heart could not tolerate - the excessive bleeding.
- No.
He did not survive the surgery.
I'm sorry.
You're saying you're saying, he's dead.
Yes.
Say it.
Teddy When you inform the family, you have to say it so that they know that it's really happening.
It's the first thing that you're taught.
I never really thought about it But now I get it, and, um Cristina I need you I need you to say it.
Henry is dead.
Thank you.
Where's Teddy? I don't know.
Wait.
You told her? Of course I did.
You shoulda let me.
I should've been the one Oh, my god.
This is not about you.
Who cares who told her? Okay, I told her, because you made me stand there and talk and joke and-and lie to her for hours, for hours.
I am sorry.
I had to No, I know, I know.
I don't wanna I don't wanna hear it.
And neither will she.
Oh, um Give me the chart.
Uh Just give me the chart.
Thank you.
Get out.
I'll give you your privacy.
So what happens now? His heart rate will slow down, and that's gonna make the alarm sound, but I'll I can turn the sound off.
And then his breathing is going to get slower and slower.
And then his organs will start to fail because they need oxygen to survive.
And then when there's no breathing and no pulse, that's when he's gone.
Is this it? This is it, sweetie.
I'll wait outside.
No, please.
Please wait.
Okay, okay.
I really should be taking the fall for this.
I agree.
All right.
Well, then I'm just gonna walk in there and I'm gonna tell him.
Look, let me let me spell it out for you, Avery.
This is on me.
Yes, it was your mistake, and, yes, you should feel like crap, but I'm your attending, you're a fifth year, which means that I'm responsible for what happens in my O.
R.
- and you get a free ride.
- I don't want a free ride.
Well, I don't want to give it to you, but I will, because you're still young and inexperienced and hopefully, you' learn something here.
You'll start double-checking your work, and the work of your residents when the time comes, because otherwise, you'll be me, walking in to apologize to a family that hates me almost as much as I hate myself right now.
Dr.
Torres, there you are.
I need to talk to you.
I know.
I know, Mr.
Lewis.
I want to talk, too.
Yeah, you owe me an explanation.
Okay? A real explanation.
What happened to Laura this is totally unacceptable.
I, uh, I understand.
I was rude to you before when you mentioned Henry.
I'm used to it.
It's kinda your thing.
Look, when bad things happen to you, you lash out.
You want space.
That's why I'm sitting way over here at my own table.
I'm I'm giving you space.
I didn't just lose a patient today.
I lost a friend.
I'm sorry.
I wouldn't mind if you didn't give me quite so much space.
Canner did a good job.
Yeah, she did.
Don't screw this one up.
I like her.
She's a keeper.
I'll be close by if you need me.
You can't prepare for a sudden impact.
You can't brace yourself.
It just hits you out of nowhere.
And suddenly the life you knew before is over forever.
Ohh.
What's wrong? There's no food, and I'm hungry.
I just ordered pizza.
For breakfast? We've been up for 39 straight hours.
It's dinner.
It's a very, very late dinner.
Oh, that cheese is old.
I'm hungry.
I might die.
Don't eat the old cheese.
Come and sit down by me.
Put your head down.
I'd like to put a little salt on your nose and eat a bite.
The pizza will be here any minute.
Mm-hmm.
We'll be okay if it's just the two of us if that's what you want.
I love you.
Pizza.
Don't start eating that pizza without me.
Meredith? - Derek.
- Yes? Is that our baby? Yes.
Yes, it is.
She's yours.
Hi.
Hi.
Come here.