Grey's Anatomy s09e14 Episode Script
The Face Of Change
I'm not big into change.
Okay, great.
Um, now let's just try a few where you're actually smiling.
In oncology, when a normal cell changes into something malignant, it's called cellular transformation.
Look, I don't even want to be the hospital mascot, whatever you do Brand ambassador, and you haven't been appointed yet.
You're just a very strong contender.
Handsome, good with kids Just what the buyers want.
I'm outta here.
The damn cells turn toxic right in front of your eyes.
So as far as I'm concerned Look, you're going to have some public relations reps following you around tomorrow.
Try and be civil.
Transformation sucks.
Brand ambassador? What does that even mean? You get to wear a funny hat and cut things with oversized scissors? All I know is, Cahill creeps me out.
That creeps me out.
Who comes over to somebody else's house and starts sucking face? You invited 'em.
What's that? We are directly underneath Yang's room, and Owen's visiting.
What do you think? Oh.
Is that him or her? Do napkins work as earplugs? What the hell? You're nuts.
What is that? I don't know.
A giraffe.
Dinosaur.
For the millionth time, Jo and I are not into each other.
Oh, please.
You and Ponytail-McGee were canines in heat last night.
literally.
Told you they were doing it, Avery.
Pay up.
I don't like him like that.
Guys don't just hang out with girls.
It's not in their D.
N.
A.
That's not true.
Okay, it's true.
You two are, like, one drink away from crazy monkey sex.
Just stuff her turkey.
You'll feel better.
I feel fine.
Look, I'm not screwing my ex every night and I'm not taking advantage of interns on someone else's sofa.
You're gonna pay to have that thing disinfected.
Not taking advantage.
It's a really nice sofa, though.
Hey, apes.
Hey, here's a question.
Um, what ever happened to good old-fashioned romance? No stuffing of turkeys or disinfecting sofas, but, you know, what about nice normal dates where people talk, share a meal, get to know each other, and then wind up together, not because they're monkeys, but because they have genuine feelings in a committed way.
I mean, what is so wrong with that, huh? Are you gonna eat all of those? Y unh I like this, seeing you every morning.
It's, uh, it's nice.
Yeah, it is.
It's really nice.
I feel bad, though.
I mean, you guys shouldn't even be here now that the E.
R.
is closed.
Nicole's just standing out there.
Oh.
You sure you don't want your seat back? Aren't you cold? My burrito will keep me warm.
You okay? You seem a little off.
Yeah.
I worked all night.
Do you do you know how boring a night shift is with no incoming traumas? I was praying someone's appendix would burst just to keep me awake.
I how am I supposed to train to be a trauma surgeon with no E.
R.
, no trauma? I'm sorry.
I'm, uh, tired and I'm venting.
Dispatch to unit 33, we've got a 55-year-old male with chest pain, prior M.
I.
, near pioneer square.
Over.
Unit 33 responding.
You have to go already? I'm afraid so.
Okay.
Hey, uh You want to come, too? You're with me all day? We just want to get to know who you are, Dr.
Karev.
See you in your element.
It's important we choose just the right ambassador for our brand.
Your brand? This hospital isn't a luxury car.
Hold please.
Uh, good morning, Dr.
Karev.
Pre-rounds went well.
Got your scans.
Do you want to tell me who the creepy lady is taking our photo? Uh, I'm Amrita.
I do public image assessment for Pegasus Horizons.
They're buying the hospital, and they want a face to slap on some posters.
And they chose you? Maya Noel, 13 days old with gastroschisis and staged silo repair.
She was born with her intestines outside of her body.
They've been too swollen to fit back inside.
Is that Am I looking at a bag of organs? We've been gradually compressing the organs a little bit each day to help them fit back inside the body.
Imagine going two weeks without getting to hold your own baby.
Well, good news.
Looks like we're finally gonna be able to close her up.
Today is the day.
Oh, my god.
Oh, thank you.
Thank you! Thank you! Thank you! Thank you! Hold please.
Thanks, guys.
If I could just have you sign this release.
Yeah.
These are real people with sick kids.
This is not a photo op.
- I was just trying - Look, I don't care, all right? The next kid I'm about to go see is a very sensitive case.
All right? You don't say a word.
You do not take a photo.
You're a shadow, a freaking shadow.
Got it? Protective of your patients.
Passionate.
I like it.
Forget it.
You're waiting in the hall.
Great.
Great.
Now if you could just move a little closer to her him.
Oh, I-I'm the him.
She's the her.
I-I no, I was born a her, and Jess was a him.
I get it's confusing.
- Yeah.
- You're kidding.
Cahill's got more of you guys trailing me? He's "trailing me.
" It's for this brand ambassador thing or something.
It's not a not a big deal.
- Just, uh, we'll be done in a sec.
- Ready? One, two, and three.
How's that? You really think it's okay to let these people in here? The patient's fine with it.
If he gets to stay, I get to stay.
It's the ambassador thing.
You think this kid makes you look good.
I always look good.
We're at U.
W.
together.
I'm a sophomore, and Brian's a freshman.
And is that where you met? Uh, actually, no.
Uh, Dr.
Karev introduced us.
A few years ago, I booked an appointment to see how old I had to be to, you know, start the process.
He was 14.
And, uh, Dr.
Karev told me about this transgender support group.
That's where Jess and I met.
Brian walked in that first day, and all I could think was, oh, my god.
He's so cute.
I thought he'd never notice me.
It's impossible not to notice you.
I've been saving up for this ever since that appointment.
Well, Dr.
Karev, you really changed Brian's life.
Well, you could also say that I'm changing Brian's life, today, in surgery, where I'll be taking the lead.
And what is today's surgery exactly? A full gender reassignment? Oh, no.
Uh, nothing that drastic yet.
Today we're just chopping off my boobs.
All right, enough questions.
Uh, Edwards, Wilson, take these guys outside.
Jackson Avery as the new face of Seattle Grace Now that makes sense.
Alex also makes sense.
If you want a face that's unshaven and sweating light beer.
You've got this in the bag.
Walk with me.
Here's what I know.
They like Avery's looks and they like his name.
Now you don't have either of those.
Gee, thanks.
But you have Africa.
Lead with Africa.
He's a scrapper and a fighter.
Now some people find that charming, but you're an Avery.
Use it.
Own it.
Impress them.
They want to be impressed.
And I saw your breakfast.
Your brain can't function on powdered sugar.
Here.
Oh, you just carry those around in your pocket? Every time I touch this thing, it deletes another patient.
It deletes a patient? I did the exact same thing this morning.
Here.
Let me see something.
Who are your stalkers? Oh, uh, the new guys are looking for a hospital show pony A face for the brochure.
Yeah, Karev's my competition.
- Mm.
If you can call it that.
- You can't.
Bite me, pretty boy.
And why are there no women in the running? Oh, there was.
I turned them down.
This face only goes on the nobel brochure.
And here we have a fully centralized electronic records system.
Everything you need to know about any client at anytime.
Smart, streamlined, efficient Oh, efficient.
It would be more efficient if it didn't keep deleting my patients.
- Sing it, Grey.
- Don't encourage her.
Why not? Cahill deserves it.
This morning she gave me this whole load of crap about how to talk to the buyers.
Emphasize sports medicine.
Don't emphasize my research.
She doesn't want anything to jeopardize the sale, and neither should you.
Research is risky.
Mm-hmm.
The suits don't like it.
Whereas, if you've got the seahawks as patients Ah.
She doesn't call 'em "Patients.
" She calls 'em "Clients," like we're, uh, oh, I don't know, real estate agents.
Real estate agents look happy.
Maybe we'll be happy.
Their benefits package says they have dental, including orthodontics.
Now I happen to have a family history of very straight teeth, but Tuck may grow up and need braces.
I don't know.
But if he does, they have dental.
That's I'm just gonna focus on that.
No, no, no.
We cannot settle.
We have to rise up and we have to do something.
You've done plenty.
Maybe those of us from the plane should keep our heads down for a while.
Am I crazy? I mean, am I the only one that thinks these wonks are gonna destroy the place? No.
You're not crazy at all.
I just felt like, what kind of doctor would I be if I didn't try to help out all those African kids.
It takes a lot of dedication to get a program like that off the ground.
This is your fault.
You put these ideas into her head.
His head.
And while I do support the decision, believe me, he came to it all on his own.
She's barely out of high school - He.
- For god sake.
She is a child! He.
- She doesn't know what she wants! - He! He! Jess, is everything okay here? Are you the one? What? Are you the one who wants to hack my little girl into pieces?! Hey, hey, calm down.
It's gonna be okay.
Pegasus racing you to a brighter tomorrow.
I'm gonna hurl.
Mm.
Click there where it says "Hospitals.
" Holy crap.
They must own half the hospitals in the country.
They're the guys who bought out Portland Gen last year.
Right there.
Hey, look at this.
"Hand in hand, we'll walk together," "partners on the road to your brighter tomorrow.
" This is who's buying us.
That's a cute logo.
Sofia would like it.
She likes horses.
It's not a horse.
It's a pegasus.
And it wants to hold your hand.
Hmm? This web site has not one tangible piece of information about the company or health care.
Why doesn't this bother you? It does, but they're buying us.
And we are all about to gallop down the road towards a brighter tomorrow.
So, you know, cool your heels.
Chill out.
There's nothing we can do about it.
She just told me to cool my heels.
Have you ever known me to cool my heels? How do you feel about a road trip? I'm sorry.
I lost my cool.
You think? It's just, I learned about this surgery last night in an e-mail.
I mean, a stupid e-mail.
I had no idea about any of this.
Guys, you can go.
We're fine here.
Scram.
Let's go.
A surgery like this is a big adjustment for any parent, let alone if you're hearing about it for the first time.
So let's just take a breath and Dad.
What are you doing here? My name's Calliope T Plant Tain.
Plantain.
And this is my husband.
Um, uh Julio Plantain.
And he needs a doctor.
Can I see some I.
D.
? He has chest pain.
Yeah.
So by the end of this seminar, I expect all of you to be able to perform basic wound closures using the interrupted 2-layer technique.
I don't like that guy in the back.
I can feel him watching me.
No, it's just me.
I like to look at you.
Quick question, Dr.
Avery.
Do you use this technique more often when you perform butt lifts or breast implants? Actually, isn't this the technique you used to attach the face on to your last face transplant patient? Well, I've never actually done Sidebar.
What do you find more fulfilling liposuction or body sculpting? Sidebar.
Isn't it true you've completed more successful skin grafts than any other doctor in this hospital? Um Yeah.
What are you doing? Saving your ass.
You hit a rock and you're sinking.
Iceberg ahead, captain.
Larry.
You know, we've got a free station right over here if you want to try your hand at some actual surgery.
Please.
Oh, excuse me one moment.
Have a seat, please.
What's up? I'm kind of in the middle of something.
I know and I swear I wouldn't call unless it were an emergency.
Look, I did a ride along today, and we got this call a kid, about 10 years old, hit and run.
Damn it.
He's still locked down.
- We can't intubate.
- Can you ventilate him? Barely.
His SATs are still in the gutter.
Okay, let's get him backboarded.
We need to load and go.
Seattle Pres is slammed, so they're diverting us to Redmond, but that's an hour away, and this kid He doesn't have an hour, Jackson.
He doesn't.
All right.
All right.
How are his vitals? Bad.
We've got no airway.
I can't crike.
He's got sub-Q emphysema.
He will die en route if we have to go way out there.
He will die.
Are you asking what I think you're asking? If I am, will you do it? And a few years ago, we renovated the waiting room to provide Chief, a moment, please.
Give me a moment.
Kepner's calling with a hit-and-run kid.
- He's in bad shape.
- Wait.
Kepner's in the field? They diverted her to Redmond.
Okay? We're closer.
Much closer.
- So I can arrange - Absolutely not.
We are not a trauma center anymore.
If we take them in, and something happens to them Chief, it's a kid.
Protocol dictates the patient goes to the nearest trauma center, and that's not us.
I'm sorry.
You need to get back to the seminar.
And you have to step it up.
What do you need, a pep talk, tough love? No amount of tough love is gonna make up for the babies Alex saves on a daily basis.
Can I trust you? Why do I have to be the patient? 'Cause you look the part.
Oh, and I'm naturally vivacious.
Yeah, "Manic's" more a word for it.
I'm so sorry for the wait.
We're gonna get a doctor to you just as soon as possible.
Well, it really wasn't a wait.
Ew.
Wow.
You're a happy one, aren't you? He's up there, too.
Oh, god.
It's like Hello, I'm Dr.
Mattoo.
You can call me Kan if you'd like.
You wouldn't be here if you weren't experiencing some pain or discomfort.
I apologize if we exacerbated that with a wait.
Uh, we got here, like, half a minute ago.
It's Okay, Mr.
Plantain.
- Uh, it's like the fruit.
- It's cuban.
Can you spell that for me? Um, p-l-a-n uh, t-a-i-n.
well, Mr.
Plantain, we know you have a lot of options for your health care management, and we are honored that you've chosen us today.
It's my pleasure.
Saw your E.
K.
G.
It looks pretty good.
How are you feeling today? Uh, well, uh, Dr.
Kan, uh, you know, the last 24 hours, I-I've Uh, uh, sorry.
Let me let me put that another way.
What brought you in today? I'm sorry.
What's wrong with asking him how he feels? That could take us down the wrong road, and because your time is valuable to us, we don't want to get off on any tangents.
Mm.
Well, if you ask him how he's feeling, maybe he'll tell you that he's he's blue, 'cause - Yeah.
- You know, his company - was just purchased by a bigger company - Yeah.
That he doesn't like.
And, you know, he can't talk to me about it 'cause I'm the self-involved type.
You know, we just, like, you know, shop online and redecorate the house.
And so he's been he's been, uh, hanging out at the local watering hole, where he has been bumming cigarettes.
And, uh, now he's experiencing shortness of breath.
So if you ask him what brought him in today, he's just gonna tell you "Shortness of breath.
" And then you'd miss the whole cigarette connection.
I ask about smoking on screen two.
Fine.
Whatever.
Okay, let me get back to screen one.
Darn it.
The screen froze.
Sorry.
Technical difficulties.
Uh, I'm gonna have to exit the system and take us back to the top.
Uh, it-it-it's okay.
Uh, take-take your time.
Can't really do that.
We've only got 15 minutes together today.
There we go.
Mr.
Plantain, can you spell that for me? Wow.
They really cleared the place out.
Okay, where do we start? You can start by guarding the door.
Hey, no one can know about this.
No one comes in.
You understand? Okay.
Medusa me all you want.
You're not getting in.
I'm an attending and I'm ordering you to let me in.
Well, you're not my attending today, so Don't make me force you.
I'd like to see you try.
Jo.
It's okay.
I paged her.
She's cool.
I hope you understand.
I would never ordinarily speak to you that way and I look forward to working on your service again soon.
How can I help? You're barely 18.
You know, what if you wake up, you realize this was all a mistake? This isn't a haircut or some meaningless tattoo.
This is my life.
This is me.
All right.
You feel different.
You want to belong.
Okay.
I get that, but you have your whole life ahead I mean, what-what what's the rush? I'm just asking for you to wait.
Brian feels like he's dying inside.
We both do.
If you'd listen, Brian will tell you that living inside of a body like this I'm sorry.
Could you just give us a moment alone? No, I-I don't want her to go.
And I don't want you mutilating yourself! - I'm not! - Brian's just trying to be Oh, for god sake.
Her name is Brianna! Dad, just get out.
Go.
Just get out! You heard him.
I just snagged a monitor, a ventilator, and central line kits.
I have saline, infusion pumps, a crash cart, and Cristina.
I'm sorry.
They overpowered me.
The fewer people who know about this, the better guys.
I brought lackeys.
What? No, I don't need interns.
No, this room has three internal exits.
You have a lookout on one.
Happy, ponytail, you man the doors.
Mousy, um, be the nurse.
We need gloves.
On it.
Why do I have to be the nurse? We are gonna need lights.
No, if I turn on more overheads you can see it from the hallway.
We can use those.
Hello.
Yep.
Okay.
All right.
They're pulling up now.
Let's go.
Oh, jeez.
I'm okay.
That's why we needed interns.
The door won't open? Watch the I.
V.
S.
Hurry.
April, what's going on? I don't know.
Jackson? Jackson! Pull.
It's starting to give.
More! More! Go sit down, Mer.
Oh, come on.
Just because my uterus is occupied Go sit down.
I'm not kidding.
Give me your spot.
What don't worry.
I ditched my P.
R.
chick before I got down here.
- How did you know that we - I paged him.
You've got an incoming kid.
You're gonna need kid-sized equipment.
I brought a peds cart with a bunch of crap.
All right.
Are we doing this? All right, guys, on my count.
One, two, three! Go, go, go, go.
Go.
Come on, guys.
We need to do rapid sequence intubation, stat! We could only get a 20- and a 22-gauge in the field.
I'll start a central line.
I need some lactated ringers.
On it.
I got it.
I can see the cords.
Paralytics are working.
All right, uh, I-I need an E.
T.
tube.
Orange drawer.
Orange drawer.
I knew that.
No chest sounds on the right.
I have to throw in a chest tube.
uh, I think I saw betadine somewhere.
Wait a second.
Does anybody actually have chest tubes? I'm trying to set up this saline drip, and I can't get this thing to stop beeping.
Anyone? I can give it a shot.
All right, I'm not finding chest tubes now, but I got N.
G.
tubes.
Did anybody actually bring suction? Uh, there's a portable suction in the rig.
Okay.
I'll go get it.
Thank you.
Incoming! Lights.
All clear.
I'm in.
Brooks, bag him.
So Dr.
Avery is taking a power nap.
He likes to rest up before big surgeries.
And Dr.
Karev had a dentist appointment.
Even doctors have to go to the doctor.
Meanwhile, have you seen the skin lab where Dr.
Avery grows actual skin? Come on.
Okay, I'm back.
I got it.
Help me secure this N.
G.
tube.
All right, hook it up so we can suction.
Okay, who's got the portable ultrasound? We don't have one? - Happy? - On it.
Wilson, get in here.
We need some more hands.
If this kid dies because you brought Red along on same lame idea of a date The ride along was a date? I need some 4x4s to control the bleeding on the scalp.
All three lines are patent.
We can start dopamine at 5 mics per kilo per minute, but we need to figure out his I.
V.
drip rate.
It's different for kids, depending on size.
Um, anybody have a calculator? I always ask a nurse.
Not a real nurse.
Broselow tape says says he's 30 kilos.
Standard concentration of dopamine is 1,600 mics per CC.
So 5 times 30 is 150 times 60 minutes in an hour is 9,000.
Divide that by 1,600.
Infusion rate is 5.
625 CC's per hour.
What? I'm really good at math.
Okay, let's, uh, give him 5.
6 Except we don't have any dopamine, guys.
We don't have access to any non-code medications at all unless we have a nurse or a code Yes, you do.
You paged him, too? Well, I knew we were gonna need meds.
I have the codes.
Tell me what the patient needs.
"Don't smoke"? That was his big advice? Uh, yeah, he examined me and found nothing wrong, which in fact, is the case.
Oh, he was an idiot.
And now I feel like an idiot.
We're just wandering around.
We look like interlopers.
Hey, you know, let's grab a cup of coffee.
You always look like you belong when you're carrying a coffee.
- Ah.
- Yeah.
No, walk with purpose.
Don't look shifty.
I don't.
Okay.
Oh, look.
Okay.
Want to make sure we're on the same page.
That makes sense.
I think one more diagnostic Do we have time for that? Just one? I think we're pretty good.
All right.
Can a doctor learn anything in that little time? You get really efficient.
And patient outcomes don't suffer? Wow.
You're that efficient? Are you visiting a patient? Hmm? Oh, uh, I'm Richard Webber.
This is my colleague, uh, Callie Torres.
Um, we're with Pegasus, and we just wanted to check in, get a little feedback.
See if you had any concerns.
Really? Really.
Okay, you need propofol Gentamicin and, uh - You will be really impressed by our next stop - Dopamine.
Downstairs, which will be the site for our new hernia clinic.
Get down there now.
- Okay.
- Alana.
Is this the group from Pegasus you mentioned? Hi, I'm Dr.
Shepherd.
Good to see you.
Hi, very nice to meet you.
How's the tour going? Good? We like what we're seeing so far.
Oh, I'm glad to hear that.
You know this is more than just a hospital for a lot of us.
And I don't want to sound cheesy, but it's, uh, it's like family.
- it's like home.
- Good.
Hey, have you ever seen a human brain up close? I can't say that I have.
You know what? I'm gonna give you the unofficial tour by way of the third-floor coffee cart.
We'll have some coffee first.
You're gonna love it.
I've got free fluid in the left upper quadrant.
Crap.
What time is it? We have surgery on Brian in 20 minutes.
Cahill will definitely notice if we don't show.
If you guys need to go, go.
We can handle this.
Look, I'm seeing a pneumopericardium.
Okay, we should put in another chest tube on the left, just to be sure.
Well, this kid needs an O.
R.
Guys, we've gotta move him.
We can't.
Not till we have someplace for him to go.
There's no time.
Cahill's on her way down her right now.
Okay.
We're staying.
Are you hungry? Can I buy you lunch? Actually, we have a very tight schedule.
We need to get down to the hernia clinic now.
Oh, yeah.
Okay.
You know what? Why don't I join you? We gotta move the rig.
It's still parked outside.
- It's okay.
Go.
- Move, guys.
Move! Hurry! We gotta get this thing mobile.
- What happened? - He's bradying down.
- We gotta keep moving.
- I'm not getting a pulse! Ross, start C.
P.
R.
Damn it.
His trachea is deviated to the left.
His SATs are dropping.
I think he has a tension pneumo.
He has bilateral chest tubes.
It must have gotten blocked.
Someone find me a 14-gauge cannula or a 16-gauge.
Whatever you can find, the biggest.
- Um, got it! - Guys, what about Cahill? Oh, god.
What what if he dies? What if we brought him here and what if he dies? Hernias are one of the most common general surgery procedures.
And as it turns out, also one of the most lucrative.
- Why did I agree to this? - Guys, we gotta keep moving.
I can't even think! We have to move! Cahill's coming down right now.
If we don't move - We're moving.
Yang.
- Wait one second.
One second.
Now keep in mind, the site is still under construction, but you'll just have to use a little imagination.
Before we go in there, I'd like to, uh Okay, right this way.
And, uh, watch your step please.
Last month, I had to do a cardiac cath on a patient with no signs of heart disease.
It's putting the patient at risk for no reason.
Forget physician advocacy.
It doesn't exist.
We have no say in anything at all.
Yeah, and if you decide to go crazy and think for yourself, they know, like, instantly.
I swear the walls have ears.
Are you the reps from Pegasus? Uh, Dr.
Webber and Dr.
Torres.
Hi.
Callie Torres from Seattle Grace? Uh, I'm do I do I know you? No.
Kenton Giles.
I'm an ortho just like you.
Yeah, I read all about your cartilage generation work.
It's incredible.
I didn't realize you stopped practicing.
So you work for Pegasus now? Yeah.
Yeah, I guess I needed a I needed to mix it up a little, so She peaked, you know, with the cartilage generation.
Uh, you know, sometimes it's best - to get out before you decline.
- Yeah.
And after the anesthesia is administered, Brian will be ready for surgery.
And when exactly are we gonna see doctors Avery and Karev again? No offense, but we're here to trail them, not you.
Edwards, nice work.
- Ah.
- No problem.
We're ready to scrub in.
Wilson, could you show our friends up to the gallery? - You guys can watch from up there.
- Mm-hmm.
You have a little bit of blood on your left shoulder.
Everyone, right this way.
here we go.
by streamlining the process, we will significantly decrease the hospital's hernia complication rate and become a destination medical center.
How many patients will this place accommodate at a time? Upwards of 30 once everything is finished.
Shepherd, uh, would you mind taking over? Uh, if you'll excuse me.
Right.
Uh, yes.
I was gonna try a similar research project, but now that I'm the face of Portland Gen, I don't have that kind of time.
Really? Yeah.
I do a lot of press.
About orthopedic surgery? That's great.
Well, more like, you know, wellness, nutrition, get eight hours sleep, take a walk.
Uh, sometimes I do a photo op in the O.
R.
They don't want to shoot a real person, so they have me cutting a chicken breast or something.
Well, I work on the Portland trailblazers, though.
Real guys, not chickens.
Yeah.
Yeah, that's-that's good.
Nothing innovative like Dr.
Torres does.
Or did, I guess I should say.
Y-you know what? Uh I was wondering, can this stay between us, not get back to Pegasus? Nothing you say to us will ever get back to Pegasus.
Great.
Well, now that you're not practicing is there an ortho opening at Seattle Grace? Well, I hope you get it, the brand ambassador thing.
I don't want to be the face of any hospital where I have to sneak around and risk my job just to do the right thing.
Screw that.
I hope you get it.
All right, well, this keyhole incision is done.
We're ready to begin closing.
Who are you operating on, Dr.
Avery? My transgender patient, why? What did you do? This part of the lung is fried.
I'm gonna have to do a resection.
The spleen is out.
Let's irrigate with antibiotic solution.
Does somebody want to tell me where the hell this patient came from? Whose patient is this? Fine.
You don't have to tell us.
We can just look it up.
All I need is the patient's name.
Wait.
No, um I can do it.
I'll look it up.
It's my patient.
You got this? Thank you, Dr.
Grey.
Appreciate your cooperation.
Sure.
No problem.
I'm happy to.
Okay.
I just have to get into the patient file.
- Oh, no.
- What? This keeps happening to me.
I try to go into the patient file and I guess I deleted it.
What happened? Cahill figured it out? They're taking us in one at a time to see who'll break first.
I can't lie.
I'm no good at it.
They'll see right through me.
Stay strong, dopey.
You can do it.
They started with the interns.
I'm just trying to find out what happened.
You want to know what happened? I'll tell you what happened.
A kid was dying, and we kept him alive.
Dr.
Karev, hello.
You mentioned the word "We.
" Who else was involved? I was.
This was my call.
I took the kid in.
I decided to treat him.
We did the right thing.
We saved his life.
And that's what matters.
Not these idiotic new policies or some stupid ad campaign.
So you can punish us however you want.
We don't care because That's enough.
Just go.
Oh, that's it? You're not going to discipline them or Go.
You paged me? - No.
- Yes.
We have a problem.
My presence seems to have ignited an uprising, which makes it a little tough for me to do my job, especially when you help them.
What? It was your code that accessed the medication case on floor five.
Is that true? That stuff you said, Dr.
Shepherd, about how this hospital is such a family? It was lovely, really.
I even think you meant it.
But it means nothing if there is no hospital.
Do you know how much this stunt would've cost this place if that kid had died on our watch? Pegasus would've backed out.
And without them, you're done.
I am trying to help you.
But I can't do that if you are undermining me at every turn.
If you care anything about this hospital or the people in it, then it's time that you get on board.
Otherwise the next doors to close will be yours.
Jess, the surgery went very well.
Brian should be in recovery soon.
You'll be able to visit him then.
Mr.
Weston? Is that you? I'm sorry.
I just want to hear how Bri how everything went.
I sent you the e-mail last night.
Not Brian.
It was me.
He wasn't gonna tell you.
I know you guys don't talk that much since he moved out, but he talks about you a lot.
He admires you.
I think he wants to grow up and be you.
And you're his dad.
It was a major surgery.
I thought you should know.
I get why you blame me for this.
He met me and started changing dressing differently and acting differently.
But I'm not It's hard being like us trying to fit into this this mold that doesn't fit.
He just wants you to love him, Mr.
Weston The way he loves you.
He didn't tell you because he didn't want to mess that up.
You guys okay on rent? Here.
That's all I have on me.
You don't want to be there when he wakes up? Change is a funny thing.
Not everyone can handle it.
Hey.
So I know you keep saying that you and Wilson aren't a thing.
'Cause we're not.
Well, maybe you should be.
She kinda kicked ass today.
Just saying.
Come on.
Come on where.
Just come on.
It can sneak up on you.
It's funny how you don't appreciate a thing until you're about to lose it.
No.
No, don't don't say that.
That's we can still fight this.
You can fight this.
Me? I've got an early retirement package waiting.
Maybe I'll take it.
Good night, Torres.
Good night.
Things aren't what they used to be.
Matthew? Oh, hey.
I was hoping to catch you.
Uh, how's the, uh, kid? He is doing great.
He made it through surgery with flying colors.
Oh, that's that's great.
That's, uh, that's good.
Yeah.
Uh, April, I, um, oh, man.
I had this whole thing that I-I wanted to say to you, and then you look at me, and I just Gah.
Okay.
Pull it together.
You are the strongest, most fearless, beautiful woman I've ever met.
You were incredible today.
You are incredible.
And, uh I like you.
I-I really like you.
And I just thought I should say that so you knew, because I Your whole world has transformed.
What are we doing in here? just wait.
I stole them from the nurses in derm.
They won't eat 'em anyway.
They're all "No sugar" and "Gluten-free.
" Cheers to an incredible day.
You deserve it.
Actually, I helped, too.
So cheers to us.
Hey, powdered sugar's your favorite.
Yeah, no.
This is great.
Thanks.
What? Nothing.
Mm.
You realize the ground beneath you has shifted.
You guys are killing me.
It was the right thing to do.
Yeah.
You're still killing me.
Things are uncertain.
And there's no turning back.
She's not answering.
I really want to wait for Cristina.
Okay, fine.
Fine.
Let's wait for Cristina.
Let's just wait downstairs where it's warm.
Yeah.
No, we can't.
The walls have ears.
- I'm outta here.
- Okay, all right.
Uh, look, I called this meeting because we can't just keep our heads down and lay low.
Okay, we're the reason the hospital's in trouble.
We have to do something.
We can't let Pegasus take over.
We have a responsibility.
Which is why I think we should buy the hospital ourselves.
The world around you is different now Sir.
Unrecognizable and there's nothing you can do about it.
You're stuck.
The future's staring you in the face.
And you're not sure you like what you see.
Like I said, I'm not big into change.
Okay, great.
Um, now let's just try a few where you're actually smiling.
In oncology, when a normal cell changes into something malignant, it's called cellular transformation.
Look, I don't even want to be the hospital mascot, whatever you do Brand ambassador, and you haven't been appointed yet.
You're just a very strong contender.
Handsome, good with kids Just what the buyers want.
I'm outta here.
The damn cells turn toxic right in front of your eyes.
So as far as I'm concerned Look, you're going to have some public relations reps following you around tomorrow.
Try and be civil.
Transformation sucks.
Brand ambassador? What does that even mean? You get to wear a funny hat and cut things with oversized scissors? All I know is, Cahill creeps me out.
That creeps me out.
Who comes over to somebody else's house and starts sucking face? You invited 'em.
What's that? We are directly underneath Yang's room, and Owen's visiting.
What do you think? Oh.
Is that him or her? Do napkins work as earplugs? What the hell? You're nuts.
What is that? I don't know.
A giraffe.
Dinosaur.
For the millionth time, Jo and I are not into each other.
Oh, please.
You and Ponytail-McGee were canines in heat last night.
literally.
Told you they were doing it, Avery.
Pay up.
I don't like him like that.
Guys don't just hang out with girls.
It's not in their D.
N.
A.
That's not true.
Okay, it's true.
You two are, like, one drink away from crazy monkey sex.
Just stuff her turkey.
You'll feel better.
I feel fine.
Look, I'm not screwing my ex every night and I'm not taking advantage of interns on someone else's sofa.
You're gonna pay to have that thing disinfected.
Not taking advantage.
It's a really nice sofa, though.
Hey, apes.
Hey, here's a question.
Um, what ever happened to good old-fashioned romance? No stuffing of turkeys or disinfecting sofas, but, you know, what about nice normal dates where people talk, share a meal, get to know each other, and then wind up together, not because they're monkeys, but because they have genuine feelings in a committed way.
I mean, what is so wrong with that, huh? Are you gonna eat all of those? Y unh I like this, seeing you every morning.
It's, uh, it's nice.
Yeah, it is.
It's really nice.
I feel bad, though.
I mean, you guys shouldn't even be here now that the E.
R.
is closed.
Nicole's just standing out there.
Oh.
You sure you don't want your seat back? Aren't you cold? My burrito will keep me warm.
You okay? You seem a little off.
Yeah.
I worked all night.
Do you do you know how boring a night shift is with no incoming traumas? I was praying someone's appendix would burst just to keep me awake.
I how am I supposed to train to be a trauma surgeon with no E.
R.
, no trauma? I'm sorry.
I'm, uh, tired and I'm venting.
Dispatch to unit 33, we've got a 55-year-old male with chest pain, prior M.
I.
, near pioneer square.
Over.
Unit 33 responding.
You have to go already? I'm afraid so.
Okay.
Hey, uh You want to come, too? You're with me all day? We just want to get to know who you are, Dr.
Karev.
See you in your element.
It's important we choose just the right ambassador for our brand.
Your brand? This hospital isn't a luxury car.
Hold please.
Uh, good morning, Dr.
Karev.
Pre-rounds went well.
Got your scans.
Do you want to tell me who the creepy lady is taking our photo? Uh, I'm Amrita.
I do public image assessment for Pegasus Horizons.
They're buying the hospital, and they want a face to slap on some posters.
And they chose you? Maya Noel, 13 days old with gastroschisis and staged silo repair.
She was born with her intestines outside of her body.
They've been too swollen to fit back inside.
Is that Am I looking at a bag of organs? We've been gradually compressing the organs a little bit each day to help them fit back inside the body.
Imagine going two weeks without getting to hold your own baby.
Well, good news.
Looks like we're finally gonna be able to close her up.
Today is the day.
Oh, my god.
Oh, thank you.
Thank you! Thank you! Thank you! Thank you! Hold please.
Thanks, guys.
If I could just have you sign this release.
Yeah.
These are real people with sick kids.
This is not a photo op.
- I was just trying - Look, I don't care, all right? The next kid I'm about to go see is a very sensitive case.
All right? You don't say a word.
You do not take a photo.
You're a shadow, a freaking shadow.
Got it? Protective of your patients.
Passionate.
I like it.
Forget it.
You're waiting in the hall.
Great.
Great.
Now if you could just move a little closer to her him.
Oh, I-I'm the him.
She's the her.
I-I no, I was born a her, and Jess was a him.
I get it's confusing.
- Yeah.
- You're kidding.
Cahill's got more of you guys trailing me? He's "trailing me.
" It's for this brand ambassador thing or something.
It's not a not a big deal.
- Just, uh, we'll be done in a sec.
- Ready? One, two, and three.
How's that? You really think it's okay to let these people in here? The patient's fine with it.
If he gets to stay, I get to stay.
It's the ambassador thing.
You think this kid makes you look good.
I always look good.
We're at U.
W.
together.
I'm a sophomore, and Brian's a freshman.
And is that where you met? Uh, actually, no.
Uh, Dr.
Karev introduced us.
A few years ago, I booked an appointment to see how old I had to be to, you know, start the process.
He was 14.
And, uh, Dr.
Karev told me about this transgender support group.
That's where Jess and I met.
Brian walked in that first day, and all I could think was, oh, my god.
He's so cute.
I thought he'd never notice me.
It's impossible not to notice you.
I've been saving up for this ever since that appointment.
Well, Dr.
Karev, you really changed Brian's life.
Well, you could also say that I'm changing Brian's life, today, in surgery, where I'll be taking the lead.
And what is today's surgery exactly? A full gender reassignment? Oh, no.
Uh, nothing that drastic yet.
Today we're just chopping off my boobs.
All right, enough questions.
Uh, Edwards, Wilson, take these guys outside.
Jackson Avery as the new face of Seattle Grace Now that makes sense.
Alex also makes sense.
If you want a face that's unshaven and sweating light beer.
You've got this in the bag.
Walk with me.
Here's what I know.
They like Avery's looks and they like his name.
Now you don't have either of those.
Gee, thanks.
But you have Africa.
Lead with Africa.
He's a scrapper and a fighter.
Now some people find that charming, but you're an Avery.
Use it.
Own it.
Impress them.
They want to be impressed.
And I saw your breakfast.
Your brain can't function on powdered sugar.
Here.
Oh, you just carry those around in your pocket? Every time I touch this thing, it deletes another patient.
It deletes a patient? I did the exact same thing this morning.
Here.
Let me see something.
Who are your stalkers? Oh, uh, the new guys are looking for a hospital show pony A face for the brochure.
Yeah, Karev's my competition.
- Mm.
If you can call it that.
- You can't.
Bite me, pretty boy.
And why are there no women in the running? Oh, there was.
I turned them down.
This face only goes on the nobel brochure.
And here we have a fully centralized electronic records system.
Everything you need to know about any client at anytime.
Smart, streamlined, efficient Oh, efficient.
It would be more efficient if it didn't keep deleting my patients.
- Sing it, Grey.
- Don't encourage her.
Why not? Cahill deserves it.
This morning she gave me this whole load of crap about how to talk to the buyers.
Emphasize sports medicine.
Don't emphasize my research.
She doesn't want anything to jeopardize the sale, and neither should you.
Research is risky.
Mm-hmm.
The suits don't like it.
Whereas, if you've got the seahawks as patients Ah.
She doesn't call 'em "Patients.
" She calls 'em "Clients," like we're, uh, oh, I don't know, real estate agents.
Real estate agents look happy.
Maybe we'll be happy.
Their benefits package says they have dental, including orthodontics.
Now I happen to have a family history of very straight teeth, but Tuck may grow up and need braces.
I don't know.
But if he does, they have dental.
That's I'm just gonna focus on that.
No, no, no.
We cannot settle.
We have to rise up and we have to do something.
You've done plenty.
Maybe those of us from the plane should keep our heads down for a while.
Am I crazy? I mean, am I the only one that thinks these wonks are gonna destroy the place? No.
You're not crazy at all.
I just felt like, what kind of doctor would I be if I didn't try to help out all those African kids.
It takes a lot of dedication to get a program like that off the ground.
This is your fault.
You put these ideas into her head.
His head.
And while I do support the decision, believe me, he came to it all on his own.
She's barely out of high school - He.
- For god sake.
She is a child! He.
- She doesn't know what she wants! - He! He! Jess, is everything okay here? Are you the one? What? Are you the one who wants to hack my little girl into pieces?! Hey, hey, calm down.
It's gonna be okay.
Pegasus racing you to a brighter tomorrow.
I'm gonna hurl.
Mm.
Click there where it says "Hospitals.
" Holy crap.
They must own half the hospitals in the country.
They're the guys who bought out Portland Gen last year.
Right there.
Hey, look at this.
"Hand in hand, we'll walk together," "partners on the road to your brighter tomorrow.
" This is who's buying us.
That's a cute logo.
Sofia would like it.
She likes horses.
It's not a horse.
It's a pegasus.
And it wants to hold your hand.
Hmm? This web site has not one tangible piece of information about the company or health care.
Why doesn't this bother you? It does, but they're buying us.
And we are all about to gallop down the road towards a brighter tomorrow.
So, you know, cool your heels.
Chill out.
There's nothing we can do about it.
She just told me to cool my heels.
Have you ever known me to cool my heels? How do you feel about a road trip? I'm sorry.
I lost my cool.
You think? It's just, I learned about this surgery last night in an e-mail.
I mean, a stupid e-mail.
I had no idea about any of this.
Guys, you can go.
We're fine here.
Scram.
Let's go.
A surgery like this is a big adjustment for any parent, let alone if you're hearing about it for the first time.
So let's just take a breath and Dad.
What are you doing here? My name's Calliope T Plant Tain.
Plantain.
And this is my husband.
Um, uh Julio Plantain.
And he needs a doctor.
Can I see some I.
D.
? He has chest pain.
Yeah.
So by the end of this seminar, I expect all of you to be able to perform basic wound closures using the interrupted 2-layer technique.
I don't like that guy in the back.
I can feel him watching me.
No, it's just me.
I like to look at you.
Quick question, Dr.
Avery.
Do you use this technique more often when you perform butt lifts or breast implants? Actually, isn't this the technique you used to attach the face on to your last face transplant patient? Well, I've never actually done Sidebar.
What do you find more fulfilling liposuction or body sculpting? Sidebar.
Isn't it true you've completed more successful skin grafts than any other doctor in this hospital? Um Yeah.
What are you doing? Saving your ass.
You hit a rock and you're sinking.
Iceberg ahead, captain.
Larry.
You know, we've got a free station right over here if you want to try your hand at some actual surgery.
Please.
Oh, excuse me one moment.
Have a seat, please.
What's up? I'm kind of in the middle of something.
I know and I swear I wouldn't call unless it were an emergency.
Look, I did a ride along today, and we got this call a kid, about 10 years old, hit and run.
Damn it.
He's still locked down.
- We can't intubate.
- Can you ventilate him? Barely.
His SATs are still in the gutter.
Okay, let's get him backboarded.
We need to load and go.
Seattle Pres is slammed, so they're diverting us to Redmond, but that's an hour away, and this kid He doesn't have an hour, Jackson.
He doesn't.
All right.
All right.
How are his vitals? Bad.
We've got no airway.
I can't crike.
He's got sub-Q emphysema.
He will die en route if we have to go way out there.
He will die.
Are you asking what I think you're asking? If I am, will you do it? And a few years ago, we renovated the waiting room to provide Chief, a moment, please.
Give me a moment.
Kepner's calling with a hit-and-run kid.
- He's in bad shape.
- Wait.
Kepner's in the field? They diverted her to Redmond.
Okay? We're closer.
Much closer.
- So I can arrange - Absolutely not.
We are not a trauma center anymore.
If we take them in, and something happens to them Chief, it's a kid.
Protocol dictates the patient goes to the nearest trauma center, and that's not us.
I'm sorry.
You need to get back to the seminar.
And you have to step it up.
What do you need, a pep talk, tough love? No amount of tough love is gonna make up for the babies Alex saves on a daily basis.
Can I trust you? Why do I have to be the patient? 'Cause you look the part.
Oh, and I'm naturally vivacious.
Yeah, "Manic's" more a word for it.
I'm so sorry for the wait.
We're gonna get a doctor to you just as soon as possible.
Well, it really wasn't a wait.
Ew.
Wow.
You're a happy one, aren't you? He's up there, too.
Oh, god.
It's like Hello, I'm Dr.
Mattoo.
You can call me Kan if you'd like.
You wouldn't be here if you weren't experiencing some pain or discomfort.
I apologize if we exacerbated that with a wait.
Uh, we got here, like, half a minute ago.
It's Okay, Mr.
Plantain.
- Uh, it's like the fruit.
- It's cuban.
Can you spell that for me? Um, p-l-a-n uh, t-a-i-n.
well, Mr.
Plantain, we know you have a lot of options for your health care management, and we are honored that you've chosen us today.
It's my pleasure.
Saw your E.
K.
G.
It looks pretty good.
How are you feeling today? Uh, well, uh, Dr.
Kan, uh, you know, the last 24 hours, I-I've Uh, uh, sorry.
Let me let me put that another way.
What brought you in today? I'm sorry.
What's wrong with asking him how he feels? That could take us down the wrong road, and because your time is valuable to us, we don't want to get off on any tangents.
Mm.
Well, if you ask him how he's feeling, maybe he'll tell you that he's he's blue, 'cause - Yeah.
- You know, his company - was just purchased by a bigger company - Yeah.
That he doesn't like.
And, you know, he can't talk to me about it 'cause I'm the self-involved type.
You know, we just, like, you know, shop online and redecorate the house.
And so he's been he's been, uh, hanging out at the local watering hole, where he has been bumming cigarettes.
And, uh, now he's experiencing shortness of breath.
So if you ask him what brought him in today, he's just gonna tell you "Shortness of breath.
" And then you'd miss the whole cigarette connection.
I ask about smoking on screen two.
Fine.
Whatever.
Okay, let me get back to screen one.
Darn it.
The screen froze.
Sorry.
Technical difficulties.
Uh, I'm gonna have to exit the system and take us back to the top.
Uh, it-it-it's okay.
Uh, take-take your time.
Can't really do that.
We've only got 15 minutes together today.
There we go.
Mr.
Plantain, can you spell that for me? Wow.
They really cleared the place out.
Okay, where do we start? You can start by guarding the door.
Hey, no one can know about this.
No one comes in.
You understand? Okay.
Medusa me all you want.
You're not getting in.
I'm an attending and I'm ordering you to let me in.
Well, you're not my attending today, so Don't make me force you.
I'd like to see you try.
Jo.
It's okay.
I paged her.
She's cool.
I hope you understand.
I would never ordinarily speak to you that way and I look forward to working on your service again soon.
How can I help? You're barely 18.
You know, what if you wake up, you realize this was all a mistake? This isn't a haircut or some meaningless tattoo.
This is my life.
This is me.
All right.
You feel different.
You want to belong.
Okay.
I get that, but you have your whole life ahead I mean, what-what what's the rush? I'm just asking for you to wait.
Brian feels like he's dying inside.
We both do.
If you'd listen, Brian will tell you that living inside of a body like this I'm sorry.
Could you just give us a moment alone? No, I-I don't want her to go.
And I don't want you mutilating yourself! - I'm not! - Brian's just trying to be Oh, for god sake.
Her name is Brianna! Dad, just get out.
Go.
Just get out! You heard him.
I just snagged a monitor, a ventilator, and central line kits.
I have saline, infusion pumps, a crash cart, and Cristina.
I'm sorry.
They overpowered me.
The fewer people who know about this, the better guys.
I brought lackeys.
What? No, I don't need interns.
No, this room has three internal exits.
You have a lookout on one.
Happy, ponytail, you man the doors.
Mousy, um, be the nurse.
We need gloves.
On it.
Why do I have to be the nurse? We are gonna need lights.
No, if I turn on more overheads you can see it from the hallway.
We can use those.
Hello.
Yep.
Okay.
All right.
They're pulling up now.
Let's go.
Oh, jeez.
I'm okay.
That's why we needed interns.
The door won't open? Watch the I.
V.
S.
Hurry.
April, what's going on? I don't know.
Jackson? Jackson! Pull.
It's starting to give.
More! More! Go sit down, Mer.
Oh, come on.
Just because my uterus is occupied Go sit down.
I'm not kidding.
Give me your spot.
What don't worry.
I ditched my P.
R.
chick before I got down here.
- How did you know that we - I paged him.
You've got an incoming kid.
You're gonna need kid-sized equipment.
I brought a peds cart with a bunch of crap.
All right.
Are we doing this? All right, guys, on my count.
One, two, three! Go, go, go, go.
Go.
Come on, guys.
We need to do rapid sequence intubation, stat! We could only get a 20- and a 22-gauge in the field.
I'll start a central line.
I need some lactated ringers.
On it.
I got it.
I can see the cords.
Paralytics are working.
All right, uh, I-I need an E.
T.
tube.
Orange drawer.
Orange drawer.
I knew that.
No chest sounds on the right.
I have to throw in a chest tube.
uh, I think I saw betadine somewhere.
Wait a second.
Does anybody actually have chest tubes? I'm trying to set up this saline drip, and I can't get this thing to stop beeping.
Anyone? I can give it a shot.
All right, I'm not finding chest tubes now, but I got N.
G.
tubes.
Did anybody actually bring suction? Uh, there's a portable suction in the rig.
Okay.
I'll go get it.
Thank you.
Incoming! Lights.
All clear.
I'm in.
Brooks, bag him.
So Dr.
Avery is taking a power nap.
He likes to rest up before big surgeries.
And Dr.
Karev had a dentist appointment.
Even doctors have to go to the doctor.
Meanwhile, have you seen the skin lab where Dr.
Avery grows actual skin? Come on.
Okay, I'm back.
I got it.
Help me secure this N.
G.
tube.
All right, hook it up so we can suction.
Okay, who's got the portable ultrasound? We don't have one? - Happy? - On it.
Wilson, get in here.
We need some more hands.
If this kid dies because you brought Red along on same lame idea of a date The ride along was a date? I need some 4x4s to control the bleeding on the scalp.
All three lines are patent.
We can start dopamine at 5 mics per kilo per minute, but we need to figure out his I.
V.
drip rate.
It's different for kids, depending on size.
Um, anybody have a calculator? I always ask a nurse.
Not a real nurse.
Broselow tape says says he's 30 kilos.
Standard concentration of dopamine is 1,600 mics per CC.
So 5 times 30 is 150 times 60 minutes in an hour is 9,000.
Divide that by 1,600.
Infusion rate is 5.
625 CC's per hour.
What? I'm really good at math.
Okay, let's, uh, give him 5.
6 Except we don't have any dopamine, guys.
We don't have access to any non-code medications at all unless we have a nurse or a code Yes, you do.
You paged him, too? Well, I knew we were gonna need meds.
I have the codes.
Tell me what the patient needs.
"Don't smoke"? That was his big advice? Uh, yeah, he examined me and found nothing wrong, which in fact, is the case.
Oh, he was an idiot.
And now I feel like an idiot.
We're just wandering around.
We look like interlopers.
Hey, you know, let's grab a cup of coffee.
You always look like you belong when you're carrying a coffee.
- Ah.
- Yeah.
No, walk with purpose.
Don't look shifty.
I don't.
Okay.
Oh, look.
Okay.
Want to make sure we're on the same page.
That makes sense.
I think one more diagnostic Do we have time for that? Just one? I think we're pretty good.
All right.
Can a doctor learn anything in that little time? You get really efficient.
And patient outcomes don't suffer? Wow.
You're that efficient? Are you visiting a patient? Hmm? Oh, uh, I'm Richard Webber.
This is my colleague, uh, Callie Torres.
Um, we're with Pegasus, and we just wanted to check in, get a little feedback.
See if you had any concerns.
Really? Really.
Okay, you need propofol Gentamicin and, uh - You will be really impressed by our next stop - Dopamine.
Downstairs, which will be the site for our new hernia clinic.
Get down there now.
- Okay.
- Alana.
Is this the group from Pegasus you mentioned? Hi, I'm Dr.
Shepherd.
Good to see you.
Hi, very nice to meet you.
How's the tour going? Good? We like what we're seeing so far.
Oh, I'm glad to hear that.
You know this is more than just a hospital for a lot of us.
And I don't want to sound cheesy, but it's, uh, it's like family.
- it's like home.
- Good.
Hey, have you ever seen a human brain up close? I can't say that I have.
You know what? I'm gonna give you the unofficial tour by way of the third-floor coffee cart.
We'll have some coffee first.
You're gonna love it.
I've got free fluid in the left upper quadrant.
Crap.
What time is it? We have surgery on Brian in 20 minutes.
Cahill will definitely notice if we don't show.
If you guys need to go, go.
We can handle this.
Look, I'm seeing a pneumopericardium.
Okay, we should put in another chest tube on the left, just to be sure.
Well, this kid needs an O.
R.
Guys, we've gotta move him.
We can't.
Not till we have someplace for him to go.
There's no time.
Cahill's on her way down her right now.
Okay.
We're staying.
Are you hungry? Can I buy you lunch? Actually, we have a very tight schedule.
We need to get down to the hernia clinic now.
Oh, yeah.
Okay.
You know what? Why don't I join you? We gotta move the rig.
It's still parked outside.
- It's okay.
Go.
- Move, guys.
Move! Hurry! We gotta get this thing mobile.
- What happened? - He's bradying down.
- We gotta keep moving.
- I'm not getting a pulse! Ross, start C.
P.
R.
Damn it.
His trachea is deviated to the left.
His SATs are dropping.
I think he has a tension pneumo.
He has bilateral chest tubes.
It must have gotten blocked.
Someone find me a 14-gauge cannula or a 16-gauge.
Whatever you can find, the biggest.
- Um, got it! - Guys, what about Cahill? Oh, god.
What what if he dies? What if we brought him here and what if he dies? Hernias are one of the most common general surgery procedures.
And as it turns out, also one of the most lucrative.
- Why did I agree to this? - Guys, we gotta keep moving.
I can't even think! We have to move! Cahill's coming down right now.
If we don't move - We're moving.
Yang.
- Wait one second.
One second.
Now keep in mind, the site is still under construction, but you'll just have to use a little imagination.
Before we go in there, I'd like to, uh Okay, right this way.
And, uh, watch your step please.
Last month, I had to do a cardiac cath on a patient with no signs of heart disease.
It's putting the patient at risk for no reason.
Forget physician advocacy.
It doesn't exist.
We have no say in anything at all.
Yeah, and if you decide to go crazy and think for yourself, they know, like, instantly.
I swear the walls have ears.
Are you the reps from Pegasus? Uh, Dr.
Webber and Dr.
Torres.
Hi.
Callie Torres from Seattle Grace? Uh, I'm do I do I know you? No.
Kenton Giles.
I'm an ortho just like you.
Yeah, I read all about your cartilage generation work.
It's incredible.
I didn't realize you stopped practicing.
So you work for Pegasus now? Yeah.
Yeah, I guess I needed a I needed to mix it up a little, so She peaked, you know, with the cartilage generation.
Uh, you know, sometimes it's best - to get out before you decline.
- Yeah.
And after the anesthesia is administered, Brian will be ready for surgery.
And when exactly are we gonna see doctors Avery and Karev again? No offense, but we're here to trail them, not you.
Edwards, nice work.
- Ah.
- No problem.
We're ready to scrub in.
Wilson, could you show our friends up to the gallery? - You guys can watch from up there.
- Mm-hmm.
You have a little bit of blood on your left shoulder.
Everyone, right this way.
here we go.
by streamlining the process, we will significantly decrease the hospital's hernia complication rate and become a destination medical center.
How many patients will this place accommodate at a time? Upwards of 30 once everything is finished.
Shepherd, uh, would you mind taking over? Uh, if you'll excuse me.
Right.
Uh, yes.
I was gonna try a similar research project, but now that I'm the face of Portland Gen, I don't have that kind of time.
Really? Yeah.
I do a lot of press.
About orthopedic surgery? That's great.
Well, more like, you know, wellness, nutrition, get eight hours sleep, take a walk.
Uh, sometimes I do a photo op in the O.
R.
They don't want to shoot a real person, so they have me cutting a chicken breast or something.
Well, I work on the Portland trailblazers, though.
Real guys, not chickens.
Yeah.
Yeah, that's-that's good.
Nothing innovative like Dr.
Torres does.
Or did, I guess I should say.
Y-you know what? Uh I was wondering, can this stay between us, not get back to Pegasus? Nothing you say to us will ever get back to Pegasus.
Great.
Well, now that you're not practicing is there an ortho opening at Seattle Grace? Well, I hope you get it, the brand ambassador thing.
I don't want to be the face of any hospital where I have to sneak around and risk my job just to do the right thing.
Screw that.
I hope you get it.
All right, well, this keyhole incision is done.
We're ready to begin closing.
Who are you operating on, Dr.
Avery? My transgender patient, why? What did you do? This part of the lung is fried.
I'm gonna have to do a resection.
The spleen is out.
Let's irrigate with antibiotic solution.
Does somebody want to tell me where the hell this patient came from? Whose patient is this? Fine.
You don't have to tell us.
We can just look it up.
All I need is the patient's name.
Wait.
No, um I can do it.
I'll look it up.
It's my patient.
You got this? Thank you, Dr.
Grey.
Appreciate your cooperation.
Sure.
No problem.
I'm happy to.
Okay.
I just have to get into the patient file.
- Oh, no.
- What? This keeps happening to me.
I try to go into the patient file and I guess I deleted it.
What happened? Cahill figured it out? They're taking us in one at a time to see who'll break first.
I can't lie.
I'm no good at it.
They'll see right through me.
Stay strong, dopey.
You can do it.
They started with the interns.
I'm just trying to find out what happened.
You want to know what happened? I'll tell you what happened.
A kid was dying, and we kept him alive.
Dr.
Karev, hello.
You mentioned the word "We.
" Who else was involved? I was.
This was my call.
I took the kid in.
I decided to treat him.
We did the right thing.
We saved his life.
And that's what matters.
Not these idiotic new policies or some stupid ad campaign.
So you can punish us however you want.
We don't care because That's enough.
Just go.
Oh, that's it? You're not going to discipline them or Go.
You paged me? - No.
- Yes.
We have a problem.
My presence seems to have ignited an uprising, which makes it a little tough for me to do my job, especially when you help them.
What? It was your code that accessed the medication case on floor five.
Is that true? That stuff you said, Dr.
Shepherd, about how this hospital is such a family? It was lovely, really.
I even think you meant it.
But it means nothing if there is no hospital.
Do you know how much this stunt would've cost this place if that kid had died on our watch? Pegasus would've backed out.
And without them, you're done.
I am trying to help you.
But I can't do that if you are undermining me at every turn.
If you care anything about this hospital or the people in it, then it's time that you get on board.
Otherwise the next doors to close will be yours.
Jess, the surgery went very well.
Brian should be in recovery soon.
You'll be able to visit him then.
Mr.
Weston? Is that you? I'm sorry.
I just want to hear how Bri how everything went.
I sent you the e-mail last night.
Not Brian.
It was me.
He wasn't gonna tell you.
I know you guys don't talk that much since he moved out, but he talks about you a lot.
He admires you.
I think he wants to grow up and be you.
And you're his dad.
It was a major surgery.
I thought you should know.
I get why you blame me for this.
He met me and started changing dressing differently and acting differently.
But I'm not It's hard being like us trying to fit into this this mold that doesn't fit.
He just wants you to love him, Mr.
Weston The way he loves you.
He didn't tell you because he didn't want to mess that up.
You guys okay on rent? Here.
That's all I have on me.
You don't want to be there when he wakes up? Change is a funny thing.
Not everyone can handle it.
Hey.
So I know you keep saying that you and Wilson aren't a thing.
'Cause we're not.
Well, maybe you should be.
She kinda kicked ass today.
Just saying.
Come on.
Come on where.
Just come on.
It can sneak up on you.
It's funny how you don't appreciate a thing until you're about to lose it.
No.
No, don't don't say that.
That's we can still fight this.
You can fight this.
Me? I've got an early retirement package waiting.
Maybe I'll take it.
Good night, Torres.
Good night.
Things aren't what they used to be.
Matthew? Oh, hey.
I was hoping to catch you.
Uh, how's the, uh, kid? He is doing great.
He made it through surgery with flying colors.
Oh, that's that's great.
That's, uh, that's good.
Yeah.
Uh, April, I, um, oh, man.
I had this whole thing that I-I wanted to say to you, and then you look at me, and I just Gah.
Okay.
Pull it together.
You are the strongest, most fearless, beautiful woman I've ever met.
You were incredible today.
You are incredible.
And, uh I like you.
I-I really like you.
And I just thought I should say that so you knew, because I Your whole world has transformed.
What are we doing in here? just wait.
I stole them from the nurses in derm.
They won't eat 'em anyway.
They're all "No sugar" and "Gluten-free.
" Cheers to an incredible day.
You deserve it.
Actually, I helped, too.
So cheers to us.
Hey, powdered sugar's your favorite.
Yeah, no.
This is great.
Thanks.
What? Nothing.
Mm.
You realize the ground beneath you has shifted.
You guys are killing me.
It was the right thing to do.
Yeah.
You're still killing me.
Things are uncertain.
And there's no turning back.
She's not answering.
I really want to wait for Cristina.
Okay, fine.
Fine.
Let's wait for Cristina.
Let's just wait downstairs where it's warm.
Yeah.
No, we can't.
The walls have ears.
- I'm outta here.
- Okay, all right.
Uh, look, I called this meeting because we can't just keep our heads down and lay low.
Okay, we're the reason the hospital's in trouble.
We have to do something.
We can't let Pegasus take over.
We have a responsibility.
Which is why I think we should buy the hospital ourselves.
The world around you is different now Sir.
Unrecognizable and there's nothing you can do about it.
You're stuck.
The future's staring you in the face.
And you're not sure you like what you see.
Like I said, I'm not big into change.