Grey's Anatomy s11e13 Episode Script
Staring at the End
I don't like questions without any answers, like "where do we go when we die?" I mean, I know what happens physiologically speaking, but beyond that, what really happens? Anything? That's what you start asking yourself when you live on a clock.
All these questions without any answers they'll drive you nuts.
That's why I like what I do fixing babies, birthing babies.
No ambiguity there, no questions, just answers clear, precise, obvious answers.
And life beautiful new life.
Hope for the future.
God, I miss that.
Morning! Robbins, are you ever not chirpy? Does that ever happen? Are you ever not snarky? Also, you snore.
I can't crash here again tonight without earplugs.
Okay, so, we have seven cases today.
The first one is in two hours.
Also, it's Friday, so that's MRI day.
You know the drill.
limited life-span wasted.
Mm, come on, come on.
God! I'm coming.
- Stop chirping.
- Stop snarking.
Whew! After this, we've got the diaphragmatic hernia.
Baby's 27 weeks.
We'll do a, um, tracheal balloon occlusion Hey.
Figured you could use this Which should, if we're lucky, ensure the blood - before the big lecture.
- Oh, um, thanks.
Thank you.
Um, they already scheduled a follow-up procedure on the baby, as well.
You're cultivating quite a bit of buzz, you know? - Really? - Mm-hmm.
I heard from two hospitals wanting us to record your talk.
But we won't be too close to the due date.
- And if - I have a lot on my plate right now, just with, uh, Herman and her tumor.
Uh, her surgery.
I really need to focus On the tumor.
Don't need any distractions, and you're Very hard to ignore.
Hey, I ju It was just coffee.
No, I so appreciate the coffee.
Uh, I was just getting some coffee for myself, and It's good coffee.
It It's great coffee.
I, uh I can I can just get my own if if you I mean, you can get your own so easily.
I don't want to get my own coffee.
I I mean I do.
I can.
I will.
I I can get my own coffee all day long.
I just Owen.
Thank you for bringing me the coffee.
I really like it.
Uh, you're welcome.
So, how's my head? The tumor seems stable.
I was worried about the inferomedial margin, but the good news is, there's no sign of growth.
It hasn't invaded the optic nerve yet.
Well, how long till it does? I need a number, Shepherd.
I have things to plan.
About six weeks Maybe eight if you go in for the localized radiation treatments I've prescribed for you.
- I'd like for those to start today.
- No, no, no, no.
I tried that.
Hated it.
Doctor's orders.
It is our best chance to shrink the part of the tumor on your optic chiasm.
- Oh, crap.
- Glenda Castillo! We're headed to surgery, Dr.
Bailey.
No time to talk.
But you haven't given me an answer.
Actually, I have.
It was no.
But you haven't given me the right answer.
You could at least meet with her.
I've seen the case, okay? I'm sorry, but I'm working on a very limited time frame with a very specific list of surgeries to teach Robbins, and Glenda Castillo isn't one of them.
Okay, well, as a personal favor to me, just me per I have no time to make it personal.
It's a no.
I'm sorry.
I'll get you some names good people.
She can see one of them.
Um, sorry.
Three down, all these to go.
We've got four months' worth of surgeries up here.
I mean, how are we gonna get four months of surgeries done in eight weeks? We just do, I suppose.
You'll do the next one yourself.
I'll watch.
What? No.
No, thank you.
I appreciate the vote of confidence, but I'm not even actually sure that I know how I need to see what you've learned, what you can and can't do on your own while I'm still around to fix it when you screw up.
Gee, thanks.
It's not a vote of confidence.
It's a necessity.
Training wheels are off, Robbins.
Time is up.
What's next? Uh, your radiation treatment.
Ugh.
Radiation hasn't worked yet.
I don't see why it's suddenly supposed to start working.
- Radiation is bull - Shepherd says that it's necessary.
She's the doctor here.
"Life will out.
" The origins and lessons of life and evolution are long and complex, but what they basically boil down to is, life will out.
Life will always find a way to continue.
Always.
Life will out.
This is a massive grade IV astrocytoma.
I want you to take a look at it.
Really look.
Look at its size.
Look at the way it invades healthy tissue.
Look at its vasculature.
It is blood and tissue and flesh.
It's growing Adapting to its environment, struggling to survive, to stay alive.
It is alive.
We don't like to think of it that way, but it's nested in the womb of a human brain, feeding on its host, growing and fighting for life almost like a fetus.
No, scratch that.
Let's just for science and giggles say exactly like a fetus.
Because like a healthy fetus, it is thriving.
You know, there are even some types of tumors that grow teeth, hair A stray eye.
Have I repulsed you? - It's gross, right? - Yeah.
I mean, that is a problem.
Nobody wants something that nasty in their head.
I'd like you for one moment to consider the idea that, to the tumor, we are the problem, we are the invader.
We are the danger.
To the tumor, we are the cancer.
And the tumor? Well, the tumor sees itself as a sweet, cute, fat-cheeked baby just trying to make its way into the world, and we want to stop it, destroy it, tear it from its happy little home like barbarians.
To the tumor, we are the soulless, murderous monsters.
Why do I do this? Why do I call it "baby" and talk about killing it? Because this kind of tumor deserves respect.
It deserves a little humanity.
Charming, isn't it? They put clouds on the ceiling to distract you.
Least they could do is put something interesting up there, like porn.
It's not just a tumor.
It's ingenuity.
It's strength.
It's adaptability.
It's poetry.
It's one of God's masterpieces.
It is alive.
Mm.
You okay? Sure.
And like any living thing, it wants to stay alive.
Like any living thing, it is going to fight like hell to survive.
And when I saw open that skull and come face-to-face with it, with that tumor, with that living thing, it will be almost impossible to remove Well, I'll see you after.
Because it would rather destroy the brain that holds it than go gently into that good night.
It is alive.
And what's it all come down to? Life Will Out.
Grey's Anatomy 11x13 Staring at the End So, our fat-cheeked-baby tumor that's nestled in that brain, it's a creature of habit.
It has the same routine day in and day out to grow, to spread out, to take up space.
That's it.
At this point, our baby tumor is so enmeshed, so invasive, it's touching virtually every single brain structure.
It's pushed existing tissue aside, shoved brain matter out of the way to find room for itself.
How do you remove it without destroying the brain around it? How do you kill the baby without killing the mother? I stare at these scans, and the tumor stares back at me, daring me to try to extract it.
I mean, this tumor is bold and brazen.
This tumor thinks it's in charge.
This tumor thinks it owns the place.
I don't have to explain myself to you.
You missed your radiation session this morning.
- I told you, I'm not doing that anymore.
- That is not your call.
My tumor, my head it absolutely is my call.
The tumor will be exponentially easier to remove after the radiation.
Nicole, please.
Go to radiation! - I will think about it.
- Okay.
The thing about a tumor like this is, you can't let it intimidate you.
The tumor isn't smarter than you.
You just need a plan of attack.
Here.
Feel that? You must be methodical.
You want to find a spot with just the right amount of give.
That's where you want to cut.
Scalpel.
Point of access is key.
- You're up, Robbins.
- I know.
I've never done that part before.
So, um, you were really serious about that? It's time.
Make the cut.
- But I don't know I've never - Make the cut.
And then you start.
That is the most daunting step pushing a blade into that first squishy blob of flesh Because the first cut is what sets the tone.
It determines every single move from that point on.
So, you have to be careful.
You have to be sure.
Or you're in trouble.
It's like a - Just look at them.
- Who? Arizona and Herman they're practically joined at the hip.
I'll take one of those, too.
Well, she is Herman's fellow.
Isn't she sort of supposed to follow Herman around? They're laughing all the time, And Arizona seems so Happy like really happy.
- So? - You seem happy Ish.
- Why do you even care? - I don't, obviously.
I'm just making conversation.
Don't you guys think it's weird how they're always together? They're not always together.
- They do bunk up together sometimes.
- What? - Alex.
- Robbins has been crashing with Herman.
She hasn't slept at the house all week.
- What?! - Alex.
- I don't mean like that.
- They're not together together, and you know that.
Mm-hmm.
Arizona used to hate her.
Now they're having sleepovers? Well, it's a good thing, right, that they're getting along? Herman's not exactly the warmest person, so When you talk to Derek tonight, would you ask him something for me without saying it's for me? I don't know that I w Just ask him what he'd use to avoid disrupting the gratiolet radiations off the geniculate body of the thalamus.
- Why don't you ask him that? - No, no, no.
No, no.
That's the point.
You ask him.
I can't ask him for help.
I cannot listen to the smugness in his voice.
You can hear it.
He has transcontinental smugness.
You know what? Forget it.
I'm fine.
I don't need him.
I don't need Derek.
I will figure it out myself.
When did this happen? She found the perfect rebound without having to actually find a rebound I mean, she just gets all the good times and the fun, none of the bad times or the mess, no chance of getting hurt.
You don't even have to wax.
It's not fair! Oh, my God.
Am I seriously wishing for a sexless relationship where I don't have to groom myself? - Is that where I am now? - It sounds good to me.
- Welcome to my life these days.
- You chicks need to get laid.
That also sounds good to me.
Not without the grooming.
It's in there.
He can find it.
What, he can't do a little work first? I like her.
Eddie.
- Excuse me? - Uh, Glenda Castillo, the patient you and Herman turned down last week, her husband's name was Eddie.
I lost him six months ago after he was injured in a head-on collision.
My hands were inside of his body when his heart stopped beating.
My hands held Glenda's when I told her Eddie died on my watch.
Three weeks later, she found out she was pregnant.
She's not insured, but she remembered me and this hospital, so, she came here to see if I could give her some prenatal care, and guess what we found out.
Her baby has a tumor a large, dangerous tumor that's not just messing with the baby's system, it's messing with hers.
I couldn't save her husband's life, but I can help save her baby.
I owe this woman that much.
Herman has to take her on as a patient.
Just just have her meet Glenda, all right? - Then she'll - I can't, I can't! I can't trick her into seeing a patient she doesn't want to treat.
Who's in charge of her schedule? Who tells her where to go and when? Who tells her what surgery or post-op or anonymous consult she should see next? Uh I'm concerned about her blood pressure.
It's increased to 140 systolic in the past week, and her swelling's gotten worse.
Uh, I used to have ankles.
Now I have balloons with toes.
So, your baby has a large tumor in his lower back.
It's most likely benign, but because of its size and vascular nature, it could cause an accumulation of fluids in the baby.
But the tumor can be removed, right? Dr.
Bailey says amazing things about you, that you're one of the best.
Bailey said that? How flattering.
That was Glenda Castillo.
I told you no twice now.
And you, how am I supposed to trust you at all - when you pull something like that? - She didn't do anything except try to get your help on a patient who needs your help.
But if you heard her story, if you knew she was Is that how Bailey convinced you? It's a tactic, Robbins, appealing to your sad, bleeding heart.
Doesn't work with me.
Well, then, let me appeal to your ego.
You walk around here telling anyone who will listen that you're the best.
Well, then, be the best.
You can save her baby's life, so save that baby's life! No.
Ohh.
- What the hell? - Robbins, drop it.
No, I get that I get that I've seen tumors like that before, but this can't all be about my education.
I mean, at some point, I have to At some point, we have to make decisions and stick to them.
I wish we had time, but we don't.
We have very little control over the time we have, and we have a plan.
Can't we make an exception? Can't we just, you know, sort of adjust the plan? You fine.
You want to? Adjust the plan.
What are you doing? Take down one of these cards so we have time to help Mrs.
Castillo.
Which one? How about Meghan Carlson congenital airway obstruction? Her husband's in Iraq right now.
Or Julie Hall vasa previa.
She went through two years of fertility treatments.
So, pick one.
Decide which baby doesn't get to live so Glenda Castillo's does.
Go ahead.
Pick a card.
You choose.
That's what I thought.
_ No.
No.
Get me out! Get me out of here! Get me out! - You have to.
- I don't.
The radiation treatments are going to help.
They are gonna shrink the borders of the tumor, which will make it easier to resect.
It's a minimal gain for you.
I will take what I can get.
I am trying to save your life! You are making me feel like I've already died.
I'm sick.
I'm losing my hair.
I refuse to spend the last few months of my life feeling like a pile of crap.
No more.
That's final.
Dr.
Stanley, please report I am going to give you more than a few months.
I am going to save your life.
And I am about to get up in front of a bunch of people and tell them how I plan on doing it.
It makes it really hard for me to do that or even care about doing that when you don't seem to care at all! Well, that's your problem.
Well, the word's spreading.
This was a good idea, Hunt a master class in neurosurgery.
This is gonna put Amelia Shepherd on the map.
Mm.
Unless it fails.
It won't.
If it does There's a lesson in that, too.
So, she just spitballs this stuff with you? It's just the two of you hanging out, talking tumor? Pretty much.
I want to talk tumor! - I want to talk tumor so bad.
- Shh! - Oh, my God.
Look at that thing - Yeah.
Previous attempts to treat Dr.
Herman's tumor with radiation proved unsuccessful.
I had hoped to use high radioactive doses to reduce the margins, but at this juncture, that course seems to be unrealistic.
But that's not enough to make me quit.
This tumor is fierce and intimidating and aggressive, but so am I.
Now, the trick to this is, you can't touch the vessel while you're lasering the mass not even a little bit.
If you do The field fills with blood, obscuring the camera, and visualization is compromised.
First, I need to see the tumor, all of it every margin, every last ripple and ridge.
So, what do you do? I have two choices open her up and stop the bleeding if I can, or deliver the baby regardless of how early.
Very good.
So, I will employ fluorescein dye to delineate every border of the tumor, to help me anticipate every possible problem before I get to it.
I don't want to leave anything up to chance.
What happened? The pressure's dropped.
She's in a lot of pain, and she's cramping.
It hurts! It hurts, it hurts! It's okay, Julie.
We've got you, we've got you.
She has a vasa previa.
She's scheduled for an ablation tomorrow.
I've been trying to get her pressure back up, but there is no fetal heartbeat.
Damn it.
Where's her husband? Is that blood?! I'm bleeding?! - Gown me.
- Keep him out of here.
Robbins, you're gonna get this baby out right here, right now.
Here? We need a C-section tray set up in here.
Call peds.
Get an incubator, stat.
Wait! What?! I'm gonna have the baby now?! Julie, I'm gonna give you something to calm you down, okay? I never had to do a crash C on my own before, okay? - I mean, not like this.
- You know what to do.
It's the same three basic steps, just like any other C-section Open the abdomen, open the uterus, deliver.
Okay, I'm okay.
Pressure's steady at 100/60.
- Okay, I can do this.
- Betadine.
Okay.
- Robbins? - I'll do I'll do this.
It's fine, Robbins.
I'll do it.
Scalpel.
I'm so sorry.
We did everything we could do.
I'm so sorry.
Good job.
Let's go.
Stop crying.
Oh, for the love of - Stop crying! - I'm Stop it now! Just Stop it right now.
There's no time for crying.
We have work to do.
What? How can you even 'Cause that's the way it goes, Robbins.
Call Bailey.
Tell her we're on.
_ _ Now, arguably, the most important part of the brain is the part that makes us hope Dream Imagine.
One singular, almost immeasurable part is what makes you you And me me And everyone Everyone.
It's technically called the fornix, but I call it the "dream box.
" The question is What happens when the dream box is being invaded, when a tumor is so large, so demanding, it's sucking the dream box dry? It's taking over it's stealing away hopes and dreams.
Imagine, when that tumor is removed, what what will actually be left? Or, rather, who is left? Anything? Anyone? I remember my mom telling me once that when we die, we go to heaven.
I couldn't picture it.
All I could imagine was what we see in cartoons little people in robes with wings, sitting on clouds.
But nobody really knows what's up there, do they? When I was a kid, I used to think that we were like dandelions like, the part that makes us us would just blow away and land and grow into I don't want to be buried, by the way.
- Have me cremated.
- W Excuse me? If I survive the surgery but don't wake up, give me five days a week, tops - then pull the plug.
- This is We don't need to be talking about this.
If I do wake up but I'm dependent on vents or tubes, pull the plug then, too.
You know what? You're not you're not dying.
You're not gonna wake up gorked.
Shepherd knows - what she's doing.
She does.
- Okay.
Sure.
- She does! - I heard you.
That bird is gonna poop on us.
Oh - What's next today? - Glenda Castillo.
I'm so glad you brought me back in.
Have a look.
Well, the teratoma has grown.
It's showing early signs of hydrops.
- Is everything okay? - Glenda, your baby's retaining fluid, which is starting to affect his heart.
I'm recommending we do the surgery tonight.
Tonight? No, that's way too soon.
The tumor is creating pressure on your placenta.
It's not only endangering the baby, but now it's putting you at risk.
But my baby wouldn't survive, would he, if you suddenly had to deliver? 'Cause I'm only 24 weeks along, and I know that it would help him if he had time to grow, right? If I could just hold on for a few more weeks It's not what's best for you.
I don't care about me.
Glenda, if Dr.
Herman thinks that No, my husband is dead.
But this baby that is inside of me, this baby of ours, I cannot risk his life.
I won't.
So, if there is a choice between helping me or helping my baby, I choose my baby.
What does she think we're trying to do here? I am not negotiating with a patient.
I am the doctor.
I'm gonna tell her when we're go I'm sorry.
- Robbins, what's the hell? - What's funny about this? I'm sorry, I'm sorry.
It's just it's just it's funny listening to you get so bent out of shape when this is the exact same thing that you've been doing to Amelia Shepherd ever since she offered to save her life.
I mean, she has.
Exactly.
"We'll do the surgery when I'm ready.
" And it's so frustrating.
It's torture, and it drives us crazy.
So, it's just fun to watch it happen to you.
It's like divine justice.
Pretend that I'm not here.
Keep going.
I will give Ms.
Castillo an extra week, but I want her admitted.
And if she so much as hiccups funny, - I'm taking her to surgery.
- J understood.
Hey, thank you for taking her case.
Oh, shut up.
I can't How do I access that area of the brain when it's so hidden? And once I access that area, even with the perfect tools, the perfect approach How do I keep from screwing it up? If there's edema, it's post-fixed.
It's too narrow, too close the fornix.
If I hit the hypothalamus, game over.
Not gonna work, not gonna work, not gonna work.
Do you want some food? Have I figured this out yet? - No.
- Then I don't want any food.
This has never been done before.
All these steps in this order on this kind of tumor has never been done.
Is that a good thing or a bad thing? Who do I even think I am? Who am I to even try this? Okay, a bad thing.
Have you called your brother? - What did I saw about my brother? - I know.
You don't need him.
I was just thinking you could, just to have someone to bounce these ideas off of who understands this kind of thing the way that you do A peer.
He might have a suggestion.
I do not need my brother! I am not stuck! I am thinking! I am figuring it out! I am right on the edge of figuring it out, of making the breakthrough of a lifetime! I am this close! My genius is flying around this room right now, trying to find a clear path to land on me, but I can't clear the runway for landing because I can't find any quiet because some idiot resident keeps talking to me! I shouldn't have said that.
I didn't mean it.
I'm tired, and I'm frustrated.
I I am so sorry.
I just This tumor is making me crazy.
Edwards.
As bad as you want to get that tumor, that's as bad as I want to watch you get that tumor.
You're tired and frustrated and terrified, but guess what.
I don't give a damn.
You're supposed to be my mentor.
You are my mentor.
I believe in you, I look up to you, I want to be you.
That's an enormous responsibility, so don't call me names.
And stop pouting because you don't understand what to do.
Be worthy of being believed in, of being looked up to.
Or if you can't actually be worthy, if I am actually wasting my time, if there is nothing about you that is special or wise, for God's sake, at least have the decency to pretend that there is.
Get it together, Dr.
Shepherd.
Get it together, Dr.
Shepherd.
_ Okay, bye.
Bye.
- Hey.
Um, how are you? - Uh, good.
How's Dr.
Herman? Is she good? Is everything good? Yeah, I mean, she's killing me with back-to-back surgeries but Yeah, and Amelia's plan? You good with that? - Callie, what are you - What? I'm not I'm just checking in, okay? I'm just Seeing how you are and, uh, how, um - Callie? - Well, it just seems like you and Dr.
Herman are getting along really, really well, and you used to complain that she was killing you, but now you're happy that she's killing you, and it seems like you really, really like her.
I do.
Actually, I do.
She's great.
- She's I mean, she's amazing.
- And she's sick.
- So, I worry.
- Amelia's got it covered.
- She's gonna be fine.
- I worry about you.
I know I shouldn't.
I know it's none of my business, but, uh, old habits.
Well, that's, um Thanks.
- Oh, I got to go.
- Okay, okay.
Wow, that's tall.
Yeah.
Really big.
Just so you know, the auditorium is packed.
The fire marshall actually made me move a bunch of people out to an overflow room.
Amelia.
Just give me a minute.
- Amelia.
- Shh! Hang on.
You can talk to me.
You're wound pretty tight.
I just want you to know you can talk to me.
My whole career, I have been the other Dr.
Shepherd.
He's the real one.
I'm the other one.
Right now, this plan of mine is theoretical.
It's just talk.
But at some point, I am going to slice into Dr.
Herman's brain, and I have this sick feeling that when I face that tumor, I will discover that I am not just the other Dr.
Shepherd I'm the wrong Dr.
Shepherd.
Hey.
Look, I know you've been having me take the lead so I can learn, but you need to handle this case.
- Why would I do that? - Because it's emergent, and I've never tried cutting umbilical bands.
- First time for everything.
- Well Listen to me, okay? I'm not ready to take this over yet.
Doesn't matter.
Stop! Stop! You You're not hearing me.
It does matter.
I'm not ready.
And you think I am? You think this is easy for me? You think I'm ready? I was fine.
I got fine with dying.
And then you infected me with your stupid with Shepherd and her plan and your stupid hope.
And now it's harder than ever to hand all this over.
I don't want to.
I'm scared to.
And I'm scared to let go of it, and it's all your fault, so I think the very least you could do is deserve it.
Take over, do well, make me not regret it.
Can you do that? Please? This is the part where things get a little fast and furious.
It is arguably the most dangerous, most precarious portion of the operation.
It also needs to happen the fastest.
Every step, every move before this has laid the groundwork for this very moment, the moment where I place the radioactive seeds.
It requires precision I just need to slip these shears under the band.
And accuracy and speed things that do not go together well.
I can't get the last band.
This grip's not flexible enough.
Can you coax it through? Mm.
It's not no.
It won't give.
- You have to cut that last band.
- I know.
- Have you tried a smaller scissor? - Mm.
It's not the problem.
Imagine picking up little grains of salt while wearing oven mitts.
That is what I'm doing inside somebody's brain.
- Hand me a glove.
- What? Somebody hand me a glove.
Scissors.
There's this thing that we used to do in peds.
I think it'll work.
I just need a more flexible opening, and I can make it out of a glove.
That's not in my notes, Robbins.
- Are you serious? - It's gonna work.
But once I do it, once I place the final seed, well It's smooth sailing.
Ha! Did you see that?! It worked! It it it absolutely worked! 'Night, 'night, tumor baby.
It has been lovely, but we are done.
I'd like to open things up to a few questions.
Yes.
Are you nervous? Uh I'd be crazy not to be.
Yes, of course I'm nervous, but I'm also very excited.
This is history.
This surgery will be history.
How could I not be excited about that? Excellent, excellent.
You should be very proud of yourself.
Close up now.
Where are you going? What you're describing is seven different surgeries all using the hardest techniques you've ever tried.
How long do you anticipate the entire surgery actually taking? Give or take some hours.
Uh, follow-up question do you need a second resident on the case? Uh, not unless Edwards is planning to bail on me.
You planning to bail, Edwards? No, ma'am.
Yes, in the back.
Will you have help? Um Sorry? Well, I'm just, uh Well, are you gonna be doing this whole surgery yourself, or is Derek uh, Dr.
Shepherd coming? I'm I'm just I'm just asking.
I mean, given everything, is it a good idea? Should you be doing this yourself? Well, I am, so Next question.
I need you to scan me.
Something's happening.
I'm experiencing symptoms fuzziness around the edges, a little like, uh, blinders, and it's, uh, dark darker than it should be, I think.
Okay.
Let's go.
- Bailey? - Where's Dr.
Herman? She stepped out.
What do you need? Uh It's Glenda Castillo.
Hey, I need Herman right now.
Glenda Castillo's baby is in distress, and Glenda is severely hypertensive, showing signs of heart failure.
We need to operate on her immediately, so if you could finish up What are you doing? - Why are you standing there? I - Arizona.
Oh, God.
It's time.
Now? I'm gonna go Get an O.
R.
ready.
Okay.
Okay.
You ready for this? Mm-hmm.
Amelia.
I'll get an O.
R.
prepped.
You'll inform the patient? Oh.
Robbins.
Surgery's all finished? Yeah.
I see.
Shepherd's prepping the O.
R.
? Yes.
If I had to guess, I'd say the tumor's invaded the optic chiasm.
Ah.
My chariot awaits.
A little privacy, guys? Did you, uh, need me for something a patient? Um, yeah.
Glenda Castillo's baby has hydrops.
Mom is mirroring, and she's going into CHF.
Wow.
Looks like a big day for both of us.
What you need to do first is try to embolize the vessels fetoscopically.
Make sure her blood pressure is stabilized.
She has you.
Amelia has you.
This is the point where you trust her, okay? Don't go in without checking Glenda's platelet counts and crossmatching.
This is the point where you trust her, okay? All set.
Don't let Glenda's platelet count drop below - Will you tie me? - Yeah.
Let's do this.
I never placed much value in wondering about an afterlife.
My concern was always this life, what would I do with it? How would I make my mark? Be sure, be fast.
You don't have half the time you imagine.
Try to ablate all the vessels, but don't wait too long.
Don't be afraid to make that call.
If she's awake, she'll tell you for the 15th time to save her child's life before hers.
Listen to her, let her say her piece, - then you do what needs to be done.
- I don't think I don't I don't know I don't know if I can do this.
- I can't.
I can't do this.
- You can.
- Nicole.
- You will.
Let's get you inside now, okay? I wanted to break new ground.
I wanted to leave a legacy.
I wanted my life, my brain, my existence To mean something.
Hey, hey, hey, You're gonna be fine, okay? Amelia's got this.
You've got this.
The thing that I never really thought about, though, the thing I never really wrapped my brain around until now was Wait, Robbins.
No.
Don't you dare.
Don't you dare say it, Nicole.
In order to do that, in order to be remembered, in order to leave something significant behind Time to go.
You have to leave.
All these questions without any answers they'll drive you nuts.
That's why I like what I do fixing babies, birthing babies.
No ambiguity there, no questions, just answers clear, precise, obvious answers.
And life beautiful new life.
Hope for the future.
God, I miss that.
Morning! Robbins, are you ever not chirpy? Does that ever happen? Are you ever not snarky? Also, you snore.
I can't crash here again tonight without earplugs.
Okay, so, we have seven cases today.
The first one is in two hours.
Also, it's Friday, so that's MRI day.
You know the drill.
limited life-span wasted.
Mm, come on, come on.
God! I'm coming.
- Stop chirping.
- Stop snarking.
Whew! After this, we've got the diaphragmatic hernia.
Baby's 27 weeks.
We'll do a, um, tracheal balloon occlusion Hey.
Figured you could use this Which should, if we're lucky, ensure the blood - before the big lecture.
- Oh, um, thanks.
Thank you.
Um, they already scheduled a follow-up procedure on the baby, as well.
You're cultivating quite a bit of buzz, you know? - Really? - Mm-hmm.
I heard from two hospitals wanting us to record your talk.
But we won't be too close to the due date.
- And if - I have a lot on my plate right now, just with, uh, Herman and her tumor.
Uh, her surgery.
I really need to focus On the tumor.
Don't need any distractions, and you're Very hard to ignore.
Hey, I ju It was just coffee.
No, I so appreciate the coffee.
Uh, I was just getting some coffee for myself, and It's good coffee.
It It's great coffee.
I, uh I can I can just get my own if if you I mean, you can get your own so easily.
I don't want to get my own coffee.
I I mean I do.
I can.
I will.
I I can get my own coffee all day long.
I just Owen.
Thank you for bringing me the coffee.
I really like it.
Uh, you're welcome.
So, how's my head? The tumor seems stable.
I was worried about the inferomedial margin, but the good news is, there's no sign of growth.
It hasn't invaded the optic nerve yet.
Well, how long till it does? I need a number, Shepherd.
I have things to plan.
About six weeks Maybe eight if you go in for the localized radiation treatments I've prescribed for you.
- I'd like for those to start today.
- No, no, no, no.
I tried that.
Hated it.
Doctor's orders.
It is our best chance to shrink the part of the tumor on your optic chiasm.
- Oh, crap.
- Glenda Castillo! We're headed to surgery, Dr.
Bailey.
No time to talk.
But you haven't given me an answer.
Actually, I have.
It was no.
But you haven't given me the right answer.
You could at least meet with her.
I've seen the case, okay? I'm sorry, but I'm working on a very limited time frame with a very specific list of surgeries to teach Robbins, and Glenda Castillo isn't one of them.
Okay, well, as a personal favor to me, just me per I have no time to make it personal.
It's a no.
I'm sorry.
I'll get you some names good people.
She can see one of them.
Um, sorry.
Three down, all these to go.
We've got four months' worth of surgeries up here.
I mean, how are we gonna get four months of surgeries done in eight weeks? We just do, I suppose.
You'll do the next one yourself.
I'll watch.
What? No.
No, thank you.
I appreciate the vote of confidence, but I'm not even actually sure that I know how I need to see what you've learned, what you can and can't do on your own while I'm still around to fix it when you screw up.
Gee, thanks.
It's not a vote of confidence.
It's a necessity.
Training wheels are off, Robbins.
Time is up.
What's next? Uh, your radiation treatment.
Ugh.
Radiation hasn't worked yet.
I don't see why it's suddenly supposed to start working.
- Radiation is bull - Shepherd says that it's necessary.
She's the doctor here.
"Life will out.
" The origins and lessons of life and evolution are long and complex, but what they basically boil down to is, life will out.
Life will always find a way to continue.
Always.
Life will out.
This is a massive grade IV astrocytoma.
I want you to take a look at it.
Really look.
Look at its size.
Look at the way it invades healthy tissue.
Look at its vasculature.
It is blood and tissue and flesh.
It's growing Adapting to its environment, struggling to survive, to stay alive.
It is alive.
We don't like to think of it that way, but it's nested in the womb of a human brain, feeding on its host, growing and fighting for life almost like a fetus.
No, scratch that.
Let's just for science and giggles say exactly like a fetus.
Because like a healthy fetus, it is thriving.
You know, there are even some types of tumors that grow teeth, hair A stray eye.
Have I repulsed you? - It's gross, right? - Yeah.
I mean, that is a problem.
Nobody wants something that nasty in their head.
I'd like you for one moment to consider the idea that, to the tumor, we are the problem, we are the invader.
We are the danger.
To the tumor, we are the cancer.
And the tumor? Well, the tumor sees itself as a sweet, cute, fat-cheeked baby just trying to make its way into the world, and we want to stop it, destroy it, tear it from its happy little home like barbarians.
To the tumor, we are the soulless, murderous monsters.
Why do I do this? Why do I call it "baby" and talk about killing it? Because this kind of tumor deserves respect.
It deserves a little humanity.
Charming, isn't it? They put clouds on the ceiling to distract you.
Least they could do is put something interesting up there, like porn.
It's not just a tumor.
It's ingenuity.
It's strength.
It's adaptability.
It's poetry.
It's one of God's masterpieces.
It is alive.
Mm.
You okay? Sure.
And like any living thing, it wants to stay alive.
Like any living thing, it is going to fight like hell to survive.
And when I saw open that skull and come face-to-face with it, with that tumor, with that living thing, it will be almost impossible to remove Well, I'll see you after.
Because it would rather destroy the brain that holds it than go gently into that good night.
It is alive.
And what's it all come down to? Life Will Out.
Grey's Anatomy 11x13 Staring at the End So, our fat-cheeked-baby tumor that's nestled in that brain, it's a creature of habit.
It has the same routine day in and day out to grow, to spread out, to take up space.
That's it.
At this point, our baby tumor is so enmeshed, so invasive, it's touching virtually every single brain structure.
It's pushed existing tissue aside, shoved brain matter out of the way to find room for itself.
How do you remove it without destroying the brain around it? How do you kill the baby without killing the mother? I stare at these scans, and the tumor stares back at me, daring me to try to extract it.
I mean, this tumor is bold and brazen.
This tumor thinks it's in charge.
This tumor thinks it owns the place.
I don't have to explain myself to you.
You missed your radiation session this morning.
- I told you, I'm not doing that anymore.
- That is not your call.
My tumor, my head it absolutely is my call.
The tumor will be exponentially easier to remove after the radiation.
Nicole, please.
Go to radiation! - I will think about it.
- Okay.
The thing about a tumor like this is, you can't let it intimidate you.
The tumor isn't smarter than you.
You just need a plan of attack.
Here.
Feel that? You must be methodical.
You want to find a spot with just the right amount of give.
That's where you want to cut.
Scalpel.
Point of access is key.
- You're up, Robbins.
- I know.
I've never done that part before.
So, um, you were really serious about that? It's time.
Make the cut.
- But I don't know I've never - Make the cut.
And then you start.
That is the most daunting step pushing a blade into that first squishy blob of flesh Because the first cut is what sets the tone.
It determines every single move from that point on.
So, you have to be careful.
You have to be sure.
Or you're in trouble.
It's like a - Just look at them.
- Who? Arizona and Herman they're practically joined at the hip.
I'll take one of those, too.
Well, she is Herman's fellow.
Isn't she sort of supposed to follow Herman around? They're laughing all the time, And Arizona seems so Happy like really happy.
- So? - You seem happy Ish.
- Why do you even care? - I don't, obviously.
I'm just making conversation.
Don't you guys think it's weird how they're always together? They're not always together.
- They do bunk up together sometimes.
- What? - Alex.
- Robbins has been crashing with Herman.
She hasn't slept at the house all week.
- What?! - Alex.
- I don't mean like that.
- They're not together together, and you know that.
Mm-hmm.
Arizona used to hate her.
Now they're having sleepovers? Well, it's a good thing, right, that they're getting along? Herman's not exactly the warmest person, so When you talk to Derek tonight, would you ask him something for me without saying it's for me? I don't know that I w Just ask him what he'd use to avoid disrupting the gratiolet radiations off the geniculate body of the thalamus.
- Why don't you ask him that? - No, no, no.
No, no.
That's the point.
You ask him.
I can't ask him for help.
I cannot listen to the smugness in his voice.
You can hear it.
He has transcontinental smugness.
You know what? Forget it.
I'm fine.
I don't need him.
I don't need Derek.
I will figure it out myself.
When did this happen? She found the perfect rebound without having to actually find a rebound I mean, she just gets all the good times and the fun, none of the bad times or the mess, no chance of getting hurt.
You don't even have to wax.
It's not fair! Oh, my God.
Am I seriously wishing for a sexless relationship where I don't have to groom myself? - Is that where I am now? - It sounds good to me.
- Welcome to my life these days.
- You chicks need to get laid.
That also sounds good to me.
Not without the grooming.
It's in there.
He can find it.
What, he can't do a little work first? I like her.
Eddie.
- Excuse me? - Uh, Glenda Castillo, the patient you and Herman turned down last week, her husband's name was Eddie.
I lost him six months ago after he was injured in a head-on collision.
My hands were inside of his body when his heart stopped beating.
My hands held Glenda's when I told her Eddie died on my watch.
Three weeks later, she found out she was pregnant.
She's not insured, but she remembered me and this hospital, so, she came here to see if I could give her some prenatal care, and guess what we found out.
Her baby has a tumor a large, dangerous tumor that's not just messing with the baby's system, it's messing with hers.
I couldn't save her husband's life, but I can help save her baby.
I owe this woman that much.
Herman has to take her on as a patient.
Just just have her meet Glenda, all right? - Then she'll - I can't, I can't! I can't trick her into seeing a patient she doesn't want to treat.
Who's in charge of her schedule? Who tells her where to go and when? Who tells her what surgery or post-op or anonymous consult she should see next? Uh I'm concerned about her blood pressure.
It's increased to 140 systolic in the past week, and her swelling's gotten worse.
Uh, I used to have ankles.
Now I have balloons with toes.
So, your baby has a large tumor in his lower back.
It's most likely benign, but because of its size and vascular nature, it could cause an accumulation of fluids in the baby.
But the tumor can be removed, right? Dr.
Bailey says amazing things about you, that you're one of the best.
Bailey said that? How flattering.
That was Glenda Castillo.
I told you no twice now.
And you, how am I supposed to trust you at all - when you pull something like that? - She didn't do anything except try to get your help on a patient who needs your help.
But if you heard her story, if you knew she was Is that how Bailey convinced you? It's a tactic, Robbins, appealing to your sad, bleeding heart.
Doesn't work with me.
Well, then, let me appeal to your ego.
You walk around here telling anyone who will listen that you're the best.
Well, then, be the best.
You can save her baby's life, so save that baby's life! No.
Ohh.
- What the hell? - Robbins, drop it.
No, I get that I get that I've seen tumors like that before, but this can't all be about my education.
I mean, at some point, I have to At some point, we have to make decisions and stick to them.
I wish we had time, but we don't.
We have very little control over the time we have, and we have a plan.
Can't we make an exception? Can't we just, you know, sort of adjust the plan? You fine.
You want to? Adjust the plan.
What are you doing? Take down one of these cards so we have time to help Mrs.
Castillo.
Which one? How about Meghan Carlson congenital airway obstruction? Her husband's in Iraq right now.
Or Julie Hall vasa previa.
She went through two years of fertility treatments.
So, pick one.
Decide which baby doesn't get to live so Glenda Castillo's does.
Go ahead.
Pick a card.
You choose.
That's what I thought.
_ No.
No.
Get me out! Get me out of here! Get me out! - You have to.
- I don't.
The radiation treatments are going to help.
They are gonna shrink the borders of the tumor, which will make it easier to resect.
It's a minimal gain for you.
I will take what I can get.
I am trying to save your life! You are making me feel like I've already died.
I'm sick.
I'm losing my hair.
I refuse to spend the last few months of my life feeling like a pile of crap.
No more.
That's final.
Dr.
Stanley, please report I am going to give you more than a few months.
I am going to save your life.
And I am about to get up in front of a bunch of people and tell them how I plan on doing it.
It makes it really hard for me to do that or even care about doing that when you don't seem to care at all! Well, that's your problem.
Well, the word's spreading.
This was a good idea, Hunt a master class in neurosurgery.
This is gonna put Amelia Shepherd on the map.
Mm.
Unless it fails.
It won't.
If it does There's a lesson in that, too.
So, she just spitballs this stuff with you? It's just the two of you hanging out, talking tumor? Pretty much.
I want to talk tumor! - I want to talk tumor so bad.
- Shh! - Oh, my God.
Look at that thing - Yeah.
Previous attempts to treat Dr.
Herman's tumor with radiation proved unsuccessful.
I had hoped to use high radioactive doses to reduce the margins, but at this juncture, that course seems to be unrealistic.
But that's not enough to make me quit.
This tumor is fierce and intimidating and aggressive, but so am I.
Now, the trick to this is, you can't touch the vessel while you're lasering the mass not even a little bit.
If you do The field fills with blood, obscuring the camera, and visualization is compromised.
First, I need to see the tumor, all of it every margin, every last ripple and ridge.
So, what do you do? I have two choices open her up and stop the bleeding if I can, or deliver the baby regardless of how early.
Very good.
So, I will employ fluorescein dye to delineate every border of the tumor, to help me anticipate every possible problem before I get to it.
I don't want to leave anything up to chance.
What happened? The pressure's dropped.
She's in a lot of pain, and she's cramping.
It hurts! It hurts, it hurts! It's okay, Julie.
We've got you, we've got you.
She has a vasa previa.
She's scheduled for an ablation tomorrow.
I've been trying to get her pressure back up, but there is no fetal heartbeat.
Damn it.
Where's her husband? Is that blood?! I'm bleeding?! - Gown me.
- Keep him out of here.
Robbins, you're gonna get this baby out right here, right now.
Here? We need a C-section tray set up in here.
Call peds.
Get an incubator, stat.
Wait! What?! I'm gonna have the baby now?! Julie, I'm gonna give you something to calm you down, okay? I never had to do a crash C on my own before, okay? - I mean, not like this.
- You know what to do.
It's the same three basic steps, just like any other C-section Open the abdomen, open the uterus, deliver.
Okay, I'm okay.
Pressure's steady at 100/60.
- Okay, I can do this.
- Betadine.
Okay.
- Robbins? - I'll do I'll do this.
It's fine, Robbins.
I'll do it.
Scalpel.
I'm so sorry.
We did everything we could do.
I'm so sorry.
Good job.
Let's go.
Stop crying.
Oh, for the love of - Stop crying! - I'm Stop it now! Just Stop it right now.
There's no time for crying.
We have work to do.
What? How can you even 'Cause that's the way it goes, Robbins.
Call Bailey.
Tell her we're on.
_ _ Now, arguably, the most important part of the brain is the part that makes us hope Dream Imagine.
One singular, almost immeasurable part is what makes you you And me me And everyone Everyone.
It's technically called the fornix, but I call it the "dream box.
" The question is What happens when the dream box is being invaded, when a tumor is so large, so demanding, it's sucking the dream box dry? It's taking over it's stealing away hopes and dreams.
Imagine, when that tumor is removed, what what will actually be left? Or, rather, who is left? Anything? Anyone? I remember my mom telling me once that when we die, we go to heaven.
I couldn't picture it.
All I could imagine was what we see in cartoons little people in robes with wings, sitting on clouds.
But nobody really knows what's up there, do they? When I was a kid, I used to think that we were like dandelions like, the part that makes us us would just blow away and land and grow into I don't want to be buried, by the way.
- Have me cremated.
- W Excuse me? If I survive the surgery but don't wake up, give me five days a week, tops - then pull the plug.
- This is We don't need to be talking about this.
If I do wake up but I'm dependent on vents or tubes, pull the plug then, too.
You know what? You're not you're not dying.
You're not gonna wake up gorked.
Shepherd knows - what she's doing.
She does.
- Okay.
Sure.
- She does! - I heard you.
That bird is gonna poop on us.
Oh - What's next today? - Glenda Castillo.
I'm so glad you brought me back in.
Have a look.
Well, the teratoma has grown.
It's showing early signs of hydrops.
- Is everything okay? - Glenda, your baby's retaining fluid, which is starting to affect his heart.
I'm recommending we do the surgery tonight.
Tonight? No, that's way too soon.
The tumor is creating pressure on your placenta.
It's not only endangering the baby, but now it's putting you at risk.
But my baby wouldn't survive, would he, if you suddenly had to deliver? 'Cause I'm only 24 weeks along, and I know that it would help him if he had time to grow, right? If I could just hold on for a few more weeks It's not what's best for you.
I don't care about me.
Glenda, if Dr.
Herman thinks that No, my husband is dead.
But this baby that is inside of me, this baby of ours, I cannot risk his life.
I won't.
So, if there is a choice between helping me or helping my baby, I choose my baby.
What does she think we're trying to do here? I am not negotiating with a patient.
I am the doctor.
I'm gonna tell her when we're go I'm sorry.
- Robbins, what's the hell? - What's funny about this? I'm sorry, I'm sorry.
It's just it's just it's funny listening to you get so bent out of shape when this is the exact same thing that you've been doing to Amelia Shepherd ever since she offered to save her life.
I mean, she has.
Exactly.
"We'll do the surgery when I'm ready.
" And it's so frustrating.
It's torture, and it drives us crazy.
So, it's just fun to watch it happen to you.
It's like divine justice.
Pretend that I'm not here.
Keep going.
I will give Ms.
Castillo an extra week, but I want her admitted.
And if she so much as hiccups funny, - I'm taking her to surgery.
- J understood.
Hey, thank you for taking her case.
Oh, shut up.
I can't How do I access that area of the brain when it's so hidden? And once I access that area, even with the perfect tools, the perfect approach How do I keep from screwing it up? If there's edema, it's post-fixed.
It's too narrow, too close the fornix.
If I hit the hypothalamus, game over.
Not gonna work, not gonna work, not gonna work.
Do you want some food? Have I figured this out yet? - No.
- Then I don't want any food.
This has never been done before.
All these steps in this order on this kind of tumor has never been done.
Is that a good thing or a bad thing? Who do I even think I am? Who am I to even try this? Okay, a bad thing.
Have you called your brother? - What did I saw about my brother? - I know.
You don't need him.
I was just thinking you could, just to have someone to bounce these ideas off of who understands this kind of thing the way that you do A peer.
He might have a suggestion.
I do not need my brother! I am not stuck! I am thinking! I am figuring it out! I am right on the edge of figuring it out, of making the breakthrough of a lifetime! I am this close! My genius is flying around this room right now, trying to find a clear path to land on me, but I can't clear the runway for landing because I can't find any quiet because some idiot resident keeps talking to me! I shouldn't have said that.
I didn't mean it.
I'm tired, and I'm frustrated.
I I am so sorry.
I just This tumor is making me crazy.
Edwards.
As bad as you want to get that tumor, that's as bad as I want to watch you get that tumor.
You're tired and frustrated and terrified, but guess what.
I don't give a damn.
You're supposed to be my mentor.
You are my mentor.
I believe in you, I look up to you, I want to be you.
That's an enormous responsibility, so don't call me names.
And stop pouting because you don't understand what to do.
Be worthy of being believed in, of being looked up to.
Or if you can't actually be worthy, if I am actually wasting my time, if there is nothing about you that is special or wise, for God's sake, at least have the decency to pretend that there is.
Get it together, Dr.
Shepherd.
Get it together, Dr.
Shepherd.
_ Okay, bye.
Bye.
- Hey.
Um, how are you? - Uh, good.
How's Dr.
Herman? Is she good? Is everything good? Yeah, I mean, she's killing me with back-to-back surgeries but Yeah, and Amelia's plan? You good with that? - Callie, what are you - What? I'm not I'm just checking in, okay? I'm just Seeing how you are and, uh, how, um - Callie? - Well, it just seems like you and Dr.
Herman are getting along really, really well, and you used to complain that she was killing you, but now you're happy that she's killing you, and it seems like you really, really like her.
I do.
Actually, I do.
She's great.
- She's I mean, she's amazing.
- And she's sick.
- So, I worry.
- Amelia's got it covered.
- She's gonna be fine.
- I worry about you.
I know I shouldn't.
I know it's none of my business, but, uh, old habits.
Well, that's, um Thanks.
- Oh, I got to go.
- Okay, okay.
Wow, that's tall.
Yeah.
Really big.
Just so you know, the auditorium is packed.
The fire marshall actually made me move a bunch of people out to an overflow room.
Amelia.
Just give me a minute.
- Amelia.
- Shh! Hang on.
You can talk to me.
You're wound pretty tight.
I just want you to know you can talk to me.
My whole career, I have been the other Dr.
Shepherd.
He's the real one.
I'm the other one.
Right now, this plan of mine is theoretical.
It's just talk.
But at some point, I am going to slice into Dr.
Herman's brain, and I have this sick feeling that when I face that tumor, I will discover that I am not just the other Dr.
Shepherd I'm the wrong Dr.
Shepherd.
Hey.
Look, I know you've been having me take the lead so I can learn, but you need to handle this case.
- Why would I do that? - Because it's emergent, and I've never tried cutting umbilical bands.
- First time for everything.
- Well Listen to me, okay? I'm not ready to take this over yet.
Doesn't matter.
Stop! Stop! You You're not hearing me.
It does matter.
I'm not ready.
And you think I am? You think this is easy for me? You think I'm ready? I was fine.
I got fine with dying.
And then you infected me with your stupid with Shepherd and her plan and your stupid hope.
And now it's harder than ever to hand all this over.
I don't want to.
I'm scared to.
And I'm scared to let go of it, and it's all your fault, so I think the very least you could do is deserve it.
Take over, do well, make me not regret it.
Can you do that? Please? This is the part where things get a little fast and furious.
It is arguably the most dangerous, most precarious portion of the operation.
It also needs to happen the fastest.
Every step, every move before this has laid the groundwork for this very moment, the moment where I place the radioactive seeds.
It requires precision I just need to slip these shears under the band.
And accuracy and speed things that do not go together well.
I can't get the last band.
This grip's not flexible enough.
Can you coax it through? Mm.
It's not no.
It won't give.
- You have to cut that last band.
- I know.
- Have you tried a smaller scissor? - Mm.
It's not the problem.
Imagine picking up little grains of salt while wearing oven mitts.
That is what I'm doing inside somebody's brain.
- Hand me a glove.
- What? Somebody hand me a glove.
Scissors.
There's this thing that we used to do in peds.
I think it'll work.
I just need a more flexible opening, and I can make it out of a glove.
That's not in my notes, Robbins.
- Are you serious? - It's gonna work.
But once I do it, once I place the final seed, well It's smooth sailing.
Ha! Did you see that?! It worked! It it it absolutely worked! 'Night, 'night, tumor baby.
It has been lovely, but we are done.
I'd like to open things up to a few questions.
Yes.
Are you nervous? Uh I'd be crazy not to be.
Yes, of course I'm nervous, but I'm also very excited.
This is history.
This surgery will be history.
How could I not be excited about that? Excellent, excellent.
You should be very proud of yourself.
Close up now.
Where are you going? What you're describing is seven different surgeries all using the hardest techniques you've ever tried.
How long do you anticipate the entire surgery actually taking? Give or take some hours.
Uh, follow-up question do you need a second resident on the case? Uh, not unless Edwards is planning to bail on me.
You planning to bail, Edwards? No, ma'am.
Yes, in the back.
Will you have help? Um Sorry? Well, I'm just, uh Well, are you gonna be doing this whole surgery yourself, or is Derek uh, Dr.
Shepherd coming? I'm I'm just I'm just asking.
I mean, given everything, is it a good idea? Should you be doing this yourself? Well, I am, so Next question.
I need you to scan me.
Something's happening.
I'm experiencing symptoms fuzziness around the edges, a little like, uh, blinders, and it's, uh, dark darker than it should be, I think.
Okay.
Let's go.
- Bailey? - Where's Dr.
Herman? She stepped out.
What do you need? Uh It's Glenda Castillo.
Hey, I need Herman right now.
Glenda Castillo's baby is in distress, and Glenda is severely hypertensive, showing signs of heart failure.
We need to operate on her immediately, so if you could finish up What are you doing? - Why are you standing there? I - Arizona.
Oh, God.
It's time.
Now? I'm gonna go Get an O.
R.
ready.
Okay.
Okay.
You ready for this? Mm-hmm.
Amelia.
I'll get an O.
R.
prepped.
You'll inform the patient? Oh.
Robbins.
Surgery's all finished? Yeah.
I see.
Shepherd's prepping the O.
R.
? Yes.
If I had to guess, I'd say the tumor's invaded the optic chiasm.
Ah.
My chariot awaits.
A little privacy, guys? Did you, uh, need me for something a patient? Um, yeah.
Glenda Castillo's baby has hydrops.
Mom is mirroring, and she's going into CHF.
Wow.
Looks like a big day for both of us.
What you need to do first is try to embolize the vessels fetoscopically.
Make sure her blood pressure is stabilized.
She has you.
Amelia has you.
This is the point where you trust her, okay? Don't go in without checking Glenda's platelet counts and crossmatching.
This is the point where you trust her, okay? All set.
Don't let Glenda's platelet count drop below - Will you tie me? - Yeah.
Let's do this.
I never placed much value in wondering about an afterlife.
My concern was always this life, what would I do with it? How would I make my mark? Be sure, be fast.
You don't have half the time you imagine.
Try to ablate all the vessels, but don't wait too long.
Don't be afraid to make that call.
If she's awake, she'll tell you for the 15th time to save her child's life before hers.
Listen to her, let her say her piece, - then you do what needs to be done.
- I don't think I don't I don't know I don't know if I can do this.
- I can't.
I can't do this.
- You can.
- Nicole.
- You will.
Let's get you inside now, okay? I wanted to break new ground.
I wanted to leave a legacy.
I wanted my life, my brain, my existence To mean something.
Hey, hey, hey, You're gonna be fine, okay? Amelia's got this.
You've got this.
The thing that I never really thought about, though, the thing I never really wrapped my brain around until now was Wait, Robbins.
No.
Don't you dare.
Don't you dare say it, Nicole.
In order to do that, in order to be remembered, in order to leave something significant behind Time to go.
You have to leave.