Grey's Anatomy s12e06 Episode Script

According to this man's family, he was not a smoker.
But the truth is, he smoked two packs a day in his car for 20 years while his wife and children slept.
Sometimes the patient's shame is the elephant in the room.
They try to hide it from us.
But you can't hide from a surgeon, because the body doesn't lie.
The truth is right here, for everyone to see.
And it doesn't need to say a single word.
So, uh Deluca and I are basically not talking.
Just like you two.
Only different.
Obviously.
Yeah, I mean, we say "hi," but, uh There's no talking.
I mean, after the amazing sex.
Once you've had that, you would think it would be easier to have a conversation.
So That woman starts today the resident from Dillard.
Do you want to talk about that? 'Cause you should.
It doesn't burn when I pee anymore.
It's your first day.
H-how do you how It's okay.
You don't have to do that.
Hi.
Can you guys tell me how to find out whose service I'm on? I mean, which attending? You should ask her.
I'm probably not qualified to answer that.
Just check your e-mail.
Thank you.
As you know, transfer residents traditionally do their first rotation with the chief of general surgery, which is you, and, as you also know, our newest transfer, Penelope Blake, is starting today.
So you understand how this could have happened What is "this"? Dr.
Blake is on your service.
However, um, Dr.
Webber has offered to take over.
Or I can.
You just say the word.
I'll take Blake.
You don't have to.
I'm chief of general.
It's the job.
You sure? Of course.
I'll do it.
Uh uh, s-sir? Sir, y-you can't park there.
Oh, no, I'm not parking.
I'm just stopping for a sec.
No, this is for patients only.
Yeah, yeah, I got a patient.
No worries.
All righty.
Well, we're a little late, but we're here.
You ready for this? Yeah.
Did this case a year ago.
Looks amazing.
- And we're doing something like this again today? - Yeah.
April's bringing in a kid from Jordan with Ollier's disease.
You can see, these are the enchondromas.
Cartilaginous tumors.
- They they grow from the growth plates, right? - Exactly.
Which is why you're gonna want to do a wide local excision, expose the bone so I can get in there and reconstruct the hand Wait, wait, wait, wait.
I will? I'll dissect the tumors? I thought so.
If you're up for it.
Hell yes, I am.
Are you ready? They're on their way up.
Uh, why don't you head up to Peds, help him get settled? Yeah.
Thank you for doing this.
Listen, it's a great case.
And it's just a resection.
He's such a sweet kid.
He's an amazing kid.
He's been through hell in Jordan, and and he just never gives up.
Since he lost his family, he's been living at the hospital, and we just we give him all these odd jobs to do and April, you can stop selling him.
Okay? It's happening.
We are doing it, so Good.
Just I just Thanks for putting our stuff aside, and Let's go see him.
Yes.
I am I understand I'm on your service today.
That's right.
D-Dr.
Grey, I just want to say, I don't want today to be awkward or uncomfortable.
So don't make it awkward or uncomfortable like this, right now.
If there's anything that I Consult in the pit.
We're walking.
Robert Matthews, 30s, fell down two flights of stairs.
Possible L.
O.
C.
He's been complaining of abdominal pain.
I can arrange for a head C.
T.
or page neuro.
All I need is an ultrasound.
No! Oh! Whoa, whoa! Calm down.
Okay.
No, I-I have to go! Okay.
Relax! I did something bad really bad and I Where am I? How'd I get here? Relax.
You fell down some stairs.
I was trying to get up to the choir loft.
Choir loft? I'm the pastor at First Lutheran, and I had there was an accident.
I accidentally Oh, God.
I have to go! Hey.
Okay, listen, Robert, you have to calm down, or you're gonna make this worse, okay? It's not okay! I sent it to everyone.
Sent what? The church bulletin.
I went to attach the video of the youth volleyball game, and I've been seeing someone a woman a nice, but sort of adventurous woman.
But nice and Okay, now you lost me.
I attached the wrong video.
You sent a sex tape? To my entire congregation.
Oh, good God! Yeah, can we not talk about him right now? I rode on a bus, a train, a plane, three cars, and a helicopter.
That's amazing! Um, Kamal, I want you to meet Dr.
Avery.
- He's gonna perform your operation.
- Hi.
You are the guy? "The guy"? Um There she is! The machine! Nathan! - Hey.
- Oh, man! Hey! Thank you, thank you, thank you for bringing him here.
Hey, come on.
Of course.
Nathan and I worked together on my last tour.
- Dr.
Riggs, this is Jackson Dr.
Avery.
- Oh.
- Yeah, Nathan Riggs.
- Hey.
- Hey.
- Trauma surgeon? Cardiothoracic, but over there, it's pretty much all trauma, you know? Sure.
Sure, yeah.
Dr.
Riggs! He is the guy! What is "the guy"? The first time we met Kamal, Keps said, "I know the guy who can fix your hands," so ever since, he's been talking about meeting "the guy.
" Well, Kamal, let's take a look, huh? Ohh.
Okay.
Let's get this guy up here.
All right.
Look at this.
Okay.
Uh-huh.
You can fix them? That's the plan.
You never told me it was this advanced.
The tumors are massive.
Okay, maybe I downplayed it a little.
You downplayed it?! This looks impossible! I don't understand.
You sent him the scans, right? Didn't you see the scans? She told me the scans were lost in Jordan.
I didn't want him to see the scans.
Wait.
What? Keps, what the hell?! You lied! If you had seen the scans, you might have said no, and I wanted you to meet that little boy.
And he's here now.
So how do we help him? Hey.
So, Blake's on Meredith's service? Uh, looks like it.
- She gonna be all right? - I don't know.
We haven't spoken since the party.
She feels like I'm on Meredith's side.
And I am, you know? But it doesn't mean I'm not on Penny's side, too.
And now Meredith's not even talking to me, so win-win! Oh, God.
They know.
They all know.
What's your assessment? - Well, I think - Not you Blake.
Ultrasound showed fluid in Morison's pouch.
We should get an abdominal C.
T.
And what are we looking for on the C.
T.
? We need to rule out bleeding from the liver or the spleen.
We should also evaluate the retroperitoneal space.
If there's active bleeding on the C.
T.
, we set him up for an ex-lap.
Are you forgetting anything? Uh, we cleared his c-spine, we sent blood out for a trauma panel, tox screen, alcohol levels.
And? And, uh Order a type and crossmatch.
Oh.
Of course.
Obviously.
I-I skipped that.
Okay, well, let's not skip steps.
We're a level I trauma center.
I need to know what Dillard taught you.
Let's fill him with fluids and prep him for a C.
T.
I didn't lie.
I You bent the truth a bit.
Until it broke.
It was a good lie.
Okay, it was a bad lie, but for a good reason.
You know, you haven't been saying yes to anything lately not when it comes from me.
Look at the scans, April.
Okay, these areas are pure cartilage, right? They probably destroyed any bone that was in their path.
Guys, we don't even know there's anything resembling hands underneath these things.
Can you even repair the tendons and the neurovascular bundles? That's doubtful.
Well, Hopkins and Case Western did similar cases.
They they reconstructed using bone grafts.
Oh, so have I, and you know those cases are nothing compared to Kamal's.
April, he's saying no.
Look, we'll just keep looking until we find someone.
And they will all say the exact same thing.
Thanks.
Thanks for taking the time.
Look, I'm not saying no.
I'm saying I will do some biopsies so that we can all get a full picture of what it is we're dealing with here.
Thank you.
I heard there was a bad driver in the house.
Uncle Richard! Man, you look Bald.
And you look old.
"Uncle Richard"? Yeah, Adele and I knew Paul and his late wife, Lois, before we got married.
Bumpy and I go way back.
"Bumpy"? Why "Bumpy"? Uh Hey.
Morning, Angela.
Uh Tell me about the accident.
How did it happen? All I know is I pressed the brake, but the damn car kept going.
Right into a tree.
Yeah, she's got a severely displaced clavicular fracture and a weak pulse in her right arm.
How about Paul? I'll be fine.
Angela got the worst of it.
Still, I want to work you up, too, just to be safe.
So I'll go ahead and schedule that C.
T.
A.
That sound good to you, Bumpy? That'll be quite enough of that.
Sorry.
Dr.
Bumpy.
Tell me what you see.
Retroperitoneal fluid.
Around what? Be specific.
The right kidney.
It's a grade IV injury with an active extravasation.
We are gonna need to do an ex-lap.
Should I call upstairs? What do we have? Uh, patient came in with a head lac, G.
C.
S.
of 14, loss of consciousness at the scene Can you clear the head C.
T.
So we can take him up for an ex-lap? There's no shift, contusion, or bleed.
It's a mild concussion.
I'll do a quick exam, but he's cleared for surgery.
Is this the pastor who gave his congregation a, uh special blessing? Word travels fast.
All around the hospital.
Yeah, I bet the pews will be full on Sunday.
Monitor for any neurodeficits.
I will do another check, post-op.
Blake, get him ready for transport.
Edwards, show her where it is.
It's not enough to have her here in the same building.
You invited her on your service, too? I am trying to rise above.
And you should, too.
No, you should have ended it that night.
Forget it.
It was better when we weren't talking.
As I feared, the biopsy showed precancerous cells in the tumor.
Both sides.
- Okay.
Then we need to get in there A.
S.
A.
P.
- April, listen, there is no clear way to excise all the tumor.
So I have to recommend amputation.
Of both hands.
No.
It is his best shot before it progresses to cancer.
No.
I brought him to you to save his hands.
This is how we save his life.
Well, I don't know.
I don't see how he survives over there with no hands and no one to take care of him.
I understand.
I'm sorry.
I could have told you sooner if I had all the information.
You mean you could have given up sooner.
Yes, you're right because there's nothing to be done.
You could try! You could make an effort instead of just giving up and walking away! And you don't think I want to? All right, we're not doing this.
Could you leave us alone for a second, please? Oh, absolutely, I'm gonna leave, and I'm gonna take Kamal with me, all right? 'Cause this isn't about you two! Okay? This is about a little boy who had to see his family murdered, who saw his home burnt to the ground, who would've been taken as a child soldier if it wasn't for his deformed hands.
All right, he doesn't have the time for you guys to be working out your crap! He deserves the best care he can get, and I'm gonna make sure he finds it.
Why'd you even bring him to me? You saw the scans.
You're a good surgeon.
You knew this was hopeless.
I wasn't hopeless.
I don't know why you are.
Because there's nothing here to save.
What's the trickiest part of a partial nephrectomy? - Well, I think it's essential that - Not you Blake.
Mobilizing the colon quickly to get adequate exposure of the kidney.
By your third year, you should know this surgery inside and out.
- I do.
- Okay.
So you are gonna walk me through this.
Your hands are my hands, and my hands do not like making mistakes.
Are you ready? I am.
Yes, I'm ready.
With what? Because I have nothing in my hands.
Right.
Uh, 10 blade.
C.
T.
A.
results showed an injury to an artery in Angela's chest.
She's on her way to pre-op now.
She doesn't want you to worry, and neither do I.
You sound just like Bumpy.
You have to tell me why you call him "Bumpy.
" Well, that's 'cause, back in the day, when we were in college Got your results back.
Oh, you hurt your foot? No, no, it's fine.
It's Pins and needles, is all.
It's it's, uh it's just a little numb.
It'll go away.
I don't think it will not by itself.
Your labs show elevated hemoglobin A1 C levels.
And your blood glucose level is very high.
You're diabetic.
But you already knew that.
Listen, Bumpy, I've been taking better care of myself.
Angela doesn't know, and and I want us to keep it that way.
That pain in your foot? It's a symptom, Paul.
It's called diabetic nerve pain.
It could be the reason you crashed your car.
Are you saying I put my baby in the hospital? No.
It was an accident.
She loves you.
She'll understand.
Just tell her do you have any children, Richard? Do you? No.
No, I don't.
So you don't know a damn thing.
You can't possibly understand.
Please, just just take care of my little girl, and leave me be.
I'll let you know as soon as Angela's out of surgery.
And now Jackson wants to amputate.
He won't even try.
He said it was hopeless.
He he asked me why I even brought Kamal to him.
What? Well? Why did you? You lied about a little boy, April.
I'm s what what are you saying? Nothing.
Sorry.
W I'm saying, I know what it's like when it feels like everything's coming apart and you need something to pull it together.
I just I know.
Are you sure? Well, maybe you can show them to Rogers.
Yeah, I'd appreciate it.
All right, call me back.
Thanks, Charlie.
Riggs? Hunt.
What are you doing here? April Kepner and I met in Jordan.
I've been working with the relief effort in Afghanistan Yeah, yeah, yeah.
What are you doing here? We have a patient with Ollier's disease.
Brought him in to your hand guy.
And then you're leaving.
Yeah, well, maybe a little sooner than I I'm not asking you, Riggs.
I'm telling you.
Nice catching up.
Incise gerota's fascia.
Go on.
U-um cauterize cortical bleeders Now close using a running absorbable suture to avoid post-op fistulas.
You can even reinforce using an absorbable mesh.
Well, that's thinking ahead.
I like that.
Dr.
Grey, Dr.
Blake.
I thought I'd stop in to see how the first day was going.
Thank you, sir.
It's been Blake has been dictating my surgical steps.
- Great.
How's she doing? - Not too well.
If I had done what she just suggested, the patient would have major renal cortex bleeding.
I what? What did I do that you missed? Uh, debride, hemostasis, close Come on.
Figure it out.
Deluca, can you fill in the blanks? Um, Dr.
Blake didn't tell you to clamp the hilum.
Dr.
Grey, the hilum is clamped.
It is, sir, because I clamped it on my own.
I didn't skip a step, and therefore, the patient did not hemorrhage and die.
Blake, hand your suction to Deluca.
Dr.
Grey, I know this procedure.
If your hands had been my hands on this patient, he'd be dead.
It's that simple.
Step away from the table.
What's wrong? Dr.
Grey is what's wrong.
And attendings are hard on residents.
I know that.
It's how we learn.
And she should be hard on me.
She should be grilling me.
And I should be able to handle it.
But I let her in my head.
I froze.
I knew that surgery backwards and forwards.
Okay, I can talk to her.
No.
Don't.
I'm sorry.
I just I will figure this out.
It's not your problem.
I sent the biopsies, the scans to three other guys.
Any luck? No.
Well, I'd like to have been wrong.
Hey, look, I'm sorry you got pulled into this, man.
April can be No, look, I know.
She's The Machine.
She's the What? Oh, that's what we call her over there "The Machine.
" It never slows down, never lets it get to her.
Just makes everyone else want to work harder.
When she decides on something, nothing's gonna stop her.
You can't call that one off.
No, that's true.
Thing is, she's usually right.
Go find out what Callie Torres is doing right now.
Oh.
Angela's surgery is over? How how'd it go? Did a primary repair of the subclavian artery.
It went very well.
You can tell your friend she's fine.
Maggie, uh About Paul you know, what he said about my not having children Paul knew me with Adele, my wife I know.
I know.
It's it's awkward.
Awful.
No, you don't have to say another word.
I get it.
Okay.
I just wanted to make sure Are y-you No.
No, no.
Of course not.
This is, um, this is allergies.
Can we please pretend that it's allergies? Maggie, if I did something No, no.
God, no.
You you cheated on your wife.
Why should you admit that to your friend? Who would that help? Not you, not him.
And, you know, you don't owe me anything.
You and I, we're not I don't know what we are.
That's just the thing.
I don't exactly know how to a-address you - Yeah, you don't have to.
- But It's fine.
You have nothing to be ashamed of really.
But Both of them? We would have to amputate them right right about here, at the wrist.
You see? Will I still carry things? Well, let's talk about that, buddy.
You'll be here when I'm done? Yes.
I promise.
You sure about this? Nope.
Not even a little bit.
We'll have a soda waiting for you, okay? Okay.
God.
All right, guys, how we doing this? Doing what? I figure we'll just debulk the tumor from the dorsal surface, and you can show me what, if any, usable bone we can find.
There's been a change of plans.
Yeah, judging by the scans, - I'm not sure there's anything at all.
- I know.
It just might end up being the world's slowest amputation, but can't hurt to try.
Mm-hmm.
We lied.
We had to.
Didn't want to get his hopes up again.
He's gonna try? Mm-hmm.
You lied! To me! It was a good lie.
Come on.
It was a good lie.
Oh, my god.
Oh, my God.
He's gonna try.
We need to talk.
What's wrong? I thought you were stepping up, putting Blake on your service, but what I saw in that O.
R.
wasn't teaching.
She crapped out on a basic surgical principle.
You were hazing her.
If she cracks under the pressure of an emergent surgery, she does not belong in this program.
Blake was at the top of her class at Dillard.
Her references were impeccable.
I checked them myself.
You checked? So you knew where she was from? You checked her case record? Her losses? Did you know that she She was an excellent candidate.
You were the only reason not to hire her.
And you didn't find that reason enough? Your labs are within normal limits.
That's good news.
I'm on every website.
Got an e-mail from our bishop.
I'm fired.
Someone's threatening to bring me up on charges as a sexual predator.
I'm done.
We're supposed to be a community.
I make one simple mistake, and they destroyed me.
Put it away.
My mother saw it.
Her friends won't talk to her.
Everybody's trying to figure out who the woman is, as if it's any of their business.
Thank the lord, she's okay.
At least her life isn't over, too.
Nothing is over.
It's different for us the clergy.
People put their trust in us their faith.
We break that trust, it stays broken.
I can't believe that.
You know who you are.
You can stand up to them and have faith in that have faith in yourself.
I have to believe that.
They say he doesn't give you more than you can handle.
You say that, actually.
Yes, I do.
Ow.
Are you okay? My stomach.
Nurse! Coming! There is a clot in his catheter.
His bladder's about to rupture.
I need a syringe with some saline and heparin, and page Dr.
Grey now! Right away.
You're okay.
Those nerves are going everywhere.
How do you build something from that? Well, for what it's worth, I think you were right about him.
He's good.
I know.
He's talking about divorce.
Well, you kind of saw that coming, though, right? He said "don't go.
" You went.
On some level it's not gonna happen.
It's not what I want.
I don't believe it's what he wants.
I know it's not what God wants from me.
We're looking at a kid who's lost his family, his home Might even lose his hands now.
Maybe God has more on his mind than judging whether you get a divorce or not.
Don't you think he has bigger fish to fry? I've got about 60% of bone structure over here.
How's it going over there? I only see free floating distal phalanges, and some of them are eroded by tumor.
We're approaching the carpals or what's left of them.
Mm.
I'm looking for metacarpals over here.
Do you see any viable bone at all? Well, uh Damn it.
What? What is it? Tell me.
Jackson, I'm s I'm sorry.
I'm just There's nothing here.
I No, no, no.
Wait.
Just wait one second.
Well, no.
There's no bone to work with.
I mean, lookit.
Look right here.
There's fingers, and then there's nothing.
- I don't - Come on.
Come on.
Jackson, I think just wait, okay? I think that you were right.
I don't want to be right, though.
I just Let's keep going, please, okay? Yeah, of course.
Put that down! We are working here! We're gonna keep going until we are sure that there is nothing left.
Now, do not pick that up again unless I tell you to.
Jackson? I'm sorry.
I was just No, no, no, Jackson, look right here.
Look.
I found something.
I found lunate bone.
This is good lunate bone.
What happened? I think he clotted his Foley.
I've flushed it five times.
I can't get a new one in.
He's hypotensive.
Get me a 50 CC with a 14-gauge needle.
- You got it.
- How did this happen? I was doing a post-op check, and I saw that there was blood in his bag.
How long did it take for you to notice? I don't uh, we were talking you realize if he goes into renal failure, this will undo everything we did in the O.
R.
today.
Dr.
Grey, I didn't miss this.
I caught it.
It shouldn't have happened! You froze in the O.
R.
, you screwed up his post-op care! Is there any part of this job that you can handle, Blake? I Get out.
You're not touching this patient.
You're off my service.
Get out! Now! All right.
The hamate bone's intact.
There's the trapezoid And There's the scaphoid.
That makes four good carpal bones.
Which is not much.
And almost no metacarpal.
But we'd have a base for a proximal phalanx, so that might regenerate.
He is young, so Maybe we could sculpt the bone and graft the gap in between? We could wire them with rib grafts.
I mean, then I could actually make something out of that.
Yes! Look! Look! That's a fifth metacarpal head! Look! Right there! - That's a hand.
- That is what we needed.
Under there, that's that is a hand! We got a hand, people! Whew! Oh, my God! Whew! I can't friggin' believe it.
I did.
She is going to be fine.
And you should talk to her.
I don't even know if I can look her in the eye now, let alone talk to her.
I cheated on Adele.
And I had a daughter.
I have a daughter.
Adele never told Lois or anyone about the affair.
She never bashed me to her family.
She lived with that pain and embarrassment for years alone.
She protected me, and I'm ashamed of that.
It was a mess.
I made a mess.
And for as much pain as I caused and felt, I would have never believed that anything good would have come of it.
But it did.
She did.
And I am very proud to know her.
You were right.
She doesn't belong here.
She almost killed a patient.
She can't be trusted not in the O.
R.
, not with patients.
She's just dangerous.
Say it again.
What? I was right.
I tried to rise above because it's the right thing to do.
But she has made mistake after mistake, and she just is impossible.
I'm sorry.
It's the truth.
She is working at a hospital that is above her skill level.
I have tried to teach her all day.
I have tried.
Oh, please.
You're being a bully.
And you've gone out of your way to make her you don't teach by shoving someone else's face in the dirt.
That's not teaching.
That's just being mean and and small.
Leave me alone.
Since when do you pray? I'm not.
Or talk to God or whatever.
I'm not talking to God.
Well, you talk to Tequila.
I'm talking to Derek.
Oh.
Okay, I'll go.
I'm trying.
I tried to rise, I've tried to teach her, but I just Don't think I can.
I thought he might know what I'm supposed to do with her, why she's here.
I thought maybe he could tell me.
So, I'm just gonna sit here and Wait for some divine intervention or whatever.
They look like hands.
They are.
They're your hands, bud.
They're real hands! I can hold a ball.
Yeah.
Take a little bit of time, a few more surgeries, but yes.
What did we tell you? He's the guy.
You are the guy.
Oh.
Aww.
He never did tell me why they call you "Bumpy.
" There was a dance called the bump before your time and I excelled at it.
You didn't tell him it was me.
Well, I feel, if you want to tell people, that's your decision, not mine.
I'm sorry.
I'm still trying to figure this out.
Okay.
But for the record I'd be fine with it if you did.
Very fine.
Noted.
Yeah.
April.
I, uh I never said thanks for bringing Kamal.
I'm so sorry for lying, but God, you have no idea what you did for that little boy.
No, no, no.
You did it.
I mean, you brought him.
'Cause I knew you could do it.
Okay.
We did it.
Just Thank you.
Do you want to go Hey.
You ready? Um, Nathan's leaving tomorrow, so Bailey was gonna take us out for drinks.
She wanted to hear war stories.
Yeah.
Um, but I could just tell them that I-I don't have to go.
Oh, no, no.
Come on.
You guys you guys go celebrate.
Well, come with us.
Yeah, come on.
I owe you a drink.
Another time.
Really, you guys have fun.
I didn't want Blake here.
I fought it.
Then why did you hire her? Because I've been accused of coddling you, and I didn't want to do that.
I didn't think you'd want me to.
That was one reason.
I didn't want you here, either.
When you were accepted to this program, I didn't know how I was gonna look at you every day And be reminded of the best and worst times of my life.
And you walked in, the spitting image of your mother.
Talented, smart Here every day.
And I decided that wasn't fair to you.
I decided to put aside my personal feelings to Rise above.
And I'm glad I did that.
Every day.
He would have said the same thing.
Derek he probably would have even liked her.
Excuse me.
I'm looking for a patient.
Robert Matthews? Are you his family? No, I'm hi uh, we work together.
Or worked together.
I'm the choir director at our church.
Oh.
You're the Oh.
God.
You saw it.
Well, I mean, of course you saw it.
All of America saw it.
Okay, he doesn't deserve this.
It's not fair that he's all of these amazing things, and and this one mistake is all anybody's even gonna think about him.
Look, can I see him, please? I want him to know that You know, he's got me, at least.
They say shame controls every aspect of human behavior.
it's about who we believe we are.
This was a mistake.
I don't think I can do this.
I don't think that I want to do this.
I kind of went off on Grey about you.
Callie Why? Why are you making this harder? I did what I should've done at the party.
Callie, I get it.
They're your friends.
He was You're a surgeon.
We make mistakes.
We need to be forgiven.
I will if you will.
And I'm here.
If if you are.
I'm here, too.
But in the end, you can't hide, and the body doesn't lie.
The truth is right there for the world to see.
It's Grey.
She wants me all week.
Hmm.
She still wants to work with me? Or she still wants to ruin you.
Yeah.
Yeah, it's definitely one of those.
Come on.
Our shame can choke us, kill us.
It can rot us from the inside if we decide to let it.
Don't let that happen to you.