Grey's Anatomy s18e02 Episode Script
Some Kind of Tomorrow
1
[WHISPERING INDISTINCTLY.]
MEREDITH: Homeostasis is our body's way of maintaining a consistent and steady internal state.
Pushin' away only gets me closer - Fallin' fast - Nick? Can we move it slower? Hi.
- Hi.
- [CHUCKLES.]
Yes, sorry.
This is a very old-fashioned way to ask a girl on a date.
I know.
I know.
I'm sorry.
I-I forgot to ask for your phone number, and then I-I didn't want to wake you.
So note.
Throw me in the water So, what do you think Should we get some dinner? I know a place that's great.
It's, uh, right by the lake.
Yes.
Okay.
I'll pick you up at 7:00.
Okay.
Okay.
Okay.
- I'll see you at 7:00.
- Okay.
I know I'm not getting out alive Why would I even wanna try? 'Cause I'm stuck to you Multiple systems work in sync to regulate factors like temperature, blood pressure, even sodium levels.
Are we too far from the path we drew? Okay.
I'm not going to tell you how to parent your son, but this not going in Luna's bag.
[BOTH LAUGH.]
But I don't wanna be a fool for you No, I don't wanna be a fool for you These systems are designed to resist and combat anything that tries to throw our bodies off.
I know I'm not getting out alive Why would I even wanna try? It's a continual loop with checks and balances.
So, what time did you tell them? Ahh.
Should be any minute now.
[CHUCKLES.]
Feels like the old days.
Finally.
'Cause I'm stuck to you Until something manages to break the cycle.
'Cause I'm stuck to you Hi-e-e-e! How are you so awake? Kombucha, girl.
[YAWNING.]
Remind me why we signed up to do this again? To save lives.
Overrated.
Hey, Ortiz, where's your mom? She transferred her residency to take a job with Dr.
Avery and the foundation.
Good for her.
Better for us.
More cases.
TARYN: There's no statistical evidence that proves residents learn better at the crack of dawn.
I checked.
I think we need to stage a sleep-in.
- Who's with me? - [CLEARS THROAT.]
[INDISTINCT CONVERSATIONS IN DISTANCE.]
You finished? Big day.
And a long one.
Hope you ate breakfast.
[QUIETLY.]
We didn't.
Meet me in the skills lab, four minutes.
[ WOMAN SPEAKING INDISTINCTLY OVER P.
A.
.]
He said four minutes.
It's at least an eight-minute walk.
I'm with cardio today.
They requested me.
But have fun going back to day one.
[CHUCKLES.]
Thanks for coming on such short notice.
Well, I went down two wrong hallways, which feels like a metaphor for my life.
[LAUGHS.]
But when somebody offers to pick you up in their private jet, you get on that jet.
Meanwhile, Scout has decided it is no longer cool to sleep through the night, so I looked like crap when I dropped him off to Link, who has mastered quiet disappointment.
But somehow looks so good doing it.
I think you look great.
Wait.
Are you kidding? They're giving you a lab? Oh, you are definitely not coming back to Seattle.
By the way, who actually sent the private jet Amelia.
We're being offered millions of dollars to cure Parkinson's.
Us? Well, me.
But I'm asking you, so it's us.
[CHILDREN LAUGHING.]
TEDDY: Leo says that Elsa needs a cape, but he shoved it in the dishwasher last night.
- Wasn't great.
- Well, even Snow Queens need to learn that actions - have consequences.
- [WHISPERING.]
Thanks.
So, is it, um, costume day or something? No.
Leo's world.
We just live in it.
- Oh.
- [CELLPHONE CHIMES, VIBRATES.]
Oh.
Incoming trauma.
- Okay.
I gotta go.
- Okay.
- Teddy.
- Yeah.
Allison, Elsa.
I love you.
Bye.
Bye.
Bye.
Bye.
I'm sorry.
Do you have a problem? 'Cause you're staring at my kid.
Oh, uh, I'm staring at his costume.
No, I-I know, and I would really appreciate if Oh, my wife and I have been looking for that same one everywhere.
Oh.
Oh, yeah.
- I-I'll I'll ask my husband.
- Mm.
Oh, uh, here.
- Thanks.
- Yeah.
Hey.
Hi.
We're gonna get you a new cape, okay? Luna, it's important work, okay? Just stop being so cute for 5 seconds.
Stop.
Stop.
I remember when Scout used to cry when I dropped him off.
Now look at him.
Basically ready for his first studio apartment.
[WHIMPERS.]
Ow! Okay.
Um, I'm on scut all day, so can you just, like, hop up here and check on her every 5 minutes? Nope.
Webber roped me into a thing with the residents.
Luna's like a 36-second elevator ride away, if you need to see her.
Plus, they text you pictures.
Go.
- Go! - Ugh.
[SIREN WAILING IN DISTANCE.]
Rashida Flowers, 34, chronic kidney disease secondary to diabetes, admitted for dialysis access insertion after a thrombosed AV fistula.
RASHIDA: After two failed grafts, I'm back in the hospital, y'all.
Have to have another procedure.
But guess what? My new doctor is a brother.
Mm! And he fly.
[LAUGHS.]
Say hi, Dr.
Ndugu! Hey.
Do you mind not recording so I can examine you? Oh, right, of course.
Gotta go, y'all.
Kisses.
[SMOOCHES.]
Sorry.
Gotta keep my followers happy.
I used to be a travel influencer, ventured around the world, but now I'm DiabeticBae, which is way less exciting, so I gotta get content where I can.
Well, today won't be too exciting, I'm afraid.
I'll be inserting a catheter into your chest to help you start dialysis.
How long have you been diabetic? Years now.
But I was able to manage it until I was visiting Thailand, living my best life, and I got real sick.
Hit my kidneys hard.
And every time my doctors tried to get access for dialysis, my body wouldn't cooperate because plot twist I have a clotting disorder.
But none of this was a shock.
Both my mother and brother were diabetic, and they both died from kidney failure.
Sorry to hear that.
Were they able to get kidney transplants? They weren't even able to get on the list.
And neither am I.
You're not on the transplant list? Nope.
Ortiz, set me up a consult with Rashida's nephrologist, Dr.
Krause.
Look, I know it's bad.
But it's okay.
That's really why I record everything.
I want the world to know who I am before this disease ends me.
[SIRENS WAILING.]
Hey.
Where's my resident? I'm not their keeper.
- What do we got? - PARAMEDIC: Noah Young, 35, auto vs.
tree, restrained driver, denies loss of consciousness, O2 sats 89%, - no visible chest trauma.
- Okay.
NOAH: My son! I need to find my son! Okay.
We got Danny Young, 7, GCS 15, vital signs stable, bleeding facial laceration.
- Daddy! - There's my big guy! I need to see my son, please! Okay.
Let's get you both inside first, okay? I'm fine! I just need to [COUGHING, WHEEZING.]
Trauma one, let's get a chest X-ray and a full trauma panel.
Let's move! Somebody find me a resident! Becoming a skilled surgeon is like learning how to drive.
The more you do it, the better you become.
And over the last year, you have participated in fewer surgeries than any class of surgeon ever has.
Which means that you are not where you're supposed to be, people.
We woke up early to be shamed.
[GROANS.]
Today, you will embark on the toughest surgical workout you have ever experienced.
Through a series of simulations and skill assessments, each of you will be evaluated in four areas Laparoscopic, suturing, vascular skills, and endoscopic techniques.
You will be graded on your proficiency and speed, judged by your attendings.
Any questions? [WHISPERING.]
It's like the surgical Olympics.
Or the Hunger Games.
I thought Dr.
Grey was running the residency program now.
Who do you think taught Dr.
Grey? - [RESIDENTS CHUCKLE.]
- Oh, and one more thing.
The resident with the highest score flies solo in the OR this afternoon with a surgery that's appropriate to their level.
Laparoscopic skills start now.
Ah! - AMELIA: Relax your wrist for me.
- DAVID: You know, back in my day, every neurosurgeon I worked with was an egotistical prick.
So you can imagine my delight right now.
You are brilliant and charming, Dr.
Shepherd.
Oh, except when I'm being an egotistical prick.
[LAUGHS.]
Well, as my friend Stephen Sondheim said, "Nice is different than good.
" You're friends with Stephen Sondheim? Oh, I could be.
AMELIA: Okay.
Follow my movements.
So, Dr.
Shepherd, what's your golden opinion? How do I look? Well, you only have a mild resting tremor and slight bradykinesia, which is good, but Parkinson's is unpredictable.
Your dopaminergic neurons are degenerating gradually, and it's only a matter of time.
Have you considered switching your meds or deep-brain stimulation? You know, I'm not interested in a Band-Aid.
I need something that'll make me whole again.
Dr.
Hamilton, Parkinson's is not a condition that surgery can fix.
Yet.
A condition that surgery can't fix yet.
Enter brilliant, charming, egotistical you.
As long as we can convince your sister-in-law over here.
Chest pain, no.
Open fracture, too specialized.
Oh, right upper quadrant pain Now, that's promising.
Dr.
Bailey.
Wong.
Uh, Richard's holding the surgical Olympics.
It's a slow day, so I'm looking for something good to be the solo.
You got anything? Dr.
Bailey, you've rescheduled our meeting twice now.
- You're avoiding me.
- No I had surgeries.
Uh, important ones.
He's also looking for judges, so if you'd prefer to help out that way No, I'm here to tender my resignation, which I've been trying to do [SIGHS.]
- for days now.
- I know.
I just didn't want you to.
Chief, I'm retiring.
I already bought a condo, picked out tile.
Okay, what could you possibly want to do instead of surgery? Mystery novels.
- I'm sorry? - I have a series of books where the main character is a PI and a surgeon.
"Doc Undercover.
" [LAUGHS.]
Uh, sounds n-nice.
Wong, look, the hospital, t-the country We're in dire need of physicians with yo Miranda.
Truthfully? It's just not fun anymore.
I'll start your paperwork.
Perfect suturing ensures proper wound closure, less bleeding, and a lower risk of infection.
Excellence matters.
This is an atraumatic tie.
You will have 20 seconds to tie three square knots.
Do not move the soda can.
Any movement counts against you.
And absolutely no air knots.
On your mark, set - Go! - [STOPWATCH CLICKS.]
Call me cynical, but original Tryin' to fit into a world that's so digital Came to let you know I left the pigeon hole Kinda sloppy, Tseng.
Now I gotta find an edge, won't let it go I know my mind This could be our time - Huh.
- What's that supposed to mean? It means, "Huh.
" - Is that better? - Nope.
All I need It don't let me down, it don't let me down I'd start over if I were you.
Opening with a compliment is customary.
- [STOPWATCH CLICKS.]
- Time's up! Lincoln, do we have a winner? - Schmitt takes the gold.
- Yes! [GRUNTS.]
Is there a silver? [WHISTLING "TWINKLE, TWINKLE, LITTLE STAR".]
Name that tune.
[CONTINUES WHISTLING.]
I don't know.
Um, how long did you say that you have been experiencing abdominal pain for? - Uh, a few days.
- Okay.
Whistling calms my nerves when someone's, you know, inspecting my hooha.
[CHUCKLES, CONTINUES WHISTLING.]
Ow.
Sorry, but I-I feel something.
It was "Twinkle, Twinkle, Little Star.
" [CHUCKLES.]
- What? - The song I was whistling.
"Twinkle, Twinkle"? - Oh.
- Technically, it's the same melody as the ABCs.
And "Baa Baa Black Sheep.
" Ah.
Who knew.
Okay, I Yep, there's something in here I Robin, there was a strawberry lodged in your Ohhhh.
Yep.
That tracks.
So would that explain my abdominal pain? Um, it shouldn't.
Why? Is there something strange in there, too? [CHUCKLES.]
Maybe? Danny.
[ WOMAN SPEAKING INDISTINCTLY OVER P.
A.
.]
How you feeling? Looks like you had quite the adventure.
Yeah.
Got to ride in an ambulance.
And now you have superhero marks.
Do they come with powers? Maybe, if you eat enough cherry Jell-O and Popsicles.
Owen's sister, right? Oh, uh, yeah.
You're peds? - Cormac Hayes.
- Oh.
You coming to join our humble staff? [CHUCKLES.]
Bailey just asked me to help out, cover some of Grey's cases.
Grey? Big shoes to fill.
Eh.
So she performed an abdominal-wall transplant.
Big whoop.
It was actually my idea to even need an entirely new abdominal wall so Grey could win the Fox award, so, who's the genius now? - So you were the patient? - Yep.
Alright, Danny, I'll be back to check on you, okay? Where's my dad? Can I please go sit with him? He shouldn't be alone out there.
We have contacted your wife, and she is on her way, okay? It was supposed to be a father-and-son weekend.
Fishing, camping out by Deception Bay.
- I don't know what happened.
- Maybe you passed out.
Your oxygen levels are very low.
How long have you had shortness of breath? It It's nothing.
Okay, let's do an X-ray, please? - No! No X-ray! - Hey.
Look, I'm fine.
Relieved that me and Danny are alive.
Could you please let me out of here so I can try to salvage this weeken [COUGHING.]
I, uh I saw your tattoo.
Bassett Infantry? - 3rd generation, Bassett Infantry.
- Mm.
You? Army trauma surgeon, two tours Iraq.
Two tours Afghanistan, one Jordan, one Djibouti, two Iraq.
And I've never been to Vancouver.
Well, sounds like you need a new travel agent.
[LAUGHS, COUGHS.]
[COUGHING.]
[RETCHING.]
Let's put him on high-flow O2.
Let's push 50 of fentanyl, and somebody page Altman! We're gonna get him up to CT! Okay? [CONTINUES COUGHING.]
- Okay.
- [GASPS.]
Dr.
Krause, hi.
Winston Ndugu, cardiothoracic surgery.
- Do you have a minute? - Barely.
I've been drowning in cases.
My patients put off seeing me for months, and now I'm dealing with the backlog.
- What can I do for you? - Yeah, I'm consulting on your patient Rashida Flowers.
She mentioned that she's not on the transplant list.
Yeah.
Rashida, she's been through a lot.
Unfortunately, she doesn't fit the transplant criteria.
But Rashida's renal function tests seem to make her a prime candidate.
Well, you would think, but Rashida's eGFR is high.
It's over 20, disqualifying her from the list.
- Estimated.
- I'm sorry? It's an estimated number of what her kidney function should be, - not what it really is.
- Dr.
Ndugu, the eGFR is the standard clinical formula, used in the field for the past 20 years.
It's what we use to determine care and qualification of kidney transplant.
A transplant could save her from having to need dialysis in the first place, which we both know has high mortality rates, especially in the first three months.
I'm aware, but Rashida just doesn't qualify.
And believe me, I hate that, at least as much as you do.
MEREDITH: So, what if we fail? How do we know you'll even survive it? I think we can both agree that you learn more in the attempt than the outcome.
And I am under no delusion about how risky it is.
But what's life without risk? AMELIA: Meredith? Meredith.
[CHUCKLES.]
Is this that robot arm that does cell culture? DR.
BARTLEY: It is.
And please don't touch it.
Dr.
Grey, Dr.
Shepherd, please meet Dr.
Kai Bartley, a neuroscientist who accepted an offer they couldn't refuse.
MEREDITH: It's great to meet you.
I've been reading your stem cell research.
Which is brilliant.
I've been following it for years.
Um, they were at Hopkins a couple years behind me.
Um, o-okay.
When you inject the cells into the brain, what about the risk of the cells developing tumors? That very question stalled my research for two years.
But once I teamed up with David Once they took my funding.
I uncovered a Chinese herbal compound that completely removes the undifferentiated cells.
That's amazing.
They're amazing.
Excuse me, I have a conference call.
But we'll talk more later? - MEREDITH: Great to meet you.
- Thank you, Dr.
Bartley.
Thank you, David.
So? What do you Yes.
All the yeses.
An opportunity to impact Parkinson's, change the world, with this equipment and this team? I am I'm in.
Dr.
Grey? Just say yes.
[MACHINE WHIRRING.]
TEDDY: Hey.
Should we shelve the Elsa costume? - What? - You know, put Leo in more T-shirts and jeans? Just, is that the right parenting move? - Did something happen? - No, I just You know, none of the other kids at daycare are wearing costumes, so I just What do we got? MVC with no visible trauma.
A young vet who did several tours in Iraq.
He has finger clubbing, cyanosis, dyspnea.
He coughed up blood when he was downstairs.
His chest X-ray does not look good.
And I'm thinking it's some kind of respiratory illness.
Are you sure nothing happened? Oh, my God.
Owen [SIGHS.]
His lungs look like a war zone.
Is Pierce taking a job in Boston? Is that why you paged me? Because if I lose one more surgeon No, her dad is having hip surgery.
Oh.
Well, now I feel badly.
Uh, Chief, I have a patient, 34, Black woman with chronic kidney disease from diabetes.
She hasn't been able to get on dialysis due to a clotting disorder.
A candidate for transplant? Well, her eGFR is too high, according to her nephrologist.
But look.
Here's another patient on the transplant list.
Almost the same age, weight, and health profile to my patient.
The only real differentiating factor is that they're white.
SARA: So their eGFR measures lower, making them better transplant candidates.
When the estimated GFR was developed, it was assumed that Black people have higher muscle mass.
It added a multiplier to account for that assumption, which then increases a Black patient's GFR and registers them as having less severe disease than other people.
Making them ineligible for transplants.
How does this even happen? Stems from a long line of "assumptions" about Black people that have snaked their way into medicine You know, that we have a higher tolerance for pain different bone density, lower lung capacity.
And yet these assumptions still exist in clinical formulas.
I-I never even stopped to think about the eGFR.
Is there any way around it, Chief? Uh, can I write an appeal to the transplant board? That only works if the patient qualifies for medically urgent status.
Rashida might not have that kind of time.
There's a lot of Rashidas, though.
Fight for them, too.
[CELLPHONE VIBRATES.]
The IR suite is ready for us.
Sergeant Young, this is Dr.
Teddy Altman.
Major Teddy Altman.
- Where's Danny? - He's with Dr.
Hayes.
He's fine, but we need to do a head CT just to be sure.
TEDDY: Your scans reveal severe scarring in both your lungs.
We'd like to admit you and I have pulmonary fibrosis.
Mystery solved.
That's why I didn't want any work-ups, no treatments.
I know what I have, and I know there's no cure.
Just a crap-ton of different ways to the poor house.
When were you diagnosed, Sergeant? About a year ago.
I started coughing after the second Iraq tour.
I couldn't shake it.
I started hearing from buddies about the burn pits, how they were linked to all these cancers and mystery illnesses.
The VA's gotta cover these conditions.
[CHUCKLES, COUGHS.]
Barely.
They just started covering stuff like asthma.
But I haven't heard of a single vet who's been covered for conditions like mine.
All kinds of ways to twist it so you can't prove it was service-related.
Cherry on top? I lost my job at the seafood plant 'cause I was too weak to finish my shift.
So I got no insurance, no job, and a stack of medical bills.
- Sergeant, look - Please, just call me Noah.
Noah, would you sit down with one of our pulmonologists? We'll redo your workup, and we will get you in for some tests so that we can start some treatments Pass.
No tests, no treatments.
Nothing against you guys, but whatever time I have left, I'd like to spend it with my son.
- Move.
That's four.
- I know, I know, I know! Pop these balloons, Tseng! Come on! If you lose to a second-year, you're cleaning the bathroom for six months! - Get away from me! - HAYES: Endoscopic proficiency is just as important as speed.
One slip could mean you've perforated a colon.
20 seconds! - Yes, yes, yes! - One more.
What category are they on? - Endoscopy.
- Mm.
It's a trash fire.
- Mnh-mnh.
- You're a resident now.
Sleep when you can, eat when you can.
Nah, I'm on the scut diet.
Rectal exams? Vaginas.
Right.
Pink.
[RESIDENTS SHOUTING INDISTINCTLY.]
The scrubs! [LAUGHS.]
I found a strawberry in my patient.
[LAUGHS.]
Back in med school, I found a yam.
20 bucks on Tseng.
- Okay, I'll take Helm.
- Come on, come on, come on! - Go, go! - Taryn, it's right there, it's right there, it's right there! Go, go, go! Come on, come on, come on! - Go, go.
- [ALL CHEERING.]
[ALL SHOUTING INDISTINCTLY.]
- Done! - Finished, finished.
Me.
It's Tseng.
[ALL CHEERING.]
[TSENG LAUGHS, SIGHS.]
Today's winner of the competition Schmitt, you will be flying solo today.
I won.
I won, I won! I won! Oh! Of course he won.
There was no actual blood.
Oh, come on! Wait, wait.
What's the What's the What's the surgery? - Find anything good? - Wilson did.
[CLEARS THROAT.]
Ex-lap on foreign-body extraction.
Yes! Oww! Get it, get it! Oww! Yes! I love you! [LAUGHS, CLAPS HANDS.]
AMELIA: Hmm, let's think.
Deep pockets, unlimited time, space, Kai Bartley's groundbreaking research, and a chance at curing a neurodegenerative disease.
You're forgetting about the part where we have kids who need stability.
And I have a job that I love that I just got back to.
I don't want to abandon them.
We're not abandoning anyone.
We're revolutionizing medicine, and that's a great example to set for our kids.
And Grey-Sloan, they're gonna be proud to have us be part of something so high-profile.
Exactly.
If this surgery works, it's huge.
If it doesn't, we've killed an incredible surgeon and set the research back years.
Give us more credit than that, Meredith.
You asked me here for my opinion.
I'm saying yes.
Because people with Parkinson's need more than just hope.
[MONITOR BEEPING.]
SARA: Is this her last possible access port for dialysis? WINSTON: It is.
We need to pull back the catheter just a bit.
What about transhepatic or translumbar access? It'd be too dangerous, given her clotting disorder.
Fluoro.
This isn't how medicine should work.
Anybody who needs life-saving care should get it.
Heparinized saline.
What if this port clots off and she loses it? You tell me.
Waste will build up in her blood, leading to uremia, and her organs will start to shut down, one after the other.
Secure the catheter with stitches on the wings and shaft.
Get a chest X-ray.
Where are you going? To get her a kidney.
You don't need to escort me off the premises.
[CHUCKLES.]
That's not what I'm doing.
- Go home to your baby.
- [VEHICLE DOOR OPENS.]
I just wanted to make sure that I'm not being completely ridiculous for even entertaining this.
No, you're being ridiculous because you haven't accepted the offer yet.
I mean, we're talking about curing Parkinson's, Meredith.
Parkinson's.
I mean, what is the matter with you? This This famous surgeon is basically throwing money at us to play with the most innovative equipment in the world.
And not only that, he wants to give us his diseased brain as a testing ground! I mean, when you started your career, you wanted to go into neuro.
This is your chance to get back to that.
I mean, maybe this is what you're supposed to do.
What we're supposed to do.
And I-I I cannot, for the life of me, understand why you would walk away from something like this.
I [SIGHS.]
So don't.
I will see you at home.
I inserted Rashida's access point.
Great.
Thanks.
Rashida needs to be on the transplant list.
We found six cases of patients with similar clinical profiles, who are on the list.
The only major difference is that these patients are white.
Are those cases patients of mine? - A few.
- [SCOFFS.]
There's got to be more to it than that.
The patients' eGFR Yeah, their eGFR is lower, which makes them eligible, but that's only because the formula unjustifiably uses race as a factor.
Dr.
Krause, we all know race doesn't play a role in kidney function.
- Dr.
Ndugu - I know, you're busy, but if you look at Rashida's eGFR without accounting for her race, she falls below the criterion of 20.
I don't understand.
The eGFR is the field's standard.
It's a tried and true formula.
Yes.
And it's time we start questioning our standards.
[ELEVATOR BELL DINGS.]
Look, I have clinic right now, but I'll look into it.
Rashida doesn't have other options for a dialysis port - if this one fails.
- I hear you.
I'll look into it, Dr.
Ndugu.
Thank you.
Robin Jeter, 23, abdominal pain.
X-ray shows a lodged crystal causing intestinal obstruction.
I think you mean to say intestinal stone.
- No, I don't.
- No, she didn't.
ROBIN: It's a yoni egg.
- Amethyst, specifically.
- Uh It's It's It's a crystal egg that is typically inserted into the vagin - Got it.
- Huh? Uh, I was doing a ritual I saw on social media that was supposed to bring love and healing into your life.
But, um, I was doing it so fast, I mixed it all up.
I was supposed to eat the strawberry and insert the yoni egg.
What did you do with the strawberry? Oh.
Uh, I-I see.
Um.
[CLEARS THROAT.]
Oh! Right.
I'm up.
Hello, Robin.
I'm Dr.
Schmitt.
I'll be doing your surgery today, uh, to remove, uh, the - The - Yoni egg.
Mm-hmm.
How old is he? MEGAN: Yeah, these symptoms sound familiar.
I have treated dozens of soldiers exposed to burn pits.
What are burn pits? Electronics, plastics, soiled uniforms, human waste.
Douse it all with some jet fuel, light it with a match, then fwoosh I mean, what could possibly go wrong? I mean, some of these men have illnesses that we haven't even named yet.
Others are in pain 24/7.
They get nowhere with the VA.
OWEN: The guy did six tours of service.
To protect us.
Never questioning, never complaining.
He just answered the call, and we need to do the same for him.
Tomorrow, I'm gonna go down to the VA.
I'm gonna demand answers.
Okay, so after you defeat the US military, maybe grab some lunch, and then take on Putin? [CHUCKLES.]
- How's his kid? - Danny's gonna be fine.
Head CT was clear.
He can be discharged later today.
Maybe Avery can help Noah through the foundation.
He'll be dead before we even line up the votes on the board.
We can't save Noah.
He just needs immediate medical care just to be comfortable.
And we can give him that.
We'll figure out the details later.
Look at you two, breaking rules and saving lives.
Aren't you glad I got you to tie that knot? [DANNY SPEAKING INDISTINCTLY.]
[MONITOR BEEPING RAPIDLY.]
- WINSTON: What happened? - Her sats dropped, and her face and neck keep swelling more and more.
Superior vena cava syndrome.
The catheter must have blocked her SVC entirely.
- I'm taking it out.
- Can we take her back to the IR suite - and reposition it? - No.
How else would she get dialysis? - She wouldn't.
- Dr.
Ndugu She's already clotted off multiple access points.
Who's to say it wouldn't happen again? Page Dr.
Krause! It's fine.
Everyone's watching.
That's what happens.
People watch, you screw up, and then you quit and go find a rock to hide under.
[NEEDTOBREATHE'S "ALIVE" PLAYS.]
RICHARD: You ready? Scalpel.
Flashes of doubt that grow into a rage [ CHEERS AND APPLAUSE.]
Locked out the truth, they keep your dreams at bay Don't stand there waitin' for the time to come C'mon, c'mon, catch me, we got miles to run We are alive, our skin is leaving these bones Fire in the wind, we're burning out of control We are the children chasing wondrous thrills Chasing a vision, baby, like we're running downhill, oh - Nice extraction, Schmitt.
- Thank you.
3-0 chromic, please.
[MONITOR BEEPS.]
Doppler.
Relax, Schmitt.
If you're calm, everyone else is calm.
[SUCTION GURGLING.]
Someday this body's gonna come to rest [SIGHING.]
Oh, this can't happen.
Come on, come on, come on, come on.
Think.
You can do this.
Think.
These hills take longer than we think to get down So I'll get used to living with my feet off the ground BAILEY: I'm turning the speaker on.
Help him out, people.
Are you getting a good signal from the adjacent segments? LEVI: Yes, both sides.
Resect that segment.
Do a hand-sewn End to end anastomosis.
Uh, stapler.
Fire in the wind, we're burning out of control We are the children chasing wondrous thrills To close, start bringing the bowel together with a vicryl suture, coming around the corner - with a Connell stitch and - TARYN: And a 3 millimeter gap between every two sutures.
LEVI: Got it.
[PANTING.]
Suction, Taryn Dr.
Helm.
[SUCTION GURGLING.]
What happened? There was a complication from the catheter, - so I had to remove it.
- So you'll reinsert it? I won't.
And because we couldn't gain access for dialysis, Rashida needs to be placed on the transplant list immediately.
Rashida's been my patient for months.
These aren't your decisions to make.
Except that now she's also my patient.
And she has suffered from multiple unnecessary procedures, so I'm not putting her through even more.
This is not protocol.
It's not.
It's a life.
Rashida's.
Even if we list her, we don't know when a kidney will come through.
It'll come faster than if we didn't.
Oh, Hayes, uh, I'm looking for Danny and Noah.
Uh, they left.
What do you mean they left? I didn't discharge Noah.
No, but I discharged his son, and he said he wanted to go home with him.
So you just let him go? Without asking me? He said he declined all further testing, and then he signed an AMA.
He has severe fibrosis in both lungs.
He needs supplementary oxygen, a full pulmonary workup, an evaluation by a specialist, and we're gonna need to do more studies, okay, - if we're gonna - Hunt, he's terminal.
[SIGHS.]
You know that, I know that, Noah knows that, and he's accepted that.
- Hayes, just - Which is very difficult to do when you've got a little one at home.
Believe me.
All those things you want to do for him, they take time.
They take energy.
They're two things Noah wants to give his son right now while he still can.
Look, I'm sorry I didn't ask you, but I'm not sorry I let him go.
[SIREN WAILING, HORNS HONKING IN DISTANCE.]
You look amazing.
But, yeah, you may want to change.
[CHUCKLES.]
Sorry.
It's okay.
Listen.
You hear that? [INSECTS CHIRPING.]
- MEREDITH: What? - Exactly.
I mean, this right here, this is why I pulled back on my hours.
I was I was ignoring everything around me.
You know? The perfect silence, the 2-mile hike through the woods behind my house, just sitting here, sitting, staring up at the stars.
I don't stargaze much.
I'm sorry, since when? Since ever.
Ooh, we're gonna have so much fun.
[CHUCKLES.]
I've got so much to teach you.
[LAUGHS.]
Hey, tell me about this, um, top-secret project.
Well, If I told you, it wouldn't be top-secret.
Fine.
Tell me one thing.
You really struggle with the concept of secrets.
I guess I do.
[SIGHS.]
I'm scared to say yes.
Hm.
And I am very rarely scared.
What are you scared of? Failure.
This project will cost millions of dollars, will be very risky, win or lose, will eventually be written about.
And I'm just not sure that I want the first thing that I do after surviving COVID to be a public failure.
And I know that's my ego.
I have a very comfortable situation in Seattle.
I have safety.
I have comfort.
And now you're gonna trade all of that in.
You're gonna risk it all.
Listen, you're not a safety person, Meredith.
You're not a comfort person.
- It's not your nature.
- How do you know? Because it's not mine, either.
And it takes one to know one.
[CHUCKLES.]
You're gonna risk it all, and win or lose it's gonna be a hell of a ride.
[SIRENS WAILING IN DISTANCE.]
WINSTON: I'm really sorry to say this, Rashida.
We couldn't gain access for your dialysis.
But you're on the transplant list, Rashida.
[EXHALES SHARPLY.]
Wait, what? Are you serious? Yeah.
[SIGHS.]
Wow.
[BREATHES DEEPLY.]
[VOICE BREAKING.]
I honestly never thought I would see this day.
You're not just saving my life.
You're changing it.
I can go back to who I was.
I don't know how to thank you.
[BREATHES DEEPLY.]
I can't wait to tell everyone.
[BREATHES DEEPLY.]
Oh, and, Dr.
Ndugu, when my followers find out how you helped me [SNIFFLES.]
Are you single? [CHUCKLES.]
I'm not.
I'm actually married to another cardiothoracic surgeon at this hospital Dr.
Pierce.
And she fly.
- What? - Mm-hmm.
A cute doctor couple? - Mm-hmm.
- Okay! [CHUCKLES.]
I gotta meet her ASAP.
Ooh, have you guys ever thought about becoming influencers? The brands would come flocking.
Influencers? For what? Health? Yeah, I mean, there are influencers for everything.
Okay, movies, restaurants, plants.
- [CHUCKLES.]
- There are dog influencers, too.
Mm-hmm.
Biggie the Pug has 2 million followers.
Ha! Come on.
Okay.
We gotta go live.
Hey! - Hey.
- Ah! I haven't seen them this happy in months.
[CHUCKLES.]
Helm's more thrilled than Schmitt.
- He let her keep the crystal.
- [CHUCKLES.]
And you seem to be the happiest of them all.
Feels good to be back, in front of them.
Well, Dr.
Wong gave me his retirement notice today.
Dr.
Wong? He used to be a student of mine.
Is something wrong? Healthy as a horse.
And it's getting worse, Richard.
Every day, someone retires or quits or moves to Minnesota We don't know if that's happening.
[SIGHS.]
Whether it's burnout or exhaustion or just needing a change, these residents aren't the only ones that need to reset.
This whole hospital needs to remember why we're here.
COVID took that from us.
You know, remember when we used to have, like, pizza night and retreats, and and residents would prank each other - and - You hated that.
But there was joy and the feeling that we were all in this together, for something bigger than ourselves.
I want to make room for that.
I want to make space for that again.
You want people to remember the why.
So do I.
Feels just like we're dreaming wide awake I got some ideas, Bailey.
And I know we're only going Up, up, up Big ones.
Here we go Oooh - And if that mockingbird don't sing - [SCOUT CRYING.]
Daddy's gonna buy you a diamond ring And if all of those rings don't work Daddy's gonna feel like a big old jerk Okay, you need to stop with the depressing lullabies.
- Put him to sleep.
- [SIGHS.]
Link, I-I know that you are upset and sad and grieving the future you thought you had.
Obviously, I have been there.
And what did you do? I looked for joy anywhere that I could.
Then along came [SIGHS.]
OB and Luna.
I know that it sucks right now, but you're gonna be okay.
Ooh-ooh-ooh, ooh, ooh-ooh-ooh-ooh-ooh Something did happen earlier with Leo.
I-I-I thought a parent was being judgy about his Elsa costume, - so I-I confronted him.
- Who was it? No, no one.
He wasn't being judgy.
I'm just Owen, I'm worried.
I I-I want Leo to be okay in the world, and I'm I'm I'm worried, what if we What if we let him be himself? I'm worried that the world won't be kind.
I'm worried that it will be hard.
I'm worried that people will be cruel.
No, I don't wanna be so lonely And maybe they will be.
frozen But we won't be.
Leo's happy.
Let's Let's just let him be happy, okay? Okay.
- LEO: Mommy! - Oh, there he is.
- Hey! - Hey! [CHUCKLES.]
Hey.
How are you? [GRUNTS.]
- Look what I got.
- [BOTH GASP.]
- Whoa.
- A new cape for Elsa, the Snow Queen.
You like it? Yeah.
I love it.
[CHUCKLING.]
Hi! - You got her? - Yeah.
I'll take him.
Hi! Hi! - Let's go home.
- Okay.
I have no one left to blame in the end - How was your day? - Ah.
Yeah, I'm awake MEREDITH: There is such a thing as predictive homeostasis.
Late night.
Ooh-ooh-ooh, ooh I'm awake You don't own me.
Mm, I know.
I need autonomy picking the team.
Absolutely.
I'd like any progress that we make from this process to be public and accessible to everyone with Parkinson's.
Of course.
It's when our body anticipates responses to future challenges.
I'd like to move the whole project to Grey-Sloan.
Mnh.
That I can't do.
It's It's expensive.
Frankly, I don't have the time.
We have everything we need here.
I can't move to Minnesota.
I need you here as much as possible.
I can't see the road I'm driving I don't need to look behind me I could set up a satellite lab in Seattle.
I could travel back and forth once a week.
That's the best I can offer.
I'm awake Done.
It understands that change is inevitable - Does this mean you're in? - I'm awake Ooh-ooh-ooh, ooh, ooh-ooh-ooh-ooh-ooh - It means I'm in.
- Yah, I'm awake Ooh-ooh-ooh, ooh, ooh-ooh-ooh-ooh-ooh and doesn't have to be catastrophic.
I'm awake
MEREDITH: Homeostasis is our body's way of maintaining a consistent and steady internal state.
Pushin' away only gets me closer - Fallin' fast - Nick? Can we move it slower? Hi.
- Hi.
- [CHUCKLES.]
Yes, sorry.
This is a very old-fashioned way to ask a girl on a date.
I know.
I know.
I'm sorry.
I-I forgot to ask for your phone number, and then I-I didn't want to wake you.
So note.
Throw me in the water So, what do you think Should we get some dinner? I know a place that's great.
It's, uh, right by the lake.
Yes.
Okay.
I'll pick you up at 7:00.
Okay.
Okay.
Okay.
- I'll see you at 7:00.
- Okay.
I know I'm not getting out alive Why would I even wanna try? 'Cause I'm stuck to you Multiple systems work in sync to regulate factors like temperature, blood pressure, even sodium levels.
Are we too far from the path we drew? Okay.
I'm not going to tell you how to parent your son, but this not going in Luna's bag.
[BOTH LAUGH.]
But I don't wanna be a fool for you No, I don't wanna be a fool for you These systems are designed to resist and combat anything that tries to throw our bodies off.
I know I'm not getting out alive Why would I even wanna try? It's a continual loop with checks and balances.
So, what time did you tell them? Ahh.
Should be any minute now.
[CHUCKLES.]
Feels like the old days.
Finally.
'Cause I'm stuck to you Until something manages to break the cycle.
'Cause I'm stuck to you Hi-e-e-e! How are you so awake? Kombucha, girl.
[YAWNING.]
Remind me why we signed up to do this again? To save lives.
Overrated.
Hey, Ortiz, where's your mom? She transferred her residency to take a job with Dr.
Avery and the foundation.
Good for her.
Better for us.
More cases.
TARYN: There's no statistical evidence that proves residents learn better at the crack of dawn.
I checked.
I think we need to stage a sleep-in.
- Who's with me? - [CLEARS THROAT.]
[INDISTINCT CONVERSATIONS IN DISTANCE.]
You finished? Big day.
And a long one.
Hope you ate breakfast.
[QUIETLY.]
We didn't.
Meet me in the skills lab, four minutes.
[ WOMAN SPEAKING INDISTINCTLY OVER P.
A.
.]
He said four minutes.
It's at least an eight-minute walk.
I'm with cardio today.
They requested me.
But have fun going back to day one.
[CHUCKLES.]
Thanks for coming on such short notice.
Well, I went down two wrong hallways, which feels like a metaphor for my life.
[LAUGHS.]
But when somebody offers to pick you up in their private jet, you get on that jet.
Meanwhile, Scout has decided it is no longer cool to sleep through the night, so I looked like crap when I dropped him off to Link, who has mastered quiet disappointment.
But somehow looks so good doing it.
I think you look great.
Wait.
Are you kidding? They're giving you a lab? Oh, you are definitely not coming back to Seattle.
By the way, who actually sent the private jet Amelia.
We're being offered millions of dollars to cure Parkinson's.
Us? Well, me.
But I'm asking you, so it's us.
[CHILDREN LAUGHING.]
TEDDY: Leo says that Elsa needs a cape, but he shoved it in the dishwasher last night.
- Wasn't great.
- Well, even Snow Queens need to learn that actions - have consequences.
- [WHISPERING.]
Thanks.
So, is it, um, costume day or something? No.
Leo's world.
We just live in it.
- Oh.
- [CELLPHONE CHIMES, VIBRATES.]
Oh.
Incoming trauma.
- Okay.
I gotta go.
- Okay.
- Teddy.
- Yeah.
Allison, Elsa.
I love you.
Bye.
Bye.
Bye.
Bye.
I'm sorry.
Do you have a problem? 'Cause you're staring at my kid.
Oh, uh, I'm staring at his costume.
No, I-I know, and I would really appreciate if Oh, my wife and I have been looking for that same one everywhere.
Oh.
Oh, yeah.
- I-I'll I'll ask my husband.
- Mm.
Oh, uh, here.
- Thanks.
- Yeah.
Hey.
Hi.
We're gonna get you a new cape, okay? Luna, it's important work, okay? Just stop being so cute for 5 seconds.
Stop.
Stop.
I remember when Scout used to cry when I dropped him off.
Now look at him.
Basically ready for his first studio apartment.
[WHIMPERS.]
Ow! Okay.
Um, I'm on scut all day, so can you just, like, hop up here and check on her every 5 minutes? Nope.
Webber roped me into a thing with the residents.
Luna's like a 36-second elevator ride away, if you need to see her.
Plus, they text you pictures.
Go.
- Go! - Ugh.
[SIREN WAILING IN DISTANCE.]
Rashida Flowers, 34, chronic kidney disease secondary to diabetes, admitted for dialysis access insertion after a thrombosed AV fistula.
RASHIDA: After two failed grafts, I'm back in the hospital, y'all.
Have to have another procedure.
But guess what? My new doctor is a brother.
Mm! And he fly.
[LAUGHS.]
Say hi, Dr.
Ndugu! Hey.
Do you mind not recording so I can examine you? Oh, right, of course.
Gotta go, y'all.
Kisses.
[SMOOCHES.]
Sorry.
Gotta keep my followers happy.
I used to be a travel influencer, ventured around the world, but now I'm DiabeticBae, which is way less exciting, so I gotta get content where I can.
Well, today won't be too exciting, I'm afraid.
I'll be inserting a catheter into your chest to help you start dialysis.
How long have you been diabetic? Years now.
But I was able to manage it until I was visiting Thailand, living my best life, and I got real sick.
Hit my kidneys hard.
And every time my doctors tried to get access for dialysis, my body wouldn't cooperate because plot twist I have a clotting disorder.
But none of this was a shock.
Both my mother and brother were diabetic, and they both died from kidney failure.
Sorry to hear that.
Were they able to get kidney transplants? They weren't even able to get on the list.
And neither am I.
You're not on the transplant list? Nope.
Ortiz, set me up a consult with Rashida's nephrologist, Dr.
Krause.
Look, I know it's bad.
But it's okay.
That's really why I record everything.
I want the world to know who I am before this disease ends me.
[SIRENS WAILING.]
Hey.
Where's my resident? I'm not their keeper.
- What do we got? - PARAMEDIC: Noah Young, 35, auto vs.
tree, restrained driver, denies loss of consciousness, O2 sats 89%, - no visible chest trauma.
- Okay.
NOAH: My son! I need to find my son! Okay.
We got Danny Young, 7, GCS 15, vital signs stable, bleeding facial laceration.
- Daddy! - There's my big guy! I need to see my son, please! Okay.
Let's get you both inside first, okay? I'm fine! I just need to [COUGHING, WHEEZING.]
Trauma one, let's get a chest X-ray and a full trauma panel.
Let's move! Somebody find me a resident! Becoming a skilled surgeon is like learning how to drive.
The more you do it, the better you become.
And over the last year, you have participated in fewer surgeries than any class of surgeon ever has.
Which means that you are not where you're supposed to be, people.
We woke up early to be shamed.
[GROANS.]
Today, you will embark on the toughest surgical workout you have ever experienced.
Through a series of simulations and skill assessments, each of you will be evaluated in four areas Laparoscopic, suturing, vascular skills, and endoscopic techniques.
You will be graded on your proficiency and speed, judged by your attendings.
Any questions? [WHISPERING.]
It's like the surgical Olympics.
Or the Hunger Games.
I thought Dr.
Grey was running the residency program now.
Who do you think taught Dr.
Grey? - [RESIDENTS CHUCKLE.]
- Oh, and one more thing.
The resident with the highest score flies solo in the OR this afternoon with a surgery that's appropriate to their level.
Laparoscopic skills start now.
Ah! - AMELIA: Relax your wrist for me.
- DAVID: You know, back in my day, every neurosurgeon I worked with was an egotistical prick.
So you can imagine my delight right now.
You are brilliant and charming, Dr.
Shepherd.
Oh, except when I'm being an egotistical prick.
[LAUGHS.]
Well, as my friend Stephen Sondheim said, "Nice is different than good.
" You're friends with Stephen Sondheim? Oh, I could be.
AMELIA: Okay.
Follow my movements.
So, Dr.
Shepherd, what's your golden opinion? How do I look? Well, you only have a mild resting tremor and slight bradykinesia, which is good, but Parkinson's is unpredictable.
Your dopaminergic neurons are degenerating gradually, and it's only a matter of time.
Have you considered switching your meds or deep-brain stimulation? You know, I'm not interested in a Band-Aid.
I need something that'll make me whole again.
Dr.
Hamilton, Parkinson's is not a condition that surgery can fix.
Yet.
A condition that surgery can't fix yet.
Enter brilliant, charming, egotistical you.
As long as we can convince your sister-in-law over here.
Chest pain, no.
Open fracture, too specialized.
Oh, right upper quadrant pain Now, that's promising.
Dr.
Bailey.
Wong.
Uh, Richard's holding the surgical Olympics.
It's a slow day, so I'm looking for something good to be the solo.
You got anything? Dr.
Bailey, you've rescheduled our meeting twice now.
- You're avoiding me.
- No I had surgeries.
Uh, important ones.
He's also looking for judges, so if you'd prefer to help out that way No, I'm here to tender my resignation, which I've been trying to do [SIGHS.]
- for days now.
- I know.
I just didn't want you to.
Chief, I'm retiring.
I already bought a condo, picked out tile.
Okay, what could you possibly want to do instead of surgery? Mystery novels.
- I'm sorry? - I have a series of books where the main character is a PI and a surgeon.
"Doc Undercover.
" [LAUGHS.]
Uh, sounds n-nice.
Wong, look, the hospital, t-the country We're in dire need of physicians with yo Miranda.
Truthfully? It's just not fun anymore.
I'll start your paperwork.
Perfect suturing ensures proper wound closure, less bleeding, and a lower risk of infection.
Excellence matters.
This is an atraumatic tie.
You will have 20 seconds to tie three square knots.
Do not move the soda can.
Any movement counts against you.
And absolutely no air knots.
On your mark, set - Go! - [STOPWATCH CLICKS.]
Call me cynical, but original Tryin' to fit into a world that's so digital Came to let you know I left the pigeon hole Kinda sloppy, Tseng.
Now I gotta find an edge, won't let it go I know my mind This could be our time - Huh.
- What's that supposed to mean? It means, "Huh.
" - Is that better? - Nope.
All I need It don't let me down, it don't let me down I'd start over if I were you.
Opening with a compliment is customary.
- [STOPWATCH CLICKS.]
- Time's up! Lincoln, do we have a winner? - Schmitt takes the gold.
- Yes! [GRUNTS.]
Is there a silver? [WHISTLING "TWINKLE, TWINKLE, LITTLE STAR".]
Name that tune.
[CONTINUES WHISTLING.]
I don't know.
Um, how long did you say that you have been experiencing abdominal pain for? - Uh, a few days.
- Okay.
Whistling calms my nerves when someone's, you know, inspecting my hooha.
[CHUCKLES, CONTINUES WHISTLING.]
Ow.
Sorry, but I-I feel something.
It was "Twinkle, Twinkle, Little Star.
" [CHUCKLES.]
- What? - The song I was whistling.
"Twinkle, Twinkle"? - Oh.
- Technically, it's the same melody as the ABCs.
And "Baa Baa Black Sheep.
" Ah.
Who knew.
Okay, I Yep, there's something in here I Robin, there was a strawberry lodged in your Ohhhh.
Yep.
That tracks.
So would that explain my abdominal pain? Um, it shouldn't.
Why? Is there something strange in there, too? [CHUCKLES.]
Maybe? Danny.
[ WOMAN SPEAKING INDISTINCTLY OVER P.
A.
.]
How you feeling? Looks like you had quite the adventure.
Yeah.
Got to ride in an ambulance.
And now you have superhero marks.
Do they come with powers? Maybe, if you eat enough cherry Jell-O and Popsicles.
Owen's sister, right? Oh, uh, yeah.
You're peds? - Cormac Hayes.
- Oh.
You coming to join our humble staff? [CHUCKLES.]
Bailey just asked me to help out, cover some of Grey's cases.
Grey? Big shoes to fill.
Eh.
So she performed an abdominal-wall transplant.
Big whoop.
It was actually my idea to even need an entirely new abdominal wall so Grey could win the Fox award, so, who's the genius now? - So you were the patient? - Yep.
Alright, Danny, I'll be back to check on you, okay? Where's my dad? Can I please go sit with him? He shouldn't be alone out there.
We have contacted your wife, and she is on her way, okay? It was supposed to be a father-and-son weekend.
Fishing, camping out by Deception Bay.
- I don't know what happened.
- Maybe you passed out.
Your oxygen levels are very low.
How long have you had shortness of breath? It It's nothing.
Okay, let's do an X-ray, please? - No! No X-ray! - Hey.
Look, I'm fine.
Relieved that me and Danny are alive.
Could you please let me out of here so I can try to salvage this weeken [COUGHING.]
I, uh I saw your tattoo.
Bassett Infantry? - 3rd generation, Bassett Infantry.
- Mm.
You? Army trauma surgeon, two tours Iraq.
Two tours Afghanistan, one Jordan, one Djibouti, two Iraq.
And I've never been to Vancouver.
Well, sounds like you need a new travel agent.
[LAUGHS, COUGHS.]
[COUGHING.]
[RETCHING.]
Let's put him on high-flow O2.
Let's push 50 of fentanyl, and somebody page Altman! We're gonna get him up to CT! Okay? [CONTINUES COUGHING.]
- Okay.
- [GASPS.]
Dr.
Krause, hi.
Winston Ndugu, cardiothoracic surgery.
- Do you have a minute? - Barely.
I've been drowning in cases.
My patients put off seeing me for months, and now I'm dealing with the backlog.
- What can I do for you? - Yeah, I'm consulting on your patient Rashida Flowers.
She mentioned that she's not on the transplant list.
Yeah.
Rashida, she's been through a lot.
Unfortunately, she doesn't fit the transplant criteria.
But Rashida's renal function tests seem to make her a prime candidate.
Well, you would think, but Rashida's eGFR is high.
It's over 20, disqualifying her from the list.
- Estimated.
- I'm sorry? It's an estimated number of what her kidney function should be, - not what it really is.
- Dr.
Ndugu, the eGFR is the standard clinical formula, used in the field for the past 20 years.
It's what we use to determine care and qualification of kidney transplant.
A transplant could save her from having to need dialysis in the first place, which we both know has high mortality rates, especially in the first three months.
I'm aware, but Rashida just doesn't qualify.
And believe me, I hate that, at least as much as you do.
MEREDITH: So, what if we fail? How do we know you'll even survive it? I think we can both agree that you learn more in the attempt than the outcome.
And I am under no delusion about how risky it is.
But what's life without risk? AMELIA: Meredith? Meredith.
[CHUCKLES.]
Is this that robot arm that does cell culture? DR.
BARTLEY: It is.
And please don't touch it.
Dr.
Grey, Dr.
Shepherd, please meet Dr.
Kai Bartley, a neuroscientist who accepted an offer they couldn't refuse.
MEREDITH: It's great to meet you.
I've been reading your stem cell research.
Which is brilliant.
I've been following it for years.
Um, they were at Hopkins a couple years behind me.
Um, o-okay.
When you inject the cells into the brain, what about the risk of the cells developing tumors? That very question stalled my research for two years.
But once I teamed up with David Once they took my funding.
I uncovered a Chinese herbal compound that completely removes the undifferentiated cells.
That's amazing.
They're amazing.
Excuse me, I have a conference call.
But we'll talk more later? - MEREDITH: Great to meet you.
- Thank you, Dr.
Bartley.
Thank you, David.
So? What do you Yes.
All the yeses.
An opportunity to impact Parkinson's, change the world, with this equipment and this team? I am I'm in.
Dr.
Grey? Just say yes.
[MACHINE WHIRRING.]
TEDDY: Hey.
Should we shelve the Elsa costume? - What? - You know, put Leo in more T-shirts and jeans? Just, is that the right parenting move? - Did something happen? - No, I just You know, none of the other kids at daycare are wearing costumes, so I just What do we got? MVC with no visible trauma.
A young vet who did several tours in Iraq.
He has finger clubbing, cyanosis, dyspnea.
He coughed up blood when he was downstairs.
His chest X-ray does not look good.
And I'm thinking it's some kind of respiratory illness.
Are you sure nothing happened? Oh, my God.
Owen [SIGHS.]
His lungs look like a war zone.
Is Pierce taking a job in Boston? Is that why you paged me? Because if I lose one more surgeon No, her dad is having hip surgery.
Oh.
Well, now I feel badly.
Uh, Chief, I have a patient, 34, Black woman with chronic kidney disease from diabetes.
She hasn't been able to get on dialysis due to a clotting disorder.
A candidate for transplant? Well, her eGFR is too high, according to her nephrologist.
But look.
Here's another patient on the transplant list.
Almost the same age, weight, and health profile to my patient.
The only real differentiating factor is that they're white.
SARA: So their eGFR measures lower, making them better transplant candidates.
When the estimated GFR was developed, it was assumed that Black people have higher muscle mass.
It added a multiplier to account for that assumption, which then increases a Black patient's GFR and registers them as having less severe disease than other people.
Making them ineligible for transplants.
How does this even happen? Stems from a long line of "assumptions" about Black people that have snaked their way into medicine You know, that we have a higher tolerance for pain different bone density, lower lung capacity.
And yet these assumptions still exist in clinical formulas.
I-I never even stopped to think about the eGFR.
Is there any way around it, Chief? Uh, can I write an appeal to the transplant board? That only works if the patient qualifies for medically urgent status.
Rashida might not have that kind of time.
There's a lot of Rashidas, though.
Fight for them, too.
[CELLPHONE VIBRATES.]
The IR suite is ready for us.
Sergeant Young, this is Dr.
Teddy Altman.
Major Teddy Altman.
- Where's Danny? - He's with Dr.
Hayes.
He's fine, but we need to do a head CT just to be sure.
TEDDY: Your scans reveal severe scarring in both your lungs.
We'd like to admit you and I have pulmonary fibrosis.
Mystery solved.
That's why I didn't want any work-ups, no treatments.
I know what I have, and I know there's no cure.
Just a crap-ton of different ways to the poor house.
When were you diagnosed, Sergeant? About a year ago.
I started coughing after the second Iraq tour.
I couldn't shake it.
I started hearing from buddies about the burn pits, how they were linked to all these cancers and mystery illnesses.
The VA's gotta cover these conditions.
[CHUCKLES, COUGHS.]
Barely.
They just started covering stuff like asthma.
But I haven't heard of a single vet who's been covered for conditions like mine.
All kinds of ways to twist it so you can't prove it was service-related.
Cherry on top? I lost my job at the seafood plant 'cause I was too weak to finish my shift.
So I got no insurance, no job, and a stack of medical bills.
- Sergeant, look - Please, just call me Noah.
Noah, would you sit down with one of our pulmonologists? We'll redo your workup, and we will get you in for some tests so that we can start some treatments Pass.
No tests, no treatments.
Nothing against you guys, but whatever time I have left, I'd like to spend it with my son.
- Move.
That's four.
- I know, I know, I know! Pop these balloons, Tseng! Come on! If you lose to a second-year, you're cleaning the bathroom for six months! - Get away from me! - HAYES: Endoscopic proficiency is just as important as speed.
One slip could mean you've perforated a colon.
20 seconds! - Yes, yes, yes! - One more.
What category are they on? - Endoscopy.
- Mm.
It's a trash fire.
- Mnh-mnh.
- You're a resident now.
Sleep when you can, eat when you can.
Nah, I'm on the scut diet.
Rectal exams? Vaginas.
Right.
Pink.
[RESIDENTS SHOUTING INDISTINCTLY.]
The scrubs! [LAUGHS.]
I found a strawberry in my patient.
[LAUGHS.]
Back in med school, I found a yam.
20 bucks on Tseng.
- Okay, I'll take Helm.
- Come on, come on, come on! - Go, go! - Taryn, it's right there, it's right there, it's right there! Go, go, go! Come on, come on, come on! - Go, go.
- [ALL CHEERING.]
[ALL SHOUTING INDISTINCTLY.]
- Done! - Finished, finished.
Me.
It's Tseng.
[ALL CHEERING.]
[TSENG LAUGHS, SIGHS.]
Today's winner of the competition Schmitt, you will be flying solo today.
I won.
I won, I won! I won! Oh! Of course he won.
There was no actual blood.
Oh, come on! Wait, wait.
What's the What's the What's the surgery? - Find anything good? - Wilson did.
[CLEARS THROAT.]
Ex-lap on foreign-body extraction.
Yes! Oww! Get it, get it! Oww! Yes! I love you! [LAUGHS, CLAPS HANDS.]
AMELIA: Hmm, let's think.
Deep pockets, unlimited time, space, Kai Bartley's groundbreaking research, and a chance at curing a neurodegenerative disease.
You're forgetting about the part where we have kids who need stability.
And I have a job that I love that I just got back to.
I don't want to abandon them.
We're not abandoning anyone.
We're revolutionizing medicine, and that's a great example to set for our kids.
And Grey-Sloan, they're gonna be proud to have us be part of something so high-profile.
Exactly.
If this surgery works, it's huge.
If it doesn't, we've killed an incredible surgeon and set the research back years.
Give us more credit than that, Meredith.
You asked me here for my opinion.
I'm saying yes.
Because people with Parkinson's need more than just hope.
[MONITOR BEEPING.]
SARA: Is this her last possible access port for dialysis? WINSTON: It is.
We need to pull back the catheter just a bit.
What about transhepatic or translumbar access? It'd be too dangerous, given her clotting disorder.
Fluoro.
This isn't how medicine should work.
Anybody who needs life-saving care should get it.
Heparinized saline.
What if this port clots off and she loses it? You tell me.
Waste will build up in her blood, leading to uremia, and her organs will start to shut down, one after the other.
Secure the catheter with stitches on the wings and shaft.
Get a chest X-ray.
Where are you going? To get her a kidney.
You don't need to escort me off the premises.
[CHUCKLES.]
That's not what I'm doing.
- Go home to your baby.
- [VEHICLE DOOR OPENS.]
I just wanted to make sure that I'm not being completely ridiculous for even entertaining this.
No, you're being ridiculous because you haven't accepted the offer yet.
I mean, we're talking about curing Parkinson's, Meredith.
Parkinson's.
I mean, what is the matter with you? This This famous surgeon is basically throwing money at us to play with the most innovative equipment in the world.
And not only that, he wants to give us his diseased brain as a testing ground! I mean, when you started your career, you wanted to go into neuro.
This is your chance to get back to that.
I mean, maybe this is what you're supposed to do.
What we're supposed to do.
And I-I I cannot, for the life of me, understand why you would walk away from something like this.
I [SIGHS.]
So don't.
I will see you at home.
I inserted Rashida's access point.
Great.
Thanks.
Rashida needs to be on the transplant list.
We found six cases of patients with similar clinical profiles, who are on the list.
The only major difference is that these patients are white.
Are those cases patients of mine? - A few.
- [SCOFFS.]
There's got to be more to it than that.
The patients' eGFR Yeah, their eGFR is lower, which makes them eligible, but that's only because the formula unjustifiably uses race as a factor.
Dr.
Krause, we all know race doesn't play a role in kidney function.
- Dr.
Ndugu - I know, you're busy, but if you look at Rashida's eGFR without accounting for her race, she falls below the criterion of 20.
I don't understand.
The eGFR is the field's standard.
It's a tried and true formula.
Yes.
And it's time we start questioning our standards.
[ELEVATOR BELL DINGS.]
Look, I have clinic right now, but I'll look into it.
Rashida doesn't have other options for a dialysis port - if this one fails.
- I hear you.
I'll look into it, Dr.
Ndugu.
Thank you.
Robin Jeter, 23, abdominal pain.
X-ray shows a lodged crystal causing intestinal obstruction.
I think you mean to say intestinal stone.
- No, I don't.
- No, she didn't.
ROBIN: It's a yoni egg.
- Amethyst, specifically.
- Uh It's It's It's a crystal egg that is typically inserted into the vagin - Got it.
- Huh? Uh, I was doing a ritual I saw on social media that was supposed to bring love and healing into your life.
But, um, I was doing it so fast, I mixed it all up.
I was supposed to eat the strawberry and insert the yoni egg.
What did you do with the strawberry? Oh.
Uh, I-I see.
Um.
[CLEARS THROAT.]
Oh! Right.
I'm up.
Hello, Robin.
I'm Dr.
Schmitt.
I'll be doing your surgery today, uh, to remove, uh, the - The - Yoni egg.
Mm-hmm.
How old is he? MEGAN: Yeah, these symptoms sound familiar.
I have treated dozens of soldiers exposed to burn pits.
What are burn pits? Electronics, plastics, soiled uniforms, human waste.
Douse it all with some jet fuel, light it with a match, then fwoosh I mean, what could possibly go wrong? I mean, some of these men have illnesses that we haven't even named yet.
Others are in pain 24/7.
They get nowhere with the VA.
OWEN: The guy did six tours of service.
To protect us.
Never questioning, never complaining.
He just answered the call, and we need to do the same for him.
Tomorrow, I'm gonna go down to the VA.
I'm gonna demand answers.
Okay, so after you defeat the US military, maybe grab some lunch, and then take on Putin? [CHUCKLES.]
- How's his kid? - Danny's gonna be fine.
Head CT was clear.
He can be discharged later today.
Maybe Avery can help Noah through the foundation.
He'll be dead before we even line up the votes on the board.
We can't save Noah.
He just needs immediate medical care just to be comfortable.
And we can give him that.
We'll figure out the details later.
Look at you two, breaking rules and saving lives.
Aren't you glad I got you to tie that knot? [DANNY SPEAKING INDISTINCTLY.]
[MONITOR BEEPING RAPIDLY.]
- WINSTON: What happened? - Her sats dropped, and her face and neck keep swelling more and more.
Superior vena cava syndrome.
The catheter must have blocked her SVC entirely.
- I'm taking it out.
- Can we take her back to the IR suite - and reposition it? - No.
How else would she get dialysis? - She wouldn't.
- Dr.
Ndugu She's already clotted off multiple access points.
Who's to say it wouldn't happen again? Page Dr.
Krause! It's fine.
Everyone's watching.
That's what happens.
People watch, you screw up, and then you quit and go find a rock to hide under.
[NEEDTOBREATHE'S "ALIVE" PLAYS.]
RICHARD: You ready? Scalpel.
Flashes of doubt that grow into a rage [ CHEERS AND APPLAUSE.]
Locked out the truth, they keep your dreams at bay Don't stand there waitin' for the time to come C'mon, c'mon, catch me, we got miles to run We are alive, our skin is leaving these bones Fire in the wind, we're burning out of control We are the children chasing wondrous thrills Chasing a vision, baby, like we're running downhill, oh - Nice extraction, Schmitt.
- Thank you.
3-0 chromic, please.
[MONITOR BEEPS.]
Doppler.
Relax, Schmitt.
If you're calm, everyone else is calm.
[SUCTION GURGLING.]
Someday this body's gonna come to rest [SIGHING.]
Oh, this can't happen.
Come on, come on, come on, come on.
Think.
You can do this.
Think.
These hills take longer than we think to get down So I'll get used to living with my feet off the ground BAILEY: I'm turning the speaker on.
Help him out, people.
Are you getting a good signal from the adjacent segments? LEVI: Yes, both sides.
Resect that segment.
Do a hand-sewn End to end anastomosis.
Uh, stapler.
Fire in the wind, we're burning out of control We are the children chasing wondrous thrills To close, start bringing the bowel together with a vicryl suture, coming around the corner - with a Connell stitch and - TARYN: And a 3 millimeter gap between every two sutures.
LEVI: Got it.
[PANTING.]
Suction, Taryn Dr.
Helm.
[SUCTION GURGLING.]
What happened? There was a complication from the catheter, - so I had to remove it.
- So you'll reinsert it? I won't.
And because we couldn't gain access for dialysis, Rashida needs to be placed on the transplant list immediately.
Rashida's been my patient for months.
These aren't your decisions to make.
Except that now she's also my patient.
And she has suffered from multiple unnecessary procedures, so I'm not putting her through even more.
This is not protocol.
It's not.
It's a life.
Rashida's.
Even if we list her, we don't know when a kidney will come through.
It'll come faster than if we didn't.
Oh, Hayes, uh, I'm looking for Danny and Noah.
Uh, they left.
What do you mean they left? I didn't discharge Noah.
No, but I discharged his son, and he said he wanted to go home with him.
So you just let him go? Without asking me? He said he declined all further testing, and then he signed an AMA.
He has severe fibrosis in both lungs.
He needs supplementary oxygen, a full pulmonary workup, an evaluation by a specialist, and we're gonna need to do more studies, okay, - if we're gonna - Hunt, he's terminal.
[SIGHS.]
You know that, I know that, Noah knows that, and he's accepted that.
- Hayes, just - Which is very difficult to do when you've got a little one at home.
Believe me.
All those things you want to do for him, they take time.
They take energy.
They're two things Noah wants to give his son right now while he still can.
Look, I'm sorry I didn't ask you, but I'm not sorry I let him go.
[SIREN WAILING, HORNS HONKING IN DISTANCE.]
You look amazing.
But, yeah, you may want to change.
[CHUCKLES.]
Sorry.
It's okay.
Listen.
You hear that? [INSECTS CHIRPING.]
- MEREDITH: What? - Exactly.
I mean, this right here, this is why I pulled back on my hours.
I was I was ignoring everything around me.
You know? The perfect silence, the 2-mile hike through the woods behind my house, just sitting here, sitting, staring up at the stars.
I don't stargaze much.
I'm sorry, since when? Since ever.
Ooh, we're gonna have so much fun.
[CHUCKLES.]
I've got so much to teach you.
[LAUGHS.]
Hey, tell me about this, um, top-secret project.
Well, If I told you, it wouldn't be top-secret.
Fine.
Tell me one thing.
You really struggle with the concept of secrets.
I guess I do.
[SIGHS.]
I'm scared to say yes.
Hm.
And I am very rarely scared.
What are you scared of? Failure.
This project will cost millions of dollars, will be very risky, win or lose, will eventually be written about.
And I'm just not sure that I want the first thing that I do after surviving COVID to be a public failure.
And I know that's my ego.
I have a very comfortable situation in Seattle.
I have safety.
I have comfort.
And now you're gonna trade all of that in.
You're gonna risk it all.
Listen, you're not a safety person, Meredith.
You're not a comfort person.
- It's not your nature.
- How do you know? Because it's not mine, either.
And it takes one to know one.
[CHUCKLES.]
You're gonna risk it all, and win or lose it's gonna be a hell of a ride.
[SIRENS WAILING IN DISTANCE.]
WINSTON: I'm really sorry to say this, Rashida.
We couldn't gain access for your dialysis.
But you're on the transplant list, Rashida.
[EXHALES SHARPLY.]
Wait, what? Are you serious? Yeah.
[SIGHS.]
Wow.
[BREATHES DEEPLY.]
[VOICE BREAKING.]
I honestly never thought I would see this day.
You're not just saving my life.
You're changing it.
I can go back to who I was.
I don't know how to thank you.
[BREATHES DEEPLY.]
I can't wait to tell everyone.
[BREATHES DEEPLY.]
Oh, and, Dr.
Ndugu, when my followers find out how you helped me [SNIFFLES.]
Are you single? [CHUCKLES.]
I'm not.
I'm actually married to another cardiothoracic surgeon at this hospital Dr.
Pierce.
And she fly.
- What? - Mm-hmm.
A cute doctor couple? - Mm-hmm.
- Okay! [CHUCKLES.]
I gotta meet her ASAP.
Ooh, have you guys ever thought about becoming influencers? The brands would come flocking.
Influencers? For what? Health? Yeah, I mean, there are influencers for everything.
Okay, movies, restaurants, plants.
- [CHUCKLES.]
- There are dog influencers, too.
Mm-hmm.
Biggie the Pug has 2 million followers.
Ha! Come on.
Okay.
We gotta go live.
Hey! - Hey.
- Ah! I haven't seen them this happy in months.
[CHUCKLES.]
Helm's more thrilled than Schmitt.
- He let her keep the crystal.
- [CHUCKLES.]
And you seem to be the happiest of them all.
Feels good to be back, in front of them.
Well, Dr.
Wong gave me his retirement notice today.
Dr.
Wong? He used to be a student of mine.
Is something wrong? Healthy as a horse.
And it's getting worse, Richard.
Every day, someone retires or quits or moves to Minnesota We don't know if that's happening.
[SIGHS.]
Whether it's burnout or exhaustion or just needing a change, these residents aren't the only ones that need to reset.
This whole hospital needs to remember why we're here.
COVID took that from us.
You know, remember when we used to have, like, pizza night and retreats, and and residents would prank each other - and - You hated that.
But there was joy and the feeling that we were all in this together, for something bigger than ourselves.
I want to make room for that.
I want to make space for that again.
You want people to remember the why.
So do I.
Feels just like we're dreaming wide awake I got some ideas, Bailey.
And I know we're only going Up, up, up Big ones.
Here we go Oooh - And if that mockingbird don't sing - [SCOUT CRYING.]
Daddy's gonna buy you a diamond ring And if all of those rings don't work Daddy's gonna feel like a big old jerk Okay, you need to stop with the depressing lullabies.
- Put him to sleep.
- [SIGHS.]
Link, I-I know that you are upset and sad and grieving the future you thought you had.
Obviously, I have been there.
And what did you do? I looked for joy anywhere that I could.
Then along came [SIGHS.]
OB and Luna.
I know that it sucks right now, but you're gonna be okay.
Ooh-ooh-ooh, ooh, ooh-ooh-ooh-ooh-ooh Something did happen earlier with Leo.
I-I-I thought a parent was being judgy about his Elsa costume, - so I-I confronted him.
- Who was it? No, no one.
He wasn't being judgy.
I'm just Owen, I'm worried.
I I-I want Leo to be okay in the world, and I'm I'm I'm worried, what if we What if we let him be himself? I'm worried that the world won't be kind.
I'm worried that it will be hard.
I'm worried that people will be cruel.
No, I don't wanna be so lonely And maybe they will be.
frozen But we won't be.
Leo's happy.
Let's Let's just let him be happy, okay? Okay.
- LEO: Mommy! - Oh, there he is.
- Hey! - Hey! [CHUCKLES.]
Hey.
How are you? [GRUNTS.]
- Look what I got.
- [BOTH GASP.]
- Whoa.
- A new cape for Elsa, the Snow Queen.
You like it? Yeah.
I love it.
[CHUCKLING.]
Hi! - You got her? - Yeah.
I'll take him.
Hi! Hi! - Let's go home.
- Okay.
I have no one left to blame in the end - How was your day? - Ah.
Yeah, I'm awake MEREDITH: There is such a thing as predictive homeostasis.
Late night.
Ooh-ooh-ooh, ooh I'm awake You don't own me.
Mm, I know.
I need autonomy picking the team.
Absolutely.
I'd like any progress that we make from this process to be public and accessible to everyone with Parkinson's.
Of course.
It's when our body anticipates responses to future challenges.
I'd like to move the whole project to Grey-Sloan.
Mnh.
That I can't do.
It's It's expensive.
Frankly, I don't have the time.
We have everything we need here.
I can't move to Minnesota.
I need you here as much as possible.
I can't see the road I'm driving I don't need to look behind me I could set up a satellite lab in Seattle.
I could travel back and forth once a week.
That's the best I can offer.
I'm awake Done.
It understands that change is inevitable - Does this mean you're in? - I'm awake Ooh-ooh-ooh, ooh, ooh-ooh-ooh-ooh-ooh - It means I'm in.
- Yah, I'm awake Ooh-ooh-ooh, ooh, ooh-ooh-ooh-ooh-ooh and doesn't have to be catastrophic.
I'm awake