Grey's Anatomy s18e16 Episode Script
Should I Stay or Should I Go
1
In 2019, the World Health Organization
officially recognized burnout
in its International
Classification of Diseases.
Chief Bailey, everything okay? I'm just, um, waiting to get my smoothie.
Um, but I was gonna get your smoothie.
Not today.
Today, I'm getting it myself, 'cause I can't bring myself to go into that depressing building.
Can I help in any way? Yeah, just leave me alone.
Studies show that doctors who report signs of burnout have enlarged amygdalas, the area in the brain that regulates fear and aggression.
If that's how you speak to your residents, no wonder we are on probation.
- Catherine - In your office.
Now.
But burnout isn't an academic exercise.
It's an all-consuming, systemic condition.
It's your entire body sending you one clear message.
You know what, why don't you go ahead, and I'll take them to daycare.
- Here, give me this.
- Oh.
Thank you.
You sure you're ready? I'm cleared for surgery.
I'm feeling good.
I'm just a little slow.
Okay.
Alright.
Uh, I'll see you in the pit.
Alright, give Daddy hugs.
Okay, bye.
Bye, bye, bye, bye, bye.
Mwah.
Okay.
Hey! Look at you.
My little cowboy.
I'm not a cowboy.
I'm a girl.
Okay.
Alright.
Cowgirl.
No.
I'm just a girl, silly.
No, honey, you're a boy.
This is just a cowgirl costume.
Right? It's pretend, remember? Oh.
Okay.
Alright.
I'll see you in there.
- Bye.
- Come on Come with me.
Whoop.
Let's go this way.
Something has to change, and it has to change now.
If the surgery program loses its accreditation, there's no guarantee that we'll find another residency spot somewhere else.
I don't think that's gonna happen.
Well, and even if we do, it might not be a surgical residency.
We might have to switch to something else.
Like family medicine.
It's my first day back.
Would you please consider shutting up? Well, that was awkward.
I have spent years rebranding this organization into something respectable that bears my name.
I'm not going to let my entire legacy shrivel and die because one hospital can't get its crap together.
Well, don't you think that's a little extreme? The Medical Accreditation Council has inquired about visiting 20 different Fox Foundation hospitals as of this morning.
With all due respect, Catherine, you supported the Webber method Are we here to point fingers or are we here to solve problems? Dr.
Lawrence to the NICU.
Dr.
Lawrence to the NICU.
How long have they been in there? Well, I've been here 10 minutes, and she hasn't let either of them get a word in.
I need to tell Bailey that my fellow quit this morning.
Makes sense.
People start to feel the ship sink, they jump.
Oh, my God.
Are you still considering taking that offer? I made my decision before I knew about this probation.
Tell Nick that you've changed your mind.
It isn't about Nick.
Not just about Nick.
Fine.
Congratulations.
I have a presentation.
Some of us are loyal and want to save this place.
She'll get over it.
Everyone will.
And I will come visit you.
I am pro-Minnesota.
You are pro-sex in Minnesota.
Well, well.
How far the mighty have fallen.
What the hell did you all do to this place? Probation? Really? You've always known how to make an entrance.
Ooh.
Trinity Lab's "HeartPatch" can be placed on a patient's arm or chest, and within seconds, will continuously transmit ECG, respiratory rate, and oxygen saturation right to an app on your phone.
You get instant monitoring of your patient while you're out doing rounds, brushing your teeth hell, you know what, you could even check them on the golf course.
Phase III results rival the gold standard telemetry monitors.
And Grey-Sloan could be at the forefront of this cutting-edge technology.
So, anybody has questions, I'm here, and don't forget, we got donuts.
Hey.
Thanks for the coffee.
I like that suit.
That's nice.
Yeah, yeah.
I got to look sharp for my Seattle Pres and St.
Joseph's pitches this afternoon.
You know, we should try these patches on a couple of our patients today.
Richard said that we needed to improve our tech and "modernize.
" So Really? Absolutely.
Stay right here.
I'll grab a few samples.
Hey.
What are you doing here? Snickerdoodles.
My sister baked them and insisted I bring you some.
Oh, wow.
That's so nice.
Yeah, well, my office is walking distance, so it wasn't Oh, you're talking about her making the cookies.
Yes.
But the delivery service is also appreciated.
How's Laura? She's good, but I just heard about the residency program getting shut down.
Am I gonna need to find her a new hospital? It is not shut down.
It's on probation, and it's just the surgical residency program.
Oh, okay, great.
So I'll just make sure the paramedics don't send me here if I get hit by a car.
Our attending surgeons are very good.
Yeah? Is that why they kicked you out? Um, I have to get going to a meeting, but I'll see you later? - Yes.
- Okay.
Okay.
I didn't realize you were still hanging out with Tad.
It's Todd, and yes.
He brought me cookies.
Because he's nice.
How thoughtful.
What's so funny? Nothing.
I just see how hard you're trying to like him.
I want nice to be my type.
Great.
I support that.
Hey, so, uh So, this morning with Leo Yeah, we should figure out what to do.
What do you mean, "what to do"? Well, he's obviously confused.
We should get a therapist.
I mean, one for him and and one for us and Help! We need Oh, wow.
Get a gurney now! What's his name? What's his name? - C-Colin.
- Okay.
Alright, ma'am, step over here, please.
His name is Colin Colin Renfield.
We work together at an e-tail fulfillment center.
His arm got cut off on the conveyor belt 20 minutes ago.
Is that the, uh His arm.
Okay, let's get saline and ice.
Let's get him to Trauma One now.
Let's go.
Is there anything else you need from me? - No, we're good, thank you.
- Okay, good.
Why don't you wait over here and we'll - Oh, God, she's going down! - I got her! Alright, get the wheelchair.
Alright.
Alright.
We got you.
He's a little hypotensive.
Normal sats.
- Let's type and cross him for blood.
- Colin? Colin, we're gonna do a quick X-ray to assess your injuries, okay? Push another 50 of fentanyl.
You can put my arm back on, right? We're gonna do our very best.
Okay? I promise.
- My wife - We'll inform her right away.
This is a marathon surgery.
Could be 10 hours.
Are you sure you're up for it? No shame calling in reinforcements.
What reinforcements? Okay, let's page neuro and tell the OR we are on our way.
Let's go.
Heart rate and blood pressure are improving.
Sorry.
I got woozy.
It's okay.
You had a vasovagal response.
It could be triggered by a number of things.
The sight of blood, emotional distress How's Colin? Can they reattach his arm? They're still trying to figure it out.
It was horrifying.
It just keeps replaying in my head, over and over again.
You saw it happen? The gears on the conveyor belt They made a terrible noise, and then Colin started screaming and his arm ripped off his shoulder and went flying around, spraying blood everywhere.
It was on the floor, on the merchandise.
Some of it hit my mouth.
I Oh, no, it's happening again.
Alright.
That's alright.
We got you.
I have a woman pregnant with a transplanted uterus and her dead husband's sperm, and she's now experiencing pain.
I mean, should I be transferring her to a hospital that isn't on probation? Well, the hospital isn't on probation.
Just the surgical residency program.
And also this hospital's been through much worse.
Okay, that doesn't make me feel better.
But the transplant worked? Tovah's officially pregnant? Mm-hmm.
One uterus, two IVF cycles.
She is 11 weeks today.
That's amazing.
So, how much is David Hamilton offering you? - Sorry.
- Oh, come on.
The rumors are everywhere.
I made so many people angry by even considering it.
Bailey? And Richard.
Meredith Grey back in neuro, pissing people off? It's like I never left.
There she is.
My favorite student.
Hi, Richard.
You need to be trying to save the program, not sulking.
I am recruiting.
These are résumés for attending surgeons.
Right now, you need to be focused on keeping the residents.
You know when a program goes on probation, they panic, and flee, and we lose government funding.
Well, they'll stay if we have enough attendings to teach them.
No, no.
We will not hire any outside surgeons until we have assurance that our residents intend to stay and plan to give good reviews to the council's follow-up visit.
In fact, you will speak to every one of them.
Today.
And I will observe.
Where are you going? To line up residents to beg.
Highlight of my year.
Haven't done a full arm reattachment in years.
I've never done one.
Believe it or not, this is a career first.
- Irrigation.
- Good to see you back in an OR.
Are we ready to reattach an arm? Edges are all freshened up and ready to go.
Alright.
Let's make sure we have plenty of blood product on hand, and everybody buckle up.
We are going nerve by nerve, vessel by vessel, muscle by muscle.
I think we get the idea.
I'm gonna scrub.
V-fib! He's lost too much blood.
Push epi.
Starting CPR.
I know we have a blood shortage, but call for another three units! - Come on.
- Come on! Okay, back to sinus.
Hell of a first surgery back.
Owen, you saved his life.
But now he's too unstable to reattach the arm.
- Life before limb.
- I wanted to save both, okay? Let's get him up to the ICU and prep him for resuscitation.
That's your baby.
Heartbeat's strong.
Oh, my God.
Thank you.
Hi, baby.
Hi, sweetheart.
Sorry.
You don't need to be sorry.
I'm scared.
It's my last embryo, from the last of my husband's sperm.
- And it's still there.
- Yeah.
Okay, I'm gonna switch to Doppler now, Schmitt.
Have a look at the uterine vessels.
So, if the baby's okay, why am I feeling all this pressure in my belly? That is what we're trying to figure out, Tovah.
Have a look, Schmitt.
Oh.
What? What is it? Tell me.
It looks like there's diminished blood flowing to both sides of the uterus, Tovah.
Right side looks a little thrombosed.
It's a-a blood clot.
Oh, no.
Oh, God.
But the baby The baby is fine, okay? We just need to order some more scans.
Alright, let's order an MR angio right away, and page Webber and Grey.
I want their eyes on this in case we need an IR intervention.
Uh, both of them? They're They're having a little Yeah, I don't care.
I'm not a high-school teacher.
I don't care who's talking to who and who isn't.
Page Webber and Grey.
Yes.
Okay.
Step at a time, Tovah.
How's Colin? He's okay.
There was a slight complication in the operating room, but we were able to resuscitate him.
Thank God.
And his arm? At this point, he's just not stable enough to withstand a 10-hour surgery to reattach it.
So, you'll do it later? Unfortunately, without blood flow his arm won't survive much longer.
This is all my fault.
Yesterday, when I got to work, I saw that one of the conveyor belts was acting up again, but I didn't tell anyone to fix it.
When I got to work this morning, I wasn't paying attention, and then he switched it on.
I could have done something.
I could have stopped this from even happening.
Can I see him? Of course.
Think about all the military vets that we've seen lose limbs in combat, and they've gone on to live very full lives.
It's gonna be an adjustment, but - Wait, where are you going? - To find that arm.
I think I can save it.
Two rounds of IVF, 11 weeks today, so - Hey.
- Hey.
Um, we already have a general surgeon.
Oh.
Well, if I'm not needed here.
Yeah, that's a good idea.
Just leave and that'll fix everything.
You are, and she is.
You're not exactly subtle, you know that? Okay, as delightful as this is, I have a patient at risk of losing her uterus and a fetus, so if we could just focus up here, please.
Damn it.
The right outflow is completely clotted off.
The left side is severely stenosed, but salvageable.
We could do a fibrinolysis and dissolve the clot.
Not if you don't want to kill the fetus.
Well, of course I don't want to kill the fetus.
We could do a balloon angioplasty on the left side and see if that widens the blood vessel.
Let's prep her for angio.
You don't need the both of us there.
On a normal case, I wouldn't, but this isn't a normal case.
Tovah's making medical history.
We all are.
Look, I don't care what kind of giant dumpster fire this hospital is, I refuse to let Tovah burn with it.
So, we're all adults here.
Let's act like it.
- The ashes are falling.
- Oh! Hi, Bailey.
H-How are you? I'm desperate.
I'm in need.
And if I remember correctly, I've been very good to you when you were in need.
Do you need something specific? I need you back as a general surgery attending.
And I know how big an ask this is, and I wouldn't be coming to you if I had other options.
You want me to just give up my OB residency spot a year in? As soon as the program is off probation, you can return to OB.
Okay, and what if they fill my spot in the meantime? On average, I'm having to cancel seven scheduled surgeries per day.
That's seven patients who have to wait.
That's seven surgeries that residents do not get to assist.
If I had even one more attending on the schedule, you, well, I could cut that number in half.
Bailey Please, don't make me beg.
I don't like it, and I'm not very good at it.
Do I have to decide right now? You have to decide yesterday, if possible.
This hospital has given you a lot, Wilson.
Hopefully, you'll return the favor.
That little Band-Aid's supposed to monitor all my vitals? Heart rhythm, oxygen levels, respiratory rate.
There is even something to measure your sleep quality.
Whatever happened to the good old stethoscope? Alright.
Here you go.
Sorry, our Wi-Fi is not having it today.
Stethoscopes don't need no Wi-Fi.
Oh, it's up! It says he's dead.
- What? - Huh? Yeah, it Okay, hold on.
Ah! Try it now.
Oh, no, you're dead, too.
I find that slightly comforting.
You basically re-created an entire circulatory system to support the arm.
It's called ex-vivo limb perfusion.
It was being tested for military use when Teddy and I were in Iraq.
- Think it'll work? - I hope so.
I'll keep you both posted.
Thank you.
That's so cool.
Owen, this technique hasn't been approved for civilian use.
And if it works, what does it matter? - If the military finds out - Then they will say, "Congratulations, Dr.
Hunt.
You saved an arm.
" Do you really want their attention right now? I will cross that bridge if it comes to it.
Oh.
So your plan is to just wing it? Is that what you want to do with Leo? Owen, this is a big deal.
What happened this morning is a big deal.
Our son told us that he's a girl.
Yes, and you immediately said, "No, you're not.
" I know.
I'm sorry.
It It was a mistake.
We've We've let him wear dresses and we've laughed and smiled, but maybe we should be paying closer attention.
We can't just wing it.
Think about how your mom is gonna react.
We need to have a plan so that we can try and help him.
The only thing that needs help in this exact moment is our patient.
So, can you please just go and check on him while I try and keep this arm from dying? Four generations of surgeons.
All students of Dr.
Richard Webber.
Technically, it's three generations, plus Dr.
Webber.
I-I literally don't know why I'm talking.
You know, there was a time when being my student meant something.
But now, there's no loyalty.
Spare me the loyalty speech, please.
In case you're curious, Schmitt, Dr.
Montgomery was a machine during her residency.
There was a stretch where she and Derek Shepherd were my students.
We're doing this now, huh? They did these gauntlets of back-to-back surgeries over the course of several days.
I mean, no sleep, barely a meal break.
I mean, it was astonishing.
That's one version of the story.
Care to elaborate? Not particularly.
Let's just say that my memory of that time isn't quite as romantic as yours, Dr.
Webber.
Well, would you prefer that I talk about your residency years instead, Meredith? No, I would not.
Of course the HeartPatches are garbage.
My brother is a walking pawn shop.
Maybe we got a bad batch.
Or maybe we didn't apply it properly.
Yeah, you know, somehow, I doubt that.
Okay.
Let's see.
Hey, your pulse ox is good, heart rate is good.
Why don't you try doing something to increase your heart rate? What are you doing? What are you doing? I am increasing my heart rate.
Is it working? Actually, yeah.
Mm.
Oh, no.
Oh.
Well, I know you're not dead.
You wanna stop and go tell Wendell right now? Mnh-mnh.
Nope.
Hey.
If you tell me this coffee's only for attendings, I will break the pot into a thousand pieces.
Okay.
I'm sorry for earlier.
You deserve a nice guy.
It's Bailey asked me to come back to general surgery to save the program.
Wow.
Yeah.
So, what are you gonna do? I don't know.
I just Can we grab dinner tonight? I just I need to talk this through over several drinks.
Aren't you going out with Todd? Yes, but he doesn't talk medicine or accreditation probation, so can you please just join us? Unless it's weird.
Nope.
Not weird.
I'll do all the pros and cons of vaginas versus colons.
With the nice guy you're dating.
Thank you.
Joe's? - Of course.
- You're the best.
Oh.
Thank you.
Yeah.
So, um, ooh, what are you gonna tell Wendell about the patch? Uh, I'm gonna tell him the truth.
These don't work.
It's a medical device.
What if Grey-Sloan bought them? While on probation? - This place cannot - Whoa! Maggie, Winston.
What's up, bro? You never texted me back.
Is your shirt inside out? Yeah, I'm I'm just Wait, are you gonna leave us a review? 'Cause, you know I work off commissions, right? And, uh, a rave from a renowned heart surgeon would definitely give me a sales bump.
These don't work.
Ah, get out of here.
What? Oh, oh, oh.
You know what? I-I know what the problem was.
I gave you the beta models from testing.
No, these These are discontinued.
Let me give you the retail model.
Fully FDA approved.
Okay, yeah, I guess we could try those.
Right, Winston? Right.
Let's go.
Inflating the balloon.
Let's get the stent ready.
When did it become a thing that we "owe" the hospital that we did our residency at? You trained at Columbia.
I don't see you still working there.
I don't think that's what anyone's saying.
I have earned the right to spread my wings.
Of course you have.
But it's not just about that.
Amelia told me that when you had COVID, this place nearly broke without you.
100%.
The hospital broke because of COVID.
And you weren't there to lead them through it.
I may remember you as a featherweight in light blue scrubs, but apparently, you've become some sort of hospital mascot in the years since then.
Okay, removing the catheter.
You know that Richard's not mad because he's losing a surgeon.
I'm not his student anymore.
You were never just his student.
Fetal decels.
The uterus isn't getting enough blood flow.
Contrast and shoot fluoro.
That left vessel is completely clotted off.
It's over.
Damn it! Okay, um Let's prep an ex-lap and remove the uterus and fetus.
Okay, no, no, no.
We can do a vascular revision.
If we can harvest the saphenous vein, we can maybe bypass the thrombosed vessels and save the pregnancy and the uterus.
Prep the abdomen and leg.
We're opening her up, and Richard, I swear, if your head's not in this I'm right here.
Let's do it.
Scrubbing in.
Oh, Dr.
Wright.
Do come in.
I've heard so many good things about you.
Wow.
Really? Yes.
Dr.
Bailey is quite the fan.
Well, uh, the feeling's mutual.
Dr.
Wright, why do you draw? I mean, I know you draw every surgery before you perform it, but why? I'm ambitious, Dr.
Bailey.
I always knew I wanted to be a surgeon, but it's hard to have the patience it takes Doing every step without getting ahead of yourself.
But when you draw the body, I mean, you see the body, yeah, but by taking the time to draw it, you're telling yourself that the body's worth your time, worth taking a closer look at.
So then, when a body's on an operating table, it's it's not something trying to defeat you.
The body's a work of art.
What's this? Um, it's the, uh, forms to complete your transfer, uh, back to the Clinic.
Oh, you mean from the Clinic? I called your program director in Minnesota.
They still haven't filled your spot.
- Miranda.
- Did I do something wrong? Quite the opposite.
Your work is stellar.
You are one of the finest residents I've had the pleasure of teaching.
Which is why you need to leave.
Dr.
Bailey, can we have a word outside, please? This is my office.
If you want a word, you can have it here.
Dr.
Wright, what Dr.
Bailey's trying to say to you What I am trying to say is if I fail to save this program, which I might through no fault of my own, every resident will be orphaned.
I don't know if you'd be able to get a spot somewhere else, and I want to protect your future.
So, please, go back to Minnesota.
And hey, you can still learn from Meredith Grey out there.
Clot scissors, please.
Cutting the vein.
Removing the vein.
Syringe, please.
Let's flush the vein.
No leaking.
Perfect.
Here you go, Dr.
Webber.
Suture.
One more.
There we go.
I think we're done here.
Okay.
Unclamp.
Unclamping.
Sponge stick.
Blood flow looks good.
No leaks.
I think we did it.
Schmitt, go and get the Doppler and check the fetal heartbeat.
Stand by.
Schmitt? No.
No.
No! Addison, I'm so sorry.
Yeah, me, too.
Okay, let's prep for a D&C.
This looks like the same model.
It is.
There is no other model.
I don't understand.
I got a loan, and I bought it.
All of it.
You're saying it doesn't work? Look, Winston, if I can't sell this stuff You got a loan? Yeah, like Like, from a bank? Not from a bank.
How could you be this stupid? No, you know what? How could Ibe this stupid? You said you had a real job.
You were working on commission.
You lied to me.
It works.
I swear.
I-I saw it on an online presentation.
Oh, my God, dude.
Look, I saw an opportunity.
Surgeons in the family, direct connection to the Fox Foundation.
Look, I put the pieces together, and I went for it.
How much are you out? 10 grand.
Look, everything I have is in this.
If you're saying it doesn't work, if if I can't sell this stuff you have to help me sell it or pay back the loan.
Wendell If you're my brother, if we're family, you will.
You have to help me.
Please.
Colin's wife is half an hour away.
It worked? Yep.
Toxins are flushing, arm is looking pink, and tissue is oxygenating properly.
That's great news.
Listen, Teddy, I'm not winging it with Leo, okay? I'm just I thought this might happen ever since he started wearing a tutu, didn't you? At four? No.
I thought we were raising a son who loves dress-up.
Teddy, if Leo says, "I'm a girl," - I'm gonna listen.
- So, that's it? We're just gonna tell everyone that Leo's a girl now? What, before he can even tie his own shoes? Maybe? I don't know.
He might change his mind in two months.
Then we'll just tell everyone that he's a boy again.
Won't that be even more confusing? I don't know, Teddy.
I don't have all the answers, okay? I just think we have to follow his lead.
Meredith Grey.
Catherine, I can't do this right now.
You would leave this place right when it - Catherine - Do not interrupt me! Please don't talk to her that way.
You are not her boss, nor are you mine.
- Boss? - Excuse you? This is about honor.
This is about the standing of this hospital.
- Okay, can we not do this? - The standing of this foundation! Can we just stop?! For a minute.
A woman just lost her pregnancy.
A pregnancy that she fought for with everything that she had left in her body.
Through grief, through pain, through loss.
She fought and she lost her pregnancy.
Can we just take a moment and honor her? Just a moment to honor Tovah? Mrs.
Renfield, your husband has been through major trauma.
Will he be okay? He has to be okay.
We've given him some time to stabilize, but we've scheduled his surgery for first thing tomorrow morning.
It was touch and go, but in the end, we were able to save it.
We're gonna reattach the arm.
Thank God.
Thank you.
Thank you so much.
I'm so sorry, Tovah.
We'll try again, just as soon as we can.
When my grandfather died, our rabbi taught me the Mourner's Kaddish.
I know it's not really the normal time to say it, but it's always helped me.
Yitgadal v'yitkadash sh'mei raba b'alma di-v'ra chirutei, v'yamlich malchutei b'chayeichon uvyomeichon uvchayei, d'chol beit yisrael, ba'agala uvizman kariv.
V'im'ru.
Amen.
Amen.
I feel like I failed her.
Her uterus is still intact.
She can try again.
Yeah, but not with her husband.
You really don't remember your residency fondly? Do you? Oh, come on, Richard.
You changed my life.
Okay? But I remember pain.
I remember insomnia.
I remember bullying attendings.
I remember learning to treat patients as wins and losses instead of people.
Took me years to unlearn that.
I mean, people haven't complained before.
I mean, not like this.
Come on.
We couldn't complain.
I couldn't complain.
The surgery world's small.
If you complain, you lose your spot, and you never get it back.
That was the culture, and you know it, Richard.
Look, you know, you are trying to save a version of the program that is old.
It's broken, alright? You gotta stop with the reminiscing about the past and look to the future.
What's the new way to train surgeons? I tried that.
It got us shut down.
Well try again.
So, if you say yes Then I could lose my OB residency spot.
And if she says no, then the chief of surgery asked her for a favor, and she was like, "Nah.
" Got it.
So, it's a Hobson's choice.
Mm.
When you're offered a choice and there's really only one option.
Oh.
When I was in grad school, I told my dissertation chair that I wanted to study the impact of climate change on global migration.
So, in addition to environmental science, it would involve public policy, sociology, and geography.
Is this story your way of telling us you have a PhD? I already knew that, but isn't that what you studied? Yeah.
I decided to go for it.
I basically lived at the library, but I did it, and I didn't have to spend a year of my life studying the atmospheric effect of moss, which is what she wanted me to do.
I mean, no offense to moss, but point is, maybe you could do both.
I mean, I know it'd be more work, but if that's what you want, I say go for it.
What he said.
Yeah.
Keep your residency and moonlight for Bailey.
I've seen you handle worse.
But I have a baby.
I have a tiny human.
- Right.
- It's only for a few weeks, or a few months, and, uh, I can help you out with Luna.
I could help with Luna, too.
Yeah, no, scratch that.
Next round's on me, though.
- Okay.
- Okay.
Hey.
Hey.
I want Leo to be happy.
I never wanted anything but happiness for our kids.
But I just, uh I don't want to mess this up, and it just feels like there are a million ways to get it wrong, and if Leo were 10, then we'd be having a different conversation, but he's not, and, you know, neither one of us has done enough research to know how to handle this.
And I want to get it right, and going all-in now, it just it doesn't seem right, Owen.
Hey, you remember when Leo said that he was an owl? Did you feel the need to, you know, call him silly and correct him? - No.
- No.
No, you just loved him.
You just let him explore.
Let's just love Leo, okay? Let's listen when he tells us who he is.
It's more complicated than that.
Yeah.
Yeah.
It is.
Then let's get a therapist.
But for us.
For us, not for Leo.
I'm not correcting Leo.
I'm not telling Leo that there is something wrong with Leo.
Let's not be our kid's first bully.
Yeah, I agree with all of that.
I-I just What if we don't agree on the approach? Honestly? Honestly, I don't know.
Therapy it is.
Yeah.
I was in pain when you came to see me.
You dumped me and told me to go away.
I know.
I did.
But when you were in pain, I kept showing up.
I guess that's the difference between me and you.
Um, I-I've arranged a phone call for us with a major consultant to help us with a more formalized plan.
Where are you going? - On vacation.
- What? I haven't just taken a vacation day ever in my life, and I have a new little girl at home, two teenaged boys who haven't seen both me and Ben in the same room in months, and they need me.
This hospital needs you.
Yeah.
This hospital needs too much of me.
No, I'm done being the superhero.
If Meredith Grey can go away, then so can I.
Miranda Catherine, I respect the hell out of you.
You know I do.
And I know you understand what it's like to be a woman at the top of her field who isn't allowed to rest.
So, I need you to hear me when I say I'm not quitting, I'm not taking a leave or saying that I can't handle this job.
I am taking a vacation day.
Maybe two.
'Cause I'm no good to you like this.
Put simply, burnout comes from a deep imbalance.
Too much stress with too few rewards.
You're exhausted, depleted.
You no longer have patience, pleasure, or serotonin.
This is the end, unless What are you doing here? Well, you know what? I don't even care.
I'm so happy to see you.
No, but ask me.
I have a speech.
Oh.
Okay.
Nick, what are you doing here? Don't come to Minnesota.
Look, if you leave right now, your people won't be okay, and you won't be okay.
You won't be happy, and you'll always resent me just a little bit.
And I know you have kids.
They're gonna have to get used to me being around, but I am gonna get my own place, and we are gonna do this thing the normal way.
You know, having dinner together and not having to get on a plane just to kiss each other.
And look, I have days, I have tons of personal days, and I'm taking a few months and I'm staying here, and I'm gonna work locum tenens at Grey-Sloan, and we can be together.
Here.
I have the right to leave.
I've earned the right to leave.
Other people from my residency class, they left and took other opportunities.
I stayed.
I worked.
I researched.
I won awards for that place.
I did everything that was expected of me, and then some.
And now, if I want to leave, I'm considered disloyal? It's ridiculous.
It's absurd.
You know what else it is? It's my decision, and I've made my decision.
So this is all very patronizing.
Okay.
I-I wasn't suggesting we stay here forever.
I'm suggesting we stay long enough to save the program.
And then we can go to Minnesota.
We can go wherever we want, because you have absolutely earned the right to leave.
You couldn't have led with that? I thought I had.
I'm sorry.
Now you've seen my angry side.
I'm not gonna lie, it was kinda scary.
You turn it into something else and find your path to recovery.
What? Okay.
Fine.
We can stay.
But just for a little while.
Pick the pieces you want from your life and find a new way forward.
Chief Bailey, everything okay? I'm just, um, waiting to get my smoothie.
Um, but I was gonna get your smoothie.
Not today.
Today, I'm getting it myself, 'cause I can't bring myself to go into that depressing building.
Can I help in any way? Yeah, just leave me alone.
Studies show that doctors who report signs of burnout have enlarged amygdalas, the area in the brain that regulates fear and aggression.
If that's how you speak to your residents, no wonder we are on probation.
- Catherine - In your office.
Now.
But burnout isn't an academic exercise.
It's an all-consuming, systemic condition.
It's your entire body sending you one clear message.
You know what, why don't you go ahead, and I'll take them to daycare.
- Here, give me this.
- Oh.
Thank you.
You sure you're ready? I'm cleared for surgery.
I'm feeling good.
I'm just a little slow.
Okay.
Alright.
Uh, I'll see you in the pit.
Alright, give Daddy hugs.
Okay, bye.
Bye, bye, bye, bye, bye.
Mwah.
Okay.
Hey! Look at you.
My little cowboy.
I'm not a cowboy.
I'm a girl.
Okay.
Alright.
Cowgirl.
No.
I'm just a girl, silly.
No, honey, you're a boy.
This is just a cowgirl costume.
Right? It's pretend, remember? Oh.
Okay.
Alright.
I'll see you in there.
- Bye.
- Come on Come with me.
Whoop.
Let's go this way.
Something has to change, and it has to change now.
If the surgery program loses its accreditation, there's no guarantee that we'll find another residency spot somewhere else.
I don't think that's gonna happen.
Well, and even if we do, it might not be a surgical residency.
We might have to switch to something else.
Like family medicine.
It's my first day back.
Would you please consider shutting up? Well, that was awkward.
I have spent years rebranding this organization into something respectable that bears my name.
I'm not going to let my entire legacy shrivel and die because one hospital can't get its crap together.
Well, don't you think that's a little extreme? The Medical Accreditation Council has inquired about visiting 20 different Fox Foundation hospitals as of this morning.
With all due respect, Catherine, you supported the Webber method Are we here to point fingers or are we here to solve problems? Dr.
Lawrence to the NICU.
Dr.
Lawrence to the NICU.
How long have they been in there? Well, I've been here 10 minutes, and she hasn't let either of them get a word in.
I need to tell Bailey that my fellow quit this morning.
Makes sense.
People start to feel the ship sink, they jump.
Oh, my God.
Are you still considering taking that offer? I made my decision before I knew about this probation.
Tell Nick that you've changed your mind.
It isn't about Nick.
Not just about Nick.
Fine.
Congratulations.
I have a presentation.
Some of us are loyal and want to save this place.
She'll get over it.
Everyone will.
And I will come visit you.
I am pro-Minnesota.
You are pro-sex in Minnesota.
Well, well.
How far the mighty have fallen.
What the hell did you all do to this place? Probation? Really? You've always known how to make an entrance.
Ooh.
Trinity Lab's "HeartPatch" can be placed on a patient's arm or chest, and within seconds, will continuously transmit ECG, respiratory rate, and oxygen saturation right to an app on your phone.
You get instant monitoring of your patient while you're out doing rounds, brushing your teeth hell, you know what, you could even check them on the golf course.
Phase III results rival the gold standard telemetry monitors.
And Grey-Sloan could be at the forefront of this cutting-edge technology.
So, anybody has questions, I'm here, and don't forget, we got donuts.
Hey.
Thanks for the coffee.
I like that suit.
That's nice.
Yeah, yeah.
I got to look sharp for my Seattle Pres and St.
Joseph's pitches this afternoon.
You know, we should try these patches on a couple of our patients today.
Richard said that we needed to improve our tech and "modernize.
" So Really? Absolutely.
Stay right here.
I'll grab a few samples.
Hey.
What are you doing here? Snickerdoodles.
My sister baked them and insisted I bring you some.
Oh, wow.
That's so nice.
Yeah, well, my office is walking distance, so it wasn't Oh, you're talking about her making the cookies.
Yes.
But the delivery service is also appreciated.
How's Laura? She's good, but I just heard about the residency program getting shut down.
Am I gonna need to find her a new hospital? It is not shut down.
It's on probation, and it's just the surgical residency program.
Oh, okay, great.
So I'll just make sure the paramedics don't send me here if I get hit by a car.
Our attending surgeons are very good.
Yeah? Is that why they kicked you out? Um, I have to get going to a meeting, but I'll see you later? - Yes.
- Okay.
Okay.
I didn't realize you were still hanging out with Tad.
It's Todd, and yes.
He brought me cookies.
Because he's nice.
How thoughtful.
What's so funny? Nothing.
I just see how hard you're trying to like him.
I want nice to be my type.
Great.
I support that.
Hey, so, uh So, this morning with Leo Yeah, we should figure out what to do.
What do you mean, "what to do"? Well, he's obviously confused.
We should get a therapist.
I mean, one for him and and one for us and Help! We need Oh, wow.
Get a gurney now! What's his name? What's his name? - C-Colin.
- Okay.
Alright, ma'am, step over here, please.
His name is Colin Colin Renfield.
We work together at an e-tail fulfillment center.
His arm got cut off on the conveyor belt 20 minutes ago.
Is that the, uh His arm.
Okay, let's get saline and ice.
Let's get him to Trauma One now.
Let's go.
Is there anything else you need from me? - No, we're good, thank you.
- Okay, good.
Why don't you wait over here and we'll - Oh, God, she's going down! - I got her! Alright, get the wheelchair.
Alright.
Alright.
We got you.
He's a little hypotensive.
Normal sats.
- Let's type and cross him for blood.
- Colin? Colin, we're gonna do a quick X-ray to assess your injuries, okay? Push another 50 of fentanyl.
You can put my arm back on, right? We're gonna do our very best.
Okay? I promise.
- My wife - We'll inform her right away.
This is a marathon surgery.
Could be 10 hours.
Are you sure you're up for it? No shame calling in reinforcements.
What reinforcements? Okay, let's page neuro and tell the OR we are on our way.
Let's go.
Heart rate and blood pressure are improving.
Sorry.
I got woozy.
It's okay.
You had a vasovagal response.
It could be triggered by a number of things.
The sight of blood, emotional distress How's Colin? Can they reattach his arm? They're still trying to figure it out.
It was horrifying.
It just keeps replaying in my head, over and over again.
You saw it happen? The gears on the conveyor belt They made a terrible noise, and then Colin started screaming and his arm ripped off his shoulder and went flying around, spraying blood everywhere.
It was on the floor, on the merchandise.
Some of it hit my mouth.
I Oh, no, it's happening again.
Alright.
That's alright.
We got you.
I have a woman pregnant with a transplanted uterus and her dead husband's sperm, and she's now experiencing pain.
I mean, should I be transferring her to a hospital that isn't on probation? Well, the hospital isn't on probation.
Just the surgical residency program.
And also this hospital's been through much worse.
Okay, that doesn't make me feel better.
But the transplant worked? Tovah's officially pregnant? Mm-hmm.
One uterus, two IVF cycles.
She is 11 weeks today.
That's amazing.
So, how much is David Hamilton offering you? - Sorry.
- Oh, come on.
The rumors are everywhere.
I made so many people angry by even considering it.
Bailey? And Richard.
Meredith Grey back in neuro, pissing people off? It's like I never left.
There she is.
My favorite student.
Hi, Richard.
You need to be trying to save the program, not sulking.
I am recruiting.
These are résumés for attending surgeons.
Right now, you need to be focused on keeping the residents.
You know when a program goes on probation, they panic, and flee, and we lose government funding.
Well, they'll stay if we have enough attendings to teach them.
No, no.
We will not hire any outside surgeons until we have assurance that our residents intend to stay and plan to give good reviews to the council's follow-up visit.
In fact, you will speak to every one of them.
Today.
And I will observe.
Where are you going? To line up residents to beg.
Highlight of my year.
Haven't done a full arm reattachment in years.
I've never done one.
Believe it or not, this is a career first.
- Irrigation.
- Good to see you back in an OR.
Are we ready to reattach an arm? Edges are all freshened up and ready to go.
Alright.
Let's make sure we have plenty of blood product on hand, and everybody buckle up.
We are going nerve by nerve, vessel by vessel, muscle by muscle.
I think we get the idea.
I'm gonna scrub.
V-fib! He's lost too much blood.
Push epi.
Starting CPR.
I know we have a blood shortage, but call for another three units! - Come on.
- Come on! Okay, back to sinus.
Hell of a first surgery back.
Owen, you saved his life.
But now he's too unstable to reattach the arm.
- Life before limb.
- I wanted to save both, okay? Let's get him up to the ICU and prep him for resuscitation.
That's your baby.
Heartbeat's strong.
Oh, my God.
Thank you.
Hi, baby.
Hi, sweetheart.
Sorry.
You don't need to be sorry.
I'm scared.
It's my last embryo, from the last of my husband's sperm.
- And it's still there.
- Yeah.
Okay, I'm gonna switch to Doppler now, Schmitt.
Have a look at the uterine vessels.
So, if the baby's okay, why am I feeling all this pressure in my belly? That is what we're trying to figure out, Tovah.
Have a look, Schmitt.
Oh.
What? What is it? Tell me.
It looks like there's diminished blood flowing to both sides of the uterus, Tovah.
Right side looks a little thrombosed.
It's a-a blood clot.
Oh, no.
Oh, God.
But the baby The baby is fine, okay? We just need to order some more scans.
Alright, let's order an MR angio right away, and page Webber and Grey.
I want their eyes on this in case we need an IR intervention.
Uh, both of them? They're They're having a little Yeah, I don't care.
I'm not a high-school teacher.
I don't care who's talking to who and who isn't.
Page Webber and Grey.
Yes.
Okay.
Step at a time, Tovah.
How's Colin? He's okay.
There was a slight complication in the operating room, but we were able to resuscitate him.
Thank God.
And his arm? At this point, he's just not stable enough to withstand a 10-hour surgery to reattach it.
So, you'll do it later? Unfortunately, without blood flow his arm won't survive much longer.
This is all my fault.
Yesterday, when I got to work, I saw that one of the conveyor belts was acting up again, but I didn't tell anyone to fix it.
When I got to work this morning, I wasn't paying attention, and then he switched it on.
I could have done something.
I could have stopped this from even happening.
Can I see him? Of course.
Think about all the military vets that we've seen lose limbs in combat, and they've gone on to live very full lives.
It's gonna be an adjustment, but - Wait, where are you going? - To find that arm.
I think I can save it.
Two rounds of IVF, 11 weeks today, so - Hey.
- Hey.
Um, we already have a general surgeon.
Oh.
Well, if I'm not needed here.
Yeah, that's a good idea.
Just leave and that'll fix everything.
You are, and she is.
You're not exactly subtle, you know that? Okay, as delightful as this is, I have a patient at risk of losing her uterus and a fetus, so if we could just focus up here, please.
Damn it.
The right outflow is completely clotted off.
The left side is severely stenosed, but salvageable.
We could do a fibrinolysis and dissolve the clot.
Not if you don't want to kill the fetus.
Well, of course I don't want to kill the fetus.
We could do a balloon angioplasty on the left side and see if that widens the blood vessel.
Let's prep her for angio.
You don't need the both of us there.
On a normal case, I wouldn't, but this isn't a normal case.
Tovah's making medical history.
We all are.
Look, I don't care what kind of giant dumpster fire this hospital is, I refuse to let Tovah burn with it.
So, we're all adults here.
Let's act like it.
- The ashes are falling.
- Oh! Hi, Bailey.
H-How are you? I'm desperate.
I'm in need.
And if I remember correctly, I've been very good to you when you were in need.
Do you need something specific? I need you back as a general surgery attending.
And I know how big an ask this is, and I wouldn't be coming to you if I had other options.
You want me to just give up my OB residency spot a year in? As soon as the program is off probation, you can return to OB.
Okay, and what if they fill my spot in the meantime? On average, I'm having to cancel seven scheduled surgeries per day.
That's seven patients who have to wait.
That's seven surgeries that residents do not get to assist.
If I had even one more attending on the schedule, you, well, I could cut that number in half.
Bailey Please, don't make me beg.
I don't like it, and I'm not very good at it.
Do I have to decide right now? You have to decide yesterday, if possible.
This hospital has given you a lot, Wilson.
Hopefully, you'll return the favor.
That little Band-Aid's supposed to monitor all my vitals? Heart rhythm, oxygen levels, respiratory rate.
There is even something to measure your sleep quality.
Whatever happened to the good old stethoscope? Alright.
Here you go.
Sorry, our Wi-Fi is not having it today.
Stethoscopes don't need no Wi-Fi.
Oh, it's up! It says he's dead.
- What? - Huh? Yeah, it Okay, hold on.
Ah! Try it now.
Oh, no, you're dead, too.
I find that slightly comforting.
You basically re-created an entire circulatory system to support the arm.
It's called ex-vivo limb perfusion.
It was being tested for military use when Teddy and I were in Iraq.
- Think it'll work? - I hope so.
I'll keep you both posted.
Thank you.
That's so cool.
Owen, this technique hasn't been approved for civilian use.
And if it works, what does it matter? - If the military finds out - Then they will say, "Congratulations, Dr.
Hunt.
You saved an arm.
" Do you really want their attention right now? I will cross that bridge if it comes to it.
Oh.
So your plan is to just wing it? Is that what you want to do with Leo? Owen, this is a big deal.
What happened this morning is a big deal.
Our son told us that he's a girl.
Yes, and you immediately said, "No, you're not.
" I know.
I'm sorry.
It It was a mistake.
We've We've let him wear dresses and we've laughed and smiled, but maybe we should be paying closer attention.
We can't just wing it.
Think about how your mom is gonna react.
We need to have a plan so that we can try and help him.
The only thing that needs help in this exact moment is our patient.
So, can you please just go and check on him while I try and keep this arm from dying? Four generations of surgeons.
All students of Dr.
Richard Webber.
Technically, it's three generations, plus Dr.
Webber.
I-I literally don't know why I'm talking.
You know, there was a time when being my student meant something.
But now, there's no loyalty.
Spare me the loyalty speech, please.
In case you're curious, Schmitt, Dr.
Montgomery was a machine during her residency.
There was a stretch where she and Derek Shepherd were my students.
We're doing this now, huh? They did these gauntlets of back-to-back surgeries over the course of several days.
I mean, no sleep, barely a meal break.
I mean, it was astonishing.
That's one version of the story.
Care to elaborate? Not particularly.
Let's just say that my memory of that time isn't quite as romantic as yours, Dr.
Webber.
Well, would you prefer that I talk about your residency years instead, Meredith? No, I would not.
Of course the HeartPatches are garbage.
My brother is a walking pawn shop.
Maybe we got a bad batch.
Or maybe we didn't apply it properly.
Yeah, you know, somehow, I doubt that.
Okay.
Let's see.
Hey, your pulse ox is good, heart rate is good.
Why don't you try doing something to increase your heart rate? What are you doing? What are you doing? I am increasing my heart rate.
Is it working? Actually, yeah.
Mm.
Oh, no.
Oh.
Well, I know you're not dead.
You wanna stop and go tell Wendell right now? Mnh-mnh.
Nope.
Hey.
If you tell me this coffee's only for attendings, I will break the pot into a thousand pieces.
Okay.
I'm sorry for earlier.
You deserve a nice guy.
It's Bailey asked me to come back to general surgery to save the program.
Wow.
Yeah.
So, what are you gonna do? I don't know.
I just Can we grab dinner tonight? I just I need to talk this through over several drinks.
Aren't you going out with Todd? Yes, but he doesn't talk medicine or accreditation probation, so can you please just join us? Unless it's weird.
Nope.
Not weird.
I'll do all the pros and cons of vaginas versus colons.
With the nice guy you're dating.
Thank you.
Joe's? - Of course.
- You're the best.
Oh.
Thank you.
Yeah.
So, um, ooh, what are you gonna tell Wendell about the patch? Uh, I'm gonna tell him the truth.
These don't work.
It's a medical device.
What if Grey-Sloan bought them? While on probation? - This place cannot - Whoa! Maggie, Winston.
What's up, bro? You never texted me back.
Is your shirt inside out? Yeah, I'm I'm just Wait, are you gonna leave us a review? 'Cause, you know I work off commissions, right? And, uh, a rave from a renowned heart surgeon would definitely give me a sales bump.
These don't work.
Ah, get out of here.
What? Oh, oh, oh.
You know what? I-I know what the problem was.
I gave you the beta models from testing.
No, these These are discontinued.
Let me give you the retail model.
Fully FDA approved.
Okay, yeah, I guess we could try those.
Right, Winston? Right.
Let's go.
Inflating the balloon.
Let's get the stent ready.
When did it become a thing that we "owe" the hospital that we did our residency at? You trained at Columbia.
I don't see you still working there.
I don't think that's what anyone's saying.
I have earned the right to spread my wings.
Of course you have.
But it's not just about that.
Amelia told me that when you had COVID, this place nearly broke without you.
100%.
The hospital broke because of COVID.
And you weren't there to lead them through it.
I may remember you as a featherweight in light blue scrubs, but apparently, you've become some sort of hospital mascot in the years since then.
Okay, removing the catheter.
You know that Richard's not mad because he's losing a surgeon.
I'm not his student anymore.
You were never just his student.
Fetal decels.
The uterus isn't getting enough blood flow.
Contrast and shoot fluoro.
That left vessel is completely clotted off.
It's over.
Damn it! Okay, um Let's prep an ex-lap and remove the uterus and fetus.
Okay, no, no, no.
We can do a vascular revision.
If we can harvest the saphenous vein, we can maybe bypass the thrombosed vessels and save the pregnancy and the uterus.
Prep the abdomen and leg.
We're opening her up, and Richard, I swear, if your head's not in this I'm right here.
Let's do it.
Scrubbing in.
Oh, Dr.
Wright.
Do come in.
I've heard so many good things about you.
Wow.
Really? Yes.
Dr.
Bailey is quite the fan.
Well, uh, the feeling's mutual.
Dr.
Wright, why do you draw? I mean, I know you draw every surgery before you perform it, but why? I'm ambitious, Dr.
Bailey.
I always knew I wanted to be a surgeon, but it's hard to have the patience it takes Doing every step without getting ahead of yourself.
But when you draw the body, I mean, you see the body, yeah, but by taking the time to draw it, you're telling yourself that the body's worth your time, worth taking a closer look at.
So then, when a body's on an operating table, it's it's not something trying to defeat you.
The body's a work of art.
What's this? Um, it's the, uh, forms to complete your transfer, uh, back to the Clinic.
Oh, you mean from the Clinic? I called your program director in Minnesota.
They still haven't filled your spot.
- Miranda.
- Did I do something wrong? Quite the opposite.
Your work is stellar.
You are one of the finest residents I've had the pleasure of teaching.
Which is why you need to leave.
Dr.
Bailey, can we have a word outside, please? This is my office.
If you want a word, you can have it here.
Dr.
Wright, what Dr.
Bailey's trying to say to you What I am trying to say is if I fail to save this program, which I might through no fault of my own, every resident will be orphaned.
I don't know if you'd be able to get a spot somewhere else, and I want to protect your future.
So, please, go back to Minnesota.
And hey, you can still learn from Meredith Grey out there.
Clot scissors, please.
Cutting the vein.
Removing the vein.
Syringe, please.
Let's flush the vein.
No leaking.
Perfect.
Here you go, Dr.
Webber.
Suture.
One more.
There we go.
I think we're done here.
Okay.
Unclamp.
Unclamping.
Sponge stick.
Blood flow looks good.
No leaks.
I think we did it.
Schmitt, go and get the Doppler and check the fetal heartbeat.
Stand by.
Schmitt? No.
No.
No! Addison, I'm so sorry.
Yeah, me, too.
Okay, let's prep for a D&C.
This looks like the same model.
It is.
There is no other model.
I don't understand.
I got a loan, and I bought it.
All of it.
You're saying it doesn't work? Look, Winston, if I can't sell this stuff You got a loan? Yeah, like Like, from a bank? Not from a bank.
How could you be this stupid? No, you know what? How could Ibe this stupid? You said you had a real job.
You were working on commission.
You lied to me.
It works.
I swear.
I-I saw it on an online presentation.
Oh, my God, dude.
Look, I saw an opportunity.
Surgeons in the family, direct connection to the Fox Foundation.
Look, I put the pieces together, and I went for it.
How much are you out? 10 grand.
Look, everything I have is in this.
If you're saying it doesn't work, if if I can't sell this stuff you have to help me sell it or pay back the loan.
Wendell If you're my brother, if we're family, you will.
You have to help me.
Please.
Colin's wife is half an hour away.
It worked? Yep.
Toxins are flushing, arm is looking pink, and tissue is oxygenating properly.
That's great news.
Listen, Teddy, I'm not winging it with Leo, okay? I'm just I thought this might happen ever since he started wearing a tutu, didn't you? At four? No.
I thought we were raising a son who loves dress-up.
Teddy, if Leo says, "I'm a girl," - I'm gonna listen.
- So, that's it? We're just gonna tell everyone that Leo's a girl now? What, before he can even tie his own shoes? Maybe? I don't know.
He might change his mind in two months.
Then we'll just tell everyone that he's a boy again.
Won't that be even more confusing? I don't know, Teddy.
I don't have all the answers, okay? I just think we have to follow his lead.
Meredith Grey.
Catherine, I can't do this right now.
You would leave this place right when it - Catherine - Do not interrupt me! Please don't talk to her that way.
You are not her boss, nor are you mine.
- Boss? - Excuse you? This is about honor.
This is about the standing of this hospital.
- Okay, can we not do this? - The standing of this foundation! Can we just stop?! For a minute.
A woman just lost her pregnancy.
A pregnancy that she fought for with everything that she had left in her body.
Through grief, through pain, through loss.
She fought and she lost her pregnancy.
Can we just take a moment and honor her? Just a moment to honor Tovah? Mrs.
Renfield, your husband has been through major trauma.
Will he be okay? He has to be okay.
We've given him some time to stabilize, but we've scheduled his surgery for first thing tomorrow morning.
It was touch and go, but in the end, we were able to save it.
We're gonna reattach the arm.
Thank God.
Thank you.
Thank you so much.
I'm so sorry, Tovah.
We'll try again, just as soon as we can.
When my grandfather died, our rabbi taught me the Mourner's Kaddish.
I know it's not really the normal time to say it, but it's always helped me.
Yitgadal v'yitkadash sh'mei raba b'alma di-v'ra chirutei, v'yamlich malchutei b'chayeichon uvyomeichon uvchayei, d'chol beit yisrael, ba'agala uvizman kariv.
V'im'ru.
Amen.
Amen.
I feel like I failed her.
Her uterus is still intact.
She can try again.
Yeah, but not with her husband.
You really don't remember your residency fondly? Do you? Oh, come on, Richard.
You changed my life.
Okay? But I remember pain.
I remember insomnia.
I remember bullying attendings.
I remember learning to treat patients as wins and losses instead of people.
Took me years to unlearn that.
I mean, people haven't complained before.
I mean, not like this.
Come on.
We couldn't complain.
I couldn't complain.
The surgery world's small.
If you complain, you lose your spot, and you never get it back.
That was the culture, and you know it, Richard.
Look, you know, you are trying to save a version of the program that is old.
It's broken, alright? You gotta stop with the reminiscing about the past and look to the future.
What's the new way to train surgeons? I tried that.
It got us shut down.
Well try again.
So, if you say yes Then I could lose my OB residency spot.
And if she says no, then the chief of surgery asked her for a favor, and she was like, "Nah.
" Got it.
So, it's a Hobson's choice.
Mm.
When you're offered a choice and there's really only one option.
Oh.
When I was in grad school, I told my dissertation chair that I wanted to study the impact of climate change on global migration.
So, in addition to environmental science, it would involve public policy, sociology, and geography.
Is this story your way of telling us you have a PhD? I already knew that, but isn't that what you studied? Yeah.
I decided to go for it.
I basically lived at the library, but I did it, and I didn't have to spend a year of my life studying the atmospheric effect of moss, which is what she wanted me to do.
I mean, no offense to moss, but point is, maybe you could do both.
I mean, I know it'd be more work, but if that's what you want, I say go for it.
What he said.
Yeah.
Keep your residency and moonlight for Bailey.
I've seen you handle worse.
But I have a baby.
I have a tiny human.
- Right.
- It's only for a few weeks, or a few months, and, uh, I can help you out with Luna.
I could help with Luna, too.
Yeah, no, scratch that.
Next round's on me, though.
- Okay.
- Okay.
Hey.
Hey.
I want Leo to be happy.
I never wanted anything but happiness for our kids.
But I just, uh I don't want to mess this up, and it just feels like there are a million ways to get it wrong, and if Leo were 10, then we'd be having a different conversation, but he's not, and, you know, neither one of us has done enough research to know how to handle this.
And I want to get it right, and going all-in now, it just it doesn't seem right, Owen.
Hey, you remember when Leo said that he was an owl? Did you feel the need to, you know, call him silly and correct him? - No.
- No.
No, you just loved him.
You just let him explore.
Let's just love Leo, okay? Let's listen when he tells us who he is.
It's more complicated than that.
Yeah.
Yeah.
It is.
Then let's get a therapist.
But for us.
For us, not for Leo.
I'm not correcting Leo.
I'm not telling Leo that there is something wrong with Leo.
Let's not be our kid's first bully.
Yeah, I agree with all of that.
I-I just What if we don't agree on the approach? Honestly? Honestly, I don't know.
Therapy it is.
Yeah.
I was in pain when you came to see me.
You dumped me and told me to go away.
I know.
I did.
But when you were in pain, I kept showing up.
I guess that's the difference between me and you.
Um, I-I've arranged a phone call for us with a major consultant to help us with a more formalized plan.
Where are you going? - On vacation.
- What? I haven't just taken a vacation day ever in my life, and I have a new little girl at home, two teenaged boys who haven't seen both me and Ben in the same room in months, and they need me.
This hospital needs you.
Yeah.
This hospital needs too much of me.
No, I'm done being the superhero.
If Meredith Grey can go away, then so can I.
Miranda Catherine, I respect the hell out of you.
You know I do.
And I know you understand what it's like to be a woman at the top of her field who isn't allowed to rest.
So, I need you to hear me when I say I'm not quitting, I'm not taking a leave or saying that I can't handle this job.
I am taking a vacation day.
Maybe two.
'Cause I'm no good to you like this.
Put simply, burnout comes from a deep imbalance.
Too much stress with too few rewards.
You're exhausted, depleted.
You no longer have patience, pleasure, or serotonin.
This is the end, unless What are you doing here? Well, you know what? I don't even care.
I'm so happy to see you.
No, but ask me.
I have a speech.
Oh.
Okay.
Nick, what are you doing here? Don't come to Minnesota.
Look, if you leave right now, your people won't be okay, and you won't be okay.
You won't be happy, and you'll always resent me just a little bit.
And I know you have kids.
They're gonna have to get used to me being around, but I am gonna get my own place, and we are gonna do this thing the normal way.
You know, having dinner together and not having to get on a plane just to kiss each other.
And look, I have days, I have tons of personal days, and I'm taking a few months and I'm staying here, and I'm gonna work locum tenens at Grey-Sloan, and we can be together.
Here.
I have the right to leave.
I've earned the right to leave.
Other people from my residency class, they left and took other opportunities.
I stayed.
I worked.
I researched.
I won awards for that place.
I did everything that was expected of me, and then some.
And now, if I want to leave, I'm considered disloyal? It's ridiculous.
It's absurd.
You know what else it is? It's my decision, and I've made my decision.
So this is all very patronizing.
Okay.
I-I wasn't suggesting we stay here forever.
I'm suggesting we stay long enough to save the program.
And then we can go to Minnesota.
We can go wherever we want, because you have absolutely earned the right to leave.
You couldn't have led with that? I thought I had.
I'm sorry.
Now you've seen my angry side.
I'm not gonna lie, it was kinda scary.
You turn it into something else and find your path to recovery.
What? Okay.
Fine.
We can stay.
But just for a little while.
Pick the pieces you want from your life and find a new way forward.