Grey's Anatomy s21e05 Episode Script
You Make My Heart Explode
1
MEREDITH: Every time a surgeon operates,
it's for the first time all over again.
- I'm feeling it now ♪
- [SIGHS]
I rise above ♪
Nothing bringing me down ♪
- Ohh! Wha What are you doing?!
- Huh? I'm hiding from James.
I just saw his car pull up.
I thought you liked him.
I did. We had sex.
- Oh.
- Twice.
And then I find his
wedding album. To Ryan.
I had sex with Ryan's husband.
- How did I miss this?
- This is not a problem.
He is a man of God who cheats.
- I'm pregnant with twins.
- [GASPS]
Hey. I I can see you! Can we talk?
- Whoa!
- Brought you tea!
Oh. I can't hear you!
Ask him if it's caffeinated.
Fine. I'll get coffee from the cart.
Look, I know this is a lot,
but we'll figure it out.
We're gonna get a night nurse.
My mom can move in for a while.
I'm moving up ♪
- Where are we going?
- The other entrance.
Even if you've done
hundreds of kidney resections
or heart transplants,
you've never resected this kidney
or transplanted this heart.
Past experience usually helps,
but for unique cases, you fake it first.
No. Sorry.
Then who are those for?
Me. I'm going to put them in the fridge.
I don't have time to come back here.
Hope you made time for an EKG
after consuming 400
milligrams of caffeine.
I have taken two of
Yasuda's shifts this week.
Same. She and her sister
really appreciate it.
Well, not enough to share her
mom's cookies she sent her.
I'm just glad that Chloe
seems to be recovering well.
WOMAN: Excuse me. Have
you registered to vote?
- Already registered.
- Yeah, me too.
- Same.
- Not my thing.
You rehearse on replicas
for hours on end,
and hopefully when the real
patient is on the table,
you know what you're doing.
Lots of people put sex on the calendar.
MARSHA: When you're
juggling two busy schedules,
it's perfectly normal
to schedule intimacy.
- Okay. You schedule a haircut.
- [GROANS]
I do not want to have to
schedule sex with my wife.
Why do you think this bothers you?
It feels like she's
not trying to fix anything.
You know? We are hemorrhaging,
and she's just reaching for a Band-Aid.
So if I don't want to fix our
problems the same way that you do,
- that means that I'm not trying?
- No, no, no.
Unfortunately, we
have to stop for today,
but I want you to see this through.
Have scheduled sex this
week and see how it feels.
It might not be what you
think. For either of you.
Well, I guess I'll see you
at 10:00 tomorrow night.
Um, would this be a bad time to tell you
that I have to reschedule?
[KNOCK ON DOOR]
Hey. Haven't seen you in a while.
I know. Yeah. Sorry. It's been busy.
[BOTH CHUCKLE]
- Been meaning to give this to you.
- Oh.
Yeah. Left it at my place, so
- Yeah.
- Oh!
- Mm-hmm.
- Ha-ha. Yeah.
I guess you have been really
busy. Because this is not mine.
- [STAMMERS] You sure?
- [LAUGHS] Yeah.
It's a really nice color, though.
- She has good taste.
- Oh, my God. I'm so sorry.
[DOOR OPENS]
Hey. You needed a consult?
Uh, I have a patient coming in
from Friday Harbor with a head injury.
The local hospital's
sending in the scans.
- Should I come back?
- No.
I was just leaving.
I'm gonna go.
Have the nurses page me
when the scans are in. Heh.
Hm.
- [DOOR CLOSES]
- [SIGHS]
BEN: Schmitt is with Dr. Beltran today,
so I've got your assignments.
Let's do a lineup. A lineup.
It's something we did at the fire
station to get the day started right.
Discipline, organization.
Or you can stay exactly where
you are. That works, too.
So, Yasuda's out on PTO today.
But, Adams, you're with
Schmitt on Beltran's service.
Millin, you're with me and Ndugu.
Griffith, with Lincoln.
Um, you forgot someone.
And you've forgotten your dictations.
There are over 100 incomplete
records with your name on it.
Have fun staring at a computer
all day playing catch-up.
[GROANS]
WOMAN ON P.A.: Orderly to 6 East.
Any available orderly to 6 East.
Are you lurking?
Okay. Your your evaluation
forms were sent out today.
I know. Ndugu will be the first one
who will officially assess me.
You know? How do you know?!
Um, you left your laptop open
on the kitchen counter today.
Hey, hey, hey. You lurk, I snoop.
Okay. Just just
Mnh. Just be yourself!
I've never been to Friday Harbor.
I went on a field trip in seventh grade.
We picked apples.
Hey. Today you are
picking up Ofelia Lopez.
She's 10 years old. She
fell off a moving tractor.
Her vitals are stable, but she's got
a bad leg injury and a TBI,
so she needs a higher level of care
than her community hospital can provide.
I would go myself, but I
got a full patient roster.
I don't mind getting
out of the hospital.
- It's a nice drive.
- I'm sure it is.
But you're taking a helicopter.
- No!
- Nice!
Taking an ambulance would
be more cost-efficient,
m-more environmentally friendly.
- And it's not up in the sky.
- Update me when you arrive!
♪
[BUTTON CLICKS]
♪
Morning, Mr. Riley.
No, no. Left, right, left.
The other left, Kenneth. Ugh.
Instructions go in one ear
and out the other with this kid.
Maybe he's missing his director, huh?
He's missing something, alright.
[CHUCKLES] Go ahead.
Uh, Darren Riley, 55, presented with
antibiotic-resistant
pneumonia with a concern
for a rapidly progressing
necrotizing infection.
Was intubated but couldn't oxygenate
despite maximal ventilation settings.
Placed on VV ECMO and
was extubated last night.
Mr. Riley's X-rays from this morning.
Left lung's completely whited out.
WINSTON: Let's order
him a CT with contrast.
Mr. Riley, I'm gonna change
your cannula dressing.
Well, I can take care of that
as soon as I place this order.
We'll just meet you in radiology.
That's not necessary. I want
to help with transport anyway.
Oh, but we can handle that.
Moving a patient on ECMO can be tricky,
so I'd like to be there for it.
Okay. Uh, great.
All risks and benefits were explained
and patient agreed to
sign informed consent
- [GROANS]
- Hey. Are you okay?
Yeah. Yeah. Good. Must have slept funny.
[CHUCKLES]
The patient was taken to an
operating room and placed
- [ZAYNE GROANS]
- Hey. Are you sure you're okay?
I could take a look if you want.
[ZAYNE GRUNTING]
Someone get me a gurney!
♪
Mr. Wheeler, how are you feeling?
Fit as a fiddle. Think
I'm about ready to go home?
Not quite yet. I saw some
fluid building around your heart
on this morning's echo.
It's a common complication
after heart surgery.
We might have to do a
procedure to drain it,
in which case we'd have to
keep you a little bit longer.
Oh, no. I can't stay longer.
I have to be home next week.
It's my 40th wedding anniversary.
Congratulations. That's a big milestone.
Hey, why don't we watch it and
see if it resolves on its own
before we jump into a new procedure?
Macie and I got engaged when we were 19.
She wanted this big church wedding,
but our parents didn't approve,
so we eloped at city hall.
[CHUCKLES] We know how that goes.
We wanted to get married in the park,
but we wound up doing it in a bar.
Every year, we recreate
our wedding dinner
hot dogs from the cart on the corner.
You know, we should go to
Joe's for our anniversary.
It's the only place we ever go.
Look, I want to run
another set of coags,
and we will take it from there.
Get her flowers on your way home.
Works every time.
- Thanks for the tip.
- Yeah.
WOMAN ON P.A.: Dr. Horowitz,
6-2-9-6. Dr. Horowitz
Thanks for making the
trip. She's got severe
left lower extremity trauma,
extensive soft-tissue damage,
as well as vascular injury.
Suffered some head trauma
with multiple contusions
and lacerations.
- Okay. Hi.
- Hi.
LEVI: Her respirations
look a bit labored.
Her sats were in the
80s when she arrived.
The oxygen's helped.
- But you didn't intubate?
- Our only ventilator's in use,
and we don't have the
resources to manually bag her
- if we did RSI.
- Okay.
NANETTE: We rushed her
here as soon as we could.
This doctor said you'll
be able to help her more?
Will her leg be alright? She
loves to play in the fields.
I'm Dr. Schmitt. This is Dr. Adams.
We'll have a better idea
- once we examine her, okay?
- Okay.
We temporized with a
splint and tourniquet.
Ischemia time is about 45 minutes.
Um
Hi. I'm Levi.
Your name's Ofelia, right?
My friend Lucas and I are gonna
help make you feel better, okay?
Okay.
Okay. This is my number.
We're gonna get to
Grey-Sloan before you,
so once you get there, give me a call.
Wait. We can't go with you?
I'm so sorry. There's not
enough room in the helicopter.
But I promise we'll take
excellent care of her, okay?
- Okay.
- Okay.
♪
- JOSE: We love you, mija.
-
♪
We're gonna have to amputate the
leg if we don't get back fast,
- so let's intubate for transport ASAP.
- Okay.
[SIGHS] Back to the helicopter.
Dr. Kwan? Aren't you supposed to
Look, I know I'm behind on charts
and when I'm behind,
it becomes your problem,
and you don't like problems.
Uh, is that Zayne from custodial staff?
Yeah, he, uh, collapsed
with a severe abdominal and hip pain.
Mr. Johnson, I see you took
that whole rack down with you. You okay?
Pain started way before that rack fell.
I've been managing it
fine for months now.
Alright, well, we need
to get you to the E.R.
to get you checked out. Hospital rules.
I'll just take something
once my shift ends.
Let me save you the trouble.
You can fight her on this,
but you will lose. We all do.
- Can you make it quick?
- I will make it thorough.
Come on. Let's go.
You too, Kwan!
- Doctor should be in soon.
- Okay.
We are never going to fit
four car seats in either of our cars.
Are we gonna have to get a minivan?
You know what's transporting
those babies right now?
Me!
Every horrible pregnancy
symptom, double it!
Twice the the reflux,
the weight gain, the exhaustion.
And then after all that,
I'm gonna return to work,
delivering other people's babies,
taking care of not
one, but two newborns.
But, sure, by all means,
you go test-drive minivans.
How can I help?
I wish I could tell
you, but all the energy
that used to go to my brain
is now being diverted to my uterus.
- [PHONE BUZZING]
- You know what?
I really need this to
not take a long time.
I have a patient who is 29 weeks
and she's about to deliver triplets.
Three babies. Hmm? [CHUCKLES]
Could be worse! Heh!
You want three?
[PHONE BUZZING]
[SIGHS] A consult in the E.R.
Just go.
I'm staying for the ultrasound.
It's gonna show the
same as it did yesterday,
and then you're gonna smile
and say, "We've got this."
And right now I really
I frankly don't
really don't need that.
- [EXHALES HEAVILY]
- [DOOR OPENS AND CLOSES]
Did you play? Marching band?
No.
Cool. Me neither.
Oh, I didn't do sports.
But it's band.
Do they wear uniforms?
Then I didn't do it.
[BEEPING]
Oh. Damn it.
His lung is completely liquified
from all the necrotic tissue.
[SIGHS] What's your recommendation?
Chest tube and change the antibiotics.
Oh, a chest tube won't drain this,
and the antibiotics aren't penetrating,
so we'll need to completely
remove the source.
The source is his lung.
Book an O.R I'm gonna
get him off the table.
Well, don't you want us to
get him [CLEARS THROAT]
Does he normally have
to do everything himself?
Well, he let me sew a patch
graft angioplasty once.
Maybe it's you.
[DOOR SLIDES]
SIMONE: When you say
it's "not your thing,"
you don't mean like
you never vote, right?
Like it's a recent thing?
- What about in 2016?
- What do we got?
Uh, Zayne Johnson, 32.
Diffuse pain, greatest in
his abdomen and right hip
after a supply rack fell on him.
We're still working on his history.
Do you take any medication?
How much room do you have
on that thing? [GROANS]
I take folic acid,
hydroxyurea, ibuprofen,
and tramadol as needed.
- You have sickle cell?
- Yeah.
And I know about that new
gene therapy that cures it,
but my insurance won't cover it
and I don't have $3
million laying around,
so I still got it.
FDA approves a cure, and
nobody can afford to get it.
If I had three mill, I wouldn't
want to spend it on treatments.
I'd buy a boat and
sail around the world.
I was kind of in the middle
of another patient upstairs.
Yeah, I brought you here for that hip.
The articular surface
is completely destroyed.
Griffith, take him upstairs for an MRI.
And we should also get an abdominal CT.
- No, no. I
- Ah. It won't take long. Okay?
If there's anything you need,
you let these interns know.
- Don't be shy.
- [GROANS]
[THUNDER CRASHES]
PILOT: We've hit a bit of rain and fog.
I'm trying to steer us out of it.
Think about puppies.
Gravity blankets. Wizards and adventure.
Well, either somebody died
or you're ghosting someone.
I am ignoring a mistake.
And don't look at my phone.
Is it the guy from the hallway?
So what? Does he hate dogs?
Puts the toilet paper on wrong?
Does he not know how
to cook a real meal?
Do you? I'm just saying.
Just because it's a bad match
doesn't mean it's a mistake.
You're right. It wasn't a mistake.
It was a giant failure!
[THUD]
- [RAPID BEEPING]
- Oh, my God.
Her blood pressure spiked.
She might be herniating.
Okay.
[MONITOR BEEPING RAPIDLY]
Her pupils aren't blown.
Actually, they're pinpoint.
Her heart rate's in the 50s.
- Okay.
- Okay. We got you.
Okay. We got you. We got you.
She's diaphoretic, bradycardic.
Her eyes are tearing up.
We keep having to suction her.
Her parents said that she likes
playing in the fields, right?
The farm probably uses pesticides.
Are you thinking
organophosphate poisoning?
Yeah. Let's get her on atropine.
Okay. Oh. She's seizing!
Oh! Oh! Okay.
Damn it. The tourniquet.
Did it come loose?
No. The clasp is broken.
We have to stop this bleeding!
- Holding pressure!
- Yeah, I got her leg!
Find the atropine!
[THUNDER RUMBLES]
Hey, uh, Aurelio's labs are back.
Okay. Great. Thank you.
Can I get an ultrasound and
a pericardiocentesis kit?
I just need to finish
reviewing these scans.
Teddy, it's still a small effusion.
He's coagulopathic. I
mean, we can either do
the pericardiocentesis now
or we can wait till he crashes
in the middle of the
night and do it then.
We don't know that's gonna happen.
Didn't you accuse me
of what was it
putting a Band-Aid on a
hemorrhage this morning?
What does that have to do with this?
So now I am trying to
face this problem head on,
and that doesn't seem to
be good enough, either.
I mean, forget about
my years of experience
treating pericardial effusions. Teddy
[CLEARS THROAT] Uh, I was
just getting a cup of tea.
Oh, well, um Well,
we were just, um
We were just discussing a patient.
Look, I can give it another hour,
but then we're gonna
need another set of scans
and a repeat echo.
Okay.
Oh, you should try the Moroccan Mint.
It's very, uh refreshing. Hm!
SIMONE: What about local elections?
State propositions? Or public surveys?
I send those straight to spam.
LINK: Griffith, what are we looking at?
Studying his abdominal CT.
His hip MRI is about to come up.
You can relax, Zayne.
Pretend you're in that $3-million boat.
That's not relaxing. I get seasick.
But you want to sail around the world?
No, but my son does, and
I'd do anything for him.
SIMONE: Is that his
spleen? It's so small.
Pretty much nonfunctional at this point.
Also, those are iron
deposits in his liver.
Should we take care
of his gallstones, too?
The gallbladder wall's
not acutely inflamed.
- [LINK SIGHS]
- The sickle cell has
- basically ravaged his body, including
- His hip, which you all
would have seen if you
noticed his MRI was up.
He's got subchondral collapse and
flattening of the femoral head.
We're gonna have to
replace the whole joint.
Oh, he's not gonna like that.
We don't have a choice if
he wants to stop this joint
from completely degenerating.
♪
Hey. Did you get the films
from my transfer patient?
Schmitt and Adams are
worried about the leg.
- My fellow will need to take it.
- Okay.
Hey. I took a look at Ofelia's scans.
Minor subdural. No swelling, no shift.
I'm not terribly worried, but I
will re-evaluate when they land.
Their ETA is 25 minutes.
Okay. I'm gonna check on a patient.
Text me if they get here sooner.
Hey. A-About earlier,
it wasn't exactly what it looked like.
- Uh, none of my business.
- Okay.
LUCAS: The tourniquet's
completely broken.
I can't get it to hold tight enough.
I'm gonna need another one.
Oh, it looks like there's an injury
to her superficial femoral artery.
There's another tourniquet in this bag.
Hold as much pressure
as you can. Got it.
[GRUNTS] Here.
Alright.
♪
Once we get a signal, we
need to update Beltran.
♪
Got it.
♪
Damn it.
It's basically beyond repair.
She's gonna need an amputation.
Well, we have I.V. tubing.
What if we make a temporary shunt,
see if we can reconnect the
femoral artery with the tubing?
If the pilot is re-routing,
it's gonna take us a
lot longer to get back.
The tourniquet's been
on for almost two hours.
The leg looks ischemic.
If we do nothing, she'll lose it.
[THUNDER CRASHES]
♪
- Okay. Yeah. I'm in.
- Okay. Alright.
[SIREN WAILS]
So, if you take my lung, I'll
be rid of this thing here?
Unfortunately, due to
your smoking history,
your other lung won't be
able to oxygenate your body
well enough by itself.
You'd have to stay on ECMO
until we can get you a lung transplant.
Any chance that happens before
the NorthPac Band Review?
JULES: We don't know.
It could be tomorrow.
It could be weeks from now.
There will be other performances.
I was thinking about my alto sax.
First instrument I ever picked up.
Thing was nearly bigger than me.
But once I got the hang
of it, I fell in love.
I haven't been able to play in weeks.
[BREATHING SHARPLY]
What if I can't ever play again?
Or, worse
what if I can't teach?
The band's more than just my job.
It's my life.
Well, music and teaching,
it's in your bones.
Losing a lung won't change that.
Just might need a little
extra practice after surgery.
That's all.
Let's get you prepped.
♪
Mr. Johnson?
Dr. Bailey and Dr. Lincoln
would like to talk to you.
I have to finish work so I can get home
for dinner with my son.
Uh, your scans show something called
avascular necrosis in your hip.
I'll make an appointment to come back.
My son needs extra attention,
and my sister's had him all day.
Your pain is only gonna get worse.
The sickled cells in the joint cut off
the blood supply to the bone,
which is causing it to die.
But we can replace the joint today,
and your insurance covers it.
And then I won't feel pain?
Well, we can at least help
with the pain in your hip.
So instead of curing my pain,
they're gonna let every joint and organ
in my body deteriorate and
then they'll pay to fix it?
I know. It doesn't make
sense. And the system sucks.
Maybe I shouldn't say that, but
I've been through this before.
I know the frustration of
trying to fight a system
that doesn't care if you suffer
or even if you live or die.
They only see you as a code or a cost
or some number in a sea of numbers.
The system couldn't care less about you.
But if you care about yourself,
you should get the surgery.
[EXHALES SHARPLY]
SIMONE: Think about your son.
If you weren't able to walk
or continue to do your job,
it'll be a lot harder
to take care of him.
♪
Okay.
What's next?
I'll go tell Dr. Lincoln.
Don't bother. I'll do it.
[KNOCK ON DOOR]
Oh. Uh, I'm about to
meet with Balcom Medical.
You know, I've always
had a great relationship
with Ethan Chen,
so if there's anything
the hospital needs,
- I'm your man.
- Oh. Ethan is retired.
Oh. Well, good for him.
Yeah, the new CFO is Erika Desai.
She is great.
But her husband Nirav's
also very prominent on the board,
and he only hears what he
wants to hear, which is himself.
Ooh. It sounds like
a communication issue.
And he often overlooks
how hard I am trying
to make everything work!
And then he insinuates that I only
care about what is best for me,
regardless of what anyone else wants.
You mean what's best for the hospital.
This isn't about Balcom, is it?
So you want advice or a pep talk?
Is there one that's less
irritating than the other?
You've already been
through a war together.
- You can do this.
- That's the least irritating one?!
[SIGHS]
WINSTON: Tissue's very fibrotic.
- Millin, suction?
- JULES: Got it.
BEN: My mom really wanted
me to learn an instrument.
Then my fourth-grade class
got sent home with recorders.
My brother and I were
learning the accordion
- for a few months.
- Didn't stick with it?
Our teacher didn't want to be
paid in lemons from our yard.
- [CHUCKLES]
- I'm at the hilum.
You need more retraction?
- That'd be great.
- Harrington, please.
BEN: Oh.
Could you hold that right there, Warren?
- Uh-huh.
- Thank you, Bokhee.
With all due respect, I
may be on a trial basis,
but I'm coming in as
a fourth year resident.
I'm perfectly capable of retracting
and prepping patients for transport
and moving them to the CT.
Hell, I'm capable of
a lot more than that.
Alright. Specimen.
Here we go.
[DRILL WHIRRING]
How's he doing?
SIMONE: Feels like this could have been
a much less extensive surgery years ago.
BAILEY: Well, seeking treatment
when you have sickle cell
is a minefield of stigmas
and misunderstandings.
That's not on Zayne.
Kwan, careful with the drill!
This bone is like stone!
[DRILL WHIRRING]
You know I'll take over.
BAILEY: Oh, let him give
it another try. Go again.
Easy this time.
[DRILL WHIRRING]
Put put the drill down!
BAILEY: If he doesn't
try again, he won't learn.
We're not doing second
chances right now.
This man is in constant, agonizing pain.
And I'm just talking
literal physical pain,
not the hell of suffering in silence
because nobody cares or believes in him.
It's the only way he can get by,
even though it causes more
pain and more suffering!
Damn it!
Someone get me a new drill bit!
BAILEY: Are you done?
Yeah. Whatever you're going through,
go through it on your own time.
We are taking care of Zayne right now.
I cannot take care of you, too.
[MONITOR BEEPING]
[DRILL WHIRRING]
♪
Suction, please. Adams! Suction!
I'm trying!
- I just have one more tie.
- [THUD]
Oh! Oh, my God! Ohh! Okay.
Whoa!
- Let's do this fast.
- Alright.
Okay.
Ah! Damn it! Can't get it to stay.
- Can you hold it, please?
- Yeah.
♪
Okay. [GRUNTS]
- I think that's it.
- Okay.
Tourniquet coming off.
Okay. Okay.
♪
It's holding.
- [LAUGHS]
- [CHUCKLING] We did it.
[THUD]
Ohh! What's happening?!
I don't know! I can't see anything!
PILOT: I can't get around this storm!
I'm gonna attempt an emergency landing!
♪
Macie. Macie.
How long has he been like this?
15 minutes. Muffled heart sounds.
Low BP, JVD.
Cardiac tamponade. This is why I
wanted to do the procedure earlier.
- He wasn't this symptomatic.
- Alright.
We're gonna need to reopen
him and relieve the pressure.
We're doing a needle aspiration
bedside. We're already prepped.
It's much more controllable in the O.R.
MACIE: I'm his wife. Let me through!
There's blood seeping out
of his incision already.
We don't have time. Scalpel.
I'm right here, dear.
[MACIE SCREAMS] Oh, my God! Whoa!
I need a crash cart! Prepare
for open cardiac massage!
Someone get her out of here, please!
[CRYING] No!
[GASPS]
I feel so much better now.
- He's alive?!
- AURELIO: Ohh.
OWEN: His vitals have stabilized!
We need to get him to the O.R. now!
What's happening?! My husband's okay?!
It was a buildup of pressure
from fluid and blood,
but it was around the
heart, not the heart itself.
We're gonna know
more when we get him
in there, but we
need to move fast!
Let's go, let's go, let's
go, let's go! Let's go!
What would you do with $3 million?
Fund voter-registration drives.
How do you think the system gets fixed?
Well, it's my game. You
have to spend it on yourself.
I'd hire an at-home nurse,
and my granny wouldn't
have to live in a facility.
Pay off my loans.
Start a maternal-health nonprofit.
Boring!
Let me guess. You'd
buy an obnoxious car.
Oh, for starters, I'd get my own place
so I don't have to live
with you fools anymore.
I'd travel, and, yes,
buy an obnoxious car.
Mm-hmm.
But if I had a curable
disease, you'd be damn sure
I'd spend every penny to heal myself.
What's crazy is he
works at a hospital
and he can't even get the
treatment he needs covered.
And he'd probably be a
great candidate for it.
It's out there. It's available.
We have everything we need
to cure his sickle cell.
Everything except the money.
♪
[THUNDER RUMBLES]
JOSE: What do you
mean we beat them here?
- It's a three-hour drive.
- When the weather is bad,
they often re-route to
get around the storm.
And how much longer until they arrive?
And is Ofelia still okay?
This doesn't necessarily mean anything,
but at the moment, we've
lost contact with them.
No. No.
I'm calling Dr. Schmitt and Dr. Adams.
We will also keep trying
them until we get through.
We trusted your team with our daughter.
They promised to take
care of our little baby!
AMELIA: I know that this is terrifying.
We are closely monitoring the situation.
Dr. Beltran has a whole staff
that is prepared to treat Ofelia
as soon as she arrives.
Come on. Let's go take a seat. Come on.
♪
[KNOCK ON DOOR]
[THUNDER RUMBLES]
Oh. Kwan, Griffith.
Yeah, yeah, sorry to bother
you, but this is important.
It's about a patient, and it's urgent.
Can you page another attending?
We need you or Dr. Altman,
but she's headed to emergent surgery.
Our patient has sickle cell disease,
and there's a new gene
therapy that could cure him,
but it's expensive and his
insurance won't cover it.
We know the hospital can't
treat everyone pro bono,
but this man works here.
H-he walks the same halls as us
and eats the same cafeteria food.
How can we look him in the eye
knowing we're not gonna help him
just 'cause some idiot
suit in an insurance office
says we can't?
[WOMAN SNEEZES]
Doctors, these are some of our partners
from Balcom Medical.
These are two of our surgical interns
who I believe have rounds?
- We We do.
- Thank you for your time.
[KWAN CHUCKLES NERVOUSLY]
His chest tubes are
putting out minimal fluid,
and he's stable on ECMO.
[WOMAN ON P.A. SPEAKING INDISTINCTLY]
Yeah, he knew he was sick for a while,
but he's been trying to work through it.
He said if he's gonna drop,
he'd rather do it around
people than at home by himself.
And all I've done
since he showed up here
is give him bad news, and he's
had to take it all on by himself.
He doesn't have any family.
And his students can't visit.
So my personal interest in
providing Mr. Riley's care
has nothing to do with
anyone's capability.
I just don't want him to feel alone.
Break down ♪
So, um, Millin, put
in the post-op labs.
- Of course.
- Great.
Warren, start to wean him off sedation
and extubate him when
you think he's ready.
Breathe in ♪
You got it. Alright.
Breathe out again ♪
Clouds hangin' over my shoulder ♪
I
Feelin' heavy now, weighs me down ♪
AMELIA: Anything new?
Just my increased blood pressure.
They should've connected
with an ambulance
when they made it down
if they made it down.
[RADIO CRACKLING]
[BEEP] Hello?
This is Grey-Sloan Memorial.
Is there anyone there? Come in.
[RADIO STATIC]
Let down again
I sent them. I specifically
sent Schmitt in my place.
I sent your nephew.
If something happens,
I'm gonna have to call Schmitt's family
and tell them that I put
him on that helicopter.
And your family.
- Crash and burn again ♪
- I'm really sorry.
I-I just had to go to the
worst case scenario in my head,
and it's really hard not to
when they're flying right now over water
and other things that
could spell disaster.
Well, I've experienced enough
that I always go to
the worst case scenario.
And sometimes you've just
got to accept the situation
at face value
so you can keep moving forward.
- [THUNDER CRASHES]
- [PHONE BUZZES]
Somebody tap me out ♪
Hello?
[SIREN WAILS]
Wide asleep ♪
Playin' hide-and-seek ♪
Can you rescue me? ♪
Ohh, ohh, ohh ♪
Wide asleep ♪
Chasin' fever dreams ♪
Playin' hide-and-seek ♪
Can you rescue me? ♪
Before I ♪
Break down again ♪
His heart exploded, and
now he's completely fine.
[CHUCKLES]
[LAUGHING]
[LAUGHING] That poor wife!
She was covered! Covered in blood.
- It was
- [BOTH LAUGHING]
This is terrible! Ohh!
I can still feel it in my socks.
[BOTH LAUGHING]
Ohh!
Ohh
Owen, we don't have to schedule sex.
Well, technically,
it's now our homework,
and I have always been a
straight-A student, so
We're gonna get through this.
We have gotten through a lot worse.
I'm not sure if you're
talking about Iraq or the kids.
[BOTH CHUCKLE]
Teddy can I take you on a date?
Somewhere that's not Joe's.
I'd really like that.
♪
[THUNDER RUMBLES]
[ZAYNE MOANS]
Is it over?
Oh, yes. Your surgery went very well.
- How do you feel?
- Really tired.
BLUE: The paid meds are still working.
So, is this Zayne Johnson?
ZAYNE: Either these pain
meds are really strong,
or you're not Dr. Lincoln.
I'm Dr. Webber. I have some good news.
There's a possibility you could
get sickle-cell gene therapy.
What? H-How?
We're doing it pro bono?
No, my partners and I at
Balcom heard your story,
and we'd like to open a discussion
about how you can apply
for a grant we have.
I can't believe this. Thank you.
Thank your advocates. They
really made an impression.
Okay. We're talking about that later.
RICHARD: If you get to go-ahead,
we need to get you started soon.
This whole process
could take almost a year.
- A year?
- Well, sometimes as soon as eight months.
You'll get blood transfusions,
then you'll stay in the hospital
to collect your stem cells.
And after gene therapy,
you'll be given chemo
and kept in isolation for about a month
until your immune system recovers.
At night ♪
I don't think I could do that.
My son has special needs,
and I can't afford a caretaker
or to be away from him for that long.
Just past nine ♪
Okay. Um Well, you think about it,
and, um, maybe you'll
figure something out.
Shoulders get heavy when mothers cry ♪
The system still sucks.
Yeah, if only there was
something we could do about it.
turns the light ♪
[MONITOR BEEPING]
[THUNDER RUMBLES]
And we used to fly ♪
Hm, hm, hm, hm, hm ♪
Hm-hm, hm ♪
♪
MONICA: She's still
in critical condition,
but she should be okay.
And and her leg?
We were able to save it.
She'll likely need more surgery,
but hopefully with
some physical therapy,
she'll regain function.
Thank you. Thank you.
Thank you. Thank you, Doctors.
Dr. Adams will take you in.
And unlike your dad, I hope you cry ♪
♪
[SIGHS]
Do you think peds was your calling?
You know I applied for the fellowship.
I don't mean your interest.
I've heard all about your interest.
I mean, do you truly believe
that it's what you're meant to do?
[SIGHS]
When I was a kid, I was
obsessed with helicopters,
so for my fifth birthday,
my mom splurged on an
aerial tour of Seattle.
Got to take pictures with the pilot,
put on the cool headphones.
Then we got up in the
air, and I freaked out.
I rode the entire trip
with my eyes closed.
♪
That was my only
helicopter ride until today.
And your heart ♪
I pretended to nap the
whole way to Friday Harbor,
but on the way back, when
she started to deteriorate,
all I could think about was Ofelia.
Even when we were
going down in the storm,
I only wanted to keep her safe.
I know peds is my calling
but I don't know how to
prove that to everyone else.
Well, I've never been more certain
that a resident belongs in peds.
That I believe ♪
- [EXHALES SHARPLY]
- I want to help.
I think that ship has sailed.
Hm. For now.
But I have a lot of friends
who got their fellowship
after doing research.
And I have a colleague in Texas
who's looking for help
with a clinical trial.
You interested?
Sure. Great.
'Cause I already told him you'd
call him to schedule something.
You know more than you think, Schmitt.
Trust yourself.
♪
Check on Mr. Riley?
Yeah, he's stable for now.
I asked the nurse to let
us know if anything changes.
Alright. Thanks. If it
does, I'll handle it.
- Not because you can't.
- [BOTH CHUCKLE]
I'll just be across the
street at Joe's, so
Are you meeting folks?
No. Just, uh, grabbing some dinner.
Maybe watch the game.
I like the noise.
You ready?
I just told Tuck to put
the casserole in the oven
and Pru to clean up her Play-Doh.
Actually, I think I'm gonna head over
to Joe's with Ndugu.
Oh, I don't want to go to Joe's.
Well, it's a good thing
you weren't invited.
Have a nice time.
- I'll see you at home.
- [CHUCKLES]
MEREDITH: The old saying goes
fake it till you make it.
Because sometimes pretending
you have confidence
helps you find the real thing.
Okay.
You can go home. I can
stay and monitor Ofelia.
Are you still avoiding that guy?
Just because we shared
a near-death experience
doesn't mean I have to answer you.
Sure, but he's following us.
- Oh, God.
- Hey, Levi. Hi. Can we talk?
I know about Ryan.
Okay.
I thought what we had was real,
something deep.
- I'm sorry I didn't say anything.
- I'm sure you are.
It's hard to know when to tell people
about your dead husband.
What?
Oh, I d I didn't realize.
I'm so sorry.
It'll be four years this summer.
Um, I just haven't done a
lot of dating since then,
so this is all new to me.
Yeah, yeah.
Wait. Did you think I was cheating?
No! No.
I m I mean, may
maybe a little bit.
[CHUCKLES]
I think what we have is real.
Okay? You're kind of the best thing
that's happened to me
in a really long time.
When it doesn't work,
when life doesn't give us second chances
or dress rehearsals
you can walk away
or you can go all-in.
Hey. Ofelia's vascular checks look good.
- Mm. Nice.
- Yeah.
Thanks for your help today.
I just did a neuro exam.
No, I was freaking out,
and you calmed me down.
[CHUCKLING] Oh.
I'm being genuine!
No, I It's not you. It's the irony
that you would see
if you knew me better.
[CHUCKLES]
Listen. The thing with Ndugu
It's just casual. We were just
going through something similar.
You don't owe me an explanation. Really.
You and I are good.
Good night.
We tell ourselves we don't care.
Hey! Hey.
Sometimes it's gotta
fade before it shines ♪
Ultrasound showed two strong heartbeats.
Equal fluid level.
DeLuca saw nothing to worry about.
When your heartbeat stops ♪
Great.
And the world won't spin ♪
I'm sorry.
I was so freaked out over
one baby, and now it's
And I'm exhausted. You know, I worked
20 hours straight last week.
I delivered eight
babies with no caffeine.
I told you you should rest after that.
Are you mad at me?
Oh, could the story end ♪
You locked me out of
your car this morning.
You kicked me out of the
ultrasound appointment.
I didn't kick you out. I
I was overwhelmed and hormonal.
This is a high-risk pregnancy!
The odds of making it full
term with two healthy babies?!
I'm scared!
Yeah, and you think I'm
just worried about cars?
- No, I d
- I'm scared out of my mind!
I'm scared for them.
I'm scared about you.
Every outcome we envision ♪
We're supposed to be partners.
If we're falling apart just
thinking about having twins,
what's gonna happen when
we actually have them?
Fall before you fly ♪
[EXHALES HEAVILY]
Sometimes it's gotta
fade before it shines ♪
We can try to hide our doubts and fears.
When your heartbeat stops ♪
Ooh-ooh ♪
And the world won't spin ♪
Ooh-ooh ♪
When your time is gone ♪
Ooh-ooh ♪
- Don't know where it went ♪
- [CHUCKLES]
Ooh-ooh ♪
Ohh, ohh ♪
Or we can accept the unknown
What's this?
and dive in.
Where we begin, whoa-oh ♪
Where we begin ♪
Ohh-ohh ♪
Where we begin ♪
Ohh-ohh ♪
I've had an extremely long day.
I just wanted to end it with you.
And a real meal.
Mm-hmm.
Are you hungry?
Starving.
[BOTH LAUGH]
We can start again ♪
The real thing is better anyway.
We begin ♪
♪
♪
MEREDITH: Every time a surgeon operates,
it's for the first time all over again.
- I'm feeling it now ♪
- [SIGHS]
I rise above ♪
Nothing bringing me down ♪
- Ohh! Wha What are you doing?!
- Huh? I'm hiding from James.
I just saw his car pull up.
I thought you liked him.
I did. We had sex.
- Oh.
- Twice.
And then I find his
wedding album. To Ryan.
I had sex with Ryan's husband.
- How did I miss this?
- This is not a problem.
He is a man of God who cheats.
- I'm pregnant with twins.
- [GASPS]
Hey. I I can see you! Can we talk?
- Whoa!
- Brought you tea!
Oh. I can't hear you!
Ask him if it's caffeinated.
Fine. I'll get coffee from the cart.
Look, I know this is a lot,
but we'll figure it out.
We're gonna get a night nurse.
My mom can move in for a while.
I'm moving up ♪
- Where are we going?
- The other entrance.
Even if you've done
hundreds of kidney resections
or heart transplants,
you've never resected this kidney
or transplanted this heart.
Past experience usually helps,
but for unique cases, you fake it first.
No. Sorry.
Then who are those for?
Me. I'm going to put them in the fridge.
I don't have time to come back here.
Hope you made time for an EKG
after consuming 400
milligrams of caffeine.
I have taken two of
Yasuda's shifts this week.
Same. She and her sister
really appreciate it.
Well, not enough to share her
mom's cookies she sent her.
I'm just glad that Chloe
seems to be recovering well.
WOMAN: Excuse me. Have
you registered to vote?
- Already registered.
- Yeah, me too.
- Same.
- Not my thing.
You rehearse on replicas
for hours on end,
and hopefully when the real
patient is on the table,
you know what you're doing.
Lots of people put sex on the calendar.
MARSHA: When you're
juggling two busy schedules,
it's perfectly normal
to schedule intimacy.
- Okay. You schedule a haircut.
- [GROANS]
I do not want to have to
schedule sex with my wife.
Why do you think this bothers you?
It feels like she's
not trying to fix anything.
You know? We are hemorrhaging,
and she's just reaching for a Band-Aid.
So if I don't want to fix our
problems the same way that you do,
- that means that I'm not trying?
- No, no, no.
Unfortunately, we
have to stop for today,
but I want you to see this through.
Have scheduled sex this
week and see how it feels.
It might not be what you
think. For either of you.
Well, I guess I'll see you
at 10:00 tomorrow night.
Um, would this be a bad time to tell you
that I have to reschedule?
[KNOCK ON DOOR]
Hey. Haven't seen you in a while.
I know. Yeah. Sorry. It's been busy.
[BOTH CHUCKLE]
- Been meaning to give this to you.
- Oh.
Yeah. Left it at my place, so
- Yeah.
- Oh!
- Mm-hmm.
- Ha-ha. Yeah.
I guess you have been really
busy. Because this is not mine.
- [STAMMERS] You sure?
- [LAUGHS] Yeah.
It's a really nice color, though.
- She has good taste.
- Oh, my God. I'm so sorry.
[DOOR OPENS]
Hey. You needed a consult?
Uh, I have a patient coming in
from Friday Harbor with a head injury.
The local hospital's
sending in the scans.
- Should I come back?
- No.
I was just leaving.
I'm gonna go.
Have the nurses page me
when the scans are in. Heh.
Hm.
- [DOOR CLOSES]
- [SIGHS]
BEN: Schmitt is with Dr. Beltran today,
so I've got your assignments.
Let's do a lineup. A lineup.
It's something we did at the fire
station to get the day started right.
Discipline, organization.
Or you can stay exactly where
you are. That works, too.
So, Yasuda's out on PTO today.
But, Adams, you're with
Schmitt on Beltran's service.
Millin, you're with me and Ndugu.
Griffith, with Lincoln.
Um, you forgot someone.
And you've forgotten your dictations.
There are over 100 incomplete
records with your name on it.
Have fun staring at a computer
all day playing catch-up.
[GROANS]
WOMAN ON P.A.: Orderly to 6 East.
Any available orderly to 6 East.
Are you lurking?
Okay. Your your evaluation
forms were sent out today.
I know. Ndugu will be the first one
who will officially assess me.
You know? How do you know?!
Um, you left your laptop open
on the kitchen counter today.
Hey, hey, hey. You lurk, I snoop.
Okay. Just just
Mnh. Just be yourself!
I've never been to Friday Harbor.
I went on a field trip in seventh grade.
We picked apples.
Hey. Today you are
picking up Ofelia Lopez.
She's 10 years old. She
fell off a moving tractor.
Her vitals are stable, but she's got
a bad leg injury and a TBI,
so she needs a higher level of care
than her community hospital can provide.
I would go myself, but I
got a full patient roster.
I don't mind getting
out of the hospital.
- It's a nice drive.
- I'm sure it is.
But you're taking a helicopter.
- No!
- Nice!
Taking an ambulance would
be more cost-efficient,
m-more environmentally friendly.
- And it's not up in the sky.
- Update me when you arrive!
♪
[BUTTON CLICKS]
♪
Morning, Mr. Riley.
No, no. Left, right, left.
The other left, Kenneth. Ugh.
Instructions go in one ear
and out the other with this kid.
Maybe he's missing his director, huh?
He's missing something, alright.
[CHUCKLES] Go ahead.
Uh, Darren Riley, 55, presented with
antibiotic-resistant
pneumonia with a concern
for a rapidly progressing
necrotizing infection.
Was intubated but couldn't oxygenate
despite maximal ventilation settings.
Placed on VV ECMO and
was extubated last night.
Mr. Riley's X-rays from this morning.
Left lung's completely whited out.
WINSTON: Let's order
him a CT with contrast.
Mr. Riley, I'm gonna change
your cannula dressing.
Well, I can take care of that
as soon as I place this order.
We'll just meet you in radiology.
That's not necessary. I want
to help with transport anyway.
Oh, but we can handle that.
Moving a patient on ECMO can be tricky,
so I'd like to be there for it.
Okay. Uh, great.
All risks and benefits were explained
and patient agreed to
sign informed consent
- [GROANS]
- Hey. Are you okay?
Yeah. Yeah. Good. Must have slept funny.
[CHUCKLES]
The patient was taken to an
operating room and placed
- [ZAYNE GROANS]
- Hey. Are you sure you're okay?
I could take a look if you want.
[ZAYNE GRUNTING]
Someone get me a gurney!
♪
Mr. Wheeler, how are you feeling?
Fit as a fiddle. Think
I'm about ready to go home?
Not quite yet. I saw some
fluid building around your heart
on this morning's echo.
It's a common complication
after heart surgery.
We might have to do a
procedure to drain it,
in which case we'd have to
keep you a little bit longer.
Oh, no. I can't stay longer.
I have to be home next week.
It's my 40th wedding anniversary.
Congratulations. That's a big milestone.
Hey, why don't we watch it and
see if it resolves on its own
before we jump into a new procedure?
Macie and I got engaged when we were 19.
She wanted this big church wedding,
but our parents didn't approve,
so we eloped at city hall.
[CHUCKLES] We know how that goes.
We wanted to get married in the park,
but we wound up doing it in a bar.
Every year, we recreate
our wedding dinner
hot dogs from the cart on the corner.
You know, we should go to
Joe's for our anniversary.
It's the only place we ever go.
Look, I want to run
another set of coags,
and we will take it from there.
Get her flowers on your way home.
Works every time.
- Thanks for the tip.
- Yeah.
WOMAN ON P.A.: Dr. Horowitz,
6-2-9-6. Dr. Horowitz
Thanks for making the
trip. She's got severe
left lower extremity trauma,
extensive soft-tissue damage,
as well as vascular injury.
Suffered some head trauma
with multiple contusions
and lacerations.
- Okay. Hi.
- Hi.
LEVI: Her respirations
look a bit labored.
Her sats were in the
80s when she arrived.
The oxygen's helped.
- But you didn't intubate?
- Our only ventilator's in use,
and we don't have the
resources to manually bag her
- if we did RSI.
- Okay.
NANETTE: We rushed her
here as soon as we could.
This doctor said you'll
be able to help her more?
Will her leg be alright? She
loves to play in the fields.
I'm Dr. Schmitt. This is Dr. Adams.
We'll have a better idea
- once we examine her, okay?
- Okay.
We temporized with a
splint and tourniquet.
Ischemia time is about 45 minutes.
Um
Hi. I'm Levi.
Your name's Ofelia, right?
My friend Lucas and I are gonna
help make you feel better, okay?
Okay.
Okay. This is my number.
We're gonna get to
Grey-Sloan before you,
so once you get there, give me a call.
Wait. We can't go with you?
I'm so sorry. There's not
enough room in the helicopter.
But I promise we'll take
excellent care of her, okay?
- Okay.
- Okay.
♪
- JOSE: We love you, mija.
-
♪
We're gonna have to amputate the
leg if we don't get back fast,
- so let's intubate for transport ASAP.
- Okay.
[SIGHS] Back to the helicopter.
Dr. Kwan? Aren't you supposed to
Look, I know I'm behind on charts
and when I'm behind,
it becomes your problem,
and you don't like problems.
Uh, is that Zayne from custodial staff?
Yeah, he, uh, collapsed
with a severe abdominal and hip pain.
Mr. Johnson, I see you took
that whole rack down with you. You okay?
Pain started way before that rack fell.
I've been managing it
fine for months now.
Alright, well, we need
to get you to the E.R.
to get you checked out. Hospital rules.
I'll just take something
once my shift ends.
Let me save you the trouble.
You can fight her on this,
but you will lose. We all do.
- Can you make it quick?
- I will make it thorough.
Come on. Let's go.
You too, Kwan!
- Doctor should be in soon.
- Okay.
We are never going to fit
four car seats in either of our cars.
Are we gonna have to get a minivan?
You know what's transporting
those babies right now?
Me!
Every horrible pregnancy
symptom, double it!
Twice the the reflux,
the weight gain, the exhaustion.
And then after all that,
I'm gonna return to work,
delivering other people's babies,
taking care of not
one, but two newborns.
But, sure, by all means,
you go test-drive minivans.
How can I help?
I wish I could tell
you, but all the energy
that used to go to my brain
is now being diverted to my uterus.
- [PHONE BUZZING]
- You know what?
I really need this to
not take a long time.
I have a patient who is 29 weeks
and she's about to deliver triplets.
Three babies. Hmm? [CHUCKLES]
Could be worse! Heh!
You want three?
[PHONE BUZZING]
[SIGHS] A consult in the E.R.
Just go.
I'm staying for the ultrasound.
It's gonna show the
same as it did yesterday,
and then you're gonna smile
and say, "We've got this."
And right now I really
I frankly don't
really don't need that.
- [EXHALES HEAVILY]
- [DOOR OPENS AND CLOSES]
Did you play? Marching band?
No.
Cool. Me neither.
Oh, I didn't do sports.
But it's band.
Do they wear uniforms?
Then I didn't do it.
[BEEPING]
Oh. Damn it.
His lung is completely liquified
from all the necrotic tissue.
[SIGHS] What's your recommendation?
Chest tube and change the antibiotics.
Oh, a chest tube won't drain this,
and the antibiotics aren't penetrating,
so we'll need to completely
remove the source.
The source is his lung.
Book an O.R I'm gonna
get him off the table.
Well, don't you want us to
get him [CLEARS THROAT]
Does he normally have
to do everything himself?
Well, he let me sew a patch
graft angioplasty once.
Maybe it's you.
[DOOR SLIDES]
SIMONE: When you say
it's "not your thing,"
you don't mean like
you never vote, right?
Like it's a recent thing?
- What about in 2016?
- What do we got?
Uh, Zayne Johnson, 32.
Diffuse pain, greatest in
his abdomen and right hip
after a supply rack fell on him.
We're still working on his history.
Do you take any medication?
How much room do you have
on that thing? [GROANS]
I take folic acid,
hydroxyurea, ibuprofen,
and tramadol as needed.
- You have sickle cell?
- Yeah.
And I know about that new
gene therapy that cures it,
but my insurance won't cover it
and I don't have $3
million laying around,
so I still got it.
FDA approves a cure, and
nobody can afford to get it.
If I had three mill, I wouldn't
want to spend it on treatments.
I'd buy a boat and
sail around the world.
I was kind of in the middle
of another patient upstairs.
Yeah, I brought you here for that hip.
The articular surface
is completely destroyed.
Griffith, take him upstairs for an MRI.
And we should also get an abdominal CT.
- No, no. I
- Ah. It won't take long. Okay?
If there's anything you need,
you let these interns know.
- Don't be shy.
- [GROANS]
[THUNDER CRASHES]
PILOT: We've hit a bit of rain and fog.
I'm trying to steer us out of it.
Think about puppies.
Gravity blankets. Wizards and adventure.
Well, either somebody died
or you're ghosting someone.
I am ignoring a mistake.
And don't look at my phone.
Is it the guy from the hallway?
So what? Does he hate dogs?
Puts the toilet paper on wrong?
Does he not know how
to cook a real meal?
Do you? I'm just saying.
Just because it's a bad match
doesn't mean it's a mistake.
You're right. It wasn't a mistake.
It was a giant failure!
[THUD]
- [RAPID BEEPING]
- Oh, my God.
Her blood pressure spiked.
She might be herniating.
Okay.
[MONITOR BEEPING RAPIDLY]
Her pupils aren't blown.
Actually, they're pinpoint.
Her heart rate's in the 50s.
- Okay.
- Okay. We got you.
Okay. We got you. We got you.
She's diaphoretic, bradycardic.
Her eyes are tearing up.
We keep having to suction her.
Her parents said that she likes
playing in the fields, right?
The farm probably uses pesticides.
Are you thinking
organophosphate poisoning?
Yeah. Let's get her on atropine.
Okay. Oh. She's seizing!
Oh! Oh! Okay.
Damn it. The tourniquet.
Did it come loose?
No. The clasp is broken.
We have to stop this bleeding!
- Holding pressure!
- Yeah, I got her leg!
Find the atropine!
[THUNDER RUMBLES]
Hey, uh, Aurelio's labs are back.
Okay. Great. Thank you.
Can I get an ultrasound and
a pericardiocentesis kit?
I just need to finish
reviewing these scans.
Teddy, it's still a small effusion.
He's coagulopathic. I
mean, we can either do
the pericardiocentesis now
or we can wait till he crashes
in the middle of the
night and do it then.
We don't know that's gonna happen.
Didn't you accuse me
of what was it
putting a Band-Aid on a
hemorrhage this morning?
What does that have to do with this?
So now I am trying to
face this problem head on,
and that doesn't seem to
be good enough, either.
I mean, forget about
my years of experience
treating pericardial effusions. Teddy
[CLEARS THROAT] Uh, I was
just getting a cup of tea.
Oh, well, um Well,
we were just, um
We were just discussing a patient.
Look, I can give it another hour,
but then we're gonna
need another set of scans
and a repeat echo.
Okay.
Oh, you should try the Moroccan Mint.
It's very, uh refreshing. Hm!
SIMONE: What about local elections?
State propositions? Or public surveys?
I send those straight to spam.
LINK: Griffith, what are we looking at?
Studying his abdominal CT.
His hip MRI is about to come up.
You can relax, Zayne.
Pretend you're in that $3-million boat.
That's not relaxing. I get seasick.
But you want to sail around the world?
No, but my son does, and
I'd do anything for him.
SIMONE: Is that his
spleen? It's so small.
Pretty much nonfunctional at this point.
Also, those are iron
deposits in his liver.
Should we take care
of his gallstones, too?
The gallbladder wall's
not acutely inflamed.
- [LINK SIGHS]
- The sickle cell has
- basically ravaged his body, including
- His hip, which you all
would have seen if you
noticed his MRI was up.
He's got subchondral collapse and
flattening of the femoral head.
We're gonna have to
replace the whole joint.
Oh, he's not gonna like that.
We don't have a choice if
he wants to stop this joint
from completely degenerating.
♪
Hey. Did you get the films
from my transfer patient?
Schmitt and Adams are
worried about the leg.
- My fellow will need to take it.
- Okay.
Hey. I took a look at Ofelia's scans.
Minor subdural. No swelling, no shift.
I'm not terribly worried, but I
will re-evaluate when they land.
Their ETA is 25 minutes.
Okay. I'm gonna check on a patient.
Text me if they get here sooner.
Hey. A-About earlier,
it wasn't exactly what it looked like.
- Uh, none of my business.
- Okay.
LUCAS: The tourniquet's
completely broken.
I can't get it to hold tight enough.
I'm gonna need another one.
Oh, it looks like there's an injury
to her superficial femoral artery.
There's another tourniquet in this bag.
Hold as much pressure
as you can. Got it.
[GRUNTS] Here.
Alright.
♪
Once we get a signal, we
need to update Beltran.
♪
Got it.
♪
Damn it.
It's basically beyond repair.
She's gonna need an amputation.
Well, we have I.V. tubing.
What if we make a temporary shunt,
see if we can reconnect the
femoral artery with the tubing?
If the pilot is re-routing,
it's gonna take us a
lot longer to get back.
The tourniquet's been
on for almost two hours.
The leg looks ischemic.
If we do nothing, she'll lose it.
[THUNDER CRASHES]
♪
- Okay. Yeah. I'm in.
- Okay. Alright.
[SIREN WAILS]
So, if you take my lung, I'll
be rid of this thing here?
Unfortunately, due to
your smoking history,
your other lung won't be
able to oxygenate your body
well enough by itself.
You'd have to stay on ECMO
until we can get you a lung transplant.
Any chance that happens before
the NorthPac Band Review?
JULES: We don't know.
It could be tomorrow.
It could be weeks from now.
There will be other performances.
I was thinking about my alto sax.
First instrument I ever picked up.
Thing was nearly bigger than me.
But once I got the hang
of it, I fell in love.
I haven't been able to play in weeks.
[BREATHING SHARPLY]
What if I can't ever play again?
Or, worse
what if I can't teach?
The band's more than just my job.
It's my life.
Well, music and teaching,
it's in your bones.
Losing a lung won't change that.
Just might need a little
extra practice after surgery.
That's all.
Let's get you prepped.
♪
Mr. Johnson?
Dr. Bailey and Dr. Lincoln
would like to talk to you.
I have to finish work so I can get home
for dinner with my son.
Uh, your scans show something called
avascular necrosis in your hip.
I'll make an appointment to come back.
My son needs extra attention,
and my sister's had him all day.
Your pain is only gonna get worse.
The sickled cells in the joint cut off
the blood supply to the bone,
which is causing it to die.
But we can replace the joint today,
and your insurance covers it.
And then I won't feel pain?
Well, we can at least help
with the pain in your hip.
So instead of curing my pain,
they're gonna let every joint and organ
in my body deteriorate and
then they'll pay to fix it?
I know. It doesn't make
sense. And the system sucks.
Maybe I shouldn't say that, but
I've been through this before.
I know the frustration of
trying to fight a system
that doesn't care if you suffer
or even if you live or die.
They only see you as a code or a cost
or some number in a sea of numbers.
The system couldn't care less about you.
But if you care about yourself,
you should get the surgery.
[EXHALES SHARPLY]
SIMONE: Think about your son.
If you weren't able to walk
or continue to do your job,
it'll be a lot harder
to take care of him.
♪
Okay.
What's next?
I'll go tell Dr. Lincoln.
Don't bother. I'll do it.
[KNOCK ON DOOR]
Oh. Uh, I'm about to
meet with Balcom Medical.
You know, I've always
had a great relationship
with Ethan Chen,
so if there's anything
the hospital needs,
- I'm your man.
- Oh. Ethan is retired.
Oh. Well, good for him.
Yeah, the new CFO is Erika Desai.
She is great.
But her husband Nirav's
also very prominent on the board,
and he only hears what he
wants to hear, which is himself.
Ooh. It sounds like
a communication issue.
And he often overlooks
how hard I am trying
to make everything work!
And then he insinuates that I only
care about what is best for me,
regardless of what anyone else wants.
You mean what's best for the hospital.
This isn't about Balcom, is it?
So you want advice or a pep talk?
Is there one that's less
irritating than the other?
You've already been
through a war together.
- You can do this.
- That's the least irritating one?!
[SIGHS]
WINSTON: Tissue's very fibrotic.
- Millin, suction?
- JULES: Got it.
BEN: My mom really wanted
me to learn an instrument.
Then my fourth-grade class
got sent home with recorders.
My brother and I were
learning the accordion
- for a few months.
- Didn't stick with it?
Our teacher didn't want to be
paid in lemons from our yard.
- [CHUCKLES]
- I'm at the hilum.
You need more retraction?
- That'd be great.
- Harrington, please.
BEN: Oh.
Could you hold that right there, Warren?
- Uh-huh.
- Thank you, Bokhee.
With all due respect, I
may be on a trial basis,
but I'm coming in as
a fourth year resident.
I'm perfectly capable of retracting
and prepping patients for transport
and moving them to the CT.
Hell, I'm capable of
a lot more than that.
Alright. Specimen.
Here we go.
[DRILL WHIRRING]
How's he doing?
SIMONE: Feels like this could have been
a much less extensive surgery years ago.
BAILEY: Well, seeking treatment
when you have sickle cell
is a minefield of stigmas
and misunderstandings.
That's not on Zayne.
Kwan, careful with the drill!
This bone is like stone!
[DRILL WHIRRING]
You know I'll take over.
BAILEY: Oh, let him give
it another try. Go again.
Easy this time.
[DRILL WHIRRING]
Put put the drill down!
BAILEY: If he doesn't
try again, he won't learn.
We're not doing second
chances right now.
This man is in constant, agonizing pain.
And I'm just talking
literal physical pain,
not the hell of suffering in silence
because nobody cares or believes in him.
It's the only way he can get by,
even though it causes more
pain and more suffering!
Damn it!
Someone get me a new drill bit!
BAILEY: Are you done?
Yeah. Whatever you're going through,
go through it on your own time.
We are taking care of Zayne right now.
I cannot take care of you, too.
[MONITOR BEEPING]
[DRILL WHIRRING]
♪
Suction, please. Adams! Suction!
I'm trying!
- I just have one more tie.
- [THUD]
Oh! Oh, my God! Ohh! Okay.
Whoa!
- Let's do this fast.
- Alright.
Okay.
Ah! Damn it! Can't get it to stay.
- Can you hold it, please?
- Yeah.
♪
Okay. [GRUNTS]
- I think that's it.
- Okay.
Tourniquet coming off.
Okay. Okay.
♪
It's holding.
- [LAUGHS]
- [CHUCKLING] We did it.
[THUD]
Ohh! What's happening?!
I don't know! I can't see anything!
PILOT: I can't get around this storm!
I'm gonna attempt an emergency landing!
♪
Macie. Macie.
How long has he been like this?
15 minutes. Muffled heart sounds.
Low BP, JVD.
Cardiac tamponade. This is why I
wanted to do the procedure earlier.
- He wasn't this symptomatic.
- Alright.
We're gonna need to reopen
him and relieve the pressure.
We're doing a needle aspiration
bedside. We're already prepped.
It's much more controllable in the O.R.
MACIE: I'm his wife. Let me through!
There's blood seeping out
of his incision already.
We don't have time. Scalpel.
I'm right here, dear.
[MACIE SCREAMS] Oh, my God! Whoa!
I need a crash cart! Prepare
for open cardiac massage!
Someone get her out of here, please!
[CRYING] No!
[GASPS]
I feel so much better now.
- He's alive?!
- AURELIO: Ohh.
OWEN: His vitals have stabilized!
We need to get him to the O.R. now!
What's happening?! My husband's okay?!
It was a buildup of pressure
from fluid and blood,
but it was around the
heart, not the heart itself.
We're gonna know
more when we get him
in there, but we
need to move fast!
Let's go, let's go, let's
go, let's go! Let's go!
What would you do with $3 million?
Fund voter-registration drives.
How do you think the system gets fixed?
Well, it's my game. You
have to spend it on yourself.
I'd hire an at-home nurse,
and my granny wouldn't
have to live in a facility.
Pay off my loans.
Start a maternal-health nonprofit.
Boring!
Let me guess. You'd
buy an obnoxious car.
Oh, for starters, I'd get my own place
so I don't have to live
with you fools anymore.
I'd travel, and, yes,
buy an obnoxious car.
Mm-hmm.
But if I had a curable
disease, you'd be damn sure
I'd spend every penny to heal myself.
What's crazy is he
works at a hospital
and he can't even get the
treatment he needs covered.
And he'd probably be a
great candidate for it.
It's out there. It's available.
We have everything we need
to cure his sickle cell.
Everything except the money.
♪
[THUNDER RUMBLES]
JOSE: What do you
mean we beat them here?
- It's a three-hour drive.
- When the weather is bad,
they often re-route to
get around the storm.
And how much longer until they arrive?
And is Ofelia still okay?
This doesn't necessarily mean anything,
but at the moment, we've
lost contact with them.
No. No.
I'm calling Dr. Schmitt and Dr. Adams.
We will also keep trying
them until we get through.
We trusted your team with our daughter.
They promised to take
care of our little baby!
AMELIA: I know that this is terrifying.
We are closely monitoring the situation.
Dr. Beltran has a whole staff
that is prepared to treat Ofelia
as soon as she arrives.
Come on. Let's go take a seat. Come on.
♪
[KNOCK ON DOOR]
[THUNDER RUMBLES]
Oh. Kwan, Griffith.
Yeah, yeah, sorry to bother
you, but this is important.
It's about a patient, and it's urgent.
Can you page another attending?
We need you or Dr. Altman,
but she's headed to emergent surgery.
Our patient has sickle cell disease,
and there's a new gene
therapy that could cure him,
but it's expensive and his
insurance won't cover it.
We know the hospital can't
treat everyone pro bono,
but this man works here.
H-he walks the same halls as us
and eats the same cafeteria food.
How can we look him in the eye
knowing we're not gonna help him
just 'cause some idiot
suit in an insurance office
says we can't?
[WOMAN SNEEZES]
Doctors, these are some of our partners
from Balcom Medical.
These are two of our surgical interns
who I believe have rounds?
- We We do.
- Thank you for your time.
[KWAN CHUCKLES NERVOUSLY]
His chest tubes are
putting out minimal fluid,
and he's stable on ECMO.
[WOMAN ON P.A. SPEAKING INDISTINCTLY]
Yeah, he knew he was sick for a while,
but he's been trying to work through it.
He said if he's gonna drop,
he'd rather do it around
people than at home by himself.
And all I've done
since he showed up here
is give him bad news, and he's
had to take it all on by himself.
He doesn't have any family.
And his students can't visit.
So my personal interest in
providing Mr. Riley's care
has nothing to do with
anyone's capability.
I just don't want him to feel alone.
Break down ♪
So, um, Millin, put
in the post-op labs.
- Of course.
- Great.
Warren, start to wean him off sedation
and extubate him when
you think he's ready.
Breathe in ♪
You got it. Alright.
Breathe out again ♪
Clouds hangin' over my shoulder ♪
I
Feelin' heavy now, weighs me down ♪
AMELIA: Anything new?
Just my increased blood pressure.
They should've connected
with an ambulance
when they made it down
if they made it down.
[RADIO CRACKLING]
[BEEP] Hello?
This is Grey-Sloan Memorial.
Is there anyone there? Come in.
[RADIO STATIC]
Let down again
I sent them. I specifically
sent Schmitt in my place.
I sent your nephew.
If something happens,
I'm gonna have to call Schmitt's family
and tell them that I put
him on that helicopter.
And your family.
- Crash and burn again ♪
- I'm really sorry.
I-I just had to go to the
worst case scenario in my head,
and it's really hard not to
when they're flying right now over water
and other things that
could spell disaster.
Well, I've experienced enough
that I always go to
the worst case scenario.
And sometimes you've just
got to accept the situation
at face value
so you can keep moving forward.
- [THUNDER CRASHES]
- [PHONE BUZZES]
Somebody tap me out ♪
Hello?
[SIREN WAILS]
Wide asleep ♪
Playin' hide-and-seek ♪
Can you rescue me? ♪
Ohh, ohh, ohh ♪
Wide asleep ♪
Chasin' fever dreams ♪
Playin' hide-and-seek ♪
Can you rescue me? ♪
Before I ♪
Break down again ♪
His heart exploded, and
now he's completely fine.
[CHUCKLES]
[LAUGHING]
[LAUGHING] That poor wife!
She was covered! Covered in blood.
- It was
- [BOTH LAUGHING]
This is terrible! Ohh!
I can still feel it in my socks.
[BOTH LAUGHING]
Ohh!
Ohh
Owen, we don't have to schedule sex.
Well, technically,
it's now our homework,
and I have always been a
straight-A student, so
We're gonna get through this.
We have gotten through a lot worse.
I'm not sure if you're
talking about Iraq or the kids.
[BOTH CHUCKLE]
Teddy can I take you on a date?
Somewhere that's not Joe's.
I'd really like that.
♪
[THUNDER RUMBLES]
[ZAYNE MOANS]
Is it over?
Oh, yes. Your surgery went very well.
- How do you feel?
- Really tired.
BLUE: The paid meds are still working.
So, is this Zayne Johnson?
ZAYNE: Either these pain
meds are really strong,
or you're not Dr. Lincoln.
I'm Dr. Webber. I have some good news.
There's a possibility you could
get sickle-cell gene therapy.
What? H-How?
We're doing it pro bono?
No, my partners and I at
Balcom heard your story,
and we'd like to open a discussion
about how you can apply
for a grant we have.
I can't believe this. Thank you.
Thank your advocates. They
really made an impression.
Okay. We're talking about that later.
RICHARD: If you get to go-ahead,
we need to get you started soon.
This whole process
could take almost a year.
- A year?
- Well, sometimes as soon as eight months.
You'll get blood transfusions,
then you'll stay in the hospital
to collect your stem cells.
And after gene therapy,
you'll be given chemo
and kept in isolation for about a month
until your immune system recovers.
At night ♪
I don't think I could do that.
My son has special needs,
and I can't afford a caretaker
or to be away from him for that long.
Just past nine ♪
Okay. Um Well, you think about it,
and, um, maybe you'll
figure something out.
Shoulders get heavy when mothers cry ♪
The system still sucks.
Yeah, if only there was
something we could do about it.
turns the light ♪
[MONITOR BEEPING]
[THUNDER RUMBLES]
And we used to fly ♪
Hm, hm, hm, hm, hm ♪
Hm-hm, hm ♪
♪
MONICA: She's still
in critical condition,
but she should be okay.
And and her leg?
We were able to save it.
She'll likely need more surgery,
but hopefully with
some physical therapy,
she'll regain function.
Thank you. Thank you.
Thank you. Thank you, Doctors.
Dr. Adams will take you in.
And unlike your dad, I hope you cry ♪
♪
[SIGHS]
Do you think peds was your calling?
You know I applied for the fellowship.
I don't mean your interest.
I've heard all about your interest.
I mean, do you truly believe
that it's what you're meant to do?
[SIGHS]
When I was a kid, I was
obsessed with helicopters,
so for my fifth birthday,
my mom splurged on an
aerial tour of Seattle.
Got to take pictures with the pilot,
put on the cool headphones.
Then we got up in the
air, and I freaked out.
I rode the entire trip
with my eyes closed.
♪
That was my only
helicopter ride until today.
And your heart ♪
I pretended to nap the
whole way to Friday Harbor,
but on the way back, when
she started to deteriorate,
all I could think about was Ofelia.
Even when we were
going down in the storm,
I only wanted to keep her safe.
I know peds is my calling
but I don't know how to
prove that to everyone else.
Well, I've never been more certain
that a resident belongs in peds.
That I believe ♪
- [EXHALES SHARPLY]
- I want to help.
I think that ship has sailed.
Hm. For now.
But I have a lot of friends
who got their fellowship
after doing research.
And I have a colleague in Texas
who's looking for help
with a clinical trial.
You interested?
Sure. Great.
'Cause I already told him you'd
call him to schedule something.
You know more than you think, Schmitt.
Trust yourself.
♪
Check on Mr. Riley?
Yeah, he's stable for now.
I asked the nurse to let
us know if anything changes.
Alright. Thanks. If it
does, I'll handle it.
- Not because you can't.
- [BOTH CHUCKLE]
I'll just be across the
street at Joe's, so
Are you meeting folks?
No. Just, uh, grabbing some dinner.
Maybe watch the game.
I like the noise.
You ready?
I just told Tuck to put
the casserole in the oven
and Pru to clean up her Play-Doh.
Actually, I think I'm gonna head over
to Joe's with Ndugu.
Oh, I don't want to go to Joe's.
Well, it's a good thing
you weren't invited.
Have a nice time.
- I'll see you at home.
- [CHUCKLES]
MEREDITH: The old saying goes
fake it till you make it.
Because sometimes pretending
you have confidence
helps you find the real thing.
Okay.
You can go home. I can
stay and monitor Ofelia.
Are you still avoiding that guy?
Just because we shared
a near-death experience
doesn't mean I have to answer you.
Sure, but he's following us.
- Oh, God.
- Hey, Levi. Hi. Can we talk?
I know about Ryan.
Okay.
I thought what we had was real,
something deep.
- I'm sorry I didn't say anything.
- I'm sure you are.
It's hard to know when to tell people
about your dead husband.
What?
Oh, I d I didn't realize.
I'm so sorry.
It'll be four years this summer.
Um, I just haven't done a
lot of dating since then,
so this is all new to me.
Yeah, yeah.
Wait. Did you think I was cheating?
No! No.
I m I mean, may
maybe a little bit.
[CHUCKLES]
I think what we have is real.
Okay? You're kind of the best thing
that's happened to me
in a really long time.
When it doesn't work,
when life doesn't give us second chances
or dress rehearsals
you can walk away
or you can go all-in.
Hey. Ofelia's vascular checks look good.
- Mm. Nice.
- Yeah.
Thanks for your help today.
I just did a neuro exam.
No, I was freaking out,
and you calmed me down.
[CHUCKLING] Oh.
I'm being genuine!
No, I It's not you. It's the irony
that you would see
if you knew me better.
[CHUCKLES]
Listen. The thing with Ndugu
It's just casual. We were just
going through something similar.
You don't owe me an explanation. Really.
You and I are good.
Good night.
We tell ourselves we don't care.
Hey! Hey.
Sometimes it's gotta
fade before it shines ♪
Ultrasound showed two strong heartbeats.
Equal fluid level.
DeLuca saw nothing to worry about.
When your heartbeat stops ♪
Great.
And the world won't spin ♪
I'm sorry.
I was so freaked out over
one baby, and now it's
And I'm exhausted. You know, I worked
20 hours straight last week.
I delivered eight
babies with no caffeine.
I told you you should rest after that.
Are you mad at me?
Oh, could the story end ♪
You locked me out of
your car this morning.
You kicked me out of the
ultrasound appointment.
I didn't kick you out. I
I was overwhelmed and hormonal.
This is a high-risk pregnancy!
The odds of making it full
term with two healthy babies?!
I'm scared!
Yeah, and you think I'm
just worried about cars?
- No, I d
- I'm scared out of my mind!
I'm scared for them.
I'm scared about you.
Every outcome we envision ♪
We're supposed to be partners.
If we're falling apart just
thinking about having twins,
what's gonna happen when
we actually have them?
Fall before you fly ♪
[EXHALES HEAVILY]
Sometimes it's gotta
fade before it shines ♪
We can try to hide our doubts and fears.
When your heartbeat stops ♪
Ooh-ooh ♪
And the world won't spin ♪
Ooh-ooh ♪
When your time is gone ♪
Ooh-ooh ♪
- Don't know where it went ♪
- [CHUCKLES]
Ooh-ooh ♪
Ohh, ohh ♪
Or we can accept the unknown
What's this?
and dive in.
Where we begin, whoa-oh ♪
Where we begin ♪
Ohh-ohh ♪
Where we begin ♪
Ohh-ohh ♪
I've had an extremely long day.
I just wanted to end it with you.
And a real meal.
Mm-hmm.
Are you hungry?
Starving.
[BOTH LAUGH]
We can start again ♪
The real thing is better anyway.
We begin ♪
♪
♪