Grey’s Anatomy – S18E04 – With a Little Help from My Friends | Transcript

Richard recruits Meredith and Bailey to help him launch a new program. Meanwhile, Addison's patient has complications from a procedure, and Jo helps a woman who goes into premature labor.
Grey's Anatomy - S18E04 - With a Little Help from My Friends

Original air date: October 21, 2021

Richard recruits Meredith and Bailey to help him launch a new program. Meanwhile, Addison’s patient has complications from a procedure, and Jo helps a woman who goes into premature labor.

* * *

♪♪

Meredith: Surgeons like to believe they’re the center of the universe, that their million-dollar hands are the only thing that matters.

I don’t know how you do the thing you just did…

[Chuckles]

…but it… mm… was…spectacular.

Mm-hmm! [Chuckles]

Well, I got to give you a reason to keep me around.

[Both laugh]

Well, maybe tonight,

I might just return the favor.

♪ Nobody tryna play you Ooh. ♪

♪ Red pill, blue, what to choose? ♪

Maybe sooner than that. Hm?

Richard Webber, are you still on that?

Come on. I already told you no.

Well, maybe it’s time to reconsider.

Well, what if something goes wrong, baby?

Trust me.

♪ Fall in love with me tonight ♪

♪ No need to play it cool, babe ♪

You only need a scalpel and the patient to use it on.

No one else.

[Pounding on door]

I used to believe it, too.

[Pounding continues]

Taryn: Levi!

Um, I’ll be right there.

Check your phone.

But that was before I had kids.

[Gasps]

Oh, my God. What?

Webber’s back as residency director, officially.

What happened to Grey?

Uh, it says she’ll be splitting her time

between doing surgery and research.

Taryn: Levi!

[Pounding continues] Uh…

Oh, it also says we were supposed to be

in the skills lab 15 minutes ago! [Grunts]

[Pounding continues]

Okay. I’m coming!

♪ Stubborn like a mule, babe ♪

♪ Trying to save your pride ♪

[Scoffs]

What?

♪ You ain’t got to hide ♪

♪ I can tell how I look you in the eyes ♪

Truth is, from the time your patient first gets sick to the time they’re lying on your table…

Hey. Hey.

I thought you were leaving early this morning.

She started seizing when I was on my way to the airport, so I hit her with lorazepam, phenobarbital and put her in an induced coma.

And now I need a world-class neurosurgeon to help me figure out why my landmark transplant patient is circling the drain.

♪ Come fall all the way ♪

…a team of internists, specialists, and nurses have already interacted with that patient more than you ever will.

♪ No need to play it cool ♪

I was starting to think you weren’t gonna show up.

[Sighs] I almost didn’t. I can’t stand the whining.

[Chuckles] Well, you don’t have to stay long.

Is that Roy?

When you write these testimonials, I want you to lay it all on the table.

I want to know every diagnosis, every symptom.

Did you lose 40 pounds?

Are you sweating through your sheets?

Explosive diarrhea.

[Laughter] Do not hold back.

Testimonials?

Roy’s headed to Washington next month to lobby.

Won’t shut up about it.

We gotta do to the VA what Barb Simmons did to me

in the fourth grade when I was hanging on the monkey bars… pull their shorts down and expose them.

[Laughter] Bastards.

[Indistinct conversations]

No, it couldn’t be.

[Coughs]

Sergeant.

Colonel.

Thought you said you’d never be caught dead at one of these.

Anyone’s dying, it’s you, old man.

[Laughter] Yeah.

It’s good to see you, man.

Good to see you. You look good.

Roy, I want to introduce you to Major…

Owen Hunt, Army trauma surgeon.

Welcome.

And what delightful disease have you been blessed with?

None, fortunately.

Um, I’m here because I’m hoping we might be able to work together.

I’m starting a study to prove the link between burn pits and your illnesses so that the VA will have to auto–

[Coughing] You okay?

Roy.

Roy?

Roy, Roy!

Put him on his side. Call 911!

[Coughing]

[Baby crying]

Is she okay?

Oh, teething.

Well, in that case, are you okay?

[Sighs] I haven’t slept, all I’ve eaten is a handful of cereal…

no, no, no, no, no!

…and I’m late for work.

I’m sorry I asked.

[Crying continues]

Jo: Thank you.Okay.

I knew how to be alone, but now I’m alone with Luna.

I’m responsible for her life.

I’m so tired, I could drop dead.

[Horn honks]

Tough stuff being a single parent.

You don’t happen to have any teething tips, do you?

At this point, I would try ritual sacrifice.

[Tires screech]

Earplugs? Oh.

[Horn honks]

Man: Help!

I need some help! Okay.

Oh, I’m sorry, I’m sorry, I’m sorry.

I don’t… I don’t know what’s wrong with her.

She just started screaming and breathing and…

[Groaning] Are you in labor?

I’m not due for a couple more weeks.

Okay, um…

You’re pregnant?

Is it mine?

We’ve been together for four weeks.

How would it be yours?

I’m gonna page OB.

Oh, I am OB.

Here. Can you, um, take her to daycare for me?

Bye, baby. Gladly.

Okay, um, go inside and ask for a wheelchair.

[Groaning lightly]

Now, now!

Yeah, okay.

[Crying, groaning]

Hi. Congratulations. You’re doing great.

Okay, deep breaths.

Woman over P.A.: Nurse Tyler to the OR. Nurse Tyler to the OR.

Grey! I thought you’d be settled in Minnesota by now.

[Chuckles] I leave later on this evening.

And I’m only going for a couple of days a week. Mm.

And I’m still your chief of general.

And as long as you credit Grey-Sloan when you save humanity, you do you.

What I want to know is why Webber has paged us here to the skills lab.

And cleared my whole schedule.

You too? Yes.

Well, I don’t know who approved this, but it sure wasn’t…

I did.

Meredith: Would you like to tell us why?

Richard: It’s a big day.

Not only is it my first official day back as residency director, I’m debuting a new teaching method, and the two of you are going to help me. Uh…

Come on.

Uh… [Sighs]

Alright, attention, everyone.

Today is gonna be a day that you will remember for the rest of your careers.

Each one of you is gonna perform a lap chole start to finish…

…on your own.

Today, you will be attendings.

What?!

[Laughing] Oh, my God!

Are you kidding? He’s serious.

Welcome to the Webber Method.

[Chuckles]

[Cheers and applause]

I take it back.

What?

You can’t go to Minnesota.

This man has lost his damned mind.

Oh, my God. Oh, my God.

Yes, God!

Hunt, what’s going on? Roy Davis, 60, experienced syncope after an episode of hemoptysis.

BP is 160 over 100, and he’s tachycardic.

Gonna need chest films ASAP.

Roy.

They won’t show anything good, I can promise you that.

Roy, I’m here.

He has the same thing I have…

…pulmonary fibrosis… more advanced.

Listen, I know you’d rather chew gravel than hang out here, so don’t…

I’m staying.

Trauma 1 is open.

Okay, let’s get him inside!

You stay in the lobby.

I’ll update you as soon as I can, okay?

[Coughs]

[Groans] Niki, you are 5 centimeters dilated and having this baby today.

Congratulations.

But it’s too early. I’m not ready.

And…

And…

And today’s our one-month anniversary.

Wow! It’s a special day all around.

Who’s the dad?

No dad. Just a hook-up.

We had sex. A lot of sex.

I had a lot of sex with a pregnant woman.

It works just the same.

Okay, but, like, I’m pretty sure that’s outside of my moral code.

W-Why didn’t you tell me?

Look at me. I thought you knew.

I just thought you were…

Aaaah! Okay. Uh, Dustin, right?

Uh, Niki is in good hands.

Why don’t you take a breather, go find some ice chips?

For her, not you.

[Groans]

Niki, are you okay?

My chest really hurts.

Okay, Wilson, let’s get an EKG and vitals.

Right.

Okay. Breathe.

[Breathes deeply] Good.

Okay, now, this system of concurrent surgeries will allow us to put experienced residents in the OR as leads, and then attendings can rotate in and out for maximum efficiency.

I don’t like it.

Look, look. If you look here, the average lap chole lasts what… 45 minutes?

But the most critical part only lasts…

5 to 10. Exactly.

Which means, if each attending rotates according to the schedule, we can be in each and every OR…

At precisely the moment we need to be.

Yes.

I still don’t like it.

[Chuckling] Bailey, this is the answer to our biggest challenge right now….

…the physician shortage.

A-And it’s lap choles.

It’s not transplants and Whipples.

Look, this generation of residents… they don’t have a thousand hours to watch us operate while we work them to the bone.

I mean, they want to work smarter, not harder.

And who would blame them?

I don’t need generation education.

I need patients not to die.

I’ve been saying for a long time that we need to get the residents out of the lab and into the OR.

Uh…

What do you say, Bailey?

You ready to do 12 lap choles today?

Look, the system only works with three attendings.

We all have to be on board.

God help us. Fine. Let’s do it.

You won’t regret it. Okay.

Let’s not go that far.

[Laughs]

Woman over P.A.: Dr. Wagner to radiology.

Dr. Wagner to radiology.

Oh, Hayes, hey.

Do you have a quick second for a pediatric consult?

For Grey’s award-winning abdomen? Sure.

[Chuckles] A 14-year-old kid, plays soccer in a park near our hotel.

Mm-hmm. Seemed to be getting extra winded the other day.

Um, his ankles look a little swollen.

Is that… Is that anything?

[Sighs] Could be. Or not.

I’m sorry. I’d have to examine him myself to tell you anything more definitive.

I was afraid you’d say that.

[Telephone rings in distance]

[Indistinct conversations in distance]

Roy: So, how’d you meet Noah?

He avoids doctors like the plague.

I, uh, treated him and his son recently.

Ah, the accident. [Coughs]

That tree will never be the same.

Or the car.

Noah’s the closest thing I have to a son.

[Coughs] Met him when he was a pimple-faced recruit whose voice had barely dropped.

I watched him grow up, get married, [coughs] have Danny.

Have you met Heather yet? [Coughs]

His wife? No, not yet.

I love Noah, but he punched above his weight on that one.

[Laughter]

The scans are up.

[Beeping]

Oh, man. Damn it.

See that nodule there?

Lung cancer.

Probably an early stage, but since he’s also got pulmonary fibrosis…

Might as well be terminal.

All because the U.S. military couldn’t be bothered to properly dispose of its trash.

Lotta silence out there. Must be good news, huh?

♪♪

Amelia: CT’s negative, labs look good.

She has no history of seizures?

You don’t think I would have told you if there’s a history of seizures?

Mm. No family history?

Same answer.

Okay, but it is my job to ask the questions.

No, I get that, but maybe just ask smarter questions.

Are you okay? No, I’m not the patient.

Ask smarter questions about my patient.

Addie

No. Just no, no, no.

I’m Dr. Montgomery. You’re Dr. Shepherd.

And we are fixing this woman who’s lost so many pregnancies and then lost her husband.

We are fixing this woman whose sisters literally begged her not to participate in my clinical trial because they were so afraid of losing her, too.

We are fixing this woman, Dr. Shepherd.

And, ideally, we are going to fix her without having to remove the donor uterus, setting my study all the way back.

[Monitor beeping, respirator hissing]

Okay, Dr. Montgomery. I need an MRI.

Um, because she was in status, let’s get an EEG.

And re-run her electrolyte panel and her immunosuppressant levels.

That sounds like an excellent plan.

Mm-hmm.

Hi.

Back so soon?

Uh, that patient I told you about… he’s here.

Exam Room 4.

That was fast.

A little too fast.

But just make sure you talk to him like a doctor.

I am a doctor.

Be straight with him with both of us, okay?

Okay.

Dr. Hayes, this is my son, Farouk.

Hi.

♪♪

Mm.

Hm.

Meredith: Are you…

Praying. Yes.

[Breathes deeply]

It’s going to be okay, Bailey.

These are human beings.

These are human beings with children and parents and sisters and brothers.

And we’re putting their bodies, their lives in the hands of… children.

But they’re not children.

But they look like children… with scalpels.

Well, so did we once.

♪ One time Mnh-mnh. ♪

♪ Oh, yeah ♪

♪ Two times ♪

You’ve done this before, right?

In Pakistan?

Years ago. Many years ago.

Scalpel.

♪ It make me wanna dance ♪

♪ Big sound ♪

♪ In my system ♪

♪ Four times ♪

♪ Is a rebellion ♪

♪ Sweetie make me happy ♪

What are you doing?

I saw Shepherd do it once.

♪ Oh, yeah, oh, yeah oh, yeah, oh, yeah ♪

Scalpel.

♪ Searchin’ for some lovin’ ♪

♪ Don’t you worry ’cause I’m here ♪

Scalpel.

♪ You’re my ♪

♪ One in a million ♪

♪ Oh ♪

♪ Are you ready? ♪

♪ Are you ready for some fun? ♪

♪ Oh, na, yeah ♪

♪ Are you ready? ♪

♪ We can’t stop ♪

♪ We’ve only just begun ♪

♪ Oh, yeah ♪

♪ Ooo ♪

♪ I show you somethin’ new ♪

♪ Hey ♪

♪ I’m gonna make you move ♪

♪ I show you something ♪

♪ You’re my ♪

♪ One in a million ♪

♪ Ooo ♪

♪ Are you ready? ♪

♪ We can’t stop ♪

♪ We’ve only just begun ♪

♪ Oh, yeah ♪

♪ Ooo ♪

♪ I show you something new ♪

♪ Hey ♪

♪ I’m gonna make you move ♪

Hey, Doctor.

Um, can you give this to Niki?

She asked me to charge it, and so it’s charged.

Here.

Oh, come on. You’re leaving?

You can’t just hold her hand for a few hours so she doesn’t give birth alone?

We matched online a month ago.

I’m not a bad guy. I work at the Post Office. [Sighs]

I live in a studio apartment. I’m not ready to be a dad.

And she lied to me.

I mean, don’t you think this is a pretty big lie?

Just give me the phone. [Sighs]

[Telephone ringing in distance]

[Indistinct conversations in distance]

Okay.

Um…

[Clears throat]

Farouk’s EKG shows nonspecific ST changes.

And I hear a concerning murmur.

So I’m not losing my mind.

No.

[Sighs]

Is there anything I should know about Farouk’s medical history?

He used to get a lot of ear infections.

[Chuckles] He once fell off his bike and knocked out his two front teeth, and it was just

Right.

Not relevant.

He was treated for TB about 10 years ago in Iraq.

I don’t know anything about the first four years of his life.

Iraq. That’s where he grew up?

He was born in Syria, but he came to Iraq as a refugee after his parents died.

I raised him while I was being held as a POW and, you know, getting my abs exploded.

You and your brother both served.

I didn’t realize.

How would you?

I want to do an echo.

Do it. Do it all.

Uh, Hayes, and do you mind just keeping this between us for now?

If Owen finds out about this, he’ll freak out, and I’m already freaking out a little bit.

I’ve been there. [Breathes sharply]

Of course. Thank you.

[Conversations continue]

[Child babbling in distance]

[Conversations continue]

Owen: Hey there, Roy.

Roy: Well, you two gonna tell me what you saw on those scans?

My ex-wife looks happier to see me than you two.

[Laughter]

Noah, you mind giving us a minute?

No, it’s okay, Doc. He

He… He can stay.

[Clears throat]

Roy, there was an abnormality in a section of your lung, and it looks like it’s an early stage of cancer.

Early.

Doesn’t sound so bad.

Well, with cancer, the usual surgical treatment would be a lobectomy.

We’d take out that entire section.

But with fibrosis this advanced, you can’t afford to give up that much of your lung function.

Well, I didn’t exactly think I had a whole decade in front of me.

[Clicks tongue]

So, what’re we talking? [Coughs]

A couple years?

Sooner?

[Coughs] Hmm?

What can you do to get me to Congress next month?

Well, we could try a segmentectomy, where we’d just remove the mass.

It’s very risky, though. [Coughs]

Honestly, I don’t know that I’d recommend it.

But it could buy me some more time, yeah?

Possibly. A little.

Well, let let’s do it. Slice me open.

Roy, no.

Send somebody else to Washington.

Hey, if I collapse while I’m there, it might help our case, right? [Coughs]

It’s fine.

I have a little cancer, yeah?

I’ve spent my entire career… hell, my entire life– fighting.

Why would I stop now?

I want the surgery.

Okay.

[Machinery whirring]

Tell me why you left Scout’s dad.

I already told you.

No, you told me you said no to his proposal, but you didn’t tell me why.

Uh. Well, everything about it was a disaster.

I mean, it felt gaslighty and manipulative that he did it at Maggie’s wedding, using Mer’s kids as props.

Is he a gaslighty and manipulative guy as a rule?

No.

Because, you know, the other way you could see that proposal is that he was being incredibly earnest and romantic.

I mean, if you were a person who saw the world through rose-colored glasses, you know, like people in… in love do.

Okay, I want to go back to pretending we don’t know each other.

And we’ll do that when the films are up.

How come you get to make all the rules?

Because I’m older and because my patient might be brain-damaged, and I need to be distracted.

So tell me why you said no.

Um… [Sighs]

I knew for months that I didn’t want what he wanted.

We had Scout, and we had Mer’s kids because she was in the hospital with…

I heard. I prayed. Yeah.

So we were drowning in children and domesticity, and every day, I felt like I might die of it.

[Sighs]

I love all the kids, but every day, I thought I might die of monotony and boredom and dirty diapers and dirty dishes and laundry.

And every day, I thought about doing drugs.

And every night, I went to virtual meetings.

And I am here to tell you that those virtual meetings… [Clears throat]

…while better than no meetings, are no substitute for regular in-person meetings.

They’re not the same.

And, so, I was hanging by a thread, and, um, Link…wasn’t.

He was falling in love with domesticity.

And he was the world’s most stand-up guy.

And he started proposing all the time, despite me saying no.

And he decided that he wanted more kids, and I felt like I couldn’t breathe.

And, um, then I judged myself for that, like I think you are judging me now.

During the pandemic, I drank so much red wine, I seriously considered checking myself into rehab.

Really? Addison: Really.

I looked like a swollen tick.

[Both laugh]

I lost it.

Lost it.

I just hated… hated… being stuck at home.

You know, some people loved it.

They baked bread. I don’t like bread.

I began to truly hate my video-game-obsessed son and my husband, who, by the way, took up a model-train hobby that seemed to truly delight him.

No. Exactly.

Mm.

Yeah, I um… I went really dark, Amelia.

I had dark, dark thoughts.

I was daydreaming about going to sleep and never waking up, and that thought… comforted me.

I hate that for you.

[Sniffles]

And thank you.

Thank you.

Because…me too.

[Beeping]

Films are up, Dr. Shepherd.

[Clears throat]

♪♪

Venting the ports.

[Monitor beeping, ventilator hissing]

You’re already finished?

Yeah. Is that bad?

Oh, gosh. Did I forget something?

No, no, no. It’s

It’s…

We just got one more lap chole through the ER.

You’re making excellent time.

How’s about a double feature, Schmitt?

Hell yeah.

Dr. Webber, sir.

That’s what I’m talking about.

Your patient will be in OR 7.

Khan, you’ll assist.

[Monitor beeping, respirator hissing]

[Singsong voice] We got two lap choles!

We got two lap choles!

Yes, we did! [Laughs]

0 Vicryl, please.

Looking good, brother.

[Coughs]

Okay.

Whoa! Looks like you have some visitors, Roy.

Eh, just a few familiar faces.

Look at this sorry lot, huh?

[Laughter]

Eh, Noah shouldn’t have bothered you all.

Well, you knew we had to get our last licks in before you went under the knife.Ah, yeah.

Listen, if I don’t make it out of there…

Will you shut up? Of course you’ll make it.

[Laughs] You know, at our base, the guys from the Afghan army would bring chickens and cook them for us.

Well, one day, they brought a live sheep.

Remember this?

And Roy insisted on helping out.

Told ’em he’d, uh, butchered pigs before or some lie.

[Laughs, coughs]

I stand by that lie.

[Laughter]

And this sheep… well, he did not like Roy.

The second he got near him, he got kicked in the head, knocked on his ass, and trampled.

[Laughter]

What happened to the sheep?

Well, he took off, left Roy on the ground, bloody and bruised.

That’s gotta hurt.

So I run over, and Roy is out cold.

And just when I start to panic, his crazy eyes fly open.

He jumps up, screaming, “Yeehaw!”

And he takes off after that sheep.

I have no memory of that. I… I…

[Coughs] Probably because of the concussion.

Point is, if that angry sheep can’t get rid of you, nothing can.

[Coughs, groans]

Pbht.

[Grunting]

♪♪

Okay.

You guys, I won’t forget this.

You all coming here for me.

♪♪

We ready?

We’re ready.

Go. Yeah.

Man: We got your six.

Alright, brother.

You got this, brother.

Get ’em, Roy.

♪♪

Jo: Niki, your EKG looks normal, and cardio couldn’t see anything on your echo.

So is it possible that you’re experiencing a little anxiety?

Niki: Is it possible?!

I’m having a baby, and, somehow, my new boyfriend didn’t notice I was pregnant.

Of course it is possible.

[Groans]

Where is Dustin with those ice chips?

What is important right now is that you take some deep breaths and stay calm, okay?

He left, didn’t he?

[Sighs]

[Voice breaking] I’m all alone.

I can’t do this all alone.

Yes, you can. I know you can.

All my friends thought I was crazy for having some random guy’s baby.

And my parents told me they wanted no part of it.

[Crying] So I moved across the country.

And I was lonely and scared.

And then I met Dustin, and he didn’t seem to mind.

How did he not notice?

I don’t know, Niki.

But

But you wanted to have this baby, and you are about to meet him.

I just wanted someone to hold my hand.

I’ll hold your hand.

[Both laugh]

Who’s gonna deliver the baby?

Um, hey, uh, can you page Dr. DeLuca, please?

Now.

Here we go. [Sniffles]

We almost have the critical view of safety cleared.

Are we ready to move forward?

[Monitor beeping, respirator hissing]

[Monitor beeping rapidly] The field is filling with blood.

Why is the field filling with blood?

Maybe you should suction.

But you’re my assist. Maybe you should suction!

Okay, uh, indications to convert to open cholecystectomy… adhesions, fibrosis, unclear anatomy, hemorrhage.

This could be the cystic artery, the hepatic artery…

[Monitor beeping rapidly]

We have to open her up.

We? Get the trocars out.

And somebody call an attending.

[Rapid beeping continues]

Okay, the good news is, there’s no sign of CVA, edema, or tumor.

And there’s no electrolyte abnormalities or infection.

Okay, well, that’s good news and bad news.

Why?

Because with everything else ruled out, it’s likely that the seizures are being caused by neurotoxicity from anti-rejection meds.

Damn it. Damn it!

We can switch her immunosuppressants and keep her on anticonvulsants and watch her like a hawk.

I live in Los Angeles, okay?

And as much as I hated them when I was trapped in a house with them, I do love my son and my husband.

I have to get back home to them.

I mean, I-I had arranged for the clinical-trial team to monitor her from here on out.

I can, too.

Oh, I can’t because I’m going back and forth to Minnesota.

But Bailey can or s-someone can.

[Sighs]

What I’m saying is, we can help.

You’ll just have to share credit when you publish.

Don’t say that like it’s a small thing.

I mean, it’s risky. She’s had so many seizures.

If she seizes up again, I

[Door closes]

Well, we’ve loaded her with anticonvulsants.

We will watch her closely.

If we have to take out the uterus, we take out the uterus.

But let’s cross that bridge when we come to it.

I want to agree with you.

Okay, so what’s stopping you?

I need to not kill this patient.

I need to not let her die.

And… And helping her helped me.

It excited me. A uterine transplant?

I mean, the thought of creating something for her that didn’t exist before her made me want to get out of bed in the morning.

But I don’t want to make a decision that’s selfish.

I need to prioritize her life over the study.

And I need you to tell me if there’s a chance that you think I’m not.

Dr. Montgomery, your patient was so in love with her husband that she is having a baby with him even though he is dead.

She’s so in love with the idea of becoming a mother that she entered your study knowing that she was risking her life.

You are not being selfish.

You are doing every single thing you can to help her live her dream.

And that is an excellent reason to get out of bed in the morning.

♪♪

We’re almost ready here, Roy.

Are you sure you still want to go through with this?

[Groans]

I got a daughter.

She lives on the East Coast with her husband, two kids.

I don’t ever see them.

She took her mother’s side in the divorce, and that… that was it.

But if someone had done this to her, if someone had made her breathe in that crap and caused her a lifetime of pain, I’d want that person dead.

Roy, we’re going to stop this.

We’re going to hold the people at fault responsible, okay?

I’m responsible.

I’m not sure I understand.

I authorized it.

The burn pit on our base.

Trash was piling up.

There was no plumbing, no sewage system.

And it’s not like the garbageman comes on Tuesdays. I…

[Coughing] I heard the, uh, other bases were burning it all.

[Coughs, sniffs]

So…that’s what I told them to do.

I didn’t invent the idea…

[Coughs]

…but when I close my eyes at night, I see that black smoke billowing up from the ground, and I know that I committed the worst crime…

…complicity.

♪♪

[Sniffles]

So, at the end of the day, I might deserve to die.

Everyone else deserves to live.

Let’s do it.

Let’s go.

[Whooshing]

[Monitor beeping rapidly]

What happened? I-I don’t know.

The field filled with blood, and now I converted to open.

And now…

Well, you should have waited.

She was bleeding out. You still should have waited.

I’m sorry, Chief, but…

Step aside.

Okay, I need another suction and I need laps now.

What can I do?

If you want this patient to live, step aside.

Okay.

Okay, suction.

Okay, clamp.

Owen: I have never seen lung tissue like this. You?

I have in advanced ARDS, secondary to COVID.

And it didn’t end well. Suction.

[Sighs] The tissue’s just falling apart in my hands.

Stapler.

Thanks.

[Suction gurgling]

Okay.

Thank you for doing this.

I know you didn’t think it was a good idea.

No, I didn’t, but I believe in fighting for what’s right, and if giving this guy a few more months helps make life better for others, I’m in.

Okay. Alright.

[Monitor beeping rapidly]

He’s hemorrhaging.

Hold pressure. I’ll try to find the source.

Yep.

DeBakey clamp now!

Yeah, yeah. Come on.

Come on.

There. Got it.

[Rapid beeping stops]

[Breathes deeply]

Alright. So, that’s how this is gonna go, huh, Roy?

[Chuckles] I’ve only known this guy for eight hours.

I’m pretty sure he’s not going to make it easy on us.

I operated in Boston for 15 years.

No patient made it easy on me.

Hemostats.

[Suction gurgling, monitor beeping]

Finished.

And that, ladies and gentlemen, is how it’s done.

Yes, it is!

[Both laugh]

Flawless technique on not one, but two lap choles today.

Take notes if you want to survive.

Thank you, sir, for the opportunity, the patients, the wis–You know, by working together, we saved 13 patients from cholecystitis… a hospital record.

You should all be proud. Now, study hard.

Today was lap chole.

Tomorrow, it could be something more.

Don’t come unprepared.

[Cheers and applause]

Yes!

♪♪

Hi, Tovah.

I’m Dr. Shepherd.

♪ Every little heartache ♪

Is it gone? Did I… Did I lose it?

Did you take the uterus?

No.

But, Tovah… you didn’t reject it.

♪ When I was wasted ♪

Is there still a chance?

There’s still a chance.

We’re gonna step up your protocol, and you’re still in the trial.

[Crying] Oh, my God, thank you.

♪ I mostly now forget ♪

Thank you. My God. [Sniffles]

♪ I flew all around the world ♪

I’m gonna do a quick neuro check.

Let just… give her a minute to cry.

♪ It was all the same ♪

♪ It was all a game ♪

[Groans]

Wilson, what are you doing?!

She won’t let go of my hand!

Okay, you’re an OB.

[Door closes]

Your job is to deliver the babies, not to hold hands.

♪ So break my heart ♪

Okay.

[Groans]

A-And she’s crowning.

Niki, I need to help get the baby out, but I will be right over here.

No, no, no. No, I can’t do this.

I just can’t.

Niki, you’re worried about being alone.

You’re not alone.

You have your son, and as soon as he comes out, he will be your whole heart.

And it’s hard, and it’s exhausting, and there are days when you will turn around and wonder,

“Where is this baby’s mother?

Because it absolutely cannot be me.”

♪ Go on and break my heart ♪

But you will love him so much, you’ll let him sleep on you anywhere, anytime, no matter how uncomfortable you are.

And just one smell of his head will make you feel like your heart could explode.

And that is worth so much more than your fear.

Okay? You ready to start pushing?

On the count of three.

One, two, three.

[Groans, screams]

Push, push, push, push.

Here’s the head.

Good.

[Groaning] Wait, wait, wait.

Niki, stop pushing.

Okay, uh, shoulder dystocia.

Baby’s shoulder is caught behind the pubic bone.

Okay, Wilson, what do you do?

Uh, we’re doing a McRoberts maneuver to get the baby out.

Wait. A what?

We’ve got you, Niki.

♪ Every little heartache, every little mistake ♪

Alright. We ready to push again?

[Crying] Okay. Alright.

One, two, three.

Go. [Groans, screams]

Okay, Wilson, put your hand in and find the anterior shoulder, okay?

You got it?

Yep. Okay.

Now push the back of the baby’s shoulder towards the chest.

[Groaning] Gently.

Okay. [Groans]

Here he comes.

Oh, my goodness.

You have a boy.

Oh, my goodness.

♪♪

Well done, Wilson.

♪ Into a thousand parts ♪

[Baby crying]

♪♪

[Indistinct conversations in distance]

Farouk’s echo and cardiac MRI show constrictive pericarditis.

Most likely secondary to the TB. Hm.

[Sighs] I’m so sorry.

I-I wish it was better news.

He’s already been through so much, more than any kid should. [Scoffs]

And the hits just keep coming.

Do you want to be alone?

[Crying] I’m sorry. I don’t… I don’t usually do this. [Sobs]

It’s your son. All bets are off.

Mnh.

[Sniffles]

Uh, okay, so… so what does this mean?

Is he gonna need surgery or… [Sniffles]

I have to consult with cardio, but I think so, yes.

Most likely a pericardiectomy.

Oh, God.

I’ll admit him, and we’ll go from there.

Oh, Farouk! Oh, my God!

God, he’s so he’s so good.

I mean, he’s a teenager, but…

God, he’s just always been such a good kid, despite what this messed-up world has given him.

He has to be okay.

I will do everything in my power to make sure that he is.

That’s a promise.

Okay.

Do you want me to call your brother?

I’ll tell him, just not yet.

I… I-I need to sit with this by myself for… for a minute.

Take all the time you need.

♪♪

[Sniffles]

♪♪

So, his lungs had more scarring than we expected.

It’s gonna be a tough road ahead.

Well, he can handle it.

I know he can.

[Coughing]

[Breathes sharply]

Thank you.

Honestly, you’re the first doctor I’ve met who actually gave a crap, who’s really done anything for any of us.

Well…I’m sorry that’s the case.

But this is personal to me, you know?

I am in this with all of you guys, okay?

[Monitor beeping]

[Monitor beeping rapidly]

W-What’s happening?

Dr. Hunt!

Noah, I’m gonna need you to leave, okay?

I’m not leaving him.

Sergeant, step outside, now!

Now!

Winston: Damn it, his O2 is plummeting.

Noah, you got to go.

Come on, Roy.

V-fib! Paddles!

Come on, Roy. Sir, you’re not allowed in here.

Sir, you’ve got to go. Come on, Roy.

Come on, Roy. Hang in there!

Okay, let’s charge to 120.

Ready? And clear.

[Paddles thud]

No change. Push 1 of epi.

Charge to 150. And…clear!

[Paddles thud]

Come on, Roy.

200!

And clear!

[Paddles thud]

♪♪

Who wants cider? Congratulations, sweetheart.

[Laughing] Ah. I know I was skeptical, but 13 lap choles, that is something.

[Laughs] Yes.

Even though you did con me into agreeing this morning.

Con? Mm-hmm.

Is that what you’re calling it, what we did?

Mm-hmm.

[Gasps] [Laughs]

Well, you’ve set the bar very high for yourself.

The residents are going to expect this all the time.Ohh.

I mean, who knows? The scrub nurses may walk out.

[Laughs] Ah, well, everyone will adapt.

They’ll have to, because from now on, this is gonna be my primary method of teaching.

To the Webber Method. Yeah.

Ooh! Rolls off the tongue, doesn’t it?

Mm-hmm. [Laughs]

Ah. You still don’t like it.

No, I don’t.

Look, Helm clipped that artery with no attending in the room.

When I first walked in and saw all that blood, even I didn’t know which way was up, so how was a resident supposed to?

You know as well as I that complications could happened to… to… to any one of us.

Which is why we owe it to them and the patients to be there in the room.

Bailey, 10 years from now, we are going to be short tens of thousands of surgeons if we don’t rethink what we’re doing here.

We’re a teaching hospital, and we have a moral imperative to make sure that people don’t die because there’s no one to operate on them.

That’s what we owe these patients.

Meredith: Helm did prove the system worked.

She asked for help.

She did exactly what she was supposed to do.

And you were there, and you helped.

The patient’s alive and stable and in recovery.

It did work.

[Mumbling] Oh, yeah. To the Webber Method.

No. I-I’m sorry. What, now?

To the Webber Method! Ah!

[Laughter]

[Mugs clink]

♪♪

♪♪

I’m so sorry, Noah. We did everything we could.

Winston: Roy’s lungs were just…too far gone, and the damage put too much stress on his heart.

Owen: Noah…

♪♪

I can help you continue Roy’s work, you know, the data, the testimonials.

Yeah, I don’t want your help.

I never wanted it in the first place, but you convinced me.

You convinced me to introduce you to my friends, my family, and look what happened.

You made it so much worse.

♪♪

♪♪

You know, I almost left Jake in the first lockdown, in the thick of it, about two months in.

I wasn’t even drinking. I was stone-cold sober.

I just…

[Chuckling] God.

They were bickering about “Game of Thrones,” and I just got up off the couch, got in the car, and drove.

Drove for about two hours before I stopped and even thought to ask myself what I was doing.

Are you asking if I’m sure?

I am saying that when one is in a slight mental-health crisis, one might regret the decisions she makes later.

I didn’t leave when I was thinking about doing drugs.

And I didn’t leave when I was wondering if Link would ever really understand me.

I stayed through all of that because I thought I must be crazy, because who leaves a really good and decent guy?

But I don’t feel crazy now.

And I don’t want to get high.

I just don’t want a ring, and I don’t want to have any more babies.

And… And I didn’t even leave him.

He left me. But…

[Breathes deeply]

But I hated the life that he loved, and so I think that the sanest and kindest thing I could possibly do is to let him go, no matter how much it sometimes aches.

[Elevator bell dings, doors open]

Look at you.

♪♪

Look at me, what?

Look at you, Amelia Shepherd, all grown up.

♪♪

♪ Pieces of my heart ♪

♪ Scatter like stones ♪

♪ And I’m just trying to figure it out ♪

Rough day? Yeah, I had better.

Sorry to hear that.

♪ For every one I find ♪

Hey, I don’t want to talk about it, but do you want to get a drink at Joe’s?

I think I, um… I think I need a minute before I go home to the wife and the kids.

♪ I’m just trying to puzzle peace ♪

Yeah, sure.

Sounds good.

♪♪

♪ I’m just trying to get some sleep ♪

♪♪

♪ But the ocean of my heart is raging ♪

Hey. Hey.

What’s up?

[Breathing heavily]

♪ I take a breath and try to breathe ♪

Mm!

♪ I’m just trying to puzzle peace ♪

♪♪

I-I heard you did two flawless lap choles today.

I did.

My rock-star boyfriend.

Huh? Say it again.

My rock-star boy–

Meredith: I’ve had to operate alone before…

♪ Looking for answers ♪

…in circumstances I would have never thought possible.

♪ But wise words only get me so far ♪

We’ll go home in a minute.

♪ I’d pull it apart ♪

[Yawning] I just need to find the energy to walk to the car and get in it… [Crunching]

…which might be tomorrow.

By now, I know what I’m capable of, how much I can handle on my own.

♪ I’m just trying to get some sleep ♪

And you know what?

I can handle a lot.

♪♪

♪ But the ocean of my heart is raging ♪

You’re playing the surgery over and over in your head, right?

[Clicks tongue]

When you saw that bloody field, you felt numb, but cold, and sick to your stomach?

Yeah. How’d you know?

[Chuckles]

You don’t think I ever made a mistake in the OR before?

♪♪

Or watched Meredith Grey make a mistake?

♪♪

[Sighs] I feel awful.

You should.

Thanks.

If you didn’t, you’d be in the wrong line of work.

It’s that feeling, that… that… that awfulness… it sticks with us so we don’t ever make that same mistake again.

♪♪

It’s how we become great.

♪ I’m just trying to puzzle peace ♪

[Chuckles lightly, breathes deeply]

Night, Helm.

But that doesn’t mean I’m going to turn down an assist from another pair of skilled hands.

♪ Oh-oh ♪

♪ Oh-oh ♪

♪ Oh-oh ♪

♪ Oh-oh ♪

♪ Oh-oh ♪

♪ Oh-oh ♪

♪ Oh-oh ♪

Because at the end of the day, just because I can do a surgery alone doesn’t mean I have to.

Hi. Let me guess… emergent kidney transplant.

Uh, liver, actually.

How’d it go?

Good. No bad. Good.

You’re here.

I’m here.

Should we get some dinner tonight?

Yes. [Chuckling] Okay.

Let’s do it. Let’s do it.

Okay. Okay.

Go get some rest. I will.

See you.

♪ I don’t really know what to say ♪

Knowing someone else has your back?

♪ And I take a breath and try to breathe ♪

It’s everything.

♪♪

♪ I’m just trying to puzzle peace ♪

♪♪

♪♪

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