09x17 - Transplant Wasteland

[bunniefuu]

To a critically ill patient, an organ transplant means a new start, a second chance.

But the body is designed to fight off

any outside invader, even one that's trying to save it.

Jackson Avery really has a bigger say than any of us in running this hospital?

That can't be true. Can it?

Well, he's a voting member of the management team and he also represents the Harper Avery foundation.

And their 175 million bucks.

As opposed to our $15 million apiece.

According to Stan, not only does he have the deciding vote, he can veto ours.

Because a transplant doesn't guarantee

that it's an easier life.

That is ridiculous. He's a fellow.

So are you.

But he's a plastics fellow. And I'm me.

Well, let's not overreact.

I mean, it's Jackson. He's not some corporate stranger.

He's one of us.

No, you're right. He's a smart kid.

He's gonna follow our lead.

No. No. We made this plan.

We pulled it together.

Look, I'm grateful to Harper Avery for an infusion of cash, but I'm-I'm not gonna let some-some ... Plastics fellow?

Plastics fellow tell me how to run my service

'cause his mommy said he could.

Preach.

There's a thr*at that the body

will reject the organ outright.

It was your idea.

It was pillow talk.

And suddenly, it's a business plan.

You were all for it at the time.

You investing in the hospital, sure.

Anointing your son boy king?

What on earth makes you think that young man's prepared to take on this kind of responsibility?

He's my son. I know what he's capable of.

And he's my student. I do, too.

You know, actually, I should revise that.

Now he's my boss, and my girlfriend is my boss' boss.

What could possibly go wrong?

You are forgetting who you're dating, Richard.

I'm the chairman of the board of a large foundation.

I have made an extremely savvy investment.

And I will manage my investment as I see prudent.

I've placed at the top of the organization an individual that is energetic, motivated, and responsive.

There's only one room in which I take orders from my boyfriend.

This is not it.

Good morning, ladies and gentlemen.

Good morning.

Shall we?

Okay, so we're agreed that the peds and adult E. R. s will be combined to save on personnel?

Yeah.

I'm sorry, guys.

I was running on time, and then my last rounds'

patient turned into a crier.

Pow.

Uh, we were discussing the reopening of the E. R.

and the trauma department.

Oh, yes.

Um, I'm not ready for that just yet.

If you need more time with the material, we can go ahead ... No, no, I've-I've read it.

Uh, it's just that the foundation feels like the E. R. is not a forgone conclusion.

They need a site visit, a chance to look over the numbers.

It could be a month before a decision.

Okay. The foundation knows we plan on getting our level-I trauma designation back, right?

They know that's the idea, yeah.

Uh, it's the fact.

I think we should table this until we can bring in Owen.

Uh, he'll have a lot of thoughts on this, too.

Yeah ... that's-that's the other thing.

What thing?

Okay.

Since we are starting fresh, the thought is that new leadership would be good for morale.

What, like, uh, chief of surgery?

Oh, no way.

f*ring Owen?

Okay, we're not f*ring Owen.

Okay, well, the foundation thinks that ... Your mother.

The Harper Avery foundation ... Your mother, Avery. Just say it.

It's a recommendation.

It's an inappropriate one.

Oh, tell your mom that. This is bull ... And this is going nowhere. I have surgery.

Yeah. Me, too. We should get back to this.

You know, I don't care who's giving you your marching orders, this thing with Owen is not happening.

Well, say what you want, but without the Harper Avery foundation, none of us are here.

And we appreciate that.

But no one expected them to come in and start dictating policy.

Yeah, well, no one asked you to sue the hospital into bankruptcy either.

For the plane crash that k*lled Lexie?

If we put Kepner's donor to O.R. 1, that moves Bailey's hernia to O.R. 5.

Robbins is in 5.

Okay, 6.

We don't have enough nurses to staff 6.

I thought you said you were getting them back.

I'm trying. Some of them are bitchier than I am.

Chief.

Yeah.

U. N. O. S. just called.

They got a kidney that's a match for Jaelynn Donovan.

Yeah, we have no room today, Karev.

No O.R. staff. Half the nurses have quit, including the transplant coordinator.

You may need to decline this one.

This girl's 16.

She's been on dialysis for 3 years.

Okay. All right.

Well, we'll figure it out, okay?

Okay, so ... Owen.

Uh, just a second.

Owen, they're talking about replacing you.

Ruth, excuse us, please.

What? W-why? Who is?

Avery.

But we're not gonna let that happen.

I just didn't want you to hear a rumor and think I didn't tell ... Dr. Yang, it's U. N. O. S.

They have a heart and lungs.

I'm gonna talk to Catherine Avery.

You're not gonna do anything. I am. Take your call.

Dr. Yang here.

Bradley Parker, 31 years old, end-stage A. L. S.

Uh, trach-dependent.

Had a lap-chole three weeks ago.

Now presents with a chief complaint of hematochezia.

He actually used the word "Hematochezia."

Yeah, he was an internal medicine resident at Mercy West while I was there.

He did a residency with A. L. S. ?

He was diagnosed second year and worked till he couldn't anymore.

He's an amazing guy.

Is that coming from ... Hey, could you turn that down?

Hey, guys. What the hell is going on here?

This is a hospital. There are very sick people here.

That includes you, too, Brad.

Okay, everyone out.

Let's go. Out. Come on.

It's all right.

I invited them.

Well, Dr. Edwards and I need to discuss your next steps.

So maybe if everyone could leave ... I already know my next step.

I'm donating my organs.

We do organ donation after a patient's brain dead.

You're nowhere close to brain dead.

I'm doing ... Mom.

He's doing D.C. D.

Uh, donation after cardiac death.

He can give if his heart stops.

I'm being kept alive by this vent.

Once we disconnect it ... Booyah.

Chief Hunt signed off.

Welcome to my funeral.

Avery ... Am I in or out?

What? That's ... Word is I might be out of a job, so I'd like to hear it from you.

Yeah, there was a thought that a change in leadership could be good for staff morale.

Oh, for morale?

I've been k*lling myself to keep morale up for the past three weeks, to keep this place open.

And no one is saying that you haven't ... Nobody's saying anything.

I've been shut out of every decision that you people make.

And now I hear this?

All right. Calm down.

Don't tell me to calm down!

Guys, guys, guys. Let's take this somewhere else.

Oh, this is coming from you, too?

You're all just talking about a new chief?

No. No.

It was brought up, and we tabled it.

Oh, you tabled it?

You shouldn't even be talking about it.

Listen, this is a decision that we have ... Avery, enough.

I'm just trying to explain ... Avery, go!

You know as well as I do there are politics here.

Mm-hmm.

We're trying to find our way. Just sit tight.

I am through sitting tight.

I am through looking like an idiot while you all lie to me.

No, we're not lying to you.

Oh, when you said that we were in this together, I thanked you, and then one hour later, you quit.

You're a liar.

No, no, no, no.

You lied to the staff.

We are doing the best we can.

And then I'm this poor sucker running around trying to fix this mess that you all made!

You don't!

You do not want to get into whose responsibility this is.

You don't want to get into who's responsible for all of this.

You don't!

Well, I can make this decision easier for you.

I quit.

Whoa.

Owen, what happened?

Did you get the heart and the lungs?

I ... yes.

That's great.

Talk to me.

Nothing happened, I'm just ... I'm done.

I should've been done a long time ago.

Okay, what are you talking about?

Shepherd is right. This is all on me.

No one blames you.

Well, somebody does.

And as long as that's true, I ... I don't see how I can be effective here.

Depending on when the organs come in, you might need to adjust the O.R. board, move things off until tomorrow.

Sweetheart. Owen ... Not the same.

Surgeons save lives.

You just catch it when it falls out of someone.

O. B. s do surgery.

Mm.

If a baby is not coming out ... Mm-hmm.

I go in, and I get it.

It's not the same.

Oh, plus every patient that I have is two patients in one.

So b*at that.

You wear pink scrubs.

Yeah.

Yeah, you win.

I have no response for that.

You really pull it off, though.

Oh, thank you.

Alex, do you know Jason?

Yeah, chest peckwell.

Jason Myers.

Have you seen where Jaelynn Donovan'parents are?

Isn't Jaelynn up in dialysis?

I know where she is. I asked about her parents.

Excuse me.

Are you getting on or what?

I'll take the stairs.

I'm going up there, too.

Oh, are you?

Mm-hmm.

Turn to page six, everyone, the ... Dr. Avery, could you ... Oh, come on in, sweetheart.

We're just going over the purchase agreement you'll be signing tonight.

I'm sure you've read through them.

Can I speak with you outside for just a moment?

Of course. Excuse me.

Oh, of course.

Yeah, it's right here.

No, I did not read through them, as I couldn't possibly read through them as they are not in english.

I understand.

I am not a lawyer and I am not an accountant.

Stop. Breathe.

Nobody understands those documents.

That's why these smart people are here to explain them to us.

All you have to do is hear what they have to say.

Ask a couple of questions, and trust your gut.

Now put on your game face and go in there and listen to the suits.

Try not to nod off when they start talking about debt-to-equity ratios.

It's like a sedative. Go on.

Okay, one more thing.

When we are in there, I am not "Sweetheart."

Okay, baby.

Okay ... What the ... Who is this?

God. It's Thelonious, dad.

We've only been getting dialysis for, like, an entire year together.

I'd be more comfortable if you were in your own chair.

It's bad enough to be in kidney failure.

Now you're gonna suck all the fun out of it?

I'm just asking ... Honey, let's not fight. Not now.

It's too big a day.

Oh, no.

What?

We found a kidney, Jaelynn.

No more dialysis.

Oh, my god, Theo. I'm getting a kidney.

Sweet.

Yeah.

Sweet.

Did anyone call Jackson for this?

Who cares? I mean, this is ... this is his fault.

Why do we need an emergency meeting?

Hunt quit.

What?

You can't keep throwing that plane crash in his face.

Oh, don't make this my fault.

He walked out. You shouldn't have told him.

Wh ... wait. Wait. You told him?

That he might be getting fired? Of course I did.

Oh. Nothing was decided, and besides, we weren't gonna let Avery get rid of Hunt.

Avery has his own agenda.

No, warning Owen is the least we can do.

We went behind his back long enough.

Cristina, we should probably keep what's said in here private.

Well, then count me out.

I have a heart-lung transplant coming in.

Oh, well, Karev's kid just got a kidney from U. N. O. S.

Two transplants in one day?

Three with Kepner's D.C. D.

Three? That doesn't happen.

Well, it did, okay?

And the O.R. s are fully booked.

We have half the nursing staff and no transplant coordinator.

Who was handling all that?

Hunt.

Ohh.

Nurses' station.

No.

Oh, Avery. Hey, what are you all doing about the, uh, Pegasus protocols?

The what now?

Pegasus put all these protocols in place, one of which is telling me that I have to do hernia repairs using their stupid varner technique.

Now I have a hernia repair today.

I would like to do it the way I've been successfully doing it since you were sucking your thumb.

We'll look at that.

Well, when?

There's all sorts of idiotic rules here, like the O.R. layout and organ transports, bariatric centers.

Isn't that why you're the boss now, so the place won't be run by idiots?

Thank you, Bailey.

You're welcome, boss.

Hey, have you guys seen chief Hunt?

I would like to know why he signed a death warrant on one of my patients.

Well, good luck. He's gone. He quit.

He ... what? Hunt?

Ask boss man over here.

There was a disagreement about policy.

Yeah, well, then change the stupid policy.

Unh-unh, not before he changes my stupid policy first.

My hernia's this afternoon.

They're going to get the donor heart and lung as we speak.

We should have you in the O.R. sometime this afternoon.

Oh, not a minute too soon.

You should've seen what I coughed up this morning.

I swear to god, the thing had hands.

Dr. Yang.

I was hoping I'd catch you.

Hey, you get your fat head out of my door.

Bad enough I gotta watch you go by my window 80 times a day while you walk your stupid laps.

I just want to know if Dr. Yang knows about the pepperoni pizza you've been smuggling in here.

Snitch all you want.

I'm not gonna be here much longer.

No kidding? You're dying.

Hey, there is a god, and he's heard my prayers.

Uh, Mr. Schulz is getting a heart-lung transplant.

A heart?

Well, he doesn't need a heart.

He's got junky lungs.

I've been on this machine for three months, and you're giving that bastard my heart?

You're not looking too good, Herman.

Somebody might be dying today.

Shut up.

Mr. Crump, please calm down.

Mr. Schulz's heart is compromised because of the stress caused by his pulmonary hypertension.

So a heart-lung transplant is the ... You're gonna have pulmonary hypertension unless you get a supervisor down here.

That doesn't make any sense.

A supervisor, now!

Absolutely. Right away.

Yeah.

So why do they hate each other so much?

They were neighbors.

Crump's wife left him for Schulz, like, 30 years ago.

No.

Yes. She ended up leaving him, too, for some other guy in the neighborhood.

No.

Yes.

No.

Can your mind be blown on your own time?

Right now I have to talk with my supervisor.

Um, well, you own the hospital now.

So doesn't that make you the supervisor?

It does.

So I will have that conversation with myself.

Well, should I, like, stick around for that or ... You're pushing all of our surgeries?

There's no place to do them.

Mer, I need you to do a kidney procurement in Missoula.

I gotta stay here and do the transplant, and Robbins is in surgery.

I can't. Hunt is gone, and I have to sort out where all these patients are going.

Come on. I'm not gonna risk some Missoula hack screwing up the dissection and giving me some unusable kidney.

Jaelynn got a kidney? Can I do anything?

I said I need a surgeon. You're not a surgeon yet.

And I forgot. Neither are you.

Upper management's too busy to get a kid a kidney.

Dr. Immerman to peds I.C.U.

Dr. Immerman to peds I.C.U.

Call Dr. Shepherd and ask him to fix this board, and book me a plane to Missoula.

The patient's this really sweet kid ... Whatever. You can come, too.

I-I've heard your plan, but you still haven't heard mine.

I can see not wanting a colonoscopy, but that's not the only option.

We could do radionuclide scans, angiography.

I mean, there's a-a bunch of endoscopic procedures that we could try.

This is why

I didn't tell you.

I knew you'd disagree.

And I didn't want to have to spend valuable minutes of my life convincing you.

You're depressed, but we can treat that.

I'm not.

I'm.

A. L. S ... is 100% fatal.

If I donate my organs, my death can mean something.

If I keep fighting, I get an infection and can't donate.

I've decided to stop fighting it.

So ... We're extra careful and we just make sure that you don't get an infection.

Come on. Please let me help you.

There are people who love you, who need you.

Come on. You ... you are still alive and so ... so you.

April.

Yes.

You're fired.

This is where you should check your meds off every day.

Okay?

You'll start your mornings with prednisolone and mycophenolate at 8:00 A. M.

Then follow that with, uh, fk-506 at 10:00 A. M.

and 10:00 P. M ... . those are for every day.

Then you'll also be on trimethoprim-sulfa three times a week.

Now you're just making up words.

Look, you have to take them no matter what, all right?

Or you'll lose the kidney. You can't miss a dose.

She won't.

Fine. I'll do whatever you just said.

Okay, the meds, uh, they can cause pretty dramatic mood swings, uh, hair thinning, weight gain, diarrhea, acne.

I mean, they don't always happen, but if they do, don't be alarmed.

If you were dying, would you donate your organs?

Of course.

Even if you still had time?

Mm. This the D.C. D. guy?

I have a plan. He just won't even listen to it.

You know, he's a doctor. He knows the deal.

He's not gonna get any better.

Yeah, but ... He's gonna save a crapload of people.

I think it's awesome.

He's got perfectly good organs. Might as well use them.

Oh, my god.

He has good organs.

That is genius. I am a genius.

So you'll have to pick up Zola.

Did you sort out the O.R. board?

I started, but I have a surgery.

I have Torres looking at it right now.

Why are you on a plane?

Oh, because Alex wants his kid's kidney mobilized before perfusion, and he's being a giant baby about it.

All right. Well, call me when you get back.

Okay.

He doesn't mean to be a giant baby.

Karev ... I think he just hates feeling like you guys left him in the dark.

You don't have to teach me how to speak Alex. I'm fluent.

I'm just learning.

I shouldn't take it personally that he's acting like he hates me, right?

I mean, he's just feeling abandoned by everyone in his life right now, and the fact that I'm dating a guy and not available to go to Joe's bar every night is just ... He's feeling hurt and lonely.

Or he hates you.

Thanks.

You're welcome.

What's wrong?

She locked herself in there.

Jaelynn, sweetie. It's okay. Come on out.

Jaelynn, it's Dr. Karev.

Look, Jaelynn, come on. I know it's scary.

Just come out and we'll talk.

You can ask me whatever you want.

It's the silent treatment.

She won't cr*ck.

Once we took her phone from her.

She didn't speak to us for seven days.

Oh, she's talking to somebody.

She texting you?

Maybe.

Tell her to come out of the bathroom.

I don't tell her what to do.

Just do it.

Make me.

Are you for real?

"Dr. D. F."?

Dr. Douche face.

Who's that supposed to be?

Who do you think? Now give it back.

Make me.

It's called a domino transplant.

Because you guys are the same blood type, we will put the new heart and lungs into Mr. Schulz, and then take Mr. Schulz's original heart and give it to Mr. Crump.

So his heart in my body?

Nothing doing.

It-it's the best solution in this case.

The best solution is a 62 year old getting a 70-year-old's hand-me-downs?

Technically, all donor hearts are hand-me-downs.

Mr. Schulz's heart is 80% functional.

Yours is only 10%.

Yeah, you hear that? 80%.

You'd be lucky to get a ticker like this one.

I'd be lucky if you dropped dead right now and I got the fresh heart.

Mr. Crump, you should really consider this op ... Look, I would rather croak than have this bastard's old lump of meat in my chest.

Hey.

This day just keeps getting better and better.

Yeah, right. It's great.

Okay, sir. You need to sit down.

No, I need to get out of this room.

Sir, calm down. Just ... please.

Get out of my ... So he's rejecting the heart out of spite?

Yeah.

I can't figure out how to talk him into taking it.

Have you talked to Owen?

Uh, no. But I know him. He just needs time.

What is your husband's deal anyway?

Oh, Cristina.

You know, it's like everyone has gone crazy.

Owen and Derek are at each other's throats.

Avery's on some kind of power trip.

You know, I am supposed to be prepping for a major transplant, and Callie's left me with an O.R. board that's like a rubik's cube.

Wow. In charge one day, and already the hospital's spinning out of control?

Okay, I gotta go. We're here.

Uh, you need to stop listening to my conversations.

Is the place really spinning out of control?

What? No, of course not. Shut up.

Everything's perfectly fine.

Where is everybody?

They've gone. We're pretty much done here.

What do you mean done? Where's our kidney?

Why do you look confused?

Where is our kidney?

Hands off my kidney!

I'm telling you, this isn't your kidney.

And I'm telling you, show me the paperwork to prove that, or I'm gonna reach down your throat and take one of yours.

I found our kidney.

Great. Now call off your att*ck dog.

Wilson, stand down.

Where is it?

It hopped a flight to Seattle.

All by itself? How'd it do that?

I don't know. We gotta get home. Come on.

Let's go.

You sent her an emoticon of a bee and an ice cube?

It means "Be chill"

and come out of the bathroom.

I know it's you.

Theo would never text emoticons.

Just ... give me five minutes, and then I will never bother you about it again.

Okay. Five minutes, but in here.

I know you're scared, but you need this kidney.

At least with dialysis, I won't go bald, get fat, and poop my pants.

That's not the solution, and you know it.

Can't I, like, take the next one?

I'm, like, not ready for this.

Yes, you are.

Look, Jaelynn, um, there's this girl, and I didn't tell her that I was into her, and now she's with some dude with big arms.

Um, are you, like, hitting on me?

'Cause you're, like, old.

God. No. No.

No, my-my p-point is, is that this-this kidney is a good thing, and that you need to take the good things when they're in front of you, because if you don't, someone else will.

So you're saying, take this kidney so some dude with big arms doesn't get it?

Yeah.

Let's get her prepped.

Don't leave her side.

Got it.

Hey. How's it looking?

You sent me all the way out here to get a kidney that's already flying coach to Seattle as an unaccompanied minor?

What?

I don't even know who's coming to pick it up.

Find out.

Alex, I ... Look, just deal with it, okay?

Are you okay there? You look a little overwhelmed.

Anything I can help you with?

Can you read everything in my arms and own this hospital?

You actually gonna look at those protocols or just keep carrying 'em around?

Right. Your hernia. I'm gonna get you an answer just as soon as I ... Too late. I already did it, my way.

That's not ... Bailey, you shouldn't ... Well, you couldn't make a decision, so I made it myself.

You gonna get rid of me now like you did Hunt?

I didn't get rid of Hunt. Why ... Sign this.

What is this?

Authorization for a domino transplant.

Yes, why am I ... Because when you anoint yourself king, it comes with certain responsibilities.

You have to sign this.

I need to know what this is first.

Well, I could take the time to explain to you how a heart-lung domino transplant works, but by then, both my patients will be dead.

I know how a damn domino works.

Hey, April. Here, take these.

What are they?

Hunt left before he could coordinate the recovery teams for your D.C. D. patient.

So it's just a list of which organs are going where.

Yeah, well, he's not my patient anymore, Pehis request ... Just sign this.

Just handle it, please.

Hey, make sure you sign your own name, not your mom's.

Ooh.

Really?

Avery.

What?

I want to know who the hell sent my kidney flying coach to Seattle when I sent two surgeons to pick it up.

Wait. What are you talking about?

He's talking about the protocols.

Look ... Pegasus policy states, look, "Donated kidneys coming from outside a certain radius"

"will be flown unaccompanied,"

"saving personnel hours."

So when the other hospital called, the nurse just told 'em to put it on a plane.

Told you they were stupid rules.

You should read 'em sometime.

Oh, great. Does anybody know what's going on?

Tough day, boss?

He is drowning, and he is taking my hospital down with him.

Where is all this drama coming from?

He will handle this. Just give him time.

He's paralyzed.

Decisions are like building blocks.

He'll make one, then another will follow.

You do not do this job one calmly thought-out decision at a time.

You're spinning plates, ten at a time, and you're doing it at a sprint.

He will get there.

You act like I don't have any idea what I'm talking about.

When I was chief, I worked hand in hand with the board.

So I know what it takes to ... You are not doing it now, Richard.

I am not thinking of myself, Catherine.

I'm thinking of your son.

Look, if he fails at this, it will follow him his whole life.

It'll define his entire career ... this failure ... and he didn't even choose it.

His mother chose it for him.

Ca ... You find me a real heart yet?

I've got a real heart for you.

You just have to get over yourself.

Move on.

Whatever it is that happened between the two of you is so far in the past ... It's like it was yesterday.

Okay, fine.

You can't forgive him. So don't.

b*at him.

Take his perfectly good heart and outlive him with it.

There's, uh ... Really enough juice left in that heart to get me to his funeral?

There's enough juice to get you dancing on his grave.

Then my heart will stop.

The monitor will flatline.

And you guys will have to get out of there.

Mm. Because the docs ... will only have five minutes to open me up or my organs will be no good.

Are you sure?

Are you sure?

Don't do this now, mom.

I know it's selfish, but I want more minutes.

The closer it gets ... I will support you either way.

But if you want to stop ... We can end this right now and go home.

Mom.

She just wants to make sure that if you have any doubts ... Your son is still a doctor.

And ... he wants to save a-a

17-year-old girl in Idaho who is gonna get one of his kidneys.

The other one is going to a-a

44-year-old councilman in Nevada.

His kidney could be president one day.

You get it now.

I do.

Keep going.

Half of your liver is going to a-a 50-year-old artist right here at Seattle Grace.

And a 10-year-old in Oregon will get to play on his little league team

'cause of the other half.

Did you get the O.R. straightened out?

The place doesn't run without Owen, Derek.

You know it.

I didn't force him to leave.

But once he started talking about who's to blame ... Because he feels the blame, every day since it's happened.

And you remind him again and again.

You say you forgive him, but you don't or you won't.

So what is it?

What is this about?

'Cause it's not about him.

Where are you going?

Surgery. Remember that?

No, I'm in 2.

No, you're not. I am.

Move. I've got a domino transplant.

And I'm getting a kid off dialysis.

I can totally wait.

No, you can't.

Well, I can't. Let's get this show on the road.

This kid's a flight risk. Find someplace else.

This O.R. 's the only one that's staffed.

Could you guys please shut up?

My patient is trying to die in here, and he'd like to do it in silence.

Oh, god. He's dying in there?

Maybe you should go first.

How long is he gonna be?

Because Yang needs the O.R.

I've got an O.R.

Shut up!

Hey, all of you shut up.

All right, here's what you're gonna do ... Okay, just, uh, give me one second.

Kepner, go back to your patient.

He can take as long as he needs. We will wait.

Yang, you're in O.R. 2.

What? No.

Heart and lungs Tr*mp kidneys.

Take the patient back to holding, and the next O.R. that's available is yours.

You can't ... That is it.

Well, you heard the man.

He's the boss. Now move.

It's about time.

You mean "Thank you, Meredith"

"for carrying a kidney across state lines for me."

Whatever. Hand it over.

Can I scrub in? I'd love to ... I got Murphy.

You want me to apologize, Alex?

I'm sorry.

I'm sorry we bought the hospital.

I'm sorry you have to think of us as your bosses now.

But we didn't do it for just us.

We did it for everyone ... For you, for Wilson, who, by the way, fought so hard for you today, I thought she might cut someone to get you that kidney.

So drop the attitude before nobody wants to work with you anymore.

There's nothing to talk about, Shepherd.

Move on.

Oh, come on. This is costing me gas.

You can afford it.

Nobody blames you for hiring the plane.

Not me, not anybody else, and you shouldn't either.

You never would've signed that paper if you knew what was gonna happen.

Let it go.

You blame me.

You said it, Shepherd.

You said it again this morning.

I was pissed.

I've been pissed, but not at you.

The world.

Yeah.

Yeah ... I'm pissed at Mark.

You gotta let that go.

It's almost time.

When the monitor goes, when he's gone.

They'll have to start operating, so ... We should probably pay our respects now.

Time of death ... 18:46.

Start the clock.

No. No.

Hazel, we only have five minutes or this will all have been for nothing.

Come on.

Okay. I'm sorry.

No!

Honey, we've been preparing for this. Let's go.

No.

Come on.

No!

Come on, dear.

No.

Okay, I am ... I am sorry, Hazel.

I'm so, so sorry. Come on.

Come on.

No. Sweetie.

Come on.

No.

Was he there?

No.

Oh.

Move over.

Um, hi.

Yeah. I heard you almost k*lled somebody trying to get Jaelynn her kidney, and I was kind of a douche face, and ... anyway, I'm-I'm sorry. And thanks.

Okay.

Can I, uh, buy you a beer or something?

Um, I'm all set.

Yeah, we both are. We're all set.

Yeah.

Well, that was, uh ... What were we talking about?

I'm sorry.

What?

Okay, thanks.

Thank you, doctor.

He stepped up, didn't he, my reluctant son?

If I were the kind of woman to say

"I told you so,"

this might be the time.

He got through the day.

Oh, come on.

Can't you just say that I was right once?

No, not when the stakes are this high.

You want him to step up, but the steps are too high, and the consequences for his career are too grave.

It's not fair to him.

Don't you tell me what's not fair for my son.

You want to give professional advice? Fine.

But you're wandering into parenting advice, and that is not your place.

Yeah, you're right. I'm sorry. I overstepped.

Yes, sir, you did.

You ever ... You ever say something and then a minute later, realize you sound like a complete imbecile?

Um, that's ... never happened to me.

I've been a single mom for 28 years, ever since Jackson's dad ran off to god knows where because he couldn't stand the pressure of being an Avery.

And I've been looking for a man who cared about Jackson the way a parent would, and ... the moment I find him, I bite his head off.

You're always gonna know what's best for Jackson.

Yeah?

Okay, thank you, doctor.

Yeah, right there.

Okay, thank you.

Well ... That's it, then. Wow.

We're officially the new board of directors.

Ooh.

For better or worse.

Thank you.

Congratulations, everyone.

Actually, I'd like to share a list of a few things I think are our top priority.

You mean that the foundation thinks ... No, I don't, actually ... mean the foundation or my mom or these stupid protocols.

I mean me.

Okay, well ... let's just listen.

Okay, I'll listen.

All right.

Number one, I move that we reinstate Owen Hunt as chief of surgery, effective immediately.

Dr. Hunt has agreed to this.

There were some conditions.

Which brings me to my second point.

We are reopening the E. R.

We will be a level-I trauma center again.

That will be top priority once Owen Hunt is here to share his input.

From now on, the foundation will follow our lead.

We will tell them our decisions as we make them.

Well, hear, hear.

Yeah. No, that sounds good.

I've got one more thing.

Maybe you shouldn't push it.

The transplant process is very scary.

We are building a new hospital.

And that was your vision, not mine.

My priority is to make sure your vision comes true.

And while it is important that we become a leading center for research and innovation, we have to remember something ... We are now officially a hospital run by doctors.

That should mean something.

It is our responsibility to be the best doctors we can possibly be so that those who come after us can strive to be their best.

So ... with that in mind, I move to rename the hospital.

Again?

Why would we do that?

To-to what?

Let me guess. The Harper Avery hospital?

No.

I propose that we give this hospital a name that can honor the very reason we've come together and been able to do this, a name that exemplifies the spirit of this hospital, but also the depth of our dedication.

A patient goes from worrying about getting an organ

to worrying if the organ will be rejected.

All in favor?

Aye.

Mm-hmm.

Aye.

The anxiety continues

until they can finally open their eyes after surgery

and see that their gift has been accepted.