20x01 - We've Only Just Begun

[bunniefuu]

- I didn't get married.
- [ADAMS] You didn't get married?

Adams isn't good enough for you.

If you decide to be with him,

your whole trajectory changes.

Congratulations, Dr. Ndugu.

Head of Cardio?

- You need a dentist.
- Maxine.

She has a DNR and DNI.

Get me an intubation tray
so I can save her life.

We have to question
everything we know

about Alzheimer's if
we're gonna cure it.

This is huge. And you can't
tell anyone outside of this room.

I do believe that we have been
focused on-on the wrong thing.

Your vodka tonic, sir.

Oh, I was just coming to check on you

but I guess you're covered.

What the hell happened?

[KWAN] Chest tube started pouring blood.

His aorta must have transected.

I need you to work
as quickly as you can.

[KWAN] Page Hunt. Page everyone.

I'm in love with you,
Jo. How do you not see that?

I want to live a whole life with
love and mess and pain and you.

You saved my favorite person.

So now I don't get to just hate you.

I have to love you too.

[BREATHING SHAKILY] Teddy. Clear.

[GREY] Researchers
say the average

length of a dream is
two to three minutes.

[DOCTOR] Do not do anything
until an attending gets here.

[KWAN] Paged everyone, no one's
coming and we don't have time.

[GREY] But many people
experience their dreams as hours.

[GRIFFITH] I just lost her pulse.

[DOCTOR] She's DNI.
Why is she intubated?

[KWAN] Help me fight to get her back.

[ADAMS] Simone, he's dying.

[GREY] If they can remember them at all.

The science of dreaming has been
questioned for hundreds of years.

[GRIFFITH] Chief Altman,
you do not die on me.

[HUNT] Teddy, stay with me.

[BREATHING SHAKILY] Clear.

[GREY] Some hypothesize that dreams

are our way of processing real events

that occur when we're awake.

They may also serve as an outlet
for repressed hopes and desires.

Neuroscientists introduce a
new theory every few years.

But honestly, no one knows why we dream.

[SCHMITT] Gown and glove me.

[GREY] Or why we have nightmares.

[SCHMITT] Dr. Altman, we've got you.

[GREY] We just hope
that after the dream,

we wake up.

[MARSH] Morning.

[MILLIN] Morning.

So, which one of you am I f*ring?

Owen, we are so sorry.

- Are you okay?
- I'm fine.

She collapsed in the
OR and went into V-fib.

We resuscitated her and an echo
revealed bacterial endocarditis.

- Caused by what?
- Most likely a dental infection.

The bacterial growths caused
severe aortic valve insufficiency,

so Beckman and Schmitt did
an emergent valve replacement.

We still need to follow up
on blood and tissue cultures,

consult ID and cardiology.

[NDUGU] All right. Thank you.

- Why don't you go get some rest?
- I'm not going anywhere.

Teddy's now my patient and
you're my patient's husband.

I need to focus on her and I
can't do that with you here.

Owen... [CLEARS THROAT] we
should check on the kids.

Okay.

- You too.
- Oh.

All right. We might
as well stay and work,

but let us know the
minute something changes.

All right. I'll need to
see her post-op CT scans.

- I haven't scanned her yet.
- Why not?

I didn't think that
was standard protocol.

The first 24 hours after surgery

are just as important as
the surgery itself, Schmitt.

It's not about standard.
It's about being hypervigilant.

- Get her to CT ASAP.
- Okay.

- [MARSH] How long was I gone?
- You left in the morning and...

Nope. Not a real question, Millin.

What I mean is, I approved you all
to attend Griffith's wedding.

Yeah, it didn't happen. Ask Adams.

- What is that supposed to mean?
- Means home-wrecker.

- Tell me what DNI means?
- [MARSH] Stop, stop.

You all had specific assignments
for your shift afterwards.

But when I read the notes this morning,

no one was where they
were supposed to be.

- Why were you with Sam Sutton?
- Yasuda and I switched services.

Because Adams got
punched by his patient.

Griffith's ex-fiancé.

At least he didn't
conveniently forget

about someone's
medical directive.

Maxine is stable now...

- Great, but Adams filleted a patient.
- [MARSH] Okay, so...

[YELLS] Shut up. Shut up!

Shut up, all of you.

A patient d*ed.

You understand? Their life is over.

That and the disrespect of
someone's medical directive,

you all just opened up this hospital
to about five different lawsuits

which, as your
teacher, I could be

named. So now you're
risking my career.

And right now none of
you is worth that to me.

- Wait, so you're f*ring... all of us?
- [PHONE CHIMES, VIBRATING]

- I just want to ex...
- [YASUDA] I didn't...

Stop. I'm needed in the
ICU, but we're not done.

Stay here. Do not move.

Do not practice medicine.

[GREY] You made me get on your
plane in the middle of the night

and fly across the
country for a conversation.

How long do I have to wait?

I've spent every minute on the
phone since your antics last night

doing damage control with the donors.

- I know. I sat by you on the plane.
- Oh, don't be snide.

I haven't had to dance
like that since the '80s.

I had to spin your lunacy into
dehydration and exhaustion.

- You lied.
- I saved your career.

You made my foundation look like a joke.

You hired a batch of interns
that are clearly only interested

in sinking this
hospital's reputation.

They're foolish and dangerous.

And... frankly, the only reason
they're here is because of you.

In 12 hours you have potentially
caused me two PR nightmares

that would take thousands
of dollars to fix.

f*ring you would just
add to a media storm,

so you have two options.

Shut up about your
theories on Alzheimer's,

or I shut down your lab.

You can go back to Boston now.

But not on my plane.

I can't believe you're practicing
knots, when we might all be fired.

Well, can't get rusty. We
might be looking for new jobs.

- [CELL PHONE BEEPS]
- It's Ndugu from the CCU.

Dr. Marsh said we
can't leave the room.

So you want me to ignore
the new chief of cardio?

Yeah, I don't need this.

What?

You said a thing last night.

[MILLIN] I said a lot of things.

Wanna talk about it?

I wanna go check on Maxine,

see if she's ready to be extubated.

- Dr. Marsh?
- Yeah.

I wanna assure you, I can carry out

whatever plan you have
in mind for the interns.

Ooh, that's okay. I've got it.

Right, well, as chief resident,
or technically co-chief...

- Yeah.
- if I could know what the plan is?

Well, I don't know what that is yet.

And once I do, I will handle it myself.

I couldn't be in three
places at once last night...

Excuse me. You're a
chief resident. Act like it.

[ANNOUNCER] Dr. Sally to
Psychiatry. Dr. Sally to Psychiatry.

Lucas, can you wait? Lucas, damn it.

You have barely said two
words to me since last night.

We need to talk about what happened.

- I'm fine.
- I am not.

There's gonna be an investigation.

They're gonna ask whose
decision it was to open Sam up.

- Tell 'em it was mine.
- Hey, can you give us a hand?

Engine crapped out. Patient's 43, male.

MVC. GCS nine. Intubated in the field.

Prominent seat belt
sign. Vitals, borderline.

We gave him 500 cc bolus of LR en route.

We called for another rig, but
SFD is stuck in an industrial fire.

- Can you help us get him to the ER?
- We're not technically... Hey.

Adams, no practicing medicine.

The longer this patient has to wait,

the higher the chance
he could decompensate.

- [PARAMEDIC] Do you mind bagging?
- Actually, I do.

Marsh cannot find out about this.

[TIRES SCREECHING]

Get out of the way. Get out of the way.

[BOTH GROANING]

- Y-You okay?
- Oh, it's superficial.

[ADAMS] Okay.

You're doing good.

[BREATHES DEEPLY] Thank you.

- [MACHINE BEEPS]
- Okay.

- [ADAMS] Whoa, he's desatting.
- Oh, crap, the Ambu.

- [CRASHING]
- [YELPS] What was that?

- [STAMMERING] I don't know.
- [MACHINE BEEPS]

Um, his blood pressure
is starting to drop.

- Can you open the doors?
- Yeah.

It's stuck.

- [CRASHING]
- [ADAMS GRUNTS]

Oh, no. We ha... We
have to get out of here.

[LUCAS YELLING] Help! Hey!

- Somebody help!
- [GRIFFITH] Hey! Hey!

Hey.

Did you get some sleep?

Um, a little bit, yeah.

[PHONE BEEPS]

- What is it?
- [SIGHS]

Sam Sutton's mom is here.

[SIGHS]

[SHEPHERD] Teddy is stable so far.

I'll do a neuro exam on her
once they wean her off sedation.

I'll go check on Owen.

- I'm gonna keep an eye on him.
- Okay.

- Meredith.
- Yes?

I read it all.

Your research. I went through your data.

Transcripts on the image tampering,

the inconsistencies in the drug trials.

And? You see what I see.

Hey, sorry. Uh, I'm on my way to
the OR. How'd it go with Catherine?

- I'm gonna check on Owen.
- [GREY] Okay.

Uh, you know, if I don't
shut up, I'll be fired.

- Yeah.
- What about the interns?

Uh, no one's giving me a straight

story and the notes are indecipherable.

Look, if they stay, the
whole surgical department,

they're gonna need to be evaluated.

You're thinking about
getting rid of them?

Well, I don't know yet, but none
of them will go near a patient today

and maybe even for a very
long time, especially Adams.

- What happened to second chances?
- Not a second chance anymore.

With Adams it's more like an eighth.

I'm gonna text you
when I'm out of surgery.

Okay.

Mer, come with me.
Interns are in trouble.

- Please tell me it isn't Adams.
- Uh...

[HUNT] Leo, please, will
you just get dressed?

Well, tell Grandma that Dad said
you can wear whatever you want.

[SIGHS] Oh, and remember that
it's sharing day at school.

Soon. Yeah. Mommy will be home soon.

I was on my way to Teddy's
office to check her calendar.

I don't wanna miss
anything for the kids.

Does it matter?

It's okay to miss something today.

I mean, let the kids
stay home from school.

Let them eat ice cream for breakfast.

Today is not a normal day. You
don't have to pretend that it is.

[SHEPHERD EXHALES]

When is the last time you ate something?

[SIGHS]

Come on.

[MILLIN] So, um, I did a thing,

and maybe you already know
because you were in the room,

but I kinda told Blue that
I love him while crying

and not in a "oh, it's just allergies"

kind of way, and I know what you'd say.

"Who cares what you did?
You're getting a good lay."

But... that's not why I'm here.

I'm here to work. And
now my job is on the line

because of what he did.

But I am also really glad
that you're still alive.

[WEBBER] You about done?

I need to check her lungs.

- Uh, yeah.
- [THUDS]

[WEBBER SIGHS, CLEARS THROAT]

[MUTTERS] Her ABG has improved.

Well, hopefully we
can pull the tube soon.

- Thank you, sir.
- Mm-hmm.

Uh, Dr. Webber, um,

Dr. Marsh mentioned that there
would be consequences for last night.

I was not as involved as the others.

You can check the charts, check
the nurses, check everything.

Well, Dr. Millin, your name is
all over this patient's chart.

Doctors cannot make objective decisions

on care when it comes to family.

You are this patient's
medical proxy and doctor.

You are absolutely involved. Excuse me.

[NDUGU] CT scans show no
further source of infection.

Blood cultures and path report, Yasuda?

Both should be updated now.

- Did Marsh assign you to this case?
- I did.

Yasuda, let's proceed
with vascular checks.

Dr. Ndugu, I should tell you that the

interns are under review at the moment.

That is not my problem. Dr.
Altman is in critical condition.

We need surgeons watching
this room at all times.

No. Damn it.

It's cold. There's no pulse.

- Give me the Doppler.
- [YASUDA] Uh-huh.

- [STATIC ON MACHINE]
- Nope. No signal.

- Should I call for a CT angio?
- No, there's no time.

Schmitt, call up to IR. Tell them to

prep for an endovascular embolectomy.

We need to get her in there
before she loses her leg.

- What should I do?
- You need to find Hunt. Let's move.

[PARAMEDIC] No one go near the car.

- [BAILEY] What in the world?
- [CAR] Obstacle detected.

We got three in the rig, one unstable,

and the car's obviously malfunctioning.

Until we can deactivate it,

we can't safely
extricate the patients

without putting them
or ourselves in danger.

- Okay. Well, where's the driver?
- Why is he in the back seat?

No, no, no. I'm not the driver.

- [CAR] Malfunction.
- It's a RoGo.

- A what?
- It's a RoGo. It's a driverless rideshare.

I work for the company and we're
beta testing a new SUV model.

[CRYING] Can someone get me out?

My arm is throbbing and Wayne
locked the doors and the window.

- What... Oh, no. Oh, no.
- [YELLING] No, it's happening again.

- Can you shut it off?
- The car's name is Wayne.

- They all have names.
- Turn Wayne off!

I've tried. Clearly
he's not listening.

- Wayne, power down.
- [BAILEY] Okay. Call inside.

Tell them that we need someone on

standby for his head lac and his arm.

[GREY] Griffith, Adams. Are
you okay? Can you hear me?

- Dr. Grey?
- Yes, unexpected visit.

We're fine, but...
Mr... Mr. Campbell isn't.

His blood pressure's tanking.

Okay. Well, heads up! There's
gonna be another impact.

- Hey, when are we getting out of here?
- Car company's headed here.

This is the third accident we've
reported to them in the last week.

- No, how long?
- Maybe 20 minutes?

Okay, we don't have 20 minutes.

Have either one of you
run a trauma before?

- No.
- Why?

[GRUNTS] You seen one?

- [ADAMS] Of course.
- Time to do one.

The ambulance is now your trauma room.

[LINCOLN] It started as a small tear

in his aorta caused from his accident.

And normally these things only
need to be closely monitored,

but in rare cases, they can rapidly

bleed before we're able to repair it.

[CHUCKLES]

[SOBBING] I worried for years.

Every time the phone rang,
my stomach would lurch

and I'd wonder if it was the air

force calling to tell
me that he was dead.

He spent his life doing
death-defying things.

[WILSON] I know. He
seemed in-incredible.

Yeah. He was.

So when I hear that
he d*ed in a hospital

surrounded by medical professionals

because you didn't catch
a tear in his aorta on time,

- I just don't understand.
- [PHONE BEEPS]

Uh, Mrs. Sutton, I know this
is very difficult for you...

Do you two have kids?

- I do.
- [WILSON] Yes.

Then I don't need to
tell you how I ache inside,

knowing that I'm still
here and my son is not.

Sam hated being in the
hospital. [SNIFFLES]

But he mentioned the two of you and...

[SIGHS]

When he did,

it was clear that the two of
you meant something to him.

- But...
- [PHONE BEEPS]

- Um...
- [MRS. SUTTON CHUCKLES] Oh.

For you, he was just another
patient, wasn't he?

I... I have to take this.
It... It's an emergency.

Mrs. Sutton, I am deeply
sorry for your loss.

- [SCOFFS]
- [LINCOLN CLEARS THROAT]

[DOOR OPENS, CLOSES]

- Okay. I ate. Feel better?
- Do you?

- I will after I check on the pit.
- Owen, you can't go to work.

I need to make sure my
department's okay.

Your department is aware of
what's happening. They're fine.

The ER is never fine, okay?

Owen, you can't
treat patients right now.

I-I gave her a smoothie, Amelia.

The last moment I had with Teddy
was I gave her a stupid smoothie.

- Owen.
- She had a toothache from an infection

that went directly to her
heart, and I gave her a smoothie

and now she could die.

Dr. Ndugu sent me to find you.

You're still here?

- I follow instructions.
- [MILLIN SCOFFS]

Since when?

I'm not an idiot.

I wouldn't have ignored
any other patient's DNI,

but you love Maxine,

and I know what it feels
like to lose someone you love.

[AMBULANCE WAILING IN DISTANCE]

I don't want you to
have to go through that.

[AMBULANCE BLARES]

[MILLIN] What?

We'll talk later.

- [WAYNE] Pedestrian...
- [LINCOLN] What is happening?

[BAILEY] Stupidity. Brace for impact!

[PASSENGER] It's happening again!

- Obstacle detected.
- [PASSENGER GROANING]

Cones usually work by
blocking the sensors.

The signal's interrupted,
and the system's shut down.

[BAILEY] His arm is swollen, but I'm

not sure how you're gonna examine him.

I used to have to worry
about teenagers driving.

Now we have to worry
about nobody driving?

[PASSENGER] It has
collision avoidance systems.

- There is no driver.
- Hey, can I help?

Look, you get this RoGo to stop,
and you can do whatever you want.

- [GREY] Talk to us!
- [GRIFFITH] He's about to code.

Adams is bolusing him with fluids.

[BAILEY] Is his abdomen
rigid, distended?

Uh. Y-Yes.

Okay, low BP, distended, rigid.

- He's bleeding internally.
- Yeah.

Okay, he needs an emergency ex lap.

You're gonna have
to find a scalpel and...

Oh, damn it. How fast can you cut?

Because it appears that you
have about 30 seconds between...

- That!
- [GRUNTS]

- You-You want us to open him?
- [BAILEY] Yes.

- In here?
- [BAILEY] Yes!

- And then what?
- You're gonna buy us some time,

so we can get him to
the OR and save his life.

- Okay.
- [BREATHING SHAKILY]

All right.

[NDUGU] It's likely a
vegetation that showered off

from the infected heart valve.

So, we'll do an angio
and locate the occlusion.

We'll fish out the clot
and reestablish blood flow.

Obviously, there's a risk that
the clot could break into pieces,

but we'll do everything in our
power so that that won't happen.

You don't have a lot of time.

Owen, Winston needs your consent.

[NDUGU] Hunt.

I've done hundreds of embolectomies.

And if you don't trust
me right now, I get it.

So trust your wife.

She's the one who
made me chief of cardio.

Do the procedure.

- [LINCOLN] Sir!
- [PASSENGER] Oh, no.

I need you to keep your arm...
keep your arm as still as possible.

It's most likely fractured.

These cars were supposed to
have an override function,

like a button you push.

Yeah, uh-huh. Wayne seems
to be malfunctioning.

I've honestly never had to use it.

Wayne has always
stopped when I need him to.

- He must be going through something today.
- Sensors offline.

Okay, did you find
any towels or ABD Pads?

- [ADAMS] Yes, a whole box.
- Okay, good.

You're gonna need to
identify the xiphoid process,

and then make an abdominal incision.

And whoever cuts, the
other one has to alternate

between bolusing fluids and bagging.

- [PASSENGER] Wayne!
- Okay, impact.

- [ADAMS GRUNTS]
- [GREY] In a true trauma ex lap,

you should be able to get into
the abdomen with three quick cuts,

but it's going to take you longer.

Because we're not in an OR?

Because you're an intern.

Uh, uh, right.

Um, of course. Uh,
yeah. Okay, I'm ready.

- Wait. I don't think we should do this.
- He's dying.

- Okay, brace for impact.
- [CRASHES]

Lucas, please. We don't
have the right tools, light.

We don't have blood. Think about Sam.

Think about what happened last night.

If we hadn't opened
him, could he be alive?

I can't do nothing!

I can't have another death
on my hands because of you!

[PASSENGER] No, no, no. Come on.

We designed the AI tech to
simulate human decision-making.

Um, but of course there's the whole

ethical issue of the trolley problem.

It looks more like a car problem.

No, the-the trolley problem.

Does the, uh, trolley stop
to save one pedestrian,

thereby risking the passengers inside?

Or does it prioritize the passengers

and k*ll the pedestrian?
[CHUCKLES] You know?

[GRIFFITH] Dr. Bailey, Dr. Grey?
He's in hemorrhagic shock.

Can we keep buying him time
with fluids without cutting?

If he codes, we'll start CPR.

Okay, only you two can answer
that. You have eyes on the patient.

Well, he's bleeding out. We
have to open him to try and stop it.

- [BAILEY] Impact!
- [CRASHES]

Lucas.

- [GREY] If you're gonna cut, do it now.
- Lucas.

[GRIFFITH] No.

[WAYNE] Obstacle detected.

[GREY] You're going to
encounter a lot of blood.

Don't panic. Just keep packing.

- [PARAMEDIC] Everyone, heads up!
- Okay, impact!

[ADAMS GRUNTS]

His BP's bottoming out. He's... He's

not perfusing. I'm
starting compressions.

Don't put too much pressure on
the small bowel. You can injure...

It doesn't matter if
he's bled out before then.

Uh, bleeding's coming from the liver,

but holding pressure isn't helping.

Okay, then do a Pringle maneuver.

- You ever done one?
- No. Have you?

Do they know how to
do a Pringle maneuver?

[GRUNTS] Okay. Clamp the
hepatoduodenal ligament.

It runs from the duodenum to the liver.

- We have no clamps.
- Uh, two fingers can do it.

[GRIFFITH EXHALES SHARPLY]

- All right. Just...
- I got it. Take over.

[GRIFFITH] Okay.

Okay.

[BREATHES HEAVILY]

Portal vein, hepatic
artery, common bile duct.

I think I'm there. How
do I know if I'm there?

Well, once you apply pressure,
the BP should slowly start to rise.

- [BAILEY] There it is. Okay. Impact!
- [PASSENGER] No.

No! Turn the engine off.

Systolic's holding in the 90s.

You doin' okay?

- [KWAN] ... sensors in the tires.
- I won a Fox Award last night,

and today, I'm in the damn parking

lot teaching interns
how to do an ex lap.

Well, as someone who learned
how to do an ex lap from you,

you're very good at it.

Wait. What is... What is he doing?

[WAYNE] Low tire pressure.

- Hey!
- [WAYNE] Low tire pressure.

- [PASSENGER LAUGHS] The sensors work!
- That worked?

Somebody get a gurney over
here. Right here. Come on.

Okay, we're gonna
get you out of there.

[MACHINERY WHIRRING]

[HUNT SIGHS]

- Say something.
- What?

Anything. Because I'm obsessing
over every possible complication,

so please just say something so I

stop visualizing Teddy having a stroke,

whatever's in your head.

An infection in Teddy's mouth
led to severe damage to her heart.

Two parts of the body completely
separate from one another.

You told me to say whatever's
in my... I'm sorry.

I... It was making me think that
maybe Meredith isn't insane.

This is not making me feel better.

Meredith is hypothesizing
that Alzheimer's

might not be singularly connected

to plaque formation in the brain.

What if it's not caused by
anything in the brain at all?

- So what's it caused by then?
- Well, I don't know.

And the person I want to talk to
about it is not here anymore. [SIGHS]

Let go of the smoothie, Owen.

I said awful and frustrating things
to Derek the last time I saw him,

and I agonized over it constantly...

until someone convinced me to stop.

[EXHALES] Yeah.

[NDUGU] There. The clot's causing a

cutoff at the right
common femoral artery.

- [YASUDA] Is it?
- [SCHMITT] It's huge.

[NDUGU] It's too big. I
can't get it in there vascularly.

It's too risky. We
need to do an arteriotomy.

I'm opening up her leg.
Yasuda, take the catheter out.

[YASUDA] Please don't die. Please
don't die. Please don't die.

- [NDUGU] Yasuda.
- Can... Can you repeat what you said?

No. Schmitt, take out the
catheter and hold pressure here.

Yasuda, step back,
take the vest off and go.

Where?

Once I get into the artery, I'll
need a Fogarty catheter, Schmitt.

[SCHMITT] Yasuda.

I'm gonna do this fast. If I don't,
there won't be a happy outcome.

So, if you're feeling distracted by
personal feelings about this patient,

I need you gone too.

- I'm good.
- Scalpel.

Okay. Griffith, as
soon as we get in there,

they will place a vascular
clamp, and you can let go.

Type and cross for
blood and activate MTP.

We're probably looking
at a high-grade liver injury.

So we'll need a hybrid room
for possible angioembolization.

Hey, you scrubbing in?

- I am scrubbing in.
- Ah! [CHUCKLES]

Okay.

I really don't
understand what happened.

Wayne failed the test.

But the algorithms were working.

Well, your arm is fractured into pieces,

and it'll be weeks of
recovery after surgery.

Also, does your company know
how many car accident victims

pass through the hospital every day?

Actually, it's part of
our research. Very depressing.

Well, that number will significantly
increase with self-driving cars.

- More people will be injured, if not dead.
- Or the opposite.

Automation doesn't just bring improved

customer satisfaction and efficiency.

It's about safety. How many drivers

get in accidents because they're tired,

distracted, angry at someone
who just cut them off?

Humans have feelings and feelings
don't belong behind the wheel.

I-It only leads to bad
decision-making, errors and pain.

No, it leads to
compassion and connection.

Nobody cares about those things anymore.

They do if they save lives.

Do you think you've saved
more lives than surgical robots?

[ELEVATOR DINGS]

- OR's prepped and ready.
- Could someone check on Wayne?

Because no one has told me
where they're towing him.

Kwan, track him down.

It's not a "him." It's a car.

It's a car.

[WEBBER] Thank you.

[ANNOUNCER] Dr. Lloyd to Radiology.

Um, I finished the rest of your
patient's progress notes.

Oh. Thank you, Millin.

I also removed my name
from Maxine's chart as her doctor.

It was completely unprofessional

and I used bad judgment.
It won't happen again.

Is there something else you needed?

I was wondering if you had reconsidered

putting in a good word
for me with Dr. Marsh.

No. I mean, you're
taking accountability.

That's not an easy thing.
I know that more than you know.

Accountability is what will allow

you to move forward after the mistake.

Ideally, you'll never
make the same mistake again

because if you do, your
career might not survive it.

After what Kwan and Adams did,

I might not have a career.

You know what goes hand in hand
with accountability, don't you?

Forgiveness.

Could you maybe tell that to Dr. Marsh?

[NURSE] Dr. Webber, she's ready.

Maxine's ready to be extubated.

Oh, I-I-I will... I will stay out here.

Okay.

[BAILEY] Teddy's in
IR. Clot in the femoral.

[GREY] Well, I trust Ndugu.

Marsh doesn't know what he
wants to do with these interns.

[BAILEY CHUCKLES] Been there.
That job is like parenting,

but interns won't take care
of your things when you die.

Oh, I'm sorry, you think your
class wasn't as bad as this one?

You all cut an LVAD wire and
that's just one example.

- You sabotaged clinical trials.
- [GREY] And look at me now.

[BAILEY] Remember how you got there.

Hey! I'm lead, you're assisting.

[ADAMS] The patient's prepped and ready.

Massive transfusion protocol activated.

After you place the
clamp, you want us to leave?

- No.
- Dr. Marsh said we weren't to...

[GREY] Forget about Marsh.

How are you supposed to learn to do

better if you're not in the room, right?

- Grey, you don't work here.
- Adams, go scrub.

[BAILEY CHUCKLES]
Still giving me trouble.

Let me get in here.

Okay. Hold that there. Good.

All right, let's get a clamp.

All right, on my count, Griffith.

Here.

One.

Two. And three.

Got it.

♪ When the truth is
wrapped around my neck ♪

♪ What happens now ♪

[NDUGU] Fogarty catheter.

♪ What happens then ♪

We don't have much time.
We have to reperfuse this leg.

Deploy the balloon.

♪ It's a cruel game
of cause and effect ♪

♪ Such a cruel game ♪

♪ But it's not over yet ♪

[BAILEY] Ah! There. You
were right. Liver lac.

- [MONITOR BEEPS RAPIDLY]
- Griffith, suction.

[BAILEY] We need to try to
do a primary vascular repair.

♪ No stopping it, stopping
it once it starts ♪

Hey.

Hey.

Are you okay?

- Mika?
- I... I don't think I can sit.

♪ It gets me high
yeah, it gets me low ♪

♪ It's a w*r between
my head and my heart ♪

[CHOKING]

[COUGHING]

[GASPING, COUGHING]

♪ It's a w*r ♪

♪ Between my head and my heart ♪

♪ It's a w*r ♪

♪ Between my head and my heart ♪

[SNIFFS]

Yasuda. Is-Is Doctor
Altman... Is-Is she...

[YASUDA] Where were you?

- Are you okay?
- Am I okay?

No. No, I'm not okay.

Where have you been?

You were one of Sam's doctors.

You constantly reminded me of
it, and you weren't there.

- Yasuda, I'm...
- No!

Where were you? I-I
genuinely want to know.

I need to know.

His blood is still on my shoes.

And my hands... my hands kept Dr.
Altman's heart b*ating last night.

And I don't even know
if she's alive right now

because Ndugu kicked
me out of the IR suite.

I... I can't focus.

I... I can't think,
and I also might be fired.

From the only place that
would hire me as a surgeon.

[BREATHES SHAKILY] We are interns.

You were supposed to be there when we

called, but we-we called and we paged,

and we hoped that someone
would come through those doors

and no one did until it was too late.

[SIGHS]

[BAILEY CHUCKLES]

People keep asking me what's next.

I thought I'd at least get


Well, how about taking over my
surgical cases for the next few days?

Uh. Everything okay?

You knocked a drink out of my
hand, yesterday on the plane.

[SCOFFS]

And then last night I
ordered one after the awards.

I didn't drink it.

I almost did. And it's been in my
mind ever since it happened, and...

I don't trust myself
in the OR right now.

- I'm not sure I ever will.
- Oh, you will.

And you've been here before,
and you know how to get back.

And starting over can be hard...

[BREATHES DEEPLY]

but it'll remind you why
you have made it this far.

- And don't worry about your surgeries.
- Thanks, Bailey.

I successfully removed the clot
and restored circulation to her leg.

So we'll keep her on heparin for now,

and then we'll monitor her closely.

[HUNT SIGHS]

Thank you, really. Thank you.

- I'll go get you some coffee.
- [HUNT] Okay.

All right, I've got
the cue on vascular

checks and the coags,
so you can go home.

Oh, but I'm the resident on
the case, and it's Dr. Altman.

And you've been up all night,
so go home and get some rest.

Are you going to?

Go home before I
change my mind, Schmitt.

[SIGHS]

[EXHALES SHARPLY]

- [MARSH] Hey.
- Hey.

How's Teddy?

Uh, she still hasn't woken up yet.

- You're mad?
- No.

Now you're lying, and you're mad.

Look, I told them not to move, okay?

I said they couldn't touch
patients or practice medicine,

but instead of listening to
me, they screwed up again.

And this was different.

Yeah, right, this time, they
actually performed an ex lap.

Right, because the patient was dying.

And I was right there
guiding them through it.

Yeah, Meredith, you don't get it.

If they keep screwing up
over and over and over again,

I can't move to Boston.

What?

If the program's falling apart,

I can't leave in
good conscience. Okay?

Even if it is to be with
you, I can't do it.

- You hate Boston.
- [LAUGHS]

Yes, I do. But, you
know, second chances.

Well, I don't even know if
I still have a job in Boston.

Well, you do if you shut
up about your research.

Look, hey, you'll
find a way. You always do.

You just talked two interns through an

ex lap inside of a crushed ambulance.

- You'll find a way.
- I had help.

Mmm. Mmm.

[INHALES SHARPLY]

- What's happening?
- [GREY STAMMERS]

- I have an idea.
- [CHUCKLING] Oh.

Okay.

Dr. Webber extubated Maxine.

She is hungry, talking and annoyed.

Hey, uh.

You wanna come over tonight?

I said I hated you.

I mean, I also said that I love
you, but I said that I hated you.

So what?

One cancels the other out?

What I'm saying is that I
clearly wasn't making sense.

I was an emotional
mess because of Maxine

and vulnerability leads
to emotional extremes.

And I say both of those
things to a lot of people.

Like, as in now?

I don't subscribe to mononormativity.

And also I... I can't be walking around

worrying about disappointing the
one person I'm supposed to love.

I'm sorry if I gave
you the wrong idea.

No.

[SIGHS] It's... It's a relief.

You know, that's what I wanted to talk

to you about. I agree. It's better.

Hmm.

You know, so things won't be weird.

Oh.

Well.

Great.

- Great.
- Mmm.

- [DOOR OPENS]
- Do you or do you not check your texts?

Marsh's on his way back to the lab.

Hey, uh, Bailey wants us to check
on the patient's labs in an hour.

[SIGHS]

I've wanted one thing my entire life.

This.

To be a surgeon.

And I could lose everything.

All I've worked for...
once again... because...

Say it, Simone.

Because of me.

[INHALES SHARPLY] Why did you
agree to help me last night?

You could've said no.

You could've run out of the
room and grabbed an attending,

but instead you grabbed
a pair of gloves.

Because I can't say no to you, Lucas.

We k*lled a man in
less than two minutes.

Good surgeons own their
failures. They apologize.

Why can't you? Why can't you...

admit that what we did was wrong?

Because it wasn't.

I won't apologize for it, Simone.

I... I won't ever
apologize for trying.

I don't live with regrets.

I guess that's where
you and I are different.

Do you regret us?

No, I just...

You and me last night...

Everything's happened so fast,
and I think I... need a minute.

[PHONE CHIMES, VIBRATES]

[ADAMS] Yeah.

[DOOR OPENS, CLOSES]

[LINCOLN SIGHS]

Do you feel guilty about Sam?

I feel badly about him.
Sam was our patient.

I... know that I could've
been a better version of myself

- around him, at moments, but...
- But... we weren't there.

[SIGHS] We weren't.

But Sam didn't die because of
something we did or didn't do.

He had a terrible complication

that some of the most talented
cardiothoracic surgeons can't fix.

It just feels...

so wrong to be this happy when other

people will never get that chance again.

Why... Why do I deserve all this?

Deserve you?

- [SIGHS] It's just...
- You have had a lifetime of hard.

And every time I've seen you go

through something
awful, it broke my heart.

Because you are the fiercest,

kindest...

- smartest, most loyal person. You're...
- [CHUCKLES]

Those years when we weren't in each

other's lives, those were dark years.

And I thought of you every single day.

So we've been through
too much, together and apart.

You deserve this.

We deserve this.

And what if we don't work out?

Uh, we're gonna work out.

I just wasted 20 years of
my life not acting on it.

[GREY] Some people spend their lives
trying to make a dream come true.

♪ Ooh, time is ♪

On the outside, um...

♪ Always on the run ♪

I didn't break my sobriety.

But it feels like I did.

So I'm here to ask for
your help with a reset.

Tonight...

I'm one day sober.

[GREY] We set a goal and make
a plan on how to achieve it.

Catherine. I'll focus the
research back on the black.

Excuse me?

You gave me an opportunity
to make a difference,

and that is what I will do.

I will stick with
what's being funded.

You win.

[GREY] It works for some people.

[WHISPERING] I always do.

[GREY] But for others,
it's not so easy.

- [SHEPHERD] Hey.
- Hi.

Well, I got your text.

What is this mysterious favor?

My research.

I have, uh... I have
papers, I have proposals.

I have notes from phone calls with

neuroscientists from around the country.

I've gotten a little further
than I'd led you to believe.

And what do you want from me?

I need you to help me keep it going.

But nobody can know.

[GREY] As hard as you
work toward the dream,

it can feel like the whole
world has plotted against you.

♪ We only go in one direction ♪

[GREY] As you get further away from it,

you cling to any sign of hope.

Hey. Teddy.

♪ Hold me steady ♪

What, um...

- What happened?
- [WHIMPERS]

♪ Hold me steady ♪

- Hey. [SIGHS]
- [SIGHS]

[GREY] And the longer it takes
and the more it costs you...

- [HUNT] Hey.
- [ALTMAN] Hi.

[GREY] ... you start to consider
whether you should give up.

[MARSH CLEARS THROAT]

[CLEARS THROAT]

- You all still work here.
- [YASUDA] Oh, thank God.

Uh, but I no longer do. I'm
leaving, but it's not because of you.

I, uh... Despite what
I said this morning,

I-I still believe in you. I always will.

And I'm not worried because I'm
leaving you in very capable hands.

- Who?
- [GREY] Do you find a new dream?

Or do you stick to
the one that started

you on this journey
in the first place?

I have five rules.