18x16 - Should I Stay or Should I Go

[bunniefuu]

[JOSH JOHNSON X VANYO'S
"LOOK ALIVE" PLAYS]

MEREDITH: In ,
the World Health Organization

officially recognized burnout

in its International
Classification of Diseases.

Chief Bailey, everything okay?

♪ Son of my father ♪

I'm just, um, waiting
to get my smoothie.

Um, but I was gonna get your smoothie.

Not today. Today, I'm getting it myself,

'cause I can't bring myself

to go into that depressing building.

Can I help in any way?

Yeah, just leave me alone.

Studies show that doctors
who report signs of burnout

have enlarged amygdalas,

the area in the brain that
regulates fear and aggression.

If that's how you speak
to your residents,

no wonder we are on probation.

Catherine... In your office.

Now.

But burnout isn't an academic exercise.

It's an all-consuming,
systemic condition.

It's your entire body sending
you one clear message.

You know what, why don't you go ahead,

and I'll take them to daycare.

- Here, give me this.
- Oh. Thank you.

You sure you're ready?

I'm cleared for surgery.
I'm feeling good.

I'm just a little... slow.

Okay. Alright.

Uh, I'll see you in the pit.
Alright, give Daddy hugs.

Okay, bye. Bye, bye, bye, bye, bye.

Mwah. Okay.

Hey! Look at you.

My little cowboy.

I'm not a cowboy. I'm a girl.

Okay. Alright. Cowgirl.

No. I'm just a girl, silly.

No, honey, you're a boy.

This is just a cowgirl costume.

Right? It's pretend, remember?

Oh. Okay.

Alright. I'll see you in there.

- Bye.
- Come on... Come with me.

Whoop. Let's go this way.

Something has to change,

and it has to change now.

♪ Light the fire, let it rise ♪

If the surgery program
loses its accreditation,

there's no guarantee that we'll find

another residency spot somewhere else.

I don't think that's gonna happen.

Well, and even if we do,

it might not be a surgical residency.

We might have to switch
to something else.

Like family medicine.

It's my first day back.

Would you please consider shutting up?

[ELEVATOR BELL DINGS]

♪

♪ Light the fire, let it rise ♪

[ELEVATOR BELL DINGS]

♪ Burn the life into your eyes ♪

♪ Ooh ♪

Well, that was awkward.

♪ So, look alive, look alive ♪

I have spent years
rebranding this organization

into something respectable
that bears my name.

I'm not going to let
my entire legacy shrivel and die

because one hospital
can't get its crap together.

Well, don't you think
that's a little extreme?

The Medical Accreditation Council

has inquired about visiting different

Fox Foundation hospitals
as of this morning.

With all due respect, Catherine,

you supported the Webber method...

Are we here to point fingers

or are we here to solve problems?

[INDISTINCT CONVERSATION]

WOMAN ON PA: Dr. Lawrence to the NICU.

Dr. Lawrence to the NICU.

How long have they been in there?

Well, I've been here minutes,

and she hasn't let either
of them get a word in.

I need to tell Bailey that
my fellow quit this morning.

Makes sense.

People start to feel
the ship sink, they jump.

Oh, my God. Are you still
considering taking that offer?

I made my decision before I knew
about this probation.

Tell Nick that you've changed your mind.

It isn't about Nick.

Not just about Nick.

Fine. Congratulations.

I have a presentation.

Some of us are loyal
and want to save this place.

She'll get over it. Everyone will.

And I will come visit you.
I am pro-Minnesota.

You are pro-sex in Minnesota.

Well, well.
How far the mighty have fallen.

What the hell did you all
do to this place?

Probation? Really?

You've always known
how to make an entrance.

[CHUCKLES] Ooh.

Trinity Lab's "HeartPatch"

can be placed on
a patient's arm or chest,

and within seconds, will
continuously transmit ECG,

respiratory rate, and oxygen saturation

right to an app on your phone.

You get instant monitoring of
your patient

while you're out doing rounds,
brushing your teeth...

hell, you know what,

you could even check them
on the golf course.

[LAUGHTER]

Phase III results rival the gold
standard telemetry monitors.

And Grey-Sloan could be at the forefront

of this cutting-edge technology.

So, anybody has questions, I'm here,

and don't forget, we got donuts.

[LAUGHTER]

[INDISTINCT CONVERSATIONS]

Hey.

Thanks for the coffee.

I like that suit. That's nice.

Yeah, yeah.

I got to look sharp for my Seattle Pres

and St. Joseph's pitches this afternoon.

You know, we should try these patches

on a couple of our patients today.

Richard said that we needed to

improve our tech and "modernize."

So...

Really?

Absolutely.

Stay right here.

I'll grab a few samples.

Hey.

What are you doing here?

Snickerdoodles.

My sister baked them
and insisted I bring you some.

Oh, wow. That's so nice.

Yeah, well, my office is walking
distance, so it wasn't...

Oh, you're talking about
her making the cookies.

[CHUCKLES] Yes.

But the delivery service
is also appreciated.

How's Laura? She's good,

but I just heard about

the residency program getting shut down.

Am I gonna need to find her
a new hospital?

It is not shut down.

It's on probation, and it's just
the surgical residency program.

Oh, okay, great. So I'll just make sure

the paramedics don't send me
here if I get hit by a car.

[LAUGHS] Our attending
surgeons are very good.

Yeah? Is that why they kicked you out?

[LAUGHS]

Um, I have to get going to a meeting,

but I'll see you later?

- Yes.
- Okay.

Okay.

I didn't realize you were still
hanging out with Tad.

It's Todd, and yes.

He brought me cookies.

Because he's nice.

How thoughtful. [CHUCKLES]

What's so funny?

Nothing. I just see how hard
you're trying to like him.

I want nice to be my type.

Great. I support that.

♪

[INDISTINCT ANNOUNCEMENT OVER PA]

Hey, so, uh...

So, this morning with Leo...

Yeah, we should figure out what to do.

What do you mean, "what to do"?

Well, he's obviously confused.

We should get a therapist.

I mean, one for him and...
and one for us and...

- [MAN SCREAMING]
- Help! We need...

Oh, wow.

Get a gurney now!

What's his name? What's his name?

- C-Colin.
- Okay.

Alright, ma'am, step over here, please.

His name is Colin... Colin Renfield.

We work together at
an e-tail fulfillment center.

His arm got cut off on the
conveyor belt minutes ago.

Is that the, uh...

His arm.

OWEN: Okay, let's get saline and ice.

Let's get him to Trauma One now.
Let's go.

[GROANING]

Is there anything else you need from me?

- No, we're good, thank you.
- Okay, good.

Why don't you wait over here
and we'll...

- Oh, God, she's going down!
- I got her!

Alright, get the wheelchair.

Alright. Alright.

We got you.

LINK: He's a little hypotensive.
Normal sats.

- Let's type and cross him for blood.
- Colin?

Colin, we're gonna do a quick X-ray

to assess your injuries, okay?

Push another of fentanyl.

You can put my arm back on, right?

We're gonna do our very best.
Okay? I promise.

- My wife...
- We'll inform her right away.

This is a marathon surgery.
Could be hours.

Are you sure you're up for it?

No shame calling in reinforcements.

What reinforcements?

Okay, let's page neuro

and tell the OR we are on our way.
Let's go.

Heart rate and blood pressure
are improving.

Sorry.

I got... woozy.

It's okay. You had a vasovagal response.

It could be triggered
by a number of things.

The sight of blood,
emotional distress...

How's Colin? Can they reattach his arm?

They're still trying to figure it out.

[SIGHS] It was horrifying.

It just keeps replaying in
my head, over and over again.

You saw it happen?

[EXHALES SHARPLY]

The gears on the conveyor belt...

They made a terrible noise,

and then Colin started screaming

and his arm ripped off his shoulder

and went flying around,

spraying blood everywhere.

It was on the floor, on the merchandise.

Some of it hit my mouth.

I...

Oh, no, it's happening again.

Alright. That's alright. We got you.

I have a woman pregnant

with a transplanted uterus
and her dead husband's sperm,

and she's now experiencing pain.

I mean, should I be transferring her

to a hospital that isn't on probation?

Well, the hospital isn't on probation.

- Just the surgical residency program.
- [CELLPHONE SWISHES]

And also this hospital's
been through much worse.

Okay, that doesn't make me feel better.

But the transplant worked?

Tovah's officially pregnant?

Mm-hmm. One uterus, two IVF cycles.

She is weeks today.

That's amazing.

So, how much is David Hamilton
offering you?

- Sorry.
- Oh, come on.

The rumors are everywhere.

I made so many people angry
by even considering it.

Bailey?

- And Richard.
- [ELEVATOR BELL DINGS]

Meredith Grey back in neuro,
pissing people off?

- It's like I never left.
- [BOTH CHUCKLE]

There she is. My favorite student.

[CHUCKLES]

Hi, Richard.

You need to be trying to save
the program, not sulking.

I am recruiting.

These are résumés for
attending surgeons.

Right now, you need to be focused

on keeping the residents.

You know when a program goes on
probation, they panic, and flee,

and we lose government funding.

Well, they'll stay if we have
enough attendings to teach them.

No, no.

We will not hire any outside surgeons

until we have assurance that
our residents intend to stay

and plan to give good reviews to
the council's follow-up visit.

- [SIGHS]
- In fact,

you will speak to every one of them.

Today. And I will observe.

♪

[SIGHS]

Where are you going?

To line up residents to beg.

Highlight of my year.

[GRUNTS]

[SIGHS]

Haven't done a full arm
reattachment in years.

I've never done one.

Believe it or not,
this is a career first.

- Irrigation.
- AMELIA: Good to see you back in an OR.

[CHUCKLES]

Are we ready to reattach an arm?

Edges are all freshened up
and ready to go.

Alright. Let's make sure we have

plenty of blood product on hand,
and everybody buckle up.

We are going nerve by nerve,

vessel by vessel, muscle by muscle.

I think we get the idea.

I'm gonna scrub.

[ALARM BLARING]

- [FLATLINING]
- V-fib!

He's lost too much blood. Push epi.

Starting CPR.

I know we have a blood shortage,

but call for another three units!

♪

- Come on.
- Come on!

[MONITOR BEEPING]

Okay, back to sinus.

[SIGHS]

Hell of a first surgery back.

Owen, you saved his life.

But now he's too unstable
to reattach the arm.

- Life before limb.
- I wanted to save both, okay?

Let's get him up to the ICU
and prep him for resuscitation.

♪

[ULTRASOUND WARBLING]

- That's your baby.
- TOVAH: [CHUCKLES]

Heartbeat's strong.

- Oh, my God.
- [CHUCKLES]

Thank you.

[CHUCKLES]

Hi, baby. Hi, sweetheart.

[SOBS] Sorry.

You don't need to be sorry.

I'm scared.

It's my last embryo,

from the last of my husband's sperm.

- And it's still there.
- Yeah.

Okay, I'm gonna switch to
Doppler now, Schmitt.

Have a look at the uterine vessels.

So, if the baby's okay,

why am I feeling all this
pressure in my belly?

That is what we're trying to
figure out, Tovah.

[ULTRASOUND WARBLING]

Have a look, Schmitt.

Oh.

What? What is it? Tell me.

It looks like there's diminished blood

flowing to both sides
of the uterus, Tovah.

Right side looks a little thrombosed.

It's a-a blood clot.

Oh, no. Oh, God. But the baby...

The baby is fine, okay?

We just need to order some more scans.

Alright, let's order an MR angio
right away,

and page Webber and Grey.

I want their eyes on this in
case we need an IR intervention.

Uh, both of them? They're...
They're having a little...

Yeah, I don't care.
I'm not a high-school teacher.

I don't care who's talking
to who and who isn't.

Page Webber and Grey.

Yes.

Okay. Step at a time, Tovah.

[DOOR CLOSES]

[INHALES SHARPLY]

[INDISTINCT ANNOUNCEMENT OVER PA]

[MONITOR BEEPING]

How's Colin?

He's okay.

There was a slight complication
in the operating room,

but we were able to resuscitate him.

Thank God.

And his arm?

At this point,
he's just not stable enough

to withstand a -hour surgery
to reattach it.

So, you'll do it later?

Unfortunately, without blood flow...

[SIGHS] his arm won't survive
much longer.

This is all my fault.

Yesterday, when I got to work,

I saw that one of the conveyor
belts was acting up again,

but I didn't tell anyone to fix it.

When I got to work this morning,

I wasn't paying attention,

and then he switched it on.

I could have done something.

I could have stopped this
from even happening.

♪

Can I see him?

Of course.

♪

Think about all the m*llitary vets

that we've seen lose limbs in combat,

and they've gone on
to live very full lives.

It's gonna be an adjustment, but...

♪

- Wait, where are you going?
- To find that arm.

I think I can save it.

♪

Two rounds of IVF, weeks today, so...

- Hey.
- Hey.

Um, we already have a general surgeon.

Oh. Well, if I'm not needed here.

Yeah, that's a good idea.

Just leave and that'll fix everything.

You are, and she is.

You're not exactly subtle,
you know that?

Okay, as delightful as this is,

I have a patient at risk of
losing her uterus and a fetus,

so if we could just
focus up here, please.

[COMPUTER BEEPING]

Damn it. The right outflow
is completely clotted off.

The left side is severely
stenosed, but salvageable.

We could do a fibrinolysis
and dissolve the clot.

Not if you don't want to k*ll the fetus.

Well, of course I don't
want to k*ll the fetus.

We could do a balloon
angioplasty on the left side

and see if that widens the blood vessel.

Let's prep her for angio.

You don't need the both of us there.

On a normal case, I wouldn't,
but this isn't a normal case.

Tovah's making medical history.
We all are.

Look, I don't care what kind of

giant dumpster fire this hospital is,

I refuse to let Tovah burn with it.

So, we're all adults here.
Let's act like it.

♪

[INDISTINCT ANNOUNCEMENT OVER PA]

- The ashes are falling.
- Oh!

Hi, Bailey.

H-How are you?

I'm desperate. I'm in need.

And if I remember correctly,

I've been very good to you
when you were in need.

Do you need something specific?

I need you back
as a general surgery attending.

And I know how big an ask this is,

and I wouldn't be coming to you
if I had other options.

You want me to just give up
my OB residency spot a year in?

As soon as the program is off probation,

you can return to OB.

Okay, and what if they fill
my spot in the meantime?

On average, I'm having to cancel

seven scheduled surgeries per day.

That's seven patients who have to wait.

That's seven surgeries that
residents do not get to assist.

If I had even one more attending
on the schedule,

you, well, I could
cut that number in half.

Bailey...

Please, don't make me beg.

I don't like it,
and I'm not very good at it.

Do I have to decide right now?

You have to decide yesterday,
if possible.

This hospital has given you
a lot, Wilson.

♪

Hopefully, you'll return the favor.

♪

That little Band-Aid's supposed
to monitor all my vitals?

Heart rhythm, oxygen levels,
respiratory rate.

There is even something to
measure your sleep quality.

Whatever happened to
the good old stethoscope?

[CHUCKLES]

Alright. Here you go.

Sorry, our Wi-Fi is not having it today.

Stethoscopes don't need no Wi-Fi.

- [TABLET BEEPS]
- MAGGIE: Oh, it's up!

[FLATLINING]

It says he's dead.

- What?
- Huh?

Yeah, it...

Okay, hold on.

Ah!

[TABLET BEEPS]

Try it now.

- [FLATLINING]
- Oh, no, you're dead, too.

I find that slightly comforting.

♪

You basically re-created
an entire circulatory system

to support the arm.

It's called ex-vivo limb perfusion.

It was being tested for m*llitary use

when Teddy and I were in Iraq.

- Think it'll work?
- I hope so.

I'll keep you both posted.

Thank you.

That's so cool.

Owen, this technique hasn't been
approved for civilian use.

And if it works, what does it matter?

- If the m*llitary finds out...
- Then they will say,

"Congratulations, Dr. Hunt.
You saved an arm."

Do you really want
their attention right now?

I will cross that bridge
if it comes to it.

Oh. So your plan is to just wing it?

Is that what you want to do with Leo?

Owen, this is a big deal.

What happened this morning
is a big deal.

Our son told us that he's a girl.

Yes, and you immediately said,
"No, you're not."

I know. I'm sorry.
It... It was a mistake.

We've... We've let him wear dresses

and we've laughed and smiled,

but maybe we should be
paying closer attention.

We can't just wing it.

Think about how your mom is gonna react.

We need to have a plan so that
we can try and help him.

The only thing that needs help
in this exact moment

is our patient.

So, can you please just go
and check on him

while I try and keep this arm
from dying?

♪

[SIGHS]

♪

[MONITOR BEEPING]

Four generations of surgeons.

All students of Dr. Richard Webber.

Technically, it's three
generations, plus Dr. Webber.

I-I literally don't know
why I'm talking.

You know, there was a time when

being my student meant something.

But now, there's no loyalty.

Spare me the loyalty speech, please.

In case you're curious, Schmitt,

Dr. Montgomery was a machine
during her residency.

There was a stretch where

she and Derek Shepherd were my students.

We're doing this now, huh?

They did these gauntlets of
back-to-back surgeries

over the course of several days.

I mean, no sleep, barely a meal break.

I mean, it was astonishing.

That's one version of the story.

Care to elaborate?

Not particularly.

Let's just say that
my memory of that time

isn't quite as romantic
as yours, Dr. Webber.

Well, would you prefer that I talk about

your residency years instead, Meredith?

No, I would not.

Of course the HeartPatches are garbage.

My brother is a walking pawn shop.

Maybe we got a bad batch.

Or maybe we didn't apply it properly.

Yeah, you know, somehow, I doubt that.

Okay. Let's see.

Hey, your pulse ox is good,
heart rate is good.

Why don't you try doing something

to increase your heart rate?

What are you doing? What are you doing?

I am increasing my heart rate.

Is it working?

Actually, yeah.

Mm.

[MONITOR BEEPING]

[FLATLINING]

Oh, no. Oh.

Well, I know you're not dead.

You wanna stop
and go tell Wendell right now?

Mnh-mnh.

Nope.

[DOOR CLOSES]

- [COFFEE POURS]
- LINK: Hey.

If you tell me this coffee's
only for attendings,

I will break the pot
into a thousand pieces.

Okay. I'm sorry for earlier.

You deserve a nice guy.

It's... [SIGHS]

Bailey asked me to come back
to general surgery

to save the program.

Wow.

Yeah.

So, what are you gonna do?

I don't know. I just...

Can we grab dinner tonight?

I just... I need to talk this
through over several drinks.

Aren't you going out with Todd?

Yes, but he doesn't talk medicine

or accreditation probation,
so can you please just join us?

Unless it's weird.

Nope. Not weird.

I'll do all the pros and cons
of vaginas versus colons.

With the nice guy you're dating.

Thank you. Joe's?

- Of course.
- You're the best.

Oh. Thank you.

Yeah.

So, um,

ooh, what are you gonna tell
Wendell about the patch?

Uh, I'm gonna tell him the truth.

These don't work.

It's a medical device.

What if Grey-Sloan bought them?

While on probation?

- This place cannot...
- Whoa!

Maggie, Winston.

What's up, bro?
You never texted me back.

Is your shirt inside out?

[CHUCKLES]

Yeah, I'm... I'm just...

Wait, are you gonna leave us a review?

'Cause, you know I work off
commissions, right?

And, uh, a rave from
a renowned heart surgeon

would definitely give me a sales bump.

These don't work.

Ah, get out of here.

[CHUCKLES]

What?

Oh, oh, oh. You know what?

I-I know what the problem was.

I gave you the beta models from testing.

No, these... These are discontinued.

Let me give you the retail model.

Fully FDA approved.

Okay, yeah, I guess we could try those.

Right, Winston?

♪

Right.

Let's go.

♪

[MONITOR BEEPING]

Inflating the balloon.

Let's get the stent ready.

When did it become a thing
that we "owe" the hospital

that we did our residency at?

You trained at Columbia.

I don't see you still working there.

I don't think that's
what anyone's saying.

I have earned the right
to spread my wings.

Of course you have.
But it's not just about that.

Amelia told me that when you had COVID,

this place nearly broke without you.

%.

The hospital broke because of COVID.

And you weren't there to
lead them through it.

I may remember you as a featherweight

in light blue scrubs, but apparently,

you've become some sort of
hospital mascot

- in the years since then.
- [CHUCKLES]

Okay, removing the catheter.

You know that Richard's not mad
because he's losing a surgeon.

I'm not his student anymore.

You were never just his student.

- [ALARM BEEPING]
- Fetal decels.

The uterus isn't getting
enough blood flow.

Contrast and sh**t fluoro.

♪

That left vessel is
completely clotted off.

♪

It's over.

Damn it! Okay, um...

Let's prep an ex-lap
and remove the uterus and fetus.

Okay, no, no, no.

We can do a vascular revision.

If we can harvest the saphenous vein,

we can maybe bypass
the thrombosed vessels

and save the pregnancy and the uterus.

♪

Prep the abdomen and leg.

We're opening her up, and Richard,

I swear, if your head's not in this...

I'm right here. Let's do it.

Scrubbing in.

♪

[DOOR OPENS]

[KNOCK ON DOOR]

Oh, Dr. Wright.

Do come in.

I've heard so many
good things about you.

Wow. Really?

Yes. Dr. Bailey is quite the fan.

Well, uh, the feeling's mutual.

Dr. Wright, why do you draw?

I mean, I know you draw every surgery

before you perform it, but why?

I'm ambitious, Dr. Bailey.

I always knew I wanted to be a surgeon,

but it's hard to have
the patience it takes...

Doing every step without
getting ahead of yourself.

But when you draw the body,

I mean, you see the body, yeah,

but by taking the time to draw it,

you're telling yourself that
the body's worth your time,

worth taking a closer look at.

So then, when a body's
on an operating table,

it's... it's not something
trying to defeat you.

The body's a work of art.

What's this?

Um, it's the, uh, forms

to complete your transfer,
uh, back to the Clinic.

Oh, you mean from the Clinic?

I called your program director
in Minnesota.

They still haven't filled your spot.

- Miranda.
- Did I do something wrong?

Quite the opposite.
Your work is stellar.

You are one of the finest residents

I've had the pleasure of teaching.

Which is why you need to leave.

Dr. Bailey, can we have a word
outside, please?

This is my office. If you want
a word, you can have it here.

Dr. Wright, what Dr. Bailey's
trying to say to you...

What I am trying to say is
if I fail to save this program,

which I might
through no fault of my own,

every resident will be orphaned.

I don't know if you'd be able to
get a spot somewhere else,

and I want to protect your future.

[VOICE BREAKING] So, please,

go back to Minnesota.

[GEOGRAPHER'S "THE REASON" PLAYS]

♪

And hey, you can still learn
from Meredith Grey out there.

♪

[MONITOR BEEPING]

♪

♪ What have I become? ♪

MEREDITH: Clot scissors, please.

♪ Water on the sun ♪

Cutting the vein.

LEVI: Removing the vein.

Syringe, please.

♪ The b*llet in the g*n ♪

Let's flush the vein.

♪ The light inside the siren ♪

No leaking.

Perfect.

Here you go, Dr. Webber.

♪ The reason's going in and out ♪

♪

Suture.

♪ Our lonely ghosts
will scream and shout ♪

One more.

There we go.

♪ If they could only hear me now ♪

I think we're done here.

Okay. Unclamp.

Unclamping.

Sponge stick.

♪ They'd leave their
chains upon the ground ♪

♪ 'Cause the reason's with me now ♪

Blood flow looks good.

No leaks. I think we did it.

Schmitt, go and get the Doppler
and check the fetal heartbeat.

LEVI: Stand by.

♪

Schmitt?

[MONITOR BEEPING]

♪

No.

♪

No.

No!

[CLATTERING]

[SIGHS]

Addison, I'm so sorry.

[EXHALES SHARPLY]

Yeah, me, too.

Okay, let's prep for a D&C.

This looks like the same model.

It is. There is no other model.

I don't understand.

I got a loan, and I bought it.

All of it.

You're saying it doesn't work?

Look, Winston, if I can't
sell this stuff...

You got a loan?

Yeah, like... Like, from a bank?

Not from a bank.

How could you be this stupid?

No, you know what?
How could Ibe this stupid?

You said you had a real job.

You were working on commission.
You lied to me.

It works.

I swear. I-I saw it on
an online presentation.

Oh, my God, dude.

Look, I saw an opportunity.

Surgeons in the family,

direct connection to the Fox Foundation.

Look, I put the pieces together,
and I went for it.

How much are you out?

grand.

[EXHALES SHARPLY]

Look, everything I have is in this.

If you're saying it doesn't work,

if... if I can't sell this stuff...

you have to help me sell it

or pay back the loan.

Wendell...

If you're my brother,

if we're family, you will.

You have to help me.

Please.

TEDDY: Colin's wife
is half an hour away.

It worked?

Yep. Toxins are flushing,

arm is looking pink,

and tissue is oxygenating properly.

That's great news.

Listen, Teddy, I'm not
winging it with Leo, okay?

I'm just... I thought this might happen

ever since he started
wearing a tutu, didn't you?

At four? No.

I thought we were raising a son
who loves dress-up.

Teddy, if Leo says, "I'm a girl,"

- I'm gonna listen.
- So, that's it?

We're just gonna tell everyone
that Leo's a girl now?

What, before he can even
tie his own shoes?

Maybe? I don't know.

He might change his mind in two months.

Then we'll just tell everyone
that he's a boy again.

Won't that be even more confusing?

I don't know, Teddy.

I don't have all the answers, okay?

I just think we have to follow his lead.

Meredith Grey.

Catherine, I can't do this right now.

You would leave this place
right when it...

- Catherine...
- Do not interrupt me!

Please don't talk to her that way.

You are not her boss, nor are you mine.

- Boss?
- Excuse you?

This is about honor.

This is about the standing
of this hospital.

- Okay, can we not do this?
- The standing of this foundation!

Can we just stop?!

For a minute.

A woman just lost her pregnancy.

A pregnancy that she fought for

with everything that she had
left in her body.

Through grief, through pain,
through loss.

She fought and she lost her pregnancy.

Can we just take a moment
[CHUCKLES] and honor her?

Just a moment to honor Tovah?

♪

[LUKE SITAL-SINGH'S
"TURNING TIDES" PLAYS]

Mrs. Renfield, your husband has
been through major trauma.

Will he be okay?

He has to be okay.

We've given him some time to stabilize,

but we've scheduled his surgery

for first thing tomorrow morning.

It was touch and go, but in the end,

we were able to save it.

We're gonna reattach the arm.

Thank God.

Thank you. Thank you so much.

♪ Maybe this time ♪

♪ There'll be more to say ♪

♪ It'll all have changed ♪

- [CRYING]
- I'm so sorry, Tovah.

We'll try again, just as soon as we can.

[SOBBING]

♪ I've got a worried mind ♪

♪ Maybe half the time ♪

When my grandfather d*ed,

our rabbi taught me
the Mourner's Kaddish.

♪

I know it's not really
the normal time to say it,

but it's always helped me.

[SOBBING]

♪ And I get hurt ♪

♪ But I get by ♪

Yitgadal v'yitkadash sh'mei
raba b'alma di-v'ra

chirutei, v'yamlich malchutei

b'chayeichon uvyomeichon uvchayei,

d'chol beit yisrael,

ba'agala uvizman kariv.

V'im'ru. Amen.

- Amen.
- [SOBBING]

♪ Like an unheard prayer ♪

♪ But it's alright ♪

♪ If we just hold on tight ♪

♪ They'll be wearing gold ♪

♪ When my story's told ♪

♪ I love ♪

I feel like I failed her.

Her uterus is still intact.

She can try again.

Yeah, but not with her husband.

♪ Can someone slow the turning tides ♪

You really don't remember
your residency fondly?

[CHUCKLES]

Do you?

Oh, come on, Richard.

You changed my life.

Okay? But I remember pain.

I remember insomnia.

I remember bullying attendings.

I remember learning to treat patients

as wins and losses instead of people.

Took me years to unlearn that.

I mean, people haven't
complained before.

I mean, not like this.

Come on.

We couldn't complain.

I couldn't complain.

The surgery world's small.

If you complain, you lose your spot,

and you never get it back.

That was the culture,
and you know it, Richard.

Look, you know, you are trying to save

a version of the program that is old.

It's broken, alright?

You gotta stop with
the reminiscing about the past

and look to the future.

What's the new way to train surgeons?

I tried that. It got us shut down.

Well... try again.

♪ Ooh ♪

♪ Oh, I won't be far behind ♪

So, if you say yes...

Then I could lose my OB residency spot.

And if she says no,
then the chief of surgery

asked her for a favor,
and she was like, "Nah."

Got it. So, it's a Hobson's choice.

Mm.

When you're offered a choice

and there's really only one option.

Oh. [CHUCKLES]

When I was in grad school,
I told my dissertation chair

that I wanted to study the impact

of climate change on global migration.

So, in addition to
environmental science,

it would involve public policy,
sociology, and geography.

Is this story your way of
telling us you have a PhD?

I already knew that, but isn't
that what you studied?

Yeah. I decided to go for it.

I basically lived at
the library, but I did it,

and I didn't have to
spend a year of my life

studying the atmospheric effect of moss,

which is what she wanted me to do.

I mean, no offense to moss,

but point is, maybe you could do both.

I mean, I know it'd be more work,

but if that's what you want,
I say go for it.

♪

What he said.

Yeah.

Keep your residency
and moonlight for Bailey.

I've seen you handle worse.

But I have a baby. I have a tiny human.

- Right.
- It's only for a few weeks,

or a few months,

and, uh, I can help you out with Luna.

♪

I could help with Luna, too.

♪

Yeah, no, scratch that.

Next round's on me, though.

- Okay.
- Okay.

♪

Hey.

Hey.

I want Leo to be happy.

I never wanted anything but
happiness for our kids.

But I just, uh...

I don't want to mess this up,

and it just feels like there are
a million ways to get it wrong,

and if Leo were , then we'd be
having a different conversation,

but he's not, and, you know,
neither one of us

has done enough research
to know how to handle this.

And...

[SIGHS]

I want to get it right,
and going all-in now,

it just... it doesn't seem right, Owen.

Hey, you remember when
Leo said that he was an owl?

Did you feel the need to, you know,

call him silly and correct him?

[SIGHS]

- No.
- No.

No, you just loved him.

You just let him explore.

Let's just love Leo, okay?

Let's listen when he tells us who he is.

It's more complicated than that.

Yeah. Yeah. It is.

Then let's get a therapist.

But for us.

For us, not for Leo.

I'm not correcting Leo.

I'm not telling Leo that there
is something wrong with Leo.

Let's not be our kid's first bully.

Yeah, I agree with all of that.

I-I just...

[SIGHS]

What if we don't agree on the approach?

♪

Honestly?

Honestly, I don't know.

♪

Therapy it is.

Yeah.

♪

♪

♪

I was in pain

when you came to see me.

You dumped me and told me to go away.

I know. I did.

But...

when you were in pain,
I kept showing up.

[ELEVATOR BELL DINGS]

I guess that's the difference
between me and you.

♪

♪

[DOOR OPENS]

Um, I-I've arranged a phone call for us

with a major consultant

to help us with a more formalized plan.

Where are you going?

- On vacation.
- What?

I haven't just taken
a vacation day ever in my life,

and I have a new little girl at home,

two teenaged boys who haven't
seen both me and Ben

in the same room in months,

and they need me.

This hospital needs you.

[CHUCKLES] Yeah.

This hospital needs too much of me.

No, I'm done being the superhero.

If Meredith Grey can go away,
then so can I.

Miranda...

Catherine,
I respect the hell out of you.

You know I do.

And I know you understand what it's like

to be a woman at the top of her
field who isn't allowed to rest.

So, I need you to hear me when I say

I'm not quitting,

I'm not taking a leave

or saying that I can't handle this job.

I am taking a vacation... day.

Maybe two.

[EXHALES SHARPLY]

'Cause I'm no good to you like this.

♪

Put simply, burnout comes from
a deep imbalance.

Too much stress with too few rewards.

You're exhausted, depleted.

♪ Feel so restless ♪

♪ Feel so out of time ♪

You no longer have patience,
pleasure, or serotonin.

This is the end, unless...

What are you doing here?

Well, you know what?

I don't even care.
I'm so happy to see you.

No, but ask me.

I have a speech.

Oh. Okay.

Nick, what are you doing here?

Don't come to Minnesota.

[SIGHS]

Look, if you leave right now,

your people won't be okay,
and you won't be okay.

You won't be happy,

and you'll always resent me
just a little bit.

And I know you have kids.

They're gonna have to
get used to me being around,

but I am gonna get my own place,

and we are gonna do this thing
the normal way.

You know, having dinner together

and not having to get on a plane
just to kiss each other.

And look, I have days,
I have tons of personal days,

and I'm taking a few months
and I'm staying here,

and I'm gonna work locum tenens
at Grey-Sloan,

and we can be together.

Here.

♪

I have the right to leave.

I've earned the right to leave.

Other people from my residency class,

they left and took other opportunities.

I stayed. I worked. I researched.

I won awards for that place.

I did everything that was
expected of me, and then some.

And now, if I want to leave,
I'm considered disloyal?

It's ridiculous. It's absurd.

♪

You know what else it is?

It's my decision,
and I've made my decision.

So this is all very patronizing.

♪ If you think you were wrong ♪

♪ Every time that your eyes meet mine ♪

♪ I feel unsteady ♪

Okay. [SCOFFS]

I-I wasn't suggesting
we stay here forever.

I'm suggesting we stay long
enough to save the program.

And then we can go to Minnesota.

We can go wherever we want,

because you have absolutely
earned the right to leave.

You couldn't have led with that?

I thought I had. I'm sorry.

♪ Ooh ♪

[SIGHS]

Now you've seen my angry side.

I'm not gonna lie, it was kinda scary.

[CHUCKLES]

[CHUCKLES]

♪

You turn it into something else

and find your path to recovery.

♪

What?

[SIGHS]

Okay. Fine.

We can stay.

But just for a little while.

Pick the pieces you want from your life

and find a new way forward.

♪ We were not ready to fall ♪

♪

♪

♪