Original subtitles

[Meredith] In order to get a good diagnosis...

[thunder rumbling]

[lightning crackles]

...doctors have to constantly change their perspective.

["Blindness" by Metrics playing]

We start by getting the patient's point of view.

Though they often don't have a clue what's going on.

So we look at the patient from every possible angle.

We rule things out.

We uncover new information.

Trying to get to what's actually wrong.

We're asked for second opinions.

Hoping we'll see something others might have missed.

- [tires screech] - [glass shatters]

For the patient, a fresh perspective

can mean the difference between living and dying.

For the doctor, it can mean you're picking a fight

with everyone who got there before you.

- Someone's getting fired. - Stop it.

She wasn't even my patient.

- What? - Nothing.

How long is this gonna take?

- Why, you need to make a phone call? - [snickers]

- [Owen] Whoa! - [woman] Get off of him!

[doctors all yelling at once]

[indistinct shouting]

- [Richard] That's enough! - Are you kidding me?

[Richard] I said enough!

What happened here tonight,

what happened to that patient, was inexcusable.

And we're gonna be here till I find out who's responsible for it.

So until then, you will sit down,

you will shut up and you'll wait to be called.

Hunt.

[thunder rumbling]

I'm not going down for this.

Someone is.

[thunder rumbling]

Dr. Hunt, you know Larry Jennings from our board.

And this is our in-house counsel.

We're just trying to get in front of this thing...

Uh, I need you to give me the lay of the land of your ER tonight,

from the beginning.

We were slammed with a mass casualty, a hotel fire

half a dozen burn victims, a penetrating chest wound,

a firefighter with multiple traumas.

What doctors were working?

[Owen] Yang, Grey, Karev, Adamson,

that big kid whose name I don't know,

uh, Kepner, Avery and Torres.

And who was on the patient in question, the one that died?

Everyone. Everyone was everywhere.

All right. Who got the chart first?

- Dr. Yang. - [thunder rumbling]

[Cristina] It wasn't my patient.

I had it for two seconds, and then I was called outside.

OK, start from the beginning.

I was paged to the ER.

[woman speaking indistinctly over P.A.]

[scoffs]

[sighs] I'm putting myself on a time-out

- before I kill someone. - Have you seen Bailey?

She was supposed to sign my discharge papers after her appy.

Oh, good. You know, go home, get better and then come back,

'cause I need you.

Are the Mercy West people that bad?

They're everywhere and there are more of them than us,

and they're kicking our asses. God, I miss Izzie.

- We need more "uses," so get back here. - I have to be discharged first.

- You want to forge Bailey's signature? - No, that'll get me fired.

Ooh. Ask one of the new ones to do it. Get them fired.

[pager beeps]

Time-out's over.

Well, send Bailey.

[Owen] Try to keep the burn unit and the trauma rooms clear.

And call respiratory. We need ventilators on standby.

- [woman] I got it. - I got a burn victim and her kid.

Take your pick.

- Yang, come with me. - [woman] Oh, we can help.

Oh, great. Here. Take these.

[Cristina] I handed it off.

To who? Who did you hand it to?

I have no idea.

[thunder rumbling]

I got her chart.

[Bailey] Yang, come with me.

We can help.

Great. Here. Take these.

Sucks.

Yang's turfing us all the crap cases while she runs outside for the good ones.

[siren wailing]

Uh, Cathy Becker?

- Yes, hi. - [Reed] And you must be Danny.

I'm Dr. Adamson. Can you come this way with me? Thanks.

- Come on. - All right.

Uh, we were driving up to Vancouver to visit my husband.

- He's up there for work. - Mm-hmm.

And the rain wouldn't let up, so we thought, you know...

Hey, why don't we just stop for the night?

Bet you wish you kept driving, huh?

All right, can you lean forward and take a deep breath.

[inhales]

- [exhales] - I'm glad you made it out.

- Oh, thank God we were on the first floor. - [Danny] I was scared.

My mom getted burned.

[Cathy] Mommy's all right, baby. You're safe.

- Everybody is all right, OK? - [Reed] Everybody's safe now.

- Can you say "ahh" for me? - Ahh.

Very good.

[Reed lowered voice] See? One for them.

[Kepner lowered voice] And one for us.

Stop being so paranoid.

They hate us, April.

It doesn't matter how good we are, we're gonna fail

because they were here first and they rule the school and they hate us.

I'm not gonna let them turn me into someone they can hate.

I'm easy to like.

Actually, it takes a while. I hated you at first.

- Just shut up. - Sorry.

[sighs] Uh, OK. Um, your lungs sound good.

- Mm-hmm. - Your vitals are great.

Um, open up, please.

[gasps] Oh, my God.

- Well, Charlie got a good one. - See? We win.

OK, um, you look good.

These burns on your chest are pretty minor.

But the one on your calf might be third-degree,

so what I'm gonna do, uh, hang on one second. Dr. Sloan.

I'm just gonna have the plastic surgeon

- come and take a look, OK? - OK.

I just did her initial exam.

She was a burn patient and she wasn't surgical.

There was-there was nothing more for me to do for her.

[Richard] And at that point, you went...

I went to go help Dr. Bailey.

[doctors] Whoa!

- [metal clatters] - What, what did I just say?

I got it!

Dr. Bailey really needed some help.

[thunder rumbling]

[thunder rumbling]

He fainted.

- He fainted? - He fainted.

- [Larry] From what? - Better have a brain tumor or something,

'cause that's just unacceptable.

There was a blood drive today.

[indistinct conversations]

[Jackson] This place is a freakin' maze.

I've gotten lost, like, 11 times. No joke.

- I lost a patient. - That's bad, dude.

- How'd he die? - No, I lost her.

Parked her in a hallway, went to get her labs,

couldn't find the hallway. Of course, no one would help me.

Yeah, don't even ask for help.

These Seattle Grace people are kinda douchey.

Shh.

Case in point.

Douche.

- [laughs] - [pagers beeping]

It's the ER. Mass casualty.

Hey, I need to, um...

- Emergency. I'm a surgeon. Hello. - [siren whoops]

Apparently, he grabbed the fire ax out of the case

and tried to run down the stairs with it.

Mom was right. No running on the stairs.

[Bailey] OK, on my count, one, two, three.

OK, I want a CBC, chem panel,

and make sure there's an OR ready, wait, wait. Just stop.

Uh, I need to see what I'm looking at.

- Um, you have steady hands? - Uh, yes, ma'am. In college, I was...

I don't want your life story. I need both hands on this handle.

Do not push the ax in. Do not pull the ax out.

Do not move. Understand?

Yep.

In retrospect, I should've had a cookie.

- [Bailey] Wh... - [doctors] Whoa.

[clatters]

Oh!

Stupid. Stupid, stupid, stupid, stupid.

- [doctors] Whoa! - What, what did I just say?

[April] I got it!

Here. Apply pressure.

OK, come with me.

[groans]

Hey, Karev.

Clean that up.

[groaning]

[sighs]

And that was the last you saw of the patient?

Yes, with Dr. Sloan, who treated her burn.

- No, he didn't. I treated her burn. - You did? Where was Sloan?

Uh, Karev, clean that up.

OK, ready?

One, two, three, four, I declare a thumb war. Go.

[Mark] I'd say this is deep second-degree.

Why don't you start cleaning while I finish debriding?

- [gasps] Oh. - [Danny] Does it hurt?

Yeah, a little bit, sweetie. But it's OK.

The doctors are making it all better.

All right, now you gotta watch or I'm gonna get you.

- [Arizona] Dr. Sloan, need you. - All right, finish debriding,

cover the entire wound with silver sulfadiazine,

- then loose gauze, loose, not too tight. - I got it, I got it.

Evan Lang, 16, second and third-degree burns over 60% of his body.

Hey, Grey. Come on when you're done,

'cause we need hands.

[whimpering]

[sighs]

So Robbins was rushing you? You felt rushed?

No. I-I didn't rush. I took my time.

[woman speaking indistinctly over P.A.]

- [exhales] - [man whimpers]

Aah!

Oh.

Sorry. I know it hurts.

- [groaning] - [Cathy] No. No.

I'm fine. Come here.

I'm just fine.

[man screaming]

[Lexie] And then I joined Dr. Sloan and Dr. Robbins.

OK, this is all set.

Oh! I'm sorry. Sorry.

- Hey, are you free? I need a hand. - Uh, yeah, I'll be right there.

[Arizona] It's OK. You're OK.

- [man screaming] - We're just gonna examine you,

and then we're gonna get you warmed up again, OK, Evan?

[Evan groaning]

My dad.

- Where is my dad? - You just give me his name,

and we'll find him, OK? 'Cause he's gotta be looking for you, too.

[Evan whimpering]

Here. For the smell.

Listen,

burns like this are really difficult.

You don't really... You wanna switch with someone

- Karev or somebody? - You think I can't handle this?

- No, no, I-I... - Because I-I can.

I'm good. I'm here.

[Richard] So you stayed with the burn patient in the trauma room?

I... Yeah, I did.

And who was with Mrs. Becker?

- [Lexie] Reed Adamson. - OK, this is all set.

No, I was never with Mrs. Becker.

I was with her little boy.

I had just finished with him, actually.

- Oh! I'm sorry. Sorry. - Hey, are you free? I need a hand.

- Uh, yeah, I'll be right there. - OK.

So good news, big guy. You are fine.

His pulse-ox looks good. Everything looks good.

- He's totally fine. - Oh, thank you.

Mwah.

Uh, hey, can he stay in here with me,

just until his dad comes?

Yeah, no problem. It's a full house anyway.

So I went to help Dr. Torres.

Roy Macinaw, 56-year-old firefighter. Fell three stories from a ladder.

Looks like a hip and femur fracture.

Maybe radius, too. He's waking up.

What happened?

Uh, I-I-I had him. I-I got, I got to the window.

[Owen] Roy, Roy, you fell from the ladder. It was a bad fall.

But we're gonna fix you up.

Give him 10 of morphine and get him admitted.

Where's the kid? I had him.

He was going after a kid?

- [Owen] Shepherd. - Yeah.

- He has uneven pupils. - Abdomen's rigid.

He's gonna need an ultrasound.

Yeah. He's gonna need a head CT, too.

- Page me when you get his scans. - He needs everything.

- Let's take him now. Let's go. - Let's go.

[Richard] And you left the ER at that point?

I took him to X-ray, yes.

Did you ever hear Mrs. Becker say anything about pain?

No.

The nurse did. He said she was in a lot of pain.

Whose patient is bed one, Cathy Becker?

- Not mine. - Not mine.

She's complaining of pain.

At this point, who was in charge of Mrs. Becker's care?

Whose patient was she?

- I was never on her. - I was in the OR with Dr. Bailey.

- I'm not, I-I don't... - Not mine.

- No idea. - Did you order pain meds?

No, Yang did.

Next time I saw her, she was, she was dying.

[choking]

[thunder rumbling]

When you saw her, she was dying?

No, she wasn't dying. She said she had some pain.

[nurse] Whose patient is bed one, Cathy Becker?

- Not mine. - [Jackson] Not mine.

She's complaining of pain.

Hey, Karev. You got bed one?

- No. - Your initials are on the chart, man.

[Richard] So you checked with Karev?

I tried to. He was on the phone.

[Alex] I had never even seen that patient.

- I-I was stitching up nosedive. - [Richard] Nosedive?

- What's his name? - The-the dude that, uh, that fainted.

- Dr. Percy. - [Larry laughs] Nosedive.

That's gonna stick.

So you were with Dr. Percy?

He was supposed to be.

- Hey, Karev, you have bed one? - No.

Your initials are on the chart, man.

[Alex] Iz, I'm done.

I'm done leaving you messages.

I'm done talking to your mom, who's probably lying to me.

Hey, are you gonna help me with this?

Listen, it's been a week, Iz.

And I don't know if you're alive or dead.

So if I don't hear from you by tonight,

I am calling the police and I'm reporting you as a missing person.

- So who gave her the morphine? - [Alex] No idea.

I never even saw her.

I ordered it. I did.

Your initials are on the chart, man.

[Jackson] How long do I have to work here before they insert a bug up my ass?

You guys are all so cranky.

[Cristina] Well, Dr. Avery seemed uncomfortable

uh, consulting on a patient that wasn't his.

So I checked with the patient and asked her about her pain,

And she said it was localized to her chest burns.

So I checked her chart for any allergies or drug interactions

and saw that she had silver sulfadiazine

and 1 gram of cefazolin and 800 of ibuprofen,

so I ordered 2 of morphine.

You memorized her chart?

Yeah, I checked it three times 'cause she wasn't my patient.

So you ordered the morphine. Did you follow up?

Uh, no. My patient had come back from CT.

All right, people, people, listen up.

The burn unit and the ICU are full.

All patients are staying here until some beds open up, all right?

Let's keep the trauma rooms clear for the burn cases, please.

Head CT was fine.

Abdominal scans show a liver lac and a possible kidney hematoma.

I'm gonna check on an OR. Page me when he's stable.

Uh-huh.

[Evan screaming and crying]

That's him.

The kid, the kid in the window.

Is he dying?

Oh, I don't know what he's here for...

He's fine, Roy. He's being taken care of.

- You saved his life. - Oh, no.

No.

I killed him.

[woman] Can I ask something?

You say the patient asked for meds for pains in her chest?

No, on her chest. She had burns.

All right, thank you, Dr. Yang.

What, are you saying that she had chest pains,

that I ordered the wrong medication?

It's hard to say. The next entry on her chart was Dr. Grey

- putting in a chest tube, so... - Thank you, Dr. Yang.

- Meredith? - No, Lexie.

- Well, I thought Lexie was on the burn... - Thank you, Dr. Yang.

I was. I was supposed to be with the burn ki...

with Evan Lang.

[Evan whimpering]

All right, people, listen up.

The burn unit and the ICU are full.

All patients are staying here until some more beds open up, all right?

Let's keep the trauma rooms clear for the burn cases, please.

[monitor beeps]

- I can't get a pulse on the doppler. - OK, Evan, I have to do an escharotomy.

Now I have to cut into the burned skin to restore circulation to your arm, OK?

[crying] Did you find my dad?

[Arizona] You know what? I'll ask again in a sec, OK?

Push another 25 of fentanyl.

OK, Evan, you're just gonna talk to me, all right?

So you said you're in town looking at a college?

Yeah, I got a scholarship to Cornish.

I'm not sure I can take the rain.

[screaming]

[crying]

- No! No! - I'm sorry. I'm sorry. I know.

You're OK, pal. You're gonna be OK.

[Arizona] That's what I thought at first, too

about the rain. Dr. Grey, you grew up here, right?

- So you get used to the rain... - [crying]

[whispers] Lexie.

[continues crying]

Dr. Grey, step out. Come back when you've got it together.

Go.

[panting]

She can't breathe.

Oh, it's OK. I'm OK.

My mom. She can't breathe.

[choking]

It was a pneumothorax.

- What's that? - Her lung collapsed.

One, two, three.

Danny... don't let him see me die.

You're not gonna die. I promise.

- One, two, three. - [Richard] You got the chest tube in?

No, I w-I was getting there. I was count...

[Richard] Did you go in below the fifth intercostal space?

- You could've punctured her diaphragm. - I know, I just, I lost count.

Why?

[chokes]

Four...

[gasps]

[gasp]

[moans]

[Richard] Did you get the chest tube in?

I did. I... I did. I... I just...

She did. She just missed a step.

One, two, three, four, f...

[gasps and sighs]

Why did you do that?

I had to, OK? She was running out of time.

It was a tension pneumothorax. You have to relieve the pressure

So that she doesn't croak before you put the chest tube in.

- Do you want me to do it? - No, I-I can do it. I-I got it.

Three, four, five.

- [Richard] And did she have it? - [Jackson] Yeah, I watched.

- She-she was a little distracted, but... - You were distracted?

- What were you... - Dr. Yang was making a toddler cry.

Stop!

- [crying] - What the hell are you doing?

- Ugh. - [crying continues]

OK, let me just say for the record

that it was no toddler.

- He was, like, five, if he was a day. - Yang...

- Well, you would've yelled at him, too. - Why was he there in the first place?

I don't know how he got there.

- The patient was coding and... - The patient was coding?

- Coags are stable. - Good, OR is ready. Let's take him up.

Yang, you're with me. Torres, Adamson will call you

when we're ready for the femur.

Roy, your whole crew's in the waiting room.

They'll see you after, OK? They're saying you're a hero.

Tell him I'm sorry. Tell him I'm so sorry.

- Who is he talking about? - The kid in trauma 2. Roy, he's fine.

- He's gonna be... - Almost had him.

I was at the window.

I could feel his fingers in my hand.

I went to pull him out, and, and I missed a step.

- [crying] One stupid mistake. - You fell, Roy. It was an accident.

He was burning.

[sobs]

- And then I went... - [monitor beeping erratically]

V- tach. No pulse.

Start CPR. Bag him. Push one of epi.

Charging to 200.

- [defibrillator whines] - Oh.

[monitor beeping rhythmically]

Or that works, too.

- [exhales] - Thanks. Had it.

Stop!

- [crying] - What the hell are you doing?

[Richard] Who was watching that kid?

That's what I said.

Hey, hey. Who's watching this kid?

I took the kid.

He was with me, but I-I can't watch him. I'm supposed to be in trauma 2.

[Evan crying and screaming]

All right, I-I-I got him. I'll take him.

Come on.

[Richard] And you left his mother alone?

[Lexie] She was stable, And-and I was supposed to be with the boy.

- But his mother had a collapsed lung. - No, no, no, not that boy.

I was supposed to be with the other boy.

You want something sweet for dinner?

What the hell are you doing?

I have to sit with him until his dad comes.

- I left him alone... - No, you left him.

Come here.

Hey, can you sit with him until his dad comes? Thanks.

[woman speaking indistinctly over P.A.]

You left him alone. When were you planning to...

- I'm-I'm sorry. I just... I-I feel like... - No, you don't get to feel anything

because he's feeling everything.

His every nerve is exposed and raw, and we have to make him feel worse

before he's gonna feel better.

So if you're having feelings, then you need to shut them down.

You need to shut them down and talk to him about his future

and remind him that he has one past all of this pain.

And if you can't do that, if you can't do your job,

then you find someone who can and you send them to me.

[Richard] Did you see Mrs. Becker again?

- No. - [Richard] Did you see Karev

perform an emergency cricothyrotomy?

I wasn't there.

I was right there. I saw it.

Then you find someone who can and you send them to me.

Have you seen Karev? He didn't finish my stitches.

No, I-I, I-I don't...

[indistinct conversations]

Doctor, she's not breathing.

Move. Move, move, move. Get me a 7 ET tube.

[monitor beeping erratically]

Ah.

Oh, crap. She's completely closed off. I can't see her cords.

- You can't intubate a patient? - Of course I can, I just...

I was having trouble.

Her airway was completely closed off. I mean, I couldn't tube her either.

- What's going on? - [monitor beeping erratically]

There's too much swelling in the airway.

- Um, get me a smaller tube, a 6-0. - [nurse] 6-0. Here you go.

[beeping continues]

- Damn it. - [Alex] Move!

[Larry] Did Karev try to intubate?

First Charles tried to tube her, then Reed came to help,

- and then Karev performed the crike. - [Richard] I thought you didn't see it.

- I did. I... - And you didn't try and help?

[Reed] There's too much swelling in the airway.

- Um, get me a smaller tube, a 6-0. - [nurse] 6-0. Here you go.

[monitor beeping erratically]

[Alex] Move! She needs a crike.

[beeping continues]

[indistinct conversations]

My patient needed me.

[Evan crying]

[Lexie] OK, here's the thing about the rain,

it usually just drizzles. It's-it's not like tonight.

But when it stops, everything is super green,

and it's beautiful, and it smells like trees.

You know that smell?

Dr. Karev seemed to have it under control.

Karev seemed totally out of control.

Move! She needs a crike.

Get me an ambu bag.

He was pale, shaky, just...

really unsteady.

She's got no landmarks. I was hoping that...

What are you... You're going in blind?

Uh, hit the carotid.

- Hit the carotid. - [Reed] And he kept saying something

about hitting her carotid.

[squishing]

[Richard] Did you give blood today, Dr. Karev?

- What? - You've been described as looking,

"Pale, shaky and unsteady."

We already had one doctor pass out after giving blood.

- I'm asking... - We all give blood.

Avery gave blood, Yang gave blood,

uh, Grey gave blood.

I give blood every two months.

Just because some dumb-ass didn't eat a cookie...

I'm asking if you gave blood today, Dr. Karev.

[rainfall]

No.

[thunder rumbling]

And-and you haven't heard from her since then?

You'll tell me if she calls?

Right.

I know, Robbie.

Thanks.

[Jackson] These Seattle Grace people are kinda douchey.

Case in point.

Douche.

[pagers beeping]

Wait, wait.

Don't stick me. I gotta go. Sorry.

[Richard] So what was the problem?

There was no problem.

There was a problem. I came back from seeing the firefighter off to surgery.

Hey. Uh, my guys would like to line the hall for Roy

when he comes out of surgery.

You know, make a show of support.

He's, uh, 35 years on the job, so we figured we would...

That's great. That's, um...

Ex-excuse me.

[Reed] And there was a problem,

and Charles waved me over to help.

No, I wasn't waving at Reed.

I was waving at Karev, but he wouldn't get off the phone.

He what?

Oh, crap. She's completely closed off.

I can't see her cords.

...come home so we can talk.

- I hung up the phone. - What the hell was so important, Karev?

I hung up the phone, I came over and I criked her.

After another doctor got there first. A patient was dying.

Look, I hung up the phone.

Ow! Yeah, that, oh, that's good and tight there.

Ow.

[cell phone rings]

Hello. Izzie?

Iz.

Uh...

Hello, Iz.

- Hey. - Where are you? Are you OK?

No, I know. Your mom, your mom, she said she...

[Arizona] You left him alone.

- When were you planning to... - I'm sorry. I feel like...

Iz, I'm asking you to wait, please.

No, I got... look, just wait.

- Iz just come home. - [Tyler] Doctor!

- Come home and we can talk about it. - She's not breathing.

[Charlie] Move, move, move. Get me a 7 ET tube.

Wait, what does that mean?

- [man] Coming through. - You're not, you're not coming back yet

Or you're not coming back?

Just... wait, wait, wait.

[Reed] What's going on?

Iz, just give me a number.

Give me a number, and I'll call you back.

Give me a number so... I have to...

Look, just give me a number, Iz.

- ...get me a smaller tube, a 6-0. - [nurse] 6-0. Here you go.

I, wait.

- Izzie, just... - Damn it.

Move! She needs a crike.

Ambu bag.

She's got no landmarks. I was hoping that she would...

What are you, you're going in blind?

Don't hit the carotid. Don't hit the carotid.

Don't hit the carotid.

- Don't hit the carotid. - [monitor beeping erratically]

[squishing]

Got it. Start ventilating.

[sighs]

I got there in time.

I did the crike.

I got off the phone.

[thunder rumbling]

I stayed with her after that.

[Richard] And at that point, you had her under control.

It was a good crike. She was stable.

Then out of nowhere, we started to lose her.

She's got pulmonary edema.

Switch to high-frequency jet ventilation.

Get a CBC, Lytes, ABG...

Just shotgun her, get everything.

[Karev] She had ARDS.

B.P. was dropping. We started fluids. She was sinking fast.

Trauma 1 is clear. We should move her.

- What happened? Why is she... - I-I don't know.

Hey, can you give me a hand?

Somebody page Hunt and get me those labs.

[April] I got her labs. I was shocked.

You're AK, right?

April Kepner?

Uh, no, no. This is Alex Karev.

Wait a second. What the hell?

Her carbon monoxide level was 28, and she was spiraling down.

- [monitor beeping erratically] - What the hell?

B.P. is 69 over 32. Pulse is 158.

We're already filling her with fluids. Yeah.

She was acidotic. We pushed bicarb.

They needed more hands.

[Owen] Keep her on 100% oxygen. No, no, do not.

Not until she is more stable.

Cristina, scrub out, go see if you can help. Go.

There was so much swelling, we couldn't find good veins.

We-we had to start a central line.

[monitor beeping erratically]

We can't use the hyperbaric chamber until she's stable.

Her CK level's over 75,000.

She's got fulminant rhabdo.

Everything was failing, the-the kidneys, liver, lungs.

Her chart was like a phone book now.

She's in SVT. Push 6 of adenosine.

Systolic's in the 70s. Um, start her on dopamine, 5 mics.

She was coding when I got there.

[monitor beeping erratically]

What the hell?

- She's in V-fib. - OK, starting manual ventilation.

[beeping continues]

[Jackson] Charging to 200.

[beeping continues]

- [defibrillator whines] - [Alex] Clear.

[paddles thunk]

[beeping continues]

- Uh, 300. - [defibrillator whines]

Clear.

[paddles thunk]

[beeping continues]

[Reed] No, there's blood. Wait!

She started bleeding out.

She's got blood in her crike tube. She's got blood in the tube.

[beeping continues]

[thunder rumbling]

Oh, my God.

I know what happened.

I know why she died.

- [Reed] No, no, no. - [Jackson] Get an amp of bicarb in her!

- [Alex] Push one of epi. - [April] What about calcium?

- Did anyone try calcium? - No, no, she's bleeding...

[Cristina] Get two more units of PRBCs in here!

- And bring some FFP. - Where is all this blood coming from?

- DIC. Her organs are shutting down. - She's bleeding out. She is bleeding out.

- [Derek] Just stop. - [doctors yelling over each other]

Stop. Everybody, stop! It's over.

You've lost her.

[flatline]

Somebody call it.

Well, whose patient is she?

[tone continues]

[Derek] Whose patient is this?

What?

I'm sorry.

I am so, so sorry.

Dr. Kepner.

What-what did you tell them? What did you say?

[thunder rumbling]

[door closes]

[Richard] I don't know you.

But Dr. Adamson just spent 20 minutes in that chair

telling me what an excellent doctor you are.

Your school records,

your evaluation from Mercy West all say the same thing.

And I believe it.

I believe you're good.

Dr. Webber, I-I don't know...

So you should be able to tell me what would've caused

Cathy Becker to bleed out and die from multisystem organ failure.

She had DIC.

Burns can cause massive tissue injury...

[Richard] But the burn was properly cleaned and dressed.

Well, there must have been more damage. I mean, she had a collapsed lung.

- [gasps] - [Richard] That's right .

She needed a chest tube.

But why would her lungs have failed?

She, uh, she went into respiratory distress.

They said they criked her.

I wasn't there for any of this.

And why would she need a crike? Why not intubate?

Well, her airway was too swollen. They couldn't get...

But what would cause that kind of inflammation in her throat?

Soot. Smoke inhalation.

- But she didn't have... - How did Mrs. Becker's throat look?

[rainfall]

[stammering] No, she w-she, she wasn't hoarse.

- She... she wasn't coughing. - [Richard] How did it look, Dr. Kepner?

Her breath sounds were good.

- She, her respiratory rate was... - [Richard] What, I'm asking you...

What it looked like?

[thunder rumbling]

[mutters]

OK. Your lungs sound good, and your vitals are great.

- Open up, please. - Oh, my God.

[sounds distorting]

OK. Um, you look good.

These burns on your chest are pretty minor.

But the one on your calf might be third-degree.

[Richard] You never looked.

You didn't look in her throat,

because if you had, you would've seen soot.

And you would've intubated immediately.

And none of this would've ever happened.

No, that's, it... I got distracted.

- [Richard] I know. I know. - It was-it was insane.

It was a simple mistake.

In the circumstances you were under, I know...

[Larry clears throat]

[sighs]

I'm sorry, Dr. Kepner.

- No, I m... I missed one step. I... - [Richard] I know.

And look what it's led to.

[monitor beeping erratically]

[thunder rumbling]

- [gasps] - [crying]

- [beeping increases] - [defibrillator whines]

- [paddles thunk] - [doctors all talking at once]

[Cristina] She's bleeding out. She is bleeding out.

Just stop. Stop. Everybody, stop!

It's over. You've lost her.

[flatline]

Well, whose patient is she?

[Derek] Whose patient is this?

Time of death is 12:45 a.m.

You're fired.

[rainfall]

[flatline]

[speaking inaudibly]

[siren wailing]

[woman speaking indistinctly over P.A.]

[wailing continues]

Oh, my God. Danny.

Oh, God.

Oh. Mwah. Mm. You're OK.

Oh. Where's your mommy, pal?

Let's go find mommy, huh?

[Meredith] When we're headed toward an outcome

that's too horrible to face...

[thunder rumbling]

...that's when we go looking for a second opinion.

It's not the doctors, Richard.

They're all good doctors.

I know that.

What do you think this was for?

For Jennings, it was about legal.

But this was for me.

I needed to know who finally was responsible.

At least I was able to do that.

Hmm.

[thunder rumbling]

Say it, Derek.

Maybe it's not one doctor.

Maybe it's too many doctors...

who don't know each other and who don't trust each other.

When I got to that room

there was chaos.

Because that's the system now,

chaos.

That has been the system

that has been in place since this merger.

Your system.

♪ I'm burned out and wasted ♪

I'm saying you should look again at who's responsible.

♪ I'm tired of pacing ♪

♪ I'm busy erasing ♪

♪ Voices of the dead ♪

[Meredith] And sometimes...

♪ Everything changes and everyone's... ♪

The answer we get just confirms our worst fears.

♪ I want to replace this ♪

♪ Darkness in my head ♪

[elevator bell dings]

But sometimes...

♪ ...strange place ♪

♪ Lying on the edge of a star ♪

[Meredith] It can shed new light on the problem...

♪ In these violent days ♪

Make you see it in a whole new way.

♪ Even fools they say ♪

♪ Can find a way out of the dark ♪

Hey, is she gone? Did she leave?

♪ Help me out of the dark ♪

You know what? She was good.

She was a better doctor than I am.

Just... please shut up.

Hey, you talk to April?

No, I haven't.

What?

Just waiting to see if you're gonna try to hit me again.

I'm sorry. I was just, uh...

Forget it. Rough night, right?

So April missed an airway, huh?

- That's so stupid. - Airway first.

It's, like, med school 101, right?

It's pretty basic.

[Reed] It was one second.

She got distracted and she made a mistake.

- That we all nearly got fired for. - Nosedive's got a point.

Thank you. What?

We nearly got fired for trying to fix what she screwed up in the first place.

Yeah, because that's our job.

What, you didn't make any mistakes today?

You've been distracted for the entire week.

And who knows what you screwed up?

But our patients didn't die, and that's why we didn't get caught.

It could've happened to any one of us.

[Meredith] After all the opinions have been heard

and every point of view has been considered...

Here she comes.

♪ Can find a way out of the dark ♪

♪ Of the dark ♪

...you finally find...

what you were after.

April.

[Meredith] The truth.

[thunder rumbling]

But the truth isn't where it ends.

Thank God. I was beginning to think you went home

and left me here to rot.

Go home.

That's it?

Ready to go?

Very. I've been waiting for Bailey all night.

♪ In these violent days ♪

That's just where you begin again.

♪ I only want to be where you are ♪

- You OK? - Yeah.

Let's go home.

♪ Out of the dark ♪

♪ Of the dark ♪

♪ Help me out of the dark ♪

What happened today?

With a whole new set of questions.

♪ Help me out of the dark ♪