Original subtitles

[♪ upbeat music playing]

[Grey] Every time a surgeon operates, it's for the first time all over again.

♪ I'm feeling it now ♪

[sighs]

♪ I'll rise above Nothing bringing me down... ♪

- Whoa. W-What-What are you doing? - [panting] I'm hiding from James.

- I just saw his car pull up. - I thought you liked him.

- I did. We had sex. Twice. - Oh.

And then, I find his wedding album. To Ryan.

I had sex with Ryan's husband. How did I miss this?

- This is not a problem. [sighs] - He is a man of God who cheats.

I'm pregnant with twins.

- [gasps, grunts] - [knocks]

Hey, I...

- I can see you. Can we talk? - [knocking]

- Whoa! Oh. - Brought you tea.

I can't hear you.

Ask him if it's caffeinated.

[sighs] Fine, I'll get coffee from the cart.

Look, I know this is a lot, but we'll figure it out.

We're gonna get a night nurse. My mom can move in for a while.

- Where are we going? - The other entrance.

[Grey] Even if you've done hundreds of kidney resections or heart transplants,

you've never resected this kidney or transplanted this heart.

Past experience usually helps, but for unique cases, you fake it first.

No. Sorry.

Then who are those for?

Me. I'm going to put them in the fridge. I don't have time to come back here.

Hope you made time for an EKG after consuming 400 mg of caffeine.

I have taken two of Yasuda's shifts this week.

Same. She and her sister really appreciate it.

Not enough to share her mom's cookies she sent her.

I'm just glad that Chloe seems to be recovering well.

- Excuse me. Have you registered to vote? - Ah. Already registered.

- Yeah, me too. - Same.

Not my thing.

[Grey] You rehearse on replicas for hours on end,

and hopefully, when the real patient is on the table,

- you know what you're doing. - [song ends]

Lots of people put sex on the calendar.

When you're juggling two busy schedules,

it's perfectly normal to schedule intimacy.

- Okay. You schedule a haircut. - [sighs]

I do not wanna have to schedule sex with my wife.

Why do you think this bothers you?

It feels like she's not trying to fix anything.

You know, we're hemorrhaging, and she's just reaching for a Band-Aid.

So if I don't wanna fix our problems the same way that you do,

- that means I'm not trying? - No, no, no...

Unfortunately, we have to stop for today. But I want you to see this through.

Have scheduled sex this week and see how it feels.

It might not be what you think. For either of you.

Well, I guess I'll see you at 10:00 tomorrow night. [laughs]

Um...

Would this be a bad time to tell you that I have to reschedule?

[knocking on door, door opens]

Hey. Haven't seen you in a while.

[sighing] I know, yeah. Sorry. It's been busy.

- [both chuckle] - Been meaning to give this to you.

- Oh. - You left it at my place. So...

Yeah.

- Oh. - Mm-hmm.

[chuckles]

Yeah, I guess you have been really busy. Because this is not mine.

- [stammering] Uh, you sure? Uh... - [chuckling] Yeah.

It's a really nice color though. She has good taste.

Oh, my God. I'm so sorry.

- [both chuckle] - [door opens]

Hey. You needed a consult?

Uh, I have a patient coming in from Friday Harbor with a head injury.

Uh, the local hospital's sending in the scans.

- Should I come back? - No.

I was just leaving. [stammers] I'm gonna go.

Have the nurses page me when the scans are in. [laughs]

[sighs]

[Warren] Schmitt is with Dr. Beltran today,

so I've got your assignments.

Let's do a lineup.

A lineup. It's something we did in the fire station

to get the day started right.

Discipline, organization.

Or you can stay exactly where you are. That works too.

So, uh, Yasuda's out on PTO today.

But, Adams, you're with Schmitt on Beltran's service.

Millin, you're with me and Ndugu.

Griffith with Lincoln.

Um, hey, you forgot someone.

And you've forgotten your dictations.

There are over a hundred incomplete records

with your name on it.

Have fun staring at a computer all day playing catch-up.

[groans]

[on PA] Orderly to 6 East. Any available orderly to 6 East.

Are you lurking?

[sighs] Okay, your...

Your evaluation forms were sent out today.

I know. Ndugu will be the first one who will officially assess me.

You know? How do you know?

Um, you left your laptop open on the kitchen counter today.

Hey, hey, hey. You lurk, I snoop.

Okay, just... just... Mmm...

Just be yourself.

[sighs] I've never been to Friday Harbor.

I went on a field trip in 7th grade. We picked apples.

Hey. Today, you are picking up Ofelia Lopez. She's ten years old.

She fell off a moving tractor.

Her vitals are stable, but she's got a bad leg injury and a TBI.

She needs a higher level of care than her community hospital can provide.

I would go myself, but I've got a full patient roster.

I don't mind getting out of the hospital. It's a nice drive.

I'm sure it is, but you're taking a helicopter.

- No! - Nice.

Taking an ambulance would be more cost efficient.

M-More environmentally friendly.

- And it's not up in the sky. - Update me when you arrive.

[Schmitt sighs]

Morning, Mr. Riley.

No, no. Left, right, left.

The other left, Kenneth.

[groans] Instructions go in one ear and out the other with this kid.

[chuckles] Maybe he's missing his director, huh?

- He's missing something, all right. - [chuckling]

Go ahead.

Uh, Darren Riley, 55.

Presented with antibiotic-resistant pneumonia,

with a concern for a rapidly progressing necrotizing infection.

Was intubated but couldn't oxygenate despite maximal ventilation settings,

placed on VV ECMO, and was extubated last night.

Mr. Riley's X-rays from this morning.

Uh, left lung's completely whited out.

We need to order him a CT with contrast.

Mr. Riley, I'm gonna change your cannula dressing.

Oh, I can take care of that as soon as I place this order.

- We'll just meet you in radiology. - That's not necessary.

- I wanna help with transport anyway. - Oh, but we can handle that.

Moving a patient on ECMO can be tricky, so I'd like to be there for it.

Okay. Uh, great.

All risks and benefits were explained,

and patient agreed to sign an informed consent...

Hey, are you okay?

Yeah, yeah. Good. Must've slept funny. [chuckles]

The patient was taken to an operating room and placed...

[janitor grunting]

Hey, are you sure you're okay?

- I could take a look if you want. - [gasps, chuckles]

[grunts]

[clattering]

Someone get me a gurney!

Mr. Wheeler, how are you feeling?

Fit as a fiddle.

- Think I'm about ready to go home? - Not quite yet.

I saw some fluid building around your heart on this morning's echo.

It's a common complication after heart surgery.

We might have to do a procedure to drain it,

in which case we'd have to keep you a bit longer.

Oh, no. I can't stay longer.

I have to be home next week.

It's my 40th wedding anniversary.

Congratulations. That's a big milestone.

Hey, why don't we watch it and see if it resolves on its own

before we jump into a new procedure?

[Mr. Wheeler] Macie and I got engaged when we were 19.

She wanted this big church wedding,

but our parents didn't approve, so we eloped at city hall.

[laughs] We know how that goes.

We wanted to get married in the park, but we wound up doing it in a bar.

[Mr. Wheeler] Every year, we recreate our wedding dinner.

Hot dogs from the cart on the corner.

You know, we should go to Joe's for our anniversary.

[scoffs] It's the only place we ever go.

Look, I wanna run another set of coags, and we will take it from there.

Get her flowers on your way home. Works every time.

- Thanks for the tip. - Yeah.

Thanks for making the trip. She's got severe left lower extremity trauma.

Extensive soft tissue damage as well as vascular injury.

Suffered some head trauma with multiple contusions and lacerations.

- [Schmitt] Okay. Hi. - Hi.

[Schmitt] Her respirations look a bit labored.

Her sats were in the 80s when she arrived. The oxygen's helped.

- But you didn't intubate? - Our only ventilator's in use,

and we don't have the resources to manually bag her if we did RSI.

- Okay. - We rushed her here as soon as we could.

This doctor say you'll be able to help her more?

[parent 1] Will her leg be all right? She loves to play in the fields.

I'm Dr. Schmitt. This is Dr. Adams.

We'll have a better idea once we examine her, okay?

Okay.

We temporized with a splint and tourniquet.

- Ischemia time is about 45 minutes. - [sighing]

Um...

Hi.

I'm Levi.

Your name's Ofelia, right?

My friend Lucas and I are gonna help make you feel better, okay?

Okay.

Okay. This is my number.

We're gonna get to Grey-Sloan before you, so once you get there,

give me a call.

Wait, we can't go with you?

I'm so sorry. There's not enough room in the helicopter.

But I promise we'll take excellent care of her, okay?

- Okay. - Okay.

[parent 2]

[parent 1] We love you, mija.

[parent 2]

[parent 2 sniffs]

We're gonna have to amputate the leg if we don't get back fast.

- So let's intubate for transport ASAP. - Okay.

[sighs] Back to the helicopter.

- Dr. Kwan? Aren't you supposed to... - Look, I know I'm behind on charts,

and when I'm behind, it becomes your problem,

and you don't like problems...

Uh, is that Zayne from custodial staff?

Yeah. He, uh, collapsed with a severe abdominal and hip pain.

Mr. Johnson, I see you took the whole rack down with you. You okay?

Pain started way before that rack fell. I've been managing it fine for months now.

All right. We need to get you to the ER to get you checked out. Hospital rules.

I'll just take something once my shift ends.

Let me save you the trouble.

You can fight her on this, but you will lose.

- We all do. - Can you make it quick?

I'll make it thorough. Come on. Let's go.

You too, Kwan.

- [nurse] Doctor should be in soon. - Okay.

We are never going to fit four car seats in either of our cars.

Are we gonna have to get a minivan?

You know what's transporting those babies right now?

Me.

Every horrible pregnancy symptom, double it.

Twice the-the-the-the reflux, the weight gain, the exhaustion.

And then after all that, I'm gonna return to work,

delivering other people's babies.

Taking care of not one, but two newborns.

But sure, by all means, you go test drive minivans.

- [sighs] - How can I help?

I wish I could tell you,

but all the energy that used to go to my brain is now

- being diverted to my uterus. - [pager buzzes]

You know what, I really need this to not take a long time.

I have a patient who is 29 weeks, and she's about to deliver triplets.

Three babies. Hmm? [laughs]

Could be worse.

- You want three? - [pager buzzes]

[sighs] Consult in the ER.

Just go.

I'm gonna stay for the ultrasound.

It's gonna show the same as it did yesterday.

And then you're gonna smile and say, "We've got this."

And right now, I really... I frankly don't...

Really don't need that.

[sighs deeply]

[Warren] Did you play? Marching band?

- No. - Cool. Me neither.

Oh, I didn't do sports.

But it's band.

- Do they wear uniforms? - Yeah.

Then I didn't do it.

Oh. Damn it.

[sighs] His lung is completely liquified from all the necrotic tissue.

[sighs] What's your recommendation?

Chest tube and change the antibiotics.

No. The chest tube won't drain this. And the antibiotics aren't penetrating.

So, we need to completely remove the source.

The source is his lung.

Book an OR. I'm gonna get him off the table.

[sighs]

Don't you want us to get him off... [clears throat]

Does he normally have to do everything himself?

Well, he let me sew a patch graft angioplasty once.

Maybe it's you.

When you say, "it's not your thing,"

you don't mean, like, you never vote, right?

Like it's a recent thing?

What about in 2016?

What do we got?

Uh, Zayne Johnson, 32.

Diffuse pain greatest in his abdomen and right hip

after a supply rack fell on him.

We're still working on his history. Do you take any medication?

How much room do you have on that thing?

[grunts] I take folic acid, hydroxyurea, ibuprofen, and tramadol as needed.

- You have sickle cell? - Yeah.

And I know about that new gene therapy that cures it,

but my insurance won't cover it.

And I don't have three million dollars laying around, so I still got it.

FDA approves a cure, and nobody can afford to get it.

Even if I had three mill, I wouldn't wanna spend it on treatments.

- I'd buy a boat and sail around the world. - [chuckles]

I was kinda in the middle of another patient upstairs.

Yeah. I brought you here for that hip.

[Lincoln] The articular surface is completely destroyed.

- Griffith, take him upstairs for an MRI. - Mm-hmm.

And we should also get an abdominal CT.

- No, no... - [tuts] It won't take long, okay?

If there's anything you need, you let these interns know.

Don't be shy.

[sighs]

[pilot] We've hit a bit of rain and fog. I'm trying to steer us out of it.

Think about puppies. Gravity blankets.

Wizards and adventure.

[phone chimes]

Well, either somebody died, or you're ghosting someone.

I am ignoring a mistake. And don't look at my phone.

Is it the guy from the hallway? So what, does he hate dogs?

Put the toilet paper on wrong?

- Does he not know how to cook a real meal? - Do you?

I'm just saying, just because it's a bad match,

doesn't mean it's a mistake.

You're right. It wasn't a mistake. It was a giant failure.

- [turbulence clattering] - Oh, no! Oh, my God.

[Adams] Her blood pressure spiked. She might be herniating.

[monitor beeping rapidly]

[Schmitt] Her pupils aren't blown.

Actually, they're pinpoint.

Her heart rate's in the 50s.

- [panting] Okay, kiddo. We got you. - [beeping continues]

Okay. We got you. We got you.

She's diaphoretic, bradycardic.

Her eyes are tearing up. We keep having to suction her.

Her parents said that she likes playing in the fields, right?

The farm probably uses pesticides. You're thinking organophosphate poisoning?

- Yeah. Let's get her on atropine. - Okay.

Oh, she's seizing.

Oh, oh...

Damn it. The tourniquet.

[Adams] Did it come loose?

[Schmitt] No, the clasp is broken.

We have to stop this bleeding. Holding pressure!

Okay, I got her leg. Find the atropine!

[thunderclap]

[Hunt] Hey. Uh, Aurelio's labs are back.

- Okay. Great. Thank you. - Mm-hmm.

Can I get an ultrasound and a pericardiocentesis kit?

I just need to finish reviewing these scans.

Teddy, it's still a small effusion.

He's coagulopathic. I mean, we can either do the pericardiocentesis now,

or we can wait till he crashes in the middle of the night and do it then.

We don't know that's gonna happen.

Didn't you accuse me of, what was it?

Putting a Band-Aid on a hemorrhage this morning?

What does that have to do with this?

So now I'm trying to face this problem head-on,

and that doesn't seem to be good enough either.

I mean, forget my years of experience treating pericardial effusions...

- Teddy... - [Webber clears throat] Uh...

- Was just getting a cup of tea. - [Hunt chuckles]

Oh, we, um... Well, we were just, um... We were just discussing a patient.

Look, I can give it another hour.

But then we're gonna need another set of scans and a repeat echo.

Okay.

[sucks teeth, inhaling sharply]

Oh, you should try the Moroccan Mint.

It's very, uh, refreshing. [chuckles]

[MRI machine buzzing]

[Griffith] What about local elections?

State propositions?

Or public surveys?

I send those straight to spam.

[Lincoln] Griffith, what are we looking at?

Studying his abdominal CT. His hip MRI's about to come up.

You can relax, Zayne.

Pretend you're in that three-million-dollar boat.

[Zayne] That's not relaxing.

I get seasick.

But you wanna sail around the world?

[Zayne] No, but my son does. I'd do anything for him.

[Griffith] Is that his spleen? It's so small.

[Bailey] Pretty much nonfunctional at this point.

Also those are iron deposits in his liver.

Should we take care of his gallstones too?

The gallbladder wall is not acutely inflamed.

The sickle cell's basically ravaged his body, including...

His hip, which you all would've seen if you noticed his MRI was up.

He's got subchondral collapse and flattening of the femoral head.

We're gonna have to replace the whole joint.

- He's not gonna like that. - We don't have a choice

if he wants to stop this joint from completely degenerating.

Hey, did you get the films from my transfer patient?

Schmitt and Adams are worried about the leg.

My fellow will need to take it.

- Okay. - [Shepherd] Hey.

I took a look at Ofelia's scans. Minor subdural. No swelling, no shift.

I'm not terribly worried, but I will reevaluate when they land.

Their ETA is 25 minutes.

Okay. I'm gonna check on a patient. Text me if they get here sooner.

Hey, uh, about earlier, it wasn't exactly what it looked like...

Uh, none of my business.

Okay.

[Adams] The tourniquet's completely broken.

I can't get it to hold tight enough. I'm gonna need another one.

Uh, looks like there's an injury to her superficial femoral artery.

There's another tourniquet in this bag. Hold as much pressure as you can.

Got it.

[Schmitt] Here.

All right.

Once we get a signal, we need to update Beltran.

[Adams] Got it.

- Damn it. - It's basically beyond repair.

She's gonna need an amputation.

Well, we have IV tubing.

What if we make a temporary shunt?

See if we can reconnect the femoral artery with the tubing?

[grunts] Look, the pilot is rerouting,

it's gonna take us a lot longer to get back.

The tourniquet's been on for almost two hours.

The leg looks ischemic.

If we do nothing, she'll lose it.

Okay, yeah. I'm in.

Okay. All right.

So, if you take my lung,

I'll be rid of this thing here?

Unfortunately, due to your smoking history,

your other lung won't be able to oxygenate your body well enough by itself.

You'd have to stay on ECMO until we can get you a lung transplant.

Any chance that happens... [gasps] ...before the NorthPac Band Review?

We don't know. It could be tomorrow, could be weeks from now.

There will be other performances.

Just thinking about my alto sax.

[gasping] First instrument I ever picked up.

Thing was nearly bigger than me. [chuckles]

But once I got the hang of it, I fell in love.

I haven't been able to play in weeks. [gasps]

What if I can't ever play again?

Or worse... [panting]

...what if I can't teach?

The band is more than just my job.

It's my life.

Well, music and teaching, it's in your bones.

Losing a lung won't change that.

You just might need a little extra practice after surgery, that's all.

Let's get you prepped.

Mr. Johnson, Dr. Bailey and Dr. Lincoln would like to talk to you.

I have to finish work, so I can get home for dinner with my son.

Your scans show something called avascular necrosis in your hip.

I'll make an appointment to come back.

My son needs extra attention, and my sister's had him all day.

Your pain is only gonna get worse.

The sickled cells in the joint cut off the blood supply to the bone,

which is causing it to die.

But we can replace the joint today, and your insurance covers it.

And then I won't feel pain?

Well, we can at least help with the pain in your hip.

So instead of curing my pain,

they're gonna let every joint and organ in my body deteriorate

and then they'll pay to fix it.

I know. It doesn't make sense, and...

the system sucks, so...

Look, maybe shouldn't say that, but I've been through this before.

I know the frustration of trying to fight a system

that doesn't care if you suffer, or even if you live or die.

They only see you as a code, or a cost, or some number in a sea of numbers.

The system couldn't care less about you

but if you care about yourself, you should get the surgery.

[Griffith] Think about your son.

If you weren't able to walk or continue to do your job,

be a lot harder to take care of him.

Okay.

- What's next? - I'll go tell Dr. Lincoln.

Don't bother. I'll do it.

[knocks on door]

Oh. Uh, I'm about to meet with Balcom Medical.

You know, I've always had a great relationship with Ethan Chen.

So if there's anything the hospital needs, I'm your man.

Oh, Ethan is retired.

- Oh. Well, good for him. - Yeah, the new CFO is Erika Desai.

She is great, but her husband Nirav is also very prominent on the board.

And he only hears what he wants to hear, which is himself.

Sounds like a communication issue.

And he often overlooks how hard I am trying

to make everything work.

And then he insinuates that I only care about what is best for me

regardless of what anyone else wants.

You mean what's best for the hospital.

This isn't about Balcom, is it?

So, you want advice or a pep talk?

Is there one that's less irritating than the other?

You already been through a war together.

You can do this.

That's the least irritating one?

[sighs]

[Ndugu] Tissue's very fibrotic.

- Millin, suction. - [Millin] Got it.

[Warren] My mom really wanted me to learn an instrument.

Then my fourth grade class got sent home with recorders.

[Millin] My brother and I were learning the accordion for a few months.

- Didn't stick with it? - Our teacher didn't wanna be paid

in lemons from our yard.

- [Warren chuckles] - All right, I'm at the hilum.

- You need more retraction? - That'd be great.

[Ndugu] Harrington, please.

[Warren] Oh.

[Ndugu] Could you hold that right there, Warren?

[Warren] Mm-hmm.

[Ndugu] Thank you, BokHee.

With all due respect, I may be in a trial basis,

but I am coming in as a fourth year resident.

I'm perfectly capable of retracting and prepping patients for transport

and moving them to the CT.

Hell, I'm capable of a lot more than that.

[Ndugu] All right. Specimen.

There we go.

[drill whirring]

[Bailey] How's he doing?

[Griffith] Feels like this could've been a much less extensive surgery years ago.

[Bailey] Well, seeking treatment when you have sickle cell is a minefield

of stigmas and misunderstandings.

That's not on Zayne.

Kwan, careful with the drill. This bone is like stone.

[drilling]

[stammers] I'll take over.

[Bailey stammers] Oh. Let him give it another try. Go again.

Easy this time.

[drilling]

[stammers] Pu-Put the drill down.

[Bailey] If he doesn't try again, he won't learn.

We're not doing second chances right now.

This man is in constant, agonizing pain.

And I'm just talking literal, physical pain,

not the hell of suffering in silence because nobody cares or believes in him.

It's the only way he can get by, even though it causes more pain

and more suffering...

- [drill bit breaks] - Damn it!

Someone get me a new drill bit!

Are you done?

- Yeah. - Whatever you're going through,

go through it on your own time.

We are taking care of Zayne right now,

I cannot take care of you too.

[drilling]

[Schmitt] Suction, please.

Adams, suction!

- I'm trying. - [Schmitt] I just have one more tie.

- [thunderclap] - Whoa. Oh! Oh, my God.

[sighs]

[Adams] Whoa.

- Let's do this fast. - All right.

Okay.

[groans] Damn it. I can't get it to stay.

- Can you hold it please? - Yeah.

[Schmitt] All right.

Okay.

Okay.

[groans] I think that's it.

Okay, tourniquet coming off. [sighs]

Okay.

Okay.

- [chuckling] - [Adams] It's holding. We did it.

- [both chuckle] - [thunderclap]

- [Schmitt] Oh! What's happening? - [Adams] I don't know.

- [Adams] I can't see anything. - [pilot] I can't get around this storm.

I'm gonna attempt an emergency landing.

Macie. Macie.

- How long has he been like this? - 15 minutes.

Muffled heart sounds, low BP, JVD.

Cardiac tamponade. This is why I wanted to do the procedure earlier.

- He wasn't this symptomatic. - All right.

We're gonna need to reopen him and relieve the pressure.

We're doing a needle aspiration bedside. We're already prepped.

- It's much more controllable in the OR. - [Macie] I'm his wife!

There's blood seeping out of his incision already, we don't have time. Scalpel.

[Macie] I'm right here, dear.

- [Macie screaming] - Whoa! Whoa! Whoa!

- [Macie] Oh, my God. - I need a crash cart.

Prepare for open cardiac massage.

Someone get her out of here, please!

[weeping]

[exhales sharply]

I feel so much better now.

He's alive?

- [Mr. Wheeler exhales sharply] - [Hunt] Vitals have stabilized.

We need to get him to the OR now.

What's happening? My husband's okay?

There's a buildup of pressure from fluid and blood

but it was around the heart, not the heart itself.

We're gonna know more when we get him in there, but we need to move fast.

- Let's go, let's go, let's go. - Let's go.

[Kwan] What would you do with $3,000,000?

Fund voter registration drives. How do you think the system gets fixed?

Well, it's my game. You have to spend it on yourself.

I'd hire an at-home nurse so my granny wouldn't have to live in a facility.

Pay off my loans. Start a maternal health nonprofit.

Boring.

Let me guess. You'd buy an obnoxious car.

No. For starters, I'd get my own place

so I don't have to live with you fools anymore.

I'd travel. And yes, buy an obnoxious car.

Mm-hmm.

But if I had a curable disease,

you'd be damn sure I'd spend every penny to heal myself.

What's crazy is he works at a hospital,

and he can't even get the treatment he needs covered.

And he'd probably be a great candidate for it.

It's out there, it's available, we have everything we need

to cure his sickle cell.

Everything except the money.

What do you mean we beat them here? It's a three-hour drive.

[Beltran] When the weather's bad,

they often reroute to get around the storm.

And how much longer until they arrive? Is Ofelia still okay?

This doesn't necessarily mean anything,

but at the moment, we've lost contact with them.

No. No.

I'm calling Dr. Schmitt and Dr. Adams.

We will also keep trying them until we get through.

We trusted your team with our daughter.

They promised to take care of our baby.

[Shepherd] I know that this is terrifying. We are closely monitoring the situation.

Dr. Beltran has a whole staff that is prepared

to treat Ofelia as soon as she arrives.

- Come on. Let's go take a seat, okay? - [cries]

[knocks on door]

Oh. Kwan, Griffith.

Yeah. Sorry to bother you, but this is important.

It's about a patient, and it's urgent.

Can you page another attending?

We need you, or Dr. Altman, but she's heading to emergent surgery.

Our patient has sickle cell disease.

And there's a new gene therapy that could cure him.

But it's expensive, and his insurance won't cover it.

We know the hospital can't treat everyone pro bono,

but this man works here.

He walks the same halls as us and eats the same cafeteria food.

How can we look him in the eye knowing we're not gonna help him

just 'cause some idiot suit in an insurance office says we can't?

- [smacks lips] - [nearby sneeze]

[Kwan] Uh...

Doctors, these are some of our partners from Balcom Medical.

These are two of our surgical interns who I believe have rounds.

- We-We do. - Thank for your time.

[chuckles] And you look beau... [grunts]

Chest tubes are putting out minimal fluid and he's stable on ECMO.

[sighs]

Yeah. He knew he was sick for a while, but he's been trying to work through it.

He said if he's gonna drop,

he'd rather do it around people than at home by himself.

And all I've done since he showed up here is give him bad news.

And he's had to take it all on by himself.

He doesn't have any family.

And his students can't visit.

So, my personal interest in providing Mr. Riley's care

has nothing to do with anyone's capability.

- [sighs] - I just don't want him to feel alone.

[♪ "Breakdown" playing]

- So, um, Millin, put in the post-op labs. - Of course.

Great. Warren, start to wean him off sedation

and, um, extubate him when you think he's ready.

♪ Breathe in... ♪

You got it.

All right.

♪ Clouds hanging over my shoulder ♪

All right, then.

♪ Feeling heaven now... ♪

[Shepherd] Anything new?

Just my increased blood pressure.

They should've connected with an ambulance when they made it down.

If they made it down.

[radio static, beeps]

Hello. This is Grey-Sloan Memorial. Is there anyone there? Come in.

[radio feedback static]

I sent them.

I specifically sent Schmitt in my place. I sent your nephew.

If something happens, I'm gonna have to call Schmitt's family

and tell them that I put him on that helicopter.

And your family...

I'm really sorry. I-I just had to go to the worst-case scenario in my head.

And it's really hard not to when they're flying right now

over water and other things that could spell disaster.

Well, I've experienced enough

that I always go to the worst-case scenario.

And sometimes you've just gotta accept the situation at face value,

so you can keep moving forward.

[thunder rumbles]

[phone buzzing]

Hello?

[sirens wailing]

♪ Wide asleep ♪

[thunder rumbles]

♪ Playing hide-and-seek ♪

♪ Can you rescue me? ♪

♪ Wide asleep ♪

♪ Tracing fever dreams ♪

♪ Playing hide-and-seek ♪

♪ Can you rescue me ♪

♪ Before I breakdown ♪

♪ Breakdown again? ♪

His heart exploded. And now he's completely fine.

- [chuckles] - [laughs]

That poor wife.

[laughing] She was... She was covered... covered in blood.

[both laughing]

This is terrible.

Ugh, I can still feel it in my socks.

[both laughing]

- [laughing] Oh. - [chuckles]

Owen, we don't have to schedule sex.

Well, technically, it's now our homework,

and I've always been a straight A student, so...

We're gonna get through this. We have gotten through a lot worse.

I'm not sure if you're talking about Iraq or the kids.

[both chuckle]

Teddy, can I take you on a date?

Somewhere that's not Joe's.

I'd really like that.

[grunts]

- [groans] Is it over? - Uh, yes. Your surgery went very well.

- How do you feel? - Really tired.

- [Kwan] The pain meds are still working. - [Zayne groans]

So, is this Zayne Johnson?

Either these pain meds are really strong or you're not Dr. Lincoln.

I'm Dr. Webber. I have some good news.

There's a possibility you could get sickle cell gene therapy.

What? [stammers] How?

[stammering] We're doing it pro bono?

No. My partners and I at Balcom heard your story

and we'd like to open a discussion

about how you can apply for a grant we have.

[♪ "Your Eyes Tell Stories" playing]

[chuckling] I can't believe this. Thank you.

Thank your advocates. They really made an impression.

Okay. We're talking about that later.

[Webber] If you get the go-ahead, we need to get you started soon.

This whole process could take almost a year.

[stammers] A year?

Well, sometimes as soon as eight months. You'll get blood transfusions

then you'll stay in the hospital to collect your stem cells.

Then after gene therapy, you'll be given chemo

and kept in isolation for about a month until your immune system recovers.

I don't think I can do that.

My son has special needs.

And I can't afford a caretaker or to be away from him for that long.

[Webber] Okay. Um...

Well, think about it. And maybe you'll figure something out.

♪ Shoulders get heavy when mothers cry ♪

The system still sucks.

Yeah. If only there were something we could do about it.

♪ And we used to fly ♪

She's still in critical condition, but she should be okay.

- And-And her leg? - We were able to save it.

She'll likely need more surgery,

but hopefully, with some physical therapy, she'll regain function.

Thank you. Thank you.

[parent 1] Thank you, doctors.

- Doctor Adams will take you in. - Thank you.

Thank you.

♪ Unlike your dad, I hope you cry ♪

[Schmitt sighs]

Do you think peds is your calling?

You know I applied for the fellowship.

I don't mean your interest. I heard all about your interest.

I mean, do you truly believe that it's what you're meant to do?

[Schmitt sighs]

When I was a kid, I was obsessed with helicopters.

So for my fifth birthday, my mom splurged on an aerial tour of Seattle.

Got to take pictures with the pilot, put on the cool headphones.

Then we got up in the air and I freaked out.

I rode the entire trip with my eyes closed.

That was my only helicopter ride until today.

I pretended to nap the whole way to Friday Harbor.

On the way back, once she started to deteriorate,

all I could think about was Ofelia.

Even when we were going down in the storm, I only wanted to keep her safe,

I know peds is my calling.

But I don't know how I prove that to everyone else.

Well, I've never been more certain that a resident belongs in peds.

[breathes shakily]

I wanna help.

I think that ship has sailed.

Hmm, for now.

But I have a lot of friends who got their fellowship after doing research.

And I have a colleague in Texas

who's looking for help with a clinical trial.

Are you interested?

Sure.

Great. 'Cause I already told him you'd call him to schedule something.

You know more than you think, Schmitt. Trust yourself.

- You check on Mr. Riley? - Yeah. He's stable for now.

I asked the nurse to let us know if anything changes.

All right. Thanks.

If it does, I'll handle it.

- But not because you can't. - [laughs]

I'll just be across the street at Joe's, so...

Are you meeting folks?

Nah. Just, uh, grabbing some dinner, maybe watch the game.

I like the noise.

You ready? I just told Tuck to put the casserole in the oven

and Pru to clean up her Play-Doh.

[stammers] Actually, uh, I think I'm gonna head over to Joe's with Ndugu.

Oh. I don't wanna go to Joe's.

Well, it's a good thing you weren't invited.

- Have a nice time. I'll see you at home. - [chuckling]

[Grey] The old saying goes, "Fake it till you make it."

Because sometimes pretending you have confidence

helps you find the real thing.

[sighs] Okay.

You can go home. I can stay and monitor Ofelia.

Are you still avoiding that guy?

[scoffs] Just because we shared a near-death experience

doesn't mean I have to answer you.

- Sure, but he's following us. - Oh, God.

Hey, Levi. Hi. Can we talk?

I know about Ryan.

Okay.

I thought what we had was real, something deep.

- Well, I'm sorry I didn't say anything. - I'm sure you are.

It's hard to know when to tell people about your dead husband.

What?

Oh, I... I didn't realize. I'm so sorry.

[stammers] It'll be four years this summer.

- Um... - Okay.

I just haven't done a lot of dating since then, so this is all new to me.

Yeah. Yeah.

- Wait, did you think I was cheating? - No.

[stuttering] I mean, maybe a little bit.

I think what we have is real.

Okay? You're kinda the best thing

that's happened to me in a really long time.

[♪ "We Begin" playing]

[Grey] When it doesn't work,

when life doesn't give us second chances or dress rehearsals,

you can walk away, or you can go all in.

Hey.

- Ofelia's vascular checks look good. - Hmm.

- Nice. - Yeah.

Thanks for your help today.

I just did a neuro exam.

No. I was freaking out and you calmed me down.

[scoffs, chuckles]

I'm being genuine.

No. I... It's not you. It's the irony that you would see if you knew me better.

[chuckling]

Listen, the thing with Ndugu, it's just casual.

We're just going through something similar.

You don't owe me an explanation. Really.

You and I are good.

- Good night. - Mm-hmm.

[Grey] We tell ourselves we don't care...

Hey. Hey.

[sighs] Ultrasound showed two strong heartbeats, equal fluid level.

DeLuca saw nothing to worry about.

Great.

I'm sorry.

I was so freaked out over one baby, and now it's...

And I'm exhausted. I... You know, I worked 20 hours straight last week,

I delivered eight babies with no caffeine.

- I told you you should rest after that. - Are you mad at me?

You... locked me out of your car this morning

and you kicked me out of the ultrasound appointment.

I didn't kick you out, I...

I was overwhelmed.

And hormonal. This is a high-risk pregnancy.

The odds of making it full term, with two healthy babies... I'm scared.

Yeah and you think I'm just worried about cars?

- No, I didn't... - I'm scared out of my mind.

I'm scared for them. I'm scared about you.

We're supposed to be partners.

If we're falling apart just thinking about having twins,

what's going to happen when we actually have them?

[sighs]

♪ Sometimes it's gotta fade... ♪

[Grey] ...we can try to hide our doubts and fears...

♪ When your heartbeat stops And the world won't spin ♪

♪ When your time is gone Don't know where it went... ♪

[Grey] ...or we can accept the unknown...

What's this?

[Grey] ...and dive in.

♪ Where we begin ♪

♪ Where we begin ♪

♪ Where we begin ♪

I've had an extremely long day.

I just wanted to end it with you.

And a real meal.

Mm-hmm...

- Are you hungry? - Starving.

[both chuckle softly]

♪ We can start again ♪

[Grey] The real thing is better anyway.

♪ We begin ♪

[song ends]