Émission TV: Grey's Anatomy - 21x16
Medical textbooks from the Middle Ages contained a chart called the "Sphere of Life and Death."
Doctors used it to predict health outcomes based only on a patient's name.
Morning.
What are you doing?
I am practicing my running sutures for my fem-pop bypass with Ndugu today.
That's supposed to be my dinner.
And I'm also saving you from salmonella.
You want a turn with Meryl Peep?
I'm moving the spare key.
The sphere was based on numerology, the zodiac, the moon and stars.
It's pseudoscience, compared to modern metrics.
But humans have always craved certainty.
What about Cedar Valley Estate with a fountain?
Looks bucolic.
I saw them.
Also saw they have a 250-person minimum.
Wildwood Gardens?
I thought you wanted a live band.
They don't allow live music?
No, not after 8:00 p.m.
Well, what if we have a small ceremony here at the chapel, and then host dinner in the back room at Nicoletti's?
Mmm, I don't know.
Well, we'd bring our own flowers...
When someone hesitates and says, "I don't know," it means "I don't want it."
Copy that.
Diagnosis, prognosis, genetic predisposition, they're all ways of placing ourselves on the sphere.
We ask science to protect us from the simplest fact of life.
It's full of surprises.
Do you know that the first fem-pop bypass was performed in 1948 on a patient with a foot ulcer?
I do, because I know everything there is to know about this procedure.
I postponed Mr.
Hall's fem-pop.
His INR was too high.
Gotta wait for it to come down.
No, I sutured raw chicken to prep for this.
Ah, I gotta check in with Dr.
Webber.
Can you pull the chest tube on Mrs.
Babbitt?
Does she need a fem-pop?
I will handle it.
All right.
Hey, good morning.
Good morning.
Listen, I know that you think there's something going on between me and Dr.
Millin.
I said no such thing.
You did with your eyes, and I just want to clear it up.
I'm her mentor, she's my student.
Nothing more.
Whatever you say.
Hey, heard you're not remediating.
Congrats on not being a total reject.
Yeah, well, the attendings need someone they can count on in the OR.
I thought I lost that mug.
Oh, I'm just keeping it warm until you move back in.
Is that your way of saying I'm never getting it back?
You turned down Griffith?
What are you talking about?
What are you talking about?
Wait, is Simone asking me to move in?
Kwan, I need an assist.
No, I...
Say it.
Gotta go.
Uh, is this about the hernia repair?
I saw it on your schedule.
I have bigger problems than a hernia.
A lap chole?
A colectomy?
I had the perfect incoming class, and now I have to hurry up and fill a Lucas Adams-size hole, and I need you to help me sell a prospective intern on our program.
A vacancy will be a red flag to interns looking to match next year, and it means more work for you.
You want more work, Kwan?
Uh, I kind of want the hernia repair.
This is your hernia repair.
Dylan Gatlin, nine years old, treated by Dr.
Beltran and Dr.
Griffith for a right radial fracture a few weeks ago.
I fell out of a tree on my Silver Star campout.
We were chaperoning.
Not our finest parenting moment.
When they ran a CT to check for her head trauma post fall, they made the incidental finding of a cavernous angioma in her brain stem.
Which is, uh, Dr.
Griffith?
A benign but abnormal cluster of blood vessels in the brain.
Yeah, she's scheduled for a resection of the angioma this afternoon.
Are you ready?
I'm an expedition scout.
I'm always ready.
Mmm.
Good.
I'm sorry.
So is Dr.
Shepherd.
She goes on expeditions every day.
Does she have any badges?
Oh.
So many.
She leaves them at home.
Mmm.
What is that?
It's a trail map for my next campout to Deep Lake.
I'm planning it now to get my navigation badge.
I mapped four routes and they're color coded.
Wow, I can barely get home using my GPS.
Guess what?
We are gonna make a trail map of your brain.
How cool is that, bunny?
Pretty cool, I guess.
The brain stem is about the size of a thumb.
It's where the right and left motor neurons cross, which makes access tricky.
Thanks to new MRI technology, we will be able to map Dylan's neural tracts, which will be instrumental in helping me reach the angioma.
Do I have to lie in that tube again?
It's gonna be over before you know it.
All right.
I will see you two up there.
Yes.
See you in a bit.
Yeah.
You ready?
Mm-hmm.
So then, it'll look like that.
Nice, right?
Looks great.
Hi.
Mariana, I'm so sorry I'm late.
I'm Dr.
Wilson.
Hi, they sent me from the clinic.
This cramping, it's...
it's...
Ow.
Um, I have endometriosis, so I'm used to the pain during my period, but this is next-level.
And you reported blood in your urine?
Yeah, is that bad?
I'll run labs to find out more.
Okay.
May I examine you?
Okay.
Mm-hmm.
Do you want me to call your mom?
No.
No.
She'll want to come over, and then your mom will want to come...
...over...
...then they'll start panicking about the wedding and Grandpa Hector.
We're getting married in four days.
On a Thursday?
Mm-hmm.
On the date that our moms met.
They're friends?
Yeah, they're best friends.
They met here in the OB ward.
Edgar and I were preemies in the NICU together, so they bonded over worrying about us.
Oh, my God, you're the NICU couple.
I-I thought that you looked familiar.
I pass by your engagement photo every day on the bulletin board.
The bouquet...
What is that?
Sweet peas.
They're our flower.
Yes.
Okay, a little pressure.
Okay.
Ow!
Ow, ow, ow, ow, oh.
Okay, doing great.
Ooh.
Okay, sorry.
Those flowers are also really hard to find on place cards, so we're making them.
Edgar is.
I'm...
I'm...
I'm in too much pain to help.
I told you I don't mind.
You deserve to have a perfect day.
Ow, ow, ow, ow, ow.
Please stop.
Are you okay?
If okay feels like someone is ripping my insides apart, then yeah, I'm great.
Your initial imaging is consistent with endometriosis, but we will order labs and an MRI to get a closer look and we will get you something for your pain.
Okay.
Okay?
Thank you, Doctor.
Of course.
It's okay.
Okay.
This better be cooler than a bypass.
You gotta let it go.
Let what go?
Nothing.
What do we got?
Spencer Purdy, status post-MVC.
Restrained driver.
Rear-ended, then T-boned on the driver's side.
GCS 15, hemodynamically stable.
Bad left chest injury.
Spencer, you're at Grey-Sloan.
We got you, okay?
On my count.
One, two, three.
I feel...
I feel fine.
I...
I need to go home.
I...
I just got paid and the cash for rent is in my wallet and w-we can't be late again.
I'll find it.
Is there someone we could call?
A-A parent?
Uh, yeah, my dad.
Can you just tell him that it's not my fault?
Oh, my God.
His lung has herniated right through his chest wall.
All right, I need X-ray in here, a full trauma panel, and a FAST exam.
Yeah, I don't care about the bypass anymore.
I know this whole intern thing is a priority, but if we finish early do you think...
If you ask me one more time, I'm going to give that hernia repair to Adams and make you watch it.
There she is.
Hello, Dr.
West.
Hi, I'm Dr.
Bailey.
This is Dr.
Kwan.
Hi.
Everyone here calls me Blue.
I don't.
Welcome to Grey-Sloan.
Ooh, I'm excited to be here.
It is colder than in Durham, though.
Uh-huh.
You went to Duke?
No, I went to med school in Grenada, but it's difficult to match in the US from an international school, so I'm doing a prelim year to beef up my résumé.
I went to medical school in St.
Kitts.
Seriously?
Yeah.
What a coincidence.
Dr.
Blue.
Hmm?
Oh, yes, uh...
Well, let me show you what this program has to offer.
Okay.
Come on.
Okay, FAST is negative.
Where's my soaked gauze?
What's taking so long?
X-rays up.
Uh, Millin, what...
what do you see?
Uh, left pneumothorax, a couple of broken ribs, nothing on the right side.
Mediastinum looks good.
The soaked gauze is here.
Can I?
Okay, I'll walk you through reducing the lung into the chest.
Spence?
Dad?
Dad, is that you?
I'm here.
What the hell happened?
Mr.
Purdy, you're gonna have to wait outside.
I need some light.
That looks serious.
Is he gonna need surgery?
Oh, God.
Is-Is that my lung?
Oh, God.
Oh, my God.
You're okay.
You're okay.
Uh, his O2 is dropping.
Breathe deep, son.
We need to intubate.
What's happening?
Get him out of here.
Thinking of becoming an expedition scout?
I wish.
My dad wouldn't let me.
He said he was afraid I'd be mauled by a bear.
I think he just wanted me at home.
Uh, speaking of home, uh, have you and Kwan decided what you're gonna do with Yasuda's room yet?
We're still figuring it out.
Is it gonna hurt when you cut my brain open?
Not even a little bit.
You'll be asleep the whole time.
You can relax now.
This is Dylan's brain with diffusion tensor imaging.
What do the colors mean?
Blue are neural tracts that go up and down, green goes front to back, and red goes side to side.
You've got to cut parallel to the pathways so you don't sever them.
Well, someone came prepared.
And where everything crosses?
It's the brain stem.
Due to its complexity, tiny errors can cause catastrophic damage.
Mmm, no pressure.
Right.
And ten years ago, this surgery would have been impossible, but these images give us a clarity we have never had before.
How do you know you're on course?
By mapping this onto Dylan's brain in the OR.
It appears if I do an extreme lateral approach, I should be able to get deep enough to get to Dylan's angioma right here.
Better than GPS.
Oh, a thousand times better.
And I checked Mr.
DiBianca's Dopplers, and they sound good.
Great, uh, let me know if there's any decrease in signals.
Okay.
So much for the wedding.
Oh, we'll find a venue, just not Prospect Estate.
A 30K deposit builds resentment, not love.
No, not ours, Mariana and Edgar's.
Grey-Sloan's NICU couple.
They were here at the NICU together 26 years ago, and now they're engaged.
Mariana and Edgar.
Mariana and Edgar.
Saying their name over and over again isn't gonna make me remember them.
Their whole story was in the hospital newsletter.
It's like a real-life fairy tale, and I'm about to crush it.
Look, her endometriosis has taken over her pelvis and implanted in her pubic synthesis.
I've never seen anything like this.
Me neither.
I've done a ton of excision surgeries, I've never seen tissue invade bone like this before.
When was she diagnosed?
A couple of years ago.
After a decade of symptoms.
Endometrial lesions must have been growing out of control for years.
Mm-hmm.
If we put as much money into researching this as we did erectile dysfunction, millions of women would have less pain.
I don't see how you treat this without shaving down the bone.
I know.
Can you help?
Thought you'd never ask.
Mr.
Purdy, uh, Spencer's on his way to a pre-op.
We will take excellent care of him in surgery.
That kid has had a lead foot since he was on a tricycle.
I keep telling him nothing is so important that you need to drive that fast.
Well, he said he had to pay rent.
And as someone who also lives paycheck to paycheck, rent is pretty important.
I just can't believe this is happening.
I have a bag of his personal belongings, and I thought you might want to hold on to it.
Thank you.
He always has his Mariners hat on.
Nice to have a little piece of him with me.
He's a good kid.
No thanks to me.
Oh, I'm sure that's not true.
Why don't you head to the waiting room and we'll come find you once we have an update, okay?
You gotta be kidding me.
No, no.
Leave it alone.
Spencer needs us more in the OR.
Come on.
You sure it won't hurt?
Oh, of course not.
This hospital has really good medicine.
You can even pick the flavor.
Bubble gum, peach or strawberry.
Okay, everyone ready?
It's about that time.
I wanna go home.
We will, sweetie, in a few days.
The doctors, they're just gonna fix you up, okay?
I wanna go home now.
I wanna sleep in my tent with my stuffies and my lantern.
You're gonna be home in your tent so soon.
I promise.
But what if the scans are wrong?
What if I don't need surgery?
I don't want surgery.
I really don't want it.
I'm scared.
Okay, bunny.
Okay.
It's okay.
Please don't let them take me anymore, Mommy.
Please don't let them take me.
I just wanna stay with you.
It's okay.
We're right here.
You're gonna be okay.
She's calmed down a bit.
Hey, sorry, um, I don't know how we're gonna get her to leave that room.
I've never seen her like this.
It's completely normal for Dylan to be scared.
This happens all the time.
Um, maybe we should just wait, give you guys all, like, a couple of extra days to prepare.
There's only one possible approach to her angioma, which could be compromised if it grows.
We should do it now.
And if we do nothing...
She could live another five to ten years.
Mm-hmm.
Or she could die sooner.
Could I talk to you for second?
Uh-huh.
Five to ten years may not be a long life, but it is a life.
I'm not giving up on her.
Neither am I.
This is a very, very, very big gamble.
The surgery could kill her, you know that, right?
The surgery could kill her, right?
It is very high-risk.
You asked me to find a way.
This is what I found.
Jenna?
If something happens to her...
I know, but...
You know.
Our daughter loves adventure.
And she loves hiking, and camping, and swimming, and...
I don't know how because you and I can't find our way out of a sleeping bag, but...
Dylan needs to lead a full and robust life.
Don't you want that for her?
Of course I do.
She just looks so small in that bed right now.
I know.
I wish I could go in there with her and hold her hand, but I...
What if you could?
It's not every day a patient opens up his own chest for surgery.
CT showed extensive damage to the inferior lobe, so it might be a long one.
You update the father?
If you mean the jackass, yeah, we did.
That's not a term I would recommend using for a patient's family members.
He stole money from his son.
We saw him take the cash out of Spencer's wallet and stuff it in his own pocket.
Well, maybe he took it for safekeeping.
Or maybe he's a dirtbag.
We should have said something.
If you had gotten up in that man's face, it would have turned into an ugly fight.
That does not help our patient.
Neither is getting evicted because he can't pay rent.
We are doing a wedge resection, and then we are going to figure out how to cover the defect.
Everybody ready?
Right behind you.
So our residents typically finish with over 1500 cases, more than enough to meet your requirements.
I just hit 175 procedures for the year.
Mmm, I'm at 230.
Uh, well, we are a Level-1 trauma center, so there's plenty of interesting cases.
Impalements, MVCs, severe burns.
I mean, we see it all.
Gosh.
I...
I wanted to be a trauma surgeon since my mom and I were in an MVC when I was five.
Shoot.
Uh, I'm needed in the OR.
Keep going.
Here.
And I'll find you.
I can show you the skills lab.
No, I wanna see what this place is really like.
You wanna show me the insider's tour?
I can show you whatever you want.
We shouldn't be doing this surgery.
Why not?
It's extremely risky, and her dad doesn't want it.
No, he came on board.
Because his wife pushed him into it.
Should we ask Shepherd about it?
By "we," do you mean "you"?
Because I don't have a problem with it.
Last time I questioned her, it didn't go that well.
Why didn't you ask me about moving in?
How'd you...
Kwan slipped.
We were talking about what to do with Mika's room, and you moving in was one option in a long list of options.
Great.
So I'm on a list between what, aquarium and game room?
No.
Yeah, we haven't even known each other for a year.
Can't we just enjoy where we are right now...
Are you enjoying this?
Almost done.
That's great.
Though, at this rate, they're gonna have to wheel me down the aisle.
Ow.
Mariana.
Hi.
Hi, this is Dr.
Helm and Dr.
Lincoln.
He is the orthopedic surgeon who will be helping me with your case.
Why do I need an orthopedic surgeon?
Well, your scans showed something called deep infiltrative endometriosis, or DIE.
D-I-E?
Like, die?
It's not a great name.
Oh, no, it's also not fatal.
But it is very painful and affects up to 15% of women with endometriosis.
It's where your tissue invades your organs and in your case, the top of your pubic bone.
The only way to treat it is to remove it surgically.
So, the idea is I will go in and remove the lesions throughout your pelvis, and Dr.
Lincoln will shave your pubic bone.
What about the wedding?
Don't worry about that right now.
No, you took a second job to pay for it.
I wiped out my entire savings.
It's okay.
Will this surgery actually stop the pain?
We're optimistic that it will help.
Okay.
Okay.
Okay.
Uh, this disease has been a never-ending nightmare.
Ten years of lying on the bathroom floor, writhing in pain with every period, and doctors told me that it was normal.
One even thought I was exaggerating, so that I could get painkillers.
And now it's in my bones?
I want it to stop.
I need it to stop.
What if we got married now before you go into surgery?
I mean, I could get the hospital chaplain, right?
Look, I know it wouldn't be our picture-perfect wedding, but it is kind of perfect, right?
Two NICU babies getting married in the hospital where they were born.
People would love that.
What do you think?
I, um...
I don't know.
Honey...
I'm so sorry we do have to get her to pre-op, so we can get the paperwork started.
To be continued.
Yeah.
It was a dumb idea.
I love you.
I love you so much.
It's gonna be okay.
Dylan, remember the trail map I told you about?
There it is.
See?
Look at how beautiful your brain is.
Doing hard things even when we're scared is what makes us brave.
This is gonna be your biggest expedition yet, and I'm gonna be right here waiting for you.
It's not goodbye, it's just good night.
You'll stay with me until I fall asleep?
Of course.
Save my baby, please.
I'll be right there.
Okay.
I need a minute.
Listen, if I was in this OR with any other neurosurgeon, I'd be scared out of my mind.
You should be.
No other neurosurgeon has done this.
Including me.
I've seen you do the impossible, and this time you have a road map.
Stop talking.
I don't need to hear how good I am or how many successes I've had.
None of that has anything to do with Dylan.
She is nine years old.
She is their only kid.
And whether she lives or dies is in my hands.
You're not alone in there.
I am the one who is slicing into the part of her body that controls all function.
I am the face they will remember if something happens to their kid.
I am the one who will never forget it if I kill her on the table, so when I say I need a minute, I need a damn minute.
All this lung is shredded.
I think most of it's salvageable though.
Lovelace.
Retract more here.
Yep.
I understand you have a problem with how I chose to handle our patient's situation.
If by handle, you mean ignore?
Millin.
My dad took me on a drug run when I was ten.
He left me in the car while he went and got high, and then he made me drive him home.
Um, well, I'm sorry you went through that.
I survived, but I have a pretty great radar for crappy dads.
I'll bet yours is a wholesome sitcom dad.
Dr.
Millin, are you too preoccupied to be in here right now?
Are you kicking me out?
I'm asking, are you too preoccupied to be in this OR?
No, I'm good.
GIA stapler.
Just a couple lesions on the rectum and bladder, and it is your turn.
Take your time.
I'm not going anywhere.
And I'm guessing she's in no hurry to get back to her Romeo.
Definitely trouble in paradise.
Clearly, you two don't know them.
Do you?
She hesitated.
Someone told me that means she probably doesn't want it.
She was in pain.
In more ways than one.
The wedding is going to be epic.
Everything is handmade.
Both their moms are officiating.
There's a photo booth and an oyster bar, a string quartet, and a live band.
Sounds like a good time.
No, it's more than that.
They're made for each other.
They're...
Mariana and Edgar?
I once went to a wedding with fireworks, aerial bartenders, and life-sized ice sculptures of the bride and groom.
They annulled the marriage a week later.
Ouch.
Yeah, weddings are just a big party.
It has nothing to do with what comes after.
Well, that may be true, but I am still rooting for them.
Okay, I've excised and shaved all the lesions that I can see.
You're up.
Periosteal elevator.
So this is the surgical ICU where many of us have the luxury of rotating on the night shift.
I'm familiar.
The newest doctors keeping the sickest patients alive.
While the attendings get their beauty sleep.
Code blue.
Surgical ICU.
BP is crashing.
Do you need to help with that?
No.
They got it.
And what about that one?
Get an epi ready.
Code blue.
We have V-fib.
Get the paddles.
Sats are plummeting.
He's tachy.
Diminished breath sounds on the right side.
ET tube is in place.
He needs a chest tube.
Okay.
What can I do?
Open these for me.
I'll get a crash cart.
Anyone know what's along that red path there?
The lateral lemniscus.
Which controls?
Her hearing.
That's why we are steering clear.
According to our map, splitting these blue paths is the safest corridor.
Do you need more room?
I'm good.
Thanks for asking.
Is that...
A developmental venous anomaly.
Good eye.
Suction, Griffith.
Now, please.
Sorry.
Don't apologize, just keep up.
Damn it.
What happened?
There's bleeding.
I see it.
Tell us what you need.
It's not stopping.
I need suction and Gelfoam now.
Dylan, hang on.
Spencer's out of surgery.
The damage to his chest and lung was extensive, but we were able to remove the injured lung and cover the wound.
Oh, thank God.
This day took a turn, didn't it?
We could take you to his room if you like.
Is he awake?
Ah, he should be soon.
I know he wants to see you.
I don't wanna bother him if he's sleeping.
I haven't eaten all day.
Do you have any, uh, recommendations around here?
I believe it's chili day in the cafeteria or if you want some fresh air, La Belle is popular on Maple.
I think I'll do that.
I'll come right back.
I don't trust anyone who doesn't like the hospital chili.
Well, good thing you don't have to.
What are you doing?
Putting in a chest tube.
Stop.
I've done this before.
It's fine.
Give me the scalpel.
Now.
Gelfoam.
It's right there on her hand.
I can't see and I can't take my eyes off the field.
Just pass it to me.
Got it.
Bipolar, now.
Turn the coag down to five.
Because why?
Uh, because the higher...
We need energy as low as possible to prevent thermal injury to the brain.
Correct.
Come on.
Come on.
There.
Okay, bleeding has stopped.
All right, everyone, gather yourselves.
That bleed is over, but we may encounter more and we still have to wrestle the angioma.
Slow and steady, shall we?
The patient's stable.
What were you thinking?
His vitals were tanking.
You weren't even supposed to be in this part of the hospital.
I have done chest tubes before.
Did you screw them up too?
Because you almost cut into that man's liver.
I counted down to the 5th intercostal space.
I was at the midaxillary line.
You don't work here.
We have standards.
We put patients first, and we definitely don't walk in here like we own the place, and if you can't figure that out, you don't belong here.
You don't deserve to be here, maybe anywhere.
Dr.
Kwan.
I have to go.
No.
I will deal with you later.
How's he looking?
Only ten cc's out of the chest tube.
Good.
Keep checking every hour and follow up on his labs.
Mmm.
Hey.
Welcome back.
Your surgery went really well, and you're doing great.
Just sit back.
Uh, what time is it?
It's a little past 6:00.
Oh, no, no, no.
Rent was due at 5:00.
Don't worry.
I can write you a very compelling doctor's note.
Did you find my wallet?
I gave it to your dad.
Wha...
Is he here?
My dad?
He didn't wanna disturb you while you were asleep.
He'll be back.
God, this is so embarrassing.
I swear I'm not a crier.
Well, sometimes we need our parents, no matter how old we are.
And you just had a very serious trauma, so try to get some rest and we'll be back in an hour to check on you.
Okay?
All right, call his dad and let him know Spencer's awake.
Do you think that'll make him come back from driving to Vegas?
Are you done?
Because I'm not your co-intern BFF.
I am chief of the cardiothoracic department.
I don't get messy in my patients' lives, and I don't gossip with my mentees.
I keep my head down, and I do my job.
And I suggest you do the same.
If I hear another word about it, you're off my service.
Hey.
You did great.
Thanks.
We got through the scar tissue and removed as many lesions as we could, and I was able to save your uterus and your ovaries.
That's amazing.
Yeah.
We'll put you back on birth control to slow the growth of the lesions, but, as you know, endometriosis is a lifelong journey.
Yeah.
It can come back.
Yes, but we will watch it closely.
Mm-hmm.
And if it gets worse, we'll be on top of it and there are other hormonal treatments that we can use, but...
hopefully, your pain should improve.
I just never thought much about life without it.
Thank you.
I'll tell Edgar you're awake.
Oh, actually, could I have a minute?
Oh.
Of course.
You think I'm a monster?
Absolutely not.
I feel like one.
Yeah, we've been destined to be together since birth.
Our moms call us their great love story.
But...
it's not yours.
You know, he's...
He's wonderful.
Yeah.
And my best friend, and I do love him.
I do.
But I don't know if that's because he's the one or...
Because that's what you've always known.
Yeah.
He'll understand.
Eventually.
You know, most of our guests are already in town.
Everything's already paid for.
It's just a party.
Take it from someone who's gotten married for the wrong reasons.
It always catches up with you.
That's too bad.
Yeah.
Livingston Manor would have made for a beautiful wedding.
Mr.
Purdy, your son's been waiting for you.
I'll be there in a minute.
If you want some, just ask.
Did you buy this with your kid's rent money?
It's none of your damn business.
The hell?
Your son almost died today.
Do you realize that?
Get off me!
You're the parent!
You are supposed to take care of him, provide for him, keep him safe.
You don't know what you're talking about.
I know he's better off without you.
I know that.
You hear what I'm saying?
He's alone by himself all day...
What are you doing?
...and you left him there.
Get off him!
Dr.
West withdrew her name from consideration.
You had one job, Kwan, one job.
I know.
She had top scores.
Grades aren't everything.
She had glowing recommendations, including one from the Chief of General Surgery at Duke.
I-I didn't know.
Of course you didn't.
But even if you did, what on God's green earth made you think you could treat her like that?
I found her about to cut into a patient to place a chest tube, and if there's anything I learned this year, it's that overstepping is one of the biggest mistakes an intern can make.
Except she was about to cut into the liver instead of the pleural cavity, which is also a pretty big mistake.
And I am sorry I scared her off.
Well, I guess we dodged a bullet.
We did?
I've had enough rogue interns.
We'll find someone else.
So if I'm not in trouble, do you think I could scrub in on your...
No.
But nice job on that chest tube.
You've come a long way.
Hey, are you okay?
I...
Move.
What happened?
I should've listened to you, and I should have said something to him earlier.
Well, I don't know about that because then security would have pulled you off him instead of me.
I have a difficult dad too.
And usually, I keep all that buried deep, especially when I run into people like that who don't do right by their kids.
Turns out it's actually not buried as deep as I thought.
Yeah, I get it.
Trust me.
All right.
Uh, do you want to...
Do you wanna grab a cup of coffee?
Just decaf.
It's been a...
a long day and I feel like we both need to decompress.
I think maybe we both need sleep.
I'll see you in the morning.
Okay.
We are very pleased to present you with our highest honor, the Grey-Sloan Badge of Bravery.
Yes.
Wow.
Easiest badge ever.
I was asleep the whole time.
Thank you, Dr.
Shepherd.
Thank you.
Mm-hmm.
You gave us our whole world back.
We're very grateful.
Dylan is an inspiration.
I can't wait to hear about her adventures.
Yeah, now you gotta work on your rest and recovery badge.
It requires a lot of sleep and ice cream.
Oh, I think that could be arranged, yes.
Second easiest badge ever.
Oh, right back at you, dill pickle.
Get some rest, okay?
I'm sorry for biting your head off earlier.
I wasn't blowing smoke.
I really did believe you could do it.
Well, my brother couldn't.
He tried a few times, and it freaked me out 'cause in my eyes, he could do no wrong, so if he couldn't do it, what chance did I have?
Well, as someone who's never met your brother and who only compares you to you, I can say with full confidence that I would bet on you every time.
You were right.
It was worth the risk.
Yeah, well, I'm only right about 5% of the time, so it makes sense for you to question it.
Now I'm gonna try to take a risk.
I was gonna ask you to move in the other night.
But when you started talking about our future...
Just scared me.
Why?
Last time I planned a future with a boyfriend, my life exploded.
I had to leave it all behind, rebuild from the ground up.
I'm just not sure I'm ready to open myself up to that again.
I'm not Trey.
I know.
I love you.
I want a future with you.
I just need a little more time.
Yeah, okay, why didn't you just say that?
Because you were excited about getting back into the class.
I didn't want you to think my feelings for you had changed.
So instead, you just let Kwan make me feel like an idiot?
Let's go pick up dinner.
We can go home and talk.
I-I-I thought you didn't know your schedule.
Lucas n...
I'm on tonight anyway.
I'll see you tomorrow.
Mariana called off the wedding.
Aw, I'm sorry.
How are you holding up?
Well, um, I'm sad for them, but it's for the best.
I think I just saw us in them.
They've known each other their whole lives.
They're best friends.
I didn't wanna believe they weren't gonna make it.
We're not them.
We're not.
By the way, I found a perfect venue.
Thank God.
I was about to suggest the taco stand on the corner.
All right.
Uh...
Livingston Manor.
It's gorgeous.
There's plenty of parking, it's reasonably priced and it has a place for a live band.
Sounds amazing.
Right?
Do you think they'll have, uh, availability in the next year?
They do, because there was a cancellation.
Mariana and Edgar?
No, no, no.
Yes.
No, listen to me.
We need a wedding venue, and they have one that they're not using.
In four days.
No, we can't possibly be ready in four days.
We-We need, uh, invitations, food, drinks.
If my mom's coming, we need drinks.
Listen, I love you, and I can't wait to marry you, and that's all that matters, and-and the wedding is just the icing on the cake.
And listen, if you and I can figure out a way to relieve a woman's pain after ten years of suffering, we can throw a wedding in four days.
Okay.
Okay.
All right, let's get married.
Okay.
Okay.
We're not gonna regret it.
It's gonna be amazing.
We trust science to predict the future.
But even so, surprises are the only thing we can count on.
Okay, if Adams isn't moving in, my friend's uncle's boss's son is looking for a place.
We've been over this.
No strangers.
Are you secretly rich?
Give me some of them fries.
Uh-uh.
She's hot.
Yeah, it's the intern from today.
Mmm.
I should buy her a drink.
Mm-mmm.
Seriously, you are probably the reason she is drinking.
You said she was hot.
Sometimes surprises are good.
They lift you up and make life exquisite.
But then there's the other kind of surprise, when the bottom drops out.
Dr.
Ndugu.
How are you doing this morning?
Honestly, I'm feeling a little burnt out.
I'm gonna take a day and sit behind a desk, decompress.
Do you think you can take my intern?
Millin?
Yeah, I'd be happy to.
Tell me we are doing Mr.
Honor's lobectomy today.
I stayed up all night studying lung tissue.
You're with Dr.
Webber today, all right?
Is he okay?
He's taking an administrative day.
Oh.
Hey, lucky for you.
I've got three feet of bowel incarcerated in a man's groin.
Can't wait.
However desperate you might be,
Doctors used it to predict health outcomes based only on a patient's name.
Morning.
What are you doing?
I am practicing my running sutures for my fem-pop bypass with Ndugu today.
That's supposed to be my dinner.
And I'm also saving you from salmonella.
You want a turn with Meryl Peep?
I'm moving the spare key.
The sphere was based on numerology, the zodiac, the moon and stars.
It's pseudoscience, compared to modern metrics.
But humans have always craved certainty.
What about Cedar Valley Estate with a fountain?
Looks bucolic.
I saw them.
Also saw they have a 250-person minimum.
Wildwood Gardens?
I thought you wanted a live band.
They don't allow live music?
No, not after 8:00 p.m.
Well, what if we have a small ceremony here at the chapel, and then host dinner in the back room at Nicoletti's?
Mmm, I don't know.
Well, we'd bring our own flowers...
When someone hesitates and says, "I don't know," it means "I don't want it."
Copy that.
Diagnosis, prognosis, genetic predisposition, they're all ways of placing ourselves on the sphere.
We ask science to protect us from the simplest fact of life.
It's full of surprises.
Do you know that the first fem-pop bypass was performed in 1948 on a patient with a foot ulcer?
I do, because I know everything there is to know about this procedure.
I postponed Mr.
Hall's fem-pop.
His INR was too high.
Gotta wait for it to come down.
No, I sutured raw chicken to prep for this.
Ah, I gotta check in with Dr.
Webber.
Can you pull the chest tube on Mrs.
Babbitt?
Does she need a fem-pop?
I will handle it.
All right.
Hey, good morning.
Good morning.
Listen, I know that you think there's something going on between me and Dr.
Millin.
I said no such thing.
You did with your eyes, and I just want to clear it up.
I'm her mentor, she's my student.
Nothing more.
Whatever you say.
Hey, heard you're not remediating.
Congrats on not being a total reject.
Yeah, well, the attendings need someone they can count on in the OR.
I thought I lost that mug.
Oh, I'm just keeping it warm until you move back in.
Is that your way of saying I'm never getting it back?
You turned down Griffith?
What are you talking about?
What are you talking about?
Wait, is Simone asking me to move in?
Kwan, I need an assist.
No, I...
Say it.
Gotta go.
Uh, is this about the hernia repair?
I saw it on your schedule.
I have bigger problems than a hernia.
A lap chole?
A colectomy?
I had the perfect incoming class, and now I have to hurry up and fill a Lucas Adams-size hole, and I need you to help me sell a prospective intern on our program.
A vacancy will be a red flag to interns looking to match next year, and it means more work for you.
You want more work, Kwan?
Uh, I kind of want the hernia repair.
This is your hernia repair.
Dylan Gatlin, nine years old, treated by Dr.
Beltran and Dr.
Griffith for a right radial fracture a few weeks ago.
I fell out of a tree on my Silver Star campout.
We were chaperoning.
Not our finest parenting moment.
When they ran a CT to check for her head trauma post fall, they made the incidental finding of a cavernous angioma in her brain stem.
Which is, uh, Dr.
Griffith?
A benign but abnormal cluster of blood vessels in the brain.
Yeah, she's scheduled for a resection of the angioma this afternoon.
Are you ready?
I'm an expedition scout.
I'm always ready.
Mmm.
Good.
I'm sorry.
So is Dr.
Shepherd.
She goes on expeditions every day.
Does she have any badges?
Oh.
So many.
She leaves them at home.
Mmm.
What is that?
It's a trail map for my next campout to Deep Lake.
I'm planning it now to get my navigation badge.
I mapped four routes and they're color coded.
Wow, I can barely get home using my GPS.
Guess what?
We are gonna make a trail map of your brain.
How cool is that, bunny?
Pretty cool, I guess.
The brain stem is about the size of a thumb.
It's where the right and left motor neurons cross, which makes access tricky.
Thanks to new MRI technology, we will be able to map Dylan's neural tracts, which will be instrumental in helping me reach the angioma.
Do I have to lie in that tube again?
It's gonna be over before you know it.
All right.
I will see you two up there.
Yes.
See you in a bit.
Yeah.
You ready?
Mm-hmm.
So then, it'll look like that.
Nice, right?
Looks great.
Hi.
Mariana, I'm so sorry I'm late.
I'm Dr.
Wilson.
Hi, they sent me from the clinic.
This cramping, it's...
it's...
Ow.
Um, I have endometriosis, so I'm used to the pain during my period, but this is next-level.
And you reported blood in your urine?
Yeah, is that bad?
I'll run labs to find out more.
Okay.
May I examine you?
Okay.
Mm-hmm.
Do you want me to call your mom?
No.
No.
She'll want to come over, and then your mom will want to come...
...over...
...then they'll start panicking about the wedding and Grandpa Hector.
We're getting married in four days.
On a Thursday?
Mm-hmm.
On the date that our moms met.
They're friends?
Yeah, they're best friends.
They met here in the OB ward.
Edgar and I were preemies in the NICU together, so they bonded over worrying about us.
Oh, my God, you're the NICU couple.
I-I thought that you looked familiar.
I pass by your engagement photo every day on the bulletin board.
The bouquet...
What is that?
Sweet peas.
They're our flower.
Yes.
Okay, a little pressure.
Okay.
Ow!
Ow, ow, ow, ow, oh.
Okay, doing great.
Ooh.
Okay, sorry.
Those flowers are also really hard to find on place cards, so we're making them.
Edgar is.
I'm...
I'm...
I'm in too much pain to help.
I told you I don't mind.
You deserve to have a perfect day.
Ow, ow, ow, ow, ow.
Please stop.
Are you okay?
If okay feels like someone is ripping my insides apart, then yeah, I'm great.
Your initial imaging is consistent with endometriosis, but we will order labs and an MRI to get a closer look and we will get you something for your pain.
Okay.
Okay?
Thank you, Doctor.
Of course.
It's okay.
Okay.
This better be cooler than a bypass.
You gotta let it go.
Let what go?
Nothing.
What do we got?
Spencer Purdy, status post-MVC.
Restrained driver.
Rear-ended, then T-boned on the driver's side.
GCS 15, hemodynamically stable.
Bad left chest injury.
Spencer, you're at Grey-Sloan.
We got you, okay?
On my count.
One, two, three.
I feel...
I feel fine.
I...
I need to go home.
I...
I just got paid and the cash for rent is in my wallet and w-we can't be late again.
I'll find it.
Is there someone we could call?
A-A parent?
Uh, yeah, my dad.
Can you just tell him that it's not my fault?
Oh, my God.
His lung has herniated right through his chest wall.
All right, I need X-ray in here, a full trauma panel, and a FAST exam.
Yeah, I don't care about the bypass anymore.
I know this whole intern thing is a priority, but if we finish early do you think...
If you ask me one more time, I'm going to give that hernia repair to Adams and make you watch it.
There she is.
Hello, Dr.
West.
Hi, I'm Dr.
Bailey.
This is Dr.
Kwan.
Hi.
Everyone here calls me Blue.
I don't.
Welcome to Grey-Sloan.
Ooh, I'm excited to be here.
It is colder than in Durham, though.
Uh-huh.
You went to Duke?
No, I went to med school in Grenada, but it's difficult to match in the US from an international school, so I'm doing a prelim year to beef up my résumé.
I went to medical school in St.
Kitts.
Seriously?
Yeah.
What a coincidence.
Dr.
Blue.
Hmm?
Oh, yes, uh...
Well, let me show you what this program has to offer.
Okay.
Come on.
Okay, FAST is negative.
Where's my soaked gauze?
What's taking so long?
X-rays up.
Uh, Millin, what...
what do you see?
Uh, left pneumothorax, a couple of broken ribs, nothing on the right side.
Mediastinum looks good.
The soaked gauze is here.
Can I?
Okay, I'll walk you through reducing the lung into the chest.
Spence?
Dad?
Dad, is that you?
I'm here.
What the hell happened?
Mr.
Purdy, you're gonna have to wait outside.
I need some light.
That looks serious.
Is he gonna need surgery?
Oh, God.
Is-Is that my lung?
Oh, God.
Oh, my God.
You're okay.
You're okay.
Uh, his O2 is dropping.
Breathe deep, son.
We need to intubate.
What's happening?
Get him out of here.
Thinking of becoming an expedition scout?
I wish.
My dad wouldn't let me.
He said he was afraid I'd be mauled by a bear.
I think he just wanted me at home.
Uh, speaking of home, uh, have you and Kwan decided what you're gonna do with Yasuda's room yet?
We're still figuring it out.
Is it gonna hurt when you cut my brain open?
Not even a little bit.
You'll be asleep the whole time.
You can relax now.
This is Dylan's brain with diffusion tensor imaging.
What do the colors mean?
Blue are neural tracts that go up and down, green goes front to back, and red goes side to side.
You've got to cut parallel to the pathways so you don't sever them.
Well, someone came prepared.
And where everything crosses?
It's the brain stem.
Due to its complexity, tiny errors can cause catastrophic damage.
Mmm, no pressure.
Right.
And ten years ago, this surgery would have been impossible, but these images give us a clarity we have never had before.
How do you know you're on course?
By mapping this onto Dylan's brain in the OR.
It appears if I do an extreme lateral approach, I should be able to get deep enough to get to Dylan's angioma right here.
Better than GPS.
Oh, a thousand times better.
And I checked Mr.
DiBianca's Dopplers, and they sound good.
Great, uh, let me know if there's any decrease in signals.
Okay.
So much for the wedding.
Oh, we'll find a venue, just not Prospect Estate.
A 30K deposit builds resentment, not love.
No, not ours, Mariana and Edgar's.
Grey-Sloan's NICU couple.
They were here at the NICU together 26 years ago, and now they're engaged.
Mariana and Edgar.
Mariana and Edgar.
Saying their name over and over again isn't gonna make me remember them.
Their whole story was in the hospital newsletter.
It's like a real-life fairy tale, and I'm about to crush it.
Look, her endometriosis has taken over her pelvis and implanted in her pubic synthesis.
I've never seen anything like this.
Me neither.
I've done a ton of excision surgeries, I've never seen tissue invade bone like this before.
When was she diagnosed?
A couple of years ago.
After a decade of symptoms.
Endometrial lesions must have been growing out of control for years.
Mm-hmm.
If we put as much money into researching this as we did erectile dysfunction, millions of women would have less pain.
I don't see how you treat this without shaving down the bone.
I know.
Can you help?
Thought you'd never ask.
Mr.
Purdy, uh, Spencer's on his way to a pre-op.
We will take excellent care of him in surgery.
That kid has had a lead foot since he was on a tricycle.
I keep telling him nothing is so important that you need to drive that fast.
Well, he said he had to pay rent.
And as someone who also lives paycheck to paycheck, rent is pretty important.
I just can't believe this is happening.
I have a bag of his personal belongings, and I thought you might want to hold on to it.
Thank you.
He always has his Mariners hat on.
Nice to have a little piece of him with me.
He's a good kid.
No thanks to me.
Oh, I'm sure that's not true.
Why don't you head to the waiting room and we'll come find you once we have an update, okay?
You gotta be kidding me.
No, no.
Leave it alone.
Spencer needs us more in the OR.
Come on.
You sure it won't hurt?
Oh, of course not.
This hospital has really good medicine.
You can even pick the flavor.
Bubble gum, peach or strawberry.
Okay, everyone ready?
It's about that time.
I wanna go home.
We will, sweetie, in a few days.
The doctors, they're just gonna fix you up, okay?
I wanna go home now.
I wanna sleep in my tent with my stuffies and my lantern.
You're gonna be home in your tent so soon.
I promise.
But what if the scans are wrong?
What if I don't need surgery?
I don't want surgery.
I really don't want it.
I'm scared.
Okay, bunny.
Okay.
It's okay.
Please don't let them take me anymore, Mommy.
Please don't let them take me.
I just wanna stay with you.
It's okay.
We're right here.
You're gonna be okay.
She's calmed down a bit.
Hey, sorry, um, I don't know how we're gonna get her to leave that room.
I've never seen her like this.
It's completely normal for Dylan to be scared.
This happens all the time.
Um, maybe we should just wait, give you guys all, like, a couple of extra days to prepare.
There's only one possible approach to her angioma, which could be compromised if it grows.
We should do it now.
And if we do nothing...
She could live another five to ten years.
Mm-hmm.
Or she could die sooner.
Could I talk to you for second?
Uh-huh.
Five to ten years may not be a long life, but it is a life.
I'm not giving up on her.
Neither am I.
This is a very, very, very big gamble.
The surgery could kill her, you know that, right?
The surgery could kill her, right?
It is very high-risk.
You asked me to find a way.
This is what I found.
Jenna?
If something happens to her...
I know, but...
You know.
Our daughter loves adventure.
And she loves hiking, and camping, and swimming, and...
I don't know how because you and I can't find our way out of a sleeping bag, but...
Dylan needs to lead a full and robust life.
Don't you want that for her?
Of course I do.
She just looks so small in that bed right now.
I know.
I wish I could go in there with her and hold her hand, but I...
What if you could?
It's not every day a patient opens up his own chest for surgery.
CT showed extensive damage to the inferior lobe, so it might be a long one.
You update the father?
If you mean the jackass, yeah, we did.
That's not a term I would recommend using for a patient's family members.
He stole money from his son.
We saw him take the cash out of Spencer's wallet and stuff it in his own pocket.
Well, maybe he took it for safekeeping.
Or maybe he's a dirtbag.
We should have said something.
If you had gotten up in that man's face, it would have turned into an ugly fight.
That does not help our patient.
Neither is getting evicted because he can't pay rent.
We are doing a wedge resection, and then we are going to figure out how to cover the defect.
Everybody ready?
Right behind you.
So our residents typically finish with over 1500 cases, more than enough to meet your requirements.
I just hit 175 procedures for the year.
Mmm, I'm at 230.
Uh, well, we are a Level-1 trauma center, so there's plenty of interesting cases.
Impalements, MVCs, severe burns.
I mean, we see it all.
Gosh.
I...
I wanted to be a trauma surgeon since my mom and I were in an MVC when I was five.
Shoot.
Uh, I'm needed in the OR.
Keep going.
Here.
And I'll find you.
I can show you the skills lab.
No, I wanna see what this place is really like.
You wanna show me the insider's tour?
I can show you whatever you want.
We shouldn't be doing this surgery.
Why not?
It's extremely risky, and her dad doesn't want it.
No, he came on board.
Because his wife pushed him into it.
Should we ask Shepherd about it?
By "we," do you mean "you"?
Because I don't have a problem with it.
Last time I questioned her, it didn't go that well.
Why didn't you ask me about moving in?
How'd you...
Kwan slipped.
We were talking about what to do with Mika's room, and you moving in was one option in a long list of options.
Great.
So I'm on a list between what, aquarium and game room?
No.
Yeah, we haven't even known each other for a year.
Can't we just enjoy where we are right now...
Are you enjoying this?
Almost done.
That's great.
Though, at this rate, they're gonna have to wheel me down the aisle.
Ow.
Mariana.
Hi.
Hi, this is Dr.
Helm and Dr.
Lincoln.
He is the orthopedic surgeon who will be helping me with your case.
Why do I need an orthopedic surgeon?
Well, your scans showed something called deep infiltrative endometriosis, or DIE.
D-I-E?
Like, die?
It's not a great name.
Oh, no, it's also not fatal.
But it is very painful and affects up to 15% of women with endometriosis.
It's where your tissue invades your organs and in your case, the top of your pubic bone.
The only way to treat it is to remove it surgically.
So, the idea is I will go in and remove the lesions throughout your pelvis, and Dr.
Lincoln will shave your pubic bone.
What about the wedding?
Don't worry about that right now.
No, you took a second job to pay for it.
I wiped out my entire savings.
It's okay.
Will this surgery actually stop the pain?
We're optimistic that it will help.
Okay.
Okay.
Okay.
Uh, this disease has been a never-ending nightmare.
Ten years of lying on the bathroom floor, writhing in pain with every period, and doctors told me that it was normal.
One even thought I was exaggerating, so that I could get painkillers.
And now it's in my bones?
I want it to stop.
I need it to stop.
What if we got married now before you go into surgery?
I mean, I could get the hospital chaplain, right?
Look, I know it wouldn't be our picture-perfect wedding, but it is kind of perfect, right?
Two NICU babies getting married in the hospital where they were born.
People would love that.
What do you think?
I, um...
I don't know.
Honey...
I'm so sorry we do have to get her to pre-op, so we can get the paperwork started.
To be continued.
Yeah.
It was a dumb idea.
I love you.
I love you so much.
It's gonna be okay.
Dylan, remember the trail map I told you about?
There it is.
See?
Look at how beautiful your brain is.
Doing hard things even when we're scared is what makes us brave.
This is gonna be your biggest expedition yet, and I'm gonna be right here waiting for you.
It's not goodbye, it's just good night.
You'll stay with me until I fall asleep?
Of course.
Save my baby, please.
I'll be right there.
Okay.
I need a minute.
Listen, if I was in this OR with any other neurosurgeon, I'd be scared out of my mind.
You should be.
No other neurosurgeon has done this.
Including me.
I've seen you do the impossible, and this time you have a road map.
Stop talking.
I don't need to hear how good I am or how many successes I've had.
None of that has anything to do with Dylan.
She is nine years old.
She is their only kid.
And whether she lives or dies is in my hands.
You're not alone in there.
I am the one who is slicing into the part of her body that controls all function.
I am the face they will remember if something happens to their kid.
I am the one who will never forget it if I kill her on the table, so when I say I need a minute, I need a damn minute.
All this lung is shredded.
I think most of it's salvageable though.
Lovelace.
Retract more here.
Yep.
I understand you have a problem with how I chose to handle our patient's situation.
If by handle, you mean ignore?
Millin.
My dad took me on a drug run when I was ten.
He left me in the car while he went and got high, and then he made me drive him home.
Um, well, I'm sorry you went through that.
I survived, but I have a pretty great radar for crappy dads.
I'll bet yours is a wholesome sitcom dad.
Dr.
Millin, are you too preoccupied to be in here right now?
Are you kicking me out?
I'm asking, are you too preoccupied to be in this OR?
No, I'm good.
GIA stapler.
Just a couple lesions on the rectum and bladder, and it is your turn.
Take your time.
I'm not going anywhere.
And I'm guessing she's in no hurry to get back to her Romeo.
Definitely trouble in paradise.
Clearly, you two don't know them.
Do you?
She hesitated.
Someone told me that means she probably doesn't want it.
She was in pain.
In more ways than one.
The wedding is going to be epic.
Everything is handmade.
Both their moms are officiating.
There's a photo booth and an oyster bar, a string quartet, and a live band.
Sounds like a good time.
No, it's more than that.
They're made for each other.
They're...
Mariana and Edgar?
I once went to a wedding with fireworks, aerial bartenders, and life-sized ice sculptures of the bride and groom.
They annulled the marriage a week later.
Ouch.
Yeah, weddings are just a big party.
It has nothing to do with what comes after.
Well, that may be true, but I am still rooting for them.
Okay, I've excised and shaved all the lesions that I can see.
You're up.
Periosteal elevator.
So this is the surgical ICU where many of us have the luxury of rotating on the night shift.
I'm familiar.
The newest doctors keeping the sickest patients alive.
While the attendings get their beauty sleep.
Code blue.
Surgical ICU.
BP is crashing.
Do you need to help with that?
No.
They got it.
And what about that one?
Get an epi ready.
Code blue.
We have V-fib.
Get the paddles.
Sats are plummeting.
He's tachy.
Diminished breath sounds on the right side.
ET tube is in place.
He needs a chest tube.
Okay.
What can I do?
Open these for me.
I'll get a crash cart.
Anyone know what's along that red path there?
The lateral lemniscus.
Which controls?
Her hearing.
That's why we are steering clear.
According to our map, splitting these blue paths is the safest corridor.
Do you need more room?
I'm good.
Thanks for asking.
Is that...
A developmental venous anomaly.
Good eye.
Suction, Griffith.
Now, please.
Sorry.
Don't apologize, just keep up.
Damn it.
What happened?
There's bleeding.
I see it.
Tell us what you need.
It's not stopping.
I need suction and Gelfoam now.
Dylan, hang on.
Spencer's out of surgery.
The damage to his chest and lung was extensive, but we were able to remove the injured lung and cover the wound.
Oh, thank God.
This day took a turn, didn't it?
We could take you to his room if you like.
Is he awake?
Ah, he should be soon.
I know he wants to see you.
I don't wanna bother him if he's sleeping.
I haven't eaten all day.
Do you have any, uh, recommendations around here?
I believe it's chili day in the cafeteria or if you want some fresh air, La Belle is popular on Maple.
I think I'll do that.
I'll come right back.
I don't trust anyone who doesn't like the hospital chili.
Well, good thing you don't have to.
What are you doing?
Putting in a chest tube.
Stop.
I've done this before.
It's fine.
Give me the scalpel.
Now.
Gelfoam.
It's right there on her hand.
I can't see and I can't take my eyes off the field.
Just pass it to me.
Got it.
Bipolar, now.
Turn the coag down to five.
Because why?
Uh, because the higher...
We need energy as low as possible to prevent thermal injury to the brain.
Correct.
Come on.
Come on.
There.
Okay, bleeding has stopped.
All right, everyone, gather yourselves.
That bleed is over, but we may encounter more and we still have to wrestle the angioma.
Slow and steady, shall we?
The patient's stable.
What were you thinking?
His vitals were tanking.
You weren't even supposed to be in this part of the hospital.
I have done chest tubes before.
Did you screw them up too?
Because you almost cut into that man's liver.
I counted down to the 5th intercostal space.
I was at the midaxillary line.
You don't work here.
We have standards.
We put patients first, and we definitely don't walk in here like we own the place, and if you can't figure that out, you don't belong here.
You don't deserve to be here, maybe anywhere.
Dr.
Kwan.
I have to go.
No.
I will deal with you later.
How's he looking?
Only ten cc's out of the chest tube.
Good.
Keep checking every hour and follow up on his labs.
Mmm.
Hey.
Welcome back.
Your surgery went really well, and you're doing great.
Just sit back.
Uh, what time is it?
It's a little past 6:00.
Oh, no, no, no.
Rent was due at 5:00.
Don't worry.
I can write you a very compelling doctor's note.
Did you find my wallet?
I gave it to your dad.
Wha...
Is he here?
My dad?
He didn't wanna disturb you while you were asleep.
He'll be back.
God, this is so embarrassing.
I swear I'm not a crier.
Well, sometimes we need our parents, no matter how old we are.
And you just had a very serious trauma, so try to get some rest and we'll be back in an hour to check on you.
Okay?
All right, call his dad and let him know Spencer's awake.
Do you think that'll make him come back from driving to Vegas?
Are you done?
Because I'm not your co-intern BFF.
I am chief of the cardiothoracic department.
I don't get messy in my patients' lives, and I don't gossip with my mentees.
I keep my head down, and I do my job.
And I suggest you do the same.
If I hear another word about it, you're off my service.
Hey.
You did great.
Thanks.
We got through the scar tissue and removed as many lesions as we could, and I was able to save your uterus and your ovaries.
That's amazing.
Yeah.
We'll put you back on birth control to slow the growth of the lesions, but, as you know, endometriosis is a lifelong journey.
Yeah.
It can come back.
Yes, but we will watch it closely.
Mm-hmm.
And if it gets worse, we'll be on top of it and there are other hormonal treatments that we can use, but...
hopefully, your pain should improve.
I just never thought much about life without it.
Thank you.
I'll tell Edgar you're awake.
Oh, actually, could I have a minute?
Oh.
Of course.
You think I'm a monster?
Absolutely not.
I feel like one.
Yeah, we've been destined to be together since birth.
Our moms call us their great love story.
But...
it's not yours.
You know, he's...
He's wonderful.
Yeah.
And my best friend, and I do love him.
I do.
But I don't know if that's because he's the one or...
Because that's what you've always known.
Yeah.
He'll understand.
Eventually.
You know, most of our guests are already in town.
Everything's already paid for.
It's just a party.
Take it from someone who's gotten married for the wrong reasons.
It always catches up with you.
That's too bad.
Yeah.
Livingston Manor would have made for a beautiful wedding.
Mr.
Purdy, your son's been waiting for you.
I'll be there in a minute.
If you want some, just ask.
Did you buy this with your kid's rent money?
It's none of your damn business.
The hell?
Your son almost died today.
Do you realize that?
Get off me!
You're the parent!
You are supposed to take care of him, provide for him, keep him safe.
You don't know what you're talking about.
I know he's better off without you.
I know that.
You hear what I'm saying?
He's alone by himself all day...
What are you doing?
...and you left him there.
Get off him!
Dr.
West withdrew her name from consideration.
You had one job, Kwan, one job.
I know.
She had top scores.
Grades aren't everything.
She had glowing recommendations, including one from the Chief of General Surgery at Duke.
I-I didn't know.
Of course you didn't.
But even if you did, what on God's green earth made you think you could treat her like that?
I found her about to cut into a patient to place a chest tube, and if there's anything I learned this year, it's that overstepping is one of the biggest mistakes an intern can make.
Except she was about to cut into the liver instead of the pleural cavity, which is also a pretty big mistake.
And I am sorry I scared her off.
Well, I guess we dodged a bullet.
We did?
I've had enough rogue interns.
We'll find someone else.
So if I'm not in trouble, do you think I could scrub in on your...
No.
But nice job on that chest tube.
You've come a long way.
Hey, are you okay?
I...
Move.
What happened?
I should've listened to you, and I should have said something to him earlier.
Well, I don't know about that because then security would have pulled you off him instead of me.
I have a difficult dad too.
And usually, I keep all that buried deep, especially when I run into people like that who don't do right by their kids.
Turns out it's actually not buried as deep as I thought.
Yeah, I get it.
Trust me.
All right.
Uh, do you want to...
Do you wanna grab a cup of coffee?
Just decaf.
It's been a...
a long day and I feel like we both need to decompress.
I think maybe we both need sleep.
I'll see you in the morning.
Okay.
We are very pleased to present you with our highest honor, the Grey-Sloan Badge of Bravery.
Yes.
Wow.
Easiest badge ever.
I was asleep the whole time.
Thank you, Dr.
Shepherd.
Thank you.
Mm-hmm.
You gave us our whole world back.
We're very grateful.
Dylan is an inspiration.
I can't wait to hear about her adventures.
Yeah, now you gotta work on your rest and recovery badge.
It requires a lot of sleep and ice cream.
Oh, I think that could be arranged, yes.
Second easiest badge ever.
Oh, right back at you, dill pickle.
Get some rest, okay?
I'm sorry for biting your head off earlier.
I wasn't blowing smoke.
I really did believe you could do it.
Well, my brother couldn't.
He tried a few times, and it freaked me out 'cause in my eyes, he could do no wrong, so if he couldn't do it, what chance did I have?
Well, as someone who's never met your brother and who only compares you to you, I can say with full confidence that I would bet on you every time.
You were right.
It was worth the risk.
Yeah, well, I'm only right about 5% of the time, so it makes sense for you to question it.
Now I'm gonna try to take a risk.
I was gonna ask you to move in the other night.
But when you started talking about our future...
Just scared me.
Why?
Last time I planned a future with a boyfriend, my life exploded.
I had to leave it all behind, rebuild from the ground up.
I'm just not sure I'm ready to open myself up to that again.
I'm not Trey.
I know.
I love you.
I want a future with you.
I just need a little more time.
Yeah, okay, why didn't you just say that?
Because you were excited about getting back into the class.
I didn't want you to think my feelings for you had changed.
So instead, you just let Kwan make me feel like an idiot?
Let's go pick up dinner.
We can go home and talk.
I-I-I thought you didn't know your schedule.
Lucas n...
I'm on tonight anyway.
I'll see you tomorrow.
Mariana called off the wedding.
Aw, I'm sorry.
How are you holding up?
Well, um, I'm sad for them, but it's for the best.
I think I just saw us in them.
They've known each other their whole lives.
They're best friends.
I didn't wanna believe they weren't gonna make it.
We're not them.
We're not.
By the way, I found a perfect venue.
Thank God.
I was about to suggest the taco stand on the corner.
All right.
Uh...
Livingston Manor.
It's gorgeous.
There's plenty of parking, it's reasonably priced and it has a place for a live band.
Sounds amazing.
Right?
Do you think they'll have, uh, availability in the next year?
They do, because there was a cancellation.
Mariana and Edgar?
No, no, no.
Yes.
No, listen to me.
We need a wedding venue, and they have one that they're not using.
In four days.
No, we can't possibly be ready in four days.
We-We need, uh, invitations, food, drinks.
If my mom's coming, we need drinks.
Listen, I love you, and I can't wait to marry you, and that's all that matters, and-and the wedding is just the icing on the cake.
And listen, if you and I can figure out a way to relieve a woman's pain after ten years of suffering, we can throw a wedding in four days.
Okay.
Okay.
All right, let's get married.
Okay.
Okay.
We're not gonna regret it.
It's gonna be amazing.
We trust science to predict the future.
But even so, surprises are the only thing we can count on.
Okay, if Adams isn't moving in, my friend's uncle's boss's son is looking for a place.
We've been over this.
No strangers.
Are you secretly rich?
Give me some of them fries.
Uh-uh.
She's hot.
Yeah, it's the intern from today.
Mmm.
I should buy her a drink.
Mm-mmm.
Seriously, you are probably the reason she is drinking.
You said she was hot.
Sometimes surprises are good.
They lift you up and make life exquisite.
But then there's the other kind of surprise, when the bottom drops out.
Dr.
Ndugu.
How are you doing this morning?
Honestly, I'm feeling a little burnt out.
I'm gonna take a day and sit behind a desk, decompress.
Do you think you can take my intern?
Millin?
Yeah, I'd be happy to.
Tell me we are doing Mr.
Honor's lobectomy today.
I stayed up all night studying lung tissue.
You're with Dr.
Webber today, all right?
Is he okay?
He's taking an administrative day.
Oh.
Hey, lucky for you.
I've got three feet of bowel incarcerated in a man's groin.
Can't wait.
However desperate you might be,