Grey's Anatomy (2005–…): Season 10, Episode 21 - Change of Heart - full transcript
Derek's sister Amelia comes for a visit; Alex confronts Arizona and the rest of the hospital about his decision; Dr Webber finds out the truth about Harper Avery award from Catherine.
Over the past 20 years,
one of the most valuable tools a doctor
has is the algorithm.
Your patient's main complaint
goes into a box...
Cristina was supposed to fly
out with us this morning,
and she didn't show.
And then the formula helps
you decide what to do next.
Her phone's still off.
No, uh, Derek, all-all she said was,
"that's how it goes."
Last night after the ceremony.
And then that smug idiot's speech
was a 20-minute ode to himself.
Ma'am, we're shutting the doors.
She'll just be one second.
His research wasn't even research.
I read his paper on lymph nodes.
It sounded plagiarized.
I'm very sorry, but you'll
need to put your phone away.
I heard you.
Uh, I'll call you when we land.
But what happens when the problem
doesn't fit into a box?
All right, mama hung up on us.
Zola, time to put on your shoes, sweetie.
Well...
You're suddenly on your own, unexpectedly,
with about a thousand paths to choose from.
I should have called. I know.
- Uh...
- But if I called, you'd have said no.
And then I wouldn't get to
see how grown up you are.
Zola! Wow!
Look at you!
What are you, like 16 now?
And I wanted to meet my nephew. Oh.
Um... hello to you, too.
I haven't talked to you in like two months.
Amy, what are you doing here?
A... thing happened.
James proposed.
Ah! Congratulations.
- And I freaked.
- I'm sure you did.
Just sort of freaked, not...
not flee-the-country freaked.
Just... suddenly...
There's the possibility
that I may be facing
a different kind of life...
The kind that you and Meredith have...
so I thought I would come visit
and see what it's like and get... unfreaked.
Hopefully.
You're mad.
No. I'm happy to show you.
Hey, Zola, auntie Amy is gonna
play with you and Bailey today
- while I go to work.
- Oh. Oh.
- Wow. Really not mad.
- No, I'm excited.
- Yeah.
- So, Bailey gets a bottle in an hour.
His schedule's on the refrigerator.
Zola likes
to stick stuff up her nose,
so keep an eye on her.
Oh. Okay.
I'll see you later.
Okay, so, we turkey-baste me in may.
- And then the baby's born in February?
- Yep.
Sorry. Just, uh,
need to borrow some toothpaste.
As you were.
Okay, so, I take off the spring,
recover, nurse,
and then you take off the summer.
Mm-hmm. And then I put
Karev in charge of peds.
I think that that works.
Are you sure about that?
'Cause if you're gone in the summer,
you're gone when the new interns start.
You really want Karev in
charge of all the new kids?
Maybe-maybe push off
the insemination to July?
Kepner. Kepner.
Get out of my vagina.
Yes. Right.
Oh, wow.
It's really only been two nights?
'Cause it feels like 10.
No. I'm not gonna have time to pre-round.
Screw pre-rounds.
Your peds fellow needs a consult.
No! No, no, no. Wait-wait.
You have to work, too.
You're avoiding something.
Less talk, more stuff.
No, Alex. I'm serious.
What's going on?
I got an offer from Lebackes
to work at his practice.
It's a good offer...
a really good offer.
Oh! That's great!
Why don't you look like it's great?
I'm supposed to give them
an answer by the end of the day.
Oh.
Robbins is gonna be so pissed.
What am I gonna tell her?
Just be pleasant and confident and firm,
smile when you talk,
and just tell her how excited you are
about this great new opportunity.
If she starts making her scary, angry face,
distract her with a compliment.
That works? The compliments thing?
Mm-hmm.
God, you're sexy.
Doesn't work on me.
Frankie McNeil,
post-op day 2 after LVAD implantation.
Currently listed status 1a for transplant.
Despite the LVAD,
we haven't been able to
reverse her end-organ damage.
The good news is, a heart
became available this morning.
We're just waiting for confirmation
from the hospital in Oakland.
- I'm sorry, but who are you again?
- Arizona: Oh, I'm sorry.
Um, Dr. Russell is our head
of cardiothoracic surgery.
Since Dr. Yang's not back,
he'll be performing
Frankie's transplant today.
But Dr. Yang's our surgeon.
No offense, but how do
we know you're as good?
I'm an attending. She's a fellow.
Trust me... I'm as good.
Dr. Robbins and I will
be in the O.R. the entire time.
Frankie's in good hands.
And Link?
Breath sounds are strong,
and this morning's echo was all clear,
and his heart pump is doing
everything it should.
Link, buddy, that's great.
You're getting better.
When can Ivy come back in here?
Um...
Well, she's still sick,
so she needs to stay in
there a little bit longer.
Unfortunately, Ivy's still in rejection.
UNOS has her listed as status 1b,
and we're monitoring her
very closely.
Page, when we know the heart's a go...
Here you go, doctor.
So... Dr. Yang won't be back today?
Well, I haven't heard from her,
and I can't exactly postpone the surgery.
Has anyone heard from her?
Y... just make sure that
Frankie's ready and prepped.
Why are you hovering?
- Woman: Thank you.
- What's wrong with your face?
- I like your hair.
- Oh, what did you do?
Radiology's backed up.
Can you get me in line for
the next available MRI?
- Sure.
- Hey, Shepherd,
You're back to more of a regular
surgical schedule, right?
Yes. Why?
The foundation asked me
to report on the status
of our surgeon-run research projects...
Want to see which ones are
actually getting results.
So, what, they can start
shutting other ones down?
Neurological research
takes a really long time.
I'm looking at all the projects,
Derek, not just yours.
We can start making these
decisions ourselves
or wait for the foundation to do it for us.
Remember... Dr. Torres and I
have a presidential seal of approval.
You're back!
You're gonna want to
stay away from me today.
Where's Cristina? She must be devastated.
If I were here, I'd be face-first
in a pile of chocolate-chip cookies.
Stop it!
Cristina Yang doesn't need your pity!
She was robbed! And you robbed her!
Oh! I did?
Yes! You! You're an Avery by association!
That pack of fools can't tell
their asses from their elbows,
never mind an award-winning surgeon
versus some half-wit
who tinkers with science kits
in his mother's basement!
I told you to stay away
from me today, didn't I?
Mm-hmm.
- When did all this happen?
- About a month ago.
Lebackes approached me.
I've been doing work
with him on my off time.
He thinks I could make a really good fit.
So you've already decided? You're leaving?
No. I-I don't know.
I mean, my fellowship is almost over, so...
Well, um, when do they need to know by?
Tonight.
What, you're not gonna
yell at me or something?
Frankie's heart is on its way.
See, we-we just don't understand.
Two days ago, he was fine,
and now he's struggling to even breathe.
You gave him chemo last night.
Is that what's making him so much sicker?
I mean, I know it has something
to do with the gene therapy.
Well, the chemo obliterated the bone marrow,
which contained the enzyme-deficient cells.
Such a mild dose wouldn't make him sick.
We believe he picked up a viral infection.
How?! He's in isolation!
He-he has no contact with anyone.
How is that possible?
Your son has no immune system.
We-we've taken every precaution,
but this is a hospital.
Look at him! He's barely alive!
Maybe we should just stop everything...
- Yes.
- And let him get better, just let him rest.
Remember, we went through this.
He could get sicker before he got better.
We're still on track for this afternoon.
When you inject an HIV virus
into our very-sick little boy.
Inject a deactivated HIV...
O-o-okay, look, look,
w-we just need to hang
on a little while longer.
We're almost there.
Brady bug.
Let's give this kid a new heart, shall we?
10 blade.
I've got it, Dr. Russell.
Yang!
This is a surprise. When'd you get back?
Thank you for covering, Russell,
but I've got it from here.
I'm already scrubbed and ready to go.
Why don't you take a load off?
You must be tired.
I've followed Frankie McNeil
since day 1. Thank you.
Tough loss last night, Yang.
Must have stung.
Better luck next time.
It was an honor just to be nominated.
10 blade.
What on earth are you doing here?!
Ohh!
Mwah!
I like to keep you guessing.
Ooh!
You better get in here
before I do something
that will embarrass Henry.
Oh, wow!
Ooh! Mmm.
Mm.
Mm. I should surprise you more often.
Well, I'm not that surprised.
How come?
I thought you might show up and poke around,
trying to figure out why
Dr. Yang didn't get her award.
Oh, please. I planned
this trip a long time ago.
I figured you'd be
exhausted from the ceremony
and need a little getaway.
You didn't plan it as a victory lap
to celebrate Yang's big win?
Mm... That would have been a nice feature.
Mm. Yeah.
But I think the weekend
will have other nice features.
Oh. Really?
So, why don't you finish what you're doing?
- Mm-hmm.
- I'll sit here and watch the magic,
and then I'll take you to dinner.
Mm.
Yes, Dr. Webber.
Hey.
Hi. How are you?
Good.
How'd you sleep?
Fine, thanks.
Have you talked to Cristina? Is she okay?
I really thought that she had...
Yeah, I-I know. I was shocked, too.
Um, so... I need to come home tonight.
You want to talk?
I...
I need my iPod.
- I went running today, and I wished...
- Sure. Sure.
Are you okay?
You look...
Stressed. I'm a little stressed.
I got to compile a report for the foundation
on the value of people's
research projects,
'cause we're not gonna be able to
keep all of them, I don't think.
Wow.
What?
You guys deny her the award
and not 24 hours later,
you're talking about
shutting down her research?
You know that that was, like,
her life's dream, right?
That's not what we're doing.
They're looking for ways to...
Classy move, Avery family.
Way to make it all about the medicine.
Okay. What do we got?
Sam Roane, 23...
Been walking cross-country
for the past three months,
stopping only for sleep
and the pickup that took him out.
Hypotensive with multiple blunt trauma
and deformity
to the right lower extremity.
Paramedics splinted him in the field.
So, three months? That means
you started walking from...
- Wilmington.
- Callie: Wow.
Were you, uh, walking for charity?
No. I mean, I fell in with a few
cancer groups along the way,
you know, for the snacks,
but it was more about really
committing to something
and following it through to the end.
And then I got hit by a truck.
Okay, the femur fracture must have
transected the femoral artery.
Whoa.
That's why he's so hypotensive.
He is losing all his blood
volume into his thigh.
- Mm-hmm.
- Foot is pulseless and cold.
We need to do an angio in
the O.R. Let's move now.
I mean, they screwed her!
And I was ready to make a scene,
but she just sat there in her seat.
She clapped for him.
She applauded him, Derek!
No, go ahead. Get it out.
And now I can't even get ahold of her.
I mean, she could still be in Boston.
She could be in Mexico.
I have no idea where...
She's in O.R. 1. Thank god!
Is that a spinal schwannoma?
- It is.
- Extended into the retropleural space?
Mm-hmm.
Is that for me?
We're overdue for a date.
O.R. 3, you in fresh scrubs,
me in a ferry-boat scrub cap.
You in?
Well, this could take hours.
What about the kids?
- Amy's with them.
- We have a babysitter named Amy?
- Amy my sister.
- The junkie?
She's a recovering addict,
and she loves kids.
I've only been gone a day.
The tumor involves the great vessels.
- I know what you're doing.
- Mm-hmm.
And it's working.
Mm-hmm.
Yeah, his femur's toast.
He'll need an ex-fix.
SFA's transected.
Okay. We got to relieve
the pressure on this leg.
I just heard from Grey...
Cristina's in O.R.
1, doing a heart transplant.
Karev and Robbins are with her.
Hey, Wilson, did you happen to put on
boot covers before you came in here?
Why would I...
Okay. I get it.
It's in my socks.
Oh! That never gets old.
I just feel like it's one thing
after another, after another.
I don't know how you do
it with three sick kids.
I'm barely keeping it
together with just one.
- Teresa?
- Hm?
Uh, do you have those consent
forms for this afternoon?
Oh. Yeah, I forgot. Hang on.
Yeah. Take your time.
I mean, you're their parent.
You're who they trust.
But you can't actually help them.
That's the doctor's job.
Then weeks go by, and all this... stuff
that's supposed to be making them better
keeps not working.
And I just... I start to wonder,
"do these doctors really
know what's best for my kids?"
"Am I just kidding myself?"
"Will we ever go home?"
Sorry, doctor. No offense.
Nope. None taken.
Uh, Teresa, I'm sorry.
You just have a couple more to sign.
Removing cross clamp to
re-establish blood flow.
I don't see one tear, one leak.
You did it perfectly.
I mean, I've really never seen
such an efficient anastomosis.
- Look, Karev.
- Awesome job, Yang.
- Inspiring.
- Flawless.
Charge it to 20.
Should be pumping any minute now.
How long does it take?
Usually, it's pretty much right
after restoring blood flow,
so eyes on the field.
This is not something you want to miss
on your first transplant.
So...
shouldn't it be contracting by now?
Dr. Yang?
Starting cardiac massage.
- Pacing wires now.
- Get me intracardiac epi.
Come on, come on, come on. Beat.
What's UNOS saying?
We're waiting on a call back.
I don't understand. How does that happen?
They sent us a freaking lemon heart.
They must have injured it when
they were moving it from the donor.
It's UNOS. They've located
another heart that's a match.
- It's in Portland.
- How often does that happen?
Karev and I will go get it.
We can't risk another screw-up.
- Well, both of us don't need to...
- Now. Let's go.
- Cristina, you okay?
- Yeah.
Dr. Yang, Frankie's already
been on bypass for hours.
And she's gonna stay on it.
Keep monitoring her.
Page me if anything changes.
All right.
That's it.
Shall we?
You really thought I would come here
and question why Yang
didn't get a Harper Avery?
Well, you're a proud papa.
She's your prize student.
I know it's important to you.
I-it's important to the whole hospital.
And you're an investor in that hospital,
so I think it'd be important to you, too.
It is.
That's why it's good that there
is an impartial committee.
Well...
"Well" what?
It's not that impartial.
Look, it makes no sense that she lost.
See, I read her paper,
I read every other nominated paper.
There's no comparison...
unless there was some statistical
calculation she blew,
some gross error
buried way down in the data.
You know as well as I do
none of them even holds a candle
to what Yang's been doing.
Number one, I'm glad you're alive.
Number two,
who do you want me to go after?
- Because I'm in your corner.
- Mer.
But I can't be in your corner
if you disappear on me.
- Mer, not now.
- Nurse: Dr. Yang,
they're asking for you in the CCU.
Ivy McNeil's SATs dropped below 70.
Dr. Yang. You're back. Thank god.
Ivy's heart is failing.
She has a lot of fluid in her lungs.
I need to intubate right away.
Prepare for RSI with 15 of
etomidate and 10 of vec.
Link. Link, don't look, buddy.
I'm here, honey.
Push etomidate.
I barely
got two words out of her.
She's obviously not okay, right?
You said she got
pulled into an emergency.
I'm sure she's fine.
You know, this is the most
time we've spent together,
just the two of us, in weeks.
It's really nice.
We have to do it more often.
Grey?
Should have left a tie on the door.
About your portal vein project...
Do you really need lab
staff five days a week?
- Yes. Say yes.
- Yes. Why?
- The foundation is trimming research.
- What?!
- No, no, no. They're just looking...
- The hell they are...
the Harper Avery foundation
doesn't make any decisions
about this hospital.
If there's one thing
the Harper Avery foundation
can't do well,
it's decide who should get something.
Okay, I am just...
Tell them that if they cut my funding,
I cut their tires.
Cristina Yang deserved that award,
not Dr. Nobody Sucksalot from Hopkins.
And tell them in short sentences
with little, tiny words,
because they are boneheads!
And we were having so much fun.
Jackson and I
aren't having just a fight.
This is important... it's not something
that can be just glossed over,
ignored, or fixed.
It... I can't pretend like nothing's wrong.
Yeah, I know. I know.
You said all that last night,
then again this morning over breakfast.
And now... you're saying it all again now.
Hey. Wow. Look at that.
His ex-fix really looks ready to go.
Sadly, I think our work is done here.
W-w-wha... y-y-y-you're leaving?
Y-you're not leaving.
Don't we need to review
the measurements with imaging?
No, we do. We do. Uh, it's just...
We should really stay out
of Kepner and Hunt's way,
so we're gonna do it in radiology,
where there are bigger screens
and better lighting. Sound good?
Well, we're almost done here, so...
N... take your time. Let's go, Wilson.
We should take him home!
Let him get better!
Let this treatment get more established!
We don't have to be the guinea pig!
But the treatment
can bring us our son back.
He can live a normal life.
Or it could kill him!
They say it won't, but this therapy
is made with HIV.
That doesn't freak you out?
It's deactivated!
Do you even know what that means?!
Do you know what that means?
Excuse me. I need to do one
final blood test on Braden.
No! No more blood draws! No more injections!
Nothing else! We're done!
This treatment is too much!
It's killing him!
Okay, Teresa, look,
I know that you're scared.
Teresa...
No, tell Dr. Bailey
we have changed our minds.
You're not injecting Braden with
anything today. You got it?
The last time
that we were on a plane...
Can we not talk about the
last time you were on a plane?
No.
Alex, the last time that
we were on a plane together...
the first time we met.
Look, I know
you brought me on this plane
to talk me out of taking this job.
We'll be in Portland soon.
Just get it over with and
say what you're gonna say.
It's not like I can go anywhere.
We were on our way to pick up a liver
and a small bowel for a 10-year-old...
And now you think I'm selling out,
that I'm choosing money over substance,
and that it's a waste of
my talent or whatever...
That there's more to life
than nice schedules and a big, fat paycheck.
Well, I've thought about it hard.
You've been awesome, but I've
already stayed here once for you.
I have to start thinking about myself,
about what I want.
I've worked hard, and I deserve this.
I deserve to think about
myself for once, okay?
Yang is a robot.
If I just lost the Harper Avery,
I'd be awol,
in my bed with a bottle of scotch.
Although, she did just throw pickups
across a crowded O.R.
Yang's a surgeon.
She cares more about
her patients than stupid awards.
What's the latest A.B.G.?
Uh, pH is 7.15,
pCO2 is 52.
Crap. She's acidotic.
Push bicarb and increase her sweep.
- Okay.
- Okay, good. Good.
Shane, she's bleeding.
It's coming
from one of the suture lines.
Page Dr. Yang now!
Ivy's lungs are doing
better after the intubation,
but I need to place a special line
to get a more accurate
measurement of her heart.
You may want to leave during this procedure.
No. I'm staying. I want to stay.
You ran in here after
Frankie's surgery. Is she...
There was a... complication
with Frankie's donor heart,
but a second one has been located,
and it's on its way.
I just wanted to keep Frankie
in the O.R. until it arrives.
What?
Is... is that safe? Is she gonna be okay?
She's being closely monitored.
Dr. Yang,
Dr. Ross and Dr. Murphy are
on the phone from O.R. 1.
Put them on speaker.
- Ross, update me.
- I'm here with Frankie's dad.
Frankie's bleeding
from one of her suture lines.
And she's really acidotic.
- John, you should step out.
- I'm staying.
- Ross, did you push bicarb?
- We did.
- How are her coags?
- Stable, but this bleed isn't slowing down.
Okay, well, you need to stop that bleeding.
If she continues to bleed...
The triad of death... we know.
I'm so sorry, sir.
Okay, throw
a horizontal mattress stitch,
but careful with her tissues.
They're extremely friable, so soft hands.
You're on the right side of the table.
You have one chance,
or else you could rip through the aorta,
which is essential to connecting
the new heart when it arrives.
Nope.
Just take a breath, just throw the stitch.
You can do this.
I've never put a horizontal mattress
in an aorta before... only in a bowel.
From this side, I'll just
tear through her native aorta.
- Well, what if I tear through it?
- You won't!
You can do this.
Ross! Murphy!
We got it. We stopped the bleed.
She's fine.
They're both fine.
She gets results.
She always has, and this is no exception.
M-make me understand,
because my read is that Yang
should have clearly won.
I mean, what am I missing?
From where I'm standing,
she had it by a mile.
Richard, honestly,
tell me you're not this naive.
Well, what is that
supposed to mean?
The Harper Avery foundation
co-owns the hospital
Cristina Yang works for.
She could never win that award.
I don't know how long
this stitch is gonna hold.
- pH and bicarb?
- Man: 7.0 and 14.
Dr. Yang, now she's oozing from the IVC.
- I see it, Shane.
- Aren't we gonna put in a suture?
If we just keep throwing in stitches,
she'll dissect all over the place.
We have to get Frankie off this table.
How? She's getting a transplant.
In this state, she'll never survive it.
First, she gets a lemon heart,
and now we don't know
if the new one's gonna make it?
Wait. Is that Robbins?
How we doing?
The heart is out, and we're on the move.
Want to let the coordinator know?
Oh. Phone the pilot.
Let him know we're on our way.
So, this is how it's gonna be now?
Radio silence
till the end of my fellowship?
That's how
you're gonna leave things?
Alex, I brought you here today
because I trusted your skills
to properly procure this heart.
And then we got on that plane,
and I started feeling sad
because you're leaving
soon and I will miss you.
I didn't bring you today to scold you.
I'm proud of you and I'm happy for you,
and all I wanted was to share
a freaking memory, okay?
I was being sentimental!
Oh.
You know, if I take the job,
I'm still gonna have hospital privileges.
You'll see me around.
Shut up, Karev. Moment's ruined.
Just a few more sutures.
You know where he was when he got hit?
He was crossing highway 519.
He could see the water.
All he wanted to do
was walk from ocean to ocean.
He was just so freaking close.
Okay, let's check the pulse.
It's not fair, you know?
You make a commitment,
it's supposed to mean something,
and then a... pickup truck
just takes you out.
Hey, you okay?
S... sorry.
I just f-feel like
this fight with Jackson is,
like, the fight,
and I...
I don't know how we recover from it.
Listen.
Some fights, you just can't get past.
You know?
Like me and Cristina,
it was... it was about kids.
You and Avery?
This is your first fight.
You will get past this,
and then something else will come along,
and you'll fight about that, too.
And you guys will recover every time.
This is not your pickup truck.
Now that it's thawed,
and I've added the virus to the culture,
I just have to wash them down
and give him the injection
within the next four to six hours,
and then, theoretically,
that's when the magic will happen.
See, that's the problem, though, Bailey.
So far, all of this is theoretical,
and the foundation needs actual results.
I need you to help me out, okay?
Give me something, anything concrete,
that shows that your project
is producing results.
No, d... it will be.
Once I give this targeted gene therapy
to my bubble boy, I know it will.
I-I can feel it.
Okay, I can't exactly pitch
that we need to keep your lab
because you have a feeling, can I?
You said you're doing this today?
Yes, I am.
And it's going to work.
Dr. Bailey, do you have a minute?
You pursued her. You encouraged her.
You all but told her she was a front runner,
when you knew she was
nothing but window dressing.
She was not window dressing!
She was nominated for a prestigious award
that brought publicity to
her and the hospital.
You used her!
She was never gonna win that
damn thing for a second.
Nobody from Grey-Sloan memorial
will ever win a Harper Avery,
will they... ever?
Do you want me to remind you
why there is
a Grey-Sloan memorial hospital?
Or should I just take
my $24 million and go home?
What draws me to you,
Richard, is your idealism.
I find it extremely attractive.
But this is business.
And I do not appreciate
your coming all the way across the country
to harangue me about the fact
that your prize pony didn't get a ribbon!
And if it makes you feel better...
she had the votes.
Are you that naive?
Catherine, do you really think
that's why I came all this way,
why I planned an entire weekend
with the things that you love?
- Richard...
- I made reservations at Cipriani's
because I know you love it there.
And I was going to wait
until just before dessert
and the waiter was gonna bring
you a glass of champagne,
and I was going to tell
you how much I love you
and how right for one another we are,
how you make me feel excited to be alive,
how you give me a reason
to get up each morning
and say a thankful prayer every night.
I was gonna ask you to be by my side
for the rest of our lives.
That's why I'm here.
That's why I came.
And now I'm leaving.
I'm-I'm sorry. What?
You're gonna have to say...
You're gonna have to say it all again.
Dr. Robbins is on her way
with a new heart for Frankie,
but Ivy's deterioration has caused her
to shoot up to the top of
the transplant list, too.
Ivy is also a perfect match
for the donor heart en route.
But t-that's Frankie's heart.
Officially, yes, but...
under the circumstances,
the heart could be redirected.
To Ivy?
You w... you want to give
Frankie's heart to Ivy?
No, I don't want...
Medically speaking,
Frankie's condition is declining rapidly.
Technically, Ivy is more stable,
which would give the heart
a better chance of survival.
Wait. Just...
But... b-b-but if Frankie's worse,
don't you have to give the heart
to the one that's the worst?
Unless she thinks it's a waste.
You think the heart will
be wasted on Frankie?
I just want to explain all your options.
Our options? This is our decision?
Wait. You're... you're asking us to choose?
You want us to try to pick
which of our children gets a heart
and which one doesn't?
Frankie can be fitted with
a total artificial heart for now.
We can't choose. You have to do it.
We have three children, Dr. Yang...
Three... amazing...
beautiful, kind children.
And we can't...
we can't try and pick between two of them.
We won't.
You have to make this decision.
Please.
Please.
There you are.
Frankie's heart is as stiff as a rock,
and Ivy's got
global systolic dysfunction.
It's absolutely impossible.
Why didn't you call me?
Mer already
yelled at me about this.
I'm sorry, okay? I just...
I wanted to be alone, so I left.
I'm not talking about...
I just heard about the McNeils.
You should have called me to
help you make this decision.
No surgeon should have to make a
decision like this on their own.
That's why I'm here. That's why
you have a chief of surgery.
They're my patients. I know their status.
I can decide this.
But you don't have to.
Yes, I do.
Prepare to start
sectioning off the vessels.
Is that a Gustafson artificial heart?
We're getting Frankie off
this table immediately.
And the heart that's on its way?
We're reallocating that heart.
It's going to Ivy.
Russell's prepping her now.
Okay, let's move.
You guys gonna be home for dinner?
Yeah. Sure. Sounds good.
Okay, awesome! Can't wait!
Yeah, neither can we.
Does that mean what I think it means?
That there's gonna be dinner waiting for us
on our dining room table when we get home?
Have we ever even used
our dining room table?
Just remind me to thank my sister
for letting me actually spend
an entire day with my wife.
Well, she's not a permanent solution.
Ah, not yet,
but we have a spare bedroom.
We could give her surgical privileges.
That would give her less time for childcare.
I know it's not permanent,
but we spent an entire day
without dropping any balls.
You know, maybe she'll
even put the kids to bed.
Maybe we could have some wine.
You know, Amy is making dinner for the kids.
Maybe we have time for a little mm-mm.
It would be a shame to end such a great day
with no dessert.
Why aren't you trying
to talk me into staying?
Oh, god. Are we still on this?
Can't we just focus
on transplanting the heart
we just retrieved?
Yeah. Never mind. I'll shut up.
Of course I want you to stay.
But this sounds like
an incredible job opportunity,
and you're right...
you did stay here for me once,
and I don't want
to stand in your way again,
so if you want to leave, you should leave...
but not because of something
that I do or don't say.
You should leave
because this is
the next best thing for you
and because you're excited about this job
and you're ready to go do great things.
And collect a big, fat paycheck.
Really big.
I guess you have a decision to make.
Don't screw this one up.
Okay, let's transport her.
B.P.'s stable. I'm gonna see
how Russell's doing with Ivy.
Bring in the bed.
What happened?
Ventricular pressure's up to 200.
She's dissecting.
Now she's plummeted to 15. What the hell?
Damn it. It-it ruptured.
Okay, we're gonna have to reopen her.
Staple remover!
I mean, the thing I don't understand is,
won't Braden die
if he doesn't get this treatment?
It's possible.
So...
I mean, does this happen often
with experimental treatments?
That the parents or the guardians
just withdraw their consent?
Please stop talking.
And then what do I do
with these consent forms she just signed?
I mean, do I... do I shred them?
Do I toss them?
I told you... stop talking!
Uh, I'll take care of those.
Just get one damn suture to hold.
How's her ventricular pressure?
Zero.
Pupils?
Fixed and nonreactive.
Cristina.
What?!
Cristina, we've been at
this for almost an hour.
Ivy's transplant went perfectly.
Her post-op echo is completely normal.
She should be awake soon.
And Frankie?
No.
No!
I-it can't be.
You...
Well, how-how the hell did this...
We trusted you!
What the hell did you do to our child?!
We are so sorry for your loss.
Oh, god!
We need to be with our kids.
Your stitch held.
So?
I've never seen vessels that friable,
and I've been around
a lot of diseased hearts.
You did an amazing thing.
Shane, the kid died.
It wasn't anything you did.
They want us to be
the center of innovation,
- but they don't want to pay for it.
- They love it when we innovate.
They nominated Yang for an award.
She was robbed. They're boneheads.
We can't give with one hand
and take with the other.
We have to stop this.
There's no stopping this.
Guys, they own the place.
We are just their managing board.
This conversation is our relationship now.
Best we can do is try to guide
them to make the right decision.
That's by making our own decision,
as tough as that might be.
Look, this is my report, all right?
All the projects are here...
operating budgets
versus progress to date.
Best to worst.
Take a look, but the decision
is pretty clear to me.
Uh, y-you got a second?
- Never mind. I'll come back.
- No, no. Alex, come in.
You okay?
Uh, yeah. Yeah.
I, uh, just wanted to let you know
that, uh, my fellowship is, uh, almost done,
and, uh... well, I got an offer
from Lebackes
pediatric surgery clinic,
Oliver Lebackes' practice,
and, uh...
well, I gave it
some serious consideration,
and I've decided to take it.
So, I guess this is my notice.
Cristina, please don't
disappear on me again.
Where are you?
Please, just... call me.
Hunt. We need to talk.
If it can wait, I really...
No, it can't.
Well?
I almost didn't go through with it.
But... then I did.
And I think
it's gonna be good, right?
Are you kidding?!
It's gonna be awesome!
Baby!
Oh. Compartment syndrome?
Yes. Blood went everywhere.
Mm. Torres loves that trick.
You should just toss those.
I know. You're right.
Why am I scrubbing those nasty things,
when now you can afford to buy me new ones?
What happened?
Wait. Where are the kids?
They're asleep... totally fine.
What's wrong?
I can't do this.
The children broke your sister.
No, it's not them.
I didn't come here to see how
your perfect life worked.
I came to see if I could do it...
the whole freaking thing,
the kids and marriage and
the full-time careers...
because I want that... with James.
And I am wrecked after one day.
It goes on the list of things
that I suck at because...
I can't.
Well, I knew that was too good to be true.
Why don't you go fix your sister?
I'll order takeout.
Hey.
Hey.
So, you are...
Right.
Uh, I'll see you tomorrow.
April.
I said a lot of things the
other night that I regret.
And I'm sorry that I hurt your feelings.
I'm sorry, too.
Good. So come home. Stay.
This is a conversation we're
always gonna have to have.
It's a part of who we are.
It's gonna take some talking.
But we got married. We love each other.
We made vows to push
through this sort of thing.
I know.
I love you, too, and we made a commitment.
And if you believe in god,
then you believe he made me...
your husband...
who shares your values, which I do.
I believe
we shouldn't kill or steal.
I believe
that you should be truthful.
I believe
that you should treat others
the way you want to be treated.
I agree.
So, then, we can
push through this problem.
At our core,
we believe the same things.
Until I think about telling our children
how unbelievably loved they are
by the creator of the universe,
who also made them,
and I can just see you standing there,
judging and dismissive,
and I just can't get past it.
Can we please just take a break
from our hypothetical children for...
No, we can't, because
they're not hypothetical anymore.
Jackson, I'm pregnant.
So, what do you do?
How do you decide?
When you're left in the dark?
How do you make sure
you're not making the worst mistake
of someone's life?
So, now what?
We just... cross our fingers
and hope he gets better?
Guess so.
Good night, Edwards.
You close your eyes...
You block out everyone
and everything around you...
Cristina?
Cristina?
Cristina?
Are you okay?
Cristina,
they were very sick kids.
Every one of them
would have been looking
at a death sentence without you.
The fact that any of them survived...
I know this, Owen.
Frankie was on borrowed time
from the moment she got here.
You made the right decision.
You made the right call.
I know I made the right call.
You don't have to tell me.
It was an impossible decision,
and I stand by it.
I did everything...
exactly as I was supposed to.
I did it perfectly.
So what is wrong?
What's the point, Owen?
What's the point of anything?
You won.
The Harper Avery... you got the most votes.
Richard just told me.
The politics screwed you.
The foundation's relationship
with us... they used you.
You never stood a chance.
And pray that the voice
inside you...
Is right.
Because once you've decided...
You can't ever go back.
one of the most valuable tools a doctor
has is the algorithm.
Your patient's main complaint
goes into a box...
Cristina was supposed to fly
out with us this morning,
and she didn't show.
And then the formula helps
you decide what to do next.
Her phone's still off.
No, uh, Derek, all-all she said was,
"that's how it goes."
Last night after the ceremony.
And then that smug idiot's speech
was a 20-minute ode to himself.
Ma'am, we're shutting the doors.
She'll just be one second.
His research wasn't even research.
I read his paper on lymph nodes.
It sounded plagiarized.
I'm very sorry, but you'll
need to put your phone away.
I heard you.
Uh, I'll call you when we land.
But what happens when the problem
doesn't fit into a box?
All right, mama hung up on us.
Zola, time to put on your shoes, sweetie.
Well...
You're suddenly on your own, unexpectedly,
with about a thousand paths to choose from.
I should have called. I know.
- Uh...
- But if I called, you'd have said no.
And then I wouldn't get to
see how grown up you are.
Zola! Wow!
Look at you!
What are you, like 16 now?
And I wanted to meet my nephew. Oh.
Um... hello to you, too.
I haven't talked to you in like two months.
Amy, what are you doing here?
A... thing happened.
James proposed.
Ah! Congratulations.
- And I freaked.
- I'm sure you did.
Just sort of freaked, not...
not flee-the-country freaked.
Just... suddenly...
There's the possibility
that I may be facing
a different kind of life...
The kind that you and Meredith have...
so I thought I would come visit
and see what it's like and get... unfreaked.
Hopefully.
You're mad.
No. I'm happy to show you.
Hey, Zola, auntie Amy is gonna
play with you and Bailey today
- while I go to work.
- Oh. Oh.
- Wow. Really not mad.
- No, I'm excited.
- Yeah.
- So, Bailey gets a bottle in an hour.
His schedule's on the refrigerator.
Zola likes
to stick stuff up her nose,
so keep an eye on her.
Oh. Okay.
I'll see you later.
Okay, so, we turkey-baste me in may.
- And then the baby's born in February?
- Yep.
Sorry. Just, uh,
need to borrow some toothpaste.
As you were.
Okay, so, I take off the spring,
recover, nurse,
and then you take off the summer.
Mm-hmm. And then I put
Karev in charge of peds.
I think that that works.
Are you sure about that?
'Cause if you're gone in the summer,
you're gone when the new interns start.
You really want Karev in
charge of all the new kids?
Maybe-maybe push off
the insemination to July?
Kepner. Kepner.
Get out of my vagina.
Yes. Right.
Oh, wow.
It's really only been two nights?
'Cause it feels like 10.
No. I'm not gonna have time to pre-round.
Screw pre-rounds.
Your peds fellow needs a consult.
No! No, no, no. Wait-wait.
You have to work, too.
You're avoiding something.
Less talk, more stuff.
No, Alex. I'm serious.
What's going on?
I got an offer from Lebackes
to work at his practice.
It's a good offer...
a really good offer.
Oh! That's great!
Why don't you look like it's great?
I'm supposed to give them
an answer by the end of the day.
Oh.
Robbins is gonna be so pissed.
What am I gonna tell her?
Just be pleasant and confident and firm,
smile when you talk,
and just tell her how excited you are
about this great new opportunity.
If she starts making her scary, angry face,
distract her with a compliment.
That works? The compliments thing?
Mm-hmm.
God, you're sexy.
Doesn't work on me.
Frankie McNeil,
post-op day 2 after LVAD implantation.
Currently listed status 1a for transplant.
Despite the LVAD,
we haven't been able to
reverse her end-organ damage.
The good news is, a heart
became available this morning.
We're just waiting for confirmation
from the hospital in Oakland.
- I'm sorry, but who are you again?
- Arizona: Oh, I'm sorry.
Um, Dr. Russell is our head
of cardiothoracic surgery.
Since Dr. Yang's not back,
he'll be performing
Frankie's transplant today.
But Dr. Yang's our surgeon.
No offense, but how do
we know you're as good?
I'm an attending. She's a fellow.
Trust me... I'm as good.
Dr. Robbins and I will
be in the O.R. the entire time.
Frankie's in good hands.
And Link?
Breath sounds are strong,
and this morning's echo was all clear,
and his heart pump is doing
everything it should.
Link, buddy, that's great.
You're getting better.
When can Ivy come back in here?
Um...
Well, she's still sick,
so she needs to stay in
there a little bit longer.
Unfortunately, Ivy's still in rejection.
UNOS has her listed as status 1b,
and we're monitoring her
very closely.
Page, when we know the heart's a go...
Here you go, doctor.
So... Dr. Yang won't be back today?
Well, I haven't heard from her,
and I can't exactly postpone the surgery.
Has anyone heard from her?
Y... just make sure that
Frankie's ready and prepped.
Why are you hovering?
- Woman: Thank you.
- What's wrong with your face?
- I like your hair.
- Oh, what did you do?
Radiology's backed up.
Can you get me in line for
the next available MRI?
- Sure.
- Hey, Shepherd,
You're back to more of a regular
surgical schedule, right?
Yes. Why?
The foundation asked me
to report on the status
of our surgeon-run research projects...
Want to see which ones are
actually getting results.
So, what, they can start
shutting other ones down?
Neurological research
takes a really long time.
I'm looking at all the projects,
Derek, not just yours.
We can start making these
decisions ourselves
or wait for the foundation to do it for us.
Remember... Dr. Torres and I
have a presidential seal of approval.
You're back!
You're gonna want to
stay away from me today.
Where's Cristina? She must be devastated.
If I were here, I'd be face-first
in a pile of chocolate-chip cookies.
Stop it!
Cristina Yang doesn't need your pity!
She was robbed! And you robbed her!
Oh! I did?
Yes! You! You're an Avery by association!
That pack of fools can't tell
their asses from their elbows,
never mind an award-winning surgeon
versus some half-wit
who tinkers with science kits
in his mother's basement!
I told you to stay away
from me today, didn't I?
Mm-hmm.
- When did all this happen?
- About a month ago.
Lebackes approached me.
I've been doing work
with him on my off time.
He thinks I could make a really good fit.
So you've already decided? You're leaving?
No. I-I don't know.
I mean, my fellowship is almost over, so...
Well, um, when do they need to know by?
Tonight.
What, you're not gonna
yell at me or something?
Frankie's heart is on its way.
See, we-we just don't understand.
Two days ago, he was fine,
and now he's struggling to even breathe.
You gave him chemo last night.
Is that what's making him so much sicker?
I mean, I know it has something
to do with the gene therapy.
Well, the chemo obliterated the bone marrow,
which contained the enzyme-deficient cells.
Such a mild dose wouldn't make him sick.
We believe he picked up a viral infection.
How?! He's in isolation!
He-he has no contact with anyone.
How is that possible?
Your son has no immune system.
We-we've taken every precaution,
but this is a hospital.
Look at him! He's barely alive!
Maybe we should just stop everything...
- Yes.
- And let him get better, just let him rest.
Remember, we went through this.
He could get sicker before he got better.
We're still on track for this afternoon.
When you inject an HIV virus
into our very-sick little boy.
Inject a deactivated HIV...
O-o-okay, look, look,
w-we just need to hang
on a little while longer.
We're almost there.
Brady bug.
Let's give this kid a new heart, shall we?
10 blade.
I've got it, Dr. Russell.
Yang!
This is a surprise. When'd you get back?
Thank you for covering, Russell,
but I've got it from here.
I'm already scrubbed and ready to go.
Why don't you take a load off?
You must be tired.
I've followed Frankie McNeil
since day 1. Thank you.
Tough loss last night, Yang.
Must have stung.
Better luck next time.
It was an honor just to be nominated.
10 blade.
What on earth are you doing here?!
Ohh!
Mwah!
I like to keep you guessing.
Ooh!
You better get in here
before I do something
that will embarrass Henry.
Oh, wow!
Ooh! Mmm.
Mm.
Mm. I should surprise you more often.
Well, I'm not that surprised.
How come?
I thought you might show up and poke around,
trying to figure out why
Dr. Yang didn't get her award.
Oh, please. I planned
this trip a long time ago.
I figured you'd be
exhausted from the ceremony
and need a little getaway.
You didn't plan it as a victory lap
to celebrate Yang's big win?
Mm... That would have been a nice feature.
Mm. Yeah.
But I think the weekend
will have other nice features.
Oh. Really?
So, why don't you finish what you're doing?
- Mm-hmm.
- I'll sit here and watch the magic,
and then I'll take you to dinner.
Mm.
Yes, Dr. Webber.
Hey.
Hi. How are you?
Good.
How'd you sleep?
Fine, thanks.
Have you talked to Cristina? Is she okay?
I really thought that she had...
Yeah, I-I know. I was shocked, too.
Um, so... I need to come home tonight.
You want to talk?
I...
I need my iPod.
- I went running today, and I wished...
- Sure. Sure.
Are you okay?
You look...
Stressed. I'm a little stressed.
I got to compile a report for the foundation
on the value of people's
research projects,
'cause we're not gonna be able to
keep all of them, I don't think.
Wow.
What?
You guys deny her the award
and not 24 hours later,
you're talking about
shutting down her research?
You know that that was, like,
her life's dream, right?
That's not what we're doing.
They're looking for ways to...
Classy move, Avery family.
Way to make it all about the medicine.
Okay. What do we got?
Sam Roane, 23...
Been walking cross-country
for the past three months,
stopping only for sleep
and the pickup that took him out.
Hypotensive with multiple blunt trauma
and deformity
to the right lower extremity.
Paramedics splinted him in the field.
So, three months? That means
you started walking from...
- Wilmington.
- Callie: Wow.
Were you, uh, walking for charity?
No. I mean, I fell in with a few
cancer groups along the way,
you know, for the snacks,
but it was more about really
committing to something
and following it through to the end.
And then I got hit by a truck.
Okay, the femur fracture must have
transected the femoral artery.
Whoa.
That's why he's so hypotensive.
He is losing all his blood
volume into his thigh.
- Mm-hmm.
- Foot is pulseless and cold.
We need to do an angio in
the O.R. Let's move now.
I mean, they screwed her!
And I was ready to make a scene,
but she just sat there in her seat.
She clapped for him.
She applauded him, Derek!
No, go ahead. Get it out.
And now I can't even get ahold of her.
I mean, she could still be in Boston.
She could be in Mexico.
I have no idea where...
She's in O.R. 1. Thank god!
Is that a spinal schwannoma?
- It is.
- Extended into the retropleural space?
Mm-hmm.
Is that for me?
We're overdue for a date.
O.R. 3, you in fresh scrubs,
me in a ferry-boat scrub cap.
You in?
Well, this could take hours.
What about the kids?
- Amy's with them.
- We have a babysitter named Amy?
- Amy my sister.
- The junkie?
She's a recovering addict,
and she loves kids.
I've only been gone a day.
The tumor involves the great vessels.
- I know what you're doing.
- Mm-hmm.
And it's working.
Mm-hmm.
Yeah, his femur's toast.
He'll need an ex-fix.
SFA's transected.
Okay. We got to relieve
the pressure on this leg.
I just heard from Grey...
Cristina's in O.R.
1, doing a heart transplant.
Karev and Robbins are with her.
Hey, Wilson, did you happen to put on
boot covers before you came in here?
Why would I...
Okay. I get it.
It's in my socks.
Oh! That never gets old.
I just feel like it's one thing
after another, after another.
I don't know how you do
it with three sick kids.
I'm barely keeping it
together with just one.
- Teresa?
- Hm?
Uh, do you have those consent
forms for this afternoon?
Oh. Yeah, I forgot. Hang on.
Yeah. Take your time.
I mean, you're their parent.
You're who they trust.
But you can't actually help them.
That's the doctor's job.
Then weeks go by, and all this... stuff
that's supposed to be making them better
keeps not working.
And I just... I start to wonder,
"do these doctors really
know what's best for my kids?"
"Am I just kidding myself?"
"Will we ever go home?"
Sorry, doctor. No offense.
Nope. None taken.
Uh, Teresa, I'm sorry.
You just have a couple more to sign.
Removing cross clamp to
re-establish blood flow.
I don't see one tear, one leak.
You did it perfectly.
I mean, I've really never seen
such an efficient anastomosis.
- Look, Karev.
- Awesome job, Yang.
- Inspiring.
- Flawless.
Charge it to 20.
Should be pumping any minute now.
How long does it take?
Usually, it's pretty much right
after restoring blood flow,
so eyes on the field.
This is not something you want to miss
on your first transplant.
So...
shouldn't it be contracting by now?
Dr. Yang?
Starting cardiac massage.
- Pacing wires now.
- Get me intracardiac epi.
Come on, come on, come on. Beat.
What's UNOS saying?
We're waiting on a call back.
I don't understand. How does that happen?
They sent us a freaking lemon heart.
They must have injured it when
they were moving it from the donor.
It's UNOS. They've located
another heart that's a match.
- It's in Portland.
- How often does that happen?
Karev and I will go get it.
We can't risk another screw-up.
- Well, both of us don't need to...
- Now. Let's go.
- Cristina, you okay?
- Yeah.
Dr. Yang, Frankie's already
been on bypass for hours.
And she's gonna stay on it.
Keep monitoring her.
Page me if anything changes.
All right.
That's it.
Shall we?
You really thought I would come here
and question why Yang
didn't get a Harper Avery?
Well, you're a proud papa.
She's your prize student.
I know it's important to you.
I-it's important to the whole hospital.
And you're an investor in that hospital,
so I think it'd be important to you, too.
It is.
That's why it's good that there
is an impartial committee.
Well...
"Well" what?
It's not that impartial.
Look, it makes no sense that she lost.
See, I read her paper,
I read every other nominated paper.
There's no comparison...
unless there was some statistical
calculation she blew,
some gross error
buried way down in the data.
You know as well as I do
none of them even holds a candle
to what Yang's been doing.
Number one, I'm glad you're alive.
Number two,
who do you want me to go after?
- Because I'm in your corner.
- Mer.
But I can't be in your corner
if you disappear on me.
- Mer, not now.
- Nurse: Dr. Yang,
they're asking for you in the CCU.
Ivy McNeil's SATs dropped below 70.
Dr. Yang. You're back. Thank god.
Ivy's heart is failing.
She has a lot of fluid in her lungs.
I need to intubate right away.
Prepare for RSI with 15 of
etomidate and 10 of vec.
Link. Link, don't look, buddy.
I'm here, honey.
Push etomidate.
I barely
got two words out of her.
She's obviously not okay, right?
You said she got
pulled into an emergency.
I'm sure she's fine.
You know, this is the most
time we've spent together,
just the two of us, in weeks.
It's really nice.
We have to do it more often.
Grey?
Should have left a tie on the door.
About your portal vein project...
Do you really need lab
staff five days a week?
- Yes. Say yes.
- Yes. Why?
- The foundation is trimming research.
- What?!
- No, no, no. They're just looking...
- The hell they are...
the Harper Avery foundation
doesn't make any decisions
about this hospital.
If there's one thing
the Harper Avery foundation
can't do well,
it's decide who should get something.
Okay, I am just...
Tell them that if they cut my funding,
I cut their tires.
Cristina Yang deserved that award,
not Dr. Nobody Sucksalot from Hopkins.
And tell them in short sentences
with little, tiny words,
because they are boneheads!
And we were having so much fun.
Jackson and I
aren't having just a fight.
This is important... it's not something
that can be just glossed over,
ignored, or fixed.
It... I can't pretend like nothing's wrong.
Yeah, I know. I know.
You said all that last night,
then again this morning over breakfast.
And now... you're saying it all again now.
Hey. Wow. Look at that.
His ex-fix really looks ready to go.
Sadly, I think our work is done here.
W-w-wha... y-y-y-you're leaving?
Y-you're not leaving.
Don't we need to review
the measurements with imaging?
No, we do. We do. Uh, it's just...
We should really stay out
of Kepner and Hunt's way,
so we're gonna do it in radiology,
where there are bigger screens
and better lighting. Sound good?
Well, we're almost done here, so...
N... take your time. Let's go, Wilson.
We should take him home!
Let him get better!
Let this treatment get more established!
We don't have to be the guinea pig!
But the treatment
can bring us our son back.
He can live a normal life.
Or it could kill him!
They say it won't, but this therapy
is made with HIV.
That doesn't freak you out?
It's deactivated!
Do you even know what that means?!
Do you know what that means?
Excuse me. I need to do one
final blood test on Braden.
No! No more blood draws! No more injections!
Nothing else! We're done!
This treatment is too much!
It's killing him!
Okay, Teresa, look,
I know that you're scared.
Teresa...
No, tell Dr. Bailey
we have changed our minds.
You're not injecting Braden with
anything today. You got it?
The last time
that we were on a plane...
Can we not talk about the
last time you were on a plane?
No.
Alex, the last time that
we were on a plane together...
the first time we met.
Look, I know
you brought me on this plane
to talk me out of taking this job.
We'll be in Portland soon.
Just get it over with and
say what you're gonna say.
It's not like I can go anywhere.
We were on our way to pick up a liver
and a small bowel for a 10-year-old...
And now you think I'm selling out,
that I'm choosing money over substance,
and that it's a waste of
my talent or whatever...
That there's more to life
than nice schedules and a big, fat paycheck.
Well, I've thought about it hard.
You've been awesome, but I've
already stayed here once for you.
I have to start thinking about myself,
about what I want.
I've worked hard, and I deserve this.
I deserve to think about
myself for once, okay?
Yang is a robot.
If I just lost the Harper Avery,
I'd be awol,
in my bed with a bottle of scotch.
Although, she did just throw pickups
across a crowded O.R.
Yang's a surgeon.
She cares more about
her patients than stupid awards.
What's the latest A.B.G.?
Uh, pH is 7.15,
pCO2 is 52.
Crap. She's acidotic.
Push bicarb and increase her sweep.
- Okay.
- Okay, good. Good.
Shane, she's bleeding.
It's coming
from one of the suture lines.
Page Dr. Yang now!
Ivy's lungs are doing
better after the intubation,
but I need to place a special line
to get a more accurate
measurement of her heart.
You may want to leave during this procedure.
No. I'm staying. I want to stay.
You ran in here after
Frankie's surgery. Is she...
There was a... complication
with Frankie's donor heart,
but a second one has been located,
and it's on its way.
I just wanted to keep Frankie
in the O.R. until it arrives.
What?
Is... is that safe? Is she gonna be okay?
She's being closely monitored.
Dr. Yang,
Dr. Ross and Dr. Murphy are
on the phone from O.R. 1.
Put them on speaker.
- Ross, update me.
- I'm here with Frankie's dad.
Frankie's bleeding
from one of her suture lines.
And she's really acidotic.
- John, you should step out.
- I'm staying.
- Ross, did you push bicarb?
- We did.
- How are her coags?
- Stable, but this bleed isn't slowing down.
Okay, well, you need to stop that bleeding.
If she continues to bleed...
The triad of death... we know.
I'm so sorry, sir.
Okay, throw
a horizontal mattress stitch,
but careful with her tissues.
They're extremely friable, so soft hands.
You're on the right side of the table.
You have one chance,
or else you could rip through the aorta,
which is essential to connecting
the new heart when it arrives.
Nope.
Just take a breath, just throw the stitch.
You can do this.
I've never put a horizontal mattress
in an aorta before... only in a bowel.
From this side, I'll just
tear through her native aorta.
- Well, what if I tear through it?
- You won't!
You can do this.
Ross! Murphy!
We got it. We stopped the bleed.
She's fine.
They're both fine.
She gets results.
She always has, and this is no exception.
M-make me understand,
because my read is that Yang
should have clearly won.
I mean, what am I missing?
From where I'm standing,
she had it by a mile.
Richard, honestly,
tell me you're not this naive.
Well, what is that
supposed to mean?
The Harper Avery foundation
co-owns the hospital
Cristina Yang works for.
She could never win that award.
I don't know how long
this stitch is gonna hold.
- pH and bicarb?
- Man: 7.0 and 14.
Dr. Yang, now she's oozing from the IVC.
- I see it, Shane.
- Aren't we gonna put in a suture?
If we just keep throwing in stitches,
she'll dissect all over the place.
We have to get Frankie off this table.
How? She's getting a transplant.
In this state, she'll never survive it.
First, she gets a lemon heart,
and now we don't know
if the new one's gonna make it?
Wait. Is that Robbins?
How we doing?
The heart is out, and we're on the move.
Want to let the coordinator know?
Oh. Phone the pilot.
Let him know we're on our way.
So, this is how it's gonna be now?
Radio silence
till the end of my fellowship?
That's how
you're gonna leave things?
Alex, I brought you here today
because I trusted your skills
to properly procure this heart.
And then we got on that plane,
and I started feeling sad
because you're leaving
soon and I will miss you.
I didn't bring you today to scold you.
I'm proud of you and I'm happy for you,
and all I wanted was to share
a freaking memory, okay?
I was being sentimental!
Oh.
You know, if I take the job,
I'm still gonna have hospital privileges.
You'll see me around.
Shut up, Karev. Moment's ruined.
Just a few more sutures.
You know where he was when he got hit?
He was crossing highway 519.
He could see the water.
All he wanted to do
was walk from ocean to ocean.
He was just so freaking close.
Okay, let's check the pulse.
It's not fair, you know?
You make a commitment,
it's supposed to mean something,
and then a... pickup truck
just takes you out.
Hey, you okay?
S... sorry.
I just f-feel like
this fight with Jackson is,
like, the fight,
and I...
I don't know how we recover from it.
Listen.
Some fights, you just can't get past.
You know?
Like me and Cristina,
it was... it was about kids.
You and Avery?
This is your first fight.
You will get past this,
and then something else will come along,
and you'll fight about that, too.
And you guys will recover every time.
This is not your pickup truck.
Now that it's thawed,
and I've added the virus to the culture,
I just have to wash them down
and give him the injection
within the next four to six hours,
and then, theoretically,
that's when the magic will happen.
See, that's the problem, though, Bailey.
So far, all of this is theoretical,
and the foundation needs actual results.
I need you to help me out, okay?
Give me something, anything concrete,
that shows that your project
is producing results.
No, d... it will be.
Once I give this targeted gene therapy
to my bubble boy, I know it will.
I-I can feel it.
Okay, I can't exactly pitch
that we need to keep your lab
because you have a feeling, can I?
You said you're doing this today?
Yes, I am.
And it's going to work.
Dr. Bailey, do you have a minute?
You pursued her. You encouraged her.
You all but told her she was a front runner,
when you knew she was
nothing but window dressing.
She was not window dressing!
She was nominated for a prestigious award
that brought publicity to
her and the hospital.
You used her!
She was never gonna win that
damn thing for a second.
Nobody from Grey-Sloan memorial
will ever win a Harper Avery,
will they... ever?
Do you want me to remind you
why there is
a Grey-Sloan memorial hospital?
Or should I just take
my $24 million and go home?
What draws me to you,
Richard, is your idealism.
I find it extremely attractive.
But this is business.
And I do not appreciate
your coming all the way across the country
to harangue me about the fact
that your prize pony didn't get a ribbon!
And if it makes you feel better...
she had the votes.
Are you that naive?
Catherine, do you really think
that's why I came all this way,
why I planned an entire weekend
with the things that you love?
- Richard...
- I made reservations at Cipriani's
because I know you love it there.
And I was going to wait
until just before dessert
and the waiter was gonna bring
you a glass of champagne,
and I was going to tell
you how much I love you
and how right for one another we are,
how you make me feel excited to be alive,
how you give me a reason
to get up each morning
and say a thankful prayer every night.
I was gonna ask you to be by my side
for the rest of our lives.
That's why I'm here.
That's why I came.
And now I'm leaving.
I'm-I'm sorry. What?
You're gonna have to say...
You're gonna have to say it all again.
Dr. Robbins is on her way
with a new heart for Frankie,
but Ivy's deterioration has caused her
to shoot up to the top of
the transplant list, too.
Ivy is also a perfect match
for the donor heart en route.
But t-that's Frankie's heart.
Officially, yes, but...
under the circumstances,
the heart could be redirected.
To Ivy?
You w... you want to give
Frankie's heart to Ivy?
No, I don't want...
Medically speaking,
Frankie's condition is declining rapidly.
Technically, Ivy is more stable,
which would give the heart
a better chance of survival.
Wait. Just...
But... b-b-but if Frankie's worse,
don't you have to give the heart
to the one that's the worst?
Unless she thinks it's a waste.
You think the heart will
be wasted on Frankie?
I just want to explain all your options.
Our options? This is our decision?
Wait. You're... you're asking us to choose?
You want us to try to pick
which of our children gets a heart
and which one doesn't?
Frankie can be fitted with
a total artificial heart for now.
We can't choose. You have to do it.
We have three children, Dr. Yang...
Three... amazing...
beautiful, kind children.
And we can't...
we can't try and pick between two of them.
We won't.
You have to make this decision.
Please.
Please.
There you are.
Frankie's heart is as stiff as a rock,
and Ivy's got
global systolic dysfunction.
It's absolutely impossible.
Why didn't you call me?
Mer already
yelled at me about this.
I'm sorry, okay? I just...
I wanted to be alone, so I left.
I'm not talking about...
I just heard about the McNeils.
You should have called me to
help you make this decision.
No surgeon should have to make a
decision like this on their own.
That's why I'm here. That's why
you have a chief of surgery.
They're my patients. I know their status.
I can decide this.
But you don't have to.
Yes, I do.
Prepare to start
sectioning off the vessels.
Is that a Gustafson artificial heart?
We're getting Frankie off
this table immediately.
And the heart that's on its way?
We're reallocating that heart.
It's going to Ivy.
Russell's prepping her now.
Okay, let's move.
You guys gonna be home for dinner?
Yeah. Sure. Sounds good.
Okay, awesome! Can't wait!
Yeah, neither can we.
Does that mean what I think it means?
That there's gonna be dinner waiting for us
on our dining room table when we get home?
Have we ever even used
our dining room table?
Just remind me to thank my sister
for letting me actually spend
an entire day with my wife.
Well, she's not a permanent solution.
Ah, not yet,
but we have a spare bedroom.
We could give her surgical privileges.
That would give her less time for childcare.
I know it's not permanent,
but we spent an entire day
without dropping any balls.
You know, maybe she'll
even put the kids to bed.
Maybe we could have some wine.
You know, Amy is making dinner for the kids.
Maybe we have time for a little mm-mm.
It would be a shame to end such a great day
with no dessert.
Why aren't you trying
to talk me into staying?
Oh, god. Are we still on this?
Can't we just focus
on transplanting the heart
we just retrieved?
Yeah. Never mind. I'll shut up.
Of course I want you to stay.
But this sounds like
an incredible job opportunity,
and you're right...
you did stay here for me once,
and I don't want
to stand in your way again,
so if you want to leave, you should leave...
but not because of something
that I do or don't say.
You should leave
because this is
the next best thing for you
and because you're excited about this job
and you're ready to go do great things.
And collect a big, fat paycheck.
Really big.
I guess you have a decision to make.
Don't screw this one up.
Okay, let's transport her.
B.P.'s stable. I'm gonna see
how Russell's doing with Ivy.
Bring in the bed.
What happened?
Ventricular pressure's up to 200.
She's dissecting.
Now she's plummeted to 15. What the hell?
Damn it. It-it ruptured.
Okay, we're gonna have to reopen her.
Staple remover!
I mean, the thing I don't understand is,
won't Braden die
if he doesn't get this treatment?
It's possible.
So...
I mean, does this happen often
with experimental treatments?
That the parents or the guardians
just withdraw their consent?
Please stop talking.
And then what do I do
with these consent forms she just signed?
I mean, do I... do I shred them?
Do I toss them?
I told you... stop talking!
Uh, I'll take care of those.
Just get one damn suture to hold.
How's her ventricular pressure?
Zero.
Pupils?
Fixed and nonreactive.
Cristina.
What?!
Cristina, we've been at
this for almost an hour.
Ivy's transplant went perfectly.
Her post-op echo is completely normal.
She should be awake soon.
And Frankie?
No.
No!
I-it can't be.
You...
Well, how-how the hell did this...
We trusted you!
What the hell did you do to our child?!
We are so sorry for your loss.
Oh, god!
We need to be with our kids.
Your stitch held.
So?
I've never seen vessels that friable,
and I've been around
a lot of diseased hearts.
You did an amazing thing.
Shane, the kid died.
It wasn't anything you did.
They want us to be
the center of innovation,
- but they don't want to pay for it.
- They love it when we innovate.
They nominated Yang for an award.
She was robbed. They're boneheads.
We can't give with one hand
and take with the other.
We have to stop this.
There's no stopping this.
Guys, they own the place.
We are just their managing board.
This conversation is our relationship now.
Best we can do is try to guide
them to make the right decision.
That's by making our own decision,
as tough as that might be.
Look, this is my report, all right?
All the projects are here...
operating budgets
versus progress to date.
Best to worst.
Take a look, but the decision
is pretty clear to me.
Uh, y-you got a second?
- Never mind. I'll come back.
- No, no. Alex, come in.
You okay?
Uh, yeah. Yeah.
I, uh, just wanted to let you know
that, uh, my fellowship is, uh, almost done,
and, uh... well, I got an offer
from Lebackes
pediatric surgery clinic,
Oliver Lebackes' practice,
and, uh...
well, I gave it
some serious consideration,
and I've decided to take it.
So, I guess this is my notice.
Cristina, please don't
disappear on me again.
Where are you?
Please, just... call me.
Hunt. We need to talk.
If it can wait, I really...
No, it can't.
Well?
I almost didn't go through with it.
But... then I did.
And I think
it's gonna be good, right?
Are you kidding?!
It's gonna be awesome!
Baby!
Oh. Compartment syndrome?
Yes. Blood went everywhere.
Mm. Torres loves that trick.
You should just toss those.
I know. You're right.
Why am I scrubbing those nasty things,
when now you can afford to buy me new ones?
What happened?
Wait. Where are the kids?
They're asleep... totally fine.
What's wrong?
I can't do this.
The children broke your sister.
No, it's not them.
I didn't come here to see how
your perfect life worked.
I came to see if I could do it...
the whole freaking thing,
the kids and marriage and
the full-time careers...
because I want that... with James.
And I am wrecked after one day.
It goes on the list of things
that I suck at because...
I can't.
Well, I knew that was too good to be true.
Why don't you go fix your sister?
I'll order takeout.
Hey.
Hey.
So, you are...
Right.
Uh, I'll see you tomorrow.
April.
I said a lot of things the
other night that I regret.
And I'm sorry that I hurt your feelings.
I'm sorry, too.
Good. So come home. Stay.
This is a conversation we're
always gonna have to have.
It's a part of who we are.
It's gonna take some talking.
But we got married. We love each other.
We made vows to push
through this sort of thing.
I know.
I love you, too, and we made a commitment.
And if you believe in god,
then you believe he made me...
your husband...
who shares your values, which I do.
I believe
we shouldn't kill or steal.
I believe
that you should be truthful.
I believe
that you should treat others
the way you want to be treated.
I agree.
So, then, we can
push through this problem.
At our core,
we believe the same things.
Until I think about telling our children
how unbelievably loved they are
by the creator of the universe,
who also made them,
and I can just see you standing there,
judging and dismissive,
and I just can't get past it.
Can we please just take a break
from our hypothetical children for...
No, we can't, because
they're not hypothetical anymore.
Jackson, I'm pregnant.
So, what do you do?
How do you decide?
When you're left in the dark?
How do you make sure
you're not making the worst mistake
of someone's life?
So, now what?
We just... cross our fingers
and hope he gets better?
Guess so.
Good night, Edwards.
You close your eyes...
You block out everyone
and everything around you...
Cristina?
Cristina?
Cristina?
Are you okay?
Cristina,
they were very sick kids.
Every one of them
would have been looking
at a death sentence without you.
The fact that any of them survived...
I know this, Owen.
Frankie was on borrowed time
from the moment she got here.
You made the right decision.
You made the right call.
I know I made the right call.
You don't have to tell me.
It was an impossible decision,
and I stand by it.
I did everything...
exactly as I was supposed to.
I did it perfectly.
So what is wrong?
What's the point, Owen?
What's the point of anything?
You won.
The Harper Avery... you got the most votes.
Richard just told me.
The politics screwed you.
The foundation's relationship
with us... they used you.
You never stood a chance.
And pray that the voice
inside you...
Is right.
Because once you've decided...
You can't ever go back.