Grey's Anatomy (2005–…): Season 11, Episode 24 - Time Stops - full transcript
The doctors must set their emotions aside and focus on a catastrophe.
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Time stops
when you're in the OR.
You step up to the table,
you evaluate the patient,
you pick up a scalpel...
He's too big for that.
...and then you go into a bubble.
It's just you and your surgery,
and nothing else matters,
not time, not pain, not exhaustion.
Nothing.
Ripped By mstoll
Hey, just finished my corpectomy.
- Did I miss it?
- No, you're good.
Wow.
- That was fast.
- What was fast?
I put out feelers with a real-estate agent
about the house,
and looks like I got an offer.
- You're selling the house?
- No.
I don't know. Maybe.
Why do people constantly feel
the need to kill their arteries?
Are they here yet?
Oh, did I miss it? Tell me I didn't miss it.
- Nope.
- I almost forgot.
I can't wait to see the beads of sweat
on their freaked-out little faces.
- Oh, man. Did I miss it?
- Nope. Nope.
I want to see someone crap,
actually crap.
Seen it, smelled it.
Not as fun as you'd think.
It's happening!
The baby chicks and ducks are here!
It happens in real life, too.
When something big happens,
something tragic,
you freeze.
You retreat into your happy bubble...
- Derek.
- Derek.
- Right. Meredith.
- Meredith.
...for what seems like a second
until you look up.
And suddenly you realize
it's a whole new year.
Each of you today comes here hopeful,
wanting in on the game.
A month ago, you were in med school,
being taught by doctors.
Today, you are the doctors.
The five years you spend here
as surgical residents
will be the best and worst of your lives.
They will...
- You have a question?
- Yes. Why?
Uh, you raised your hand.
No, I'm sorry. I mean, why will these be
the best and worst years of our lives?
- Uh, I was getting to that.
- Sorry.
Um, where was I? Oh, right.
You will be pushed
to the breaking point.
Look around you.
Say hello to your competition.
Eight of you
will switch to an easier specialty.
Five of you will crack
under the pressure.
Two of you will be asked to leave.
This is your starting line.
This is your arena.
How well you play,
that's up to you.
- They look stupid.
- They look like babies.
Were we ever that young?
- They're so well rested.
- And stupid.
- And eager, like puppies.
- No, not like puppies.
- Chicks and ducks.
- Chicks and ducks.
When did we start calling them that?
You've been gone for a year.
Left to their own devices,
they would drown.
And take the patients
down with them.
God help us all.
They look good. Pretty good.
Some of them.
I mean, for chicks and ducks.
I'll at least get some good ones, right?
You'll make sure I get some good ones?
Yeah. You're gonna hook me up.
Uh, listen up. This is Dr. Edwards.
Some of you are lucky enough
to be under her supervision.
Listen closely to everything she says.
Observe. Learn.
She has the power to mold you
into fine surgeons.
Thank you, Dr. Webber.
Oh, and congratulations, sir.
Dr. Webber's getting married
this afternoon.
Wow.
- Mazel tov, sir.
- Congratulations.
- Hooray!
- Thank you.
Now, um, who's got Dr. Edwards?
I did not hook you up.
All right. I have three rules.
One, listen to the nurses.
Respect the nurses.
Do whatever the nurses say.
You may think
you know more than the nurses.
You do not.
- Two, your life is now all about me.
- Charge to 200.
- Not about you or your boyfriend...
- Charged.
Your fight with your sister
or your nasty little rash down there.
So, when we are focused on me,
we are learning to be surgical gods.
When we are focused on you,
we're working at a gas station.
Three, no complaining.
You complain and you are out. Got it?
You. Rules. Repeat.
Listen to nurses, worship you,
complain and die.
Good. Let's go.
Hunt. How much longer is Richard
gonna be interim chief?
Because I want to expand
my department,
and he has kind of
a different approach to the budget.
- So, when are you coming back?
- Uh, I'm not.
The board's gonna appoint a new chief.
We are? When?
- Why?
- Yeah, why?
Because I've been chief long enough.
And it's time for something else.
Dr. Meadows. Dr. Meadows.
Jackson. Jackson!
This is... You are just making a mess.
- What are you doing?
- Oh. Do you want some?
Sweetheart, you don't have to be here.
Really, I'm fine.
I am supporting you.
I'm your maid of honor.
April said the job of the maid of honor,
support the bride, keep her company.
So, I'm supportin'.
I'm keeping you company.
You know, Meredith also said
that the maid of honor
drives the getaway car
if you want to make a run for it.
So, you know, you want to make
a run for it, I'm standing by.
Ready to go. Just give me a holler.
Until then, we're up on LA by four.
I thought April would be with you
when you came over.
Is everything okay?
- Yeah. Fine.
- Mmm.
Well.
I know it's a challenge.
The woman that came back
from the combat zone
is not the same girl that left here.
April has changed.
It would be understandable
if that created problems.
Jackson.
Is that Richard? Tell me that he's here.
Tell me he's here, finally.
I told him not to go to that hospital.
We interrupt this program...
It's not Richard.
...to bring you late-breaking news
from our studios
- in downtown Seattle.
- What's wrong?
These images are just coming in.
- You know how many incoming?
- No.
We don't even know what happened.
But it is big.
I guess we're probably not making it
outta here in time for that wedding.
- You did a lobectomy on a dirt road?
- Well, we had to.
The nearest medical center
was 150 miles away.
- Does anybody know what happened?
- Not a clue.
So, was it just a 24-7 adrenaline rush?
- What was a 24-7 adrenaline rush?
- The desert. No.
You get desensitized pretty fast.
There's another group leaving
in two weeks if you're interested.
You're not living in a tent.
- I grew up in a car.
- That had doors.
- We should both go.
- I'm definitely not living in a tent.
Okay. Here we go.
- What have we got?
- Mid-60s female with crush injuries.
Massive blood loss at the scene.
We've done chest compressions
for 28 minutes.
A 49-year-old male.
Went into V-fib en route.
Shocked times three.
He had two rounds of epi and vaso.
There are four more
ambulances behind us.
Every last one of them's
got nothing but DOAs.
- What's going on?
- Why aren't the ambulances unloading?
Because they aren't ambulances.
They're freakin' hearses.
All the patients are dead.
What the hell happened out there?
A tunnel on 99
collapsed during rush hour.
The north entrance
completely caved in,
trapping nearly 20 vehicles
under the rubble.
Do we know how many victims?
They're trying to get people out
as fast as they can.
But for now, we're just waiting
for them to find someone with a pulse.
How many dead?
- Thirteen fatalities so far.
- God.
- Coming through!
- We got a live one! Clear a path!
Scott Henry, 17 years old.
Penetrating trauma to the abdomen.
He arrested as soon
as we took him off the rig.
Let's get him into trauma one,
- and page Karev!
- On it!
I know everyone wants to help,
but back up, give them room to work.
Dr. Karev to the ER.
Dr. Karev to the ER.
We got one alive. There could be more.
I wouldn't get your hopes up.
- There could be more.
- There could be more.
There could be more.
Three rigs pulling in now
with more right behind them.
They don't know how many, but they'll
bring as much as we can handle.
We've got live ones coming in, people,
and we want them to stay that way.
We need surgical trays
by each trauma bed,
and reserve O-neg on standby!
There's always more.
Uh...
I know.
Look, I am sorry.
I was on my way to the hotel,
but we crashed the OR floor.
- It was too big just to...
- I'm not here to haul you out of here.
I'm here to help.
I'm looking for a pair of scrubs.
This. This is reason number 537
why you and I are made for one another.
- Surgery is sexy, honey. It's hot.
- Yes, it is.
- And tonight, on our wedding night...
- Mmm-hmm?
...Dr. Webber,
I'm gonna show you just how hot
- a morning surgery can make me.
- Mmm.
There are people dying.
You are so uptight for a best man.
Now, don't worry.
You're not off the hook.
Good. I've never been
anybody's best man before.
You know they're appointing
a new chief soon.
I'm recommending you.
Unless you don't want it.
No, I've just heard you
say this once before.
About the board seat.
But then I find out
it'd been given to Alex Karev.
You're like the chief who cried wolf.
Who's on the board now, you or Karev?
Dr. Teller, extension
2219. Dr. Teller, extension 2219.
Heel, ducklings! Heel!
A 34-year-old pregnant female
with prolonged extrication
from a crushed vehicle.
Her name is Joan Paulson.
She's 40 weeks pregnant
and in active labor.
BP's 100 over 60.
She's been complaining
of severe neck pain
and an obvious fracture
of her right arm.
- And who are you?
- I'm Andrew. Sorry.
I was on my way into work.
I saw the collapse. I stopped to help.
We've got to go back!
We've got to go back!
- We've got it from here, sir.
- I'm a doctor. Actually a surgeon.
Her contractions are five minutes apart.
- Her husband's still trapped in the car.
- Let's page OB!
You've got to get Keith out!
Please, you've got to go back
and get him out!
Hey, don't you worry, okay, Joan?
We just need to focus on keeping
- you and your baby healthy.
- All right, thank you.
That was Urban Search & Rescue.
They have a victim they can't extract.
They need us to send a team.
Who's on the field rotation list?
We've got Pierce, Shepherd,
Kepner, and Grey.
- No, Grey hasn't been cleared yet, sir.
- I'll sub in for Grey.
And leave everything going on here?
It's a mass casualty.
- Grey!
- You need me?
We're sending a team on-site.
You've been cleared. Go get ready.
She's still supposed to be supervised.
She had a year off.
You can't give her special treatment
just 'cause something bad's
happened to her.
- You can't spoil her like that.
- The hell I can't.
Dr. Sanders, 1524. Dr. Sanders, 1524.
Ow! Careful!
- We're looking for our friend!
- Are you a doctor?
- One at a time.
- His name's Scott. He's 17.
Uh, he was in the backseat
when this huge piece of cement
came down and...
He was really messed up.
They took him away in an ambulance.
We just got here.
We're not even from Seattle.
- Okay. Uh, where are your parents?
- Back home. In Missoula.
They didn't come with us.
Our parents let us do stuff.
We don't get in much trouble.
- We're...
- Dorks.
We're supposed to be
touring UW right now.
Wilson. We could use some
more hands on our kid in trauma one.
- Is he talking about Scott?
- He's not gonna die, right?
Is that Scott?
- V-fib.
- Push an amp of epi.
Charge to 150. Paddles!
- Wilson, get in here and help bag!
- Clear!
Fetal monitor is on. OB is coming.
And, we should get Ortho
take a look at her arm and her neck.
- On it! Right away!
- My baby. Is my baby okay?
Baby's looking just fine, Joan.
Heart rate's right on target.
Dr. Edwards, is it true
that the fetus can be compromised
if the patient is in the supine position?
The fetus is compromised?
- Out.
- I'm sorry, did you mean...
Out! This is not question time.
All of you just go to Radiology.
Check on the reads.
I will call you if I need you.
- Where is Radiology...
- Scram!
The contractions
started this morning.
The doctor said we could take our time,
but I wanted to leave.
I made Keith take that stupid tunnel!
He wanted to take the bridge,
but I said the tunnel was faster.
I'm constantly telling him what to do.
How long have you two
been married, Joan?
We're not married.
We met each other
nine months and three days ago.
I barely knew him.
It's crazy
what you find out about a person
when you get knocked up
on the first date.
We're gonna get married next week.
Please tell me
we're getting married next week.
Get some water over here.
Over here!
Tape, bandages, and a splint.
Will someone call
my husband? I need my husband!
- Help me! Help me!
- Okay, all right. Calm down.
- Please! Please!
- Tell me your name.
He's 10 years old.
T-shirt and jeans.
- He was in the backseat?
- Yes.
Ma'am,
can you follow my finger?
His name is Tyler.
Stay with me, okay?
Help us.
- You're the surgeons from Grey Sloan?
- We are. Where's the patient?
- This way.
- We're gonna help you.
- What's his name?
- Keith Gardner.
We got one. He's still alive.
My ear!
I can't hear anything!
Help!
Car's been crushed
by debris. We got his wife out, but...
- Oh, my God.
- He's in there?
- He's alive?
- Barely.
Back on the truck.
All right, come on, you guys.
We're gonna
get you out, buddy. Don't worry.
Hey, Keith.
My name is Meredith.
We're gonna get you out of there, okay?
That'd be great.
- How do we even start?
- We just do.
The door's coming off!
I'm looking for my wife.
- There.
- She's good.
- I need some more lap pads in here.
- You got it, Doc. Here you go.
Keith, can you follow my light
with your eyes?
My fianc?e, Joan, she was with me.
Is she okay?
We saw her arrive at the hospital.
She's alive.
Okay. Okay. Good.
She made it there. She's alive.
I need some packing!
Do you know
we're having a baby?
Keith, we're trying to listen
to your breathing.
Stop talking, please.
It's hard to hear breath sounds out here,
but he could have a collapsed lung.
How's his abdomen?
Lot of blood,
from what I can see.
Keith, I'm just gonna check
your torso, okay?
He's impaled in two places.
- It's pretty bad, huh?
- It's pretty bad.
But I've seen worse.
Okay. Make sure you got
that crushed leg.
Call Respiratory for bed two,
and get a repeat crit on bed eight.
- Thanks.
- Uh, Dr. Hunt?
- Yeah?
- Hi. I'm Andrew DeLuca.
Oh, right. You came in
with the pregnant woman.
Yes. Is there any paperwork
I should fill out or...
You can do it later if you're good
to just jump in and keep helping.
Of course. Sure.
- Oh, God, there's another one!
- Okay. Keep breathing. Nice and slow.
Edwards, nice job reducing the wrist.
Actually, Dr. DeLuca did that
in the field.
- Doctor who?
- Me. Hi. Dr. DeLuca.
- He was at the scene.
- Paramedics ran out of splints,
- so that's actually my tie.
- Was your tie. Sorry.
It's not a problem.
It was my favorite one, though.
- Oh, God!
- All right, 3 centimeters dilated.
- I think she has a fracture at C5-6.
- What's a C5-6?
Joan, you fractured
a bone in your neck,
but it is stable for now,
so we will fix it after you deliver, okay?
Keep her in the collar
until her labs come back,
then we'll get her upstairs
so she can deliver,
- and repair the fracture.
- Got it.
Have them page me
when her contractions
- become more frequent, okay?
- All right.
- Thank you so much for your help.
- It was my pleasure.
He's losing blood faster
than we can put it in him.
- We should get him upstairs.
- We need to open his chest. Glove me.
Crack his chest and then what?
That still might not buy us enough time
to get to the OR and fix his injuries.
- Then we stop time.
- How?
Put him on bypass,
drain out all of his blood,
and replace it with cold saline,
and then we operate.
- Can you do that?
- No, he can't. That's way too risky.
We put him in suspended animation,
cooling him from inside out,
his brain, his heart, his organs.
That buys us an hour or two.
- Hunt!
- Ten blade.
Dr. Miguel...
How's it going out there?
Um, they're coming in faster
than we can treat them.
Um, listen, Catherine, I hate to say this,
but, you know,
under the circumstances,
do you think
we should postpone the wedding?
I already did.
My assistant is notifying
our guests as we speak.
Oh.
- You're sure you don't mind?
- Of course I mind.
But we both know where we need to be.
Hey, uh, Chief. We need you.
You can't just say
"suspended animation"
like it's a real thing. It's science fiction.
It's called emergency
preservation and resuscitation.
Trauma programs have been
discussing it for years.
It's a way to save patients
who can't make it to an OR.
Yeah, a risky way, an irresponsible way.
'Cause the safe option is to keep
transfusing him and race him upstairs.
- How do you do it?
- We cannulate the aorta,
drain out his blood, infuse cold saline,
- then drop his core temp to 50 degrees.
- You put him in hibernation?
You replace his entire
blood volume with ice water.
You're gonna do what to him?
- Get her out of here.
- So, you induce hypothermia.
Hold on.
We're not gonna consciously kill a kid
over something you discuss over beers
with your trauma buddies.
Kid's gonna die anyway. At least
this way we can try to bring him back.
- I say do it.
- No. It's way too experimental.
And we would need Pierce.
She's at the site.
This is not a cardio procedure.
It is if you can't get
his heart beating again!
What are you gonna do if you
can't get him back after bypass?
What then?
That's why we don't do things
like this on a whim.
- This is not a whim. This is a Hail Mary.
- On a child?
The patient is a minor.
We don't have consent.
By the time you find
the parents, it'll be too late.
I agree with Jackson. It's a no, Hunt.
We're wasting time
having this conversation.
Okay. We only need
two physicians to give consent. Karev?
Really?
- That's how you wanna play this?
- In.
Webber?
Chief?
- Just do it.
- I need a cannula!
Too many people have died today.
We're not adding this kid to the list.
- How's his airway?
- His sats are okay.
There's definitely blood
in his chest on the left side.
- Meredith, can you get the packing in?
- I'm trying.
I can't really reach it from this angle.
Uh, I need some more trauma pads
and cellulose polymer, please.
What's going on?
Whenever I press on the wound,
blood is flowing out of his abdomen.
The metal is tamponading it,
but it's not going to last very long.
And he needs surgery soon.
If he doesn't suffocate on his blood first.
I got to get a chest tube in here.
Do you have access?
No. Maybe.
We have to get him out of there.
What about
from the other side of the car?
- I could be your other hand.
- Yeah.
Do you really think
that you can get me out of here?
I have to. You said it yourself.
You're having a baby.
- Do you have kids?
- I have three.
Wow, three. One is freaking me out.
We did it backwards,
though, you know?
You meet someone, you, uh, fall in love,
get married, have a kid.
It gets bigger, right?
Joan and I, we did this huge thing first.
"We're, uh, having a baby.
Nice to meet you."
We're still getting to know each other,
learning all these little things.
It's good stuff.
She, uh, sleeps with her socks on.
- We like... We like watching tennis...
- Get me a stethoscope.
But not playing.
She likes techno.
Would have been a deal-breaker,
but we got this big,
huge baby thing coming, so...
I really... I really love all her little things.
It's like I'm home. She's like my home.
I should really tell her that.
Right?
Come on, guys!
I got it.
I should... Hey!
- Slow down!
- I'm sorry.
What is in your mouth?
A brie tart.
With prosciutto.
Brie? Brie!
Um, there are patients here
that had chunks of cement
fall on them
during their morning commute.
But, please, have some brie.
While carrying lab samples.
That's nasty.
What's the matter with you?
Oh. Where'd you get this?
- It looks wonderful.
- What the...
Did you try this? I'll try that.
No, yeah. It's vegetarian.
Oh, hey, I heard Catherine Avery had
all the food from the wedding
sent here, you know, for the staff,
and I have two minutes.
How many sliders you think
I could eat in two minutes?
Is that pesto?
Do you think that Catherine's
gonna help pick the new chief?
- I mean, why wouldn't Hunt just do it?
- I don't...
God, it would save us so much trouble.
The 12-page r?sum?s
and the phone calls
and the polite vetting and...
Who would want to be chief?
Would you?
I... Well, I had... Are you asking?
Hunt should just do it, right?
Oh.
Those crab cakes look really good.
But I don't want to
make a pig of myself.
Exactly what I was thinking.
Exactly.
Well, yes.
Yes, I would like to be chief.
- Did you get ahold of Scott's parents?
- Not yet.
We left messages. We're trying.
I mean, they should know
that you're killing their son.
- I'm sorry, what?
- Yeah.
- We have some questions.
- From our research, we think this plan
is completely untried and experimental.
Your research?
You're trying suspended animation
through induced hypothermia.
- So, you heard Dr. Hunt.
- It's basically science fiction.
It's still undergoing clinical trials,
and there's
no documentation suggesting
that this will work on humans.
Whoa, whoa!
Where did you get this research?
Dr. Hunt, this procedure's
only been successful on pigs?
Wait, what?
It wasn't successful
on humans?
It hasn't been tried on humans.
They've started trials,
but they have no outcomes. Not yet.
Core temp's down to 55.
- Where are you getting this?
- Those kids. His friends.
You said there were techniques
that were developed
and the studies were published.
The animal studies
have had incredible success.
And the technique
has to start somewhere.
I can name 30 soldiers
this technique would have saved.
So, you want to try it
on a high-school kid
without parental consent?
You better pray this works.
Even if we resuscitate him,
he could end up brain-dead.
His core temp's down to 53.
It doesn't matter now.
We're doing it. We've done it.
- So, either get on board or get out.
- Karev is right.
Anybody who doesn't
want to be part of this
is welcome to leave.
I'll stay.
We're there. Core temp's 50 degrees.
Okay. He's cold.
We have an hour, 90 minutes tops.
We ready?
Start the clock. Scalpel.
- I said no.
- I know what you said.
If anything goes wrong in that OR,
it jeopardizes
our entire surgical program.
It could be the boy's only hope.
I don't need you to defend
the technique to me, Richard.
- I need you to follow orders.
- Orders?
- I'm an owner in this hospital.
- I am, too.
- But I'm also the chief. It's my call.
- You mean interim chief.
That boy had no chance.
We're giving him one.
I don't feel bad about that.
Now, if you'll excuse me,
I have another surgery.
We can't tell where
Keith ends and the door begins.
If we use the Jaws of Life to get him out,
it'll rip him to shreds.
He'll bleed to death in seconds.
What about trying an ex-lap?
Then we can try to separate...
We're not sterile.
There's no blood bank.
This is not a controlled environment.
I know. I know. I know.
We could put a balloon catheter
into his aorta.
It could buy us some time.
If we were closer
to the hospital,
I would say maybe,
but we're 25 minutes out.
- He'll never make it.
- Okay, what if...
He's a black tag, guys.
We can't do anything else for him.
Then I'm calling it.
We're gonna cut him out.
Maybe we'll get lucky.
- You should go.
- No, we can stay...
I'll stay.
You go save people that you can save.
I'll do what I can for him.
Okay, Keith.
We're gonna cut you
out of there now, all right?
Sure thing.
Uh, Joan, Dr. Edwards asked us
to take you to the OR now. Okay?
And we can do that,
because we know exactly where that is.
I knew our first day would be intense.
I figured we might get to watch
some stuff or start an IV,
but there was a mass casualty today.
I've never seen
so many mangled people,
so many dead people.
Doctors from this hospital
just spent hours in the field
trying to extract a guy.
Hours. That's gonna be us some day.
Did they get him out? The guy?
Huh? Oh, no, I don't think so.
I heard he was too far gone.
- Can't breathe.
- So, they just left him there?
- Got it.
- I can't breathe.
- I can't breathe. Let me out.
- What?
- Okay. Is it the collar?
- I need this off.
- I need to get out.
- Okay. I can loosen it.
- Not much, but maybe a little.
- I need to get out.
- Should you do that?
- They left Keith.
They left Keith. He's gone!
No, don't!
There's a shock through my body.
What's happening?
We need to stabilize her spine.
Um, help me reduce her dislocation.
I'll hold her steady
and you attach the tongs.
- What, me?
- Yeah, I got her. Go.
If we hurry, maybe we can
save her from total paralysis.
But I can't.
I mean, I could try,
but I don't think it's the best idea.
- What do you mean? Just attach...
- I don't know how to do it.
- Why?
- 'Cause I'm just an intern.
Okay? Today's my first day. I was late.
I was on my way here.
I saw the tunnel collapse.
What? You're an intern?
- Maybe if we...
- It wouldn't have worked.
Yeah. No.
He didn't have a chance.
It was the right call.
Huh.
What?
What'd I do?
Wiggle your toes for me, Joan.
I can't. I can't feel anything,
not even my contractions.
- What did you do?
- Am I paralyzed?
We're working very, very hard
to prevent that,
- but I need you to stay calm.
- Can I do something?
You can go stand over there
with the interns, intern.
What the hell
happened in here?
She dislocated her fracture at C5-6.
I'm decompressing.
Okay. Baby's got decels.
I'm getting
the first 5-pound bag.
How the hell did she dislocate?
She was having trouble breathing.
- I thought it was the collar.
- Get out!
Okay. I need to get this baby
out of here.
- Let's get her up to the OR.
- All of you out now.
So, if this works,
they're gonna do this in the army?
- Absolutely.
- We should go.
We should take a year, do the program.
We'd spend our time
doing things like this all the time.
It would be amazing.
You're in the middle of your residency.
I'll take a research year.
We could have an adventure.
I'm not looking for an adventure.
- Oh, crap.
- What is it?
It's an infrarenal IVC injury.
Damn it!
- How long's it gonna take to fix?
- I don't know. About 30 minutes?
We don't have that.
Okay, he can live without it.
Just ligate it.
Got it. O silk ties.
There was a mass casualty today.
They needed us
back here at the hospital.
I know, but maybe
there was still something
- that we could've...
- We did everything we could do.
- Why are you second-guessing?
- I'm just saying that maybe...
I was willing to try an ex-lap.
Oh, my God, would you shut up
about the stupid ex-lap?
- That is not the point!
- No.
No, the point is that
maybe we should have stayed.
Maybe we didn't try everything
we possibly could have to save him.
We were all there. We all saw that car.
And there's a difference
between knowing
when you can
realistically save someone
and when it's time to walk away.
And when is that, Meredith?
When is that point?
When do you look
at a horrible, sad situation
and decide that you are ready
to turn your back on it? I'm curious.
I'm curious how you make
those decisions,
you specifically.
When are you okay making the call
that someone
no longer has any chance?
How do you look around
and decide that?
When do you decide
that you should walk away?
Dr. Shepherd? Dr. Edwards says she
needs you in trauma two right away.
I'm Dr. Shepherd.
Oh, sorry.
Dr. Edwards says
she needs you right away.
She wasn't...
They need you upstairs. Go.
- Core temp's 98.6 degrees.
- No pulse.
Heart should be beating
by now.
We're way over time.
The IVC repair...
- He'll come back.
- Come on, Scott.
Lf we lost him...
What the hell did you people do?
We put him in hibernation,
and we're bringing him back out.
Are we?
Okay. Let's get him off bypass.
We got a heartbeat.
- The boy's reviving.
- I'm thrilled to hear it.
- I made the right call.
- Talk to me when we see
what kind of brain function
he wakes up with.
Thinking like that would have
left that boy dead on the table.
I can assure you that your successor
will be nowhere near so cavalier.
I'll make certain of that
when I choose the next chief.
Oh, when you choose?
Well, it's not up to you, Catherine.
- It's a board decision.
- We'll see about that.
You can't just come in here
and think you can...
I don't need you to tell me
how this hospital works.
I've seen plenty of that today.
Dr. Thompson to Oncology.
Dr. Thompson to Oncology.
I'm sorry about leaving
the patient there.
I didn't want to leave him there, either.
And I am sorry for not talking
to you about the house.
You don't talk to me
about a lot of things.
And you're mad at me for going away,
- and I am sorry about that.
- That's not...
I mean, I couldn't breathe.
I couldn't exist.
You know,
I looked around at that house,
and my kids, our kids.
- I couldn't breathe.
- You didn't call me.
I didn't call anyone. I needed time.
I am a neurosurgeon.
I could have saved him.
- And you didn't call me.
- Amelia...
Who contacted you first?
The police? The paramedics?
How far away was the hospital?
How long were you sitting there
waiting for them
to declare him brain-dead?
How many hours later was it
before I was even informed?
How many chances did you have
when you could have called me?
Why didn't you call me?
There wasn't anything
you could've done.
He was too far gone.
- You don't know that. You don't know.
- Yes, I do.
What if I could've helped him?
What if I had a chance?
I pull off miracles for a living.
I have proven that I can reverse
the impossible.
I should have been there.
- If I had seen him or treated him...
- It was too late.
By the time they...
It was too late.
How could you do it?
How could you unplug him
without letting me know?
I didn't get to see him.
I didn't get to tell him goodbye.
I thought you would've at least given me
the courtesy and the respect
when my own brother was dying.
I didn't get to tell him goodbye.
Because of you.
Damn it!
Hey. Sorry about the wedding.
Oh, no. It was the right idea to cancel.
Postpone you mean. Right?
The odds aren't in my favor, Miranda.
You know, I've tried this before.
And failed.
Twice.
Well, it always comes
between choosing
between the woman and the work.
- And when pressed, I...
- You choose the work.
Yeah. You'd think I'd learn
at some point.
Sounds like you have.
You just need to be okay with it.
But with Catherine and me,
it's already been a problem,
and it's still gonna be a problem.
I'm not sure I want to go down the road
if it's gonna go nowhere.
Carefully. Carefully.
Okay. All right.
You're doing great, Joan.
Deep breaths.
What is it? Talk to us, Joan.
I feel something. In my fingers.
- Okay.
- Good.
- That means the traction's working.
- And in my toes!
Oh, thank God. I can feel my legs again.
Oh, my God!
Oh, my God. I can feel everything.
- Oh, my God!
- She's having a contraction.
All right, Joan.
Joan, I know it hurts,
but you have to keep still, okay?
We need to prevent your neck
from dislocating again.
You were right today.
I was taking a big risk.
You were lucky today. Really lucky.
I understand.
- Is Kepner back yet from the tunnel?
- I don't know.
I don't know much about her lately.
She's different
since she came back
from her training with you.
And I'm glad that she found something
that makes her this happy,
I guess.
But it's weird.
We're just not
on the same page anymore.
Ever, it seems.
It happens. More than you think.
You go away, you come back.
The world has shifted.
Things that made sense once
don't anymore.
You heard that I'm resigning as chief?
Give her time.
That's all you can do.
That's the face you're gonna make?
The kid's alive.
I don't want to have this fight.
- What fight?
- This fight.
This "I told you so" fight.
This thing where
this insane surgery works,
and then you get back
on this army thing,
and then I tell you you're not going,
and then you get pissed.
You're gonna tell me
what I can and can't do?
You do that,
I'm gonna be more than pissed.
You know what? Screw it.
You want to go, then go.
What's your problem?
It sounded interesting.
And for a minute, I thought
it could be something
that we'd do together. Why not?
I have worked really freaking hard
to get to where I'm at right now.
I have finally found my place,
and it's at this hospital
doing this job with these people.
- Alex, I'm...
- Last year was crap.
And now Mer is home,
and I finally feel like things are back.
I don't need to go anywhere.
I don't want to.
I've put roots down here.
I've never put roots down anywhere.
I'm not walking away, not from this.
If you want to go, then go.
I can't stop you.
It's your life. Do what you want.
Go join the freaking army.
You're almost there, Joan.
Almost there!
Uh, hey, guys.
- Okay. She's crowning.
- She was only 6 centimeters.
I need to...
I need to push one more time.
This baby's coming now.
Edwards, hold her steady.
Occupied! Occupied!
Dr. Guillaume. Dr. Guillaume.
Hey.
I needed to ask you something,
but I didn't want to
because I knew you'd say yes.
Then don't ask.
I went away. I pressed pause on my life.
And I really needed that.
But since I've been back,
I just... I can't unpause.
I just can't get things going again.
I go home every night
to my house and it's...
It's not my house.
It was mine and Derek's house.
And now he's gone,
and it really just feels like a house.
I came back, but I'm not home.
And I really want to be home.
Can the kids and I come and stay
with you for a while?
Yeah. No big deal.
Well, you better check with Wilson
because you know how she gets.
Trust me, I don't need
to check in with Wilson.
No.
No. Well, then explain it to me again.
When did this happen?
Mom, how can you say that?
Okay.
You're doing great, Joan.
One more big push
and that should do it, okay?
I can't... I can't do this. I can't.
He's supposed to be here
with me, with us, and he's gone!
Joan, we know it hurts,
but we need you to keep going, okay?
The head's out!
How do you step back
into the world?
Joan, you did great.
Keith was supposed to
cut the cord.
He was supposed to hear the first cry.
Hold your baby.
Everything is fine.
Mom, say hello to your son.
It's scary.
This isn't how it's supposed to be.
It's not part of the plan.
Keith should be here.
Keith should be here.
Keith should be here!
- Hi, baby.
- Time stood still...
Mom, I have to go. I have, um...
Uh...
Goodbye.
... and now it's speeding by.
- ER?
- Yep.
I thought we'd seen the last of it.
You are looking for a lifeboat.
- You okay?
- Yeah. Yeah, I'm fine.
Something to give you hope.
But are you really ready
to leave your happy little bubble
and step back out
into the big, blinding,
bloody, terrible world?
I stopped them
from trying to extract him.
I couldn't watch him bleed out.
You were right.
You said if he were closer
to the hospital,
he might have a chance.
So, let's give him a chance.
Are you ready to achieve
the impossible?
Ripped By mstoll
---
Time stops
when you're in the OR.
You step up to the table,
you evaluate the patient,
you pick up a scalpel...
He's too big for that.
...and then you go into a bubble.
It's just you and your surgery,
and nothing else matters,
not time, not pain, not exhaustion.
Nothing.
Ripped By mstoll
Hey, just finished my corpectomy.
- Did I miss it?
- No, you're good.
Wow.
- That was fast.
- What was fast?
I put out feelers with a real-estate agent
about the house,
and looks like I got an offer.
- You're selling the house?
- No.
I don't know. Maybe.
Why do people constantly feel
the need to kill their arteries?
Are they here yet?
Oh, did I miss it? Tell me I didn't miss it.
- Nope.
- I almost forgot.
I can't wait to see the beads of sweat
on their freaked-out little faces.
- Oh, man. Did I miss it?
- Nope. Nope.
I want to see someone crap,
actually crap.
Seen it, smelled it.
Not as fun as you'd think.
It's happening!
The baby chicks and ducks are here!
It happens in real life, too.
When something big happens,
something tragic,
you freeze.
You retreat into your happy bubble...
- Derek.
- Derek.
- Right. Meredith.
- Meredith.
...for what seems like a second
until you look up.
And suddenly you realize
it's a whole new year.
Each of you today comes here hopeful,
wanting in on the game.
A month ago, you were in med school,
being taught by doctors.
Today, you are the doctors.
The five years you spend here
as surgical residents
will be the best and worst of your lives.
They will...
- You have a question?
- Yes. Why?
Uh, you raised your hand.
No, I'm sorry. I mean, why will these be
the best and worst years of our lives?
- Uh, I was getting to that.
- Sorry.
Um, where was I? Oh, right.
You will be pushed
to the breaking point.
Look around you.
Say hello to your competition.
Eight of you
will switch to an easier specialty.
Five of you will crack
under the pressure.
Two of you will be asked to leave.
This is your starting line.
This is your arena.
How well you play,
that's up to you.
- They look stupid.
- They look like babies.
Were we ever that young?
- They're so well rested.
- And stupid.
- And eager, like puppies.
- No, not like puppies.
- Chicks and ducks.
- Chicks and ducks.
When did we start calling them that?
You've been gone for a year.
Left to their own devices,
they would drown.
And take the patients
down with them.
God help us all.
They look good. Pretty good.
Some of them.
I mean, for chicks and ducks.
I'll at least get some good ones, right?
You'll make sure I get some good ones?
Yeah. You're gonna hook me up.
Uh, listen up. This is Dr. Edwards.
Some of you are lucky enough
to be under her supervision.
Listen closely to everything she says.
Observe. Learn.
She has the power to mold you
into fine surgeons.
Thank you, Dr. Webber.
Oh, and congratulations, sir.
Dr. Webber's getting married
this afternoon.
Wow.
- Mazel tov, sir.
- Congratulations.
- Hooray!
- Thank you.
Now, um, who's got Dr. Edwards?
I did not hook you up.
All right. I have three rules.
One, listen to the nurses.
Respect the nurses.
Do whatever the nurses say.
You may think
you know more than the nurses.
You do not.
- Two, your life is now all about me.
- Charge to 200.
- Not about you or your boyfriend...
- Charged.
Your fight with your sister
or your nasty little rash down there.
So, when we are focused on me,
we are learning to be surgical gods.
When we are focused on you,
we're working at a gas station.
Three, no complaining.
You complain and you are out. Got it?
You. Rules. Repeat.
Listen to nurses, worship you,
complain and die.
Good. Let's go.
Hunt. How much longer is Richard
gonna be interim chief?
Because I want to expand
my department,
and he has kind of
a different approach to the budget.
- So, when are you coming back?
- Uh, I'm not.
The board's gonna appoint a new chief.
We are? When?
- Why?
- Yeah, why?
Because I've been chief long enough.
And it's time for something else.
Dr. Meadows. Dr. Meadows.
Jackson. Jackson!
This is... You are just making a mess.
- What are you doing?
- Oh. Do you want some?
Sweetheart, you don't have to be here.
Really, I'm fine.
I am supporting you.
I'm your maid of honor.
April said the job of the maid of honor,
support the bride, keep her company.
So, I'm supportin'.
I'm keeping you company.
You know, Meredith also said
that the maid of honor
drives the getaway car
if you want to make a run for it.
So, you know, you want to make
a run for it, I'm standing by.
Ready to go. Just give me a holler.
Until then, we're up on LA by four.
I thought April would be with you
when you came over.
Is everything okay?
- Yeah. Fine.
- Mmm.
Well.
I know it's a challenge.
The woman that came back
from the combat zone
is not the same girl that left here.
April has changed.
It would be understandable
if that created problems.
Jackson.
Is that Richard? Tell me that he's here.
Tell me he's here, finally.
I told him not to go to that hospital.
We interrupt this program...
It's not Richard.
...to bring you late-breaking news
from our studios
- in downtown Seattle.
- What's wrong?
These images are just coming in.
- You know how many incoming?
- No.
We don't even know what happened.
But it is big.
I guess we're probably not making it
outta here in time for that wedding.
- You did a lobectomy on a dirt road?
- Well, we had to.
The nearest medical center
was 150 miles away.
- Does anybody know what happened?
- Not a clue.
So, was it just a 24-7 adrenaline rush?
- What was a 24-7 adrenaline rush?
- The desert. No.
You get desensitized pretty fast.
There's another group leaving
in two weeks if you're interested.
You're not living in a tent.
- I grew up in a car.
- That had doors.
- We should both go.
- I'm definitely not living in a tent.
Okay. Here we go.
- What have we got?
- Mid-60s female with crush injuries.
Massive blood loss at the scene.
We've done chest compressions
for 28 minutes.
A 49-year-old male.
Went into V-fib en route.
Shocked times three.
He had two rounds of epi and vaso.
There are four more
ambulances behind us.
Every last one of them's
got nothing but DOAs.
- What's going on?
- Why aren't the ambulances unloading?
Because they aren't ambulances.
They're freakin' hearses.
All the patients are dead.
What the hell happened out there?
A tunnel on 99
collapsed during rush hour.
The north entrance
completely caved in,
trapping nearly 20 vehicles
under the rubble.
Do we know how many victims?
They're trying to get people out
as fast as they can.
But for now, we're just waiting
for them to find someone with a pulse.
How many dead?
- Thirteen fatalities so far.
- God.
- Coming through!
- We got a live one! Clear a path!
Scott Henry, 17 years old.
Penetrating trauma to the abdomen.
He arrested as soon
as we took him off the rig.
Let's get him into trauma one,
- and page Karev!
- On it!
I know everyone wants to help,
but back up, give them room to work.
Dr. Karev to the ER.
Dr. Karev to the ER.
We got one alive. There could be more.
I wouldn't get your hopes up.
- There could be more.
- There could be more.
There could be more.
Three rigs pulling in now
with more right behind them.
They don't know how many, but they'll
bring as much as we can handle.
We've got live ones coming in, people,
and we want them to stay that way.
We need surgical trays
by each trauma bed,
and reserve O-neg on standby!
There's always more.
Uh...
I know.
Look, I am sorry.
I was on my way to the hotel,
but we crashed the OR floor.
- It was too big just to...
- I'm not here to haul you out of here.
I'm here to help.
I'm looking for a pair of scrubs.
This. This is reason number 537
why you and I are made for one another.
- Surgery is sexy, honey. It's hot.
- Yes, it is.
- And tonight, on our wedding night...
- Mmm-hmm?
...Dr. Webber,
I'm gonna show you just how hot
- a morning surgery can make me.
- Mmm.
There are people dying.
You are so uptight for a best man.
Now, don't worry.
You're not off the hook.
Good. I've never been
anybody's best man before.
You know they're appointing
a new chief soon.
I'm recommending you.
Unless you don't want it.
No, I've just heard you
say this once before.
About the board seat.
But then I find out
it'd been given to Alex Karev.
You're like the chief who cried wolf.
Who's on the board now, you or Karev?
Dr. Teller, extension
2219. Dr. Teller, extension 2219.
Heel, ducklings! Heel!
A 34-year-old pregnant female
with prolonged extrication
from a crushed vehicle.
Her name is Joan Paulson.
She's 40 weeks pregnant
and in active labor.
BP's 100 over 60.
She's been complaining
of severe neck pain
and an obvious fracture
of her right arm.
- And who are you?
- I'm Andrew. Sorry.
I was on my way into work.
I saw the collapse. I stopped to help.
We've got to go back!
We've got to go back!
- We've got it from here, sir.
- I'm a doctor. Actually a surgeon.
Her contractions are five minutes apart.
- Her husband's still trapped in the car.
- Let's page OB!
You've got to get Keith out!
Please, you've got to go back
and get him out!
Hey, don't you worry, okay, Joan?
We just need to focus on keeping
- you and your baby healthy.
- All right, thank you.
That was Urban Search & Rescue.
They have a victim they can't extract.
They need us to send a team.
Who's on the field rotation list?
We've got Pierce, Shepherd,
Kepner, and Grey.
- No, Grey hasn't been cleared yet, sir.
- I'll sub in for Grey.
And leave everything going on here?
It's a mass casualty.
- Grey!
- You need me?
We're sending a team on-site.
You've been cleared. Go get ready.
She's still supposed to be supervised.
She had a year off.
You can't give her special treatment
just 'cause something bad's
happened to her.
- You can't spoil her like that.
- The hell I can't.
Dr. Sanders, 1524. Dr. Sanders, 1524.
Ow! Careful!
- We're looking for our friend!
- Are you a doctor?
- One at a time.
- His name's Scott. He's 17.
Uh, he was in the backseat
when this huge piece of cement
came down and...
He was really messed up.
They took him away in an ambulance.
We just got here.
We're not even from Seattle.
- Okay. Uh, where are your parents?
- Back home. In Missoula.
They didn't come with us.
Our parents let us do stuff.
We don't get in much trouble.
- We're...
- Dorks.
We're supposed to be
touring UW right now.
Wilson. We could use some
more hands on our kid in trauma one.
- Is he talking about Scott?
- He's not gonna die, right?
Is that Scott?
- V-fib.
- Push an amp of epi.
Charge to 150. Paddles!
- Wilson, get in here and help bag!
- Clear!
Fetal monitor is on. OB is coming.
And, we should get Ortho
take a look at her arm and her neck.
- On it! Right away!
- My baby. Is my baby okay?
Baby's looking just fine, Joan.
Heart rate's right on target.
Dr. Edwards, is it true
that the fetus can be compromised
if the patient is in the supine position?
The fetus is compromised?
- Out.
- I'm sorry, did you mean...
Out! This is not question time.
All of you just go to Radiology.
Check on the reads.
I will call you if I need you.
- Where is Radiology...
- Scram!
The contractions
started this morning.
The doctor said we could take our time,
but I wanted to leave.
I made Keith take that stupid tunnel!
He wanted to take the bridge,
but I said the tunnel was faster.
I'm constantly telling him what to do.
How long have you two
been married, Joan?
We're not married.
We met each other
nine months and three days ago.
I barely knew him.
It's crazy
what you find out about a person
when you get knocked up
on the first date.
We're gonna get married next week.
Please tell me
we're getting married next week.
Get some water over here.
Over here!
Tape, bandages, and a splint.
Will someone call
my husband? I need my husband!
- Help me! Help me!
- Okay, all right. Calm down.
- Please! Please!
- Tell me your name.
He's 10 years old.
T-shirt and jeans.
- He was in the backseat?
- Yes.
Ma'am,
can you follow my finger?
His name is Tyler.
Stay with me, okay?
Help us.
- You're the surgeons from Grey Sloan?
- We are. Where's the patient?
- This way.
- We're gonna help you.
- What's his name?
- Keith Gardner.
We got one. He's still alive.
My ear!
I can't hear anything!
Help!
Car's been crushed
by debris. We got his wife out, but...
- Oh, my God.
- He's in there?
- He's alive?
- Barely.
Back on the truck.
All right, come on, you guys.
We're gonna
get you out, buddy. Don't worry.
Hey, Keith.
My name is Meredith.
We're gonna get you out of there, okay?
That'd be great.
- How do we even start?
- We just do.
The door's coming off!
I'm looking for my wife.
- There.
- She's good.
- I need some more lap pads in here.
- You got it, Doc. Here you go.
Keith, can you follow my light
with your eyes?
My fianc?e, Joan, she was with me.
Is she okay?
We saw her arrive at the hospital.
She's alive.
Okay. Okay. Good.
She made it there. She's alive.
I need some packing!
Do you know
we're having a baby?
Keith, we're trying to listen
to your breathing.
Stop talking, please.
It's hard to hear breath sounds out here,
but he could have a collapsed lung.
How's his abdomen?
Lot of blood,
from what I can see.
Keith, I'm just gonna check
your torso, okay?
He's impaled in two places.
- It's pretty bad, huh?
- It's pretty bad.
But I've seen worse.
Okay. Make sure you got
that crushed leg.
Call Respiratory for bed two,
and get a repeat crit on bed eight.
- Thanks.
- Uh, Dr. Hunt?
- Yeah?
- Hi. I'm Andrew DeLuca.
Oh, right. You came in
with the pregnant woman.
Yes. Is there any paperwork
I should fill out or...
You can do it later if you're good
to just jump in and keep helping.
Of course. Sure.
- Oh, God, there's another one!
- Okay. Keep breathing. Nice and slow.
Edwards, nice job reducing the wrist.
Actually, Dr. DeLuca did that
in the field.
- Doctor who?
- Me. Hi. Dr. DeLuca.
- He was at the scene.
- Paramedics ran out of splints,
- so that's actually my tie.
- Was your tie. Sorry.
It's not a problem.
It was my favorite one, though.
- Oh, God!
- All right, 3 centimeters dilated.
- I think she has a fracture at C5-6.
- What's a C5-6?
Joan, you fractured
a bone in your neck,
but it is stable for now,
so we will fix it after you deliver, okay?
Keep her in the collar
until her labs come back,
then we'll get her upstairs
so she can deliver,
- and repair the fracture.
- Got it.
Have them page me
when her contractions
- become more frequent, okay?
- All right.
- Thank you so much for your help.
- It was my pleasure.
He's losing blood faster
than we can put it in him.
- We should get him upstairs.
- We need to open his chest. Glove me.
Crack his chest and then what?
That still might not buy us enough time
to get to the OR and fix his injuries.
- Then we stop time.
- How?
Put him on bypass,
drain out all of his blood,
and replace it with cold saline,
and then we operate.
- Can you do that?
- No, he can't. That's way too risky.
We put him in suspended animation,
cooling him from inside out,
his brain, his heart, his organs.
That buys us an hour or two.
- Hunt!
- Ten blade.
Dr. Miguel...
How's it going out there?
Um, they're coming in faster
than we can treat them.
Um, listen, Catherine, I hate to say this,
but, you know,
under the circumstances,
do you think
we should postpone the wedding?
I already did.
My assistant is notifying
our guests as we speak.
Oh.
- You're sure you don't mind?
- Of course I mind.
But we both know where we need to be.
Hey, uh, Chief. We need you.
You can't just say
"suspended animation"
like it's a real thing. It's science fiction.
It's called emergency
preservation and resuscitation.
Trauma programs have been
discussing it for years.
It's a way to save patients
who can't make it to an OR.
Yeah, a risky way, an irresponsible way.
'Cause the safe option is to keep
transfusing him and race him upstairs.
- How do you do it?
- We cannulate the aorta,
drain out his blood, infuse cold saline,
- then drop his core temp to 50 degrees.
- You put him in hibernation?
You replace his entire
blood volume with ice water.
You're gonna do what to him?
- Get her out of here.
- So, you induce hypothermia.
Hold on.
We're not gonna consciously kill a kid
over something you discuss over beers
with your trauma buddies.
Kid's gonna die anyway. At least
this way we can try to bring him back.
- I say do it.
- No. It's way too experimental.
And we would need Pierce.
She's at the site.
This is not a cardio procedure.
It is if you can't get
his heart beating again!
What are you gonna do if you
can't get him back after bypass?
What then?
That's why we don't do things
like this on a whim.
- This is not a whim. This is a Hail Mary.
- On a child?
The patient is a minor.
We don't have consent.
By the time you find
the parents, it'll be too late.
I agree with Jackson. It's a no, Hunt.
We're wasting time
having this conversation.
Okay. We only need
two physicians to give consent. Karev?
Really?
- That's how you wanna play this?
- In.
Webber?
Chief?
- Just do it.
- I need a cannula!
Too many people have died today.
We're not adding this kid to the list.
- How's his airway?
- His sats are okay.
There's definitely blood
in his chest on the left side.
- Meredith, can you get the packing in?
- I'm trying.
I can't really reach it from this angle.
Uh, I need some more trauma pads
and cellulose polymer, please.
What's going on?
Whenever I press on the wound,
blood is flowing out of his abdomen.
The metal is tamponading it,
but it's not going to last very long.
And he needs surgery soon.
If he doesn't suffocate on his blood first.
I got to get a chest tube in here.
Do you have access?
No. Maybe.
We have to get him out of there.
What about
from the other side of the car?
- I could be your other hand.
- Yeah.
Do you really think
that you can get me out of here?
I have to. You said it yourself.
You're having a baby.
- Do you have kids?
- I have three.
Wow, three. One is freaking me out.
We did it backwards,
though, you know?
You meet someone, you, uh, fall in love,
get married, have a kid.
It gets bigger, right?
Joan and I, we did this huge thing first.
"We're, uh, having a baby.
Nice to meet you."
We're still getting to know each other,
learning all these little things.
It's good stuff.
She, uh, sleeps with her socks on.
- We like... We like watching tennis...
- Get me a stethoscope.
But not playing.
She likes techno.
Would have been a deal-breaker,
but we got this big,
huge baby thing coming, so...
I really... I really love all her little things.
It's like I'm home. She's like my home.
I should really tell her that.
Right?
Come on, guys!
I got it.
I should... Hey!
- Slow down!
- I'm sorry.
What is in your mouth?
A brie tart.
With prosciutto.
Brie? Brie!
Um, there are patients here
that had chunks of cement
fall on them
during their morning commute.
But, please, have some brie.
While carrying lab samples.
That's nasty.
What's the matter with you?
Oh. Where'd you get this?
- It looks wonderful.
- What the...
Did you try this? I'll try that.
No, yeah. It's vegetarian.
Oh, hey, I heard Catherine Avery had
all the food from the wedding
sent here, you know, for the staff,
and I have two minutes.
How many sliders you think
I could eat in two minutes?
Is that pesto?
Do you think that Catherine's
gonna help pick the new chief?
- I mean, why wouldn't Hunt just do it?
- I don't...
God, it would save us so much trouble.
The 12-page r?sum?s
and the phone calls
and the polite vetting and...
Who would want to be chief?
Would you?
I... Well, I had... Are you asking?
Hunt should just do it, right?
Oh.
Those crab cakes look really good.
But I don't want to
make a pig of myself.
Exactly what I was thinking.
Exactly.
Well, yes.
Yes, I would like to be chief.
- Did you get ahold of Scott's parents?
- Not yet.
We left messages. We're trying.
I mean, they should know
that you're killing their son.
- I'm sorry, what?
- Yeah.
- We have some questions.
- From our research, we think this plan
is completely untried and experimental.
Your research?
You're trying suspended animation
through induced hypothermia.
- So, you heard Dr. Hunt.
- It's basically science fiction.
It's still undergoing clinical trials,
and there's
no documentation suggesting
that this will work on humans.
Whoa, whoa!
Where did you get this research?
Dr. Hunt, this procedure's
only been successful on pigs?
Wait, what?
It wasn't successful
on humans?
It hasn't been tried on humans.
They've started trials,
but they have no outcomes. Not yet.
Core temp's down to 55.
- Where are you getting this?
- Those kids. His friends.
You said there were techniques
that were developed
and the studies were published.
The animal studies
have had incredible success.
And the technique
has to start somewhere.
I can name 30 soldiers
this technique would have saved.
So, you want to try it
on a high-school kid
without parental consent?
You better pray this works.
Even if we resuscitate him,
he could end up brain-dead.
His core temp's down to 53.
It doesn't matter now.
We're doing it. We've done it.
- So, either get on board or get out.
- Karev is right.
Anybody who doesn't
want to be part of this
is welcome to leave.
I'll stay.
We're there. Core temp's 50 degrees.
Okay. He's cold.
We have an hour, 90 minutes tops.
We ready?
Start the clock. Scalpel.
- I said no.
- I know what you said.
If anything goes wrong in that OR,
it jeopardizes
our entire surgical program.
It could be the boy's only hope.
I don't need you to defend
the technique to me, Richard.
- I need you to follow orders.
- Orders?
- I'm an owner in this hospital.
- I am, too.
- But I'm also the chief. It's my call.
- You mean interim chief.
That boy had no chance.
We're giving him one.
I don't feel bad about that.
Now, if you'll excuse me,
I have another surgery.
We can't tell where
Keith ends and the door begins.
If we use the Jaws of Life to get him out,
it'll rip him to shreds.
He'll bleed to death in seconds.
What about trying an ex-lap?
Then we can try to separate...
We're not sterile.
There's no blood bank.
This is not a controlled environment.
I know. I know. I know.
We could put a balloon catheter
into his aorta.
It could buy us some time.
If we were closer
to the hospital,
I would say maybe,
but we're 25 minutes out.
- He'll never make it.
- Okay, what if...
He's a black tag, guys.
We can't do anything else for him.
Then I'm calling it.
We're gonna cut him out.
Maybe we'll get lucky.
- You should go.
- No, we can stay...
I'll stay.
You go save people that you can save.
I'll do what I can for him.
Okay, Keith.
We're gonna cut you
out of there now, all right?
Sure thing.
Uh, Joan, Dr. Edwards asked us
to take you to the OR now. Okay?
And we can do that,
because we know exactly where that is.
I knew our first day would be intense.
I figured we might get to watch
some stuff or start an IV,
but there was a mass casualty today.
I've never seen
so many mangled people,
so many dead people.
Doctors from this hospital
just spent hours in the field
trying to extract a guy.
Hours. That's gonna be us some day.
Did they get him out? The guy?
Huh? Oh, no, I don't think so.
I heard he was too far gone.
- Can't breathe.
- So, they just left him there?
- Got it.
- I can't breathe.
- I can't breathe. Let me out.
- What?
- Okay. Is it the collar?
- I need this off.
- I need to get out.
- Okay. I can loosen it.
- Not much, but maybe a little.
- I need to get out.
- Should you do that?
- They left Keith.
They left Keith. He's gone!
No, don't!
There's a shock through my body.
What's happening?
We need to stabilize her spine.
Um, help me reduce her dislocation.
I'll hold her steady
and you attach the tongs.
- What, me?
- Yeah, I got her. Go.
If we hurry, maybe we can
save her from total paralysis.
But I can't.
I mean, I could try,
but I don't think it's the best idea.
- What do you mean? Just attach...
- I don't know how to do it.
- Why?
- 'Cause I'm just an intern.
Okay? Today's my first day. I was late.
I was on my way here.
I saw the tunnel collapse.
What? You're an intern?
- Maybe if we...
- It wouldn't have worked.
Yeah. No.
He didn't have a chance.
It was the right call.
Huh.
What?
What'd I do?
Wiggle your toes for me, Joan.
I can't. I can't feel anything,
not even my contractions.
- What did you do?
- Am I paralyzed?
We're working very, very hard
to prevent that,
- but I need you to stay calm.
- Can I do something?
You can go stand over there
with the interns, intern.
What the hell
happened in here?
She dislocated her fracture at C5-6.
I'm decompressing.
Okay. Baby's got decels.
I'm getting
the first 5-pound bag.
How the hell did she dislocate?
She was having trouble breathing.
- I thought it was the collar.
- Get out!
Okay. I need to get this baby
out of here.
- Let's get her up to the OR.
- All of you out now.
So, if this works,
they're gonna do this in the army?
- Absolutely.
- We should go.
We should take a year, do the program.
We'd spend our time
doing things like this all the time.
It would be amazing.
You're in the middle of your residency.
I'll take a research year.
We could have an adventure.
I'm not looking for an adventure.
- Oh, crap.
- What is it?
It's an infrarenal IVC injury.
Damn it!
- How long's it gonna take to fix?
- I don't know. About 30 minutes?
We don't have that.
Okay, he can live without it.
Just ligate it.
Got it. O silk ties.
There was a mass casualty today.
They needed us
back here at the hospital.
I know, but maybe
there was still something
- that we could've...
- We did everything we could do.
- Why are you second-guessing?
- I'm just saying that maybe...
I was willing to try an ex-lap.
Oh, my God, would you shut up
about the stupid ex-lap?
- That is not the point!
- No.
No, the point is that
maybe we should have stayed.
Maybe we didn't try everything
we possibly could have to save him.
We were all there. We all saw that car.
And there's a difference
between knowing
when you can
realistically save someone
and when it's time to walk away.
And when is that, Meredith?
When is that point?
When do you look
at a horrible, sad situation
and decide that you are ready
to turn your back on it? I'm curious.
I'm curious how you make
those decisions,
you specifically.
When are you okay making the call
that someone
no longer has any chance?
How do you look around
and decide that?
When do you decide
that you should walk away?
Dr. Shepherd? Dr. Edwards says she
needs you in trauma two right away.
I'm Dr. Shepherd.
Oh, sorry.
Dr. Edwards says
she needs you right away.
She wasn't...
They need you upstairs. Go.
- Core temp's 98.6 degrees.
- No pulse.
Heart should be beating
by now.
We're way over time.
The IVC repair...
- He'll come back.
- Come on, Scott.
Lf we lost him...
What the hell did you people do?
We put him in hibernation,
and we're bringing him back out.
Are we?
Okay. Let's get him off bypass.
We got a heartbeat.
- The boy's reviving.
- I'm thrilled to hear it.
- I made the right call.
- Talk to me when we see
what kind of brain function
he wakes up with.
Thinking like that would have
left that boy dead on the table.
I can assure you that your successor
will be nowhere near so cavalier.
I'll make certain of that
when I choose the next chief.
Oh, when you choose?
Well, it's not up to you, Catherine.
- It's a board decision.
- We'll see about that.
You can't just come in here
and think you can...
I don't need you to tell me
how this hospital works.
I've seen plenty of that today.
Dr. Thompson to Oncology.
Dr. Thompson to Oncology.
I'm sorry about leaving
the patient there.
I didn't want to leave him there, either.
And I am sorry for not talking
to you about the house.
You don't talk to me
about a lot of things.
And you're mad at me for going away,
- and I am sorry about that.
- That's not...
I mean, I couldn't breathe.
I couldn't exist.
You know,
I looked around at that house,
and my kids, our kids.
- I couldn't breathe.
- You didn't call me.
I didn't call anyone. I needed time.
I am a neurosurgeon.
I could have saved him.
- And you didn't call me.
- Amelia...
Who contacted you first?
The police? The paramedics?
How far away was the hospital?
How long were you sitting there
waiting for them
to declare him brain-dead?
How many hours later was it
before I was even informed?
How many chances did you have
when you could have called me?
Why didn't you call me?
There wasn't anything
you could've done.
He was too far gone.
- You don't know that. You don't know.
- Yes, I do.
What if I could've helped him?
What if I had a chance?
I pull off miracles for a living.
I have proven that I can reverse
the impossible.
I should have been there.
- If I had seen him or treated him...
- It was too late.
By the time they...
It was too late.
How could you do it?
How could you unplug him
without letting me know?
I didn't get to see him.
I didn't get to tell him goodbye.
I thought you would've at least given me
the courtesy and the respect
when my own brother was dying.
I didn't get to tell him goodbye.
Because of you.
Damn it!
Hey. Sorry about the wedding.
Oh, no. It was the right idea to cancel.
Postpone you mean. Right?
The odds aren't in my favor, Miranda.
You know, I've tried this before.
And failed.
Twice.
Well, it always comes
between choosing
between the woman and the work.
- And when pressed, I...
- You choose the work.
Yeah. You'd think I'd learn
at some point.
Sounds like you have.
You just need to be okay with it.
But with Catherine and me,
it's already been a problem,
and it's still gonna be a problem.
I'm not sure I want to go down the road
if it's gonna go nowhere.
Carefully. Carefully.
Okay. All right.
You're doing great, Joan.
Deep breaths.
What is it? Talk to us, Joan.
I feel something. In my fingers.
- Okay.
- Good.
- That means the traction's working.
- And in my toes!
Oh, thank God. I can feel my legs again.
Oh, my God!
Oh, my God. I can feel everything.
- Oh, my God!
- She's having a contraction.
All right, Joan.
Joan, I know it hurts,
but you have to keep still, okay?
We need to prevent your neck
from dislocating again.
You were right today.
I was taking a big risk.
You were lucky today. Really lucky.
I understand.
- Is Kepner back yet from the tunnel?
- I don't know.
I don't know much about her lately.
She's different
since she came back
from her training with you.
And I'm glad that she found something
that makes her this happy,
I guess.
But it's weird.
We're just not
on the same page anymore.
Ever, it seems.
It happens. More than you think.
You go away, you come back.
The world has shifted.
Things that made sense once
don't anymore.
You heard that I'm resigning as chief?
Give her time.
That's all you can do.
That's the face you're gonna make?
The kid's alive.
I don't want to have this fight.
- What fight?
- This fight.
This "I told you so" fight.
This thing where
this insane surgery works,
and then you get back
on this army thing,
and then I tell you you're not going,
and then you get pissed.
You're gonna tell me
what I can and can't do?
You do that,
I'm gonna be more than pissed.
You know what? Screw it.
You want to go, then go.
What's your problem?
It sounded interesting.
And for a minute, I thought
it could be something
that we'd do together. Why not?
I have worked really freaking hard
to get to where I'm at right now.
I have finally found my place,
and it's at this hospital
doing this job with these people.
- Alex, I'm...
- Last year was crap.
And now Mer is home,
and I finally feel like things are back.
I don't need to go anywhere.
I don't want to.
I've put roots down here.
I've never put roots down anywhere.
I'm not walking away, not from this.
If you want to go, then go.
I can't stop you.
It's your life. Do what you want.
Go join the freaking army.
You're almost there, Joan.
Almost there!
Uh, hey, guys.
- Okay. She's crowning.
- She was only 6 centimeters.
I need to...
I need to push one more time.
This baby's coming now.
Edwards, hold her steady.
Occupied! Occupied!
Dr. Guillaume. Dr. Guillaume.
Hey.
I needed to ask you something,
but I didn't want to
because I knew you'd say yes.
Then don't ask.
I went away. I pressed pause on my life.
And I really needed that.
But since I've been back,
I just... I can't unpause.
I just can't get things going again.
I go home every night
to my house and it's...
It's not my house.
It was mine and Derek's house.
And now he's gone,
and it really just feels like a house.
I came back, but I'm not home.
And I really want to be home.
Can the kids and I come and stay
with you for a while?
Yeah. No big deal.
Well, you better check with Wilson
because you know how she gets.
Trust me, I don't need
to check in with Wilson.
No.
No. Well, then explain it to me again.
When did this happen?
Mom, how can you say that?
Okay.
You're doing great, Joan.
One more big push
and that should do it, okay?
I can't... I can't do this. I can't.
He's supposed to be here
with me, with us, and he's gone!
Joan, we know it hurts,
but we need you to keep going, okay?
The head's out!
How do you step back
into the world?
Joan, you did great.
Keith was supposed to
cut the cord.
He was supposed to hear the first cry.
Hold your baby.
Everything is fine.
Mom, say hello to your son.
It's scary.
This isn't how it's supposed to be.
It's not part of the plan.
Keith should be here.
Keith should be here.
Keith should be here!
- Hi, baby.
- Time stood still...
Mom, I have to go. I have, um...
Uh...
Goodbye.
... and now it's speeding by.
- ER?
- Yep.
I thought we'd seen the last of it.
You are looking for a lifeboat.
- You okay?
- Yeah. Yeah, I'm fine.
Something to give you hope.
But are you really ready
to leave your happy little bubble
and step back out
into the big, blinding,
bloody, terrible world?
I stopped them
from trying to extract him.
I couldn't watch him bleed out.
You were right.
You said if he were closer
to the hospital,
he might have a chance.
So, let's give him a chance.
Are you ready to achieve
the impossible?
Ripped By mstoll