Grey's Anatomy (2005–…): Season 13, Episode 13 - It Only Gets Much Worse - full transcript
The residents get caught up in a conflict between attending physicians; April has a rough first day in her new role at the hospital.
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In 1949, Edward Murphy conducted
a rocket-sled experiment...
...to see how much pressure
a human being could withstand.
Good morning.
I've organized
the monthly rotation schedule,
I got up to speed
on all the upcoming
general elective surgeries,
and I have some ideas
about which residents
are ready for the next phase
of Dr. Minnick's training.
Um, I could run that by you, or...
Murphy's experiment failed...
spectacularly.
Or not.
Over and over.
Uh, whatever you like. Sorry.
What... What would Dr. Grey usually do?
Uh, Dr. Grey wouldn't
talk to me about any of it.
She would just do it.
Go. Do it.
Oh. Okay. Sure. Yeah.
Needless to say, he didn't
start off on the right foot.
Kepner, you don't have
to check in with me.
I trust you.
You do you.
It's your department now.
That's why it's called Murphy's Law.
Because if anything
can go wrong, it will.
You may have thought you were done
talking about this, but I wasn't.
Richard, it was 3:00 in the morning.
I have surgery. I needed sleep.
You need sleep. Come on.
You told Bailey to replace me.
No, baby, no.
I told Bailey there was a problem.
- You told her there was a problem.
- Yes.
You see a problem in our marriage,
will I hear about it,
or will some consultant
come and kick me out of our bedroom?
Stop. You know me better than that.
No, Catherine, right now, I don't.
I really don't.
Take O.R. 4 and make sure
you do the post-op debriefing
with the resident right away.
Is Dr. Grey out sick or something?
Dr. Grey is suspended.
I am the interim department
chief until further notice.
You are?
Yes.
Yes.
Yes.
Okay.
Oh, Dr. Kepner, Dr. Bailey told me
you're filling in for
Dr. Grey as Chief of General.
I am.
Well, congrats.
Well, I didn't...
I mean, it was a... a necessary...
- I need your help.
- Oh.
I'm beginning phase two
of my teaching program today...
Right. Phase two.
And I need someone to supervise
Ben Warren through a colectomy.
Dr. Hawkins was gonna do it,
but he's sick.
Can you assign someone else?
Yeah, let's see who has a colectomy.
Oh.
Is there a problem?
No. No.
Not at all. All good.
Um, I do have a surgeon
available with one,
and I will just assign it to him.
Great. Thanks.
Sure. Yeah.
Do you know where Dr. Webber is?
Did April say anything?
Like why she jumped ship?
I haven't seen her.
She was home late and out early.
Oh, she's slinking, then.
She knows what she did. She's slinking.
Traitor.
No offense.
Look, I can't believe
that she would have done this, either.
I can't believe Bailey asked her.
How's Grey holding up?
She's bored.
She's worried Kepner's
gonna kill all of her patients.
Kepner's a solid surgeon.
You have to give her that,
no matter how anyone feels
about her taking the job.
Yeah, of course she's a great surgeon.
Guys, we're losing ground here, okay?
We lost Grey. We're...
Now we're losing April...
And we don't have the residents.
They love Minnick.
And she's about to start
phase two of her program.
Phase two?
A resident gets to be
the primary surgeon
on their own case.
One procedure, pre-op
to post-op, start to finish.
Under supervision, right?
Yeah, but the resident does it all.
The attending is there to assist.
The resident?
Start to finish, baby!
Oh, would you quit bragging already?
Yes!
I don't get it. Why you two?
'Cause Minnick recognizes
I'm the best resident.
Obviously.
I don't know why you got one.
Special treatment.
From his Chiefwife.
It's not special treatment,
and don't call her that.
Minnick told me
she drew names from a hat.
See?
Whatever... Mr. Bailey.
She's really gonna let you do
a whole surgery with no help?
No hand-holding, no training wheels,
no safety belts, no gutter bumpers.
Phase two, baby!
Shut up, baby.
Yeah, what happened to you?
Last night, you were like,
"Let's start a revolution!"
Well, this morning,
I would say that we're winning.
Now, gosh, if you'll
excuse me, children,
Mama's got to go do surgery.
- Aah!
- Ohho-ho!
Good morning.
Kepner.
April. How's your new job going?
So busy, as I'm sure you know.
Dr. Webber, can I talk to you for a sec?
Sure.
Maybe could we go somewhere
a little more private, or...?
Oh, you know what, Kepner?
I'm... I'm pretty busy.
W-What do you have to say?
Um, it's about your
partial colectomy today.
It's now Ben Warren's.
- I beg your pardon?
- Start to finish.
I'd like Dr. Warren
to scrub in as primary surgeon.
You'd like?
And you can assist and help...
only when requested...
but it will be Dr. Warren's O.R.
Why don't you let Bailey take this one?
Because I've assigned it to you.
Well, I suggest you unassign it.
I would... I would really
rather not, Dr. Webber.
Sir.
Please?
Just... please?
Sure thing...
Chief.
- There you are.
- Yes.
And I am ready.
I have Mrs. Mallenbaum's labs,
I booked an O.R...
Edwards, unbook it.
Mrs. Mallenbaum had a complication.
What? Did she have breakfast?
No. She died.
Oh.
Oh, God.
That's...
- That's awful.
- It's okay to be disappointed.
You were excited.
I was excited, too.
So, should I go down to the pit
or something instead, or...
You know what? Yes.
If you're gonna do
a true start-to-finish,
we should both go down to the E.R.
and see if we can start one on intake.
We're trolling?
We're trolling.
Can you check Mr. Lewis' drains
for me, please?
Yes, Doctor.
All right, I've been thinking.
All right, we are in a corner.
Okay? It's time.
One of us needs to talk
to my mother about this,
and I know what
you're gonna say, all right?
- And I don't care how it looks...
- Jackson, she knows.
Sh...
She knew before anyone.
She's not with us.
No, sh...
This was my mother's idea?
I-I-I thought...
I thought this was Bailey's
So did I.
But, no, Bailey decided I didn't need...
- You should stop talking right now.
- What?
Dr. Webber.
Oh, need something, Warren?
Well, um...
Well, you, sir.
Uh, I have my start-to-finish
surgery today,
and you were assigned to...
Assist you, yeah.
Right.
- We'll talk later.
- Mm-hmm.
Warren.
Jackson.
- Boring, boring.
- Weird and gross.
Exceptionally boring.
None of these are surgical.
Can I get a portable ultrasound
- to Bed 2, please?
- Of course.
Dr. Murphy, talk to me about Bed 2.
It's a 9-year-old boy
with right upper quadrant pain.
I'm betting it's acute cholecystitis,
but I've got to get
the ultrasound to confirm.
Mm-hmm.
That won't be necessary.
Am I missing something?
Wait. No, no, no, no!
Dr. Edwards is taking over this
case now, from start to finish.
Thank you for finding it for her.
No! I started it. I get to finish it!
I love gallstones!
Yes!
You will get your turn, Dr. Murphy,
and when that happens,
Dr. Edwards will be there
to support you.
Physical Therapy to 5 West.
Physical Therapy to 5 West.
Wait, honey, tell me again...
where's Dr. Grey?
Good morning, Ms. Gagliano. I am Dr...
Not Dr. Grey.
She's not Dr. Grey.
Where's Dr. Grey?
Dr. Grey is unavailable
to perform your surgery, Lynne,
so, uh, Dr. Kepner will be
performing it with Dr. Pierce.
She's gonna take out my cancer?
Ms. Gagliano, I have
successfully operated
on several esophageal cancer...
Listen, Dr. NotGrey,
I don't care what you've done.
Dr. Grey found my cancer.
She told me about it.
She held my hand
while I bawled about it.
She told me how
she was gonna take it out.
I've been going to the same
hairstylist for 23 years.
Why?
Because she knows
how I like my roots done.
Dr. Grey knows my roots.
Let's cancel the surgery.
I'll wait for Dr. Grey.
Lynne, that kind of loyalty
is really appreciated.
Thank you.
Loyalty is so rare in this world.
But we're not sure
when Dr. Grey will be back,
and with the risk
of your cancer spreading,
we can't wait.
But I'll be there.
Your roots are safe with me.
When did the pain start?
When we were in our car,
on the way to the seaport.
Matty kept complaining
about his stomach.
It's been off and on
for the last few days,
but it kept getting worse,
so we just turned around
and came back here.
I mean, it's probably
just a stomach bug, right?
We're going on a cruise.
Ooh, that's fun.
It's called an Explorer Cruise.
It's all-inclusive, three ports of call.
And they have rock-climbing walls
and even movie nights.
And they teach you
to surf right on deck!
See, he... he's more excited
than Matty is about this trip.
It's like I have two children.
Matty, can you raise your arms for me?
Also, if we get to the car
within the hour,
we can still make it.
Dana...
Maybe we're just overreacting.
- Dana...
- I'm being optimistic.
Matty's been looking forward
to this for a year.
Hillary, Dana, I'm afraid
Matty has gallstones
and a very inflamed gallbladder.
Gallstones?
But he's nine.
Very rare in someone Matty's age,
but it can happen.
Oh, gosh. Oh, sweetie.
But will we still be able to go?
It's okay, son. Don't worry.
Will we be... able to go?
Not today, buddy.
You need surgery.
My God.
That was so hard.
Hey, they can reschedule a vacation.
You can't get caught up
in their story...
Not your job.
No, it was so hard to keep from smiling,
especially when I said,
"You're gonna need surgery."
Ahh!
I'm just happy that you're here.
I'm trying not to hug you right now.
Okay, make it quick.
Thank you!
All right, now talk me
through your surgical plan.
Well, after trocar insertion,
I'll...
Your very own start-to-finish
partial colectomy, huh?
Pretty spiffy.
Yeah, yeah. Should be pretty cool.
What's the matter?
Oh, are you nervous?
No, it's not nerves. It's just...
I wish I had a different
attending, that's all.
I mean, if people don't
like what Minnick's doing,
- they don't really try...
- Well, who's the attending?
I'll talk to them.
Dr. Webber.
But... yeah. Yeah.
So this should be fun.
And, no, no, you won't talk to him.
I have enough problems
being your First Lady.
Just stay out of it.
My First what?
Dr. Pierce, do you
think I might have a chance
to dissect the thoracic esophagus?
No, Wilson.
I don't see why not, Dr. Pierce, if...
Because we already have one surgeon
we didn't plan for is why not.
Okay, I get it.
You are unhappy about Dr. Grey,
but I am not the one who suspended her.
I'm unhappy about the fact
that Dr. Grey and I worked hard
to plan this surgery,
and you are skipping steps.
You just ligated a branch
that we might need
for the anastomosis.
And now the esophagus
is ready to be excised,
which was quicker.
V-fib!
She's in cardiac arrest!
Ready?
Grab the paddles!
1, 2, 3.
Paddles!
Charge to 120.
Clear.
So, what now?
Can we still excise the tumor?
No, we can't.
She's too unstable.
We have to close her up,
do a cardiac work-up,
observe her in ICU.
Sorry, Lynne, you're gonna
have to keep waiting.
Why are you looking at me?
I didn't give her a heart attack.
Dr. Bailey.
Need something?
Warren is doing
his start-to-finish surgery.
I thought I'd observe.
Really?
Observe Warren or me?
You asked her to come in here?
You don't trust me
to follow the protocol?
No, sir.
I-I didn't even know
that she was gonna come.
Uh, he didn't say that,
and I didn't say that.
You said that.
I think we're good.
I think I'd like to watch.
I had a heart attack?
Yes, but we were able
to intervene very quickly.
But you didn't get the damn cancer out?
No, we weren't able to remove the tumor.
After your heart attack...
I knew something was gonna go wrong.
The minute Dr. NotGrey showed up, I...
Dr. Grey wouldn't have
been able to do anyth...
You know, why don't we...
why don't we give you
a few minutes of peace and quiet?
That poor woman's body
is still riddled with cancer.
We did just save her life.
You'd think she'd see that as a plus.
Shut up!
Just... shut your face.
- Maggie!
- I thought you were with us.
I thought you were with Richard.
And then you go and do this?
I took a job!
It was an opportunity!
It's aiding the enemy!
I'm not saying I agree
with what Bailey did...
But you are saying
that it's not a deal-breaker!
Not for you.
Not if it gets you what you want.
Traitor!
I'm doing my job!
This is my job, Maggie!
Someone here has to act like an adult!
And now I am dividing
the white line of Toldt.
Beautiful dissection, Dr. Warren.
Thank you, sir.
Uh, Dr. Webber, more suction.
Are you gonna be one of those surgeons
who plays music in his O.R.?
I might be.
Well, choose your playlist carefully.
I once had this resident who
made it all the way to close,
and then all of a sudden,
this music comes on.
It was the most
ridiculous song I ever heard.
It was complete gibberish.
Stay away from the ureter.
Yep.
Uh, more traction, please?
I was that resident.
And "MMMBop" was very popular
at the time.
That was you, huh?
Mm. It was catchy.
Dr. Warren, did you know
that my first solo surgery
was also with Dr. Webber?
Oh, indeed.
But somewhere between then and now,
Dr. Bailey forgot
that I know how to teach.
What I'm saying is,
the chief gives an order,
you... you follow the order.
You... You try to make it work.
Spoken like a true soldier.
Spoken like a former chief.
Right on both counts.
So you're neutral is what you're saying.
You're Switzerland.
No, I'm saying Bailey's the chief,
but that doesn't mean
that I-I-I-I'm against Webber.
Yeah, I get that. I really do.
But what the hell are you supposed to do
when you're completely against the order
that you've been given?
Well, that's called a coup.
Frowned upon
but sometimes very necessary.
Oh, so that's what
we're talking about here?
Throwing Minnick out
- or throwing Bailey out?
- No, no, no.
It's just, we want Webber in.
That's all... I mean, yeah,
I guess that means Minnick has to go.
So what?
I don't know what we're gonna do here,
but we got to do something.
So, Hunt, are you with us?
Or are you too busy
being Switzerland over there?
How's Kepner doing?
What do you mean, how's Kepner doing?
She's a turncoat.
She's also a friend.
Yes, she's a friend.
She's a poor, misguided,
very confused friend.
It's like when you find out
that your friend voted wrong.
Can you vote wrong?
- Yes.
- Absolutely.
Yeah.
I'm sorry, but she was
leading the charge,
and then Bailey dangles a little carrot,
and suddenly it's, "See ya, Webber."
I'm sure there's more to it than that.
Well, it's not right, what Bailey did.
You can't just throw anybody in
as Chief of General Surgery.
Keps is good, but Grey put in
the time for that job, okay?
She deserves it.
- All right.
- I'm gonna get back to work.
You know, Switzerland doesn't engage
in international conflicts.
It serves in peacekeeping missions
and protects Switzerland itself.
Keeping the peace
and protecting ourselves...
that's what we're doing.
So we're all Switzerland,
then, aren't we?
Doesn't feel like it.
What the hell?
Is that the O.R. schedule?
Yeah, but why is a resident
listed as a lead surgeon
on a lap chole on a peds case?
Damn it, Minnick...
I didn't want you "out of the way."
Why would you say that?
Anastomosis looks...?
Uh, it's good, good.
We can pull out the trocar.
Let me see. Okay.
- You fired me...
- I didn't fire you.
Then you fired Grey.
I suspended Grey.
Does the umbilical port get closed
with a deep or superficial closure?
- Both. - Both. - Okay.
You know, pretty soon,
you're gonna find yourself
out of teachers.
It's tough to be a leader
when there's no one to lead.
I'm not afraid to be unpopular,
- for the good of the hospital.
- Oh, that's not you.
I know that Catherine
put you up to this.
I know it was her idea!
Fascia's closed.
I love my wife.
- "Great, Dr. Warren. Keep going."
- But she is very hard to stand up to...
- 3-0 nylon and Steri-Strips...
- and I think it's time we stood up to her.
I can stand up just fine,
and that's exactly what I did.
Who gave you permission
to let a resident
operate on a 9-year-old?
We're implementing phase two
of my program...
No, you're not implementing
phases on a kid.
Look, he's really big for his age.
It's a lap chole.
It's a simple procedure
that Dr. Edwards is perfectly capable...
You're not a peds surgeon.
You are a sports-medicine ortho surgeon.
I am scrubbing in.
I was trained in general surgery,
just like you, and I teach for a living.
I taught five lap choles last month,
but if it will make you
feel more comfortable,
then, please, join us, Dr. Robbins.
I'd love to have you.
Good.
But only to observe.
I'm gonna go get Matty prepped.
No.
No?
No.
You go give the parents a pre-game.
You are the lead surgeon,
which means I prep your patient.
Seriously?
Mm-hmm.
Okay.
Look at that.
See?
When you let yourself
have a little fun...
Don't do that.
Just... don't.
- Don't do what?
- That.
It was cute in the beginning,
but it's not anymore.
You'd rather sacrifice your students
than swallow your pride
and admit that someone found
a better way to teach them.
- All right, scissors.
- Instead of...
you want to devote your time
to bringing this hospital down
and me along with it.
Hey, I can't stop you.
And I am done.
Steri-Strip and dress
the wounds, please.
- Yeah, well done.
- Yeah, uh, good job, Warren.
Really?
Well, don't you think so?
No, I do. It's just...
This was my first time
as primary on a surgery.
It should have at least been fun,
but you two were so busy arguing
about how to teach or not teach students
that you forgot
that you had one in here!
I'm sorry. No disrespect.
It's just...
This was my first,
and I'm never gonna get another one.
I need to go dictate the post-op report.
Thank you, everyone.
It's a really simple surgery.
I just make a tiny, little hole,
and in that hole,
I insert my camera
and all my instruments...
Okay.
...and you just end up with
an itty-bitty scar right there.
Okay?
Okay.
All right.
I think it's time to take you up.
I will come and talk to you
when we're done.
I said I think it's time we take him up,
which means take him to the O.R.
and mark the incision spot.
I prefer an infra-umbilical incision.
You can give him .5 milligrams...
- Uh, Edwards?
- Yeah.
- Rein it in.
- Okay.
Her vitals look good.
How are you feeling, Lynne?
Any pain?
Lots, thanks to you.
Okay, can we just be nice for a minute?
Wilson, check the repeat
enzymes, please.
You know who was nice?
Dr. Grey.
- What?
- Dr. Grey is nice.
- Yeah, no.
- I just...
Noth...
I'm nicer... than Dr. Grey.
I mean, ask anyone in this hospital.
I mean, there are comparisons
that you can make
between myself and Dr. Grey,
but in a contest of niceness,
I take that win.
I win by a lot. I am the nicest.
Yeah.
Well, Dr. Grey would've gotten my can...
Lynne?
Lynne, what's going on?
Are you okay?
Hard to breath!
She's tachycardic. Pressure's down.
I need an EKG and a portable X-ray!
Is it another M.I.?
Uh, Dr. Pierce, there's
gastric fluid in her lungs.
The esophageal stump
must've perfed into her chest.
My staples didn't hold.
Lynne, there's been a complication.
We have to take you back
to the O.R. right away.
You screwed up.
First I was dying of cancer,
and now I'm dying because...
You're trying to kill me.
Let's move!
Okay.
You can be in here on one condition.
I can be in here however I want.
This isn't about me. It's about Edwards.
She needs to feel confident,
and she won't
if you're standing over her shoulder.
You're welcome to observe,
but if you don't think
you can keep your hands to yourself,
you have to leave.
Fine.
In the peritoneum.
Optical trocar and camera, please.
There's a lot of resistance.
I'm... I'm not sure how hard to push.
Right.
You won't know until you do it.
Keep going. You're good.
It's all about the feel.
Mm-hmm.
Together.
You're in.
That was the hard part.
The rest is a piece of cake.
- What now?
- Insufflation.
I knew you were moving too fast.
She was having a heart attack.
I stapled as quickly as I could.
- I know.
- So, what?
Dr. Grey can staple
better than I can now?
Lynne is prepped and ready.
Thank you, Wilson.
Dr. Pierce, you can go.
What?
This is my revision. I don't need you.
You can go.
She's my patient.
No, actually, she's Dr. Grey's patient,
and I'm Dr. Grey now.
I'm in charge,
whether you like it or not,
and until you get on board with that,
you are not welcome in my O.R.
So you can stop scrubbing...
and you can go.
You're gonna need an extra set of hands.
Wilson has hands.
That was badass.
Shut up.
Dissecting the gallbladder now.
Just remember to stay away from the...
From the CBD, got it.
Dr. Robbins, please.
Almost there.
There's the duct.
He's tachycardic.
His pressure's trending down.
Edwards, can you see if there's bleeding
coming from the liver bed?
Do you know how to...
Dr. Edwards knows what to do.
Checking the liver.
No bleeding. The field looks clear.
Well, the blood's coming from somewhere,
so check the hepatic artery.
I don't see any...
I don't see any bleeding.
Turn the camera.
What?
Turn the camera,
and check out the rest of his abdomen.
Just do it.
Oh, God.
All right, his pelvis
is filled with blood.
All right, pull the trocars.
He's been bleeding out this whole time.
I don't understand.
Why would I have not seen that?
His pressure's bottomed out!
Hang two units!
I need platelets and FFP!
Move, move! Back up!
Scalpel!
All right, lap pads.
Bovie.
- Suction.
- Suction.
- Come on, Edwards.
- I don't understand.
More lap pads!
Okay.
Edwards, suction.
All right, his mesentery's bleeding.
Can you localize the bleeder?
Help me get some proximal control of the
SMA.
Suction!
There's injury to the superior
mesenteric artery.
Must have nicked it with the trocar.
All right, lost his pressure!
Clamp, clamp, clamp, clamp! Come on!
He's bleeding out faster
than we can put it in!
What did I do?
Did I... Did I skip a step?
Did I... Should I have done
something differently?
I mean, did I... did I kill that boy?
Hey.
Hey! Where are you going?!
Neither of us is up for cooking tonight.
So let's pick something up,
or I could just make
reservations at our place.
No, I'm not hungry.
Come on. Can't we be civil?
I was always a fine surgeon.
But I am an excellent teacher,
and today, I was a complete failure.
I know you thought
this program had problems,
but it sure as hell has them now.
Richard...
Bailey was my favorite student.
I brought her in as an intern.
I saw her all the way through to chief.
She was my "start-to-finish."
And you turned her against me.
Come here, my little bug.
Oh, I thought you were, uh...
I thought I was taking her home.
Hi.
Mwah!
I just wanted to kiss her good night.
'Cause I'm gonna be here late
prepping for a department meeting.
Got it.
And then I've also got a tumor
debulking to prep for, so...
You're really enjoying this,
aren't you?
Yeah.
Yeah, I am.
You don't remember that you
and I started this for Webber?
I still support Webber.
So then you should have told Bailey no.
And ignore my responsibility
to this hospital,
'cause of a political pissing match?
Yesterday, it was a noble cause.
What are you talking about?
Oh, but now, all of a sudden,
you've got your shiny new title, right?
What? What...
What does that mean?
You realize how this looks, don't you?
You realize what everybody's saying?
That you're an opportunist?
That you're an overly ambitious...
And you told them
that they're wrong, right?
Because you know me,
and you know better.
Right?
I'm surprised by you.
That's what I am.
Look, Bailey gave you a choice.
That's what that was.
It was a choice. You chose wrong.
But it's not too late.
You could still resign.
You could still tell her
that you made a mistake.
Yeah, but I didn't make a mistake.
I have a duty to this hospital.
My chief asked me to step up, so I...
Did she? Or was that my mom again?
Telling Bailey that she should pick you.
Why would you say that?
Uh, 'cause it's probably true.
It's not even your fault.
It's her. It's what she does.
No. No, it's you.
Because you refuse to believe
that I got this because I earned it.
That's... Because I'm good.
That's not...
What the hell is wrong with you?
She asked you a question.
She needed an answer.
I know.
What kind of teacher are you?
I mean, you don't just teach them
what to do with their hands.
You teach them what to do with this,
how to live through this.
I mean, you take it on yourself.
I know.
You don't!
You are the attending!
This is your loss.
Okay? You take the hit.
Because if you... if you put it on her,
she might quit.
She might think
that she can't survive it,
so you show her that she can.
You tell her,
"When this happened to me..."
It hasn't.
What?
It's never happened to me.
I never had a child die.
Never?
Not a kid.
Not in residency, not as a fellow,
and now I work on athletes...
and old people...
old, broken hips, torn ligaments.
Never a little boy.
I took that boy from his parents.
And now I have to tell them.
And I don't know how.
How do you do it?
How do you stop feeling like this?
You don't.
You... You just learn how to...
You learn how to feel
this way a little faster.
You let it hurt, and then you...
you put it behind you so that
you can face forward to the...
the next kid who needs you.
I remember my first...
like it was yesterday, so...
take your time.
And then, we'll go.
Dr. NotGrey, you're still here.
I am still here. And so are you.
Dr. Wilson?
The repair went very well.
You fixed the thing you broke?
I fixed the thing I broke.
And that nasty esophageal tumor
is in the medical waste,
where it belongs.
You got the damn cancer?
We got the damn cancer.
You got it?
Well, Dr. Wilson and I did.
Full excision, good margins.
We still need to run some tests,
but it appears as though
you are cancer-free.
What's your name again?
Hemostasis was established,
and the patient was sent to
post-op without complications.
Dr. Webber?
May I, uh... May I run something by you?
By me?
I thought you were working
with Dr. Minnick.
Routine lap-chole, 9-year-old patient,
when the patient became
tachycardic and hypotensive.
Uh, I couldn't... I couldn't
locate the bleeder initially,
then we discovered that his pelvis
was filled with blood.
Dr. Robbins converted to an ex lap w...
and she found an injury to
the superior mesenteric artery.
Dr. Robbins tried a repair,
but the bleeding...
Edwards, what happened?
He died.
Okay.
He was my patient, and he died.
- Okay.
- He was a little boy.
You know what? Here.
- Why don't you sit down?
- No, I can't sit down.
A tear in a vessel
with a trocar insertion...
it happens.
It's not common, but it happens,
and it's usually an easy fix.
But you can't fix what you can't see.
I mean, you had no reason
to suspect bleeding
until you did.
And by then, you were racing the clock,
and the clock will more often win.
Against all of us.
I know you feel responsible...
But I am responsible.
You couldn't have known
you tore that vessel.
Dr. Robbins didn't catch it.
Dr. Minnick didn't catch it.
Anybody's hands
could've been on that trocar.
They wouldn't have caught it.
You lost.
It's not your fault.
You lost.
Every good surgeon does.
It might be your worst, but...
it won't be your last.
What was his name?
Matty.
Matty.
Matty.
What... What... What do I do next?
Okay, so, if you think
you're gonna lose it,
then I'll jump in.
I think I'll be fine.
I just...
I guess I'm off the hook.
I have a tip for you.
The work that's on the page
and not on the patient?
Take it home.
At least be comfortable.
Be in your pajamas.
Uh, I'd just as soon stay here.
Why is that?
Because my roommate is a narrow-minded,
short-sighted, judgmental,
and insulting piece of...
...work.
Oh, and I am sorry.
I should not have said that to you.
He's mad you took the job.
Did you...
Did you put me up for this?
No.
It was all Bailey.
I thought it was smart.
April, Jackson can never
understand what you did.
He's not like you and me.
Like you and me?
He was raised with money,
connections, a name.
You and I had to work for it.
I don't know.
I mean, Jackson has worked...
Oh, Jackson's always worked hard...
He worked hard in school.
He works hard now.
He's earned his success.
It's just...
he's never had to worry like us.
He's always known if he leaps,
there's always a safety net.
The tough choices
for you and me are tougher.
I just... I felt like
what was asked of me was...
bigger than me, bigger than Richard.
It is.
You saw that.
Put that away. Come on.
- Let's go get some dinner and
celebrate this. -
I don't exactly have a party
waiting for me at home, either.
Oh, I better not.
Honey, you are the boss.
Okay.
- Okay.
- All right.
Are we going to talk about
what happened today?
Can we not?
Look, I... I need a break.
I'm in the middle of everything
- at the hospital...
- You are in the middle of everything?
Yes, me, Miranda.
I'm a resident, you know?
So I want to side with them
because Minnick is great for us,
but the attendings are my friends.
Now they stop talking when I'm around,
because I'm married to you.
Yeah, I'm in it.
Well, if you're so in it,
whose side are you on?
I would like to know.
I just want to go to bed
and turn my brain off
until I fall asleep and stay out of it.
Once things start going wrong,
it's hard to break the cycle.
Murphy's Law is not physics.
It's just a thing a guy said...
to try and make sense of a crappy day.
Just because things go wrong,
it doesn't mean
they're out of our control.
Pop the hood!
You don't have to...
Pop your hood.
Can you not? This is bad enough...
I pulled out your horn wire,
so you're gonna need to get that fixed.
Thank you.
You're welcome.
I mean...
thank you.
It's on us to fix things.
You know, you could have friends here,
if you wanted to.
It's on us to take everything
that can go wrong...
...and make it go right.
It's on us to try, anyway.
---
In 1949, Edward Murphy conducted
a rocket-sled experiment...
...to see how much pressure
a human being could withstand.
Good morning.
I've organized
the monthly rotation schedule,
I got up to speed
on all the upcoming
general elective surgeries,
and I have some ideas
about which residents
are ready for the next phase
of Dr. Minnick's training.
Um, I could run that by you, or...
Murphy's experiment failed...
spectacularly.
Or not.
Over and over.
Uh, whatever you like. Sorry.
What... What would Dr. Grey usually do?
Uh, Dr. Grey wouldn't
talk to me about any of it.
She would just do it.
Go. Do it.
Oh. Okay. Sure. Yeah.
Needless to say, he didn't
start off on the right foot.
Kepner, you don't have
to check in with me.
I trust you.
You do you.
It's your department now.
That's why it's called Murphy's Law.
Because if anything
can go wrong, it will.
You may have thought you were done
talking about this, but I wasn't.
Richard, it was 3:00 in the morning.
I have surgery. I needed sleep.
You need sleep. Come on.
You told Bailey to replace me.
No, baby, no.
I told Bailey there was a problem.
- You told her there was a problem.
- Yes.
You see a problem in our marriage,
will I hear about it,
or will some consultant
come and kick me out of our bedroom?
Stop. You know me better than that.
No, Catherine, right now, I don't.
I really don't.
Take O.R. 4 and make sure
you do the post-op debriefing
with the resident right away.
Is Dr. Grey out sick or something?
Dr. Grey is suspended.
I am the interim department
chief until further notice.
You are?
Yes.
Yes.
Yes.
Okay.
Oh, Dr. Kepner, Dr. Bailey told me
you're filling in for
Dr. Grey as Chief of General.
I am.
Well, congrats.
Well, I didn't...
I mean, it was a... a necessary...
- I need your help.
- Oh.
I'm beginning phase two
of my teaching program today...
Right. Phase two.
And I need someone to supervise
Ben Warren through a colectomy.
Dr. Hawkins was gonna do it,
but he's sick.
Can you assign someone else?
Yeah, let's see who has a colectomy.
Oh.
Is there a problem?
No. No.
Not at all. All good.
Um, I do have a surgeon
available with one,
and I will just assign it to him.
Great. Thanks.
Sure. Yeah.
Do you know where Dr. Webber is?
Did April say anything?
Like why she jumped ship?
I haven't seen her.
She was home late and out early.
Oh, she's slinking, then.
She knows what she did. She's slinking.
Traitor.
No offense.
Look, I can't believe
that she would have done this, either.
I can't believe Bailey asked her.
How's Grey holding up?
She's bored.
She's worried Kepner's
gonna kill all of her patients.
Kepner's a solid surgeon.
You have to give her that,
no matter how anyone feels
about her taking the job.
Yeah, of course she's a great surgeon.
Guys, we're losing ground here, okay?
We lost Grey. We're...
Now we're losing April...
And we don't have the residents.
They love Minnick.
And she's about to start
phase two of her program.
Phase two?
A resident gets to be
the primary surgeon
on their own case.
One procedure, pre-op
to post-op, start to finish.
Under supervision, right?
Yeah, but the resident does it all.
The attending is there to assist.
The resident?
Start to finish, baby!
Oh, would you quit bragging already?
Yes!
I don't get it. Why you two?
'Cause Minnick recognizes
I'm the best resident.
Obviously.
I don't know why you got one.
Special treatment.
From his Chiefwife.
It's not special treatment,
and don't call her that.
Minnick told me
she drew names from a hat.
See?
Whatever... Mr. Bailey.
She's really gonna let you do
a whole surgery with no help?
No hand-holding, no training wheels,
no safety belts, no gutter bumpers.
Phase two, baby!
Shut up, baby.
Yeah, what happened to you?
Last night, you were like,
"Let's start a revolution!"
Well, this morning,
I would say that we're winning.
Now, gosh, if you'll
excuse me, children,
Mama's got to go do surgery.
- Aah!
- Ohho-ho!
Good morning.
Kepner.
April. How's your new job going?
So busy, as I'm sure you know.
Dr. Webber, can I talk to you for a sec?
Sure.
Maybe could we go somewhere
a little more private, or...?
Oh, you know what, Kepner?
I'm... I'm pretty busy.
W-What do you have to say?
Um, it's about your
partial colectomy today.
It's now Ben Warren's.
- I beg your pardon?
- Start to finish.
I'd like Dr. Warren
to scrub in as primary surgeon.
You'd like?
And you can assist and help...
only when requested...
but it will be Dr. Warren's O.R.
Why don't you let Bailey take this one?
Because I've assigned it to you.
Well, I suggest you unassign it.
I would... I would really
rather not, Dr. Webber.
Sir.
Please?
Just... please?
Sure thing...
Chief.
- There you are.
- Yes.
And I am ready.
I have Mrs. Mallenbaum's labs,
I booked an O.R...
Edwards, unbook it.
Mrs. Mallenbaum had a complication.
What? Did she have breakfast?
No. She died.
Oh.
Oh, God.
That's...
- That's awful.
- It's okay to be disappointed.
You were excited.
I was excited, too.
So, should I go down to the pit
or something instead, or...
You know what? Yes.
If you're gonna do
a true start-to-finish,
we should both go down to the E.R.
and see if we can start one on intake.
We're trolling?
We're trolling.
Can you check Mr. Lewis' drains
for me, please?
Yes, Doctor.
All right, I've been thinking.
All right, we are in a corner.
Okay? It's time.
One of us needs to talk
to my mother about this,
and I know what
you're gonna say, all right?
- And I don't care how it looks...
- Jackson, she knows.
Sh...
She knew before anyone.
She's not with us.
No, sh...
This was my mother's idea?
I-I-I thought...
I thought this was Bailey's
So did I.
But, no, Bailey decided I didn't need...
- You should stop talking right now.
- What?
Dr. Webber.
Oh, need something, Warren?
Well, um...
Well, you, sir.
Uh, I have my start-to-finish
surgery today,
and you were assigned to...
Assist you, yeah.
Right.
- We'll talk later.
- Mm-hmm.
Warren.
Jackson.
- Boring, boring.
- Weird and gross.
Exceptionally boring.
None of these are surgical.
Can I get a portable ultrasound
- to Bed 2, please?
- Of course.
Dr. Murphy, talk to me about Bed 2.
It's a 9-year-old boy
with right upper quadrant pain.
I'm betting it's acute cholecystitis,
but I've got to get
the ultrasound to confirm.
Mm-hmm.
That won't be necessary.
Am I missing something?
Wait. No, no, no, no!
Dr. Edwards is taking over this
case now, from start to finish.
Thank you for finding it for her.
No! I started it. I get to finish it!
I love gallstones!
Yes!
You will get your turn, Dr. Murphy,
and when that happens,
Dr. Edwards will be there
to support you.
Physical Therapy to 5 West.
Physical Therapy to 5 West.
Wait, honey, tell me again...
where's Dr. Grey?
Good morning, Ms. Gagliano. I am Dr...
Not Dr. Grey.
She's not Dr. Grey.
Where's Dr. Grey?
Dr. Grey is unavailable
to perform your surgery, Lynne,
so, uh, Dr. Kepner will be
performing it with Dr. Pierce.
She's gonna take out my cancer?
Ms. Gagliano, I have
successfully operated
on several esophageal cancer...
Listen, Dr. NotGrey,
I don't care what you've done.
Dr. Grey found my cancer.
She told me about it.
She held my hand
while I bawled about it.
She told me how
she was gonna take it out.
I've been going to the same
hairstylist for 23 years.
Why?
Because she knows
how I like my roots done.
Dr. Grey knows my roots.
Let's cancel the surgery.
I'll wait for Dr. Grey.
Lynne, that kind of loyalty
is really appreciated.
Thank you.
Loyalty is so rare in this world.
But we're not sure
when Dr. Grey will be back,
and with the risk
of your cancer spreading,
we can't wait.
But I'll be there.
Your roots are safe with me.
When did the pain start?
When we were in our car,
on the way to the seaport.
Matty kept complaining
about his stomach.
It's been off and on
for the last few days,
but it kept getting worse,
so we just turned around
and came back here.
I mean, it's probably
just a stomach bug, right?
We're going on a cruise.
Ooh, that's fun.
It's called an Explorer Cruise.
It's all-inclusive, three ports of call.
And they have rock-climbing walls
and even movie nights.
And they teach you
to surf right on deck!
See, he... he's more excited
than Matty is about this trip.
It's like I have two children.
Matty, can you raise your arms for me?
Also, if we get to the car
within the hour,
we can still make it.
Dana...
Maybe we're just overreacting.
- Dana...
- I'm being optimistic.
Matty's been looking forward
to this for a year.
Hillary, Dana, I'm afraid
Matty has gallstones
and a very inflamed gallbladder.
Gallstones?
But he's nine.
Very rare in someone Matty's age,
but it can happen.
Oh, gosh. Oh, sweetie.
But will we still be able to go?
It's okay, son. Don't worry.
Will we be... able to go?
Not today, buddy.
You need surgery.
My God.
That was so hard.
Hey, they can reschedule a vacation.
You can't get caught up
in their story...
Not your job.
No, it was so hard to keep from smiling,
especially when I said,
"You're gonna need surgery."
Ahh!
I'm just happy that you're here.
I'm trying not to hug you right now.
Okay, make it quick.
Thank you!
All right, now talk me
through your surgical plan.
Well, after trocar insertion,
I'll...
Your very own start-to-finish
partial colectomy, huh?
Pretty spiffy.
Yeah, yeah. Should be pretty cool.
What's the matter?
Oh, are you nervous?
No, it's not nerves. It's just...
I wish I had a different
attending, that's all.
I mean, if people don't
like what Minnick's doing,
- they don't really try...
- Well, who's the attending?
I'll talk to them.
Dr. Webber.
But... yeah. Yeah.
So this should be fun.
And, no, no, you won't talk to him.
I have enough problems
being your First Lady.
Just stay out of it.
My First what?
Dr. Pierce, do you
think I might have a chance
to dissect the thoracic esophagus?
No, Wilson.
I don't see why not, Dr. Pierce, if...
Because we already have one surgeon
we didn't plan for is why not.
Okay, I get it.
You are unhappy about Dr. Grey,
but I am not the one who suspended her.
I'm unhappy about the fact
that Dr. Grey and I worked hard
to plan this surgery,
and you are skipping steps.
You just ligated a branch
that we might need
for the anastomosis.
And now the esophagus
is ready to be excised,
which was quicker.
V-fib!
She's in cardiac arrest!
Ready?
Grab the paddles!
1, 2, 3.
Paddles!
Charge to 120.
Clear.
So, what now?
Can we still excise the tumor?
No, we can't.
She's too unstable.
We have to close her up,
do a cardiac work-up,
observe her in ICU.
Sorry, Lynne, you're gonna
have to keep waiting.
Why are you looking at me?
I didn't give her a heart attack.
Dr. Bailey.
Need something?
Warren is doing
his start-to-finish surgery.
I thought I'd observe.
Really?
Observe Warren or me?
You asked her to come in here?
You don't trust me
to follow the protocol?
No, sir.
I-I didn't even know
that she was gonna come.
Uh, he didn't say that,
and I didn't say that.
You said that.
I think we're good.
I think I'd like to watch.
I had a heart attack?
Yes, but we were able
to intervene very quickly.
But you didn't get the damn cancer out?
No, we weren't able to remove the tumor.
After your heart attack...
I knew something was gonna go wrong.
The minute Dr. NotGrey showed up, I...
Dr. Grey wouldn't have
been able to do anyth...
You know, why don't we...
why don't we give you
a few minutes of peace and quiet?
That poor woman's body
is still riddled with cancer.
We did just save her life.
You'd think she'd see that as a plus.
Shut up!
Just... shut your face.
- Maggie!
- I thought you were with us.
I thought you were with Richard.
And then you go and do this?
I took a job!
It was an opportunity!
It's aiding the enemy!
I'm not saying I agree
with what Bailey did...
But you are saying
that it's not a deal-breaker!
Not for you.
Not if it gets you what you want.
Traitor!
I'm doing my job!
This is my job, Maggie!
Someone here has to act like an adult!
And now I am dividing
the white line of Toldt.
Beautiful dissection, Dr. Warren.
Thank you, sir.
Uh, Dr. Webber, more suction.
Are you gonna be one of those surgeons
who plays music in his O.R.?
I might be.
Well, choose your playlist carefully.
I once had this resident who
made it all the way to close,
and then all of a sudden,
this music comes on.
It was the most
ridiculous song I ever heard.
It was complete gibberish.
Stay away from the ureter.
Yep.
Uh, more traction, please?
I was that resident.
And "MMMBop" was very popular
at the time.
That was you, huh?
Mm. It was catchy.
Dr. Warren, did you know
that my first solo surgery
was also with Dr. Webber?
Oh, indeed.
But somewhere between then and now,
Dr. Bailey forgot
that I know how to teach.
What I'm saying is,
the chief gives an order,
you... you follow the order.
You... You try to make it work.
Spoken like a true soldier.
Spoken like a former chief.
Right on both counts.
So you're neutral is what you're saying.
You're Switzerland.
No, I'm saying Bailey's the chief,
but that doesn't mean
that I-I-I-I'm against Webber.
Yeah, I get that. I really do.
But what the hell are you supposed to do
when you're completely against the order
that you've been given?
Well, that's called a coup.
Frowned upon
but sometimes very necessary.
Oh, so that's what
we're talking about here?
Throwing Minnick out
- or throwing Bailey out?
- No, no, no.
It's just, we want Webber in.
That's all... I mean, yeah,
I guess that means Minnick has to go.
So what?
I don't know what we're gonna do here,
but we got to do something.
So, Hunt, are you with us?
Or are you too busy
being Switzerland over there?
How's Kepner doing?
What do you mean, how's Kepner doing?
She's a turncoat.
She's also a friend.
Yes, she's a friend.
She's a poor, misguided,
very confused friend.
It's like when you find out
that your friend voted wrong.
Can you vote wrong?
- Yes.
- Absolutely.
Yeah.
I'm sorry, but she was
leading the charge,
and then Bailey dangles a little carrot,
and suddenly it's, "See ya, Webber."
I'm sure there's more to it than that.
Well, it's not right, what Bailey did.
You can't just throw anybody in
as Chief of General Surgery.
Keps is good, but Grey put in
the time for that job, okay?
She deserves it.
- All right.
- I'm gonna get back to work.
You know, Switzerland doesn't engage
in international conflicts.
It serves in peacekeeping missions
and protects Switzerland itself.
Keeping the peace
and protecting ourselves...
that's what we're doing.
So we're all Switzerland,
then, aren't we?
Doesn't feel like it.
What the hell?
Is that the O.R. schedule?
Yeah, but why is a resident
listed as a lead surgeon
on a lap chole on a peds case?
Damn it, Minnick...
I didn't want you "out of the way."
Why would you say that?
Anastomosis looks...?
Uh, it's good, good.
We can pull out the trocar.
Let me see. Okay.
- You fired me...
- I didn't fire you.
Then you fired Grey.
I suspended Grey.
Does the umbilical port get closed
with a deep or superficial closure?
- Both. - Both. - Okay.
You know, pretty soon,
you're gonna find yourself
out of teachers.
It's tough to be a leader
when there's no one to lead.
I'm not afraid to be unpopular,
- for the good of the hospital.
- Oh, that's not you.
I know that Catherine
put you up to this.
I know it was her idea!
Fascia's closed.
I love my wife.
- "Great, Dr. Warren. Keep going."
- But she is very hard to stand up to...
- 3-0 nylon and Steri-Strips...
- and I think it's time we stood up to her.
I can stand up just fine,
and that's exactly what I did.
Who gave you permission
to let a resident
operate on a 9-year-old?
We're implementing phase two
of my program...
No, you're not implementing
phases on a kid.
Look, he's really big for his age.
It's a lap chole.
It's a simple procedure
that Dr. Edwards is perfectly capable...
You're not a peds surgeon.
You are a sports-medicine ortho surgeon.
I am scrubbing in.
I was trained in general surgery,
just like you, and I teach for a living.
I taught five lap choles last month,
but if it will make you
feel more comfortable,
then, please, join us, Dr. Robbins.
I'd love to have you.
Good.
But only to observe.
I'm gonna go get Matty prepped.
No.
No?
No.
You go give the parents a pre-game.
You are the lead surgeon,
which means I prep your patient.
Seriously?
Mm-hmm.
Okay.
Look at that.
See?
When you let yourself
have a little fun...
Don't do that.
Just... don't.
- Don't do what?
- That.
It was cute in the beginning,
but it's not anymore.
You'd rather sacrifice your students
than swallow your pride
and admit that someone found
a better way to teach them.
- All right, scissors.
- Instead of...
you want to devote your time
to bringing this hospital down
and me along with it.
Hey, I can't stop you.
And I am done.
Steri-Strip and dress
the wounds, please.
- Yeah, well done.
- Yeah, uh, good job, Warren.
Really?
Well, don't you think so?
No, I do. It's just...
This was my first time
as primary on a surgery.
It should have at least been fun,
but you two were so busy arguing
about how to teach or not teach students
that you forgot
that you had one in here!
I'm sorry. No disrespect.
It's just...
This was my first,
and I'm never gonna get another one.
I need to go dictate the post-op report.
Thank you, everyone.
It's a really simple surgery.
I just make a tiny, little hole,
and in that hole,
I insert my camera
and all my instruments...
Okay.
...and you just end up with
an itty-bitty scar right there.
Okay?
Okay.
All right.
I think it's time to take you up.
I will come and talk to you
when we're done.
I said I think it's time we take him up,
which means take him to the O.R.
and mark the incision spot.
I prefer an infra-umbilical incision.
You can give him .5 milligrams...
- Uh, Edwards?
- Yeah.
- Rein it in.
- Okay.
Her vitals look good.
How are you feeling, Lynne?
Any pain?
Lots, thanks to you.
Okay, can we just be nice for a minute?
Wilson, check the repeat
enzymes, please.
You know who was nice?
Dr. Grey.
- What?
- Dr. Grey is nice.
- Yeah, no.
- I just...
Noth...
I'm nicer... than Dr. Grey.
I mean, ask anyone in this hospital.
I mean, there are comparisons
that you can make
between myself and Dr. Grey,
but in a contest of niceness,
I take that win.
I win by a lot. I am the nicest.
Yeah.
Well, Dr. Grey would've gotten my can...
Lynne?
Lynne, what's going on?
Are you okay?
Hard to breath!
She's tachycardic. Pressure's down.
I need an EKG and a portable X-ray!
Is it another M.I.?
Uh, Dr. Pierce, there's
gastric fluid in her lungs.
The esophageal stump
must've perfed into her chest.
My staples didn't hold.
Lynne, there's been a complication.
We have to take you back
to the O.R. right away.
You screwed up.
First I was dying of cancer,
and now I'm dying because...
You're trying to kill me.
Let's move!
Okay.
You can be in here on one condition.
I can be in here however I want.
This isn't about me. It's about Edwards.
She needs to feel confident,
and she won't
if you're standing over her shoulder.
You're welcome to observe,
but if you don't think
you can keep your hands to yourself,
you have to leave.
Fine.
In the peritoneum.
Optical trocar and camera, please.
There's a lot of resistance.
I'm... I'm not sure how hard to push.
Right.
You won't know until you do it.
Keep going. You're good.
It's all about the feel.
Mm-hmm.
Together.
You're in.
That was the hard part.
The rest is a piece of cake.
- What now?
- Insufflation.
I knew you were moving too fast.
She was having a heart attack.
I stapled as quickly as I could.
- I know.
- So, what?
Dr. Grey can staple
better than I can now?
Lynne is prepped and ready.
Thank you, Wilson.
Dr. Pierce, you can go.
What?
This is my revision. I don't need you.
You can go.
She's my patient.
No, actually, she's Dr. Grey's patient,
and I'm Dr. Grey now.
I'm in charge,
whether you like it or not,
and until you get on board with that,
you are not welcome in my O.R.
So you can stop scrubbing...
and you can go.
You're gonna need an extra set of hands.
Wilson has hands.
That was badass.
Shut up.
Dissecting the gallbladder now.
Just remember to stay away from the...
From the CBD, got it.
Dr. Robbins, please.
Almost there.
There's the duct.
He's tachycardic.
His pressure's trending down.
Edwards, can you see if there's bleeding
coming from the liver bed?
Do you know how to...
Dr. Edwards knows what to do.
Checking the liver.
No bleeding. The field looks clear.
Well, the blood's coming from somewhere,
so check the hepatic artery.
I don't see any...
I don't see any bleeding.
Turn the camera.
What?
Turn the camera,
and check out the rest of his abdomen.
Just do it.
Oh, God.
All right, his pelvis
is filled with blood.
All right, pull the trocars.
He's been bleeding out this whole time.
I don't understand.
Why would I have not seen that?
His pressure's bottomed out!
Hang two units!
I need platelets and FFP!
Move, move! Back up!
Scalpel!
All right, lap pads.
Bovie.
- Suction.
- Suction.
- Come on, Edwards.
- I don't understand.
More lap pads!
Okay.
Edwards, suction.
All right, his mesentery's bleeding.
Can you localize the bleeder?
Help me get some proximal control of the
SMA.
Suction!
There's injury to the superior
mesenteric artery.
Must have nicked it with the trocar.
All right, lost his pressure!
Clamp, clamp, clamp, clamp! Come on!
He's bleeding out faster
than we can put it in!
What did I do?
Did I... Did I skip a step?
Did I... Should I have done
something differently?
I mean, did I... did I kill that boy?
Hey.
Hey! Where are you going?!
Neither of us is up for cooking tonight.
So let's pick something up,
or I could just make
reservations at our place.
No, I'm not hungry.
Come on. Can't we be civil?
I was always a fine surgeon.
But I am an excellent teacher,
and today, I was a complete failure.
I know you thought
this program had problems,
but it sure as hell has them now.
Richard...
Bailey was my favorite student.
I brought her in as an intern.
I saw her all the way through to chief.
She was my "start-to-finish."
And you turned her against me.
Come here, my little bug.
Oh, I thought you were, uh...
I thought I was taking her home.
Hi.
Mwah!
I just wanted to kiss her good night.
'Cause I'm gonna be here late
prepping for a department meeting.
Got it.
And then I've also got a tumor
debulking to prep for, so...
You're really enjoying this,
aren't you?
Yeah.
Yeah, I am.
You don't remember that you
and I started this for Webber?
I still support Webber.
So then you should have told Bailey no.
And ignore my responsibility
to this hospital,
'cause of a political pissing match?
Yesterday, it was a noble cause.
What are you talking about?
Oh, but now, all of a sudden,
you've got your shiny new title, right?
What? What...
What does that mean?
You realize how this looks, don't you?
You realize what everybody's saying?
That you're an opportunist?
That you're an overly ambitious...
And you told them
that they're wrong, right?
Because you know me,
and you know better.
Right?
I'm surprised by you.
That's what I am.
Look, Bailey gave you a choice.
That's what that was.
It was a choice. You chose wrong.
But it's not too late.
You could still resign.
You could still tell her
that you made a mistake.
Yeah, but I didn't make a mistake.
I have a duty to this hospital.
My chief asked me to step up, so I...
Did she? Or was that my mom again?
Telling Bailey that she should pick you.
Why would you say that?
Uh, 'cause it's probably true.
It's not even your fault.
It's her. It's what she does.
No. No, it's you.
Because you refuse to believe
that I got this because I earned it.
That's... Because I'm good.
That's not...
What the hell is wrong with you?
She asked you a question.
She needed an answer.
I know.
What kind of teacher are you?
I mean, you don't just teach them
what to do with their hands.
You teach them what to do with this,
how to live through this.
I mean, you take it on yourself.
I know.
You don't!
You are the attending!
This is your loss.
Okay? You take the hit.
Because if you... if you put it on her,
she might quit.
She might think
that she can't survive it,
so you show her that she can.
You tell her,
"When this happened to me..."
It hasn't.
What?
It's never happened to me.
I never had a child die.
Never?
Not a kid.
Not in residency, not as a fellow,
and now I work on athletes...
and old people...
old, broken hips, torn ligaments.
Never a little boy.
I took that boy from his parents.
And now I have to tell them.
And I don't know how.
How do you do it?
How do you stop feeling like this?
You don't.
You... You just learn how to...
You learn how to feel
this way a little faster.
You let it hurt, and then you...
you put it behind you so that
you can face forward to the...
the next kid who needs you.
I remember my first...
like it was yesterday, so...
take your time.
And then, we'll go.
Dr. NotGrey, you're still here.
I am still here. And so are you.
Dr. Wilson?
The repair went very well.
You fixed the thing you broke?
I fixed the thing I broke.
And that nasty esophageal tumor
is in the medical waste,
where it belongs.
You got the damn cancer?
We got the damn cancer.
You got it?
Well, Dr. Wilson and I did.
Full excision, good margins.
We still need to run some tests,
but it appears as though
you are cancer-free.
What's your name again?
Hemostasis was established,
and the patient was sent to
post-op without complications.
Dr. Webber?
May I, uh... May I run something by you?
By me?
I thought you were working
with Dr. Minnick.
Routine lap-chole, 9-year-old patient,
when the patient became
tachycardic and hypotensive.
Uh, I couldn't... I couldn't
locate the bleeder initially,
then we discovered that his pelvis
was filled with blood.
Dr. Robbins converted to an ex lap w...
and she found an injury to
the superior mesenteric artery.
Dr. Robbins tried a repair,
but the bleeding...
Edwards, what happened?
He died.
Okay.
He was my patient, and he died.
- Okay.
- He was a little boy.
You know what? Here.
- Why don't you sit down?
- No, I can't sit down.
A tear in a vessel
with a trocar insertion...
it happens.
It's not common, but it happens,
and it's usually an easy fix.
But you can't fix what you can't see.
I mean, you had no reason
to suspect bleeding
until you did.
And by then, you were racing the clock,
and the clock will more often win.
Against all of us.
I know you feel responsible...
But I am responsible.
You couldn't have known
you tore that vessel.
Dr. Robbins didn't catch it.
Dr. Minnick didn't catch it.
Anybody's hands
could've been on that trocar.
They wouldn't have caught it.
You lost.
It's not your fault.
You lost.
Every good surgeon does.
It might be your worst, but...
it won't be your last.
What was his name?
Matty.
Matty.
Matty.
What... What... What do I do next?
Okay, so, if you think
you're gonna lose it,
then I'll jump in.
I think I'll be fine.
I just...
I guess I'm off the hook.
I have a tip for you.
The work that's on the page
and not on the patient?
Take it home.
At least be comfortable.
Be in your pajamas.
Uh, I'd just as soon stay here.
Why is that?
Because my roommate is a narrow-minded,
short-sighted, judgmental,
and insulting piece of...
...work.
Oh, and I am sorry.
I should not have said that to you.
He's mad you took the job.
Did you...
Did you put me up for this?
No.
It was all Bailey.
I thought it was smart.
April, Jackson can never
understand what you did.
He's not like you and me.
Like you and me?
He was raised with money,
connections, a name.
You and I had to work for it.
I don't know.
I mean, Jackson has worked...
Oh, Jackson's always worked hard...
He worked hard in school.
He works hard now.
He's earned his success.
It's just...
he's never had to worry like us.
He's always known if he leaps,
there's always a safety net.
The tough choices
for you and me are tougher.
I just... I felt like
what was asked of me was...
bigger than me, bigger than Richard.
It is.
You saw that.
Put that away. Come on.
- Let's go get some dinner and
celebrate this. -
I don't exactly have a party
waiting for me at home, either.
Oh, I better not.
Honey, you are the boss.
Okay.
- Okay.
- All right.
Are we going to talk about
what happened today?
Can we not?
Look, I... I need a break.
I'm in the middle of everything
- at the hospital...
- You are in the middle of everything?
Yes, me, Miranda.
I'm a resident, you know?
So I want to side with them
because Minnick is great for us,
but the attendings are my friends.
Now they stop talking when I'm around,
because I'm married to you.
Yeah, I'm in it.
Well, if you're so in it,
whose side are you on?
I would like to know.
I just want to go to bed
and turn my brain off
until I fall asleep and stay out of it.
Once things start going wrong,
it's hard to break the cycle.
Murphy's Law is not physics.
It's just a thing a guy said...
to try and make sense of a crappy day.
Just because things go wrong,
it doesn't mean
they're out of our control.
Pop the hood!
You don't have to...
Pop your hood.
Can you not? This is bad enough...
I pulled out your horn wire,
so you're gonna need to get that fixed.
Thank you.
You're welcome.
I mean...
thank you.
It's on us to fix things.
You know, you could have friends here,
if you wanted to.
It's on us to take everything
that can go wrong...
...and make it go right.
It's on us to try, anyway.