Grey's Anatomy s11e09 Episode Script

Where Do We Go From Here

When exposed to trauma, the body deploys its own defense system.
Do you know why I resent you? I gave up everything for you.
From the first second the brain receives the signal that a catastrophe has happened You have a piece of paper? For what? We need to make vows.
I-I have post-its.
What do we want to promise each other? The blood rushes to the organs that need help the most.
Blood floods into the muscles, the lungs, the heart, the brain.
The brain makes a decision for the rest of the body either face the danger or run away.
It's a mechanism designed to protect the body from harm From knowing that what has happened might be irreparable.
To love each other even when we hate each other.
No running.
We call it shock.
The person who cares for your kids is an important choice.
You want to make sure it's the right fit.
So we'll sit and talk.
I'll find out about your needs, you'll learn about me Right.
Just, right now, I'm a little pressed for time.
Oh, absolutely.
You're busy.
That's why we're here to help.
Yeah, there's a trauma coming in, and I Of course.
Listen, I've worked with doctors before, many times.
I know the drill.
How about if I wait in the lobby until you have some time? That's great.
I'll find you.
Who was that? Uh, new nanny, hopefully.
You got a nanny? I had to.
Derek left.
What? - We don't have numbers yet - Meredith? Shh! But be prepared for as many as 20 casualties, many of them kids.
What happened? A woman drove off a bridge with her two kids in the car.
Witnesses are saying that the woman started speeding, she rammed a bunch of vehicles, and then took a sharp right off the bridge I-into the water.
Police believe this was intentional.
Oh, my God.
With her kids? Let's cooperate with the police and do our jobs, okay? God, is she one of those crazy moms who tries to drown her kids? Maybe she needed a nanny.
What kind of mother does that to her own kids? Why is it somehow worse when a woman kills her kids? That's sexist.
Women are just as crappy and homicidal as men.
Is there something you want to tell me? Or a grand jury? Shut up.
I'm just making a point.
It's not like I'm advocating killing your kids.
Oh, hi, Dr.
You heard Dr.
We've got at least six criticals on the way.
Why are you both standing there? You're right.
I'm sorry.
I told Jackson about the baby.
Oh, God.
I was just standing here shouting about killing kids.
Why didn't you tell me to shut up? Does she know? Uh, I don't know.
Right? I mean, if she knew if you found out that your unborn baby had a fatal disease, you wouldn't be at work, right? No.
What do we got? GCS of 14 but was unconscious at the scene.
Deep facial lac.
Little brother and mom are right behind us.
Mia, I'm Dr.
Can you hear me? Where's my mom? Is she okay? We'll find out as soon as we can.
Let's get her inside.
Parker James, age 5.
Minor injuries include facial lacerations, left-arm deformity, normal vitals.
Where's my sister? She's right inside, Parker.
We've got you, okay? We got a Brooke James, submerged restrained driver, unresponsive since we arrived on the scene.
She is hypotensive, tachycardic.
- Wait is this the driver? - Yeah.
Let's move.
Come on.
Police want to question her, but I said there's no way in her condition.
Did they say what happened? Did she go nuts? She could have lost her footing on the gas pedal.
We do not know.
We do know she's hypotensive, had a low D-Stick reading and free fluid in the belly.
She's too unstable for a C.
Let's get her up to the O.
Driver's in bad shape.
We're taking her up.
I'm gonna alert the O.
I-I'm looking for my wife and kids.
Uh, uh, Brooke James.
Uh, kids are Mia and Parker, right? They said some woman hit their car and drove off the bridge? Mr.
James, your wife is on her way to surgery.
Your kids are being treated.
Your wife was the driver.
She drove off the bridge.
What? Oh, no.
T-that's crazy.
Sir No, she wouldn't do that.
That's crazy.
- Mr.
James, can you come with us? - Whoa, whoa, whoa.
Excuse me.
She wouldn't do that.
Can you come with us? Mr.
James thank you, Sir.
She'd never do that.
It's a lie! I'm here.
We're on our way up.
I'm gonna want more scans, to know this tumor better.
I'm gonna need to draw up measurements and trajectories.
When do I get to speak to her previous doctors? Um, well, as soon as I talk to Dr.
When are you doing that? It's a big cliff.
You just got to leap.
I stole medical records.
I racked up about a thousand HIPAA violations.
It's not a cliff.
That's prison.
And I'm too pretty for prison.
Arizona, you are saving her life.
Well, I'm saving her life, but you made it possible.
Once you tell her, once she understands, she she will be okay with it.
She'll be happy.
Ultimately, she will be thrilled.
You want me to tell her? No.
I have to do it.
I have to do it.
I just need to figure out how and when.
How and when.
That's my tumor.
That's my tumor! Where did you get it and why do you have it?! You showed my tumor to other doctors, without my consent I needed to understand You have no right.
You stole them.
I had to.
Do you know how many laws you're breaking right now? You weren't telling me anything! I can remove the tumor.
I don't know who you've been seeing for this.
I'm sure they're great.
I'm sure they are the best in their field.
But I can only tell you, they lack imagination.
They lack scope.
Your tumor is smart.
It's brilliant.
But so am I.
I can beat it.
I will beat it.
I have a surgery.
Chief, uh, just wanted to let you know that I don't think Kepner's gonna make it in today.
We had some news, um April's here.
What? Yeah.
She's been here all morning.
She's just on her way up to surgery.
Everything okay? Uh, yeah, yeah.
Thank you.
You know what? No.
Actually, I need you to pull her out of surgery right now.
Avery, I can't No, look.
She shouldn't operate.
She shouldn't even be at work today at all, so she should definitely not be operating.
I need you trust me when I say that.
Kelly, more lap pads? I think I see the source of the cut.
I got it.
Owen? Grey.
How we doing in here? Well, it's a mess, but we've got it under control.
April, I'm Tagging you out.
I'll take this one.
Why? I'll just I'll take this one.
I'm good.
You can go.
I-it's okay.
I'm tagging you out.
Owen? Listen, it's okay.
We've got this.
Go ahead and go.
Do we have a problem here? No Yes.
Yes, there is Jackson.
Jackson's my problem, right, Hunt? He went to you, and now you know, and you've decided what's best for me.
Jackson's downstairs, and he's waiting for you.
Well, I'm working here.
April I am taking over for you.
Is this an order? Is that what's happening? Are you ordering me out of my O.
? I'm asking you.
Well, then, my answer is no.
Then it is an order.
That is an order, Kepner.
You're in so much trouble.
Shut up.
You are.
You wanted to go out.
Got some bruises and contusions, nothing surgical.
You guys had a pretty rough ride, huh? It was awesome.
That car slamed right into us.
And then they flew off the bridge, into the water! And then all the other cars started slamming into each other! It was like "Grand Theft Auto"! Son of a bitch.
Dad's gonna freak when he sees the car.
- Where is your dad? - You can't tell my dad.
Yeah, 'cause he's gonna ground you till you're dead.
Shut your mouth assface.
You're an assface.
You want to be so cool, but you're a crappy driver, and your mustache is stupid.
Wait you were driving? How old are you? Yeah, and I'm 25, assface.
Hey, shh, shh.
Duodenal perf duct looks severed.
Head of the pancreas is badly injured.
What do you think trauma Whipple? Looks like it.
What happened with you and Kepner? Nothing.
Well, it better have been something.
You kicked her out of her own O.
She shouldn't even be in an O.
She's got personal stuff.
We all have personal stuff.
My husband left me.
I'm here.
What? I thought he would have e-mailed you now.
He went to D.
When did this happen? Last night.
You want to throw me out? Shoud go get my nails done, have a good cry? Listen, Jackson didn't tell me what it was, just that oh, so her husband tells you to do something, and that's enough okay, it's about their baby.
It's bad.
And then your mom started driving faster.
Did she say anything? She she told us to shut up.
She said that? She's never said that.
We weren't even making noise.
And then we started to hit other cars, and then we went into the water, and then a fireman pulled me out.
Oh, God.
You said "shut up" was a bad word.
You said No, it's okay.
You're okay.
It's true, Parker.
You're a lucky kid.
All you need is a little splint on that wrist, but that's it.
Well, your daughter's still just a little groggy.
Just need to stitch up that laceration on her face.
- She's good to go.
- Yes.
Of course.
Please, do whatever you have to do.
Avery, a word? Uh Excuse me.
One second.
You all right? I'll get somebody to cover for me, and we can just go home What is wrong with you? Letting a cop interrogate a 5-year-old? They Needed to know Those two kids were almost killed by their mother.
T-they are they're terrified.
- Okay.
Slow down.
- They're they're in shock.
Listen, listen, I think you're in shock, actually.
They shouldn't even be down here.
Get them out of here.
Get them someplace safe.
Get them admitted.
Let's just go home.
Have you seen those people in there?! What that woman did?! I know, and there are plenty of people here that can take care of them, right? You need to I I need to be in an O.
But you seem to be making all sorts of decisions for me today.
I'm trying to help you.
Yeah, well, you're not helping.
You go to Owen, and then two men decide what they think is best for the little lady, like I'm some helpless idiot, and then I suddenly find myself standing outside of my O.
? That that that is not helping! Why don't you tell me what is, then? Talk to me instead of running away.
Tell me what you need.
Tell me what I can do.
Tell me how you feel.
Tell me something anything.
Say something.
Talk to me.
I'm trying to help you.
That's all I'm trying to do here.
Okay, okay.
- You want to help? - Yes.
Just get that family into a room and stitch up that girl's face.
Everything okay? No.
Everything is not okay.
We need your parents' names.
They need to know that you're here and you're safe.
Just cough it up.
You don't say a word.
You're a brick wall.
Dylan's C.
shows mesenteric stranding and some thickening of the bowel wall.
Could be just a mesenteric injury, but it also looks like a bucket-handle injury.
I'll just go in and take a look first with the laparoscope.
Nuh-unh! No.
Come here.
No, we need to get in there, open him up, and see what's happening.
Laparoscopic isn't the standard.
You could miss a bowel perf but I'm trying to save this kid a massive scar and a long recovery.
Yeah, but we shouldn't risk Why do you keep saying "we"? You're not doing it at all.
He's a kid.
You don't tell me what I'm doing and not do you're a kid.
I'm an attending pediatric surgeon, and he's a kid.
It's my call, and I'm going in laparoscopically.
Is that how it's gonna be? Yeah.
It is.
And maybe while I do that, you can get his little rat brother to roll over on his parents.
Okay? Let's get him ready to roll.
You're a brick wall, Jack.
Brick it! Okay, that should prevent any tamponading.
One woman loses it, and look at all the damage she can do.
There's a chest contusion with intermittent arrhythmias in bed 6.
Can you take a look at that next? Mm-hmm.
Boy or girl? What? Oh, are you guys not finding out? I am such a control freak.
I don't think I could handle not knowing.
I would want to have a list of names in mind.
That would be the hardest part, I think choosing the name.
Bed 6, consult now, please.
Uh, I'm looking for Greg James.
Is he still down here? I need to talk to you.
So, you talked to Jackson.
Are you are you okay? Can I do anything? You saw something on my ultrasound.
Yes, you saw something, and you didn't say anything.
I-I know.
I wasn't I was right there in the room.
It was my baby, and you said nothing.
I just wanted to be sure before I told you.
Oh, but you had no problem going and telling other people.
You had no problem telling Jackson before I even had a chance to process.
I'm sorry.
To have you, of all people, knowing before I did I'm sorry.
Yeah, well, you should be.
James is upstairs.
His kids were admitted.
This is O.
Did he tell Amelia? Did he pass off his cases? Well, I'm sure he did.
Derek wouldn't just leave his patients.
Or his wife or his kids.
I mean, it's it's just hard to believe.
Well, he did.
And what do you need someone to blame? It's my fault.
I did it.
I told him to go.
Grey, her tox screen's back.
Any drugs or alcohol? Antipsychotics? Antidepressants? All negative.
Damn it! What are you after? An explanation something.
Someone puts her whole family in danger, you want to find out there was a good reason.
You want to believe she didn't have any choice.
Have you talked to Cristina? I presume you guys talk all the time, especially now.
Yeah, we usually get on the phone Friday nights for me, Saturday mornings for her, pour drinks, settle in.
So, today's Friday.
You gonna call her today? Yeah, I've missed the Last couple.
Why? Well, before she left, she said something about Derek and I, and She was right.
And I don't want her to be right.
Okay, so, no history of diabetes in the family.
What about, uh, current illnesses or mental illnesses? Are you asking if my wife's crazy? No, I'm I'm we're trying to see if there's something that could have made her do To hurt my kids? Nothing.
She wouldn't.
I didn't think she would.
Brooke I mean, she's, uh She's busy.
You know, she's tired and stressed.
And she forgets things.
She's got a lot going on with getting them from school and violin and baseball And making sure they're happy.
And I I work too much.
I don't know.
I I don't know my wife.
I don't know anything anymore.
I left you alone for a few minutes.
Am I gonna find my wallet in your pocket? I'm sorry that I went behind your back.
You're understating it.
You betrayed me.
I thought I could trust you.
Shepherd is fully convinced that she can do a complete resection.
She's convinced Shepherd is in a party of one.
If there's even the slightest bit of hope, don't you want to know that? Robbins, can you name the single worst, most malignant symptom of terminal cancer? It's hope.
It's recurrent, and it keeps creeping back in, no matter how many times it gets ripped apart.
Mayo gave me hope in a phase 3 clinical trial.
It failed.
hoped that radiosurgery would work.
It didn't.
And Barrow had high, high hopes for a potent combination of chemo and ablation.
No go.
And every time the hope goes, it takes chunks of you with it, until you can only find comfort in the one thing that you know you can count on that this thing is gonna kill you.
So you tell Shepherd to keep her hope to herself.
Better yet, tell her where to stick it.
Let's start the anastomoses.
4-0 prolene.
Husband says there's no history of diabetes.
Anything else? Uh, yeah.
She's been exhausted, forgetful, stressed running around, taking care of the kids I don't know.
Maybe she snapped.
Well, running around taking care of her kids doesn't sound like a mom who's about to kill herself, in my experience.
It doesn't make sense.
Her blood-sugar levels were so low when she came in.
My mother always used to say, "the pancreas is the self-destruct button of the body.
" And her pancreas was really friable.
And her husband said she's been forgetful.
I bet there's a tumor on that pancreas.
That would explain her anxiety, confusion, erratic behavior.
That would explain everything.
I need to call your parents, Jack.
Look, you're scared.
You think you're in trouble now.
But believe me, the longer you wait, the worse it'll be.
Your parents are scared right now, wondering where you are.
A-and they're getting more and more scared by the minute.
When they finally see you, they'll be so relieved.
But I mean, all that fear has got to go somewhere.
All that fear will turn into white-hot anger that will banish you to a world with no video games forever.
Trust me.
I have a little boy, too.
I'm a brick wall.
Give me your cellphone.
I'm 7.
Would you give your 7-year-old a cellphone? Look, I am trying to help you.
If you don't cooperate, then I'll have to call Child Protective Services.
Do you know what that means? Hey, you want to do this the hard way? Then I will make that call.
You do what you've got to do.
I stole a car once when I was 12.
Didn't make it two blocks.
What stopped you? A dumpster.
First time I stole a car, I sideswiped the mirror.
First time? Second time, I ran out of gas.
Third, I got away with it.
- Fourth - Fourth? Flat tire.
- Are you messing with me? - No.
Was there a fifth? Yeah.
I lived in that one.
- Damn it.
- What just happened? Mesentery's bleeding like crazy.
We got to open him up.
I thought that's what we were trying to avoid.
We got no choice.
We got to get in there, and we got to get in there now.
Are you almost done here? I've got two tib-fib fractures and an l45 compression fracture in trauma 4.
Hang on.
All right, I'm gonna count to three, and then I'll do it, okay? Okay.
You ready? Yeah.
One Two Aah! Ah.
Always better when you don't see it coming.
Go ahead and put a shoulder sling on him, please.
All right, Kepner.
What's next? I already told you, if you'd been listening.
What is going on? I'm fine.
No, you're not, and I know because I'm the queen of taking my personal crap out on other people especially you.
It looks like this.
What's going on? I-I don't want to talk about it.
And I don't want you snapping at me.
You can't have a baby.
Excuse me? And it's what you want.
All you want is to have a baby and love that baby and nurture that baby and raise that baby, and this woman this Woman throws her perfectly healthy kids off of a bridge.
Doesn't that just enrage you? - April - I'm saying how are you not screaming right now at what she's done? To her kids? To all of these people?! How is any of this fair?! April! April.
Now Patients are waiting.
Uh Will my daughter have a scar for the rest of her life? Oh.
I took my time.
Any any scar, it would be very minimal.
Every time she looks in a mirror, she'll remember this.
My kids They lost everything.
They have you.
I don't I'm not sure how good that is.
Look, I missed this.
You know, I Whatever was happening With Brooke I just wasn't seeing it.
You know, you worry about everything.
But I was not prepared for this.
Should I have seen it coming? How could I have prepared for this? Why do we want to avoid putting in another port? Each incision increases the chances of rupturing the membranes.
Robbins? Um, sorry to interrupt.
I wanted to ask if I could meet with you and talk you and me and April.
Her hands are a little full right now, Doctor.
Of course.
We're almost done here.
Yeah, I meant after.
But soon, please.
I just, um I need to be prepared For whatever it is.
We need to know everything we can.
Just what it is, what we can do.
I'll come find you.
All right.
My friends the baby with osteogenesis imperfecta.
I see.
You're clear on what to tell them? Yeah, I know.
Just remember what I said about hope.
Don't make it any harder for them than it already is.
Can you take this, please? - Robbins.
- I am done here.
Robbins! They examined every slice? I stood in path and watched them.
Have them do it again.
I did.
There's no evidence of insulinoma.
Get me the ultrasound.
The tumor is in here.
It doesn't have to be.
The husband says she was stressed and overtaxed.
Sounds like she was headed for a nervous breakdown.
It sounds like she's a mother, Owen.
Where is that ultrasound? I'm just saying, people have breakdowns for all kinds of Owen.
Shut up.
You're not gonna find anything.
I'm not? Give me your hand.
What's that, right there? It's it's tiny.
Feels like the head of a pin.
But it's there.
I knew it was there.
Excellent work, Dr.
Scrub in.
Whew! Hmm.
Give me your phone.
I don't have a phone.
Give me your phone! It's not mine.
It's Dylan's.
This is not a game, Jack.
Your brother is very badly hurt.
He is lying open on an operating table, with two doctors working very hard to save his life! There are no restart buttons.
There's no replays.
This is not a game.
When it's over, it's over.
It's real.
Now, he needs his parents! So what are you gonna do? It's all my fault.
I wanted to go to the ice-cream shop, and I asked him to drive me there.
I want to go home.
I want my mom.
She should wake up soon.
A tumor? Benign, but it secretes Insulin, which causes major fluctuations in glucose levels.
And that was the exhaustion, the confusion, the forgetfulness The accident.
It was the tumor.
And it's gone now.
I'm sorry.
I should have never thought it.
Not for one second.
I should have never thought that you would hurt them.
I'm sorry.
It's only 4:00 A.
I told Cristina to go, too.
It was the only thing to do.
She had to go.
If she'd stayed, it would have been worse.
I know that now.
Tell her "hello" for me.
Robbins, you don't ever walk out of an O.
in the middle of a procedure ever.
You have a shot! You have a chance! And it may be small and it may be risky, but it's a chance.
A chance that my friends would give anything to have, and you're ignoring it you're wasting it.
Grey? I'm still here.
Lynn the nanny? Oh! Lynn! I'm sorry.
You're still here? I am.
It's fine.
Uh, now, tell me what it is you're needing.
Uh, I, um I need, uh, help with the kids, obviously.
More specifically ? Uh, I need Support.
My life and my work is very unpredictable.
And I need someone who understands that and who can be there when I can't and who understands that if I can't be there, it's because I must be where I am.
And I need someone who believes in that and who supports that.
I need a person Who is in it with me And who believes in that.
And I'm sorry.
I'm sorry.
I know I seem like I'm crazy.
And I'm I'm really not.
But I've just had this day.
No, no, no.
It's okay.
Let's talk.
See this here? This linear hypointensity? It is a CSF plane.
That's what can give me a clean dissection.
If I leave behind one billionth of a malignancy, the tumor will be back, so I am going to have to use every tool in the box cusa, lasers, fluoroscein, radioactive seeds.
I will not stop until I have completely decimated each and every last cell.
Chief? What do you think? It is Complex, and it is risky.
I see three scenarios here.
One, Shepherd operates and I die on the table.
Two, Shepherd operates and resects something she shouldn't and I wake up gorked.
And three least likely of all Shepherd operates, removes all of the tumor, and I wake up alive, deficit-free.
Am I right? Yes.
But as I how far does the tumor need to reach before it becomes impossible to resect in its entirety? Nicole We need to do this now.
How far? Once it goes through the optic apparatus and breaches the hypothalamus, there's no way I won't touch it.
If if you clot or bleed it's too risky.
Then, we wait.
And when the tumor starts threatening the optic nerve and heading to the hypothalamus, you can operate.
That is a dangerous plan.
It's a stupid plan.
This is the plan.
You get at my tumor, you get at my knowledge, I get at my life.
Everyone's happy.
When did the parents get here? A few minutes ago.
I'm waiting to see if they hug that kid or slap him.
You're a really good mom.
What makes you say that? I mean, you've been riding me all day, making sure I don't screw up.
Crap, you've been doing it for years.
It sucks, it's annoying, but It's nice.
Tuck stole a candy bar a couple of weeks ago.
I only found out about it last night.
I got so mad.
I yelled at him.
Turns out, Ben already made him go back to the store and pay for the damn thing.
I didn't even know about it.
I mean, I'm so busy at work, I haven't been there to how do I watch out for my own kid if I'm not even there? Huh? How do I do that? I stole a bunch of stuff.
I turned out okay.
Take her up to the I.
and check her coags every hour.
Yes, Doctor.
Who's next? That's it.
Take a look at the board, babe.
Everyone's been either admitted or discharged.
No, there were there were at least 25 patients here.
And you treated every one.
It's damn good you were down here.
Listen, um You and I have a real chance here, you know? We're able to see this thing coming.
Then we are gonna find out exactly what it is and prepare ourselves.
I already talked to Arizona.
She's gonna sit down with us.
We're gonna get some answers.
I already have answers.
Jackson, I spent all night looking it up.
I pulled case study after case study.
Yeah, I did the same thing, but those are other cases.
There are four types of osteogenesis imperfecta, ranging from a manageable disability to completely fatal.
Types II and III are the most severe.
I'm talking about our baby.
So am I.
I studied my ultrasounds.
Best case our kid gets surgery after surgery.
Worst case our kid lives only minutes after birth.
I don't I don't need answers.
What I needed today was just To do something, to treat things I could treat, to help people I could help.
At the very least, undo some of the damage this lunatic woman did to her kids and all of these people here.
She had a tumor.
It turns out she had an insulinoma.
Causes cognitive deficits.
Hunt told me all about it.
Look, she was not trying to hurt anyone.
She had no control.
Why? Why would that happen? Why would God give her kids, give her a family, and let that why would God let that happen?! I-I don't understand it! You can do everything right, and I-it doesn't even Why? I don't know.
I don't know.
I I just I don't want you to hold me, 'cause if you hold me, I'll start to cry, and I don't want to start crying.
'Cause if I start crying, I I will not be able to stop.
I will never be able to stop.
Whatever you need I'm here.
Did I tell you that it's a boy? We're having a boy.
When shock wears off When the body can accept that a trauma has happened When it can let down its defenses Are you there? Uh, no.
I'm about to, um Meredith? I don't want to fight anymore.
Oh, I don't, either.
And I don't want you gone.
I know that I told you to go, but I mean this isn't us.
This isn't how we end, is it? I don't want it to.
I'm trying.
I'm trying, too.
Listen, my flight's been delayed all day.
I'm still at the airport.
I can come home.
It's a scary moment.
Do I come home? What do we want to promise each other? That you'll love me, even when you hate me.
"To love each other, even when we hate each other.
" It's vulnerable.
No, go.
You know, in in in a good way.
And do what you have to do.
We can do this.
People do this.
No running ever.
Nobody walks out, no matter what happens.
People do, yes.
So, go and do what you have to do.
And we will figure this out.
We can do this.
We can do this.
Call me when you land.
And, Derek? Yes? I'm going to miss you.
This can work.
We will make this work.
We will.
Are you still there? Meredith? Mer Meredith? Meredith, I'm losing you.
Derek? This is forever.
Now what? Now I kiss the bride.
The shock response had protected us And it just might have saved us.

Previous EpisodeNext Episode