"Meredith:" "Your kids, your keys, your family photo album." "[ Monitor beeping ] Little more suction." "Perfect." "There it is." "Clipping the cystic duct." "It's the list you repeat in your head before you fall asleep. [ Suction ]" "I just went to prep Lizzie Hagans for her biopsy, and it was already done." " By you." "At 5:00 A.M.?" " You're welcome." "I thought you were going to D.C." "I was until Mr. Cordell got septic from his gallstones." "Derek can wait." "Mr. Cordell can't." "Why is your girlfriend stalking me?" "It's the short list of things you'd grab in case of disaster." "So apparently, Grey starts morning pre-rounds in the middle of the night now." "I've been here for hours." "Shh." "The list makes you feel in control." "What are we looking at?" "I don't know." "I'll know when I see it." "Okay, now what am I looking at?" "All of Grey's surgeries since November." "At first, I thought it was just a fluke." "Oh, my God." "Is this right?" " Mm-hmm." " Your kids." "She hasn't lost a single patient..." "Not one bad outcome... since November?" "How is that possible?" "She's on a streak." "Your keys." "It's time for rounds." "Let's go." "Dude, Grey is pitching a no-hitter." "She hasn't lost a single patient since November." "What?" "Your family photo album." "[Rumbling]" " Whoa." "Whoa." "Ohh." " When the fire starts..." "When the tsunami hits... [Clatter] when the earth literally quakes, do you remember your list?" "[ Indistinct shouting ]" "[ Metal rattling ]" "[ People gasping ]" "Whoa!" "Watch the cabinet!" "[ Glass shatters ] [ Gasps ]" "[ Rumbling continues ]" " Somebody..." " I got it!" "I got it!" "[ Clatter ]" "[ Rumbling stops ]" "Or do you just duck and cover?" "You okay?" "We're okay." " Everybody okay?" "[ Electricity crackles ]" "We're not moving. [ Button clicking ]" "Ethan:" "Yeah, safety feature." "It did this to me after the last earthquake." "The last earthquake?" "I did a lot of research about Seattle before I moved out here." "Earthquakes were never mentioned." "They don't happen too often." "Only when you ride in elevators, apparently." "[ Sighs ]" " Apparently." "Remind me not to ride in an elevator with you again." "Sure, Dr. Pierce, or I guess I could just start taking the stairs." "[ Laughs ]" "It is Dr. Pierce, right?" "Yeah, uh... um..." "Ethan." "Sorry." "Ethan." "Yeah." "[ Stammers ] Oncology, right?" "Uh, radiology." "Sorry. [ Chuckles ]" "No problem." "[ Thud ]" "[ Elevator bell dings ]" " Ah." "There we are." " Oh." "Yeah." "Anyway, see you around." "Yep." "[ Indistinct conversations ]" "Miranda:" "My God!" "Oh, you had to dive on top of me?" "I was being your human shield." "I-I was protecting you." "Oh, do I strike you as a woman who needs protecting?" "You're right." "All right." "Next time, I'm gonna use you as my human shield." "[ Chuckles ]" "Oh, I should call and check on Tuck." "Oh, you know who probably felt it where she lives?" " Hmm?" " Your sister." "Yeah, you should call and see if she's okay." "I will call when I am ready." "Just..." "I've asked you, Miranda." "Please, just let this rest." "Well, what about the trans-family support group tonight, the one I told you about?" "You planning to go, or... ?" " No." " Why not?" "Why is this any of your business?" "Why, indeed?" "Miranda." "Miranda!" "Warren." "There he is." "Hey, you feel that quake?" "Yes." "Yes, I did." "Exciting stuff, exciting stuff." "Almost as exciting as what I have planned for you today." "Breast enhancements and nose jobs." "Oh, you need to fix that attitude." "[Elevator bell dings] Today is all about instilling self-confidence and changing lives." "So, you play your cards right, you just might get an invite from me to join the plastics posse." "[ Elevator bell dings ] You think that sounds cool?" "I did not..." "At first, but... but it grows on you." "[ Chuckles ]" "[ Telephone ringing ]" "Come on." "[ Sighs ]" "[ Siren walls in distance ] Two more on the way... one adult male, blunt abdominal trauma, one minor with a leg fracture post-fall." "Page Grey and Karev." "Right away." "[Telephone ringing] [Indistinct conversations]" "Kepner, y-you're here." "I'm glad to see you back. [ Sighs ]" "Yep, back and busy." "Here, you take bed eight." "I'm gonna head over to five and six." "[ Telephone rings ]" "[ Sighs ] Grey-Sloan emergency." " I got a page?" " Uh, bed seven." "Okay." "Got it." "Did you need something else?" "Oh, no, no." "Uh, bed eight." "Um, I'm..." "I'm on my way." "Okay." "Yes." " Yeah." " You've got more incoming?" "I was paged about a hip?" "Yes." "Jean Dominy, 75..." "Angioplasty patient, discharged last week, brought in today with shortness of breath after a fall." "Well, I fell out of bed, dear, onto my hip." "I'm pretty sure I busted the damn thing." "You know, I had it replaced 15 years ago." "Oh, wow." "Okay, so the earthquake threw you off balance?" "Yes." "Well, that and Herbert." "He lives down the hall." "I invited him over so I could spit-shine his 9 iron." "[ Chuckles ]" "His club, dears." "Oh, of course." "I mean, his penis..." "Ohh." "Anyway, well, we were having sex." "You know, vigorously, legs up in the air." "I mean... well, you..." "You know how it goes." " Mm-hmm." " And then..." "Okay." "So I'll check off the box for "sexually active."" " Yeah." " Oh, uh, yeah." "See, I have this book with all the positions listed." "It is like a menu for love-making." "Really?" "And, anyway, we were trying number 28, you know the..." "Uh-huh." "Oh." "And then the earth started shaking." "And I thought, "whoa, there is no way that Herbert..."" "Ow!" " Ooh." " Hmm." "See, now, that's no good." "I'll never get to 29 if I'm hurting like that." "[ Elevator bell dings ] [ Laughs ]" "Y-you can fix it, right?" "I'll tell you what." "We're gonna get you some films." "And then we'll go from there, okay?" " Uh-huh." "Okay." " Okay." "14-year-old male, sustained a non-displaced tib-fib fracture" "Secondary to a 14-foot fall from a chair lift." "44-year-old male with blunt abdominal trauma." "B.P. is 135 over 85, pulse 95." "So, you all were skiing when the earthquake hit?" "If only." "Didn't even get a chance to ski, thanks to the dweeb." "Danielle, be nice." "Meredith:" "Edwards, set up for a trauma panel and an abdominal ultrasound." " On it." " We were on the lift." "I-I was with Danielle." "Brian was with Micah." "Everything started shaking, and they fell." "You mean "the dweeb fell." Dad tried to stop him." "And he took my dad down with him." "Danielle!" "You know, he shouldn't have been up there." "He doesn't ski." "He didn't even want to go." "Okay, why don't you and your mom go wait in the waiting room, please?" " She's not my mom." " Yet." "We're engaged." "Brian thought we should take a family ski trip." "Of course, we always do what Brian wants to do." " Shut your face." " Shut your face." "Why don't we all shut our faces and let us figure out what's wrong with you guys, okay?" "Hey, we need to re-stock the supply cart in trauma two right away." " Right away." "[ Indistinct conversations ]" "Hey, that kid in bed two's ready to be discharged." "Ditto bed one, who has hypochondria and not a giant tumor growing in her head. [ Siren walls in distance ]" "[Laughs] Um, heard anything from Herman?" "How's she doing?" "[ Telephone ringing ] Ooh, um..." ""Enjoying Blind Institute." ""Learning how to not bump into things."" ""Not typing this, obvi..."" ""Don't kill any babies." [ Laughs]" " Okay, well, she sounds all right." "[ Ringing continues ] Is somebody gonna answer that call?" " Not it." " Yeah, no, all yours." "[ Ringing continues ]" "Woman:" "I'll page someone for you." "Grey-Sloan emergency." "Ruby:" "Is this the hospital?" "I need help." "Well, you need to hang up and call 911." "I tried." "It was busy." "My mom fell off a chair." "She's not moving..." "I-I don't know what to do." "What do I do?" "Your... your what?" "Your mom?" "How old are you?" " I'm 11." " Where are you?" "O-our cabin." "I don't know." "The power's out." "Please help." "[ Indistinct conversations ] All right, it's all right." "Just... just hang on." "Somebody..." "Kepner, get on with 911 and get them to trace the call on line three right now." "It's a kid with her injured mom in the mountains somewhere." " Go." " Okay." "Ruby:" "Are you still there?" "I'm here." "I'm right here." " What's your name?" " Ruby." "Ruby, I'm Owen." "Are you a doctor?" "Can... can you help?" "I can." "I'm right here, and I'm going to help you." "[ Rumbling ]" "Ruby:" "We were making s'mores." "She was getting hot chocolate from the cabinet." " Watch your back." " Yes, it's a line coming into Grey-Sloan Memorial." "She was standing on the chair, and then everything was shaking." "Then she fell." "Now..." "Now she's on the floor." "I-I can barely see anything." "She's on the floor." "Is she awake?" " Two hours!" "I waited two hours!" " No." "What do I do?" "And now I still can't leave because somebody double-parked behind me!" "Shh." "Quiet, please." "Don't you have security here or a valet?" "Listen, I-I'll find someone..." "You better waive my co-pay!" "He said, "quiet"!" "[ Radio chatter ]" "Man:" "I'll get it." "I'll help you." "Ruby, I am gonna move to another phone so I can hear you better." " Don't hang up." "No, no, no." "I'm just..." "I'm just moving to another phone." "I'll..." "I'll be right there, okay?" " Okay?" " Okay." "Okay." "[ Indistinct conversations ]" "I always screw this up." " What?" " No, no, no." "No." "Nothing. don't worry." "Uh, I'll be right back." "Just hang on." "Where's that chest X-ray?" "[ Sighs ]" "[ Beeping ]" "[ Indistinct conversations ]" "[ Telephone ringing ]" "Move, move." "Ruby, you still there?" "Ruby:" "I-I'm here." "What's going on?" "Okay. [Beep]" "Uh, is your mom breathing?" "Uh, yes, yes." "I-I-it sounds like she's snoring." "And is..." "What position is she in?" " Is she on her side?" "Is she..." " She's on her back." " She's just laying there." " 11-year-old kid..." "Her mom fell at a vacation cabin somewhere." "Uh, Kepner's trying to trace the call." "Uh, Ruby, I need you to hold the phone to your mom's mouth, okay?" "I need to listen." "Okay. [ Ragged breathing ]" "An obstructed airway." "We need a trauma room." "This one's free, right?" " No." " No." "Occupied, apparently." "She needs to call 911 from a land line." "It's the only way the E.M.S. Can trace her directly." "Ruby, listen to me." "Uh, what kind of phone are you calling on?" "If it is the phone in the cabin, you need to hang up and call 911." "Ruby:" "No, that one's dead." "I-I'm on a cell... my mom's." "Cell won't work." "Crap." "Okay, okay." "Her..." "Her lips are blue." "Why are her lips turning blue?" "[ Sighs ]" "Because your mom's not getting enough air." "[ Siren walls in distance ]" "So, no go on the open trauma room." "It's fine." "These injuries look pretty superficial." "You know, we would be on the Wolf Run right now if it was just you and me on the trip, like it was supposed to be." "Dani, honey, this is not Micah's fault." "It's not his fault he can't sit in a chair?" "Because I think it is." "The kids... don't get along." "Oh, you're kidding." "[ Sighs ]" "Karen and I got engaged over the summer after three years of dating." "I would have proposed after the third date, but the kids..." "I thought, "let's take a trip." ""Let's do something together as a family, see if it might help."" "I think I made it worse." "[ Telephone ringing ]" "Do you think I make it worse?" "[ Inhales deeply ]" "Sometimes, adversity can make a family stronger." "[ Sighs ]" "Or tear it apart." "I'm just saying, swap me out." "I want to be close to the good stuff." "Not that you're not the good stuff, but she's got a streak going." "Stop saying that, and definitely don't say it to Meredith, unless you want it to end." "You'll jinx her." "[ Indistinct conversations ]" "Ow." " That hurts?" "I'm concerned about this abdominal tenderness." "Schedule a C.T. and rush his labs." "So... so, you're not gonna swap me out?" "Never mind." "Ellie:" "Could you go back one?" "[ Beeping ]" "One more?" "[ Beeping ]" "[ Horn honks in distance ]" "This one." "Uh, how soon can we do it?" "Well... well, uh..." "You know what?" "We're not gonna schedule the surgery quite yet." "But I want to do it before summer." "Six weeks." "Then we'll all meet again." "We'll talk through our options." "Thanks for coming in." "Yeah, I don't get it." "Are we no longer granting wishes today, or..." "Did you see how she looked to the boyfriend?" "He's not here for support." "He's here for approval." "Six weeks." "That's how long - it's gonna take her to realize that it's not her wish that we'd be granting." "So, you're saying she was being too hasty." "I'm saying I'm not giving that girl a set of new breasts that were never her idea in the first place." "That's just a bra full of regret." "All right, time to power up." "The posse's got a big afternoon." "Ruby, open your mom's mouth and... and take two fingers and sweep the back of your mom's throat, like a..." "like a scooping motion." "She might have something blocking her airway." "Let's see if you can get it." "Ruby:" "O-okay, okay." "There's nothing." "What now?" "Try a Heimlich." "Give a hard push on your mom's..." "Belly?" "I've seen it on TV." "How hard do I... ?" "As hard as you can." "[ Grunting ]" "Nothing happened." "Nothing..." "Nothing came out." "Her..." "Her breathing's getting worse." "Okay, um..." "Okay, okay, we're gonna..." "We're gonna try opening her airway another way." "I-I need you to put your hand under your mom's chin and very gently lift it up." "No, wait, stop." "You'll..." "you'll paralyze her." "[ Siren walls in distance ]" "H-hello?" "What should I do?" "H-hello?" "So, the good news is, your EKG and chest films came back clear." "Oh, so my ticker's good." "How about my kicker?" "[ Laughs ]" "Well, you have what is called a below-the-stem femur fracture." "Oopsy." "Now, you have two cracks in the bone... one here and here." "So, uh, how do we get me back in the saddle?" "[ Laughs ] So to speak." "Well, I would like to completely replace the hardware." "Now, it's a very big surgery, and it does carry risks, but you would come out of it with full flexibility, which I think is what..." "So I'd be good to go o-on my back?" "You should be." "Mm-hmm." "Or on my side." "Or... or that thing, you know, where you bend over the couch and then he, uh..." "Like I said, full flexibility." "Yeah, okay, but considering your cardiac history," "I'm not sure a big surgery is a great idea." "Tell me dear, um, - have you ever been married?" "Are you seeing anyone or..." "Getting laid?" "Well, that's not..." "I mean..." "You see, I was married to my husband for 44 years." "That's 44 years with the same man." "We had three children, seven grandchildren, and a lifetime of memories." "Huh." "He was the first man that I ever loved." "And he's the only man that I ever will love." "But I'll be hot-damned if he's going to be the only man to ever razz my berries." "I mean, I have time left, and there's still things that I want to do, you know?" "There's things that..." "That I haven't done, and there's - a whole lot of things that," "I-I mean, I didn't even know you could do." "You know... you know, like that thing where you go... you know?" "Yeah." "Yeah." "Yeah." "Right, right, we got it." "Yeah. [ Sighs, laughs ]" "I mean, what's the point of living" "I-if you can't try something new?" "Hmm?" "I want that surgery." "Sounds good." "That is a 5-hour surgery on a 75-year-old who has a stent and is on blood thinners." "I can't believe you would suggest a surgery like that to a patient without running it by me first." "I'm sorry." " You called me for my opinion." "Look, I do hip replacements all the time on far older patients with far weaker hearts." "She is clearly still active." "Uh, I think her heart's in pretty good shape." "That's not your call." "Okay, we are talking about a healthy, vibrant woman here." "She deserves the best quality of life that we can give her." "If she wants a new hip, that's her call." "So she can get laid?" "Really?" "Really?" "You think that's important enough to risk her dying on the table?" "If her hip is so damaged that she winds up immobilized and bed-ridden for the rest of her life, then, yeah, I sure do, because either way, she's dying." "[ Indistinct talking over P.A. ]" "Fine." "I will reevaluate the images and take a closer look." "Maybe there's another option. [ Sighs ] Okay?" "Thank you." "Richard:" "Kepner told me about the little girl." "What can I do?" "What?" "Can I help?" "We are trying to get an airway." "By risking paralysis." "I'd rather have her paralyzed and alive than dead with respiratory arrest." "Do you have a better idea?" "Ruby:" "H-hello?" "Are you still there?" "[ Beep ] Ruby." "Go ahead." "Lift her chin... and pull it forward... gently." "O-okay." "Okay, now put the phone on your mom's chest okay?" "And let me listen." "[ Deep breathing ] The stridor's gone." "She opened the airway, but..." "She still could be in distress." "Mm." " It's something else." "[ Inhales sharply ]" "Ruby, put your head on your mom's chest on the left side and listen." "Ruby:" "I don't hear anything." "What am I listening for?" "Breathing." "Do you hear her breathing?" "No." "Owen." "[ Sighs ]" " Owen." "Okay, okay, um, okay, Ruby, now put your ear on the right side and listen." "Anything?" "Ruby?" "She... she's breathing!" "I-I hear it!" "Okay, could be a tension pneumo." "Mm-hmm." "Ruby, um, now just push the phone into your mom's chest, r-right where you were just listening." "Just push the phone in and move it." "[ Crackling ] [ Deep breathing ]" "That's sub-q air." "Do you hear that?" "Mm-hmm." "She's gonna need..." "She's gonna need to release the trapped air with a chest tube or something." "Okay." "It's... it's the only way, or her mom's gonna suffocate." "Oh, you mean..." "You're gonna ask her to..." "Okay." "Ruby, I'm gonna ask you to try something." "It's gonna be fine, and I'm gonna walk you through it, step by step, okay?" "Ruby:" "O-okay, but can you tell me fast?" "The phone keeps beeping." "I-I think it's running out of battery." "[ Whirring ]" "[ Indistinct talking over P.A. ]" "[ Telephone ringing ]" " What are you doing here?" " I am hiding out." "We're waiting on the dad's labs, but I couldn't sit there and listen to those two bite each other's heads off anymore." "Mm." "Me, neither." "Brian's labs came back clear." "How's Micah?" "Looks like a grade IV splenic lac, possible rupture." "We need to prep him for ex-lap." "[ Rapid beeping ]" "What?" "He's crashing." "Crap." " Oh, crap!" "His pressure's bottoming out." "Hurry up!" " He's in v-fib." "We got to bag him." "One, two, three." "Easy." "Where is that crash cart?" "I need those paddles." "[ Beeping continues ]" "Almost here." "There's no time." "[ Rhythmic beeping ]" "[ Exhales sharply ] Got a rhythm." "Edwards, you and Wilson go and prep that O.R., please." "Magical." " Told you." "What?" "Nothing." "Get going." "Move." "Owen:" "Ruby, do you guys have straws in the kitchen?" "Ruby:" "No." " A pen, maybe?" "A ballpoint pen?" "Anything?" "Not yet." "Lines are down because of the earthquake." "They're trying to triangulate from the cell towers." "How's the mom?" "Okay." "Wait!" "Wait." "We got milkshakes on the way here." "Got a straw!" "Great." "Now, we're gonna need you to get a..." "Amelia:" "What?" "What?" "I don't want to ask her to do this." "[ Sighs ] Ruby, we're gonna..." "We're gonna need you to get a knife." "Not a big one, but a sharp..." "Y-you were making s'mores?" "Are the skewers there?" "Y-yes." "Got one." "Oh, God." "You want me to stick this into her, don't you?" "Ruby, you can do this." "You can." "It's gonna help your mom, okay?" "We just need you to find the..." "Second intercostal." "I don't know how to explain that to her." "Wait, wait, wait." "Um..." "Ruby." "Okay, um, touch your mom's left collarbone, the one that looks like a wing, coming out from her neck." "Now walk your fingers down from it." "Two steps." "You got it?" "Okay." "One." "Two." " Stop." "Stop." "Now slide your finger right underneath that rib." "And with your other hand, right above that finger, push the skewer in about an inch." "Ruby:" "I can't do that." "Ruby, yes you can." "What if we're wrong?" "I'm not wrong." "Okay." " Ruby, you can do this." "She could puncture her heart." "She won't." "Ruby, right now." "Oh, God." "Ruby, push." "Hard." "Push hard." "Push hard." "Right now." "Aah!" "Oh, my God!" "Oh!" "There's blood!" "She... she's bleeding!" "It's okay." "It's okay." "Now take the..." "Take the straw and put it over the skewer into the hole that you just made and push hard." "She's breathing a lot!" "You did it." "Thank God." "[ Sighs ]" "Wait, wait." "She stopped." "Her lips are going blue again." "Ruby, put your fingers on the right side of her neck, right by her throat." "Do you feel a pulse?" "Ruby:" "No." "Okay. [ Sighs ]" "Ruby, I need you to get on top of your mom and put your hands on her chest and push hard right now." "Okay, I'm gonna teach you how to do CPR." "All right, let's take a look." "[ Keyboard clacks ]" "Yikes." "That hip took a hell of a pounding." "[ Laughs ] Oh, Ethan, you have no idea." "Could you please zoom in on the right femoral prosthesis?" "Sure thing." "Twice in one day, Dr. Pierce." "[ Laughs ] Yeah." "Careful, or you'll get sick of me." "Unlikely." "[ Telephone ringing ]" "Yeah, see that?" "There." "Her femur distal to the stem is cracked." "Her hip isn't gonna resolve on its own." "[ Sighs ]" " She needs surgery." "Although, oh, I guess the femur fracture isn't displaced." "Maybe I could put in a plate to bridge the fracture, go in from the side." "It would be a little less invasive." "And less time in the O.R.?" "Oh, a lot less, actually." "Good, so she could stay on her blood thinners, substantially lowering the risk to her heart." "And she can get back to getting her freak on." "[ Laughs ] I'll let her know." " [ Scoffs ]" "I've been taking the stairs, by the way." "Since this morning, you know, just in case." "Oh, I wasn't..." "I wasn't serious before." "I was just..." "Yeah, I know." "I'm not actually taking the stairs." "Oh." "Okay." "I would like to take you out, though, sometime." "Maybe for coffee?" "Or a drink?" "Or... ?" "The point is, I'm flexible." "This is coming out all wrong." "I'm gonna start over... no, no, it's..." " I'm gonna stop you, actually." "[ Sighs ] I'm sorry, Ethan." "You seem really..." "Tall and nice." "But I'm just..." "I'm not..." "I don't..." "Sure." "That's okay." "I understand." "Okay." "This is basically my office, so, if you're waiting for me to make this less awkward by leaving, I..." "Oh, right." "Of course." "Okay." "I'm gonna get out of here." "Take this with me." "Bye." "[ Door closes ]" "[ Sighs ]" "Is Karen around?" "She went to get snacks." "How's Micah?" "Alex:" "Actually, uh, we need to talk to Karen." "Sorry." "Legally, we can only talk to the legal parent." "Are you serious?" "Danielle:" "Who cares?" "Dani!" "What?" "They didn't have Turkey, so I got a Ham and Swiss." "Ugh." "Nasty." "Lovely." "Really?" "They have news on Micah." "Micah's stable, but I'm afraid his injury is worse than we thought." "His spleen is ruptured, and he's lost a lot of blood." "He had a cardiac episode in C.T., and his heart stopped beating." " Oh, God." " But we're taking him to surgery now." "We do have to remove his spleen." "Oh, my God." "What were we doing up there?" "Why did I let you talk us into that stupid ski trip?" "Karen, come on." " I-it..." "it was an accident." "But he didn't want to go." "There was an earthquake." "Karen, come on." "For God's sake, this is..." "I-I didn't plan on any..." "Okay, so we will give you an update as soon as Micah is out of surgery." "[ Inhales sharply ] He's 14." "He's 14!" "This couple might be the biggest casualty of the earthquake." "Oh, my God!" "Ruby, you're doing great." "Ruby:" "My battery's at 5%." "I'm..." "I'm getting tired." "You can do this." "Just keep pushing." "Push, push, push, over and over, like the beat of a song." "Uh, Ruby, do you know the song "Stayin' Alive"?" "Is it new?" "[ Laughs ]" "Uh, we'll sing it for you, okay?" "And you just... you push to the beat, just like this... ♪ Ha, ha, ha, ha" "♪ staying' alive, stayin' alive ♪" "♪ huh, huh all: ♪ ha, ha, stayin' alive, stayin' alive ♪" "Okay, Ruby, you sing now." "You sing with us." "Both:" "♪ ha, ha, ha, ha, stayin' alive, stayin' alive ♪" "They found the region." "Ruby, did you hear that?" "♪ Ha, ha, ha, ha help is on their way." "They're gonna find you." "♪ Stayin' alive, stayin' alive some of the roads are blocked." "They're sending a helicopter, and they don't know how long it will take." "♪ Ha, ha, ha, ha, stayin' alive, stayin' alive ♪" "Okay, Ruby, you just keep going until they find you, okay?" "♪ Ha, ha, ha, ha, stayin' alive, stayin' alive ♪" "You keep singing, and you keep pushing." "And when they find you, u-use their phone and you call me back. ♪ ha, ha, ha, ha" "Ruby: [ Voice breaking ] Okay." "♪ Stayin' alive, stayin' alive okay." " ♪ ha, ha, ha, ha, stayin' alive, stayin' alive ♪" "[ Static ]" "♪ Ha, ha, ha, ha, stayin' alive, stayin' alive ♪" "♪ ha, ha, ha, ha, stayin' alive, stayin' alive ♪" "♪ ha, ha, ha, ha... [ static ]" "Ruby?" "[ Sighs ] She's gone." "They'll find her." "She'll call." "They'll find her." "Yeah, she could be on her way in right now." "[Sighs] Unless she's alone in a cabin with her dead mother." "She'll call." "Anything?" "[ Sighs ]" "She'll call." "Alex:" "Did you hear the mom going at that guy?" "That couple is doomed..." "All that fighting." "I do not miss that. [ Suction ]" "Look at us... we're both in adult, stable relationships." "For once, we're on the healthy side of things." "Sure." "I had to cancel D.C., but it's okay." "Sometimes he cancels, and I say it's okay." "We're happy." "We're in a groove." "Kind of sounds like a rut." "We are not in a rut." "Whatever." "I resent you saying it." "Okay." "And you're hardly an expert at long-term relationships." "Really?" "And that's not even true." "What?" "Izzie?" "That was a cancer marriage that lasted five minutes." "Oh, and then there was Ava, who peed on my couch." "All right, would you quit it?" "No, there's one more I'm forgetting." "Hello?" "I'm right here." "Oh, I know." "The nurse who had syph." "As in syphilis?" "!" "It was a long time ago, Wilson." "Relax." "Bovie." "It's not a rut." "I have an entire world to manage, all on my own." "My world does not and should not revolve around Derek Shepherd." "I wanted to go to D.C. this weekend, but I'm a busy surgeon with two kids at home, and he's at the N.I.H." "So right now, we're just going to have to accept that this is the way our lives work." "But that doesn't mean we're not happy." "All right, fine." "You have a happy marriage." "With no husband in it." "[ Drill whirs ]" "All right, plate's in position." "I'll be placing the screws next." "Her pressure's good." "Rhythm's stable." "So..." "You and Ethan." "Is that a thing?" "Oh, no." "I'm not..." "N-no, he's not my type." "Sure." "Right." "You're not so into cute, smart, or funny?" "No, he is." "I mean, he... he's great." "He's, um..." "He's a radiologist." "Whoa, whoa, whoa." "Did... did you just go all upstairs/downstairs?" "No." "No!" "No, I didn't mean it like that." "No, I just..." "I don't date at work." "Or you don't date down at work." "No, no, it's cool." "Don't worry." "I'm sure you have many other fine qualities." "It's okay if you're kind of a snob." "Oh!" "I am not a..." "God, you make me sound awful." ""Dating down"?" "What is that even?" "I-I just don't date people who are..." "Beneath you?" "No, that is not what I was going to say." "Underlings?" " No, stop it." "I wasn't gonna say..." "[ British accent ] Just a lowly maker of x-rays, madam." "I didn't mean to..." "Will you stop it?" "!" "And we'll use the rasp to smooth out the bridge." "You know," " Mrs. Thurman could come out looking like - a completely different person." "So that she can be happy with what she sees in the mirror." "But what if it's not her nose that makes her unhappy?" "I mean, maybe it's some other part of her life, like..." "Like that patient - with her boyfriend's boobs." "How can you be sure that she's making the right choice?" "You do realize I can't talk to you about your sister's case, right?" "I-I'm not asking about my sister's case." "I-I'm asking about this lady right here." "All right, well, I know she's making the right choice because I talked to her at length, and I listened." "And I've..." "Gotten very good at knowing." "[ Sighs ]" "[ Telephone rings ]" "[ Elevator bell dings ]" "44-year-old female..." "Vitals stable, tension pneumo relieved by a needle thoracotomy." "Is she okay?" "Is she..." "Trauma from the fall." "Her pupils are fully responsive." " GCS of 8." " Yeah, I got this." "Ruby?" "[ Grunts ] Hey." "[ Chuckles ]" "My phone died, but I kept singing till they came, just like you said." "I know." "I know." "You did great." "You were perfect." "[ Sobs ]" " You're okay." "How is she?" "Subdural hematoma with a shift." "What can I tell Ruby?" "Nothing." "Not yet." " [ Sighs ]" "[ Rapid beeping ]" "Heart rate's dropping." "Damn it." "Drill... now." "I need to evacuate this clot." "What can I do?" "Let me help." "Let me work." "[ Drill whirring ]" "[ Indistinct talking over P.A. ] [ Telephone ringing ]" "Mrs. thurman's awake." "Good." "She looks like she's been in a bar fight, and she says she can't wait to see what she looks like when the swelling goes down." "What else?" "Nothing." "It's a big change." "She's had that nose for plenty of years." "I just..." "I hope she doesn't regret it." "It was not a new thing, this change that she wanted." "It wasn't a whim." "It was how she had always seen herself." "Her best version of her." "The one that was the most true." "Now, with a patient like this one, a patient who's dreamt about these changes since they were 6 years old..." "Those patients do not change their mind." "For them, change isn't elective." "It's not a choice." "It's a chance." "It is her chance." "And you can't know that without talking." "And listening." "[ Banks' "Goddess" plays ]" "[ Vocalizing ]" "It's not because he's a radiologist." "Okay, and it's not just because I don't date people from work." "I just..." "I kind of don't date." "Hey, listen. [ Laughs ]" "I was just giving you a hard time." " No, no, no." " I didn't..." "There's a gap between me and most people." "There just always has been." "I used to think it was because I was younger in school, but even after school... [ Sighs ] the gap... it just got bigger and more impossible." "I wasn't too young." "I was just too..." "Different." "So I know what it looks like when I say yes to Ethan." "It's fun, and we're happy for awhile until it's not." "Things always get awkward and weird." "So I overcorrect, or he misinterprets." "And then we're not on the same page anymore because we never were on the same page." "We were always Miles and Miles apart with this gap between us, pretending it wasn't there." "I don't want to pretend." "I came here to work and just stay focused on that, and I'm fine on my side of the gap." "I'm a little lonely, but..." "Fine." "There's just no point to me saying yes." "Yeah." "Okay, that's a load of crap." "[ Scoffs ]" "Uh, when you were younger, fine." "Kids are weird." "But now?" "[ Laughs ]" "You're a grown-up doing your grown-up job with other grown-ups." "There's no gap." "And... and there's..." "There's nothing to lose." "There's just you being scared." "And for no reason. [ Laughs ]" "So choose not to be." "Life's too short to be scared." "Screw the gap." "Let Ethan..." "I don't know..." "Razz your berries." "Ew." " Okay, goose your gander." " Okay." " Tickle your tail feathers." " Mm." " Cup your coconuts." " Nope." "Rock your rump." "[ Door opens ] Poke your hontas." "Wallop your wonderland!" "[ Laughing ]" "♪ Trying to claim her, 'cause she's gone ♪" "There's still bleeding from the short gastric arteries." "Meredith:" "I see it." " Close to the pancreas." " I see it!" "Well, I can't get to it from here." "How many units did he use?" "Four units." "If everyone would just shut up and give me two freaking seconds," "I can get this suture to hold." "There." "Edwards?" "No leaks." "Looks good." "[ Sighs ] The streak's alive." "What was that, Wilson?" "Oh, no." "Wait, nothing." "I didn't..." "I didn't..." "I didn't say anything." "You said, "the streak is alive."" "No!" "No, I said, "freak."" "I said, "the freak is alive."" "No, you didn't." "No, she didn't." "I didn't hear anything." "I..." "You're pitching a no-hitter." "You haven't lost a single patient since November 14th." "89 surgeries in a row with good outcomes." "Did you say November 14th?" "Yeah, a-and 22 were traumas." "I mean, who..." "Who does that?" "You, because you're magic." "♪ With a goddess, and you get a little colder ♪" "Edwards, you can close." "Wilson can assist." "What did I tell you?" "[ Vocalizing ]" "Look, I told her not to tell you." "This kind of thing messes with your head." "I'm on a streak." "There's no such thing." "It's just dumb luck." "Look, you're not that great, anyway, so just forget about it." "No, no, no, it's not that." "It's the date that it started." "What about it?" "That's the day that Derek left." "And I've been perfect ever since, have not lost one patient..." "Not one..." "Since the day he left." "What does that tell you?" "That you're right?" "That I'm better off without him?" "[ Sighs ]" "Brian, your repeat labs look really good." "I should be able to discharge you very soon." "How's Micah?" "Not my kid." "I know." "Karen won't even speak to me right now, and, uh, you know, I had all the best intentions." "I was trying to bring the family together." "I thought I was helping us." "It all backfired. [ Sighs ]" "Maybe now we're too far gone." "Maybe I can't get Karen back." "Maybe Danielle is right." "Maybe Karen and Micah are better off without me." "All I wanted was for us to be happy, be a family." "[ Sighs ]" "Can you just nod or blink twice or something if Micah's okay?" "Thank you, Dr. grey." "Thank you." "You know, you should try and close your eyes, get some sleep." "It could still be a while." "Do you think I hurt her?" "No." "No." "Ruby, you did everything right." "You don't know that." "[ Indistinct talking over P.A. ]" "How is she?" "She's fine." "Ruby, your mom is gonna be fine." "Really?" "Absolutely." "[ Ed Sheeran's "photograph" plays ]" "[ Telephone rings ]" "So, uh, I called my sister and checked in." "A bookcase fell." "But other than that, she's fine." "Good." "Okay." "[ Keyboard clacking ]" "I owe you an apology for what I said earlier." "Yes, you do." "And I will consider accepting your apology," "Ben Warren, if you make it up to me." "♪ Loving can hurt at home. ♪" "You can, uh, start by making me dinner." "Mm-hmm." "♪ loving can hurt sometimes ♪ and then some other things that I haven't even thought of yet." "♪ But it's the only thing ♪ [ Laughs ]" "Well, um, you know I'm still on call." "♪ that I know ♪" "I can wait." "[ Elevator bell dings ]" "♪ And when it gets hard ♪" "♪ you know it can get hard sometimes ♪" "♪ it is the only thing ♪" "♪ that makes us feel alive ♪ [ chuckles ]" "♪ We keep this love in a photograph ♪" "Six weeks, right?" "Eight just to be sure." "♪ we made these memories for ourselves ♪" "Ease back in." "Herbert isn't gonna know what hit him." "♪ Where our eyes are never closing ♪ [ Laughs ] Or Edward." "♪ Our hearts are never broken or Irving." "♪ And time's forever frozen still ♪" "Or... maybe that guy upstairs with the bad toupee." "♪ So you can keep me mm. ♪" " Lucky guys." "Mm-hmm." "♪ Inside the pocket ♪ I'm telling you, girls." "♪ Of your ripped jeans ♪" " You have healthy hips." "Put them to good use." "♪ You won't ever be alone ♪ [ Laughs ]" "Hmm. [ Chuckles ] [ Elevator bell dings ]" "♪ Wait for me to come home ♪" "Hold that!" "Wait, please!" "Hi." "I will have that drink with you." "♪ Loving can heal ♪ If you want to, if you still want to." "Great." "Let's do it." "Wait." "Now?" "Do you mean now?" "♪ Loving can mend your soul ♪" "No." "Yes?" "I don't know." "♪ And is the only thing ♪ End of the week?" "Yes." "♪ That I know ♪" "♪ know ♪" "♪ I swear it will get easier ♪ [ Indistinct conversation ]" "[ Sighs ]" "[ Both chuckle ] ♪ remember that with every piece of ya ♪" "♪ mm, mm ♪" "♪ and it's the only thing ♪ Thank you." "For today." "Oh, you're welcome." "♪ We take with us when we die [ Both chuckle ]" "Mm." " [ Laughs ]" "♪ Mm, mm, mm" "♪ we keep this love in a photograph ♪" "[ Sighs ]" "♪ We make these memories for ourselves ♪" "♪ where our eyes are never closing ♪" "♪ our hearts were never broken ♪" "♪ and time's forever frozen still ♪" "♪ so you can keep me ♪" "♪ inside the pocket ♪" "♪ of your ripped jeans ♪" "♪ holding me closer ♪" "♪ till our eyes meet ♪" "♪ you won't ever be alone ♪" "So my streak lives on?" "Sure." "If you believe in that stuff." "♪ And if you hurt me ♪ You're right." "I don't need Derek." "♪ Well, that's okay, baby, only words bleed ♪" " I don't need him in my house." "I obviously don't need him to prove I can have 89 good outcomes in a row." "♪ Inside these pages, you just hold me ♪ I'm doing great." "♪ And I won't ever let you go ♪ My kids are happy." "My career is soaring." "Derek going to D.C. did exactly what it was supposed to do, which is remind me of who I am outside of my marriage," "Which, by the way, I'm kind of amazing." "Okay." "But that doesn't mean that I don't want to share it with him." "I want to tell him that I'm..." "We're on a streak." "I can handle Micah's post-op if you want to take off." "♪ Inside the necklace you got when you were 16 ♪" "That list of things you'd grab in a disaster." "♪ Next to your heartbeat, where I should be ♪ - [Beep]" "[ Ringing ] Woman:" "Hello?" "♪ Keep it deep within your soul ♪ Hi." "Is he in the lab?" "What?" "♪ And if you hurt me ♪" "I know this is Derek Shepherd's phone." "♪ Well, that's okay, baby, only words bleed ♪" " Who is this?" "Your kids, your keys, your family photo album." "♪ Inside these pages, you just hold me ♪ Who is this?" "That list goes out the window... ♪ And I won't ever let you go ♪ Who is this?" "♪ When I'm away ♪ Hello?" "When the disaster starts with you wondering" "♪ I will remember ♪ If this must be the woman," "♪ How you kissed me ♪ who's been screwing your husband." "[ Click, dial tone ] ♪ Under the lamppost back on 6th street ♪" "That's a whole other earthquake." "♪ Hearing you whisper through the phone ♪" "♪ Wait for me to come home ♪"