"Meredith:" "Time stops when you're in the O.R." "You step up to the table... you evaluate the patient... you pick up a scalpel..." "Big brother." "[ Chuckles ] [ Babbling ]" "And then you go into a bubble." "It's just you and your surgery, and nothing else matters, not time, not pain, not exhaustion..." "Nothing." "Hey." "Just finished my corpectomy." "Did I miss it?" "No, you're good." "[ Cellphone chimes ]" "Wow." "That was fast." "What was fast?" "I put out feelers with a real-estate agent about the house, and looks like I got an offer." "You're selling the house?" "No." "I-I don't know." "Maybe." "Why do people constantly feel the need to kill their arteries?" "[ Sighs ] Are they here yet?" "Oh, did I miss it?" "Tell me I didn't miss it." "Nope." "I almost forgot." "I can't wait to see the beads of sweat on their freaked-out little faces." "Oh, man." "Did I miss it?" "Nope." "Nope." "I want to see someone crap..." "Actually crap." "Seen it, smelled it." "Not as fun as you'd think." "Arizona:" "It's happening!" "The baby chicks and ducks are here!" "It happens in real life, too." "When something big happens, something tragic, you freeze." "You retreat into your happy bubble..." "Derek." "Meredith:" "Derek." "Right." "Meredith." "Meredith." "For what seems like a second..." "[ Door thuds closed ]" "Until you look up." "¶ There's blood in my mouth ¶" "¶ 'cause I've been biting my tongue all week ¶ and suddenly you realize..." "¶ I keep on talking trash ¶ it's a whole new year." "¶ but I never say anything ¶" "Richard:" "Each of you today comes here hopeful, wanting in on the game." "¶ And the talking leads to touching ¶ a month ago, you were in med school, being taught by doctors." "¶ And the touching leads to sex ¶ today, you are the doctors." "¶ And then there is no mystery left ¶ the five years you spend here as surgical residents will be the best and worst of your lives." "They will... ¶ and it's bad news ¶ you have a question?" "Yes." "Why?" "¶ Baby, I'm bad news ¶ uh, you raised your hand." "No, I'm sorry." "¶ I'm just bad news ¶ I mean why will these be" "¶ bad news, bad news ¶ the best and worst years of our lives?" "Uh, I-i was getting to that." "Sorry." "Um, where was I?" "Oh, right." "You will be pushed to the breaking point." "Look around you." "Say hello to your competition." "Eight of you will switch to an easier specialty." "Five of you will crack under the pressure." "Two of you will be asked to leave." "¶ I know I'm alone if I'm with or without you ¶ this is your starting line." "This is your arena." "How well you play... ¶ But just being around you ¶ that's up to you." "¶ Offers me another form of release ¶ they look stupid." "They look like babies." "Were we ever that young?" "¶ When the loneliness leads to bad dreams ¶ they're so..." "Well rested." "And stupid." "¶ And the bad dreams lead me to calling you ¶ and eager, like puppies." "¶ I call you and say ¶ no, not like puppies." "Chicks and ducks." "Chicks and ducks." "¶ "Come here" ¶ when did we start calling them that?" "You've been gone for a year." "Left to their own devices, they would drown." "¶ And it's bad news ¶ and take the patients down with them." "¶ Baby, I'm bad news ¶ god help us all." "[ Man speaking indistinctly ]" "¶ I don't care, I like you ¶ [ sighs ]" "[ Man speaking indistinctly ]" "[ Indistinct conversations, laughter ]" "They look good." "Pretty good." "Some of them." "I mean, for chicks and ducks." "[ Sighs ]" "I'll at least get some good ones, right?" "You'll make sure I get some good ones?" "Yeah." "You're gonna hook me up." "[ Lockers open, close ]" "Uh, listen up." "This is Dr. Edwards." "Some of you are lucky enough to be under her supervision." "Listen closely to everything she says." "Observe." "Learn." "She has the power to mold you into fine surgeons." "Thank you, Dr. Webber." "Oh, and congratulations, sir." "Dr. Webber's getting married this afternoon." "Hey!" "Hey!" "Wow!" "That's..." "Man:" "Whoo!" "Man #2:" "Yeah." "Mazel tov, sir." "Congratulations." "Hooray!" "[ Chuckles ]" "Thank... thank you." "Uh, now, um..." "Who's got Dr. Edwards?" "I did not hook you up." "All right." "I have three rules." "One..." "listen to the nurses." "Respect the nurses." "Do whatever the nurses say." "You may think you know more than the nurses." "You do not." "Two... your life is now all about me..." "Man:" "Charge to 200." "Not about you or your boyfriend..." "Woman:" "Charged." "Clear!" "Your fight with your sister..." "[ Paddles thump ]" "Or your nasty little rash down there." "So, when we are focused on me, we are learning to be surgical gods." "When we are focused on you, we're working at a gas station." "Three... no complaining." "You complain and you are out." "Got it?" "You." "Rules." "Repeat." "Listen to nurses, worship you, complain and die." "Good." "Let's go." "Hunt." "How much longer is Richard gonna be interim chief?" "Because I want to expand my department, and he has kind of a different approach to the budget." "So when are you coming back?" "Uh, I'm not." "The board's gonna appoint a new chief." "We are?" "When?" "Why?" "Yeah, why?" "Because..." "Uh..." "I've been chief long enough." "And..." "It's time for something else." "Woman:" "Dr. meadows." "Dr. meadows." "[ Siren walls ]" "[ Whistle blows, man speaking indistinctly on television ]" "Jackson." "Jackson!" "This is... uh..." "You are just making a mess." "[ Laughing ] What are you doing?" "[ Garbled ] Oh." "Do you want some?" "Sweetheart, you don't have to be here." "Really, I'm fine." "I am supporting you." "I'm your maid of honor." "April said the job of the maid of honor..." "Support the bride." "Keep her company." "So I'm supporting'." "I'm keeping you company." "You know, Meredith also said that the maid of honor drives the getaway car if you want to make a run for it." "So, you know, you want to make a run for it," "I'm standing by." "Ready to go." "Just give me a holler." "Until then, we're up on L.A. by 4." "I thought April would be with you when you came over." "Is everything okay?" "[ Sighs ]" "Yeah." "Fine." "Mm." "Well." "I know it's a challenge." "The woman that came back from the combat zone is not the same girl that left here." "April has changed." "It would be understandable if that created problems." "Jackson." "[ Cellphone chimes, vibrates ]" "Is that Richard?" "Tell me that he's here." "Tell me he's here, finally." "I told him not to go to that hospital today." "Woman:" "We interrupt this program to bring you late-breaking news..." "It'snotRichard." "From our studios in downtown Seattle." "What's wrong?" "These images are just coming in." "You know how many incoming?" "No." "We don't even know what happened." "But it is big." "I guess we're probably not making it out of here in time for that wedding." "You did a lobectomy on a dirt road?" "Well, we had to." "The nearestmedical center was 150 miles away." "Hey, does anybody know what happened?" "Not a clue." "So, was it just a 24/7 adrenaline rush?" "What was a 24/7 adrenaline rush?" "The desert." "No." "You get desensitized pretty fast." "There's another group leaving in two weeks if you're interested." "You're not living in a tent." "I grew up in a car." "That had doors." "We should both go." "I'm definitely not living in a tent." "Callie:" "Okay." "Here we go." "[ Horn honks ]" "[ Brakes squeal ]" "What have you got?" "Mid-60s female with crush injuries." "Massive blood loss at the scene." "We've done chest compressions for 28 minutes." "[ Radio chatter ]" "49-year-old male." "Went into v-fib en route." "Shocked times three." "He had two rounds of epi and vaso." "[ Monitor flatlining ]" "There are four more ambulances behind us." "Every last one of them's got nothing but d.O.A.S." "What's going on?" "Why aren't the ambulances unloading?" "Because they aren't ambulances." "They're freakin' hearses." "All the patients are dead." "What the hell happened out there?" "A tunnel on 99 collapsed during rush hour." "The north entrance completely caved in, trapping nearly 20 vehicles under the rubble." "Do we know how many victims?" "[ Sighs ]" "They're trying to get people out as fast as they can." "But for now, we're just waiting for them to find someone with a pulse." "How many dead?" "13 fatalities so far." "[ All groan ] God." "Man:" "Coming through!" "We got a live one!" "Clear a path!" "Scott Henry. 17 years old." "Penetrating trauma to the abdomen." "He arrested as soon as we took him off the rig." "Let's get him into trauma one, and page Karev!" "Woman:" "On it!" "I know everyone wants to help, but back up." "Give them room to work." "Woman:" "Dr. Karev to the E.R. [ Sighs ]" "Dr. Karev to the E.R." "We got one alive." "There could be more." "I wouldn't get your hopes up." "There could be more." "There could be more." "There could be more." "[ Indistinct conversations, telephone rings ]" "Three rigs pulling in now with more right behind them." "They don't know how many, but they'll bring as much as we can handle." "We've got live ones coming in, people, and we want them to stay that way." "We need surgical trays by each trauma bed, and reserve "o" neg on standby!" "There's always more." "Richard:" "Uh." "I-I know." "Look, I am sorry." "I was on my way to the hotel, but we crashed the O.R. floor." "It was too big just to..." "I'm not here to haul you out of here." "I'm here to help." "I'm looking for a pair of scrubs." "[ Sighs ]" "This." "This is reason number 537 why you and I are made for one another." "Mmm!" "Mwah!" "Surgery is sexy, honey." "Mmm." "It's hot." "Yes, it is. [ Chuckles ]" "And tonight, on our wedding night..." "Mm-hmm?" "Dr. Webber, I'm gonna show you just how hot a morning surgery can make me." "Mm." "[ Clears throat ]" "There are people dying." "You are so uptight for a best man." "[ Smooches ]" "Now, don't worry." "You're not off the hook." "Good." "I've never been anybody's best man before." "You know they're appointing a new chief soon." "I'm recommending you." "Unless you don't want it." "No, j..." "I've just heard you say this once before." "About the board seat." "But then I find out it'd been given to Alex Karev." "You're like the chief who cried wolf." "Who's on the board now, you or Karev?" "Woman:" "Dr. teller, extension 2219." "Dr. teller, extension 2219." "Heel, ducklings!" "Heel!" "[ Sirens wailing, horns honking ]" "Nicole:" "34-year-old pregnant female with prolonged extrication from a crushed vehicle." "Her name is Joan Paulson." "She's 40 weeks pregnant and in active labor." "BP's 100 over 60." "She's been complaining of severe neck pain and an obvious fracture of her right arm." "And who are you?" "I'm Andrew." "Sorry." "I was on my way into work." "I saw the collapse." "I stopped to help." "We've got to go back!" "We've got to go back!" "Well, we've got it from here, sir." "I'm a doctor." "Actually a surgeon." "[ Groans ] Her contractions are five minutes apart." "Her husband's still trapped in the car." "Let's page o.B.!" "[ Groaning ]" "You've got to get Keith out!" "Please, you've got to go back and get him out!" "Hey, don't you worry, okay, Joan?" "Just need to focus on keeping you and your baby healthy." "All right, thank you." "That was urban search and rescue." "They have a victim they can't extract." "They need us to send a team." "Who's on the field rotation list?" "Uh, we've got Pierce, Shepherd, Kepner, and grey." "No, grey hasn't been cleared yet, sir." "I'll sub in for grey." "And leave everything going on here?" "It's a mass casualty." "Grey!" "You need me?" "We're sending a team on-site." "You've been cleared." "Go get ready." "She's still supposed to be supervised." "She had a year off." "You can't give her special treatment just 'cause something bad's happened to her." "You can't spoil her like that." "The hell I can't." "Woman:" "Dr. Sanders, 1524." "Dr. Sanders, 1524." "Oh!" "Ow!" "Careful!" "We're looking for our friend!" "Are you a doctor?" "One at a time." "His name's Scott." "He's 17." "Uh, he was in the backseat when this huge piece of cement came down and..." "He was really messed up." "They took him away in an ambulance." "We just got here." "We're not even from Seattle." "Okay." "Uh, where are your parents?" "Back home." "In missoula." "They didn't come with us." "Our parents let us do stuff." "We don't get in much trouble." "We're..." "Dorks." "We're supposed to be touring u.W. Right now." "Wilson!" "We could use some more hands on our kid in trauma one." "Is he talking about Scott?" "He's not gonna die, right?" "[ Radio chatter ]" "Is that Scott?" "[ Monitors beeping rapidly ]" "V-fib." "Push an amp of epi." "Charge to 150." "Paddles!" "Jackson:" "Wilson, get in here and help bag!" "Clear!" "[ Paddles buzzing ]" "[ Beeping ]" "[ Monitors beeping rapidly ]" "Fetal monitor is on." "O.B. Is coming." "And we should get ortho to take a look at her arm and her neck." "On it!" "Right away!" "I will!" "My baby." "Is my baby okay?" "Baby's looking just fine, Joan." "Heart rate's right on target." "Dr. Edwards, is it true that the fetus can be compromised if the patient is in the supine position?" "The fetus is compromised?" "Out." "I'm sorry, did you mean..." "Out!" "This is not question time." "All of you, just go to radiology." "Check on the reads." "I will call you if I need you." "Where is radiolog..." "Scram!" "Joan:" "The contractions started this morning." "The doctor said we could take our time, but I wanted to leave." "I made Keith take the stupid tunnel!" "He wanted to take the bridge, but I said the tunnel was faster." "I'm constantly telling him what to do." "How long have you two been married, Joan?" "We're not married." "We met each other nine months and three days ago." "I barely knew him." "It's crazy what you find out about a person when you get knocked up on the first date." "We're gonna get married next week." "[ Voice breaking ] Please tell me we're getting married next week." "[ Monitor beeps ]" "[ Siren wailing ]" "[ Horn honks ]" "[ Brakes squeal ]" "[ Man speaking indistinctly ]" "Man:" "Get some water over here." "Man #2:" "Over here!" "Man #3:" "And tape, bandages, and a splint." "[ Helicopter blades whirring ]" "Woman:" "Will someone call my husband?" "I need my husband!" "Woman #2:" "Help me!" "Help me!" "Man 4:" "Okay, all right." "Calm down." "Please!" "Please!" "Tell me your name." "Woman #3:" "He's 10 years old." "T-shirt and jeans." "Man 5:" "He was in the backseat?" "Yes." "Man #6:" "Ma'am, can you follow my finger?" "His name is Tyler." "Stay with me, okay?" "Woman #4:" "Help us." "[ Horn honks ]" "[ Woman screams ]" "[ Indistinct conversations ]" "You the surgeons from grey-Sloan?" "We are." "Where's the patient?" "This way." "Man:" "We're gonna help you." "What's his name?" "Keith." "Gardner." "Man:" "We got one." "He's still alive." "[ Crying ]" "Woman:" "My ear..." "I can't hear anything!" "Woman #2:" "Help!" "[ Helicopter blades whirring ]" "Car's been crushed by debris." "We got his wife out, but..." "Amelia:" "Oh, my god." "He's in there?" "He's alive?" "Woman:" "Help me!" "Barely." "Man:" "Back on the truck." "Woman:" "Ohh!" "[ Helicopter blades whirring ]" "Man #2:" "All right, come on, you guys." "Man #3:" "We're gonna get you out, buddy." "Don't worry." "[ Indistinct conversations ]" "[ Horn honks ]" "Meredith:" "Hey, Keith." "My name is Meredith." "We're gonna get you out of there, okay?" "That'd be great." "[ Woman shouting indistinctly ]" "How do we even start?" "We just do." "[ Sirens wailing ]" "[ Horn honks, helicopter blades whirring ]" "[ Indistinct conversations ]" "Man:" "The door's coming off!" "Man #2:" "I'm looking for my wife." "Woman:" "Please!" "There." "Man #3:" "She's good." "I need some more lap pads in here." "EMT:" "You got it, doc." "Here you go." "Keith, can you follow my light with your eyes?" "My fiancée, Joan, she was with me." "Is she okay?" "We saw her arrive at the hospital." "She's alive." "Okay." "Okay." "Good." "She made it there." "She's alive." "I need some packing!" "Do you know w-we're having a-a baby?" "Keith, we're trying to listen to your breathing." "Stop talking, please." "[ Coughs ]" "It's hard to hear breath sounds out here, but he could have a collapsed lung." "How's his abdomen?" "Lot of blood, from what I can see." "Keith, I'm just gonna check your torso, okay?" "He's impaled in two places." "It's pretty bad, huh?" "It's pretty bad." "But I've seen worse." "[ Indistinct conversations ]" "[ Man shouts indistinctly ]" "Man:" "Okay." "Man #2:" "Make sure you got that crushed leg." "[ Helicopter blades whirring ]" "Owen:" "Call respiratory for bed two, and get a repeat crit on bed eight." "Thanks." "Uh, Dr. Hunt." "Yeah?" "Hi." "Uh, I'm Andrew deluca." "Oh, right." "You came in with the pregnant woman." "Yes." "Uh, is there any paperwork I should fill out or...?" "You can do it later if you're good to just jump in and keep helping." "Of course." "Sure." "Oh, god, there's another one!" "Okay." "Keep breathing." "Nice and slow." "Edwards, nice job reducing the wrist." "Uh, actually Dr. deluca did that in the field." "Dr. who?" "Me." "Hi." "Dr. deluca." "He was at the scene." "Paramedics ran out of splints, so that's actually my tie." "Was your tie." "Sorry." "Eh, it's not a problem." "It was my favorite one, though." "Oh, god!" "All right." "Three centimeters dilated." "Look, she has a fracture at c5-6." "What's a c5-6?" "Callie:" "Joan, you fractured a bone in your neck, but it is stable for now, so we will fix it after you deliver, okay?" "Keep her in the collar until her labs come back, then we'll get her upstairs so she can deliver, and repair the fracture." "Stephanie:" "Got it." "Have them page me when her contractions become more frequent, okay?" "All right." "Thank you so much for your help." "It was my pleasure." "[ Monitor beeping rapidly ]" "Jackson:" "He's losing blood faster than we can put it in him." "We should get him upstairs." "We need to open his chest." "Glove me." "Crack his chest and then what?" "That still might not buy us enough time to get to the O.R. and fix his injuries." "Then we stop time." "How?" "Put him on bypass, drain out all of his blood and replace it with cold saline, and then we operate." "Can you do that?" "No, he can't." "That's way too risky." "We put him in suspended animation, cooling him from inside out..." "His brain, his heart, his organs." "That buys us an hour or two." "Hunt!" "Ten blade." "[ Monitor beeping rapidly ]" "Woman:" "Dr. Miguel..." "Dr. Miguel." "How's it going out there?" "Um, they're coming in faster than we can treat them." "Mm." "Um, listen, Catherine..." "I-I-i hate to say this, but, you know, under the circumstances, do you think we should postpone the wedding?" "I already did." "My assistant is notifying our guests as we speak." "Oh." "You're sure you don't mind?" "Of course I mind." "But we both know where we need to be." "Hey, uh, chief." "Uh, we need you." "Jackson:" "You can't just say" ""suspended animation" like it's a real thing." "It's science fiction." "It's called emergency preservation and resuscitation." "Trauma programs have been discussing it for years." "It's a way to save patients who can't make it to an O.R." "Yeah, a risky way, an irresponsible way." "'Cause the safe option is to keep transfusing him and race him upstairs." "How do you do it?" "Well, we cannulate the aorta, drain out his blood, infuse cold saline, then drop his core temp to 50 degrees." "You put him in hibernation?" "You replace his entire blood volume with ice water." "You're gonna do what to him?" "Get her out of here." "So you induce hypothermia." "Hold on." "We're not gonna consciously kill a kid over something you discuss over beers with your trauma buddies." "Kid's gonna die anyway." "At least this way we can try to bring him back." "I say do it." "No." "It's way too experimental." "And we would need Pierce." "She's at the site." "This is not a cardio procedure." "It is if you can't get his heart beating again!" "What are you gonna do if you can't get him back after bypass?" "What then?" "That's why we don't do things like this on a whim." "This is not a whim." "This is a hail Mary." "On a child?" "The patient is a minor." "We don't have consent." "By the time you find the parents, it'll be too late." "I agree with Jackson." "It's a no, hunt." "We're wasting time having this conversation." "[ Rapid beeping continues ]" "Okay." "We only need two physicians to give consent." "Karev?" "Really?" "That's how you want to play this?" "In." "Webber?" "Chief?" "Just do it." "I need a cannula!" "Too many people have died today." "We're not adding this kid to the list." "How's his airway?" "His sats are okay." "There's definitely blood in his chest on the left side." "Meredith, can you get the packing in?" "I'm trying." "I can't really reach it from this angle." "Uh, I need some more trauma pads and cellulose polymer, please." "What's going on?" "Whenever I press on the wound, blood is flowing out of his abdomen." "The metal is tamponading it, but it's not going to last very long." "[ Coughs ] And he needs surgery soon." "If he doesn't suffocate on his blood first." "I got to get a chest tube in here." "[ Sighs ] Do you have access?" "[ Keith coughing ] No." "Maybe." "We have to get him out of there." "What about from the other side of the car?" "I could be your other hand?" "Yeah." "Do you really think that you can get me out of here?" "I have to." "You said it yourself..." "You're having a baby." "Do you have kids?" "I have three." "Wow, three." "One is freaking me out." "We did it backwards, though, you know?" "Y-you meet someone, you, uh, fall in love, get married, have a kid..." "It gets bigger, right?" "Joan and I, we... we did this huge thing first." ""We're, uh, having a baby." "Nice to meet you."" "We're still getting to know each other, learning all these little things." "It's good stuff." "She, uh..." "Sleeps with her socks on." "We like... we like watching tennis..." "Get me a stethoscope." "But not playing." "She likes techno." "Would have been a deal-breaker, but we got this big, huge baby thing coming, so..." "[ Groans ]" "[ Breathing shakily ]" "I really..." "I-I really love all her little things." "It's like I'm home." "She's like my home." "I should really tell her that." "Right?" "Man:" "Come on, guys!" "[ Coughing ]" "[ Helicopter blades whirring ]" "[ Man speaks indistinctly ]" "Man #2:" "I got it." "[ Indistinct conversations ]" "I should..." "Hey!" "Slow down!" "I'm sorry." "What is in your mouth?" "A brie tart." "With prosciutto." "Brie?" "Brie!" "Um, there are patients here that had chunks of cement fall on them during their morning commute." "But, please, have some brie." "While carrying lab samples." "That's nasty." "What's the matter with you?" "[ Garbled ] Oh." "Where'd you get this?" "[ Laughter ]" "Woman:" "It looks wonderful." "What the..." "Did you try this?" "Woman #2:" "I'll try that." "Man:" "No, yeah." "It's vegetarian." "Oh, hey." "I heard Catherine Avery had all the food from the wedding sent here, you know, for the staff, and I have two minutes." "How many sliders do you think I could eat in two minutes?" "Is that Pesto?" "Do you think that Catherine's gonna help pick the new chief?" "I mean, why wouldn't hunt just do it?" "I don't, um..." "God, it would save us so much trouble." "The 12-page résumés and the phone calls and the polite vetting and..." "Who would want to be chief?" "Would you?" "I..." "Well, I had..." "Are you asking?" "Hunt should just do it, right?" "Oh." "Those crab cakes look really good." "Man:" "But I don't want to make a pig of myself." "Man #2:" "Exactly what I was thinking... exactly." "Well, yes." "Yes, I would like to be chief." "[ Indistinct conversations, siren wails ]" "I know." "Did you get ahold of Scott's parents?" "Not yet." "We left messages." "We're trying." "I mean, they should know that you're killing their son." "I'm sorry, what?" "Yeah." "We have some questions." "From our research, we think this plan is completely untried and... and experimental." "Your research?" "You're trying suspended animation through induced hypothermia." "So you heard Dr. Hunt." "It's basically science fiction." "It's still undergoing clinical trials, and there's no documentation suggesting that this will work on humans." "Whoa, whoa." "Where did you get this research?" "[ Sighs ]" "[ Suctioning ]" "Dr. Hunt, this procedure's only been successful on pigs?" "Wait, what?" "It wasn't successful on humans?" "It hasn't been tried on humans." "They've started trials, but they have no outcomes." "Not yet." "Core temp's down to 55." "Where are you getting this?" "Those kids." "His friends." "You said there were techniques that were developed and the studies were published." "The animal studies have had incredibly success." "And the technique has to start somewhere." "I can name 30 soldiers this technique would have saved." "So you want to try it on a high-school kid without parental consent?" "You better pray this works." "Even if we resuscitate him, he could end up brain-dead." "His core temp's down to 53." "It doesn't matter now." "We're doing it." "We've done it." "So either get on board or get out." "Karev is right." "Anybody who doesn't want to be part of this is welcome to leave." "I'll stay." "We're there." "Core temp's 50 degrees." "Okay." "He's cold." "We have an hour, 90 minutes, tops." "We ready?" "Start the clock." "Scalpel." "[ Clicks ]" "I said no." "I know what you said." "If anything goes wrong in that O.R., it jeopardizes our entire surgical program." "It could be the boy's only hope." "I don't need you to defend the technique to me, Richard." "I need you to follow orders." "Orders?" "I'm an owner in this hospital." "I am, too." "But I'm also the chief." "It's my call." "You mean interim chief." "That boy had no chance." "We're giving him one." "I don't feel bad about that." "Now, if you'll excuse me, I have another surgery." "[ Door opens, closes ]" "¶ You fixed your eyes on us ¶ [ Sirens wailing ]" "April:" "We can't tell where Keith ends and the door begins." "If we use the jaws of life to get him out, it'll rip him to shreds." "He'll bleed to death in seconds. ¶ Your flesh and blood ¶ what about trying an ex-lap?" "Then we can try to separate... ¶ a sculpture of water ¶ we're not sterile." "There's no blood bank." "This is not a controlled environment." "I know." "I know." "I know." "¶ And unsettled dust ¶ we could put a balloon catheter into his aorta." "It could buy us some time." "Meredith:" "If we were closer to the hospital," "¶ and there was bad blood in us ¶ I would say maybe, but we're 25 minutes out." "He'll never make it." "Okay, what if..." "He's a black tag, guys." "We can't do anything else for him." "¶ we learned our lesson ¶ [ helicopter blades whirring ]" "¶ Genesis to the last generation ¶ [ cellphone chiming, vibrates ] Then I'm calling it." "We're gonna cut him out." "Maybe we'll get lucky." "¶ So we wrestle with it all ¶ [ Ringing continues ]" "You should go." "No, we can stay and help..." "I'll stay." "You go save people that you can save. ¶ The concept of grace ¶" "I'll do what I can for him." "¶ How they feel brand-new against different time frames ¶" "April:" "Okay, Keith." "We're gonna cut you out of there now, all right?" "¶ A den of cold words ¶ sure thing." "¶ Against different time frames ¶ [ siren wailing ]" "[ Indistinct conversations ]" "¶ We know it all by heart ¶ uh, Joan, Dr. Edwards asked us to take you to the O.R. now. ¶ The whole is greater ¶ okay?" "¶ Than the sum of its parts ¶ and we can do that, because we know exactly where that is." "¶ We heard it all before ¶ I knew our first day would be intense." "I figured we might get to watch some stuff or start an I.V., but there was a mass casualty today." "¶ and beauty there echoes ¶" "I've never seen so many mangled people," "¶ the speck of our souls ¶ so many dead people." "Doctors from this hospital just spent hours in the field ¶ and beauty there echoes ¶ trying to extract a guy." "Hours." "That's gonna be us some day." "¶ the speck of our souls ¶ man:" "Did they get him out?" "The guy?" "Huh?" "Oh, no, I don't think so." "I heard he was too far gone." "Can't breathe." "¶ Like firewood ¶ so they just left him there?" "Ah!" "Got it." "I can't breathe." "¶ Burning bright in the dead of winter ¶ I can't breathe." "Let me out." "What?" "O-okay." "I-is it the collar?" "I need this off." "I need to... i need to get out." "Okay." "I-i can loosen it." "N-not much, but maybe... maybe a little." "I need to get out." "Should you do that?" "I-i don't... they left Keith." "¶ Now only the flicker ¶ they left Keith." "He's gone!" "¶ Can cling to this life ¶ no, don't!" "[ Screaming ]" "¶ So we heard it over mass ¶ there's a shock through my body." "What's happening?" "We need to stabilize her spine." "Um, help me reduce her dislocation." "¶ Is a faith a prediction?" "¶ I'll hold her steady and you attach the tongs." "What, me?" "Yeah, I got her." "Go." "If we hurry, maybe we can save her from total paralysis." "¶ Wear our tradition ¶ but I-i can't." "¶ Until we collapse ¶ I mean, I-i could try, but I don't think it's the best idea." "What do you mean?" "Just attach..." "i don't know how to do it." "Why?" "'Cause I'm just an intern." "¶ And argue our bearings until we collapse ¶ okay?" "Today's my first day." "I was late." "I was on my way here." "I saw the tunnel collapse." "What?" "Well, you..." "What?" "What?" "You're an intern?" "Maybe if we..." "It wouldn't have worked." "Yeah." "No." "He didn't have a chance." "It was the right call." "Huh." "What?" "Woman:" "We're on the third floor." "Man:" "What'd I do?" "Stephanie:" "Wiggle your toes for me, Joan." "Joan:" "I can't." "I can't feel anything..." "Not even my contractions." "What did you do?" "Am I paralyzed?" "We're working very, very hard to prevent that, but I need you to stay calm." "Can I do something?" "You can go stand over there with the interns, intern." "What the hell happened in here?" "She dislocated her fracture at c5-6." "I'm decompressing." "Okay." "Baby's got decels." "All right." "I'm getting the first five-pound bag." "How the hell did she dislocate?" "Man:" "Uh, she was having trouble breathing." "I-I-i thought it was the collar." "Get out!" "Okay." "I need to get this baby out of here." "Let's get her up to the O.R. all of you out now." "[ Monitor beeping ]" "So, if this works, they're gonna do this in the army?" "Absolutely." "We should go." "We should take a year, do the program." "We'd spend our time doing things like this all the time." "It would be amazing." "You're in the middle of your residency." "Well, I'll take a research year." "We could have an adventure." "Not looking for an adventure." "[ Monitor beeps ] Oh, crap." "What is it?" "It's an infra-renal ivc injury." "Damn it!" "How long's it gonna take to fix?" "I don't know, about 30 minutes?" "We don't have that." "Okay, he can live without it." "Just ligate it." "Got it." "Oh, silk ties." "There was a mass casualty today." "They needed us back here at the hospital." "I know, but maybe there was still something that we could've... we did everything we can do." "Why are you second-guessing?" "I'm just saying that maybe..." "I was willing to try an ex-lap." "Oh, my god, would you shut up about the stupid ex-lap?" "That is not the point!" "No." "No, the point is that maybe we should have stayed." "Maybe we didn't try everything we possibly could have to save him." "We were all there." "We all saw that car." "And there's a difference between knowing when you can realistically save someone and when it's time to walk away." "And when is that, Meredith?" "When is that point?" "When do you look at a horrible, sad situation and decide that you are ready to turn your back on it?" "I'm curious." "I'm curious how you make those decisions..." "You specifically." "When are you okay making the call that someone no longer has any chance?" "How... how do you look around and decide that?" "When do you decide that you should walk away?" "Dr. Shepherd?" "Dr. Edwards says she needs you in trauma two right away." "I'm Dr. Shepherd." "Oh, sorry." "Dr. Edwards says she needs you right away." "[ Ambulance door closes, siren wailing ]" "She wasn't..." "Um..." "I..." "They need you upstairs." "Go." "Ben:" "Core temp's 98.6 degrees." "Jo:" "No pulse." "Jackson:" "Heart should be beating by now." "We're way over time." "The ivc repair..." "He'll come back." "Come on, Scott." "[ Flatlining ]" "If we lost him..." "[ Door opens ]" "What the hell did you people do?" "We put him in hibernation, and we're bringing him back out." "Are we?" "[ Flatlining continues ]" "[ Monitor beeps ]" "[ Sighs ]" "Okay." "Let's get him off bypass." "[ Metal clinking ]" "[ Sighs ]" "We got a heartbeat." "The boy's reviving." "I'm thrilled to hear it." "I made the right call." "Talk to me when we see what kind of brain function he wakes up with." "Thinking like that would have left that boy dead on the table." "I can assure you that your successor will be nowhere near so cavalier." "I'll make certain of that when I choose the next chief." "Oh, when you choose?" "Well, it's not up to you, Catherine." "It's a board decision." "We'll see about that." "You can't just come in here and think you can..." "I don't need you to tell me how this hospital works." "I've seen plenty of that today." "[ Door opens ]" "Woman:" "Dr. Thompson to oncology." "Dr. Thompson to oncology." "I'm sorry about leaving the patient there." "I didn't want to leave him there, either." "And I am sorry for not talking to you about the house." "You don't talk to me about a lot of things." "And you're mad at me for going away, and I am sorry about that." "That's not..." "I mean, I couldn't breathe." "I couldn't exist." "You know, I looked around at that house, and my kids, our kids..." "I couldn't breathe." "You didn't call me." "I didn't call anyone." "I needed time." "I am a neurosurgeon." "I could have saved him." "And you didn't call me." "Amelia..." "Who contacted you first?" "The police?" "The paramedics?" "How far away was the hospital?" "How long were you sitting there waiting for them to declare him brain-dead?" "How many hours later was it before I was even informed?" "How many chances did you have when you could have called me?" "Why didn't you call me?" "There wasn't anything you could've done." "He was too far gone." "You don't know that." "You don't know." "Yes, I do." "What if I could've helped him?" "What if I had a chance?" "I pull off miracles for a living." "I have proven that I can reverse the impossible." "I should have been there." "If I had seen him or treated him..." "It was too late." "By the time they..." "[ Sighs ]" "It was too late." "[ Voice breaking ] How could you do it?" "How could you unplug him without letting me know?" "I didn't get to see him." "I didn't get to tell him goodbye." "I thought you would've at least given me the courtesy and the respect when my own brother was dying." "[ Sniffles ]" "[ Breathes sharply ]" "I didn't get to tell him goodbye..." "Because of you." "[ Door closes ]" "Damn it!" "[ Clipboard clatters ]" "[ Crying ]" "[ Sniffles ]" "[ Breathing deeply ]" "[ Sniffling ]" "[ Clipboard clatters ]" "[ Breathes deeply ]" "[ Indistinct conversations ]" "Hey." "Sorry about the wedding." "Oh, no." "It was the right idea to cancel." "Postpone you mean." "Right?" "The odds aren't in my favor, Miranda." "You know, I've tried this before." "And failed." "Twice." "Well, it always comes between choosing between the woman and the work." "And when pressed, I..." "You choose the work." "Yeah." "You'd think I'd learn at some point." "Sounds like you have." "You just need to be okay with it." "But with Catherine and me, it's already been a problem, and it's still gonna be a problem." "I'm not sure I want to go down the road if it's gonna go nowhere." "Carefully." "Carefully." "Okay." "All right." "You're doing great, Joan." "Deep breaths." "[ Gasps ]" "What is it?" "Talk to us, Joan." "I feel something." "In my fingers." "Okay." "Good." "That means the traction's working." "And in my toes!" "Oh, thank god." "I can..." "I can feel my legs again." "[ Laughs ]" "Oh, my... oh, my god!" "[ Chuckles ] Oh, my god." "I can feel everything." "Oh, my god!" "She's having a contraction." "All right, Joan." "Joan I know it hurts, but you have to keep still, okay?" "[ Moans ]" "We need to prevent your neck from dislocating again." "[ Groans, crying ]" "You were right today." "I was taking a big risk." "You were lucky today." "Really lucky." "I understand." "Is Kepner back yet from the tunnel?" "I don't know." "I don't know much about her lately." "She's..." "Different since she came back from her training with you." "And I'm glad that she found something that makes her this happy," "I guess." "But it's weird." "We're just not on the same page anymore." "Ever, it seems." "It happens..." "More than you think." "You go away, you come back." "The world has shifted." "Things that made sense once don't anymore." "You heard that I'm resigning as chief?" "Give her time." "That's all you can do." "That's the face you're gonna make?" "The kid's alive." "I don't want to have this fight." "What fight?" "This fight." "This "I told you so" fight." "This thing where this insane surgery works, and then you get back on this army thing, and then I tell you you're not going, and then you get pissed." "You're gonna tell me what I can and can't do?" "You do that, I'm gonna be more than pissed." "You know what?" "Screw it." "You want to go, then go." "What's your problem?" "It sounded interesting." "And for a minute, I thought it could be something that we'd do together... why not?" "I have worked really freaking hard to get to where I'm at right now." "I have finally found my place, and it's at this hospital doing this job with these people." "Alex, I'm..." "Last year was crap." "And now mer is..." "I-i-is home, and I finally feel like things are back." "I don't need to go anywhere." "I don't want to." "I've put roots down here." "I've never put roots down anywhere." "I'm not walking away, not from this." "If you want to go, then go." "I can't stop you." "It's your life." "Do what you want." "Go join the freaking army." "You're almost there, Joan." "Almost there!" "[ Groaning ]" "Uh, hey, guys..." "Okay." "She's crowning." "She was only six centimeters." "I need to... need to push one more time." "This baby's coming now." "Edwards, hold her steady." "[ Elevator bell dings ]" "Occupied!" "Occupied!" "[ Groans ]" "Woman:" "Dr. Guillaume." "Dr. Guillaume." "Hey." "I needed to ask you something, but I didn't want to because I knew you'd say yes." "Then don't ask." "I went away." "I pressed pause on my life." "And I really needed that." "But since I've been back, I just..." "I can't unpause." "I just can't get things going again." "I go home every night to my house and it's..." "It's not my house." "It was mine and Derek's house." "And now he's gone, and it really just feels like a house." "I came back, but I'm not home." "And I really want to be home." "Can the kids and I come and stay with you for a while?" "Yeah." "No big deal." "Well, you better check with Wilson because you know how she gets." "Trust me, I don't need to check in with Wilson." "[ Cellphone chimes, vibrates ]" "No." "No." "Well, then, explain it to me again." "[ Scoffs ]" "Well, m..." "Uh, when did this happen?" "Mom, how can you say that?" "[ Scoffs ]" "[ Groaning ]" "Arizona:" "Okay." "You're doing great, Joan." "One more big push and that should do it, okay?" "I can't..." "I can't do this." "I can't." "He's supposed to be here with me, with us, and he's gone!" "Joan, we know it hurts, but we need you to keep going, okay?" "The head's out!" "[ Groans ]" "Meredith:" "How do you step back into the world?" "[ Baby cries ] This wasn't part of the plan." "Joan, you did great." "Keith was supposed to cut the cord." "[ Crying ] He was supposed to hear the first cry." "Hold your baby." "Everything is fine." "Mom, say hello to your son." "It's scary." "This isn't how it's supposed to be." "It's not part of the plan." "Keith should be here." "Keith should be here." "Keith should be here!" "Hi, baby." "Time stood still..." "[ Cellphone chimes ]" "Mom, I have to go." "I have, um..." "Uh..." "G-goodbye." "[ Cellphone beeps ]" "And now it's speeding by." "E.R.?" "Yep." "I thought we'd seen the last of it." "You are looking for a lifeboat..." "You okay?" "Yeah." "Yeah, I'm fine." "Something to give you hope." "[ Siren wailing ] But are you really ready to leave your happy little bubble and step back out into the big, blinding, bloody, terrible world?" "I stopped them from trying to extract him." "I couldn't watch him bleed out." "You were right..." "You said if he were closer to the hospital, he might have a chance." "So let's give him a chance." "Are you ready to achieve..." "The impossible?" "[ Sirens wailing ]" "[ Horn honks ]"