Only Mama Knows

"This is how my mother wanted to be remembered. My memory of her is a little biit different. I'm sure everyone remembers their own version of her. Versions I wouldn't even recognize. It's all that's really left of someone when they're gone. But that's the tricky thing. Nobody's memory is perfect or complete. We jumble things up. We lose track of time. We are in one place and another. And it all feels like one long, inescapable moment. It's just like my mother used to say: The carousel never stops turning. They say we can repress our memories. I wonder if we're just keeping them safe somewhere. Because no matter how painful they are, they are our most valuable possessions. They made us who we are."

- Meredith Grey

 is the fourth episode of the eleventh season and the 224th overall episode of Grey's Anatomy.

Short Summary
Secrets from Ellis Grey’s past come to light when Meredith watches old videos and reads through her mother’s journals. Meanwhile, Maggie rocks the hospital with an unexpected announcement. Alex gets new responsibilities and Callie focuses her attention on the Veterans' project.

Main Cast

 * Ellen Pompeo as Dr. Meredith Grey
 * Justin Chambers as Dr. Alex Karev
 * Chandra Wilson as Dr. Miranda Bailey
 * James Pickens, Jr. as Dr. Richard Webber
 * Sara Ramírez as Dr. Callie Torres (credit only)
 * Kevin McKidd as Dr. Owen Hunt
 * Jessica Capshaw as Dr. Arizona Robbins
 * Sarah Drew as Dr. April Kepner (credit only)
 * Jesse Williams as Dr. Jackson Avery
 * Caterina Scorsone as Dr. Amelia Shepherd
 * Camilla Luddington as Dr. Jo Wilson
 * Jerrika Hinton as Dr. Stephanie Edwards
 * Patrick Dempsey as Dr. Derek Shepherd

Guest Stars

 * Annet Mahendru as Ana
 * Sally Pressman as Young Ellis Grey
 * J. August Richards as Dr. Richard Webber
 * Kelly McCreary as Dr. Margaret Pierce
 * Kate Burton as Dr. Ellis Grey

Co-Starring

 * Rafael J. Noblé as Roy Pepper
 * Walter Addison as Chief Martin Vance
 * Aria Leabu as Young Meredith
 * Sara Rowe as Nadia
 * Danny Jacobs as Doctor

Marty Secord

 * Diagnosis:


 * Doctors:
 * Arizona Robbins (pediatric surgeon)
 * Alex Karev (pediatric surgeon)


 * Treatment:

Marty's liver enzymes were good, but Arizona was worried he'd have to go back in for an ERCP, so she asked Alex to keep an eye on him.

Roy Pepper

 * Diagnosis:
 * Aortic aneurysm
 * High spinal injury


 * Doctors:
 * Margaret Pierce (cardiothoracic surgeon)
 * Amelia Shepherd (neurosurgeon)
 * Derek Shepherd (neurosurgeon)
 * Jo Wilson (surgical resident)


 * Treatment:
 * TEVAR procedure
 * Spinal cord drainage
 * Sternotomy
 * Aneurysmoplasty

Roy was having a TEVAR procedure for an aortic aneurysm. Pierce became concerned about the blood flow to his spine being cut off, potentially paralyzing him, so she asked him to wiggle his toes. When he was unable to do that, Amelia checked for the Babinski reflex, a sign of paralysis. His toes fanned out, indicating a high spinal injury. She sedated Roy and then worked to avoid permanent paralysis. She induced hypertension and adjusted the stent, but it didn't work, so he needed spinal cord drainage, which Derek was called in to do. When that didn't work, it looked like he would be paralyzed permanently, but then Pierce had the idea to do an aneurysmoplasty to fix it. She used the aneurysm to build a new aorta just to provide blood flow to his spine. Once she was finished, she woke him up enough to have him attempt to wiggle his toes. He was able to do so, indicating that it was a success.

Nadia

 * Diagnosis:
 * Peritonitis
 * Abdominal tumor


 * Doctors:
 * Meredith Grey (general surgeon)
 * Alex Karev (pediatric surgeon)
 * Stephanie Edwards (surgical resident)


 * Treatment:
 * Surgery
 * Balloon tamponade

Nadia, 10, was brought into the ER with abdominal swelling. Alex used an ultrasound to rule out pregnancy as the cause and they found a tumor, with free fluid in her abdomen. Meredith suspected the mass had ruptured, so they rushed her into emergency surgery. They removed a large portion of the tumor, which weighed 7.8 lbs. and then removed the rested in pieces as they repaired the damage it caused. When she started bleeding out from her liver, Meredith had the idea to use a balloon tamponade to stop the liver bleeding and give them time to repair the liver. She was successful and Meredith told her mother that she would be fine.

Ellis's Patient

 * Diagnosis:
 * Gun shot wounds
 * Penetrating injury to the liver


 * Doctors:
 * Ellis Grey (general surgeon)
 * Richard Webber (general surgeon)


 * Treatment:
 * Surgery
 * Balloon tamponade

Ellis and Richard operated on a patient with gun shot wounds. Ellis used a balloon tamponade to stop the bleeding and give them time to repair the wound. It was successful.

Ellis Grey

 * Diagnosis:
 * Wrist lacerations


 * Doctors:


 * Treatment:
 * Stitches

Ellis's suicide attempt was shown in flashback.

Patient

 * Diagnosis:


 * Doctors:
 * Nicole Herman (fetal surgeon)
 * Arizona Robbins (pediatric surgeon)


 * Treatment:
 * Shunt

Arizona observed a shunt placement performed by Herman.

Music
There was no music used in this episode, making it only the second episode in the entire show's history to do so.

Notes and Trivia

 * This episode's title originated from the song , originally sung by Paul McCartney.
 * This episode scored million viewers.
 * The episode was filmed from August 26th to September 9th, 2014.
 * This is the first episode since she became a series regular not to feature Sara Ramírez as Dr. Callie Torres.