Grey's Anatomy Universe Wiki
Grey's Anatomy Universe Wiki

Almost half of this country doesn't go to the doctor when they should. Many don't have access but a lot of others, they just don't want to because they don't believe anything is actually wrong. Most patients put off facing the truth for as long as possible. And we get it. We do it, too. We ignore things. we stay under the covers. We don't pick up the phone. We don't face the music and all that crap. But the longer we hide, the worse it can be. So open the test results. Have the hard conversation. Say what you mean. Good or bad. You may be surprised at what you find. And at the very least, you'll know what you're dealing with.

A Hard Pill to Swallow is the eleventh episode of the sixteenth season and the 353rd overall episode of Grey's Anatomy.

Short Summary[]

Richard finds out Maggie quit Grey Sloan and is concerned about how she's handling the death of her patient who was her estranged cousin. Bailey returns to work after taking some personal time off, although Koracick doesn’t make her first day as easy as she'd like. Meanwhile, Meredith thinks she might miss DeLuca, and Amelia has an update for Link on her pregnancy.

Full Summary[]

Meredith texts Cristina about Cormac, wanting more information. Despite her questions, Cristina refuses to say more. Amelia walks into the lounge and asks Meredith if she's heard anything from Maggie and Meredith says she's still not ready to talk. Amelia wants to stay in bed herself, or go back to it. She then commits to being brave and facing her problem. Cormac comes in and offers his help as Amelia struggles to tie her own shoe. He ties it for her, then offers Meredith coffee and they have a brief conversation about how good the coffee is. After he's gone, Amelia makes a comment about him being attractive and Meredith unties her newly-tied shoe before leaving.

Jo gives report on the ER patients to Teddy, who is frantically searching the area. When Jo asks, she says she lost her engagement ring. Jo says she'll keep an eye out.

Meredith finds Andrew and tells him she didn't like him telling her to take time to think. He's worried about his patient, who is post-op day three on an appendectomy, but still not out of the hospital. Meredith says she'll think on it, but he should also tell Bailey. Before she leaves, she tells him she misses him. He says he didn't dump her and she doesn't have to miss him.

Link finds Amelia by the coffee cart and notices she's upset about something. She then sits him down and tells him, with difficulty, that he might not be the father. He knows the other option is Owen. Amelia says he doesn't know. She wanted to tell him first because she wants to be with him and a paternity test won't change that. She loves what they have. She tells him to take some time to think.

Andrew updates Bailey on the injured residents and then tells her about his mystery case. She tells him to lead the way to the patient. Tom then finds them and is surprised that Bailey took some time off amid her residents being out. She says she had other services cover their gaps and arrives at the room of Andrew's patient.

In the room, Bailey is surprised to see Hadley and Mei Li Britland crawling on the floor. Mei Li asks to be done, but Suzanne Britland, the patient, says to go a few more times. She then explains to the doctors that Mei Li was recently diagnosed with attachment disorder and the crawling is part of her therapy. Hadley is Suzanne's sister and is wondering why Suzanne is still in the hospital after an appendectomy. Suzanne admits to a sore throat, but still wants to go home with antibiotics. Her kids are missing so much school. Hadley offers to take them to school, but both kids object. Suzanne explains that their father died last year after an ER doctor sent them home and said he'd be fine. He ended up being not fine.

Meredith asks Cormac what Cristina said to him. He's not sure who she's talking about. She asks if he's coming to the Pit, but he's not sure what she means. She admits to not knowing why they call it that. In the ER, they hear coughing and see Kai Hale cough up blood. They step in to intubate and tell the nurse to set up for a bronchoscopy.

Maggie walks down the stairs to answer a knock at the door. When she gets a text from Richard, she moves to go back upstairs, but then another text comes through saying he saw that. She opens the door and says there's no way he actually saw her. He's there to take her to eat, but after seeing her appearance, he says eating in is better. She didn't know he could cook.

Jo finds Link, who is thinking. He tells her about Amelia's news. Just then, they hear Evan call out for help. He's leading Chuck Thompson. He was trying to get Chuck to the ER and accidentally slammed his hand in the cab door. They were on their way to the ER because of the fish. There's a fish in his throat.

Cormac explains to Daniel Hale and Kai's friends that there was no bleeding in his lungs, but there was in his esophagus. His friends deny any drinking or smoking, saying he only cares about his swimming. Cormac says they're going to take him for a CT next and will keep him posted.

Richard is surprised to see little food in the house. He looks around for something to make. She doesn't believe she deserves compassion, especially from Richard. He offers her use of Pac-North's psychologist. She starts to freak out because she's awful and just wants to be alone. Richard says they'll start with coffee and goes to make some.

Owen surprises Teddy. He wants to take her to lunch and talk wedding plans. She starts crying and admits that she lost the ring. He says the ring is more important to his mother than to him. He tells her not to worry because they'll find it.

As they look at Chuck's scans, Evan explains that the bar had an aquarium and they dared each other to swallow some fish. Chuck grabbed the largest fish and then swallowed it. The fish started fighting back and wouldn't come out. Then it puffed up. Whatever it is has spikes. Evan goes to call the bar to find out what kind of fish it is. Chuck then begs them not to tell Roxanne, his fiancée who told them not to do anything stupid.

In Suzanne's room, the family is practicing Matty's vocabulary words. They disagree over the meaning of penultimate. Just then, Andrew and Bailey and come in and say her white count is up again. They want to keep her one more night and get a CT in the morning. Suzanne says she'd like last night to be her penultimate night in the hospital. Bailey says there's no reason to wait, so they can get the CT right away.

As they scrub in, Jo tells Jackson and Link that the fish he swallowed was a bronze catfish. It gives off toxins, but not enough to worry about. Link and Jo talk about the situation with Amelia after Jackson enters the OR. He says it doesn't change anything. He's trying to look on the bright side. Amelia doesn't want a paternity test anyway. Jo's shocked that he's okay with that and calls him on it. She says he can love her and be mad at her at the same time. Both things can be true.

As Owen opens the pipes in the sink, Teddy goes over the last time she saw the ring. Amelia comes in and is surprised to see them. She's awkward as they talk, but hand waves it when they ask. Owen gets a text that Leo threw up all over day care, so they leave to go get him.

Cormac and Meredith talk about his sons and their teenage stupidity as they wait for Kai's CT. He says it's around the time of year he lost their mom to cancer, so he asks her not to hold his first meeting with her against him. It's been two years ago. She says two years is tough. It gets better. Not all the way, but a little bit. Kai's lungs look like a smoker's. Cormac is willing to be that he vapes.

Kai's dad denies that he vapes, but Elijah and Tyler admit that it's true. Half the school does. They don't think it's like smoking. He shows them healthy lungs and Kai's lungs and tells them to go tell all their friends at school what vaping is doing to them. Once they're gone, Cormac assures Daniel that his son isn't dying. But he'll need to have surgery to repair his esophagus and remove a portion of his lung. Meredith suggests using coiling to stop the bleeding, which will preserve the lung. Daniel wants to do that, so Cormac agrees to let her try it.

Richard gives Maggie coffee over her objections that she wants to be alone. He says he does, too, but he came to find out why she quit. Richard says she was Sabi's only shot. He says the reason he couldn't look at her wasn't because of what she did to Sabi, but because of what he did to her. He sent her in there knowing Sabi was unlikely to survive. Maggie admits that it was her mistake, that she didn't ask about her clotting time as she didn't know the policy was different at Pac-North. Now Sabi is dead and she can't go back into the OR and pretend she belongs there. She begs Richard to leave. He gets up and walks out.

Teddy and Owen try to figure out why Leo might have vomited. They got an x-ray anyway. Karen peeks in to tell them his x-ray is ready. The look at it and see that he swallowed Teddy's ring.

Meredith is using the coiling. She says Cormac could have done this, but he wanted her to do it. He's seen this before and coiling often isn't enough. Just then, the bleeding starts again. They have to open him up and do it Cormac's way.

Jackson is having difficulty removing the fish, but it's coming out in pieces. Link tries to defend his actions, but quickly realizes how he sounds.

Cormac says he's had the coil or resect debate before. Last time, he was on her side. His colleague disagreed and things went sideways when he tried his way. The colleague was Cristina, whom he describes as a nightmare.

Suzanne is having her CT, which she does not like. Andrew and Bailey aren't seeing anything on the scan, which means it wasn't Andrew's screw up. Tom comes in and is surprised Bailey's going a follow-up on an appendectomy. Bailey stands up and closes the door in his face. Just the, Suzanne starts crashing. They're forced to do pericardiocentesis in the CT booth to save her life.

Jackson explains to Chuck that he removed all the spines, but he'll probably feel some discomfort over the next few days. He'll also need to come in for a follow-up on his hand in a few weeks. Chuck asks them for advice on explaining it to Roxanne. Evan suggests telling the truth, given what she's overlooked in the past. Roxanne then comes in angry because of what he did. She says he's dumb, unbelievably dumb. Once she knows he's going to live, she decides it's time to leave him. She's done making excuses for him. She gives him the ring back and leaves.

Bailey and Andrew talk to Hadley and the kids. They still don't know what caused the cardiac tamponade. They'll keep looking, but they don't know. Mei Li runs in, despite them trying to stop her. She finds her mom and says she wants to go home. Suzanne reassures Mei Li that she's alive and she's not sick like Daddy was sick. The doctors she has are the best and the smartest and they're going to figure it out. Hadley then leads Mei Li out and Suzanne asks if they're going to figure out. Bailey says they've been through a lot and yes, they'll figure it out.

In the hallway, Bailey tells Andrew to put everyone on the case and create a war room. They can't let her die.

Maggie is surprised when Richard comes in with a bag. He says it's food and he wants her to try eating something. She asks him to yell and be mad at her. She liked Sabi and wanted a relationship with her, but knows that Richard lost so much more than she did. Richard just tells her to open the flour. Richard says that his mother died when he was ten. He doesn't remember a lot, but he remembers that when he got into trouble, she would always make them pancakes and tell them they'd talk about it when he'd had something to eat. He never forgot that lesson.

Richard has been replaying the case over and over again, wondering what he could have done better. Maggie says it's not on him. He says he knew better, but he put her in that OR anyway. Richard says she's imperfect. She's human, too. She says no one has ever had to tell her that before. He tells her to let her insurance settle with Chris. It won't bring Sabi back, but it'll give him the sense that something came from it. He tells her quitting now would be quitting on all the lives only she can save. Sabi wouldn't want that. Maggie wishes she could have had more time with her. Richard says to ask him anything she wants to know. Talking about her is the only thing he wants to do right now.

Owen and Teddy are waiting for the ring to make its way through Leo. Teddy still feels guilty for losing it. He says he shouldn't have given it to her in the first place because she's a trauma surgeon. She says she wants to wear it. He suggests wearing a necklace with letters for each member of their family and keeping the ring hidden away for special occasions. They realize Leo has finally pooped. They start playing rock-paper-scissors to figure out who will change it, but Teddy agrees to change it without complaint.

Cormac explains to Daniel that they had to resect part of Kai's lung. It'll be a difficult recovery. In time, he'll swim again, but not competitively. Daniel thinks the stuff is flavored like French toast. He always smelled it and feels stupid for not realizing. Cormac says they target kids with the flavors. They're evil. Daniel thanks him for saving Kai.

Cormac tells Meredith he won't rub it in. When it was him, Yang drove him mad, saying she told him so. Cormac realizes when Meredith comments that she knows Cristina. Meredith makes an excuse to leave without saying anything about it.

Tom makes another comment about Bailey having been on vacation and she finally tells him she wasn't. She was at home crying and drinking tea because she had a miscarriage. He tells her to light a candle. His ex-wife had two miscarriages before they had David, one at ten weeks and one at eighteen. People have this idea that you just get over it, but that wasn't his experience. Or Dana's. So every years, on what would be their birthdays, he lights a candle. They took pieces of their hearts and they'll never be replaced.

Link is waiting in the plant room. Amelia comes in, having been paged there. Link says there are tests and he should have known from the beginning if there was a question of who the father was. Amelia admits that she's chaotic and doesn't always think things through and sometimes that hurts people. She apologizes for hurting him. He says there are a bunch of people involved in this who deserve to know. He also deserves to know. Amelia asks what will happen if they find out he's not the father. He says he wants to be the guy who says that doesn't matter, but he doesn't know yet. He doesn't know how much it matters, but they should gather information and take it one step at a time.

Meredith finds Andrew, who starts talking to Meredith about the case. Meredith looks at Suzanne's scans and has him walk her through it from the beginning.

Bailey lights a candle in the chapel and sits down.

Richard comes home to find Catherine. She asks him about his day. She also tells him Dr. Wells from Pac-North called looking for him because he didn't go to work. He says he was trying to convince Maggie to go back to work. She questions if that took him all day. Richard says things won't work if she doesn't trust him. She's not sure it is working. She thinks it's time for a much bigger conversation.


Main Cast[]

Guest Stars[]


Medical Notes[]

ER Patients[]

  • Diagnosis:
  • Treatment:

Jo gave report to Teddy about the ER patients, including a facial lac in bed 6, an MVC victim about to go for a CT, and an ortho consult for bed 4.

Suzanne Britland[]

  • Diagnosis:
    • Cardiac tamponade
  • Treatment:
    • Pericardiocentesis

Suzanne was post-op day three on an appendectomy and was a bit of a mystery because she still had a fever and a high white count. When they visited her, they learned she had a sore throat. She was eager to be sent home, but they said they couldn't do that. Her labs showed her white count was still high, so they had to keep her one more night. While they were doing a CT, she crashed and they had to do a pericardiocentesis in the CT booth. They sent the fluid to the lab for testing, but didn't know why she had crashed.

Blake Simms[]

  • Diagnosis:
  • Treatment:

Blake's trach had been removed and he was on soft foods.

Taryn Helm[]

  • Diagnosis:
  • Treatment:
    • Physical therapy

Taryn's chest tubes had been removed and she had started taking steps in physical therapy.

Casey Parker[]

  • Diagnosis:
  • Treatment:
    • Neural rehab

Casey had been sent to neural rehab.

Kai Hale[]

  • Diagnosis:
    • Esophageal tear
  • Treatment:
    • Partial lung resection

Kai, 17, had come into the ER with shortness of breath and started coughing up blood. They intubated and did a bronchoscopy, which show no bleeding in his lungs, just inflammation. They found bleeding in his esophagus, so they took him to CT. This showed that his lungs had significant damage. Cormac was certain he had been vaping. His friends confirmed it. Cormac suggested repairing the esophagus and removing part of his lung, but Meredith said they could try coiling to stop the bleeding and preserve his lung. Meredith tried it, but it failed, so they had to do a thoracotomy and remove a portion of his lung, permanently reducing his lung capacity.

Chuck Thompson[]

  • Diagnosis:
    • Ingested body
    • Broken hand
  • Treatment:
    • Surgical extraction
    • Surgical repair

Chuck had attempted to swallow a live fish and it got caught in his throat. Then on the way to the hospital, his friend slammed his hand in a door, breaking it. While Link worked on his hand, Jackson removed the fish from his throat. He was told he'd have some discomfort for a while in his throat.

Leo Hunt[]

  • Diagnosis:
    • Ingested object
  • Doctors:
  • Treatment:

After Leo threw up at daycare, they did an x-ray, which showed that he'd swallowed Teddy's ring. They waited to retrieve it until he had a bowel movement.


Song Performer Scene
"Spotlight" Lex Junior feat. Carmen
  • Meredith texts Cristina about Cormac, but gets nothing.
  • Amelia and Meredith talk for a moment.
  • Amelia struggles to tie her shoe, so Cormac steps in to help.
  • The three of them talk about coffee for a minute.
  • After he leaves, Amelia says he's well-wrapped.
"Hope" Texada
  • Rosanne puts down the ring and leaves.
  • Bailey updates Suzanne's family.
  • Mei Li runs in and Suzanne reassures her.
  • Bailey tells Andrew to put every brain on it he can find.
  • Maggie sits at the table.
"Loud" Hayden Everett
  • Bailey considers Tom's advice.
  • Amelia comes to the plant room, where Link has paged her.
  • Link and Amelia talk about their situation.
  • He wants her to find out the paternity.
  • Meredith goes to talk to Andrew, who presents Suzanne's case to her.
  • Meredith has him walk her through the case from the beginning.
  • Bailey lights a candle in the chapel.
  • Richard comes home to Catherine.
  • They have a tense conversation and Catherine says it's time to have a much bigger conversation.

Notes and Trivia[]


Grey's Anatomy 16x11 Promo "A Hard Pill to Swallow" & Station 19 3x02 Promo "Indoor Fireworks" (HD)

  • This episode's title originated from the song Hard Pill to Swallow, originally sung by Blacklite District.
  • This episode scored 5.55 million viewers.
  • The storyline about the patient who swallowed a fish is based on a true news story about a drunk man who swallowed a bronze catfish.
  • The episode was filmed around November 14, 2019.


Episode Stills[]

Behind the Scenes[]


See Also[]

A complete overview of this episode's crew can be found here.