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All diseases have a genetic component. But of course, genes are not always to blame. In diagnosing a disease, physicians must take into account other factors: their environment, their lifestyle, ... However, some genetic traits are, annoyingly, unavoidable. Thanks, Mom. Blood is thicker than water. It means the family you're born into is important above all else, right? Wrong. The original proverb goes a little differently. It actually says, "The blood of the covenant is thicker than the water of the womb." Meaning the bloodshed on the proverbial battlefield bonds us more than simple genetics. And yes, DNA matters when it comes to medical history. But I'm a doctor and I say family is family. I don't give a crap whose blood you have.

Blood and Water is the sixteenth episode of the fifteenth season and the 333rd overall episode of Grey's Anatomy.

Short Summary[]

Meredith finds herself having to side with either Alex or DeLuca during a difficult situation, but she doesn't want to betray either of them. Meanwhile, Maggie reveals details about her personal life that cause a public stir, and Levi struggles with whether or not to tell his family about Nico.

Full Summary[]

Maggie greets a crafting Zola in the kitchen. Zola asks if Ellis is her mother. Maggie says she is biologically, but Bill and Diane raised her. Zola understands it's like her parents raised her. Suddenly, Ellis appears and criticizes Maggie's article for typos. Maggie tells her not to make the face that Meredith also makes. Amelia walks in and introduces herself to Ellis. Ellis goes to whisper something in Zola's ear. She tells her to write it down. Her mother will know what it means. Ellis reminds everyone to take their vitamins.

Meredith wakes up from her dream and immediately grabs a journal to write down "The light in the blood."

Nico and Levi's making out is interrupted by a phone call from the latter's mother. Nico shouts hi, but Levi shushes him. Nico is not pleased. Levi admits she doesn't know about him yet. Levi says his mother's a lot. She has a lot of opinions and he doesn't want her to get to know him as the shirtless guy he's in bed with. Nico puts his shirt back on and leaves.

Andrew visits Meredith in her lab. She says she dreamed about the answer to a question and she's trying to figure out what it is. She asks about his father. Andrew says he seems stable. He's going to pitch a medical breakthrough, but Andrew thinks it won't amount to much. Carina thinks he's bipolar, but he refuses treatment. He claims he just feels the world deeply. Andrew has to go. He kisses her and leaves.

Maggie's doing a medical podcast. Outside the room, Richard wonders why they call it a podcast. Inside, the interviewers are going over Maggie's impressive career. She says her parents encouraged her to be whatever she wanted. She can't remember not ever wanting to be a doctor. She brings up her biological parents and Meredith. The interviewer are shocked to learn that famous Ellis Grey had a love child.

Jo and Alex are showing Helen around. Alex has back-to-back meetings, but he'll find Helen later for lunch. Jo finds baby hats in her bag. Helen says they are for their kids. She read an article that gender is a fluid concept, hence the neutral colors.

While walking off, Jo asks Alex if they are in the baby hat place yet. Alex admits he told Helen they want kids, because they do. Also, the hats are large because Alex had a very big head. Jo claims she has a surgery and walks off. Alex catches up with Bailey and asks her to cover the pit, since Owen and Teddy both have personal days. Bailey is counting down the 22 days until she has to stop taking orders from him.

Link, Nico, Levi, and Jackson enter Hunter Martinez's room. Link greets Hunter with a personal handshake. He also knows Jenny, the patient's mother. She hopes they can fix her son so he can get called up next year. Hunter has an osteosarcoma of the distal femur. They'll perform a rotationplasty, meaning they'll remove part of his leg and rotate the remaining part of his lower leg so that his ankle joint becomes a new knee, which'll fit a prosthetic. Hunter only told Jenny three weeks ago. She learns he went through three months of chemo, which upsets her. She says they'll talk about this later.

Vincenzo, Carina, and Andrew meet with Alex about Vincenzo's research. He wants to create an external gestational sack so premature babies can develop if mothers can't carry them to term. In fact, he has already created it. He's already in animal trials. One healthy sheep was born after gestating in the bag for 125 days. Vincenzo is looking for funding.

Owen and Amelia are meeting with Blanca Rodriguez, a lawyer. Their adoption of Leo is very straightforward, but they hit a bump when Blanca discovers they don't live together anymore. They are totally committed to Leo so they want to do whatever it takes to make it work. Blanca says it's not a problem, but it complicates things.

Jo finds Link and asks him to put her on any surgery. Jackson and Link do their handshake and invite her in on the rotationplasty, meaning Levi is out. Levi objects, but Jo pulls seniority.

Maggie finds Meredith working on her dream science. Maggie says Ellis got in her head, too. Maggie says she let it slip to the medical community that she's Ellis's secret love child. Meredith says it's not a big deal. It's Maggie's life. Maggie takes a look at Meredith's board and suggests it's about biomarkers. Meredith assures Maggie that Richard will be fine, too.

Jenny watches her son being wheeled off to surgery. She asks Jo how long it'll take. Jo says it could take 8 hours, but they will update her regularly. Jenny admits she's enraged. Her own child didn't tell her about 3 months of chemo just so she wouldn't freak out. She asks if there's a punching bag in the hospital.

Levi arrives in the pit. Bailey puts him on Frank Nelstadt's case. The man has a fever and a reductive cough. Levi walks up to the patient's bed and introduces himself. Frank's husband Danny arrives. Ella told him about Frank's cough. Levi wants an X-ray or CT to rule out anything serious. Danny goes after him for being a child doctor and goes to request a real doctor with Bailey. Frank starts gasping for air and coughs up a blood clot in the shape of a bronchial tree. He feels better afterwards.

Hunter's surgery has started. Link understands Hunter's wanting to protect his mother. They remove the middle part of his leg and rotate the lower part. Link asks about Helen. Jo says she's still sleeping on their couch, but it's fine. She rambles on about her and Alex planning for babies.

Meredith paged Alex to her lab so she wouldn't have to concede to his superior job title. She tells him about her dream and asks about Vincenzo DeLuca. Alex tells her about his amazing pitch. Alex asked for a day or two to think it over, but he wants to say yes. Meredith asks if he called the man's hospital in Italy. Alex did and they loved him there. Meredith advises him to dig deeper.

Blanca asks Owen and Amelia about how they envision their shared custody of Leo, but they haven't thought that through yet. Owen doesn't want Leo to be away from him half the time and argues in favor of consistency. Blanca says they need to get on the same page before she takes this to a judge. She has to leave for another meeting, but they can use her office to discuss this further.

Bailey explains to Frank, Danny, and Ella what Frank coughed up. The coughing must have caused some bleeding but she has no idea why it congealed so fast. Frank soon starts gasping for air again. Bailey has Levi intubate him while she prepares for an ultrasound. She suspects a massive PE.

Alex and Helen are having lunch in the park. He hates himself for not having had Vincenzo's feeling. She recognizes the feeling but mostly from when she's off her meds. He asks what she thought he'd be when he grew up. She says he once asked what the inside of a doorknob looked like. She took it apart and showed him. It made her think he'd become an engineer. Alex says he's more of a fixer instead of an innovator. Helen's not too sure about that. She's always been in awe of his brain. Alex says she freaked out Jo with the baby hats. Helen only meant to give her a little nudge.

Richard finds Maggie and asks why he's been asked for a comment on the Maggie-Ellis Grey story. She explains what happened. He hates that the entire medical community knows he and Ellis had an affair and blames her for not thinking.

Everything's looking good in Hunter's surgery. Jackson asks Jo if she doesn't want kids like Alex. She wants them someday, but she wasn't prepared for someday to be today. Jackson admits it's not always good. Jo asks if the cute outweighs the terror. You never stop worrying about them. She uses Hunter as an example. He's a successful baseball player who got cancer and now his mother is having a nervous breakdown because she made the mistake of ruining her life by having a child. Jackson is offended.

Owen and Amelia are finishing up a schedule. They're going for the 2-2-3 approach. Amelia thinks this will all go out the window once Teddy gives birth. Owen angrily says she and Koracick are babymooning in Palm Springs. Amelia says it's not the time for Teddy feelings and texts the lawyer they've worked things out. Owen tells Amelia he also wants her in his life, not just Leo's. He chose her and that never changed. She says it did. It changed with Teddy. She says this is no one's fault, but breaking up with him was a moment of clarity for her. It hurts, but it hurts less than the alternative. He says it actually is her fault. The alternative is letting him love her and she can't do that. He tried to convince himself it was all the tumor but apparently there is some fundamental part of her that can't love or be loved. Blanca enters the room and asks about their plan.

Andrew and Vincenzo are waiting in line for coffee. Vincenzo is fond of Andrew's life. Andrew asks how he's doing. Vincenzo says Carina worries and controls, like his mother did. Andrew is like him, recognizing a good idea when he sees one. Vincenzo thinks his mother came between them. He knows he's part of the reason why Andrew has kept his distance, but he wants to make up for it. If they do this together, they can put Andrew on the map. Vincenzo thinks Meredith is beyond him at this point. Even he has heard about Meredith Grey all the way back home. She's not just beauty, she's brains. Putting Andrew on the map will fix that.

Bailey and Levi are using a catheter to deliver tPA near Frank's clot. They still need to figure out what's the cause of the blood clots.

Maggie sits down with Richard in the gallery. Hunter's surgeons are closing up. Maggie thinks Richard is mad. He claims he's not. It's her story to tell. She'd like to hear him say that in a different tone. Richard says Catherine doesn't need his affair spread in the medical community on top of everything she's already dealing with. He's not particularly proud of that story. Maggie says it's the story that culminated in her existence.

Meredith comes across the arguing DeLuca siblings. Carina wants to shut down the research project. Andrew wants his father to do the project here. Meredith thought he had mental illness. Andrew admits he does, but he's not dangerous. Until he is, Meredith says. Carina says it's not even his field. She knows better than anyone how bad her father can get. She spent three months with him. Their father knows Andrew always comes running when he calls. Andrew announces he's signing on to participate in the trial and leaves. Meredith advises Carina to go talk to the chief.

Alex finds Meredith in her lab and asks why she didn't tell him about Vincenzo's mental problems. Meredith reminds him she told him to dig deeper. She couldn't tell him directly since she didn't want to break Andrew's trust. Alex doesn't want to say no just because Vincenzo has mental illness. It's an amazing project. Andrew appears in the doorway. Alex tells him he's sorry he grew up like that as he leaves. Andrew doesn't like that Alex knows. Andrew thinks his father is okay. Meredith has her own complicated history and she knows how clouded one's judgment can get. Andrew asks her to trust him on this.

Levi and Bailey tell Danny and Ella that Frank is okay. Levi says they ran some tests. Frank has Factor V Leiden, a genetic disorder which leads to an abnormal amount of clots. Danny wants Ella to get tested right away.

Jo apologizes to Jackson for what she said. Jackson says kids can be monsters, but at the same time, they give you the feeling that everything's right. Kids can ruin lives, but they can also give you a reason to live when life tries to ruin you.

Blanca tells Amelia and Owen that this will take time. It's the nature of the beast. Amelia wants to make a change. She doesn't want to be on the paperwork. She'll be in Leo's life as much as Owen will let her. She'll be aunty Amelia, who is fundamentally incapable of love. She tells Owen they are over, so this is what's best for Leo. She has clarity on this. Leo is and has always been his. She leaves the office.

Hunter wakes up post-op. While the sight of his leg is weird, it is tumor-free. They can't promise he'll play again, but they're optimistic. He'll have to retrain his brain. Hunter says he can do that.

Jo drops by Alex's office. She tells him he turned out perfect despite his big head. Alex thinks she doesn't want to pass on his crazy gene to their kids. Jo says she's not afraid of his genes. She's terrified of her own. She doesn't know about her biological parents' medical history. She has learned to live with that, but she doesn't want to not know when it comes to their kids. She doesn't want to meet her family, so she's going to have her genome examined. Alex says he's going to grow a baby in a bag.

Levi visits the Nelstadt family. They got Ella's test results back. She tested positive. It never mattered to her which one of her fathers is her biological father, so they will not be flipping out about this.

Maggie has e-mails from several media outlets. Richard walks up to her and says despite the shame about what he did, he's only grateful about her existence. She knows that. She's a scandal. Richard says he is. She is the best of Ellis, him, and her parents, who raised her beautifully. He's proud to be any part of her. And that'll be his only answer if the press asks. Maggie says her father will hear the podcast. He'll be heartbroken.

Levi catches up with Nico on his way out and says he loves him. He hasn't come out to his mom because she spins out. Not because he's a man or Asian. Flipping out is what she did. They literally had three conversations about his new backpack. Nico is his first love. He knows he's not Nico's and that's okay. Levi just wants to lock him in through his own eyes before he sees all the death traps through his mother's. Nico kisses him. Levi asks if he's not going to say it back. Nico says he didn't reciprocate the "I love you" just to see him sweat it out. He will say it in two minutes.

Andrew and Carina meet outside their father's lab. She hopes he's right about this one. So does he. They enter the lab.

Owen gives Leo a snack and signs the adoption papers.

Maggie has brought Amelia home with her. She's not ready to talk about what happened. While Jackson starts looking for ingredients to cook the sisters dinner. Maggie asks Meredith if she has found her question. Meredith thinks the question is if there's a way to diagnose diseases in a way as non-invasive as taking a vitamin. She puts aside her research and comforts a distraught Amelia.


Main Cast[]

Guest Stars[]


Medical Notes[]

Hunter Martinez[]

  • Diagnosis:
    • Osteosarcoma
  • Treatment:
    • Chemotherapy
    • Rotationplasty

Hunter, 20, was diagnosed with osteosarcoma in his right femur. After three months of chemotherapy, he was at the hospital for a rotationplasty, to remove the cancerous portion of his leg and turn his ankle into his new knee for a prosthetic. His surgery went well and he was told they'd be able to start working with prosthetics and retraining his brain because his ankle was now his knee once he had healed.

Frank Nelstadt[]

  • Diagnosis:
    • Factor V Leiden
  • Treatment:
    • TPA

Frank, 47, came into the ER with fever, sore throat, and a productive cough. He said he'd had the cough for a few days and said it wasn't bad, but his daughter said it sounded like he was coughing up a lung. He starting having trouble breathing which was resolved when he coughed up a blood clot shaped like a bronchial tree. When it happened again, he was intubated and taken to have TPA injected. They also diagnosed Factor V leiden, which is why he was forming large clots.

Ella Nelstadt[]

  • Diagnosis:
    • Factor V leiden
  • Treatment:

Ella was tested for Factor V leiden after one of her dads was diagnosed. She received the same diagnosis.


Song Performer Scene
"Just Dance" Kid Something
  • Nico and Levi are making out in an on-call room when Levi's phone rings.
  • He says hi to his mother and shushes Nico. Nico's upset about that, but Levi says his mom just has a lot of opinions.
  • Nico grabs his shirt and leaves.
  • Andrew finds Meredith in the lab and they talk about his father.
"Feel It" Norman
  • Jackson and Link operate on Hunter and talk about his decision not to tell his mother.
"Used to Be" Luca Fogale
  • Hunter wakes up and sees his new leg. Jackson re-affirms his assertion that Hunter could play again, but it'll take work.
  • Hunter's mother starts crying.
  • Jo comes into Alex's office and says he turned out perfect. She says she's not afraid of Alex's genes, but she's afraid of her own. She's getting her DNA tested so she'll know.
  • Alex tells her he's going to grow babies in bags.
  • The Nelstadts are told that Ella has the same condition as Frank and she says knowing that Frank's her biological father doesn't change that they're both her dads.
"Here We Go" WILD
  • Nico kisses Levi after hearing that Levi loves him. He says he'll say it back, but he wanted Levi to sweat it out.
  • Carina tells Andrew she hopes he's right as they watch their father set up his lab.
  • Owen feeds Leo and signs the paperwork.
  • Maggie brings in a sad Amelia and Jackson tells the sisters he's cooking.
  • Meredith tells the others about her new idea.
  • They comfort Amelia.

Notes and Trivia[]


Grey's Anatomy 15x16 Promo "Blood and Water" (HD) Season 15 Episode 16 Promo

  • This episode's title originated from the song Blood and Water, originally sung by Grandson.
  • This episode scored 6.55 million viewers.
  • Jaicy Elliot was credited as a guest star in the press release for the episode, but Taryn is only mentioned.


Episode Stills[]


See Also[]

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