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Bottle Up and Explode!

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“ In a recent experiment, scientists observed that single human cells in a petri dish will actually seek each other out and adhere to each other to form new connections. When cells team up, they become stronger. They thrive and evolve and eventually become something bigger than their single cells ever could have been. We are an extension of our cells. Just like them, we are programmed to find others, to reach out for one another and find nourishment and love. Like our cells, we're not meant to be alone. So once we find each other, try not to let go. ”

Bottle Up and Explode! is the fifth episode of the eighteenth season and the 385th overall episode of Grey's Anatomy.

Short Summary[]

The Grey Sloan doctors spring into action after an explosion rocks Seattle, with the incoming trauma hitting close to home. Owen experiences PTSD after he hears the explosion, while his sister Megan enlists help from Winston and Hayes in confidence. In Minnesota, Meredith and Amelia meet up with a familiar face who assists in their study.

Full Summary[]

As she gets ready for the day, Meredith receives a text from Nick Marsh asking what she's wearing. She texts back a chastity belt. He says he weirdly is, too. She smiles.

Amelia is surprised to find Kai already at the lab. Kai says they are always first at work. Today is a big day.

Winston is texting flirtatiously with Maggie as Richard joins him on the elevator. Winston greets him and Richard tells him they are first-name basis since Richard married him and Maggie. Winston is planning to fly out next week to visit Maggie at her father's. They are met by residents waiting for Richard, asking what procedure they should be prepared for. Richard says the Webber Method is going well.

Winston joins Cormac in Farouk's room. Farouk has done research and found that Winston is very good at what he does. They are performing his pericardiectomy today. Cormac stays behind for a bit to talk to Megan, who knows how complex the procedure is. He wonders if she has talked to Owen yet. She will do so right now.

Teddy and Owen are at the clinic with Vinicius Velo and Amy Sacilotto, two more veterans who are enrolling in the study. The VA is still stonewalling on coverage but they are making progress. Amy says that Noah has gone radio silent after Roy's death. Megan comes in to talk to Owen and Teddy. Only seconds later, the room starts shaking. Everyone ducks for cover.

Link runs into Jo in the hallway. Their kids are fine in daycare. They are paged to the ER.

The surgeons are still in the dark as to what happened but Owen thinks they should activate mass casualty protocol. Owen suspects that it was a bomb. He hands out instructions to Levi and then recruits Amy and Vinicius to help them set up a triage area outside. The news report then reveals it was a pipeline explosion. Bailey tries to reach Ben, to no avail.

At the Grey Center, Meredith tells her team that the FDA requires proof that the cells can survive at every stage. Kai succeeded at the cell maturation process. Now they need to prove that the cells can survive after injection into the brain. They inject some test cells into a 3D-printed hydrogel brain. Unfortunately, the cells stay in a blob rather than dispersing, which means they'll die. David asks how many fake brains they have. Tom appears in the doorway and says they have plenty. David is less than thrilled to see him.

Owen is beginning to suffer from a PTSD attack in the empty OR. Amy informs him there have only been firefighters with minor injuries so far. He instructs her to stay ready. Teddy has been unable to find Megan, who ran off after the blast. Owen is sure she's fine. He claims he is too. Everyone is fine except the people injured by that bomb. Teddy says it wasn't a bomb. Owen wants to focus on doing his job.

Megan enters the OR to check on Farouk. He was already under when the explosion happened. Megan sits down by Farouk's head. She refuses to leave his side. Winston and Cormac begrudgingly start the procedure.

After checking on Luna through a picture from daycare, Jo tells Bailey that most patients are apparently either dead or at Seattle Pres. Bailey then sends her back to OB. Jo wants to apologize for her throwaway comment without thinking of Ben but Bailey cuts her off. The first rig brings in Victoria Hughes, who is stable and high on pain meds. She says she almost died.

As Tom marvels over the robot, David tells Meredith he did not approve his presence. Meredith says Amelia requested a second neurosurgeon and Tom has experience with micro-injectors. Also, he fast-tracked the hydrogel brains for them. Tom adds he signed an NDA. They round up for a second round of injection, with a changed cell concentration, but the cells still form a blob. Tom says the problem is in the injection technique, not the cells or the suspension. David can't hide his disdain for Tom and leaves the room. Tom refuses to share his history with David.

Owen and Bailey are checking out Vic, who tells Bailey that Ben is fine. She tells them what happened to her. Dean saved her. She thinks Dean is in love with her. Richard comes in to inform that there was a second blast. A couple of rigs with firefighters are on the way. They head out to the ambulance bay. The first one brings in Pat Aquino, who has a penetrating wound to the abdomen and an unstable pelvic fracture. Link takes him inside. A second, silent rig arrives. Bailey realizes there is a dead person inside. She is relieved when Ben and Jack climb out the back but then notices how distraught he is. They brought in Dean Miller. Bailey comforts Ben as Dean's body is wheeled to the morgue.

Bailey brings Ben some water. She tells him they are running tests on Vic to rule out cardiac injury. Ben says Hughes will be destroyed over Dean's death. Bailey realizes that Dean is leaving behind a daughter. Ben then shares that when they were adrift, he told Dean he would take Pruitt. Bailey is shocked but Andy and Travis appear before she can properly react. Ben hugs them. Travis wants to go tell Vic, who hates it when people keep stuff from her. Bailey walks with him. Andy checks if Pru is going with Ben and Bailey. Ben says they are still figuring that out. Andy leaves to go get Pru from daycare.

David tells Meredith that Tom slept with his daughter. Meredith points out he's working against a breakthrough because his daughter had consensual sex. David wants Tom out of his lab. Meredith reminds him of their deal but David insists on keeping Tom's name off of his research.

Winston and Cormac work carefully to avoid damaging the phrenic nerve with Megan watching like a hawk. Megan recalls telling him about cartoons when she was in captivity. She'd hum cartoon themes which she ended up doing again when loud noises would startle him in L.A. Cormac then tells her to hum tunes.

Richard and Link diagnose an open-book pelvic fracture and an internal abdominal bleeding. Owen, struggling with his PTSD, stands frozen in the doorway. He leaves the case to Richard. He struggles with his breathing as Jo and Carina arrive with Aaliyah. Jo notices he's struggling. He asks if they're all dead, which confuses Jo. Owen then walks off.

Levi gives Mabel unsolicited advice as she performs a cardiac ultrasound on Vic. Vic then recognizes Levi as the intern who brought her flowers when Ripley died. Mabel finds no abnormalities. Vic is happy to see Travis walk in. She says Miller sort of told her he was in love with her. Travis then sits down and Vic realizes something is wrong. She thinks something happened to Theo. He assures her Theo is fine and then tells her about the second explosion and Dean's death. As Vic breaks down with Bailey and Ben watching from outside the room, Bailey asks Ben if he said yes to Dean's request. Ben confirms that he did and that Miller put it on paper. Bailey can't believe he never asked her, pointing out the dangers that their job entails. Ben reminds her she brought home Joey. Bailey points out the difference between an 18-year-old boy and a 2-year-old girl. Vic suddenly goes into V-fib. Bailey rushes in and asks to have Teddy paged. She starts CPR.

Teddy and Bailey run the code as a teary-eyed Ben and Travis watch from outside the room. It takes multiple tries with the debrillator to bring her heart back to sinus rhythm. Teddy wants to have her admitted to the CCU for close observation. Teddy leaves to find Owen. Travis comes in and tells Vic not to ever do that again. Vic asks him if everything is real. He nods. She breaks down again.

Back in the Grey Center, Tom tells Amelia and Kai that he's doing great splitting his time between Boston and Baltimore. He met a lovely former social worker. Tom asks Amelia about her family. Amelia denies being married and asks Tom about a motorized injector to inject cells as they pull out. Kai warns Tom not to make a pulling-out joke. He informs them that he's followed the HR seminars ever since she was a post-grad in his research lab. His seminar was all she needed to decide she was not interested in dealing with neurosurgeons. Amelia says they're not all as bad as Tom. Tom shows them that he had already been working on the motorized injector idea.

Meredith visits Nick in his office. She's angry and needs information on David. He's having a tantrum and she needs to know if he's a textbook narcissist or if she has some wiggle room. Nick says doctors make the worst patient. He knows what's going on to some degree. Nick is sure that David is not in for the greater good. Meredith hates that she fell for the charm. She thought of him as an investor rather than a desperate surgeon who can't operate anymore. Nick points out it's hard to become obsolete after having been regarded as a God. He advises her to cut him some slack but not let him walk over her.

Ben finds Bailey and brings up Pru, who needs someone to love her. Bailey says Pru has grandparents. Bailey always wanted a little girl but it hasn't been in the cards for her. Bailey can't let herself fall in love with that girl, only for grandparents to come and take her away.

Winston removes the clamps, after which the heart starts swelling up. He injects epi. It could be minutes or days for it to work.

Owen struggles to suppress his PTSD symptoms. Teddy finds him hiding out in the supply closet. The vets and what they have been through have been triggering him. She tells him it's okay to step back from the project but he insists on pulling through. Somebody taught him how to manage his PTSD, and he is, but nobody's helping those vets with anything. That is on him. Teddy supports him as he does his breathing exercises.

Meredith meets David outside the lab and reminds him she has autonomy in picking her team. He has to let her do her job. David notes the resemblance to Ellis. He admits he's not at his best self. David tells Meredith he worked with Ellis when she started exhibiting her first Alzheimer's symptoms back in 2003. When he tried talking to her about it, she bit his head off. Terror doesn't begin to describe the feeling. David is losing his purpose, his being. Meredith is trying to help but she can't do that if he keeps second-guessing her. She's going to do this job however long and whomever it takes.

The epinephrine is starting to work so Winston wants to give Farouk's heart 30 more minutes to see if the swelling goes down. Cormac has a nurse bring him a stool and asks the clear the room. He sits down with Megan and starts humming the tune to Postman Pat. She doesn't recognize it. Megan laughs and thanks him for staying. She hums with him.

Outside of Vic's room, Travis asks Levi if she's going to be okay. Levi says the cardiac echo looked good. She's young and healthy so she should be okay. Travis says she might physically but Miller meant more to Vic than to anyone else on the team. Travis hates that she has to go through grief yet again.

Jo checks in on Bailey, who apologizes for earlier. Bailey tells her about the Pru situation. Jo thinks Pru is lucky not to grow up without a home. She then realizes Bailey hasn't made her decision yet. Ben comes over and points out that Andy has arrived with Pru. Bailey caves and goes to hug and comfort Pru.

Winston has returned to the OR. The heart has returned to its normal size. Winston gets ready to close up Farouk. Megan leaves the room and breaks down in the scrub room. Cormac comes in and assures her that Farouk is alright.

Cormac arrives to see Owen say goodbye to Amy and Vinicius. Owen explains they are going to help him collect data for a burn pit study. Cormac wants to talk about Megan.

Owen and Teddy arrive in the PICU. Megan starts to apologize but Owen stops her. He needs her to know that they are her family. She never has to do this alone. Megan says everybody says that before they end up leaving. Teddy says no one is going anywhere. Cormac watches the family from the desk.

Theo, Andy, and Travis are sitting by Vic's side. Ben and Bailey are outside the room with Pru. They leave for the night.

Winston ends up on the elevator with Richard again. Winston admits to missing Maggie. Catherine is out of town, too. Richard invites him to Joe's for a burger. Winston gladly accepts.

Link meets Jo outside the hospital. His firefighter patient made it. Jo wonders what happens to Luna if she were to die. Link assures her that he's got Luna. Jo thanks him. They go home together.

Tom leaves the lab. Amelia is trying to be the last one out so she can earn some points with Hamilton after having brought Tom in. As a favor to Amelia, Kai will leave since David already worships them. Kai inquires about Amelia's family. Amelia explains that she has a son with beautiful dad but she is single. Kai says they are married to the lab. Kai then leaves.

On a rooftop terrace, Meredith facetimes her children before they go to bed. Nick appears seconds after she hangs up. He ran late because of a surgery. She tells him she worked things out with Hamilton. He's glad she's not fired. They then share their first kiss.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Farouk Shami Hunt[]

  • Diagnosis:
    • Constrictive pericarditis
  • Treatment:
    • Pericardectomy
    • Epinephrine

Farouk, 14, was in the hospital to have a pericardectomy to treat constrictive pericarditis. They finished the surgery, but his heart began swelling, so they pushed epinephrine and waited to see if the swelling would go down enough that they could close. The swelling started to go down, so they decided to wait an extra thirty minutes to see if they'd be able to close. The swelling went down and they were finally able to close his chest.

Vinicius Velo[]

  • Diagnosis:
    • Pulmonary fibrosis
  • Treatment:

Vinicius was participating in Owen's study of veterans with pulmonary fibrosis following exposure to burn pits. He had collected chest x-rays, blood samples, and pulmonary function tests as part of this.

Amy Sacilotto[]

  • Diagnosis:
    • Pulmonary fibrosis
  • Treatment:

Amy was participating in Owen's study of veterans with pulmonary fibrosis following exposure to burn pits. He had collected chest x-rays, blood samples, and pulmonary function tests as part of this.

Victoria Hughes[]

  • Diagnosis:
    • Electrical burns
    • Myocardial injury
    • Arrhythmias
  • Treatment:

Vic, 32, came to the hospital after being electrocuted. She was fully conscious and stable in the ER, but was in shock. Owen ordered tests. Mabel did an echo, which showed no free fluid or pericardial effusion, but she crashed after learning that Dean had died. She was resuscitated, then Teddy had her moved to the CCU and ordered cardiac enzymes every two hours. When Vic woke up, Teddy told her the electrocution had caused a myocardial injury, which was causing arrhythmias. Travis was told her labs were consistent with someone who'd had a heart attack, but her echo looked good.

Pat Aquino[]

  • Diagnosis:
    • Penetrating abdominal wound
    • Full-thickness facial burns
    • Open-book pelvic fracture
  • Treatment:
    • Surgery

Pat came into the ER with a penetrating abdominal wound, full-thickness burns to his face, and an unstable pelvis. An x-ray showed an open-book pelvic fracture and he had severe abdominal bleeding, so he was rushed into surgery. After surgery, Link said he'd need a few months of physical therapy, but would make it.

Aaliyah[]

  • Diagnosis:
    • Pregnancy
  • Treatment:

Aaliyah was 32 weeks pregnant and was brought into the ER.

Music[]

Song Performer Scene
"Don't Mess Around" Brittany Pfantz
  • Meredith flirts with Nick over text.
  • Amelia comes in and finds Kai already in the lab.
  • Maggie and Winston flirt over text.
  • Winston talks to Richard about Maggie's dad.
  • The residents greet Richard excitedly as he gets off the elevator.
"Hold Me Down" Joy Oladokun
  • Teddy and Bailey run the code on Vic.
  • It's successful and Travis and Ben come back in.
  • Vic asks Travis if it's real and he nods.
"Postman Pat Theme Song" Cast (Richard Flood)
  • Cormac hums, then sings, the Postman Pat theme song.
"Far from Home" Plàsi
  • Levi stands with Travis as he cries.
  • Bailey apologizes to Jo and tells her about Pru.
  • Andy brings in Pru and Bailey hugs her.
  • Winston and Cormac prepare to close Farouk.
  • Megan cries in the scrub room. Cormac tells her it's all right.
"Our Bones Turn to Stone" Aquilo
  • Owen, Teddy, and Megan sit with Farouk.
  • Andy, Theo, and Travis sit with Vic.
  • Ben and Bailey take Pru.
  • Winston and Richard meet in an elevator again. They decide to go eat together.
  • Jo asks Link what happens to Luna if she dies. Link says he'll take her.
  • Tom leaves. Kai and Amelia are competing to be last to leave. Kai agrees to leave first.
  • Before leaving, Kai asks about Amelia's "happy little family."
  • Amelia says she's single. Kai says they're married to this lab.
  • Meredith says good night to her kids.
  • Nick and Meredith flirt and then kiss.

Notes and Trivia[]

  • This episode's title originated from the song Bottle Up and Explode!, originally sung by Elliott Smith.
  • This episode scored 4.75 million viewers.[1]
  • This episode marks the directorial début of Lindsay Cohen, who had been working on the show as a script supervisor since season 8.
  • Almost the entire main cast from Station 19 crosses over to this episode. Only Danielle Savre and Boris Kodjoe are missing.
  • Goof: In the Netflix subtitles, some of Tom's lines were ascribed to "Ted."

Gallery[]

Episode Stills[]

Behind the Scenes[]

Quotes[]

See Also[]

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


References[]

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