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There's an old story of a father who had two sons. When he knew a civil war was about to break out, he sent one son to fight for the North, and one to the South. He figured if he had sons on both sides, there'd be a better chance one would survive. Because when you fight a war at home, the casualties are your neighbors, your friends, your family, leaving you all alone. War isn't civil. You pick sides and defend them. You attack. You hurt people. You get hurt. You fight, and you fight, and you fight. To what end? What are we fighting against? What are we fighting for? When is it time to just quit all of this nonsense and simply surrender?

Civil War is the fifteenth episode of the thirteenth season and the 284th overall episode of Grey's Anatomy.

Short Summary

Richard, Jackson, April, and Catherine tackle a grueling trauma case intensified by hospital politics, Amelia finally faces her feelings about Owen, and Meredith gets caught between Nathan and Alex over a patient.

Full Summary

As Meredith's voiceover talks about a father sending one of his sons to each side of the civil war, hoping one would live, April avoids seeing Jackson. Catherine wakes up alone. Richard wakes up alone in an on-call room. Owen wakes up on the couch alone. Amelia sleeps on Meredith's couch until Maggie wakes her to ask for a favor. She has a patient who needs heart surgery, but can't get it until she has her aneurysm clipped. Amelia agrees with persuasion and the promise that Maggie will make sure Owen doesn't see her.

April welcomes Meredith back to work and tells her all the things she did while Meredith was gone. Nathan comes in and is surprised Meredith folded so quickly. She says she didn't fold; Richard asked her to come back. After he's gone, Alex tells Meredith to be with Nathan if she's into him. She says she isn't, but Alex doesn't believe her.

Alex gets on an elevator, followed by Andrew. He asks Andrew if they're cool or if they're going to have problems working on kids together. Andrew says they're cool.

Bailey has a request from Richard to replace all the mattresses in the all the on-call rooms, because they're uncomfortable. Arizona agrees. Catherine comes up behind him and tells him if he wants to sleep soundly, he should come home and sleep next to her. Bailey says she'll take the request under advisement and leaves. Arizona comes up to Richard and asks if he's okay. He says no, his back hurts. And there's nothing like having your dirty laundry aired. As long as Minnick is there, it's going to stay bad. Richard is about to give in, but Arizona says everyone's behind him. Richard knows he's losing support, but Arizona says she's behind him and offers him her guest room to stay in. He says it'll be fine, but thanks her for sticking with him. She's a good friend.

Jackson tells Arizona, Meredith, and Maggie that they're losing ground because everyone loves Minnick. It looks bad that Meredith got suspended for supporting him and now is back to work. Meredith says they don't have a position if Richard is asking them to stop. Maggie says the problem is that Minnick's program is good and people like it. Jackson is shocked that they're abandoning it. He's going to continue to fight, using his influence as an Avery.

Catherine tells April her patient's injury has healed itself, meaning she doesn't have to call in Jackson, which she was dreading. April's not sure she can live with him anymore. It's made things easier with Harriet, but it's making everything else harder. It's also embarrassing being demoted, going from running a department to being a trauma surgeon again. Catherine says the title's only as good as the person who earned it. Meredith is good, but while she wasn't there, they turned to April. Catherine tells her to act like she knows she's good.

Alex and Andrew examine a newborn. Nearby, his parents, Mr. Endris and Kate Endris, haven't decided on a name. They agreed they'd flip a coin after he was born. Dr. Hundley tells Alex she heard a murmur during his after-birth examination. Mr. Endris flips a coin, which determines that the baby is named August Endris. Alex orders labs and a cardio consult. Then he tells the parents they'll get an update when he can give them one.

Jackson tries to talk to Catherine about Eliza. She says Eliza's doing fine, but Jackson says he's the board representative for the Harper Avery Foundation. It's a job he didn't want, but he's doing it now and he says he'll go over her head to get Eliza out and Richard back in.

April and Catherine talk about Jackson. April's surprised he's using his power because he's never been interested in it. April displays knowledge of the Avery Foundation's work in medicine and says she likes the aspects of the job that Meredith hates. Catherine invites her to go see the Avery hospital in Chicago. April's interested to see how they run things, but Catherine actually wants them to see how she runs things.

Ben leads in Paramedic Mullen, who is bringing in Mike, who was injured when a propane tank exploded. Pieces of shrapnel are embedded in his chest. His family has minor injuries, but he took the brunt of it. April and Catherine step in to examine him and April calls for a plastics consult.

In the nursery, Nathan diagnoses baby Gus with hypoplastic left heart syndrome. They review his labs and Nathan tells Andrew to put Gus on the transplant list. Alex disagrees. He thinks they should do a Norwood instead of waiting for a heart that might not come in time. Nathan doesn't think that Gus will survive the Norwood. They go to talk to the parents.

Ben approaches Rodney, who is coming into the hospital with his sister, Pam, and fiancé, Jim. Pam wants to know where their dad is, but Rodney's arm is burned and he needs treatment first. Jim says it's the only thing he knows how to cook and he was trying to do something special. Pam is upset and blames Jim for what happened. Ben tells Rodney he'll have to learn to change the dressings while his burn heals. He'll send someone over to take care of it and get an update on their dad.

Jackson and Richard have joined April and Catherine on Mike. They disagree about in what order his injuries need to be treated. They have Ben book an OR and he's irritated they're all fighting.

Amelia scrubs out and tells Maggie Agnes's surgery went well. Amelia admits that it feels good to be back at work, but she's not ready to see Owen. Maggie says she can start with hi, but tells Amelia it's okay to wait until she's ready. Amelia asks Maggie to check to see if the hallway is clear so she doesn't have to see Owen when she walks out.

Gus's parents listen as Andrew explains his condition. Alex explains their two options and he and Nathan each advocate for their own position. Kate asks the doctors just to tell them what to do. She and her husband disagree as well.

In the hallway, Alex and Nathan argue about what happened with the Endrises. Alex walks away angry and Nathan tells Andrew to put Gus on the transplant list and not to tell Alex about it.

Ben walks into the scrub room to find the four doctors still arguing over Mike. He suggests that they just go in and explore. Then the best choice will become obvious. That's something Eliza suggested they do, working the problem together. April says that'll work and thanks him.

Alex tells Meredith she was right about Nathan. He's a snake. Meredith says she didn't say that. Alex says Nathan's a snake.

Stephanie sees Amelia and shrieks and starts hugging her. She's glad Amelia's back. Stephanie hopes she's not anti-Minnick. Amelia corrects that she's not back and asks Stephanie to check the ER for Owen. Stephanie says she won't do that because she has work to do.

Arizona meets up with Eliza on the stairs. Eliza asks about Arizona's stove, confusing her. Eliza says she wants to make Arizona pierogi, but her stove sucks, so she wants to make it at Arizona's house. She does pierogi very well. She says she doesn't have to stay or anything, but she wants to make pierogi. Then, in Polish, she tells Arizona that once she has her pierogi, she won't want anyone else's. Arizona doesn't know what she said, but she wants Eliza to say more of it. Eliza says she'll see Arizona at eight and she'll bring everything.

Richard and April disagree as they operate. Catherine stands up for April's side. Catherine also tells April when she's free to go to Chicago. She also suggests other things they can do, including seeing Hamilton, which upsets Richard.

Jo sits next to Andrew and eats yogurt. She's exhausted after a long surgery. She sees Andrew's face and asks if something's wrong. He says he's stuck between two doctors and doesn't know what to do. Jo tells him he'll make the right choice. He always does. Jo gets paged away and leaves. Andrew picks up his phone and dials.

Owen grabs a gown for an incoming MCC as Amelia watches.

Outside, Paramedic Grace brings in a man with a skull fracture and other serious injuries. He calls for neuro, but Amelia steps up and says neuro's there. They take him inside.

April defends Eliza's program. Jackson says the stitch he's doing came from Mark Sloan, who taught Jackson how to do it after Jackson watched him do it many times. April and Jackson continue to argue about the hiring decision until Catherine puts a stop to it. She tells him he keeps saying he's an Avery, but he's not acting like it. The name is only as powerful as the person who owns it. She tells him he's an outstanding surgeon. Things get awkward for a moment and then April says Mike's too far gone for them to do more tonight. They'll take him to ICU and start again tomorrow. The others agree.

Amelia and Owen examine their patient. He didn't know she was back. She says she just stopped by for floss. Stephanie comes in with the results and Owen asks her to page neuro. Amelia says she can handle it.

Richard tells Arizona about being stuck on a case with Catherine, Jackson, and April. He'd like to take her up on her offer after all. When he sees her reaction, he asks if it's still okay. She tells him she has a date, but she can cancel since she just made the plan and probably shouldn't be doing it anyway. He insists and tells her to have fun. He should probably stay at the hospital for the patient anyway. He tells her to give him the dirt tomorrow.

Amelia and Owen wait for their patient's scans. Maggie sees them and is surprised Amelia's still there. She tells Amelia Agnes is still doing well, revealing to Owen that Amelia lied. Amelia sends Maggie away and avoids talking to Owen by saying the scans are up.

Meredith finds Nathan at the desk and pulls him into a room to ask him why he's being a jerk. She talked to Alex. Meredith tells him messing with Alex is not the way to get somewhere with her. He takes that as an admission that there's somewhere to get with her. Nathan defends his medical opinion. He thinks he's right. He leaves angrily, telling Meredith he's done.

Jackson and April talk to Rodney, Pam, and Jim. Jim asks if they can see him. Pam is upset at that and Jim says he meant them. Jackson says it's not a good idea. He needs to rest. April suggests they get some food and rest. Rodney and Pam don't want to leave, so Jim offers to get them food and bring it back. Pam is even more upset with that. Rodney tells Jim it might be best if he leaves and doesn't come back. He can't think about anything else when he looks at Jim but that his father is almost dead.

Amelia and Owen talk about their surgery as they scrub in. It might be a lost cause. Owen asks if Amelia was planning to see him at all that day. She admits she wasn't. She was hiding. She was just in to do a favor for Maggie. Their patient is ready, but Owen tells her she can leave since surgery probably won't save him anyway. Amelia says no one's a lost cause.

Arizona jolts awake as Eliza comes in late. She asks if she missed the window. Arizona says no, she's good. Eliza knows she's exhausted. Eliza's exhausted too. The residents had tons of questions. They sit down to rest for a minute before they rally.

Andrew's phone rings, waking him. He gets up and starts running as he answers.

Alex comes in and asks Nathan what's going on. Nathan explains that Gus has a new heart on its way. Alex is upset that Nathan put Gus on the list. Nathan tells him it's a good thing. Now they just have to have an awkward conversation with the parents before they save a life.

Owen and Amelia scrub out. Their patient died. Owen asks Amelia if she wants to be married to him. She says she does, but she's not ready to fight with him. They're on opposite sides, so there will be a fight and someone has to win. Or no one wins. Owen leaves to talk to the family.

Alex is reporting Nathan to Maggie. Maggie says the only fight is to keep the kid alive. They won the battle, so they need to finish the war and figure out how to work together to do the heart transplant.

Ben has Mike back in surgery. Mike started bleeding, so Ben rushed him back in. The others file in as Ben works. Richard sees that Ben has it handled, so he has Ben take care of it while he suctions.

As Nathan prepares Gus for transplant, Alex and Andrew work on the heart. Alex asks Andrew if he called UNOS. Andrew says it's kids. Alex takes the heart over to Nathan, who puts it in Gus's chest.

Jackson and Richard scrub out and Jackson questions Richard about what happened with Ben. Richard says it was the same thing he's always done with residents, but Jackson says it's different. Jackson says there are things he can do, but Richard tells him not to do it. It'll tear Jackson and his mother apart. Jackson thinks Catherine has found a weakness and is exploiting it. Richard says they'll be okay. Jackson says she'll keep fighting until she wins, no matter the cost. He warns Richard not to let her.

Richard tells Rodney and Pam that their father is out of surgery and he'll have a long recovery, but he'll make it. Rodney pulls out his phone. Pam is shocked, but Rodney says it was an accident and Jim loves their dad. Richard takes Pam to see Mike as Rodney hesitates over his phone.

Jackson goes into a room where Catherine is working. She questions how he can do this to someone she cares about. She says it's business, but he wonders if love means nothing to her. Catherine says they're very different people. He's never been interested in the Avery Foundation before. He thinks she's taking April to be the Avery she always wanted him to be. She says she's proud he's taking his own way and she's happy with who he is. But she doesn't think he is. He leaves.

As Meredith leaves, she meets up with Nathan, who tells her they saved the baby. Meredith says that's good. Nathan says now she's being the jerk. Meredith says Alex was right about him. Nathan tells him people are always in her ear, telling her what to think about him, but Meredith says no one tells her what to think. Nathan says he doesn't want their opinions. He cares what Meredith thinks. He tells her he thinks about her. A lot. He can't stop and he's in. If she is. He asks her what she thinks. Before she can reply, he tells her to wait until she knows and when she does, give him a call. He walks away.

Eliza and Arizona wake up together on the couch. It's nearly morning. They spent the night together. They lean in for a kiss, but pull apart when the door opens. It's Richard, who is surprised at what he sees. He turns around and walks back out.

Maggie and Amelia leave together. Amelia watches Owen walk out of the hospital. Maggie asks Amelia if it was as bad as she thought it would be. She says it kind of was. They need to talk. Maggie says they don't have to talk tonight. She leads Amelia out.

Catherine finds Richard in an on-call room getting ready for bed. She tells him to get a good night's sleep. He tells her he didn't want to come between her and Jackson. She knows that. As he gets into the bed, she tells him good night and closes the door.

April sees a scan on Jackson's computer and says it's a nasty throat tumor. He has a patient at the Avery hospital in Montana. He needs to go there for a consult. April finds it suspicious that he's going to an Avery hospital when she's planning to. She asks if he's jealous and he says he isn't. April insists that she's not a puppet. She has her own brain and her own opinions. Working with Catherine gives her opportunities. Jackson goes to go to bed. April asks what's going on with him, but he tells her it's not her business.

Cast

Main Cast

Guest Stars

Co-Starring

Medical Notes

Sister Agnes

  • Diagnosis:
    • Aneurysm
  • Treatment:
    • Surgery

Agnes was in the hospital for heart surgery, but she also had an aneurysm that needed to be clipped first. Her surgery went well and she was ready for her heart surgery.

April's Patient

  • Diagnosis:
    • Colovesical fistula
  • Treatment:

Catherine consulted on April's patient and said the fistula closed on its own, so no need for abdominal reconstruction.

August Endris

  • Diagnosis:
    • Hypoplastic left heart syndrome
  • Treatment:
    • Heart transplant

Gus had a murmur after birth. After exam and tests, he was diagnosed with hypoplastic left heart syndrome. Nathan wanted to wait for a heart transplant, but Alex wanted to do a Norwood instead. They presented both to the parents and left them to decide. However, Nathan secretly had Gus put on the UNOS list. A heart became available before the parents made their decision and Gus received a heart transplant.

Mike

  • Diagnosis:
    • Burns
    • Partially de-gloved leg
    • Shrapnel
    • Bowel evisceration
  • Treatment:
    • Bladder repair
    • Exploratory laparotomy

Mike was burned when a propane tank exploded. He had severe burns on the left side of his body, a partially de-gloved left leg, and shrapnel imbedded in his chest. His bowel was eviscerated. He needed a bladder repair and an exploratory laparotomy. They did damage control in the OR and then moved him to the ICU to let him rest. He later started bleeding again, so Ben took him back into surgery to make repairs. After his surgery, his family was told he'd be okay.

Rodney

  • Diagnosis:
    • Partial-thickness burn
  • Treatment:
    • Dressing

Rodney was burned when a propane tank exploded. He had a partial-thickness burn on his arm. He was told he'd need to learn to change the dressings.

Owen and Amelia's Patient

  • Diagnosis:
    • Open skull fracture
    • Epidural hematoma
    • Massive internal injuries
    • Diffuse axonal injury
  • Treatment:
    • Surgery

A patient came in after an accident. He had an open skull fracture, epidural hematoma, and massive internal injuries. He also had diffuse axonal injury, which meant surgery might not help him. They decided to operate anyway. However, the patient didn't survive the surgery.

Music

Song Performer Scene
"Got Your Number" Serena Ryder
  • April avoids Jackson.
  • Catherine wakes up alone.
  • Richard wakes up in an on-call room.
  • Owen wakes up on the couch alone.
  • Amelia sleeps on Meredith's couch.
"Way Down We Go" Kaleo
  • Pam is upset that Jim has offered to get them food.
  • Rodney tells Jim he should go and not come back.
  • Amelia and Owen scrub in.
  • He asks if she's been working on cases.
  • She says no, she just came in as a favor to Maggie.
  • Stephanie tells them the patient is ready.
  • Owen tells Amelia she should leave, because it's a lost cause.
  • Amelia tells him she's going in, because there are no lost causes.
"(No One Knows Me) Like the Piano" Sampha
  • Ben is trying to save the patient, who is coding, as the others scrub in.
  • Richard steps up to suction and let Ben take the lead. Catherine questions why they're even there and they ask if Ben has it, which he says he does.
  • Nathan retrieves the heart for transplant.
  • Alex and Andrew prepare the heart for transplant.
  • Nathan transplants the heart into Gus.
  • Richard and Jackson scrub out and Jackson tries to call Richard out on him letting Ben do the surgery.
"I Know Better" John Legend
  • Jackson leaves the conference room, surprised.
  • Nathan tells Meredith he saved the baby.
  • He says Meredith's being the jerk now.
  • He tell her that he's in if she is and he wants to ask her out.
  • Eliza and Arizona wake up on the couch together. They discover they were there all night.
  • They go to kiss, but Richard interrupts. He leaves quickly.
  • Maggie and Amelia leave the hospital and see Owen on their way out.
  • Maggie asks Amelia if the day was as bad as she thought it would be.
  • Amelia says she and Owen need to talk, but Maggie says they don't have to talk tonight.
  • Richard prepares to sleep in an on-call room when Catherine comes in. Richard says he never wanted to come between her and Jackson. He climbs into bed and she says good night before leaving.

Notes and Trivia

Grey's_Anatomy_13x15_Promo_"Civil_War"_(HD)_Season_13_Episode_15_Promo

Grey's Anatomy 13x15 Promo "Civil War" (HD) Season 13 Episode 15 Promo

  • This episode's title originated from the song Civil War, originally sung by Guns N' Roses.
  • This episode scored 7.31 million viewers.
  • The prep dates for this episode were from December 6 to December 14, 2016.
  • Filming for this episode was scheduled from December 15, 2016 to January 12, 2017, with a holiday break for the cast and crew included.
  • DeLuca's stethoscope changes during the episode. He starts with a black stethoscope and then suddenly uses a blue different model for the rest of the episode. This is because he switches an adult stethoscope for one designed for babies.

Gallery

Episode Stills

Behind the Scenes

Quotes

April: So, when I was Chief...
Meredith: Interim Chief.
April: I took the liberty of catching you up on all your backlog resident reports, department budgets, supply orders, so...
Meredith: I was gonna do that.
April: Of course you were, I just figured, you know, the same way you fill the tank with gas when you return someone's car.
Meredith: You stole the car.
April: You're welcome.

Catherine: I'm also getting us Hamilton tickets.
April: Yay!
Richard: You're going to Hamilton without me?!

Jackson: You know what, this stitch that I just did? No one else does it like this and do you know why? Because Mark Sloan took the time to teach me how to do it, cause I watched him and I watched him and I learned from him, much in the same way so many surgeons have learned from Doctor Webber, learned from his artistry. And you're telling me what, those days are over? Doctor Webber makes artists here. Doctor Minnick makes robots.

Catherine: Jackson, stop it. You keep saying "I'm an Avery, I'm an Avery," but you're not. Not in the way that you're trying to be. A title doesn't mean anything, it's the person who owns it. Yes, I took your father's name, but it's what I did with it. It's what I made with it. That's what matters.

Meredith: Why are you being a jerk?
Nathan: What?
Meredith: Alex said you were being a jerk.
Nathan: Ah, of course. He tattled.
Meredith: Let me make something very clear to you. If you wanna get anywhere with me, messing with Alex is not the way. Do not contradict him in front of patients and please don't speak to him like he's an idiot.
Nathan: Back up. Get anywhere with you? So you admit it?
Meredith: Admit what?
Nathan: That there's somewhere to get with you.
Meredith: Don't change the subject. I'm talking about Alex.

Catherine: Jackson, you and I are two very different people.
Jackson: Yeah, no kidding. I've never been happier about that fact in my life.
Catherine: You have never shown one ounce of interest in this business. That's fine.
Jackson: Yeah, that's fine because you have April now, right? You can finally get that Avery that you always wished that I was.
Catherine: No, no, son. No. You've always been your own man, you've always made your own way. Nothing could make a parent more proud than that. Nothing. I am so happy with who you are. I am. I just wish you were, too.

Meredith: Alex was right about you.
Nathan: Yes, of course, cause everybody's always in your ear telling you what to think about me.
Meredith: Nobody tells me what to think.
Nathan: Good, cause I don't want their opinion. Okay? I care about what you think.
Meredith: About you? Actually, I think a lot of things...
Nathan: No, no, no. No banter. No more quips. I'll tell you what I think. I think about you a lot. I can't stop. And I'm telling you, I'm in. If you are. I'm in this. So I'm just gonna ask you outright. What do you think? Actually, don't answer. Not 'till you know. When you do, just give me a call.

Catherine: Come home. Just get a good night's sleep.
Richard: I never wanted to come between the two of you. You and Jackson. I never wanted that.
Catherine: I know.

April: I'm going to an Avery hospital, now you're going to an Avery hospital.
Jackson: Oh, come on, really? Yeah, it's not that.
April: Are you jealous? Is that it?
Jackson: Jealous of my mom manipulating you? No.
April: Oh, stop. I'm not some puppet. I have my own brain. I have my own opinions. Working with your mom in the Foundation, it's full of opportunities for me. And I get that you never wanted that and that's fine, but she sees something in me.

See Also

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

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