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Come Fly With Me

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“ As doctors, we rely heavily on data to treat our patients and minimize risk. So when there is no data, any move can be extremely scary. We have to solely practice medicine on a hunch, relying on instincts and hope. Sometimes, it does not go our way. Sometimes it does. Before there was a cure for diabetes, scientists followed their instincts and gave sick children an experimental extract called insulin. As terrifying as it was, that risk has now saved millions of lives. But even if your hunch is strong, before taking the leap, some part of you always worries, "What if I'm about to make a huge mistake?" The experimental drug, the impossible dream, the fork in the road; we face dozens of choices every day and have to weigh our options. Sometimes, you fail utterly. But to move forward, you have to take the leap of faith. You never know where you'll land. ”

Come Fly With Me is the seventeenth episode of the nineteenth season and the 417th overall episode of Grey's Anatomy.

Short Summary[]

Teddy calls an emergency meeting to discuss the intern program. Link wrestles with his own self-doubt as he preps for a massive surgery, and Nick shares some much-needed guidance with a struggling Lucas.

Full Summary[]

Early in the morning, Amelia runs into Nick outside the hospital. He says he's being stood up and hands her a cup of coffee.

Lucas, Mika, and Simone arrive at the hospital late. Mika uses Simone to shield herself from Teddy, whom she thinks is going to fire her for moonlighting at Joe's. Taryn does not remember what she said during her rage blackout.

Jules gets on the elevator, where Benson is talking to Stella Owens. He tells Stella "ladies first" as the elevator arrives. He then looks at Jules, who says she's good.

Jo is making arrangements for Luna. Link offers to help out but she's got it covered. Owen comes up to ask Link for a consult in the ICU and tells him to reschedule his other consult.

Lucas finds Nick in the ICU and apologizes for being late. Nick doesn't care about his excuses and gives him a list of things to do. Also, he hardly yells, so it's serious when he does.

In the ER, Bailey thanks Benson for stopping that patient who came after her. Benson then sees Maxine Anderson. She doesn't want Jules to know that she's here. She woke up feeling dizzy and wants to get checked out. Benson takes her to a bed and says she's a VIP.

Teddy has called a meeting with Nick, Amelia, Richard, and Bailey. She hands out surveys that Levi distributed among the interns. Underneath some nonsensical requests are actually valuable responses, like the statement that the salary doesn't even cover the average annual living cost in Seattle.

En route, Owen informs Link that the patient slammed into a rock wall while basejumping in a wingsuit. Miraculously, there was no head injury. He was stabilized at Boise General but they didn't have the resources for the rest. They enter Sam Sutton's ICU room. He broke all extremities and his pelvis.

Benson is examining Maxine, who brings up his being friends with benefits with Jules. Jules has spilled the tea. Levi joins them and finds that Maxine is a little dehydrated so they'll get her some IV fluids and run labs. Levi will come to check on her later. Benson inquires what else Jules has told her but Maxine calls girls code.

Simone presents Sam's case. Owen introduces Sam to Link, who checks if they've ordered CT angios on all four extremities. Link wants to examine the limbs but even touching the dressing is painful, so he'll wait until they're in the OR. Link can't help but mention how lucky Sam is. Sam's buddy Kwame Reynolds was with Sam when it happened. They were in the Army together and now they're wingsuit buddies. Kwame avoids the giant rocks. Sam knows he's looking at a long recovery but he hopes he can deliver on his promise to his nephew that he'd teach him to ride a bike this summer. Link is cautious but Owen stresses that Link is the best.

Outside the room, Kwame asks Owen if they should get a second opinion from someone other than Link, whom he knows killed the Tank. Owen says even the best can have a bad day. Kwame says whenever Sam's mind takes him to a dark place, his body gets him through it by chasing adrenaline. He needs his limbs so Link better not have a bad day. Link promises he'll do his best and asks Simone and Jules to page him when the scans are up. Once they're alone, Jules tells Simone that Lucas gave her his post-its with wedding stuff written on it. Jules realizes that Simone didn't know that Jules is now her maid of honor. Jules says she'll only do whatever Simone texts her to do.

Lucas finds Mika outside the meeting room. The attendings in the meeting cancelled their electives for the morning. Lucas is struggling to read Marsh's handwriting but Mika doesn't feel like helping him since she's about to be fired. Levi comes up and states they're not helping any patients. He helps out Lucas and Mika goes back to work.

Owen, Link, Simone, and Jules are studying Sam's scans. So far, Link has counted 75 fractures. The rib and spinous process fractures will heal on their own. It's a wonder that Sam's spine is still intact but his limbs are like jigsaw puzzles. Link plans to put them back together with staged surgeries. Jules wonders why they're not fixing everything in one surgery. Link says the prolonged time under anesthesia means an increased risk of complications, such as clots. Life over limb, Simone says. If the bone and tissue loss is too great, they may need to amputate.

Sam refuses to let one of his limbs die waiting in line. Link assures him it's the safer option. Owen jumps in and says they could fix everything in one sitting. Link strongly advises against that while Owen states that waiting also has its risks, such as sepsis from the open wounds. Sam was trained to assess major risks and he opts for the one surgery.

Down in the ER, Benson asks Levi for a chance to observe Link's surgery but Levi refuses. They return to Maxine, who has a UTI, presumably from dehydration since she assures them she always pees after sex. Levi says they'll start her on oral antibiotics and get her more fluids. Benson will be nearby if she needs anything.

As they await Sam's angio scans, Jules tells Simone not to be mad at Lucas. Simone realizes she shouldn't have asked him but she wanted to go through this with someone who knows her. Jules does a round of rapid fire questions to get to know her better. Sam tells them he's worried about Kwame. He'll give them Kwame's wife's number and if Sam dies, they need to make sure that she comes to pick him up because he will be too proud to call her himself.

Owen joins Link in the imaging room. CT angio shows diminished blood flow all over. Link is still trying to wrap his head around this. Owen stresses that they need to get Sam into an OR as soon as possible. Link says Owen ruined his plan by telling Sam they could do it all at once. Owen understands Sam. He was running on adrenalin, risk, and terror in the Army. Regular life gets dull really fast when you come home. The thrill of being a trauma surgery is what kept Owen sane. Sam is not a daredevil, he is dealing with PTSD. Link throws Owen out of the room as to not waste any more time.

Teddy was planning on appealing to Catherine and the Foundation but Richard points out the salaries are government-funded. Richard says money may be tight as a resident but you don't need to live a fancy lifestyle. The hospital covers their malpractice insurance, free parking, and a meal stipend of $15 a day. Nick is paged 911 to the ICU. Richard adds that residents get four weeks of paid vacation a year. Bailey says that started when she was coming up. Her great-aunt died and she asked for a week off to help her mother. Her attending told her residents are called that because they live in the hospital. She did not even go to the funeral. The attending in question was Richard.

Maxine talks to Benson about Marshall, her one that got away. She met him in pre-law, where she only went to find hot guys. A trauma is brought in and Maxine tells Benson he can go. He promises to come back and check on her, then heads to the trauma room.

Lucas arrives in the ICU later than Nick, who scolds him for not following his instructions. He forgot to turn off the patient's insulin drip. The patient went into hypoglycemic shock. Nick doesn't want any more excuses from Lucas. He wants effort and change. Nick gave him advice on how to improve. He knows Lucas has it in him but he keeps being distracted and making mistakes. He has to try harder. He needs to grow up if he wants Nick on his side. Nick tells him to get his ADHD medication adjusted or he risks losing his career.

The attendings share horror stories from their residencies. Teddy knows there is something to be said for family, tradition, and adversity making people stronger but there should be no more abuse like they suffered. Amelia admits she overreacted to Mika. Bailey excuses herself as she sees a confused-looking Maxine wandering down the hall.

Lucas asks Mika if he has ADHD. She can see it. He tells her about what happened in the ICU. She can't believe that he wasn't fired while half of the surgical chiefs are meeting about her taking a second job to make ends meet. She can't help but feel that is because of his family.

Jo brings Link some cookies. She heard about his case. He found two more hairline fractures, bringing the total to 93. Everybody is talking about the case, which is making Link very nervous. It's not an unlikely scenario that he'll lose this patient. Jo asks him what he needs. He wants to work in two surgical teams, one to help him reduce and repair fractures and one to position the next extremity ahead of time and start the wash-out; also a full anesthesia team and surgeons to perform vascular anastomoses and rotational flaps. It'll take at least six surgeons. Jo can help out.

Once the whole team is assembled, Link talks them through his plan.

Outside the room, Jules knows that Simone is worried about the surgery and if Link is the right guy for the job. Simone admits she's right. Jules points out she knows her better than she thinks.

Bailey is scolding Benson for having lost track for Maxine. He's lucky she owes him one. Levi is waiting by Maxine's bedside and welcomes Benson back. Maxine introduces Levi as her grandson Hugh. Since her vitals start showing signs of sepsis, Bailey has her admitted to the ICU. Maxine is delirious from the UTI.

Jules tells Sam his labs are looking good, meaning he's ready for takeoff to the OR. Jules is paged 911 to the ICU. Kwame has three kids and another one of the way. They love their uncle Sam. Maybe if Sam doesn't make it through this surgery, Kwame and Kelly will finally name a kid Sam. Jo comes in to send Griffith to check if the OR is ready. Jo introduces herself to Sam, who asks her if she's single since he might be dying. She says she is. He states he now has something to live for.

Mika interrupts the attendings' meeting. She accepts the responsibility and consequences of her mistakes but it seems right now her only mistake is not having enough money. She wasn't born with a silver spoon and doesn't have the family pedigree to fall back on. Her students loans and the possibility of her parents losing their house if she can't make her loan payments is very real. She will continue to devote herself to this program but that devotion has to include working a second job. Richard disagrees. Mika quickly says she quits so they can't fire her. Amelia says she's not getting fired. Teddy says they are starting an emergency relief fund for any resident that might need it. It won't pay off all her loans but it can help make ends meet. Mika can be the first recipient. Mike rescinds her quitting and thanks them. Nick says they sometimes need reminders.

Jules joins Benson in Maxine's room. She asks what the hell happened.

Simone informs Link that the cadaver graphs are ready, as is Sam. Simone recalls the surgery on the Tank and asks if Link is sure this is the right plan. Owen cuts in and says that complication could have happened to anyone at any time, and he doesn't need an intern questioning Link's plan, skills, or professionalism. Link says it was not his plan. Owen tells Simone that if she doesn't share his confidence in Link, she should keep it to herself. He walks off. Simone apologizes to Link, who understands how the Tank's surgery haunts her. He needs Simone to tackle this surgery with a clear head. This is what Sam wants and they are his best shot. Mika comes up. Jules is out so Bailey sent her to cover. Simone asks if this is her one last surgery. Mika says she's just getting started.

Before Sam is put under, Owen tells the team that Sam is a veteran and a hero. They'll thank him for his service by keeping him alive today. Sam says "all or nothing" before he's put under. Link then tells the team that they'll get tired and hungry. When that happens, they should think about Sam. There is no margin for error. They'll get Sam through this. All or nothing.

Benson explains to Jules why he didn't call her, Maxine's emergency contact, and what happened. She can't believe he left Maxine. She thinks he was too busy stealing surgeries or flirting with surgeons. She decides to take over from him.

Up in the gallery, Bailey wonders which fool was first to put on a squirrel suit. Lucas tells her about Franz Reichelt. He was into aviation as a kid and knows weird stuff. Franz died.

The surgeons work on Sam's limbs while Kwame sits in the waiting room. People rotate in and out of the gallery. Simone updates as night falls over Seattle. The surgery continues for hours until the morning. The staff and spectators applaud after the last cast is applied to Sam's right arm.

Link and Owen wake up Kwame and inform him that Sam made it through. Owen says Link managed to save all the limbs. Sam is lucky for many reasons but one of them was that he was brought here. Link is optimistic that with extensive PE, he will walk again and use his fingers fully. Kwame is sure that he will. Sam's one to defy expectations. As they walk off, Owen congratulates Link, who tells him they'll have a problem if he ever puts him in a position like that again in front of a patient. Then he thanks Owen for his service.

Amelia approaches Mika as she stretches after the surgery and asks her to talk. Mika is grateful for the grant and not being fired but she is not in right headspace to process being told she made another mistake. Amelia says she herself made a mistake. She apologizes for having overreacted. She believes in accountability so she apologizes. Mika instinctively apologizes, too, but then says she meant "apology accepted."

Nick sits down with Lucas outside. He says he was wrong to call out Lucas on his ADHD. Lucas says he was never diagnosed but he's been reading up on it and things are coming together. Nick recognized the lack of attention to details, hyperfocus, poor organizational skills, and improved performance when complicated tasks are broken down. Also, it takes one to know one. Nick was diagnosed in college and got the help he needed. Lucas always saw himself as just the black sheep but never thought of himself as neurodivergent. Nick tells him the next step is to get checked out.

Simone goes to check on Sam but finds Link in the room. Everything is looking stable but Link is going to stay by his side just in case. Link compliments her work today. She returns the compliment and leaves. Jo comes in with coffee and decides to sit with Link.

Simone joins Jules in Maxine's room.

Richard finds Taryn at Joe's bar. He didn't listen when he came here a couple of months ago and she shared how difficult it was to come back. But he's listening now. He asks her what it would take for her to come back.

Amelia chases Winston as he leaves work. She owes him an apology. She blamed him for Maggie leaving even though she knew the truth was complicated and none of her business. She took out her pain on him, which has been happening a lot. This is just one stop on the Amelia Shepherd apology tour. Even so, he is a good man and she was wrong. She's sorry. He just walks off.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Nick's Patients[]

  • Diagnosis:
  • Treatment:

Nick gave Lucas instructions for caring for his patients, including rounding on his post-ops, checking on Mr. Kane's lab results, and monitor Sarah Hawkins. When her blood sugar stabilized, he needed to turn off her insulin drip. Lucas neglected to do that final check and Sarah Hawkins ended up in hypoglycemic shock.

Maxine Anderson[]

  • Diagnosis:
    • Urinary tract infection
    • Sepsis
  • Treatment:
    • IV fluids
    • Antibiotics

Maxine came back to the ER when she woke up feeling dizzy. Benson examined her and Levi noted she was dehydrated. He ordered test and fluids. The test showed a urinary tract infection, so Levi ordered more fluids and an antibiotic. Benson was told to monitor her, but when a trauma came in, he left to join that. She ended up leaving her bed wandering the halls. They got her back in bed, but she was confused. They realized she had developed sepsis, so they admitted her to the ICU and ordered more antibiotics.

Sam Sutton[]

  • Diagnosis:
    • Pneumothorax
    • 93 fractures
  • Treatment:
    • Chest tube
    • Surgical repair

Sam, 44, was in a wingsuiting accident in which he slammed into a granite wall. He was brought to Boise General, but they didn't have the resources to treat him, as he had broken all his limbs in multiple places as well as his pelvis, ribs, and spine, so he was moved to Grey Sloan Memorial. In addition to his many fractures, he had a left-side pneumothorax, for which they'd placed a chest tube. Owen had ordered a CT angio to check the blood flow in his limbs. Link decided to repair his limbs in stages, over multiple surgeries. He wanted to start with the right femur, and do one repair at a time until they were all finished. This saved Sam from an extended time under anesthesia, but would prolong his recovery and increase his chances of infection eventually requiring amputation. Sam disliked this plan, so Owen proposed fixing all of them at once. Over Link's objections, Sam insisted on the longer single surgery. Link reviewed his scans, which showed a total of 93 fractures, and developed a surgical plan involving multiple teams to work on the limbs in sequence. The surgery was successful and Sam was stable in the ICU afterward.

Jo's Patient[]

  • Diagnosis:
    • Pregnancy
  • Treatment:
    • Delivery

Jo's patient delivered a baby named Mae Ashley, who weighed 6 pounds, 8 ounces.

Music[]

Song Performer Scene
"I Will Rise" MILCK
  • Amelia and Nick share in their misery.
  • Mike, Simone, and Lucas arrive at work.
  • Mike worries she'll be fired and avoids Teddy.
  • Jules gets on an elevator with Benson and Stella.
  • Jo schedules an appointment.
"Moving On" Foreign Air
  • Link plans Sam's surgery.
  • Simone talks to Jules.
"Changin'" Marieme
  • Mika gets a grant.
  • Jules goes to see Max.
  • Link, Owen, and Simone prepare for Sam's surgery.
  • Mika tells Simone she's just getting started.
  • Owen and Link give speeches.
"Mercy" Devon Gilfillian
  • The surgeons work on Sam.
  • Kwame waits.
  • People come in and out of the gallery.
  • Simone updates Kwame, then goes back.
  • Link places the final cast and takes off his mask.
  • Everyone applauds.
"Hesitate" Hazlett
  • Jo brings Link coffee and company.
  • Jules sits by Max's bedside.
  • Simone comes to sit with her.
  • Taryn is cleaning up when Richard comes in.
  • He talks to her about her residency.
  • Amelia apologizes to Winston.

Notes and Trivia[]

  • This episode's title originated from the song Come Fly With Me, originally sung by Frank Sinatra.
  • This episode scored 3.10 million viewers.[1]
  • Goof: In the episode's opening monologue, Meredith says "Before there was a cure for diabetes, scientists followed their instincts and gave sick children an experimental extract called insulin.". However, even today, a cure for diabetes has not been found and there are only ways to manage it, including with insulin.

Gallery[]

Episode Stills[]

Quotes[]

See Also[]

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


References[]

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