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Out of Nowhere

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“ There are some disasters you just don't see coming, no matter how carefully you plan. A little surprise that changes everything. In surgery, we call it a complication. In life, it's a catastrophe. In surgery, we call it a complication, a disruption, a glitch, a nasty surprise. It calls for extreme measures. You have to react quickly, try to catch up, because it came out of nowhere. And it can take everything away. ”

Out of Nowhere is the eighth episode and mid-season finale of the fourteenth season and the 301st overall episode of Grey's Anatomy.

Short Summary[]

A hacker compromises the hospital’s computer system, causing monitors, phones, labs and patient files to all go down. As technology fails them, Bailey attempts to keep the peace but chaos erupts and the doctors are forced to get creative in their methods to treat the patients.

Full Summary[]

Ben is working out outdoors.

Meredith is giving an interview about winning the Harper Avery Award. She's asked if her goal is two, like her mother. Meredith jokes she wants three to drive her crazy. The interviewer guesses what comes next is the toughest part, but Meredith says this is interview is. She wants to go prep for her spleen surgery later. The interviewer wants to go back to her time in college when she decided to go into medicine.

Jo, the new Chief Resident, is practicing her scary speech. She's trying to sound like Bailey, but Alex admits she's doing a horrible job at it. There's loud thumping and Jo tells Alex it's Andrew and the intern, every day, like some sort of addiction.

In the on-call room next door, Sam and Andrew are kissing as her alarm goes off. They just forgot to sleep. They quickly get dressed.

April is on the elevator with Owen and Carina as Arizona gets on. April senses the awkwardness.

Bailey is talking to Richard about running her surgical contest, which she's told him is funded by anonymous donor. Since people found out, surgeons from all over are calling and kissing her ring. Richard knows she doesn't want to run the contest because she wants to compete, but so does he. She thinks he owes her because he allowed her husband to call his firefighter fantasy a fellowship. Ben made an excellent case for it. Richard will run the contest on one condition: he wants to know the identity of the donor. Bailey says it's Aretha Franklin, but not really. Richard agrees to take the contest, but he won't keep it. Jo walks by as she's giving her speech to the interns. Richard thinks she needs to work on that.

Meredith's walking with Amelia and Maggie. Meredith is complaining about not getting to do real surgeries anymore since winning, while Maggie is saying yes to a Tinder date. They walk up to Jo and ask for their interns. Casey is with Maggie while Meredith chooses Glasses herself, leaving Jo to choose for Amelia.

Casey is presenting Claude Markham's case. He's here for a thyroidectomy and bilateral neck dissection to rule out nodal metastases. Casey watches the scan and comments he should have come in sooner, but better late than never. Maggie says his lungs sound congested, so they want an echo to ensure that his heart can withstand surgery. A younger woman is present and she wonders if she should leave. Claude tells her she shouldn't feel like she has to, but she can stay if she wants. She says she will if he wants her to. Jackson decides and tells her to sit down.

Levi is presenting Judy Kemp, here for a diagnostic splenectomy for idiopathic splenomegaly. They have to explain idiopathic to Judy, who then keeps using the word. Levi points out she keeps using it wrong.

Levi follows Meredith and thanks her for choosing him. She says she did so because he's the only one who didn't suck up. Levi says it's hard when your reputation proceeds you. Meredith says they are not friends so he doesn't get to talk about her legend. He meant his own. He'll always be the one who dropped glasses in a person. Her legend is a true legend. Meredith makes it clear he has to stop talking.

Taryn is presenting Frankie Baner, a young boy scheduled for a carotid canal AVM embolization tomorrow. Frankie knows he has thick blood disease. Frankie is admitted now to reverse his anticoagulation with vitamin K. Jo compliments Taryn's presentation but tells her to wait until the mom's present next time, because she'll have questions. Frankie says his mother is in the bathroom putting on lipstick for Dr. Alex. She thinks he's stupid hot. The mother comes out of the bathroom and smiles at Alex.

Jo and Alex leave the room as she mocks him about being candy for single moms. He asks about her new job. She admits she's not scary.

Outside Claude's room, Maggie and Jackson are speculating what the relationship between Claude and Naomi is. Naomi comes running out of the room and says her father can't breathe. Father makes sense to the surgeons given the age difference. The monitor is indicating flatline, but Maggie examines and says that's not right. She asks to get Claude oxygen.

April orders meds for her patient and then walks up to Owen. She brings up Carina. Owen says it's just for fun. A monitor flatlines. As they go to defibrillate, another monitor flatlines. As April rushes over, all the monitors flatline. Intern Sam wonders what's happening. The supposedly-flatlining woman sits up and asks what's going on. Sam shocks the man in the next bed just as Owen warns her not to. The man screams and says he was sleeping. Owen has no clue what's going on.

Maggie and Jackson are in the ICU, where all of the monitors are flatlining as well.

Back in the ER, Sam attempts to calm everyone down. She says there's a technical problem but they have nothing to worry about. As she stammers on that they may have something to worry about since they are in an ER, Owen cuts in and announces they'll fix this. April finishes a call and informs Owen there are two MVC victims on the way. Owen is making calls to find out if this is happening at other hospitals.

Meredith enters her OR and assures Judy. She's never been in the hospital, so she's very nervous. Meredith shortly explains the procedure and assures her everything will be okay. As she goes to scrub, a nurse says the monitor is being weird. She'll go find another one.

Taryn paged Jo and Alex to Frankie's room. He's having a bad headache, which might mean he's having another stroke. Alex tells her to page Amelia and order a head CT. Alex asks if Frankie already got his vitamin K last night to reverse the blood thinner, but Taryn can't open the chart. Alex tries, but he can't open it either.

Bailey is experiencing the same problem as Arizona sits down with her. OB is short-staffed and they keep paging her. Bailey gives Carina privileges so she can deliver babies. The IT guy Bailey called arrives. The problem is on every computer. Tim says the cardiac monitors are also down. Arizona rushes off after hearing that. Tim is alarmed. When she re-modelled the hospital, the systems were all networked so these problems might be related to the problem with the monitors. Bailey tells him to make it stop since she can't run a hospital like this. As she says this, a message appears on every screen. Bailey starts reading: "Hello Grey Sloan Memorial. Currently, we control your hospital. We own your servers." Tim panics.

"We own your systems. We own your patients' medical records," Jackson reads in the ICU. Maggie finds this creepy.

"To regain access to your medical records you need an encryption key... which only we have," Jo and Alex continue reading on a monitor.

"You will need to pay us exactly 4,932 bitcoin to retrieve the key," Bailey reads.

"Failure to pay this ransom in a timely manner will cause your records to be destroyed and your systems to be rendered inoperable," April goes to read, but Owen quickly turns off the big screen in the ER so the patients won't panic.

April, Richard, Alex, and Amelia have gathered in a conference room with Bailey. They can't order meds, see which meds their patients are on, or monitor the patients. Bailey turns to Tim. She thought they were prepared for this. Tim says the cybersecurity seminar is this Friday. Amelia asks what they need to do. Intern Casey runs by the room and falls over a supply cart. Bailey says that is exactly what they won't do. They don't have to lose their minds just because they lost their computers. They will solve this problem calmly and quietly. None of the patients need to know about what's happening. As she says that, a team of FBI agents arrives. Heyward, the head agent, tells everyone to back away from their computers and asks for the person in charge. Richard points out people know now.

Bailey leads to the team to another conference room where they can set up. Heyward needs all computers turned off and all personnel needs to turn off WiFi on their phones. Bailey wonders how they are supposed to communicate then. She urges the agents to work fast.

Richard is giving out instructions. They are going back to paper charts and they should all share cell numbers. They need to gather all the portable monitors and distribute them to the ORs, ICU, and ER. April asks what they use in the ER in the meantime. Richard says they will have to monitor the patients themselves. Back to the Stone Age, April says.

Owen is in a trauma room with one of the MVC patients. Owen wishes he could see the CT, but it's in the patient's records so he can't access it. Owen is frustrated and wants to throw something. Dahlia hands him a pack of gauze. She also has a solution for the CT: there's one CT machine that hasn't been connected to the network yet, so they can use that.

Noami bluntly asks Maggie and Jackson if her father is dying. Maggie says his lungs are filling up with fluid, which is why she wants to put him on ECMO. That'll oxygenate Claude's blood for him so his lungs can rest and heal. They need Naomi to sign a consent form. Naomi says she can't consent since she barely knows him. Her mother left him when she was pregnant, and all she ever talked about was how bad he was in bed. Last month at her funeral, he showed up and he seemed like a pretty decent guy. She just met him and she doesn't want him to die. Maggie says they can help her get to know him if she signs the consent form. She does so.

Sam brings a portable monitor into the OR, but Meredith says they don't need it since the anesthesia monitor works. Sam updates her on the scale of the hack. They don't even have access to labs. Sam yells they are all trying not to panic. Meredith tells her to try harder and focuses back on her surgery. Levi points out that technology made this the safest time ever to get sick, but now that the computer has a bug, they are all screwed. Meredith then says she's thinking about converting to an open procedure, but then decides that she's good as long as the scope's working. She just wants to hurry and get this done.

Arizona thanks Carina for coming. A few OBs are out with the flu and the computers are all down. Carina now understands the screen must have been frozen on her last patient. She thought it was the saddest climax she'd ever seen. She's happy to help out. They walk up to the desk, where a woman is in labor. Dayna says they were having a home water birth, but Peggy panicked so here they are. April asks about the NICU. Arizona says the monitors weren't networked yet so they are unaffected. She also tells April to tell people to stop paging her for births and page Carina instead. Meanwhile, Peggy tells Carina that she wants an epidural and all the drugs and monitoring. Carina is excited to have her first patient, clarifying to Peggy that she meant in this hospital.

Owen and Dahlia find that the CT is backed up since everybody had the same idea. Owen tries to get priority, but Alex is ahead of him and says his patient also needs a head CT. They bicker and Alex thinks he wins because he has a kid. He clarifies there will be no cuts.

Richard, Bailey, and Tim are in the FBI conference room. Tim clarifies this is big. Richard says Denver Medical said they stopped the hackers, but he knows the Chief. It was just PR. They paid the ransom. Richard says they only want 5,000 so he'll write a check right now. Tim clarifies that 5,000 bitcoin translates to roughly 20 million dollars now.

Heyward wonders why they are asking for that amount of money, since they usually ask an amount that the target can easily hand over. Bailey says they announced the contest, and the hackers must think they have the money. Jackson comes in to answer Bailey's page. Bailey asks him for 20 million dollars from the Harper Avery Foundation or his inheritance. She explains they need to pay off a nerd so he can move out of his mother's basement. She would use the money from the anonymous donor, but she'd rather not contact that person. Jackson understands and says he can make it work. Heyward says it's not that simple. If they give in and pay, nothing stops hackers from pulling this on to other hospitals. Heyward asks to give his guys time to work. Jackson is with Bailey, so he'll transfer the funds if she gives him the word. He leaves the room and Bailey urges an agent to work faster.

Jackson checks with Maggie if Claude is stable. Since he is, Jackson would like to transfer him since his life is depending on a machine. Maggie says they can transport him and they rush off.

Arizona was paged to OB again. Carina did that because her patient is terrified. She wants drugs Carina can't access and she's too far along to go somewhere else. Her patient also won't listen to her since Carina suggested her partner initiate an orgasm. Arizona tells her to be choosy about that. Carina figured Arizona could calm her down since she's a mother, too.

April is working on the other MVC victim. The abdomen is distended but she can't find free fluid with the ultrasound, so they'll need to take a CT. She asks Sam and Dahlia to take her, but Richard comes in and says CT will take at least an hour. April says they don't have that kind of time. Richard has an idea. He asks for a newspaper. April goes out and grabs one from a man in the waiting room. Richard says that if you can read the newspaper through the drained abdominal fluid, there's not a clinically significant amount of blood in the belly. Since they can read the newspaper, they decide the patient can wait. Richard tells April that's how they did it in the Stone Age.

Amelia and Alex tells Frankie's mother that the head CT was clear, but it may have been too early to see a new clot or a bleed. They will monitor him closely. As the mother goes back into the room, Amelia tells Alex she's worried this might be an early warning of another stroke. Jo comes over and says she found the nurse on the case. The nurse has no idea if Frankie was given his vitamin K last night because he wasn't working, and he doesn't know who was. They need to know because they might need to administer heparin to prevent a clot, but if he was given vitamin K already, heparin would cause a brain bleed. Jo comes out of the room and says Frankie remembered Doc McStuffins was on when someone gave him an injection. It's on at 6 AM. Nurse James says Karen was working then. Since they can't call her, Jo and James run off to find her. Amelia and Alex contemplate telling the mother, but they deem it would only cause panic.

Andrew asks Richard for advice. His patient combined adderall with a Red Bull so he's tachycardic, but adenosine is contra-indicated for asthma patients. Richard says putting the patient in Trendelenburg will do the trick, and if it doesn't, he has to dunk the patient's head in a bucket of ice. Richard says there wasn't a pill for everything back in his day.

It's finally Owen's turn at the CT, but as he's asking for it, the power dies.

It also happens in the OR. Meredith starts swearing. She asks for head lamps. Levi goes to get them but bumps into a tray in the dark. As Levi starts panicking, the power goes back on. Meredith says they can't panic. She will convert to an open procedure now. She asks four units of O neg, but since the phones are down, they need to send someone down to get them. Levi leaves the sterile field before Meredith can tell him she didn't mean him, so he can go get them. Meredith tells BokHee he almost went ten minutes without screwing up.

Jackson and Maggie are transporting Claude to the helipad. They inform Naomi what hospital they are airlifting him to. Naomi wonders why as he is unstable. Jackson explains the hospital is experiencing technical issues, and if the power dies again, so will he. It's far more dangerous not to move the patient. They will see her at the other hospital.

On the elevator, Jackson says it's weird. He, Maggie, and Naomi all just met their dads recently. Maggie didn't know Jackson met his dad. Jackson says technically he knew his dad when he was young, but all he remembers from his father is him throwing him around in the pool at the Club. Maggie asks if he means the Charles River Country Club. He does. Maggie says she worked there. They come from very different families. Thank God for that, Jackson says. The elevator arrives and they wheel Claude towards the helicopter.

Meredith is struggling in the OR. She doesn't want to use anything that needs to be plugged in. She wonders what's keeping Schmitt.

Levi is trying to access the blood bank, but the code doesn't work. Jo is following nurse Karen and asks about Frankie, but Karen asked someone else to do it since she was stuck with another patient. Levi says the code won't work. Karen tells Jo she asked boy Taylor to do it. Jo runs off as Levi asks if someone changed the code to the blood bank.

Alex enters Frankie's room. Frankie is throwing up. Alex explains the headache is causing nausea. Frankie's mother wonders why it's getting worse. Alex says they are trying to find out about his meds. The mother asks him to take over so she can rinse some vomit off. Frankie feels like he's going to die. Alex says that won't happen. Frankie asks Alex to marry his mother if he dies. Alex repeats he won't die, but he doesn't look too sure.

The lights going off caused Peggy to panic, so she insists on going somewhere else to have this baby. The doctors and Dayna are trying to get her back in the bed. Arizona notices she's walking strangely. She does a quick exam and says she can feel the baby's head. She's coming now. Peggy says she's not a mother and freaks out. She's sure she'll lose her daughter. Arizona says this baby is coming. They get a gurney for Peggy to lean on. Arizona assures Peggy she can do this. She knows it feels like everything will change, but once she looks at her baby, she won't care about life before anymore. Arizona assures Peggy she wants to meet her daughter. She guides Peggy, who starts pushing. Carina catches the baby. They wrap it in a blanket as they receive an applause.

Carina congratulates Peggy and Dayna on their daughter and leaves the room. She feels like she screwed up her first patient, but Arizona tells her it was smart to call her. They made a good team. Carina says she's missed Arizona. Arizona also misses her. Arizona asks about Owen. Carina says that's just for fun, as he keeps telling her every morning. Jo runs past them.

Outside the room, Alex tells Amelia they can't just stand by and do nothing. Amelia says Frankie has a known risk of ischemic stroke, no known history of hemorrhagic ones. They have no reason to believe this is a brain bleed, but they have every reason to think he's throwing another clot. If she were a gambler, she'd administer heparin. Alex knows what he has to do.

Levi has returned to Meredith's OR. He says they are locked out of the blood bank. Meredith says Judy needs blood. Levi tells Meredith she's got this. Meredith says she doesn't, because she never would have opened Judy up if she had known she wouldn't have access to blood. Meredith asks if anyone's O -. Levi raises his hand.

Maggie and Jackson are on the helicopter. Maggie's never done that before. Jackson brings up the Club. He says he would have noticed her, but she doubts that. He guesses there are some people you don't see right away, who kind of sneak up on you. She's scared as the chopper shakes, so he takes her hand to calm her. She asks what he meant with his response to them being from different families. As the helicopter heavily shakes, one of the tubes of Claude's ECMO becomes disconnected, spurting blood all over the doctors and the helicopter. As they struggle to catch the tube, Jackson's phone falls onto the ground. He manages to catch the tube and they move to reconnect it.

Owen finds Bailey in the FBI room. They are locked out of blood and meds. They need to talk about evacuating patients. Bailey asks if they are close to stopping this. Heyward says it takes time. She's not unconcerned about all the possible future hacks and the patient lives that may be endangered by them, those are out of her control. The real patients in this hospital are in her control. They medicine they need is 20 million dollars, and she can pay them. She takes her phone to call "Aretha Franklin."

Jackson and Maggie have reconnected the tube as the pilot informs them they are cleared to land. Jackson's phone buzzes, but it's on the floor covered in blood.

Levi is donating blood. He's squeamish. Meredith tells him he's got this.

Jo finally finds nurse Taylor. Jo asks if he gave Frankie Baner vitamin K this morning. Taylor does his best to remember. He did not give him vitamin K, meaning they can not give him heparin or he'll bleed out. Jo thanks him and runs off.

Meanwhile, Alex injects the heparin.

Jo is on the elevator, trying to call Alex. He doesn't answer, so she quickly texts him not to give Frankie heparin. As she gets off the elevator, she runs into her estranged husband. He greets her and calls her Brooke, though he supposes it's Jo now. He smirks as she goes numb.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Claude Markham[]

  • Diagnosis:
    • Cancer
    • ARDS
  • Treatment:
    • ECMO

Claude, 66, was in the hospital for a thyroidectomy and bilateral neck dissection to rule out nodal metastases. His cardiac workup was good, but his lungs were congested, so they did a cardiac workup. He later stopped breathing and had to be intubated. His lungs were filling with fluid, so they put him on ECMO then moved him out of the hospital. During transport, his tube came disconnected and spurted blood everywhere.

Judy Kemp[]

  • Diagnosis:
    • Idiopathic splenomegaly
  • Treatment:
    • Laparoscopic Splenectomy

Judy, 45, was in the hospital for a diagnostic splenectomy because she had an enlarged spleen. Meredith did the procedure laparoscopically, but considered converting to an open procedure when she learned the computer systems were down, but decided to stay with the original plan. During surgery, the power went out for a minute, so they opened her up. Meredith called for blood, so Levi went to get it, but the hackers blocked access. Desperate, Meredith asked everyone in the OR if they had the right blood type. Levi was the only one, so he was hooked to Judy to give a direct transfusion.

Frankie Baner[]

  • Diagnosis:
    • Factor V Leiden
    • AVM
  • Treatment:

Frankie, 7, was in the hospital for a carotid canal AVM embolization. He'd had a stroke and needed vitamin K to reverse his blood thinners. When he developed a headache during the day, they ran a CT, which didn't show anything. They still worried that it was an early sign of another stroke, so they tried to access his records to see if he'd gotten the vitamin K or not, so they'd know what kind of stroke he was having. Due to his medical history, they believed he was having an ischemic stroke, so Alex prepared to give him heparin just as Jo learned he hadn't been given his vitamin K, meaning heparin would cause a brain bleed.

MVC Patient[]

  • Diagnosis:
  • Treatment:

A man who had been in an MVC came into the ER. He had a head CT, but because of the computer failure, he had to have a second one.

Peggy Knox[]

  • Diagnosis:
    • Pregnancy
  • Treatment:
    • Vaginal delivery

Peggy came into the hospital in advanced labor. She wanted medicine, but because of the hack, Carina didn't have access to that. Peggy refused to listen to Carina after she suggested that her partner initiate orgasm as pain relief, so she brought in Arizona. Peggy tried to leave when the power went out, but Arizona determined that she was crowning, so she talked to her and convinced her to push and her baby was born.

MVC Patient 2[]

  • Diagnosis:
    • Abdominal bleeding
  • Treatment:

A woman came into the ER after being in an MVC. Ultrasound showed blood in her abdomen, so April wanted a CT. Because they didn't have the hour to wait, Richard used a newspaper to check how much blood was in her abdomen. They determined she could wait.

ER Patient[]

  • Diagnosis:
    • Increased heart rate
    • Asthma
  • Treatment:
    • Trendellenburg

Andrew treated a man in the ER who had had adderrall and a Red Bull, which spiked his heart rate. He couldn't have adenosine because of asthma, so Richard suggested putting him in Trendellenburg and dunking him in cold water to reduce his heart rate.

Music[]

Song Performer Scene
"You're Dreaming" Wolf Parade
  • Ben trains outside.
  • Meredith is interviewed about her Harper Avery Award.
  • Jo practices her Chief Resident speech in the mirror.
  • They talk about Andrew and Sam, who are having lots of sex.

Notes and Trivia[]

Grey's_Anatomy_14x08_Promo_"Out_of_Nowhere"_(HD)_Season_14_Episode_8_Promo_Winter_Finale

Grey's Anatomy 14x08 Promo "Out of Nowhere" (HD) Season 14 Episode 8 Promo Winter Finale

  • This episode's title originated from the song Out of Nowhere, originally sung by Ella Fitzgerald.
  • This episode scored 7.52 million viewers.[1]
  • This marks Ellen Pompeo's 300th appearance as Meredith Grey, with two voice-only appearances included.
  • It also marks Jessica Capshaw's 200th appearance as Arizona Robbins.
  • The opening title card is special, showing the Grey's Anatomy logo morphing into flatline.
  • Jason George appears with no lines. Since his training scenes were filmed in July and scattered throughout the season, he filmed no new scenes for this episode due to his transfer to the spinoff.[source?]
  • Owen references The Walking Dead, a popular post-apocalyptic zombie show.
  • Jo also mentions Doc McStuffins, in which Ellen Pompeo once voiced a character.
  • Bryan Mendoza, one of the show's boom operators, makes a cameo as the boom operator shown during Meredith's interview.[source?]

Gallery[]

Episode Stills[]

Behind the Scenes[]

Quotes[]

Jo: So, just know that I'm here for you. I will lead and support you. And in return, you will not be stupid or slow or make me look bad.
Bailey: She needs to work on that speech.
Richard: You want me to run your surgical contest? Your multimillion-dollar contest?
Bailey: Okay, it's not my money. It's an anonymous donor's. And it's not my contest. It's Grey-Sloan's. Ever since we announced it, surgeons from all over have been calling, coming to kiss my ring and pitch to me. And I keep thinking it's your ring they should be kissing.
Richard: Well, I feel like something else is getting kissed.
Owen: My guy needs a head CT stat.
Alex: Yeah, so does mine.
Owen: Listen. My guy's an MVC, and he has two kids.
Alex: So? My guy's in kindergarten. So, if you want to play human poker, my hand beats yours. No cuts.
Owen: It's not cuts, Karev. This not high school.
Alex: Well, you're lucky, 'cause I was a wrestler in high school.
Carina: I haven't delivered a baby since I started my research. And this is my first patient here, and I totally screwed the dog.
Arizona: Uh, the pooch. You screwed the pooch.
Carina: Oh.
Arizona: And you didn't. You didn't. You were smart, and you called me, and we made a good team.
Carina: I think so, too. I've missed you.
Arizona: I've missed you, too. So, aren't you aren't you with Hunt now?
Carina: Nah. He tells me every morning that it's just for fun and we're not a thing.
Arizona: Well, that's so good.
Arizona: Will you tell them to stop paging me to OB? I can deliver babies, but I am not an OB. I used to be a pediatric surgeon, and now I work on fetuses and moms. And I did not go into ladies' vaginas because I do not like to mix business with pleasure.
Paul: Hey, Brooke. Oh, wait. It's Jo now, right?

See Also[]

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


References[]

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