On average, our hearts beat 70 times per minute. In the same 60-second period, we blink between 10 and 15 times, swallow once, and take up to 20 breaths. Our hearts beat. Our lungs breathe. Our bodies keep us alive. And most of us barely notice. We just take it all for granted. So much of the world operates without us ever thinking about it. We expect it to work out in our favor. And most of the time it does. We worry about the future and think about the past. And we so often miss what's right in front of us. We take what's good and easy and working for granted. Until it's no longer good and easy and working for us. It's normal, but we can do better because there are tiny, beautiful gifts we're given every day. And it's up to us to appreciate them to the fullest while we can.

Head Over High Heels is the twenty-second episode of the fifteenth season and the 339th overall episode of Grey's Anatomy.

Short SummaryEdit

Meredith debates how to handle an unexpected situation in her personal life, while Richard has an untimely reunion with an old friend. Jo has a hard time at work, and Owen tries therapy.

Full SummaryEdit

Meredith and Andrew have sex in her bedroom. When they're done, she tells him he can't fall asleep here because of the kids. He gets dressed and leaves after a kiss. He sneaks down the stairs quietly, but runs into Zola as she exits the kitchen with a cup of water. He doesn't know what to say.

He just told Meredith what happened. Meredith says her kids know him as the sad guy from the couch. She had a plan about how she was going to tell them. He's glad she was planning on telling them. She checks if the coast is clear before letting him out.

Owen's carrying a crying Leo while he's on the phone with Megan. He promises he'll go to the special therapy she recommended.

Over the phone, Tucker's yelling at Bailey for having Tuck call Ben "Dad." Meredith asks how she told Tuck when she started dating Ben. Bailey knows this is about DeLuca. Meredith tells her what happened. Alex comes up and tells them Jo's back. He tells Bailey not to be Bailey about it. Jo comes up. Bailey greets her weirdly and welcomes her back. Jo leaves for the lab.

Amelia catches up with Link and Tom. It's happening. Amelia needs a moment to wag her tail before they go in. They then enter Kari's room. They got her into a clinical trial where stem cells are injected into the spine, which may cure her quadriplegia. Toby's hopeful that it'll work.

Levi and Nico are talking about the latter's upcoming job interview. The job would be in San Francisco. Levi wants him to stay here and lists some advantages of Seattle. Nico isn't listening. They have a vertebroplasty together later, so he'll see him then.

Dahlia is examining Avi Styron. She has a IBD, so she knows this is just another obstruction. Her symptoms fit her self-diagnosis. Avi knows she needs a CT to confirm. She goes to consult Andrew, but their conversation is cut short by a woman who wandered in in her bathrobe. She opens it and reveals her thorax was impaled by a high heel.

Maggie diagnoses a small pericardial effusion. Gemma says she went dancing at a new underground club. She had a few shots too many. She took off her shoes to walk up the stairs to her apartment and that's all she remembers. She must have slept like this. Richard appears in the doorway. They know each other through AA.

Levi presents John Sterman, 21, who has hereditary osteoporosis that caused a compression fracture of T11 to T12. He's scheduled for a percutaneous vertebroplasty, meaning Nico will inject cement into the vertebral body. He'll be out in time for dinner. Bailey comes up and recognizes Pop-Pop, Josh's grandfather and one of her patients for recurrent diverticulitis. Thanks to Bailey, he got to watch Josh grow up. Warren checks why Link isn't available, but Bailey assures him Nico is great, too, citing his numerous job offers, including major sports teams.

Alex discovers that Gus has built the Arc de Triomphe from Paris. Meredith appears. They haven't heard from the rare blood organizations. Meredith tried Cristina and even Marie Cerone, but none of them could help out. Meredith asks about Jo. Alex says she hasn't talked yet. It's happening. His partners are happy for a while, but then they break and leave him. She assures him Jo isn't Izzie, or Ava, or Lexie, or his mother. Neither of them is broken. Jo's been through worse. She's just not ready to talk yet.

Jackson finds Jo in her lab. She says this is the lab where boring things go to get more boring. Bailey's piling on now that she's Chief again and Jo's absence didn't help either. Jackson invites her to help him out with his spray-on skin research. Jo accepts.

Owen arrives at his therapist's office. He's skeptical that this form of therapy will work. The therapist explains that NET - Neuro Emotional Technique - is a psychotherapeutic modality in which he uses muscle testing to determine where in his body he might be holding on to unresolved patterns of stress, like trauma. Owen doesn't buy muscle testing. The therapist admits it's not the most precise manner of diagnosis, but when your mind is trying to hide something, your body can still throw you under the bus. Owen's willing to give it a shot since it helped Megan. Owen says this will supposedly help him to realize he can let joy exist in his life.

Avi's pain is causing her to move in the CT machine. Andrew paged Meredith. He's not sure it's an obstruction because Avi's in too much pain for that. It might be a perf. Andrew asks about Zola. Meredith says she seemed fine. She asks if Andrew likes kids. He shares he has 16 first cousins and his relationship with some of them. He likes kids. The scans come up. She's pregnant. The doctors are shocked. Avi's in labor and crowning.

Richard asks Maggie for a few minutes alone with Gemma, but Gemma refuses. She doesn't want Richard in here. He owes it to Ollie to check on her, but Gemma disagrees. He has a wife and kids, but she only had Ollie. And now she has tequila waiting for her at home. She threatens to call security, forcing him out.

Meredith and Andrew are delivering the baby while Bailey inquires how this happened. Qadri ordered the CT. Avi says she had her period yesterday. Bailey studies the scans and finds that Avi has two wombs. She's only pregnant in one. Meredith delivers the baby and hands him over to Avi.

Jackson brings up Jo's birth mother. He swears he hasn't talked to Alex. She wants to focus on the work, but that's also boring.

Nico injects the cement. He makes it look easy, but he swears that it isn't.

Toby asks Link if they have the stem cells. Link tells them they just have to get blood samples from their mother first. Toby says they are so aware of their limbs now. They are in awe of their body now. People mope about stupid stuff. They are so grateful for their body now. They want that for their mother.

Tom is trying to go over the procedure, but Amelia's distracted. He knows she misses her Ortho Barbie. He mocks her for dating Link. Amelia dishes that the sex is great and he's fun and easy to hang out with, which is so not her type. Tom says he's her Altman, someone who's so kind and unbroken that they seem wrong for you, but really, you've never been happier. Amelia pities him.

The therapist learns of Owen's situation with Teddy and Amelia. The therapist is not sure Owen blew it in Germany on accident. It seems like Owen's caught in a pattern. If they find the cause, they can stop it. They can do that with NET.

Bailey checks in with Josh after the surgery. Everything's looking good. Josh needs to go to the bathroom. Nico and Levi help him out of bed. Josh asks about Nico's number one choice. UCSF, Levi replies. He has a Skype interview later. Josh thinks he should find a sports team instead of a hospital. Josh suddenly loses consciousness.

Maggie's scrubbing in for Gemma's surgery. It'll be pretty simple. Richard joins her in the scrub room. The last time he saw Gemma, she had a cake for 17 years sobriety. He guesses she, too, stopped going to meetings. He didn't drink, but he was a dry drunk. He was angry. A nurse comes to get Maggie for a 911 Cardio page from Ortho. Richard can handle Gemma's case. He'll talk Qadri through it.

Andrew checks on Avi and her boy. Outside the room, Bailey declines another call from Tucker. There are worse things than having two good men who Tuck feels close to. Meredith again asks Bailey how she told Tuck. Bailey says he already knew at some level. Meredith just has to talk with her kids and make sure they know she's not going anywhere. Andrew comes out of the room and says Qadri did a pregnancy test but didn't wait for the results because Avi was so sure. Bailey reminds him to always trust but verify.

Owen and his therapist have moved on to muscle testing, which narrows the problem down to Owen's own distrust. He does not feel distrustful of Teddy. Owen thinks it's the war, but the muscle testing proves him wrong. It originated when he was 10. The therapist asks him to find the memory. Owen remembers he won an science bee award and he was really proud.

Tom and Amelia are discussing Owen and Teddy's Germany situation. Tom was hoping the baby was more of a one-night stand situation, but Amelia says it's a love baby. Amelia thinks Owen and Teddy are inevitable. Link comes in. The stem cells have arrived and the OR is prepped. Tom says inevitable doesn't scare him.

Maggie is rushing to save Josh. His pulmonary artery is destroyed. She managed to piece it back together but the graft is not holding. It's a temporary fix at best, but she's considering the transplant list. Blood starts gushing out as the repair breaks.

Owen says he ran home after school with his certificate. His mom was waiting for him. Before he could show it, she told him to sit down and told him his father had died that day. He never told anybody about the certificate. He was ashamed for being so proud and happy while his mother was so sad. The therapist thinks Owen doesn't trust joy. He stops it before the terrible news comes, but it's not coming anymore. That moment is over. He made it through. They need to stop the replay. He puts Owen in a specific position, caushing him to let go and start weeping.

Richard enters Gemma's ICU room. He tells her Maggie was called away, so he did her surgery. Gemma could sue him. Richard says it would make her a serious ingrate. He calls her a stubborn drunk. She laughs. They laugh together about what happened. Gemma says she had 17 years. She wants them back. Richard says the years don't matter. Only today matters. He tells her he nearly lost all his years not too long ago. She asks him to tell her about that day.

Before they start, Amelia thanks Link for finding the study. He thanks her for inspiring him to do so. Tom asks them to stop. They start the procedure.

Bailey's on the phone with Tuck. She tells him he hurt his father's feelings, so he's going to have to call Ben by his name again. She comes across Pop-Pop in the waiting area, who tells her something went wrong. She leaves to check what's going on.

She enters the OR, where Josh has just died. Maggie explains the massive PE caused by the bone cement. Bailey turns to Nico. He says the cement leaked out and caused a clot. Bailey points out that this man is dead because of Nico's mistake. She tells Schmitt to close and orders Nico to come with so he can take in the grandfather's grief so he'll never make this mistake again.

Jackson asks Jo what she meant by "I was right." He thinks he could help her feel less creepy. Jo says she shouldn't have gone looking like he said. Jackson says she went looking anyway, which means she needed it. Jo says she had everything. Jackson says she still does. Jo says Alex is not happy anymore. Jackson says he's just trying to help her. He's worried. Jo says communicating would only hurt. She threw all her happy aside. She took her happiness for granted and now it feels impossible to get it all back. Jackson admits Meredith asked Jackson to check in on her. Jo points out she came to work, so she's doing her best. Jackson knows she's drunk. He's glad she had the decency not to see patients today. He asks her to talk, but she goes to leave. He warns her she won't be met with compassion if she ever comes to work drunk again.

Maggie finds Richard outside Gemma's room. Unlike his surgery, hers didn't go well.

Bailey delivers the bad news to Josh's grandfather. He reminds Bailey she told them Josh was in good hands. As she comforts him, Nico stands there to take in the grief.

Andrew is holding Avi's baby. Meredith watches him from the hallway.

Tom and Amelia stand outside Kari's room. All they can do is wait now. Link invites Amelia for sushi burritos. She gladly accepts and asks Link to give her and Tom a minute. Once he's gone, Amelia tells Tom she knows he thinks he's being brave by fighting for Teddy, but that's not what's happening. Tom thinks hope scares her, which is why she's hiding behind Link to cover up the fact that she's still hung up on Owen. Amelia has learned life is a series of choices and sometimes, there is an easier way. Link is uncomplicated and it's so refreshing. She is hung up on Owen, but she is not using Link. She's just choosing an easier path. He might want to try it.

Levi finds Nico as he prepares for his Skype job interview. He thought Nico might have postponed given the circumstances. Nico lashes out at him. He refuses to let failure define his life. It might be Levi's entire identity, but it's not his. The call comes in. Nico answers and Levi leaves, slamming the door.

Maggie and Jackson have a moment in the blue room. He wants to go home and order in. She has to go home for clothes and she's so tired she might just crash there. Jackson asks her to move in. He doesn't want to take love for granted.

Owen's sleeping as Leo plays next to him. He's woken up by a text from Teddy, who's checking in on him at Megan's request.

Alex comes home. He heard about her being drunk at work. He's done playing. He needs her to talk to him. He's done hearing he has to leave her alone if he loves her. He threatens to go to Pittsburgh to find out what happened. She gets angry. She will talk to him when she's ready. If he ever threatens to go to Pittsburgh again, she will leave him. He will tell Bailey if she comes to work drunk again. She says they have a deal.

Meredith sits down with her children with ice cream. She tells them that she and Andrew are spending more time together. She confirms he is her boyfriend. He won't be sleeping on the couch again, but he will be visiting a lot more. She assures her children she's not going anymore. Zola hopes he'll leave his guitar at home. They all have a laugh.


  • Meredith Grey
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Owen Hunt
  • Jackson Avery
  • Amelia Shepherd
  • Jo Karev
  • Maggie Pierce
  • Andrew DeLuca
  • Tom Koracick
  • Atticus Lincoln
  • Kari Donnelly
  • Gemma
  • Levi Schmitt
  • Warren Sterman
  • Dahlia Qadri
  • Avi Styron
  • Therapist
  • Toby Donnelly
  • Nico Kim
  • Josh Sterman
  • Zola Grey Shepherd
  • Gus Carter
  • E. Hogans
  • Nurse Liv
  • Derek Bailey Shepherd

Main CastEdit

Guest StarsEdit


Medical NotesEdit

Kari DonnellyEdit

  • Diagnosis:
    • Paralysis
  • Treatment:
    • Stem cell injection

Kari was still in the hospital following her accident. Tom, Amelia, and Link went to her and said they wanted to try stem cell treatment, injected directly into her cervical spine, which held the possibility of her using her arms again.

Josh StermanEdit

  • Diagnosis:
    • Hereditary osteoporosis
    • Arterial rupture
    • Pulmonary artery embolism
  • Treatment:
    • Percutaneous vertebroplasty
    • Arterial graft

Josh, 21, had hereditary osteoporosis, which caused a compression fracture from T11 to T12. He was in the hospital for a percutaneous vertebroplasty, which involved cement being injected into his spinal column to stabilize it. Josh had his surgery and the cement was placed quickly. After his surgery, he seemed fine until he got up to walk with assistance and crashed. They took him back into surgery, where Maggie discovered that his pulmonary artery was destroyed due to a mistake Nico had made. She tried to patch it, but the graft wouldn't hold. Despite their best efforts, Josh was pronounced dead in the OR.

Avi StyronEdit

  • Diagnosis:
    • Irritable Bowel Syndrome
    • Pregnancy
    • Uterus didelphys
  • Treatment:
    • Vaginal delivery

Avi came into the ER with abdominal pain. She was sure it was bowel obstruction as she has IBD and had three prior obstructions, which all required surgery. Dahlia ordered a CT. Andrew called Meredith for a consult because he believed it was a perforation rather than just an obstruction because of the amount of pain she was in. When the CT came up, they were shocked to see she was pregnant and giving birth at that moment. They paged OB and Meredith stepped in to deliver the baby as Bailey observed on the CT that Avi has two uteruses, which is why she was able to have a period for the duration of her pregnancy.


  • Diagnosis:
    • Impalement injury
    • Pericardial effusion
  • Treatment:
    • Pericardial window

Gemma came into the ER with a shoe impaled into her chest. An ultrasound showed pericardial effusion. She said she'd come home after drinking a little too much and tripped on the stairs, impaling herself on her shoe. When Maggie was called away, Richard did a pericardial window to remove the shoe and repair the damage.

Gus CarterEdit

  • Diagnosis:
    • Thymoma
    • Anemia
  • Treatment:

Gus was still in the hospital awaiting his blood transfusion so he could have his surgery.

Owen HuntEdit

  • Diagnosis:
    • PTSD
  • Doctors:
  • Treatment:
    • Neuroemotional technique

Owen went to his first therapy session. The therapist used the neuroemotional technique to find the cause of Owen's pain. He narrowed the cause to when Owen was ten, prompting Owen to tell him about winning a science bee at school on the same day his mother told him his father had died. Because of that event, he sabotaged every chance he had to be happy.


Song Performer Scene
"I Like You" Club Yoko
  • Meredith and Andrew have sex.
  • Afterwards, she tells him to leave the house.
  • He gets dressed and leaves after a kiss.
  • He runs into Zola downstairs.
"Grace" Lewis Capaldi
  • Meredith delivers Avi's baby boy.
  • Jo dodges Jackson's questions about her birth mother.
  • Nico finishes up the vertebroplasty.
  • Toby tells Link they're very aware of their limbs. They want that for their mother.
  • Amelia is distracted.
"Say Something" Kadiatou
  • Richard and Maggie talk about their surgeries.
  • Bailey delivers the bad news to Josh's grandfather.
  • Meredith watches Andrew with Avi's son.
  • Link invites Amelia for sushi burritos.
  • Tom thinks Amelia is still hung up on Owen. She has learned to look for uncomplicated options. She suggests Tom do the same.
  • Nico prepares for his interview.
"Stars Are on Your Side" Ross Copperman
  • Jackson asks Maggie to move in.
  • Teddy checks in on Owen.
  • Alex threatens to go to Pittsburgh to find out what happened. Jo threatens to leave him if he does. She'll talk when she's ready but she agrees not to go to work drunk again.
  • Meredith tells her kids about Andrew.

Notes and TriviaEdit

Grey's Anatomy 15x22 Promo "Head Over High Heels" (HD) Season 15 Episode 22 Promo

Grey's Anatomy 15x22 Promo "Head Over High Heels" (HD) Season 15 Episode 22 Promo

  • This episode's title originated from the song Head Over High Heels, originally sung by Dolly Parton.
  • This episode scored 6.24 million viewers.
  • The episode was produced as the 21st of the season but aired as the 22nd instead.
  • Writer William Harper appears as Owen's therapist.
  • This marks Kevin McKidd's 250th appearance as Owen Hunt.
  • Jaicy Elliot was credited in the press release but she did not appear, nor was she credited in the episode itself.


Episode StillsEdit

Behind the ScenesEdit


Meredith: My kids know you as the sad guy from the couch.
Andrew: Embarrassing chapter in my life, yes. Have I apologized for that recently? I'd like to.
Meredith: I mean, I had a whole plan for telling my kids about us with ice cream, and they could talk about their feelings, and now it's just blown.

Alex: Jo's back. She's here.
Bailey: Oh, and here, I thought she might be dead, or...
Alex: Don't do that. Don't give a speech about how you thought she was dead or lost a limb or left me or whatever, all right? She's not okay, and I don't know why. Just don't be Bailey about it, please.
Bailey: Dr. Karev.... Welcome back.
Jo: I'll be in the lab.
Meredith: That was way worse than if you had been Bailey about it.

Tom: You miss your boyfriend.
Amelia: Who?
Tom: Ortho Barbie. Shepherd, I can't believe you have a thing with a jock!
Amelia: It's not... Shut up.
Tom: Is it weird having sex with a cartoon character? Does he drip ink on you when he sweats?

Jackson: Look, the way I see it is we can keep working in awkward silence until it's time for you to go home, or...
Jo: I vote that.
Jackson: ...or you can tell me what you meant by "I was right." 'Cause I could, maybe, help you feel, I don't know, one drop less crappy.
Jo: You told me not to go looking, and you were right. That's all, so...
Jackson: Jo, I told you not to go looking if everything was okay. You went looking, so maybe everything was not okay. Maybe you needed that.
Jo: No, no. You know what? I had everything. I had a marriage and a job and...
Jackson: Yeah, Alex is right here. You got a great job right here. You're doing it right now.
Jo: I'm spraying water on a paper towel, and Alex is anything but happy.
Jackson: 'Cause he's worried about you. He's trying to help. Come on.
Jo: I knew it. I knew it. He sent you here.
Jackson: No, he didn't. Jo, that's not what this is.
Jo: Then what is it?
Jackson: The guy's worried, okay? He's wondering. Why don't you just communicate with him?
Jo: 'Cause it would only hurt, and it won't help.
Jackson: You don't know that.
Jo: I had all this happy, and I just tossed it aside like it would always exist. I mean, we we see it all the time. We diagnose patients with terrible diseases or we tell someone that their husband dropped dead of of a heart attack, and all they can say is they were fine yesterday, and they were. They were fine. I was fine. And I took it for granted, and now it feels impossible to get it back.
Jackson: It was Mer. It was Meredith that asked me to look in on you. She knows how our parents can screw with our heads.
Jo: I'm here, okay? I'm working.
Jackson: You came to work drunk, Jo. You're still drunk. I can smell it. I'm thinking vodka in the water bottle. I'm glad you had the decency not to see any patients today. That's nice.
Jo: You don't know what you're talking about.
Jackson: You're in a lot of pain, and you're trying to numb it. I get that, okay? :Jo: It's not gonna work. I'm telling you. You're gonna ruin your life. Jo, don't leave. Just talk to me for a second. I'm trying to help you. You set foot in this hospital drunk again, you're not gonna be met with compassion.

Link: How do you feel about sushi burritos?
Amelia: That sounds like a culinary abomination, and I need one immediately.

Amelia: Look, I know you think you're being brave by fighting for Teddy, but that's not what's happening here. Your hopes are up. They're way up.
Tom: And hope scares you. And that's why you're hiding behind a very pretty, very decent guy to cover the fact that you're still hung up on Owen Hunt.
Amelia: Mm-hmm. Yeah. A thing I've learned is that life is a series of choices. And that sometimes, there is an easier, softer way. He is uncomplicated, yeah. And it so refreshing. It is like diving into a cold pool on a hot day. Am I hung up on Owen? Sure. Maybe I always will be. But am I using Link? No. I'm just choosing an easier path. You might want to try it.

Levi: Hey. I was looking all over for you. Thought you might've tried to postpone.
Nico: Can't just postpone a job interview.
Levi: Yeah, I know. But they could make an exception, you know? Because of what happened today.
Nico: Oh, you mean 'cause I screwed up so completely that someone's dead? Oh, yeah, sure, let me just call up the hiring committee and fill them in, Levi.
Levi: So, you think you're in the best condition to interview for your dream job? Just e-mail 'em, okay? Then we can get out of here.
Nico: No, you don't get it! 'Cause you let failure hold you back your whole life. It's basically your entire identity. But it's not mine.

See AlsoEdit

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

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