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It Only Gets Much Worse

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“ In 1949, Edward Murphy conducted a rocket sled experiment to see how much pressure a human being could withstand. Murphy's experiment failed spectacularly, over and over. Needless to say, he didn't start off on the right foot. That's why it's called Murphy's law. Because if anything can go wrong, it will. Once things start going wrong, it's hard to break the cycle. Murphy's law is not physics. It's just a thing a guy said to try and make sense of a crappy day. Just because things go wrong, it doesn't mean they're out of our control. It's on us to fix things. It's on us to take everything that can go wrong, and make it go right. It's on us to try, anyway. ”

It Only Gets Much Worse is the thirteenth episode of the thirteenth season and the 282nd overall episode of Grey's Anatomy.

Short Summary[]

The residents are excited for Eliza's next phase of teaching, but they spend the day caught between the warring attendings. Meanwhile, April has a challenging first day in her new role at the hospital.

Full Summary[]

As Meredith's voiceover talks about finding the limits of what people can handle, April takes a deep breath and steps off the elevator. April finds Bailey and tells her about all the work she's done. Bailey tells her Meredith wouldn't talk to her about it; she'd just do it. And she tells April to "do you" because she trusts her.

Catherine and Richard come in. Richard's not done talking about it. He's upset that she told Bailey to replace him, which she says is not what she said. She just told Bailey there was a problem. Richard asks if she'll tell him if there's a problem in their marriage or if he'll hear about it from some consultant.

April talks to an attending, who is confused to learn that she's the new department chief while Meredith is suspended. He leaves and Eliza comes up. She's heard the news and congratulates April. Then she says she needs an attending to supervise Ben doing a colectomy. The doctor who was going to do it is sick. April checks and says there's a doctor with a colectomy. She won't tell Eliza who it is but promises to get him on the surgery. Once Eliza's gone, she asks the desk nurse if she knows where Richard is.

Richard asks Jackson if he knows anything about April. He doesn't, because she was home late and out early. Maggie says she's slinking because she knows what she did. She's a traitor. Jackson's shocked that she did it. Arizona's surprised Bailey even asked her. Nathan asks how Meredith's holding up. Maggie says she's bored and worried April will kill all her patients. Nathan says April's a good surgeon. Jackson says they're losing ground. They lost Meredith and April and they don't have the residents because they love Eliza. She's starting phase two, where a resident gets to be the lead surgeon on a case. No help from the attending unless it's requested.

Stephanie's excited. Jo tells her to stop bragging. She and Ben high-five. Leah asks why it's those two. Stephanie says Eliza knows she's the best resident. She doesn't know why Ben got one. Leah thinks it's special treatment because his wife's the chief, but Ben denies that. Jo says Eliza said she drew names from a hat. Leah still thinks it's favoritism. Leah's surprised Stephanie's so excited, because last night, she wanted to start a revolution, but Stephanie says it looks like they're winning. She leaves.

April approaches Richard at the surgical board. Richard and Arizona both greet her and Arizona asks how her new job is going. April says she's busy, but it's going well. She asks to talk to Richard. She wants to go somewhere more private, but he says he's busy and tells her to say it. She tells him that his surgery is now Ben's. He tries to refuse, but she insists and he agrees.

Stephanie tells Eliza she's ready for her surgery. Eliza tells her to cancel the OR because the patient died. She asks if she should go to the pit. Eliza says yes, they should go to the ER to see if they can start one at intake. They're trolling.

Jackson tells Richard he thinks it's time they talk to his mom. Richard tells Jackson she already knows. She knew before everyone else. She's not with them. Jackson is surprised. He thought it was Bailey's idea. Ben comes up to them and says he's there for Richard because he's supposed to assist in Ben's surgery.

Stephanie is looking at the ER board and dismisses all the cases as boring or gross. Leah comes up and asks the nurse at the desk for a portable ultrasound. Eliza asks about the case. It sounds like acute cholecystitis, but she needs ultrasound to confirm. The case is now Stephanie's. Eliza says she'll get her turn and when she does, Stephanie will be there to support her.

Jackson watches April walk to a patient room.

April enters a room where Lynne Gagliano is asking where Dr. Grey is. She doesn't want April because she's not Dr. Grey. She's told Dr. Grey is unavailable, so April's going to take out her cancer. Lynne doesn't care because Meredith found her cancer, held her hand, and told her how she was going to take it out. She's been going to the same hairstylist for 23 years because she knows how Lynne likes her roots done. She wants to cancel her surgery and wait. Maggie applauds her loyalty but says they can't wait because of the risk of her cancer spreading. Maggie will be there and Lynne's roots are safe with her.

Stephanie asks Matty when the pain started. His father, Dana, explains that they were on their way to the seaport when he complained about his stomach. Hillary, his mother, adds that it's been on and off for a few days, but it got worse, so they went to the hospital. Matty says they're going on an explorer cruise. He and his dad are both very excited. Stephanie says he has gallstones and an inflamed gallbladder. He needs surgery, so they won't be able to go on their cruise.

Out in the hallway, Stephanie says that was hard. Eliza advises her not to get involved in their personal stories, but Stephanie says it was hard not to smile when she said he needed surgery. She could hug Eliza. Eliza looks around and tells her to make it quick. Stephanie quickly hugs her. Eliza tells Stephanie to talk her through her surgical plan.

Bailey's proud that Ben's doing his first start-to-finish surgery. Ben's not as excited because he wishes he had a different attending. Bailey says she'll talk to the attending. Ben says it's Richard and not to talk to him. He has enough problems being her first lady.

Jo asks if she can dissect the thoracic esophagus. Maggie says no. April says she doesn't see why not. Maggie says they already have one surgeon they didn't plan for. April knows she's unhappy about Meredith, but it's not her fault. Maggie says she and Meredith carefully planned the surgery and April just ligated a branch they might need. April defends her actions. Just then, Lynne goes into cardiac arrest. They quickly roll her onto her back and defibrillate, which stabilizes her. They have to close because she's too unstable to do the tumor resection. April asks why Maggie's looking at her because she didn't give Lynne the heart attack.

Bailey comes into the scrub room where Richard and Ben are preparing for surgery. She says she wants to watch. Richard thinks she's in there to make sure he does what she's supposed to and she thinks Ben asked her to come. Bailey says he didn't, but she wants to watch.

The doctors explain to Lynne what happened and they couldn't remove the tumor. She knew something would go wrong when Dr. NotGrey showed up. Maggie says they'll give her a few minutes and they walk out.

Outside the room, Maggie yells at April, telling her to shut up. She thought April was with them. April defends that she's just doing her job and someone has to act like an adult.

Ben talks through each step as he operates. Richard asks if he'll be the kind of surgeon who plays music in the OR. Ben might. Richard says he should pick his music carefully because he once had a resident nearly finished with surgery when a nonsensical song came on. Bailey says that resident was her and MmmBop was a very popular song at the time. Richard admits it was catchy. Bailey says her first solo surgery was also with Richard and Richard says somewhere between then and now, she forgot he knows how to teach.

Owen defends April, saying that if the Chief gives you an order, you follow it. Nathan says spoken like a soldier and Arizona thinks it's like a former chief. Owen agrees on both counts. Maggie asks if he's neutral. Owen says Bailey's the Chief, but he's not against Webber. Jackson asks what happens when you completely disagree with an order you've been given. Owen says that's a coup, which is sometimes necessary. They watch as April goes and sits at a table by herself. Jackson says they have to do something. Owen asks how April is doing. Maggie says she's a turncoat. Owen says she's also a friend. Arizona says she's a poor, misguided friend. It's like finding out your friend voted wrong. Owen asks if you can vote wrong and the others all agree that you can. Maggie says April was leading the charge, but Bailey dangled a carrot and she jumped ship. Nathan says April's great, but Meredith put the time in for the job and she deserves it. They agree to keep the peace and protect themselves. Arizona is shocked to see that a resident is a lead surgeon in a peds case.

Bailey and Richard argue as Ben finishes operating. Richard knows it was Catherine.

Arizona yells at Eliza about Matty's case. Arizona says she can't implement phase two on a kid. Eliza says Stephanie's capable of it. Arizona says Eliza's not a peds surgeon, so she's scrubbing in. Eliza says she's trained in general surgery, like Arizona, but Arizona's welcome to come in, but to observe only. Stephanie goes to prep Matty, but Eliza says she's lead surgeon, so she needs to give the family a pep talk and Eliza will prep. Once Stephanie's gone, Eliza tries to tell Arizona that's what happens when you let yourself have fun, but Arizona says not to do that. It was cute at first, but now it's not.

Bailey and Richard are still fighting. Ben finishes. They tell him he did a good job, but he's upset because they fought through it. It was his first surgery as primary and he'll never get another one. He goes to dictate the post-op report.

Stephanie explains the surgery to Matty and his parents. She says she'll come to talk to them when she's done. Stephanie then hints to Eliza that it's time for them to take Matty to the OR. She continues to give orders until Arizona tells her to rein it in.

Lynne is stable but in pain. She blames April. April asks her to be nice. She says Dr. Grey was nice. April says she's nicer than Dr. Grey. Lynne starts to cough and struggle to breathe. There's gastric fluid in her lungs. The staples didn't hold. She has to be taken back into surgery. She blames April again as they rush her to the OR.

Arizona approaches the operating table. Eliza tells her she can be in there as long as she thinks she can keep her hands to herself. If she can't, she has to leave. Arizona agrees.

Stephanie goes to place the trocar. She struggles to get it through the abdominal wall and isn't sure how hard to push. Eliza helps her push and she gets it in. Eliza tells her that was the hard part.

Maggie and April argue as they scrub in for surgery. Maggie blames April, but April defends that it could have happened to Meredith just as easily. She then tells Maggie that she can go. She doesn't need Maggie there and she has Jo if she needs extra hands. Once she's gone, Jo says that was badass. April tells her to shut up.

Stephanie is operating. Arizona reminds her of something, but Eliza reminds her to step back. Matty becomes tachycardic. The area's not bleeding, so Arizona suggests other places to check. His pelvis is full of blood. Arizona tells her to pull the trocars and she pushes Eliza aside and opens Matty's abdomen. He bleeds profusely from a mesenteric tear. He's bleeding faster than they can transfuse blood. A monitor shows that he's flatlining.

Eliza, Arizona, and Stephanie leave the scrub room. Stephanie asks what she did. Did she skip a step or should she have done something differently? She asks if she killed Matty. Arizona is shocked to see Eliza walk away and asks where she's going. Stephanie then runs in the opposite direction.

Catherine asks Richard about dinner. Richard says he's not hungry. Catherine wants them to be civil, but Richard says he was always a fine surgeon, but he is an excellent teacher. Today, he was a failure. The program has problems now. Bailey was his favorite surgeon. He took her from intern to Chief. She was his start-to-finish and Catherine turned Bailey against him. He walks away.

In the daycare, Jackson picks up Harriet. April comes in and takes her from Jackson. He thought he was taking her home, but April says she just wanted to say good night because she's working late. Jackson asks if she's enjoying this. She says she is. Jackson reminds her that they started it for Richard. April says she's still on Richard's side. They disagree about April's intent. Jackson says April chose wrong. She can tell Bailey she made a mistake and resign. April says she didn't make a mistake. Jackson thinks Catherine's pulling the strings. April hands Harriet back to Jackson and walks out.

Arizona comes into a lounge and asks Eliza what's wrong with her. Stephanie needed an answer. She's a teacher. You don't just teach them what to do with their hands. You teach them what to do with this, how to live through losing a patient. Eliza knows. Arizona says she's the attending, so it's her loss. She can't put it on Stephanie because then Stephanie might leave the program. She won't think she'll survive it. So you have to take it on yourself, tell her when it happened to her ... Eliza interrupts that it hasn't. She's never lost a kid before. She works mainly on athletes and older people. She took Matty from his parents and now she has to tell them and she doesn't know how. She asks Arizona how she does it, how she stops feeling like this? Arizona says you don't. You just learn how to feel it faster. You let it hurt, then you move on to the next kid who needs you. She remembers her first like it was yesterday, so Eliza should take her time and then they'll go tell Matty's parents.

Lynne wakes up. She's upset that April's still there. April says Lynne's still there, too. The repair went well and April also removed the tumor. Lynne is glad to hear that and asks April what her name was again. They'll have to run tests, but it looks like she's cancer-free.

Stephanie finds Richard and asks to run something by him. She tells him about Matty's case. He reassures her, saying it's not common, but it happens and neither Arizona nor Eliza caught it either. She couldn't have known. She lost and it's not her fault. Every good surgeon loses sometimes. It might be her worst, but it won't be her last. She nods. He asks the patient's name and she tells him it's Matty. She starts to cry and he hugs her. She asks what she does next.

Arizona says that if Eliza doesn't think she can do it, she'll step in. Eliza thinks she'll be fine. They get to the room and see Richard and Stephanie telling Hillary and Dana. Richard sees Eliza through the window.

Catherine sees April in a conference room working. She gives April the advice that if she can, she should work from home so she can be comfortable. April says she'd rather not because of her roommate. She stops complaining about him when Catherine makes a face. Catherine knows Jackson's mad. April asks if Catherine pulled the strings. Catherine says no, it was all Bailey. But she supported it. Jackson doesn't understand what she did because he was born with a name that means something and money. They had to work for it. Jackson works hard, but he's never had to worry like they did. There's always a safety net if he jumps. April thinks what was asked of her was bigger than herself. Catherine invited April to go have dinner with her. April says she better not, but Catherine reminds her that she's the boss, so she agrees to go.

Ben and Bailey arrive at home. Bailey asks if they're going to talk about what happened. Ben doesn't want to. He's in the middle of everything at the hospital. He's a resident, so he wants to side with them because Eliza is great for them. But the attendings are his friends. They stop talking when he's around now because he's married to her. He's in it. Bailey asks him what side he's on. He says he just wants to go to bed and stay out of it.

Arizona walks toward her car but stops when she sees Eliza in her car crying and hitting the steering wheel. She hits the horn and it honks continuously. Arizona tells her to pop the hood. Eliza yells that she doesn't have to, but Arizona says to pop the hood. Then she opens the hood up and pulls a wire, turning off the horn. Eliza gets out of the car. Arizona tells her she pulled out the horn wire, so she'll need to get it fixed. Eliza thanks her. Arizona says she's welcome and Eliza says thank you again. Arizona hugs her and tells her she could have friends there if she wanted.

Catherine and April eat dinner together.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Ben's Patient[]

  • Diagnosis:
  • Treatment:
    • Partial colectomy

Ben did a partial colectomy solo while Richard and Bailey observed. It went well and the patient was stable afterward.

Mrs. Mallenbaum[]

  • Diagnosis:
  • Treatment:

Mrs. Mallenbaum was supposed to be Stephanie's first start-to-finish surgery, but she died before her scheduled surgery.

Mr. Lewis[]

  • Diagnosis:
  • Treatment:
    • Drain

Jackson asked a nurse to check Mr. Lewis's drain.

Matty[]

  • Diagnosis:
    • Acute cholecystitis
    • Gallstones
  • Treatment:
    • Laparoscopic cholecystectomy
    • Exploratory laparotomy

Matty, 9, came into the ER with abdominal pain. Leah believed he had acute cholecystitis and ordered an ultrasound to confirm. However, Stephanie took over the case and did the ultrasound, which showed an inflamed gallbladder and gallstones. They took him into surgery and Stephanie successfully removed his gallbladder. However, there was bleeding in his abdomen. Stephanie moved the camera around to locate the source, but when his abdomen and pelvis filled with blood, Arizona took over and converted to an exploratory laparotomy. She found a tear in the mesenteric artery from the trocar insertion, but she was unable to stop the bleeding and Matty died in the OR.

Lynne Gagliano[]

  • Diagnosis:
    • Esophageal cancer
    • Myocardial infarction
  • Treatment:
    • Tumor resection

Lynne had been diagnosed with esophageal cancer. She was in the hospital to have surgery to remove it. However, during her surgery, she had a heart attack. They were able to resuscitate her, but she was too unstable to continue her tumor resection. Lynne later struggled to breathe. She had gastric fluid in her lungs and they had to rush her back into the OR, where April repaired the damage and removed Lynne's tumor.

Music[]

Song Performer Scene
"Found My Vibe" Sarah Bollinger
  • As Meredith's voiceover talks about humans under pressure, April steps off the elevator after taking a breath.
  • She talks to Bailey about her work.
  • Bailey says Meredith wouldn't talk to her about it. She'd just do it.
  • She tells April to "do you."
"Kiss My Feet" Laura Mvula
  • Arizona steps in to take over Matty's surgery.
  • She hurries to try to save his life, but he's bleeding faster than they can transfuse.
  • A monitor shows a flatline.
"Blinded By the Lights" Dan Caplen
  • Catherine and April leave to have dinner.
  • Ben and Bailey come home and Bailey asks if they're going to talk about what happened.
  • Ben says he needs a break, because he's in the middle of everything, being a resident married to the Chief.
  • She asks whose side he's on.
  • He says he just wants to go to bed and stay out of it.
  • Arizona sees Eliza crying in her car.
  • Arizona goes to help her turn off her horn.
  • They hug and Arizona says she could have friends there if she wants.
  • Arizona goes to her own car.
  • Catherine and April eat dinner.

Notes and Trivia[]

Grey's_Anatomy_13x13_Promo_"It_Only_Gets_Much_Worse"_(HD)_Season_13_Episode_13_Promo

Grey's Anatomy 13x13 Promo "It Only Gets Much Worse" (HD) Season 13 Episode 13 Promo

  • This episode's title originated from the song It Only Gets Much Worse, originally sung by Nate Ruess.
  • This episode scored 7.68 million viewers.[1]
  • The prep dates for this episode were from November 15 to November 23, 2016.[source?]
  • Filming for this episode was scheduled from November 28 to December 8, 2016.[source?]
  • This episode was produced as episode 13x10 while You Can Look (But You'd Better Not Touch) was produced as 13x13, and they were switched in the episode order of the season. However, given the continuity between You Can Look (But You'd Better Not Touch) and Jukebox Hero, it's obvious they were meant to air in the order that they did.[source?]
  • The other kids shown in the background at the day care at the hospital are mostly kids of crew members.[source?]
  • This episode is the last to feature Tessa Ferrer as Leah Murphy.

Gallery[]

Episode Stills[]

Behind the Scenes[]

Quotes[]

April: I'm nicer than Dr. Grey. I mean, ask anyone in this hospital. I mean, there are comparisons that you can make between myself and Dr. Grey, but in a contest of niceness, I take that win. I win by a lot. I am the nicest.
Jackson: You realize how this looks, don't you? You realize what everybody's saying? That you're an opportunist? That you're an overly ambitious...
April: And you told them that they're wrong, right? Because you know me, and you know better. Right?
Jackson: I'm surprised by you. That's what I am. Look, Bailey gave you a choice. That's what that was. It was a choice. You chose wrong. But it's not too late. You could still resign. You could still tell her that you made a mistake.
April: Yeah, but I didn't make a mistake. I have a duty to this hospital. My chief asked me to step up, so I...
Jackson: Did she? Or was that my mom again, telling Bailey that she should pick you?
April: Why would you say that?
Jackson: Cause it's probably true. It's not even your fault. It's her. It's what she does.
April: No. No, it's you. Because you refuse to believe that I got this because I earned it.
Eliza: It's never happened to me. I never had a child die.
Arizona: Never?
Eliza: Not a kid. Not in residency, not as a fellow, and now I work on athletes and old people. Old, broken hips, torn ligaments. Never a little boy. I took that boy from his parents and now I have to tell them. And I don't know how. How do you do it? How do you stop feeling like this?
Arizona: You don't. You just learn how to... You learn how to feel this way a little faster. You let it hurt, and then you put it behind you so that you can face forward to the next kid who needs you.
Catherine: April, Jackson can never understand what you did. He's not like you and me.
April: Like you and me?
Catherine: He was raised with money, connections, a name. You and I had to work for it.
April: I don't know. I mean, Jackson has worked...
Catherine: Oh, Jackson's always worked hard. He worked hard in school. He works hard now. He's earned his success. It's just, he's never had to worry like us. He's always known if he leaps, there's always a safety net. The tough choices for you and me are tougher.
Ben: I need a break. I'm in the middle of everything at the hospital.
Miranda: You are in the middle of everything?
Ben: Yes, me, Miranda. I'm a resident, you know? So I want to side with them because Minnick is great for us, but the attendings are my friends. Now they stop talking when I'm around, because I'm married to you. Yeah, I'm in it.
Miranda: Well, if you're so in it, whose side are you on? I would like to know.
Ben: I just want to go to bed and turn my brain off until I fall asleep and stay out of it.
Maggie: She's my patient.
April: No, actually, she's Dr. Grey's patient, and I'm Dr. Grey now. I'm in charge, whether you like it or not, and until you get on board with that, you are not welcome in my OR. So you can stop scrubbing and you can go.
Maggie: You're gonna need an extra set of hands.
April: Wilson has hands.

See Also[]

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


References[]

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