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Pick Yourself Up

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“ In 1952, doctor Virginia Apgar pioneered a scoring system to quickly evaluate a newborn's physical health. It's given at 1 minute and 5 minutes after birth and it assesses the baby's appearance, pulse, reflexes, muscle tone, and breathing. The baby's medical team gets a score for each category, then adds them to gauge whether the baby needs immediate care. Designed to fight infant mortality the idea was simple: if we knew which babies were in trouble, could we save them? Tests and algorithms don't tell the whole story. They're snapshots in time. There's not a roadmap for every uncertainty we meet. With some things, we just have to wait and see. We have to reach down inside ourselves and find that last piece of strength. As impossible as it can be to find, we have to rise to meet the occasion. We have to rise to keep going. ”

Pick Yourself Up is the twelfth episode of the nineteenth season and the 412th overall episode of Grey's Anatomy.

Short Summary[]

In the immediate aftermath of shocking events at the clinic, the hospital goes on lockdown and the Grey Sloan doctors split up to save multiple lives. Meanwhile, Maggie lands in hot water with Winston, and Jules' roommate makes a surprise appearance.

Full Summary[]

Addison and Tia are both loaded into ambulances.

Richard is informed of the attack. He tells Amelia, who rushes off to the ER.

Levi, Link, Owen, Simone, and Lucas head out to the ambulance bay.

Teddy arrives at the scene of attack. The ambulances drive off and police arrive.

Link and Owen meet the rig with Tia Marwood. Carina informs them about Tia, who suffered blunt trauma to the abdomen. She is experiencing sharp abdominal pain. There is no vaginal bleeding. They take her inside. Jo says Bailey and Addison are right behind them; she confirms to Link that she is fine. A numb Mika trails the other doctors. Teddy announces a hospital-wide lockdown until law enforcement confirms that there is no longer a treat. The paramedics then wheel in Addison, trailed by Bailey and Benson. Addison maintains she was just clipped that it's only her shoulder. Teddy directs her to bed 5 for a full assessment anyway. Addison requests that Bailey check on Tia. Levi shouts that OB/GYN upstairs has room for the rest of the clinic overflow. Once the current group of patients is cleared, they can move on to intake of the next group. A worried Carlos checks on Levi, having heard that he was handling clinic patients and with Levi not answering his calls. Levi gets back to work while Owen, Jo, Carina, Lucas, and Bailey start the trauma work-up on Tia. Mika is told to activate massive transfusion protocol. Owen shows Lucas ultrasound images, revealing free fluid in the perihepatic and perisplenic region. Bailey wants a CT but Carina says not until they've seen the baby's tracing. Tia wishes she didn't understand how bad this is. She says her baby's name is Connor. She asks Jo to promise that they won't deliver him yet. Jo instead tells her to focus on her breathing. Carina says there are late decels, meaning the baby is in distress. Seconds later, Tia goes into V-fib. They turn her on her left side. Owen defibrillates while Lucas alerts the OR. Meanwhile, Amelia and Link are examining Addison, who insists that she is fine and refuses to be sedated for her shoulder to be reduced. She wants to help Tia. Amelia says she has six capable doctors working on her right now. Benson knocks over an instrument tray, causing Amelia to notice the band-aid on his forehead. Upon hearing about the brick, she insists on checking him out to rule out head injury. Addison then pressures Link to pop her shoulder back in. Link does so with Simone's assistance. Immediately after, Addison gets out of bed and has Simone follow her to Tia. Carina informs her about the category III tracing while Jo, Owen, and Bailey continue to perform CPR and defibrillation. Tia has been down for almost two minutes. Addison says the CPR won't work since Tia is bleeding out into her abdomen. They need to prep for a C-section. Addison refuses to let that driver take out two lives out of this family. She, Owen, and Carina get gowned and gloved while nurse Linda preps Tia for the procedure. Jo has Lucas take over the Ambu bag so she can get gowned and gloved as well. Bailey stops compressions as Carina makes the incision.

Mika is stunned as she watches the doctors work on Tia from the other side of the ER. Levi instructs her to get back to work and do intake on bed 4. Instead, she leaves the ER.

Lucas questions why they're packing Tia's abdomen, thinking she's already gone. Owen says they don't stop until they've done everything they can. Carina delivers the baby and Jo cuts the cord. Carina moves the baby to the incubator. Bailey restarts compressions on Tia, whose pulse returns. They rush her to the OR. Lucas will get Tia's husband's phone number for Bailey. Carina intubates Connor after which Addison ventilates. Simone will inform the NICU.

Ben and Maya are blocked from entering the building by a security guard until Teddy interferes. As they walk, Teddy assures them that Bailey and Carina are okay. Ben and Maya split off from Teddy to find their partners.

Amelia and Jules await Benson's head CT. Jules recalls a time where doctors were considered heroic. Benson's scan proves that there is no traumatic brain injury. Since he might be concussed, Amelia thinks he should go home but he points out he lives alone. Amelia than agrees to let him stay under supervision with regular neuro checks, which she assigns Jules to do. He can only do notes and patient intake.

Winston checks in on Maggie. He tells her Tia might not make it. Maggie can't process this so she wants to focus on her patients. They agree the world doesn't make a lot of sense. Winston says Sound Science sent copies for the partial heart transplant feature. He hasn't gotten around to read it yet but he is sure she did great. Maggie wants to tell him something but instead just thanks him for checking in.

Maxine Anderson asks Levi to get dr. Millin. He already paged her but Mika should have done her intake already. With Benson in tow, Jules arrives, surprised to see Maxine. Maxine says her friend Norma Douglas needs a knee replacement. Her knee is very swollen and red. Maxine and Norma heard that some doctors got hit by a car. Benson assures them that he is fine. Levi asks some questions regarding Norma's knee and has Jules page ortho. Norma then adds that Maxine has a burning sensation when she pees. Jules recalls the last time she kept quiet. Benson will get her a cup for a urinalysis. As they walk off, Jules informs Benson that Maxine is her roommate.

Bailey's on the phone with Brandon, Tia's husband, while she and Owen are scrubbing in. Brandon tells her not to hedge. She informs him a cardiac arrest forced them to perform an emergency C-section. A team is working on his baby as they speak. Brandon tells her to do whatever she has to to keep his family alive. After they hang up, Bailey sends Lucas to inform reception of Brandon's arrival. Bailey heads into the OR as Maya and Ben appear in the gallery. She gestures that she is okay.

Simone and Addison have gotten the baby settled in the NICU with an umbilical line. His vitals suddenly drop. Simone AMBUs while Addison starts chest compressions while urging the baby not to give up now after everything his mother has been through. They get him back. Simone is relieved.

Jules quizzes Benson on dural sutures to test his neurological status. He asks about her living with a 90-year-old. Jules was friends with her grandson in medical school and she only pays a third of what she would pay for any other place. They return to Norma's bed as Link and Levi get ready to aspirate some fluid to rule out septic arthritis. Jules moves Benson out of the way to get a front row seat to Link's movements while Norma and Maxine gush about Link's looks.

Maggie walks with Teddy, who rants about the immense pressure of the situation. Maggie brings up how the articles quotes her as saying dr. Ndugu was part of her highly skilled team of assistants. They neglected to include that it was a 50/50 effort, like she told them it was. Maggie wants the hospital to ask for a retraction. Teddy will try to put a call through to the PR department once things calm down but she advises Maggie to talk to Winston.

Maya and Ben arrive at daycare, where Pru is peacefully playing oblivious to all the chaos outside. Maya runs off while Ben looks at her in awe.

Link meets Amelia outside the NICU. She can tell Addison's in pain. Addison is like a sister to her so Link will keep an eye on her. Amelia is paged away.

Richard finds Mika experiencing a panic attack in the hallway. She admits that she's not okay.

Owen, Bailey, Jo, and Lucas are working on Tia, who is decompensating. They need to perform a splenectomy. Tia was the first applicant for the fellowship. Tia came here while pregnant because she wanted to learn how to help women. Today, she became a mother. Tia codes.

Brandon calls Bailey's phone while the surgeons rush to stop all of the bleeders. Tia's acidotic, coagulopathic, and hypothermic. They decide pack Tia and to move her to the ICU so her body can get some rest.

Maya finds Carina on the L&D floor. Carina thanks her for coming and heads into a patient room to deliver a baby.

Richard has moved Mika to an empty exam room. He hands her an ice pack to help break the shock. He has her name five objects from the room. Mike is mortified that she froze. She can't get the image of a wounded Tia out of her head. She keeps thinking it could have been her. Richard tells her not to apologize. Today was traumatic and violent. The clinic was attacked and she did not sign up for that. That's not a normal part of the job. He tells her to take the time and space she needs. This reaction makes her human.

Down in the ER, Levi informs Jules and Benson that Norma and Maxine's prelim test results are in.

Norma and Maxine refuse to be separated before being told their test results. They both have gonorrhea. Norma's settled in her knee, causing the arthritis. Norma and Maxine are asked to call their sexual partners. They take out their phones and simultaneously call Hal.


Full summary to be continued.

Cast[]

Main Cast[]

Special Guest Star[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Tia Marwood[]

  • Diagnosis:
    • Pregnancy
  • Treatment:
    • C-section delivery
    • Exploratory laparotomy
    • Splenectomy
    • Pringle maneuver

Tia, 29, was 28 weeks pregnant when she was hit by a car. She had blunt trauma to her abdomen and was complaining of sharp abdominal pain, but had no vaginal bleeding. She was taken into the ER where an ultrasound showed blood around her liver and spleen. Bailey wanted a CT, but Carina said not until she could see the baby's heart rate tracing. Tia begged them not to deliver the baby because he was too early. Carina said the baby was in distress, so they went to move her, but she crashed. They intubated and started CPR. After two minutes of CPR, Carina did a c-section. They simultaneously started an exploratory laparotomy. Once the baby was delivered, they resumed chest compressions. They were able to restore sinus rhythm and they moved her to the OR. Her spleen was shattered and her liver was lacerated, so they removed her spleen. After that, they decided to pack her and move her to the ICU to give her a break. When she started coding again, they had to open her abdomen in the ICU. Bailey did a Pringle maneuver to control the bleeding from her liver. Then they monitored and gave her fluids. She later woke up and asked about her son.

Addison Forbes Montgomery[]

  • Diagnosis:
    • Dislocated shoulder
  • Treatment:
    • Closed reduction
    • Physical therapy

Addison's shoulder was dislocated when she was clipped by a car. She was taken into the ER, where Link reduced the dislocation and Amelia checked her neurological status. Link told her she'd have to wear the sling for about four weeks, but to keep the rest of her arm moving. He also told her to do her physical therapy.

Benson Kwan[]

  • Diagnosis:
    • Head injury
  • Treatment:

When Amelia noticed Benson acting off, she insisted on him getting a CT following his head being hit by a brick. There was no bleeding and no fracture, so Benson went back to work under supervision. Amelia told Jules to keep doing neuro checks.

Connor Marwood[]

  • Diagnosis:
    • Prematurity
    • Pneumothorax
  • Treatment:
    • Chest tube
    • Surfactant

Connor was born at 28 weeks gestation via emergency c-section. Carina intubated him in the ER and then he was taken to the NICU. Addison had to do chest compressions when his heart rate dropped, which was successful. When he coded again later, Addison diagnosed pneumothorax, which she treated. She placed a chest tube and ordered surfactant.

Norma Douglas[]

  • Diagnosis:
    • Gonorrhea
    • Gonococcal arthritis
  • Treatment:
    • Antibiotics

Norma was in the ER with swelling in her knee. She said she hadn't fallen and had no relevant medical history. They called for an ortho consult. An x-ray showed no sign of fracture, but she had fluid build up around her knee. Link took a sample of it and diagnosed gonorrhea, which had settled in her knee. She was given antibiotics to cure it.

Maxine Anderson[]

  • Diagnosis:
    • Gonorrhea
  • Treatment:
    • Antibiotics

Maxine had burning pain upon urination. They did urinalysis, which showed she had gonorrhea. They gave her antibiotics.

Jackie[]

  • Diagnosis:
    • Pregnancy
  • Treatment:

Jackie was in labor and dilated to six centimeters.

Hal Stillman[]

  • Diagnosis:
    • Gonorrhea
  • Treatment:
    • Antibiotics

Hal was informed by two of his sexual partners that they had gonorrhea. They told him they wanted to give him the shot of antibiotics before his results came back because he was likely the source. He was also told to contact his other sexual partners.

Music[]

Song Performer Scene
"Daffodil" Florence + the Machine
  • The injured are loaded into ambulances.
  • Richard tells Amelia what happened.
  • Owen leads the interns.
  • Teddy checks on the incident.
  • Tia is brought into the ER.
  • Teddy orders a lockdown.
"Gold" SAILR
  • Brandon sits by Tia and Connor's bedsides.
  • Carlos brings Levi coffee.
  • Richard and Bailey send Addison off on her way.
  • Tia wakes up and asks about Connor.
  • Jo gets on the elevator with Link and cries.
  • Simone shows Tia Connor on her phone.
  • Addison gets back to the PRT.

Notes and Trivia[]

  • This episode's title originated from the song Pick Yourself Up, originally composed and written for the 1936 film Swing Time, in which it was performed by Fred Astaire.
  • This episode scored 3.70 million viewers.[1]
  • The opening sequence of the episode is one continuous shot, marking the first time in the show's history that an entire act features only shot. After director Kevin McKidd spent a long period of time putting the shot together with stand-ins, the main cast and crew rehearsed for a whole half day and only did two takes of the entire scene, the second take being the one used for the episode.[2]

Gallery[]

Episode Stills[]

Quotes[]

See Also[]

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


References[]

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