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Unless you're paid to be there, no one ever wants to go into an OR. It's freezing, you're naked, and a stranger will be cutting into your body with knives. But what patients don't know, and what we try to keep them from knowing, is sometimes, it's just as terrifying for us. Traumas, heart surgery, anything to do with the pancreas. Any surgeon who says they're not afraid of those is lying. But no matter how risky the surgery, no matter how scared you might be, your job is to reassure your patient and tell them everything is going to be okay. Whether you believe it or not. Sometimes, surgeries go better than planned. There's no better gift you can give someone than saying you've saved the person they love. I look forward to those moments. Unfortunately, those perfect outcomes are rare. You would think it gets easier, but it doesn't. Each one hurts just as much as the last one. So we hope for the best and prepare for the worst. Because the worst has a nasty way of finding you.

Put on a Happy Face is the twenty-first and final episode of the sixteenth season and the 363rd overall episode of Grey's Anatomy.

Short SummaryEdit

Link tries to convince Amelia to take it easy during the final stage of her pregnancy. Hayes asks Meredith a surprising question. Owen makes a shocking discovery.

Full SummaryEdit

Catherine sits by Richard's bed and holds his hand as he stares straight forward.

The doctors go over possible diagnoses for Richard.

Bailey is playing cards with Richard when he suddenly blanks and stops playing.

Meredith writes something on the board and Andrew tells her she just wrote that in another place. She erases it.

Maggie brings coffee and a pastry to a minimally-responsive Richard.

The doctors come in and out of the room and pore over books, looking for possibilities.

Andrew asks Meredith if Richard has had hiccups because it could be Creutzfeldt-Jacob. Andrew leaves to get another tablet because his has died. After he's gone, Maggie puts a piece of paper in front of Meredith, saying it's the permission form for Zola's field trip. Meredith says that's next week but Maggie tells her now is next week. Maggie asks if Andrew's been sleeping and Meredith doesn't know. Maggie reminds her of when her mother was sick and Maggie couldn't accept that she was dying and put her through unnecessary tests and hurt her. She thinks Meredith is doing the same thing by refusing to accept that it's Alzheimer's. Tom and Amelia both think so and Catherine's taking him home.

Amelia finds Link at the surgical board. They both have surgeries schedule. Link suggests that she should take it easy, but she reminds him that she'll be off for some time after giving birth. Nurse James tells her her OR is ready and she goes to operate.

Teddy gives Taryn instructions on her patients. Taryn congratulates her on the wedding, even though marriage is an outdated concept. They come across Owen and Tom, who are arguing. Owen says Tom ignored his request for time off for the wedding. Tom says he didn't even see it. He saw the subject line and it didn't seem urgent because the wedding's a few months away. Owen corrects that it's actually tonight. Tom is surprised to learn that, but approves Owen's time off. Once Owen walks away, Tom calls Teddy out for not warning him. Tom feigns happiness for her.

Cormac, Jo, and Jackson enter the room of Daya Burman. She tells them she'd be better if she could get a smiling picture for this dating profile, which is not hers, but her father's. Daya has Moebius Syndrome, which has left her unable to produce normal facial expressions, leaving her in a permanent frown. They're planning a surgery to harvest nerve and muscle from her leg and graft them into her face. Daya says she knows the surgery because it's been scheduled and cancelled four times in the past year. Her father is scared of hospitals since her mom died and has bailed out on her having the surgery because of that. Daya says she wants this for herself, before she goes to high school. Daya snaps a photo of her father and says she won't post it if he promises not to chicken out again.

Levi meets an ambulance outside the hospital. Inside is CJ Madison, who was hit in the chest with a baseball bat. Levi thinks blunt trauma, but is surprised to see the bat is impaled in his chest. CJ says Levi should see the other guy. He's totally fine.

Andrew tries to convince Catherine not to take Richard home. Catherine says they've had weeks and have found nothing. Andrew tells her if she takes him home, she'll be killing him and Meredith calls him out on that and tells him to take a walk. Meredith apologizes for Andrew's behavior. Meredith told him not to come up there, but he didn't listen.

Richard says he's not a child and doesn't want to get into the wheelchair. Bailey tells him it's just to the door. He stands to walk and slips back onto the bed. He gets angry and insists it's just because his feet were asleep. He asks for a minute to get the feeling back in his toes. Meredith asks what he means by that. He says they're numb and tingly. His fingers are as well. She touches his leg and he flinches away. That's not consistent with Alzheimer's, so she wants to do an EMG to check his nerve function. Catherine agrees to let Meredith run the test.

In the ER, Owen is checking out CJ and orders tests. He's worried that it might be in his heart when he hears Owen ask for cardio. He's a minor league baseball player hoping to get called up to the majors soon. They prepare to take him to CT and then to surgery to remove the bat.

Richard is having the test as Amelia explains what they're doing to Taryn. Tom shocks him twice and his toes don't move as expected either time.

Meredith says this shows that his body is breaking down, not just his mind. Tom and Amelia also agree that it's not Alzheimer's. They agreed to do a nerve biopsy and keep searching. Maggie gets called away for a consult, then Amelia turns Richard over to Tom because her water just broke. She tells them to go ahead and take care of Richard as she apologizes for the mess on the floor and then starts talking to labor and delivery. Meredith says she'll call Link and wishes Amelia good luck.

Daya asks if they're at the line only patients and doctors can cross yet. They aren't and she says she asked because of her father, who has suddenly appeared to call off the surgery again. He's freaked out and says he just doesn't want to lose Daya and thinks she's perfect just as she is. She reminds him that her mom wanted her to have it. She wanted her to be able to smile. Jackson explains to Samar the importance of the surgery for Daya. Daya says she wants to be able to smile. He agrees to let her go forward with the surgery and she hugs him. She wants him to promise to swipe right at least once while she's in surgery.

Tom enters an elevator where Teddy is. She heard about Richard. Tom says that's the talk of the hospital, that and her upcoming wedding. Teddy doesn't want to talk about it. She says she loves Owen. Tom says she also loves him and she's rushing to the altar to convince herself she can live without him, but she can't. Teddy says the wedding his happening. Tom doesn't think it will.

Link rushes in and Carina says he just missed the initial exam which showed that Amelia is at five centimeters, surprising both Amelia and Link. Link asks if she felt any contractions. She say no and then thinks. She says they started at 9 AM, but she ignored them because she thought they were just Braxton Hicks. Carina says she's definitely in active labor and goes to get a fetal monitor. Amelia sees that Link brought a bag and asks if he's skipping town. He tells her it actually just has supplies for them. He offers to go get her something to eat, but she asks him to stay.

Levi flinches in pain looking at CJ who is getting a CT. Owen says it's not in his chest. Maggie comes in to consult and also reacts to the injury. Maggie looks at the scan and says she can fix it without bypass unless it tears. Levi says he's a pitcher in the minors hoping to get called up, but Maggie says that won't happen anytime soon. Levi flinches again and Owen says it's not happening to him. Levi says that CJ worked his whole life for this.

Jo wonders if Samar will do as Daya asked and swipe right. Jo wonders if dating apps are her only option now. She doesn't know what to put in her profile because she hates everything except mac and cheese from a box. Jo asks Jackson if uses dating apps. Jo then asks Cormac, who says he doesn't have any dating apps. Jo says he has his own personal matchmaker and changes the subject when he tries to ask her about that.

Andrew struggles to stay awake as he checks another book.

Tom finds Catherine, who hasn't heard anything about Richard yet. She says she's screwed up everything this year. Tom reminds her of the time she borrowed his car and forgot to put the parking break on, which led to his car rolling down a hill and sinking in a lake. Catherine says depending on the results of the biopsy, she might be asking him to play a bigger role at the Foundation. Her first choice is Jackson, but she doesn't want to put extra pressure on him. He tells her the Foundation is her life and she says it won't be for as long as Richard needs her. She gave up on him once and she'll never do that again.

Bailey and Meredith prepare to do the biopsy. Bailey wants to say to bring in someone who isn't family, but both she and Meredith know that person doesn't exist. As Bailey prepares to cut, Andrew comes into the room to stop her. He says Richard got a hip replacement in Boston three years ago. Bailey tells him to wait outside and they'll talk about his thing afterward. He knocks a tray of instruments on the floor and asks if they can talk now. Bailey orders him out of the OR. But he tells her that she doesn't need to do the biopsy because his hip is made out of cobalt. They tested for heavy metals, but that one wasn't on the test. It could be deteriorating and that would explain everything. Bailey says they need to draw some blood, but Meredith has already done it. Bailey sends it to the lab with Andrew and instructs him to move it to the front of the line.

Catherine asks if she really believes a hip replacement caused all this. Meredith believes so because it's a metal on metal joint and it's possible the friction caused it to wear away and get soaked into his bloodstream. He definitely got a cobalt hip. The labs come in and show a cobalt level of 200, much higher than the normal average of 8. The damage won't be permanent. They just have to get the hip out as soon as possible and replace it. Catherine tells them to go operate right away. Andrew asks to scrub in, but Bailey tells him to go home. Meredith says it was a major save and he should get to scrub in. Bailey tells him he can scrub in, but he can't touch Richard. Bailey goes to find Link. Meredith says he's with Amelia, but Bailey says he won't be anymore. Andrew thanks Meredith, but she just says not to make her regret it.

Amelia apologizes to Link as she squeezes his hand. He tells her it's okay even though he's in visible pain. Carina says she's progressing nicely. Bailey comes in and says she needs Link. She explains that it's for Richard and Amelia says it's okay for him to go once Carina confirms they still have hours to go. Link kisses her and tries to leave, but she pulls him back in for another one, saying it helps with the pain. Carina does a little dance when she hears that and says she told them. Once he's gone, Amelia reaches out her hand to Bailey, saying she stole the father of her baby while she's in active labor. Bailey reluctantly takes Amelia's hand.

Jackson is almost ready to close Daya's cheek. Jo says she read that 98% of women have been told to smile more at work. She doesn't know why there's so much pressure to smile all the time. It's not natural. Taryn then comes in and asks if Jackson's almost done. She tells him about Richard. Cormac tells him to go and they can finish and close for him. Jo says that's score one for Andrew, but Cormac is still surprised they let him anywhere near the case with how he's been acting.

Maggie's phone chimes as she works on removing the bat. She asks what the odds are that the bat would shatter. Owen says maple bats shattered easily, which is why they're phasing them out in favor of ash. Maggie's phone chimes again, so she sends Levi to check it. She has a text from Winston, which Maggie tells him not to read. She also has texts from Meredith, Bailey, and Taryn, telling her about Richard's hip. Owen says Maggie can go if she needs to, but she says she's okay. After a second, she goes back to operating.

Teddy goes to see Tom, who paged her. Tom tells her a story of when he stopped his car when he saw a man on the bridge hanging over the edge. He thought the man was going to jump, but he was actually calling a radio station for concert tickets and the reception was better over the water. He tells Teddy not to throw her life away. She tells him she's marrying Owen, but Tom reminds her that she loves him, too. He won't give up on her. He says he'll be in his car in lot B at 7:00, waiting for her, to take her wherever she wants to go. They start kissing, but Teddy says they can't do it. He kisses her again and she admits that she loves him, too.

Catherine watches as Link preps for Richard's surgery. Jackson comes in and sits next to her. Link asks if they ended Andrew's suspension and he says they did temporarily. Bokhee says a prayer as more people file into the gallery. Link takes a moment and then asks for the scalpel and starts the surgery.

They find that the hip replacement has mostly turned to sludge. He starts to pull it out. He says it's not just Richard because these hips were the new standard for a while. Link asks for an update on Amelia.

Bailey takes a rag for Amelia's forehead as Carina comes in to check on her. The contractions are less than three minutes apart. Carina again offers Amelia an epidural, but Amelia knows there's fentanyl in those and declines. Amelia then wonders how, after the first time, any woman ever gave birth again or allowed another woman to do that. Bailey says they do it because they're so in love with someone that the two of them can't contain it all, so they create another person out of that love. Amelia suddenly remembers Bailey's miscarriage and apologizes to her. She says Bailey can leave if she wants. Bailey says that would go against the rules of Pregnancy Club and holds Amelia's hand.

Jo and Cormac tell Samar and Daya that her surgery went well and the bandages should be able to come off soon. Her recovery will be long and she'll need rehab and speech therapy. Daya tells her dad that everything was fine. Just then, Katrina Scott comes in and asks Samar how she's doing. Then she notices that Daya's awake. Daya's surprised to see her Algebra teacher there. Katrina tries to make up an excuse, but Daya realizes they're dating. Their dentist set them up and he didn't know she was Daya's teacher at the time. They didn't want to tell her until the school year was over. Samar thinks she's upset, but Daya says she's actually trying to smile.

Jo says now they know why Samar never swiped right. Cormac says he hates set-ups, but if it makes them happy. Cormac asks Jo about her lack of interest in dating personally. She says her being miserable doesn't mean everyone else should have to be. He says he suspects people are having conversations about his personal life behind his back. Jo tells him he should smile more and then leaves.

Carina tells Amelia it's time to push. Amelia says she can't. Those other woman have drugs and masturbation and c-sections and she doesn't even have Link. Bailey tells her to sit up and then moves behind her. She has Amelia lean back into her and helps her push. Carina tells her she needs one more.

Link continues to work on Richard, removing the old hardware. Then he places a new hip and checks the mobility. He then gives a thumbs up to the gallery.

Maggie removes the bat shard. Maggie's phone goes off again and Levi tells him Richard's out of surgery and stable. Linda cheers as Maggie is relieved. Maggie says she'll stay and finish the surgery. She suggests Owen might need to leave to get to his wedding, but he says he's okay to stay. His phone chimes and Levi checks it. It's a voicemail from Teddy and Owen has him put it on speaker. He does and it's Teddy moaning. Owen has him turn it off and says that must have been meant just for him, like a wedding gift. They all laugh nervously, but go back to the surgery.

Link comes into the room and asks Amelia if it was another false alarm. She says she's okay and Bailey calls him over to meet his son. He walks over to Bailey and she hands him the baby. He then walks over to the bed and sits on the bed next to Amelia. She says he's beautiful and Link says they both are. Bailey looks at them for a moment and then leaves the room.

Bailey checks on Richard, who is stable but still unconscious. They won't know more until he wakes up, but the hip was rotted.

Owen gives Levi orders on CJ. Levi is upset that CJ is missing his chance at the majors. Owen reminds him again that it's not happening to him personally. He tells him to suck it up and do his job. If he can't, he needs to find a different job.

Owen goes into a supply closet and plays the voicemail again. The rest of the voicemail reveals that she's having sex with Tom, though she tells Tom that it's goodbye and she's going to marry Owen still.

Richard starts to wake up and recognizes Maggie. She asks him some simple questions and he answers them easily. He's also able to hold out his arm with no tremor. Just then, Catherine comes in and says the nurses are going to bring in a bed so she can spend the night with him. He knows who she is, but is upset that she's there. She says she's been there the whole time, but he reminds her of when she sold the hospital he worked at to get back at him. He tells her to get out. Jackson tells her to give him some time and leads her out.

Cormac finds Meredith and says that was an incredible catch with Webber. She tells him it wasn't all her. He invites her to get a drink to celebrate. She wants to, but she's too tired. She tells him to ask her another time and he says he will. Once Cormac is gone, Meredith sees Andrew leaning up against the nurses' station, crying. She tells him it's over. He says he doesn't know what's going on, so she tells him they'll go home and leads him out.

Amelia and Link sit with their son.

Teddy looks at herself in the mirror. She's in her wedding dress. She goes out to the living room to find Evelyn taking down the decorations. She says they'll reschedule. Teddy's confused. Evelyn says Owen got called into a last-minute surgery and didn't call Teddy.

CastEdit

  • Meredith Grey
  • Miranda Bailey
  • Richard Webber
  • Owen Hunt
  • Jackson Avery
  • Amelia Shepherd
  • Jo Karev
  • Maggie Pierce
  • Andrew DeLuca
  • Teddy Altman
  • Tom Koracick
  • Levi Schmitt
  • Atticus Lincoln
  • Catherine Fox
  • Cormac Hayes
  • Evelyn Hunt
  • Carina DeLuca
  • Taryn Helm
  • CJ Madison
  • Samar Burman
  • Daya Burman
  • Katrina Scott
  • Nurse James
  • Lab Tech Jeffrey
  • Paramedic
  • Hannah Brody
  • Mabel Tseng
  • Nurse Karen
  • Bokhee

Main CastEdit

Guest StarsEdit

Co-StarringEdit

Medical NotesEdit

Richard WebberEdit

  • Diagnosis:
    • Cobalt poisoning
  • Treatment:
    • Explantation and hip replacement

Richard continued to struggle as the doctors searched for a diagnosis. After two weeks of tests, Catherine decided to take him home, believing he had Alzheimer's. When he was being discharged, he mentioned that his toes were tingling, but just believed they'd fallen asleep. His fingers were also numb. Since the symptoms were inconsistent with Alzheimer's, Meredith asked to do an EMG to check his nerve function. The test showed nerve degeneration. The next step was to do a nerve biopsy. They went to do the biopsy, but Andrew came in and stopped them. He said that Richard's replacement hip was made of cobalt, which he believed was leeching into Richard's body. They drew blood and tested him. He came up positive for cobalt toxicity, which explained all his symptoms. Link took him in to remove the hip and replace it with a new one. His surgery was successful and he was stable and awake afterward.

Daya BurmanEdit

  • Diagnosis:
    • Moebius syndrome
  • Treatment:
    • Bilateral gracilis transfer

Daya, 13, had Moebius syndrome, which left her unable to make facial expressions. They planned a bilateral gracilis transfer. She'd been scheduled to have the surgery four times in the past year, but her father backed out each time. He tried again to withdraw his consent, but the surgery went forward. They harvested the nerves and muscle from her legs and transferred them to her face. The surgery went well and she was told she'd need speech and rehab as part of her recovery.

CJ MadisonEdit

  • Diagnosis:
    • Impaled object
  • Treatment:
    • Surgical removal

CJ, 21, came into the ER with a baseball bat impaled in his chest. They took him for a CT and prepared to operate and remove the bat. Maggie consulted and joined the surgery due to the bat's proximity to his heart. They were able to remove the bat and repair the damage. He was stable after his surgery.

Amelia ShepherdEdit

  • Diagnosis:
    • Pregnancy
  • Treatment:
    • Vaginal delivery

Amelia's water broke, so she went to OB. She had a pelvic exam which showed she was at 5 cm. She then admitted she'd been having contractions since 9 that morning, but thought they were Braxton Hicks. Her labor progressed over several hours and she gave birth.

MusicEdit

Song Performer Scene
"Up, Up & Away" Chance Peña
  • Catherine sits with Richard.
  • The doctors talk about diagnoses.
  • Bailey plays cards with Richard.
  • Meredith and Andrew go over options.
  • Maggie brings Richard food and sits him up to eat.
  • Everyone works around the clock on Richard's case.
"Love Like Ours" Aron Wright
  • Tom tells Teddy he'll wait for her in his car.
  • She tries to pull back, but then admits that she loves him.
  • Jackson joins Catherine to watch Richard's surgery.
  • Link is surprised to see Andrew in the surgery.
  • Bokhee prays and then they start.
"Here Right Now" Lindsey Ray
  • Bailey sits behind Amelia as she pushes.
  • Richard's surgery continues.
  • Link finishes and checks the joint, then gives a thumbs up to the gallery.
"Cloud Chaser" Jill Andrews
  • Bailey hands Link the baby and he takes the baby to Amelia.
  • Bailey checks on Richard, who is stable.
  • Owen gives orders to Levi.
  • Owen goes into a supply closet and listens to the voicemail.
  • He hears Tom and Teddy, then Teddy saying she's marrying Owen and that was goodbye.
"Lonely Hearts Club" Winona Oak
  • Jackson leads Catherine out.
  • Cormac and Meredith talk about Richard and he invites her to get a drink.
  • She says yes, but she's exhausted, so he should ask another time.
  • Meredith finds Andrew crying and takes him home.
  • Amelia and Link sit with their baby.
  • Teddy is dressed for the wedding.
  • She finds Evelyn taking the decorations down, saying Owen got called into a last-minute surgery.

Notes and TriviaEdit

Grey's Anatomy 16x21 Promo "Put on a Happy Face" (HD) Season 16 Episode 21 Promo Season Finale

Grey's Anatomy 16x21 Promo "Put on a Happy Face" (HD) Season 16 Episode 21 Promo Season Finale

  • This episode's title originated from the song Put on a Happy Face, originally from the musical Bye Bye Birdie.
  • This episode scored 7.33 million viewers, a season high.
  • This is the final episode which was filmed before COVID-19 forced them to shut down production, which led to it becoming the finale for the season.
  • This is the first season finale since Family Affair not to be directed by Debbie Allen.
  • It's the first season finale ever not to feature Justin Chambers as Alex Karev.
  • This is the only season finale of the series not to air in May.
  • The scene where Bailey sits behind Amelia because Link wasn't in the room to help Amelia with the birth, is a parallel to when George sat behind Bailey when Tucker wasn't in the room when Bailey was giving birth in As We Know It.
  • The terms "swipe right" and "swipe left" used in the episode come from the popular dating app Tinder.
  • Many clifhangers are left such as:

What will happen to Deluca?

What will happen with Teddy and Owen?

Is Richard out of the woods?

What will Amelia and Link name their baby boy?

What will happen with the aftermath of Alex leaving Jo?

What will happen with Maggie and Winston?

GalleryEdit

Episode StillsEdit

Behind the ScenesEdit

QuotesEdit

See AlsoEdit

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

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