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Should I Stay or Should I Go

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“ In 2019, the World Health Organization officially recognized burnout in its international classification of diseases. Studies show that doctors who report signs of burnout have enlarged amygdalas, the area in the brain that regulates fear and aggression. But burnout isn't an academic exercise. It's an all-consuming, systemic condition. It's your entire body sending you one clear message. Something has to change and it has to change now. Put simply, burnout comes from a deep imbalance. Too much stress with too few rewards. You're exhausted. Depleted. You no longer have patience, pleasure, or serotonin. This is the end. Unless you turn it into something else and find your path to recovery. Pick the pieces you want from your life and find a new way forward. ”

Should I Stay or Should I Go is the sixteenth episode of the eighteenth season and the 396th overall episode of Grey's Anatomy.

Short Summary[]

Bailey faces an unhappy Catherine who is facing audits for several of her Foundation hospitals. Meanwhile, Addison is back at Grey Sloan, tensions rise between Meredith and Richard, and Owen returns to work.

Full Summary[]

Bailey is in line to get her smoothie when Jordan shows up to get her the smoothie. She wants to do it herself because she can't bring herself to go inside that depressing building. She asks him to leave her alone. Catherine overheard her telling off her resident and summons her to her office.

The Hunt family arrives at the hospital. It's Owen's first day back at work. As Owen says goodbye to cowboy Leo, Leo says he's a girl. Teddy quickly corrects and says it's just a costume. She then takes the kids to daycare.

Taryn and Levi are on the elevator. Taryn reads that if the program loses its accreditation, they are orphaned and might not get a residency spot somewhere else. They might even have to switch to a different field of medicine. Levi doesn't want to hear this on his first day back. Nico gets on the elevator with them. They all stand in silence until he gets off.

Catherine has gathered Bailey and Richard in the Chief's office. Her foundation's reputation is threatened since the Medical Accreditation Council is looking to visit 20 other Fox Foundation hospitals. They need to solve this problem.

Meredith overhears their arguing as she walks past the Chief's office. Maggie needs to tell Bailey that her fellow quit this morning. Amelia says it makes sense to jump ship. Maggie wants Meredith to reverse her decision but she made it before the probation was announced. Maggie comments some people are actually interested in saving GSMH and leaves for a presentation. Amelia is pro Minnesota. Addison then arrives asking what they did to this place. Amelia hugs her.

Wendell is giving a presentation on HeartPatch, a patch that will transmit a continuous ECG and a patient's vitals to an app. Wendell charms the room but Winston appears skeptical. Maggie suggests they try out the patches on some patients today. Wendell goes to grab a few samples.

Jo runs into Todd, whose sister baked snickerdoodles for Jo. Todd heard about the probation situation. Jo explains it's just the surgical program and the hospital will continue to operate through its attendings. Todd has to leave for a meeting. Link comments that Jo appears to be trying hard to like Todd. She wants nice to be her type. Link supports that.

In the ER, Owen brings up the incident from this morning. Teddy thinks they should get a therapist. Their conversation is interrupted by the arrival of a bloodied Colin, supported by Diana, a colleague of his. His arm got cut off by a conveyor belt. She hands the arm to a resident as Owen moves Colin to a trauma room. Diana collapses right after.

Link and Owen examine Colin and promise to inform his wife. Link questions if Owen is up for a marathon surgery that is an arm reattachment. They move Colin to the OR and page neuro.

Teddy and Jordan find that Diana just had a vasovagal response. She saw the accident happening and it keeps playing over and over in her head.

Addison is worried that the hospital isn't functioning well enough to handle Tovah's case. Tovah is experiencing pain while she is now 11 weeks pregnant after two IVF cycles. Amelia informed Addison of Meredith's offer. Meredith adds that Bailey and Richard are pissed off. It reminds Addison of the old times. She gets on the elevator with Richard, who hugs his "favorite student" with a meaningful glance at Meredith.

Bailey is going through resumes of attending surgeons but Catherine wants her to stay focused on keeping the residents, which she should do by talking to each and every resident personally, with Catherine observing. Bailey leaves to go line up the residents.

Link and Owen get to work on the arm reattachment. Amelia arrives and tells everyone to buckle up. The patient goes into V-fib due to blood loss. Owen starts CPR. They get sinus rhythm but this means Colin's too unstable to get through the procedure. Owen is disappointed that they won't be able to save the arm.

Addison performs an ultrasound on Tovah, which shows a strong fetal heartbeat. Tovah is relieved because it was her last embryo. The Doppler then reveals decreased blood flow to both sides of the uterus. Addison orders an MR angio and requests both Meredith and Richard's eyes on this case. She doesn't care about the drama between them.

Teddy arrives in the ICU with Diana. Owen tells her about the complication in the OR. The arm won't survive long enough without blood flow to attempt to reattach it later. Diana saw yesterday that the conveyor belt was acting up again but she didn't tell anyone. She wasn't paying attention this morning when Colin turned it on. Teddy tells Owen they have seen plenty of vets who lost limbs live a full life. Owen leaves with a plan to save the arm.

Richard snaps at Meredith as she arrives in the angio suite. Addison urges them to stay focused. The right side is completely clotted off and the left one is severely stenosed but salvageable. Addison has Tovah prepped for the angioplasty. She wants both Richard and Meredith in the room since they are making medical history. They have to act like adults.

Bailey vists Jo in the OB department. She is in need. She needs Jo back as a general surgery attending. As soon as the program is off probation, she can return to OB. Bailey has to postpone 7 surgeries per day on average. Jo can help her cut that number in half. Bailey reminds her of all the hospital has given her and hopes she will return the favor.

Zander, Maggie, and Winston are testing out the HeartPatch. After some network connection issues, the patch doesn't transmit a heart rhythm. It doesn't work on Winston either.

Owen has set up an ex vivo limb perfusion system to keep Colin's arm alive. Amelia and Link are impressed. Once they leave, Teddy reminds Owen that this technique hasn't been used for civilian use. She reminds him it's not a good idea to draw the military's attention right now. He'll cross that bridge when it comes to it. Teddy can't believe his plan is to just wing it, like he apparently wants to do with Leo. Teddy says it's a big deal what happened this morning. She knows she reacted poorly this morning. They've smiled and played along and let him wear dresses but now that it's getting more serious, they need a plan. Owen wants to focus on Colin's arm now.

As they scrub, Addison comments there are four generations of surgeons in the room, all students of Richard's. Levi says it's only three generation of students plus Webber himself. Richard says being his student meant something once upon a time. Now, there is no loyalty. Meredith is not interested in the loyalty. Richard remembers how Addison and Derek were machines in their residency. Addison doesn't remember that time so fondly.

Maggie and Winston have retreated to an on-call room to try out the patches again. It transmits vitals and a rhythm for a while but as they start making out to increase his heart rate, the rhythm flatlines again.

Link meets Jo in the attendings' lounge. He apologizes for earlier and says she does deserve a nice guy. Jo tells him about Bailey's request. Jo wants to talk this through over several drinks so she asks Link to join her and Todd for drinks tonight at Joe's.

Maggie and Winston leave the on-call room. Wendell has been charming a group of nurses but stops as he spots them. Wendell notices that Winston's shirt is inside out. Wendell is hoping for a good review since he works off commission. Winston says the patches don't work. Wendell claims they got a beta model but promises to get them the retailed model. Winston reluctantly agrees.

Meredith and Addison work on Tovah with Richard and Levi observing. Meredith wonders when it became a thing to owe the hospital where you were trained at. Addison agrees she has earned the right to spread her wings but she also heard from Amelia that Meredith has apparently become a hospital mascot. She quietly adds that Richard is this mad because she was never just a student to him. Levi warns them about fetal decels. Addison injects contrast and they find that the left vessel is now completely clotted off. Addison thinks it's over but Meredith suggests a vascular revision. They can bypass the thrombosed vessel and save the uterus and pregnancy. Richard swears his head's in the right space and goes to scrub in to assist.

Bailey fondly looks at pictures of Pru when Jordan joins her and Catherine in the office. Catherine has heard good things about him. Bailey asks Jordan why he draws before every surgery. Jordan says it reminds him to take his time for the human body rather than just rushing ahead. Much to Catherine and Jordan's surprise, Bailey hands Jordan the forms to arrange a transfer back to Minnesota. His spot hasn't been filled yet. He is one of the finest residents she has ever taught and she cannot risk him going down with the program if she were to fail to save it, which would orphan all the residents. Also, he can still learn from Meredith Grey out there. Catherine is confused.

Meredith, Addison, Richard, and Levi work quietly and in unison. They successfully insert the graft with good blood flow. However, Levi finds no more fetal heartbeat. Addison works out her frustration on an instrument tray and then proceeds to perform a D&C.

Winston and Wendell are out in the parking lot by the latter's car. His trunk is full of patches, all the same model. Wendell got a loan - not from a bank - and bought the whole lot. Everything he has is in this business. Winston can't believe he fell for this. Wendell swears it works as he saw it on an online presentation. Wendell is out 10 grant and needs Winston's connections to make this work so he can get his money back.

Teddy finds Owen working on Colin's arm. The tissue is oxygenating properly. Owen assures Teddy that he's not winging it with Leo. He thought this might happen when Leo started wearing tutus. Teddy thought he just loved dress-up. Owen has decided to listen if Leo is telling them he's a girl. Teddy objects that he may change his mind in two months. Owen says they'll just follow Leo's lead.

Catherine enters the scrub room to yell at Meredith for leaving. Addison tries to stop her but Catherine yells at her for interrupting. Meredith points out she doesn't have the right to yell since she's not their boss. Catherine says this is about honor and the standing of the hospital and the foundation. Addison yells to stop. Tovah just lost her pregnancy. Addison needs a moment to honor Tovah and everything she's been through. She leaves the room, where the rest stays quiet.

Teddy and Owen inform Lucy, Colin's wife, that they have scheduled the reattachment procedure for first thing tomorrow morning. Lucy and Diana head into Colin's room.

Addison has just delivered the bad news to Tovah. They'll try again as soon as they can. Addison leaves the room while Levi sits down with Tovah to say the Mourner's Kaddish to offer her some comfort. Levi comforts her as she breaks down.

Outside Tovah's room, Addison tells Richard that she feels like she failed Tovah. Tovah now can't ever have her husband's baby. Richard asks if she really doesn't remember her residency fondly. Addison remembers pain, insomnia, bullying attendings, and treating patients as wins or losses rather than people. It took her years to unlearn that. Richard states that people haven't complained before. Addison points out the culture in the field doesn't allow for complaining. Addison says he is trying to save a broken version of the program. He has to find a new way to train surgeons. He tried that. Addison tells him to try again.

Jo, Link, and Todd are out drinking at Joe's. They talk over Jo's dilemma, which Todd deems a Hobson's choice. Recalling his own dissertation, he thinks Jo can combine the two options. Link agrees and offers to help out with Luna for the weeks or months that she'll be moonlighting for Bailey on top of her OB work. Todd quickly offers to help out, too, though realizes how weird that is. He goes to get the next round of drinks. Jo smiles as she watches after him, which doesn't go unnoticed by Link.

Teddy sits down with Owen outside the hospital. She wants Leo to be happy but she's afraid that they'll mess this up. Neither one of them knows how to properly handle this. Going all-in now feels wrong to her. Owen reminds her she didn't feel the need to correct Leo when he once declared that he was an owl. She just let him explore. They should just listen when he tells them who he is. He knows it's more complicated than that. They agree to get a therapist for themselves. Teddy wonders what'll happen if they don't agree on the approach. Owen doesn't know either.

Nico gets on the elevator with Levi. Levi says he was in pain when he dumped Nico and told him to go away. He reminds Nico that he kept showing up with Nico was in pain. Nico says that is the difference between them, then. He gets off and walks away.

Bailey returns to her office where Catherine tells her she booked a phone call with a major consultant to help them set up a more formalized plan. Bailey announces that she is taking a vacation day or two. Pru and her boys need her. Catherine says the hosptial needs her. Bailey knows. It needs too much of her. She's done being a superhero. She knows Catherine understands what it's like to be a woman on top of her field who's not allowed to rest. She's not quitting or saying she can't handle this job, she just needs a short vacation.

Meredith is happily surprised to find Nick waiting for her on her porch. Nick has a speech. He tells her not to go to Minnesota. If she leaves right now, neither she nor her people here will be happy and she'll always resent him a little bit. Her kids also need time to get used to having him in their lives. He has decided to take up all of his personal days to take a few months off from the Clinic. He's getting his own place in Seattle so they can ease him into Merdith's life while he works locum tenens at Grey Sloan. Meredith is not pleased. She has earned the right to leave. Other people from her residency class left to pursue other opportunities while she stayed and worked and researched and won awards for the hospital. She did everything that was expected of her and then some. She finds it ridiculous that she's considered disloyal for leaving. Also, it's patronizing for him to meddle with her decision. Nick clarifies he only meant for them to stay here until the program is saved. Afterward, they can go wherever they want because she absolutely has the right to leave. Meredith says he has seen her angry side now. He admits it was scary. She thinks it over for a moment and agrees to stay for a little while longer. They hug.

Cast[]

Main Cast[]

Special Guest Star[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Colin Renfield[]

  • Diagnosis:
    • Traumatic amputation
  • Treatment:
    • Ex-vivo limb perfusion

Colin came into the ER with one arm traumatically amputated by a conveyor belt. His co-worker brought him and his arm to the emergency room. In the trauma room, they did an x-ray of his arm and then moved him to the operating room, where they prepared to re-attach the arm. However, as they got started, Colin coded. They were able to restore sinus rhythm, but Colin wasn't stable enough to endure the long surgery to re-attach his arm, so they moved him to the ICU. Owen then had the idea to use an experimental military procedure, ex-vivo limb perfusion, to keep the arm viable until Colin was stable enough to re-attach it. When his wife arrived, they told her he would have his arm re-attached the following morning.

Diana Cortez[]

  • Diagnosis:
    • Syncope
  • Treatment:

Diana fainted in the ER after bringing in Colin. They got her into a bed and checked her blood pressure, which they said was improving, along with her heart rate. When she talked about the incident, she fainted again, so they put her head back and legs up.

Tovah Freedman[]

  • Diagnosis:
    • Pregnancy
    • Thrombosed veins
  • Treatment:
    • Vascular revision
    • Dilation and curettage

Tovah was 11 weeks pregnant in her transplanted uterus and was in pain, so Addison came to Seattle to check on her. Addison did an ultrasound and saw that there was reduced blood flow to both sides of her uterus, due to a blood clot. Addison ordered an MR angio and had Levi page Meredith and Richard. The MR angio showed that the right side was completely clotted off, while the left was severely stenosed, but salvageable. Meredith suggested a fibrinolysis to break up the clot, although it carried some risk for the fetus. Addison suggested balloon angioplasty on the left side to widen the blood vessel. In the IR suite, they discovered that there was no blood flow on the left side. Addison was ready to remove the graft and the fetus, but Meredith suggested a vascular revision to bypass the thrombosed veins with the intent of saving the graft and the pregnancy. They did the revision and got good blood flow to the graft, but there was no fetal heartbeat on ultrasound, so they had to do a D&C.

Sam Reynolds[]

  • Diagnosis:
  • Treatment:

Sam was a patient they used to test the medical patches Wendell was selling. They put a patch on his arm and the patch showed that Sam was dead. Winston moved the patch to his own skin and got the same result.

Music[]

Song Performer Scene
"Look Alive" Vanyo feat. Josh Johnson
  • Wright checks on Bailey, who is getting a smoothie for herself.
  • She asks Wright to leave her alone and Catherine tells her to get to her office.
  • Teddy sends Owen ahead while she takes the kids to daycare.
  • Leo says she's a girl.
  • Taryn and Levi worry about the hospital losing its accreditation.
  • The doors open to reveal Nico.
"The Reason" Geographer
  • Bailey tells Jordan to go back to Minnesota.
  • Addison, Richard, and Meredith work on Tovah.
  • They finish their work, but can't find a fetal heartbeat.
"Turning Tides" Luke Sital-Singh
  • Teddy and Owen update Colin's wife.
  • Addison consoles Tovah, telling her they'll try again.
  • Levi recites the Mourner's Kaddish with Tovah.
  • Addison tells Richard she feels like she failed Tovah.
  • Richard and Addison talk about residency.
  • Addison tells him to find a new way to reach residents.
"Give It Up" Spectre Jones
  • Todd, Jo, and Link talk about the decision Jo has to make.
  • Todd says Jo can do both things.
  • Link offers to help with Luna so she can.
"We Were Not Ready" Brooke Annibale
  • Bailey leaves the hospital.
  • Meredith comes home to find Nick waiting for her.
  • Nick tells her not to come to Minnesota.
  • He tells her about his plan be in Seattle with her.
  • She says she has the right to leave.
  • Nick says he just wants her to stay long enough to save the program.

Notes and Trivia[]

  • This episode's title originated from the song Should I Stay or Should I Go, originally sung by The Clash.
  • This episode scored 3.90 million viewers.[1]
  • Owen tells Link that he has never reattached an arm in his career, even though he took part in an arm transplant in These Arms of Mine.

Gallery[]

Episode Stills[]

Behind the Scenes[]

Quotes[]

Nick: Don't come to Minnesota. Look, if you leave right now, your people won't be okay, and you won't be okay. You won't be happy and you'll always resent me just a little bit. And I know you have kids. They're gonna have to get used to me being around. But I'm gonna get my own place, and we are gonna do this thing the normal way. You know, having dinner together and not having to get on a plane just to kiss each other. And look, I have days, I have tons of personal days, and I'm taking a few months and I'm staying here and I'm gonna work locum tenens at Grey Sloan and we can be together. Here.
Meredith: I have the right to leave. I 've earned the right to leave. Other people from my residency class, they left and took other opportunities. I stayed. I worked. I researched. I won awards for that place. I did everything that was expected of me, and then some. And now if I want to leave, I'm considered disloyal? It's ridiculous. It's absurd. You know what else it is? It's my decision. And I've made my decision. So this is all very patronizing.
Nick: Okay. I wasn't suggesting we stay here forever. I'm suggesting we stay long enough to save the program. And then we can go to Minnesota. We can go wherever we want, because you have absolutely earned the right to leave.
Meredith: You couldn't have led with that?
Nick: I thought I had. I'm sorry.
Meredith: Now you've seen my angry side.
Nick: I'm not gonna lie, it was kinda scary.
Meredith: Okay. Fine. We can stay. But just for a little while.

See Also[]

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


References[]

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