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Some Kind of Tomorrow

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“ Homeostasis is our body's way of maintaining a consistent and steady internal state. Multiple systems work in sync to regulate factors like temperature, blood pressure, even sodium levels. These systems are designed to resist and combat anything that tries to throw our bodies off. It's a continual loop with checks and balances. Until something manages to break the cycle. There is such a thing as predictive homeostasis. It's when our body anticipates responses to future challenges. It understands that change is inevitable and doesn't have to be catastrophic. ”

Some Kind of Tomorrow is the second episode of the eighteenth season and the 382nd overall episode of Grey's Anatomy.

Short Summary[]

Meredith seeks advice from Amelia. Meanwhile, Richard is reenergized as he takes teaching to a new level at the hospital, and Winston treats a patient suffering from kidney failure.

Full Summary[]

Late at night, Meredith walks into the main area of her hotel suite when a note is slid under the door. She quickly grabs and reads it. She opens the door and calls for Nick, who comes back around the corner. He forgot to ask for her number and wanted to ask her out without waking her up. She says yes to a date at a place by the lake. Meredith smiles as she heads back to bed.

Early in the morning, Link and Jo help each other pack diaper bags.

Winston is texting Maggie from his bed in an on-call room. He tries to sext but she is with her father. He gets up.

Bailey joins Richard as he overlooking the lobby. She says it seems like the old days. "Finally," he says.

The tired residents are getting ready in their lounge. Sara informs the others that her mother transferred her residency to Boston to work with Jackson. As Taryn complains about this thing starting at the crack of dawn, Richard walks in. Richard says they have a big day ahead and invites them to meet him in the skills lab. Sara is exempt because Cardio requested her today.

Meredith flew Amelia out to Minnesota. Amelia dropped Scout off with Link, who has mastered quiet disappointment. Meredith walks Amelia to the Grey Center. Meredith says she is being offered millions to cure Parkinson's and she's inviting Amelia to be part of the project. Amelia stares at the lab in awe.

Teddy and Owen take their kids to daycare. Leo is dressed as Elsa from Frozen but he's missing his cape because he shoved it in the dishwasher last night. Owen thinks it's a good lesson for him to learn about consequences. Owen heads to the pit. Teddy catches a father staring at Leo and starts scolding him, but the man was actually looking at the costume because he couldn't find that one anywhere. She says she'll ask her husband and hands him the sign-in sheet.

Jo and Link also drop their kids off at daycare. Jo hates missing her daughter. She can't come check on her because she is on scut all day. Richard roped Link into this thing with the residents so he can't check for her either.

Sara presents Rashida Flowers, chronic kidney disease secondary to diabetes, who was admitted for dialysis access insertion after a thrombosed AV fistula. Rashida is streaming everything live to all her followers. She introduces her followers to Winston, who says hi and then requests she turn it off for the physical exam. Rashida used to be a travel influencer but now she's DiabeticBae. She was managing her diabetes until she got sick in Thailand, which hit her kidneys hard. Every attempt to get access for dialysis went wrong because of her clotting disorder. Both her diabetic mother and brother died from kidney failure. Winston is surprised to hear that she is not a transplant list. Winston requests a consult with her nephrologist. Rashida says she is recording everything so the world knows who she is before this disease ends her.

Owen meets an ambulance in the ambulance bay. The patient is Noah Young, 35, who drove into a tree. A second rig brings in Noah's son Danny. Noah gets upset because he can't see his son due to being restrained to the gurney. He starts coughing and wheezing as he and his son are wheeled inside. Owen notices an Army tattoo on Noah's shoulder as they move him.

In the skills lab, Richard says becoming a good surgeon is like learning to drive. Practice makes perfect. Due to the pandemic, they are a year behind, so he has organized a surgical workout. Through a series of simulations and skills assessments, they will be evaluated in four areas: laparoscopic, suturing, vascular skills, and endoscopic techniques. They will be graded by their attendings. The resident with the highest score will get to perform a solo surgery appropriate to their level. The first task starts now.

Amelia examines David, who is delighted she is not the typical egotistical prick. He is experiencing relatively mild symptoms. She suggests changing his meds or DBS but he wants more than a band-aid. She says Parkinson's is not a condition than be fixed surgically. Yet, he adds. All they need to do is convince Meredith.

Bailey is looking for a suitable solo surgery in the ER when she is approached by dr. Wong. He knows she has been avoiding him because he wants to tender his resignation. He is ready to retire. Her pleas to get him to postpone his retirement don't work. She promises to start his paperwork.

Link and Richard walk around and watch as the residents get 20 seconds to complete three atraumatic knots. Link decides that Levi is the winner.

Jo is performing a vaginal exam on Robin Jeter, who is whistling to calm her nervous. Much to her surprise, Jo finds a strawberry in Robin's vagina. Robin then realizes why she has been having abdominal pain.

Cormac arrives in the ER, where Megan has stitched up Danny's facial lacs. Cormac introduces himself and she explains Bailey asked her to help out to take on some of Meredith's patient. Cormac points out those are big shoes to fill and Megan reveals that she was the abdominal wall transplant patient that earned Meredith her Fox Award.

Noah wants to go sit with his son. This was supposed to be a father-son weekend. Owen says he likely passed out due to low oxygen levels. He orders an X-ray but Noah objects. He just wants to go and salvage what's left of the weekend. Owen then brings up the tattoo. Noah has completed six tours of service. When Noah starts coughing up blood, Owen has Teddy paged. He rushes Noah up to CT.

Winston finds Dr. Krause, Rashida's nephrologist. She is drowning in patients who put off seeing her due to the pandemic. She knows Rashida's case but unfortunately her eGFR is too high to meet the transplant list criteria. Winston points out the eGFR is just an estimated kidney function test. Krause says it's the standard clinical formula. She regrets that Rashida is not eligible but there's nothing she can do about it.

While Amelia admires the equipment, Meredith asks David what happens if they fail. David says you learn more in the attempt than the outcome. David is very aware of the risk. They join Amelia by the robot arm that does cell culture. They are joined by Dr. Kai Bartley, a neuroscientist who has already agreed to board the project. Meredith and Amelia are aware with their brilliant stem cell research. Due to David's funding, they discovered a Chinese herbal compound that completely removes undifferentiated cells before the stem cells are injected back into the patient. Amelia has no doubts. She's all in. Meredith is still hesitant.

As they wait for Noah's scans, Teddy asks Owen if it would be the right parenting move to dress Leo in more regular boys' clothes. Owen asks if something happened for her to be thinking this but she brushes it off. He briefs her about their patient. The scans reveal major lung damage.

Bailey was paged by Winston. She fears Maggie is taking a job in Boston but he explains she just went to be with her father, who is having hip surgery. He then tells her about Rashida. He found a similar patient on the transplant list with the only differentiating factor being that the patient on the list is white. White patients' eGFR is measured lower, making them better transplant candidates. It stems from a long line of assumptions about Black people. Bailey is baffled. Winston suggests writing an appeal to the transplant board but Bailey asks him to think bigger for other Rashidas out there. Sara informs Winston the IR suite is ready for them.

Owen introduces Noah to Teddy. Hayes is with Danny to do a head CT to be sure. Teddy starts talking about the damage to his lungs but Noah reveals he has pulmonary fibrosis. He knows what he has and that there is no cure hence his refusal for more tests. He started coughing after his second tour in Iraq. He started hearing from buddies about how burn pits were linked to cancers and other diseases. Owen thinks the VA should cover it but Noah says they twist it so you can't prove it's service-related. Noah once again refuses all further testing so he can spend all the time he has left with his son.

The residents are practicing their endoscopic proficiency with Cormac judging. Jo sits down with Link and refuses some chips. She tells him about the strawberry. Bailey walks in as Cormac declares Mabel the winner over Taryn. She smiles upon seeing their enthusiasm. Richard announces that the overall winner is Levi. Jo found an ex-lap for foreign body extractions for him to perform. Levi does a victory dance.

Amelia sits down with Meredith to talk through David's proposal. She sees no downside. Meredith reminds her of their kids who need stability. Amelia says revolutionizing medicine is a great example for their kids. It'll make Grey Sloan proud. Meredith is cautious about the consequences of a possible failure. Amelia declares that she is all in.

As they work, Winston confirms to Sara that this is Rashida's last possible dialysis access point. He has Sara talk him through what will happen if this access port clots off, which leads to her organs shutting down. Winston leaves Sara to secure the catheter and leaves to get Rashida a kidney.

Meredith walks Amelia to her car. She needed Amelia's input to make sure she wasn't ridiculous for even entertaining this. As Amelia talks about how it's ridiculous that Meredith has not yet accepted the offer, Meredith sees Nick. Amelia reminds Meredith of how she wanted to get into neuro. This is her chance to get back to that. She better not walk away from it. Nick and Meredith share a look as Amelia gets in the car.

Winston finds Krause and tells her Rashida should be on the transplant list like the six other cases with similar profiles that he found. Winston explains the problem with the eGFR. Krause promises to look into it when he stresses the dire situation that Rashida is in.

Taryn presents Robin's case. There is a large crystal causing an intestinal obstruction. Robin explains it's a yoni egg. She wanted to perform a healing ritual she saw on social media but she was rushing and mixed up the strawberry and the yoni egg. It takes Richard a few second to piece together what she did with the yoni egg. Levi then introduces himself to Robin and says he will be performing her surgery today.

Owen and Teddy are consulting Megan, who has seen similar conditions before. Cormac joins them and she explains the concept of burn pits to him. Owen wants to go down to the VA and demand answers, which Megan point out will lead nowhere. Cormac says Danny's CT was clear so he can be discharged later. Teddy suggests getting Noah help through Jackson but Owen says Noah doesn't have that kind of time. He needs immediate care to be comfortable. Owen and Teddy watch Noah and Danny.

Winston rushes to the PACU where Sara is tending to Rashida. She has superior vena cava syndrome, likely due to the catheter blocking it completely. They need to pull it out right away. He has Krause paged.

Levi salutes his fellow residents up in the gallery after getting gloved. Richard is observing with Taryn assisting him. He steps up to the table and asks for the scalpel. The residents cheer as he makes the cut. The surgery proceeds swiftly. After extracting the egg, part of the bowel turns blue. Levi struggles to remain calm. Bailey turns the speaker on and Levi's peers assist him.

Krause arrives in the PACU. Winston informs her of the situation and says he won't reinsert the catheter because it will just happen again. She needs to be put on the transplant list immediately. Winston refuses to put her through even more unnecessary procedures. Krause says they don't know when a kidney will become available but he says it's worth a try.

Owen finds Cormac, who informs him Danny and Noah left. Noah signed an AMA so he could go home with his son. Owen insists they need to do more studies on him but Cormac firmly says Noah is terminal. They both know it. Noah has accepted that, which is hard to do when you have a kid at home. Cormac is not sorry that he let Noah go.

Meredith arrives in the lobby all dressed up for her date with Nick. She is surprised to see him waiting for her in casual clothes. He says she should change.

Meredith and Nick are lying on a blanket by the lake. He tells her to listen to the sounds of nature. He pulled back on his hours because he was ignoring the world around him. He loves coming here to stargaze. She says she doesn't do much stargazing. He tells her they'll have so much fun. Nick asks her about her top-secret project. She is scared to say yes. She is very rarely scared. She is scared of failure. It'll cost millions of dollars, it's risky, it will be written about no matter the outcome. She doesn't want to be a public failure. She has a safe and comfortable situation in Seattle. Nick knows she'll trade it all in for this project. She is not a safety person. It's not his nature either and it takes one to know one. No matter the outcome, it'll be one hell of a ride.

Winston and Sara inform Rashida that they couldn't get access for dialysis but she is on the transplant list. Rashida starts crying. Winston is changing her life. She can go back to who she was. She can't wait to tell her followers, who will want to know if Winston is single. Winston talks about his wife. Rashida suggests they become influencers. She starts going live.

Outside the skills lab, Bailey and Richard observe the residents. Richard is the happiest of them all. It feels good to be in front of the residents again. Bailey tells her about Wong retiring. They are losing doctors every day. This whole hospital needs a reminder of why they're there. She recalls pizza night and residents pranking each other. There was joy and the feeling that they were all in it together. She wants to make space for that again. Richard agrees with her. He has some big ideas for that.


Link sings a depressing lullaby to Scout to get him to sleep, which works. Jo knows he is grieving the future he thought he had. She has been in that place. She looked for joy anywhere that she could and along came OB and Luna. It sucks right now but Link will be okay.

On their way to daycare, Teddy tells Owen about the incident with the other father in daycare. Teddy wants Leo to be okay in the world and she's worried that the world won't be kind to him if they let him be himself. People will be cruel. Owen says the world might be but they won't be. Leo should be happy. They then pick up Leo from daycare and Teddy shows him the new cape she got for his costume. The family then heads home together.

Meredith finds David in the lab. Meredith sets rules for her to accept the position. David doesn't own her. She needs autonomy to pick the team. Any progress they make should be public and accessible for anyone with Parkinson's. David agrees to all of those. He can't, however, move the project to Grey Sloan. It's expensive and he doesn't have the time. Meredith says she set up a sattelite lab in Seattle and travel back and forth once a week. David agrees to that. Meredith confirms she's in. They shake hands on it.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Rashida Flowers[]

  • Diagnosis:
    • Diabetes
    • Chronic kidney disease
    • Superior vena cava syndrome
  • Treatment:

Rashida, 34, had chronic kidney disease secondary to diabetes. She was in the hospital for dialysis access insertion after a thrombosed AV fistula. She'd been diabetic for years when she got sick and her kidneys started failing. They had trouble getting access for dialysis because she also had a clotting disorder. She had a mother and brother who were both diabetic and died of kidney failure. She wasn't eligible for the transplant list. According to her nephrologist, her eGFR was over 20, disqualifying her from the transplant list. Winston looked into it and found out that Black people were assumed to have higher muscle mass when the eGFR was developed as a diagnostic tool, so a multiplier was added, which made it seem as though they had better kidney function than they actually did, making them ineligible for transplant. They were down to her last possible access port and needed to make sure it didn't clot off, which would doom her to death. Winston went back to Dr. Krause and made a plea for Rashida to be put on the transplant list, as she qualified without the multiplier. Shortly afterward, Rashida developed superior vena cava syndrome, forcing them to remove the catheter they'd just placed. He then insisted that she be placed on the transplant list. When she woke up, they told her they hadn't been able to get access, but that she was on the transplant list.

Noah Young[]

  • Diagnosis:
    • Finger clubbing
    • Cyanosis
    • Dyspnea
    • Pulmonary fibrosis
  • Treatment:

Noah, 35, was brought to the ER after he hit a tree with his car. He denied having lost consciousness. In the ER, he had shortness of breath, but declined a chest x-ray. When he coughed up blood, Owen took him for a CT, which showed pulmonary fibrosis. He knew about his diagnosis, but declined any treatment as he knew his condition was terminal.

Danny Young[]

  • Diagnosis:
    • Facial laceration
  • Treatment:
    • Stitches

Danny, 7, was brought to the hospital after a car accident. He had a laceration to his face which was stitched up in the ER. Cormac ordered a head CT, which was clear, so he discharged him.

David Hamilton[]

  • Diagnosis:
    • Parkinson's Disease
  • Treatment:

Amelia examined David and told him he had only a slight resting tremor and slight bradykinesia. She asked what options he'd tried and he said he wasn't interested in a bandage. He wanted Amelia to work with Meredith to find a cure for him.

Robin Jeter[]

  • Diagnosis:
    • Foreign body in vaginal canal
    • Foreign body in abdomen
    • Intestinal obstruction
  • Treatment:
    • Manual extraction
    • Exploratory laparotomy with surgical extraction

Robin, 23, was at the hospital for a pelvic exam due to pain. Jo examined her and extracted a strawberry from her vagina. Robin said she also had abdominal pain and admitted she might have a foreign body there as well. She'd swallowed a yoni egg and inserted the strawberry into her vagina instead of the other way around as intended. Levi scrubbed in to remove it. He was able to remove it easily, but struggled when he went to sew her back up. From the gallery, the other residents offered him tips and talked him through the rest of the surgery.

Music[]

Song Performer Scene
"Throw Me in the Water" WILD
  • Nick leaves a note under Meredith's door.
  • She catches him in the hallway and they make plans.
  • Link and Jo pack for their kids.
  • Winston texts Maggie, who's with her dad.
  • Richard and Bailey wait for the residents to arrive.
  • The residents gather in the lounge.
"All I Need" Jake Bugg
  • The residents compete to see who can do the best sutures.
"Alive" NEEDTOBREATHE
  • Levi steps up and starts his surgery with Taryn assisting.
  • When Levi struggles, the other residents pitch in to help from the gallery.
"Away We Go" All the Tall Trees
  • Rashida, Winston, and Sara talk about his marriage and influencing.
  • They all go live.
  • Bailey and Richard watch the residents and talk about the physician shortage.
  • Bailey wants them to recapture the joy for everyone.
"Hush Little Baby" Cast (Chris Carmack)
  • Link sings Scout to sleep.
""
  • Teddy talks to Owen about Leo's costume.
  • They pick up Leo and give him his new cape.
  • Meredith gives Hamilton her demands for the project, including moving it.
  • He says he doesn't have the time to move it, so she agrees to commute. They shake on it.

Notes and Trivia[]

  • This episode's title originated from the song Some Kind of Tomorrow, originally performed by Jane Ira Bloom and Mark Helias.
  • This episode scored 4.04 million viewers.[1]
  • This marks the first episode since You're My Home when a series regular, Scott Speedman, is annotated with "and" before their credited name. Previously, Patrick Dempsey held this distinction.
  • Originally, Maggie was supposed to be the central main character in the storyline surrounding Rashida. However, due to a pregnant Kelly McCreary having to stop working early rather unexpectedly (having already shot a couple of scenes involving the storyline), the scenes were re-written and re-shot with Winston taking Maggie's place.[source?]

Gallery[]

Episode Stills[]

Quotes[]

See Also[]

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


References[]

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