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in: All Episodes, GA Episodes, GA S20 Episodes
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The Marathon Continues

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“ Genetics, diet, exercise. All of these factors have shown to be the key determinants of longevity. But researchers discovered another way to predict our live spans: our zip codes. In some cities, a few blocks could increase the likelihood of dying 30 years earlier. Where we live determines how we live. And how we live matters more than you might imagine. No matter where we live, we all wish for long, healthy lives for our family, for our loved ones, for our children. But even if the odds are in your favor, predictions are only part of the picture. We live in a world where everything can change in the blink of an eye. You could be on top of the world one minute but you never know when the rug might be pulled out from under you. When that happens, which it inevitably will, all you can do is hold on. And hope it won't end you. ”

The Marathon Continues is the sixth episode of the twentieth season and the 426th overall episode of Grey's Anatomy.

Short Summary[]

Mika and Teddy receive a patient from a nearby penitentiary. Catherine pushes back on Link and Monica's treatment plan for a VIP. Bailey tries to integrate wellness into the residency program.

Full Summary[]

Winston arrives at the hospital after a run. He passes Jo and Link, whose kids are in their strollers holding tablets. Amelia walks by and is dismayed to see Scout has his own tablet. She advocated for limited screen time. She's paged for a consult.

Taryn catches up with Mika, who has been ignoring her. Her Meditations for a Woman Scorned podcast advised waiting until she's no longer angry before talking. She reveals that she's mad at Taryn for getting in the way of her becoming a better surgeon. She doesn't want to talk about it. Taryn assigned her to cardio today.

Catherine is getting ready in Richard's office. She has back-to-back meetings all day and she has to make an appearance on the peds floor since important benefactors are coming in with their daughters. Richard has an administrative day, which she points out he has been having frequently lately.

Levi catches up with Monica. He submitted his personal statement for his fellowship application. He was hoping she would put in a good word. She asks him why peds. He says Webber suggested it, he likes kids, and peds surgeons are in demand. Based on his answer, she declines a recommendation.

In the skills lab, Lucas declines Simone's offer to study together a the house tonight. Bailey arrives with wellness kits to help them take care of themselves. One by one, the interns are paged by their services.

Teddy and Mika enter the controlled access unit to see a patient with suspected TB who came from prison. Mika is curious why the man landed in prison. Teddy warns her the patient room is a little different, with limited supplies and everything strapped down. Inside, they meet Daniel Jiménez, who thanks them for seeing him. Teddy has the guard remove one pair of handcuffs as she listens to a coughing Daniel's chest.

In the VIP room, Jules presents the case of Misty Valentine, 15, who had an above-the-knee amputation two years ago following an MVC. She has pain from the socket connecting her residual limb to the prosthesis. She was a long-distance cyclist. Catherine comes in to meet with the parents, who thank her getting them in. Link says the plan is to perform a residual limb revision to give the prosthesis a better fit, in hopes of reducing the pain.

Outside the room, Catherine questions if that surgery is the best Monica and Link can do. Link says it's the standard of care. Catherine reminds them that the Valentines are major benefactors and urges them to do better. She walks off as Link describes what just happened as the Catherine Fox Effect.

In the ICU, Dorian tells his mother to back off. He wants real food and to be discharged. Richard says they're not quite there yet. His labs this morning showed an anemia so they need to run more tests. Dorian refuses. He's done with all the tests. He wants to go home. He makes everyone leave the room.

Outside, Valeria asks Richard not to give up on her son. Richard tells her to go home so she can get a break. He asks Lucas to come back later to try again, even if he has to try every hour. He sees this kind of behavior more often in long-time ICU patients. All they can do is be patient.

Owen finds Bailey handing out more wellness bags in the lobby. She disapproves of the interns' lack of gratitude.

Down in the ER, Benson confronts Simone with his suspicion that she told Bailey about what he said up on the roof, leading to her focus on mental health. She denies but he doesn't buy it.

Link tells Monica about his idea for osseointegration, which entails implanting a titanium rod into Misty's bone so it can attach to the prosthesis directly. Monica is not a fan since it may require future surgeries to make adjustments as Misty grows. This would be his first pitch if Misty were over 21. Besides, Monica thinks this is just Catherine pushing things. She says just because she wants something, doesn't mean she should have it. Misty will have to wait a few years. Having overheard, Amelia agrees with the statement. Citing his tablet decision, she states saying "no" is not Link's forte. Link doesn't want to take Misty's dream away if there is a chance at keeping it alive. Monica is on board if Misty and her parents agree. Since Link apparently has enough arguing in his life already, she will hold back the threats of what'll happen if this fails.

While Daniel is having an X-ray taken, he says he's also been having back pain and his stomach has been hurting. He also lost weight. The X-ray reveals a large lesion in Daniel's left lung, which doesn't fit with the small cavitary lesion that TB usually presents with. They need a CT.

Lucas tries to reason with Dorian to get another blood sample but Dorian doesn't consent. Lucas says he must know it's not a good idea to refuse care. Dorian will take those odds. Dorian asks him to at least respect the fact that he needs a break from the nightmare that a hospital stay is for him. Lucas will return in an hour.

Link demonstrates his idea to Misty, her parents, and Catherine. The hope is it'll cause less chafing and pain. Because it attaches to muscle and bone, it will grow stronger with use, which increases mobility. Link admits he's only done two surgeries like this, on adults, but he is confident that it is a viable option. Misty turns to Monica for her opinion. Monica says it sucks having to make this decision at her age. Misty agrees. She wants to be able move without the pain and the surgery is offering her a chance to have that.

Daniel feels trapped as he's handcuffed for the CT. Upon seeing her smartphone, Daniel reflects on the fact that the world advances and leaves you behind when you're in prison. He wonders if his old school's cafeteria still sells lemon-berry coffee cake. Based on her face when she saw the X-ray, he knows he's in for bad news.

Winston joins Teddy and Mika in the booth. Teddy thinks she can resect the mass on the X-ray. However, the CT reveals two additional masses in the right lung as well as mets on his liver, spine, adrenal glands, and pelvis. Teddy orders an image-guided biopsy. Winston welcomes Teddy back.

Simone finds Benson and says she thinks he wishes she had said something to Bailey and he's mad that she didn't. Simone can accept his not wanting to level with her but she doesn't deserve for him to take out whatever's going on with him on her. Benson admits to eating chips from the vending machines for lunch. He hasn't had a decent night's sleep for months because of the music from his upstairs neighbors. All that is not because of mental health issues but rather being a first-year resident. Simone agrees the lecture on wellness is useless. They should be given raises and have their hours reduced. Benson agrees. Having overheard their conversation, Bailey tells the two of them to go home.

Teddy just received word that the pathologist's prelim result on the biopsy is adenocarcinoma. The cancer is definitely inoperable. With all the red tape, it's highly unlikely that he'll get chemo. They'll set him up with pain meds. Mika can't believe they are sending Daniel back to prison, which means signing his death certificate. Teddy says they can at least talk to Daniel.

At the intern house, Benson and Simone are quizzing each other for their ABSITE exam. Since it's way past lunchtime, Simone suggests they order pizza. Benson decides to check out what's in the wellness bags.

Lucas returns to Dorian's room. He still refuses to have blood drawn. Lucas asks about his education. Dorian has decided he is not going back to grad school since engineering was his parents' dream, not his. Lucas says his parents always wanted him to be a doctor, which was a reason for him not to go to medical school. One day, he got in a car accident in college. Surgeons saved his life and he changed his life. Dorian throws up blood. Lucas has Webber paged.

In the OR, Link allows Levi to screw the implant into Misty's bone, which Monica is not too happy about. Link guides Levi to use a little more force. The fluoro reveals that the rod is not in perfect position, meaning they have to take it out. Monica can't believe he did not anticipate this. Link says nothing can predict this until you feel the bone quality. They'll have to remove more of Misty's femur. Link leaves to get the parents' consent. Monica is dismissive of Levi's attempt at keeping it light.

Link has asked the parents. Catherine cuts in and says they can revert to the old plan. Link says it'll make Misty comfortable for a few months, after which it'll start to hurt again. But as a teenage competitive cyclist, Misty will keep silent and push through it and do more damage. He knows this is not exactly what they want but he believes the outcome will be worth it. The parents give their consent.

Richard arrives in Dorian's room. His vitals are tanking. Richard zones out for a moment until Lucas gets through to him. Richard calls for an endo tower and intubates Dorian.

Benson and Simone are cutting up the vegetables from their bags. He watched for years how his mother turned whatever was in their fridge into something delicious. He explains the concept of stir-frying. She inquires about his mother's cooking. He reveals that she died a while ago. Simone says her mother died when she was born. He tells her to take over the stir-frying from him.

Owen asks Bailey if she has some leftover wellness bags since he didn't have time to go grocery shopping. Bailey says she is exhausted from having four jobs. She only gets five hours of sleep a night. She still took time out of her schedule to do something about the interns' wellness. She cares about these people and she only gets blatant disrespect in return. Owen thinks it sounds like she needs a break.

Teddy and Mika have broken the news to Daniel. He talks about a guy in his block dying quickly of colon cancer. Mika confirms this is why he's been feeling this awful. Teddy says there are treatments that they could look into to buy him more time, but they may also cause him more pain than good. Upon hearing he has months to live, Daniel decides to forego treatment. He spent nights out of breath begging for people to listen. He got locked up at age 17. He was tough on the outside but scared on the inside. He would pray every night that he wouldn't get stabbed or beaten to death. He never thought he would go out like this. Teddy says she's very sorry.

In the OR, Link once again allows Levi to screw the implant into the bone. Levi is confident that it felt good. The fluoro reveals a perfection position this time. Jules smiles from the scrub room. Link compliments Levi's work. Levi turns to Monica, who says to look for the sciatic nerve so they can start the targeted muscle reinnervation.

Teddy asks Mika if she's done with Daniel's discharge paperwork since the prison transport is on its way. Mika is looking into clinical trials. Teddy reiterates that Daniel does not want treatment. Mika doesn't want to fail Daniel like the system did. His punishment was supposed to be time, not death. Teddy knows this is all very frustrating, especially knowing that it might have been prevented with earlier intervention. However, feeling out of control with nobody listening to you is also frustrating. They can't imagine what Daniel has been through. They have to trust that patients know their lives better than they do. The best way for them to help Daniel is alleviating his suffering the best they can. Teddy says it's good that Mika cares like this. Not many people do.

Richard's doing a gastroscopy on Dorian, revealing a bleeding ulcer. He injects epi, which doesn't stop the bleeding. He then places a clip, which does work. Lucas compliments Richard's work. Richard says he's been doing this since before Lucas was born. He orders repeat labs. Richard breathes a sigh of relief as he leaves the room.

Simone and Benson continue the quizzing over their meal. They agree Bailey's wellness plan kinda worked. Benson assures Simone that he is okay. Med school was a rough time in his life but he worked through it. She's glad to hear that. Benson clears the table. She jokes that he can open a restaurant if he has to drop out of medicine.

Link and Monica inform Misty that despite them having to take more bone, the surgery went well and they are confident she'll be able to ride again. Misty doesn't know how to thank them. Catherine says she expected nothing less from her surgeons. Misty invites the doctors to her first ride. Misty's parents tell Catherine she should never hesitate to ask them for means to support her work in the future. Catherine says they have to celebrate.

Outside the room, Link instructs Jules to keep an eye on Misty's labs. Link once again compliments everyone's work, specifically Levi stepping up, and leaves. Levi then asks Monica if she has a problem with him. He has impeccable bedside manner and really stepped up today when placing the implant. He wonders why she can't compliment his work like Link did. She says peds is not right for him if he needs anyone's validation. Levi says everyone likes validation. She thinks it's needy. She misses his passion for the work as that is what will get him through the bad days, when there won't be validation. She tells him to show her more of that.

Lucas tells Dorian about the bleeding. Dorian says the thought of being a civil engineer for the rest of his life left him unable to breathe. He wanted to work on the boat for a few months and come back enlightened, but instead, he ended up stuck here. Lucas says he has to let them do their job in order to get him out of here. He won't reach the other side if he pushes away the people trying to help him.

Teddy and Winston wheel Daniel to the transportation van. They have notified the penitentiary system of his condition and provided prescription refills. They also sent documentation to support his compassionate release application. Mika comes running up with a piece of lemon-berry coffee cake, which she got through a nurse whose son goes to Fremont High. Daniel thanks her. The guards climb into the van with him and it drives off.

Dorian's mother hands Richard chocolates to thank him for saving Dorian's life again. She hugs him and then heads into Dorian's room. Catherine comes up and compliments him for saving lives on his admin day. He says he's still got it. Richard lets her taste some chocolate.

Amelia finds Monica playing a game on her phone outside to recharge. Amelia heard her surgery went well and how pleased Catherine was. Monica talks about losing a NICU patient this morning. She asks about Amelia's kid. Amelia says her kid is great, though she's no longer together with his father. Monica invites Amelia to sit with her.

Outside daycare, Link is struggling to get Scout to give him his tablet. Jo comes up with Luna. Link then swaps out the tablet with a stuffed toy. Scout starts crying.

Taryn finds Mika. She's sorry that Mika got puked on but she can't play favorites and give Mika all the best assignments. Neither of them want to fight anymore. Taryn says Lucas finished his procedure log, meaning Mika is a step closer to getting back into the OR. Mika says she wants to be alone now. She continues to study as Taryn walks off.

Ben comes home to find Bailey preparing a relaxing bath for herself. The intern wellness program was a huge failure. The system is designed to push doctors past their limits. She didn't have patient in the afternoon so she came home early per Owen's suggestion. She sent the kids out for pizza. Ben says he could also use little wellness.

Lucas arrives at the intern house. He heads upstairs as no one answers him. He finds Benson moving into his old room. Benson hands him a charger he forgot in the dresser.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

June Sally[]

  • Diagnosis:
  • Treatment:
    • Chest tube

Levi told Monica that June's chest tube had minimal output and no air leak, so she would be ready to be discharged tomorrow.

Daniel Jiménez[]

  • Diagnosis:
    • Metastatic adenocarcinoma
  • Treatment:
    • Image-guided biopsy

Daniel was at the hospital to be tested for tuberculosis. He said he'd had the cough for about a year and back pain and stomach pain more recently. He'd also lost some weight. They got blood work and did a chest x-ray, which showed a large mass. They ordered a CT to get a better look at the mass. The CT showed mets on his liver, spine, pelvis, and adrenal glands in addition to those in his lungs. They performed an image-guided biopsy, and the preliminary diagnosis from pathology was adenocarcinoma. They looked at his options, which were limited by him being in a prison. After hearing about his options, Daniel decided not to get any treatment.

Misty Valentine[]

  • Diagnosis:
  • Treatment:
    • Residual limb revision
    • Rod implantation

Misty, 15, had been in a car accident two years prior resulting in the amputation of her leg above the knee. She had pain in her residual limb due to her prosthetic, so Link was planning to due a residual limb revision to allow her prosthetic to fit better. When Catherine challenged them to do better, Link proposed osseointegration, implanting a titanium rod into her femur, which would connect directly to her prosthesis. Link had only done two before, both in adults, but he was sure he could do it on Misty. In surgery, they placed the rod, but found it hadn't worked and wouldn't fit perfectly, so Link got her parents' permission to remove more of her femur to make it fit perfectly. The surgery was successful and Misty was told she'd be able to ride her bike again.

Dorian Cardenas[]

  • Diagnosis:
    • Anemia
    • Ulcer
    • Upper GI bleed
  • Treatment:
    • Endoscopy

Dorian was struggling with his prolonged stay in the ICU, as he wasn't allowed to eat and he wanted to leave the hospital. His hemoglobin was low, so they wanted to run more tests, but Dorian refused to allow them to draw more blood or do any more tests. When he started coughing up blood, Richard did an endoscopy, which showed an upper GI bleed due to an ulcer. They were able to clip the bleed and he stabilized.

Miss Land[]

  • Diagnosis:
  • Treatment:
    • Home health

Benson asked a nurse to make sure home health was set up for Miss Land.

Jagger[]

  • Diagnosis:
    • Necrotizing enterocolitis
  • Treatment:

Jagger, 3 months, died of advanced necrotizing enterocolitis.

Music[]

Song Performer Scene
"The Good Life" Fire Choir
  • Winston jogs to work.
  • Link and Jo arrive with their kids.
  • Amelia and Link disagree over screen time.
  • Taryn and Mika argue over work.
  • Catherine gets ready for her day and talks to Richard about him not operating.
"Breathing Under Water" Jeremy Lister
  • Daniel decides not to accept treatment.
  • Link, Monica, and Levi operate on Misty.
  • The surgery works.
  • Mika talks to Teddy about Daniel.
"Comeback" HAERTS
  • Lucas talks to Dorian about his condition.
  • Winston and Winston see Daniel off.
  • Mika brings him coffee cake.
"Head First" Swansi
  • Amelia sits down with Monica.
  • Link takes the tablet from Scout.
  • Taryn apologizes to Mika, who brushes her off.
  • Bailey prepares a bath for herself and talks to Ben.
  • Ben joins Bailey for the bath.
  • Lucas comes to the intern house and find Benson moving in.

Notes and Trivia[]

  • This episode's title originated from the song The Marathon Continues, originally sung by J. Stone.
  • This episode scored 2.92 million viewers.[1]

Gallery[]

Episode Stills[]

Quotes[]

See Also[]

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

References[]

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