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Walk on the Ocean

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“ In 1963, Dr. Thomas Starzl performed the first five liver transplants. One patient bled to death on the operating table. The other four died within days. As a result, the operation was considered too dangerous to be performed on humans and liver transplantation was suspended worldwide for the next four years. It wasn't exactly an auspicious start for a surgery that has saved countless lives. Progress doesn't happen overnight and setbacks are all but inevitable. Sometimes, it can make you feel like Sisiphus, endlessly pushing the same boulder on the same hill. But where we would be if doctor Starzl hadn't persevered to perfect the liver transplant, if he had let the setbacks win? As tempting as it can be to throw in the towel, sometimes you have to take the obstacles as they come and find a new path forward. ”

Walk on the Ocean is the third episode of the twentieth season and the 423rd overall episode of Grey's Anatomy.

Short Summary[]

Meredith and Amelia work to secure funds for their research while Amelia finds herself at odds with a new attending. Levi runs into someone from his past, and Owen gives Winston advice. Lucas ditches Mika, forcing her to treat a patient alone.

Full Summary[]

Amelia and Meredith are presenting their planned research to an investment committee. Karl is quick to say that the board will vote in favor of funding given Meredith's affiliation with the Fox Foundation. Amelia and Meredith are taken aback when he asks to set up a meeting with Catherine to discuss next steps.

Mika parks her van in the hospital parking lot. Lucas comes running up and scolds her for almost hitting him when she made a turn. Simone quickly heads inside for a wound vac change in order to avoid Lucas. While still mad at him, Mika declares a momentary truce to support him after getting dumped. He insists it was a mutual breakup. She states he's making it hard to be Team Skywalker.

As they pull into the parking lot, Meredith tells Amelia she's not attending any more meetings since someone is bound to tell Catherine since their affiliation is so well-known. Amelia steals a parking spot from a woman who's on her phone while waiting for the spot to free up. The woman then honks and Amelia points out she was on her phone. The woman angrily drives off.

Richard and Bailey meet Winston at the OR board. Dorian's abdominal washout is cancelled. He's stable for now. Bailey then invites Winston to tell her about his problems with the changes she's made to the residency program. He's going on a vacation to Chicago so he's not giving into any negativity today. When he's back, he does want to discuss an idea about the interns.

Levi hands out assignments to the interns. They proceed to make trades in order to fill out their procedure logs but Levi shuts that down. Levi is shocked to see Jo meeting with Nico in the waiting area.

Amelia and Monica Beltran, the new peds attending whose parking spot Amelia stole, arrive to consult on Malan Vasconcellos. Monica apologizes for being late and dismisses Amelia as she introduces herself. Malan was diagnosed with congenital hydrocephalus at birth. She's had 5 VP shunts but her mom claims she's "not acting like herself." The mother explains that she's less energetic than usual. Amelia's exam reveals no abnormalities. Monica is quick to say that that doesn't mean anything. Amelia wasn't finished talking yet and she proposes scans. Maria-Flor is opposed to yet another shunt surgery. Amelia says they'll wait for the imaging results.

Owen requests all available surgeons for a big incoming trauma. Winston has to leave in a couple of hours but Owen welcomes any help he can get until then. Jules, Simone, and Link tag along.

In the back lot, they meet Nate Ardilla, whose self-made watercraft was hit by a containership. He couldn't be fully extricated at the scene. Nate explains he built a self-propelled floating bubble. He regrets the steel rims now. The surgeons are not sure they'll be able to get him out.

Bailey has a full day in the OR so she instructs Mika and Lucas to keep Dorian alive, who is stable in the ICU after his abdominal closure today. Mika knows they are looking out for elevated peak and plateau pressures on the ventilator. If only the peak pressure alarm goes off, the tube is dislodged or kinked, which they can fix on their own. Lucas is disappointed to be just monitoring Dorian. Mika interrupts his complaining and thanks Bailey. Once she's gone, Mika calls off the truce.

Nate explains it was his fourth try. He wanted to get to Hong Kong. He wants to do better than billionaire Rich Doyle, who set a solo record rowing from San Francisco to Hawaii. Rich is his wife's ex-boyfriend. He thinks she still thinks about him. Link is sure there is a vascular injury to the arm. He's at risk of losing his arm if they don't get him out soon. Nate starts spiraling. Owen explains that the pressure from the bars might be the only thing keeping him alive now, so he urges him to stay still. Nate wants someone to call his wife. Simone will take care of that. Firefighters start cutting at the bars.

Levi tracks down Jo and confronts her about not telling him about Nico being here today. Jo can't tell him why Nico's here because of HIPAA. Levi wonders why Nico is in need of an OB/GYN. Jo stays mum.

Teddy runs into Meredith on her way to physical therapy. Meredith claims to be here for a consult. Teddy says Winston has locked her out of the cardio charts, Owen refuses to tell her about Leo acting up, and Richard refuses to let her help with admin so that she can rest. Teddy invites Meredith to join her for PT so they can both get in their steps. Meredith refuses but changes her mind as soon as she spots Catherine in the lobby.

As they wait for Malan's scans, Benson asks Beltran and Amelia about their medical schools and residencies. Monica tells Amelia to just say Harvard rather than Boston as it's not any less pretentious. Benson says he went to Saint Kit's, which Monica comments is balmy. The scans confirm that the shunt is malfunctioning again. Amelia wants to replace it but Monica says it'll keep disconnecting as Malan grows. Monica suggests the less-invasive endoscopic ventriculostomy, which is not the standard of care. Besides, Amelia says she is a candidate because of a history of ventriculitis and an abnormal basilar artery. Monica challenges her to take a minute to figure it out. Amelia doesn't have the time for that in her day. Monica points out that impatience appears to be Amelia's thing. She lists the things she has on her plate today and then says she's going to tell Malan's mother that Amelia is looking into other options.

Simone leaves Nate's wife a voicemail as she and Jules fetch supplies from the ER. Jules comments on Simone's new hairdo and asks what happened between her and Lucas. Simone says they are just roommates because apparently she's selfish. Jules doesn't want to get involved, especially when Simone asks her about her and Kwan.

After finishing some calculations for Dorian's drugs, Mika tries to make small talk with Lucas. Instead, he gets up against Bailey's instructions and leaves to collect procedures for his log. He ignores Mika's objections.

After checking his phone, Winston decides to stay for Nate's extrication. Nate fears he's going to die. Winston snaps that all his actions attributed to is loss of the coast guard's and their resources. Nate needs to talk to his wife. Owen decides they can wait a few minutes so Simone can try calling her again.

Mariaflor asks Benson to get Malan noise-cancelling headphones so she can block out hospital noises. Monica cuts in and tells him to make arrangements with Radiology to make it happen. She then asks him to fetch Amelia for an update.

Richard checks on Amelia, who has broken several pencils. She tells him that Monica is pushing her to pursue a risky alternative procedure. He derives that she is more aggravated with Monica than her suggestion. Richard hired Monica so he knows she's a boundary-pusher.

Nico approaches Levi but they are soon joined by Jason, Nico's boyfriend, who fetched snacks for their surrogate. Jason doesn't appear to know about Levi and Nico's history. Nico and Jason leave to get back to Erin. Jason says goodbye too "Levon."

While on the treadmill, Teddy talks to Meredith about Owen and his mother helping out with the kids. Meredith recalls that during the COVID times, Teddy used to tell her to get rest and ask for help. Teddy inquires about Boston but slips on the treadmill before Meredith can answer.

Simone informs Owen that Jules and Link are preparing the OR. Simone failed to reach Jessica. As he becomes increasingly hypotensive, Simone asks Nate what he wants to tell his wife. He loves her so much and everything he does is for her. He wants her to be proud of him so she won't ever have to have doubts about choosing him ever again. He'll never give up trying to do right by her. Simone promises to tell Jessica all that. The crew performs the extrication. Nate begins to bleed out. They get him on the gurney. Winston asks for shear and a REBOA to slow the bleeding so they can get him to the OR.

Levi tells Jo that Jason didn't know about him. He's offended that Nico has not mentioned him. It seems like he doesn't even know Nico anymore. Jo says Levi is just upset that Nico's life has moved further along than his. She points out he only talks about wanting to meet someone and getting into peds but he's not taking action to make it happen. He has to get in the game.

Amelia shows Benson and Monica Malan's scans. The aberrant basilar artery poses a problem to insert the balloon to create the shunt. There is not even a millimetre of wiggle room. There is no alternate route but Amelia thinks that if they can combine the computer system with the intraoperative imaging technology used to map brain tumors, they can program it as a real-time guide with ultra precision. The tech team has the system ready to go already. If Mariaflor consents, Amelia is willing to try it. Monica thinks Amelia is much more effective when she takes her time.

Jules clears a path to the OR. Once they get there with Nate, Winston gets gowned and gloved without scrubbing. The OR staff gets to work on cutting of Nate's wetsuit. Simone tries to call Jessica again as the door is closed on her and Jules.

Mika is studying next to Dorian when the ventilator alarm goes off. The tube is secured and not obstructed. Mika calls for help.

Meredith takes Teddy to an exam room to have a look at her ankle. Catherine comes in to check and inquires why Meredith is here. She non-convincingly says it's for a consult. Teddy backs her up stating it's for one of her old patients and adds that there was stuff with the house. Catherine says it's good to have her here. She's looking forward to Meredith's research update next month. Teddy then asks Meredith why she's actually here.

Lucas joins Jules and Simone in the OR gallery until he's paged about Dorian. Jules comments on the tension between him and Simone.

Nico finds Levi. They're still at the hospital because Erin is getting tested for gestational diabetes. Nico says he corrected Jason in the elevator earlier. Jason and Nico have been together for nine months. Jason had already started the surrogacy process, which Nico didn't know about until after they started dating. He freaked out at first but he couldn't bear the thought of losing Jason. Levi is happy for Nico and wishes him good luck.

Teddy has heard the truth from Meredith. She likens it to living in a medical thriller. Meredith says their plan to get money failed, so their secret research may be over soon. Teddy brings up her discretionary fund, which they could use to publish an initial report to open more doors. If they can far enough to prove the worth of their idea, Catherine won't be able to deny it. Teddy is willing to take that risk on Meredith.

Monica and Amelia scrub in together. Benson comes in to ask if he can observe but Monica instructs him to wait with Mariaflor instead. Amelia disagrees but Monica says he's on her service.

Mika informs Lucas that both the peak and plateau pressure alarms are going off. Combined with his low urine output and hypotension, Mika figures that Dorian has abdominal compartment syndrome. Mika runs out to get a cut down tray. Bailey arrives moments later. Lucas repeats Mika's reasoning. Bailey decides to open up Dorian. She colds Mika for taking a break when she returns with the tray, cutting her off as she tries to explain. Bailey instructs Lucas to gown and glove. He stays silent as Mika stares at him.

Owen, Link, and Winston frantically work on Nate.

Amelia and Monica operate on Malan. It goes well and they share a look.

Mika watches as Bailey lets Lucas cut open Dorian's incision.

Benson sits with Mariaflor as she lights a candle and says a prayer in the chapel.

The doctors rush to resuscitate Nate when he crashes in the OR. Winston calls time of death 18:45. Simone realizes she has to deliver bad news to his wife.

Amelia and Monica find Mariaflor in the chapel. They tell her the surgery went well. They removed the old shunt and successfully created a new opening for the fluid to drain. Mariaflor thanks the doctors and says they make a wonderful team. Benson takes her to go see her daughter. Amelia echoes Mariaflor's statement, only to realize that Monica has already left.

Winston, Owen, and Simone deliver the bad news to Jessica. Jessica says her husband sets sail every morning but he always comes home because something goes wrong. She can't believe it's different this time. She regrets always telling him he was ridiculous and paranoid when she should have been telling him that she loved him. She never wanted Rich Doyle. It's all her fault that he's gone. Simone cuts in and says that Nate told her that sailing to Hong Kong was never about her. She claims he wanted to prove to himself that he could do it. He told her to tell Jessica that he loved her so much. All that matters is that they loved each other.

Benson finds Monica to tell her he finished her progress notes. Without a word of acknowledgement, she asks for a post-op check on another patient. Benson says he went to Yale for almost a full year, until he had to move home to care for his mother. He may not have a fancy pedigree but he's a quick study and he works hard. Monica says the hand-holding assignment wasn't punitive because of his education, it was punitive because he dismissed Mariaflor's concerns. You never bet against the moms. Monica requested him for her service tomorrow.

Owen and Winston watch as Nate's watercraft is towed away. Winston was supposed to meet Maggie but she cancelled on him. He took it out on a patient, who then died. Owen says they did everything they could. Winston says Maggie and him are supposed to talk about what's next for them but there is always something getting in the way on her side. He wonders when he stops trying. Owen thinks the real question is why he's trying.

Mika enters the locker room and yells at Lucas for stealing her diagnosis and ex lap. Lucas wonders if there is a rule that says the person making the diagnosis gets to do the procedure. Benson says no. Mika hates that he pulled this after she tried to be his friend. She goes off on him until Simone tells her to give Lucas a chance to explain first. Mika knows he sharked her. It's all his fault anyway that they are barred from the OR. She also wonders why Simone of all people is defending Lucas. Simone is tired of all the blame and finger-pointing. They all screwed up and all they can do is move on. Mika announces to Lucas that she is done being his friend. Benson, Jules, and Mika agree to get a drink.

Levi introduces himself to Monica and says he's applying for a peds fellowship. He'd love to buy her coffee and pick her brain. They walk out together.

Jules watches Benson flirt with a woman over darts and orders another shot with Mika.

Still on the stairs outside the hospital, Winston takes off his wedding ring.

Amelia paged Meredith to her lab. She doesn't want to quit. She's hopeful that this could lead to a cure. Meredith is happy to hear her say that. She shares the news about Teddy's funding.

At home, Simone drops by Lucas's room to talk, only to find that he has moved out.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Dorian Cardenas[]

  • Diagnosis:
    • Abdominal compartment syndrome
  • Treatment:
    • Abdominal washout
    • Exploratory laparotomy

Dorian had an abdominal washout and was stable in the ICU. Bailey left Mika and Luca in charge of monitoring him. When he crashed, Mika evaluated his symptoms and diagnosed abdominal compartment syndrome. While she was getting a cutdown tray, Bailey came in and opened him up in the ICU, then moved him to the operating room for an exploratory laparotomy.

Malan Vasconcellos[]

  • Diagnosis:
    • Congenital hydrocephalus
  • Treatment:
    • Endoscopic ventriculostomy

Malan, 8, had been diagnosed with congenital hydrocephalus at birth and had had five VP shunts to control the build-up of fluid. Her mom said she wasn't acting like herself. They did tests which showed that her shunt was no longer worked. Amelia wanted to replace it, but Monica proposed an endoscopic ventriculostomy to drain the cerebral spinal fluid, as her mother didn't want her to have another surgery just to have the shunt fail again. Amelia said Malan wasn't a candidate due to a history of ventriculitis and an aberrant basilar artery, which made getting a scope in impossible. Monica ask Amelia to take a minute to figure it out, so Amelia figured out a way to use a computer guidance system combined with intraoperative imaging to keep them on the safest path. The procedure was successful and Malan's mom was told she'd be okay.

Nate Ardilla[]

  • Diagnosis:
    • Vascular injury to the arm
    • Crush injuries
  • Treatment:
    • REBOA
    • Surgery

Nate 34, was driving a water craft he built himself when he was clipped by a container ship. They were unable to extricate him in the field, so they brought him to the hospital inside his water bubble. The doctors evaluated him as the firefighters worked to free him. Link found a vascular injury to his arm, threatening use of it. He also had crush injures to his abdomen. When they removed the bar across his abdomen, he started bleeding profusely, so Winston did REBOA in the parking lot to give him more time to get to the OR. In the OR, they operated, but the bleeding was too severe and he was pronounced dead at 18:45.

Teddy Altman[]

  • Diagnosis:
    • Sprained ankle
  • Treatment:
    • Bandaging

Teddy came to the hospital to do her physical therapy. While walking on a treadmill, she slipped and hurt her ankle. She was insistent it was just a sprain, but agreed to an x-ray. Then Meredith wrapped it for her.

Music[]

Song Performer Scene
"Magic Motion" Joy Pageant feat. BEADIE
  • Mika arrives at work and fights with Lucas.
  • Simone snubs Lucas.
  • Mika asks Lucas if he's okay.
  • Meredith and Amelia discuss their meeting.
  • Amelia steals someone's parking space.
"Always On Your Side" Adona, Oshins
  • Monica and Amelia scrub in.
  • Mika and Lucas work on Dorian.
  • Bailey comes in and confirms Mika's diagnosis.
  • Link, Owen, and Winston operate on Nate.
  • Monica and Amelia work on Malan.
  • Maria-Flor lights a candle in the chapel.
  • Nate crashes and dies.
"Better Now" Texada
  • Monica and Amelia tell Maria-Flor her daughter's okay.
  • Winston and Owen tell Nate's wife that he's dead.
  • She says she should have spent more time reassuring him.
  • Simone tells Nate's wife that the loved her.
  • Benson makes his case to Monica.
  • Monica tells him she requested him for her service.
"Changes" The Careful Ones
  • Benson, Jules, and Mika agree to get drinks.
  • Levi talks to Monica about a fellowship.
  • Mika and Jules do shots and Jules watches Benson flirt with someone else.
  • Winston takes off his ring.
  • Amelia tells Meredith they shouldn't quit.
  • Meredith says she found them some money.
  • Simone goes to talk to Lucas, but he's moved out.

Notes and Trivia[]

  • This episode's title originated from the song Walk on the Ocean, originally sung by Toad the Wet Sprocket.
  • This episode scored 3.26 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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