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Wasn't Expecting That

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“ My mother always used to say that you can tell the difference between an intern and a second-year resident by their sutures. One of the more common mistakes an intern makes is tying their sutures too tightly, which causes tension. The more tension, the longer it takes the wound to heal. It decreases blood flow, increases scar formation, and even necroses the skin. So even though they may have technically closed the wound, they may have opened a door to even more problems. Tensions exists throughout the entire body. How it affects you depends on how you manage it. Some people can self-regulate by breathing, meditation, exercise. They develop tools that help them fight the stress and reduce the pain it causes. But not all people are wired that way. Some people feel completely overwhelmed by it. And the tension freezes their bodies until they can't move at all. ”

Wasn't Expecting That is the second episode of the nineteenth season and the 402nd overall episode of Grey's Anatomy.

Short Summary[]

The attending surgeons and interns work together to solve a medical mystery when a college kid comes in with what first looks like food poisoning but has escalating and dire complications. Meanwhile, Jo spends her day off with Bailey.

Full Summary[]

Simone leaves her house in the morning but she is summoned back by her grandmother, who hands her her lunch. It's a bag with random stuff from around the house. Simone thanks Joyce and tells her to go back inside.

Jules witnesses how Mika climbs out of the back of an old van in the parking lot. It's Mika's first home. She just installed a WiFi hotspot. A curious Jules peeks inside.

Amelia catches Lucas as he changes into his scrubs in an on-call room. He's living there until he finds a permanent spot. He asks her not to tell his mother but Amelia is not on speaking terms with her. Amelia invites him to Meredith to spend at least one good night but he insist on no special favors. As they exit, Benson comes running by and makes a quick inference about the situation. Benson and Lucas rush off, almost running into Maggie and Meredith. Meredith talks about Nick's changes to the program. Meredith was expecting a little more communication from him. Meredith invites her sisters to come see Zola's presentation for the Pacific Northwest scholars. Her paper on her hero, dr. Ellis Grey, is on the shortlist for their merit program.

Nick and Levi enter the intern locker room. Nick has a kidney transplant and inquires about the three leading causes for end-stage renal disease. Benson enters without raising his hand, which Nick doesn't care about. He leaves Levi to hand out assignments. Levi has not slept in two days and answering pages from six different services. Adams is with Maggie, Kwan is with Winston, Mika is with Owen, and Jules and Simone can tackle a surgical consult in the ER together. Levi warns the interns not to embarrass him. The interns leave to get to work.

Benson finds Winston, who shows him an X-ray. He diagnoses a pericardial effusion. The teaching moment is interrupted by Maggie, who bestows a list of tasks onto Winston, having pushed his lobectomy to this afternoon. Winston is not pleased since he has already postponed that patient twice. Maggie thanks Winston and says she'll check in after her TAVR. Lucas is excited that they are doing a valve replacement but she tasks him with her scut.

Teddy is scolding Owen for inserting a chest tube without direct supervision. Mika reports for Owen's service. Teddy laughs as Owen suggests she find a different service. Teddy is now Chief of Trauma since her husband lost his mind. She clarifies that Owen will lose his license if the Washington Medical Commission finds out he does anything medical on his own, meaning she has to call an additional attending for everything.

Simone and Jules take the history of Chase Sams and Bruno, Chase's college roommate, who appear to have food poisoning. They had a few drinks while gaming last night. They split some leftover fried rice at 3 AM. Suddenly, Chase starts having difficulty breathing. The doctors start oxygen and find a rash on his abdomen and chest. They have no clue what is going on.

Jo and Luna meet Bailey and Pru at the park. Bailey is all organized for a day out. Jo is happy to have something to do other than work and watching Link bring home half of female Seattle.

Both Richard and Meredith arrive at Chase's bed. Jules and Simone each paged an attending. The interns brief the attendings. Meredith finds that the rash has spread to Chase's limbs as well. She orders blood cultures and a chest X-ray and has Chase administered to the ICU. They can page her once they are done.

Owen is seeing Harold Peters, who is experiencing abdominal discomfort. Just as Harold wants to share what is causing it, his wife Sharon arrives. Harold told her to wait in the car but she finds it a stupid idea since she still hasn't found her phone. The kids might call him and he's in no position to help. Owen says he wants to perform an ultrasound.

Teddy arrives to supervise the ultrasound. She only has three minutes. Owen fears he might not survive them. Teddy reminds him it's all due to his own fault and refuses to take over to teach Owen a lesson. As Owen starts the exam, Mika excuses herself to chase Levi down the hall.

Levi is already behind on all his work. Mika says she can't be working for Owen and Teddy with all of the mind games going on between them but Levi instructs her to go do her job.

Amelia finds Maggie in the CT boot. She just asked Winston to assist her with an anterior approach to a spinal fusion and he told her to check with Maggie. Maggie says he's monitoring a few of her patients and she may need his assist on a TAVR later. Lucas offers to assist. Amelia orders him out of the room. Amelia says Winston seemed mad. Maggie says he's doing his scissor talk rather than yelling. She has pushed his surgery because she's a perfectionist and she wants him in her OR since there are no senior residents. Amelia leaves. Lucas returns and reminds Maggie they have one senior resident. She has him page Levi.

Meredith arrives in the ICU. Chase became completely unresponsive and his rash is now everywhere. Meredith intubates Chase as the interns watch her closely. Simone checks for breath sounds and hears them on both sides. Meredith goes to leave but Jules calls her back in upon noticing that Chase is bleeding from his central line.

Levi enters Joe's bar and asks Taryn, who's bartending, to come back. She is enjoying her life now. If she makes a mistake here, nobody dies. He reminds her he is Chief Resident now, which she says is only due to the fact that she is not coming back. He challenges her to prove him wrong and even says Meredith wants her back. Taryn sees through his lie. Meredith is straight and Taryn has enough self-esteem now to only fall for women who might love her back. Levi gives up and returns to answer Maggie's page.

Meredith is going over Chase's case with Teddy and Richard. Chase has a bilateral pleural effusions and is showing signs of DIC. The rash could be petechiae. Simone says this cannot be food poisoning. Meredith tells her to gather the interns and hit the research to figure this out before it's too late.

Richard catches up with Teddy to tell her he's glad that she and Owen are back, which he imagines is hard with everything Owen has to go through. Teddy thinks Owen asked Richard to intervene about her drinking habits. Richard just wants to know how she's doing. She spent the last six months working locum tenens in LA while Owen built sandcastles with the kids. His legal team bankrupted them. Seeing his face fills her with annoyance so she has to go outside and pretend to garden to get rid of the rage. She hasn't left him because he is the father of her kids and somewhere deep down, she still loves him. Wine helps her remember that though she has everything under control.

Amelia intercepts Lucas in the lobby as he's walking with Benson. She claims to want to run something by him about a patient. Benson walks off. Amelia shows Lucas some apartments to look at. One of them is close to Meredith's so he can come over for free food. Lucas asks her to keep her distance. He doesn't want people to know they are related and people already think they are screwing.

Jules proposes toxic shock syndrome but Simone shuts that down as there is no liver or renal dysfunction. Jules briefs the other interns on the case, adding that she has never seen so much vomit despite the fact that her parents did so much hallucinogens. Mike is paged to go find an attending to supervise Owen. Lucas proposes rickettsial disease, which Benson dismisses.

Owen and Mika inform Harold that the ultrasound was inconclusive so they'll order a CT scan. Harold wants to talk to his doctor without his wife. Sharon has located her phone using an app and found that it's in the room. She calls her phone with Harold's phone. The buzzing comes from Harold's body. He stuck her phone up his ass. Harold yells that she's always on the damn thing. Mika is asked to page Teddy so Owen can retrieve the phone.

As they enjoy some fruit at the park, Bailey asks Jo if things are improving at Grey Sloan but Jo instead asks how Bailey manages to keep it together while being faced with a world full of issues that she has to raise her daughter in. Bailey reminds herself that Pru has already lost a parent so she cannot get herself arrested. Jo says she and Carina have extended clinic hours to accommodate patients from other states. Bailey inquires about her surgical hours. Jo realizes that Bailey is using her to get information about the hospital while she thought Bailey could be a her mom friend.

As Teddy supervises, Mika applies pressure on the lower left quadrant while Harold bears down. Owen manages to extract the phone.

Simone sits with Bruno to get some information on Chase. After a bunch of information on Chase's personal life, she clarifies she wants medical information but Bruno only knows he's had syphilis once.

Nick finds Meredith and informs her that the kidney transplant went well. She brings up the changes he made. He asks if there's a problem. She denies and proceeds to make small talk, which he deems weird. Jules comes up to talk to Meredith about Chase.

Link is checking on Chase's leg. It's cold and darkened and he can't find a Doppler signal below the knee. Chase's mother is on her way. Link says they have to amputate. He tells Jules she gets to do it and orders her to prep Chase.

Maggie is guiding Levi through the TAVR procedure as Winston enters the cath lab. Winston needed Levi in OR 4 after he specifically begged Winston to assist. Levi says the schedule changed so much and he follows hierarchy, so he came when the Head of the department paged him. Winston has to reschedule the lobectomy again.

Richard finds Nick to inquire about mini grand rounds. Nick says interns present cases to the group which helps with lecture capabilities and future rounds. Nick wanted Richard to be there to provide feedback. He wonders if someone will criticize every change that he makes. Richard says six months ago, he wasn't his best self. Nick deserves an apology, too. Nick appreciates that but he feels like there is more to it. Richard says it's none of his business but Meredith is worth taking a job for, if that is why he did. As of now, the program is all Nick's.

Jules and Link get gowned and gloved in the OR. Mika is surprised to find Benson in the gallery. He explains that Winston's procedure was rescheduled by Maggie. There are clearly issues between them. Mika complains about her situation with Owen and Teddy. She is then paged again.

Jules find that Link has written "Cut this leg :) you've got this" on Chase's left leg and "not this leg :(" on the right one. She openly questions if Link is flirting with her on a sick patient's leg. Link says this is him being a supportive teacher. He also genuinely doesn't want her to cut off the wrong leg. Jules asks for a scalpel and makes the first cut.

Owen enters Harold's room, where Mika is performing CPR. Sharon says he started breathing weird. Harold's gone into cardiac arrest and needs to be intubated. There is no time to page Teddy so Owen talks Mika through the intubation. She pulls it off successfully. Owen says they'll now work to get his circulation back.

Bruno says he requested a single room because he grew up an only child with social anxiety. He dreaded parties and even reading the word mixers made him panic. He almost dropped out when he was told he would get a roommate, until he met Chase. He likens him to an emotional support animal. They've been living closely together in a crowded dorm without any fights. They went through colds and flus together. Simone wonders if Chase received all of his childhood vaccination. She rushes off.

Link instructs Jules to cut harder. Simone bursts into the OR and says the food poisoning was a distractor. Chase has meningococcus. The cultures aren't definite yet but she checked his records and he was never vaccinated for them. Meningococcus is common in college dorms. Jules alerts Link to heavy bleeding. Chase is not clotting properly due to the DIC. Link has the tourniquet tightened as Jules elevates the leg.

As they walk with their daughter, Jo has informed Bailey on all the changes that Nick has made to the residency program. She likes the changes but she has tried to implement similar changes, which was always met with resistance. Jo tells her she is allowed to change her mind and come back. Bailey has started a garden at Pru's school. She gives talks about plants and how, if you plant a seed, the roots have to grow before anything else. She wrote a sex ed program with a community clinic and is answering phones for a women's organization. She is planting seeds and growing roots. She's not ready to return. But she does count Jo as a mom friend. Jo smiles.

Richard joins Owen in a trauma room so he can place a central line. Owen is sure Teddy is loving every moment, thinking she considers this payback for the six months when he couldn't work. He hated those months. He is wired to work. He surfed to distract himself and wrote letters to Congress in support of burn pit legislation rather than drink and look at people with hate. Maybe he chose the most expensive lawyer to save his career but she is the one who made them run away, not him. And now she's posting their credit card bill on the fridge. So now, not only is he living with someone who resents him, she now stands over him at work as well. Richard suggests Owen find some physical space.

Maggie finds Winston and apologizes for messing up his schedule. He asks if that includes the past six months. Maggie explains that she needed people she could trust in her OR. Interns are not senior residents. Winston points out that doesn't make it okay for her to treat him like her resident like she did at Tufts. Winston says he is talented because he had a good teacher. She can't expect people to be good unless they teach those people, which he can't do if she messes with his cases and schedule. Maggie understands.

Simone and Meredith took Bruno to see him in the ICU. He'll get to live, although without his lower left leg, due to Simone's quick thinking. The culture confirmed her diagnosis. They get Bruno gowned and gloved so he can sit with Chase. Meredith informs Simone they all need to start a four-day antibacterial regimen due to being exposed. She asks how Jules is doing. Simone doesn't know. Meredith tells her that any one of them would have struggled to control that bleeding. She should be there for Jules because one day, Simone will be the one who makes a mistake and her fellow interns will be the only ones who understand. It's too early to go numb. Simone is not the comforting type but Meredith says there must be something that cheers her up after such a day.

Simone has taken Jules to the gift shop. It's the only place in the hospital that smells good. Also, the stuffed animals are pretty soft, too.

Meredith paged Nick to her office. She wanted to go over the budget request for the lunch and learns, which is when the department provides protected lunch time once a week and rotating attendings lecture during lunch. Nick wonders why it seems that Meredith is mad at him. She's not. She wonders why he has barely spoken two words to her since he's been here. He needs her to say it here. Owen bursts in and says he can't work with Teddy watching over his shoulder. He talked an intern through an intubation and he has decided he wants to be a teacher for the next sixth months rather than work and keep attendings away from their work. Nick and Meredith consent. Owen leaves. Nick then goes to leave as well since he doesn't have time for all this back and forth. Meredith says she went numb. The program was shut down, they lost a patient, and Nick didn't have her back. She has lost so many people and when he walked away, she thought she lost him, too. When she saw again last week, she could feel again. She is still in love with him. If that's what he needs to hear, she'll say it as many times as he needs to hear it. He smiles. He wants to take her to dinner. She declines but he can take her to Zola's presentation instead.

Jules and Simone join the other interns in the tunnels. They hand out stuffed animals. A study has shown that touching a stuffed animal helps reduce anxiety, especially in people with low self-esteem. Mika happily shares that she intubated a patient today. Benson then announces that Lucas is sleeping with Amelia. Unless Lucas has a different explanation for the on-call room and the whispering. Lucas stays silent. Jules says everyone owes her $12 for the stuffed animal. Mika switches hers with Benson's.

Meredith, Nick, Amelia, Maggie, and Winston attend Zola's presentation. On stage, Zola talks about Ellis' clinical trials and how one was cut short due to her exhibiting symptoms of early-onset Alzheimer's disease. Zola then loses focus as she starts talking about how the disease is genetic. She spirals out and says her mother and aunt will get it, too. They'll die and she'll have no one left. She starts crying as Meredith runs onto the stage to comfort her.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Nick's Patient[]

  • Diagnosis:
    • Kidney failure
  • Treatment:
    • Kidney transplant

Nick mentioned he was doing a kidney transplant.

Winston's Patient[]

  • Diagnosis:
    • Pericardial effusion
  • Treatment:

Winston had Kwan look at a patient's scan and identify pericardial effusion, which was compressing the patient's heart.

Mr. Veras[]

  • Diagnosis:
    • Trach infection
  • Treatment:

Mr. Veras was back in the hospital with an infected trach and Maggie sent Winston to tend to him.

Maggie's Patient[]

  • Diagnosis:
  • Treatment:

Maggie said she had a patient who needed an echo and admissions orders for observation and asked Winston to do that.

Winston's Other Patient[]

  • Diagnosis:
  • Treatment:
    • VATS Lobectomy

Winston was supposed to be doing a VATS lobectomy, but Maggie pushed it back. When the time came, Winston was upset that Levi didn't scrub in because he was in another surgery, so he pushed the surgery back again.

Maggie's Other Patient[]

  • Diagnosis:
  • Treatment:
    • Transcatheter aortic valve replacement

Maggie said she was doing a TAVR. She asked Levi to assist her and he did.

Owen's Patient[]

  • Diagnosis:
  • Treatment:
    • Chest tube

Owen put a chest tube in a patient and Teddy questioned if another doctor had been observing him when he did it.

Chase Sams[]

  • Diagnosis:
    • Septic shock
    • DIC
    • Bilateral pleural effusions
    • Meningococcus
  • Treatment:
    • High-flow oxygen
    • Pressors
    • Below the knee amputation

Chase, 19, was in the ER vomiting. He and his friend said they'd had a few drinks and then gone home and shared fried rice they had leftover. They believed they had food poisoning causing the vomiting. Simone and Jules planned to start IV fluids, but Chase began to struggle to breathe. They put him on oxygen and examined him. They found a rash on his abdomen and paged Richard and Meredith. Meredith examined him more closely and found the rash was also on his legs and arms. She ordered a chest x-ray, blood cultures, and told them to admit him to the ICU on high-flow oxygen. In the ICU, his pressure tanked and he became completely unresponsive. The rash also spread to his entire body. Meredith ordered pressors and intubated him, which stabilized him. Then he started bleeding around his central line. He was in septic shock and in DIC, with bilateral pleural effusions. Meredith challenged the interns to solve the mystery before he died. They searched medical textbooks and tossed around different possible diagnoses. Chase got worse and Link found that his lower leg was at risk of gangrene, meaning they had to amputate below the knee. While Jules was operating, Simone came in and told them he had meningococcus. At the same time, he started bleeding profusely due to the DIC. They were able to get the bleeding under control and finish the amputation. His friend was told he'd be okay.

Bruno[]

  • Diagnosis:
    • Food poisoning
  • Treatment:
    • Fluids

Cruno came to the ER with his friend, Chase, also vomiting. They believed they had food poisoning from leftover fried rice. Simone and Jules started IV fluids.

Harold Peters[]

  • Diagnosis:
    • Foreign body in rectum
    • Cardiac arrest
  • Treatment:
    • Manual extraction
    • CPR

Harold was in the ER with abdominal pain. He said he may know what it was, but before he could tell them, Harold's wife came in. Owen said his abdomen was distended and he wanted to do an ultrasound. The ultrasound showed nothing abnormal, so they planned to do a CT, but before they could, Harold's wife called her phone and revealed that it was inside Harold. He'd put it inside his rectum. They manually extracted the phone. Later, he went into cardiac arrest and Owen had Mika intubate him while he did CPR.

Amelia's Patient[]

  • Diagnosis:
  • Treatment:
    • Spinal fusion

Amelia had a patient who needed a spinal fusion and she wanted to do an anterior approach. She asked Winston to assist, but he said she had to check with Maggie.

ER Patient[]

  • Diagnosis:
  • Treatment:

Owen placed a central line in the ER while Richard observed.

Doctors[]

  • Diagnosis:
  • Doctors:
  • Treatment:
    • Prophylactic antibiotics

All the doctors who treated Chase Sams were put on a four-day regimen of prophylactic antibiotics due to their exposure to meningococcus.

Music[]

Song Performer Scene
"Good Good Day" Ryan Corn & Anna Graceman
  • Simone's grandma gives her her lunch. Inside the bag is a remote.
  • Mike and Jules talk as they arrive for work.
  • Amelia finds out Lucas is living at the hospital.
  • She tells him to stay at Meredith's.
  • Lucas runs into Blue as he leaves the room.
"Shake Me to the Bone" Jason Hickman
  • Levi asks Taryn to come back to work and she refuses.
"Are You Ready?" Kenny Sharp
  • Mika and Blue talk as they watch a surgery.
  • Mika gets paged away.
  • Jules and Link have an awkward moment as she prepares to operate.
  • Jules makes the first cut.
"Myself" Marvin Brooks
  • Meredith and Simone tell Chases's friend he'll be okay.
  • Meredith tells Simone to go comfort Jules.
  • Simone takes Jules to the gift shop.
"Walk This Road" Regina Price
  • Nick leaves Meredith's office.
  • Jules hands out stuffed animals to the interns.
  • Blue tells the others Lucas is sleeping with Amelia.
  • Lucas can't defend himself.
  • Zola starts to struggle while presenting.
  • Meredith goes onto the stage to help her.

Notes and Trivia[]

  • This episode's title originated from the song Wasn't Expecting That, originally sung by Jamie Lawson.
  • This episode scored 3.32 million viewers.[1]
  • This episode marks the first time that the hospital's gift shop is shown on screen.

Gallery[]

Episode Stills[]

Quotes[]

Mika: Mika Yasuda, reporting for Dr. Hunt's service. I'm his intern today.
Owen: You know, you might want to find a new service.
Teddy: Yeah, Dr. Hunt used to be Chief of Trauma, and then he lost his mind, so now I'm Chief of Trauma.
Owen: Yeah, also, she's my lovely wife and mother of my children. Her favorite color is blue.
Teddy: Did she really need to know that?
Owen: Yes. To humanize you!
Jules: Are you flirting with me on a sick patient's leg?
Link: No. No, no, no. Crap. No. That is not me flirting. That is me being an encouraging teacher. Supportive. In an appropriate way. I didn't put a winky face next to it or anything. I genuinely don't want you to cut off the wrong leg.
Richard: Hello, Altman. Well, I'm glad you and Hunt decided to come back. I imagine it's hard with everything he has to go through right now.
Teddy: Let me guess. Owen thinks that I'm drinking too much, so he asked you to intervene. Thanks. I'm good.
Richard: I was just asking how you were doing.
Teddy: Well, I have spent the last six months on my feet working locum tenens in L.A. while Owen developed an artistic penchant for building sand castles, which was fun for the kids, but, honestly, the sand castles were pretty basic. And since his legal team bankrupted us, Owen and I now have lengthy arguments about important topics like whether to buy name-brand or store-brand shampoo. Every time I look at his face, I am filled with such annoyance that I have to go outside and pretend to garden when, really, my kids are just seeing me rip up plants. The worst part of all of it is that I still don't want to leave him because he's the father of my kids, and somewhere really deep down inside, I still love him. And wine helps me remember that, so I drink three glasses a night. But never at work. And the kids are in bed by 8, and I don't get behind the wheel. I mean, the riskiest thing that I may do is watch too many puppy videos at night. Is that a problem for you, sir?
Richard: Always good to see you, Altman.
Nick: Look, I don't have time for all this back and forth, Meredith. And based on the way people just walk on in here, neither do you. Good night.
Meredith: I went numb. The program shut down, and we lost a patient. And you didn't have my back. You know how many people I've lost in my life. And when I watched you walk away, and I thought I lost you, then I went numb. That's why I didn't call you for six months. And then when I saw you in the surgical corridor, I could feel again. I know I'm still in love with you. I know my life is crazy. And I know I can't stop people from coming in the door every five minutes and interrupting absolutely everything I do. But I do know that I love you. So if that's what you need to hear, I'll say it, as many times as you need to hear it.

See Also[]

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


References[]

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