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When I Get to the Border

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“ When researchers studied the way surgeons make decisions in the OR, they found newer surgeons tend to rely on the standard operating procedures they learnt in school. It makes sense. Newer surgeons have limited experience to fall back on. But seasoned surgeons are more intuitive. They mine from years of practice to make quick and effective decisions. The more experience we have, the less likely we are to be thrown when we encounter complications. We can shift gears more easily when it's needed. With enough practice, surgeons learn how and when to pivot from standard operating procedures. Experience gives us more context to know when we need a different approach. It gives us more options to help our patients. One-size-fits-all solutions don't always work. Every patient is different, just like every person is different. We each have various factors to consider when facing life's big decisions. So we gather the facts. We analyze the options. And we use our knowledge and experience to make the choices that are right for us. ”

When I Get to the Border is the fifth episode of the nineteenth season and the 405th overall episode of Grey's Anatomy.

Short Summary[]

Bailey and Addison take a road trip to volunteer at a family planning center, but a patient's ectopic pregnancy leads to complications. Elsewhere, the interns play detective about Lucas' relationship with Amelia, and Meredith catches up with Jackson on a trip to Boston.

Full Summary[]

In Boston, Meredith and Zola arrive at the Brookline Steam Academy. It has one of the best science program in the country. After having toured New Hampshire and New York, Zola just wants to go back to Seattle but Meredith encourages her to keep an open mind. Meredith explains they are going to find a school where the other students are as bright as her. Zola is shadowing today so she can make an informed decision. If she doesn't like it, she doesn't ever have to come back.

Bailey and Addison are on a road trip. Addison is on the phone with Jake and Henry, who has lost his lucky baseball card. They are en route to meet Cynthia, Bailey's first-year college roommate. Cynthia is now running a clinic in Pullman, Washington. Cynthia is thrilled that they are coming to help out with patients from Idaho flowing in after the state restricted abortion. They arrive at the clinic and are met with a crowd of anti-abortion protestors. They park their van and make their way through the shouting crowd.

Amelia runs into Lucas as they arrive at the hospital. He specifically took the bus to avoid her after she woke him up to make lunches for Ellis and Bailey. As Amelia is paged, she asks him to take Scout to daycare. She claims she would ask any trusted intern to do this and promises to let the group know that he's coming.

Cynthia meets up with Addison and Bailey. The family planning clinic has been open for 45 years. Last year, they helped out over 2,000 patients. When Roe was overturned, they moved the staff offices and break room to convert more space into exam rooms. Cynthia needs volunteers for the clinic to continue running. She shows them the massive pile of patients files of patients who need to be seen.

Tom meets up with Jackson and Catherine outside the Foundation building. Tom and Catherine disappear for a mysterious project that they refuse to inform Jackson about. Once they are gone, Meredith arrives and hugs Jackson. He wants to hear what's going on with her. She wants to go up to his office to have her nervous breakdown in private.

Addison finishes off her consult with a pregnant patient. Bailey has already seen six patients who came in looking for medical abortions. Just as they cheer about their progress, more files are added to the pile.

As Lucas searches for Dad-o, Scout's favorite stuffed toy, Scout presses all the elevator buttons. The doors open for Benson, who smirks upon seeing Lucas with Scout. He needs to go down so doesn't get on. Simone and Mika get on on the next floor. Lucas explains that Shepherd needed a favor. Mika wonders what other favors he's doing for her. Scout says "Dad-o" again, making the others think that Scout is calling him dad. Lucas says he just can't say dino yet. Lucas gets off to the stairs for the rest of the way.

Addison and Bailey agree that they miss paper charts. Cynthia informs them about a 39-year-old with a cesarean scar ectopic pregnancy. The patient is in Idaho and her OB, who diagnosed it, is refusing to remove the pregnancy despite it being a life-threatening condition. Since there is cardiac activity, the OB doesn't want to risk losing his license or being charged with a felony. The patient just called from the OB's parking lot since her car won't start. Bailey fetches the keys to the van.

Meredith has informed Jackson about Zola's panic attacks, which are causing her grades to slip and for her to become isolated from her friends. With her mind going in seventeen directions at once, she's been thinking about early-onset Alzheimer's a lot. Weekly therapy is not enough. Meredith is beating herself up over having missed Zola's severy anxiety. She never had to worry about her. Meredith is clueless. She keeps reading about Alzheimer's, thinking taht curing the disease might help Zola. Jackson points out it may not be a ridiculous thought.

As they talk about the way their kids text, Addison offers to take over driving since she likes it. They're only 20 minutes out. Addison never thought she would have to drive across state lines to pick up a patient.

The van arrives as Susan finishes up making arrangements for her daughter. Susan gets in the van and the surgeons introduce themselves.

Richard is having the interns work on their square knot. 15 minutes of practice a day is a good investment. Lucas is struggling. Lucas receives a 911 page from daycare about Scout. He rushes off.

Tom is afraid that Jackson is onto them but Catherine assures him that this is between the two of them. Catherine wants him to tell her about her scans. As they enter the radiology suite, he tells her the tumor has grown by 2 mm. Catherine considers that to be nothing. She is feeling the same. Tom recalls that when they found out the tumor had grown two months ago, she said she would consider more treatment if it would continue to grow. It grew more, meaning she is not in remission. He thinks she needs to talk to Jackson and Richard. Catherine says her name is on the building and she will decide what she needs.

Lucas arrives at daycare, where Alacia informs him that Scout wet himself. They used his backup clothes last week and never got new ones. Both of his parents are in surgery and they still had Lucas's information from this morning. Alacia suggests he buy something at the gift shop.

Susan is on the phone with her husband to inform him about the childcare arrangements she made. She reminds him they also need to provide snacks for soccer. Susan's a little thrown by the diagnosis. As she looks for her keys, she finds a bunch of friendship bracelets that her daughter made. She hands one to Bailey and Addison. Susan shows them a picture of her daughter. She is turning six next week and the only present she wants is a sister. Susan hopes she can still get pregnant after this. Addison says it's hard to say without proper imaging but it's possible. She suddenly experiences cramping and notices vaginal bleeding.

Tom mentions all the treatment options that are available in clinical trials. One of them already helped her but it made her feel like hell. She has considered the options but she doesn't want more treatment at this point. On her travels, she learned all about energy medicine and frequency medicine, none of which make her feel like she's suffering. Her acupuncturist has helped more with her pain than any one of Tom's pills. Catherine knows that Tom means well but it's her cancer and thus her choice.

Jackson finds a grand request made by a team from Brussels for research about the connection between Alzheimer's and gut microbial composition. Meredith has read studies on the matter since there are also studies that connect it to Parkinson's. Meredith says it's all theoretical but Jackson points out that is how the Parkinson's research started as well. Jackson says they have the tech and facilities to fund her project as well as a partnership with MIT's brain science program. Meredith Grey studying the disease that killed her mother is a story that would draw funding. Jackson notices that Meredith is hesitant. She could never move to Boston if Zola would not be happy here. Zola has been through so much and all of that is coming to the surface now, so Meredith wants to focus on her. Jackson is not about to give up on Meredith and this idea.

Bailey calls 911 while Addison tends to Susan. Dispatch sends an ambulance to their location. Addison starts looking for a uterine balloon tamponade, which Bailey tells her she won't find. Susan is confused as her OB told her she was okay. Addison says it's hard to predict when or if a rupture will happen. Addison finds a Foley catheter, which they can use to slow down the bleeding. As Addison inserts it, Susan wonders if she could have prevented this by not getting a C-section. Addison says C-sections are safe. Ectopic pregnancies in the scar are extremely rare. Just as Addison inflates the catheter, Bailey is forced to stop the van as they hit a traffic jam.

Lucas is buying clothes for Scout in the gift shop as the other interns walk in. He tries to cover up but since he forgot his wallet, Benson spots him and discovers the clothes. He figures out who the clothes are for. The interns are paged by Schmitt. Mika says she'll let Schmitt know that Lucas has child care issues.

Jackson recalls Meredith's decision to leave neuro for Derek and how Ellis factored into her decision to pursue general surgery. Jackson talks about meeting his father, who had loomed so large his entire life. Spending time with him taught Jackson that he was just a regular man filled with wasted potential, regrets, and flaws. It also made him see that he was living his life on cruise control, not living up to his full potential. Now he's here doing work that makes him happy. Maybe this thing with Zola and Alzheimer's is just all of the pieces of Meredith's life coming together. Her breakdown is more of a breakthrough, it seems. Meredith wonders what happens if she fails. Jackson points out she'll have moved the needle and Zola will know that she did everything in her power to cure the disease.

Bailey has no clue what is causing the traffic jam. Addison doesn't know how long the catheter will hold and Susan is slowly slipping away. Addison urges her to talk about Emily's birthday party. Susan wants to see her daughter grow up. She soon passes out. Addison starts CPR as Bailey pulls over and calls 911 again. She's informed a big accident is causing a delay in response time. They move Susan to the ground. Since Susan is in hypovolemic shock due to the abdominal bleed, the compressions won't work. It's too late. Susan's gone. Bailey calls time of death.

Tom inquires if consistently lying to her loved ones keeps Catherine up at night. Tom says persistence is part of his charm, especially when his friend's life is at stake. Catherine is adamant about her decision. If she stays this course, she'll have a few good years without chemo. She can still change her mind in the future. Tom proposes they just inform Richard and Jackson but Catherine declines. She is lying to protect her privacy and her peace. Jackson arrives and he leaves with Catherine to catch Harriet's ballet recital.

Amelia asks Benson if he's seen Lucas. Benson says he was buying clothes for her son. Amelia thinks he knows the truth. Benson says it's obvious when you see the two of them together. He suggests they can make it less obvious if she gave the other interns more neuro cases. He has steady hands and many skills in other areas, just in case Amelia's interests are expansive. Amelia understands he thinks she's playing favorites with Lucas, who comes up and drags her away.

In an empty patient room, she tells she appreciates his coming clean to the other interns. Lucas then says the interns think they are sleeping together. Lucas admits they assumed things and he didn't correct them. Amelia then understands Kwan was offering her sexual favors just now. Amelia is disgusted because rumors spread and people will think she's having sex with her nephew. She orders him to fix it.

Meredith finds Zola playing with a gyroscope with two other girls, who are picked up by Sonata's mother. Zola says the tour was just okay.

As Susan's body bag is zipped up, a defeated Addison and Bailey are approached by the medical examiner, who is looking for medical records for the report. Addison directs him to Susan's OB in Idaho. She is furious. Bailey reminds her the OB was just following the law. Addison agrees it's all on the lawmakers, who should be made to come out here and witness the carnage they have caused. She hates how her trained hands are bound by laws written by people who are so far removed from this reality and lack all experience concerning the matter. Women's lives are on the line here. Bailey looks around the scene with Susan's blood having poured everywhere.

Addison is trying to clean the seats in the van. Bailey informs her they have been requested to stay for a little while longer. Bailey wants to stay to inform the husband. Addison says the future is looking bleak. Bailey has always supported the right to choose, even though she never felt the choice was for her. She talks about her incomplete miscarriage. She had a D&C, which is the same procedure as an abortion. She is worried doctors will now be afraid to perform it and that new doctors won't get to properly learn it. She wants to teach the doctors at Grey Sloan. She realizes it won't be nearly enough.

Lucas finds Amelia in her lab and tells her that it's her behavior toward him that made the other interns suspicious. Not blowing his cover at work was the one thing he asked of her. She insists that that doesn't make it okay. For all of Lucas's life, people have assumed he only got somewhere because of his family's connections and he's always been the family's big disappointment. He never lived up to the Shepherd expectations so he wanted to see what life would be like if he was not a Shepherd. Due to her indiscretion, people have still connected the two of them. While their idea is admittedly disturbing, for his purpose, it's better than the truth. She gives him three days to come clean, or she will.

Bailey and Addison have arrived back at Grey Sloan. Bailey's clinic will open in a couple of days and she's already thinking about how to expand. Addison wants to do more, too. She wants to go to places where people need her. Her unique set of skills can make a difference. Bailey suggests southern Illinois as a base of operations with all the surrounding states having banned abortion. Bailey thought about doing it herself but Pru needs her at home. Addison is still reeling from losing Susan. Bailey assures her she did everything she could in those circumstances. Bailey then thinks of the PRT. It's sidelined now but she has an idea to repurpose it.

Zola and Meredith are having lobster rolls for dinner. Zola shares a fact about lobsters that she learned at Brookline's marine science lab. Meredith asks why Zola didn't like it there. Zola wonders what happens if they move and she still has panic attacks or fails school. They'll have left Seattle and Meredith's job for nothing. Meredith says she'll worry about that. She tells Zola that Jackson offered her a job here, working on a cure for Alzheimer's. Zola wonders what if she decides not to become a doctor. Meredith swears she would not be disappointed. She'll make her mark no matter what she'll end up doing. Zola is extraordinary. Having been comforted, Zola then enthusiastically says she loves Brookline. She wants to sign up for the robotics team and join the orchestra when they move. Meredith happily agrees to that.

Catherine is reading to Harriet at bedtime. A picture of Jackson and April is on Harriet's nightstand.

Amelia watches from outside the room as Lucas practices his stitches.

Bailey shows Addison the PRT. They smile.

Over dessert, Meredith texts Jackson that she's in. They are moving to Boston. Zola shows her a brochure on the robotics team.

Cast[]

Main Cast[]

Special Guest Star[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Amelia's Patient[]

  • Diagnosis:
    • Epidermal hematoma
  • Treatment:

Amelia was paged for an epidural hematoma.

Jessica[]

  • Diagnosis:
    • Pregnancy
  • Treatment:
    • Prenatal vitamins

Jessica came to the clinic for pre-natal care. Addison examined her and gave her pre-natal vitamins.

Clinic Patients[]

  • Diagnosis:
    • Pregnancy
  • Treatment:
    • Medication abortions

Bailey saw six patients and gave five of them medication abortions. The sixth changed her mind.

Susan Miles[]

  • Diagnosis:
    • Ruptured ectopic pregnancy
  • Treatment:

Susan, 39, had a caesarean scar ectopic pregnancy. Her OB found it on ultrasound, but wouldn't remove it, so Addison and Bailey were sent to pick her up in Idaho and bring her back to Pullman for treatment. While on the way back to Pullman, Susan hemorrhaged. Bailey called for help and continued driving. Addison found a foley catheter and used it to slow the bleeding, but they ended up caught in traffic due to an accident. When Susan lost her pulse, they pulled over and pulled her out of the van. They started CPR, but were unable to save her and she was pronounced dead at 13:34.

Catherine Fox[]

  • Diagnosis:
    • Chondrosarcoma
  • Treatment:

Tom told Catherine her tumor was 2 millimeters bigger. She was unconcerned, but he reminded her that they'd detected previous growth two months prior and she promised to consider more treatment if it grew further. She considered it and reviewed studies with Tom, but ultimately decided not to seek more treatment or tell Jackson or Richard. She instead decided to continue with alternative treatments.

Music[]

Song Performer Scene
"Get Up" Revel Day
  • Zola doesn't like the school they're touring.
  • Meredith tells her to keep an open mind.
"What a Time" Devon Gilfillian
  • Addison starts CPR as Bailey calls for help.
  • Bailey checks on Susan and tells Addison she's dead.
  • Bailey calls time of death.
"Barely on My Mind" The Regrettes
  • Zola plays with a gyroscope.
  • Zola says goodbye to her new friends and tells Meredith it was okay.
"New Day" Only Little Clouds
  • Meredith and Zola have dinner together.
  • Meredith says she saw Zola making friends.
  • Meredith tells Zola about Jackson's offer.
  • Zola admits she loves Brookline.
  • Catherine reads to Harriet.
  • Amelia watches Lucas practice stitches.
  • Bailey shows Addison the PRT.
  • Meredith tells Jackson she's in.

Notes and Trivia[]

  • This episode's title originated from the song When I Get to the Border, originally sung by Richard & Linda Thompson.
  • This episode scored 3.13 million viewers.[1]
  • The episode was filmed around August 25, 2022.[source?]
  • The scenes taking place outside the Catherine Fox Foundation building in Boston were filmed at the California Market Center in Los Angeles.[2]

Gallery[]

Episode Stills[]

Behind the Scenes[]

Quotes[]

See Also[]

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

References[]

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