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With a Little Help From My Friends

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“ Surgeons like to believe they're the center of the universe, that their million-dollar hands are the only thing that matters. You only need a scalpel and a patient to use it on. No one else. I used to believe it, too. But that was before I had kids. Truth is, from the time your patient first gets sick to the time they're lying on your table, a team of internists, specialists, and nurses have all already interacted with that patient more than you ever will. I've had to operate alone before in circumstances I would've never thought possible. By now, I know what I'm capable of, how much I can handle on my own. And you know what? I can handle a lot. But that doesn't mean I'm going to turn down an assist from another pair of skilled hands. Because at the end of the day, just because I can do a surgery alone, doesn't mean I have to. Knowing someone else has your back? It's everything. ”

With a Little Help From My Friends is the fourth episode of the eighteenth season and the 384th overall episode of Grey's Anatomy.

Short Summary[]

Richard recruits Meredith and Bailey to help him launch a new program. Meanwhile, Addison's patient has complications from a procedure, and Jo helps a woman who goes into premature labor.

Full Summary[]

As they get ready for the day, Catherine embraces Richard. They had some fun this morning and she might re-pay the favor tonight. She then brings up his plan, which she fears could end up without someone being hurt. He asks her to trust him.

Nico and Levi are making out in on-call room. Taryn persists in knocking on the door and yells at Levi to check his phone. He does so and reads that Richard is back as residency director while Grey will split her time between surgery and research. They were supposed to be in the skills lab already. He gets dressed and rushes out.

Amelia meets Addison in Tovah's ICU room. Tovah started seizing while Addison was en route to the airport. She needs Amelia's help to figure out what happened.

Noah meets Owen at a meeting with veterans. The leader, Roy, asks the veterans to write down all their symptoms and diagnoses. Roy is heading to Washington next month to lobby. Roy plans to expose the VA. Roy then spots Noah in the back. They share a hug. Noah introduces Roy to Owen, who explains he's here because he's hoping to start a study about the diseases caused by burn pits. Roy then coughs up blood and collapses.

Cormac runs into Jo in the parking lot. Luna is teething. Jo is running late. Cormac lends her a hand. Jo admits she's struggling as a single mother. As they're heading in, a car pulls up and the driver calls for help. The passenger, Niki, appears to be in labor but she says she's not due for another couple of weeks. Dustin is shocked that she is pregnant. They have only been together for four weeks. Jo hands Luna over to Cormac and then sends Dustin to fetch a wheelchair.

Bailey walks with Meredith to the skills lab. Meredith is leaving for Minnesota in the evening. Bailey hopes she'll credit Grey Sloan when she publishes. Both of their schedules have been cleared. Outside the skills lab, they meet up with Catherine and Richard, who says they are helping him début a new teaching method.

Inside, Richard asks for the residents' attention. Each of them will be performing a lap chole start to finish on their own. They are attendings today. The residents are ecstatic, contrary to Meredith and Bailey. Richard announces that this is the Webber Method.

Winston meets Owen and Roy in the ambulance bay. Owen informs him what happened and orders chest films. Roy says they won't show anything good. Noah arrives as they rush Roy inside. Owen promises to come update him as soon as he can.

After an exam, Carina tells Niki that she is having her baby today. Niki utters that it's her one-month anniversary with Dustin, who asks about the father. Niki says it was just a random hook-up. Dustin can't believe he had sex with a pregnant woman. He thought she was just big. Jo sends him to get find ice chips. Niki says her chest hurts.

Richard shows Meredith and Bailey his schedule of concurrent surgeries. It allows experienced residents to be the lead surgeons while attendings rotate in and out to maximize efficiency. The critical part of the surgeries only lasts 10 out of the 45 total minutes so by rotating in and out, the attendings will be there for that part of the procedure. Richard says this is the answer to the physician shortage. This generation of residents wants to work smarter, not harder. Meredith is on board to get the residents in the OR. Bailey begrudgingly agrees as well.

Megan finds Hayes and asks him for a consult. She talks about a 14-year-old boy who seemed to be getting extra winded the other day playing soccer outside their hotel, and his ankles were a little swollen. Cormac needs to examine the boy to tell her anything definitive. Megan leaves.

While in the CT machine, Roy asks Owen how he met Noah, who avoids doctors like the plague. Roy cares for Noah like a son. He met him as a young recruit and watched him grow up, get married, and have his son. The scans come up and reveal a nodule, likely to be lung cancer. It looks like it's in the early stages but with his pulmonary fibrosis, it might as well be terminal. Owen hates that this is happening because the US military can't be bothered to dispose of its waste.

Amelia is going over Tovah's file and asks if there's a history of seizures. Addison tells her to ask smarter questions. They are drs. Montgomery and Shepherd now. They are fixing this woman whose sister begged her not to participate in the clinical trial because she couldn't lose someone else. Ideally, they fix her without having to remove the uterus and set Addison's research all the way back. Amelia orders an MRI, an EEG, and labs.

Megan finds Cormac again and says the patient is in exam room 4. Megan asks Cormac to be straight with him and her. They enter the exam room and Megan introduces him to Farouk.

Meredith finds Bailey praying in front of the OR board. The patients are human beings and they are putting their lives in the hands of children with scalpels. Meredith says they were like that once.

Levi and Khan are teamed up. It's been many years since Khan performed a lap chole. Levi makes the first cut.

Tseng does the superhero pose before she asks Linda for the scalpel.

Taryn and James are paired up, too. Taryn is the first of them to take the lead.

The general attendings rotate in and out of the OR's as planned. They give some pointers where needed but everything goes well.

Dustin asks Jo to give Niki her phone back. He's leaving. Jo was hoping he could hold her hand. Dustin says they met a month ago but he is not ready to be a dad. Also, Niki lied to him. Jo understands.

Cormac tells Megan that Farouk's ECG shows non-specific ST-changes and he hears a murmur. Cormac asks about Farouk's medical history. He was treated for TB about 10 years ago in Iraq. She doesn't know anything about his history before he was 4 years old. She tells Cormac she raised him while she was a POW. He didn't realize she served, too. Cormac wants a cardiac echo. She consents and asks him not to tell Owen just yet.

Winston and Owen enter Roy's room. They ask Noah to leave but Roy allows him to stay. Owen shares their findings. Normally, they would perform a lobectomy but with his fibrosis, he can't afford to give up that much of his lung function. Roy asks about his prognosis. He wants to make it to Congress next month. Winston says a risky approach would be to perform a segmentectomy, where they only remove the mass. He wouldn't recommend it. Roy says the possibility of little extra time is all he needs to go for it. He has fought for all of his life and he's not stopping now.

As they wait for Tovah's MRI, Addison asks Amelia why she left Link. Amelia says his proposal was a disaster. Addison says the proposal could be seen as earnest and romantic rather than gaslight-y and manipulative. Addison says they are back to being sisters now until the scans come up. Amelia says she said no because she knew for months that she didn't want what he wanted. When they were drowning in children during the pandemic, she felt like she was dying of monotony and boredom and domestic life. She thought about doing drugs every night and did virtual meetings. She was hanging on by a thread while Link was falling in love with domesticity. He started proposing all the time despite her saying no and he wanted more kids. She felt like she couldn't breathe and she judged herself for that. Addison reveals she drank so much wine during the pandemic that she considered checking herself into rehab. She hated being stuck at home and she began to hate her video game-addicted son and her husband, who took up model trains. Addison went dark. She was daydreaming about going to sleep and never waking up, a thought that comforted her. Amelia thanks her because she felt the same. The films come up, meaning they are back to being doctors.

Richard enters the OR and is surprised to find that Levi has already finished. Another lap chole came in through the ER so Richard offers him a double feature. Levi gladly accepts.

Owen and Winston find a group of veterans in Roy's room. Roy wants to say something in case he doesn't make it but Noah tells him he'll make it out. He shares a story of a sheep trampling Roy on base. If that angry sheep couldn't take him down, nothing can. Roy tells the vets that he won't forget all of them coming here for him. He is then taken to the OR.

Jo tells Niki that her cardiac work-up looked good. She suspects Niki is experiencing some anxiety. Niki points out her situation, so yeah, that would be possible. Niki asks about Dustin. Jo dodges the question. Niki realizes he left. She can't do this alone. All of her friends told her she was crazy for having some random guy's baby. Her parents wanted no part of it so she moved across the country. She met Dustin and he didn't seem to mind. She doesn't understand how he did not notice. Jo says she'll hold Niki's hand and asks a nurse to page Carina.

When the field floods with blood, Taryn decides to convert to an open procedure. She calls for an attending.

Amelia and Addison go over the results. They can rule out everything but neurotoxicity from the anti-rejection meds. Amelia says they can switch the meds, keep Tovah on anticonvulsants and watch her like a hawk. Addison says she has to return to Los Angeles. She had arranged for her clinical trial team to monitor Tovah from here on out. Amelia can't monitor her because she's going back and forth between Minnesota.

They head into the attendings' lounge. Amelia says they have her loaded on anticonvulsants and they can take out the uterus if they absolutely have to. Addison can't let Tovah die. Helping Tovah helped Addison. It made her want to get out of bed in the morning. She needs to prioritize Tovah's life over her study and she needs Amelia to tell her that there is a chance. Amelia says Tovah loved her husband so much and wanted his kid so bad that she entered Addison's study knowing that she was risking her life. Addison is doing everything she can to help her live her dream.

Roy gets settled on the OR table. He has a daughter on the East Coast. She took her mother's side in the divorce. If someone had made her breathe in all that crap that caused this disease, he would want that person dead. Owen says they'll hold the people at fault responsible. Roy reveals he authorized the burn pit on his base. He knows he committed the worst crime: complicity. So, at the end of the day, he might deserve to die. He is ready.

Bailey gets gowned and gloved in Taryn's OR. She tells Taryn she should have waited to convert to an open procedure. She orders her to step aside.

Owen and Winston are working on Roy. The lung tissue is severely damaged. Winston compares it to advanced ARDS with COVID. Owen thanks Winston for doing this. Winston wants to do what's right. Roy starts hemorrhaging. Winston clamps the source. They knew Roy wasn't going to make it easy on them.

Levi finishes up his procedure. The other residents and Catherine applaud his flawless technique and the success of Richard's technique. Levi thanks Richard, who cuts him off to announce that they set a hospital record. He encourages the residents to study hard because who knows what procedure they'll get to perform tomorrow.

Tovah wakes up in the ICU. She fears they had to remove the uterus. Addison says she didn't reject it. There is still a chance for her to have her husband's baby. Amelia wants to do a neuro check but Addison asks her to give Tovah a minute to cry.

As she enters the room, Carina tells Jo that it's her job to deliver babies rather than hold hands. Niki is crowning. Jo lets go of her hand to assist Carina. Jo tells Niki she is not alone. She has her son. As soon as he comes out, he will be her whole heart. There will be days where she can't believe that she's that boy's mother, but she will love him so much. One smell of his head will make her feel like her heart can explode. That is worth so much more than the fear. Jo tells her to start pushing. Jo then finds that there is shoulder dystocia. With some guidance from Carina, she performs a McRoberts manoeuvre and delivers the baby.

In an empty radiology suite, Cormac tells Megan that Farouk's echo and cardiac MRI show constrictive pericarditis, most likely secondary to the TB. Megan hates that the hits for Farouk just keep coming. She breaks down in tears. Cormac says he'll most like have to undergo a pericardectomy. Megan says Farouk is such a good kid despite of all the things that he has been through. He has to pull through. Cormac will do everything in his power to make sure that he does. She decides not to tell Owen yet.

In the ICU, Owen tells Noah that Roy has a tough road ahead because of all the scar tissue. Noah is sure that he can handle it. Noah asks Owen for doing all this for them. Owen says this is personal to him. Suddenly, Roy goes into V-fib. Owen orders Noah to step out. He is escorted out by a nurse and watches as Winston and Owen defibrillate until a nurse closes the curtains.

Richard, Bailey, Meredith, and Catherine celebrate with cider in Richard's office. Meredith says he set a high bar for the residents. Richard says this will be his primary method of teaching from new on. Bailey is still not on board. Helm clipped that artery with no attending present and even Bailey initially couldn't tell which way was up. Richard says complications can always happen. Bailey thinks that is why they owe it to their patients to be in the room. Richard says they'll be short tens of thousands of surgeons in a few years if they don't rethink what they're doing here. Meredith says Taryn asked for help. The patients made it out alive. The system works. Bailey concedes and toasts to the Webber Method.

Winston and Owen find Noah in the waiting room. They did everything they could. The surgery put too much stress on Roy's heart. Owen offers Noah to help him to keep Roy's work going. Noah doesn't want his help. He didn't want any of this but Owen convinced him. He introduced Owen to his friends and family and he made it worse.

On her way out, Addison tells Amelia she almost left Jake two months into the first lockdown. She was stone cold sober at that point. When Jake and Henry were bickering about Game of Thrones, she got up off the couch, got in her car, and drove for two hours before she stopped to ask herself what she was even doing. Addison says when one is in a slight mental health crisis, one might later regret the decisions they made. Amelia says she didn't leave when she was thinking about doing drugs or when she was wondering if Link would ever really understand her. She stayed because she thought she must be crazy to leave a good guy. But she doesn't feel crazy now. She doesn't want to get high. She just doesn't want a ring or more babies. Also, she didn't leave Link. He left her. But she hated the life that he loved, so the sanest and kindest thing to do is to let him go, no matter how much it aches sometimes. Addison says that Amelia Shepherd is all grown up.

Owen enters the attendings' lounge. Cormac sees he's had a rough day. Owen invites him for drinks at Joe's. They head out together.

Levi meets Nico and drags him into a supply closet. They start making out. Nico heard Levi was a rock-star today, which turns Levi on.

Jo is sitting on a bench outside the hospital with Luna. She's gathering up energy to walk to the car.

On her way out, Bailey walks by Taryn on another bench. She knows Taryn is playing the surgery over and over again in her head. When she saw the bloody field, she felt cold and numb and sick to her stomach. She knows the feeling because she has made mistakes in the OR before, as has Meredith. Taryn feels awful. Bailey says that feeling ensures that they don't make a mistake like that again. It's how they become great.

Meredith arrives in Minnesota. She runs into Nick in the parking lot. He just performed a liver transplant. He's glad to see her. He invites her to dinner tonight, which she accepts. She tells him to get some rest. He looks after her as she heads into the building smiling.

Cast[]

Main Cast[]

Special Guest Star[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Tovah Freedman[]

  • Diagnosis:
    • Seizure
  • Treatment:
    • Lorazepam
    • Phenobarbital
    • Induced coma
    • Immunosuppressants

Tovah was still in the hospital after her transplant. She had a seizure, so Addison gave her lorazepam and phenobarbital and put her in an induced coma, then called Amelia for a consult. Amelia did a CT, which was negative. Her labs were also good, so Amelia ordered an MRI, an EEG, and an electrolyte panel. All of those came out clear, so they thought she might have neurotoxicity from her anti-rejection meds. They adjusted her medications and they were able to wake her up and tell her they hadn't had to remove the graft.

Roy Davis[]

  • Diagnosis:
    • Pulmonary fibrosis
    • Lung cancer
  • Treatment:
    • Segmentectomy

Roy, 60, collapsed while leading a meeting of sick veterans and was taken to the hospital. They took him into the ER for chest films. He already knew he had pulmonary fibrosis. His MRI showed lung cancer. It was early stage, but because of his pulmonary fibrosis, he was still considered terminal. They told Roy about the diagnosis and said they could operate and try to remove just the mass, but it wouldn't cure him. It would at most give him a little extra time. Winston didn't recommend it, but Roy asked them to do it anyway. He survived the surgery, but became unstable afterward and was unable to resuscitated.

Niki[]

  • Diagnosis:
    • Pregnancy
  • Treatment:
    • Vaginal delivery

Niki came to the hospital in labor. She said she wasn't due for a few more weeks. Carina examined her and told her she was five centimeters dilated and would be having her baby that day. Shortly afterward, Niki grabbed her chest, so Carina checked her heart and ordered an EKG. Her EKG was normal, so they attributed her chest pain to anxiety. Later, when the time came for the baby to be born, Jo noticed shoulder dystocia. Jo did a McRoberts maneuver to complete the delivery. Once he was born, they handed the baby to Niki.

Cholecystectomy Patients[]

  • Diagnosis:
    • Cholecystitis
  • Treatment:
    • Laparascopic cholecystectomy

Richard arranged for the residents to do solo cholecystectomies back-to-back, with himself, Meredith, and Bailey rotating through the ORs to supervise the most difficult part of the surgeries. Most of the surgeries went well, but Taryn was forced to convert to an open procedure when there was unexpected bleeding in her patient. She also had Bailey paged to help. With Bailey's help, she was able to save the patient. In total, they operated successfully on 13 patients.

Farouk Shami Hunt[]

  • Diagnosis:
    • Constrictive pericarditis
  • Treatment:

Farouk, 14, was extra winded while playing soccer and had swollen ankles, so his mother brought him to the hospital so Cormac could examine him. Cormac did an EKG, which showed non-specific ST changes and he heard a murmur, so he did an echo and a cardiac MRI, which showed constrictive pericarditis, likely secondary to tuberculosis, which he'd had ten years prior. Cormac told Megan he'd most likely need a pericardectomy.

Music[]

Song Performer Scene
"Fall In Love" Kenny Sharp
  • Catherine and Richard flirt as they get ready for their days.
  • Taryn interrupts Levi and Nico. Levi finds out he was supposed to be in the lab 15 minutes ago.
  • Addison watches Tovah, who has had a seizure. She needs Amelia to help her.
"Something New" Tiggs Da Author
  • The residents start their surgeries.
  • Bailey, Meredith, and Richard rotate through the surgeries.
"The Coast" Noah Gundersen
  • Amelia and Addison tell Tovah she didn't reject the uterus.
  • Carina tells Jo her job is to deliver babies, not hold hands.
  • Jo goes to help with the delivery and talks to Niki about being a mother.
  • The baby gets stuck and Carina helps Jo get him unstuck.
"Puzzle Peace" Sailr
  • Addison tells Amelia she's all grown up before she leaves.
  • Owen invites Cormac to get a drink.
  • Levi and Nico make out in a closet.
  • Jo sits on the bench with Luna.
  • Bailey talks to Helm about her surgery.
  • Meredith meets Nick in Minnesota. They make plans for dinner.

Notes and Trivia[]

  • This episode's title originated from the song With a Little Help From My Friends, originally sung by The Beatles.
  • This episode scored 3.91 million viewers.[1]
  • This is the first time that Catherine appears without Jackson.

Gallery[]

Episode Stills[]

Quotes[]

See Also[]

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


References[]

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