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You Are the Blood

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“ Before the advent of surgery, many illnesses were treated with phlebotomy, also known as bloodletting. Bloodletting is the withdrawal of blood from a patient to prevent or cure illness and disease. It was one of the most common medical practices performed by surgeons from ancient Greece until the late 19th century. The practice has largely been abandoned because we now know that in the overwhelming majority of cases, the use of bloodletting is harmful to patients. And yet, we did it as a standard medical practice for over 2,000 years. It wasn't a blip in the history of medicine. It was an era. For decades, many doctors were convinced that bloodletting was harming more than it helped. But just as many were convinced that it was the only cure. Doctors, like most human beings, are risk-averse. We prefer the safety of what we know over the thrill of new innovations. Surgeons and doctors, as a general rule, like to know for sure that we are right before we make a move. And so, for us, change requires incontrovertible proof, which is not always easy to come by. It has been theorized that surgery itself is just an era that will pass. But that's a long way away. And in the meantime, there are eras within eras. We discover new science, we posit, prove new theories. And then we bang our heads against the wall trying to convince ourselves to actually change our practices in line with what we know. Because the end of an era is easier said than done. ”

You Are the Blood is the twentieth episode and season finale of the eighteenth season and the 400th overall episode of Grey's Anatomy.

Short Summary[]

The blood shortage at Grey Sloan Memorial continues. Meanwhile, Meredith makes a risky decision regarding a patient, and Owen's actions to help his fellow veterans come to light.

Full Summary[]

Jackson gives a eulogy about his mother in the oncology unit, who is still very much alive but thinks it's foolish to wait to say nice things until a person is dead. April and Harriet are there, too. Jackson leaves to find Jamarah Blake to save the program. Catherine then urges April to start her speech.

At the accident site, Travis and Ben are trying to recuperate the undamaged bags of blood. Travis rants about his dirty gay blood not being allowed. He knows where the guideline stems from but no one rallies like gay men. If they changed the rules, the blood shortage would be over within a week.

With Jamarah and Richard watching from the gallery, Nick finds that Cora's liver keeps oozing. Meredith is confident the blood is coming. Taryn arrives to inform them of the accident. Meredith then decides to transport Cora to the ICU where they'll have more control. They'll pack her up for now and resume when the blood is available. Meredith looks up at the gallery and recalls her first day as intern as she and her peers applauded George.

Bailey yells at Owen and Teddy for adding to her problems. Just as she wonders who is covering the pit, April enters the lounge to fetch coffee. Bailey tells her to cover the pit and hands her a coffee to go. April picks up on the tension in the room and complies.

Simon tells Kristen not to force their son to play baseball just because he did. Winston and Maggie come in to check on Simon. Kristen experiences painful contractions. Levi goes to page Jo.

April meets Ben out in the ambulance bay. He brought 37 units of blood. April has no idea what's going on so Ben informs her about the acute blood shortage at Grey Sloan and the accident. Ben tells April the ER should close to trauma.

Jackson informs Jamarah that the Foundation is doubling funding on the skills lab and residents' wellness program. Taryn runs by with FFP. Jamarah says Meredith is leaving, which she had to overhear from a resident. She wonders what else is being kept from her.

Owen tries to explain to Bailey why he did what he did. Teddy pleads what if it had been Ben. Bailey says he is not a law-breaker. Teddy and Owen bring up their experiences on the frontline and the military turning their back on soldiers.

A sign has been placed outside the ER stating that it is closed due to blood shortage.

Amelia meets April in the ER as she's donating blood. She came to see if April needed help. Amelia is talking to Catherine's oncologist later today. As April inquires about how Amelia is doing, Amelia starts crying. Amelia explains she can't seem to shove down the feelings about the breakup that she's going through. This love made her feel seen and known. It felt like a perfect fit, but they don't want what she wants and has. April says sometimes love comes back around.

In the ICU, Taryn and Nick hang the FFP. Taryn wonders why they did the surgery today with the blood shortage. Meredith snaps that they had to to prevent Cora from dying of obstruction of catastrophic GI bleeding. As she yells, she remembers some of Derek's tough teaching moments. Richard arrives, upset about the fact that Meredith went ahead with the surgery. He yells that as always, it's about Meredith and what she wants, with no regards for the consequences. With her actions, she may have killed the residency program along with Cora. Richard suspects that that was exactly what she was aiming to do, burning the place behind her as she left. Richard states that Ellis would finally be proud of her. Meredith flashes back to Ellis telling her to be extraordinary. Meredith insists the tumor had to come out.

Jo is trying to get more information from Kristen, who can't clearly say what she is experiencing. Jo wants to take her to the OB floor for a proper exam. Kristen starts panicking. Moments later, she starts losing blood. Jo is worried about a placental abruption. Jo needs extra hands. Maggie volunteers since Carina is stuck in surgery. Jo orders Levi to go find B- blood.

Levi meets Maggie, Jo, and Kristen on the OR floor. He has two units of blood ready for them but they need at least four. Maggie urges Levi to think on his feet.

Levi arrives back in Simon's room. He asks for the blood that Winston was about to give to Simon. Simon wants the blood to go to his wife. Winston consents as Link arrives. Knowing he's a dead man, he wants the doctors to do everything to save his wife and child.

Outside Cora's room, Meredith is plagued by memories from her mother. Meredith tells Nick that her mother told her once, in a lucid moment, not to go to Seattle Grace. She didn't believe Richard had what it took to teach her. Meredith didn't listen since she doesn't love being told what to do. Nick then says they could have waited to do the surgery. Nick thinks she is feeling insecure about leaving. Their conversation is cut short by Cora coding.

Jamarah interrupts Bailey's talk with Owen and Teddy. Jamarah brings to Bailey's attention that her ER is closed to trauma. Bailey admits she's not surprised. She asks Jamarah for a few more minutes here. Jamarah will wait in Bailey's office. Bailey invites her to donate blood in the meantime. Once Jamarah is gone, Bailey says she has to call the police, which she will do after she handles the life-threatening blood shortage, which will take her a few hours. She accepts their resignations and wishes them the best of luck.

Owen and Teddy have changed out of their scrubs. Their bags are packed. Teddy says they should go right now since John may have called the police already. Owen decides to have Amelia pick up the kids. On their way out, they run into two police officers who ignore them.

Amelia meets Richard and Catherine in the former's office. Amelia delivers the news that her tumor is responding to the chemo trial. Richard hugs her and Catherine tells her to get her speech ready for the preemptive memorial. Amelia leaves to take a call.

Simon asks Winston if they need to turn off the machine now. Winston says without fresh blood products, there is a higher chance of him bleeding or clotting. Link confirms there is still a chance for him to meet his son. Witnessing Simon's love story has been privilege for his doctors. Simon says Kristen changed his life. She noticed everything about him. Little by little, she showed him how to love himself. He's had a life well lived. He asks Link to tell Kristen that. Winston then leaves with the bag of blood that was still being administered.

Meredith loses herself in the process of running Cora's code. She flashes back to saving Derek after he had been shot. Nick tells Meredith to let go.

Jo delivers Kristen's baby. Kristen has lost a lot of blood. They have just used the last available bag. Jo decides to perform a hysterectomy. Winston arrives with the last bag of blood. Winston waits for a minute until the peds team member declares the baby ready for transport.

Link waits by Simon's side. He is losing strength by the second.

Winston rushes the baby to the ICU.

Meredith stops performing CPR, which reminds her of Derek's death. She calls time of death and abruptly leaves.

Link spots Winston and warns Simon that his son has arrived. Simon doesn't react until they put his son on his chest. Simon tells his son "hello forever." Seconds later, he passes away.

Amelia arrives at Joe's bar with Allison and Leo. She inquires what's going on but Teddy and Owen refuse to answer her questions beyond assuring her that everyone is fine. Owen promises to call her soon and they rush off with the kids.

Meredith finds Sally with the social worker. She introduces herself and informs her that Cora has died. Sally barely reacts. She doesn't remember Cora. It reminds Meredith of her mother's disease.

Bailey finds men lined up in the ER waiting to donate blood. The residents called their friends and launched a call on social media. Their (sexless) gay friends answered the call. Bailey smiles and swears to Levi that she will fight this hateful rule with him.

Kristen wakes up in her ICU room. Maggie and Winston sit by her side as she meets her son. Link and Jo watch from outside the room. She notices he is upset but can't bring herself to comfort him.

At a hospital exit, Link takes a moment to stare at the rain. Amelia comes running as she returns from the bar. She inquires if he knows anything about Owen and Teddy but he's just in the dark as she is. Amelia seizes the moment to apologize to Link for breaking his heart the way she did. She had forgotten how badly that hurts. Looking back now, she would have handled it differently. Link says she gave him Scout, which lightened up the dark world for him. Thanks to her, he is a dad now, so he can't hate her. He loves her, just not in a painful way anymore.

Bailey finally sits down with Jamarah, who heard about the accident. Bailey says the residents saved them with their blood drive. Bailey then admits that her head of trauma and co-head of cardiothoracic surgery quit. Jamarah brings up Meredith performing an unnecessary and extremely bloody surgery, going directly against the Foundation's Chief Medical Officer's orders. Meredith wasted the blood that the residents were scrambling to collect. Jamarah points out that the problem in this program seems to be that the people in charge have been working together for too long. They have became a dysfunctional family with no clear person in charge, which makes for messy situations. Despite Bailey's objections, Jamarah announces that she is pulling the hospital's general surgery residency accreditation. As the curious residents gather outside the office, Jamarah says she'll make sure the orphaned residents land on their feet while Bailey works to turn the program around.

Bailey and Pru wipe all the surgeries off the OR board.

With echoes from her intern year in her mind, Meredith watches as the residents pack up their stuff and say goodbye in their lounge.

Teddy and Owen have boarded a plane with their kids, heading towards a new life.

A joyful Richard and Catherine head home together.

In the parking lot, Winston tells Maggie he never said "I love you" to anyone before her. His parents weren't big on those words so they always felt like a lie to him. He didn't say those words to her lightly. It takes time for him to open up. Maggie understands that. She loves her sisters but she grew up an only child. It takes a lot for her to tell her secrets to anyone. Winston doesn't think they got married too early. They have to keep learning each other and protect this love that they share. They share a kiss.

Link runs into Jo as she picks up Luna from daycare. They share a tense look. Jo then invites him to come watch Encanto for the 57th time. Link is her best friend and the world is so screwed up that she can't have their friendship be screwed up, too. Link accepts her invitation but warns her that he'll be singing along.

Jackson has informed Meredith that Richard and Catherine have taken an impromptu sabbatical. Jackson thinks they hope that Jackson will run the Foundation entirely while Meredith and Bailey rebuild the program. Jackson asks Meredith to take back her notice. That article was noisy and if she and Richard leave at the same time, the hospital is sunk. Meredith's reputation is their only chance at rebuilding. Meredith resents Jackson for asking this of her. Jackson says this place can't not exist. It's a standing tribute to anyone who's ever trained here. Bailey then comes over and hands Meredith the keys to the Chief's office. She has to protect her health and sanity, so she quits. She's done. She and Pru have cookies to bake. Bailey takes a brief look around before taking her daughter home. Jackson concludes that Meredith really can't leave now. He's making her Chief of Surgery plus 20% more than whatever Minnesota is offering. Meredith thinks Bailey will be back. April comes up with Harriet and gleefully greets Meredith, who only sighs. Jackson knows Meredith needs some time to think it over. They'll talk tomorrow. Jackson and April get on the elevator with their daughter, where they share a kiss.

Amelia is surprised to see Kai in the parking lot. Kai says they can't sleep. They share a passionate kiss.

As Cristina's words about her being the sun echo in her mind, Meredith ponders her future as she sits in the Chief's chair. Nick comes in. Meredith tells him to go back to Minnesota, to where his life is. Her life is here. Nick clarifies he never meant to say she intentionally sabotaged the program. She wonders if he meant to say she's so indecisive, to the degree that she risked and ended a woman's life. Nick meant to say that she spent her entire adult life in one place, which makes it hard to leave. There are moments in everyone's life that they don't know what's driving them. Everyone has unpacked issues and trauma. That's why it is undoubtedly hard for her to leave, and what they did today made it harder. He doesn't think those two are unrelated. Meredith wonders why he didn't stop her then. Nick says he has enough humility and respect to entertain the possibility that he was wrong. Also, she is Meredith Grey and she doesn't like being told what to do. Meredith starts crying and again says he should go to Minnesota. She has a lot of work to do here. She evades his gaze. He leaves, slamming the door behind him. After her life in Seattle flashes before her eyes, Meredith envisions her younger, intern self staring at her. Meredith then gets up and runs out of the room, calling out for Nick.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Catherine Fox[]

  • Diagnosis:
    • Chondrosarcoma
  • Treatment:
    • Chemotherapy

Catherine was still receiving experimental chemotherapy for her chondrosarcoma. Amelia later told her that her tumor was responding to the treatment.

Cora James[]

  • Diagnosis:
    • Pancreatic head tumor
  • Treatment:
    • Surgical resection

When Meredith learned that they'd lost their backup blood in an accident, she suggested moving Cora to the ICU to keep her alive while they waited for more blood to arrive. Cora later coded in the ICU and, despite their best efforts, was pronounced dead at 5:18.

Simon Clark[]

  • Diagnosis:
    • Metastatic synovial sarcoma
  • Treatment:
    • ECMO

Simon was stable on ECMO. When he learned that Kristen needed blood for her surgery, he asked Levi to divert all the blood meant for him so his wife and baby could be saved. After the baby was delivered, Winston brought him to Simon, who kissed him and told him "hello forever" before dying.

Kristen Clark[]

  • Diagnosis:
    • Pregnancy
    • Placental abruption
  • Treatment:
    • C-section delivery
    • Hysterectomy

Kristen started having sharp pains, which she hoped were the start of labor. Jo came to check on her and said they needed to go upstairs so she could do a proper examination. Before they could move, Kristen experienced terrible pain and started bleeding vaginally. They immediately moved her upstairs so they could do a c-section. After the baby was delivered, Jo did a hysterectomy to stop the bleeding. She was stable in a hospital room after her surgery.

Carina's Patient[]

  • Diagnosis:
  • Treatment:
    • Surgery

Carina was said to have just started a surgery.

Music[]

Song Performer Scene
"How to Save a Life" Talk
  • Jackson talks about his mother while Catherine, April, and Harriet watch.
  • Ben and Travis clean up the accident and talk about the ban on gay men donating.
  • Taryn tells Meredith and Nick that the blood was in an accident.
  • Meredith and Nick prepare to move Cora.
"The Story" Davis Naish
  • Meredith continues the code on Cora.
  • Kristen's baby is delivered and Jo starts a hysterectomy.
  • Winston takes the baby to see Simon.
  • Meredith stops and calls time of death.
  • Winston puts the baby on Simon's chest and Simon says hello then he dies.
"Song Beneath the Song" Ben Abraham
  • Amelia brings the kids to Teddy and Owen.
  • Owen and Teddy refuse to answer her questions but promise to call soon.
  • Meredith has to tell Sally that Cora is gone, but Sally doesn't remember Cora.
  • Bailey finds that the residents have brought in blood donors.
  • Kristen meets her baby and tells him about Simon.
"Where Does the Good Go" Luca Fogale
  • The residents clean out their cubbies.
  • Teddy and Owen fly somewhere with their children.
  • Richard and Catherine leave the hospital together.
  • Winston and Maggie talk about their relationship.
  • Link sees Jo in the daycare.
"Chasing Cars" Tommee Profitt, Fleurie
  • Jackson and April kiss.
  • Kai tells Amelia they can't sleep.
  • Amelia kisses Kai.
  • Meredith sits at the Chief's desk.
  • Nick comes in and she tells him he should go back to Minnesota.
  • He tells her he knows it's hard to leave.
  • She tells him to go, because she has a lot of work to do.
  • Meredith calls after Nick.

Notes and Trivia[]

18x20TitleCard

The ending title card.

  • This episode's title originated from the song You Are the Blood, originally sung by Castanets.
  • This episode scored 4.19 million viewers.[1]
  • The episode ends with a special title card with "400" added besides the series' title against a background of stills from the show's rich history.[source?]
  • The episode features a cover of "Where Does the Good Go" by Luca Fogale. The artist shared on Instagram that all net proceeds of sales and streaming of his recording would be donated to the Tegan and Sara Foundation, a foundation set up by the song's original artists that aims to improve the lives of LGBTQ+ women and girls.[2]
  • All of Jesse Williams's scenes were filmed in one day, given his limited availability due to his Broadway play.[source?]
  • In an interview about her appearance on the episode, Sarah Drew said it was pitched to her that April has also taken on a role with the Fox Foundation.[source?]
  • When asked about any future appearances, Sarah said the final scene with Jackson and April left many cast and crew members wondering if Sarah was coming back next season, though that wasn't discussed with her in any kind of official capacity. She said she would always be willing to return for more, yet preferably in a guest star capacity due to other projects she was working on.[3]

Gallery[]

Episode Stills[]

Behind the Scenes[]

400th Party[]

Quotes[]

See Also[]

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


References[]

  1. ↑ https://showbuzzdaily.com/articles/showbuzzdailys-thursday-5-26-2022-top-150-cable-originals-network-finals.html
  2. ↑ Instagram @lucafogale
  3. ↑ Deadline.com ‘Grey’s Anatomy’: Krista Vernoff & Sarah Drew Preview Japril’s Return In “Dramatic” 400th Episode Season 18 Finale
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