Grey's Anatomy Season 21 Episode 7
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00:00in 1986 Congress passed the emergency medical treatment and labor act which
00:09prohibits emergency rooms from denying patients care if you don't have a
00:14dollar to your name it doesn't matter you can go to any emergency room at any
00:18time and they have to treat you is your hand broken door was open that's not an
00:23excuse what are you doing socks got mixed up again where are your clothes I
00:26stopped putting them away it saves time
00:31shoot ah try knocking some people think this law has contributed to overcrowding
00:36and hospital closures the shooter open up
00:46but I don't know a single ER doctor who would turn a patient away even if they
00:50could sometimes all that means is treating an air infection
00:58other times you see a patient on the table and your heart stops
01:04the rarest of diseases hopeless comorbidities
01:14cases you've never seen that you're not trained to handle
01:22all you can do is close your eyes and say a prayer
01:24because once a patient enters the emergency room they're yours
01:32they're yours
01:34so should we go out for breakfast for your last day and miss my last chance at burnt
01:43coffee and watery oatmeal and watery oatmeal from the cafeteria
01:54i'll be back before you know it
01:58six weeks feels like forever
02:01maybe i can i can take a sick day come visit you for a long weekend
02:06yeah and you'll be back for your mom's birthday
02:10actually my mom is thinking about coming down to san antonio she wants to see where i'm living
02:17well there's a fourth of july but tickets are probably through the roof
02:26texas is feeling really far away right now
02:28for the lord has not given us a spirit of fear but of power and love
02:38and of a sound mind second timothy 1 7.
02:44is it wrong that i think it's hot when you quote bible verses
02:49for there is no fear in love or perfect love cast it out fear
02:58that i think it's hot when you're in love
03:05can we talk i don't want you to be upset about this
03:10if i could just talk you through what happened
03:12you let someone kiss you when we're supposed to be working on our marriage i think i know enough
03:18hey can you play baseball
03:21pitched 85 miles per hour in college
03:23my god are you free saturday you resurrecting the hospital softball sir yeah i mean i wanted
03:30to do something fun with everybody outside the hospital but uh griffith asked if she could use
03:34a tea and millen said she'll hit but she won't run yeah i would love to but uh i have to take my
03:38kid to a birthday party oh can't dr bailey do that you would ask her two incoming traumas i'll meet you
03:44outside oh there you are how'd it go last night oh uh yeah tux team one by two uh prue and i got
03:55a visit from the tooth fairy and uh yeah uh you they saved a patient lost a resident oh yeah i heard
04:02about schmidt you okay he's happy i'm happy oh boy okay i'll see you at home 22 year old female two
04:11car collision gcs-14 bilateral crush injuries to both lower extremities given morphine for pain and
04:17root Chloe this is dr weber my legs they hurt so much okay we'll take a look we got you
04:25where's mika we'll check you just be still okay this is yasuda's sister
04:30yesuda that's yesuda what yesuda seven-year-old female gcs-14 brief l-o-c blood trauma to the
04:39abdomen dps 90 over 40 received one liter of bolus at lr you see that it's altman and bailey
04:45chloe is my sister she's here now weber's got it all right let's move let's get her to trauma one
04:52come on come on go go go go go we got you we got you uh prominent bruising in the right upper
05:05quadrant she's hypotensive and tacky all right let's get a fast exam trauma panel and chest x-rays
05:11right now weren't you on last night i operated with her this morning x-rays are other way no
05:17adams you shouldn't be in here no i want to help do it somewhere else no no i need to stay skylocker
05:25go take care of chloe
05:36oh sats are dropping we need to intubate right now adams go all right push etomidate and sucks
05:41and i need a seven o et tube no major lacerations we just need steering strips
05:46where do you want me in the waiting room push 50 of fentanyl on it chloe i need you to be brave
05:54for me okay you can do this you should ask me to help her sister you know the rules no friends
05:58no family with all due respect you've spent more time with chloe than i have i can't help in there
06:02please let me stay go pull up the x-rays for dr lincoln okay catch me up chloe yasuda 22 year old
06:08female mvc with crush injuries to the bilateral lower extremities fast exam came back negative
06:12yesuda is she yeah okay what do we got in the x-ray it's coming up now multiple combinated fractures
06:20all right weak dp pulses bilaterally we're gonna have to check for blood flow in the legs
06:24adams go get the doppler monitor
06:30where is with her from bailey alman and indigo she's in trauma one
06:33come on all right putting in the chest tube how are you doing on your side scuffle
06:42oh my god oh no no you all need to step away and let us take care of her
06:47she's definitely bleeding in the abdomen i i need a counting glove millen there's nothing for you to do
06:53right now damn it we need to put an essential line call the blood bank and activate mtp come on let's go
06:59no no she's she's bleeding out she needs to go to the lr now she's coding all right starting
07:06compressions no no amica amica amica you're out of here now no no come on we'll be fine people do
07:19long distance all the time and i've always wanted to work with kids i've only lived in seattle i've
07:26only been here just like you we need to get out into the world and experience something new
07:36make our mark
07:39right
07:42your graduation speech needs work yeah is this ruby gunner yeah i helped deliver her is she going
07:50home yeah well if she can pass her car seat test
07:52i can't believe you're leaving me i'll be back all the time yeah but you'll be with james
08:00do you think it's a mistake doing long distance i haven't even moved yet it's already hard i am not
08:07in the position to be giving relationship advice reno well dr yusita was brought into the er mvc she's in
08:15the trauma bay oh my god do you need to go hi we know we're early but we're excited to bring her
08:21home how's your car seat test going well she's not loving it
08:28she's turning blue
08:30okay someone get me a neonatal innovation kit what's happening is she breathing mr mrs gardner i need you
08:36to go to the waiting area so that we can take care of your daughter okay we're not going anywhere
08:40where's me nurse dadison can you thank you okay yeah yeah got it
08:52cut your page where do you need me prepping for a thoracotomy got me stop compressions
08:59oh we got a sinus right she's lost a lot of blood she's in hemorrhagic shock it's got to be a
09:04diaphragmatic rupture it looks like her liver herniated into her chest she's still too unstable we got to get
09:09her to the or now i'm calling up now have the blood products sent up to the operating room
09:13chlorovacs are ready to go hang another unit oh take over i'll meet you up there
09:20come with me
09:24neither leg's getting a signal somebody give me the pressure monitor
09:27she just had her first round of chemo we need to look out for acute kidney injury high pressure in
09:32both legs no blood flow bone crush injuries legs are tight that's acute compartment syndrome
09:36all right we got to relieve the pressure so she doesn't lose her legs okay adams step aside i'll
09:40take the right leg warren you take the left we're going to do bilateral fasciotomies i want full skin
09:45incisions anterolateral and posterior medial all right make it quick let's go
09:54how is she doing better now that she can breathe her parents worried you think being pregnant will
10:01make me more sympathetic but i'm kind of just annoyed her baby's already out you're okay ruby
10:07i'm right here for today then he's leaving us to fend for ourselves traitor are you being mean
10:13because you're having separation anxiety no i am tired and hormonal don't psychoanalyze me okay there
10:19it is float around the heart probably from the viral infection she had a couple weeks ago gonna have
10:25to run some labs and aspirate you want me to consent to parents oh you don't have to do that it's not your
10:30job don't mind i don't know what i would have done all these years without you oh my god shut up i am
10:37not crying before lunch okay ruby all right so she appears to have extensive liver damage how's her
10:48neural exam no signs of tbi yet we'll have to scan her after the or we will try and keep you updated but
10:55right now she is our first priority dr bailey please we're going to do everything we can she means
11:01a lot to all of us she really couldn't be in better hands i i switched with her she worked the night
11:09shift i was swamped and she helped me and then i told and do good to let her scrub in she hadn't been
11:14on the road when she was you have to stop that great advice from the no feelings that's not what i'm
11:19but look you can't think like that or the guilt will eat you alive okay trust me don't tell me what
11:25to think you don't know what the hell happened neither do you i'm just stating facts okay you
11:30want to hear facts our friend is fighting for her life in there and there's nothing we can do about
11:35it i know that might not matter to you and your stone heart but it matters to me
11:49hey how's it going it's pretty brutal at least you get to do something i feel helpless i just want to
11:56camp out in the orc corridor and wait for updates but i can't find millen she won't text me back then
12:00i'm just talking hey keep me posted on chloe okay
12:17you okay i uh i called out yasuda once for eating an old donut it was after a meeting and i found her
12:25pulling it out of the trash and for some reason it just set me off
12:29she was struggling and she didn't deserve it i'm sure she forgives you i'm sorry about cas i know
12:37don't think about that right now teddy look at me
12:43we can do this we can do this
12:53yeah abdomen and chest look good has anybody called their parents yet yeah weber was trying
13:03to get in touch with them you know yasuda she's the glue of our class and somehow she manages to be
13:10best friends with everybody yeah i'm still getting to know everyone but i got your suitor's number right
13:15away yeah one time um when i was living at the house one day i thought there was an earthquake but
13:23turns out it was just you see to pumping herself up for a night shift
13:28your being a doctor is never harder than when you personally care for your patient
13:34how's it look no chest or abdominal injuries and the leg scans are coming up now
13:39all right see the irregularity in the popliteal artery now let's just keep an eye on it and get a
13:47vascular consult when we open her up all right these are complex fractures we're gonna have to do a
13:51combined approach of oris and x fixes in both legs let's go to prep for surgery
14:01target is id below the left of the xiphoid bone okay needles ready visual confirmation on the ultrasound
14:09okay all right we're almost ready and then you'll feel better and your parents will feel better
14:16i sure do love you even though you've been living in different places are you about to compare the
14:23life of a baby in the nicu to your long distance relationship well you didn't give me advice
14:31monitor showing bradycardia you need to move okay here we go okay move the ultrasound probe yeah right
14:37there hey ruby you're gonna feel a little sting you are my sunshine my only sunshine
14:47you make me happy when skies are gray remember when you dropped your glasses in somebody's abdomen
14:55i try really hard not to you you've come a long way
15:01all right heart rate is back to normal rhythm great you want to tell the parents that i may
15:08need to keep her another couple nights but then she should be able to leave sure
15:11okay you want advice long distance is awful it's expensive and lonely and i would never recommend it
15:22but if you are committed to making it work it will
15:34okay
15:44bears or worms i'm not hungry she's gonna get through this i came down here to be alone
15:53she isn't just your friend i know that do you know that because you are acting like this is
15:57happening just to you we are all freaking out here we all need each other right now mika and i aren't
16:03just friends like you're together yes no i don't know okay what
16:12what what what do you call it when when you flirt with someone and then sometimes you kiss and you
16:20want to be together but then her sister gets sick and you work together and it's all just complicated
16:25yeah
16:29yeah that's exactly it
16:34gun needs something stronger than gummy bears
16:41all right spleen's intact and there's no bleeding in the retroperitoneum okay at least there's that
16:46you're still losing a lot of blood hang two more units more lap pads okay this liver is fractured
16:50right down the middle wrinkle maneuver it's worth a try clamp okay and staple uh bleeding is still
17:00too profuse we should try huma static agent lobes are jack we need to remove the liver before she
17:05bleeds out to death no we are not adding liver failure to someone who is too hypotensive and too
17:10unstable that could kill her i agree with altman let's move to damage control embolize an ir then
17:14resuscitate in the icu until she's stable and then we move her back to the oar you need to be more
17:19aggressive she'll continue to believe we need to excise the liver and put her on the transplant list
17:22now she just coded she could code again and we might not get her back again okay enough this is
17:28one of our own lying on this table she needs us to stop arguing and to save her life we will not
17:33remove her liver thank you and we will also not leave her in the icu overnight do you have a better plan
17:38okay we will pack her scan her head to toe then get her to the icu give her blood letters stabilize
17:50for a few hours while we get our acts together and figure out a better plan anybody feels the need
17:55to disagree step the hell out let pass
18:06how's she doing she's putting up a good fight i can sit with her if you have things to do okay page
18:16me if you need anything i'll be close
18:32you messed up laundry again i don't have a single clean sock and i know what you're gonna say
18:41i left my clothes in the washer but
18:46yeah i i don't have a good justification for that
18:52you still suck at laundry though
19:01i'll tell you what you pull through this and i'll
19:04do all your laundry for as long as we live together but don't get greedy because i can't
19:10start doing everything for you dishes in the sink the
19:16hair in the drain the dried toothpaste um that's all you
19:26not that you actually do any of those things
19:28you're a terrible roommate
19:49altman said you were here i didn't believe her
19:51uh whenever i'm stuck on something i'd like to go for a walk it clears the mind
19:58settles the nerves but i don't want to be far from my patient so
20:04treadmill let's get some steps in
20:06makes sense any ideas not yet collectively the four of us have probably published close to 300 case
20:13studies you count it oh no i'm just saying based on how much we've seen and how much we've
20:19accomplished we should have ideas yeah i let you sue to do the bronchial anastomosis
20:27on a lung transplant this morning she's got real skills of course she does i trained her
20:34you like teaching yeah i didn't even think about it when i decided to go into surgery but
20:39yeah i do it's my favorite part of the job i get it you get to support fledgling doctors and watch them
20:45grow into surgeons who can stand on their own it's fulfilling
20:54you hit your step goal i've got an idea yes yeah okay her ct scan shows that only 25 percent of her
21:03liver remains viable not enough to preserve function agreed i still think the risk of removing it is too
21:08high i agree with that too so what exactly is your plan we resect the entire right lobe then we resect the
21:19damaged areas in the left then we give the remainder of the liver the circulatory support
21:26it needs to recover and grow with dialysis and aggressive resuscitation how the common hepatic artery is
21:34completely damaged at the takeoff we remove her spleen and use its vessels to reconstruct and feed
21:46what's left of the liver you think the remaining piece of the liver will be functional i am hoping
21:51it will this won't be as simple as you make the sound okay i know it's a long shot right but yusuda
21:58is strong and we've all seen her give everything she's got to her family her patients she would do
22:04it for any one of us yeah i mean yeah me too all right let's get her back to the o.r
22:15hi hey how's your last day it's graduation day for the preemies they get to leave the hospital
22:26huh do you need a chaplain for that no well is there anything else i can help you with
22:34you could move to texas with me what people get into car accidents and people die and life
22:42is short and you've lived all over the world why not san antonio with me i mean my whole life
22:48is here you know my job i just bought my loft i'm falling in love with you
22:54i'm sorry to put you on the spot like this you don't have to
22:57decide this second you don't even have to decide today just just think about it
23:03sorry let's talk about this later i'll meet you in the lobby after work okay
23:26nothing you don't feel a tiny bit better they're babies who could also die in a terrible car accident
23:32one day come with me you're not going to make me hold one of them are you
23:45that's it do not test me not today
24:08oh my god it's like sitting into a hug
24:15how long have you and yasuda been a thing we haven't had sex yet if that's what you're asking
24:32it's not what i'm asking
24:35a couple months
24:38we keep trying to slow it down then we just pick it back up again
24:41why can't you just be together because we're friends we work together hi
24:55i've never had a relationship that feels like this so easy and electric and
25:04i think we were both scared messing it up
25:13it's kind of ironic now
25:18mika is not going down without a fight especially if she has you to fight for
25:24this poor kid she just started chemo and now this makes you count your blessings huh
25:34the popliteal already is bleeding out damn it
25:36vascular clamp how can i help
25:39it's too much blood okay page vascular she's gonna lose her leg if they don't get her quick clamp all
25:43right i'll go get someone good right there more suction speak now or forever hold your peace
25:50please
25:55here we go tighten please
26:00how's the liver looking ischemic and still bleeding suction
26:05yeah i need dr opener dr andygu we're a little busy right now oh yeah it's a bad vascular bleed
26:09she's about to lose her leg all right i'll go yeah oh and take over for me what or is she in
26:16four
26:20adams they need you and chloe's or adams
26:33oh
26:34here's the doppler back can i retract here you got it how's the signal down her leg weak at this
26:51point there could be irreversible ischemic damage here myoglobin and ck levels are elevated we should
26:56continue sodium bicarb and start muclemy sorry i got held up got a glove i need 6-0 proline and vessel
27:02loops all right chloe hang in there stay with me we got you
27:16oh
27:19i see a house up on the hill
27:26a light in the window
27:30an evening blue i wish you could see
27:35like stay
27:37like i do
27:39painting with colors
27:41all right
27:43if no
27:45i see
27:47you
27:49standing in the ashes
27:51born on
27:55I see it now, a light on the horizon.
28:02I see it now, I'm calling out to you.
28:08I see it now, I've been reading all the signs.
28:16But everyone brings me back to you.
28:22Can you see it now?
28:30See it now.
28:37See it now.
28:44Vascular anastomosis is complete.
28:48It's holding.
28:50Hey, removing the clamp.
28:57Now we all pray to God it works.
29:00Through every storm, standing still.
29:07Hey, I just told a woman that's been laboring for 14 hours that she was only two centimeters
29:16dilated.
29:17I thought she was going to punch me.
29:19How's Ruby?
29:20Good.
29:21Her vitals have improved.
29:22Okay.
29:23Great.
29:24Well, maybe he got held up with a patient.
29:31You don't have to try to make me feel better.
29:33If I haven't completely freaked him out, maybe it's just back to long distance.
29:39I'll rack up a bunch of frequent flyer miles and we'll talk on the phone all the time.
29:45I could get better at sexting.
29:47Mm-hmm.
29:48Yeah, yeah, yeah.
29:49It's a silver lining.
29:52Getting drunk and sleeping with you was the best mistake I ever made.
30:04Will you be my baby's godfather?
30:06Are those two things supposed to be related?
30:09No.
30:11When I'm upset, you're my first call.
30:16Because even on my worst days, you always make me laugh.
30:21And the reason I was so mad when you quit, OB, wasn't because I got you the job.
30:29It was because I was losing my favorite person to work with.
30:32And now I'm losing you again.
30:35I'm not dying.
30:37We're gonna talk all the time.
30:40The world is a hardened place, full of hardened people.
30:44But you, you walk through life with this giant, open heart.
30:53I want you in my kids' lives.
30:56I want you to teach them to be gentle and warm-hearted.
31:02And all of that Star Wars stuff.
31:07That'll be fun.
31:09So be their godfather.
31:11They'd be lucky to be loved by you.
31:14I'm flattered.
31:17I mean, I love them so much already.
31:22But I am Jewish.
31:23Is that even allowed?
31:25Just say yes.
31:26I'm by the amazing gifts.
31:29I would love to be their godfather.
31:31I didn't like her when I first met her.
31:42What?
31:43Ow.
31:44I like her now.
31:46She was just so loud and all up in my face all the time.
31:50I like calm, quiet.
31:55I met her right after I bumped into someone I'd slept with.
31:59She rescued me.
32:01Hey, who'd you sleep with?
32:03That's not the point of the story.
32:05Wait, I kind of remember this.
32:07Did you sleep with Lincoln?
32:09What?
32:11What?
32:12Well, I'm really glad I didn't run into any of you jerks that day.
32:15No.
32:16No.
32:27She's stable.
32:29And she's recovering in the ICU.
32:32We wait and see.
32:43Well, I guess this is one way to get out of charting.
32:46Uh, you should have re-signed your paperwork today.
32:48Yeah, well, it's pretty much the only thing they'd let me do all day,
32:51so I figured I might as well finish it.
32:53Not that she cares.
32:56All right, Yasuda weirdly loves paperwork.
32:59She blasts music and times herself.
33:02Code blue.
33:04Room 4429.
33:06Surgical ICU.
33:08Code blue.
33:09It's Chloe.
33:10Room 4429.
33:12Surgical ICU.
33:13Pay into the tending.
33:14Code blue.
33:15Room 4429.
33:16Someone start bagging.
33:18I'll bag.
33:22Which one of Epi?
33:23I'll get the Epi.
33:25Okay.
33:28Come on.
33:29Come on.
33:30Come on.
33:31Come on.
33:34Break water holding back a ways.
33:41Oh, hey.
33:42How's Yasuda?
33:43Mom, she's, uh...
33:46She's good.
33:47Interns are with her.
33:52No, I'm assuming she's...
33:53Look, I know that today's...
33:55you go
33:58I overreacted
34:02it was a mistake
34:04you told me right away
34:06you did nothing wrong
34:07I'm still sorry
34:09I just
34:10I would never want to cause you any pain
34:13I know
34:13come on
34:16thank you
34:19let's go home
34:20let's go home
34:22charge to 200
34:23clear
34:27get out
34:32again
34:34what happened
34:35clear
34:36her potassium spikes you wanted to be fair
34:39charge to 300
34:43clear
34:46come on come on come on
34:50how long has it been
34:5140 minutes of CPR
34:53Adams
34:56Adams
35:00you've done all you can
35:02time of death
35:092216
35:12no
35:12no you can't
35:13stop
35:14someone back
35:16Millen
35:17back away
35:18come on
35:19come on
35:20come on
35:21come on
35:22come on
35:22come on
35:22come on
35:23come on
35:24come on
35:25Jules
35:26she's gone
35:29wait
35:37wait
35:37what's that
35:51Chloe's personal belongings
35:53she didn't
35:57she didn't
35:57she didn't
35:57make it
35:58rhabda
35:59crush injuries
36:01on top of
36:01chemo
36:02is just
36:02too much
36:04for her body
36:04to handle
36:05it's her shoes
36:07and her phone
36:07for when
36:08your suitor wakes up
36:09if she wakes up
36:10no no no
36:13because it's not over
36:14I have to stay vigilant
36:16you know if you hug me
36:17I'm gonna cry
36:18and I cannot cry
36:19you're staying here
36:27I know that means
36:30another night away
36:30from you and the kids
36:31but
36:31don't even worry
36:32about that
36:32alright
36:33the suitor needs you
36:34tomorrow morning
36:35you give the kids
36:36whatever they want
36:37for breakfast
36:38right
36:38waffles
36:39pizza
36:39I don't care
36:40just
36:40we can do that
36:41you make something
36:43good happen
36:44Ben Warren
36:45I need something
36:47good to happen
36:48okay
36:53okay
36:53okay
36:53okay
36:54okay
36:55okay
37:15one year
37:15met with the impossible
37:16the only place
37:17to turn is toward each other she told me to take care of her sister do not blame yourself
37:22you did all you could i read her code i called her time of death none of this is your fault
37:32she'll understand no i have to go lucas when you lose you have someone to cry with
37:41when you walk into the unknown you have someone to hold your hand
37:48i'm dr schmitz you made the right call
38:11when the morning comes
38:14oh the light and clear
38:18does the night slip away from me
38:23oh
38:27oh
38:30oh
38:32oh
38:34levi hi i'm i'm so sorry about the lobby i i just it's okay this was a big ask and you
38:43weren't ready no i was in the admin office residing from my job you still want me to go to texas with
38:50you right
38:52wait wait uh please tell me that this is a yes because i just quit my job
39:07yes
39:08let's go
39:12together
39:14and when you win there's someone by your side to celebrate and suddenly the impossible feels possible
39:31but sometimes there's no one to turn to sometimes you're all alone
39:38it's late you all should go home
39:40it could be days before she wakes up okay go get some rest
39:48could you let us know if anything changes i'll call the second it does
40:10in those times you have to keep the faith
40:17just as the sun might
40:24there's still a night to cross the sky
40:31remember that even if you can't see them or feel them or hear them
40:44your people are out there
40:46waiting for you
40:48your surgery it went well you're gonna be okay
41:01mm-hmm
41:03chloe
41:05you're welcome back
41:07your surgery it went well you're gonna be okay
41:11mm-hmm
41:12chloe
41:14chloe
41:17chloe
41:18chloe
41:20chloe
41:24chloe
41:28no
41:29no
41:30no
41:31no
41:32no
41:33no
41:34no
41:35no
41:36no
41:55no
41:56no
41:57no