Now...
Who can tell me the steps of a partial laryngectomy?
In group settings,
men are 75% more likely to speak up than women,
and when a woman does speak up, it's statistically probable
her male counterparts will either interrupt her
or speak over her.
It's not because they're rude.
Cross.
It's science. The female voice is scientifically proven
to be more difficult for a male brain to register.
What does this mean?
It means in this world,
where men are bigger, stronger, faster,
if you're not ready to fight,
the silence will kill you.
(Horns honking) (Indistinct shouting)
This is killing me.
We have not moved in 10 minutes.
(Sighs) (Bee buzzing)
I swear that Bumblebee has passed this car twice already.
It passed us, it circled the earth,
and then came back around to pass us again.
Yeah, because we left late because you overslept.
Not fun when you're driving
- and someone makes you late. - If you want to stay up all night
screwing around with some dude, I don't care,
till you spend all morning complaining about it in my car.
I don't know what you're talking about.
We share a wall.
So move out!
Nobody told you you could crash in Amelia's room, anyway!
Okay, it's not Amelia's room anymore.
- What is that? Two fire trucks? - And three ambulances.
That's got to be like a four or five-car pileup.
50 bucks says a big rig's involved.
- Hey. Hey! That's not a good idea. - Let's go, Karev.
Screw it.
(Sirens wailing)
(Man screaming)
Keps, I could use another set of hands here.
I'm on it.
(Screaming continues)
We've been paging you for half an hour.
I've been a little busy.
We got a 45-year-old male with a head lac,
positive LOC on the scene.
Also has abdominal contusion.
I'd like to say it's not as bad as it looks, but...
Major pileup, multiple wounds.
A big rig flipped. Bigger mess.
Do you think he has intra-abdominal injury?
Well, there's one way to find out.
All right, let's get her inside.
I got this. Go.
A bony deformity in the temporal region.
- 5 centimeter head lac. - Abdomen's clear.
Palpable pulses in all four extremities.
We've got mild pupillary asymmetry.
We need to get a head C.T.
- Let's page Neuro. - Mm-hmm.
Starting to regret taking that tour of the city today.
(Groans)
No rain. Thought it was a good idea.
- I got more than I bargained for. - Yeah, hey, Dr. Warren here.
Well, you did hit your head pretty good, Lou...
but we're gonna get you fixed up.
Wasn't my most graceful landing, either.
Yeah, sure.
Pushing 150 of fentanyl. This should help with the pain.
You know they had a wall at Pike's Market
covered in people's chewing gum?
I do, in fact, know that, Lou. I grew up here.
- Mm. - Thanks.
(Sighs)
- Where's Neuro? - Paged. No response.
Well, then go get them.
(Sighs)
- Any pain here, Lou? - Just a little sore.
- A little sore? - (Groans)
- He's lost his pulse! - (Groans)
- All right, cover your ears. - Why?
(Bone cracks) (Screams)
- That's why. - I want hourly Neuro checks on bed 6,
sign off on beds 4 and 8.
- Bed 7. - What?
Bed 7. We don't have a patient in bed 8.
Right. So busy in here, who can remember?
(Pager buzzes)
- We're being paged to... - Trauma 1.
- Dr. Grey. - And Trauma 3. Dr. Hunt.
Both urgent, not critical. Do want Hunt first or Grey?
- Dr. Grey told me to come find you. - Really?
Meredith actually asked for me, or did she just want Neuro in general?
I... I don't remember.
Yeah, you do.
Have Grey give us a page if her patient becomes critical.
- Where's Hunt? Trauma 3, right? - 3.
We'll be there in less than 10 minutes.
Dr. Warren, some help over here, please.
Coming through!
(Gasping)
I need O2 tanks over here for transport.
We're out here visiting my sister.
She and my kids are on a girls' day out.
So I decided to go see the Space Needle.
Now I'm seeing all kinds of needles.
(Laughs)
Yeah, it's corny. I know. Sorry.
My daughters tell me I make the worst jokes.
How many kids do you have?
Two.
- They're 10 and 6. - Aww. Sweet.
And they are smart, man.
(Chuckles)
They're smarter than I...
- Whoa! - Okay.
What are we looking at?
- Um... - Come on, speak up!
- A tonic clonic seizure. - That's right. Let's roll him.
1, 2, 3.
- Okay, what do we do now? - We wait for it to pass.
We wait for it to pass.
It's going on too long.
We need 10 of lorazepam. It's locked in Pharma. Go... now.
It's okay, Lou. I got you.
(Exhales slowly)
Ooh.
That was a big one.
Okay.
All right.
Oh. He's gonna need a new gown and fresh sheets.
Oh, I hate it when they do that.
- Could you get an orderly? Do you mind? - Okay.
- Be right back. - Okay, hey, there's no rush,
but if you do see Neuro, get them up here, please.
Lou.
You need to lay down. You shouldn't be up. Lou.
(Moaning)
Let's get back on the bed, Lou.
- (Grunts) - Mm!
(Grunts)
Ugh! Aah!
(Both grunting)
- Coming through! - I need that chest X-ray!
V-fib, charge to 300.
Charged.
All right. All right, ready?
- Clear! - (Beeping)
Come on. Come on, come on, come on.
Right. Clear!
(Beeping)
Come on.
(Flatline continues)
Okay. I'm calling it.
Time of death... 11:42.
Crap.
I really thought we had him.
Yeah, me too.
(Sighs)
Synced and corrected by johnyd13 www.addic7ed.com
I need some help in here now!
Trauma panel. Send blood for a crossmatch.
- Belly is soft. - Bruising on the left chest.
- Decreased breath sounds on the left. - Art line is going in.
Pulse ox is down to 88.
For a trauma series. Hook up those monitors.
We need a wide bore I.V.
Get Ortho here. Add some left arm and leg films.
- Has anyone told the chief? - Okay, do not page her.
This is one patient. We can do this one, okay?
She has to handle everything else.
The guy who did this... he was stable, non-aggressive.
He wasn't a threat. I left for like five minutes, and this happens.
He was postictal.
Hyper-aggression can occur after a seizure.
Temporary fugue state.
- He won't even remember it. - Where is he now?
Restrained, and being treated right next door.
(Door opens)
(Sighs)
- Her vein's collapsed. I can't get in. - Put in a central line.
- I got it. - Oh, okay.
Obvious dislocation of the left elbow.
We got some left knee swelling.
Rib fractures on the left with palpable crepitus.
- Get Ortho here. - Get a blood gas from the art line.
- We need a wide bore I.V. - No obvious flail.
(Heart beating)
(No audio)
- Damn it. - Send for a trauma panel and a cross.
Somebody get Jackson in here right now!
- Grey. - On it.
Grey, we're gonna shoot a quick X-ray, all right?
Hi. I'm here.
(No audio)
1, 2, 3, easy.
- (Screams) - Easy, easy, easy, easy.
Okay. Easy.
All right, okay. All right, everybody back.
(Groans)
Okay. All right, ready? On three.
1, 2, 3.
(Screams)
All right, easy.
- No, no, no, no. - Meredith, it's okay.
It's okay, it's okay. It's okay.
It's okay.
We're here. What have we...
Possible concussion, head contusions,
multiple blunt-force blows to the head and neck.
It's... it's Grey. I'm sorry. I thought you knew.
Dr. Shepherd?
(Monitor beeping rapidly)
Dr. Shepherd.
Dr. Shepherd!
- Here's the films. - Okay. Pressure's 90 over 60.
She's got a 30% pneumo.
- No obvious effusion. - She needs a chest tube.
I need a 36 tube, Betadine, and 6 1/2 gloves.
Set up the pleurovac.
(Heart beating)
Just got labs. Crit is stable.
Oh, good. Draw blood gas from the a-line.
- What is this? What the hell happened? - She was attacked by a patient.
The neck is bruised and swollen. She needs an airway evaluation.
All right, I'm on it, I'm on it.
No bony deformity. Positive battle's sign.
Okay, Meredith, we're gonna have to put in a chest tube, all right?
Your lung is collapsing.
(No audio)
And this is gonna burn. I'm injecting the Lido.
You can't work on your family.
Everybody in this damn room is her family.
- It's fine. - Here we go.
(Meredith groans)
(Gasps, coughs)
- Breathe, Mer, breathe. Breathe. - Chest tube is in.
Okay, easy, easy, easy. Easy, easy.
Pulse ox is coming back up. 88, 90.
No evidence of traumatic brain injury.
No... no focal deficits.
Uh, except...
uh, uh, Dr. Grey, I need you to move your fingers for me.
Or your toes.
Come on. Just come on. wiggle something.
She responded to the painful stimulus.
- It doesn't make sense... - Pulse ox is dropping again.
Unless...
- The chest tube has a small air leak. - No, she has mild sub-Q emphysema.
We need to secure this airway and tube her.
- Got it. - Guys.
Guys. I don't think she can hear us.
- What? - Are you sure?
No. Mer.
I see evidence of barotrauma, possibly from the blows.
I think Karev might be right.
I don't think she can hear anything we're saying.
Her jaw is locked.
- Suction! - Suction.
Can we take a look?
All right. Let me see. Yeah, yeah, easy, easy.
Yeah, we've got a dislocation here, possible fracture.
There's no way we're getting a tube in there.
You have to get a tube in. You have to preserve her airway.
Or we have to trach her.
No, no, no. Um... All right, wait a second.
If I can reduce the dislocation,
we can probably get her mouth open just enough to intubate.
It's gonna hurt like hell, though.
Okay. Hang tight.
I'm sorry. Here. Okay, Mer.
Okay, we're gonna have to pop your jaw open, okay?
I'm sorry. I know. But we have to do it.
And we're gonna do this on the count of three, you guys. Ready? 1...
2...
Aah!
(No audio)
Hey.
What's wrong, Meredith?
Hey.
Just get it out, get it all out.
(Crying)
The tears, all the...
God, you've got a lot of snot.
(Laughs)
I'm serious. I'm for real.
I mean, you might have a serious condition.
Come on, woman. Blow your damn nose.
Hang on.
Mer.
(Snapping fingers) Can you hear me?
- Mm-hmm. - You can hear me?
- Mm-hmm. - (Laughs)
(Laughing) Oh, my God.
Oh.
(Both laugh)
It is important that you continue the voice rest, okay?
Your tracheal injury is not...
fully healed, and your latest audiometry
shows that the hearing in your right ear
has almost completely returned.
On your left, you're looking at about 55%, which is good.
It's only been a few weeks, you know,
so I'm not concerned about it.
It's gonna come back, Meredith, okay?
- (Loudly) I want you to continue to... - Mm.
(Softly) I want you to continue to move your fingers while in the cast,
and you will remain non-weight-bearing on your leg
until we take the cast off.
Yeah, there's a little swelling in that left leg.
It's probably local edema,
but I've ordered a doppler just to be safe.
- Anything else? - No.
_
Lou? What's... who's Lou?
The patient who attacked Meredith.
I've been calling him something else.
Look, we don't have to go into that right now.
She wants to know. Tell her.
Okay. Lou suffered a severe epidural hematoma in the accident.
It's what caused the seizure.
We think he was in a postictal* state when he attacked.
After a few minutes,
he woke up and had no idea what he had done.
He had surgery and was discharged.
He's doing fine. (Clears throat)
Lou has reached out.
He has made a couple of requests to see you.
- Mnh-mnh. - I think...
he would just like to apologize.
It's okay.
She's kicking us out. Let's go.
- (Clears throat) - Go ahead.
(Whiteboard squeaking)
- Apologize? Are you serious? - Of course I'm serious.
Yeah, I don't see why.
Because the last time that woman got hurt working for this hospital,
she purchased this hospital. That is why.
And what do you think will happen if she sees him again?
- Nothing good. - Exactly.
(Thunder crashes)
(Thunder rumbles)
Good, good.
All right. Try and lift your leg for me.
Good, good. Decent mobility.
I don't know.
Well, we're done, and it's all good, so...
- Thanks. - (Clears throat)
Uh, he has been working a lot of night shifts,
and she's been...
They haven't been talking, I don't think,
or hanging or anything, from what I can tell.
So, anyway...
- Let's do this again. - (Sighs)
Follow the pen.
(Laughs)
Okay, this isn't exactly the right shade,
but it's doing a pretty good job of covering the bruising.
(Inhales deeply) All right.
So...
Don't try and get up, okay?
Just let them come to you.
And smile.
But try not to open your mouth
because it's still pretty swollen in there
and the wires... the metal wires...
they're a little scary.
You ready? Okay, all right.
Hey, hey, hey! Look who's here, guys!
Your mommy is so excited to see you! Come here.
Come on in. Go ahead. Go tell her. Tell her what we talked about, okay?
- I don't want to. - Oh, come on, Zola.
You ask me every day, "when can we go see Mommy?"
Look. She's right over there.
- Go give her a big hug! - No!
No, no, no!
(Muffled) Zo-Zo, come see Mommy.
- I want to go. - Come on.
(Speaking indistinctly)
(Muffled) Zo-zo, come see Mommy, honey. Come on!
(Ellis crying) Zo-Zo! Come see Mommy, honey!
Come on, honey!
Come on, Zo!
Come on, honey. Please.
Zola, come on.
- Lets go talk to her. - You know... you know what?
- Let's do this later. It's not... - No, no.
Let's do this later. It's not okay.
Come on, come on, come on, come on.
Come on, come on. Let's do this later.
Let's do this later. We're gonna do it later, okay?
We're gonna do it later. Okay.
Okay, does anybody want anything yummy from the cafeteria?
All right.
Zola!
(Crying)
(Groans)
(Knock on door)
- Dr. Robbins wanted... - (muffled) Come in here!
- Get in here! - Dr. Grey. Okay, okay.
- Okay. - I can't breathe!
Okay, you're okay. Hang on, hang on. Deep breath. Deep breath.
I need you to breathe for me.
Breathe for me, Dr. Grey.
Breathe.
(Whimpering)
- Stay still. - (Coughs)
Stay still. I'm gonna get you some air.
Just stay still. I'm gonna open you up, okay?
Okay. I'm opening you up.
Stay still. Please.
- (Groaning) - Okay.
(Groaning)
(Breathing heavily)
Okay.
Hold on.
(Breathing heavily)
All right. Good.
Hey, what the hell are you doing?!
She... she was having a panic attack. She couldn't breathe.
Do you not realize how delicate the jaw actually is?
You could jeopardize the entire healing process here.
She couldn't breathe! Look at her!
She's been stuck in this room in that bed for weeks.
She can't move. She can't talk.
But I'm her surgeon now, right?
You can't come in here and just take out her wires.
She is my patient.
I know what I am doing!
You can rewire her jaw tomorrow morning,
but right now, she needed some air,
so I got her some damn air!
(Panting)
- I brought you something to eat... - Drink.
- Mm. - I know. I'm sorry.
Morning!
- Oh, come on. - Or not.
How's the pain today?
(Thuds)
- And the discomfort? - (Thuds loudly)
Well, her energy's up.
All right. I'm sorry.
I have all of five minutes to update you on the miracle...
That I've been working on your service this week,
but it seems like a bad time.
Uh, I'm gonna check in and update you later.
Maybe we all could check in later.
Yeah.
I'm just gonna...
Leave that.
(Thudding)
Whoa. What happened?
Everything okay?
(Telephone rings) Nurses station.
Yeah, okay. I got it. You don't want to look at me.
I get it.
Do you think that I want to be out there
hanging out outside your door
like some pathetic little rat looking for scraps?
Do you think that feels good for me?
I...
I have been out there trying to figure out how to make amends...
As if that would matter to you.
I know I'm a mess...
Who talks too much and feels too much,
and I know that it drives you crazy,
but that is the one way I know how to stay sober,
and every time I try to suck it up and shut up
and just be cold and normal, I end up drunk...
Or on pills or at a funeral.
Do you know what it felt like to walk into that trauma room
and see you on that table and think to myself,
"great. I did it again.
Here comes another funeral."
(Sighs)
You know what?
Forget it. I...
I don't even know why I came in.
(Sighs)
Hello.
Cross...
Let's get Dr. Grey a wheelchair.
♪ I got sunshine ♪
♪ on a cloudy day ♪
_
♪ I got the month of May ♪
♪ well, I guess you'd say ♪
_
♪ What can make me feel this way? ♪
I understand you saw Amelia.
Look, look, look. I know you're not in the mood for a lecture.
But... are you finished?
She came to see you the night after the attack.
She was drunk.
She was upset...
Because you'd called her for a consult that day...
the day of the attack.
And she had a choice between coming to you
and going to another trauma,
and she went to the other trauma
because she was mad at you.
Forgiveness is a powerful thing, Meredith...
Not only to make the other person feel good,
but to heal you.
You need to forgive her, Mer.
Forgive her for not being Derek...
For being the wrong Shepherd...
Just enough to remind you of what's missing,
but not enough to bring him back.
That's not her fault.
You need to forgive her.
You don't have to like her.
You don't have to love her.
But forgive her, okay?
So you can forgive Blake for being in that room
when a wrong decision cost you your husband.
To forgive Derek for dying too soon.
To forgive yourself
for hating him for dying too soon.
Let it go, Meredith...
(Sniffles)
and forgive.
(Sighs)
Sun feels good on the face, doesn't it?
What is the point of counseling, then,
if you're just gonna suddenly, without even talking about it, just...
Oh, come on. All we do is talk, April.
So, what? You just... you just... just serve me papers?
Just like that? Just no warning, no... no any...
Do you have any idea what a slap in the face this is?
Are you kidding me?
You ready?
Hi, Dr. Grey.
Lou. Um...
Thank you for meeting me.
This is my wife, Joanne,
my daughter, Kylie.
I told you about her... the youngest, really smart.
And that's my Anne.
Um...
Um, have a seat, girls.
Um, you got kids?
Right.
Forgot you can't talk.
The... jaw.
Um...
I wanted to...
I didn't know what I was doing.
What I did to you...
I didn't know.
I would never...
I would never hurt a woman.
I...
I just want you...
I just want you to know that I'm sorry.
Truly sorry.
(Inhales deeply)
It's my 30-day chip.
I'm sober.
And I'm starting back at work on Monday, so...
I'm trying.
Meredith: I know you are.
You...
You can talk. That, um...
That's great. They, uh, took the wires off?
Yeah, this morning.
(Thunder crashes)
I'm just not ready to forgive you yet.
I'm not...
exactly ready, either.
See you later.
(Thunder crashes)
(Aron Wright's "I Surrender" plays)
♪ Oh, this road has been hard ♪
♪ on my feet, on my heart ♪
♪ Led me to the gates of hell ♪
♪ I know sorrow all too well ♪
♪ lost my love to the wind ♪
♪ Left me half of who I am ♪
(Screaming, glass shattering)
♪ Heaven knows, I'm tired ♪
♪ I give up ♪
Mer.
♪ I give in ♪
Let's go.
♪ I lay down ♪
♪ I surrender ♪
Do you want anything? You know... like a sandwich or a...
Or a blanket?
All right, all right. I'm good. I'm good. Sit down, sit down.
♪ I lay down ♪
I just spent six weeks in a bed, unable to speak.
When that happens, you see things.
There's a lot of things that people don't say to each other
that they should just say,
so I need you to hear me when I say this.
I know I've needed you a lot lately.
But I also know, and I have known for a long time
that Jo loves you.
"Post-it on the wall" loves you.
♪ There's a hand guiding me ♪
Don't ignore that.
You can have more than one person.
I used to think you couldn't, but now I know.
I mean, turns out I have a whole damn village.
So you don't have to worry about me.
Go be with Jo.
I'll be fine. I'm okay.
♪ I lay down ♪
♪ I surrender ♪
♪ I won't fight ♪
♪ I won't try ♪
Don't let fear keep you quiet.
"And the moon gave everything a magical glow
as if they were dancing on the Milky Way."
- Mommy. - Yes?
You have a voice.
So use it.
Speak up.
Raise your hands.
Shout your answers.
Make yourself heard.
Whatever it takes.
Just find your voice.
And when you do...
♪ I surrender ♪
fill the damn silence.
Synced and corrected by johnyd13 www.addic7ed.com