Grey’s Anatomy – The Room Where It Happens
By: Jamie Steinberg
The episode begins with Meredith (Ellen Pompeo) telling the story of an Italian family who suffered from a genetic disease that didn’t allow them to sleep. She reminds us that while we still don’t know why we need to sleep, but without it we make poor decisions and even see things that aren’t there.
As “Drag Me Down” by One Direction plays we watch an OR being prepared for surgery. A male patient is brought in and Meredith gets ready to be his surgeon. She says she hasn’t slept in forty-eight hours and Owen (Kevin McKidd) said he had seen her go home earlier. Unfortunately, Zola seems to be boycotting sleep and son Ellis has an earache. As she begins to operate, Edwards offers assistance. Things quickly go wrong, but Webber interrupts (noting how refreshed and well fed he is) to help with the patient’s destroyed liver. Webber (James Pickens Jr.) is recounting some past glory about a kidney save he once did when Meredith and Owen begin to argue over how to save the patient’s life. Interrupting the discussion, Webber wants Edwards (Jerrika Hinton) to talk to him about the patient. When she begins to describe his injuries, Webber corrects her by saying he wants to know who the man is in life. When she doesn’t have answers (even if he is the victim or the cause of the accident he was in), Hunt gets short tempered. Webber would rather them not “be mechanics” and have them treat the patient like he was a sack of organs. Webber wants to play a game to imagine the life story (name, occupation, etc.) behind the person they are operating on.
Edwards tries her hand at the game a couple of times, but Webber disagrees with her choices. He selects the patient to be a woman named Gail (Monique Cash) who is a prodigy at the cello. Webber imagines Gail is a single mother of three kids (two boys and a girl) so her home life is a bit of a mess. He suggests that with the liver shredded they call UNOS to get a transplant. Continuing the game, Webber thinks Gail takes night shifts to make extra money. When Webber asks Hunt to join in the game, Owen says he isn’t interested as he operated on hundreds of John Doe’s when he was in the Army. We cut to a scene where Hunt is still an Army surgeon and is arguing with his sister (Bridget Regan). Cutting back to present day, Owen wants to do a sternotomy, which is something Meredith is quite against. We hear a giggle and it cuts back to Owen arguing with his sister. She says she thinks he doesn’t know what to do next with his patient, something that carries over to present day patient. We see Hunt’s sister mention that she only appears in his mind when he feels guilty and she wants to know what he is feeling guilty about at that moment. She knows something is wrong and pushes him to figure out if it is because things aren’t working out Amelia. Present day Meredith makes a remark and we see Hunt’s sister appear in their OR. His sister thinks that Meredith is the cause of his guilt and pushes him by saying she thinks he should have married her. Owen’s sister says he has been making bold moves lately and is currently wasting hospital resources. She says they should just call it because the patient will surely die. Hunt says you don’t stop until you have a final answer – until you save them or find out that they are dead. With that in mind, he removes the man’s liver and tells Edwards to call UNOS afterall.
Meredith argues that the patient won’t survive without a liver. She doesn’t know if a match will come through, but Hunt says he can do a procedure to keep him alive a couple more hours to find out. Hunt remarks that Gail must be tough to go through this. Webber says she was, even when back pain started keeping her up at night. When the patient gets blood in his urine and starts showing neck bruises, a young girl appears behind Edwards telling her that they can’t hear her because she needs to be louder. The little girl tells Edwards that they know what is going on because they had read all about it. Edwards thinks that the patient has a blood disorder and Meredith thinks they need to take him to ICU while they decide what to do next. The little girl begins reading from a book about what to do and tells Edwards, “You know what Nurse Paula would say. She would say, ‘If you got something to say, SPEAK UP!’” Finally finding her voice, Edwards hollers for them to listen to her about her theory that he has an autoimmune disease. The little girl reads from the medical book again and Edwards uses that knowledge to give her opinion on how to fix the patient’s platelet issue. She says if they were her, they should listen to her. Hunt asked why she knows so much and the little girl explains that when you are stuck in a bed your whole childhood you kind of get obsessed with the thing that put you there. Edwards explains she reads a lot.
The patient still won’t stabilize, but a nurse comes through the OR doors to say they may have an ID for him. The nurse gives them a digital camera to take a photo of the patient so they show the wife for verification. They get the ID confirmed as “Carl” and Edwards wants to know if they can switch names now. Meredith asks if there are children and the nurse says they are with the mother. Immediately police sirens and flashing lights cover Meredith’s face. We see her looking on as past Meredith walks into the hospital with her own children. She begins to snap at Webber and Hunt that they took over her decision making and Webber accuses of her from being negative from the start. Hunt thinks it is time to compromise as Meredith sees herself looking at her children in the past and visions of what happened when she learned that Derek passed away. We see her meeting with her children to explain what happened to their father. Zola wants Meredith to fix her daddy because “she can fix anything,” but Meredith must explain this time it isn’t going to work because he died. Finally, Meredith understands what Webber has been doing – he didn’t make Gail up. Webber explains that you come up with whatever you need to – whatever helps – like an old patient. Meredith says, “Someone good.” We watch imaginary Gail say, “It’s okay, son. You were only ten years old. There was nothing you could do.” These words reveal that imaginary Gail was actually Webber’s mother.
Webber explains that his mother claims to have hated doctors so they thought everything was fine. She taught her music classes, made them do their homework, cooked dinner and played the cello for hours. Edwards wants to know what she had and Webber wants her to do the diagnosing. She decides it was cancer and Meredith figures out it was pancreatic cancer. Webber notes she had six months to live at that diagnosis. Meredith realizes that they should keep the patient open to do a partial liver transplant using half of the old one. They would repair part of the liver and then wait for the transplant. It is a hail Mary! As the team attempts to save the patient, we watch their imaginary helpers from the episode smile on. Owen tells Meredith it was a nice save.
Webber explains when he began being a surgeon he was trained to de-personalize the patient. You had to stay focused and have your hands just inside mannequins. One day Webber lost a patient and went to tell them the news – numb. After watching them console one another, it had no effect on him. It was a patient he lost who died from the same cancer his mother had so after that he started to change the rules, which made him a better surgeon.
We hear Meredith narrating about how we have all hit a point of exhaustion. She tells Webber that by now she has saved Gail about a thousand times. Meredith narrates the symptoms of exhaustion and then asks how someone is able to keep going by then. She explains something it is easy because you can play games in your head or you make up someone in your head – someone good. We end the episode with imaginary Derek saying hello to Meredith.