Previously on Grey's Anatomy:
We received word of a mass casualty incident.
You cannot tell Shepherd
- until I've told Meredith. - Cristina and I are engaged.
Immediate! I need help!
- My buddy's trapped under a car. - Dr. O'Malley and I made a deal.
He's going to find my son before I go into surgery.
We have to bandage him up, find someone to take him and find your mom.
- I got to get out of here! - Sir, don't move!
Like I said, disappearances happen.
Pains go phantom.
Blood stops running.
And people...
People fade away.
There's more I have to say.
So much more.
But...
I've disappeared.
Did you check on Kramer in 2309? Because his X Rays are done.
Higgins in 2312 needs diet orders before he can eat.
Done. I need you to monitor Collins in 2323.
Page me if his systolic drops below 90.
I gave him a loading dose of dig to lower his heart rate.
- You seen Dr. Grey? - I checked on her. She's sedate today.
Not Dr. Ellis Grey. Dr. Meredith Grey.
- No. - Not since this morning.
Fine. If there's anything emergent, page me in the pit.
George, did you find him?
Is Chris OK? Is he awake? Is he...?
Answer Mrs. Heit, O'Malley.
Chris is fine.
He's glad you're OK, he'll be waiting for you after surgery.
- He's being very brave. - That's my Chris. That's my boy.
Thank you, Dr. O'Malley. So much.
Dr. O'Malley. Hold up a second.
What happens when the happy mother in there wakes up after surgery
and her son isn't there to greet her? What then?
How are you going to explain that, O'Malley?
If she wakes up because my lie helped us save her life,
I'm OK with that, Dr. Bailey.
- Find that child. - Yes, ma'am.
Her echo showed cardiac tamponade.
Mmm. So our priority is stabilize the pericardial effusion.
Keeping mom alive means keeping baby alive.
- I'll monitor the surgery. - I'll notify the OR.
Chief, we got a mob scene in the clinic
of people looking for family members and a two-hour-old list.
No one has any more information than you do.
The police are asking us questions. Search and Rescue can't track it.
- We'll have to do it ourselves. - Is there some system...?
You're the system, Karev. Figure it out.
How she doing?
We won't know until we get her to the OR.
- She still a Jane Doe? - Yeah.
To be in that condition and have no one who knows you even know.
- What? - She's all alone. It makes you think.
You know if I went missing, would anyone notice I was gone?
- Do something! - There's nothing more I can do.
You're supposed to put something in his mouth.
Nobody's putting anything in his mouth. Let him ride it out.
What're you going to do? You just can't let him die.
They're going to come in a little while and they'll get him out.
- We don't got much time. - What if they don't get him out?
I don't know. I don't know, OK? I don't know.
Please. You can't quit on us now. You just got to try something else.
I'm out of practice. I've been watching.
For weeks I've just been watching.
I'm sorry.
You stopped the bleeding, that was good.
Come on, please. I know this guy. I believe in him.
I believe he can make it.
You got to believe in it too.
You got to believe you can do this. Please.
Don't stop now.
Who's got a cell phone?
You guys good? You OK?
- What you got? - Nearly severed leg,
but he had his artery tied off so, that's something.
Yeah. Who tied off the artery?
- Was it Dr. Grey? This is her jacket. - We found him like this.
- She must have moved on. - Yeah.
- Doc! - Yeah.
What is it?
Yeah, just stabilize the fracture.
Get him to the hospital as soon as possible.
Three more rescues en route.
Hey. You OK?
Did the doctor bring you here? Huh? Meredith.
Is Meredith OK?
I'm hungry.
Hi. My name's George.
Is your name Chris?
No.
Is he...? Thank you.
Thank you very much.
- Do you have a new list? - Uh, not yet.
- How can there be no new information? - Isn't there someone you can call?
- Nobody knows anything right now. - That doesn't make sense.
That's ridiculous!
Come on!
Quiet!
All right, that list is all I have for you and it sucks, but that's it!
I can't believe you don't have some kind of a system.
If you give me a minute to think, I'll come up with the damn system!
I want you to know that I understand you're under a lot of pressure.
If you need to sit for a minute,
or if you need a hand or a hug...
I'll hang the bag.
Pulse ox is 98.
- This is ChiefWebber. - Oh, Chief.
I got a guy here and we can't extricate him.
- Who is this? - I've tried everything.
- Who's this? - Izzie Stevens. I'm at the dock.
I've got a patient with a skull fracture and intracranial bleed.
- Showing signs of increased pressure? - Yes.
His left pupil is blown, he's gone limp.
He's seizing and now his right pupil is dilating.
- Could be herniating. What's your ETA? - We can't get him out!
He's stuck under a car. We can't get him out.
- First you've got to stay calm. - I can't stay calm.
Calm was over minutes ago. Calm is gone. Calm is an impossibility.
I've got his friends here. I can't let him die.
So please just tell me what I need to do.
You need to do some burr holes.
Burr holes? I can't do burr holes out here.
- Do you want to save his life, Stevens? - Yes.
I need to check something out in the book, then I'll talk you through it.
- In a book? - I'm not a neurosurgeon, Stevens.
And I want to make sure we get this right.
Somebody find me a copy of Boardman's Neurosurgery!
Everything OK?
You know anything about making burr holes?
- Done it a couple times. - Good. Don't go anywhere.
Stevens, listen to me.
- I need a drill. - There's one in my truck.
What do you need a drill for?
I've got to drill holes in your friend's head.
Watch your back. Coming through.
Hello. I'm suturing here.
- I'm sorry. - Did you just get back?
Yeah. I'm looking...
Have you seen any lost children?
Is Meredith back? It's important.
- This kid, his mom's in surgery. - What kind of surgery?
This kid's lost.
You didn't see it today. You weren't out there.
I know.
Have you seen any lost kids down here or not?
Not. Do you know where Meredith is?
- I'm leaving. - Yeah, I know.
If you can identify the patient,
- write their name on the picture. - I've got markers.
These patients are in surgery and these patients are in the ICU.
- This is Fatima! Is she OK? - Yeah. She's in the OR. Stable.
These people have been transferred from other hospitals.
And I have the details.
- Is that him? - No.
- Hey, it's me. - I got a case I need to check on.
- My husband's not on that board! - Kelly Winter's not either.
What does that mean?
It's... they could be in shock
or walked away from the site...
Just say it. A lot of people died! They're dead!
We don't know that.
So, how can we know?
My wife, she wasn't in these photos either.
But she's pregnant. Is it possible you just didn't see her?
She's pregnant?
What? It's OK. Just think.
Where is she? Which way she go?
It's OK. Take your time.
Take all the time you need. You're doing great.
- What is it? - Good.
OK. Use your words.
Where exactly is Meredith?
The leak in the heart is from the right atrium.
You gonna put her on bypass? That could compromise the baby.
I can fix her heart while it's beating. Push 40 milligrams of esmolol.
I found her husband. I found him.
She's not a Jane Doe. Her name's Casey. Casey Clark.
- What? - How do you know?
- What? - How do you know it's Casey Clark?
She's pregnant...
There were hundreds of people on that ferry, Alex. Hundreds.
Chances are that more than one was pregnant.
Now do not give that man hope unless you are certain.
Do not give him hope until you've checked every last body in the morgue.
- Dr. Burke, can I...? - Yes. Make it fast.
I gotta tell you, this group of interns...
- Emotional. - Headstrong.
Hotheaded. Stubborn. They think they know everything.
You can only give them so much rope before they hang themselves.
They lose all rationality, don't listen to reason.
Jeez, Preston. Don't hold back.
She's getting hypotensive.
I'm seeing some late decels on the fetal heart monitor.
The baby is not getting enough blood!
Almost. Just got one more stitch.
Got it. Turn on the echo.
Baby's heart rate's stabilized.
I think we've seen the worst of it.
What's the deal?
Know how massive this hospital is? How many people...
If I'm a little kid, how many places can I hide?
He's little. A little kid could hide anywhere.
- What, you're looking for a kid? - Yeah.
His mom's in surgery and I... If I don't find him
Bailey will...
To start she'll change her son's middle name
to "Elvis" or "Tupperware".
I'm not kidding. Anything will be better than George.
I know a place a kid might be.
Really?
- You could've warned me. - Yeah.
- You didn't check down here, right? - No.
So, stop whining and tell me if you find a pregnant chick.
You're not the only one with a detail that sucks.
You know? I'm supposed to deal with these freaked out families.
I'm not good with people. They should let me stick to patients.
Patients are people. Especially kids.
- You know what I mean. - He's face down.
How does that...?
Come here and help me turn this body right.
- Dude. - Don't tell me it doesn't matter!
- God. I swear to God. - Dramatic much?
This doesn't bother you? Any of this?
All this death doesn't mean anything to you?
I'm working. Why would it?
Yeah, but it was working...
Caucasian female about 30-years-old.
She's... She's pretty.
She looks about seven months pregnant.
Now remember, Stevens, that drill isn'tjust going to stop
like a neurosurgical drill. So as soon as you feel the release in pressure,
stop the drill or you'll pierce his brain.
- Even if I don't see blood? - Trust your instincts, the feel of it.
I'm ready. No, wait. I need to clean the drill off one more time.
You've cleaned it a dozen times.
It's as clean as it's going to get.
You ready?
Yes.
OK. Place three fingers above the ear and two or three fingers
in front of that on the side where the first pupil blew.
Got it.
Now use the scalpel to make a vertical scalp incision down to the skull.
Jeez.
I see a lot of blood. A lot.
Superficial bleeders. Nothing to worry about.
- Are you at the skull? - Yes.
Drill a hole in the middle of the incision.
Oh, God!
OK, that can't happen. Do you understand me?
Sounds can't happen. Freaking out can't happen.
If you freak out, I'll freak out.
I'm the one holding a drill to your friend's brain.
If you're gonna vomit, if you're gonna make sounds, step away.
If you're going to stay here, you have to pull it together. OK?
We're good, doc.
OK. I'm ready.
The temporal bone's only going to be a couple millimeters thick.
OK. I'm in.
But the dura looks fine.
- You're going to have to go in again. - Frontal lobe, right?
That's right. Just behind the hairline. A few centimeters off the midline.
This bone will be thicker. Five times as thick as the temporal bone.
OK.
Got it.
- Second hole done. - What do you see?
I think I see... blood. I see some blood.
OK, now this is important.
Drill around the hole. You have to try and relieve the pressure.
OK.
OK. The hole's about two centimeters around now. I see blood.
I definitely see blood.
Try to evacuate as much of the clot as you can.
With what? I don't have suction!
Use your finger. Gauze. Anything!
- I see clotted blood. - No arterial?
- No. - Good.
Now how does the dura look? Is it bulging or does it look lax?
It's pulsating regularly with the heart beat.
That's another good, right?
That's great, Stevens.
If it's pulsating, that means blood and oxygen are entering the brain.
Now pack it with gauze so you can minimize the bleeding.
OK.
Get the rescue rig in here.
Nicely done, Stevens.
Is that it? Is he going to be OK?
We've relieved the pressure on his brain but he's got a lot of other injuries.
Hey.
His eyes are open.
Hey, kid. Kid?
You OK?
You need to come with me.
Kid?
One, two, three, four, five.
- ETA is five minutes. - One, two, three, four, five.
One, two, three, four, five.
- How is she doing? - Good. No intestinal damage.
Missed all her vital organs. She's almost done here. You find her son?
I've looked everywhere.
I've been in contact with the scene, with Mercy West,
with Seattle Presbyterian, I checked in the...
He's lost.
Or...
- Or... - He's in the water.
When she wakes up, I get to inform her that she's not going to die.
- She's just going to want to die. - I'm sorry. I'll...
- I'm going to keep looking. - Yeah, you do that.
His right pupil's not dilated, but his pulse is still up in the 130's.
- What's his neurological status? - GCS is eight.
I'm sorry, I had to use some guy's t-shirt.
- It wasn't sweaty or anything. - Tell the OR we're coming up.
I dropped the scalpel in the field
and I had used all the alcohol swabs on the drill bits,
so I think we should load him up with lots of antibiotics.
You put a drill through a man's skull and didn't hit his brain.
You saved his life.
Get cleaned up and get to the OR. You got work to do.
- The OR? - Yes. The OR.
You're officially off probation.
Oh, Cristina! You are not going to believe what I just did.
You're gonna think I made the whole thing up.
- Is Meredith back? - I drilled a hole into a guy's skull.
Several holes, with a drill I borrowed from a guy named Vince.
Packed the hole with tissue, then brought him here.
- I get to scrub in! - You haven't seen Meredith?
It was a roller coaster ride with adrenaline shooting out of my ears!
You think my hands would be shaking, but they weren't.
- Did I mention the drill? - OK, Izzie, I get it.
You are a hero, I am jealous.
But I need to know where the hell Meredith is.
OK. I don't know where the hell Meredith is.
She should be back here. I didn't see her at the scene.
The scene where I was a rock star, by the way.
Did I mention I'm off probation?
Rock star!
These photos are fatalities.
I know it's difficult, but please try to ID who you can.
We've agreed to let you do the honors.
A few more burr holes to start the craniotomy.
Really?
You saved his life, you might as well help finish what you started.
After I strip off the periosteum,
you can see what a high-speed pneumatic neurosurgical drill feels like.
Drill, please.
We, uh, have two pregnant women.
One of them, she's in bad shape. She's pretty beat up.
She might be hard to recognize.
I don't know.
- What color is her hair? - Brown. Reddish.
My wife is blonde. Brownish, but blonde.
Well, sometimes the blood makes it look darker like that... red.
You can't tell from the photo, but her eyes, they're pretty distinctive.
Casey's eyes are very distinctive.
Brown.
But not that really dark, dark brown. More golden. And really warm.
It's not her. Casey's eyes are blue.
Very, very blue.
I'm sorry.
I thought you said you had two pregnant women?
Yeah. We...
The other one is...
She's...
Oh, God. Oh! Oh, God.
Oh, Casey.
- What do we got? - Jane Doe, drowning.
It's not a Jane Doe! It's Meredith Grey!
Derek. Derek! Derek, how long she been down?
I don't know. She's alive.
- One, two. She's alive. - Derek!
OK, look. I need you to help me get her inside.
Clear a trauma bay! Stat!
Move it!
Dr. Wilson, Dr. Eric Wilson, to the OR.
How was your surgery, Dr. Burke?
The patient is out of the woods now, Dr. Yang. Thanks for asking.
- Ow! - You're numbed.
Whatever. It looked harsh.
Fran, finish this, please.
- What is your problem? - Everyone's back except her.
And I listen to her.
Every day about her McLove-life and McDreamy and the crap.
And on the one day... the one day I have a thing... she disappears.
Meredith. This is about Meredith?
- She doesn't know yet. - Meredith.
- She's my person. - Right.
And if Meredith doesn't approve, then what?
This is not about getting her approval.
- It's about... - What?
Telling her makes it... makes it...
If I murdered someone,
she's the person I'd call to help me drag the corpse across the floor.
OK, see now? You're likening someone here to a corpse.
I'm done.
She's my person.
Removing the bone flap.
Ready with suction.
- Looking good. - Yes.
Yes it is.
- Dr. Stevens? It's your pager. - That's OK. It can wait.
I think you want to take this page.
How she doing?
She's holding steady for now.
- Anybody claim her yet? - No.
She's still a Jane Doe.
- I'd notice. - What?
If you went missing, I'd notice.
Trauma team to OR four. Trauma team to OR four.
- I need a little more suction, please. - Callie.
O'Malley, I'm working. What do you want?
You're doing an internal fixation of the spine
on a John Doe from the ferry crash, age seven.
- That's right. - Can I see his face?
- I'm in the middle of surgery. - I know.
Is this boy your patient?
I know the picture's hard to see.
Please tell me it's him. Tell me he has been right here,
under my nose, open on your table all day
and not drifting along the bottom of the ocean.
Just please tell me that.
Hold the photo under the light so I can get a better look.
Oh, yeah. That's my kid. I could spot those goofy ears anywhere.
- Really? - Really.
Callie O'Malley, I can't kiss you right now because you're scrubbed in,
but tonight, when you get home, I am going to...
OK! OK. All right. You know what?
People, let's focus. George, I'm working.
- Yeah. - I'm working.
- OK. - So... Bye.
Oh, my God!
You're safe. You're safe.
Oh, honey. Mommy's sorry she got lost.
Lisa.
They could only put a 20-gauge IV in.
I'll start a central line, you have to get out of the way.
We put three milligrams of epi down the ET tube.
- Derek. - The last dose was three minutes ago.
- Push... - Shepherd, get out.
I think we should push just one atropine.
I think I saw some reactivity in the pupils before the atropine.
She might have actually had some cardiac activity...
Shepherd, get out!
We need to put an external pacer on.
We need to save her life.
You can't do this. We need to do this. Now go.
- Go. - Three, four, five. One, two...
She has a new 18-gauge in her left AC.
Push one of epi through it.
The chief is working on her, man.
He threw me out.
What do you need?
I need you to go in there.
Give me a new warm blanket. Her temp's still only at 80 degrees.
- What can I do? - She needs an ABG.
Whoa, was that v-fib? Charge to 300.
Let's go! Let's go! Let's go!
OK. Clear!
Back to asystole. Keep compressions going.
- Oh, my God. - She's hypothermic.
Uh... Have you tried a warm peritoneal lavage
or even continuous bladder lavage with warmed fluids?
- You could do a thoracotomy. - Get back to ABG.
Come on. Let's go, people.
How's her temp?
- Only up to 81 now. - Come on, Meredith. Don't do this.
- It's Meredith? - Yeah.
Are you sure? Did you see her?
It's Meredith.
Oh.
Oh... oh.
- She will come through this. - You don't know that.
She will come through this.
People die.
I know people die.
People die in front of us every day.
But I believe Meredith will survive this.
I believe...
I believe in the good.
I believe that it's been a hell of a year
and I believe that in the face of overwhelming evidence to the contrary,
we will all be OK.
I believe a lot of things.
I believe that...
I believe that Denny is always with me.
And I believe that if I eat a tub of butter and no one sees me
that calories don't count.
And I believe that surgeons who prefer staples over stitches are just lazy.
And I believe that you are a man who made a terrible mistake marrying Callie.
And I believe that because I'm your best friend
I can tell you this and we can be OK.
I believe that even though you made this mistake, you will be OK.
I believe we survive, George.
I believe that believing we survive
is what makes us survive.
She's going to be OK.
Push another epi.
- How many is that? - This is our fourth round, sir.
- We've been here 20 minutes, sir. - Still in asystole.
We're losing her.
Hey.
Am I... dead?
Damn right you are.
Holy...