Wednesday, October 27, 2021

Grey’s Anatomy 18x04 Recap: “With a Little Help From My Friends” (The Ultimate Test) [Contributor: Julia Siegel]

“With a Little Help From My Friends”
Original Airdate: October 21, 2021

If you missed the third episode of Grey’s Anatomy, I highly recommend you watch it before checking out this week’s hour, as it is a direct continuation of the previous stories. New character pairings and teaching methods take center stage again, which helps shake up the show in a good way. Plus, a new medical issue alludes to one doctor sticking around a bit longer than you might have thought. 


This episode attempts to put equal focus on three storylines, two of which will continue to play out throughout the season. It is officially Richard’s first day as sole director of the residency program, which any Grey’s Anatomy fan should be happy about. Having Richard back in his best role is exactly what this season needs. In an on-call room at Grey Sloan Memorial, Schmitt and Nico enjoy a morning make-out session before being interrupted by Helm banging on the door. She shouts at Schmitt to check his phone, as he missed the text announcing Richard as the residency director yet again and Meredith’s impending trial. The text also says that he was supposed to be in the skills lab fifteen minutes ago, so Schmitt runs out in a panic.

Bailey meets up with Mer in the hospital and quips that she thought Mer would be in Minnesota by now. To say that Bailey is upset by Mer’s career news is an understatement. Mer informs her boss that she is leaving tonight, and both women wonder why their schedules have been cleared for the day. They run into Richard and Catherine, who reveal that they cleared the schedules to have help with a new teaching initiative. The four attendings head to the skills lab, where Richard tells the eager residents that they will get to act as attendings for the day and each perform a laparoscopic cholecystectomy (a.k.a. lap coli, a.k.a. gallbladder removal) on their own. He announces his new hands-on teaching approach as “the Webber method”, which will surely be used over and over throughout the season. Bailey looks Mer in the eyes and deadpans how she can’t leave for Minnesota because Richard has lost his mind.

Since Bailey is very hesitant about the day’s teaching method, Richard speaks to her and Mer privately to explain why he thinks his new idea works best. He feels that by having the residents perform simple surgeries on their own, the hospital’s physician shortage won’t be as much of a strain. Richard discusses how attendings don’t need to be in the OR for the whole lap coli procedure, rather they can pop in for the most important part which only lasts ten minutes. If the attendings only need to rotate in for ten minutes, they will have more time to perform other surgeries. Mer likes the idea and brings up how she keeps saying that they need to get the residents out of the lab and into live ORs. Bailey finally agrees, even though she still isn’t completely on board with the plan.

Right before the surgeries begin, Mer finds Bailey praying at the surgical schedule board. Mer tries to comfort Bailey by telling her it will be okay, but Bailey can’t get past the thought that they are putting patients’ lives in the hands of children. Mer reminds her that they were both young residents once too. The surgeries begin in earnest, and Mer, Richard, and Bailey go from OR to OR when they are needed. They rotate through as Catherine watches from the galleries above. Schmitt and Khan finish their lap coli so quickly that Schmitt asks Richard if he forgot something. Richard is impressed by their work and gives them another lap coli, since they made such good time. 

However, not everyone has good luck. Helm and Chee’s surgery doesn’t go as planned when the surgical field starts filling up with blood. Unsure of what to do, Helm decides to convert to an open surgery and asks a nurse to page an attending for help. Bailey is naturally upset by the complication. She tells Helm that they should have waited to convert to open surgery. Helm assures Bailey that she doesn’t know what went wrong, and Bailey pushes her aside as the patient continues to crash. Back in the other OR, Schmitt and Khan flawlessly complete their second lap coli. Richard is thrilled with the results of the day and deems the lesson a success.

Later on, Richard, Catherine, Bailey, and Mer celebrate the residents’ success. Catherine is happy that Richard conned her into agreeing with his idea, while Mer says that the high bar they set will make the residents expect this all the time. Richard wants to make solo surgeries his primary way of teaching, but Bailey wants to clip the plan. She doesn’t want to celebrate because in her mind, Helm cutting an artery without an attending in the room has ruined the success. Richard tries to remind her that complications can happen to any surgeon, yet Bailey still feels that attendings should always be in the OR. 

Richard explains his belief that they need to teach young doctors properly, otherwise no one will want to become surgeons. Mer seconds Richard’s thoughts by saying that Helm proved the system works because she did ask for help, Bailey showed up, and the patient survived. Bailey begrudgingly joins the toast and agrees that the Webber method is a success. We then see Schmitt pull Nico into a closet to make out. Schmitt is on a high from being a rock star in the OR, and it’s good to see the young doc have some confidence.

As Bailey goes to leave the hospital, she passes Helm sitting on a bench outside. Bailey asks her if she is playing the surgery over and over in her head. Helm asks her how she knows that, to which Bailey replies that she knows the feeling. Bailey sits down next to Helm to offer some advice. She tells the resident how she has made mistakes and so has Mer. Bailey tells Helm that she should feel awful about what happened because she would be in the wrong line of work if she didn’t. She explains that the awfulness sticks with you so you don’t make the same mistake again, which is how one becomes a great surgeon. 

At the end of the episode, we see Mer arrive in Minnesota and pass Nick as they go in opposite directions. They make plans to meet for dinner that night before going their separate ways. Mer is all smiles and super happy, and even just a few seconds of these two sharing the screen is the perfect ending to the episode. 


The second large story of the episode focuses on Addison and Amelia, who we finally get to see share a good chunk of screen time together since 2013. Amelia finds Addison sitting in Tovah’s room. Addison couldn’t leave Seattle because Tovah had a seizure and needed to be put in a medically induced coma. She wants to see the case through and needs Amelia’s help as a neurosurgeon to figure out why Tovah seized. After running a CT scan and blood tests, Amelia informs Addison that everything came back negative. Addison starts to unravel quickly, prompting Amelia to ask if she’s okay. Addison is obsessing over fixing Tovah and doesn’t want the answer to be that she is rejecting her transplanted uterus. Amelia decides to get an MRI, EEG, and rerun some blood panels to make Addison feel better.

The two doctors have a rather frank discussion while waiting for Tovah’s MRI scans. Addison randomly asks Amelia the question we have all been waiting to hear the answer to: Why did she leave Link? Amelia starts by saying that she felt Link was gas lighting her with a proposal. Addison asks if Link has a tendency to gas light her, and Amelia replies no. Addison doesn’t get why Amelia doesn’t think his well-planned proposal wasn’t romantic in that case. Amelia doesn’t really have an answer for that and instead goes into a speech about how she didn’t want what Link wanted. During the pandemic, she was drowning in kids, monotony, and boredom, which led her to think about doing drugs every day. Amelia explains that virtual meetings weren’t the same and didn’t work for her. She hated that she was hanging by a thread and that Link wasn’t. She felt like she couldn’t breathe while Link was thriving, and Amelia reveals she judged herself for that.

She feels that Addison is probably judging her too, so Addison launches into a talk on how she felt very similarly during the pandemic. Addison reveals that she drank so much wine that she thought about checking herself into rehab somewhere. She hated being stuck at home, especially during the initial lockdown. Addison had really dark thoughts like daydreaming about going to sleep and never waking up, which she says comforted her. Amelia hates that Addison went through that and thanks her for sharing, since they had similar feelings.

The scans don’t show any issues with Tovah’s brain, so the doctors feel that the seizure was caused by increased toxicity levels from the anti-rejection medications. With that answer, Addison is ready to go home to her family, and Amelia quips that the Grey Sloan Memorial staff will oversee Tovah for her as long as their names all get on the eventual publication for the trial. Addison tells Amelia that she doesn’t want to let Tovah die because the idea of a uterine transplant was what made her want to get out of bed in the morning. Amelia assures Addison that she isn’t being selfish and is instead doing everything in her power to help Tovah achieve her dream.

Amelia and Addison are in the room when Tovah wakes up after they get her medications under control. Addison gets to tell her patient that she didn’t reject the uterus and will remain in the trial. All three women are very happy, which is a nice ending to the story. After they leave the room, Addison tells Amelia that she almost left her husband during lockdown. She couldn’t stand that her son and husband were bickering about Game of Thrones, so she got in her car and drove off for two hours before realizing that she should go home. Amelia says that she didn’t leave Link when she wanted drugs and that she currently doesn’t feel crazy or want drugs. She knows she doesn’t want a ring or more babies and feels that Link left her, not the other way around. Amelia feels that the sanest thing she could have done was to let him go, no matter how much it hurt her. Addison smiles and says, “Look at you, Amelia Shepherd, all grown up,” before getting in the elevator and leaving. I hope this isn’t the last we see of Addison Montgomery, but they managed to pack in everything you would want from her in two episodes.


The other continuing story from the past few episodes follows Owen and Noah, who we see meet at a meeting for veterans who want the VA to be exposed for not paying medical bills. Noah’s former colonel, Roy, runs the group and plans to present information in Washington D.C. in a month to help veterans get the support they are owed. Owen wants Roy’s help with Noah’s case, but before he can say much, Roy starts coughing up blood. Winston meets Roy’s ambulance at the hospital, which Owen hitched a ride with. Noah drives to the hospital and meets them to inform the doctors that Roy has pulmonary fibrosis like him. 

While Owen and Winston take him for an MRI, Roy tells them all about how long he has known Noah for and their backstory. Winston finds a spot of lung cancer on the scans, which he knows will be terminal due to Roy’s pulmonary fibrosis. Noah is sitting with Roy when the doctors go to tell the colonel the bad news, but Roy wants Noah to stay. Owen tells Roy that he has lung cancer and that they can’t perform the lobectomy necessary to remove it because he can’t lose any of his lung due to his condition. Winston says they could do a very risky surgery that they don’t recommend, which would involve attempting to only remove the tumor. Roy wants to do the surgery so he can keep fighting and make it to Washington in a few weeks.

When the doctors return to take Roy to surgery, they find a big group of veterans there to support their friend. Roy is moved that everyone came, and he says he will keep on fighting. In the OR, Owen and Winston prep Roy. Owen assures Roy that they will hold someone responsible for his condition no matter what the outcome of the surgery is. Roy tells Owen that his condition is his own fault because he authorized the missile strike that caused his issues. The damage that the strike caused makes Roy question whether he deserves to live or not, which is a very sad moment.

Owen and Winston begin operating, and Owen is surprised by how damaged Roy’s lungs are. He tells Winston he has never seen tissue so damaged, and Winston says he only saw similar tissue once, in a COVID-19 patient. Owen thanks Winston for helping, and both doctors want to give Roy at least a few more months to make a difference in the world. They hit a little speed bump during the surgery, but quickly fix the problem. They know it won’t be an easy surgery, but Roy winds up surviving. 

After the surgery, Owen tells Noah, who is sitting by the colonel’s bedside, that Roy’s lungs are more scarred than they expected. Roy will have a tough road ahead of him, and Noah thanks Owen for caring, saying he is the first doctor to really care. Owen tells Noah that he is in the fight with all of the veterans. When he turns to leave, Roy starts to crash, so Owen promptly starts CPR. Winston comes running into the room and kicks Noah out. We hear them shock Roy three times before Noah walks away. 

We then see Owen and Winston finding Noah to tell him that Roy died. They explain that Roy’s lungs were too far gone, which put too much stress on his heart. Owen wants to help continue Roy’s work, but Noah doesn’t want his help. He tells Owen he never wanted his help in the first place, and Noah also thinks Owen made everything worse. The impassioned words hit Owen hard. Owen walks in an attendings’ lounge, where Hayes is packing up for the night. He asks Hayes if he would like to join him for a drink at Joe’s, as he needs a minute before going home to Teddy and the kids. Hayes agrees, and poor Owen doesn’t even know the other distressing piece of news from the day yet, but more on that shortly.


Let’s take a break from the more dramatic plots to quickly discuss Jo’s first big OB story, which also lends itself as the humor of the episode. In the morning, Jo tries to get out of her car with Luna in GSM’s parking lot, but Luna won’t stop screaming. Hayes happens to be walking by and asks if everything is okay. Jo states that she is so tired that she might drop dead, so Hayes acknowledges how hard it is to be a single parent. As they are about to walk into the hospital, a car drives up behind them and honks. A man gets out of the driver’s seat and asks for help, as his girlfriend, Niki, is pregnant and going into labor. Jo asks Hayes to take Luna to daycare so she can help her new patient out.

Inside, Jo and Carina tell Niki that she is going to have a baby. The boyfriend is appalled because they have only known each other for four weeks and he wasn’t aware that she was pregnant. Niki’s chest starts hurting, so Carina orders a full vitals check and an EKG. In the hallway, Niki’s boyfriend asks Jo if she can give Niki her cellphone. Jo asks him to stay and hold Niki’s hand for a few hours, but he’s not ready to be a dad. He explains that they met online and that Niki lied to him, so Jo takes the phone.

Jo goes back to Niki’s room and asks her if she is experiencing some anxiety since all the tests came back normal. Niki wonders where her boyfriend is, then realizes that he left. She starts freaking out because she feels she can’t have a baby on her own. Jo assures her that she can do it. Niki tells Jo that her friends think she is crazy for having a baby by herself and that her parents moved across the country when they heard the news. Jo decides that she will hold Niki’s hand to be helpful and Carina can deliver the baby.

Carina comes back to deliver the baby and isn’t happy to see Jo holding Niki’s hand instead of working. Carina wants Jo to deliver the baby while she holds Niki’s hand. Jo gives Niki a pep talk that includes how having a baby “is worth so much more than your fear.” Jo tells Niki to push, and the baby’s shoulder gets stuck. Carina walks Jo through how to solve the issue and the baby is delivered safely. At the end of the night, Jo holds Luna while sitting on a bench outside the hospital. Jo tells her baby that they will go home once she has the energy to get to the car, which might not be until tomorrow.


The last storyline of the episode introduces what is most certainly going to become a recurring plot. Megan Hunt is still in Seattle and helping out at Grey Sloan Memorial. She asks Hayes for a pediatric consult on a fourteen-year-old kid who she has seen playing soccer near her hotel. She has noticed that he has swollen ankles and seems a little out of breath and wants Hayes’ opinion. Hayes can’t give her much help without the examining kid. Megan thought he might say that and quickly walks away.

Shortly afterward, Megan finds Hayes again and tells him the patient is in Exam Room 4. As he goes into the room, Megan introduces the boy as her son Farouk, which you might have figured out from her previous description. After his examination, Hayes tells Megan that Farouk’s EKG shows some abnormalities and that he hears a heart murmur. Megan is slightly relieved to hear that she’s not losing her mind and making up medical conditions for her son. She tells Hayes that Farouk has a history of ear infections and had tuberculosis ten years ago in Iraq. She tells Hayes about how she raised Farouk while she was a prisoner of war, and Hayes replies that he didn’t know Megan served in the military too. With the new information, Hayes wants to do an echo on Farouk. Megan agrees to the test and asks Hayes to keep Farouk’s condition between them. She doesn’t want Owen to know and freak out before she has a diagnosis to tell him.

Later that afternoon, Hayes meets Megan in another room to talk about Farouk’s test results. Hayes informs her that Farouk has restrictive pericarditis, which was most likely caused by the TB. He is sorry that it is not better news, and Megan starts to cry. She apologizes for breaking down, and Hayes tries to comfort her by saying he understands. Hayes needs to consult with the cardio department, but he thinks Farouk will need surgery and wants to admit him. Megan says that Farouk has always been a good kid despite what the world has given him. Hayes promises he will do everything in his power to fix Farouk. Megan wants to process the news before telling Owen, so Hayes leaves to give her some space. With Farouk's heart issue, it appears that Megan will have a reason to stick around in Seattle longer than we may have expected. While the storyline is quite sad, I’m happy we will see more of Megan. Grey’s Anatomy will be taking the next few weeks off and will return on Thursday, November 11 with a big two-hour crossover event with Station 19.


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