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HomeNewsGrey's anatomy season 19 episode 01:" Everything Has Changed"

Grey’s anatomy season 19 episode 01:” Everything Has Changed”

Simone Griffith exits the parking garage while people clean up the mess left by the tornado.

A nervous-looking Jules Millin gets off the elevator. She runs into Link. They recognize one another from a night they’d spent together. He apologizes for not having called like he had said. She says she works here now. Mika Yasuda passes by so Jules quickly tags along to find scrubs together. Jules immediately shares she’s already slept with an attending.

Simone is disappointed to find that the coffee cart outside has been trashed by the tornado.

Lucas Adams enters the intern locker room and gets dressed. He introduces himself Jules, Mika, and Benson Kwan and asks them not to call him Skywalker. Lucas tries to make smalltalk. Benson scoffs. He’s sizing up the competition and he likes his odds. Mika blurts out that Jules has already slept with an attending, much to Jules’ dismay.

Simone arrives in the lobby and freezes for a moment.

She sprints down a hallway only to be stopped by Richard. Simone claims she’s late due to the tornado. Richard points her in the right direction. She arrives at the locker room as the other interns exit, all changed into their scrubs already.


Meredith welcomes the interns to the OR, which has been equipped with new high-tech equipment. She sees she appreciates their awe. The equipment is useless without highly skilled surgeons to operate it. They will use to save lives. And end one as well, as it’s part of the game. They went to med school regardless, which makes them brave. They weren’t picked for their grades. They were picked for their fight. Simone bursts in late. Meredith calls her out. Simone says the tornado created a family situation. Meredith advises her to make some extra time in the morning as expecting the unexpected is part of the job.

Bailey joins the other attendings in the gallery as Meredith continues her speech. Bailey heard about the new class and the new OR and couldn’t resist coming to check them out. She points out that there are no senior residents around. Richard says their former residents are all happy at their new spots.

Levi is delivering a baby under Jo’s guidance. He has trouble keeping his face straight.

When they’re done, Levi informs Jo that he’s done. He can’t do this. She’s upset because she vouched for him.

Bailey walks with Richard and points out that while he was galavanting around the world, his wife threw a mountain of money at the hospital for new surgical equipment. Then he made a residency class from the bottom of the barrell six months early. Bailey says it looks desperate and she won’t co-sign. Richard says they combed through hundreds of applicants to find the gems. These interns have stories, hearts, and empathy. That counts for a lot. His travels opened up his mind. Levi comes running up and says he promised Jo to see the OB/GYN residency through no matter when the surgical residency program opened back up. So, he’s risking his job and a friendship for this, but it looks like they are in need of senior residents, even a Chief Resident, and he thinks he’s the right person for the job. If he ever gets soft, he’ll think back to the OB/GYN residency to toughen up. Bailey wishes Richard good luck and leaves the hospital. Richard tells Levi to go talk to Chief Meredith.


Amelia walks with the interns as she informs them the tornado flipped a bus off a cliff. Many of the passengers were not wearing seatbelts, so they are looking at a large numbers of patients with catastrophic brain injuries. She asks how they declare brain death. Benson correctly answers the questions. Lucas asks how many patients there are. Amelia tells him to raise his hand before speaking. He does so and she says there are fourteen potentially brain dead patients. Nine of those are organ donors. “Organ palooza,” Mika says. Amelia instructs her not to talk for the rest of the day.

As they continue on their way, Amelia says the families have been moved to the waiting room while they run the confirmatory tests. Transplant surgeons from all over the country are on stand-by so not one organ goes to waste. They enter the ICU section with all of the the patients, which makes it all too real.

The interns examine patients as Amelia rotates. Lucas’ patient is the first to be declared brain dead. Amelia instructs him to go inform his mother. Next up is Simone’s patient, also brain dead. She goes to tell the patient’s husband. Once his patient is declared brain dead as well, Benson swiftly goes to update their next of kin. Jules finds it harder to deliver the news. Only Mika’s patient is still showing cranial reflexes, meaning she is not brain dead.

Winston finds Maggie pacing in the hallway. She just heard they may have a match for Howard, a patient dear to her heart, but it’s not official yet. Jules comes up. She’s a big fan of Maggie’s after having read her article about racial disparities in outcomes after bypass surgery. After some fangirling, she’s urged by Winston to get to the point. Jules confirms that they have a match for Howard Jones. Maggie cheers. Jules asks if she can join her because she needs to witness some good news.

Mika tells Mrs. Milton that her daughter is not showing signs of brain death. They are hoping the swelling in Marina’s brain will go down. There is a chance she might live through it. Ms. Milton is too afraid to hope. Mika will hope for her then. She has seven sisters and one of them is around Marina’s sister.

Howard’s husband has started crying after the good news. Howard thought this day would never come. Maggie has Jules measure Howard’s blood pressure and happily shares that the residency program has opened back up.

Jo is excited to see a delivery of black scrubs. Since the female body has become a war zone in this country, the department is changing scrub colors. Link shares that his one-night stand from Saturday works here now as a surgical intern. Jo laughs and advises him to talk to the Chief.

Winston is happy to see Nick in the long line of transplant surgeons. It’s been a while since they’ve seen one another. Benson asks Winston is he can join in so he can see what goes into an organ procurement. Lucas wants in, too. Winston consents and the interns get in line. Nick has never seen anything like this. Eight deaths save up to 40 lives. It’s a horrible but also a beautiful day. Nick asks Winston how things have been since the shutdown. Winston complains about having to replace the residents as junior attending. Nick clarifies he was inquiring about Meredith. She’s a good Chief. She’s officially the interim Chief but it feels official after six months. From the other end of the hallway, Maggie spots Nick and rushes off.

Link is waiting for Meredith to finish her phone call with UNOS. She’s asked to hold. Link says he slept with an intern. Meredith advises him to steer clear of elevators for the foreseeable future and directs him to HR. Maggie then shares that Nick is in the hospital. Meredith is not surprised. Maggie urges her to go talk to him but she’s holding for UNOS. She has a triple-organ match for her patient, Sarah Martinez, but UNOS claims some other patient is in line ahead of her. Maggie points out that Meredith has been sad for six months, which even Zola has noticed. UNOS then informs Meredith that her patient is getting the organs. Levi comes in to talk to Meredith, who figures he hates OB. She immediately says he would make a good Chief Resident.

Meredith walks towards Nick with an excited Maggie tailing her. She checks with Lucas if the donor patient, Liam Collins, has been brought to the surgical floor. Lucas confirms they are prepping him now. Meredith asks him to take point on the three-organ transplant procedure since she can’t disappear into an OR for 25 hours as Chief on the first day of a new residency class. Nick’s resident, Lee Kang, will fly their liver back to Minnesota. Nick can’t help but accept the proposal since it’s so rare. They go to inform Sarah’s family together. Maggie and Winston stay behind. They had pictured that reunion differently. Simone then comes up and asks Lucas why he didn’t talk to his patient’s family before sending him to pre-op. Liam’s mother is screaming at Amelia in the ICU. Lucas must have spoken to the wrong mother. He rushes off. Benson is amused.

Amelia is apologizing to Jane Collins. While her intern made a horrible mistake, Amelia herself performed the final assessment and her son is, in fact, brain dead. Jane can’t bring herself to trust Amelia after they took away her chance to say goodbye to her son. Lucas and Simone arrive with Liam. Lucas apologizes to Jane. Amelia offers to run the last test again but Jane wants her to repeat the entire process. Lucas privately tells Amelia that this patient is Meredith’s triple organ match. She instructs him to go talk to Meredith and asks Simone to tag along to make sure he doesn’t screw up again.

Meanwhile, Meredith and Nick are forced to participate in a group hug with Sarah’s family. Lucas knocks on the window and his body language makes it clear to Meredith that trouble is ahead.

Outside the room, Lucas repeats that he spoke to the wrong family. Nick thinks Liam’s mother is saying goodbye now but Lucas can’t bring himself to say the truth out loud. Simone says that Amelia has to run all the tests again or the mother won’t consent to the organ donation. Nick asks if Liam’s vitals were stable. Lucas doesn’t know. Meredith explains that if the patient codes before Amelia is done, the one-in-a-million match for Sarah got wasted because of him. He’ll be the one to tell Sarah’s family that. Meredith orders the interns to go help Amelia.

Lucas throws up on his way back.

Amelia tells Lucas and Simone that Jane brought in their family physician, the only doctor she still trusts. Simone leaves to get him. Lucas explains to Amelia that he used to the first name when he went to talk to the family. She points out they have good reason not to do that. The woman that Lucas talked to also has a son who is brain dead.

Simone finds Jane and Dr. Shagrin by Liam’s bedside. Shagrin knows time is of the essence yet as an old man, he walks very slowly.

Simone has put Shagrin in a wheelchair and races across the hospital with him.

Amelia has shown Shagrin the scans and test results. He agrees with her assessment.

Simone mistakenly ends up on the peds floor on her way back to the ICU waiting room. Once there, she tells Jane that Shagrin has confirmed the diagnosis. Jane breaks down while Simone freezes up. Benson steps in and comforts Jane with a story about the death of his younger brother, who saved many lives by donating his organs. Jane then consents to donate her son’s organs. As they walk off, Simone thanks Benson. He says he never had a brother, he just wanted in on a triple-organ transplant.

Nick tells Meredith his gut says that Sarah is getting her organs today but his gut has been proven to be wrong sometimes. Meredith regrets telling him to go back to Minnesota. He heard her calling after him but he was hurt and wanted her to put in some effort. It’s been a very difficult six months. He knows how stubborn and proud she is. Simone and Benson simultaneously share the news that they got consent. As a reward, they both get to scrub in.

Sarah tells her family that if she dies, she wants her body to be turned into fertilizer for a tree. She doesn’t want to become pollution, which a casket and cremation are. She’s ready for the procedure. The doctors take her to the OR.

In the OR, Maggie says it’s a no. There are too many hematomas on the heart for it to be used for a transplant. Maggie leaves Jules to close the donor under Levi’s supervision. She’ll tell Howard today is not the day. Before she starts, Levi cautions Jules to be polite to Bokhee.

Nick spots Lucas in the scrub room of Sarah’s OR. Lucas wanted to make sure she was okay before he gets fired. Nick says everyone makes mistakes. You’re good as long as you learn from them. Lucas learned to raise his hand, save his shame for the other day, and use full names when talking to next of kin. Nick tells him to scrub in so his day ends better than it began.


Nick, Winston, Richard, and Lucas get gowned and gloved and step up to the table. Nick informs everyone about the donor and recipient. “It’s a beautiful day to save lives,” Lucas says. Richard looks up to the gallery, to Meredith and Amelia. Amelia says Derek was a God to Lucas. Lucas was Derek’s favorite nephew. She loves him, too. Amelia doubts that he has what it takes. He’s messy and doesn’t follow instructions. Meredith hired him because he has a stroke of the Shepherd family genius. And he’s a bit of a black sheep. It’s not Derek whom Lucas reminds her of. Amelia guesses that is why Lucas drives her crazy, then. Meredith says Lucas has the spark. He just needs a chance. Amelia says the interns need to be watched closely.

Surgeons rotate in and out of the gallery as the surgeons down in the OR perform the heart transplant. Benson goes to update Sarah’s family while the surgeons find that there’s a heartbeat.

A tired Mika gathers herself before heading back to the ICU to check on Marina again. There are no changes to report to Marina’s mother.

The sun rises over the city. Simone reports to the Martinez family that the surgeons have completed the liver transplant. She returns to the OR as the kidney transplant starts. The gallery completely fills up as the surgeons complete the final steps. Sarah is weaned off ECMO and her vitals hold. The surgical team is met with a loud round of applause.

Simone delivers the good news to Sarah’s family.

Link meets Jules outside the intern locker room. He asks about her shift. It’s endless, exhilarating and devastating. She sewed human flesh for the first time on a living human being. Link says he brought HR paperwork for her to sign. It says their relationship predates her employment here. She points out they have no relationship. He claims he doesn’t want one, making her wonder why he’s waiting outside the locker room like a stalker.

Mika is checking on Marina again. Much to her surprise, Marina moves her hand and looks at her. She wakes up Marina’s mother. Amelia watches them from a distance. Ms. Milton thanks Mika for hoping. Privately, Amelia asks Mika how that dark sense of humor is working out. Mika softly smiles.

Sarah wakes up in the ICU as her doctors are checking on her. She asks if she’s a tree. Sarah wants to see her family but she needs to rest and recover for a couple of days first. Sarah wants to thank her donor’s family. She knows what it’s like to lose a child. This hits close to home for Simone, who leaves the room. Nick tells Sarah they’ll talk about it later.

Richard finds Simone outside the hospital and inquires if she’s alright. Simone says her mother died in this hospital when Simone was born. She hasn’t been here since her birth. She was late because of a panic attack over having to come back here. She always pictured this place with beige walls and they turned out to be blue. It’s disorienting, disappointing always, that she got it wrong all this time. Richard says they were beige up until a few years ago. Simone sighs a sigh of relief. It makes her feel better. She apologizes for having lied but Richard understands.

Jo laughs at Link for his encounter with Jules. Levi comes up but Jo tells him to keep walking since they are not speaking terms. She can be mean when she wants to be.

Nick meets Meredith in her office. He thanks her for giving him his first triple-organ transplant. Sarah is doing fine. Meredith says she needs a residency director. He’s the best teacher she knows and this class reminds her of Nick at their age. They either didn’t match anywhere else or got kicked out. They are diamonds in the rough. She never would’ve them if she hadn’t known his story. She hopes he’ll consider it. Before he can answer, Teddy and Owen enter the office. Meredith called them three weeks ago but he couldn’t work three weeks ago. Teddy adds that he needs to be supervised. Owen has been surfing every day while they paid out their entire life savings to an expensive attorney. Nick promises to think about the offer and leaves. Owen’s attorney got all criminal charges dropped. Owen’s license is suspended and he’ll need to be supervised for six months. Teddy is not pleased.

The interns are hanging out in the tunnels. They’re dead tired. Lucas wonders if Simone has a nickname but she doesn’t. Benson is truly stunned that Lucas has not been fired. Lucas promises to remember this moment when Benson inevitably screws up one day, too. Benson doubts that’ll happen. They call him “Blue” after the blue ribbon because he always wins. Simone says this a program for losers or rejects so he must’ve lost at some point. Simone still can’t believe he lied to that mother. Benson says he just comforted her to create a win-win situation. Moments later, all the interns are paged. They rush off to get back to work.

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