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Grey’s Anatomy: Season 20, Episode 9, “I Carry Your Heart,” Recap & Spoilers

 

The most recent Grey’s Anatomy episode, “I Carry Your Heart,” begins by checking on some of Grey-Sloan Memorial Hospital’s couples. Jo Wilson, who is just arriving home, has had her final day as a general surgeon so she can focus on OB-GYN, so Atticus “Link” Lincoln has made her dinner, and the kids are already in bed. It’s time to celebrate. Teddy Altman and Owen Hunt, on the other hand, are going over his new bleeding intervention program. When Owen asks Teddy about funding, though, she distracts him with a kiss, which means she hasn’t figured out how she’s going to fund his project yet.

At the hospital, Lucas Adams and Simone Griffith are in the on-call room together, blowing off steam from their recently completed intern exam. The rest of the interns are playing a card game with Dorian, who finally seems to be getting better after being shot in Season 20, Episode 2, “Keep the Family Close.” Taryn Helm pokes her head into the room, hoping to get Mika Yasuda to join her for a bite to eat, but Yasuda isn’t interested. She tells Dorian, Benson Kwan, and Jules Millin that she and Helm have talked and are going to keep trying at their relationship, but it appears to be pretty dead. It doesn’t help Yasuda’s mood when she abruptly loses the game, either.

In the neuro department, Amelia Shepherd finds Catherine Fox in her research lab being given a tour by another doctor. Unsure of what Catherine saw in the lab, Shepherd picks up the phone as soon as Catherine leaves. As soon as the person on the other end of the line answers, Shepherd can only say one thing: “We have a problem.”

Altman is in her office, where she’s waiting for Miranda Bailey and Adams. The results of the intern exam aren’t back yet, but even if he passes, there has been a recommendation from the GME Council, who investigated Sam Sutton’s death from Season 19, Episode 20, “Happily Ever After,” in Season 20, Episode 4, “Baby Can I Hold You,” that Adams repeat his intern year. It’s not the final decision — Catherine Fox’s office will be reaching out to meet with Adams — but it’s a jarring piece of information for him. He tries to defend himself, asking what he should have done instead and reminding them that he wasn’t the only intern operating on Sutton, and Altman tells him that it’s his judgment, his decision to make the cut, that is in question, not his skills as a surgeon. Bailey tries to give him more information, maybe even some consolation, but Adams has heard enough. He flies out of Altman’s office, offering only a “thanks for letting me know” as he goes.

On the pediatric floor, Winston Ndugu, Monica Beltran, and Griffith are meeting with a 16-year-old patient and his parents, who can’t stop arguing. The patient, Mason Peterson, has idiopathic pulmonary hypertension and was admitted for new onset congestive heart failure. Beltran asks Mason if he has any plans for the day, and while he jokes that he’ll be running a marathon, Griffith is busting at the seams. Ndugu finally gives her a nod, and she tells Mason that he’ll need new lungs to do that. Which he’ll be getting, along with a new heart.

In a different cardiac wing, Maggie Pierce has returned to Grey-Sloan for the day. After a warm reunion with Richard Webber — and an awkward one with Ndugu — Pierce, who is there to see her former patient, runs into Adams and puts him on her service. Levi Schmitt, who is shocked to see her and doesn’t put anyone on her service, tries to tell her that Adams is supposed to be in the pit, but Pierce is already leading Adams into her patient’s room. Brady Hauser, 42, had a heart transplant, and now, four years later, he appears to be rejecting his heart. Adam rattles off Brady’s stats, impressing Pierce, one of the doctors who pushed him the hardest when he first began his internship. Brady is there with his boyfriend, Ian, and both of them are devastated to learn that Brady needs to go back on the transplant list.

In Boston, Nick Marsh, Meredith Grey, and the Grey-Shepherd kids, Zola, Bailey, and Ellis, are getting ready for the day when Amelia arrives. She has packed hard drives, papers, and everything they have for their research into suitcases. She couldn’t risk Catherine finding anything. After Nick and the kids leave, Amelia and Meredith call Teddy, who tells them they need to wrap things up and quickly. She asks them how much time they need and is shocked when they still need a few weeks to analyze their data, as they’ve had months. “Well, we’re trying to find a cure for Alzheimer’s. Did you think that was gonna happen in a couple of months?” Meredith asks. Teddy understands, but they need to find a way to speed it up. Amelia tells her they could maybe do it in four days if they didn’t take any breaks, but Meredith has a better idea and wants to know who is on Teddy’s service for the day and if they can be trusted.

Back at Grey-Sloan, Webber and Bailey are checking on Dorian, who seems to be doing very well. Bailey is still nervous, considering how much he’s gone through and wants to run a second set of tests when his white blood cell count comes back slightly elevated. Webber agrees, but he can tell something is up with Bailey.

In the attending break room, Ndugu finds Pierce lounging on the couch. Their conversation is less stilted than their first interaction, especially once Ndugu asks if she wants to scrub in on his heart and lung transplant. They talk briefly about their divorce and the papers that Ndugu still hasn’t signed, but their interaction is mostly positive. It’s almost like they’re in love again.

Altman has set Kwan and Millin, who are on her service for the day, up in the skills lab with a couple of laptops and several binders to help her with a “very important, highly confidential project.” They’ll be entering Meredith and Amelia’s gut microbiome sequence data into the database, which means no time in the OR. Griffith comes in, looking for Adams, and wants to know what they’re doing. Kwan tells her that she can know if she gives him her spot on the heart-lung transplant, but Griffith “doesn’t care that much.” Kwan and Millin pack up their things and head for a more private location.

Elsewhere, Wilson is looking for Link to get a consult on a patient with a cystic mass behind her uterus. She’s just 17 weeks pregnant, so Wilson thinks they should watch the mass and wait, but Link tells her that they should remove it. Yasuda, who is on Link’s service, ends up in the middle of a heated discussion between Link and Wilson, which eventually ends in Link agreeing with Wilson, at least for the time being. Later, Link sends Yasuda to get pre-op labs for the patient, which really pisses off Wilson, especially because Link went to Carina DeLuca, Wilson’s boss, to get the result he wanted for the patient.

Adams, who is checking on Brady, runs into Ian, who was thinking about proposing to Brady and wanted to check if his grandfather’s ring fit. The ring is now stuck, as the heart failure is causing Brady’s fingers to swell, so Adams finds vaseline to take it off, trying incredibly hard not to wake Brady. Moments after the ring is off, Brady’s monitors begin beeping, and Adams has to call a code blue, yelling for someone to page Dr. Pierce. When Pierce finally gets there, Adams has gotten a rhythm back, but something still isn’t right. Pierce tells him they have to put Brady on ECMO and sends Adams to call UNOS and tell them that Brady’s status has changed. He’s going to need a new heart much sooner than they thought.

In an on-call room, Kwan is complaining about how long the upload of the data is taking when Millin reveals that she’s written a code to do the work for them. Millin tells him that she taught herself to code in high school so that she could rig online sweepstakes, which he finds slightly diabolical, though not enough to stop him from asking her to optimize his dating apps. She seems offended at first, telling him that she won’t write code so he can get laid, but when he comments that it must be too hard, she tells him to hand over his phone. When he rejects one of the women she suggests to him and she accuses him of just wanting a dumb trophy wife, he turns it around and accuses her of being jealous. Eventually, she admits that she has a tiny crush on him, telling him that he’s “like a cold. I have it. I’ll get over it. And then it’ll be like it never happened.” Before she can say anything else, he kisses her, and they end up having sex while their data is uploading.

Adams, who is racing to help Pierce, and Griffith, who is on her way to assist in the OR, finally run into each other. Griffith wants to know how the meeting with Altman and Bailey went, and when he tells her that he’s going to have to repeat his intern year, Griffith immediately blames herself. She is, after all, the one who told the GME Council that if Adams hadn’t been in the OR, she wouldn’t have cut. She tells him that she’ll talk to someone, and he tells her to just let it go. He’s the one who made the decision, not her.

Griffith heads to the OR, where she begins scrubbing in with Ndugu and Beltran and asks a question that changes everything. “I know he needs a new heart so it can adapt to the new lungs, but isn’t Mason’s heart technically fine for someone else? Why won’t UNOS accept it as a donor?” Ndugu tells her that the heart has adapted to Mason’s pulmonary hypertension, so the heart would have to be a match, and the person would have to have similar physiological conditioning. As he’s answering her question, Ndugu seems to have a realization and sends Griffith to page Schmitt to take over for her in the OR so she can check on something for him. Once she does, he sends her to Pierce. Mason’s heart is a match for Brady. Ian overhears Griffith telling Pierce and Adams, and Pierce has to make sure he doesn’t get his hopes up. They have to call UNOS, and she needs to look at the heart, but it is possible. Brady could get a new heart.

Back in Boston, Amelia and Meredith argue about the next step for their research, assuming they find something in the data. Meredith wants to publish an abstract, but Amelia is worried about doing that without presenting it to Catherine first. The Fox Foundation funds her other research, and she doesn’t want to lose her job. Not to mention, the work they are doing erases any work Derek Shepherd did. Amelia’s still struggling with how she feels about that. Meredith doesn’t understand why Amelia is bringing it up now, and Amelia tells her that she thought she had more time to process. Instead, they’re days away from “his entire contribution to this field just disappearing.” Meredith assures her that Derek would have been okay with that because he knew as well as they do that “new discoveries replace existing theories every day.” Amelia knows she isn’t being rational, but it doesn’t change her feelings about it. Meredith tells her they’ve come too far to throw the towel in, and all Amelia can do is leave the lab.

Down in the pit at Grey-Sloan, Altman pulls Hunt aside because she has a problem. She finally tells him that she’s been funding Meredith’s Alzheimer’s research even though Catherine shut it down, and now she thinks Catherine is onto her. “What made you think that was a good idea?” Hunt asks, though Altman still believes it was a good idea. “It’s a potential cure for Alzheimer’s disease. And it’s not like I stole something,” she tells him. She also thought that, with 30 hospitals, there would be no way that Catherine would notice a small line item. Hunt’s entire face changes because this is his fault now. He didn’t want to keep pestering Altman about the funding for his program, so he went to Catherine at the end of Season 20, Episode 8, “Blood, Sweat and Tears,” and she told him she was going to be looking at the discretionary budget. Whoops.

At first, Altman is upset because he went behind her back. She’d told him she was working on it. “You’re accusing me, yet you’re the one who’s misappropriating funds,” he says. Altman nearly laughs. “Oh, like you have never bent the rules around here?” Their fight fizzles out quickly after that since Hunt knows he doesn’t really have any ground to stand on, especially after his rule-bending cost him his medical license for a while. He tells her to go to Catherine and tell her the truth. “She will respect you for doing the hard thing, and then you can figure it out together.” Altman agrees. She can do the hard thing.

Up in the OR, Ndugu, Beltran, Schmitt, and Griffith are finishing the lung and heart transplant on Mason. Pierce and Adams come in to look at the heart, which is healthy, though Pierce is concerned that the superior vena cava (SVC) is too narrow. When Ndugu gets Mason’s new heart beating in his chest, he asks Beltran to close Mason’s chest and joins Pierce and Adams. Pierce and Ndugu begin discussing what to do about the SVC, and Ndugu ultimately suggests a bovine pericardial patch to reconstruct the SVC entirely. Pierce is skeptical at first, but then he reminds her that they’ve done more difficult reconstructions together before. They once did a partial heart transplant. They can do this.

In Boston, Nick finds Meredith to find out what is going on and why Amelia is in town. When she tells him, he starts to get worried and asks her, “When you get fired from the Fox Foundation, what happens then?” Meredith tells him that she’ll continue the work somewhere else, which only upsets him more. In the kitchen, before Amelia arrived, he was showing her a house to buy because they’re talking about moving in together. Nick reminds her that he moved to Seattle for her, then to Boston. Now, even though she lives in Boston, she’s constantly flying back to Seattle. The truth spills out of him. He wants to marry her, but he’s frustrated because she “can’t even be bothered to ask if I’m on board before you burn it all to the ground.”

Yasuda, who has been caught in the middle of fighting couples before, is riding an elevator with Link and Wilson back at Grey-Sloan, and it is rough. Wilson is still angry that Link went to DeLuca, and then he says maybe the worst thing he can say. “Jo, I value your opinion, but you’re a resident. It was a rare tumor. I wanted to talk with somebody who had more experience.” As Yasuda desperately runs off the elevator to get out of the conversation, Link asks if they can continue the conversation later because he has patients to check on. Wilson gives him a death glare and says, “You’re an attending. Just have your resident do it.”

Back in the OR, Adams is carefully holding Brady’s new heart while Ndugu and Pierce work on it. Ndugu checks on Beltran and Schmitt, who have just finished closing up Mason’s chest. Beltran even praises Schmitt’s work placing sternal wires, which brings a smile to Schmitt’s face that can be seen in his eyes. In Season 20, Episode 6, “The Marathon Continues,” Schmitt and Beltran had a conversation about validation, during which she told him she wanted to see more passion in him. It’s clear he appreciates her compliment even more after having had that conversation with her.

As Pierce and Ndugu finish up the work on Brady’s heart, Adams seems to be asking all the right questions. Pierce and Ndugu are teaching him and Griffith, but they also seem to be flirting. Either way, they’re thrilled when the reconstruction works. Adams places the heart carefully on ice so that they can prep Brady for the transplant. After, in the waiting room, Ndugu and Beltran are sharing with Mason’s parents that he did well. They ask about the person who got Mason’s heart, but they can’t share information about another patient. Ian, who is talking to Pierce and Adams nearby, overhears them. He asks if their son donated a heart, and when they tell him yes, he starts to cry. Ian thanks them, and all three of them embrace, sharing a particularly special moment. Pierce and Ndugu share a look and Adams, who seems to be upset, walks away.

Pierce chases Adams down the hall, telling him that he did a great job. She asks him if he likes it at Grey-Sloan and then tells him that they have a categorical position at the Heart Center. He would train at the University of Chicago, but he would do his research with the Heart Center, and Pierce thinks he would do well. He tells her that he always assumed he would do neuro, to which Pierce responds, “Why? Because you’re a Shepherd?” She knows that being a neurosurgeon is cool, but cardio is pretty great. All she asks is that he think about it. Later, when he and Griffith see each other in the intern locker room, he tells Griffith that he’s considering it. He won’t have to repeat his intern year if he goes.

Ready to leave Boston, Amelia stops one more time at Meredith’s lab. She’s just in time, as Millin and Kwan have uploaded their last data set. Meredith runs the calculation, and the result shocks them both. The confidence interval, or the probability that there is a correlation between gut microbiomes and Alzheimer’s disease progression, is at 95% and exists before patients have symptoms. The discovery is huge. It means that people could be diagnosed before they’re symptomatic, and Meredith points out that there is potential to prevent the disease altogether if they’re able to alter the gut microbiome. Meredith tells Amelia that she’s thought about Derek during all of this, but mostly, she’s thought about her mother and how the disease robbed her of her identity. The research is as much Amelia’s as it is Meredith’s though, so if Amelia doesn’t want to publish, they can find another way. Amelia, knowing how personal this is for Meredith and how important this revelation is, tells her that Derek and Ellis would want them to push through, no matter the cost. They have an abstract to write.

On their way out of the hospital, Maggie and Pierce are having a good conversation. So good, that Maggie tries to kiss him, quickly realizing that it’s a mistake. Winston understands because, for years, they’d make a save in the OR and then celebrate after, but it’s time for them both to move on. He hands her signed divorce papers, and once she’s left in a town car, he heads to Joe’s, where he runs into Beltran. Over several beers, they share that they’re both recently divorced and even lament about the weirdest parts of their weddings — Monica and her ex had doves, Winston and Maggie had custom sand sculptures. The night doesn’t end at Joe’s, though. Winston takes Monica back to his apartment, and they sleep together.

Webber, who ran all of Dorian’s test results a second time, finally brings them to Bailey. Dorian is doing just fine, especially considering how much he went through. Then Webber asks Bailey about the interns and their exam, and she finally tells him what has been going on with her. The interns have come a long way, and she’s worried about what will happen if any of the rest of them have to start over, like Adams. She tries to dismiss Webber when he says that she’s come to care for them, but he knows firsthand what it’s like to care for interns. He’s done it for years.

Yasuda, who has been avoiding Helm all day, finally finds her down in the pit and tells her that she can’t be in their relationship anymore. Helm has meant a lot to Yasuda and done a lot of things for her, but Yasuda can’t put aside that Helm is her boss now. She doesn’t think their feelings are strong enough to prioritize the relationship over everything else, and suddenly Helm gets it. Yasuda is choosing work.

Altman, who has finally come clean with Catherine about using the discretionary money to fund Meredith’s research, is relieved when Catherine tells her that being honest about it takes courage, and it tells Catherine that Altman is a woman of great principle. Altman says that she knew Catherine would understand, but there’s a problem. She never said she understood.

In Boston, Meredith tries to talk to Nick, who stayed with the kids until she got home. She admits that she’s terrible at relationships but that he’s the most important person to her besides her children. She doesn’t know if she can marry him, but only because she did it once before and doesn’t know if she can do it again. It isn’t because she doesn’t love him because she does. She can promise to love him forever or as long as she can remember him. He tells her that he loves her too, but that’s not the issue, and she knows. “The issue is that I put work before you, and you’re right, I do. But just right now. That’s not forever. And if you love me, then you’ll support me. And if you support me, then I can do this.”

Meredith asks Nick if he’s in. Before he can answer, her phone rings. He tells her to take the call and leaves as she picks up the phone. It’s Teddy. Meredith asks if everything is okay, and Teddy says just four words. “Catherine just fired me.”

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