Grey's Anatomy

In order to be designated a Level 1 trauma center,

hospitals must meet a variety of requirements.

Ooh! What are you doing? Get out of the way. I'm almost to the next level.

I am cleaning up Katie's stuff.

Does it have to be right now? I haven't played in days.

Oh, I'm sorry the dying patient got in the way of your video games.

Hey, can you give this to Lucas?

Give it to him yourself.

They must maintain usable ORs within 15 minutes,

employ a minimum number of certified specialists...

No.

...and admit at least 1,200 trauma patients a year.

Hospitals in big cities pass the test easily.

But the farther away you get...

Adams? Come on. It's morning.

Mmm.

I know Katie was a tough loss. I'm feeling it too.

If you want me to find someone else for your assignment...

No, I'm good. I'm good. I'm going.

...hospitals are Level 2, 3, even 4,

and sometimes all they can do is transfer people to get the care they need

and hope they hang on.

We shouldn't be doing this. We have to stop.

Uh-huh.

Iris is back from vacation today. What if she walks in here?

Why would an L&D nurse go into a CCU closet?

Um...

She... Listen. She doesn't deserve to be treated like this.

I have to break it off.

When are you going to talk to her?

As soon as humanly possible.

Uh, we were just looking for...

-Gauze. -Yeah.

I don't care.

Oh, I actually do need to grab a Cordis kit.

I'll see you at rounds.

Okay.

I'm freezing my eggs.

Sill don't care.

Richard. Hey, are you gonna change?

Uh, we're hitting the road in a half an hour.

Oh, I'm heading out, but not to Enumclaw.

- Why? -Well, my schedule changed.

Didn't you see my email?

-No. -Well, uh, I...

I forgot to hit send.

I told Cascade Hill I'm bringing them four surgeons.

Well-Well, you will. I got you a backup.

Oh, here she comes.

-Hey. - Hey.

-Hey, hi. - Um...

...have fun out there.

-Thanks. -

Listen, if you're too busy for this, I can just take the residents.

Oh, oh, Richard asked for a favor.

I made time, but I...

-I mean, if you don't want me to go-- -No, no, no, no.

These patients need all the help they can get.

Right.

I love field trips.

-Are you excited? -Not really.

Well, Dr. Hunt said last time he volunteered at Enumclaw,

there was a guy that was crushed by a horse.

Cool.

If you're not interested in rural medicine, then why did you volunteer?

I was looking for some peace and quiet.

Adams, hi. Are you coming too?

-No. -Hey, I texted you about Katie...

Is he okay?

Clearly wouldn't know.

-Okay, did you pack up all the supplies? -Yes.

-All right, let's go. -Oh, I made a playlist.

-I-I also brought earbuds, so. -Great.

Okay.

-Hi. -Planning a vacation?

If all goes well, we're gonna take a road trip, see some national parks.

Oh, Yosemite is one of my favorite places on Earth.

- Mmm. -I don't like nature.

He's warming up to the idea.

I'm gonna go get some food.

Hmm.

They say God made teenagers so it's easier to let them go.

-Kwan. - Quinn Durston, 43,

-with stage 4 hepatocellular carcinoma. - Mm-hmm.

He's had chemo and radiation. Now presenting with biliary stenosis.

He's scheduled for an ERCP to place a stent.

Waiting to hear from the FDA whether we can implant

a synthetic lymph node for compassionate use.

So there's still no decision?

I'll be following up right after this.

Do they know that I'm a single dad,

and if this treatment really could give me more time,

that'd be life-changing for Logan.

Unfortunately, they're only looking at the medical facts of the case.

Let me worry about the FDA.

In the meantime, Dr. Kwan?

-I'll run pre-op labs for the stent. -Good.

Okay. Right. Here we are.

-Dr. Hunt. So good to see you. -Dr. Braider.

-Come here. -Oh.

This is Dr. Altman, Dr. Griffith, Dr. Spencer.

This is Dr. Lorna Braider. She is in family medicine.

And OB, orthopedic, pediatric, geriatric,

basically anything that comes in those doors.

Keeps things exciting around here.

-Why don't you put us to work? -Absolutely.

We've got a head lac in bed 3, abscess in bed 2.

Everything should be easy to find, but Dr. Hunt knows his way around.

- -I can take the head lac.

Yeah, I'm on it.

Okay. All right, well, we've got some supplies in the van.

-I'll go get them. -You are a literal lifesaver.

- -Oh. Hang on. Hold on those supplies.

Incoming rig. Let's go.

May not be a big city, but there is rarely a dull moment.

June Rojas, 23, fell while rafting the Green River.

-Trauma to the left arm. - Where's Keaton?

- Vitals stable. -Where's Keaton?

-We dressed the injury at the scene. -You want to take the lead,

-see what it's like to be in charge here? - June?

I'm Dr. Hunt. This is Dr. Braider and Dr. Altman.

-We're gonna take care of your arm, okay? -Have they found him?

-Who's him? -Boyfriend.

He's not my boyfriend. He's my soulmate.

Search and rescue's looking now.

Keaton has to be alive. I have to find him.

Take me back out there.

They're doing everything they can to find him, but I'm worried about your arm.

We're gonna get you inside and clean you up, all right?

Accomplished trauma surgeon with bedside manner.

Like I said, perfect match for Cascade Hill.

Are you-- Were you offered a job here?

Hey, there's a range of symptoms, and sometimes there aren't symptoms at all.

That's why getting screened is important.

Well, Dr. Adams?

I got a colonoscopy last year.

Yeah, those don't detect prostate cancer.

Prostate cancer screenings

typically start with a physical exam or a blood test.

But good for you on the colonoscopy. Keep that up.

-I'll take one of those. For my dad. - Oh, take two.

Black men are more likely to get it at a younger age.

Wanna ask your doctor when you turn around 40.

-Any other questions? -What if I just don't want to know?

Well, that's your prerogative, but it's very treatable if it's caught early.

Uh, oh, excuse me.

Um, Adams.

Um, where do you think you're going?

Uh, we've talked to everybody, so I was gonna grab a coffee next door.

Not quite everyone.

I think my barber, Jones, would benefit from some conversation.

No. No, no, no, we have an agreement, okay?

He gives me a clean shave, and I keep my mouth shut about medicine.

You know, church and state.

Fine, I'll give it to him.

No, wait a minute. That's not gonna do anything.

You gotta find an opening to talk to him.

You do remember how to talk, right?

-Did you put in Mr. Saks's pre-op orders? -I did.

Okay, maybe I should go review them.

Do you know that cows hate bad weather?

They'll run away from it until they get tired,

and then the storm catches up with them.

-Why do you know this? -But buffalo are brave.

-There's more. -They run right into the storm,

so they get through it faster.

-I'm a cow in this analogy? -Mmm.

- Dr. Ndugu. -Run into the storm.

Hey, welcome back.

Thanks. Good to be back.

Yeah, um...

Do you have a minute? Can we talk?

-Sure. - Happy birthday!

-Happy birthday, Iris. - You guys are so sweet.

- Here you go, birthday girl. -Thank you!

- Who planned this? - Come here.

Oh, you guys.

- Thank you. - Have a good day.

- Bye. Thanks. - See you later, Iris.

So what was it that you wanted to talk about?

Happy birthday.

-Thank you. -Yeah.

Uh-huh.

It's like flour.

Or Maldon salt.

Except it took years and millions to make. Stop touching it.

Okay.

So we add a liquid diluent

and then deliver percutaneously as close as we can to the tumor.

There we go.

Ah. Damn near perfect.

Can I try?

Mmm.

So, after injection, it'll form a gel.

A tiny blob training an army of immune cells

to attack the tumor without chemo side effects.

Huh, It's like a secret lymph node.

Or spy node?

The rebel base on Yavin 4.

They trained to destroy the Death Star?