They can't save the mother, all they can do is try to get the baby out before the drugs get into it's system and even then, there's a chance that it won't survive. The mother is seriously underweight for being 34 weeks pregnant which means the baby is severely undernourished and underdeveloped.
Arizona scrubs quickly, all the while going over the procedure in her head. There was no time to run the usual tests, so she's going in blind. She glances over at Murphy, who is scrubbing beside her.
"When we get in there, I need you to follow my instructions to the letter. I know that you will have questions, but I may not be able to answer them. We're going in blind and I've got a baby to save. You're going to make the first cut and open her up, so that I can remove the baby as quickly as possible. The mother isn't going to survive this overdose, but hopefully the baby will," Arizona explains.
The resident nods, but remains silent. She knows that Arizona is laser focused and she doesn't want to distract her.
"Oh and Murphy, the surgery will be recorded, so that we can review it together, then you ask questions," Arizona adds.
"Thank you Dr Robbins," Murphy replies.
"Okay, well let's go save this baby," Robbins says heading into the OR.
"Because of the location of the obstruction, we can't resect it laparoscopically," Meredith explains to Edwards as they scrub into the surgery. "I know that Minnick expects you to be lead surgeon on this case, but this isn't a typical resection. The margins are tight and it's possible that we'll need to perform an ileostomy, which I will let you perform. Understood?" Meredith asks her.
"Yes Dr Grey," Edwards replies keeping her voice steady to hide her excitement.
"Let's review the ileostomy procedure, step-by-step," Meredith prompts the resident.
"The first step will be to bring the ileum through the intestinal wall," Edwards begins but is interrupted by Minnick entering the scrub room.
"What are you doing here?" Meredith asks brusquely.
"Why is she outlining an ileostomy? She's going to perform a bowel resection," Minnick questions.
"No, she isn't. This is an open procedure due to the location of the obstruction, I am going to do the resection and then if needed, Edwards will do the ileostomy," Meredith explains.
"That's not acceptable, this is a teaching hospital Dr Grey," Minnick reminds her.
"I know and I prefer to teach my students how not to kill patients, so she will observe the open procedure," Meredith says firmly.
"Dr Minnick, I-I'm fine with this," Edwards adds. Hoping that Minnick will back down and not piss off Dr Grey.
The door opens again and Dr Bailey enters tying on a mask.
"Not you too?" Meredith groans. "Out both of you," she shouts.
"Excuse me Dr Grey, are you telling me that I can not observe a procedure in my hospital?" Bailey challenges.
"I am saying that neither of you are going into that OR, you both can observe from the gallery," Meredith snaps. Then as she moves past the resident, she adds, "Edwards, let's go."
Minnick and Bailey glance at each other as they walk out of the scrub room. Standing in front of the OR schedule, they each survey the board. Bailey quickly notices that there has been a change. She notes that Robbins and Murphy have taken over OR 4 for an emergency c-section, which is odd because Robbins made it clear that she wasn't going to work with Murphy after everything that happened between them. Deciding to investigate on her own without alerting Minnick, she mumbles that she needs to go, leaving Minnick to stare at the board on her own.
Bailey enters the viewing gallery and silently observes the procedure taking place below. Robbins instructs Murphy to begin the c-section, then she steps in quickly to remove the baby. Verbally outlining each step of the procedure while Murphy follows along closely. As Robbins steps away with the tiny baby, the mother goes into distress.
Murphy calls out what is happening and Robbins lets her talk herself through it, offering guidance when needed, but otherwise focused on the other patient.
"She's in cardiac arrest," Murphy calls out, but she knows exactly what to do and she instructs the surgical team confidently.
Bailey watches. Robbins is focused on intubating the baby. Murphy is focused on doing what she can for the mother. The Chief leaves the OR gallery satisfied that bringing Murphy back into the program was the right thing do.
Next Bailey heads into the gallery over Dr Grey's procedure, she isn't surprised to find Minnick observing the procedure.
"How is it going?" She asks the other surgeon.
"The superior mesenteric artery is compressing the area that needs to be resected," Minnick replies.
"Hmm," Bailey murmurs as she watches Meredith carefully work to excise around the artery.
Meredith glances up at the gallery and notices Bailey has joined Minnick.
"Dr Edwards, would you explain to the observers what I am doing now?" She prompts the resident.
"Yes, you are excising the damaged section of the small intestine, which is complicated due to the SMA encroaching on the area," Edwards replies. "Your approach is unusually conservative to ensure that you do not nick the artery."
Meredith glances up and Bailey nods. The Chief knows exactly what Meredith is doing. It was just a few years ago that Bailey was the attending and Meredith was the resident. They performed a similar procedure and Meredith is teaching Edwards the exact way that Bailey taught her.
"I think I've seen all that I need to see," Bailey announces and turns to leave.
Minnick follows her out of the gallery and into the hall. "The resident should be cutting, she's not learning," Minnick argues.
"I disagree," Bailey replies turning to face the other surgeon. "I taught Dr Grey how to perform this surgery and it is not lost on me, that she is teaching this resident exactly how I taught her."
"But surgical residents need to do more than just stand around observing," Minnick insists.
"Edwards is a good resident," Bailey retorts. "A good resident doesn't simply watch. No, a good resident observes every step of the procedure and imagines herself making the cuts. When Grey asked her to tell us what was going on, she knew exactly what was going on. She didn't hesitate or need a minute to figure it out. She knew because in her head, she was performing the surgery," Bailey points out.
Up in the NICU, Arizona is still working to stabilize the small infant.
"That was amazing," Murphy exclaims as she steps up beside the blonde surgeon. "How is he doing?"
"He has trace amounts of heroin in his system so the next 24 hours are critical," Arizona answers. "We'll need to monitor him closely."
"Dr Robbins, I want to stay on this case. Can I monitor him tonight?" Murphy asks.
"No, I'm taking the overnight. You should go home," the blonde replies.
Murphy begins to protest, "But Dr Robbins..."
Arizona puts a hand on the resident's shoulder. "Murphy, go home and get some sleep because I need you to monitor him tomorrow and if he makes it, you'll stay and take the overnight."
"Really?" Murphy blurts out surprised. "Dr Robbins, thank you. Thank you."
From the doorway of the NICU, Minnick watches the exchange.
"How did it go with Robbins?" She asks following Murphy out into the hall.
"It was awesome. She is awesome and I'm kind of feeling awesome," Murphy exclaims.
"Did you cut or observe?" Minnick asks.
"I cut. The mother was my patient, I opened and closed the c-section," Murphy replies before going on to explain everything that happened in the OR after Robbins left with the infant.
"She left you in the OR with a patient on the table?" Minnick questions.
"Before she left the patient coded and died," Murphy explains. "Now excuse me, Dr Robbins has sent me home for the day."
"Wait, she sent you home for the day? Why aren't you in there monitoring the baby?" Minnick asks.
"The baby has trace levels of heroin in his system. Dr Robbins is monitoring him tonight and tomorrow, he will be my case. Excuse me now Dr Minnick, I need to go," Murphy says excitedly.
Minnick enters the doctor's lounge and plops down on the sofa. Frustrated that nothing has worked out today, she swings around to lay down and closes her eyes for a moment, she needs to think this through before she makes another move.
"I called it," the woman says entering the lounge with another doctor.
"Just because she let her back on her service, doesn't mean that they are back together," the other doctor points out.
"Of course they're together. First Robbins bans her from her service, then Murphy finagles her way on to her service anyway and now they've had two cases together. Double or nothing Murphy applies for the Fellowship next," the first doctor counters.
"You're so off base. Robbins is just a good person, she recognizes that Murphy is a decent resident and she's just trying to do the right thing and train her," the second doctor replies.
The two women go to sit down at the table to eat their food, when they suddenly realize that they're not alone in the lounge.
"Uh, sorry we didn't see you there," the second doctor says when Eliza sits up.
"Were you talking about Dr Robbins and Leah Murphy?" Minnick asks.
Busted the two doctors look at each other and then back to Minnick.
"Uh," the first woman says nervously.
"Please forget what she said," the second one replies. "Dr Robbins has been completely professional in regards to Murphy coming back."
"But they dated previously?" Minnnick asks. "I'm just asking because I'm the resident supervisor and I wasn't aware of this history between them."
"Oh, but it's ancient history. Murphy moved on and has a girlfriend now," the second one points out.
Minnick stands up and looks at them both. "Thank you," she says before leaving the lounge.
"May I have a word with you Dr Grey," Chief Bailey asks stepping into Meredith's office.
"Look, I know what you're going to say, but in my defense..." Meredith begins.
"I know what you're doing. I even know why you're doing it," Bailey admits before sitting down in the chair beside the desk. "Meredith, the truth is if I was you, I would probably do exactly what you're doing." She adds.
Meredith stares at her a moment, considering how to respond.
"Miranda, you trained me to be a surgeon. And you trained me to teach surgeons. I am head of General Surgery because you know that I am capable of doing both of those things well," Meredith reminds her.
"I know. But we can be better," Bailey says defensively.
"If you were concerned about the program, you should have come to me and Richard to talk about it before hiring some consultant behind our backs," Meredith retorts angrily.
"Yes, I know, which is why I'm calling a meeting of department heads later this week. I want all of you to work together with Minnick to improve our resident training program. Minnick will still be monitoring it, but she won't be in charge of it," Bailey replies. "Can I expect your cooperation?" She asks.
"Have you told her about this yet? Because I can't see her going along with this," Meredith challenges.
"She will go along with it or she'll break her contract," Bailey answers.
"You lied to me," Eliza Minnick announces accusingly from the office doorway.
Arizona spins around to face her. "Excuse me?" she spits out.
"You led me to believe that you had met someone, as in a new relationship. But that's not it. You're involved with an ex, who also happens to be a resident," Minnick replies stepping into the office and closing the door behind her.
"Wow, that is beyond offensive. Not to mention that this accusation has no merit," Arizona retorts crossing her arms defensively.
"Are you denying that you have a history with Leah Murphy?" Minnick asks.
"Wait, you think that I am currently involved with Murphy? Her girlfriend was just here last week, what kind of person do you think I am?" Arizona says angrily. "And before you answer that let me just remind you," she says rising to her feet. "Not only am I head of my department, I am also on the Board of this hospital and I am a partial owner of this hospital."
"Are you threatening me Dr Robbins?" Minnick asks.
"No, if I were threatening you, I would mention that it would take me less than 30 minutes to call a quorum together and void your contract," Arizona points out. "Now get the hell out of my office."