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Suicide is Painless

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“ Dying isn't easy. The body was designed to stay alive; thick skull, strong heart, keen senses. When the body starts to fail, medicine takes over. Surgeons are arrogant enough to think there's no one they can’t save. Like I said dying isn’t easy. Living is better than dying... until it's not. But even if letting a person die is the right thing to do, it's not what surgeons are built for. We are arrogant and competitive. We don’t like to lose and death feels like a loss even when we know it’s not. We know it’s time. We know it’s right. We know we did everything we could. It is hard to shake that feeling that you could've done more. ”

Suicide is Painless is the eighteenth episode of the sixth season and the 120th overall episode of Grey's Anatomy.

Short Summary[]

When Teddy's patient seeks to end treatment and her life, she turns to Hunt for help. The situation triggers Hunt's memories of his life at war and his past relationship with Teddy. Meanwhile, Callie and Arizona have a difference in opinion on what their future holds, and Richard tries to adjust to his role as a surgeon.

Full Summary[]

As Owen can't sleep, he gets out of the bed and goes to the living room. He exercises, eats a little and watches some TV. About two hours later, he sneaks back into bed with Cristina and only a minute later, the alarm goes off. They tell each other good morning and Cristina gets out of bed.

Teddy walks into Kim's room. Kim says she feels ready. Today is the day. Sean claims he's doing good, too.

Teddy finds Owen for a consult on Kim's case. Teddy resected a second mass from Kim's lung two months ago, but the cancer had already spread too much. Kim was readmitted last week and she's still having difficulties breathing. As Teddy tells Owen that Kim doesn't want to be intubated, Owen doesn't see what else they can do. Teddy says Kim wants them to help her die.

Teddy explains to Sean and Kim that since the state requires two physicians's signatures, she asked Dr. Hunt to consult. Kim was declared mentally fit, she only has 6 months left to live, and Teddy's gone over all of her treatment options. This serves as Kim's second oral request. She has to tell Teddy she wants to die twice with at least 15 days between the two times. Sean thinks she's having second thoughts, but Kim is sure. She takes off her oxygen mask and states she wants to die through physician-assisted suicide. Owen suddenly walks out. Kim asks Teddy how long it takes to die. Sean doesn't feel ready for it just yet, but Teddy tells Kim it takes about 45 minutes.

Arizona and Mark are in Callie's lab, where Callie is working on her cartilage. Mark is surprised to see how much you learn about other people if you stay upright. He feels really grown. Arizona kisses Callie, whom she's proud of, and walks out. Callie then blurts out to Mark that Arizona doesn't want kids, ever. Even though Callie doesn't want to be the crazy girl with the aching womb, Mark advises her to tell Arizona that she wants kids.

Derek is going over administration stuff in a conference room as Meredith appears in the doorway. He pauses the meeting and she tells him about a tumor that Shadow Shepherd is going to let her operate on. "That's it?" Derek asks, and then returns to work. 

Alex, Charles, and Jackson are in the ambulance bay, waiting for an incoming ambulance. Mark concludes it must be Nicole behind the wheel then. Charles says he'd love to hit her ass as Richard joins them. The ambulance arrives and as she presents the case, a man with fractures following a heli-skiing accident, Charles checks her out, which she notices, calling him Chachi.

Teddy finds Owen and asks what that was all about. Owen doesn't agree with the plan and he doesn't think doctors should help people die. Teddy, in contrary, understands and thinks of it as an act of mercy. Owen states Teddy is killing Kim by writing the prescription. Teddy says she'll find someone else and walks off. Watching her walk off triggers Owen to think back to his past in the army.

A flashbacks shows him and his team, including Teddy, playing soccer in a desert as planes fly over. Owen and Teddy score and cheer. The doctors grab their stuff as a helicopter lands with patients for them. Owen stays a little behind and watches Teddy walk off.

In a similar way, Teddy walks down the hallway in the present.

Mark, Callie, Richard, and Jackson are in a trauma room with Nick, the heli-skiing man.

Meanwhile, Alex, Lexie, and Bailey bring in Phil, one of Nick's friends who went heli-skiing with him. Nick yells that he needs to get better so they can run with the bulls in Pamplona next year. Owen counts and they all move Phil off the gurney and onto an ER bed.

A flashbacks shows Owen and Teddy working in the medical tent. The wounded soldiers are victims of a car bomb. They have to improvise as they're low on supplies. Corporal Burnett informs Captain Dan that the Command's ordered them to move back. Teddy says she's almost got her patient stabilized. The captain orders her to ride on the medivac with a couple of patients. Owen offers to trade places with Teddy as he knows she hates helicopters, but she says she's fine. They'll see each other back there.

Bailey asks Owen if they should scan the patient first, bringing Owen back to the present. Owen tells Bailey to take the case and walks off. Bailey asks Tommy, who was with Nick and Phil, why he didn't get hurt in the avalanche. Because he hadn't jumped out the helicopter yet. Nick and Phil feel sorry for him, as it was "friggin' awesome". Bailey tends to disagree.

Cristina walks into Kim's room, having heard from Altman that Kim requested her pain meds be lowered. They make her fuzzy, and she doesn't want to be fuzzy today. Cristina heard Kim's going home to die, but Kim says she's changed her mind. Not about the suicide, she says when she sees how surprised Sean is. She decided she wants to do it in the hospital so that Sean doesn't have to deal with her body afterwards. Kim says they can make it homey in her by getting rid of the machines and bringing some stuff and some wine. She thinks Sean will need the wine, because she noticed he seems scared. She has no idea how he's feeling, but he tells her not to worry about him and claims he's not feeling anything. Kim doesn't think that's the truth, but he just goes off to get the stuff and the wine. Kim tells Cristina it's always the same fights, them refusing to tell you how they're feeling, even when you're dying. Kim thinks they just really don't know how they're feeling. Cristina notices she's short of breath and puts the oxygen mask back on.

Teddy finds Mark and asks him how he feels about physician-assisted suicide. He thinks it's them getting to know each other, but Teddy informs him it's not that. She informs him about Kim's case.

Jim Nelson and Meredith are studying their patient's scans. He's allowing her to debulk the tumor. April suddenly comes and takes the scans, as Shepherd requested them. Meredith holds on to them and says it's her tumor, but April snatches the scans and says it's Shepherd's now.

Owen steals a chart from Tyler's nurses station.

A flashbacks shows Owen, a patient and the rest of his platoon driving through the desert. They can't reach the base, but the Captain doesn't worry because they know they're coming. It's probably the storm. Owen assures the patient that they're going to get him stabilized and then home. He asks if Teddy got there yet, but they haven't heard. The Captain is sure that his girl is fine. Owen seriously tells him they're just friends. "Yeah, keep telling yourself that," the Captain smilingly says and suddenly, there's an explosion.

Owen crawls out of the wrecked vehicle and sees a severed body part. As his Captain screams, asking if he's all right, Owen finds their patient, dead. Dan thinks they've hit an I.E.D. As Owen walks around the vehicle, he finds that everyone's died. Then he sees Dan trapped under the vehicle.

Cristina calling Owen's name brings him back to the present. He stole Kim's chart and he paged her as he saw she ordered pulmonary function tests last week. He wants to know if she did a bronchoscopy during these tests. He says these tests may give false positives, so maybe Kim's decided to kill herself because of incorrect data. Cristina wonders why he's interrogating her and says that they probably did a bronchoscopy as it's routine. Owen aggressively asks if probably is good enough for her and Altman. She asks what's going on, but he walks off.

Nick tells Tommy to call his wife when he goes into surgery and to downplay the injuries. Meanwhile, Mark takes care of the frostbite on Phil's fingers. Phil says this is worse than when he broke his ankle on Kilimanjaro. Callie says they're hardcore. Nick says they these kind of trips are the only thing to keep their blood moving, as they have boring jobs. Tommy wants to show Mark a picture of him on top of the mountain, but accidentally shows him a picture of his daughter. Mark shows the picture to Callie to prove that she does want to have kids.

Meredith finds Derek and April and yells at him for stealing her surgery. She wants to scrub in, but he doesn't want her to switch services as it'll look like favoritism. April tries to calm her down, but Meredith yells at her to stop talking. Meredith yells to everyone around that Derek stole her surgery and walks off. Richard asks Derek if everything is okay, which Derek says it is. Richard suggests they get lunch together, but Derek can't go to the cafeteria anymore as people needing things from him come up to him all the time there. Owen comes over and asks Derek for a minute. Case in point.

Arizona, Callie, and Mark sit down with Owen with their lunch. Mark continues to urge Callie to tell Arizona that she wants kids. Richard comes over too, but as they all seem to find it weird having him around, he goes to another table. As Arizona asks Callie and Mark what's going on between them, Teddy comes over to ask Owen what his problem is. She yells at him for going to Shepherd behind her back for a case he doesn't even know. So, she wants to know what his problem is. Everyone is looking at them, and he just walks off.

Mark finds Richard eating alone in a conference room and informs him on the argument between Teddy and Owen. Everyone's talking about it. "Not to me," Richard says, adding that all conversation stops when he comes in. Mark explains you don't talk locker room talk in front of the coach. Richard points out he's not the coach anymore. Mark says he's only a little bit like everybody else, but mostly he's still the coach. It's a sign of respect, and he'd be wrong to take it any other way.

Teddy explains the pulmonary function tests to Kim again. Sean asks why they're doing these again, as they did them already last week. Sean thinks that that means the test results may have been wrong. Teddy tells him questions have been raised. Sean wants to know by whom, because he's spent the entire day thinking his wife's going to die today, so if there's a chance she's gonna get better, he wants to know. Cristina says that won't happen. The tests are just the hospital covering its ass. Sean understands and Teddy thanks Cristina.

In the OR, Richard asks a nurse to see if Bailey's on her way. He whispers to Alex that he'd hit the nurse hard if he weren't married. Jackson, Charles, and Alex are shocked. Alex says he thinks Richard meant to say he'd hit that. Bailey, having just entered, says she thinks he didn't want to say that at all.

Jackson meets Meredith in the scrub room. He's heard her yelling that Derek stole her surgery. Using a Whoville metaphor, Jackson tells her not to be too mad about it and just shine in the aneurysm surgery she has with Nelson now.

Lexie staples Phil's head wound and his screams make Owen continue to think back to the death of his platoon.

Owen is doing his best to save Dan's arm, while Dan himself is putting pressure on an open wound in his neck with his other arm. Owen had to take off Dan's wedding ring as his hands was swelling and he uses a belt to tie off Dan's bleeding arm. Dan loses consciousness, causing the wound to squirt blood. Owen quickly tries to stop the bleeding.

Derek finds Owen and tells him Kim's second bronchoscopy confirmed that nothing more can be done. Sloan signed off on the suicide. Owen says he won't let Derek kill him. Derek says the patient is a woman and no one's killing her, she's choosing to die. Derek sees something's wrong and orders Owen to go home.

In the desert, it's gone dark. Owen is still keeping pressure and keeping Dan awake. He says they have to move him and to find something to pack the wound until someone comes. Owen tries to move him, but Dan screams in pain. Dan is giving up. Owen's been saying for hours that help is coming. Dan says it's okay. He asks Owen to stay with him and say a Hail Mary with him. So they do. Dan wants Owen to make sure Lisa gets his ring, and not use it to propose to Altman or something. They laugh and Owen says he's engaged to Beth. Dan orders Owen to move his hand so that he can die, but Owen refuses.

Owen is standing outside in the rain in front of the hospital, and goes back inside.

Callie tells Tommy that Nick's recovery process will be long, so they have to call his wife and be honest about his injuries. Tommy says he called his wife to call Nick's wife, as she's better at those things. Callie finds it odd that he's scared of his friend's wife, given all their trips. Tommy confesses he was scared at all of their trips. He hated every minute of them, but he went with Phil and Nick because they're a team and they love it. He just sucks it up for them.

Teddy is in Kim's room, which has been made homey, and writes her the prescription for the suicide drugs. Teddy can't actually give her the drugs, but she can get the prescription filled at the hospital pharmacy. Owen barges in and asks Kim what if they find a cure. It's a long shot, but he thinks her life is worth gambling on a long shot. Teddy threatens to call security on him, but Sean would like to hear Kim's answer. Kim replies that there's this time where death stops being scary. It's the hope that starts being scary, because it's not true. Even if they found a cure tomorrow, it's too late for her. Hanging on to hope maybe makes him feel better, but it makes her feel alone. She doesn't want to die alone and she's not afraid of this. She wonders why Owen is. So is Teddy.

Sean finds Owen sitting on a bench outside the hospital and tells him the pharmacy wouldn't take his insurance card. There were some problems so he had to go to the cash machine. He's been running around to get enough money to buy the pills that are going to kill his wife. He's got them now. Sean sits down. Owen tells him there'll be moment when Kim dies. A moment where all of Kim's pain will disappear and Sean will feel relieved. He'll know with absolute certainty that he did the right thing. Just for a moment. 

In a flashback, Dan begs Owen to let him go, saying it's okay. This hurts him. As he keeps saying it's okay, Owen lets go. 

Owen tells Sean to hold on to that moment, because all the rest is just his own garbage.

Callie tells Phil and Nick will be in physical therapy for six months, but with some luck, they'll be ready for their trip next year. Tommy pretends to be enthusiastic with them, but Callie tells Nick and Phil that Tommy hates this stuff. He just does it for them. Callie apologizes for her rant, but she likes to see people keep their legs. Phil says he's starting his own business, which keeps his blood running too, so he's with Tommy on this. Nick says he actually wanted to go wine tasting in Napa instead of the heli-skiing. Callie urges them to go Napa then, which they agree to do. They cheer.

Derek finds Richard in his old office, which looks different to Richard now. Richard knows why Derek stole Meredith's surgery. He was jealous of her, missing the adrenaline of back-to-back surgeries. Richard understands and advises him to schedule himself a surgery once a day, an hour earlier than everybody else normally starts. Also, he doesn't actually have to sign all the paperwork as Patricia is an excellent forger. And if he eats with someone else in the cafeteria, people most likely will leave him alone. He could eat with Richard, for example. Derek thanks him for the tips.

Sean gives his wife the pills. She takes them with a sip of wine. Sean confesses he's scared. He lies down next to Kim and they comfort each other. Teddy watches them from outside the room.

Meredith is reading in bed as Derek walks in. He apologizes, knowing she's mad. She says she's not mad, as she's in Whoville. She laughs and kisses him. 

Callie tells Arizona she has something to say and that she really cares for her. Arizona thinks she's breaking up with her and thinks Callie is one of these fake lesbians, just taking a vacation in lesbian land. Callie tells her to stop talking and says it's not a bad thing. She wants a baby at some point in her life. She really has to have a baby. Arizona lets go of Callie's hands.

Teddy visits Mark at his place. She says she helped her patient die today, but she doesn't want to talk about it. They kiss and start undressing.

Owen is lying awake again next to Cristina.

He thinks back to letting go of Dan's wound and Dan dying only seconds later. Owen closes Dan's eyes and not long after, a helicopter with Teddy on it finds him. Both she and Owen are happy to see each other again. The helicopter lands.

Owen is doing push-ups in the living room as Cristina comes in, asking what he's doing. He says he couldn't sleep. She asks if he's okay. He says he is and tells her to go back to bed. She wants to know what he's thinking, but he says he's thinking nothing. He tells her again to go back to bed. So she does. He continues doing push-ups as he remembers the soccer game with Teddy, Dan and another colleague.

Cast[]

Main Cast[]

Guest Stars[]

Co-Starring[]

Medical Notes[]

Kim Allen[]

  • Diagnosis:
    • Stage IV large-cell lung cancer
    • Pulmonary edema
  • Treatment:
    • Physician-assisted suicide

Kim had terminal cancer. She'd had a second mass removed from her right lung two months prior, but the cancer had spread to her lymph nodes and her liver and she was readmitted to the hospital with pulmonary edema. She decided she wanted to end her life through physician-assisted suicide. Teddy asked Owen to be the second physician signature, but he raised doubts due to his personal beliefs and so she had to have a bronchoscopy run to confirm her status as terminal. After that was performed, she was given the barbiturates and she died in the hospital.

Neuro Patient[]

  • Diagnosis:
    • Ependymoma
  • Treatment:
    • Intraventricular resection

Meredith told Derek about her patient who had come into the ER with abdominal pain she'd had on and off for six months. Meredith determined that she actually had a brain tumor and she was scrubbing in with Nelson, who said she could debulk the tumor. Derek later took over the case.

Nick Kelsey[]

  • Diagnosis:
    • Open tibia fracture
    • Hip fracture
    • Ankle dislocation
    • Frostbite
  • Treatment:
    • Closed reduction
    • Surgery
    • Physical therapy

Nick, 32, was injured skiing off a helicopter into an avalanche. He had an open tibia fracture and a hip fracture. He also had frostbite in the tips of his fingers. His ankle was also dislocated and had to be reduced. He also had free fluid around his kidney, so they did a CT. They took him into surgery to fix his legs and repair his kidney damage. He was told it would be a long recovery process and he'd need six months of physical therapy.

Phil[]

  • Diagnosis:
    • Abdominal bruising
    • Frostbite
    • Scalp laceration
  • Treatment:
    • Staples

Phil was injured skiing off a helicopter into an avalanche. He had abdominal bruising, so they ran a CT. He had a scalp laceration, which they determined was small enough that the shot of lidocaine would hurt worse than the staples, so they did them without numbing him.

Billy Linneman[]

  • Diagnosis:
    • Gun shot wound
  • Treatment:
    • Bandages

Bill had a gun shot wound to his abdomen. They had no occlusive bandages, so Owen used wet towels and a plastic bag to keep him stable until he could have surgery. He was evacuated in an APC, but he died when they hit an IED.

Iraq Patient 2[]

  • Diagnosis:
  • Treatment:
    • Laryngoscopy
    • Intubation

Teddy treated a patient in Iraq injured during battle. He needed to be intubated. Teddy stabilized him and he was medevaced out.

Iraq Patient 3[]

  • Diagnosis:
  • Treatment:

Dan treated a patient in Iraq. The patient's pupils were fixed and dilated, so Dan moved on to the next person.

Dan's Patients[]

  • Diagnosis:
  • Treatment:

Dan mentioned having a patient with an amputation and one with head trauma. They were taken out in the medevac.

Dan Mooney[]

  • Diagnosis:
    • Arm injury
    • Neck laceration
  • Treatment:
    • Tourniquet

Dan was injured when they hit an IED while evacuating. He had an arm injury, which Owen eventually tourniqueted to stop the bleeding. He also had a cut on his neck which bled profusely when he released pressure. Owen used pressure to slow the bleeding, but Dan realized that night that he was in the triad of death. He tried to get Owen to move his hand so he would bleed out, but Owen refused. Owen later assented and removed his hand, which allowed Dan to die.

Nelson's Patient[]

  • Diagnosis:
    • Aneurysm
  • Treatment:
    • Surgery

Nelson was given an aneurysm to clip in place of the tumor resection taken from him.

Music[]

Song Performer Scene
"Holding Out For Love" Ashtar Command
  • Owen lies awake in the middle of the night.
  • He gets up and exercises, before getting back in bed before Cristina wakes up.
  • Teddy goes to see Kim, who is ready to end her life.
"Hold On" Angus and Julia Stone
  • Owen watches Teddy walk away.
  • Owen and Teddy play soccer in the desert with their unit.
  • They hear a helicopter come in and go in to work.
"Static Waves" Andrew Belle feat. Katie Herzig
  • Arizona, Callie, Mark, and Owen eat lunch. Mark prod Callie to talk to Arizona.
  • Richard comes to the table and there's an awkward moment before he walks away.
  • Teddy comes in and yells at Owen about what he said.
"Draw Your Swords" Angus and Julia Stone
  • Owen talks to Kim's husband about Kim dying and him having to get the pills for her.
  • Owen tells him to hold onto the moment right as she dies where she's not in any pain.
  • Dan begs Owen to let him go.
"Heaven" Brett Dennen
  • The guys decide that they don't need dangerous adventures to have fun.
  • Derek finds Richard in his office.
  • Richard gives Derek some tips for being Chief while still feeling like a surgeon.
  • Kim takes the pills with a glass of wine and cuddles with her husband.
  • Derek apologizes to Meredith about the surgery.
  • Callie tells Arizona she wants to have a baby someday.
"Abandon Ship" Sorry Kisses
  • Mark and Teddy start kissing and undressing.
  • Dann gets Owen to pull his hand away and let him bleed out.
  • Just after he's gone, Owen hears the helicopter and sees Teddy inside.
  • Cristina finds Owen up in the middle of the night and asks if he's okay.
  • He says he's fine and sends her back to bed as he continues while remembering Iraq.

Notes and Trivia[]

Grey's_Anatomy_6x18

Grey's Anatomy 6x18

  • This episode's title originated from the song Suicide is Painless, originally sung by Johnny Mandel. Suicide is Painless is the theme song to M*A*S*H.
  • This episode scored 11.57 million viewers.[1]
  • This episode won an Emmy award for Outstanding Makeup for a Single-Camera Series (Non-prosthetic).[source?]
  • This is the last episode in which Katherine Heigl is credited, although she didn't appear in it.

Quotes[]

Richard: If I wasn't happily married, I'd hit her. I'd hit her hard.
Alex: Sir, I think what you wanted to say is, "hit that".
Miranda: I don't think you wanted to say that- at all.
Mark: You missed it. Altman tore Hunt a new one in the cafeteria. The whole hospital's talking about it.
Richard: Not to me. I walk in the room, and all the conversation grinds to a halt.
Mark: Oh come on, you don't talk locker room talk in front of the coach.
Richard: I'm not a coach anymore. I'm a player. I take a shower like everybody else.
Mark: Richard. You're a little bit like everybody else. But mostly, you're still a coach. It's a sign of respect. It would be wrong to take it any other way.
Teddy: What is your problem? You go to Shepherd behind my back about a patient you don't even know. You have no idea what she has been dealing with - the kind of pain that she is in. Pain that's only gonna be worse after I ram a tube down her throat, because you are having some kind of problem with her exercising her legal right to die. So I want to know, what the hell is your problem?
Callie: This is really hard for me to say, 'cause I really care about you and...
Arizona: Oh my God, you're breaking up with me. Mark? I-is-is it Mark? Are you sleeping with Mark again? Are you one of those fake lesbians just-- just having a va-vacation in lesbian land?
Callie: No. Stop. God, it's not bad. This thing I have to tell you isn't bad. Um... I just... I wanna have a baby. At some point in my life. That's all. I really... I have to have a baby.
Derek: I'm sorry. I know that you're mad at me.
Meredith: I'm not mad. I'm in Whoville.
Derek: Whoville?
Meredith: Whoville.

See Also[]

A complete overview of this episode's crew can be found here.

The Grey Matter blog post on this episode can be found here.

References[]

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