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Transplant Wasteland
Season 9, episode 17
9x17new-9
Callie and Arizona listening to Jackson.
Episode Information
Airdate

March 14, 2013

Written by

Zoanne Clack

Directed by

Chandra Wilson

Episode Guide
Previous

This is Why We Fight

Next

Idle Hands

.
To a critically ill patient, an organ transplant means a new start, a second chance. But the body is designed to fight off any outside invader. Even one that's trying to save it. Because a transplant doesn't guarantee that it's an easier life. There's a threat that the body will reject the organ out right. The transplant process is very scary. A patient goes from worrying about getting an organ to worrying if the organ will be rejected. The anxiety continues until they can finally open their eyes after surgery and see that their gift has been accepted.

Transplant Wasteland is the seventeenth episode of the ninth season and the 189th overall episode of Grey's Anatomy.

Short Summary Edit

Discord and chaos created by new management causes one doctor to question his future at Seattle Grace; the doctors and interns juggle multiple transplant surgeries simultaneously.

Full Summary Edit

Five of the six members of the new board of directors, Derek, Cristina, Meredith, Callie, and Arizona, are in a conference room. They are waiting for Jackson, who has a bigger vote than them and who can veto theirs, Derek says. The others don't like this, but Meredith says that Jackson is one of them. Derek thinks he will follow their lead too. "I'm not gonna let some plastics fellow tell me how to run my service 'cause his mommy said he could," Callie says.

Richard and Catherine are bickering over Jackson. Richard thinks running the hospital is too much responsibility for him, while Catherine thinks he'll be able to handle it. Catherine enters a conference room, leaving Richard alone.

As Arizona agrees with the others that the peds and adult ER will be combined to save on personnel, Jackson comes in with pastries. One of his patients made him late for the meeting. Meredith informs him that they were discussing the reopening of the ER and the trauma department. He tells them that they'll have to wait another month for that, as the Foundation wants look into it a little more. As Cristina suggests to hear Owen's thoughts on the case, Jackson confesses that the Foundation thinks a new Chief of Surgery would be good for moral. The others don't go agree, and Jackson keeps defending the Foundation. "Your mother, Avery, just say it!" Callie says. Everyone gets ready to leave, and Cristina says that the thing with Owen won't happen. "Without the Harper Avery Foundation, none of us are here," Jackson says. Meredith says they're grateful, but that they didn't expect the Foundation to dictate policy. Jackson comments that them suing the hospital lead to the bankruptcty in the first place. "For the plane crash that killed Lexie," Meredith says, and she and Cristina walk away.

Owen and nurse Ruth are trying to fit surgeries into the OR board, which is a mess. The ORs are all understaffed, as several nurses quit, and so did the transplant coordinator. Alex informs Owen that UNOS called to let him known that they have a kidney that's a match for one of his patients. As the kid has been on dialysis for 3 years, Owen agrees to schedule the surgery. Cristina comes over, and she tells him that Jackson is talking about replacing him. Ruth walks away, and Cristina tells him that she didn't want him to hear it as a rumor. Heather comes over to say that UNOS has a heart and lungs, and Owen goes off to talk to Jackson.

Stephanie and April are on their way to a patient. April knows the guy, as he was an internal medicine resident at Mercy West until he became sick. As they enter his room, there's loud music and a lot of people in his room. They turn down the music, and April sends most people out. April and Stephanie want to discuss his next step, but he already knows it: he's doing DCD (donation after cardiac death). He knows he's being kept alive by the ventilator, and he says Owen signed off on it.

Owen finds Jackson and asks if he's out of a job. Jackson confesses that a change of leadership might be good for the morale of the hospital, while Owen says that he's been killing himself the past three weeks to keep the hospital open. As Owen starts yelling, Derek comes over. He tells Owen that the idea was tabled when Jackson brought it up,  Owen gets mad because they were even talking about it. Jackson wants to interfere, but Derek shuts him up. Owen is mad that Derek and the others keep lying to him, like when they said that they were with him, only to walk out on him an hour later. He also mentions that he's running around, trying to fix the mess that they all made. "You do not wanna get in to whose responsibility this is! You don't want to get in who's responsible for all of this! You don't!" Derek says. Owen says he'll make the decision easy for them, and he quits.

Owen is outside, getting ready to leave. Cristina runs up to him, and he says that he's done, which he should've been a long time ago. "Shepherd is right. This is all on me," Owen says, but Cristina says no one blames him. "Somebody does, and as long as that's true, I don't see how I can be effective here," Owen says, and before driving off, he tells Cristina that she may have to change the OR board when the organs for her patient arrive.

Jo and Jason are in an elevator, discussing the difference between surgery and obstetrics and gynecology, and they kiss. When the doors open, Alex is introduced to Jason, though Alex doesn't shake Jason's hand. He asks Jo where his patient's parents are, but she doesn't know. 

Jackson enters the conference room where his mother and suits are looking over the purchase agreement. "I'm sure you've read through them" Catherine asks, while she gives him a look. He asks to speak her outside. Jackson tells her he didn't understand any of it, but Catherine says it's normal, and that that's the reason why the suits are there: to explain the documents to them. She tells him just to pretend like he's at least understanding some of the documents,  and they go back in.

Jaylen's parents find their daughter, Alex's patient, kissing a guy who's on dialysis too. Her father doesn't like it, but the mother doesn't want them to fight today, because Jaylen will be getting a kidney transplant. The girl is enthusiastic, but Theo, the guy on dialysis, isn't.

Meredith enters a conference room, where Callie and Arizona are waiting for an emergency board meeting. They tell her Owen quit, and Cristina and Derek come in to, while bickering over Owen. Arizona says that Cristina should separate her professional and personal life. "Then count me out," Cristina says, as she gets paged for her transplant surgery. Together with Alex's transplant surgery and April's DCD, this makes 3 transplants, which normally doesn't happen, and now it seems impossible with no transplant coordinator and the fully booked and understaffed ORs. "Who's handling all that?" Derek asks. "Hunt!" Callie and Arizona yell. 

Bailey is reading one of the protocols that were put in place by Pegasus and she asks Avery what he's going to do about them. One of the protocols says she needs to perform a hernia repair using the Varner technique, but she'd like to do it the way she's been successfully doing it for the past couple of years. She gives the protocols to Jackson and asks him to read them through. April comes over and asks if anyone has seen Owen, because she'd like to know why he signed a death warrant on her patient. "Good luck, he's gone, he quit," Bailey says. April is surprised. "Ask bossman over here," Bailey says, pointing her eyes at Jackson. "There was a disagreement about policies," Jackson says. "Then change the stupid policies!" April says. "Not before he changes my stupid policy first! My hernia is this afternoon!" Bailey says.

Heather and Cristina tell Mr. Schultz that his new heart and lungs will arrive in the afternoon. Herman, another one Dr. Yang's patients, walks past the room, and he and Schultz start scolding each other. Herman is jealous that Schultz will get a new heart, when he needs one too. Cristina explains that because of Mr. Schultz's pulmonary hypertension, a new heart is necessary. "Now you're going to have pulmonary hypertension unless you get a supervisor down here," Herman says. Cristina says she will get one. A little later, she explains to Heather that the patients hate each other because Crum's wife left him for Schultz and she says that she needs to talk to her supervisor now. "You own the hospital now, so doesn't that make you the supervisor?" Heather asks. "It does, so I will have that conversation with myself," she says.

Meredith is pushing all the surgeries as there's no place to do them. Alex wants her to do a kidney procurement in Missoula. Meredith says she's too busy figuring out where all the patients have to go now the surgeries have to be pushed back, and Alex gets pissed and walks away, saying the "upper management is too busy to get kiddy kidney". Meredith then decides to go, and orders Jo to book a plane to Missoula and get Shepherd so he can figure out the OR board. Meredith lets Jo come with her.

April tells her Bradley that there are other procedures they can try. He says that he didn't tell her about the DCD before because he didn't want to spend minutes of his life convincing her that it was the right option. April thinks he's depressed, but he says he's not. He knows he'll die anyway, so he wants his death to mean something by donating his organs now that he still can. April beggs him to let her help him, but he fires her as his doctor.

Alex is explaining to Jaylen when she has to take her anti-rejection meds and he tells her about the side effects they can have.

April asks Cristina if she would donate her organs if she were dying and Cristina says she would. She says that she thinks it's awesome that Bradley wants to save other people with his perfectly healthy organs. She suddenly realizes something. "He has good organs," she says, and she walks out.

Derek is on the phone with Meredith, who's on thep lane. He's about to operate, and Meredith explains that Alex wants her to go pick up the kidney. They hang up, and Jo tells her Alex doesn't like that they left him in the dark. "You don't have to learn me how to speak Alex, I'm fluent," Meredith says. Jo asks if she should take it personally that Alex is acing like he hates her. "He's just feeling abandoned by everyone in his life right now and the fact that I'm dating a guy and not available to go to Joe's bar every night is just... He's feeling hurt and lonely," Jo guesses. "Or he hates you," Meredith says.

Jaylen has locked herself in the bathroom. Alex tries to talk to her, but the father says she's giving them the silent treatment. He hears phone sounds, and says that she's talking to somebody. He goes to the dialysis room, where he asks Theo, who's texting Jaylen, to ask her to come out of the bathroom. "Make me," Theo says. Alex grabs his phone, and Theo asks to give it back. "Make me," Alex says, and he walks back to Jason's room. Theo can't follow him, as he's still on dialysis.

Heather and Cristina are explaining the domino transplant they will perform on Mr. Schultz and Herman. They will put the new heart into Mr. Schultz's chest, and pu Mr. Schultz's heart in Herman's body. Herman doesn't want to do it because he really hates Mr. Schultz.

Meredith, who arrived in Missoula with Jo, and Cristina are on the phone. Cristina tells her about the domino transplant she wants to perform, while trying to figure out the OR board. She also asks why Derek is so mad at Owen. They hang up, and Jo overheard the conversation. Meredith assures her that everything is perfectly fine. As they enter the OR, the surgeon tells them that there almost done. When Meredith asks where their kidney is, the surgeon looks confused.

Jo is telling a surgeon to get her hands off their kidney, but the surgeon says that it's not their kidney. Jo wants to see the paperwork to prove it. Meredith comes back in, saying that she found their kidney. The kidney hopped on a flight to Seattle. They don't know how that's possible, and they leave.

Alex is texting Jaylen emoticons, trying to pretend to be Theo. Jaylen comes out of the bathroom, saying she knows it's him. He asks for five minutes, after which he promises to never bother her again. She agrees, but only if they talk  in the bathroom. She wants to stay on dialysis, so she won't experience any of the side effect of the meds she has to take. She says she's not ready for it yet. He says she needs to take the good things before someone else does, and she agrees. Alex tells Leah to prep her for surgery, and not to leave her side. 

Meredith is on the phone with Alex. She's angry because he sent her to Missoula Hospital to pick up a kidney that's already its way. She doesn't even know who's going to pick it up in Seattle. He says she has to deal with it and hangs up the phone. 

Jackson is carrying around the Pegasus protocols. Bailey says that she already did the hernia repair like she used to do it. "You wanna get rid of me now, like you did with Hunt?" she asks. As Jackson starts to object, Cristina comes over and asks him to sign off on her domino transplant. He asks why he has to do that, and she replies that "being king" comes with certain responsibilities. April walks by, and he gives her a list with which organs of her patient are going where. She doesn't want to take it as Bradley's not her patient anymore, but he forces her to deal with it. As he signs Cristina's papers, Callie comments that he needs to make he signs his own name, and not his mother's. Alex comes over and says he wants to know who sent his kidney flying to Seattle when he sent two surgeons to pick it up. Bailey says that that's part of the Pegasus protocol, to save on personnel hours. "Though day, boss?" she asks.

Richard tells Catherine that Jackson is drowning, and taking the hospital down with him. Catherine asks him to give Jackson some time. They continue arguing, and Richard says that if Jackson fails at this, it'll follow him for his entire career. He says that it'll be a failure that his mother choose for him. This angres Catherine, and as she walks away, we see that Jackson overheard their conversation.

Cristina comes into Herman's room. She says that he needs to get over what happened in the past. "It's like it was yesterday," Herman says. "Fine. You can't forgive him, so don't," Cristina says. She sits down and tells him to beat Schultz. "Take his perfectly good heart and outlive him with out," she says. He asks if the heart is still good enough to get him to Mr. Schultz's funeral, and Cristina says the heart will get him even dancing on Schultz's grave.

Bradley is explaining to his family what will happen. After his death, the doctors will only have 5 minutes to get his organs out, as they won't be good otherwise. His mother once again asks if he's sure. She's getting scared now that it's getting close and she wants to make sure he's completely sure. April is standing in the doorway. She says that Bradley is still a doctor, and she starts listing the people that Bradley's organs will save. This helps his family accepting it too.

Cristina is getting ready for her surgery. She tells Derek, who asked her about the OR board, that the hospital cannot function without Owen. She says that Owen has felt the blame every day since the crash because Derek keeps reminding him. "You say you forgive, but you don't, or you won't. So what is it? What is this about? Because it's not about him," Cristina says.

Bradley is taken to the OR, where he'll die. In the OR, his family sits next to him as he's taken off the ventilator. 

The kidney for Jaylen is delivered at the hospital. 

Alex and Cristina take their patients to the OR. It turns out they're both scheduled to operate in OR 2. As they start arguing over who gets the OR, April comes out of hers to tell them that her patient would like to die in silence. Alex tells her that Cristina needs her OR. "I've got an OR!" Cristina yells. Callie interferes, and as she looks at the OR board to come up with a solution, Jackson steps in. He tells April to get back inside and let her patient take as long as he needs, while Cristina gets the OR as heart and lungs trump kidneys. He promises Alex that the next available OR will be his. None of them moves. "You heard the man, he's the boss, now move!" Bailey says. 

Meredith and Jo enter Alex's OR with the kidney. He's curtly and when Jo asks if she can scrub in, he says he's got Murphy. Jo leaves the OR. "You want me to apologize, Alex? I'm sorry, I'm sorry we bought the hospital. I'm sorry you have to think of us as your bosses now, but we didn't do it for just us. We did it for everyone. For you, for Wilson, who, by the way, fought so hard for you today, I thought she might cut someone to get you that kidney. So drop the attitude before no one wants to work with you anymore," Meredith says. She leaves the OR too.

Derek is driving next to Owen, who's jogging. They are at Derek's trailer. Derek gets out of his car, and he tells Owen to stop blaming himself. He confesses that he has been pissed, but not at Owen. He's pissed at Mark. "You gotta let that go," Owen says, while tears well up in Derek's eyes.

Bradley is dying. As he passes away, April turns off the monitor and calls time of death. The family gets ready to leave the OR, but the mother starts crying and clamps herself to her son's body. As April watches the surgeons waiting and the time left on the surgical clock, she pulls her off of Bradley's body. The family leaves the OR, and the surgeons get ready to harvest his organs.

Alex enters Joe's bar, where he sits down next to Jason. He says that he heard what she did to get him the kidney, and he apologizes for being a doucheface and thanks her. He asks her if he can buy her a drink. "We're all set," Jason says. Alex leaves, and Jason and Jo resume their conversation.

Catherine tells Richard that Jackson stepped up, like she expected him to. She wants him to say that she was right, but he doesn't want to as he still thinks that, even though Jackson stepped up, the steps are still too high, which is not fair to him. Catherine gets angry because he's wandering into parental advice, which is not his place. She steps away, only to realize that she was too harsh just a couple of seconds later. She walks back to Richard, and she says that has been looking out for 28 years for a man who cares for Jackson the way a parent would. "The moment I find him, I bite his head off," she says. Richard takes her hand, and he says that she'll always know what's best for Jackson.

Arizona is the last one to sign a couple of documents, making her, Callie, Derek, Meredith, Cristina and Jackson officially the new board of directors. Before they can leave, Jackson wants to share a couple of things first. He takes the Pegasus protocols and throws them into the trash can. This convinces the others to listen to him. Jackson tells that he wants to reinstitute Owen Hunt as Chief of Surgery, to which Owen agreed. "There was some conditions," Derek reminds him. "Which brings me to my second point. We are reopening the ER. We will be a level 1 trauma center again. That will be top priority, once Owen Hunt is here to share his input," he says. He continues, saying that the Foundation will from now on follow their lead. "That sounds good," Arizona says. He has one last proposal. "While it is important that we become a leading center for research and innovation, we have to remember something. We are now officially a hospital run by doctors. That should mean something. It is our responsibillity to be the best doctors we can possibly be, so those who come after us, can strive to be their best. So, with that in mind, I move to rename the hospital," he says. "To what?" Arizona asks. "Let me guess. The Harper Avery Hospital?" Callie asks. "No, I propose that we give this hospital a name that can honor the very reason we've come together and been able to do this. A name that exemplifies the spirit of this hospital, but also the debt of our dedication," Jackson says. He turns around a paper, which says "Grey Sloan Memorial Hospital". "All in favor?" he asks, and they all agree.

Cast Edit

  • Meredith Grey
  • Cristina Yang
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Owen Hunt
  • Arizona Robbins
  • April Kepner
  • Jackson Avery
  • Derek Shepherd
  • Catherine Avery
  • Mr. Schultz
  • Herman Crump
  • Jo Wilson
  • Heather Brooks
  • Stephanie Edwards
  • Leah Murphy
  • Jason Myers
  • Bradley Parker
  • Jaylen Donovan
  • Hazel Parker
  • Nick Parker
  • Mr. Donovan
  • Mrs. Donovan
  • Nurse Ruth
  • Transplant Surgeon
  • Closing Surgeon
  • Theo

Main CastEdit

Guest Stars Edit

Co-Starring Edit

Medical Notes Edit

Bailey's PatientEdit

  • Diagnosis:
    • Hernia
  • Treatment:
    • Hernia repair

Owen talked about moving Bailey's hernia patient to OR 5. Bailey questioned whether she should do the hernia based on the Pegasus protocol or do it her own way. When she didn't get a response, she did the surgery her own way and it went fine.

Jaylen DonovanEdit

  • Diagnosis:
    • Kidney failure
  • Treatment:
    • Dialysis
    • Kidney transplant
    • Anti-rejection drugs

Jaylen, 16, had been on dialysis for three years when a kidney became available for transplant. Meredith and Jo went to retrieve the kidney, but found that it had been sent back to the hospital on its own. It was successfully transplanted into Jaylen.

Mr. SchultzEdit

  • Diagnosis:
    • Pulmonary hypertension
  • Treatment:
    • Heart-lung transplant

Mr. Schultz was in the hospital waiting for a heart-lung transplant to come through. One finally did. When he received his transplanted heart and lungs, his 80% functional heart was donated to Herman Crum.

Bradley ParkerEdit

  • Diagnosis:
    • Amyotrophic lateral sclerosis
    • Hematochezia
  • Treatment:
    • Mechanical ventilation

Bradley, 31, had been diagnosed with ALS. He had a laproscopic cholecystectomy and was complaining of blood in his stool. He decided that his condition had progressed to the point where he wanted to donate his organs using donation after cardiac death. In an OR, they removed the tube from his tracheotomy and allowed his heart to stop before stepping in to retrieve his organs.

TheoEdit

  • Diagnosis:
    • Kidney failure
  • Doctors:
  • Treatment:
    • Dialysis

Theo was in dialysis for kidney failure.

Herman CrumEdit

  • Diagnosis:
  • Treatment:
    • Heart transplant

Herman was waiting for a heart transplant. When Mr. Schultz had a heart-lung transplant, Cristina proposed that when the new heart was put in Mr. Schultz's chest that they take his native heart and transplant it into Herman's chest.

Derek's PatientEdit

  • Diagnosis:
  • Treatment:

Derek was seen getting ready to operate.

Music Edit

Song Performer Scene
"Miracle Mile" Cold War Kids
  • Clips of Seattle.
  • Callie, Arizona, Derek, Meredith and Cristina are now board members and talk about their and Jackson's rights.
  • Richard and Catherine Avery talk about Jackson owning the hospital.
"Distant Shouts" Little Children
  • April tells Bradley's parents what their son's organs will be used for.
  • Cristina and Derek talk about Derek not forgiving Owen.
  • Bradley is brought to an OR to die.
  • Alex and Cristina both need the only available OR.
"Go First" Rose Cousins
  • Bradley dies and his mother refuses to leave his side, forcing April to pull her aside.
  • Surgeons prepare to take Bradley's organs out.
"Sugar on Sunday" Left Hand Smoke
  • Alex disrupts Jo and Jason's date to apologize.

Notes and Trivia Edit

Grey's Anatomy 9x17 Promo 00:20

Grey's Anatomy 9x17 Promo "Transplant Wasteland" (HD)

  • This episode's title originated from the song Transplant Wasteland, originally sung by The Arcana.
  • This episode scored 8.20 million viewers.

Gallery Edit

Episode StillsEdit

Behind the ScenesEdit

Quotes Edit

Callie: (to Jackson) Make sure you sign your own name, and not your mom's.

See AlsoEdit

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

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