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Episode Title: Hold Back The River

Episode Number: 14x18

Directed By: Geary McLeod

Written By: Alex Manugian

Original Airdate: April 5, 2018

Viewers: 6.84 Millions

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April 15, 2018

14×18 – Hold Back the River

www.ellen-pompeo.com/greysanatomy > 14×18 – Hold Back the River

Life doesn’t owe us a thing. It just is. Like a river, it goes where it goes. You can try to fight against the current. Or you can learn to ride it. As surgeons, we dedicate ourselves to an endless fight against the current. All day, every day, we fight against the current. Sometimes we lose, sometimes we win. Sometimes, the current carries us exactly where we need to go. And sometimes, it slams us right into the rocks. ”
— Meredith Grey


Guest Stars For This Episode.

.Mary Kay Place as Olive Warner


Greg Germann as Dr. Thomas Koracick


Hal Sparks as Dr. Scott Hanson


Caitlin McGee as Liz Brosniak


Jeanine Mason as Dr. Sam Bello


Annie Sertich as Peggy Knox

Full Summary





Alex and Jo are walking across a bridge. They stop to kiss.

Owen emerges from the bathroom and picks up his travel bag. He attempts to rip off the Germany tag, but fails. Frustrated, he throws the bag across the room.

Ben and Bailey are kissing in bed. He has a present for her. It’s a pill box so she can carry her meds with her without anyone knowing. She’s not that happy with it, but he climbs out of bed without noticing.

April goes to the chapel to gather strength. She smiles.

Alex and Jo arrive at work. Meredith tells Jo that their Jimi Hendrix mouse died. They are trying out all the seven different polymers Jo found, but it looks like they are failing. They really need to find something to make it work. Jo thinks they are beating Marie Cerone, but Meredith reminds her it’s about saving lives.

Owen is frustrated. Amelia suggests he call Teddy, but she doesn’t want to hear from him. Amelia then decides to call Teddy herself, but Teddy makes it clear she’s not interested. Arizona comes up to ask about Teddy. Owen snaps it went great and walks off.

Ben arrives in the ambulance bay with a woman who collapsed at an AA meeting. They got her breathing again, only to discover her DNR bracelet afterwards. The woman asked for Richard since he’s her personal physician. The patient is unloaded from the rig. It’s Olive Warner, Richard’s sponsor. She assures him she hasn’t been drinking.

Amelia and Alex are explaining the ultrasound procedure to Liz while Noah is listening to music. She’s worried about the risk. Alex says it’s a non-invasive procedure, but Amelia clarifies it’s very risky because of the heat. The procedure will be slow. However, it’s also Noah’s last real chance. She ends by saying they are excellent and that they want this to work almost as badly as Liz does. As Noah laughs again, Liz signs the consent form.

Outside the room, Amelia and Alex disagree on whether they were harsh enough. Alex leaves to go tell Kimmie the procedure is on. Tom comes up. He’s very cheerful because it’s so cutting-edge. He leaves to go update Andrew and Sam.

Alex just delivered the news to Peg and Kimmie. It’s a big step towards Kimmie going back out there and singing. She’s very much aware that it’s not a cure. She’s sick of hospitals. She wants to go back to school and see her friends. A friend invited her to come along to New York in the summer to see Dear Evan Hanson. She hopes she can make it to then.

Ollie wonders if she’s getting special treatment. Her liver has survived longer than it should have. Her dying liver resulted in cardiomyopathy. She has reached her expiration date. Richard asks when she decided on the DNR. She replies eight months ago, and she also chose for an advance directive for no intervention. Richard hates that she didn’t tell him since they talk at least three times a week. She says she takes her problems to her own sponsor. Ollie says they are more than friends. She didn’t know how to sponsor him through her death. He says he won’t let her die.

Arizona meets Peggy and Dayna in the ER as Levi and Owen are working on Dayna. The baby’s doing fine, but Dayna is a mess. Dayna puked on her when they were driving, causing her to drive into a tree. All the airbags went off except for Dayna’s. As she says her ribs feel a bit sore, she starts crying. Arizona assures her that a rush of emotions is not unusual after an accident, but Dayna says she’s not out of harms way. She has stage 2 breast cancer and just had her second round of chemo, so that’s why she got sick.

Jackson and Maggie get on the elevator together. They kiss. He apologizes for not having had a lot of free time, but he had to take care of Harriet with April’s issues. She tells him not to apologize for that. They get off the elevator and walk into the lobby, where they see April. He hasn’t told her yet, but he’s going to try to today.

April finds Tom and tells him she’s sorry for being horrible to him while he was being vulnerable and kind. He doesn’t mind being used for sex. He figures she made up with God. Tom thinks God would approve of her using him for sex.

Dayna says Dr. Hanson told her she would be nauseous, so she doesn’t know why she’s upset. Peggy reminds her Hanson also told her to stay positive. He promised they’d get through it. His success rates are amazing. He cured her friend Lucille without surgery. Owen doesn’t know the guy. He orders a CT for Dayna and directs Peggy to the waiting room. As they walk away, Owen teaches Levi not to promise a cure to cancer patients. He asks Levi to reach out to Hanson and get Dayna’s records.

Noah’s procedure is being set up. The doctors are going to monitor from inside the room. Amelia is afraid they’ll melt Noah’s brainstem. Andrew notices she’s nervous and does the superhero pose. She and Tom join in.

Richard is walking to Ollie’s room with Meredith and Maggie. He makes sure they know how important Ollie is. Ollie summons him into the room. She asks what the protocol is when a physician disregards a patient’s wish for no intervention. He says going to his superior wouldn’t yield much result since he married the head of the hospital and mentored the Chief. Ollie threatens to reveal his secret to any doctor he brings in here. Richard calls in Meredith and Maggie and introduces them. She knows them from his stories. Richard says he’s asked them to come up with every possible option. He tells Ollie he trusts them completely, so she has his blessing to share whatever she wants.

Noah’s procedure has started. There are microphones in Noah’s helmet to listen for popping sounds, which would mean his brain is boiling. The temperature is rising so Tom asks Amelia to stop. Amelia says they are close to a cavitation event. Tom says they need to separate the tumor from the brain stem or Noah will not wake up. Andrew tells Amelia to stop since it’s definitely too hot now. The heat can’t disperse anywhere, so this is going to take a while.

Arizona finds Owen yelling at Levi for not having brought the medical records. Levi was told they couldn’t release them. Arizona sends him off to go try again. She tells Owen not to take things out on the interns. She talked to Teddy and scolds Owen for double dipping. Dayna’s scans are up and they look fine, including her breasts. Owen would bet his license that she does not have cancer.

Meredith and Maggie are examining Ollie. She says it’s hard to lose your sponsor after a long time. Also, recovering drunks are not fond of chance. Richard will need a new sponsor. Maggie tells her not to give up hope. Ollie says she’s hoping to move out of this broken shell of a body and move on. She imagines it feels like when she first got sober. She has plenty of hope, but she needs acceptance from Richard. He needs to get through this without a bottle. She asks them to work on that.

April approaches Owen and apologizes for her behavior lately, especially trauma cert day. She was going through a thing and she’s sorry for having worried him. He forgives her because she is a good person who doesn’t deserve to be crucified for one bad move. Jackson comes up to talk to April, but she runs off and claims to be busy. Levi returns. Hanson’s office claimed the systems are down so the records are unavailable. Owen says he’ll take it from here. Arizona found out that Dayna was referred by a friend who was in the exact same situation: a second opinion after an inconclusive mammogram. Arizona hasn’t told Dayna yet because they don’t have her records. Owen thinks two rounds of chemo would be miraculous to be cured already. Arizona suspects it might just be a misdiagnosis, but Owen discovers that Dr. Hanson is not a member of the American Society of Clinical Oncology.

Bailey is waiting for Ben in bed, but he’s exhausted. He’s too tired to put on pyjamas after his shower. Bailey turns off the light and starts rubbing his body, but he’s fallen asleep already.

The doctors are still working on Noah. His vitals are stable, but his skull temperature is reaching upper limit again. Tom thinks it’s time to stop, but Amelia wants to go for another round to make sure it’s all gone. Tom says it’s time to let it go. Amelia gets up and runs out of the room with Andrew following her to make sure she’s alright. She throws up in a garbage bag. Sam hopes they saved Noah. Tom says they’ll know if Noah wakes up. He welcomes Sam to the frontier of medicine.

Maggie wants to tell Richard that Ollie wants to be let go, but Meredith cuts in and says Ollie has had enough for today. She thinks they can run more tests in the morning. He will keep an eye on her overnight and asks them not to go too far away. Once he’s gone, Meredith tells Maggie that Richard almost lost everything the last time he fell off the wagon. They decide to see if they can get Catherine to come. Meredith asks Maggie to take care of that and runs off to her lab.

Jo and Taryn are working as she comes in. Jerry died and they have three mice left. Luckily, big companies like Cerone’s move slow, so they can still beat her. Meredith again reminds her it’s about the lives they can save. She wishes they could work faster. Meredith tells them they can go home, but they both decide to stay.

Amelia is sitting with Noah in his ICU room. Alex comes in and finds out there’s still no change. Amelia feels guilty for what they did.

Andrew and Sam are woken up by his phone. Noah is still not awake. Sam expected more. She then realizes they spent the night in an on-call room. He says it’s not so bad. She then realizes he never even talks about his place. She looks around and discovers a box of his stuff. He explains he’s in between places because his previous roommates both hooked up with his sister. She laughs at him and then asks him to move in with her.

Arizona and Owen arrive at the Hanson Oncology Clinic and introduce themselves as Mr. and Mrs. Otis Hunt. The receptionist gives them forms to fill out. Owen wonders why the fake names, since she told him good doctors make mistakes. Arizona says he only gets 5 stars on Yelp, which is too good to be true. Nobody gets 5 stars. She figured Hanson would give more away if he thinks they aren’t doctors. He goes to check his score on Yelp, but she tells him he has 3.5 stars.

Bailey goes to see Richard in his office. She just spoke to Catherine. Richard has spoken to Ollie more than he has spoken to everyone in his life. She’s the keeper of his secrets. She is how he feels God’s presence. Bailey says he has a big village of people here. He knows.

Casey catches up with April to ask a question about a patient. April seizes the opportunity to apologize for not having been fair on trauma cert day. His work was impressive. He thanks her. He figured she was having a nervous breakdown so he didn’t take it personally. She clarifies they will not speak of this again.

April walks up to Levi in the ER, but he quickly apologizes to her. He doesn’t know for what, but he’s very sorry. She rolls with it.

Meredith and Maggie tell Richard and Ollie that all options have poor prognosis. Ollie saw it coming. Richard thinks a small possibility for a good result is better than a guaranteed bad one. Ollie says coming to terms with her pending death was the second hardest thing she has ever done in her life. She’s at peace now. Or she was, because he is one nagging and stubborn problem. He’s driving her to drink and she wants to leave the world sober. He just thinks his keeping her alive is his job.

Outside the room, Jackson tells Maggie and Meredith that his mother had to stay in Boston due to post-op complications on one of her patients. Meredith leaves. Maggie realizes it falls on her to talk to Richard. She doesn’t know what to say that could change his mind. Jackson knows the feeling, because it’s how he felt when her mother was dying. He offers to be with Maggie when she tells Richard, but she says he already helped.

Hanson is doing an ultrasound on Arizona’s breasts while Owen does his best not to look. Hanson finds it refreshing that a husband came along. Hanson says the right breast looks healthy. However, he finds a solid lesion in her left breast. Arizona and Owen don’t buy it, but they are thrown for a loop when Hanson shows them the image, which confirms the lesion’s presence. Arizona is shocked.

Arizona and Owen come marching into the ER. April tries to apologize to Arizona, but she cuts her off and asks to come with them.

Tom and Alex were paged to the ICU. They find Noah genuinely laughing over a cartoon. They are so relieved that they hug. Alex also goes to hug Amelia. They all can’t help but smile.

April finishes up her ultrasound. She declares Arizona 100% clean. Owen takes a look for himself. Arizona is extremely relieved. That means Hanson fakes the ultrasound images. He is poisoning healthy women just to charge them for the chemo. They need to destroy. Owen decides it’s the perfect opportunity to work out his anger and leaves.

Maggie joins Richard on his bench at the park. He’s only interested in what she has to say if she found an option to help Ollie. She says he reminds her of herself when her mother was dying. She worked so hard to find anything as it felt like what she had to do. Her mother shaped her more than anyone else. Doing everything in her power to save her could not possibly feel wrong. Richard realizes Maggie wasn’t doing it for her mother. Maggie would give anything for another chance, to give her mother the ending she wanted. That protocol she made her mother do made her suffer while all Diane wanted was peace and to know that Maggie would be okay.

April runs into Jackson outside daycare. She asks if she can take Harriet, because she’d really like to. She assures Jackson she’s okay. She tells him she lost God after losing all these patients for no reason. That has never happened to her before and it scared her. It made her angry. All through their marriage, she wanted Jackson to know God like she did. So when she lost God, it felt to her like Jackson won. She hated that and it made her hate Jackson. She knows now he was just trying to help and he did. He made sure Harriet was okay. Now she has found God again. She realizes now that even when it felt like God wasn’t there, Jackson was. She thanks him for that. She’s really sorry. He puts her arm around her.

Alex finds Tom and Amelia planning to treat Kimmie with chemo and radiation so she can make it to summer. Tom will take a few weeks off to go see musicals with her. Alex reminds them Noah made it through, but Tom says it was like skiing down a mountain blindfolded. They ran into a dozen things they did not see coming, and Kimmie’s procedure is way more difficult than Noah’s. Kimmie’s procedure is years away so Tom refuses to try now. Alex refuses to accept it and begs them to do it. As they refuse, Alex pushes Tom into a desk. He calms down and starts cleaning up the mess his outburst made.

Arizona shows Dayna that her scans are clean. Peggy and Dayna are relieved. Dayna wants to tell Hanson, but Arizona says Owen is doing that now.

Owen arrives at the empty clinic as Hanson is closing up. Owen makes him move back until he sits in his chair. Owen wonders what the secret is. He asks about the process. Owen looks around and finds a bag of chemo fluid. He starts preparing the infusion. Hanson wants to leave, but Owen pushes him back into the chair. He takes a needle and instructs Hanson to roll up his sleeve. Hanson refuses, so Owen does it for him. He reveals he knows that Hanson is poisoning healthy women just to make a few extra bucks. He starts looking for a vein when the police arrive outside. Owen stops and tells Hanson not to worry because he’s with him, mimicking Hanson. He then leaves.

Richard finds Amelia. She needs to get away from her mind. She admits she feels the need to drink. He asks her to come.

They enter Ollie’s room. They are doing a meeting. Richard closes the door and Amelia introduces herself to Ollie. They hold hands and open the meeting with the serenity prayer. Richard has accepted the things he cannot change.

Alex is watching Kimmie from outside her room.

Jo and Meredith enter the lab. Taryn and Jo show Meredith that a mouse is growing a new liver that is 60% of normal size. The surprise is that it’s the mouse they injected the liver cells into without a polymer. The liver cells migrated by themselves. They never needed the polymer. Jo says they are going to save a lot of lives, but Meredith says they are going to beat Cerone. Taryn and Jo cheer and hug.

Ben barges into the bedroom because Bailey called him for an urgent matter. He yells at her for faking an urgent call, but she tells him to listen. She knows she gave him a real scare, but he’s been scared long enough. She’s not dying. She’s very much alive and so is he. It is urgent that they celebrate being alive, right here, right now. Naked. She takes off her robe and tears open his shirt. She pushes him onto the bed and starts kissing him.

Jackson and Maggie are on their way out, but he realizes he forgot his keys. He runs back to get them. April comes up with Harriet in a stroller and apologizes to Maggie for being awful at game night. She’s really sorry. Maggie says April was the least of her problems. She slept with a married man and she’s still ashamed over it. April can relate. She slept with the douchey intern and Tom Koracick. And she jumped her ex-husband in the closet. She was a total mess. She says sorry again and then goes to take Harriet home. Jackson returns and asks Maggie if she’s ready, but she just stares at him.

Pictures


Trivia About The Episode

This episode’s title originated from the song Hold Back the River, originally sung by James Bay.


This episode scored 6.84 million viewers.


The table read for this episode took place on January 25, 2018.


The promotional stills for the episode show a party. The scene ended up being cut from the episode, but Camilla Luddington provided context about the content. It was an engagement party thrown for Alex and Jo, who wore a veil made out of gauze. Kimmie Park sang at the party.


Nina Millin tweeted that the baby playing Peggy and Dayna’s daughter was the same baby as the one who played their daughter in Out of Nowhere.

Music Of The Episode

Good Morning By Max Frost


Won’t Let Go of Me By Andrew Jenny Owen Youngs
Broken By Patrick Watson


Love Vendetta By Arrow Benjamin


Bad Got Me Good By Gin Wigmore

Quotes From The Episode

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