Grey's Anatomy Season 21, Episode 4, "This One's for the Girls," is easily the season's best episode so far. The episode focused on the interns, brought back Helm, and even dropped a couple of surprises for its viewers — including that Meredith's absence, with the exception of her voiceover, was unnoticeable.
As "This One's for the Girls" opens, Mika Yasuda is pacing impatiently outside the hospital. Viewers who caught Season 21, Episode 3, "I Can See Clearly Now," will likely guess — correctly — that Yasuda is waiting for her younger sister to arrive. Chloe was diagnosed with colorectal cancer during "I Can See Clearly Now," and Yasuda has asked the doctors at Grey-Sloan Memorial to help. As Yasuda awaits Chloe's rideshare driver, the other interns show up for work, though they're running late. Simone Griffith doesn't want to be late, especially since it's Miranda Bailey's first day back, and Lucas Adams and Benson Kwan are already taking shots at each other, but the three of them run into Jules Millin and then stop to see Yasuda just in time for Chloe to arrive. Yasuda makes introductions and then sends them off to see Bailey, taking her sister into the hospital while reassuring her.
Not yet at the hospital are Jo Wilson and Atticus "Link" Lincoln, who are taking advantage of having a little extra time in the morning to be intimate in the shower. Ben Warren has his first day back at Grey-Sloan Memorial, and on the way in, Bailey is trying to explain new systems and processes to him when they run into Richard Webber and Winston Ndugu.
Webber introduces Warren to Ndugu, which is odd enough already, since it's not as if Warren lived under a rock while he was working as a firefighter at Station 19. However, Warren then sticks his foot in his mouth by talking about Ndugu's wedding to Maggie Pierce. Bailey manages to steer the conversation to Catherine Fox — the results from the biopsy done in "I Can See Clearly Now" have come in, and they're negative, thank goodness. As they're leaving, though, she tells Warren that her grabbing his arm was a signal to stop talking. His wedding comments were in poor taste, as Ndugu and Pierce are getting a divorce.
Taryn Helm is back, and when she meets up with Levi Schmitt to exchange information about patients, she's still obviously in vacation mode. "This is nothing like a café crème," she says when she sips her coffee, leaving Schmitt exasperated — at least until James shows up, and Helm easily clocks Schmitt's nervous behavior around the chaplain. He asks about her coffee, and she says something about "drinking French now," but the real result of the moment is that Schmitt finally asks James to join him for coffee.
Warren gets a warm welcome from former colleagues inside, but Kwan — as usual — is being unnecessarily competitive and even calls him "Mr. Dr. Bailey." Bailey tells the interns that yes, Warren is her husband, but no, he will not be getting special treatment, and besides, she's more concerned about getting the rest of them through the last four months of their internship year. She passes them off to Helm, who sends Griffith to work with Ndugu and tells Millin and Adams to come with her. Warren and Benson are stuck in The Pit together.
Teddy Altman, back in as the Chief of Surgery since Season 21, Episode 2, "Take Me to Church," comes out of the OR to 100 emails, and her husband, Owen Hunt, who is also just getting out of surgery. Their typically easy cadence is off — Teddy sent muffins and bagels to the house since Owen is often doing the morning routine with the kids, but he came in overnight and didn't bother to tell her. Plus, when she talks with him about the many things she has to do that day, including back-to-back meetings and a quarterly budget report, he tries to tell her to take a break. Teddy curtly reminds him that the job is very different from when he held it a decade ago, and then leaves to go fire an anesthesiologist.
In the loading dock, Helm is instructing Millin and Adams on their task, which is to scan the truck full of cadavers that will ultimately be used for an anatomy dissection class. Neither of them is thrilled, but Helm offers little support, tossing them a phrase in French before leaving them to help unload the truck. Later, it's just the two of them lifting each cadaver onto the bed of the MRI machine for their scan, which is hardly the most exciting job to do at Grey-Sloan Memorial.
In the Cardiac ICU, Griffith and Ndugu are meeting with their patient, 55-year-old Darren Riley (guest star Troy Winbush), who has been admitted for multi-drug resistant gram-negative pneumonia and is itching to be discharged. As a band director who is trying to win a fourth state championship, Riley tells Griffith that there's "music" in her voice and asks if she sings. She tells him that she marched in high school and played the trombone, and he's thrilled to know that she's both a musician and a doctor. Which is good, because the man has no local family and Ndugu is concerned he might be on the verge of some serious heart issues. Griffith is supposed to take him for scans and then stay close. If something happens, someone will need to be on hand quickly.
Yasuda and Chloe are meeting with Webber, who does not have great news for them. The colorectal cancer is more aggressive than originally thought, which has Yasuda pacing around the room before Chloe finally asks her to sit down. There will be chemotherapy and radiation, along with potential surgery, and Chloe starts asking questions about side effects, which is when Webber mentions impaired ovarian function. Chloe is 22 and doesn't know if she wants kids but seems concerned she might not be able to have them, so Webber suggests she meet with an OB/GYN to discuss options. The more they talk about Chloe's treatment, the more Yasuda seems to panic.
Away from the hospital, Schmitt and James have picked up coffee and are taking a walk as they get to know each other better. James tells Schmitt that he was a global nomad before becoming a chaplain, and Schmitt admits that he's never really left Seattle. They talk about James becoming a chaplain — raised Episcopalian and found his faith again after his parents died — and then Schmitt makes a joke about his mother and how she's "a whole other conversation." "You know, I have time," James says. "Do you want to get lunch?" Absolutely, he does.
In The Pit, Warren and Kwan get assigned to a patient who has a thigh laceration, with Warren taking the lead as a fourth-year resident. The only problem is, things have changed since he was last at Grey-Sloan, so Kwan has to help him find sutures, which makes Kwan feel great but diminishes Warren's spirit. Their patient, Judith, recently had a Brazilian Butt Lift, and finally felt well enough to go out, only to fall in her heels. The cut isn't large, but Judith is also complaining of hip pain, so Warren asks Kwan to get Judith's labs while he stitches her up and gets the X-rays.
Back in the Cardiac ICU, Griffith is putting in orders for Ndugu and getting ready to start her rounds when she's approached by Bailey, who asks her to run to The Pit. Griffith asks if there is a particular patient Bailey wants to add to her roster, but Bailey just wants her to observe how the patients are doing — and maybe even the doctors too. That's when Griffith realizes what Bailey actually wants is some intel on how Warren is doing. Though she looks slightly uncomfortable with the task, Griffith isn't about to say no to Bailey.
Elsewhere, Yasuda and Chloe are meeting with Wilson, who talks with them about hormone-replacement therapy, which could help with fertility in the future. Wilson then suggests the step most likely to be successful, which is retrieving and freezing her eggs. Yasuda is hesitant — the process will take at least a month, and that's assuming it works the first time, and the cancer could spread in that time. She asks Wilson for other options, but Wilson says there aren't any. Yasuda begins to get upset and nearly demands that Wilson look at other colorectal cancer cases and talk to the department. That's when Chloe cuts her off.
Back in The Pit, Link has joined Warren, Kwan, and Hunt for a look at Judith's X-rays. The only problem is that the X-ray is the wrong one — it's hard to see hip joints on the X-ray Warren got, though he did think he ordered the whole series. Link says that the system is funky, giving Warren a little leeway, and then Kwan suggests a CT scan. Link says he's right, but Warren's face says it all. It would have been nice of Kwan to suggest that earlier, but it's clear that Kwan is trying to show Warren up a little. Griffith, who has made it to The Pit, overhears the entire exchange.
Near the hospital's information desk, Yasuda runs directly into Millin while carrying a stack of books and papers, all of which end up on the ground. Yasuda shares the news about Chloe's cancer being more advanced, and that Webber has connected them to the Chief of Oncology. Millin, who likes finding the bright side, says that it's good that they've been connected with the chief, but to Yasuda it's terrible. "She has to start chemo and radiation right away, which means she doesn't have time to protect her fertility." Millin inquires if she wants kids, but that's a hard question to answer. "She's 22," Yasuda says. "She doesn't know what she wants for breakfast tomorrow."
Yasuda shares with Millin that Chloe is the youngest of 8 sisters, which meant she spent her whole life being taken to their practices and recitals and wearing their hand-me-downs. "Now that she's finally out of our shadows and starting to live her own life…this." Yasuda and Millin finish picking up the materials Yasuda was carrying as she speaks. "Her future should be wide open, not limited by an awful disease."
The tone of the entire conversation changes when Millin offers the bright side that "at least she'll still be alive." Yasuda lashes out, telling Millin that she can't possibly understand what it feels like before storming off, leaving Millin confused and more than a little heartbroken. One of Grey's Anatomy's other couples is having a much better time than Millin and Yasuda. Sitting at the bar near Grey-Sloan, Schmitt and James are arguing about whether the Millennium Falcon or the Enterprise is better. Their discussion is beginning to get heated, but not in a bad way.
James: "So you would rather be the captain of the Enterprise than Han Solo?"
Schmitt: "Obviously!"
James: "Do you want to go back to my place?"
Schmitt: "Obviously."
The two men leave the bar in a rush, falling into bed together, and it's a very sexy moment — and exactly the kind of joyful love Schmitt has always deserved.
Also in a joyful rush are Adams and Griffith, back at the hospital. She's racing back to the Cardiac unit when he grabs her for a kiss in the stairwell, though it pretty quickly gets interrupted. Then she asks him a "hypothetical question," and wants to know if he would mention a colleague making an inconsequential error. He clarifies that there was no major error and there wouldn't be any consequences, and she tells him that he answered her question. Their exchange is sweet, especially after they went through so much will-they-won't-they in previous seasons, and it's good to see them challenging and supporting each other in Season 21.
Webber finds Yasuda in the library, where she's trying to find information about colorectal cancer and fertility. He reminds her that she's a surgeon, and surgeons often want to fix things, even when there isn't another fix. She admits that Wilson is right, egg freezing seems to be the best option, but then Webber says something that triggers another thought. "Everyone has the same questions, and they reckon with the same concerns," he says. "Cancer is universal that way." Universal. Yasuda wonders aloud if she might be able to find precedent for protecting fertility when treating other cancers, and Webber says exactly what she wants to hear.
On a different floor, Warren finds Wilson, who is thrilled to see him, but he doesn't have time for pleasantries — he has just given someone a heparin drip instead of a prophylaxis, and he needs to know how to stop it. Wilson does what no one else has done all day and walks him through the steps on his tablet, giving him the opportunity to fix it and have time for a breather. "I've had three careers, you'd think I'd remember that the first day is always rough." He says, then sharing with her that it feels like Kwan is "lapping" him, "and "he's only been a doctor eight months." Wilson assures him that he'll be fine and shares that she's had similar transition issues moving from general surgery to OB/GYN. When he asks what is new in her life, she gets ready to tell him about the baby, but Yasuda interrupts them, carrying her stack of papers and books. She needs Wilson's help.
Owen Hunt chases down Altman, bringing her a turkey burger and an apology, sort of. Then, he asks her if she'd get a butt lift, though not because she needs one, an explanation he stumbles through as they get on the elevator. He tells her that he doesn't get the urge to get a butt lift. "It's a surgery, with risks, and why?" He asks. "So you can wear different clothes?" Like always, Owen Hunt has managed to say the wrong thing.
Altman's comments are, as usual, particularly poignant and well-thought-out. Hunt tells her that he was just asking, and she assures him that she was just answering, but the look on his face tells viewers he's regretting bringing Teddy that burger.
Warren and Kwan are finally getting Judith that CT scan, and while they're waiting, her lab tests come back. Judith's white blood cell count is 18,000, which is extremely high. Then the scans come up. There are extensive signs of infection, which Warren races into the other room to look at. Judith has Necrotizing Fasciitis, also known as the "flesh-eating disease." They need to get into the OR right away.
Bailey comes to find Griffith, who tells her that everything was under control, and she doesn't think Bailey has anything to worry about. Bailey, of course, lands on the word "think," and tries to get more. She finally admits that it isn't that she thinks he won't succeed, she also wants to make sure that his experience is objective and that he's being treated the same as everyone else. If she goes and checks herself, that objectivity is taken away, so Griffith agrees to spare another 5 minutes, an action she'll soon regret.
Yasuda, Wilson, and Webber have found a solution for protecting Chloe's fertility that has been successful with cervical cancer patients. They'd move her ovaries up, attaching them to the abdominal wall so that they are outside the radiation field. It hasn't necessarily been done for colorectal cancer before, but Wilson doesn't see why it wouldn't work for Chloe if it worked for cervical cancer patients and tells her that there is a 50 to 80 percent success rate, and Chloe might not even need hormone replacements in the future. Chloe is in and wants to get it done as quickly as possible, and her only falter comes when she learns Yasuda can't be in the room with her because family isn't allowed. "It'll be over before you know it and I'll be as close as I can be, okay?" Yasuda says, and Chloe pushes through her fear. She wants to get it done.
On the way to the OR, Kwan, Link, Hunt, and Warren are trying to explain what is happening to Judith as quickly as possible. She wants a second opinion because she doesn't want them to take her new glutes, but there isn't time for a second opinion. Especially not once Judith codes because she's septic. Once they get her under, Hunt and Link work as fast as they can to remove the infected tissue. Hunt says they need an extra set of hands and asks Warren if he wants to help, praising him for his quick and decisive "yes." When Kwan offers to help, Link tells him to keep suctioning, so ultimately it's Warren who gives Kwan the opportunity to assist. It's a great exchange for the two men, who seem to respect each other more after it happens.
In the Cardiac ICU, Mr. Riley is having some serious trouble breathing and Griffith is nowhere to be found. Ndugu pulls in Helm, who helps apply cricoid pressure so that Ndugu can intubate, but they still have to move him to ECMO. When Griffith finally gets there, Ndugu tells her to wait outside the room, furious that she wasn't watching the patient like he asked.
Finally on their last cadaver, Millin and Adams discuss their cadavers from their anatomy labs. Adams's cadaver was a woman, and they named her Marge and decided she was a trucker. Millin, who never knew either of her grandmothers, looked at her cadaver and thought, "she could be my grandma," and then hoped that she didn't feel alone and was surrounded by people who truly appreciated her. It's a moment that pushes Adams to help re-load the cadavers onto the truck with extra care, and it sends Millin running to take care of something really important.
Back in the Cardiac ICU, Ndugu is still furious that Griffith wasn't with his patient when he began to have trouble breathing and wants to know why she was in the ER when none of his patients are there. Bailey, who had just arrived to try to get more information from Griffith about Warren, steps in before Ndugu can say something he regrets or doesn't mean, especially since it's her fault that Griffith wasn't where she was supposed to be. Bailey explains that she had asked Griffith to be in the ER, not realizing that Ndugu's patient was borderline critical. He tells Bailey that Griffith knew and should have said no, but Bailey reminds him that she's Griffith's boss. "It's not her fault," she tells him.
When Ndugu asks for more information from Bailey about sending Griffith to the ER, since even she wasn't supposed to be working there, he pretty quickly picks up that she sent Griffith to spy on Warren. "Take it from the guy who married, and then divorced, his boss. Get out of your husband's way," Ndugu says, shocking Bailey. "At home you need to be a team. At work, let him be his own person." Ndugu isn't wrong, but he's also clearly still not over what happened with Pierce.
On the OR floor, Chloe is being prepared for her surgery, and Yasuda is watching from the gallery when Millin comes in to hold Chloe's hand through the surgery. It's a moment that shows Yasuda how much she means to Millin, even after she blew up at Millin earlier in the day.
Judith, out of surgery, is devastated at the loss of her new butt. Warren sits down with her and tells her that she hasn't really lost anything — sure, the fat isn't there anymore, but the confidence she gained after the procedure didn't go anywhere.
After Chloe's surgery, Millin tells Yasuda that things went well, and Yasuda thanks her for sitting with Chloe. As Millin leaves, Webber comes to check in and reminds Yasuda that she also has to care for herself, because watching a loved one go through cancer isn't easy. Yasuda learns she'll be able to do that even better than she thought several hours later when the other four interns show up with balloons, flowers, and snacks, along with the announcement that they've covered her shifts for the week, just so she can be with Chloe.
Elsewhere, Wilson races to find Link as she has missed their OB appointment. Carina DeLuca has left, though hopefully Stefania Spampinato will actually make an appearance some time in the near future, but Wilson has another idea.
Hunt finds Altman after she concludes a meeting and tells her he wants to take her to dinner. She starts to tell him she can't, but he explains that they haven't had a conversation that isn't about work or the kids for at least three weeks. He feels like there is something eating away at their relationship, and she finally admits that she feels it too. Hopefully, it isn't something too big — Hunt and Altman have had too many relationship problems already.
On their way out of the Grey's Anatomy hospital, Bailey asks Warren if her being his boss is a mistake. He doesn't think so — they're professionals, and he promises that he will tell her if it ever gets uncomfortable or isn't working. Then he tells her that they should go home because he now has pre-rounds in the morning. Bailey laughs at him.
In the final moments of the Grey's Anatomy Season 21 episode, viewers get a last glimpse at Schmitt and James. They spent the day together, talking about travel and spending more time in bed. While James is asleep and Schmitt is out of bed getting a snack, he reaches for a book James has about Greece, only to uncover the last thing he'd ever want to see — what appears to be the wedding album for James and another man.
Finally, "This One's for the Girls" returns to Wilson and Link. Wilson has taken Link to a private room, and they're using the ultrasound machine together to see the baby. Link can't see the baby at first, but then he spots the fetus. The thing is, there isn't just one fetus — they're having twins.
Grey's Anatomy airs Thursdays at 10/9c on ABC and streams the next day on Hulu.