Grey’s Anatomy Season-Finale Recap: Hail to the Chief

Grey’s Anatomy really does have an ace up its sleeve, doesn’t it? Even after the most dismal season — let’s be honest, season 18 was one of the tougher ones to get through — the show can suck you right back in by putting its history on display. Not every show has 400 episodes to work with! I’m sorry, I’m no match for “Chasing Cars” over a montage of clips from 18 seasons, including Cristina telling Meredith that Derek is not the sun, she is!! I will always get chills when Cristina does that, and that’s just something I have to live with. While the majority of this season was a bit of a snooze (except that literal cliffhanger, baby!), the finale episode — again, the show’s 400th, can you even believe? — resets the game while paying homage to the past in some moving ways.

Or maybe I’ve been subconsciously trained to bawl my eyes out whenever “Where Does the Good Go” plays. WHO CAN SAY?

There’s a lot of tension baked into this double-episode finale. We’ve arrived at that crucial day when Ms. Blake from the Medical Accreditation Board has returned to see what changes have been implemented since she first reviewed Grey Sloan and will make her final verdict on whether the General Surgery Residency Program should be shut down. Oh, and there’s a major blood shortage. So any elective surgeries, and most others, too, if it can’t be helped, are being postponed as long as possible. This hospital is on the precipice of chaos at the exact worst time, but Chief Bailey assures that all will be well once that emergency supply of blood arrives.

Oh, sweet babes, you know that blood is never going to arrive!

But for Meredith Grey, it doesn’t matter much that without more blood even low-risk procedures become dicey once Nick consults with her on a patient’s wild tumor. Cora’s tumor is at the juncture of a whole host of her internal organs, making it almost impossible to operate on, especially with the low blood supply. But Cora doesn’t have a ton of time left, and she’s responsible for her aunt Sally, who suffers from dementia. Cora is up for any type of Hail Mary at this point. After some discussion, Meredith and Nick come up with a solution: an ex vivo surgery in which they would remove all of Cora’s organs, operate on the tumor outside of her body, and then transplant the organs back in. Does that sound risky and dangerous? Good! It is. Webber immediately says no. He’s the chief of chiefs from the Catherine Fox Foundation, so he has the power here. Not only is this 20-hour surgery risky on a good day, with no blood … well, you get it. Not to mention that a screwup here could cost them the residency program. “It’s not the day to go rogue!” he tells them.

Surprising no one: Meredith doesn’t care what Webber says. This isn’t going rogue; this is “cutting edge,” she says! This could save the program, she says! The residency program is in trouble because of something Webber did, and Cora doesn’t deserve to die for that, she says! Nick goes along with his girl, and they convince Cora that she needs this surgery right now. It’s been 400 episodes, I don’t really need to tell you what happens next, right? They get into surgery and everyone is watching — including Ms. Blake — and things go south. They can’t continue without more blood. Meredith says they’ll just pause and wait until that blood shipment arrives. And that’s when we learn that the vehicle transporting the blood was in an accident and all of the blood they need is now scattered in the streets of Seattle.

They take Cora to the ICU, but Meredith is panicking. You know it’s bad when Meredith Grey is panicking! Even Helm is questioning why they had to do the surgery today and not just wait until the blood supply was up. Helm! Webber is livid. He lets Meredith have it: He yells at her for caring only about her opinions, says it’s always whatever Meredith Grey wants, and even says she probably wanted to burn this hospital down before walking away from it all. “Congratulations, Meredith, Ellis would finally be proud of you,” he spits at her. And when I say my jaw dropped immediately to the floor! That is so spiteful and cutting, and we are really living now, people. Nick finally pipes in to say that, uh, maybe Webber is right. They didn’t have to do the surgery today — that was Meredith’s call. And maybe Meredith’s pushing for the surgery did, whether she knew it or not, have some tie to her leaving. Or rather, her not being able to leave.

Cora crashes. Meredith goes out of her mind trying to resuscitate her. We’ve been cutting to clips from old episodes throughout the entire double-episode as memories of Grey’s drama pop into Mer’s mind, and here is an especially gutting one: Meredith trying to keep Derek alive after he’s been shot. It’s intense! Nick is telling Mer she needs to call it, it’s over. Meredith thinks about when she had to take Derek off life support. We are reliving hell! Finally, a broken Meredith stops. Cora is dead. Everything’s a mess.

Ms. Blake has seen enough. She has been up in arms since she overheard that Meredith Grey was leaving and started to wonder what else Bailey may be keeping from her. She understands the blood-shortage situation has added some difficulties to the day, and she knows Bailey is in a good place with fixing the physician shortage, but after everything with the Cora situation, Ms. Blake can see the problems at Grey Sloan much more clearly. The problem, she tells Bailey, is that certain people have been working here so long they’ve become family, and that makes leadership and chain of command confusing. This is a “dysfunctional family,” Blake says. “Webber doesn’t respect your authority over him, Grey doesn’t respect his authority over her.” It makes things messy, and that’s dangerous. So she’s shutting down the residency program, and she wants Bailey to take stock, rebuild, and start fresh.

Well, Bailey decides to “start fresh” in a surprising way: She’s quitting as chief of surgery. This is a problem for many reasons, including that Richard is also leaving. Catherine learned her cancer is responding well to the treatment, and the two of them are celebrating by going on sabbatical. Jackson was already trying to convince Meredith to stay at Grey Sloan a little longer to help Bailey fix things, but now with Bailey leaving too, the convincing turns into begging. She can’t just leave this place now, not after everything. He makes her interim chief of surgery.

We should be celebrating this momentous occasion, right? Our little intern has become chief of surgery! But no one wants to celebrate right now, least of all Meredith, who is angry and upset and, honestly, probably hungry; it’s been a long day. Nick finds her in her office, and it’s time to finish that conversation they started before Cora coded. They did not leave things well! He tries to explain that he doesn’t think Meredith sabotaged Cora’s surgery on purpose, but he does think her decision to operate was informed by a lot of emotional, traumatic factors tied to how Meredith is, whether she wants to admit it or not, having a terrible time bringing herself to leave Grey Sloan. Meredith is livid and beyond upset and tells Nick to go back to Minnesota. He seems to know he can’t reason with her right now — she is processing!! — and although it looks like it pains him, he walks out.

We get a gorgeous final montage that spans all 18 seasons of this show, then Meredith sees herself as an intern standing in the hallway, looking back at her now. What would intern Meredith think of who she is now? What has it all been for? Meredith bolts out the door and calls after Nick, but we’ll have to wait for episode 401 to see how it all shakes out for Meredith Grey, interim chief of surgery at Grey Sloan Memorial Hospital.

The O.R. Board

• Wow, that Simon-Kristen story line really paid off. It was nice to have a patient story worth caring about again, even if we knew it was always going to end with Simon dying. Kristen has an abruption, and they need to deliver the baby — but they also need blood to keep her alive, and in case you haven’t heard THERE IS A BLOOD SHORTAGE. In a devastating turn, Simon, who has been put on ECMO to keep him alive a little longer, tells Winston and Link to give the blood they’ve set aside for the ECMO to his wife. He sacrifices the little time he has left for her! But don’t worry, he gets to hold his son for a moment before he finally dies.

• What a gift! Japril returns for the 400th episode! Jackson is there to deal with the accreditation business as head of the Fox Foundation and also to see his mom, but really they’re there to assure us that Jackson and April are endgame, baby! They kiss! And in an elevator, no less, which, as you know, is Grey’s Anatomy sacred ground. Japril forever!

• After all the Wendell stuff, Maggie is worried that she doesn’t know Winston at all, that they got married too fast. After watching everything with Simon and Kristen, Winston makes a big romantic speech to his wife about how she’s wrong and how they have to “protect this love” that they have because not everyone gets something like this. It’s very nice!!

• Amelia’s walking around brokenhearted — hey, at least it pushes her to have a real heart-to-heart with Link, and those two get some closure finally — but it’s all for naught! In a truly swoony moment, while “Chasing Cars” is playing (!!), Kai shows up in the parking lot and tells Amelia they can’t sleep. The look on their face! Such pain! They are so in love with her! Amelia and Kai get a big sweepingly romantic kiss to close out the season.

• What a way for ol’ Todd to go out, standing there alone with his sex bear. We all knew he was too nice for Jo, and Jo learning that Todd sings one long note when he has an orgasm was just a bridge too far. She dumps his ass. She and Link are still making eyes at each other, especially now that Link has realized he’s fully moved on from Amelia. After a hard day, Jo tells Link that he’s her favorite person and her best friend and that she needs it not to be weird between them. Can’t wait until it gets weird between them again after one kisses the other!

• Doctors on the run?! I knew Owen illegally giving out life-ending medication was going to come back around eventually, but I never thought it would end with Owen and Teddy and their kids as fugitives after the husband of a dying vet reports them when they refuse to help his wife die. But here we are, Doctors on the Run, coming this fall to ABC.

• Where are my Felicity fans at? Did you notice who’s playing Nick’s patient Cora? That’s Kristin Lehman, who you may also remember as Avery, one of Ben’s more manipulative girlfriends. Just a little Ben-Avery reunion happening on Grey’s. If only the ghost of Henry Burton had walked out to say hello!

• Don’t worry, they also used covers of “How to Save a Life” and “The Story” in the 400th episode. Did I miss any big Grey’s musical moments?