Grey's Anatomy, Season 15

Meredith:
[voice over] There is a portion of the cerebral cortex of your brain, folded deep within an area between the temporal and frontal lobes. It's called the insula, and it's where desire starts. The insula is only about the size of a pea,but what it triggers in our bodies and, by extension, in our lives,can be epic.

Meredith:
[voice over] We'd like to imagine that we're in control. But more often than not...the chemicals in our brains control us. The insula lights up,and we are compelled to change our lives. Compelled by longing. Compelled by yearning. Compelled by desire for more.

Meredith:
[voice over] Just like we need food and water, humans need each other. A brain study revealed that, when placed in an MRI,a patient's reward center lit up when another person sat in the room. Neurons fire when we talk to someone, think about someone,and they go haywire when we hold someone's hand. Our brains and bodies are actually programmed to seek each other out and connect. So, then why do so many people prefer being alone?

Meredith:
[voice over] Why do we often run for the hills when we feel the slightest connection? Why do we feel compelled to fight what we're hard-wired to do? Maybe it's because when we find something or someone to hold onto,that feeling becomes like air...and we're terrified we're going to lose it. And trust me,you can get pretty good at the along thing. But most things are better when they're shared with someone else.

Meredith:
[Voice Over] In the early days of medicine, surgical students would perfect their sewing technique on tree branches. Because looking at an exposed bone in an amputation, human instinct is to recoil, not cut. They needed students to get out of the habit of listening to instinct. A lot of our training is breaking instinct. Developing new habits. Don't react to bad news in front of patients. Don't show fear when faced with uncertainty. When you are looking at that exposed bone, CUT. So the trick is trying to stay human when we have shut down all those gut feelings, all those messy instincts. "

Meredith:
[Voice Over] So what about those times when there is no road map? Should we go with our gut then? If instinct is all we have, it's not always a bad thing. It can bring us wonderful places. Joyful places. And it can also serve an important purpose. Because our gut is usually what warns us when trouble lies ahead.

Meredith:
[Voice Over] When I was little I once asked my mother, how do you tell people such bad news? You tell them the truth, she said. But you tell them the best version of the truth you can come up with. My mother also never told me I had a little sister, so... grain of salt. "

Meredith:
[Voice Over] My mother said, tell the truth! Just tell the best version of the truth you can. Because the truth is going to come out some time. And the one thing you can't do with the truth, is hide from it. Because the truth is gonna come looking. Until it finds you. "

Meredith:
[Voice Over] Everyday we're surrounded by people who ask how we're doing. But when surgeons ask how you're doing, we generally care about your answer. Your answer to "How are you doing?" Tells us how good of a job we're doing at taking care of you. Unfortunately, caretaking outside of medicine is usually more complicated. "

Meredith:
[Voice Over] Surgeons are trained to provide care for others. Some biologists believe it's human nature, the desire to help. Scientists believe we're biologically programmed to empathize. I think it's one of the reasons our species has lasted this long. We have an innate instinct to support each other. You can only take care of yourself for so long. Because lets face it, some problems are way too big to carry on our own. "

Meredith:
[Voice Over] The poet Octavio Paz once wrote, the Mexican is familiar with death. Jokes about it, caresses it, sleeps with it, celebrates it. I can relate. But in a hospital, death isn't celebrated. It's avoided at all costs. And when it comes, it's clinical, almost routine. But still with all that practice. Even surgeons are surprised by death. Especially when it happens to the ones we love. "

Meredith:
[Voice Over] Every religion, every country, every culture. Death means something to all of us. We all have different ideas about how to honour the dead. Different ideas on how to grieve. Different ways of moving on. Well, I may not be an expert, but I do have some experience with losing people I love. And I say, that right way to grieve. Is however the hell you want! "

Meredith:
[Voice Over]

Meredith:
[Opening Voice Over] Time is a strange thing. When you're waiting for something good to happen, it can feel like time is dragging on. But when you want it to slow down, it goes by in the blink of an eye. The off part is time isn't real. It's concept imagined by scientists based on the imperfect movement of the earth around the sun. So why do we put so much importance on something that's just a theory? Because it's all we have.

Meredith:
[Ending Voice Over] there's never enough time. Work, kids, life, death. Something always cuts our time short. So our best bet is to make the most of the time we have. Or make up for lost time. But sometimes, if we're really lucky ...time stand still.

Webber (voice over):
Scientists devour textbooks and data in an attempt to understand the world to gain confidence or clarity. Surgeons are the worst offenders. We study for decades and stare down the barrel of worst-case scenarios. We ignore sleep and friends and food and sex and actual real-life so that we're ready for anything, so we know what to expect and know there's nothing we can't handle.

Webber (voice over):
The problem with all the how-to, step-by-step books is they don't take into account the exceptions to the rules. They never leave room for the outliers, the geniuses, the miracles because books are black and white, and everything in real life is a messy shade of gray. So nothing can truly prepare us for the beautiful, painful things we never imagined possible or the moments no one ever saw coming.

Meredith (voice over):
When we're hurt our body sends signals to form blood-clots directly at the injury to help stop any bleeding. It's our body's system of checks and balances. It's a system that's supposed to save our lives, or so we hope.

Meredith (voice over):
Sometimes our body's signals get messed up and our failsafe goes haywire. Instead of making clots, our body destroys them. And the thing that's supposed to help us only hurts us. It means we start to bleed and everything shuts down.

Meredith (voice over):
We all need a place to feel safe, to feel sheltered, protected. For most people, it means a home. For most surgeons, it means a hospital. In the hospital, we are rarely blindsided. And there's always something to keep us busy. We always know what to do next. It's a cozy little box.

Meredith (voice over):
We look for shelter in a storm but, sometimes, we can't find it. Sometimes, we're at the mercy of the winds - we have nothing left but to accept it. When we face the storm no matter how scary, no matter how much power it has over us, when we face it, we find we are the shelter. We'll survive. We find ourselves coming out the other side stronger for it. We might even find ourselves happy.

Meredith (voice over):
There is an invisible line in the OR - you scrub, you gown, you glove, and you approach the sterile field. It is an important boundary. It's there to protect the patient and you. Without that line about a million things can go wrong. Funny that something so important is completely invisible.

Meredith (voice over):
There is a reason so many babies' first word is "NO". It's because it's the word they hear the most. From the second we are born, we want to cross the line, push the boundaries, test the limits. But then we grow up and learn that not all rules are bad. Some boundaries protect us, some lines keep us safe. But the nice thing is that we can choose for ourselves - we can screw the rules or we can make our own.

Meredith (voice over):
Pharmaceuticals are designed to mimic the body's natural chemicals, the ones that make you feel good, make you feel better, make you feel unstoppable. They make it in a lab and put it in a pill for pain relief, giving you the high your body creates naturally anytime you're doing something you love.

Meredith (voice over):
They call it a high for a reason because the flip side is really low. The chemical version isn't worth what comes after. But the dopamine rush from a job well done? That's free and it's one of the very best parts of being alive.

Meredith (voice over):
In 1967, surgeons and in South Africa performed the first successful heart transplant. The following year, there were 100 heart transplants worldwide. The problem was - the patients kept dying. So the following year transplants fell to 18. Kinda seems like people were a little too eager to celebrate.

Meredith (voice over):
Surgeons are reluctant to celebrate. Even in success, they obsess with what could have been better. And don't get it wrong, that self-reflection is important. We only get better when we admit our shortcomings, acknowledge our limits. But there are so many moments along the way to celebrate. Some are bigger than others, and you really don't want to miss those moments. Because bad times are gonna find you all on their own.

Meredith (voice over):
All diseases have a genetic component. But of course, genes are not always to blame. In diagnosing a disease, physicians must take into account other factors - their environment, their lifestyle. However, some genetic traits are, annoyingly, unavoidable.

Meredith (voice over):
Blood is thicker than water. It means the family you're born into is important above all else, right? Wrong. The original proverb goes a little differently. It actually says, " The blood of the covenant is thicker than the water of the womb". Meaning the bloodshed on the proverbial battlefield bonds us more than simple genetics. And, yes, DNA matters when it comes to medical history. Family is family.

Meredith (voice-over):
Anesthesiology is a lot more challenging than it looks because it's mostly math. A patient's weight, their estimated blood volume, their lung function - all these variables have to be accounted for. It takes careful calculation to suspend a person between life and death. And if one of those variables is off, you might wake up in the middle of your surgery, or never wake up at all.

Meredith (voice-over):
If only life's variables were as cut and dried as the rules of mathematics. If only there were clear answers. Certainty, clarity, right or wrong. But you can only eliminate as many unknowns as possible. Then pick an answer and hope that, at the end of the day, it's an answer you can live with.

Meredith (voice-over):
When there is a poisonous snake on our path, we freeze. When we smell smoke, we run. When faced with danger, fear takes over, and we react desperate to feel safe. But for someone who suffers from trauma, it's the everyday things - a song in a coffee shop, the smell of rubbing alcohol - seemingly random, common things convincing your brain and body you're in danger and there is no way out

Meredith (voice-over):
Too often, trauma gets dismissed as "just in our head". But the pain is real. We feel it in our muscles, our cells, our hearts, our heads. And while there is no magic fix, no pill to make it disappear, we can ask for help. And we can tell our truth whenever we are ready.

Meredith (voice-over):
If the option, we prep our surgery for days - we study, we practice, we run through it over and over again in our minds. Taking on a patient's case is not unlike a marriage. We get to know you inside and out. You trust us with your lives and we promise to protect and care for you. In sickness and health. For better or worse.

Meredith (voice-over):
Almost all human cells reproduce on a cycle. Up to 10% of your heart is replaced each year. Red blood cells are replaced every four months. Skin cells - every two weeks. But neurons, the cells that make up the brain and spinal cord, don't regenerate.

Meredith (voice-over):
It turns out that, under the right conditions, neurons can recover. If they can break from normal operations, and focus on healing, they have a chance at regrowth. It's human nature to want to fix what's broken. We may not be able to replicate exactly what we lost, but in its place will grow something new. It's a long process but it happens slowly, but surely, until we have what we need.

Meredith (voice over):
On average, our heart beats 70 times per minute. In the same 60-second period, we blink between 10 and 15 times, swallow once, and take up to 20 breaths. Our hearts beat, our lungs breathe, our bodies keep us alive, and most of us barely notice. We just take it for granted.

Meredith (voice over):
So much of the world operates without us ever thinking about it. We expect it to work out in our favor, and, most of the time, it does. We worry about the future and think about the past. And we so often miss what's right in front of us. We take what's good and easy and working for granted until it's no longer good and easy and working for us. It's normal but we can do better because there are tiny beautiful gifts we're given every day. And it's up to us to appreciate them to the fullest while we can.

Meredith (voice over):
Here's a partial list of chemicals that our bodies produce when we're falling in love. P.E.A. is a natural form of amphetamine. It puts us on high alert. Pheromones, produced from DHEA, create an inexplicable sense of well-being and comfort. Oxytocin has been called "the cuddle hormone", and it stimulates the secretin of dopamine, estrogen, and LHRH. This cascade of feel-good hormones and neurotransmitters is also generally accompanied by poor judgment. No wonder they call it "crazy in love".

Meredith (voice over):
When we're in love, the prefrontal cortex, where we make most of our good, rational decisions, goes into sleep mode. And the amygdala, which activates our threat response defenses, calls in sick, which leaves us pretty vulnerable to take more risk. And left alone without our normal neurological protections, we might find ourselves in dangerous and unexpected places we normally wouldn't dream of going.

Meredith (voice over):
When a patient is dying on the table, the surgeon has to keep going, no matter what. When we have to pee, we hold it. When we're heartbroken, we ignore it. When we're having a miscarriage and our husband just has been shoot, well, you remember. The hope that we can fix this patient is what keeps us going through the worst moments of our lives.

Meredith (voice over):
There will be no shortage of times when you feel like giving up. But you can't let that fear or desperation stop you even when you feel trapped, even when it feels like there is no end in sight, even when things are moving faster than you can comprehend, even when every part of you is certain that all is lost.

Meredith (voice over):
...fear, unbearable pain, cruel injustice. As surgeons, we are faced with it every day - impossible diagnosis, family tragedy, looming mortality. We face yours while we face our own. And some days, in the thick of it, in the worst of it, we feel just as lost as you do.

Meredith (voice over):
When there is no clear path all we can do is put one foot in front of the other. All we can do is the next right thing. And then the next. In the darkness, in the fog, all we can do is feel our way through. And try to trust that somehow we will come out on the other side.