Grey’s Anatomy Season 21 Episode 18 Review: How Do I Live

Grey’s Anatomy Season 21 Episode 18, “How Do I Live,” leaves us with a cliffhanger that questions how many of Grey-Sloan’s doctors could be hurt…  or worse. 

The season finale opens in a lighthearted way that focuses on romantic pairings. There’s the man Simone slept with the night before casually telling her he put his phone number in her phone, Link and Jo wishing they could be on a honeymoon, and some awkwardness between Jules and Winston.

It’s also the interns’ last day, and Bailey brings in their white coats and tells them that everyone will get to scrub in today. In a bit of unfortunate news, though, Bailey also has to tell Ben that Altman has decided whether or not he’ll stay on permanently at the hospital — and the answer is no.  

Meredith is visiting as well, not only to meet the new interns when they arrive, but also to meet with Catherine. She announces that her research is going well and says she wants to sell her shares of the hospital. 

Her being there also means she’s a part of the solution when the tone of the episode takes a decided shift. Dylan’s mom, Jenna, threatens Amelia with an explosive device — a cylinder of highly flammable acetylene.

It’s a suspenseful situation fit for a finale, and it comes with some complex emotional moments too. Given that Amelia must now do brain surgery without the resources she should have for an operation like this, it’s also wildly irrational. 

Amelia’s skills are put to the ultimate test because of it, and she references something she once learned from Derek to help her stay on track. Lucas is there too, because even though Amelia tried to keep him from coming in, her efforts weren’t quick enough.

Two Shepherds working together in this situation, all with the memory of Derek, feels especially significant.

Beltran happens to notice what’s happening to alert everyone else, which quickly creates a panicked situation outside of the OR. SWAT arrives, and Meredith becomes a part of the leadership that decides how to handle the situation — including being part of the phone call to Jenna. 

And in classic Meredith Grey fashion — and I mean classic as in, early dark and twisty Meredith, she busts into the OR with a solution to help Dylan after reading over her labs.

It’s one of the first times all season that Meredith being around felt organic and actually added something to the story as opposed to pulling away from it. There’s no one better to come in at that moment, to take that risk, but also to be able to empathize with Jenna.

Meredith tells her she understands where she’s coming from. She understands the impulse of a mother who would do anything for their child, and everything she says feels completely genuine. 

Meredith’s solution works to allow Amelia to complete Dylan’s surgery, and in the most suspenseful moment of the episode, Jenna drops the tank of acetylene as she cries with relief.

Piper Perabo’s performance here is stellar — it’s emotional, gut-wrenching, and powerful as she declares the tank was empty all along and she drops to the floor in tears of relief while officers come in to arrest her. 

It seems like that’s everything, but with plenty of time left on the episode, any savvy Grey’s Anatomy viewer must have a feeling that more is going to happen — and it does.

In a conversation with Jenna’s husband, after everything has gone back to normal, surgeries are continuing as planned, and everyone’s guard is down — Jenna’s husband reveals that the tank couldn’t have possibly been empty. Despite Lucas running quickly through the halls of the hospital to keep something bad from happening, the episode ends with an explosion that Meredith witnesses from the ground below. 

Just about everyone else is still inside.

For Meredith, this comes after a conversation with Richard and Catherine, where she asks if she can come back to work at Grey Sloan during the summers. She realized she misses being in the OR (and we’ve missed her there too!), so it sets up a more seamless way for her to be in the show in this part-time way that she’s been doing, hopefully, without it feeling so disjointed. 

In part, some of what Richard has said to her has helped her make this decision, too, though his attitude about all of it has been petty, if you ask me.

There’s no telling if this explosion, and whatever casualties might have resulted from it, could affect her plans moving forward to keep her closer to the hospital. 

While the hostage situation is the most suspenseful part of the episode overall, it’s not the only one. Teddy and Winston are also operating on Nora, which they do in the OR right next door, and Teddy refuses to stop and evacuate.

Oddly, it’s reminiscent of Derek refusing to operate on Bailey’s husband when there was another similar situation in Season 2. Remember the bomb in the body episode?

Here, though, Teddy has in her hands the life of a woman she believes her husband is in love with. It’s almost tragic how dedicated she is to saving Nora, desperately wanting to be sure that if anything did happen to Nora, it wouldn’t be her fault.

She and Winston also manage a successful surgery, but after that, Teddy decides to walk away from her marriage. I’ve said it all season, but the problems with Teddy and Owen feel like they’ve come out of nowhere this season — so much so that it’s hard to pinpoint where it all began. 

I’d rather have seen them work everything out, but at least this is some point of resolution. 

Again, though, there’s no telling who’s hurt in that explosion, so this could take an entirely different direction when the series returns for Season 22 in the Fall. 

Other thoughts:

• Of course, among the new interns is the very man Simone had slept with the night before. This is a classic Grey’s Anatomy move at this point, but it still works well and sets up the potential for some interesting drama. 
• Simone and Lucas seem to reconcile after being in a life-or-death situation together, though Simone is still just a little bit hesitant with Lucas’s declarations of love. See my above bullet point to consider how dramatic this could all get.
• Jo and Link are not entirely fun to watch on this episode, though it does add a bit of levity when they emerge from an on-call room to see the chaos — having been completely unaware of what was going on in the hospital while they were in there together.
• The last shift for this group of interns before they move into their second year is… entirely appropriate for anyone working at the hospital Cristina Yang once called “Seattle Grace Mercy Death.”
• Richard talks about retiring and how he hoped that one day when he did, it would be Bailey and Meredith running the hospital. Meredith’s response is what every viewer must also be thinking: “You’ve been threatening to retire since Bailey and I were residents.”

 

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Grey’s Anatomy will return next Fall to ABC.

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