Jackson and April head to the Avery Medical Center in Bozeman, Montana for a throat transplant
“Freezing. Choking. Getting tongue-tied. It’s what we call it when your mind goes from brilliant to blank.” Got that, kids? As always, this theme will come up later. Jackson and his mother take a car to the Avery jet. Harriet will be in the loving care of her grandmother while her father, Jackson, is away for a few days. He tells his mother to call if she needs him for anything. Catherine reminds him that they could always ship the patients to Grey-Sloan if he doesn’t want to leave, but with the operation being a transplant, and the donor is also in the same hospital, it doesn’t make sense to move them both.
When they arrive at the airstrip, a taxi pulls up with April. Jackson was supposed to be going with Meredith, but Catherine tells him that Meredith’s daughter, Zola, has the flu. Catherine and April have been getting closer lately, so Jackson low-key views this as some kind of scheme. But nevertheless, April hands over baby Harriet to Catherine, and she and Jackson head over to the plane.
Once they’re seated, April can’t help but marvel over how amazing this is, while Jackson is annoyed with her chumminess with his mother. As April sees it, Catherine made the Avery foundation what it is today, so she is definitely someone worth admiring. The stewardess calls April ‘Dr. Grey,’ not knowing that the plans had changed, and offers them champagne, which Jackson rejects on behalf of both of them. They’ll be going straight to the hospital when they land, so they need to be completely sober.
They arrive at the Avery Hospital in Bozeman, Montana, and quickly find out that the donor hasn’t been secured yet. (Sidenote: the doctor previously on the case, Dr. Corridan, had said that a patient in need of a transplant and a perfect donor being in the same hospital at the same time was like winning the lottery. It’s funny to hear him say this when it happens at least once a year at Grey-Sloan.) Here’s the situation: a girl is in need of a new throat after having cancer on her vocal cords. There’s a donor lined up: a brain dead child, but his father has yet to sign consent forms. He believes that Jackson and April have flew in from Seattle to offer a second opinion on his son and come up with some fancy fix. Dr. Corridan leaves it to Japril to give the patient their “second opinion.” (“Oh, yes, we came here with the intent to save your child, but oops, sorry, there really is nothing we or anyone else can do.” Ugh, I hate Corridan for passing this difficult job to someone else.)
The boy’s father, Eric, is so excited to see these fresh-faced surgeons, and ask them what their plan of action is. Do they need to run tests first, or take him straight to surgery? How long until they think he’ll wake up? It had been the son’s 10th birthday, and they attempted to climb a mountain. With a heavy heart, April has to tell Eric that there is nothing they can do. He’s confused why they even came here, and she tells him that they want to talk to him about donating his son’s organs. This deeply upset Eric, and Jackson steps up and tells him that he understands what he’s going through, because when he lost his son, he just needed to find a little meaning in it. At this, Eric agrees to sign the papers.
Jackson and April meet the mothers, Risa and Mary Hodges, of the girl who needs the transplant, Caroline. Mary immediately goes into a rant about how they’ve already met with dozens of doctors who made promises they can’t keep. She makes it clear that Caroline needs this tumor gone, but she needs her voice, too. Jackson introduces himself as a plastic surgeon and ENT specialist (a fact that I forgot until halfway through this episode. “Why is Jackson even here? Why did they send someone who is a plastic surgeon, and why is no one on their staff an ears-nose-throat doctor? Did they ever have one of those on the show before? OH MARC WAS ONE… who was also a plastic surgeon, and oh yeah I guess that’s exactly what Jackson is, too.”). He also introduces himself as a dad (to April’s annoyance) who has came all this way to help their daughter, and he reassures that he does not make promises he can’t keep.
Mary is still unsure about the transplant and thinks the laryngectomy is still the safest option. She’s worried that they’ll cut open her throat and the transplant won’t work. In that case, Caroline would need a permanent trach. Jackson tells them that the transplant is her best chance at survival and maintaining her voice, and he gets Mary to agree to the surgery once again.
April is annoyed (I’m sorry for the repetitive use of the word annoyed, you guys, but that’s what the whole dealio is right now) with Jackson for using his status as a dad to make patients take his advice. Jackson tells her that this is his life, and he doesn’t care if she doesn’t like him using the information with patients. Jackson has somewhere to be, so he leaves April at the hospital.
Jackson stands outside the Jefferson Grill, nervous about going in. He finds his bearings and walks up to the door. Peering through the window, we see a man (played by Eric Roberts). Jackson’s phone rings and April says that she spread out Caroline’s charts and ordered Chinese food, if he wants to come over. He declines, saying he needs to prep alone. He sets up his laptop and charts at a table in the restaurant. Eric Roberts walks over with a beer that is ‘on the house for new customers.’ Eric Roberts is super friendly and upbeat, but Jackson can’t manage to say anything in response.
April gets a call and updates the family that there was a lesion on the donor’s throat, which means it’s no longer a viable option for a transplant. Mary is angry that they had talked her into this, and now it has fallen through. April says that the laryngectomy is the best option now, but Risa says that that is no option at all because Caroline needs her vocal cords. Mary says they’ve already told Jackson that this is not an option. (Throwback to a couple of minutes ago when Mary said that she believed that this was the safest option. My how the times have changed.) They ask if Jackson agrees that this is the best option, but April hasn’t been able to get ahold of him.
She leaves the hospital, calls him, checks his room, and finally finds him at Jefferson’s Grill. Jackson is on his fourth beer and his phone had died, so he wasn’t aware that April had called and texted as much as she had. As he sees it, there’s no organs, so there’s nothing he can do. When April accuses him of bailing on her, Jackson starts to lose his temper and Eric Roberts walks over. At this, Jackson slams his laptop shut, gathers his things, and walks home. April lingers behind for a minute, and Eric Roberts sits down with her. Jackson had left a book, and the man asks if they’re working on airway reconstruction. He clarifies that, though he now runs this bar, he used to be a surgeon. He compares work as a surgeon to work as a bartender, and then introduces himself as Robert Avery. Yes, if it had taken you this long to realize it, this man is Jackson’s father.
Jackson comes to April’s hotel room early the next morning seeming completely fine. She’s asks if he’s okay. He says that he is, and they head to the hospital. April keeps making comments about not knowing why they had to come to Montana instead of moving the patients to Seattle. They quickly start to fight about how Jackson didn’t want her to be the other surgeon on this case, and how April is friends with his mom. She tells him that Catherine compared herself to April because they were born without money, whereas Jackson has always been privileged.
Jackson’s phone rings, and they run to Caroline’s room. Dr. Corridan informs them that Caroline is being discharged. April says that she’s not stable enough to move, but Risa says that the doctors at Baylor think she is. A doctor there thinks that aggressive chemo-radiation, with staged excision after two weeks, is the way to go. April and Jackson had already shot this idea down, but they feel they need to give their daughter a voice, since she doesn’t have one of her own. (I really hope they’ve given the girl a notebook or laptop or something where she can write things out. They act as if she has no way to communicate with anybody.) Since there is a chance of her dying from choking on her own tumor when they move her, they have to sign an AMA form. Mary tells the doctors that they need to give them a reason to stay (Okay, Pacey Witter). Jackson decides to tell them that he has an idea on how to fix Caroline’s voice, when really he doesn’t. Mary gives them until tomorrow at 3.
In the parking lot, April blows up on Jackson for lying to that family. Jackson thinks they’ll miraculously come up with a solution. “Where? At the diner?” April retorts, before confronting Jackson about his father. Jackson says he’s only here because of this patient, as if anyone believes this anymore.
Later, Jackson and April get together to FaceTime with Harriet. Once they’re done, it’s just Jackson and April alone in a room, and Jackson opens up about meeting his father. He had unrealistic expectations about his father seeing him and just knowing who he was. His father handed him a beer and that was it, as if he were anyone. Jackson wanted to tell him what an ass he was for leaving. Even if he couldn’t hack it as an Avery, he should have still showed up for his kid. (This is actually a mini-theme from an episode closer to the beginning of the season with Alex’s pregnant patient at the clinic who has cancer.) When Jackson says that his father doesn’t know his own son, April says that he needs to make his father know who he is.
April walks Jackson to the Jefferson Grill. Jackson tries to back out, but April urges him to say what he needs to say so that all of this will be over and they can get back to work.
Robert walks outside telling Jackson that they’re closed. When he doesn’t budge, he offers to make Jackson something to go. Jackson finally blurts out his name and that he is his son. After a pause, Robert re-greets him with excitement and a hug.
Robert talks so much that it’s overwhelming and Jackson doesn’t know what to do. He asks Jackson if he’s a surgeon and here on to work on a case with April. Robert vaguely tells him about his work at the bar before busting out a special coffee blend that he and his friends created for Jackson to try. Jackson admits that it’s good, and then his father asks him to tell him anything and everything about himself and his life. He pulls up two barstools. Jackson tells him:
- Head of Plastics
- Board chair
- Developing a new protocol with skin grafts, particularly burn victims.
Robert cuts him off, though, saying that with his mother’s name and influence, he knows Jackson would be doing well in his career. What he wants to know is about social life. If he’s married. If he has kids. If he’s happy. When he says, “Yeah, of course.” Robert says that there is no “of course” about it. Jackson asks him the same question, and Robert tells him that he is happy, which is clearly not the answer Jackson had expected to hear. His father has been happy living his life without him. Being an Avery wasn’t Robert’s ‘thing.’ He wasn’t into the galas and the handshaking. He likes his life running a diner. Robert decides to tell Jackson about the night he met his mother. They were both at a gala. She was beautiful and had an amazing laugh. The way he describes it, he was born into that life, but she was born for it. He comments that Catherine’s expectations are crushing, and Jackson gets angry. Classic “I know my family member is The Worst™, but only I’m allowed to address that.” Robert makes to apologize, but Jackson leaves, storming past April outside.
In the morning, Jackson brings April coffee as a friendly gesture/peace offering. She asks if he wants to talk about last night, but he starts talking about the case. The pros and cons of different options. What could work, what could definitely not work. He bobs and weaves between discussing the patient and discussing his father. He tells April about how talkative and polite Robert was, while he clammed up couldn’t make himself say anything. In all of this time growing up without his father, he had never anticipated that his father wouldn’t have even missed him. Jackson mixes up an expression and says that his guts were in his throat, which gives him an idea to use Caroline’s own guts for her own throat.
They tell Dr. Corridan that they want to use a section of her intestines to create Caroline’s throat. Both of her parents have approved this, but Dr. Corridan doesn’t believe it is a good idea since it’s never been done before. Jackson said that it’s never been done before, until today. They’ll be making history, and ask Dr. Corridan if he wants to make history with them. When put like that, he can’t turn them down, but he’s still worried about approval. Pulling out his Avery card, Jackson reminds Corridan that this is an Avery hospital, and he is an Avery, so the only approval Jackson needs is his own.
Mary hugs Jackson before the surgery and tells him that she believes in him. While scrubbing in, Jackson pouts that this isn’t a teaching hospital with a gallery, so no one is even going to witness this surgery like they would at Grey-Sloan.
After the surgery, April and Jackson return to the hotel to get some sleep. Instead of parting ways, Jackson mentions their track record with hotels and kisses April and carries her into his room, shutting the door behind them.
Later, Jackson speculates that his mother knew he was going to seek out his father, and she put April on this case so he wouldn’t be alone. Still lying in bed, April tells Jackson that she has had a good father her entire life, so she is able to say that Jackson is a good father, too. Even with everything that has happened between the two of them, he has been there for April and Harriet, which is something Robert wasn’t able to do for Jackson. She encourages Jackson to truly confront his father.
Jackson makes his third trip to the Jefferson Grill. Robert is excited to see him again, but Jackson says he’s not staying. When he tries to make loose plans for next time, Jackson tells him that he won’t be back. Jackson answers a question from the night before – that he has a daughter named Harriet. Robert calls himself a grandfather, but Jackson informs him that he can’t be a grandfather when he’s never been a regular father. He sees fatherhood as a promise, and he doesn’t break his promises (or so he’s said for the third time this episode. Vows are kind of promises, though, aren’t they? And he divorced April when she begged him to stay).
Caroline’s surgery was a success, and once she is awake, she is able to speak! Tears all around.
Catherine and Harriet are waiting outside of a car when Jackson and April land in Seattle. April takes her daughter, while Jackson thanks his mother for everything.