Grey’s Anatomy Season 19, Episode 1: “Everything Has Changed”

Tenaya Wallace
published on
November 15, 2022
Episode Review

The premiere episode of Grey Anatomy’s 19th season featured a transplant storyline and the first three minutes of “Everything Has Changed” are basically a PSA for organ donation.

The episode begins with Meredith Grey’s voiceover sharing facts about transplant, such as hearts and lungs can only last for four to six hours outside the body. She tells us about medical advancements, like the profusion options we all saw at AOPO to transport such organs farther. She notes that the goal is to make more organs available and save more lives. Meredith even tells us the number of people waiting, “And for over 100,000 in this country who are currently waiting for an organ, it’s a chance at a new life.”

“Everything Has Changed” takes place on the first day for the new residents. Their focus for the day is on a large number of patients with catastrophic brain injuries after a bus overturned.

The writers use this storyline to give a master-class on brain death.

When Dr. Amelia Shepherd asks the new residents how to declare brain death, Dr. Quan recites: “numerous criteria must be met before the determination of brain death including at least two clinical exams and a confirmatory test such as a brain scan.” The episode goes on to show us the actual brain death testing of 14 patients. When one patient’s eyes are tracking Dr. Shepherd says, “she is not brain dead. She is not dead.” Later in the episode this patient wakes up in a moving moment between a mother, daughter and new resident.

What is noteworthy in this episode is that Grey’s writers go beyond PSA statistics and brain death testing. They take care to humanize the gift of life in many different ways.

When a new resident calls the number of potential donors an “organpalooza” Dr. Shepherd admonishes her saying, “every one of those organs came from a person who was living their life yesterday, a person with family and friends who are devastated today and praying for a miracle.”

When explaining to the new residents how to tell the next of kin that their loved one is brain dead Dr. Shepherd says, “you will take time and care. You will be kind and you will be gentle.” In the OR Dr. Nick Marsh leads a prayer honoring the donor, “The donor is Erin Collins. He loved rugby and he loved science.” The recipient of a three-organ transplant says after surgery, “I want to thank the donor family. Someone’s child died. I want to tell them, I know what they lost.”

The writers also mention the OPO.

This is something television shows are doing more often at the urging of the DLH campaign. Dr. Shepherd says, “we have already alerted the OPOs for potential donors.” Although we don’t see an OPO professional in action, we got the mention.

But television is never perfect and there are two issues with the episode that could impact people’s perception of donation:

1) Dr. Shepherd says that of the 14 patients who are potentially brain dead, nine are organ donors. The problem is, there is no way she would know that information. Indeed, the question itself needs clarification. Do you want to know:

How many of the 14 people are registered as donors? Doctors don’t have that information. Only the OPO can access a state’s donor registry.

How many people meet the criteria for both brain death and organ donation? The doctors wouldn’t have that information until after brain death testing.

2) Dr. Quan lies to a donor family. This was the thing that most people brought to my attention after the episode. However, the lie served a purpose: it help develop a new character.

Dr. Quan shares a moving personal experience with the mother of a potential donor in order to encourage her to say yes to organ donation. He tells her, “I lost my brother in an accident when he was only 16. It was devastating and my life was never the same and there is nothing anyone can say that can take your pain away. But the lives my brother saved when he donated his organs….I cling to that. I cling to it after all these years.”

It was a powerful speech, and a lie since Dr. Quan never had a brother. Through this lie we gleam a clear insight into Dr. Quan’s personality. Grey’s fans now know what he is willing to do to get ahead.

Dr. Quan’s words may not have been true for him, but they speak to a truth that almost every donor family feels. Organ donation is the one good that families cling to and gives meaning to a sudden and tragic death.

“Everything Has Changed” will receive a 2023 Inspire Award. Yes, there were a couple issues, but the episode had a clear explanation of brain death, showed care for donors and their families and highlighted the need for organ donation. That’s a win.