Cowgirls Don't Cry

is the thirteenth episode of the nineteenth season and the 413th overall episode of Grey's Anatomy.
==Short Summary==
A bull rider shows up at Grey Sloan with severe injuries, forcing Maggie, Amelia, Owen and Blue to examine their own biases. Elsewhere, Simone can't find anyone to be her maid of honor, and Mika takes drastic measures to pay down her student debt.
==Full Summary==
Maggie and Winston are at couples' counseling. After some encouragement from the therapist, Maggie says she appreciates his kindness the most. Winston in turn says he appreciates her being here as it shows she's willing to work on them, then adds he appreciates how hard she works. Maggie questions how that is a bad thing. He didn't say it was.
Link finds Jo still in bed while the kids are ready to go. She doesn't feel well and asks him to take Luna to daycare.
Ben is driving Bailey to work. He's got the day off. She knows he's just keeping an extra eye on her. They arrive at the hospital and she shows him that they have extended the safety perimeter. She maintains that she'll be fine.
Mika arrives late at the Biomed Donation Center for her bimonthly donation. She is weighed and is told she's three pounds underweight, meaning she can't donate and loses out on the $75 reward.
Levi FaceTimes Carlos and invites him to the on-call room on the fourth floor. Carlos is in Phoenix as he finished his gig in Seattle. Levi didn't know. Carlos says he always seemed more interest in the on-call room than talking. He hangs up on Levi.
Simone talks about how Trey's brother cried when he asked him to be his best man. She and her sister are not speaking. Benson clarifies to Jules that Simone is asking her to be her maid of honor but Jules declines. Lucas arrives angry because Simone and Mika left him again. He was late, even despite the fact that they gave him a fake earlier time of departure, so they left him. Mika stays behind to grab a box of pastries from a trash can. As she stuffs a doughnut into her mouth, she turns around and sees Teddy staring at her. Mika awkwardly leaves. Teddy finishes up her call and tells Amelia that Maggie is being poached by a number of hospitals following her article. Amelia hadn't heard about the offers. She promises to talk to Maggie to get her to stay.
Down in the ER, Owen assigns a case of the sniffles to Simone while taking Benson up to the helipad to meet an incoming trauma from a rural hospital. Mika approaches a coughing patient at the desk when a man in severe abdominal pain walks in. Lucas and Simone rush over to him.
On the elevator, Owen informs Benson that a bull rider was bucked off and stomped on by a bull. Benson hates bull riding, torturing animals to make testosterone-addicts feel more like a man. The patient turns out to be Georgia Arkins, a 16-year-old girl. She has a retrohepatic bleed from an IVC tear and multiple lumbar fractures. Georgia wants to try again as she only lasted 5 seconds on the bull.
Winston says Maggie got a numerous amazing offers. Maggie enthusiastically talks about bio-artificial heart research that she was invited to take part in at the Heart Center of Chicago. Maggie loves Chicago and its deep-dish pizza. Winston is not a fan of the winters there and criticizes the pizza. The therapist asks Maggie if she's considering it. As she starts answering, Winston interjects that he already moved across the country for her. Then when he changed specialties, also for her, she lost all respect for him. Maggie asks him not to put words in her mouth but he points out those were her exact words. Maggie receives a text and says she has to go. Winston think she's walking out because she's in the hot seat now while he put up with her ceasefire for weeks until they finally got her. He can't say he's surprised. She shows him the text was a page since she's on trauma call. She leaves.
Link returns to Jo with coffee. He knows she's not sick. He took a personal day. He knows her body aches to get her to slow down. He knows she deserves a day off. He brought her the mini doughnuts with pink frosting she likes.
Richard is examining Seth's abdomen. He feels like his intestines are being diced and asks for her pain meds but Richard wants to finish the physical exam first. Richard has Simone and Lucas rule out appendicitis with labs and a scan.
Maggie joins Amelia, Jules, Owen, and Benson in the trauma room. Owen informs her about the retrohepatic bleed, which looks contained for now. Amelia diagnoses multiple burst fractures, one of which requires immediate surgery. Georgia asks the doctors not to inform her parents given their reactions over previous injuries she sustained. Maggie decides not to operate since the hematoma is stable. She will be there to monitor while Amelia works on the spine.
Mika is examining Natalie Benardi, the coughing patient. She wants an X-ray but Natalie says she cannot pay for that with her low-wage job without benefits. She just wants antibiotics. Mika needs the imaging to know how serious this is. She promises she'll be back.
Levi is hanging out at Joe's with Taryn. He says Carlos accused him of only caring about the sex. Levi thinks he's the victim here while Taryn says he holds the power as the doctor. Levi says in gay culture, the hotter one holds the power, thus Carlos in this case. Levi is just the nice guy who once again got left. Taryn says the interns who come drinking here don't think he's nice. Levi leaves to go back to work.
Owen, Maggie, and Amelia are talking to Georgia's parents. The safest option would be to monitor Georgia in the ICU. She would likely be paralyzed but leaving the hematoma alone makes for a better chance of survival. Cody says it sounds like the hematoma could rupture at any time, which Maggie confirms. He then asks the doctors to operate to save Georgia's ability to ride.
Lucas and Richard are going over Seth's scans. Lucas is quick to say there is no cause for his complaints. As Richard tells him he's going too fast, Simone arrives to inform them that Seth has been to multiple ER's over the past three weeks. He was discharged each time with a prescription for controlled pain meds.
Seth's doctors confront him with his previous ER visits and his record showing a history of drug use he neglected to tell them about. Seth swears he does not have an addiction. As a young private equity analyst, he used to need adderall to keep going but he hasn't used it in years. Richard contacted the other doctors, who also didn't see anything on the scans. Lucas suggests they need to take more time to study the images but Richard says those other doctors weren't interns. Richard decides to run extra tests and if they are negative, Seth will be discharged with a referral to an addiction specialist. Seth regrets he ever came clean about his drug use.
As Benson and Jules help the scrub nurses to prep the OR, Amelia confronts Maggie in the scrub room about the scrub room. Amelia is sure that if Maggie asks Teddy or Richard for what she needs for her research, they'll approve it. Jules informs them that Georgia is ready.
Lucas finds out that Simone gave him a wrong time for study sessions before. Simone is informed all of Seth's tests came back clean, except his urine analysis, which shows opioid use. Simone decides to discharge Seth per Richard's instructions but Lucas calls Tessa Hobbes. He swore he would follow his gut feeling after they lost her and his gut is telling him that Seth is not lying. He asks Simone to have his back this once.
Georgia's BP is steady so far as Amelia works on her spine. Mika joins Teddy in the ER and asks if they can do her patient's X-ray pro bono. Teddy tells her to follow the protocol and fill out the paperwork for accounting, which may take a day. Mika explains she was eating doughnuts to gain weight in order to be eligible to donate plasma, which she needs to do since she's broke, just like her patient. Teddy insists she go through the proper channels but invites Mika to eat the protein bars in her office any time.
Amelia critiques Georgia's father for his decision. Owen comments lots of parents live out their own fantasies through their kids. Maggie keeps hovering over Amelia. Owen points out they fix up pro football players to get them back on the field in hopes of making the playoffs. Benson repeats his stance on bull riding. Maggie requests they keep the chatter to a minimum.
Levi checks in on Simone and Lucas, feigning interest in their lives. Lucas says Richard told them to discharge this patient but they really think there is something more to it. Levi drops his nice façade and orders them to follow Richard's instructions. Bailey overheard his yelling at them not to question Webber ever again.
Link informs Jo that Tia and her baby are both okay. He checked on them for her. Link assures her she deserves a day off after what happened at the clinic. Jo asks him why it is so hard for her to rest, seeing as he knows her so well. Link says it's hard for him to rest because as a sick kid, he would hear his parents fighting while he was stuck in bed. Therefor, he associates rest with misery. Jo disagrees. She thinks he only has trouble resting when he's not taking care of someone else. He learned to emotionally take care of the people that were supposed to take care of him. That's why he can't rest when he's by himself. He doesn't feel safe when he's not taking care of someone else. Link then says Jo can't rest because she never had anyone to take care of her, so she stays busy all the time to take care of herself. Jo needs a nap. She would like for him to stay. He caresses her hair.
Simone and Lucas are going over Seth's previous scans from the other hospitals but none of them reveal a cause. Lucas is playing with a football, which clears his mind. Simone has the same thing with ice skating, which surprises him. She says he doesn't know everything about her. He agrees. He never picked her as the type to have a big wedding. She only wants the marriage. Trey is the romantic, even making getting pizza a moment to remember. Lucas then realizes scans are just moments, frozen in time. He starts ordering the scans.
In surgery, Benson says riders need to stay on the bull for 8 seconds because that is when the animal starts losing its strength and they stop bucking, which is when people stop being entertained. Georgia's BP drops suddenly. The hematoma ruptured. Maggie orders the staff to flip Georgia. This is her OR now.
Once Georgia has been flipped, Maggie makes the incision. Dr. Knox starts pressors. Winston arrives in the gallery as Maggie works on Georgia.
Georgia's parents worry in the waiting area.
Lucas keeps rearranging the scans as Simone watches.
As Maggie finally visualizes the hepatic vein injury, Benson takes over from Jules to perform cardiac massage. As Maggie ligates, Owen starts packing the retrohepatic space.
Mika returns to the ER, where a nurse has just given Natalie an inhaler and the antibiotics. Natalie wants to go back to work but Mika asks her to stay. They just need to fill out the forms. Natalie insists that Mika can't understand it with her cushy salary. Mika says her government-funded salary does not make up for the 2k worth of debt, let alone the part that she sends to her parents for their mortgage payment after they co-signed all of her loans. Even despite all that, she would get the X-ray to diagnose pneumonia that could prove fatal or keep her out of work for weeks. The payment might be a huge, long-lasting pain in the ass but at least she would be alive. The patient agrees to the X-ray.
Bailey finds Levi in the trauma room as he encourages the ER staff to work faster. She recalls being called a Nazi as Chief Resident. She was sensitive as a child, so she figured she had to overcompensate as a resident, especially Chief Resident. She then realized her idea of herself was out of sync with who she actually had become. She tells Levi he no longer has to think of himself as an underdog. There are many ways to demand excellence from the interns. He wanted to be the vagina of the program because vaginas are strong. They also bring joy and life. He has to be the whole vagina, not just the muscle.
Lucas shows Simone that if you look at the scans in order, there is a re-appearing pattern of flare-ups. He thinks there is a foreign object causing inflammation. Richard then comes in screaming, asking how the patient he told them to discharge is still in the ER.
In the PICU, Amelia and Maggie find a private moment with Georgia's mother. She realizes what they think about her husband. Georgia's grandfather, father, and uncles are all champion riders. Cody never wanted her near a bull. Every Christmas, he gave her typical toys for girls but she always wanted bull riding gear. They figured she would lose interest when she took her first spill but she didn't. After a crushed trachea, they forbade her from riding. She wouldn't eat, speak or sleep afterward. The light in her eyes was gone. They worry about her dying every day but taking her dream away from her would kill her, too. The mother leaves to find her husband. Amelia knows parenting is hard but you have to be a parent. Maggie wonders if it would have worked on her as a teenager. Amelia says she did drugs to hide some very real pain. Maggie points out that may be the case for Georgia. Maybe she's masking the pain of people telling her that she is selfish for chasing her one true passion in life. Georgia wakes up and pulls out her tube.
Maggie and Amelia are tending to Georgia, who wants to know how long it'll take before she can ride again. Amelia says going back would be a mistake. Georgia asks if they would tell her same thing if she were a guy. Maggie says like Georgia, she was very good at something at her age. She skipped grades and won prizes and people thought it was her parents pushing her, but it was all her. She understands Georgia's passion and determination but she was nearly dead or paralyzed a few hours ago. Georgia has to stop fighting them so they can save her future.
Richard is doing a colonoscopy on Seth with Simone and Lucas by his side. In the distal ileum, they find a tooth pick. It's embedded in the intestinal wall thus hidden on the scan. They remove it carefully. Richard is sure it will take away Seth's pain. Richard tells Lucas he pulled off an amazing safe.
In the locker room, Benson brags about having had his hand on a beating heart. He mocks Lucas for finding a bobby pin in a guy's ass although he deems Mika spending her day convincing a patient to get an X-ray even sadder. Lucas thanks Simone for having his back today and he'd like to return the favor. She has an idea, though he can say no if it's too hard for him. He knows her better than anyone here so she would like him to be her man of honor, to have a friend to help her get through all this. Lucas accepts. Levi comes in and compliments all of their work today. He invites them to drinks at Joe's.
At the bar, Mika asks Taryn if they could use another bartender. She'll figure out when to sleep. Taryn will put in a good word. Mika takes a tray of shots to the table. After doing the shots, Lucas hands Simone his beer as a chaser. Benson wonders if he's her babysitter. Lucas then shares he's her man of honor. Jules is relieved that she won't have to carry around blood vials, which is what her mother did at her uncle's wedding. Mika comments that is widely inappropriate. Jules goes to order food and Benson follows her. Levi then asks Simone when the wedding is. It's next month and she immediately adds that she won't take extra time off as Trey will handle most of the logistics. Levi says he was just asking.
Benson invites Jules to get out of here together. She can't since he told her no feelings and she found his stance on animal rights very hot. He says there are no feelings on his side, which convinces her. They leave together.
Maggie is waiting for Winston outside. Winston feels like Italian takeout but she already ordered from Chang's Garden. He's not surprised that she already decided for them. He walks away and she orders him to stop and look at her for what she's about to say. She recalls how he abandoned her the first time she met his family over Zoom. He showed her right then and there who he is and she should have believed him. He retreats when the going gets tough to protect himself, no matter what it costs everybody else. He throws her considering the job in Chicago in her face. She says marriages can survive that but he doesn't seem interested in them surviving. He seems to want to punish her with his absence. He took his love and disappeared inside himself. He couldn't even think of something nice to say about her this morning. Quitting cardio was also him retreating, giving up his gift to avoid direct conflict with her. That is what she does not respect. It's the cowardice that she does not respect. Chicago has the best pizza in the world and she's taking her extraordinary passion there to build hearts and save thousands of lives. He can stay here and pretend that he is the one who was abandoned but they'll both know the truth. She walks off.
Link picks up Scout and goes to check on Jo. He asks her how she's feeling. She hesitates. He hopes she's about say she feels better. She does feel better. Link cheers.
Amelia hands Richard a cup of coffee at an AA meeting. He tells her missed a diagnosis today. But a Shepherd bailed him out. Amelia then says she may be losing another sister.
Ben is waiting for Bailey in the parking lot when someone slips a sheet of paper under his wiper. He gets out of the car and finds it has a picture of Bailey on it, with "Baby Killer" written over it, and her home address and personal phone number underneath. The same paper is on every car in the parking lot. Bailey arrives and he shows her what's going on. He says they are not fine. Bailey is horrified as she realizes that she's being doxed, like Addison was.
==Cast==
19x13MirandaBailey.png|Miranda Bailey
19x13RichardWebber.png|Richard Webber
19x13OwenHunt.png|Owen Hunt
19x13AmeliaShepherd.png|Amelia Shepherd
19x13JoWilson.png|Jo Wilson
19x13MaggiePierce.png|Maggie Pierce
19x13TeddyAltman.png|Teddy Altman
19x13LeviSchmitt.png|Levi Schmitt
19x13AtticusLincoln.png|Atticus Lincoln
19x13WinstonNdugu.png|Winston Ndugu
19x13SimoneGriffith.png|Simone Griffith
19x13BensonKwan.png|Benson Kwan
19x13JulesMillin.png|Jules Millin
19x13MikaYasuda.png|Mika Yasuda
19x13LucasAdams.png|Lucas Adams
19x13BenWarren.png|Ben Warren
19x13TarynHelm.png|Taryn Helm
19x13CarlosGarcia.png|Carlos Garcia
19x13SethKnight.png|Seth Knight
19x13NatalieBenardi.png|Natalie Benardi
19x13ShenaiArkins.png|Shenai Arkins
19x13ZoeyMarchand.png|Zoey Marchand
19x13Paramedic1.png|Paramedic #1
19x13Paramedic2.png|Paramedic #2
19x13NurseLiv.png|Nurse Liv
19x13YvetteBergeron.png|Yvette Bergeron
19x13CodyArkins.png|Cody Arkins
19x13GeorgiaArkins.png|Georgia Arkins
19x13ScoutDerekShepherdLincoln.png|Scout Derek Shepherd Lincoln
===Main Cast===
*Ellen Pompeo as Dr. Meredith Grey (voice only)
*Chandra Wilson as Dr. Miranda Bailey
*James Pickens, Jr. as Dr. Richard Webber
*Kevin McKidd as Dr. Owen Hunt
*Caterina Scorsone as Dr. Amelia Shepherd
*Camilla Luddington as Dr. Jo Wilson
*Kelly McCreary as Dr. Maggie Pierce
*Kim Raver as Dr. Teddy Altman
*Jake Borelli as Dr. Levi Schmitt
*Chris Carmack as Dr. Atticus Lincoln
*Anthony Hill as Dr. Winston Ndugu
*Alexis Floyd as Dr. Simone Griffith
*Harry Shum Jr. as Dr. Benson "Blue" Kwan
*Adelaide Kane as Dr. Jules Millin
*Midori Francis as Dr. Mika Yasuda
*Niko Terho as Dr. Lucas Adams
===Guest Stars===
*Jason George as Dr. Ben Warren
*Jaicy Elliot as Dr. Taryn Helm
*Calvin Seabrooks as Carlos Garcia
*TJ Power as Seth Knight
*Jan Hoag as Natalie Benardi
*Kristin Slaysman as Shenai Arkins
*Anisha Adusumilli as Dr. Zoey Marchand
===Co-Starring===
*Curtis Walker as Paramedic #1
*Laura Linda Bradley as Paramedic #2
*Olivia-Diane Joseph as Nurse Liv
*Brittany Freeth as Nurse Yvette Bergeron
*Brent Walker as Cody Arkins
*Marcelle LeBlanc as Georgia Arkins
*Karis Barry & Kieran Barry as Scout
==Medical Notes==
===Bed Six===
*Diagnosis:
*Doctors:
**Simone Griffith (surgical intern)
*Treatment:
A patient in bed six had the sniffles. Owen asked Simone to check on it.
===Natalie Benardi===
*Diagnosis:
*Doctors:
**Mika Yasuda (surgical intern)
*Treatment:
**Antibiotics
**Inhaler
Natalie, 60, came into the ER coughing. Mika listened to her lungs and heard wheezing, so she wanted to order an x-ray to check for pneumonia. Natalie said she didn't want that because she couldn't afford it. Mika finally persuaded her to get the x-ray and the nebulizer treatment she needed and pay the minimum on the bills until it was paid off.
===Seth Knight===
*Diagnosis:
**Foreign body in the instestine
*Doctors:
**Richard Webber (general surgeon)
**Lucas Adams (surgical intern)
**Simone Griffith (surgical intern)
*Treatment:
**Manual extraction
Seth came into the ER in severe abdominal pain. Richard examined him and he said he had no nausea. They ran labs and got a CT. His scans showed nothing and Simone found out that Seth had visited several other hospitals and gotten pain medication at all of them. He also had a history of drug use. Seth said that drug use was Adderall to stay up for work, but he hadn't done it in years. Richard said they'd run additional tests and if they showed nothing, he would be discharged with a referral to an addiction specialist. The tests showed nothing, but Lucas had a feeling that they were missing something, so he and Simone looked over his scans and eventually saw signs that he had a foreign body in his intestine. They took their findings to Richard, who did endoscopy, which showed that he had a toothpick stuck in his intestine that had perforated his bowel. They used the forceps to remove it.
===Georgia Arkins===
*Diagnosis:
**Crush injuries
**Retrohepatic hematoma
**IVC tear
**T10-L3 unstable burst fractures
*Doctors:
**Amelia Shepherd (neurosurgeon)
**Owen Hunt (trauma surgeon)
**Maggie Pierce (cardiothoracic surgeon)
**Benson Kwan (surgical intern)
**Jules Millin (surgical intern)
*Treatment:
**Spinal surgery
**IVC repair
Georgia, 16, was thrown off and then trampled by a bull. She had crush injuries and retrohepatic hematoma from an IVC tear. She also had multiple lumbar burst fractures. Her spine was unstable, so Amelia said she would stabilize Georgia's spine after Maggie repaired the IVC, but Maggie said she wasn't going to operate on it and instead wanted to wait and see if it would resolve itself. She encouraged Amelia to operate on her spine anyway. They presented the two options to Georgia's parents, who asked Amelia to do her spinal surgery immediately. The hematoma ruptured while Amelia had her spine open, so they quickly covered her incision, then flipped her so Maggie could repair the tear in her IVC. When Georgia woke up after surgery, she pulled out her breathing tube. She was told she'd take six to eight weeks to recover.
==Music==
Song 	Performer 	Scene
"Vibrations" 	Brandon Jenner 	
*Jo asks Link to take Luna to daycare.
*Ben drives Bailey to work.
*Bailey enters the clinic.
*Mika signs in to sell plasma, but she's underweight.
"Set Me Free"	Kelson 	
*The doctors flip Georgia.
*Maggie opens her up.
*Georgia's parents waiting in the waiting room
*Lucas movies around Seth's scans.
*Winston watches Georgia's surgery.
*Maggie finds the injury to Georgia's hepatic vein.
"It's a Vibe"	Beginners, C4 	
*Mika asks Taryn about a job and Taryn offers to put in a good word.
*Levi and the interns do shots.
*Benson and Jules talk at the bar then leave together.
"Fallout" 	Amy Stroup, Oshins	
*Maggie tells Winston she's going to Chicago.
*Link checks on Jo, who says she feels better.
*Amelia and Richard talk.
*Ben finds a flyer doxxing Bailey.
*He tries to chase the person responsible.
*He shows the flyer to Bailey.
"Vibrations" - Brandon Jenner
"Set Me Free" - Kelson
"Fallout" - Amy Stroup, Oshins
==Notes and Trivia==
*This episode's title originated from the song , originally sung by Brooks & Dunn.
*This episode scored 3.30 million viewers.
*Harry Shum Jr. has expressed interest in directing and shadowed director Chandra Wilson while filming this episode.Variety.com ‘Grey’s Anatomy’ Cast, Showrunner Talk Season 19 Relationships, New Intern Class
==Gallery==
===Episode Stills===
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===Behind the Scenes===
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==Quotes==
==See Also==
de:Cowgirls weinen nicht
Category:All Episodes
Category:GA Episodes
Category:GA S19 Episodes