Grey's Anatomy has always loved to fictionalize real medical emergencies, but tonight's episode was really, really real for writer and executive producer Elisabeth Finch.
Finch, who wrote tonight's episode and the fall episode "Anybody Have a Map?," modeled Catherine Fox's (Debbie Allen) cancer journey after her own, writing her own experiences into the show and then watching them play out on set and on screen in front of her. That, for her, was the hardest part.
"Often when I'm writing things I separate a little bit and don't consciously know that I'm putting in so much of my own personal story, and then I go to set and I hear it over and over and over again. And then I realized, oh, holy crap, I just put my life out there and I'm watching it happen," Finch tells E! News.
While Finch admits writing herself into the badass Catherine Fox is a bit of "wish fulfillment," most of Catherine's journey so far matches hers pretty closely, especially in terms of the surgery and the result.
"I did not get to dance it out in my OR, which I super regret now," Finch joked. "You know, Catherine is a very different person than I am fundamentally, but it's the same... I had the same type of cancer, Chondrosarcoma. It was in my spine and my lower spine adjusted it where it would be so that it would impact, potentially, her surgical career, which I do not have, but the outcome is very similar."
Catherine's surgery didn't go 100% as planned. It went more like 95% planned, as one piece of the tumor had to be left to keep her spine intact, which is exactly the same way that surgery went for Finch.
"The majority of my tumor was shrunk with chemo and dealt with in very different medical ways. But some of it remains and may always remain, and that's true of Catherine as well, so Catherine will be walking in the world as a person living with cancer in a similar way that I do. She will continue to be a surgeon. She will continue to have her family and her friends and her full life. I'm the same way that I have a full time job in friends and family and a life."
Finch says she really wanted to say no when showrunner Krista Vernoff asked if she would write her own cancer experiences into the show, but the request came after Finch's own complaints in the writers' room about the way cancer is typically dealt with.
"The genesis of it was me talking in the writer's room casually one day, just about the language that we use surrounding cancer and how much that can aggravate me, and Krista approached me a couple days after that and said, you know, you have a unique perspective on this because you're living with cancer. Would you consider doing a story about that?" Finch recalls. "And I said I would. I wanted to say no because I was a little intimidated by it."
Finch told Vernoff that she would do it, but only on one condition.
"I said that I would if it wasn't just a patient of the week, because I wanted to see a person beyond the surgery. I wanted to normalize what it is to live with cancer, to live with a chronic illness and then only can really happen if it happened to somebody who was on our series. So it was a plan from the beginning to give Catherine a diagnosis and then to have a big surgery and then to have the outcome of that surgery [be], we got most of it and then you're going to have to live with a little bit that's left behind. And that's something we'll get to follow moving forward because that to me is the part that we don't see on television."
From what Finch has seen, the true experience of living with cancer in the way that she is hasn't been shown on TV before.
"It's new to this audience is new to frankly most television audiences," she says. "I've yet to see a version of my cancer on television. I've yet to see a version of my disability on television. And to be clear, everybody with cancer does not have a disability, but because mine is chronic, it's become that, and that's how I identify. We will get to watch Catherine have her normal life, and every once in awhile and do what I do, which is go get some scans and get told whether things shrunk or stayed the same."
As Finch's life has remained much the same, Catherine's will too.
"The fact of the matter is my life is typical and every once in a while is a scan, and I live scan to scan, and I just appreciate the time that I have in between. That's going to be the same for Catherine. We're going to to watch her do surgery again and be with her husband and all those things she listed off [as she woke up]. We're going to get to see Catherine [Fox], and once in a while, we're going to see her managing her cancer."
While Finch says she's not the badass outspoken woman that Catherine is, she is a planner the same way Catherine is, and a little bit of a control freak like Catherine.
"There was a moment in the OR where she hands her son all the plans for all the potential outcomes of the surgery, which I 100% did. I didn't hand it over to someone but I had it in an envelope where it was like planned for every potential outcome during different parts of my illness, which was fun to put it in as a small thing," she says. "And the reality is that cancer is not all bad, devastating moments all of the time. There's weird quirky humor and there's telling people you love to shut the hell up. And Catherine, Catherine and Debbie Allen of course, straddled that humor and that heart so, so, well."
Tonight's only other storyline was one that hit hard for longtime fans of the show. Meredith finally went to visit her dying father, who we haven't seen on screen since 2011.
Thatcher's cancer hadn't responded to treatment, and he had gone into hospice to live out the end of his life at home. Finch said she wanted to be able to show another side to cancer, completely different to Catherine's and her own.
"I wanted to show another version of it without judgment," she said. "He went through treatment, it didn't work, and he is going to die and that's a fact."
"It was an interesting counterpoint to Catherine's experience into the overall theme of when we get sick and we take our medicine and some of us live and some of us die," she continued. "So that was interesting to show from that point of view, and then I just wanted to put those two people in a room who have been so disconnected and give them a ticking clock. Time is running out and they were either going to figure out a way to have some sort of connection through all of the hurt and pain that they've had over the years and disconnect or they weren't.
Meredith and Thatcher talked about everything, from Lexie's devastating death to Derek's devastating death. Turns out Thatcher did attend the funeral, but Meredith was so out of it that he didn't even talk to her.
They ended with Meredith telling Thatcher all about his grandkids, and then he died.
"I think anytime you lose a parent, it's impossible to not take that with you on some level, but I think unlike with so many other people in her life, she had warning, she had a heads up, she's known about him dying for quite some time and she only now made the choice to go, but she's known and she's wrestled with it," Finch explains. "Lexie was taken so quickly and Derek was taken so quickly, there wasn't time to say those things, to have a conversation, to laugh and reminisce and have feeling in real time with that person. And so I think that it does bring a certain sense of peace. It's not perfect. It was never going to be perfect. There was not enough time to write all of the wrongs to fix everything that was broken with them, but they had a little bit of time and a little bit of grace."
Leave it to Grey's Anatomy to hit us where it hurts on every level, in real life and on screen, with a little bit of life and a little bit of death at the same time.
Grey's Anatomy airs Thursdays at 8 p.m. on ABC.