Grey’s Anatomy is a television behemoth from the brilliant mind of Shonda Rhimes. The show started as a simple idea, as Rhimes heard a female doctor mention how difficult it was to shave her legs in a hospital shower. It created a spark in her mind, and she used her previous experience working as a candy striper to create what would later become her magnum opus.
Grey’s premiered two decades ago, making it the longest-running medical drama in primetime TV history. The show has 21 seasons, over four hundred episodes, and an endless stream of emotional rollercoasters featured throughout. But, without question, there’s nothing more heartbreaking than a character death, and Shonda Rhimes is a master at crafting death scenes to create the maximum amount of suffering for fans. She does it so often that certain cases are bound to get lost in the shuffle, even when they weigh heavily on main characters like Dr. Bailey, including one of the most agonizing deaths in Grey’s Anatomy.
Dr. Bailey Didn’t Always Know Her Specialty
Dr. Miranda Bailey has taken on several roles throughout Grey’s Anatomy’s 21 seasons, ranging from Chief Resident to Chief of Surgery and the director of the hospital’s residency program. But when introduced in the pilot episode, she was a junior resident, a couple of years ahead of the beloved MAGIC era’s interns. Because she was further along in her residency, Bailey’s job was to teach Meredith, Alex, George, Izzie, and Cristina how to be surgeons in their first year.
That dynamic sticks around until Season 4, when the group, except for George, moves into their second year in the residency program, graduating from interns to baby residents. That year, Bailey was promoted to Chief Resident. It was clear from the jump that Bailey was Chief Richard Webber’s favorite and intended protégé, but Bailey wasn’t always on board.
Most surgeons who walk through the halls of the Seattle-based hospital in Grey’s have absolutely no clue what their futures hold. During the first years of residency, the surgeons-in-training aren’t allowed to choose a specialty, but many of them go into the program with a favorite specialty and expect to follow that path. Cristina Yang entered the program for cardiothoracic surgery and followed through. However, others like Meredith Grey leaned toward neuro at the beginning before following in her mother’s footsteps as a general surgeon. General surgery is Webber’s forte, and until Season 5, it seemed that Miranda Bailey would also focus on general surgery. But then she swerved towards pediatric surgery.
Pediatric Cases Can Be Brutal, But Bailey Had a Connection
While the introduction of Dr. Addison Montgomery in the first major Grey’s Anatomy cliffhanger brought fetal surgery to the show, and the surgeons dealt with minors before, the main characters didn’t really deal with pediatric patients until Season 5. In the episode, “Wish You Were Here,” Bailey takes point on a former patient of hers, Jackson, who had a dozen bowel resections and still needed treatment.
She formed a bond with the child and his mother, and instructed Alex Karev to take care of them alongside the hospital’s lead pediatric surgeon, Dr. Kenley. When Kenley suddenly dies in Jackson’s room, Dr. Arizona Robbins wheels into the hospital and rubs Bailey the wrong way in her treatment plan for Jackson. He became a recurring character for several episodes in Season 5. It was gutwrenching for Jackson’s mom, Dr. Bailey, and the audience, as Arizona braced them for the reality that Jackson might not get better.
Thankfully, his luck turned around, but it was only the beginning for Dr. Bailey, who was assigned a nine-year-old cardio patient alongside the visiting cardio surgeon, Dr. Dixon. Dr. Dixon tells Bailey that she acts more like a pediatric surgeon than a general surgeon. The comment resonates, leading Bailey to reject the opportunity to skip the fellowship stage and jump right in as a general surgery attending, instead choosing the peds route. She hoped that choosing to work with children would give her more purpose and help her connect with her maternal instincts more, and while it did, one patient in particular marked the beginning of the end of Bailey’s peds era.
One Patient Was Especially Heartbreaking
Every pediatric case featured throughout Grey’s Anatomy is often tough to watch, as they all involve sick or injured kids. But most of those kids have a fighting chance because of doctors like Arizona Robbins and her protégé, Justin Chambers’ Alex Karev. Season 5’s 20th episode, “Sweet Surrender,” introduced one of the only peds patients that came to Seattle Grace for palliative care.
Jessica Smithson was a six-year-old little girl suffering from a rare genetic disorder called Tay-Sachs, which causes progressive damage to the central nervous system by killing off nerve cells in the brain and spinal cord. The disease primarily affects children, with juvenile Tay-Sachs giving its victims a life expectancy of around 15 years. Infantile Tay-Sachs is the most common form of the disease and cuts the expectancy to around four or five years. Jessica Smithson made it to age six before her time ran out.
Understandably, her dad wasn’t ready to lose Jessica. So, for most of the episode, he’s running around trying to organize enough money to take Jessica to Mexico for an experimental treatment. Jessica is barely conscious, waking up every once in a while to ask for her dad. Dr. Bailey stays with her all day, rocking the child in a nearby chair, noting that she rocks her son, Tuck, when he’s scared. Bailey tells Jessica’s dad to stop and hold her because “she needs her daddy for this part.” Bailey doesn’t leave their side as Mr. Smithson tells Jessica how beautiful Mexico will be when they get there, as her heart stops.
Grey’s Anatomy always has sad patient deaths, but they usually don’t have much of an impact on the show’s plot or any character developments. Jessica’s case wasn’t monumental, but it was part of Bailey’s decision to walk away from a pediatric fellowship. After Jessica’s death, Bailey expressed frustration with not feeling like a surgeon that day. She was also going through a lot around that point, with Izzie Stevens battling cancer and her marriage causing problems. It’s fair to say that Jessica’s case helped push Bailey away from peds, though her husband’s threat of divorce was the final straw. Either way, it’ll always be hard for Grey’s to beat little Jessica Smithson’s death in its ever-growing mission to break the audience’s hearts.
