Immunology

Ex-Merck R&D exec Robert Plenge jumps ship to Celgene – FierceBiotech

Robert Plenge is to take the plunge and leave his role at Merck as VP and head of translational medicine to take up a new position at Celgene to run its immunology R&D.

The news has not however come from an official PR from either Merck or Celgene, but rather from Bio-Twitter. Last night Bruce Booth, a partner at Atlas Venture, and David Shaywitz at Forbes, helped break the news.

Exciting (if buried) news from @rplenge hes heading to @Celgene, great get for them, and congratulations, Robert!, Shaywitz said, with Booth adding: The news is out! @rplenge is newest member of R&D leadership team CELG, running immunology research. Great for Robert and for CELG!

The news only came out when it was noticed under Plenges latest blog post that he added: [Disclaimer: I am an employee of Merck, although will soon transition to a new role at Celgene.] His Twitter bio, from which he re-tweeted Shaywitz and Booth this weekend, also now says: soon at Celgene, ex-Merck.

Despite the bulk of its sales coming from several cancer meds, and although it is currently only headed up in the market by its psoriasis drug Otezla (apremilast), immunology and inflammation is a core research area for Celgene.

On the horizon for this unit is ozanimod, which could yield blockbuster sales in multiple sclerosis if approved (filing is expected in that indication by years end at the FDA), with it also in testing for GI disorders including Crohns disease.

And back in January, Celgene spent $300 million upfront with $475 million in biobucks for Delinia, boosting its inflammation and immunology pipeline, as it nabbed the upstarts lead program DEL106, a new IL-2 mutein Fc fusion protein designed to preferentially upregulate regulatory T cells.

It also got its hands on related second generation programs, with its newly acquired early pipeline potentially targeting against a variety of autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis.

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Ex-Merck R&D exec Robert Plenge jumps ship to Celgene - FierceBiotech

Genetics

Young: Into the Tar Pit of Genetics – WorkCompCentral (subscription)

By Julius Young

Workers compensation in California is about to enter the tar pit of genetics.

Julius Young

Thats the take-away fromCity of Jackson v. WCAB (Christopher Rice), an April 26, 2017, ruling by the California Court of Appeals 3rd District that has been certified for publication.

Writing for the three-judge panel, (Blease, Hoch and Renner), Justice Blease finds thatapportionment may be properly based on genetics/heritability.

The case involved a claim of cumulative trauma to the neck of a 29-year-old police officer who had served for five years. This was not a long work history, but Rice alleged that repetitive bending and twisting of his head and neck on the job was the cause of his neck, shoulder, arm and hand pain.

X-rays demonstrated degenerative disc disease, and the qualified medical evaluator found that Rice had cervical radiculopathy and cervical disc disease.

The QMEs report and deposition indicated that heritability and genetics, and genetic issues, were a causative factor meriting apportionment.

In a supplemental report and in deposition,the QME cited various journal articles for the proposition that genomics is a significant causative factorin cervical spine disability.One such study claimed that the role of genetic factors in disc degeneration was as much as 75%. Another study claimed it was 73%.

The court notes that the QMEdecided to err on the side of the patient in case there was some unknown inherent weakness in the studyand thusapportioned out 49% to Rices personal history, including but not limited to the genetic cause of degenerative disease.

The award of the trial judge was based on the QMEs opinion, but the Workers' Compensation Appeals Boardpanel reversed, returning the case to the trial judge for an unapportioned award. The WCAB panel noted that:

Finding causation on applicants genetics opens the door to apportionment of disability to impermissible immutable factors ... Without proper apportionment to specific identifiable factors, we cannot rely upon Dr. [Sloane] Blairs determination as substantial medical evidence to justify apportionment 49% of applicants disability to non-industrial factors.

Rices employer appealed, and thus the case was eventually heard by the Court of Appeals panel.

After noting that there are a number of post-SB 899 cases thatuphold apportionment based on non-industrial pathological degenerative changes, the 3rd DCA states that:

We perceive no relevant distinction between allowing apportionment based on a pre-existing congenital or pathological condition and allowing apportionment based on a pre-existing degenerative condition caused by heredity or genetics.

Rice argued that the QME cannot have known his degenerative disc disease was caused by genetics because the QMEhad never developed data on his family medical history. The DCA panel states:

It was unnecessary for Dr. Blair to conduct such an analysis because her research indicated that genetics or heredity was a majority factor inallcases of degenerative disc disease."

Whether this case will be a game-changer in California workers comp remains to be seen.

The case will be appealed to the California Supreme Court, but whether itdecides to hear it is discretionary.

In the meantime, Ill make some predictions:

And there are major unknowns:

Were already in an era when some individuals are engaging their own genetic tests. Ive participated in 23andme.com, sending off a vial of my saliva. And in fact I get periodic updates about various screenings they do with my genetic material. As mapping the genome gets cheaper, will we see efforts to use that sort of data to rule in/rule out a genetic component to disability? And how scientifically sophisticated are the studies about genetic causation, anyway? This is a field that is rapidly evolving.

There are many questions to be answered. But it looks like a tar pit to me.

Julius Young is a claimants' attorney for the Boxer & Gerson law firm in Oakland. This column was reprinted with his permission from his blog,www.workerscompzone.com.

The Hartford has reported net income of $378 million for the first quarter of the year, a 17% increase from $323 million in the first quarter of 2016. Net income for commercial lines was up 3% in the quarter, to $231 million. But the commercial lines combined ratio of 96.0 was a 4.9-point increase. Read More

One of West Virginia Gov. Jim Justices family coal operations was fined $10,684 for six safety violations following the death of a worker in February. Gov. Jim Justice The state Office of Miners Health, Safety and Training fined Justice Low Seam Mining Inc. for violations discovere. Read More

The Honorable Frank R. McKay, Chairman of the Georgia State Board of Workers Compensation,

Please plan to join us for our Annual All-Day Seminar on Tuesday, May 9, 2017. We hope you find it

The Texas Department of Insurance will host its 2017 Texas Safety Summit from May 9-11 at the Hilt

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Young: Into the Tar Pit of Genetics - WorkCompCentral (subscription)

Genetics

Caring Connections Hosts Talk About Genetics and Cancer and When to Consider Testing – Bangor Daily News

Thursday, May 25, 2017 6 p.m. to 7:30 p.m.

Location: Bangor YMCA, 17 Second Street, Bangor, Maine

For more information: 207-941-2808; bangory.org

On Thursday May 25th, at 6 pm, Caring Connections, a cooperative program of the Bangor YMCA and Eastern Maine Medical Center, will host a talk on genetic testing with Margaret Rieley, MD, ABMG. Dr. Rieley is a physician specializing in the role inherited genetic changes have in our health. She has been working with EMMC Cancer Care since 2014.

About 5 to 10 percent of cancers have an association with an inherited risk. At the present time testing is most commonly available for risks associated with breast, colon, melanoma, ovarian, pancreatic, prostate and uterine cancers. It is now possible to evaluate a large number of genes simultaneously through a blood sample.

When a change associated with an increased risk is identified in someone who has been diagnosed with cancer, it can help them make decisions about their care. Family members can be tested and if they carry the same gene change, screening plans can identify potential cancers at the earliest possible stage.

This presentation is open to anyone interested in learning more about this topic. For more information or to register, call Caring Connections at 941-2808 x 338.

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Genetics

NIMH awards CMU team $7 mil for autism genetics research – CMU The Tartan Online

A team of researchers from various institutions, including some from Carnegie Mellon, working on the Autism Sequencing Consortium (ASC) project has been awarded funding from the National Institute of Mental Health (NIMH) to continue their work through 2022. The grant totals seven million dollars and will allow ASC to expand their work even further in its search for genetic markers of autism. Autism is a spectrum of mental disorders ranging from mild forms that have little to no impact on peoples lives to severe forms that prevent patients from communicating properly, getting regular jobs, or going to regular schools.

ASC was established in 2010 in order to collect, share, and analyze genetic markers from autistic patients, with the ultimate goal of finding genetic signatures correlated with autism.

In our latest project we analyze the entire genomes of 500 autism families. Thats a tremendous amount of data 3 billion base pairs per genome, says Kathryn Roeder, a professor of statistics and computational biology at Carnegie Mellon and a principal investigator of the ASC project, in a university press release.

The grant from NIMH will allow ASC to expand the sample a hundred times larger, to over 50,000 families. So far, around 29,000 individual genomes have been sequenced as part of the project, which is the largest autism sequencing study to date.

According to Bernie Devlin, another principal investigator on the project and a professor of psychiatry and genetics at the University of Pittsburghs School of Medicine, increasing the sample size is necessary to make important discoveries about autism in the long term. Another professor on the team of collaborators, Joseph D. Buxbaum, who is the G. Harold and Leila Y. Mathers Research Professor of Psychiatry, Neuroscience and Genetics and Genomic Sciences at Mount Sinai, summed up the importance of being able to increase the sample size: Historically, the number of risk genes found has steadily increased with the number of patients studied, so its important that we continue to add patients to the data set. He described the team as being thrilled to receive this grant, which he said would accelerate crucial research work.

The research work by the ASC has already produced tangible results on the path to ASCs ultimate goal of determining genetic associations for autism. It has, among other things, developed statistical tools that identified 65 different genes associated with autism risk and predicted the existence of several hundred more such markers, provided information about the possible genetic makeup of autism, and found that although some rare genetic markers can dramatically heighten the risk for autism, most genetic risks for the disorder are carried in common gene variants.

The awarding of this grant means that these findings may well be the roadmap toward finding a more comprehensive set of genetic data for autism and paving the way toward novel methods for helping autistic patients.

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NIMH awards CMU team $7 mil for autism genetics research - CMU The Tartan Online

Embryology

MATC continuing effort to prepare professionals for biotech industry – Wisbusiness.com

Madison Area Technical College is continuing a decades-old effort to churn out workplace-ready professionals to impact the ever-changing field of biotechnology.

Also known as Madison College, MATC offers a certificate in stem cell technologies that was created for working professionals. The 32-week nighttime program was developed in 2011 to help people enter the fields of stem cells and regenerative medicine. Since then, more than 70 people have graduated. But MATC initially launched a biotech training program in 1987.

The school receives major funding from the National Science Foundation for Academic Programs Advanced Technology Education program. Between ATE and other government grants, the school has received about $4.5 million dollars over the last 14 years to develop workforce programs.

Its stem cell program alone has netted $1.6 million, and has a placement rate in the industry of over 90 percent, says Thomas Tubon, project director for the stem cell program at MATC and member of the board of directors for BioForward, a state biotech advocacy group.

The program is split into two semesters; the first focuses on the core lab components of culturing these cells, managing media, and all the fundamentals of stem cells, according to Tubon.

The second semester involves working with industry-based advanced technology like 3D culturing, CRISPR-Cas9 genomic editing, and gene modification.

You name it -- if its on the cutting edge of our emerging industries here in Wisconsin, were trying to move it into the classroom, he said. And were trying to do that with support from our industries, and our academic folks as well.

CRISPR-Cas9 is a relatively new method. It lets scientists accurately cut and paste parts of DNA, giving them the power to determine which genes are expressed in a particular organism, and which are not. They can even introduce unique qualities from other living things.

With the advent of CRISPR/Cas9 for gene editing, this has been fairly easy to do, relatively -- to introduce mutations of interest, said Christine L. Mummery, professor of developmental biology and chair of the department of anatomy and embryology at Leiden University Medical Center in the Netherlands.

This method is already being used to mitigate genetic disorders in animals, and two clinical trials using CRISPR-Cas9 for targeted cancer therapies have been approved in China and the United States, according to a 2016 article in Nature.

Mummery spoke April 19 at the 12th annual Wisconsin Stem Cell Symposium in Madison on the subject of induced pluripotent stem cells. These iPSC are derived from adult cells found in skin, blood or other parts of the body, which are reprogrammed to return to an embryonic-like state. This means they can be developed into any type of human cell, which can then be used for testing.

The sort of low-hanging fruit, and the most exciting area in my opinion, is to do disease modeling, Mummery said. We can look at the underlying mechanisms of disease in humans that weve not been able to do previously as well with mice.

Mummery pointed to drug rehabilitation as another exciting avenue to pursue.

So basically, you find a drug which actually works really well that has nasty side effects, and what a chemist can do is cut off the bits of the molecule and check whether the side effects disappear or not, she said.

The iPSC models can be used to test the effectiveness of these modified drugs, but also for toxicity testing and regenerative medicine, to treat things like Parkinsons, kidney disease and diabetes.

Parkinsons disease looks to be very promising, she added.

MATC was one of the first programs in the United States doing workforce training in biotech, according to Tubon. Its initial biotech program launched in 1987, and the college has been pushing to stay on the frontline of innovation ever since.

As one of the lead programs, weve maintained that status moving forward with developing workforce programs for biotech, for bioinformatics, for stem cells -- for whatever we can project into the future, Tubon said. My assumption is its probably going to be something in the space of tissue engineering. I think thats a pretty safe bet, and well see how far we can push that envelope.

The next MATC effort funded by the NSF will be to get what weve done here, distribute it, and start it at as many colleges as we can across the United States, Tubon says.

About 137 targeted colleges are part of the schools immediate network, and Tubon estimates up to 350 colleges nationwide have the capacity to start their own stem cell workforce development program.

Were reaching out to our first level of partners to get this going, and Im doing that this summer and next summer to help them generate capacity, and then well expand out from there, he said.

--By Alex Moe WisBusiness.com

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MATC continuing effort to prepare professionals for biotech industry - Wisbusiness.com

Embryology

Dr Hrishikesh D. Pai – Huffington Post India (blog)

Dr Hrishikesh D Pai is a seasoned Gynaecologist with almost 3 decades of experience in IVF and infertility management. He is the Medical Director of the Bloom IVF Group which runs nine IVF centres all over India including Lilavati Hospital and Bhatia Hospital, Mumbai and Fortis Hospitals in New Delhi, Gurgaon, Faridabad, Noida, Mohali, and Navi Mumbai. Dr Pai currently holds the position of Secretary General of the Federation of Obstetrics and Gynaecological Societies of India, one of the largest organizations of professional doctors in the country consisting of 33,000 gynaecologists.

Dr Pai began his career after graduating with three distinctions and 2 gold medals in his MD in the year 1989 from the G.S. Medical College in Mumbai. He also has a Master of Science in Clinical Embryology and Andrology from the Eastern Virginia Medical School, USA. He went on to do a clinical fellowship from the Royal Women's Hospital in Melbourne, where the world's second test-tube baby was born. He mastered this technique only to come back and set up the first IVF centre in Mumbai in 1991. Being one of the pioneers in the field of Micromanipulation in India, his unit was the third in India to start the procedure of Micromanipulation- ICSI in 1996 in Mumbai.

Not only has he performed over 10,000 test-tube baby procedures but has also introduced many path-breaking and pioneering techniques in the field of Assisted Reproductive Technology such as assisted laser hatching, spindle view, ovarian tissue freezing for cancer patients, oocyte freezing, IMSI, and embryoscope. His clinic is one of the 10 IVF clinics in India to be recognized to offer Fellowship in super specialty of ART by the National Board, New Delhi.

As part of his teaching and academic pursuits, Dr Pai is an Asst. Adjunct Professor at East Virginia Medical School, USA; Assistant Professor at the D Y Patil Medical College; and post graduate teacher in Gynaecology at the National DNB Examinations, and has trained more than 1000 gynaecologists. He is also the Founder Editor of The Journal of Gynecological Endoscopy& Surgery. He has held many other responsible positions namely President of the Mumbai Obstetrics and Gynaecological Society; and President of the Indian Association of Gynaecological Endoscopists. Previously, Dr Pai was also the Senior Vice President of FOGSI in 2006. He has had many articles and research papers published in national and international books and journals, and has delivered more than 500 guest lectures all over India and abroad.

Dr Pai has been a key contributor to various policy-making bodies of the central and state government. He is member of the Still Birth Committee of the Ministry of Health, GOI, New Delhi 2015. Dr Pai was invited as an expert to suggest changes to the ART Bill 2013 by the ICMR, New Delhi in 2014. He was also a Member of the Committee formed by the Government of Maharashtra, to suggest changes to the ART Bill 2013 and the PCPNDT Act regarding Infertility in 2013 and 2015.

In order to enable poor patients to have access to advanced services, Dr Pai has an IVF unit in the D Y Patil Medical College. In appreciation of his enormous contributions, the international agency Frost & Sullivan bestowed upon him the best IVF group in India award in 2013. Additionally, he was elected to the highest positionin IVF the Immediate Past President of the Indian Society for Assisted Reproduction (ISAR). Dr Pai was also elected as the Member Board of Directors of the World body of Infertility namely International Federation of Fertility Societies (IFFS): a first for an Indian.

Dr Pai has been the Honorary Asst. Consultant for Kurla Municipal Hospital, serving patients for free from 1991 till 2007. Twice, he has been the Community Service Director of Rotary Club. He won the best interns prize for a vaccination programme in the Mumbai slums of Malawni. In another first of its kind in India, Dr Pai as President of the Indian Society for Assisted Reproduction had launched Project Hope. In this, poor patients below poverty line (BPL) can obtain IVF services free of charge in private clinics of ISAR members all over India.

In appreciation of the yeoman scientific, medical, and community service, Dr Pai has been the recipient of numerous awards such as the Rashtriya Ekta Award, Indian Medical Association (Mumbai West) Best Doctor Award, Navshakti Newspaper Award, Jai Hind College Alumni Award, RK Trust Award, Medscape India National Award, Lions International Gold Award, Ferticon Life Time Achievement Award, and Dr Kanal Goel National Indian Medical Association Award amongst others.

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Dr Hrishikesh D. Pai - Huffington Post India (blog)

Cell Biology

Human cartilage has been successfully 3D printed – ZME Science

3D printers have been causing revolutions in many different fields, with materials as different as food, mud, plastic, and plants. The game-changer is that you can create very precise, complex shapes that werent able to be created before. Another use of 3D printing is a potentially life-saving one. 3D bioprinters are being developed that can print out tissues and organs. Some that are being tested now areskin cells, bone, heart tissue, and now cartilage. A team of researchers at Sahlgrenska Academy has created cartilage tissue by printing stem cells with a 3D-bioprinter. It appears to be just like human cartilage and could be used to replace damaged cartilage.

In nature, the differentiation of stem cells into cartilage is a simple process, but its much more complicated to accomplish in a test tube. Were the first to succeed with it, and we did so without any animal testing whatsoever, says Stina Simonsson, Associate Professor of Cell Biology, who led the research.

The lead researcher, Stina Simonsson, holding some 3D-printer cartilage. Image credits: Elin Lindstrm Claessen.

The researchers took cartilage cells from patients who had recently had knee surgery and their cells were manipulated to become pluriplotent, so they can develop into many different types of cells. Next, they created a scaffold to print the cells on. The stem cells were coated withnanocellulose to survive the printing process. Once printed, the stem cells multiplied and were given growth factors so they differentiated into cartilage tissues. The cells formed cartilage cells on the printed structure. After a few weeks, the cells lost their ability to change into other cells. This change is good because pluripotency increases the risk of tumour formation.

We investigated various methods and combined different growth factors. Each individual stem cell is encased in nanocellulose, which allows it to survive the process of being printed into a 3D structure. We also harvested mediums from other cells that contain the signals that stem cells use to communicate with each other so called conditioned medium. In laymans terms, our theory is that we managed to trick the cells into thinking that they arent alone, says Stina Simonsson.

Cartilage can be 3D-printed. Image credits: United States NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases.

The 3D bio-printed structure is very similar to human cartilage. Experienced surgeons did not see a difference between natural and bio-printed cartilage. The cells appear well-formed under the microscope and similar to the patients own cartilage.

When this method is perfected, cartilage could be 3D printed from a patients own stem cells to repair damaged cartilage or heal osteoarthiritis(cartilage decay in the joints). The method can create a lot of cartilage, making it very useful for cartilage replacement. Right now, it isnt known how compatible it is in the human body. The structural material needs to be ableto break down and be absorbed safely by the body so only cartilage is left. Further development and testing needto be conducted. Bioprinting has a lotof potential;in the near future, tissues and organ could be printed on demand.

Journal reference: Nguyen, D. et al. 2017. Cartilage Tissue Engineering by the 3D Bioprinting of iPS Cells in a Nanocellulose/Alginate Bioink. Scientific Reports.

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Human cartilage has been successfully 3D printed - ZME Science

Anatomy

Production halts on ‘The Last Ship’ while its star Eric Dane battles depression – NEWS.com.au

Actor Eric Dane is taking a hiatus from his show to battle depression.

ONE of the best loved stars from Greys Anatomy Eric Dane has taken an indefinite hiatus from his new show The Last Ship to battle depression.

A representative for the actor announced the US navy show would take a brief production hiatus to allow Dane, who is the star of the show, to recover.

Eric asked for a break to deal with personal issues, a representative for the actor told People. He suffers from depression and has asked for a few weeks of downtime and the producers kindly granted that request. He looks forward to returning, he added.

Eric Dane on his TNT show The Last Ship.Source:Alamy

Dane shot to fame for his role as the good looking doctor McSteamy on Greys Anatomy. He starred on the hit medical drama until the shows ninth season in 2012.

The actor has been very open about his struggles in the past.

He announced he was going to rehab in 2011 for an addiction to painkillers from a sports injury and he and his wife Rebecca Gayheart made headlines in 2009 when they became the victims of a leaked, nude video with former Miss Teen USA Kari Ann Peniche.

Dane married Gayheart, who is also an actor, in 2004 and they have since had two girls Billie, seven, and Georgia, five.

Dane with his wife Rebecca Gayheart in 2010. (Picture: Frazer Harrison)Source:AFP

Since his stint in rehab, the actor seemed to be doing well.

I honestly think Im exactly where Im supposed to be at this moment in time, the actor, 44, told PEOPLE in 2014. And Im really happy.

Weve all made mistakes. My one regret is that I got the person I love most wrapped up in all that: Rebecca, Dane added.

The fourth season of The Last Ship is set to premiere in a few months and the show has already been renewed for a fifth season.

The navy drama is a hit for the US cable channel TNT with an average of more than 7 million viewers per episode.

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Production halts on 'The Last Ship' while its star Eric Dane battles depression - NEWS.com.au

Anatomy

Grey’s Anatomy Review: Did Meredith Betray Maggie? – TVOvermind

From day one on Greys Anatomy, Meredith Grey has had difficulty relating to the typical definition of family and sisterhood. She created her own family, adopted her own sister and brother in Alex and Cristina, and learned to accept the family she had by biology. The trick was finding out how to relate her version of family with the families her siblings grew up knowing. It worked out with Lexie, which is what made losing her sister that much more painful. That experience made Meredith that much more protective of her relationship with Maggie. Nothing makes you appreciate the sibling bond than losing one. Meredith has tried to be the best big sister she could be to Maggie, but has a lie of omission changed their bond for good?

Despite the cliche, standing by your partner through the rough times does not make a relationship. Getting to the other side of those rough times stronger does. This applies to both romantic and sibling relationships. Take the medical cases of the week. April, Webber, and Stephanies worm-infested patient cant hope to keep a man when she is a medical marvel. That couple overdramatizes their romance, and when the going gets gross, the grossed-out say goodbye. At least thats what happens at first. Sometimes squishy, dramatic love does beat out worms. On the other hand, Alex, Amelia, and Arizonas patient has the strongest bond of all. I cant imagine anything beating having a baby with your best friend. Its the person you already trust with everything in the world. It doesnt mean you wont disagree on things, but you know your best friend enough to trust in them. Veronica trusted Jeremy to be by her side for the duration of her pregnancy and decline of her cancer battle. She then had to trust that Jeremy would stand by their son the same way, which gave her the strength to let go.

Of all the doctors, Bailey might have the greatest understanding of human bonds. She has a very good understanding of her own marriage, which is why she and Ben have been so stable despite all the career interference. Bailey knows exactly the position Catherine is in because she was Catherine. Bailey didnt know how to be married the first time around because she wasnt married to her equal in intelligence and ego. Now she is, and so is Catherine, but Catherine doesnt know how to do marriage. Catherine is so used to handling things on her own, she couldnt admit she made a mistake that hurt her husband. Thats Amelia and Owens problem too, which is why they cant get on the same page. At least Bailey can kick Catherine into getting it together long enough to apologize to her husband.

Ill give this to Meredith Grey. She has been a much better sibling to Maggie than she was to Lexie in the beginning, and their relationship hasnt had nearly the amount of drama that she has had with Amelia (though I could dissect Amelia and Meredith ten different ways). As Meredith so eloquently explains from practicing her speech with Alex, she really didnt do anything wrong. She never intentionally meant to hurt her sister throughout this thing with Riggs. Nevertheless, the lie of omission is what hurt Maggie. Shes been hanging on by a thread since her mother died, so did not need to be lied to right now. Not to mention, its a little humiliating to find out that your sister has been sleeping with a guy youve been pining over. Maggie wont stay angry at Meredith forever, but that doesnt mean she has to forgive her either.

Is Maggie justified in her anger?

Summary

Meredith has learned to be a better sister since the early days of Grey's Anatomy, but did she come through this time around?

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Grey's Anatomy Review: Did Meredith Betray Maggie? - TVOvermind

Anatomy

Grey’s Anatomy Recap: A Can of Worms – Vulture

Ellen Pompeo as Meredith, Martin Henderson as Riggs. Photo: Mitch Haaseth/ABC

Dont Stop Me Now Season 13 Episode 21

Editor's Rating 3 stars

Worms, you guys. So many worms. Yes, much more emotional stuff went down in Dont Stop Me Now, but attention must be paid to those worms.

You know what? If a gut full of worms puts gross-out aficionado Richard Webber in his happy place, we should allow it. That guy needs to spend a little time in his happy place!

The worms arrive at Grey Sloan Memorial via a very unsuspecting and very lovestruck young lady named Mary. She and her boyfriend, Dennis, are in lurve. Like, barf-inducing love. Stephanies eye rolls are all of our eye rolls. Dennis promises to be there through anything. Well, except for that time when April rushes into the room, having just pulled a worm out of the puke Mary spat all over Aprils hair, and they all realize Mary has a big ol belly full of worms. Dennis wont be there through that. He is disgusted. We all are.

Bailey, however, thinks that since Richard is in a lovely worm-induced happiness, it would be the perfect time for her to attempt to fix his and Catherines relationship. She feels guilty, you see. So, she decides to take on Catherine even if she is the one human whom Bailey fears and enlists April to work on Webber while theyre deworming their patient. Of course, the fact that Dennis possibly bailed on Mary once he heard about the worms makes it easy for April to work in some pointed thoughts about people not being perfect and giving the person you love a second chance. (Dont worry, lovers of love Dennis sheepishly returns to Mary.) It also very easily allows Webber to talk about how sometimes when you find ugliness inside a person, you have the right to walk away.

As you can surmise, April gets nowhere with Webber. After April reminds Bailey that she and Catherine are basically the same person, Bailey casts her Catherine fears aside and goes to talk some sense into the woman. Look at April giving pep talks! In other news, remember when April and Jackson hooked up a few weeks ago? Are we just never going to talk about that again? What happens near a Montana bar owned by Eric Roberts stays near a Montana bar owned by Eric Roberts?

Back to the Bailey at hand. She marches in to see Catherine, and though it starts off rocky, she launches into a Very Bailey Speech about Catherine setting her ego aside so that she can be with a man who loves and respects her. Since Bailey Speeches always work, its enough to convince Catherine to find her man and apologize for the Minnick situation. Honestly, we all deserve an apology for that, but beggars cant be choosers, I guess.

Instead, were given a very cute scene in which Catherine simply says shes sorry and Webber invites her into his on-call room to look at pictures of him removing worms out of a human persons body. Okay, now Webber is truly in his happy place.

There are some figurative worms in Dont Stop Me Now, too. By which I mean the whole can of worms that gets cracked open by a press conference for our airplane heroes, Meredith and Riggs. As the two docs recount what happened on their flight (they couldnt bring the pediatric dentist in for an interview or something? Come on!), Maggie, standing in the crowd like the proud little sister she is, notices Riggs rubbing Merediths shoulder in a more-than-just-friends kind of way. When Meredith catches Maggies eye, its clear that Maggie knows.

She was planning on telling Maggie that day, too! Instead of having a sisterly heart-to-heart, as Meredith had hoped and rehearsed for, Maggie wavers between avoiding Meredith completely and making snide comments about her new relationship all day. The real crux of the episode is their eventual blowout argument. Mer has had enough of Maggies jerk attitude. She is sorry that she didnt tell her, sorry that she hurt her, and she wants them to talk about it. When Maggie finds out that Meredith and Riggs have been, well, Meredith and Riggs since before Amelia and Owens wedding, she really lets her sister have it. Maggies own mother lied to her, and she thought Meredith never would. She trusted Meredith to be honest. Meredith was all she had left. It makes the whole Meredith-Riggs-Maggie shenanigans much more than two girls fighting over a boy. Its really about trust between (new-ish) sisters. Its a great moment.

Back at the homestead, Meredith and Amelia head out for a sister unwinding, but Meredith finds Maggie drinking wine alone on the couch. Maggie wants nothing to do with her, but Meredith wont stand for it. Shes not losing Maggie over some guy. Shes going out whether she likes it or not. Theyre sisters! Maggie gets that she might be mad at Meredith, but she still loves her, too. A girls night it is.

Praise be, you guys! I thought wed be dragging the Meredith and Maggie fight out for several episodes. Perhaps its a reward for sitting through episode after episode of Meredith going back-and-forth on her feelings for Riggs. Man, that was brutal.

Speaking of brutal, Veronica and Jeremy are back. You remember them, right? The pair of best friends who tore our hearts out when they revealed they were having a baby together and that Veronica has aggressive pancreatic cancer and will pretty much only live long enough to give birth? You know, the Veronica who talked about seeing Jeremy watch Star Wars with their child, and the Jeremy who wept when he learned his best friend was dying? THOSE TWO.

Theyre back, and Veronica isnt doing well. Her cancer has spread and Amelia thinks she only has two or three months to live. Arizona and Alex want to deliver the baby now, even if shes only at 34 weeks. Its risky, especially with all the stress Veronicas body is under, but its the best option for the baby. Its a no-brainer for Veronica and Jeremy. Theyre having their baby today.

When Veronica has Amelia and Arizona alone, she asks to fill out a DNR. Shes already dying, and if something should go wrong in surgery, she doesnt want to leave Jeremy with the burden of making that decision. Obviously, something is going to go wrong in surgery. Oh, Greys, you evil bitch.

Before the C-section begins, Veronica makes Jeremy promise that their baby is his priority, not her. So, after their son is safely delivered and the three of them get some short time together, Veronica pushes Jeremy to go to the NICU once things start going downhill and he dutifully does.

Veronica has thrown a blood clot and its in her lungs. They need to remove it immediately or shell die. But Amelia cant guarantee that opening her up to remove the clot will save her life, and so Veronica refuses the surgery. As Veronicas stats drop and she reminds the helpless doctors that she signed a DNR, Amelia sits down next to her patient. She doesnt want her to be alone. Veronica tells Amelia about how shes always loved Jeremy, and how hes loved her for her entire life, and that hell keep on loving her after her death. She wants Amelia to tell him not to look back. To be fearless, for their son. And then Amelia holds Veronica until she passes.

We all knew this is where wed end up. We are all suckers.

Mercifully, we dont have to hear Alex give Jeremy the news. We just watch as he hands Jeremy his son and tells him that his best friend is gone.

Dear lord, can we bring back the worms?

Maam. Doctor. Avery. Good night. Okay, so Baileys speech to Catherine isnt 100 percent like her other speeches. But Catherines not a peasant, so

What was funnier: Baileys disgust when she realizes April had a worm in her hair, or Aprils stink-eye when she realizes Bailey doesnt want to be around her for that very reason?

Webbers disbelief that Catherine would even have to ask if he took pictures with the gut worms makes me extra thankful that they finally make amends.

Perhaps the best reaction to the worms comes from Ben Are Those Worms? Warren. That dude has had some solid O.R. gallery moments this season.

Alex telling Meredith to use the plane as an excuse for how she and Riggs got together because planes have taken so much from them is the truest thing uttered on this show.

Just because you know its coming doesnt make it hurt any less. R.I.P., Veronica, you will be missed.

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The fallout from Chucks big move in Golden Frog Time will be catastrophic.

I will destroy you in ways that are so creative they will honor me for it at the Kennedy Center.

This show is proof that rich storytelling is still possible on network TV.

Its not easy being the CEO of PiperChat.

The series fourth season is scheduled to premiere in June.

Crazy Whitefella Thinking is a wall-to-wall showcase for Scott Glenn.

The pragmatic reality was that there was no money to do a new opening title sequence.

The Bone Orchard is an ambitious, messy introduction.

I was overjoyed, I called Damon up and I said, thank you thank you thank you.

The latest comic ambassador for New York neuroses is from a red state, too.

Our long, national daymare is almost over.

Behold the pre-summer box-office doldrums.

The whole gang was there. (Even Marlon Brando, in a sense.)

Robs secret drinking finally catches up to him.

As soon as you double down on your blackness, they will double down on their bull.

She shouldve just stayed at the beach. Honestly.

Alas, well always have Robby Ray Stewart.

Its hard to get a bead on what Catastrophe is doing this season.

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Grey's Anatomy Recap: A Can of Worms - Vulture