1 00:00:01,139 --> 00:00:03,003 [Lea] Previously on The Good Doctor... 2 00:00:03,037 --> 00:00:04,452 You go going to the club or work? 3 00:00:04,487 --> 00:00:06,592 Yeah, these early calls are gonna take some getting used to. 4 00:00:06,627 --> 00:00:07,938 [Shaun] Browne retractor. 5 00:00:07,973 --> 00:00:09,250 No Browne retractor. 6 00:00:09,285 --> 00:00:11,011 [Jared] I thought I put it on your tray from the supply room. 7 00:00:11,045 --> 00:00:12,460 [Dr. Andrews] Dr. Kalu is not your peer. 8 00:00:12,495 --> 00:00:14,221 He's your employee, and you are his boss. 9 00:00:14,255 --> 00:00:17,189 I do not plan to give Jared special treatment. 10 00:00:17,224 --> 00:00:20,020 And if I see it, it won't be good for either of you. 11 00:00:20,054 --> 00:00:22,022 I'm not expecting special treatment, Shaun, 12 00:00:22,056 --> 00:00:24,472 but I don't appreciate being treated like an intern either. 13 00:00:24,507 --> 00:00:27,337 Dr. Andrews said he is judging my performance off of your performance, 14 00:00:27,372 --> 00:00:29,236 and your performance is not good. 15 00:00:29,270 --> 00:00:33,033 [Jordan] You come in with your fancy car and your old tricks and think, 16 00:00:33,067 --> 00:00:35,656 "Ta-da, I'm a surgeon," but you're not. 17 00:00:35,690 --> 00:00:37,313 I just want to prove that I belong here. 18 00:00:37,347 --> 00:00:39,349 When I checked on Yara post-operatively, 19 00:00:39,384 --> 00:00:41,075 I noticed you only used eight sutures when you closed, 20 00:00:41,110 --> 00:00:42,973 and she had a small bleed. You should have used ten. 21 00:00:43,008 --> 00:00:45,252 Dr. Glassman closed the galea and skin. 22 00:00:45,286 --> 00:00:48,910 -Dr. Glassman skipped two sutures? -Guess so. 23 00:00:48,945 --> 00:00:50,429 [tense music playing] 24 00:00:52,017 --> 00:00:53,605 [elevator chimes] 25 00:00:54,951 --> 00:00:57,643 At what time did you wake up yesterday morning? 26 00:00:57,678 --> 00:00:59,576 The usual, 5:30. Why? 27 00:00:59,611 --> 00:01:01,854 At lunch, you had a Cobb salad with balsamic vinaigrette, 28 00:01:01,889 --> 00:01:04,443 so that's 450 calories ingested, assuming you kept it down. 29 00:01:04,477 --> 00:01:06,066 Yes, I kept it down. 30 00:01:06,100 --> 00:01:09,517 Did you use a sauna, engage in rigorous exercise, and/or experience diarrhea? 31 00:01:09,551 --> 00:01:11,174 No, I didn't do any of those things. 32 00:01:11,209 --> 00:01:12,693 What's with the questions, Shaun? 33 00:01:12,727 --> 00:01:15,005 You made an error in yesterday's craniotomy. 34 00:01:15,039 --> 00:01:16,731 I'm trying to evaluate various factors 35 00:01:16,765 --> 00:01:18,733 that would negatively impact focus. 36 00:01:18,768 --> 00:01:19,872 I made an error? 37 00:01:19,907 --> 00:01:21,908 You closed with only eight sutures. 38 00:01:21,943 --> 00:01:23,773 The size of the wound required ten. 39 00:01:23,807 --> 00:01:25,188 We need to figure out why. 40 00:01:25,223 --> 00:01:26,948 Why do we need to figure out why? 41 00:01:26,983 --> 00:01:28,881 Two sutures, it's a blip. It's not a thing. 42 00:01:28,916 --> 00:01:32,264 It could be part of a more troubling pattern needing attention. 43 00:01:32,299 --> 00:01:35,233 -Shaun, the surgery was a success, right? -Yes. 44 00:01:35,267 --> 00:01:36,786 The patient had a great outcome. 45 00:01:36,820 --> 00:01:37,925 There is no pattern. 46 00:01:39,478 --> 00:01:40,789 Goodbye. 47 00:01:40,824 --> 00:01:42,826 [upbeat rhythmic music playing] 48 00:01:47,485 --> 00:01:50,420 [softly] I'm a surgeon, and I belong here. 49 00:01:50,455 --> 00:01:53,354 I'm a surgeon, and I belong here. 50 00:01:53,389 --> 00:01:54,976 [sighs] 51 00:01:55,011 --> 00:01:56,012 [exhales sharply] 52 00:01:58,773 --> 00:02:02,260 You are a surgeon, and you belong here. 53 00:02:02,294 --> 00:02:04,054 -[exhales sharply] -[laughter] 54 00:02:04,089 --> 00:02:05,780 I just keep imagining you in the mirror 55 00:02:05,815 --> 00:02:10,301 like, "You have the hair of Tracee Ellis Ross and the swag of Beyonce." 56 00:02:10,336 --> 00:02:11,890 Do not shame my self-care. 57 00:02:11,924 --> 00:02:13,133 [chuckles] 58 00:02:13,995 --> 00:02:16,274 Affirmations are backed by research. 59 00:02:17,206 --> 00:02:18,931 fMRI evidence shows a correlation 60 00:02:18,966 --> 00:02:21,693 with positive changes in the brain. 61 00:02:21,727 --> 00:02:24,144 I've just put the finishing touches on a surprise. 62 00:02:25,145 --> 00:02:26,594 Drum roll please. 63 00:02:28,872 --> 00:02:30,460 Or not. 64 00:02:30,495 --> 00:02:31,841 Well, get your song lists ready 65 00:02:31,875 --> 00:02:34,188 because you are all officially invited to... 66 00:02:34,223 --> 00:02:37,709 -[phone whooshes] -[phones chime] 67 00:02:37,743 --> 00:02:40,608 Star Karaoke, 7:00 p.m. until question mark, question mark. 68 00:02:40,643 --> 00:02:43,853 You know it's gonna be a party when there's double punctuation involved. 69 00:02:43,887 --> 00:02:47,028 Yeah, just the chance to unwind and get to know you all a little better. 70 00:02:47,063 --> 00:02:48,961 Sounds fun. Thanks for the invite. 71 00:02:48,996 --> 00:02:52,413 Prepare to be destroyed. My "Someone Like You" slays. 72 00:02:52,448 --> 00:02:55,485 Need a surgical consult for a clinic patient with a dislocated patella. 73 00:02:55,520 --> 00:02:57,832 -[phone buzzes] -Mm, sorry, ER. 74 00:02:57,867 --> 00:02:59,281 [quirky music playing] 75 00:02:59,317 --> 00:03:02,354 You two are it. Room one. 76 00:03:07,394 --> 00:03:10,190 When did the chest pain start? 77 00:03:10,224 --> 00:03:11,950 I first noticed it Tuesday morning 78 00:03:11,984 --> 00:03:13,503 along with shortness of breath. 79 00:03:14,435 --> 00:03:16,644 [Asher] Are you taking any medications? 80 00:03:16,679 --> 00:03:18,991 I started with one, then switched a few times. 81 00:03:20,890 --> 00:03:23,030 These are used to treat ADHD. 82 00:03:23,064 --> 00:03:24,687 And brain fog. 83 00:03:24,721 --> 00:03:25,757 I'm a COVID long-hauler. 84 00:03:27,276 --> 00:03:32,073 Um, and I just started guanfacine and N-acetylcysteine, 85 00:03:32,108 --> 00:03:35,525 which may actually be helping finally. 86 00:03:35,560 --> 00:03:38,183 -When was your initial infection? -Eight months ago. 87 00:03:38,218 --> 00:03:41,151 It just felt like a mild flu, but then it got worse, 88 00:03:41,186 --> 00:03:43,533 like someone poured molasses on my brain. 89 00:03:43,567 --> 00:03:45,708 I've done cognitive therapy, 90 00:03:45,742 --> 00:03:47,641 memory exercises, 91 00:03:47,675 --> 00:03:48,849 still am, 92 00:03:48,883 --> 00:03:51,023 whatever I can do to get back in the field. 93 00:03:51,714 --> 00:03:53,578 -Which one? -Clover. 94 00:03:54,889 --> 00:03:56,236 I'm an evolutionary biologist. 95 00:03:56,960 --> 00:03:58,514 -Oh. -Wow. 96 00:03:58,548 --> 00:04:02,725 I have been studying how white clover adapts to environmental changes... 97 00:04:04,071 --> 00:04:07,730 [breathing shakily] And I'm on indefinite leave. 98 00:04:07,764 --> 00:04:08,938 Please stop talking now. 99 00:04:11,147 --> 00:04:14,184 Bluish skin, low O2 levels, rapid heart rate. 100 00:04:14,219 --> 00:04:15,600 And increasingly labored breathing. 101 00:04:15,634 --> 00:04:17,291 Possible pulmonary embolism. 102 00:04:17,326 --> 00:04:19,569 Order a chest CTA and echo, stat. 103 00:04:19,603 --> 00:04:20,570 I have to go. 104 00:04:23,608 --> 00:04:26,576 [printer whirring] 105 00:04:28,544 --> 00:04:29,545 Oh. 106 00:04:32,651 --> 00:04:33,825 You will need this. 107 00:04:33,859 --> 00:04:36,414 I sent one half of a high volume order to your printer. 108 00:04:37,794 --> 00:04:40,659 These are Glassman's op reports? 109 00:04:40,694 --> 00:04:42,730 For the last three months. January to March. 110 00:04:42,765 --> 00:04:45,733 October to December is printing in Park's and my office. 111 00:04:45,768 --> 00:04:48,805 So you sent reports for, like, 100 surgeries to my printer? 112 00:04:48,840 --> 00:04:51,152 No, 176 surgeries. 113 00:04:51,187 --> 00:04:52,947 473 pages. 114 00:04:52,982 --> 00:04:55,329 I've emailed Operations to replace your toner. 115 00:04:55,364 --> 00:04:56,986 Many elements are in color. 116 00:04:57,020 --> 00:04:59,299 And why, exactly, do you need all of this? 117 00:05:00,300 --> 00:05:02,819 To find out if his mistake was a blip. 118 00:05:03,648 --> 00:05:06,754 [printer continues whirring] 119 00:05:06,789 --> 00:05:09,343 [opening theme music playing] 120 00:05:16,799 --> 00:05:18,697 Second time I've dislocated my knee. 121 00:05:18,732 --> 00:05:22,114 Uh, first was a few months ago, I think. 122 00:05:22,149 --> 00:05:24,324 -That was the sprained ankle. -Ah. 123 00:05:24,358 --> 00:05:26,153 The dislocation was last year. 124 00:05:26,187 --> 00:05:29,777 Your MRI shows no associated damage to bones or ligaments. 125 00:05:30,813 --> 00:05:34,437 She's also been complaining about dizziness, 126 00:05:34,472 --> 00:05:37,820 swollen ankles, maybe menopause-related. 127 00:05:37,854 --> 00:05:40,478 Dr. Reznick is looking to get her on hormone replacement therapy. 128 00:05:40,512 --> 00:05:43,308 Orion insisted I come in and get everything checked out 129 00:05:43,343 --> 00:05:46,173 before she leaves and moves 6,000 miles away 130 00:05:46,207 --> 00:05:47,968 to live alone. 131 00:05:48,002 --> 00:05:50,971 I'm moving to Prague next week for a new job, 132 00:05:51,005 --> 00:05:53,007 and you can come visit me anytime you want, Mom. 133 00:05:53,042 --> 00:05:54,388 [scoffs] Not with a busted knee. 134 00:05:55,216 --> 00:05:56,804 To move forward with HRT, 135 00:05:56,839 --> 00:05:58,496 I need to confirm all the medications 136 00:05:58,530 --> 00:06:00,290 you've used over the last five years. 137 00:06:00,325 --> 00:06:04,640 Oh, uh, there was a purple triangle one, 138 00:06:04,674 --> 00:06:07,194 but they took me off that last year 139 00:06:07,228 --> 00:06:09,369 and an orange-shaped one. 140 00:06:09,403 --> 00:06:10,577 I'll review it with you. 141 00:06:12,337 --> 00:06:14,512 We need to see how your knee is moving. 142 00:06:14,546 --> 00:06:15,754 Lay back, please. 143 00:06:19,448 --> 00:06:21,553 Go ahead with the exam, Dr. Kalu. 144 00:06:22,554 --> 00:06:23,866 I thought I'd observe. 145 00:06:23,900 --> 00:06:25,005 It's a knee exam, 146 00:06:25,039 --> 00:06:27,283 not a multi-ligament reconstruction. 147 00:06:27,317 --> 00:06:29,906 You told me last time not to assume I know everything. 148 00:06:29,941 --> 00:06:31,287 This is just making me do your job. 149 00:06:31,839 --> 00:06:34,290 [snoring] 150 00:06:34,842 --> 00:06:37,293 [gasping] 151 00:06:37,327 --> 00:06:40,296 That sounded like an apneic spell. Check her tonsils. 152 00:06:40,917 --> 00:06:41,987 Ms. Garcia. 153 00:06:42,022 --> 00:06:44,231 [snores] 154 00:06:44,265 --> 00:06:45,370 [clears throat] 155 00:06:45,405 --> 00:06:46,682 Mm? 156 00:06:46,716 --> 00:06:49,409 Oh, did I fall asleep again? 157 00:06:49,443 --> 00:06:50,789 Yes. 158 00:06:50,824 --> 00:06:52,446 Can I take a quick look in your mouth? 159 00:06:52,481 --> 00:06:53,758 Mm-hmm. 160 00:06:53,792 --> 00:06:55,553 [rhythmic music playing] 161 00:06:56,761 --> 00:06:58,383 Kissing tonsils. 162 00:06:58,418 --> 00:06:59,902 They're so enlarged, they're touching 163 00:06:59,936 --> 00:07:02,422 and obstructing your airway, causing severe apnea. 164 00:07:03,388 --> 00:07:04,907 You need a tonsillectomy right away. 165 00:07:10,084 --> 00:07:13,087 No pulmonary embolism, but multiple cardiac issues. 166 00:07:13,122 --> 00:07:15,227 Severe narrowing of the pulmonic valve, 167 00:07:15,262 --> 00:07:16,781 hypertrophied right ventricle 168 00:07:16,815 --> 00:07:18,472 and opening between the lower chambers. 169 00:07:18,507 --> 00:07:21,130 This set of defects almost looks like 170 00:07:21,164 --> 00:07:22,787 -tetralogy of Fallot, but-- -It is. 171 00:07:24,858 --> 00:07:26,963 She has the fourth malformation, 172 00:07:26,998 --> 00:07:28,137 overriding aorta. 173 00:07:28,171 --> 00:07:30,450 I've never seen tet in an adult before. 174 00:07:30,484 --> 00:07:32,486 [soft dramatic music playing] 175 00:07:32,521 --> 00:07:34,246 How is she still alive? 176 00:07:36,007 --> 00:07:37,111 Hang on a sec. 177 00:07:37,146 --> 00:07:38,457 I have to write everything down now. 178 00:07:40,874 --> 00:07:43,082 [Dr. Lim] Tet is almost always diagnosed in infancy. 179 00:07:43,117 --> 00:07:45,154 Doctors somehow missed it in your case. 180 00:07:45,188 --> 00:07:47,467 [Shaun] Oh, you have a rare presentation. 181 00:07:47,501 --> 00:07:49,469 The right ventricle obstruction has been balanced 182 00:07:49,503 --> 00:07:51,747 by an increased flow into the left ventricle. 183 00:07:51,781 --> 00:07:54,612 Damage from COVID disrupted the balance. 184 00:07:54,646 --> 00:07:56,027 The virus may have saved your life. 185 00:07:56,061 --> 00:07:57,683 Very few undiagnosed tet patients 186 00:07:57,718 --> 00:07:58,926 survive past childhood. 187 00:07:58,961 --> 00:08:01,066 A mere 2% make it to 40. 188 00:08:01,101 --> 00:08:02,447 You're saying 189 00:08:02,482 --> 00:08:04,104 I would have just dropped dead at some point? 190 00:08:04,138 --> 00:08:06,106 It's very likely. 191 00:08:06,140 --> 00:08:09,799 We can remove that risk with two separate procedures. 192 00:08:09,834 --> 00:08:12,043 First, we'll close the extra vessels 193 00:08:12,077 --> 00:08:14,701 that have formed to compensate for your heart defects. 194 00:08:14,735 --> 00:08:16,772 Then we'll do a surgery to repair those defects. 195 00:08:19,706 --> 00:08:21,880 Is it possible the tet is connected 196 00:08:21,915 --> 00:08:23,433 to my long COVID symptoms? 197 00:08:23,468 --> 00:08:25,366 Could fixing my heart clear up my head, 198 00:08:27,023 --> 00:08:28,162 the brain? 199 00:08:29,129 --> 00:08:31,614 No. I'm sorry. 200 00:08:31,649 --> 00:08:33,616 [tender music playing] 201 00:08:41,072 --> 00:08:42,245 You snagged our table. 202 00:08:43,315 --> 00:08:44,869 Beat Hawks and Nunez to it. 203 00:08:44,903 --> 00:08:46,733 You're a champion. 204 00:08:46,767 --> 00:08:49,390 One Splenda, half Sugar in the Raw, light almond milk. 205 00:08:49,425 --> 00:08:50,495 Now who's the champion? 206 00:08:50,530 --> 00:08:51,531 Mm. 207 00:08:55,258 --> 00:08:56,536 I have something for you. 208 00:08:57,606 --> 00:08:58,917 -Really? -Mm-hmm. 209 00:09:02,749 --> 00:09:03,715 [chuckles] 210 00:09:05,717 --> 00:09:08,720 An agreement acknowledging a consensual relationship. 211 00:09:08,755 --> 00:09:11,033 I, Marcus Andrews, would like to take you, 212 00:09:11,067 --> 00:09:13,760 Dalisay Villanueva, on a date. 213 00:09:13,794 --> 00:09:17,867 And as hospital president, you know, I already signed it. 214 00:09:17,902 --> 00:09:19,869 [chuckles] 215 00:09:19,904 --> 00:09:20,939 This is so romantic. 216 00:09:22,078 --> 00:09:23,114 Give me the pen. 217 00:09:26,600 --> 00:09:27,774 [chuckles] 218 00:09:30,155 --> 00:09:32,744 -Dinner this weekend? -Let me see. 219 00:09:32,779 --> 00:09:34,539 -[phone chimes] -Oh, I'm needed on the ward. 220 00:09:35,160 --> 00:09:36,679 Sorry. Lock it down later? 221 00:09:36,714 --> 00:09:37,715 Sure. 222 00:09:45,723 --> 00:09:46,758 Iced coffee? 223 00:09:46,793 --> 00:09:48,139 I'm good. 224 00:09:49,105 --> 00:09:50,417 How about a hot coffee? 225 00:09:52,937 --> 00:09:56,181 In honor of Daphne's successful tonsillectomy, 226 00:09:56,216 --> 00:09:57,597 I got a few options. 227 00:09:59,253 --> 00:10:00,738 Is that a latte? 228 00:10:00,772 --> 00:10:01,739 Mm. 229 00:10:03,810 --> 00:10:06,053 It was a routine tonsillectomy. 230 00:10:06,088 --> 00:10:07,917 Those were unusually large tonsils. 231 00:10:09,298 --> 00:10:10,713 A good thing her daughter brought her in. 232 00:10:13,440 --> 00:10:15,097 You think Daphne was better off not breathing? 233 00:10:15,131 --> 00:10:16,719 I don't think it's a daughter's job 234 00:10:16,754 --> 00:10:18,514 to make sure Mom goes to the doctor. 235 00:10:19,066 --> 00:10:20,412 [phones chime] 236 00:10:21,931 --> 00:10:22,967 It's Daphne. 237 00:10:23,001 --> 00:10:25,659 [dramatic music playing] 238 00:10:25,694 --> 00:10:27,178 Heart rate spiked. She's hypoxic. 239 00:10:27,212 --> 00:10:28,662 Turn up oxygen to max flow. 240 00:10:32,977 --> 00:10:35,186 Loud murmur from the right ventricle and atrium. 241 00:10:35,220 --> 00:10:37,015 Chronic damage from apnea could have increased 242 00:10:37,050 --> 00:10:38,810 the pressure in her lungs, causing right heart failure. 243 00:10:38,845 --> 00:10:40,605 -[machine beeping] -BP's dropping. 244 00:10:40,640 --> 00:10:41,744 We need to get her to the cath lab. 245 00:10:47,612 --> 00:10:48,993 [Dr. Lim] Positioning coiling system. 246 00:10:50,304 --> 00:10:51,789 [Perez] Two vessels left to close. 247 00:10:51,823 --> 00:10:53,307 [monitor beeping steadily] 248 00:10:53,342 --> 00:10:54,550 [Dr. Lim] Deploying the coil. 249 00:10:57,311 --> 00:10:59,831 O2 sats are dropping. 250 00:10:59,866 --> 00:11:03,317 Her infundibular muscle is clamping down. 251 00:11:03,352 --> 00:11:06,769 -She is having a tet spell. -[machine beeping urgently] 252 00:11:06,804 --> 00:11:09,116 Give phenylephrine and 100% oxygen. 253 00:11:09,151 --> 00:11:11,049 I have never seen one in-person before. 254 00:11:12,706 --> 00:11:14,432 We need to move blood up to the lungs. 255 00:11:14,466 --> 00:11:16,365 Give her a bolus and up the opiates. 256 00:11:16,399 --> 00:11:18,850 [tense music playing] 257 00:11:20,714 --> 00:11:22,129 If we don't stop the spasm, 258 00:11:22,164 --> 00:11:23,683 she could have permanent brain damage. 259 00:11:29,723 --> 00:11:31,069 [beeping stops] 260 00:11:31,691 --> 00:11:32,692 [sighs] 261 00:11:34,901 --> 00:11:38,076 [Shaun] The chance of a future infundibular spasm is very high. 262 00:11:39,664 --> 00:11:42,667 Her tet repair surgery will be much more risky. 263 00:11:42,702 --> 00:11:44,704 [soft dramatic music playing] 264 00:11:50,433 --> 00:11:52,884 Pressure in Daphne's lungs is still critically high. 265 00:11:52,919 --> 00:11:54,506 Not a routine tonsillectomy at all. 266 00:11:55,715 --> 00:11:56,923 Puncturing the atrial septum. 267 00:11:56,957 --> 00:11:58,752 [machine beeping softly] 268 00:11:58,787 --> 00:12:01,410 Right heart is decompressing. 269 00:12:01,444 --> 00:12:04,620 Give nitric oxide to relax and dilate the vasculature. 270 00:12:04,654 --> 00:12:07,899 Her apnea really did a number on her pulmonary vessels. 271 00:12:07,934 --> 00:12:10,177 No wonder she's clumsy and forgetful. 272 00:12:10,212 --> 00:12:13,456 She's been sleep- and oxygen-deprived for decades. 273 00:12:13,491 --> 00:12:16,252 It still doesn't make her her daughter's responsibility. 274 00:12:16,287 --> 00:12:18,876 Would you want Kellan to put his life on hold to take care of you? 275 00:12:19,773 --> 00:12:21,982 Not his whole life, no, 276 00:12:22,017 --> 00:12:25,330 but I don't think being overly devoted is the worst quality in a kid. 277 00:12:25,365 --> 00:12:26,573 Remove the catheters. 278 00:12:27,885 --> 00:12:30,439 I was one of six growing up, only girl. 279 00:12:30,473 --> 00:12:31,716 Mom and dad worked a lot, 280 00:12:31,751 --> 00:12:34,374 so I was basically second mom since kindergarten. 281 00:12:35,755 --> 00:12:37,066 I love my brothers, but... 282 00:12:39,413 --> 00:12:41,622 there's a lot you miss out on 283 00:12:41,657 --> 00:12:43,866 if you're all about taking care of someone else. 284 00:12:43,901 --> 00:12:45,281 [beeping continues] 285 00:12:48,422 --> 00:12:50,390 She's throwing a lot of PVCs. 286 00:12:50,424 --> 00:12:51,771 Maybe an electrolyte issue. 287 00:12:53,324 --> 00:12:54,704 [machine beeping urgently] 288 00:12:54,739 --> 00:12:56,637 BP's dropping. Heart rate 172. 289 00:12:56,672 --> 00:12:59,571 We're barely getting a pulse. She's in V-tach. Defib pads. 290 00:12:59,606 --> 00:13:01,781 [tense music playing] 291 00:13:03,610 --> 00:13:05,405 [defibrillator hums sharply] 292 00:13:05,439 --> 00:13:07,407 [defibrillator beeps, thumps] 293 00:13:13,275 --> 00:13:14,414 [beeping steadily] 294 00:13:15,311 --> 00:13:16,312 [sighs] 295 00:13:17,451 --> 00:13:19,246 BP and heart rate stabilizing. 296 00:13:21,317 --> 00:13:23,285 Get a new chemistry, chest X-ray, EKG. 297 00:13:23,319 --> 00:13:25,080 We need to figure out what else is going on with her heart. 298 00:13:35,331 --> 00:13:37,506 Oh, please don't disturb my materials. 299 00:13:37,540 --> 00:13:40,543 Which are what, exactly? 300 00:13:40,578 --> 00:13:42,960 Dr. Glassman made an uncharacteristic surgical error. 301 00:13:42,994 --> 00:13:44,789 I am determining if it was an anomaly 302 00:13:44,824 --> 00:13:46,549 or part of a pattern. 303 00:13:46,584 --> 00:13:48,586 Glassman must be really pleased about that. 304 00:13:48,620 --> 00:13:49,621 He is not. 305 00:13:50,691 --> 00:13:51,934 You are being sarcastic. 306 00:13:51,969 --> 00:13:53,694 Performance review is a standard practice 307 00:13:53,729 --> 00:13:55,351 and benefits both doctors and patients. 308 00:13:55,386 --> 00:13:58,458 I have identified three additional errors made in the last four months. 309 00:13:58,492 --> 00:14:00,046 I don't see a pattern. 310 00:14:00,080 --> 00:14:02,531 A dural tear on scarred tissue, 311 00:14:02,565 --> 00:14:04,464 closing with a running nylon instead of Monocryl-- 312 00:14:04,498 --> 00:14:05,603 Is that even a mistake? 313 00:14:05,637 --> 00:14:08,675 Dr. Glassman has always used subcutaneous Monocryl. 314 00:14:08,709 --> 00:14:10,919 These are variations, minor missteps. 315 00:14:10,953 --> 00:14:13,404 You pore through four months of any surgeon's op reports, 316 00:14:13,438 --> 00:14:15,061 and you'll find discrepancies like this. 317 00:14:15,544 --> 00:14:17,718 -No. -Yes. 318 00:14:17,753 --> 00:14:19,168 Not in mine. 319 00:14:19,824 --> 00:14:22,240 That's probably true. 320 00:14:22,275 --> 00:14:24,070 Eh, if you're not finding a pattern, 321 00:14:25,002 --> 00:14:26,313 maybe it's because there isn't one. 322 00:14:27,314 --> 00:14:28,833 [phone buzzes] 323 00:14:29,869 --> 00:14:31,042 My patient is awake. 324 00:14:33,113 --> 00:14:36,565 Does this mean you can't move forward with the tet repair? 325 00:14:36,599 --> 00:14:38,498 There's a medication called propranolol 326 00:14:38,532 --> 00:14:40,258 that will significantly reduce the risk 327 00:14:40,293 --> 00:14:42,502 of having another spasm during surgery, 328 00:14:42,536 --> 00:14:44,159 but because of your long COVID, 329 00:14:44,193 --> 00:14:46,092 you're at risk for some very rare side effects. 330 00:14:46,782 --> 00:14:48,784 -Are they serious? -Yes. 331 00:14:48,818 --> 00:14:50,682 Well, some of them are not, like nausea, vomiting, 332 00:14:50,717 --> 00:14:52,719 muscle aches, and dizziness, but others, 333 00:14:52,753 --> 00:14:54,928 such as hypoglycemia or visual changes-- 334 00:14:54,963 --> 00:14:56,343 We'll start you on the propranolol. 335 00:14:56,378 --> 00:14:59,277 There's a good chance you won't experience the rare side effects, 336 00:14:59,312 --> 00:15:01,107 but we'll need to keep a close eye on you. 337 00:15:03,281 --> 00:15:04,696 And are those patients ahead of her 338 00:15:04,731 --> 00:15:06,388 also seniors with diabetes? 339 00:15:07,423 --> 00:15:08,700 Do not hang up on me, Phillip, 340 00:15:08,735 --> 00:15:10,081 or I'll head down to do this in person. 341 00:15:10,875 --> 00:15:11,876 I'll wait. 342 00:15:13,326 --> 00:15:14,292 [whispering] Hey. 343 00:15:16,398 --> 00:15:20,195 There is a great new Portuguese spot I read about. 344 00:15:20,229 --> 00:15:23,267 I can make reservations for us Friday or Saturday at 7:00? 345 00:15:24,924 --> 00:15:26,580 Uh, I'm working a double both days. 346 00:15:26,615 --> 00:15:28,789 It's been a nonstop scramble since Baker and Linh left. 347 00:15:28,824 --> 00:15:30,964 Well, you have two new travelers starting on Monday. 348 00:15:30,999 --> 00:15:32,276 We need staff nurses. 349 00:15:32,310 --> 00:15:33,656 These nurses are highly skilled. We-- 350 00:15:33,691 --> 00:15:35,382 It doesn't matter how skilled they are. 351 00:15:35,417 --> 00:15:37,074 Travel nurses disrupt workflow, 352 00:15:37,108 --> 00:15:38,661 don't build long-term relationships. 353 00:15:38,696 --> 00:15:41,733 Right now, we just don't have the resources for permanent replacements. 354 00:15:41,768 --> 00:15:43,804 You just hired a new full-time surgical resident 355 00:15:43,839 --> 00:15:45,599 to replace someone who left way more recently. 356 00:15:45,634 --> 00:15:47,153 That was Lim's department. I-- 357 00:15:48,016 --> 00:15:49,949 Yes, great. I'm sending her down. 358 00:15:51,019 --> 00:15:52,227 Sorry. We'll talk later? 359 00:15:52,261 --> 00:15:53,297 Of course. 360 00:15:56,334 --> 00:15:58,785 So you're watching to see if I throw up? 361 00:15:58,819 --> 00:16:00,856 Or faint, seize, or have muscle spasms. 362 00:16:05,826 --> 00:16:08,415 You know, before COVID, my brain was-- 363 00:16:09,796 --> 00:16:12,730 I did evolutionary patterns, 364 00:16:12,764 --> 00:16:15,284 genetic, uh... 365 00:16:16,699 --> 00:16:19,185 how genes go together. 366 00:16:20,634 --> 00:16:21,635 The sequence. 367 00:16:24,259 --> 00:16:26,606 Now my brain can't handle the sequence of brushing my teeth. 368 00:16:28,988 --> 00:16:32,508 My focus, my working memory, all of the... 369 00:16:34,165 --> 00:16:35,822 [sighs] 370 00:16:35,856 --> 00:16:38,135 The executive function. 371 00:16:38,169 --> 00:16:40,447 [sighs] 372 00:16:40,482 --> 00:16:43,347 It's not always happening. 373 00:16:43,381 --> 00:16:46,212 [soft dramatic music playing] 374 00:16:46,246 --> 00:16:49,318 Please page Dr. Wolke to monitor her and stay until he comes. 375 00:16:51,424 --> 00:16:52,804 Push your hand against mine. 376 00:16:54,151 --> 00:16:56,394 The pattern is errors in executive function. 377 00:16:56,429 --> 00:16:57,809 Shaun, I'm in the middle of doing something. 378 00:16:57,844 --> 00:17:00,743 Your brain cancer may have returned. 379 00:17:07,060 --> 00:17:09,406 -All errors are tied to executive function. -Shaun-- 380 00:17:09,442 --> 00:17:11,651 Specifically to working and procedural memory governed 381 00:17:11,685 --> 00:17:13,308 by the dorsolateral prefrontal cortex, 382 00:17:13,342 --> 00:17:15,241 a common site for a recurrent glioma, 383 00:17:15,275 --> 00:17:18,415 which strongly suggests your cancer has returned. 384 00:17:18,451 --> 00:17:21,522 My last scan came back completely clear. I'm fine. 385 00:17:21,557 --> 00:17:23,145 Your last scan was six months ago. 386 00:17:23,180 --> 00:17:25,527 These errors all took place in the last four months. 387 00:17:25,560 --> 00:17:27,046 So you need another scan. 388 00:17:27,079 --> 00:17:28,357 The evidence is very compelling. 389 00:17:28,392 --> 00:17:29,807 No, it's really not. 390 00:17:29,841 --> 00:17:32,258 I perform complex surgeries, Shaun, 391 00:17:32,292 --> 00:17:35,192 more so than any other doctor on this staff, by the way. 392 00:17:35,226 --> 00:17:37,056 So yeah, the percentages would dictate 393 00:17:37,090 --> 00:17:41,198 that I might make more minor and irrelevant missteps, 394 00:17:41,232 --> 00:17:43,234 if that's what you want to call them, and-- 395 00:17:43,269 --> 00:17:44,994 And the rate of errors has increased. 396 00:17:45,029 --> 00:17:47,549 Yeah, because I take on the tougher cases, 397 00:17:47,583 --> 00:17:48,929 the ones no one else will. 398 00:17:48,964 --> 00:17:51,863 No, you need another MRI now. 399 00:17:51,898 --> 00:17:54,176 Shaun, what I need is to get back to my patient. 400 00:17:54,211 --> 00:17:57,559 And you need to knock first next time. 401 00:17:57,593 --> 00:18:00,079 [soft dramatic music playing] 402 00:18:02,150 --> 00:18:03,634 It's the greening of the-- 403 00:18:05,222 --> 00:18:06,568 My turn. 404 00:18:08,742 --> 00:18:10,675 I'm trying to get some of my cognitive exercises in. 405 00:18:10,710 --> 00:18:12,608 What are you memorizing? 406 00:18:12,643 --> 00:18:14,748 It's a poem from The Carrying,Ada Limon. 407 00:18:14,783 --> 00:18:15,853 [Dr. Lim] Hmm. 408 00:18:15,887 --> 00:18:17,544 The collection is mostly about... 409 00:18:19,822 --> 00:18:23,067 not having the life you thought you'd have, I guess. 410 00:18:24,344 --> 00:18:29,038 The one I was just reading, it's about spring coming, 411 00:18:29,073 --> 00:18:31,248 Instructions on Not Giving Up. 412 00:18:31,972 --> 00:18:33,940 -Sounds useful. -Yeah. 413 00:18:33,974 --> 00:18:35,114 Too bad I can't read it all at once. 414 00:18:35,976 --> 00:18:38,496 I've just graduated from haikus. 415 00:18:38,531 --> 00:18:41,154 I never even thought to look at a poem before I got sick. 416 00:18:42,707 --> 00:18:44,744 Didn't have the patience for it at the time, 417 00:18:45,952 --> 00:18:47,471 but it's basically all I read now. 418 00:18:48,679 --> 00:18:50,163 I started writing, too. 419 00:18:50,198 --> 00:18:53,891 It's kind of a creative therapy. 420 00:18:53,925 --> 00:18:55,479 [Dr. Lim] Mm. 421 00:18:55,513 --> 00:18:58,654 There was a kind of poetry 422 00:18:58,689 --> 00:19:01,795 to the genetic variations in white clover too. 423 00:19:01,830 --> 00:19:03,832 [gentle music playing] 424 00:19:05,282 --> 00:19:06,766 I'd give anything to... 425 00:19:11,322 --> 00:19:12,496 [sighs] 426 00:19:12,530 --> 00:19:14,187 Your blood pressure is going down, 427 00:19:14,222 --> 00:19:15,361 and your heart rate's climbing. 428 00:19:15,395 --> 00:19:16,465 I feel kind of dizzy. 429 00:19:16,500 --> 00:19:17,501 Let me check your glucose. 430 00:19:21,539 --> 00:19:23,921 She's having a seizure. Crash cart now! 431 00:19:23,955 --> 00:19:26,130 [tense music playing] 432 00:19:26,165 --> 00:19:28,512 [Jared] We thought something else was going on with your heart, 433 00:19:28,546 --> 00:19:29,616 but it's a kidney issue. 434 00:19:29,651 --> 00:19:31,515 You have a narrowing of your renal arteries, 435 00:19:31,549 --> 00:19:33,620 which was exacerbated by the pulmonary hypertension, 436 00:19:33,655 --> 00:19:34,690 causing your kidneys to fail. 437 00:19:34,725 --> 00:19:37,141 And this is because of my sleep apnea? 438 00:19:37,176 --> 00:19:39,143 We believe so, yeah. 439 00:19:39,178 --> 00:19:42,042 Uh, can she get a transplant? 440 00:19:42,077 --> 00:19:44,183 I can do a test, see if I'm a match. 441 00:19:44,217 --> 00:19:47,738 Unfortunately, your other health concerns rule out a transplant, 442 00:19:47,772 --> 00:19:52,225 but a renal artery bypass would allow your kidneys to heal on their own. 443 00:19:52,260 --> 00:19:55,021 There's risk of complications, some quite serious. 444 00:19:56,298 --> 00:20:01,027 But in success, you could live a full, independent life. 445 00:20:01,061 --> 00:20:04,306 But-- oh, but serious, 446 00:20:04,341 --> 00:20:07,067 as in I could die? 447 00:20:07,102 --> 00:20:10,174 Some complications can be fatal. 448 00:20:10,209 --> 00:20:12,003 But the risk is relatively low. 449 00:20:13,212 --> 00:20:15,214 Are there other options? 450 00:20:15,766 --> 00:20:17,146 Well, there's dialysis, 451 00:20:17,181 --> 00:20:20,322 but you'd need multiple sessions a week for the rest of your life. 452 00:20:22,635 --> 00:20:26,225 Um, that's less risky, but I-- 453 00:20:27,398 --> 00:20:30,436 I don't think I could handle all that on my own. 454 00:20:30,470 --> 00:20:35,095 Mom, Mom, if you want to choose the dialysis, I'll stay in San Jose. 455 00:20:37,615 --> 00:20:38,685 I'm sorry. 456 00:20:39,790 --> 00:20:41,240 I don't want to keep you. 457 00:20:41,274 --> 00:20:44,243 No, you have nothing to be sorry for. 458 00:20:44,277 --> 00:20:47,142 All this time you've been sick and struggling, and I-- 459 00:20:48,454 --> 00:20:49,420 I judged you. 460 00:20:50,559 --> 00:20:51,871 But your new job. 461 00:20:54,425 --> 00:20:55,426 It's just a job. 462 00:21:04,297 --> 00:21:07,369 So the medication you gave me 463 00:21:07,404 --> 00:21:09,751 to make my surgery safer 464 00:21:09,785 --> 00:21:12,305 will actually make it more risky? 465 00:21:12,340 --> 00:21:13,306 That's right. 466 00:21:14,169 --> 00:21:15,722 But without that medication, 467 00:21:15,757 --> 00:21:18,553 I'm much more likely to have another tet spell. 468 00:21:18,587 --> 00:21:22,384 Yes, and possibly more severe than the last time. 469 00:21:22,419 --> 00:21:25,801 The brain fog, all my deficits... 470 00:21:27,527 --> 00:21:28,597 could get worse, 471 00:21:30,530 --> 00:21:32,152 for possibly forever? 472 00:21:33,361 --> 00:21:34,500 Yes. 473 00:21:34,534 --> 00:21:36,156 [tender music playing] 474 00:21:36,191 --> 00:21:38,055 But if we don't do the tet repair, 475 00:21:38,089 --> 00:21:40,160 your heart will stop at some point. 476 00:21:43,474 --> 00:21:45,407 I've already been through 477 00:21:45,442 --> 00:21:48,928 losing my thoughts, my whole self. 478 00:21:53,173 --> 00:21:54,347 I can't do that again. 479 00:21:59,387 --> 00:22:00,974 Find another way to fix my heart. 480 00:22:19,338 --> 00:22:21,167 All right, new idea. 481 00:22:21,201 --> 00:22:23,652 We go back to the old idea and just do the surgery. 482 00:22:23,687 --> 00:22:25,136 It's a non-starter. 483 00:22:25,171 --> 00:22:28,174 We need to present a way to help her tet without triggering her tet. 484 00:22:28,208 --> 00:22:31,073 A percutaneous valve and VSD closure could help with blood flow. 485 00:22:31,108 --> 00:22:32,661 That involves catheters in the heart, 486 00:22:32,696 --> 00:22:34,214 which would cause the muscle to spasm. 487 00:22:35,112 --> 00:22:37,528 All right. It's time for some WWSMD. 488 00:22:37,563 --> 00:22:40,151 Whatever you and Jerome do on your own time is-- 489 00:22:40,186 --> 00:22:41,360 It's "what would Shaun Murphy do?" 490 00:22:42,706 --> 00:22:44,673 [spirited orchestral music playing] 491 00:22:56,271 --> 00:22:58,066 [poppy guitar chord playing] 492 00:23:01,725 --> 00:23:03,243 [orchestra music resumes] 493 00:23:03,278 --> 00:23:04,935 [heart beating] 494 00:23:04,969 --> 00:23:07,662 [upbeat pop music playing] 495 00:23:07,696 --> 00:23:09,422 [birds chirping] 496 00:23:13,253 --> 00:23:16,498 ♪ If a party is what you need ♪ 497 00:23:16,533 --> 00:23:18,086 ♪ They're dancing ♪ 498 00:23:18,120 --> 00:23:19,121 [Perez] What about a shunt? 499 00:23:20,364 --> 00:23:22,401 It would improve blood flow, buy a few months 500 00:23:22,435 --> 00:23:24,057 to continue her cognitive recovery. 501 00:23:24,092 --> 00:23:26,266 Once she feels better about where her brain's at, 502 00:23:26,301 --> 00:23:27,785 maybe she lets us fix her heart. 503 00:23:27,820 --> 00:23:30,339 Her tet will likely kill her before that, 504 00:23:30,374 --> 00:23:34,309 but placing a shunt won't trigger a spell, 505 00:23:34,343 --> 00:23:36,380 making it something she'd actually accept. 506 00:23:39,038 --> 00:23:41,316 [sighs] I'll take it to her. 507 00:23:42,559 --> 00:23:44,353 I can stay only 45 minutes. 508 00:23:44,388 --> 00:23:46,528 I have to review Dr. Glassman's OR videos. 509 00:23:46,563 --> 00:23:47,805 Didn't you already review them? 510 00:23:47,840 --> 00:23:49,600 Not for symptoms of glioma recurrence. 511 00:23:49,635 --> 00:23:51,913 New evidence will convince Dr. Glassman to get a scan. 512 00:23:51,947 --> 00:23:54,709 Okay, you binged months of data in one day. 513 00:23:54,743 --> 00:23:56,055 You'll have a clearer head in the morning. 514 00:23:56,089 --> 00:23:59,058 Until then, here we are, karaoke rager. 515 00:23:59,092 --> 00:24:00,646 -Yay. -It is yay. 516 00:24:00,680 --> 00:24:02,924 We have song lists. Plus Jared's our friend. 517 00:24:02,958 --> 00:24:04,788 He just moved back. Celebration is in order. 518 00:24:05,858 --> 00:24:08,377 I will review the videos in the morning. 519 00:24:08,412 --> 00:24:09,413 Yay! 520 00:24:10,172 --> 00:24:11,622 It sounds pretty wild in there. 521 00:24:11,657 --> 00:24:15,281 ♪ Because maybe ♪ 522 00:24:15,315 --> 00:24:19,354 ♪ You're gonna be the one That saves me ♪ 523 00:24:20,804 --> 00:24:22,668 ♪ And after-- ♪ 524 00:24:22,702 --> 00:24:24,980 ["Wonderwall" playing] 525 00:24:25,809 --> 00:24:26,948 [music stops] 526 00:24:26,982 --> 00:24:29,191 [clears throat] I was just warming up. 527 00:24:29,226 --> 00:24:32,160 -Where is everyone? -There is a lot of food. 528 00:24:32,194 --> 00:24:34,611 Yeah, I had it catered. You're the first to arrive. 529 00:24:35,474 --> 00:24:38,338 And so far, last-minute rain checks 530 00:24:38,373 --> 00:24:40,927 from Morgan, Park, Asher, Danny. 531 00:24:40,962 --> 00:24:42,239 [phone chimes] 532 00:24:42,273 --> 00:24:43,482 Oh, and Jerome. 533 00:24:45,794 --> 00:24:47,037 So it's just us four? 534 00:24:47,071 --> 00:24:50,765 Which means that all these snacks 535 00:24:50,799 --> 00:24:53,975 and song binders are for us. 536 00:24:54,009 --> 00:24:55,804 Oh. Yes. 537 00:24:55,839 --> 00:24:59,187 The low turnout is the perfect opportunity to discuss symptoms. 538 00:24:59,221 --> 00:25:00,844 [quirky music playing] 539 00:25:00,878 --> 00:25:02,880 In your recent surgeries with Dr. Glassman, 540 00:25:02,915 --> 00:25:04,606 do you recall observing any balance issues, 541 00:25:04,641 --> 00:25:06,159 tremors, or motor weakness? 542 00:25:11,544 --> 00:25:13,201 That sounds like the perfect option. 543 00:25:14,478 --> 00:25:16,653 How soon can you do the shunt procedure? 544 00:25:16,687 --> 00:25:19,000 I'll try to schedule it for tomorrow. 545 00:25:23,694 --> 00:25:25,972 I've had a strange year myself. 546 00:25:29,251 --> 00:25:31,046 Eleven months ago, 547 00:25:31,081 --> 00:25:32,358 I was attacked 548 00:25:32,392 --> 00:25:34,360 and paralyzed from the waist down. 549 00:25:35,568 --> 00:25:38,157 I thought it was permanent. Almost everyone did. 550 00:25:41,125 --> 00:25:45,371 At first, all I wanted was to walk again. 551 00:25:46,752 --> 00:25:50,100 I was ready to risk my life to get back to the old me. 552 00:25:51,619 --> 00:25:52,896 But as time went on, 553 00:25:54,069 --> 00:25:58,867 I started to appreciate my new life, my new self. 554 00:25:58,902 --> 00:26:00,869 [tender music playing] 555 00:26:01,594 --> 00:26:03,596 I started a new relationship 556 00:26:03,631 --> 00:26:05,287 that wouldn't have happened otherwise. 557 00:26:07,773 --> 00:26:09,533 In many ways, my life improved. 558 00:26:10,638 --> 00:26:13,157 You recognize you walked in to tell me this story? 559 00:26:13,192 --> 00:26:15,056 [chuckles] 560 00:26:15,090 --> 00:26:16,713 I only agreed to do the surgery 561 00:26:16,747 --> 00:26:18,093 once I knew my life wasn't at risk. 562 00:26:18,128 --> 00:26:20,613 And even then, I had doubts. 563 00:26:22,477 --> 00:26:24,134 I liked who I'd become. 564 00:26:24,168 --> 00:26:25,791 I wanted to hold on to her. 565 00:26:30,105 --> 00:26:31,106 I'm not... 566 00:26:33,937 --> 00:26:35,283 losing my mind... 567 00:26:37,216 --> 00:26:38,286 all over again. 568 00:26:41,151 --> 00:26:43,498 You don't strike me as someone who's lost her mind. 569 00:26:59,825 --> 00:27:01,240 [upbeat music playing] 570 00:27:01,274 --> 00:27:03,138 That covers the thrombectomy. 571 00:27:03,173 --> 00:27:04,277 In February, you assisted on a-- 572 00:27:04,312 --> 00:27:07,764 Okay, I'm playing the pregnant lady card. 573 00:27:09,041 --> 00:27:10,387 We're going, Shaun. 574 00:27:10,421 --> 00:27:11,595 Okay. 575 00:27:12,803 --> 00:27:14,460 Thank you. Goodbye. 576 00:27:16,186 --> 00:27:17,601 I should head out, too. 577 00:27:19,120 --> 00:27:21,536 -Early morning. -Yeah. 578 00:27:25,678 --> 00:27:28,923 Maybe focus on being a first-year resident 579 00:27:28,957 --> 00:27:33,065 before adding party planner to your resume. 580 00:27:33,099 --> 00:27:34,204 [chuckles] 581 00:27:35,239 --> 00:27:37,207 The catering may have been a bridge too far. 582 00:27:38,173 --> 00:27:39,209 Yeah. 583 00:27:43,869 --> 00:27:45,180 I bounced around growing up. 584 00:27:47,182 --> 00:27:50,461 Different schools, cities, countries. 585 00:27:51,911 --> 00:27:55,777 But, um, wherever we were, my parents had a big house, 586 00:27:56,675 --> 00:27:58,021 and I knew how to throw a party. 587 00:28:01,196 --> 00:28:04,303 Closest I'd get to feeling like I fit. 588 00:28:07,202 --> 00:28:08,652 Old habits die hard, I guess. 589 00:28:11,413 --> 00:28:13,312 Fitting in takes time. 590 00:28:14,382 --> 00:28:17,178 But I never have, anywhere. 591 00:28:18,420 --> 00:28:20,422 [soft dramatic music playing] 592 00:28:21,941 --> 00:28:23,080 Maybe not everyone 593 00:28:24,703 --> 00:28:25,704 finds their place. 594 00:28:28,707 --> 00:28:29,880 [phone chimes] 595 00:28:31,088 --> 00:28:33,159 Daphne is getting septic. We have to go. 596 00:28:40,028 --> 00:28:42,341 [sighs] Morning. 597 00:28:42,375 --> 00:28:43,963 Hello. 598 00:28:43,998 --> 00:28:45,033 Mm. 599 00:28:46,759 --> 00:28:48,278 You should not have that. 600 00:28:48,312 --> 00:28:50,832 I'm permitted 12 ounces a day. Experts agree. 601 00:28:50,867 --> 00:28:53,870 Yes, but that was brewed when I woke up at 3:30 a.m. 602 00:28:53,904 --> 00:28:55,872 [quirky music playing] 603 00:28:56,596 --> 00:28:58,115 You make it through the videos? 604 00:28:58,150 --> 00:29:00,531 Yes, and integrated the observations 605 00:29:00,566 --> 00:29:02,292 Doctors Kalu and Allen made last night 606 00:29:02,326 --> 00:29:04,708 regarding possible glioma symptoms. 607 00:29:05,744 --> 00:29:07,124 [exhales deeply] 608 00:29:07,159 --> 00:29:10,265 I am now ready to present Dr. Glassman with the revised evidence, 609 00:29:10,300 --> 00:29:12,233 which is very compelling. 610 00:29:12,267 --> 00:29:13,268 [Lea] Mm. 611 00:29:16,340 --> 00:29:19,758 Thankfully, your infection is responding to the antibiotics. 612 00:29:19,792 --> 00:29:22,795 The infection started around your dialysis port. 613 00:29:22,830 --> 00:29:24,383 That could easily happen again. 614 00:29:25,902 --> 00:29:29,043 The renal artery bypass is still an option. 615 00:29:29,077 --> 00:29:30,596 It's too risky. 616 00:29:31,114 --> 00:29:32,080 So is sepsis. 617 00:29:33,772 --> 00:29:36,947 Thank you, Doctor, but I'll settle for being alive. 618 00:29:36,982 --> 00:29:37,983 You shouldn't. 619 00:29:40,295 --> 00:29:41,503 You deserve more than that. 620 00:29:42,781 --> 00:29:44,921 I know you've had a whole life of feeling sick 621 00:29:44,955 --> 00:29:48,476 and stuck and repeating the same old, bad patterns, 622 00:29:48,510 --> 00:29:51,134 but your past does not have to tell your future where to go. 623 00:29:55,276 --> 00:29:57,554 You can choose a different path 624 00:29:57,588 --> 00:29:59,556 and who you're gonna be on it. 625 00:29:59,590 --> 00:30:01,420 [tender music playing] 626 00:30:01,454 --> 00:30:03,353 And let your daughter do the same. 627 00:30:08,599 --> 00:30:10,153 Prague is beautiful in the spring. 628 00:30:15,641 --> 00:30:17,712 [upbeat acoustic music playing] 629 00:30:47,707 --> 00:30:49,951 We've scheduled the shunt placement for this afternoon. 630 00:30:51,815 --> 00:30:53,334 And that whole speech last night? 631 00:30:53,368 --> 00:30:56,406 I stand by it, but it's your decision. 632 00:31:02,170 --> 00:31:05,173 I've been waiting for the old me to come back, and... 633 00:31:05,208 --> 00:31:07,175 [tender music playing] 634 00:31:09,419 --> 00:31:11,214 That person may not exist anymore. 635 00:31:14,010 --> 00:31:15,045 And... 636 00:31:17,461 --> 00:31:19,153 maybe I should be okay with that. 637 00:31:25,055 --> 00:31:26,194 Do the tet repair. 638 00:31:41,278 --> 00:31:42,693 [Dr. Park] Releasing the proximal clamp. 639 00:31:45,248 --> 00:31:46,766 What made Daphne change her mind? 640 00:31:47,975 --> 00:31:50,046 Dr. Allen has a way of getting through to people. 641 00:31:54,705 --> 00:31:56,673 Blood flow looks obstructed. 642 00:31:56,707 --> 00:31:57,916 There's a kink in the graft. 643 00:31:59,572 --> 00:32:01,574 We can undo it, but most likely, it happens again. 644 00:32:01,609 --> 00:32:03,231 [soft tense music playing] 645 00:32:05,578 --> 00:32:09,651 We could anchor the bypass off of the aorta instead. 646 00:32:09,686 --> 00:32:11,446 At that angle, less chance of a kink. 647 00:32:14,484 --> 00:32:15,485 Could work. 648 00:32:18,177 --> 00:32:19,316 [Jared chuckles] 649 00:32:28,187 --> 00:32:30,155 -[Dr. Lim] Extending the incision. -[Asher] Sternal saw. 650 00:32:34,953 --> 00:32:36,955 [Dr. Lim] Starting the sternotomy. 651 00:32:36,989 --> 00:32:38,784 [machine beeping urgently] 652 00:32:38,818 --> 00:32:39,819 [Perez] O2 dropped to 78. 653 00:32:40,751 --> 00:32:42,581 -65. -She's having a tet spell. 654 00:32:42,615 --> 00:32:46,067 Give her 500 cc fluid bolus and 100% oxygen. 655 00:32:46,102 --> 00:32:48,897 Giving a mini bolus to increase pulmonary flow. 656 00:32:48,932 --> 00:32:51,762 [dramatic music playing] 657 00:32:51,797 --> 00:32:55,180 [Shaun] O2 sats are 50. 45. 658 00:32:55,214 --> 00:32:56,595 Come on, come on. 659 00:32:59,011 --> 00:33:01,082 Give her more oxygen and up the opiates. 660 00:33:02,463 --> 00:33:03,774 [Shaun] It has stopped registering. 661 00:33:03,809 --> 00:33:05,259 [beeping continues] 662 00:33:07,640 --> 00:33:09,884 [tense music playing] 663 00:33:21,068 --> 00:33:22,138 [urgent beeping stops] 664 00:33:22,172 --> 00:33:23,691 [Asher] O2's rising. 665 00:33:25,900 --> 00:33:27,005 Heart rate's stabilizing. 666 00:33:30,215 --> 00:33:33,149 She was in prolonged gross hypoxia. 667 00:33:33,183 --> 00:33:35,806 [Shaun] That could extend cognitive deficits... 668 00:33:37,291 --> 00:33:39,051 or worse. 669 00:33:39,086 --> 00:33:40,535 [Dr. Lim] We won't know until she wakes. 670 00:33:40,570 --> 00:33:42,399 Let's get her on bypass before she has another one. 671 00:33:45,644 --> 00:33:46,852 -Okay. -Mm-hmm. 672 00:33:47,887 --> 00:33:50,373 To a successful renal artery bypass. 673 00:33:50,407 --> 00:33:53,203 Cheers. Facilitated by moving speech 674 00:33:53,238 --> 00:33:54,963 from a wise and persuasive surgeon. 675 00:33:54,998 --> 00:33:58,001 Mm, with a great surgical save by a guy 676 00:33:58,036 --> 00:34:00,900 who's about to have some life-changing tacos. 677 00:34:00,935 --> 00:34:01,936 Okay. 678 00:34:05,284 --> 00:34:07,355 Mm! Oh, my God. 679 00:34:07,390 --> 00:34:10,013 Okay, these are amaz-- you're amazing! 680 00:34:10,047 --> 00:34:12,601 Told you. Blue corn tortillas. 681 00:34:12,636 --> 00:34:15,018 -Mm-hmm. I can get used to this. -[chuckles] 682 00:34:16,399 --> 00:34:17,538 [snorts] 683 00:34:18,435 --> 00:34:21,335 -You have some lettuce there. -Oh. 684 00:34:21,369 --> 00:34:24,062 -No, no, no, mirror image. -Mm. 685 00:34:24,096 --> 00:34:25,270 -Now? -[laughs] 686 00:34:25,304 --> 00:34:26,995 -No. -No laughing. 687 00:34:27,030 --> 00:34:28,065 No, right, right, right. Very-- 688 00:34:28,100 --> 00:34:29,722 [clears throat] Very serious matter. 689 00:34:30,723 --> 00:34:32,380 [both laugh] 690 00:34:34,417 --> 00:34:37,246 Here. Um, yeah. 691 00:34:37,282 --> 00:34:38,559 Oh. 692 00:34:38,592 --> 00:34:40,216 Just a little bit more. 693 00:34:40,250 --> 00:34:42,217 [tender music playing] 694 00:34:51,606 --> 00:34:54,161 -We should go. -Mm. 695 00:34:54,195 --> 00:34:58,441 -Yeah. -Um, we need to get back early for Daphne's post-op. 696 00:34:58,475 --> 00:35:01,444 Yeah, right. Um, let's go. 697 00:35:01,478 --> 00:35:03,446 [soft dramatic music playing] 698 00:35:09,866 --> 00:35:12,662 The bypass went smoothly, and post-op labs look good. 699 00:35:13,456 --> 00:35:14,560 We expect a full recovery. 700 00:35:16,079 --> 00:35:17,218 How are you feeling, Mom? 701 00:35:18,944 --> 00:35:20,048 I'm... 702 00:35:20,083 --> 00:35:23,811 [breathes deeply] Breathing. 703 00:35:23,845 --> 00:35:26,331 Kind of feels like the first time in my life. 704 00:35:27,987 --> 00:35:31,853 The post-op swelling from the tonsillectomy has gone down. 705 00:35:31,888 --> 00:35:34,546 You're finally breathing without any obstruction. 706 00:35:34,580 --> 00:35:37,514 You'll need to stay on top of your medications and follow-up visits, 707 00:35:37,549 --> 00:35:39,309 observe some dietary guidelines, 708 00:35:39,344 --> 00:35:41,794 but the discharge plan lays it all out. 709 00:35:43,002 --> 00:35:44,487 I'll be there to help, Mom. 710 00:35:47,455 --> 00:35:48,456 No. 711 00:35:50,458 --> 00:35:51,839 You won't. 712 00:35:51,873 --> 00:35:53,875 [tender music playing] 713 00:35:56,154 --> 00:35:58,156 You need to live your own life. 714 00:36:01,676 --> 00:36:04,679 But I... I will accept FaceTime calls. 715 00:36:06,060 --> 00:36:07,648 And once I recover, 716 00:36:09,167 --> 00:36:10,685 I'll come visit. 717 00:36:15,034 --> 00:36:17,692 I hear that Prague is beautiful in the spring. 718 00:36:18,969 --> 00:36:20,661 [laughs] 719 00:36:21,800 --> 00:36:23,215 That sounds like a plan. 720 00:36:34,847 --> 00:36:37,298 Mm, things not go well with Glassy? 721 00:36:37,333 --> 00:36:39,542 He returned the files with a note saying 722 00:36:39,576 --> 00:36:42,683 he did not look at them and does not intend to. 723 00:36:42,717 --> 00:36:45,030 I'm sorry. He probably-- 724 00:36:45,064 --> 00:36:47,101 It was a mistake to leave them for him to read on his own. 725 00:36:47,135 --> 00:36:51,105 Once I reorder the files, I will go to his office to review with him in person. 726 00:36:51,139 --> 00:36:53,141 He made it pretty clear he doesn't want to see them. 727 00:36:53,176 --> 00:36:55,489 But he doesn't know about the new evidence. 728 00:36:55,523 --> 00:36:57,387 Maybe he doesn't want to know. 729 00:36:57,422 --> 00:37:00,494 Cancer survivors have to live with that uncertainty that-- 730 00:37:00,528 --> 00:37:02,185 Knowing is better than not knowing. 731 00:37:05,084 --> 00:37:07,397 If he's not ready to look at this, 732 00:37:07,432 --> 00:37:09,088 you can't force him. 733 00:37:10,469 --> 00:37:13,231 Maybe he's scared, Shaun. 734 00:37:14,128 --> 00:37:16,095 And I think maybe you're scared, too. 735 00:37:17,614 --> 00:37:20,168 We're about to have a baby, 736 00:37:20,203 --> 00:37:22,550 you're about to be a dad, 737 00:37:22,585 --> 00:37:25,070 and I think you're worried about family, 738 00:37:25,104 --> 00:37:26,554 and Glassman is a part of that. 739 00:37:28,384 --> 00:37:31,594 But if you keep pushing, you risk damaging 740 00:37:31,628 --> 00:37:34,252 one of the most important relationships in your life. 741 00:37:42,950 --> 00:37:44,192 [indistinct chatter] 742 00:37:44,227 --> 00:37:45,228 Hey. 743 00:37:48,576 --> 00:37:49,715 -Hey. -Hey. 744 00:37:53,098 --> 00:37:54,548 I've been thinking, 745 00:37:54,582 --> 00:37:56,170 and I need a break from our coffees. 746 00:37:56,826 --> 00:37:58,483 Dalisay-- 747 00:37:58,517 --> 00:38:00,070 I don't think dinner's a good idea either. 748 00:38:01,451 --> 00:38:03,798 So we have a different point of view about hospital business. 749 00:38:03,833 --> 00:38:06,214 That doesn't change the way I feel about you. 750 00:38:06,249 --> 00:38:07,975 On or off the clock, I'm the same person. 751 00:38:08,976 --> 00:38:11,841 To me, if you don't value what the nurses do 752 00:38:11,875 --> 00:38:14,878 enough to treat us like a resource to invest in, 753 00:38:14,913 --> 00:38:16,397 not a line item to be cut, 754 00:38:17,778 --> 00:38:19,193 how much can you care about me? 755 00:38:20,919 --> 00:38:21,989 And to be honest, 756 00:38:22,990 --> 00:38:24,612 if that is your point of view... 757 00:38:27,443 --> 00:38:29,203 it undercuts the respect I have for you. 758 00:38:40,835 --> 00:38:43,597 Harper Louise Decrane, 759 00:38:43,631 --> 00:38:46,324 March 30, 1994. 760 00:38:47,290 --> 00:38:48,498 And do you know why you're here? 761 00:38:49,465 --> 00:38:50,604 For my heart issues. 762 00:38:52,330 --> 00:38:53,779 [sighs] 763 00:38:53,814 --> 00:38:55,333 I had another tet spell, didn't I? 764 00:38:56,575 --> 00:38:58,128 We'll need to conduct more tests, 765 00:38:58,163 --> 00:39:00,372 but your speech and memory seem intact. 766 00:39:00,407 --> 00:39:03,513 And with regard to your heart, we expect a full recovery. 767 00:39:03,548 --> 00:39:07,517 And with time, you may recover your full cognitive abilities as well. 768 00:39:08,035 --> 00:39:09,036 Maybe. 769 00:39:10,555 --> 00:39:14,490 But for now, I'll just focus on being here. 770 00:39:17,009 --> 00:39:19,011 [gentle music playing] 771 00:39:30,229 --> 00:39:32,197 "It's the greening of the trees 772 00:39:33,025 --> 00:39:34,544 That really gets to me 773 00:39:36,097 --> 00:39:39,066 When all the shock of white and taffy 774 00:39:39,100 --> 00:39:41,931 Leave the pavement strewn With the confetti of aftermath 775 00:39:44,209 --> 00:39:45,383 The leaves come 776 00:39:46,591 --> 00:39:48,351 Patient, plodding 777 00:39:50,077 --> 00:39:53,494 A green skin growing over Whatever winter did to us 778 00:39:55,979 --> 00:39:59,880 A return to the strange idea Of continuous living 779 00:39:59,914 --> 00:40:01,399 Despite the mess of us 780 00:40:01,433 --> 00:40:03,055 The hurt, the empty..." 781 00:40:04,194 --> 00:40:05,264 Shaun, what? 782 00:40:06,576 --> 00:40:09,441 Lea thinks that because I'm going to be a dad, 783 00:40:10,615 --> 00:40:12,617 I am worried about my family. 784 00:40:14,688 --> 00:40:15,965 Okay. 785 00:40:15,999 --> 00:40:18,933 She also thinks you are scared. 786 00:40:20,279 --> 00:40:21,936 I'm not scared, Shaun. I'm fine. 787 00:40:21,971 --> 00:40:25,077 She says if you don't want to do the scan, I should let it go. 788 00:40:29,461 --> 00:40:30,531 She... 789 00:40:32,878 --> 00:40:34,293 is right. 790 00:40:36,088 --> 00:40:37,400 Good. Thank you. 791 00:40:39,816 --> 00:40:41,093 I am scared. 792 00:40:54,797 --> 00:40:55,901 Dr. Glassman... 793 00:41:00,630 --> 00:41:04,323 I am asking you to do the scan 794 00:41:05,773 --> 00:41:06,740 because... 795 00:41:08,673 --> 00:41:11,779 the data and the evidence are sound... 796 00:41:17,820 --> 00:41:18,924 and because... 797 00:41:26,553 --> 00:41:28,589 it would be hard to lose my father 798 00:41:28,624 --> 00:41:30,315 just as I am about to become one. 799 00:41:37,184 --> 00:41:38,772 [breathes shakily] 800 00:41:38,806 --> 00:41:40,152 Do the scan for me. 801 00:41:50,749 --> 00:41:51,716 [chuckles] 802 00:41:52,648 --> 00:41:54,857 Shaun, I'll do the scan. 803 00:41:58,343 --> 00:41:59,482 [sighs softly] 804 00:42:13,669 --> 00:42:17,431 "'Fine then, I'll take it' The tree seems to say 805 00:42:17,465 --> 00:42:21,055 A new slick leaf unfurling Like a fist to an open palm 806 00:42:21,953 --> 00:42:23,368 'I'll take it all'" 807 00:42:30,617 --> 00:42:32,584 [closing theme music playing]