1 00:00:01,535 --> 00:00:03,037 DR. REZNICK: Your primary care doctor was right. 2 00:00:03,171 --> 00:00:04,838 The mass is on the smaller side. 3 00:00:04,972 --> 00:00:06,574 We'll confirm with the new images, 4 00:00:06,707 --> 00:00:08,276 but it should be manageable with medication. 5 00:00:08,409 --> 00:00:10,278 No surgery needed. 6 00:00:10,411 --> 00:00:13,281 Well, my fiance will be so relieved. 7 00:00:13,414 --> 00:00:15,416 He's been worried I'll look like Frankenstein in all our photos. 8 00:00:16,250 --> 00:00:17,218 Also that I might die. 9 00:00:18,152 --> 00:00:19,153 When's the big day? 10 00:00:19,887 --> 00:00:21,622 June. 11 00:00:21,755 --> 00:00:23,191 You've been dealing with wedding planning 12 00:00:23,324 --> 00:00:24,858 on top of a pituitary tumor? 13 00:00:26,127 --> 00:00:27,661 You deserve a medal. 14 00:00:27,795 --> 00:00:29,463 Our medical record system, on the other hand, 15 00:00:29,597 --> 00:00:31,132 it has you listed as female. 16 00:00:32,500 --> 00:00:34,302 Probably because of the Pap smears. 17 00:00:34,435 --> 00:00:37,305 Software clearly needs a trans update. Deep breath. 18 00:00:37,438 --> 00:00:39,573 (BREATHES DEEPLY) I'll fix it so everything is correct going forward. 19 00:00:39,707 --> 00:00:41,575 Please confirm your gender and pronouns. 20 00:00:41,709 --> 00:00:43,644 Male, he/him/his. Thanks for asking. 21 00:00:43,777 --> 00:00:45,813 We're the ones with the messed-up software. 22 00:00:45,946 --> 00:00:48,482 Your scans from this morning were just uploaded. 23 00:00:56,524 --> 00:00:59,160 In less than two weeks, the tumor's doubled in size. 24 00:01:04,031 --> 00:01:06,500 WOMAN: ** You're just too good to be true 25 00:01:06,634 --> 00:01:08,769 ** I can't take my eyes off of you 26 00:01:08,902 --> 00:01:11,038 ** You'd be like heaven to touch... 27 00:01:11,172 --> 00:01:12,673 FEMALE PARAMEDIC: 34-year-old female, Zara Norton. 28 00:01:12,806 --> 00:01:14,242 Tachycardic and delirious. 29 00:01:14,375 --> 00:01:16,244 (CONTINUES SINGING) Dr. Guerin, update vitals. 30 00:01:16,377 --> 00:01:17,778 Dr. Wolke, draw blood for CBC and electrolytes. 31 00:01:17,911 --> 00:01:19,380 ** Oh, pretty baby 32 00:01:19,513 --> 00:01:20,914 ** Now that I've found you, stay ** 33 00:01:21,048 --> 00:01:23,251 Pupils are dilated, but reactive. 34 00:01:23,384 --> 00:01:26,019 Ms. Norton, smells like you've had some marijuana? 35 00:01:26,154 --> 00:01:28,722 Mmm-mmm. I just unloaded a shipment at the dispensary. 36 00:01:28,856 --> 00:01:30,358 Test for THC and a full tox screen. 37 00:01:30,491 --> 00:01:31,459 I am a peddler. 38 00:01:31,592 --> 00:01:33,861 ** Not a user ** 39 00:01:33,994 --> 00:01:35,229 Run it. 40 00:01:35,363 --> 00:01:37,097 BP's elevated, 180 over 115. 41 00:01:37,231 --> 00:01:38,566 That could explain the delirium. 42 00:01:38,699 --> 00:01:40,934 Ooh, that sound high. Better take my meds. 43 00:01:41,068 --> 00:01:42,836 See, I never miss a... Oh, no. 44 00:01:44,205 --> 00:01:45,273 Oh, no, that's not it. 45 00:01:45,406 --> 00:01:46,940 BP's climbing, 210 over 120. 46 00:01:47,074 --> 00:01:49,277 Enalaprilat, 1.25 milligrams, IV. 47 00:01:49,410 --> 00:01:50,444 Ms. Norton, do you remember the name of your medication? 48 00:01:50,578 --> 00:01:52,746 You can call me Zara. 49 00:01:52,880 --> 00:01:55,082 See? It say right here on the... (GROANS SOFTLY) 50 00:01:55,216 --> 00:01:57,084 CLAIRE: Okay, forget about the meds. She is not taking any. 51 00:01:57,218 --> 00:01:58,952 This is untreated chronic hypertension. 52 00:01:59,086 --> 00:02:01,088 What if you're wrong? What if she's on a loop diuretic for her pressure? 53 00:02:01,222 --> 00:02:01,922 This could cause renal failure. 54 00:02:02,055 --> 00:02:03,424 (ALARMS BEEPING) 55 00:02:03,557 --> 00:02:04,558 She's heading into hypertensive crisis. 56 00:02:05,993 --> 00:02:07,060 What if we try an angiotensin receptor blocker? 57 00:02:07,195 --> 00:02:08,562 No drug interaction. 58 00:02:08,696 --> 00:02:10,564 Angiotensin receptor blockers work too slowly. 59 00:02:10,698 --> 00:02:11,732 I'm giving her the ACE inhibitor. 60 00:02:11,865 --> 00:02:12,600 (BEEPING CONTINUES) 61 00:02:16,404 --> 00:02:17,571 (BEEPING SLOWS) BP's going down. 62 00:02:18,372 --> 00:02:19,373 Nice call. 63 00:02:24,044 --> 00:02:25,779 (THEME MUSIC PLAYING) 64 00:02:36,056 --> 00:02:37,591 Latest budget report. 65 00:02:37,725 --> 00:02:39,293 Yeah, the PDF's sitting in my inbox. 66 00:02:39,427 --> 00:02:41,295 I'm trying to ignore it. 67 00:02:41,429 --> 00:02:42,596 And thus... 68 00:02:45,466 --> 00:02:46,767 A sit-down visit? 69 00:02:46,900 --> 00:02:48,001 Just checking in, see how you're doing. 70 00:02:48,135 --> 00:02:49,870 Okay. You? 71 00:02:50,003 --> 00:02:52,773 Me? I'm... recovering from the year, 72 00:02:53,641 --> 00:02:54,742 like everybody else. 73 00:02:54,875 --> 00:02:56,777 Pandemic, the surge. 74 00:02:56,910 --> 00:02:58,612 You were here for every minute of every day. 75 00:02:58,746 --> 00:03:00,248 It must have taken a toll. 76 00:03:00,381 --> 00:03:02,650 It... comes with the territory. 77 00:03:02,783 --> 00:03:05,319 You're not, uh, stressed or distracted? 78 00:03:06,587 --> 00:03:09,323 I'm... tired. 79 00:03:09,457 --> 00:03:12,293 Okay. Well, maybe you should take some time off. 80 00:03:12,426 --> 00:03:13,394 No. 81 00:03:15,929 --> 00:03:17,465 But thank you. I'm fine. 82 00:03:22,336 --> 00:03:23,337 You don't seem fine. 83 00:03:28,876 --> 00:03:30,744 Are there issues with my work performance? 84 00:03:30,878 --> 00:03:32,079 No, you do great work. 85 00:03:32,212 --> 00:03:33,547 Then I'm not sure why we're having this conversation. 86 00:03:33,681 --> 00:03:35,048 Because I'm worried about you. 87 00:03:36,784 --> 00:03:38,719 Because other people are worried about you. 88 00:03:39,953 --> 00:03:41,655 There's no shame in struggling a little bit. 89 00:03:42,990 --> 00:03:44,558 You know, what would be weird is 90 00:03:44,692 --> 00:03:46,660 if you didn't struggle at all. 91 00:03:48,195 --> 00:03:51,231 If you need to see someone, the hospital will cover the cost. 92 00:03:51,365 --> 00:03:54,234 Great. You'll pay my bills. 93 00:03:54,368 --> 00:03:56,737 And the damage to my reputation, who takes care of that? 94 00:03:58,306 --> 00:04:00,741 I don't think that seeing a therapist 95 00:04:00,874 --> 00:04:02,876 will affect your career. 96 00:04:04,177 --> 00:04:05,078 Says the white guy. 97 00:04:08,482 --> 00:04:09,483 Okay. 98 00:04:11,919 --> 00:04:14,021 Privacy protections are there for a reason. 99 00:04:14,154 --> 00:04:15,456 No one needs to know. 100 00:04:15,589 --> 00:04:16,990 Thank you for checking in. 101 00:04:20,528 --> 00:04:21,529 (SIGHS SOFTLY) 102 00:04:33,541 --> 00:04:35,809 How you feeling? Good. 103 00:04:35,943 --> 00:04:38,245 Be better when I understand what landed me up in here. 104 00:04:38,379 --> 00:04:40,448 You had an acute hypertensive crisis. 105 00:04:40,581 --> 00:04:41,882 Oh, I know my blood pressure's high. 106 00:04:42,015 --> 00:04:43,050 I'm already on medication for it. 107 00:04:43,183 --> 00:04:43,917 You probably wanna know what it is. 108 00:04:45,052 --> 00:04:46,320 There's no medication. 109 00:04:47,988 --> 00:04:49,423 We need to do an echocardiogram 110 00:04:49,557 --> 00:04:51,224 to make sure your heart wasn't damaged in the crisis. 111 00:04:51,359 --> 00:04:52,360 Fine by me. 112 00:04:53,861 --> 00:04:55,329 Here's 10% discount 113 00:04:55,463 --> 00:04:58,131 on any purchase over $50 or more at Z & B Naturals. 114 00:04:58,265 --> 00:05:00,634 I'm Z. B is my partner Bill. 115 00:05:01,769 --> 00:05:02,836 You're surrounded by pot all day, every day, 116 00:05:02,970 --> 00:05:03,937 but you never touch the stuff? 117 00:05:04,071 --> 00:05:05,473 How? Why? 118 00:05:05,606 --> 00:05:06,740 It's just never been my thing. 119 00:05:09,943 --> 00:05:11,278 Ah. 120 00:05:11,412 --> 00:05:12,312 The name always trips me up. 121 00:05:12,446 --> 00:05:13,747 Chlorthalidone. 122 00:05:14,682 --> 00:05:15,716 That's for hypertension. 123 00:05:15,849 --> 00:05:16,917 Yeah, bottle seems pretty full. 124 00:05:17,050 --> 00:05:18,051 How long have you been on this? 125 00:05:18,185 --> 00:05:19,620 About six months. Just refilled it. 126 00:05:20,320 --> 00:05:21,054 Take it every day. 127 00:05:26,794 --> 00:05:27,761 DR. REZNICK: Smile. 128 00:05:28,696 --> 00:05:29,663 Head tilt. 129 00:05:31,064 --> 00:05:32,332 Now he smiles. 130 00:05:33,801 --> 00:05:35,102 Burst of laughter. 131 00:05:35,235 --> 00:05:35,969 (CHUCKLES) 132 00:05:37,337 --> 00:05:38,338 Yeah. 133 00:05:45,613 --> 00:05:47,180 Rio Gutierrez, 29, 134 00:05:47,314 --> 00:05:49,316 pituitary mass went from manageable with meds 135 00:05:49,450 --> 00:05:50,951 to likely surgery. 136 00:05:51,084 --> 00:05:54,588 So, talking to the new radiology resident, huh? 137 00:05:54,722 --> 00:05:58,191 I wanted Dr. D'Souza's opinion on an intriguing set of scans. 138 00:05:58,325 --> 00:05:59,092 She is very talented. 139 00:06:00,528 --> 00:06:01,361 You're crushing on her. 140 00:06:02,262 --> 00:06:02,996 N... No. 141 00:06:03,764 --> 00:06:05,399 I am not. I love Lea. 142 00:06:05,533 --> 00:06:06,867 Well, those two things aren't mutually exclusive. 143 00:06:09,269 --> 00:06:12,205 Mr. Gutierrez's blood has high levels of prolactin. 144 00:06:12,339 --> 00:06:14,608 Prolactin is produced in the pituitary gland. 145 00:06:14,742 --> 00:06:16,276 The tumor could be secreting it. 146 00:06:16,410 --> 00:06:18,111 Or the tumor could be reacting to the high levels of hormones 147 00:06:18,245 --> 00:06:19,179 being produced elsewhere in the body. 148 00:06:20,481 --> 00:06:21,982 The patient is a transgender man. 149 00:06:25,686 --> 00:06:26,687 Do an ultrasound. 150 00:06:28,789 --> 00:06:31,191 Advance the probe until you see the cardiac chamber. 151 00:06:32,860 --> 00:06:34,394 ENRIQUE: Maybe Zara has secondary hypertension 152 00:06:34,528 --> 00:06:35,996 due to renal vascular disease. 153 00:06:36,129 --> 00:06:37,731 She doesn't. Her creatinine is 1.2. 154 00:06:37,865 --> 00:06:39,733 Her GFR is in normal range. 155 00:06:39,867 --> 00:06:42,035 Well, that would make it unlikely, but not impossible. 156 00:06:42,169 --> 00:06:44,805 It'd also explain why her prescribed hypertension meds weren't working 157 00:06:44,938 --> 00:06:47,007 and why she got better when you gave her that ACE inhibitor. 158 00:06:47,140 --> 00:06:48,976 Mmm. Simpler explanation, she's not taking her meds. 159 00:06:49,109 --> 00:06:50,343 Valve looks normal. 160 00:06:50,478 --> 00:06:52,212 Should I move on to the two-chamber view? 161 00:06:52,345 --> 00:06:53,681 Yeah. 162 00:06:53,814 --> 00:06:55,749 We have no reason to think that she's lying. 163 00:06:55,883 --> 00:06:57,851 She seems to be telling the truth about her pot usage. 164 00:06:57,985 --> 00:06:59,953 No THC in her blood or urine. 165 00:07:00,087 --> 00:07:02,556 She couldn't possibly be lying about something else. 166 00:07:02,690 --> 00:07:04,492 The left ventricle is thickened, 167 00:07:04,625 --> 00:07:06,860 which is consistent with untreated hypertension. 168 00:07:06,994 --> 00:07:08,496 (MONITOR BEEPING RAPIDLY) 169 00:07:08,629 --> 00:07:09,362 Heart rate's climbing. 170 00:07:11,264 --> 00:07:12,833 Cardiac output is dropping. 171 00:07:12,966 --> 00:07:14,234 Stroke volume as well. 172 00:07:14,367 --> 00:07:15,736 She's in cardiogenic shock. 173 00:07:15,869 --> 00:07:16,870 (ALARMS BEEPING) 174 00:07:19,573 --> 00:07:21,241 Would you mind if I did an ultrasound on your abdomen? 175 00:07:22,375 --> 00:07:23,777 For a brain tumor? 176 00:07:23,911 --> 00:07:27,481 This is my fiance, Eli Simpson. 177 00:07:27,615 --> 00:07:28,849 When I heard about the new scans, 178 00:07:28,982 --> 00:07:29,783 I kind of stormed the castle. 179 00:07:31,118 --> 00:07:32,052 My hero. 180 00:07:33,186 --> 00:07:34,888 Your prolactin levels are very high, 181 00:07:35,022 --> 00:07:36,089 which might be caused by the tumor, 182 00:07:36,223 --> 00:07:37,791 unless another condition raised your prolactin, 183 00:07:37,925 --> 00:07:38,892 encouraging more growth. 184 00:07:40,160 --> 00:07:41,328 What condition boosts prolactin? 185 00:07:43,330 --> 00:07:44,798 Do you think I'm pregnant? 186 00:07:46,366 --> 00:07:48,702 He can't be. He's on testosterone. 187 00:07:48,836 --> 00:07:50,604 Except for a few weeks last month. 188 00:07:50,738 --> 00:07:52,205 I forgot to take my shot before our trip. 189 00:07:53,807 --> 00:07:54,808 But there's no way that... 190 00:07:54,942 --> 00:07:55,909 You're pregnant. 191 00:08:10,123 --> 00:08:11,625 You went into cardiogenic shock 192 00:08:11,759 --> 00:08:13,627 because your heart wasn't pumping adequately. 193 00:08:13,761 --> 00:08:16,897 We did a minor procedure and installed an Impella pump, 194 00:08:17,030 --> 00:08:18,999 but it's a short-term solution. 195 00:08:19,132 --> 00:08:20,868 I do feel a little out of breath. 196 00:08:21,001 --> 00:08:23,136 But that might be just 'cause of you, Dr. Andrews. 197 00:08:23,270 --> 00:08:24,905 Ms. Norton, I'm a married man and your doctor. 198 00:08:25,038 --> 00:08:25,939 (CHUCKLES) 199 00:08:27,474 --> 00:08:28,876 You have a rare condition. 200 00:08:29,009 --> 00:08:30,678 Certain parts of your heart muscle 201 00:08:30,811 --> 00:08:32,580 have become abnormally thick. 202 00:08:32,713 --> 00:08:36,049 So, this wall in between the chambers, that's the septum. 203 00:08:36,183 --> 00:08:36,950 That's a normal one. 204 00:08:38,485 --> 00:08:40,020 This is what yours looks like. 205 00:08:40,788 --> 00:08:41,755 Oh, wow. 206 00:08:41,889 --> 00:08:43,791 It's gonna require surgery. 207 00:08:43,924 --> 00:08:46,026 We're gonna run a few more tests to determine the best approach. 208 00:08:47,828 --> 00:08:49,429 Wait. You gonna be my surgeon, Dr. Andrews? 209 00:08:49,963 --> 00:08:50,964 I sure will. 210 00:08:51,965 --> 00:08:52,966 And y'all two gonna be with him? 211 00:08:54,001 --> 00:08:55,368 Yeah. 212 00:08:55,502 --> 00:08:57,805 (CHUCKLES) My lucky day. 213 00:08:57,938 --> 00:09:00,373 Three doctors of color taking care of me. 214 00:09:00,507 --> 00:09:02,710 Doctors who won't talk down to me. 215 00:09:02,843 --> 00:09:04,945 Not exactly what I'm used to. 216 00:09:05,078 --> 00:09:06,279 You guys know what I mean. 217 00:09:06,413 --> 00:09:07,915 My mother made me wear a suit and tie 218 00:09:08,048 --> 00:09:10,550 whenever we went to the pediatrician. 219 00:09:10,684 --> 00:09:13,687 Put on your Sunday best just to get on the scale and touch your toes. 220 00:09:13,821 --> 00:09:16,990 Yeah. Made me so mad, I wound up becoming a doctor. 221 00:09:17,524 --> 00:09:18,391 (CHUCKLES) 222 00:09:19,326 --> 00:09:21,228 The testing confirmed 223 00:09:21,361 --> 00:09:24,064 your tumor is a hormone-producing prolactinoma. 224 00:09:24,197 --> 00:09:27,000 And the pregnancy is about six weeks along. 225 00:09:27,134 --> 00:09:28,902 Do you consider yourself gay? 226 00:09:30,671 --> 00:09:32,039 I don't think that's... ELI: Yes. 227 00:09:33,040 --> 00:09:35,342 Because I am gay. 228 00:09:35,475 --> 00:09:38,345 But you have vaginal intercourse with your fiance. 229 00:09:38,478 --> 00:09:41,381 That is how he got pregnant... Dr. Murphy, that's enough. 230 00:09:41,514 --> 00:09:43,016 I... I just want... I think you should leave. 231 00:09:52,459 --> 00:09:53,861 I'm sorry. 232 00:09:53,994 --> 00:09:56,063 That was completely inappropriate. 233 00:09:58,065 --> 00:09:59,366 Our treatment plan for your tumor 234 00:09:59,499 --> 00:10:01,234 depends on your plan for your pregnancy. 235 00:10:02,502 --> 00:10:03,236 So... 236 00:10:07,574 --> 00:10:09,242 We've talked about kids, 237 00:10:09,376 --> 00:10:12,312 but I always figured that was way down the road. 238 00:10:14,347 --> 00:10:15,448 And not this way. 239 00:10:16,549 --> 00:10:17,751 I always assumed we'd adopt. 240 00:10:20,754 --> 00:10:23,223 I'd have go off T, and stay off. 241 00:10:25,192 --> 00:10:26,827 If Rio doesn't continue the pregnancy, 242 00:10:27,627 --> 00:10:28,628 then what happens? 243 00:10:29,697 --> 00:10:31,064 Your hormone levels would drop quickly, 244 00:10:31,198 --> 00:10:32,766 which would cause the tumor to shrink. 245 00:10:32,900 --> 00:10:36,103 After that, we'd use medication, possibly a minor surgery. 246 00:10:39,172 --> 00:10:40,573 I'd like to terminate the pregnancy. 247 00:10:44,244 --> 00:10:45,879 ENRIQUE: I looked over all of Zara's labs. 248 00:10:46,013 --> 00:10:49,616 All signs point to her taking her hypertension medicine regularly. 249 00:10:49,750 --> 00:10:53,954 Her MRIs show significant ventricular septal thickness, 250 00:10:54,087 --> 00:10:55,388 bad turbulence jet flow. 251 00:10:56,489 --> 00:10:58,325 There's myocardial edema, too. 252 00:10:59,592 --> 00:11:02,329 The ACE inhibitors were a bad call. 253 00:11:02,462 --> 00:11:04,932 Which eventually sent our patient into cardiogenic shock. 254 00:11:06,734 --> 00:11:08,501 (KEYBOARD CLACKS, COMPUTER BEEPS) 255 00:11:08,635 --> 00:11:10,403 Why'd you ignore what she was telling us? 256 00:11:11,772 --> 00:11:13,173 (SCOFFS SOFTLY) I made a medical diagnosis 257 00:11:13,306 --> 00:11:15,675 based on pattern processing 258 00:11:15,809 --> 00:11:17,110 that we're taught in med school, 259 00:11:17,244 --> 00:11:21,815 which involves considering, you know, race, education, 260 00:11:21,949 --> 00:11:24,617 occupation, BMI. 261 00:11:24,752 --> 00:11:26,586 Always sounded like profiling to me. 262 00:11:30,357 --> 00:11:31,124 (COMPUTER BEEPS) 263 00:11:34,261 --> 00:11:35,662 MAN ON TV: Yes, we have the rain, 264 00:11:35,796 --> 00:11:37,497 but more impressively, the wind. 265 00:11:37,630 --> 00:11:39,299 That rain's going to be coming in sideways. 266 00:11:39,432 --> 00:11:41,668 Just take a look at how the wind increases 267 00:11:41,802 --> 00:11:43,036 as we progress throughout the day. 268 00:11:43,170 --> 00:11:44,872 So, this afternoon, we're talking about 269 00:11:45,005 --> 00:11:46,473 50-mile-per-hour gusts possible. 270 00:11:46,606 --> 00:11:47,307 Sorry for crashing. 271 00:11:48,241 --> 00:11:49,943 Radiology doesn't have a TV. 272 00:11:50,077 --> 00:11:50,844 (TV CONTINUES PLAYING INDISTINCTLY) 273 00:11:52,345 --> 00:11:54,014 You like The Weather Channel? 274 00:11:55,615 --> 00:11:56,817 I find it soothing. 275 00:11:58,986 --> 00:11:59,853 Would you like to join me? 276 00:12:02,189 --> 00:12:04,557 And we have more intense rainfall coming through, 277 00:12:04,691 --> 00:12:07,160 and that's going to also lead to some flood potential. 278 00:12:07,294 --> 00:12:08,896 All of us are going to get into the action. 279 00:12:09,029 --> 00:12:10,563 You got the mountains. 280 00:12:10,697 --> 00:12:13,333 Would you mind if I lowered the volume by four output levels? 281 00:12:15,002 --> 00:12:16,003 Oh. 282 00:12:17,004 --> 00:12:18,371 That would be perfect. 283 00:12:18,505 --> 00:12:20,340 All the areas around here in Northern California, 284 00:12:20,473 --> 00:12:22,075 Modesto, Stockton, Sacramento. 285 00:12:22,209 --> 00:12:24,077 (VOLUME DECREASES) The northern part of San Francisco... 286 00:12:24,211 --> 00:12:25,012 (TV CONTINUES PLAYING INDISTINCTLY) 287 00:12:32,820 --> 00:12:35,188 I find the reflection on the screen so distracting. 288 00:12:38,591 --> 00:12:39,559 So do I. 289 00:12:52,072 --> 00:12:53,106 Could I 290 00:12:55,675 --> 00:12:56,476 do this? 291 00:13:41,254 --> 00:13:42,255 Nurse paged me. 292 00:13:44,958 --> 00:13:45,926 Is something wrong? 293 00:13:47,560 --> 00:13:48,461 I've changed my mind. 294 00:13:51,798 --> 00:13:52,900 I want to keep the baby. 295 00:13:58,438 --> 00:13:59,839 Since you're continuing the pregnancy, 296 00:13:59,973 --> 00:14:01,909 we'll need to surgically remove the prolactinoma. 297 00:14:03,043 --> 00:14:05,612 So, you'll cut into his brain? 298 00:14:05,745 --> 00:14:07,647 Our safest option is to go in through the nasal cavity 299 00:14:07,780 --> 00:14:11,384 in what's known as a transsphenoidal surgery, TSS for short. 300 00:14:11,518 --> 00:14:13,887 It's less invasive than our other option. 301 00:14:15,155 --> 00:14:16,356 That still sounds dangerous. 302 00:14:17,490 --> 00:14:18,858 I've made up my mind. 303 00:14:18,992 --> 00:14:20,293 Do I get any say in this? 304 00:14:23,596 --> 00:14:26,133 I'm all for us having a family, but I'm not ready to... 305 00:14:26,266 --> 00:14:27,867 No one's ever ready for kids. 306 00:14:28,001 --> 00:14:30,603 Yesterday, you said that you never considered getting pregnant, 307 00:14:30,737 --> 00:14:32,305 and now you're willing to risk your life for it. 308 00:14:37,144 --> 00:14:38,311 When I was about seven, 309 00:14:39,579 --> 00:14:41,314 I had this one refuge. 310 00:14:43,650 --> 00:14:45,953 I'd hang a quilt over a couple chairs 311 00:14:46,086 --> 00:14:48,321 and hide out with my two buds, 312 00:14:50,223 --> 00:14:51,925 Foxie the Fox and Fuzz the Lion, 313 00:14:53,526 --> 00:14:54,327 and I'd imagine, 314 00:14:55,528 --> 00:14:56,329 I was the dad. 315 00:14:59,866 --> 00:15:02,002 And they were my twin little guys, 316 00:15:03,003 --> 00:15:04,404 fraternal, obviously. 317 00:15:06,639 --> 00:15:07,407 We were a family. 318 00:15:11,011 --> 00:15:13,413 When I transitioned, I put that dream aside. 319 00:15:14,681 --> 00:15:16,716 At least, as far as them coming from me. 320 00:15:16,849 --> 00:15:17,850 But now... 321 00:15:22,189 --> 00:15:23,356 Whether we planned it or not, 322 00:15:24,824 --> 00:15:25,858 this is our baby. 323 00:15:32,365 --> 00:15:34,501 How soon can you do the surgery? 324 00:15:34,634 --> 00:15:36,403 I'll order an image-guidance MRI to get things started. 325 00:15:46,679 --> 00:15:49,282 CLAIRE: Based on the cardiac MRI and catheterization, 326 00:15:49,416 --> 00:15:50,917 there are two treatment options. 327 00:15:51,051 --> 00:15:53,320 Myectomy, basically open heart surgery, 328 00:15:53,453 --> 00:15:55,955 and alcohol septal ablation, 329 00:15:56,089 --> 00:15:59,392 where we use the alcohol to kill targeted sections of the heart muscle. 330 00:16:00,293 --> 00:16:02,495 Well, what would you recommend? 331 00:16:02,629 --> 00:16:05,898 The surgery is more invasive, tougher recovery, 332 00:16:06,033 --> 00:16:07,800 but better efficacy long-term. 333 00:16:07,934 --> 00:16:09,936 The ablation is less dangerous, 334 00:16:10,070 --> 00:16:13,206 but you're more likely to need further medical interventions. 335 00:16:14,274 --> 00:16:16,009 Now, you call that a recommendation? 336 00:16:16,143 --> 00:16:18,111 There are pros and cons to both. 337 00:16:18,245 --> 00:16:20,147 Uh, you'll need to weigh them. 338 00:16:20,280 --> 00:16:21,281 I'll give you some time. 339 00:16:22,915 --> 00:16:24,751 You always want to take care of people, Dr. Browne? 340 00:16:24,884 --> 00:16:25,618 Pretty much. 341 00:16:26,553 --> 00:16:28,455 Me, too. 342 00:16:28,588 --> 00:16:31,424 Oh. Well, you run a marijuana dispensary. 343 00:16:31,558 --> 00:16:33,360 It's not all about getting people high. 344 00:16:33,493 --> 00:16:37,064 No, maybe not, but I'm guessing most of your clientele... 345 00:16:37,197 --> 00:16:38,931 My Great-Aunt Lucy had pancreatic cancer. 346 00:16:42,069 --> 00:16:43,136 A year, she hung on. 347 00:16:44,304 --> 00:16:45,305 In agony. 348 00:16:46,973 --> 00:16:50,677 Marijuana was the only thing that helped her eat or sleep. 349 00:16:50,810 --> 00:16:52,445 Doctors didn't give her anything for the pain? 350 00:16:53,313 --> 00:16:54,447 They suggested ibuprofen. 351 00:16:56,683 --> 00:16:58,351 Now, you know doctors are 22% less likely 352 00:16:58,485 --> 00:17:00,653 to give pain meds to Black patients 353 00:17:00,787 --> 00:17:02,655 than to white patients with the same symptoms. 354 00:17:04,657 --> 00:17:07,460 My point is, you and I, we're a lot alike. 355 00:17:09,129 --> 00:17:10,997 We're both strong, Black women finding our way in the world, 356 00:17:11,131 --> 00:17:14,167 but one of us knows more about medicine than the other. 357 00:17:14,301 --> 00:17:18,338 So, I'd like to know, what would you do in my situation? 358 00:17:22,509 --> 00:17:24,777 The open myectomy is a bigger risk 359 00:17:24,911 --> 00:17:27,480 but offers more long-term benefits. 360 00:17:30,117 --> 00:17:30,850 I've made my decision. 361 00:17:34,421 --> 00:17:35,488 I'm with you, Dr. Browne. 362 00:17:36,789 --> 00:17:37,890 Book the myectomy. 363 00:17:45,998 --> 00:17:48,668 Here's the Rio Gutierrez imaging for your upcoming TSS. 364 00:17:48,801 --> 00:17:50,370 Set that on the table, please. 365 00:17:54,641 --> 00:17:56,409 I, um... 366 00:17:56,543 --> 00:17:58,678 I noted the tumor's suprasellar expansion 367 00:17:58,811 --> 00:18:02,081 and surrounding edema and splaying of circle of Willis. 368 00:18:02,215 --> 00:18:03,683 That is very helpful. 369 00:18:07,019 --> 00:18:08,020 Bye, Dr. Murphy. 370 00:18:11,558 --> 00:18:12,959 You're safe, Shaun. She's gone. 371 00:18:13,092 --> 00:18:14,427 Not really. 372 00:18:15,562 --> 00:18:17,697 Dr. D'Souza is still in my brain. 373 00:18:17,830 --> 00:18:18,565 I don't like it. 374 00:18:19,566 --> 00:18:20,533 We kissed. 375 00:18:21,834 --> 00:18:22,902 When? What? 376 00:18:23,035 --> 00:18:24,904 I have so many thoughts about her, 377 00:18:25,037 --> 00:18:27,574 and I have so many questions I want to ask Rio. 378 00:18:27,707 --> 00:18:29,041 Wouldn't he get more pleasure for... 379 00:18:29,176 --> 00:18:30,310 Questions you're not supposed to ask him. 380 00:18:30,443 --> 00:18:32,044 The kiss, Shaun. When did you kiss? 381 00:18:32,179 --> 00:18:33,746 Last night. In my dream. 382 00:18:35,382 --> 00:18:39,519 If I can't ask questions, how do I understand? 383 00:18:39,652 --> 00:18:41,554 My... My brain... 384 00:18:41,688 --> 00:18:44,557 My... My brain isn't behaving the way I want it to. 385 00:18:44,691 --> 00:18:45,625 How do I make it stop? 386 00:18:50,297 --> 00:18:51,764 You're attracted to Dr. D'Souza. 387 00:18:52,732 --> 00:18:53,600 Why does that bother you? 388 00:18:56,436 --> 00:19:00,973 When I was with Carly and had feelings for Lea, 389 00:19:01,107 --> 00:19:03,810 it meant I was supposed to be with Lea. 390 00:19:03,943 --> 00:19:06,346 What if this means I'm supposed to be with Dr. D'Souza? 391 00:19:06,479 --> 00:19:09,081 No. You've loved Lea for years. 392 00:19:09,216 --> 00:19:11,584 This is just... attraction. 393 00:19:13,686 --> 00:19:16,956 But shouldn't loving Lea make it go away? 394 00:19:18,625 --> 00:19:21,594 Relationships would be a lot easier if it worked that way. 395 00:19:23,696 --> 00:19:25,131 You're feeling guilty. 396 00:19:25,265 --> 00:19:28,167 I say take Lea out for a nice dinner, something special. 397 00:19:28,301 --> 00:19:30,337 And tell her about my crush. 398 00:19:30,470 --> 00:19:32,138 I need to let Lea know. 399 00:19:32,272 --> 00:19:33,373 No, definitely not. No, you do not. 400 00:19:35,275 --> 00:19:37,544 I want to get your thoughts on the suprasellar extension of the tumor 401 00:19:37,677 --> 00:19:38,911 for this TSS. You remember Sarah Pepper? 402 00:19:39,045 --> 00:19:40,613 Runs nephrology at S.F. Regional? 403 00:19:41,414 --> 00:19:42,982 Always wears a shawl? 404 00:19:43,115 --> 00:19:46,353 So, during the staff meeting last week, she fell apart. 405 00:19:46,486 --> 00:19:48,621 Screaming, crying in front of the whole department. Totally nuts. 406 00:19:49,489 --> 00:19:52,058 Rough day at the office. 407 00:19:52,191 --> 00:19:54,461 Wonder how you'd approach and resect without getting a CSF leak. 408 00:19:55,127 --> 00:19:56,796 Yeah. 409 00:19:56,929 --> 00:19:59,499 Place a lumbar drain, then infuse saline and do Valsalva maneuver. 410 00:19:59,999 --> 00:20:01,368 Okay. 411 00:20:01,501 --> 00:20:04,203 Apparently, Pepper's meltdown was so over the top, 412 00:20:04,337 --> 00:20:05,905 the hospital forced her to take a leave. 413 00:20:07,340 --> 00:20:08,641 How long? Unspecified. 414 00:20:10,076 --> 00:20:12,479 She's always been a little crazy. 415 00:20:12,612 --> 00:20:15,948 Last I checked, eccentric and emotional didn't qualify as crazy. 416 00:20:16,082 --> 00:20:16,883 Thanks for taking a look. 417 00:20:23,656 --> 00:20:24,991 I read that cisgender people 418 00:20:25,124 --> 00:20:28,060 often reduce transgender people to their genitalia, 419 00:20:28,194 --> 00:20:29,362 and that that is offensive. 420 00:20:30,297 --> 00:20:31,664 Did I do that to you and Rio? 421 00:20:32,732 --> 00:20:33,666 Yes. 422 00:20:35,368 --> 00:20:36,503 I'm sorry. 423 00:20:39,839 --> 00:20:41,674 Rio will be going into surgery soon. 424 00:20:43,710 --> 00:20:45,678 He's been asking for you. 425 00:20:45,812 --> 00:20:46,679 You haven't been answering your phone. 426 00:20:48,147 --> 00:20:49,248 Thanks for letting me know. 427 00:20:54,086 --> 00:20:56,222 He is very confusing to me, too. 428 00:20:56,356 --> 00:20:58,658 Rio has worked so hard, 429 00:20:58,791 --> 00:21:01,694 he had a bilateral subcutaneous mastectomy 430 00:21:01,828 --> 00:21:03,396 and takes hormone replacement therapy, 431 00:21:03,530 --> 00:21:08,401 but now he is choosing the most female act. 432 00:21:11,103 --> 00:21:13,005 It's not female if Rio's doing it. 433 00:21:17,043 --> 00:21:19,078 Y... Yes. 434 00:21:19,211 --> 00:21:21,881 And he must have dealt with a lot of prejudice 435 00:21:22,582 --> 00:21:24,116 during his transition. 436 00:21:24,250 --> 00:21:25,918 I dealt with prejudice. 437 00:21:26,052 --> 00:21:27,954 My brother helped me. Does he have a brother? 438 00:21:30,022 --> 00:21:31,724 His family doesn't talk to him. 439 00:21:36,863 --> 00:21:39,966 And now Rio is having brain surgery. 440 00:21:43,403 --> 00:21:44,437 He is very brave. 441 00:21:45,938 --> 00:21:46,906 You can stay here. 442 00:21:52,078 --> 00:21:54,947 I have a patient, Zara Norton. 443 00:21:55,081 --> 00:21:57,283 We, uh... We diagnosed her with HOCM. 444 00:21:57,417 --> 00:21:58,918 I saw the file. 445 00:21:59,051 --> 00:22:01,754 Dr. Guerin expressed some concerns 446 00:22:01,888 --> 00:22:04,657 about my initial handling of the case in the ER. 447 00:22:06,258 --> 00:22:10,329 He thinks I stereotyped her, based on her race. 448 00:22:10,463 --> 00:22:11,197 Do you think you did? 449 00:22:13,433 --> 00:22:15,001 She was crashing. 450 00:22:15,134 --> 00:22:17,637 I had to make a call. I didn't have a lot to go on. 451 00:22:20,072 --> 00:22:21,608 Glassman came to see me this morning. 452 00:22:22,909 --> 00:22:25,277 Someone told him I'm unstable and need help. 453 00:22:25,412 --> 00:22:26,546 Any idea where he heard that? 454 00:22:28,981 --> 00:22:30,316 I asked for help. You can, too. 455 00:22:30,450 --> 00:22:31,651 You're a resident. No one cares if you need help. 456 00:22:33,586 --> 00:22:35,755 I got this job in part 457 00:22:35,888 --> 00:22:39,492 because my main competition, a man, backed me. 458 00:22:39,626 --> 00:22:41,994 The second anyone thinks I can't handle this... 459 00:22:42,128 --> 00:22:43,162 No one is gonna think that... 460 00:22:43,295 --> 00:22:44,697 They will if you keep telling them I'm a mess. 461 00:22:45,331 --> 00:22:47,500 You have PTSD. 462 00:22:47,634 --> 00:22:49,101 You shouldn't be ashamed. 463 00:22:49,235 --> 00:22:51,804 Says the women who just profiled a Black female patient. 464 00:22:54,373 --> 00:22:55,374 You judged her, 465 00:22:56,342 --> 00:22:58,978 just like people will judge me 466 00:22:59,111 --> 00:23:00,947 and whisper that I've always been a little intense, 467 00:23:01,080 --> 00:23:02,982 so no wonder I was asked to step down. 468 00:23:04,451 --> 00:23:05,184 (SIGHS SOFTLY) 469 00:23:07,920 --> 00:23:08,888 Nobody needs to know. 470 00:23:10,189 --> 00:23:11,190 (SCOFFS) 471 00:23:12,024 --> 00:23:12,825 Exactly. 472 00:23:15,361 --> 00:23:17,163 You tell me that it doesn't matter. 473 00:23:17,296 --> 00:23:19,231 You tell me everyone will understand, 474 00:23:19,365 --> 00:23:21,734 and then you tell me to keep it to myself. 475 00:23:21,868 --> 00:23:23,470 Should I be ashamed, or shouldn't I be? 476 00:23:25,237 --> 00:23:27,907 All right, Ms. Norton, time to head to pre-op. 477 00:23:30,843 --> 00:23:32,144 ZARA: What's in the bag, handsome? 478 00:23:32,278 --> 00:23:35,682 I like to know what goes into my body. 479 00:23:35,815 --> 00:23:39,051 Uh, cefazolin. It's a prophylactic antibiotic we give before surgeries. 480 00:23:39,185 --> 00:23:39,919 Makes sense. 481 00:23:41,921 --> 00:23:44,356 Hey, what was the med y'all gave me when I first got here to the ER? 482 00:23:45,558 --> 00:23:47,994 Enalaprilat. It's an ACE inhibitor. 483 00:23:48,127 --> 00:23:49,161 Isn't that for hypertension? 484 00:23:49,295 --> 00:23:50,162 Mmm-hmm. 485 00:23:51,964 --> 00:23:53,265 But I thought I already told y'all 486 00:23:53,399 --> 00:23:54,734 I was on meds for my blood pressure. 487 00:23:55,768 --> 00:23:57,036 You did. 488 00:23:57,169 --> 00:23:58,304 So, you figured I needed more? 489 00:24:02,074 --> 00:24:03,275 Or did you not believe me? 490 00:24:17,389 --> 00:24:18,390 I'm sorry. 491 00:24:22,428 --> 00:24:23,395 You must be scared. 492 00:24:25,197 --> 00:24:26,766 You shouldn't have to be scared alone. 493 00:24:27,600 --> 00:24:28,568 (SNIFFLES) 494 00:24:29,101 --> 00:24:30,069 I love you. 495 00:24:31,037 --> 00:24:31,904 I love you, too. 496 00:24:37,209 --> 00:24:37,944 Eli. 497 00:24:40,547 --> 00:24:41,814 I can't see you. 498 00:24:41,948 --> 00:24:44,517 I'm right here, babe. 499 00:24:44,651 --> 00:24:46,418 Can you follow this with your eyes? 500 00:24:49,421 --> 00:24:50,823 It keeps disappearing. 501 00:24:50,957 --> 00:24:52,124 You've lost peripheral vision. 502 00:24:52,258 --> 00:24:53,993 The tumor is impinging on the optic fibers. 503 00:24:54,126 --> 00:24:55,928 We can't perform the TSS surgery. 504 00:25:02,234 --> 00:25:04,270 DR. LIM: With the tumor's continued growth, 505 00:25:04,403 --> 00:25:07,940 the best remaining option is the open pterional craniotomy. 506 00:25:08,074 --> 00:25:11,510 But it is higher risk with a lengthier recovery. 507 00:25:11,644 --> 00:25:14,346 All of which is on top of the potential for gender dysphoria 508 00:25:14,480 --> 00:25:15,715 during pregnancy. 509 00:25:15,848 --> 00:25:17,617 Is that still a concern? 510 00:25:19,819 --> 00:25:21,654 I think back to before I started taking T, 511 00:25:22,622 --> 00:25:24,023 how terrible that felt. 512 00:25:27,259 --> 00:25:28,961 The thought of feeling that all over again... 513 00:25:33,099 --> 00:25:35,134 We could go back to the original plan. 514 00:25:37,837 --> 00:25:38,971 You mean terminate the pregnancy? 515 00:25:40,640 --> 00:25:42,174 The tumor should shrink on its own. 516 00:25:46,278 --> 00:25:50,416 After everything you've done to get where you are in your life, 517 00:25:50,549 --> 00:25:53,352 it's scary to think about doing something that would put that at risk. 518 00:25:55,822 --> 00:25:56,789 (SIGHS) 519 00:25:57,489 --> 00:25:58,991 This is my next step. 520 00:26:00,627 --> 00:26:03,229 I'm ready to take it, even if I'm scared. 521 00:26:06,332 --> 00:26:08,367 You have to take risks sometimes, Dr. Lim. 522 00:26:18,645 --> 00:26:20,346 Thank you. 523 00:26:20,479 --> 00:26:22,181 Shouldn't you be prepping Zara for surgery? 524 00:26:22,314 --> 00:26:23,816 It's canceled. 525 00:26:23,950 --> 00:26:25,484 She wants to be transferred to a different hospital. 526 00:26:27,954 --> 00:26:31,023 One where she won't be "racially profiled into heart failure." 527 00:26:33,893 --> 00:26:34,894 (SIGHS SOFTLY) 528 00:26:39,799 --> 00:26:42,034 Shaun, you okay? 529 00:26:45,204 --> 00:26:47,807 SHAUN: I am having thoughts I don't want to have. 530 00:26:47,940 --> 00:26:50,442 Both Park and Jordan say I shouldn't tell you. 531 00:26:52,211 --> 00:26:53,612 But you're going to, aren't you? 532 00:26:55,882 --> 00:26:57,416 Yes, I am. 533 00:26:57,549 --> 00:26:59,218 I have a work crush. 534 00:26:59,351 --> 00:27:01,854 Also, my patient is a pregnant trans man... 535 00:27:01,988 --> 00:27:03,055 Okay, one at a time, Shaun. 536 00:27:03,723 --> 00:27:06,325 About this... crush? 537 00:27:06,458 --> 00:27:08,227 Her name is Dr. Cintia D'Souza. 538 00:27:08,360 --> 00:27:10,096 She is a second-year radiology resident. 539 00:27:10,229 --> 00:27:12,431 Last night, I dreamed we were in the Residents' Lounge, 540 00:27:12,564 --> 00:27:14,600 watching The Weather Channel, and then we started kissing... 541 00:27:14,734 --> 00:27:15,467 Okay, I got it. 542 00:27:17,670 --> 00:27:19,338 Are you mad? 543 00:27:19,471 --> 00:27:21,107 Park and Jordan were right. I shouldn't have told you. 544 00:27:22,408 --> 00:27:25,011 No. I'm not mad. 545 00:27:25,144 --> 00:27:28,080 A little surprised, but that's okay. 546 00:27:31,684 --> 00:27:33,085 I'm still attracted 547 00:27:34,020 --> 00:27:35,087 to other guys sometimes. 548 00:27:35,955 --> 00:27:36,956 N... No. 549 00:27:37,957 --> 00:27:39,358 No. What? Who? 550 00:27:39,491 --> 00:27:40,492 It doesn't matter. Who? 551 00:27:41,928 --> 00:27:45,765 There... Okay, there is this one physical therapist... 552 00:27:45,898 --> 00:27:46,899 N... No. 553 00:27:47,366 --> 00:27:48,334 No. 554 00:27:48,801 --> 00:27:49,802 No. 555 00:27:53,572 --> 00:27:57,576 What if we're attracted to other people 556 00:27:57,710 --> 00:28:00,747 because there is something wrong with our relationship? 557 00:28:02,749 --> 00:28:05,684 You're not planning on kissing Dr. D'Souza in real life? 558 00:28:05,818 --> 00:28:06,819 No. 559 00:28:06,953 --> 00:28:08,821 Or working late with her, 560 00:28:08,955 --> 00:28:11,223 doing some X-rays alone, 561 00:28:11,357 --> 00:28:14,493 where you might end up leaning over the same light box. 562 00:28:14,626 --> 00:28:16,996 We don't use light boxes anymore. 563 00:28:22,001 --> 00:28:24,136 And I don't plan to work late with her. 564 00:28:24,270 --> 00:28:27,139 Then I don't think either of us has anything to be worried about. 565 00:28:27,774 --> 00:28:28,775 (INHALES SHARPLY) 566 00:28:39,819 --> 00:28:42,154 I have to go prep for a pterional craniotomy. 567 00:28:49,328 --> 00:28:51,330 I'm Dr. Glassman, president of the hospital. 568 00:28:52,698 --> 00:28:54,566 Unless you're here to drive me to S.F. Regional, 569 00:28:54,700 --> 00:28:56,068 you can head right back on out. 570 00:28:57,870 --> 00:29:00,873 I apologize for your experience in the emergency room. 571 00:29:01,007 --> 00:29:02,574 That's mighty white of you. 572 00:29:03,810 --> 00:29:05,978 (SIGHS SOFTLY) 573 00:29:06,112 --> 00:29:09,015 I don't recommend that you transfer to S.F. Regional, 574 00:29:09,148 --> 00:29:10,516 or any other hospital, for that matter. 575 00:29:10,649 --> 00:29:13,085 I'm sure they got the same fancy equipment, 576 00:29:13,219 --> 00:29:15,187 same shiny sets of diplomas y'all got here, 577 00:29:15,321 --> 00:29:17,356 and maybe a few less racist doctors. 578 00:29:19,225 --> 00:29:21,994 Well, apparently, that doesn't seem to be the case. 579 00:29:22,128 --> 00:29:25,798 I pulled data on comparable hospitals within 100 miles, 580 00:29:26,899 --> 00:29:29,969 did numbers on surgical outcomes 581 00:29:30,102 --> 00:29:34,406 and patient satisfaction, aggregated by race. 582 00:29:34,540 --> 00:29:38,577 Apparently, we're doing well, comparatively. 583 00:29:42,181 --> 00:29:45,384 Your argument is that your hospital may be racially biased, 584 00:29:45,517 --> 00:29:47,686 but it's less racially biased than these other hospitals? 585 00:29:49,688 --> 00:29:51,023 Yeah. Pretty much. 586 00:29:52,724 --> 00:29:54,493 Stay at St. Bonaventure, 587 00:29:54,626 --> 00:29:57,930 the president of the hospital will monitor your care every step of the way. 588 00:29:59,431 --> 00:30:00,432 For whatever it's worth, 589 00:30:01,934 --> 00:30:03,235 I don't think you can do better than that. 590 00:30:14,080 --> 00:30:16,248 She's gonna stay, on one condition. 591 00:30:17,683 --> 00:30:18,750 That you're off the team. 592 00:30:30,129 --> 00:30:32,198 DR. LIM: Dr. Park, please open Sylvian fissure. 593 00:30:32,331 --> 00:30:33,900 DR. PARK: Arachnoid knife and Rhoton dissector. 594 00:30:34,033 --> 00:30:34,766 (MONITOR BEEPING) 595 00:30:36,102 --> 00:30:38,270 Tumor is visible. 596 00:30:39,972 --> 00:30:41,273 What makes someone a man? 597 00:30:43,342 --> 00:30:45,978 I thought it was just the chromosomes, 598 00:30:46,112 --> 00:30:47,646 but that must not be it, 599 00:30:47,779 --> 00:30:50,616 which makes things confusing and difficult, 600 00:30:50,749 --> 00:30:52,484 and I know Rio was uncomfortable when he... 601 00:30:52,618 --> 00:30:54,820 Life is uncomfortable. 602 00:30:54,954 --> 00:30:58,290 It hits you with tough situations and you muscle through them. 603 00:30:58,424 --> 00:31:00,026 I see a tiny bleed in the circular sinus. 604 00:31:00,159 --> 00:31:01,293 Pack it with Floseal. 605 00:31:08,267 --> 00:31:10,136 (ALARM BEEPING) DR. LIM: Someone give me an update. 606 00:31:10,269 --> 00:31:12,204 DR. PARK: We got a drop in end tidal CO2 and oxygen sat. 607 00:31:12,338 --> 00:31:14,140 DR. LIM: See any evidence of exposed air cells? 608 00:31:14,273 --> 00:31:17,709 No. But waxing bone edges just to be safe. 609 00:31:17,843 --> 00:31:21,713 But the tumor thinned the sellar floor and sphenoid wall. 610 00:31:21,847 --> 00:31:23,182 DR. LIM: Making it permeable to oxygen. 611 00:31:25,151 --> 00:31:26,652 It's an air embolism. 612 00:31:26,785 --> 00:31:29,021 (ALARMS BEEPING) JORDAN: BP's dropping. 613 00:31:32,224 --> 00:31:33,525 Dr. Lim, what should we do? 614 00:31:39,031 --> 00:31:40,799 (BEEPING FADES, VOICES SPEAKING INDISTINCTLY, ECHOING) 615 00:31:43,735 --> 00:31:44,503 (ALARM BEEPING) 616 00:31:45,204 --> 00:31:46,205 (VOICES ECHOING) 617 00:31:48,540 --> 00:31:49,942 (BEEPING CONTINUES) (VOICES ECHOING) 618 00:31:56,949 --> 00:31:58,584 Saline gauze, 619 00:31:58,717 --> 00:32:01,053 tilt the table to eliminate the negative air pressure gradient, 620 00:32:01,187 --> 00:32:02,054 and place a central line. 621 00:32:03,655 --> 00:32:04,690 This will stop the air leak 622 00:32:04,823 --> 00:32:06,492 and allow us to access the air bubble. 623 00:32:06,625 --> 00:32:08,594 DR. PARK: Inserting Bunegin air-aspirating cath. 624 00:32:11,463 --> 00:32:13,365 You are 2 centimeters from the superior vena cava. 625 00:32:15,601 --> 00:32:17,603 Aspirate the right atrium until you don't see any more air bubbles. 626 00:32:21,840 --> 00:32:22,574 (BEEPING SLOWS) 627 00:32:28,880 --> 00:32:30,049 Nice save, Dr. Lim. 628 00:32:31,783 --> 00:32:33,752 Let's get this tumor out. 629 00:32:33,885 --> 00:32:36,455 DR. ANDREWS: Make your transverse aortotomy with Potts scissors, Dr. Wolke. 630 00:32:38,424 --> 00:32:42,094 ASHER: Extending the muscular incision down to the mid-ventricle. 631 00:32:42,228 --> 00:32:43,262 DR. ANDREWS: There's the myectomy site. 632 00:32:45,297 --> 00:32:46,465 There's the aberrant muscle bundle. 633 00:33:11,623 --> 00:33:12,624 Get her off bypass, 634 00:33:13,559 --> 00:33:14,426 see how she does. 635 00:33:24,536 --> 00:33:25,437 (MONITOR BEEPING) 636 00:33:27,906 --> 00:33:28,907 How's the cardiac output? 637 00:33:30,609 --> 00:33:31,443 ENRIQUE: Reduced and insufficient. 638 00:33:33,179 --> 00:33:36,682 Low output could mean we need to further reduce the septum. 639 00:33:36,815 --> 00:33:38,484 Unless it means that we reduced it too much. 640 00:33:38,617 --> 00:33:39,951 Damaged the cardiac electrical conductors 641 00:33:40,086 --> 00:33:41,287 that control the heart rate. (ALARM BEEPING) 642 00:33:41,420 --> 00:33:42,521 She's having third-degree heart block. 643 00:33:43,322 --> 00:33:44,323 Enrique's right. 644 00:33:45,291 --> 00:33:46,158 We took too much muscle. 645 00:33:47,493 --> 00:33:48,560 DR. ANDREWS: Put her back on bypass. 646 00:33:48,694 --> 00:33:51,029 We could augment the wall with a bovine patch. 647 00:33:51,163 --> 00:33:52,864 Still wouldn't insulate the electrical system. 648 00:33:52,998 --> 00:33:55,467 She'd still be at risk of complete heart block and cardiac arrest. 649 00:33:59,338 --> 00:34:01,840 CLAIRE: We could insert a dual chamber pacer. 650 00:34:01,973 --> 00:34:04,343 She won't need the conduction system in the wall of her heart 651 00:34:04,476 --> 00:34:05,644 to control her heart rate. 652 00:34:08,480 --> 00:34:09,481 Let's go! 653 00:34:15,354 --> 00:34:16,122 How was the craniotomy? 654 00:34:17,123 --> 00:34:18,390 It went well. 655 00:34:18,524 --> 00:34:19,558 The patient is in recovery. 656 00:34:23,362 --> 00:34:25,864 Your text said you have good news. 657 00:34:25,997 --> 00:34:26,998 And by good news, I mean bad news for Dr. D'Souza. 658 00:34:28,234 --> 00:34:30,569 Plenty of great stuff to crush a crush. 659 00:34:31,303 --> 00:34:32,504 First observation, 660 00:34:33,972 --> 00:34:35,374 she smells like cinnamon. 661 00:34:37,008 --> 00:34:37,743 Mmm. 662 00:34:39,611 --> 00:34:42,080 Which is more puzzling than irritating. 663 00:34:42,214 --> 00:34:45,484 Actually kind of nice. Which is obviously not helpful. 664 00:34:45,617 --> 00:34:48,654 Oh, okay. She does this weird self-grooming gesture 665 00:34:48,787 --> 00:34:50,389 where she tucks her hair behind her ear. 666 00:34:52,591 --> 00:34:54,593 And then sorta massages her ear. 667 00:34:54,726 --> 00:34:56,695 Also n... not helpful. 668 00:34:56,828 --> 00:34:58,397 Okay. I'm sorry. I'm sorry. (CHUCKLES) 669 00:34:59,030 --> 00:35:00,031 Mmm-hmm. 670 00:35:00,166 --> 00:35:02,368 Okay. At the salad bar, 671 00:35:02,501 --> 00:35:05,371 she used the cucumber tongs to reach for the cucumbers, 672 00:35:06,638 --> 00:35:07,906 and then the tomatoes. 673 00:35:11,477 --> 00:35:12,711 And the olives. 674 00:35:13,879 --> 00:35:14,613 (SIGHS) 675 00:35:15,214 --> 00:35:16,548 And the pickles. 676 00:35:18,250 --> 00:35:19,251 Ugh. Mmm. 677 00:35:20,186 --> 00:35:21,153 Mmm-hmm. 678 00:35:53,385 --> 00:35:54,353 Hey. 679 00:35:56,422 --> 00:35:57,423 Hey. 680 00:35:59,891 --> 00:36:00,992 I can see all of you. 681 00:36:06,732 --> 00:36:08,334 How'd... How'd we do? 682 00:36:08,467 --> 00:36:12,571 Great. We got all of the mass, vision is restored. 683 00:36:12,704 --> 00:36:14,773 You have every reason to expect a full recovery 684 00:36:15,874 --> 00:36:16,642 and a healthy pregnancy. 685 00:36:20,546 --> 00:36:21,580 We're gonna be dads. 686 00:36:22,080 --> 00:36:23,081 (BOTH CHUCKLE) 687 00:36:25,951 --> 00:36:26,685 Are you ready? 688 00:36:29,788 --> 00:36:31,623 I've never been a pregnant man before. 689 00:36:34,125 --> 00:36:36,295 You'll always be the best man that I've ever known. 690 00:36:38,297 --> 00:36:39,298 (CHUCKLES) 691 00:36:50,842 --> 00:36:53,111 Came to see how you were doing. 692 00:36:53,245 --> 00:36:55,847 Dr. Andrews told me you was the one who figured out how to save me. 693 00:37:01,186 --> 00:37:02,654 Still don't change what went down earlier, though. 694 00:37:09,495 --> 00:37:10,962 When I got to med school, 695 00:37:15,166 --> 00:37:17,669 people took one look at me and they thought they knew exactly who I was. 696 00:37:19,170 --> 00:37:20,839 Black girl on financial aid. 697 00:37:22,941 --> 00:37:24,676 She must not be that smart. 698 00:37:24,810 --> 00:37:26,912 She must have gotten a lot of breaks. 699 00:37:28,213 --> 00:37:29,681 She'll probably need a lot more. 700 00:37:35,220 --> 00:37:35,954 And I worked... 701 00:37:38,089 --> 00:37:40,626 I worked so hard 702 00:37:40,759 --> 00:37:41,693 to prove them wrong, 703 00:37:42,794 --> 00:37:44,262 that I wasn't who they thought I was, 704 00:37:44,396 --> 00:37:46,264 that I deserved to be there, that I... 705 00:37:46,998 --> 00:37:48,199 (SIGHS) that I fit in. 706 00:37:54,640 --> 00:37:56,107 When you came into the ER, 707 00:37:59,378 --> 00:38:00,979 loud and messy, 708 00:38:03,715 --> 00:38:05,917 I saw... (SIGHS) 709 00:38:06,051 --> 00:38:10,722 I saw everything I have tried hard not to be. 710 00:38:14,826 --> 00:38:16,595 And I think it made me angry. 711 00:38:22,768 --> 00:38:24,102 (VOICE BREAKING) And I'm ashamed of that. 712 00:38:27,406 --> 00:38:28,574 And I'm really sorry. 713 00:38:32,778 --> 00:38:33,979 I used to be that way. 714 00:38:37,649 --> 00:38:40,185 But I got tired of working that hard to make white people comfortable. 715 00:38:56,802 --> 00:38:58,169 You two heading out for the night? 716 00:38:59,237 --> 00:38:59,971 (EXHALES SHARPLY) 717 00:39:01,840 --> 00:39:03,509 We sure are. 718 00:39:03,642 --> 00:39:06,144 How did the craniotomy go, Shaun? 719 00:39:06,277 --> 00:39:08,780 (SNIFFS) Did you guys get all the prolactinoma? 720 00:39:10,115 --> 00:39:10,849 Yes. 721 00:39:12,618 --> 00:39:14,019 Is that cafeteria salad? 722 00:39:16,422 --> 00:39:17,589 Are there pickles in there? 723 00:39:19,825 --> 00:39:20,792 Did you want some? 724 00:39:20,926 --> 00:39:23,429 You know, I'm good. Thank you. 725 00:39:23,562 --> 00:39:24,596 Shaun, did you... 726 00:39:25,731 --> 00:39:27,799 No, thank you. Mmm-hmm. 727 00:39:33,505 --> 00:39:36,307 It does help to focus on her irresponsible salad bar practices 728 00:39:36,442 --> 00:39:37,976 and dietary preferences. 729 00:39:38,109 --> 00:39:40,812 I've got a ton of strategies to manage discomfort. 730 00:39:41,346 --> 00:39:42,313 So do I. 731 00:39:45,884 --> 00:39:46,818 Hey. DR. LIM: Hey. 732 00:39:48,454 --> 00:39:49,821 To replenish your supply, 733 00:39:50,822 --> 00:39:51,823 and a peace offering. 734 00:39:52,858 --> 00:39:55,627 I wasn't aware we were at war. 735 00:39:55,761 --> 00:39:58,830 Well, seemed like my gossip about Pepper kind of landed wrong. 736 00:40:00,632 --> 00:40:02,167 Bad day. 737 00:40:02,300 --> 00:40:03,769 Sorry to crash the party. 738 00:40:03,902 --> 00:40:06,605 Dr. Glassman wanted me to show this to you two. 739 00:40:08,540 --> 00:40:11,577 I asked Lea to run some numbers on various metrics by race, 740 00:40:11,710 --> 00:40:14,446 and the results are not great, 741 00:40:14,580 --> 00:40:16,414 especially when it comes to pain management. 742 00:40:16,548 --> 00:40:19,851 We are under-treating African-American and Latinx patients 743 00:40:19,985 --> 00:40:22,654 by a considerable margin. 744 00:40:22,788 --> 00:40:24,222 I think I need a little of that peace offering. 745 00:40:24,355 --> 00:40:25,857 Help yourself. 746 00:40:25,991 --> 00:40:27,759 Anyone else? No. Thank you. 747 00:40:30,328 --> 00:40:31,697 Uh... me, neither. 748 00:40:38,770 --> 00:40:39,771 I... 749 00:40:42,373 --> 00:40:43,742 Started taking sertraline. 750 00:40:45,744 --> 00:40:46,745 For PTSD. 751 00:40:47,345 --> 00:40:48,313 (SIGHS) 752 00:40:49,715 --> 00:40:50,716 Sorry to hear that. 753 00:40:52,718 --> 00:40:53,885 You doing okay? 754 00:40:57,222 --> 00:40:57,956 Not really. 755 00:41:00,158 --> 00:41:00,892 But I'm 756 00:41:02,528 --> 00:41:03,361 working on it. 757 00:41:04,796 --> 00:41:05,897 Okay. 758 00:41:09,735 --> 00:41:11,903 Dr. Browne, good work. 759 00:41:14,305 --> 00:41:15,306 Thank you. 760 00:41:25,183 --> 00:41:25,917 (SIGHS) 761 00:41:42,668 --> 00:41:43,835 I apologized to Zara. 762 00:41:47,639 --> 00:41:50,976 She pointed out I spent med school 763 00:41:52,711 --> 00:41:54,646 trying to make white people comfortable. 764 00:41:58,950 --> 00:41:59,951 I mean, she's right. 765 00:42:01,152 --> 00:42:02,320 It wasn't just med school. 766 00:42:05,423 --> 00:42:06,391 Exhausting, isn't it? 767 00:42:09,928 --> 00:42:10,962 But we had to do it, right? 768 00:42:12,831 --> 00:42:13,832 To be here? 769 00:42:31,650 --> 00:42:33,384 (CLOSING THEME MUSIC PLAYING)