1 00:00:00,516 --> 00:00:02,414 Previously on "The Good Doctor"... 2 00:00:02,469 --> 00:00:04,960 You need to take a break, clear your head. 3 00:00:05,031 --> 00:00:06,328 You need a vacation. 4 00:00:08,200 --> 00:00:09,467 I'm gonna quit my job. 5 00:00:09,469 --> 00:00:12,103 I'm not looking forward to moving 6 00:00:12,105 --> 00:00:13,738 to Hershey, Pennsylvania. 7 00:00:13,740 --> 00:00:15,406 I don't want kids. 8 00:00:16,508 --> 00:00:18,075 Ever. 9 00:00:20,512 --> 00:00:21,746 I've just been fired 10 00:00:21,748 --> 00:00:23,414 for physically assaulting an employee. 11 00:00:24,716 --> 00:00:26,417 Go ahead. Chop us in half. 12 00:00:27,904 --> 00:00:29,357 When will they wake up? 13 00:00:29,422 --> 00:00:31,656 They should've already. 14 00:00:49,809 --> 00:00:51,809 We were worried about you, Jenny. 15 00:00:51,811 --> 00:00:53,778 So glad you're back. 16 00:00:53,780 --> 00:00:55,846 I am gonna give you three words. 17 00:00:55,848 --> 00:00:57,048 Try to remember them. 18 00:00:57,050 --> 00:01:00,618 Apple. Ball. House. 19 00:01:00,620 --> 00:01:03,187 Can you count back from 100 by 7 for me? 20 00:01:03,189 --> 00:01:05,856 I'm going to Harvard, you know. 21 00:01:08,494 --> 00:01:16,233 93, 86, 79, 72, 65. 22 00:01:16,235 --> 00:01:17,768 And what city are we in? 23 00:01:17,770 --> 00:01:19,270 San Jose. 24 00:01:19,272 --> 00:01:20,671 And what were those three words? 25 00:01:20,673 --> 00:01:24,041 Apple. Ball. House. 26 00:01:24,043 --> 00:01:26,610 Look out, Harvard. 27 00:01:26,612 --> 00:01:28,746 We'll be doing a lot more tests to know for sure, 28 00:01:28,748 --> 00:01:31,949 but your heart does sound better. 29 00:01:31,951 --> 00:01:34,351 How's Katie? 30 00:01:34,353 --> 00:01:38,556 You woke up before her, so too soon to tell. 31 00:01:38,558 --> 00:01:41,192 There's virtually no alpha or beta brain activity. 32 00:01:41,194 --> 00:01:43,627 We must have missed something during the separation surgery. 33 00:01:43,629 --> 00:01:44,729 We didn't. 34 00:01:44,731 --> 00:01:46,831 Katie's BP was steady, sats were fine, 35 00:01:46,833 --> 00:01:48,899 regional blood supplies were reconstructed. 36 00:01:48,901 --> 00:01:50,835 Just like Jenny, yet she's awake, 37 00:01:50,837 --> 00:01:52,169 Katie's in a coma. 38 00:01:52,171 --> 00:01:53,938 Katie's got the new sagittal graft. 39 00:01:53,940 --> 00:01:56,674 A problem with blood flow in that vein could cause her condition. 40 00:01:56,676 --> 00:01:58,676 An MRI angiogram should tell us if the graft is open or not. 41 00:01:58,678 --> 00:01:59,710 Hello. 42 00:02:01,613 --> 00:02:03,914 I will proceed with the angiogram. 43 00:02:03,916 --> 00:02:05,249 Whoa! 44 00:02:05,251 --> 00:02:06,584 Murphy, you've been gone for two days. 45 00:02:06,586 --> 00:02:07,952 How about we start there? 46 00:02:07,954 --> 00:02:09,620 Okay. 47 00:02:09,622 --> 00:02:11,555 Just because you talked to the president 48 00:02:11,557 --> 00:02:13,324 doesn't qualify as permission. 49 00:02:13,326 --> 00:02:15,493 Okay. Yes. 50 00:02:15,495 --> 00:02:19,196 I... will notify Dr. Melendez 51 00:02:19,198 --> 00:02:21,766 next time I go on a road trip with my girlfriend. 52 00:02:21,768 --> 00:02:23,234 Amazing. 53 00:02:23,236 --> 00:02:24,902 "Road trip"? 54 00:02:24,904 --> 00:02:27,772 Dr. Glassman said you were dealing with a personal crisis. 55 00:02:27,774 --> 00:02:30,875 That is true. 56 00:02:30,877 --> 00:02:33,022 Do you know the definition of personal crisis? 57 00:02:33,047 --> 00:02:37,081 Yes. A stage in a sequence of events 58 00:02:37,083 --> 00:02:40,317 at which the trend of all future events is determined. 59 00:02:40,319 --> 00:02:42,686 - A death, an illness. - Yes. 60 00:02:42,688 --> 00:02:44,355 No, not a road trip. 61 00:02:45,524 --> 00:02:46,724 Okay. 62 00:02:48,160 --> 00:02:49,460 You and Dr. Browne 63 00:02:49,462 --> 00:02:51,562 get going on Katie's angiogram, unless, of course, 64 00:02:51,564 --> 00:02:53,931 you have any personal emergencies to attend to. 65 00:02:53,933 --> 00:02:56,500 No. My crisis is over. 66 00:03:00,306 --> 00:03:03,040 Come in. 67 00:03:03,042 --> 00:03:04,141 Hey. 68 00:03:06,044 --> 00:03:07,509 How are the twins doing? 69 00:03:07,534 --> 00:03:08,867 Jenny's in recovery. 70 00:03:08,892 --> 00:03:11,092 Her numbers look good. She's talking. 71 00:03:11,117 --> 00:03:12,449 Katie... not so good. 72 00:03:13,418 --> 00:03:15,719 We need to talk about Murphy. 73 00:03:15,721 --> 00:03:17,321 I told you he's on personal leave. 74 00:03:17,323 --> 00:03:18,923 Yeah, well, that's not what he said. 75 00:03:20,392 --> 00:03:21,392 You talked to him? 76 00:03:21,394 --> 00:03:23,260 Yes. 77 00:03:23,262 --> 00:03:25,329 In the surgical unit five minutes ago. 78 00:03:28,167 --> 00:03:31,402 There's the sagittal vein graft we constructed for Katie. 79 00:03:31,404 --> 00:03:34,271 It's open with good flow. 80 00:03:34,273 --> 00:03:36,240 Graft is fine. 81 00:03:36,242 --> 00:03:40,010 Which means we still have no explanation for her coma. 82 00:03:40,012 --> 00:03:43,180 Go in closer. 83 00:03:45,351 --> 00:03:47,618 The middle cerebral vein, 84 00:03:47,620 --> 00:03:49,653 it has low flow out of the brain. 85 00:03:49,655 --> 00:03:51,522 You're thinking low flow out means low flow in? 86 00:03:51,524 --> 00:03:54,258 Yes, that is what I'm thinking. 87 00:03:54,260 --> 00:03:58,929 We should look at the arterial inflow phase. 88 00:03:58,931 --> 00:04:02,533 We'd like to look at the arterial inflow phase, please. 89 00:04:04,803 --> 00:04:06,370 So, what'd you do on your trip? 90 00:04:08,974 --> 00:04:12,443 Well, sometimes when we take a road trip, 91 00:04:12,445 --> 00:04:14,111 we're running away from something. 92 00:04:14,113 --> 00:04:17,581 I kissed Lea. 93 00:04:17,583 --> 00:04:20,718 And Dr. Glassman is mad at me. 94 00:04:20,720 --> 00:04:22,953 What is he mad at you about? 95 00:04:24,990 --> 00:04:27,124 It's almost entirely blocked. 96 00:04:27,126 --> 00:04:31,562 And... there's a malformation in the Circle of Willis. 97 00:04:31,564 --> 00:04:34,098 Katie is barely getting any blood to her brain. 98 00:04:35,268 --> 00:04:38,302 Excuse me. Shaun? May I speak with you, please? 99 00:04:38,304 --> 00:04:40,971 Dr. Melendez... He was not angry. 100 00:04:40,973 --> 00:04:44,375 Oh, no, Shaun. Dr. Melendez is angry with you. 101 00:04:44,377 --> 00:04:46,610 He's also angry with me. 102 00:04:46,612 --> 00:04:48,178 W-Why? 103 00:04:48,180 --> 00:04:51,782 "Why"? Because I lied to him for you. 104 00:04:51,784 --> 00:04:53,717 Why did you run away? 105 00:04:53,719 --> 00:04:55,953 I didn't... didn't run away. 106 00:04:55,955 --> 00:04:57,988 When you leave without notifying your attending, 107 00:04:57,990 --> 00:05:02,293 when you drop all of your responsibilities at this hospital... 108 00:05:02,295 --> 00:05:05,529 When you leave without telling anyone, including me, 109 00:05:05,531 --> 00:05:08,766 then you are running away. 110 00:05:08,768 --> 00:05:10,801 Did this trip with this girl help? 111 00:05:12,837 --> 00:05:15,239 Yes. Yes, it did. 112 00:05:15,241 --> 00:05:18,208 Okay. How? 113 00:05:20,445 --> 00:05:23,547 I would like to give two-weeks notice. 114 00:05:23,549 --> 00:05:26,550 Synced & corrected by kinglouisxx www.addic7ed.com. 115 00:05:33,592 --> 00:05:38,862 Mom, can you ask them to bring me some more ice chips? 116 00:05:38,864 --> 00:05:40,364 I'll get them, sweetie. 117 00:06:21,940 --> 00:06:23,207 I'll get a doctor. 118 00:06:23,209 --> 00:06:24,875 No. 119 00:06:24,877 --> 00:06:26,477 I'm just... 120 00:06:26,479 --> 00:06:29,613 When you left, there was no one here. 121 00:06:31,349 --> 00:06:35,119 For the first time in my life, I was alone. 122 00:06:35,121 --> 00:06:37,488 Sweetie. 123 00:06:37,490 --> 00:06:40,691 It felt... cold. 124 00:06:42,794 --> 00:06:46,997 Well, sometimes it is cold. 125 00:06:46,999 --> 00:06:48,732 But you know what? 126 00:06:48,734 --> 00:06:51,802 Someday, you might find that you like it. 127 00:06:55,975 --> 00:06:58,142 Wrongful termination. 128 00:06:58,144 --> 00:07:00,711 Dr. Kalu assaulted an attending surgeon. 129 00:07:00,713 --> 00:07:03,080 I don't think you have strong legal footing here. 130 00:07:03,082 --> 00:07:05,516 There's more to the story. 131 00:07:08,887 --> 00:07:12,256 And I am sympathetic to Dr. Kalu, 132 00:07:12,258 --> 00:07:13,991 but his ends don't justify his means. 133 00:07:13,993 --> 00:07:15,893 Obviously we can't tolerate staff members... 134 00:07:15,895 --> 00:07:17,094 And yet you do. 135 00:07:17,096 --> 00:07:18,829 Please read on. 136 00:07:27,573 --> 00:07:29,006 The middle cerebral has narrowed. 137 00:07:29,008 --> 00:07:30,607 It's less than 2 millimeters. 138 00:07:30,609 --> 00:07:34,078 We bypass the artery here and restore blood flow. 139 00:07:34,080 --> 00:07:35,879 Open her back up? 140 00:07:35,881 --> 00:07:37,815 She's just been through a massive operation. 141 00:07:37,817 --> 00:07:39,516 The brain tissue hasn't settled. 142 00:07:39,518 --> 00:07:42,052 Another could very well stroke Katie out. 143 00:07:42,054 --> 00:07:44,188 Other options. 144 00:07:44,190 --> 00:07:46,890 Intravascular. 145 00:07:46,892 --> 00:07:49,159 I don't see how an intravascular ultrasound 146 00:07:49,161 --> 00:07:50,894 - gives us a better picture. - No, not imaging. 147 00:07:50,896 --> 00:07:53,397 He wants a stent in the middle cerebral artery 148 00:07:53,399 --> 00:07:54,904 in the angio lab. I like it. 149 00:07:54,929 --> 00:07:57,534 Stenting is usually reserved for the heart and the carotid. 150 00:07:57,536 --> 00:08:00,270 It's not the usual, but we are way past the usual. 151 00:08:00,272 --> 00:08:02,706 It would lower the danger of a stroke. 152 00:08:05,277 --> 00:08:07,077 Dr. Murphy, would you like to assist? 153 00:08:07,079 --> 00:08:09,446 Y-Yes. 154 00:08:09,448 --> 00:08:11,448 Dr. Melendez, would you like to write me 155 00:08:11,450 --> 00:08:13,417 a letter of recommendation? 156 00:08:17,623 --> 00:08:20,724 You see the narrowing there, in the horizontal segment 157 00:08:20,726 --> 00:08:24,328 - of the middle cerebral artery. - Middle cerebral artery. 158 00:08:24,353 --> 00:08:27,154 Yeah. I've heard about you. 159 00:08:27,266 --> 00:08:29,299 You're the one making the old guard nervous. 160 00:08:31,971 --> 00:08:35,072 W-Why would I make people nervous? 161 00:08:36,841 --> 00:08:39,109 'Cause you have a gift. 162 00:08:39,111 --> 00:08:41,445 And surgeons judge themselves against their peers, 163 00:08:41,447 --> 00:08:43,147 and right now, you're winning. 164 00:08:45,583 --> 00:08:46,850 We're in position. 165 00:08:46,852 --> 00:08:49,219 Dr. Murphy, please inflate the balloon. 166 00:08:54,025 --> 00:08:56,026 Give us another squirt of contrast. 167 00:08:56,028 --> 00:08:59,997 And we should have good blood flow. 168 00:09:02,334 --> 00:09:05,335 Yes, the proximal end of the artery is dissecting. 169 00:09:05,337 --> 00:09:06,837 The balloon is damaging her artery. 170 00:09:06,839 --> 00:09:08,338 Waveform is worsening. 171 00:09:08,340 --> 00:09:09,573 Stent won't hold. 172 00:09:09,575 --> 00:09:11,729 She's gonna stroke. I'm aborting. 173 00:09:11,754 --> 00:09:13,277 Okay. 174 00:09:20,219 --> 00:09:23,086 Waveform is normalizing. 175 00:09:23,088 --> 00:09:25,722 We're right back where we started. 176 00:09:25,724 --> 00:09:27,624 Katie's brain is starving. 177 00:09:31,197 --> 00:09:33,530 I want to see Katie. 178 00:09:33,532 --> 00:09:37,134 I know she's in a coma. I still need to see her. 179 00:09:37,136 --> 00:09:38,702 I miss her. 180 00:09:38,704 --> 00:09:41,171 We can't risk contamination for either of you. 181 00:09:41,173 --> 00:09:42,773 She needs to know I'm there. 182 00:09:42,775 --> 00:09:43,774 We understand. 183 00:09:43,776 --> 00:09:45,909 You can't understand. 184 00:09:45,911 --> 00:09:47,277 No one can. 185 00:09:47,279 --> 00:09:49,413 We have always been there for each other, 186 00:09:49,415 --> 00:09:51,815 and now when she needs me most, I'm not there. 187 00:09:51,817 --> 00:09:54,618 You've just been through a 40-hour surgery. 188 00:09:54,620 --> 00:09:56,954 We need you to focus on your own healing. 189 00:09:56,956 --> 00:09:58,622 And what about her heart? 190 00:09:58,624 --> 00:10:01,124 We're going to do a cardiac catheterization test 191 00:10:01,126 --> 00:10:03,026 to see if her heart circulation has improved. 192 00:10:04,896 --> 00:10:08,999 Inject the contrast to evaluate the heart's blood supply. 193 00:10:09,001 --> 00:10:10,767 How's my soul looking? 194 00:10:12,003 --> 00:10:14,404 That's a different specialty. 195 00:10:16,274 --> 00:10:19,443 Katie says the eyes are the window to the soul. 196 00:10:19,445 --> 00:10:22,012 I say the eyes lie. It's the heart. 197 00:10:22,014 --> 00:10:24,681 Well, then, so far your soul is looking good. 198 00:10:24,683 --> 00:10:26,583 Strong, unobstructed blood flow. 199 00:10:26,585 --> 00:10:29,119 Ventriculogram will tell us how the muscle function's doing. 200 00:10:41,699 --> 00:10:44,001 So quiet. Is everything okay? 201 00:10:45,536 --> 00:10:47,204 Ventricle's strained and dilated. 202 00:10:47,206 --> 00:10:49,439 We were hoping for some improvement post-separation, 203 00:10:49,441 --> 00:10:50,807 but it's barely pumping. 204 00:10:50,809 --> 00:10:52,776 It just doesn't make any sense. 205 00:10:52,778 --> 00:10:54,077 The separation was supposed 206 00:10:54,079 --> 00:10:56,613 to relieve the stress on Jenny's heart. 207 00:10:56,615 --> 00:10:58,282 Half the need, half the work. 208 00:10:58,284 --> 00:11:00,584 Jenny's heart was even sicker than it appeared. 209 00:11:00,586 --> 00:11:02,419 Seems we couldn't see that because Katie's heart 210 00:11:02,421 --> 00:11:03,620 was doing all the work for Jenny's. 211 00:11:03,622 --> 00:11:04,988 What can we do to fix it? 212 00:11:04,990 --> 00:11:06,490 Give her a new heart. 213 00:11:06,492 --> 00:11:08,292 We're not gonna find a donor match in time. 214 00:11:08,294 --> 00:11:11,495 Yes, we already have the perfect heart for Jenny. 215 00:11:11,497 --> 00:11:15,499 The sisters are monozygotic and therefore a genetic match. 216 00:11:16,467 --> 00:11:18,635 On the other hand, Katie is alive. 217 00:11:18,637 --> 00:11:21,038 - She is GCS-3. - Her heart is still beating. 218 00:11:21,040 --> 00:11:22,739 Yes, but she is unresponsive. 219 00:11:22,741 --> 00:11:25,642 And I don't see a way to return blood flow to the brain. 220 00:11:25,644 --> 00:11:28,623 In all likelihood, Katie's not coming back. 221 00:11:28,624 --> 00:11:31,592 Yes, Katie very well may die, but we can't predict when that'll be. 222 00:11:31,617 --> 00:11:33,717 It could be today. It could be 20 years from now. 223 00:11:33,719 --> 00:11:35,185 If Katie stays on the ventilator. 224 00:11:35,187 --> 00:11:37,454 - That's not up to us. - I know. 225 00:11:37,456 --> 00:11:39,656 But I also know that, based on these scans, 226 00:11:39,658 --> 00:11:41,325 Jenny might not make it through the night. 227 00:11:44,263 --> 00:11:46,163 We need to propose this to the mother. 228 00:11:53,427 --> 00:11:56,231 There's no chance Katie will wake up? 229 00:12:00,193 --> 00:12:02,394 We can't say with 100% certainty, 230 00:12:02,419 --> 00:12:06,497 but from what we saw on Katie's brain scan... 231 00:12:07,691 --> 00:12:09,324 we have little reason for hope. 232 00:12:09,326 --> 00:12:11,333 But what we can say with certainty 233 00:12:11,528 --> 00:12:14,329 is that without Katie's heart, Jenny will die. 234 00:12:16,465 --> 00:12:18,379 Can we wait? 235 00:12:18,802 --> 00:12:20,377 Just a little. Maybe you'll know more. 236 00:12:20,402 --> 00:12:21,936 Maybe something will change. 237 00:12:22,035 --> 00:12:25,303 If we don't do anything, Jenny's heart will stop before the morning. 238 00:12:29,275 --> 00:12:31,276 How do you... 239 00:12:35,682 --> 00:12:37,182 Would it be painful? 240 00:12:37,792 --> 00:12:41,853 No. We simply power down Katie's ventilator. 241 00:12:41,855 --> 00:12:44,890 Once off life support, she will peacefully pass. 242 00:13:00,874 --> 00:13:03,008 Do you want us to explain this to Jenny? 243 00:13:03,010 --> 00:13:04,509 I'm sure she'll want to be present. 244 00:13:04,544 --> 00:13:06,144 No. 245 00:13:08,782 --> 00:13:11,916 I put trust in them from an early age, 246 00:13:11,918 --> 00:13:15,019 thinking responsibility would build strength. 247 00:13:16,790 --> 00:13:19,624 I think it worked. 248 00:13:19,626 --> 00:13:21,392 But this... 249 00:13:21,394 --> 00:13:24,095 No. 250 00:13:24,097 --> 00:13:26,164 Jenny can't be part of this in any way. 251 00:13:26,166 --> 00:13:27,599 It'd destroy her. 252 00:13:31,771 --> 00:13:33,805 I'll tell her Katie died. 253 00:13:41,247 --> 00:13:43,381 "Dr. Shaun Murphy 254 00:13:43,383 --> 00:13:46,332 exhibits technical skills beyond his years." 255 00:13:46,357 --> 00:13:48,319 - You wrote that? - Yes. 256 00:13:48,321 --> 00:13:50,455 That's why I signed my name at the bottom. 257 00:13:52,091 --> 00:13:54,692 You think Shaun survives at another hospital? 258 00:13:55,694 --> 00:13:57,662 I didn't think he'd survive here. 259 00:13:57,664 --> 00:14:01,366 Without your endorsement, Shaun isn't going anywhere. 260 00:14:02,735 --> 00:14:04,769 I may have my issues with him, 261 00:14:04,771 --> 00:14:07,605 but no matter how stupid an idea this may be, 262 00:14:07,607 --> 00:14:10,441 I'm not gonna stop him from going after what he wants. 263 00:14:12,645 --> 00:14:14,579 There's another signature line next to mine. 264 00:14:14,581 --> 00:14:16,661 It's where the president of the hospital has to sign. 265 00:14:23,122 --> 00:14:24,756 The chief oncologist. 266 00:14:24,758 --> 00:14:27,759 This is before I came here in December of '14. 267 00:14:27,761 --> 00:14:30,395 Dr. Marshall shoved a scrub nurse 268 00:14:30,397 --> 00:14:32,363 during a post-op discussion of some sort. 269 00:14:32,365 --> 00:14:33,464 Do you remember that? 270 00:14:33,466 --> 00:14:34,499 I do. 271 00:14:34,501 --> 00:14:36,534 Your response was to settle with the nurse 272 00:14:36,536 --> 00:14:39,570 while Dr. Marshall was let off with a warning. 273 00:14:39,572 --> 00:14:44,108 There's another almost identical instance earlier in that year. 274 00:14:44,110 --> 00:14:47,712 In both cases, the doctors in question were white. 275 00:14:47,714 --> 00:14:50,882 They were censured. Dr. Kalu was fired. 276 00:14:51,133 --> 00:14:54,149 You think this was a racial matter? 277 00:14:54,421 --> 00:14:57,755 Do you think I'm racist? 278 00:14:57,757 --> 00:14:59,390 That I favor white people? 279 00:14:59,392 --> 00:15:03,361 Then why the leniency then and not now? 280 00:15:05,898 --> 00:15:07,598 They're stars... 281 00:15:07,600 --> 00:15:10,301 that happened to be white. 282 00:15:10,303 --> 00:15:13,705 Doctors like Marshall allow St. Bonaventure 283 00:15:13,707 --> 00:15:16,541 to compete with other West Coast institutions. 284 00:15:16,543 --> 00:15:18,023 So, that's our defense? 285 00:15:18,048 --> 00:15:20,445 "We're not racist. We just allow our doctors 286 00:15:20,447 --> 00:15:22,980 to assault people as long as they bring in enough donors." 287 00:15:22,982 --> 00:15:24,796 They were reprimanded. 288 00:15:24,821 --> 00:15:26,555 And there were no further incidents. 289 00:15:26,580 --> 00:15:29,520 And how do you think all of this is gonna play out in court? 290 00:15:34,027 --> 00:15:35,827 Settle. 291 00:15:38,465 --> 00:15:40,031 Okay. 292 00:15:44,104 --> 00:15:45,269 Hi. 293 00:15:47,506 --> 00:15:48,673 Floor? 294 00:15:48,675 --> 00:15:49,741 Four. 295 00:15:53,012 --> 00:15:56,147 Shaun asked Dr. Melendez for a letter of recommendation. 296 00:15:56,149 --> 00:15:59,183 Yeah. 297 00:15:59,185 --> 00:16:01,619 All I have to do is sign it and off he goes. 298 00:16:05,424 --> 00:16:07,992 I think... 299 00:16:07,994 --> 00:16:10,928 he might think that you're mad at him. 300 00:16:18,404 --> 00:16:22,974 If you don't sign, it reinforces what he thinks. 301 00:16:22,976 --> 00:16:26,010 But if you do, 302 00:16:26,012 --> 00:16:28,546 it lets him know that you believe in him. 303 00:16:40,660 --> 00:16:42,493 Can I touch her? 304 00:16:42,495 --> 00:16:44,195 Of course. 305 00:16:57,043 --> 00:16:59,477 Goodbye, baby. 306 00:17:08,788 --> 00:17:11,055 - Are you ready? - Yes. 307 00:17:45,458 --> 00:17:47,124 She's stabilizing. 308 00:17:49,294 --> 00:17:51,562 I don't understand. 309 00:17:51,564 --> 00:17:53,097 What's going on? 310 00:17:55,899 --> 00:17:57,833 Katie's not ready to go. 311 00:18:01,627 --> 00:18:03,939 She's breathing on our own, which means Katie has 312 00:18:03,978 --> 00:18:05,780 normal brain stem function, correct? 313 00:18:05,863 --> 00:18:08,404 When a ventilator is removed, life can continue. 314 00:18:08,475 --> 00:18:10,174 It's rare, but it can happen. 315 00:18:10,176 --> 00:18:12,109 It doesn't change the prognosis for awakening. 316 00:18:12,111 --> 00:18:13,989 Off the ventilator with normal vitals 317 00:18:14,036 --> 00:18:16,567 suggests long-term vegetative state, right? 318 00:18:16,614 --> 00:18:18,637 Yeah. 319 00:18:18,750 --> 00:18:21,651 We just lost our remedy for Jenny's heart. 320 00:18:21,653 --> 00:18:23,686 What about ECMO? 321 00:18:23,688 --> 00:18:25,855 Use the machine as a replacement for Jenny's heart. 322 00:18:25,857 --> 00:18:27,690 Buys us... two weeks of life? 323 00:18:27,692 --> 00:18:29,692 I don't like it. 324 00:18:29,694 --> 00:18:32,971 ECMO requires blood thinners. She just had brain surgery. 325 00:18:32,996 --> 00:18:34,597 It could cause a catastrophic bleed. 326 00:18:34,599 --> 00:18:37,567 Well, ECMO and its complications may be our only avenue. 327 00:18:37,569 --> 00:18:39,836 R-Re-conjoin them. 328 00:18:40,838 --> 00:18:43,072 You want... You want to put their heads back together? 329 00:18:43,074 --> 00:18:45,775 Not the heads. 330 00:18:45,777 --> 00:18:47,877 The thighs, the femoral vessels. 331 00:18:48,980 --> 00:18:51,547 Is it a funny idea? 332 00:18:51,549 --> 00:18:53,649 I think it's funny that I didn't think of it. 333 00:18:53,651 --> 00:18:55,284 The girls' blood is identical. 334 00:18:55,286 --> 00:18:58,821 No need for anti-clotting meds, so no possibility of a bleed. 335 00:18:58,823 --> 00:19:01,424 As long as they're attached, Katie's heart will beat for Jenny. 336 00:19:01,426 --> 00:19:04,026 When Katie dies, we sever the femoral connection 337 00:19:04,028 --> 00:19:07,029 and transplant Katie's heart into Jenny. 338 00:19:08,866 --> 00:19:12,702 We just spent 40 hours separating them, 339 00:19:12,704 --> 00:19:15,405 and now we want to put them back together. 340 00:19:15,407 --> 00:19:18,040 You tried to kill Katie? 341 00:19:18,042 --> 00:19:20,176 No. 342 00:19:20,178 --> 00:19:23,112 You took her off life support. 343 00:19:23,114 --> 00:19:24,841 What do you call that? 344 00:19:25,016 --> 00:19:27,771 Mercy. Not just for her. 345 00:19:28,153 --> 00:19:31,177 You need a heart or you're going to die. 346 00:19:31,498 --> 00:19:34,341 Katie's alive. 347 00:19:36,894 --> 00:19:39,962 She was then, and she's even more now. 348 00:19:39,964 --> 00:19:44,167 Katie's alive in the sense that she has basic organ function, 349 00:19:44,169 --> 00:19:46,969 but she has no higher-cognitive brain activity. 350 00:19:46,971 --> 00:19:49,138 She's surviving, 351 00:19:49,140 --> 00:19:50,973 but she is not living. 352 00:19:50,975 --> 00:19:55,111 Hours ago, 353 00:19:55,113 --> 00:19:57,413 you thought she'd die 354 00:19:57,415 --> 00:20:01,317 as soon as you pulled the plug. 355 00:20:03,154 --> 00:20:04,921 You were wrong. 356 00:20:04,923 --> 00:20:08,791 How do I know you're not wrong this time, too? 357 00:20:10,894 --> 00:20:12,795 The demand on... on Katie's heart 358 00:20:12,797 --> 00:20:14,564 is minimal in her resting state. 359 00:20:14,566 --> 00:20:18,401 She can easily tolerate helping you. 360 00:20:21,139 --> 00:20:26,008 I won't ask Katie to be my life-support machine. 361 00:20:51,236 --> 00:20:52,602 Dr. Andrews. 362 00:20:56,139 --> 00:20:59,275 Let's put the sisters in the same room overnight. 363 00:20:59,277 --> 00:21:03,546 I don't think that Jenny sees herself as an individual yet. 364 00:21:03,548 --> 00:21:06,182 You know, I'm thinking the only thing that'll change Jenny's mind 365 00:21:06,184 --> 00:21:08,518 about the reattachment is Katie. 366 00:21:08,520 --> 00:21:12,188 Being close might help Jenny to see her as lifeless. 367 00:21:12,190 --> 00:21:14,457 Could backfire... 368 00:21:14,459 --> 00:21:16,826 and cement her feelings that she's killing her sister. 369 00:21:16,828 --> 00:21:19,762 Yeah, possibly. 370 00:21:19,764 --> 00:21:23,466 And then we're in the same position anyways. 371 00:21:24,902 --> 00:21:26,502 Okay, do it. 372 00:21:32,042 --> 00:21:33,409 Well, what about baseballs 373 00:21:33,411 --> 00:21:35,211 that this girl caught at a Giants game 374 00:21:35,213 --> 00:21:37,013 signed by Mr. Hunter Pence? 375 00:21:37,015 --> 00:21:39,248 He didn't hit it, but that doesn't matter. 376 00:21:41,818 --> 00:21:44,921 - So, where is the sporting-goods one? - There. 377 00:21:44,923 --> 00:21:49,225 Oh, no, that does not go in sporting goods. 378 00:21:49,227 --> 00:21:50,293 It doesn't? 379 00:21:54,531 --> 00:21:56,132 I'm applying to move my residency 380 00:21:56,134 --> 00:21:58,334 to Hershey, Pennsylvania. 381 00:21:58,336 --> 00:21:59,869 Really? 382 00:21:59,871 --> 00:22:02,638 Yes. Penn State Medical Center. 383 00:22:05,075 --> 00:22:06,742 Are you following me? 384 00:22:11,481 --> 00:22:12,815 I need to make sure 385 00:22:12,817 --> 00:22:16,118 you're not just doing this to stay close to me. 386 00:22:16,120 --> 00:22:17,720 No. 387 00:22:17,722 --> 00:22:19,488 Shaun. 388 00:22:19,490 --> 00:22:21,724 I want my own life. 389 00:22:21,726 --> 00:22:24,760 I want a life that I control, not Dr. Glassman. 390 00:22:24,762 --> 00:22:26,963 Dr. Glassman is just trying to help you. 391 00:22:26,965 --> 00:22:28,364 I don't want help. 392 00:22:30,901 --> 00:22:33,703 But what if... you need help? 393 00:22:37,708 --> 00:22:40,346 How will I know if I stay? 394 00:22:43,513 --> 00:22:46,749 Too much stuff. You have too much stuff. 395 00:22:54,459 --> 00:22:56,058 We should book a trip. 396 00:22:58,228 --> 00:23:00,129 Maybe somewhere warm. 397 00:23:04,736 --> 00:23:08,522 Wow. You are so slow. 398 00:23:08,573 --> 00:23:10,640 You're only folding underwear. Underwear's easy. 399 00:23:10,642 --> 00:23:13,009 Mnh-mnh. 400 00:23:13,011 --> 00:23:14,443 Okay. 401 00:23:14,445 --> 00:23:16,278 No, Neil, I don't want to... 402 00:23:21,219 --> 00:23:22,885 Fine. 403 00:23:22,887 --> 00:23:24,920 Let's go, Preston. 404 00:23:24,922 --> 00:23:26,288 I'm ready. 405 00:23:26,290 --> 00:23:27,723 Go. 406 00:23:30,495 --> 00:23:31,894 Boom. 407 00:23:48,111 --> 00:23:50,146 You're the only good thing about my day. 408 00:24:43,040 --> 00:24:44,993 I couldn't sleep last night. 409 00:24:47,829 --> 00:24:51,924 I couldn't even close my eyes until... 410 00:24:54,393 --> 00:24:58,592 I could feel Katie's heart beat in my hand. 411 00:25:05,523 --> 00:25:07,778 If I do this, 412 00:25:07,925 --> 00:25:12,895 at some point Katie's heart will beat for me, right? 413 00:25:16,834 --> 00:25:18,534 That's the plan. 414 00:25:26,544 --> 00:25:30,445 Then wherever I go, she will always be with me. 415 00:25:39,056 --> 00:25:41,323 Okay. I'll do it. 416 00:25:51,116 --> 00:25:53,016 How you doing, Jenny? 417 00:25:53,018 --> 00:25:54,951 I can't feel anything. 418 00:25:54,953 --> 00:25:57,254 That would be the magic of local anesthetic. 419 00:26:02,960 --> 00:26:05,929 Vessels are clamped. Okay, Doctor. 420 00:26:05,931 --> 00:26:08,198 We're ready to proceed with the anastomotic grafts. 421 00:26:32,925 --> 00:26:35,792 It's done, isn't it? 422 00:26:35,794 --> 00:26:37,427 I can tell. 423 00:26:39,163 --> 00:26:41,523 Let's put both the girls' vitals next to each other, please. 424 00:26:47,172 --> 00:26:49,106 Come on now. 425 00:26:49,108 --> 00:26:51,375 Give it a few cardiac cycles to adjust. 426 00:27:03,922 --> 00:27:05,322 How'd we do? 427 00:27:05,324 --> 00:27:08,125 You did great. 428 00:27:16,869 --> 00:27:18,368 Why Hershey? 429 00:27:21,806 --> 00:27:25,976 Lea is moving there. 430 00:27:25,978 --> 00:27:28,545 Ah. 431 00:27:28,547 --> 00:27:31,214 Well, they... they make good candy bars. 432 00:27:31,216 --> 00:27:34,618 I don't like candy bars. 433 00:27:34,620 --> 00:27:36,453 I love pancakes. 434 00:27:36,455 --> 00:27:38,655 Well, they make those, too. 435 00:27:45,897 --> 00:27:49,065 I brought you here because... 436 00:27:49,067 --> 00:27:51,868 I thought this place 437 00:27:51,870 --> 00:27:54,538 would provide a challenge for your abilities. 438 00:27:56,808 --> 00:27:58,842 But I realized I really brought you here 439 00:27:58,844 --> 00:28:01,144 because I thought you needed me. 440 00:28:14,592 --> 00:28:18,195 This is a now signed letter of recommendation. 441 00:28:19,898 --> 00:28:21,898 But... 442 00:28:21,900 --> 00:28:23,667 I don't want you to go. 443 00:28:26,871 --> 00:28:28,438 If you stay, I'll... I'll back off. 444 00:28:28,440 --> 00:28:30,607 I'll... 445 00:28:30,609 --> 00:28:32,342 I'll let you make your own choices, 446 00:28:32,344 --> 00:28:34,845 your own mistakes. 447 00:28:53,698 --> 00:28:55,632 I believe in you, Shaun. 448 00:29:06,944 --> 00:29:11,815 Their blood pressure dropped. 449 00:29:11,817 --> 00:29:14,584 5 millimeters of Mercury. 450 00:29:14,586 --> 00:29:17,087 I like when you say "their." 451 00:29:17,089 --> 00:29:18,889 You're gonna see some fluctuation. 452 00:29:18,891 --> 00:29:22,058 BP drops 5 millimeters every complete cardiac circulation. 453 00:29:22,060 --> 00:29:24,694 Shouldn't the fluctuation be inconsistent? 454 00:29:24,696 --> 00:29:28,398 Maybe Katie's heart isn't picking up the workload for Jenny as expected. 455 00:29:28,400 --> 00:29:30,433 Jenny. 456 00:29:36,274 --> 00:29:37,741 Jenny. 457 00:29:42,435 --> 00:29:45,315 I'm... I'm right h-here, Katie. 458 00:29:46,517 --> 00:29:49,155 Right next to you. 459 00:29:54,825 --> 00:29:57,193 Take Murphy and get a shotgun work-up on Katie. 460 00:29:57,195 --> 00:29:59,796 I want everything... EKG, EEG, and labs, 461 00:29:59,798 --> 00:30:01,364 and an echo on Jenny. 462 00:30:22,721 --> 00:30:25,486 Katie has an awake alpha rhythm on her EEG. 463 00:30:25,549 --> 00:30:27,115 She's doing remarkably well. 464 00:30:27,164 --> 00:30:30,099 We're still not entirely sure what caused Katie to regain consciousness. 465 00:30:30,127 --> 00:30:33,528 Attaching them again could have redistributed fluid into Jenny's system, 466 00:30:33,530 --> 00:30:35,783 possibly decreasing the swelling in Katie's brain. 467 00:30:35,846 --> 00:30:38,088 Just don't know. 468 00:30:38,549 --> 00:30:40,388 I know. 469 00:30:41,418 --> 00:30:44,453 They need each other. They always have. 470 00:30:46,389 --> 00:30:50,025 The issue right now has become Jenny and her heart. 471 00:30:50,027 --> 00:30:52,961 When Katie was in a coma, the metabolic demand on her heart was very low, 472 00:30:52,963 --> 00:30:54,463 but now that she's alert and active, 473 00:30:54,465 --> 00:30:56,500 there just isn't enough heart for both of them. 474 00:30:56,525 --> 00:30:58,258 What does that mean? 475 00:30:58,302 --> 00:31:00,906 We're awaiting test results. 476 00:31:01,605 --> 00:31:03,752 We're not sure how long Katie's heart 477 00:31:03,777 --> 00:31:06,345 can tolerate the strain of supporting Jenny's circulation. 478 00:31:06,370 --> 00:31:09,738 We'll closely monitor them with cardiac labs and echoes. 479 00:31:09,847 --> 00:31:13,248 We need to find a donor heart for Jenny as soon as possible. 480 00:31:19,873 --> 00:31:20,972 No. 481 00:31:20,997 --> 00:31:22,192 "No"? 482 00:31:22,217 --> 00:31:25,218 I've had CEOs settle for half of what I just got for you. 483 00:31:25,243 --> 00:31:26,821 I don't care about the money. 484 00:31:26,846 --> 00:31:29,962 That's beautiful. It's admirable, even. 485 00:31:30,032 --> 00:31:32,922 But, you see, this is how it works because we live in a civilized society... 486 00:31:32,947 --> 00:31:34,279 they hurt you, 487 00:31:34,304 --> 00:31:37,506 we hurt them by making them cut you a massive check. 488 00:31:37,531 --> 00:31:38,997 I don't want them to hurt. 489 00:31:39,022 --> 00:31:40,422 I want them to give me my job back. 490 00:31:40,511 --> 00:31:42,667 A third of "your job back" is, 491 00:31:42,692 --> 00:31:45,714 by my calculation, uh, almost nothing. 492 00:31:48,600 --> 00:31:50,268 I'll pay you a third of this settlement. 493 00:31:50,371 --> 00:31:52,838 What are you talking about? 494 00:31:52,840 --> 00:31:55,607 You'll be paying me more than you earn in a year. 495 00:31:55,609 --> 00:31:57,009 I want my job back. 496 00:32:01,180 --> 00:32:02,781 Lunch is on you. 497 00:32:02,783 --> 00:32:05,751 Lunch is on me. 498 00:32:08,855 --> 00:32:11,657 Are you moving to Pennsylvania to be with Lea? 499 00:32:14,160 --> 00:32:16,728 Does she know that? 500 00:32:16,730 --> 00:32:20,799 Lea knows I'm moving to Hershey. 501 00:32:20,801 --> 00:32:23,302 Yeah, but does she know you're going there 502 00:32:23,304 --> 00:32:25,304 because she is going there? 503 00:32:25,306 --> 00:32:26,872 I'm not. 504 00:32:32,145 --> 00:32:33,912 Lea makes me happy. 505 00:32:38,284 --> 00:32:41,086 Well, Lea's not the only one that can do that. 506 00:32:45,525 --> 00:32:47,125 I'm gonna miss you. 507 00:32:50,730 --> 00:32:52,464 Your BNP. 508 00:32:54,701 --> 00:32:56,635 Jenny Kunkler's cardio protein levels are... 509 00:32:56,637 --> 00:32:58,570 I've never seen anything like it. 510 00:32:58,572 --> 00:33:03,308 That's because the levels are for two hearts, not one. 511 00:33:03,310 --> 00:33:05,310 Now Jenny is killing Katie! 512 00:33:09,049 --> 00:33:11,054 - What's going on? - We got to separate them now 513 00:33:11,085 --> 00:33:12,951 - or we're gonna lose them both. - We got the twins on the way? 514 00:33:12,953 --> 00:33:14,152 In transit. 515 00:33:19,226 --> 00:33:20,926 J.L.'s gonna do a local on the fly. 516 00:33:22,161 --> 00:33:26,298 On my count. Three, two, one. 517 00:33:28,669 --> 00:33:31,862 We can't do this. You'll die. 518 00:33:32,039 --> 00:33:33,271 We're gonna do it. 519 00:33:33,273 --> 00:33:35,040 No. 520 00:33:35,042 --> 00:33:36,742 We're in this together. 521 00:33:36,744 --> 00:33:38,777 The way we've always been. 522 00:33:38,779 --> 00:33:40,812 The way we were meant to be. 523 00:33:47,532 --> 00:33:49,085 It's Jenny! He's in v-fib! 524 00:33:49,110 --> 00:33:50,756 Push a milligram epinephrine now! 525 00:33:50,758 --> 00:33:52,124 Prepping Ambu bag. 526 00:33:52,126 --> 00:33:54,866 Murphy, start chest compressions! 527 00:34:27,939 --> 00:34:29,634 It's Jenny. 528 00:34:30,454 --> 00:34:33,252 Her heart had nothing left to give. 529 00:34:36,598 --> 00:34:38,798 Katie? 530 00:34:38,800 --> 00:34:40,433 She's stable. 531 00:34:40,435 --> 00:34:42,702 Her vitals are good, 532 00:34:42,704 --> 00:34:45,821 but we have an issue that we need your help with. 533 00:34:45,846 --> 00:34:47,379 Okay. 534 00:34:47,421 --> 00:34:51,613 Um, Katie won't allow us to separate her from Jenny. 535 00:34:51,661 --> 00:34:55,296 If she doesn't acquiesce, Katie will clot and die. 536 00:34:57,766 --> 00:35:00,301 Bring 10,000 units on board. 537 00:35:08,411 --> 00:35:11,446 We'll clear out and give you some privacy. 538 00:35:21,458 --> 00:35:23,024 Baby. 539 00:35:28,398 --> 00:35:30,298 We have to let her go. 540 00:35:30,300 --> 00:35:34,302 I won't let them separate us. 541 00:35:34,304 --> 00:35:38,005 I never wanted to do this. 542 00:35:38,007 --> 00:35:41,609 You used to say we were made this way for a reason. 543 00:35:44,980 --> 00:35:47,882 I won't let them do this. 544 00:35:47,884 --> 00:35:49,750 Even if it kills me. 545 00:35:52,387 --> 00:35:54,856 I want you to look at your sister. 546 00:35:56,358 --> 00:35:57,992 Look at her. 547 00:36:10,673 --> 00:36:14,242 I can't lose both of my daughters. 548 00:36:36,399 --> 00:36:38,920 Dr. Andrews. Evening. 549 00:36:39,035 --> 00:36:41,102 I, uh, checked out the twins' file. 550 00:36:41,104 --> 00:36:42,236 It's an amazing case. 551 00:36:42,238 --> 00:36:46,073 To be clear, Jared, I don't want you here. 552 00:36:46,075 --> 00:36:48,843 What we presented to Miss Preston was the truth. 553 00:36:48,845 --> 00:36:51,479 I understand that. 554 00:36:51,481 --> 00:36:54,315 And those problem doctors and the ways we police ourselves 555 00:36:54,317 --> 00:36:56,250 will be dealt with, should have been dealt with a long time ago, 556 00:36:56,252 --> 00:36:57,585 but you stepped over a line. 557 00:36:57,587 --> 00:36:58,686 I fought for my job. 558 00:36:58,688 --> 00:37:01,088 You compromised your integrity. 559 00:37:02,457 --> 00:37:05,359 The incident with that jerk Coyle had nothing to do with black or white, 560 00:37:05,361 --> 00:37:07,762 but that's what you and your lawyer sold for leverage. 561 00:37:07,764 --> 00:37:11,032 And when you misrepresent racism for something it's not... 562 00:37:15,038 --> 00:37:17,038 it sets us two steps back. 563 00:37:22,245 --> 00:37:24,278 She's ready. 564 00:37:32,722 --> 00:37:34,533 Jared, you're on suction. 565 00:37:40,997 --> 00:37:42,969 Mayos. 566 00:37:49,806 --> 00:37:52,100 I'm cold. 567 00:38:14,163 --> 00:38:16,197 Gone fishing. 568 00:38:16,199 --> 00:38:18,165 Store's closed. 569 00:38:18,167 --> 00:38:20,234 I spoke to Claire. 570 00:38:56,172 --> 00:38:58,305 Hey. 571 00:38:58,307 --> 00:39:00,274 I want to break up. 572 00:39:04,347 --> 00:39:07,782 Why? 573 00:39:07,784 --> 00:39:10,751 Because I love you. 574 00:39:10,753 --> 00:39:12,653 Odd reason to break up with somebody. 575 00:39:13,655 --> 00:39:15,623 I want you to have everything in your life. 576 00:39:17,726 --> 00:39:20,594 Which includes kids. 577 00:39:20,596 --> 00:39:23,397 I told you I was willing to not have kids. 578 00:39:23,399 --> 00:39:26,500 You're gonna regret that decision one day. 579 00:39:26,502 --> 00:39:29,303 - I won't. - Yes, you will. 580 00:39:29,305 --> 00:39:31,972 You're just too decent to think it, but you will. 581 00:39:31,974 --> 00:39:34,709 So what? 582 00:39:34,711 --> 00:39:36,143 We all have regrets. 583 00:39:36,145 --> 00:39:38,446 I-I wanted to play third base for the Astros. 584 00:39:38,448 --> 00:39:40,614 It's not the same. That is a child's dream. 585 00:39:40,616 --> 00:39:41,716 This is your life! 586 00:39:41,718 --> 00:39:43,350 This is my life, 587 00:39:43,352 --> 00:39:46,353 and it'd be more devastating to be resented by you 588 00:39:46,984 --> 00:39:49,390 than to have my heart broken. 589 00:39:52,327 --> 00:39:58,032 And you are going to be a great dad. 590 00:40:12,148 --> 00:40:14,181 Shaun. 591 00:40:14,183 --> 00:40:17,451 I wanted to give you something. 592 00:40:21,590 --> 00:40:24,158 I'm letting you borrow it. 593 00:40:24,160 --> 00:40:27,294 Bring it when you come visit? 594 00:40:27,296 --> 00:40:29,096 Okay. 595 00:40:29,098 --> 00:40:30,564 Promise? 596 00:40:30,566 --> 00:40:32,556 You're gonna come visit, right? 597 00:40:32,668 --> 00:40:35,236 I promise. I like Hershey. 598 00:40:35,377 --> 00:40:38,868 - You've never been to Hershey. - Lea's there. 599 00:40:45,314 --> 00:40:47,982 Can I put my arms around you? 600 00:41:02,365 --> 00:41:05,065 Are you a good doctor? 601 00:41:05,535 --> 00:41:09,870 'Cause when I think of you, I think you are. 602 00:41:32,622 --> 00:41:35,782 Remember, I said borrow. 603 00:42:19,197 --> 00:42:23,397 Synced & corrected by kinglouisxx www.addic7ed.com