After six open houses,
I'm sure that "fixer-upper" means decrepit.
Part of the fun is imagining what something could be.
It could be expensive, and messy and loud and even dangerous.
Do your thing with the real estate agent. I'll go wander.
Hi. Tori Vargas.
- Any questions? - Yes.
I have many, about school districts,
drought tolerant landscaping, seismic retrofitting...
Someone came prepared. Does that include loan pre-approval?
If not, I can help.
No, going to open houses out of our price range is our new hobby.
Sometimes there's cookies.
How fun! Excuse me for just a sec.
Hi, there.
I grew up with a reading nook just like this one.
I'd lay in a pile of pillows, watch the falling snow.
That sounds uncomfortable.
A lot of the work is just cosmetic.
I could do most of it myself, make it a perfect home.
These window frames are just painted shut, but all you have to do is…
- Damn it. - See?
Dangerous.
Forks and knives?
Hands only. Don't drown my shao bing in hot sauce.
Yes, ma'am.
A scallion omelet in sesame flatbread.
Did I forget an anniversary?
This is a thank you for planning our first road trip.
I'm planning more.
I can't wait to head south on PCH.
The last trip was a solo one on my Ducati.
Hold on. You're a biker chick?
Was. In another life.
You miss it, the other life?
Motorcycles are too dangerous. You could end up paralyzed.
Nice deflection.
I didn't know you in the other life. I like this one.
Still feel that way if I get hot sauce?
- We haven't had a chance to talk... - You kissing me.
Thereby crossing the line you said we shouldn't cross,
right as I was headed on a date.
- How did that go? - Great.
I barely heard a word he said
because the whole time, I was thinking about our kiss.
It was amazing.
Yes, it was.
Look, I like you, but I need some clarity here.
Okay.
Let me be clear.
How about I make you dinner tomorrow at my place
and talk about where we're headed?
Sounds good.
It's a date, then?
A date.
Good morning, Dr. Lim. Did Clay stay over last night?
- He did. - Excellent.
You're likely in a good mood and amenable because of the sex.
Amenable to what?
I think you will like it.
There was movement, flexion and lateral rotation,
which means that there was engagement with the psoas and the glutes,
and I saw it twice.
Signals are getting through to your spinal column.
This deformity is not just scar tissue, it's a compressive syrinx.
We enter from myelotomy, drain the fluid, after we detether your cord.
- I could… - You could walk again.
Audrey, this approach is much safer than the one we discussed last time.
I need time to think it over.
Of course.
Okay, today is the first day I will be implementing my new system.
I'm sure you agree it is a major improvement.
Don't know what you're talking about.
My new rating system for first-year residents?
I emailed you multiple drafts. You never responded.
Once all the data is in, I will share the completed version.
Can't wait.
When I asked where you worked, I didn't mean a challenge.
Had to get you on the mat to see if you exaggerated.
I'm not a fan of walks on the beach.
- Sunsets are overrated. - All right.
Nice.
What happens on the third date?
Lily?
Lily.
You okay?
My new system has over 50 metrics that go into your scores.
Everything will be assessed.
Everything? Could you be specific?
- No. - Is it a head-to-head competition?
It's to make you aware of your strengths and weaknesses.
Residents with more strengths are likely to get a full residency.
Hi, Teddy. Dr. Powell. What happened to your head?
I smacked myself with a 20-pound kettlebell.
Kettlebell injuries are common.
My gym has a printout of ten ways you can hurt yourself.
- Did you witness the accident? - Yeah, I'm there for workouts.
So you're his trainer?
- His brother. - My baby brother.
He's got a real knack for making me suffer.
All right. We're gonna run a full concussion protocol,
get a CT as precaution.
Not until we take care of this gash.
You're also experiencing abdominal pain.
Did that pain start before or after you hit your head?
Kind of simultaneous?
Mind lifting your shirt?
You've recently lost weight.
- Seventy pounds. - In five months.
Getting that summer beach bod.
Keeping the T-shirt on for now.
Mind if we laid you back to get a better look?
Got a lump, an inguinal hernia. It's non-reducible.
I think it's also strangulated.
Dr. Perez is right.
The blood flow to your herniated intestine is cut off. You need surgery.
Okay.
This is Lily, 37. Dizziness, epistaxis, purulent nasal discharge.
Let's get full labs and blood cultures.
I guess the upside of dating a doctor is no waiting in the ER.
I dated a guy at the DMV for that very reason.
- Do you have history of nosebleeds? - Yes.
Part of my perpetual sinus infection. Been on and off antibiotics for a year.
I figured it's because I teach kung fu to kids.
Adorable. Do you feel any sinus pressure? Also, how did you two meet?
Yes and Bumble.
Thanks, Doctor. I got this.
He's right. This will be awkward. I'm his ex.
Don't worry. We're friends now. Any other recent symptoms?
I've had a few migraines and a bad taste in my mouth.
Temp's elevated and she's hypertensive.
Acute-on-chronic bacterial rhinosinusitis?
Probably. Given the headaches,
I want a brain and sinus CT with and without contrast.
Hernia is reduced.
Next step in the tension-free hernioplasty?
Use mesh to cover the fascial defect.
By strengthening the inguinal floor, we hope to prevent hernias.
No extra credit will be given for statements of the obvious.
It's impressive how much weight Teddy's lost.
Hope he's doing it for the right reasons.
Hard to see a wrong reason. He was clearly overweight.
I agree. Obesity increases health risks
for diabetes, heart disease and some cancers.
Fair, but our culture can really go overboard in the fat-shaming,
which can lead to low self-esteem, depression,
none of which is healthy.
Trying to change to please someone else rarely works.
Getting someone you love to do what is best for them is a good thing.
There's ectopy in the EKG. QT looks prolonged.
Push two grams IV of magnesium.
He's going into Torsade's.
- Proper response? - Synchronized cardioversion.
Yes, prepare to shock him.
Charging 200 joules. Clear.
Good catch, Dr. Powell.
I caught the strangulated hernia.
His arrhythmia's likely a sign of an underlying condition.
It could be quite dangerous.
You'll be assessed on how you can determine what's causing it.
Suture scissors.
I'll start with the sinuses.
I found you a new prospect.
Unless your last date was a love connection.
That's a no.
How terrible for him, how exciting for me.
Berkeley law grad, former fitness model, just moved back to the valley from Paris.
Thanks, but I'll pass.
That's severe opacification.
Sinus mucosa's thickened.
There's already bone erosion.
Lily needs endoscopic sinonasal debridement.
He's smart, he's ripped,
he's worldly, and unlike Perez, he's available.
- We kissed. - What?
- You and Perez? - Yeah.
What about his boundaries?
Haven't figured that out,
but he did invite me to dinner at his place.
I'm exploring.
Just be careful, okay?
Okay.
The infection spread through her skull base.
That's a massive six-by-four-centimeter abscess.
Page Park. If that ruptures, she'll die. Lily needs sinus and brain surgery.
Sinus debridement looks very good.
Pulling the scope.
Bacitracin-coated telfa.
We'll use burr holes to drain the abscess using ultrasound guidance.
How did you get approval to operate on your new girlfriend?
Two dates doesn't equal a girlfriend. No approval necessary.
Trajectories look good.
Drainage tool.
Plus or minus, to parade her in front of Morgan?
Definitely not parading.
And Morgan and I are friends… So neither.
This is as much as I can get without risking rupture.
The rest is up to the antibiotics. Leave the drain and close.
Would you say you loved, liked or hated the last house we saw?
Are those the only options?
- I should examine your hand. - It's fine.
I can't stop thinking about the crown molding and the reading nook,
so if you don't hate it,
I think we should talk to a broker about making an offer.
You said going to open houses was only for fun.
I've looked at finances. We can swing it.
Rent is spent. A mortgage payment is
what rhymes with "payment," it means good investment.
My research shows we should adhere to the 28/36 rule,
with regards to monthly pre-tax income.
You have swelling around your second digit and over your thumb.
I've done worse.
Shaun, we can be homeowners. Doesn't that excite you even a little?
I am a little excited that you are excited.
Good, because I made an appointment with the mortgage broker
and you guys can talk 25/36.
Twenty-eight.
It's silly to be competitive.
Said the loser while losing.
Olive branch.
I don't know what's causing arrhythmia.
- Do you? - I have ideas.
Okay. So you can present them and land a knockout blow,
if you're confident.
Or?
Or we bounce ideas, get the right answer and help him.
For all we know, one of Dr. Murphy's metrics is
cooperation amongst colleagues.
Fine, but I present.
Do you have any idea how often women get zero credit
even when it comes out of their mouths?
Fine.
Blood shows critically low potassium and sodium,
which makes no sense,
given the power diet his brother's got him on.
There's plenty of nutrients, so maybe celiac?
IgA and IgG antibody tests were normal.
I'm thinking primary aldosteronism.
Interesting.
Please present your ideas on what's causing our patient's arrhythmia.
We think that Teddy has primary aldosteronism.
Explains initial electrolyte levels and…
Doesn't align with urine studies or lack of hypertension.
This was your idea.
Congenital long QT syndrome.
QT levels returned to normal and he has no family history.
He has critically low levels of potassium, sodium and magnesium.
I noticed that, despite a good diet. It suggests absorption…
What happened to cooperation amongst colleagues?
I didn't realize you'd be wrong.
Slight enamel erosion on the molars, and trauma to the oral mucosa.
And these tiny abrasions on his knuckles are from his teeth.
Self-induced vomiting led to malnutrition and arrhythmia.
Teddy, you are bulimic.
Quite the cocktail.
Not the kind I was hoping we'd share, but here we are.
Not what I would have worn either.
We're hoping the antibiotics will clear
the remaining areas of your sinuses and brain.
Feel like I'm already getting the VIP treatment from you.
Dr. Reznick was right.
She said your flower game is very solid.
- She stopped by? - Yes.
Ostensibly to check on me, but mostly to sing your praises.
How many guys have an ex as a hype man?
Lucky me.
It's too soon to discharge Teddy.
He has responded well to electrolytes, no signs of recurrent arrhythmia.
The hernioplasty only requires simple care.
He's bulimic.
I know. I diagnosed him, thank you, after you and Dr. Powell failed to.
Eating disorders have the highest mortality rate of any mental illness.
I referred him for a psych consult and provided a list of clinics.
He needs help now, not in a few weeks.
Maybe I can get psych to talk to him.
Points are given for passion and commitment,
and taken away for arguing.
I don't care about the points.
We can't keep him hospitalized without a clear surgical indication.
Stop hounding me.
I'm having a coffee. Can't I have a coffee?
You're hovering.
I'm excited about the prospect of getting you back on your feet.
This surgery is not an easy decision.
The surgical plan is very good.
Yes, it's a solid plan.
But?
But my life is good right now, really good.
Better than it's been in a while.
And the idea of that changing...
Lea said we'd go to open houses for fun, but now she wants to buy one.
- Shaun, I'm in the middle of a... - No, you're not.
A house? Okay. Congratulations, look at you two.
Grown-up-ing.
It's a fixer-upper. Dr. Glassman, I don't like it.
Did you tell Lea that?
She is excited when she talks about the house.
It makes her happy, and I think she's been sad lately.
Why has she been sad?
I told you we have to wait to get pregnant,
because of her Asherman's syndrome.
Well, maybe Lea is looking for a way to move you two forward.
You think if we buy that house, Lea will be less sad?
Buying a house could be exciting.
It's a distraction. Distractions can be useful.
I do not like distractions.
Shaun, you've been rating residents for quite a while now,
and now you've revamped your entire system.
- When did you decide? - After the sextuplets were born.
Wasn't that around the time you found out about Lea's Asherman's?
Yes, we were both very sad.
You think my new system was a distraction?
Yeah, and now maybe Lea needs one.
Excellent idea.
Thank you, Dr. Glassman.
Brought your ride out of here, and your discharge papers.
Got you a psych consult at an eating disorder clinic in two days.
Thanks, but I'm good.
This hospital stay was the wake-up call I needed.
You don't have to go through this alone.
Discharge party. I brought drinks.
A special potassium powerhouse for my big bro.
Thanks.
So, Teddy tells me he has some, like, freak electrolyte deficiency.
Do you know what caused it?
Teddy's got all the info.
Do I need to make any adjustments?
Dial back on the weight loss goals.
- Why? - Simon, let's just go.
Is it dangerous for him to diet now? For how long?
I can't really say.
Simon, forget it.
- It's on me to make sure you're okay. - No, it's not.
It's my life.
I'm just being supportive.
Otherwise micromanaging everything I do.
You are miserable and a mess, okay? I'm getting you healthy.
What am I missing?
Tell him.
It wasn't your workouts that took off the weight.
I've been… purging.
Making myself puke.
Is that what caused your heart thing?
Why would you do something so stupid?
'Cause you're obsessed with me not being an embarrassment.
- I never said that. - Didn't have to.
You've never been so excited as when I mentioned weight.
- Because I'm worried... - You're ashamed of me.
It's been years since we've hung out,
and now you're all over me to meet you at the gym.
You're killing yourself, but this is my fault?
Get your own ride home. I don't want to micromanage.
- Teddy, I'm so sorry. - It's fine.
I can Uber.
- You sent her flowers, from me? - You're welcome.
Have you considered I may not want to see her?
She's clearly a keeper and you need a girlfriend.
How is that your business?
I need you and not to make the same mistake.
We've been teetering on falling back into us.
- You're out of your mind. - Like you haven't thought about it.
Read too much into friendly gestures.
- Like offering me your sperm? - For IVF.
Could the symbolism be any more heavy-handed?
We can't go back.
You made it clear I'm not what you wanted, and I haven't changed, so move on.
- How long? - Just over a minute.
We pushed lorazepam.
The antibiotic is clearly not working. Push another two lorazepam.
Why do you look like you watched the first two minutes of Up?
I thought Teddy wasn't gonna get help.
I thought his meddling brother might make sure he did.
Not a bad plan.
The execution was flawed.
Congratulations on your upcoming victory.
Help! Someone call the RRT.
I got it.
Teddy.
He's ruptured his esophagus. Page Dr. Murphy and prep an OR.
Chest tube placed.
The lung drainage is orange.
What's left of the smoothie.
Advance the endoscope.
He is fortunate that you responded so quickly, Dr. Perez.
I pushed Teddy to admit his bulimia to his brother.
They fought and then he did this.
That was not helpful,
and there is too much damage for primary esophageal repair.
Place an endoscopic stent, wait until edema improves?
It will leak.
- What about omentum as a patch? - The tissue is too friable.
It's usually for kids, but what about gastric transposition?
Resect the esophagus, reconstruct using stomach tissue.
Good idea, Dr. Perez. This will improve your score.
We need to open him up.
The abscess is not responding to the antibiotics.
Infection is seeding to the brain.
I could drill another burr hole, get aggressive with drainage.
- Same approach, same results. - Thanks for the cliché.
She needs a bifrontal craniotomy with sinus exenteration.
Remove both sides, rebuild it to stop bacteria.
I'm not consigning her to years of reconstructive surgery.
Save her life or protect her face?
Are you accusing me of acting unethically, after your flowers?
- What flowers? - Shut up.
I'm accusing you of your judgment being clouded
because you don't wanna agree.
I'm making the right call for the patient. Disagreeing is a bonus.
Get Lily and the OR prepped.
Removing the devitalized segment of the esophagus.
We have a good plane of healthy tissue.
Dr. Perez,
you may perform the two-layered, inverted hand-sewn anastomosis.
I had a late night on a research project. My hands aren't stable enough.
Dr. Powell should take this.
Starting to suture.
I'm ready to go home.
I'm not,
thanks to Andrew's dumping reconfiguring the remote interface in my lap.
It's weeks of debugging code.
Well, that was fast.
When I asked him to assign you a new project,
he couldn't think of any. How is your hand?
Annoyed, along with the rest of me. Why would you do that?
You've been sad that we have to wait to have a baby.
Work will be a better distraction than restoring an old house.
That's not a judgment for you to make, Shaun.
I'll pick my own distractions.
And I have been sad.
And that house is just a chance to make something broken beautiful again.
So is reconfiguring the remote interface.
The house feels like a step forward.
I can really see us being happy there, Shaun.
I just wish you would try to see that too.
Okay.
Okay, we can make an offer?
No, I meant, okay, I will try.
Thanks.
I'll see you at home later.
Sorry I'm late. I had an impulse.
NBA2K. Prepared to get smoked.
Tip-off will have to wait. I'm buried.
Maybe I could help. Trouble with a case?
Yeah.
- My own. - What's happened?
Glassman found movement in my psoas and glutes.
He and Murphy found an endoscopic solution.
They'll detether your spinal cord. That's great.
Is there a problem with the surgical plan?
It's quite elegant.
Then what's holding you back?
I feel like we've been living in this bubble, this perfect bubble,
and if I step outside of it, it'll pop.
This surgery would change you.
Not us.
What we have isn't going to disappear if you walk again.
You need to believe that.
I want to.
Please, I can't be the reason you say no.
We successfully repaired his distal esophagus
with reconstructed stomach tissue.
He'll be able to eat and swallow normally,
but any further purging will cause irreparable damage.
I thought we were finally close again.
He's been hurting and I…
I had no idea.
How do I fix this?
Sometimes, trying to fix the problem is the problem.
I went through some tough times too,
and plenty of people had ideas about how to fix me.
You see, I didn't need that.
I just needed them…
to love me.
Broken or not.
Even though I don't like sanding, and paint is sticky and smells terrible,
and power tools are loud and dangerous,
I am positive that we, mostly you, can make that fixer-upper
into a beautiful home for us and the family we will have.
Are you saying we should buy the house?
If it will make you happy.
I bulldozed you, didn't I?
Yes, but I do not mind.
But I do. I'm being selfish.
Thank you for letting me.
But the only step forward I need right now is one we make together.
Let's find a place we both love.
That's a good approach.
Let's get my hand checked out. It does really hurt.
Advancing into the abscess.
Couldn't stay away?
Lily is my patient. I admitted her.
Resecting last bits of capsule from the cavity.
Got it. Pulling the scope.
Heart rate's 32. BP 210 over 122.
Her brain is starting to herniate.
Give 100 grams of mannitol, high-dose propofol.
Get her CO2 below 30.
I'm aware. Place an EVD.
Pivot to bifrontal craniotomy?
No time.
Connect the burr holes and run a small craniotomy flap?
No, but a hemicraniectomy will reduce brain pressure.
You can debride the infection.
- Good. - Good.
That was hot.
Doing this surgery is a good decision.
- I hope so. - Doubts?
No. I'm a little nervous, but no doubts.
Thank you both for not giving up.
You're welcome.
We'll see you in recovery.
Welcome back.
You've got a visitor.
You're okay?
Getting there.
No gym for a while. You need time to heal.
I'm on it, Doc.
Remember when we were kids,
you made me watch Alien vs. Predator?
I had to let you sleep in my room for three months.
Turns out, the combined Alien-Predator canon includes 13 movies.
You and I are gonna watch them.
If that's cool with you.
Sounds stupid…
but fun.
Looks like both brothers are on the mend.
Take video, Murphy will give you some points.
I'm good.
What happened in the OR, when you handed over the anastomosis?
It didn't feel like my day.
I devised my first-year resident rating system as a distraction.
It was very complicated and encouraged too much competition.
So I have decided to retire it.
You okay?
Easily the worst date I've ever been on.
Next one, I'll put the rest of your skull back on.
We have to wait till the swelling in your brain goes down.
Am I gonna be okay?
You've got a long road ahead, but yes.
And you won't be alone.
That's a lot of commitment.
Especially when you and Dr. Reznick don't really seem done.
Thanks for everything…
Dr. Park.
I'm glad you didn't move on.
From the case.
Glad you listened.
I'm working on it.
Lily will be lucky to have you through her recovery,
unless you decided not to see her anymore.
You were right. She's a keeper.
I'm happy for you two.
Visiting hours still open?
They don't usually let visitors into pre-op.
Nobody says no to a guy in a wheelchair.
I had to see you.
I recognize this is terrible timing
and kind of bonkers,
but I couldn't let you go in before asking.
Audrey…
will you marry me?
Definitely bonkers.
I don't expect an answer now.
This is me telling you that I am all in.
Thank you.
That's my cue.
I'll be waiting.
Do I look as silly as this feels?
Miss Dilallo?
We have to postpone your CT.
I brought ice cream. Better let me in before it melts.
Danny?
Danny!
No. Oh, no.
Oh, no. Danny?
Danny!
- Shaun. - What's wrong?
I'm pregnant.
My OB told us it isn't safe for me or the baby.
I'm really scared.
Okay.
You… told me to imagine what could be.
Yeah.
Let's do that.
Together.