1 00:00:02,411 --> 00:00:05,229 -Previously on the Resident... -Good morning. These are 2 00:00:05,247 --> 00:00:06,338 -the interns I told you about. -I'm Zach, 3 00:00:06,490 --> 00:00:07,655 -Primary Care. -Let's get started, shall we? 4 00:00:07,675 --> 00:00:08,899 Listen, I'm not a man 5 00:00:08,917 --> 00:00:09,916 that you'll find in Child's Pose, 6 00:00:10,011 --> 00:00:11,251 so I'm just gonna be on my way to... 7 00:00:11,403 --> 00:00:13,420 AJ, I happen to know from personal experience 8 00:00:13,572 --> 00:00:15,347 that you could really benefit from a little extra flexibility. 9 00:00:15,574 --> 00:00:18,075 -(laughter) -All right, come lie down and grab a mat. 10 00:00:18,093 --> 00:00:19,743 I don't know if I want kids. 11 00:00:19,836 --> 00:00:20,927 At least not right now. 12 00:00:21,080 --> 00:00:23,004 What Padma wants can help us both. 13 00:00:23,098 --> 00:00:25,357 I can give her the egg she so desperately wants 14 00:00:25,584 --> 00:00:27,526 so she can have a baby, and at the same time 15 00:00:27,753 --> 00:00:30,487 I can freeze some for us. 16 00:00:32,682 --> 00:00:34,733 -What about him? -This guy? 17 00:00:34,960 --> 00:00:36,976 Yeah. He runs marathons, 18 00:00:37,129 --> 00:00:38,278 plays the cello and, 19 00:00:38,372 --> 00:00:42,524 Oh, Leela, look at that chubby little face. Aww. 20 00:00:42,601 --> 00:00:45,936 Well, I wish we could meet "Tall & Talented" in person. 21 00:00:45,954 --> 00:00:48,789 Or maybe see an adult photo, not just a baby photo. 22 00:00:48,941 --> 00:00:50,440 Well, then these anonymous sperm donors 23 00:00:50,459 --> 00:00:52,033 wouldn't be very anonymous, would they? 24 00:00:52,053 --> 00:00:53,552 I just want the father of your child 25 00:00:53,703 --> 00:00:54,702 to be as amazing as you. 26 00:00:54,797 --> 00:00:56,463 My sister deserves Grade A sperm. 27 00:00:56,615 --> 00:00:58,432 Thank you for doing this for me. 28 00:01:00,043 --> 00:01:01,376 What, you think I'm doing this for you? No. 29 00:01:01,395 --> 00:01:03,287 I'm only giving you my egg so I can be an auntie. 30 00:01:03,305 --> 00:01:06,273 (laughs) Well, you're gonna be the best one. 31 00:01:07,234 --> 00:01:09,443 -We should get to Chastain. -Wait. 32 00:01:10,963 --> 00:01:12,053 What about him? 33 00:01:12,073 --> 00:01:13,906 -"The Right Stuff"? -Yeah. 34 00:01:14,057 --> 00:01:16,967 He loves yoga, travel and Basquiat. 35 00:01:16,985 --> 00:01:18,893 No markers for genetic disease. 36 00:01:18,987 --> 00:01:20,913 And he's South Asian. 37 00:01:21,064 --> 00:01:22,472 I think it's a sign. 38 00:01:22,566 --> 00:01:24,583 Okay, well, why don't we email the sperm bank 39 00:01:24,734 --> 00:01:28,312 -and try to get a voice sample? -Leel, he is the one, I can feel it. 40 00:01:28,330 --> 00:01:30,238 No, no, you don't need to decide right now. 41 00:01:30,257 --> 00:01:33,650 -Padma, are you sure? -I am. 42 00:01:33,743 --> 00:01:35,001 (both laugh) 43 00:01:35,096 --> 00:01:37,412 "The Right Stuff" it is. 44 00:01:37,431 --> 00:01:39,556 ♪ ♪ 45 00:01:44,663 --> 00:01:47,231 (children's song playing) 46 00:01:49,017 --> 00:01:51,017 Sorry, I know how busy you are. 47 00:01:51,094 --> 00:01:52,594 Not a problem. Happy to help. 48 00:01:52,613 --> 00:01:54,113 Usually I'm texting you to do something a bit more fun, huh? 49 00:01:54,264 --> 00:01:55,856 -Yeah. -(laughs) 50 00:01:55,932 --> 00:01:58,099 It's probably just a stomachache, 51 00:01:58,268 --> 00:02:01,027 -but Gigi insisted that you check. -Oh, did she? 52 00:02:01,180 --> 00:02:03,455 I told Peter you fix hurt tummies. 53 00:02:03,682 --> 00:02:04,606 Hey, Peter, remember me? 54 00:02:04,625 --> 00:02:05,791 Your Gigi's dad. 55 00:02:06,018 --> 00:02:08,293 I am. What's going on, buddy? 56 00:02:08,445 --> 00:02:11,371 We were playing super space, Daddy. 57 00:02:11,523 --> 00:02:12,856 Yeah, these two can go all day. 58 00:02:12,875 --> 00:02:16,026 He is the astronaut, she is the alien. 59 00:02:16,119 --> 00:02:16,802 Peter said he didn't want to play, 60 00:02:17,029 --> 00:02:20,213 but he always wants to play. 61 00:02:20,307 --> 00:02:21,548 I'm gonna place my hands on your stomach 62 00:02:21,642 --> 00:02:23,533 for a second, okay? 63 00:02:23,627 --> 00:02:25,310 All right. 64 00:02:25,462 --> 00:02:26,812 (groaning) 65 00:02:26,963 --> 00:02:28,963 MARION: Peter's dad is on the way. 66 00:02:28,983 --> 00:02:32,133 Have him meet me in the ER. 67 00:02:32,227 --> 00:02:34,211 Do you like piggyback rides? 68 00:02:34,229 --> 00:02:36,880 Yeah, I thought so. Hop on. 69 00:02:36,973 --> 00:02:38,064 Can I go with you, Daddy? 70 00:02:38,233 --> 00:02:40,717 You wait here, my little alien. 71 00:02:40,736 --> 00:02:43,311 I'll come back soon and let you know how Peter's doing. 72 00:02:43,330 --> 00:02:45,497 Kids, we're going on a field trip. 73 00:02:45,649 --> 00:02:46,740 A rite of passage. 74 00:02:46,834 --> 00:02:48,225 When I was a first year, like you, 75 00:02:48,243 --> 00:02:50,727 Dr. Hawkins took me, and now it's your turn. 76 00:02:50,746 --> 00:02:51,837 Our turn for what? 77 00:02:52,064 --> 00:02:53,488 Since the start of your intern year, 78 00:02:53,507 --> 00:02:56,249 you've learned to become doctors inside these walls, 79 00:02:56,326 --> 00:02:58,177 and today you are going outside Chastain 80 00:02:58,404 --> 00:03:02,181 to treat one of the most challenging patient populations. 81 00:03:02,408 --> 00:03:05,742 A place you'll tackle complex medical cases 82 00:03:05,761 --> 00:03:07,019 that make great doctors. 83 00:03:07,170 --> 00:03:09,246 Dr. Voss and Dr. Bell will be joining us, 84 00:03:09,264 --> 00:03:10,247 so let's get moving. 85 00:03:10,265 --> 00:03:11,932 Where are we going? 86 00:03:12,008 --> 00:03:13,417 Dr. Pravesh didn't tell you? 87 00:03:13,435 --> 00:03:16,111 Let's not spoil the surprise. 88 00:03:21,593 --> 00:03:23,160 Okay. 89 00:03:34,790 --> 00:03:37,507 All right, here we are. 90 00:03:39,611 --> 00:03:41,136 KIT: Shall we? 91 00:03:44,541 --> 00:03:45,632 We got played. 92 00:03:45,801 --> 00:03:48,227 Oh, my God, old folks? 93 00:03:49,805 --> 00:03:51,396 ♪ ♪ 94 00:04:03,318 --> 00:04:05,560 All right, Mr. Astronaut, 95 00:04:05,654 --> 00:04:07,729 can you tell me when it started to hurt? 96 00:04:07,823 --> 00:04:09,823 Does the pain move around at all? 97 00:04:09,975 --> 00:04:11,641 I'm okay now. 98 00:04:11,735 --> 00:04:12,993 Is my dad coming? 99 00:04:13,145 --> 00:04:15,495 Yeah, he's coming. 100 00:04:15,647 --> 00:04:17,981 To take me home? I don't want to go home. 101 00:04:18,000 --> 00:04:20,000 Oh, you're not going home, hon. 102 00:04:20,094 --> 00:04:22,076 You're gonna stay here with us until we can 103 00:04:22,096 --> 00:04:24,746 figure out why you're not feeling so great. 104 00:04:24,765 --> 00:04:27,007 -Hey, bud. -Hey, Daddy. 105 00:04:27,101 --> 00:04:28,158 Are you okay? What's going on? 106 00:04:28,251 --> 00:04:30,084 Hey, Spencer. This is Nurse Hundley. 107 00:04:30,104 --> 00:04:32,178 Spencer works in our IT department. 108 00:04:32,331 --> 00:04:33,680 Nice to meet you. 109 00:04:33,832 --> 00:04:35,515 Peter has a stomachache. 110 00:04:35,667 --> 00:04:38,535 Normally, that's not a reason to be worried. 111 00:04:38,562 --> 00:04:39,945 His temp's a little low. 112 00:04:40,172 --> 00:04:41,521 It could be a sign of infection. 113 00:04:41,598 --> 00:04:43,189 -Oh. -He seemed fine this morning. 114 00:04:43,284 --> 00:04:44,616 Said that he and Gigi were going to space. 115 00:04:44,768 --> 00:04:47,027 Has he been sick at all in the past few weeks? 116 00:04:47,195 --> 00:04:48,787 Had a cold a few days ago, 117 00:04:48,938 --> 00:04:50,271 but nothing out of the ordinary. 118 00:04:50,291 --> 00:04:52,349 Any dietary changes this morning? 119 00:04:52,367 --> 00:04:55,794 I made him a smoothie, um, as a treat. 120 00:04:55,963 --> 00:04:58,463 Bananas, yogurt, protein powder, juice. 121 00:04:58,632 --> 00:05:00,857 I mean, we shared it. I feel all right. 122 00:05:00,876 --> 00:05:02,042 He won't tell us more about his pain. 123 00:05:02,194 --> 00:05:04,210 He keeps saying he's fine. 124 00:05:04,363 --> 00:05:05,971 Well, I think because he doesn't want to go home. 125 00:05:06,122 --> 00:05:08,473 -Right? -I'll go home 126 00:05:08,700 --> 00:05:10,517 if you stay with me, Daddy. 127 00:05:12,962 --> 00:05:15,372 I'll stay right here, no matter what. 128 00:05:15,465 --> 00:05:16,815 Okay, bud? 129 00:05:17,042 --> 00:05:18,299 No matter what. 130 00:05:18,393 --> 00:05:20,060 HUNDLEY: I'll get us ready to draw labs. 131 00:05:20,212 --> 00:05:21,302 I'm gonna step aside for a second, okay? 132 00:05:21,396 --> 00:05:24,047 -Can I talk to you? -Yeah, sure. 133 00:05:24,066 --> 00:05:26,575 HUNDLEY: We're good here, right, hon? 134 00:05:27,569 --> 00:05:30,570 Uh... 135 00:05:30,722 --> 00:05:33,056 he's got separation anxiety. 136 00:05:33,075 --> 00:05:36,818 His mom left us both three months ago. 137 00:05:36,912 --> 00:05:40,172 She hasn't been back, or even called. 138 00:05:40,248 --> 00:05:42,507 New boyfriend, drug problem. 139 00:05:42,659 --> 00:05:44,760 It's a long story. 140 00:05:46,162 --> 00:05:49,330 I'm sorry to hear that. 141 00:05:49,350 --> 00:05:52,834 Now Peter's afraid you might disappear, too? 142 00:05:52,853 --> 00:05:53,927 Yes. 143 00:05:54,079 --> 00:05:56,096 He feels safe at Chastain because 144 00:05:56,190 --> 00:05:58,339 he knows that I work in the building. 145 00:05:58,433 --> 00:06:00,083 Well, separation anxiety may be behind this. 146 00:06:00,102 --> 00:06:02,027 It can cause stomach trouble. 147 00:06:02,254 --> 00:06:04,254 Do some blood work, run some tests, 148 00:06:04,272 --> 00:06:05,755 and then we'll go from there, all right? 149 00:06:06,775 --> 00:06:09,851 WOMAN (over P.A.): Dr. Milner to Emergency. 150 00:06:09,870 --> 00:06:12,496 Dr. Milner to Emergency. 151 00:06:15,951 --> 00:06:19,285 ♪ ♪ 152 00:06:19,438 --> 00:06:21,438 There he is. 153 00:06:21,531 --> 00:06:23,030 The Brookhaven resident who happens to be 154 00:06:23,125 --> 00:06:25,291 -one of my health care heroes. -Dr. Kravitz? 155 00:06:25,386 --> 00:06:26,793 Yes. 156 00:06:26,870 --> 00:06:30,371 Just be aware he has early mild cognitive impairment. 157 00:06:30,540 --> 00:06:33,116 He remembers people and events from the past perfectly, 158 00:06:33,118 --> 00:06:34,709 but his short-term memory's going. 159 00:06:34,728 --> 00:06:36,269 Okay, got it. 160 00:06:37,398 --> 00:06:41,883 -Dr. Kravitz. -Kit. Lovely to see you. 161 00:06:41,902 --> 00:06:43,143 I did a gerontology rotation 162 00:06:43,237 --> 00:06:44,903 with Dr. Kravitz when I was a resident. 163 00:06:45,072 --> 00:06:46,905 He was one of my finest teachers. 164 00:06:47,056 --> 00:06:49,557 This is Dr. Randolph Bell. 165 00:06:49,618 --> 00:06:50,800 It's an honor. 166 00:06:50,819 --> 00:06:52,244 You're a legend in the field of geriatrics. 167 00:06:52,395 --> 00:06:53,394 You know, your book, 168 00:06:53,488 --> 00:06:54,913 Compassionate Care of the Elderly, 169 00:06:55,064 --> 00:06:58,065 has been on my shelf for decades. 170 00:06:58,085 --> 00:07:00,735 I-I'm sorry, your name again? 171 00:07:00,904 --> 00:07:02,028 Randolph Bell. 172 00:07:02,180 --> 00:07:03,404 Randolph, Randolph, Randolph... 173 00:07:03,573 --> 00:07:05,315 So do all your friends here wheedle you for free care? 174 00:07:05,333 --> 00:07:08,910 Oh, absolutely not. We won't allow it. 175 00:07:08,929 --> 00:07:10,654 Arthur here is fully retired. 176 00:07:10,672 --> 00:07:12,413 He's earned the right to have others care for him. 177 00:07:12,507 --> 00:07:16,176 Gloria, darling, this is Kit, and this-this is... 178 00:07:16,328 --> 00:07:17,936 Well, there's no introduction necessary, sweetie. 179 00:07:18,163 --> 00:07:20,346 Everybody knows the famous Dr. Randolph Bell. 180 00:07:20,499 --> 00:07:23,608 KRAZITZ: (chuckles) She not only has my heart, 181 00:07:23,760 --> 00:07:24,776 she is now my head. 182 00:07:25,003 --> 00:07:26,836 In every way, she takes care of me. 183 00:07:26,855 --> 00:07:29,448 -Well, it's mutual. -(chuckles) 184 00:07:29,599 --> 00:07:31,174 Well, it was nice of you to come today. 185 00:07:31,193 --> 00:07:32,433 You know, it can be kind of hard to get 186 00:07:32,527 --> 00:07:34,769 some of us old coots to get our regular check-ups. 187 00:07:34,863 --> 00:07:36,179 Well, we have an ulterior motive 188 00:07:36,198 --> 00:07:38,348 for bringing some of our interns here today. 189 00:07:38,366 --> 00:07:40,942 We're hoping to inspire them to join your field. 190 00:07:40,961 --> 00:07:42,852 This country needs more gerontologists, 191 00:07:42,913 --> 00:07:44,278 and even some of the best doctors 192 00:07:44,372 --> 00:07:46,298 don't understand the particular needs of senior citizens. 193 00:07:46,467 --> 00:07:50,026 Geriatricians have higher career satisfaction 194 00:07:50,045 --> 00:07:52,696 than other medical specialties. 195 00:07:52,714 --> 00:07:56,366 But the pay... not what you get in surgery. 196 00:07:56,459 --> 00:07:58,960 Would you consider talking to some of our interns 197 00:07:58,979 --> 00:08:00,795 about your career? 198 00:08:00,814 --> 00:08:02,731 Let me at 'em. 199 00:08:05,544 --> 00:08:07,819 (sighs) Do you think we'll still be that in love 200 00:08:07,971 --> 00:08:10,805 when we're their age? 201 00:08:10,824 --> 00:08:12,449 Why wouldn't we be? 202 00:08:17,164 --> 00:08:19,072 Padma, now that you picked a sperm donor, 203 00:08:19,224 --> 00:08:21,148 we'll start Leela's daily injections of hormones 204 00:08:21,168 --> 00:08:23,001 to encourage her body to produce more eggs 205 00:08:23,152 --> 00:08:26,004 -than it does in a usual cycle. -We're excited. 206 00:08:26,155 --> 00:08:28,748 Me, too. We'll be monitoring you with blood tests 207 00:08:28,842 --> 00:08:30,175 and ultrasounds. 208 00:08:30,326 --> 00:08:32,252 I read about this thing called, uh, 209 00:08:32,404 --> 00:08:34,904 -ovarian hyper-something. -Hyperstim. 210 00:08:34,998 --> 00:08:36,515 Yeah. Do we need to worry about that? 211 00:08:36,666 --> 00:08:39,351 No, not with regular monitoring of my estradiol levels. 212 00:08:39,502 --> 00:08:42,521 If they get too high, we back off, lower the dose. 213 00:08:43,932 --> 00:08:45,431 That question wasn't for me. 214 00:08:45,584 --> 00:08:47,842 But you're right. This is quite a safe process. 215 00:08:47,861 --> 00:08:49,343 Okay, what can I do to help? 216 00:08:49,437 --> 00:08:50,770 For now, nothing. Not until we start you 217 00:08:50,864 --> 00:08:53,590 on meds in a few weeks to prepare for the embryo transfer. 218 00:08:53,608 --> 00:08:55,516 -Okay. -Okay? 219 00:08:55,536 --> 00:08:57,944 Leela, I will walk you through your first injection. 220 00:08:58,096 --> 00:09:00,597 PADMA: Um, I was thinking... 221 00:09:00,615 --> 00:09:02,690 maybe I can do it. 222 00:09:02,784 --> 00:09:03,858 You want to stick a needle in me? 223 00:09:03,877 --> 00:09:05,544 I just want to be part of this 224 00:09:05,712 --> 00:09:07,604 in every way that I can. 225 00:09:07,622 --> 00:09:10,531 -You know. -Of course. 226 00:09:10,625 --> 00:09:13,134 I would like that, too. 227 00:09:15,889 --> 00:09:19,465 Does our patient have a visitor? 228 00:09:19,618 --> 00:09:21,876 -He does indeed. -(Hundley laughs) 229 00:09:21,895 --> 00:09:24,137 -Gigi! -Hi, Peter. 230 00:09:24,289 --> 00:09:26,956 (grunts) Ah, good friends are good medicine. 231 00:09:26,975 --> 00:09:28,958 All right, you two, behave. 232 00:09:28,977 --> 00:09:31,144 I'm gonna chat with your dad real quick. 233 00:09:32,147 --> 00:09:34,814 Thought a fun distraction for Peter could be good. 234 00:09:34,908 --> 00:09:36,741 So his labs came back. 235 00:09:36,968 --> 00:09:39,226 White blood cell count was normal, no sign of infection. 236 00:09:39,246 --> 00:09:42,080 Appendicitis, uh... seems unlikely. 237 00:09:42,231 --> 00:09:44,398 Maybe it's psychological. 238 00:09:44,492 --> 00:09:46,993 You know, he's been through a lot. 239 00:09:47,145 --> 00:09:49,813 My gut's telling me it's more than anxiety, 240 00:09:49,906 --> 00:09:51,648 and I want to run a few more tests. 241 00:09:51,741 --> 00:09:52,665 What's up? 242 00:09:52,818 --> 00:09:54,426 Did you fix his tummy, Daddy? 243 00:09:54,653 --> 00:09:56,410 It's always his tummy. 244 00:09:56,430 --> 00:09:58,838 What do you mean, "always," sweetheart? 245 00:09:58,932 --> 00:10:00,098 It happened before? 246 00:10:00,267 --> 00:10:02,842 How often does your tummy hurt, Pete? 247 00:10:02,936 --> 00:10:04,844 A whole lot of times. 248 00:10:04,938 --> 00:10:07,755 Why didn't you tell me anything, Pete? 249 00:10:07,774 --> 00:10:10,350 -I don't understand. -I didn't want to stay at home. 250 00:10:10,444 --> 00:10:14,762 I wanted to come here, with you. 251 00:10:14,781 --> 00:10:17,765 I'll never leave you, okay? 252 00:10:17,934 --> 00:10:20,160 I'll never leave you. 253 00:10:22,789 --> 00:10:23,955 Do you understand? 254 00:10:24,182 --> 00:10:26,182 Daddy, there's something else. 255 00:10:26,275 --> 00:10:28,852 It's weird, but maybe I should tell you. 256 00:10:28,870 --> 00:10:30,703 This morning, Peter and I were playing 257 00:10:30,797 --> 00:10:32,780 that we were on another planet. 258 00:10:32,799 --> 00:10:35,024 He kept saying that I had two heads. 259 00:10:35,043 --> 00:10:37,043 Yeah, you told me that. Pretending. 260 00:10:37,195 --> 00:10:38,803 No, he meant it. 261 00:10:39,030 --> 00:10:43,016 He said I really was a space alien. 262 00:10:45,294 --> 00:10:49,022 Peter, does anyone else have two heads? 263 00:10:49,816 --> 00:10:52,484 That nurse lady and you, 264 00:10:52,635 --> 00:10:54,468 kind of. 265 00:10:55,304 --> 00:10:57,447 Double vision. How many fingers am I holding up? 266 00:11:00,218 --> 00:11:02,661 -What's going on? -This could be neurological. 267 00:11:02,829 --> 00:11:05,372 We need to get him to CT. 268 00:11:07,242 --> 00:11:10,985 So this woman, who is 83, kept chickens. 269 00:11:11,062 --> 00:11:13,079 And she loved her chickens. 270 00:11:13,231 --> 00:11:14,898 She named each one of them. 271 00:11:14,916 --> 00:11:18,418 The-the first day I spent with her, she gave me eggs. 272 00:11:18,512 --> 00:11:21,996 Anyway, she had a problem with worsening anemia. 273 00:11:22,090 --> 00:11:25,332 Fatigue, muscle weakness, intestinal problems. 274 00:11:25,427 --> 00:11:29,762 She started forgetting things and... falling. 275 00:11:29,915 --> 00:11:32,840 Now, any ideas what was wrong with her? 276 00:11:32,934 --> 00:11:35,435 Likely more than one thing. 277 00:11:35,587 --> 00:11:38,922 Alzheimer's, and possibly cancer? 278 00:11:38,940 --> 00:11:40,514 Or a recent stroke. 279 00:11:40,608 --> 00:11:41,941 I'll give you a hint. 280 00:11:42,093 --> 00:11:44,185 The key was the chickens. 281 00:11:44,204 --> 00:11:46,946 People who name their chickens don't eat them. 282 00:11:47,098 --> 00:11:49,432 Exactly. He's smart. 283 00:11:49,525 --> 00:11:50,875 You-you could be a gerontologist. 284 00:11:51,027 --> 00:11:52,377 I don't get it. 285 00:11:52,528 --> 00:11:55,529 Okay, it's a B12 deficiency, common with age. 286 00:11:55,549 --> 00:11:58,032 Learned that from Dr. Kravitz's book. 287 00:11:58,051 --> 00:12:02,779 So I'm guessing that the patient was a... vegan, 288 00:12:02,872 --> 00:12:05,372 because she gave away the eggs. 289 00:12:05,392 --> 00:12:07,800 Bingo. 290 00:12:07,953 --> 00:12:11,120 The woman's vegan diet was a good choice 291 00:12:11,139 --> 00:12:13,456 because it reduced her risk of heart disease, 292 00:12:13,549 --> 00:12:14,974 Type 2 diabetes, certain cancers. 293 00:12:15,068 --> 00:12:17,351 But she forgot to supplement with B12, 294 00:12:17,462 --> 00:12:19,312 which was the source of all of her symptoms. 295 00:12:19,464 --> 00:12:23,800 This is why gerontology is a great profession. 296 00:12:23,893 --> 00:12:26,227 You spend time with patients. 297 00:12:26,246 --> 00:12:27,820 You talk with them, you get to know the whole person, 298 00:12:27,897 --> 00:12:31,583 all the while keeping your eye on the big picture. 299 00:12:31,810 --> 00:12:33,918 Which is the key to diagnosis. 300 00:12:34,070 --> 00:12:36,813 Oh! My lady awaits. 301 00:12:36,831 --> 00:12:40,316 And I see that they have put out snacks, and I am peckish. 302 00:12:40,409 --> 00:12:42,510 -Excuse me. -BELL: Thank you, Dr. Kravitz. 303 00:12:45,840 --> 00:12:47,991 Hi, sweetie. 304 00:12:48,009 --> 00:12:50,101 Hey, maybe gerontology is an aphrodisiac. 305 00:12:50,328 --> 00:12:52,586 This old goat has the prettiest lady in the place, 306 00:12:52,606 --> 00:12:55,515 -and I have not had a date since high school. -Oh... 307 00:12:55,667 --> 00:12:57,609 No, no, I'm kidding. 308 00:12:57,760 --> 00:13:00,503 KRAVITZ: Gloria! 309 00:13:00,596 --> 00:13:01,687 Her pulse is thready. 310 00:13:01,782 --> 00:13:03,114 Call 911. Let's get her to Chastain. 311 00:13:03,266 --> 00:13:04,507 Somebody grab these pills. to take with us. 312 00:13:04,526 --> 00:13:06,326 we're gonna need to know what she's been taking. 313 00:13:13,442 --> 00:13:15,609 I don't understand. Are you telling me I fainted? 314 00:13:15,703 --> 00:13:16,686 Yes. And they're going to 315 00:13:16,779 --> 00:13:17,796 figure out why. 316 00:13:17,872 --> 00:13:19,947 I was probably just dehydrated. 317 00:13:19,966 --> 00:13:21,633 I didn't ruin your event, did I? 318 00:13:21,784 --> 00:13:23,709 No, we were winding down anyway. 319 00:13:23,862 --> 00:13:25,286 You added the drama. 320 00:13:25,380 --> 00:13:27,639 The good news is, your wrist isn't broken. 321 00:13:27,790 --> 00:13:28,881 You just need a splint. 322 00:13:29,034 --> 00:13:30,700 And your EKG and your labs look normal. 323 00:13:30,793 --> 00:13:33,052 So how did you feel right before you passed out? 324 00:13:33,204 --> 00:13:36,372 I got dizzy. A little lightheaded. 325 00:13:36,465 --> 00:13:38,224 A-A drop in blood pressure. It's not uncommon 326 00:13:38,376 --> 00:13:40,318 among women on blood pressure meds. 327 00:13:40,545 --> 00:13:41,561 But she's-she's not on any. 328 00:13:41,655 --> 00:13:44,030 Oh, well, yes, I am, dear. 329 00:13:45,567 --> 00:13:47,733 -You are? -Mm-hmm. 330 00:13:47,886 --> 00:13:49,476 Why didn't you tell me? 331 00:13:49,496 --> 00:13:51,737 I did. 332 00:13:51,832 --> 00:13:54,574 Let's start here. 333 00:13:54,726 --> 00:13:57,151 My thought exactly. 334 00:13:57,170 --> 00:13:59,745 CONRAD: Houston to Rocket Nine Niner, 335 00:13:59,898 --> 00:14:01,506 do you read me? 336 00:14:01,657 --> 00:14:04,250 Copy, Rocket Nine Niner. 337 00:14:04,402 --> 00:14:06,511 Please keep your hands and arms 338 00:14:06,662 --> 00:14:08,662 inside the spacecraft. 339 00:14:08,740 --> 00:14:10,073 We are go for liftoff. 340 00:14:10,166 --> 00:14:13,518 Over and out. (imitating static, beeping) 341 00:14:13,669 --> 00:14:14,835 (Billie laughs) 342 00:14:14,929 --> 00:14:17,522 Was that for him or for you? 343 00:14:17,673 --> 00:14:19,932 A little bit of both. 344 00:14:20,085 --> 00:14:22,176 I'm worried about him. 345 00:14:23,196 --> 00:14:25,605 If Peter's abdominal issues are caused by 346 00:14:25,699 --> 00:14:28,992 a neurological one, we could be looking at a bleed. 347 00:14:34,933 --> 00:14:36,782 I don't see one. 348 00:14:36,859 --> 00:14:39,878 No evidence of a stroke, either. 349 00:14:40,029 --> 00:14:42,772 (sighs) But his ventricles are a little... 350 00:14:42,774 --> 00:14:45,425 Too little. 351 00:14:49,114 --> 00:14:50,704 His brain is swelling. 352 00:14:50,798 --> 00:14:52,873 Now, if we don't figure out why and the swelling worsens, 353 00:14:52,893 --> 00:14:54,117 I'll have to perform a craniectomy 354 00:14:54,119 --> 00:14:55,209 to relieve the pressure. 355 00:14:55,453 --> 00:14:57,211 Cutting a six-year-old's head open on an "if." 356 00:14:57,230 --> 00:14:58,971 Of course not, but if things move south quickly, 357 00:14:59,065 --> 00:15:00,456 we have to be ready to move to the OR. 358 00:15:00,549 --> 00:15:02,808 Fine, but let's keep in mind the risks aren't just 359 00:15:02,961 --> 00:15:04,051 bleeding and infection. 360 00:15:04,070 --> 00:15:05,403 There could be permanent brain damage. 361 00:15:05,630 --> 00:15:08,798 We need to figure out how to avoid surgery altogether. 362 00:15:08,816 --> 00:15:10,909 Let's start Peter on meds to lower the pressure 363 00:15:10,985 --> 00:15:12,485 on his brain immediately, 364 00:15:12,637 --> 00:15:14,095 hope they work and move him to ICU. 365 00:15:14,155 --> 00:15:16,806 Yes, that sounds like a plan. 366 00:15:16,899 --> 00:15:20,660 Well, why didn't you tell me you were taking all of these? 367 00:15:20,812 --> 00:15:21,920 Oh, I did, dear. 368 00:15:22,071 --> 00:15:23,922 Every time I added a medication. 369 00:15:24,073 --> 00:15:26,907 But you can't be expected to remember all these. 370 00:15:27,001 --> 00:15:29,076 I-I forgot all of them. 371 00:15:29,095 --> 00:15:30,929 Multiple medications, called polypharmacy, 372 00:15:31,080 --> 00:15:33,765 is associated with adverse outcomes, 373 00:15:33,934 --> 00:15:36,008 particularly as we age. They interact, 374 00:15:36,161 --> 00:15:38,177 causing falls, drug reactions, 375 00:15:38,329 --> 00:15:41,164 and can even lead to increased mortality. 376 00:15:41,182 --> 00:15:42,999 It all started with the arthritis. 377 00:15:43,017 --> 00:15:44,943 The ibuprofen wasn't doing anything, 378 00:15:45,094 --> 00:15:47,853 so a doctor put me on prednisone. 379 00:15:47,948 --> 00:15:49,930 Well, that gave me heartburn, 380 00:15:49,950 --> 00:15:51,783 so he gave me omeprazole. 381 00:15:51,934 --> 00:15:53,192 But then that made me nauseous, 382 00:15:53,361 --> 00:15:56,437 so they added ondansetron for my stomach. 383 00:15:56,531 --> 00:15:59,940 That made my heart flutter, so they gave me metoprolol, 384 00:15:59,960 --> 00:16:01,442 and then my legs started to swell, 385 00:16:01,461 --> 00:16:03,035 so they gave me furosemide, and that's when 386 00:16:03,129 --> 00:16:05,279 I stopped walking very much, 387 00:16:05,298 --> 00:16:08,207 and, uh, my blood pressure shot up, so they-- 388 00:16:08,359 --> 00:16:09,968 Should I keep going? 389 00:16:10,195 --> 00:16:11,711 MAN (over P.A.): ...practitioner to the ER, please. 390 00:16:11,863 --> 00:16:13,721 Nurse practitioner to the ER. 391 00:16:17,702 --> 00:16:19,035 Double shift? 392 00:16:19,128 --> 00:16:22,538 (chuckles) Actually, I'm just starting. 393 00:16:22,631 --> 00:16:24,373 Been having a hard time sleeping. 394 00:16:24,467 --> 00:16:27,210 -Oh, that sucks. -Yeah, tell me about it. 395 00:16:27,228 --> 00:16:32,381 Oh, um, Leela told me about your mother. 396 00:16:32,475 --> 00:16:33,825 How is she? 397 00:16:33,976 --> 00:16:36,719 Sorry, it's... it's none of my business. 398 00:16:36,738 --> 00:16:38,888 No, it isn't. 399 00:16:38,890 --> 00:16:40,999 But it's nice of you to ask. 400 00:16:41,150 --> 00:16:42,908 She just moved in with me on Saturday. 401 00:16:43,061 --> 00:16:45,077 It's been good having her close. 402 00:16:45,230 --> 00:16:46,671 And how are you? 403 00:16:46,898 --> 00:16:49,340 Well, I'm trying to resist the urge 404 00:16:49,417 --> 00:16:51,734 to check my home security camera every five minutes 405 00:16:51,827 --> 00:16:54,070 to see how she's doing. 406 00:16:54,163 --> 00:16:56,663 Okay, well, actually, I'm not resisting. 407 00:16:56,758 --> 00:17:00,518 Would you look at this woman? She's out there gardening. 408 00:17:00,669 --> 00:17:01,911 Are those rhododendrons? 409 00:17:01,929 --> 00:17:06,415 A little pink for my taste, but she loves them. 410 00:17:06,434 --> 00:17:09,694 I'm leading a meditation at 3:00. 411 00:17:09,921 --> 00:17:13,156 -Join us. -Maybe I will. 412 00:17:14,776 --> 00:17:16,942 -So, how are you? -Great. 413 00:17:17,095 --> 00:17:18,852 I just injected my sister with hormones 414 00:17:18,930 --> 00:17:20,020 so she can donate her eggs to me 415 00:17:20,114 --> 00:17:21,947 and I can be a mom. Hmm! 416 00:17:22,042 --> 00:17:25,293 Oh, wear something comfortable. 417 00:17:29,716 --> 00:17:34,052 DEVON: So they put her on hydrochlorothiazide... 418 00:17:34,203 --> 00:17:36,203 And that made Gloria feel fatigued. 419 00:17:36,297 --> 00:17:38,038 So they gave her methylphenidate. 420 00:17:38,058 --> 00:17:39,540 Which could have had a negative interaction 421 00:17:39,634 --> 00:17:42,301 with the linezolid that she was taking for that cellulitis. 422 00:17:42,453 --> 00:17:43,895 Or the zolpidem or quetiapine, 423 00:17:44,046 --> 00:17:46,397 which Gloria was also on. 424 00:17:49,294 --> 00:17:51,218 -(exhales sharply) -What are we even doing, 425 00:17:51,312 --> 00:17:52,461 Dr. Pravesh? 426 00:17:52,480 --> 00:17:55,648 We're looking into all contraindications. 427 00:17:55,742 --> 00:17:58,150 But she is a sick older lady who needs these drugs. 428 00:17:58,303 --> 00:18:00,745 Like, which do you even stop? 429 00:18:00,896 --> 00:18:02,580 We move carefully, 430 00:18:02,807 --> 00:18:06,334 removing one by one. 431 00:18:07,829 --> 00:18:09,312 No. 432 00:18:09,330 --> 00:18:12,832 This is over my head and, honestly, kind of boring. 433 00:18:12,984 --> 00:18:14,258 I need to find a surgery to observe. 434 00:18:14,410 --> 00:18:17,987 I thought you were going into primary care. 435 00:18:18,005 --> 00:18:20,005 No. I want to be a surgeon. 436 00:18:20,158 --> 00:18:21,415 It's exciting, and you fix problems 437 00:18:21,509 --> 00:18:24,510 that are actually fixable, not buff up old people 438 00:18:24,662 --> 00:18:25,845 until they die. 439 00:18:25,997 --> 00:18:27,588 You don't think people die on the OR table? 440 00:18:27,682 --> 00:18:29,014 They do all the time. 441 00:18:29,167 --> 00:18:30,833 Not everything is fixable with a knife. 442 00:18:30,926 --> 00:18:31,925 You get that, right? 443 00:18:31,945 --> 00:18:33,669 You can fix things with your brain. 444 00:18:33,762 --> 00:18:35,095 Excuse me, have you met me? 445 00:18:35,189 --> 00:18:36,689 I read that surgeons don't actually have 446 00:18:36,765 --> 00:18:40,284 the highest IQ, and I thought, there, that's my specialty. 447 00:18:40,453 --> 00:18:41,452 Hmm. 448 00:18:41,679 --> 00:18:43,604 This woman needs us, 449 00:18:43,623 --> 00:18:46,532 and Dr. Kravitz needs her. 450 00:18:46,626 --> 00:18:49,794 So if you're not interested, I say go hunt down Dr. Austin 451 00:18:50,021 --> 00:18:52,037 and see if he'll let you into his OR. 452 00:18:52,190 --> 00:18:53,965 But be aware that he will not consider it 453 00:18:54,116 --> 00:18:56,192 for one nanosecond 454 00:18:56,285 --> 00:18:59,512 when I tell him you deserted this patient. 455 00:19:04,978 --> 00:19:07,311 Okay, I will stay. 456 00:19:07,480 --> 00:19:11,524 But don't tell him about that IQ thing, either. 457 00:19:16,805 --> 00:19:18,305 I want to go with him. 458 00:19:18,399 --> 00:19:20,158 You can't, honey. He needs special care 459 00:19:20,385 --> 00:19:21,975 in a special part of the hospital. 460 00:19:21,995 --> 00:19:24,311 You mean he's really sick? 461 00:19:24,330 --> 00:19:25,646 You fix people. 462 00:19:25,665 --> 00:19:29,667 -You'll fix him, can't you, Daddy? -Spencer. 463 00:19:29,818 --> 00:19:32,086 I'll be right there. 464 00:19:33,898 --> 00:19:36,990 What's happening? His daddy is scared. 465 00:19:37,010 --> 00:19:39,218 You have to save Peter. 466 00:19:42,907 --> 00:19:44,907 I got him. 467 00:19:44,926 --> 00:19:46,392 I got him, I promise. 468 00:19:51,432 --> 00:19:52,932 (Spencer sighs) 469 00:19:53,008 --> 00:19:54,192 He seems much worse. 470 00:19:54,360 --> 00:19:56,843 Please tell me you have some news. 471 00:19:56,938 --> 00:19:58,178 We gave him another round of meds 472 00:19:58,272 --> 00:20:00,013 to lower the intracranial pressure, 473 00:20:00,033 --> 00:20:03,701 but it'll take time... if it works. 474 00:20:06,355 --> 00:20:09,031 He was hurting, and I totally missed it. 475 00:20:10,284 --> 00:20:13,336 I get guilt, believe me, but it is not earned here. 476 00:20:17,458 --> 00:20:19,866 Help him. Please. 477 00:20:19,961 --> 00:20:23,370 We're doing everything we can. 478 00:20:23,464 --> 00:20:25,056 Uh, just... 479 00:20:25,283 --> 00:20:28,041 I don't want anybody cutting his head open. 480 00:20:28,061 --> 00:20:29,376 Not if we can avoid it. 481 00:20:29,395 --> 00:20:31,062 Understood. 482 00:20:36,627 --> 00:20:37,526 You all right? 483 00:20:39,313 --> 00:20:41,647 Now I feel guilty, about how lucky I am 484 00:20:41,799 --> 00:20:43,241 not to be in Spencer's shoes. 485 00:20:43,468 --> 00:20:44,891 Peter has to make it through this. 486 00:20:44,986 --> 00:20:46,969 -I know. -And Gigi, she lost her mother. 487 00:20:46,988 --> 00:20:47,987 She can't lose her best friend. 488 00:20:48,155 --> 00:20:49,080 We have to make sure they both come 489 00:20:49,307 --> 00:20:50,322 -out of this. -(retching) 490 00:20:50,458 --> 00:20:52,458 Uh, Dr. Hawkins! 491 00:20:55,404 --> 00:20:59,257 Vomiting means his intracranial pressure must be rising. 492 00:21:01,761 --> 00:21:02,927 I'm a little confused. 493 00:21:03,078 --> 00:21:04,411 -I'm sorry. -So the metoprolol 494 00:21:04,505 --> 00:21:05,654 helped your heart, 495 00:21:05,673 --> 00:21:07,265 but it also lowered your blood pressure. 496 00:21:07,492 --> 00:21:08,991 ZACH: And with all the water pills you were on, 497 00:21:09,010 --> 00:21:10,268 plus the stimulants, your heart rate sped 498 00:21:10,495 --> 00:21:12,937 and BP lowered, which caused you to lose consciousness. 499 00:21:13,164 --> 00:21:14,830 Other doctors have been telling me 500 00:21:14,923 --> 00:21:17,349 that these meds are saving my life, and you're telling me 501 00:21:17,502 --> 00:21:19,926 -the opposite? -No, just listen to them, hon. 502 00:21:19,946 --> 00:21:23,188 They want to take you off medications you may not need, 503 00:21:23,341 --> 00:21:25,024 and-and keep you on ones that are working. 504 00:21:25,118 --> 00:21:26,342 But we'd like to keep you here 505 00:21:26,360 --> 00:21:28,119 to monitor you while we do it. 506 00:21:28,288 --> 00:21:30,937 But it's just for a day, and then, um, you'll go home. 507 00:21:31,032 --> 00:21:34,517 -There's hope for him yet. -Mm. 508 00:21:34,519 --> 00:21:36,109 Thank you both. 509 00:21:36,129 --> 00:21:38,704 We've given Peter the maximum doses, 510 00:21:38,856 --> 00:21:41,281 but he's... he's not improving. 511 00:21:41,375 --> 00:21:42,949 Well, time to book an OR. 512 00:21:42,969 --> 00:21:45,469 No, let's just... (exhales) 513 00:21:45,621 --> 00:21:46,971 ...start with a drain 514 00:21:47,122 --> 00:21:49,181 before you open his head. 515 00:21:52,628 --> 00:21:54,103 Okay, we can try it. 516 00:21:55,873 --> 00:21:58,149 I'll get an EVD monitor. 517 00:22:01,212 --> 00:22:04,046 -Talk to me. -We're putting in a drain. 518 00:22:04,065 --> 00:22:06,657 It should help relieve the pressure on his brain. 519 00:22:06,809 --> 00:22:08,284 It's a first step. 520 00:22:11,164 --> 00:22:14,540 I don't know how much longer we can put off a craniectomy. 521 00:22:16,610 --> 00:22:18,419 It's my son. 522 00:22:22,233 --> 00:22:24,008 Let's take everything one step at a time. 523 00:22:24,159 --> 00:22:27,845 Right now, we need to sedate and intubate, 524 00:22:28,072 --> 00:22:30,573 and to protect his airway. 525 00:22:30,591 --> 00:22:34,093 I have to talk to him first, before you, before you... 526 00:22:34,245 --> 00:22:37,271 Of course. Of course. 527 00:22:45,423 --> 00:22:47,848 Hey, bud. 528 00:22:47,867 --> 00:22:48,941 (sighs) 529 00:22:49,035 --> 00:22:52,778 I just want you to know... 530 00:22:52,930 --> 00:22:57,023 I want you to know that every second that you're asleep, 531 00:22:57,043 --> 00:22:59,860 I'm gonna be right here beside you. 532 00:22:59,879 --> 00:23:02,296 Deal? 533 00:23:07,387 --> 00:23:08,869 Okay. 534 00:23:08,963 --> 00:23:10,346 (exhales sharply) 535 00:23:26,722 --> 00:23:28,572 Hey, there she is. 536 00:23:28,724 --> 00:23:30,466 So, how'd it go this morning? 537 00:23:30,484 --> 00:23:35,228 The hormone shot was fine, but this is not. Look. 538 00:23:35,322 --> 00:23:36,897 Padma picked a donor, but I did a little bit 539 00:23:36,991 --> 00:23:38,249 of digging into this sperm bank. 540 00:23:38,400 --> 00:23:40,084 It's facing three lawsuits from families who claim 541 00:23:40,235 --> 00:23:42,828 their donors misrepresented themselves. 542 00:23:42,922 --> 00:23:44,313 In one case, the family alleged 543 00:23:44,331 --> 00:23:46,090 that the donor had an undisclosed history 544 00:23:46,317 --> 00:23:47,091 of schizophrenia. 545 00:23:47,318 --> 00:23:48,241 In another, 546 00:23:48,261 --> 00:23:50,152 a donor covered up a criminal record. 547 00:23:50,171 --> 00:23:52,988 Some claim college degrees when they're really dropouts. 548 00:23:53,007 --> 00:23:54,414 These families were lied to. 549 00:23:54,434 --> 00:23:57,435 Yes. About the biggest decision they'll ever make. 550 00:23:57,586 --> 00:23:59,270 The genes their kids will share with its father. 551 00:23:59,421 --> 00:24:02,589 Yeah, but, I mean, this is just 552 00:24:02,667 --> 00:24:04,608 a few cases out of how many, right? 553 00:24:04,760 --> 00:24:06,001 I mean, I had a lot of friends 554 00:24:06,170 --> 00:24:07,427 in med school who donated. They were good guys, 555 00:24:07,447 --> 00:24:09,004 they just needed cash; they wanted to help. 556 00:24:09,097 --> 00:24:10,689 Is this your way of saying 557 00:24:10,783 --> 00:24:12,950 there are little Devons out there? 558 00:24:13,101 --> 00:24:16,178 If it helps, every single one of these donors 559 00:24:16,271 --> 00:24:17,846 had to undergo genetic testing. 560 00:24:17,940 --> 00:24:20,683 There is no test to show whether you're a pathological liar, 561 00:24:20,701 --> 00:24:22,293 have a mental illness or a criminal record. 562 00:24:22,444 --> 00:24:24,203 -And you're missing the point. -No, I get it. 563 00:24:24,279 --> 00:24:25,204 Sperm banks are unregulated. 564 00:24:25,298 --> 00:24:27,280 The FDA requires that donors are tested 565 00:24:27,300 --> 00:24:30,617 for infectious diseases, but beyond that, nothing. 566 00:24:30,636 --> 00:24:32,377 Their bios aren't even verified. 567 00:24:32,530 --> 00:24:33,787 That may work for some people. 568 00:24:33,881 --> 00:24:35,547 There are amazing kids out there from anonymous donors, 569 00:24:35,700 --> 00:24:36,790 but that won't work for me. 570 00:24:36,809 --> 00:24:38,124 -This is my egg. -Hey, babe... 571 00:24:38,293 --> 00:24:42,295 You have to accept that this is Padma's choice. 572 00:24:43,374 --> 00:24:45,874 Well, I need to make sure she knows what she's choosing. 573 00:24:45,893 --> 00:24:48,652 (pager vibrating, beeping) 574 00:24:48,804 --> 00:24:49,820 (scoffs) 575 00:24:49,989 --> 00:24:52,448 We'll talk later, okay? 576 00:24:57,663 --> 00:24:59,054 -Are you hot or cold? -Both. 577 00:24:59,147 --> 00:25:00,146 Okay, don't worry, we're gonna help you. 578 00:25:00,166 --> 00:25:02,148 She's in A-fib and hypotensive. 579 00:25:02,226 --> 00:25:03,834 A-fib could be because we took her off metoprolol. 580 00:25:04,061 --> 00:25:05,227 Let me check if her pressure dropped 581 00:25:05,246 --> 00:25:06,337 before she slipped into arrhythmia. 582 00:25:06,488 --> 00:25:08,080 I-I was here. Her BP started to fall first, 583 00:25:08,232 --> 00:25:09,732 then her heart rate spiked. 584 00:25:09,750 --> 00:25:11,008 Peritonitis? 585 00:25:11,159 --> 00:25:13,660 -Gloria, tell me where it hurts. -(groans, cries out) 586 00:25:13,679 --> 00:25:16,071 -Rebound tenderness. -This has nothing to do with the meds. 587 00:25:16,164 --> 00:25:17,406 She has an acute abdomen and she may need surgery. 588 00:25:17,499 --> 00:25:19,742 Let's get her four of morphine. 589 00:25:19,760 --> 00:25:20,684 Hang pressors and page Bell. 590 00:25:20,877 --> 00:25:23,503 Hey, hang in there, okay? 591 00:25:23,597 --> 00:25:25,439 (gasps) 592 00:25:29,695 --> 00:25:31,011 Where to begin? 593 00:25:31,105 --> 00:25:33,531 Gloria has three lumbar compression fractures 594 00:25:33,682 --> 00:25:34,698 from osteoporosis. 595 00:25:34,925 --> 00:25:37,017 And a hiatal hernia. All incidental findings. 596 00:25:37,111 --> 00:25:38,427 Consequence of living for eight decades. 597 00:25:38,520 --> 00:25:42,022 So here's today's problem. Colonic perforation. 598 00:25:42,041 --> 00:25:43,098 No wonder she was in so much pain. 599 00:25:43,117 --> 00:25:44,266 And no idea what caused this? 600 00:25:44,285 --> 00:25:46,285 It couldn't have been the fall. 601 00:25:46,437 --> 00:25:47,770 We thought she passed out from too many meds, 602 00:25:47,863 --> 00:25:49,288 but something else was going on. We just don't know what. 603 00:25:49,440 --> 00:25:52,365 Well, what we do know is that without surgery, 604 00:25:52,459 --> 00:25:53,884 Gloria won't make it. 605 00:25:54,036 --> 00:25:56,554 You're talking about a surgery that's dangerous at any age, 606 00:25:56,705 --> 00:25:58,280 and with Gloria nearly 80... 607 00:25:58,449 --> 00:26:00,783 Well, we'll be sure to be very clear with her 608 00:26:00,801 --> 00:26:02,542 about what we're facing here. 609 00:26:02,562 --> 00:26:05,729 But I agree with you. It's the only option. 610 00:26:05,922 --> 00:26:08,381 Okay. At least she's in the best hands. 611 00:26:08,401 --> 00:26:10,809 Well, I've had success with patients older than her, 612 00:26:10,961 --> 00:26:12,127 much sicker. 613 00:26:12,146 --> 00:26:14,363 I really hope she's one of them. 614 00:26:19,227 --> 00:26:19,985 So you think "The Right Stuff" is secretly 615 00:26:20,228 --> 00:26:21,728 -some sort of axe murderer? -No. 616 00:26:21,822 --> 00:26:22,988 I'm just saying we can't 617 00:26:23,140 --> 00:26:24,990 -really be sure who he is. -Okay, look, 618 00:26:25,142 --> 00:26:26,917 I really appreciate you being protective of me, 619 00:26:27,069 --> 00:26:28,977 but there's no guarantees with kids. 620 00:26:28,996 --> 00:26:30,254 I mean, look at us. 621 00:26:30,481 --> 00:26:31,663 What, there's a one-in-a-million chance 622 00:26:31,816 --> 00:26:32,831 of having twins? 623 00:26:32,983 --> 00:26:34,666 One in 250. 624 00:26:34,743 --> 00:26:37,911 And we are proof that a random genetic accident 625 00:26:37,988 --> 00:26:39,655 can be the best gift ever. 626 00:26:39,673 --> 00:26:42,749 Look, I can't give up on being a mother 627 00:26:42,827 --> 00:26:43,750 just because there's risks. 628 00:26:43,844 --> 00:26:45,102 I don't want you to. 629 00:26:45,329 --> 00:26:47,587 I just want you to be aware of what those risks are. 630 00:26:47,607 --> 00:26:52,351 Which is why I asked Dr. Nolan to join us. 631 00:26:52,445 --> 00:26:53,593 What's up, ladies? 632 00:26:53,613 --> 00:26:55,337 Show her what you showed me. 633 00:26:55,356 --> 00:26:56,447 Oh. 634 00:26:59,193 --> 00:27:00,525 PADMA: "Dream Doc"? 635 00:27:00,678 --> 00:27:02,694 I don't understand. 636 00:27:02,788 --> 00:27:04,455 -It's him. -It's me. 637 00:27:05,941 --> 00:27:07,440 You're six-foot five? 638 00:27:07,460 --> 00:27:09,201 I do slouch some. 639 00:27:09,353 --> 00:27:10,628 And fluent in French? 640 00:27:10,779 --> 00:27:12,020 Yeah. 641 00:27:12,114 --> 00:27:14,089 (bad accent): Je suis Rosetta Stone. 642 00:27:15,301 --> 00:27:18,026 -Trombone prodigy? -I got a standing ovation 643 00:27:18,045 --> 00:27:19,637 at my ninth grade recital. 644 00:27:19,788 --> 00:27:21,713 (pager beeping) 645 00:27:21,790 --> 00:27:24,391 -Just think about it. -Mm. 646 00:27:25,961 --> 00:27:27,886 Think about what? 647 00:27:28,038 --> 00:27:31,464 Surgery? Sounds... dangerous. 648 00:27:31,484 --> 00:27:34,134 Yeah, I'm not gonna lie to you. It is. 649 00:27:34,153 --> 00:27:37,804 But it is the only option. 650 00:27:37,898 --> 00:27:42,384 And without it, you may only have days. 651 00:27:42,403 --> 00:27:43,476 Maybe a week. 652 00:27:43,570 --> 00:27:46,054 I'm sorry. 653 00:27:46,073 --> 00:27:48,832 Y-You always say how 654 00:27:49,059 --> 00:27:52,169 e-easy choices are your favorite. 655 00:27:53,564 --> 00:27:57,174 I wish I could offer you more time 656 00:27:57,401 --> 00:27:58,992 to make this decision. 657 00:27:59,011 --> 00:28:00,903 But the sooner you operate, 658 00:28:00,921 --> 00:28:03,430 the better my chances are? 659 00:28:06,911 --> 00:28:09,002 Well, then, I'm ready. 660 00:28:09,021 --> 00:28:12,672 Arthur, I'm sure everybody over at Brookhaven is worried. 661 00:28:12,766 --> 00:28:14,841 You think maybe you could go call them 662 00:28:14,935 --> 00:28:17,436 -and fill them in? -Oh, of course. 663 00:28:17,530 --> 00:28:18,862 Any-Anything, darling. 664 00:28:19,089 --> 00:28:20,923 Yes, Brookhaven. 665 00:28:21,016 --> 00:28:22,941 Update, update Brookhaven. 666 00:28:23,093 --> 00:28:26,370 Update Brookhaven. 667 00:28:26,597 --> 00:28:27,763 (sighs) 668 00:28:27,781 --> 00:28:29,022 I can't leave him. 669 00:28:29,116 --> 00:28:31,375 -He needs me. -Oh, I... 670 00:28:31,526 --> 00:28:33,210 I get it. 671 00:28:33,361 --> 00:28:37,363 You have got to be better than you have ever been. 672 00:28:38,125 --> 00:28:40,776 Neither one of us have children. 673 00:28:40,869 --> 00:28:42,945 (sniffles) Not even siblings. 674 00:28:42,963 --> 00:28:45,038 It's just the two of us. 675 00:28:45,057 --> 00:28:47,282 He has no one else. 676 00:28:47,301 --> 00:28:49,284 I have no one else. 677 00:28:50,471 --> 00:28:52,896 Do you know what it's like to find the love of your life 678 00:28:53,065 --> 00:28:56,400 this late in the game? 679 00:28:56,477 --> 00:28:59,052 Actually, I do. 680 00:28:59,146 --> 00:29:01,630 And when the day comes, 681 00:29:01,723 --> 00:29:03,890 and he forgets my name, 682 00:29:03,984 --> 00:29:06,392 I won't even care. 683 00:29:06,561 --> 00:29:10,748 I'll fill in that blank, 'cause he'll still love me. 684 00:29:11,900 --> 00:29:13,399 And I'll love him. 685 00:29:13,419 --> 00:29:15,753 To the end. 686 00:29:15,904 --> 00:29:19,298 Just don't let it be today. 687 00:29:20,742 --> 00:29:22,426 Okay. 688 00:29:24,989 --> 00:29:27,389 (monitor beeping) 689 00:29:32,012 --> 00:29:34,679 His intracranial pressure is still rising, 690 00:29:34,774 --> 00:29:36,681 and we're not sure of the cause. 691 00:29:36,834 --> 00:29:38,591 The MRI didn't show any tumors 692 00:29:38,611 --> 00:29:41,612 or blood clots in his brain. 693 00:29:41,839 --> 00:29:42,946 So what does this mean? 694 00:29:43,098 --> 00:29:44,764 That the drain wasn't enough. 695 00:29:44,858 --> 00:29:46,858 Mr. Shafer, we have no choice but to 696 00:29:47,011 --> 00:29:48,176 proceed with the craniectomy 697 00:29:48,195 --> 00:29:49,769 to relieve the pressure in Peter's brain. 698 00:29:49,863 --> 00:29:51,497 My God. 699 00:29:53,867 --> 00:29:55,367 I can't believe this is happening. 700 00:29:55,519 --> 00:29:57,536 There must be something else you can do. 701 00:29:57,688 --> 00:30:01,039 If we wait any longer, he's at risk of brain damage. 702 00:30:01,191 --> 00:30:03,191 Treat him like he's your child. 703 00:30:03,285 --> 00:30:08,096 Would you agree to this if it was Gigi? 704 00:30:12,052 --> 00:30:14,311 Spencer, give us a minute to review. 705 00:30:18,133 --> 00:30:21,209 -Tell me there's another option. -There isn't. 706 00:30:21,228 --> 00:30:23,153 What he just said in there won't help Peter. 707 00:30:23,380 --> 00:30:26,048 Keeping your objectivity will. You have to. 708 00:30:26,066 --> 00:30:27,473 I'm sorry to interrupt, 709 00:30:27,493 --> 00:30:29,493 but the preschool's been trying to get in touch. 710 00:30:29,662 --> 00:30:31,745 Gigi needs you. 711 00:30:34,241 --> 00:30:36,750 Do what you have to do to reduce the swelling. 712 00:30:46,737 --> 00:30:48,236 Hey. She's been like this 713 00:30:48,330 --> 00:30:49,588 since Peter left this morning. 714 00:30:49,664 --> 00:30:52,432 She won't eat or talk. 715 00:30:53,093 --> 00:30:55,477 -Thank you. -Yeah. 716 00:31:03,362 --> 00:31:04,528 What is that? 717 00:31:04,679 --> 00:31:07,105 A space helmet for Peter. 718 00:31:07,257 --> 00:31:11,034 If he goes into space, he can't die. 719 00:31:12,763 --> 00:31:16,039 Is he gonna die, like Mommy? 720 00:31:20,862 --> 00:31:23,255 (sighs) 721 00:31:25,867 --> 00:31:28,944 I'm fighting for Peter. 722 00:31:28,962 --> 00:31:31,780 -I'm scared. -I know. That's okay. 723 00:31:31,798 --> 00:31:33,223 I knew he was sick when 724 00:31:33,375 --> 00:31:35,541 he didn't want to eat my sandwich. 725 00:31:35,594 --> 00:31:39,287 We trade. He always eats my sandwich. 726 00:31:39,289 --> 00:31:41,881 When his mommy left, his daddy started 727 00:31:41,901 --> 00:31:45,385 making his lunch with roast beef. 728 00:31:45,404 --> 00:31:49,364 After he ate it all, his tummy started hurting. 729 00:31:55,397 --> 00:31:57,247 Did he eat your sandwich this morning? 730 00:31:57,474 --> 00:31:59,249 No, Daddy. 731 00:32:06,833 --> 00:32:08,717 Craniotome to me. 732 00:32:12,431 --> 00:32:15,098 I've done this a hundred times, but rarely on a child. 733 00:32:15,250 --> 00:32:19,144 You're more than qualified. 734 00:32:21,331 --> 00:32:23,832 Watch for bleeding, be gentle. 735 00:32:23,925 --> 00:32:26,193 When I pass through bone, I stop. 736 00:32:26,928 --> 00:32:30,338 Now, let's get started. 737 00:32:30,432 --> 00:32:31,673 (whirring) 738 00:32:31,766 --> 00:32:32,857 Wait! 739 00:32:33,010 --> 00:32:34,284 I think Peter has urea cycle disorder. 740 00:32:34,511 --> 00:32:36,769 It's a genetic enzyme deficiency that makes it hard 741 00:32:36,789 --> 00:32:38,363 for people to break down protein. 742 00:32:38,457 --> 00:32:41,107 Whenever Spencer packs his son roast beef, he trades it away 743 00:32:41,276 --> 00:32:42,701 because it makes his stomach hurt. 744 00:32:42,853 --> 00:32:43,776 I think sharing his dad's 745 00:32:43,796 --> 00:32:45,187 protein shake this morning 746 00:32:45,280 --> 00:32:47,022 gave him more protein than he could process, 747 00:32:47,191 --> 00:32:48,448 and his body was already under stress from his recent cold. 748 00:32:48,467 --> 00:32:50,968 Talk about a zebra. Urea cycle is extremely rare. 749 00:32:51,136 --> 00:32:52,377 But it would explain all the symptoms. 750 00:32:52,471 --> 00:32:53,953 Let's get him back to the ICU, 751 00:32:53,973 --> 00:32:55,973 start him on dialysis, clear the ammonia. 752 00:32:56,200 --> 00:32:57,307 Yeah, but do we have that kind of time? 753 00:32:57,459 --> 00:32:59,309 The odds you're right are vanishingly small, 754 00:32:59,461 --> 00:33:00,644 and if you're wrong, this boy's brain 755 00:33:00,871 --> 00:33:01,961 continues to swell, 756 00:33:01,981 --> 00:33:03,271 which will cause him permanent damage. 757 00:33:05,133 --> 00:33:06,299 We need to operate now. 758 00:33:06,393 --> 00:33:08,134 CONRAD: A craniectomy is a gamble, too. 759 00:33:08,228 --> 00:33:09,728 At the rate the swelling is worsening, 760 00:33:09,804 --> 00:33:11,896 best-case scenario, what, it buys Peter days? 761 00:33:12,049 --> 00:33:14,566 It doesn't fix the problem. 762 00:33:14,718 --> 00:33:16,159 That is true. 763 00:33:17,830 --> 00:33:20,405 So let's do both. 764 00:33:20,557 --> 00:33:23,316 Dialysis right here. We can watch his ICP. 765 00:33:23,335 --> 00:33:25,577 If it doesn't drop, I'm ready to 766 00:33:25,729 --> 00:33:27,129 start a crani immediately. 767 00:33:38,166 --> 00:33:40,166 I'll be right here when you wake up. 768 00:33:40,227 --> 00:33:44,312 Okay, this is as far as you can go. 769 00:33:52,013 --> 00:33:54,439 I love you. 770 00:33:54,608 --> 00:33:57,701 I love you more. 771 00:33:57,928 --> 00:34:00,412 (chuckles) 772 00:34:02,857 --> 00:34:04,332 Okay. 773 00:34:20,634 --> 00:34:23,185 Wire, please. 774 00:34:29,309 --> 00:34:31,276 Dilator. 775 00:34:35,799 --> 00:34:38,408 All right, we're almost there. 776 00:34:38,635 --> 00:34:40,243 All right, catheter in. 777 00:34:40,470 --> 00:34:42,913 If you're right, the pressure should trend down 778 00:34:43,064 --> 00:34:44,322 once the proteins are filtered out. 779 00:34:44,474 --> 00:34:46,541 Yeah, well, it's not gonna happen immediately. 780 00:34:51,998 --> 00:34:53,465 If that number doesn't come down soon, I start. 781 00:34:54,793 --> 00:34:57,094 Whether I want to or not. 782 00:35:00,006 --> 00:35:02,324 We're working through some unexpected adhesions. 783 00:35:02,417 --> 00:35:04,843 Did Gloria mention anything about prior surgeries? 784 00:35:04,995 --> 00:35:07,011 None. Any sign of the perforation? 785 00:35:07,088 --> 00:35:08,254 Running the bowel now. 786 00:35:08,273 --> 00:35:11,349 There's no sign of widespread ischemia. 787 00:35:11,501 --> 00:35:12,109 Oh, there it is. 788 00:35:12,260 --> 00:35:13,276 Can you repair it? 789 00:35:13,428 --> 00:35:15,112 Well, the surrounding bowel is thickened 790 00:35:15,339 --> 00:35:18,340 with extensive lymphadenopathy. 791 00:35:18,433 --> 00:35:20,784 It sounds like whatever's going on 792 00:35:20,935 --> 00:35:22,101 caused significant inflammation. 793 00:35:22,195 --> 00:35:24,121 I should be able to repair the perf, 794 00:35:24,348 --> 00:35:26,030 but, you know, this didn't happen overnight. 795 00:35:26,125 --> 00:35:27,607 It's been going on for years. 796 00:35:27,684 --> 00:35:30,185 Bowel inflammation is extremely painful. 797 00:35:30,203 --> 00:35:33,046 Her daily steroids must have been masking it. 798 00:35:34,800 --> 00:35:36,466 See the big picture. 799 00:35:36,618 --> 00:35:38,360 Dr. Kravitz told me in geriatrics 800 00:35:38,378 --> 00:35:40,971 you always gotta keep your eye on the big picture. 801 00:35:41,198 --> 00:35:43,289 What if the arthritis and the bowel inflammation 802 00:35:43,308 --> 00:35:44,808 are all part of the same disease process? 803 00:35:45,035 --> 00:35:47,269 It's possible. 804 00:35:48,388 --> 00:35:50,221 If the side effects of her medications 805 00:35:50,315 --> 00:35:54,234 were actually symptoms of the underlying issue. 806 00:35:55,320 --> 00:35:57,562 We've been looking at this all wrong. 807 00:35:57,714 --> 00:36:00,215 Let's get back to Gloria's prescriptions 808 00:36:00,308 --> 00:36:01,641 and see if we can't get her some answers 809 00:36:01,660 --> 00:36:03,451 when she wakes up. 810 00:36:06,390 --> 00:36:07,922 BILLIE: It just keeps rising. 811 00:36:07,924 --> 00:36:09,332 Can we dialyze faster? 812 00:36:09,409 --> 00:36:11,893 Any faster and his neurons could shear from diffusion. 813 00:36:11,912 --> 00:36:13,152 Just give it a minute. 814 00:36:13,246 --> 00:36:14,504 Conrad, this is the brain. A minute can be 815 00:36:14,731 --> 00:36:15,821 the difference between life and death. 816 00:36:15,916 --> 00:36:17,065 Just give me one more minute. 817 00:36:17,158 --> 00:36:18,341 We don't have good choices here. 818 00:36:18,568 --> 00:36:21,344 -Billie, we're on the same side. -But this is my OR. 819 00:36:31,431 --> 00:36:33,005 (monitor beeps) 820 00:36:33,025 --> 00:36:35,108 -It dropped. -Wait, Dr. Sutton. 821 00:36:36,253 --> 00:36:38,111 That number's still dangerously high. 822 00:36:46,596 --> 00:36:48,279 (monitor beeps) 823 00:36:48,432 --> 00:36:49,998 (laughs) 824 00:36:52,769 --> 00:36:54,753 It worked. 825 00:36:57,532 --> 00:36:58,698 (exhales sharply) 826 00:36:58,866 --> 00:37:01,292 JESSICA: You ready to close? 827 00:37:01,445 --> 00:37:04,346 Sure am. 828 00:37:10,120 --> 00:37:12,804 Focus on that still space 829 00:37:12,956 --> 00:37:15,881 between our inhale 830 00:37:15,959 --> 00:37:18,401 and our exhale. 831 00:37:18,553 --> 00:37:19,811 (phone chimes) 832 00:37:19,963 --> 00:37:21,646 Please remember to silence your devices 833 00:37:21,740 --> 00:37:23,389 before we begin the class. 834 00:37:23,483 --> 00:37:25,700 (phone chimes) 835 00:37:27,487 --> 00:37:29,329 (phone chimes) 836 00:37:32,734 --> 00:37:34,459 (pager beeps) 837 00:37:50,327 --> 00:37:52,251 -I seem to have gotten turned around. -Okay. 838 00:37:52,271 --> 00:37:53,845 My wife is in surgery. 839 00:37:53,997 --> 00:37:55,755 Can you direct me to the waiting room? 840 00:37:55,849 --> 00:37:58,316 Uh, here, let me show you. 841 00:38:00,928 --> 00:38:03,095 The cavalry has arrived. 842 00:38:03,115 --> 00:38:04,005 77-year-old woman with a bowel perf. 843 00:38:04,024 --> 00:38:05,264 Pressure started tanking. 844 00:38:05,284 --> 00:38:06,616 At first I thought it was peritonitis, 845 00:38:06,768 --> 00:38:08,676 then I saw her neck. 846 00:38:08,678 --> 00:38:09,786 I need ultrasound now. 847 00:38:10,013 --> 00:38:11,437 Any idea why she might be in tamponade? 848 00:38:11,456 --> 00:38:13,105 No idea what the underlying issue is. 849 00:38:13,125 --> 00:38:15,350 Right now, we just need to get her off the table. 850 00:38:15,443 --> 00:38:17,443 Start another epi and bolus a liter. 851 00:38:17,462 --> 00:38:19,871 There's fluid around her heart. We need to prep her 852 00:38:19,965 --> 00:38:21,205 for pericardiocentesis. 853 00:38:21,300 --> 00:38:22,966 Okay, I'll finish up so I can assist. 854 00:38:23,117 --> 00:38:24,208 All right, but if she doesn't stabilize, Bell, 855 00:38:24,361 --> 00:38:25,710 I'm gonna have to crack her chest open. 856 00:38:25,862 --> 00:38:28,263 Oh, God, let's hope not. 857 00:38:41,545 --> 00:38:43,878 Oh, man, I can't wait to tell 'em. 858 00:38:43,971 --> 00:38:45,322 Hey, we figured it out. 859 00:38:45,473 --> 00:38:47,306 Gloria's medications didn't cause her problems, 860 00:38:47,433 --> 00:38:48,842 but they masked an underlying one: 861 00:38:48,844 --> 00:38:50,309 Whipple's disease. 862 00:38:50,329 --> 00:38:52,554 That's what caused her arthritis, weight loss, fatigue. 863 00:38:52,572 --> 00:38:54,814 And steroids that her doctors first thought was arthritis 864 00:38:54,908 --> 00:38:56,148 only made it worse. 865 00:38:56,242 --> 00:38:57,909 She told us that they increased her dose, 866 00:38:58,061 --> 00:38:59,169 leading to the perf. 867 00:38:59,320 --> 00:39:00,503 ZACH: Now all Gloria needs is an antibiotic. 868 00:39:00,655 --> 00:39:01,838 We can take her off of 869 00:39:01,989 --> 00:39:03,898 -almost everything else. -She didn't make it. 870 00:39:03,917 --> 00:39:06,843 -I'm sorry. -What? She... 871 00:39:07,070 --> 00:39:09,995 BELL: She developed cardiac tamponade, 872 00:39:10,090 --> 00:39:12,407 which was probably the final complication 873 00:39:12,576 --> 00:39:14,075 of her undiagnosed Whipple. 874 00:39:14,094 --> 00:39:16,594 And Austin was working to place a pericardial drain 875 00:39:16,688 --> 00:39:18,521 when she coded. 876 00:39:18,673 --> 00:39:21,099 We did five rounds of CPR. 877 00:39:21,193 --> 00:39:23,751 More than I should have on a woman her age. 878 00:39:23,753 --> 00:39:25,195 It was a tough one. 879 00:39:25,364 --> 00:39:26,863 BELL: Now, if she'd been treated properly, 880 00:39:27,014 --> 00:39:28,180 or if she'd gotten to us sooner, 881 00:39:28,316 --> 00:39:30,758 maybe we could have done something 882 00:39:30,777 --> 00:39:31,868 to turn it around. 883 00:39:32,095 --> 00:39:35,330 But today... it was just far too late. 884 00:39:37,601 --> 00:39:39,292 Dr. Kravitz... 885 00:39:41,863 --> 00:39:43,621 Kit is his friend, 886 00:39:43,715 --> 00:39:46,549 so I will call her to tell him. 887 00:39:57,545 --> 00:39:59,729 DEVON: Even if we had diagnosed her sooner, 888 00:39:59,881 --> 00:40:01,973 Gloria's disease began years ago. 889 00:40:02,125 --> 00:40:03,382 There's nothing we could have done. 890 00:40:03,402 --> 00:40:06,903 Gloria wasn't just another fragile old lady. 891 00:40:07,054 --> 00:40:09,964 She was strong, in love. 892 00:40:10,057 --> 00:40:12,575 She deserved more time. 893 00:40:12,727 --> 00:40:17,305 But every doctor looked at her like just another lost cause. 894 00:40:17,398 --> 00:40:18,990 No one cared enough to see 895 00:40:19,084 --> 00:40:20,992 that by just treating her symptoms, 896 00:40:21,144 --> 00:40:23,420 they were actually making her worse. 897 00:40:28,260 --> 00:40:32,429 No one saw the bigger picture until you did. 898 00:40:34,582 --> 00:40:37,825 Reconsider going into gerontology, Zach. 899 00:40:37,844 --> 00:40:39,978 You may have a gift. 900 00:40:43,667 --> 00:40:46,025 (door opens) 901 00:40:47,504 --> 00:40:49,279 (door closes) 902 00:40:58,957 --> 00:41:01,866 ♪ ♪ 903 00:41:01,960 --> 00:41:04,443 -I am so sorry. -(sobbing) 904 00:41:04,463 --> 00:41:06,688 I'm so sorry. 905 00:41:06,856 --> 00:41:09,090 ♪ ♪ 906 00:41:26,133 --> 00:41:28,376 Look what I made you. 907 00:41:28,469 --> 00:41:30,044 Wow! 908 00:41:30,137 --> 00:41:31,395 Hey. 909 00:41:31,715 --> 00:41:34,306 So we'll continue dialysis until we lower his ammonia levels, 910 00:41:34,326 --> 00:41:37,385 but with some attention and lifestyle modifications 911 00:41:37,478 --> 00:41:38,495 we can manage this. 912 00:41:38,663 --> 00:41:40,054 You will need to look out for any signs that 913 00:41:40,073 --> 00:41:40,997 his ammonia levels are up. 914 00:41:41,224 --> 00:41:43,224 Sluggishness, nausea, vomiting. 915 00:41:43,243 --> 00:41:44,334 Avoid extreme temps. 916 00:41:44,561 --> 00:41:47,170 Keep him hydrated and on a low-protein diet. 917 00:41:47,397 --> 00:41:49,822 -No more roast beef sandwiches. -(soft laughter) 918 00:41:49,841 --> 00:41:52,324 He'll do great. 919 00:41:52,344 --> 00:41:54,493 I can't thank you enough. 920 00:41:54,662 --> 00:41:57,496 Well, we did have help. 921 00:41:57,516 --> 00:41:58,906 How would you two like a surprise? 922 00:41:59,000 --> 00:42:02,185 What is it, Daddy? What is it? 923 00:42:09,919 --> 00:42:12,529 GIGI: Wow! 924 00:42:12,756 --> 00:42:16,115 It's beautiful. 925 00:42:29,047 --> 00:42:31,789 Nolan as a sperm donor? (laughs) Our Nolan? 926 00:42:31,941 --> 00:42:33,716 -Yep. -Ooh. 927 00:42:33,793 --> 00:42:36,778 -That put the fear of God in me. -Yeah, I bet. 928 00:42:36,796 --> 00:42:39,130 But the eggs are gonna be retrieved in about two weeks, 929 00:42:39,299 --> 00:42:41,799 which means I need a volunteer, fast. 930 00:42:41,893 --> 00:42:44,710 Someone I trust, someone I care about. 931 00:42:44,729 --> 00:42:46,137 What are you gonna do? 932 00:42:46,289 --> 00:42:49,957 Actually, um, I had a crazy idea. 933 00:42:50,051 --> 00:42:51,401 You and I are good friends, 934 00:42:51,552 --> 00:42:54,720 now that we aren't lovers, and I wouldn't mind 935 00:42:54,814 --> 00:42:56,631 a kid a lot like you. 936 00:42:56,724 --> 00:42:58,633 You could do worse. 937 00:42:58,726 --> 00:43:01,152 So what if I did... 938 00:43:01,228 --> 00:43:04,539 have a kid just like you? 939 00:43:07,234 --> 00:43:10,295 You want me to be your sperm donor? 940 00:43:18,913 --> 00:43:21,580 Captioning sponsored by 20th CENTURY FOX TELEVISION 941 00:43:21,600 --> 00:43:24,100 and TOYOTA. 942 00:43:24,327 --> 00:43:27,729 Captioned by Media Access Group at WGBH access.wgbh.org