1 00:00:01,673 --> 00:00:02,673 (Amy): Previously, on Doc. 2 00:00:02,674 --> 00:00:04,208 (Dr. Sheryl): She's healing, and healing fast. 3 00:00:04,209 --> 00:00:05,542 - That would explain the influx of new memories. 4 00:00:05,543 --> 00:00:07,311 - Really hope you're not rushing this. 5 00:00:07,312 --> 00:00:09,346 - I assure you, I can do this. 6 00:00:09,347 --> 00:00:10,948 - Ruth Chen, this is Cal Ferguson. 7 00:00:10,949 --> 00:00:12,383 - These are your co-chief residents. 8 00:00:12,384 --> 00:00:14,485 - Ben! I heard you were coming. (chuckling) 9 00:00:14,486 --> 00:00:16,353 - You want to replace Dr. Costa. 10 00:00:16,354 --> 00:00:19,289 - If I'm coming to Westside, it'll only be to run surgery. 11 00:00:19,290 --> 00:00:22,059 - So, now that you're not working with Dr. Larsen, 12 00:00:22,060 --> 00:00:23,861 you figured why not give cardiology a shot? 13 00:00:23,862 --> 00:00:26,463 - I'm happy to better myself. - I saw you, Jake. 14 00:00:26,464 --> 00:00:28,600 I saw how you looked at her through her window. 15 00:00:28,700 --> 00:00:30,435 - You just pushed me away. 16 00:00:33,004 --> 00:00:35,306 (engine humming) 17 00:00:36,775 --> 00:00:39,577 (country music over radio) 18 00:00:46,017 --> 00:00:47,418 (man): Help! 19 00:00:47,419 --> 00:00:49,186 Help! (tires screech) 20 00:00:49,187 --> 00:00:51,388 (panting) 21 00:00:51,389 --> 00:00:54,258 Please, help! - What happened? Are you hurt? 22 00:00:54,259 --> 00:00:56,794 - Not me. My family's in there, you've gotta help them. 23 00:00:56,795 --> 00:00:58,495 (panting) 24 00:00:58,496 --> 00:01:00,198 (tense music) 25 00:01:01,633 --> 00:01:04,202 (theme music) 26 00:01:07,872 --> 00:01:09,774 (alarm beeping) 27 00:01:22,987 --> 00:01:25,389 (chuckling) 28 00:01:25,390 --> 00:01:27,958 - Ibuprofen? - Mm-hmm. 29 00:01:27,959 --> 00:01:29,827 - I didn't realize you were a nurse. 30 00:01:29,828 --> 00:01:31,629 - Funny. (chuckling) 31 00:01:33,732 --> 00:01:35,099 And fun. 32 00:01:35,100 --> 00:01:38,469 - That's a pretty sneaky martini you make, which is not fair. 33 00:01:38,470 --> 00:01:40,104 (chuckling) - You want the recipe? 34 00:01:40,105 --> 00:01:42,973 - Oh, God, no. 35 00:01:42,974 --> 00:01:45,843 (page ripping) - How about my number? 36 00:01:45,844 --> 00:01:48,112 (soft music) 37 00:01:48,113 --> 00:01:50,014 - Oh, uh... 38 00:01:50,015 --> 00:01:51,648 - You're not gonna call me, are you? 39 00:01:51,649 --> 00:01:53,350 (both chuckling) 40 00:01:53,351 --> 00:01:56,186 - I've got a lot on my plate right now. 41 00:01:56,187 --> 00:01:58,523 - Can't blame a girl for trying. 42 00:02:05,597 --> 00:02:08,399 - It's your lucky day, pal. You're with me again. 43 00:02:08,400 --> 00:02:11,235 - Great. - Call came from on high. 44 00:02:11,236 --> 00:02:14,538 Clearly Dr. Matos sees some potential in you. 45 00:02:14,539 --> 00:02:17,408 Ooh. What you working on? 46 00:02:17,409 --> 00:02:19,910 (phone chimes) Wait... 47 00:02:19,911 --> 00:02:21,645 Is that like, Rachel, Rachel? 48 00:02:21,646 --> 00:02:24,214 - It's new, okay? So I just need you to keep it to yourself. 49 00:02:24,215 --> 00:02:27,217 All right? - Dude. Cardio code. Of course. 50 00:02:27,218 --> 00:02:28,720 (phone chimes) 51 00:02:28,820 --> 00:02:30,688 Aw, you're nervous! 52 00:02:30,689 --> 00:02:32,823 - No, that's... that's not what I said to her. 53 00:02:32,824 --> 00:02:36,760 - Right. Well, carpe diem. Let's go, grasshopper. 54 00:02:36,761 --> 00:02:38,829 Wait... 55 00:02:38,830 --> 00:02:41,231 Does this mean no more Amy? 56 00:02:41,232 --> 00:02:43,801 (exhales) 57 00:02:43,802 --> 00:02:45,903 (Amy): I had a few more memories last night, 58 00:02:45,904 --> 00:02:47,371 but nothing physical, 59 00:02:47,372 --> 00:02:48,672 so, don't go running to Michael. 60 00:02:48,673 --> 00:02:50,307 - He is the head of your department, 61 00:02:50,308 --> 00:02:51,675 and I'm out over my skis for you, 62 00:02:51,676 --> 00:02:54,678 so I will report back to him as soon as I understand 63 00:02:54,679 --> 00:02:57,247 what this is. So how is this different? 64 00:02:57,248 --> 00:03:00,017 - They're not painful or disorienting. 65 00:03:00,018 --> 00:03:04,188 Just constant and intrusive, and the last thing I need 66 00:03:04,189 --> 00:03:06,357 when I'm trying not to look back. 67 00:03:06,358 --> 00:03:09,793 - All the more reason to look ahead. 68 00:03:09,794 --> 00:03:12,797 - Amy. - Hey, Ben. 69 00:03:14,499 --> 00:03:16,468 So I guess you work here now? - Looks that way. 70 00:03:16,568 --> 00:03:19,503 (chuckling) Double espresso, please. 71 00:03:19,504 --> 00:03:21,373 - I think Joan would be glad 72 00:03:21,473 --> 00:03:22,906 that you're the one filling her position. 73 00:03:22,907 --> 00:03:25,476 - Actually, I'm taking over the department. 74 00:03:25,477 --> 00:03:27,044 - Does Dr. Costa know that? 75 00:03:27,045 --> 00:03:30,180 - Yeah, he's pretty burnt out on the admin stuff, 76 00:03:30,181 --> 00:03:32,483 and he was happy to let that part go. 77 00:03:32,484 --> 00:03:33,984 Works out for everyone. 78 00:03:33,985 --> 00:03:34,952 (ethereal ringing) 79 00:03:34,953 --> 00:03:36,220 You do background 80 00:03:36,221 --> 00:03:39,324 on everyone at the conference? Or just me? 81 00:03:40,658 --> 00:03:44,728 - Well, I'm glad you're here. I'm excited to work with you. 82 00:03:44,729 --> 00:03:45,797 - Same. 83 00:03:48,333 --> 00:03:49,601 (Sonya): Department rolling out 84 00:03:49,701 --> 00:03:53,303 the red carpet for Ben on his first day? 85 00:03:53,304 --> 00:03:56,474 - So, whose team are you on? 86 00:03:56,574 --> 00:03:59,143 - It's not dodgeball. - No. It's not. 87 00:03:59,144 --> 00:04:01,045 And I'm asking where you stand. 88 00:04:01,046 --> 00:04:02,946 (scoffs) - This is ridiculous. 89 00:04:02,947 --> 00:04:05,249 - 'Cause I heard you and grant got pretty chummy 90 00:04:05,250 --> 00:04:06,684 during the contagion. 91 00:04:06,685 --> 00:04:08,986 Maybe you knew about the coup before it happened. 92 00:04:08,987 --> 00:04:10,221 - Oh, wow. - Come on. 93 00:04:10,321 --> 00:04:12,823 - All I know is I've been a resident under Costa 94 00:04:12,824 --> 00:04:14,558 for four years, 95 00:04:14,559 --> 00:04:16,060 and he deserved better than this. 96 00:04:16,061 --> 00:04:17,896 (tense music) 97 00:04:19,631 --> 00:04:21,966 - Dr. Fox could use a Xanax. 98 00:04:22,067 --> 00:04:24,001 - He may not be wrong. 99 00:04:24,002 --> 00:04:28,138 Ben is brilliant, but Costa's the one who hired me. 100 00:04:28,139 --> 00:04:30,808 - Joan championed you. 101 00:04:30,809 --> 00:04:32,710 Costa went along. And that happened 102 00:04:32,711 --> 00:04:34,912 because you are really good. 103 00:04:34,913 --> 00:04:37,181 - Yeah, I just don't like the way things went down. 104 00:04:37,182 --> 00:04:39,149 - I get that. But you said yourself, 105 00:04:39,150 --> 00:04:41,852 Costa can be conservative. 106 00:04:41,853 --> 00:04:44,621 I think Ben will be better for the department. 107 00:04:44,622 --> 00:04:47,157 - I guess I'll find out for myself soon enough. 108 00:04:47,158 --> 00:04:48,626 - Yeah. 109 00:04:50,161 --> 00:04:51,628 (indistinct chatter) 110 00:04:51,629 --> 00:04:54,965 - Morning. - Dr. Grant. 111 00:04:54,966 --> 00:04:57,835 - I figured you'd want to discuss what happened? 112 00:04:57,836 --> 00:05:01,305 - As the guy who recommended you for an opening in surgery, 113 00:05:01,306 --> 00:05:03,574 I would've appreciated a heads up 114 00:05:03,575 --> 00:05:05,744 that you were planning to take it over. 115 00:05:05,844 --> 00:05:08,312 - Sorry if that put you in an uncomfortable situation. 116 00:05:08,313 --> 00:05:10,647 - It did. And it does. - I saw the potential 117 00:05:10,648 --> 00:05:13,050 in the department, and this was the only move 118 00:05:13,051 --> 00:05:15,285 that made sense for me. And apparently the board 119 00:05:15,286 --> 00:05:17,221 saw an opportunity to upgrade. 120 00:05:17,222 --> 00:05:18,622 - I don't disagree with their decision 121 00:05:18,623 --> 00:05:20,691 or the direction you want to take things. 122 00:05:20,692 --> 00:05:23,594 But surgery and medicine have to work together. 123 00:05:23,595 --> 00:05:27,598 And I'd be lying if I said you haven't lost some trust. 124 00:05:27,599 --> 00:05:31,702 - Well, I hope you'll give me a chance to earn it back. 125 00:05:31,703 --> 00:05:33,637 (door opens) - Dr. Grant? 126 00:05:33,638 --> 00:05:34,872 You're needed in surgery. 127 00:05:34,873 --> 00:05:37,775 And they want you in the ICU. - Okay. 128 00:05:37,776 --> 00:05:40,477 - Teenage son was driving. ER checked him out. 129 00:05:40,478 --> 00:05:43,514 Scraps and a mild concussion. Mom's got rhabdo, 130 00:05:43,515 --> 00:05:46,216 causing renal failure and a subdural hematoma. 131 00:05:46,217 --> 00:05:48,719 12-year-old sister has a liver lac 132 00:05:48,720 --> 00:05:53,190 from the seatbelt, a pelvic ring fracture, and DIC. 133 00:05:53,191 --> 00:05:55,359 They're on their way up. 134 00:05:55,360 --> 00:05:58,796 Uh, we should assign the interns to floor work. 135 00:05:58,797 --> 00:05:59,930 They're just gonna get in the way today. 136 00:05:59,931 --> 00:06:02,633 - Well, opportunities don't come when you're ready, 137 00:06:02,634 --> 00:06:04,469 they come when they come. 138 00:06:04,569 --> 00:06:07,137 - I think it's a mistake but fine. 139 00:06:07,138 --> 00:06:08,739 You can have Kyle, I got Ruth. 140 00:06:08,740 --> 00:06:11,842 - Try not to break her on day two. 141 00:06:11,843 --> 00:06:13,277 (elevator dings) 142 00:06:13,278 --> 00:06:16,380 - Anthony Evans, 48, MVA. 143 00:06:16,381 --> 00:06:18,982 Deer versus auto. Riding shotgun. 144 00:06:18,983 --> 00:06:21,819 FD came to extricate after he was found impaled 145 00:06:21,820 --> 00:06:25,255 on the scene. Wife and daughter are in the ER. 146 00:06:25,256 --> 00:06:26,990 - All right, take him to OR 1. 147 00:06:26,991 --> 00:06:30,127 Dr. Coleman, call Radiology. I need a bedside chest film. 148 00:06:30,128 --> 00:06:31,395 - You got it. 149 00:06:31,396 --> 00:06:33,898 (tense music) 150 00:06:36,801 --> 00:06:38,536 - Can you tell me what happened? 151 00:06:41,773 --> 00:06:46,043 - Last night I, I was... I... 152 00:06:46,044 --> 00:06:48,278 (breathing heavily) 153 00:06:48,279 --> 00:06:49,680 - Dr. Ferguson, can you get 154 00:06:49,681 --> 00:06:51,782 Mrs. Evans's latest files, please? 155 00:06:51,783 --> 00:06:53,183 - Yeah. 156 00:06:53,184 --> 00:06:54,985 Uh, Dr. Larsen wants vitals. 157 00:06:54,986 --> 00:06:57,055 - Hey, I know how hard this must be, 158 00:06:57,155 --> 00:06:58,722 but we are gonna do everything in our power 159 00:06:58,723 --> 00:07:00,791 to help your family. 160 00:07:00,792 --> 00:07:03,560 But in order to do that, I need you to tell me 161 00:07:03,561 --> 00:07:04,862 what happened. 162 00:07:04,863 --> 00:07:06,330 - Um... 163 00:07:06,331 --> 00:07:08,098 We went to Mestiizos 164 00:07:08,099 --> 00:07:10,501 to celebrate Harper's middle school graduation. 165 00:07:10,502 --> 00:07:12,703 - Mm-hmm. - My sister can never decide 166 00:07:12,704 --> 00:07:14,071 between sushi and Mexican, 167 00:07:14,072 --> 00:07:18,008 so she was excited, 'cause you know, it-it's both. 168 00:07:18,009 --> 00:07:19,510 (sighs) 169 00:07:19,511 --> 00:07:22,513 After dinner, we went back to our cabin. 170 00:07:22,514 --> 00:07:25,516 I-I begged my parents to let me drive. 171 00:07:25,517 --> 00:07:28,485 My, my mom, she said no way, 'cause I had just 172 00:07:28,486 --> 00:07:30,954 gotten my license. But my dad... 173 00:07:30,955 --> 00:07:34,024 He said I had to learn some time. 174 00:07:34,025 --> 00:07:35,526 I-I didn't see the deer. 175 00:07:35,527 --> 00:07:36,760 Before I knew what was happening, 176 00:07:36,761 --> 00:07:37,995 it crashed through the windshield. 177 00:07:37,996 --> 00:07:39,630 - So your dad was in the passenger seat? 178 00:07:39,631 --> 00:07:41,565 - Mom and Harper in the back. 179 00:07:41,566 --> 00:07:43,935 My airbag went off. We flipped into a ditch. 180 00:07:47,238 --> 00:07:49,006 The deer was kicking like crazy, 181 00:07:49,007 --> 00:07:51,475 it was freaking out, there was blood everywhere. 182 00:07:51,476 --> 00:07:53,010 - BP 110 over 73. 183 00:07:53,011 --> 00:07:55,446 Heart rate's in the 90s and she's satting 97. 184 00:07:55,447 --> 00:07:56,880 - Oh, great. 185 00:07:56,881 --> 00:07:59,616 Theo, your mom's vitals are all normal, okay? 186 00:07:59,617 --> 00:08:01,251 - Yeah. Th-Thank you. 187 00:08:01,252 --> 00:08:03,187 - During the accident, were you knocked out? 188 00:08:03,188 --> 00:08:05,789 - Not for long. It was still dark when I came to, 189 00:08:05,790 --> 00:08:07,991 but there was no one else awake. 190 00:08:07,992 --> 00:08:11,695 I tried to get help, but there was no cell service. 191 00:08:11,696 --> 00:08:14,531 Seatbelt was jammed, the door was wedged shut. 192 00:08:14,532 --> 00:08:16,334 It took so long before I got out 193 00:08:16,434 --> 00:08:17,801 that when I finally got to the road, 194 00:08:17,802 --> 00:08:19,737 there was no one there for hours. 195 00:08:19,738 --> 00:08:22,206 After sunrise, a few people drove by, 196 00:08:22,207 --> 00:08:25,409 but the... I-I know they saw me, 197 00:08:25,410 --> 00:08:27,945 but they just kept going-- - It's okay. 198 00:08:27,946 --> 00:08:30,514 You're all here now. - My dad's not here. 199 00:08:30,515 --> 00:08:32,249 I don't even know what's going on with him. 200 00:08:32,250 --> 00:08:35,152 - He's gonna be in surgery for a while longer. 201 00:08:35,153 --> 00:08:36,553 We're waiting on his latest lab results. 202 00:08:36,554 --> 00:08:38,155 Can you check on them? 203 00:08:38,156 --> 00:08:40,657 - Okay. 204 00:08:40,658 --> 00:08:42,960 (heartbeat monitor beeping) 205 00:08:42,961 --> 00:08:45,896 - Are you in? If you didn't get a flash, 206 00:08:45,897 --> 00:08:47,498 then you're not in the vein. - Sorry. 207 00:08:47,499 --> 00:08:49,900 I've only done IVs on chicken thighs. 208 00:08:49,901 --> 00:08:53,470 - Like, from the grocery store? 209 00:08:53,471 --> 00:08:55,105 (loud beeping) 210 00:08:55,106 --> 00:08:57,375 (Theo): What's wrong with her? - Her heart rate's rising. 211 00:08:57,475 --> 00:09:00,911 It's okay, Theo. They'll take care of it. 212 00:09:00,912 --> 00:09:02,212 - Liz. 213 00:09:02,213 --> 00:09:03,480 - Okay. 214 00:09:03,481 --> 00:09:05,416 - Harper has a grade 4 liver lac. 215 00:09:05,417 --> 00:09:07,551 Dr. Costa wanted to just monitor, 216 00:09:07,552 --> 00:09:08,920 but now BP's getting soft. 217 00:09:09,020 --> 00:09:10,788 She's hemodynamically unstable. 218 00:09:10,789 --> 00:09:12,690 - She needs to go to the OR. 219 00:09:12,691 --> 00:09:14,525 - Yeah. But DIC puts her at higher risk 220 00:09:14,526 --> 00:09:15,993 for bleeding out mid-surgery. 221 00:09:15,994 --> 00:09:17,961 - Okay, so go with her and manage it 222 00:09:17,962 --> 00:09:20,631 while they operate on her liver. It has to happen now. 223 00:09:20,632 --> 00:09:22,966 - Mm-hmm. Okay. (Julie): All right. 224 00:09:22,967 --> 00:09:24,435 (Sonya): Okay. Okay, I got this. 225 00:09:24,436 --> 00:09:26,170 (bed rails clicking) 226 00:09:26,171 --> 00:09:28,339 (tense music) 227 00:09:28,340 --> 00:09:29,840 - What's going on? 228 00:09:29,841 --> 00:09:31,375 - We have to operate on your sister. 229 00:09:31,376 --> 00:09:33,143 - What, her too? 230 00:09:33,144 --> 00:09:34,378 Will she be okay? 231 00:09:34,379 --> 00:09:36,648 (monitor alarm beeping) 232 00:09:39,651 --> 00:09:41,018 - Did I miss something? Is it my fault. 233 00:09:41,019 --> 00:09:43,054 - No, you did nothing wrong. 234 00:09:44,489 --> 00:09:46,590 - This can't be happening! 235 00:09:46,591 --> 00:09:49,059 - Can you start it? 236 00:09:49,060 --> 00:09:50,762 Hey, Theo. 237 00:09:52,397 --> 00:09:54,031 I know this is scary. 238 00:09:54,032 --> 00:09:57,869 - You have to save my family. Please. 239 00:10:02,073 --> 00:10:05,776 - So early wound management and antibiotics are everything. 240 00:10:05,777 --> 00:10:10,280 Any wound that doesn't heal in a diabetic patient 241 00:10:10,281 --> 00:10:14,118 is osteomyelitis until proven otherwise. 242 00:10:14,119 --> 00:10:17,187 Try to remember, when we come across these patients, 243 00:10:17,188 --> 00:10:20,758 we're not just treating an infection, 244 00:10:20,759 --> 00:10:23,761 we're saving a limb. 245 00:10:23,762 --> 00:10:25,929 Thank you. (applause) 246 00:10:25,930 --> 00:10:30,969 Uh, I think it's time for Q and A. Any questions? 247 00:10:32,904 --> 00:10:34,371 Yes? 248 00:10:34,372 --> 00:10:37,107 - Yeah, with all due respect, 249 00:10:37,108 --> 00:10:40,077 I'd argue surgical intervention is more effective 250 00:10:40,078 --> 00:10:42,946 than non-operative wound management of diabetic ulcers. 251 00:10:42,947 --> 00:10:46,116 - The well-worn dichotomy, surgery versus medicine. 252 00:10:46,117 --> 00:10:48,152 - It's not about cutting for the sake of cutting. 253 00:10:48,153 --> 00:10:49,820 - Never is. - Studies have shown 254 00:10:49,821 --> 00:10:52,289 that patients who undergo early surgical debridement 255 00:10:52,290 --> 00:10:55,492 have a much higher rate of remission, so... 256 00:10:55,493 --> 00:10:58,762 - It was one study. I saw it. 257 00:10:58,763 --> 00:11:01,231 And the rate of remission by patient 258 00:11:01,232 --> 00:11:03,434 was anywhere from 28 to 81 percent, 259 00:11:03,435 --> 00:11:06,570 that's hardly consistent enough to call evidence. 260 00:11:06,571 --> 00:11:09,673 I guess Harvard didn't teach you to read the footnotes, 261 00:11:09,674 --> 00:11:12,043 Dr. Grant? 262 00:11:13,978 --> 00:11:15,479 - I have never seen anything like this. 263 00:11:15,480 --> 00:11:19,083 - Neither have I. And I've got over 25 years on you. 264 00:11:19,084 --> 00:11:21,085 - And between the blood and the antlers, 265 00:11:21,086 --> 00:11:23,787 I could barely make out much of the hilum or lungs. 266 00:11:23,788 --> 00:11:25,689 - We'll have to go in blind. - It doesn't help 267 00:11:25,690 --> 00:11:27,658 that no one stopped for the kid. Cost us hours. 268 00:11:27,659 --> 00:11:28,893 - No one stopped? 269 00:11:30,662 --> 00:11:32,963 Dr. Fox. Ready to assist? - Born ready. 270 00:11:32,964 --> 00:11:35,899 - Good. We'll start by tying off any arterial injuries 271 00:11:35,900 --> 00:11:37,301 that could be the source of the bleeding. 272 00:11:37,302 --> 00:11:39,069 - What about removing the antlers? 273 00:11:39,070 --> 00:11:40,070 - That's where Dr. Coleman comes in. 274 00:11:40,071 --> 00:11:41,972 If I'm right, they're acting like a fish hook. 275 00:11:41,973 --> 00:11:43,841 Wrapping around the pulmonary artery, 276 00:11:43,842 --> 00:11:46,144 vein bronchi, which means... 277 00:11:46,244 --> 00:11:48,245 - If we just pull them out, could rip out the entire 278 00:11:48,246 --> 00:11:51,281 vascular pedicle to his lung, make it impossible to repair. 279 00:11:51,282 --> 00:11:53,985 - Exactly. So, no removal without more data. 280 00:11:54,085 --> 00:11:55,719 I need you to track down any case reports 281 00:11:55,720 --> 00:11:57,221 of similar penetrating injures. 282 00:11:57,222 --> 00:11:59,556 Every operative solution you can find. 283 00:11:59,557 --> 00:12:01,859 Go. Fast. 284 00:12:01,860 --> 00:12:03,828 Scrub in. - Yeah. 285 00:12:03,928 --> 00:12:06,363 (tense music) 286 00:12:06,364 --> 00:12:08,565 - He has severe acidosis. 287 00:12:08,566 --> 00:12:10,267 - Well, given his massive pulmonary contusions, 288 00:12:10,268 --> 00:12:12,169 makes sense his blood gas is abnormal. 289 00:12:12,170 --> 00:12:14,471 - It's a mixed acidosis. The lung trauma alone 290 00:12:14,472 --> 00:12:15,573 wouldn't explain it. 291 00:12:15,674 --> 00:12:16,874 There's gotta be something else going on. 292 00:12:16,875 --> 00:12:18,876 - Guess you gotta figure it out then. 293 00:12:18,877 --> 00:12:20,678 - Excuse me? - Medicine's your area. 294 00:12:20,679 --> 00:12:25,449 Mine is to operate like hell before he bleeds out. Excuse me. 295 00:12:25,450 --> 00:12:26,984 (ringing) 296 00:12:26,985 --> 00:12:29,319 Who said I'm back out there? 297 00:12:29,320 --> 00:12:31,122 (equipment beeping) 298 00:12:31,222 --> 00:12:33,157 - Serena, repeat the trauma panel 299 00:12:33,158 --> 00:12:35,559 and get a rhotem to the lab, stat. 300 00:12:35,560 --> 00:12:37,162 We need to look for everything. 301 00:12:39,330 --> 00:12:41,865 - We're observing Mrs. Evans' hematoma for now. 302 00:12:41,866 --> 00:12:43,734 Kidneys are responding to IV hydration, 303 00:12:43,735 --> 00:12:47,037 but I think I saw PVCs on the monitor. 304 00:12:47,038 --> 00:12:49,506 So, I want a second opinion. 305 00:12:49,507 --> 00:12:53,477 - Dr. Heller. What is a PVC? 306 00:12:53,478 --> 00:12:54,645 - Are you kidding me? 307 00:12:54,646 --> 00:12:55,813 - You're a beginner in cardiology, 308 00:12:55,814 --> 00:12:57,115 so we start at the beginning. 309 00:12:58,483 --> 00:13:02,152 - It is a premature beat arising from the ventricle. 310 00:13:02,153 --> 00:13:04,288 - And how frequently does this occur? 311 00:13:04,289 --> 00:13:07,091 - Can we socratically skip to the solution, please? 312 00:13:07,092 --> 00:13:08,359 - Mmm. 313 00:13:08,360 --> 00:13:10,794 - We should check for any electrolyte abnormalities. 314 00:13:10,795 --> 00:13:12,663 Get a 12-lead EKG and an echo. 315 00:13:12,664 --> 00:13:15,199 - Correct, young Skywalker. - Okay, you don't cut that out, 316 00:13:15,200 --> 00:13:16,767 I'm gonna break out my lightsaber, 317 00:13:16,768 --> 00:13:18,202 send you on a visit to Obi-Wan. 318 00:13:18,203 --> 00:13:21,672 - Okay, got it, yeah, sorry sir. (clears throat) 319 00:13:21,673 --> 00:13:23,240 (equipment beeping) (exhales) 320 00:13:23,241 --> 00:13:26,310 - Jamie, sponge. There's a significant 321 00:13:26,311 --> 00:13:28,178 amount of bleeding from the liver. 322 00:13:28,179 --> 00:13:30,714 We're gonna need to administer cryo, fibrinogen, 323 00:13:30,715 --> 00:13:32,816 and TXA to get this under control. 324 00:13:32,817 --> 00:13:34,551 - Then you operate on the fracture? 325 00:13:34,552 --> 00:13:36,955 - No. She can't handle that. 326 00:13:38,123 --> 00:13:41,258 - He didn't stabilize the pelvic fracture surgically? 327 00:13:41,259 --> 00:13:42,893 - Just put a binder on. Said she's too 328 00:13:42,894 --> 00:13:44,962 critically ill already. 329 00:13:44,963 --> 00:13:46,397 Too conservative, right? 330 00:13:46,398 --> 00:13:47,965 - Even with borderline displacement, 331 00:13:47,966 --> 00:13:49,133 he should've operated. - Mmm. 332 00:13:49,134 --> 00:13:51,902 - I'd keep an eye on her hematocrit. 333 00:13:51,903 --> 00:13:53,170 - Any luck on your end? 334 00:13:53,171 --> 00:13:54,938 - Turns out antlers through the chest 335 00:13:54,939 --> 00:13:57,007 is a one-in-a-million kind of situation 336 00:13:57,008 --> 00:13:58,709 and I am on the clock here. 337 00:13:58,710 --> 00:14:02,813 - What is it... improvise, adapt...? 338 00:14:02,814 --> 00:14:05,849 - Overcome? That's the marines. 339 00:14:05,850 --> 00:14:07,718 - Whatever, ranger. 340 00:14:07,719 --> 00:14:09,053 Think outside the box. 341 00:14:09,054 --> 00:14:12,423 Ben trusts you. Maybe trust yourself. 342 00:14:12,424 --> 00:14:13,490 (equipment beeping) 343 00:14:13,491 --> 00:14:15,292 (Fox): I'm seeing some ventricular strain. 344 00:14:15,293 --> 00:14:19,797 (Ben): We're in here now. No turning back. 345 00:14:19,798 --> 00:14:23,567 (Amy): Keep scrolling, Carin. Show me the enzymes and lactate. 346 00:14:23,568 --> 00:14:27,871 - What are you looking for? - I'll know when I see it. 347 00:14:27,872 --> 00:14:31,508 - Okay, this is unusual. 348 00:14:31,509 --> 00:14:32,943 - Oh, God. 349 00:14:32,944 --> 00:14:35,546 (tense music) 350 00:14:35,547 --> 00:14:37,915 - Dr. Grant, Dr. Larsen's on the phone for you. 351 00:14:37,916 --> 00:14:39,983 - Now? - She says it's urgent. 352 00:14:39,984 --> 00:14:41,919 - Put her on speaker. 353 00:14:41,920 --> 00:14:43,654 What is it? (Amy): His results came back. 354 00:14:43,655 --> 00:14:46,223 Troponins BNP and lactate are off the charts. 355 00:14:46,224 --> 00:14:49,193 You need to stop the surgery. 356 00:14:49,194 --> 00:14:51,462 - Wha... Where am I? 357 00:14:51,463 --> 00:14:53,263 - It's okay. It's okay. 358 00:14:53,264 --> 00:14:57,634 You're at Westside Hospital in Minneapolis. 359 00:14:57,635 --> 00:14:59,036 (groans) 360 00:14:59,037 --> 00:15:02,172 - My head is killing me. What happened? 361 00:15:02,173 --> 00:15:05,977 - You were in an accident. Your car hit a deer. 362 00:15:07,278 --> 00:15:10,314 Careful. Careful. - Am I okay? 363 00:15:10,315 --> 00:15:11,982 - This'll sound worse than it is, 364 00:15:11,983 --> 00:15:14,418 but you have a bleed around your brain. Now-- 365 00:15:14,419 --> 00:15:15,986 (door opens) 366 00:15:15,987 --> 00:15:18,155 - Mom, you're okay! 367 00:15:18,156 --> 00:15:20,724 - Ah, I'm sorry. I don't know who you are. 368 00:15:20,725 --> 00:15:22,459 (dramatic music) 369 00:15:22,460 --> 00:15:25,396 - I'm your son. 370 00:15:25,397 --> 00:15:27,364 Theo. 371 00:15:27,365 --> 00:15:29,700 - What is he talking about? 372 00:15:29,701 --> 00:15:31,236 I-I don't have a son. 373 00:15:36,741 --> 00:15:39,310 - So, did I use up all my questions? 374 00:15:41,212 --> 00:15:43,682 - Depends. Can you handle more of my answers? 375 00:15:43,782 --> 00:15:46,384 - Oh, I think so. - Okay, then. 376 00:15:46,484 --> 00:15:49,520 - You do background on everyone at the conference? 377 00:15:49,521 --> 00:15:50,821 Or just me? 378 00:15:50,822 --> 00:15:55,125 - Did you really come up here to ask me that or eat crow? 379 00:15:55,126 --> 00:15:56,794 (chuckling) 380 00:15:56,795 --> 00:16:00,130 - Both. (chuckling) 381 00:16:00,131 --> 00:16:03,034 But I prefer to atone over a drink. 382 00:16:04,703 --> 00:16:05,936 (equipment beeping) 383 00:16:05,937 --> 00:16:07,938 - What are you doing? 384 00:16:07,939 --> 00:16:09,940 I told you to stop. - I heard you. 385 00:16:09,941 --> 00:16:11,375 - The transfusions we've given him 386 00:16:11,376 --> 00:16:13,777 have caused fluid overload. He's in heart failure. 387 00:16:13,778 --> 00:16:15,579 - I've controlled all the bleeders I can visualize, 388 00:16:15,580 --> 00:16:17,681 but there could be more hiding behind the antlers. 389 00:16:17,682 --> 00:16:20,117 I'm pretty sure if I stop, he'll bleed out. 390 00:16:20,118 --> 00:16:22,152 - If you don't stop, he's gonna die on your table. 391 00:16:22,153 --> 00:16:24,555 I have to fix the heart failure first. 392 00:16:24,556 --> 00:16:28,058 - And how you gonna do that? - Goal-directed diuresis. 393 00:16:28,059 --> 00:16:29,526 - He can't handle single-lung ventilation. 394 00:16:29,527 --> 00:16:31,929 Had to put him on VV ECMO. - I'm aware. 395 00:16:31,930 --> 00:16:35,065 - All right. I'll get him ready for you, but if he's not back 396 00:16:35,066 --> 00:16:36,533 in my OR in four hours, 397 00:16:36,534 --> 00:16:40,739 the circuit will clot, and he'll die in your ICU. 398 00:16:42,741 --> 00:16:46,443 (tense music) 399 00:16:46,444 --> 00:16:48,779 - Can you do that? In four hours? 400 00:16:48,780 --> 00:16:50,382 - We have no choice. 401 00:16:55,053 --> 00:16:56,653 (phone ringing) 402 00:16:56,654 --> 00:16:58,222 (nurse): ICU? 403 00:16:58,223 --> 00:16:59,823 (Ruth): Your sister should be waking up soon. 404 00:16:59,824 --> 00:17:03,594 Dr. Costa was able to get her bleeding under control. 405 00:17:03,595 --> 00:17:05,729 - She looks so small. 406 00:17:05,730 --> 00:17:07,564 - She's... She's strong. 407 00:17:07,565 --> 00:17:10,402 And stable for now. That's... That's good. 408 00:17:10,502 --> 00:17:12,703 - Why doesn't my mom know me? 409 00:17:12,704 --> 00:17:14,204 - It's not just you. 410 00:17:14,205 --> 00:17:16,608 She doesn't remember anyone right-- 411 00:17:18,777 --> 00:17:20,477 Um... 412 00:17:20,478 --> 00:17:23,580 We're not sure yet. Not yet. 413 00:17:23,581 --> 00:17:25,716 She's getting... She's getting a repeat CT. 414 00:17:25,717 --> 00:17:29,753 It's a scan of her brain so they can figure it out. 415 00:17:29,754 --> 00:17:33,391 - What about my dad? Is he gonna be okay? 416 00:17:35,593 --> 00:17:37,361 - Um... 417 00:17:37,362 --> 00:17:40,798 we-- we're doing what... 418 00:17:40,799 --> 00:17:42,299 What... 419 00:17:42,300 --> 00:17:46,937 We're doing everything we can. For him. 420 00:17:46,938 --> 00:17:48,672 Okay? 421 00:17:48,673 --> 00:17:51,176 (soft music) 422 00:17:54,846 --> 00:17:56,080 Sorry. 423 00:17:56,081 --> 00:17:58,882 - Stay here and monitor Harper's serial crits 424 00:17:58,883 --> 00:18:02,587 and drain output. Any changes, let me know right away. 425 00:18:04,556 --> 00:18:06,358 (breathes deeply) 426 00:18:09,828 --> 00:18:12,830 - Come on, Harp. Wake up. 427 00:18:12,831 --> 00:18:14,631 Can she hear me? - Probably. 428 00:18:14,632 --> 00:18:17,434 The anesthesia just takes some time to wear off. 429 00:18:17,435 --> 00:18:19,103 - If you wake up now, I'll show you 430 00:18:19,104 --> 00:18:21,438 how to code in python. 431 00:18:21,439 --> 00:18:23,540 She's been bugging me to teach her. 432 00:18:23,541 --> 00:18:26,745 (tense music) 433 00:18:26,845 --> 00:18:28,779 - Theo, she needs to rest. 434 00:18:28,780 --> 00:18:31,048 I'm gonna take you to the waiting room, okay? 435 00:18:31,049 --> 00:18:32,349 - Why? What-What's going on? 436 00:18:32,350 --> 00:18:34,084 - I just, I need you to come with me. 437 00:18:34,085 --> 00:18:36,720 - I-Is this about my mom? - No. 438 00:18:36,721 --> 00:18:38,655 - Well, they took her away and they won't tell me 439 00:18:38,656 --> 00:18:40,891 why she doesn't remember! - Remember what? 440 00:18:40,892 --> 00:18:43,428 - Me! She doesn't know who I am. 441 00:18:44,662 --> 00:18:47,031 - Um, I'm sorry, I've been treating your father. 442 00:18:47,032 --> 00:18:48,432 But I'll get you an update. 443 00:18:48,433 --> 00:18:50,734 I need you to go to the waiting room. Okay? 444 00:18:50,735 --> 00:18:52,803 Someone will be by soon. 445 00:18:52,804 --> 00:18:54,638 - Why did he have to go? Did something happen? 446 00:18:54,639 --> 00:18:56,607 - We're bringing his father up here now. 447 00:18:56,608 --> 00:18:58,742 (ominous music) 448 00:18:58,743 --> 00:19:00,244 (gasping) - Oh. 449 00:19:00,245 --> 00:19:03,514 Oh, my God. The antler's still in him. 450 00:19:03,515 --> 00:19:05,949 (Amy): We more access. Get a second line going. 451 00:19:05,950 --> 00:19:08,886 He needs Furosemide, Cefepime, and Vancomycin. 452 00:19:08,887 --> 00:19:12,089 - I can get it. - Julie's got it. Stay back. 453 00:19:12,090 --> 00:19:13,390 - You paged Cardiology? 454 00:19:13,391 --> 00:19:14,758 - Yeah, I need a transesophageal echo 455 00:19:14,759 --> 00:19:17,127 to monitor his cardiac function. - Yeah, no problem. 456 00:19:17,128 --> 00:19:18,896 - I just need to get some more dressings. 457 00:19:18,897 --> 00:19:20,330 - Yeah. 458 00:19:20,331 --> 00:19:23,167 - Mrs. Evans doesn't remember what happened. 459 00:19:23,168 --> 00:19:26,136 Or recognize Theo or anyone in her family. 460 00:19:26,137 --> 00:19:27,671 - Brain bleed must be getting worse. 461 00:19:27,672 --> 00:19:31,508 - So we were wrong about it being stable enough to monitor? 462 00:19:31,509 --> 00:19:33,344 - No, you weren't wrong. 463 00:19:33,345 --> 00:19:35,045 - Her hematoma's getting smaller. 464 00:19:35,046 --> 00:19:37,314 - Oh, so what's causing her symptoms? 465 00:19:37,315 --> 00:19:39,183 (knocking) (door opens) 466 00:19:39,184 --> 00:19:40,317 - I'm sorry to interrupt. 467 00:19:40,318 --> 00:19:42,786 Dr. Hamda, can I have a word, please? 468 00:19:42,787 --> 00:19:44,488 - EEG? MRI? 469 00:19:44,489 --> 00:19:46,123 - Yeah, and I'll want to do 470 00:19:46,124 --> 00:19:47,959 some more advanced cognitive testing. 471 00:19:49,728 --> 00:19:52,062 - What can I do for you? - Yeah, I just want to make sure 472 00:19:52,063 --> 00:19:54,666 you've been apprised of the situation with my patient. 473 00:19:54,766 --> 00:19:56,166 - Your patient? 474 00:19:56,167 --> 00:19:57,601 - The guy with the antler in his chest. 475 00:19:57,602 --> 00:19:59,603 - Anthony Evans. What about him? 476 00:19:59,604 --> 00:20:02,039 - Dr. Larsen insisted that I stop mid-surgery 477 00:20:02,040 --> 00:20:05,476 so she can find a medical solution to his heart failure. 478 00:20:05,477 --> 00:20:07,344 - And? - And he was already at risk 479 00:20:07,345 --> 00:20:08,679 of dying from impalement. 480 00:20:08,680 --> 00:20:10,514 The longer we delay, she compounds that risk 481 00:20:10,515 --> 00:20:12,716 with the likelihood of ECMO failure and infection. 482 00:20:12,717 --> 00:20:14,718 - Are you implying she's not up to the task? 483 00:20:14,719 --> 00:20:16,520 - Listen, I just checked on the Evans's status, 484 00:20:16,521 --> 00:20:18,255 and they are no closer to an answer. 485 00:20:18,256 --> 00:20:20,692 So maybe you wanna give her a hand. 486 00:20:24,496 --> 00:20:25,462 (equipment beeping) - How is he? 487 00:20:25,463 --> 00:20:27,231 - Still alive for the moment. 488 00:20:27,232 --> 00:20:28,832 Julie, get me updated Is and Os, 489 00:20:28,833 --> 00:20:31,903 and his latest ABG and trops. - On it. 490 00:20:33,271 --> 00:20:36,206 - I heard about Mrs. Evans. 491 00:20:36,207 --> 00:20:37,408 Poor Theo's a mess. 492 00:20:37,409 --> 00:20:38,542 - He's actually handling it 493 00:20:38,543 --> 00:20:39,777 pretty well, considering. 494 00:20:39,778 --> 00:20:43,013 - Right. I guess you're an expert. 495 00:20:43,014 --> 00:20:46,517 When I woke up from my accident, I wasn't much fun either. 496 00:20:46,518 --> 00:20:48,752 - Well, at least you remembered me. 497 00:20:48,753 --> 00:20:51,155 What's your plan here? - It's a tightrope. 498 00:20:51,156 --> 00:20:53,323 We gave him diuretics to get rid of the excess fluid 499 00:20:53,324 --> 00:20:55,426 and then the ECMO started chugging. 500 00:20:55,427 --> 00:20:57,428 - Not enough blood flow to the pump. You drop the RPM? 501 00:20:57,429 --> 00:20:59,563 - Yeah, I did, but if that doesn't work, 502 00:20:59,564 --> 00:21:01,198 we're gonna have to give him more fluids 503 00:21:01,199 --> 00:21:02,299 and then we're back at square one. 504 00:21:02,300 --> 00:21:04,201 And his clotting's gotten worse. 505 00:21:04,202 --> 00:21:06,203 - Just as Dr. Grant predicted. 506 00:21:06,204 --> 00:21:08,138 - You talked to him? - I did. 507 00:21:08,139 --> 00:21:10,140 He's wary about what you're attempting. 508 00:21:10,141 --> 00:21:11,208 - Well, that tracks. 509 00:21:11,209 --> 00:21:13,310 - Is there something I should know about you two? 510 00:21:13,311 --> 00:21:14,378 (ringing) 511 00:21:14,379 --> 00:21:16,648 - What did you sign up for? 512 00:21:18,516 --> 00:21:20,351 - Did you just have another memory? 513 00:21:20,352 --> 00:21:22,586 - I'm managing. I'm fine. 514 00:21:22,587 --> 00:21:26,524 We need to regain control of his fluid status. 515 00:21:32,564 --> 00:21:35,799 - Don't take it personally. 516 00:21:35,800 --> 00:21:37,101 - Thought I was doing pretty well, 517 00:21:37,102 --> 00:21:38,802 but suddenly, she's acting like I'm in the way. 518 00:21:38,803 --> 00:21:41,638 - Yeah, it gets hard to predict which version you're gonna get. 519 00:21:41,639 --> 00:21:43,440 And today especially. 520 00:21:43,441 --> 00:21:45,743 Not sure what you know about her, but... 521 00:21:45,744 --> 00:21:49,480 - Oh, we all know. Everything. 522 00:21:49,481 --> 00:21:52,549 - 'Kay, well then, this should make sense. 523 00:21:52,550 --> 00:21:55,587 Car accident? Woman losing her memory? 524 00:21:55,687 --> 00:21:57,421 Family hanging in the balance? 525 00:21:57,422 --> 00:21:59,491 - Right. - But you can't control any 526 00:21:59,591 --> 00:22:01,859 of that. All you can do is just manage you. 527 00:22:01,860 --> 00:22:03,994 And try not to wake the beast. (chuckling) 528 00:22:03,995 --> 00:22:06,063 - Thanks for the consult. 529 00:22:06,064 --> 00:22:07,297 - Yeah. 530 00:22:07,298 --> 00:22:09,767 (hospital din) - Jen Evans, coming in. 531 00:22:09,768 --> 00:22:13,103 - Her face is drooping. Speech is slurred. 532 00:22:13,104 --> 00:22:14,505 She's getting worse. 533 00:22:14,506 --> 00:22:16,840 - No signs on the imaging, but it looks like a stroke. 534 00:22:16,841 --> 00:22:18,909 I started a low-dose heparin drip. 535 00:22:18,910 --> 00:22:21,645 Hopefully it reverses the effects and the memory loss. 536 00:22:21,646 --> 00:22:23,847 - Theo really wants an update. - Yeah. 537 00:22:23,848 --> 00:22:25,483 - Okay. 538 00:22:27,185 --> 00:22:30,488 Just, um... text me the number. 539 00:22:31,856 --> 00:22:33,491 Thanks. 540 00:22:37,696 --> 00:22:40,664 That was Albert. My dad's friend. 541 00:22:40,665 --> 00:22:42,533 - I'm glad you have someone to talk to. 542 00:22:42,534 --> 00:22:44,001 - He's trying to find me a lawyer. 543 00:22:44,002 --> 00:22:45,969 - Why would you need a-- - You think I don't know 544 00:22:45,970 --> 00:22:48,272 what's going on? The way you're all acting? 545 00:22:48,273 --> 00:22:50,641 My dad's not gonna make it. 546 00:22:50,642 --> 00:22:54,545 And my mom... she doesn't even know who we are. 547 00:22:54,546 --> 00:22:56,246 Look, we don't have anyone else. 548 00:22:56,247 --> 00:22:58,482 They'll put us in foster care. They'll separate us! 549 00:22:58,483 --> 00:23:00,284 - Theo, you're getting ahead of yourself. 550 00:23:00,285 --> 00:23:01,485 - Look, don't lie to me. 551 00:23:01,486 --> 00:23:03,120 You already sent your social worker 552 00:23:03,121 --> 00:23:04,722 to come talk to me. 553 00:23:04,723 --> 00:23:06,657 - I'm sorry. They shouldn't have done that. 554 00:23:06,658 --> 00:23:08,192 - I don't get it! 555 00:23:08,193 --> 00:23:11,195 I'm old enough to drive. Old enough to kill my parents. 556 00:23:11,196 --> 00:23:14,432 But I'm not old enough to take care of my sister? 557 00:23:15,834 --> 00:23:18,469 (sobbing) 558 00:23:18,470 --> 00:23:19,837 I-I'm sorry, I just... 559 00:23:19,838 --> 00:23:22,607 (sniffling) - Hey. It's okay. 560 00:23:24,175 --> 00:23:25,676 - She didn't want me to drive, 561 00:23:25,677 --> 00:23:29,547 but I really thought I was ready. 562 00:23:31,282 --> 00:23:34,118 (equipment beeping) - Uh, Dr. Maitra? 563 00:23:34,119 --> 00:23:35,085 - What's going on? 564 00:23:35,086 --> 00:23:36,720 - I know you said to watch her hematocrit, 565 00:23:36,721 --> 00:23:39,423 but Harper's getting tachypneic. 566 00:23:39,424 --> 00:23:40,891 I figured I should tell you. 567 00:23:40,892 --> 00:23:43,028 (tense music) 568 00:23:47,365 --> 00:23:49,800 - You paged me? - Respiratory distress. 569 00:23:49,801 --> 00:23:51,735 I think it's a fat embolism from the pelvic fracture. 570 00:23:51,736 --> 00:23:54,872 Need an echo to confirm. - Okay, I got it. 571 00:23:54,873 --> 00:23:56,874 - Decreasing RPM and giving volume isn't working. 572 00:23:56,875 --> 00:23:59,476 BP's still too low. - I know that, Michael. 573 00:23:59,477 --> 00:24:00,878 - Well, d'you think there's bleeding? 574 00:24:00,879 --> 00:24:03,748 - Sorry, I know you're busy. - Not now, Kyle. 575 00:24:03,848 --> 00:24:04,882 (ringing) 576 00:24:04,883 --> 00:24:06,750 Do you have any idea what you're doing? 577 00:24:06,751 --> 00:24:09,454 (equipment beeping) - But we got the labs back. 578 00:24:09,554 --> 00:24:11,655 His hemoglobin's 19. That's high, right? 579 00:24:11,656 --> 00:24:13,490 - Very high. - So he's not bleeding. 580 00:24:13,491 --> 00:24:14,825 Doesn't make sense. 581 00:24:14,826 --> 00:24:16,160 (exhales) 582 00:24:16,161 --> 00:24:19,163 - Stay, Kyle. 583 00:24:19,164 --> 00:24:20,964 It's capillary leak syndrome. 584 00:24:20,965 --> 00:24:23,467 The hemoglobin's falsely elevated 585 00:24:23,468 --> 00:24:25,102 because his blood vessels are leaking fluid 586 00:24:25,103 --> 00:24:27,871 into his tissues. It can happen after a trauma. 587 00:24:27,872 --> 00:24:30,274 - Explains the heart failure and why nothing we've been doing 588 00:24:30,275 --> 00:24:31,575 has worked to raise his BP. 589 00:24:31,576 --> 00:24:33,644 - What about Hepastarch to pull the fluid back 590 00:24:33,645 --> 00:24:35,446 into his blood vessels? - His kidneys still won't 591 00:24:35,447 --> 00:24:37,348 get rid of the excess fluid in time. 592 00:24:37,349 --> 00:24:39,783 - What if we dialyze him via his ECMO 593 00:24:39,784 --> 00:24:42,219 to fix the fluid overload in the OR? 594 00:24:42,220 --> 00:24:43,153 - What does that mean? 595 00:24:43,154 --> 00:24:46,190 - His ECMO is letting us bypass his lungs. 596 00:24:46,191 --> 00:24:48,258 If we hooked up a dialysis machine to it, 597 00:24:48,259 --> 00:24:49,494 we could bypass his kidneys, 598 00:24:49,594 --> 00:24:50,861 taking the fluid off faster, 599 00:24:50,862 --> 00:24:52,863 but still keeping it controlled. 600 00:24:52,864 --> 00:24:57,668 - Which would allow Dr. Grant to proceed with the surgery. 601 00:24:57,669 --> 00:24:59,603 (hospital din) - No journal articles, not one? 602 00:24:59,604 --> 00:25:00,938 - All traditional lit was a bust. 603 00:25:00,939 --> 00:25:02,539 - There's gotta be something out there. 604 00:25:02,540 --> 00:25:04,041 - Good for you if you can find it. 605 00:25:04,042 --> 00:25:05,876 The fact that I couldn't, got me thinking. 606 00:25:05,877 --> 00:25:07,378 Docs who have dealt with this 607 00:25:07,379 --> 00:25:08,746 aren't the ones who write papers. 608 00:25:08,747 --> 00:25:11,515 They're the ones with real-life, hands-on experience. 609 00:25:11,516 --> 00:25:13,751 So, I called around to rural hospitals. 610 00:25:13,752 --> 00:25:15,753 Found a similar case in Grand Marais. 611 00:25:15,754 --> 00:25:17,054 Another one in Drummond. 612 00:25:17,055 --> 00:25:18,822 Based on what those surgeons said, 613 00:25:18,823 --> 00:25:20,557 I worked out a strategy for us. 614 00:25:20,558 --> 00:25:22,693 - Keep talking. 615 00:25:22,694 --> 00:25:25,295 - We need to treat it like a tumor, not a trauma. 616 00:25:25,296 --> 00:25:27,698 Instead of trying to save the damaged blood vessels 617 00:25:27,699 --> 00:25:30,300 by taking out the antler piece by piece, 618 00:25:30,301 --> 00:25:32,669 we should remove the whole section of the antler, 619 00:25:32,670 --> 00:25:34,905 and the penetrated vessels, and the airway. 620 00:25:34,906 --> 00:25:36,540 - And then what? Watch him die? 621 00:25:36,541 --> 00:25:38,909 - Then we take what's left over from the artery and bronchus, 622 00:25:38,910 --> 00:25:40,411 put those two ends back together. 623 00:25:40,412 --> 00:25:41,712 - He'll bleed like a stuck pig. 624 00:25:41,713 --> 00:25:43,714 - Means we gotta move fast. 625 00:25:43,715 --> 00:25:44,782 - I like it. 626 00:25:44,783 --> 00:25:46,684 But it's all moot if Dr. Larsen can't stabilize 627 00:25:46,685 --> 00:25:49,720 the patient for surgery. She's got an hour. Tops. 628 00:25:49,721 --> 00:25:51,555 - I already checked in. Not ready yet. 629 00:25:51,556 --> 00:25:53,090 - Argh. (gurney wheels clattering) 630 00:25:53,091 --> 00:25:54,692 - We've got Harper, pelvic binder wasn't enough. 631 00:25:54,693 --> 00:25:56,093 She needs ORIF. 632 00:25:56,094 --> 00:25:57,995 - Echo confirmed the fracture's causing fat emboli. 633 00:25:57,996 --> 00:26:00,531 - Should I page Dr. Costa? - No, I got this. 634 00:26:00,532 --> 00:26:01,899 Let's go, Dr. Fox. 635 00:26:01,900 --> 00:26:04,101 Tell Dr. Larsen I'll be ready in 30, 636 00:26:04,102 --> 00:26:07,272 so she won't be waiting on me. Prep OR 2 right now. 637 00:26:12,544 --> 00:26:14,244 - So, how long have you been separated? 638 00:26:14,245 --> 00:26:20,117 - Mm. Three months. We were together 26 years. 639 00:26:20,118 --> 00:26:22,686 - Can't be easy getting back out there. 640 00:26:22,687 --> 00:26:24,855 - Who said I'm back out there? (chuckling) 641 00:26:24,856 --> 00:26:26,857 - Yeah, I'm sure it's going well for you. 642 00:26:26,858 --> 00:26:28,826 - Ask me again in an hour. 643 00:26:28,827 --> 00:26:30,327 (soft music playing) 644 00:26:30,328 --> 00:26:33,297 - Really? Does that work on the other women? 645 00:26:33,298 --> 00:26:35,132 - There are no other women. (chuckling) 646 00:26:35,133 --> 00:26:38,369 Um, as far as my ex knows, at least. 647 00:26:38,370 --> 00:26:39,703 (chuckling) 648 00:26:39,704 --> 00:26:42,406 No, yeah, our divorce isn't exactly amicable. 649 00:26:42,407 --> 00:26:43,974 - So you did something wrong? 650 00:26:43,975 --> 00:26:45,642 - I did lots of things wrong. 651 00:26:45,643 --> 00:26:49,646 But if you're asking was I unfaithful? 652 00:26:49,647 --> 00:26:52,116 No. We just disconnected. 653 00:26:52,117 --> 00:26:53,884 Kept it together for the kids, but once they were 654 00:26:53,885 --> 00:26:56,720 out of the house... you know. 655 00:26:56,721 --> 00:27:01,558 Well... okay. Your turn. 656 00:27:01,559 --> 00:27:03,361 - No. 657 00:27:03,461 --> 00:27:06,630 No, I didn't sign up for that. 658 00:27:06,631 --> 00:27:09,401 - What did you sign up for? 659 00:27:11,036 --> 00:27:12,503 (equipment beeping) (Ben): Fluoro shows excellent 660 00:27:12,504 --> 00:27:14,638 alignment and stabilization of Harper's pelvic ring. 661 00:27:14,639 --> 00:27:17,341 - She gonna be okay? - She will now. 662 00:27:17,342 --> 00:27:20,210 - So, you would've operated on the pelvis this morning. 663 00:27:20,211 --> 00:27:22,112 - After the liver? Yeah. 664 00:27:22,113 --> 00:27:25,683 (over speaker): You were wrong. I am waiting for you. 665 00:27:25,684 --> 00:27:27,886 Mr. Evans is ready. 666 00:27:29,320 --> 00:27:30,654 - Dr. Fox, close up. 667 00:27:30,655 --> 00:27:33,257 Dr. Coleman, suit up and scrub in. 668 00:27:33,258 --> 00:27:35,426 - Really? - It's your plan. Let's go. 669 00:27:35,427 --> 00:27:36,927 - Pick-ups. 670 00:27:36,928 --> 00:27:39,196 (intriguing music) 671 00:27:39,197 --> 00:27:40,164 (tap running) 672 00:27:40,165 --> 00:27:41,432 - Dr. Larsen, 673 00:27:41,433 --> 00:27:42,833 I'll need you to keep him stable 674 00:27:42,834 --> 00:27:44,601 so I can finish the surgery this time. 675 00:27:44,602 --> 00:27:45,769 - Oh, I'll do my part. 676 00:27:45,770 --> 00:27:48,306 Curious how you plan to do yours. 677 00:27:48,406 --> 00:27:50,709 - Ask Dr. Coleman. 678 00:27:51,976 --> 00:27:53,711 - We'll follow sleeve resection guidelines 679 00:27:53,712 --> 00:27:56,347 for antler removal and anastomosis. 680 00:27:56,348 --> 00:27:58,649 Pull the whole thing out, then put the damaged vessels 681 00:27:58,650 --> 00:27:59,750 and the bronchi back together. 682 00:27:59,751 --> 00:28:01,720 (tense music) 683 00:28:03,755 --> 00:28:05,255 - What's happening? 684 00:28:05,256 --> 00:28:07,324 - She's responding well to the heparin, 685 00:28:07,325 --> 00:28:09,960 but now she's got 102-degree fever. 686 00:28:09,961 --> 00:28:12,096 - Well, maybe it wasn't the trauma. 687 00:28:12,097 --> 00:28:14,231 Could the stroke have been caused by an infection? 688 00:28:14,232 --> 00:28:16,467 - I started her on broad-spectrum antibiotics 689 00:28:16,468 --> 00:28:18,602 just in case. (alarm beeping) 690 00:28:18,603 --> 00:28:19,970 (exhales) Now she's tachycardic. 691 00:28:19,971 --> 00:28:21,271 - She needs more fluids. 692 00:28:21,272 --> 00:28:23,875 (intense music) 693 00:28:26,945 --> 00:28:28,112 - Why is she getting worse? 694 00:28:28,113 --> 00:28:30,981 - Theo, you can't be here right now. Liz! 695 00:28:30,982 --> 00:28:32,816 - Please, help my mom. 696 00:28:32,817 --> 00:28:34,852 - Yes. Yes, they will. Theo, they will. Okay? 697 00:28:34,853 --> 00:28:36,720 But we gotta go now. 698 00:28:36,721 --> 00:28:39,390 C'mon. 699 00:28:39,391 --> 00:28:42,726 - Got a lot of bleeding here. What's the fluid status? 700 00:28:42,727 --> 00:28:44,795 - Ultrafiltration is working. 701 00:28:44,796 --> 00:28:47,197 - Dr. Coleman, I need you to ligate that bleeder 702 00:28:47,198 --> 00:28:49,199 with an O silk. 703 00:28:49,200 --> 00:28:50,001 I'm right here. 704 00:28:50,135 --> 00:28:51,836 And you gotta learn sometime. Let's go. 705 00:28:58,376 --> 00:29:00,911 (tools clicking) 706 00:29:00,912 --> 00:29:03,380 (hospital din) 707 00:29:03,381 --> 00:29:06,317 (indistinct chatter) 708 00:29:07,852 --> 00:29:09,521 - You all right? 709 00:29:11,856 --> 00:29:13,290 - When I finished med school, 710 00:29:13,291 --> 00:29:15,592 they gave me a piece of paper that said, you know, 711 00:29:15,593 --> 00:29:16,994 I'm a doctor. 712 00:29:16,995 --> 00:29:18,462 But I don't feel like a doctor. 713 00:29:18,463 --> 00:29:22,733 I feel the exact same way I did a month ago. 714 00:29:22,734 --> 00:29:24,034 - You helped save his sister's life. 715 00:29:24,035 --> 00:29:25,302 - Yeah, but what about his mom? 716 00:29:25,303 --> 00:29:27,204 His dad? What're we gonna tell that poor kid? 717 00:29:27,205 --> 00:29:29,206 - It's not easy. But you're gonna need 718 00:29:29,207 --> 00:29:31,442 to learn to compartmentalize. 719 00:29:31,443 --> 00:29:34,346 Otherwise you're just gonna keep freezing like you did earlier. 720 00:29:37,148 --> 00:29:41,985 - I'm gonna get better at this. I promise. 721 00:29:41,986 --> 00:29:43,287 (Michael): CBC is normal. 722 00:29:43,288 --> 00:29:45,189 - RVP and blood cultures all negative. 723 00:29:45,190 --> 00:29:48,325 - Still, the fever's going up. It's at 104 now. 724 00:29:48,326 --> 00:29:50,394 - This has to be an infection. - Yeah, but from what? 725 00:29:50,395 --> 00:29:53,331 The antibiotics would've treated all the usual suspects. 726 00:29:54,966 --> 00:29:56,500 - The deer carcass. 727 00:29:56,501 --> 00:29:59,903 It was bleeding everywhere, she had open wounds. 728 00:29:59,904 --> 00:30:02,439 The fever, stroke, cognitive impairment. 729 00:30:02,440 --> 00:30:06,977 - It's Brucellosis. From the infected deer's blood. 730 00:30:06,978 --> 00:30:10,014 (Ben): This is the point of no return. 731 00:30:10,015 --> 00:30:12,082 All right, I got a proximal and distal control 732 00:30:12,083 --> 00:30:14,118 with the clamps. As soon as this comes out, 733 00:30:14,119 --> 00:30:16,153 every millisecond counts. 734 00:30:16,154 --> 00:30:18,322 I'll reattach artery and bronchi as fast as I can. 735 00:30:18,323 --> 00:30:20,024 The rest of you, do whatever you need to do 736 00:30:20,025 --> 00:30:21,825 to control the blood and keep him stable. 737 00:30:21,826 --> 00:30:23,560 Understood? Everybody copy? - Got it. 738 00:30:23,561 --> 00:30:24,862 - Yeah? 739 00:30:24,863 --> 00:30:27,432 All right. We got this. 740 00:30:29,634 --> 00:30:31,702 One... 741 00:30:31,703 --> 00:30:34,505 Two... 742 00:30:34,506 --> 00:30:35,739 Three. 743 00:30:35,740 --> 00:30:37,274 (splattering) Ah! 744 00:30:37,275 --> 00:30:40,577 (intense music) 745 00:30:40,578 --> 00:30:42,746 Serena, goggles. 746 00:30:42,747 --> 00:30:43,881 TJ, suction. 747 00:30:43,882 --> 00:30:46,984 (machine whirring) 748 00:30:46,985 --> 00:30:50,120 - Dr. Grant. Dr. Grant. 749 00:30:50,121 --> 00:30:54,058 Ben! There's air in the circuit. - Get it out. Now. 750 00:30:54,059 --> 00:30:57,061 - Turn the ventilator to 100 percent FiO2. 751 00:30:57,062 --> 00:31:01,066 Dr. Ferguson, get me a 60cc syringe. 752 00:31:06,571 --> 00:31:08,105 (monitor beeping rapidly) 753 00:31:08,106 --> 00:31:10,541 - His oxygen is tanking! - 'Cause he's not getting any. 754 00:31:10,542 --> 00:31:12,776 I just need a few more minutes to finish reconstructing 755 00:31:12,777 --> 00:31:15,347 the pulmonary artery anastomosis. 756 00:31:15,447 --> 00:31:17,648 (beeping continues) 757 00:31:17,649 --> 00:31:19,250 Can you get the air out? 758 00:31:22,620 --> 00:31:23,488 Amy? 759 00:31:25,857 --> 00:31:27,625 You got this? 760 00:31:31,796 --> 00:31:34,264 So... 761 00:31:34,265 --> 00:31:37,468 How do we rate? (elevator dings) 762 00:31:37,469 --> 00:31:38,335 - What do you mean? 763 00:31:38,336 --> 00:31:40,037 - My hospital hosted the conference. 764 00:31:40,038 --> 00:31:42,440 Need to report back how we did. 765 00:31:43,908 --> 00:31:47,344 - Ask me again in an hour. 766 00:31:47,345 --> 00:31:50,181 (sultry music) 767 00:32:18,443 --> 00:32:20,310 You still questioning my skills? 768 00:32:20,311 --> 00:32:22,646 - Hey, my focus was on the patient. 769 00:32:22,647 --> 00:32:24,081 And you came through. 770 00:32:24,082 --> 00:32:25,449 In the end. 771 00:32:25,450 --> 00:32:27,951 (chuckling) - That's not an apology. 772 00:32:27,952 --> 00:32:30,020 - Now, listen. What we did in there today 773 00:32:30,021 --> 00:32:32,289 was impossible on paper. 774 00:32:32,290 --> 00:32:34,425 I needed a rockstar to get it done, and I, 775 00:32:34,426 --> 00:32:38,128 I just wasn't sure you were the same doctor you used to be. 776 00:32:38,129 --> 00:32:41,132 - Well, now you know. Just as good as I ever was. 777 00:32:41,232 --> 00:32:43,000 - With all due respect, you'd be chief of medicine 778 00:32:43,001 --> 00:32:44,234 if that were true. 779 00:32:44,235 --> 00:32:46,036 - I gotta say, this is really starting 780 00:32:46,037 --> 00:32:47,671 to feel personal. 781 00:32:47,672 --> 00:32:49,740 (scoffs) - How could it? 782 00:32:49,741 --> 00:32:52,509 We barely know each other. 783 00:32:52,510 --> 00:32:57,281 - I guess nobody told you. I get memories sometimes. 784 00:32:57,282 --> 00:33:02,019 Especially when I'm, uh, triggered emotionally. 785 00:33:02,020 --> 00:33:03,921 (scoffs) 786 00:33:03,922 --> 00:33:07,091 - Um... 787 00:33:07,092 --> 00:33:09,660 I started to text you the other day, 788 00:33:09,661 --> 00:33:11,862 but I wasn't sure when was the right time to tell you 789 00:33:11,863 --> 00:33:13,997 or... or how. 790 00:33:13,998 --> 00:33:16,401 - Tell me what, exactly? 791 00:33:19,170 --> 00:33:20,672 - We had, um... 792 00:33:22,507 --> 00:33:23,808 a dalliance. 793 00:33:25,377 --> 00:33:27,411 - A dalliance? - After your divorce. 794 00:33:27,412 --> 00:33:30,280 It was about four years ago. On and off. 795 00:33:30,281 --> 00:33:35,819 Long distance. And mostly, we'd meet at conferences. 796 00:33:35,820 --> 00:33:39,523 - Uh, so nothing serious? 797 00:33:39,524 --> 00:33:42,426 - No. And you did a preliminary review 798 00:33:42,427 --> 00:33:46,430 of my clinical trials as a courtesy. 799 00:33:46,431 --> 00:33:49,867 I guess you didn't read anything about that in your emails. 800 00:33:49,868 --> 00:33:51,603 - It doesn't ring a bell. 801 00:33:53,772 --> 00:33:56,173 How did it end? Us? 802 00:33:56,174 --> 00:33:59,543 - Petered out with no hard feelings. 803 00:33:59,544 --> 00:34:00,344 (ringing) 804 00:34:00,345 --> 00:34:01,512 - I should've called 805 00:34:01,513 --> 00:34:03,515 after that last night in New York. 806 00:34:05,050 --> 00:34:07,751 - So, uh, we're good. 807 00:34:07,752 --> 00:34:08,852 - Absolutely. 808 00:34:08,853 --> 00:34:13,323 And Dr. Heller is a great guy. I'm happy for you. 809 00:34:13,324 --> 00:34:16,294 - Yeah. Okay. (chuckling) 810 00:34:17,796 --> 00:34:19,763 You were outstanding today. 811 00:34:19,764 --> 00:34:22,800 - Back at you. 812 00:34:22,801 --> 00:34:25,170 (soft music) 813 00:34:28,106 --> 00:34:30,742 (equipment beeping steadily) 814 00:34:34,946 --> 00:34:36,847 (Harper): Theo? 815 00:34:36,848 --> 00:34:38,148 - Harpo! 816 00:34:38,149 --> 00:34:39,950 - That's not my name. 817 00:34:39,951 --> 00:34:44,455 - It is if I say so. (chuckling) 818 00:34:44,456 --> 00:34:47,691 - Don't make me laugh. It hurts. 819 00:34:47,692 --> 00:34:52,129 Mom, is she okay? 820 00:34:52,130 --> 00:34:53,997 - Doctors say she will be. 821 00:34:53,998 --> 00:34:57,301 - What about Dad? - He's still in surgery. 822 00:34:57,302 --> 00:34:59,738 (Michael): Actually, he's out. 823 00:34:59,838 --> 00:35:03,007 He's stable and resting in the recovery room. 824 00:35:03,008 --> 00:35:04,341 (chuckles) 825 00:35:04,342 --> 00:35:06,977 Now, I'm not really supposed to do this, but... 826 00:35:06,978 --> 00:35:08,879 you wanna go see him? 827 00:35:08,880 --> 00:35:10,382 - Yeah! 828 00:35:12,751 --> 00:35:14,218 - I just wanna warn you, 829 00:35:14,219 --> 00:35:17,221 surgery can cause swelling, discoloration. 830 00:35:17,222 --> 00:35:19,556 Your dad won't look like himself. 831 00:35:19,557 --> 00:35:20,825 - I understand. 832 00:35:25,163 --> 00:35:27,331 - Look what you did today. 833 00:35:27,332 --> 00:35:30,567 You fought with everything you had to get out of that car. 834 00:35:30,568 --> 00:35:32,536 To find help, to save your family. 835 00:35:32,537 --> 00:35:36,306 And you did it. You saved them. 836 00:35:36,307 --> 00:35:39,344 You said before you thought you were ready. 837 00:35:40,745 --> 00:35:44,481 Nobody's ever ready for anything until they do it. 838 00:35:44,482 --> 00:35:49,953 But after today, you can handle whatever's coming. 839 00:35:49,954 --> 00:35:52,557 (soft music) 840 00:35:59,230 --> 00:36:01,533 (equipment beeping steadily) 841 00:36:10,709 --> 00:36:12,510 (sighs) 842 00:36:17,349 --> 00:36:19,384 - Are you the one who operated? 843 00:36:23,054 --> 00:36:24,556 Thank you. 844 00:36:29,260 --> 00:36:32,429 - You're welcome, my friend. 845 00:36:32,430 --> 00:36:34,264 - What am I thanking you for? - For accepting you 846 00:36:34,265 --> 00:36:37,101 into the secret society of saviors. 847 00:36:37,102 --> 00:36:38,836 Surgery loves to steal all the glory, 848 00:36:38,837 --> 00:36:41,238 but we Cardio Kings, we had a big part 849 00:36:41,239 --> 00:36:42,539 in saving that family today. 850 00:36:42,540 --> 00:36:44,908 - Uh, to be fair, I think Dr. Grant gets the MVP, 851 00:36:44,909 --> 00:36:47,177 but, yeah, we can take some of the credit. 852 00:36:47,178 --> 00:36:48,746 - Yeah, we can. 853 00:36:48,747 --> 00:36:50,981 People only notice us when things go wrong. 854 00:36:50,982 --> 00:36:53,717 We're basically the FBI. - You see right there. 855 00:36:53,718 --> 00:36:56,020 We almost had a moment, and you ruined it. 856 00:36:56,021 --> 00:36:57,689 (chuckling) 857 00:36:59,724 --> 00:37:02,826 (Amy clears throat) - Great work today. 858 00:37:02,827 --> 00:37:04,295 - Yeah, you too. 859 00:37:07,799 --> 00:37:10,768 - Go home to your soon-to-be-non-ex-wife and kid, 860 00:37:10,769 --> 00:37:11,969 my brave squire. 861 00:37:11,970 --> 00:37:15,740 And my pursuit of domestic bliss shall continue as ever. 862 00:37:24,683 --> 00:37:27,017 - He wasn't supposed to know about that. 863 00:37:27,018 --> 00:37:28,552 - Well, it won't come from me, 864 00:37:28,553 --> 00:37:32,456 but it's gonna get out eventually. 865 00:37:32,457 --> 00:37:35,859 And it's not fair for Amy to be blindsided. 866 00:37:35,860 --> 00:37:37,529 - Yeah. 867 00:37:39,964 --> 00:37:42,800 - Dr. Costa. 868 00:37:42,801 --> 00:37:44,502 Good work today. 869 00:37:51,409 --> 00:37:54,011 - When a patient of mine is in trouble, 870 00:37:54,012 --> 00:37:55,379 I expect to be paged. 871 00:37:55,380 --> 00:37:57,382 - Noted. 872 00:38:04,556 --> 00:38:06,156 - You didn't mention the pelvic binder. 873 00:38:06,157 --> 00:38:08,425 - He understands what happened. 874 00:38:08,426 --> 00:38:10,462 No reason to rub it in his face. 875 00:38:12,097 --> 00:38:14,164 (door closes) 876 00:38:14,165 --> 00:38:16,100 - Heard you killed it today. 877 00:38:16,101 --> 00:38:18,569 - I don't know about that. 878 00:38:18,570 --> 00:38:20,637 - You caught the first sign of emboli. 879 00:38:20,638 --> 00:38:22,339 Saved that little girl's life. 880 00:38:22,340 --> 00:38:25,409 - And you survived Dr. Maitra. 881 00:38:25,410 --> 00:38:26,911 - Barely. 882 00:38:29,614 --> 00:38:31,548 - How was Ruth today? 883 00:38:31,549 --> 00:38:34,151 - She's still intact and she learned some lessons. 884 00:38:34,152 --> 00:38:37,055 So maybe you were right. - Good. 885 00:38:39,357 --> 00:38:41,826 (soft tense music) 886 00:38:49,434 --> 00:38:51,302 I know what my reputation is. 887 00:38:51,403 --> 00:38:52,836 From when I was Chief of Medicine. 888 00:38:52,837 --> 00:38:56,241 And I suspect some of my behavior today 889 00:38:56,341 --> 00:38:59,410 may have reinforced it. 890 00:38:59,411 --> 00:39:01,845 - Yeah. I mean, you acted like I was in the way 891 00:39:01,846 --> 00:39:04,582 when I'm here to learn and contribute. 892 00:39:06,951 --> 00:39:08,352 Was that too honest? 893 00:39:08,353 --> 00:39:09,319 - Uh-- - My folks say 894 00:39:09,320 --> 00:39:10,020 I can be that way. 895 00:39:10,021 --> 00:39:12,123 - No, honesty can be underrated. 896 00:39:14,426 --> 00:39:17,428 - Well, I saw a lot today, too. 897 00:39:17,429 --> 00:39:21,066 I learned a lot. So, you know, thanks for that. 898 00:39:24,436 --> 00:39:27,004 - I'm sorry that I behaved badly. 899 00:39:27,005 --> 00:39:28,873 - I just want to do well. 900 00:39:30,342 --> 00:39:32,177 Doesn't seem like it was really about me. 901 00:39:38,183 --> 00:39:40,617 - Well, I'm hearing she hasn't changed very much. 902 00:39:40,618 --> 00:39:42,653 - From who? (chuckles) 903 00:39:42,654 --> 00:39:45,389 - I'm sure you know that these walls have ears. 904 00:39:45,390 --> 00:39:47,491 Apparently she went toe-to-toe 905 00:39:47,492 --> 00:39:49,927 with our new Chief of Surgery today? 906 00:39:49,928 --> 00:39:53,564 - They managed to work it out and save the patient. 907 00:39:53,565 --> 00:39:56,967 - But, she's not exactly treading lightly. 908 00:39:56,968 --> 00:39:59,169 - Well, I don't think she ever will, Max. 909 00:39:59,170 --> 00:40:01,572 - Which is why you put some serious guard rails on her. 910 00:40:01,573 --> 00:40:04,675 - Around the management of her TVI, of course. 911 00:40:04,676 --> 00:40:06,944 - And what's your prognosis regarding that? 912 00:40:06,945 --> 00:40:08,946 (sighs) - Her brain's a wild card. 913 00:40:08,947 --> 00:40:11,682 You know, has been ever since the accident. What is this? 914 00:40:11,683 --> 00:40:14,284 - You asked to be Chief of Medicine knowing 915 00:40:14,285 --> 00:40:16,487 it meant overseeing her. 916 00:40:16,488 --> 00:40:18,422 - Yes. - And you understand 917 00:40:18,423 --> 00:40:21,725 that your success or failure in that job will depend greatly 918 00:40:21,726 --> 00:40:23,293 on how you navigate the situation. 919 00:40:23,294 --> 00:40:26,230 - You know, we've had this conversation a dozen times. 920 00:40:26,231 --> 00:40:27,998 - We've had this conversation when you were sitting 921 00:40:27,999 --> 00:40:31,502 on this floor. Now you're running Internal Medicine. 922 00:40:31,503 --> 00:40:33,004 And I know what it means to stake out 923 00:40:33,104 --> 00:40:34,872 a new path for yourself. 924 00:40:34,873 --> 00:40:37,676 So, if you're thinking of giving her the kind of leeway 925 00:40:37,776 --> 00:40:39,810 you have in the past, 926 00:40:39,811 --> 00:40:42,046 everyone knows the history there. 927 00:40:42,047 --> 00:40:45,482 - You just said it yourself, Max. It's history. 928 00:40:45,483 --> 00:40:47,084 There's nothing between us anymore. 929 00:40:47,085 --> 00:40:48,452 And everyone also knows, 930 00:40:48,453 --> 00:40:50,621 my life would be easier if she wasn't here. 931 00:40:50,622 --> 00:40:53,425 - Well, if you want her gone, just fire her. 932 00:40:53,525 --> 00:40:54,958 We'll back you. 933 00:40:54,959 --> 00:40:56,827 - I won't do that without cause. 934 00:40:56,828 --> 00:40:59,029 But rest assured-- (exhales) 935 00:40:59,030 --> 00:41:00,898 ...she does anything to earn my distrust 936 00:41:00,899 --> 00:41:05,703 or to jeopardize this hospital's reputation, 937 00:41:05,704 --> 00:41:07,806 I'll be the first one showing her the door. 938 00:41:09,207 --> 00:41:12,209 - Well, that's a helluva thing to say about the woman 939 00:41:12,210 --> 00:41:14,111 you once loved. 940 00:41:14,112 --> 00:41:16,213 If you mean it. 941 00:41:16,214 --> 00:41:20,384 (tender music) 942 00:41:20,385 --> 00:41:24,555 ♪ You could say it's all my fault ♪ 943 00:41:24,556 --> 00:41:27,257 ♪ We just couldn't get along 944 00:41:27,258 --> 00:41:28,559 (car door opens and shut) 945 00:41:28,560 --> 00:41:30,361 - Go get him. - Daddy! 946 00:41:30,362 --> 00:41:31,395 (chuckles) 947 00:41:31,396 --> 00:41:32,863 (fake groans) 948 00:41:32,864 --> 00:41:34,698 - Oh, what're you doing up this late? 949 00:41:34,699 --> 00:41:36,868 - She wouldn't go to sleep until she saw you. 950 00:41:38,236 --> 00:41:40,305 Hi. - Hey. 951 00:41:43,108 --> 00:41:45,509 - Come on. 952 00:41:45,510 --> 00:41:47,778 - Let's go, Princess? 953 00:41:47,779 --> 00:41:50,782 - Yeah. - Okay, go find it. 954 00:41:52,650 --> 00:41:56,754 ♪ There's nothing left to fix 955 00:41:56,755 --> 00:42:00,424 ♪ You can say I lost my grip 956 00:42:00,425 --> 00:42:02,659 ♪ Say whatever feels better 957 00:42:02,660 --> 00:42:06,231 ♪ Whatever, you can just say I'm crazy ♪ 958 00:42:08,033 --> 00:42:12,803 ♪ You can say it's all my fault ♪ 959 00:42:12,804 --> 00:42:16,640 ♪ We just couldn't get along 960 00:42:16,641 --> 00:42:18,842 ♪ And so you know, I'll say 961 00:42:18,843 --> 00:42:23,014 ♪ I don't know, but no one's gonna be asking me ♪ 962 00:42:26,084 --> 00:42:31,923 (whirring) 963 00:42:40,665 --> 00:42:45,302 ♪ You can say it's all my fault ♪ 964 00:42:45,303 --> 00:42:47,939 ♪ We just couldn't get along ♪ 965 00:42:52,110 --> 00:42:56,147 (theme music) 966 00:43:16,534 --> 00:43:19,938 Subtitling: difuze