1 00:00:00,934 --> 00:00:02,201 - Previously, on Doc. 2 00:00:02,202 --> 00:00:03,168 (Ben): Wasn't sure if you were 3 00:00:03,169 --> 00:00:04,436 the same doctor you used to be. 4 00:00:04,437 --> 00:00:06,338 - Now you know I'm as good as I was. 5 00:00:06,339 --> 00:00:09,642 (Ben): We had um, a dalliance. Petered out. No hard feelings. 6 00:00:09,776 --> 00:00:10,944 - I want to have a child. 7 00:00:11,044 --> 00:00:13,479 - We've wasted so much time. - I know. 8 00:00:13,480 --> 00:00:15,914 I'm sorry. - Which cologne are you wearing? 9 00:00:15,915 --> 00:00:17,117 - What are you, pregnant? 10 00:00:17,917 --> 00:00:19,485 (Amy): Ruth, crash cart! - Coming! 11 00:00:19,486 --> 00:00:21,787 (labored breathing) - That's the supply cart! 12 00:00:21,788 --> 00:00:22,921 - I don't feel like a doctor. 13 00:00:22,922 --> 00:00:25,124 - Where is the Chief, Dr. Larsen? 14 00:00:25,125 --> 00:00:26,493 - She has early-onset Alzheimer's. 15 00:00:26,593 --> 00:00:28,327 - Cece? It was your heart all along. 16 00:00:28,328 --> 00:00:30,296 You're going to get your life back. 17 00:00:30,830 --> 00:00:32,597 - It was beyond frightening. 18 00:00:32,598 --> 00:00:36,101 I actually thought I had Alzheimer's for almost a year. 19 00:00:36,102 --> 00:00:38,237 But then my amazing doctor at Westside 20 00:00:38,238 --> 00:00:40,105 figured out it was an issue with my heart. 21 00:00:40,106 --> 00:00:41,508 - I wish you'd told me. 22 00:00:41,608 --> 00:00:43,108 When you thought you were so sick. 23 00:00:43,109 --> 00:00:44,476 - What was I going to say? 24 00:00:44,477 --> 00:00:46,378 I'm losing my mind, come quick, 25 00:00:46,379 --> 00:00:47,981 let me apologize for all those things 26 00:00:48,081 --> 00:00:49,648 I screwed up in our marriage? 27 00:00:49,649 --> 00:00:51,985 - Wouldn't have minded that. (scoffs) 28 00:00:52,886 --> 00:00:56,088 Wouldn't mind it now either. Since who knows how long I have. 29 00:00:56,089 --> 00:00:58,257 - Don't talk like that. 30 00:00:58,258 --> 00:00:59,792 - I have an inoperable tumor, Cece, 31 00:00:59,793 --> 00:01:02,227 what do you want me to say? - That you're going to fight! 32 00:01:02,228 --> 00:01:04,229 - I am. I have been. - I know. 33 00:01:04,230 --> 00:01:05,964 But now that my own medical ordeal 34 00:01:05,965 --> 00:01:07,399 has been resolved, I wanna be there... 35 00:01:07,400 --> 00:01:10,103 (distant echo): ...for whatever you need. 36 00:01:10,470 --> 00:01:12,004 Oh! Dear! 37 00:01:12,005 --> 00:01:13,238 Bonnie? 38 00:01:13,239 --> 00:01:14,740 (tense music) 39 00:01:14,741 --> 00:01:15,875 Bonnie! 40 00:01:18,478 --> 00:01:19,578 (exhales) 41 00:01:19,579 --> 00:01:21,014 Please talk to me! 42 00:01:21,114 --> 00:01:22,748 - I can't feel my arm. 43 00:01:22,749 --> 00:01:24,317 - I'm calling an ambulance. 44 00:01:26,586 --> 00:01:28,488 (theme music) 45 00:01:36,296 --> 00:01:38,631 - Hey! Got your text. 46 00:01:39,399 --> 00:01:40,532 What are we doing here? 47 00:01:40,533 --> 00:01:43,168 - I'm having kind of a crisis. 48 00:01:43,169 --> 00:01:46,772 - I got that from the way you ran out last night. 49 00:01:46,773 --> 00:01:47,840 I've been worried. 50 00:01:47,841 --> 00:01:51,210 - I know. I'm sorry I didn't respond till now. 51 00:01:51,211 --> 00:01:53,480 - Okay, what's going on? 52 00:01:57,517 --> 00:01:59,919 (soft music) 53 00:02:00,687 --> 00:02:01,821 - Yeah. 54 00:02:02,455 --> 00:02:06,291 My OB couldn't get me in till next week, 55 00:02:06,292 --> 00:02:08,060 and I didn't want to go downstairs, 56 00:02:08,061 --> 00:02:10,230 so I need an ultrasound. 57 00:02:10,997 --> 00:02:15,501 I-I know this is weird and we're not friends, but... 58 00:02:15,502 --> 00:02:18,237 I also know that I can trust you. 59 00:02:18,238 --> 00:02:20,407 - Yes, you can. 60 00:02:27,180 --> 00:02:28,715 Um... 61 00:02:47,200 --> 00:02:48,233 There. 62 00:02:48,234 --> 00:02:50,269 There it is. 63 00:02:50,270 --> 00:02:52,572 (tender music) 64 00:02:54,374 --> 00:02:58,411 (equipment beeping) CRL suggests seven weeks. 65 00:02:59,112 --> 00:03:01,246 - Oh. (equipment beeps) 66 00:03:01,247 --> 00:03:03,350 So we can hear the heartbeat? 67 00:03:04,818 --> 00:03:06,386 - Are you sure? 68 00:03:06,486 --> 00:03:09,555 - Yeah, I've been up all night and... 69 00:03:09,556 --> 00:03:11,890 I'm sure there are a million reasons why 70 00:03:11,891 --> 00:03:14,393 I should just keep going with my life as it is. 71 00:03:14,394 --> 00:03:17,229 And-and thank God I have the right to choose, but... 72 00:03:17,230 --> 00:03:20,299 We see so much death here, every day, 73 00:03:20,300 --> 00:03:23,102 and this just feels like I can do this. 74 00:03:23,103 --> 00:03:27,139 And why not see this as a blessing? 75 00:03:27,140 --> 00:03:28,807 I-I mean, I can do this, right? 76 00:03:28,808 --> 00:03:31,710 I have a great job, and financial security, 77 00:03:31,711 --> 00:03:33,045 and a community. 78 00:03:33,046 --> 00:03:34,714 - And TJ. 79 00:03:35,115 --> 00:03:37,783 - Yeah. Yes. Of course. 80 00:03:37,784 --> 00:03:38,852 TJ. 81 00:03:39,853 --> 00:03:41,153 - You haven't told him yet? 82 00:03:41,154 --> 00:03:43,555 - We're having dinner tonight. 83 00:03:43,556 --> 00:03:46,726 I just need the day, I think. 84 00:03:49,696 --> 00:03:51,931 - Then maybe wait on the heartbeat. 85 00:03:53,166 --> 00:03:57,904 So you can hear it together when it's time. 86 00:03:59,739 --> 00:04:00,640 - Yeah. 87 00:04:05,078 --> 00:04:07,813 - Dr. Shaw's running behind, we haven't even gone in yet. 88 00:04:07,814 --> 00:04:09,916 - Okay, well, just take it one step at a time. 89 00:04:10,016 --> 00:04:11,316 And give my love to Wendy. 90 00:04:11,317 --> 00:04:12,718 - I'm the one who's gonna need the love 91 00:04:12,719 --> 00:04:14,319 if this doesn't go how we hope. 92 00:04:14,320 --> 00:04:17,556 - Can you at least try to let yourself be excited? 93 00:04:17,557 --> 00:04:19,059 This is incredible. 94 00:04:19,826 --> 00:04:22,529 - There's a fine line between excitement and anxiety. 95 00:04:23,063 --> 00:04:24,296 I'll check in later. 96 00:04:24,297 --> 00:04:25,799 - Okay, bye. 97 00:04:31,638 --> 00:04:33,872 - So I'm sure Dr. Maitra told you... 98 00:04:33,873 --> 00:04:36,475 She thinks I have a problem with compartmentalization. 99 00:04:36,476 --> 00:04:38,143 - Look, we all have our stuff. 100 00:04:38,144 --> 00:04:42,881 We just have to be aware of our blind spots and triggers 101 00:04:42,882 --> 00:04:45,150 and try to stay ahead of them so they don't affect our work. 102 00:04:45,151 --> 00:04:47,753 - Well, I just want you to know that I've been working on it. 103 00:04:47,754 --> 00:04:49,621 And I feel really confident that I'll be able to deal 104 00:04:49,622 --> 00:04:50,889 with whatever's thrown my way. 105 00:04:50,890 --> 00:04:53,592 - Ruth, I'm glad that you're acknowledging this, 106 00:04:53,593 --> 00:04:56,495 but I think you need to slow down and hear me. 107 00:04:56,496 --> 00:04:59,699 You are not going to solve this in one day. 108 00:05:01,334 --> 00:05:03,602 - I know you have a relationship with Dr. Larsen, 109 00:05:03,603 --> 00:05:05,404 but there are other internists I can bring in 110 00:05:05,405 --> 00:05:08,073 if she's unavailable. - Absolutely not. 111 00:05:08,074 --> 00:05:10,342 She's the best and we will wait. 112 00:05:10,343 --> 00:05:11,944 (door opens) - Hi. 113 00:05:11,945 --> 00:05:15,515 I'm Dr. Larsen, this is Dr. Chen, and we're-- 114 00:05:15,615 --> 00:05:18,350 Cece! Hi! - Finally. 115 00:05:18,351 --> 00:05:19,986 Dr. Grant here was trying to pawn me off 116 00:05:20,086 --> 00:05:21,487 on one of your underlings. 117 00:05:21,488 --> 00:05:23,522 Dr. Larsen, meet Bonnie Carroll. 118 00:05:23,523 --> 00:05:25,792 Tenured professor of archaeology at the U of M. 119 00:05:25,892 --> 00:05:27,794 She was also once married to yours truly, 120 00:05:27,894 --> 00:05:29,795 but that's the least of her accomplishments. 121 00:05:29,796 --> 00:05:31,930 Bonnie, this is Chief Larsen. 122 00:05:31,931 --> 00:05:35,134 The brassy broad who saved my life at least twice. 123 00:05:35,135 --> 00:05:37,037 - Chief Larsen? 124 00:05:37,504 --> 00:05:41,073 - I-- it is so good to see you, Cece-- 125 00:05:41,074 --> 00:05:45,277 but I have a confession to make, I am no longer Chief. 126 00:05:45,278 --> 00:05:47,446 - They demoted you? - No, not exactly. 127 00:05:47,447 --> 00:05:48,947 I had a car accident 128 00:05:48,948 --> 00:05:51,517 and I was recovering neurologically. 129 00:05:51,518 --> 00:05:52,685 So the last time I saw you, 130 00:05:52,686 --> 00:05:55,554 I was actually working as an intern. 131 00:05:55,555 --> 00:05:57,189 - You told me you were Chief. 132 00:05:57,190 --> 00:05:58,691 - You were pretty unstable 133 00:05:58,692 --> 00:06:02,461 and insistent that you saw the doctor that you remembered. 134 00:06:02,462 --> 00:06:04,263 - Sounds like you, Cece. 135 00:06:04,264 --> 00:06:05,565 - So you lied? 136 00:06:05,665 --> 00:06:07,833 - I did. To help you. 137 00:06:07,834 --> 00:06:10,302 I've been promoted to Chief Resident. 138 00:06:10,303 --> 00:06:11,970 But if you prefer, we can ask the new 139 00:06:11,971 --> 00:06:14,039 Chief of Medicine to come and see you. 140 00:06:14,040 --> 00:06:16,176 (low, tense music) 141 00:06:18,745 --> 00:06:21,481 - Will you enlighten her, Dr. Grant? 142 00:06:23,183 --> 00:06:24,450 - Yes. 143 00:06:24,451 --> 00:06:26,118 Ms. Carroll comes to us from Eastside, 144 00:06:26,119 --> 00:06:28,320 where she was being treated for an unresectable 145 00:06:28,321 --> 00:06:30,323 Pancoast tumor. Biopsy confirmed 146 00:06:30,423 --> 00:06:32,592 lung adenocarcinoma in the right upper lobe. 147 00:06:32,692 --> 00:06:33,792 She has weakness in the right arm, 148 00:06:33,793 --> 00:06:36,995 with near-complete paralysis in grip for 24 hours. 149 00:06:36,996 --> 00:06:40,099 - So the tumor has infiltrated the lower brachial plexus. 150 00:06:40,100 --> 00:06:42,468 - Those incipient doctors were trying to shrink it 151 00:06:42,469 --> 00:06:43,869 with chemo and radiation, 152 00:06:43,870 --> 00:06:45,604 and now they're saying that's failed. 153 00:06:45,605 --> 00:06:46,872 - They believe the tumor's inoperable 154 00:06:46,873 --> 00:06:48,774 given the invasion of the subclavian artery. 155 00:06:48,775 --> 00:06:50,342 They're recommending palliative care. 156 00:06:50,343 --> 00:06:51,877 - And we refuse to accept it. 157 00:06:51,878 --> 00:06:54,681 Present us with another option. 158 00:06:56,483 --> 00:06:58,217 - Dr. Chen, get full admissions labs 159 00:06:58,218 --> 00:06:59,952 and update the staging scans. 160 00:06:59,953 --> 00:07:00,886 - Mm-hmm. 161 00:07:00,887 --> 00:07:04,124 - If there is another way, we will find it. 162 00:07:09,062 --> 00:07:10,162 - Morning! - Morning. 163 00:07:10,163 --> 00:07:11,897 - Heard you talking to Dr. Douglas the other day, 164 00:07:11,898 --> 00:07:13,265 saying you were on a vanilla kick. 165 00:07:13,266 --> 00:07:15,234 - Ah, I am. Thank you. 166 00:07:15,235 --> 00:07:17,503 You're on clinic duty today. 167 00:07:17,504 --> 00:07:19,338 - Clinic duty? 168 00:07:19,339 --> 00:07:20,707 - That a problem? 169 00:07:21,374 --> 00:07:22,908 - Not at all. 170 00:07:22,909 --> 00:07:25,044 - Paige, Dr. Heller's yours today. 171 00:07:25,045 --> 00:07:28,248 - Full house down there. Get ready to move some meat. 172 00:07:30,750 --> 00:07:33,519 - Hey, listen, Doc, I am due back at work in an hour, 173 00:07:33,520 --> 00:07:35,054 so I would-- - Yeah. 174 00:07:35,055 --> 00:07:36,656 - ...appreciate if kept this, y'know, efficient. 175 00:07:36,756 --> 00:07:38,390 - Yes, sir, I'm going to try my best, 176 00:07:38,391 --> 00:07:39,658 but you got some catching up to do. 177 00:07:39,659 --> 00:07:41,193 It looks like you missed all of your appointments 178 00:07:41,194 --> 00:07:43,262 after your aortic valve replacement last year? 179 00:07:43,263 --> 00:07:44,530 - Yeah, I am sorry about that. 180 00:07:44,531 --> 00:07:46,832 Uh, recovery took a lot of months, and... 181 00:07:46,833 --> 00:07:51,271 I'm still paying that off, so I can't really miss work. 182 00:07:52,372 --> 00:07:57,009 Also, Dr. Swanson said that the surgery went well, so... 183 00:07:57,010 --> 00:07:59,412 (quiet, tense music) 184 00:07:59,779 --> 00:08:02,381 - Have you been feeling sick lately? Fatigued? 185 00:08:02,382 --> 00:08:03,816 - I mean, yeah, 186 00:08:03,817 --> 00:08:07,420 but I've been working a ton of overtime on site. 187 00:08:07,821 --> 00:08:09,689 - Okay, well, I need to run a few more tests, 188 00:08:09,789 --> 00:08:10,757 but it's all routine. 189 00:08:10,857 --> 00:08:13,258 I'll get the procedure set up as soon as I can. 190 00:08:13,259 --> 00:08:14,093 - Are you serious? 191 00:08:14,094 --> 00:08:16,162 - I-I know you're in a rush, but... 192 00:08:16,262 --> 00:08:18,063 gotta get this done. 193 00:08:18,064 --> 00:08:20,600 Okay? Just sit tight. 194 00:08:22,168 --> 00:08:23,669 (equipment whirring) 195 00:08:23,670 --> 00:08:24,970 - I'm sorry. 196 00:08:24,971 --> 00:08:27,106 I didn't know what you were stepping into earlier. 197 00:08:27,107 --> 00:08:29,708 - I hope not. 'Cause I kind of caught you 198 00:08:29,709 --> 00:08:31,444 enjoying it a bit too much. 199 00:08:31,878 --> 00:08:33,245 - I was just trying to figure out 200 00:08:33,246 --> 00:08:35,714 how you pulled it off with Cece. - What do you mean? 201 00:08:35,715 --> 00:08:37,616 - What people tell me is that 202 00:08:37,617 --> 00:08:39,451 this version of you is pretty different 203 00:08:39,452 --> 00:08:40,920 than the one back then. 204 00:08:42,088 --> 00:08:43,189 (whoosh) 205 00:08:44,557 --> 00:08:46,159 (equipment beeping) Dr. Coleman, just in time. 206 00:08:47,193 --> 00:08:49,294 - Whoa. That tumor's a beast. 207 00:08:49,295 --> 00:08:52,431 - Yeah. It's infiltrating the subclavian artery, 208 00:08:52,432 --> 00:08:53,599 vein, and brachial plexus, 209 00:08:53,600 --> 00:08:55,367 it's even growing around the vertebrae. 210 00:08:55,368 --> 00:08:57,870 - Yeah, I guess we know why Eastside refused to cut into it. 211 00:08:57,871 --> 00:09:00,005 - Plus her uncontrolled hypertension from the chemo 212 00:09:00,006 --> 00:09:02,708 puts her in danger of having a stroke mid-operation. 213 00:09:02,709 --> 00:09:05,310 They were right. You can't get it. 214 00:09:05,311 --> 00:09:06,946 - They can't get it. I can. 215 00:09:07,047 --> 00:09:08,348 - How's that? 216 00:09:08,448 --> 00:09:09,748 - Most surgeons don't have the stomach 217 00:09:09,749 --> 00:09:11,550 or the stamina to resect it. 218 00:09:11,551 --> 00:09:15,154 Just have to go at it with three different approaches at once. 219 00:09:15,155 --> 00:09:18,424 - Wa-- we'll need to lower her BP before even considering this. 220 00:09:18,425 --> 00:09:20,893 - Not at all. We can handle it ourselves in the OR. 221 00:09:20,894 --> 00:09:24,296 - A lot better if I find a medical solution first. 222 00:09:24,297 --> 00:09:26,632 - Now, we have been down this road before. 223 00:09:26,633 --> 00:09:28,768 - That man had antlers in his chest. 224 00:09:28,868 --> 00:09:32,171 Plus, we don't have to scramble with this patient. 225 00:09:32,172 --> 00:09:34,040 - It'll be risky no matter when we attempt it. 226 00:09:34,140 --> 00:09:37,643 You try to manage a risk away and she'll die waiting. 227 00:09:37,644 --> 00:09:39,245 - Where are you going? 228 00:09:39,346 --> 00:09:40,312 - I'm taking my solution to them. 229 00:09:40,313 --> 00:09:42,515 Now, if you have a better idea, be my guest. 230 00:09:42,615 --> 00:09:44,117 Pitch it. 231 00:09:46,186 --> 00:09:49,621 - I need some time. Don't let him start cutting. 232 00:09:49,622 --> 00:09:52,025 (tense music) 233 00:09:56,930 --> 00:09:59,799 - You sure you have to go? - My panel starts in an hour. 234 00:09:59,899 --> 00:10:01,234 And then it's straight to the airport. 235 00:10:01,334 --> 00:10:02,968 - I'm just saying, we have the room till 11, 236 00:10:02,969 --> 00:10:04,871 and these panels, they never start on time. 237 00:10:06,806 --> 00:10:08,307 (murmurs decline) Ooh. 238 00:10:08,308 --> 00:10:12,078 Or maybe we pick this up in Austin next month. 239 00:10:12,212 --> 00:10:14,813 Assuming you're going to the AustinMed conference. 240 00:10:14,814 --> 00:10:16,548 - Round three. 241 00:10:16,549 --> 00:10:17,783 - Only thing is, um, 242 00:10:17,784 --> 00:10:19,318 my divorce is getting kind of nasty, 243 00:10:19,319 --> 00:10:21,820 so if we could just keep this on the down-low. 244 00:10:21,821 --> 00:10:24,290 - Yeah. How about if we're in the same city, 245 00:10:24,391 --> 00:10:25,457 if it makes sense. 246 00:10:25,458 --> 00:10:27,793 There's no need to make it into something it's not. 247 00:10:27,794 --> 00:10:29,828 - Yeah. And let's say no texting. 248 00:10:29,829 --> 00:10:32,399 To be safe. Just calls. 249 00:10:32,932 --> 00:10:34,167 - Yeah. 250 00:10:35,735 --> 00:10:36,835 - So you've done this before? 251 00:10:36,836 --> 00:10:39,204 - Well, not this approach exactly. 252 00:10:39,205 --> 00:10:41,507 But I've dealt with a lot of complex, invasive tumors, 253 00:10:41,508 --> 00:10:44,076 and this will take more time. But it's not impossible. 254 00:10:44,077 --> 00:10:46,112 - Still, you have not done this. 255 00:10:46,212 --> 00:10:47,946 I'm not sure I love the sound of that. 256 00:10:47,947 --> 00:10:50,082 - What choice do we have? Palliative care? 257 00:10:50,083 --> 00:10:52,018 This is amazing news, Cece. 258 00:10:53,119 --> 00:10:56,321 - Sorry I'm late. I was doing my own assessment 259 00:10:56,322 --> 00:10:57,456 of Bonnie's condition. 260 00:10:57,457 --> 00:10:58,991 - Good. Because he's selling us 261 00:10:58,992 --> 00:11:00,993 on a surgery he's never performed before. 262 00:11:00,994 --> 00:11:03,028 - The surgery's a legitimate solution. 263 00:11:03,029 --> 00:11:05,998 But Bonnie's blood pressure needs to be stabilized first. 264 00:11:05,999 --> 00:11:07,399 And I have found a way 265 00:11:07,400 --> 00:11:09,968 to bring it under control with fewer risks. 266 00:11:09,969 --> 00:11:11,837 - He said he could manage the blood pressure. 267 00:11:11,838 --> 00:11:13,006 And he's the Chief of Surgery. 268 00:11:13,106 --> 00:11:15,441 - Everyone told me I had Alzheimer's. 269 00:11:15,442 --> 00:11:16,876 And look at me now. 270 00:11:16,976 --> 00:11:18,277 What's your plan, Dr. Larsen? 271 00:11:18,278 --> 00:11:20,746 - It's called carotid baroreflex stimulation, 272 00:11:20,747 --> 00:11:23,849 I've done it before-- - When exactly? 273 00:11:23,850 --> 00:11:25,618 - Three times, last year. 274 00:11:25,719 --> 00:11:27,721 - I see. Dr. Larsen... 275 00:11:29,522 --> 00:11:30,857 A word. 276 00:11:31,991 --> 00:11:33,360 - I'll be right back. 277 00:11:37,530 --> 00:11:38,564 - When I said come up with something, 278 00:11:38,565 --> 00:11:41,167 I was hoping it'd be a procedure you remember. 279 00:11:41,267 --> 00:11:43,502 Not one you had to find in your old notes. 280 00:11:43,503 --> 00:11:45,037 - My notes are thorough. 281 00:11:45,038 --> 00:11:46,772 And at least I've done the procedure. 282 00:11:46,773 --> 00:11:48,273 - And are you going to tell Bonnie and Cece 283 00:11:48,274 --> 00:11:50,275 that you never actually recovered neurologically? 284 00:11:50,276 --> 00:11:52,277 - My memory loss isn't an issue here. 285 00:11:52,278 --> 00:11:55,881 Bonnie could die on the table if we do it your way. 286 00:11:55,882 --> 00:11:57,783 What I'm presenting is lower risk, 287 00:11:57,784 --> 00:11:59,218 and if you actually read my notes, 288 00:11:59,219 --> 00:12:01,186 you will see that all three patients 289 00:12:01,187 --> 00:12:03,188 were in much worse condition than Bonnie. 290 00:12:03,189 --> 00:12:05,624 - Right now, her BP's high. But it's predictable. 291 00:12:05,625 --> 00:12:08,527 If you destabilize it, then surgery is off the table. 292 00:12:08,528 --> 00:12:10,296 And we're out of options. 293 00:12:11,664 --> 00:12:12,798 (whoosh) 294 00:12:12,799 --> 00:12:14,900 Thank you. For taking time today 295 00:12:14,901 --> 00:12:16,503 to come see what I've been doing. 296 00:12:17,904 --> 00:12:20,072 - Did you think I was a good doctor? 297 00:12:20,073 --> 00:12:21,941 When you knew me before? 298 00:12:22,042 --> 00:12:24,810 - You were brilliant. - That hasn't changed. 299 00:12:24,811 --> 00:12:27,013 So how about you trust me this time? 300 00:12:29,683 --> 00:12:32,419 - Okay. I will. 301 00:12:36,956 --> 00:12:38,357 - Before I give you numbers, 302 00:12:38,358 --> 00:12:40,693 I want you to remember that you're an individual, 303 00:12:40,694 --> 00:12:42,061 not a statistic. 304 00:12:42,062 --> 00:12:44,063 - We've done all the research, and we know the odds. 305 00:12:44,064 --> 00:12:45,831 We're here because we know we need your help. 306 00:12:45,832 --> 00:12:47,366 - Yeah. - So you know that it could be 307 00:12:47,367 --> 00:12:49,101 very difficult? The important thing 308 00:12:49,102 --> 00:12:50,836 is you came here today, because at this point, 309 00:12:50,837 --> 00:12:52,137 every day matters. 310 00:12:52,138 --> 00:12:54,908 - I've been taking really good care of myself. 311 00:12:55,608 --> 00:12:57,509 And we have faith. - Mm-hmm. 312 00:12:57,510 --> 00:13:01,147 - Well, I was honestly assuming we would test both of you. 313 00:13:01,948 --> 00:13:03,882 - Both of us? 314 00:13:03,883 --> 00:13:05,452 - Why not? 315 00:13:05,885 --> 00:13:07,619 - Um, I'm 48. 316 00:13:07,620 --> 00:13:09,355 - And I've had patients give birth 317 00:13:09,356 --> 00:13:11,990 to beautiful healthy children as old as 51. 318 00:13:11,991 --> 00:13:15,595 You're here. Might as well see what we're working with. 319 00:13:18,164 --> 00:13:20,165 - More doctors? - I know you're anxious 320 00:13:20,166 --> 00:13:21,867 to get out of here, but unfortunately, 321 00:13:21,868 --> 00:13:23,736 your stress test results indicate you might need 322 00:13:23,737 --> 00:13:25,004 to be brought into internal medicine. 323 00:13:25,005 --> 00:13:27,006 - Oh. (phone vibrating) 324 00:13:27,007 --> 00:13:30,376 - Oh, my God, I'm so sorry. It's my husband. 325 00:13:30,377 --> 00:13:31,977 - Uh-- - Hello? 326 00:13:31,978 --> 00:13:35,114 - What is this, a circus? - I'm sure that was important. 327 00:13:35,115 --> 00:13:37,549 (breathing heavily) He's 13 months post-surgical 328 00:13:37,550 --> 00:13:40,285 aortic valve replacement of a congenital bicuspid valve. 329 00:13:40,286 --> 00:13:42,489 Heard a new murmur on exam, and he reports worsening 330 00:13:42,589 --> 00:13:43,757 fatigue upon exertion. 331 00:13:43,857 --> 00:13:45,759 - That's also 'cause I'm on a construction site 332 00:13:45,859 --> 00:13:47,893 12 hours a day. 333 00:13:47,894 --> 00:13:48,762 (breathing heavily) 334 00:13:48,862 --> 00:13:50,630 (melancholy music) 335 00:13:51,464 --> 00:13:52,399 What's going on? 336 00:13:53,166 --> 00:13:55,601 - I'm afraid you're in heart failure again. 337 00:13:55,602 --> 00:13:57,703 (gasping) - What? 338 00:13:57,704 --> 00:14:01,774 Dr. Swanson said this would be over after surgery. 339 00:14:01,775 --> 00:14:03,442 Now I need another one? 340 00:14:03,443 --> 00:14:06,680 I can't afford to miss two more months of work. 341 00:14:07,180 --> 00:14:09,883 - Let's just take this one step at a time. 342 00:14:10,684 --> 00:14:12,751 - Okay... (gasping) 343 00:14:12,752 --> 00:14:15,587 - We need to figure out how long his heart's been in failure. 344 00:14:15,588 --> 00:14:18,190 - That's the problem. He missed all of his follow-ups 345 00:14:18,191 --> 00:14:20,192 with Swanson, so there won't be any echoes. 346 00:14:20,193 --> 00:14:21,960 - Oh. So, what are you thinking? 347 00:14:21,961 --> 00:14:24,063 - We need valve gradients, leaflet motion, 348 00:14:24,064 --> 00:14:26,533 ventricular function, so let's start with the TE, 349 00:14:26,633 --> 00:14:28,067 then get CBCs-- - Yeah. 350 00:14:28,068 --> 00:14:29,803 - ...CRP... - Blood cultures 351 00:14:29,903 --> 00:14:30,936 to rule out endocarditis. 352 00:14:30,937 --> 00:14:32,037 - Yep. 353 00:14:32,038 --> 00:14:35,008 Be nice if your intern was available to manage that. 354 00:14:35,675 --> 00:14:37,577 (indistinct) 355 00:14:38,078 --> 00:14:41,114 - It's fine. I'll order them myself. 356 00:14:41,948 --> 00:14:45,084 (tense music) 357 00:14:45,085 --> 00:14:47,420 (equipment beeping) 358 00:14:55,195 --> 00:14:56,261 - The peak gradient's 80 359 00:14:56,262 --> 00:14:58,063 and the leaflets are barely moving. 360 00:14:58,064 --> 00:15:00,100 - Well, that valve's critically obstructed. 361 00:15:00,200 --> 00:15:01,700 No wonder he's back in heart failure. 362 00:15:01,701 --> 00:15:03,203 - I'll call surgery. 363 00:15:05,205 --> 00:15:07,040 - Thanks, Mike, we can take it from here. 364 00:15:08,108 --> 00:15:09,309 (electronic beep) 365 00:15:11,011 --> 00:15:12,211 (door closes) 366 00:15:12,212 --> 00:15:14,513 Swanson didn't implant the valve correctly. 367 00:15:14,514 --> 00:15:16,949 - Well, a post-op echo would have showed that. 368 00:15:16,950 --> 00:15:19,084 He should never have been discharged. 369 00:15:19,085 --> 00:15:21,387 - It's not here. - He never ordered it? 370 00:15:21,388 --> 00:15:22,855 - I don't know, but it's not here 371 00:15:22,856 --> 00:15:24,256 and I need to find out why. 372 00:15:24,257 --> 00:15:27,292 - So what we're doing here is using electrical pulses 373 00:15:27,293 --> 00:15:29,728 to trick your brain into lowering your blood pressure. 374 00:15:29,729 --> 00:15:31,263 How are her vitals? 375 00:15:31,264 --> 00:15:35,000 - Uh, BP is 195 over 100, heart rate 85. 376 00:15:35,001 --> 00:15:37,871 - Hi, I'm Dr. Hamda, Chief of Internal Medicine. 377 00:15:37,971 --> 00:15:40,839 Cece suggested I might pay a little visit. 378 00:15:40,840 --> 00:15:42,909 - She does love authority figures. 379 00:15:43,410 --> 00:15:46,845 - So. Carotid baroreflex stimulation. 380 00:15:46,846 --> 00:15:48,147 - Did you want to supervise? 381 00:15:48,148 --> 00:15:52,118 - I'll observe and assist if needed. 382 00:15:52,585 --> 00:15:53,753 - Great. 383 00:15:54,120 --> 00:15:56,488 Are you ready? - I trust Cece. 384 00:15:56,489 --> 00:15:58,323 And she trusts you. 385 00:15:58,324 --> 00:16:00,893 - You tell us if it gets too much for you, okay? 386 00:16:00,894 --> 00:16:02,494 (Bonnie exhales) 387 00:16:02,495 --> 00:16:04,097 (electronic beeping) 388 00:16:06,866 --> 00:16:08,300 (electronic beeping) 389 00:16:08,301 --> 00:16:11,003 Increasing frequency to 80 hertz. 390 00:16:11,004 --> 00:16:13,906 (quiet, tense music) 391 00:16:13,907 --> 00:16:15,542 (electronic beeping) 392 00:16:17,077 --> 00:16:20,646 Systolic's down to 150. So far so good, Bonnie. 393 00:16:20,647 --> 00:16:22,147 You doing okay? 394 00:16:22,148 --> 00:16:25,151 - Feels weird, but I'm fine. - Okay. 395 00:16:26,186 --> 00:16:27,286 (electronic beeping) 396 00:16:27,287 --> 00:16:30,123 120s now... Almost there! 397 00:16:32,158 --> 00:16:33,426 (alarm beeping) 398 00:16:34,494 --> 00:16:35,561 (alarm beeping) 399 00:16:35,562 --> 00:16:37,497 - Uh, systolic's 190 and climbing? 400 00:16:38,064 --> 00:16:39,331 - It's all good. 401 00:16:39,332 --> 00:16:41,767 Increasing stimulation settings to compensate. 402 00:16:41,768 --> 00:16:43,269 (electronic beeping) 403 00:16:45,505 --> 00:16:46,405 (alarm beeping) 404 00:16:46,406 --> 00:16:47,807 (exhales) 405 00:16:49,342 --> 00:16:51,844 (breathing rapidly) - I'm feeling a bit... 406 00:16:51,845 --> 00:16:53,212 (alarms beeping) 407 00:16:53,213 --> 00:16:54,847 (louder alarms bleeping) 408 00:16:54,848 --> 00:16:56,582 (ominous music) - Uh-- 409 00:16:56,583 --> 00:16:58,083 - She's hypotensive, with a weak pulse. 410 00:16:58,084 --> 00:17:00,720 - She's losing consciousness. - Crash cart! Now! 411 00:17:01,221 --> 00:17:04,724 - Bonnie?! Bonnie! Can you hear me? Bonnie! 412 00:17:07,127 --> 00:17:08,861 (restaurant din) - I'm on my own 413 00:17:08,862 --> 00:17:10,229 for my birthday this go around. 414 00:17:10,230 --> 00:17:12,398 Actually, the first time in three decades. 415 00:17:12,399 --> 00:17:14,000 - Yeah? How are you gonna celebrate? 416 00:17:14,100 --> 00:17:15,501 - With this mess of a year? 417 00:17:15,502 --> 00:17:18,438 Drinking a whiskey and watching the Knicks. 418 00:17:18,805 --> 00:17:20,440 - That sounds heavenly. 419 00:17:20,540 --> 00:17:21,774 - Right? - Ben! 420 00:17:21,775 --> 00:17:23,142 Thought you were heading back last night? 421 00:17:23,143 --> 00:17:27,079 - Hey! Um, well, Dr. Larsen cornered me 422 00:17:27,080 --> 00:17:29,348 after my VATs talk and offered to lecture me 423 00:17:29,349 --> 00:17:31,850 on post-op pleural effusion management. 424 00:17:31,851 --> 00:17:33,720 Over lukewarm omelettes. 425 00:17:33,820 --> 00:17:35,387 - An offer he couldn't refuse. 426 00:17:35,388 --> 00:17:37,890 - Understandable. Your reputation precedes you. 427 00:17:37,891 --> 00:17:39,625 Elliot Norman. A pleasure. 428 00:17:39,626 --> 00:17:41,528 - Yeah, I feel like I know you from all of your 429 00:17:41,628 --> 00:17:43,862 acknowledgements in JAMA. - Angling for another one 430 00:17:43,863 --> 00:17:44,997 soon if Ben gets his way. 431 00:17:44,998 --> 00:17:46,865 - Eliot is the Chief Research Officer 432 00:17:46,866 --> 00:17:48,001 overseeing my bridge heart trial 433 00:17:48,101 --> 00:17:48,801 at St. Mark's. - Oh. 434 00:17:48,802 --> 00:17:50,269 - Love to get your read on it, 435 00:17:50,270 --> 00:17:52,272 if you're gonna be in New York any time soon. 436 00:17:52,372 --> 00:17:53,539 - I'm not a cardiologist. 437 00:17:53,540 --> 00:17:55,541 - No, but there are a dozen medical co-morbid factors 438 00:17:55,542 --> 00:17:56,942 that can complicate the trial. 439 00:17:56,943 --> 00:17:58,877 Gotta make sure he's not getting a home court advantage 440 00:17:58,878 --> 00:17:59,678 from our internists. 441 00:17:59,679 --> 00:18:01,781 - Hey, it's more than fine by me. 442 00:18:04,384 --> 00:18:07,754 - I'm actually passing through New York in a couple of weeks. 443 00:18:07,854 --> 00:18:09,288 I'd love to stop by. 444 00:18:09,289 --> 00:18:12,291 - Splendid. Ben can give you the details for my office. 445 00:18:12,292 --> 00:18:14,293 I'll make sure your hotel and flights are covered. 446 00:18:14,294 --> 00:18:16,396 - Good to see ya. - Thank you. 447 00:18:18,998 --> 00:18:20,300 - Couple of weeks? 448 00:18:20,400 --> 00:18:23,536 - Well, it seems like he really wants me there. 449 00:18:26,006 --> 00:18:27,439 (tense music) (equipment beeping) 450 00:18:27,440 --> 00:18:29,408 - So, she is in a medically induced coma 451 00:18:29,409 --> 00:18:30,676 for hypertensive crisis. 452 00:18:30,677 --> 00:18:32,579 - The increase in stimulation was minimal. 453 00:18:32,679 --> 00:18:34,913 There's no way it could've bottomed out her BP like this. 454 00:18:34,914 --> 00:18:36,148 - What's the MRI show? 455 00:18:36,149 --> 00:18:37,416 - There's no anoxic brain damage. 456 00:18:37,417 --> 00:18:38,917 I'm loading her on phenytoin. 457 00:18:38,918 --> 00:18:40,419 - And an EEG. 458 00:18:40,420 --> 00:18:42,054 I don't need her seizing on my table 459 00:18:42,055 --> 00:18:43,689 if you ever manage to get her there. 460 00:18:43,690 --> 00:18:46,458 - I'm sensing you had a stark difference of opinion 461 00:18:46,459 --> 00:18:47,760 about the correct course of action. 462 00:18:47,761 --> 00:18:49,328 - We did, yes. - Well, that should've been 463 00:18:49,329 --> 00:18:50,596 brought to me. - I'm assuming if that 464 00:18:50,597 --> 00:18:52,464 were the protocol, Dr. Larsen would've done so. 465 00:18:52,465 --> 00:18:53,832 - We sorted it out ourselves, 466 00:18:53,833 --> 00:18:57,202 and Dr. Grant agreed that my idea was lower risk. 467 00:18:57,203 --> 00:18:58,437 - And obviously I was wrong. 468 00:18:58,438 --> 00:19:00,607 - I just got off the phone with Eastside. 469 00:19:00,707 --> 00:19:02,342 I want her transferred there now. 470 00:19:02,442 --> 00:19:04,443 - That's not possible, Ms. Reinhold. 471 00:19:04,444 --> 00:19:05,878 She's in no condition to be moved. 472 00:19:05,879 --> 00:19:07,746 - There is a variable that we all missed. 473 00:19:07,747 --> 00:19:10,082 But as soon as I find it, we will address it 474 00:19:10,083 --> 00:19:11,450 before there are any more complications. 475 00:19:11,451 --> 00:19:13,085 You need to trust me. 476 00:19:13,086 --> 00:19:14,654 - I already made that mistake. 477 00:19:15,455 --> 00:19:16,889 - Labs just came back. 478 00:19:16,890 --> 00:19:19,725 BUN and creatinine are elevated, but TSH is normal. 479 00:19:19,726 --> 00:19:21,193 (Dr. Larsen): Okay, thank you, Ruth. 480 00:19:21,194 --> 00:19:22,628 - If Bonnie's going to stay here, 481 00:19:22,629 --> 00:19:24,196 I want you, the head of the department, 482 00:19:24,197 --> 00:19:26,498 taking charge. And maybe you can figure out 483 00:19:26,499 --> 00:19:29,369 what Dr. Larsen and this little intern did 484 00:19:29,469 --> 00:19:31,236 that has backfired so disastrously. 485 00:19:31,237 --> 00:19:33,639 - Now, outcomes can't always be predicted. 486 00:19:33,640 --> 00:19:36,375 And Bonnie was in terrible shape when she walked in our door. 487 00:19:36,376 --> 00:19:37,911 But we hear you. 488 00:19:38,011 --> 00:19:40,680 And I'll be running point on this from here on out. 489 00:19:41,481 --> 00:19:42,582 - If you'll excuse me, I'll have to explain 490 00:19:42,682 --> 00:19:46,385 to her family why they may never get to say goodbye to her. 491 00:19:46,386 --> 00:19:48,355 (footsteps retreat) 492 00:19:49,222 --> 00:19:50,556 - I'll be standing by 493 00:19:50,557 --> 00:19:52,726 if you can ever find your way back from this. 494 00:19:54,227 --> 00:19:55,394 - Dr. Chen. 495 00:19:55,395 --> 00:19:57,664 Trend BUN, creatinine and urine output, 496 00:19:57,764 --> 00:20:00,799 and, uh, try to let that slide off of you. 497 00:20:00,800 --> 00:20:02,668 - Yeah, I appreciate that. I'm fine. 498 00:20:02,669 --> 00:20:04,303 - I'm going to insert a central line 499 00:20:04,304 --> 00:20:06,538 so we can monitor her CVPs and fluid status. 500 00:20:06,539 --> 00:20:09,008 And get me your notes on those old cases. 501 00:20:09,009 --> 00:20:10,477 - Michael. 502 00:20:11,144 --> 00:20:13,245 I don't know yet what went wrong, 503 00:20:13,246 --> 00:20:15,482 but it was the right call. 504 00:20:21,521 --> 00:20:23,389 - So Dr. Swanson's not here? 505 00:20:23,390 --> 00:20:26,325 - He is, uh, tied up in another surgery at the moment. 506 00:20:26,326 --> 00:20:28,660 But listen, Dr. Humphrey is excellent, okay? 507 00:20:28,661 --> 00:20:30,295 We're lucky that he was on call. 508 00:20:30,296 --> 00:20:31,430 He reviewed your TEE, 509 00:20:31,431 --> 00:20:32,698 came up with an airtight game plan, okay? 510 00:20:32,699 --> 00:20:34,066 - I don't understand what went wrong 511 00:20:34,067 --> 00:20:35,401 in the first place. 512 00:20:35,402 --> 00:20:37,569 - We're still trying to get to the bottom of that. 513 00:20:37,570 --> 00:20:39,705 Okay, but listen, right now, the important thing 514 00:20:39,706 --> 00:20:41,807 is that we solve this problem once and for all, okay? 515 00:20:41,808 --> 00:20:45,277 - Thanks, Doc. I-I do appreciate it. 516 00:20:45,278 --> 00:20:47,380 - See you in post-op. 517 00:20:50,784 --> 00:20:52,185 (equipment beeping) 518 00:20:52,285 --> 00:20:54,653 Hey, Roger, you got a sec? 519 00:20:54,654 --> 00:20:56,455 - I got 60. 520 00:20:56,456 --> 00:20:58,190 - Listen, I wanted to give you a heads up 521 00:20:58,191 --> 00:21:00,192 that one of your patients was readmitted 522 00:21:00,193 --> 00:21:01,894 with an improperly seeded aortic valve. 523 00:21:01,895 --> 00:21:05,031 - Oh. Who was it? - Johnny Parsons. 524 00:21:05,565 --> 00:21:07,333 Aortic valve stenosis, 33, 525 00:21:07,334 --> 00:21:09,435 works construction, needed a SAVR? 526 00:21:09,436 --> 00:21:10,636 - I can't say I remember him, 527 00:21:10,637 --> 00:21:12,204 but, uh, I'm happy to get back in there 528 00:21:12,205 --> 00:21:13,605 and patch him up after this. 529 00:21:13,606 --> 00:21:16,208 - Yeah, he's already in surgery. Humphrey was on call. 530 00:21:16,209 --> 00:21:17,944 - And I'm just hearing about it now? 531 00:21:18,578 --> 00:21:20,479 - I would have had a duty to disclose 532 00:21:20,480 --> 00:21:22,215 your potential negligence before allowing you 533 00:21:22,315 --> 00:21:23,382 to operate on him again. 534 00:21:23,383 --> 00:21:24,950 So, this just felt more expedient. 535 00:21:24,951 --> 00:21:26,218 - Negligence? 536 00:21:26,219 --> 00:21:27,386 - I'm not talking about the valve. 537 00:21:27,387 --> 00:21:28,487 That could've happened to anybody. 538 00:21:28,488 --> 00:21:29,621 I'm referring to the post-op echo 539 00:21:29,622 --> 00:21:30,622 that I can't seem to find. 540 00:21:30,623 --> 00:21:31,890 That would've shown a gradient. 541 00:21:31,891 --> 00:21:33,359 You never would've discharged him. 542 00:21:33,360 --> 00:21:36,228 - Oh, so, you're a detective now? 543 00:21:36,229 --> 00:21:37,997 Or is it Internal Affairs? 544 00:21:39,499 --> 00:21:41,100 - Okay, well, I'm headed to radiology. 545 00:21:41,101 --> 00:21:42,702 Sure hoping they can find it. 546 00:21:43,703 --> 00:21:44,838 - Dr. Heller? 547 00:21:46,339 --> 00:21:48,140 Proper protocol would have been 548 00:21:48,141 --> 00:21:49,742 to go to the head of the department. 549 00:21:49,743 --> 00:21:52,378 Does Dr. Matos know you're running around like this? 550 00:21:52,379 --> 00:21:55,047 First-year fellow on second week on the job? 551 00:21:55,048 --> 00:21:57,249 - You know, I was giving you the benefit of the doubt. 552 00:21:57,250 --> 00:21:58,785 Now I'm not so sure it was earned. 553 00:21:58,885 --> 00:22:01,855 - Dr. Swanson. We're ready for you. 554 00:22:06,359 --> 00:22:08,394 - So, none of your other patients 555 00:22:08,395 --> 00:22:09,762 had a BP spike like Bonnie's, 556 00:22:09,763 --> 00:22:11,798 even though they were in the same hypertensive range? 557 00:22:11,898 --> 00:22:16,469 - No. Which makes her reaction all the more puzzling. 558 00:22:17,370 --> 00:22:19,873 - I'm not sure how you could've ever liked her. 559 00:22:20,707 --> 00:22:23,375 - She uses anger to cover her grief. 560 00:22:23,376 --> 00:22:25,545 And I know a bit about that. 561 00:22:25,645 --> 00:22:27,180 I'm sure you've heard. 562 00:22:27,914 --> 00:22:30,683 - Bonnie's EEG tracing continues to be within normal limits, 563 00:22:30,684 --> 00:22:33,419 but now her temperature's all over the place, too. 564 00:22:33,420 --> 00:22:35,155 She's been as high as 102. 565 00:22:36,056 --> 00:22:39,191 - Do the fluctuations track with her blood pressure spikes? 566 00:22:39,192 --> 00:22:41,628 (ominous music) 567 00:22:42,529 --> 00:22:43,897 - Almost to the second. 568 00:22:44,831 --> 00:22:47,700 - We've been treating the tumor like an adenocarcinoma, 569 00:22:47,701 --> 00:22:50,036 but what if there's more going on? 570 00:22:50,704 --> 00:22:52,071 - Divergent differentiation. 571 00:22:52,072 --> 00:22:54,573 - So the tumor consists of two different cell types, 572 00:22:54,574 --> 00:22:56,275 not just the one? - Exactly. 573 00:22:56,276 --> 00:22:57,710 So what kind of tumor cell 574 00:22:57,711 --> 00:22:59,578 could explain simultaneous spikes 575 00:22:59,579 --> 00:23:02,482 in both blood pressure and body temperature, Dr. Chen? 576 00:23:02,682 --> 00:23:04,684 - One secreting catecholamines. 577 00:23:04,851 --> 00:23:07,086 - Yeah. - Go get plasma metanephrines. 578 00:23:07,087 --> 00:23:08,153 - Yeah. 579 00:23:08,154 --> 00:23:09,322 - If you're right, 580 00:23:09,422 --> 00:23:11,524 delaying surgery saved her life. 581 00:23:17,097 --> 00:23:19,732 - Pharmacadia's device only lasts two years, 582 00:23:19,733 --> 00:23:22,001 and a quarter of the patients die waiting for transplants. 583 00:23:22,002 --> 00:23:24,770 This is gonna blow them out of the water. 584 00:23:24,771 --> 00:23:27,473 - In terms of long-term durability? 585 00:23:27,474 --> 00:23:28,241 - No, not just durability, 586 00:23:28,341 --> 00:23:30,876 this could be a permanent solution. 587 00:23:30,877 --> 00:23:32,479 - Oh, you're getting a little bit ahead of yourself. 588 00:23:32,579 --> 00:23:35,115 - Well, a man can dream. 589 00:23:36,449 --> 00:23:39,618 - So, uh, this is what the book's gonna be about? 590 00:23:39,619 --> 00:23:41,653 - Wha-- no, no, no, I'm not publishing on this yet. 591 00:23:41,654 --> 00:23:44,256 Uh, the book is about my father. 592 00:23:44,257 --> 00:23:46,926 And grandfather. Both surgeons. 593 00:23:47,494 --> 00:23:50,396 - That's quite the legacy. - Both giants. 594 00:23:50,397 --> 00:23:52,765 Dad still is. 595 00:23:52,766 --> 00:23:55,534 - Well, I'm sure this will make him very proud. 596 00:23:55,535 --> 00:23:58,004 - Well, he's a tough one, we'll see. 597 00:23:59,773 --> 00:24:02,508 - So what is it that Elliot wants me to look at? 598 00:24:02,509 --> 00:24:03,942 (ominous music) 599 00:24:03,943 --> 00:24:06,045 - A catecholamine-secreting tumor. 600 00:24:06,046 --> 00:24:08,414 - And Eastside had no reason to look for it 601 00:24:08,415 --> 00:24:09,682 after the initial biopsy. 602 00:24:09,683 --> 00:24:11,418 But clearly, the chemo 603 00:24:11,518 --> 00:24:13,185 is not what was causing her BP spikes. 604 00:24:13,186 --> 00:24:15,921 - And if I'd resected her tumor the way I planned, 605 00:24:15,922 --> 00:24:17,956 the hormone secretion into her bloodstream 606 00:24:17,957 --> 00:24:20,926 would've killed her. - In all likelihood, yes. 607 00:24:20,927 --> 00:24:23,163 - In all certainty, but I appreciate you 608 00:24:23,263 --> 00:24:25,030 not rubbing it in my face. 609 00:24:25,031 --> 00:24:26,433 - Not really my style. 610 00:24:26,533 --> 00:24:28,868 At least, not anymore. 611 00:24:30,003 --> 00:24:31,838 (knocking) 612 00:24:32,272 --> 00:24:33,339 - I gave Cece the update 613 00:24:33,340 --> 00:24:36,675 and told her we're deciding best course of action. 614 00:24:36,676 --> 00:24:38,811 Can you still operate? - Well, I was hoping to do 615 00:24:38,812 --> 00:24:40,814 a three-stage approach, but now I can't. 616 00:24:40,914 --> 00:24:42,414 I mean, I-I would need to remove 617 00:24:42,415 --> 00:24:43,682 the hormone-secreting tumor first, 618 00:24:43,683 --> 00:24:45,818 which is a whole different scale. 619 00:24:45,819 --> 00:24:48,555 - Didn't you do a paraganglioma resection last year? 620 00:24:49,089 --> 00:24:51,091 - You read that? - 20 minutes ago. 621 00:24:51,191 --> 00:24:53,425 - I can do an en bloc removal in my sleep, 622 00:24:53,426 --> 00:24:55,195 but her tumor's like an octopus now. 623 00:24:55,295 --> 00:24:56,296 And it's in her lung, 624 00:24:56,396 --> 00:24:57,696 not her bladder like in that surgery. 625 00:24:57,697 --> 00:24:59,965 - Plus, the catecholamine release. 626 00:24:59,966 --> 00:25:01,600 The second you touch it, she could stroke out. 627 00:25:01,601 --> 00:25:04,203 - And we're talking six, maybe eight hours 628 00:25:04,204 --> 00:25:05,571 poking around in there. 629 00:25:05,572 --> 00:25:07,973 - Phentolamine for any hypertensive surges, 630 00:25:07,974 --> 00:25:10,275 metyrosine to suppress the hormone production, 631 00:25:10,276 --> 00:25:14,080 and titrate minute to minute. It would be on me. 632 00:25:15,048 --> 00:25:16,348 - I'm game if you are. 633 00:25:16,349 --> 00:25:18,184 - It's up to him. 634 00:25:21,888 --> 00:25:23,123 - Once Johnny's out of surgery, 635 00:25:23,223 --> 00:25:25,991 do a post-op exam and present your findings to me. 636 00:25:25,992 --> 00:25:29,728 Till then, it's admission H&Ps in 617, 621-- 637 00:25:29,729 --> 00:25:31,463 (phone vibrating) 638 00:25:31,464 --> 00:25:32,499 Your husband? 639 00:25:32,599 --> 00:25:35,200 - I am so, so sorry. It's the sitter. 640 00:25:35,201 --> 00:25:36,135 My husband's out of town 641 00:25:36,136 --> 00:25:37,603 and our little guy isn't feeling well. 642 00:25:37,604 --> 00:25:40,840 (phone vibrating) - Oh, um, it's okay. Take it. 643 00:25:42,108 --> 00:25:43,742 - Hey, how's he doing? 644 00:25:43,743 --> 00:25:46,178 - So radiology doesn't have a post-op echo. 645 00:25:46,179 --> 00:25:48,514 Swanson never ordered one. - Unbelievable. 646 00:25:48,515 --> 00:25:51,350 - That patient of yours, awhile back, um, 647 00:25:51,351 --> 00:25:52,618 I think he was a delivery driver, 648 00:25:52,619 --> 00:25:54,788 what was his name, Abe? - Yeah. What about him? 649 00:25:54,888 --> 00:25:56,790 - Didn't you tell me that Joan had to step in 650 00:25:56,890 --> 00:25:59,491 because Swanson closed up mid-surgery or something 651 00:25:59,492 --> 00:26:01,226 to go on vacation? - Well, it wasn't quite 652 00:26:01,227 --> 00:26:02,895 that simple, but yeah. 653 00:26:02,896 --> 00:26:04,663 What, are you building a case? 654 00:26:04,664 --> 00:26:06,398 - Well, I checked into the timing 655 00:26:06,399 --> 00:26:07,900 of Johnny's surgery last year. 656 00:26:07,901 --> 00:26:09,168 It was Friday night at seven. 657 00:26:09,169 --> 00:26:11,036 So, you and I both know the echo team 658 00:26:11,037 --> 00:26:13,405 would've been gone by then, so Swanson would've had to call 659 00:26:13,406 --> 00:26:15,174 someone in, wait around for hours. 660 00:26:15,175 --> 00:26:17,242 - So you think he never ordered an echo 661 00:26:17,243 --> 00:26:18,510 because it was inconvenient? 662 00:26:18,511 --> 00:26:19,912 - I don't know. Could be. 663 00:26:19,913 --> 00:26:21,647 But can you get me the records on that case? 664 00:26:21,648 --> 00:26:23,248 - I can. - Okay. 665 00:26:23,249 --> 00:26:24,783 - But you should tread lightly. 666 00:26:24,784 --> 00:26:26,919 You're already on probation with Matos. 667 00:26:26,920 --> 00:26:29,155 - Email it to me, okay? - M-kay. 668 00:26:31,691 --> 00:26:33,293 - Sorry to keep you waiting. 669 00:26:35,095 --> 00:26:38,298 The results are showing a more complicated picture 670 00:26:38,398 --> 00:26:39,365 than we had hoped. 671 00:26:39,366 --> 00:26:42,134 But, ultimately, there's a path forward here. 672 00:26:42,135 --> 00:26:43,703 - Okay. 673 00:26:44,237 --> 00:26:46,205 - So, Wendy, I know this will be disappointing, 674 00:26:46,206 --> 00:26:49,843 but your ovarian reserve has become very low. 675 00:26:50,810 --> 00:26:53,413 With Gina, however, there's good news. 676 00:26:54,047 --> 00:26:56,750 Your eggs appear to still be viable. 677 00:26:57,684 --> 00:26:59,585 - Really? - Well, as I said, 678 00:26:59,586 --> 00:27:01,488 you're an individual, not a statistic. 679 00:27:01,588 --> 00:27:04,556 And we can get started with treatments as soon as tomorrow. 680 00:27:04,557 --> 00:27:06,158 Which I would recommend. 681 00:27:06,159 --> 00:27:07,826 (melancholy music) 682 00:27:07,827 --> 00:27:10,162 (exhaling softly): You... 683 00:27:10,163 --> 00:27:11,931 You made me wait. 684 00:27:13,333 --> 00:27:14,901 - Wendy. 685 00:27:15,735 --> 00:27:16,802 - You made me wait, 686 00:27:16,803 --> 00:27:19,773 and now you get to have everything that I wanted. 687 00:27:20,707 --> 00:27:23,443 - This is something we're gonna do together. 688 00:27:26,346 --> 00:27:28,682 - Sorry, I just need a minute. 689 00:27:35,989 --> 00:27:37,990 - Check his electrolytes every 12 hours, 690 00:27:37,991 --> 00:27:40,759 and keep an eye on his sats. - On it. 691 00:27:40,760 --> 00:27:43,262 Hey, thanks for being so understanding today, 692 00:27:43,263 --> 00:27:45,330 Dr. Maitra. I know I need to leave 693 00:27:45,331 --> 00:27:46,432 my personal life at home. 694 00:27:46,433 --> 00:27:49,134 - Well, you have a kid. Some things can't wait. 695 00:27:49,135 --> 00:27:52,137 - Uh, no, I don't have a kid, that was about my dog. 696 00:27:52,138 --> 00:27:54,174 I mean, he's a puppy, and we're training, 697 00:27:54,274 --> 00:27:57,210 so it's a lot right now. - Uh, excuse me? 698 00:27:57,310 --> 00:27:58,912 - He's my Wheaten terrier! 699 00:27:59,012 --> 00:28:00,412 (laughing) Oh God, a kid, 700 00:28:00,413 --> 00:28:03,048 could you imagine? - Uh, lots of doctors have kids. 701 00:28:03,049 --> 00:28:05,584 - Well, I would never. I mean, climate change alone. 702 00:28:05,585 --> 00:28:08,153 - Okay, that is the most cynical thing I've ever heard. 703 00:28:08,154 --> 00:28:10,222 You just wanna give up on humanity? 704 00:28:10,223 --> 00:28:11,758 - It's just an opinion. 705 00:28:11,858 --> 00:28:13,193 Kind of thought we were all entitled to one. 706 00:28:13,293 --> 00:28:16,496 - Just get back to work, Claire. And no more calls. 707 00:28:20,233 --> 00:28:22,369 (equipment beeping) 708 00:28:26,039 --> 00:28:27,940 (water rushing) - Oh, um, 709 00:28:27,941 --> 00:28:29,908 the nurses said you might have a second to talk, 710 00:28:29,909 --> 00:28:31,443 but it's a little delicate, so I'll come back later. 711 00:28:31,444 --> 00:28:33,079 - No, no, no, you're looking at the closest thing 712 00:28:33,179 --> 00:28:35,982 I have to free time today. So, shoot. 713 00:28:36,649 --> 00:28:39,252 - We need to talk about Swanson. 714 00:28:44,057 --> 00:28:46,226 - Tell me about your book. - Mm. 715 00:28:46,993 --> 00:28:48,193 Well... 716 00:28:48,194 --> 00:28:50,329 My grandfather studied at Howard. 717 00:28:50,330 --> 00:28:52,698 Under the great Daniel Hale Williams. 718 00:28:52,699 --> 00:28:54,534 - No! - Yeah, and by the time 719 00:28:54,634 --> 00:28:56,068 my father came around, 720 00:28:56,069 --> 00:28:58,937 living under the shadow of a man who studied with the pioneer 721 00:28:58,938 --> 00:29:01,240 of open-heart surgery, it just... 722 00:29:01,241 --> 00:29:03,208 He really had no choice of what he was gonna do. 723 00:29:03,209 --> 00:29:06,412 - And then, the third generation just, what, had 724 00:29:06,413 --> 00:29:07,946 to follow in their footsteps? 725 00:29:07,947 --> 00:29:09,081 - Well, if they had been cobblers, 726 00:29:09,082 --> 00:29:10,683 would I be mending soles? 727 00:29:10,684 --> 00:29:12,551 Probably not. (chuckling) 728 00:29:12,552 --> 00:29:13,987 No, what they did was inspiring. 729 00:29:14,087 --> 00:29:16,455 - I'm the first generation in my family 730 00:29:16,456 --> 00:29:18,457 to even go to college, so... 731 00:29:18,458 --> 00:29:20,460 It's all upside for me. 732 00:29:21,094 --> 00:29:23,228 - Thank you for taking time today 733 00:29:23,229 --> 00:29:25,432 to come see what I've been doing. 734 00:29:26,833 --> 00:29:28,301 (alarm beeps) 735 00:29:28,401 --> 00:29:30,436 - Heart rate's spiking. 736 00:29:30,437 --> 00:29:32,304 Pushing esmolol. 737 00:29:32,305 --> 00:29:33,473 (tense music) 738 00:29:33,573 --> 00:29:34,541 (alarm beeps) 739 00:29:36,509 --> 00:29:39,378 - You see that translucent area under my probe, Dr. Coleman? 740 00:29:39,379 --> 00:29:41,013 - Looks more like a cyst than a tumor. 741 00:29:41,014 --> 00:29:42,247 - That's a bag of adrenaline. 742 00:29:42,248 --> 00:29:43,849 If we squeeze it or if we rupture it-- 743 00:29:43,850 --> 00:29:46,318 - Things get very interesting for me. 744 00:29:46,319 --> 00:29:47,386 Her BP's stable. 745 00:29:47,387 --> 00:29:49,389 I'd appreciate you keeping it that way. 746 00:29:49,489 --> 00:29:52,559 - All right. Retract very gently on your side. 747 00:29:58,898 --> 00:30:00,332 (alarm beeps) 748 00:30:00,333 --> 00:30:01,935 Easy, easy. 749 00:30:03,436 --> 00:30:04,938 (alarm stops) 750 00:30:06,606 --> 00:30:08,108 (tense music) 751 00:30:09,709 --> 00:30:11,044 It's matted to the Pancoast tumor. 752 00:30:11,144 --> 00:30:13,045 Can you give me more blood pressure control, Dr. Larsen? 753 00:30:13,046 --> 00:30:15,248 We'll be getting aggressive. - Nicardipine. 754 00:30:15,348 --> 00:30:17,217 Fine-tuned as we go. 755 00:30:17,617 --> 00:30:20,053 - Smart. - I try. 756 00:30:20,153 --> 00:30:22,322 - Okay, we need to time this perfectly. 757 00:30:22,422 --> 00:30:24,890 You retract very slowly on your side, 758 00:30:24,891 --> 00:30:27,227 and I'll release the last adherent part. 759 00:30:28,628 --> 00:30:30,096 Let's pull this monster out. 760 00:30:32,465 --> 00:30:34,501 (tense music continues) 761 00:30:35,635 --> 00:30:37,370 (alarm sounds) 762 00:30:41,641 --> 00:30:43,376 (alarm stops) 763 00:30:44,010 --> 00:30:46,246 Okay. Here we go. 764 00:30:57,290 --> 00:30:58,190 (alarm sounds) 765 00:30:58,191 --> 00:31:00,092 - Pressure crashing. Pushing nor-epi. 766 00:31:00,093 --> 00:31:01,927 (items clattering) 767 00:31:01,928 --> 00:31:04,397 (beeping continues) 768 00:31:09,936 --> 00:31:11,171 (Amy): Come on. 769 00:31:13,406 --> 00:31:14,440 (alarm ends) 770 00:31:14,441 --> 00:31:16,142 (exhaling deeply) 771 00:31:17,777 --> 00:31:19,145 - Stuck the landing. 772 00:31:20,113 --> 00:31:22,682 Alright. Let's put her back together. 773 00:31:24,784 --> 00:31:26,352 (exhaling) 774 00:31:26,353 --> 00:31:27,954 - So everything went great. (hospital din) 775 00:31:28,054 --> 00:31:30,557 - I have heard that one before. - Yeah, I know. 776 00:31:31,391 --> 00:31:33,259 Julie, you mind giving us the room? 777 00:31:39,065 --> 00:31:42,001 Look, man, I know today's been a terrible day, 778 00:31:42,002 --> 00:31:43,569 and you have every right to be upset, 779 00:31:43,570 --> 00:31:45,270 but the good news is we know 780 00:31:45,271 --> 00:31:46,839 you don't have something that's gonna put you 781 00:31:46,840 --> 00:31:48,374 back in the hospital a year from now. 782 00:31:48,375 --> 00:31:50,443 - And how can you be sure of that? 783 00:31:51,077 --> 00:31:53,579 - Because the problem was surgeon error. 784 00:31:53,580 --> 00:31:55,280 (melancholy music) 785 00:31:55,281 --> 00:31:59,252 The valve that Swanson put in was placed incorrectly. 786 00:31:59,352 --> 00:32:01,887 Now, they should've caught that with the post-op study, 787 00:32:01,888 --> 00:32:02,921 but he never ordered one. 788 00:32:02,922 --> 00:32:05,191 That's why you went into heart failure again. 789 00:32:05,725 --> 00:32:07,526 - What, was he, um... 790 00:32:07,527 --> 00:32:09,262 supposed to order one? I mean, normally, 791 00:32:09,362 --> 00:32:12,164 the surgeon would do that? - Yes. That is protocol. 792 00:32:12,165 --> 00:32:14,767 - So that's malpractice I could sue, right? 793 00:32:14,768 --> 00:32:16,769 - You can. And between you and me, 794 00:32:16,770 --> 00:32:18,170 I'd be rooting for you. 795 00:32:18,171 --> 00:32:19,538 - But do I have a case? 796 00:32:19,539 --> 00:32:21,440 - I-I don't know, Johnny, I'm not a lawyer. 797 00:32:21,441 --> 00:32:23,643 - Then talk to me like a human being. 798 00:32:25,445 --> 00:32:27,746 - All I can tell you is that if I'm deposed, 799 00:32:27,747 --> 00:32:29,048 I will tell the truth. 800 00:32:29,049 --> 00:32:31,884 - You're saying he almost killed me. 801 00:32:31,885 --> 00:32:33,018 (breathing shakily) 802 00:32:33,019 --> 00:32:35,154 So why isn't this a slam dunk? 803 00:32:35,155 --> 00:32:38,157 - The thing is, you did skip your follow-up visits. 804 00:32:38,158 --> 00:32:41,361 And that delayed the diagnosis. 805 00:32:41,761 --> 00:32:43,196 - So this is on me? 806 00:32:43,296 --> 00:32:45,164 - That's what the hospital's going to argue, yeah. 807 00:32:45,165 --> 00:32:47,433 - So he's gonna get away with this. 808 00:32:47,434 --> 00:32:49,301 And be able to do it to other people. 809 00:32:49,302 --> 00:32:51,470 - I've already talked to the Chief of Surgery. 810 00:32:51,471 --> 00:32:54,506 I'm hopeful that he can have more eyes on him from now on. 811 00:32:54,507 --> 00:32:55,742 (scoffs) 812 00:32:56,309 --> 00:32:58,345 - And that's supposed to be enough. 813 00:33:01,314 --> 00:33:03,049 - Tell me about Johnny Parsons. 814 00:33:03,149 --> 00:33:04,249 - Dr. Heller came to you. 815 00:33:04,250 --> 00:33:07,052 - Radiology says you never ordered a post-op echo. 816 00:33:07,053 --> 00:33:08,954 Is that true? 817 00:33:08,955 --> 00:33:11,323 - Look, I checked the date, 818 00:33:11,324 --> 00:33:14,827 and, uh, my wife had an event that night, so I had-- 819 00:33:14,828 --> 00:33:16,562 - That's the wrong answer, Roger. 820 00:33:16,563 --> 00:33:18,230 - I get it. 821 00:33:18,231 --> 00:33:19,698 I intended to do it in the morning, 822 00:33:19,699 --> 00:33:21,967 but I must've gotten slammed. 823 00:33:21,968 --> 00:33:23,669 It won't happen again. 824 00:33:23,670 --> 00:33:25,571 - Are you sure about that? 825 00:33:25,572 --> 00:33:26,973 - Excuse me? 826 00:33:27,073 --> 00:33:29,074 - Two months ago, a hotshot attorney 827 00:33:29,075 --> 00:33:30,642 needs a heart procedure. 828 00:33:30,643 --> 00:33:34,480 And you come in on a Saturday and stay until midnight. 829 00:33:34,481 --> 00:33:36,382 A real estate mogul week before, well, 830 00:33:36,383 --> 00:33:40,486 he gets a whole buffet of post-op tests and VIP treatment. 831 00:33:40,487 --> 00:33:43,222 But a delivery driver comes in a couple months back, 832 00:33:43,223 --> 00:33:46,092 and you left him to catch a flight to the Bahamas. 833 00:33:46,192 --> 00:33:47,760 - There were complications in that situation-- 834 00:33:47,761 --> 00:33:49,395 - Which you were uninterested in resolving 835 00:33:49,396 --> 00:33:50,996 because of your vacation. 836 00:33:50,997 --> 00:33:52,731 - You're cherry-picking a couple cases 837 00:33:52,732 --> 00:33:54,099 out of a 23-year career. 838 00:33:54,100 --> 00:33:55,367 - In my experience, 839 00:33:55,368 --> 00:33:57,270 where there's smoke, there's fire. 840 00:33:57,370 --> 00:33:59,973 And I don't like the way this smells, Roger. 841 00:34:00,373 --> 00:34:02,541 - Yeah, okay, so... What is this? 842 00:34:02,542 --> 00:34:05,377 Suspension? Because I'm not taking a demotion. 843 00:34:05,378 --> 00:34:07,847 - There's no need. You're fired. 844 00:34:09,783 --> 00:34:12,719 Four months' severance. Leave your badge in your locker. 845 00:34:15,121 --> 00:34:18,224 (tense music builds) 846 00:34:23,129 --> 00:34:25,365 (indistinct chatter) (phone vibrating) 847 00:34:26,399 --> 00:34:29,268 Ah, excuse me. Hey, there. 848 00:34:29,269 --> 00:34:31,871 Good timing, I just confirmed the hotel in Philly. 849 00:34:31,971 --> 00:34:33,806 - Ben, I'm reviewing some of your data. 850 00:34:33,807 --> 00:34:36,442 I don't love the trends in some of these bicarbs. 851 00:34:36,443 --> 00:34:39,311 And serum creatinine levels are elevated. 852 00:34:39,312 --> 00:34:42,014 I think you've got a big problem here. 853 00:34:42,015 --> 00:34:43,583 - I get that, but they... 854 00:34:43,683 --> 00:34:45,017 they'll self-resolve in two weeks, 855 00:34:45,018 --> 00:34:47,887 so... I'll send you the kidney numbers on the Phase One trials 856 00:34:47,987 --> 00:34:50,756 and you'll see. 857 00:34:50,757 --> 00:34:52,425 (equipment beeping) 858 00:34:52,525 --> 00:34:55,061 - You did the right thing, bringing her here. 859 00:34:55,161 --> 00:34:57,029 And trusting Dr. Grant. 860 00:34:57,030 --> 00:34:58,498 - And you. 861 00:34:59,299 --> 00:35:02,769 I should've known you'd find what was overlooked. 862 00:35:03,737 --> 00:35:05,304 I lost Bonnie once, 863 00:35:05,305 --> 00:35:08,807 and I was scared of it happening again. 864 00:35:08,808 --> 00:35:11,176 - Well, I appreciate that. 865 00:35:11,177 --> 00:35:13,013 But I get it. 866 00:35:13,446 --> 00:35:16,048 - What happened to you? In your accident-- 867 00:35:16,049 --> 00:35:17,617 the neurological issues. 868 00:35:17,717 --> 00:35:20,019 - I lost eight years of my memory. 869 00:35:20,020 --> 00:35:23,589 When you came in here last year, I didn't even know who you were. 870 00:35:23,590 --> 00:35:26,192 - So it's all been an act, even today? 871 00:35:26,292 --> 00:35:28,727 - No, I'm all caught up on the medicine. 872 00:35:28,728 --> 00:35:32,331 The memory doesn't affect how I do my job. 873 00:35:32,332 --> 00:35:34,199 - You sure about that? 874 00:35:34,200 --> 00:35:36,835 - Well, how did I do today? 875 00:35:36,836 --> 00:35:38,638 And the last time you were here? 876 00:35:39,472 --> 00:35:41,073 - Brilliance is brilliance, I suppose. 877 00:35:41,074 --> 00:35:42,374 (chuckling) 878 00:35:42,375 --> 00:35:44,610 But you should've told me before. 879 00:35:44,611 --> 00:35:48,214 - I like to think it's my business. 880 00:35:48,314 --> 00:35:50,849 If I told every patient who came through that door 881 00:35:50,850 --> 00:35:52,084 what I've been struggling with, 882 00:35:52,085 --> 00:35:53,820 do you think they'd let me treat them? 883 00:35:56,356 --> 00:35:59,358 I'm not giving up this gift I have. 884 00:35:59,359 --> 00:36:02,696 What I can do with it for others. 885 00:36:03,263 --> 00:36:05,965 - Well, I know what it's like to be forsaken. 886 00:36:07,000 --> 00:36:09,702 This will stay between us. 887 00:36:09,703 --> 00:36:13,440 (tender music) 888 00:36:14,808 --> 00:36:16,676 (hospital din) 889 00:36:19,879 --> 00:36:21,380 - I hope Cece said thank you. 890 00:36:21,381 --> 00:36:24,049 - She did. And she apologized. 891 00:36:24,050 --> 00:36:27,153 And I explained to her why I ran that charade on her 892 00:36:27,253 --> 00:36:28,387 a few months ago. 893 00:36:28,388 --> 00:36:30,389 - So you two are okay now? 894 00:36:30,390 --> 00:36:32,325 - We were okay then. 895 00:36:33,760 --> 00:36:35,260 Conflict can be healthy. 896 00:36:35,261 --> 00:36:37,897 Even sometimes when it looks unhealthy. 897 00:36:37,997 --> 00:36:41,501 - So, what? Embrace the mess? 898 00:36:43,003 --> 00:36:44,637 - I think you're learning. 899 00:36:57,851 --> 00:36:59,519 (sighing) 900 00:37:06,760 --> 00:37:08,894 - I'm sorry... 901 00:37:08,895 --> 00:37:10,630 that I made us wait. 902 00:37:11,831 --> 00:37:15,468 - I'd accepted my life, and you dropped a bomb. 903 00:37:15,568 --> 00:37:19,339 - And I can only imagine how much that must hurt. 904 00:37:20,073 --> 00:37:22,042 But I asked Dr. Shaw. 905 00:37:23,076 --> 00:37:24,943 You can carry the baby. 906 00:37:24,944 --> 00:37:27,446 (uplifting music) 907 00:37:27,447 --> 00:37:28,881 The child will be ours, 908 00:37:28,882 --> 00:37:33,620 we will do it together, and it will be incredible. 909 00:37:34,788 --> 00:37:36,222 (exhales) 910 00:37:36,322 --> 00:37:40,760 - It's just not the vision that I had this morning. 911 00:37:41,728 --> 00:37:44,463 - It's okay if you want to be mad at me. 912 00:37:44,464 --> 00:37:46,800 I can take it. 913 00:37:48,601 --> 00:37:52,305 - I don't want to be mad at you. 914 00:38:00,080 --> 00:38:02,949 (hospital din) 915 00:38:05,085 --> 00:38:06,485 - How you doing? 916 00:38:06,486 --> 00:38:08,788 - Long shift. How's Ruth doing? 917 00:38:08,888 --> 00:38:11,990 - Uh, learning by osmosis, I hope. 918 00:38:11,991 --> 00:38:13,492 (chuckles) 919 00:38:13,493 --> 00:38:15,928 Claire told me that you snapped at her. 920 00:38:15,929 --> 00:38:19,498 - Well, there's a role reversal, huh? 921 00:38:19,499 --> 00:38:23,370 Hmm. - So, you're still freaking out. 922 00:38:23,470 --> 00:38:25,971 - I think so, yeah. 923 00:38:25,972 --> 00:38:27,406 - About which part? 924 00:38:27,407 --> 00:38:29,542 - Well, pretty soon, I'm gonna be waddling around, 925 00:38:29,642 --> 00:38:31,944 trying to train these people, with all the street cred 926 00:38:31,945 --> 00:38:33,679 of someone about to go on maternity leave. 927 00:38:33,680 --> 00:38:37,017 - Oh. That can be handled, Sonya. Come on. 928 00:38:38,852 --> 00:38:40,720 - I know, I... 929 00:38:43,857 --> 00:38:45,524 - It's TJ. 930 00:38:45,525 --> 00:38:47,827 - We've been together for four months. 931 00:38:47,927 --> 00:38:50,296 Do you think this is what he signed up for? 932 00:38:50,397 --> 00:38:52,531 - He won't run from his responsibilities. 933 00:38:52,532 --> 00:38:54,800 - No, of course not. He's TJ. 934 00:38:54,801 --> 00:38:56,835 He'll say all the right things, 935 00:38:56,836 --> 00:38:59,472 he'll do what needs to be done, but... 936 00:39:00,540 --> 00:39:02,308 From this point on, I'll never know 937 00:39:02,409 --> 00:39:04,543 if that's what he really wants. 938 00:39:04,544 --> 00:39:06,980 Or if it's what I really want. 939 00:39:08,281 --> 00:39:10,050 - Do you love him? 940 00:39:11,685 --> 00:39:14,154 - I think we were on our way, 941 00:39:14,821 --> 00:39:18,557 but now we'll never get a clean shot to figure it out. 942 00:39:18,558 --> 00:39:22,728 And I don't want him to be with me out of obligation. 943 00:39:22,729 --> 00:39:23,962 - You know, look, you're right. 944 00:39:23,963 --> 00:39:25,864 He will say and do all the right things. 945 00:39:25,865 --> 00:39:28,134 But if you obsess about whether or not 946 00:39:28,234 --> 00:39:31,171 you're both forcing it, the relationship will be doomed. 947 00:39:31,271 --> 00:39:33,807 - I know that, trust me. I do. 948 00:39:35,709 --> 00:39:39,612 - Love is a risk. Always. 949 00:39:39,713 --> 00:39:43,083 And you can't control what life is gonna throw at you. 950 00:39:43,183 --> 00:39:46,519 All you can do is lean in. 951 00:39:47,754 --> 00:39:50,589 (soft music) 952 00:39:50,590 --> 00:39:53,726 - I hear you caused quite the ruckus in surgery today. 953 00:39:53,727 --> 00:39:57,463 And gave our general council a liability scare. 954 00:39:57,464 --> 00:39:59,632 - I was just advocating for my patient. 955 00:39:59,733 --> 00:40:00,900 - And why wasn't I looped in? 956 00:40:01,001 --> 00:40:02,635 - I wanted to come to you with a solution 957 00:40:02,736 --> 00:40:04,738 rather than a problem. - You didn't come to me at all. 958 00:40:04,838 --> 00:40:07,139 I had to hear about it from Ben Grant. 959 00:40:07,140 --> 00:40:09,775 - I wanted to avoid putting you into a difficult situation. 960 00:40:09,776 --> 00:40:11,877 I know you and Swanson have a long-standing relationship. 961 00:40:11,878 --> 00:40:13,779 - So now you're suggesting that I wouldn't have 962 00:40:13,780 --> 00:40:16,015 handled it objectively. - No. No, that's not what-- 963 00:40:16,016 --> 00:40:18,484 - Not for nothing, but I thought that Swanson 964 00:40:18,485 --> 00:40:21,487 was a tool 20 years ago. I think he's a tool now. 965 00:40:21,488 --> 00:40:23,756 But he is a reasonably good doctor, 966 00:40:23,757 --> 00:40:25,891 and what you did today got him fired. 967 00:40:25,892 --> 00:40:27,660 - I think I can live with that. 968 00:40:27,761 --> 00:40:29,763 - I'm glad your conscience feels clear. 969 00:40:29,863 --> 00:40:32,531 Dr. Grant can make whatever decision he wants 970 00:40:32,532 --> 00:40:34,533 in his department. But he should've made it 971 00:40:34,534 --> 00:40:38,405 after talking to me, not to you. That's the protocol. 972 00:40:38,505 --> 00:40:41,408 - Understood. Won't happen again. 973 00:40:42,075 --> 00:40:45,044 - I suppose you're learning how things work 974 00:40:45,045 --> 00:40:47,513 when you don't have special privileges. 975 00:40:47,514 --> 00:40:48,948 - Excuse me? - Well, I get the sense 976 00:40:49,049 --> 00:40:51,917 you had a very wide berth with Dr. Larsen. 977 00:40:51,918 --> 00:40:54,521 Because of your romantic relationship. 978 00:40:54,621 --> 00:40:56,690 - So that's what this is about. 979 00:40:56,790 --> 00:40:58,525 - It's a question of character, Dr. Heller. 980 00:40:58,625 --> 00:41:00,427 Character informs judgment. 981 00:41:00,527 --> 00:41:04,263 And from what I've seen, yours is severely lacking. 982 00:41:04,264 --> 00:41:06,566 Across the board. 983 00:41:08,001 --> 00:41:09,602 (door opens) 984 00:41:12,005 --> 00:41:13,039 (door closes) 985 00:41:13,540 --> 00:41:15,174 - There you are. 986 00:41:15,175 --> 00:41:16,710 Hey, we really can't be late. 987 00:41:16,810 --> 00:41:20,012 It took me forever to get us reservations to this restaurant. 988 00:41:20,013 --> 00:41:21,147 - I'm pregnant. 989 00:41:23,550 --> 00:41:26,252 About seven weeks. (shaky sigh) 990 00:41:26,920 --> 00:41:28,521 - Okay. 991 00:41:30,056 --> 00:41:31,624 Wow. 992 00:41:32,158 --> 00:41:35,561 Wow. That is... 993 00:41:35,562 --> 00:41:37,997 - I only found out yesterday. 994 00:41:38,932 --> 00:41:41,967 - And you... already did the ultrasound? 995 00:41:41,968 --> 00:41:44,871 - Yeah, this morning. (exhales deeply) 996 00:41:47,874 --> 00:41:50,576 I'm keeping it, TJ. - Right, right. 997 00:41:50,577 --> 00:41:53,480 Right, for sure. We can handle it. 998 00:41:53,580 --> 00:41:54,980 - You don't have to say that. 999 00:41:54,981 --> 00:41:56,582 Whatever you're thinking, if you're freaking out, 1000 00:41:56,583 --> 00:41:59,318 it's fine-- - I'm not. I'm-I'm not. 1001 00:41:59,319 --> 00:42:00,719 Okay? 1002 00:42:00,720 --> 00:42:03,189 This is beautiful. 1003 00:42:04,324 --> 00:42:06,859 I'm gonna take care of you. 1004 00:42:06,860 --> 00:42:09,929 No matter what. You don't have to worry. 1005 00:42:10,630 --> 00:42:12,565 (tender music) 1006 00:42:14,167 --> 00:42:15,601 - 'Kay, I won't. 1007 00:42:15,602 --> 00:42:18,604 (laughing) 1008 00:42:18,605 --> 00:42:20,340 (sniffling) 1009 00:42:21,741 --> 00:42:23,677 - We can do this. 1010 00:42:24,210 --> 00:42:25,345 (exhales) 1011 00:42:27,347 --> 00:42:28,814 (hospital din) 1012 00:42:28,815 --> 00:42:30,082 - Hey. 1013 00:42:30,083 --> 00:42:31,750 - Hey! 1014 00:42:31,751 --> 00:42:33,353 Bonnie's doing well. 1015 00:42:33,453 --> 00:42:34,888 I hope we got it all. 1016 00:42:34,988 --> 00:42:37,524 - I'm sorry to start the day going toe to toe like that, 1017 00:42:37,624 --> 00:42:39,358 and for not giving you the benefit of the doubt 1018 00:42:39,359 --> 00:42:41,660 when things went wrong. 1019 00:42:41,661 --> 00:42:43,395 - I think maybe we're both used to being 1020 00:42:43,396 --> 00:42:44,897 the smartest person in the room. 1021 00:42:44,898 --> 00:42:47,199 - Oh, for sure. (chuckling) 1022 00:42:47,200 --> 00:42:49,536 Anyway, you'll have a couple days with me out of your hair. 1023 00:42:49,636 --> 00:42:51,070 I'm headed to New York tomorrow 1024 00:42:51,071 --> 00:42:52,805 to check in on my clinical trial. 1025 00:42:52,806 --> 00:42:54,673 - I heard it's being transferred here. 1026 00:42:54,674 --> 00:42:56,910 - Yeah. That's what I'm organizing now. 1027 00:42:57,010 --> 00:43:00,013 - Is that the trial that I consulted on? 1028 00:43:00,113 --> 00:43:00,914 - It is. 1029 00:43:01,047 --> 00:43:04,016 And happy to have you wander down to us 1030 00:43:04,017 --> 00:43:05,518 whenever we get it up and running. 1031 00:43:06,052 --> 00:43:08,988 - I don't love the trends in some of these bicarbs. 1032 00:43:10,390 --> 00:43:11,958 Look forward to it. 1033 00:43:12,959 --> 00:43:13,993 - Good. 1034 00:43:16,529 --> 00:43:19,399 (unsettling music) 1035 00:43:45,658 --> 00:43:49,029 Subtitling: difuze