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Patients who undergo an amputation
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00:00:09,553 --> 00:00:12,912
often feel sensation
where the missing limb was...
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As if it's still there.
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The syndrome is called "Phantom limb."
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Hey, what do we got?
6
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Plane crash. Open fracture
of the left femur.
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Signs of massive infection.
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It's as if the body can't accept
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that a terrible trauma has occurred.
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The mind is trying to make
the body complete again.
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Patients who experience phantom limb...
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What? What's wrong?
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Nothing.
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Is it hurting again?
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No, I'm fine. I'm fine. Go back to sleep.
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Okay.
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Report many different sensations.
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But by far, the most common...
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is pain.
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Uh, an acoustic neuroma?
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- Oh, boy.
- A long, difficult surgery
22
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With a stupid-high post-excision
mortality/morbidity?
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That's what you want
to start my hand with?
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It's my hand.
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And thanks for making it sound so fun.
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You can't try something with
a little margin for error?
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I was supposed to operate
on Jimmy months ago,
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but then the plane crashed.
It has to be today.
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Well, if you can do this,
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I guess my hand can do anything.
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Still my hand.
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Okay, folks. Let's just start.
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As many of you know,
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Seattle Grace Mercy West has suffered
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a financial setback.
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00:01:57,189 --> 00:01:58,975
The administration is working hard
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00:01:58,976 --> 00:02:01,224
to keep the impact of that
setback as small as possible.
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00:02:01,225 --> 00:02:01,928
To that end,
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00:02:01,929 --> 00:02:04,787
we're gonna have to initiate
some cost-cutting measures.
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The board has hired
a physician advisor to help.
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00:02:08,664 --> 00:02:09,954
What's a physician advisor?
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00:02:09,955 --> 00:02:12,009
Well, she consults on
maximizing efficiency,
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streamlining processes,
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assessing where we can trim our budgets.
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Who to fire and when to fire them?
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She's here to advise and to help.
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I was hoping to introduce her in person,
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but she seems to be late.
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Oh, on her first day?
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Not very efficient.
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You can expect to see her in the halls,
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in your labs, in the O.R.
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So we're gonna have an accountant
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following us around the O.R.s?
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She's not an accountant.
She is a trained surgeon.
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- Frankly, she is here to try to help us.
- Oh, okay. Help us. Right.
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Thank you for your cooperation.
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Hey. Can I get a minute?
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It's urgent.
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Yeah.
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00:02:46,616 --> 00:02:47,860
This was urgent?
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00:02:48,054 --> 00:02:50,107
Yes. It's the stupid pregnancy hormones.
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It makes me want to have
sex all the time, urgently.
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Oh, I like the stupid hormones.
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- Oh, no.
- What?
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- Oh, I have a consult.
- What?
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I have a consult.
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Are you crying?
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No.
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Yes.
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I cry every time I get mad.
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You're not... you're mad?
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00:03:10,684 --> 00:03:12,095
Yes, I'm mad, because I can't have sex
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because I have this stupid consult.
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- Dr. Shepherd?
- Ross?
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Sorry to bother you, sir,
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but I was hoping to
scrub in with you today,
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00:03:18,612 --> 00:03:20,567
and I'm supposed to be on
Dr. Grey's service.
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So I was wondering
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- if maybe you could talk to your wife for me.
- I'm gonna kill him.
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No, Ross, he cannot talk
to his wife for you,
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because you are with me,
and we have a consult
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with a pregnant lady with abdominal pain.
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So go do the workup,
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and I will see you there.
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I am liking the stupid hormones.
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Here you go, doctor.
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Dr. Kepner, um, we're swamped,
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and I have a shortness-of-breath lady
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who needs a consult,
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and you probably have better things to do,
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but I need help, please.
I'm drowning here.
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What bed?
94
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One, two, three...
95
00:04:01,776 --> 00:04:02,769
What are you... stop it.
96
00:04:02,770 --> 00:04:04,074
Edwards, if you're covering the pit,
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00:04:04,075 --> 00:04:06,428
it is your job to know
every bed in the pit.
98
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Okay. Put on your big-girl pants.
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You're about to learn how
to run the pit. Let's go.
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I apologize for the wait, ma'am.
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You're experiencing shortness of breath?
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Luckily, no. 45 minutes in an E.R. bed
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before a doctor pulls out a stethoscope?
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I'd likely be experiencing
shortness of life.
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I don't understand.
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Alana Cahill. I'm a physician advisor.
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Could you point me towards chief Hunt?
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I'm afraid you've made
me late for a meeting.
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My bad.
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It's like a knife is stabbing me.
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00:04:38,198 --> 00:04:39,463
You're sure it isn't early labor?
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00:04:39,464 --> 00:04:40,767
Because if it is,
I'm gonna need to call my sister
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and have her bring me my makeup bag.
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I'm determined to look cuter
than the baby in the pictures.
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Heidi.
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Sorry, honey. I babble when I'm nervous.
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Brie hates it. She's the quiet one.
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- Aah!
- Usually.
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Okay, well, it's definitely not labor,
120
00:04:52,827 --> 00:04:54,297
because I'm not seeing any contractions.
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And the baby's heart rate is good.
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Did you hear that, honey? The baby's fine.
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Then what is going on?
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There's a few possibilities.
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The labs should help clarify.
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Ross, did you get that chem-18 I ordered?
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00:05:03,083 --> 00:05:05,295
Um, I thought I checked off that box,
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00:05:05,296 --> 00:05:07,241
but apparently I checked chem-7.
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My mistake, which I'll quickly fix.
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In the meantime, I'll leave you
the lab work I didn't forget.
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I guess he babbles when he's nervous, too.
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- Ah!
- Okay, okay.
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Everyone at Namboze was
so worried when we heard
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the program might move to U.C.L.A.,
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myself included.
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You make the kids feel so at home here.
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Well, we were never gonna let that happen.
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No, I was away, but now I'm back.
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And as long as Dr. Karev and I are here,
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then the program stays here.
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Okay, um, Nyah's
pericarditis is quite severe.
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The pericardial sac around
her heart is inflamed
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and starting to adhere
to the heart itself.
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So I'll perform what's
called pericardial stripping.
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So I'll remove the sac,
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and her heart will start
beating on its own again.
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What shall I tell her?
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Oh, tell her we're gonna fix her heart,
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and she'll breathe much better.
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Nice program.
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Shame to see it go.
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Thanks. Wait. What?
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We're getting a visit
from the efficiency fairy.
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You think she's not gonna
make this disappear?
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Look, shut up. We just got it back.
156
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She's trimming fat.
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You're flying kids across the world
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for a pro bono surgery.
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That's pretty fatty.
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Yeah, they're orphans.
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Well, now you're just making my point.
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Oh, my god.
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Mac 3 and cricoid pressure.
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- Is she okay?
- E.T. tube.
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Yeah, start her on 10 mics of dopamine,
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and where are the damn labs?
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Here. She's in liver failure.
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Talk to me, Bailey. What's going on?
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Yeah, uh, Ross is right.
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Brie's liver won't last another week.
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I just went to the gift shop.
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What happened?
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Is this because of the baby?
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No, no, no. It appears to be
unrelated to the pregnancy.
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Brie's liver stopped filtering out toxins,
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so her body's shutting down.
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Without a transplant,
her liver may not last 72 hours.
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00:07:02,998 --> 00:07:04,573
Don't people wait years for a liver?
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00:07:04,574 --> 00:07:06,620
Not always. In emergency cases like this,
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00:07:06,621 --> 00:07:08,379
patients get moved to the top of the list.
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00:07:08,380 --> 00:07:09,939
So we've notified U.N.O.S.,
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and as soon as they have a liver...
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00:07:11,164 --> 00:07:12,456
What-what-what about the baby?
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00:07:12,457 --> 00:07:15,012
The baby is perfectly fine for now.
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So now we just wait, okay?
186
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Okay.
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Do not...
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say anything.
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I am so... so sorry.
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Is this you not saying anything?
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Go away
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00:07:31,404 --> 00:07:32,789
and do not come back
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without a liver.
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00:07:34,007 --> 00:07:35,795
Um, can I get you a tissue?
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Go!
196
00:07:38,562 --> 00:07:39,542
Hey, there's my guy.
197
00:07:39,543 --> 00:07:42,124
Jimmy. Hey, Carla. How are you?
198
00:07:42,125 --> 00:07:43,653
Please say you're not still married.
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00:07:43,654 --> 00:07:44,693
Ah, afraid so.
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00:07:44,694 --> 00:07:46,299
- Ignore my sister. No boundaries.
- Ah.
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00:07:46,300 --> 00:07:48,657
You think she cares?
Unless she's the wife.
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00:07:48,813 --> 00:07:49,509
You the wife?
203
00:07:49,510 --> 00:07:51,238
- Oh, no. You're in the clear.
- Headaches still bad?
204
00:07:51,239 --> 00:07:53,153
He can barely get off the couch,
he's so dizzy.
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00:07:53,154 --> 00:07:55,662
Meanwhile, I have to wait on
him like he's the boy prince.
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00:07:55,663 --> 00:07:56,630
Warms your heart, doesn't she?
207
00:07:56,631 --> 00:07:58,190
Yeah. Wilson, what are
some of the other symptoms
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00:07:58,191 --> 00:07:59,271
of an acoustic neuroma?
209
00:07:59,272 --> 00:08:01,551
Hearing loss, increased
intracranial pressure,
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00:08:01,552 --> 00:08:02,748
tingling in the face...
211
00:08:02,749 --> 00:08:04,056
And being a giant pain in my ass.
212
00:08:04,057 --> 00:08:06,590
I tried to find another surgeon
while your hand healed.
213
00:08:06,591 --> 00:08:08,441
Turns out, no one will go
anywhere near this thing.
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00:08:08,442 --> 00:08:09,665
Well we're gonna run some scans
215
00:08:09,666 --> 00:08:10,496
and some labs
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00:08:10,497 --> 00:08:12,099
and see if the tumor has progressed.
217
00:08:12,100 --> 00:08:13,202
You mean, it could be worse?
218
00:08:13,203 --> 00:08:15,523
Well, we'll have a clearer
idea once we see the scans.
219
00:08:16,628 --> 00:08:18,330
See if you can switch with Ross.
220
00:08:19,442 --> 00:08:20,344
Oh. Did I...
221
00:08:20,345 --> 00:08:21,246
No, it's nothing you did wrong.
222
00:08:21,247 --> 00:08:23,287
It's that Ross knows what
I want before I even ask for it.
223
00:08:23,288 --> 00:08:25,244
I won't have time to
teach you on this one.
224
00:08:26,665 --> 00:08:28,793
Shepherd, this is Alana Cahill.
225
00:08:28,794 --> 00:08:30,563
She is our physician advisor.
226
00:08:30,564 --> 00:08:31,263
Derek Shepherd.
227
00:08:31,264 --> 00:08:33,473
Neuro. I saw you're doing
an acoustic neuroma.
228
00:08:33,474 --> 00:08:35,313
- Very exciting.
- First thing tomorrow.
229
00:08:35,314 --> 00:08:36,687
Patient's here today.
230
00:08:36,757 --> 00:08:39,247
Are pre-op overnight stays
typical in all departments?
231
00:08:39,248 --> 00:08:40,755
That is a question for chief Hunt.
232
00:08:40,756 --> 00:08:42,806
If you'll excuse me, I have to prep.
233
00:08:43,381 --> 00:08:45,332
Hmm. Well, I'll see you
in the O.R. tomorrow.
234
00:08:46,861 --> 00:08:48,371
Typically, you need to be invited.
235
00:08:48,372 --> 00:08:49,609
If things were running typically,
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00:08:49,610 --> 00:08:51,637
I wouldn't be here, now would I?
237
00:08:56,531 --> 00:08:57,595
Okay.
238
00:08:58,387 --> 00:08:59,789
Brian Turner, age 55.
239
00:08:59,790 --> 00:09:01,614
Minor head injury. Vital signs stable.
240
00:09:01,615 --> 00:09:03,503
Fell off the damn ladder
cleaning the damn gutter.
241
00:09:03,504 --> 00:09:05,593
I was gonna say all that. Fewer damns.
242
00:09:05,613 --> 00:09:07,374
You'll need to know if he lost
consciousness in the field.
243
00:09:07,375 --> 00:09:08,951
Sir, did you lose
consciousness in the field?
244
00:09:08,952 --> 00:09:11,059
I didn't fall in a damn field.
I fell in my damn yard.
245
00:09:11,060 --> 00:09:12,975
Ask the paramedic, not the patient.
246
00:09:12,976 --> 00:09:14,634
Oh, he was conscious the whole damn time.
247
00:09:14,635 --> 00:09:15,577
Um, could we just start over?
248
00:09:15,578 --> 00:09:17,381
Uh, no time. Get him triaged. Go.
249
00:09:18,176 --> 00:09:21,058
45 minutes in an E.R.
bed before I saw a doctor.
250
00:09:21,059 --> 00:09:22,823
Well, that's not good.
251
00:09:22,824 --> 00:09:24,463
No, it's not.
252
00:09:24,558 --> 00:09:25,805
Alana Cahill?
253
00:09:25,806 --> 00:09:27,981
Uh, Dr. Webber.
254
00:09:29,647 --> 00:09:32,131
Wow. Uh, Alana was a student of mine,
255
00:09:32,132 --> 00:09:33,185
uh, how many years ago now?
256
00:09:33,186 --> 00:09:34,613
Oh, do we really have to say?
257
00:09:34,614 --> 00:09:37,443
She was a great student
and a gifted surgeon.
258
00:09:37,652 --> 00:09:39,155
So what brings you back?
259
00:09:39,156 --> 00:09:40,282
You looking at joining the staff?
260
00:09:40,283 --> 00:09:43,356
Uh, she is the physician
advisor that I told you about.
261
00:09:45,389 --> 00:09:48,698
Um, well, we should get
a cup of coffee, catch up.
262
00:09:48,699 --> 00:09:51,041
I'd love to, but I'm pretty booked.
263
00:09:51,042 --> 00:09:52,755
- In fact, we should get going.
- Mm-hmm.
264
00:09:52,756 --> 00:09:55,797
O-of course. It was, uh, great to see you.
265
00:09:57,545 --> 00:09:59,930
Your hero sent me to
trade services with you.
266
00:09:59,931 --> 00:10:00,788
You're welcome.
267
00:10:00,789 --> 00:10:02,953
Can't. I'm waiting for
U.N.O.S. to call with a liver.
268
00:10:02,954 --> 00:10:04,135
So go wait in the O.R.
269
00:10:04,136 --> 00:10:05,578
While you play teacher's
pet with Shepherd.
270
00:10:05,579 --> 00:10:07,200
I'm not moving from this spot.
271
00:10:07,201 --> 00:10:09,008
Great cell reception. See? Five bars.
272
00:10:09,009 --> 00:10:10,906
You know it's not like
ordering a pizza, right?
273
00:10:10,907 --> 00:10:11,868
It could take days.
274
00:10:11,869 --> 00:10:13,038
My patient doesn't have days.
275
00:10:13,039 --> 00:10:14,429
Okay, fine. I'll wait.
276
00:10:14,430 --> 00:10:17,362
And when U.N.O.S. calls,
I'll run to Medusa. I promise.
277
00:10:17,363 --> 00:10:18,609
Give me my phone.
278
00:10:18,926 --> 00:10:20,361
If I miss the call, Grey is gonna kill me.
279
00:10:20,362 --> 00:10:21,854
If I go back to Shepherd and I'm not you,
280
00:10:21,855 --> 00:10:22,993
he's gonna kill me.
281
00:10:22,994 --> 00:10:24,238
Give me my phone.
282
00:10:25,099 --> 00:10:25,914
Oh, my god.
283
00:10:25,915 --> 00:10:27,163
Give me my phone.
284
00:10:28,546 --> 00:10:29,387
Hello?
285
00:10:29,388 --> 00:10:31,834
The pericardium is free.
286
00:10:32,084 --> 00:10:34,095
You should see an increase in,
uh, cardiac function.
287
00:10:34,096 --> 00:10:35,594
It's weird. Heart's floppy.
288
00:10:35,595 --> 00:10:37,161
Still not the way
a kid's heart should look.
289
00:10:37,162 --> 00:10:39,188
Mm. Could be endocarditis.
290
00:10:39,537 --> 00:10:40,573
I'll do a biopsy.
291
00:10:40,574 --> 00:10:42,065
Uh, biopsy needle, please.
292
00:10:42,700 --> 00:10:43,903
Unless it's...
293
00:10:44,110 --> 00:10:45,854
Oh, my god. It couldn't, could it?
294
00:10:45,957 --> 00:10:48,245
Could this be endomyocardial fibrosis?
295
00:10:48,246 --> 00:10:51,221
I-I've only read about it.
It's rare, subtropical.
296
00:10:51,222 --> 00:10:52,816
- Could this be that?
- Maybe.
297
00:10:52,817 --> 00:10:54,972
Remember we had that kid
with pentalogy of cantrell?
298
00:10:54,973 --> 00:10:56,256
This program...
299
00:10:56,750 --> 00:10:59,719
is a medical freak show goldmine.
300
00:10:59,813 --> 00:11:00,705
They can't cut it.
301
00:11:00,706 --> 00:11:03,106
Nobody's cutting it. Robbins,
tell her to stop saying that.
302
00:11:03,254 --> 00:11:04,511
I'm sorry. What?
303
00:11:04,512 --> 00:11:05,655
- You all right?
- Uh-huh.
304
00:11:05,656 --> 00:11:07,738
Okay, um, take that to path. Stat, please.
305
00:11:07,739 --> 00:11:08,549
Oh, you know what? I'll take it.
306
00:11:08,550 --> 00:11:10,520
- Alex, you take my place.
- The nurse can take it.
307
00:11:10,521 --> 00:11:12,262
No, I'd rather take it myself.
308
00:11:38,182 --> 00:11:39,510
Are there pastries
309
00:11:39,511 --> 00:11:42,239
and bagels in every one of your lounges?
310
00:11:42,240 --> 00:11:44,074
No. Well, maybe. I don't know.
311
00:11:44,075 --> 00:11:46,631
Is that the kind of thing
you're gonna be looking at?
312
00:11:46,632 --> 00:11:49,149
I will be looking at everything, doctor.
313
00:11:49,372 --> 00:11:51,072
Huh. Um, Dr. Robbins.
314
00:11:51,073 --> 00:11:52,782
This is Alana Cahill.
315
00:11:54,203 --> 00:11:56,013
Oh. Uh, are you all right?
316
00:11:56,014 --> 00:11:57,860
Mm-hmm. I'm fine. I'm sorry.
317
00:11:57,861 --> 00:11:58,657
I...
318
00:11:58,658 --> 00:12:00,976
Could you just give us a minute?
319
00:12:01,088 --> 00:12:02,194
Of course.
320
00:12:09,162 --> 00:12:11,214
That was the efficiency lady, right?
321
00:12:11,316 --> 00:12:13,809
Yeah, so I probably look
as crazy as a bag of cats.
322
00:12:13,810 --> 00:12:15,898
So it was nice working with you.
323
00:12:20,644 --> 00:12:22,184
Is it phantom limb pain?
324
00:12:22,809 --> 00:12:24,589
Callie said it only happens at night.
325
00:12:24,590 --> 00:12:25,866
Until now.
326
00:12:26,665 --> 00:12:27,742
I'm going crazy. I...
327
00:12:27,743 --> 00:12:30,126
You're not. You're not crazy.
328
00:12:30,592 --> 00:12:33,109
Phantom limb is a very real thing.
329
00:12:33,110 --> 00:12:35,494
I just left a surgery
because there was pain
330
00:12:35,495 --> 00:12:37,987
in a part of me that no longer exists.
331
00:12:37,988 --> 00:12:39,772
So I... what are you doing?
332
00:12:39,773 --> 00:12:42,703
We're helping you visualize
a leg that doesn't hurt.
333
00:12:43,854 --> 00:12:45,459
Here we go. Now...
334
00:12:45,848 --> 00:12:46,677
just look at that.
335
00:12:46,678 --> 00:12:48,049
I... are you kidding me?
336
00:12:48,050 --> 00:12:50,315
We are rerouting your brain,
337
00:12:50,316 --> 00:12:51,907
reminding it of what happened.
338
00:12:51,908 --> 00:12:53,531
There are many treatments
for phantom limb.
339
00:12:53,532 --> 00:12:55,906
There's heat, there's massage,
340
00:12:55,907 --> 00:12:57,345
there's virtual reality therapy.
341
00:12:57,346 --> 00:13:00,292
I knew a guy in the army who
had to stab his prosthetic
342
00:13:00,293 --> 00:13:02,630
- with a screwdriver as hard... as he could.
- Oh, great.
343
00:13:02,631 --> 00:13:03,814
Well, that's not crazy.
344
00:13:03,815 --> 00:13:06,707
Well, for him, it was the
only thing that worked.
345
00:13:06,708 --> 00:13:07,761
Now...
346
00:13:09,019 --> 00:13:10,455
is your pain any better?
347
00:13:14,409 --> 00:13:17,215
Y-ye... it is, a-a-a little.
348
00:13:17,216 --> 00:13:20,160
You see? You just need to
figure out what works for you.
349
00:13:20,161 --> 00:13:22,030
Callie knows all this. What does she say?
350
00:13:23,041 --> 00:13:24,864
I ha... I haven't told her.
351
00:13:24,921 --> 00:13:26,614
She's an orthopedic surgeon.
352
00:13:26,615 --> 00:13:30,383
And I have been her patient for so long.
353
00:13:30,746 --> 00:13:32,803
And I just am starting to
feel like a wife again,
354
00:13:32,804 --> 00:13:35,458
and she needs me to. I cannot have this.
355
00:13:35,459 --> 00:13:36,792
I am finally getting
my life back together,
356
00:13:36,793 --> 00:13:38,656
and-and I will not be screwed over
357
00:13:38,657 --> 00:13:40,245
by something that's not even there!
358
00:13:44,489 --> 00:13:45,393
All right.
359
00:13:46,271 --> 00:13:47,598
We're gonna work together.
360
00:13:47,997 --> 00:13:49,622
We're gonna work together,
and I'm gonna help you,
361
00:13:49,623 --> 00:13:51,340
and we are gonna figure this out.
362
00:13:53,819 --> 00:13:54,765
Okay?
363
00:13:58,328 --> 00:14:00,444
African babies are a godsend.
364
00:14:00,578 --> 00:14:01,959
You don't have to tell me.
365
00:14:01,979 --> 00:14:03,890
Oh, not Zola. Not the cute ones.
366
00:14:04,064 --> 00:14:05,319
The sick ones.
367
00:14:05,320 --> 00:14:06,797
They're exotically diseased,
368
00:14:06,798 --> 00:14:08,116
beautiful little train wrecks.
369
00:14:08,117 --> 00:14:09,492
I just found a case of E.M.F.,
370
00:14:09,493 --> 00:14:11,049
and I get to do an endocardial stripping
371
00:14:11,050 --> 00:14:12,277
of the left ventricle.
372
00:14:12,278 --> 00:14:13,873
Do you know how many other
people have done that?
373
00:14:13,874 --> 00:14:15,971
- No.
- Me neither. It's unheard of.
374
00:14:16,017 --> 00:14:16,623
Where are you going?
375
00:14:16,624 --> 00:14:18,226
I have to see a man about a liver.
376
00:14:18,974 --> 00:14:19,995
Dr. Bailey.
377
00:14:22,947 --> 00:14:25,941
Can I please get another intern?
378
00:14:25,942 --> 00:14:27,143
What's wrong with Ross?
379
00:14:28,166 --> 00:14:28,753
A lot.
380
00:14:28,754 --> 00:14:30,748
The kid made a tiny mistake.
381
00:14:30,749 --> 00:14:31,830
Because he's an idiot.
382
00:14:31,831 --> 00:14:33,413
If I have to work with
him one more second,
383
00:14:33,414 --> 00:14:34,574
I'm probably gonna kill him.
384
00:14:34,575 --> 00:14:36,311
Uh, you think I didn't want to kill you?
385
00:14:36,312 --> 00:14:38,781
You cut L-vad wires,
and yet there you stand.
386
00:14:38,782 --> 00:14:41,846
So... be merciful and suck it up.
387
00:14:43,837 --> 00:14:46,500
Cousin Dora sent him
a stupid giant cookie,
388
00:14:46,501 --> 00:14:47,847
but he can't eat before surgery.
389
00:14:47,848 --> 00:14:49,307
So now I'm starving and I gotta look
390
00:14:49,308 --> 00:14:51,564
at this giant freakin'
cookie that I can't have!
391
00:14:51,565 --> 00:14:53,536
I keep just telling her
to eat the damn thing.
392
00:14:53,537 --> 00:14:54,919
Oh, so you can make fat jokes?
393
00:14:54,920 --> 00:14:56,302
- Then throw it away.
- Jimmy...
394
00:14:56,303 --> 00:14:58,732
Oh, no. What's that look? What's wrong?
395
00:14:59,148 --> 00:15:00,543
The tumor's progressed.
396
00:15:03,346 --> 00:15:04,905
But you could still operate, right?
397
00:15:05,017 --> 00:15:05,974
Yes, we can,
398
00:15:05,975 --> 00:15:07,743
but all those risks we
talked about before...
399
00:15:07,744 --> 00:15:08,852
- Like me going deaf...
- Mm-hmm.
400
00:15:08,853 --> 00:15:10,903
Or half my face being melted
like it was blowtorched,
401
00:15:10,904 --> 00:15:12,407
or me not surviving at all?
402
00:15:12,408 --> 00:15:15,459
Yeah, the chances of those
things happening are much higher.
403
00:15:15,460 --> 00:15:17,634
So... you should take some time
404
00:15:17,635 --> 00:15:19,979
and think about if you still
want to do the surgery.
405
00:15:21,195 --> 00:15:22,601
I've taken time.
406
00:15:23,975 --> 00:15:26,072
I waited for months for you to get better.
407
00:15:26,545 --> 00:15:27,568
Doc, I can't just sit here
408
00:15:27,569 --> 00:15:29,160
and wait for this thing to kill me.
409
00:15:29,837 --> 00:15:31,279
I...
410
00:15:33,158 --> 00:15:35,089
I'm dying, she makes it about her.
411
00:15:41,122 --> 00:15:42,106
Hey.
412
00:15:42,231 --> 00:15:44,058
I'm sorry. I can't let him see me cry.
413
00:15:44,059 --> 00:15:45,238
I'll never hear the end of it.
414
00:15:45,239 --> 00:15:46,085
No, it's okay.
415
00:15:46,086 --> 00:15:47,659
It's a horrible thing to say, I know,
416
00:15:47,660 --> 00:15:49,559
but when I heard you
were in a plane crash,
417
00:15:49,560 --> 00:15:50,845
part of me was relieved.
418
00:15:50,846 --> 00:15:52,059
It's an awful thing that happened to you,
419
00:15:52,060 --> 00:15:53,501
and I'm so sorry.
420
00:15:53,805 --> 00:15:56,271
But it gave me more time with my brother.
421
00:15:56,456 --> 00:15:59,694
These past months have
been the best we've had.
422
00:16:01,721 --> 00:16:02,792
I'm ready.
423
00:16:03,412 --> 00:16:04,456
We both are.
424
00:16:11,004 --> 00:16:13,600
Here's the recheck on
the calcium level you asked for.
425
00:16:14,644 --> 00:16:16,047
Ross is gone, sir. I'm sorry.
426
00:16:16,048 --> 00:16:18,091
He and Dr. Grey went to go get a liver.
427
00:16:19,176 --> 00:16:20,702
I don't want anybody in the gallery.
428
00:16:21,157 --> 00:16:22,641
I don't need an audience.
429
00:16:23,169 --> 00:16:24,297
You up for this?
430
00:16:41,950 --> 00:16:44,012
I want you to know,
the thing with the labs,
431
00:16:44,490 --> 00:16:45,477
it won't ever happen again.
432
00:16:45,478 --> 00:16:48,129
Okay. Just let it go, okay?
433
00:16:50,330 --> 00:16:51,736
Congrats on the baby.
434
00:16:51,835 --> 00:16:52,861
Thank you.
435
00:16:53,483 --> 00:16:55,957
You must be, what, three months in?
436
00:16:58,040 --> 00:16:59,503
Baby's the size of a lemon.
437
00:17:00,288 --> 00:17:03,311
So... second trimester, huh?
438
00:17:05,301 --> 00:17:06,866
The fetus is growing feet...
439
00:17:07,707 --> 00:17:10,202
discharging urine into the amniotic fluid.
440
00:17:10,487 --> 00:17:12,449
And you must be feeling better,
441
00:17:12,600 --> 00:17:13,786
less nausea.
442
00:17:15,436 --> 00:17:18,378
But the second trimester's
also known to bring with it
443
00:17:18,379 --> 00:17:22,574
swollen gums, heartburn, gas...
444
00:17:22,575 --> 00:17:24,264
Do you want me to start crying?!
445
00:17:29,316 --> 00:17:31,584
And on three. One, two, three.
446
00:17:33,086 --> 00:17:34,425
Last B.P. was 110 over 70,
447
00:17:34,426 --> 00:17:35,948
but there was significant
dashboard damage.
448
00:17:35,949 --> 00:17:38,045
Stop. Dr. Edwards, what injuries
are we most concerned with
449
00:17:38,046 --> 00:17:38,858
in this patient?
450
00:17:38,859 --> 00:17:40,029
We always start with the ABCs.
451
00:17:40,030 --> 00:17:40,974
If you'd been listening to the paramedic,
452
00:17:40,975 --> 00:17:42,498
you'd have your answer.
Can you start over?
453
00:17:42,499 --> 00:17:44,207
There was significant
damage to the dashboard...
454
00:17:44,208 --> 00:17:46,297
What's the basic law of motion, Edwards?
455
00:17:46,298 --> 00:17:46,997
The basic...
456
00:17:46,998 --> 00:17:48,581
Energy cannot be created or destroyed,
457
00:17:48,582 --> 00:17:50,234
but can change in form or be absorbed.
458
00:17:50,235 --> 00:17:51,679
Uh, which means
the impact to the dashboard
459
00:17:51,680 --> 00:17:52,709
was absorbed by the patient.
460
00:17:52,710 --> 00:17:54,599
So the injuries
we're most concerned with are?
461
00:17:54,600 --> 00:17:56,964
Are knee injury, possible pelvis, C-spine.
462
00:17:56,965 --> 00:17:57,609
Correct.
463
00:17:57,610 --> 00:17:59,561
Matthew here stabilized
the pelvis in the field.
464
00:17:59,625 --> 00:18:00,889
Uh, it really wasn't that big of a...
465
00:18:00,890 --> 00:18:02,398
So now you can start your exam.
466
00:18:06,417 --> 00:18:09,318
So I'll just... see myself out then.
467
00:18:11,227 --> 00:18:12,250
Okay.
468
00:18:20,305 --> 00:18:22,144
Okay, Ross. There's the knot.
469
00:18:22,240 --> 00:18:23,485
It's a nice one.
470
00:18:24,173 --> 00:18:25,163
Uh, okay.
471
00:18:25,164 --> 00:18:27,396
Yes, thank you. Scissors.
472
00:18:27,948 --> 00:18:29,038
Careful now.
473
00:18:29,039 --> 00:18:30,498
We're just gonna cut the suture
474
00:18:30,499 --> 00:18:32,627
as close to the knot as possible
475
00:18:32,628 --> 00:18:33,657
without...
476
00:18:33,658 --> 00:18:34,789
Oh, no.
477
00:18:34,790 --> 00:18:36,302
Are you serious?!
478
00:18:36,303 --> 00:18:38,076
Oh, no, no, no, no, no.
479
00:18:41,357 --> 00:18:43,457
You cut the hepatic artery in the hilum.
480
00:18:43,458 --> 00:18:46,051
You cut the hilum before
I had a chance to say,
481
00:18:46,052 --> 00:18:47,473
"Don't cut the hilum!"
482
00:18:47,474 --> 00:18:48,546
You see what he did?
483
00:18:49,260 --> 00:18:50,457
Don't ever do that.
484
00:18:52,061 --> 00:18:53,159
Clamp.
485
00:18:57,686 --> 00:19:00,777
I don't know. Um, Dr. Robbins.
486
00:19:00,778 --> 00:19:01,345
Hey.
487
00:19:01,346 --> 00:19:02,758
Everything, uh, work out all right?
488
00:19:02,759 --> 00:19:04,261
Yeah, I'm sorry that you had to see that.
489
00:19:04,262 --> 00:19:05,368
It was a-a personal...
490
00:19:05,369 --> 00:19:07,059
- You were having a moment.
- Yeah.
491
00:19:07,060 --> 00:19:08,148
We all have 'em.
492
00:19:08,149 --> 00:19:10,089
Just sucks when they
happen at work, right?
493
00:19:10,090 --> 00:19:11,977
I was, uh, just telling Dr. Cahill
494
00:19:11,978 --> 00:19:14,082
how well Nyah's surgery went.
495
00:19:14,137 --> 00:19:14,730
Yeah.
496
00:19:14,731 --> 00:19:17,344
And that you let me finish
the surgery on my own.
497
00:19:17,345 --> 00:19:18,653
- Yeah.
- Thanks again.
498
00:19:18,654 --> 00:19:20,540
That's impressive for a fellow.
499
00:19:20,541 --> 00:19:22,674
Oh, well, he's... he's more than qualified.
500
00:19:22,675 --> 00:19:25,029
Well, I will be observing
Nyah's second surgery tomorrow.
501
00:19:25,030 --> 00:19:27,460
So will that be you or Dr. Karev?
502
00:19:27,619 --> 00:19:29,011
Oh, no, me, of course.
503
00:19:29,012 --> 00:19:31,384
Yeah. Uh, with our cardio fellow Dr. Yang.
504
00:19:31,469 --> 00:19:32,603
All right. I will see you there.
505
00:19:32,604 --> 00:19:33,587
Okay.
506
00:19:35,767 --> 00:19:36,810
What's going on?
507
00:19:36,992 --> 00:19:39,220
Nothing. I'm fine.
508
00:19:39,226 --> 00:19:41,260
I'm sorry about this morning.
Are we all set for tomorrow?
509
00:19:41,261 --> 00:19:43,344
Uh... 8:30, O.R. 2.
510
00:19:43,345 --> 00:19:44,122
Great.
511
00:19:44,123 --> 00:19:45,827
Uh, look, if you want to sit it out,
512
00:19:45,828 --> 00:19:47,360
Yang and I can handle it.
513
00:19:48,557 --> 00:19:50,753
Maybe, you know,
you should just take it easy.
514
00:19:51,811 --> 00:19:53,238
It's just that Yang keeps squawking about
515
00:19:53,239 --> 00:19:55,037
how they're gonna cut the program,
516
00:19:55,038 --> 00:19:56,631
nd I just don't want anything to...
517
00:19:56,632 --> 00:19:58,725
Yeah. Um, are you finished?
518
00:19:58,726 --> 00:20:00,746
I just want everything to go well.
519
00:20:00,958 --> 00:20:02,397
Then I'll see you tomorrow morning.
520
00:20:09,542 --> 00:20:10,810
10-blade, please.
521
00:20:21,446 --> 00:20:22,536
Did...
522
00:20:24,153 --> 00:20:25,512
did you see that?
523
00:20:38,958 --> 00:20:41,422
God! Ah!
524
00:21:28,746 --> 00:21:29,846
Morning.
525
00:21:31,594 --> 00:21:34,338
Oh. You all right in there?
526
00:21:34,591 --> 00:21:35,612
Um, yeah.
527
00:21:35,613 --> 00:21:37,657
No, I'm fine. I'm fine. I was just...
528
00:21:37,658 --> 00:21:38,897
I'm about to take a shower.
529
00:21:38,898 --> 00:21:40,477
Oh, want some company?
530
00:21:40,478 --> 00:21:42,143
Um, yeah, of course I do.
531
00:21:42,144 --> 00:21:44,360
It's just, I'm, um, I'm running late.
532
00:21:44,361 --> 00:21:46,272
So how about tonight?
533
00:21:46,587 --> 00:21:48,402
Yeah. How about a movie night?
534
00:21:48,403 --> 00:21:49,881
Yeah. You read my mind.
535
00:21:49,882 --> 00:21:52,173
Okay. All right.
536
00:21:59,584 --> 00:22:02,105
Unfortunately there was
a surgical complication
537
00:22:02,106 --> 00:22:04,742
with the donor liver,
and it is no longer viable.
538
00:22:04,799 --> 00:22:05,794
Oh, god.
539
00:22:05,795 --> 00:22:07,493
Okay. So what happens now?
540
00:22:07,494 --> 00:22:10,134
Well, Brie is back on the transplant list.
541
00:22:10,135 --> 00:22:11,790
We'll continue supportive care
542
00:22:11,791 --> 00:22:13,456
so her body's ready
543
00:22:13,457 --> 00:22:15,830
if another liver becomes available
544
00:22:15,831 --> 00:22:18,434
or if we have to deliver the baby.
545
00:22:18,435 --> 00:22:19,274
A C-section?
546
00:22:19,275 --> 00:22:20,481
Can-can she handle that?
547
00:22:20,482 --> 00:22:21,857
Any surgery is risky,
548
00:22:21,858 --> 00:22:25,152
and her condition is causing
her blood to stop clotting.
549
00:22:25,153 --> 00:22:27,611
So we need to continue
with the blood transfusions
550
00:22:27,612 --> 00:22:30,500
and buy her some time until
a liver becomes available.
551
00:22:30,501 --> 00:22:32,406
If a new liver becomes available.
552
00:22:33,967 --> 00:22:34,798
Yes.
553
00:22:34,799 --> 00:22:35,906
Oh, god.
554
00:22:36,013 --> 00:22:38,589
The last thing I said to her is,
"You're gonna be fine."
555
00:22:39,690 --> 00:22:41,523
You have to fix her, please.
556
00:22:42,881 --> 00:22:44,352
Yeah. Here.
557
00:22:44,353 --> 00:22:46,707
You can see that she's
still on the respirator.
558
00:22:47,344 --> 00:22:48,983
Her vitals actually...
559
00:22:52,150 --> 00:22:54,046
I hope you won't mention
560
00:22:54,047 --> 00:22:56,692
my colossal incompetence to your husband.
561
00:22:57,153 --> 00:22:59,623
He... still thinks I'm the golden boy.
562
00:22:59,624 --> 00:23:02,206
No, stop that. You don't get to do that.
563
00:23:02,207 --> 00:23:03,917
You don't get to feel sorry for yourself
564
00:23:03,918 --> 00:23:06,255
or make little self-deprecating remarks.
565
00:23:06,256 --> 00:23:09,265
You destroyed a perfectly
good liver today.
566
00:23:09,266 --> 00:23:11,667
When I look at you, that is all I see.
567
00:23:11,770 --> 00:23:13,026
A perfectly...
568
00:23:13,027 --> 00:23:15,009
- good liver.
- Hold on a sec.
569
00:23:15,010 --> 00:23:17,636
- I'm not done. Put your phone away.
- I'm-I'm sorry.
570
00:23:17,637 --> 00:23:19,375
Don't be sorry. Be better.
571
00:23:19,376 --> 00:23:20,793
I think it's U.N.O.S.
572
00:23:25,657 --> 00:23:26,686
Hello.
573
00:23:31,545 --> 00:23:32,610
Hmm. Can I help you find something?
574
00:23:32,611 --> 00:23:35,403
No. I'm just observing surgeries today,
575
00:23:35,404 --> 00:23:38,040
and I'm trying to maximize my time.
576
00:23:38,041 --> 00:23:40,674
Shepherd's acoustic neuroma is at 8:00,
577
00:23:40,675 --> 00:23:42,500
and that's gonna be a long one.
578
00:23:42,501 --> 00:23:44,318
Just trying to be everywhere at once.
579
00:23:44,319 --> 00:23:46,642
Actually, Shepherd's surgery
got pushed till later.
580
00:23:49,867 --> 00:23:52,649
Oh, I totally misread that.
581
00:23:52,650 --> 00:23:55,049
That is going to work
so much better for me.
582
00:23:55,050 --> 00:23:56,365
Thank you, doctor.
583
00:23:56,433 --> 00:23:59,102
Well, maybe that, uh,
gives us time for coffee.
584
00:23:59,239 --> 00:24:00,838
I'm afraid not.
585
00:24:01,152 --> 00:24:03,107
Just time for me to see more surgeries.
586
00:24:03,108 --> 00:24:06,848
Well, I always did expect
to see you in the O.R.
587
00:24:08,069 --> 00:24:09,948
One way or another, right?
588
00:24:12,196 --> 00:24:13,323
Right.
589
00:24:16,785 --> 00:24:19,659
Okay, now breathe.
590
00:24:21,924 --> 00:24:24,461
Try to calm the waves.
591
00:24:24,462 --> 00:24:25,876
Try to slow them down.
592
00:24:25,958 --> 00:24:27,577
What... what's the point here?
593
00:24:28,126 --> 00:24:29,748
Well, the idea is,
594
00:24:29,749 --> 00:24:32,008
if you can teach
your mind to calm the waves,
595
00:24:32,009 --> 00:24:34,497
you can teach it to... calm the pain.
596
00:24:34,498 --> 00:24:35,513
But I...
597
00:24:36,254 --> 00:24:37,764
I-I can't do it. I can't do it.
598
00:24:37,765 --> 00:24:39,243
It's... this is dumb.
599
00:24:39,492 --> 00:24:41,963
This is not dumb. It is biofeedback.
600
00:24:41,964 --> 00:24:44,799
Look, I can't-I can't stop
the stupid make-believe waves.
601
00:24:44,800 --> 00:24:47,342
So... what else you got?
602
00:24:47,343 --> 00:24:49,870
Well, I have a minimally
invasive spinal surgery
603
00:24:49,871 --> 00:24:50,941
that can deaden your nerves.
604
00:24:50,942 --> 00:24:52,113
No, no, I have to operate today.
605
00:24:52,114 --> 00:24:53,497
Then I got make-believe waves,
606
00:24:53,498 --> 00:24:55,355
or I got a make-believe waterfall,
607
00:24:55,356 --> 00:24:57,349
or a make-believe campfire.
608
00:24:57,350 --> 00:24:58,924
Or I could just find a screwdriver
609
00:24:58,925 --> 00:25:00,300
and stab it in your foot.
610
00:25:00,300 --> 00:25:02,129
Just stab me in the head.
611
00:25:08,864 --> 00:25:11,095
C.T. results on pelvic fracture.
612
00:25:12,783 --> 00:25:14,628
Thoracentesis if positive effusion.
613
00:25:14,629 --> 00:25:17,656
Um, musculoaponeurotic grafts?
614
00:25:17,657 --> 00:25:19,847
- What are you doing?
- What am I... what are you doing?
615
00:25:19,909 --> 00:25:20,458
I thought you were trying to talk dirty.
616
00:25:20,459 --> 00:25:22,350
I didn't want you to feel
like the only giant nerd.
617
00:25:22,351 --> 00:25:23,583
I was talking out loud?
618
00:25:23,584 --> 00:25:24,592
Yeah.
619
00:25:25,233 --> 00:25:27,484
Though I was weirdly kind of into it.
620
00:25:31,345 --> 00:25:33,635
Um, I have 60 million things to do today,
621
00:25:33,636 --> 00:25:34,982
and I'm sure I'm gonna forget something.
622
00:25:35,761 --> 00:25:37,009
Kepner's running me ragged.
623
00:25:37,010 --> 00:25:39,809
And that's not working for me anymore.
624
00:25:40,121 --> 00:25:41,063
Um...
625
00:25:41,477 --> 00:25:43,204
You know, if you're too busy for this,
626
00:25:43,205 --> 00:25:44,268
we can, um...
627
00:25:44,805 --> 00:25:46,385
I am not too busy for this.
628
00:25:50,091 --> 00:25:50,987
Mm.
629
00:25:51,012 --> 00:25:52,592
I am too busy for this.
630
00:25:52,758 --> 00:25:53,746
All right.
631
00:25:54,439 --> 00:25:55,810
Thank you for understanding.
632
00:25:55,811 --> 00:25:56,870
Okay.
633
00:26:01,010 --> 00:26:03,816
Her last A.S.T. was 23-42.
634
00:26:04,163 --> 00:26:05,283
I.N.R. was 6.
635
00:26:05,284 --> 00:26:06,353
Is it viable?
636
00:26:06,354 --> 00:26:07,739
I think it's a match.
637
00:26:07,752 --> 00:26:09,172
She'd be crying if it wasn't.
638
00:26:09,356 --> 00:26:12,302
She cries when she's angry,
which is whenever she sees me.
639
00:26:12,926 --> 00:26:13,733
Look.
640
00:26:13,832 --> 00:26:15,363
She's looking at me and not crying.
641
00:26:15,396 --> 00:26:16,093
It's gotta be a match.
642
00:26:16,094 --> 00:26:17,664
Thank you so much. Thank you.
643
00:26:18,790 --> 00:26:19,788
We have a match.
644
00:26:19,965 --> 00:26:21,616
You're gonna fly to Portland, Oregon.
645
00:26:21,643 --> 00:26:23,474
I will fly to Portland, Oregon,
646
00:26:23,475 --> 00:26:24,819
to retrieve a liver for a woman
647
00:26:24,820 --> 00:26:26,439
who I've already destroyed one liver?
648
00:26:26,440 --> 00:26:28,151
Is that the wisest use of our resources?
649
00:26:28,152 --> 00:26:30,393
I can't. I can't get on a plane.
You know that.
650
00:26:30,394 --> 00:26:32,480
I know you haven't been on a plane.
651
00:26:32,481 --> 00:26:33,910
Maybe it's time you try again.
652
00:26:33,911 --> 00:26:36,792
Their procurement team is
going to do all of the work.
653
00:26:36,793 --> 00:26:37,806
You know good and well
654
00:26:37,807 --> 00:26:39,768
we prefer to do the recovery ourselves.
655
00:26:39,769 --> 00:26:41,737
All he has to do is carry a cooler.
656
00:26:41,737 --> 00:26:42,303
Meredith.
657
00:26:42,304 --> 00:26:44,922
If he's been to a picnic,
he can handle this.
658
00:26:44,923 --> 00:26:46,600
Shane, have you ever been to a picnic?
659
00:26:46,601 --> 00:26:47,404
I've been to a picnic.
660
00:26:47,405 --> 00:26:48,994
Oh, look at that. He's been to a picnic.
661
00:26:48,995 --> 00:26:50,505
These women deserve more experience
662
00:26:50,506 --> 00:26:53,042
than a fool who's eaten
a potato salad in a park.
663
00:26:53,043 --> 00:26:54,702
She's right. Maybe I'm
not the best person...
664
00:26:54,703 --> 00:26:55,511
You're an intern.
665
00:26:55,512 --> 00:26:56,674
Of course you're gonna make mistakes.
666
00:26:56,675 --> 00:26:59,833
Bad things happen,
but you have to move past it.
667
00:26:59,834 --> 00:27:01,362
Leave it behind you,
the sooner the better,
668
00:27:01,363 --> 00:27:03,271
and stop you from moving forward.
669
00:27:03,272 --> 00:27:04,972
So just get over yourself.
670
00:27:04,973 --> 00:27:08,267
Move past it, and get
your butt on that plane.
671
00:27:09,598 --> 00:27:11,792
So... now I'm confused.
672
00:27:11,811 --> 00:27:13,112
Who's going to Portland?
673
00:27:15,046 --> 00:27:16,241
I can't.
674
00:27:18,867 --> 00:27:20,961
You and I are going to Portland.
675
00:27:22,637 --> 00:27:23,859
Mm. Okay.
676
00:27:24,564 --> 00:27:26,597
So, Wilson, what do you see?
677
00:27:27,683 --> 00:27:30,188
Cerebellum and occipital brain tissue.
678
00:27:30,189 --> 00:27:32,092
Mm-hmm. Healthy, perfect tissue...
679
00:27:32,093 --> 00:27:33,283
Tissue that needs to be wet.
680
00:27:33,284 --> 00:27:35,725
So every ten minutes when
you hear that timer ding,
681
00:27:35,903 --> 00:27:37,959
you need to drench the tissue.
682
00:27:38,210 --> 00:27:38,724
Okay.
683
00:27:38,725 --> 00:27:40,415
Okay, good.
Now when I get close to the tumor,
684
00:27:40,416 --> 00:27:42,340
what I'm gonna do is,
I'm gonna ask you to...
685
00:27:42,341 --> 00:27:43,342
Drench the tissue. Got it.
686
00:27:43,343 --> 00:27:46,593
No. I'm going to stimulate
the facial nerve with a probe.
687
00:27:47,287 --> 00:27:48,196
And then I'm gonna ask you
688
00:27:48,197 --> 00:27:50,476
to tell me when Jimmy's face twitches.
689
00:27:51,272 --> 00:27:53,171
As long as we see a twitch,
690
00:27:53,172 --> 00:27:55,805
his facial function is still intact.
691
00:27:56,902 --> 00:27:58,098
Okay. Drench the tissue.
692
00:28:06,895 --> 00:28:08,935
Well, let's go. What are we waiting for?
693
00:28:09,566 --> 00:28:11,188
I got word to hold a minute.
694
00:28:15,789 --> 00:28:17,696
Okay, you're right. I can do this.
695
00:28:18,880 --> 00:28:19,976
Get off.
696
00:28:34,320 --> 00:28:36,385
All right. Well, call me when
you get eyes on the liver.
697
00:28:36,548 --> 00:28:37,514
Yeah.
698
00:29:22,566 --> 00:29:24,087
It looks good so far, Bailey.
699
00:29:24,407 --> 00:29:25,752
Now remember, once we get it out,
700
00:29:25,753 --> 00:29:27,462
we're only 50 minutes out.
701
00:29:27,597 --> 00:29:29,352
So you can start prepping her.
702
00:29:31,255 --> 00:29:32,848
Dr. Ross. I-I, no.
703
00:29:32,858 --> 00:29:35,179
I can't make the cut this time.
704
00:29:35,332 --> 00:29:36,726
Let's stop while we're ahead.
705
00:29:36,727 --> 00:29:37,960
No, I don't want you to make the cut.
706
00:29:37,961 --> 00:29:39,097
I want you to get the basin
707
00:29:39,098 --> 00:29:40,812
so I can put the liver in the basin.
708
00:29:40,813 --> 00:29:41,468
Can you do that?
709
00:29:41,469 --> 00:29:43,635
Yes. That I can do.
710
00:29:52,324 --> 00:29:54,057
Uh, Dr. Grey...
711
00:29:55,194 --> 00:29:57,009
Is... that a mass?
712
00:29:59,805 --> 00:30:01,207
- No.
- It isn't?
713
00:30:01,208 --> 00:30:02,576
No, I mean, it is.
714
00:30:02,577 --> 00:30:04,640
I... we have to have that biopsied.
715
00:30:09,756 --> 00:30:12,672
And how much does the Africa program cost?
716
00:30:12,673 --> 00:30:13,868
Less than you'd think.
717
00:30:13,869 --> 00:30:15,517
Admin costs comes out of an endowment,
718
00:30:15,518 --> 00:30:17,727
and all the surgical time is donated.
719
00:30:17,728 --> 00:30:19,817
But endowments don't tend to grow
720
00:30:19,818 --> 00:30:21,876
with the popularity of these programs,
721
00:30:21,877 --> 00:30:25,071
where, very soon,
you have every sick kid in Africa
722
00:30:25,072 --> 00:30:26,821
banging down your door.
723
00:30:29,129 --> 00:30:29,954
What happened?
724
00:30:29,955 --> 00:30:31,370
You need me to step in?
725
00:30:33,084 --> 00:30:34,405
No. No.
726
00:30:37,668 --> 00:30:38,692
Robbins?
727
00:30:39,088 --> 00:30:40,512
Try to picture the waves.
728
00:30:40,513 --> 00:30:41,715
I'm trying.
729
00:30:42,738 --> 00:30:44,724
Okay, really, what is... what is happening?
730
00:30:44,725 --> 00:30:47,170
Just calm the waves.
731
00:30:47,171 --> 00:30:48,665
These are tsunami-force waves, Owen.
732
00:30:48,666 --> 00:30:50,026
What is wrong with this woman?
733
00:30:50,027 --> 00:30:52,044
I mean, is she having a panic attack?
734
00:30:52,045 --> 00:30:53,227
Should she even be in the O.R.?
735
00:30:53,228 --> 00:30:54,667
Don't you have another operation
736
00:30:54,668 --> 00:30:55,465
you need to go see?
737
00:30:55,466 --> 00:30:56,434
I mean, Shepherd's doing...
738
00:30:56,435 --> 00:30:58,232
Yeah, an acoustic neuroma,
but that's later.
739
00:30:58,233 --> 00:31:00,459
No, it's now. He started hours ago.
740
00:31:00,989 --> 00:31:02,200
Look, you should go. I'll take over.
741
00:31:02,201 --> 00:31:03,597
All right. No one is moving.
742
00:31:03,598 --> 00:31:05,789
I'm stripping the endocardium
from the papillary muscle.
743
00:31:05,790 --> 00:31:07,886
I screw this up, I'll have
to replace the mitral valve,
744
00:31:07,887 --> 00:31:09,228
so don't move.
745
00:31:09,569 --> 00:31:10,196
I can switch out...
746
00:31:10,197 --> 00:31:12,871
Just shut up. I'm at the beach.
747
00:31:19,448 --> 00:31:20,553
Something's wrong.
748
00:31:21,347 --> 00:31:23,315
They should be back by now.
Something's wrong, isn't it?
749
00:31:23,316 --> 00:31:24,729
Uh, um...
750
00:31:25,665 --> 00:31:28,572
there was a mass on the liver.
751
00:31:28,605 --> 00:31:29,749
We're waiting for pathology to...
752
00:31:29,750 --> 00:31:31,118
Oh, god. A mass means cancer.
753
00:31:31,119 --> 00:31:33,203
It's cancer. You got two
donor livers in two days.
754
00:31:33,204 --> 00:31:34,305
There's no chance
we're getting another one.
755
00:31:34,306 --> 00:31:35,143
If this one has cancer, then...
756
00:31:35,144 --> 00:31:38,461
Okay, okay, Heidi,
just... it's not bad news yet.
757
00:31:38,462 --> 00:31:40,093
Okay? So just come on.
758
00:31:40,194 --> 00:31:42,009
Take deep breaths.
759
00:31:43,096 --> 00:31:43,719
Okay?
760
00:31:43,720 --> 00:31:44,736
Oh.
761
00:31:45,478 --> 00:31:46,317
Grey.
762
00:31:47,371 --> 00:31:49,214
Okay. Yeah.
763
00:31:49,684 --> 00:31:51,415
I'll see you in 50 minutes.
764
00:31:52,184 --> 00:31:52,734
Liver's fine.
765
00:31:52,735 --> 00:31:53,748
Oh, thank god.
766
00:31:53,811 --> 00:31:55,432
Okay. Oh. Thank you.
767
00:31:55,433 --> 00:31:56,102
All right.
768
00:31:56,103 --> 00:31:58,710
Okay, now we have to remove the tumor
769
00:31:59,049 --> 00:32:00,085
from the nerve sheath.
770
00:32:00,090 --> 00:32:01,054
Stimulator.
771
00:32:01,055 --> 00:32:02,994
Uh, I don't see any nerve fibers.
772
00:32:02,995 --> 00:32:04,135
It encased the entire nerve?
773
00:32:04,136 --> 00:32:07,190
Yeah, I'm afraid so.
Okay, facial function.
774
00:32:09,808 --> 00:32:10,936
Still twitching.
775
00:32:11,387 --> 00:32:12,375
Syringe.
776
00:32:13,212 --> 00:32:14,963
I was worried I missed the whole thing.
777
00:32:14,980 --> 00:32:15,501
Where are we at?
778
00:32:15,502 --> 00:32:16,846
Where we're at is, I'm trying to focus.
779
00:32:16,847 --> 00:32:19,132
I mean, how long has
the patient been open?
780
00:32:19,133 --> 00:32:20,181
Counting the minutes I'm wasting
781
00:32:20,182 --> 00:32:21,308
answering your questions?
782
00:32:21,309 --> 00:32:23,402
I'd have fewer questions,
but your intern told me
783
00:32:23,403 --> 00:32:25,275
that the surgery had been moved to 3:00.
784
00:32:25,276 --> 00:32:26,536
Clearly, it wasn't.
785
00:32:26,537 --> 00:32:28,323
So forgive me if I'm
trying to play catch up.
786
00:32:28,324 --> 00:32:29,675
Intern mistake. I apologize.
787
00:32:29,676 --> 00:32:32,300
Dr. Wilson was under orders
not to allow any visitors...
788
00:32:32,301 --> 00:32:34,011
I'm not a visitor, Dr. Shepherd.
789
00:32:34,012 --> 00:32:35,988
Anyone who is not surgically necessary
790
00:32:36,098 --> 00:32:37,950
is not welcome in my O.R.
791
00:32:44,197 --> 00:32:45,327
All right, cottonoid,
792
00:32:45,396 --> 00:32:46,644
Boki, please.
793
00:32:53,650 --> 00:32:55,332
I have to switch, Alex.
794
00:32:55,333 --> 00:32:56,375
No one is switching.
795
00:32:56,376 --> 00:32:58,443
You're holding the mitral valve,
so don't move.
796
00:32:58,444 --> 00:32:59,286
What's wrong? Are you sick?
797
00:32:59,287 --> 00:33:01,457
Alex, take that scalpel...
798
00:33:01,621 --> 00:33:02,664
What? What are you doing?
799
00:33:02,665 --> 00:33:03,860
And stab me in the foot.
800
00:33:03,861 --> 00:33:04,636
What? What?
801
00:33:04,637 --> 00:33:06,928
- My prosthetic. Stab me.
- What is wrong with you?
802
00:33:06,929 --> 00:33:07,863
- Dr. Karev.
- Ohh!
803
00:33:07,864 --> 00:33:09,200
I am the chief of surgery.
804
00:33:09,201 --> 00:33:10,282
This is an order.
805
00:33:10,365 --> 00:33:12,784
Stab Dr. Robbins in the foot right now.
806
00:33:13,151 --> 00:33:14,087
What?
807
00:33:15,401 --> 00:33:16,001
Alex.
808
00:33:16,002 --> 00:33:17,360
Of course.
809
00:33:19,477 --> 00:33:21,635
Arizona? Alex!
810
00:33:42,691 --> 00:33:43,697
That's better.
811
00:33:43,769 --> 00:33:44,783
That's better.
812
00:33:49,254 --> 00:33:50,136
Suction.
813
00:33:50,558 --> 00:33:51,182
What happened? Did I...
814
00:33:51,183 --> 00:33:53,304
You didn't do anything.
It's a bleeder. Cautery.
815
00:33:57,260 --> 00:33:58,151
Cottonoid.
816
00:33:58,796 --> 00:33:59,697
Okay.
817
00:34:00,124 --> 00:34:02,493
Got it. How's the facial function?
818
00:34:07,164 --> 00:34:09,025
I'm sorry. I don't see a twitch.
819
00:34:13,949 --> 00:34:15,519
Come on, Jimmy. Twitch.
820
00:34:19,286 --> 00:34:20,157
Damn it.
821
00:34:22,231 --> 00:34:22,913
What does that mean?
822
00:34:22,914 --> 00:34:25,958
It means we may have cost Jimmy
823
00:34:25,959 --> 00:34:27,751
the ability to move half his face.
824
00:34:30,190 --> 00:34:31,626
We won't know until he wakes up.
825
00:34:41,958 --> 00:34:43,625
Oh, perfect timing, Grey.
826
00:34:53,714 --> 00:34:55,654
Oh, no. Did I step on your foot?
827
00:34:55,655 --> 00:34:57,441
No. I'm not mad this time.
828
00:34:57,442 --> 00:34:59,827
Oh. So you cry when you're happy, too?
829
00:35:02,294 --> 00:35:03,582
Apparently.
830
00:35:04,686 --> 00:35:07,254
Eyes on the liver. Learn something.
831
00:35:15,508 --> 00:35:16,616
Edwards, status report.
832
00:35:16,617 --> 00:35:17,900
Uh, uh...
833
00:35:18,254 --> 00:35:20,741
Your M.V.C. is in bed 1
waiting on an angio.
834
00:35:20,780 --> 00:35:22,632
I paged an ortho consult for bed 2,
835
00:35:22,633 --> 00:35:24,358
and drunk guy in bed 3.
836
00:35:24,359 --> 00:35:26,137
- And what's in bed 4?
- New patient. Patellar dislocation.
837
00:35:26,138 --> 00:35:27,050
And bed 13?
838
00:35:27,604 --> 00:35:28,974
There is no bed 13.
839
00:35:30,512 --> 00:35:32,289
Good job, Edwards. You passed.
840
00:35:32,290 --> 00:35:34,929
And your waiting room is clear.
Nicely done.
841
00:35:35,132 --> 00:35:36,558
Ah, sorry to interrupt.
842
00:35:36,559 --> 00:35:37,686
Do you need something?
843
00:35:38,280 --> 00:35:39,044
Kinda.
844
00:35:39,996 --> 00:35:41,254
I've been watching you for two days.
845
00:35:41,255 --> 00:35:42,905
You don't seem to slow down.
846
00:35:43,046 --> 00:35:43,962
I thought you might need a break.
847
00:35:43,963 --> 00:35:45,552
Maybe grab a cup of coffee?
848
00:35:47,814 --> 00:35:48,402
Probably shouldn't have started
849
00:35:48,402 --> 00:35:51,156
with the whole "Watching you" thing, huh?
850
00:35:51,631 --> 00:35:54,185
Now you think I'm some
sort of creeper. I'm not.
851
00:35:54,392 --> 00:35:56,005
Unless you're inclined to
have coffee with creepers,
852
00:35:56,006 --> 00:35:57,655
in which case, I totally creep,
853
00:35:57,656 --> 00:35:59,278
like, all the time.
854
00:36:02,440 --> 00:36:04,270
Her heart is, uh, pumping like a champ.
855
00:36:04,271 --> 00:36:06,181
Thank you, both of you.
856
00:36:07,648 --> 00:36:09,622
What else do you have over there?
857
00:36:10,768 --> 00:36:11,652
I'm sorry?
858
00:36:11,669 --> 00:36:13,693
Uh... sick...
859
00:36:13,723 --> 00:36:15,552
orphan... children?
860
00:36:15,689 --> 00:36:16,971
Kids with heart problems?
861
00:36:16,972 --> 00:36:17,759
Aah.
862
00:36:17,856 --> 00:36:19,636
She means, she's glad the program
863
00:36:19,637 --> 00:36:21,331
is up and running again.
864
00:36:21,432 --> 00:36:22,557
Both of us are.
865
00:36:23,721 --> 00:36:24,597
Yes.
866
00:36:27,501 --> 00:36:28,918
Look at me. I'm a mess.
867
00:36:29,141 --> 00:36:30,876
I ate a stupid big cookie.
868
00:36:31,042 --> 00:36:32,840
That's what you get when
you keep me worried sick
869
00:36:32,841 --> 00:36:34,518
for 22 hours.
870
00:36:35,449 --> 00:36:37,207
Hey, Jimmy, can you wince like that again?
871
00:36:38,948 --> 00:36:40,114
Answer the man.
872
00:36:42,186 --> 00:36:43,440
Facial expression looks symmetrical.
873
00:36:43,441 --> 00:36:44,347
Mm-hmm.
874
00:36:44,391 --> 00:36:47,410
Did he... can you hear me?
875
00:36:48,023 --> 00:36:49,880
Who could ignore that voice?
876
00:37:00,321 --> 00:37:02,749
All right, welcome. Welcome, everyone.
877
00:37:02,750 --> 00:37:05,035
Thank you so much for coming.
878
00:37:05,413 --> 00:37:07,143
It has been a privilege to watch you work,
879
00:37:07,144 --> 00:37:09,320
and I am so impressed with what I've seen.
880
00:37:09,581 --> 00:37:12,437
Dr. Karev's pediatric
African exchange program...
881
00:37:12,438 --> 00:37:14,057
You cannot cut that program.
882
00:37:16,101 --> 00:37:17,125
I'm sorry, but these children,
883
00:37:17,126 --> 00:37:19,844
these... little orphans...
884
00:37:20,311 --> 00:37:22,893
we are the only hope they have.
885
00:37:23,061 --> 00:37:25,066
Many of them have rare disorders
886
00:37:25,235 --> 00:37:26,731
that most western doctors
887
00:37:26,732 --> 00:37:28,685
rarely have the opportunity to treat.
888
00:37:28,994 --> 00:37:29,886
And if you stop the program,
889
00:37:29,887 --> 00:37:31,582
I will never get that chance again.
890
00:37:37,315 --> 00:37:38,106
They.
891
00:37:39,593 --> 00:37:42,353
They will never get that chance,
892
00:37:43,618 --> 00:37:44,864
the precious children.
893
00:37:45,145 --> 00:37:47,620
I have no intention of cutting it.
894
00:37:48,022 --> 00:37:48,679
Super.
895
00:37:48,680 --> 00:37:51,227
It's a no-brainer from a P.R. standpoint.
896
00:37:51,629 --> 00:37:55,041
That kind of positive visility is gold.
897
00:37:56,249 --> 00:37:59,061
However, there will have to be some cuts.
898
00:38:00,020 --> 00:38:01,518
And I'm going to suggest one
899
00:38:01,519 --> 00:38:04,273
that is going to seem surprising at first,
900
00:38:04,433 --> 00:38:06,342
but that addresses fiduciary concerns
901
00:38:06,343 --> 00:38:08,683
with nominal impact on the core facility
902
00:38:08,684 --> 00:38:10,668
and the human and physical resources.
903
00:38:10,669 --> 00:38:11,701
Oh, I'm sorry. What?
904
00:38:11,702 --> 00:38:13,126
Uh, yeah. I'm out.
905
00:38:15,085 --> 00:38:18,105
I am proposing that we close your E.R.
906
00:38:18,431 --> 00:38:20,602
What?
907
00:38:20,603 --> 00:38:23,012
We're a level 1 trauma center.
908
00:38:23,013 --> 00:38:24,282
We're a hospital.
909
00:38:24,290 --> 00:38:25,654
In the last three days,
910
00:38:25,655 --> 00:38:27,642
your E.R. went from being in shambles
911
00:38:27,643 --> 00:38:28,648
to peak efficiency.
912
00:38:28,649 --> 00:38:29,942
Well, then why would
you propose cutting it?
913
00:38:29,943 --> 00:38:33,271
This allowed me to see
that in either case,
914
00:38:33,383 --> 00:38:34,614
it's not bringing in the money.
915
00:38:34,615 --> 00:38:36,655
It's bringing in the patients.
916
00:38:36,844 --> 00:38:39,451
Over half of whom are non-emergent,
917
00:38:39,592 --> 00:38:40,573
under-insured,
918
00:38:40,574 --> 00:38:43,451
and belong in a primary
care physician's office.
919
00:38:43,452 --> 00:38:46,610
You have surgical interns
in there doing chest exams.
920
00:38:46,749 --> 00:38:49,096
It's hemorrhaging resources.
921
00:38:49,616 --> 00:38:52,034
Look, I know these cuts
are going to be painful.
922
00:38:52,048 --> 00:38:53,512
But understand that I am trying
923
00:38:53,719 --> 00:38:55,031
to keep your hospital doors open.
924
00:38:55,032 --> 00:38:59,212
This is ridiculous.
You can't close the E.R.
925
00:38:59,353 --> 00:39:01,654
You went to med school.
You have to ask yourself...
926
00:39:01,655 --> 00:39:03,388
Do you have a better idea?
927
00:39:03,737 --> 00:39:05,654
Because the way I see it,
928
00:39:05,655 --> 00:39:09,535
this woman is trying to keep
the hospital from closing,
929
00:39:09,536 --> 00:39:12,269
in-in which case there'd be no patients,
930
00:39:12,284 --> 00:39:13,290
we'd have no jobs,
931
00:39:13,291 --> 00:39:16,803
and some of us don't have
a few million to fall back on.
932
00:39:16,804 --> 00:39:19,346
So unless you have a better idea,
933
00:39:19,526 --> 00:39:20,608
why don't you just sit there
934
00:39:20,609 --> 00:39:22,405
and listen to what she has to say?
935
00:39:27,371 --> 00:39:28,321
All right.
936
00:39:28,475 --> 00:39:30,965
So... the other proposals
937
00:39:30,966 --> 00:39:34,523
include a review of I.C.U.,
step-down closures
938
00:39:34,567 --> 00:39:36,380
with a reorganization of post-op care...
939
00:39:45,368 --> 00:39:46,323
Alana.
940
00:39:46,979 --> 00:39:49,468
Uh, you've been here three days.
941
00:39:49,793 --> 00:39:51,119
I've been here for years.
942
00:39:51,273 --> 00:39:53,192
Maybe you judged us a little harshly.
943
00:39:53,496 --> 00:39:54,189
Maybe we can work together...
944
00:39:54,190 --> 00:39:55,528
Being a harsh judge
945
00:39:55,529 --> 00:39:58,022
is a necessary part of my job, sir.
946
00:39:58,496 --> 00:40:00,028
I can see you're disappointed in me,
947
00:40:00,029 --> 00:40:02,963
but it was your job to judge me
when you were my teacher.
948
00:40:03,103 --> 00:40:04,175
You're not anymore.
949
00:40:04,176 --> 00:40:04,826
No, that's not the case. I'm...
950
00:40:04,827 --> 00:40:07,088
You said something to us
during my intern year
951
00:40:07,089 --> 00:40:08,823
that I have never forgotten.
952
00:40:09,478 --> 00:40:12,899
You said, "Medicine is
constantly changing."
953
00:40:13,269 --> 00:40:16,374
"You need to be part of
that change or get out."
954
00:40:17,270 --> 00:40:19,103
I'll be making some changes.
955
00:40:19,603 --> 00:40:20,566
You should be proud of me.
956
00:40:23,550 --> 00:40:24,611
By the way,
957
00:40:25,209 --> 00:40:26,763
you logged fewer O.R. hours
958
00:40:26,764 --> 00:40:30,015
than any other general
surgeon on staff last month.
959
00:40:33,079 --> 00:40:34,057
Good night.
960
00:40:36,577 --> 00:40:39,568
The body can be stubborn when
it comes to accepting change.
961
00:40:39,754 --> 00:40:40,816
Ugh. This...
962
00:40:42,501 --> 00:40:44,022
this is so stupid.
963
00:40:44,649 --> 00:40:45,950
We're a level 1 trauma center.
964
00:40:45,951 --> 00:40:47,138
This woman's an idiot.
965
00:40:47,139 --> 00:40:48,479
Well, and a little bitchy.
966
00:40:48,480 --> 00:40:51,574
Ugh. This was supposed to be a good day.
967
00:40:51,575 --> 00:40:53,646
Shepherd did a 23-hour surgery.
968
00:40:53,647 --> 00:40:55,751
We're supposed to be popping champagne.
969
00:40:55,987 --> 00:40:57,168
Let's try and go to sleep.
970
00:40:57,169 --> 00:41:00,165
Ugh! I don't think I can. I'm so pissed.
971
00:41:00,230 --> 00:41:01,578
The mind holds out hope
972
00:41:01,579 --> 00:41:03,747
that the body can be whole again.
973
00:41:04,706 --> 00:41:06,527
Do you want to go to the beach with me?
974
00:41:07,557 --> 00:41:08,423
What?
975
00:41:09,004 --> 00:41:11,346
And the mind will always fight for hope,
976
00:41:12,459 --> 00:41:13,973
tooth and nail...
977
00:41:14,390 --> 00:41:16,889
Bailey had no business
calling you out like that.
978
00:41:16,890 --> 00:41:18,072
She's nervous.
979
00:41:18,560 --> 00:41:19,958
Everybody's nervous.
980
00:41:21,849 --> 00:41:23,468
Everybody should be nervous.
981
00:41:23,631 --> 00:41:25,442
It's not our fault.
982
00:41:25,940 --> 00:41:26,955
Is it?
983
00:41:28,321 --> 00:41:29,605
It feels like it is.
984
00:41:32,588 --> 00:41:34,051
Hey, congratulations.
985
00:41:34,759 --> 00:41:35,831
For what?
986
00:41:35,934 --> 00:41:37,480
Your acoustic neuroma.
987
00:41:37,481 --> 00:41:38,135
Mm.
988
00:41:38,136 --> 00:41:40,916
You got your hand back. You're you again.
989
00:41:41,423 --> 00:41:43,048
We can be happy about that.
990
00:41:44,232 --> 00:41:46,044
Until it finds a way of understanding
991
00:41:46,045 --> 00:41:47,344
this new reality...
992
00:41:47,488 --> 00:41:49,250
I flew on a plane today.
993
00:41:49,251 --> 00:41:50,440
You did?
994
00:41:51,055 --> 00:41:51,968
I did.
995
00:41:54,323 --> 00:41:55,881
Congratulations.
996
00:41:59,168 --> 00:42:01,126
And accepts that what is gone...
997
00:42:07,959 --> 00:42:09,529
Is gone forever.
998
00:42:19,031 --> 00:42:20,851
This really kind of works.
999
00:42:27,287 --> 00:42:37,187
Sync by YYeTs
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