1 00:00:01,277 --> 00:00:02,894 He's putting me on a renal diet. 2 00:00:02,895 --> 00:00:04,576 And if that doesn't turn things around, then... 3 00:00:04,577 --> 00:00:05,576 Dialysis? 4 00:00:05,577 --> 00:00:07,379 I'm so sorry. 5 00:00:07,380 --> 00:00:10,173 I don't advertise my immigration status, 6 00:00:10,174 --> 00:00:11,896 but I'm undocumented. 7 00:00:11,897 --> 00:00:15,066 My future always feels precarious. 8 00:00:15,067 --> 00:00:16,806 More money in our checks! 9 00:00:16,807 --> 00:00:18,856 We are essential! 10 00:00:18,857 --> 00:00:20,986 - You're striking? - It's very important 11 00:00:20,987 --> 00:00:23,296 that Liliana feels like I have her back. 12 00:00:23,297 --> 00:00:24,856 I'm going with my friends to celebrate. 13 00:00:24,857 --> 00:00:26,076 - Come! - Oh, no... 14 00:00:26,077 --> 00:00:28,167 - You have to come. - You're my boyfriend. 15 00:00:34,567 --> 00:00:35,876 Lil. 16 00:00:35,877 --> 00:00:37,306 Daniel. 17 00:00:37,307 --> 00:00:38,436 Oh, the time. 18 00:00:38,437 --> 00:00:40,446 I didn't realize. 19 00:00:40,447 --> 00:00:42,396 I... I'm almost finished. 20 00:00:42,397 --> 00:00:44,796 I'm usually done before you arrive. 21 00:00:44,797 --> 00:00:45,886 - I'm sorry. - Oh, no. 22 00:00:45,887 --> 00:00:47,056 No, let me get that. Let me get that. 23 00:00:47,057 --> 00:00:49,056 I'm the one who should be apologizing. 24 00:00:49,057 --> 00:00:52,016 No. No, I had the interns in for pizza last night. 25 00:00:52,017 --> 00:00:52,976 Then they dragged me out for a drink, 26 00:00:52,977 --> 00:00:54,626 and... and we just left. 27 00:00:54,627 --> 00:00:55,846 It's OK. I've got it. 28 00:00:55,847 --> 00:00:57,416 I apologize for the mess. Really, I do. 29 00:00:57,417 --> 00:00:58,716 It's OK. 30 00:00:58,717 --> 00:01:00,987 Compared to other offices, it's not that bad. 31 00:01:03,597 --> 00:01:06,376 Oh! 32 00:01:06,377 --> 00:01:08,596 Daniel, have a good day. 33 00:01:08,597 --> 00:01:09,907 You too. 34 00:01:15,127 --> 00:01:16,126 Ah. 35 00:01:16,127 --> 00:01:18,916 I think this belongs to you. 36 00:01:18,917 --> 00:01:20,876 - Indeed, it does. - Where did you find it? 37 00:01:20,877 --> 00:01:22,136 This time? Waiting room. 38 00:01:22,137 --> 00:01:23,966 - Top of the vending machine. - Mm. 39 00:01:23,967 --> 00:01:26,316 You know, maybe I should just put it 40 00:01:26,317 --> 00:01:28,316 in a little red-and-white striped shirt, 41 00:01:28,317 --> 00:01:30,356 put a bobble hat on it, black glasses, 42 00:01:30,357 --> 00:01:33,976 and call it my "Where's Waldo?" water bottle, huh? 43 00:01:33,977 --> 00:01:35,976 You get it? 44 00:01:35,977 --> 00:01:37,546 I get it. 45 00:01:37,547 --> 00:01:39,157 You have to stay hydrated. 46 00:01:39,977 --> 00:01:41,587 Thanks, Mom. 47 00:01:44,937 --> 00:01:46,286 Dr. Cuevas. 48 00:01:46,287 --> 00:01:49,036 - Ms. Goodwin, good morning. - Good morning. 49 00:01:49,037 --> 00:01:52,556 Do you have a moment to discuss your DACA renewal? 50 00:01:52,557 --> 00:01:55,166 Oh. Um, now? 51 00:01:55,167 --> 00:01:57,736 Well, the paperwork's not due for a few months, 52 00:01:57,737 --> 00:02:00,346 but I want to make sure we get everything filed early, 53 00:02:00,347 --> 00:02:02,916 just in case there's an unexpected policy change. 54 00:02:02,917 --> 00:02:05,486 - Right, of course. - I appreciate that. 55 00:02:05,487 --> 00:02:07,916 I just was about to dig into these overnight charts. 56 00:02:07,917 --> 00:02:09,526 Understood. 57 00:02:09,527 --> 00:02:12,276 How about we meet up at the end of the day? 58 00:02:12,277 --> 00:02:15,016 Yeah. Sure, that works. 59 00:02:15,017 --> 00:02:17,017 I will... I'll see you then. 60 00:02:19,887 --> 00:02:21,066 - Dr. Asher. - Mm-hmm? 61 00:02:21,067 --> 00:02:22,066 - Need you. - Oh, yeah. 62 00:02:22,067 --> 00:02:23,716 Come this way. 63 00:02:23,717 --> 00:02:25,116 Hi, I'm Dr. Asher. 64 00:02:25,117 --> 00:02:27,856 Leah, what's going on? 65 00:02:27,857 --> 00:02:29,506 Parents and their daughter. 66 00:02:29,507 --> 00:02:31,856 Came in a few minutes ago. They're terrified. 67 00:02:31,857 --> 00:02:34,516 - Even scared me. - Going to two. 68 00:02:34,517 --> 00:02:36,256 - I didn't get a history. - Just came for you. 69 00:02:36,257 --> 00:02:38,296 - Excuse me, Doctor. - We need your help. 70 00:02:38,297 --> 00:02:40,216 - Our daughter. - All right. 71 00:02:40,217 --> 00:02:42,606 Hi, I'm Dr. Halstead. What's your name? 72 00:02:42,607 --> 00:02:44,216 Maria. 73 00:02:44,217 --> 00:02:46,216 Her name is Maria. Very sick! 74 00:02:46,217 --> 00:02:49,267 Listen. 75 00:02:52,397 --> 00:02:54,616 I'm sorry. I don't speak Spanish. 76 00:02:54,617 --> 00:02:56,486 Get Dr. Cuevas. 77 00:02:56,487 --> 00:02:59,887 I'm just gonna feel your neck, OK? 78 00:03:00,927 --> 00:03:02,276 Does that hurt? 79 00:03:02,277 --> 00:03:03,587 ¿Malo? Bad? 80 00:03:13,687 --> 00:03:14,896 What are they saying? 81 00:03:14,897 --> 00:03:17,036 They're saying that she has the sickness, 82 00:03:17,037 --> 00:03:19,427 and if we don't help her, she will die. 83 00:03:34,527 --> 00:03:36,448 Thank you. 84 00:03:36,449 --> 00:03:38,450 Hey. How's Maria doing? 85 00:03:38,451 --> 00:03:39,542 Still a bit groggy, 86 00:03:39,543 --> 00:03:41,366 but responding to questions in English. 87 00:03:41,367 --> 00:03:43,586 Whatever this is, it seems to be sporadic. 88 00:03:43,587 --> 00:03:45,456 - Any guesses? - I don't know. 89 00:03:45,457 --> 00:03:48,546 Maybe infectious encephalitis, but her vitals were normal. 90 00:03:48,547 --> 00:03:50,026 I'm hoping labs shed some light. 91 00:03:50,027 --> 00:03:51,626 What did Mom and Dad have to say? 92 00:03:51,627 --> 00:03:53,276 The sickness that they're referring to 93 00:03:53,277 --> 00:03:54,926 has to do with her older brother, Hugo. 94 00:03:54,927 --> 00:03:57,266 About a month ago, he came down with an illness, 95 00:03:57,267 --> 00:03:58,916 was admitted to Oakview Community Hospital, 96 00:03:58,917 --> 00:04:01,876 - and then died a few days later. - Oh, man. 97 00:04:01,877 --> 00:04:03,186 Yeah, and even worse, 98 00:04:03,187 --> 00:04:05,146 Oakview couldn't make a diagnosis. 99 00:04:05,147 --> 00:04:07,016 Well, explains why they're beating down our doors. 100 00:04:07,017 --> 00:04:09,456 They're afraid whatever ravaged Hugo is now attacking Maria. 101 00:04:09,457 --> 00:04:12,496 But a death in the family, no answers, 102 00:04:12,497 --> 00:04:15,126 plus the fear that she might have the same illness? 103 00:04:15,127 --> 00:04:17,516 Since nothing's jumping out, I think it's possible 104 00:04:17,517 --> 00:04:19,646 that her emotions could be manifesting physically. 105 00:04:19,647 --> 00:04:21,386 I want to talk to her, see if there could be 106 00:04:21,387 --> 00:04:22,686 - a psych explanation. - OK. 107 00:04:22,687 --> 00:04:24,246 Meantime, I'll reach out to Oakview, 108 00:04:24,247 --> 00:04:26,126 get Hugo's records and autopsy results. 109 00:04:26,127 --> 00:04:27,486 If Maria does have the same illness, 110 00:04:27,487 --> 00:04:30,236 - there could be a clue in there. - OK. 111 00:04:30,237 --> 00:04:32,416 OK, Layla, you're 7 centimeters dilated, 112 00:04:32,417 --> 00:04:34,066 100% effaced. 113 00:04:34,067 --> 00:04:35,676 How long ago did your water break? 114 00:04:35,677 --> 00:04:38,377 About an hour, hour and a... 115 00:04:39,767 --> 00:04:41,946 7:02 a.m., I think. 116 00:04:41,947 --> 00:04:43,776 This baby is coming out sideways. 117 00:04:43,777 --> 00:04:45,076 No, it just feels like that. 118 00:04:45,077 --> 00:04:46,206 Your fetus is OP, 119 00:04:46,207 --> 00:04:47,776 meaning it's facing up instead of down. 120 00:04:47,777 --> 00:04:49,086 - Something's wrong? - No. 121 00:04:49,087 --> 00:04:50,696 Baby's just moving around, letting us know 122 00:04:50,697 --> 00:04:52,436 that it is time to come out. 123 00:04:52,437 --> 00:04:54,046 I'll have a nurse let L&D know. 124 00:04:54,047 --> 00:04:55,476 Oh, my God. 125 00:04:55,477 --> 00:04:57,306 Quentin, our son is coming. 126 00:04:57,307 --> 00:04:59,096 I'm gonna be a mom today. 127 00:04:59,097 --> 00:05:01,316 You know, I can't remember if I turned off the oven 128 00:05:01,317 --> 00:05:02,536 before we left the house. 129 00:05:02,537 --> 00:05:04,356 Quentin, we haven't cooked in days. 130 00:05:04,357 --> 00:05:05,796 The oven is off. 131 00:05:05,797 --> 00:05:07,016 I'm just gonna go home and check. 132 00:05:07,017 --> 00:05:08,236 Quentin, no! 133 00:05:08,237 --> 00:05:10,016 - Mr. Bell, please don't go. - You know what? 134 00:05:10,017 --> 00:05:11,716 Maybe you can have a neighbor check on it, 135 00:05:11,717 --> 00:05:13,146 or maybe it's just nervous energy 136 00:05:13,147 --> 00:05:14,976 that's making you think that you left it on. 137 00:05:14,977 --> 00:05:17,326 Yeah, I just don't feel like myself. 138 00:05:17,327 --> 00:05:19,326 I get it. It's a big day. 139 00:05:19,327 --> 00:05:20,546 You know, a lot of new experiences 140 00:05:20,547 --> 00:05:21,816 all happening at once. 141 00:05:21,817 --> 00:05:25,336 But, Quentin, this is not new for me. 142 00:05:25,337 --> 00:05:26,946 I have been here many, many times, 143 00:05:26,947 --> 00:05:28,426 and I know exactly how to help you and Layla 144 00:05:28,427 --> 00:05:30,686 get through this. 145 00:05:30,687 --> 00:05:31,907 Thank you. 146 00:05:33,127 --> 00:05:34,176 Sorry, Lay. 147 00:05:34,177 --> 00:05:36,087 I just lost my mind for a minute. 148 00:05:38,217 --> 00:05:40,957 - Nice save. - Mm-hmm. 149 00:05:42,527 --> 00:05:46,006 Hey, Sam. This is Dr. Tanaka-Reed. 150 00:05:46,007 --> 00:05:47,406 He's gonna be scrubbing in with me today. 151 00:05:47,407 --> 00:05:48,926 He's one of my surgical residents. 152 00:05:48,927 --> 00:05:50,496 Uh, technically I'm a resident 153 00:05:50,497 --> 00:05:52,056 but definitely not a beginner. 154 00:05:52,057 --> 00:05:52,976 OK. 155 00:05:52,977 --> 00:05:54,936 Anyway, like we discussed, 156 00:05:54,937 --> 00:05:56,586 it's a straight appendix removal. 157 00:05:56,587 --> 00:05:58,066 You're gonna be a bit sore afterwards, 158 00:05:58,067 --> 00:06:00,326 but in a week or two, you'll be back to full strength. 159 00:06:00,327 --> 00:06:01,936 Mm, perfect, 160 00:06:01,937 --> 00:06:03,896 because I've been itching to get back in the gym. 161 00:06:03,897 --> 00:06:05,636 Rugged Maniac is this summer. 162 00:06:05,637 --> 00:06:07,856 - Rugged Maniac? - The adventure race? 163 00:06:07,857 --> 00:06:09,596 - You know it? - Yeah, sort of. 164 00:06:09,597 --> 00:06:10,686 A couple of guys from the community 165 00:06:10,687 --> 00:06:11,996 are putting a team together. 166 00:06:11,997 --> 00:06:13,866 Community? You mean other doctors? 167 00:06:13,867 --> 00:06:16,866 No, CrossFit. 168 00:06:16,867 --> 00:06:19,176 From my Kalsu group. Kalsu's a workout. 169 00:06:19,177 --> 00:06:21,046 We do burpees and thrusters for time. 170 00:06:21,047 --> 00:06:22,616 Anyway, back to the task at hand. 171 00:06:22,617 --> 00:06:24,527 If you're ready, we're ready. 172 00:06:25,327 --> 00:06:27,156 - Let's do this. - Great. 173 00:06:27,157 --> 00:06:28,896 Nurse Trisha will be in to get the prep started. 174 00:06:28,897 --> 00:06:31,376 - Anesthesia after that. - Sounds good, Doc. 175 00:06:31,377 --> 00:06:33,377 See you on the other side, all right? 176 00:06:35,577 --> 00:06:38,196 - Appendix removal... - Pretty basic. 177 00:06:38,197 --> 00:06:39,886 Well, sorry Sam's not sick enough for you. 178 00:06:39,887 --> 00:06:41,196 Oh, you know what I mean. 179 00:06:41,197 --> 00:06:43,636 OR 2.0 is a Ferrari... Sexy surgery. 180 00:06:43,637 --> 00:06:45,766 But a lap appy? That's a minivan. 181 00:06:45,767 --> 00:06:47,806 Well, not even in that today. 182 00:06:47,807 --> 00:06:50,596 Sam had a sigmoid colon resection 18 months ago. 183 00:06:50,597 --> 00:06:52,036 Likely adhesions in his pelvis, 184 00:06:52,037 --> 00:06:54,686 so we're gonna do this appy open... 185 00:06:54,687 --> 00:06:56,426 Right lower quadrant incision. 186 00:06:56,427 --> 00:06:58,086 - OK? - Old school. 187 00:06:58,087 --> 00:07:01,086 Gee, hope I'm up to the challenge. 188 00:07:01,087 --> 00:07:03,736 For a resident, guy sure is full of himself. 189 00:07:03,737 --> 00:07:05,177 I'm not a fan. 190 00:07:08,227 --> 00:07:09,917 Hugo's gone. 191 00:07:11,647 --> 00:07:14,127 I'm oldest now. I need to be strong. 192 00:07:15,917 --> 00:07:17,838 For my other brothers and sisters. 193 00:07:19,307 --> 00:07:20,697 For my parents. 194 00:07:23,590 --> 00:07:25,695 They've been a wreck since Hugo died. 195 00:07:27,707 --> 00:07:29,576 They can't sleep. 196 00:07:29,577 --> 00:07:31,536 They can't eat. 197 00:07:31,537 --> 00:07:34,537 Now I'm putting them through it again. 198 00:07:36,339 --> 00:07:38,196 - I have it too. - No. 199 00:07:38,197 --> 00:07:40,376 Hey, we don't know that. 200 00:07:40,377 --> 00:07:43,856 All of the labs Dr. Halstead ran came back normal. 201 00:07:43,857 --> 00:07:46,557 Then what's wrong with me? 202 00:07:47,727 --> 00:07:50,076 In some cases, it's possible 203 00:07:50,077 --> 00:07:53,946 for grief and fear to lead to physical symptoms. 204 00:07:53,947 --> 00:07:56,606 No, I'm not imagining this. 205 00:07:56,607 --> 00:07:58,436 No, you're not. 206 00:07:58,437 --> 00:08:01,696 Your symptoms are very real. 207 00:08:01,697 --> 00:08:05,565 You suffered a devastating loss, a trauma. 208 00:08:08,707 --> 00:08:11,187 Hugo's tests were normal too. 209 00:08:14,187 --> 00:08:16,107 And then he died. 210 00:08:20,197 --> 00:08:21,976 I don't think we're looking at a psych condition. 211 00:08:21,977 --> 00:08:23,636 In conversion disorder, it's rare 212 00:08:23,637 --> 00:08:26,116 that patients can express their emotions the way Maria is. 213 00:08:26,117 --> 00:08:28,416 But her awareness of the situation, 214 00:08:28,417 --> 00:08:31,426 her acknowledgment of the fear, it doesn't fit. 215 00:08:31,427 --> 00:08:34,206 There's definitely something physical going on. 216 00:08:34,207 --> 00:08:35,646 I wish I knew what. 217 00:08:35,647 --> 00:08:37,476 Medical examiner said Hugo died of brain swelling 218 00:08:37,477 --> 00:08:39,296 but don't know what caused it. 219 00:08:39,297 --> 00:08:41,216 It was only three days 220 00:08:41,217 --> 00:08:43,346 from when Hugo was admitted to the time he died. 221 00:08:43,347 --> 00:08:46,957 OK, so whatever it is, it moved really fast. 222 00:08:48,917 --> 00:08:51,706 I think he's stuck. 223 00:08:51,707 --> 00:08:52,926 No, just a big head. 224 00:08:52,927 --> 00:08:54,926 That's all. 225 00:08:54,927 --> 00:08:56,186 Oh, my God. 226 00:08:56,187 --> 00:08:57,886 - Is he gonna fit? - Yes, he will. 227 00:08:57,887 --> 00:08:59,316 We just need to open up the birth canal a bit wider. 228 00:08:59,317 --> 00:09:00,716 - McRoberts? - Yes. 229 00:09:00,717 --> 00:09:02,586 Call the OB resident on call. 230 00:09:02,587 --> 00:09:05,106 Layla, we're gonna adjust you to a new position, OK? 231 00:09:05,107 --> 00:09:06,676 It makes it easier for the baby to come out. 232 00:09:06,677 --> 00:09:07,976 OK. 233 00:09:07,977 --> 00:09:09,726 - I'm right here. - All right, Quentin. 234 00:09:09,727 --> 00:09:11,546 Why don't you let him take over for you, OK? 235 00:09:11,547 --> 00:09:12,726 - And I can use some pressure. - Yep. 236 00:09:12,727 --> 00:09:15,116 I'm right here. 237 00:09:15,117 --> 00:09:16,856 OK, now on your next contraction, 238 00:09:16,857 --> 00:09:18,516 I want you to give me everything you've got. 239 00:09:18,517 --> 00:09:19,776 - Everything. - OK. 240 00:09:19,777 --> 00:09:21,126 - OK. - I can do this. 241 00:09:21,127 --> 00:09:22,956 - Yes, you can. - You got this. 242 00:09:22,957 --> 00:09:25,516 - You got this. You got this. - OK. 243 00:09:25,517 --> 00:09:27,397 Oh. 244 00:09:29,617 --> 00:09:31,656 I've got the head. 245 00:09:31,657 --> 00:09:32,857 Shoulder. 246 00:09:34,447 --> 00:09:36,056 I've got him. 247 00:09:36,057 --> 00:09:38,316 I got him. He's here. 248 00:09:38,317 --> 00:09:40,097 He's here. 249 00:09:41,097 --> 00:09:43,366 - He's here. - Oh, my God. 250 00:09:43,367 --> 00:09:45,806 Oh, my God. 251 00:09:45,807 --> 00:09:47,716 I'm a mom. 252 00:09:47,717 --> 00:09:50,456 Our baby, he's beautiful. 253 00:09:50,457 --> 00:09:52,156 He's perfect. 254 00:09:52,157 --> 00:09:54,506 Hey, Dad, do you want to cut the umbilical cord? 255 00:09:54,507 --> 00:09:56,416 Yeah. 256 00:09:56,417 --> 00:09:59,179 OK. Just right here in the middle, OK? 257 00:10:02,997 --> 00:10:04,816 I want to hold him. 258 00:10:04,817 --> 00:10:06,646 That's not my son. 259 00:10:08,567 --> 00:10:11,086 What? 260 00:10:11,087 --> 00:10:13,486 Layla, who's the father? 261 00:10:13,487 --> 00:10:15,396 You are, Quentin. 262 00:10:15,397 --> 00:10:17,226 You are. That's our baby. 263 00:10:17,227 --> 00:10:19,316 - No, you're lying! - You're lying! 264 00:10:19,317 --> 00:10:20,316 Hey, Quentin, it's OK. 265 00:10:20,317 --> 00:10:21,876 We'll figure this out, all right? 266 00:10:21,877 --> 00:10:23,576 - That's not my son. - That's our baby. 267 00:10:23,577 --> 00:10:25,316 - Of course it is! - No, get back! 268 00:10:25,317 --> 00:10:28,196 - Of course it is! - Of course it is! 269 00:10:28,197 --> 00:10:29,716 - I got to get out of here. - Hey, deep breaths, OK? 270 00:10:29,717 --> 00:10:30,886 Quentin, breathe with me. 271 00:10:30,887 --> 00:10:32,286 Breathe with me, Quentin. Deep breaths. 272 00:10:32,287 --> 00:10:34,026 - I got to get out of here! - Stay! Baby, stay! 273 00:10:34,027 --> 00:10:35,856 - Hey, call security. - Help! 274 00:10:35,857 --> 00:10:37,506 Oh, my God. What's happening? 275 00:10:37,507 --> 00:10:40,596 Hey! Hey, stop! 276 00:10:40,597 --> 00:10:42,637 Hey, guards! Quentin, stop! 277 00:10:44,557 --> 00:10:47,386 Why are you chasing me? Just leave me... leave me alone! 278 00:10:47,387 --> 00:10:50,296 - Hey, Quentin... - Stay back! Stay back! 279 00:10:50,297 --> 00:10:51,826 It's OK. It's OK. 280 00:10:51,827 --> 00:10:54,346 Deep breath. Please, just breathe. 281 00:10:54,347 --> 00:10:56,346 I just got to get out of here. 282 00:10:56,347 --> 00:10:58,467 - I just got to get out of here! - No, no, no, no, no! 283 00:11:03,537 --> 00:11:05,616 All right, Quentin. 284 00:11:05,617 --> 00:11:07,537 It's OK. 285 00:11:09,297 --> 00:11:12,686 Oh, my God, the scissors, they're pulsating. 286 00:11:12,687 --> 00:11:14,126 They're penetrating the carotid artery. 287 00:11:14,127 --> 00:11:15,476 I'll get someone to turn off the machine. 288 00:11:15,477 --> 00:11:18,306 No, the magnet is holding everything in place, 289 00:11:18,307 --> 00:11:19,656 including the scissors. 290 00:11:19,657 --> 00:11:21,476 If gravity takes over, it'll shift everything, 291 00:11:21,477 --> 00:11:24,746 and we'll have maybe 20 seconds before he bleeds out. 292 00:11:24,747 --> 00:11:26,706 OK, we need help. Call Dr. Archer. 293 00:11:26,707 --> 00:11:28,707 - Dr. Charles too. - Yeah. 294 00:11:30,547 --> 00:11:34,156 Do not touch the scissors, OK? 295 00:11:34,157 --> 00:11:36,466 We got you. 296 00:11:36,467 --> 00:11:38,297 Everything's gonna be OK. 297 00:11:42,653 --> 00:11:45,056 Coming through. Excuse me. 298 00:11:45,057 --> 00:11:46,626 Thank you guys for coming. 299 00:11:46,627 --> 00:11:48,676 Absolutely. 300 00:11:48,677 --> 00:11:50,327 - Hey, fellas. - Doctor. 301 00:11:52,717 --> 00:11:54,986 He's conscious and calm but out of it. 302 00:11:54,987 --> 00:11:56,896 He's not being crushed. He's able to breathe. 303 00:11:56,897 --> 00:11:59,116 - He's got to be in pain, though. - OK. 304 00:11:59,117 --> 00:12:02,076 So let's give him 50 mics of fentanyl IM. 305 00:12:02,077 --> 00:12:03,996 Syringe is plastic and the needle nonferrous, 306 00:12:03,997 --> 00:12:05,386 so it should be MRI safe. 307 00:12:05,387 --> 00:12:06,866 OK, I'll get it. 308 00:12:06,867 --> 00:12:08,776 Dr. Asher went back to be with his wife, Layla. 309 00:12:08,777 --> 00:12:10,826 - She's still in L&D. - OK. 310 00:12:10,827 --> 00:12:12,306 It's a rescue situation. 311 00:12:12,307 --> 00:12:13,696 I just don't really know where to start. 312 00:12:13,697 --> 00:12:15,356 All of our tools have metal. 313 00:12:15,357 --> 00:12:19,006 So nothing is usable as long as the MRI machine is running. 314 00:12:19,007 --> 00:12:21,836 All right, well, let's say we did turn the machine off. 315 00:12:21,837 --> 00:12:23,146 Everything falls to the floor. 316 00:12:23,147 --> 00:12:25,146 Bed alone is a couple hundred pounds. 317 00:12:25,147 --> 00:12:27,316 I can put two of my guys in there to try and catch it, 318 00:12:27,317 --> 00:12:29,146 then get it out of the way so you can get to Quentin. 319 00:12:29,147 --> 00:12:31,366 Scissors in his neck are magnetic too. 320 00:12:31,367 --> 00:12:33,156 Cut the MRI's power, they're gonna move. 321 00:12:33,157 --> 00:12:34,716 Quentin will bleed out fast. 322 00:12:34,717 --> 00:12:37,326 If you could go in there with clamps and stem the flow, 323 00:12:37,327 --> 00:12:39,806 - would that buy us some time? - Not enough. 324 00:12:39,807 --> 00:12:41,946 Odds of survival are less than 1%. 325 00:12:41,947 --> 00:12:44,206 I'm running outcome probabilities on our options, 326 00:12:44,207 --> 00:12:46,036 and turning off the machine cold turkey is the worst. 327 00:12:46,037 --> 00:12:48,036 So what's the best? 328 00:12:48,037 --> 00:12:50,426 If CFD can secure Quentin 329 00:12:50,427 --> 00:12:52,346 and ensure the bed won't displace him 330 00:12:52,347 --> 00:12:54,736 and Dr. Archer can stabilize the neck wound 331 00:12:54,737 --> 00:12:56,266 all before turning off the MRI machine, 332 00:12:56,267 --> 00:12:59,526 then the odds of survival are roughly 61%. 333 00:12:59,527 --> 00:13:02,096 OK, we've got a plan. Can it be done? 334 00:13:02,097 --> 00:13:04,876 Well, safest way to secure the patient 335 00:13:04,877 --> 00:13:07,276 would be to do a webbing harness. 336 00:13:07,277 --> 00:13:09,666 We can throw the ropes over the MRI machine, 337 00:13:09,667 --> 00:13:11,926 and then two of my guys can hold it on the other side. 338 00:13:11,927 --> 00:13:14,106 OK, the magnet's off, the bed falls. 339 00:13:14,107 --> 00:13:17,236 How do we ensure that Quentin doesn't go with it? 340 00:13:17,237 --> 00:13:19,286 We can create a buffer zone between him and the bed 341 00:13:19,287 --> 00:13:22,066 using wooden cribbing, wedges, and airbags. 342 00:13:22,067 --> 00:13:23,896 We can run some hoses and inflate them 343 00:13:23,897 --> 00:13:25,336 from a tank here in the hallway. 344 00:13:25,337 --> 00:13:26,906 All right, we're halfway there. 345 00:13:26,907 --> 00:13:28,596 - Dr. Archer? - Yeah. 346 00:13:28,597 --> 00:13:30,206 I just need to clamp the artery 347 00:13:30,207 --> 00:13:31,296 in order to control the bleeding. 348 00:13:31,297 --> 00:13:33,386 Then I could take the scissors out. 349 00:13:33,387 --> 00:13:36,346 But the issue is the tools needed to do it. 350 00:13:36,347 --> 00:13:38,386 I can make them plastic. 3D printers. 351 00:13:38,387 --> 00:13:39,606 There are four in the robotics lab. 352 00:13:39,607 --> 00:13:40,916 All right. Get on it. 353 00:13:40,917 --> 00:13:44,096 And get a few of the 2.0 engineers to help. 354 00:13:44,097 --> 00:13:47,006 - We'll get started too. - Good. 355 00:13:47,007 --> 00:13:48,446 OK, you're doing great. 356 00:13:48,447 --> 00:13:50,056 Gonna give you a little injection. 357 00:13:50,057 --> 00:13:51,446 Some pain meds, all right? 358 00:13:51,447 --> 00:13:54,626 To just make you a little more comfortable, OK? 359 00:13:54,627 --> 00:13:56,497 Little pinch. 360 00:14:01,323 --> 00:14:02,633 OK. 361 00:14:04,247 --> 00:14:06,946 Daniel? 362 00:14:06,947 --> 00:14:08,286 I'm just gonna step away for a second, 363 00:14:08,287 --> 00:14:09,596 have a little chat with my colleague. 364 00:14:09,597 --> 00:14:11,467 I'm not going anywhere, OK? 365 00:14:14,517 --> 00:14:16,866 How's he doing? 366 00:14:16,867 --> 00:14:21,216 Well, you know, I mean, he's pinned to an MRI machine, so... 367 00:14:21,217 --> 00:14:23,916 Do you have any theories on what sparked the break? 368 00:14:23,917 --> 00:14:26,356 I've been really focusing on trying to keep him calm. 369 00:14:26,357 --> 00:14:29,046 But how's the plan to get him off the thing going? 370 00:14:29,047 --> 00:14:30,486 Well, we've got one. 371 00:14:30,487 --> 00:14:32,666 But it's a possibility that it won't work, Daniel, 372 00:14:32,667 --> 00:14:36,056 so I've asked Dr. Asher to bring Quentin's wife down here 373 00:14:36,057 --> 00:14:38,976 to see him 'cause it may be the last time. 374 00:14:38,977 --> 00:14:40,887 OK, thank you. 375 00:14:43,357 --> 00:14:45,447 OK, making the incision. 376 00:14:47,250 --> 00:14:48,450 OK. 377 00:14:50,417 --> 00:14:52,987 OK, nice and easy. 378 00:14:54,867 --> 00:14:56,067 Lab cut. 379 00:15:01,167 --> 00:15:02,956 Yep. 380 00:15:02,957 --> 00:15:05,046 Definitely feeling some adhesions. 381 00:15:05,047 --> 00:15:06,216 Point taken. 382 00:15:06,217 --> 00:15:08,396 Open surgery was the right call. 383 00:15:08,397 --> 00:15:10,486 Go ahead, say it. "I told you so." 384 00:15:10,487 --> 00:15:12,096 Yeah, maybe later. 385 00:15:12,097 --> 00:15:14,796 For now, why don't you get some practice old-school style? 386 00:15:14,797 --> 00:15:16,617 Come around. 387 00:15:19,447 --> 00:15:21,106 OK. You got it? 388 00:15:21,107 --> 00:15:22,716 - Yeah. - All right. 389 00:15:22,717 --> 00:15:24,067 Babcock. 390 00:15:31,457 --> 00:15:33,206 You OK? 391 00:15:33,207 --> 00:15:34,946 Yeah, it's just a little heartburn. 392 00:15:34,947 --> 00:15:36,297 I'm fine. 393 00:15:37,727 --> 00:15:39,947 Oh, uh... 394 00:15:41,817 --> 00:15:44,166 Uh, God, excuse me. I'm sorry. 395 00:15:44,167 --> 00:15:46,436 Stop it. 396 00:15:46,437 --> 00:15:47,996 Stop. 397 00:15:47,997 --> 00:15:49,346 It's no big deal. 398 00:15:49,347 --> 00:15:53,047 It happens, OK? Just focus on the field. 399 00:15:54,567 --> 00:15:57,007 Stay focused. 400 00:15:58,527 --> 00:16:00,796 Uh-oh, here comes another one. 401 00:16:00,797 --> 00:16:02,186 Kai? 402 00:16:02,187 --> 00:16:04,536 Kai, talk to me. 403 00:16:04,537 --> 00:16:06,056 Hey, buddy! Hey! 404 00:16:06,057 --> 00:16:08,677 Angel. Angel, check him. 405 00:16:10,417 --> 00:16:11,936 - Got a pulse. - All right. 406 00:16:11,937 --> 00:16:13,936 Give me the babcock, please. 407 00:16:13,937 --> 00:16:15,456 - Maria! - Need some help in here! 408 00:16:15,457 --> 00:16:17,116 Maria! 409 00:16:17,117 --> 00:16:18,546 I was helping her to the bathroom, 410 00:16:18,547 --> 00:16:19,466 and she started seizing. 411 00:16:19,467 --> 00:16:21,037 OK, 4 milligrams of Ativan. 412 00:16:22,647 --> 00:16:24,127 Please help her. Please. 413 00:16:27,477 --> 00:16:29,217 Ativan's in. 414 00:16:34,047 --> 00:16:35,656 OK, she's gonna be postictal for a while. 415 00:16:35,657 --> 00:16:36,826 Put her on a foley. 416 00:16:36,827 --> 00:16:37,876 I don't want her getting out of the bed, 417 00:16:37,877 --> 00:16:39,447 not even for the bathroom. 418 00:16:47,107 --> 00:16:49,056 A seizure expands our differential tenfold. 419 00:16:49,057 --> 00:16:50,886 We got to widen our net... CT panscan, 420 00:16:50,887 --> 00:16:53,106 MRI brain, sed rate, autoimmune labs. 421 00:16:53,107 --> 00:16:54,286 - Let's rope in neurology. - Guys. 422 00:16:54,287 --> 00:16:55,456 Ms. Goodwin just called. 423 00:16:55,457 --> 00:16:56,976 She said stand down. No more treatment. 424 00:16:56,977 --> 00:16:58,116 What? What are you talking about? 425 00:16:58,117 --> 00:16:59,116 She's in the MRI suite. 426 00:16:59,117 --> 00:17:01,117 Be here as soon as she can, OK? 427 00:17:04,687 --> 00:17:06,686 - Hey, you OK? - This is overkill. 428 00:17:06,687 --> 00:17:08,466 I probably just had some bad oatmeal. 429 00:17:08,467 --> 00:17:10,606 Well, bad oatmeal doesn't drop you 430 00:17:10,607 --> 00:17:11,996 in the middle of surgery. 431 00:17:11,997 --> 00:17:14,737 So how about you let me check you out? 432 00:17:17,177 --> 00:17:19,306 - How's Sam? - Appendectomy go OK? 433 00:17:19,307 --> 00:17:21,696 - Yeah, all good. - Dr. Graham is finishing up. 434 00:17:21,697 --> 00:17:23,176 At least it's just an appendectomy. 435 00:17:23,177 --> 00:17:25,007 Not missing much. 436 00:17:28,017 --> 00:17:29,887 Oh, my chest. Pressure. 437 00:17:32,887 --> 00:17:34,497 Oh, God. I'm sorry. 438 00:17:36,147 --> 00:17:37,846 That was weird. 439 00:17:37,847 --> 00:17:39,846 Your heart rate plummeted, but as soon as you passed gas, 440 00:17:39,847 --> 00:17:41,066 it came back. 441 00:17:41,067 --> 00:17:43,027 Will you sit up for me? 442 00:17:45,857 --> 00:17:47,297 Take a deep breath. 443 00:17:49,557 --> 00:17:51,206 All right. Lean back for me. 444 00:17:51,207 --> 00:17:53,996 Hey, Mike. Let's get an X-ray in here. 445 00:17:53,997 --> 00:17:55,346 What, did you hear a murmur? 446 00:17:55,347 --> 00:17:57,086 Honestly, I'm not sure what I heard. 447 00:17:57,087 --> 00:17:58,516 You're joking, right? Come on. 448 00:17:58,517 --> 00:18:01,136 Has heartburn been an issue before today? 449 00:18:01,137 --> 00:18:02,656 I mean, I get it. 450 00:18:02,657 --> 00:18:04,916 Even when I was a kid, it would flare up here and there. 451 00:18:04,917 --> 00:18:07,316 But it's never been an issue. 452 00:18:07,317 --> 00:18:09,707 X-ray up. Clear. 453 00:18:15,847 --> 00:18:18,366 - What the hell? - That's my colon. 454 00:18:18,367 --> 00:18:19,846 It shouldn't be in my chest. 455 00:18:19,847 --> 00:18:22,107 No, it should not. 456 00:18:24,327 --> 00:18:26,636 Her brother. Hugo, was a patient treated at Oakview. 457 00:18:26,637 --> 00:18:27,856 So was Maria. 458 00:18:27,857 --> 00:18:30,246 She was admitted yesterday via ambulance, 459 00:18:30,247 --> 00:18:33,336 but this morning, her family just walked her out. 460 00:18:33,337 --> 00:18:34,776 They just left... absconded. 461 00:18:34,777 --> 00:18:36,386 Well, her brother died at Oakview, 462 00:18:36,387 --> 00:18:37,866 and they didn't get any answers. 463 00:18:37,867 --> 00:18:39,216 You see how scared they are. 464 00:18:39,217 --> 00:18:40,346 It's no wonder that they didn't want to stay. 465 00:18:40,347 --> 00:18:42,256 Look, I agree, but walking out 466 00:18:42,257 --> 00:18:44,656 is the same as leaving against medical advice. 467 00:18:44,657 --> 00:18:47,046 It's triggered an insurance nightmare 468 00:18:47,047 --> 00:18:48,656 with the family's HMO. 469 00:18:48,657 --> 00:18:50,876 They won't pay for any more treatment 470 00:18:50,877 --> 00:18:52,966 until Maria is placed back 471 00:18:52,967 --> 00:18:56,446 with their preferred network provider, Oakview. 472 00:18:56,447 --> 00:18:58,926 - Are you kidding me? - They're a community hospital. 473 00:18:58,927 --> 00:19:01,236 They don't have the resources to run the tests she needs. 474 00:19:01,237 --> 00:19:02,626 Well, I've already reached out 475 00:19:02,627 --> 00:19:05,066 to the director of patient services at Oakview, 476 00:19:05,067 --> 00:19:07,416 and she assured me they'll do the best they can. 477 00:19:07,417 --> 00:19:09,066 The best they can? 478 00:19:09,067 --> 00:19:12,076 Ms. Goodwin, can't you reason with the insurance company? 479 00:19:12,077 --> 00:19:14,376 Hector and Gloria aren't trying to take advantage of them. 480 00:19:14,377 --> 00:19:16,076 They're trying to save their daughter's life. 481 00:19:16,077 --> 00:19:17,596 Look, I know, and I share 482 00:19:17,597 --> 00:19:19,556 in your frustration, but they're... 483 00:19:19,557 --> 00:19:21,906 No. No, I don't care what the insurance company says. 484 00:19:21,907 --> 00:19:24,256 I'm not sending Maria back to Oakview until I get a guarantee 485 00:19:24,257 --> 00:19:25,916 she gets the treatment she needs in time. 486 00:19:25,917 --> 00:19:28,436 Dr. Halstead, the tests that you ordered 487 00:19:28,437 --> 00:19:30,356 will cost tens of thousands of dollars, 488 00:19:30,357 --> 00:19:32,706 and I know that's not coming out your pocket. 489 00:19:32,707 --> 00:19:36,267 The family has to decide how to proceed. 490 00:19:45,437 --> 00:19:47,384 OK, Quentin, so listen, 491 00:19:47,385 --> 00:19:49,696 we're gonna secure you to the machine 492 00:19:49,697 --> 00:19:51,826 while it's still running with a harness. 493 00:19:51,827 --> 00:19:53,876 So then, Dr. Archer, who is an excellent surgeon, 494 00:19:53,877 --> 00:19:55,486 is gonna come in here and clamp your artery, 495 00:19:55,487 --> 00:19:57,136 stabilize your neck wound, 496 00:19:57,137 --> 00:19:59,406 and make it safer when they pull out the scissors. 497 00:19:59,407 --> 00:20:01,666 All right? Then we turn off the machine. 498 00:20:01,667 --> 00:20:03,926 The idea is, bed falls to the side, 499 00:20:03,927 --> 00:20:07,236 you're held firmly in place by the harness, OK? 500 00:20:07,237 --> 00:20:09,106 - Still with me? - Mm-hmm. 501 00:20:09,107 --> 00:20:10,716 Great. Last thing. 502 00:20:10,717 --> 00:20:13,326 Lower you onto a gurney, shoot you off the ER, 503 00:20:13,327 --> 00:20:15,546 and finish fixing up your neck. 504 00:20:15,547 --> 00:20:17,507 - How's that sound? - Mm-hmm. 505 00:20:27,127 --> 00:20:29,436 Am I gonna die? 506 00:20:29,437 --> 00:20:31,176 Look, this is a complicated situation. 507 00:20:31,177 --> 00:20:34,696 But some really skilled people have come up with this plan, 508 00:20:34,697 --> 00:20:36,566 and it's the best option we got. 509 00:20:36,567 --> 00:20:39,576 Breathe in and out, 510 00:20:39,577 --> 00:20:43,706 stay as still as you possibly can, OK? 511 00:20:43,707 --> 00:20:45,276 All right. 512 00:20:45,277 --> 00:20:47,497 Take all the time you need. 513 00:20:49,757 --> 00:20:52,237 Hey, hold the work. Everybody, out. 514 00:21:00,157 --> 00:21:02,986 You're my everything. 515 00:21:02,987 --> 00:21:06,577 From our first date, I knew that I was in love. 516 00:21:06,578 --> 00:21:08,349 And now we're parents. 517 00:21:10,368 --> 00:21:11,576 Uh... 518 00:21:13,557 --> 00:21:15,647 The nurse took a picture of him. 519 00:21:18,617 --> 00:21:21,526 I named him Trevor, after your dad. 520 00:21:21,527 --> 00:21:23,617 I think he'd like that. 521 00:21:25,317 --> 00:21:28,276 Tell Trevor I love him. 522 00:21:28,277 --> 00:21:31,236 You're gonna tell him yourself. 523 00:21:31,237 --> 00:21:33,937 You're gonna be a great mother. 524 00:21:35,457 --> 00:21:37,546 I love you, Quentin. 525 00:21:37,547 --> 00:21:40,506 I will see you again, you hear me? 526 00:21:40,507 --> 00:21:42,897 I will see you again. 527 00:21:57,257 --> 00:21:59,176 Sorry. 528 00:21:59,177 --> 00:22:02,306 I didn't know what to say. 529 00:22:02,307 --> 00:22:04,966 How do you put into words when... 530 00:22:04,967 --> 00:22:07,006 You can't. 531 00:22:07,007 --> 00:22:09,316 But we could feel your love for each other. 532 00:22:09,317 --> 00:22:11,186 I just don't understand, 533 00:22:11,187 --> 00:22:14,146 because Quentin is my rock, 534 00:22:14,147 --> 00:22:19,236 and I don't even recognize the man that's in there. 535 00:22:19,237 --> 00:22:21,546 He just snapped. 536 00:22:21,547 --> 00:22:23,586 How does that happen all of a sudden? 537 00:22:23,587 --> 00:22:26,726 I mean, usually there are signs, you know? 538 00:22:26,727 --> 00:22:30,116 Extreme expressions of emotional frustration, 539 00:22:30,117 --> 00:22:32,166 anger, confusion, outbursts. 540 00:22:32,167 --> 00:22:35,606 You noticed anything like that in Quentin recently? 541 00:22:35,607 --> 00:22:38,696 - I don't think so. - How about physical changes? 542 00:22:38,697 --> 00:22:40,956 I noticed he had some lumps on the back of his neck. 543 00:22:40,957 --> 00:22:42,526 Have you... Do you know what those are? 544 00:22:42,527 --> 00:22:46,306 Lumps? I don't know. 545 00:22:46,307 --> 00:22:51,006 I just wanted to get to today and to have the baby. 546 00:22:51,007 --> 00:22:53,096 I've been so consumed by the pregnancy 547 00:22:53,097 --> 00:22:56,836 that I haven't noticed anything else. 548 00:22:56,837 --> 00:22:58,587 Oh, Quentin. 549 00:23:04,367 --> 00:23:06,196 Uh, give it to Spellman. 550 00:23:06,197 --> 00:23:07,326 Thanks, Lori. 551 00:23:07,327 --> 00:23:09,026 Mystery solved. Your chest CT. 552 00:23:09,027 --> 00:23:11,896 - Hiatal hernia. - No, diaphragmatic. 553 00:23:11,897 --> 00:23:14,556 Big enough that your colon migrated into your chest. 554 00:23:14,557 --> 00:23:17,036 So the gas moving through it, 555 00:23:17,037 --> 00:23:19,776 it puts pressure on the vagus nerve, drops your heartbeat. 556 00:23:19,777 --> 00:23:21,476 Breaking wind releases the pressure. 557 00:23:21,477 --> 00:23:23,036 - Heart returns to a normal rate. - Yeah. 558 00:23:23,037 --> 00:23:24,646 You said you had heartburn since you were a kid. 559 00:23:24,647 --> 00:23:26,606 Undiagnosed 560 00:23:26,607 --> 00:23:29,656 asymptomatic congenital diaphragmatic hernia. 561 00:23:29,657 --> 00:23:31,266 I've never passed out before, though. 562 00:23:31,267 --> 00:23:34,096 Well, my guess is it's been slowly expanding over time. 563 00:23:34,097 --> 00:23:35,576 But you do CrossFit now, 564 00:23:35,577 --> 00:23:37,926 so the thrusters, burpees, other workouts... 565 00:23:37,927 --> 00:23:40,576 Safe bet that they've exacerbated the condition. 566 00:23:40,577 --> 00:23:42,926 - Led to today. - Yeah, well, I'll own that. 567 00:23:42,927 --> 00:23:44,586 But I can't resist dropping in the OR again, 568 00:23:44,587 --> 00:23:46,756 - so let's fix this hernia. - OK. 569 00:23:46,757 --> 00:23:50,066 Well, you've got a few surgical options. 570 00:23:50,067 --> 00:23:51,456 - Open. - No. 571 00:23:51,457 --> 00:23:53,066 That's a huge incision. Lots of digging around. 572 00:23:53,067 --> 00:23:55,076 I'll be laid up in the ICU for weeks. 573 00:23:55,077 --> 00:23:56,426 Laparoscopic, then. 574 00:23:56,427 --> 00:23:58,206 Be more incisions for the scope and tools, 575 00:23:58,207 --> 00:24:00,596 - but less invasive... - No old-school approaches. 576 00:24:00,597 --> 00:24:02,256 Robotic assist in OR 2.0. 577 00:24:02,257 --> 00:24:04,087 Shortest recovery time. 578 00:24:05,827 --> 00:24:08,126 I just want this to be over with. 579 00:24:08,127 --> 00:24:10,826 OK, I'm gonna scrub in. 580 00:24:10,827 --> 00:24:12,087 I'll see you after, OK? 581 00:24:17,447 --> 00:24:19,746 Holy cow. Look at this place. 582 00:24:19,747 --> 00:24:21,756 It's like you guys are living in 2050 up here. 583 00:24:21,757 --> 00:24:24,366 So don't break anything. 584 00:24:24,367 --> 00:24:26,056 How's it going with the surgical tools? 585 00:24:26,057 --> 00:24:28,106 - Almost there. - Scalpel's printed. 586 00:24:28,107 --> 00:24:29,716 Two of the three angled peripheral vascular clamps 587 00:24:29,717 --> 00:24:30,806 are printed as well. 588 00:24:30,807 --> 00:24:32,066 One Weitlaner retractor printed. 589 00:24:32,067 --> 00:24:34,066 - One to go. - Oh, it's like the real thing. 590 00:24:34,067 --> 00:24:36,466 It is the real thing, just plastic. 591 00:24:36,467 --> 00:24:38,206 These tools, I think they can work. 592 00:24:38,207 --> 00:24:39,636 They'll have to. 593 00:24:39,637 --> 00:24:41,077 They're all we got. 594 00:24:46,647 --> 00:24:49,086 They never wanted to go to Oakview, 595 00:24:49,087 --> 00:24:51,046 but the ambulance took them there anyway. 596 00:24:51,047 --> 00:24:53,086 Because Maria didn't require specialty care, 597 00:24:53,087 --> 00:24:55,617 paramedics took her to the nearest hospital instead. 598 00:25:05,017 --> 00:25:08,496 I'm so sorry that you've been put in this situation. 599 00:25:08,497 --> 00:25:10,756 We can continue to treat Maria, 600 00:25:10,757 --> 00:25:13,717 but your insurance won't cover the costs. 601 00:25:24,167 --> 00:25:27,906 He said he'll sell the car. He can get a second job. 602 00:25:27,907 --> 00:25:29,646 His oldest son can get a job as well. 603 00:25:29,647 --> 00:25:31,346 No. Papa, no. 604 00:25:31,347 --> 00:25:32,996 No. 605 00:25:32,997 --> 00:25:34,866 I'll go back. 606 00:25:34,867 --> 00:25:37,136 No. 607 00:25:37,137 --> 00:25:39,346 Maria... 608 00:25:39,347 --> 00:25:41,657 Maria. 609 00:26:06,727 --> 00:26:10,557 You know, maybe Oakview will figure it out. 610 00:26:16,087 --> 00:26:17,086 All right. 611 00:26:17,087 --> 00:26:20,957 Um, I'll set up the transfer. 612 00:26:27,617 --> 00:26:29,136 What was Maria saying? 613 00:26:29,137 --> 00:26:31,406 If she lets her parents bankrupt the family 614 00:26:31,407 --> 00:26:34,186 paying for her medical care, then all of the opportunities 615 00:26:34,187 --> 00:26:37,756 they've worked so hard to give their children will be lost. 616 00:26:37,757 --> 00:26:39,586 She is risking her life. 617 00:26:39,587 --> 00:26:41,366 No. 618 00:26:41,367 --> 00:26:43,586 No, she's sacrificing it. 619 00:26:43,587 --> 00:26:45,898 And it's awful, 620 00:26:47,120 --> 00:26:48,605 but I get it. 621 00:26:58,167 --> 00:26:59,367 Ready to inflate? 622 00:27:02,297 --> 00:27:03,647 Up on blue. 623 00:27:05,387 --> 00:27:06,657 Hold. 624 00:27:08,217 --> 00:27:09,787 Up on red. 625 00:27:15,527 --> 00:27:16,797 Hold. 626 00:27:21,097 --> 00:27:23,796 - How's, uh... - how's Layla doing? 627 00:27:23,797 --> 00:27:26,886 She's in shock, full of grief, 628 00:27:26,887 --> 00:27:28,456 and a first-time mom all at the same time. 629 00:27:28,457 --> 00:27:31,546 It's a lot, but a psych resident is with her. 630 00:27:31,547 --> 00:27:34,856 Mm. And how about you? 631 00:27:34,857 --> 00:27:37,336 How are you doing? 632 00:27:37,337 --> 00:27:40,246 Honestly, I didn't see this coming. 633 00:27:40,247 --> 00:27:43,946 I just thought Quentin was a nervous first-time dad, 634 00:27:43,947 --> 00:27:46,516 like the ones I see every single day. 635 00:27:46,517 --> 00:27:48,256 Never suspected mental illness. 636 00:27:48,257 --> 00:27:50,216 You know, I'm not sure it is, per se. 637 00:27:50,217 --> 00:27:53,216 You know those lumps on the back of his neck? 638 00:27:53,217 --> 00:27:54,876 I have a very strong hunch that they're indicative 639 00:27:54,877 --> 00:27:56,616 of a physical issue that could very well 640 00:27:56,617 --> 00:27:59,576 be causing a sudden psychosis. 641 00:27:59,577 --> 00:28:01,136 It's physical, not psychological? 642 00:28:01,137 --> 00:28:02,886 Yeah, I'm leaning that way. 643 00:28:02,887 --> 00:28:05,627 I mean, can't be sure until we run some tests. 644 00:28:17,247 --> 00:28:18,986 Maria, this is a thumb drive 645 00:28:18,987 --> 00:28:21,156 with all the work we did here, along with our notes. 646 00:28:21,157 --> 00:28:24,556 You give this to the doctors as soon as you get there. 647 00:28:24,557 --> 00:28:25,817 Thank you. 648 00:28:29,647 --> 00:28:31,827 All right. Empty her foley. 649 00:28:39,567 --> 00:28:40,877 It's OK, Mama. 650 00:28:43,487 --> 00:28:45,667 Wait. 651 00:28:47,627 --> 00:28:48,927 Will? 652 00:28:52,757 --> 00:28:54,197 You smell that? 653 00:29:01,197 --> 00:29:02,506 We have to run one more test. 654 00:29:02,507 --> 00:29:04,687 I'll pay for it myself, if I have to. 655 00:29:10,257 --> 00:29:11,736 I'm scared. 656 00:29:11,737 --> 00:29:14,296 Well, you'll be less frightened if you can't see it, 657 00:29:14,297 --> 00:29:17,217 so I'm gonna drape your face, OK? 658 00:29:19,307 --> 00:29:20,656 Yeah. 659 00:29:20,657 --> 00:29:22,656 All right. 660 00:29:22,657 --> 00:29:24,177 Here we go. Careful. 661 00:29:25,837 --> 00:29:27,707 That's right. All right. 662 00:29:28,837 --> 00:29:30,706 All right. 663 00:29:30,707 --> 00:29:33,666 10cc's of lidocaine, please. 664 00:29:33,667 --> 00:29:35,716 OK. 665 00:29:35,717 --> 00:29:38,107 All right. 666 00:29:47,207 --> 00:29:48,466 OK. 667 00:29:48,467 --> 00:29:51,426 Scalpel. 668 00:29:51,427 --> 00:29:53,076 All right. Grab hold of those scissors. 669 00:29:53,077 --> 00:29:55,907 I don't want them flopping after I make the incisions. 670 00:29:59,387 --> 00:30:01,177 Here we go. 671 00:30:06,097 --> 00:30:08,486 OK. 672 00:30:08,487 --> 00:30:09,616 All right. 673 00:30:09,617 --> 00:30:11,097 Wheaties. 674 00:30:14,667 --> 00:30:16,146 All right. 675 00:30:16,147 --> 00:30:18,716 All right. Watch your fingers there. 676 00:30:18,717 --> 00:30:21,366 That's it. That's it. Don't move it. Don't move it. 677 00:30:21,367 --> 00:30:22,847 Clamp. 678 00:30:27,507 --> 00:30:28,707 All right. 679 00:30:37,777 --> 00:30:39,906 All right. 680 00:30:39,907 --> 00:30:42,126 Carotid clamps in place. CFD, you're up. 681 00:30:42,127 --> 00:30:43,696 All right. Spread out around the bed. 682 00:30:43,697 --> 00:30:45,956 When it falls down, we pull it away from the MRI machine. 683 00:30:45,957 --> 00:30:49,226 All right. And no slack at all, you understand? 684 00:30:49,227 --> 00:30:51,486 If there's any movement, his clamps could pop off, 685 00:30:51,487 --> 00:30:54,226 and then we'll have a problem we might not be able to fix. 686 00:30:54,227 --> 00:30:55,576 All right. 687 00:30:55,577 --> 00:30:58,626 On three, you're gonna cut the power to the MRI. 688 00:30:58,627 --> 00:30:59,846 We ready? Everybody, ready? 689 00:30:59,847 --> 00:31:00,926 Ready. 690 00:31:00,927 --> 00:31:04,237 One, two, three. 691 00:31:08,027 --> 00:31:10,156 All right. Clamps are holding. 692 00:31:10,157 --> 00:31:11,897 I'm gonna remove the scissors now. 693 00:31:15,597 --> 00:31:16,906 All right. 694 00:31:16,907 --> 00:31:18,776 All right, we're clear. OK, bed. 695 00:31:18,777 --> 00:31:21,477 Let's lower Quentin. 696 00:31:24,167 --> 00:31:26,827 - Lower him slowly. - One, two, three. 697 00:31:28,527 --> 00:31:29,877 Slack! 698 00:31:31,827 --> 00:31:33,437 All right. 699 00:31:35,177 --> 00:31:37,006 OK, ropes are free. 700 00:31:37,007 --> 00:31:39,576 All right. 701 00:31:39,577 --> 00:31:41,886 - Incredible, Doc. - Freaking incredible. 702 00:31:41,887 --> 00:31:45,056 Thanks. Can someone get me a bottle of water, please? 703 00:31:45,057 --> 00:31:47,276 Dr. Archer, you did it. 704 00:31:47,277 --> 00:31:49,366 - Dean, you all right? - Yeah. 705 00:31:49,367 --> 00:31:51,676 I got to get to the OR, so... 706 00:31:51,677 --> 00:31:53,286 Whoa, whoa, whoa, whoa, whoa. 707 00:31:53,287 --> 00:31:55,936 Page Dr. Lanik to take over with Quentin. 708 00:31:55,937 --> 00:31:56,856 I'm just feeling a little dizzy. 709 00:31:56,857 --> 00:31:58,077 That's all. 710 00:32:05,076 --> 00:32:06,506 Hernia fixed? 711 00:32:06,507 --> 00:32:08,686 I'd say you're as good as new. 712 00:32:08,687 --> 00:32:10,646 Yeah, not quite. 713 00:32:10,647 --> 00:32:12,206 I'm the fart doctor now. 714 00:32:12,207 --> 00:32:14,166 - A punchline. - No. 715 00:32:14,167 --> 00:32:16,126 What happened today was a result 716 00:32:16,127 --> 00:32:17,306 of a medical ailment, OK? 717 00:32:17,307 --> 00:32:18,566 Like anyone's gonna care about that. 718 00:32:18,567 --> 00:32:20,256 All they're gonna remember is the fart. 719 00:32:20,257 --> 00:32:22,397 - Oh, come on. - It'll blow over. 720 00:32:24,007 --> 00:32:26,396 Sorry. Poor choice of words, but it will. 721 00:32:26,397 --> 00:32:28,926 I doubt it. 722 00:32:28,927 --> 00:32:30,226 All right, look. 723 00:32:30,227 --> 00:32:32,626 I'll check on you a little later, OK? 724 00:32:32,627 --> 00:32:33,827 All right. 725 00:32:35,367 --> 00:32:38,536 - So his neck is fixed, then? - Yeah. 726 00:32:38,537 --> 00:32:40,626 The artery repair went very well. 727 00:32:40,627 --> 00:32:43,236 - What about his mind? - Because before... 728 00:32:43,237 --> 00:32:45,246 Well, I gave him a very small dose 729 00:32:45,247 --> 00:32:47,336 of an antipsychotic called risperidone, 730 00:32:47,337 --> 00:32:49,466 and he does seem to be thinking more clearly. 731 00:32:49,467 --> 00:32:52,646 And you think he'll stay that way? 732 00:32:52,647 --> 00:32:54,076 I don't think that what happened today 733 00:32:54,077 --> 00:32:55,906 is the result of mental illness. 734 00:32:55,907 --> 00:32:57,206 You know, tests are still pending, 735 00:32:57,207 --> 00:32:59,426 but all indications are is that Quentin has 736 00:32:59,427 --> 00:33:02,866 a genetic disease called neurofibromatosis type 2. 737 00:33:02,867 --> 00:33:05,046 - Is it curable? - It's not. 738 00:33:05,047 --> 00:33:07,396 But there are a lot of effective treatments out there. 739 00:33:07,397 --> 00:33:09,876 And the good news is that with a little luck, 740 00:33:09,877 --> 00:33:12,666 Quentin is gonna be the man you know again. 741 00:33:12,667 --> 00:33:15,016 Genetic means he's had it forever. 742 00:33:15,017 --> 00:33:17,056 Why'd it suddenly go berserk today? 743 00:33:17,057 --> 00:33:20,276 NF is thought to be an inflammatory ailment, right? 744 00:33:20,277 --> 00:33:23,276 So possibly triggered by changes in environment, 745 00:33:23,277 --> 00:33:24,886 you know, lifestyle, 746 00:33:24,887 --> 00:33:29,026 possibly diet, medication. 747 00:33:29,027 --> 00:33:32,116 Diet. 748 00:33:32,117 --> 00:33:33,816 Oh, my God. 749 00:33:33,817 --> 00:33:37,386 The minute I got pregnant, my hormones went crazy. 750 00:33:37,387 --> 00:33:39,076 Smells were intense, 751 00:33:39,077 --> 00:33:42,086 and Quentin's breath was the worst. 752 00:33:42,087 --> 00:33:44,906 Everything he ate made me throw up. 753 00:33:44,907 --> 00:33:47,126 So he gave up his entire diet. 754 00:33:47,127 --> 00:33:49,696 No more fruits, vegetables, fish. 755 00:33:49,697 --> 00:33:51,526 For the past nine months, he's been eating nothing 756 00:33:51,527 --> 00:33:54,266 but bland, processed crap for me. 757 00:33:54,267 --> 00:33:58,147 Mrs. Bell, Quentin's asking to see you. 758 00:34:08,757 --> 00:34:10,636 Hi, honey. 759 00:34:10,637 --> 00:34:13,466 Layla... 760 00:34:13,467 --> 00:34:15,376 I don't entirely understand 761 00:34:15,377 --> 00:34:19,116 what happened or why, 762 00:34:19,117 --> 00:34:20,986 but I know I put you in danger. 763 00:34:20,987 --> 00:34:22,296 I'm sorry. 764 00:34:22,297 --> 00:34:24,606 No, Quentin. 765 00:34:24,607 --> 00:34:27,296 I was so tied up in the pregnancy, 766 00:34:27,297 --> 00:34:29,866 I was oblivious to what was going on with you. 767 00:34:29,867 --> 00:34:33,436 I should've seen the signs. Forgive me. 768 00:34:33,437 --> 00:34:36,916 Oh, honey, there's nothing to forgive. 769 00:34:36,917 --> 00:34:38,356 I love you. 770 00:34:38,357 --> 00:34:41,096 I love you too. 771 00:34:41,097 --> 00:34:44,497 Someone's been missing you guys. 772 00:34:49,237 --> 00:34:52,326 Hi. 773 00:34:52,327 --> 00:34:54,507 Here you go. 774 00:34:56,287 --> 00:34:59,766 - Hi, sweetheart. - Look who's here. 775 00:34:59,767 --> 00:35:01,116 Hi. 776 00:35:01,117 --> 00:35:03,297 I'm your dad. 777 00:35:04,597 --> 00:35:07,476 I love you. 778 00:35:07,477 --> 00:35:11,346 - Shh, sweetheart. - Hi. 779 00:35:11,347 --> 00:35:14,216 - A metabolic condition? - Yeah. 780 00:35:14,217 --> 00:35:16,396 It's called maple syrup urine disease, 781 00:35:16,397 --> 00:35:18,526 and it's a rare condition that makes it difficult 782 00:35:18,527 --> 00:35:20,836 for the body to break down certain amino acids. 783 00:35:20,837 --> 00:35:24,186 The trademark symptom is a distinct maple syrup smell 784 00:35:24,187 --> 00:35:25,616 that shows up in urine. 785 00:35:25,617 --> 00:35:27,446 It usually presents in childhood, 786 00:35:27,447 --> 00:35:29,146 and it's almost unheard of 787 00:35:29,147 --> 00:35:31,886 to discover it in someone your age, 788 00:35:31,887 --> 00:35:33,456 or Hugo's. 789 00:35:33,457 --> 00:35:35,896 It's likely that he had it too. 790 00:35:35,897 --> 00:35:37,106 And I suspect this is why 791 00:35:37,107 --> 00:35:39,506 Oakview couldn't diagnose him in time. 792 00:35:39,507 --> 00:35:41,506 He didn't have a seizure or a foley catheter. 793 00:35:41,507 --> 00:35:43,506 It made his doctors' jobs even harder. 794 00:35:43,507 --> 00:35:47,076 Wait, this disease killed Hugo. 795 00:35:47,077 --> 00:35:48,386 Does that mean... 796 00:35:48,387 --> 00:35:50,776 No, you're gonna be OK. 797 00:35:50,777 --> 00:35:53,166 You have an intermittent form of the disease, 798 00:35:53,167 --> 00:35:55,956 which can be managed by closely monitoring protein levels. 799 00:35:55,957 --> 00:35:57,656 We've already reached out to nephrology 800 00:35:57,657 --> 00:35:59,656 to discuss treatment options. 801 00:35:59,657 --> 00:36:03,487 Maria. 802 00:36:14,407 --> 00:36:15,627 Gracias. 803 00:36:24,897 --> 00:36:26,727 - Hello, Daniel. - Ooh! 804 00:36:28,207 --> 00:36:30,776 Hey, you're, uh... You're a little early. 805 00:36:30,777 --> 00:36:33,556 Oh, I couldn't wait to see you. 806 00:36:33,557 --> 00:36:36,516 What's this? You cleaned your office? 807 00:36:36,517 --> 00:36:37,717 No, I didn't. 808 00:36:39,127 --> 00:36:41,176 I'm tidying up a little bit. 809 00:36:41,177 --> 00:36:43,307 Why? 810 00:36:45,007 --> 00:36:48,006 I was very embarrassed by what happened this morning. 811 00:36:48,007 --> 00:36:52,446 And um, you know, I just, uh... 812 00:36:52,447 --> 00:36:56,496 I don't ever want you to feel that I... 813 00:36:56,497 --> 00:36:59,716 I take for granted the job that you do, or... 814 00:36:59,717 --> 00:37:01,416 Or that I'm oblivious to how hard you work. 815 00:37:01,417 --> 00:37:03,546 I really don't want that to happen. 816 00:37:03,547 --> 00:37:05,587 You're very sweet. 817 00:37:07,157 --> 00:37:09,946 I care about you too, Daniel. 818 00:37:09,947 --> 00:37:11,147 A lot. 819 00:37:12,207 --> 00:37:13,776 - Yeah? - Mm-hmm. 820 00:37:13,777 --> 00:37:14,977 Huh. 821 00:37:24,997 --> 00:37:27,086 - Hey. - Hey. 822 00:37:27,087 --> 00:37:28,486 Ah! 823 00:37:28,487 --> 00:37:30,396 - Where'd you find it? - Nurses' station. 824 00:37:30,397 --> 00:37:31,916 Oh, makes sense. 825 00:37:31,917 --> 00:37:34,266 That's where I was when the call about Quentin came in. 826 00:37:34,267 --> 00:37:35,796 Yeah, I totally get it. 827 00:37:35,797 --> 00:37:38,626 I would have run off and left it behind too. 828 00:37:38,627 --> 00:37:42,626 But my kidneys can handle some mild dehydration. 829 00:37:42,627 --> 00:37:44,276 - Yours can't. - Yeah, yeah. 830 00:37:44,277 --> 00:37:47,586 Yeah, pretty sure there will be another emergency tomorrow, 831 00:37:47,587 --> 00:37:49,506 and the day after that, 832 00:37:49,507 --> 00:37:53,376 so I'm gonna give you something. 833 00:37:53,377 --> 00:37:55,856 - It is a tracking device. - Ah. 834 00:37:55,857 --> 00:37:57,506 App connects it to your phone. 835 00:37:57,507 --> 00:38:00,386 And I haven't lost my keys since I put it on, so... 836 00:38:00,387 --> 00:38:03,956 Well, keep it. I'm past water bottles. 837 00:38:03,957 --> 00:38:05,646 Nephrologist just left. 838 00:38:05,647 --> 00:38:08,957 Uh, my kidneys are getting worse. 839 00:38:14,267 --> 00:38:15,657 Dialysis? 840 00:38:25,187 --> 00:38:28,366 That was a big win today. 841 00:38:28,367 --> 00:38:31,156 You saved that family. 842 00:38:31,157 --> 00:38:33,936 Yeah. 843 00:38:33,937 --> 00:38:37,286 I suppose it's time to talk about my DACA renewal. 844 00:38:37,287 --> 00:38:39,166 I know I've been dragging my feet. 845 00:38:39,167 --> 00:38:42,336 It's been a long day. We can speak in the morning. 846 00:38:42,337 --> 00:38:44,466 No. No, I'm ready. 847 00:38:44,467 --> 00:38:46,827 Yeah? All right. 848 00:38:50,177 --> 00:38:53,396 Truth is, I've been thinking about leaving Med. 849 00:38:53,397 --> 00:38:55,266 Really? 850 00:38:55,267 --> 00:38:58,706 I've always been in school or protected by my residency, 851 00:38:58,707 --> 00:39:02,666 so my immigration status has always been stable. 852 00:39:02,667 --> 00:39:06,146 But my parents, despite them always having jobs, 853 00:39:06,147 --> 00:39:07,576 could never solidify theirs, 854 00:39:07,577 --> 00:39:09,796 so they moved to Canada. 855 00:39:09,797 --> 00:39:11,276 Hmm. 856 00:39:11,277 --> 00:39:14,936 But they can't enter the country to come visit me. 857 00:39:14,937 --> 00:39:19,066 And if I leave to go see them, I might be denied reentry. 858 00:39:19,067 --> 00:39:22,506 So... 859 00:39:22,507 --> 00:39:25,516 I haven't hugged my parents in a decade. 860 00:39:25,517 --> 00:39:27,466 Ugh. 861 00:39:27,467 --> 00:39:30,556 That's... that's heartbreaking. 862 00:39:30,557 --> 00:39:34,306 But Maria today, her bravery, 863 00:39:34,307 --> 00:39:39,046 what she was willing to sacrifice for her family, 864 00:39:39,047 --> 00:39:42,266 reminded me that 865 00:39:42,267 --> 00:39:44,966 "no one puts their child in a boat 866 00:39:44,967 --> 00:39:47,666 unless the water is safer than the land." 867 00:39:47,667 --> 00:39:50,406 Warsan Shire. 868 00:39:50,407 --> 00:39:53,067 Oh, that's a beautiful poem. 869 00:39:54,407 --> 00:39:56,106 So... 870 00:39:56,107 --> 00:40:00,586 my parents' sacrifice to get me here 871 00:40:00,587 --> 00:40:04,246 put me in this boat, 872 00:40:04,247 --> 00:40:06,727 which is why I have to stay. 873 00:40:08,037 --> 00:40:09,946 And Dr. Cuevas, 874 00:40:09,947 --> 00:40:14,296 I believe that you will find a way 875 00:40:14,297 --> 00:40:17,256 to see your parents again. 876 00:40:17,257 --> 00:40:19,736 But until that day, 877 00:40:19,737 --> 00:40:23,706 know that you have family here in us at Med. 878 00:40:24,856 --> 00:40:26,067 Thank you.