.
- Any chance you'd want to be my advisor?
- Yeah, I'd like that.
- We need to be deliberate and tactical
in our approach to medicine.
- We can't just do a three-minute evaluation.
Gotta spend more time with the patients.
- Maybe psychiatry just doesn't belong here.
- I'm Jessa Rinaldi.
We at Vasic want to make the Vas-COM
the new standard of care.
Doctor cooper said that you could be a real asset.
- I am definitely interested.
- So is anything jumping out?
- No.
Each of these patients,
I think Dr. Cooper's choice to use the Vas-COM
was appropriate. - Yeah, I did too.
- But that's good. It's a relief, actually.
- Mm, there he is.
- And the rep, Jessa Rinaldi?
Do you think she's in on it with him?
- As far as device reps go, she's as green as they come.
Hasn't even graduated from the backpack
to the roller board. - [chuckles]
- You should know, she and Dr. Cooper asked me
to pitch the Vas-COM at Grand Rounds.
We're having a practice round today.
- Well, that's good. Show them you're onboard.
Just don't agree
to actually go through with Grand Rounds.
- Yeah, I won't. [phone dings]
- Oh, I gotta go.
Hey, break a leg.
- Thanks.
- Oh! Hi, Dr. Halstead. Good morning.
I didn't even see you sitting here.
- Hiding in plain sight, I guess.
- I am so excited for today.
If everything goes well,
you can start pitching the Vas-COM for real.
- Maybe! One step at a time.
- Can't wait to get you
in front of those department heads.
Go team!
- Well, here, take my table.
I, uh, gotta get to my shift.
- Looking forward to later.
[inquisitive music]
♪
- Morning, Dr. Scott. - Morning, Maggie.
- So I was wondering--
- No thanks, not interested.
- You don't even know what I was gonna
talk to you about.
- You got a friend you think I'd like.
- No, uh, a cousin.
- Mm. - You're sharp.
Once a cop, always a cop, huh?
- Yeah, I made you as soon as you started
walking my way. - Right.
- You know, the cop thing, it doesn't mean that
you can't have some fun.
[phone buzzes] - [chuckles] Right.
Hey, Pam. Yeah, what's up?
Whoa, whoa, slow down.
Uh-huh, yeah. I'm on my way.
Hey, Maggie, I gotta jet. - What's going on?
Family I look after, there's an issue
with the son, Roland. He's in trouble.
- Want me to call the paramedics?
The police? - No, don't call anybody.
- Wha--
[apprehensive music]
- Mom! Mom, where are you?
- I'm right here, baby.
[siren wailing] - Get back! You're too close.
I--I can't-- - I'm right here, baby.
- No! Get away from me! Leave me alone.
- Dylan, thank God.
- [yells]
- Hey, Roland. It's D.
Roland?
It's all right. I'm here.
You all right? - [sobs]
Dylan. Dylan.
- Yeah, man, it's me. You hear me?
Huh? Roland?
- Hey, sir, step back.
Step back.
- Hey, this man is in the midst
of a psycho-- - Sir, he said step back.
Let us do our jobs.
- Get away from me!
- Show me your hands!
[gun clicks] - Hey...
Look, I'm a doctor, all right?
Look, you see my badge?
This man is experiencing a psychiatric episode.
- [sobs]
- Please, just let me work with him.
♪
Hey, Roland. I'm stepping back, okay?
- I don't see you.
Where are you? - Hey, I'm right here.
I'm right here. Just focus on my voice.
All right?
- D--don't hurt me. - I would never hurt you.
I'm your friend.
Hey, Roland?
I just need you to breathe deep for me, okay?
- [breathes deeply] - Uh-huh.
- [inhales deeply] - Come on, don't stop.
Come on.
- D.
There you are. - I'm here.
I'm right here.
- Please, help me.
- I got you.
♪
Breathe, Roland. Come on.
Come here, come here. Come here.
It's all right. - Help me.
- It's all right.
- Help me! [sobs]
- I got you. I got you.
- [sobbing]
You all right? You're safe.
- Hey, morning, Dr. Taylor.
- Hi, Dr. Marcel.
I've got three patients in process.
- Oh. - First, a 26-year-old female.
Ankle injury, said she wore heels on the "L"
instead of sneakers and changing at the office.
X-ray's negative. It's just a sprain.
Other two are a father and his teenage daughter.
Single vehicle crash. Driving lesson gone wrong.
Exams were unremarkable, cleared their c-spines.
Both were amnestic to the event so I'm getting CT Heads.
- Wow, well done.
My only confusion--
I'm 30 minutes early for our shift,
and you're already tripled up on patients?
- I like getting here a little early.
- Uh-huh. - Or a lot early.
I have a lot of energy it needs to go somewhere.
- Okay, look, Vanessa, I'm all for the gung-ho spirit,
but it's important to pace yourself.
These days, residents getting rest is a good thing
And required.
- That's what they say, not what they mean.
- All right, then.
[sighs]
- What's this?
- Your prescription.
Every now and then, take a break.
- [chuckles]
- Did you catch that? Vanessa and Crockett?
- Yup.
- First-year resident falling for their mentor?
That's not good.
Doesn't usually end well for the resident.
[alarm blares] - Nope.
[siren wailing]
Ambo's coming in. We're in Treatment 4.
- On it.
Vanessa, got time for another case?
- Definitely.
- Ashley Bardsley, 48, in line at Starbucks
when she had a seizure.
Witnesses said she fell pretty hard,
hit her head.
- Gross deformity of the left arm.
She was groggy when we arrived,
but protecting her airway.
BP 120 over 80, heart rate 72,
sats 100% on oxygen.
Couldn't get an IV.
- Okay, let's transfer on three.
One, two, three.
- [groans]
- Thank you, Courtney. - Yep.
[suspenseful music]
- Hey.
Good breath sounds. Ashley?
Can you hear me?
Ashley. Still out of it.
- Post-ictal phase is a wildcard.
Fuzziness could last a while.
Get a good IV, CBC, BMP, chest X-ray, and a head CT.
- You got it.
- What about the arm?
- Life over limb.
- We'll deal with it after the CT.
[machinery beeping]
- Mr. Channing, I'm Dr. Halstead.
- Oh, call me Pete.
I'm not going to be Mr. Channing
until at least 35.
- You got it.
Tell me, what's going on?
- I've been puking up a storm.
- How fun.
- Vitals are normal. Temp's elevated, 101.1.
- Not for nothing, Pete, but you smell like a keg.
- Yeah, sorry.
Back on campus after a year and a half online.
Been making up for lost time on the party front.
- Aha.
- [groans] - That hurt?
- Everything kind of hurts.
I thought it was just another bad hangover,
but the elixir that usually knocks them out, isn't.
- May I?
That coconut water?
With some electrolyte powder and ice.
I've been drinking it nonstop all morning,
but I'm not feeling any better.
- Okay, all right, well, let's run some labs,
and we'll go from there, okay?
CBC, BMP, amylase, lipase, and a chest X-ray.
I'll be back in a bit.
- Saw you in the café this morning
with that device rep.
Was gonna say hi, but I didn't want
to be a third wheel.
- Jut business, Dean. - Hey, my mistake.
Must be one hell of a device.
- It's all right, come on. It's okay.
Maggie, what's open? - Treatment 3.
- Okay. - You need a psych tech?
- On standby. Dr. Charles?
- On his way down. - All right.
[apprehensive music]
♪
Hey, you need anything?
Water? Something to eat? - No. No, thank you.
- Hey, you call for a psych tech?
- Yeah, just stay close.
- Restraints? - No.
It's okay. It's all right.
Hey, Dr. Charles.
Roland is 22--he was diagnosed with schizophrenia,
like, three months ago.
These are his meds.
- Fluphenazine. First generation antipsychotic.
30 milligrams a day? Heavy dose.
- His mom, Pam Baxter, says he never misses a dose,
yet today he still had a break.
- How you doing?
Nothing I haven't dealt with before, man.
- Ms. Baxter?
How are you doing? I'm Dr. Charles.
It's great to meet you.
- You'll help my son? - That's why I'm here.
Uh, you mind if I say hello to him?
Roland, how you doing? I'm Dr. Charles.
- It's all right. It's okay.
Pam, let me show you to the waiting room, okay?
- Cardiac output and index.
Pulse pressure and stroke volumes.
Central venous pressure, mean arterial pressure,
and calculated values like oxygen delivery.
The Vas-COM is the all-in-one cardiac monitoring device.
It almost makes us unnecessary. Almost.
- [giggles] I love that.
- Dr. Cooper.
- So with Covid cases, it can be useful
to quantify pulmonary edema.
Is that something the Vas-COM is capable of?
- Lung water volume? Absolutely.
- Oh, I'm sorry. I didn't mean to interrupt.
Uh, I just--I left my water bottle there
from the budget meeting.
Gotta stay hydrated, right? [chuckles]
Sorry, just forget I'm not here.
Uh, actually, speaking of water,
what were you saying about lung water volume or...
- Right. Yes.
It can be calculated in seconds.
The reason:
the Vas-COM's sophisticated neural network AI.
This, in combination with a thermistor at the tip
of the central venous line and the waveform analysis
from the arterial side ensures the device delivers
consistent and accurate measurements.
And it's minimally invasive.
- Well, not when it comes to your wallet.
I mean, those catheters are pretty pricey, right?
Oh, I'm sorry, I didn't mean to say that out loud.
- No, I mean, it's a fair point.
What do you think, Dr. Halstead?
- Well, yes and no.
I mean, the Vas-COM is more expensive
than other devices, but it's certainly
not overpriced considering the multitude of functions
it's capable of.
- Oh, yeah, I mean, it is
a Swiss army knife, there's no doubt about that.
- Dr. Archer, that's not a bad thing.
- Uh, no, but it's not necessary, either.
At the end of the day, the Vas-COM just seems
like a high-tech repackaging of all the hemodynamic devices
already out there.
I mean, why complicate things
when info from central venous pressure's been working
perfectly well for decades?
At least, that's, you know, that's how I see it, so.
- Well, I disagree.
I'd liken the CVP you're describing
to a flip phone.
The Vas-COM though, is the smart phone
we all want in our pockets.
- Yeah, well, not all of us.
Some of us just want to make a phone call, right?
And this has been working excellent
for me, still does.
Anyway, I'm old school.
All right, I got my water, and I'll leave you to it.
[tense music]
♪
- X-rays on Ashley's arm. Distal radius fracture.
I paged Ortho--
they're gonna come down and cast it.
Is that her CT? - Take a look.
Oh, man. Lesions.
Four. - Yeah.
And this area here is a resection cavity.
Surrounding tissue shows evidence of radiation necrosis.
So there was a tumor that was removed.
It must have been cancerous given the dead tissue.
- Anaplastic astrocytoma.
I was able to pull up Ashley's medical records
dating back to 2000.
That's when everything started going digital.
Diagnosis was made sometime before that.
Yes, since 2000,
there have been three recurrences.
Appears biopsies on those lesions, though,
were all negative.
- So all benign, but only three recurrences?
I'm counting four here on her CT.
- Yeah, there's a new lesion. The cancer may be back.
.
- So I'm thinking an adverse reaction to his meds
definitely had a lot to do with his episode this morning.
- Yeah, I was leaning that way too.
I noticed some spastic muscle contractions
when I brought him in.
- Yeah, he's also having a hard time
controlling his tongue inside his mouth.
Both of those things, you know, symptoms of overmedication.
I just think his dose is too high.
- He's coming down now, though. - Oh, yeah.
Gave him some Ativan and some Benadryl so he can rest.
I'm gonna reassess in a bit.
- [exhales heavily]
You know, I've known the family since I was a rookie cop.
Roland's always been a bright kid
but shy, sensitive.
Doesn't help that his neighborhood's a war zone.
- Yeah.
I'm sorry that you had to go it alone out there,
but, look, thank God you were there, right?
So a good job.
I'll check back.
- Hey, Mr. Kumar. I'm Dr. Marcel.
I'm the E.D. surgeon on call today.
- Oh, man, I've been upgraded?
That's--that's not a good sign.
- Well, the resident you saw when you came in
asked me to consult because of your chest X-ray results.
It's protocol, not necessarily an omen.
- All right, the X-ray. Lay it on me.
- So it showed a widened mediastinum,
partition between your lungs.
So given your symptoms, fatigue, back pain,
trouble swallowing, hypertension.
The widened mediastinum could by symptomatic
of a lot of things, or it could be nothing.
Nothing. Let's-- Yeah, let's go with that.
- Right.
Well, you know, I'm gonna send you
for a CT of your chest and abdomen.
Get a better look at what's doing,
and then we'll go from there, okay?
- I'd be on my bike by now.
- I'm sorry?
- I had to pull out of a Half-Ironman triathlon.
- Oh. - 1.2 mile saltwater swim,
56 mile bike ride.
Now it tires me out just watching the race online.
- Well, I'm sorry to hear that, man.
Yeah, well, listen, hang in there.
Tech'll be by soon, get you that scan, okay?
- Okay. - All right.
[apprehensive music]
- It started with migraines when I was in the 11th grade,
and they found the tumor a year later.
The day after I graduated from high school,
they took it out, and I felt much better.
No speech issues, no more balance problems.
I was healed, or so I thought.
Turns out the tumor was cancerous.
Anaplastic astrocytoma has been my life since 1991.
- The previous recurrences were benign.
It's possible that this one is too.
But we can't be sure without-- - A biopsy.
Digging out a little more of my brain.
No, thank you.
- Do you not want to know what it is?
- The original chemo and radiation,
they were brutal.
And the biopsies?
Each one has left me a little worse for wear.
My eyesight's bad, my hearing's going,
my hormones are out of whack,
my bones are brittle.
I just don't want to risk anymore damage.
So, okay, you can treat my arm.
But after that, I want to go home.
♪
- Okay.
Ortho will be by soon.
- I feel so bad for her.
- She's been through hell, there's no question.
But her diagnosis, Anaplastic astrocytoma,
it doesn't add up.
- What do you mean?
- A.A. is fatal.
Life expectancy post-diagnosis is a few years at best.
Ashley has survived 30.
- You don't think she has it.
- I don't know what's going on.
But whatever's happening, it started in 1991
with that original tumor.
- 30 years.
I mean, any chance a tissue sample still exists?
- Oh, no, I doubt it.
But maybe the pathology report still does.
- Pre-dates 2000, so it won't be
in her electronic file,
but it has to be on paper somewhere.
- Yep.
Let's start looking. - Okay.
- Roland's sleeping now.
When he wakes up,
Dr. Charles will come do another exam.
- We were on the bus when the break happened.
To visit Harold Washington.
- Hmm. City College?
- Since the diagnosis,
Roland hasn't left the apartment.
But yesterday,
he said he wanted to try again at school.
I was so hopeful it was...
The beginning of something for him.
[voice breaking] But the bus was crowded.
And there was traffic.
If you hadn't come,
it was almost my family today.
[sighs]
Roland is a sweet boy. Kind.
- He is.
- I wish we weren't the only ones who knew that.
- Labs are back on Pete, your belly patient.
White count's 21,000.
- That's high. Let me see the chest X-ray?
Motion artifact. Tough to read.
- He vomited just before the image was taken.
He had a hard time staying still.
- All right.
- Oh, Doc, thank God you're back.
My stomach is killing me.
- Yeah, your labs show you're fighting
more than just a hangover.
Let me take another look.
- Ahh!
That hurts way worse than before.
- Okay, Trini, grab Mike.
Sorry, I gotta keep checking. - [yells]
Oh, this is bad isn't it?
Oh, God, okay, no more crap food.
Just give me salads and vegetables.
No, no, full vegan from now on. I promise.
- Let's get another X-ray before you make
any huge life decisions.
Upright chest, 90 degrees.
And Pete, I know you're in a lot of pain,
but you gotta stay really still, okay?
- [groans] - Clear.
- Yep, free air under the right diaphragm.
Trini, find me Dr. Archer.
- [grunts] What's going on?
- So you need surgery.
Your stomach pain is from a tear in your GI tract.
Air is leaking into your belly.
- Leaking? How does that happen?
- Well, around here, typically I see it
from penetrative trauma, uh, bullets, stab wounds...
- Guns and knives?
But I'm keg stands and peer pong.
[retches]
I think I'm gonna puke again.
I need my drink.
- Sorry, man, no liquids before surgery.
Hey, your elixir. I saw you eating ice.
Is that always part of the process?
- Yeah, chewing on a cold cube is just satisfying.
- Well, I think one might have caused the tear.
Yeah, it's likely been getting bigger
with each cube you've swallowed since.
- Seriously? An ice cube?
- It's looking that way. - What's up?
- Hey, so this is the surgeon. I'm gonna fill him in,
then he's gonna take over, okay?
- [groans]
- Pneumoperitoneum.
I suspect the tear's somewhere near
the gastro-esophageal junction.
- Yeah, there's no blood.
- Ah, wasn't shot or stabbed.
I think an ice cube went down the wrong way.
- Get out, really? All right, cool.
- All right, I'll take it from here.
[suspenseful music]
- You know, Dean, kid's a nervous wreck.
Not in the greatest shape, either.
Post-surgery, I think cardiac monitoring
would be appropriate.
- Uh, let me guess, uh, use the Vas-COM?
I know you like your old-school CVP,
but I do think the Vas-COM might be better suited
for this patient.
- Well, I'll consider it.
- Thank you.
- Okay, I've considered it.
No. I'll stick with my device.
.
- Archer's a real ball buster, huh?
- Yeah, he enjoys it, too.
But still, part of me hoped
he would at least consider the Vas-COM.
- You mind if I offer you a little advice?
- Please.
- Look, you nailed highlighting
the Vas-COM's positives. You nailed it.
But you whiffed on pointing out the CVP's negatives.
That monitor has to be leveled and calibrated
before each use. - Right.
- But what if that's not done appropriately?
All the numbers are off.
None of that data can be trusted.
- A bad calibration in the moment.
That's happened before?
- Not to me. Because I use a Vas-COM.
- [chuckles] - Anyway, food for thought.
You know, as we move toward Grand Rounds.
- See? Right there.
CT shows the wall of the aorta has thickened.
I think it's an aortic tumor.
- No way.
Thoracoabdominal aortic aneurysm.
- I don't know, the walls are abnormally shaped.
Aneurysms are symmetrical.
- It isn't a classic presentation,
I'll give you that, but aortic tumors
are super rare, aortic aneurysms are not.
- Okay, look, I get it, Dr. Bickman.
Common things are common,
but that doesn't rule out a curveball.
- No, but your point is moot 'cause that's a fast ball.
Thoracoabdominal aortic aneurysm.
- I'm not comfortable with that diagnosis.
- It's an IR case now, Dr. Marcel.
Send him up to the cath lab.
I'll put in a stent,
and he'll be good as new.
- How's it going?
- I've only come across four cases in which
patients outlived a diagnosis of anaplastic astrocytoma,
and two of them were determined to be misdiagnoses.
- So odds are Ashley likely isn't another medical miracle.
- No. But can we prove it?
- Maggie and I have been trying to dig up
her original files and path reports.
Slow go.
Sweet. She's got something.
Your research, good stuff.
- Hey, Dr. Hammer.
How many cases you working?
- Just one.
- That's an improvement. You had any food?
I'll take that as a no.
- I'll grab something later,
but this is just more important than lunch.
- Yeah, I disagree.
You can't help your patients if you run out of gas.
Dolmeh, koufteh ghelgheli. Made them last night.
Take five. Recharge.
[knock at door]
- Roland. How you feeling?
I'm Dr. Charles. We met earlier.
- I remember. Kind of.
I'm sorry about my behavior earlier, sir.
- You have absolutely nothing to apologize for.
You mind if I come in? We can chat a bit?
- Sure.
Last time the doctor just stayed in the doorway,
wrote me a prescription.
- So, um, I understand that you and Dr. Scott
go way back.
- Long as I can remember.
We not as tight as we used to be, though.
- No?
- I mean, he doesn't send the calls
to voicemail or nothing, it's just...
He's a doc now, so, you know,
he's not around as much anymore.
I miss him.
- I can understand that. I would too.
- Yeah.
I wish I was more like D.
Guy's not afraid of nothing.
Shadow doesn't even mess with him.
- Shadow?
- It's outside.
Waits for me to leave the apartment.
Always feels like it's gonna attack me.
- So do you ever see the shadow inside
when you're at home?
- No. Except when I don't sleep.
- What does the shadow look like?
I mean, is it a person? Does it have a specific shape?
- I don't know. It's just a thing.
A blur.
I see it, but when I turn around,
it's someplace else.
- Shadow ever speak to you?
I mean, does it have a voice?
- No. It don't make any noises.
It's just always there.
Watching.
- You know what, I really appreciate
you sharing all this stuff with me.
Really, I do.
I'm just going to get back with Dr. Scott,
and then come check in on you in a bit, okay?
- That's it? That's all the questions?
- For now, yeah.
- Last time, the doctor had a checklist.
I'd answer yes or no.
- Guess we do things a little bit differently around here.
I'll see you in a bit.
[apprehensive music]
♪
- How'd it go? He talk about the shadow?
- He did. He did.
You know, there's no doubt in my mind
that it's very real to him,
but it could be related to irregular sleep cycles.
- Hmm.
- Also, you know, he only sees the shadow, right?
It doesn't talk to him, and with schizophrenia,
you'd think there'd be an auditory hallucination as well.
Also, there's this extreme level of agoraphobia,
and I don't know, it's just not tracking.
- So you don't think it's schizophrenia.
- You know, I'm not ruling it out,
but I honestly have my doubts.
- Let's go ahead and order the labs and imaging.
Hopefully it will point us one way or the other.
- Yeah. - This one.
♪
- Oh, hey, Dr. Halstead.
- Hey, hi, Trish.
What's new?
- Same old, same old.
But who knows what tomorrow may bring.
Powerball's up to 68 million.
- Nice.
Might need to get myself a few tickets.
- Oh, were you in here waiting for me?
Did you need anything?
- No, no, I was just checking on the patient, Pete.
But I guess he's, uh--
- This is what I like to see. Hero's welcome.
Hold your applause, please.
Okay, so, I placed a line during surgery.
Connect him to the CVP, grab a baseline.
I am going to change my scrubs
and, uh, please page me when he wakes up, all right?
So as you suspected, esophageal tear at the GEJ.
That's a hell of an ice cube.
- Guess he needs a new hangover cure.
- Yeah, I got one. Drink less.
- College senior, Dean.
Not sure moderation is realistic.
- Yeah, well, you know, what do I know, right?
- Dr. Archer, there's an issue with the CVP.
Vitals are normal, but a CVP of 38 is--
- Yeah, way too high. Way high, I see that.
I see that.
Yes. Yes.
I can't zero it out.
- Here, let me try. Maybe I can recalibrate--
- No, no, just hold on a second.
Let me just check something, let me just check something.
Ah. Look at this.
Cable's got a kink in it. See that?
Can I have a new one, please? - Yeah.
- Yeah, must have snagged on the bed railings
on the trip from the O.R.
[machine beeps] Oh, yeah.
CVP of 11. And problem solved.
That was a close shave, yeah?
- [chuckles] Yeah. Glad it worked out.
- Yeah. See you back in the E.D.
- Yeah. - All right.
♪
- [groans] Help me!
Please. Help me, please.
- Hey, Mr. Kumar, I'm here. What's going on?
My back. My back is on fire.
- Okay. - Radiologist said
that the stent would ease the pain,
but it's worse, it's worse.
And my legs are numb.
They're numb. - Okay.
- I can't move them. - Okay, we're gonna
figure this out.
No way this is an aneurysm. [grunts]
- I need an MRI. - Ow!
[sobs]
.
- Damn it. I knew it.
- Tumor in the inner layer of the aorta.
- It's occluding several perforating vessels
to the spine. It's not getting enough blood.
Explains why his legs went numb.
- Looks like blood's leaking into the wall of the aorta.
If it keeps compressing the vessels--
- His legs will go from numb to paralyzed.
That tumor's gotta come out.
- Roland doesn't have schizophrenia?
- I don't believe he does.
After talking with him, looking at his test results,
getting more medical history from Dr. Scott,
it's my belief that the more appropriate diagnosis
would be bipolar disorder.
- But the other psychiatrist-- - Was wrong.
- But he was so sure. Said he'd seen it before.
- Psychiatry is far from an exact science.
And unfortunately, research does show
that African Americans, particularly males,
are misdiagnosed with schizophrenia
far more than whites.
- We're perceived as dangerous,
and so we get a diagnosis to match that perception.
- This why the dosage on Roland's meds
was so high also?
Because he was assumed to be a threat?
- It's very likely.
And that high dose also probably contributed
to exacerbating the condition that I think
that he actually has.
- Today could have been avoided.
- I'm so sorry.
- Is there a way to make things right?
- We do a complete reassessment, okay?
New meds. The right doses. Therapy.
I know of an outpatient clinic
that I think that Roland would really respond to.
Okay?
I'm gonna leave you two for a minute.
- Thank you. - Of course.
[solemn music]
- What do you think?
- I think he sees the same thing in Roland
that we see.
What do you say? Follow Dr. Charles' advice?
- An anomaly? I don't understand.
According to your medical records,
we have reason to question whether your original tumor
was in fact anaplastic astrocytoma.
- We came across a pathology report
that suggests it might be pilocytic astrocytoma.
- Well, what's the difference?
- Anaplastic is malignant. Pilocytic is benign.
- So I might not have cancer?
- We don't know.
- There's no tissue left from that original tumor
to examine.
In order to make an updated diagnosis,
we'd need to test a new sample.
- Biopsy the latest recurrence.
- In 1991, technology only allowed us
to analyze the tumor's tissue.
Today, we're able to dissect its molecular structure.
Identification will be exact.
- Even so, I might still have cancer.
- More and more I'm suspecting that
that is not the case. - Why?
- Because you're alive.
People with anaplastic astrocytoma
simply don't live as long as you have.
- [sighs] Okay.
Okay, do the biopsy.
♪
- Dr. Marcel, I presume. - Yeah.
- Dr. Simms, cardiothoracic surgery.
- Pleasure.
- Radiology filled me in on the patient.
Aortic tumor. - Mm-hmm.
- Nice call.
From the get go and despite the cath lab, I hear.
- Yeah, it wasn't a straight line, but, uh,
we're back on track now.
- I appreciate the head start, but I'll take it from here.
- Uh, I assumed I would perform the surgery.
- I understand,
but this is a cardiovascular procedure.
Not a trauma. Little out of your lane.
- I'm aware of what it is, and I have the skills.
- Maybe, but you don't have the credentials.
You're a general surgeon, not a specialist.
- I just want to make something very clear,
Mr. Kumar is my patient.
- Dr. Marcel.
Do you really want to waste time
fighting an argument you're not going to win?
You're free to watch from the observation room.
[tense music]
♪
.
- Wow. What a view.
You can almost see the entire city.
And yet, it's the best spot in the hospital to be alone.
- Rehearsal didn't go well this morning.
- Okay...
- So I flirted with the subtle suggestion
from Dr. Cooper to sabotage Dr. Archer's CVP monitor.
- Sabotage? - Yeah.
So that the Vas-COM could save the day.
And I came this close to doing it.
- But you didn't.
- But I'm afraid I could've.
- Look, in the past,
every time you've acted injudiciously,
you've always kept your patient's best interest
at heart, and I know you always will.
[pensive music]
- Thanks.
- And Dr. Halstead...
If this ever gets to be too much for you,
tell me, and I'll put a stop to the whole thing.
♪
- Benign?
So all this time, I never had cancer?
- No.
There are two pathologists listed in your medical records.
The first who examined your tumor
thought that it was benign.
But he was a young attending. Inexperienced.
Wanted a second opinion.
So he sent a sample to a renowned cancer center,
and the pathologist there
diagnosed anaplastic astrocytoma.
- 30 years.
Every headache, every seizure.
Just feeling off, I thought it was the end.
Three decades of facing death every single day,
and my family and my friends, they suffer too.
- Ashley.
I'm so sorry for what you've been through.
But at least
you are no longer living on borrowed time.
Your future can be anything that you want it to be.
[knock at door]
- Heard your door is always open.
- Literally, right? Come on in.
Am I sensing that it might be time
for a little drink?
- Oh, pour it up.
- Have a seat. - Thanks.
Oh, man.
Had I not beaten the cops to the scene today,
Roland could be in the system now, or worse.
Seems like happy endings are hard to come by these days.
- Seems that way, huh?
- Situation like today,
there's nobody else to call for help but the police.
But they're not equipped
to handle mental illness, you know.
I mean, don't get me wrong, there are a few bad cops,
but the rest, most, are just doing the best they can
with the tools they've been given.
- It's a tough job. - Huh.
And in need of some updates.
- So, uh, so what are you thinking?
- CPD is developing a crisis intervention program.
A unit trained specifically for de-escalation.
- Sounds like a solid first step in police reform to me.
- Agreed.
I mean, it's what I did today on the street.
- Which proves that it works.
- Was hoping you'd say that.
So the thing is, the program, it's on the table,
but it's stuck there.
Lots of training needed for police,
but not enough training resources.
I don't know the time commitment,
and I can only imagine that the bureaucracy
will be infuriating-- - I'm in.
- [laughs] That was easy.
- Oh, excuse me. Just grabbing a snack.
- Taking five, I hope?
- More like a 30-second breather.
But, since I've been caught,
I guess I have four and a half minutes to go.
- You okay?
- Yeah.
No.
My aortic patient.
His procedure was a success, I just--
I wasn't able to see it all the way through.
Got benched by the powers that be.
It's frustrating, you know?
- I'm sorry.
- Yeah.
- Sorry. I, um--
I didn't mean to, uh--
you know what, that was inappropriate.
I don't know what I was thinking.
- It's okay. We're good.
Don't worry. - Okay. Cool.
I have to go, uh, check on some test results, so, uh.
Uh, Dr. Hammer, Maggie, I just--I need a minute.
- Sure.
That's gonna sting for a bit. She'll be okay.
♪
Heavy day. - Yep.
- And not just the case.
I, um--
I made a fool of myself for Dr. Marcel.
- The doctors' lounge?
- I'm so embarrassed. I'm crushing on my advisor?
Seriously, I'm a cliché.
- Kind of. Welcome to the club.
- For real? You? - Yeah.
My Crockett was Dr. Andrew Jacobson.
- Well, I'm sure you handled it
better than I did.
- If only.
Would have spared me a lot of heartache.
Instead I married him.
- Oh, I didn't even know that you were married.
- I'm not, no. Didn't work out.
[siren blares] That's our cue.
Get back to it? - Let's go.
[dramatic music]
♪
[wolf howls]