1 00:00:04,526 --> 00:00:07,833 - The night that you left, I kissed Crockett. 2 00:00:07,877 --> 00:00:09,139 I'm sorry. 3 00:00:09,183 --> 00:00:10,662 - April? Really? 4 00:00:10,706 --> 00:00:13,187 Huh? All this time acting like this? 5 00:00:13,230 --> 00:00:15,319 Come on! - Hey! 6 00:00:15,363 --> 00:00:17,060 - I couldn't let you keep treating patients. 7 00:00:17,104 --> 00:00:18,714 I had to make your addiction known. 8 00:00:18,757 --> 00:00:21,325 - What you did was a betrayal. - You're an excellent doctor. 9 00:00:21,369 --> 00:00:23,458 I wasn't about to let you throw your life away. 10 00:00:23,501 --> 00:00:26,591 - You were right. They gave me my life back. 11 00:00:30,030 --> 00:00:31,640 - It's beautiful, Ben. 12 00:00:31,683 --> 00:00:33,511 - You're beautiful. 13 00:00:33,555 --> 00:00:35,861 - I pronounce you husband and wife. 14 00:00:38,603 --> 00:00:40,214 - I'll say it till the day I die: 15 00:00:40,257 --> 00:00:42,346 there is no better pizza than Chicago deep dish. 16 00:00:42,390 --> 00:00:45,262 - But it's not even pizza. It's lasagna. 17 00:00:45,306 --> 00:00:46,872 - We're gonna have to agree to disagree. 18 00:00:46,916 --> 00:00:48,309 - I will not agree to disagree. 19 00:00:48,352 --> 00:00:50,050 No, you are flat wrong. 20 00:00:50,093 --> 00:00:53,053 Flat. The way that pizza should be. 21 00:00:54,706 --> 00:00:56,186 - Lasagna, huh? 22 00:00:56,230 --> 00:00:57,927 That's good. Smart lady. 23 00:00:57,970 --> 00:00:59,885 - No, Dr. Charles, not you too. 24 00:00:59,929 --> 00:01:03,802 - I don't know that-- that you and Dr. Asher were... 25 00:01:03,846 --> 00:01:05,065 - Friends. - Yeah. 26 00:01:05,108 --> 00:01:06,936 Good. That's good. 27 00:01:06,979 --> 00:01:08,677 - And? 28 00:01:08,720 --> 00:01:11,506 - And she needs a strong support system right now. 29 00:01:11,549 --> 00:01:14,596 So I'm glad that she has you as a--as a friend. 30 00:01:16,163 --> 00:01:17,381 - Look, I get it. 31 00:01:17,425 --> 00:01:19,253 Romantic relationships are discouraged 32 00:01:19,296 --> 00:01:20,993 during the first year of recovery. 33 00:01:21,037 --> 00:01:23,692 - Neurochemically, very little difference between 34 00:01:23,735 --> 00:01:26,651 the dopamine rush that we get from drugs and alcohol 35 00:01:26,695 --> 00:01:29,219 and the rush that we get from romance. 36 00:01:29,263 --> 00:01:30,960 - Well, you know, I'm sure as with anything, 37 00:01:31,003 --> 00:01:32,831 there are exceptions to the rule. 38 00:01:32,875 --> 00:01:35,399 - I have never actually seen that go well. 39 00:01:35,443 --> 00:01:37,619 Well, at least not in my, you know, 40 00:01:37,662 --> 00:01:39,795 three decades of experience counseling people in recovery. 41 00:01:39,838 --> 00:01:41,231 - Next! 42 00:01:46,149 --> 00:01:47,846 - Hey. 43 00:01:47,890 --> 00:01:50,110 So how are things with Ethan? 44 00:01:50,153 --> 00:01:52,460 - Okay, I guess. 45 00:01:52,503 --> 00:01:54,157 I tried to get him to talk about it, 46 00:01:54,201 --> 00:01:55,593 and he hasn't wanted to. 47 00:01:55,637 --> 00:01:58,205 - Hmm, maybe that's his way of processing. 48 00:01:58,248 --> 00:02:01,382 - Yeah. Maybe. 49 00:02:01,425 --> 00:02:03,253 - Will, you're up. 50 00:02:03,297 --> 00:02:05,560 Ambo's landed. You're going to Trauma 2. 51 00:02:05,603 --> 00:02:07,866 - All right. 52 00:02:09,303 --> 00:02:11,305 - Evelyn Myers. 49-year-old female 53 00:02:11,348 --> 00:02:12,697 with progressive early-onset Alzheimer's. 54 00:02:12,741 --> 00:02:14,090 Passed out at home. 55 00:02:14,134 --> 00:02:16,440 Did a 12-lead in the ambo. She's got peaked T Waves. 56 00:02:16,484 --> 00:02:18,094 - And did she hit her head when she passed out? 57 00:02:18,138 --> 00:02:19,487 - Her daughter, Molly, didn't think so. 58 00:02:19,530 --> 00:02:21,402 No overt signs of head trauma. 59 00:02:21,445 --> 00:02:22,838 - I'm pretty sure that she didn't, 60 00:02:22,881 --> 00:02:24,970 but I was in the other room when it happened. 61 00:02:25,014 --> 00:02:26,581 I shouldn't have left her alone. 62 00:02:26,624 --> 00:02:28,191 - Evelyn, I'm Dr. Halstead. 63 00:02:28,235 --> 00:02:31,151 All right, on my count. One, two, three. 64 00:02:32,326 --> 00:02:33,544 Thanks, guys. - Yup. 65 00:02:37,200 --> 00:02:38,854 Rhonchi, both sides. 66 00:02:38,897 --> 00:02:40,769 Blunted breath sounds at the base. 67 00:02:40,812 --> 00:02:42,684 - 2 plus pitting edema. 68 00:02:44,642 --> 00:02:45,382 - Yeah. 69 00:02:48,037 --> 00:02:50,953 Molly, is your mom on any medications for kidney disease? 70 00:02:50,996 --> 00:02:52,476 - I'm not sure. 71 00:02:52,520 --> 00:02:54,696 She takes something called Capto... 72 00:02:54,739 --> 00:02:57,089 - Captopril? - I think so. 73 00:02:57,133 --> 00:02:58,482 Sorry, I'm not with her every day. 74 00:02:58,526 --> 00:02:59,962 I'm just home for spring break. 75 00:03:00,005 --> 00:03:01,833 - Any family history of kidney problems? 76 00:03:01,877 --> 00:03:03,835 - Uh, yeah, yeah. 77 00:03:03,879 --> 00:03:05,359 My grandma, my mom's mom, 78 00:03:05,402 --> 00:03:06,577 she had something wrong with her kidneys. 79 00:03:06,621 --> 00:03:08,100 My dad will know what it's called. 80 00:03:08,144 --> 00:03:10,102 - CBC, CMP stat. - What's going on? 81 00:03:11,756 --> 00:03:14,324 Molly, I told you to call me if anything happened with Mom. 82 00:03:14,368 --> 00:03:16,239 - Sorry, Dad. I just freaked out. 83 00:03:16,283 --> 00:03:17,719 - It's okay. 84 00:03:17,762 --> 00:03:20,112 - Hi, I'm Dr. Halstead. - Elliot. 85 00:03:20,156 --> 00:03:22,463 - Elliot, well, we still need labs, 86 00:03:22,506 --> 00:03:25,770 but I suspect Evelyn's in acute renal failure. 87 00:03:25,814 --> 00:03:27,903 In which case, she needs emergency dialysis. 88 00:03:27,946 --> 00:03:30,340 - No. No dialysis. 89 00:03:30,384 --> 00:03:32,777 It's against Evelyn's advance directive. 90 00:03:32,821 --> 00:03:35,737 - Don't listen to him. He lies. 91 00:03:35,780 --> 00:03:39,262 - Evelyn, honey, you signed an advance directive. 92 00:03:39,306 --> 00:03:41,612 - Advance directive? What is that, Dad? 93 00:03:41,656 --> 00:03:44,136 - No, I didn't sign anything. No. 94 00:03:44,180 --> 00:03:46,051 - You don't want dialysis, my love. 95 00:03:46,095 --> 00:03:47,879 - Yes, I do. I do! 96 00:03:47,923 --> 00:03:49,751 Help me! 97 00:04:02,285 --> 00:04:04,069 - Hey, take a look. 98 00:04:04,113 --> 00:04:06,855 - Did you get Mrs. Myers' lab work back? 99 00:04:06,898 --> 00:04:09,031 - She's profoundly uremic and hyperkalemic. 100 00:04:09,074 --> 00:04:10,728 She's not making urine. 101 00:04:10,772 --> 00:04:12,339 If we don't dialyze her, she'll die. 102 00:04:12,382 --> 00:04:14,689 - Well, I've reviewed her advance directive. 103 00:04:14,732 --> 00:04:18,693 She prepared it shortly after her Alzheimer's diagnosis, 104 00:04:18,736 --> 00:04:20,695 and I'll tell you, Mrs. Myers outlined 105 00:04:20,738 --> 00:04:25,352 a number of interventions she didn't want including dialysis. 106 00:04:25,395 --> 00:04:28,311 And she appointed her husband to be her proxy 107 00:04:28,355 --> 00:04:30,705 when she could no longer speak for herself. 108 00:04:30,748 --> 00:04:32,446 - But she can speak for herself, 109 00:04:32,489 --> 00:04:33,882 and she has changed her mind. 110 00:04:33,925 --> 00:04:35,797 I mean, people can modify their advanced directives 111 00:04:35,840 --> 00:04:37,320 at any time, right? 112 00:04:37,364 --> 00:04:38,974 - As long as they still have decisional capacity. 113 00:04:39,017 --> 00:04:41,237 - Well, you do an evaluation 114 00:04:41,281 --> 00:04:43,413 and then we'll take it from there. 115 00:04:43,457 --> 00:04:45,415 - Great. 116 00:04:46,634 --> 00:04:48,462 - Sharon? - Yeah. 117 00:04:48,505 --> 00:04:50,420 - Your assistant called. Michael's plane has landed. 118 00:04:50,464 --> 00:04:52,204 - Oh, good. 119 00:04:52,248 --> 00:04:55,382 It's silly, I know, but he's 33 years old. 120 00:04:55,425 --> 00:04:56,774 - Mm-hmm. 121 00:04:56,818 --> 00:04:57,906 - I still get nervous when he flies. 122 00:04:59,560 --> 00:05:01,997 I guess I just feel a lot better 123 00:05:02,040 --> 00:05:04,913 when I know he's got two feet back on the ground. 124 00:05:04,956 --> 00:05:06,828 - Well, he's your baby boy. 125 00:05:06,871 --> 00:05:09,221 How long is he in town? - Just 24 hours. 126 00:05:09,265 --> 00:05:12,964 Interviewing for a sales job at Kender Bio Systems. 127 00:05:13,008 --> 00:05:15,750 I would love to have at least one of my kids 128 00:05:15,793 --> 00:05:17,447 living in the city. 129 00:05:17,491 --> 00:05:20,276 - Need some help over here! 130 00:05:20,320 --> 00:05:22,104 - This is Nick Elms. 131 00:05:22,147 --> 00:05:24,193 Experiencing severe abdominal pain. 132 00:05:24,236 --> 00:05:26,630 Haven't finished uploading his information into the system. 133 00:05:26,674 --> 00:05:28,589 - I can tell you anything you need to know. 134 00:05:28,632 --> 00:05:29,938 I'm his wife, Alice. 135 00:05:29,981 --> 00:05:31,853 - Trini, where we headed? - 4's open. 136 00:05:31,896 --> 00:05:33,550 - Just breathe. 137 00:05:33,594 --> 00:05:35,030 - All right, Mr. Elms, we're gonna take you right here. 138 00:05:35,073 --> 00:05:37,206 - Ready? 139 00:05:37,249 --> 00:05:39,861 One, two, three. There you go. 140 00:05:39,904 --> 00:05:42,298 All right. When did the pain start? 141 00:05:42,342 --> 00:05:43,952 - Last night. 142 00:05:43,995 --> 00:05:47,390 Nick has a condition called familial adenomatous polyposis. 143 00:05:47,434 --> 00:05:49,392 It causes polyps in his-- - Colon and rectum. 144 00:05:49,436 --> 00:05:52,308 I'm familiar. 145 00:05:52,352 --> 00:05:55,311 - When was he first diagnosed? - Five years ago. 146 00:05:55,355 --> 00:05:58,227 It had already developed into colorectal cancer. 147 00:05:58,270 --> 00:06:00,185 He had multiple runs of chemo, 148 00:06:00,229 --> 00:06:02,100 but it came back again last year. 149 00:06:02,144 --> 00:06:04,102 He developed congestive heart failure from the chemo. 150 00:06:04,146 --> 00:06:05,756 - Nick, can you tell me 151 00:06:05,800 --> 00:06:07,497 when you had your last bowel movement? 152 00:06:07,541 --> 00:06:08,933 - Yesterday morning. 153 00:06:08,977 --> 00:06:10,935 No, the day before. 154 00:06:10,979 --> 00:06:12,546 - All right, well, we do need a CT scan, 155 00:06:12,589 --> 00:06:14,504 but I'm worried there's a colonic obstruction. 156 00:06:14,548 --> 00:06:17,594 Which means a colostomy, right? 157 00:06:17,638 --> 00:06:18,987 - Mm-hmm. 158 00:06:19,030 --> 00:06:20,597 - My doc warned me that was coming. 159 00:06:20,641 --> 00:06:21,990 - Well, it may be short term. 160 00:06:22,033 --> 00:06:23,557 In as a little as 12 weeks, they can reverse-- 161 00:06:23,600 --> 00:06:25,863 - That's long term for me, Doc. 162 00:06:25,907 --> 00:06:29,345 I got four months left at the most. 163 00:06:29,389 --> 00:06:32,479 I really gotta spend it defecating into a bag? 164 00:06:37,527 --> 00:06:40,704 - Hey, Mags, can you page general surgery for a consult? 165 00:06:40,748 --> 00:06:43,011 Patient is Nick Elms. 166 00:06:43,054 --> 00:06:45,840 Late stage colorectal cancer due to FAP. 167 00:06:45,883 --> 00:06:47,537 Suspected colonic obstruction. 168 00:06:47,581 --> 00:06:48,930 - Mm-hmm. - Thank you. 169 00:06:48,973 --> 00:06:50,584 - Got it. 170 00:06:52,629 --> 00:06:54,022 - Hey, Mags. - Mm-hmm? 171 00:06:54,065 --> 00:06:55,850 - I can do the consult. 172 00:06:55,893 --> 00:06:57,199 - You sure? 173 00:06:57,242 --> 00:06:58,722 I thought you were clocking out. 174 00:06:58,766 --> 00:07:00,768 - Yeah, well, I got nowhere to be till cocktail hour. 175 00:07:00,811 --> 00:07:02,683 Have at it. 176 00:07:08,906 --> 00:07:11,082 - Come in. 177 00:07:12,301 --> 00:07:13,998 Bert. 178 00:07:14,042 --> 00:07:15,435 What's up? 179 00:07:15,478 --> 00:07:18,525 - Sorry to show up unannounced. 180 00:07:18,568 --> 00:07:21,571 I spoke with Michael. 181 00:07:22,529 --> 00:07:25,270 With him in town, I thought it would be a good opportunity 182 00:07:25,314 --> 00:07:26,881 to smooth things over with him. 183 00:07:26,924 --> 00:07:29,971 Our relationship hasn't been the best since the divorce. 184 00:07:30,014 --> 00:07:32,147 - That's between you and Michael. 185 00:07:32,190 --> 00:07:37,544 - I just thought if I told him about us... 186 00:07:38,632 --> 00:07:40,590 - Whoa, whoa, whoa. 187 00:07:40,634 --> 00:07:44,246 Uh, told him what exactly? 188 00:07:44,289 --> 00:07:46,204 - Jus that we've been seeing each other. 189 00:07:49,338 --> 00:07:51,819 I should've checked with you first. 190 00:07:51,862 --> 00:07:55,039 - Yeah. That would've been nice. 191 00:07:55,083 --> 00:07:58,565 And now we're seeing each other? 192 00:07:58,608 --> 00:08:01,306 We're seeing each other? 193 00:08:01,350 --> 00:08:02,917 - We go out once a week, Sharon. 194 00:08:02,960 --> 00:08:04,048 What would you call it? 195 00:08:05,528 --> 00:08:08,923 - Look, Bert, I don't have time for this. 196 00:08:08,966 --> 00:08:10,664 - Okay. 197 00:08:21,805 --> 00:08:24,504 - Babe, what are you doing here? 198 00:08:25,983 --> 00:08:27,985 And who's your sidekick? 199 00:08:28,029 --> 00:08:30,292 - This is Auggie, one of my students. 200 00:08:30,335 --> 00:08:32,860 Auggie this is my wife, Ms. Lockwood. 201 00:08:32,903 --> 00:08:34,775 - Nonsense. You call me Maggie. 202 00:08:34,818 --> 00:08:37,517 - Hi, Maggie. - What's going on, little man? 203 00:08:39,344 --> 00:08:41,303 - Auggie has cirrhosis from something they call 204 00:08:41,346 --> 00:08:43,261 chronic autoimmune... 205 00:08:43,305 --> 00:08:46,351 - Autoimmune chronic hepatitis? - Yup, that. 206 00:08:46,395 --> 00:08:47,962 And when he showed up at school this morning, 207 00:08:48,005 --> 00:08:49,354 he sounded winded. 208 00:08:49,398 --> 00:08:51,792 He was running a slight fever as well. 209 00:08:51,835 --> 00:08:53,489 - All right, little man. 210 00:08:53,533 --> 00:08:55,796 Why don't you come with me, fellas? 211 00:08:55,839 --> 00:08:57,928 We're going right here. 212 00:08:57,972 --> 00:09:02,542 Babe, why don't you help Auggie hop up and grab a seat? 213 00:09:02,585 --> 00:09:04,369 - All right. 214 00:09:07,024 --> 00:09:08,635 - Why don't you scoot back, Auggie? 215 00:09:08,678 --> 00:09:09,984 There you go. 216 00:09:10,027 --> 00:09:12,682 And I am gonna grab you 217 00:09:12,726 --> 00:09:15,032 all the fruit snacks you could want. 218 00:09:15,076 --> 00:09:17,252 - I don't have any money. 219 00:09:18,558 --> 00:09:20,951 - You're a very important person, Auggie. 220 00:09:20,995 --> 00:09:23,084 The fruit snacks are on the house. 221 00:09:25,303 --> 00:09:28,002 Give me a sec. 222 00:09:30,134 --> 00:09:32,659 Earl. 223 00:09:32,702 --> 00:09:35,487 Do you mind keeping my friend Auggie company for a sec? 224 00:09:36,401 --> 00:09:38,142 - Oh, no. Not at all. 225 00:09:38,186 --> 00:09:39,666 - Awesome. Auggie, this is Earl. 226 00:09:39,709 --> 00:09:42,016 He works here. 227 00:09:42,059 --> 00:09:44,235 - Hey, big man. 228 00:09:44,279 --> 00:09:47,151 All right, buddy, give me some. 229 00:09:47,195 --> 00:09:49,545 Bop, bam, boom. 230 00:09:49,589 --> 00:09:50,851 - Did you get ahold of his parents? 231 00:09:50,894 --> 00:09:52,461 - Auggie's in foster care. 232 00:09:52,504 --> 00:09:55,507 I haven't been able to reach his foster mom, Ruth, just yet. 233 00:09:55,551 --> 00:09:57,509 But I'll keep trying. - All right. 234 00:09:57,553 --> 00:09:59,642 I'll go get a doctor and some fruit snacks. 235 00:09:59,686 --> 00:10:01,513 Oh, babe, did you remember to-- 236 00:10:01,557 --> 00:10:04,038 - To call the spa at the resort? 237 00:10:04,081 --> 00:10:05,909 We're booked for a couples massage 238 00:10:05,953 --> 00:10:07,955 on the beach tomorrow morning. 239 00:10:10,522 --> 00:10:13,221 - Joy, you fractured your distal fibula. 240 00:10:13,264 --> 00:10:14,788 It doesn't require surgery, 241 00:10:14,831 --> 00:10:16,920 but you'll need to be in a boot for 6-8 weeks. 242 00:10:16,964 --> 00:10:18,618 - I feel like I'm cursed. 243 00:10:18,661 --> 00:10:20,402 You know, I started this diet two months ago. 244 00:10:20,445 --> 00:10:21,882 I can't lose any weight. 245 00:10:21,925 --> 00:10:23,144 That's why I joined the gym. 246 00:10:23,187 --> 00:10:24,362 I thought I had to exercise more. 247 00:10:24,406 --> 00:10:26,234 - Babe, what happened? 248 00:10:26,277 --> 00:10:27,801 You passed out on the treadmill? 249 00:10:27,844 --> 00:10:30,760 - Dr. Choi, Nurse Sexton, this is Max, my fiancé. 250 00:10:30,804 --> 00:10:32,936 I was telling them the reason I joined the gym 251 00:10:32,980 --> 00:10:34,938 is 'cause I was having trouble losing weight. 252 00:10:34,982 --> 00:10:36,244 - You look great. - Max! 253 00:10:36,287 --> 00:10:38,507 It's not about that, right? 254 00:10:39,595 --> 00:10:41,336 Now I just wanna get healthier. 255 00:10:41,379 --> 00:10:43,251 - Well, Joy, there are certain conditions 256 00:10:43,294 --> 00:10:44,600 that could make weight loss difficult, 257 00:10:44,644 --> 00:10:46,602 but most of them are commonly treatable. 258 00:10:46,646 --> 00:10:48,560 While you're here, we can run some tests 259 00:10:48,604 --> 00:10:50,084 if you don't mind waiting a bit. 260 00:10:50,127 --> 00:10:51,302 - Sounds good. 261 00:10:51,346 --> 00:10:53,174 - April, let's get a CBC, FSH, TSH, 262 00:10:53,217 --> 00:10:54,436 and a cortisol level to start. 263 00:10:54,479 --> 00:10:55,567 - Okay. - We'll see you in a bit. 264 00:10:55,611 --> 00:10:56,830 - All right. Thanks. 265 00:11:09,407 --> 00:11:12,280 - Hey Ethan, listen, man, I... 266 00:11:18,199 --> 00:11:19,940 - How'd it go? 267 00:11:19,983 --> 00:11:23,595 - Evelyn definitely does not have decisional capacity. 268 00:11:23,639 --> 00:11:26,686 I mean, she didn't understand the treatment being offered 269 00:11:26,729 --> 00:11:28,339 or even that she had an issue with her kidneys 270 00:11:28,383 --> 00:11:30,559 in the first place. 271 00:11:30,602 --> 00:11:33,301 - Did she seem depressed? Suicidal? 272 00:11:33,344 --> 00:11:35,390 - No, I wouldn't say that. 273 00:11:35,433 --> 00:11:37,305 - So, she still possesses the will to live. 274 00:11:37,348 --> 00:11:39,307 She just can't articulate it clearly. 275 00:11:39,350 --> 00:11:41,744 - Well, except that when she was of sound mind, 276 00:11:41,788 --> 00:11:45,400 she made it very clear in writing and to her husband-- 277 00:11:45,443 --> 00:11:47,881 - Who she seems highly suspicious of, by the way. 278 00:11:47,924 --> 00:11:49,273 - That's not uncommon. 279 00:11:49,317 --> 00:11:51,275 I mean, it's often the primary caregivers 280 00:11:51,319 --> 00:11:53,190 that get the brunt of the paranoia 281 00:11:53,234 --> 00:11:55,105 in situations like this. 282 00:11:55,149 --> 00:11:56,498 - Well, I--I don't know. 283 00:11:56,541 --> 00:11:58,935 Maybe it's worth convening an ethics committee then? 284 00:11:58,979 --> 00:12:00,458 - An ethics committee? 285 00:12:00,502 --> 00:12:01,808 - Yeah, just get some other perspectives. 286 00:12:01,851 --> 00:12:03,505 - Will, I don't think that's necessary. 287 00:12:03,548 --> 00:12:05,507 I gave her a very thorough evaluation. 288 00:12:05,550 --> 00:12:07,204 I'm confident in my assessment. 289 00:12:07,248 --> 00:12:09,250 - Yeah, but ultimately, it is subjective. 290 00:12:09,293 --> 00:12:10,642 Your opinion-- - That's right. 291 00:12:10,686 --> 00:12:12,427 My professional opinion, which is based on-- 292 00:12:12,470 --> 00:12:13,907 - Decades of experience. I know. 293 00:12:13,950 --> 00:12:16,779 - That's right. Decades of experience. 294 00:12:20,130 --> 00:12:22,132 I'll see ya. 295 00:12:29,096 --> 00:12:30,793 - Oh. 296 00:12:30,837 --> 00:12:32,621 Why does it look like that? 297 00:12:32,664 --> 00:12:34,144 - Ascites. 298 00:12:34,188 --> 00:12:36,538 Fluid accumulates in the peritoneal cavity. 299 00:12:36,581 --> 00:12:38,583 Can happen in patients with cirrhosis. 300 00:12:42,196 --> 00:12:44,589 - Did you tell Ruth that your belly was hurting this morning? 301 00:12:44,633 --> 00:12:47,505 - She goes to work before the school bus comes. 302 00:12:47,549 --> 00:12:49,681 - Auggie, I'm going to need to do a procedure 303 00:12:49,725 --> 00:12:51,292 called paracentesis. 304 00:12:51,335 --> 00:12:52,946 What I'll do is I'll insert a needle-- 305 00:12:52,989 --> 00:12:55,252 - A needle into my tummy to get all the bad stuff out. 306 00:12:59,169 --> 00:13:03,217 It's not so bad, Mr. Campbell. Just sounds scary. 307 00:13:03,913 --> 00:13:05,741 - So I'll be performing the abdominal portion 308 00:13:05,785 --> 00:13:07,134 of the surgery robotically, 309 00:13:07,177 --> 00:13:09,745 while Dr. Castaneda works endoscopically from below. 310 00:13:09,789 --> 00:13:11,486 Dr. Manning. Perfect timing. 311 00:13:11,529 --> 00:13:14,968 - Good morning, Dr. Marcel. Robots and endoscopes? 312 00:13:15,011 --> 00:13:16,447 Doesn't sound like a colostomy. 313 00:13:16,491 --> 00:13:19,363 - Yeah, Nick and Alice and I were discussing it 314 00:13:19,407 --> 00:13:21,235 and we're gonna take a different approach. 315 00:13:21,278 --> 00:13:24,412 Transanal Total Mesorectal Excision. 316 00:13:24,455 --> 00:13:26,066 TaTME. 317 00:13:26,109 --> 00:13:28,546 - I'm sorry, forgive me. I'm not familiar with it. 318 00:13:28,590 --> 00:13:32,115 I am aware of TME, which is a major surgery. 319 00:13:32,159 --> 00:13:34,770 - Right, well, this is a new approach 320 00:13:34,814 --> 00:13:36,728 that allows for better visualization 321 00:13:36,772 --> 00:13:38,861 and removal of tumors in the lower rectum. 322 00:13:38,905 --> 00:13:40,558 - Well, I'm sure you've explained the risks 323 00:13:40,602 --> 00:13:41,864 to Nick and Alice. 324 00:13:41,908 --> 00:13:43,518 - I sure have. Yeah? 325 00:13:43,561 --> 00:13:45,041 - We're ready to move Mr. Elms upstairs. 326 00:13:45,085 --> 00:13:47,000 - Great. All right. 327 00:13:47,914 --> 00:13:49,741 So I'll see you in a couple hours. 328 00:13:49,785 --> 00:13:51,352 - Thanks. Dr. Marcel. - All right. 329 00:13:51,395 --> 00:13:52,919 Alice, I'll see you. 330 00:13:55,922 --> 00:13:57,880 - Crockett. - Yeah? 331 00:13:57,924 --> 00:13:59,795 Why would you suggest a radical surgery 332 00:13:59,839 --> 00:14:01,057 for a terminal patient? 333 00:14:01,101 --> 00:14:02,537 Even if it's successful, 334 00:14:02,580 --> 00:14:05,061 it is highly unlikely it's gonna save his life. 335 00:14:05,105 --> 00:14:06,802 - But it could buy him more time 336 00:14:06,846 --> 00:14:08,673 and a better quality of life. 337 00:14:08,717 --> 00:14:09,979 - Yeah, if he doesn't die on the table, 338 00:14:10,023 --> 00:14:12,199 which is a real risk, given his heart problems. 339 00:14:12,242 --> 00:14:13,765 - And I didn't sugarcoat that risk. 340 00:14:13,809 --> 00:14:15,506 - He has seen many surgeons, 341 00:14:15,550 --> 00:14:17,378 and none of them have put this option on the table. 342 00:14:17,421 --> 00:14:19,510 - Yeah, 'cause most of them are gutless, 343 00:14:19,554 --> 00:14:20,860 obsessed with their stats. 344 00:14:20,903 --> 00:14:23,123 - Okay, you say gutless. I'd say pragmatic. 345 00:14:23,166 --> 00:14:24,907 - Oof. 346 00:14:24,951 --> 00:14:27,040 I see us edging towards a semantics debate. 347 00:14:27,083 --> 00:14:28,606 I know when I'm out of my depth. 348 00:14:34,786 --> 00:14:36,223 - Why don't you just stay with me? 349 00:14:36,266 --> 00:14:38,268 - No, the company's putting me up at the Peninsula. 350 00:14:38,312 --> 00:14:41,054 - Ooh, fancy! They must really want you. 351 00:14:41,097 --> 00:14:43,447 - Mm-hmm. 352 00:14:46,276 --> 00:14:49,453 - So I gotta ask about this nonsense Dad was talking. 353 00:14:49,497 --> 00:14:51,151 It's not for real, right? 354 00:14:54,676 --> 00:14:56,939 Wait, you're not seriously considering taking Dad back? 355 00:14:56,983 --> 00:14:58,245 - Michael. 356 00:14:58,288 --> 00:15:01,813 - He--he walked out after 35 years of marriage. 357 00:15:01,857 --> 00:15:03,424 Ink was barely dry on the divorce papers 358 00:15:03,467 --> 00:15:04,947 when he started seeing someone else. 359 00:15:04,991 --> 00:15:07,819 - Your father and I had a drink. 360 00:15:07,863 --> 00:15:09,996 Maybe he read more into it. 361 00:15:11,736 --> 00:15:13,390 - So you're not dating or anything? 362 00:15:15,349 --> 00:15:17,046 - No. 363 00:15:17,090 --> 00:15:19,309 - I figured he was full of it. 364 00:15:21,616 --> 00:15:23,313 So are we still on for dinner? 365 00:15:23,357 --> 00:15:26,534 I got us a reservation at Swift & Sons for seven. 366 00:15:26,577 --> 00:15:28,928 - No, no, no! That's too expensive! 367 00:15:28,971 --> 00:15:31,974 - Only the best for my mom! 368 00:15:32,018 --> 00:15:33,889 - And the company's paying for it. 369 00:15:41,549 --> 00:15:45,205 - Hey, are you busy tonight? 370 00:15:45,248 --> 00:15:48,077 This new Thai place opened up in the neighborhood. 371 00:15:48,686 --> 00:15:51,863 Wanna give it a whirl? - Let's give it a whirl. 372 00:15:51,907 --> 00:15:53,300 - Seven-ish? 373 00:15:53,343 --> 00:15:55,041 - Works for me. 374 00:16:01,569 --> 00:16:04,615 - Dr. Choi, something's wrong! 375 00:16:06,748 --> 00:16:09,011 - 5 of Ativan. 376 00:16:09,055 --> 00:16:10,795 Has Joy ever had a seizure before? 377 00:16:10,839 --> 00:16:12,449 - No. Never. 378 00:16:12,493 --> 00:16:14,408 Joy? Babe? 379 00:16:15,670 --> 00:16:17,019 Well, I thought you said all her labs were normal. 380 00:16:17,063 --> 00:16:19,195 - They were. - Meds are in. 381 00:16:19,239 --> 00:16:20,936 - Well, so, is this like an allergic reaction 382 00:16:20,980 --> 00:16:22,416 to something you gave her? 383 00:16:22,459 --> 00:16:25,114 - We only gave her ibuprofen, and she's had that before. 384 00:16:31,381 --> 00:16:34,384 - "TaTME: Innovative Surgery for Rectal Cancer," 385 00:16:34,428 --> 00:16:37,039 co-authored by Crockett Marcel, M.D. 386 00:16:37,083 --> 00:16:39,781 - Oh, you internet stalking me, Manning? 387 00:16:39,824 --> 00:16:41,217 - Don't flatter yourself. 388 00:16:41,261 --> 00:16:43,654 I found it when I was researching the procedure. 389 00:16:43,698 --> 00:16:45,265 - Good for you. 390 00:16:45,308 --> 00:16:47,310 - You spent your lab-year studying the technique. 391 00:16:47,354 --> 00:16:49,660 You did your fellowship in the surgical center 392 00:16:49,704 --> 00:16:51,140 that helped pioneer it. 393 00:16:51,184 --> 00:16:53,012 - Which makes me, what? 394 00:16:53,055 --> 00:16:55,188 Highly qualified to perform the procedure? 395 00:16:55,231 --> 00:16:56,972 - No, it makes you biased 396 00:16:57,016 --> 00:16:59,757 and motivated by professional advancement. 397 00:17:02,238 --> 00:17:04,545 - You see what you want to see. Excuse me. 398 00:17:06,112 --> 00:17:07,939 - You are potentially costing Nick 399 00:17:07,983 --> 00:17:11,160 the chance to see the birth of his child. 400 00:17:11,204 --> 00:17:14,163 What, so you can get a shot at performing a complex surgery? 401 00:17:14,207 --> 00:17:17,471 - I answer to my patients, not to you. 402 00:17:25,131 --> 00:17:27,524 - Sats are down to 85. - Get her on a mask. 403 00:17:27,568 --> 00:17:29,352 - What's wrong with her? 404 00:17:29,396 --> 00:17:31,441 - She has fluid in her lungs. Another dose of Lasix. 405 00:17:31,485 --> 00:17:35,097 - I gave her 10mg an hour ago. It's not working. 406 00:17:35,141 --> 00:17:36,707 - Just do it. 407 00:17:37,491 --> 00:17:40,102 Where's your father? - We went to get his coffee. 408 00:17:41,147 --> 00:17:42,583 - Stats are still dropping. 409 00:17:42,626 --> 00:17:44,411 - You have to do something! Help her! 410 00:17:44,454 --> 00:17:46,108 - Molly, I would need to intubate. 411 00:17:46,152 --> 00:17:47,457 - So do that. - I can't. 412 00:17:47,501 --> 00:17:49,111 It's against your mom's advanced directive. 413 00:17:49,155 --> 00:17:51,940 - Mom, you have to listen to me, okay? 414 00:17:51,983 --> 00:17:54,508 You want the doctor to help you, right? 415 00:17:55,857 --> 00:17:57,728 Mom, please. 416 00:17:59,556 --> 00:18:01,645 - What was that, Mom? 417 00:18:05,432 --> 00:18:07,303 Molly? - That's right. 418 00:18:07,347 --> 00:18:09,131 It's me. It's Molly. 419 00:18:09,175 --> 00:18:10,959 She hasn't called me Molly in months. 420 00:18:11,002 --> 00:18:12,482 - Evelyn? 421 00:18:13,657 --> 00:18:16,399 Do you want me to save your life? 422 00:18:16,443 --> 00:18:18,706 Yeah, I need a verbal response. 423 00:18:18,749 --> 00:18:21,100 Do I have your permission to intubate, to save your life? 424 00:18:21,143 --> 00:18:22,536 Yes or no? 425 00:18:22,579 --> 00:18:23,667 - Yes. 426 00:18:23,711 --> 00:18:26,017 - Intubation. Give 70 of ketamine. 427 00:18:26,061 --> 00:18:27,845 - Mom, it's gonna be okay. 428 00:18:41,859 --> 00:18:44,558 - Okay, I'm in. Bag her. 429 00:18:45,646 --> 00:18:49,215 - Oh, my God. What the hell did you just do? 430 00:18:58,093 --> 00:19:00,878 - I mean, really. This is like déjà vu. 431 00:19:00,922 --> 00:19:02,837 Getting sued didn't teach you 432 00:19:02,880 --> 00:19:06,057 why you don't ignore an advance directive? 433 00:19:06,101 --> 00:19:08,103 Ms. Goodwin, this is a completely different situation. 434 00:19:08,147 --> 00:19:09,496 I wasn't ignoring the patient's wishes, 435 00:19:09,539 --> 00:19:10,932 I was honoring them, 436 00:19:10,975 --> 00:19:12,499 and her daughter will back me up on that. 437 00:19:12,542 --> 00:19:15,197 - Yes? 438 00:19:15,241 --> 00:19:17,330 - Peter Kalmick is waiting for you in the board room. 439 00:19:17,373 --> 00:19:18,983 - Tell him I'll be right there. 440 00:19:19,027 --> 00:19:23,205 Excuse me while I attempt to clean up your mess. 441 00:19:26,904 --> 00:19:28,689 - Dr. Charles, you weren't there. 442 00:19:28,732 --> 00:19:30,343 - Oh, come on, Will. 443 00:19:30,386 --> 00:19:32,867 An Alzheimer's patient has a fluctuation in cognition 444 00:19:32,910 --> 00:19:36,697 doesn't mean they've recovered their decisional capacity. 445 00:19:36,740 --> 00:19:38,525 I mean, when Evelyn was making her wishes known, 446 00:19:38,568 --> 00:19:39,743 she certainly understood that. 447 00:19:39,787 --> 00:19:41,702 The most important thing she understood 448 00:19:41,745 --> 00:19:43,530 is that eventually this disease 449 00:19:43,573 --> 00:19:46,228 was going to take everything from her. 450 00:19:46,272 --> 00:19:47,534 Signing that piece of paper 451 00:19:47,577 --> 00:19:50,363 was her final act of self-determination. 452 00:20:01,025 --> 00:20:03,767 - Alice. - Dr. Manning. 453 00:20:03,811 --> 00:20:05,813 I was just heading up to pre-op to meet Nick. 454 00:20:05,856 --> 00:20:07,858 - Oh, good. I'm so glad I caught you. 455 00:20:07,902 --> 00:20:10,078 You know, everything just moved to quickly this morning. 456 00:20:10,121 --> 00:20:13,473 I wanted to make sure that you are onboard with the surgery. 457 00:20:13,516 --> 00:20:14,778 - I'm not. 458 00:20:14,822 --> 00:20:16,563 - Well, did you tell Nick how you feel? 459 00:20:16,606 --> 00:20:18,478 - I begged him not to do it, 460 00:20:18,521 --> 00:20:21,220 especially after Dr. Marcel warned us about the risks, 461 00:20:21,263 --> 00:20:23,439 but Nick was adamant. 462 00:20:23,483 --> 00:20:26,007 He said he wanted to help improve 463 00:20:26,050 --> 00:20:28,096 the treatment options for our son, 464 00:20:28,139 --> 00:20:31,142 even if it meant he may not live to see him. 465 00:20:31,186 --> 00:20:32,927 - Your son. 466 00:20:32,970 --> 00:20:35,625 He could inherit the FAP gene. 467 00:20:35,669 --> 00:20:37,366 - There's a 50% chance. 468 00:20:38,759 --> 00:20:40,674 - This pregnancy was a surprise. 469 00:20:40,717 --> 00:20:42,415 When we found out, all Nick could think about 470 00:20:42,458 --> 00:20:44,330 was our baby's future, 471 00:20:44,373 --> 00:20:47,071 and doing everything he could 472 00:20:47,115 --> 00:20:50,161 to prevent our son from facing the same fate. 473 00:21:02,217 --> 00:21:04,088 - Trini, will you take over for a minute? 474 00:21:04,132 --> 00:21:05,829 I'll be right back. A word outside? 475 00:21:10,051 --> 00:21:12,662 Auggie's primary physician sent over his medical records. 476 00:21:12,706 --> 00:21:15,143 Turns out he's supposed to have paracentesis every two weeks, 477 00:21:15,186 --> 00:21:17,276 but he hasn't shown up to his last couple appointments. 478 00:21:17,319 --> 00:21:19,495 - No wonder his ascites got so bad. 479 00:21:19,539 --> 00:21:21,149 - Yeah, I'm calling Child Protective Services. 480 00:21:21,192 --> 00:21:22,237 - Yeah, whoa, whoa, whoa. Hold on a second. 481 00:21:22,281 --> 00:21:24,674 - Dr. Lanik, can you please wait 482 00:21:24,718 --> 00:21:26,415 until we speak to his caregiver? 483 00:21:26,459 --> 00:21:28,635 Maybe there's a reasonable explanation. 484 00:21:28,678 --> 00:21:30,289 - I thought she was MIA. 485 00:21:30,332 --> 00:21:32,595 - I'm working on trying to reach her. 486 00:21:32,639 --> 00:21:34,423 Fine. 487 00:21:34,467 --> 00:21:36,556 You have until 4:00, but if she is not here in the flesh, 488 00:21:36,599 --> 00:21:37,905 I'm making the call. 489 00:21:41,430 --> 00:21:43,650 - Maybe you don't want to take care of her anymore. 490 00:21:43,693 --> 00:21:44,825 - You know that isn't true. 491 00:21:44,868 --> 00:21:46,348 You know I'd do anything for your mom. 492 00:21:46,392 --> 00:21:48,524 - Then you can't let her die. I won't let you! 493 00:21:48,568 --> 00:21:50,874 - Honey... 494 00:22:01,842 --> 00:22:03,800 - Ms. Myers? 495 00:22:03,844 --> 00:22:05,324 My name is Sharon Goodwin. 496 00:22:05,367 --> 00:22:08,152 I'm in charge of patient services here at the hospital. 497 00:22:08,196 --> 00:22:10,720 - Yeah, I saw you talking to my dad. 498 00:22:11,852 --> 00:22:13,201 What if I don't want the doctors 499 00:22:13,244 --> 00:22:15,159 to take out my mom's breathing tube? 500 00:22:16,422 --> 00:22:19,207 Would I have to sue my dad? 501 00:22:19,250 --> 00:22:20,251 - Well... 502 00:22:23,733 --> 00:22:26,693 Before we get into logistics, 503 00:22:26,736 --> 00:22:29,478 are you sure you want to do that? 504 00:22:30,261 --> 00:22:32,786 Do you really believe your father isn't acting 505 00:22:32,829 --> 00:22:35,223 in your mother's best interests? 506 00:22:37,965 --> 00:22:40,924 I mean, he loves her. I just... 507 00:22:40,968 --> 00:22:43,840 I don't want to lose her. 508 00:22:43,884 --> 00:22:46,452 I don't know what to do. 509 00:22:47,801 --> 00:22:50,673 My mom kept me in the dark about all of this. 510 00:22:53,284 --> 00:22:57,898 - You know, when parents don't share things 511 00:22:57,941 --> 00:23:00,117 with their children, 512 00:23:00,161 --> 00:23:04,470 it's usually out of a desire to protect them. 513 00:23:04,513 --> 00:23:07,473 I suspect your mother knew how painful it would be 514 00:23:07,516 --> 00:23:10,258 for you to know her wishes. 515 00:23:10,301 --> 00:23:13,435 And she didn't want to place the burden 516 00:23:13,479 --> 00:23:17,396 of carrying them out on your shoulders. 517 00:23:18,875 --> 00:23:21,312 - She put a lot on my dad's shoulders. 518 00:23:21,356 --> 00:23:22,444 - Yes. 519 00:23:22,488 --> 00:23:25,491 Because she knew he could handle it. 520 00:23:25,534 --> 00:23:29,495 But you're right, it is a lot, 521 00:23:29,538 --> 00:23:32,062 and he's going to need you. 522 00:23:32,106 --> 00:23:34,456 You're going to need each other. 523 00:23:46,512 --> 00:23:48,905 - Dr. Marcel, you should be seeing me. 524 00:23:48,949 --> 00:23:53,519 - Yup, seeing your sponge now. 525 00:23:53,562 --> 00:23:55,303 Nice to finally meet up. 526 00:23:55,346 --> 00:23:57,871 Okay, let's bring the pressure down to 12. 527 00:23:57,914 --> 00:23:59,612 - Ready to take the rectum out? 528 00:23:59,655 --> 00:24:01,614 - You bet. 529 00:24:01,657 --> 00:24:03,572 Here we go, Nick. 530 00:24:09,535 --> 00:24:11,928 - Joy, your seizure was caused by high levels of ammonia 531 00:24:11,972 --> 00:24:13,147 in your blood. 532 00:24:13,190 --> 00:24:14,931 - How'd she get ammonia in her blood? 533 00:24:14,975 --> 00:24:18,065 - Testing revealed Joy has a urea cycle disorder. 534 00:24:18,108 --> 00:24:20,589 It's a genetic condition that causes a deficiency 535 00:24:20,633 --> 00:24:22,156 in one of the six enzymes 536 00:24:22,199 --> 00:24:24,506 responsible for removing ammonia from the bloodstream. 537 00:24:24,550 --> 00:24:28,771 - But if it's genetic, why was I never diagnosed as a child? 538 00:24:28,815 --> 00:24:30,469 - With milder forms of the disorder, 539 00:24:30,512 --> 00:24:33,646 often undiagnosed until a trigger unmasks it. 540 00:24:33,689 --> 00:24:35,082 Such as childbirth-- 541 00:24:35,125 --> 00:24:37,345 - Another possible trigger can be a dramatic increase 542 00:24:37,388 --> 00:24:38,868 in protein intake. 543 00:24:38,912 --> 00:24:40,653 - Could you be taking in more protein with your new diet? 544 00:24:40,696 --> 00:24:42,002 - Not really. 545 00:24:42,045 --> 00:24:44,004 I actually cut out red meat and most dairy. 546 00:24:44,047 --> 00:24:46,006 - What about protein bars or shakes? 547 00:24:46,049 --> 00:24:48,530 - No. I drink green smoothies. 548 00:24:48,574 --> 00:24:51,098 - Triggers aside, how do you treat it? 549 00:24:51,968 --> 00:24:54,014 - Well, you're going to have to be on an enzyme supplement 550 00:24:54,057 --> 00:24:55,494 for the rest of your life, 551 00:24:55,537 --> 00:24:57,191 and maintain a very low protein diet. 552 00:24:57,234 --> 00:24:59,846 - We can manage that. Right, babe? 553 00:24:59,889 --> 00:25:01,325 - Yeah. 554 00:25:01,369 --> 00:25:02,892 - Joy, just so you understand, 555 00:25:02,936 --> 00:25:04,677 if you don't regulate your protein intake, 556 00:25:04,720 --> 00:25:06,505 there can be serious consequences. 557 00:25:06,548 --> 00:25:07,941 - Understood. 558 00:25:07,984 --> 00:25:09,551 - Now, even a few high protein meals-- 559 00:25:09,595 --> 00:25:11,640 - I said I understand, Dr. Choi. 560 00:25:11,684 --> 00:25:13,947 What, do you think because I'm fat I have no self-control? 561 00:25:13,990 --> 00:25:16,123 - No. Not at all. 562 00:25:16,166 --> 00:25:18,212 I'm just suggesting if protein is the trigger-- 563 00:25:18,255 --> 00:25:20,997 - Yeah, and I just told you that it wasn't. 564 00:25:21,041 --> 00:25:24,392 - Dr. Choi, may I speak with you outside, please? 565 00:25:24,435 --> 00:25:26,394 - Excuse us. 566 00:25:29,919 --> 00:25:32,139 What? - You're so suspicious of Joy. 567 00:25:32,182 --> 00:25:34,707 I can't help but wonder if you're projecting. 568 00:25:34,750 --> 00:25:36,230 - I'm not projecting anything. 569 00:25:36,273 --> 00:25:38,580 The only trigger that makes sense is protein. 570 00:25:38,624 --> 00:25:40,800 So she's either lying about what she's eating, 571 00:25:40,843 --> 00:25:42,758 or she's in denial. 572 00:25:52,028 --> 00:25:54,378 - I am so sorry I missed your calls. 573 00:25:54,422 --> 00:25:55,597 My manager doesn't allow us to check our messages 574 00:25:55,641 --> 00:25:56,729 while we're working. 575 00:25:56,772 --> 00:25:59,079 - This should never have happened. 576 00:25:59,122 --> 00:26:00,210 We know that Auggie has missed 577 00:26:00,254 --> 00:26:01,995 his last two doctor's appointments. 578 00:26:02,038 --> 00:26:03,823 - And I'm really sorry about that. 579 00:26:03,866 --> 00:26:06,695 I--I do my best to get him there, 580 00:26:06,739 --> 00:26:09,176 but the clinic's 40 miles from my house. 581 00:26:09,219 --> 00:26:12,527 I--I don't have a car, and I can't always get off of work. 582 00:26:12,571 --> 00:26:14,442 - Is there someone else that could help out? 583 00:26:14,485 --> 00:26:17,358 Maybe a babysitter that could take him? 584 00:26:17,401 --> 00:26:19,012 - Who's gonna pay for that? 585 00:26:19,055 --> 00:26:23,059 - Ms. Johnson, we're supposed to report this as neglect. 586 00:26:23,103 --> 00:26:26,280 But if we do that, they might remove Auggie from your home. 587 00:26:26,323 --> 00:26:28,804 - Maybe you should. - What? 588 00:26:28,848 --> 00:26:31,241 - Maybe you should report it. 589 00:26:34,244 --> 00:26:36,246 I love that little boy. 590 00:26:36,290 --> 00:26:38,422 I love him, but... 591 00:26:39,641 --> 00:26:42,644 But it's too much. 592 00:26:42,688 --> 00:26:45,429 It's too much. 593 00:26:46,213 --> 00:26:47,867 And I can't. 594 00:26:58,007 --> 00:26:59,487 - Alice. 595 00:27:03,534 --> 00:27:06,799 - He did well, Alice. Real well. 596 00:27:06,842 --> 00:27:09,236 You can visit him in the recovery room shortly. 597 00:27:09,279 --> 00:27:12,065 - Oh, thank God. 598 00:27:28,472 --> 00:27:29,735 - So, what happens now? 599 00:27:29,778 --> 00:27:31,824 - Evelyn's family is gonna take her home 600 00:27:31,867 --> 00:27:35,871 to receive hospice care until she dies. 601 00:27:38,091 --> 00:27:41,007 - I wasn't trying to prove you wrong today, 602 00:27:41,050 --> 00:27:43,139 if that's what you're thinking. 603 00:27:44,053 --> 00:27:48,754 - Will, I never thought of you as a spiteful person. 604 00:27:49,798 --> 00:27:53,280 But we all have a tendency to put blinders on 605 00:27:53,323 --> 00:27:56,283 when we're confronted with things 606 00:27:56,326 --> 00:27:57,980 that we don't wanna hear. 607 00:28:11,777 --> 00:28:13,909 - That's why we thought it would be better 608 00:28:13,953 --> 00:28:16,738 for you go live with another family. 609 00:28:17,608 --> 00:28:20,307 - Since she can't always take you to the doctor 610 00:28:20,350 --> 00:28:22,004 when you need it. 611 00:28:22,048 --> 00:28:24,659 She doesn't want you to get sick again, Auggie. 612 00:28:25,486 --> 00:28:29,098 - I know it's scary going to live somewhere new. 613 00:28:29,142 --> 00:28:30,839 - I'm not scared. 614 00:28:32,406 --> 00:28:34,451 I know why she doesn't want me. 615 00:28:34,495 --> 00:28:38,194 - Oh, sweetie, it's not that she doesn't want you. 616 00:28:38,238 --> 00:28:40,980 She just-- - No one wants a sick kid. 617 00:28:49,858 --> 00:28:52,731 - Max, I know Joy wants to be discharged, 618 00:28:52,774 --> 00:28:56,604 but this meal plan she's on, is she adhering to it? 619 00:28:56,647 --> 00:28:58,388 - Yeah. 620 00:28:58,432 --> 00:28:59,738 - Because her tests results 621 00:28:59,781 --> 00:29:01,783 and what she's saying, they don't add up. 622 00:29:04,046 --> 00:29:05,482 Max... 623 00:29:05,526 --> 00:29:08,050 - Okay, um... 624 00:29:08,094 --> 00:29:10,792 I have an idea of what's going on. 625 00:29:10,836 --> 00:29:14,013 Sometimes I wake up in the middle of the night, 626 00:29:14,056 --> 00:29:17,581 and I hear Joy downstairs in the kitchen. 627 00:29:17,625 --> 00:29:19,845 And in the morning, there's food missing 628 00:29:19,888 --> 00:29:22,238 from the fridge and the pantry. 629 00:29:22,282 --> 00:29:23,892 - Have you ever talked to her about it? 630 00:29:23,936 --> 00:29:25,720 - No, I'm guessing she's real self-conscious. 631 00:29:25,764 --> 00:29:27,504 That's why she does it after I'm asleep. 632 00:29:27,548 --> 00:29:28,897 - Yeah. 633 00:29:28,941 --> 00:29:32,161 Sounds like she may have a binge-eating disorder. 634 00:29:32,205 --> 00:29:34,555 I like to bring in psychiatry to come speak with her. 635 00:29:34,598 --> 00:29:35,861 - No. 636 00:29:35,904 --> 00:29:38,037 I know her, and an ambush will just humiliate her. 637 00:29:38,080 --> 00:29:39,995 - This has to be dealt with now. 638 00:29:40,039 --> 00:29:42,128 If she overloads on protein again, it could kill her. 639 00:29:43,738 --> 00:29:45,827 - God. - Tell you what. 640 00:29:45,871 --> 00:29:48,003 I'll let you speak with Joy first. 641 00:29:49,962 --> 00:29:51,398 Come on. 642 00:29:59,798 --> 00:30:00,929 - I can't do this. 643 00:30:02,801 --> 00:30:05,978 Joy doesn't binge in the middle of the night. 644 00:30:06,021 --> 00:30:09,068 I've been slipping protein powder in her green smoothies. 645 00:30:09,111 --> 00:30:10,373 - Why? 646 00:30:10,417 --> 00:30:13,115 - I read protein powder can make you gain weight 647 00:30:13,159 --> 00:30:15,074 by increasing your overall caloric-- 648 00:30:15,117 --> 00:30:16,292 - Why were you trying to make Joy gain weight? 649 00:30:16,336 --> 00:30:17,772 - I wasn't trying to make her gain weight, 650 00:30:17,816 --> 00:30:20,035 I was trying to keep her from losing weight. 651 00:30:21,123 --> 00:30:22,777 I know it sounds insane. - And criminal. 652 00:30:22,821 --> 00:30:24,648 - I wasn't gonna do it forever. 653 00:30:24,692 --> 00:30:28,435 Just long enough for-- for her to get discouraged 654 00:30:28,478 --> 00:30:29,871 and stop dieting. 655 00:30:29,915 --> 00:30:32,831 And I never meant to hurt her. 656 00:30:32,874 --> 00:30:34,615 I was scared that if Joy lost weight, 657 00:30:34,658 --> 00:30:36,443 she'd leave me. 658 00:30:39,881 --> 00:30:42,579 - You need to tell Joy the truth or I will. 659 00:30:47,149 --> 00:30:49,543 - So Alice and I were talking, Doc, 660 00:30:49,586 --> 00:30:51,675 and while we really would like 661 00:30:51,719 --> 00:30:53,416 to name our son in your honor.... 662 00:30:53,460 --> 00:30:54,765 - Oh! 663 00:30:54,809 --> 00:30:57,029 - We're just not sure about Crockett. 664 00:30:58,160 --> 00:31:00,336 - It is a statement. That's for sure. 665 00:31:01,511 --> 00:31:03,905 - I don't suppose you have a middle name 666 00:31:03,949 --> 00:31:05,602 that's a little more... 667 00:31:05,646 --> 00:31:07,909 - Nick? Nick? 668 00:31:07,953 --> 00:31:09,955 Honey, what's wrong? 669 00:31:09,998 --> 00:31:11,913 - Okay, take slow, deep breaths. 670 00:31:11,957 --> 00:31:13,915 Nice and easy, okay? 671 00:31:13,959 --> 00:31:16,875 Nick, bud? Talk to me. 672 00:31:16,918 --> 00:31:18,485 Let's get a mask on him. 673 00:31:19,965 --> 00:31:21,183 - Let's go. Come on. 674 00:31:21,227 --> 00:31:22,968 Drop it. 675 00:31:23,011 --> 00:31:24,926 - Heart rate's 133. BP's 77. 676 00:31:24,970 --> 00:31:26,754 - Nick, Nick. I need you to breathe. 677 00:31:26,797 --> 00:31:28,799 Hey, Nick? - He's in VFib! 678 00:31:28,843 --> 00:31:29,975 - Nick, honey, wake up. - Nick! 679 00:31:30,018 --> 00:31:31,454 No pulse. All right, let's go. 680 00:31:31,498 --> 00:31:32,673 Bag him. Milligram of epi. 681 00:31:32,716 --> 00:31:34,066 Let's go. Come on. 682 00:31:34,109 --> 00:31:36,198 Paddles and charge to 200. 683 00:31:36,242 --> 00:31:37,765 - Oh, my God! 684 00:31:37,808 --> 00:31:39,071 - Nick? 685 00:31:39,114 --> 00:31:40,811 - Charged. Clear. 686 00:31:40,855 --> 00:31:42,552 - Let's go. Come on. 687 00:31:46,905 --> 00:31:49,124 Another round of epi. Let's go. 688 00:31:49,168 --> 00:31:51,213 Charge 200. - Charged. 689 00:31:51,257 --> 00:31:52,432 Clear! 690 00:31:55,826 --> 00:31:57,567 - Nick? Nick, can you hear me? 691 00:31:57,611 --> 00:31:59,482 - I am right here, honey. 692 00:31:59,526 --> 00:32:00,919 Nick. 693 00:32:00,962 --> 00:32:02,616 - Epi and charge. Let's go. 694 00:32:02,659 --> 00:32:04,313 - Clear. 695 00:32:10,711 --> 00:32:12,191 - You'll be fine. 696 00:32:12,234 --> 00:32:14,280 - He's asystole. 697 00:32:14,323 --> 00:32:15,629 - No... 698 00:32:15,672 --> 00:32:17,283 Come on! 699 00:32:27,728 --> 00:32:29,556 - No. 700 00:32:29,599 --> 00:32:32,211 No. No. 701 00:32:35,736 --> 00:32:38,173 No. No. 702 00:32:38,217 --> 00:32:40,871 No. 703 00:32:40,915 --> 00:32:44,136 - Time of death, 16:54. 704 00:32:46,834 --> 00:32:48,749 No! 705 00:32:59,760 --> 00:33:00,891 - Thank you so much, Ms. Gastern. 706 00:33:00,935 --> 00:33:03,372 Bye-bye. 707 00:33:03,416 --> 00:33:04,939 DCFS is going to start looking 708 00:33:04,983 --> 00:33:07,463 for a new foster placement for Auggie tomorrow. 709 00:33:11,424 --> 00:33:12,599 - What about tonight? 710 00:33:12,642 --> 00:33:15,210 - Well, I got him a bed on the peds floor. 711 00:33:15,254 --> 00:33:17,343 And since Earl is back for night shift, 712 00:33:17,386 --> 00:33:18,866 he promised that he would try to check in 713 00:33:18,909 --> 00:33:19,998 on Auggie upstairs. 714 00:33:20,041 --> 00:33:23,001 - That's good. 715 00:33:23,044 --> 00:33:25,133 Taxi's here. We should... 716 00:33:25,177 --> 00:33:26,439 - Right. 717 00:33:36,971 --> 00:33:39,278 Baby. 718 00:33:40,453 --> 00:33:43,282 Just, uh... - Yeah. 719 00:33:44,239 --> 00:33:46,067 Okay. 720 00:33:46,111 --> 00:33:49,940 I'll call the airline and the hotel, reschedule. 721 00:33:49,984 --> 00:33:53,118 And we'll spend the night with Auggie. 722 00:33:53,161 --> 00:33:55,294 - You know how amazing you are? 723 00:33:55,337 --> 00:33:58,471 - Mmm. 724 00:33:58,514 --> 00:34:00,951 You're pretty amazing yourself, Mr. Ben Campbell. 725 00:34:00,995 --> 00:34:02,823 - I'm a lucky man. 726 00:34:02,866 --> 00:34:04,825 - Go ahead, and yes, you are. 727 00:34:06,305 --> 00:34:09,960 - Oh, thank you. - Joy. 728 00:34:10,004 --> 00:34:13,747 You should know what Max did was a form of assault. 729 00:34:13,790 --> 00:34:17,316 And I can call CPD, and you can press charges against him. 730 00:34:17,359 --> 00:34:19,100 - No, no, you don't have to call them. 731 00:34:19,144 --> 00:34:20,884 I'm not pressing charges. 732 00:34:20,928 --> 00:34:22,973 - Joy, he lied to you, betrayed your trust. 733 00:34:23,017 --> 00:34:24,410 You don't have to act like nothing happened. 734 00:34:24,453 --> 00:34:27,587 - No, I know what Max did was so messed up, 735 00:34:27,630 --> 00:34:29,284 but we talked it out. 736 00:34:29,328 --> 00:34:30,633 You know, and he was acting 737 00:34:30,677 --> 00:34:34,202 from a place of fear and insecurity, and... 738 00:34:34,246 --> 00:34:37,684 you know, Max is a good person. 739 00:34:38,946 --> 00:34:40,513 Okay, I know his heart. 740 00:34:42,297 --> 00:34:44,125 Can I just go? 741 00:34:46,171 --> 00:34:48,129 - Take care. 742 00:34:51,045 --> 00:34:52,655 - Unbelievable. 743 00:34:52,699 --> 00:34:54,135 - If it were me, I'd be furious. 744 00:34:54,179 --> 00:34:56,485 - Anyone would. - Really? 745 00:34:56,529 --> 00:34:59,314 - Of course. - Then why aren't you? 746 00:34:59,358 --> 00:35:01,534 - What? - Ethan, I lied to you. 747 00:35:01,577 --> 00:35:02,665 - Oh, God. April... 748 00:35:02,709 --> 00:35:03,840 - I betrayed your trust. 749 00:35:03,884 --> 00:35:05,146 - Look, what do you want me to say? 750 00:35:05,190 --> 00:35:07,017 That I can't believe you kissed someone else? 751 00:35:07,061 --> 00:35:08,149 Someone we work with? 752 00:35:08,193 --> 00:35:09,542 You want to know how crazy it makes me 753 00:35:09,585 --> 00:35:11,109 that I have to see that son of a bitch every day? 754 00:35:11,152 --> 00:35:12,675 Is this what you want to hear? - Yeah, I do. 755 00:35:12,719 --> 00:35:14,329 I want to know what you're feeling. 756 00:35:14,373 --> 00:35:16,418 - Why? Why couldn't you just tell me? 757 00:35:16,462 --> 00:35:19,378 Why did it take physically harming yourself to come clean? 758 00:35:22,294 --> 00:35:24,165 Are you in love with him? 759 00:35:24,209 --> 00:35:26,080 - What? No! 760 00:35:26,124 --> 00:35:27,560 Of course not. 761 00:35:27,603 --> 00:35:29,518 It was just a meaningless attraction. 762 00:35:29,562 --> 00:35:30,693 - Well, if it's so meaningless, 763 00:35:30,737 --> 00:35:32,782 why are we even talking about it? 764 00:35:32,826 --> 00:35:34,219 - Because I-- 765 00:35:34,262 --> 00:35:37,439 you deserve to know everything. 766 00:35:37,483 --> 00:35:39,528 Ethan, I love you. 767 00:35:39,572 --> 00:35:41,704 I made a mistake. 768 00:35:41,748 --> 00:35:45,186 That day, when I found out I couldn't have children-- 769 00:35:45,230 --> 00:35:47,928 - You pushed me away and ran into another man's arms. 770 00:36:00,332 --> 00:36:01,985 - Hey. 771 00:36:03,291 --> 00:36:05,032 - You called it. 772 00:36:05,075 --> 00:36:07,730 Played out just like you said it would. 773 00:36:07,774 --> 00:36:10,037 - You don't know what killed Nick. 774 00:36:10,080 --> 00:36:13,562 - He was tachycardic, hypotensive, and desatting. 775 00:36:13,606 --> 00:36:17,349 Classic trifecta. Had to be a PE. 776 00:36:17,392 --> 00:36:19,394 - If that's the case, then the clot could have been there 777 00:36:19,438 --> 00:36:20,874 prior to the surgery. 778 00:36:20,917 --> 00:36:24,443 I mean, Nick had pretty much been bedridden for months. 779 00:36:24,486 --> 00:36:27,794 - Surgery caused it. End of story. 780 00:36:27,837 --> 00:36:29,970 - You don't know that. 781 00:36:30,013 --> 00:36:32,407 - You know... 782 00:36:32,451 --> 00:36:34,888 if I hadn't put that surgery on the table, 783 00:36:34,931 --> 00:36:36,629 chances are he'd still be alive. 784 00:36:40,415 --> 00:36:41,938 - Crockett. 785 00:36:44,637 --> 00:36:48,989 Sometimes in the ED, we get tunnel vision. 786 00:36:50,556 --> 00:36:53,689 All we can see is the patient in front of us. 787 00:36:53,733 --> 00:36:57,780 But Nick could see past that, beyond his own benefit, 788 00:36:57,824 --> 00:36:59,652 and I think you did too. 789 00:37:02,089 --> 00:37:04,526 You know, with new surgery, the more you do it, 790 00:37:04,570 --> 00:37:07,442 the better you'll get, the more lives you'll save. 791 00:37:07,486 --> 00:37:10,445 And maybe you couldn't save Nick's, 792 00:37:10,489 --> 00:37:13,970 but maybe someday, you'll save his son's. 793 00:37:17,322 --> 00:37:19,106 - Hey! 794 00:37:21,587 --> 00:37:23,632 We still on for The Green Mill, Crockett? 795 00:37:23,676 --> 00:37:25,591 The next set starts in an hour. 796 00:37:25,634 --> 00:37:27,723 - Yeah, of course, darling. 797 00:37:28,420 --> 00:37:31,510 Okay. Good night, Dr. Manning. 798 00:37:31,553 --> 00:37:33,686 - Night. 799 00:37:48,701 --> 00:37:50,355 - Hey, Mom, you look nice. 800 00:37:50,398 --> 00:37:51,834 Thank you. 801 00:37:58,014 --> 00:38:01,235 - What's Dad doing here? - I invited him. 802 00:38:03,977 --> 00:38:05,761 - It's good to see you, son. 803 00:38:07,154 --> 00:38:09,330 - If he's staying, I'm leaving. 804 00:38:09,374 --> 00:38:10,897 - Sit down. 805 00:38:16,946 --> 00:38:20,210 Now this Cold War you've got going with your father 806 00:38:20,254 --> 00:38:21,777 ends tonight. 807 00:38:21,821 --> 00:38:24,040 - After what he did to you? Forget it. 808 00:38:24,084 --> 00:38:25,738 - You don't know the full story. 809 00:38:28,610 --> 00:38:30,133 - What are you talking about? 810 00:38:31,570 --> 00:38:34,137 - Look... 811 00:38:34,181 --> 00:38:39,012 I thought I was protecting you and David and Tara 812 00:38:39,055 --> 00:38:42,537 by not talking to you about the divorce. 813 00:38:42,581 --> 00:38:45,627 But it was painful. 814 00:38:45,671 --> 00:38:48,978 - Yeah, and Dad caused that pain. 815 00:38:49,762 --> 00:38:53,156 - Son, the end of any relationship, 816 00:38:53,200 --> 00:38:57,552 especially one with a 35-year history, 817 00:38:57,596 --> 00:38:59,859 is complicated. 818 00:38:59,902 --> 00:39:01,948 But the bottom line, Michael, 819 00:39:01,991 --> 00:39:05,560 is you can spend your whole life looking back 820 00:39:05,604 --> 00:39:07,736 and pointing fingers, 821 00:39:07,780 --> 00:39:11,740 or you could choose to move forward. 822 00:39:11,784 --> 00:39:17,180 I--I don't know what's to come of your father and me, 823 00:39:17,224 --> 00:39:21,141 but it's time for this family to start healing. 824 00:39:21,184 --> 00:39:24,274 You need your father, 825 00:39:24,318 --> 00:39:26,668 and your father needs you. 826 00:39:36,896 --> 00:39:39,681 Let's start by having dinner. 827 00:39:51,476 --> 00:39:53,782 - You wanna come up? 828 00:39:53,826 --> 00:39:55,305 I cleared out my liquor cabinet, 829 00:39:55,349 --> 00:39:59,005 but I do have a pretty stellar tea collection. 830 00:40:01,877 --> 00:40:04,358 But you know, if tea is not your thing, 831 00:40:04,402 --> 00:40:07,753 I can make a gin and tonic, sans the gin. 832 00:40:07,796 --> 00:40:09,668 - No, it's not... 833 00:40:10,712 --> 00:40:12,845 I want to come up. I do. 834 00:40:14,412 --> 00:40:16,936 I just wonder if that's a good idea. 835 00:40:18,590 --> 00:40:20,243 - Okay. 836 00:40:20,287 --> 00:40:22,332 - You may be surprised to hear this, 837 00:40:22,376 --> 00:40:25,335 but there's actually very little neurochemical difference 838 00:40:25,379 --> 00:40:27,250 between drug addiction-- 839 00:40:27,294 --> 00:40:28,948 - And romance addiction? 840 00:40:28,991 --> 00:40:32,299 And should something go wrong inside the relationship, 841 00:40:32,342 --> 00:40:35,694 it increases the chances of relapse. 842 00:40:36,434 --> 00:40:37,609 - Yeah. 843 00:40:37,652 --> 00:40:39,349 - I've been going to the meetings, Will. 844 00:40:39,393 --> 00:40:41,482 This stuff's been drilled into my head. 845 00:40:44,964 --> 00:40:47,662 - So, um, what do we do? 846 00:40:52,537 --> 00:40:54,495 - Let's go up and discuss it.