1 00:00:03,699 --> 00:00:04,047 . 2 00:00:04,091 --> 00:00:06,310 - With the suggestion from Dr. Cooper 3 00:00:06,354 --> 00:00:08,312 I could've sabotaged Archer's CVP monitor 4 00:00:08,356 --> 00:00:10,401 so that the Vas-COM could save the day. 5 00:00:10,445 --> 00:00:12,099 And I came close to doing it. 6 00:00:12,142 --> 00:00:14,231 - If this ever gets to be too much for you, 7 00:00:14,275 --> 00:00:16,190 I'll put a stop to the whole thing. 8 00:00:16,799 --> 00:00:18,105 - I'll take it from here. 9 00:00:18,148 --> 00:00:19,628 - I assumed I'd perform the surgery. 10 00:00:19,671 --> 00:00:20,890 - You're free to watch. 11 00:00:20,933 --> 00:00:24,633 - Best by the powers that be. - I'm sorry. 12 00:00:24,676 --> 00:00:26,809 I made a fool of myself with Dr. Marcel. 13 00:00:26,852 --> 00:00:29,159 I'm crushing on my advisor. 14 00:00:29,812 --> 00:00:31,118 - How long you been doing this? 15 00:00:31,161 --> 00:00:33,076 - 35 years. - How? 16 00:00:33,120 --> 00:00:35,078 - You got to hang on to those good days. 17 00:00:35,122 --> 00:00:36,732 You got to hang on to those wins. 18 00:00:42,346 --> 00:00:45,480 - Really, Dad? - What? It's fine. 19 00:00:45,523 --> 00:00:48,091 - It's a red zone. It's for emergencies only. 20 00:00:50,485 --> 00:00:52,095 No-- - See? 21 00:00:52,139 --> 00:00:53,444 Now, it's an emergency. 22 00:00:53,488 --> 00:00:56,882 Oh, you know what? I wanna check this out. 23 00:00:56,926 --> 00:00:58,536 New PDT system. 24 00:00:58,580 --> 00:01:01,322 I can check all of my units in real time. 25 00:01:01,365 --> 00:01:02,540 - But, look, can I check it out later? 26 00:01:02,584 --> 00:01:04,194 I really do have to go. I'm late. 27 00:01:04,238 --> 00:01:07,371 - Everything okay here? - Oh, yeah, we all good. 28 00:01:07,415 --> 00:01:08,807 Just a little ride-along. 29 00:01:08,851 --> 00:01:11,201 Letting a civilian see what a real job looks like. 30 00:01:11,245 --> 00:01:13,725 - Yeah, thanks. - Yeah. 31 00:01:13,769 --> 00:01:15,901 Am I embarrassing you? 32 00:01:15,945 --> 00:01:17,207 - I'll see you later. 33 00:01:18,469 --> 00:01:19,644 [siren beeps] 34 00:01:19,688 --> 00:01:22,212 Come on, Dad. - [laughs] 35 00:01:22,256 --> 00:01:24,867 [siren beeps] Okay, I'm gone. 36 00:01:27,261 --> 00:01:29,915 - [laughs] 37 00:01:29,959 --> 00:01:32,570 - Hey, what's up? 38 00:01:32,614 --> 00:01:33,963 - Do you remember how when we were 39 00:01:34,006 --> 00:01:36,618 in physical exam class, when we did breast exams, 40 00:01:36,661 --> 00:01:38,141 they would tell us to make small talk 41 00:01:38,185 --> 00:01:39,229 with the patient actors? 42 00:01:39,273 --> 00:01:40,535 - Yeah, to help put them at ease. 43 00:01:40,578 --> 00:01:42,798 - Yeah and there was that one guy, Mandelbrot. 44 00:01:42,841 --> 00:01:44,756 Super awkward. Caught hell for asking 45 00:01:44,800 --> 00:01:46,584 one of them what she was doing that weekend. 46 00:01:46,628 --> 00:01:48,804 - Oh. - He is a panelist 47 00:01:48,847 --> 00:01:51,676 at the next summit for female physicians. 48 00:01:51,720 --> 00:01:56,159 [laughs] - Wait, that wasn't Mandelbrot. 49 00:01:56,203 --> 00:01:57,247 It was Richardson. 50 00:01:57,291 --> 00:01:58,727 - No, pretty sure it was Mandelbrot. 51 00:01:58,770 --> 00:02:02,818 - No, it was Richardson. - You haven't changed a bit. 52 00:02:02,861 --> 00:02:05,560 Always got to one-up me. - I'm not trying to one-up you. 53 00:02:05,603 --> 00:02:07,779 - Two shots for Dr. Hammer. Three for Dr. Halstead. 54 00:02:07,823 --> 00:02:12,436 - [laughs] Thank you. 55 00:02:12,480 --> 00:02:14,786 Have a good day. - You too. Thanks, Carly. 56 00:02:14,830 --> 00:02:18,181 - Morning. - Good morning. 57 00:02:18,225 --> 00:02:21,184 Dr. Halstead, how are things with Dr. Cooper? 58 00:02:21,228 --> 00:02:24,231 - Uh, pretty well, I think. - Oh, yeah? 59 00:02:24,274 --> 00:02:26,798 - I mean, he hasn't said anything otherwise. 60 00:02:26,842 --> 00:02:28,626 - Good morning, Ms. Goodwin, Will. 61 00:02:28,670 --> 00:02:30,411 - Matt. 62 00:02:30,454 --> 00:02:31,586 - Just the man I was looking for. 63 00:02:31,629 --> 00:02:32,456 I want to tell you about the conference 64 00:02:32,500 --> 00:02:33,849 coming up in a few weeks. 65 00:02:33,892 --> 00:02:35,546 - National Critical Care Society annual meeting. 66 00:02:35,590 --> 00:02:37,461 - It's here in Chicago. You should go. 67 00:02:37,505 --> 00:02:39,637 Vasik's gonna be a platinum sponsor. 68 00:02:39,681 --> 00:02:41,639 They're gonna have a corner booth. 69 00:02:41,683 --> 00:02:43,250 It's gonna be the perfect chance 70 00:02:43,293 --> 00:02:44,729 for you to meet some of the upper-level execs. 71 00:02:46,470 --> 00:02:49,821 Oh, do you think that you could spare him for the day? 72 00:02:49,865 --> 00:02:51,867 - It's always good when our doctors 73 00:02:51,910 --> 00:02:53,477 broaden their expertise. 74 00:02:53,521 --> 00:02:55,479 - I'll be there. - Okay, great. 75 00:02:55,523 --> 00:02:58,613 I'll get you the details. Um, Ms. Goodwin. 76 00:03:00,267 --> 00:03:02,660 - This might be good. 77 00:03:02,704 --> 00:03:06,447 And maybe I can get them to offer me a deal like Cooper's. 78 00:03:06,490 --> 00:03:08,144 [phone buzzes] 79 00:03:08,188 --> 00:03:12,453 - Geez, I got to get this, but, uh, you're on the right track. 80 00:03:15,020 --> 00:03:18,023 - Thank you, La'Shawn. Morning, Alim. 81 00:03:18,067 --> 00:03:19,242 Hey. - Hey. 82 00:03:19,286 --> 00:03:20,417 - What time did you get in? 83 00:03:20,461 --> 00:03:22,680 - Uh, I don't know. Like, around four. 84 00:03:22,724 --> 00:03:24,421 - Why so early? 85 00:03:24,465 --> 00:03:25,857 - Always try to get a leg up on the day. 86 00:03:27,032 --> 00:03:28,991 - Two hours before your shift? 87 00:03:29,034 --> 00:03:30,949 - Well, if I'm meeting with my patients earlier, 88 00:03:30,993 --> 00:03:32,473 then I can read up on their conditions. 89 00:03:32,516 --> 00:03:34,257 That way, I'm running rounds, I'll have all the answers. 90 00:03:34,301 --> 00:03:35,345 Plus, if I'm here a little early, 91 00:03:35,389 --> 00:03:36,781 I can study for my boards. 92 00:03:36,825 --> 00:03:39,262 - Sleep ever a factor in this equation? 93 00:03:39,306 --> 00:03:41,438 - Life of an intern. What can I tell ya? 94 00:03:41,482 --> 00:03:42,700 - Dr. Marcel. - Yeah. 95 00:03:42,744 --> 00:03:45,529 - Treatment three incoming. [bell beeping] 96 00:03:45,573 --> 00:03:46,617 - What do we got? 97 00:03:46,661 --> 00:03:48,358 - Avery Quinn, 28-year-old female. 98 00:03:48,402 --> 00:03:51,405 Pedestrian versus auto. BP 80/45. 99 00:03:51,448 --> 00:03:53,537 Heart rate 114, satting at 88. 100 00:03:53,581 --> 00:03:54,886 - Okay, Avery, I'm Dr. Marcel. 101 00:03:54,930 --> 00:03:56,061 We're gonna take good care of you, okay? 102 00:03:56,105 --> 00:03:57,715 - It hurts so much. 103 00:03:57,759 --> 00:03:59,587 - Trigger the MTP, give her 50 of fentanyl. 104 00:04:01,066 --> 00:04:03,460 Here we go, guys. Transfer on my count. 105 00:04:03,504 --> 00:04:06,550 One, two, three. - [groans] 106 00:04:06,594 --> 00:04:09,553 - There it is. All right, let's roll her. 107 00:04:09,597 --> 00:04:12,295 You're okay, we got you. The board... 108 00:04:12,339 --> 00:04:16,734 - [groans] 109 00:04:16,778 --> 00:04:19,911 - All right, we're good. 110 00:04:19,955 --> 00:04:22,392 Avery, can you put your arms by your side for me? 111 00:04:22,436 --> 00:04:23,785 You're gonna feel a little bit of pressure, okay? 112 00:04:25,961 --> 00:04:28,311 - [groans] - O2 sats down to 82. 113 00:04:28,355 --> 00:04:31,401 - Avery, Avery. Avery...she's out. 114 00:04:31,445 --> 00:04:33,751 We need to intubate. 20 of etomidate, 100 of sux. 115 00:04:33,795 --> 00:04:36,537 Get a CBC, CMP, type and cross four units. 116 00:04:36,580 --> 00:04:38,756 Let's get a fastscan and have them prep OR 12. 117 00:04:38,800 --> 00:04:41,585 - No, she's going to OR seven. - Excuse me? 118 00:04:41,629 --> 00:04:42,934 - Yeah, I'll take it from here. 119 00:04:42,978 --> 00:04:45,502 And let's add a coag panel and LFTs. 120 00:04:45,546 --> 00:04:46,982 - Dr. Blake, I think you're mistaken. 121 00:04:47,025 --> 00:04:49,071 This is a trauma, not a transplant surgery. 122 00:04:49,114 --> 00:04:51,029 - Yeah, I can see that. 123 00:04:51,073 --> 00:04:53,510 She's got free fluid, and she's in shock. 124 00:04:53,554 --> 00:04:55,077 Her liver's ruptured but repairable. 125 00:04:55,120 --> 00:04:58,036 We got to get her up now. - I'm in. Bag her. 126 00:04:58,080 --> 00:05:01,779 All do respect, Dr. Blake, you're a transplant surgeon. 127 00:05:01,823 --> 00:05:03,781 I got this. - Thank you, Dr. Marcel, 128 00:05:03,825 --> 00:05:05,348 but I'll be taking over the case now. 129 00:05:05,392 --> 00:05:06,784 - I'm sorry, I can't let you do that. 130 00:05:06,828 --> 00:05:08,264 This is my patient. 131 00:05:08,308 --> 00:05:10,310 - And I understand that, but she's also my daughter. 132 00:05:11,615 --> 00:05:13,008 Now, I'm gonna need you to move. 133 00:05:13,051 --> 00:05:14,749 Let's go. 134 00:05:14,792 --> 00:05:21,712 [dramatic music] 135 00:05:21,756 --> 00:05:23,758 - You got a transplant patient? 136 00:05:23,801 --> 00:05:25,847 - No, I don't. 137 00:05:25,890 --> 00:05:27,544 But we have a problem. 138 00:05:27,588 --> 00:05:33,333 ♪ 139 00:05:42,385 --> 00:05:42,777 . 140 00:05:42,820 --> 00:05:44,866 - Hey, Alex, I'm Dr. Scott. 141 00:05:44,909 --> 00:05:46,215 - I'm Susan. This is Todd. 142 00:05:46,258 --> 00:05:49,087 And this is Ry--Ryan, come on. 143 00:05:49,131 --> 00:05:51,525 - Hey, Ryan, can I get a couple of those? 144 00:05:53,353 --> 00:05:56,225 - Ryan, enough with the gloves, okay? 145 00:05:56,268 --> 00:05:58,183 - Thanks. [laughs] 146 00:05:58,227 --> 00:06:01,796 Alex, says here that you 147 00:06:01,839 --> 00:06:04,059 got hit in the head with a Nerf gun. 148 00:06:04,102 --> 00:06:07,062 - Yeah. - Oof, I bet that hurt. 149 00:06:07,105 --> 00:06:10,195 The thing is, you're supposed to get hit with the foam dart, 150 00:06:10,239 --> 00:06:11,545 not the actual gun. [chuckles] 151 00:06:11,588 --> 00:06:13,285 - Stop it. 152 00:06:13,329 --> 00:06:16,419 - It was an accident. The boys were playing. 153 00:06:16,463 --> 00:06:18,421 - Mom, it wasn't a Nerf gun. - Okay. 154 00:06:18,465 --> 00:06:20,075 I--I didn't even see it happen. I--okay. 155 00:06:20,118 --> 00:06:21,119 - Ryan. - Mom---mom. 156 00:06:21,163 --> 00:06:22,294 - Hey, just a minute. - Mom-- 157 00:06:22,338 --> 00:06:23,470 - They were down in the basement and-- 158 00:06:23,513 --> 00:06:24,906 - It wasn't a Nerf gun. - Ryan, okay. 159 00:06:24,949 --> 00:06:26,603 - Hey, hey, hey, Ryan. 160 00:06:26,647 --> 00:06:28,257 What's up, buddy? Talk to me. 161 00:06:28,300 --> 00:06:30,955 - It was an Ultra Blaster. - Oh, yeah? 162 00:06:30,999 --> 00:06:33,001 Triple action with the slam-fire? 163 00:06:33,044 --> 00:06:36,134 - Uh-huh. - Sweet. Yeah. 164 00:06:36,178 --> 00:06:38,310 - "I'm sorry, Doctor"? 165 00:06:38,354 --> 00:06:39,616 Todd, you want to take him for a walk to the truck? 166 00:06:39,660 --> 00:06:42,140 Give him his meds. Okay, go with Dad. Go. 167 00:06:46,318 --> 00:06:49,409 - Oh, man. Tough day, huh, bro? 168 00:06:49,452 --> 00:06:51,149 - He has ADHD. 169 00:06:51,193 --> 00:06:52,934 - Yeah, we have him on Adderall, 170 00:06:52,977 --> 00:06:54,979 but we keep upping the dose, 171 00:06:55,023 --> 00:06:56,459 and some days are just a little tough. 172 00:06:56,503 --> 00:06:59,506 - [whispers] I know. It's okay. 173 00:06:59,549 --> 00:07:02,030 What about you? How you doing? 174 00:07:03,031 --> 00:07:04,293 - [whispers] I'm fine. 175 00:07:04,336 --> 00:07:06,121 - You sure? 176 00:07:07,470 --> 00:07:09,211 Okay then. 177 00:07:09,254 --> 00:07:11,082 For now, we're gonna keep applying pressure 178 00:07:11,126 --> 00:07:13,215 and get you all stitched up. Shouldn't be too long. 179 00:07:19,395 --> 00:07:22,485 Hey, Mags, I need somebody to throw stitches in six. 180 00:07:22,529 --> 00:07:23,573 - I'm on it. 181 00:07:23,617 --> 00:07:25,009 - You already have two patients up. 182 00:07:25,053 --> 00:07:26,141 You sure you have time? - Don't worry. 183 00:07:26,184 --> 00:07:27,403 I got it. 184 00:07:33,409 --> 00:07:34,410 - [sighs] 185 00:07:35,716 --> 00:07:37,544 - Rough morning, huh? - Yeah. 186 00:07:37,587 --> 00:07:39,284 It's a tricky family dynamic. 187 00:07:39,328 --> 00:07:41,025 I'm treating a 10-year-old named Alex. 188 00:07:41,069 --> 00:07:42,244 His brother has ADHD. 189 00:07:42,287 --> 00:07:43,419 Seems like it's pretty tough on them. 190 00:07:43,463 --> 00:07:44,638 - Yeah. 191 00:07:44,681 --> 00:07:46,030 - Takes up a lot of the family's energy. 192 00:07:46,074 --> 00:07:47,423 - Oh, yeah. 193 00:07:47,467 --> 00:07:49,991 Parents so focused on--on the kid with the illness 194 00:07:50,034 --> 00:07:52,297 that they see right through the other one. 195 00:07:52,341 --> 00:07:54,082 Yeah, unfortunately not at all uncommon. 196 00:07:54,125 --> 00:07:56,084 There's even a name for it. It's called--it's called 197 00:07:56,127 --> 00:07:57,433 glass child syndrome. 198 00:07:57,477 --> 00:07:59,696 - Oh, that sounds like exactly what's happening. 199 00:07:59,740 --> 00:08:02,046 - Yeah, happy to provide you with a couple referrals 200 00:08:02,090 --> 00:08:03,526 for a therapist for the--for the kid 201 00:08:03,570 --> 00:08:05,049 if you think the parents'll be open to it. 202 00:08:05,093 --> 00:08:06,224 - I think that'd be great. Thanks. 203 00:08:06,268 --> 00:08:08,226 [phone buzzes] - Oh. 204 00:08:08,270 --> 00:08:09,619 Dr. Choi, I've been bugging him 205 00:08:09,663 --> 00:08:11,142 for an update on his rehab. I better take this. 206 00:08:11,186 --> 00:08:13,318 - Go ahead, man, and tell him I look forward to meeting. 207 00:08:13,362 --> 00:08:14,189 - Will do. 208 00:08:16,278 --> 00:08:17,714 - I understand this must be hard for you, 209 00:08:17,758 --> 00:08:19,716 but that's the very reason I can't let you go in there. 210 00:08:19,760 --> 00:08:21,718 - I appreciate your concern, but I'm fine. 211 00:08:21,762 --> 00:08:23,590 - Dr. Blake. - Ms. Goodwin. 212 00:08:23,633 --> 00:08:26,418 - You know very well it's against hospital policy 213 00:08:26,462 --> 00:08:28,029 to operate on a family member. 214 00:08:28,072 --> 00:08:30,161 - I am perfectly qualified to perform this surgery. 215 00:08:30,205 --> 00:08:32,512 - Pamela, you are a transplant surgeon. 216 00:08:32,555 --> 00:08:34,209 - Dr. Archer and I see these cases every day. 217 00:08:34,252 --> 00:08:35,732 - And I make more money for this hospital 218 00:08:35,776 --> 00:08:39,083 than any other doctor here. - That is not the point. 219 00:08:40,476 --> 00:08:43,305 Dr. Archer is a top trauma surgeon. 220 00:08:43,348 --> 00:08:46,526 He will do an excellent job. 221 00:08:48,049 --> 00:08:49,746 - I will, and if you're so inclined, 222 00:08:49,790 --> 00:08:51,705 I'd be happy to have you observe. 223 00:08:51,748 --> 00:08:57,972 ♪ 224 00:09:05,066 --> 00:09:06,371 - Ryan. - Ryan-- 225 00:09:06,415 --> 00:09:09,287 can you sit still for just one minute? 226 00:09:09,331 --> 00:09:10,985 - [sighs] I'm gonna go get some air. 227 00:09:11,028 --> 00:09:12,377 - Yeah. 228 00:09:17,513 --> 00:09:19,515 - Will, can I get your opinion on something? 229 00:09:19,559 --> 00:09:22,170 - Sure. What's going on? 230 00:09:22,213 --> 00:09:23,563 - I've got a 71-year-old woman 231 00:09:23,606 --> 00:09:25,608 who's hypotensive and tachycardic. 232 00:09:25,652 --> 00:09:27,305 Passed out this morning at home. 233 00:09:27,349 --> 00:09:29,786 No medical history other than asthma. 234 00:09:29,830 --> 00:09:31,614 She could use some cardiac monitoring, 235 00:09:31,658 --> 00:09:33,311 and I know that you're big on the Vas-COM. 236 00:09:33,355 --> 00:09:34,704 - Well, I mean, there are a number 237 00:09:34,748 --> 00:09:38,099 of good cardiac output monitors. 238 00:09:38,142 --> 00:09:40,580 But the Vas-COM is a terrific device. 239 00:09:40,623 --> 00:09:42,625 You mind if I, uh, have a look at her? 240 00:09:42,669 --> 00:09:44,279 See if she's a good candidate? - Yeah, yeah, sure. 241 00:09:48,370 --> 00:09:50,328 - Eleanor, Ron, this is Dr. Halstead. 242 00:09:50,372 --> 00:09:51,634 - Hi. 243 00:09:51,678 --> 00:09:52,940 - He's just going to ask you a few questions. 244 00:09:52,983 --> 00:09:55,072 - Nice to meet you. - You have to help her. 245 00:09:55,116 --> 00:09:56,334 Ellie, tell him, 246 00:09:56,378 --> 00:09:57,640 you've never been sick a day in your life. 247 00:09:57,684 --> 00:10:00,643 - Ron-- - No, no, that's good to hear. 248 00:10:00,687 --> 00:10:02,645 You mind if I? - Mm-hm. 249 00:10:02,689 --> 00:10:04,038 - Make a fist. 250 00:10:05,430 --> 00:10:07,432 And release. - [sighs] 251 00:10:07,476 --> 00:10:08,782 - Good. 252 00:10:08,825 --> 00:10:10,435 Does she have any sensitivities or allergies? 253 00:10:10,479 --> 00:10:12,220 Recent injuries, meds that would interfere 254 00:10:12,263 --> 00:10:14,657 with an arterial line? - Just seasonal allergies. 255 00:10:14,701 --> 00:10:17,355 - Okay. Eleanor, do you ever have any trouble 256 00:10:17,399 --> 00:10:20,054 when you get your blood drawn? - I don't think so. 257 00:10:20,097 --> 00:10:24,362 - What about leg swelling? Long car rides, trips? 258 00:10:24,406 --> 00:10:26,190 - No, not that I can remember. 259 00:10:28,497 --> 00:10:29,672 - That's good. 260 00:10:29,716 --> 00:10:32,109 All right, it was nice to meet you. 261 00:10:32,153 --> 00:10:33,850 I'll have a chat with Dr. Hammer. 262 00:10:33,894 --> 00:10:35,069 We'll be right back. 263 00:10:37,724 --> 00:10:39,508 - What do you think? She look good for the Vas-COM? 264 00:10:39,551 --> 00:10:40,814 - Uh, maybe. 265 00:10:40,857 --> 00:10:42,554 She was a little vague in her answers. 266 00:10:42,598 --> 00:10:43,686 - But she definitely should have 267 00:10:43,730 --> 00:10:45,253 her cardiac output monitored? 268 00:10:45,296 --> 00:10:47,255 - Dr. Hammer, if you're interested, 269 00:10:47,298 --> 00:10:48,604 I could give you copies 270 00:10:48,648 --> 00:10:51,868 of the Vas-COM's FDA-approved usage criteria? 271 00:10:51,912 --> 00:10:54,088 - You know, that--that won't be necessary. 272 00:10:54,131 --> 00:10:56,394 I think Eleanor would be a great candidate. 273 00:10:56,438 --> 00:10:58,614 - Okay, good. I'll get it set up. 274 00:11:05,229 --> 00:11:07,144 - Dr. Scott. - Alex? 275 00:11:07,188 --> 00:11:08,798 - Dr. Taylor. - Buddy? What? 276 00:11:08,842 --> 00:11:10,670 Alex. - Bud... 277 00:11:10,713 --> 00:11:13,716 - Excuse me. - Honey, honey? 278 00:11:13,760 --> 00:11:15,849 What--what's happening? - He's having a seizure. 279 00:11:15,892 --> 00:11:18,547 Give him 12 liters of O2 and .five of Ativan. 280 00:11:18,590 --> 00:11:20,505 - Wait, seizure? Why is he having a seizure? 281 00:11:20,549 --> 00:11:21,724 - I'm not sure yet. 282 00:11:21,768 --> 00:11:23,465 [whispers] Come on. 283 00:11:23,508 --> 00:11:26,555 Come on, come on, come on, come on. 284 00:11:26,598 --> 00:11:32,604 ♪ 285 00:11:34,563 --> 00:11:37,174 Hey, Alex, you with me? 286 00:11:37,218 --> 00:11:38,785 - Uh-huh. 287 00:11:38,828 --> 00:11:40,482 - [whispers] Okay. 288 00:11:40,525 --> 00:11:46,575 ♪ 289 00:11:46,618 --> 00:11:48,925 We're gonna figure this out as soon as we can. 290 00:11:48,969 --> 00:11:50,579 Dr. Taylor. 291 00:11:50,622 --> 00:11:52,755 ♪ 292 00:11:52,799 --> 00:11:55,410 - Hi, hi, okay. It's okay. 293 00:11:55,453 --> 00:11:57,325 - Has that cut been bleeding like that the whole time? 294 00:11:57,368 --> 00:11:59,153 - I tried holding pressure, but it didn't work. 295 00:11:59,196 --> 00:12:00,545 And if I would've tried to stitch too soon, 296 00:12:00,589 --> 00:12:01,721 he would've got a hematoma. 297 00:12:01,764 --> 00:12:02,765 - He could have a bleeding disorder. 298 00:12:02,809 --> 00:12:04,288 Did you order coags? 299 00:12:04,332 --> 00:12:06,856 - Um, well, no. I-- - Get a coag panel, Maggie. 300 00:12:06,900 --> 00:12:08,771 And let CT know we're on our way. 301 00:12:08,815 --> 00:12:11,600 - Wait, do you think he could have a subdural hematoma? 302 00:12:11,643 --> 00:12:13,602 - Yes, and if he does have a bleeding disorder, 303 00:12:13,645 --> 00:12:15,169 then the trauma from getting hit in the head 304 00:12:15,212 --> 00:12:16,518 could've caused a bleed in the skull, 305 00:12:16,561 --> 00:12:18,781 which means he could herniate at any moment. 306 00:12:18,825 --> 00:12:20,391 All right, now. Let's go. 307 00:12:20,435 --> 00:12:23,568 ♪ 308 00:12:23,612 --> 00:12:25,570 - [whispering] Oh, my God. 309 00:12:28,922 --> 00:12:29,139 . 310 00:12:29,183 --> 00:12:31,576 - Okay, ready to release the pringle. 311 00:12:31,620 --> 00:12:33,796 - Hold on, I didn't get a good look at the duodenum. 312 00:12:33,840 --> 00:12:36,625 - It's clear. - Okay. 313 00:12:36,668 --> 00:12:37,887 - All right, pulling back on the lap. 314 00:12:37,931 --> 00:12:39,671 [heart monitor beeping] 315 00:12:39,715 --> 00:12:41,151 Looks good. 316 00:12:42,152 --> 00:12:43,806 - What's her pH and temp? 317 00:12:43,850 --> 00:12:45,852 - 7.34 and 36.9. 318 00:12:45,895 --> 00:12:47,810 - All right, looks like you're good to close. 319 00:12:47,854 --> 00:12:52,119 - Uh, actually, we're just gonna pack and leave her open. 320 00:12:52,162 --> 00:12:53,773 - No, her bleeding's under control. 321 00:12:53,816 --> 00:12:55,949 Packing her isn't necessary. - I disagree. 322 00:12:55,992 --> 00:12:57,777 She's got a grade four liver laceration. 323 00:12:57,820 --> 00:12:59,256 The risk of re-bleeding is too high. 324 00:12:59,300 --> 00:13:00,997 - She's a healthy 28-year-old. 325 00:13:01,041 --> 00:13:02,825 Leaving her open puts her at increased risk 326 00:13:02,869 --> 00:13:05,654 for infection, coagulopathy, hypothermia, and acidosis. 327 00:13:05,697 --> 00:13:07,830 - Dr. Blake, I-- - Close her up, doctor. 328 00:13:07,874 --> 00:13:10,572 - I understand your concerns. - No, no, point well taken. 329 00:13:10,615 --> 00:13:12,313 I see the merit in what Dr. Blake is saying. 330 00:13:12,356 --> 00:13:13,836 - Dr. Archer-- - All right, hold off 331 00:13:13,880 --> 00:13:15,838 on the lap. I need Celox, Gelfoam, 332 00:13:15,882 --> 00:13:18,754 and get an O Max and suture for Dr. Marcel. 333 00:13:18,798 --> 00:13:20,843 - Dr. Archer, you-- - Dr. Marcel. 334 00:13:20,887 --> 00:13:23,672 ♪ 335 00:13:23,715 --> 00:13:25,065 [knocking] 336 00:13:25,108 --> 00:13:27,589 - Mr. and Mrs. Miller, I'm Dr. Charles. 337 00:13:27,632 --> 00:13:29,286 I had been consulting 338 00:13:29,330 --> 00:13:31,854 with--with Dr. Scott on Alex's case. 339 00:13:31,898 --> 00:13:34,161 - Psychiatry? - Head injury. 340 00:13:34,204 --> 00:13:36,250 You know, can't be too careful. 341 00:13:36,293 --> 00:13:38,295 Anyway, Dr. Scott wanted me to let you know that 342 00:13:38,339 --> 00:13:41,211 Alex's scans are almost ready. And in the meantime, 343 00:13:41,255 --> 00:13:42,691 is there anything I can get you? 344 00:13:42,734 --> 00:13:43,866 A bottle of water? - Thank you, but we're fine. 345 00:13:43,910 --> 00:13:45,259 - Yeah. [cell phone buzzes] 346 00:13:45,302 --> 00:13:46,651 Oh, sorry. This is work. 347 00:13:46,695 --> 00:13:48,697 Um, don't forget to text my parents. 348 00:13:48,740 --> 00:13:49,959 Excuse me. - Oh, okay. Yep. 349 00:13:51,221 --> 00:13:52,657 - Ryan? Is it Ryan? How about you, buddy? 350 00:13:52,701 --> 00:13:55,225 Can I get you something? - Do you mind if I... 351 00:13:55,269 --> 00:13:56,357 - No, not at all. - Okay, I'll be right back. 352 00:13:56,400 --> 00:13:58,881 - Not at all. 353 00:13:58,925 --> 00:14:02,232 - Would you, uh, like a sandwich or something? 354 00:14:04,278 --> 00:14:07,020 No? Bag of chips? 355 00:14:07,063 --> 00:14:09,370 Soda? Anything at all? 356 00:14:09,413 --> 00:14:12,025 - No! You interrupted me. 357 00:14:12,068 --> 00:14:15,289 - Oh, I'm sorry. I, uh, I--I didn't mean to. 358 00:14:15,332 --> 00:14:17,900 - Now I have to start all over again. 359 00:14:17,944 --> 00:14:21,382 - Oh, you were counting. Huh? 360 00:14:21,425 --> 00:14:24,254 Okay, well, I'm--again, I'm very sorry. 361 00:14:24,298 --> 00:14:26,300 You--you get back to that. All right? 362 00:14:28,084 --> 00:14:32,915 - Mr. and Mrs. Miller, we just got Alex's test results back. 363 00:14:32,959 --> 00:14:34,917 Alex is stable right now, 364 00:14:34,961 --> 00:14:38,181 but the scan did confirm that he is bleeding into his brain. 365 00:14:40,096 --> 00:14:41,924 And the intracranial pressure is great enough 366 00:14:41,968 --> 00:14:44,884 that he needs immediate surgical evacuation. 367 00:14:44,927 --> 00:14:46,059 - Oh, my God. 368 00:14:46,102 --> 00:14:48,061 - Wait, wait, wait. How'd this happen? 369 00:14:48,104 --> 00:14:50,150 - Well, his test results came back positive 370 00:14:50,193 --> 00:14:53,327 for a bleeding disorder called Von Willebrand disease. 371 00:14:53,370 --> 00:14:56,852 So the impact from a small toy could've caused a bleed 372 00:14:56,896 --> 00:14:59,289 that his body just wasn't able to stop. 373 00:15:00,203 --> 00:15:01,770 - I--I know this is a lot, 374 00:15:01,813 --> 00:15:03,772 but Dr. Abrams will be doing the surgery, 375 00:15:03,815 --> 00:15:05,252 and he's our very best. 376 00:15:05,295 --> 00:15:06,949 The procedure shouldn't be that long. 377 00:15:06,993 --> 00:15:09,169 I'll be here for status updates or if you have any questions. 378 00:15:09,212 --> 00:15:11,780 - And if we have your consent, 379 00:15:11,823 --> 00:15:12,999 we could get started right away. 380 00:15:13,042 --> 00:15:14,174 - Sure. - Yeah, of course. 381 00:15:14,217 --> 00:15:15,392 Whatever you need. - Okay. 382 00:15:15,436 --> 00:15:16,785 So why don't I take you somewhere 383 00:15:16,828 --> 00:15:17,960 that's more comfortable to wait? 384 00:15:18,004 --> 00:15:20,223 - Um, Ryan. Hey, buddy. 385 00:15:20,267 --> 00:15:21,311 Come on, buddy. We're gonna take 386 00:15:21,355 --> 00:15:22,965 a little walk, all right? 387 00:15:23,009 --> 00:15:29,972 ♪ 388 00:15:33,236 --> 00:15:34,846 [all talking briefly] 389 00:15:37,458 --> 00:15:39,242 - Hey, I saw Eleanor's oxygenation 390 00:15:39,286 --> 00:15:40,809 and cardiac output are down. 391 00:15:40,852 --> 00:15:42,158 Have you gotten her labs back yet? 392 00:15:42,202 --> 00:15:43,986 - Yeah; they don't show much. Mild infiltrates 393 00:15:44,030 --> 00:15:46,032 on her chest X-ray and some eosinophilia. 394 00:15:46,075 --> 00:15:47,903 Still don't know what's going on. 395 00:15:47,947 --> 00:15:49,687 - I'm a little concerned. 396 00:15:49,731 --> 00:15:51,298 One of her fingers and two of her toes are going cold. 397 00:15:51,341 --> 00:15:52,995 - Oh, could just be a vasospasm. 398 00:15:53,039 --> 00:15:55,215 - That could be, but-- 399 00:15:55,258 --> 00:15:57,347 look, the major drawback to any arterial line, 400 00:15:57,391 --> 00:15:59,175 including the Vas-COM, is the potential 401 00:15:59,219 --> 00:16:00,263 for thrombus formation. 402 00:16:00,307 --> 00:16:01,743 So I think we should pull it out. 403 00:16:01,786 --> 00:16:03,440 - Pull it out? 404 00:16:03,484 --> 00:16:05,747 I mean, thromboembolization in arterial lines 405 00:16:05,790 --> 00:16:07,444 is extremely rare, and it almost never occurs 406 00:16:07,488 --> 00:16:09,794 this quickly. - I understand. 407 00:16:09,838 --> 00:16:11,361 I just think we should err on the side of safety. 408 00:16:13,059 --> 00:16:14,538 What? 409 00:16:14,582 --> 00:16:18,325 - Is something going on? It's getting us great numbers. 410 00:16:18,368 --> 00:16:20,022 Keeping Eleanor's meds titrated 411 00:16:20,066 --> 00:16:22,024 and her pressure and heart rate optimized. 412 00:16:22,068 --> 00:16:23,373 Without it, we'd just be shooting in the dark. 413 00:16:23,417 --> 00:16:25,158 - I know. I just want to make sure 414 00:16:25,201 --> 00:16:28,161 we're using it appropriately. - I think we are. 415 00:16:28,204 --> 00:16:30,206 Let's just give it a little more time. 416 00:16:30,250 --> 00:16:33,209 [uneasy music] 417 00:16:33,253 --> 00:16:36,038 ♪ 418 00:16:36,082 --> 00:16:38,301 - Dr. Archer. - Yeah. 419 00:16:38,345 --> 00:16:40,042 - What the hell happened back there? 420 00:16:40,086 --> 00:16:41,130 - What? 421 00:16:41,174 --> 00:16:43,045 - Giving in to Dr. Blake like that. 422 00:16:44,264 --> 00:16:46,962 - The surgery was a success, and if you'll excuse me, 423 00:16:47,006 --> 00:16:48,485 I have an ED to run. 424 00:16:48,529 --> 00:16:50,357 - Hold on, Dean. 425 00:16:50,400 --> 00:16:52,141 You know, with that kind of injury, 426 00:16:52,185 --> 00:16:54,056 keeping her open is the right thing to do. 427 00:16:54,100 --> 00:16:56,363 - Dr. Blake's reasoning was medically sound. 428 00:16:56,406 --> 00:16:58,539 I mean, I could argue it either way. 429 00:16:58,582 --> 00:17:00,193 - Oh, come on! - Crockett... 430 00:17:00,236 --> 00:17:03,065 hospital politics is a lot like the military. 431 00:17:03,109 --> 00:17:05,067 You put in your time. You do as your told. 432 00:17:05,111 --> 00:17:08,201 And eventually you can rise up to become a Dr. Blake, too. 433 00:17:08,244 --> 00:17:15,208 ♪ 434 00:17:15,251 --> 00:17:18,211 - Hey, buddy. This is my friend, Dr. Charles. 435 00:17:18,254 --> 00:17:19,734 - Hey, Alex. 436 00:17:19,777 --> 00:17:21,214 - We just came to check in on you before your surgery, 437 00:17:21,257 --> 00:17:22,867 see if you had any questions. 438 00:17:23,955 --> 00:17:25,870 - Is this gonna hurt? - No, no. 439 00:17:25,914 --> 00:17:27,046 They're gonna give you some medicine. 440 00:17:27,089 --> 00:17:28,090 It's gonna put you right to sleep. 441 00:17:28,134 --> 00:17:29,309 You won't feel a thing. 442 00:17:29,352 --> 00:17:32,225 - Even when they open my head? 443 00:17:32,268 --> 00:17:34,444 - Next thing you know, you're just gonna 444 00:17:34,488 --> 00:17:36,925 wake up in recovery. We promise. 445 00:17:37,969 --> 00:17:38,970 - Okay. 446 00:17:41,147 --> 00:17:42,452 - Anything else on your mind? 447 00:17:42,496 --> 00:17:44,889 - No. 448 00:17:49,851 --> 00:17:53,159 It's just, when they look inside my head, 449 00:17:53,202 --> 00:17:55,248 will they see my secrets? 450 00:17:56,988 --> 00:17:59,426 - Uh, I don't think so. 451 00:17:59,469 --> 00:18:02,559 But if there is something on your mind, 452 00:18:02,603 --> 00:18:06,215 a lot of kids tell me that it's just better to get it out. 453 00:18:08,174 --> 00:18:10,132 - This wasn't Ryan's fault. 454 00:18:10,176 --> 00:18:12,178 - Oh, don't worry about that. Ryan's not in any trouble. 455 00:18:12,221 --> 00:18:14,093 - No, I made him do it. 456 00:18:15,616 --> 00:18:18,619 I made fun of him, and I know if I did it enough, 457 00:18:18,662 --> 00:18:21,230 then he'd get really mad and hit me. 458 00:18:23,189 --> 00:18:25,016 - Yeah? 459 00:18:25,060 --> 00:18:26,453 Why would you want him to hit you? 460 00:18:28,150 --> 00:18:31,371 - Because... 461 00:18:31,414 --> 00:18:32,589 - Because? 462 00:18:34,461 --> 00:18:36,332 If you got hurt, maybe 463 00:18:36,376 --> 00:18:38,291 Mom and Dad pay a little more attention to you? 464 00:18:41,511 --> 00:18:43,513 - It was stupid. I shouldn't have done it. 465 00:18:43,557 --> 00:18:45,515 - Hey, it's okay. 466 00:18:47,996 --> 00:18:50,477 Let's get you taken care of. All right? 467 00:18:52,261 --> 00:18:55,046 - Alex, it's gonna be okay, buddy. 468 00:18:55,090 --> 00:18:57,353 You're gonna be fine. We'll see you in a bit. 469 00:18:59,964 --> 00:19:02,489 - [sighs] Man, listen, I deal with a lot of sick kids, 470 00:19:02,532 --> 00:19:04,186 but what do you do for this? 471 00:19:04,230 --> 00:19:07,494 - So... kid with ADHD, control issues, right? 472 00:19:07,537 --> 00:19:09,931 Random outbursts. - True. 473 00:19:09,974 --> 00:19:13,978 - Yeah, but Alex knew he could only get Ryan to lash out 474 00:19:14,022 --> 00:19:16,198 if he backed him into a corner. That's not random. 475 00:19:16,242 --> 00:19:18,505 - So, what are we looking at if this isn't ADHD? 476 00:19:18,548 --> 00:19:20,898 - I think maybe an anxiety disorder. 477 00:19:20,942 --> 00:19:23,074 - Oh, another misdiagnosis. Second in a week. 478 00:19:23,118 --> 00:19:25,033 - And if I'm right, that misdiagnosis 479 00:19:25,076 --> 00:19:27,166 is causing this family a lot of problems. 480 00:19:30,386 --> 00:19:31,996 [alarm beeping] - You have to come quick. 481 00:19:32,040 --> 00:19:34,085 Something's wrong with Ellie. 482 00:19:34,129 --> 00:19:36,087 [dramatic music] 483 00:19:36,131 --> 00:19:38,481 [monitor beeping] 484 00:19:38,525 --> 00:19:41,223 - Eleanor, can you hear me? - Yeah. 485 00:19:41,267 --> 00:19:44,357 - Okay. - Squeeze my hand. 486 00:19:44,400 --> 00:19:50,101 ♪ 487 00:19:50,145 --> 00:19:52,278 - What's happening? Why's she like this? 488 00:19:52,321 --> 00:19:54,236 - She had a TIA, a mini-stroke. 489 00:19:54,280 --> 00:19:56,064 Start her on aspirin and clopidogrel 490 00:19:56,107 --> 00:19:57,326 and call for an MRI of her head. 491 00:19:57,370 --> 00:19:59,241 - A stroke? What--what? Why? 492 00:19:59,285 --> 00:20:01,243 - 'Cause she's forming thrombi. They're blood clots 493 00:20:01,287 --> 00:20:02,984 in her vessels, and one's travelled to her brain. 494 00:20:03,027 --> 00:20:04,333 - Oh, my God. 495 00:20:04,377 --> 00:20:07,075 ♪ 496 00:20:07,118 --> 00:20:09,251 - Get a suture kit. We have to pull the Vas out. 497 00:20:09,295 --> 00:20:11,253 - I'll call Dr. Hammer. Excuse me, Mr. Halt. 498 00:20:11,297 --> 00:20:12,559 She's up in radiology. - No, no, no. 499 00:20:12,602 --> 00:20:13,734 Every minute that passes 500 00:20:13,777 --> 00:20:15,257 increases her risk of a major stroke. 501 00:20:15,301 --> 00:20:16,519 We have to pull it right now. 502 00:20:16,563 --> 00:20:22,569 ♪ 503 00:20:29,924 --> 00:20:30,316 . 504 00:20:30,359 --> 00:20:32,753 - Hey, you okay? 505 00:20:34,798 --> 00:20:37,323 - No. I screwed everything up today. 506 00:20:39,934 --> 00:20:42,458 - I saw Alex's notes. 507 00:20:42,502 --> 00:20:44,678 Von Willebrand disease? You couldn't have known. 508 00:20:44,721 --> 00:20:46,767 - I could've ordered those labs earlier. 509 00:20:46,810 --> 00:20:47,985 - But it doesn't matter. 510 00:20:48,029 --> 00:20:49,248 The outcome still would've been the same. 511 00:20:50,727 --> 00:20:52,599 Look, you're always gonna wish that you could've done 512 00:20:52,642 --> 00:20:54,296 something earlier. 513 00:20:54,340 --> 00:20:55,689 It's part of being a good doctor. 514 00:20:55,732 --> 00:20:57,386 - Alex is in surgery, Maggie. 515 00:20:57,430 --> 00:20:59,736 He's bleeding into his brain. 516 00:20:59,780 --> 00:21:01,651 - Which isn't your fault. 517 00:21:07,831 --> 00:21:12,662 ♪ 518 00:21:12,706 --> 00:21:15,317 - You pulled my patient's Vas-COM? 519 00:21:21,062 --> 00:21:22,542 - She had a TIA. 520 00:21:22,585 --> 00:21:23,804 The Vas-COM was most likely the source. 521 00:21:23,847 --> 00:21:25,762 - You don't know that. Could've been lupus, 522 00:21:25,806 --> 00:21:27,721 endocarditis, even leukemia. 523 00:21:27,764 --> 00:21:29,679 And now we have no way to monitor her. 524 00:21:29,723 --> 00:21:31,420 - She could've had another stroke at any minute. 525 00:21:31,464 --> 00:21:32,421 What--what was I supposed to do? 526 00:21:32,465 --> 00:21:34,597 - She's my patient, Will. 527 00:21:34,641 --> 00:21:36,077 You at least should've asked me. 528 00:21:36,120 --> 00:21:37,513 - By the time you got down here-- 529 00:21:37,557 --> 00:21:38,949 I'm not taking that chance. - No, you were afraid 530 00:21:38,993 --> 00:21:40,560 that I would disagree and that I'd stop you. 531 00:21:40,603 --> 00:21:41,778 - No. 532 00:21:41,822 --> 00:21:42,953 - It's the same old Will from med school, 533 00:21:42,997 --> 00:21:44,651 always thinking that you know better. 534 00:21:44,694 --> 00:21:47,306 - Stevie, that's not what this was about. 535 00:21:47,349 --> 00:21:49,046 - You tell yourself that. 536 00:21:49,090 --> 00:21:55,575 ♪ 537 00:21:55,618 --> 00:21:56,967 - Hi. 538 00:21:57,011 --> 00:21:58,404 I don't know if you remember me from this morning. 539 00:21:58,447 --> 00:22:00,710 I'm the surgeon on your case, Dr. Marcel. 540 00:22:00,754 --> 00:22:01,929 How you feeling? 541 00:22:01,972 --> 00:22:04,584 - Like I got hit by a car. 542 00:22:04,627 --> 00:22:06,629 - Well, you did just have major surgery, 543 00:22:06,673 --> 00:22:08,109 but, uh, it went well, 544 00:22:08,152 --> 00:22:11,591 and I imagine you will feel a little better each day. 545 00:22:11,634 --> 00:22:13,593 - Here you go. 546 00:22:13,636 --> 00:22:16,335 Dr. Blake said to go slow. - Thanks, Dina. 547 00:22:16,378 --> 00:22:20,077 - Ice chips. My mom is in love with them. 548 00:22:20,121 --> 00:22:21,818 Frankly, I think they're just as much 549 00:22:21,862 --> 00:22:24,604 an aspiration risk as liquids. - Aspiration risk? 550 00:22:24,647 --> 00:22:26,562 What, are you a--you a doctor, too? 551 00:22:26,606 --> 00:22:28,869 - Made it halfway through a third year of med school. 552 00:22:28,912 --> 00:22:30,436 - Oh, okay. 553 00:22:30,479 --> 00:22:33,134 - Realized I was doing it for my mom, not for me. 554 00:22:33,177 --> 00:22:34,396 - Oh. 555 00:22:34,440 --> 00:22:36,355 - I'm assuming you've met her by now? 556 00:22:37,704 --> 00:22:39,967 - Made her acquaintance, yeah. 557 00:22:40,010 --> 00:22:42,056 - She try to scrub in? 558 00:22:42,099 --> 00:22:44,014 - How'd you guess? - [groans] 559 00:22:44,058 --> 00:22:45,451 I know my mom. - [laughs] 560 00:22:45,494 --> 00:22:47,017 - She didn't talk to me for six months 561 00:22:47,061 --> 00:22:50,412 after I quit med school. - Wow, that's rough. 562 00:22:50,456 --> 00:22:51,761 - No. 563 00:22:51,805 --> 00:22:54,416 The day I took control of my life? 564 00:22:54,460 --> 00:22:56,375 Best move I ever made. 565 00:22:59,465 --> 00:23:01,554 - Anyway, I should let you get some rest. 566 00:23:01,597 --> 00:23:06,907 Um, enjoy your ice chips, and I'll check back later. 567 00:23:06,950 --> 00:23:10,476 So wait, what did you end up doing after med school? 568 00:23:10,519 --> 00:23:13,000 - A malpractice lawyer. - Medical? 569 00:23:14,741 --> 00:23:17,526 Your mom must be very proud. - [laughs] 570 00:23:21,574 --> 00:23:23,532 - Mr. and Mrs. Miller, I have an update for you. 571 00:23:26,535 --> 00:23:27,536 - Be right back, buddy. 572 00:23:29,930 --> 00:23:32,106 - So, look, they're--they're just finishing up 573 00:23:32,149 --> 00:23:33,586 in surgery now. 574 00:23:33,629 --> 00:23:36,458 All indications are that the procedure was a success. 575 00:23:36,502 --> 00:23:38,068 And Alex is doing great. 576 00:23:38,112 --> 00:23:41,202 - Oh, my God, really? Thank you so much. 577 00:23:41,245 --> 00:23:44,031 Listen, Dr. Scott and I talked to Alex 578 00:23:44,074 --> 00:23:45,685 before the procedure today. 579 00:23:45,728 --> 00:23:49,471 And I understand that you have a lot on your plate right now, 580 00:23:49,515 --> 00:23:51,691 but I--I also think it's important that I share 581 00:23:51,734 --> 00:23:53,040 this conversation with you. 582 00:23:53,083 --> 00:23:54,563 both: Okay. 583 00:23:54,607 --> 00:23:56,870 - So--so what he told us is that 584 00:23:56,913 --> 00:23:59,699 he provoked Ryan into this outburst today. 585 00:23:59,742 --> 00:24:00,961 He feels terrible. 586 00:24:01,004 --> 00:24:02,963 I think he is looking for some attention. 587 00:24:03,006 --> 00:24:05,922 But where Ryan's concerned-- what this means to me 588 00:24:05,966 --> 00:24:08,664 is that it wasn't an impulsive outburst. 589 00:24:08,708 --> 00:24:11,188 It wasn't--it wasn't random. 590 00:24:11,232 --> 00:24:15,497 And that and a couple other things I've observed today 591 00:24:15,541 --> 00:24:17,717 are leading me to believe it's very possible 592 00:24:17,760 --> 00:24:20,676 that--that your son has been misdiagnosed with ADHD 593 00:24:20,720 --> 00:24:22,548 and that we were probably looking 594 00:24:22,591 --> 00:24:24,724 at some kind of anxiety disorder instead. 595 00:24:24,767 --> 00:24:25,899 - Wait, what are you talking about? 596 00:24:25,942 --> 00:24:27,596 Look at him. He can't sit still. 597 00:24:27,640 --> 00:24:30,251 - But Mr. Miller, it's--it's the counting, right? 598 00:24:30,294 --> 00:24:31,644 The tapping. 599 00:24:31,687 --> 00:24:33,210 I think that he's self-soothing 600 00:24:33,254 --> 00:24:35,735 to help him cope with these feelings of anxiety. 601 00:24:35,778 --> 00:24:37,084 And when that stops working, 602 00:24:37,127 --> 00:24:39,173 I think he feels backed into a corner, 603 00:24:39,216 --> 00:24:41,915 and then you have a fight-or-flight situation. 604 00:24:41,958 --> 00:24:43,525 - Well, what about the Adderall? 605 00:24:43,569 --> 00:24:44,787 His doctor said that would help. 606 00:24:44,831 --> 00:24:48,617 - If he actually had ADHD, it would be working. 607 00:24:48,661 --> 00:24:51,751 But it's not, right? I think that in Ryan's case, 608 00:24:51,794 --> 00:24:53,274 it's actually working against him 609 00:24:53,317 --> 00:24:55,755 and serving to only intensify these feelings of anxiety 610 00:24:55,798 --> 00:24:57,278 to the point where they're often, 611 00:24:57,321 --> 00:24:58,801 frankly, unbearable. 612 00:24:58,845 --> 00:25:00,760 - Dr. Charles, man, look I--I-- 613 00:25:00,803 --> 00:25:02,544 we appreciate everything you're doing. 614 00:25:02,588 --> 00:25:04,938 Really, but please, our son's in surgery. 615 00:25:04,981 --> 00:25:07,941 - I am sorry. This is just not an ideal time 616 00:25:07,984 --> 00:25:10,030 to have this conversation. But I just wouldn't 617 00:25:10,073 --> 00:25:11,640 be doing my job if I didn't tell you 618 00:25:11,684 --> 00:25:13,947 how important I think it would be to reassess Ryan 619 00:25:13,990 --> 00:25:16,558 and make sure that you are looking at the right diagnosis 620 00:25:16,602 --> 00:25:19,126 for him, for his brother, for all of you, 621 00:25:19,169 --> 00:25:21,955 for your whole family. - No, Dr. Charles, it's just-- 622 00:25:21,998 --> 00:25:24,566 it's just been a long day. 623 00:25:24,610 --> 00:25:26,699 - Listen, I am going to check back with you 624 00:25:26,742 --> 00:25:27,874 when Alex wakes up, okay? 625 00:25:27,917 --> 00:25:30,050 - Yeah, yeah. - Okay. 626 00:25:35,142 --> 00:25:37,884 - I should've consulted you before pulling the Vas-COM. 627 00:25:37,927 --> 00:25:40,669 It wasn't my place. I'm sorry. 628 00:25:40,713 --> 00:25:42,149 And besides, you were right. 629 00:25:42,192 --> 00:25:44,630 She's getting worse and still having embolic events. 630 00:25:44,673 --> 00:25:46,109 So it wasn't the Vas-COM after all. 631 00:25:46,153 --> 00:25:48,634 - Clearly, but I've gone through 632 00:25:48,677 --> 00:25:50,679 every clotting disorder, and none of it fits. 633 00:25:50,723 --> 00:25:53,203 - Is it possible we're looking at this wrong? 634 00:25:53,247 --> 00:25:55,597 That she doesn't even have a clotting disorder? 635 00:25:55,641 --> 00:25:59,906 - Of course. It's just so little to go on. 636 00:25:59,949 --> 00:26:02,648 I mean, history of asthma, eosinophils, 637 00:26:02,691 --> 00:26:03,997 and left-sided lung infiltrates. 638 00:26:04,040 --> 00:26:05,085 - Left? 639 00:26:05,128 --> 00:26:06,652 I thought they were on the right. 640 00:26:06,695 --> 00:26:09,568 - Seriously, Will? - No, no, wait. 641 00:26:09,611 --> 00:26:11,744 The X-ray from this morning had them on the left. 642 00:26:11,787 --> 00:26:13,354 But look... 643 00:26:13,397 --> 00:26:15,574 The one from this afternoon shows they moved to the right. 644 00:26:17,706 --> 00:26:19,665 - Migratory infiltrates. 645 00:26:22,189 --> 00:26:25,061 Could this be vasculitis? Churg-Strauss? 646 00:26:25,105 --> 00:26:26,672 - I mean maybe. She could've moved 647 00:26:26,715 --> 00:26:29,065 from the asthmatic stage into the vascular stage today. 648 00:26:29,109 --> 00:26:32,155 - It's a long shot, but it's possible. 649 00:26:32,199 --> 00:26:34,201 - If we're right, her organs could start 650 00:26:34,244 --> 00:26:36,116 to shut down at any moment. 651 00:26:36,159 --> 00:26:37,770 - I'll start her on prednisone and azathioprine 652 00:26:37,813 --> 00:26:39,685 and set her up for a diagnostic lung biopsy. 653 00:26:39,728 --> 00:26:41,774 - Dr. Hammer, Dr. Halstead, you need to come. 654 00:26:41,817 --> 00:26:43,036 Eleanor's getting worse. 655 00:26:49,433 --> 00:26:49,782 . 656 00:26:49,825 --> 00:26:52,219 - I don't like these QRS complexes. 657 00:26:52,262 --> 00:26:54,177 - Eleanor, do you feel any pain in your chest or arm? 658 00:26:54,221 --> 00:26:56,963 - It feels tight. - Oh, God, Ellie. 659 00:26:57,006 --> 00:26:58,007 - Why don't you come here? 660 00:26:58,051 --> 00:26:59,792 [beeping] 661 00:26:59,835 --> 00:27:01,228 - She's going into v-tach. - I'll get the paddles. 662 00:27:01,271 --> 00:27:03,578 - No, no, Ellie. - Wait. 663 00:27:03,622 --> 00:27:06,320 If this is Churg-Strauss, this could be a tamponade. 664 00:27:06,363 --> 00:27:07,930 We need to aspirate the fluid. 665 00:27:07,974 --> 00:27:09,410 - I know, but if we're wrong, 666 00:27:09,453 --> 00:27:11,412 we won't have time to cardiovert. 667 00:27:11,455 --> 00:27:13,893 - I think we're right about this. 668 00:27:13,936 --> 00:27:15,590 - I do, too. 669 00:27:15,634 --> 00:27:18,854 18 gauge on a syringe. - 18 gauge. 670 00:27:18,898 --> 00:27:21,074 [beeping] 671 00:27:21,117 --> 00:27:23,859 - Ron, there's fluid around Eleanor's heart. 672 00:27:23,903 --> 00:27:25,818 They need to drain it. 673 00:27:25,861 --> 00:27:27,471 [beeping] 674 00:27:27,515 --> 00:27:29,430 - Nothing. 675 00:27:35,305 --> 00:27:37,830 Got it. 676 00:27:37,873 --> 00:27:40,049 - Sinus rhythm. 677 00:27:40,093 --> 00:27:42,922 - Eleanor, can you hear me? 678 00:27:42,965 --> 00:27:44,967 - Uh-huh. - Oh, thank God. 679 00:27:45,011 --> 00:27:46,403 - Call IR. Tell them we're coming up 680 00:27:46,447 --> 00:27:49,276 for a drain and a lung biopsy. - You got it. 681 00:27:50,233 --> 00:27:51,887 - Good job. 682 00:27:58,285 --> 00:28:00,330 - Hey. How you feeling? 683 00:28:01,462 --> 00:28:04,291 - Okay. - Good. 684 00:28:05,988 --> 00:28:07,511 Surgery went well. 685 00:28:10,297 --> 00:28:12,995 In fact, the neurosurgeon said 686 00:28:13,039 --> 00:28:14,518 that you had the best-looking brain 687 00:28:14,562 --> 00:28:16,346 he's seen in quite a while. 688 00:28:17,870 --> 00:28:20,176 - Yeah? - Yeah. 689 00:28:20,220 --> 00:28:23,527 Told your parents, but they weren't surprised. 690 00:28:23,571 --> 00:28:26,226 Said they always knew you had a great brain. 691 00:28:27,618 --> 00:28:29,185 - They said that? 692 00:28:31,405 --> 00:28:34,887 - Yeah, they did. 693 00:28:38,020 --> 00:28:41,154 You know, Alex, kids with great brains-- 694 00:28:41,197 --> 00:28:42,982 they don't always get the most attention, 695 00:28:43,025 --> 00:28:45,419 but... people notice. 696 00:28:51,947 --> 00:28:53,340 - What's going on? 697 00:28:53,383 --> 00:28:56,517 - O2 sats are 91. BP's down to 83/50. 698 00:28:56,560 --> 00:28:58,519 - Drains are full. 699 00:28:58,562 --> 00:29:00,956 - [groans] - Belly's firm. 700 00:29:01,000 --> 00:29:02,392 Okay, etomidate and sux, then transduce 701 00:29:02,436 --> 00:29:03,654 to a bladder pressure. Let's go. 702 00:29:03,698 --> 00:29:05,265 Hey, Avery, look at me. 703 00:29:05,308 --> 00:29:07,006 You're re-bleeding into your abdomen. 704 00:29:07,049 --> 00:29:09,530 I need to intubate and take you back to the OR, okay? 705 00:29:09,573 --> 00:29:12,359 - [groans] 706 00:29:12,402 --> 00:29:13,577 - What happened? 707 00:29:13,621 --> 00:29:14,970 - Abdominal compartment syndrome. 708 00:29:15,014 --> 00:29:17,059 We're going back to the OR. - No, no need. 709 00:29:17,103 --> 00:29:19,279 You can use a cordis catheter and decompress here. 710 00:29:19,322 --> 00:29:21,020 - There's too much blood. We don't have enough time. 711 00:29:21,063 --> 00:29:22,543 I'm in. Bag her. 712 00:29:22,586 --> 00:29:24,371 - And if you open her up, there'll be too much swelling, 713 00:29:24,414 --> 00:29:26,199 and you'll never be able to close. 714 00:29:26,242 --> 00:29:27,374 - Get the cordis. 715 00:29:29,506 --> 00:29:31,552 - Dr. Marcel, bladder pressure's 35. 716 00:29:31,595 --> 00:29:35,556 [beeping] - It's too high. 717 00:29:35,599 --> 00:29:37,297 We need to open her up to release the pressure. 718 00:29:37,340 --> 00:29:38,385 Get me a 10 blade. 719 00:29:38,428 --> 00:29:39,560 - Dr. Marcel, I already told you-- 720 00:29:39,603 --> 00:29:42,215 - Back off, Dr. Blake. Here we go. Ready? 721 00:29:42,258 --> 00:29:46,001 [beeping] 722 00:29:46,045 --> 00:29:52,138 ♪ 723 00:29:53,487 --> 00:29:57,578 - Sats are up to 96 and BP's 112/83. 724 00:29:57,621 --> 00:29:59,580 She's stable. 725 00:29:59,623 --> 00:30:01,669 - All right, get her up to the OR. 726 00:30:01,712 --> 00:30:03,236 ♪ 727 00:30:03,279 --> 00:30:04,585 - Make sure you get her swelling down. 728 00:30:04,628 --> 00:30:06,108 ♪ 729 00:30:06,152 --> 00:30:08,241 You're gonna need to close her up as soon as possible. 730 00:30:08,284 --> 00:30:15,291 ♪ 731 00:30:27,738 --> 00:30:30,089 - How is Alex? 732 00:30:30,132 --> 00:30:33,135 - Um, his surgery just ended. 733 00:30:33,179 --> 00:30:34,571 He's doing really well. 734 00:30:34,615 --> 00:30:36,747 - Alex probably hates me. 735 00:30:36,791 --> 00:30:39,185 I want to tell him I'm really, really sorry. 736 00:30:39,228 --> 00:30:40,534 - You'll be able to see him soon. 737 00:30:40,577 --> 00:30:43,450 And then you can tell him. - Can I see him now? 738 00:30:44,625 --> 00:30:47,323 - I'm not supposed to let you until he's in his room. 739 00:30:47,367 --> 00:30:49,151 - Please? 740 00:30:51,327 --> 00:30:54,113 - Okay, maybe we could just take a quick peek. 741 00:30:54,156 --> 00:30:56,071 If it's okay with your parents. 742 00:30:56,115 --> 00:30:57,768 - Mom, can I go with the doctor? 743 00:30:57,812 --> 00:30:59,379 - Yeah, honey. 744 00:30:59,422 --> 00:31:01,685 - Okey doke, let's go. 745 00:31:06,299 --> 00:31:07,691 So he's still a little sleepy, 746 00:31:07,735 --> 00:31:09,693 so we're just gonna give him a quick wave hi, okay? 747 00:31:15,351 --> 00:31:17,353 - That's not Alex. 748 00:31:17,397 --> 00:31:18,615 - It's okay. 749 00:31:18,659 --> 00:31:20,313 He's just a little bandaged from surgery. 750 00:31:20,356 --> 00:31:22,489 - I didn't do that. - No, of course you didn't. 751 00:31:22,532 --> 00:31:24,186 - I didn't mean to. No, I'm sorry. 752 00:31:24,230 --> 00:31:25,187 I'm sorry. - Hey, hey, Ryan, 753 00:31:25,231 --> 00:31:26,406 Ryan, Ryan, it's okay. 754 00:31:26,449 --> 00:31:27,755 Listen to me. Listen to me. Ryan, look, 755 00:31:27,798 --> 00:31:29,017 you didn't do anything wrong. - Stop it. 756 00:31:29,061 --> 00:31:30,149 - Ryan! 757 00:31:31,715 --> 00:31:34,196 Ryan! Ryan! 758 00:31:34,240 --> 00:31:41,247 ♪ 759 00:31:50,517 --> 00:31:52,475 I'm so sorry. This is all my fault. 760 00:31:52,519 --> 00:31:53,650 - The security camera picked him up. 761 00:31:53,694 --> 00:31:54,869 We're okay. 762 00:31:54,913 --> 00:31:57,176 - Still, I just can't apologize enough. 763 00:31:57,219 --> 00:31:58,873 Maybe I should talk to his parents or-- 764 00:31:58,917 --> 00:32:00,266 - You know what? 765 00:32:00,309 --> 00:32:01,615 I think it's probably better if I handle this. 766 00:32:01,658 --> 00:32:03,530 Listen, Vanessa, not your fault. 767 00:32:03,573 --> 00:32:04,748 Okay? 768 00:32:04,792 --> 00:32:06,533 You were trying to help. 769 00:32:06,576 --> 00:32:09,449 ♪ 770 00:32:09,492 --> 00:32:11,190 - Ryan, your brother just had surgery. 771 00:32:11,233 --> 00:32:14,889 That's why he looks like that. He's gonna be fine, buddy. 772 00:32:14,933 --> 00:32:17,065 Now, can you please come out? 773 00:32:18,632 --> 00:32:19,850 - Please, Ryan? 774 00:32:19,894 --> 00:32:25,117 ♪ 775 00:32:25,160 --> 00:32:27,423 - Mind if I give it a try? - Yes. 776 00:32:29,295 --> 00:32:30,600 - Hey, Ryan. 777 00:32:34,256 --> 00:32:35,431 You know what? 778 00:32:36,693 --> 00:32:39,609 I don't think that you wanted to hurt your brother today. 779 00:32:41,916 --> 00:32:44,179 I think the only reason you threw that toy today 780 00:32:44,223 --> 00:32:47,226 was because you didn't know what else to do. 781 00:32:48,749 --> 00:32:50,272 - I got so mad. 782 00:32:52,274 --> 00:32:54,798 - 'Cause those feelings, they just... 783 00:32:54,842 --> 00:32:57,801 They just keep building and building. 784 00:32:59,629 --> 00:33:01,501 - Uh-huh. I can't stop them. 785 00:33:01,544 --> 00:33:03,546 And I'm always getting in trouble. 786 00:33:07,550 --> 00:33:09,552 - What if I told you that I didn't think that 787 00:33:09,596 --> 00:33:13,252 that was your fault? - That's not what people say. 788 00:33:13,295 --> 00:33:15,254 They're always telling me to reset. 789 00:33:15,297 --> 00:33:17,473 - Well, you know what? I don't think it's your fault. 790 00:33:19,432 --> 00:33:22,783 Not only that, you know those--those feeling you get? 791 00:33:24,176 --> 00:33:25,960 I get them, too. 792 00:33:26,004 --> 00:33:27,744 - You do? - Oh, yeah. 793 00:33:27,788 --> 00:33:30,269 Everybody does. 794 00:33:30,312 --> 00:33:35,448 And one of the things that really helps me when I get them 795 00:33:35,491 --> 00:33:37,493 is, actually, to talk about them. 796 00:33:38,842 --> 00:33:41,628 You know, there's this weird magic when you-- 797 00:33:41,671 --> 00:33:43,630 when you get them out. 798 00:33:43,673 --> 00:33:47,634 They just--they just don't seem to bother you as much. 799 00:33:48,678 --> 00:33:50,289 - Really? - Yeah. 800 00:33:51,551 --> 00:33:55,729 And I guarantee you, whatever feeling you're having 801 00:33:55,772 --> 00:33:58,210 there are people in your life-- 802 00:33:58,253 --> 00:34:01,778 they want to hear about it. I mean, your mom and dad... 803 00:34:01,822 --> 00:34:04,868 They would really want to hear about them. 804 00:34:04,912 --> 00:34:07,784 - They would? - Of course we would, honey. 805 00:34:10,048 --> 00:34:12,267 - And you won't think that I'm bad? 806 00:34:13,312 --> 00:34:15,662 - Ryan, we never think you're bad. 807 00:34:15,705 --> 00:34:22,712 ♪ 808 00:34:30,068 --> 00:34:33,332 - I got you. 809 00:34:33,375 --> 00:34:40,382 ♪ 810 00:34:41,731 --> 00:34:43,907 - You really don't think this is ADHD? 811 00:34:44,691 --> 00:34:45,822 - I don't think it is. 812 00:34:48,564 --> 00:34:52,220 - So this Adderall isn't helping? 813 00:34:52,264 --> 00:34:54,483 - I think it's actually making it worse. 814 00:34:54,527 --> 00:35:01,534 ♪ 815 00:35:09,933 --> 00:35:10,108 . 816 00:35:10,151 --> 00:35:12,110 - Hey, I just saw Eleanor's biopsy results. 817 00:35:12,153 --> 00:35:15,025 Churg-Strauss. 818 00:35:15,069 --> 00:35:18,159 - Hey, maybe we work well together after all. 819 00:35:18,203 --> 00:35:20,727 - Maybe we do. 820 00:35:20,770 --> 00:35:22,468 I'll see you tomorrow. - See you tomorrow. 821 00:35:22,511 --> 00:35:25,732 Oh, I made a few calls. 822 00:35:25,775 --> 00:35:30,302 It was definitely Mandelbrot. [laughter] 823 00:35:30,345 --> 00:35:32,869 Bye. 824 00:35:32,913 --> 00:35:34,175 - Bye. 825 00:35:34,219 --> 00:35:37,483 - Will, I just met Eleanor. 826 00:35:37,526 --> 00:35:41,139 Churg-Strauss, one in a million. 827 00:35:41,182 --> 00:35:42,792 - Yeah. 828 00:35:42,836 --> 00:35:44,272 - Though I did see you had to pull her Vas-COM. 829 00:35:44,316 --> 00:35:46,448 - Yeah, I hated to do it. 830 00:35:46,492 --> 00:35:48,058 Uh, but she was throwing emboli, 831 00:35:48,102 --> 00:35:49,582 had some cold fingers and toes-- 832 00:35:49,625 --> 00:35:51,105 - Hey, hey, Will, you absolutely did the right thing. 833 00:35:51,149 --> 00:35:52,628 The last thing we need is for the Vas-COM 834 00:35:52,672 --> 00:35:54,500 to be used inappropriately and then it gets a bad rap. 835 00:35:54,543 --> 00:35:56,806 - That--that's what I thought, too. 836 00:35:56,850 --> 00:35:59,200 - Now that she's stable, however, it did seem 837 00:35:59,244 --> 00:36:01,202 medically warranted to get her on better monitoring again, 838 00:36:01,246 --> 00:36:03,030 so I just put in another Vas-COM. 839 00:36:03,073 --> 00:36:04,249 ♪ 840 00:36:04,292 --> 00:36:05,641 - Okay. 841 00:36:05,685 --> 00:36:07,948 - Anyway, I'm glad you're coming to the conference. 842 00:36:07,991 --> 00:36:10,211 - Yeah, same here. 843 00:36:10,255 --> 00:36:12,387 - Hey, maybe, um, if you get there early. 844 00:36:12,431 --> 00:36:13,388 we could have a drink? 845 00:36:13,432 --> 00:36:16,174 - Sure. 846 00:36:16,217 --> 00:36:23,181 ♪ 847 00:36:31,841 --> 00:36:34,279 - [groans] So what do you think? 848 00:36:36,324 --> 00:36:37,934 - What do I think? 849 00:36:37,978 --> 00:36:42,417 Um, I think that they have made a crucial breakthrough. 850 00:36:42,461 --> 00:36:44,071 And now they got some work to do. 851 00:36:45,638 --> 00:36:47,814 - Yeah, you know, it's something-- 852 00:36:47,857 --> 00:36:50,251 how easy it is, even in a loving family, 853 00:36:50,295 --> 00:36:52,166 to feel so unseen. 854 00:36:52,210 --> 00:36:53,298 - Huh? 855 00:36:55,865 --> 00:36:58,999 - I guess I didn't always appreciate how good I had it. 856 00:36:59,042 --> 00:37:05,048 ♪ 857 00:37:11,446 --> 00:37:15,320 - Your numbers look good. And your drains are clear. 858 00:37:18,061 --> 00:37:19,062 - [groans] 859 00:37:22,022 --> 00:37:24,329 - So, if you get thirsty, 860 00:37:24,372 --> 00:37:27,027 you can just ask the nurses for some ice chips. 861 00:37:34,948 --> 00:37:36,558 - Ice chips. 862 00:37:38,256 --> 00:37:40,345 - [laughs] 863 00:37:48,527 --> 00:37:50,920 - Finally going to get some sleep? 864 00:37:50,964 --> 00:37:53,445 - Boards aren't going to study for themselves. 865 00:37:54,533 --> 00:37:56,012 - Believe me, a nap wouldn't hurt. 866 00:37:58,363 --> 00:38:00,495 Anyway, I'm going to run this boy's Adderall 867 00:38:00,539 --> 00:38:03,890 over to the pharmacy, then I'm out of here. 868 00:38:07,415 --> 00:38:10,549 - All right, well, um, see you tomorrow. 869 00:38:11,593 --> 00:38:13,334 - Hey, Vanessa, 870 00:38:13,378 --> 00:38:15,597 I know how tough internship can be. 871 00:38:15,641 --> 00:38:18,600 But everyone here already sees what a good doctor you are. 872 00:38:20,994 --> 00:38:22,430 - Thanks, Maggie. 873 00:38:24,693 --> 00:38:26,086 - Yeah. 874 00:38:28,175 --> 00:38:29,350 - Hey, Mike. - Hey, Phil. 875 00:38:29,394 --> 00:38:33,049 ♪ 876 00:38:33,093 --> 00:38:34,355 - Hey, Dad. 877 00:38:34,399 --> 00:38:36,575 - Hey, Dylan, what are you doing here? 878 00:38:36,618 --> 00:38:39,969 - Oh, you know, stopping by. - Okay. 879 00:38:40,013 --> 00:38:41,144 - Italian beef? 880 00:38:42,145 --> 00:38:45,323 - Is that Al's? Oh, come on. 881 00:38:45,366 --> 00:38:47,063 It's been a long time. - I know. 882 00:38:47,107 --> 00:38:48,195 Ever since you used to bring them 883 00:38:48,238 --> 00:38:49,370 to me every day at medical school. 884 00:38:49,414 --> 00:38:51,329 - [laughs] 885 00:38:51,372 --> 00:38:53,113 Really, that was just so I could get one, too. 886 00:38:53,156 --> 00:38:54,984 - [laughs] 887 00:38:55,028 --> 00:38:57,247 Here you go. - Thank you. 888 00:38:57,291 --> 00:38:58,423 Mmm, mmm, mmm. - Yeah. 889 00:39:01,295 --> 00:39:03,558 You know, um, 890 00:39:03,602 --> 00:39:07,127 just wanted to say thank you, Dad. 891 00:39:08,433 --> 00:39:10,957 - For what? Bringing you sandwiches? 892 00:39:12,045 --> 00:39:13,438 - No, no. 893 00:39:14,743 --> 00:39:16,528 For everything. 894 00:39:16,571 --> 00:39:23,578 ♪ 895 00:39:31,369 --> 00:39:32,761 - Okay, you know what, boy? 896 00:39:32,805 --> 00:39:34,241 How many times I got to tell you 897 00:39:34,284 --> 00:39:36,199 you got to ask for extra giardiniera over there? 898 00:39:36,243 --> 00:39:43,119 ♪ 899 00:39:43,163 --> 00:39:44,556 [phone dings] 900 00:39:52,041 --> 00:39:54,609 - Dr. Marcel, this is Enid, from Dr. Blake's service. 901 00:39:54,653 --> 00:39:56,524 Dr. Blake has a kidney transplant 902 00:39:56,568 --> 00:39:58,787 that she would like you to scrub in on. 903 00:39:58,831 --> 00:40:00,485 Uh, please be here in half an hour. 904 00:40:10,059 --> 00:40:11,757 - [sighs] 905 00:40:11,800 --> 00:40:19,025 ♪ 906 00:40:24,160 --> 00:40:25,423 [clears throat] 907 00:40:25,466 --> 00:40:32,430 ♪ 908 00:41:50,812 --> 00:41:52,814 [wolf howls]