1
00:00:01,168 --> 00:00:02,604
Previously on
The Good Doctor...
2
00:00:02,737 --> 00:00:04,271
You go going
to the club or work?
3
00:00:04,404 --> 00:00:06,106
Yeah, these early calls
are gonna take
some getting used to.
4
00:00:06,240 --> 00:00:07,509
Browne retractor.
5
00:00:07,642 --> 00:00:09,076
No Browne retractor.
6
00:00:09,209 --> 00:00:10,612
I thought I put it on
your tray from the supply room.
7
00:00:10,745 --> 00:00:12,145
Dr. Kalu
is not your peer.
8
00:00:12,279 --> 00:00:13,848
He's your employee,
and you are his boss.
9
00:00:13,982 --> 00:00:16,818
I do not plan to give Jared
special treatment.
10
00:00:16,951 --> 00:00:19,621
And if I see it, it won't
be good for either of you.
11
00:00:19,754 --> 00:00:21,823
I'm not expecting
special treatment, Shaun,
12
00:00:21,956 --> 00:00:24,157
but I don't appreciate being
treated like an intern either.
13
00:00:24,291 --> 00:00:26,995
Dr. Andrews said
he is judging my performance
off of your performance,
14
00:00:27,127 --> 00:00:29,096
and your performance
is not good.
15
00:00:29,229 --> 00:00:32,634
You come in
with your fancy car
and your old tricks and think,
16
00:00:32,767 --> 00:00:35,369
"Ta-da, I'm a surgeon,"
but you're not.
17
00:00:35,503 --> 00:00:36,971
I just want to prove
that I belong here.
18
00:00:37,104 --> 00:00:39,007
When I checked
on Yara post-operatively,
19
00:00:39,139 --> 00:00:40,875
I noticed you only used
eight sutures when you closed,
20
00:00:41,009 --> 00:00:42,544
and she had a small bleed.
You should have used ten.
21
00:00:42,677 --> 00:00:44,879
Dr. Glassman
closed the galea and skin.
22
00:00:45,013 --> 00:00:48,482
-Dr. Glassman
skipped two sutures?
-Guess so.
23
00:00:54,822 --> 00:00:57,157
At what time did you wake up
yesterday morning?
24
00:00:57,291 --> 00:00:59,259
The usual, 5:30. Why?
25
00:00:59,393 --> 00:01:01,629
At lunch,
you had a Cobb salad
with balsamic vinaigrette,
26
00:01:01,763 --> 00:01:04,097
so that's
450 calories ingested,
assuming you kept it down.
27
00:01:04,231 --> 00:01:06,034
Yes, I kept it down.
28
00:01:06,166 --> 00:01:09,202
Did you use a sauna,
engage in rigorous exercise,
and/or experience diarrhea?
29
00:01:09,336 --> 00:01:10,772
No, I didn't do
any of those things.
30
00:01:10,905 --> 00:01:12,372
What's with the questions,
Shaun?
31
00:01:12,507 --> 00:01:14,576
You made an error
in yesterday's craniotomy.
32
00:01:14,709 --> 00:01:16,443
I'm trying to evaluate
various factors
33
00:01:16,578 --> 00:01:18,245
that would negatively
impact focus.
34
00:01:18,378 --> 00:01:19,413
I made an error?
35
00:01:19,547 --> 00:01:21,448
You closed
with only eight sutures.
36
00:01:21,583 --> 00:01:23,283
The size of the wound
required ten.
37
00:01:23,417 --> 00:01:24,786
We need to figure out why.
38
00:01:24,919 --> 00:01:26,721
Why do we need
to figure out why?
39
00:01:26,854 --> 00:01:28,656
Two sutures, it's a blip.
It's not a thing.
40
00:01:28,790 --> 00:01:31,893
It could be part
of a more troubling pattern
needing attention.
41
00:01:32,026 --> 00:01:34,862
-Shaun, the surgery
was a success, right?
-Yes.
42
00:01:34,996 --> 00:01:36,296
The patient had
a great outcome.
43
00:01:36,430 --> 00:01:37,532
There is no pattern.
44
00:01:39,033 --> 00:01:40,334
Goodbye.
45
00:01:47,240 --> 00:01:50,078
I'm a surgeon,
and I belong here.
46
00:01:50,210 --> 00:01:52,780
I'm a surgeon,
and I belong here.
47
00:01:58,553 --> 00:02:01,889
You are a surgeon,
and you belong here.
48
00:02:03,758 --> 00:02:05,526
I just keep imagining you
in the mirror
49
00:02:05,660 --> 00:02:09,931
like, "You have the hair
of Tracee Ellis Ross
and the swag of Beyonce."
50
00:02:10,064 --> 00:02:11,431
Do not shame my self-care.
51
00:02:13,701 --> 00:02:15,770
Affirmations are backed
by research.
52
00:02:16,904 --> 00:02:18,472
fMRI evidence
shows a correlation
53
00:02:18,606 --> 00:02:21,408
with positive changes
in the brain.
54
00:02:21,542 --> 00:02:23,578
I've just put
the finishing touches
on a surprise.
55
00:02:24,846 --> 00:02:26,114
Drum roll please.
56
00:02:28,482 --> 00:02:30,118
Or not.
57
00:02:30,250 --> 00:02:31,619
Well, get your song lists ready
58
00:02:31,753 --> 00:02:33,788
because you are all
officially invited to...
59
00:02:37,558 --> 00:02:40,293
Star Karaoke, 7:00 p.m.
until question mark,
question mark.
60
00:02:40,427 --> 00:02:43,598
You know it's gonna be a party
when there's double punctuation
involved.
61
00:02:43,731 --> 00:02:46,601
Yeah, just the chance
to unwind and get to know
you all a little better.
62
00:02:46,734 --> 00:02:48,736
Sounds fun.
Thanks for the invite.
63
00:02:48,870 --> 00:02:52,272
Prepare to be destroyed.
My "Someone Like You" slays.
64
00:02:52,406 --> 00:02:55,143
Need a surgical consult
for a clinic patient
with a dislocated patella.
65
00:02:55,275 --> 00:02:57,344
Mm, sorry, ER.
66
00:02:59,013 --> 00:03:01,849
You two are it. Room one.
67
00:03:07,121 --> 00:03:09,791
When did the chest pain start?
68
00:03:09,924 --> 00:03:11,491
I first noticed it
Tuesday morning
69
00:03:11,626 --> 00:03:13,027
along with shortness of breath.
70
00:03:14,162 --> 00:03:16,296
Are you taking
any medications?
71
00:03:16,430 --> 00:03:18,633
I started with one,
then switched a few times.
72
00:03:20,501 --> 00:03:22,570
These are used to treat ADHD.
73
00:03:22,704 --> 00:03:24,371
And brain fog.
74
00:03:24,505 --> 00:03:25,338
I'm a COVID long-hauler.
75
00:03:27,175 --> 00:03:31,646
Um, and I just
started guanfacine
and N-acetylcysteine,
76
00:03:31,779 --> 00:03:35,183
which may actually be
helping finally.
77
00:03:35,315 --> 00:03:38,019
-When was
your initial infection?
-Eight months ago.
78
00:03:38,152 --> 00:03:40,722
It just felt like a mild flu,
but then it got worse,
79
00:03:40,855 --> 00:03:43,191
like someone poured molasses
on my brain.
80
00:03:43,323 --> 00:03:45,193
I've done cognitive therapy,
81
00:03:45,325 --> 00:03:47,128
memory exercises,
82
00:03:47,260 --> 00:03:48,563
still am,
83
00:03:48,696 --> 00:03:50,665
whatever I can do
to get back in the field.
84
00:03:51,498 --> 00:03:53,101
-Which one?
-Clover.
85
00:03:54,702 --> 00:03:55,670
I'm an evolutionary biologist.
86
00:03:56,571 --> 00:03:58,371
-Oh.
-Wow.
87
00:03:58,506 --> 00:04:02,309
I have been studying
how white clover adapts
to environmental changes...
88
00:04:03,878 --> 00:04:07,215
And I'm on indefinite leave.
89
00:04:07,347 --> 00:04:08,549
Please stop talking now.
90
00:04:11,018 --> 00:04:13,755
Bluish skin, low O2 levels,
rapid heart rate.
91
00:04:13,888 --> 00:04:15,255
And increasingly
labored breathing.
92
00:04:15,388 --> 00:04:16,891
Possible pulmonary embolism.
93
00:04:17,024 --> 00:04:19,227
Order a chest CTA and echo,
stat.
94
00:04:19,359 --> 00:04:20,094
I have to go.
95
00:04:28,069 --> 00:04:29,070
Oh.
96
00:04:32,405 --> 00:04:33,775
You will need this.
97
00:04:33,908 --> 00:04:35,910
I sent one half
of a high volume order
to your printer.
98
00:04:37,578 --> 00:04:40,347
These are
Glassman's op reports?
99
00:04:40,480 --> 00:04:42,415
For the last three months.
January to March.
100
00:04:42,550 --> 00:04:45,418
October to December is printing
in Park's and my office.
101
00:04:45,553 --> 00:04:48,288
So you sent reports
for, like, 100 surgeries
to my printer?
102
00:04:48,421 --> 00:04:50,725
No, 176 surgeries.
103
00:04:50,858 --> 00:04:52,693
473 pages.
104
00:04:52,827 --> 00:04:54,929
I've emailed Operations
to replace your toner.
105
00:04:55,062 --> 00:04:56,731
Many elements are in color.
106
00:04:56,864 --> 00:04:58,766
And why, exactly,
do you need all of this?
107
00:05:00,001 --> 00:05:02,402
To find out
if his mistake was a blip.
108
00:05:16,584 --> 00:05:18,351
Second time
I've dislocated my knee.
109
00:05:18,485 --> 00:05:21,656
Uh, first was
a few months ago, I think.
110
00:05:21,789 --> 00:05:23,925
-That was the sprained ankle.
-Ah.
111
00:05:24,058 --> 00:05:25,927
The dislocation was last year.
112
00:05:26,060 --> 00:05:29,329
Your MRI shows
no associated damage
to bones or ligaments.
113
00:05:30,598 --> 00:05:34,035
She's also been complaining
about dizziness,
114
00:05:34,168 --> 00:05:37,505
swollen ankles,
maybe menopause-related.
115
00:05:37,638 --> 00:05:40,107
Dr. Reznick is looking
to get her on
hormone replacement therapy.
116
00:05:40,241 --> 00:05:42,910
Orion insisted I come in
and get everything checked out
117
00:05:43,044 --> 00:05:45,713
before she leaves
and moves 6,000 miles away
118
00:05:45,847 --> 00:05:47,682
to live alone.
119
00:05:47,815 --> 00:05:50,685
I'm moving to Prague
next week for a new job,
120
00:05:50,818 --> 00:05:52,720
and you can come visit me
anytime you want, Mom.
121
00:05:52,854 --> 00:05:53,855
Not with
a busted knee.
122
00:05:54,889 --> 00:05:56,489
To move forward with HRT,
123
00:05:56,624 --> 00:05:58,125
I need to confirm
all the medications
124
00:05:58,259 --> 00:05:59,861
you've used
over the last five years.
125
00:05:59,994 --> 00:06:04,298
Oh, uh, there was
a purple triangle one,
126
00:06:04,431 --> 00:06:06,767
but they took me off that
last year
127
00:06:06,901 --> 00:06:08,970
and an orange-shaped one.
128
00:06:09,103 --> 00:06:10,104
I'll review it with you.
129
00:06:12,006 --> 00:06:14,141
We need to see
how your knee is moving.
130
00:06:14,275 --> 00:06:15,309
Lay back, please.
131
00:06:19,146 --> 00:06:21,048
Go ahead
with the exam, Dr. Kalu.
132
00:06:22,283 --> 00:06:23,351
I thought I'd observe.
133
00:06:23,483 --> 00:06:24,752
It's a knee exam,
134
00:06:24,886 --> 00:06:27,054
not a multi-ligament
reconstruction.
135
00:06:27,188 --> 00:06:29,624
You told me last time
not to assume
I know everything.
136
00:06:29,757 --> 00:06:30,825
This is just making me
do your job.
137
00:06:37,198 --> 00:06:39,834
That sounded like
an apneic spell.
Check her tonsils.
138
00:06:40,501 --> 00:06:41,502
Ms. Garcia.
139
00:06:45,106 --> 00:06:46,340
Mm?
140
00:06:46,473 --> 00:06:49,010
Oh, did I fall asleep again?
141
00:06:49,143 --> 00:06:50,477
Yes.
142
00:06:50,611 --> 00:06:52,046
Can I take a quick look
in your mouth?
143
00:06:52,179 --> 00:06:53,413
Mm-hmm.
144
00:06:56,517 --> 00:06:57,985
Kissing tonsils.
145
00:06:58,119 --> 00:06:59,587
They're so enlarged,
they're touching
146
00:06:59,720 --> 00:07:01,856
and obstructing your airway,
causing severe apnea.
147
00:07:03,057 --> 00:07:04,491
You need a tonsillectomy
right away.
148
00:07:09,897 --> 00:07:12,833
No pulmonary embolism,
but multiple cardiac issues.
149
00:07:12,967 --> 00:07:14,769
Severe narrowing
of the pulmonic valve,
150
00:07:14,902 --> 00:07:16,436
hypertrophied right ventricle
151
00:07:16,570 --> 00:07:18,072
and opening between
the lower chambers.
152
00:07:18,205 --> 00:07:20,875
This set of defects
almost looks like
153
00:07:21,008 --> 00:07:22,310
-tetralogy of Fallot, but--
-It is.
154
00:07:24,645 --> 00:07:26,446
She has
the fourth malformation,
155
00:07:26,580 --> 00:07:27,882
overriding aorta.
156
00:07:28,015 --> 00:07:30,051
I've never seen tet
in an adult before.
157
00:07:32,219 --> 00:07:33,888
How is she still alive?
158
00:07:35,589 --> 00:07:36,857
Hang on a sec.
159
00:07:36,991 --> 00:07:37,925
I have to write
everything down now.
160
00:07:40,661 --> 00:07:42,797
Tet is almost always
diagnosed in infancy.
161
00:07:42,930 --> 00:07:44,899
Doctors somehow missed it
in your case.
162
00:07:45,032 --> 00:07:47,068
Oh, you have
a rare presentation.
163
00:07:47,201 --> 00:07:49,070
The right ventricle obstruction
has been balanced
164
00:07:49,203 --> 00:07:51,405
by an increased flow
into the left ventricle.
165
00:07:51,539 --> 00:07:54,241
Damage from COVID
disrupted the balance.
166
00:07:54,375 --> 00:07:55,743
The virus may have
saved your life.
167
00:07:55,876 --> 00:07:57,311
Very few undiagnosed
tet patients
168
00:07:57,445 --> 00:07:58,612
survive past childhood.
169
00:07:58,746 --> 00:08:00,581
A mere 2% make it to 40.
170
00:08:00,715 --> 00:08:02,016
You're saying
171
00:08:02,149 --> 00:08:03,617
I would have just dropped dead
at some point?
172
00:08:03,751 --> 00:08:05,820
It's very likely.
173
00:08:05,953 --> 00:08:09,457
We can remove that risk
with two separate procedures.
174
00:08:09,590 --> 00:08:11,759
First, we'll close
the extra vessels
175
00:08:11,892 --> 00:08:14,328
that have formed to compensate
for your heart defects.
176
00:08:14,462 --> 00:08:16,297
Then we'll do a surgery
to repair those defects.
177
00:08:19,433 --> 00:08:21,535
Is it possible
the tet is connected
178
00:08:21,669 --> 00:08:23,004
to my long COVID symptoms?
179
00:08:23,137 --> 00:08:24,939
Could fixing my heart
clear up my head,
180
00:08:26,607 --> 00:08:27,775
the brain?
181
00:08:28,743 --> 00:08:31,212
No. I'm sorry.
182
00:08:40,654 --> 00:08:41,856
You snagged our table.
183
00:08:42,957 --> 00:08:44,525
Beat Hawks and Nunez to it.
184
00:08:44,658 --> 00:08:46,360
You're a champion.
185
00:08:46,494 --> 00:08:48,963
One Splenda,
half Sugar in the Raw,
light almond milk.
186
00:08:49,096 --> 00:08:50,097
Now who's the champion?
187
00:08:50,231 --> 00:08:50,965
Mm.
188
00:08:54,869 --> 00:08:55,970
I have something for you.
189
00:08:57,304 --> 00:08:58,472
-Really?
-Mm-hmm.
190
00:09:05,446 --> 00:09:08,349
An agreement acknowledging
a consensual relationship.
191
00:09:08,482 --> 00:09:10,718
I, Marcus Andrews,
would like to take you,
192
00:09:10,851 --> 00:09:13,387
Dalisay Villanueva, on a date.
193
00:09:13,522 --> 00:09:17,324
And as hospital president,
you know, I already signed it.
194
00:09:19,660 --> 00:09:20,494
This is so romantic.
195
00:09:21,662 --> 00:09:22,696
Give me the pen.
196
00:09:29,970 --> 00:09:32,373
-Dinner this weekend?
-Let me see.
197
00:09:32,507 --> 00:09:34,842
Oh, I'm needed on the ward.
198
00:09:34,975 --> 00:09:36,310
Sorry. Lock it down later?
199
00:09:36,444 --> 00:09:37,211
Sure.
200
00:09:45,453 --> 00:09:46,387
Iced coffee?
201
00:09:46,521 --> 00:09:47,721
I'm good.
202
00:09:48,889 --> 00:09:50,024
How about a hot coffee?
203
00:09:52,693 --> 00:09:55,696
In honor of Daphne's
successful tonsillectomy,
204
00:09:55,830 --> 00:09:57,031
I got a few options.
205
00:09:58,866 --> 00:10:00,367
Is that a latte?
206
00:10:00,502 --> 00:10:01,235
Mm.
207
00:10:03,538 --> 00:10:05,739
It was a routine tonsillectomy.
208
00:10:05,873 --> 00:10:07,441
Those were
unusually large tonsils.
209
00:10:09,143 --> 00:10:10,211
A good thing her daughter
brought her in.
210
00:10:13,314 --> 00:10:14,782
You think Daphne was
better off not breathing?
211
00:10:14,915 --> 00:10:16,350
I don't think
it's a daughter's job
212
00:10:16,484 --> 00:10:18,052
to make sure
Mom goes to the doctor.
213
00:10:21,689 --> 00:10:22,623
It's Daphne.
214
00:10:25,392 --> 00:10:26,894
Heart rate spiked.
She's hypoxic.
215
00:10:27,027 --> 00:10:28,129
Turn up oxygen to max flow.
216
00:10:32,733 --> 00:10:34,902
Loud murmur from
the right ventricle and atrium.
217
00:10:35,035 --> 00:10:36,704
Chronic damage from apnea
could have increased
218
00:10:36,837 --> 00:10:38,439
the pressure in her lungs,
causing right heart failure.
219
00:10:38,573 --> 00:10:40,207
BP's dropping.
220
00:10:40,341 --> 00:10:41,242
We need to get her
to the cath lab.
221
00:10:47,281 --> 00:10:48,517
Positioning
coiling system.
222
00:10:50,117 --> 00:10:51,418
Two vessels
left to close.
223
00:10:52,953 --> 00:10:54,088
Deploying the coil.
224
00:10:56,924 --> 00:10:59,460
O2 sats are dropping.
225
00:10:59,594 --> 00:11:03,063
Her infundibular muscle
is clamping down.
226
00:11:03,197 --> 00:11:05,534
She is having a tet spell.
227
00:11:06,500 --> 00:11:08,802
Give phenylephrine
and 100% oxygen.
228
00:11:08,936 --> 00:11:10,605
I have never seen one
in-person before.
229
00:11:12,406 --> 00:11:13,974
We need to move blood
up to the lungs.
230
00:11:14,108 --> 00:11:15,910
Give her a bolus
and up the opiates.
231
00:11:20,414 --> 00:11:21,815
If we don't stop the spasm,
232
00:11:21,949 --> 00:11:23,150
she could have
permanent brain damage.
233
00:11:34,828 --> 00:11:37,632
The chance
of a future infundibular spasm
is very high.
234
00:11:39,333 --> 00:11:42,269
Her tet repair surgery
will be much more risky.
235
00:11:50,277 --> 00:11:52,514
Pressure in Daphne's lungs
is still critically high.
236
00:11:52,647 --> 00:11:54,148
Not a routine
tonsillectomy at all.
237
00:11:55,416 --> 00:11:56,551
Puncturing the atrial septum.
238
00:11:58,485 --> 00:12:01,155
Right heart is decompressing.
239
00:12:01,288 --> 00:12:04,391
Give nitric oxide to relax
and dilate the vasculature.
240
00:12:04,526 --> 00:12:07,529
Her apnea really did a number
on her pulmonary vessels.
241
00:12:07,662 --> 00:12:09,863
No wonder
she's clumsy and forgetful.
242
00:12:09,997 --> 00:12:13,200
She's been sleep-
and oxygen-deprived
for decades.
243
00:12:13,334 --> 00:12:15,936
It still doesn't make her
her daughter's responsibility.
244
00:12:16,070 --> 00:12:18,372
Would you want Kellan
to put his life on hold
to take care of you?
245
00:12:19,473 --> 00:12:21,842
Not his whole life, no,
246
00:12:21,976 --> 00:12:24,845
but I don't think
being overly devoted
is the worst quality in a kid.
247
00:12:24,979 --> 00:12:26,180
Remove the catheters.
248
00:12:27,616 --> 00:12:29,950
I was one of six growing up,
only girl.
249
00:12:30,084 --> 00:12:31,519
Mom and dad worked a lot,
250
00:12:31,653 --> 00:12:33,988
so I was basically
second mom since kindergarten.
251
00:12:35,456 --> 00:12:36,591
I love my brothers, but...
252
00:12:39,026 --> 00:12:41,395
there's a lot you miss out on
253
00:12:41,529 --> 00:12:43,497
if you're all about taking care
of someone else.
254
00:12:48,035 --> 00:12:49,903
She's throwing a lot of PVCs.
255
00:12:50,037 --> 00:12:51,238
Maybe an electrolyte issue.
256
00:12:54,408 --> 00:12:56,410
BP's dropping. Heart rate 172.
257
00:12:56,544 --> 00:12:59,113
We're barely getting a pulse.
She's in V-tach. Defib pads.
258
00:13:17,264 --> 00:13:18,799
BP and heart rate stabilizing.
259
00:13:21,101 --> 00:13:22,970
Get a new chemistry,
chest X-ray, EKG.
260
00:13:23,103 --> 00:13:24,606
We need to figure out what else
is going on with her heart.
261
00:13:35,115 --> 00:13:37,051
Oh, please don't disturb
my materials.
262
00:13:37,184 --> 00:13:40,287
Which are what, exactly?
263
00:13:40,421 --> 00:13:42,590
Dr. Glassman made
an uncharacteristic
surgical error.
264
00:13:42,724 --> 00:13:44,391
I am determining
if it was an anomaly
265
00:13:44,526 --> 00:13:46,293
or part of a pattern.
266
00:13:46,427 --> 00:13:48,128
Glassman must be
really pleased about that.
267
00:13:48,262 --> 00:13:49,263
He is not.
268
00:13:50,331 --> 00:13:51,566
You are being sarcastic.
269
00:13:51,700 --> 00:13:53,267
Performance review
is a standard practice
270
00:13:53,400 --> 00:13:55,069
and benefits both doctors
and patients.
271
00:13:55,202 --> 00:13:57,971
I have identified
three additional errors
made in the last four months.
272
00:13:58,105 --> 00:13:59,674
I don't see a pattern.
273
00:13:59,808 --> 00:14:02,276
A dural tear on scarred tissue,
274
00:14:02,409 --> 00:14:03,977
closing with a running nylon
instead of Monocryl--
275
00:14:04,111 --> 00:14:05,346
Is that even a mistake?
276
00:14:05,479 --> 00:14:08,248
Dr. Glassman has always used
subcutaneous Monocryl.
277
00:14:08,382 --> 00:14:10,752
These are variations,
minor missteps.
278
00:14:10,884 --> 00:14:13,120
You pore through four months
of any surgeon's op reports,
279
00:14:13,253 --> 00:14:14,522
and you'll find discrepancies
like this.
280
00:14:15,155 --> 00:14:17,291
-No.
-Yes.
281
00:14:17,424 --> 00:14:18,693
Not in mine.
282
00:14:19,493 --> 00:14:21,895
That's probably true.
283
00:14:22,029 --> 00:14:23,598
Eh, if you're not finding
a pattern,
284
00:14:24,733 --> 00:14:25,866
maybe it's because
there isn't one.
285
00:14:29,537 --> 00:14:30,538
My patient is awake.
286
00:14:32,841 --> 00:14:36,310
Does this mean you can't move
forward with the tet repair?
287
00:14:36,443 --> 00:14:38,212
There's a medication
called propranolol
288
00:14:38,345 --> 00:14:39,947
that will
significantly reduce the risk
289
00:14:40,080 --> 00:14:42,216
of having another spasm
during surgery,
290
00:14:42,349 --> 00:14:43,818
but because of your long COVID,
291
00:14:43,951 --> 00:14:45,587
you're at risk for some
very rare side effects.
292
00:14:46,487 --> 00:14:48,556
-Are they serious?
-Yes.
293
00:14:48,690 --> 00:14:50,424
Well, some of them are not,
like nausea, vomiting,
294
00:14:50,558 --> 00:14:52,493
muscle aches, and dizziness,
but others,
295
00:14:52,627 --> 00:14:54,529
such as hypoglycemia
or visual changes--
296
00:14:54,662 --> 00:14:56,263
We'll start you
on the propranolol.
297
00:14:56,397 --> 00:14:58,932
There's a good chance
you won't experience
the rare side effects,
298
00:14:59,066 --> 00:15:00,602
but we'll need to keep
a close eye on you.
299
00:15:03,036 --> 00:15:04,238
And are those patients
ahead of her
300
00:15:04,371 --> 00:15:05,939
also seniors with diabetes?
301
00:15:07,207 --> 00:15:08,442
Do not hang up on me, Phillip,
302
00:15:08,576 --> 00:15:09,577
or I'll head down
to do this in person.
303
00:15:10,545 --> 00:15:11,345
I'll wait.
304
00:15:13,113 --> 00:15:13,848
Hey.
305
00:15:16,183 --> 00:15:19,888
There is a great new
Portuguese spot I read about.
306
00:15:20,020 --> 00:15:22,791
I can make reservations for us
Friday or Saturday at 7:00?
307
00:15:24,592 --> 00:15:26,326
Uh, I'm working a double
both days.
308
00:15:26,460 --> 00:15:28,563
It's been a nonstop scramble
since Baker and Linh left.
309
00:15:28,696 --> 00:15:30,565
Well, you have
two new travelers
starting on Monday.
310
00:15:30,698 --> 00:15:31,932
We need staff nurses.
311
00:15:32,065 --> 00:15:33,400
These nurses
are highly skilled. We--
312
00:15:33,535 --> 00:15:35,068
It doesn't matter
how skilled they are.
313
00:15:35,202 --> 00:15:36,704
Travel nurses disrupt workflow,
314
00:15:36,838 --> 00:15:38,472
don't build
long-term relationships.
315
00:15:38,606 --> 00:15:41,509
Right now, we just
don't have the resources
for permanent replacements.
316
00:15:41,643 --> 00:15:43,578
You just hired a new
full-time surgical resident
317
00:15:43,711 --> 00:15:45,112
to replace someone
who left way more recently.
318
00:15:45,245 --> 00:15:46,648
That was Lim's department. I--
319
00:15:47,749 --> 00:15:49,416
Yes, great.
I'm sending her down.
320
00:15:50,718 --> 00:15:51,886
Sorry. We'll talk later?
321
00:15:52,052 --> 00:15:52,821
Of course.
322
00:15:56,089 --> 00:15:58,358
So you're watching
to see if I throw up?
323
00:15:58,492 --> 00:16:00,394
Or faint, seize,
or have muscle spasms.
324
00:16:05,499 --> 00:16:07,968
You know, before COVID,
my brain was--
325
00:16:09,436 --> 00:16:12,272
I did evolutionary patterns,
326
00:16:12,406 --> 00:16:14,809
genetic, uh...
327
00:16:16,310 --> 00:16:18,680
how genes go together.
328
00:16:20,247 --> 00:16:21,248
The sequence.
329
00:16:24,218 --> 00:16:26,186
Now my brain can't handle
the sequence
of brushing my teeth.
330
00:16:28,690 --> 00:16:32,092
My focus, my working memory,
all of the...
331
00:16:35,530 --> 00:16:37,765
The executive function.
332
00:16:40,267 --> 00:16:43,003
It's not always happening.
333
00:16:46,173 --> 00:16:48,843
Please page
Dr. Wolke to monitor her
and stay until he comes.
334
00:16:51,211 --> 00:16:52,446
Push your hand against mine.
335
00:16:53,882 --> 00:16:56,049
The pattern is errors
in executive function.
336
00:16:56,183 --> 00:16:57,351
Shaun, I'm in the middle
of doing something.
337
00:16:57,484 --> 00:17:00,354
Your brain cancer
may have returned.
338
00:17:06,961 --> 00:17:09,096
-All errors are tied
to executive function.
-Shaun--
339
00:17:09,229 --> 00:17:11,365
Specifically to working
and procedural memory governed
340
00:17:11,498 --> 00:17:12,967
by the dorsolateral
prefrontal cortex,
341
00:17:13,100 --> 00:17:14,869
a common site
for a recurrent glioma,
342
00:17:15,003 --> 00:17:18,105
which strongly suggests
your cancer has returned.
343
00:17:18,238 --> 00:17:21,208
My last scan came back
completely clear. I'm fine.
344
00:17:21,341 --> 00:17:22,777
Your last scan
was six months ago.
345
00:17:22,911 --> 00:17:25,212
These errors all took place
in the last four months.
346
00:17:25,345 --> 00:17:26,648
So you need another scan.
347
00:17:26,781 --> 00:17:28,016
The evidence
is very compelling.
348
00:17:28,148 --> 00:17:29,349
No, it's really not.
349
00:17:29,483 --> 00:17:31,886
I perform complex surgeries,
Shaun,
350
00:17:32,020 --> 00:17:34,822
more so than any other doctor
on this staff, by the way.
351
00:17:34,956 --> 00:17:36,858
So yeah,
the percentages would dictate
352
00:17:36,991 --> 00:17:40,828
that I might make more minor
and irrelevant missteps,
353
00:17:40,962 --> 00:17:42,864
if that's what you want
to call them, and--
354
00:17:42,997 --> 00:17:44,566
And the rate of errors
has increased.
355
00:17:44,699 --> 00:17:47,234
Yeah, because I take on
the tougher cases,
356
00:17:47,367 --> 00:17:48,503
the ones no one else will.
357
00:17:48,636 --> 00:17:51,639
No, you need another MRI now.
358
00:17:51,773 --> 00:17:53,808
Shaun, what I need
is to get back to my patient.
359
00:17:53,942 --> 00:17:57,244
And you need to knock first
next time.
360
00:18:01,849 --> 00:18:03,216
It's the greening of the--
361
00:18:04,953 --> 00:18:06,153
My turn.
362
00:18:08,556 --> 00:18:10,190
I'm trying to get some
of my cognitive exercises in.
363
00:18:10,324 --> 00:18:12,326
What are you memorizing?
364
00:18:12,459 --> 00:18:14,261
It's a poem from
The Carrying, Ada Limon.
365
00:18:14,394 --> 00:18:15,395
Hmm.
366
00:18:15,530 --> 00:18:17,097
The collection
is mostly about...
367
00:18:19,667 --> 00:18:22,537
not having the life
you thought you'd have,
I guess.
368
00:18:24,072 --> 00:18:28,610
The one I was just reading,
it's about spring coming,
369
00:18:28,743 --> 00:18:30,745
Instructions on Not Giving Up.
370
00:18:31,646 --> 00:18:33,480
-Sounds useful.
-Yeah.
371
00:18:33,615 --> 00:18:34,582
Too bad I can't read it
all at once.
372
00:18:35,650 --> 00:18:38,185
I've just graduated
from haikus.
373
00:18:38,318 --> 00:18:40,622
I never even thought to look
at a poem before I got sick.
374
00:18:42,523 --> 00:18:44,324
Didn't have the patience
for it at the time,
375
00:18:45,593 --> 00:18:46,995
but it's basically
all I read now.
376
00:18:48,261 --> 00:18:49,764
I started writing, too.
377
00:18:49,897 --> 00:18:53,433
It's kind of
a creative therapy.
378
00:18:53,568 --> 00:18:55,135
Mm.
379
00:18:55,268 --> 00:18:58,372
There was a kind of poetry
380
00:18:58,506 --> 00:19:01,308
to the genetic variations
in white clover too.
381
00:19:04,979 --> 00:19:06,346
I'd give anything to...
382
00:19:12,285 --> 00:19:13,821
Your blood pressure
is going down,
383
00:19:13,955 --> 00:19:14,989
and your heart rate's climbing.
384
00:19:15,123 --> 00:19:16,124
I feel kind of dizzy.
385
00:19:16,256 --> 00:19:17,025
Let me check your glucose.
386
00:19:21,294 --> 00:19:23,463
She's having a seizure.
Crash cart now!
387
00:19:26,067 --> 00:19:28,168
We thought
something else was going on
with your heart,
388
00:19:28,301 --> 00:19:29,436
but it's a kidney issue.
389
00:19:29,570 --> 00:19:31,171
You have a narrowing
of your renal arteries,
390
00:19:31,304 --> 00:19:33,306
which was exacerbated
by the pulmonary hypertension,
391
00:19:33,440 --> 00:19:34,474
causing your kidneys to fail.
392
00:19:34,609 --> 00:19:36,711
And this is
because of my sleep apnea?
393
00:19:36,844 --> 00:19:38,746
We believe so, yeah.
394
00:19:38,880 --> 00:19:41,616
Uh, can she get a transplant?
395
00:19:41,749 --> 00:19:43,985
I can do a test,
see if I'm a match.
396
00:19:44,118 --> 00:19:47,487
Unfortunately,
your other health concerns
rule out a transplant,
397
00:19:47,622 --> 00:19:52,026
but a renal artery bypass
would allow your kidneys
to heal on their own.
398
00:19:52,160 --> 00:19:54,629
There's risk of complications,
some quite serious.
399
00:19:56,229 --> 00:20:00,601
But in success, you could live
a full, independent life.
400
00:20:00,735 --> 00:20:03,905
But-- oh, but serious,
401
00:20:04,038 --> 00:20:06,641
as in I could die?
402
00:20:06,774 --> 00:20:09,777
Some complications
can be fatal.
403
00:20:09,911 --> 00:20:11,646
But the risk is relatively low.
404
00:20:12,914 --> 00:20:14,615
Are there other options?
405
00:20:15,348 --> 00:20:16,951
Well, there's dialysis,
406
00:20:17,085 --> 00:20:19,821
but you'd need
multiple sessions a week
for the rest of your life.
407
00:20:22,389 --> 00:20:25,693
Um, that's less risky, but I--
408
00:20:27,128 --> 00:20:30,297
I don't think I could handle
all that on my own.
409
00:20:30,430 --> 00:20:34,669
Mom, Mom, if you want
to choose the dialysis,
I'll stay in San Jose.
410
00:20:37,171 --> 00:20:38,238
I'm sorry.
411
00:20:39,574 --> 00:20:40,842
I don't want to keep you.
412
00:20:40,975 --> 00:20:44,045
No, you have nothing
to be sorry for.
413
00:20:44,178 --> 00:20:46,681
All this time you've been sick
and struggling, and I--
414
00:20:48,182 --> 00:20:48,916
I judged you.
415
00:20:50,317 --> 00:20:51,451
But your new job.
416
00:20:54,155 --> 00:20:54,922
It's just a job.
417
00:21:03,998 --> 00:21:06,968
So the medication you gave me
418
00:21:07,101 --> 00:21:09,436
to make my surgery safer
419
00:21:09,570 --> 00:21:11,906
will actually make it
more risky?
420
00:21:12,039 --> 00:21:12,774
That's right.
421
00:21:13,841 --> 00:21:15,408
But without that medication,
422
00:21:15,543 --> 00:21:18,212
I'm much more likely
to have another tet spell.
423
00:21:18,345 --> 00:21:21,983
Yes, and possibly more severe
than the last time.
424
00:21:22,116 --> 00:21:25,385
The brain fog,
all my deficits...
425
00:21:27,255 --> 00:21:28,122
could get worse,
426
00:21:30,258 --> 00:21:31,726
for possibly forever?
427
00:21:33,060 --> 00:21:34,128
Yes.
428
00:21:35,863 --> 00:21:37,598
But if we don't do
the tet repair,
429
00:21:37,732 --> 00:21:39,734
your heart will stop
at some point.
430
00:21:43,204 --> 00:21:45,039
I've already been through
431
00:21:45,173 --> 00:21:48,543
losing my thoughts,
my whole self.
432
00:21:52,814 --> 00:21:53,815
I can't do that again.
433
00:21:59,086 --> 00:22:00,588
Find another way
to fix my heart.
434
00:22:19,040 --> 00:22:20,942
All right, new idea.
435
00:22:21,075 --> 00:22:23,311
We go back to the old idea
and just do the surgery.
436
00:22:23,443 --> 00:22:25,046
It's a non-starter.
437
00:22:25,179 --> 00:22:27,949
We need to present a way
to help her tet
without triggering her tet.
438
00:22:28,082 --> 00:22:30,818
A percutaneous valve
and VSD closure
could help with blood flow.
439
00:22:30,952 --> 00:22:32,320
That involves catheters
in the heart,
440
00:22:32,452 --> 00:22:33,788
which would cause
the muscle to spasm.
441
00:22:34,956 --> 00:22:37,158
All right.
It's time for some WWSMD.
442
00:22:37,291 --> 00:22:39,694
Whatever you and Jerome do
on your own time is--
443
00:22:39,827 --> 00:22:40,828
It's "what would
Shaun Murphy do?"
444
00:23:17,765 --> 00:23:18,733
What about a shunt?
445
00:23:20,034 --> 00:23:22,003
It would improve blood flow,
buy a few months
446
00:23:22,136 --> 00:23:23,804
to continue
her cognitive recovery.
447
00:23:23,938 --> 00:23:25,840
Once she feels better
about where her brain's at,
448
00:23:25,973 --> 00:23:27,440
maybe she lets us
fix her heart.
449
00:23:27,575 --> 00:23:29,911
Her tet will likely kill her
before that,
450
00:23:30,044 --> 00:23:34,081
but placing a shunt
won't trigger a spell,
451
00:23:34,215 --> 00:23:35,850
making it something
she'd actually accept.
452
00:23:38,653 --> 00:23:40,855
I'll take it to her.
453
00:23:42,256 --> 00:23:43,925
I can stay only 45 minutes.
454
00:23:44,058 --> 00:23:46,127
I have to review
Dr. Glassman's OR videos.
455
00:23:46,260 --> 00:23:47,494
Didn't you already review them?
456
00:23:47,628 --> 00:23:49,230
Not for symptoms
of glioma recurrence.
457
00:23:49,363 --> 00:23:51,599
New evidence will convince
Dr. Glassman to get a scan.
458
00:23:51,732 --> 00:23:54,368
Okay, you binged months
of data in one day.
459
00:23:54,502 --> 00:23:55,770
You'll have a clearer head
in the morning.
460
00:23:55,903 --> 00:23:58,572
Until then,
here we are, karaoke rager.
461
00:23:58,706 --> 00:24:00,274
-Yay.
-It is yay.
462
00:24:00,408 --> 00:24:02,610
We have song lists.
Plus Jared's our friend.
463
00:24:02,743 --> 00:24:04,345
He just moved back.
Celebration is in order.
464
00:24:05,646 --> 00:24:07,949
I will review the videos
in the morning.
465
00:24:08,082 --> 00:24:08,883
Yay!
466
00:24:09,817 --> 00:24:11,252
It sounds pretty wild in there.
467
00:24:26,767 --> 00:24:28,936
I was just warming up.
468
00:24:29,070 --> 00:24:31,906
-Where is everyone?
-There is a lot of food.
469
00:24:32,039 --> 00:24:34,108
Yeah, I had it catered.
You're the first to arrive.
470
00:24:35,176 --> 00:24:37,912
And so far,
last-minute rain checks
471
00:24:38,045 --> 00:24:40,414
from Morgan, Park,
Asher, Danny.
472
00:24:41,916 --> 00:24:42,917
Oh, and Jerome.
473
00:24:45,553 --> 00:24:46,787
So it's just us four?
474
00:24:46,921 --> 00:24:50,424
Which means
that all these snacks
475
00:24:50,558 --> 00:24:53,461
and song binders are for us.
476
00:24:53,594 --> 00:24:55,663
Oh. Yes.
477
00:24:55,796 --> 00:24:58,699
The low turnout
is the perfect opportunity
to discuss symptoms.
478
00:25:00,634 --> 00:25:02,536
In your recent surgeries
with Dr. Glassman,
479
00:25:02,670 --> 00:25:04,205
do you recall observing
any balance issues,
480
00:25:04,338 --> 00:25:05,773
tremors, or motor weakness?
481
00:25:11,245 --> 00:25:12,813
That sounds like
the perfect option.
482
00:25:14,148 --> 00:25:16,283
How soon can you do
the shunt procedure?
483
00:25:16,417 --> 00:25:18,552
I'll try to schedule it
for tomorrow.
484
00:25:23,424 --> 00:25:25,526
I've had a strange year myself.
485
00:25:28,863 --> 00:25:30,531
Eleven months ago,
486
00:25:30,664 --> 00:25:31,899
I was attacked
487
00:25:32,033 --> 00:25:33,968
and paralyzed
from the waist down.
488
00:25:35,302 --> 00:25:37,772
I thought it was permanent.
Almost everyone did.
489
00:25:40,941 --> 00:25:44,979
At first, all I wanted
was to walk again.
490
00:25:46,480 --> 00:25:49,683
I was ready to risk my life
to get back to the old me.
491
00:25:51,318 --> 00:25:52,453
But as time went on,
492
00:25:53,888 --> 00:25:58,527
I started to appreciate
my new life, my new self.
493
00:26:01,295 --> 00:26:03,197
I started a new relationship
494
00:26:03,330 --> 00:26:04,899
that wouldn't
have happened otherwise.
495
00:26:07,501 --> 00:26:09,003
In many ways, my life improved.
496
00:26:10,539 --> 00:26:12,673
You recognize you walked in
to tell me this story?
497
00:26:14,875 --> 00:26:16,343
I only agreed to do the surgery
498
00:26:16,477 --> 00:26:17,778
once I knew
my life wasn't at risk.
499
00:26:17,912 --> 00:26:20,081
And even then, I had doubts.
500
00:26:22,149 --> 00:26:23,851
I liked who I'd become.
501
00:26:23,984 --> 00:26:25,319
I wanted to hold on to her.
502
00:26:29,690 --> 00:26:30,691
I'm not...
503
00:26:33,694 --> 00:26:34,895
losing my mind...
504
00:26:36,831 --> 00:26:37,898
all over again.
505
00:26:40,968 --> 00:26:43,037
You don't strike me
as someone who's lost her mind.
506
00:27:01,122 --> 00:27:02,823
That covers the thrombectomy.
507
00:27:02,957 --> 00:27:03,991
In February,
you assisted on a--
508
00:27:04,125 --> 00:27:07,261
Okay, I'm playing
the pregnant lady card.
509
00:27:08,796 --> 00:27:09,930
We're going, Shaun.
510
00:27:10,064 --> 00:27:11,065
Okay.
511
00:27:12,534 --> 00:27:14,068
Thank you. Goodbye.
512
00:27:15,769 --> 00:27:17,071
I should head out, too.
513
00:27:18,906 --> 00:27:21,075
-Early morning.
-Yeah.
514
00:27:25,379 --> 00:27:28,583
Maybe focus on being
a first-year resident
515
00:27:28,716 --> 00:27:32,554
before adding party planner
to your resume.
516
00:27:35,055 --> 00:27:36,790
The catering may have been
a bridge too far.
517
00:27:37,758 --> 00:27:38,792
Yeah.
518
00:27:43,598 --> 00:27:44,765
I bounced around growing up.
519
00:27:46,967 --> 00:27:50,104
Different schools,
cities, countries.
520
00:27:51,640 --> 00:27:55,276
But, um, wherever we were,
my parents had a big house,
521
00:27:56,343 --> 00:27:57,579
and I knew
how to throw a party.
522
00:28:00,981 --> 00:28:03,918
Closest I'd get
to feeling like I fit.
523
00:28:06,987 --> 00:28:08,122
Old habits die hard, I guess.
524
00:28:11,025 --> 00:28:12,927
Fitting in takes time.
525
00:28:13,994 --> 00:28:16,764
But I never have, anywhere.
526
00:28:21,670 --> 00:28:22,637
Maybe not everyone
527
00:28:24,371 --> 00:28:25,172
finds their place.
528
00:28:30,844 --> 00:28:32,713
Daphne is getting septic.
We have to go.
529
00:28:39,787 --> 00:28:41,855
Morning.
530
00:28:41,989 --> 00:28:43,390
Hello.
531
00:28:43,525 --> 00:28:44,559
Mm.
532
00:28:46,460 --> 00:28:47,995
You should not have that.
533
00:28:48,128 --> 00:28:50,464
I'm permitted 12 ounces a day.
Experts agree.
534
00:28:50,599 --> 00:28:53,500
Yes, but that was brewed
when I woke up at 3:30 a.m.
535
00:28:56,237 --> 00:28:57,771
You make it through the videos?
536
00:28:57,905 --> 00:29:00,307
Yes, and integrated
the observations
537
00:29:00,441 --> 00:29:02,009
Doctors Kalu and Allen
made last night
538
00:29:02,142 --> 00:29:04,178
regarding possible
glioma symptoms.
539
00:29:07,181 --> 00:29:09,950
I am now ready
to present Dr. Glassman
with the revised evidence,
540
00:29:10,084 --> 00:29:11,720
which is very compelling.
541
00:29:11,852 --> 00:29:12,853
Mm.
542
00:29:16,156 --> 00:29:19,561
Thankfully, your infection
is responding
to the antibiotics.
543
00:29:19,694 --> 00:29:22,396
The infection started
around your dialysis port.
544
00:29:22,530 --> 00:29:23,964
That could easily happen again.
545
00:29:25,600 --> 00:29:28,703
The renal artery bypass
is still an option.
546
00:29:28,836 --> 00:29:30,204
It's too risky.
547
00:29:30,871 --> 00:29:31,606
So is sepsis.
548
00:29:33,675 --> 00:29:36,578
Thank you, Doctor,
but I'll settle
for being alive.
549
00:29:36,711 --> 00:29:37,512
You shouldn't.
550
00:29:40,080 --> 00:29:41,115
You deserve more than that.
551
00:29:42,449 --> 00:29:44,552
I know you've had a whole life
of feeling sick
552
00:29:44,686 --> 00:29:48,255
and stuck and repeating
the same old, bad patterns,
553
00:29:48,389 --> 00:29:50,692
but your past does not
have to tell your future
where to go.
554
00:29:55,062 --> 00:29:57,097
You can choose a different path
555
00:29:57,231 --> 00:29:59,099
and who you're gonna be on it.
556
00:30:01,268 --> 00:30:02,936
And let your daughter
do the same.
557
00:30:08,242 --> 00:30:09,678
Prague is beautiful
in the spring.
558
00:30:47,582 --> 00:30:49,450
We've scheduled
the shunt placement
for this afternoon.
559
00:30:51,485 --> 00:30:53,020
And that whole speech
last night?
560
00:30:53,153 --> 00:30:55,989
I stand by it,
but it's your decision.
561
00:31:01,929 --> 00:31:04,833
I've been waiting
for the old me
to come back, and...
562
00:31:09,236 --> 00:31:10,772
That person
may not exist anymore.
563
00:31:13,708 --> 00:31:14,542
And...
564
00:31:17,277 --> 00:31:18,680
maybe I should be okay
with that.
565
00:31:24,786 --> 00:31:25,720
Do the tet repair.
566
00:31:41,034 --> 00:31:42,336
Releasing
the proximal clamp.
567
00:31:45,005 --> 00:31:46,340
What made Daphne
change her mind?
568
00:31:47,876 --> 00:31:49,544
Dr. Allen has a way
of getting through to people.
569
00:31:54,348 --> 00:31:56,216
Blood flow looks obstructed.
570
00:31:56,350 --> 00:31:57,384
There's a kink in the graft.
571
00:31:59,386 --> 00:32:01,121
We can undo it,
but most likely,
it happens again.
572
00:32:05,392 --> 00:32:09,396
We could anchor the bypass
off of the aorta instead.
573
00:32:09,531 --> 00:32:11,031
At that angle,
less chance of a kink.
574
00:32:14,067 --> 00:32:15,068
Could work.
575
00:32:28,148 --> 00:32:29,651
- Extending the incision.
- -Sternal saw.
576
00:32:34,656 --> 00:32:36,558
Starting the sternotomy.
577
00:32:38,492 --> 00:32:39,393
O2 dropped to 78.
578
00:32:40,427 --> 00:32:42,296
-65.
-She's having a tet spell.
579
00:32:42,429 --> 00:32:45,667
Give her 500 cc fluid bolus
and 100% oxygen.
580
00:32:45,800 --> 00:32:48,469
Giving a mini bolus
to increase pulmonary flow.
581
00:32:51,438 --> 00:32:54,809
O2 sats are 50. 45.
582
00:32:54,943 --> 00:32:56,210
Come on, come on.
583
00:32:58,713 --> 00:33:00,582
Give her more oxygen
and up the opiates.
584
00:33:02,249 --> 00:33:03,317
It has
stopped registering.
585
00:33:21,903 --> 00:33:23,303
O2's rising.
586
00:33:25,573 --> 00:33:26,440
Heart rate's stabilizing.
587
00:33:29,944 --> 00:33:32,780
She was in
prolonged gross hypoxia.
588
00:33:32,914 --> 00:33:35,449
That could extend
cognitive deficits...
589
00:33:36,818 --> 00:33:38,653
or worse.
590
00:33:38,786 --> 00:33:40,254
We won't know
until she wakes.
591
00:33:40,387 --> 00:33:41,956
Let's get her on bypass
before she has another one.
592
00:33:45,259 --> 00:33:46,460
-Okay.
-Mm-hmm.
593
00:33:47,529 --> 00:33:50,030
To a successful
renal artery bypass.
594
00:33:50,163 --> 00:33:52,834
Cheers.
Facilitated by moving speech
595
00:33:52,967 --> 00:33:54,536
from a wise
and persuasive surgeon.
596
00:33:54,669 --> 00:33:57,572
Mm, with a great
surgical save by a guy
597
00:33:57,705 --> 00:34:00,474
who's about to have
some life-changing tacos.
598
00:34:00,608 --> 00:34:01,475
Okay.
599
00:34:05,013 --> 00:34:07,015
Mm! Oh, my God.
600
00:34:07,147 --> 00:34:09,617
Okay, these are amaz--
you're amazing!
601
00:34:09,751 --> 00:34:12,319
Told you. Blue corn tortillas.
602
00:34:12,452 --> 00:34:14,488
- Mm-hmm.
I can get used to this.
603
00:34:18,225 --> 00:34:20,995
-You have some lettuce there.
-Oh.
604
00:34:21,128 --> 00:34:23,665
-No, no, no, mirror image.
-Mm.
605
00:34:23,798 --> 00:34:24,899
Now?
606
00:34:25,033 --> 00:34:26,568
-No.
-No laughing.
607
00:34:26,701 --> 00:34:27,702
No, right, right, right. Very--
608
00:34:27,835 --> 00:34:29,336
Very serious matter.
609
00:34:34,174 --> 00:34:36,878
Here. Um, yeah.
610
00:34:37,011 --> 00:34:38,245
Oh.
611
00:34:38,378 --> 00:34:39,847
Just a little bit more.
612
00:34:51,391 --> 00:34:53,962
-We should go.
-Mm.
613
00:34:54,094 --> 00:34:58,098
-Yeah.
-Um, we need to get back early
for Daphne's post-op.
614
00:34:58,231 --> 00:35:01,101
Yeah, right. Um, let's go.
615
00:35:09,711 --> 00:35:12,245
The bypass went smoothly,
and post-op labs look good.
616
00:35:13,213 --> 00:35:14,114
We expect a full recovery.
617
00:35:15,750 --> 00:35:16,718
How are you feeling, Mom?
618
00:35:18,586 --> 00:35:19,621
I'm...
619
00:35:19,754 --> 00:35:23,558
Breathing.
620
00:35:23,691 --> 00:35:25,827
Kind of feels like
the first time in my life.
621
00:35:27,862 --> 00:35:31,599
The post-op swelling
from the tonsillectomy
has gone down.
622
00:35:31,733 --> 00:35:34,434
You're finally breathing
without any obstruction.
623
00:35:34,569 --> 00:35:37,204
You'll need to stay
on top of your medications
and follow-up visits,
624
00:35:37,337 --> 00:35:38,940
observe some
dietary guidelines,
625
00:35:39,073 --> 00:35:41,408
but the discharge plan
lays it all out.
626
00:35:42,677 --> 00:35:44,045
I'll be there to help, Mom.
627
00:35:47,015 --> 00:35:47,982
No.
628
00:35:50,217 --> 00:35:51,385
You won't.
629
00:35:55,857 --> 00:35:57,625
You need to live your own life.
630
00:36:01,461 --> 00:36:04,264
But I... I will accept
FaceTime calls.
631
00:36:05,733 --> 00:36:07,200
And once I recover,
632
00:36:08,870 --> 00:36:10,270
I'll come visit.
633
00:36:14,909 --> 00:36:17,277
I hear that Prague
is beautiful in the spring.
634
00:36:21,415 --> 00:36:22,684
That sounds like a plan.
635
00:36:34,662 --> 00:36:36,898
Mm, things not go well
with Glassy?
636
00:36:37,031 --> 00:36:39,199
He returned the files
with a note saying
637
00:36:39,332 --> 00:36:42,170
he did not look at them
and does not intend to.
638
00:36:42,302 --> 00:36:44,806
I'm sorry. He probably--
639
00:36:44,939 --> 00:36:46,874
It was a mistake
to leave them for him
to read on his own.
640
00:36:47,008 --> 00:36:50,878
Once I reorder the files,
I will go to his office
to review with him in person.
641
00:36:51,012 --> 00:36:52,714
He made it pretty clear
he doesn't want to see them.
642
00:36:52,847 --> 00:36:55,149
But he doesn't know
about the new evidence.
643
00:36:55,282 --> 00:36:57,217
Maybe he doesn't want to know.
644
00:36:57,350 --> 00:37:00,154
Cancer survivors
have to live with
that uncertainty that--
645
00:37:00,287 --> 00:37:01,656
Knowing is better
than not knowing.
646
00:37:04,726 --> 00:37:07,028
If he's not ready
to look at this,
647
00:37:07,161 --> 00:37:08,663
you can't force him.
648
00:37:10,198 --> 00:37:12,700
Maybe he's scared, Shaun.
649
00:37:13,801 --> 00:37:15,670
And I think
maybe you're scared, too.
650
00:37:17,370 --> 00:37:19,741
We're about to have a baby,
651
00:37:19,874 --> 00:37:22,210
you're about to be a dad,
652
00:37:22,342 --> 00:37:24,645
and I think you're worried
about family,
653
00:37:24,779 --> 00:37:26,080
and Glassman is a part of that.
654
00:37:28,082 --> 00:37:31,251
But if you keep pushing,
you risk damaging
655
00:37:31,384 --> 00:37:33,688
one of the most important
relationships in your life.
656
00:37:43,898 --> 00:37:44,699
Hey.
657
00:37:48,335 --> 00:37:49,269
-Hey.
-Hey.
658
00:37:52,740 --> 00:37:54,208
I've been thinking,
659
00:37:54,341 --> 00:37:55,710
and I need a break
from our coffees.
660
00:37:56,409 --> 00:37:58,112
Dalisay--
661
00:37:58,246 --> 00:37:59,714
I don't think dinner's
a good idea either.
662
00:38:01,381 --> 00:38:03,483
So we have
a different point of view
about hospital business.
663
00:38:03,618 --> 00:38:05,787
That doesn't change
the way I feel about you.
664
00:38:05,920 --> 00:38:07,588
On or off the clock,
I'm the same person.
665
00:38:08,823 --> 00:38:11,559
To me, if you don't value
what the nurses do
666
00:38:11,692 --> 00:38:14,394
enough to treat us
like a resource to invest in,
667
00:38:14,529 --> 00:38:15,897
not a line item to be cut,
668
00:38:17,565 --> 00:38:18,733
how much can you care about me?
669
00:38:20,535 --> 00:38:21,602
And to be honest,
670
00:38:22,837 --> 00:38:24,138
if that is
your point of view...
671
00:38:27,175 --> 00:38:28,743
it undercuts
the respect I have for you.
672
00:38:40,621 --> 00:38:43,257
Harper Louise Decrane,
673
00:38:43,390 --> 00:38:45,760
March 30, 1994.
674
00:38:46,961 --> 00:38:47,995
And do you know
why you're here?
675
00:38:49,197 --> 00:38:50,131
For my heart issues.
676
00:38:53,601 --> 00:38:54,769
I had another tet spell,
didn't I?
677
00:38:56,304 --> 00:38:57,905
We'll need
to conduct more tests,
678
00:38:58,039 --> 00:39:00,174
but your speech
and memory seem intact.
679
00:39:00,308 --> 00:39:03,343
And with regard to your heart,
we expect a full recovery.
680
00:39:03,476 --> 00:39:07,014
And with time,
you may recover your full
cognitive abilities as well.
681
00:39:07,648 --> 00:39:08,649
Maybe.
682
00:39:10,284 --> 00:39:13,988
But for now,
I'll just focus on being here.
683
00:39:29,904 --> 00:39:31,806
"It's the greening of the trees
684
00:39:32,640 --> 00:39:34,041
That really gets to me
685
00:39:35,943 --> 00:39:38,813
When all the shock
of white and taffy
686
00:39:38,946 --> 00:39:41,515
Leave the pavement strewn
With the confetti of aftermath
687
00:39:43,851 --> 00:39:44,852
The leaves come
688
00:39:46,320 --> 00:39:47,822
Patient, plodding
689
00:39:49,924 --> 00:39:52,994
A green skin growing over
Whatever winter did to us
690
00:39:55,796 --> 00:39:59,567
A return to the strange idea
Of continuous living
691
00:39:59,700 --> 00:40:01,002
Despite the mess of us
692
00:40:01,135 --> 00:40:02,670
The hurt, the empty..."
693
00:40:03,838 --> 00:40:04,839
Shaun, what?
694
00:40:06,307 --> 00:40:08,910
Lea thinks that because
I'm going to be a dad,
695
00:40:10,344 --> 00:40:12,113
I am worried about my family.
696
00:40:14,215 --> 00:40:15,683
Okay.
697
00:40:15,816 --> 00:40:18,519
She also thinks you are scared.
698
00:40:19,954 --> 00:40:21,656
I'm not scared, Shaun.
I'm fine.
699
00:40:21,789 --> 00:40:24,692
She says if you don't want
to do the scan,
I should let it go.
700
00:40:29,163 --> 00:40:30,031
She...
701
00:40:32,465 --> 00:40:33,868
is right.
702
00:40:35,703 --> 00:40:36,871
Good. Thank you.
703
00:40:39,373 --> 00:40:40,708
I am scared.
704
00:40:54,555 --> 00:40:55,423
Dr. Glassman...
705
00:41:00,361 --> 00:41:03,898
I am asking you to do the scan
706
00:41:05,533 --> 00:41:06,267
because...
707
00:41:08,402 --> 00:41:11,305
the data and the evidence
are sound...
708
00:41:17,578 --> 00:41:18,478
and because...
709
00:41:26,253 --> 00:41:28,222
it would be hard
to lose my father
710
00:41:28,356 --> 00:41:29,924
just as I am about
to become one.
711
00:41:38,566 --> 00:41:39,767
Do the scan for me.
712
00:41:52,380 --> 00:41:54,415
Shaun, I'll do the scan.
713
00:42:13,367 --> 00:42:17,204
"'Fine then, I'll take it'
The tree seems to say
714
00:42:17,338 --> 00:42:20,641
A new slick leaf unfurling
Like a fist to an open palm
715
00:42:21,709 --> 00:42:22,977
'I'll take it all'"