1
00:00:00,933 --> 00:00:02,433
Dr. Larsen was in a car accident,
2
00:00:02,458 --> 00:00:04,569
she has no recollection
of the last eight years.
3
00:00:04,593 --> 00:00:06,088
(AMY): Previously on Doc.
4
00:00:06,112 --> 00:00:08,717
- Let me run Internal Medicine.
- Back to your roots.
5
00:00:08,741 --> 00:00:10,463
When you need time to
work out things with Michael,
6
00:00:10,487 --> 00:00:12,802
I accept it, but when the shoe's
on the other foot...
7
00:00:12,826 --> 00:00:13,970
When the shoe's on the other foot,
8
00:00:13,994 --> 00:00:15,373
you have a hard time
telling me the truth.
9
00:00:15,397 --> 00:00:17,044
Delayed decisions on his care
10
00:00:17,068 --> 00:00:18,445
have been hurting him a long time.
11
00:00:18,469 --> 00:00:20,485
You don't have to tell me
the system's broken.
12
00:00:20,509 --> 00:00:23,222
How much prednisone does it
take to get you through a shift?
13
00:00:23,246 --> 00:00:25,026
You will flame out in weeks.
14
00:00:25,050 --> 00:00:26,830
It's time for you to use your greatness
15
00:00:26,854 --> 00:00:28,834
to pull the greatness out of others.
16
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I'm going to miss you.
17
00:00:38,845 --> 00:00:42,150
(COUGHING)
18
00:00:42,478 --> 00:00:44,966
Sorry. This guy loves his sleep.
19
00:00:44,990 --> 00:00:48,782
Oh, there he is. Hey, can I have a hug?
20
00:00:49,799 --> 00:00:52,398
Oh my goodness, this is yummy.
21
00:00:52,422 --> 00:00:54,720
Ethan was sorry to miss you,
he had a really early meeting.
22
00:00:54,744 --> 00:00:56,623
Well, Robbie's the main event, right?
23
00:00:56,647 --> 00:00:59,963
What fabulous holiday have they
cancelled school for this time?
24
00:00:59,987 --> 00:01:01,509
It's Lunar New Year.
25
00:01:01,533 --> 00:01:02,936
Oh, well.
26
00:01:02,960 --> 00:01:04,204
(SPEAKING MANDARIN)
27
00:01:04,228 --> 00:01:05,833
(SAMANTHA): Grandma's been
all over the world.
28
00:01:05,857 --> 00:01:07,946
You know, she could probably
teach you to say hello
29
00:01:07,970 --> 00:01:09,181
in 50 different languages.
30
00:01:09,205 --> 00:01:11,051
67, but who's counting?
31
00:01:11,324 --> 00:01:12,771
I should be back around six.
32
00:01:12,795 --> 00:01:14,306
And thanks so much for doing this.
33
00:01:14,330 --> 00:01:16,311
Are you kidding?
The more time I get to spend
34
00:01:16,335 --> 00:01:17,562
with this little man, the better.
35
00:01:17,586 --> 00:01:19,116
Oh. Brought you donuts,
36
00:01:19,140 --> 00:01:20,652
your dad said they're your favorite.
37
00:01:20,676 --> 00:01:22,082
(ROBBIE): Thanks, Grandma.
38
00:01:25,086 --> 00:01:27,423
(COUGHING)
39
00:01:28,258 --> 00:01:29,704
Joan, you okay?
40
00:01:29,728 --> 00:01:30,937
(COUGHING)
41
00:01:30,961 --> 00:01:32,093
I'm fine.
42
00:01:32,117 --> 00:01:35,081
(COUGHING AND WHEEZING)
43
00:01:35,105 --> 00:01:37,086
(SAMANTHA): Robbie,
why don't you go upstairs?
44
00:01:37,110 --> 00:01:38,989
Oh my God.
45
00:01:39,013 --> 00:01:41,027
- Grandma!
- Joan?
46
00:01:41,051 --> 00:01:42,096
Grandma!
47
00:01:42,120 --> 00:01:44,199
(COUGHING)
48
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Synced & corrected by -robtor-
www.addic7ed.com
49
00:01:54,144 --> 00:01:57,449
(INDISTINCT CHATTER)
50
00:02:02,794 --> 00:02:06,769
(TENSE MUSIC)
51
00:02:07,604 --> 00:02:09,016
Good morning, everyone.
52
00:02:09,040 --> 00:02:10,419
(ALL): Morning.
53
00:02:10,443 --> 00:02:13,057
This is going to be
an adjustment for all of us.
54
00:02:13,081 --> 00:02:15,228
Dr. Ridley certainly left
some big shoes to fill,
55
00:02:15,252 --> 00:02:18,634
and I know all these leadership
changes the past year
56
00:02:18,658 --> 00:02:21,407
have probably been unsteadying.
57
00:02:21,431 --> 00:02:24,246
There are a lot of reasons why
58
00:02:24,270 --> 00:02:26,985
I wanted to practice medicine again,
59
00:02:27,009 --> 00:02:29,256
but I want to be very clear
about the reason I asked
60
00:02:29,280 --> 00:02:31,327
to sit in that chair.
61
00:02:31,351 --> 00:02:33,664
The past year as your CMO,
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00:02:33,688 --> 00:02:35,302
I have seen what every person
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00:02:35,326 --> 00:02:37,272
standing in this room is capable of.
64
00:02:37,296 --> 00:02:38,473
Dr. Miller.
65
00:02:38,497 --> 00:02:40,813
(MICHAEL): Time and again,
you have risen to the occasion.
66
00:02:40,837 --> 00:02:43,018
(NURSE ON PHONE): We have
a sixty-two year old female
67
00:02:43,042 --> 00:02:46,224
in respiratory failure.
Complications from chronic MDS.
68
00:02:46,248 --> 00:02:47,359
I'm on my way down.
69
00:02:47,383 --> 00:02:49,697
I'm not here just to lead you,
70
00:02:49,721 --> 00:02:53,839
I want to join you, and help you
do what you already do so well.
71
00:02:53,863 --> 00:02:57,479
An issue, a problem, a suggestion,
72
00:02:57,503 --> 00:02:59,583
my door will always be open.
73
00:02:59,955 --> 00:03:03,291
Before we go, some
congratulations are in order.
74
00:03:03,315 --> 00:03:05,778
In two weeks, Dr. Maitra
75
00:03:05,802 --> 00:03:08,068
and Dr. Larsen will succeed Dr. Heller
76
00:03:08,092 --> 00:03:09,491
as Chief Residents,
77
00:03:09,515 --> 00:03:12,343
as we welcome our new class of interns.
78
00:03:12,367 --> 00:03:15,616
(APPLAUSE)
79
00:03:15,640 --> 00:03:17,118
Uh, now, if you both
80
00:03:17,142 --> 00:03:19,222
could hang back for a moment
with Dr. Heller.
81
00:03:19,246 --> 00:03:21,684
The rest of you, do good work.
82
00:03:25,025 --> 00:03:27,974
I'd like our co-chiefs to shadow you
83
00:03:27,998 --> 00:03:30,178
before you start your
pediatric fellowship.
84
00:03:30,202 --> 00:03:32,784
You can begin with Dr. Maitra this
morning, and then alternate days.
85
00:03:32,808 --> 00:03:35,112
- Yeah. Sounds like a plan.
- Great.
86
00:03:39,087 --> 00:03:40,632
It's quite a move.
87
00:03:40,656 --> 00:03:42,602
Well, it was either this
88
00:03:42,626 --> 00:03:44,333
or a leather jacket and a motorcycle.
89
00:03:46,368 --> 00:03:48,104
(CELLPHONE MESSAGE)
90
00:03:51,144 --> 00:03:52,674
Joan's in the ER.
91
00:03:53,115 --> 00:03:55,628
Paramedic said she was
extremely short of breath,
92
00:03:55,652 --> 00:03:57,968
likely bilateral pleural effusions.
93
00:03:57,992 --> 00:03:59,637
So is she hypoxic?
94
00:03:59,661 --> 00:04:02,944
Oxygenations improved on
the mask, but she's hypotensive.
95
00:04:02,968 --> 00:04:05,682
Let's push Norepi MAP goal above 65.
96
00:04:05,706 --> 00:04:07,386
No, Richard, that's not gonna work.
97
00:04:07,410 --> 00:04:08,955
- I'm sorry?
- She's on prednisone.
98
00:04:08,979 --> 00:04:11,194
30 milligrams and she's
tapered off, I read her chart.
99
00:04:11,218 --> 00:04:14,023
No, her chart's wrong,
she's on way more than that.
100
00:04:15,860 --> 00:04:19,201
I've been using it
to get through the surgery.
101
00:04:20,035 --> 00:04:21,671
You knew about this?
102
00:04:22,841 --> 00:04:25,082
How much has she been taking?
103
00:04:26,687 --> 00:04:28,024
Double that.
104
00:04:30,522 --> 00:04:32,870
Triple to get through the ex...
105
00:04:32,894 --> 00:04:34,673
vivo with Javi.
106
00:04:34,697 --> 00:04:39,173
My natural cortisol
production's gotta be shot.
107
00:04:40,543 --> 00:04:43,424
Okay. Lucy, 100 milligram bolus
108
00:04:43,448 --> 00:04:45,284
of hydrocortisone before pressors.
109
00:04:45,308 --> 00:04:47,656
And run a complete lab workup.
110
00:04:48,859 --> 00:04:51,330
We're all here if you
need anything, Joan.
111
00:04:55,172 --> 00:04:56,405
Should I call Ethan?
112
00:04:58,111 --> 00:04:59,489
He's on his way.
113
00:04:59,513 --> 00:05:03,130
But Amy, I need you to remember,
114
00:05:03,154 --> 00:05:05,092
I have a DNR.
115
00:05:05,116 --> 00:05:08,041
Joan, no, we're nowhere near that.
116
00:05:08,065 --> 00:05:10,168
(WHEEZING)
117
00:05:12,340 --> 00:05:14,076
Shh.
118
00:05:18,920 --> 00:05:20,866
Good morning, Dr. Walker.
119
00:05:20,890 --> 00:05:24,240
Good morning to you, Walter.
How's our rocket holding up?
120
00:05:24,264 --> 00:05:25,743
Can't wait to launch it.
121
00:05:25,767 --> 00:05:27,045
You think I can still leave today?
122
00:05:27,069 --> 00:05:29,483
Gotta examine you first,
can't let you out of here
123
00:05:29,507 --> 00:05:31,053
till we're sure you're all better.
124
00:05:31,623 --> 00:05:34,494
I really want to show the
rocket to the kids at the house.
125
00:05:34,518 --> 00:05:37,312
I bet. Looks like that thing
might actually make it to space.
126
00:05:37,336 --> 00:05:39,303
Do you ever launch
rockets with your kids?
127
00:05:39,327 --> 00:05:41,866
- I don't have any.
- Really?
128
00:05:42,533 --> 00:05:44,479
I thought about it when I was younger,
129
00:05:44,503 --> 00:05:46,351
but decided to take a different path.
130
00:05:46,375 --> 00:05:47,519
What do you mean?
131
00:05:47,543 --> 00:05:48,889
Well, being a parent's a big commitment.
132
00:05:48,913 --> 00:05:52,228
But that's also true
for being a friend, a sister,
133
00:05:52,252 --> 00:05:54,868
an aunt, especially a doctor.
134
00:05:54,892 --> 00:05:57,773
Eventually, I figured if I gave my best
135
00:05:57,797 --> 00:06:00,378
to all those other things,
that'd be enough for me.
136
00:06:00,402 --> 00:06:02,082
- You're a great doctor.
- Hmm.
137
00:06:02,106 --> 00:06:05,790
That she is, buddy.
Sorry I'm late, how's he doing?
138
00:06:05,814 --> 00:06:08,819
Well, breathing's much better.
Let's look at those knees.
139
00:06:11,324 --> 00:06:14,774
Oh. How long has your leg
been moving like that?
140
00:06:14,798 --> 00:06:16,912
Happens all the time with my RA.
141
00:06:16,936 --> 00:06:18,949
It shouldn't be now,
with the medication you're on.
142
00:06:18,973 --> 00:06:20,752
- Yeah, I'll order a CT.
- Well, that's bad.
143
00:06:20,776 --> 00:06:23,533
Just need to see what's going on.
We'll get it sorted out, though.
144
00:06:24,417 --> 00:06:26,396
Time to find your social worker.
145
00:06:26,420 --> 00:06:28,291
Again?
146
00:06:28,873 --> 00:06:31,775
Atlantoaxial instability this
severe will progress fast.
147
00:06:31,799 --> 00:06:33,311
We have to operate now.
148
00:06:33,335 --> 00:06:34,765
We don't have the go
ahead from his proxy.
149
00:06:34,789 --> 00:06:37,180
Well, his C1 and C2 are
compressing his spinal cord.
150
00:06:37,204 --> 00:06:38,755
What's everybody waiting for?
151
00:06:38,779 --> 00:06:41,227
The social worker said he'd
sign off on whatever we decide,
152
00:06:41,251 --> 00:06:43,436
but he doesn't want to get in the weeds.
153
00:06:43,460 --> 00:06:46,470
Well, that makes things tricky,
cause we have two surgical routes.
154
00:06:46,494 --> 00:06:49,677
High risk, high reward, open
the neck, expose the vertebra,
155
00:06:49,701 --> 00:06:51,246
place the corrective hardware directly.
156
00:06:51,270 --> 00:06:53,517
But you're concerned about
arterial or spinal cord trauma?
157
00:06:53,541 --> 00:06:56,858
Not to mention stroke,
infection, ventral cord damage.
158
00:06:56,882 --> 00:06:59,180
Plus, he's still recovering
from lung inflammation.
159
00:06:59,204 --> 00:07:00,365
Definitely a concern.
160
00:07:00,389 --> 00:07:02,775
And the second option is
minimally invasive fusion?
161
00:07:02,799 --> 00:07:04,659
Far less trauma and easier recovery.
162
00:07:04,683 --> 00:07:06,711
But wouldn't we be relying
on CT for navigation?
163
00:07:06,735 --> 00:07:08,644
Which means less precision
with the hardware?
164
00:07:08,668 --> 00:07:11,474
Yeah, it may require going back in,
in six months or a year.
165
00:07:11,498 --> 00:07:13,290
And there's a high chance
for a screw misplacement.
166
00:07:13,314 --> 00:07:15,820
At the C1-C2 spinal cord,
that could be severe.
167
00:07:16,621 --> 00:07:20,228
Both have risks. It's your call, Gina.
168
00:07:22,366 --> 00:07:25,205
(SOFT MUSIC)
169
00:07:28,144 --> 00:07:30,459
Do the minimally invasive fusion.
170
00:07:30,483 --> 00:07:32,085
I'll go explain to Walter.
171
00:07:34,992 --> 00:07:36,929
So...
172
00:07:37,997 --> 00:07:40,485
I've got full-blown leukemia.
173
00:07:41,371 --> 00:07:42,506
May I see?
174
00:07:45,880 --> 00:07:48,327
My belief is that the steroids
175
00:07:48,351 --> 00:07:50,265
artificially raised
your white blood cell count,
176
00:07:50,289 --> 00:07:53,104
hiding the degree
of marrow infiltration,
177
00:07:53,128 --> 00:07:56,177
and I spoke to Dr. Rose, and he agrees.
178
00:07:56,201 --> 00:07:59,851
Now, if this goes unchecked,
decline will be rapid.
179
00:07:59,875 --> 00:08:02,022
So, we'd like to start
induction chemotherapy,
180
00:08:02,046 --> 00:08:04,259
which could buy you a few extra months.
181
00:08:04,283 --> 00:08:06,163
This shows a pancytopenic picture
182
00:08:06,187 --> 00:08:08,900
without any sign of leukocytosis.
183
00:08:08,924 --> 00:08:11,908
Yes. As I just said,
the steroids are complicating things.
184
00:08:11,932 --> 00:08:14,781
Her leukemia has an
atypical presentation,
185
00:08:14,805 --> 00:08:17,552
but we need to act fast
before it progresses.
186
00:08:17,576 --> 00:08:20,814
Or her presentation is atypical
because it's not leukemia.
187
00:08:20,838 --> 00:08:21,929
Amy.
188
00:08:21,953 --> 00:08:24,404
Her counts are dropping
across every line.
189
00:08:24,428 --> 00:08:27,039
That looks like marrow failure,
not marrow takeover.
190
00:08:27,063 --> 00:08:28,921
You're reading too much
into the blast count.
191
00:08:28,945 --> 00:08:31,447
No, I'm looking at
the facts in front of us.
192
00:08:31,471 --> 00:08:34,486
She doesn't show cancer
on a peripheral smear.
193
00:08:34,510 --> 00:08:36,676
If this is pancytopenia,
we could give platelets
194
00:08:36,700 --> 00:08:38,369
and plasma to raise her levels.
195
00:08:38,393 --> 00:08:40,832
Blast proliferation and dysplasia
196
00:08:40,856 --> 00:08:42,727
are textbook signs of leukemia.
197
00:08:42,751 --> 00:08:45,508
And delaying treatment
because of wishful thinking
198
00:08:45,532 --> 00:08:47,813
will cost you significant time.
199
00:08:47,837 --> 00:08:51,598
Or, if he's wrong, the chemo
will damage all your organs.
200
00:08:52,079 --> 00:08:54,316
I believe this is Joan's decision.
201
00:08:59,046 --> 00:09:00,515
Start the chemo.
202
00:09:02,834 --> 00:09:04,871
I'll put the orders in.
203
00:09:09,815 --> 00:09:11,226
You're brilliant, Amy,
204
00:09:11,250 --> 00:09:13,588
and I know you don't
want this to be true.
205
00:09:14,891 --> 00:09:16,403
But I can't.
206
00:09:16,427 --> 00:09:20,068
I can't lose any more
time with my family.
207
00:09:23,074 --> 00:09:24,610
Yeah.
208
00:09:34,130 --> 00:09:36,277
Mom, any soreness in the incision?
209
00:09:36,301 --> 00:09:38,882
Oh, it was routine surgery, I'm fine.
210
00:09:38,906 --> 00:09:40,685
Where's John?
211
00:09:40,709 --> 00:09:43,224
He's here, having a smoke.
212
00:09:43,248 --> 00:09:45,261
Surprised you didn't go with him.
213
00:09:45,285 --> 00:09:47,565
Believe me, if I thought
I could get away with it.
214
00:09:47,589 --> 00:09:48,902
Not on my watch.
215
00:09:48,926 --> 00:09:51,606
Oh, I know, Dr. Larsen.
216
00:09:51,630 --> 00:09:53,443
Not yet, Mom.
217
00:09:53,467 --> 00:09:55,514
Speaking of which, you should
get back to Minneapolis.
218
00:09:55,538 --> 00:09:58,287
No, it's fine. Dr. Ridley
is away for a couple of weeks,
219
00:09:58,311 --> 00:10:00,792
so I finally get a little
bit of breathing room.
220
00:10:00,816 --> 00:10:02,162
Who's that?
221
00:10:02,186 --> 00:10:04,166
I've mentioned her, like, six times.
222
00:10:04,190 --> 00:10:06,871
Genius surgeon, Doctors Without Borders,
223
00:10:06,895 --> 00:10:10,011
- utterly terrifying...
- Alright. Her.
224
00:10:10,035 --> 00:10:11,848
Everybody wants her to be their mentor
225
00:10:11,872 --> 00:10:13,584
but she travels around so much,
226
00:10:13,608 --> 00:10:15,756
I don't think she ever
slows down enough to do that.
227
00:10:15,780 --> 00:10:17,525
What do you even need a mentor for?
228
00:10:17,549 --> 00:10:19,329
You want something, you get it.
229
00:10:19,353 --> 00:10:21,466
Always been that way,
barely even needed to push you.
230
00:10:21,490 --> 00:10:24,129
Well, there were times I could
have used some pushing.
231
00:10:28,271 --> 00:10:29,650
Amy.
232
00:10:29,674 --> 00:10:31,553
- Hey.
- Hi.
233
00:10:31,577 --> 00:10:33,491
I got here as fast as I could.
234
00:10:33,515 --> 00:10:35,295
She's stable now.
235
00:10:35,319 --> 00:10:38,500
She's pretty drowsy from the chemo meds.
236
00:10:38,524 --> 00:10:41,030
Right. Okay.
237
00:10:43,193 --> 00:10:47,334
Amy, Joan's co-ag panels came back.
238
00:10:48,278 --> 00:10:49,958
She has DIC.
239
00:10:49,982 --> 00:10:51,694
If we had pushed platelets
like you wanted,
240
00:10:51,718 --> 00:10:54,991
the runaway clotting could
have caused a massive stroke.
241
00:10:56,227 --> 00:10:58,374
I know how hard this is for you,
242
00:10:58,398 --> 00:11:01,070
but you're gonna have to
let me do my job.
243
00:11:06,080 --> 00:11:08,762
Ethan. I'm Dr. Miller.
244
00:11:08,786 --> 00:11:10,588
- Hi.
- It's good to meet you.
245
00:11:15,365 --> 00:11:17,578
So, rounds are done. What's next?
246
00:11:17,602 --> 00:11:19,382
Well, your partner in crime's
247
00:11:19,406 --> 00:11:20,986
sitting vigil for a friend in the ICU.
248
00:11:21,010 --> 00:11:22,618
Have you checked in on her?
249
00:11:22,642 --> 00:11:24,493
I didn't want to invade her space.
250
00:11:24,517 --> 00:11:27,065
It's always better to extend yourself.
251
00:11:27,089 --> 00:11:28,969
Trust me, she's gonna
let you know if it's unwanted.
252
00:11:28,993 --> 00:11:30,806
Oh, I'm sure she will.
253
00:11:30,830 --> 00:11:32,375
So, as Chief Resident,
254
00:11:32,399 --> 00:11:34,079
you've gotta be
able to work with anyone.
255
00:11:34,103 --> 00:11:36,383
Is there anybody else,
anything you gotta get ahead of?
256
00:11:36,407 --> 00:11:38,520
I don't know if you ever noticed,
257
00:11:38,544 --> 00:11:40,391
but Liz kind of had a thing for TJ.
258
00:11:40,415 --> 00:11:43,832
Yeah, she wasn't exactly subtle
about it. Why, what's the problem?
259
00:11:43,856 --> 00:11:45,425
I...
260
00:11:46,460 --> 00:11:48,358
So, you and TJ?
261
00:11:49,567 --> 00:11:51,079
Wow, okay.
262
00:11:51,103 --> 00:11:53,117
I guess I missed that.
How long has that been going on?
263
00:11:53,141 --> 00:11:56,223
Not very, and you of all
people don't get to judge.
264
00:11:56,247 --> 00:11:58,694
I'm just not sure how
everyone else will react.
265
00:11:58,718 --> 00:12:00,164
Well, listen.
266
00:12:00,188 --> 00:12:02,268
I mean, you can't control how
people feel about you, okay?
267
00:12:02,292 --> 00:12:04,639
All you can do is show everyone
that you're gonna be there
268
00:12:04,663 --> 00:12:06,334
for them when things get tough.
269
00:12:07,904 --> 00:12:10,284
Ah, Dr. Hamda. Do you have a minute?
270
00:12:10,308 --> 00:12:12,279
Of course, yeah. Come in, have a seat.
271
00:12:14,926 --> 00:12:18,859
I know I should have
said something sooner.
272
00:12:19,293 --> 00:12:22,009
I think I was just too afraid
273
00:12:22,033 --> 00:12:23,310
that no one was gonna take me seriously.
274
00:12:23,334 --> 00:12:26,507
It's okay, Liz. What is it?
275
00:12:28,611 --> 00:12:29,790
Dr. Miller.
276
00:12:29,814 --> 00:12:31,193
What he did to me.
277
00:12:31,217 --> 00:12:33,898
Everyone's just pretending
like nothing happened,
278
00:12:33,922 --> 00:12:36,126
but it was an abuse of power.
279
00:12:38,331 --> 00:12:42,834
I appreciate your honesty,
and I understand how you feel.
280
00:12:42,858 --> 00:12:46,547
Not how I feel. It's what happened.
281
00:12:47,917 --> 00:12:50,899
Nobody condones what Dr. Miller did,
282
00:12:50,923 --> 00:12:52,335
but an agreement was reached.
283
00:12:52,359 --> 00:12:55,041
- What agreement?
- I'm afraid I can't discuss it.
284
00:12:55,065 --> 00:12:56,700
So you won't tell me what happened?
285
00:12:59,106 --> 00:13:01,052
It was a confidential settlement.
286
00:13:01,893 --> 00:13:03,682
I'm sorry, Liz.
287
00:13:04,767 --> 00:13:06,563
I guess this just proves why I never
288
00:13:06,587 --> 00:13:09,393
should have bothered coming
forward in the first place.
289
00:13:17,877 --> 00:13:20,725
(TJ): CT confirms location,
we're clear of the vertebral artery.
290
00:13:20,749 --> 00:13:22,797
(DR. COSTA): Advancing
cannula into position.
291
00:13:22,821 --> 00:13:24,824
(CELLPHONE BUZZING)
292
00:13:28,564 --> 00:13:29,643
Hey, babe.
293
00:13:29,667 --> 00:13:32,983
Okay. So, I nearly had
to sell my body for it,
294
00:13:33,007 --> 00:13:35,789
but Spoon and Stable
finally called me back.
295
00:13:35,813 --> 00:13:37,325
They had a cancellation?
296
00:13:37,349 --> 00:13:39,830
I told them it was our
anniversary, and they said
297
00:13:39,854 --> 00:13:41,667
they could squeeze us in at six.
298
00:13:41,691 --> 00:13:43,137
Can you make that work?
299
00:13:43,161 --> 00:13:44,740
Well, looks like I'm gonna have to.
300
00:13:44,764 --> 00:13:46,376
No way we're missing
out on those oysters.
301
00:13:46,400 --> 00:13:49,984
So, there's a chance I may
need to swing back here.
302
00:13:50,008 --> 00:13:53,024
Oh no. Is it that boy you told me about?
303
00:13:53,048 --> 00:13:55,295
Found a pretty serious
issue with his spine,
304
00:13:55,319 --> 00:13:56,798
he's in surgery now.
305
00:13:56,822 --> 00:13:58,898
Oh honey, that's terrible.
306
00:13:58,922 --> 00:14:00,838
Are the social workers being helpful?
307
00:14:00,862 --> 00:14:03,277
Not really. I had to make
the decision myself
308
00:14:03,301 --> 00:14:04,813
about what surgery he should have.
309
00:14:05,203 --> 00:14:06,951
Okay, I know it's not my lane,
310
00:14:06,975 --> 00:14:10,224
and I love you for being
the person who cares this much.
311
00:14:10,248 --> 00:14:12,897
But the last time you got
this invested in a case...
312
00:14:12,921 --> 00:14:15,301
He has no one, Wendy.
313
00:14:15,638 --> 00:14:17,541
I have no choice.
314
00:14:19,333 --> 00:14:21,547
(ETHAN): Well, she told me
about the prednisone,
315
00:14:21,571 --> 00:14:24,677
that it landed her here a lot sooner
than she would have otherwise.
316
00:14:25,278 --> 00:14:28,160
Yeah. She is strong-willed.
317
00:14:28,643 --> 00:14:30,388
That's what we love about her.
318
00:14:31,057 --> 00:14:33,637
She probably felt
like she had no choice.
319
00:14:33,661 --> 00:14:36,878
You know, I, after I told her
I didn't want to see her,
320
00:14:36,902 --> 00:14:39,112
what else did she have besides work?
321
00:14:39,599 --> 00:14:42,205
And now, Robbie may never
even get to know her.
322
00:14:42,847 --> 00:14:45,929
She knew that making things
right with you was on her.
323
00:14:46,386 --> 00:14:48,122
Not you.
324
00:14:48,859 --> 00:14:51,630
All you can do now is be
there for each other.
325
00:14:56,073 --> 00:14:57,642
(DOOR OPENING)
326
00:15:08,932 --> 00:15:12,405
(OMINOUS MUSIC)
327
00:15:16,080 --> 00:15:18,551
What did you do?
328
00:15:20,122 --> 00:15:23,637
She was fine.
She was just fine an hour ago.
329
00:15:23,661 --> 00:15:24,774
What did you do?
330
00:15:24,798 --> 00:15:26,744
It's not their fault.
She had a heart attack.
331
00:15:26,768 --> 00:15:29,406
Nobody could have seen this coming.
332
00:15:34,249 --> 00:15:38,067
Amy. Uh, how is Joan doing?
333
00:15:38,091 --> 00:15:41,965
Um, she's stable for now. On chemo.
334
00:15:42,867 --> 00:15:46,083
I'm sure this must be hard for
you. If there's anything I can...
335
00:15:46,107 --> 00:15:48,354
Something's escalating in there.
336
00:15:48,378 --> 00:15:50,825
(EQUIPMENT BEEPING)
337
00:15:50,849 --> 00:15:52,329
Her temperature's dropping.
338
00:15:52,353 --> 00:15:54,199
Yeah, core temp can drop
339
00:15:54,223 --> 00:15:55,769
after starting chemotherapy,
it's normal.
340
00:15:55,793 --> 00:15:58,207
But it can also be a sign of sepsis.
341
00:15:58,231 --> 00:16:01,246
No, all of her cultures were negative.
342
00:16:01,270 --> 00:16:03,206
Is that true?
343
00:16:03,230 --> 00:16:04,787
Yes, of course that's true.
344
00:16:04,811 --> 00:16:08,227
And you should know that Dr. Larsen
345
00:16:08,251 --> 00:16:09,897
recommended a course
of treatment earlier
346
00:16:09,921 --> 00:16:11,768
that could have been
catastrophic for your mother.
347
00:16:11,792 --> 00:16:15,207
So, I don't think that it is a good idea
348
00:16:15,231 --> 00:16:17,335
for friends to treat each other.
349
00:16:20,508 --> 00:16:22,990
I admire your mom,
but I can be objective,
350
00:16:23,014 --> 00:16:24,509
and that's what she needs.
351
00:16:27,255 --> 00:16:28,524
He's right.
352
00:16:29,192 --> 00:16:31,029
Sorry, Ethan.
353
00:16:38,946 --> 00:16:40,090
- Hey.
- Hey.
354
00:16:40,114 --> 00:16:42,061
Do you have any of Joan
Ridley's blood left over?
355
00:16:42,085 --> 00:16:43,656
Yeah, we should have some extra.
356
00:16:43,680 --> 00:16:45,101
Can you run a beta-D-glucan?
357
00:16:45,125 --> 00:16:47,138
All her cultures came back negative.
358
00:16:47,162 --> 00:16:48,328
What are you looking for?
359
00:16:48,352 --> 00:16:51,146
I want to rule out
an invasive fungal infection.
360
00:16:51,170 --> 00:16:52,983
Something in the endothelial tissue.
361
00:16:53,007 --> 00:16:54,586
You got it.
362
00:16:54,610 --> 00:16:56,137
And uh, when you're done,
363
00:16:56,161 --> 00:16:58,427
can you get me the results directly?
364
00:16:58,451 --> 00:17:00,664
Says Dr. Miller's assigned.
365
00:17:00,688 --> 00:17:01,958
He is.
366
00:17:03,027 --> 00:17:06,510
I need this, Carin. Please.
367
00:17:07,044 --> 00:17:08,313
Sure.
368
00:17:08,338 --> 00:17:10,184
(CELLPHONE RINGING)
369
00:17:10,208 --> 00:17:11,719
Hey, how's it going?
370
00:17:11,743 --> 00:17:16,019
Hey. I'm at the school,
apparently Mia got into a fight.
371
00:17:17,022 --> 00:17:18,300
Let me guess, with Logan?
372
00:17:18,324 --> 00:17:20,271
I haven't had a chance
to talk to her about it,
373
00:17:20,295 --> 00:17:21,643
but figured we should do it together.
374
00:17:21,667 --> 00:17:23,177
Can I bring her by the hospital?
375
00:17:23,201 --> 00:17:24,479
Shouldn't take too long.
376
00:17:24,503 --> 00:17:26,808
Yeah, yeah, of course.
Um, yeah, I'm here.
377
00:17:33,254 --> 00:17:35,601
She killed herself, Gina.
378
00:17:35,625 --> 00:17:38,374
All those times I begged
her to quit smoking.
379
00:17:38,398 --> 00:17:41,446
Her blood pressure was through the roof,
380
00:17:41,470 --> 00:17:42,917
it was only a matter of time.
381
00:17:42,941 --> 00:17:46,351
You can't keep fixating on what
could have gone differently. Okay?
382
00:17:46,375 --> 00:17:48,627
All you can do now is start
to process your pain.
383
00:17:48,651 --> 00:17:50,174
What makes you think I haven't?
384
00:17:50,198 --> 00:17:53,103
It's been a week and a half.
You still haven't cried.
385
00:17:53,127 --> 00:17:56,075
Crying won't fix anything.
386
00:17:56,099 --> 00:17:58,085
I'm not saying force it, okay?
387
00:17:58,109 --> 00:18:00,484
But just let yourself feel.
388
00:18:00,508 --> 00:18:02,321
This is only gonna get worse
389
00:18:02,345 --> 00:18:04,286
once you're an actual shrink, isn't it?
390
00:18:04,310 --> 00:18:07,355
That's neuropsychiatrist,
thank you very much.
391
00:18:08,358 --> 00:18:10,237
I just need to focus on school.
392
00:18:10,261 --> 00:18:14,079
And maybe that hot
bartender from Stanton.
393
00:18:14,103 --> 00:18:15,514
I'm serious, Amy.
394
00:18:15,538 --> 00:18:18,520
You're in grief and mad at your mom.
395
00:18:18,544 --> 00:18:19,957
You can't just push all that away.
396
00:18:19,981 --> 00:18:22,836
- Why not?
- Cause when it comes to feelings,
397
00:18:22,862 --> 00:18:24,399
the piper has to get paid.
398
00:18:24,423 --> 00:18:26,360
One way or another.
399
00:18:29,433 --> 00:18:32,572
(CELLPHONE RINGING)
400
00:18:34,757 --> 00:18:35,807
Hey.
401
00:18:35,831 --> 00:18:39,095
Just checking on you. Joan's
BP and O2 SATs are improving.
402
00:18:39,119 --> 00:18:40,798
Chemo must be having an effect.
403
00:18:40,822 --> 00:18:43,703
I guess Richard was right.
About the leukemia.
404
00:18:43,727 --> 00:18:46,076
At least we have a diagnosis.
Where are you?
405
00:18:46,817 --> 00:18:49,515
Uh, I'm in Radiology
with another patient.
406
00:18:49,539 --> 00:18:51,945
- I'll be back soon.
- Okay.
407
00:18:54,350 --> 00:18:56,304
We won't be mad, honey.
408
00:18:56,328 --> 00:18:58,500
We just want you to
tell us what happened.
409
00:18:58,524 --> 00:19:00,762
Logan was throwing markers at me.
410
00:19:01,396 --> 00:19:03,177
I thought we said when
he did stuff like that,
411
00:19:03,201 --> 00:19:04,679
you would tell the teacher.
412
00:19:04,703 --> 00:19:06,649
I did. But he didn't stop.
413
00:19:06,673 --> 00:19:10,024
So I took my chocolate pudding
414
00:19:10,048 --> 00:19:12,195
and I dumped it on his head.
415
00:19:12,219 --> 00:19:14,165
(GIGGLING)
416
00:19:14,189 --> 00:19:16,672
Um, so, what happened?
417
00:19:16,696 --> 00:19:18,340
You told the teacher and they
didn't do anything about it?
418
00:19:18,364 --> 00:19:20,177
They had him sit in the big chair.
419
00:19:20,201 --> 00:19:21,580
What's the big chair?
420
00:19:21,604 --> 00:19:23,818
It's a big, comfy chair in the corner,
421
00:19:23,842 --> 00:19:26,456
where you sit and think
about what you did.
422
00:19:26,480 --> 00:19:28,160
So, like a timeout.
423
00:19:28,184 --> 00:19:31,666
Okay, but uh, last week,
when you won the spelling bee,
424
00:19:31,690 --> 00:19:33,738
you said you got to sit
in a big, comfy chair.
425
00:19:33,762 --> 00:19:36,342
Yeah. You sit in it
if you do something good.
426
00:19:36,366 --> 00:19:40,942
But then, sometimes, you sit
in it if you do something bad.
427
00:19:43,882 --> 00:19:45,594
I want her out of
that school, Rache. Okay?
428
00:19:45,618 --> 00:19:47,564
There's the public school,
there's the Hebrew school
429
00:19:47,588 --> 00:19:49,102
we toured, I don't care which one.
430
00:19:49,126 --> 00:19:50,775
I just think that she
needs to be somewhere
431
00:19:50,799 --> 00:19:52,475
with more boundaries and grit,
432
00:19:52,499 --> 00:19:54,669
and fewer participation trophies
and big chairs.
433
00:19:55,104 --> 00:19:56,516
Okay.
434
00:19:56,540 --> 00:19:58,755
- Okay what?
- Okay, you're right.
435
00:19:58,779 --> 00:20:01,626
I'm wrong. Let's move her.
436
00:20:01,650 --> 00:20:04,366
Hold it, did you just tell me
I was right about something?
437
00:20:04,390 --> 00:20:06,302
(LAUGHTER)
438
00:20:06,326 --> 00:20:08,173
And if you play your cards right,
439
00:20:08,629 --> 00:20:10,566
it might even happen again.
440
00:20:12,531 --> 00:20:13,942
I'll take her home?
441
00:20:13,986 --> 00:20:16,024
Yeah, yeah.
442
00:20:24,816 --> 00:20:26,152
Are you alright?
443
00:20:27,135 --> 00:20:29,382
(SOBBING)
444
00:20:29,838 --> 00:20:31,274
Yeah.
445
00:20:32,444 --> 00:20:37,353
I'm just realizing how
little power I have here.
446
00:20:41,229 --> 00:20:43,167
What happened?
447
00:20:44,837 --> 00:20:47,142
There's nothing to
be done about it, Sonya.
448
00:20:47,676 --> 00:20:50,357
No, no. I'm gonna be Chief Resident,
449
00:20:50,381 --> 00:20:52,920
which means I can advocate.
450
00:21:00,168 --> 00:21:01,547
(SIGHS)
451
00:21:01,571 --> 00:21:02,923
(RICHARD): And this is unprofessional.
452
00:21:02,947 --> 00:21:05,554
You were never going to
test for this, Richard,
453
00:21:05,578 --> 00:21:06,556
and it's positive.
454
00:21:06,580 --> 00:21:07,826
You were not gonna listen to me.
455
00:21:07,850 --> 00:21:09,195
Well, that was my call to make...
456
00:21:09,219 --> 00:21:10,688
Do you wanna tell me
what's going on here?
457
00:21:10,712 --> 00:21:12,105
She ran a test behind my back.
458
00:21:12,129 --> 00:21:14,052
That is hardly the headline here.
459
00:21:14,076 --> 00:21:16,275
Joan has a Candida organ infection,
460
00:21:16,299 --> 00:21:17,946
which he wouldn't have caught.
461
00:21:17,970 --> 00:21:19,783
I'm assuming you're
interested in treating this,
462
00:21:19,807 --> 00:21:21,686
even though I was the one who found it.
463
00:21:21,710 --> 00:21:23,657
Alright, alright. That's enough.
464
00:21:23,681 --> 00:21:25,829
Clearly, the chemo
lowered her immune response,
465
00:21:25,853 --> 00:21:27,833
decrease the dosage for now
and treat the infection.
466
00:21:27,857 --> 00:21:30,094
But we are still on the right path here.
467
00:21:33,401 --> 00:21:36,683
You know, I might be
more inclined to hear you,
468
00:21:36,707 --> 00:21:40,047
if you weren't so concerned
with putting me in my place.
469
00:21:42,753 --> 00:21:46,669
He was never gonna order
the panel. Out of spite.
470
00:21:46,693 --> 00:21:48,673
- If you needed backup...
- Which is it, Michael?
471
00:21:48,697 --> 00:21:50,544
I'm supposed to come to you
because you want to help?
472
00:21:50,568 --> 00:21:52,614
Or I'm not supposed to come to
473
00:21:52,638 --> 00:21:54,753
you because I put you
in a tough position,
474
00:21:54,777 --> 00:21:55,989
because I've heard it both ways.
475
00:21:56,013 --> 00:21:58,193
I am Chief now, of your department.
476
00:21:58,217 --> 00:22:01,333
That's a lot different than running
two floors up to talk to the CMO.
477
00:22:01,357 --> 00:22:02,869
And by the way, you lied.
478
00:22:02,893 --> 00:22:04,241
Told me you were in Radiology,
479
00:22:04,265 --> 00:22:06,099
on our first day working together.
480
00:22:10,508 --> 00:22:12,245
You're right. I'm sorry.
481
00:22:13,987 --> 00:22:15,634
I'm, I'm uh...
482
00:22:16,066 --> 00:22:20,340
Every time I look at Joan
in that bed, all I see is...
483
00:22:21,182 --> 00:22:22,427
Your mom.
484
00:22:22,452 --> 00:22:24,222
(SIGHS)
485
00:22:26,640 --> 00:22:28,319
I wish you'd been here for that.
486
00:22:28,862 --> 00:22:30,766
I'm here now.
487
00:22:31,250 --> 00:22:32,628
I know.
488
00:22:32,898 --> 00:22:35,103
Try to hold on to that.
489
00:22:38,364 --> 00:22:39,777
(MOANING)
490
00:22:39,801 --> 00:22:41,981
- Oh, I think he's waking up.
- Walter, can you hear me?
491
00:22:42,005 --> 00:22:44,222
It hurts. Please, it hurts.
492
00:22:44,246 --> 00:22:47,092
- Blood pressure's spiking.
- Walter, try to breathe.
493
00:22:47,148 --> 00:22:48,287
My neck, it hurts so bad!
494
00:22:48,312 --> 00:22:49,827
Two milligrams IV morphine, stat.
495
00:22:49,852 --> 00:22:51,053
Where in the neck?
496
00:22:51,078 --> 00:22:53,306
Why can't I move my hands?
What's happening?
497
00:22:53,331 --> 00:22:56,136
It's okay, Walter. That can
sometimes happen with swelling.
498
00:22:57,140 --> 00:22:59,445
He lost his Babinski.
499
00:23:00,241 --> 00:23:01,821
So, the spinal cord's
not sending a signal?
500
00:23:01,845 --> 00:23:03,614
Costa's running a CT to confirm,
501
00:23:03,638 --> 00:23:05,795
but it seems the cord
swelling is causing compression.
502
00:23:05,819 --> 00:23:07,664
He's on morphine for the pain,
503
00:23:07,688 --> 00:23:09,502
but he's got serious
neurological deficits.
504
00:23:09,526 --> 00:23:10,939
No movement below the neck.
505
00:23:10,963 --> 00:23:13,042
The sooner we can get back
in and operate, the better.
506
00:23:13,066 --> 00:23:15,480
But his lungs are
still inflamed from the RA.
507
00:23:15,504 --> 00:23:17,819
He may not be able to take
another round of anesthesia.
508
00:23:17,843 --> 00:23:19,790
Dr. Costa's booked an OR for
first thing in the morning.
509
00:23:19,814 --> 00:23:21,226
Anything longer than that,
510
00:23:21,250 --> 00:23:23,230
then he could have serious
neurological issues permanently.
511
00:23:23,254 --> 00:23:24,666
We should have been more aggressive.
512
00:23:24,690 --> 00:23:26,670
We can't Monday morning quarterback.
513
00:23:26,694 --> 00:23:28,039
The surgeon gave you two choices.
514
00:23:28,063 --> 00:23:29,622
And I picked the safer one,
because I was worried
515
00:23:29,646 --> 00:23:31,579
Walter doesn't have
the long term support
516
00:23:31,603 --> 00:23:33,183
to go for what was really needed.
517
00:23:33,207 --> 00:23:35,054
- It was a coin toss, Gina.
- No, it wasn't.
518
00:23:35,078 --> 00:23:36,686
You wanted to go for the other option.
519
00:23:36,710 --> 00:23:39,061
So Costa waffled. It should
not have been up to you.
520
00:23:39,085 --> 00:23:40,230
No, it shouldn't have been.
521
00:23:40,254 --> 00:23:42,334
So let me take this off your plate now.
522
00:23:42,358 --> 00:23:43,931
Tell Costa I want Walter
523
00:23:43,955 --> 00:23:45,976
in reverse Trendelenburg
during the operation,
524
00:23:46,000 --> 00:23:49,840
and to use lung protective
ventilation with low tidal volume.
525
00:23:52,973 --> 00:23:55,410
He may never walk again, Michael.
526
00:23:58,490 --> 00:24:01,926
Induction chemo did a number on me.
527
00:24:01,950 --> 00:24:03,812
Well, you're almost
through the first dose.
528
00:24:03,836 --> 00:24:06,316
But we found an invasive
fungal infection,
529
00:24:06,340 --> 00:24:07,585
presumptive Candida.
530
00:24:07,609 --> 00:24:09,289
We're, we're treating it
with antifungals.
531
00:24:09,313 --> 00:24:11,325
Candida.
532
00:24:11,725 --> 00:24:13,732
Must have seeded in my liver.
533
00:24:13,756 --> 00:24:16,035
No, not the liver.
534
00:24:16,059 --> 00:24:17,873
It's likely diffused endothelial,
535
00:24:17,897 --> 00:24:20,043
given the high beta-D-glucan level.
536
00:24:20,067 --> 00:24:22,272
Did you finish your homework?
537
00:24:22,907 --> 00:24:25,487
Is your father, is your father home yet?
538
00:24:25,511 --> 00:24:27,624
- Mom?
- Joan? Look at me.
539
00:24:27,648 --> 00:24:30,220
- What's wrong with her?
- Ethan, step back.
540
00:24:31,023 --> 00:24:32,501
(ETHAN): What's happening?
541
00:24:32,525 --> 00:24:34,004
(AMY): She's seizing.
542
00:24:34,028 --> 00:24:35,775
(RICHARD): Oxygen at 10 liters.
543
00:24:35,799 --> 00:24:38,580
Altered mental status,
it's gotta be neurological.
544
00:24:38,604 --> 00:24:40,785
Increased ICP, her brain's swelling.
545
00:24:40,809 --> 00:24:42,755
If she had leukemia,
this wouldn't be happening.
546
00:24:42,779 --> 00:24:44,459
- Not this fast.
- You're right.
547
00:24:44,483 --> 00:24:46,486
We're missing something.
548
00:24:50,629 --> 00:24:52,909
Look, I know whatever
decisions were made
549
00:24:52,933 --> 00:24:55,413
about bringing Dr. Miller back
are way above my pay grade,
550
00:24:55,437 --> 00:24:57,885
but we can't just ask Liz
to forget what happened
551
00:24:57,909 --> 00:24:59,890
cause it'll make life
easier for everyone else.
552
00:24:59,914 --> 00:25:03,196
I'm going to talk to Richard
once Joan is stabilized.
553
00:25:03,220 --> 00:25:06,002
I'm sure he'll be willing
to apologize to Liz.
554
00:25:06,026 --> 00:25:10,010
His apology is gonna be
hollow and meaningless.
555
00:25:10,034 --> 00:25:12,014
And you should know,
when Dr. Miller was Chief,
556
00:25:12,038 --> 00:25:15,545
he tried to use me to find out
mistakes Amy was making.
557
00:25:15,979 --> 00:25:19,395
Look, I'm sorry you ended up
in the middle of that.
558
00:25:19,419 --> 00:25:21,968
But um, I know the board.
559
00:25:21,992 --> 00:25:23,804
They'd rather find a way
to get rid of Liz
560
00:25:23,828 --> 00:25:25,340
than reopen this can of worms.
561
00:25:25,364 --> 00:25:28,179
Well, they can try,
but if Liz starts talking,
562
00:25:28,203 --> 00:25:30,084
they're gonna get blowback
from the nurses
563
00:25:30,108 --> 00:25:31,653
and potentially the union.
564
00:25:31,677 --> 00:25:33,556
Is uh, is that a threat?
565
00:25:33,580 --> 00:25:35,127
It's a reality.
566
00:25:35,151 --> 00:25:37,933
I'm just trying to do
the right thing for her,
567
00:25:37,957 --> 00:25:40,604
and protect the department,
which is part of my job now.
568
00:25:40,628 --> 00:25:43,911
She bears responsibility
for her own decisions, Sonya.
569
00:25:43,935 --> 00:25:45,982
As you said, she has a very strong union
570
00:25:46,006 --> 00:25:47,952
she could have gone to
when all this happened.
571
00:25:47,976 --> 00:25:49,756
I think, maybe,
you're expecting too much,
572
00:25:49,780 --> 00:25:53,831
or not understanding the dynamic
between an older man with power
573
00:25:53,855 --> 00:25:56,737
and a young woman at
the start of her career.
574
00:25:56,761 --> 00:26:00,110
It's blaming the victim,
and I don't think it'll be appreciated.
575
00:26:00,306 --> 00:26:03,345
- I do hear you.
- Well, good.
576
00:26:04,309 --> 00:26:06,890
Because you started the day
by saying your door was open,
577
00:26:06,914 --> 00:26:09,820
but now it seems like
you're closing it on Liz.
578
00:26:13,360 --> 00:26:15,907
(SPEAKING SPANISH)
579
00:26:15,931 --> 00:26:18,013
The MDS is late-stage,
580
00:26:18,037 --> 00:26:21,152
but it's obscured by high steroid usage.
581
00:26:21,176 --> 00:26:23,723
Pancytopenia, pleural effusions,
582
00:26:23,747 --> 00:26:26,229
DIC, elevated beta-D-glucan,
583
00:26:26,253 --> 00:26:29,569
and now cerebral edema,
and she's getting worse.
584
00:26:29,593 --> 00:26:32,909
Hey, just checked in on Joan.
How you holding up?
585
00:26:32,933 --> 00:26:35,882
I've been going toe to toe
with Richard all day,
586
00:26:35,906 --> 00:26:37,484
and now we're running out of time.
587
00:26:37,508 --> 00:26:38,754
Who's this?
588
00:26:38,778 --> 00:26:40,156
Um, he's a doctor in Madrid
589
00:26:40,180 --> 00:26:42,896
who has a case study
that might be relevant
590
00:26:42,920 --> 00:26:45,267
and this translation app
keeps glitching.
591
00:26:45,291 --> 00:26:47,638
Um, I mean, I minored in Spanish,
592
00:26:47,662 --> 00:26:49,208
we could see how rusty I am.
593
00:26:49,232 --> 00:26:50,334
Okay.
594
00:26:52,371 --> 00:26:56,246
(SPEAKING SPANISH)
595
00:27:25,772 --> 00:27:27,886
Gracias. So, what he's saying
596
00:27:27,910 --> 00:27:29,322
is that the symptoms were similar,
597
00:27:29,346 --> 00:27:31,459
but his patient had dormant sarcoidosis,
598
00:27:31,483 --> 00:27:33,697
so that was complicating
the clinical picture.
599
00:27:33,721 --> 00:27:35,772
But once they found that,
everything else just fell into place.
600
00:27:35,796 --> 00:27:37,618
So a patient with MDS like Joan
601
00:27:37,642 --> 00:27:39,475
presented with these symptoms
602
00:27:39,499 --> 00:27:41,813
because of a different chronic issue.
603
00:27:41,837 --> 00:27:43,717
And it went undetected for years.
604
00:27:43,741 --> 00:27:45,955
Okay, okay. Thanks.
605
00:27:45,979 --> 00:27:49,452
Just remember you gotta find a
way to work with Richard on this.
606
00:27:52,058 --> 00:27:53,904
Your spinal tap came back negative
607
00:27:53,928 --> 00:27:55,373
and a full neuro panel too.
608
00:27:55,397 --> 00:27:57,812
Well, her procalcitonin is low,
609
00:27:57,836 --> 00:27:59,515
even though she just had an infection.
610
00:27:59,539 --> 00:28:00,985
I need total protein,
611
00:28:01,009 --> 00:28:03,189
C-reactive protein
and complement levels.
612
00:28:03,213 --> 00:28:05,360
- How fast can you do that?
- 20 minutes.
613
00:28:05,384 --> 00:28:08,433
And if the results can go
to me, since I'm her doctor,
614
00:28:08,457 --> 00:28:10,060
that'd be appreciated.
615
00:28:12,131 --> 00:28:14,411
We've got a high
complement protein level,
616
00:28:14,435 --> 00:28:17,251
and the prednisone must have
dropped her immune surveillance,
617
00:28:17,275 --> 00:28:20,123
which means that we're looking
for something that's been there.
618
00:28:20,147 --> 00:28:22,528
Possibly for years, like you said,
619
00:28:22,552 --> 00:28:24,098
but that's been hiding in plain sight.
620
00:28:24,122 --> 00:28:25,935
When Joan woke up,
621
00:28:25,959 --> 00:28:27,371
and I told her about the Candida,
622
00:28:27,395 --> 00:28:28,941
she asked if it seeded in her liver.
623
00:28:28,965 --> 00:28:30,309
Well, that wouldn't be uncommon.
624
00:28:30,333 --> 00:28:32,348
But the beta-D-glucan is so high,
625
00:28:32,372 --> 00:28:35,387
the fungal load would be too
large to be isolated to her liver.
626
00:28:35,411 --> 00:28:38,092
Okay. We've been assuming that
the elevated liver enzymes
627
00:28:38,116 --> 00:28:41,699
are caused by the MDS
and the prednisone,
628
00:28:41,723 --> 00:28:44,729
but look at her blood work
going back to 2016.
629
00:28:46,165 --> 00:28:47,645
(RICHARD): Higher range of normal.
630
00:28:47,669 --> 00:28:49,582
But low enough that
nobody would flag it.
631
00:28:49,606 --> 00:28:51,419
2016,
632
00:28:52,005 --> 00:28:54,784
that's a long time for her
to be carrying something.
633
00:28:55,451 --> 00:28:59,001
Wait a minute. One of the last
memories I have of her,
634
00:28:59,025 --> 00:29:00,570
2016, she was in Ecuador.
635
00:29:00,594 --> 00:29:04,645
And she got sick, and I told
her that she should come back.
636
00:29:04,669 --> 00:29:07,852
And she self-diagnosed,
637
00:29:07,876 --> 00:29:09,555
she thought it was dysentery...
638
00:29:09,579 --> 00:29:11,659
Which means she was
drinking unfiltered water.
639
00:29:11,683 --> 00:29:13,831
So, if it was a parasite,
640
00:29:13,855 --> 00:29:16,436
she could have been sick
while she was digesting it,
641
00:29:16,460 --> 00:29:19,709
but by the time it migrated
to her liver, she was fine.
642
00:29:19,733 --> 00:29:21,729
Then she could have been
fighting this quietly for years.
643
00:29:21,753 --> 00:29:24,196
And the prednisone
weakened her immune system,
644
00:29:24,221 --> 00:29:26,090
and unleashed it on her.
645
00:29:28,049 --> 00:29:30,120
I think we have a path now.
646
00:29:34,187 --> 00:29:36,001
(TJ): He's losing sympathetic tone.
647
00:29:36,026 --> 00:29:38,942
Surgery's set for 6:00 AM,
can we up the steroids?
648
00:29:39,243 --> 00:29:40,688
Too worried about his blood pressure.
649
00:29:40,713 --> 00:29:42,326
Think we just have to stay the course
650
00:29:42,351 --> 00:29:44,421
and hope that he's strong
enough to hold on.
651
00:29:46,219 --> 00:29:48,366
I appreciate what you said before.
652
00:29:48,556 --> 00:29:50,593
Trying to let me off the hook.
653
00:29:51,596 --> 00:29:53,076
You religious at all?
654
00:29:53,100 --> 00:29:54,611
From time to time,
655
00:29:54,635 --> 00:29:57,675
depending on how I'm
feeling about the world.
656
00:29:58,343 --> 00:30:00,491
I remember going to this sermon once.
657
00:30:00,515 --> 00:30:04,365
The minister was talking about
how it can be a form of hubris
658
00:30:04,389 --> 00:30:06,202
to think that we can control things
659
00:30:06,452 --> 00:30:08,789
that are out of our control.
660
00:30:09,958 --> 00:30:12,338
Cause that's somebody else's domain?
661
00:30:12,363 --> 00:30:13,943
(TJ): Doesn't mean
it's easy to accept it.
662
00:30:13,968 --> 00:30:16,472
But I think that's the idea, yeah.
663
00:30:17,621 --> 00:30:20,302
I'll take that under
advisement, Dr. Coleman.
664
00:30:20,327 --> 00:30:21,696
Good.
665
00:30:25,957 --> 00:30:27,093
Your wife's here.
666
00:30:29,005 --> 00:30:30,650
(GASPS)
667
00:30:30,674 --> 00:30:32,487
It's my anniversary and I forgot.
668
00:30:32,511 --> 00:30:34,425
You go. I am all over this,
669
00:30:34,449 --> 00:30:37,087
hourly exams, I will not go home.
670
00:30:42,631 --> 00:30:45,380
I've been downstairs 15
minutes, tried calling you.
671
00:30:45,404 --> 00:30:48,419
I'm sorry. There were problems
with Walter's surgery,
672
00:30:48,443 --> 00:30:50,249
he needs another one tomorrow.
673
00:30:50,782 --> 00:30:53,029
Why don't we have dinner
in your office tonight?
674
00:30:53,053 --> 00:30:57,404
That way, if anything happens,
you're close.
675
00:30:57,428 --> 00:30:59,508
What did I do to deserve you?
676
00:30:59,532 --> 00:31:00,845
I don't know.
677
00:31:00,869 --> 00:31:03,406
I'm sure you'll find a way
to make it up to me.
678
00:31:04,908 --> 00:31:07,714
I'm thinking 400 milligrams albendazole.
679
00:31:08,083 --> 00:31:10,029
I'd go 300,
680
00:31:10,053 --> 00:31:12,178
given the ALT/AST,
681
00:31:12,202 --> 00:31:14,873
and 20 of Ampho B to balance it out.
682
00:31:14,897 --> 00:31:16,911
And 100 milligrams of cimetidine
683
00:31:16,935 --> 00:31:18,503
to cut the renal toxicity.
684
00:31:19,774 --> 00:31:21,118
It's a tightrope.
685
00:31:21,142 --> 00:31:23,022
Any idea where Liz is?
686
00:31:23,046 --> 00:31:24,325
Uh, let's see.
687
00:31:24,349 --> 00:31:27,630
(PA SYSTEM): Code Blue, ICU.
Code Blue, ICU.
688
00:31:27,654 --> 00:31:28,824
Joan's coding.
689
00:31:29,558 --> 00:31:31,639
(PA SYSTEM): Code Blue, ICU.
690
00:31:31,663 --> 00:31:33,610
Code Blue, ICU.
691
00:31:33,634 --> 00:31:34,813
(EQUIPMENT BEEPING)
692
00:31:34,837 --> 00:31:36,549
No pulse.
693
00:31:36,573 --> 00:31:38,186
He's in V-fib. Push one milligram Epi.
694
00:31:38,210 --> 00:31:40,280
Get the defibrillator.
695
00:31:44,222 --> 00:31:47,161
(DEFIBRILLATOR BEEP)
696
00:31:48,663 --> 00:31:50,434
Ready?
697
00:31:51,436 --> 00:31:53,273
Clear.
698
00:31:54,176 --> 00:31:56,189
(EQUIPMENT BEEPING)
699
00:31:56,572 --> 00:31:59,076
Restarting compressions.
700
00:32:06,632 --> 00:32:09,739
Danny, Danny. Someone call 911.
701
00:32:11,109 --> 00:32:12,544
(GINA): Charge to 50.
702
00:32:13,714 --> 00:32:15,717
Clear.
703
00:32:18,056 --> 00:32:20,236
(ECG LONG BEEP)
704
00:32:20,506 --> 00:32:23,045
Pushing another milligram of Epi.
705
00:32:29,245 --> 00:32:31,492
Fine V-fib, we're losing him.
706
00:32:31,516 --> 00:32:34,288
Going up to 100. Give me the paddles.
707
00:32:38,297 --> 00:32:40,467
- Ready.
- Clear.
708
00:32:47,448 --> 00:32:50,097
(EQUIPMENT BEEPING)
709
00:32:50,121 --> 00:32:51,331
Looks like Sinus.
710
00:32:51,355 --> 00:32:53,904
We have a pulse. He's back.
711
00:32:54,140 --> 00:32:57,079
Page Dr. Costa,
we can't wait on the surgery.
712
00:33:01,777 --> 00:33:06,519
(SOFT MUSIC)
713
00:33:20,200 --> 00:33:21,812
Cord is decompressed.
714
00:33:21,843 --> 00:33:26,018
Screws are seated.
Let's secure the rods.
715
00:33:26,419 --> 00:33:27,922
Hey.
716
00:33:31,269 --> 00:33:34,375
That must have been
really difficult for you.
717
00:33:35,044 --> 00:33:36,646
Yeah.
718
00:33:37,481 --> 00:33:40,297
And a hell of a first day for Michael.
719
00:33:40,593 --> 00:33:43,298
Oh, it hit pretty close to home.
720
00:33:44,495 --> 00:33:46,175
How's it going in there?
721
00:33:46,199 --> 00:33:47,912
Hardware's almost in place.
722
00:33:47,936 --> 00:33:50,183
But even if it works,
723
00:33:50,207 --> 00:33:52,320
no one's ever gonna adopt him.
724
00:33:52,344 --> 00:33:55,050
Not when he needs this kind of support.
725
00:33:58,163 --> 00:34:01,869
You're not thinking
of doing something drastic?
726
00:34:03,066 --> 00:34:04,702
Go and be with Joan.
727
00:34:05,304 --> 00:34:07,040
Gina.
728
00:34:08,177 --> 00:34:09,947
I care about him,
729
00:34:10,715 --> 00:34:13,821
but I know what the boundaries are.
730
00:34:14,221 --> 00:34:16,827
Now go, where you're needed.
731
00:34:19,834 --> 00:34:23,874
(EQUIPMENT BEEPING)
732
00:34:30,620 --> 00:34:32,467
But you've gotta quit smoking.
733
00:34:32,491 --> 00:34:34,428
You know that's never
gonna happen, honey.
734
00:34:38,603 --> 00:34:41,185
I don't know how much more
we can pump into her
735
00:34:41,280 --> 00:34:43,747
before she starts shutting down.
736
00:34:43,772 --> 00:34:46,678
Her body's so fragile.
737
00:34:48,278 --> 00:34:50,460
The chemo didn't help with that.
738
00:34:51,129 --> 00:34:53,733
She was only on it for eight hours.
739
00:34:55,270 --> 00:34:56,917
The parasite is causing this,
740
00:34:56,941 --> 00:35:00,380
that and the prednisone,
it's not on you, Richard.
741
00:35:02,752 --> 00:35:06,359
(SOMBER MUSIC)
742
00:35:11,035 --> 00:35:12,604
(SIGHS)
743
00:35:37,888 --> 00:35:39,913
Hey. It's okay, buddy.
744
00:35:50,949 --> 00:35:53,052
Can I see?
745
00:35:55,591 --> 00:35:58,557
Aww, she's gonna love this.
746
00:36:01,302 --> 00:36:03,283
Is she gonna wake up soon?
747
00:36:03,733 --> 00:36:06,237
I really hope so.
748
00:36:12,291 --> 00:36:15,530
(EQUIPMENT BEEPING SLOWLY)
749
00:36:17,168 --> 00:36:19,538
(CELLPHONE RINGING)
750
00:36:21,342 --> 00:36:22,535
Hello?
751
00:36:22,559 --> 00:36:24,463
(JOAN): Hi, Amy. It's Dr. Ridley.
752
00:36:24,487 --> 00:36:27,697
Oh. Hi.
753
00:36:27,721 --> 00:36:29,501
I hope it's not 2:00 AM there,
754
00:36:29,525 --> 00:36:31,740
I stopped tracking time zone
differences ages ago.
755
00:36:31,764 --> 00:36:34,846
No, it's noon. Is there a problem?
756
00:36:34,870 --> 00:36:36,783
I spoke with Dr. Kelly this morning,
757
00:36:36,807 --> 00:36:38,242
he told me about your mother.
758
00:36:39,678 --> 00:36:42,116
I'm just so sorry, Amy.
759
00:36:42,518 --> 00:36:45,199
Thank you, Dr. Ridley.
760
00:36:45,223 --> 00:36:47,872
And I respect your tenacity,
already being back in the hospital,
761
00:36:47,896 --> 00:36:50,376
but I just wanted to make sure
you're taking care of yourself.
762
00:36:50,906 --> 00:36:53,745
I think so.
763
00:36:55,244 --> 00:36:56,757
It's...
764
00:36:56,781 --> 00:37:00,255
It's been hard, obviously.
765
00:37:00,279 --> 00:37:02,367
(JOAN): Your world shifted on its axis.
766
00:37:02,391 --> 00:37:04,504
But you will come out the other side.
767
00:37:04,940 --> 00:37:06,544
I just...
768
00:37:07,300 --> 00:37:09,548
didn't even think you liked me.
769
00:37:09,572 --> 00:37:11,652
(JOAN): Well, that's by design, my dear.
770
00:37:11,676 --> 00:37:13,522
And now you know the truth.
771
00:37:13,965 --> 00:37:17,220
Not only do I like you,
I believe in you.
772
00:37:19,525 --> 00:37:22,641
Thank you so much. I...
773
00:37:22,665 --> 00:37:24,511
(JOAN): I know how bad
this hurts right now,
774
00:37:24,535 --> 00:37:26,648
but the best way that
you can honor your mother
775
00:37:26,672 --> 00:37:28,218
is to live a life with purpose.
776
00:37:28,242 --> 00:37:31,058
You have greatness in you, Amy.
777
00:37:31,082 --> 00:37:34,021
And I'll be there to help you find it.
778
00:37:40,600 --> 00:37:44,318
(MURMURING)
779
00:37:44,667 --> 00:37:46,647
Joan.
780
00:37:46,672 --> 00:37:49,076
Hey. Can you hear me?
781
00:37:49,664 --> 00:37:53,304
Can you get her son?
He just went to get coffee.
782
00:37:54,027 --> 00:37:57,034
Hey. It's okay.
783
00:37:57,434 --> 00:38:00,306
Just go slow. Breathe.
784
00:38:02,678 --> 00:38:05,761
- What happened?
- You had cerebral edema.
785
00:38:05,785 --> 00:38:07,196
No.
786
00:38:07,220 --> 00:38:10,971
It's not leukemia. Not yet.
787
00:38:10,995 --> 00:38:13,810
You had a parasite in your liver.
788
00:38:13,834 --> 00:38:17,316
From Ecuador. Do you remember that?
789
00:38:17,340 --> 00:38:19,211
You thought it was dysentery?
790
00:38:19,946 --> 00:38:21,482
Oh my God.
791
00:38:22,150 --> 00:38:26,202
Is that the one time
in my life I misdiagnosed?
792
00:38:26,226 --> 00:38:28,196
(LAUGHTER)
793
00:38:33,306 --> 00:38:36,212
You haven't looked after
yourself for a long time.
794
00:38:38,316 --> 00:38:39,594
I know.
795
00:38:39,618 --> 00:38:42,100
Promise me that stops now.
796
00:38:42,124 --> 00:38:43,637
Ah.
797
00:38:43,661 --> 00:38:45,941
Mom. Hey.
798
00:38:45,965 --> 00:38:47,267
Hey.
799
00:38:48,236 --> 00:38:50,140
(ETHAN): Thanks so much, Amy.
800
00:38:51,777 --> 00:38:56,085
I'll order CBC and liver function tests.
801
00:38:58,891 --> 00:39:00,603
The fact that she's conscious...
802
00:39:00,627 --> 00:39:02,731
Yeah, we got her some more time.
803
00:39:03,919 --> 00:39:07,093
I appreciate you finding
a way to trust me today.
804
00:39:08,743 --> 00:39:10,380
Yeah, it worked out today.
805
00:39:11,374 --> 00:39:14,213
But I'm never gonna trust you, Richard.
806
00:39:21,502 --> 00:39:24,484
Hey, Walter. Welcome back.
807
00:39:24,508 --> 00:39:26,343
Did you fix my spine?
808
00:39:26,367 --> 00:39:28,629
We need to run some tests
over the next few days,
809
00:39:28,653 --> 00:39:30,864
but it seems that way.
810
00:39:30,888 --> 00:39:32,601
And I'll be able to walk again?
811
00:39:32,625 --> 00:39:34,037
(GINA): It's gonna be a long recovery,
812
00:39:34,061 --> 00:39:36,943
lots of physical therapy
as your body adjusts
813
00:39:36,967 --> 00:39:38,732
to the hardware in your spine.
814
00:39:38,756 --> 00:39:41,242
But yes, you will.
815
00:39:44,795 --> 00:39:47,500
And I'll have to miss
the next adoption fair?
816
00:39:48,089 --> 00:39:51,405
There'll be lots more. I promise.
817
00:39:51,429 --> 00:39:52,975
Thank you, Dr. Walker.
818
00:39:52,999 --> 00:39:56,038
Nobody ever cared the way you do.
819
00:39:59,612 --> 00:40:01,692
(GINA): I am so sorry.
820
00:40:01,988 --> 00:40:05,128
It's okay. We'll do a raincheck.
821
00:40:08,630 --> 00:40:10,466
(SIGHS)
822
00:40:11,970 --> 00:40:15,186
Sometimes, I wonder how you
manage to leave it all
823
00:40:15,210 --> 00:40:17,080
here when you come home.
824
00:40:18,869 --> 00:40:21,307
It can be really hard.
825
00:40:21,622 --> 00:40:23,226
Yeah.
826
00:40:27,533 --> 00:40:29,470
(SIGHS)
827
00:40:33,013 --> 00:40:35,493
Let's go get a drink, huh?
828
00:40:35,517 --> 00:40:36,953
Yeah.
829
00:40:41,229 --> 00:40:43,332
(SIGHS)
830
00:40:45,604 --> 00:40:48,219
Hey. So, I spoke to Liz,
831
00:40:48,243 --> 00:40:51,140
and told her if she wants
to come forward to HR,
832
00:40:51,164 --> 00:40:52,618
we would both have her back.
833
00:40:53,153 --> 00:40:56,302
Thank you.
Oh, and I'm sorry if I was too...
834
00:40:56,326 --> 00:40:59,641
Sonya, speaking truth
to power takes courage.
835
00:40:59,984 --> 00:41:02,389
I should be thanking you.
836
00:41:03,039 --> 00:41:04,913
Sorry, I didn't mean to interrupt.
837
00:41:04,937 --> 00:41:06,697
Oh no, I was just leaving.
838
00:41:06,721 --> 00:41:09,418
Actually, I was hoping to speak to you.
839
00:41:12,457 --> 00:41:15,005
I just wanted to thank you
for checking in earlier.
840
00:41:15,029 --> 00:41:18,469
- Joan's improving.
- I heard, that's great news.
841
00:41:20,040 --> 00:41:22,720
So we're gonna do this thing? Together?
842
00:41:22,744 --> 00:41:24,591
Well, it's what she wants.
843
00:41:24,615 --> 00:41:26,528
She tends to get what she wants.
844
00:41:26,552 --> 00:41:28,022
Yeah.
845
00:41:32,899 --> 00:41:35,914
I saw Joan, she's spunky as ever.
846
00:41:35,938 --> 00:41:38,309
Can't keep that lady down.
847
00:41:39,678 --> 00:41:41,793
- Amen to that.
- Yeah.
848
00:41:41,817 --> 00:41:44,956
- (TJ): Goodnight, Jake.
- Hey. Goodnight, man.
849
00:41:51,034 --> 00:41:53,382
Hey, did you know about him and Sonya?
850
00:41:53,620 --> 00:41:55,619
What about them?
851
00:41:55,643 --> 00:41:57,657
- No.
- Yeah.
852
00:41:57,681 --> 00:41:59,394
(CHUCKLING)
853
00:41:59,418 --> 00:42:01,365
I guess we set a good example.
854
00:42:01,389 --> 00:42:03,259
(CHUCKLING)
855
00:42:07,200 --> 00:42:09,514
I heard your family was here today.
856
00:42:09,538 --> 00:42:11,218
Yeah. Um...
857
00:42:11,242 --> 00:42:13,589
Mia, she got in
trouble at school, it was,
858
00:42:13,613 --> 00:42:15,583
er, I don't know, it was ridiculous.
859
00:42:17,139 --> 00:42:20,646
Maybe you can tell me
all about it on the way home?
860
00:42:21,930 --> 00:42:25,036
Yeah, sure thing, Chief. I can do that.
861
00:42:25,938 --> 00:42:27,595
It's Co-Chief.
862
00:42:27,619 --> 00:42:30,664
Co-Chief. I'm sorry,
that's just so awkward to say.
863
00:42:30,688 --> 00:42:33,596
I know, tell me about it.
864
00:42:33,620 --> 00:42:35,233
Co-Chief.
865
00:42:35,257 --> 00:42:38,196
(♪ TAKE ME HOME BY BENSON BOONE PLAYING)
866
00:42:39,190 --> 00:42:43,364
♪ Did that fancy college
art school let you in? ♪
867
00:42:44,876 --> 00:42:47,456
♪ Well damn it they'd be crazy ♪
868
00:42:47,480 --> 00:42:49,995
♪ If they never saw in you ♪
869
00:42:50,019 --> 00:42:53,068
♪ What I failed to see at 17 ♪
870
00:42:53,092 --> 00:42:55,606
♪ I must've missed it too ♪
871
00:42:55,630 --> 00:42:57,979
♪ Oh kiss me ♪
872
00:42:58,003 --> 00:43:00,683
♪ Kiss me slowly ♪
873
00:43:00,707 --> 00:43:05,516
♪ Like you did
when we were young ♪
874
00:43:06,987 --> 00:43:11,471
♪ And hold me like you know me ♪
875
00:43:11,495 --> 00:43:13,877
♪ Like the old days ♪
876
00:43:13,901 --> 00:43:18,944
♪ Take me home ♪
877
00:43:23,920 --> 00:43:27,962
(THEME MUSIC)