1 00:00:01,044 --> 00:00:02,132 [narrator] Previously, onDoc. 2 00:00:02,176 --> 00:00:03,220 [Ben] Wasn't sure if you were 3 00:00:03,264 --> 00:00:04,613 the same doctor you used to be. 4 00:00:04,656 --> 00:00:06,267 Now you know I'm as good as I was. 5 00:00:06,310 --> 00:00:09,835 [Ben] We had um, a dalliance. Petered out. No hard feelings. 6 00:00:09,879 --> 00:00:11,489 I want to have a child. 7 00:00:11,533 --> 00:00:13,883 - We've wasted so much time. - I know. 8 00:00:13,926 --> 00:00:15,798 - I'm sorry. - How much cologne are you wearing? 9 00:00:15,841 --> 00:00:17,060 What are you, pregnant? 10 00:00:18,192 --> 00:00:19,932 - [Amy] Ruth, crash cart! - Coming! 11 00:00:19,976 --> 00:00:21,978 - [labored breathing] - That's the supply cart! 12 00:00:22,022 --> 00:00:23,153 I don't feel like a doctor. 13 00:00:23,197 --> 00:00:25,460 Where is the Chief, Dr. Larsen? 14 00:00:25,503 --> 00:00:26,983 She has early-onset Alzheimer's. 15 00:00:27,027 --> 00:00:28,680 Cece? It was your heart all along. 16 00:00:28,724 --> 00:00:31,031 You're going to get your life back. 17 00:00:31,074 --> 00:00:33,033 It was beyond frightening. 18 00:00:33,076 --> 00:00:36,384 I actually thought I had Alzheimer's for almost a year. 19 00:00:36,427 --> 00:00:38,603 But then my amazing doctor at Westside 20 00:00:38,647 --> 00:00:40,431 figured out it was an issue with my heart. 21 00:00:40,475 --> 00:00:41,954 I wish you'd told me. 22 00:00:41,998 --> 00:00:43,434 When you thought you were so sick. 23 00:00:43,478 --> 00:00:44,870 What was I going to say? 24 00:00:44,914 --> 00:00:46,785 I'm losing my mind, come quick, 25 00:00:46,829 --> 00:00:48,309 let me apologize for all those things 26 00:00:48,352 --> 00:00:50,050 I screwed up in our marriage? 27 00:00:50,093 --> 00:00:53,357 - Wouldn't have minded that. - [scoffs] 28 00:00:53,401 --> 00:00:56,360 Wouldn't mind it now either. Since who knows how long I have. 29 00:00:56,404 --> 00:00:58,580 Don't talk like that. 30 00:00:58,623 --> 00:01:00,321 I have an inoperable tumor, Cece, 31 00:01:00,364 --> 00:01:02,540 - what do you want me to say? - That you're going to fight! 32 00:01:02,584 --> 00:01:04,542 - I am. I have been. - I know. 33 00:01:04,586 --> 00:01:06,196 But now that my own medical ordeal 34 00:01:06,240 --> 00:01:07,806 has been resolved, I wanna be there... 35 00:01:07,850 --> 00:01:10,157 [distant echo] ...for whatever you need. 36 00:01:10,592 --> 00:01:12,289 Oh! Dear! 37 00:01:12,333 --> 00:01:13,508 Bonnie? 38 00:01:13,551 --> 00:01:14,900 [tense music] 39 00:01:14,944 --> 00:01:16,076 Bonnie! 40 00:01:18,600 --> 00:01:19,688 [exhales] 41 00:01:19,731 --> 00:01:21,342 Please talk to me! 42 00:01:21,385 --> 00:01:22,908 I can't feel my arm. 43 00:01:22,952 --> 00:01:24,388 I'm calling an ambulance. 44 00:01:26,695 --> 00:01:28,653 [theme music] 45 00:01:36,661 --> 00:01:38,794 Hey! Got your text. 46 00:01:39,795 --> 00:01:40,883 What are we doing here? 47 00:01:40,926 --> 00:01:43,451 I'm having kind of a crisis. 48 00:01:43,494 --> 00:01:46,932 I got that from the way you ran out last night. 49 00:01:46,976 --> 00:01:48,282 I've been worried. 50 00:01:48,325 --> 00:01:51,546 I know. I'm sorry I didn't respond till now. 51 00:01:51,589 --> 00:01:53,591 Okay, what's going on? 52 00:01:57,682 --> 00:02:00,120 [soft music] 53 00:02:00,903 --> 00:02:02,861 Yeah. 54 00:02:02,905 --> 00:02:06,604 My OB couldn't get me in till next week, 55 00:02:06,648 --> 00:02:08,302 and I didn't want to go downstairs, 56 00:02:08,345 --> 00:02:11,479 so I need an ultrasound. 57 00:02:11,522 --> 00:02:15,918 I-I know this is weird and we're not friends, but... 58 00:02:15,961 --> 00:02:18,573 I also know that I can trust you. 59 00:02:18,616 --> 00:02:20,531 Yes, you can. 60 00:02:27,451 --> 00:02:28,931 Um... 61 00:02:47,471 --> 00:02:48,516 There. 62 00:02:48,559 --> 00:02:50,605 There it is. 63 00:02:50,648 --> 00:02:52,694 [tender music] 64 00:02:54,783 --> 00:02:58,482 - [equipment beeping] - CRL suggests seven weeks. 65 00:02:59,396 --> 00:03:01,529 - Oh. - [equipment beeps] 66 00:03:01,572 --> 00:03:03,444 So we can hear the heartbeat? 67 00:03:05,010 --> 00:03:06,795 Are you sure? 68 00:03:06,838 --> 00:03:09,972 Yeah, I've been up all night and... 69 00:03:10,015 --> 00:03:12,366 I'm sure there are a million reasons why 70 00:03:12,409 --> 00:03:14,759 I should just keep going with my life as it is. 71 00:03:14,803 --> 00:03:17,501 And-and thank God I have the right to choose, but... 72 00:03:17,545 --> 00:03:20,635 We see so much death here, every day, 73 00:03:20,678 --> 00:03:23,333 and this just feels like I can do this. 74 00:03:23,377 --> 00:03:27,381 And why not see this as a blessing? 75 00:03:27,424 --> 00:03:29,296 I-I mean, I can do this, right? 76 00:03:29,339 --> 00:03:31,820 I have a great job, and financial security, 77 00:03:31,863 --> 00:03:33,300 and a community. 78 00:03:33,343 --> 00:03:35,345 And TJ. 79 00:03:35,389 --> 00:03:37,956 Yeah. Yes. Of course. 80 00:03:38,000 --> 00:03:39,044 TJ. 81 00:03:40,045 --> 00:03:41,438 You haven't told him yet? 82 00:03:41,482 --> 00:03:43,962 We're having dinner tonight. 83 00:03:44,006 --> 00:03:46,878 I just need the day, I think. 84 00:03:50,186 --> 00:03:52,188 Then maybe wait on the heartbeat. 85 00:03:53,450 --> 00:03:58,107 So you can hear it together when it's time. 86 00:03:59,761 --> 00:04:00,762 Yeah. 87 00:04:05,593 --> 00:04:08,248 Dr. Shaw's running behind, we haven't even gone in yet. 88 00:04:08,291 --> 00:04:10,162 Okay, well, just take it one step at a time. 89 00:04:10,206 --> 00:04:11,599 And give my love to Wendy. 90 00:04:11,642 --> 00:04:13,078 I'm the one who's gonna need the love 91 00:04:13,122 --> 00:04:14,602 if this doesn't go how we hope. 92 00:04:14,645 --> 00:04:17,866 Can you at least try to let yourself be excited? 93 00:04:17,909 --> 00:04:20,216 This is incredible. 94 00:04:20,260 --> 00:04:22,610 There's a fine line between excitement and anxiety. 95 00:04:23,306 --> 00:04:24,568 I'll check in later. 96 00:04:24,612 --> 00:04:26,004 Okay, bye. 97 00:04:32,097 --> 00:04:34,361 So I'm sure Dr. Maitra told you... 98 00:04:34,404 --> 00:04:36,798 She thinks I have a problem with compartmentalization. 99 00:04:36,841 --> 00:04:38,669 Look, we all have our stuff. 100 00:04:38,713 --> 00:04:43,326 We just have to be aware of our blind spots and triggers 101 00:04:43,370 --> 00:04:45,676 and try to stay ahead of them so they don't affect our work. 102 00:04:45,720 --> 00:04:48,157 Well, I just want you to know that I've been working on it. 103 00:04:48,200 --> 00:04:50,028 And I feel really confident that I'll be able to deal 104 00:04:50,072 --> 00:04:51,378 with whatever's thrown my way. 105 00:04:51,421 --> 00:04:53,945 Ruth, I'm glad that you're acknowledging this, 106 00:04:53,989 --> 00:04:56,818 but I think you need to slow down and hear me. 107 00:04:56,861 --> 00:04:59,821 You are not going to solve this in one day. 108 00:05:01,605 --> 00:05:03,955 I know you have a relationship with Dr. Larsen, 109 00:05:03,999 --> 00:05:05,740 but there are other internists I can bring in 110 00:05:05,783 --> 00:05:08,264 - if she's unavailable. - Absolutely not. 111 00:05:08,308 --> 00:05:10,614 She's the best and we will wait. 112 00:05:10,658 --> 00:05:12,442 - [door opens] - Hi. 113 00:05:12,486 --> 00:05:15,924 I'm Dr. Larsen, this is Dr. Chen, and we're-- 114 00:05:15,967 --> 00:05:18,622 - Cece! Hi! - Finally. 115 00:05:18,666 --> 00:05:20,232 Dr. Grant here was trying to pawn me off 116 00:05:20,276 --> 00:05:21,799 on one of your underlings. 117 00:05:21,843 --> 00:05:23,888 Dr. Larsen, meet Bonnie Carroll. 118 00:05:23,932 --> 00:05:26,282 Tenured professor of archaeology at the U of M. 119 00:05:26,326 --> 00:05:28,284 She was also once married to yours truly, 120 00:05:28,328 --> 00:05:30,155 but that's the least of her accomplishments. 121 00:05:30,199 --> 00:05:32,375 Bonnie, this is Chief Larsen. 122 00:05:32,419 --> 00:05:35,378 The brassy broad who saved my life at least twice. 123 00:05:35,422 --> 00:05:37,815 Chief Larsen? 124 00:05:37,859 --> 00:05:41,602 I-- it is so good to see you, Cece-- 125 00:05:41,645 --> 00:05:45,562 but I have a confession to make, I am no longer Chief. 126 00:05:45,606 --> 00:05:47,782 - They demoted you? - No, not exactly. 127 00:05:47,825 --> 00:05:49,349 I had a car accident 128 00:05:49,392 --> 00:05:51,829 and I was recovering neurologically. 129 00:05:51,873 --> 00:05:53,091 So the last time I saw you, 130 00:05:53,135 --> 00:05:55,877 I was actually working as an intern. 131 00:05:55,920 --> 00:05:57,444 You told me you were Chief. 132 00:05:57,487 --> 00:05:59,054 You were pretty unstable 133 00:05:59,097 --> 00:06:02,797 and insistent that you saw the doctor that you remembered. 134 00:06:02,840 --> 00:06:04,494 Sounds like you, Cece. 135 00:06:04,538 --> 00:06:05,930 So you lied? 136 00:06:05,974 --> 00:06:08,237 I did. To help you. 137 00:06:08,280 --> 00:06:10,544 I've been promoted to Chief Resident. 138 00:06:10,587 --> 00:06:12,372 But if you prefer, we can ask the new 139 00:06:12,415 --> 00:06:14,199 Chief of Medicine to come and see you. 140 00:06:14,243 --> 00:06:16,376 [low, tense music] 141 00:06:19,204 --> 00:06:21,511 Will you enlighten her, Dr. Grant? 142 00:06:23,426 --> 00:06:24,732 Yes. 143 00:06:24,775 --> 00:06:26,603 Ms. Carroll comes to us from Eastside, 144 00:06:26,647 --> 00:06:28,605 where she was being treated for an unresectable 145 00:06:28,649 --> 00:06:30,651 Pancoast tumor. Biopsy confirmed 146 00:06:30,694 --> 00:06:33,001 lung adenocarcinoma in the right upper lobe. 147 00:06:33,044 --> 00:06:34,481 She has weakness in the right arm, 148 00:06:34,524 --> 00:06:37,484 with near-complete paralysis in grip for 24 hours. 149 00:06:37,527 --> 00:06:40,574 So the tumor has infiltrated the lower brachial plexus. 150 00:06:40,617 --> 00:06:42,750 Those incipient doctors were trying to shrink it 151 00:06:42,793 --> 00:06:44,316 with chemo and radiation, 152 00:06:44,360 --> 00:06:45,927 and now they're saying that's failed. 153 00:06:45,970 --> 00:06:47,319 They believe the tumor's inoperable 154 00:06:47,363 --> 00:06:49,191 given the invasion of the subclavian artery. 155 00:06:49,234 --> 00:06:50,584 They're recommending palliative care. 156 00:06:50,627 --> 00:06:52,237 And we refuse to accept it. 157 00:06:52,281 --> 00:06:54,805 Present us with another option. 158 00:06:56,851 --> 00:06:58,461 Dr. Chen, get full admissions labs 159 00:06:58,505 --> 00:07:00,115 and update the staging scans. 160 00:07:00,158 --> 00:07:01,333 Mm-hmm. 161 00:07:01,377 --> 00:07:04,380 If there is another way, we will find it. 162 00:07:09,254 --> 00:07:10,647 - Morning! - Morning. 163 00:07:10,691 --> 00:07:12,214 Heard you talking to Dr. Douglas the other day, 164 00:07:12,257 --> 00:07:13,520 saying you were on a vanilla kick. 165 00:07:13,563 --> 00:07:15,478 Ah, I am. Thank you. 166 00:07:15,522 --> 00:07:17,828 You're on clinic duty today. 167 00:07:17,872 --> 00:07:19,569 Clinic duty? 168 00:07:19,613 --> 00:07:20,831 That a problem? 169 00:07:21,658 --> 00:07:23,312 Not at all. 170 00:07:23,355 --> 00:07:25,488 Paige, Dr. Heller's yours today. 171 00:07:25,532 --> 00:07:28,491 Full house down there. Get ready to move some meat. 172 00:07:31,102 --> 00:07:33,844 Hey, listen, Doc, I am due back at work in an hour, 173 00:07:33,888 --> 00:07:35,498 - so I would... - Yeah. 174 00:07:35,542 --> 00:07:37,065 ...appreciate if kept this, y'know, efficient. 175 00:07:37,108 --> 00:07:38,632 Yes, sir, I'm going to try my best, 176 00:07:38,675 --> 00:07:39,981 but you got some catching up to do. 177 00:07:40,024 --> 00:07:41,678 It looks like you missed all of your appointments 178 00:07:41,722 --> 00:07:43,463 after your aortic valve replacement last year? 179 00:07:43,506 --> 00:07:44,855 Yeah, I am sorry about that. 180 00:07:44,899 --> 00:07:47,249 Uh, recovery took a lot of months, and... 181 00:07:47,292 --> 00:07:52,907 I'm still paying that off, so I can't really miss work. 182 00:07:52,950 --> 00:07:57,128 Also, Dr. Swanson said that the surgery went well, so... 183 00:07:57,172 --> 00:08:00,088 [quiet, tense music] 184 00:08:00,131 --> 00:08:02,612 Have you been feeling sick lately? Fatigued? 185 00:08:02,656 --> 00:08:04,222 I mean, yeah, 186 00:08:04,266 --> 00:08:08,226 but I've been working a ton of overtime at the site. 187 00:08:08,270 --> 00:08:10,098 Okay, well, I need to run a few more tests, 188 00:08:10,141 --> 00:08:11,447 but it's all routine. 189 00:08:11,491 --> 00:08:13,405 I'll get the procedure set up as soon as I can. 190 00:08:13,449 --> 00:08:14,494 Are you serious? 191 00:08:14,537 --> 00:08:16,408 I-I know you're in a rush, but... 192 00:08:16,452 --> 00:08:18,236 gotta get this done. 193 00:08:18,280 --> 00:08:20,630 Okay? Just sit tight. 194 00:08:22,414 --> 00:08:23,938 [equipment whirring] 195 00:08:23,981 --> 00:08:25,374 I'm sorry. 196 00:08:25,417 --> 00:08:27,594 I didn't know what you were stepping into earlier. 197 00:08:27,637 --> 00:08:30,074 I hope not. 'Cause I kind of caught you 198 00:08:30,118 --> 00:08:32,294 enjoying it a bit too much. 199 00:08:32,337 --> 00:08:33,774 I was just trying to figure out 200 00:08:33,817 --> 00:08:36,037 - how you pulled it off with Cece. - What do you mean? 201 00:08:36,080 --> 00:08:37,952 What people tell me is that 202 00:08:37,995 --> 00:08:39,693 this version of you is pretty different 203 00:08:39,736 --> 00:08:41,085 than the one back then. 204 00:08:42,304 --> 00:08:43,392 [whoosh] 205 00:08:44,828 --> 00:08:46,351 - [equipment beeping] - Dr. Coleman, just in time. 206 00:08:47,439 --> 00:08:49,790 Whoa. That tumor's a beast. 207 00:08:49,833 --> 00:08:52,662 Yeah. It's infiltrating the subclavian artery, 208 00:08:52,706 --> 00:08:53,924 vein, and brachial plexus, 209 00:08:53,968 --> 00:08:55,883 it's even growing around the vertebrae. 210 00:08:55,926 --> 00:08:57,885 Yeah, I guess we know why Eastside refused to cut into it. 211 00:08:57,928 --> 00:09:00,452 Plus her uncontrolled hypertension from the chemo 212 00:09:00,496 --> 00:09:03,020 puts her in danger of having a stroke mid-operation. 213 00:09:03,064 --> 00:09:05,501 They were right. You can't get it. 214 00:09:05,545 --> 00:09:07,111 They can't get it. I can. 215 00:09:07,155 --> 00:09:08,635 How's that? 216 00:09:08,678 --> 00:09:10,114 Most surgeons don't have the stomach 217 00:09:10,158 --> 00:09:12,160 or the stamina to resect it. 218 00:09:12,203 --> 00:09:15,642 Just have to go at it with three different approaches at once. 219 00:09:15,685 --> 00:09:18,949 Wa-- we'll need to lower her BP before even considering this. 220 00:09:18,993 --> 00:09:21,256 Not at all. We can handle it ourselves in the OR. 221 00:09:21,299 --> 00:09:24,781 A lot better if I find a medical solution first. 222 00:09:24,825 --> 00:09:26,914 Now, we have been down this road before. 223 00:09:26,957 --> 00:09:29,177 That man had antlers in his chest. 224 00:09:29,220 --> 00:09:32,659 Plus, we don't have to scramble with this patient. 225 00:09:32,702 --> 00:09:34,530 Okay, it'll be risky no matter when we attempt it. 226 00:09:34,574 --> 00:09:37,968 You try to manage a risk away and she'll die waiting. 227 00:09:38,012 --> 00:09:39,491 Where are you going? 228 00:09:39,535 --> 00:09:40,797 I'm taking my solution to them. 229 00:09:40,841 --> 00:09:42,843 Now, if you have a better idea, be my guest. 230 00:09:42,886 --> 00:09:44,322 Pitch it. 231 00:09:46,716 --> 00:09:49,893 I need some time. Don't let him start cutting. 232 00:09:49,937 --> 00:09:52,200 [tense music] 233 00:09:56,987 --> 00:09:59,816 - You sure you have to go? - My panel starts in an hour. 234 00:09:59,860 --> 00:10:01,383 And then it's straight to the airport. 235 00:10:01,426 --> 00:10:03,037 I'm just saying, we have the room till 11, 236 00:10:03,080 --> 00:10:04,995 and these panels, they never start on time. 237 00:10:06,954 --> 00:10:08,782 [murmurs decline] Ooh. 238 00:10:08,825 --> 00:10:12,394 Or maybe we pick this up in Austin next month. 239 00:10:12,437 --> 00:10:15,136 Assuming you're going to the AustinMed conference. 240 00:10:15,179 --> 00:10:16,790 Round three. 241 00:10:16,833 --> 00:10:18,095 Only thing is, um, 242 00:10:18,139 --> 00:10:19,793 my divorce is getting kind of nasty, 243 00:10:19,836 --> 00:10:22,143 so if we could just keep this on the down-low. 244 00:10:22,186 --> 00:10:24,536 Yeah. How about if we're in the same city, 245 00:10:24,580 --> 00:10:25,929 if it makes sense. 246 00:10:25,973 --> 00:10:28,105 There's no need to make it into something it's not. 247 00:10:28,149 --> 00:10:30,151 Yeah. And let's say no texting. 248 00:10:30,194 --> 00:10:32,632 To be safe. Just calls. 249 00:10:33,067 --> 00:10:34,329 Yeah. 250 00:10:36,113 --> 00:10:37,158 So you've done this before? 251 00:10:37,201 --> 00:10:39,639 Well, not this approach exactly. 252 00:10:39,682 --> 00:10:42,032 But I've dealt with a lot of complex, invasive tumors, 253 00:10:42,076 --> 00:10:44,469 and this will take more time. But it's not impossible. 254 00:10:44,513 --> 00:10:46,602 Still, you have not done this. 255 00:10:46,646 --> 00:10:48,299 I'm not sure I love the sound of that. 256 00:10:48,343 --> 00:10:50,432 What choice do we have? Palliative care? 257 00:10:50,475 --> 00:10:52,129 This is amazing news, Cece. 258 00:10:53,609 --> 00:10:56,481 Sorry I'm late. I was doing my own assessment 259 00:10:56,525 --> 00:10:57,657 of Bonnie's condition. 260 00:10:57,700 --> 00:10:59,354 Good. Because he's selling us 261 00:10:59,397 --> 00:11:01,399 on a surgery he's never performed before. 262 00:11:01,443 --> 00:11:03,445 The surgery's a legitimate solution. 263 00:11:03,488 --> 00:11:06,361 But Bonnie's blood pressure needs to be stabilized first. 264 00:11:06,404 --> 00:11:07,841 And I have found a way 265 00:11:07,884 --> 00:11:10,321 to bring it under control with fewer risks. 266 00:11:10,365 --> 00:11:12,149 He said he could manage the blood pressure. 267 00:11:12,193 --> 00:11:13,455 And he's the Chief of Surgery. 268 00:11:13,498 --> 00:11:15,631 Everyone told me I had Alzheimer's. 269 00:11:15,675 --> 00:11:17,285 And look at me now. 270 00:11:17,328 --> 00:11:18,765 What's your plan, Dr. Larsen? 271 00:11:18,808 --> 00:11:21,028 It's called carotid baroreflex stimulation, 272 00:11:21,071 --> 00:11:24,161 - I've done it before-- - When exactly? 273 00:11:24,205 --> 00:11:25,946 Three times, last year. 274 00:11:25,989 --> 00:11:27,774 I see. Dr. Larsen... 275 00:11:29,819 --> 00:11:30,951 A word. 276 00:11:32,343 --> 00:11:33,562 I'll be right back. 277 00:11:37,827 --> 00:11:39,046 When I said come up with something, 278 00:11:39,089 --> 00:11:41,657 I was hoping it'd be a procedure you remember. 279 00:11:41,701 --> 00:11:43,703 Not one you had to find in your old notes. 280 00:11:43,746 --> 00:11:45,400 My notes are thorough. 281 00:11:45,443 --> 00:11:47,097 And at least I've done the procedure. 282 00:11:47,141 --> 00:11:48,708 And are you going to tell Bonnie and Cece 283 00:11:48,751 --> 00:11:50,666 that you never actually recovered neurologically? 284 00:11:50,710 --> 00:11:52,712 My memory loss isn't an issue here. 285 00:11:52,755 --> 00:11:56,193 Bonnie could die on the table if we do it your way. 286 00:11:56,237 --> 00:11:58,108 What I'm presenting is lower risk, 287 00:11:58,152 --> 00:11:59,675 and if you actually read my notes, 288 00:11:59,719 --> 00:12:01,590 you will see that all three patients 289 00:12:01,633 --> 00:12:03,635 were in much worse condition than Bonnie. 290 00:12:03,679 --> 00:12:06,160 Right now, her BP's high. But it's predictable. 291 00:12:06,203 --> 00:12:08,728 If you destabilize it, then surgery is off the table. 292 00:12:08,771 --> 00:12:10,512 And we're out of options. 293 00:12:11,992 --> 00:12:13,080 [whoosh] 294 00:12:13,123 --> 00:12:15,212 Thank you. For taking time today 295 00:12:15,256 --> 00:12:16,736 to come see what I've been doing. 296 00:12:18,259 --> 00:12:20,391 Did you think I was a good doctor? 297 00:12:20,435 --> 00:12:22,350 When you knew me before? 298 00:12:22,393 --> 00:12:25,092 - You were brilliant. - That hasn't changed. 299 00:12:25,135 --> 00:12:27,137 So how about you trust me this time? 300 00:12:29,966 --> 00:12:32,621 Okay. I will. 301 00:12:37,365 --> 00:12:38,845 Before I give you numbers, 302 00:12:38,888 --> 00:12:40,977 I want you to remember that you're an individual, 303 00:12:41,021 --> 00:12:42,413 not a statistic. 304 00:12:42,457 --> 00:12:44,415 We've done all the research, and we know the odds. 305 00:12:44,459 --> 00:12:46,113 We're here because we know we need your help. 306 00:12:46,156 --> 00:12:47,767 - Yeah. - So you know that it could be 307 00:12:47,810 --> 00:12:49,464 very difficult? The important thing 308 00:12:49,507 --> 00:12:51,161 is you came here today, because at this point, 309 00:12:51,205 --> 00:12:52,554 every day matters. 310 00:12:52,597 --> 00:12:54,948 I've been taking really good care of myself. 311 00:12:55,905 --> 00:12:57,994 - And we have faith. - Mm-hmm. 312 00:12:58,038 --> 00:13:01,258 Well, I was honestly assuming we would test both of you. 313 00:13:02,259 --> 00:13:04,174 Both of us? 314 00:13:04,218 --> 00:13:05,654 Why not? 315 00:13:06,220 --> 00:13:07,874 Um, I'm 48. 316 00:13:07,917 --> 00:13:09,789 And I've had patients give birth 317 00:13:09,832 --> 00:13:12,313 to beautiful healthy children as old as 51. 318 00:13:12,356 --> 00:13:15,795 You're here. Might as well see what we're working with. 319 00:13:18,623 --> 00:13:20,582 - More doctors? - I know you're anxious 320 00:13:20,625 --> 00:13:22,149 to get out of here, but unfortunately, 321 00:13:22,192 --> 00:13:23,977 your stress test results indicate you might need 322 00:13:24,020 --> 00:13:25,369 to be brought into internal medicine. 323 00:13:25,413 --> 00:13:27,328 - Oh. - [phone vibrating] 324 00:13:27,371 --> 00:13:30,548 Oh, my God, I'm so sorry. It's my husband. 325 00:13:30,592 --> 00:13:32,289 - Uh-- - Hello? 326 00:13:32,333 --> 00:13:35,466 - What is this, a circus? - I'm sure that was important. 327 00:13:35,510 --> 00:13:38,034 - [breathing heavily] - He's 13 months post-surgical 328 00:13:38,078 --> 00:13:40,732 aortic valve replacement of a congenital bicuspid valve. 329 00:13:40,776 --> 00:13:42,691 Heard a new murmur on exam, and he reports worsening 330 00:13:42,734 --> 00:13:43,997 fatigue upon exertion. 331 00:13:44,040 --> 00:13:45,955 That's also 'cause I'm on a construction site 332 00:13:45,999 --> 00:13:48,001 12 hours a day. 333 00:13:48,044 --> 00:13:49,089 [breathing heavily] 334 00:13:49,132 --> 00:13:50,873 [melancholy music] 335 00:13:51,613 --> 00:13:53,571 What's going on? 336 00:13:53,615 --> 00:13:55,791 I'm afraid you're in heart failure again. 337 00:13:55,835 --> 00:13:58,185 - [gasping] - What? 338 00:13:58,228 --> 00:14:02,058 Dr. Swanson said this would be over after surgery. 339 00:14:02,102 --> 00:14:03,886 Now I need another one? 340 00:14:03,930 --> 00:14:07,542 I can't afford to miss two more months of work. 341 00:14:07,585 --> 00:14:09,936 Let's just take this one step at a time. 342 00:14:10,980 --> 00:14:13,330 Okay... [gasping] 343 00:14:13,374 --> 00:14:16,116 We need to figure out how long his heart's been in failure. 344 00:14:16,159 --> 00:14:18,596 That's the problem. He missed all of his follow-ups 345 00:14:18,640 --> 00:14:20,555 with Swanson, so there won't be any echoes. 346 00:14:20,598 --> 00:14:22,296 Oh. So, what are you thinking? 347 00:14:22,339 --> 00:14:24,428 We need valve gradients, leaflet motion, 348 00:14:24,472 --> 00:14:26,778 ventricular function, so let's start with the TE, 349 00:14:26,822 --> 00:14:28,389 - then get CBCs... - Yeah. 350 00:14:28,432 --> 00:14:30,130 - ...CRP... - Blood cultures 351 00:14:30,173 --> 00:14:31,174 to rule out endocarditis. 352 00:14:31,218 --> 00:14:32,654 Yep. 353 00:14:32,697 --> 00:14:35,091 Be nice if your intern was available to manage that. 354 00:14:35,962 --> 00:14:38,399 [indistinct] 355 00:14:38,442 --> 00:14:41,184 It's fine. I'll order them myself. 356 00:14:42,316 --> 00:14:45,406 [tense music] 357 00:14:45,449 --> 00:14:47,625 [equipment beeping] 358 00:14:55,546 --> 00:14:56,678 The peak gradient's 80 359 00:14:56,721 --> 00:14:58,375 and the leaflets are barely moving. 360 00:14:58,419 --> 00:15:00,508 Well, that valve's critically obstructed. 361 00:15:00,551 --> 00:15:01,944 No wonder he's back in heart failure. 362 00:15:01,988 --> 00:15:03,337 I'll call surgery. 363 00:15:05,556 --> 00:15:07,123 Thanks, Mike, we can take it from here. 364 00:15:08,429 --> 00:15:09,430 [electronic beep] 365 00:15:11,388 --> 00:15:12,563 [door closes] 366 00:15:12,607 --> 00:15:15,001 Swanson didn't implant the valve correctly. 367 00:15:15,044 --> 00:15:17,220 Well, a post-op echo would have showed that. 368 00:15:17,264 --> 00:15:19,396 He should never have been discharged. 369 00:15:19,440 --> 00:15:21,790 - It's not here. - He never ordered it? 370 00:15:21,833 --> 00:15:23,096 I don't know, but it's not here 371 00:15:23,139 --> 00:15:24,619 and I need to find out why. 372 00:15:24,662 --> 00:15:27,709 So what we're doing here is using electrical pulses 373 00:15:27,752 --> 00:15:29,972 to trick your brain into lowering your blood pressure. 374 00:15:30,016 --> 00:15:31,669 How are her vitals? 375 00:15:31,713 --> 00:15:35,325 Uh, BP is 195 over 100, heart rate 85. 376 00:15:35,369 --> 00:15:38,198 Hi, I'm Dr. Hamda, Chief of Internal Medicine. 377 00:15:38,241 --> 00:15:41,070 Cece suggested I might pay a little visit. 378 00:15:41,114 --> 00:15:43,855 She does love authority figures. 379 00:15:43,899 --> 00:15:47,076 So. Carotid baroreflex stimulation. 380 00:15:47,120 --> 00:15:48,512 Did you want to supervise? 381 00:15:48,556 --> 00:15:52,212 I'll observe and assist if needed. 382 00:15:52,777 --> 00:15:54,431 Great. 383 00:15:54,475 --> 00:15:56,651 - Are you ready? - I trust Cece. 384 00:15:56,694 --> 00:15:58,740 And she trusts you. 385 00:15:58,783 --> 00:16:01,134 You tell us if it gets too much for you, okay? 386 00:16:01,177 --> 00:16:02,657 [Bonnie exhales] 387 00:16:02,700 --> 00:16:04,137 [electronic beeping] 388 00:16:07,140 --> 00:16:08,663 [electronic beeping] 389 00:16:08,706 --> 00:16:11,274 Increasing frequency to 80 hertz. 390 00:16:11,318 --> 00:16:14,190 [quiet, tense music] 391 00:16:14,234 --> 00:16:15,757 [electronic beeping] 392 00:16:17,454 --> 00:16:20,805 Systolic's down to 150. So far so good, Bonnie. 393 00:16:20,849 --> 00:16:22,459 You doing okay? 394 00:16:22,503 --> 00:16:25,245 - Feels weird, but I'm fine. - Okay. 395 00:16:26,594 --> 00:16:27,638 [electronic beeping] 396 00:16:27,682 --> 00:16:30,163 120s now... Almost there! 397 00:16:32,513 --> 00:16:33,601 [alarm beeping] 398 00:16:34,602 --> 00:16:35,951 [alarm beeping] 399 00:16:35,995 --> 00:16:37,648 Uh, systolic's 190 and climbing? 400 00:16:38,388 --> 00:16:39,694 It's all good. 401 00:16:39,737 --> 00:16:41,957 Increasing stimulation settings to compensate. 402 00:16:42,001 --> 00:16:43,350 [electronic beeping] 403 00:16:45,526 --> 00:16:46,527 [alarm beeping] 404 00:16:46,570 --> 00:16:48,050 [exhales] 405 00:16:49,747 --> 00:16:52,098 - [breathing rapidly] - I'm feeling a bit... 406 00:16:52,141 --> 00:16:53,534 [alarms beeping] 407 00:16:53,577 --> 00:16:55,101 [louder alarms bleeping] 408 00:16:55,144 --> 00:16:57,016 - [ominous music] - Uh-- 409 00:16:57,059 --> 00:16:58,408 She's hypotensive, with a weak pulse. 410 00:16:58,452 --> 00:17:01,542 - She's losing consciousness. - Crash cart! Now! 411 00:17:01,585 --> 00:17:05,024 Bonnie?! Bonnie! Can you hear me? Bonnie! 412 00:17:07,026 --> 00:17:08,853 - [restaurant din] - I'm on my own 413 00:17:08,897 --> 00:17:10,072 for my birthday this go around. 414 00:17:10,116 --> 00:17:12,640 Actually, the first time in three decades. 415 00:17:12,683 --> 00:17:14,250 Yeah? How are you gonna celebrate? 416 00:17:14,294 --> 00:17:15,686 With this mess of a year? 417 00:17:15,730 --> 00:17:18,167 Drinking a whiskey and watching the Knicks. 418 00:17:18,994 --> 00:17:20,604 That sounds heavenly. 419 00:17:20,648 --> 00:17:22,215 - Right? - Ben! 420 00:17:22,258 --> 00:17:23,477 Thought you were heading back last night? 421 00:17:23,520 --> 00:17:27,350 Hey! Um, well, Dr. Larsen cornered me 422 00:17:27,394 --> 00:17:29,700 after my VATs talk and offered to lecture me 423 00:17:29,744 --> 00:17:32,094 on post-op pleural effusion management. 424 00:17:32,138 --> 00:17:33,965 Over lukewarm omelettes. 425 00:17:34,009 --> 00:17:35,750 An offer he couldn't refuse. 426 00:17:35,793 --> 00:17:38,144 Understandable. Your reputation precedes you. 427 00:17:38,187 --> 00:17:40,059 Elliot Norman. A pleasure. 428 00:17:40,102 --> 00:17:42,017 Yeah, I feel like I know you from all of your 429 00:17:42,061 --> 00:17:44,063 - acknowledgements in JAMA. - Angling for another one 430 00:17:44,106 --> 00:17:45,194 soon if Ben gets his way. 431 00:17:45,238 --> 00:17:46,978 Eliot is the Chief Research Officer 432 00:17:47,022 --> 00:17:48,197 overseeing my bridge heart trial 433 00:17:48,241 --> 00:17:49,285 - at St. Mark's. - Oh. 434 00:17:49,329 --> 00:17:50,634 Love to get your read on it, 435 00:17:50,678 --> 00:17:52,680 if you're gonna be in New York any time soon. 436 00:17:52,723 --> 00:17:54,203 I'm not a cardiologist. 437 00:17:54,247 --> 00:17:55,900 No, but there are a dozen medical co-morbid factors 438 00:17:55,944 --> 00:17:57,467 that can complicate the trial. 439 00:17:57,511 --> 00:17:59,034 Gotta make sure he's not getting a home court advantage 440 00:17:59,078 --> 00:18:00,122 from our internists. 441 00:18:00,166 --> 00:18:02,037 Hey, it's more than fine by me. 442 00:18:04,779 --> 00:18:07,999 I'm actually passing through New York in a couple of weeks. 443 00:18:08,043 --> 00:18:09,653 I'd love to stop by. 444 00:18:09,697 --> 00:18:12,656 Splendid. Ben can give you the details for my office. 445 00:18:12,700 --> 00:18:14,615 I'll make sure your hotel and flights are covered. 446 00:18:14,658 --> 00:18:16,530 - Good to see ya. - Thank you. 447 00:18:19,272 --> 00:18:20,708 Couple of weeks? 448 00:18:20,751 --> 00:18:23,711 Well, it seems like he really wants me there. 449 00:18:26,279 --> 00:18:27,802 - [tense music] - [equipment beeping] 450 00:18:27,845 --> 00:18:29,717 So, she is in a medically induced coma 451 00:18:29,760 --> 00:18:31,110 for hypertensive crisis. 452 00:18:31,153 --> 00:18:33,068 The increase in stimulation was minimal. 453 00:18:33,112 --> 00:18:35,157 There's no way it could've bottomed out her BP like this. 454 00:18:35,201 --> 00:18:36,419 What's the MRI show? 455 00:18:36,463 --> 00:18:37,768 There's no anoxic brain damage. 456 00:18:37,812 --> 00:18:39,118 I'm loading her on phenytoin. 457 00:18:39,161 --> 00:18:40,771 And an EEG. 458 00:18:40,815 --> 00:18:42,295 I don't need her seizing on my table 459 00:18:42,338 --> 00:18:44,123 if you ever manage to get her there. 460 00:18:44,166 --> 00:18:46,821 I'm sensing you had a stark difference of opinion 461 00:18:46,864 --> 00:18:48,214 about the correct course of action. 462 00:18:48,257 --> 00:18:49,693 - We did, yes. - Well, that should've been 463 00:18:49,737 --> 00:18:51,042 - brought to me. - I'm assuming if that 464 00:18:51,086 --> 00:18:52,870 were the protocol, Dr. Larsen would've done so. 465 00:18:52,914 --> 00:18:54,307 We sorted it out ourselves, 466 00:18:54,350 --> 00:18:57,484 and Dr. Grant agreed that my idea was lower risk. 467 00:18:57,527 --> 00:18:58,789 And obviously I was wrong. 468 00:18:58,833 --> 00:19:01,052 I just got off the phone with Eastside. 469 00:19:01,096 --> 00:19:02,750 I want her transferred there now. 470 00:19:02,793 --> 00:19:04,795 That's not possible, Ms. Reinhold. 471 00:19:04,839 --> 00:19:06,362 She's in no condition to be moved. 472 00:19:06,406 --> 00:19:08,234 There is a variable that we all missed. 473 00:19:08,277 --> 00:19:10,366 But as soon as I find it, we will address it 474 00:19:10,410 --> 00:19:11,759 before there are any more complications. 475 00:19:11,802 --> 00:19:13,369 You need to trust me. 476 00:19:13,413 --> 00:19:14,805 I already made that mistake. 477 00:19:15,763 --> 00:19:17,417 Labs just came back. 478 00:19:17,460 --> 00:19:20,115 BUN and creatinine are elevated, but TSH is normal. 479 00:19:20,159 --> 00:19:21,464 [Dr. Larsen] Okay, thank you, Ruth. 480 00:19:21,508 --> 00:19:23,074 If Bonnie's going to stay here, 481 00:19:23,118 --> 00:19:24,467 I want you, the head of the department, 482 00:19:24,511 --> 00:19:26,904 taking charge. And maybe you can figure out 483 00:19:26,948 --> 00:19:29,777 what Dr. Larsen and this little intern did 484 00:19:29,820 --> 00:19:31,518 that has backfired so disastrously. 485 00:19:31,561 --> 00:19:34,085 Now, outcomes can't always be predicted. 486 00:19:34,129 --> 00:19:36,697 And Bonnie was in terrible shape when she walked in our door. 487 00:19:36,740 --> 00:19:38,438 But we hear you. 488 00:19:38,481 --> 00:19:41,789 And I'll be running point on this from here on out. 489 00:19:41,832 --> 00:19:43,443 If you'll excuse me, I'll have to explain 490 00:19:43,486 --> 00:19:46,750 to her family why they may never get to say goodbye to her. 491 00:19:46,794 --> 00:19:48,448 [footsteps retreat] 492 00:19:49,536 --> 00:19:50,972 I'll be standing by 493 00:19:51,015 --> 00:19:52,887 if you can ever find your way back from this. 494 00:19:54,497 --> 00:19:55,716 Dr. Chen. 495 00:19:55,759 --> 00:19:58,153 Trend BUN, creatinine and urine output, 496 00:19:58,197 --> 00:20:01,243 and, uh, try to let that slide off of you. 497 00:20:01,287 --> 00:20:03,114 Yeah, I appreciate that. I'm fine. 498 00:20:03,158 --> 00:20:04,638 I'm going to insert a central line 499 00:20:04,681 --> 00:20:06,944 so we can monitor her CVPs and fluid status. 500 00:20:06,988 --> 00:20:09,251 And get me your notes on those old cases. 501 00:20:09,295 --> 00:20:11,427 Michael. 502 00:20:11,471 --> 00:20:13,516 I don't know yet what went wrong, 503 00:20:13,560 --> 00:20:15,605 but it was the right call. 504 00:20:21,916 --> 00:20:23,700 So Dr. Swanson's not here? 505 00:20:23,744 --> 00:20:26,660 He is, uh, tied up in another surgery at the moment. 506 00:20:26,703 --> 00:20:29,053 But listen, Dr. Humphrey is excellent, okay? 507 00:20:29,097 --> 00:20:30,577 We're lucky that he was on call. 508 00:20:30,620 --> 00:20:31,752 He reviewed your TEE, 509 00:20:31,795 --> 00:20:33,101 came up with an airtight game plan, okay? 510 00:20:33,144 --> 00:20:34,320 I don't understand what went wrong 511 00:20:34,363 --> 00:20:35,712 in the first place. 512 00:20:35,756 --> 00:20:37,932 We're still trying to get to the bottom of that. 513 00:20:37,975 --> 00:20:40,108 Okay, but listen, right now, the important thing 514 00:20:40,151 --> 00:20:42,197 is that we solve this problem once and for all, okay? 515 00:20:42,241 --> 00:20:45,548 Thanks, Doc. I-I do appreciate it. 516 00:20:45,592 --> 00:20:47,420 See you in post-op. 517 00:20:50,945 --> 00:20:52,512 [equipment beeping] 518 00:20:52,555 --> 00:20:54,775 Hey, Roger, you got a sec? 519 00:20:54,818 --> 00:20:56,820 I got 60. 520 00:20:56,864 --> 00:20:58,474 Listen, I wanted to give you a heads up 521 00:20:58,518 --> 00:21:00,476 that one of your patients was readmitted 522 00:21:00,520 --> 00:21:02,348 with an improperly seeded aortic valve. 523 00:21:02,391 --> 00:21:05,873 - Oh. Who was it? - Johnny Parsons. 524 00:21:05,916 --> 00:21:07,614 Aortic valve stenosis, 33, 525 00:21:07,657 --> 00:21:09,746 works construction, needed a SAVR? 526 00:21:09,790 --> 00:21:11,052 I can't say I remember him, 527 00:21:11,095 --> 00:21:12,488 but, uh, I'm happy to get back in there 528 00:21:12,532 --> 00:21:14,011 and patch him up after this. 529 00:21:14,055 --> 00:21:16,492 Yeah, he's already in surgery. Humphrey was on call. 530 00:21:16,536 --> 00:21:18,886 And I'm just hearing about it now? 531 00:21:18,929 --> 00:21:20,844 I would have had a duty to disclose 532 00:21:20,888 --> 00:21:22,542 your potential negligence before allowing you 533 00:21:22,585 --> 00:21:23,717 to operate on him again. 534 00:21:23,760 --> 00:21:25,153 So, this just felt more expedient. 535 00:21:25,196 --> 00:21:26,502 Negligence? 536 00:21:26,546 --> 00:21:27,721 I'm not talking about the valve. 537 00:21:27,764 --> 00:21:28,852 That could've happened to anybody. 538 00:21:28,896 --> 00:21:29,940 I'm referring to the post-op echo 539 00:21:29,984 --> 00:21:31,028 that I can't seem to find. 540 00:21:31,072 --> 00:21:32,334 That would've shown a gradient. 541 00:21:32,378 --> 00:21:33,683 You never would've discharged him. 542 00:21:33,727 --> 00:21:36,512 Oh, so, you're a detective now? 543 00:21:36,556 --> 00:21:38,253 Or is it Internal Affairs? 544 00:21:39,863 --> 00:21:41,300 Okay, well, I'm headed to radiology. 545 00:21:41,343 --> 00:21:42,866 Sure hoping they can find it. 546 00:21:43,824 --> 00:21:45,042 Dr. Heller? 547 00:21:46,609 --> 00:21:48,394 Proper protocol would have been 548 00:21:48,437 --> 00:21:50,134 to go to the head of the department. 549 00:21:50,178 --> 00:21:52,659 Does Dr. Matos know you're running around like this? 550 00:21:52,702 --> 00:21:55,531 First-year fellow on second week on the job? 551 00:21:55,575 --> 00:21:57,533 You know, I was giving you the benefit of the doubt. 552 00:21:57,577 --> 00:21:59,230 Now I'm not so sure it was earned. 553 00:21:59,274 --> 00:22:02,059 Dr. Swanson. We're ready for you. 554 00:22:06,673 --> 00:22:08,675 So, none of your other patients 555 00:22:08,718 --> 00:22:10,154 had a BP spike like Bonnie's, 556 00:22:10,198 --> 00:22:12,287 even though they were in the same hypertensive range? 557 00:22:12,331 --> 00:22:17,640 No. Which makes her reaction all the more puzzling. 558 00:22:17,684 --> 00:22:20,077 I'm not sure how you could've ever liked her. 559 00:22:21,165 --> 00:22:23,646 She uses anger to cover her grief. 560 00:22:23,690 --> 00:22:25,953 And I know a bit about that. 561 00:22:25,996 --> 00:22:28,303 I'm sure you've heard. 562 00:22:28,347 --> 00:22:31,088 Bonnie's EEG tracing continues to be within normal limits, 563 00:22:31,132 --> 00:22:33,743 but now her temperature's all over the place, too. 564 00:22:33,787 --> 00:22:36,529 She's been as high as 102. 565 00:22:36,572 --> 00:22:39,445 Do the fluctuations track with her blood pressure spikes? 566 00:22:39,488 --> 00:22:41,751 [ominous music] 567 00:22:42,883 --> 00:22:45,233 Almost to the second. 568 00:22:45,276 --> 00:22:48,105 We've been treating the tumor like an adenocarcinoma, 569 00:22:48,149 --> 00:22:50,238 but what if there's more going on? 570 00:22:51,108 --> 00:22:52,545 Divergent differentiation. 571 00:22:52,588 --> 00:22:54,895 So the tumor consists of two different cell types, 572 00:22:54,938 --> 00:22:56,505 - not just the one? - Exactly. 573 00:22:56,549 --> 00:22:58,115 So what kind of tumor cell 574 00:22:58,159 --> 00:22:59,900 could explain simultaneous spikes 575 00:22:59,943 --> 00:23:02,598 in both blood pressure and body temperature, Dr. Chen? 576 00:23:02,642 --> 00:23:04,600 One secreting catecholamines. 577 00:23:04,644 --> 00:23:06,820 - Yeah. - Go get plasma metanephrines. 578 00:23:06,863 --> 00:23:07,908 Yeah. 579 00:23:07,951 --> 00:23:09,388 If you're right, 580 00:23:09,431 --> 00:23:11,390 delaying surgery saved her life. 581 00:23:17,439 --> 00:23:19,876 Pharmacadia's device only lasts two years, 582 00:23:19,920 --> 00:23:22,096 and a quarter of the patients die waiting for transplants. 583 00:23:22,139 --> 00:23:24,968 This is gonna blow them out of the water. 584 00:23:25,012 --> 00:23:27,188 In terms of long-term durability? 585 00:23:27,231 --> 00:23:28,668 No, not just durability, 586 00:23:28,711 --> 00:23:30,757 this could be a permanent solution. 587 00:23:30,800 --> 00:23:33,150 Oh, you're getting a little bit ahead of yourself. 588 00:23:33,194 --> 00:23:36,371 Well, a man can dream. 589 00:23:36,415 --> 00:23:39,940 So, uh, this is what the book's gonna be about? 590 00:23:39,983 --> 00:23:41,985 Wha-- no, no, no, I'm not publishing on this yet. 591 00:23:42,029 --> 00:23:44,466 Uh, the book is about my father. 592 00:23:44,510 --> 00:23:47,774 And grandfather. Both surgeons. 593 00:23:47,817 --> 00:23:50,646 - That's quite the legacy. - Both giants. 594 00:23:50,690 --> 00:23:53,127 Dad still is. 595 00:23:53,170 --> 00:23:55,825 Well, I'm sure this will make him very proud. 596 00:23:55,869 --> 00:23:58,175 Well, he's a tough one, we'll see. 597 00:24:00,134 --> 00:24:02,789 So what is it that Elliot wants me to look at? 598 00:24:02,832 --> 00:24:04,312 [ominous music] 599 00:24:04,355 --> 00:24:06,445 A catecholamine-secreting tumor. 600 00:24:06,488 --> 00:24:08,664 And Eastside had no reason to look for it 601 00:24:08,708 --> 00:24:10,013 after the initial biopsy. 602 00:24:10,057 --> 00:24:11,711 But clearly, the chemo 603 00:24:11,754 --> 00:24:13,669 is not what was causing her BP spikes. 604 00:24:13,713 --> 00:24:16,280 And if I'd resected her tumor the way I planned, 605 00:24:16,324 --> 00:24:18,369 the hormone secretion into her bloodstream 606 00:24:18,413 --> 00:24:21,329 - would've killed her. - In all likelihood, yes. 607 00:24:21,372 --> 00:24:23,374 In all certainty, but I appreciate you 608 00:24:23,418 --> 00:24:25,159 not rubbing it in my face. 609 00:24:25,202 --> 00:24:26,726 Not really my style. 610 00:24:26,769 --> 00:24:28,945 At least, not anymore. 611 00:24:30,164 --> 00:24:32,383 [knocking] 612 00:24:32,427 --> 00:24:33,776 I gave Cece the update 613 00:24:33,820 --> 00:24:36,953 and told her we're deciding best course of action. 614 00:24:36,997 --> 00:24:39,173 - Can you still operate? - Well, I was hoping to do 615 00:24:39,216 --> 00:24:41,262 a three-stage approach, but now I can't. 616 00:24:41,305 --> 00:24:42,611 I mean, I-I would need to remove 617 00:24:42,655 --> 00:24:43,960 the hormone-secreting tumor first, 618 00:24:44,004 --> 00:24:46,136 which is a whole different scale. 619 00:24:46,180 --> 00:24:49,444 Didn't you do a paraganglioma resection last year? 620 00:24:49,488 --> 00:24:51,577 - You read that? - 20 minutes ago. 621 00:24:51,620 --> 00:24:53,622 I can do an en bloc removal in my sleep, 622 00:24:53,666 --> 00:24:55,406 but her tumor's like an octopus now. 623 00:24:55,450 --> 00:24:56,582 And it's in her lung, 624 00:24:56,625 --> 00:24:58,018 not her bladder like in that surgery. 625 00:24:58,061 --> 00:25:00,324 Plus, the catecholamine release. 626 00:25:00,368 --> 00:25:01,891 The second you touch it, she could stroke out. 627 00:25:01,935 --> 00:25:04,372 And we're talking six, maybe eight hours 628 00:25:04,415 --> 00:25:05,808 poking around in there. 629 00:25:05,852 --> 00:25:08,332 Phentolamine for any hypertensive surges, 630 00:25:08,376 --> 00:25:10,770 metyrosine to suppress the hormone production, 631 00:25:10,813 --> 00:25:14,251 and titrate minute to minute. It would be on me. 632 00:25:15,209 --> 00:25:16,558 I'm game if you are. 633 00:25:16,602 --> 00:25:18,342 It's up to him. 634 00:25:22,303 --> 00:25:23,652 Once Johnny's out of surgery, 635 00:25:23,696 --> 00:25:26,350 do a post-op exam and present your findings to me. 636 00:25:26,394 --> 00:25:30,006 Till then, it's admission H&Ps in 617, 621-- 637 00:25:30,050 --> 00:25:31,660 [phone vibrating] 638 00:25:31,704 --> 00:25:32,792 Your husband? 639 00:25:32,835 --> 00:25:35,316 I am so, so sorry. It's the sitter. 640 00:25:35,359 --> 00:25:36,578 My husband's out of town 641 00:25:36,622 --> 00:25:37,884 and our little guy isn't feeling well. 642 00:25:37,927 --> 00:25:40,930 - [phone vibrating] - Oh, um, it's okay. Take it. 643 00:25:42,279 --> 00:25:44,020 Hey, how's he doing? 644 00:25:44,064 --> 00:25:46,632 So radiology doesn't have a post-op echo. 645 00:25:46,675 --> 00:25:48,764 - Swanson never ordered one. - Unbelievable. 646 00:25:48,808 --> 00:25:51,506 That patient of yours, awhile back, um, 647 00:25:51,550 --> 00:25:52,855 I think he was a delivery driver, 648 00:25:52,899 --> 00:25:55,162 - what was his name, Abe? - Yeah. What about him? 649 00:25:55,205 --> 00:25:57,164 Didn't you tell me that Joan had to step in 650 00:25:57,207 --> 00:25:59,688 because Swanson closed up mid-surgery or something 651 00:25:59,732 --> 00:26:01,385 - to go on vacation? - Well, it wasn't quite 652 00:26:01,429 --> 00:26:03,213 that simple, but yeah. 653 00:26:03,257 --> 00:26:04,954 What, are you building a case? 654 00:26:04,998 --> 00:26:06,608 Well, I checked into the timing 655 00:26:06,652 --> 00:26:08,262 of Johnny's surgery last year. 656 00:26:08,305 --> 00:26:09,568 It was Friday night at seven. 657 00:26:09,611 --> 00:26:11,395 So, you and I both know the echo team 658 00:26:11,439 --> 00:26:13,615 would've been gone by then, so Swanson would've had to call 659 00:26:13,659 --> 00:26:15,574 someone in, wait around for hours. 660 00:26:15,617 --> 00:26:17,358 So you think he never ordered an echo 661 00:26:17,401 --> 00:26:18,707 because it was inconvenient? 662 00:26:18,751 --> 00:26:20,274 I don't know. Could be. 663 00:26:20,317 --> 00:26:21,884 But can you get me the records on that case? 664 00:26:21,928 --> 00:26:23,407 - I can. - Okay. 665 00:26:23,451 --> 00:26:25,061 But you should tread lightly. 666 00:26:25,105 --> 00:26:27,281 You're already on probation with Matos. 667 00:26:27,324 --> 00:26:29,326 - Email it to me, okay? - M-kay. 668 00:26:32,025 --> 00:26:33,504 Sorry to keep you waiting. 669 00:26:35,550 --> 00:26:38,509 The results are showing a more complicated picture 670 00:26:38,553 --> 00:26:39,728 than we had hoped. 671 00:26:39,772 --> 00:26:42,252 But, ultimately, there's a path forward here. 672 00:26:42,296 --> 00:26:44,690 Okay. 673 00:26:44,733 --> 00:26:46,648 So, Wendy, I know this will be disappointing, 674 00:26:46,692 --> 00:26:49,869 but your ovarian reserve has become very low. 675 00:26:51,131 --> 00:26:54,395 With Gina, however, there's good news. 676 00:26:54,438 --> 00:26:56,789 Your eggs appear to still be viable. 677 00:26:57,920 --> 00:26:59,835 - Really? - Well, as I said, 678 00:26:59,879 --> 00:27:02,098 you're an individual, not a statistic. 679 00:27:02,142 --> 00:27:04,753 And we can get started with treatments as soon as tomorrow. 680 00:27:04,797 --> 00:27:06,276 Which I would recommend. 681 00:27:06,320 --> 00:27:08,104 [melancholy music] 682 00:27:08,148 --> 00:27:10,280 [exhaling softly] You... 683 00:27:10,324 --> 00:27:12,021 You made me wait. 684 00:27:13,544 --> 00:27:14,981 Wendy. 685 00:27:16,069 --> 00:27:17,374 You made me wait, 686 00:27:17,418 --> 00:27:19,812 and now you get to have everything that I wanted. 687 00:27:20,987 --> 00:27:23,642 This is something we're gonna do together. 688 00:27:26,557 --> 00:27:28,690 Sorry, I just need a minute. 689 00:27:36,393 --> 00:27:38,308 Check his electrolytes every 12 hours, 690 00:27:38,352 --> 00:27:41,050 - and keep an eye on his sats. - On it. 691 00:27:41,094 --> 00:27:43,618 Hey, thanks for being so understanding today, 692 00:27:43,662 --> 00:27:45,489 Dr. Maitra. I know I need to leave 693 00:27:45,533 --> 00:27:46,882 my personal life at home. 694 00:27:46,926 --> 00:27:49,493 Well, you have a kid. Some things can't wait. 695 00:27:49,537 --> 00:27:52,496 Uh, no, I don't have a kid, that was about my dog. 696 00:27:52,540 --> 00:27:54,629 I mean, he's a puppy, and we're training, 697 00:27:54,673 --> 00:27:57,414 - so it's a lot right now. - Uh, excuse me? 698 00:27:57,458 --> 00:27:59,286 He's my Wheaten terrier! 699 00:27:59,329 --> 00:28:00,896 [laughing] Oh God, a kid, 700 00:28:00,940 --> 00:28:03,420 - could you imagine? - Uh, lots of doctors have kids. 701 00:28:03,464 --> 00:28:06,075 Well, I would never. I mean, climate change alone. 702 00:28:06,119 --> 00:28:08,512 Okay, that is the most cynical thing I've ever heard. 703 00:28:08,556 --> 00:28:10,340 You just wanna give up on humanity? 704 00:28:10,384 --> 00:28:12,125 It's just an opinion. 705 00:28:12,168 --> 00:28:13,648 Kind of thought we were all entitled to one. 706 00:28:13,692 --> 00:28:16,695 Just get back to work, Claire. And no more calls. 707 00:28:20,350 --> 00:28:22,570 [equipment beeping] 708 00:28:26,400 --> 00:28:28,271 - [water rushing] - Oh, um, 709 00:28:28,315 --> 00:28:30,230 the nurses said you might have a second to talk, 710 00:28:30,273 --> 00:28:31,884 but it's a little delicate, so I'll come back later. 711 00:28:31,927 --> 00:28:33,450 No, no, no, you're looking at the closest thing 712 00:28:33,494 --> 00:28:36,062 I have to free time today. So, shoot. 713 00:28:36,932 --> 00:28:39,413 We need to talk about Swanson. 714 00:28:44,287 --> 00:28:46,333 - Tell me about your book. - Mm. 715 00:28:46,899 --> 00:28:48,552 Well... 716 00:28:48,596 --> 00:28:50,772 My grandfather studied at Howard. 717 00:28:50,816 --> 00:28:52,948 Under the great Daniel Hale Williams. 718 00:28:52,992 --> 00:28:54,820 - No! - Yeah, and by the time 719 00:28:54,863 --> 00:28:56,517 my father came around, 720 00:28:56,560 --> 00:28:59,215 living under the shadow of a man who studied with the pioneer 721 00:28:59,259 --> 00:29:01,652 of open-heart surgery, it just... 722 00:29:01,696 --> 00:29:03,611 He really had no choice of what he was gonna do. 723 00:29:03,654 --> 00:29:06,570 And then, the third generation just, what, had 724 00:29:06,614 --> 00:29:08,224 to follow in their footsteps? 725 00:29:08,268 --> 00:29:09,399 Well, if they had been cobblers, 726 00:29:09,443 --> 00:29:10,879 would I be mending soles? 727 00:29:10,923 --> 00:29:12,751 Probably not. [chuckling] 728 00:29:12,794 --> 00:29:14,361 No, what they did was inspiring. 729 00:29:14,404 --> 00:29:16,624 I'm the first generation in my family 730 00:29:16,667 --> 00:29:18,626 to even go to college, so... 731 00:29:18,669 --> 00:29:21,368 It's all upside for me. 732 00:29:21,411 --> 00:29:23,631 Thank you for taking time today 733 00:29:23,674 --> 00:29:25,589 to come see what I've been doing. 734 00:29:27,156 --> 00:29:28,505 [alarm beeps] 735 00:29:28,549 --> 00:29:30,594 Heart rate's spiking. 736 00:29:30,638 --> 00:29:32,422 Pushing esmolol. 737 00:29:32,466 --> 00:29:33,684 [tense music] 738 00:29:33,728 --> 00:29:34,729 [alarm beeps] 739 00:29:37,036 --> 00:29:39,778 You see that translucent area under my probe, Dr. Coleman? 740 00:29:39,821 --> 00:29:41,344 Looks more like a cyst than a tumor. 741 00:29:41,388 --> 00:29:42,650 That's a bag of adrenaline. 742 00:29:42,693 --> 00:29:44,086 If we squeeze it or if we rupture it-- 743 00:29:44,130 --> 00:29:46,436 Things get very interesting for me. 744 00:29:46,480 --> 00:29:47,786 Her BP's stable. 745 00:29:47,829 --> 00:29:49,918 I'd appreciate you keeping it that way. 746 00:29:49,962 --> 00:29:52,747 All right. Retract very gently on your side. 747 00:29:59,232 --> 00:30:00,407 [alarm beeps] 748 00:30:00,450 --> 00:30:01,974 Easy, easy. 749 00:30:03,584 --> 00:30:04,977 [alarm stops] 750 00:30:06,761 --> 00:30:08,197 [tense music] 751 00:30:09,938 --> 00:30:11,418 It's matted to the Pancoast tumor. 752 00:30:11,461 --> 00:30:13,376 Can you give me more blood pressure control, Dr. Larsen? 753 00:30:13,420 --> 00:30:15,378 - We'll be getting aggressive. - Nicardipine. 754 00:30:15,422 --> 00:30:17,816 Fine-tuned as we go. 755 00:30:17,859 --> 00:30:20,427 - Smart. - I try. 756 00:30:20,470 --> 00:30:22,777 Okay, we need to time this perfectly. 757 00:30:22,821 --> 00:30:25,127 You retract very slowly on your side, 758 00:30:25,171 --> 00:30:27,347 and I'll release the last adherent part. 759 00:30:28,827 --> 00:30:30,176 Let's pull this monster out. 760 00:30:32,613 --> 00:30:34,702 [tense music continues] 761 00:30:35,877 --> 00:30:37,487 [alarm sounds] 762 00:30:41,883 --> 00:30:43,493 [alarm stops] 763 00:30:44,320 --> 00:30:46,366 Okay. Here we go. 764 00:30:57,420 --> 00:30:58,552 [alarm sounds] 765 00:30:58,595 --> 00:31:00,380 Pressure crashing. Pushing nor-epi. 766 00:31:00,423 --> 00:31:02,208 [items clattering] 767 00:31:02,251 --> 00:31:04,558 [beeping continues] 768 00:31:10,172 --> 00:31:11,260 [Amy] Come on. 769 00:31:13,523 --> 00:31:14,568 [alarm ends] 770 00:31:14,611 --> 00:31:16,178 [exhaling deeply] 771 00:31:18,006 --> 00:31:19,181 Stuck the landing. 772 00:31:20,487 --> 00:31:22,881 Alright. Let's put her back together. 773 00:31:25,013 --> 00:31:26,754 [exhaling] 774 00:31:26,797 --> 00:31:28,321 - So everything went great. - [hospital din] 775 00:31:28,364 --> 00:31:30,714 - I have heard that one before. - Yeah, I know. 776 00:31:31,846 --> 00:31:33,326 Julie, you mind giving us the room? 777 00:31:39,375 --> 00:31:42,291 Look, man, I know today's been a terrible day, 778 00:31:42,335 --> 00:31:43,727 and you have every right to be upset, 779 00:31:43,771 --> 00:31:45,642 but the good news is we know 780 00:31:45,686 --> 00:31:47,079 you don't have something that's gonna put you 781 00:31:47,122 --> 00:31:48,732 back in the hospital a year from now. 782 00:31:48,776 --> 00:31:51,344 And how can you be sure of that? 783 00:31:51,387 --> 00:31:53,694 Because the problem was surgeon error. 784 00:31:53,737 --> 00:31:55,652 [melancholy music] 785 00:31:55,696 --> 00:31:59,700 The valve that Swanson put in was placed incorrectly. 786 00:31:59,743 --> 00:32:02,137 Now, they should've caught that with the post-op study, 787 00:32:02,181 --> 00:32:03,399 but he never ordered one. 788 00:32:03,443 --> 00:32:05,836 That's why you went into heart failure again. 789 00:32:05,880 --> 00:32:07,926 What, was he, um... 790 00:32:07,969 --> 00:32:09,710 supposed to order one? I mean, normally, 791 00:32:09,753 --> 00:32:12,495 - the surgeon would do that? - Yes. That is protocol. 792 00:32:12,539 --> 00:32:14,976 So that's malpractice I could sue, right? 793 00:32:15,020 --> 00:32:16,978 You can. And between you and me, 794 00:32:17,022 --> 00:32:18,501 I'd be rooting for you. 795 00:32:18,545 --> 00:32:19,981 But do I have a case? 796 00:32:20,025 --> 00:32:21,852 I-I don't know, Johnny, I'm not a lawyer. 797 00:32:21,896 --> 00:32:23,854 Then talk to me like a human being. 798 00:32:25,900 --> 00:32:27,902 All I can tell you is that if I'm deposed, 799 00:32:27,946 --> 00:32:29,338 I will tell the truth. 800 00:32:29,382 --> 00:32:32,080 You're saying he almost killed me. 801 00:32:32,124 --> 00:32:33,299 [breathing shakily] 802 00:32:33,342 --> 00:32:35,431 So why isn't this a slam dunk? 803 00:32:35,475 --> 00:32:38,478 The thing is, you did skip your follow-up visits. 804 00:32:38,521 --> 00:32:41,960 And that delayed the diagnosis. 805 00:32:42,003 --> 00:32:43,570 So this is on me? 806 00:32:43,613 --> 00:32:45,485 That's what the hospital's going to argue, yeah. 807 00:32:45,528 --> 00:32:47,835 So he's gonna get away with this. 808 00:32:47,878 --> 00:32:49,619 And be able to do it to other people. 809 00:32:49,663 --> 00:32:51,882 I've already talked to the Chief of Surgery. 810 00:32:51,926 --> 00:32:54,581 I'm hopeful that he can have more eyes on him from now on. 811 00:32:54,624 --> 00:32:56,626 [scoffs] 812 00:32:56,670 --> 00:32:58,411 And that's supposed to be enough. 813 00:33:01,631 --> 00:33:03,416 Tell me about Johnny Parsons. 814 00:33:03,459 --> 00:33:04,808 Dr. Heller came to you. 815 00:33:04,852 --> 00:33:07,333 Radiology says you never ordered a post-op echo. 816 00:33:07,376 --> 00:33:09,204 Is that true? 817 00:33:09,248 --> 00:33:11,685 Look, I checked the date, 818 00:33:11,728 --> 00:33:15,036 and, uh, my wife had an event that night, so I had-- 819 00:33:15,080 --> 00:33:16,690 That's the wrong answer, Roger. 820 00:33:16,733 --> 00:33:18,561 I get it. 821 00:33:18,605 --> 00:33:19,867 I intended to do it in the morning, 822 00:33:19,910 --> 00:33:22,217 but I must've gotten slammed. 823 00:33:22,261 --> 00:33:23,784 It won't happen again. 824 00:33:23,827 --> 00:33:25,699 Are you sure about that? 825 00:33:25,742 --> 00:33:27,266 Excuse me? 826 00:33:27,309 --> 00:33:29,355 Two months ago, a hotshot attorney 827 00:33:29,398 --> 00:33:31,096 needs a heart procedure. 828 00:33:31,139 --> 00:33:34,838 And you come in on a Saturday and stay until midnight. 829 00:33:34,882 --> 00:33:36,753 A real estate mogul week before, well, 830 00:33:36,797 --> 00:33:40,844 he gets a whole buffet of post-op tests and VIP treatment. 831 00:33:40,888 --> 00:33:43,499 But a delivery driver comes in a couple months back, 832 00:33:43,543 --> 00:33:46,459 and you left him to catch a flight to the Bahamas. 833 00:33:46,502 --> 00:33:48,156 There were complications in that situation-- 834 00:33:48,200 --> 00:33:49,723 Which you were uninterested in resolving 835 00:33:49,766 --> 00:33:51,246 because of your vacation. 836 00:33:51,290 --> 00:33:52,900 You're cherry-picking a couple cases 837 00:33:52,943 --> 00:33:54,336 out of a 23-year career. 838 00:33:54,380 --> 00:33:55,729 In my experience, 839 00:33:55,772 --> 00:33:57,644 where there's smoke, there's fire. 840 00:33:57,687 --> 00:34:00,690 And I don't like the way this smells, Roger. 841 00:34:00,734 --> 00:34:02,953 Yeah, okay, so... What is this? 842 00:34:02,997 --> 00:34:05,739 Suspension? Because I'm not taking a demotion. 843 00:34:05,782 --> 00:34:08,046 There's no need. You're fired. 844 00:34:10,265 --> 00:34:12,876 Four months' severance. Leave your badge in your locker. 845 00:34:15,444 --> 00:34:18,273 [tense music builds] 846 00:34:23,452 --> 00:34:25,454 - [indistinct chatter] - [phone vibrating] 847 00:34:26,803 --> 00:34:29,545 Ah, excuse me. Hey, there. 848 00:34:29,589 --> 00:34:32,157 Good timing, I just confirmed the hotel in Philly. 849 00:34:32,200 --> 00:34:34,246 Ben, I'm reviewing some of your data. 850 00:34:34,289 --> 00:34:36,813 I don't love the trends in some of these bicarbs. 851 00:34:36,857 --> 00:34:39,642 And serum creatinine levels are elevated. 852 00:34:39,686 --> 00:34:42,254 I think you've got a big problem here. 853 00:34:42,297 --> 00:34:44,038 I get that, but they... 854 00:34:44,082 --> 00:34:45,779 they'll self-resolve in two weeks, 855 00:34:45,822 --> 00:34:48,173 so... I'll send you the kidney numbers on the Phase One trials 856 00:34:48,216 --> 00:34:50,871 and you'll see. 857 00:34:50,914 --> 00:34:52,873 [equipment beeping] 858 00:34:52,916 --> 00:34:55,354 You did the right thing, bringing her here. 859 00:34:55,397 --> 00:34:57,269 And trusting Dr. Grant. 860 00:34:57,312 --> 00:34:59,619 And you. 861 00:34:59,662 --> 00:35:02,970 I should've known you'd find what was overlooked. 862 00:35:03,884 --> 00:35:05,581 I lost Bonnie once, 863 00:35:05,625 --> 00:35:08,976 and I was scared of it happening again. 864 00:35:09,019 --> 00:35:11,457 Well, I appreciate that. 865 00:35:11,500 --> 00:35:13,807 But I get it. 866 00:35:13,850 --> 00:35:16,244 What happened to you? In your accident-- 867 00:35:16,288 --> 00:35:18,028 the neurological issues. 868 00:35:18,072 --> 00:35:20,553 I lost eight years of my memory. 869 00:35:20,596 --> 00:35:23,947 When you came in here last year, I didn't even know who you were. 870 00:35:23,991 --> 00:35:26,559 So it's all been an act, even today? 871 00:35:26,602 --> 00:35:29,170 No, I'm all caught up on the medicine. 872 00:35:29,214 --> 00:35:32,608 The memory loss doesn't affect how I do my job. 873 00:35:32,652 --> 00:35:34,436 You sure about that? 874 00:35:34,480 --> 00:35:37,004 Well, how did I do today? 875 00:35:37,047 --> 00:35:39,746 And the last time you were here? 876 00:35:39,789 --> 00:35:41,269 Brilliance is brilliance, I suppose. 877 00:35:41,313 --> 00:35:42,705 [chuckling] 878 00:35:42,749 --> 00:35:45,012 But you should've told me before. 879 00:35:45,055 --> 00:35:48,581 I like to think it's my business. 880 00:35:48,624 --> 00:35:51,018 If I told every patient who came through that door 881 00:35:51,061 --> 00:35:52,324 what I've been struggling with, 882 00:35:52,367 --> 00:35:54,021 do you think they'd let me treat them? 883 00:35:56,676 --> 00:35:59,635 I'm not giving up this gift I have. 884 00:35:59,679 --> 00:36:03,552 What I can do with it for others. 885 00:36:03,596 --> 00:36:06,164 Well, I know what it's like to be forsaken. 886 00:36:07,252 --> 00:36:09,776 This will stay between us. 887 00:36:09,819 --> 00:36:13,519 [tender music] 888 00:36:14,955 --> 00:36:16,783 [hospital din] 889 00:36:20,090 --> 00:36:21,701 I hope Cece said thank you. 890 00:36:21,744 --> 00:36:24,530 She did. And she apologized. 891 00:36:24,573 --> 00:36:27,446 And I explained to her why I ran that charade on her 892 00:36:27,489 --> 00:36:28,664 a few months ago. 893 00:36:28,708 --> 00:36:30,710 So you two are okay now? 894 00:36:30,753 --> 00:36:32,320 We were okay then. 895 00:36:33,930 --> 00:36:35,497 Conflict can be healthy. 896 00:36:35,541 --> 00:36:38,108 Even sometimes when it looks unhealthy. 897 00:36:38,152 --> 00:36:41,590 So, what? Embrace the mess? 898 00:36:43,157 --> 00:36:44,767 I think you're learning. 899 00:36:57,998 --> 00:36:59,608 [sighing] 900 00:37:06,833 --> 00:37:09,052 I'm sorry... 901 00:37:09,096 --> 00:37:10,750 that I made us wait. 902 00:37:12,273 --> 00:37:15,842 I'd accepted my life, and you dropped a bomb. 903 00:37:15,885 --> 00:37:19,324 And I can only imagine how much that must hurt. 904 00:37:20,325 --> 00:37:22,240 But I asked Dr. Shaw. 905 00:37:23,328 --> 00:37:25,112 You can carry the baby. 906 00:37:25,155 --> 00:37:27,723 [uplifting music] 907 00:37:27,767 --> 00:37:29,334 The child will be ours, 908 00:37:29,377 --> 00:37:33,686 we will do it together, and it will be incredible. 909 00:37:34,948 --> 00:37:36,515 [exhales] 910 00:37:36,558 --> 00:37:40,867 It's just not the vision that I had this morning. 911 00:37:42,172 --> 00:37:44,697 It's okay if you want to be mad at me. 912 00:37:44,740 --> 00:37:46,916 I can take it. 913 00:37:48,962 --> 00:37:52,313 I don't want to be mad at you. 914 00:38:00,278 --> 00:38:03,150 [hospital din] 915 00:38:05,239 --> 00:38:06,762 How you doing? 916 00:38:06,806 --> 00:38:09,199 Long shift. How's Ruth doing? 917 00:38:09,243 --> 00:38:12,159 Uh, learning by osmosis, I hope. 918 00:38:12,202 --> 00:38:13,769 [chuckles] 919 00:38:13,813 --> 00:38:16,337 Claire told me that you snapped at her. 920 00:38:16,381 --> 00:38:19,819 Well, there's a role reversal, huh? 921 00:38:19,862 --> 00:38:23,736 - Hmm. - So, you're still freaking out. 922 00:38:23,779 --> 00:38:26,086 I think so, yeah. 923 00:38:26,129 --> 00:38:27,696 About which part? 924 00:38:27,740 --> 00:38:29,916 Well, pretty soon, I'm gonna be waddling around, 925 00:38:29,959 --> 00:38:32,353 trying to train these people, with all the street cred 926 00:38:32,397 --> 00:38:34,050 of someone about to go on maternity leave. 927 00:38:34,094 --> 00:38:37,227 Oh. That can be handled, Sonya. Come on. 928 00:38:38,925 --> 00:38:40,840 I know, I... 929 00:38:44,017 --> 00:38:45,845 It's TJ. 930 00:38:45,888 --> 00:38:48,282 We've been together for four months. 931 00:38:48,326 --> 00:38:50,589 Do you think this is what he signed up for? 932 00:38:50,632 --> 00:38:52,808 He won't run from his responsibilities. 933 00:38:52,852 --> 00:38:55,158 No, of course not. He's TJ. 934 00:38:55,202 --> 00:38:57,247 He'll say all the right things, 935 00:38:57,291 --> 00:38:59,511 he'll do what needs to be done, but... 936 00:39:00,860 --> 00:39:02,601 From this point on, I'll never know 937 00:39:02,644 --> 00:39:04,864 if that's what he really wants. 938 00:39:04,907 --> 00:39:07,127 Or if it's what I really want. 939 00:39:08,563 --> 00:39:10,260 Do you love him? 940 00:39:12,088 --> 00:39:15,222 I think we were on our way, 941 00:39:15,265 --> 00:39:18,878 but now we'll never get a clean shot to figure it out. 942 00:39:18,921 --> 00:39:23,099 And I don't want him to be with me out of obligation. 943 00:39:23,143 --> 00:39:24,405 You know, look, you're right. 944 00:39:24,449 --> 00:39:26,276 He will say and do all the right things. 945 00:39:26,320 --> 00:39:28,670 But if you obsess about whether or not 946 00:39:28,714 --> 00:39:31,456 you're both forcing it, the relationship will be doomed. 947 00:39:31,499 --> 00:39:33,936 I know that, trust me. I do. 948 00:39:36,025 --> 00:39:39,986 Love is a risk. Always. 949 00:39:40,029 --> 00:39:43,293 And you can't control what life is gonna throw at you. 950 00:39:43,337 --> 00:39:46,558 All you can do is lean in. 951 00:39:47,820 --> 00:39:50,866 [soft music] 952 00:39:50,910 --> 00:39:54,087 I hear you caused quite the ruckus in surgery today. 953 00:39:54,130 --> 00:39:57,743 And gave our general council a liability scare. 954 00:39:57,786 --> 00:40:00,006 I was just advocating for my patient. 955 00:40:00,049 --> 00:40:01,355 And why wasn't I looped in? 956 00:40:01,399 --> 00:40:02,922 I wanted to come to you with a solution 957 00:40:02,965 --> 00:40:05,185 - rather than a problem. - You didn't come to me at all. 958 00:40:05,228 --> 00:40:07,579 I had to hear about it from Ben Grant. 959 00:40:07,622 --> 00:40:10,146 I wanted to avoid putting you into a difficult situation. 960 00:40:10,190 --> 00:40:12,279 I know you and Swanson have a long-standing relationship. 961 00:40:12,322 --> 00:40:14,150 So now you're suggesting that I wouldn't have 962 00:40:14,194 --> 00:40:16,414 - handled it objectively. - No. No, that's not what-- 963 00:40:16,457 --> 00:40:18,720 Not for nothing, but I thought that Swanson 964 00:40:18,764 --> 00:40:21,723 was a tool 20 years ago. I think he's a tool now. 965 00:40:21,767 --> 00:40:24,073 But he is a reasonably good doctor, 966 00:40:24,117 --> 00:40:26,206 and what you did today got him fired. 967 00:40:26,249 --> 00:40:28,034 I think I can live with that. 968 00:40:28,077 --> 00:40:30,210 I'm glad your conscience feels clear. 969 00:40:30,253 --> 00:40:32,821 Dr. Grant can make whatever decision he wants 970 00:40:32,865 --> 00:40:34,867 in his department. But he should've made it 971 00:40:34,910 --> 00:40:38,697 after talking to me, not to you. That's the protocol. 972 00:40:38,740 --> 00:40:42,527 Understood. Won't happen again. 973 00:40:42,570 --> 00:40:45,443 I suppose you're learning how things work 974 00:40:45,486 --> 00:40:47,749 when you don't have special privileges. 975 00:40:47,793 --> 00:40:49,403 - Excuse me? - Well, I get the sense 976 00:40:49,447 --> 00:40:52,275 you had a very wide berth with Dr. Larsen. 977 00:40:52,319 --> 00:40:54,887 Because of your romantic relationship. 978 00:40:54,930 --> 00:40:57,063 So that's what this is about. 979 00:40:57,106 --> 00:40:58,891 It's a question of character, Dr. Heller. 980 00:40:58,934 --> 00:41:00,719 Character informs judgment. 981 00:41:00,762 --> 00:41:04,462 And from what I've seen, yours is severely lacking. 982 00:41:04,505 --> 00:41:06,551 Across the board. 983 00:41:08,117 --> 00:41:09,597 [door opens] 984 00:41:12,165 --> 00:41:13,209 [door closes] 985 00:41:13,819 --> 00:41:15,342 There you are. 986 00:41:15,385 --> 00:41:17,083 Hey, we really can't be late. 987 00:41:17,126 --> 00:41:20,086 It took me forever to get us reservations to this restaurant. 988 00:41:20,129 --> 00:41:21,348 I'm pregnant. 989 00:41:23,872 --> 00:41:26,440 About seven weeks. [shaky sigh] 990 00:41:27,049 --> 00:41:28,529 Okay. 991 00:41:30,226 --> 00:41:31,619 Wow. 992 00:41:32,359 --> 00:41:35,841 Wow. That is... 993 00:41:35,884 --> 00:41:38,104 I only found out yesterday. 994 00:41:39,322 --> 00:41:42,369 And you... already did the ultrasound? 995 00:41:42,412 --> 00:41:44,937 Yeah, this morning. [exhales deeply] 996 00:41:48,288 --> 00:41:50,856 - I'm keeping it, TJ. - Right, right. 997 00:41:50,899 --> 00:41:53,772 Right, for sure. We can handle it. 998 00:41:53,815 --> 00:41:55,338 You don't have to say that. 999 00:41:55,382 --> 00:41:56,862 Whatever you're thinking, if you're freaking out, 1000 00:41:56,905 --> 00:41:59,517 - it's fine-- - I'm not. I'm-I'm not. 1001 00:41:59,560 --> 00:42:01,040 Okay? 1002 00:42:01,083 --> 00:42:03,390 This is beautiful. 1003 00:42:04,478 --> 00:42:07,220 I'm gonna take care of you. 1004 00:42:07,263 --> 00:42:10,005 No matter what. You don't have to worry. 1005 00:42:10,963 --> 00:42:12,573 [tender music] 1006 00:42:14,314 --> 00:42:15,881 'Kay, I won't. 1007 00:42:15,924 --> 00:42:18,884 [laughing] 1008 00:42:18,927 --> 00:42:20,538 [sniffling] 1009 00:42:22,061 --> 00:42:23,715 We can do this. 1010 00:42:24,367 --> 00:42:25,543 [exhales] 1011 00:42:27,545 --> 00:42:28,850 [hospital din] 1012 00:42:28,894 --> 00:42:30,199 Hey. 1013 00:42:30,243 --> 00:42:32,027 Hey! 1014 00:42:32,071 --> 00:42:33,638 Bonnie's doing well. 1015 00:42:33,681 --> 00:42:35,335 I hope we got it all. 1016 00:42:35,378 --> 00:42:37,816 I'm sorry to start the day going toe to toe like that, 1017 00:42:37,859 --> 00:42:39,557 and for not giving you the benefit of the doubt 1018 00:42:39,600 --> 00:42:41,950 when things went wrong. 1019 00:42:41,994 --> 00:42:43,604 I think maybe we're both used to being 1020 00:42:43,648 --> 00:42:45,258 the smartest person in the room. 1021 00:42:45,301 --> 00:42:47,652 Oh, for sure. [chuckling] 1022 00:42:47,695 --> 00:42:49,828 Anyway, you'll have a couple days with me out of your hair. 1023 00:42:49,871 --> 00:42:51,481 I'm headed to New York tomorrow 1024 00:42:51,525 --> 00:42:53,135 to check in on my clinical trial. 1025 00:42:53,179 --> 00:42:54,963 I heard it's being transferred here. 1026 00:42:55,007 --> 00:42:57,357 Yeah. That's what I'm organizing now. 1027 00:42:57,400 --> 00:43:00,142 Is that the trial that I consulted on? 1028 00:43:00,186 --> 00:43:01,317 It is. 1029 00:43:01,361 --> 00:43:04,059 And happy to have you wander down to us 1030 00:43:04,103 --> 00:43:06,409 whenever we get it up and running. 1031 00:43:06,453 --> 00:43:09,108 I don't love the trends in some of these bicarbs. 1032 00:43:10,283 --> 00:43:12,024 Look forward to it. 1033 00:43:12,894 --> 00:43:13,939 Good. 1034 00:43:16,768 --> 00:43:19,597 [unsettling music]