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Previously on Good Sam...
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I have been trying to keep
up with you in a game
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that you've had rigged the entire time.
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I'm going to go and tell Sam everything.
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I think I'm all caught up.
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- Ambulance has just landed.
- Step back, Dr. Trulie.
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You don't need to worry
about your best friend
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being with your dad because
you and I are not friends.
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It was me. I called your mother.
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Her vote could be the key.
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This is not personal.
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She is my mother! I told you
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I didn't even want to think about her!
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I have to end this war.
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You ended something, all right.
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I want you to know
that you can talk to me.
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I think I lost my way.
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Morning.
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Thank you for letting me
sleep here last night
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and letting me talk your ear off.
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Of course.
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So, uh, how you feeling,
other than tired?
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Uh... Hmm. I feel like...
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a bulldozer ran over everyone
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and everything that I care about.
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All around me, I see destruction.
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And in the cold light of day, I realize
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that it was not a bulldozer
that destroyed everything.
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- It was me.
- Hmm.
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I think you're being
a little hard on yourself.
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Nah.
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You should've seen the look
on Malcolm's face.
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And what Lex said to me...
not that I blame her.
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And my mother? I accused my own
mother of not being on my side.
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Because of what? This vote for chief?
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I am a human bulldozer.
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You don't have to do that. Uh...
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- No, it's fine. I want to.
- I just...
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I didn't expect anyone, so it's a mess.
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Compared to my life, this is nothing.
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Hey, you remember the last thing
you said last night?
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Uh, was it something along the lines of,
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"I've become a power-crazed monster
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who hurts the people she loves"?
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No. It was, "I'm gonna make this right."
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And I said,
"If anyone can do it, it's you."
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Did I happen to say how
I was planning on doing that?
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No. At that point, you started
snoring like a baby rhino.
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I do not snore. Caleb!
50
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I do not snore!
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I'm gonna... I'm gonna make this right.
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I'm gonna try.
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Well, uh, guess we better get to work.
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Yeah. Hey.
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Oh.
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I'm really glad
you opened the door last night.
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Yeah, well, glad you knocked.
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- I'm gonna get dressed.
- I love you.
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Yeah, get dressed. Me, too.
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I'm gonna brush my teeth,
then I'm gonna... Yup.
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- Yeah.
- Sounds good.
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I never should have called your mom.
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Okay.
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You told me that she was on the board,
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and all I could think about
was her vote.
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But all I should've been
thinking about was you.
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And how reaching out
to her would make you feel.
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I'm...
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Damn it. It's the ER.
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You should go.
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What do we have?
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Violet Stein. 18.
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She fell at her high school track event.
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- She was in first place, too.
- Okay, just gonna take a listen.
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There's a lot of turbulence
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between atrioventricular valves.
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Is that because of her broken rib?
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They said she has a broken rib.
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Looks like this is the third bone
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you've broken at a track meet.
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A lot of kids fall at these things.
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Well, three fractures is unusual.
83
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Are you getting enough
vitamin D, calcium?
84
00:04:05,237 --> 00:04:07,373
We're very good about supplements.
85
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You have to be, on a vegan diet.
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Does this vegan diet include
a lot of soy products?
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Yes. Why?
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No air entry left side.
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And vital signs are unstable.
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Violet, can you breathe?
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Tension pneumothorax.
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14 gauge needle.
Three and a quarter inch.
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- Excuse me.
- Quickly, please!
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- What's happening?
- It's all right.
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Just hold on. Her rib is stabbing
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into her lung,
and we need to clear the air
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that's trapped in her chest cavity.
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It's all right.
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Try to relax.
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It's okay.
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Straight into the trauma bay.
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Who's the patient?
April Krane, 25, hypothermic.
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00:04:39,530 --> 00:04:41,265
I'm told her dry suit ripped
while scuba diving.
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Scuba diving? In the middle of winter?
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All the lakes are frozen.
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They cut a hole in the ice, I guess.
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Water under the surface
is about 39 degrees.
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She lost consciousness on the way over.
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Okay, let's get these wet
clothes off of her.
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Breathing is shallow, pulse is weak.
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00:04:51,517 --> 00:04:53,519
All right.
We need to get her core temp up.
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Bring a Bair Hugger in here, please.
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We could warm up her IV fluids.
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Good idea. I'll grab a bag.
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- Hi.
- Hey.
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Still on trauma?
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- Is that because of me?
- Not everything is about you.
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I am sorry that
I threw you off that patient.
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I was out of line.
120
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If you want to come off trauma,
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it will not happen again.
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I like trauma.
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Synced & corrected by -robtor-
www.addic7ed.com
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Oh, if I broke that many bones
running track,
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- I would take up chess.
- Mm.
126
00:05:34,553 --> 00:05:36,253
We should also check her B12 levels.
127
00:05:36,278 --> 00:05:39,114
Oh, it's not B12.
Cadmium is the problem.
128
00:05:39,364 --> 00:05:41,300
- Cadmium?
- Yeah, heavy metal,
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00:05:41,325 --> 00:05:42,769
chemically similar to zinc and mercury.
130
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- Yeah.
- Toxic levels
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linked to fragile bone syndrome
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- and often found in...
- In soy products.
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Doesn't explain the
mid-diastolic murmur you heard,
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00:05:49,215 --> 00:05:50,516
but does address
the fractures, at least.
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00:05:50,621 --> 00:05:52,556
Okay, I'll run the labs.
Dad, one more thing.
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Hmm?
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I'm done fighting you for the chief job.
138
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The job is yours.
139
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Uh, the vote's not for 42 days.
140
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They don't need to vote.
141
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What are you...? You quitting?
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Yeah. I'm out.
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Why?
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When you put so much into it?
145
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Too much, and that's the problem. I'm...
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I just want to focus on my patients,
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and I want to get you
through your proctorship.
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- Uh-huh.
- And speaking of which,
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we do have a double bypass
on the schedule for later today.
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- I'm aware.
- I am making you primary.
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00:06:29,831 --> 00:06:31,550
You've aced every step so far,
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and it's time
you do your first solo surgery.
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I'll see you in the OR.
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How do you
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- accidentally say "I love you"?
- It just slipped out.
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I mean, I spent the whole night
listening to her talk
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about making up with Malcolm.
158
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And then, right at the end, I blew it.
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Making up? Are they in a fight?
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00:06:48,901 --> 00:06:50,302
I heard all about it
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00:06:50,327 --> 00:06:52,295
right before dropping
the "L" bomb on her.
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I mean, who does that?
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And she didn't say anything?
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Maybe she didn't hear me.
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Maybe she thought I said "I love
the view," or, "I shove you."
166
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I just... I've never said it before.
167
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- Never to Sam?
- Never to anyone.
168
00:07:05,095 --> 00:07:07,045
You've never said
"I love you" to someone?
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00:07:07,070 --> 00:07:08,593
You don't tell your mother you love her?
170
00:07:08,618 --> 00:07:10,556
Okay, yeah. My mom, sure, but...
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00:07:10,622 --> 00:07:12,224
Why? How many people
have you said it to?
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- Hundreds.
- Hundreds?
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I'm very comfortable saying it.
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It's easier than you think.
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I love you, Caleb.
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See? Now you say it to me.
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00:07:22,526 --> 00:07:24,661
- Oh. No.
- Come on. Tell me you love me.
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You can do it, Dr. Tucker.
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00:07:30,943 --> 00:07:32,578
I love...
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...balloon angioplasty.
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And, look.
182
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There's one now in, uh, room 2115.
183
00:07:38,383 --> 00:07:40,068
So...
184
00:07:53,398 --> 00:07:55,167
Everything okay, Dr. Griffith?
185
00:07:55,400 --> 00:07:57,436
Yeah, fine. I just, uh...
186
00:07:57,461 --> 00:07:59,664
I just started thinking about my office.
187
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Maybe the desk should go here, huh?
188
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Wait. Your office?
189
00:08:04,776 --> 00:08:07,279
Yeah, well, it's not official
till the vote, obviously,
190
00:08:07,304 --> 00:08:09,651
but, uh, now that I'm running
unopposed, it's not exactly
191
00:08:09,676 --> 00:08:11,056
a nail biter.
192
00:08:11,206 --> 00:08:13,552
What-what do you mean,
you're running unopposed?
193
00:08:13,619 --> 00:08:14,820
What happened to Sam?
194
00:08:15,270 --> 00:08:17,756
Well, she wants me back in charge.
195
00:08:17,823 --> 00:08:21,293
Back in surgery, back to normal.
196
00:08:21,360 --> 00:08:22,861
S-So she dropped out?
197
00:08:22,928 --> 00:08:24,463
Did she say why?
198
00:08:24,529 --> 00:08:25,864
I think that ultimately, she realized
199
00:08:25,931 --> 00:08:27,766
I'm the leader this department needed,
200
00:08:27,833 --> 00:08:29,635
that my world-class
201
00:08:29,701 --> 00:08:31,837
reputation...
202
00:08:39,077 --> 00:08:41,013
Well, I'm not saying it was easy,
203
00:08:41,079 --> 00:08:43,015
you two fighting all the time,
204
00:08:43,040 --> 00:08:45,003
but is dropping out the solution?
205
00:08:45,028 --> 00:08:47,404
Yes. And ever since
this whole battle started,
206
00:08:47,429 --> 00:08:48,664
I haven't been myself.
207
00:08:49,179 --> 00:08:51,323
I haven't been there
for you as a friend.
208
00:08:51,348 --> 00:08:53,350
- Sure you have.
- What about your lawsuit?
209
00:08:53,375 --> 00:08:55,602
- The lawsuit settled.
- And I wasn't there for you.
210
00:08:56,455 --> 00:08:59,191
Caleb sat up with me
all night, just listening,
211
00:08:59,665 --> 00:09:01,650
and it made all the difference.
212
00:09:01,853 --> 00:09:04,193
It made all the difference?
213
00:09:04,218 --> 00:09:05,748
Labs on your track star.
214
00:09:06,610 --> 00:09:08,345
Thanks, Bernie.
215
00:09:10,508 --> 00:09:12,643
Your dad was right about the cadmium.
216
00:09:12,777 --> 00:09:15,680
The heavy metals, we can flush,
but look at her troponin levels.
217
00:09:15,705 --> 00:09:19,609
BNP's elevated, too. Her cardiac
enzymes are through the roof.
218
00:09:19,634 --> 00:09:21,703
How does a teenage track star
have the biomarkers
219
00:09:21,773 --> 00:09:24,542
of an 85-year-old
in advanced heart failure?
220
00:09:32,097 --> 00:09:34,032
Hey, there. You look a little lost.
221
00:09:34,057 --> 00:09:35,458
Yeah, I'm looking for my son.
222
00:09:35,483 --> 00:09:36,918
Apparently, he's in cardiothoracics.
223
00:09:36,943 --> 00:09:38,411
Oh, well, that's where I'm headed.
224
00:09:38,603 --> 00:09:40,072
Thank you, Doctor.
225
00:09:40,138 --> 00:09:41,740
Sure. Oh, if you want,
226
00:09:41,765 --> 00:09:44,534
I can look him up for you,
tell you what room he's in.
227
00:09:44,559 --> 00:09:47,528
Oh, no, no. My son's not
a patient. He works here.
228
00:09:53,185 --> 00:09:54,753
Hi.
229
00:09:54,778 --> 00:09:56,204
Hey.
230
00:09:56,722 --> 00:09:59,725
I didn't expect to see
you here, not that
231
00:09:59,791 --> 00:10:01,927
you're here to see me.
I shouldn't make that assumption.
232
00:10:01,993 --> 00:10:05,248
- Not everything is about me.
- I saw your dad earlier.
233
00:10:05,315 --> 00:10:06,865
He-he was in your office.
234
00:10:06,932 --> 00:10:10,368
Oh. Well, was he measuring for drapes?
235
00:10:10,393 --> 00:10:11,803
So it is true.
236
00:10:12,595 --> 00:10:14,389
You dropped out of the race.
237
00:10:15,181 --> 00:10:16,599
Mm-hmm.
238
00:10:17,876 --> 00:10:20,687
Hurting you was a wake-up call
for me, Malcolm.
239
00:10:21,359 --> 00:10:23,294
And I know that I can't undo the past,
240
00:10:23,319 --> 00:10:25,655
but I am not going to repeat it.
241
00:10:27,525 --> 00:10:30,461
For what it's worth,
I think you would've beat him.
242
00:10:30,486 --> 00:10:32,488
With or without my mom.
243
00:10:32,858 --> 00:10:34,405
To be honest, I'm just hoping
244
00:10:34,430 --> 00:10:36,386
we can put the stuff
with your mom behind us.
245
00:10:36,411 --> 00:10:38,747
Oh, it's definitely behind you.
246
00:10:42,501 --> 00:10:44,469
Hello, Malcolm.
247
00:10:46,238 --> 00:10:48,173
What are you doing here, Mom?
248
00:10:48,923 --> 00:10:50,575
Mom?
249
00:10:59,701 --> 00:11:00,635
Malcolm, please talk to me.
250
00:11:00,702 --> 00:11:01,869
You shouldn't have come.
251
00:11:01,936 --> 00:11:03,933
It wasn't my idea. Dr. Griffith called.
252
00:11:03,958 --> 00:11:07,035
Yes, and I am very sorry
253
00:11:07,060 --> 00:11:09,195
that you came all this way,
Mrs. Kingsley.
254
00:11:09,220 --> 00:11:10,815
But everything has been resolved.
255
00:11:10,840 --> 00:11:12,605
My father will take over again soon.
256
00:11:12,629 --> 00:11:14,063
Your father can't even perform surgery.
257
00:11:14,130 --> 00:11:15,832
Why do you care?
258
00:11:15,899 --> 00:11:18,535
- This isn't your concern.
- Of course it is.
259
00:11:18,601 --> 00:11:21,004
I mean, I don't do the day-to-day.
260
00:11:21,070 --> 00:11:23,006
That's supposed to be your father's job.
261
00:11:23,333 --> 00:11:25,008
But I do run this foundation.
262
00:11:25,074 --> 00:11:27,091
And should this hospital fall
into disarray,
263
00:11:27,158 --> 00:11:29,212
well, that would make
my job much harder.
264
00:11:29,279 --> 00:11:31,892
Everything is under control here.
265
00:11:31,958 --> 00:11:33,957
If that were true, you
never would have called me.
266
00:11:34,024 --> 00:11:37,754
Dr. Griffith, you know,
bad leadership leads to chaos.
267
00:11:37,821 --> 00:11:40,089
And chaos is bad for
business... yours and mine.
268
00:11:40,156 --> 00:11:42,625
Order must be restored.
269
00:11:48,305 --> 00:11:50,241
You look like
you're feeling better, April.
270
00:11:50,266 --> 00:11:53,131
I am. Super glad I'm not dead.
271
00:11:53,198 --> 00:11:54,873
Why were you diving down there
in the first place?
272
00:11:54,940 --> 00:11:57,595
Are you kidding? The Great Lakes
are full of shipwrecks.
273
00:11:57,662 --> 00:11:58,910
There's so much to explore.
274
00:11:58,977 --> 00:12:00,336
Why not explore in the summer
275
00:12:00,403 --> 00:12:03,179
when the risk of hypothermic
death is just a little bit lower?
276
00:12:03,246 --> 00:12:04,681
The risk is why I do it.
277
00:12:04,747 --> 00:12:06,115
The bigger the risk,
the bigger the rush.
278
00:12:06,182 --> 00:12:08,192
Hmm. Adrenaline junkie.
279
00:12:08,259 --> 00:12:09,719
You're like my fianc�e.
280
00:12:09,786 --> 00:12:11,254
What happened, exactly?
281
00:12:11,794 --> 00:12:13,890
I was inside one of the wrecks.
282
00:12:13,957 --> 00:12:16,327
So awesome. And...
283
00:12:16,436 --> 00:12:19,070
But then my hand cramped,
and I dropped my flashlight,
284
00:12:19,095 --> 00:12:20,797
snagged my suit going after it.
285
00:12:20,864 --> 00:12:22,065
Wait. Y-Your hand cramped so badly
286
00:12:22,131 --> 00:12:23,907
that you couldn't hold on
to your flashlight?
287
00:12:24,623 --> 00:12:26,057
Has that ever happened before?
288
00:12:26,123 --> 00:12:28,225
Yeah. All the time, actually.
289
00:12:28,292 --> 00:12:30,227
That can be a, uh, sign
290
00:12:30,294 --> 00:12:32,963
of a neurological condition
called "focal dystonia."
291
00:12:32,988 --> 00:12:34,256
Neurological?
292
00:12:34,365 --> 00:12:36,233
Is there something wrong with my brain?
293
00:12:36,573 --> 00:12:39,270
It's more like, um,
the way that your brain
294
00:12:39,295 --> 00:12:41,664
and your muscles talk to each other.
295
00:12:42,787 --> 00:12:44,831
We'll know more after the test.
296
00:12:45,509 --> 00:12:49,626
Violet Stein. That is one of the
ugliest valves I've ever seen.
297
00:12:49,693 --> 00:12:52,121
Mitral deterioration is very advanced.
298
00:12:52,188 --> 00:12:54,338
There's no family history
of heart disease?
299
00:12:54,405 --> 00:12:58,055
No. She's a typical teenager
with no preexisting conditions.
300
00:12:58,122 --> 00:13:00,124
What about the cadmium toxicity?
301
00:13:00,191 --> 00:13:01,938
Well, explains the bones,
but not the heart.
302
00:13:02,005 --> 00:13:04,228
And she's had no
symptoms of valve disease?
303
00:13:04,295 --> 00:13:07,431
No. None. We only caught it
because she fell.
304
00:13:07,498 --> 00:13:10,167
Although, the falling
could be a symptom.
305
00:13:10,192 --> 00:13:11,568
Cardiovascular syncope.
306
00:13:11,593 --> 00:13:13,504
Blood flow to her brain is
getting cut off during exertion.
307
00:13:13,571 --> 00:13:15,172
Like during a track event.
308
00:13:15,612 --> 00:13:17,507
She's broken multiple ribs.
309
00:13:17,574 --> 00:13:20,111
Because she's fallen
during multiple races.
310
00:13:20,177 --> 00:13:23,013
She's gonna keep falling
unless we replace this valve.
311
00:13:23,038 --> 00:13:27,968
We can do it today...
after Dr. Griffith's bypass.
312
00:13:28,119 --> 00:13:29,887
Back-to-back surgeries.
313
00:13:29,912 --> 00:13:31,180
- I love it.
- Yeah?
314
00:13:31,288 --> 00:13:32,756
Then why are you still standing here?
315
00:13:32,823 --> 00:13:35,092
Get to the OR, man your stations.
316
00:13:35,117 --> 00:13:36,549
Let's go, people.
317
00:13:49,039 --> 00:13:50,374
Byron.
318
00:13:51,481 --> 00:13:52,776
You know, after
319
00:13:52,843 --> 00:13:56,814
all these years, I still
don't like this tie.
320
00:13:57,615 --> 00:13:59,850
What are you doing here, Tina?
321
00:13:59,917 --> 00:14:02,453
I was called, and now that I'm here,
322
00:14:02,520 --> 00:14:04,021
I have no intention
323
00:14:04,088 --> 00:14:05,990
of rubber-stamping the reinstatement
324
00:14:06,056 --> 00:14:07,925
of Rob Griffith as chief.
325
00:14:07,992 --> 00:14:10,794
I had reservations about
him the first time around.
326
00:14:11,334 --> 00:14:13,831
You said you'd stay out
of hospital business.
327
00:14:13,856 --> 00:14:15,791
And you said you'd stay
out of our son's business.
328
00:14:15,816 --> 00:14:17,851
Yet, I see he's running around
like your little clone.
329
00:14:17,876 --> 00:14:20,145
- It was his decision to come here.
- It's not good
330
00:14:20,170 --> 00:14:21,772
for him to live
in your shadow like this.
331
00:14:22,006 --> 00:14:24,041
Don't talk to me
about what's good for him.
332
00:14:24,472 --> 00:14:26,877
You're the one who turned
your back on this family.
333
00:14:26,944 --> 00:14:28,579
Which makes you, what?
The blameless victim?
334
00:14:28,646 --> 00:14:30,214
Is that how you remember it?
335
00:14:30,281 --> 00:14:31,854
It's how it went down.
336
00:14:31,994 --> 00:14:33,863
Clearly, what our son thinks, too.
337
00:14:33,888 --> 00:14:35,757
You turned him against me.
338
00:14:36,020 --> 00:14:37,318
No.
339
00:14:38,088 --> 00:14:39,529
No, Tina.
340
00:14:40,291 --> 00:14:42,393
You did that all by yourself.
341
00:14:43,533 --> 00:14:46,564
Well, here's hoping I can undo it.
342
00:14:47,022 --> 00:14:49,491
See you at the next board meeting.
343
00:14:56,671 --> 00:14:59,343
A mechanical valve?
344
00:14:59,410 --> 00:15:01,011
Yes.
345
00:15:01,036 --> 00:15:03,539
They're strong, reliable.
346
00:15:03,647 --> 00:15:05,516
It should last you
the rest of your life.
347
00:15:05,583 --> 00:15:07,851
How can she have heart disease?
348
00:15:08,050 --> 00:15:09,352
We're vegans.
349
00:15:09,538 --> 00:15:11,774
Our diets are very healthy.
350
00:15:13,396 --> 00:15:16,227
Your diet may not have caused
your valve disease,
351
00:15:16,293 --> 00:15:19,997
but all of that soy
and cadmium did contribute
352
00:15:20,064 --> 00:15:21,560
to your broken ribs.
353
00:15:21,626 --> 00:15:25,502
Now, a new valve will help
your heart get stronger,
354
00:15:25,783 --> 00:15:27,972
but you'll likely need
to make some dietary changes
355
00:15:27,997 --> 00:15:30,333
to help your bones get stronger, too.
356
00:15:30,441 --> 00:15:32,343
What kind of changes?
357
00:15:32,977 --> 00:15:36,080
Have you ever considered
eating any fish or meat?
358
00:15:36,146 --> 00:15:37,581
- No.
- No.
359
00:15:37,648 --> 00:15:40,417
Violet has never had so much
as a glass of milk in her life.
360
00:15:40,484 --> 00:15:42,152
We are diligent about supplements,
361
00:15:42,177 --> 00:15:45,280
and getting all the nutrients we
need from non-animal sources.
362
00:15:45,389 --> 00:15:46,590
If we need to cut back on soy, we will,
363
00:15:46,615 --> 00:15:48,550
but meat is not an option.
364
00:15:52,810 --> 00:15:54,632
Why don't we get you
started with a new valve,
365
00:15:55,146 --> 00:15:57,101
and we'll take the rest from there?
366
00:16:02,570 --> 00:16:04,375
Your EMG results are in.
367
00:16:04,441 --> 00:16:06,944
Your motor unit recruitment is perfect.
368
00:16:07,053 --> 00:16:09,388
- What does that mean?
- It means whatever's causing the cramp
369
00:16:09,413 --> 00:16:10,648
is probably not neurological.
370
00:16:10,714 --> 00:16:14,184
Oh. Well, does that mean I can go?
371
00:16:14,251 --> 00:16:16,020
We still haven't found
the cause of the cramp.
372
00:16:16,086 --> 00:16:18,057
Hey, as long as my brain's okay,
373
00:16:18,124 --> 00:16:20,024
I can live
with a few dropped flashlights
374
00:16:20,090 --> 00:16:21,458
and the occasional charley horse.
375
00:16:21,525 --> 00:16:22,993
Charley horse.
376
00:16:23,060 --> 00:16:24,428
Peripheral artery disease
would explain the hand
377
00:16:24,495 --> 00:16:26,430
and the claudication
in the lower extremities.
378
00:16:26,497 --> 00:16:28,399
She needs a stress test.
379
00:16:28,465 --> 00:16:31,001
You can't go just yet, April.
380
00:16:34,004 --> 00:16:35,306
So...
381
00:16:35,686 --> 00:16:38,475
Malcolm's mom is here.
382
00:16:38,542 --> 00:16:40,611
Yes.
383
00:16:46,150 --> 00:16:48,619
But you shouldn't feel guilty
or anything. It's not like
384
00:16:48,686 --> 00:16:50,159
you told her to come.
385
00:16:51,255 --> 00:16:52,333
- And...
- Hmm.
386
00:16:52,357 --> 00:16:54,391
I need to get my head in the game.
387
00:16:56,293 --> 00:16:57,561
I blew it.
388
00:16:57,628 --> 00:16:59,636
You didn't blow it.
It was one "I love you."
389
00:16:59,703 --> 00:17:01,699
No. She's never gonna talk to me again.
390
00:17:01,765 --> 00:17:05,469
She said talking to you
made all the difference.
391
00:17:06,175 --> 00:17:07,471
She said that?
392
00:17:07,496 --> 00:17:09,264
Mm-hmm.
393
00:17:09,373 --> 00:17:11,141
All right, gentlemen,
394
00:17:11,208 --> 00:17:14,378
are you ready to be reminded
how a bypass should be done?
395
00:17:23,187 --> 00:17:25,122
You have an audience.
396
00:17:25,189 --> 00:17:26,690
It's good to be home.
397
00:17:27,071 --> 00:17:29,193
Right this way, Dr. Griffith.
398
00:17:29,259 --> 00:17:32,162
I know where
the patient's head is, Dr. Shah.
399
00:17:33,464 --> 00:17:34,698
Ah.
400
00:17:34,765 --> 00:17:37,301
Let's see if we can get
him to the heart.
401
00:17:37,326 --> 00:17:38,527
Okay.
402
00:17:38,552 --> 00:17:40,254
It's all for you, Dad.
403
00:17:40,279 --> 00:17:41,614
Ten blade to me.
404
00:17:45,376 --> 00:17:46,744
Hit it.
405
00:17:46,810 --> 00:17:50,681
* I'm back in the game *
406
00:17:50,748 --> 00:17:53,650
* I'm back in the saddle, here I go *
407
00:17:53,717 --> 00:17:55,619
* Back in *
408
00:17:56,420 --> 00:18:01,492
* I'm back in, back in the game... *
409
00:18:04,380 --> 00:18:05,815
Loupes?
410
00:18:20,419 --> 00:18:21,854
All right.
411
00:18:21,879 --> 00:18:23,547
* Back in the game *
412
00:18:23,614 --> 00:18:25,582
Remove the clamp.
413
00:18:27,618 --> 00:18:29,720
* I'm back in the game *
414
00:18:29,787 --> 00:18:31,388
* I'm back in... *
415
00:18:31,455 --> 00:18:33,257
Aortic clamp is off.
416
00:18:33,282 --> 00:18:35,685
Electrical activity
is restored. Perfect.
417
00:18:35,710 --> 00:18:37,378
Not so fast. There is excess tissue
418
00:18:37,403 --> 00:18:40,311
over the proximal anastomosis.
419
00:18:40,336 --> 00:18:42,099
* I'm back in charge, back in the mode *
420
00:18:42,124 --> 00:18:45,261
* Back in my flow, back in the show *
421
00:18:45,536 --> 00:18:46,703
* I'm back in the game *
422
00:18:46,770 --> 00:18:48,205
Now it's perfect.
423
00:18:48,272 --> 00:18:49,640
* I'm back in *
424
00:18:49,706 --> 00:18:53,277
* Back in the game. *
425
00:19:00,250 --> 00:19:02,719
Well done, Dad.
426
00:19:16,059 --> 00:19:17,360
Hey, is everything okay?
427
00:19:21,572 --> 00:19:23,540
Yeah. Just, uh, the light
428
00:19:23,607 --> 00:19:25,142
was angled towards my eyes.
429
00:19:25,209 --> 00:19:26,810
Let's watch that next time.
430
00:19:27,400 --> 00:19:29,613
Close up, Dr. Tucker.
431
00:19:39,171 --> 00:19:42,715
Nice bypass, everyone. We owe
Violet a mechanical valve.
432
00:19:42,740 --> 00:19:44,509
Next, back-to-back surgeries today.
433
00:19:44,575 --> 00:19:46,258
- Back-to-backs.
- Back-to-backs.
434
00:19:46,325 --> 00:19:47,912
Uh, I hate to miss out on all the fun,
435
00:19:47,979 --> 00:19:50,381
but I think I should probably go
and dictate an operative report
436
00:19:50,448 --> 00:19:52,149
on that bypass, don't you?
437
00:19:52,216 --> 00:19:55,686
Sooner you can sign off
on this step the better, right?
438
00:19:55,753 --> 00:19:57,588
- Yeah, sure.
- Okay.
439
00:19:57,655 --> 00:19:59,790
One step closer, Dad.
440
00:20:00,991 --> 00:20:02,659
One step closer.
441
00:20:18,134 --> 00:20:19,402
What is all this?
442
00:20:19,660 --> 00:20:21,681
We think there's a
blockage in your arteries
443
00:20:21,748 --> 00:20:23,581
restricting blood flow
to your extremities.
444
00:20:23,648 --> 00:20:24,949
This is gonna help us find it.
445
00:20:25,016 --> 00:20:26,851
- I just start running?
- Mm-hmm.
446
00:20:26,918 --> 00:20:29,320
This IV has a radioactive tracer in it.
447
00:20:29,387 --> 00:20:31,322
So we're gonna get your heart pumping
448
00:20:31,347 --> 00:20:32,815
and let the tracer
lead us to the problem.
449
00:20:33,299 --> 00:20:34,592
Take her to four.
450
00:20:35,259 --> 00:20:36,360
How fast does it go?
451
00:20:36,427 --> 00:20:38,696
Most people get up to about a six.
452
00:20:38,763 --> 00:20:41,599
- Take me to seven.
- You sure?
453
00:20:45,936 --> 00:20:47,471
Heart rate's at 140.
454
00:20:48,105 --> 00:20:50,207
All right, her hand's cramping.
Are you okay, April?
455
00:20:50,274 --> 00:20:51,576
- It hurts.
- What hurts?
456
00:20:51,642 --> 00:20:53,344
- Everything.
- Take her down.
457
00:20:53,411 --> 00:20:54,378
No! Take me higher.
458
00:20:54,445 --> 00:20:56,314
- April...
- Please, you have to. Going faster is
459
00:20:56,380 --> 00:20:58,249
- the only way to make it stop.
- Make what stop?
460
00:20:58,316 --> 00:21:00,351
- The pain!
- All right, all right. I'm pulling it.
461
00:21:00,418 --> 00:21:02,353
All right, all right.
462
00:21:07,725 --> 00:21:10,428
Mind telling me what
happened in that bypass?
463
00:21:10,494 --> 00:21:11,796
What are you talking about?
464
00:21:11,862 --> 00:21:12,964
Your father dropped an instrument
465
00:21:13,030 --> 00:21:14,699
in the middle of surgery.
466
00:21:14,765 --> 00:21:16,000
The surgery was over,
467
00:21:16,067 --> 00:21:17,668
and surgeons drop instruments
all the time.
468
00:21:17,735 --> 00:21:19,770
When was the last time he dropped one?
469
00:21:19,837 --> 00:21:21,372
I'm due in another surgery soon.
470
00:21:21,439 --> 00:21:23,507
He was in a coma for
six months. Now he can't
471
00:21:23,574 --> 00:21:25,309
get through a routine surgery
without incident.
472
00:21:25,376 --> 00:21:27,445
- There was no incident.
- I know what I saw.
473
00:21:27,511 --> 00:21:29,614
With all due respect,
I am Dr. Griffith's proctor.
474
00:21:29,680 --> 00:21:30,881
I am the only person
475
00:21:30,948 --> 00:21:32,783
who is authorized
to assess his progress,
476
00:21:32,850 --> 00:21:35,019
and I am telling you
that there is no issue
477
00:21:35,086 --> 00:21:37,555
or concern regarding his performance.
478
00:21:38,222 --> 00:21:41,959
Well, I guess
that's all there is to say.
479
00:21:47,898 --> 00:21:50,534
Stress test shows
her arteries are clear.
480
00:21:50,601 --> 00:21:52,670
We know her nerve and
muscle function are normal.
481
00:21:52,737 --> 00:21:54,372
So, what's with the hand cramp?
482
00:21:54,397 --> 00:21:56,933
It only happens during
extreme activity. My guess:
483
00:21:57,041 --> 00:21:59,043
involuntary response to stress hormones.
484
00:21:59,110 --> 00:22:00,911
So, she stops the extreme sports
485
00:22:00,978 --> 00:22:02,413
and the hand cramp goes away.
486
00:22:02,438 --> 00:22:04,373
- But she's not gonna stop.
- Why not?
487
00:22:04,482 --> 00:22:06,684
I see it with Tim, too.
He'll do anything for a rush.
488
00:22:06,751 --> 00:22:09,138
Except with April, it's even
more intense.
489
00:22:09,162 --> 00:22:10,245
What if the hand cramp
490
00:22:10,276 --> 00:22:11,922
is actually a small price to pay
for the upside
491
00:22:11,989 --> 00:22:13,591
of all of those stress hormones?
492
00:22:13,658 --> 00:22:15,760
The adrenaline, the cortisol,
all of those endorphins
493
00:22:15,826 --> 00:22:17,995
that act as natural painkillers?
494
00:22:18,062 --> 00:22:21,065
She's not chasing a high.
She's self-medicating.
495
00:22:21,132 --> 00:22:23,334
The hand cramp isn't
the problem. It's...
496
00:22:23,401 --> 00:22:25,840
it's the solution to the problem,
497
00:22:25,907 --> 00:22:28,939
Which is... chronic pain.
498
00:22:29,006 --> 00:22:31,042
Okay, let's get an MRI.
499
00:22:31,108 --> 00:22:33,711
Whatever's causing this pain,
jumping out of a airplane
500
00:22:33,778 --> 00:22:35,913
can't be the only way to treat it.
501
00:22:35,980 --> 00:22:38,048
- I'm on it.
- Thank you.
502
00:22:50,928 --> 00:22:53,064
- Hey.
- Mm. Hey.
503
00:22:53,130 --> 00:22:55,349
You want some company?
504
00:22:55,374 --> 00:22:56,734
Sure.
505
00:22:59,450 --> 00:23:01,385
I thought you were in
the valve replacement.
506
00:23:01,412 --> 00:23:03,723
Yeah, uh, so, Sam gave me the, uh,
507
00:23:03,748 --> 00:23:05,374
bypass surgery at the last minute.
508
00:23:05,861 --> 00:23:07,697
You were primary?
509
00:23:08,392 --> 00:23:10,664
Oh, that's great. How do you feel?
510
00:23:11,248 --> 00:23:13,386
Yeah, good. I, uh,
511
00:23:13,411 --> 00:23:17,405
just need to, um, come down
a bit from the adrenaline rush.
512
00:23:17,555 --> 00:23:19,006
Mm.
513
00:23:23,427 --> 00:23:27,531
All right. Well, uh, you do that,
514
00:23:27,598 --> 00:23:29,967
and come find me later.
515
00:23:30,034 --> 00:23:31,635
- Mm-hmm.
- All right.
516
00:23:31,702 --> 00:23:33,537
- Hey, do me a favor.
- Hmm?
517
00:23:33,604 --> 00:23:35,973
Just slip that back in the charger,
518
00:23:35,998 --> 00:23:38,467
preferably when Donna's not looking.
519
00:23:39,725 --> 00:23:41,050
What did you do?
520
00:23:41,630 --> 00:23:42,913
Did you drop it?
521
00:23:42,980 --> 00:23:44,749
No. It was like that when I found it.
522
00:23:44,815 --> 00:23:46,450
Liar.
523
00:23:46,475 --> 00:23:48,077
And what if Donna thinks I broke it?
524
00:23:48,102 --> 00:23:49,971
You say it was like that
when you found it.
525
00:24:02,258 --> 00:24:04,568
What are you doing with
the quarterly reports?
526
00:24:04,969 --> 00:24:06,437
Reading them.
527
00:24:06,504 --> 00:24:09,140
I would have used your father's
office, but I couldn't find it.
528
00:24:09,206 --> 00:24:11,408
- Uh, he doesn't have one.
- Doesn't have one?
529
00:24:11,475 --> 00:24:14,121
What, does he do... skulk around
like Phantom of the Opera?
530
00:24:14,188 --> 00:24:16,947
I have work. Whatever you're doing,
531
00:24:16,972 --> 00:24:18,907
can you do it somewhere else, please?
532
00:24:24,249 --> 00:24:26,318
We never talked about my leaving.
533
00:24:26,343 --> 00:24:28,211
What is there to say?
534
00:24:29,500 --> 00:24:31,504
You left. The end.
535
00:24:31,529 --> 00:24:33,050
I left him.
536
00:24:33,117 --> 00:24:35,432
I didn't leave you.
537
00:24:35,499 --> 00:24:37,001
And I didn't leave because I wanted to.
538
00:24:37,067 --> 00:24:38,669
I left because I had to.
539
00:24:39,086 --> 00:24:42,540
- You had to?
- There's only one way with your father.
540
00:24:43,132 --> 00:24:45,576
If you can be what he wants you to be,
541
00:24:45,643 --> 00:24:47,578
if you can stay within those lines
542
00:24:47,645 --> 00:24:49,713
that he draws for you, then you're good.
543
00:24:49,780 --> 00:24:51,816
But I couldn't do it, Malcolm.
544
00:24:51,882 --> 00:24:54,051
I knew that if I chose to be myself,
545
00:24:54,118 --> 00:24:56,453
it would cost me the marriage.
546
00:24:56,520 --> 00:24:59,657
But I never imagined
it would cost me my son.
547
00:25:00,700 --> 00:25:02,134
And I hope
548
00:25:02,159 --> 00:25:04,595
it's not too late to get him back.
549
00:25:04,987 --> 00:25:06,597
How can I trust you
550
00:25:06,822 --> 00:25:08,499
after all this time? I...
551
00:25:08,566 --> 00:25:11,101
I'm not asking for your trust.
552
00:25:11,168 --> 00:25:15,139
I'm asking you to give me
a chance to earn your trust.
553
00:25:17,567 --> 00:25:19,969
I-I need to get to work.
554
00:25:21,452 --> 00:25:25,289
Yeah. Yeah, me too.
555
00:25:26,209 --> 00:25:28,297
Um, you know,
556
00:25:28,322 --> 00:25:31,506
I know this hospital
better than you think.
557
00:25:31,722 --> 00:25:33,724
I could do some...
some good around here.
558
00:25:33,791 --> 00:25:35,926
With your blessing, of course. But, um,
559
00:25:35,993 --> 00:25:37,795
if you want me to leave, I...
560
00:25:37,820 --> 00:25:40,088
I can be on the next flight.
561
00:25:59,183 --> 00:26:02,519
- Ready for the valve, Dr. Shah.
- Mm-hmm.
562
00:26:03,170 --> 00:26:05,789
A new valve in healthy 18-year-old?
563
00:26:06,182 --> 00:26:08,051
You don't see that every day.
564
00:26:11,679 --> 00:26:13,664
Hold on. Something's not right here.
565
00:26:13,731 --> 00:26:14,999
I need more light.
566
00:26:17,234 --> 00:26:18,796
Look at this.
567
00:26:18,862 --> 00:26:20,739
Annular calcification.
568
00:26:20,806 --> 00:26:23,240
- But that didn't show up in the echo.
- No, it did not.
569
00:26:23,307 --> 00:26:26,243
The annulus is supposed
to be firm. This is like Jell-O.
570
00:26:26,310 --> 00:26:28,979
- Liquefactive necrosis.
- I can't attach
571
00:26:29,004 --> 00:26:30,906
the metal to this tissue.
It's too viscous.
572
00:26:30,931 --> 00:26:31,906
I...
573
00:26:31,957 --> 00:26:34,218
There's literally nothing
for me to sew into.
574
00:26:34,243 --> 00:26:36,078
You need something more pliable.
575
00:26:36,287 --> 00:26:38,656
BP and O2 sats are trending down.
576
00:26:38,722 --> 00:26:41,505
Call down for a bioprosthetic valve,
stat.
577
00:26:41,572 --> 00:26:43,127
Wh... A pig valve?
578
00:26:43,193 --> 00:26:44,695
Well, it's not a vegan option,
579
00:26:44,762 --> 00:26:47,005
but it'll keep her alive.
580
00:26:50,300 --> 00:26:52,569
Telling a vegan mother
you put a pig valve
581
00:26:52,636 --> 00:26:55,239
in her vegan daughter's heart?
Not the high point of my day.
582
00:26:55,306 --> 00:26:56,941
Well, that valve
is also keeping her alive.
583
00:26:58,676 --> 00:26:59,476
Oh.
584
00:27:00,018 --> 00:27:02,713
- Thanks, man. I appreciate it.
- Mm-hmm.
585
00:27:02,780 --> 00:27:05,582
And also... I love you.
586
00:27:05,774 --> 00:27:07,084
What?
587
00:27:07,151 --> 00:27:08,812
- Nothing.
- You did it!
588
00:27:08,837 --> 00:27:10,813
Good for you, Dr. Tucker.
589
00:27:10,921 --> 00:27:11,808
What?
590
00:27:11,832 --> 00:27:13,857
He accidentally said
"I love you" to Sam.
591
00:27:13,924 --> 00:27:16,126
We're trying to normalize it
so it's not such a big deal.
592
00:27:16,193 --> 00:27:18,228
That advice is why
some of us are engaged
593
00:27:18,295 --> 00:27:20,030
and why others are going to die alone.
594
00:27:20,097 --> 00:27:21,598
Look, I'm desperate, man, okay?
595
00:27:21,665 --> 00:27:23,267
I cannot let things get weird
with me and Sam.
596
00:27:23,334 --> 00:27:25,135
So, this is the not-weird solution?
597
00:27:25,202 --> 00:27:26,737
Just go with it.
598
00:27:26,804 --> 00:27:28,005
Fine.
599
00:27:29,112 --> 00:27:30,632
Say it again.
600
00:27:32,943 --> 00:27:34,278
I love you.
601
00:27:34,551 --> 00:27:36,052
You're not my type.
602
00:27:38,161 --> 00:27:40,563
That stung a little.
603
00:27:43,520 --> 00:27:46,657
Operative report... dotted
the I's, crossed the T's.
604
00:27:46,682 --> 00:27:48,985
Does that report mention
the scalpel that you dropped?
605
00:27:49,651 --> 00:27:50,961
Why would it?
606
00:27:51,028 --> 00:27:53,364
Because I've never
seen you drop an instrument.
607
00:27:53,430 --> 00:27:54,904
I told you, it was the lights.
608
00:27:54,929 --> 00:27:57,284
I've also never heard you
complain about the lights.
609
00:27:57,441 --> 00:27:59,136
I'm worried that I put you in too soon,
610
00:27:59,370 --> 00:28:00,971
and I want to sign off on this,
611
00:28:01,038 --> 00:28:02,639
but I need to understand
what happened in there.
612
00:28:02,706 --> 00:28:04,141
A successful bypass is what happened.
613
00:28:04,208 --> 00:28:05,776
Who cares about a scalpel?
614
00:28:05,843 --> 00:28:07,911
I'll tell you who cares.
615
00:28:07,978 --> 00:28:09,079
Dad.
616
00:28:09,838 --> 00:28:11,715
Tina Kingsley cares.
617
00:28:11,782 --> 00:28:13,884
She's raising questions
about your competency
618
00:28:13,951 --> 00:28:15,386
after what she saw.
619
00:28:15,452 --> 00:28:18,288
- I told you she never liked me.
- I covered for you.
620
00:28:18,355 --> 00:28:21,825
I said there was nothing
to worry about. Is that true?
621
00:28:21,892 --> 00:28:23,560
It was the lights.
622
00:28:33,971 --> 00:28:36,073
I heard what happened with the scalpel.
623
00:28:36,140 --> 00:28:37,775
Scrub nurses like to gossip.
624
00:28:37,841 --> 00:28:39,843
And what, you think
I'm being too hard on him?
625
00:28:39,910 --> 00:28:41,879
Because it was my idea to
put him back in surgery.
626
00:28:41,945 --> 00:28:43,714
- I know.
- This is just due diligence.
627
00:28:43,781 --> 00:28:45,082
I want to clear him.
628
00:28:45,149 --> 00:28:46,750
I don't think you should.
629
00:28:47,459 --> 00:28:49,167
You don't think he's ready?
630
00:28:49,233 --> 00:28:53,090
I think he should be ready.
I think he thinks he's ready.
631
00:28:53,157 --> 00:28:54,458
But?
632
00:28:54,925 --> 00:28:57,761
That scalpel's not
the only thing he's dropped.
633
00:29:08,627 --> 00:29:10,762
Her hands are ice-cold
and she won't wake up.
634
00:29:10,829 --> 00:29:11,796
Heart rate's 140.
635
00:29:11,863 --> 00:29:13,031
Why is she so tachycardic?
636
00:29:13,443 --> 00:29:14,966
And hypotensive.
637
00:29:15,033 --> 00:29:16,167
Blood pressure's 90/40 and dropping.
638
00:29:16,234 --> 00:29:18,710
Maybe she's turning septic.
Have we gotten another H and H?
639
00:29:18,776 --> 00:29:20,305
There's no fever, she hasn't
lost any blood volume.
640
00:29:20,372 --> 00:29:21,673
Could she be rejecting the valve?
641
00:29:21,740 --> 00:29:24,042
No, acute and chronic
rejection takes weeks to occur.
642
00:29:24,109 --> 00:29:25,810
She's been out of surgery about an hour.
643
00:29:25,877 --> 00:29:27,112
- Could be hyperacute.
- No.
644
00:29:27,178 --> 00:29:28,113
Then we would've known
before we closed up.
645
00:29:28,179 --> 00:29:29,114
This is something else.
646
00:29:29,180 --> 00:29:30,282
What's happening?
647
00:29:30,348 --> 00:29:32,250
Her heart is failing.
648
00:29:32,317 --> 00:29:34,703
I need you to increase her
Levophed, get another pressor.
649
00:29:34,770 --> 00:29:37,242
We got to get her pressure up,
and I want a cardiac MRI
650
00:29:37,309 --> 00:29:38,690
as soon as she is stable.
651
00:29:38,757 --> 00:29:41,760
Her body hates this valve.
I want to know why.
652
00:29:43,161 --> 00:29:44,863
Postoperative ultrasound confirmed
653
00:29:44,930 --> 00:29:46,197
the graft was seamless.
654
00:29:46,264 --> 00:29:48,099
Well, installation's not the problem.
655
00:29:48,166 --> 00:29:50,869
- Maybe it's a defect in the valve?
- Well...
656
00:29:50,936 --> 00:29:53,305
I'm gonna check the production
lot for reported problems.
657
00:29:56,766 --> 00:29:59,169
Look at the leaflets
on the mitral valve.
658
00:30:01,742 --> 00:30:03,581
- They're so stiff.
- Uh-huh.
659
00:30:03,952 --> 00:30:05,717
And what are those spots?
660
00:30:05,742 --> 00:30:06,976
They look like goosebumps.
661
00:30:07,623 --> 00:30:09,054
Or hives.
662
00:30:09,120 --> 00:30:11,056
Can we see
if there's inflammation, please?
663
00:30:13,587 --> 00:30:15,026
Ah.
664
00:30:15,093 --> 00:30:16,361
Lit up like a Christmas tree.
665
00:30:16,428 --> 00:30:17,896
That is an allergic reaction.
666
00:30:17,963 --> 00:30:19,898
But to what?
667
00:30:19,965 --> 00:30:21,564
Anesthesia's out of her system.
668
00:30:21,631 --> 00:30:23,234
The only thing she could
be reacting to...
669
00:30:23,301 --> 00:30:25,670
The valve itself.
670
00:30:30,008 --> 00:30:31,943
She's allergic to meat?
671
00:30:32,189 --> 00:30:34,012
To animal protein, yes.
672
00:30:34,579 --> 00:30:37,649
I've never heard of this.
What did you say it's called?
673
00:30:37,716 --> 00:30:39,617
Alpha-gal syndrome.
674
00:30:39,684 --> 00:30:42,187
It's a reaction to the
sugar molecule in most mammals.
675
00:30:42,253 --> 00:30:44,567
It is a severe allergy,
676
00:30:44,634 --> 00:30:47,959
but because Violet's never eaten
meat, she was never diagnosed.
677
00:30:48,026 --> 00:30:49,794
She was fine.
678
00:30:49,861 --> 00:30:52,764
She had a broken rib, but she was fine.
679
00:30:52,831 --> 00:30:55,200
How did things get so bad so fast?
680
00:30:55,266 --> 00:30:57,869
I know that she seemed fine,
681
00:30:57,936 --> 00:31:01,973
but something has been
damaging her heart.
682
00:31:02,040 --> 00:31:03,274
But you don't know what it is.
683
00:31:03,341 --> 00:31:04,943
The mechanical valve didn't work.
684
00:31:05,010 --> 00:31:07,645
The pig valve isn't working.
Her heart is failing.
685
00:31:07,712 --> 00:31:10,215
Which is why we need
to give her a new one.
686
00:31:16,087 --> 00:31:19,424
Your MRI shows that
you have spinal stenosis.
687
00:31:21,326 --> 00:31:23,795
It's the narrowing of your spinal cavity
688
00:31:23,862 --> 00:31:26,164
that's compressing your nerves
and causing your chronic pain.
689
00:31:26,231 --> 00:31:27,699
Well, can you fix it?
690
00:31:27,766 --> 00:31:30,235
Mm-hmm. It's called a laminectomy.
691
00:31:30,301 --> 00:31:32,237
We remove part of your vertebra
692
00:31:32,303 --> 00:31:34,172
to ease the pressure on your nerves.
693
00:31:34,668 --> 00:31:36,141
Sounds complicated.
694
00:31:36,207 --> 00:31:38,145
There are risks, but
695
00:31:38,211 --> 00:31:40,882
the bigger the risk,
the bigger the rush, right?
696
00:31:44,553 --> 00:31:46,138
Look, April,
697
00:31:47,264 --> 00:31:50,155
I know you found a way
to cope with your pain,
698
00:31:50,221 --> 00:31:52,390
but it's just temporary.
699
00:31:52,457 --> 00:31:54,959
Problems like these do not
go away on their own.
700
00:31:55,026 --> 00:31:58,229
In fact, they usually get worse.
701
00:32:09,307 --> 00:32:11,476
Lying down in the middle of a shift?
702
00:32:11,543 --> 00:32:13,244
This is another first, Dad.
703
00:32:13,311 --> 00:32:14,746
It's low blood sugar.
704
00:32:14,813 --> 00:32:17,715
Or post-exertional malaise.
705
00:32:17,782 --> 00:32:21,045
Is that why you ducked out of
the valve replacement surgery?
706
00:32:21,112 --> 00:32:23,388
I'll have some trail mix, I'll be fine.
707
00:32:23,455 --> 00:32:25,990
I want to run a blood panel
on you, a full workup.
708
00:32:26,057 --> 00:32:27,538
Whoa! Why?
709
00:32:27,605 --> 00:32:29,394
Because I know about the headaches
710
00:32:29,503 --> 00:32:31,171
and the ringing in your ears,
711
00:32:31,196 --> 00:32:33,932
the photosensitivity.
712
00:32:33,998 --> 00:32:37,268
And I hear you dropped a tablet
in addition to that scalpel.
713
00:32:39,399 --> 00:32:41,247
Et tu, Brute?
714
00:32:41,272 --> 00:32:42,873
I'm worried about you.
715
00:32:43,141 --> 00:32:45,143
Ignoring this isn't gonna
make it go away.
716
00:32:45,210 --> 00:32:47,445
I can't clear you for surgery
unless we address these symptoms.
717
00:32:47,512 --> 00:32:49,180
Symptoms? It's nothing.
718
00:32:49,247 --> 00:32:51,015
It's a little bit
of anemia or something.
719
00:32:51,082 --> 00:32:53,852
Maybe. But the headaches
could be a sentinel bleed,
720
00:32:53,918 --> 00:32:55,153
or a subarachnoid hemorrhage, or...
721
00:32:55,220 --> 00:32:56,888
- Or a tumor.
- Mm.
722
00:32:56,955 --> 00:32:59,824
I see no cause for alarm.
723
00:32:59,891 --> 00:33:03,761
Neither did our patient
until her heart started to fail.
724
00:33:03,965 --> 00:33:06,164
You need bloodwork and scans.
725
00:33:06,231 --> 00:33:07,365
I'm not having a scan.
726
00:33:07,432 --> 00:33:08,500
Dad, this is serious.
727
00:33:08,566 --> 00:33:10,301
So am I. Word gets out...
728
00:33:10,368 --> 00:33:12,103
Tina Kingsley finds out...
It's all over.
729
00:33:12,170 --> 00:33:13,350
Forget it.
730
00:33:14,643 --> 00:33:16,870
Okay, fine. Just bloodwork for now.
731
00:33:16,937 --> 00:33:18,343
I can get around Bernie.
732
00:33:20,955 --> 00:33:21,988
Yeah, I think I prefer it
733
00:33:22,013 --> 00:33:24,516
when you two don't talk to each other.
734
00:33:34,159 --> 00:33:35,626
- Uh...
- Going down?
735
00:33:35,693 --> 00:33:37,462
Uh, yeah, to the lab.
736
00:33:40,131 --> 00:33:42,333
- Thanks.
- Yeah.
737
00:33:44,869 --> 00:33:47,272
How are things going with your mom?
738
00:33:47,801 --> 00:33:49,970
Mm. She wants a fresh start.
739
00:33:50,887 --> 00:33:53,344
Not that she has any
right to ask for that.
740
00:33:54,558 --> 00:33:56,247
You're probably right.
741
00:33:56,810 --> 00:33:58,883
But you could still give her one.
742
00:33:59,396 --> 00:34:02,453
Sometimes people
just need a second chance,
743
00:34:03,233 --> 00:34:05,456
you know, before it's too late.
744
00:34:15,366 --> 00:34:17,302
I've got some bloodwork for you, Bernie.
745
00:34:17,368 --> 00:34:18,870
Who's the patient?
746
00:34:18,895 --> 00:34:21,898
Um, I didn't put a name. Say it's me?
747
00:34:22,006 --> 00:34:23,374
Is it you?
748
00:34:23,753 --> 00:34:25,986
How about we say yes
and I'll owe you one.
749
00:34:26,052 --> 00:34:29,581
You and everybody else.
It's death by a thousand cuts.
750
00:34:35,186 --> 00:34:37,255
Hang on. Bernie, can you run labs
751
00:34:37,322 --> 00:34:39,357
on something that isn't human?
752
00:34:42,927 --> 00:34:44,862
Why did you want to see
all the supplements we take?
753
00:34:44,929 --> 00:34:46,531
So that our lab could test them.
754
00:34:46,598 --> 00:34:48,344
Test them for what?
755
00:34:48,411 --> 00:34:49,801
We know Violet has alpha-gal.
756
00:34:49,867 --> 00:34:52,270
- The meat allergy.
- Yes, which explains
757
00:34:52,337 --> 00:34:53,538
your reaction to the pig valve.
758
00:34:53,605 --> 00:34:54,939
What it doesn't explain is
759
00:34:55,006 --> 00:34:56,341
the heart condition you came in with,
760
00:34:56,407 --> 00:34:58,409
because you are a lifelong vegan.
761
00:34:58,476 --> 00:35:00,345
Whatever's been damaging Violet's heart,
762
00:35:00,411 --> 00:35:02,947
we assumed it had to be
something other than meat.
763
00:35:03,014 --> 00:35:05,883
But she has no other conditions,
no other factors
764
00:35:05,950 --> 00:35:08,086
that could explain
the damage to her heart.
765
00:35:08,152 --> 00:35:09,654
It had to be the alpha-gal.
766
00:35:09,720 --> 00:35:12,290
Which means you had
to be consuming meat.
767
00:35:12,357 --> 00:35:14,198
Your vitamin B-12
768
00:35:14,264 --> 00:35:17,895
supplements are encased in a capsule
769
00:35:17,962 --> 00:35:20,031
derived from animal proteins.
770
00:35:20,098 --> 00:35:22,900
Now, the amount
in each capsule is too small
771
00:35:22,967 --> 00:35:24,235
to trigger an outward reaction.
772
00:35:24,302 --> 00:35:26,560
But the chronic insult
773
00:35:26,627 --> 00:35:29,374
to your system damaged
your heart over time.
774
00:35:29,440 --> 00:35:31,943
- The label says they're vegan.
- Yes.
775
00:35:32,010 --> 00:35:34,445
But supplements are
not regulated by the FDA.
776
00:35:34,512 --> 00:35:36,628
The-the labels, the ingredients...
777
00:35:36,695 --> 00:35:38,914
They're not verified the way the
prescription medications are.
778
00:35:38,981 --> 00:35:41,486
So, I-I've been taking meat pills?
779
00:35:42,629 --> 00:35:44,130
The good news is that you are at
780
00:35:44,155 --> 00:35:45,882
the top of the transplant list,
781
00:35:45,949 --> 00:35:48,026
and it is not too late for a new start.
782
00:35:48,092 --> 00:35:50,859
We're gonna get a nutritionist.
We'll make meal plans.
783
00:35:50,926 --> 00:35:52,630
We're gonna be okay. Stop saying "we."
784
00:35:53,928 --> 00:35:54,861
What?
785
00:35:54,886 --> 00:35:56,567
We're not the same person.
786
00:35:57,347 --> 00:36:01,339
If it were up to me,
maybe I wouldn't even be vegan.
787
00:36:01,448 --> 00:36:03,095
I might have eaten a hamburger by now
788
00:36:03,120 --> 00:36:04,609
and found out about this sooner.
789
00:36:04,676 --> 00:36:06,244
None of this would've happened
790
00:36:06,311 --> 00:36:08,680
if you had just let me
make my own decisions.
791
00:36:09,484 --> 00:36:10,648
Violet, I was just trying
to do what I thought...
792
00:36:10,715 --> 00:36:12,550
Well, you were wrong.
793
00:36:18,356 --> 00:36:20,338
Donor match for Violet Stein.
794
00:36:20,405 --> 00:36:21,515
We got a hit?
795
00:36:21,539 --> 00:36:23,148
Yeah. She'll have a new heart
by tomorrow.
796
00:36:23,172 --> 00:36:24,338
I'll get her on the schedule.
797
00:36:24,405 --> 00:36:26,464
Okay, great, and I'll
notify the family. Okay.
798
00:36:26,531 --> 00:36:28,566
Oh. Sorry.
799
00:36:30,105 --> 00:36:31,892
You know what? Uh, after you.
800
00:36:31,959 --> 00:36:33,237
- You go.
- I...
801
00:36:33,304 --> 00:36:35,006
Okay, I'll go.
802
00:36:36,941 --> 00:36:38,509
What was that?
803
00:36:39,347 --> 00:36:42,246
That was... awkward.
804
00:36:42,313 --> 00:36:43,681
Mm.
805
00:36:44,315 --> 00:36:46,184
I accidentally said "I love you."
806
00:36:46,250 --> 00:36:48,219
I've been trying to undo it, but...
807
00:36:48,286 --> 00:36:50,188
Why, because you don't love her?
808
00:37:02,600 --> 00:37:04,435
Everything okay?
809
00:37:04,502 --> 00:37:06,304
Yeah. Uh... Well,
810
00:37:06,371 --> 00:37:07,672
I can do this if you want
811
00:37:07,739 --> 00:37:09,273
to join Dr. Griffith and tell the family
812
00:37:09,340 --> 00:37:10,641
about the transplant.
813
00:37:10,708 --> 00:37:13,745
No. I got to, uh,
get to the lab, anyway, so...
814
00:37:13,811 --> 00:37:15,258
Okay.
815
00:37:21,639 --> 00:37:24,055
Dad says once you break trust,
it's gone.
816
00:37:24,122 --> 00:37:26,686
I know he'd say this is a mistake,
817
00:37:28,146 --> 00:37:29,981
but if you want to stay...
818
00:37:31,358 --> 00:37:33,026
I won't stop you.
819
00:37:34,903 --> 00:37:36,701
Thank you for this chance.
820
00:37:37,864 --> 00:37:39,504
I hope I don't regret it.
821
00:37:41,159 --> 00:37:43,574
All I want is to make things better
822
00:37:44,162 --> 00:37:46,778
for us and for this hospital.
823
00:37:48,636 --> 00:37:51,282
Starting with
the cardiothoracic department.
824
00:38:00,976 --> 00:38:02,005
Hey.
825
00:38:02,030 --> 00:38:03,161
Hey.
826
00:38:03,227 --> 00:38:04,695
Look, I know you're out of the race,
827
00:38:05,446 --> 00:38:06,697
but I just want to let you know
828
00:38:06,764 --> 00:38:09,400
that my mom has some plans
for your department.
829
00:38:09,467 --> 00:38:10,468
What do you mean?
830
00:38:10,535 --> 00:38:12,703
Well, she's opening the position
to outside candidates.
831
00:38:13,400 --> 00:38:15,072
Thought your dad might like to know
832
00:38:15,139 --> 00:38:17,341
that he won't be running
unopposed for too long.
833
00:38:17,408 --> 00:38:20,411
Um... I'll tell him.
834
00:38:20,865 --> 00:38:22,613
Yeah.
835
00:38:23,363 --> 00:38:24,942
So...
836
00:38:25,009 --> 00:38:27,318
she's sticking around, then?
837
00:38:27,385 --> 00:38:28,748
Yeah.
838
00:38:29,287 --> 00:38:32,790
Uh, I'm gonna try this whole
second chance thing.
839
00:38:35,255 --> 00:38:36,694
I'm still so sorry.
840
00:38:36,761 --> 00:38:39,564
No, no, don't. Hey, it's okay.
841
00:38:40,510 --> 00:38:42,233
It's just, I-I got to figure out
842
00:38:42,300 --> 00:38:44,235
this stuff with my mom right now, and...
843
00:38:44,889 --> 00:38:47,392
I get it. You don't have to explain.
844
00:38:49,602 --> 00:38:51,375
I will see you around.
845
00:38:52,564 --> 00:38:54,278
I'll see you around.
846
00:38:54,345 --> 00:38:55,775
Okay.
847
00:39:04,256 --> 00:39:05,224
Hey.
848
00:39:05,249 --> 00:39:06,524
How'd it go in there?
849
00:39:06,591 --> 00:39:07,892
Oh, yeah, she's stable.
850
00:39:07,959 --> 00:39:10,134
Um, I just finished the
paperwork for the transplant.
851
00:39:10,748 --> 00:39:14,499
Her mom was just doing what she
thought was best, wasn't she?
852
00:39:14,565 --> 00:39:16,334
She didn't know what
her daughter needed.
853
00:39:17,255 --> 00:39:20,771
This morning, what I said, um,
854
00:39:20,838 --> 00:39:23,407
is probably the last thing you need.
855
00:39:23,474 --> 00:39:26,143
It was probably the worst
possible time to say it,
856
00:39:26,210 --> 00:39:28,346
but I did, and I don't want
to pretend like I didn't.
857
00:39:28,412 --> 00:39:30,248
What did you say?
858
00:39:31,242 --> 00:39:32,562
I said "I love you."
859
00:39:33,417 --> 00:39:35,653
Which you clearly didn't hear.
860
00:39:35,720 --> 00:39:39,690
Um, but that's-that's good,
because it just
861
00:39:39,757 --> 00:39:42,727
slipped out. It was an accident,
and it shouldn't have happened.
862
00:39:43,594 --> 00:39:46,264
At least, not like that.
863
00:39:47,410 --> 00:39:49,233
What are you saying?
864
00:39:49,300 --> 00:39:52,165
I... love you.
865
00:39:54,425 --> 00:39:55,585
I love you.
866
00:39:56,961 --> 00:39:59,443
Oh. That's how it should've happened.
867
00:39:59,510 --> 00:40:01,679
Because that's how I feel.
868
00:40:02,133 --> 00:40:03,781
And now you know.
869
00:40:16,594 --> 00:40:18,195
What are you doing in here?
870
00:40:18,262 --> 00:40:19,664
I always used to come down here
871
00:40:19,730 --> 00:40:21,666
before surgery and after.
872
00:40:22,278 --> 00:40:25,198
Your mother would say, "He's in church."
873
00:40:27,283 --> 00:40:28,706
Me too.
874
00:40:29,159 --> 00:40:30,370
Hmm.
875
00:40:32,080 --> 00:40:35,246
Tina Kingsley is widening
the search for chief.
876
00:40:35,313 --> 00:40:37,348
She's not gonna make it easy
for me, is she?
877
00:40:37,769 --> 00:40:39,103
You'll be fine.
878
00:40:39,128 --> 00:40:42,620
Your history and relationships.
879
00:40:42,882 --> 00:40:44,555
No one can compete with you.
880
00:40:45,343 --> 00:40:47,558
I know one person who can.
881
00:40:47,625 --> 00:40:48,993
I told you I'm out, Dad.
882
00:40:49,060 --> 00:40:50,761
Well, maybe you should reconsider.
883
00:40:51,224 --> 00:40:53,698
Better you than an outsider, right?
884
00:40:54,269 --> 00:40:55,937
What about you?
885
00:40:58,982 --> 00:41:00,984
You got your test results.
886
00:41:02,340 --> 00:41:03,641
Not anemia.
887
00:41:04,585 --> 00:41:05,820
Okay.
888
00:41:05,845 --> 00:41:07,645
That doesn't mean
it's a worst-case scenario.
889
00:41:07,712 --> 00:41:09,013
Doesn't rule it out, either.
890
00:41:10,755 --> 00:41:12,189
This race may be decided for me.
891
00:41:12,214 --> 00:41:14,149
If it is, I would prefer
you to be the one...
892
00:41:14,224 --> 00:41:18,084
Stop. We're not talking about
work. We're going to imaging.
893
00:41:19,316 --> 00:41:20,951
No arguments.
894
00:41:27,604 --> 00:41:30,179
Thanks for telling me about this.
895
00:41:31,869 --> 00:41:34,405
Thanks for telling me
about his symptoms.
896
00:41:36,519 --> 00:41:38,509
I'm really glad you're here.
897
00:41:40,060 --> 00:41:41,595
Me too.
898
00:41:41,620 --> 00:41:44,882
Just want to remind
you of a little thing called
899
00:41:44,949 --> 00:41:47,318
doctor-patient confidentiality.
900
00:41:47,385 --> 00:41:49,320
A-And Sam?
901
00:41:50,617 --> 00:41:53,024
Don't worry. I'm not gonna tell Mom.
65355
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