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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:03,980 --> 00:00:06,016 Previously on Good Sam... 2 00:00:06,082 --> 00:00:08,472 I have been trying to keep up with you in a game 3 00:00:08,538 --> 00:00:10,787 that you've had rigged the entire time. 4 00:00:10,854 --> 00:00:12,722 I'm going to go and tell Sam everything. 5 00:00:12,789 --> 00:00:14,124 I think I'm all caught up. 6 00:00:14,190 --> 00:00:16,393 - Ambulance has just landed. - Step back, Dr. Trulie. 7 00:00:16,459 --> 00:00:17,994 You don't need to worry about your best friend 8 00:00:18,061 --> 00:00:20,648 being with your dad because you and I are not friends. 9 00:00:20,714 --> 00:00:23,667 It was me. I called your mother. 10 00:00:23,692 --> 00:00:25,280 Her vote could be the key. 11 00:00:25,347 --> 00:00:26,273 This is not personal. 12 00:00:26,340 --> 00:00:28,196 She is my mother! I told you 13 00:00:28,220 --> 00:00:30,089 I didn't even want to think about her! 14 00:00:30,156 --> 00:00:31,924 I have to end this war. 15 00:00:31,991 --> 00:00:33,392 You ended something, all right. 16 00:00:33,459 --> 00:00:35,427 I want you to know that you can talk to me. 17 00:00:36,020 --> 00:00:37,889 I think I lost my way. 18 00:01:03,046 --> 00:01:03,981 Morning. 19 00:01:04,055 --> 00:01:06,725 Thank you for letting me sleep here last night 20 00:01:06,750 --> 00:01:08,152 and letting me talk your ear off. 21 00:01:08,460 --> 00:01:09,970 Of course. 22 00:01:11,063 --> 00:01:14,900 So, uh, how you feeling, other than tired? 23 00:01:14,925 --> 00:01:18,494 Uh... Hmm. I feel like... 24 00:01:18,519 --> 00:01:20,509 a bulldozer ran over everyone 25 00:01:20,534 --> 00:01:22,216 and everything that I care about. 26 00:01:22,408 --> 00:01:24,877 All around me, I see destruction. 27 00:01:24,944 --> 00:01:27,112 And in the cold light of day, I realize 28 00:01:27,137 --> 00:01:30,307 that it was not a bulldozer that destroyed everything. 29 00:01:30,332 --> 00:01:32,134 - It was me. - Hmm. 30 00:01:32,159 --> 00:01:34,295 I think you're being a little hard on yourself. 31 00:01:34,486 --> 00:01:36,488 Nah. 32 00:01:36,513 --> 00:01:39,049 You should've seen the look on Malcolm's face. 33 00:01:39,074 --> 00:01:41,409 And what Lex said to me... not that I blame her. 34 00:01:41,434 --> 00:01:45,858 And my mother? I accused my own mother of not being on my side. 35 00:01:45,883 --> 00:01:48,400 Because of what? This vote for chief? 36 00:01:48,467 --> 00:01:50,236 I am a human bulldozer. 37 00:01:50,302 --> 00:01:51,570 You don't have to do that. Uh... 38 00:01:51,637 --> 00:01:53,405 - No, it's fine. I want to. - I just... 39 00:01:53,472 --> 00:01:55,641 I didn't expect anyone, so it's a mess. 40 00:01:55,708 --> 00:01:58,745 Compared to my life, this is nothing. 41 00:01:58,770 --> 00:02:01,531 Hey, you remember the last thing you said last night? 42 00:02:01,556 --> 00:02:03,983 Uh, was it something along the lines of, 43 00:02:04,049 --> 00:02:05,985 "I've become a power-crazed monster 44 00:02:06,051 --> 00:02:07,453 who hurts the people she loves"? 45 00:02:07,519 --> 00:02:10,522 No. It was, "I'm gonna make this right." 46 00:02:11,031 --> 00:02:13,784 And I said, "If anyone can do it, it's you." 47 00:02:14,785 --> 00:02:18,101 Did I happen to say how I was planning on doing that? 48 00:02:18,168 --> 00:02:21,267 No. At that point, you started snoring like a baby rhino. 49 00:02:21,292 --> 00:02:24,462 I do not snore. Caleb! 50 00:02:24,570 --> 00:02:26,188 I do not snore! 51 00:02:27,206 --> 00:02:30,276 I'm gonna... I'm gonna make this right. 52 00:02:30,301 --> 00:02:32,070 I'm gonna try. 53 00:02:32,911 --> 00:02:35,681 Well, uh, guess we better get to work. 54 00:02:35,706 --> 00:02:37,683 Yeah. Hey. 55 00:02:38,651 --> 00:02:39,776 Oh. 56 00:02:39,801 --> 00:02:42,103 I'm really glad you opened the door last night. 57 00:02:42,487 --> 00:02:44,564 Yeah, well, glad you knocked. 58 00:02:49,094 --> 00:02:50,821 - I'm gonna get dressed. - I love you. 59 00:02:52,131 --> 00:02:54,333 Yeah, get dressed. Me, too. 60 00:02:54,358 --> 00:02:56,560 I'm gonna brush my teeth, then I'm gonna... Yup. 61 00:02:56,585 --> 00:02:58,353 - Yeah. - Sounds good. 62 00:03:13,003 --> 00:03:15,239 I never should have called your mom. 63 00:03:15,521 --> 00:03:16,972 Okay. 64 00:03:17,990 --> 00:03:19,525 You told me that she was on the board, 65 00:03:19,550 --> 00:03:21,586 and all I could think about was her vote. 66 00:03:21,694 --> 00:03:24,596 But all I should've been thinking about was you. 67 00:03:24,663 --> 00:03:26,898 And how reaching out to her would make you feel. 68 00:03:27,092 --> 00:03:29,795 I'm... 69 00:03:30,027 --> 00:03:31,247 Damn it. It's the ER. 70 00:03:31,272 --> 00:03:32,612 You should go. 71 00:03:40,812 --> 00:03:42,147 What do we have? 72 00:03:42,172 --> 00:03:43,840 Violet Stein. 18. 73 00:03:43,929 --> 00:03:45,964 She fell at her high school track event. 74 00:03:45,989 --> 00:03:49,159 - She was in first place, too. - Okay, just gonna take a listen. 75 00:03:51,004 --> 00:03:52,991 There's a lot of turbulence 76 00:03:53,016 --> 00:03:54,318 between atrioventricular valves. 77 00:03:54,343 --> 00:03:55,970 Is that because of her broken rib? 78 00:03:55,995 --> 00:03:57,505 They said she has a broken rib. 79 00:03:57,530 --> 00:03:58,865 Looks like this is the third bone 80 00:03:58,890 --> 00:03:59,991 you've broken at a track meet. 81 00:04:00,144 --> 00:04:01,279 A lot of kids fall at these things. 82 00:04:01,304 --> 00:04:03,239 Well, three fractures is unusual. 83 00:04:03,469 --> 00:04:05,170 Are you getting enough vitamin D, calcium? 84 00:04:05,237 --> 00:04:07,373 We're very good about supplements. 85 00:04:07,398 --> 00:04:09,167 You have to be, on a vegan diet. 86 00:04:09,524 --> 00:04:12,059 Does this vegan diet include a lot of soy products? 87 00:04:12,126 --> 00:04:13,345 Yes. Why? 88 00:04:13,412 --> 00:04:15,410 No air entry left side. 89 00:04:15,476 --> 00:04:16,904 And vital signs are unstable. 90 00:04:16,929 --> 00:04:18,175 Violet, can you breathe? 91 00:04:18,200 --> 00:04:20,002 Tension pneumothorax. 92 00:04:20,027 --> 00:04:21,528 14 gauge needle. Three and a quarter inch. 93 00:04:21,553 --> 00:04:22,955 - Excuse me. - Quickly, please! 94 00:04:22,980 --> 00:04:24,515 - What's happening? - It's all right. 95 00:04:24,636 --> 00:04:26,200 Just hold on. Her rib is stabbing 96 00:04:26,225 --> 00:04:27,593 into her lung, and we need to clear the air 97 00:04:27,659 --> 00:04:29,027 that's trapped in her chest cavity. 98 00:04:29,094 --> 00:04:30,529 It's all right. 99 00:04:30,596 --> 00:04:31,730 Try to relax. 100 00:04:32,865 --> 00:04:34,299 It's okay. 101 00:04:34,366 --> 00:04:36,301 Straight into the trauma bay. 102 00:04:36,368 --> 00:04:39,505 Who's the patient? April Krane, 25, hypothermic. 103 00:04:39,530 --> 00:04:41,265 I'm told her dry suit ripped while scuba diving. 104 00:04:41,373 --> 00:04:42,808 Scuba diving? In the middle of winter? 105 00:04:42,833 --> 00:04:44,167 All the lakes are frozen. 106 00:04:44,192 --> 00:04:45,360 They cut a hole in the ice, I guess. 107 00:04:45,385 --> 00:04:47,320 Water under the surface is about 39 degrees. 108 00:04:47,345 --> 00:04:48,530 She lost consciousness on the way over. 109 00:04:48,555 --> 00:04:50,073 Okay, let's get these wet clothes off of her. 110 00:04:50,148 --> 00:04:51,492 Breathing is shallow, pulse is weak. 111 00:04:51,517 --> 00:04:53,519 All right. We need to get her core temp up. 112 00:04:53,544 --> 00:04:54,779 Bring a Bair Hugger in here, please. 113 00:04:54,804 --> 00:04:55,863 We could warm up her IV fluids. 114 00:04:55,888 --> 00:04:57,489 Good idea. I'll grab a bag. 115 00:05:04,296 --> 00:05:06,165 - Hi. - Hey. 116 00:05:06,231 --> 00:05:07,666 Still on trauma? 117 00:05:08,193 --> 00:05:10,462 - Is that because of me? - Not everything is about you. 118 00:05:10,803 --> 00:05:13,272 I am sorry that I threw you off that patient. 119 00:05:13,338 --> 00:05:14,573 I was out of line. 120 00:05:14,640 --> 00:05:16,809 If you want to come off trauma, 121 00:05:16,834 --> 00:05:18,169 it will not happen again. 122 00:05:18,703 --> 00:05:20,571 I like trauma. 123 00:05:21,540 --> 00:05:29,540 Synced & corrected by -robtor- www.addic7ed.com 124 00:05:30,809 --> 00:05:32,845 Oh, if I broke that many bones running track, 125 00:05:32,870 --> 00:05:34,472 - 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, 129 00:05:41,325 --> 00:05:42,769 chemically similar to zinc and mercury. 130 00:05:42,793 --> 00:05:43,756 - Yeah. - Toxic levels 131 00:05:43,780 --> 00:05:45,337 linked to fragile bone syndrome 132 00:05:45,362 --> 00:05:47,197 - and often found in... - In soy products. 133 00:05:47,222 --> 00:05:49,190 Doesn't explain the mid-diastolic murmur you heard, 134 00:05:49,215 --> 00:05:50,516 but does address the fractures, at least. 135 00:05:50,621 --> 00:05:52,556 Okay, I'll run the labs. Dad, one more thing. 136 00:05:52,581 --> 00:05:53,670 Hmm? 137 00:05:57,007 --> 00:05:59,351 I'm done fighting you for the chief job. 138 00:05:59,885 --> 00:06:01,011 The job is yours. 139 00:06:01,359 --> 00:06:03,595 Uh, the vote's not for 42 days. 140 00:06:03,620 --> 00:06:05,021 They don't need to vote. 141 00:06:05,765 --> 00:06:08,594 What are you...? You quitting? 142 00:06:08,619 --> 00:06:10,353 Yeah. I'm out. 143 00:06:12,522 --> 00:06:13,582 Why? 144 00:06:13,607 --> 00:06:15,534 When you put so much into it? 145 00:06:15,559 --> 00:06:18,462 Too much, and that's the problem. I'm... 146 00:06:18,570 --> 00:06:20,639 I just want to focus on my patients, 147 00:06:20,664 --> 00:06:22,365 and I want to get you through your proctorship. 148 00:06:23,200 --> 00:06:25,143 - Uh-huh. - And speaking of which, 149 00:06:25,168 --> 00:06:27,471 we do have a double bypass on the schedule for later today. 150 00:06:27,496 --> 00:06:29,265 - I'm aware. - I am making you primary. 151 00:06:29,831 --> 00:06:31,550 You've aced every step so far, 152 00:06:31,575 --> 00:06:34,211 and it's time you do your first solo surgery. 153 00:06:34,544 --> 00:06:36,522 I'll see you in the OR. 154 00:06:37,431 --> 00:06:38,699 How do you 155 00:06:38,724 --> 00:06:41,173 - accidentally say "I love you"? - It just slipped out. 156 00:06:41,240 --> 00:06:43,462 I mean, I spent the whole night listening to her talk 157 00:06:43,487 --> 00:06:45,155 about making up with Malcolm. 158 00:06:45,180 --> 00:06:46,448 And then, right at the end, I blew it. 159 00:06:46,504 --> 00:06:48,740 Making up? Are they in a fight? 160 00:06:48,901 --> 00:06:50,302 I heard all about it 161 00:06:50,327 --> 00:06:52,295 right before dropping the "L" bomb on her. 162 00:06:52,404 --> 00:06:53,939 I mean, who does that? 163 00:06:53,964 --> 00:06:55,365 And she didn't say anything? 164 00:06:55,390 --> 00:06:56,750 Maybe she didn't hear me. 165 00:06:56,868 --> 00:07:00,237 Maybe she thought I said "I love the view," or, "I shove you." 166 00:07:00,612 --> 00:07:02,948 I just... I've never said it before. 167 00:07:02,973 --> 00:07:05,070 - Never to Sam? - Never to anyone. 168 00:07:05,095 --> 00:07:07,045 You've never said "I love you" to someone? 169 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... 171 00:07:10,622 --> 00:07:12,224 Why? How many people have you said it to? 172 00:07:12,291 --> 00:07:14,239 - Hundreds. - Hundreds? 173 00:07:14,306 --> 00:07:16,428 I'm very comfortable saying it. 174 00:07:16,453 --> 00:07:18,788 It's easier than you think. 175 00:07:18,897 --> 00:07:20,566 I love you, Caleb. 176 00:07:20,632 --> 00:07:22,501 See? Now you say it to me. 177 00:07:22,526 --> 00:07:24,661 - Oh. No. - Come on. Tell me you love me. 178 00:07:25,712 --> 00:07:27,138 You can do it, Dr. Tucker. 179 00:07:30,943 --> 00:07:32,578 I love... 180 00:07:33,218 --> 00:07:34,613 ...balloon angioplasty. 181 00:07:34,680 --> 00:07:35,681 And, look. 182 00:07:35,747 --> 00:07:38,317 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 00:07:59,771 --> 00:08:02,257 Maybe the desk should go here, huh? 188 00:08:02,941 --> 00:08:04,710 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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