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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:05,570 --> 00:00:07,830 - He's putting me on a renal diet. 2 00:00:07,870 --> 00:00:08,830 And if that doesn't turn things around, then... 3 00:00:08,870 --> 00:00:09,830 - Dialysis? 4 00:00:09,870 --> 00:00:11,350 I'm so sorry. 5 00:00:11,400 --> 00:00:14,270 - I don't advertise my immigration status, 6 00:00:14,310 --> 00:00:16,140 but I'm undocumented. 7 00:00:16,190 --> 00:00:19,320 My future always feels precarious. 8 00:00:19,360 --> 00:00:21,060 More money in our checks! 9 00:00:21,100 --> 00:00:23,110 We are essential! 10 00:00:23,150 --> 00:00:25,240 - You're striking? - It's very important 11 00:00:25,280 --> 00:00:27,540 that Liliana feels like I have her back. 12 00:00:27,590 --> 00:00:29,126 - I'm going with my friends to celebrate. 13 00:00:29,150 --> 00:00:30,330 Come! - Oh, no... 14 00:00:30,370 --> 00:00:32,460 - You have to come. You're my boyfriend. 15 00:00:38,860 --> 00:00:40,120 - Lil. 16 00:00:40,170 --> 00:00:41,560 - Daniel. 17 00:00:41,600 --> 00:00:42,690 Oh, the time. 18 00:00:42,730 --> 00:00:44,690 I didn't realize. 19 00:00:44,740 --> 00:00:46,650 I... I'm almost finished. 20 00:00:46,690 --> 00:00:49,040 I'm usually done before you arrive. 21 00:00:49,090 --> 00:00:50,130 I'm sorry. - Oh, no. 22 00:00:50,180 --> 00:00:51,326 No, let me get that. Let me get that. 23 00:00:51,350 --> 00:00:53,310 I'm the one who should be apologizing. 24 00:00:53,350 --> 00:00:56,270 No. No, I had the interns in for pizza last night. 25 00:00:56,310 --> 00:00:57,230 Then they dragged me out for a drink, 26 00:00:57,270 --> 00:00:58,880 and... and we just left. 27 00:00:58,920 --> 00:01:00,100 - It's OK. I've got it. 28 00:01:00,140 --> 00:01:01,686 - I apologize for the mess. Really, I do. 29 00:01:01,710 --> 00:01:02,970 - It's OK. 30 00:01:03,010 --> 00:01:05,280 Compared to other offices, it's not that bad. 31 00:01:07,890 --> 00:01:10,630 Oh! 32 00:01:10,670 --> 00:01:12,850 Daniel, have a good day. 33 00:01:12,890 --> 00:01:14,200 - You too. 34 00:01:19,420 --> 00:01:20,380 Ah. 35 00:01:20,420 --> 00:01:23,170 - I think this belongs to you. 36 00:01:23,210 --> 00:01:25,120 - Indeed, it does. Where did you find it? 37 00:01:25,170 --> 00:01:26,390 - This time? Waiting room. 38 00:01:26,430 --> 00:01:28,210 Top of the vending machine. - Mm. 39 00:01:28,260 --> 00:01:30,560 You know, maybe I should just put it 40 00:01:30,610 --> 00:01:32,570 in a little red-and-white striped shirt, 41 00:01:32,610 --> 00:01:34,610 put a bobble hat on it, black glasses, 42 00:01:34,650 --> 00:01:38,220 and call it my "Where's Waldo?" water bottle, huh? 43 00:01:38,270 --> 00:01:40,220 You get it? 44 00:01:40,270 --> 00:01:41,790 - I get it. 45 00:01:41,840 --> 00:01:43,450 You have to stay hydrated. 46 00:01:44,270 --> 00:01:45,880 - Thanks, Mom. 47 00:01:49,230 --> 00:01:50,540 - Dr. Cuevas. 48 00:01:50,580 --> 00:01:53,280 - Ms. Goodwin, good morning. - Good morning. 49 00:01:53,330 --> 00:01:56,810 Do you have a moment to discuss your DACA renewal? 50 00:01:56,850 --> 00:01:59,420 - Oh. Um, now? 51 00:01:59,460 --> 00:02:01,990 - Well, the paperwork's not due for a few months, 52 00:02:02,030 --> 00:02:04,600 but I want to make sure we get everything filed early, 53 00:02:04,640 --> 00:02:07,170 just in case there's an unexpected policy change. 54 00:02:07,210 --> 00:02:09,730 - Right, of course. I appreciate that. 55 00:02:09,780 --> 00:02:12,170 I just was about to dig into these overnight charts. 56 00:02:12,210 --> 00:02:13,780 - Understood. 57 00:02:13,820 --> 00:02:16,520 How about we meet up at the end of the day? 58 00:02:16,570 --> 00:02:19,260 - Yeah. Sure, that works. 59 00:02:19,310 --> 00:02:21,310 I will... I'll see you then. 60 00:02:24,180 --> 00:02:25,310 - Dr. Asher. - Mm-hmm? 61 00:02:25,360 --> 00:02:26,320 - Need you. - Oh, yeah. 62 00:02:26,360 --> 00:02:27,970 Come this way. 63 00:02:28,010 --> 00:02:29,360 Hi, I'm Dr. Asher. 64 00:02:29,410 --> 00:02:32,100 - Leah, what's going on? 65 00:02:32,150 --> 00:02:33,760 - Parents and their daughter. 66 00:02:33,800 --> 00:02:36,110 Came in a few minutes ago. They're terrified. 67 00:02:36,150 --> 00:02:38,760 Even scared me. - Going to two. 68 00:02:38,810 --> 00:02:40,526 - I didn't get a history. Just came for you. 69 00:02:40,550 --> 00:02:42,550 - Excuse me, Doctor. We need your help. 70 00:02:42,590 --> 00:02:44,460 Our daughter. - All right. 71 00:02:44,510 --> 00:02:46,860 Hi, I'm Dr. Halstead. What's your name? 72 00:02:46,900 --> 00:02:48,470 Maria. 73 00:02:48,510 --> 00:02:50,470 Her name is Maria. Very sick! 74 00:02:50,510 --> 00:02:53,560 Listen. 75 00:02:56,690 --> 00:02:58,870 - I'm sorry. I don't speak Spanish. 76 00:02:58,910 --> 00:03:00,740 Get Dr. Cuevas. 77 00:03:00,780 --> 00:03:04,180 I'm just gonna feel your neck, OK? 78 00:03:05,220 --> 00:03:06,530 - Does that hurt? 79 00:03:06,570 --> 00:03:07,880 ¿Malo? Bad? 80 00:03:17,980 --> 00:03:19,150 What are they saying? 81 00:03:19,190 --> 00:03:21,280 - They're saying that she has the sickness, 82 00:03:21,330 --> 00:03:23,720 and if we don't help her, she will die. 83 00:03:40,820 --> 00:03:42,740 - Thank you. 84 00:03:42,780 --> 00:03:44,780 - Hey. How's Maria doing? 85 00:03:44,830 --> 00:03:45,920 - Still a bit groggy, 86 00:03:45,960 --> 00:03:47,610 but responding to questions in English. 87 00:03:47,660 --> 00:03:49,830 Whatever this is, it seems to be sporadic. 88 00:03:49,880 --> 00:03:51,700 - Any guesses? - I don't know. 89 00:03:51,750 --> 00:03:54,790 Maybe infectious encephalitis, but her vitals were normal. 90 00:03:54,840 --> 00:03:56,270 I'm hoping labs shed some light. 91 00:03:56,320 --> 00:03:57,970 What did Mom and Dad have to say? 92 00:03:58,020 --> 00:03:59,630 - The sickness that they're referring to 93 00:03:59,670 --> 00:04:01,280 has to do with her older brother, Hugo. 94 00:04:01,320 --> 00:04:03,720 About a month ago, he came down with an illness, 95 00:04:03,760 --> 00:04:05,386 was admitted to Oakview Community Hospital, 96 00:04:05,410 --> 00:04:08,330 and then died a few days later. - Oh, man. 97 00:04:08,370 --> 00:04:09,640 - Yeah, and even worse, 98 00:04:09,680 --> 00:04:11,590 Oakview couldn't make a diagnosis. 99 00:04:11,640 --> 00:04:13,486 - Well, explains why they're beating down our doors. 100 00:04:13,510 --> 00:04:15,900 They're afraid whatever ravaged Hugo is now attacking Maria. 101 00:04:15,950 --> 00:04:18,950 - But a death in the family, no answers, 102 00:04:18,990 --> 00:04:21,470 plus the fear that she might have the same illness? 103 00:04:21,520 --> 00:04:23,870 Since nothing's jumping out, I think it's possible 104 00:04:23,910 --> 00:04:26,000 that her emotions could be manifesting physically. 105 00:04:26,040 --> 00:04:27,756 I want to talk to her, see if there could be 106 00:04:27,780 --> 00:04:29,130 a psych explanation. - OK. 107 00:04:29,180 --> 00:04:30,700 Meantime, I'll reach out to Oakview, 108 00:04:30,740 --> 00:04:32,570 get Hugo's records and autopsy results. 109 00:04:32,620 --> 00:04:33,856 If Maria does have the same illness, 110 00:04:33,880 --> 00:04:36,490 there could be a clue in there. - OK. 111 00:04:36,530 --> 00:04:38,660 - OK, Layla, you're 7 centimeters dilated, 112 00:04:38,710 --> 00:04:40,320 100% effaced. 113 00:04:40,360 --> 00:04:41,930 How long ago did your water break? 114 00:04:41,970 --> 00:04:44,670 - About an hour, hour and a... 115 00:04:46,060 --> 00:04:48,200 7:02 a.m., I think. 116 00:04:48,240 --> 00:04:50,020 - This baby is coming out sideways. 117 00:04:50,070 --> 00:04:51,330 - No, it just feels like that. 118 00:04:51,370 --> 00:04:52,460 Your fetus is OP, 119 00:04:52,500 --> 00:04:54,030 meaning it's facing up instead of down. 120 00:04:54,070 --> 00:04:55,330 - Something's wrong? - No. 121 00:04:55,380 --> 00:04:56,966 Baby's just moving around, letting us know 122 00:04:56,990 --> 00:04:58,680 that it is time to come out. 123 00:04:58,730 --> 00:05:00,300 - I'll have a nurse let L&D know. 124 00:05:00,340 --> 00:05:01,730 - Oh, my God. 125 00:05:01,770 --> 00:05:03,560 Quentin, our son is coming. 126 00:05:03,600 --> 00:05:05,340 I'm gonna be a mom today. 127 00:05:05,390 --> 00:05:07,560 - You know, I can't remember if I turned off the oven 128 00:05:07,610 --> 00:05:08,780 before we left the house. 129 00:05:08,830 --> 00:05:10,610 - Quentin, we haven't cooked in days. 130 00:05:10,650 --> 00:05:12,050 The oven is off. 131 00:05:12,090 --> 00:05:13,286 - I'm just gonna go home and check. 132 00:05:13,310 --> 00:05:14,480 - Quentin, no! 133 00:05:14,530 --> 00:05:16,286 - Mr. Bell, please don't go. - You know what? 134 00:05:16,310 --> 00:05:17,960 Maybe you can have a neighbor check on it, 135 00:05:18,010 --> 00:05:19,400 or maybe it's just nervous energy 136 00:05:19,440 --> 00:05:21,230 that's making you think that you left it on. 137 00:05:21,270 --> 00:05:23,580 - Yeah, I just don't feel like myself. 138 00:05:23,620 --> 00:05:25,580 - I get it. It's a big day. 139 00:05:25,620 --> 00:05:26,816 You know, a lot of new experiences 140 00:05:26,840 --> 00:05:28,060 all happening at once. 141 00:05:28,110 --> 00:05:31,590 But, Quentin, this is not new for me. 142 00:05:31,630 --> 00:05:33,200 I have been here many, many times, 143 00:05:33,240 --> 00:05:34,696 and I know exactly how to help you and Layla 144 00:05:34,720 --> 00:05:36,940 get through this. 145 00:05:36,980 --> 00:05:38,200 - Thank you. 146 00:05:39,420 --> 00:05:40,420 - Sorry, Lay. 147 00:05:40,470 --> 00:05:42,380 I just lost my mind for a minute. 148 00:05:44,510 --> 00:05:47,250 - Nice save. - Mm-hmm. 149 00:05:48,820 --> 00:05:52,260 - Hey, Sam. This is Dr. Tanaka-Reed. 150 00:05:52,300 --> 00:05:53,676 He's gonna be scrubbing in with me today. 151 00:05:53,700 --> 00:05:55,180 He's one of my surgical residents. 152 00:05:55,220 --> 00:05:56,740 - Uh, technically I'm a resident 153 00:05:56,790 --> 00:05:58,310 but definitely not a beginner. 154 00:05:58,350 --> 00:05:59,220 - OK. 155 00:05:59,270 --> 00:06:01,180 - Anyway, like we discussed, 156 00:06:01,230 --> 00:06:02,840 it's a straight appendix removal. 157 00:06:02,880 --> 00:06:04,336 You're gonna be a bit sore afterwards, 158 00:06:04,360 --> 00:06:06,580 but in a week or two, you'll be back to full strength. 159 00:06:06,620 --> 00:06:08,190 - Mm, perfect, 160 00:06:08,230 --> 00:06:10,150 because I've been itching to get back in the gym. 161 00:06:10,190 --> 00:06:11,890 Rugged Maniac is this summer. 162 00:06:11,930 --> 00:06:14,110 - Rugged Maniac? The adventure race? 163 00:06:14,150 --> 00:06:15,850 - You know it? - Yeah, sort of. 164 00:06:15,890 --> 00:06:16,956 A couple of guys from the community 165 00:06:16,980 --> 00:06:18,240 are putting a team together. 166 00:06:18,290 --> 00:06:20,110 - Community? You mean other doctors? 167 00:06:20,160 --> 00:06:23,120 No, CrossFit. 168 00:06:23,160 --> 00:06:25,420 From my Kalsu group. Kalsu's a workout. 169 00:06:25,470 --> 00:06:27,290 We do burpees and thrusters for time. 170 00:06:27,340 --> 00:06:28,860 - Anyway, back to the task at hand. 171 00:06:28,910 --> 00:06:30,820 If you're ready, we're ready. 172 00:06:31,820 --> 00:06:33,610 - Let's do this. - Great. 173 00:06:33,650 --> 00:06:35,366 Nurse Trisha will be in to get the prep started. 174 00:06:35,390 --> 00:06:37,830 Anesthesia after that. - Sounds good, Doc. 175 00:06:37,870 --> 00:06:39,870 - See you on the other side, all right? 176 00:06:41,870 --> 00:06:44,440 - Appendix removal... Pretty basic. 177 00:06:44,490 --> 00:06:46,156 - Well, sorry Sam's not sick enough for you. 178 00:06:46,180 --> 00:06:47,450 - Oh, you know what I mean. 179 00:06:47,490 --> 00:06:49,880 OR 2.0 is a Ferrari... Sexy surgery. 180 00:06:49,930 --> 00:06:52,020 But a lap appy? That's a minivan. 181 00:06:52,060 --> 00:06:54,060 - Well, not even in that today. 182 00:06:54,100 --> 00:06:56,850 Sam had a sigmoid colon resection 18 months ago. 183 00:06:56,890 --> 00:06:58,280 Likely adhesions in his pelvis, 184 00:06:58,330 --> 00:07:00,940 so we're gonna do this appy open... 185 00:07:00,980 --> 00:07:02,680 Right lower quadrant incision. 186 00:07:02,720 --> 00:07:04,330 OK? - Old school. 187 00:07:04,380 --> 00:07:07,330 Gee, hope I'm up to the challenge. 188 00:07:07,380 --> 00:07:09,990 - For a resident, guy sure is full of himself. 189 00:07:10,030 --> 00:07:11,470 I'm not a fan. 190 00:07:14,520 --> 00:07:16,210 - Hugo's gone. 191 00:07:18,040 --> 00:07:20,520 I'm oldest now. I need to be strong. 192 00:07:22,310 --> 00:07:25,660 For my other brothers and sisters. 193 00:07:25,700 --> 00:07:27,090 For my parents. 194 00:07:30,310 --> 00:07:34,060 They've been a wreck since Hugo died. 195 00:07:34,100 --> 00:07:35,930 They can't sleep. 196 00:07:35,970 --> 00:07:37,890 They can't eat. 197 00:07:37,930 --> 00:07:40,930 Now I'm putting them through it again. 198 00:07:42,810 --> 00:07:44,550 I have it too. - No. 199 00:07:44,590 --> 00:07:46,720 Hey, we don't know that. 200 00:07:46,770 --> 00:07:50,200 All of the labs Dr. Halstead ran came back normal. 201 00:07:50,250 --> 00:07:52,950 - Then what's wrong with me? 202 00:07:54,120 --> 00:07:56,430 - In some cases, it's possible 203 00:07:56,470 --> 00:08:00,300 for grief and fear to lead to physical symptoms. 204 00:08:00,340 --> 00:08:02,960 - No, I'm not imagining this. 205 00:08:03,000 --> 00:08:04,780 - No, you're not. 206 00:08:04,830 --> 00:08:08,050 Your symptoms are very real. 207 00:08:08,090 --> 00:08:12,440 You suffered a devastating loss, a trauma. 208 00:08:15,100 --> 00:08:17,580 - Hugo's tests were normal too. 209 00:08:20,580 --> 00:08:22,500 And then he died. 210 00:08:26,590 --> 00:08:28,346 - I don't think we're looking at a psych condition. 211 00:08:28,370 --> 00:08:29,980 In conversion disorder, it's rare 212 00:08:30,030 --> 00:08:32,460 that patients can express their emotions the way Maria is. 213 00:08:32,510 --> 00:08:34,770 But her awareness of the situation, 214 00:08:34,810 --> 00:08:37,770 her acknowledgment of the fear, it doesn't fit. 215 00:08:37,820 --> 00:08:40,560 There's definitely something physical going on. 216 00:08:40,600 --> 00:08:41,990 - I wish I knew what. 217 00:08:42,040 --> 00:08:43,846 Medical examiner said Hugo died of brain swelling 218 00:08:43,870 --> 00:08:45,650 but don't know what caused it. 219 00:08:45,690 --> 00:08:47,570 it was only three days 220 00:08:47,610 --> 00:08:49,700 from when Hugo was admitted to the time he died. 221 00:08:49,740 --> 00:08:53,350 - OK, so whatever it is, it moved really fast. 222 00:08:55,310 --> 00:08:58,050 I think he's stuck. 223 00:08:58,100 --> 00:08:59,270 - No, just a big head. 224 00:08:59,320 --> 00:09:01,270 That's all. 225 00:09:01,320 --> 00:09:02,540 - Oh, my God. 226 00:09:02,580 --> 00:09:04,230 Is he gonna fit? - Yes, he will. 227 00:09:04,280 --> 00:09:05,686 We just need to open up the birth canal a bit wider. 228 00:09:05,710 --> 00:09:07,060 - McRoberts? - Yes. 229 00:09:07,110 --> 00:09:08,930 Call the OB resident on call. 230 00:09:08,980 --> 00:09:11,460 - Layla, we're gonna adjust you to a new position, OK? 231 00:09:11,500 --> 00:09:13,046 It makes it easier for the baby to come out. 232 00:09:13,070 --> 00:09:14,330 - OK. 233 00:09:14,370 --> 00:09:16,070 - I'm right here. - All right, Quentin. 234 00:09:16,120 --> 00:09:17,900 Why don't you let him take over for you, OK? 235 00:09:17,940 --> 00:09:19,096 And I can use some pressure. - Yep. 236 00:09:19,120 --> 00:09:21,470 - I'm right here. 237 00:09:21,510 --> 00:09:23,210 - OK, now on your next contraction, 238 00:09:23,250 --> 00:09:24,886 I want you to give me everything you've got. 239 00:09:24,910 --> 00:09:26,130 Everything. - OK. 240 00:09:26,170 --> 00:09:27,470 - OK. - I can do this. 241 00:09:27,520 --> 00:09:29,300 - Yes, you can. - You got this. 242 00:09:29,350 --> 00:09:31,870 You got this. You got this. - OK. 243 00:09:31,910 --> 00:09:33,790 Oh. 244 00:09:36,010 --> 00:09:38,010 - I've got the head. 245 00:09:38,050 --> 00:09:39,230 Shoulder. 246 00:09:40,840 --> 00:09:42,400 - I've got him. 247 00:09:42,450 --> 00:09:44,670 I got him. He's here. 248 00:09:44,710 --> 00:09:46,490 He's here. 249 00:09:47,490 --> 00:09:49,710 He's here. - Oh, my God. 250 00:09:49,760 --> 00:09:52,150 Oh, my God. 251 00:09:52,200 --> 00:09:54,070 I'm a mom. 252 00:09:54,110 --> 00:09:56,810 Our baby, he's beautiful. 253 00:09:56,850 --> 00:09:58,510 He's perfect. 254 00:09:58,550 --> 00:10:00,860 - Hey, Dad, do you want to cut the umbilical cord? 255 00:10:00,900 --> 00:10:02,770 Yeah. 256 00:10:02,810 --> 00:10:06,040 - OK. Just right here in the middle, OK? 257 00:10:09,390 --> 00:10:11,170 - I want to hold him. 258 00:10:11,210 --> 00:10:13,560 - That's not my son. 259 00:10:14,960 --> 00:10:17,440 - What? 260 00:10:17,480 --> 00:10:19,830 - Layla, who's the father? 261 00:10:19,880 --> 00:10:21,750 - You are, Quentin. 262 00:10:21,790 --> 00:10:23,570 You are. That's our baby. 263 00:10:23,620 --> 00:10:25,660 - No, you're lying! You're lying! 264 00:10:25,710 --> 00:10:26,660 - Hey, Quentin, it's OK. 265 00:10:26,710 --> 00:10:28,230 We'll figure this out, all right? 266 00:10:28,270 --> 00:10:29,930 - That's not my son. - That's our baby. 267 00:10:29,970 --> 00:10:31,670 Of course it is! - No, get back! 268 00:10:31,710 --> 00:10:34,540 - Of course it is! Of course it is! 269 00:10:34,590 --> 00:10:36,086 - I got to get out of here. - Hey, deep breaths, OK? 270 00:10:36,110 --> 00:10:37,240 Quentin, breathe with me. 271 00:10:37,280 --> 00:10:38,656 Breathe with me, Quentin. Deep breaths. 272 00:10:38,680 --> 00:10:40,396 - I got to get out of here! - Stay! Baby, stay! 273 00:10:40,420 --> 00:10:42,200 - Hey, call security. - Help! 274 00:10:42,250 --> 00:10:43,860 Oh, my God. What's happening? 275 00:10:43,900 --> 00:10:46,950 - Hey! Hey, stop! 276 00:10:46,990 --> 00:10:49,030 Hey, guards! Quentin, stop! 277 00:10:50,950 --> 00:10:53,740 - Why are you chasing me? Just leave me... leave me alone! 278 00:10:53,780 --> 00:10:56,650 - Hey, Quentin... - Stay back! Stay back! 279 00:10:56,690 --> 00:10:58,170 - It's OK. It's OK. 280 00:10:58,220 --> 00:11:00,700 Deep breath. Please, just breathe. 281 00:11:00,740 --> 00:11:02,700 - I just got to get out of here. 282 00:11:02,740 --> 00:11:04,790 I just got to get out of here! - No, no, no, no, no! 283 00:11:09,930 --> 00:11:11,970 All right, Quentin. 284 00:11:12,010 --> 00:11:13,930 It's OK. 285 00:11:15,890 --> 00:11:19,240 - Oh, my God, the scissors, they're pulsating. 286 00:11:19,280 --> 00:11:20,696 - They're penetrating the carotid artery. 287 00:11:20,720 --> 00:11:22,046 - I'll get someone to turn off the machine. 288 00:11:22,070 --> 00:11:24,850 - No, the magnet is holding everything in place, 289 00:11:24,900 --> 00:11:26,200 including the scissors. 290 00:11:26,250 --> 00:11:28,046 If gravity takes over, it'll shift everything, 291 00:11:28,070 --> 00:11:31,290 and we'll have maybe 20 seconds before he bleeds out. 292 00:11:31,340 --> 00:11:33,250 OK, we need help. Call Dr. Archer. 293 00:11:33,300 --> 00:11:35,300 Dr. Charles too. - Yeah. 294 00:11:37,040 --> 00:11:40,610 - Do not touch the scissors, OK? 295 00:11:40,650 --> 00:11:42,910 We got you. 296 00:11:42,960 --> 00:11:44,790 Everything's gonna be OK. 297 00:11:49,646 --> 00:11:52,010 - Coming through. Excuse me. 298 00:11:52,050 --> 00:11:53,580 - Thank you guys for coming. 299 00:11:53,620 --> 00:11:55,620 - Absolutely. 300 00:11:55,670 --> 00:11:57,320 - Hey, fellas. - Doctor. 301 00:11:59,710 --> 00:12:01,930 - He's conscious and calm but out of it. 302 00:12:01,980 --> 00:12:03,850 He's not being crushed. He's able to breathe. 303 00:12:03,890 --> 00:12:06,070 He's got to be in pain, though. - OK. 304 00:12:06,110 --> 00:12:09,030 So let's give him 50 mics of fentanyl IM. 305 00:12:09,070 --> 00:12:10,940 Syringe is plastic and the needle nonferrous, 306 00:12:10,990 --> 00:12:12,340 so it should be MRI safe. 307 00:12:12,380 --> 00:12:13,820 - OK, I'll get it. 308 00:12:13,860 --> 00:12:15,730 Dr. Asher went back to be with his wife, Layla. 309 00:12:15,770 --> 00:12:17,780 She's still in L&D. - OK. 310 00:12:17,820 --> 00:12:19,260 - It's a rescue situation. 311 00:12:19,300 --> 00:12:20,666 I just don't really know where to start. 312 00:12:20,690 --> 00:12:22,300 All of our tools have metal. 313 00:12:22,350 --> 00:12:25,960 - So nothing is usable as long as the MRI machine is running. 314 00:12:26,000 --> 00:12:28,790 All right, well, let's say we did turn the machine off. 315 00:12:28,830 --> 00:12:30,110 - Everything falls to the floor. 316 00:12:30,140 --> 00:12:32,090 Bed alone is a couple hundred pounds. 317 00:12:32,140 --> 00:12:34,286 - I can put two of my guys in there to try and catch it, 318 00:12:34,310 --> 00:12:36,116 then get it out of the way so you can get to Quentin. 319 00:12:36,140 --> 00:12:38,320 - Scissors in his neck are magnetic too. 320 00:12:38,360 --> 00:12:40,100 Cut the MRI's power, they're gonna move. 321 00:12:40,150 --> 00:12:41,670 Quentin will bleed out fast. 322 00:12:41,710 --> 00:12:44,280 - If you could go in there with clamps and stem the flow, 323 00:12:44,320 --> 00:12:46,760 would that buy us some time? - Not enough. 324 00:12:46,800 --> 00:12:48,890 Odds of survival are less than 1%. 325 00:12:48,940 --> 00:12:51,160 I'm running outcome probabilities on our options, 326 00:12:51,200 --> 00:12:53,006 and turning off the machine cold turkey is the worst. 327 00:12:53,030 --> 00:12:54,990 - So what's the best? 328 00:12:55,030 --> 00:12:57,380 - If CFD can secure Quentin 329 00:12:57,420 --> 00:12:59,300 and ensure the bed won't displace him 330 00:12:59,340 --> 00:13:01,690 and Dr. Archer can stabilize the neck wound 331 00:13:01,730 --> 00:13:03,236 all before turning off the MRI machine, 332 00:13:03,260 --> 00:13:06,480 then the odds of survival are roughly 61%. 333 00:13:06,520 --> 00:13:09,040 - OK, we've got a plan. Can it be done? 334 00:13:09,090 --> 00:13:11,830 - Well, safest way to secure the patient 335 00:13:11,870 --> 00:13:14,220 would be to do a webbing harness. 336 00:13:14,270 --> 00:13:16,620 We can throw the ropes over the MRI machine, 337 00:13:16,660 --> 00:13:18,880 and then two of my guys can hold it on the other side. 338 00:13:18,920 --> 00:13:21,060 - OK, the magnet's off, the bed falls. 339 00:13:21,100 --> 00:13:24,190 How do we ensure that Quentin doesn't go with it? 340 00:13:24,230 --> 00:13:26,256 - We can create a buffer zone between him and the bed 341 00:13:26,280 --> 00:13:29,020 using wooden cribbing, wedges, and airbags. 342 00:13:29,060 --> 00:13:30,850 - We can run some hoses and inflate them 343 00:13:30,890 --> 00:13:32,280 from a tank here in the hallway. 344 00:13:32,330 --> 00:13:33,850 - All right, we're halfway there. 345 00:13:33,900 --> 00:13:35,550 Dr. Archer? - Yeah. 346 00:13:35,590 --> 00:13:37,160 I just need to clamp the artery 347 00:13:37,200 --> 00:13:38,266 in order to control the bleeding. 348 00:13:38,290 --> 00:13:40,340 Then I could take the scissors out. 349 00:13:40,380 --> 00:13:43,300 But the issue is the tools needed to do it. 350 00:13:43,340 --> 00:13:45,340 - I can make them plastic. 3D printers. 351 00:13:45,380 --> 00:13:46,576 There are four in the robotics lab. 352 00:13:46,600 --> 00:13:47,870 - All right. Get on it. 353 00:13:47,910 --> 00:13:51,040 And get a few of the 2.0 engineers to help. 354 00:13:51,090 --> 00:13:53,960 - We'll get started too. - Good. 355 00:13:54,000 --> 00:13:55,390 - OK, you're doing great. 356 00:13:55,440 --> 00:13:57,010 Gonna give you a little injection. 357 00:13:57,050 --> 00:13:58,400 Some pain meds, all right? 358 00:13:58,440 --> 00:14:01,570 To just make you a little more comfortable, OK? 359 00:14:01,620 --> 00:14:03,490 Little pinch. 360 00:14:08,230 --> 00:14:09,540 OK. 361 00:14:11,240 --> 00:14:13,890 - Daniel? 362 00:14:13,940 --> 00:14:15,256 - I'm just gonna step away for a second, 363 00:14:15,280 --> 00:14:16,566 have a little chat with my colleague. 364 00:14:16,590 --> 00:14:18,460 I'm not going anywhere, OK? 365 00:14:21,510 --> 00:14:23,810 - How's he doing? 366 00:14:23,860 --> 00:14:28,170 - Well, you know, I mean, he's pinned to an MRI machine, so... 367 00:14:28,210 --> 00:14:30,870 - Do you have any theories on what sparked the break? 368 00:14:30,910 --> 00:14:33,300 - I've been really focusing on trying to keep him calm. 369 00:14:33,350 --> 00:14:36,000 But how's the plan to get him off the thing going? 370 00:14:36,040 --> 00:14:37,440 - Well, we've got one. 371 00:14:37,480 --> 00:14:39,610 But it's a possibility that it won't work, Daniel, 372 00:14:39,660 --> 00:14:43,010 so I've asked Dr. Asher to bring Quentin's wife down here 373 00:14:43,050 --> 00:14:45,920 to see him 'cause it may be the last time. 374 00:14:45,970 --> 00:14:47,880 - OK, thank you. 375 00:14:50,230 --> 00:14:52,320 - OK, making the incision. 376 00:14:54,190 --> 00:14:55,190 OK. 377 00:14:57,410 --> 00:14:59,980 OK, nice and easy. 378 00:15:02,240 --> 00:15:03,330 Lab cut. 379 00:15:08,160 --> 00:15:09,900 Yep. 380 00:15:09,950 --> 00:15:11,990 Definitely feeling some adhesions. 381 00:15:12,040 --> 00:15:13,170 - Point taken. 382 00:15:13,210 --> 00:15:15,340 Open surgery was the right call. 383 00:15:15,390 --> 00:15:17,430 Go ahead, say it. "I told you so." 384 00:15:17,480 --> 00:15:19,040 - Yeah, maybe later. 385 00:15:19,090 --> 00:15:21,740 For now, why don't you get some practice old-school style? 386 00:15:21,790 --> 00:15:23,610 Come around. 387 00:15:26,440 --> 00:15:28,050 OK. You got it? 388 00:15:28,100 --> 00:15:29,660 - Yeah. - All right. 389 00:15:29,710 --> 00:15:31,060 - Babcock. 390 00:15:38,450 --> 00:15:40,150 - You OK? 391 00:15:40,200 --> 00:15:41,890 - Yeah, it's just a little heartburn. 392 00:15:41,940 --> 00:15:43,290 I'm fine. 393 00:15:44,720 --> 00:15:46,940 Oh, uh... 394 00:15:48,810 --> 00:15:51,120 Uh, God, excuse me. I'm sorry. 395 00:15:51,160 --> 00:15:53,380 Stop it. 396 00:15:53,430 --> 00:15:54,950 Stop. 397 00:15:54,990 --> 00:15:56,300 It's no big deal. 398 00:15:56,340 --> 00:16:00,040 It happens, OK? Just focus on the field. 399 00:16:01,560 --> 00:16:04,000 Stay focused. 400 00:16:05,520 --> 00:16:07,740 - Uh-oh, here comes another one. 401 00:16:07,790 --> 00:16:09,140 Kai? 402 00:16:09,180 --> 00:16:11,490 Kai, talk to me. 403 00:16:11,530 --> 00:16:13,010 Hey, buddy! Hey! 404 00:16:13,050 --> 00:16:15,670 Angel. Angel, check him. 405 00:16:17,410 --> 00:16:18,890 - Got a pulse. - All right. 406 00:16:18,930 --> 00:16:20,890 Give me the babcock, please. 407 00:16:20,930 --> 00:16:22,410 - Maria! - Need some help in here! 408 00:16:22,450 --> 00:16:24,070 - Maria! 409 00:16:24,110 --> 00:16:25,510 - I was helping her to the bathroom, 410 00:16:25,540 --> 00:16:26,420 and she started seizing. 411 00:16:26,460 --> 00:16:28,030 - OK, 4 milligrams of Ativan. 412 00:16:29,640 --> 00:16:31,120 Please help her. Please. 413 00:16:34,470 --> 00:16:36,210 - Ativan's in. 414 00:16:41,040 --> 00:16:42,626 - OK, she's gonna be postictal for a while. 415 00:16:42,650 --> 00:16:43,780 Put her on a foley. 416 00:16:43,820 --> 00:16:44,846 I don't want her getting out of the bed, 417 00:16:44,870 --> 00:16:46,440 not even for the bathroom. 418 00:16:54,100 --> 00:16:56,010 - A seizure expands our differential tenfold. 419 00:16:56,050 --> 00:16:57,840 We got to widen our net... CT panscan, 420 00:16:57,880 --> 00:17:00,060 MRI brain, sed rate, autoimmune labs. 421 00:17:00,100 --> 00:17:01,256 Let's rope in neurology. - Guys. 422 00:17:01,280 --> 00:17:02,410 Ms. Goodwin just called. 423 00:17:02,450 --> 00:17:03,946 She said stand down. No more treatment. 424 00:17:03,970 --> 00:17:05,086 - What? What are you talking about? 425 00:17:05,110 --> 00:17:06,060 - She's in the MRI suite. 426 00:17:06,110 --> 00:17:08,110 Be here as soon as she can, OK? 427 00:17:11,680 --> 00:17:13,640 - Hey, you OK? - This is overkill. 428 00:17:13,680 --> 00:17:15,420 I probably just had some bad oatmeal. 429 00:17:15,460 --> 00:17:17,550 - Well, bad oatmeal doesn't drop you 430 00:17:17,600 --> 00:17:18,950 in the middle of surgery. 431 00:17:18,990 --> 00:17:21,730 So how about you let me check you out? 432 00:17:24,170 --> 00:17:26,260 - How's Sam? Appendectomy go OK? 433 00:17:26,300 --> 00:17:28,650 - Yeah, all good. Dr. Graham is finishing up. 434 00:17:28,690 --> 00:17:30,130 - At least it's just an appendectomy. 435 00:17:30,170 --> 00:17:32,000 Not missing much. 436 00:17:35,010 --> 00:17:36,880 Oh, my chest. Pressure. 437 00:17:39,880 --> 00:17:41,490 Oh, God. I'm sorry. 438 00:17:43,140 --> 00:17:44,800 - That was weird. 439 00:17:44,840 --> 00:17:46,816 Your heart rate plummeted, but as soon as you passed gas, 440 00:17:46,840 --> 00:17:48,020 it came back. 441 00:17:48,060 --> 00:17:50,020 Will you sit up for me? 442 00:17:52,850 --> 00:17:54,290 Take a deep breath. 443 00:17:56,550 --> 00:17:58,160 - All right. Lean back for me. 444 00:17:58,200 --> 00:18:00,940 Hey, Mike. Let's get an X-ray in here. 445 00:18:00,990 --> 00:18:02,290 - What, did you hear a murmur? 446 00:18:02,340 --> 00:18:04,030 - Honestly, I'm not sure what I heard. 447 00:18:04,080 --> 00:18:05,470 - You're joking, right? Come on. 448 00:18:05,510 --> 00:18:08,080 - Has heartburn been an issue before today? 449 00:18:08,130 --> 00:18:09,610 - I mean, I get it. 450 00:18:09,650 --> 00:18:11,870 Even when I was a kid, it would flare up here and there. 451 00:18:11,910 --> 00:18:14,260 But it's never been an issue. 452 00:18:14,310 --> 00:18:16,700 - X-ray up. Clear. 453 00:18:22,840 --> 00:18:25,320 - What the hell? That's my colon. 454 00:18:25,360 --> 00:18:26,800 It shouldn't be in my chest. 455 00:18:26,840 --> 00:18:29,100 - No, it should not. 456 00:18:31,320 --> 00:18:33,590 - Her brother. Hugo, was a patient treated at Oakview. 457 00:18:33,630 --> 00:18:34,800 - So was Maria. 458 00:18:34,850 --> 00:18:37,200 She was admitted yesterday via ambulance, 459 00:18:37,240 --> 00:18:40,290 but this morning, her family just walked her out. 460 00:18:40,330 --> 00:18:41,720 They just left... absconded. 461 00:18:41,770 --> 00:18:43,330 - Well, her brother died at Oakview, 462 00:18:43,380 --> 00:18:44,810 and they didn't get any answers. 463 00:18:44,860 --> 00:18:46,160 You see how scared they are. 464 00:18:46,210 --> 00:18:47,316 It's no wonder that they didn't want to stay. 465 00:18:47,340 --> 00:18:49,210 - Look, I agree, but walking out 466 00:18:49,250 --> 00:18:51,600 is the same as leaving against medical advice. 467 00:18:51,650 --> 00:18:54,000 It's triggered an insurance nightmare 468 00:18:54,040 --> 00:18:55,610 with the family's HMO. 469 00:18:55,650 --> 00:18:57,830 They won't pay for any more treatment 470 00:18:57,870 --> 00:18:59,920 until Maria is placed back 471 00:18:59,960 --> 00:19:03,400 with their preferred network provider, Oakview. 472 00:19:03,440 --> 00:19:05,880 - Are you kidding me? They're a community hospital. 473 00:19:05,920 --> 00:19:08,190 They don't have the resources to run the tests she needs. 474 00:19:08,230 --> 00:19:09,580 - Well, I've already reached out 475 00:19:09,620 --> 00:19:12,020 to the director of patient services at Oakview, 476 00:19:12,060 --> 00:19:14,370 and she assured me they'll do the best they can. 477 00:19:14,410 --> 00:19:16,020 - The best they can? 478 00:19:16,060 --> 00:19:19,020 - Ms. Goodwin, can't you reason with the insurance company? 479 00:19:19,070 --> 00:19:21,346 Hector and Gloria aren't trying to take advantage of them. 480 00:19:21,370 --> 00:19:23,046 They're trying to save their daughter's life. 481 00:19:23,070 --> 00:19:24,550 - Look, I know, and I share 482 00:19:24,590 --> 00:19:26,510 in your frustration, but they're... 483 00:19:26,550 --> 00:19:28,860 - No. No, I don't care what the insurance company says. 484 00:19:28,900 --> 00:19:31,226 I'm not sending Maria back to Oakview until I get a guarantee 485 00:19:31,250 --> 00:19:32,860 she gets the treatment she needs in time. 486 00:19:32,910 --> 00:19:35,390 - Dr. Halstead, the tests that you ordered 487 00:19:35,430 --> 00:19:37,300 will cost tens of thousands of dollars, 488 00:19:37,350 --> 00:19:39,650 and I know that's not coming out your pocket. 489 00:19:39,700 --> 00:19:43,260 The family has to decide how to proceed. 490 00:19:53,230 --> 00:19:54,970 - OK, Quentin, so listen, 491 00:19:55,010 --> 00:19:57,150 we're gonna secure you to the machine 492 00:19:57,190 --> 00:19:59,280 while it's still running with a harness. 493 00:19:59,320 --> 00:20:01,330 So then, Dr. Archer, who is an excellent surgeon, 494 00:20:01,370 --> 00:20:02,956 is gonna come in here and clamp your artery, 495 00:20:02,980 --> 00:20:04,590 stabilize your neck wound, 496 00:20:04,630 --> 00:20:06,850 and make it safer when they pull out the scissors. 497 00:20:06,900 --> 00:20:09,120 All right? Then we turn off the machine. 498 00:20:09,160 --> 00:20:11,380 The idea is, bed falls to the side, 499 00:20:11,420 --> 00:20:14,690 you're held firmly in place by the harness, OK? 500 00:20:14,730 --> 00:20:16,560 Still with me? - Mm-hmm. 501 00:20:16,600 --> 00:20:18,170 - Great. Last thing. 502 00:20:18,210 --> 00:20:20,780 Lower you onto a gurney, shoot you off the ER, 503 00:20:20,820 --> 00:20:23,000 and finish fixing up your neck. 504 00:20:23,040 --> 00:20:25,000 How's that sound? - Mm-hmm. 505 00:20:34,620 --> 00:20:36,880 Am I gonna die? 506 00:20:36,930 --> 00:20:38,620 - Look, this is a complicated situation. 507 00:20:38,670 --> 00:20:42,150 But some really skilled people have come up with this plan, 508 00:20:42,190 --> 00:20:44,020 and it's the best option we got. 509 00:20:44,060 --> 00:20:47,020 breathe in and out, 510 00:20:47,070 --> 00:20:51,160 stay as still as you possibly can, OK? 511 00:20:51,200 --> 00:20:52,720 All right. 512 00:20:52,770 --> 00:20:54,990 Take all the time you need. 513 00:20:57,250 --> 00:20:59,730 - Hey, hold the work. Everybody, out. 514 00:21:07,650 --> 00:21:10,440 - You're my everything. 515 00:21:10,480 --> 00:21:14,530 From our first date, I knew that I was in love. 516 00:21:14,570 --> 00:21:17,660 And now we're parents. 517 00:21:17,710 --> 00:21:19,190 Uh... 518 00:21:21,190 --> 00:21:23,280 The nurse took a picture of him. 519 00:21:26,110 --> 00:21:28,980 I named him Trevor, after your dad. 520 00:21:29,020 --> 00:21:31,110 I think he'd like that. 521 00:21:32,810 --> 00:21:35,720 - Tell Trevor I love him. 522 00:21:35,770 --> 00:21:38,680 - You're gonna tell him yourself. 523 00:21:38,730 --> 00:21:41,430 - You're gonna be a great mother. 524 00:21:42,950 --> 00:21:44,990 - I love you, Quentin. 525 00:21:45,040 --> 00:21:47,950 I will see you again, you hear me? 526 00:21:48,000 --> 00:21:50,390 I will see you again. 527 00:22:04,750 --> 00:22:06,620 Sorry. 528 00:22:06,670 --> 00:22:09,760 I didn't know what to say. 529 00:22:09,800 --> 00:22:12,410 How do you put into words when... 530 00:22:12,460 --> 00:22:14,460 - You can't. 531 00:22:14,500 --> 00:22:16,770 But we could feel your love for each other. 532 00:22:16,810 --> 00:22:18,640 - I just don't understand, 533 00:22:18,680 --> 00:22:21,600 because Quentin is my rock, 534 00:22:21,640 --> 00:22:26,690 and I don't even recognize the man that's in there. 535 00:22:26,730 --> 00:22:28,990 He just snapped. 536 00:22:29,040 --> 00:22:31,040 How does that happen all of a sudden? 537 00:22:31,080 --> 00:22:34,170 - I mean, usually there are signs, you know? 538 00:22:34,220 --> 00:22:37,570 Extreme expressions of emotional frustration, 539 00:22:37,610 --> 00:22:39,610 anger, confusion, outbursts. 540 00:22:39,660 --> 00:22:43,050 You noticed anything like that in Quentin recently? 541 00:22:43,100 --> 00:22:46,140 - I don't think so. - How about physical changes? 542 00:22:46,190 --> 00:22:48,410 I noticed he had some lumps on the back of his neck. 543 00:22:48,450 --> 00:22:49,970 Have you... Do you know what those are? 544 00:22:50,020 --> 00:22:53,760 - Lumps? I don't know. 545 00:22:53,800 --> 00:22:58,460 I just wanted to get to today and to have the baby. 546 00:22:58,500 --> 00:23:00,550 I've been so consumed by the pregnancy 547 00:23:00,590 --> 00:23:04,290 that I haven't noticed anything else. 548 00:23:04,330 --> 00:23:06,080 Oh, Quentin. 549 00:23:11,860 --> 00:23:13,650 - Uh, give it to Spellman. 550 00:23:13,690 --> 00:23:14,780 Thanks, Lori. 551 00:23:14,820 --> 00:23:16,480 Mystery solved. Your chest CT. 552 00:23:16,520 --> 00:23:19,350 - Hiatal hernia. - No, diaphragmatic. 553 00:23:19,390 --> 00:23:22,000 Big enough that your colon migrated into your chest. 554 00:23:22,050 --> 00:23:24,490 So the gas moving through it, 555 00:23:24,530 --> 00:23:27,230 it puts pressure on the vagus nerve, drops your heartbeat. 556 00:23:27,270 --> 00:23:28,920 - Breaking wind releases the pressure. 557 00:23:28,970 --> 00:23:30,490 Heart returns to a normal rate. - Yeah. 558 00:23:30,530 --> 00:23:32,116 You said you had heartburn since you were a kid. 559 00:23:32,140 --> 00:23:34,060 Undiagnosed 560 00:23:34,100 --> 00:23:37,110 asymptomatic congenital diaphragmatic hernia. 561 00:23:37,150 --> 00:23:38,720 - I've never passed out before, though. 562 00:23:38,760 --> 00:23:41,550 - Well, my guess is it's been slowly expanding over time. 563 00:23:41,590 --> 00:23:43,030 But you do CrossFit now, 564 00:23:43,070 --> 00:23:45,380 so the thrusters, burpees, other workouts... 565 00:23:45,420 --> 00:23:48,030 Safe bet that they've exacerbated the condition. 566 00:23:48,070 --> 00:23:50,380 Led to today. - Yeah, well, I'll own that. 567 00:23:50,420 --> 00:23:52,056 But I can't resist dropping in the OR again, 568 00:23:52,080 --> 00:23:54,210 so let's fix this hernia. - OK. 569 00:23:54,250 --> 00:23:57,520 Well, you've got a few surgical options. 570 00:23:57,560 --> 00:23:58,910 Open. - No. 571 00:23:58,950 --> 00:24:00,536 That's a huge incision. Lots of digging around. 572 00:24:00,560 --> 00:24:02,520 I'll be laid up in the ICU for weeks. 573 00:24:02,570 --> 00:24:03,870 - Laparoscopic, then. 574 00:24:03,920 --> 00:24:05,660 Be more incisions for the scope and tools, 575 00:24:05,700 --> 00:24:08,050 but less invasive... - No old-school approaches. 576 00:24:08,090 --> 00:24:09,700 Robotic assist in OR 2.0. 577 00:24:09,750 --> 00:24:11,580 Shortest recovery time. 578 00:24:13,320 --> 00:24:15,580 I just want this to be over with. 579 00:24:15,620 --> 00:24:18,280 - OK, I'm gonna scrub in. 580 00:24:18,320 --> 00:24:19,580 I'll see you after, OK? 581 00:24:24,940 --> 00:24:27,200 - Holy cow. Look at this place. 582 00:24:27,240 --> 00:24:29,200 It's like you guys are living in 2050 up here. 583 00:24:29,250 --> 00:24:31,810 - So don't break anything. 584 00:24:31,860 --> 00:24:33,510 - How's it going with the surgical tools? 585 00:24:33,550 --> 00:24:35,560 - Almost there. Scalpel's printed. 586 00:24:35,600 --> 00:24:37,186 Two of the three angled peripheral vascular clamps 587 00:24:37,210 --> 00:24:38,250 are printed as well. 588 00:24:38,300 --> 00:24:39,536 One Weitlaner retractor printed. 589 00:24:39,560 --> 00:24:41,520 One to go. - Oh, it's like the real thing. 590 00:24:41,560 --> 00:24:43,910 - It is the real thing, just plastic. 591 00:24:43,960 --> 00:24:45,650 These tools, I think they can work. 592 00:24:45,700 --> 00:24:47,090 - They'll have to. 593 00:24:47,130 --> 00:24:48,570 They're all we got. 594 00:24:54,140 --> 00:24:56,530 - They never wanted to go to Oakview, 595 00:24:56,580 --> 00:24:58,490 but the ambulance took them there anyway. 596 00:24:58,540 --> 00:25:00,540 - Because Maria didn't require specialty care, 597 00:25:00,580 --> 00:25:03,110 paramedics took her to the nearest hospital instead. 598 00:25:12,510 --> 00:25:15,940 - I'm so sorry that you've been put in this situation. 599 00:25:15,990 --> 00:25:18,210 We can continue to treat Maria, 600 00:25:18,250 --> 00:25:21,210 but your insurance won't cover the costs. 601 00:25:31,660 --> 00:25:35,350 - He said he'll sell the car. He can get a second job. 602 00:25:35,400 --> 00:25:37,100 His oldest son can get a job as well. 603 00:25:37,140 --> 00:25:38,790 - No. Papa, no. 604 00:25:38,840 --> 00:25:40,450 No. 605 00:25:40,490 --> 00:25:42,320 I'll go back. 606 00:25:42,360 --> 00:25:44,580 No. 607 00:25:44,630 --> 00:25:46,800 Maria... 608 00:25:46,840 --> 00:25:49,150 - Maria. 609 00:26:14,220 --> 00:26:18,050 You know, maybe Oakview will figure it out. 610 00:26:23,580 --> 00:26:24,530 - All right. 611 00:26:24,580 --> 00:26:28,450 Um, I'll set up the transfer. 612 00:26:35,110 --> 00:26:36,590 - What was Maria saying? 613 00:26:36,630 --> 00:26:38,850 - If she lets her parents bankrupt the family 614 00:26:38,900 --> 00:26:41,640 paying for her medical care, then all of the opportunities 615 00:26:41,680 --> 00:26:45,210 they've worked so hard to give their children will be lost. 616 00:26:45,250 --> 00:26:47,040 - She is risking her life. 617 00:26:47,080 --> 00:26:48,820 - No. 618 00:26:48,860 --> 00:26:51,040 No, she's sacrificing it. 619 00:26:51,080 --> 00:26:54,870 And it's awful, 620 00:26:54,910 --> 00:26:57,520 but I get it. 621 00:27:06,360 --> 00:27:07,530 Ready to inflate? 622 00:27:10,490 --> 00:27:11,840 Up on blue. 623 00:27:13,580 --> 00:27:14,850 Hold. 624 00:27:16,410 --> 00:27:17,980 Up on red. 625 00:27:23,720 --> 00:27:24,990 Hold. 626 00:27:29,290 --> 00:27:31,950 - How's, uh... how's Layla doing? 627 00:27:31,990 --> 00:27:35,040 - She's in shock, full of grief, 628 00:27:35,080 --> 00:27:36,626 and a first-time mom all at the same time. 629 00:27:36,650 --> 00:27:39,700 It's a lot, but a psych resident is with her. 630 00:27:39,740 --> 00:27:43,000 - Mm. And how about you? 631 00:27:43,050 --> 00:27:45,480 How are you doing? 632 00:27:45,530 --> 00:27:48,400 - Honestly, I didn't see this coming. 633 00:27:48,440 --> 00:27:52,100 I just thought Quentin was a nervous first-time dad, 634 00:27:52,140 --> 00:27:54,670 like the ones I see every single day. 635 00:27:54,710 --> 00:27:56,410 Never suspected mental illness. 636 00:27:56,450 --> 00:27:58,370 - You know, I'm not sure it is, per se. 637 00:27:58,410 --> 00:28:01,370 You know those lumps on the back of his neck? 638 00:28:01,410 --> 00:28:03,046 I have a very strong hunch that they're indicative 639 00:28:03,070 --> 00:28:04,770 of a physical issue that could very well 640 00:28:04,810 --> 00:28:07,720 be causing a sudden psychosis. 641 00:28:07,770 --> 00:28:09,290 - It's physical, not psychological? 642 00:28:09,330 --> 00:28:11,030 - Yeah, I'm leaning that way. 643 00:28:11,080 --> 00:28:13,820 I mean, can't be sure until we run some tests. 644 00:28:25,440 --> 00:28:27,140 - Maria, this is a thumb drive 645 00:28:27,180 --> 00:28:29,310 with all the work we did here, along with our notes. 646 00:28:29,350 --> 00:28:32,710 You give this to the doctors as soon as you get there. 647 00:28:32,750 --> 00:28:34,010 - Thank you. 648 00:28:37,840 --> 00:28:40,020 - All right. Empty her foley. 649 00:28:47,760 --> 00:28:49,070 - It's OK, Mama. 650 00:28:51,680 --> 00:28:53,860 Wait. 651 00:28:55,820 --> 00:28:57,120 Will? 652 00:29:00,950 --> 00:29:02,390 You smell that? 653 00:29:09,390 --> 00:29:10,660 - We have to run one more test. 654 00:29:10,700 --> 00:29:12,880 I'll pay for it myself, if I have to. 655 00:29:18,450 --> 00:29:19,880 - I'm scared. 656 00:29:19,930 --> 00:29:22,450 - Well, you'll be less frightened if you can't see it, 657 00:29:22,490 --> 00:29:25,410 so I'm gonna drape your face, OK? 658 00:29:27,500 --> 00:29:28,810 Yeah. 659 00:29:28,850 --> 00:29:30,810 - All right. 660 00:29:30,850 --> 00:29:32,370 - Here we go. Careful. 661 00:29:34,030 --> 00:29:35,900 That's right. All right. 662 00:29:37,030 --> 00:29:38,860 All right. 663 00:29:38,900 --> 00:29:41,820 10cc's of lidocaine, please. 664 00:29:41,860 --> 00:29:43,860 OK. 665 00:29:43,910 --> 00:29:46,300 All right. 666 00:29:55,400 --> 00:29:56,620 OK. 667 00:29:56,660 --> 00:29:59,580 Scalpel. 668 00:29:59,620 --> 00:30:01,230 All right. Grab hold of those scissors. 669 00:30:01,270 --> 00:30:04,100 I don't want them flopping after I make the incisions. 670 00:30:07,580 --> 00:30:09,370 Here we go. 671 00:30:14,290 --> 00:30:16,640 OK. 672 00:30:16,680 --> 00:30:17,770 All right. 673 00:30:17,810 --> 00:30:19,290 Wheaties. 674 00:30:22,860 --> 00:30:24,300 All right. 675 00:30:24,340 --> 00:30:26,860 All right. Watch your fingers there. 676 00:30:26,910 --> 00:30:29,520 That's it. That's it. Don't move it. Don't move it. 677 00:30:29,560 --> 00:30:31,040 Clamp. 678 00:30:35,700 --> 00:30:36,700 All right. 679 00:30:45,970 --> 00:30:48,060 All right. 680 00:30:48,100 --> 00:30:50,280 Carotid clamps in place. CFD, you're up. 681 00:30:50,320 --> 00:30:51,850 - All right. Spread out around the bed. 682 00:30:51,890 --> 00:30:54,126 When it falls down, we pull it away from the MRI machine. 683 00:30:54,150 --> 00:30:57,370 - All right. And no slack at all, you understand? 684 00:30:57,420 --> 00:30:59,640 If there's any movement, his clamps could pop off, 685 00:30:59,680 --> 00:31:02,380 and then we'll have a problem we might not be able to fix. 686 00:31:02,420 --> 00:31:03,730 All right. 687 00:31:03,770 --> 00:31:06,770 On three, you're gonna cut the power to the MRI. 688 00:31:06,820 --> 00:31:07,990 We ready? Everybody, ready? 689 00:31:08,040 --> 00:31:09,080 - Ready. 690 00:31:09,120 --> 00:31:12,430 - One, two, three. 691 00:31:16,220 --> 00:31:18,310 All right. Clamps are holding. 692 00:31:18,350 --> 00:31:20,090 I'm gonna remove the scissors now. 693 00:31:23,790 --> 00:31:25,050 All right. 694 00:31:25,100 --> 00:31:26,920 All right, we're clear. OK, bed. 695 00:31:26,970 --> 00:31:29,670 Let's lower Quentin. 696 00:31:32,360 --> 00:31:35,020 Lower him slowly. - One, two, three. 697 00:31:36,720 --> 00:31:38,070 Slack! 698 00:31:40,020 --> 00:31:41,630 - All right. 699 00:31:43,370 --> 00:31:45,160 - OK, ropes are free. 700 00:31:45,200 --> 00:31:47,730 - All right. 701 00:31:47,770 --> 00:31:50,030 - Incredible, Doc. Freaking incredible. 702 00:31:50,080 --> 00:31:53,210 - Thanks. Can someone get me a bottle of water, please? 703 00:31:53,250 --> 00:31:55,430 - Dr. Archer, you did it. 704 00:31:55,470 --> 00:31:57,520 - Dean, you all right? - Yeah. 705 00:31:57,560 --> 00:31:59,830 I got to get to the OR, so... 706 00:31:59,870 --> 00:32:01,440 - Whoa, whoa, whoa, whoa, whoa. 707 00:32:01,480 --> 00:32:04,090 - Page Dr. Lanik to take over with Quentin. 708 00:32:04,130 --> 00:32:05,010 - I'm just feeling a little dizzy. 709 00:32:05,050 --> 00:32:06,270 That's all. 710 00:32:13,930 --> 00:32:15,320 - Hernia fixed? 711 00:32:15,360 --> 00:32:17,230 - I'd say you're as good as new. 712 00:32:17,280 --> 00:32:19,190 - Yeah, not quite. 713 00:32:19,240 --> 00:32:20,760 I'm the fart doctor now. 714 00:32:20,800 --> 00:32:22,720 A punchline. - No. 715 00:32:22,760 --> 00:32:24,680 What happened today was a result 716 00:32:24,720 --> 00:32:25,850 of a medical ailment, OK? 717 00:32:25,900 --> 00:32:27,136 - Like anyone's gonna care about that. 718 00:32:27,160 --> 00:32:28,810 All they're gonna remember is the fart. 719 00:32:28,850 --> 00:32:30,990 - Oh, come on. It'll blow over. 720 00:32:32,600 --> 00:32:34,950 Sorry. Poor choice of words, but it will. 721 00:32:34,990 --> 00:32:37,470 I doubt it. 722 00:32:37,520 --> 00:32:38,780 - All right, look. 723 00:32:38,820 --> 00:32:41,170 I'll check on you a little later, OK? 724 00:32:41,220 --> 00:32:42,220 All right. 725 00:32:43,960 --> 00:32:47,090 - So his neck is fixed, then? - Yeah. 726 00:32:47,130 --> 00:32:49,180 The artery repair went very well. 727 00:32:49,220 --> 00:32:51,790 - What about his mind? Because before... 728 00:32:51,830 --> 00:32:53,790 - Well, I gave him a very small dose 729 00:32:53,840 --> 00:32:55,880 of an antipsychotic called risperidone, 730 00:32:55,930 --> 00:32:58,010 and he does seem to be thinking more clearly. 731 00:32:58,060 --> 00:33:01,190 - And you think he'll stay that way? 732 00:33:01,240 --> 00:33:02,646 - I don't think that what happened today 733 00:33:02,670 --> 00:33:04,460 is the result of mental illness. 734 00:33:04,500 --> 00:33:05,776 You know, tests are still pending, 735 00:33:05,800 --> 00:33:07,980 but all indications are is that Quentin has 736 00:33:08,020 --> 00:33:11,420 a genetic disease called neurofibromatosis type 2. 737 00:33:11,460 --> 00:33:13,600 - Is it curable? - It's not. 738 00:33:13,640 --> 00:33:15,950 But there are a lot of effective treatments out there. 739 00:33:15,990 --> 00:33:18,430 And the good news is that with a little luck, 740 00:33:18,470 --> 00:33:21,210 Quentin is gonna be the man you know again. 741 00:33:21,260 --> 00:33:23,560 - Genetic means he's had it forever. 742 00:33:23,610 --> 00:33:25,610 Why'd it suddenly go berserk today? 743 00:33:25,650 --> 00:33:28,830 - NF is thought to be an inflammatory ailment, right? 744 00:33:28,870 --> 00:33:31,830 So possibly triggered by changes in environment, 745 00:33:31,870 --> 00:33:33,440 you know, lifestyle, 746 00:33:33,480 --> 00:33:37,580 possibly diet, medication. 747 00:33:37,620 --> 00:33:40,670 - Diet. 748 00:33:40,710 --> 00:33:42,360 Oh, my God. 749 00:33:42,410 --> 00:33:45,930 The minute I got pregnant, my hormones went crazy. 750 00:33:45,980 --> 00:33:47,630 Smells were intense, 751 00:33:47,670 --> 00:33:50,630 and Quentin's breath was the worst. 752 00:33:50,680 --> 00:33:53,460 Everything he ate made me throw up. 753 00:33:53,500 --> 00:33:55,680 So he gave up his entire diet. 754 00:33:55,720 --> 00:33:58,250 No more fruits, vegetables, fish. 755 00:33:58,290 --> 00:34:00,096 For the past nine months, he's been eating nothing 756 00:34:00,120 --> 00:34:02,820 but bland, processed crap for me. 757 00:34:02,860 --> 00:34:06,740 - Mrs. Bell, Quentin's asking to see you. 758 00:34:17,350 --> 00:34:19,180 Hi, honey. 759 00:34:19,230 --> 00:34:22,010 - Layla... 760 00:34:22,060 --> 00:34:23,930 I don't entirely understand 761 00:34:23,970 --> 00:34:27,670 what happened or why, 762 00:34:27,710 --> 00:34:29,540 but I know I put you in danger. 763 00:34:29,580 --> 00:34:30,850 I'm sorry. 764 00:34:30,890 --> 00:34:33,150 - No, Quentin. 765 00:34:33,200 --> 00:34:35,850 I was so tied up in the pregnancy, 766 00:34:35,890 --> 00:34:38,420 I was oblivious to what was going on with you. 767 00:34:38,460 --> 00:34:41,990 I should've seen the signs. Forgive me. 768 00:34:42,030 --> 00:34:45,470 - Oh, honey, there's nothing to forgive. 769 00:34:45,510 --> 00:34:46,900 - I love you. 770 00:34:46,950 --> 00:34:49,650 - I love you too. 771 00:34:49,690 --> 00:34:53,090 - Someone's been missing you guys. 772 00:34:57,830 --> 00:35:00,880 - Hi. 773 00:35:00,920 --> 00:35:03,100 - Here you go. 774 00:35:04,880 --> 00:35:08,320 - Hi, sweetheart. Look who's here. 775 00:35:08,360 --> 00:35:09,670 - Hi. 776 00:35:09,710 --> 00:35:11,890 I'm your dad. 777 00:35:13,190 --> 00:35:16,020 I love you. 778 00:35:16,070 --> 00:35:19,900 - Shh, sweetheart. - Hi. 779 00:35:19,940 --> 00:35:22,770 - A metabolic condition? - Yeah. 780 00:35:22,810 --> 00:35:24,940 It's called maple syrup urine disease, 781 00:35:24,990 --> 00:35:27,080 and it's a rare condition that makes it difficult 782 00:35:27,120 --> 00:35:29,380 for the body to break down certain amino acids. 783 00:35:29,430 --> 00:35:32,730 - The trademark symptom is a distinct maple syrup smell 784 00:35:32,780 --> 00:35:34,170 that shows up in urine. 785 00:35:34,210 --> 00:35:36,000 - It usually presents in childhood, 786 00:35:36,040 --> 00:35:37,700 and it's almost unheard of 787 00:35:37,740 --> 00:35:40,440 to discover it in someone your age, 788 00:35:40,480 --> 00:35:42,000 or Hugo's. 789 00:35:42,050 --> 00:35:44,440 It's likely that he had it too. 790 00:35:44,490 --> 00:35:45,660 - And I suspect this is why 791 00:35:45,700 --> 00:35:48,050 Oakview couldn't diagnose him in time. 792 00:35:48,100 --> 00:35:50,060 He didn't have a seizure or a foley catheter. 793 00:35:50,100 --> 00:35:52,060 It made his doctors' jobs even harder. 794 00:35:52,100 --> 00:35:55,630 - Wait, this disease killed Hugo. 795 00:35:55,670 --> 00:35:56,930 Does that mean... 796 00:35:56,980 --> 00:35:59,330 - No, you're gonna be OK. 797 00:35:59,370 --> 00:36:01,720 You have an intermittent form of the disease, 798 00:36:01,760 --> 00:36:04,510 which can be managed by closely monitoring protein levels. 799 00:36:04,550 --> 00:36:06,200 - We've already reached out to nephrology 800 00:36:06,250 --> 00:36:08,200 to discuss treatment options. 801 00:36:08,250 --> 00:36:12,080 Maria. 802 00:36:23,000 --> 00:36:24,220 - Gracias. 803 00:36:33,490 --> 00:36:35,320 - Hello, Daniel. - Ooh! 804 00:36:36,800 --> 00:36:39,320 Hey, you're, uh... You're a little early. 805 00:36:39,370 --> 00:36:42,110 - Oh, I couldn't wait to see you. 806 00:36:42,150 --> 00:36:45,070 What's this? You cleaned your office? 807 00:36:45,110 --> 00:36:46,290 - No, I didn't. 808 00:36:47,720 --> 00:36:49,720 I'm tidying up a little bit. 809 00:36:49,770 --> 00:36:51,900 - Why? 810 00:36:53,600 --> 00:36:56,560 - I was very embarrassed by what happened this morning. 811 00:36:56,600 --> 00:37:01,000 And um, you know, I just, uh... 812 00:37:01,040 --> 00:37:05,040 I don't ever want you to feel that I... 813 00:37:05,090 --> 00:37:08,260 I take for granted the job that you do, or... 814 00:37:08,310 --> 00:37:09,986 Or that I'm oblivious to how hard you work. 815 00:37:10,010 --> 00:37:12,090 I really don't want that to happen. 816 00:37:12,140 --> 00:37:14,180 - You're very sweet. 817 00:37:15,750 --> 00:37:18,490 I care about you too, Daniel. 818 00:37:18,540 --> 00:37:19,540 A lot. 819 00:37:20,800 --> 00:37:22,320 - Yeah? - Mm-hmm. 820 00:37:22,370 --> 00:37:23,450 - Huh. 821 00:37:33,590 --> 00:37:35,640 - Hey. - Hey. 822 00:37:35,680 --> 00:37:37,030 Ah! 823 00:37:37,080 --> 00:37:38,950 Where'd you find it? - Nurses' station. 824 00:37:38,990 --> 00:37:40,470 - Oh, makes sense. 825 00:37:40,510 --> 00:37:42,820 That's where I was when the call about Quentin came in. 826 00:37:42,860 --> 00:37:44,340 - Yeah, I totally get it. 827 00:37:44,390 --> 00:37:47,170 I would have run off and left it behind too. 828 00:37:47,220 --> 00:37:51,180 But my kidneys can handle some mild dehydration. 829 00:37:51,220 --> 00:37:52,830 Yours can't. - Yeah, yeah. 830 00:37:52,870 --> 00:37:56,140 - Yeah, pretty sure there will be another emergency tomorrow, 831 00:37:56,180 --> 00:37:58,050 and the day after that, 832 00:37:58,100 --> 00:38:01,930 so I'm gonna give you something. 833 00:38:01,970 --> 00:38:04,410 It is a tracking device. - Ah. 834 00:38:04,450 --> 00:38:06,060 - App connects it to your phone. 835 00:38:06,100 --> 00:38:08,930 And I haven't lost my keys since I put it on, so... 836 00:38:08,980 --> 00:38:12,500 - Well, keep it. I'm past water bottles. 837 00:38:12,550 --> 00:38:14,200 Nephrologist just left. 838 00:38:14,240 --> 00:38:17,550 Uh, my kidneys are getting worse. 839 00:38:22,860 --> 00:38:24,250 - Dialysis? 840 00:38:33,780 --> 00:38:36,920 - That was a big win today. 841 00:38:36,960 --> 00:38:39,700 You saved that family. 842 00:38:39,750 --> 00:38:42,490 - Yeah. 843 00:38:42,530 --> 00:38:45,840 I suppose it's time to talk about my DACA renewal. 844 00:38:45,880 --> 00:38:47,710 I know I've been dragging my feet. 845 00:38:47,760 --> 00:38:50,890 - It's been a long day. We can speak in the morning. 846 00:38:50,930 --> 00:38:53,020 - No. No, I'm ready. 847 00:38:53,060 --> 00:38:55,420 - Yeah? All right. 848 00:38:58,770 --> 00:39:01,940 - Truth is, I've been thinking about leaving Med. 849 00:39:01,990 --> 00:39:03,810 - Really? 850 00:39:03,860 --> 00:39:07,250 - I've always been in school or protected by my residency, 851 00:39:07,300 --> 00:39:11,210 so my immigration status has always been stable. 852 00:39:11,260 --> 00:39:14,700 But my parents, despite them always having jobs, 853 00:39:14,740 --> 00:39:16,130 could never solidify theirs, 854 00:39:16,170 --> 00:39:18,350 so they moved to Canada. 855 00:39:18,390 --> 00:39:19,830 - Hmm. 856 00:39:19,870 --> 00:39:23,490 - But they can't enter the country to come visit me. 857 00:39:23,530 --> 00:39:27,620 And if I leave to go see them, I might be denied reentry. 858 00:39:27,660 --> 00:39:31,060 So... 859 00:39:31,100 --> 00:39:34,060 I haven't hugged my parents in a decade. 860 00:39:34,110 --> 00:39:36,020 - Ugh. 861 00:39:36,060 --> 00:39:39,110 That's... that's heartbreaking. 862 00:39:39,150 --> 00:39:42,850 - But Maria today, her bravery, 863 00:39:42,900 --> 00:39:47,600 what she was willing to sacrifice for her family, 864 00:39:47,640 --> 00:39:50,820 reminded me that 865 00:39:50,860 --> 00:39:53,520 "no one puts their child in a boat 866 00:39:53,560 --> 00:39:56,210 unless the water is safer than the land." 867 00:39:56,260 --> 00:39:58,960 - Warsan Shire. 868 00:39:59,000 --> 00:40:01,660 Oh, that's a beautiful poem. 869 00:40:03,000 --> 00:40:04,660 - So... 870 00:40:04,700 --> 00:40:09,140 my parents' sacrifice to get me here 871 00:40:09,180 --> 00:40:12,800 put me in this boat, 872 00:40:12,840 --> 00:40:15,320 which is why I have to stay. 873 00:40:16,630 --> 00:40:18,500 - And Dr. Cuevas, 874 00:40:18,540 --> 00:40:22,850 I believe that you will find a way 875 00:40:22,890 --> 00:40:25,810 to see your parents again. 876 00:40:25,850 --> 00:40:28,290 But until that day, 877 00:40:28,330 --> 00:40:32,950 know that you have family here in us at Med. 878 00:40:32,990 --> 00:40:35,340 - Thank you.62717

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