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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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