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I made you blueberry pancakes.
Would you prefer cauliflower?
Nope. Shaun, that's our baby.
I'm 36 weeks.
The baby is the size of a head of cauliflower.
Our baby will not be this bumpy.
I am very... happy.
Me, too.
We're having a baby,
I have an amazing job,
you're an attending.
We have a new family car.
Dr. Glassman has moved down the hall.
Jared is coming back to work at the hospital.
It is great that he's back.
But, you know, the dynamic might be a little different.
Research has shown that when working with friends,
you get more done in less time and have fun on the job.
But Jared will be working for you, not with you.
It can be different when you have to manage a friend.
Lines can get blurred, and that can be hard.
Hmm...
The lines are not blurred.
They are very clear.
Hey, there, Loverboy.
Give me the details.
Are you and Jerome exchanging keys,
or are you getting a whole-new place together?
Yeah, no. He did not ask me to move in.
Then what did he want to talk to you about?
I... I don't want to talk about it.
Okay, now I want to know even more,
and my interrogation will continue until...
You going to the club or work?
Yeah, these early calls are gonna take some getting used to.
- Hmm. - A little Kendrick's the perfect pick-me-up.
Never mad at Kendrick.
Yes.
Nice shirt. Tom Ford?
Yeah, my good luck charm.
Figured it couldn't hurt on my first day back.
For $700, it should give you more than luck.
On occasion, it has.
See you guys in there.
The car is a bit much, but the fashion is lit.
Now, Mr. Grumpy, what's going on with you?
Goodbye.
Dr. Kalu is not your peer, not your friend.
He is your employee and you are his boss.
I am confident that Jared will do a good job.
That's exactly what I'm talking about.
He is not "Jared." He is "Dr. Kalu."
I do not always call people by their professional titles.
- Sometimes I call Dr. Allen... - Dr. Murphy.
An informal communication style with Dr. Kalu
can create a perception of special treatment and favoritism.
I do not plan to give Jared special treatment.
That doesn't mean Dr. Kalu isn't expecting it.
And if I see it, it won't be good for either of you.
She has bruising and pain even with passive range of motion.
Some bullies at school chased her.
She fell down the stairs trying to get away.
That's not even how it happened.
I knew we should have stuck with homeschooling.
- She insisted, and look what happened.
You need to be still.
Your shoulder is fractured.
Ultrasound the patient.
Why are you laughing?
Sh-She can't help it. Yara has Tourette syndrome.
- It's why she got into the fight at school. - Mom, he was asking me.
You never let me speak for myself.
It wasn't a fight.
Some kids thought it would be funny to point and stare at me,
and I thought it would be funny to egg their lockers.
Then my stupid tics messed up my getaway.
There's significant tissue swelling
and massive hematoma at the proximal humerus.
The fracture has caused an acute compartment syndrome.
You need surgery right away.
What were you doing when you started getting dizzy?
I was sitting in gym class,
and then the room started to spin.
And then I threw up.
But I wasn't doing it.
I just introduced Carter
to the Wonder Woman comics.
He's been trying to learn the twirl.
I don't blame you. The twirl is awesome.
Where's my little guy?
- Hey, Mama E. - Hey, Carter G.
You should have called me immediately.
Elaine's my mom.
And I don't need your permission
to bring my son to the hospital.
Actually, you do.
I'm his legal guardian.
What's wrong with him?
Uh, his heart rate is... is quite low.
What does that mean?
It looks like Carter has an abnormality
of the electrical signals controlling his heartbeat.
We need to run some tests.
Echo and electrophysiology study.
The prodigal resident returns.
Aha. Lovely to see you as well, Dr. Reznick.
Will the hospital be getting a new wing
in the Kalu family name?
My family are doing well. Thanks for asking.
And I was recruited to return based on my training,
breadth of experience,
and willingness to take
a demotion back to a first year.
Ooh, it's gonna be hellish being bossed around by newbies
and people who used to be your peers.
Grab me that box on the top shelf.
I missed you, too.
You know, while I was away,
I learned how to read emotional energy.
And sniping at people's your love language.
Happy to know you still care.
Good luck, newbie.
Thanks.
I, uh...
I gotta get to surgery. Enjoy.
Your control of the shaft segment
is very precise.
Thank you.
Brown retractor.
No brown retractor.
I thought I put it on your tray from the supply room.
All of my tools must be individually selected,
sterilized, and placed in my tray
before I begin the surgery.
Understood. Got it.
That will do.
Further expose the proximal humerus.
Place sutures in rotator cuff to mobilize humeral head.
Sorry for dropping the ball with your tools.
Rookie mistake.
Don't sweat it.
You're BFFs with the boss, right?
I treat every resident the same.
Dr. Allen,
place Steinmann pins proximal to biceps tendon.
Dr. Kalu, you are on suction.
Oh.
Catheter placed in the axillary vein.
I feel bad for Carter's mom.
I can't imagine trying to raise a kid
with my mother backseat driving my every move.
Well, maybe if Bianca told Elaine
that she was taking Carter to the hospital,
she would trust her more.
Pacing wire.
Bianca was probably doing what she thought was best.
Withholding information is never for the best.
Advancing to the right ventricle.
Everything okay between you two?
We're... fine.
That can't be right.
I need contrast to clear up what I'm seeing on fluoroscopy.
L-transposition of the great arteries.
The ventricles are...
inverted.
His heart is... backward.
Your surgery went well.
We were able to decompress and release
your compartment syndrome
and stabilize your humerus fracture.
Great. When can I go back to school?
You'll only be out a few days.
Just be sure to wear your sling.
You're not going back to school.
- Why not? - It's not safe.
I'm not sending you back so they can hurt you again.
I'm not a baby. I can take care of myself.
I just need to take your vitals.
If you could take care of yourself,
we wouldn't have ended up in the hospital.
Going to school is literally the only thing that I do that is normal.
I don't want to be...
I don't want to be stuck at home with you.
You never let me do anything by mys...
Yara?
She's having a seizure.
We need 2 milligrams of lorazepam and MRI, stat!
She's sleeping like a baby.
You should've used propofol instead of Versed to sedate her.
Versed is old school.
Same effects, none of the overshooting.
Why are you changing my settings?
Peds case.
Shorter duration imaging sequences cuts the time in half.
It's your first day, remember?
You could probably use a refresher before trying a shortcut.
I'm a little out of practice,
but I've still got a few tricks up my sleeve.
Says the guy who has to repeat a year.
- Ow. - Mm-hmm.
Shaun will appreciate getting Yara's results back faster.
Trust me.
You know him better than me.
Was the patient properly sedated before you began this MRI?
Yeah, of course. I used the standard pediatric protocol with Versed.
Did Dr. Allen tell you about our revised propofol protocol?
Yeah. But in my experience, Versed provides better...
You should have listened to Dr. Allen.
I know how to perform an MRI, Shaun.
You apparently do not.
There is too much motion degradation.
These images are unusable.
Dr. Allen, please go redo the MRI.
Dr. Kalu, we need to speak privately.
You cannot take shortcuts.
You're right. I'm sorry.
You cannot expect special treatment because you are my friend.
I'm not expecting special treatment, Shaun.
But I don't appreciate being treated like an intern, either.
I know, technically, I'm a first year,
but I've been a doctor for as long as you have.
We are not peers.
I am your boss, and you have a lot to learn.
Dr. Andrews said he is judging my performance off of your performance,
and your performance is not good.
Okay?
Okay.
Good. You need to go practice basic skills
and observe our current standardized MRI process.
Heart block plus inverted cardiac anatomy.
What's your plan?
Intravenous pacemaker is out,
but we could open him up, place it surgically.
That doesn't address the underlying anatomy issue.
The defect could lead to heart failure as he gets older.
It could, but he might be fine with just the pacemaker.
But if he's already developed arrhythmia, not a great sign.
I'd recommend the double switch reconstruction,
redirect blood flow to the right ventricle.
I have Carter's BMP and cardiac labs.
Yeah, I already received them digitally.
But the hard copies are always appreciated.
- Trouble in paradise? - Everything's fine.
They've been in this passive-aggressive fight all day.
- We're not fighting. - No, that would require you talking to me.
You don't have to share,
but you do have two divorcees
with a sadly ample amount of experience between us.
Was one of you secretly in contact with an ex?
Took a job out of state without including you in the process?
Jerome lied to me, about something very important.
- I didn't lie. - A lie of omission is still a lie.
- It's not that simple. - You should have told me.
- I wanted to. - Yes, but you didn't.
Because I was afraid of how you'd react.
But you're right.
It should never have been a secret,
because there's nothing to hide.
I'm HIV positive.
Thanks to my meds, my viral load
has been undetectable for years.
I'm poz undetectable.
I can't transmit the virus.
You should go talk to him.
I have work to do.
Present the double switch surgery to the family.
If they agree, I'll scrub in.
On it.
No. How did we get from a pacemaker to reconstructing his heart?
The procedure may sound drastic,
but it will greatly reduce his risk of developing heart failure.
Can't we just give him the pacemaker now,
and do the bigger surgery if the problem gets worse?
At the point he starts showing signs of heart failure,
it'll be too late to do the reconstruction.
We should fix it now.
This isn't your decision.
You are still making me pay for mistakes I made when I was 17.
And 18, 19, 20...
I've been back for two years.
How can I be a mother when you won't even give me a chance?
Mama?
Mama E?
I don't feel good.
It's okay, baby. I'm here.
Honey, what's wrong?
My chest hurts.
The heart rate's 40 BPM.
BP 73/45.
We need a decision soon before his condition deteriorates.
I wanted to apologize for earlier.
It was unprofessional.
You have nothing to apologize for,
and no duty to disclose.
Undetectable equals untransmittable.
I appreciate you saying that.
Give Asher some time.
He's a doctor.
He knows there was never any risk to him.
What people know and how it makes them feel
are often two very different things.
You've had years to process your status.
Allow Asher to process it, too.
Please do not say, "I told you so."
I won't. But I'm gonna think it.
You seem a little spoiled.
You don't know me.
You come from money,
and you haven't had to work hard for anything.
You made it through med school. Bravo to that.
You got kicked out of this program,
but landed on your feet taking care of a billionaire.
And when you got tired of that,
you were welcomed back here with open arms.
You come in with your fancy car and your old tricks, and think,
"Ta-da, I'm a surgeon," but you're not. Yet.
You're the new kid.
Shaun is the boss, and I have seniority.
You should listen to Kendrick.
Be humble.
I just want to prove that I belong here.
To Shaun, to everyone.
But you're right.
I know.
The image is still not high enough resolution.
Have you finished redoing the imaging?
Yes, and I followed all the protocols,
but the image still doesn't look clear.
The image is clear,
but Yara's diagnosis was incorrect.
She does not have Tourette's.
She has a brain tumor.
I don't have Tourette's?
No, you have a hypothalamic hamartoma.
Your tics aren't tics.
They are gelastic seizures caused by the tumor in your brain.
Tumor? Does that mean cancer?
The tumor is not cancerous.
But a Gamma Knife radiosurgery
should stop it from growing and treat the seizures.
Will it stop this?
Not immediately.
And possibly not at all.
There are other options you can consider in the future if you don't see improvement.
Or we could consider them now.
A successful resection could stop the seizures immediately.
That procedure is very risky.
But that means I can go back to school.
I could learn how to drive.
I could take care of myself. Mommy, please.
I just want to be normal.
Tumor resection can cause stroke, partial paralysis,
learning deficits, meningitis.
The Gamma Knife is much safer.
- Yara, I'm sorry. I can't. - You can.
You just won't let me.
Please go ahead
and schedule the Gamma Knife procedure.
Have you made a decision?
I'm afraid of exposing Carter to any more trauma.
What trauma?
He was left by his mother.
- I left him with you. - Expecting me to pick up all the pieces
and fix everything, like always.
I knew he was safer with you than with me.
But I didn't know that.
I gave you too much freedom, wasn't involved enough,
and look what happened.
My mistakes were mine, not yours.
I was supposed to protect you.
And we lost you.
I have to do better for Carter.
Well, the surgery is what's best for Carter, long-term.
That kid is my heart.
I'm gonna trust you to fix his.
Lunchtime!
I'm starved.
I am not hungry.
Well, it's not good to deprive your pregnant wife her lunch.
I thought it would be fun working with a friend.
It is not fun. It is difficult.
I do not want people to think
I am giving Dr. Kalu special treatment,
because I am not giving him special treatment.
In fact, I am being very firm
because he has already made several errors,
and I do not understand why.
Well, he's a new resident on his first day.
There has to be a bit of a learning curve.
Mm, he is not acting like a new resident.
Well, he's your friend.
And he knows you expect a lot of him.
No one can follow the rules
if they don't know what they are.
Atrial septum excised.
Starting venous reconstruction.
There may not be enough tissue for redirection of flow
to the tricuspid valve.
We can use pericardium to create a baffle. Metz.
You make up with Jerome yet?
He betrayed my trust.
All right, securing edge to atrial septum.
You've never hidden anything from him?
I'd never hide something like this.
Congratulations. You win the virtue contest.
Possible prizes include the end of your relationship.
Or you could just talk it out.
Dividing the aorta.
He is the one who changed things.
I mean, why is it on me to figure out?
The question is,
do you love Jerome enough to change with him?
Suturing distal aorta to pulmonary valve.
Coronary arteries are patent.
Anastomosis looks great.
I never met a teenager who wanted to go to school as much as you.
I hate school.
But I hate not being able to control
anything in my life even more.
Egging those lockers made you feel in control?
- Kinda. - Hmm.
Those bullies messed with me, I messed with them back.
Like normal kids do.
I was bullied a lot in high school, too.
I was scrawny with braces, a lisp...
Basically a target on my back.
But my mom helped me.
Gave me her credit card to buy them off with pizza and candy.
My mom is too helpful.
She won't even let me make my own PB and J.
She thinks I'll tic out and hurt myself with the knife.
When my body isn't controlling me, she is.
When you said you can cut this tumor out of my head,
for 30 seconds...
I could imagine only laughing when something was funny.
Think I found a solution.
Oh. I have found a solution, as well.
I have made a list of boundaries and rules
to make our working relationship better.
You need to study them.
What have you found a solution for?
I think I found a better resection technique.
Has a lower risk profile,
closer to that of the Gamma Knife radiation.
And it offers a better outcome for Yara.
I presented the safest option to the patient,
which she agreed to.
And you should not have presented the tumor resection without consulting me.
That is an important boundary.
Number two on the list.
I thought you'd be happy I was thinking outside the box, like you.
You are not me. You are here to learn.
Yes. I'm also here to help people like Yara.
You need to respect that I am your attending.
Number six on the list.
I don't have to be an attending
to know that she's sad, lonely, and depressed.
We cannot make medical decisions
based off of the patient's emotions.
Well, sometimes the emotions are just as important as the medical.
You are making my job very hard!
Number ten:
At work,
follow my instructions precisely.
If you cannot comply, you will be out of the program.
I really messed up.
I should have trusted you
and been upfront about everything.
Yeah, you should have.
After my diagnosis,
it took a long time for me to feel comfortable dating,
or even being around people.
I spent so much time alone,
and when I finally put myself back out there,
there was a lot of rejection.
Guys just didn't want to deal with my status.
So, when this adorable,
brilliant doctor popped into my life,
and I liked him so much...
I was too scared to tell him the truth.
I'm sorry.
This doctor sounds pretty great.
He is.
I made sure we always used protection,
encouraged you to stay on PrEP.
All to make sure that you were safe.
That was a decision that you made for the both of us.
You did all those things to make yourself feel better
while you took away my choice.
How could you have known me and loved me
and think that this is something that I-I couldn't accept?
When I first had to make this decision, I didn't love you.
I barely knew you.
And I'm not sure I know you now.
I made a mistake.
That doesn't change who I am.
No, but maybe it changes how I feel.
I'm sorry that I put you through this,
but I'm still the one living with this disease,
and it's not easy.
It's Carter. I have to go.
He woke up from the surgery,
and he was laughing about his comic book,
then he started to turn blue.
Oxygen saturation at 80%. 120 BPM.
Blood pressure's dropping.
All right, administering oxygen and 250cc normal saline bolus.
Why can't he breathe?
I thought the surgery was supposed to prevent this.
Normal lead impedance.
The pacemaker is functioning properly.
Something else is going on.
We need a cardiac echo, stat.
A kink in Carter's reconstructed atria caused the clot in his heart.
He's stable, but he needs another operation
to remove the clot and repair the conduit.
Are there other alternatives?
We could use a catheter to dissolve the blockage with medication,
but that still leaves the risk of a clot forming again down the line.
I knew doing this was the wrong decision.
We both want what's best for Carter.
But I'm the one who is responsible for him.
And I'm sorry I put that on you.
I will never forgive myself for losing out on those years of Carter's life,
but I've realized that I need to try to let go of that.
Let go of my regret and focus on what I know,
that leaving him with you was the best decision for him.
That will never change.
And this surgery is the right decision for him, too.
You're his mother.
You know what's best for Carter.
I want my son to have the surgery.
You were right.
I usually am.
What was I right about, exactly?
I came out of the gate too hot,
annoyed Shaun,
screwed things up for Yara.
Agree.
I gotta figure out my next move.
Listen.
This whole case,
you've been pitching and shortcutting
and trying to be Mr. Fix-it for everything.
Stop flexing and listen.
Mom, let me try the tumor resection surgery. Please.
I'm sorry. No.
We're ready for you.
All right, baby.
But first, I, um...
want you to tell your mom what you told me,
about what you're dealing with.
What this surgery means to you.
I know what she's dealing with. I see it every day.
But have you listened to how it feels to her?
She doesn't care.
Of course I do.
- You just want to boss me around.
I'm just trying to help,
but no matter what I do, you're always so angry at me.
I'm angry...
I'm angry at everything.
I'm angry at my body for not doing what I want it to do.
I'm angry at other kids for being jerks.
And I'm angry at you...
for acting like the only way for me to survive in this world
is by you protecting me.
I feel like I'm a puppet
and somebody else is constantly pulling the strings,
yanking me all around.
Getting this tumor removed
is the only way for me to cut the strings.
Okay, don't... don't... Don't take her yet.
We need to talk.
I need you to scrub in
on a hypothalamic hamartoma surgery.
Okay.
I had planned to use Gamma Knife radiation,
but Dr. Kalu violated rule number two,
and now we have to do his tumor resection.
You're upset with Jared
because he changed your surgical plan?
He overstepped with me and the patient and her mother.
Well, a tumor resection seems like a pretty good idea.
Are you planning on letting Jared scrub in?
Yes, he will be on suction.
That's an insult.
He has to learn to follow rules.
He has made my job very difficult.
Shaun, sit down.
When you were a resident,
you did things completely your own way.
You still do.
You rubbed everybody the wrong way.
You made everybody's job more difficult, especially mine.
You were a pain in the ass.
But we gave you the space to learn,
and we learned from you.
And you turned yourself into an asset.
Give Jared the same opportunity.
Okay, he overstepped.
Give him a chance to learn
and to prove himself to be an asset.
Even if you think he's a pain in the ass.
I will take it into consideration.
Okay.
Please scrub in for that surgery.
Advance the catheter and endoscope gently into the ventricle.
Suction and irrigate more aggressively
so she can see what she is doing.
Proceed along the midline posteroinferior floor of the third ventricle.
Oh, there's the tumor.
We can begin excision.
Bipolar scissors.
Micro forceps.
I'll take the specimen to pathology.
No.
You are going to close.
Are you sure?
This was your surgical plan.
You will become a better surgeon
by getting a fair shot to be an asset.
I will take the specimen. Dr. Glassman will supervise.
I'm hungry.
That's a very good sign.
I'll run down to the cafe and grab him some food.
Any restrictions?
He can have as many chicken nuggets as he wants.
I'll go down.
I'll get something for you to eat, too.
You haven't left his side since we got here.
Comes with being a good mom.
I had a great teacher.
You know, a little birdie told me
that the gift shop
just got in the latest volume of Wonder Woman.
Really? Can we get it?
If your mom is okay with it.
Of course.
But no twirling just yet, okay?
Dr. Murphy was able to remove all of the tumor.
Yara?
Dr. Kalu.
Memory is intact.
The light didn't provoke a seizure.
And your tics are gone.
Thank you, Dr. Kalu.
Thank you, Yara.
Dr. Andrews.
I heard about your work on the Fields case. Good job.
Thank you.
I just came in to ask you for a favor.
Please judge me for my work, and not Shaun.
Shaun's part of the reason you're back here.
And I appreciate him for that.
But I want to stand on my own.
And if I sink, I don't want to take my friend down with me.
I'm ready to prove myself as an asset to this hospital.
I'll be watching.
Thank you.
I'm sorry for being such a jerk.
You opened yourself up, and I shut down.
And I should've trusted you
that we could figure this out together.
Yesterday, you said you didn't know me.
That adorable doctor can be kind of an ass sometimes.
I've never been in love before you.
When I was 16,
I'm pretty sure I ran over a raccoon,
but I didn't stop to check because I was running late to a baseball game.
Also...
I love a pumpkin spice latte.
- Ugh. - Even though I know it's basic.
You know those cufflinks I wore to Shaun and Lea's wedding?
Yeah.
I bought them for you, but I liked them so much, I kept them for myself.
That explains so much.
But you can totally borrow them...
sometime, probably not.
I love you.
I need you to believe that.
Just, uh, came to say good night.
And thank you.
Why are you thanking me?
For not going easy on me.
I was wrong to expect that, even if we are friends.
You are a good doctor.
And I would like to continue to be your friend
and your boss...
with boundaries.
You're right.
And I'm studying your list.
Oh, there is one rule that is not on the list.
It is a rule for me.
I will refer to you
as "Dr. Kalu"
when I am being your boss
and as "Jared" when we are in friend mode.
Yeah, that works for me, Shaun.
Good.
Jared, I would like to take you out for drinks
to celebrate you being back at Saint Bon's,
but Dr. Kalu,
when I checked on Yara postoperatively,
I noticed you only used eight sutures when you closed and she had a small bleed.
You should have used ten.
You need to go work on your suturing technique.
Happy to... to practice,
but I only replaced the small bone flap.
Dr. Glassman closed the galea and skin.
Dr. Glassman skipped two sutures?
I guess so.
Um, meet you for drinks in an hour?
- Okay. - Okay.
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