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1
00:00:02,970 --> 00:00:05,773
(MONITOR BEEPING)
(BREATHING HEAVILY)
2
00:00:05,806 --> 00:00:08,342
DR. GARCIA: I'm incising
the uterine wall.
3
00:00:08,376 --> 00:00:09,443
(SNIFFLES)
4
00:00:09,477 --> 00:00:11,145
You're doing great,
really great.
5
00:00:11,179 --> 00:00:12,313
It's gonna be okay.
6
00:00:12,346 --> 00:00:14,482
You promise?
7
00:00:14,515 --> 00:00:15,783
(SMOOCHES)
8
00:00:15,816 --> 00:00:18,686
Baby's out.
Umbilical clip.
Suction.
9
00:00:18,719 --> 00:00:20,121
(BABY CRYING)
Please,
10
00:00:20,154 --> 00:00:21,922
can I see my daughter?
11
00:00:21,955 --> 00:00:23,191
Yes.
12
00:00:23,224 --> 00:00:24,392
Of course.
13
00:00:27,328 --> 00:00:28,496
DR. LIM: Sorry.
14
00:00:28,529 --> 00:00:30,098
We'll need
to get her into surgery.
15
00:00:30,131 --> 00:00:31,799
We'll take
good care of her.
16
00:00:31,832 --> 00:00:33,467
**
17
00:00:33,501 --> 00:00:35,336
(BABY CRYING)
18
00:00:35,369 --> 00:00:37,705
**
19
00:00:44,845 --> 00:00:48,182
Your New Chief
is fashionably late.
20
00:00:48,216 --> 00:00:49,783
Our Chief.
21
00:00:49,817 --> 00:00:52,520
Just because I endorsed
Dr. Han to the Board
22
00:00:52,553 --> 00:00:53,987
doesn't mean I don't
have any concerns.
23
00:00:54,021 --> 00:00:56,557
Connections like Dr. Han's
come at a premium
24
00:00:56,590 --> 00:00:58,459
and, he assures me,
will be well worth it
25
00:00:58,492 --> 00:01:00,494
given our current predicament
with the Medical Board.
26
00:01:00,528 --> 00:01:03,030
I'm not just worried
about the money.
27
00:01:03,063 --> 00:01:04,832
When you pay that much,
28
00:01:04,865 --> 00:01:07,101
they tend to think
they're worth it.
29
00:01:07,135 --> 00:01:09,370
Makes a person think
they don't have to show up
30
00:01:09,403 --> 00:01:11,839
for their own
welcome brunch.
31
00:01:11,872 --> 00:01:13,707
(INDISTINCT CONVERSATIONS)
32
00:01:14,875 --> 00:01:16,710
(BREATHES SHARPLY)
33
00:01:21,849 --> 00:01:22,983
(MONITOR BEEPING)
34
00:01:23,016 --> 00:01:24,418
CLAIRE: The baby's
bowel protrusion
35
00:01:24,452 --> 00:01:27,087
seemed less severe
on the prenatal imaging.
36
00:01:27,121 --> 00:01:28,756
DR. LIM: And it'll have
to wait until
37
00:01:28,789 --> 00:01:30,391
we're done with
her heart problem.
38
00:01:30,424 --> 00:01:34,195
Now that I'm in here,
her septum looks
more like Swiss cheese.
39
00:01:34,228 --> 00:01:36,830
(MONITOR BEEPING)
40
00:01:36,864 --> 00:01:39,933
Page the on-call
neonatal cardiac surgeon.
41
00:01:39,967 --> 00:01:41,735
That won't be necessary.
I'll scrub in.
42
00:01:41,769 --> 00:01:43,103
DR. LIM:
And who are you?
43
00:01:43,804 --> 00:01:45,539
I'm Jackson Han.
44
00:01:45,573 --> 00:01:47,208
Your new Chief of Surgery.
45
00:01:47,241 --> 00:01:49,577
**
46
00:01:49,610 --> 00:01:51,745
**
47
00:02:01,422 --> 00:02:03,624
(MONITOR BEEPING STEADILY)
48
00:02:03,657 --> 00:02:05,726
DR. HAN:
Echo probe, please.
49
00:02:07,127 --> 00:02:08,662
And let's
turn that music on.
50
00:02:11,265 --> 00:02:13,734
( LORD HURON'S "ANCIENT NAMES
( PART 1 ) " PLAYS)
51
00:02:13,767 --> 00:02:15,236
Advance
the delivery sheath.
52
00:02:15,269 --> 00:02:17,705
**
53
00:02:17,738 --> 00:02:19,607
It's in the patient's heart,
Dr. Murphy.
54
00:02:19,640 --> 00:02:22,776
I think the music
is a little distracting.
55
00:02:22,810 --> 00:02:24,745
I feel the same way about
operating without music.
56
00:02:26,013 --> 00:02:27,781
I'll take
a longer sheath,
57
00:02:27,815 --> 00:02:29,983
and Dr. Murphy will need
some forceps.
58
00:02:30,017 --> 00:02:31,985
**
59
00:02:32,019 --> 00:02:33,787
(FORCEPS CLATTER)
* Well, the neon lights
60
00:02:33,821 --> 00:02:35,656
* Glowed red and gold
61
00:02:35,689 --> 00:02:38,826
* I came to hear
my fortune told
Five-second rule.
62
00:02:38,859 --> 00:02:41,795
* I can't imagine what she saw
63
00:02:41,829 --> 00:02:44,765
* While gazing
in her crystal ball
It was a joke.
64
00:02:44,798 --> 00:02:46,066
**
65
00:02:46,099 --> 00:02:47,601
What about her bowels?
66
00:02:47,635 --> 00:02:50,504
Why isn't Dr. Lim inserting it
into the abdomen right now?
67
00:02:50,538 --> 00:02:53,106
There is
not enough room.
68
00:02:53,140 --> 00:02:55,476
There's... There's
not enough room
69
00:02:55,509 --> 00:02:57,245
without increasing
abdominal pressure,
70
00:02:57,278 --> 00:03:00,481
which would
critically decrease
blood flow to the bowel.
71
00:03:00,514 --> 00:03:02,983
DR. HAN:
According to what
hemodynamic principle...
72
00:03:03,016 --> 00:03:04,184
Dr. Browne?
73
00:03:04,218 --> 00:03:06,454
Vascular impedance.
Blood flow is driven
74
00:03:06,487 --> 00:03:07,821
by the force induced
by the pressure gradient.
75
00:03:07,855 --> 00:03:09,423
And how
do you calculate it?
76
00:03:09,457 --> 00:03:10,858
**
77
00:03:10,891 --> 00:03:13,261
Uh. Um...
78
00:03:13,294 --> 00:03:14,728
I... I'd have
to look it up.
79
00:03:16,730 --> 00:03:19,533
Eight times L.Nu.
divided by Pi.R.4.
80
00:03:19,567 --> 00:03:21,702
Very good, Dr. Murphy.
81
00:03:21,735 --> 00:03:23,737
DR. HAN: That's also why
this occluder won't work.
82
00:03:23,771 --> 00:03:25,773
It won't hold up against
the huge pressure gradient
83
00:03:25,806 --> 00:03:27,941
in her heart.
Is there a fix?
84
00:03:27,975 --> 00:03:29,610
DR. HAN: Long-term,
I don't have one.
85
00:03:29,643 --> 00:03:32,346
Right now,
I need umbilical tape
and PE tubing.
86
00:03:32,380 --> 00:03:35,483
* I gotta get away from here
87
00:03:35,516 --> 00:03:38,218
* I'll never see
the golden sunrise
88
00:03:38,252 --> 00:03:39,687
* Oh, I gotta
get away from her...
89
00:03:39,720 --> 00:03:42,523
You're making
a pulmonary artery band.
90
00:03:42,556 --> 00:03:43,724
That should
buy us some time
91
00:03:43,757 --> 00:03:47,795
to come up with a plan
before we lose this baby.
92
00:03:47,828 --> 00:03:49,162
* Oh, if I leave
this place alive*
93
00:03:49,196 --> 00:03:50,864
**
94
00:03:52,232 --> 00:03:53,301
(BEEPS)
95
00:03:53,334 --> 00:03:54,835
WOMAN ON P.A.:
Lab technician to OR 6.
96
00:03:54,868 --> 00:03:56,337
Lab technician to OR 6.
97
00:03:56,370 --> 00:03:58,071
(DOOR OPENS)
98
00:03:59,340 --> 00:04:01,742
You canceled
my hernia repair?
99
00:04:01,775 --> 00:04:04,412
With no advance notice.
Sorry about that.
100
00:04:04,445 --> 00:04:05,846
But so great
to meet you.
101
00:04:05,879 --> 00:04:07,080
Jackson Han.
102
00:04:07,114 --> 00:04:08,816
Neil Melendez.
Oh, I know.
103
00:04:08,849 --> 00:04:09,883
You did great work
104
00:04:09,917 --> 00:04:11,184
on that piggyback
heart transplant.
105
00:04:11,218 --> 00:04:12,553
Huh.
106
00:04:12,586 --> 00:04:14,822
I need a consult
on Minesh Goyal.
107
00:04:14,855 --> 00:04:16,357
He's the founding CEO
of a company...
108
00:04:16,390 --> 00:04:18,526
What's his diagnosis?
He doesn't have one.
109
00:04:18,559 --> 00:04:21,595
He's here for a full physical,
complete diagnostic workup.
110
00:04:21,629 --> 00:04:24,264
I have a long-standing
Executive Wellness...
111
00:04:24,298 --> 00:04:26,934
I'm a surgeon,
not an internist.
112
00:04:26,967 --> 00:04:28,902
I don't do preventative
medicine.
113
00:04:28,936 --> 00:04:31,939
No matter how rich
the patient is.
114
00:04:31,972 --> 00:04:34,575
You know what's great
about rich patients?
115
00:04:34,608 --> 00:04:36,410
They allow us to treat
poor patients.
116
00:04:37,778 --> 00:04:39,413
Also, I promised Minesh
the very best.
117
00:04:39,447 --> 00:04:42,350
So, really,
who else am I gonna get?
118
00:04:42,383 --> 00:04:43,451
(BEEPS)
119
00:04:43,484 --> 00:04:45,085
WOMAN ON P.A.:
Dr. Johansen to pre-op.
120
00:04:45,118 --> 00:04:47,287
Dr. Johansen to pre-op.
121
00:04:47,321 --> 00:04:48,522
(VELCRO TEARS)
122
00:04:48,556 --> 00:04:50,157
BP's 110 over 70.
123
00:04:51,258 --> 00:04:53,761
Uh, Jackson...
Dr. Han
124
00:04:53,794 --> 00:04:55,162
says great things
about you.
125
00:04:56,997 --> 00:04:58,499
That's very kind.
126
00:04:59,667 --> 00:05:02,135
Normal EKG,
optimal BMI,
127
00:05:02,169 --> 00:05:03,537
heart and lungs
sound good.
128
00:05:03,571 --> 00:05:05,105
Any reason you're worried
enough about your health
129
00:05:05,138 --> 00:05:07,307
to endure an entire day
of tests?
130
00:05:07,341 --> 00:05:09,009
I'm not worried.
131
00:05:10,844 --> 00:05:12,880
Knowledge is power.
132
00:05:12,913 --> 00:05:14,982
Whenever I enter
a new market,
133
00:05:15,015 --> 00:05:17,284
I learn everything I can
about the landscape...
134
00:05:17,317 --> 00:05:20,120
Consumer needs,
target market,
competitors.
135
00:05:20,153 --> 00:05:21,589
You're aware your body
isn't a business.
136
00:05:21,622 --> 00:05:23,457
(CHUCKLES)
137
00:05:23,491 --> 00:05:25,426
I know I sound
like a rich lunatic
138
00:05:25,459 --> 00:05:28,295
with fantasies
about controlling
every aspect of my life.
139
00:05:29,963 --> 00:05:31,131
And I guess
I kind of am.
140
00:05:35,135 --> 00:05:38,271
My dad was
in good shape, too.
141
00:05:38,305 --> 00:05:40,107
Until he dropped dead
on his daily jog.
142
00:05:42,776 --> 00:05:44,512
**
143
00:05:47,815 --> 00:05:49,182
(INDISTINCT CONVERSATIONS)
144
00:05:49,216 --> 00:05:51,419
**
145
00:05:51,452 --> 00:05:53,787
Hi.
146
00:05:53,821 --> 00:05:56,990
WOMAN ON P.A.:
Dr. Markiel, please come
to the mental health unit.
147
00:05:57,024 --> 00:06:00,794
Dr. Markiel, please come
to the mental health unit.
148
00:06:00,828 --> 00:06:02,996
(CONVERSATIONS CONTINUE)
149
00:06:03,030 --> 00:06:04,632
(TELEPHONE RINGING)
150
00:06:07,034 --> 00:06:08,402
(EXHALES SHARPLY)
151
00:06:11,472 --> 00:06:12,706
Hi.
152
00:06:13,807 --> 00:06:16,376
Hi. I'm Larry Childs.
153
00:06:16,410 --> 00:06:18,145
I'd shake your hand,
but, you know,
154
00:06:18,178 --> 00:06:19,613
no functioning
immune system.
155
00:06:19,647 --> 00:06:20,814
(CHUCKLES)
156
00:06:20,848 --> 00:06:22,983
Aaron. Hi.
Good to meet you.
157
00:06:23,016 --> 00:06:24,518
What flavor cancer
do you have?
158
00:06:24,552 --> 00:06:26,153
(CHUCKLES)
159
00:06:26,186 --> 00:06:28,021
What flavor?
Yeah.
160
00:06:28,055 --> 00:06:29,356
Glioma.
161
00:06:29,389 --> 00:06:30,991
Shut the front door.
162
00:06:31,024 --> 00:06:33,160
Brain or spine?
163
00:06:33,193 --> 00:06:34,862
Brain.
Dude,
164
00:06:34,895 --> 00:06:36,063
we're tumor twins.
165
00:06:36,096 --> 00:06:38,999
Wh... What do they
have you on?
166
00:06:39,032 --> 00:06:40,400
Ooh. Vincristine.
167
00:06:40,434 --> 00:06:41,669
I hear that's intense.
168
00:06:41,702 --> 00:06:43,671
My doc thought
it would wipe me out.
169
00:06:43,704 --> 00:06:45,873
You doing okay
or longing for death?
170
00:06:45,906 --> 00:06:48,542
I am hanging in there.
Thank you.
171
00:06:48,576 --> 00:06:51,278
I'm on my third round
of temozolomide.
172
00:07:01,755 --> 00:07:03,423
I've seen you in here
a few times.
173
00:07:06,093 --> 00:07:07,327
I've seen you
in here a few times.
174
00:07:07,360 --> 00:07:08,929
You kind of
keep to yourself, huh?
175
00:07:10,397 --> 00:07:11,699
Yeah.
176
00:07:11,732 --> 00:07:13,400
Well, I'm happy
to introduce you around.
177
00:07:13,433 --> 00:07:14,502
It's a really
friendly group.
178
00:07:14,535 --> 00:07:15,669
I'm okay. Thank you.
179
00:07:15,703 --> 00:07:16,970
You have a support group
you go to?
180
00:07:18,205 --> 00:07:19,239
I do not.
181
00:07:20,574 --> 00:07:22,442
Everyone needs
a cancer community.
182
00:07:27,447 --> 00:07:30,183
(PAPER RUSTLES)
183
00:07:30,217 --> 00:07:32,285
**
184
00:07:34,454 --> 00:07:36,456
**
185
00:07:43,897 --> 00:07:46,066
**
186
00:07:50,003 --> 00:07:52,172
**
187
00:07:55,943 --> 00:07:57,611
And try to hold still.
(CLICKS)
188
00:07:58,746 --> 00:07:59,747
Thank you.
189
00:08:00,948 --> 00:08:02,115
For bringing us in.
190
00:08:02,149 --> 00:08:04,818
This is the
new Chief's patient.
It's a great opportunity.
191
00:08:04,852 --> 00:08:07,154
Or it's a bunch
of pointless tests.
192
00:08:07,187 --> 00:08:08,255
(SIGHS)
193
00:08:09,289 --> 00:08:11,792
Uh, for which
I thank you.
194
00:08:11,825 --> 00:08:13,160
Tell us
about Dr. Han.
195
00:08:13,193 --> 00:08:15,763
He's direct, charming,
196
00:08:15,796 --> 00:08:17,064
very sure of himself.
197
00:08:17,097 --> 00:08:18,098
Big ego.
198
00:08:22,970 --> 00:08:26,106
There's nothing wrong with
an ego if you can back it up.
199
00:08:26,139 --> 00:08:28,008
And Dr. Han's
arterial switch technique
200
00:08:28,041 --> 00:08:30,143
is performed
all over the world.
201
00:08:30,177 --> 00:08:32,145
DR. PARK: The tests
aren't all pointless.
202
00:08:32,179 --> 00:08:33,614
Way to stand
firm, Park.
203
00:08:33,647 --> 00:08:35,248
No, look at the monitor.
204
00:08:35,282 --> 00:08:36,316
He has a tumor.
205
00:08:36,349 --> 00:08:38,351
**
206
00:08:42,155 --> 00:08:43,523
(SIGHS)
207
00:08:43,557 --> 00:08:46,493
(MONITOR BEEPING)
208
00:08:46,526 --> 00:08:48,996
**
209
00:08:54,702 --> 00:08:56,970
**
210
00:09:02,242 --> 00:09:03,877
NIGEL:
Percy's stable?
211
00:09:03,911 --> 00:09:06,814
We're naming her
Persephone.
212
00:09:06,847 --> 00:09:10,350
Yes. I put in
a central line
for nutrition.
213
00:09:10,383 --> 00:09:11,819
Percy is stable
right now.
214
00:09:11,852 --> 00:09:14,722
We're looking for solutions
to her problems.
215
00:09:14,755 --> 00:09:17,157
(STAMMERS) Why does...
216
00:09:17,190 --> 00:09:19,392
Why does she have
all these birth defects?
217
00:09:19,426 --> 00:09:21,494
Diane.
218
00:09:21,528 --> 00:09:23,063
We spoke
to our obstetrician.
219
00:09:23,096 --> 00:09:25,165
She said these defects can
happen for no reason, right?
220
00:09:27,100 --> 00:09:28,335
That's true.
221
00:09:28,368 --> 00:09:30,904
Over 50% have
no known cause.
222
00:09:33,406 --> 00:09:37,811
I was taking paroxetine
for clinical depression.
223
00:09:37,845 --> 00:09:39,146
And you went off the meds
224
00:09:39,179 --> 00:09:40,848
as soon as you found out
you were pregnant.
225
00:09:40,881 --> 00:09:43,383
She was five,
six weeks at most.
226
00:09:43,416 --> 00:09:44,985
My OB told me
studies show
227
00:09:45,018 --> 00:09:47,554
antidepressants are safe
to take during pregnancy.
228
00:09:47,587 --> 00:09:48,922
But is that true,
229
00:09:48,956 --> 00:09:50,590
or is she
protecting me?
230
00:09:53,193 --> 00:09:56,196
There was a study that
associated paroxetine
231
00:09:56,229 --> 00:09:57,731
with these kinds
of defects.
232
00:09:57,765 --> 00:10:00,200
It is
a possibility.
233
00:10:00,233 --> 00:10:01,434
(EXHALES SHARPLY)
234
00:10:01,468 --> 00:10:03,637
**
235
00:10:12,079 --> 00:10:14,114
You can't tell whether
it's cancerous or benign?
236
00:10:14,147 --> 00:10:15,783
Not until
we do the biopsy,
237
00:10:15,816 --> 00:10:17,651
which I've scheduled
for later.
238
00:10:17,685 --> 00:10:19,119
We'll know what's going on
by the morning.
239
00:10:19,152 --> 00:10:21,021
**
240
00:10:21,054 --> 00:10:22,355
Good.
241
00:10:22,389 --> 00:10:23,691
That's good.
242
00:10:23,724 --> 00:10:26,626
**
243
00:10:26,660 --> 00:10:29,029
Maybe you'd like
to call someone?
244
00:10:29,062 --> 00:10:31,231
A family member,
a friend?
245
00:10:31,264 --> 00:10:33,233
I'll worry when
I know it's cancer.
246
00:10:33,266 --> 00:10:35,335
**
247
00:10:42,810 --> 00:10:45,645
We could use
a transcatheter route
248
00:10:45,679 --> 00:10:48,916
and patch each hole
individually.
249
00:10:48,949 --> 00:10:50,317
Her heart's
the size of a walnut.
250
00:10:50,350 --> 00:10:52,886
It's too small
to maneuver inside.
251
00:10:52,920 --> 00:10:55,255
A single large patch
to close the holes
252
00:10:55,288 --> 00:10:56,323
would withstand
the pressure.
253
00:10:56,356 --> 00:10:57,791
Yes.
254
00:10:59,592 --> 00:11:02,262
It would also block
electrical conduction,
255
00:11:02,295 --> 00:11:04,331
causing
deadly arrhythmias.
256
00:11:04,364 --> 00:11:07,100
Dr. Murphy,
257
00:11:07,134 --> 00:11:10,103
did you tell the mom
that she caused
her baby's birth defect?
258
00:11:10,137 --> 00:11:13,941
No. I said that
her antidepressants
could have.
259
00:11:15,375 --> 00:11:16,910
Why did you
tell her that?
260
00:11:16,944 --> 00:11:19,446
It's the truth.
261
00:11:19,479 --> 00:11:21,949
And is that relevant
to her current
medical situation?
262
00:11:23,016 --> 00:11:24,317
No.
263
00:11:26,319 --> 00:11:29,356
And how did you think
that answer would
make her feel?
264
00:11:29,389 --> 00:11:31,024
What did you think
would happen?
265
00:11:31,058 --> 00:11:32,926
**
266
00:11:32,960 --> 00:11:35,128
The mother
is devastated.
267
00:11:35,162 --> 00:11:36,629
The father
is furious.
268
00:11:36,663 --> 00:11:38,131
I would be, too.
269
00:11:38,165 --> 00:11:39,933
DR. LIM:
Shaun is a resident.
270
00:11:39,967 --> 00:11:41,401
Residents
make mistakes.
271
00:11:42,669 --> 00:11:44,671
Managing these parents'
emotional concerns
272
00:11:44,704 --> 00:11:47,440
is as much a part
of this job as operating
on their daughter.
273
00:11:47,474 --> 00:11:49,910
(SIGHS) Social cues
are hard for Shaun,
274
00:11:49,943 --> 00:11:51,444
but we've been
working with him...
275
00:11:51,478 --> 00:11:53,280
You should be focused
on your own shortcomings,
276
00:11:53,313 --> 00:11:56,549
like retaining the formula
for vascular impedance.
277
00:11:56,583 --> 00:11:57,885
SHAUN: Dr. Han.
278
00:11:57,918 --> 00:12:00,854
**
279
00:12:00,888 --> 00:12:03,490
We could patch each
individual hole in the heart
280
00:12:03,523 --> 00:12:05,392
if we cut open
the ventricle...
281
00:12:05,425 --> 00:12:06,994
Don't change the subject,
Dr. Murphy.
282
00:12:07,027 --> 00:12:08,796
I didn't, Dr. Han.
283
00:12:08,829 --> 00:12:10,998
We were talking
about the baby.
284
00:12:11,031 --> 00:12:12,032
Really?
285
00:12:13,400 --> 00:12:15,702
You don't see a difference
in the nature
of your discussion
286
00:12:15,735 --> 00:12:17,404
before I arrived
and after?
287
00:12:19,239 --> 00:12:22,876
We were talking
about the baby.
288
00:12:22,910 --> 00:12:24,878
**
289
00:12:28,548 --> 00:12:31,318
They tried the approach you
suggested at L.A. Children's.
290
00:12:31,351 --> 00:12:32,886
The baby died
a week later.
291
00:12:32,920 --> 00:12:35,455
The suture line didn't hold,
and the cardiac wall ruptured.
292
00:12:36,389 --> 00:12:37,424
Keep looking.
293
00:12:37,457 --> 00:12:39,960
Dr. Murphy,
294
00:12:39,993 --> 00:12:41,895
do not talk with
those parents again.
295
00:12:46,233 --> 00:12:47,467
I'll walk with you.
296
00:12:51,104 --> 00:12:52,973
DR. LIM: You're pretty tough
on my residents.
297
00:12:53,006 --> 00:12:54,274
Rebuking them
in public,
298
00:12:54,307 --> 00:12:56,877
pimping them
with questions
during surgery.
299
00:12:56,910 --> 00:12:58,545
Shame-based learning
isn't my style.
300
00:12:58,578 --> 00:13:00,613
I'll bear that in mind.
301
00:13:00,647 --> 00:13:02,715
But this isn't about
my treatment
of "the residents."
302
00:13:02,749 --> 00:13:04,251
You're concerned
about Dr. Murphy.
303
00:13:04,284 --> 00:13:06,686
Well, a lot of doctors
have less than ideal
bedside manner.
304
00:13:06,719 --> 00:13:08,455
He's young...
Would you ever have said
305
00:13:08,488 --> 00:13:10,590
something like that
to a patient as a resident?
306
00:13:10,623 --> 00:13:12,059
As a med student?
307
00:13:12,092 --> 00:13:13,226
And Murphy doesn't
even understand
308
00:13:13,260 --> 00:13:14,727
he did anything wrong.
309
00:13:14,761 --> 00:13:16,063
Shaun has hard-wired
differences
310
00:13:16,096 --> 00:13:18,465
in the way
he perceives things.
Exactly.
311
00:13:18,498 --> 00:13:19,732
No matter
how hard he works,
312
00:13:19,766 --> 00:13:22,435
no matter how hard
you try and help him,
313
00:13:22,469 --> 00:13:24,905
his limitations
are not going to change.
314
00:13:24,938 --> 00:13:28,241
He's going to continue to
inflict them on our patients,
315
00:13:28,275 --> 00:13:30,911
all in the name of diversity
and inclusion.
316
00:13:33,480 --> 00:13:34,915
Shaun deserves
to be here.
317
00:13:36,516 --> 00:13:39,419
Once you see what he's
capable of, you'll agree.
318
00:13:39,452 --> 00:13:40,620
I look forward
to being proven wrong.
319
00:13:40,653 --> 00:13:41,688
(ELEVATOR BELL DINGS)
320
00:13:41,721 --> 00:13:44,191
(ELEVATOR DOORS OPEN)
321
00:13:46,493 --> 00:13:48,661
Stay seated
for 20 minutes.
322
00:13:48,695 --> 00:13:49,762
Don't want you passing out
in the lobby.
323
00:13:49,796 --> 00:13:51,664
I know, I know.
Thank you.
324
00:13:57,137 --> 00:13:58,838
This disease changed
my relationships,
325
00:13:58,872 --> 00:14:01,441
changed my priorities,
changed,
326
00:14:01,474 --> 00:14:02,876
who I am.
327
00:14:02,910 --> 00:14:04,011
Cancer
is an identity.
328
00:14:04,044 --> 00:14:06,513
Cancer is a
cellular mutation.
329
00:14:06,546 --> 00:14:08,681
The people in this room
are my people.
330
00:14:08,715 --> 00:14:11,818
What are you, 20 years old?
I'm triple your age.
331
00:14:11,851 --> 00:14:13,186
I don't think
you're my "people."
332
00:14:13,220 --> 00:14:15,122
The last time I hung out
with my law-school friends,
333
00:14:15,155 --> 00:14:17,958
epic fail.
The fact that you use
the phrase "epic fail,"
334
00:14:17,991 --> 00:14:19,192
kind of case in point.
335
00:14:19,226 --> 00:14:21,061
They're all focused
on what firm
they're gonna land at,
336
00:14:21,094 --> 00:14:23,596
and I'm all about
whether
337
00:14:23,630 --> 00:14:25,298
Candice's leukemia
is responding
338
00:14:25,332 --> 00:14:27,167
to her
new chemo regimen.
339
00:14:27,200 --> 00:14:28,635
By the way, she has
this peppermint oil
340
00:14:28,668 --> 00:14:29,802
that is great
for headaches.
341
00:14:34,707 --> 00:14:36,609
Ooh, I know that look.
342
00:14:36,643 --> 00:14:38,011
Here, here.
343
00:14:38,711 --> 00:14:40,147
(VOMITING)
344
00:14:40,180 --> 00:14:42,415
(COUGHING)
345
00:14:43,483 --> 00:14:45,618
Got you, brother,
346
00:14:45,652 --> 00:14:46,954
whether you like it
or not.
347
00:14:46,987 --> 00:14:48,421
(CHUCKLES)
348
00:14:50,958 --> 00:14:53,060
Show me
where we are.
349
00:14:53,093 --> 00:14:55,562
That angle runs pretty close
to the sacral nerve roots.
350
00:14:57,364 --> 00:14:58,798
How are we doing?
351
00:14:58,831 --> 00:15:00,300
DR. MELENDEZ:
Tumor's abutting
the iliac artery.
352
00:15:00,333 --> 00:15:02,102
I'm trying not to disrupt
the entire blood supply
353
00:15:02,135 --> 00:15:03,503
to his lower body.
354
00:15:03,536 --> 00:15:05,138
Dr. Han,
I'm Morgan Reznick.
355
00:15:05,172 --> 00:15:07,507
I really enjoyed
your article on Myotomy
356
00:15:07,540 --> 00:15:11,244
for infantile hypertrophic
pyloric stenosis.
357
00:15:11,278 --> 00:15:14,181
I appreciate
the thorough research
behind your sucking up.
358
00:15:14,214 --> 00:15:15,915
And you are?
359
00:15:15,949 --> 00:15:17,517
Alex Park.
360
00:15:17,550 --> 00:15:20,153
Park...
You were a cop.
361
00:15:20,187 --> 00:15:22,289
Medicine as
a second career,
good stuff.
362
00:15:22,322 --> 00:15:24,191
Tends to bring
a fresh perspective.
363
00:15:26,159 --> 00:15:27,694
(ALARM BEEPING RAPIDLY)
364
00:15:27,727 --> 00:15:29,829
I hit an artery.
Take the needle.
365
00:15:29,862 --> 00:15:31,031
Blood's pooling
in the pelvis.
366
00:15:31,064 --> 00:15:32,599
DR. PARK: Should
we open him up?
No.
367
00:15:32,632 --> 00:15:34,501
Prep the femoral artery.
Get me an art cath set.
368
00:15:34,534 --> 00:15:36,236
DR. PARK:
Pressure's dropping.
Platinum coil.
369
00:15:36,269 --> 00:15:38,805
(BEEPING CONTINUES)
370
00:15:43,276 --> 00:15:46,113
(BEEPING STOPS)
Nice save.
371
00:15:46,146 --> 00:15:47,314
Next time,
don't hit the vessel.
372
00:15:49,549 --> 00:15:51,451
There is
no next time.
373
00:15:51,484 --> 00:15:53,053
The biopsy's
too dangerous.
374
00:15:56,823 --> 00:15:59,159
(SIGHS)
375
00:15:59,192 --> 00:16:02,462
DR. MELENDEZ: It is likely
that it's a benign
notochord cell tumor.
376
00:16:02,495 --> 00:16:04,031
They look
like chordomas,
377
00:16:04,064 --> 00:16:05,565
but they're harmless
and way more common.
378
00:16:05,598 --> 00:16:06,966
But you don't know.
379
00:16:07,000 --> 00:16:08,835
Since we can't
do the biopsy, no.
380
00:16:09,902 --> 00:16:11,604
This is the problem
with broad testing.
381
00:16:13,073 --> 00:16:14,474
Everyone has
abnormalities.
382
00:16:14,507 --> 00:16:15,908
Most of them
are nothing.
383
00:16:15,942 --> 00:16:17,744
But when we do
find them,
384
00:16:17,777 --> 00:16:19,346
we have to make
some tough choices.
385
00:16:21,014 --> 00:16:23,816
So, what exactly
is my tough choice?
386
00:16:25,485 --> 00:16:27,254
We could
remove the tumor.
387
00:16:27,287 --> 00:16:29,056
This is
a very risky surgery.
388
00:16:29,089 --> 00:16:31,058
There's a chance
of paralysis or worse,
389
00:16:31,091 --> 00:16:33,493
you may not
make it off the table.
390
00:16:33,526 --> 00:16:35,562
Or you do nothing.
391
00:16:35,595 --> 00:16:36,996
We'd continue
to monitor it,
392
00:16:37,030 --> 00:16:38,798
do imaging
every few weeks.
393
00:16:38,831 --> 00:16:40,567
But chordomas
move very quickly.
394
00:16:40,600 --> 00:16:42,802
By the time any change
showed up on imaging,
395
00:16:42,835 --> 00:16:44,971
it's most likely metastasized
throughout your body.
396
00:16:47,307 --> 00:16:50,643
So it probably
isn't cancer,
397
00:16:50,677 --> 00:16:54,081
but if it is and I wait,
then I'll die.
398
00:16:54,114 --> 00:16:55,648
That's true.
399
00:16:55,682 --> 00:16:59,519
And if I don't wait
and I get the surgery,
400
00:16:59,552 --> 00:17:01,254
then there's a good chance
I'll die.
401
00:17:01,288 --> 00:17:02,389
Yes.
402
00:17:08,228 --> 00:17:10,430
I'm gonna need
to think this over.
403
00:17:10,463 --> 00:17:12,699
**
404
00:17:18,205 --> 00:17:20,807
**
405
00:17:25,512 --> 00:17:29,382
This is the May
Annals of Neonatal Surgery.
406
00:17:29,416 --> 00:17:32,652
I just finished March.
I need to read April now.
407
00:17:32,685 --> 00:17:34,221
DR. LIM:
Oh, I have April, Shaun.
408
00:17:34,254 --> 00:17:35,955
No.
409
00:17:35,988 --> 00:17:37,757
No, you're supposed
to be reading
410
00:17:37,790 --> 00:17:40,227
New Approaches
in Neonatal Surgery.
411
00:17:40,260 --> 00:17:42,595
Claire has the British Journal
of Neonatology...
412
00:17:51,404 --> 00:17:53,506
Shaun...
413
00:17:53,540 --> 00:17:56,676
I think maybe you should
be quiet around Han
414
00:17:56,709 --> 00:17:59,346
for a little while.
415
00:17:59,379 --> 00:18:01,748
But then how will I answer
his questions?
416
00:18:03,716 --> 00:18:06,419
Direct questions,
absolutely answer.
417
00:18:06,453 --> 00:18:08,755
Otherwise,
outside of the OR,
418
00:18:08,788 --> 00:18:10,257
you should
stay out of his way.
419
00:18:13,426 --> 00:18:15,895
If someone had convinced Shaun
to do that with Dr. Melendez,
420
00:18:15,928 --> 00:18:18,131
he would still
be on suction.
421
00:18:20,633 --> 00:18:22,101
(BEEP)
422
00:18:22,135 --> 00:18:24,171
MAN ON P.A.:
Code blue. NICU, Bed 4.
423
00:18:24,204 --> 00:18:26,939
Code blue. NICU, Bed 4.
424
00:18:26,973 --> 00:18:28,441
(DOOR OPENS)
425
00:18:28,475 --> 00:18:29,942
(ALARM BEEPING RAPIDLY)
426
00:18:29,976 --> 00:18:32,545
O2 SATs dropped and central
venous pressure shot up.
427
00:18:32,579 --> 00:18:34,080
The Pulmonary Artery Band
is failing.
428
00:18:34,113 --> 00:18:36,383
Eight of dopamine.
Let's get a mask on her.
429
00:18:36,416 --> 00:18:38,285
DR. HAN: She won't
last much longer.
We need other options.
430
00:18:38,318 --> 00:18:39,986
I'll update
the parents.
431
00:18:40,019 --> 00:18:41,788
(BEEPING CONTINUES)
432
00:18:41,821 --> 00:18:43,223
DR. LIM: Let's get her
on full cardiac support.
433
00:18:43,256 --> 00:18:45,392
**
434
00:18:45,425 --> 00:18:47,760
(MACHINE BEEPING)
435
00:18:47,794 --> 00:18:49,762
(RESPIRATOR HISSING)
436
00:18:49,796 --> 00:18:51,931
**
437
00:18:59,005 --> 00:19:01,374
What have you got?
Anything?
438
00:19:01,408 --> 00:19:02,975
This Cleveland group
439
00:19:03,009 --> 00:19:05,512
repaired a bowel protrusion
using enterolysis.
440
00:19:05,545 --> 00:19:07,947
I could cut out this excess
inflammatory tissue
441
00:19:07,980 --> 00:19:09,749
and segment
of bowel atresia.
442
00:19:09,782 --> 00:19:11,751
Might make her intestines
small enough to fit.
443
00:19:11,784 --> 00:19:12,819
Promising.
444
00:19:12,852 --> 00:19:14,454
Given the size
of her abdomen,
445
00:19:14,487 --> 00:19:15,922
I need to remove
a lot of bowel.
446
00:19:15,955 --> 00:19:18,325
There's a good chance
she wouldn't be able
to absorb food.
447
00:19:18,358 --> 00:19:20,293
We'll have to find
the right balance.
448
00:19:20,327 --> 00:19:22,262
It's our only
workable plan.
449
00:19:22,295 --> 00:19:24,197
Best bet on the heart is
to cut through the ventricle,
450
00:19:24,231 --> 00:19:25,965
like Murphy suggested.
451
00:19:25,998 --> 00:19:28,801
Uh, you were concerned about
the suture line holding.
452
00:19:28,835 --> 00:19:30,570
Well, I still am.
453
00:19:30,603 --> 00:19:32,905
Hopefully, horizontal
mattress sutures will work.
454
00:19:32,939 --> 00:19:34,040
They should be able
to withstand the tension
455
00:19:34,073 --> 00:19:35,675
at the suture line.
456
00:19:35,708 --> 00:19:37,810
(FADING) There's still
a risk of an aneurysm forming
457
00:19:37,844 --> 00:19:39,846
in the tissue
underneath.
458
00:19:39,879 --> 00:19:42,782
(INDISTINCT TALKING)
459
00:19:42,815 --> 00:19:44,751
Dr. Lim?
460
00:19:44,784 --> 00:19:46,986
I have an idea
I'd like to share,
461
00:19:47,019 --> 00:19:49,622
even though Dr. Han
didn't ask me a question.
462
00:19:53,993 --> 00:19:56,028
Yeah, go ahead, Shaun.
463
00:19:56,062 --> 00:19:58,130
If we go in
through the atrium,
464
00:19:58,164 --> 00:19:59,532
we wouldn't have to worry
about the suture line...
465
00:19:59,566 --> 00:20:01,701
It's the same issue
we discussed.
466
00:20:01,734 --> 00:20:03,703
There's not enough room
inside the baby's heart
467
00:20:03,736 --> 00:20:05,104
to stitch the patches
in the place.
468
00:20:05,137 --> 00:20:07,707
Oh, we don't
need to, Dr. Han.
469
00:20:07,740 --> 00:20:10,076
We can make a plug
small enough for her heart,
470
00:20:10,109 --> 00:20:12,612
a PTFE disc with a stem
like a mushroom.
471
00:20:12,645 --> 00:20:14,347
Then we can insert the stem
through one of the holes
472
00:20:14,381 --> 00:20:15,882
until the disc presses
against the wall,
473
00:20:15,915 --> 00:20:18,551
covering all the holes.
474
00:20:18,585 --> 00:20:21,988
L-Like a stopper
in a bathtub.
475
00:20:22,021 --> 00:20:23,556
Yes.
476
00:20:23,590 --> 00:20:25,392
The higher pressure on
the left side of her heart
477
00:20:25,425 --> 00:20:26,993
would keep it
in place.
478
00:20:27,026 --> 00:20:28,695
We wouldn't even
need to stitch.
479
00:20:30,397 --> 00:20:32,299
Great idea.
480
00:20:32,332 --> 00:20:33,933
We should take this
to the parents.
481
00:20:33,966 --> 00:20:35,968
Great idea
for the heart.
482
00:20:36,002 --> 00:20:38,405
But we need to tell them
that our current plan
483
00:20:38,438 --> 00:20:39,539
for the abdominal repair
484
00:20:39,572 --> 00:20:42,008
is considerably
more of a long shot.
485
00:20:42,041 --> 00:20:45,312
And that fixing the heart
takes an option off the table.
486
00:20:45,345 --> 00:20:46,913
Withdrawing care.
487
00:20:56,689 --> 00:20:58,758
LARRY: You can't
move that card.
488
00:20:58,791 --> 00:21:00,360
Excuse me?
489
00:21:00,393 --> 00:21:01,594
Who cheats
at solitaire?
490
00:21:01,628 --> 00:21:03,162
You're literally
only cheating yourself.
491
00:21:03,195 --> 00:21:04,364
Again.
492
00:21:04,397 --> 00:21:05,798
Good morning, Larry.
493
00:21:05,832 --> 00:21:07,867
Is it a macho thing?
494
00:21:07,900 --> 00:21:09,569
Like a real man should
be able to make it through
495
00:21:09,602 --> 00:21:11,738
without leaning on a label
or the people who go with it?
496
00:21:14,106 --> 00:21:16,275
Embracing cancer
as an identity
497
00:21:16,309 --> 00:21:18,378
is the last thing
any one of us should be doing.
498
00:21:18,411 --> 00:21:21,381
It underscores everything
horrible right now.
499
00:21:22,482 --> 00:21:24,384
We're in a daily battle
for our lives.
500
00:21:24,417 --> 00:21:26,419
I see no value
in dwelling on that.
501
00:21:30,890 --> 00:21:32,325
Candice is late.
502
00:21:33,960 --> 00:21:36,128
Which means either her niece
forgot to pick her up.
503
00:21:36,162 --> 00:21:38,931
Again.
504
00:21:38,965 --> 00:21:41,368
Or she got
some bad news.
505
00:21:41,401 --> 00:21:42,735
Or she's
already dead.
506
00:21:45,538 --> 00:21:48,007
(OBJECT THUDS, BAG ZIPS)
We are in
a daily battle.
507
00:21:51,143 --> 00:21:53,546
I'd rather have
some company.
508
00:21:53,580 --> 00:21:55,682
**
509
00:22:01,087 --> 00:22:03,289
**
510
00:22:09,295 --> 00:22:11,364
I spoke to my mother
and brother,
511
00:22:11,398 --> 00:22:14,467
and they both think
I shouldn't do the surgery.
512
00:22:14,501 --> 00:22:16,403
Apparently,
they're more scared
of your surgical skills
513
00:22:16,436 --> 00:22:18,805
than they are
of this tumor.
514
00:22:18,838 --> 00:22:20,507
And where
do you stand?
515
00:22:20,540 --> 00:22:22,442
I need numbers.
516
00:22:23,109 --> 00:22:24,444
Please.
517
00:22:24,477 --> 00:22:26,546
**
518
00:22:28,080 --> 00:22:31,584
The stats on something
like this, it...
519
00:22:31,618 --> 00:22:32,885
There are a lot
of variables.
520
00:22:32,919 --> 00:22:34,754
What are the odds
I make it through the surgery
521
00:22:34,787 --> 00:22:37,924
without any complications?
522
00:22:37,957 --> 00:22:39,892
It's a challenging
procedure.
523
00:22:39,926 --> 00:22:42,729
Zero complications,
I'd say 80%.
524
00:22:44,330 --> 00:22:47,266
But it is very unlikely
this tumor is malignant.
525
00:22:47,299 --> 00:22:49,569
Give me a number.
526
00:22:49,602 --> 00:22:52,171
About 5% chance
it's a chordoma.
527
00:22:59,912 --> 00:23:01,948
The numbers agree
with your family.
528
00:23:01,981 --> 00:23:03,349
So do I.
529
00:23:07,720 --> 00:23:09,856
(BREATHES DEEPLY)
530
00:23:12,425 --> 00:23:13,893
I've always been
more comfortable with action
531
00:23:13,926 --> 00:23:15,394
than inaction.
532
00:23:18,931 --> 00:23:21,200
I want you
to do the surgery.
533
00:23:23,703 --> 00:23:24,871
(BREATHES DEEPLY)
534
00:23:24,904 --> 00:23:27,173
Certainty comes
at a price.
535
00:23:27,206 --> 00:23:29,241
**
536
00:23:35,548 --> 00:23:38,317
DIANE: She'll be
able to get off
the life support machines?
537
00:23:38,350 --> 00:23:40,152
DR. HAN: If everything
goes well, yes.
538
00:23:40,186 --> 00:23:41,788
She'll have
a strong heart.
539
00:23:41,821 --> 00:23:43,189
How soon
can you do it?
540
00:23:45,424 --> 00:23:46,993
You should know
we feel less confident
541
00:23:47,026 --> 00:23:49,762
about our plan
for her bowel.
542
00:23:49,796 --> 00:23:52,031
The chance of failure
is quite high.
543
00:23:52,064 --> 00:23:53,600
How high?
544
00:23:53,633 --> 00:23:56,836
DR. LIM: I put it at 90%
that the repair won't work.
545
00:23:56,869 --> 00:23:59,939
Which would lead
to irreversible malnutrition.
546
00:23:59,972 --> 00:24:03,776
Your daughter would slowly
starve to death over months.
547
00:24:03,810 --> 00:24:06,012
Right now,
her body is
working very hard
548
00:24:06,045 --> 00:24:07,279
just to stay alive.
549
00:24:07,313 --> 00:24:09,582
**
550
00:24:10,550 --> 00:24:12,619
If we were to turn off
the machines...
551
00:24:12,652 --> 00:24:15,087
Turn off
the machines?
552
00:24:15,121 --> 00:24:17,557
**
553
00:24:17,590 --> 00:24:20,459
...she would pass quickly.
And peacefully.
554
00:24:21,260 --> 00:24:23,630
If the heart surgery
is a success,
555
00:24:23,663 --> 00:24:25,532
that won't be
an option.
556
00:24:25,565 --> 00:24:27,567
Oh. (BREATHES DEEPLY)
557
00:24:27,600 --> 00:24:29,569
Why not try to fix
the bowel first
558
00:24:29,602 --> 00:24:30,803
to see if it works?
559
00:24:30,837 --> 00:24:32,572
We won't know
if the bowel is viable
560
00:24:32,605 --> 00:24:34,006
until after
the heart is.
561
00:24:35,441 --> 00:24:38,110
We have to do
the surgery.
562
00:24:38,144 --> 00:24:40,479
But if this doesn't work,
she could starve to death.
563
00:24:40,513 --> 00:24:43,382
It's worth the risk...
It's not our risk.
It's hers.
564
00:24:43,415 --> 00:24:46,819
So, instead, you're ready
to give up on our daughter?
565
00:24:46,853 --> 00:24:49,556
I mean, it's like
we're right back
at the ultrasound.
566
00:24:49,589 --> 00:24:51,824
We decided together
to continue this pregnancy.
567
00:24:51,858 --> 00:24:53,726
So this is as much
my fault as it is yours.
568
00:24:53,760 --> 00:24:55,227
My fault?
569
00:24:55,261 --> 00:24:56,796
Because of
the medication?
570
00:24:59,031 --> 00:25:01,801
I cannot turn off
that machine.
571
00:25:03,102 --> 00:25:05,838
Your guilt is
stopping you from admitting
what we need to do.
572
00:25:05,872 --> 00:25:08,608
My guilt has nothing
to do with this.
573
00:25:08,641 --> 00:25:11,477
I am fighting
for my daughter.
So am I.
574
00:25:13,780 --> 00:25:15,815
Since the parents can't agree,
the decision
575
00:25:15,848 --> 00:25:18,350
about the baby's care
will be made by a judge
576
00:25:18,384 --> 00:25:20,452
who will rely
on our recommendation.
577
00:25:21,153 --> 00:25:22,689
So we make the choice,
578
00:25:22,722 --> 00:25:23,956
but the parents
live with it?
579
00:25:26,292 --> 00:25:27,960
Well, maybe that's
a good thing.
580
00:25:30,229 --> 00:25:32,031
For parents to have
to decide between
581
00:25:32,064 --> 00:25:33,700
letting their daughter die
582
00:25:33,733 --> 00:25:37,369
or fighting for her life,
knowing she may
suffer horribly,
583
00:25:37,403 --> 00:25:39,305
maybe it's better
if we carry that burden.
584
00:25:42,742 --> 00:25:44,210
Dr. Lim?
585
00:25:44,243 --> 00:25:45,645
Your decision would be?
586
00:25:47,246 --> 00:25:49,115
Take her
off life support.
587
00:25:49,148 --> 00:25:51,317
The odds are stacked against
the bowel repair working.
588
00:25:51,350 --> 00:25:54,120
Those numbers reflect the
general population of doctors.
589
00:25:54,153 --> 00:25:56,555
I think Dr. Lim and I
are better than that.
590
00:25:56,589 --> 00:25:58,557
We can
beat the odds.
591
00:26:06,232 --> 00:26:07,834
One of the things
I'm not going to miss
592
00:26:07,867 --> 00:26:09,969
about being
Chief of Surgery
593
00:26:10,002 --> 00:26:12,271
is being responsible
for choices like this.
594
00:26:15,507 --> 00:26:17,677
Dr. Han,
it's your department,
595
00:26:17,710 --> 00:26:19,278
it's your call.
596
00:26:25,551 --> 00:26:26,853
(INDISTINCT CONVERSATIONS)
597
00:26:26,886 --> 00:26:28,220
DR. GLASSMAN:
You've been here all night?
598
00:26:28,988 --> 00:26:30,723
I've been
working on a case
599
00:26:30,757 --> 00:26:33,660
with the new
Chief of Surgery,
Dr. Han.
600
00:26:33,693 --> 00:26:35,928
How's that going?
Not very well.
601
00:26:35,962 --> 00:26:37,764
He plays music
in the operating room.
602
00:26:37,797 --> 00:26:39,031
Oh, geez.
One of those.
603
00:26:39,065 --> 00:26:40,332
And he says
I need to focus on
604
00:26:40,366 --> 00:26:41,968
our patients'
emotional needs.
605
00:26:43,135 --> 00:26:45,037
Well, that's a tough
assignment for you.
606
00:26:45,938 --> 00:26:47,273
Mmm.
607
00:26:51,711 --> 00:26:55,414
You ever wish you had,
you know,
608
00:26:55,447 --> 00:26:57,717
friends, co-workers
on the spectrum?
609
00:26:58,584 --> 00:27:00,352
Not usually.
610
00:27:00,386 --> 00:27:02,955
But maybe Dr. Han
wouldn't notice me as much
611
00:27:02,989 --> 00:27:05,224
if I weren't
the only doctor
with ASD.
612
00:27:08,627 --> 00:27:10,697
There's this kid
in chemo,
613
00:27:10,730 --> 00:27:13,399
just... (CHUCKLES) obsessed
with having cancer.
614
00:27:13,432 --> 00:27:14,767
It's all
he talks about.
615
00:27:14,801 --> 00:27:16,703
He wants to be friends
with everybody in the ward.
616
00:27:16,736 --> 00:27:18,104
That's very smart
of him.
617
00:27:18,137 --> 00:27:20,940
Speigel et al. showed
an increase
in overall survival
618
00:27:20,973 --> 00:27:23,409
and quality of life measures
in breast cancer patients
619
00:27:23,442 --> 00:27:26,245
who formed social bonds with
others battling the disease.
620
00:27:27,513 --> 00:27:29,281
What should I do
about Dr. Han?
621
00:27:32,151 --> 00:27:34,653
(EXHALES DEEPLY)
I don't know. Um...
622
00:27:34,687 --> 00:27:36,488
Just do your work,
623
00:27:36,522 --> 00:27:39,091
be a good surgeon,
be an excellent surgeon.
624
00:27:39,125 --> 00:27:41,127
Over time, he'll forget
about the autism.
625
00:27:41,160 --> 00:27:42,628
Why would that happen?
626
00:27:42,661 --> 00:27:45,497
He'll see that
you have the skill,
you have dedication.
627
00:27:45,531 --> 00:27:47,666
I have autism.
628
00:27:47,700 --> 00:27:49,601
It's part of who I am.
629
00:27:50,369 --> 00:27:52,138
(CONVERSATIONS CONTINUE)
630
00:27:56,542 --> 00:28:00,079
(RESPIRATOR HISSING)
(MONITOR BEEPING)
631
00:28:00,112 --> 00:28:01,680
The judge...?
632
00:28:01,714 --> 00:28:03,582
Accepted
our recommendation
633
00:28:03,615 --> 00:28:05,151
and ruled in favor
of surgery.
634
00:28:05,785 --> 00:28:07,586
Thank you, Doctor.
635
00:28:07,619 --> 00:28:09,822
**
636
00:28:11,623 --> 00:28:13,125
(SIGHS)
637
00:28:13,159 --> 00:28:14,360
Okay, Percy.
638
00:28:14,393 --> 00:28:16,628
**
639
00:28:16,662 --> 00:28:18,464
(VOICE BREAKING)
Momma loves you.
640
00:28:18,497 --> 00:28:21,167
**
641
00:28:21,200 --> 00:28:23,169
I love you, Percy.
642
00:28:23,202 --> 00:28:25,204
**
643
00:28:31,410 --> 00:28:33,846
**
644
00:28:38,818 --> 00:28:41,020
**
645
00:28:46,558 --> 00:28:48,727
**
646
00:28:58,737 --> 00:29:00,706
CLAIRE: Should we remove
more bowel?
647
00:29:00,739 --> 00:29:01,974
DR. HAN:
That would take us
to the ilium.
648
00:29:02,008 --> 00:29:04,076
She won't gain
enough weight to thrive.
649
00:29:04,110 --> 00:29:05,978
Her abdominal muscles
are tight
650
00:29:06,012 --> 00:29:07,847
from developing around
an empty cavity.
651
00:29:09,115 --> 00:29:10,917
* But the days, girl
just slip away, oh, yeah *
652
00:29:10,950 --> 00:29:13,519
They're cinched around
her tummy like a corset.
653
00:29:13,552 --> 00:29:14,753
What if we unbuttoned it?
654
00:29:14,787 --> 00:29:15,855
Released the muscle
655
00:29:15,888 --> 00:29:18,057
and increased the abdominal
circumference.
656
00:29:18,090 --> 00:29:19,525
Those muscles are part
of her abdominal wall.
657
00:29:19,558 --> 00:29:20,827
DR. LIM: Not if
we separate the layers,
658
00:29:20,860 --> 00:29:23,495
create a plane between
the skin and the muscle.
659
00:29:23,529 --> 00:29:25,531
**
660
00:29:25,564 --> 00:29:27,133
You good if Murphy and I
start on the heart?
661
00:29:28,467 --> 00:29:30,937
DR. LIM: Dr. Browne,
you're with me
on the abdomen.
662
00:29:32,304 --> 00:29:33,672
DR. PARK:
Clearing the field.
663
00:29:33,705 --> 00:29:35,574
DR. REZNICK: Han is on
the call schedule
next weekend.
664
00:29:35,607 --> 00:29:38,010
Maybe Carmen
will switch with me,
so I can cover with him?
665
00:29:38,044 --> 00:29:40,880
DR. PARK: Or maybe
you shouldn't try so hard.
666
00:29:40,913 --> 00:29:43,082
Retractor.
667
00:29:43,115 --> 00:29:45,217
Some of us don't have
a cool former career,
668
00:29:45,251 --> 00:29:47,053
or an easy-going,
mellow demeanor.
669
00:29:47,086 --> 00:29:48,254
People are never gonna
crowd in my corner
670
00:29:48,287 --> 00:29:49,588
because I'm just
so likable.
671
00:29:49,621 --> 00:29:51,623
Well, you could try
being nice to them.
672
00:29:51,657 --> 00:29:53,159
Well, this is easier.
There it is.
673
00:29:55,962 --> 00:29:57,296
Does it look
like cancer?
674
00:29:58,130 --> 00:29:59,465
It's not labeled.
675
00:29:59,498 --> 00:30:01,567
We're all gonna have to wait
for the pathologist's report.
676
00:30:02,501 --> 00:30:03,602
(MONITOR BEEPING)
677
00:30:03,635 --> 00:30:04,803
Probe.
678
00:30:04,837 --> 00:30:06,472
(BEEPING CONTINUES)
679
00:30:10,142 --> 00:30:11,911
The artery
is in the way.
680
00:30:11,944 --> 00:30:14,280
We can't get at the tumor
without him bleeding out.
681
00:30:14,313 --> 00:30:16,415
**
682
00:30:18,918 --> 00:30:20,486
We're gonna have
to take it from the back.
683
00:30:20,519 --> 00:30:21,921
But the S1 nerve root...
684
00:30:21,954 --> 00:30:23,389
Is something he can
live without.
685
00:30:23,422 --> 00:30:25,057
Dissecting scissors.
686
00:30:25,091 --> 00:30:27,426
**
687
00:30:29,261 --> 00:30:30,729
DR. HAN:
Pledget anchor.
688
00:30:30,762 --> 00:30:33,232
* You'll be leaving me soon
like hell you will
689
00:30:33,265 --> 00:30:37,736
* The owl gazing at the moon
690
00:30:37,769 --> 00:30:41,974
* Is the feeling that I get
when I'm lookin' at you
691
00:30:42,008 --> 00:30:45,978
* The sun will rise
and fade the stars
692
00:30:46,012 --> 00:30:47,146
The plug
is in position.
693
00:30:47,179 --> 00:30:48,714
You ready to test
the bowel repair?
694
00:30:48,747 --> 00:30:50,816
* And you're leaving me soon
like hell you are
695
00:30:50,849 --> 00:30:52,284
Let's take her
off cardiac support.
696
00:30:52,318 --> 00:30:54,020
Dr. Murphy,
it was your idea.
697
00:30:54,053 --> 00:30:55,521
You do the honors.
698
00:30:55,554 --> 00:30:57,656
**
699
00:31:00,859 --> 00:31:02,294
(CLICKS)
700
00:31:02,328 --> 00:31:03,495
(MONITOR BEEPING STEADILY)
701
00:31:03,529 --> 00:31:06,198
**
702
00:31:06,232 --> 00:31:09,135
Abdominal pressure
is normal.
703
00:31:09,168 --> 00:31:11,603
The intestines
are perfusing.
704
00:31:11,637 --> 00:31:13,672
**
705
00:31:15,241 --> 00:31:17,043
(ALARM BEEPING RAPIDLY)
DR. HAN: Pulmonary
pressure's spiking.
706
00:31:17,076 --> 00:31:18,310
Prostacyclin
and nitric oxide...
707
00:31:18,344 --> 00:31:19,545
We need to get
her lung pressure down.
708
00:31:19,578 --> 00:31:21,147
Oxygen SATs
are dropping.
709
00:31:21,180 --> 00:31:23,215
No response
to pulmonary vasodilators.
710
00:31:23,249 --> 00:31:26,152
DR. HAN:
Now the heart's too strong.
It's overpowering her lungs.
711
00:31:26,185 --> 00:31:27,987
DR. LIM:
She needs to go back
on cardiac support.
712
00:31:28,020 --> 00:31:29,155
(BEEPING CONTINUES)
713
00:31:29,188 --> 00:31:31,157
(CLICKS, BEEPING STEADIES)
714
00:31:31,190 --> 00:31:33,425
**
715
00:31:36,495 --> 00:31:40,199
Persephone won't
starve to death,
716
00:31:40,232 --> 00:31:42,368
but she will drown
in her own fluids.
717
00:31:42,401 --> 00:31:45,004
**
718
00:31:45,037 --> 00:31:47,273
**
719
00:31:50,376 --> 00:31:52,544
**
720
00:31:57,516 --> 00:31:58,884
DR. HAN: I'll talk
to the parents.
721
00:31:58,917 --> 00:32:00,352
May I come?
722
00:32:00,386 --> 00:32:02,554
**
723
00:32:06,258 --> 00:32:08,394
**
724
00:32:11,897 --> 00:32:14,366
Now that Persephone's heart
is pumping at full power,
725
00:32:14,400 --> 00:32:15,801
her lungs
are overwhelmed.
726
00:32:17,970 --> 00:32:19,838
The humane thing
to do
727
00:32:19,871 --> 00:32:22,141
is to turn off the machines
and let her go.
728
00:32:23,375 --> 00:32:25,611
No, I... I can't...
729
00:32:25,644 --> 00:32:27,046
I can't give up on her.
(BREATHES SHARPLY)
730
00:32:27,079 --> 00:32:30,116
**
731
00:32:30,149 --> 00:32:32,884
Because
you fought for her
732
00:32:32,918 --> 00:32:35,221
every minute since
she was born.
733
00:32:35,254 --> 00:32:37,589
Before that, when you were
taking your medication
734
00:32:37,623 --> 00:32:38,757
for the depression,
735
00:32:38,790 --> 00:32:40,926
you were fighting
to keep going
736
00:32:40,959 --> 00:32:42,894
so you could bring her
into the world.
737
00:32:42,928 --> 00:32:45,364
(BREATHING SHAKILY)
738
00:32:45,397 --> 00:32:47,433
**
739
00:32:49,468 --> 00:32:51,637
**
740
00:32:59,011 --> 00:33:01,913
But letting go of Percy
is not giving up on her.
741
00:33:01,947 --> 00:33:03,982
**
742
00:33:04,016 --> 00:33:06,752
It's listening to what
her body is telling us.
743
00:33:06,785 --> 00:33:08,854
**
744
00:33:11,757 --> 00:33:13,125
She's hit her limit.
745
00:33:13,159 --> 00:33:15,361
**
746
00:33:17,363 --> 00:33:18,797
(EXHALES SHARPLY)
747
00:33:18,830 --> 00:33:20,866
**
748
00:33:26,538 --> 00:33:28,674
**
749
00:33:30,209 --> 00:33:32,311
Okay.
750
00:33:32,344 --> 00:33:34,780
**
751
00:33:42,188 --> 00:33:44,723
**
752
00:33:48,527 --> 00:33:50,796
**
753
00:33:50,829 --> 00:33:52,698
(SOBS)
754
00:33:52,731 --> 00:33:56,001
**
755
00:33:56,034 --> 00:33:57,469
(CRYING)
756
00:33:57,503 --> 00:33:59,638
**
757
00:34:04,143 --> 00:34:06,678
(MONITOR BEEPING STEADILY)
758
00:34:06,712 --> 00:34:08,514
DR. HAN: I want Persephone
to look as good as possible
759
00:34:08,547 --> 00:34:10,182
for the parents.
760
00:34:10,216 --> 00:34:13,552
**
761
00:34:13,585 --> 00:34:15,154
(SIGHS)
762
00:34:15,187 --> 00:34:17,055
Let's turn off
cardiac support.
763
00:34:17,089 --> 00:34:19,525
**
764
00:34:19,558 --> 00:34:21,927
(CLICKS, BEEPING)
765
00:34:21,960 --> 00:34:23,395
Ventilator.
766
00:34:23,429 --> 00:34:25,164
**
767
00:34:25,197 --> 00:34:26,865
Let's take
a minute.
768
00:34:26,898 --> 00:34:29,135
(MONITOR BEEPING STEADILY)
769
00:34:29,168 --> 00:34:31,403
**
770
00:34:36,608 --> 00:34:38,744
**
771
00:34:45,251 --> 00:34:47,453
**
772
00:34:52,023 --> 00:34:54,059
(LOUD, RHYTHMIC BEEPING)
773
00:34:54,092 --> 00:34:57,363
**
774
00:34:57,396 --> 00:34:59,398
**
775
00:35:03,635 --> 00:35:05,771
**
776
00:35:09,775 --> 00:35:11,343
SHAUN: Check valve.
777
00:35:11,377 --> 00:35:13,445
**
778
00:35:15,881 --> 00:35:18,384
Every time
the heart contracted,
779
00:35:18,417 --> 00:35:20,686
blood went into the opposite
side of the heart
780
00:35:20,719 --> 00:35:22,554
and raised
lung pressure.
781
00:35:22,588 --> 00:35:25,224
The hole reduced the pressure
when it got too high
782
00:35:25,257 --> 00:35:26,725
because it allowed
backflow.
783
00:35:26,758 --> 00:35:30,061
But our repair of the defect
blocked this backwards flow.
784
00:35:30,095 --> 00:35:32,298
What if we made it so
she still had a heart defect,
785
00:35:32,331 --> 00:35:33,999
but only
when she needed it?
786
00:35:34,032 --> 00:35:38,437
It'd be like an unlatched door
in the wall of the heart.
787
00:35:38,470 --> 00:35:40,706
When the pressure
gets too high
on the right side,
788
00:35:40,739 --> 00:35:43,542
the door swings open,
releasingthe pressure
on the lungs.
789
00:35:43,575 --> 00:35:45,644
The rest of the time,
it stays shut.
790
00:35:45,677 --> 00:35:48,347
It should reduce lung pressure
by a third. Is that enough?
791
00:35:48,380 --> 00:35:49,548
It depends on how high
792
00:35:49,581 --> 00:35:51,550
her pulmonary vascular
resistance is.
793
00:35:51,583 --> 00:35:53,985
PVR is
pulmonary artery pressure
794
00:35:54,019 --> 00:35:56,588
minus wedge pressure divided
by cardiac output times 80.
795
00:35:56,622 --> 00:35:58,790
**
796
00:36:02,261 --> 00:36:04,330
**
797
00:36:07,333 --> 00:36:09,635
CANDICE: The last time
I saw my doctor,
798
00:36:09,668 --> 00:36:12,338
he told me I had
six months to live.
799
00:36:12,371 --> 00:36:14,105
He also told me I should
marry an accountant
800
00:36:14,139 --> 00:36:15,507
and move
to North Dakota.
801
00:36:15,541 --> 00:36:17,008
LARRY:
You don't say.
802
00:36:17,042 --> 00:36:19,811
When I asked if it would
help my cancer, he said no,
803
00:36:19,845 --> 00:36:22,314
just make the six months
seem much longer.
804
00:36:22,348 --> 00:36:24,316
(BOTH LAUGH)
805
00:36:25,884 --> 00:36:29,455
What's the difference between
a Neo-Nazi and cancer?
806
00:36:29,488 --> 00:36:30,822
Cancer doesn't
discriminate.
807
00:36:30,856 --> 00:36:32,424
(CANDICE LAUGHS)
808
00:36:32,458 --> 00:36:34,426
(LARRY LAUGHS)
809
00:36:34,460 --> 00:36:36,127
I knew a guy once,
810
00:36:36,161 --> 00:36:38,664
his Zodiac sign
was Cancer.
811
00:36:38,697 --> 00:36:41,667
It was really ironic
how he died.
812
00:36:43,134 --> 00:36:44,836
Uh, uh, how's that?
813
00:36:44,870 --> 00:36:46,705
He was eaten
by a giant crab.
814
00:36:46,738 --> 00:36:50,542
(LAUGHTER)
Oh, geez.
815
00:36:50,576 --> 00:36:52,110
(LAUGHS)
816
00:36:52,143 --> 00:36:54,212
Aaron, glioma.
817
00:36:54,246 --> 00:36:56,815
Candice, leukemia.
818
00:36:56,848 --> 00:36:58,149
Gin rummy
or blackjack?
819
00:36:58,183 --> 00:37:00,185
How fast do you want
to take my money?
820
00:37:00,218 --> 00:37:01,653
Blackjack.
821
00:37:01,687 --> 00:37:02,988
Cut 'em.
822
00:37:14,700 --> 00:37:16,768
Did you
get it all?
823
00:37:20,372 --> 00:37:21,640
Yes,
824
00:37:21,673 --> 00:37:23,809
totally clear
margins.
825
00:37:23,842 --> 00:37:25,644
But the only way
to achieve that
826
00:37:25,677 --> 00:37:27,779
involved removing the nerve
that controls your left foot.
827
00:37:29,581 --> 00:37:32,918
Rehab and an advanced
orthotic may help,
828
00:37:32,951 --> 00:37:35,521
but you will
walk with a limp.
829
00:37:35,554 --> 00:37:37,689
Final pathology
will let us know
if it was worth it.
830
00:37:42,093 --> 00:37:43,862
I'll let you know
when it comes in.
831
00:37:45,897 --> 00:37:47,899
It doesn't matter
anymore.
832
00:37:51,102 --> 00:37:53,138
It's not like you can
put the tumor back in.
833
00:38:01,246 --> 00:38:03,415
(BABY CRYING)
834
00:38:08,654 --> 00:38:12,223
Is she...okay?
835
00:38:12,257 --> 00:38:15,794
She still has
a surgery or two
in her future, but, yes.
836
00:38:15,827 --> 00:38:17,396
She's gonna be great.
837
00:38:18,697 --> 00:38:21,333
(BREATHES SHARPLY)
(SNIFFLES)
838
00:38:21,800 --> 00:38:23,101
Can I hold her?
839
00:38:23,134 --> 00:38:25,871
I think that would be
very nice.
840
00:38:25,904 --> 00:38:27,706
For both of you.
841
00:38:27,739 --> 00:38:29,975
**
842
00:38:37,015 --> 00:38:38,784
(BABY CRYING)
843
00:38:38,817 --> 00:38:40,852
**
844
00:38:42,954 --> 00:38:45,056
(CRYING) Hi, angel.
845
00:38:45,090 --> 00:38:46,257
**
846
00:38:46,291 --> 00:38:47,426
(BABY COOS)
847
00:38:47,459 --> 00:38:50,228
Oh, my baby.
(SMOOCHES)
848
00:38:50,261 --> 00:38:53,131
**
849
00:38:53,164 --> 00:38:54,566
Come hold her.
850
00:38:54,600 --> 00:38:56,702
**
851
00:39:01,106 --> 00:39:03,509
You were fighting
for her, too.
852
00:39:03,542 --> 00:39:05,644
**
853
00:39:06,378 --> 00:39:08,346
(SNIFFLES)
854
00:39:08,380 --> 00:39:10,649
(BOTH CHUCKLE)
She's beautiful.
855
00:39:10,682 --> 00:39:13,118
**
856
00:39:18,356 --> 00:39:20,125
Nice work.
857
00:39:21,359 --> 00:39:23,429
Thank you.
858
00:39:23,462 --> 00:39:26,197
(BABY CRYING)
She's beautiful.
859
00:39:26,898 --> 00:39:28,600
Listen to her. Oh.
860
00:39:28,634 --> 00:39:31,102
(CRYING)
861
00:39:31,136 --> 00:39:33,171
**
862
00:39:39,845 --> 00:39:41,480
Thank you.
863
00:39:41,513 --> 00:39:43,749
(SIGHS DEEPLY)
864
00:39:46,384 --> 00:39:48,353
Minesh's
biopsy results?
865
00:39:53,391 --> 00:39:55,594
(SIGHS)
866
00:39:58,764 --> 00:39:59,865
You don't want to know
if we wasted our time
867
00:39:59,898 --> 00:40:00,899
almost killing him?
868
00:40:02,400 --> 00:40:04,002
Can't put
the tumor back.
869
00:40:20,251 --> 00:40:22,053
Hello, Dr. Han.
870
00:40:23,121 --> 00:40:24,923
You take
the bus, too?
871
00:40:24,956 --> 00:40:27,025
No, Shaun.
872
00:40:27,058 --> 00:40:28,560
I just wanted
to talk to you.
873
00:40:29,928 --> 00:40:31,830
(INHALES SHARPLY)
874
00:40:31,863 --> 00:40:35,767
You really do have
remarkable diagnostic skills.
875
00:40:36,267 --> 00:40:37,435
I have to admit,
876
00:40:37,469 --> 00:40:38,904
you're an asset
to this hospital.
877
00:40:38,937 --> 00:40:41,039
Yes, I am.
878
00:40:43,942 --> 00:40:47,879
I spoke to the Residency
Director of Pathology.
879
00:40:47,913 --> 00:40:50,415
And we both agree
you'll be a great fit there.
880
00:40:53,184 --> 00:40:56,121
I'm a surgical resident.
881
00:40:56,888 --> 00:40:58,957
As a pathology resident,
882
00:40:58,990 --> 00:41:01,392
you'll touch cases
and lives
883
00:41:01,426 --> 00:41:04,930
across all
the medical departments.
884
00:41:04,963 --> 00:41:07,232
It's an opportunity
for you to help patients
885
00:41:07,265 --> 00:41:10,101
without having to
deal with patients.
886
00:41:11,637 --> 00:41:15,473
Given your difficulties with
communication and social cues,
887
00:41:15,507 --> 00:41:18,644
I think it will be
a much better fit.
888
00:41:18,677 --> 00:41:21,146
No, thank you.
889
00:41:21,179 --> 00:41:24,149
I have been working
very hard
890
00:41:24,182 --> 00:41:27,318
at my communication
skills.
891
00:41:27,352 --> 00:41:30,255
Hard work
isn't enough.
892
00:41:30,288 --> 00:41:31,757
You have to do the job.
893
00:41:34,459 --> 00:41:38,530
I am
a surgical resident.
894
00:41:40,498 --> 00:41:42,333
You were.
895
00:41:43,602 --> 00:41:46,004
And you're gonna do
great work in pathology.
896
00:41:48,506 --> 00:41:51,843
(WYLDER'S "AT THE END PT. 1"
PLAYS)
897
00:41:51,877 --> 00:41:54,980
* Oh, and when the storms come
898
00:41:55,013 --> 00:41:58,349
* Flooding through the hall
899
00:41:58,383 --> 00:42:00,686
* Rising to the landing
900
00:42:00,719 --> 00:42:04,055
* Tearing pictures
from the walls
901
00:42:04,089 --> 00:42:07,759
* The currents
pull us underneath
902
00:42:07,793 --> 00:42:10,962
* That bright tide rips us out
903
00:42:10,996 --> 00:42:13,999
* Into a tangled coral reef
904
00:42:14,032 --> 00:42:17,769
* Where we could never drown
905
00:42:17,803 --> 00:42:20,672
* Now that
906
00:42:20,706 --> 00:42:23,241
* We're at the end *
907
00:42:25,510 --> 00:42:27,713
**
908
00:42:35,386 --> 00:42:37,756
**
909
00:42:43,561 --> 00:42:45,764
**
910
00:42:51,703 --> 00:42:54,072
**
62494
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