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In college,I was the hungover premed
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00:00:06,507 --> 00:00:08,267
who fell asleepat her study carrel.
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00:00:08,399 --> 00:00:09,925
If you'rejust joining our podcast,
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00:00:10,058 --> 00:00:11,849
my guests are doctorsTeddy Altman
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00:00:11,983 --> 00:00:14,407
and Winston Ndugufrom Grey-Sloan Memorial,
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00:00:14,539 --> 00:00:17,660
who pioneered the creationof a ventral aorta surgery.
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At what point did you think,"We just broke new ground"?
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Immediately .
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- Really?- Yeah. Once that staple held,I knew.
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Sometimes you justhave a feeling.
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00:00:26,355 --> 00:00:28,943
In med school, I wasthe famous surgeon's daughter.
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It wasn'tlike that for you?
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00:00:31,101 --> 00:00:32,826
Honestly,there was so muchgoing on that night,
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I didn't have timeto process it all until later.
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NowI'm the famous surgeon.
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- So you had doubts?- Oh, yeah.
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I was never certainit would work,
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but our patientdidn't have any other option.
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I knew that we had to try.
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In medicine,your identity isconstantly changing.
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It's your job to keep up.
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Safe to sayit worked out.
What's next for you both?
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Well,we're still monitoringour patients' progress.
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- And?- So far so good.
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They sound really good,
very competent.
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00:01:00,242 --> 00:01:01,735
Yeah.
I'd come to this hospital.
27
00:01:01,868 --> 00:01:03,063
Well, speaking of...
28
00:01:03,660 --> 00:01:05,518
I made an appointment for you.
29
00:01:06,581 --> 00:01:09,303
We talked
about this, Catherine.
I don't need another opinion.
30
00:01:09,436 --> 00:01:10,829
I like Dr. Freeman.
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I know you do because he goes
along with whatever you want.
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You don't think
doctors should listen
to their patients?
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I think
you need objective advice
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from someone
whose paycheck you don't sign.
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00:01:21,285 --> 00:01:23,111
It's just another opinion.
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00:01:24,802 --> 00:01:25,832
Who am I seeing?
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Kaplan.
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Laura Kaplan? In Boston?
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I thought
you made an appointment here.
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I sent for my plane.
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She landed about an hour ago.
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Morning.
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-Hey.
-Hey.
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00:01:42,991 --> 00:01:44,751
Hey, nice job on that podcast.
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I didn't realize you and Altman
came up with that
at our wedding.
46
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Yeah, you never know
when an idea will strike.
47
00:01:49,762 --> 00:01:51,986
- Mmm.
- Go ahead, Dr. Adams.
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00:01:52,118 --> 00:01:53,779
Uh, yes. Uh, Jo Wilson.
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Post-op day seven
from emergency C-section
and Impella CP placement.
50
00:01:58,291 --> 00:02:00,814
Now post-op day three
from a 5.5 placement
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00:02:00,948 --> 00:02:02,340
through
the right axillary artery.
52
00:02:02,473 --> 00:02:04,764
Her heart function
continues to recover
53
00:02:04,897 --> 00:02:06,589
with her EF up
another five percent,
54
00:02:06,723 --> 00:02:09,310
and I heard she got
to meet her babies yesterday.
55
00:02:09,443 --> 00:02:11,202
-How are they doing?
-Hmm.
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00:02:11,334 --> 00:02:13,592
Peyton's off of CPAP
but still fragile.
57
00:02:13,726 --> 00:02:15,551
Hattie's bilirubin levels
are bad
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00:02:15,684 --> 00:02:18,041
every time
they pause phototherapy.
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00:02:18,172 --> 00:02:20,032
And you're all headed
in the right direction.
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That's what matters.
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I just...
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really want the six of us
to finally be together.
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Jo, you will never guess
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- who Marcus walked out with last night.
- -Who?
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00:02:29,923 --> 00:02:31,315
- Dr. Ndugu.
- Hey.
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00:02:31,448 --> 00:02:33,739
-I didn't know
you were doing rounds.
-Yeah.
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I'll come back later.
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00:02:39,846 --> 00:02:41,272
What was that?
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-What was what?
-Did you sleep with
my favorite nurse?
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00:02:44,560 --> 00:02:46,020
-Jo...
-Uh, should I leave?
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00:02:46,151 --> 00:02:47,679
We've just gone out
a couple times.
That's all.
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00:02:47,811 --> 00:02:49,671
Well, are you gonna
take her out again?
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Uh, just... Maybe.
It's new and--
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00:02:52,158 --> 00:02:53,621
And none of our business.
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00:02:53,753 --> 00:02:57,437
She is
the entire department's
favorite nurse.
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00:02:57,968 --> 00:03:00,358
Everybody loves her. Everyone.
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00:03:05,102 --> 00:03:06,664
- Hormones.
- Okay.
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00:03:06,796 --> 00:03:09,518
Uh, I-I need
to check on my next patient.
Are you gonna be okay?
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00:03:09,651 --> 00:03:12,406
-Yeah.
-Uh, page me
if you need anything.
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00:03:16,388 --> 00:03:17,418
Good morning.
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00:03:17,550 --> 00:03:18,613
Traitor.
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-Trouble in paradise?
-I broke our pact.
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00:03:20,902 --> 00:03:22,762
-She's bitter.
-Then you should break it too.
84
00:03:23,326 --> 00:03:24,553
What,
I can just snap my fingers?
85
00:03:24,686 --> 00:03:25,880
Who am I
supposed to sleep with?
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00:03:26,012 --> 00:03:28,999
I ordered an X-ray
for Ms. Johnson's left arm.
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00:03:29,499 --> 00:03:31,158
It was the right arm,
wasn't it?
88
00:03:31,656 --> 00:03:33,016
I will fix it.
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00:03:34,445 --> 00:03:36,103
An intern? Please.
I have dignity.
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00:03:36,236 --> 00:03:38,294
-Don't knock it
until you've tried it.
-Tried what?
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00:03:38,857 --> 00:03:39,986
Vegan sloppy joes.
92
00:03:40,119 --> 00:03:41,447
You sleeping
with an intern too?
93
00:03:41,580 --> 00:03:43,505
Wait. Who's
sleeping with an intern?
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00:03:43,638 --> 00:03:45,298
I am. Who are you texting?
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00:03:45,430 --> 00:03:46,724
Nobody.
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00:03:46,857 --> 00:03:48,650
-Doesn't look like nobody.
-Nah, she's just a patient.
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00:03:48,781 --> 00:03:50,342
Why are you texting a patient?
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00:03:50,475 --> 00:03:52,433
Yeah, well, Bailey made me
drive her an hour
to get treatment,
99
00:03:52,566 --> 00:03:53,926
and now she's sending me
dumb memes.
100
00:03:54,059 --> 00:03:55,553
-It's nothing.
-Wear a condom.
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00:03:55,686 --> 00:03:57,113
She's a cancer patient.
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00:03:57,578 --> 00:03:59,702
Hey. Did you see
that I admitted Mr. Howard?
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00:03:59,834 --> 00:04:01,394
You don't have to put
your phone down.
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00:04:01,528 --> 00:04:02,821
-It's fine.
-Sorry.
105
00:04:02,954 --> 00:04:05,477
My phone has been blowing up
since the podcast dropped.
106
00:04:05,610 --> 00:04:07,137
I listened. You sounded great.
107
00:04:07,269 --> 00:04:09,228
Well, now I've got
doctors reaching out
about their patients,
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00:04:09,360 --> 00:04:10,687
and the department chief
from Mass General
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has asked me
to do grand rounds.
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Hmm. Sounds rough.
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00:04:13,442 --> 00:04:15,368
Well, it's not like I'm getting
a Nobel Prize.
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I mean, MGH asks
everyone to guest lecture.
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They never asked me,
and I went to Harvard.
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00:04:19,450 --> 00:04:22,504
Anyway, so, Mr. Howard,
his EKG shows
a conduction block.
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00:04:22,635 --> 00:04:26,918
-Do you want an echo?
-Um, yes.
Sorry, I have to take this.
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00:04:27,051 --> 00:04:28,676
Hi, this is Altman.
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00:04:28,809 --> 00:04:32,826
Hi, Janet, I'm, uh, Dr. Millin.
I hear you're having
some leg pain.
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00:04:32,958 --> 00:04:34,319
Yeah, and some heaviness.
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00:04:34,453 --> 00:04:35,712
I'm concerned
it might be a DVT.
120
00:04:35,846 --> 00:04:37,107
I think
she should have an ultrasound.
121
00:04:37,240 --> 00:04:38,666
I assume
you want a full work up.
122
00:04:38,800 --> 00:04:41,753
CBC, D-dimer,
and a duplex ultrasound?
123
00:04:42,716 --> 00:04:43,978
I'm Jules Millin.
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00:04:44,110 --> 00:04:46,632
I'm a second-year
surgical resident.
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00:04:46,766 --> 00:04:47,861
You're
internal medicine, right?
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00:04:48,790 --> 00:04:51,213
Oh, no. Oh. I'm not a doctor.
Sorry. Yeah.
127
00:04:51,346 --> 00:04:52,905
-Oh, we were role-playing.
-Yeah.
128
00:04:53,039 --> 00:04:54,797
The more medical terms,
the better it gets.
129
00:04:54,931 --> 00:04:57,387
-Yeah.
-So, Hal does his homework.
130
00:04:58,580 --> 00:05:01,037
-So do you have
leg pain or is this--
-Oh, no, that's real.
131
00:05:01,170 --> 00:05:02,763
The pain started this morning
when we were trying
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00:05:02,896 --> 00:05:04,257
to squeeze in a quickie
before work.
133
00:05:05,451 --> 00:05:07,210
- May I do an exam?
- Mm-hmm.
134
00:05:09,434 --> 00:05:12,454
Um, how long
did the pain last for?
135
00:05:12,587 --> 00:05:14,544
-Uh, a few hours?
-Yeah.
136
00:05:14,679 --> 00:05:16,272
We've been trying
to spice things up lately,
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00:05:16,404 --> 00:05:19,226
so we just wanna
make sure we haven't,
uh, caused a problem.
138
00:05:19,856 --> 00:05:21,482
Oh, um...
139
00:05:21,616 --> 00:05:26,860
DVTs usually occur
with less, um, activity,
140
00:05:26,992 --> 00:05:30,908
but it is better
to be safe than sorry,
so I will order some tests.
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00:05:31,042 --> 00:05:32,966
- All right.
- And get back to you.
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00:05:33,099 --> 00:05:34,493
-Okay. Thank you.
-Thank you.
143
00:05:36,186 --> 00:05:37,313
Dr. Griffith.
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00:05:37,813 --> 00:05:41,463
A 38-year-old female with
a large mediastinal teratoma
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- that has been resistant
to chemotherapy.
146
00:05:44,218 --> 00:05:45,943
Presents with progressive
shortness of breath,
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00:05:46,077 --> 00:05:47,239
orthopnea, and angina.
148
00:05:47,403 --> 00:05:48,931
It has to be
at least 35 pounds.
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00:05:49,064 --> 00:05:52,084
And, uh, 27 centimeters
for the longest diameter.
150
00:05:52,217 --> 00:05:55,602
The tumor is displacing
the heart and great vessels.
151
00:05:55,735 --> 00:05:57,892
The SVC is compressed,
152
00:05:58,025 --> 00:06:01,045
and it's also indenting
the right lobe of the liver.
153
00:06:01,178 --> 00:06:02,539
Hmm. How are the lungs?
154
00:06:02,672 --> 00:06:04,032
Compressed with
near total collapse
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00:06:04,166 --> 00:06:05,260
of the mid-right
and lower lobes.
156
00:06:05,393 --> 00:06:07,185
Has anyone tried to operate
on the thing?
157
00:06:07,318 --> 00:06:09,542
Her name is London
158
00:06:09,675 --> 00:06:12,330
and, yes, there have been
two attempts at Seattle Pres.
159
00:06:12,463 --> 00:06:16,445
They had to abort both times
because she arrested
on the table.
160
00:06:16,579 --> 00:06:18,769
But you believe you would have
a different outcome
if you tried?
161
00:06:18,901 --> 00:06:22,586
Well, I have removed
extremely difficult
tumors before,
162
00:06:22,719 --> 00:06:24,876
and this one is benign.
163
00:06:25,009 --> 00:06:29,622
So, if we can
successfully remove it,
then she resumes a normal life.
164
00:06:29,755 --> 00:06:31,680
Even if
you convinced anesthesia,
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00:06:31,813 --> 00:06:34,435
you could still encounter
catastrophic bleeding.
166
00:06:34,568 --> 00:06:36,957
And that is why I'm here
at the tumor board,
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00:06:37,089 --> 00:06:41,239
where people
help their colleagues
to come up with a plan.
168
00:06:41,372 --> 00:06:46,184
If anyone here thinks this
remotely is a possibility,
please speak up.
169
00:06:46,317 --> 00:06:47,478
Yes.
170
00:06:53,187 --> 00:06:55,146
It's a tragic case,
Dr. Bailey, but...
171
00:06:56,340 --> 00:06:58,664
- It's a lawsuit
waiting to happen.
172
00:07:01,452 --> 00:07:02,481
I'll do it with you.
173
00:07:06,829 --> 00:07:09,284
- The alternative
is hospice, right?
174
00:07:09,418 --> 00:07:10,943
Dr. Hunt,
it just can't be done.
175
00:07:11,077 --> 00:07:13,466
Yeah, well,
you don't know
what we're capable of.
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00:07:18,578 --> 00:07:20,602
-Bye.
-I knew you'd have an idea.
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00:07:20,736 --> 00:07:22,129
Yeah, I got nothing.
178
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What?
179
00:07:37,430 --> 00:07:39,089
Well, look who's here.
180
00:07:39,620 --> 00:07:41,048
How was your flight?
181
00:07:41,180 --> 00:07:43,504
- Most quiet I've had
in months.
- Oh, great.
182
00:07:43,637 --> 00:07:45,594
-Dr. Webber, it's a pleasure.
-Hi.
183
00:07:46,391 --> 00:07:47,652
I've heard a lot about you.
184
00:07:47,785 --> 00:07:49,013
All good things.
185
00:07:49,146 --> 00:07:51,569
Catherine's thrilled you
joined the team in Boston.
186
00:07:51,702 --> 00:07:53,892
She's thrilled she poached me
from Sloan Kettering.
187
00:07:54,025 --> 00:07:58,373
You are at the forefront
of urologic oncology,
and that lecture that you gave
188
00:07:58,506 --> 00:08:00,828
to the
American Urological Association
last month
189
00:08:00,962 --> 00:08:02,555
brought the house down.
190
00:08:02,687 --> 00:08:07,998
And she is developing
a program that uses AI
to study biomarkers.
191
00:08:08,131 --> 00:08:09,591
We just received another grant
for it yesterday.
192
00:08:09,724 --> 00:08:10,985
You bet you did.
193
00:08:11,118 --> 00:08:14,038
Now, tell us about
my husband's prostate.
194
00:08:14,172 --> 00:08:15,366
Catherine, please.
195
00:08:16,727 --> 00:08:19,017
-If now's not a good time--
-Don't be ridiculous.
196
00:08:19,150 --> 00:08:20,643
Come on, everybody. Sit down.
197
00:08:20,776 --> 00:08:22,635
Have a seat. Come on.
198
00:08:24,195 --> 00:08:25,822
Good news is
you caught it early.
199
00:08:25,954 --> 00:08:27,514
Grade group two,
a seven Gleason.
200
00:08:27,647 --> 00:08:31,099
Well, he knows all of that.
So tell us,
what do you suggest?
201
00:08:31,695 --> 00:08:32,891
Well, given
the cancer's localized,
202
00:08:33,023 --> 00:08:34,650
and you're
generally in good health,
203
00:08:34,783 --> 00:08:36,542
I recommend
a radical prostatectomy.
204
00:08:37,172 --> 00:08:38,600
I couldn't agree more.
205
00:08:39,363 --> 00:08:40,989
If you're worried
about side effects,
206
00:08:41,122 --> 00:08:44,740
urinary incontinence,
erectile dysfunction,
they are a risk.
207
00:08:44,872 --> 00:08:47,162
-But for many men--
-What about infection?
208
00:08:47,627 --> 00:08:49,851
It's unlikely but possible.
209
00:08:49,984 --> 00:08:54,929
Blood clots, stroke,
injury to the rectum,
bladder, nerves?
210
00:08:55,062 --> 00:08:56,555
They're all possible too,
right?
211
00:08:59,741 --> 00:09:00,771
Yeah.
212
00:09:02,197 --> 00:09:03,525
Thank you for your time,
213
00:09:03,658 --> 00:09:06,545
but I've already selected
an option with my own doctor.
214
00:09:07,242 --> 00:09:08,238
Watchful waiting.
215
00:09:08,372 --> 00:09:10,031
I've got patients to see.
216
00:09:16,569 --> 00:09:18,229
Not seeing abnormalities.
217
00:09:18,361 --> 00:09:19,556
What's that wand called?
218
00:09:19,689 --> 00:09:20,817
An ultrasound probe.
219
00:09:20,951 --> 00:09:22,012
-Write that down.
-Okay.
220
00:09:23,506 --> 00:09:25,830
Right,
the ultrasound is negative.
221
00:09:26,360 --> 00:09:27,787
So, she doesn't have a clot?
222
00:09:27,920 --> 00:09:29,148
Not that I can see.
223
00:09:29,282 --> 00:09:31,007
Sounds like maybe
there still might be one...
224
00:09:31,139 --> 00:09:33,165
Well, your D-dimer
was slightly elevated,
225
00:09:33,297 --> 00:09:34,658
which is the marker
we look at for clots.
226
00:09:34,791 --> 00:09:37,147
It doesn't necessarily
mean anything,
but it is reason
227
00:09:37,280 --> 00:09:38,574
to come back
if you have any more pain.
228
00:09:38,707 --> 00:09:41,794
Maybe I just need to stretch
before I go to the doctor.
229
00:09:41,926 --> 00:09:43,122
- Mmm.
- Stretch?
230
00:09:43,254 --> 00:09:44,349
Uh, don't ask any questions.
231
00:09:44,482 --> 00:09:46,474
I'm gonna start your,
um, discharge paperwork.
232
00:09:47,336 --> 00:09:48,531
What was that all about?
233
00:09:48,664 --> 00:09:50,457
They like to role-play
doctor and patient in bed.
234
00:09:50,589 --> 00:09:52,049
Good for them.
235
00:09:53,842 --> 00:09:55,999
They're so cute.
236
00:09:56,829 --> 00:09:58,124
Rustic cute?
237
00:09:58,256 --> 00:10:00,149
Five reviews say
those rockers broke
within a year.
238
00:10:01,343 --> 00:10:02,935
How's the lake house?
239
00:10:03,070 --> 00:10:06,454
We've moved
from arguing over tile
to arguing over porch chairs.
240
00:10:07,649 --> 00:10:09,044
How was the tumor board?
241
00:10:09,175 --> 00:10:12,993
Uh, unfortunately,
they are concerned
about the risks
242
00:10:13,158 --> 00:10:15,747
and recommend
that we don't proceed.
243
00:10:15,880 --> 00:10:21,223
So naturally
I called in reinforcements.
This is Dr. Owen Hunt.
244
00:10:21,356 --> 00:10:23,845
-He's one of
our trauma surgeons.
-Hi.
245
00:10:23,979 --> 00:10:26,069
If it's okay with you,
I'd like to work
with Dr. Bailey
246
00:10:26,202 --> 00:10:28,791
to make sure that we've
explored every possible option.
247
00:10:28,925 --> 00:10:30,318
I want to help.
248
00:10:30,450 --> 00:10:32,176
- I like him.
- Mmm.
249
00:10:33,007 --> 00:10:35,860
If everyone else
has reservations,
why do you think you can do it?
250
00:10:36,458 --> 00:10:42,333
Charlie, we've actually found
surgeons that are not
giving us a hard no.
251
00:10:42,465 --> 00:10:44,523
And I've almost lost you twice.
252
00:10:44,656 --> 00:10:48,107
I'm definitely not ready
to lose you today
from some botched operation.
253
00:10:48,241 --> 00:10:51,593
-Neither are we.
-Hey, I'm still here.
254
00:10:52,290 --> 00:10:54,613
They're just asking
if they can go work on a plan.
255
00:10:55,210 --> 00:10:58,629
If their plan leads
to us growing old together,
256
00:10:58,762 --> 00:11:04,304
looking at the water
from shoddy but very cute
rocking chairs...
257
00:11:05,898 --> 00:11:08,520
I'm in. Aren't you?
258
00:11:12,702 --> 00:11:14,694
You really think you can
figure out a way to keep
259
00:11:14,827 --> 00:11:16,485
her heart from stopping
when she's on that table?
260
00:11:16,618 --> 00:11:19,505
Look, if we can't
figure this out,
we won't proceed, right?
261
00:11:19,639 --> 00:11:21,961
That was our deal
when you two came to me.
262
00:11:23,588 --> 00:11:25,414
Okay, work on your plan.
263
00:11:25,546 --> 00:11:27,339
-Okay.
-We'll be back.
264
00:11:27,471 --> 00:11:28,799
Okay.
265
00:11:35,536 --> 00:11:38,756
Hi, my cuties.
266
00:11:40,716 --> 00:11:42,707
They look bigger.
Did they get bigger?
267
00:11:42,838 --> 00:11:45,726
Hattie's put on a full ounce
in the last 24 hours,
268
00:11:45,858 --> 00:11:47,983
-and Peyton isn't far behind.
-That's right.
269
00:11:48,115 --> 00:11:49,677
Lincolns know how to bulk.
270
00:11:52,929 --> 00:11:54,622
I gotta go to PT.
Sure you're okay?
271
00:11:54,754 --> 00:11:56,181
-Yeah.
-Okay. You sure?
272
00:11:56,314 --> 00:11:57,442
Yeah.
273
00:11:58,703 --> 00:12:00,496
-All right.
-Okay.
274
00:12:01,923 --> 00:12:03,350
-See you soon.
-Yeah.
275
00:12:05,906 --> 00:12:07,533
You're Peyton and Hattie's mom?
276
00:12:08,262 --> 00:12:10,387
Mm-hmm.
277
00:12:12,178 --> 00:12:14,170
Sorry, it's just that, um...
278
00:12:14,900 --> 00:12:18,219
That's the first time that
somebody's called me their mom.
279
00:12:19,415 --> 00:12:20,444
Here.
280
00:12:22,169 --> 00:12:24,625
Oh, wait, that one's not clean.
281
00:12:26,019 --> 00:12:27,014
-Here.
-Thanks.
282
00:12:27,645 --> 00:12:31,031
I'm an OB-GYN,
and I talk to my patients
283
00:12:31,163 --> 00:12:33,719
all the time about
postpartum hormone drops,
284
00:12:33,852 --> 00:12:37,768
but I had no idea it was
this intense and just random.
285
00:12:38,267 --> 00:12:42,283
Yesterday, my boyfriend and I
were buying diapers for me
not the baby,
286
00:12:42,416 --> 00:12:46,929
and the guy ringing me up
said, "Will that be all?"
And I burst into tears.
287
00:12:47,062 --> 00:12:49,086
It's nice to know
that I'm not alone.
288
00:12:51,542 --> 00:12:53,136
What?
289
00:12:53,269 --> 00:12:55,093
You're my first mom friend.
290
00:12:55,691 --> 00:12:58,215
Oh. I'm honored.
291
00:12:58,347 --> 00:13:00,935
Did you tear or...
Can I ask you that?
292
00:13:01,067 --> 00:13:04,355
Yeah, you can ask me anything,
but, um, no, I-I didn't tear.
293
00:13:04,486 --> 00:13:08,271
I, uh...
...I had something called
a crash C-section.
294
00:13:08,402 --> 00:13:10,428
Oh, tell me everything.
295
00:13:12,916 --> 00:13:13,946
I'll be back.
296
00:13:14,079 --> 00:13:16,170
Richard,
what the hell are you doing?
297
00:13:16,834 --> 00:13:18,692
I'm about to check
Mr. Tolli's wound VAC.
298
00:13:18,825 --> 00:13:21,248
You said
you would hear Kaplan out.
299
00:13:21,380 --> 00:13:23,073
I did.
300
00:13:23,207 --> 00:13:25,165
Is this because you're worried
about the bedroom?
301
00:13:25,297 --> 00:13:27,986
Because you know
we'll figure that out.
302
00:13:30,342 --> 00:13:31,403
Come on.
303
00:13:37,245 --> 00:13:38,539
I'm not having
this conversation here.
304
00:13:38,673 --> 00:13:40,963
Is this because
you prefer a male doctor?
305
00:13:41,097 --> 00:13:42,356
Now that's insulting!
306
00:13:42,489 --> 00:13:44,017
Well, I'm just trying
to understand why
307
00:13:44,149 --> 00:13:47,401
you would dismiss
a top urologist
like she's an intern.
308
00:13:47,534 --> 00:13:49,426
I moved mountains
to bring her here for you.
309
00:13:49,559 --> 00:13:50,720
I didn't ask you to.
310
00:13:51,949 --> 00:13:53,841
Now, my cancer
hasn't metastasized.
311
00:13:53,974 --> 00:13:56,462
Watchful waiting is
a perfectly reasonable option.
312
00:13:57,094 --> 00:14:00,115
I respected
your health care decisions
even when I didn't agree.
313
00:14:00,910 --> 00:14:02,636
I need you
to do the same for me.
314
00:14:04,561 --> 00:14:07,084
...1962.
315
00:14:07,216 --> 00:14:09,706
-Who was the surgeon
at Seattle Pres?
-Collins.
316
00:14:09,839 --> 00:14:13,423
Yeah, he actually
did his residency here
a couple of years behind me.
317
00:14:13,555 --> 00:14:17,008
When his chief
wouldn't let him try again,
he sent London to me.
318
00:14:17,140 --> 00:14:19,231
If she codes the minute
she lays on the table,
319
00:14:19,363 --> 00:14:21,056
why didn't they try
a reverse Trendelenburg?
320
00:14:21,188 --> 00:14:23,645
Keep her at an incline
to take the pressure off
some of the cardiac vessels?
321
00:14:23,779 --> 00:14:26,400
Oh, no, they did.
Uh, but see how compressed
they are?
322
00:14:26,533 --> 00:14:28,059
It wasn't enough.
323
00:14:28,192 --> 00:14:29,886
Okay, what about
conscious sedation
instead of general anesthesia?
324
00:14:30,018 --> 00:14:32,507
She'd continue
to breathe on her own,
which would help
325
00:14:32,641 --> 00:14:35,361
blood return back to the heart
and minimize airway collapse.
326
00:14:35,494 --> 00:14:37,785
I mean,
it might help some...
327
00:14:37,918 --> 00:14:39,777
The tumor's matured
into its own ecosystem.
328
00:14:39,909 --> 00:14:41,335
You can see the calcifications,
329
00:14:41,469 --> 00:14:45,385
-fat, the cystic components.
-Yeah? What?
330
00:14:45,517 --> 00:14:47,809
What if we drain it?
Shrink the mass
before we go in?
331
00:14:47,940 --> 00:14:49,998
It's a good idea,
but the location
is just too risky.
332
00:14:50,131 --> 00:14:52,388
We can't risk
the contents of the tumor
spilling into the chest.
333
00:14:52,521 --> 00:14:54,213
It would just regrow.
334
00:14:54,346 --> 00:14:55,609
I gotta run to a consult
in the pit,
335
00:14:55,741 --> 00:14:56,902
but I will
keep thinking on this.
336
00:14:57,034 --> 00:14:59,092
No promises though.
337
00:15:00,154 --> 00:15:04,403
Adams, Griffith, let's look up
every case report published
on mediastinal teratomas.
338
00:15:04,536 --> 00:15:07,224
Research patterns,
cross-reference solutions,
okay?
339
00:15:08,319 --> 00:15:09,879
We all just listened
to a podcast this morning
340
00:15:10,012 --> 00:15:11,605
about how our hospital
pulled off a miracle.
341
00:15:11,739 --> 00:15:14,061
Who's to say
we can't do it again,
right? Go.
342
00:15:17,049 --> 00:15:19,306
We're gonna
come up with something.
343
00:15:20,965 --> 00:15:22,426
-Hey.
-Hi.
344
00:15:22,558 --> 00:15:24,980
-Are you done with that tablet?
-Nope, get your own.
345
00:15:25,114 --> 00:15:28,067
Bailey and Hunt have
a massive mediastinal teratoma.
346
00:15:28,533 --> 00:15:30,591
If you sweet-talk Bailey,
you can get in on it with us.
347
00:15:30,724 --> 00:15:31,720
They're looking for ideas.
348
00:15:31,851 --> 00:15:33,346
I'm too swamped down here.
349
00:15:34,308 --> 00:15:36,730
Hey, I'm sorry
about this morning.
350
00:15:36,862 --> 00:15:38,854
- Jo's crying
about everything these days.
- It's fine.
351
00:15:38,987 --> 00:15:43,502
But she loves Iris,
so she'll be happy
if you two are a thing.
352
00:15:50,571 --> 00:15:52,563
-Why are you acting weird?
-I'm not acting weird.
353
00:15:52,694 --> 00:15:54,554
Yeah, you are.
354
00:15:54,685 --> 00:15:56,910
-Help. Help my wife! Help.
-Hal?
355
00:15:57,042 --> 00:15:58,735
- Sir, you might
wanna button that.
- Oh, my God. Janet.
356
00:16:03,516 --> 00:16:04,776
I'm getting weak pulses.
357
00:16:05,341 --> 00:16:07,597
Janet, look at me.
I'm going to care of you, okay?
358
00:16:08,061 --> 00:16:09,588
We need a gurney in here!
359
00:16:16,493 --> 00:16:18,484
The plane won't be ready
for another couple of hours.
360
00:16:18,649 --> 00:16:21,570
-Catherine said
I could work in here.
-Not a problem.
361
00:16:24,889 --> 00:16:26,284
I owe you an apology.
362
00:16:27,180 --> 00:16:29,967
I was led to believe
that you were the one
seeking a second opinion.
363
00:16:30,101 --> 00:16:31,329
You couldn't have known.
364
00:16:31,926 --> 00:16:33,485
I should have
at least suspected.
365
00:16:34,084 --> 00:16:35,676
I think your wife
broke contract laws
366
00:16:35,809 --> 00:16:37,236
to ensure my employment
at her hospital.
367
00:16:37,370 --> 00:16:38,530
Don't feel bad.
368
00:16:38,663 --> 00:16:41,749
You're not the first
to fall prey to her ways.
369
00:16:42,281 --> 00:16:44,471
- I'm guessing
I won't be the last.
370
00:16:44,604 --> 00:16:46,298
She does it 'cause she cares.
371
00:16:47,294 --> 00:16:48,953
That's
what makes it infuriating.
372
00:16:53,565 --> 00:16:54,594
Feel free to say no.
373
00:16:55,656 --> 00:16:58,510
But I've got a patient with
a retroperitoneal tumor,
374
00:16:58,643 --> 00:17:03,356
and I would be remiss
if I didn't ask Fox Hospitals'
Chief of Chiefs for a consult.
375
00:17:04,817 --> 00:17:07,307
-No. Got a little time.
-Yeah.
376
00:17:07,439 --> 00:17:11,256
How about we get
a couple of pastries
to go with this coffee?
377
00:17:11,720 --> 00:17:13,745
- Thank you.
That would be great.
378
00:17:14,974 --> 00:17:16,866
"Twenty-two-pound teratoma
in the abdomen.
379
00:17:17,562 --> 00:17:21,779
San Francisco, 2018."
They started with
a CT-guided drainage.
380
00:17:21,911 --> 00:17:23,403
Yeah, but look at
the picture of the CT.
381
00:17:23,536 --> 00:17:24,865
Nowhere near the heart.
382
00:17:24,997 --> 00:17:26,922
Another dead end.
383
00:17:28,647 --> 00:17:30,043
Another dumb meme
from your patient?
384
00:17:30,175 --> 00:17:31,668
No, she's asking
for movie recs.
385
00:17:32,331 --> 00:17:33,427
She's stuck at home.
386
00:17:34,092 --> 00:17:36,547
Not exactly
a doctor-patient
conversation topic.
387
00:17:37,310 --> 00:17:39,866
She's Bailey's patient.
She has
stage four gastric cancer.
388
00:17:40,000 --> 00:17:41,991
She can ask whatever she wants.
389
00:17:42,123 --> 00:17:43,483
I mean, shouldn't you
keep it professional?
390
00:17:43,617 --> 00:17:45,442
Look, you have no idea what
you're talking about. It's--
391
00:17:45,574 --> 00:17:47,334
I'm just saying, you're young,
you're single. You...
392
00:17:48,163 --> 00:17:50,553
You look like
you might be leading her on.
393
00:17:51,948 --> 00:17:53,110
I'm her doctor.
394
00:17:53,241 --> 00:17:54,769
And she's a vulnerable patient.
395
00:17:55,566 --> 00:17:57,257
I don't...
I don't need this right now.
396
00:17:57,390 --> 00:17:59,648
-I'm just trying
to look out for you.
-Yeah, try less.
397
00:18:02,170 --> 00:18:03,830
Hunt's asking for an update.
398
00:18:06,418 --> 00:18:09,140
- Okay, anything?
- Not yet. Thanks.
399
00:18:12,824 --> 00:18:16,341
Why did you join this case
when everyone else
dismissed it?
400
00:18:16,476 --> 00:18:17,638
It's like you said,
it's benign.
401
00:18:17,770 --> 00:18:19,562
Once it's out,
she moves on with her life.
402
00:18:19,695 --> 00:18:22,350
There's no worry
of mets or recurrence.
403
00:18:25,369 --> 00:18:28,856
Yeah...
...I might be feeling
a little uninspired lately.
404
00:18:28,987 --> 00:18:32,606
Uh-huh. Wouldn't have to do
with other people solving
405
00:18:32,738 --> 00:18:34,961
cases at weddings
and doing podcasts, would it?
406
00:18:37,119 --> 00:18:38,481
I see you at drop-off.
407
00:18:38,613 --> 00:18:40,738
I know everything's falling
on you right now.
408
00:18:40,870 --> 00:18:44,188
She's lecturing
and you're packing lunches.
409
00:18:44,322 --> 00:18:47,343
I'm happy to do it,
and she deserves
all the attention.
410
00:18:47,972 --> 00:18:50,130
I just think this tumor was...
411
00:18:51,823 --> 00:18:53,183
I don't know.
412
00:18:53,317 --> 00:18:56,536
My patient cannot be the fix
to get you out of this slump.
413
00:18:57,499 --> 00:18:58,827
What have you got?
414
00:18:58,958 --> 00:19:01,481
Ten cases, at least half of
them considered inoperable.
415
00:19:01,614 --> 00:19:03,837
And none of the masses
are nearly the same size.
416
00:19:03,969 --> 00:19:06,061
There's one case that reported
a similar arrest in the OR,
417
00:19:06,194 --> 00:19:07,853
but the team
never tried it again
418
00:19:07,986 --> 00:19:10,044
because they couldn't
safely find a way
around the heart and lungs.
419
00:19:10,609 --> 00:19:13,097
Which is exactly what
happened with London.
420
00:19:13,231 --> 00:19:15,754
As difficult as this is
for me to say...
421
00:19:17,047 --> 00:19:19,071
I think we're out of options.
422
00:19:19,205 --> 00:19:20,467
What about ECMO?
423
00:19:20,599 --> 00:19:22,225
What about it?
424
00:19:22,359 --> 00:19:25,146
We need to bypass
the pulmonary system,
so why don't we use ECMO?
425
00:19:25,279 --> 00:19:26,937
The machine
oxygenates and pumps the blood
426
00:19:27,071 --> 00:19:28,730
so her heart and lungs
don't have to.
427
00:19:28,862 --> 00:19:33,377
There is no arrest
if the machine is acting
as her heart.
428
00:19:35,037 --> 00:19:37,924
Don't say no yet.
I'm gonna go find Ndugu.
429
00:19:38,489 --> 00:19:39,517
Okay.
430
00:19:41,509 --> 00:19:42,868
Almost there, Janet.
431
00:19:43,003 --> 00:19:45,126
If this is a clot,
you can fix it, right?
432
00:19:46,587 --> 00:19:48,843
Blood clots are treatable
if you catch them in time,
433
00:19:48,977 --> 00:19:50,238
so it's a good thing
you're here.
434
00:19:52,163 --> 00:19:53,424
Weird but good.
435
00:19:53,557 --> 00:19:56,444
I should
probably be embarrassed,
but I'm proud of us.
436
00:19:56,578 --> 00:19:58,733
All my friends
got bored of their spouses
437
00:19:58,866 --> 00:20:02,386
and filed for divorce,
but we got creative.
438
00:20:02,518 --> 00:20:04,707
By coming to the hospital
and having sex.
439
00:20:05,904 --> 00:20:08,591
Don't be jealous.
I'm sure other people
aren't getting any either.
440
00:20:08,724 --> 00:20:10,518
All right, let me see.
441
00:20:13,339 --> 00:20:16,127
Looks like there's
a left iliac vein thrombosis.
442
00:20:16,259 --> 00:20:17,819
Hal was right. DVT.
443
00:20:17,952 --> 00:20:21,205
If you look closely,
the iliac artery is
compressing the vein.
444
00:20:21,337 --> 00:20:23,196
-May-Thurner syndrome.
-Mm-hmm.
445
00:20:23,328 --> 00:20:24,922
All right, let's book
an angio suite
446
00:20:25,054 --> 00:20:28,472
for a thrombectomy
and iliac vein stenting
and start practicing.
447
00:20:28,604 --> 00:20:30,963
I'm gonna supervise
you doing the procedure.
448
00:20:32,522 --> 00:20:34,082
-Me?
-She means me.
449
00:20:34,879 --> 00:20:38,231
I don't care who it is
as long as you guys
are prepped and ready to go.
450
00:20:42,214 --> 00:20:43,540
You really think
this will work?
451
00:20:43,674 --> 00:20:46,694
The challenge, right,
has always been the pressure
452
00:20:46,827 --> 00:20:49,084
that your tumor is
putting on your heart,
453
00:20:49,217 --> 00:20:52,668
your lungs and major arteries
when you're positioned
for surgery.
454
00:20:52,802 --> 00:20:54,360
And the ECMO machine
makes that irrelevant
455
00:20:54,493 --> 00:20:56,518
because it oxygenates
and pumps your blood for you.
456
00:20:56,651 --> 00:20:59,406
So no matter what happens,
your body will receive oxygen
457
00:20:59,538 --> 00:21:01,132
and blood flow while we work.
458
00:21:01,929 --> 00:21:04,020
I can't believe you
actually figured it out.
459
00:21:04,152 --> 00:21:07,273
Have you done this before?
I mean, how common
is this ECMO?
460
00:21:07,404 --> 00:21:10,325
Charlie, you said you were in
if they figured it out.
461
00:21:10,458 --> 00:21:11,986
How common is it?
462
00:21:12,118 --> 00:21:15,172
It's not common for this,
and it can be hard
to wean off ECMO
463
00:21:15,303 --> 00:21:18,059
after removing something
that's compressed your lung
for so long,
464
00:21:18,192 --> 00:21:19,385
but her heart is healthy.
465
00:21:19,520 --> 00:21:21,179
I don't anticipate that
being a problem.
466
00:21:21,311 --> 00:21:23,701
But it could be a problem.
467
00:21:26,656 --> 00:21:28,247
You almost lost me twice.
468
00:21:29,178 --> 00:21:32,497
If we do nothing,
this thing just keeps growing
inside me
469
00:21:33,095 --> 00:21:38,471
until it squashes all my organs
and I'm definitely gone.
470
00:21:39,367 --> 00:21:40,795
I don't wanna live like that.
471
00:21:42,488 --> 00:21:44,179
Slowly suffocating.
472
00:21:44,910 --> 00:21:48,261
I don't want you to have
to watch me live like that.
473
00:21:49,424 --> 00:21:52,411
We asked them
to come up with a solution.
474
00:21:54,933 --> 00:21:56,361
I'm taking it.
475
00:21:56,493 --> 00:21:58,452
Okay,
Dr. Griffith and Dr. Adams
will get you prepped,
476
00:21:58,585 --> 00:22:00,908
and we will see you
in the OR, okay?
477
00:22:05,820 --> 00:22:07,179
Is it weird
that he's not blinking?
478
00:22:07,314 --> 00:22:09,538
Newborn tear ducts
aren't fully developed.
479
00:22:09,670 --> 00:22:11,562
It's so cool
that you know all this stuff.
480
00:22:12,657 --> 00:22:15,910
Is it bad if I'm not, like,
feeling anything?
481
00:22:16,041 --> 00:22:18,132
You mean you don't feel a bond?
482
00:22:19,428 --> 00:22:21,154
-I'm already a terrible mom.
-No.
483
00:22:21,286 --> 00:22:24,805
No, it's completely normal,
and you're exhausted,
484
00:22:24,938 --> 00:22:26,332
and your hormones
are all over the place.
485
00:22:26,465 --> 00:22:29,617
And to be honest,
newborns are kinda just blobs.
486
00:22:29,750 --> 00:22:33,068
In a few weeks, he'll be
laughing and smiling,
and it just...
487
00:22:33,202 --> 00:22:34,530
it gets so much better.
488
00:22:34,993 --> 00:22:36,521
You're a really good doctor.
489
00:22:37,550 --> 00:22:39,375
Are you taking new patients?
490
00:22:39,508 --> 00:22:41,068
- Well, it's--
- Hey.
491
00:22:41,200 --> 00:22:44,122
-How're my girls?
-Hey. Well, we made
a new friend--
492
00:22:44,254 --> 00:22:47,375
-Whoa. Oh, my God.
-Oh. Oh. Someone call
a rapid response!
493
00:22:47,507 --> 00:22:48,702
Right away, Doctor.
494
00:22:57,265 --> 00:22:58,493
She's still seizing.
495
00:22:59,852 --> 00:23:01,214
Someone give me IM midazolam.
496
00:23:01,779 --> 00:23:04,201
She's seven days postpartum.
Check her blood pressure.
497
00:23:04,335 --> 00:23:06,293
It's probably eclampsia.
She needs mag now.
498
00:23:06,425 --> 00:23:08,317
Did she have any symptoms
before she started seizing?
499
00:23:08,450 --> 00:23:10,740
No, she seemed completely fine.
It came out of nowhere.
500
00:23:10,872 --> 00:23:12,101
We'll need
to get her up to OB.
501
00:23:12,234 --> 00:23:13,495
Will you go up with her?
502
00:23:13,628 --> 00:23:14,755
Whatever you want.
503
00:23:15,519 --> 00:23:16,648
Call me when you get up there.
504
00:23:21,892 --> 00:23:23,186
Scissors.
505
00:23:24,315 --> 00:23:27,169
- Put two units of blood on standby.
- -Lap pad.
506
00:23:29,659 --> 00:23:31,385
All right,
I secured the cannula.
507
00:23:31,517 --> 00:23:33,342
Adams, are we ready
to remove the clamps?
508
00:23:34,139 --> 00:23:36,529
Yeah, ECMO's ready.
509
00:23:40,247 --> 00:23:42,238
Okay, the dark flow.
510
00:23:42,934 --> 00:23:43,964
We have full flow.
511
00:23:44,096 --> 00:23:45,491
Let's try lowering her down.
512
00:23:52,660 --> 00:23:55,083
- At least that worked.
- -We're gonna make all of it work.
513
00:23:55,215 --> 00:23:57,405
Griffith, Adams,
you may never see
another case like this again,
514
00:23:57,539 --> 00:23:59,032
so keep your eyes on the field.
515
00:23:59,165 --> 00:24:02,418
If you see any signs
of hemodynamic instability,
speak up.
516
00:24:02,549 --> 00:24:05,836
This is not a race.
Our goal is not to finish fast.
517
00:24:05,969 --> 00:24:08,226
It is to keep her safe.
518
00:24:08,358 --> 00:24:09,686
- Understood?
- Mm-hmm.
519
00:24:09,818 --> 00:24:10,848
Okay.
520
00:24:11,844 --> 00:24:13,138
Okay, London.
521
00:24:13,270 --> 00:24:14,930
Let's intubate.
522
00:24:19,577 --> 00:24:21,933
It's a hormonally active
adrenal mass,
523
00:24:22,066 --> 00:24:24,389
so you need to watch out
for sudden hypertension.
524
00:24:24,522 --> 00:24:26,214
-I'm planning to use
alpha-blockers.
-Good.
525
00:24:26,348 --> 00:24:29,467
Well, I assume
you're gonna do this open,
given the size?
526
00:24:29,600 --> 00:24:32,587
That's the plan.
My colleague
will actually do it.
527
00:24:32,720 --> 00:24:35,043
I usually stick to
robotic procedures.
528
00:24:35,176 --> 00:24:38,030
Oh. You got something
against the old-fashioned way?
529
00:24:38,163 --> 00:24:42,146
No, um...
...I have MS,
530
00:24:42,279 --> 00:24:46,029
so standing for long periods
in the OR just isn't an option.
531
00:24:46,162 --> 00:24:48,552
I didn't realize. I'm sorry.
532
00:24:48,685 --> 00:24:49,879
No need to be sorry.
533
00:24:50,012 --> 00:24:52,800
I mean, I was devastated
after I got the diagnosis.
534
00:24:53,829 --> 00:24:56,085
I had put in so much work
my whole career,
535
00:24:56,219 --> 00:24:59,438
and the thought of
no longer being in the OR
was soul-crushing...
536
00:25:00,534 --> 00:25:01,861
to say the least.
537
00:25:02,591 --> 00:25:05,247
But that's when I realized
it was just my fear talking.
538
00:25:06,308 --> 00:25:10,557
And I looked at my symptoms,
muscle pain and leg weakness,
and I thought,
539
00:25:11,254 --> 00:25:13,345
"If only there was
a way to operate
540
00:25:13,478 --> 00:25:16,830
while sitting down
without having
to hold a scalpel."
541
00:25:19,153 --> 00:25:20,714
Was it a difficult adjustment?
542
00:25:21,476 --> 00:25:24,530
Adjusting to living
with a chronic illness
is never easy.
543
00:25:24,663 --> 00:25:28,380
But over time,
I just turned MS into a pivot.
544
00:25:29,675 --> 00:25:30,803
Not an ending.
545
00:25:31,766 --> 00:25:34,287
Well, you seem
to be managing well.
546
00:25:34,421 --> 00:25:37,840
Oh, well,
I have my ups and downs,
believe me.
547
00:25:37,972 --> 00:25:41,590
But Catherine Fox is flying me
around on her private plane
548
00:25:41,723 --> 00:25:44,278
and paying me more money
than I know what to do with.
549
00:25:45,838 --> 00:25:47,531
And I still get to do
what I love.
550
00:25:48,261 --> 00:25:50,319
Even if it is
in a different way.
551
00:25:52,510 --> 00:25:55,994
Now they're gonna go ahead
with Bailey's giant teratoma
in OR two.
552
00:25:56,459 --> 00:25:59,081
-Ndugu's gonna have to resect--
-Can we just focus, please?
553
00:25:59,711 --> 00:26:01,305
It's a fake patient. Calm down.
554
00:26:01,437 --> 00:26:03,130
Don't tell me to calm down.
555
00:26:03,263 --> 00:26:04,724
What is wrong with you?
556
00:26:05,487 --> 00:26:08,873
Is it about Simone
breaking that dumb pact?
557
00:26:09,005 --> 00:26:11,627
No, and stop asking. I'm fine.
558
00:26:11,759 --> 00:26:13,585
No, you don't seem fine.
559
00:26:13,718 --> 00:26:16,307
Well, it's because you
are bothering me.
560
00:26:16,772 --> 00:26:19,029
Well, that can't be it.
I always bother you.
561
00:26:19,161 --> 00:26:20,323
I'm just...
562
00:26:22,381 --> 00:26:23,940
I'm just tired.
563
00:26:24,571 --> 00:26:26,197
Every day is the same.
564
00:26:26,330 --> 00:26:30,545
It's the same people
and the same rooms
and the same conversations,
565
00:26:30,678 --> 00:26:33,167
and I'm just sick of it.
566
00:26:33,300 --> 00:26:35,757
Well, I am sorry
we are not good enough for you.
567
00:26:35,889 --> 00:26:37,449
I didn't say that.
568
00:26:37,582 --> 00:26:40,436
Yeah, you don't
have to defend yourself.
We all know you're aloof.
569
00:26:49,265 --> 00:26:52,152
-You're leaving?
-Yeah, I've already done
a thrombectomy.
570
00:26:52,285 --> 00:26:53,479
You can have it.
571
00:26:53,944 --> 00:26:58,557
Dr. Prescott, please...
572
00:26:59,918 --> 00:27:01,611
What's happening?
Who's the doctor?
573
00:27:01,745 --> 00:27:05,296
-Uh... John Burnett.
-An intern?
574
00:27:05,428 --> 00:27:07,254
-Let's get a CT.
-They're getting a CT.
575
00:27:07,386 --> 00:27:08,880
No, she has eclampsia.
576
00:27:09,013 --> 00:27:10,905
Tell him she needs magnesium .
577
00:27:11,037 --> 00:27:12,599
-Really?
-Tell him.
578
00:27:12,730 --> 00:27:13,925
I...
579
00:27:14,623 --> 00:27:16,879
Excuse me,
I've got Jo Wilson
on the phone,
580
00:27:17,011 --> 00:27:19,302
and she says it's eclampsia,
and you should start her
on magnesium.
581
00:27:19,434 --> 00:27:22,720
Her BP is only 143 over 91.
It could be
an intracranial hemorrhage.
582
00:27:22,853 --> 00:27:25,044
-Put me on speaker.
-Um...
583
00:27:26,338 --> 00:27:28,296
Okay. You're on speaker.
584
00:27:28,429 --> 00:27:30,022
I understand your concern,
585
00:27:30,155 --> 00:27:33,441
but postpartum eclampsia
doesn't always present
with a really high BP.
586
00:27:33,574 --> 00:27:34,934
Neither does a brain bleed.
587
00:27:35,067 --> 00:27:36,959
-Barnett.
-It's-- It's Burnett.
588
00:27:37,092 --> 00:27:38,984
Whatever.I may be on leave,
589
00:27:39,117 --> 00:27:41,340
but that doesn't meanthat I can't schedule youto work every holiday
590
00:27:41,474 --> 00:27:43,962
and make your life miserable.So trust me when I tell you
591
00:27:44,095 --> 00:27:46,552
to start the mag now.
592
00:27:48,874 --> 00:27:50,269
Start IV magnesium.
593
00:27:56,509 --> 00:27:58,267
Your mom's gonna be okay.
594
00:28:00,291 --> 00:28:01,818
We're gonna have
to take part of the lower lobe.
595
00:28:01,951 --> 00:28:03,179
Adams,
you wanna staple the lung?
596
00:28:03,312 --> 00:28:04,805
Yep. Stapler.
597
00:28:04,939 --> 00:28:06,631
Bailey, you ready
to start resecting
the adhered diaphragm?
598
00:28:06,764 --> 00:28:08,291
Hey, ready when you are.
599
00:28:08,424 --> 00:28:10,846
Griffith,
what should we be careful
to avoid?
600
00:28:10,979 --> 00:28:12,705
Hepatic veins
and the retro-hepatic IVC.
601
00:28:12,838 --> 00:28:14,497
Good. Let's get
the next stapler ready.
602
00:28:14,630 --> 00:28:18,745
London thought
fixing up a summer house
was a lot of work.
603
00:28:18,878 --> 00:28:21,898
-It's got nothing on
fixing up a torso.
-Reload, please.
604
00:28:23,890 --> 00:28:27,641
-Uh, BP is bottoming out.
-Damn it.
I don't see any bleeding.
605
00:28:27,773 --> 00:28:29,268
Neither do I.
The staple line looks clean.
606
00:28:29,432 --> 00:28:31,093
Well, something's
got to be causing this.
What the hell is it?
607
00:28:31,226 --> 00:28:34,710
- Does the ECMO
say anything?
- There's a suction event alarm.
608
00:28:35,176 --> 00:28:38,527
Okay. Since we took
pressure off the lung,
could there be volume shifts?
609
00:28:38,659 --> 00:28:40,154
That's definitely possible.
Yeah.
610
00:28:40,287 --> 00:28:42,676
Okay, we need
to up her pressors
and flood her with fluids.
611
00:28:42,808 --> 00:28:45,795
If we don't get flow back
right away, she's done.
612
00:28:51,471 --> 00:28:52,666
Push fluids as hard as you can.
613
00:28:52,799 --> 00:28:53,994
-I am.
-BP's still dropping.
614
00:28:54,127 --> 00:28:55,586
She can't take this
much longer.
615
00:28:55,720 --> 00:28:57,445
I should've
listened to that board.
616
00:28:57,578 --> 00:28:59,239
- If I lose her--
- This is not on you.
617
00:28:59,370 --> 00:29:02,192
Come on, come on, come on.
Come on.
618
00:29:02,357 --> 00:29:03,552
BP's coming back up.
619
00:29:05,213 --> 00:29:08,564
- Well, that was close.
- Okay, folks.
620
00:29:09,394 --> 00:29:11,054
There's still
a lot of tumor left.
621
00:29:12,183 --> 00:29:13,874
Griffith, you're on
the liver resection.
622
00:29:14,008 --> 00:29:15,866
Adams, you're on
the superior mediastinum.
623
00:29:16,629 --> 00:29:18,488
If that's okay with you?
624
00:29:19,783 --> 00:29:21,509
Do what we say when we say it.
625
00:29:21,641 --> 00:29:22,803
Stapler.
626
00:29:27,814 --> 00:29:29,043
Contrast.
627
00:29:31,432 --> 00:29:34,386
There's the occlusion
in the iliac vein.
Advance more.
628
00:29:36,013 --> 00:29:37,307
Okay, pin the guide wire
629
00:29:37,440 --> 00:29:39,365
and turn on
the thrombectomy catheter,
please.
630
00:29:42,020 --> 00:29:43,779
It's a shame Janet
isn't awake to see this.
631
00:29:43,912 --> 00:29:45,206
It would really turn her...
632
00:29:46,037 --> 00:29:50,882
into a passionate fan of
biological science and anatomy.
633
00:29:51,512 --> 00:29:52,973
Okay, I'm in. Turn it off.
634
00:29:53,106 --> 00:29:55,928
I don't get it.
If you have to pretend
to be someone else
635
00:29:56,059 --> 00:29:57,320
for your partner
to wanna sleep with you,
636
00:29:57,453 --> 00:29:59,246
maybe you shouldn't
be together.
637
00:29:59,378 --> 00:30:02,664
I've learned you never know
what's going on in
another person's relationship.
638
00:30:03,694 --> 00:30:04,756
Ready.
639
00:30:05,419 --> 00:30:06,514
Contrast.
640
00:30:10,231 --> 00:30:13,285
Thrombus is gone.
The vein is patent.
641
00:30:13,883 --> 00:30:15,177
Great work.
642
00:30:15,310 --> 00:30:16,338
Now to stent.
643
00:30:19,591 --> 00:30:23,708
Thanks again for the consult.
I see why Catherine
calls you legendary.
644
00:30:23,840 --> 00:30:26,030
Well, she is prone
to exaggeration.
645
00:30:26,163 --> 00:30:28,620
I know,
but in your case it's true.
646
00:30:28,753 --> 00:30:31,407
Well, you live up
to your reputation as well.
647
00:30:31,540 --> 00:30:34,228
Oh, but not enough to
consider my recommendation?
648
00:30:36,818 --> 00:30:40,435
-I'm sorry,
I-I shouldn't have said that.
-No, it's okay.
649
00:30:41,131 --> 00:30:42,560
Can I ask you about something?
650
00:30:43,689 --> 00:30:45,480
Urosymphyseal fistulas.
651
00:30:47,405 --> 00:30:51,088
They are an extremely rare
post-op complication
of radical prostatectomy.
652
00:30:51,222 --> 00:30:52,914
But the odds aren't zero.
653
00:30:53,047 --> 00:30:54,242
They're close.
654
00:30:54,972 --> 00:30:55,967
What if it happened?
655
00:30:57,096 --> 00:31:00,450
Chronic pain,
which often leads
to difficulty walking,
656
00:31:01,112 --> 00:31:05,062
- possibly warranting
the use of opioids.
657
00:31:06,157 --> 00:31:08,515
I can treat complications.
658
00:31:09,277 --> 00:31:13,659
But if your cancer
grows and metastasizes,
that's when my hands are tied.
659
00:31:17,840 --> 00:31:19,134
If you change your mind
660
00:31:19,268 --> 00:31:22,752
or if you just
wanna talk more,
Catherine has my number.
661
00:31:35,796 --> 00:31:38,253
-Done resecting the liver.
-Good.
662
00:31:38,386 --> 00:31:39,712
Excellent hemostasis.
663
00:31:43,562 --> 00:31:45,356
All right,
no bleeding on this side.
664
00:31:45,488 --> 00:31:47,281
Okay, we are
in the home stretch.
665
00:31:47,414 --> 00:31:49,537
Let's get ready
to get this tumor out.
666
00:31:50,565 --> 00:31:52,392
Hold on, hold on.
667
00:31:52,524 --> 00:31:54,714
-Do you hear that?
-What?
668
00:31:57,602 --> 00:31:59,329
Okay, we're gonna need
more lap pads,
and hang blood.
669
00:31:59,462 --> 00:32:01,188
Adams, quickly pack her.
670
00:32:01,950 --> 00:32:04,108
Goddamn it! All right,
keep the suction coming.
671
00:32:05,170 --> 00:32:06,696
Oh... ... wait, wait.
672
00:32:06,829 --> 00:32:10,381
Okay, there's a tear
where the IVC passes
673
00:32:10,513 --> 00:32:12,206
through the diaphragm
into the chest.
674
00:32:12,339 --> 00:32:15,260
I'm trying to secure...
Let-Let me have a clamp.
675
00:32:15,723 --> 00:32:17,085
Okay, I need visualization.
676
00:32:17,218 --> 00:32:18,445
Put the suction
on the lap pads.
677
00:32:18,578 --> 00:32:21,068
Not too harsh,
gentle steady pressure, okay?
678
00:32:26,943 --> 00:32:28,369
I think I got it.
679
00:32:31,522 --> 00:32:34,212
Oh, she's stabilizing.
680
00:32:34,343 --> 00:32:36,368
Okay, everyone,
on the count of three.
681
00:32:36,501 --> 00:32:38,062
Everyone needs to help
with the specimen.
682
00:32:38,195 --> 00:32:39,355
Okay, ready?
683
00:32:39,488 --> 00:32:42,277
One, two, three.
684
00:32:47,553 --> 00:32:48,582
Okay.
685
00:32:55,021 --> 00:32:56,150
Okay.
686
00:32:56,614 --> 00:32:58,506
How do you all feel about
getting the hell out of here?
687
00:32:58,638 --> 00:33:00,831
You don't
have to ask me twice. Bovie.
688
00:33:01,692 --> 00:33:03,385
Two-O prolene.
689
00:33:10,157 --> 00:33:11,217
You can stop here.
690
00:33:11,849 --> 00:33:12,944
Iris.
691
00:33:13,608 --> 00:33:15,136
Hey,
what are you doing up here?
692
00:33:15,267 --> 00:33:18,487
So a mom from the NICU
is being treated
for postpartum eclampsia.
693
00:33:18,619 --> 00:33:21,174
Can you look up her chart?
Her name is Gina...
694
00:33:21,906 --> 00:33:23,002
I don't know her last name.
695
00:33:23,565 --> 00:33:25,789
I'm sorry, I can't.
You're not her doctor.
696
00:33:27,084 --> 00:33:28,377
I just wanna check on her.
697
00:33:29,340 --> 00:33:31,464
Do you want me
to call Marcus for you?
698
00:33:31,598 --> 00:33:33,455
No, what I want
is my friend's chart.
699
00:33:34,618 --> 00:33:36,144
-I'm sorry, Jo.
-Stop saying you're sorry.
700
00:33:36,276 --> 00:33:38,601
Sorry doesn't help me.
I'm this woman's
only friend right now
701
00:33:38,733 --> 00:33:39,962
and the person
in charge of her care
702
00:33:40,093 --> 00:33:41,555
has been a doctor
for about 90 days.
703
00:33:41,687 --> 00:33:43,646
So, if you could just
please remove the stick from--
704
00:33:43,778 --> 00:33:45,637
-Jo.
-All I want right now--
705
00:33:45,770 --> 00:33:47,562
- I think we should go.
- -No, we're not gonna go.
706
00:33:47,694 --> 00:33:48,657
-I-- No.
-Yeah.
707
00:33:48,790 --> 00:33:51,246
You cannot move me
against my will.
708
00:33:51,378 --> 00:33:53,536
Stop. I...
709
00:33:54,166 --> 00:33:55,860
This is not okay.
710
00:33:55,991 --> 00:33:57,286
Can you give me a minute?
711
00:33:57,419 --> 00:33:58,781
-This is--
-Hey, hey, hey, hey.
712
00:33:58,913 --> 00:34:01,169
Look,
I know you're scared,
okay? But...
713
00:34:02,498 --> 00:34:04,255
Hey, she's just trying
to do her job.
714
00:34:22,544 --> 00:34:26,062
It will take a few days
to wean her off ECMO.
She does have a long recovery.
715
00:34:26,195 --> 00:34:28,353
- But she's gonna come home?
- Eventually.
716
00:34:28,486 --> 00:34:30,111
That is the plan.
717
00:34:30,743 --> 00:34:32,169
I don't know how to thank you.
718
00:34:32,801 --> 00:34:34,160
I think you just did.
719
00:34:36,848 --> 00:34:39,438
She's always been able
to see what I can't.
720
00:34:39,969 --> 00:34:43,088
Her mind is filled
with these big ideas
721
00:34:43,222 --> 00:34:45,745
that always seem impossible.
722
00:34:45,876 --> 00:34:51,021
Our wedding, this lake house,
getting this tumor removed.
723
00:34:52,582 --> 00:34:54,107
But she knew you could do it.
724
00:34:56,167 --> 00:34:57,693
And she was right.
725
00:34:58,853 --> 00:35:01,676
I almost...
...tried to stop her.
726
00:35:04,132 --> 00:35:06,056
But I'm glad
I stayed out of it.
727
00:35:07,451 --> 00:35:10,139
Hey, um, we'll let you both
get some rest.
728
00:35:10,769 --> 00:35:12,727
Thank you.
729
00:35:15,450 --> 00:35:17,176
Great work today, Griffith.
730
00:35:17,308 --> 00:35:19,963
You and Adams,
you really stepped it up.
731
00:35:20,096 --> 00:35:23,879
Thank you. I really appreciate
the opportunity.
I learned a lot.
732
00:35:27,498 --> 00:35:32,543
We did a good thing today.
733
00:35:32,674 --> 00:35:35,995
-Some might call it inspiring.
-Mmm.
734
00:35:36,127 --> 00:35:37,620
Might be even something
735
00:35:37,752 --> 00:35:40,010
you could lecture about.
736
00:35:40,144 --> 00:35:43,660
Hey, I hope
I didn't overstep, you know,
jumping in with the residents.
737
00:35:43,793 --> 00:35:46,914
Oh, no. I mean,
if I'm the only voice
that's teaching them,
738
00:35:47,047 --> 00:35:48,639
they'll wind up tuning me out.
739
00:35:49,502 --> 00:35:50,997
What do you think
about having the residents
740
00:35:51,129 --> 00:35:53,485
do an ambulance ride-along
or EMS training?
741
00:35:53,617 --> 00:35:56,406
Something that could
really get them thinking
on their feet, you know?
742
00:35:56,539 --> 00:36:01,119
It could help them in the ER
or in situations like today
in the OR.
743
00:36:01,716 --> 00:36:05,899
I think you should write up
a proposal and send it to me.
744
00:36:09,615 --> 00:36:10,977
The surgery went well.
745
00:36:11,110 --> 00:36:13,102
We were able
to clear the clot
and put in a stent.
746
00:36:13,234 --> 00:36:14,230
Thank you.
747
00:36:14,363 --> 00:36:15,923
You'll need to be
on anticoagulation
748
00:36:16,055 --> 00:36:19,473
but after a while,
you'll be able to get
back to life as usual.
749
00:36:20,171 --> 00:36:23,622
I'll get back to life
as usual right away or...
750
00:36:23,755 --> 00:36:25,216
"When can I have sex?"
is what I'm asking.
751
00:36:25,347 --> 00:36:26,809
Yeah, we know.
752
00:36:26,942 --> 00:36:28,367
You need to elevate your leg
when resting
753
00:36:28,501 --> 00:36:31,421
but other than that,
it is good to move it around.
754
00:36:33,215 --> 00:36:35,073
I guess Trudy
can still see the doctor.
755
00:36:35,206 --> 00:36:37,761
Trudy's always a good time.
756
00:36:37,895 --> 00:36:42,010
But, honey,
I love you most
when you're just Janet.
757
00:36:43,968 --> 00:36:45,163
Oh.
758
00:36:45,294 --> 00:36:46,723
We'll give you some privacy.
759
00:36:58,439 --> 00:37:00,329
I checked London's labs
before leaving.
760
00:37:01,292 --> 00:37:02,221
Thanks.
761
00:37:02,355 --> 00:37:04,148
Hey, I'm sorry about earlier.
762
00:37:04,679 --> 00:37:06,704
How you interact
with your patients,
your business.
763
00:37:06,836 --> 00:37:07,931
I'll stay out of it.
764
00:37:08,064 --> 00:37:09,624
I appreciate that.
765
00:37:10,686 --> 00:37:13,441
I do value your opinion though.
766
00:37:14,006 --> 00:37:15,598
-You do?
-I do.
767
00:37:15,732 --> 00:37:21,440
Just, uh,
not about relationships.
For obvious reasons.
768
00:37:21,573 --> 00:37:23,797
Ouch.
769
00:37:23,929 --> 00:37:26,684
Hey, look,
I'm, uh, putting together
a watch list for my patient.
770
00:37:27,181 --> 00:37:28,344
What am I missing?
771
00:37:28,476 --> 00:37:30,601
Mmm.
772
00:37:32,126 --> 00:37:35,480
- Wait, she hasn't seen
any of these?
773
00:37:42,881 --> 00:37:44,207
Hey.
774
00:37:44,707 --> 00:37:45,802
Hi.
775
00:37:45,934 --> 00:37:47,627
Did you make it
through your busy day?
776
00:37:47,759 --> 00:37:49,785
Uh, I did.
777
00:37:50,847 --> 00:37:53,435
Uh, I did a thrombectomy
and placed a stent.
778
00:37:53,568 --> 00:37:55,626
Nice, Millin.
779
00:37:55,759 --> 00:37:57,916
You still haven't told me
about that thoracotomy,
by the way.
780
00:37:59,043 --> 00:38:00,206
It wasn't that big a deal.
781
00:38:00,837 --> 00:38:03,160
Uh, you saved a man's life
with your hands.
782
00:38:03,724 --> 00:38:05,251
Doesn't get
any bigger than that.
783
00:38:08,038 --> 00:38:09,533
Do you think I'm aloof?
784
00:38:10,528 --> 00:38:14,444
Aloof?
Thank you. Um...
785
00:38:15,007 --> 00:38:16,071
No.
786
00:38:16,535 --> 00:38:19,191
No, you're discerning,
you don't suffer any fools.
787
00:38:19,324 --> 00:38:22,045
But...
...that's not aloof.
788
00:38:22,178 --> 00:38:26,127
That's, um,
just protecting yourself
because you care.
789
00:38:29,148 --> 00:38:32,434
It's funny you say that
because I-I have been...
790
00:38:32,897 --> 00:38:35,421
I had the worst day.
791
00:38:35,553 --> 00:38:37,976
I need the biggest vodka tonic
that they have.
792
00:38:38,740 --> 00:38:40,532
Hi, I'm Iris.
793
00:38:40,665 --> 00:38:42,523
Uh, this is Jules Millin,
a surgical resident.
794
00:38:43,022 --> 00:38:44,482
-Nice to meet you.
-Nice to meet you.
795
00:38:44,615 --> 00:38:47,635
Um, I should go
find my friends.
796
00:38:49,229 --> 00:38:50,689
-Here.
-Thank you.
797
00:38:50,820 --> 00:38:52,082
See you later.
798
00:38:52,216 --> 00:38:54,672
It's jarringwhen your identity shifts.
799
00:38:54,803 --> 00:38:58,190
When you're suddenlya doctor, a partner, a parent.
800
00:38:59,085 --> 00:39:01,673
It helps if you focuson the thingsthat haven't changed.
801
00:39:01,806 --> 00:39:03,534
I'm gonna
have to change hospitals.
802
00:39:04,429 --> 00:39:06,652
I've cried in front of
too many people at this one.
803
00:39:06,784 --> 00:39:08,014
They understand.
804
00:39:10,767 --> 00:39:15,050
I just feel like ever since
I was admitted, I just...
805
00:39:15,646 --> 00:39:17,605
I just lost myself.
806
00:39:19,398 --> 00:39:21,124
I can't take care of our kids.
807
00:39:21,256 --> 00:39:25,239
I can't
take care of my patients.
I can't even shower.
808
00:39:25,372 --> 00:39:26,666
It's temporary.
809
00:39:27,364 --> 00:39:28,757
Your heart is recovering.
810
00:39:28,891 --> 00:39:30,152
I know.
811
00:39:31,213 --> 00:39:37,388
But for a few hours today,
I got to be a doctor again
812
00:39:37,519 --> 00:39:39,710
and help this woman
navigate a difficult time
813
00:39:39,844 --> 00:39:46,116
but then
when it really mattered,
someone else got to help her.
814
00:39:47,676 --> 00:39:49,170
At least Gina is okay.
815
00:39:50,000 --> 00:39:54,082
And I would bet that she'd
say what you did mattered too.
816
00:39:55,775 --> 00:39:57,136
Maybe even more.
817
00:39:59,293 --> 00:40:01,085
Oh, God.
It's happening again.
818
00:40:01,881 --> 00:40:05,333
- No.
- I'll get the tissues.
819
00:40:07,823 --> 00:40:12,037
Just...
820
00:40:12,702 --> 00:40:14,229
The comfort of old friends.
821
00:40:14,360 --> 00:40:17,149
Thirty-five pounds?
That's like
carrying four babies.
822
00:40:17,281 --> 00:40:19,041
Yeah, or four bowling balls.
823
00:40:19,173 --> 00:40:21,862
-Who carries
four bowling balls?
-People do weird things.
824
00:40:23,655 --> 00:40:24,816
Gotta go.
825
00:40:29,396 --> 00:40:30,856
Yeah, I'm out too.
826
00:40:31,919 --> 00:40:33,081
See you tomorrow.
827
00:40:41,113 --> 00:40:43,768
She's just a stop sign,
not a roadblock.
828
00:40:43,900 --> 00:40:44,863
How did you...
829
00:40:46,821 --> 00:40:50,074
Doesn't matter.
Wait, are you leaving me too?
830
00:40:50,671 --> 00:40:53,824
Um, sorry.
Um, hey, have a drink on me.
831
00:40:59,600 --> 00:41:00,628
Anyone sitting here?
832
00:41:06,071 --> 00:41:07,665
The thrillof trying something new.
833
00:41:07,797 --> 00:41:09,291
Hi, I'm Sally.
834
00:41:09,423 --> 00:41:11,647
Because even though youmay not recognize yourself.
835
00:41:12,244 --> 00:41:13,307
Catherine.
836
00:41:14,236 --> 00:41:17,024
I'm sorry. I am so sorry.
837
00:41:17,157 --> 00:41:20,111
I got scared and I just
called the best that I knew.
838
00:41:20,244 --> 00:41:22,102
I should've talked to you
before bringing Laura in.
839
00:41:22,235 --> 00:41:27,678
Look, I thought a lot
about letting fear
cloud judgment today.
840
00:41:27,811 --> 00:41:30,234
Whatever you wanna do,
I support--
841
00:41:31,529 --> 00:41:32,823
I'm a surgeon.
842
00:41:32,955 --> 00:41:35,013
I'm a senior member
of this hospital.
843
00:41:36,009 --> 00:41:37,403
If something were to go wrong
844
00:41:37,536 --> 00:41:40,789
and I couldn't stand
long enough
to do a simple appy,
845
00:41:40,921 --> 00:41:43,908
I'd feel weak.
846
00:41:44,938 --> 00:41:46,597
And I don't know
how to lead like that.
847
00:41:47,128 --> 00:41:48,621
I don't know who I'd be.
848
00:41:49,617 --> 00:41:50,977
But people adapt.
849
00:41:51,808 --> 00:41:53,500
I wanna go ahead
with the surgery.
850
00:42:00,238 --> 00:42:02,096
It's been you all along.
66547
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