All language subtitles for greys.anatomy.s22e08.720p.web.h264-insidious

♪♪

Meredith: In college,
I was the hungover premed

who fell asleep
at her study carrel.

Podcaster: If you're
just joining our podcast,

my guests
are Doctors Teddy Altman

and Winston Ndugu
from Grey-Sloan Memorial,

who pioneered the creation
of a ventral aorta surgery.

At what point did you think,
"We just broke new ground"?

Winston:
Immediately.
Really?

Yeah.
Once that staple held, I knew.

Sometimes you just have
a feeling.

Meredith: In med school, I was
the famous surgeon's daughter.

Podcaster:
It wasn't like that for you?

Teddy: Honestly, there was
so much going on that night,

I didn't have time
to process it all until later.

Now I'm the famous surgeon.
Podcaster: So you had doubts?

Oh, yeah.

I was never certain
it would work,

but our patient didn't have
any other option.

I knew
that we had to try.

Meredith:
In medicine,

your identity
is constantly changing.

It's your job to keep up.

Podcaster:
Safe to say it worked out.

What's next for you both?

Well, we're still monitoring
our patient's progress.

And?
So far, so good.

They sound really good.
Very competent.

Yeah.
I'd come to this hospital.

Well, speaking of,
I made an appointment for you.

We've talked about this,
Catherine.

I don't need another opinion.
I like Dr. Freeman.

I know you do --

because he goes along
with whatever you want.

You don't think doctors
should listen to their patients?

I think you need
objective advice

from someone whose paycheck
you don't sign.

It's just
another opinion.

Who am I saying?

Kaplan?

Laura Kaplan?
In Boston?

I thought you made
an appointment here.

I sent for my plane.
She landed about an hour ago.

♪♪

Morning.
Hey.

Hey.

Hey, nice job
on that podcast.

I didn't realize
you and Altman

came up with that
at our wedding.
Yeah.

You never know
when an idea will strike.

[ Chuckles ]

Go ahead, Dr. Adams.
Uh, yes.

Uh, Jo Wilson, post-op day seven
from emergent C-section

and Impella CP placement.

Now, post-op day three
from a 5.5 placement

through the right
axillary artery.

Her heart function continues
to recover,

with her EF up
another 5%.

And I heard she got to meet
her babies yesterday.

How are they doing?

Well, Peyton's off of CPAP
but still fragile.

Hattie's bilirubin levels
are bad

every time they pause
phototherapy.

And you're all headed
in the right direction.

That's what matters.

I just really want
the six of us

to finally be together.

Jo, you will never guess

who Marcus walked out with
last night.

Dr. Ndugu.
Hey.

I didn't know
you were doing rounds.
Yeah.

I'll come back later.

[ Monitor beeping ]

What was that?

What was what?

Did you sleep
with my favorite nurse?

Uh, should I leave?

We've just gone out
a couple times. That's all.

Well, are you gonna
take her out again?

Uh...maybe.
It's new.

And none of our business.

She is the entire department's
favorite nurse!

Everybody loves her!
Everyone!

[ Exhales sharply ]

[ Whispering ]
Hormones.
Okay.

Uh, I-I need to check
on my next patient.

Are you gonna be okay?

Yeah.
Uh, page me
if you need anything.

[ Indistinct conversations ]

Good morning.

Traitor.
Trouble in paradise?

I broke our pact.
She's bitter.

You should break it too.

What, like I can just snap
my fingers?

Who am I supposed to
sleep with?

I ordered an X-ray
from Ms. Johnson's left arm.

It was the right arm,
wasn't it?

I will fix it.

An intern?
Please. I have dignity.

Don't knock it
till you've tried it.

Tried what?

Vegan sloppy joes.

You sleeping
with an intern, too?

W-- Who was sleeping
with an intern?

I am.
Who are you texting?

Nobody.
Doesn't look like nobody.

Ah, she's just a patient.

Why are you texting
a patient?

Well, Bailey made me drive her
an hour to get treatment,

and now she's sending me
dumb memes.

It's nothing.
Wear a condom.

She's a cancer patient.

Hey, did you see
that I admitted Mr. Howard?

You don't have to put
your phone down.

It's fine.
Sorry.

My phone has been blowing up
since the podcast dropped.

I listened.
You sounded great.

Now I've got doctors reaching
out about their patients.

And the department chief
from Mass General

has asked me to do
grand rounds.
Ah. Sounds rough.

Well, it's not like I'm getting
a Nobel Prize.

I mean, MGH asks everyone
to guest lecture.

Well, they never asked me,
and I went to Harvard.

Anyway, so, Mr. Howard.

His EKG shows
a conduction block.

Do you want an echo?

[ Phone ringing ]
Um...Uh, yes. Sorry.

I have to take this.

Hi.
This is Altman.

Hi. Janet?
I'm Dr. Millin.

I hear you're having
some leg pain.

Yeah, and some heaviness.
I'm concerned it might be a DVT.

I think she should have
an ultrasound.

I assume you want
a full work-up --

CBC, D-dimer,
and a duplex ultrasound.

I'm Jules Millin.

I'm a second-year
surgical resident.

You're internal medicine,
right?

Oh. No. Ooh.
Oh, I'm not a doctor. Sorry.

Oh, yeah.
We were role-playing.
Yeah.

The more medical terms,
the better it gets.

Yeah.
So Hal does his homework.

So do you have leg pain
or is this...

Oh, no.
That's real.

The pain started
this morning

when we were trying to squeeze
in a quickie before work.

May I do an exam?
Mm-hmm.

♪♪

Um, how long did the pain
last for?

Uh, a few hours.
Yeah.

We've been trying to
spice things up lately,

so we just want to make sure
we haven't caused a problem.

Well, um...

DVTs usually occur with...
less, um, activity,

but it is better
to be safe than sorry,

so I will order
some tests...
All right.

...and get back to you.

Okay. Thank you.
Thank you.

♪♪

Dr. Griffith.

38-year-old female with
a large mediastinal teratoma

that has been resistant
to chemotherapy,

presents with
progressive shortness of breath,

orthopnea, and angina.

It has to be
at least 35 pounds.

And 27 centimeters
for the longest diameter.

The tumor is displacing
the heart and great vessels.

The SVC is compressed,

and it's also indenting
the right lobe of the liver.

Mm.
How are the lungs?

Compressed,
with near total collapse

of the mid, right,
and lower lobes.

Has anyone tried to operate
on the thing?

Her name is London,

and yes, there have been
two attempts at Seattle Pres.

They had to abort
both times

because she arrested
on the table.

But you believe you would have
a different outcome

if you tried?
Well, I have removed

extremely difficult tumors
before,

a-and this one is benign.

So if we can successfully
remove it,

then she resumes
a normal life.

Even if you convinced
anesthesia,

you could still encounter
catastrophic bleeding.

And that is why I'm here,
at the tumor board,

where people help
their colleagues

to come up with a plan.

If anyone here thinks
this remotely is a possibility,

please speak up.

Yes.

♪♪

It's a tragic case, Dr. Bailey,
but...

it's a lawsuit
waiting to happen.

[ Stammers, sighs ]

I'll do it with you.

♪♪

The alternative is hospice,
right?

Mm-hmm.
Dr. Hunt,
It just can't be done.

Yeah. Well, you don't know
what we are capable of.

♪♪

Bye.
I knew you'd have an idea.

Yeah.
I got nothing.

♪♪

Well, look who's here!

How was your flight?

Ah. Most quiet I've had
in months.

Great.

Dr. Webber.
It's a pleasure.

I've heard a lot about you.
All good things.

Catherine's thrilled you've
joined the team in Boston.

She's thrilled she poached me
from Sloan Kettering.

You are at the forefront
of urologic oncology.

And that lecture
that you gave

to the American Urological
Association last month

brought the house down.

And she is developing
a program

that uses AI to study
biomarkers.

We just received
another grant for it yesterday.

You bet you did.

Now, tell us about
my husband's prostate.

Catherine, please.

If now's not
a good time --

Don't be ridiculous.
Come on, everybody. Sit down.

Have a seat.
Come on.

Good news is
you caught it early.

Grade Group 2
with 7 Gleason.

He knows all of that.
So tell us. What do you suggest?

Well, given the cancer's
localized

and you're generally
in good health,

I recommend
a radical prostatectomy.

I couldn't agree more.

If you're worried about side
effects -- urinary incontinence,

erectile dysfunction --
they are a risk.

But for many men --
What about infection?

It's unlikely but possible.

Blood clots, stroke,
injury to the rectum,

bladder, nerves --

They're all possible too,
right?

♪♪

Yeah.

Thank you for your time,

but I've already selected
an option with my own doctor.

Watchful waiting.
I've got patients to see.

♪♪

[ Door opens, closes ]

I'm not seeing abnormalities.
What's that wand called?

An ultrasound probe.
Write that down.

Okay.

All right.
The ultrasound is negative.

So she doesn't have
a clot.

Not that I can see.

Sounds like...
maybe there still might be one.

Well, your D-dimer
was slightly elevated,

which is the marker we look at
for clots.

It doesn't necessarily mean
anything,

but it is reason to come back
if you have any more pain.

Maybe I just need to stretch
before I go to the doctor.
Mm.

Stretch?
Uh, don't ask
any questions.

I'm gonna start your, um,
discharge paperwork.

What was that all about?

They like to role-play
doctor and patient in bed.

Good for them.

But they're so cute.

Mm.
Rustic cute.

Five reviews said those
rockers broke within a year.

[ Chuckles ]
How's the lake house?

We've moved from arguing
over tile

to arguing
over porch chairs.

How was
the tumor board?

Uh, un-- unfortunately, they are
concerned about the risks

and recommend
that we don't proceed.

So, naturally,
I called in reinforcements.

This is Dr. Owen Hunt.
He's one of our trauma surgeons.

If it's okay with you, I'd like
to work with Dr. Bailey

to make sure that we've explored
every possible option.

I want to help.

I like him.

Everyone else has reservations.
Why do you think you can do it?

Charlie, we've actually
found surgeons

that are not giving us
a hard no.

I've almost lost you
twice.

I'm definitely not ready
to lose you today

from some botched
operation.

Neither are we.

Hey.
I'm still here.

They're just asking
if they can go work on a plan.

If their plan leads to us
growing old together,

looking at the water
from shoddy

but very cute
rocking chairs...

...I'm in.

Aren't you?

[ Monitor beeping ]

♪♪

You really think
you can figure out a way

to keep her heart from stopping
when she's on that table?

Look. If we can't figure
this out, we won't proceed.

That was our deal
when you two came to me.

Okay.
Work on your plan.

Okay.
We'll be back.

Okay.

♪♪

Hi, my beauties!

They look bigger.
Did they get bigger?

Hattie's put on a full ounce
in the last 24 hours,

and Peyton isn't far behind.

That's right.
Lincolns know how to bulk.

[ Laughs ]

Hey, I got to go to PT.

You sure you're okay?
Yeah.

You sure?
Yeah.

All right.

Okay.

See you soon.

You're Peyton
and Hattie's mom?

Mm-hmm.

S-Sorry.

It's just that, um,
that's the first time

that somebody's
called me their mom.

Here.
[ Exhales deeply ]

Oh. Wait.
That one's not clean.

Um, here.

I'm an OB-GYN, and I...
talk to my patients all the time

about postpartum
hormone drops,

but I had no idea it was
this intense and just...random.

Yesterday, my boyfriend
and I were buying diapers --

for me, not the baby --

and the guy ringing me up said,
"Will that be all?"

And I burst into tears.

It's nice to know
that I'm not alone.

What?

You're my first
mom friend.

Oh!
I'm honored.

Did you tear?
Can I ask you that?

Yeah.
You can ask me anything.

But, um, no,
I-I didn't tear.

I, uh...I had something
called a crash C-section.

Oh.
Tell me everything.

I'll be back.

Richard.
What the hell are you doing?

I'm about to check
Mr. Tolli's wound vac.

You said you would hear
Kaplan out.

I did.

Is this because you're worried
about the bedroom?

Because you know
we'll figure that out.

Come on.

Woman on P.A.: Dr. Marion
Ziegler to the Cardiac Unit.

I'm not having
this conversation here.

Is this because you prefer
a male doctor?

Now, that's insulting.

I'm just trying to
understand

why you would dismiss a top
urologist like she's an intern.

I moved mountains
to bring her here for you!

I didn't ask you to.

Now, my cancer
hasn't metastasized.

Watchful waiting is
a perfectly reasonable option.

I've respected
your healthcare decisions

even when I didn't agree.

I need you to do the same
for me.

Woman on P.A.: Dr. Manner to
PEDS. Dr. Karin Manner to PEDS.

Who was the surgeon
at Seattle Pres?

Collins.
Yeah.

Uh, he actually did
his residency here

a couple of years
behind me.

When his chief
wouldn't let him try again,

he sent London to me.

If she codes the minute
she lays on the table,

why didn't they try
a reverse Trendelenburg,

keep her on an incline
to take the pressure

off some
of the cardiac vessels?

Look. They did.
But see how compressed they are?

It wasn't enough.
Winston: Okay.

What about conscious sedation
instead of general anesthesia?

She'd continue to breathe
on her own,

which would help blood return
back to the heart

and minimize
airway collapse.

I mean,
it might help some.

The tumor's matured
into its own ecosystem.

You can see
the calcifications, fat,

the cystic components.
What...

What if we drain it,
shrink the mass before we go in?

It's a good idea, but
the location is just too risky.

We can't risk the contents
of the tumor

spilling into the chest.

It will just regrow.
Yeah.

I got to run to a consult
in the pit,

but I will keep thinking
on this.

No promises, though.

Adams, Griffith, let's look up
every case report published

on mediastinal teratomas.

Research patterns.
Cross-reference solutions, okay?

We all just listened to
a podcast this morning

about how our hospital
pulled off a miracle.

Who's to say we can't
do it again, right? Go.

[ Exhales deeply ]

We're gonna come up
with something.

♪♪

Hey.
Hi.

Are you done
with that tablet?
Nope. Get your own.

Bailey and Hunt have
a massive mediastinal teratoma.

If you sweet-talk Bailey,
you could get in on it with us.

They're looking for ideas.

I'm too swamped down here.

Hey.
I'm sorry about this morning.

Jo's crying about everything
these days.

It's fine.
But she loves Iris,

so she'll be happy
if you two are a thing.

Why are you acting weird?
I'm not acting weird.

Yeah, you are.
[ Woman gasps, door opens ]

Help! Help! My wife!
Whoa. What the...

Hal?
Sir, you might want to
button that.

Oh, my God. Janet.
[ Gasping ]

Jules:
Okay.

I'm getting weak pulses.

Okay.
Janet, look at me.

I'm going to take care of you,
okay?

We need a gurney in here!

The plane won't be ready
for another couple of hours.

Catherine said
I could work in here.

Not a problem.

I owe you an apology.

I was led to believe

that you were the one
seeking a second opinion.

You couldn't have known.

I should have
at least suspected.

I think your wife
broke contract laws

to ensure my employment
at her hospital.

Don't feel bad.

You're not the first
to fall prey to her ways.

Guessing I won't be
the last.
[ Chuckles ]

She does it
'cause she cares.

That's what makes it
infuriating.

[ Both laugh ]

Feel free to say no.

But I've got a patient
with a retroperitoneal tumor.

And I would be remiss

if I didn't ask Fox Hospitals'
chief of chiefs for a consult.

No.
I got a little time.

How about we get a couple
pastries to go with this coffee?

Thank you.
That would be great.

22-pound teratoma
in the abdomen.

San Francisco, 2018.

They started with
a CAN'T-guided drainage.

Yeah, but look at the picture
of the CT.

Nowhere near the heart.
Another dead end.

[ Phone buzzes ]

Another dumb meme
from your patient?

Uh, she's asking for movie recs.
She's stuck at home.

Not exactly a doctor-patient
conversation topic.

She's Bailey's patient,

and she has Stage 4
gastric cancer.

She can ask
whatever she wants.

Yeah, but shouldn't you
keep it professional?

Look, you have no idea
what you're talking about.

I'm just saying you're young,
you're single, you...

you look like you.

You might be
leading her on.

♪♪

I'm her doctor.

And she's a vulnerable
patient.

I-I don't --
I don't need this right now.

No. I'm just trying to
look out for you.

Yeah.
Try less.

[ Phone chimes ]

Hunt's asking
for an update.

♪♪

Okay. Anything?
Not yet.

[ Sighs ]

Why'd you join this case
when everyone else dismissed it?

It's like you said.
It's benign.

Once it's out,
she moves on with her life.

There's no worry
of mets or recurrence.

Yeah. And I might be feeling
a little uninspired lately.

Aha.

Wouldn't have to do with other
people solving cases at weddings

and doing podcasts, would it?

[ Chuckles softly ]

I'll see you at drop-off.

I know everything's
falling on you right now.

She's lecturing,
and you're packing lunches.

I'm happy to do it,

and she deserves
all the attention.

I just think this tumor
was...

I don't know.

My patient cannot be the fix
to get you out of this slump.

What do we got?

Ten cases, at least half
of them considered inoperable.

And none of the masses
are nearly the same size.

There's one case that reported
a similar arrest in the O.R.,

but the team never tried it
again because they couldn't

safely find a way
around the heart and lungs.

Which is exactly what happened
with London.

As difficult as this is
for me to say...

I think we're out of options.

What about ECMO?
What about it?

We need to bypass
the pulmonary system,

so why don't we use
ECMO?

The machine oxygenates
and pumps the blood

so her heart and lungs
don't have to.

There is no arrest if the
machine is acting as her heart.

Don't say no yet.

I'm gonna go find Ndugu.

♪♪

Jules:
Almost there, Janet.

Janet: If this is a clot,
you can fix it, right?

Blood clots are treatable
if you catch them in time.

So it's a good thing
you were here.

[ Switch clicks ]
Weird but good.

I should probably be
embarrassed,

but I'm proud of us.

All my friends got bored
of their spouses

and filed for divorce.

But we got creative.

By coming to the hospital
and having sex.

Don't be jealous.

I'm sure other people
aren't getting any either.

Teddy:
All right. Let me see.

Looks like there's a left
iliac vein thrombosis.

Hal was right.
DVT.

If you look closely,

the iliac artery
is compressing the vein.

May-Thurner syndrome.
Mm-hmm.

Let's book an angio suite
for a thrombectomy

and iliac vein stenting
and start practicing.

I am gonna supervise you doing
the procedure.

Me?
She means me.

I don't care who it is
as long as you guys are prepped

and ready to go.

♪♪

You really think
this will work?

The challenge, right,
has always been the pressure

that your tumor
is putting on your heart,

your lungs,
and major arteries

when you're positioned
for surgery.

Owen: The ECMO machine
makes that irrelevant

because it oxygenates
and pumps your blood for you.

So no matter what happens,

your body will receive oxygen
and blood flow while we work.

I can't believe
you actually figured it out.

Have you done this before?
How common is this ECMO?

Charlie, you said you were in
if they figured it out.

How common is it?
It's not common for this.

And it can be hard to wean off
ECMO after removing something

that's compressed your lung
for so long.

But her heart is healthy.

I don't anticipate that being
a problem.

But it could be
a problem.

♪♪

You almost lost me twice.

If we do nothing, this thing
just keeps growing inside me

till it squashes
all my organs...

...and I'm definitely gone.

I don't want to live
like that.

Slowly suffocating.

And I don't want you to
have to watch me live like that.

We asked them
to come up with a solution.

♪♪

I'm taking it.
Okay.

Dr. Griffith and Dr. Adams
will get you prepped.

We will see you in the O.R.,
okay?

♪♪

Is it weird
that he's not blinking?

Newborn tear ducts
aren't fully developed.

It's so cool that you know
all this stuff.

Is it bad if I'm not, like...
feeling anything?

You mean you don't feel
a bond?

I'm already
a terrible mom.
No. No.

It's completely normal,
and you're exhausted,

and your hormones
are all over the place.

And to be honest,
newborns are kind of just blobs.

In a few weeks,
he'll be laughing and smiling,

and it just --
It gets so much better.

You're a really good
doctor.

Are you taking
new patients?

Well, it's --
Hey. How are my girls?

Hey.
Well, we made a new frien--

Whoa! Oh, my God.
Oh. Whoa.

Someone call
a rapid response.

Bridget:
Right away, Doctor.

♪♪

She's still seizing.

Someone get me
IM midazolam.

She's seven days postpartum.
Check her blood pressure.

It's probably eclampsia.
She needs mag now.

Link: Did she have any symptoms
before she started seizing?

No. She seemed completely fine.
It came out of nowhere.

We'll need to get her
up to O.B.

Will you go up with her?
Whatever you want.

Call me when you get
up there, okay?

♪♪

Scissors.
[ Monitor beeping ]

Put two units of blood
on standby.

Simone:
Lap pad.

All right.
I secured the cannula.

Adams, are we ready
to remove the clamps?

Yeah.
ECMO's ready.

♪♪

Okay.
Dark flow.

We have full flow.
Let's try lowering her down.

[ Machinery whirring ]

♪♪

At least that worked.
We're gonna make
all of it work.

Griffith, Adams,
you may never see

another case like this again,
so keep your eyes on the field.

You see any signs of hemodynamic
instability, speak up.

This is not a race.
Our goal is not to finish fast.

It is to keep her safe.

Understood?
Mm.

Mm-hmm.
Okay.

Okay. London.
Let's intubate.

♪♪

It's a hormonally active
adrenal mass,

so you need to watch out
for sudden hypertension.

I'm planning to use
alpha blockers.
Oh, good.

Well, I assume you're gonna
do this open, given the size.

That's the plan.

My colleague
will actually do it.

I usually stick to
robotic procedures.

Oh. You got something against
the old-fashioned way?

No.
Um...I have M.S.

So standing for long periods in
the O.R. just isn't an option.

I didn't realize.
I-I'm sorry.

No need to be sorry.

I mean, I was devastated
after I got the diagnosis.

I had put in so much work
my whole career,

and the thought of no longer
being in the O.R.

was soul-crushing...
to say the least.

But that's when I realized
it was just my fear talking.

And I looked at my symptoms --
muscle pain and leg weakness --

and I thought, "If only
there was a way to operate

while sitting down, without
having to hold the scalpel."

Was it a difficult
adjustment?

Adjusting to living with
a chronic illness is never easy.

But over time,

I just turned mess into
a pivot...not an ending.

Well, you seem to be
managing well.

Oh, well, I have my ups
and downs, believe me.

But Catherine Fox is flying me
around on her private plane

and paying me more money
than I know what to do with.

And I still get to do
what I love,

even if it is
in a different way.

They're gonna go ahead
with Bailey's giant teratoma

in O.R. 2.

Ndugu's gonna
have to resect --

Can we just focus, please?

It's a fake patient.
Calm down.

Don't tell me
to calm down.

What is wrong with you?

Is it about Simone breaking
that dumb pact?

No. And stop asking.
I'm fine.

Well, you don't seem fine.

That's because you
are bothering me.

Well, that can't be it.
I always bother you.

I'm just...

Oh, I'm just tired.

Every day is the same.

It's the same people

and the same rooms
and the same conversations,

and I'm just sick of it.

Well, I am sorry
we are not good enough for you.

I didn't say that.

You don't have to defend
yourself.

We all know you're aloof.

You're leaving?
Yeah.

I've already done
a thrombectomy.

You can have it.

Woman on P.A.:
Dr. Cardenas to the ICU.

Dr. Maria Cardenas to the ICU.

♪♪

What's happening?
Who's the doctor?

Uh, John Burnett.

An intern?

Let's get a CT.
They're getting a CT.

No. She has eclampsia.
Tell him she needs magnesium.

Really?
Tell him.

Uh...e-excuse me.

I've got Jo Wilson on the phone,
and she says it's eclampsia

and you should start her
on magnesium.

Her BP is only 143
over 91.

It could be
an intracranial hemorrhage.

Put me on speaker.

Um...okay.

You're on speaker.
Jo:
I understand your concern,

but postpartum eclampsia
doesn't always present

with a really high BP.

Neither does a brain bleed.
Barnett --

It's -- It's Burnett.
Whatever.

I may be on leave,
but that doesn't mean

I can't schedule you
to work every holiday

and make your life miserable.

So trust me when I tell you
to start the mag now.

[ Monitor beeping ]

Start an IV of magnesium.

[ Exhales deeply ]

♪♪

Your mom's gonna be okay.

Winston: We're gonna have to
take part of the lower lobe.

Adams, you want to staple
the lung?
Yep. Stapler.

Bailey, ready to start resecting
the adhered diaphragm?

Ready when you are.

Griffith, what should we be
careful to avoid?

Simone: Hepatic veins
and the retrohepatic IVC.

Good.
Let's get the stapler ready.
Ha.

London thought fixing up a
summer house was a lot of work.

It's got nothing
on fixing up a torso.

Reload, please.
[ Monitor beeping rapidly ]

Uh, BP's bottoming out.

Damn it.
I don't see any bleeding.

Neither do I.
The staple line looks clean.

Something's got to be causing
this. What the hell is it?

Does the ECMO say anything?
There's a suction-event
alarm.

Okay. Since we took
pressure off the lung,

could there be volume shifts?

That's definitely possible.
Yeah.

Okay. We need to up her pressors
and flood her with fluids.

If we don't get flow back
right away, she's done.

[ Beeping continues ]

Push fluids
as hard as you can.
I am.

BP's still dropping.
She can't take this much longer.

I should've listened to
that board. If I lose her --

This is not on you.

Come on, come on,
come on, come on.

BP's coming back up.

Well, that was close.

Okay, folks.

There's still a lot
of tumor left.

Griffith,
you're on the liver resection.

Adams, you're on
the superior mediastinum.

If...that's okay with you.

Do what we say
when we say it.

Stapler.

[ Monitor beeping steadily ]

Jules:
Contrast.

There's the occlusion
in the iliac vein.

Advance more.

Okay.
Pin the guide wire

and turn on the thrombectomy
catheter, please.

[ Machinery clicking,
monitor beeping ]

Blue: It's a shame Janet
isn't awake to see this.

It would really turn her...

into a passionate fan
of biological science

and anatomy.

Okay. I'm in. Turn it off.
I don't get it.

If you have to pretend to be
someone else for your partner

to want to sleep with you,
maybe you shouldn't be together.

I've learned you never know
what's going on

in another person's
relationship.

Ready.

Contrast.

Thrombus is gone.
The vein is patent.

Great work.
Now to stent.

Thanks again
for the consult.

I see why Catherine
calls you legendary.

Oh, she is prone
to exaggeration.

I know.
But in your case, it's true.

Well, you live up
to your reputation as well.

Oh. But not enough to consider
my recommendation?

I'm sorry. I-I...
I shouldn't have said that.

That's okay.

Can I ask you
about something?

Urosymphseal fistulas.

They are an extremely rare
post-op complication

of radical prostatectomy.
But the odds aren't zero.

They're close.

What if it happened?

Chronic pain,

which often leads to
difficulty walking,

possibly warranting the use
of opioids.

[ Sighs ]

I can treat complications,

but if your cancer grows
and metastasizes,

that's when my hands
are tied.

[ Bell chimes, door opens ]

If you change your mind or
if you just want to talk more,

Catherine has my number.

♪♪

♪♪

Done resecting the liver.
Good.

Excellent hemostasis.

[ Suction gurgling ]

All right.
No bleeding on this side.

Okay.
We are in the home stretch.

Let's get ready
to get this tumor out.

Hold on.
Hold on.

Do you hear that?
What?

[ Monitor beeping rapidly ]
Okay. We're gonna need more
lap pads, and hang blood.

Adams, quickly pack her.
Aw, damn it.

All right.
Keep the suction coming.

Oh, w-wait. Wait.
Ah! Okay.

There's a tear
where the IVC

passes through the diaphragm
into the chest.

I'm trying to secure --
Let me have a clamp.

Okay.
I need visualization.

Put the suction on the lap pads.
Not too harsh.

Gentle, steady pressure,
okay?

[ Suction hissing,
monitor beeping rapidly ]

♪♪

I think I got it.

I think that...

Ah. She's stabilizing.
[ Chuckles ]

Owen: Okay, everyone.
On the count of three.

Everyone needs to help
with this specimen.

Okay.
Ready?

One. Two. Three.

[ Grunts ]

Underneath it.
There we go.

[ Exhales deeply ]
Okay.

Okay.

Okay.

How do we all feel about getting
the hell out of here?

Yeah. You don't have to
ask me twice.

Bovie.

2-0 prolene.

[ Chuckles softly ]

♪♪

Okay. Stop here.

Iris.
Oh. Hey!
What are you doing up here?

So, a mom from the NICU

is being treated
for postpartum eclampsia.

Can you look up her chart?

Her name is Gina...
I don't know her last name.

I'm sorry. I can't.
You're not her doctor.

I just want to check
on her.

Do you want me
to call Marcus?

No. What I want
is my friend's chart.

I'm sorry.

Stop saying you're sorry.
Sorry doesn't help me.

I'm this woman's
only friend right now,

and the person
in charge of her care

has been a doctor
for about 90 days,

so if you could just please
remove the stick --

Jo.
All I want right now --

I think we should go.
No, we're not gonna go.

No. You cannot move me
against my will.

Stop!
I...

This is not okay.
Can you give me a minute?

This is...
Hey. Hey, hey, hey, hey.

Honey, look.
I know you're scared, okay?

But...honey, she's just
trying to do her job.

[ Sobbing ]
♪ There is ♪

♪ Light on the other side ♪

It will take a few days
to wean her off ECMO.

She does have
a long recovery.

But she's gonna come home.
Eventually.

That is the plan.

I don't know
how to thank you.

I think you just did.

[ Chuckles ]

She's always been
able to see what I can't.

Her mind is filled
with these big ideas

that always seem impossible.

Our wedding.
This lake house.

Getting this tumor removed.

But she knew you could do it.

And she was right.

I almost tried to stop her.

But I'm glad I stayed out of it.

[ Chuckles softly ]

Um, we'll let you both get
some rest.

Thank you.

Mm-hmm.

Great work today, Griffith.

You and Adams...
you really stepped up.

Thank you. I really
appreciate the opportunity.

I learned a lot.

We did...a good thing
today.

Some might call it...
inspiring.

Mm.

Might be even something
you could lecture about.

[ Chuckles ]
Hey, I hope I didn't overstep.

You know,
jumping in with the residents.
Oh. No.

I mean, if I'm the only voice
that's teaching them,

they'll wind up
tuning me out.

What do you think
about having the residents do

an ambulance ride-along
or EMS training?

Something that could really get
them thinking on their feet.

You know, it could help them
in the E.R.

or in situations like today
in the O.R.

I think you should write up
a proposal and send it to me.

♪♪

Teddy:
The surgery went well.

We were able to clear the clot
and put in the stent.

Thank you.
You'll need to be
on anticoagulation,

but after a while you'll be able
to get back to life as usual.

I'll get back to life as usual
right away?

Or when can I have sex
is what I'm asking.

Yeah.
We know.

You need to elevate your leg
when resting,

but other than that,
it is good to move it around.

Guess Trudy can still see
the doctor.

Trudy's always a good time,
but, honey...

I love you most
when you're just Janet.

♪♪

We'll give you
some privacy.

♪ Let go for dear life ♪

♪ Just free fall ♪

♪ Let go for dear life ♪

♪ Just free fall ♪

♪ Let go for dear life... ♪

I checked London's labs
before leaving.

Thanks.

Hey, I'm sorry
about earlier.

How you interact with your
patients -- your business.

I'll stay out of it.

I appreciate that.

I do value your opinion,
though.

You do?
I do.

Just, uh...
not about relationships,

for obvious reasons.

Ouch.

[ Laughs ]
Hey, look.

I'm putting together
a watch list for my patient.

What am I missing?

Mm.

What, she hasn't seen
any of these?

♪ Just free fall ♪

Thank you.

[ Indistinct conversations ]

Hey.

Hi.

Did you make it through
your busy day?

Oh.
I...I did.

Um, I did a thrombectomy
and placed a stent.

Nice, Millin.
[ Chuckles ]

You still haven't told me about
that thoracotomy, by the way.

It wasn't that big
a deal.

You saved a man's life
with your hands.

Doesn't get any bigger
than that.

Do you think I'm aloof?

Aloof.
Thank you.

Um...no.

You're discerning.
You don't suffer any fools.

But...that's not aloof.

That's, um...

That's protecting yourself
because you care.

It's funny you say that,
because I have been --

I had the worst day.

I need the biggest vodka tonic
that they have.

Hi.
I'm Iris.

Uh, this is Jules Millin,
a surgical resident.

Nice to meet you.
Yeah. Nice to meet you.

Um, I should go find
my friends.

Here.
Thank you.

See you later.

Meredith: It's jarring
when your identity shifts,

when you're suddenly a doctor,
a partner, a parent.

It helps if you focus on the
things that haven't changed .

I'm gonna have to change
hospitals.

I've cried in front of
too many people at this one.

They understand.

♪ Well, I wouldn't mind
if you never... ♪

I just feel like ever since
I was admitted,

I've just lost myself.

I can't take care
of our kids.

I can't take care
of my patients.

I can't even shower.

It's temporary.

Your heart
is recovering.

I know.

But...for a few hours today,
I got to be a doctor again

and help this woman navigate
a difficult time.

But then,
when it really mattered...

someone else
got to help her.

At least Gina's okay.

And I would bet that she'd say
what you did mattered, too.

Maybe even more.

[ Voice breaking ] Oh, God.
It's happening again.

No.

I'll get the tissues.
[ Exhales deeply ]

Just...
[ Chuckles ]

[ Laughs weakly ]

The comfort of old friends.
Thirty-five pounds.

That's like carrying
four babies.

Yeah,
or four bowling balls.

Who carries four
bowling balls?

People do weird things.

Got to go.

[ Phone buzzing ]

Yeah.
I'm out too.

See you tomorrow.
♪ But I'm running
off the track ♪

♪ Oh, yeah ♪

♪ Yeah ♪

She's just a stop sign.

Not a roadblock.

How did...
[ Phone buzzing ]

Doesn't matter.

Wait.
Are you leaving me too?

Um, s-sorry.

Hey. Have a drink on me.
Mm?

♪♪

Anyone sitting here?

♪♪

The thrill of trying
something new.

Hi.
I'm Sally.

Because even though you
may not recognize yourself...

Catherine?

[ Door closes ]
I'm sorry.

I am so sorry.

I-I got scared, and I just
called the best that I knew.

I should have talked to you
before I brought Laura in.

Look.
I've thought a lot

about letting fear
cloud judgment today.

Whatever you want to do,
I support, but --

I'm a surgeon.

I'm a senior member
of this hospital.

If something
were to go wrong

and I couldn't stand long enough
to do a simple appy,

I'd feel...weak.

And I don't know
how to lead like that.

I don't know who I'd be.

But people adapt.

I want to go ahead
with the surgery.

Mm.
♪ I'm under pressure ♪

♪ I feel the pressure ♪

It's been you all along.

♪♪

♪♪

♪♪