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WWW.MY-SUBS.CO
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In college, I was the hungover premed
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who fell asleep at her study carrel.
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If you're just joining our podcast,
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my guests are doctors Teddy Altman
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and Winston Ndugu from
Grey-Sloan Memorial,
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who pioneered the creation
of a ventral aorta surgery.
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At what point did you think,
"We just broke new ground"?
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- Immediately.
- Really?
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Yeah. Once that staple held, I knew.
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Sometimes you just have a feeling.
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In med school, I was
the famous surgeon's daughter.
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It wasn't like that for you?
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Honestly, there was
so much going on that night,
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I didn't have time to
process it all until later.
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Now I'm the famous surgeon.
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- So you had doubts?
- Oh, yeah.
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I was never certain it would work,
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but our patient didn't
have any other option.
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I knew that we had to try.
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In medicine, your
identity is constantly changing.
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It's your job to keep up.
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Safe to say it worked
out. What's next for you both?
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Well, we're still
monitoring our 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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Yeah. I'd come to this hospital.
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Well, speaking of...
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I made an appointment for you.
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We talked about this, Catherine.
I don't need another opinion.
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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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It's just another opinion.
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- Who am I seeing?
- 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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Hey, nice job on that podcast.
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I didn't realize you and Altman
came up with that at our wedding.
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Yeah, you never know
when an idea will strike.
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- Mmm.
- Go ahead, Dr. Adams.
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Uh, yes. Uh, Jo Wilson.
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Post-op day seven from emergency
C-section and Impella CP placement.
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Now post-op day three
from a 5.5 placement
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through the right axillary artery.
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Her heart function continues to recover
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with her EF up another five percent,
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and I heard she got to
meet her babies yesterday.
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- How are they doing?
- Hmm.
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Peyton's off of CPAP but still fragile.
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Hattie's bilirubin levels are bad
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every time they pause phototherapy.
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And you're all headed
in the right direction.
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- That's what matters.
- 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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- Dr. Ndugu.
- Hey.
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- I didn't know you were doing rounds.
- Yeah.
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I'll come back later.
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What was that?
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- What was what?
- Did you sleep with my favorite nurse?
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- Jo...
- Uh, should I leave?
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We've just gone out a
couple times. That's all.
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Well, are you gonna take her out again?
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- Uh, just... Maybe. It's new and...
- And none of our business.
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She is the entire
department's favorite nurse.
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Everybody loves her. Everyone.
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- Hormones.
- Okay.
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Uh, I-I need to check on my next
patient. Are you gonna be okay?
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- Yeah.
- Uh, page me if you need anything.
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- Good morning.
- Traitor.
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- Trouble in paradise?
- I broke our pact.
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- She's bitter.
- Then you should break it too.
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What, I can just snap my fingers?
Who am I supposed to sleep with?
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I ordered an X-ray for
Ms. Johnson's left arm.
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It was the right arm, wasn't it?
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I will fix it.
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An intern? Please. I have dignity.
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- Don't knock it until you've tried it.
- Tried what?
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Vegan sloppy joes.
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You sleeping with an intern too?
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Wait. Who's sleeping with an intern?
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- I am. Who are you texting?
- Nobody.
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- Doesn't look like nobody.
- Nah, she's just a patient.
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Why are you texting a patient?
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Yeah, well, Bailey made me drive
her an hour to get treatment,
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and now she's sending me dumb memes.
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- It's nothing.
- Wear a condom.
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She's a cancer patient.
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Hey. Did you see that
I admitted Mr. Howard?
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You don't have to put your phone down.
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- It's fine.
- Sorry.
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My phone has been blowing
up since the podcast dropped.
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I listened. You sounded great.
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Well, now I've got doctors
reaching out about their patients,
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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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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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Anyway, so, Mr. Howard, his
EKG shows a conduction block.
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- Do you want an echo?
- Um, yes. Sorry, I have to take this.
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Hi, this is Altman.
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Hi, Janet, I'm, uh, Dr. Millin.
I hear you're having some leg pain.
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Yeah, and some heaviness.
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I'm concerned it might be a DVT.
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I think she should have an ultrasound.
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I assume you want a full work up.
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CBC, D-dimer, and a duplex ultrasound?
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I'm Jules Millin.
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I'm a second-year surgical resident.
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You're internal medicine, right?
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Oh, no. Oh. I'm not a doctor.
Sorry. Yeah.
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- Oh, we were role-playing.
- Yeah.
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The more medical terms,
the better it gets.
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- Yeah.
- So, Hal does his homework.
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- So do you have leg pain or is this...
- Oh, no, that's real.
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The pain started this
morning when we were trying
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to squeeze in a quickie before work.
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- May I do an exam?
- Mm-hmm.
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Um, how long did the pain last for?
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- Uh, a few hours?
- Yeah.
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We've been trying to
spice things up lately,
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so we just wanna make sure we
haven't, uh, caused a problem.
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Oh, um...
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DVTs usually occur
with less, um, activity,
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but it is better to be safe than
sorry, so I will order some tests.
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- All right.
- And get back to you.
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- Okay. Thank you.
- Thank you.
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Dr. Griffith.
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A 38-year-old female with
a large mediastinal teratoma
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that has been resistant to chemotherapy.
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Presents with progressive
shortness of breath,
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orthopnea, and angina.
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It has to be at least 35 pounds.
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And, uh, 27 centimeters
for the longest diameter.
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The tumor is displacing
the heart and great vessels.
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The SVC is compressed,
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and it's also indenting
the right lobe of the liver.
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- Hmm. How are the lungs?
- Compressed with near total collapse
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of the mid-right and lower lobes.
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Has anyone tried to
operate on the thing?
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Her name is London
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and, yes, there have been
two attempts at Seattle Pres.
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They had to abort both times
because she arrested on the table.
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But you believe you would have
a different outcome if you tried?
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Well, I have removed extremely
difficult tumors before,
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and this one is benign.
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So, if we can successfully remove
it, then she resumes a normal life.
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Even if you convinced anesthesia,
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you could still encounter
catastrophic bleeding.
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And that is why I'm
here at the tumor board,
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where people help their
colleagues to come up with a plan.
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If anyone here thinks this remotely
is a possibility, please speak up.
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Yes.
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It's a tragic case, Dr. Bailey, but...
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It's a lawsuit waiting to happen.
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I'll do it with you.
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The alternative is hospice, right?
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Dr. Hunt, it just can't be done.
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Yeah, well, you don't
know what we're capable of.
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- Bye.
- I knew you'd have an idea.
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Yeah, I got nothing.
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What?
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- Synced and corrected by ChrisKe -
-- for www.MY-SUBS.com --
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Well, look who's here.
How was your flight?
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Most quiet I've had in months.
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- Oh, great.
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- Dr. Webber, it's a pleasure.
- Hi.
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I've heard a lot about you.
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All good things.
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Catherine's thrilled you
joined the team in Boston.
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She's thrilled she poached
me from Sloan Kettering.
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You are at the forefront of urologic
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oncology, and that lecture that you gave
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to the American Urological
Association last month
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brought the house down.
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And she is developing a program
that uses AI to study biomarkers.
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We just received another
grant for it yesterday.
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You bet you did.
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Now, tell us about
my husband's prostate.
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Catherine, please.
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- If now's not a good time...
- Don't be ridiculous.
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Come on, everybody. Sit down.
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Have a seat. Come on.
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Good news is you caught it early.
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Grade group two, a seven Gleason.
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Well, he knows all of that. So
tell us, what do you suggest?
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00:08:31,243 --> 00:08:32,565
Well, given the cancer's localized,
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and you're generally in good health,
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I recommend a radical prostatectomy.
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00:08:36,867 --> 00:08:38,282
I couldn't agree more.
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00:08:38,975 --> 00:08:40,710
If you're worried about side effects,
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urinary incontinence, erectile
dysfunction, they are a risk.
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00:08:44,513 --> 00:08:46,791
- But for many men...
- What about infection?
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00:08:47,259 --> 00:08:49,603
It's unlikely but possible.
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00:08:49,628 --> 00:08:54,724
Blood clots, stroke, injury
to the rectum, bladder, nerves?
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They're all possible too, right?
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00:08:59,467 --> 00:09:00,468
Yeah.
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00:09:01,894 --> 00:09:03,388
Thank you for your time,
208
00:09:03,413 --> 00:09:06,244
but I've already selected
an option with my own doctor.
209
00:09:06,874 --> 00:09:08,083
Watchful waiting.
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I've got patients to see.
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Not seeing abnormalities.
212
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What's that wand called?
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An ultrasound probe.
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- Write that down.
- Okay.
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00:09:23,173 --> 00:09:25,599
Right, the ultrasound is negative.
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00:09:26,195 --> 00:09:27,644
So, she doesn't have a clot?
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00:09:27,782 --> 00:09:29,025
Not that I can see.
218
00:09:29,050 --> 00:09:31,116
Sounds like maybe there
still might be one...
219
00:09:31,141 --> 00:09:33,177
Well, your D-dimer
was slightly elevated,
220
00:09:33,202 --> 00:09:34,662
which is the marker
we look at for clots.
221
00:09:34,800 --> 00:09:37,181
It doesn't necessarily mean
anything, but it is reason
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to come back if you have any more pain.
223
00:09:38,734 --> 00:09:41,840
Maybe I just need to stretch
before I go to the doctor.
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00:09:41,865 --> 00:09:43,153
- Mmm.
- Stretch?
225
00:09:43,177 --> 00:09:44,395
Uh, don't ask any questions.
226
00:09:44,420 --> 00:09:46,387
I'm gonna start your,
um, discharge paperwork.
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00:09:47,412 --> 00:09:48,606
What was that all about?
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00:09:48,631 --> 00:09:50,540
They like to role-play
doctor and patient in bed.
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Good for them.
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They're so cute.
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00:09:56,811 --> 00:09:58,158
Rustic cute?
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00:09:58,183 --> 00:10:00,273
Five reviews say those
rockers broke within a year.
233
00:10:01,323 --> 00:10:02,945
How's the lake house?
234
00:10:02,970 --> 00:10:06,624
We've moved from arguing over
tile to arguing over porch chairs.
235
00:10:06,649 --> 00:10:08,795
How was the tumor board?
236
00:10:08,820 --> 00:10:13,103
Uh, unfortunately, they are
concerned about the risks
237
00:10:13,242 --> 00:10:15,865
and recommend that we don't proceed.
238
00:10:16,116 --> 00:10:21,466
So naturally I called in reinforcements.
This is Dr. Owen Hunt.
239
00:10:21,491 --> 00:10:24,011
- He's one of our trauma surgeons.
- Hi.
240
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If it's okay with you, I'd
like to work with Dr. Bailey
241
00:10:26,294 --> 00:10:29,060
to make sure that we've
explored every possible option.
242
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I want to help.
243
00:10:30,638 --> 00:10:32,364
- I like him.
- Mmm.
244
00:10:33,164 --> 00:10:36,482
If everyone else has reservations,
why do you think you can do it?
245
00:10:36,713 --> 00:10:39,759
Charlie, we've actually found surgeons
246
00:10:39,783 --> 00:10:42,581
that are not giving us a hard no.
247
00:10:42,606 --> 00:10:44,712
And I've almost lost you twice.
248
00:10:44,963 --> 00:10:46,660
I'm definitely not ready to lose you
249
00:10:46,684 --> 00:10:48,380
today from some botched operation.
250
00:10:48,518 --> 00:10:51,866
- Neither are we.
- Hey, I'm still here.
251
00:10:52,591 --> 00:10:55,021
They're just asking if
they can go work on a plan.
252
00:10:55,627 --> 00:10:59,079
If their plan leads to
us growing old together,
253
00:10:59,115 --> 00:11:04,638
looking at the water from shoddy
but very cute rocking chairs...
254
00:11:06,315 --> 00:11:08,938
I'm in. Aren't you?
255
00:11:13,129 --> 00:11:15,244
You really think you can
figure out a way to keep
256
00:11:15,269 --> 00:11:17,040
her heart from stopping
when she's on that table?
257
00:11:17,064 --> 00:11:20,076
Look, if we can't figure this
out, we won't proceed, right?
258
00:11:20,101 --> 00:11:22,380
That was our deal when
you two came to me.
259
00:11:24,036 --> 00:11:25,866
Okay, work on your plan.
260
00:11:25,891 --> 00:11:27,912
- Okay.
- We'll be back.
261
00:11:27,937 --> 00:11:29,249
Okay.
262
00:11:35,907 --> 00:11:39,326
Hi, my cuties.
263
00:11:41,123 --> 00:11:43,523
They look bigger. Did they get bigger?
264
00:11:43,548 --> 00:11:46,413
Hattie's put on a full
ounce in the last 24 hours,
265
00:11:46,438 --> 00:11:48,578
- and Peyton isn't far behind.
- That's right.
266
00:11:48,829 --> 00:11:50,383
Lincolns know how to bulk.
267
00:11:53,373 --> 00:11:55,466
I gotta go to PT. Sure you're okay?
268
00:11:55,491 --> 00:11:56,906
- Yeah.
- Okay. You sure?
269
00:11:56,931 --> 00:11:58,070
Yeah.
270
00:11:59,121 --> 00:12:00,915
- All right.
- Okay.
271
00:12:02,397 --> 00:12:03,812
- See you soon.
- Yeah.
272
00:12:06,533 --> 00:12:08,553
You're Peyton and Hattie's mom?
273
00:12:08,978 --> 00:12:11,083
Mm-hmm.
274
00:12:13,116 --> 00:12:15,118
Sorry, it's just that, um...
275
00:12:15,642 --> 00:12:18,921
That's the first time that
somebody's called me their mom.
276
00:12:20,083 --> 00:12:21,119
Here.
277
00:12:23,058 --> 00:12:25,491
Oh, wait, that one's not clean.
278
00:12:26,836 --> 00:12:27,837
- Here.
- Thanks.
279
00:12:28,446 --> 00:12:31,976
I'm an OB-GYN, and
I talk to my patients
280
00:12:32,001 --> 00:12:34,590
all the time about
postpartum hormone drops,
281
00:12:34,623 --> 00:12:38,827
but I had no idea it was
this intense and just... random.
282
00:12:39,146 --> 00:12:43,298
Yesterday, my boyfriend and I were
buying diapers for me not the baby,
283
00:12:43,323 --> 00:12:46,177
and the guy ringing me up said,
"Will that be all?"
284
00:12:46,202 --> 00:12:47,957
And I burst into tears.
285
00:12:47,982 --> 00:12:49,984
It's nice to know that I'm not alone.
286
00:12:52,470 --> 00:12:54,057
What?
287
00:12:54,082 --> 00:12:56,108
You're my first mom friend.
288
00:12:56,560 --> 00:12:59,114
Oh. I'm honored.
289
00:12:59,377 --> 00:13:01,965
Did you tear or... Can I ask you that?
290
00:13:02,065 --> 00:13:05,379
Yeah, you can ask me anything,
but, um, no, I-I didn't tear.
291
00:13:05,404 --> 00:13:09,393
I, uh... ... I had
something called a crash C-section.
292
00:13:09,418 --> 00:13:11,489
Oh, tell me everything.
293
00:13:13,939 --> 00:13:15,009
I'll be back.
294
00:13:15,034 --> 00:13:17,311
Richard, what the hell are you doing?
295
00:13:17,956 --> 00:13:19,886
I'm about to check
Mr. Tolli's wound VAC.
296
00:13:19,911 --> 00:13:22,327
You said you would hear Kaplan out.
297
00:13:22,352 --> 00:13:24,078
I did.
298
00:13:24,321 --> 00:13:26,410
Is this because you're
worried about the bedroom?
299
00:13:26,435 --> 00:13:29,272
Because you know we'll figure that out.
300
00:13:31,357 --> 00:13:32,393
Come on.
301
00:13:38,412 --> 00:13:39,838
I'm not having this conversation here.
302
00:13:39,862 --> 00:13:42,253
Is this because you
prefer a male doctor?
303
00:13:42,278 --> 00:13:43,668
Now that's insulting!
304
00:13:43,693 --> 00:13:45,360
Well, I'm just trying to understand why
305
00:13:45,385 --> 00:13:48,742
you would dismiss a top
urologist like she's an intern.
306
00:13:48,767 --> 00:13:50,779
I moved mountains to
bring her here for you.
307
00:13:50,804 --> 00:13:52,300
I didn't ask you to.
308
00:13:53,220 --> 00:13:55,231
Now, my cancer hasn't metastasized.
309
00:13:55,256 --> 00:13:58,183
Watchful waiting is a
perfectly reasonable option.
310
00:13:58,398 --> 00:14:01,401
I respected your health care
decisions even when I didn't agree.
311
00:14:02,229 --> 00:14:03,920
I need you to do the same for me.
312
00:14:05,888 --> 00:14:08,442
... 1962.
313
00:14:08,580 --> 00:14:11,178
- Who was the surgeon at Seattle Pres?
- Collins.
314
00:14:11,203 --> 00:14:14,941
Yeah, he actually did his residency
here a couple of years behind me.
315
00:14:14,966 --> 00:14:18,418
When his chief wouldn't let him
try again, he sent London to me.
316
00:14:18,443 --> 00:14:20,740
If she codes the minute
she lays on the table,
317
00:14:20,765 --> 00:14:22,604
why didn't they try a
reverse Trendelenburg?
318
00:14:22,629 --> 00:14:23,745
Keep her at an incline to take the
319
00:14:23,769 --> 00:14:25,060
pressure off some of
the cardiac vessels?
320
00:14:25,085 --> 00:14:28,230
Oh, no, they did. Uh, but
see how compressed they are?
321
00:14:28,255 --> 00:14:29,645
It wasn't enough.
322
00:14:29,670 --> 00:14:31,476
Okay, what about conscious sedation
instead of general anesthesia?
323
00:14:31,500 --> 00:14:33,985
She'd continue to breathe
on her own, which would help
324
00:14:34,010 --> 00:14:36,963
blood return back to the heart
and minimize airway collapse.
325
00:14:36,988 --> 00:14:39,300
I mean, it might help some...
326
00:14:39,439 --> 00:14:41,494
The tumor's matured
into its own ecosystem.
327
00:14:41,519 --> 00:14:42,969
You can see the calcifications,
328
00:14:42,994 --> 00:14:46,929
- fat, the cystic components.
- Yeah? What?
329
00:14:46,954 --> 00:14:49,493
What if we drain it? Shrink
the mass before we go in?
330
00:14:49,518 --> 00:14:51,702
It's a good idea, but the
location is just too risky.
331
00:14:51,727 --> 00:14:54,084
We can't risk the contents of
the tumor spilling into the chest.
332
00:14:54,108 --> 00:14:55,913
It would just regrow.
333
00:14:55,938 --> 00:14:57,329
I gotta run to a consult in the pit,
334
00:14:57,353 --> 00:14:58,606
but I will keep thinking on this.
335
00:14:58,630 --> 00:15:00,701
No promises though.
336
00:15:01,806 --> 00:15:03,917
Adams, Griffith, let's
look up every case
337
00:15:03,941 --> 00:15:06,164
report published on
mediastinal teratomas.
338
00:15:06,189 --> 00:15:09,255
Research patterns,
cross-reference solutions, okay?
339
00:15:09,985 --> 00:15:11,687
We all just listened to
a podcast this morning
340
00:15:11,712 --> 00:15:13,414
about how our hospital
pulled off a miracle.
341
00:15:13,438 --> 00:15:15,716
Who's to say we can't
do it again, right? Go.
342
00:15:18,636 --> 00:15:20,879
We're gonna come up with something.
343
00:15:22,802 --> 00:15:24,286
- Hey.
- Hi.
344
00:15:24,424 --> 00:15:26,840
- Are you done with that tablet?
- Nope, get your own.
345
00:15:26,865 --> 00:15:30,114
Bailey and Hunt have a
massive mediastinal teratoma.
346
00:15:30,139 --> 00:15:32,467
If you sweet-talk Bailey,
you can get in on it with us.
347
00:15:32,492 --> 00:15:33,532
They're looking for ideas.
348
00:15:33,717 --> 00:15:35,201
I'm too swamped down here.
349
00:15:35,991 --> 00:15:38,680
Hey, I'm sorry about this morning.
350
00:15:38,705 --> 00:15:39,963
Jo's crying about everything these days.
351
00:15:39,987 --> 00:15:43,227
- It's fine.
- But she loves Iris, so...
352
00:15:43,632 --> 00:15:45,472
she'll be happy if you two are a thing.
353
00:15:52,477 --> 00:15:54,558
- Why are you acting weird?
- I'm not acting weird.
354
00:15:54,583 --> 00:15:56,560
Yeah, you are.
355
00:15:56,585 --> 00:15:58,976
- Help. Help my wife! Help.
- Hal?
356
00:15:59,001 --> 00:16:00,772
- Sir, you might wanna button that.
- Oh, my God. Janet.
357
00:16:05,360 --> 00:16:06,638
I'm getting weak pulses.
358
00:16:07,381 --> 00:16:09,625
Janet, look at me. I'm
going to care of you, okay?
359
00:16:10,084 --> 00:16:11,569
We need a gurney in here!
360
00:16:16,227 --> 00:16:18,099
The plane won't be ready
for another couple of hours.
361
00:16:18,124 --> 00:16:21,368
- Catherine said I could work in here.
- Not a problem.
362
00:16:24,335 --> 00:16:25,750
I owe you an apology.
363
00:16:26,753 --> 00:16:29,861
I was led to believe that you were
the one seeking a second opinion.
364
00:16:29,886 --> 00:16:31,094
You couldn't have known.
365
00:16:31,482 --> 00:16:33,290
I should have at least suspected.
366
00:16:33,656 --> 00:16:35,244
I think your wife broke contract laws
367
00:16:35,269 --> 00:16:36,911
to ensure my employment at her hospital.
368
00:16:36,935 --> 00:16:38,144
Don't feel bad.
369
00:16:38,169 --> 00:16:41,387
You're not the first to
fall prey to her ways.
370
00:16:41,906 --> 00:16:44,081
I'm guessing I won't be the last.
371
00:16:44,578 --> 00:16:46,269
She does it 'cause she cares.
372
00:16:46,945 --> 00:16:50,121
That's what makes it infuriating.
373
00:16:53,228 --> 00:16:54,543
Feel free to say no.
374
00:16:55,188 --> 00:16:58,346
But I've got a patient with
a retroperitoneal tumor,
375
00:16:58,371 --> 00:17:00,938
and I would be remiss
if I didn't ask Fox
376
00:17:00,963 --> 00:17:03,281
Hospitals' Chief of
Chiefs for a consult.
377
00:17:04,432 --> 00:17:06,785
- No. Got a little time.
- Yeah.
378
00:17:07,137 --> 00:17:10,934
How about we get a couple of
pastries to go with this coffee?
379
00:17:11,260 --> 00:17:13,262
Thank you. That would be great.
380
00:17:14,727 --> 00:17:16,934
"Twenty-two-pound
teratoma in the abdomen.
381
00:17:17,303 --> 00:17:21,714
San Francisco, 2018." They
started with a CT-guided drainage.
382
00:17:21,739 --> 00:17:23,299
Yeah, but look at the picture of the CT.
383
00:17:23,474 --> 00:17:24,820
Nowhere near the heart.
384
00:17:24,845 --> 00:17:26,744
Another dead end.
385
00:17:28,410 --> 00:17:29,810
Another dumb meme from your patient?
386
00:17:29,835 --> 00:17:31,715
No, she's asking for movie recs.
387
00:17:32,276 --> 00:17:33,380
She's stuck at home.
388
00:17:33,992 --> 00:17:36,443
Not exactly a doctor-patient
conversation topic.
389
00:17:37,237 --> 00:17:39,757
She's Bailey's patient. She
has stage four gastric cancer.
390
00:17:39,782 --> 00:17:42,045
She can ask whatever she wants.
391
00:17:42,070 --> 00:17:43,530
I mean, shouldn't you
keep it professional?
392
00:17:43,554 --> 00:17:45,497
Look, you have no idea what
you're talking about. It's...
393
00:17:45,522 --> 00:17:47,562
I'm just saying, you're
young, you're single. You...
394
00:17:48,082 --> 00:17:50,559
You look like you
might be leading her on.
395
00:17:51,907 --> 00:17:54,737
- I'm her doctor.
- And she's a vulnerable patient.
396
00:17:55,411 --> 00:17:57,406
I don't... I don't need this right now.
397
00:17:57,430 --> 00:17:59,639
- I'm just trying to look out for you.
- Yeah, try less.
398
00:18:02,193 --> 00:18:03,850
Hunt's asking for an update.
399
00:18:06,449 --> 00:18:09,142
- Okay, anything?
- Not yet. Thanks.
400
00:18:12,826 --> 00:18:16,347
Why did you join this case
when everyone else dismissed it?
401
00:18:16,372 --> 00:18:17,873
It's like you said, it's benign.
402
00:18:17,898 --> 00:18:19,806
Once it's out, she
moves on with her life.
403
00:18:19,831 --> 00:18:22,455
There's no worry of mets or recurrence.
404
00:18:25,561 --> 00:18:29,047
Yeah... ... I might be
feeling a little uninspired lately.
405
00:18:29,072 --> 00:18:32,923
Uh-huh. Wouldn't have to
do with other people solving
406
00:18:32,948 --> 00:18:35,385
cases at weddings and
doing podcasts, would it?
407
00:18:35,719 --> 00:18:38,825
I see you at drop-off.
408
00:18:38,964 --> 00:18:41,104
I know everything's
falling on you right now.
409
00:18:41,242 --> 00:18:44,393
She's lecturing and
you're packing lunches.
410
00:18:44,418 --> 00:18:47,877
I'm happy to do it, and she
deserves all the attention.
411
00:18:48,239 --> 00:18:50,379
I just think this tumor was...
412
00:18:51,995 --> 00:18:53,120
I don't know.
413
00:18:53,145 --> 00:18:56,834
My patient cannot be the fix
to get you out of this slump.
414
00:18:57,691 --> 00:18:58,737
What have you got?
415
00:18:58,762 --> 00:19:01,952
Ten cases, at least half of
them considered inoperable.
416
00:19:01,977 --> 00:19:04,334
And none of the masses
are nearly the same size.
417
00:19:04,359 --> 00:19:06,544
There's one case that reported
a similar arrest in the OR,
418
00:19:06,568 --> 00:19:08,372
but the team never tried it again
419
00:19:08,397 --> 00:19:10,996
because they couldn't safely find
a way around the heart and lungs.
420
00:19:11,020 --> 00:19:13,506
Which is exactly what
happened with London.
421
00:19:13,738 --> 00:19:16,258
As difficult as this is for me to say...
422
00:19:17,389 --> 00:19:19,426
I think we're out of options.
423
00:19:19,979 --> 00:19:22,143
- What about ECMO?
- What about it?
424
00:19:22,168 --> 00:19:25,734
We need to bypass the pulmonary
system, so why don't we use ECMO?
425
00:19:25,759 --> 00:19:27,416
The machine oxygenates
and pumps the blood
426
00:19:27,441 --> 00:19:29,359
so her heart and lungs don't have to.
427
00:19:29,422 --> 00:19:33,909
There is no arrest if
the machine is acting as her heart.
428
00:19:35,288 --> 00:19:38,698
Don't say no yet.
I'm gonna go find Ndugu.
429
00:19:38,904 --> 00:19:39,939
Okay.
430
00:19:42,020 --> 00:19:43,545
Almost there, Janet.
431
00:19:43,570 --> 00:19:45,676
If this is a clot, you can fix it, right?
432
00:19:47,147 --> 00:19:49,551
Blood clots are treatable
if you catch them in time,
433
00:19:49,576 --> 00:19:50,856
so it's a good thing you're here.
434
00:19:52,548 --> 00:19:54,026
Weird but good.
435
00:19:54,051 --> 00:19:57,214
I should probably be
embarrassed, but I'm proud of us.
436
00:19:57,239 --> 00:19:59,379
All my friends got
bored of their spouses
437
00:19:59,760 --> 00:20:03,186
and filed for divorce,
but we got creative.
438
00:20:03,390 --> 00:20:05,564
By coming to the
hospital and having sex.
439
00:20:06,558 --> 00:20:09,245
Don't be jealous. I'm sure other
people aren't getting any either.
440
00:20:09,705 --> 00:20:11,500
All right, let me see.
441
00:20:14,004 --> 00:20:16,958
Looks like there's a left
iliac vein thrombosis.
442
00:20:16,983 --> 00:20:18,605
Hal was right. DVT.
443
00:20:18,630 --> 00:20:22,101
If you look closely, the iliac
artery is compressing the vein.
444
00:20:22,126 --> 00:20:23,990
- May-Thurner syndrome.
- Mm-hmm.
445
00:20:24,241 --> 00:20:25,863
All right, let's book an angio suite
446
00:20:25,888 --> 00:20:29,271
for a thrombectomy and iliac vein
stenting and start practicing.
447
00:20:29,296 --> 00:20:31,884
I'm gonna supervise
you doing the procedure.
448
00:20:33,195 --> 00:20:34,783
- Me?
- She means me.
449
00:20:35,651 --> 00:20:37,262
I don't care who it is... as long as
450
00:20:37,287 --> 00:20:39,074
you guys are prepped and ready to go.
451
00:20:43,025 --> 00:20:44,572
You really think this will work?
452
00:20:44,597 --> 00:20:47,600
The challenge, right, has
always been the pressure
453
00:20:47,625 --> 00:20:50,129
that your tumor is
putting on your heart,
454
00:20:50,154 --> 00:20:53,719
your lungs and major arteries
when you're positioned for surgery.
455
00:20:53,744 --> 00:20:55,446
And the ECMO machine
makes that irrelevant
456
00:20:55,470 --> 00:20:57,619
because it oxygenates and
pumps your blood for you.
457
00:20:57,644 --> 00:21:00,371
So no matter what happens,
your body will receive oxygen
458
00:21:00,396 --> 00:21:02,306
and blood flow while we work.
459
00:21:03,151 --> 00:21:05,257
I can't believe you
actually figured it out.
460
00:21:05,282 --> 00:21:08,423
Have you done this before?
I mean, how common is this ECMO?
461
00:21:08,448 --> 00:21:11,461
Charlie, you said you were
in if they figured it out.
462
00:21:11,486 --> 00:21:12,999
How common is it?
463
00:21:13,024 --> 00:21:16,362
It's not common for this, and
it can be hard to wean off ECMO
464
00:21:16,387 --> 00:21:19,114
after removing something that's
compressed your lung for so long,
465
00:21:19,139 --> 00:21:20,573
but her heart is healthy.
466
00:21:20,711 --> 00:21:22,403
I don't anticipate that being a problem.
467
00:21:22,428 --> 00:21:24,775
But it could be a problem.
468
00:21:27,715 --> 00:21:29,303
You almost lost me twice.
469
00:21:30,418 --> 00:21:33,732
If we do nothing, this thing
just keeps growing inside me
470
00:21:34,274 --> 00:21:39,624
until it squashes all my
organs... and I'm definitely gone.
471
00:21:40,549 --> 00:21:41,964
I don't wanna live like that.
472
00:21:43,690 --> 00:21:45,382
Slowly suffocating.
473
00:21:46,141 --> 00:21:49,455
I don't want you to have
to watch me live like that.
474
00:21:50,490 --> 00:21:53,458
We asked them to come
up with a solution.
475
00:21:56,220 --> 00:21:57,784
I'm taking it.
476
00:21:57,808 --> 00:21:59,855
Okay, Dr. Griffith and Dr.
Adams will get you prepped,
477
00:21:59,879 --> 00:22:02,191
and we will see you in the OR, okay?
478
00:22:07,162 --> 00:22:08,522
Is it weird that he's not blinking?
479
00:22:08,646 --> 00:22:10,890
Newborn tear ducts
aren't fully developed.
480
00:22:11,075 --> 00:22:12,939
It's so cool that you
know all this stuff.
481
00:22:14,031 --> 00:22:17,389
Is it bad if I'm not,
like, feeling anything?
482
00:22:17,508 --> 00:22:19,201
You mean you don't feel a bond?
483
00:22:20,776 --> 00:22:22,670
- I'm already a terrible mom.
- No.
484
00:22:22,695 --> 00:22:26,215
No, it's completely normal,
and you're exhausted,
485
00:22:26,240 --> 00:22:27,769
and your hormones are
all over the place.
486
00:22:27,794 --> 00:22:31,195
And to be honest, newborns
are kinda just blobs.
487
00:22:31,333 --> 00:22:34,647
In a few weeks, he'll be laughing
and smiling, and it just...
488
00:22:34,672 --> 00:22:35,984
it gets so much better.
489
00:22:36,607 --> 00:22:38,126
You're a really good doctor.
490
00:22:38,938 --> 00:22:40,767
Are you taking new patients?
491
00:22:41,306 --> 00:22:42,724
- Well, it's...
- Hey.
492
00:22:42,749 --> 00:22:45,683
- How're my girls?
- Hey. Well, we made a new friend...
493
00:22:45,821 --> 00:22:48,928
- Whoa. Oh, my God.
- Oh. Oh. Someone call a rapid response!
494
00:22:48,953 --> 00:22:50,361
Right away, Doctor.
495
00:22:56,357 --> 00:22:57,600
She's still seizing.
496
00:22:59,082 --> 00:23:00,697
Someone give me IM midazolam.
497
00:23:01,061 --> 00:23:03,477
She's seven days postpartum.
Check her blood pressure.
498
00:23:03,502 --> 00:23:05,617
It's probably eclampsia.
She needs mag now.
499
00:23:05,642 --> 00:23:07,620
Did she have any
symptoms before she started seizing?
500
00:23:07,644 --> 00:23:10,203
No, she seemed completely
fine. It came out of nowhere.
501
00:23:10,228 --> 00:23:11,622
We'll need to get her up to OB.
502
00:23:11,647 --> 00:23:14,054
- Will you go up with her?
- Whatever you want.
503
00:23:14,681 --> 00:23:15,869
Call me when you get up there.
504
00:23:21,226 --> 00:23:22,503
Scissors.
505
00:23:23,692 --> 00:23:26,730
- Put two units of blood on standby.
- Lap pad.
506
00:23:28,976 --> 00:23:30,667
All right, I secured the cannula.
507
00:23:30,692 --> 00:23:32,635
Adams, are we ready
to remove the clamps?
508
00:23:33,322 --> 00:23:35,704
Yeah, ECMO's ready.
509
00:23:39,435 --> 00:23:41,403
Okay, the dark flow.
510
00:23:42,300 --> 00:23:43,448
We have full flow.
511
00:23:43,473 --> 00:23:44,854
Let's try lowering her down.
512
00:23:51,972 --> 00:23:53,027
At least that worked.
513
00:23:53,051 --> 00:23:54,666
We're gonna make all of it work.
514
00:23:54,691 --> 00:23:56,946
Griffith, Adams, you may never
see another case like this again,
515
00:23:56,970 --> 00:23:58,488
so keep your eyes on the field.
516
00:23:58,513 --> 00:24:01,905
If you see any signs of
hemodynamic instability, speak up.
517
00:24:02,044 --> 00:24:05,323
This is not a race.
Our goal is not to finish fast.
518
00:24:05,461 --> 00:24:07,957
It is to keep her safe.
519
00:24:07,982 --> 00:24:09,302
Understood? -
Mm-hmm.
520
00:24:09,327 --> 00:24:10,328
Okay.
521
00:24:11,363 --> 00:24:12,640
Okay, London.
522
00:24:13,082 --> 00:24:14,459
Let's intubate.
523
00:24:19,130 --> 00:24:21,624
It's a hormonally active adrenal mass,
524
00:24:21,649 --> 00:24:23,865
so you need to watch out
for sudden hypertension.
525
00:24:24,073 --> 00:24:25,793
- I'm planning to use alpha-blockers.
- Good.
526
00:24:25,818 --> 00:24:29,218
Well, I assume you're gonna
do this open, given the size?
527
00:24:29,243 --> 00:24:32,325
That's the plan.
My colleague will actually do it.
528
00:24:32,350 --> 00:24:34,697
I usually stick to robotic procedures.
529
00:24:34,722 --> 00:24:37,587
Oh. You got something
against the old-fashioned way?
530
00:24:37,990 --> 00:24:41,748
No, um... I have MS,
531
00:24:42,185 --> 00:24:45,821
so standing for long periods
in the OR just isn't an option.
532
00:24:45,846 --> 00:24:49,662
- I didn't realize. I'm sorry.
- No need to be sorry.
533
00:24:49,901 --> 00:24:52,663
I mean, I was devastated
after I got the diagnosis.
534
00:24:53,640 --> 00:24:55,918
I had put in so much
work my whole career,
535
00:24:55,943 --> 00:24:59,232
and the thought of no longer being
in the OR... was soul-crushing...
536
00:25:00,192 --> 00:25:01,538
to say the least.
537
00:25:02,414 --> 00:25:05,038
But that's when I realized
it was just my fear talking.
538
00:25:06,079 --> 00:25:07,893
And I looked at my symptoms,
539
00:25:07,918 --> 00:25:10,541
muscle pain and leg
weakness, and I thought,
540
00:25:11,140 --> 00:25:13,280
"If only there was a way to operate
541
00:25:13,402 --> 00:25:17,088
while sitting down without
having to hold a scalpel."
542
00:25:19,056 --> 00:25:20,644
Was it a difficult adjustment?
543
00:25:21,429 --> 00:25:24,466
Adjusting to living with a
chronic illness is never easy.
544
00:25:24,784 --> 00:25:28,088
But over time, I just
turned MS into a pivot.
545
00:25:29,433 --> 00:25:30,537
Not an ending.
546
00:25:31,610 --> 00:25:34,387
Well, you seem to be managing well.
547
00:25:34,412 --> 00:25:37,635
Oh, well, I have my ups and
downs, believe me.
548
00:25:38,037 --> 00:25:41,661
But Catherine Fox is flying
me around on her private plane
549
00:25:41,686 --> 00:25:44,103
and paying me more money
than I know what to do with.
550
00:25:45,714 --> 00:25:47,371
And I still get to do what I love.
551
00:25:48,194 --> 00:25:50,230
Even if it is in a different way.
552
00:25:52,563 --> 00:25:56,189
Now they're gonna go ahead with
Bailey's giant teratoma in OR two.
553
00:25:56,537 --> 00:25:59,161
- Ndugu's gonna have to resect...
- Can we just focus, please?
554
00:25:59,816 --> 00:26:01,404
It's a fake patient. Calm down.
555
00:26:01,510 --> 00:26:03,347
Don't tell me to calm down.
556
00:26:03,372 --> 00:26:04,821
What is wrong with you?
557
00:26:05,615 --> 00:26:08,998
Is it about Simone
breaking that dumb pact?
558
00:26:09,249 --> 00:26:11,872
No, and stop asking. I'm fine.
559
00:26:11,897 --> 00:26:13,761
No, you don't seem fine.
560
00:26:13,786 --> 00:26:16,400
Well, it's because you are bothering me.
561
00:26:16,937 --> 00:26:19,452
Well, that can't be it.
I always bother you.
562
00:26:19,477 --> 00:26:20,616
I'm just...
563
00:26:22,049 --> 00:26:24,299
I'm just tired.
564
00:26:24,690 --> 00:26:26,347
Every day is the same.
565
00:26:26,372 --> 00:26:30,891
It's the same people and the same
rooms and the same conversations,
566
00:26:30,916 --> 00:26:33,436
and I'm just... sick of it.
567
00:26:33,461 --> 00:26:36,305
Well, I am sorry we are
not good enough for you.
568
00:26:36,330 --> 00:26:37,564
I didn't say that.
569
00:26:37,589 --> 00:26:40,719
Yeah, you don't have to defend yourself.
We all know you're aloof.
570
00:26:49,174 --> 00:26:50,493
You're leaving?
571
00:26:50,518 --> 00:26:52,437
Yeah, I've already done a thrombectomy.
572
00:26:52,576 --> 00:26:53,784
You can have it.
573
00:26:54,408 --> 00:26:58,998
Dr. Prescott, please...
574
00:27:00,325 --> 00:27:02,051
What's happening? Who's the doctor?
575
00:27:02,189 --> 00:27:05,857
- Uh... John Burnett.
- An intern?
576
00:27:05,882 --> 00:27:07,712
- Let's get a CT.
- They're getting a CT.
577
00:27:07,834 --> 00:27:09,447
No, she has eclampsia.
578
00:27:09,472 --> 00:27:11,371
Tell him she needs magnesium.
579
00:27:11,396 --> 00:27:13,175
- Really?
- Tell him.
580
00:27:13,200 --> 00:27:14,408
I...
581
00:27:15,133 --> 00:27:17,411
Excuse me, I've
got Jo Wilson on the phone,
582
00:27:17,436 --> 00:27:19,754
and she says it's eclampsia, and
you should start her on magnesium.
583
00:27:19,779 --> 00:27:23,210
Her BP is only 143 over 91.
It could be an intracranial hemorrhage.
584
00:27:23,235 --> 00:27:25,675
- Put me on speaker.
- Um...
585
00:27:26,814 --> 00:27:28,816
Okay. You're on speaker.
586
00:27:28,841 --> 00:27:30,410
I understand your concern,
587
00:27:30,435 --> 00:27:34,048
but postpartum eclampsia doesn't
always present with a really high BP.
588
00:27:34,073 --> 00:27:35,533
Neither does a brain bleed.
589
00:27:35,558 --> 00:27:37,682
- Barnett.
- It's... It's Burnett.
590
00:27:37,707 --> 00:27:39,640
Whatever. I may be on leave,
591
00:27:39,665 --> 00:27:42,100
but that doesn't mean that I can't
schedule you to work every holiday
592
00:27:42,125 --> 00:27:44,724
and make your life miserable.
So trust me when I tell you
593
00:27:44,749 --> 00:27:47,200
to start the mag now.
594
00:27:49,656 --> 00:27:51,036
Start IV magnesium.
595
00:27:57,272 --> 00:27:59,032
Your mom's gonna be okay.
596
00:28:00,777 --> 00:28:02,674
We're gonna have to
take part of the lower lobe.
597
00:28:02,698 --> 00:28:05,129
- Adams, you wanna staple the lung?
- Yep. Stapler.
598
00:28:05,154 --> 00:28:07,506
Bailey, you ready to start
resecting the adhered diaphragm?
599
00:28:07,531 --> 00:28:09,197
Hey, ready when you are.
600
00:28:09,222 --> 00:28:11,751
Griffith, what should
we be careful to avoid?
601
00:28:11,776 --> 00:28:13,728
Hepatic veins and
the retro-hepatic IVC.
602
00:28:13,753 --> 00:28:15,444
Good. Let's get the next stapler ready.
603
00:28:15,469 --> 00:28:19,803
London thought fixing
up a summer house was a lot of work.
604
00:28:19,828 --> 00:28:22,865
- It's got nothing on fixing up a torso.
- Reload, please.
605
00:28:24,676 --> 00:28:28,630
- Uh, BP is bottoming out.
- Damn it. I don't see any bleeding.
606
00:28:28,655 --> 00:28:30,288
Neither do I.
The staple line looks clean.
607
00:28:30,312 --> 00:28:32,117
Well, something's got to be
causing this. What the hell is it?
608
00:28:32,141 --> 00:28:35,627
- Does the ECMO say anything?
- There's a suction event alarm.
609
00:28:36,110 --> 00:28:37,773
Okay. Since we took pressure off the
610
00:28:37,797 --> 00:28:39,459
lung, could there be volume shifts?
611
00:28:39,651 --> 00:28:41,169
That's definitely possible. Yeah.
612
00:28:41,194 --> 00:28:43,951
Okay, we need to up her pressors
and flood her with fluids.
613
00:28:43,976 --> 00:28:46,945
If we don't get flow back
right away, she's done.
614
00:28:49,964 --> 00:28:51,285
Push fluids as hard as you can.
615
00:28:51,310 --> 00:28:52,518
- I am.
- BP's still dropping.
616
00:28:52,543 --> 00:28:54,219
She can't take this much longer.
617
00:28:54,244 --> 00:28:55,970
I should've listened to that board.
618
00:28:56,108 --> 00:28:57,879
- If I lose her...
- This is not on you.
619
00:28:57,903 --> 00:29:00,733
Come on, come on, come on. Come on.
620
00:29:00,871 --> 00:29:02,114
BP's coming back up.
621
00:29:03,805 --> 00:29:07,119
- Well, that was close.
- Okay, folks.
622
00:29:07,888 --> 00:29:09,766
There's still a lot of tumor left.
623
00:29:10,925 --> 00:29:12,616
Griffith, you're on the liver resection.
624
00:29:12,641 --> 00:29:14,471
Adams, you're on the
superior mediastinum.
625
00:29:15,335 --> 00:29:17,164
If that's okay with you?
626
00:29:18,393 --> 00:29:20,279
Do what we say when we say it.
627
00:29:20,304 --> 00:29:21,443
Stapler.
628
00:29:26,186 --> 00:29:27,428
Contrast.
629
00:29:29,801 --> 00:29:33,086
There's the occlusion in the iliac vein.
Advance more.
630
00:29:34,583 --> 00:29:36,157
Okay, pin the guide wire
631
00:29:36,182 --> 00:29:38,081
and turn on the thrombectomy
catheter, please.
632
00:29:40,565 --> 00:29:42,646
It's a shame Janet
isn't awake to see this.
633
00:29:42,671 --> 00:29:43,983
It would really turn her...
634
00:29:45,065 --> 00:29:49,897
into a passionate fan of
biological science and anatomy.
635
00:29:50,447 --> 00:29:51,932
Okay, I'm in. Turn it off.
636
00:29:51,957 --> 00:29:54,866
I don't get it. If you have
to pretend to be someone else
637
00:29:54,891 --> 00:29:56,282
for your partner to
wanna sleep with you,
638
00:29:56,306 --> 00:29:57,961
maybe you shouldn't be together.
639
00:29:57,986 --> 00:29:59,926
I've learned you never know what's going
640
00:29:59,950 --> 00:30:01,518
on in another person's relationship.
641
00:30:02,451 --> 00:30:03,521
Ready.
642
00:30:04,470 --> 00:30:05,540
Contrast.
643
00:30:09,146 --> 00:30:12,184
Thrombus is gone. The vein is patent.
644
00:30:12,844 --> 00:30:13,966
Great work.
645
00:30:14,450 --> 00:30:15,451
Now to stent.
646
00:30:18,564 --> 00:30:22,671
Thanks again for the consult.
I see why Catherine calls you legendary.
647
00:30:22,696 --> 00:30:25,137
Well, she is prone to exaggeration.
648
00:30:25,162 --> 00:30:27,647
I know, but in your case it's true.
649
00:30:27,672 --> 00:30:30,396
Well, you live up to
your reputation as well.
650
00:30:30,421 --> 00:30:33,278
Oh, but not enough to
consider my recommendation?
651
00:30:35,842 --> 00:30:38,344
I'm sorry, I-I shouldn't have said that.
652
00:30:38,368 --> 00:30:39,532
No, it's okay.
653
00:30:40,224 --> 00:30:41,627
Can I ask you about something?
654
00:30:42,797 --> 00:30:44,592
Urosymphyseal fistulas.
655
00:30:46,469 --> 00:30:48,169
They are an extremely rare post-op
656
00:30:48,194 --> 00:30:50,335
complication of radical prostatectomy.
657
00:30:50,473 --> 00:30:52,164
But the odds aren't zero.
658
00:30:52,493 --> 00:30:53,667
They're close.
659
00:30:54,161 --> 00:30:55,162
What if it happened?
660
00:30:56,297 --> 00:30:59,610
Chronic pain, which often
leads to difficulty walking,
661
00:31:00,301 --> 00:31:03,970
possibly warranting the use of opioids.
662
00:31:05,414 --> 00:31:07,795
I can treat complications.
663
00:31:08,550 --> 00:31:11,015
But if your cancer grows and metastasizes,
664
00:31:11,039 --> 00:31:12,900
that's when my hands are tied.
665
00:31:17,055 --> 00:31:18,366
If you change your mind
666
00:31:18,490 --> 00:31:21,970
or if you just wanna talk more,
Catherine has my number.
667
00:31:35,248 --> 00:31:37,699
- Done resecting the liver.
- Good.
668
00:31:37,865 --> 00:31:39,211
Excellent hemostasis.
669
00:31:42,999 --> 00:31:44,793
All right, no bleeding on this side.
670
00:31:44,932 --> 00:31:46,726
Okay, we are in the home stretch.
671
00:31:46,864 --> 00:31:48,936
Let's get ready to get this tumor out.
672
00:31:50,006 --> 00:31:51,835
Hold on, hold on.
673
00:31:52,082 --> 00:31:54,257
- Do you hear that?
- What?
674
00:31:56,495 --> 00:31:58,922
Okay, we're gonna need more
lap pads, and hang blood.
675
00:31:58,946 --> 00:32:00,671
Adams, quickly pack her.
676
00:32:01,511 --> 00:32:03,671
Goddamn it!
All right, keep the suction coming.
677
00:32:04,679 --> 00:32:05,929
Oh... ... wait, wait.
678
00:32:05,954 --> 00:32:10,035
Okay, there's a tear
where the IVC passes
679
00:32:10,060 --> 00:32:11,786
through the diaphragm into the chest.
680
00:32:11,811 --> 00:32:14,710
I'm trying to secure...
Let-Let me have a clamp.
681
00:32:15,307 --> 00:32:16,801
Okay, I need visualization.
682
00:32:16,825 --> 00:32:18,105
Put the suction on the lap pads.
683
00:32:18,130 --> 00:32:20,850
Not too harsh, gentle
steady pressure, okay?
684
00:32:26,367 --> 00:32:27,748
I think I got it.
685
00:32:30,941 --> 00:32:34,025
Oh, she's stabilizing.
686
00:32:34,050 --> 00:32:36,052
Okay, everyone, on the count of three.
687
00:32:36,077 --> 00:32:37,856
Everyone needs to
help with the specimen.
688
00:32:37,881 --> 00:32:42,102
Okay, ready? One, two, three.
689
00:32:47,155 --> 00:32:48,156
Okay.
690
00:32:54,817 --> 00:32:55,956
Okay.
691
00:32:56,417 --> 00:32:58,429
How do you all feel about
getting the hell out of here?
692
00:32:58,453 --> 00:33:00,652
You don't have to ask me twice. Bovie.
693
00:33:01,533 --> 00:33:03,190
Two-O prolene.
694
00:33:10,017 --> 00:33:11,052
You can stop here.
695
00:33:11,738 --> 00:33:12,650
Iris.
696
00:33:13,503 --> 00:33:15,169
Hey, what are you doing up here?
697
00:33:15,194 --> 00:33:18,404
So a mom from the NICU is being
treated for postpartum eclampsia.
698
00:33:18,429 --> 00:33:21,236
Can you look up her chart?
Her name is Gina...
699
00:33:21,957 --> 00:33:23,037
I don't know her last name.
700
00:33:23,575 --> 00:33:25,784
I'm sorry, I can't.
You're not her doctor.
701
00:33:27,104 --> 00:33:28,381
I just wanna check on her.
702
00:33:29,298 --> 00:33:31,565
Do you want me to call Marcus for you?
703
00:33:31,590 --> 00:33:33,419
No, what I want is my friend's chart.
704
00:33:34,627 --> 00:33:36,295
- I'm sorry, Jo.
- Stop saying you're sorry.
705
00:33:36,319 --> 00:33:38,679
Sorry doesn't help me. I'm this
woman's only friend right now
706
00:33:38,704 --> 00:33:40,125
and the person in charge of her care
707
00:33:40,150 --> 00:33:41,713
has been a doctor for about 90 days.
708
00:33:41,738 --> 00:33:43,818
So, if you could just please
remove the stick from...
709
00:33:43,843 --> 00:33:45,820
- Jo.
- All I want right now...
710
00:33:45,845 --> 00:33:47,720
- I think we should go.
- No, we're not gonna go.
711
00:33:47,744 --> 00:33:48,745
- I... No.
- Yeah.
712
00:33:48,770 --> 00:33:51,221
You cannot move me against my will.
713
00:33:51,690 --> 00:33:53,830
Stop. I...
714
00:33:54,322 --> 00:33:57,432
- This is not okay.
- Can you give me a minute?
715
00:33:57,457 --> 00:33:59,041
- This is...
- Hey, hey, hey, hey.
716
00:33:59,066 --> 00:34:01,275
Look, I know you're scared, okay? But...
717
00:34:02,621 --> 00:34:04,381
Hey, she's just trying to do her job.
718
00:34:20,192 --> 00:34:22,151
It will take a few days to
wean her off ECMO.
719
00:34:22,176 --> 00:34:23,791
She does have a long recovery.
720
00:34:23,929 --> 00:34:26,069
- But she's gonna come home?
- Eventually.
721
00:34:26,226 --> 00:34:27,849
That is the plan.
722
00:34:28,372 --> 00:34:29,788
I don't know how to thank you.
723
00:34:30,444 --> 00:34:31,790
I think you just did.
724
00:34:34,551 --> 00:34:37,105
She's always been able
to see what I can't.
725
00:34:37,658 --> 00:34:40,912
Her mind is filled with these big ideas
726
00:34:40,937 --> 00:34:43,604
that always seem impossible.
727
00:34:43,629 --> 00:34:48,738
Our wedding, this lake house,
getting this tumor removed.
728
00:34:50,176 --> 00:34:51,695
But she knew you could do it.
729
00:34:53,621 --> 00:34:55,381
And she was right.
730
00:34:56,677 --> 00:34:59,900
I almost... tried to stop her.
731
00:35:01,958 --> 00:35:03,856
But I'm glad I stayed out of it.
732
00:35:05,306 --> 00:35:07,964
Hey, um, we'll let
you both get some rest.
733
00:35:08,667 --> 00:35:10,600
Thank you.
734
00:35:13,314 --> 00:35:15,187
Great work today, Griffith.
735
00:35:15,212 --> 00:35:17,905
You and Adams, you really stepped it up.
736
00:35:17,930 --> 00:35:21,954
Thank you. I really appreciate
the opportunity. I learned a lot.
737
00:35:25,577 --> 00:35:30,617
We did a good thing today.
738
00:35:30,642 --> 00:35:34,103
- Some might call it inspiring.
- Mmm.
739
00:35:34,128 --> 00:35:35,725
Might be even something
740
00:35:35,750 --> 00:35:38,063
you could lecture about.
741
00:35:38,088 --> 00:35:39,949
Hey, I hope I didn't overstep, you
742
00:35:39,974 --> 00:35:41,835
know, jumping in with the residents.
743
00:35:41,860 --> 00:35:44,966
Oh, no. I mean, if I'm the
only voice that's teaching them,
744
00:35:44,991 --> 00:35:46,579
they'll wind up tuning me out.
745
00:35:47,590 --> 00:35:49,188
What do you think about
having the residents
746
00:35:49,212 --> 00:35:51,707
do an ambulance
ride-along or EMS training?
747
00:35:51,732 --> 00:35:54,528
Something that could really get them
thinking on their feet, you know?
748
00:35:54,553 --> 00:35:59,256
It could help them in the ER or
in situations like today in the OR.
749
00:35:59,916 --> 00:36:04,058
I think you should write up
a proposal and send it to me.
750
00:36:07,735 --> 00:36:09,116
The surgery went well.
751
00:36:09,141 --> 00:36:11,381
We were able to clear the
clot and put in a stent.
752
00:36:11,406 --> 00:36:12,442
Thank you.
753
00:36:12,467 --> 00:36:14,246
You'll need to be on anticoagulation
754
00:36:14,271 --> 00:36:17,689
but after a while, you'll be
able to get back to life as usual.
755
00:36:18,443 --> 00:36:21,895
I'll get back to life
as usual right away or...
756
00:36:21,920 --> 00:36:23,566
"When can I have sex?"
is what I'm asking.
757
00:36:23,591 --> 00:36:25,075
Yeah, we know.
758
00:36:25,100 --> 00:36:26,830
You need to elevate
your leg when resting
759
00:36:26,855 --> 00:36:29,720
but other than that, it
is good to move it around.
760
00:36:31,553 --> 00:36:33,382
I guess Trudy can still see the doctor.
761
00:36:33,497 --> 00:36:36,086
Trudy's always a good time.
762
00:36:36,239 --> 00:36:40,496
But, honey, I love you
most when you're just Janet.
763
00:36:42,377 --> 00:36:43,585
Oh.
764
00:36:43,610 --> 00:36:45,025
We'll give you some privacy.
765
00:36:56,913 --> 00:36:58,777
I checked London's labs before leaving.
766
00:36:59,731 --> 00:37:00,731
Thanks.
767
00:37:00,917 --> 00:37:02,712
Hey, I'm sorry about earlier.
768
00:37:03,108 --> 00:37:05,263
How you interact with your
patients, your business.
769
00:37:05,288 --> 00:37:06,392
I'll stay out of it.
770
00:37:06,670 --> 00:37:08,224
I appreciate that.
771
00:37:09,195 --> 00:37:11,922
I do value your opinion though.
772
00:37:12,564 --> 00:37:14,186
- You do?
- I do.
773
00:37:14,262 --> 00:37:19,958
Just, uh, not about relationships.
For obvious reasons.
774
00:37:19,983 --> 00:37:22,487
Ouch.
775
00:37:22,512 --> 00:37:25,239
Hey, look, I'm, uh, putting
together a watch list for my patient.
776
00:37:25,819 --> 00:37:26,992
What am I missing?
777
00:37:27,099 --> 00:37:29,205
Mmm.
778
00:37:30,762 --> 00:37:34,110
Wait, she hasn't seen any of these?
779
00:37:41,382 --> 00:37:42,694
Hey.
780
00:37:43,258 --> 00:37:44,397
Hi.
781
00:37:44,751 --> 00:37:46,407
Did you make it through your busy day?
782
00:37:46,510 --> 00:37:48,547
Uh, I did.
783
00:37:49,291 --> 00:37:52,275
Uh, I did a thrombectomy
and placed a stent.
784
00:37:52,300 --> 00:37:54,371
Nice, Millin.
785
00:37:54,396 --> 00:37:56,756
You still haven't told me about
that thoracotomy, by the way.
786
00:37:57,273 --> 00:37:59,389
It wasn't that big a deal.
787
00:37:59,461 --> 00:38:01,951
Uh, you saved a man's
life with your hands.
788
00:38:02,579 --> 00:38:04,064
Doesn't get any bigger than that.
789
00:38:06,753 --> 00:38:08,237
Do you think I'm aloof?
790
00:38:09,484 --> 00:38:13,384
Aloof? Thank you. Um...
791
00:38:13,730 --> 00:38:14,800
No.
792
00:38:15,505 --> 00:38:18,163
No, you're discerning,
you don't suffer any fools.
793
00:38:18,188 --> 00:38:20,950
But... ... that's not aloof.
794
00:38:21,142 --> 00:38:25,287
That's, um, just protecting
yourself because you care.
795
00:38:28,137 --> 00:38:31,416
It's funny you say that
because I-I have been...
796
00:38:31,885 --> 00:38:34,439
I had the worst day.
797
00:38:34,464 --> 00:38:37,066
I need the biggest vodka
tonic that they have.
798
00:38:37,667 --> 00:38:39,496
Hi, I'm Iris.
799
00:38:39,521 --> 00:38:41,644
Uh, this is Jules Millin,
a surgical resident.
800
00:38:42,048 --> 00:38:43,568
- Nice to meet you.
- Nice to meet you.
801
00:38:43,593 --> 00:38:46,909
Um, I should go find my friends.
802
00:38:48,237 --> 00:38:49,687
- Here.
- Thank you.
803
00:38:49,801 --> 00:38:51,078
See you later.
804
00:38:51,369 --> 00:38:53,854
It's jarring when your identity shifts.
805
00:38:53,879 --> 00:38:57,262
When you're suddenly a
doctor, a partner, a parent.
806
00:38:58,194 --> 00:39:00,748
It helps if you focus on the
things that haven't changed.
807
00:39:00,917 --> 00:39:02,643
I'm gonna have to change hospitals.
808
00:39:03,504 --> 00:39:05,713
I've cried in front of too
many people at this one.
809
00:39:06,004 --> 00:39:07,247
They understand.
810
00:39:09,930 --> 00:39:14,175
I just feel like ever since
I was admitted, I just...
811
00:39:14,797 --> 00:39:16,730
I just lost myself.
812
00:39:18,593 --> 00:39:20,319
I can't take care of our kids.
813
00:39:20,457 --> 00:39:24,427
I can't take care of my patients.
I can't even shower.
814
00:39:24,565 --> 00:39:25,842
It's temporary.
815
00:39:26,567 --> 00:39:28,314
Your heart is recovering.
816
00:39:28,339 --> 00:39:29,582
I know.
817
00:39:30,467 --> 00:39:36,680
But... for a few hours today,
I got to be a doctor again
818
00:39:36,819 --> 00:39:39,250
and help this woman
navigate a difficult time
819
00:39:39,275 --> 00:39:45,522
but then when it really mattered...
someone else got to help her.
820
00:39:47,001 --> 00:39:48,485
At least Gina is okay.
821
00:39:49,348 --> 00:39:53,421
And I would bet that she'd
say what you did mattered too.
822
00:39:55,217 --> 00:39:56,563
Maybe even more.
823
00:39:58,575 --> 00:40:00,585
Oh, God. It's happening again.
824
00:40:01,408 --> 00:40:04,860
- No.
- I'll get the tissues.
825
00:40:07,228 --> 00:40:11,474
Just...
826
00:40:12,265 --> 00:40:13,818
The comfort of old friends.
827
00:40:13,856 --> 00:40:16,843
Thirty-five pounds? That's
like carrying four babies.
828
00:40:16,868 --> 00:40:18,663
Yeah, or four bowling balls.
829
00:40:18,688 --> 00:40:21,346
- Who carries four bowling balls?
- People do weird things.
830
00:40:21,370 --> 00:40:24,219
- _
- Gotta go.
831
00:40:26,938 --> 00:40:28,916
_
832
00:40:28,940 --> 00:40:30,389
Yeah, I'm out too.
833
00:40:31,459 --> 00:40:32,633
See you tomorrow.
834
00:40:40,608 --> 00:40:43,266
She's just a stop sign, not a roadblock.
835
00:40:43,291 --> 00:40:44,291
How did you...
836
00:40:44,316 --> 00:40:46,450
_
837
00:40:46,474 --> 00:40:49,719
Doesn't matter. Wait,
are you leaving me too?
838
00:40:49,744 --> 00:40:53,695
Um, sorry. Um, hey, have a drink on me.
839
00:40:59,385 --> 00:41:00,386
Anyone sitting here?
840
00:41:05,865 --> 00:41:07,505
The thrill of
trying something new.
841
00:41:07,530 --> 00:41:09,083
Hi, I'm Sally.
842
00:41:09,260 --> 00:41:11,541
Because even though
you may not recognize yourself.
843
00:41:12,033 --> 00:41:16,850
- Catherine.
- I'm sorry. I am so sorry.
844
00:41:17,101 --> 00:41:20,069
I got scared and I just
called the best that I knew.
845
00:41:20,094 --> 00:41:22,072
I should've talked to you
before bringing Laura in.
846
00:41:22,096 --> 00:41:27,663
Look, I thought a lot about
letting fear cloud judgment today.
847
00:41:27,688 --> 00:41:30,313
Whatever you wanna do, I support...
848
00:41:31,354 --> 00:41:32,665
I'm a surgeon.
849
00:41:32,959 --> 00:41:34,961
I'm a senior member of this hospital.
850
00:41:36,012 --> 00:41:37,427
If something were to go wrong
851
00:41:37,456 --> 00:41:40,701
and I couldn't stand long
enough to do a simple appy,
852
00:41:40,839 --> 00:41:43,842
I'd feel... weak.
853
00:41:44,912 --> 00:41:46,534
And I don't know how to lead like that.
854
00:41:46,966 --> 00:41:48,485
I don't know who I'd be.
855
00:41:49,642 --> 00:41:51,023
But people adapt.
856
00:41:51,760 --> 00:41:53,417
I wanna go ahead with the surgery.
857
00:41:59,795 --> 00:42:01,625
It's been you all along.
858
00:42:02,515 --> 00:42:07,515
- Synced and corrected by ChrisKe -
-- for www.MY-SUBS.com --
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