All language subtitles for gas22e11

[♪ "NOBODY" PLAYING ♪]

[GREY] If you think choosing
a college major is hard,

wait until you have to
choose your medical specialty.

How late were you up researching
treatments for that patient?

- [SIGHS] Late.
- You need sleep.

I'll get right on that.

You have no idea how many emails you get

until you come back from
a three-month sabbatical.

Delete all.

Wait. What if some of
those are important?

I'm practicing healthy boundaries.

If they need me, they
can pick up the phone.

[SIGHS]

[GREY] It's not just what
medicine you'll practice,

it's your whole life.

Hey, should I pull the drains
on Mr. Sherwood before we round?

Uh, no, Adams can do that.

Um, Toni Wright is down a resident,

so I took the liberty of
moving you to her service.

I hope that's okay.

- Dr. Toni Wright?
- Yeah.

NIH grant recipient for research
on myofibroblasts for wound healing,

- pioneer in lymphedema, Dr. Toni Wright?
- [LAUGHS] Oh.

Yes.

- Okay, yeah. I may have read up on her.
- [BAILEY SIGHS]

- Play it cool. [STAMMERS]
- Yeah, I gotta go prep.

- [STUTTERS] Ben Warren?
- Hey, hey, hey. Come on. I...

Look, I was born cool.

Uh, okay.

[GASPS] Oh, my God.

- I'm playing. I'm playing.
- [SCOFFS]

[GREY] Who you'll work with,

whether you'll be home in time
for dinner or never see your kids.

I love how they think we
have time to go to the doctor.

Last year, I had a dental student

pull one of my teeth in the cath lab.

[CHUCKLES] Have you
considered egg freezing?

Have I considered giving myself a series

of shots and screwing up my hormones

and then going through
an uncomfortable procedure

and then paying forever to
store my eggs in a freezer

on the chance that I might want kids?

You could have just said, "No."

[INHALES DEEPLY]

I might do it.
I wanna keep my options open.

Why do they need to know when
your mom had her first period?

Oh. I hope they don't,

'cause I have no idea and no way to ask.

[GASPS] Oh, smoothies.

[GREY] The choice is yours,
and so are the consequences.

[♪ SONG ENDS ♪]

- Hey.
- Hey.

[HUNT] Hey, so my lawyer
wanted to check in.

I still haven't received
any papers to sign.

Yeah, I still have them.

[SIGHS] Your lawyer mentioned wanting

to file before the end of the month.

I-I just...
I-I've been slammed with work.

If we don't do it soon, they're gonna

make us pay additional retainers.

- [PHONE BUZZES]
- I am aware. I'm... I'm sorry.

I-I have a consult, but I will...
I will get to them as soon as I can.

Okay. [SIGHS]

[OPERATOR ON PA] Dr. Morales to the ICU.

Dr. Martha Morales to the ICU.

- Dr. Wright, Ben Warren.
- Hey.

- Thrilled to be on your service.
- Nice to meet you.

Benson, back on my service again?

Yeah, I can't get enough,
and people call me Blue.

- After the Joni Mitchell album?
- No.

Oh. Well, that's too bad. It's
one of the all-time greats.

I applied to three
colleges in California

solely because I thought it'd be cool

to sing that line about coming
home there and literally mean it.

Do either of you play guitar?

- Um, not really.
- A little.

- Well... [GRUNTS]
- Um...

Uh, listen, um, feel free to push me.
You know, I like to work hard,

and I'm actually applying
for a plastics fellowship.

Good for you.

You should have told
her you play guitar.

[SIREN BLARING]

Five minutes to answer a page?
Patient could have died in that time.

- Did somebody die?
- That's irrelevant.

- What do we got?
- Randall Lutton, 62.

He has scrotal swelling and
severe pain after blunt trauma.

BP is slightly elevated.
Gave two of morphine en route.

[GROANS] Oh, God, it hurts like hell.

Yeah, we're gonna get
you more inside, okay?

I got up to use the bathroom
in the middle of the night

and walked right into the dresser.

I'm gonna need an
ultrasound and some gel.

- Are you a doctor?
- Urologist.

No need to comment on the irony.

- Okay. Let's get him to trauma one.
- [GROANS, BREATHES SHARPLY]

Hey, Corban, just double-checking
you're getting your IV antibiotics

before rounds with Dr. Altman.

Um, do you think you could slip
me the staff Wi-Fi password?

I know the guest Wi-Fi is spotty,

but ours is used for things
like imaging and staff messaging,

so they're pretty strict about it.

Well, could you make an exception?

I just... I really want to see my
cousin get married in Big Sur today.

Second cousin, second marriage,
and he's not that great.

[SCOFFS]

- You didn't get it from me.
- Thank you.

Somehow, I am always in the hospital for

my friends' and
family's big life events.

This is his second aortic
graft to get infected in a year.

No offense to Dr. Altman,

but if this one doesn't take,
we need a second opinion.

Well, Dr. Altman's extremely skilled.

She's even kind of famous now.
She invented a new surgery.

Yeah, but like a difficult one?

Don't look at me like that.
I already know I'm becoming Mom.

- [SCOFFS]
- Surgery's incredibly complicated.

She's on a podcast. You can look it up.

Told you. I just have bad luck.

Well, hopefully the new
TEVAR gives your aorta a break

so... the antibiotics can do their job.

That's what you said last time.

I'll be back soon.

[OPERATOR ON PA]
Dr. Miley Tokugawa to the ER.

Welcome back, Dr. Shepherd.

[WARREN] Have you met our new
plastics attending, Dr. Toni Wright?

Relatively new. Nice to meet you.

We should get started.
It's a LeFort fracture.

I'm sure there will be questions.

- Did you see that?
- Uh, yes. Um, yeah, I don't know.

- I don't think she remembers me.
- [WARREN] Should she?

We went to med school together.
We were in the same study group.

She hated me.

Oh, well, maybe it's
better she doesn't remember.

Teresa Daniels, 49,
post-op day five from

a hemicraniectomy for subdural hematoma

after auto versus pedestrian.

Concomitant LeFort I fractures.

Please say you're fixing
my mom's face today.

Well, that's up to Dr. Shepherd.

She'll tell us if your mom's head bleed

has healed enough for us to proceed.

I'll do a neuro exam on her now
and make sure the EVD's working.

- So, uh, what are you studying?
- Uh, data science.

I was going to major in it,
but the intro course is hard.

- [CHUCKLES]
- I'm a freshman at UC Davis.

Do you have a study group?

- I haven't found the right people.
- Oh.

Does make a big difference.

[DAUGHTER] My mom says to stick with it.

I was complaining to
her about it on the phone

when she got...
hit by that idiot driver.

That's awful. I'm so sorry.

She'll be happy to see
you when she wakes up.

ICP is 12 and subdural is stable.

Great. So we're good to go.

Let's order a CT max/face
before bringing her to the OR.

Hey. Sorry I'm late.

How was Cousin Frank's wedding?
Were you able to stream it?

[SIGHS]

Still no contractions?

- [CHUCKLES] Don't jinx it.
- [CHUCKLES]

- Okay.
- Uh, Dr. Meade.

Corban Gregory,
28-year-old male.

Status, post-coarctation
repair when he was two.

He subsequently had two graft
repairs, both became infected.

Has now developed a pseudoaneurysm

and is here today for his second TEVAR.

- You made somebody a new aorta?
- [CHUCKLES]

He's stalking you online.
I told him it was weird.

And it said that the patient had
two repeat graft infections too.

- Can I get this?
- A TEVAR is still a solution for you.

It's less invasive and less risky.

For me or for you?

Corban, the patient that you're
reading about was much sicker.

I don't want another Band-Aid
if there's a permanent fix.

I don't want to diminish what
you're going through, but...

You think you know
what I'm going through?

My favorite thing is running,

but I can't remember the last
time I had a runner's high.

I won't be able to lift my baby nephew.

I can't travel.
I can't visit my friends.

I have spent more time in the CCU
than my own house in the last year.

Is that not sick enough for you?

- What, you just don't care?
- That's not true.

- Then why won't you fix me?
- I wish there was an easy fix.

[SCOFFS] Just get out.

- Get out!
- Okay.

- Synced and corrected by ChrisKe -
-- for www.addic7ed.com --

It's a larger patient load than usual,

but with two of you...

Adams, please tell me that
you were at the benefits fair

or rounding or anything but late.

Sorry, I was on the
phone with Boise General.

They don't have Katie
Rogers's immunotherapy either.

[STAMMERS] Well, the
government cut off funding.

You're not going to find it.

Okay, what about cytoreduction
surgery with HIPEC?

What about it?

Well, could Katie be a candidate for it?

- I-I emailed you the case report.
- [GRUNTS]

Okay, no. I appreciate your
initiative, and I will look at it.

But right now, I need you to
focus on patients that are currently

- admitted to the hospital.
- Okay.

We're down two residents due
to illness and a family wedding,

so I need you and Spencer to
get started on the floor, okay?

Ms. Hayes needs a Dobhoff
tube for tube feeds.

Ooh. [CHUCKLES] Well, I've never
inserted an NG tube on a real person

- o-or a fake one, so...
- Well, um, Adams will help you.

- Don't forget to check your email.
- I... [GRUNTS]

Just keep taking deep breaths.

New pain medication
should kick in any second.

Can I take a look?

Yeah. [GROANS]

Wow, that looks painful.

Last I checked, it
measured 20 centimeters.

I suspect a bleeding testicular artery.
Do you see anything?

I, uh... It looks like it's expanding.

Let's get an ultrasound
and page urology.

Was the dresser sharp? I mean,
I do see a couple of small lesions.

I-I must have just
snagged a drawer pull.

Oh, okay. Well, let's get him some
more fluids and a full set of labs.

- [GROANS, BREATHING HEAVILY]
- Okay.

Well, the testicles
are intact and

- they're in the correct position...
- Okay.

... but I do see some
free fluid in the scrotum.

Oh, my God, Randall.

[GASPS] Is it his heart?

[RANDALL] Uh, no, no.
My heart's just fine.

Doctors, this is my wife Kimmy.

- Hey.
- Hi.

Is that one of your...

Yeah, I walked into
the dresser. [CHUCKLES]

Probably just a hematoma.

Is this gonna jack your fertility?
I ovulate next week.

We're going to give you some privacy.

[GROANS]

[KIMMY SIGHS]

[OPERATOR ON PA]
Dr. Neil, dial radiology.

- [RINGS]
- [SHEPHERD] Oh.

- [CHIMES]
- You've been back three hours

and you've already requested a
new 3D microscope with AR tech?

Why are you reading emails when
you are supposed to be on leave?

[WEBBER] Catherine
finally left the house.

If that woman makes me take one
more nap, I'm going to lose my mind.

Um...

[WHISPERING]
When did you hire Toni Wright?

A few months ago.

I was surprised we got her.

Jackson says she's the go-to
for facial reconstruction.

Well... Jackson is the go-to for
facial reconstruction. [LAUGHS]

- Is there a problem?
- I just... I just spent the last few

months getting to a really good place.

I took Scout camping.

I went to the grocery store
during normal hours. I slept...

You need to get to the point.

[STAMMERS] Wright and I
have a history, in that...

in that, historically, she...
pushes my buttons.

If I hired people based on
whose buttons they pushed,

no one could work at this damn hospital.

And your request for
a microscope is denied.

- [BUSY SIGNAL BEEPS]
- Oh. [SIGHS]

You know, I, uh...

I read that you won the Goldstein
Award for excellence in teaching.

- Mmm?
- Um...

No. [CHUCKLES]

So, you know, you must
be an excellent teacher.

That's the name of the award.

- She is all set.
- Okay.

[MACHINE WHIRRING]

- [COMPUTER BEEPING]
- Oh. [SIGHS] Yeah.

Oh, her nasofrontal and
ZF sutures are broken.

Good. What else?

[WARREN] Her zygomatic
arch is comminuted.

And it's a LeFort III, not a LeFort I.

Yeah. This just got a
lot more complicated.

[SIGHS] Yeah.

Should I call the OR? Let them know
that we're gonna push the surgery?

Her daughter's going to be crushed.

No, we're not pushing anything.

Every day that she's intubated, it
makes it tougher for her to recover.

We're just going to have to
come up with a new plan, quickly.

[OPERATOR ON PA] Dr. Traversa to
radiology. Dr. Valentina Traversa...

- Is he asleep?
- [BREATHES DEEPLY] Just resting.

Did you get my scans back?

Everything looks stable, so
you're all set for the TEVAR.

Corban.

He was hoping you'd
say that he got worse,

so he could get that new aorta business.

The TEVAR really might work.

A new aorta would definitely work.

- If you survive it.
- [SIGHS]

I want to talk to the other guy,

the doctor that did the
new surgery with Dr. Altman.

Dr. Ndugu?

He could give me a
second opinion, right?

Dr. Altman should be in shortly.
You can ask her any questions,

- or you can...
- I'm asking for Ndugu.

This is my life. I'm not gonna ask

permission to hear about all my options.

Would you?

Just give me ten
minutes with him, please.

I'll talk to him. No promises.

Catherine, I didn't
know you were here today.

Oh. I had to get out of that house.

For ten days, I've been
taking care of my husband.

I don't know how these nurses do it.

- [CHUCKLES]
- All right, where's my consult?

Randall?

[CHUCKLES] Randall,
what are you doing here?

Good to see ya.

Oh. We missed you at
the last AUA conference.

- We were on our honeymoon.
- [AVERY] Oh, that's right.

So what... what brings you in?

Uh, you... you have more
important things to do.

[CHUCKLES] I can see a resident.

Nonsense. I am here.

Dr. Hunt, what we got?

Blunt trauma. Now experiencing
severe scrotal swelling.

- Hmm.
- It's the size of a coconut.

Thank you, Dr. Millin, for
that wonderful assessment.

Randall, may I?

Uh...

You don't have to be here for this.

Why don't you just go eat?
I'm sure you're starving after Pilates.

- [KIMMY] I'm not leaving your side.
- [RANDALL GRUNTS]

- How does it look?
- Well, for a blunt trauma, it doesn't

seem to follow the
typical injury pattern.

Will this mess up his sperm count?

Yes, it will.

From walking into a dresser?
How is it this bad?

I'll let Dr. Lutton answer that.

[SIGHS]

I didn't walk into anything. [STAMMERS]

Okay, please don't hate me.

I gave myself a vasectomy last night.

Oh.

- While I was at book club?
- [SIGHS]

- What the hell?
- I will page psych.

Mm-hmm. Yeah.

[KIMMY SCOFFS]

[CLEARS THROAT, COUGHING]

- Keep swallowing.
- Mmm, mmm.

It pushes the tube

- down your esophagus...
- Mmm. [SWALLOWS]

- ... to your intestine.
- Okay. [COUGHING]

- Does that look right?
- [ADAMS] Yeah.

Keep going until you hit the
mark we measured on the tube.

- You sure you know what you're doing?
- Uh... [CHUCKLES]

- She does. Keep sipping.
- [PHONE RINGING]

- Chin down.
- Is-Is that mine?

My catsitter's supposed to be calling.

Uh, excuse me.

Hi, this is Dr. Adams.

Uh, yeah. Uh, actually, I'm
with a patient right now.

- Can I call you back?
- [COUGHING]

- Okay, I'm done.
- [GROANS]

All right, looks good.

All right, pull out the stylet, secure

the tube and start trickle tube feeds.

Then we gotta do
research for Dr. Bailey.

She didn't mention
anything about research.

- It's for her patient.
- Oh.

Well, she's in luck. I'm
really good at research.

In med school, I-I presented a poster...

[ADAMS] Great. Finish up here
and, uh, I'm gonna get started.

- Where you going?
- [DOOR OPENS]

I'll text you.

[DOOR CLOSES]

- I'll text him. [CHUCKLES]
- [COUGHS]

[GASPS] Hey. How's it going with Wright?

- I have no idea.
- Did you change services?

[SIGHS] No, I-I'm just
getting zero vibe.

Because you're over-vibing? [CHUCKLES]

No, no, no, no, no.
Okay, I've been cool.

No excessive praise, no impulsive moves.

Well, just give it time.

Hey, if it makes you feel better,

I hear your residency
director is very impressed.

It does.

- [KIMMY] What were you even thinking?
- Psych is on their way.

That man doesn't need a psychiatrist.
He needs a marriage counselor.

[CHUCKLES] You think he was
successful doing it on himself?

We'll find out.

I gotta get him in an OR
and evacuate that hematoma.

Can I scrub in? I've never
operated on a DIY vasectomy before.

It'll be my second.

Wait, you know somebody else who
tried to do their own vasectomy?

Another urologist.
Said he was embarrassed.

I don't know why these boys don't
just pick up the phone and call me.

It's just a hollow
tube filled with sperm.

- In fact, if you ever want one...
- I-I'm good down here.

- Go scrub in.
- Uh, wait.

Just let Kimmy get in another
few rounds, then go prep him.

[KIMMY] ... laughingstock,
and you'll be to blame.

Can't even count how
many fractures she has.

Yeah, the number doesn't matter.

[KWAN] Okay, so how-how do
we plate her zygomatic arch?

It's like tempered glass. There's
nothing solid to screw into.

Warren, any ideas?

Uh, create a scaffold of
cadaveric bone paste and BMP.

You've studied this.

No, I saw it once, years ago. I...

I was an anesthesiologist
before I went into surgery. Mmm.

Interesting.

Okay, so our first step
is gonna be to wire her jaw

with her bite in the proper place.

We won't be able to have her
orally intubated for anesthesia.

Warren, trach or submental intubation?

Oh, trach. It's a straight
shot into the airway,

less risky than going through
the chin into the mouth.

Spoken like an anesthesiologist.

A plastic surgeon thinks it'll take

her three months to heal from a trach.

A submental incision
will heal in a week.

Kwan, what are the steps
of a submental intubation?

You make an incision
under the chin and...

Honestly, I-I don't know.

Of course not. You're
a gen surge resident.

- You'll learn today.
- [KWAN] Cool.

It is. Take a look at this.

[SIGHS]

So we would create a large segment
of aorta with a synthetic graft,

rerouting it from your
chest to your abdomen,

and then we would staple
off the infected piece here

and remove it at a later time.

So then no more TEVAR procedures?

If the surgery's successful, yes.
That's the idea.

And you really think this
could be a success for me?

[NDUGU] I'd need to further study

your case before I could answer that.

So shoot me his latest imaging, and

I want to do another echo. Before we...

Dr. Ndugu? Excuse me,
may I have a word, please?

Sure. Yeah. Excuse us.

[ALTMAN CLEARS THROAT]

Someone talk fast.

- Corban asked for a second...
- [ALTMAN] Not you.

You're talking to my
patient behind my back

about a procedure that
I've already said no to.

Okay, I assumed you were aware.

Don't do that.
Don't put it on the resident

to have the uncomfortable
conversation with her attending.

Your patient asked if he was a
good candidate for a ventral aorta.

I simply explained what it was.

No, you got his hopes up.

And if you had come to me first,

I would have explained
that, unlike Nora,

Corban has major scarring from a
previous esophageal reconstruction.

He is a bad candidate for it.

How do we know who's a good
candidate? We've done this once.

And that might be all we ever
do if we kill Corban with it.

Nora hasn't even hit
the six-month mark.

We need more time to see how she does.

- Okay. All right.
- [ALTMAN SIGHS]

Dr. Altman, I'm sorry. I wasn't sure...

How did Corban even know about the
ventral aorta in the first place?

If you shut me out again,
you are off this case.

I'm her boss.

Didn't she make you
chief while she was chief?

Okay, well... Okay,
so what? Now I owe her?

If I made someone chief,

and they gave my patient a
second opinion behind my back,

I would blow my stack too.

[SIGHS] Okay, yeah, yeah...

[STUTTERS] ... that part
was bad, but I'm not wrong.

This surgery could cure all
kinds of aortic disease, you know?

Wait, Toni Wright just gave
me the cold shoulder again.

It's okay. I was pretty much done.

Okay, she can do a supermicrosurgery
in a 30x magnified field,

but she can't say hi to me?

[STAMMERS] Oh. Amelia, don't...
[STAMMERS]

I can't watch this. Nope.

- Hi.
- Hi.

We went to med school together.
You hated me.

No. [STAMMERS] I didn't hate you.

So you do remember me?

Yeah.

[CHUCKLES]

Wow. I should have thought this through.

I don't really know what happens next.

Why did you think I hated you?

You ran out of your own birthday
party when I showed up uninvited.

- Oh, my God.
- [SHEPHERD] You changed study groups

and actively avoided me in labs.

Because I liked you.

- What?
- [WRIGHT] I tried to kiss you

in The Mission during orientation.

No, you were drunk. I thought...

I thought you stumbled into... into me.

No, I had a huge crush on you.

I mean, I thought you were
queer, but then I wasn't sure,

so I didn't want to get
burned, so I kept my distance.

But you have nothing to worry about.

This is all way in the past, and,
um, frankly, you're not my type.

[PHONE BUZZES]

My OR is ready.

[CHUCKLES]

For some reason, I froze
when I saw you earlier.

I'm glad we cleared the air.

I'm pretty sure Altman hates me.

If she didn't kick you off
the case, you're probably fine.

Let's talk about something else.

Uh, my patient tried to
give himself a vasectomy.

- Wow, we will always have jobs. [SIGHS]
- [MILLIN] Mm-hmm.

Everyone thinks they can
do anything themselves

if they watch enough
videos on social media.

He's a board-certified urologist.

You know, that actually seems doable
with some lidocaine and a mirror.

[CHIMES]

OR's ready. I'm out.

How come women in their 20s
have to shell out big bucks

to preserve their fertility,

but men in their 60s are
so worried about pregnancy,

they are giving themselves vasectomies?

Evolution failed us.

Do it with me. Our future and
less fertile selves will thank us.

So we can both be
hormonal at the same time?

It's a hard pass, but
I will do your shots.

I am very good at giving injections.

Don't ask why.

You can have the other half of
my sandwich if you're hungry.

- I brought it from home.
- Yeah, I'm good.

Did you email me the results

for the immunotherapy
study from San Francisco?

I included it in the
Chicago study, at the bottom.

- Okay.
- I like to cook.

Do you? It-It makes me happy
following directions and...

I wonder if we could
file a compassionate

use application for her meds.

Or maybe we could get it off-label
directly from the manufacturer.

Why is this particular
patient's research so important?

[STAMMERS] I just meant, weren't
there others in the trial?

What about them?

Look, I-I-I care about all
the patients. I do. I just...

I don't know. Katie...
She's in her late twenties just like us.

She feels like a classmate
or more like a friend.

We've just spent a lot of time
together, so she is now kind of a friend.

I get it.

It's like when you meet someone and you

feel like you've already
met them before,

like they're supposed
to be in your life.

[PHONES BUZZING]

Oh, no, it's-it's Wendy.

Hey, may I come in?

[SISTER CLEARS THROAT]

[INHALES DEEPLY]
She wanted me to apologize.

- Unbelievable.
- It's okay.

- Can we have a minute?
- Sure.

Don't say anything stupid.

You're stressing me
and the baby out enough.

If you want Dr. Ndugu
to replace your aorta,

I won't stand in your way, but I
do need you to hear me out first.

Okay, talk.

Okay. [SIGHS]

We have done this once on a person
with very, very different anatomy

who could have a
complication at any moment.

So it's not just a risk,
it's a complete unknown.

There is no way to know what will
happen if we staple your aorta shut.

And it is irreversible.

If the staples don't hold and
you hemorrhage, you'll die.

[♪ SOMBER MUSIC PLAYING ♪]

I don't want to do this surgery on
you because I want you to be able

to meet your nephew and
see your sister become a mom

and go running again
and visit your friends.

And I know the idea of going
through this again is infuriating,

but at least... at least
you'll still be alive.

[SIGHS]

I'll give you more time.

[SIGHS]

Thanks.

[WRIGHT] Oh. Nice. You
didn't skive at all.

[WARREN] And now I will lift the
scalp flap to expose the face.

[WRIGHT] Hold up.
What have you got there?

[WARREN] A beaver blade.

[WRIGHT] What, are you trying
to keep us here all day?

[WARREN] Plastic surgeons use
this to make delicate incisions.

[WRIGHT] Yeah, sure, if
we're working on a cleft lip

or somewhere where
every millimeter counts.

The scalp's robust.
Get him the 15 blade.

[♪ TENSE MUSIC PLAYING ♪]

[WARREN SIGHS]

[WRIGHT] Make sure to
stay in the same plane.

Good.

[WARREN] Oh, there's some fluid.

[WRIGHT] Give me a specimen tube.

Paper towel?

- [KWAN] It's a halo sign.
- [WRIGHT] Damn it, she's leaking CSF.

We need neuro, now.

What happened?

She was fine. I started the
trickle feeds and her sats dropped.

What's wrong?

Hold on, we're gonna
find out. Just don't move.

[GROANS]

The tube is in her lung.
Wait, you didn't see that on the X-ray?

- What X-ray?
- Let me see.

Look, you have to get an X-ray
after you insert a Dobhoff

and most importantly,
before you start feeds.

- Okay, let's pull it out, quickly now.
- [GROANS]

I'm s-sorry, this is my first one.
I-I didn't know.

It's okay, and we can fix this.

Uh, prepare for a bronchoscopy
to suction the feeds out.

- Okay.
- [PATIENT CONTINUES GROANING]

[SIGHS]

- [AVERY] Suction.
- [MILLIN] Okay.

[MILLIN] Is it... Is it weird
operating on your friend's scrotum?

[AVERY CHUCKLES] My dear, you've seen

one testicle, you've seen them all.

But ask me if I think the man
has a screw loose, ooh, mmm.

[MILLIN] He must really not want kids.

[AVERY] Of course not, he's a grandfather.

That's when all the fun starts.

Raising a child is hard,

this coming from the chairwoman
of a national hospital system.

[MILLIN] I don't know how you did it.

[AVERY] Me neither, but
I will tell you this.

As proud as I am of
all my accomplishments,

the best job I've ever
had is being Jackson's mom.

And the biggest surprise, I didn't
think I wanted to be a parent.

I... I just never had that pull.

But life is full of surprises.

[MILLIN] Yeah, just ask Kimmy.

[AVERY] Oh. She better make sure that

lawyer's looking over that prenup.

Okay, let us finish this
vasectomy in the right way.

I've palpated the vas deferens
and isolated it. Now, what is next?

[MILLIN] Exteriorize, ligate both
ends, then divide and send path.

[AVERY] Mm-hmm.

After you.

[MILLIN SIGHS] Uh, 4-0 VICRYL.

[♪ TENSE MUSIC PLAYING ♪]

- [SHEPHERD] All right, what happened?
- [WRIGHT] She has a CSF leak.

[SHEPHERD] Can you show me
where the fluid's coming from?

[KWAN] Do you think it's
from the cranial base?

[SHEPHERD] I can't see. Let's light
it up. Dilute fluorescein, please.

Inject it into the EVD and clamp it.

[KNOX] Injecting now.

[SHEPHERD] All right, now
we wait. Lights please.

[KWAN] For what?

[SHEPHERD] The drain is in her
ventricle which is filled with CSF.

If this is a leak, we should see... Oh.

Yeah, the fluorescence is coming
from the location of the dural tear.

[WRIGHT] Is it weird that
I think that's beautiful?

[SHEPHERD] Not at all.

All right, let's sew
this up. 5-0 nylon.

Actually, the dura is friable.
It's not gonna hold a stitch.

And the pericranium is too
scarred to harvest for a patch.

[WARREN] You want some fascia lata?

[SHEPHERD] I think that might be
our only option. Prep the thigh.

[WRIGHT] Not the only option.

Instead of another incision, I can

harvest fascia from the existing field.

[SHEPHERD] You think it'll have
enough bite to hold the dura?

[WRIGHT] Give me three
minutes, I'll show you.

- [SHEPHERD] Mm-hmm.
- [WRIGHT] Scalpel.

Okay, Mom. [STUTTERS] Whatever.

I'll let you know when
I know what he's decided.

Hey. Everything okay?

[BREATHING HEAVILY, SWALLOWS]

Everything's fine.
I'm just... a terrible person.

I have a hard time believing that.

You're spending your third trimester
with your brother in the CCU.

My mom's a wreck because her
son is having another big surgery

- while she's recovering from pneumonia.
- [SIGHS]

And I just yelled at her because
she didn't have an opinion

on the paint color for the nursery.

Hey, you want your mom's help.
That doesn't make you terrible.

I'm just overwhelmed.

Yeah. Of course you are.
There's a lot going on.

It's so stupid.

I am 36 years old.
I'm about to have a kid...

but I still just want my mom.

I know the feeling.

[♪ "SOFT EYES" PLAYING ♪]

[SMACKS LIPS]
I should call her and apologize.

I'll see you up there.

♪ Soft eyes, set warmth in me ♪

[BREATHING SHAKILY]

♪ Show me stillness patiently ♪

Hey, Corban made his decision.
He wants a TEVAR.

Okay.

I'd page someone else, but
we're down residents today.

I'm good.

- Do you need a minute?
- Not at all. I'll go prep him.

Okay.

- Dr. Bailey, I am so sorry.
- I take full responsibility.

I should have told Spencer to check
the KUB before starting feeds...

Yeah. Damn right. And you better
have a good reason you didn't.

Yeah, a pharmaceutical
company called with

a lead on Katie's infusion. So I just...

No, the last time I checked,
I asked you to focus on your patients

admitted in the hospital.

I only picked up long enough to
let them know that I was serious.

Wendy could have died of
chemical pneumonitis or pneumonia.

She didn't, and Katie could
die if we don't fight for her.

I know. I am fighting for her too.

[ADAMS] Are you?

Because what options have you found?
What research have you done?

Have you exhausted your contact list?

Because it feels like you've given up.

Oh, so you think after
Katie sobbed in my arms,

I... shrugged and said, "Good luck"?

That I gave her a goody
bag and sent her on her way?

- She's dying, okay? We...
- And I think about it every single day.

And I also think about my 65-year-old
with decompensated cirrhosis,

who's treatment resistant

and-and the 17-year-old that's
septic and I can't figure out why.

Don't forget about John Doe in the

ICU whose abdomen I had to leave open.

Yeah, he's also keeping me up at night.

And now I guess you can
add Wendy to my list.

See, I haven't given up on Katie,

but I also haven't given up
on the rest of my patients,

and that is where you
and I are different.

Get it together.

[♪ SONG ENDS ♪]

[OPERATOR ON PA] Dr. Brooks to oncology.
Dr. Brooks to oncology.

Hi. Randall did great.

He is recovering now, and they will

call you when he's ready for visitors.

[SIGHS] Is it bad if I don't answer?

No one would hold it against you.

I really do love him.

That's what makes this hurt so much.

I mean, it's his body and he can
do whatever he wants. [SNIFFLES]

But if I want to stay married to him,

I don't get a say in
whether I have a baby.

Well, you could always
ask him to reverse it.

[KIMMY] What's the point?

He obviously doesn't
want to have kids with me.

- [SOBBING]
- Uh...

Well, can you get a puppy?

I'm allergic.

That's unfortunate.

Yeah.

[♪ "CHASING A THREAD" PLAYING ♪]

- Hey.
- Hey.

I did Corban's TEVAR. He did great.

His numbers are improving.

Okay.

I'm-I'm sorry if I came
across as harsh earlier.

I-I still maintain
that the ventral aorta

wasn't the right call for this patient.

- What about the next one?
- [SIGHS]

You were more than happy to talk
about this surgery on podcasts

and publish abstracts, present it.

You were the one who came up with it.

What's the point if
you never do it again?

It's a break-the-glass-
in-case-of-emergency surgery.

But does it have to be?

Think of the number of people suffering

from aortic disease with no options.

We might have something
that could help them.

Why don't you want to use it?

She looks terrible.

She'll look more like herself
when the swelling goes down.

And we'll keep monitoring her
brain function to see what's intact.

Her intracranial pressure is stable

and she's not re-leaking
any fluid from her nose.

And that's good.

I think I have to drop out of school.

I can't leave her like this.
It's always been me and her.

Have you thought about
contacting the school?

Maybe take a leave of absence?
Or do your coursework remotely.

You think they'd do that?

Yeah, you've worked really hard.

And if you stop now, then it's gonna

be a lot harder to start back up again.

Never hurts to ask.

Um, excuse me.

Uh, Dr. Wright, uh, I ordered
Teresa's post-op imaging,

but it probably won't happen overnight,

so I'll make sure it's done
for first thing tomorrow.

Good, thank you.

Uh, all due respect, uh, I
don't want to be just good.

I want you to see me as excellent.

So I'm asking, what would that take?

Tell me what you need me
to do, and I will do it.

There's your problem.

That I'm not anticipating
you well enough?

You're trying to anticipate me

when you should be trying
to anticipate the medicine.

Look, over the years I've found
that the most successful residents

focus on patient care
and surgical technique.

- Mm-hmm.
- They're confident in who they are,

which translates into them
being confident in what they do.

And that is what leads
to excellence in plastics.

I didn't see that from you today.

Maybe next time.

♪ I can keep a promise
but I can't pretend ♪

♪ Oh, no, here I go again ♪

♪ Chasing a thread ♪

[♪ SONG ENDS ♪]

Hey. Did you update, uh, Ms.
Cahill's output for Baxter?

He's on tonight.

You okay?

Super.

Look, Bailey was mad at me, not
you, and she was way out of line.

[SPENCER] Bailey?

Bailey wasn't the problem.

Spencer.

I thought you were
going to apologize to me.

For what?

Look, you might have taken the
heat because you're the second year,

but I fed the tube into Wendy's lungs.

And if you had told me to get a KUB,

I would have taken a damn
X-ray and not initiated feeds.

- Okay, but we managed it. She's fine.
- She had food in her lungs!

[SIGHS]

- [BAILEY] Uh, okay. Thank you.
- [WARREN SIGHS]

Thank you.

[GRUNTS, SMACKS LIPS]

I wasn't cool.

Oh, you're being hard on yourself.

Oh, she said in no uncertain terms

that she did not see
excellence in me today.

[CHUCKLING] I'm sorry.

You know what makes it worse?

She wasn't even mean about it. She
just said it like it was a fact.

Huh.

What, you think it's a fact?

Oh, no, no, no. I was... [GRUNTS]

... thinking about
how I yelled at Adams.

Oh. What did he do now?

Well, his concern for one patient got in

the way of his care for other patients.

- Katie Rogers.
- Yeah.

I mean, truth is, if
she was our only patient,

his dedication would be admirable.

- Mmm.
- I hope I wasn't too hard on him.

[SIGHS] Um, I guess we got to have thick

skin if we're going to do this thing.

Want to go home?

- Mmm, let's go home.
- [CHUCKLES]

[SIREN BLARES]

Hey.

Everything okay?

I haven't signed the papers yet.

[HUNT GRUNTS]

But getting a divorce was your idea.

I know.

I know.

- Are you having second thoughts?
- No.

I keep taking the papers out
to sign and then I don't do it

and now... they're just
sitting in my bag

with crumbs and crayon marks on them.

[SCOFFS]

Just because it was my idea
doesn't mean that I'm not scared.

- What are you scared of?
- [ALTMAN] I don't know.

That everything will just
explode and-and fall apart.

- But hasn't that happened already?
- [BOTH CHUCKLE]

[STAMMERS] You don't
have to do them right now.

I mean, I'll-I'll-I'll take
out another retainer.

We don't have to rush this.

I have to do it sometime.

[HUNT] Okay.

[♪ "TOGETHER" PLAYING ♪]

[GREY] My sixth-grade teacher said,

"Your actions plus your
choices equals your life."

This is mostly true.

[SIGHS] I can do a whole
vasectomy, start to finish.

- It's pretty straightforward.
- Why you looking at me?

What? You changed your mind?

Yeah, today, looking at
questions about my mom,

thinking about being a mom just
brought up a lot of old feelings

I don't have time to deal
with. I need to focus on work.

[STAMMERS] What if I did it with you?

I don't have to be here for this, right?

[BOTH] No.

Thought you didn't want kids.

I don't think I do.

But I also don't want to wake up one day

and my eggs are all shriveled and dusty

and realize that I
do, and it's too late.

And then if we... if
we do it together, I...

I could be there for you
if you think about your mom.

- You'd do that?
- Yeah, yeah.

And then I can tell you about my

mom, which would make you feel better.

Fertility friends.

Don't call it that.

[PHONE BUZZES]

No, no.

[GREY] But what it doesn't
account for is luck.

- What is going on?
- Leticia, you have to wait outside.

- Someone tell me what's going on.
- Get her out, please.

- It's gonna be okay. It's gonna be okay.
- No.

- No, please.
- What happened?

I got him back after one round of epi,

but he's still hypotensive
with a narrow pulse pressure.

- Did you get an X-ray?
- Uh, right here.

Good work.

Mediastinal widening.
The leak is expanding.

Page Altman.

We need to get him
back to the angio suite.

Let's move.

[GREY] Sometimes we encounter
unexpected twists of fate.

- [WRIGHT] Hey.
- [SHEPHERD] Hey. [CHUCKLES]

Thanks for today.

You're the only neurosurgeon that's ever

responded to my page in under an hour.

Yeah, well, it was my first day
back, so I didn't have a lot going on.

[STAMMERS] Not... Not to say
that I'm not always prompt.

Right.

You need me again, I
will come just as fast.

Okay.

Uh...

- I... I made it weird.
- No.

I swear to you, the
crush is all in the past.

I've had many crushes since then,

succeeded at several,

changed programs when
others have failed.

You used to laugh more.

- I also had a crush on you.
- [EXHALES SHARPLY]

[SHEPHERD] I mean, I didn't
understand what I was feeling, but,

you know, I wish I had known. [CHUCKLES]

Sorry, that-that is... this is...

I'm not hitting on you
in the attending's lounge.

Right.

This is work.

Do you wanna go somewhere, get a coffee?

[GREY] And the best things
in life fall out of thin air.

All you have to do is catch it.

- Synced and corrected by ChrisKe -
-- for www.addic7ed.com --

- McSteamy, right?
- [♪ "CHASING CARS" PLAYS ♪]

Mark Sloan.

Oh, this is awkward.

We're the dirty mistresses.

I suppose we are.

I'll show you the Sloan Method.

How many nurses have
you slept with this week?

That's not a problem, man.
That's an adventure.

The Plastics Posse, kicking
surgical ass and taking names.

The Plastics Posse?

People don't come to me to
fix what's on the outside.

They come to me to fix
what's on the inside.

If that means giving someone a
straighter nose or bigger breasts,

if that helps a person get by...

I don't run. I don't
hide. I don't take space.

- I'm a dad. We're parents. Of a baby!
- [LAUGHS]

Why are you telling me to give
it time when there's no guarantee

- that time is gonna be there?
- [CRYING]

If you love someone, you tell 'em.

Even if you're scared that
it's not the right thing,

even if you're scared that it
will burn your life to the ground,

you say it, and you say it loud.

♪ Just know that these things
will never change for us at all ♪

Don't waste one single minute.

♪ Would you lie with me
And just forget the world? ♪