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You should put this on now.
My contractions are still nine minutes apart,
and they're not...
not that bad.
They are now 8 minutes and 45 seconds apart.
We should get pancakes. Where's my sweater?
I don't want pancakes. I want you to put this on.
Shoot-- I forgot my lucky socks.
The ones I wore last time I was in the hospital...
when my brilliant husband came up
with a miracle surgery to save our baby.
Those are hospital socks.
They are identical to all the other hospital socks.
I will get you another pair.
But they won't be my lucky ones.
- I'll go home and get them. - N-No.
You need to stay here. And put this on.
And get hooked up to a fetal monitor.
I will get the socks.
Okay.
How long after we get there will the surgery start?
You'll go straight to the pre-op,
where they'll do a chest X-ray and echo.
Oh, why waste time with that? I need a new valve.
There's no mystery here.
We'll also need blood and urine samples.
Huh. I can give you that right now.
That's... not necessary.
Efficiency, boys.
Clearly, none of you have been in the military.
Yeah. We're Oscar-Mike from the nursing home,
but some dense fog put us behind schedule.
Yeah. Make sure the O.R. is prepped
and Dr. Park is at the ready for Mr. Ermey when we get there.
On the double.
Your dad a Marine?
Brother.
Oorah.
Okay. Just make sure your "dense fog" excuse
is only for your critical care transport
and not dinner tonight.
Um, dress code?
To the nines.
Going tens.
Hello?
Danny?
You there?
Danny?
You okay?
My knee's kind of messed up, but otherwise okay.
Mr. Ermey? We've been in a crash.
All right. We're gonna get you down.
- Okay. - All right.
- You got his legs? - Yeah.
All right. three, two, one.
Gotcha.
- All right. - Take his armband off.
- Yeah, I'm all right. I'm all right. - Watch your head.
Okay. I'm gonna unstrap you.
- Okay. - All right. You ready?
- Mm-hmm. - Three-two, one.
Oh! I'm good. I'm good.
- You good? - Yeah, yeah.
Okay.
The truck came over the line. I had nowhere to go.
Are you all right?
I think my leg's broken.
Okay. Stay up there. I'll get to you.
Can you reach your radio?
We're gonna need at least five more ambulances.
Got it.
Danny, you take the driver of the pick-up truck.
- I'll get to the family. - All right.
Dispatch...
It's gonna be okay, girls.
Okay, I'm Jared. I'm a doctor.
- What's your name? - Uh, uh, Kenny.
I can't breathe.
Kenny, any pain in your chest? Trouble breathing?
Uh, uh, I'm okay. I'm okay. Help them.
All right. You sit over there. I'll get to them.
Hey, girls.
I'm gonna get you out of these car seats
so you can be with your dad, okay?
- What's your name? - I'm Bea.
- Okay, Bea. - My sister's name is Ella.
Okay. Okay. All right.
Let's get you out of there.
It's gonna be okay.
Good job, Bea. Well done.
Ella, I'll be right back for you, okay?
Good job. Now, you go to your dad.
- There you go. - I got you. I got you.
He's alive! He's alive!
But pulse is weak and thready.
Hey.
I'm gonna get you out of here safe, all right?
Yeah, yeah. Don't worry. I'm fine.
All right. Hold still, please.
Okay, Ella. I'm Dr. Kalu. Are you okay?
My chest-- I can't breathe.
Okay. Let's get you out of here so you can be with your dad, all right?
Good job, Ella.
I've got you. That's it. You're doing so well.
I've got you. Get you under here.
Come on.
Okay. Good job, guys.
Good job.
No, no, no, no, no.
No. Hey! Hey!
Stop! Stop! Hey!
Danny!
Lea's in labor.
We're having our baby today.
Congratulations.
Morning, ladies.
Eden, clocking in today?
My trial had three participants drop out at the last minute,
and every available nanny within 90 miles
is either dumb, lazy, or incompetent.
Mommy Morgan has very exacting standards.
I'm willing to lower them momentarily if you're available.
I just need a few minutes to give my spiel
to a room full of perimenopausal IBS patients.
I would, but I just got paged to the E.R.
I'll stop by later.
Be professional.
At least five seriously injured
multi-vehicle collision patients are inbound,
including Dr. Perez.
I'll take the first patient.
Then Dr. Park, then Andrews, Wolke, and Allen,
in that order.
Senior doctors, when you have stabilized your patients,
please circle back and assist the residents.
Take a deep breath, everybody.
Driver of the last car of the pile-up-- head-on collision.
Conscious, has a pulse, but not responding.
Suspected cervical spinal cord and brachial plexus injury.
Chest hurts.
Where's my phone? I need to make a call.
You'll get your phone call soon, Mr. Ermey.
Get an eFAST and assess for shock.
Let's fix that lac.
I need to drain the hemopericardium.
Give FFP to control the bleeding.
Fracture of the right femoral shaft and left distal radius.
We got it.
- Hey, are you okay? - I'm-- I'm good.
Where's Perez?
Kalu is bringing him in the last ambulance.
So, he's the least critical?
He's...
He'll be here soon.
Multiple rib fractures and associated pneumothorax.
It hurts.
Hey, I'm Dr. Wolke.
We're gonna help you, okay?
Finally.
Still no purposeful eye or limb movements.
Likely a high c-spine fracture.
Let's get her stabilized for a trauma pan-scan.
Massive right-side hemopneumothorax,
but she's holding her own on vitals.
- She needs a chest tube. - What does that mean?
- Is-- Is she gonna-- - She's gonna be okay.
We just need to make sure that you and the little one are good.
- If you could take a seat-- - I-I-I'm fine. Just a bruise from my--
Yes, I know you feel fine, but we need to make sure.
I-It's okay, Bea.
Um, I-I-I got to call my wife.
She doesn't even know any of this happened.
Abdominal ecchymosis,
peritoneal hemorrhage, possible hemothorax.
You're bleeding everywhere.
Call up to O.R. 2 for an emergency ex lap.
No opioids.
What?
Just promise me.
No opioids.
Okay.
Tell the anesthesiologist opioid-free.
Ow!
Considerable intraperitoneal fluid.
She has a perforation and needs abdominal surgery right away.
No! Dad!
It's gonna be okay, baby.
Mommy will be here soon, and we'll all play Scrabble.
We think you suffered a neck injury,
but we need to get some images so we can tell for sure.
Hey.
All stabilizing ligaments have been completely severed.
Internal decapitation.
Have you ever worked on one of these?
Never even seen one.
Why aren't you in your patient room?
Oh, I had some last-minute e-mails to send,
and my preggo-brain forgot my laptop in here.
Did you get my socks?
Is there something wrong with your room?
We could get you extra blankets.
What is this?
This is the cutest hat I've ever seen.
Oh! I got one for each of us.
Shaun, I love them.
We should take it to Glassy.
We should go to your room.
I-I know things are...
difficult between you two right now,
but his grandson is being born today.
He knows.
He said, "Congratulations,"
and then he shut the door.
Mm.
We need to get you hooked up to a fetal monitor.
The surgery went well. We repaired Ella's bowel perforation.
Mommy, did you bring snacks?
We'll go to the cafeteria together
as soon as we're done talking to the doctors.
When can she go home?
Uh, there was some damage to her spleen.
Uh, we'll need to monitor that for the next few days,
make sure it doesn't get worse.
But I'll keep you updated.
I've got to be in the O.R. in 10 minutes for my valve replacement.
Order a post-op CT and run serial hematocrits.
Mm. Sorry.
I'm not used to having consultations in my kitchen.
I've never seen that much separation between skull and spine.
Have you? Not in anyone alive.
I was thinking occipitocervical fusion surgery
using a plate with four-point fixation
and transpedicular and translaminar screws.
You're gonna have to add
iliac crest graft and Songer cables.
You're looking at over two hours just to realign
and stabilize the skull and the spine,
and then the real work begins.
Your odds of success are somewhere
between minimal and nonexistent.
Well, marathons are pointless, but millions of people run them anyway.
Feel like running?
I've been deemed "unfit."
You wouldn't be cutting. You'd be consulting.
Flattering.
You're still one of the world's foremost experts
on the brain and spine,
and my patient's head is hanging on by a thread.
This one's scary. I could use some help.
Sure.
I'm up for some... color commentary.
You have another contraction coming in one to two seconds,
and it is a big...
...one.
They are now six minutes apart and increasing in intensity.
We should have the nurse check your dilation again.
Hi. Big day. Excited for you both.
Everyone is busy because of the accident--
Lim is prepping, Andrews and Park are in surgery--
and I think my patient is in trouble.
Her latest CT shows her splenic injury is getting worse.
How's Perez doing?
They're just finishing up his surgery now.
Your patient needs a splenic artery embolization.
How long can she wait? There are no attendings available.
She cannot wait.
Shaun...
you need to do the surgery.
I...should be here with you, to give you ice chips
and hold your hand and talk about the future.
Have you been watching movies about people having babies?
I'm fine.
I have hours to go before the Peanut makes his debut,
and how complicated is this procedure?
It is quite straightforward.
I love you, and I'm so happy we're starting our family.
But there's a little girl who needs you.
Please, go.
Okay. Prep the O.R.
Do not have this baby without me!
No opioids.
Thank you.
You want the itemized list?
Multiple displaced rib fractures,
contusions on both lungs, abdominal bleeding,
and a fractured pancreas, which is as painful as it gets.
Danny, you need to let me give you pain meds,
- real pain meds. - No.
I've already got you on acetaminophen, lidocaine,
gabapentin, and magnesium.
Your heart rate and BP are still elevated.
You are at risk for a heart attack or stroke.
No.
I worked way too hard getting sober.
I can't go back to square one.
You need opioids.
What I need...
is to hear you tell me about our dinner tonight.
Please.
Distract me.
The restaurant is very romantic--
tablecloths and candles everywhere.
And the music isn't so loud that it drowns out all conversation.
The trial starts Monday.
You'd only be in-patient for three days,
then weekly check-ins for six weeks.
I suppose I could hire a dog-sitter.
But Lincoln doesn't like new people.
Or tall people. Or men.
Can you excuse me for just one second?
She's the sweetest girl.
She prefers to face out, be involved.
Yeah. Better.
I'm almost done here.
I need to push my 2:00 p.m. to 3:00 p.m., my 3:00 p.m. to tomorrow.
So, is it three days and two nights?
Or three days and three nights?
Sorry. A little more head support.
No, not like that.
Just...
Here we go. Right there.
I need to go. Lincoln's waiting.
No. Wait. Barbara, it's-- it's two nights.
Please go talk to him.
Shouldn't you be in a room somewhere, having a baby?
Congratulations, by the way.
You two cannot be in a fight today.
It's not a fight.
I know it's a big deal, but can you please put it aside,
at least for today?
I got to go to the O.R.
This is probably the most important day of Shaun's life.
He needs his father.
Oh, my God.
Either my water just broke,
or I just peed all over your office.
Either way, it would be a first.
You have plenty of time. Here, let me help you.
No, no. I'm married to Dr. Shaun Murphy.
He has walked me through the steps
of the birthing process many, many times.
I can take it from here.
Please go talk to him.
I'll call janitorial.
I just...
Gail, always a nice surprise, but you caught me on a busy day.
Well, sadly, I'm about to make it busier.
The board's calling an emergency meeting for tonight.
Okay, and what is the board defining as an emergency today?
You, Marcus.
And how you're going to handle the nurses' push to unionize.
I'm on top of it.
That's the problem.
The splenic artery embolization went very well.
Your daughter should not need any more surgeries.
She'll need to spend the next few days
in the hospital until we can remove her NG tube,
get her back on regular--
Honey? Wha--
- What's happening? - Profoundly hypotensive.
- Kenny! Pulse disparity - between arms.
This is likely an aortic dissection.
We need to get him to an O.R., stat.
Reasonably happy in this life...
Supremely happy with You forever in the next.
Amen.
Danny, your BP's 211 over 130, heart rate 194.
You're having a hypertensive crisis.
You need fentanyl. The pain is killing you.
God, grant me the serenity to accept the things
I cannot change...
He asked you not to do that.
He's not responding to the antihypertensive drips.
Right, so up the dose.
He's tachycardic and hypertensive because of the pain.
He's going into shock.
- He's not. He's praying. - He's dying.
The courage to change the things I can...
That prayer is what starts every NA meeting.
He is clinging onto his sobriety.
...and the wisdom to know the difference.
And wisdom to know the difference.
He's admitting he doesn't know what to do.
He's asking God to help him.
I'm helping him. You can leave.
Accepting hardship as a pathway to peace...
Living one day at a time...
Enjoying one moment at a time...
Forever in the next. Amen.
Forgive me.
Accepting hardship as a pathway to peace.
We need to place the graft
to replace the descending and thoracic aorta.
We need six more units of blood.
I did a full exam in the E.R.
I mean, the imaging was clear.
There were no signs of dissection.
Trim the distal aorta.
It must have started small enough to be undetected.
His blood pressure gradually expanded the tear
until it ruptured.
Oh.
There's a false lumen.
It extends past the carotid.
The graft...
won't work.
Well, can you...
Can you have one of your visions?
Come on, Shaun. There must be something.
For his family.
He's lost more than half his blood volume.
His brain has been underperfused for too long.
Time of death...
4:36 p.m.
You might have mentioned you were one of the organizers
behind the nurses' unionization push.
Does it matter?
Not to me, but the board feels differently.
Apparently, our relationship is why
I haven't been coming down hard on the nurses.
I can personally attest that you've been
a total pain about it the whole time.
Cute. They're threatening my job.
I don't want you to lose your job over us.
I don't want to lose you over my job.
You know, Shaun and Lea are having their baby today.
Yes, I'm aware.
Have you talked to him?
I said, "Congratulations."
Well, the alignment looks much better,
but she could have horrible stenosis.
Are you planning on talking to him?
Beyond one word?
I'd decompress the C1 with a laminectomy.
You know, a crotchety, old, wise man once told me
that hanging onto my anger was toxic.
I'm not "crotchety."
You were right then.
And I'm right now.
He publicly humiliated me yesterday,
as everyone in this room is quite well aware.
Well, he's having his baby today.
Pass me two 28-mill pedicle screws, please.
- I'll take those. - Right.
Old habit.
I saw your family leave a while ago.
Are they getting a hotel?
You gave me fentanyl.
I did.
Was it a hard decision?
Overriding my wishes?
Honestly?
No.
You were on the verge of a heart attack.
- Or brain bleed. - Yeah, but not definitively.
I wasn't willing to risk your life waiting for "definitively."
But you were okay sending me back to certain opiate addiction.
I couldn't...
let you die.
I stopped by to offer my nanny services.
But it looks like you're all set.
I got all three participants locked in.
Trial's starting on time.
Now I just need to tell Andrews that I'm done.
Done?
With this job.
Look, you've had a long day.
But you'll find a rhythm. And a nanny.
I can't do this job as well as I want
and take care of Eden as well as I need.
I've made the mistake of putting my career ahead of the people I love before.
I'm not doing it again.
The nurses put a chair next to the table for you,
if you would like to sit.
Is it okay to touch him?
Yes.
Just don't remove the sheet.
He was just here.
How am I gonna tell my girls?
I don't think I can do any of this without him.
When my brother Steve died,
I didn't know how I would survive.
He had always taken care of me.
But I did.
Because someone else came into my life
who took care of me and loved me.
Now he may be gone, too.
It is very hard to lose people you thought would never leave.
But you will...
be okay because you have no choice.
When we lose people we love,
we have to find a way to keep going
for the people we still have.
Take as much time as you need.
I'm going to have a baby now.
Oh, you're back.
How's the little girl?
She will be okay.
Mm.
How far apart are the contractions?
About two minutes.
Okay.
It is time to start pushing.
Are you sure?
I don't-- I don't feel anything.
That's because of the epidural,
but your prostaglandin E1 and E2 levels
are at peak concentration
for stimulating myometrial contractility.
It is time.
Oh.
I'll gown up and be right back.
I will refill your water bottle and get an extra pillow.
Do you want a warm or cold washcloth?
Either is fine, but I-I need more time.
Delaying delivery can cause excessive postpartum bleeding,
plus an increase in bacterial infections.
I'll get one warm and one cold.
Shaun, wait. Come here a minute.
I'm scared.
Really, really scared.
It is...
common for women to be anxious
about the birthing process.
For nine months, my whole goal was to keep this baby
in my belly, safe and sound and protected.
And now it feels like I'm supposed to just
shove my own heart into the world and--
and let it walk around all exposed and vulnerable
and so, so tiny.
And I'm not gonna be able to protect him anymore.
It will be okay.
Probably.
I am very excited to meet our son.
I'm really excited, too.
Okay.
Okay, let's-- let's do this.
Okay.
You're two hours out of surgery. Lie down.
When can I get back to the home?
I need to take your vitals.
Ehh.
Want us to call your family?
I got to call Martha.
- Wife? Girlfriend? - Neither.
We take walks every morning
with about 20 other old farts from the home--
all waking up to watch the damn sunrise.
Not your preferred activity?
Doc, if God wanted us to see the sunrise,
he would have put it at a more reasonable hour.
You go because Martha's there.
I think it's time I told her...
she's the reason I wake up in the morning.
Let's give her a call.
Thanks.
You're all right, Doc.
I went through my patient record.
You made the right call.
Thank you.
But...
I'm going to need all the help I can get to recover
without relapsing.
I...
need to go back to Texas with my family.
I knew when I gave you the drugs,
I might lose you.
And it wasn't a hard decision?
The decision was easy.
The aftermath is...
Well, I'm not going anywhere until we have our date.
Are you free tonight?
The levator ani muscle is undergoing a stretch ratio
of 3.26, which is normal.
Shaun, I need you up here, not down there.
Why isn't he coming out?
The little guy is just progressing slowly.
I think we need a vacuum assist to help--
You want to vacuum my baby out of me?
It is standard protocol
if a baby is stalled in the birth canal.
I covered this in the e-mail about instrum--
There were a lot of e-mails, Shaun.
Okay.
Is it safe for the baby?
Mm.
Will he have a cone-head?
Only for approximately 48 hours.
Okay, mama. You ready?
Mm-hmm.
I am here for you.
You can squeeze my hand.
You're doing great. He's almost here.
Oh!
Congratulations, Mom and Dad.
Ooh.
Oh, I can't believe you're finally here, Peanut.
He doesn't look like an alien at all.
His... head has a very nice shape.
Yeah.
He is beautiful.
Dr. Murphy, would you like to do the honors?
Yes.
I would very much like to do that.
Hi.
Look at what we made.
Hello.
It is very nice to meet you.
I am Dr. Shaun Murphy.
I'm your dad.
You think anybody would notice if we took this home with us?
I think you should leave it.
I wasn't really going to take it.
Oh, sure you were.
But...
I don't think you should resign.
Because you don't have to do it all alone.
You're the reason I wake up in the morning.
So, whatever there is to figure out,
all I want in the world is for us to do it as a family.
I love you, too.
She has a dirty diaper.
And I have 30 lab reports to review.
Thank you...
for saving my life.
You're very welcome.
I-I, um-- I didn't mean today.
I meant when you made looking for a foot in a lake fun.
When you sat next to me in church, quietly,
knowing that was exactly what I needed.
And, uh, when you trusted me...
even though I'm pretty sure I didn't deserve it.
And, of course, today.
You make me believe that I can do this.
You will be okay.
I'm gonna miss you.
Thank you.
I love a sunset as much as anyone,
but isn't this a little sentiment over science?
There's a case study out of Alabama--
internal decapitation.
They took the patient out every night--
sunset, beautiful sky, and fresh air
to help stimulate the brain.
How long before they got a response?
A couple days, but it worked.
Hey, how can you argue with a thing called "Operation Sunset"?
Your family is coming.
I know they'd love to see you smile, or even a blink.
Or you could just flip us off
because you're cold and you're afraid of heights.
You've got your methods, I've got mine.
Whatever works.
Shaun and Lea had their baby.
Do you want to go meet him?
I think I'll stay here. Thank you.
I know that losing surgery is devastating.
Don't let losing one great love cost you another.
♪ You got wings, but they won't get you off the ground ♪
♪ And you got low and got off right before the station ♪
I wanted to give you a heads-up, as a friend.
Uh-oh.
I've decided to resign.
Seriously?
Yeah.
♪ You are coming home ♪
♪ Oh, you ♪
♪ You are coming home ♪
Do you think Dr. Glassman is coming?
Let's take a picture before my adrenaline wears off
and I pass out.
I'll get the hats.
I would love the honor
of taking the first family photo.
♪ Goodbye ♪
♪ 'Cause you ♪
♪ You are coming home ♪
♪ Oh, you ♪
♪ You are coming home ♪
Hi, baby.
- Okay. - Take a good picture.
Hey, baby boy Murphy. Smile for your big debut.
Three, two, one, cheese.
Beautiful.
♪ You are coming home ♪
Hi.
Hi, baby.
This is from Dr. Glassman.
♪ You got low and got off right before the station ♪
♪ Now all you've got to do is turn around ♪
How did he know his name would be Steve?
Because he knows you.
♪ You, you are coming home ♪
♪ Oh, you ♪
♪ You are coming home ♪
♪ I will calm the rivers in your mind ♪
♪ Though it might take a little time, you know ♪
♪ But you're coming home ♪
Steven Aaron Murphy.
♪ You are not alone ♪
This is a gift from your grandfather.
♪ Coming home ♪
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