Original subtitles

Until the 17th century, scientists thought blood was a one-way street.

Corban's labs are in. His white count's 22.

- And his acidosis is getting worse.

He's septic.

All he wanted was to meet his nephew.

Should we consider comfort care measures?

No. Page Ndugu, and tell the OR desk

that I want the same team from Nora Young's ventral aorta surgery.

You're doing the ventral aortic reconstruction?

Between his sepsis and the bleeding, it's our only option,

assuming that I can get the consent from his sister.

You want me to talk to her?

I was the one who convinced him to do the TEVAR. It should be me.

They believed blood was produced by the liver

and consumed like food by the body's tissues.

Until British physician William Harvey published a treatise

so explosive, it was banned in England.

I spent a lot of time imagining this in med school

instead of studying microbiology.

Mmm. Does the real thing measure up?

I wouldn't want to inflate your ego.

Well...

...I'm a neurosurgeon, so that ship has sailed.

Hey.

This is gonna sound crazy, but, um...

Do you wanna, like, go on a proper date?

Get dinner tomorrow night?

Yeah, I'd love to, but I have my s--

Um...

My sunrise hiking club, uh, in the morning.

You hike?

I just started, you know, there's nothing like fresh air in the morning.

Right. Um...

I should go. I should probably change before rounds.

He posited that blood was part of a circulatory system

continuously pumped through the body and recycled by the heart.

In other words, when it comes to blood, what goes around comes around.

Ooh. No. Okay. Why... Why do you have to leave so early?

I have to prep for a sternal reconstruction.

Dr. Wright wants to work with me more before she'll write me

a letter of recommendation for that attending position in Boston.

You're still on this Boston thing?

-What do they have that we don't? -My parents.

-Nieces and nephews. -Mm-hmm.

-Cream pie. -Oh, I forgot about the pie.

Mmm.

-Uh, did you forget how to knock? -The door was open.

Millin, you're on my service today. Thought you'd be at work by now.

-I'll be in time for rounds. -I expect you to bring your A game.

It's an important case.

I always do.

-I'll see you both later. -Yeah.

- Simone! - Would it kill you to be nice?

She is trying to tell me what to do before I've had coffee.

Where is Simone? We're supposed to be going over fertility stuff on the way in.

-Fertility stuff? -Yeah, we're freezing our eggs.

Well, I mean, I am. I can't speak for her.

Pretty sure you just did.

Look, Simone never made it back last night. Critical patient.

- Oh, then can I get a ride? - Oh, me too. Please?

Do I look like a soccer mom to you?

-She is texting me. -I didn't say anything.

Look.

I muted her. Focusing on my other patients,

like you told me to.

You must have really handed it to him.

I gave him constructive feedback.

At least he knows where he stands. It's the same with me and Dr. Wright.

I know what I need to improve on.

See, he thinks that I don't care, but I've been searching high and low

for more infusion treatments for Katie.

Any luck?

Just a bunch of unanswered emails and dead ends.

Sugihara wants to put her on her prior immunotherapy regimen.

- That was... Yeah. - Well, I'm sorry.

Hey, what's on your schedule today?

Um, consults, meetings, residency admin.

-Push 'em. -Hmm?

Dr. Goldberg is out sick today and he needs somebody to take his procedures.

Oh, come on.

Save some lives with me.

Let's save some lives.

Luna and Hattie are still napping.

Uh, the baby monitor's on the coffee table.

All right, you already mentioned that.

Um, extra diapers are upstairs in the linen closet,

and the... the... the pediatrician's number is on the fridge.

-We're not going to Siberia. -I know that.

And we need to find a dresser big enough for the twins today.

I've been fasting in anticipation for the Swedish meatballs,

so I would love to get there

- before I go into a hypoglycemic coma.

If you have any issues at all, please don't hesitate to call.

Will do.

Okay.

I think you're supposed to hand over the baby now.

Oh, yeah. Okay. Okay, okay.

Don't wake your sisters up.

Is it weird that we're...

...handing our babies over to someone else for the first time and all I feel is--

-Unbridled joy? -Mm-hmm.

No. There might be a leak at my rental property.

Where I lived before I moved in here with you.

Oh! Wow, I always forget that you own that dump.

I installed a water sensor when the last tenants moved out,

-and I should probably check on this. -Well, just call a plumber.

Oh, no, they'll charge an arm and a leg just for showing up.

-It won't take long to fix. -Okay, I'll come.

Are you sure you really wanna hang out at that dump?

Yeah, I'll just, um, sit in the car.

First day of freedom.

Hey, so I haven't gotten to officially welcome you back yet.

You go somewhere tropical?

No, do Chicago or Boston count?

Now, sabbatical looks good on you.

What have we got?

42-year-old male, head trauma after colliding with a glass door.

GCS 15. No LOC. Presented with epistaxis and a small forehead lac.

BP is 130 over 80.

Nasal bandage was applied at the scene.

Okay, sir, welcome to Grey Sloan.

- I'm Dr. Hunt. - This is Dr. Shepherd.

Yeah, yeah, do you have a safe?

-What are you doing? -Sorry, I'm, uh... I'm done.

Only my little brother could get hospitalized running into a door.

It happens more than you think.

We were brunching with my work buds. Finally got this VP promotion.

Hey, I... I don't know what happened. I must have blacked out when I won the...

Won what?

Won biggest loser?

We've got a possible head trauma here.

What's that?

It's a lottery ticket. It says he won two million dollars.

What? You won two million dollars?

Oh. He's out!

Trauma 3 is free. Let's move!

Hey, hey, hands off.

Okay.

Hey.

Griffith said you're doing the ventral aorta.

I said she must've misheard.

Yeah, first, I need to come up with a plan

to present to Leticia, who is understandably skeptical.

Wait, you said the TEVAR went well.

Well, it did.

And then he coded.

His pseudoaneurysm degenerated.

How badly?

The aorta is unsalvageable.

Break glass in case of emergency.

The TEVAR could've worked. I had to try.

We should have done this yesterday when he was more stable.

We don't have time for hindsight.

That's on you. You were so afraid to try this surgery again

that you wasted his best shot.

Nora was just as bad, if not worse.

That was a miracle. You said it yourself,

"If this doesn't work on Corban, that's it. We'll never try this surgery again."

Now you've made that almost certain here.

What, do you want me to apologize and say that I was wrong?

I made the right call with the information that I had at the time,

and it was a bad outcome.

And now Corban is dying.

So either you can help me come up with a plan to save him or stop wasting my time.

Dr. Millin.

- Mr. Hill didn't wanna start without you. - Oh.

I was starting to think you abandoned me.

No, I was just finishing a chest tube.

I would never abandon my favorite patient or his better half.

Oh, I bet you say that to all the old fogies.

- I didn't realize you all knew each other.

I scrubbed in on Scott's CABG with Dr. Beckman a couple months ago.

Then, by all means, take it away.

Scott Hill, 73, status post-CABG complicated by osteomyelitis.

Now status post multiple debridements to the sternum and costal cartilage,

resulting in a 12-by-10-centimeter wound.

Today we are starting his reconstruction.

I thought the CABG would help me be more active in retirement.

We're in our "world-traveler era," as the kids say.

Love that for you guys.

We did have to cancel our safari in Tanzania.

Fortunately, the tour company let us reschedule.

She did what you told her to do, Dr. Millin.

What? You sweet-talked them and then cried?

Mm-hmm. The tears did them in.

Well, that, or describing this gaping hole in my chest.

We're gonna try and close that up today, okay?

Millin, Mohanty, take him for a repeat CT to confirm our surgical plan.

- You got the full refund, right? -Yes, the full refund.

I told you it works every time, every time.

- I was crying and crying.

Can't believe he won two mil. It's almost as much as I loaned the poor bastard.

You should wait outside.

Okay, let's get ready for rapid sequence intubation.

I love his broke ass, but he's a sad, bottomless money pit,

you know what I'm saying?

Whoa, whoa, hold the paralytic. He's waking up. Shepherd.

Hey, look right here.

Okay, do you know your name and where you are?

Jeremy. I'm... I'm in the hospital.

Hey, I'm right here with you, bro.

-Anything of note happen today, Jeremy? -Uh...

Yeah, my boy got paid, y'all.

Okay, let's do a FAST exam and get that bleeding under control.

I wanna get a head CT right away.

-No, I can hold on to that. -No, I think he's got it.

His sweat might melt off the numbers, bro.

Okay, I'm not seeing any free fluid.

Yeah, we need to get him upstairs.

We'll update you when we can. Can you please leave the room, sir?

Please. Thank you so much.

Goodbye. Thank you.

Thank you, Bryant. Let's get him up to CT.

I gave your sex friend a ride to work this morning.

You're welcome.

-I hope you were normal. -Griffith, you have that?

I was. Yeah, we got it.

Wish I could say the same for Millin.

Oh, crap, I was supposed to meet her.

But you didn't.

And now Bryant may or may not think that you're trying to have a baby.

What?

I'm just a messenger.

We will dissect away

the part of Corban's reconstructed esophagus that's behind the sternum,

and that should give us the access that we need.

-It should? -It's hard for us to know,

given Corban's scar tissue.

He wanted the surgery yesterday.

You talked him out of it.

It was an unnecessary risk then.

And now?

His aorta is too damaged.

It has to come out.

What do you think?

I know it's scary.

But this surgery is Corban's only chance of survival.

And Dr. Altman and Dr. Ndugu are the only surgeons who can and have done it.

Yeah, after they drew it on a napkin.

If it helps, I assisted on the first one.

I've seen it save someone's life.

If I say yes and he dies, I...

He will die for sure if you say no.

Yeah.

Do it.

Please don't make me regret it.

Did you check Scott for scars at possible donor sites?

Lots of moles, but no sign of scarring on the arms, back, abdomen or legs.

Did you measure the depth of his wound?

Same as when I staffed it with you, 4 centimeters.

How's it looking, team?

The internal mammary arteries must have been sacrificed in the debridements.

There's no local blood supply to plug a flap into,

but we could connect it with the axilla or lateral chest.

What about tunneling omentum from the abdomen?

It's interesting. Mohanty, thoughts?

It's a nice idea in theory,

but a free flap offers thicker soft-tissue coverage over the heart,

and it looks so much better.

Well, Scott doesn't care how it looks. He just wants to go on safari.

He'll care when he sees it, trust me.

Maybe, but that's if he survives a ten-hour surgery.

I mean, omentum must be less.

And it comes with a built-in blood supply.

This is lifelong coverage. It's what I would want on my chest.

Sometimes...

- ...the correct approach just takes longer. - -Yeah.

Okay, if Scott were a 20-year-old bodybuilder, we'd do the free flap,

but omentum is the right call.

- Way to jump in, Millin. - Thanks.

-I'll page general surgery. -That's the spirit.

What's your problem?

I don't have one now that we're doing omentum.

You're a second year. I'm a fellow. We're not even running the same race.

Hey, Nardi just fed Hattie, and now Peyton's down.

I gotta pee. Ooh. How's it going?

The pipe is completely corroded.

Why don't you take the car and you go without me?

God, your place is an explosion of linoleum and wood paneling.

Yeah, well, you've been here before.

Who thought popcorn ceilings were a good idea?

-Hmm. -No wonder your tenants fled.

Wow.

-Isn't it crazy they left this? -Oh.

What's with all the packages?

Oh, I, uh, ordered a few things that got delivered here by mistake.

Uh-huh.

Um...

Have you been spending time here?

Only when I have to check on something.

Okay.

When was the last time?

Ah...

Tuesday?

When you went to get diapers

and you left me with screaming twins for two hours?

I did stop here briefly.

I had to check on the mailbox, and then I just needed a little time to decompress.

Oh, yeah?

You really need to stop talking right now.

- Jo. - You know what?

You wanna decompress? You want a little space?

Be my guest.

Jo.

Well, you made that chole look easy.

I can't believe how quickly you got the critical views.

Yeah.

You still thinking about Katie?

I just feel like I failed her.

Mm-mmm, mm-mmm.

The federal government failed her.

Saving her life doesn't align with their priorities.

But I'm her doctor...

...and I'm supposed to figure it out.

"Consult request for a sternal reconstruction...

for Dr. Wright."

Wright? Uh...

You know, if you're not feeling up to it, I'm sure they can find somebody else.

You know, I can't help Katie, but I can help you get in with Wright.

- Let's show Plastics what you're made of.

Put your hands down for me. Thank you.

Would you go out with someone who has kids?

-Are you trying to set me up? -Just answer the question.

-No, thanks. -Hmm.

-Hey. -You have kids.

Mm-hmm.

When do you tell people that you're seeing about them?

Uh, only person I've dated so far already knew about them.

You two are useless.

I told him security could hold on to his ticket, but he won't let go of it.

Would you?

All right, Jeremy, hold still.

Okay. Hey, while it's just us, I'm sorry about my brother.

-No need. He's fine. -He's a jerk.

I'd tell him off for you, but he's been keeping me afloat

since I lost my job, and I don't want him to cut me off.

Didn't you just win the lottery?

Yeah, I guess I did.

He has a small contusion on the left temporal lobe.

-Bryant. -Monitor him for any change

in clinical status and give prophylactic Keppra.

I'll let you take it from here. Okay.

It's time. You can go to the waiting room.

Can he hear me?

-He's heavily sedated. -But it can't hurt to try.

Hi.

I hope my son is just like you.

We've decided to name him Corban.

And if you don't want us to, make it through surgery and tell me yourself.

Love you.

-The second that you know anything... -I will come and tell you.

Okay.

Can you come out so I can explain?

How long has this been going on?

I don't know. A few months.

What about your tenants?

I told you they moved out.

A few months ago? My God, this is worse than I thought!

You've been cheating on me with your house.

It's platonic, I swear.

Look, it's not like I was coming here when you were in the hospital with the girls.

Oh, how thoughtful of you.

We can't fit any of this stuff at our place, and music is how I relax.

Cry in the shower like a normal person.

You know what? I'll go shopping and you can stay here and jam.

Fine. I've got a new reverb pedal I can try out.

Great.

I'll call the plumber.

No, I can fix it myself.

No, you've lost that privilege.

I thought I saw signs of life in here.

Well, I'm not back to work until next week.

I'm just grabbing a few things.

Aren't you supposed to be resting?

I'll rest when I'm dead, which I'm not unless Catherine finds me.

Well, I won't tell.

Oh, um, tell Altman good luck for me.

The ventral aorta? I assumed you knew they're doing it again.

Richard, Teddy and I, we just signed divorce papers.

I'm sorry to hear that.

Honestly, I'm not sure how we ended up here.

Well, sometimes things just don't work out.

More often than not in my case.

Oh, you'll get back on your feet.

I'd stay for the surgery, but Catherine's at the dentist.

If I'm not back before she is, there'll be hell to pay.

You should go.

Yeah, I'll see if I have time. It was good to see you, Richard.

Oh.

Someone order a general surgeon?

-Oh, Dr. Bailey, thanks for joining. -Mm-hmm. Mm-hmm.

Dr. Warren, good to see you again.

At your service, or rather on your service.

-Her service actually. -Okay.

So, I took a look

-at your patient's scans... -Uh-huh.

...and, you know, it should be relatively straightforward as long as

the right gastroepiploic vessel is enough to supply the omentum.

Looks sufficient to me.

-We'll see you in the OR? -Mm-hmm.

We're gonna harvest that omentum like you've never seen.

Okay.

I panicked.

Oh, this is gonna be harder than I thought.

Oh, Kwan was right.

You are in the supply closet. Why are you in the supply closet?

We're doing another ventral aorta.

I heard. Big day.

Can you watch the kids for me tonight?

Of course. I just wanted to say good luck.

What if we can't do it again? What if Nora was just an anomaly?

There was a lot of skill involved.

If this doesn't work out, then Corban never meets his nephew, and I'm a fraud.

When you're backed into a corner, that is when you rise.

I've seen it in war zones.

I've seen it in the OR. I see it with our kids.

Don't put more pressure on me right now.

I am just saying you can do this. You're just in your head.

-You need to take a breath-- -Don't tell me what I need.

That's not your job anymore. And frankly, it was infuriating when it was.

Okay. Well, I'll, um...

I'll get the kids from school.

And, uh, good luck.

That was excellent technique with the dermatome, Dr. Mohanty.

Wanna do the honors with the mesher?

Absolutely. Thank you.

Mm-hmm.

Um, pull the omentum through for me.

Okay, no twisting on its pedicle,

and the main vascular arcade remains intact.

- Well done, Dr. Warren. - Thank you.

You're one of our best and brightest.

I'd hate to lose you to Plastics, but I know that's where your heart is,

especially with your interest in burn patients and experience as a firefighter.

Firefighter and an anesthesiologist,

how many lives have you had?

I'd like to think they all led me here.

Well, that should do it for me.

Thanks to Dr. Warren's dissection, your flap should cover everything you need.

Hey, do you call him Dr. Warren at home too?

Okay, that looks great.

- Now, we just need to finish the inset...

- ...and get the graft on. - This is OR 2.

Dr. Wright, they're asking for you on an urgent burn case in the pit.

Warren, wanna join me?

-I'd love to. -Great.

Dr. Mohanty, you and Millin here good to finish up?

Of course.

Come on now, y'all can't keep him here. We gotta go pop some bottles, celebrate.

On him for once.

Yeah, no. Sorry, doctor's orders.

All right, let's talk dollars and cents. Of course you're gonna hit me back

for the car and the back rent, right?

Millionaire. You're a millionaire, you're a millionaire...

Okay, why don't we table this until after your brother's out of the hospital?

-Yeah. -Doc, J Dog would be facedown

in a ditch if it wasn't for me.

You know, I've hated that nickname since I was eight.

Well, I've hated picking up your tab for the last 12 months,

but that's what brothers are for, right?

Hey, if you don't wanna do it, I will.

-We got a problem here? -Uh, that depends.

- Are you going to keep being a total-- - You should go.

Him or me?

Bryant, out. Now.

I'm sorry about that.

Yeah, that's...

-What's happening? -All right.

-He's seizing. -Adams, help roll him.

We need some diazepam and alert CT.

Oh. Hey, what you heard this morning isn't true.

-Okay. -I'm not actively trying to have a baby.

I'm just freezing my eggs in case I want one someday.

-Got it. -Which I might not want one.

-Just an insurance policy. -Congrats. Also, none of my business.

Oh, I just didn't want you to think I was withholding some critical information--

-I don't. Yeah. Yeah. -Great.

Because what we're doing right now doesn't have to stop.

I mean, there might be a few days here and there where we shouldn't...

-Mm-hmm. Yeah. -You know, but, overall, we can keep

-doing the thing that-- -Understood, but, uh, right now,

I'm trying to do my job, and I'm mostly failing, so I really can't talk.

Oh, how-how about a drink at Joe's later?

If they ever let me leave, sure.

Okay.

Yeah. Okay, so...

Oh, sorry. Yeah.

Okay.

- I can, uh, cut the sutures for you. - -I've got it.

- I really don't mind. - I said no.

Should I call for another resident since you clearly don't want me to help you?

Not if your idea of helping is making me look ridiculous in front of our attending.

You told me to be on my A game.

So that I can impress Dr. Wright.

I applied for an attending position at the Fox Flagship in Boston.

It's perfect. Great benefits, grant money, close to my family.

And I needed her recommendation, which I was supposed to lock down today.

If you wanted me to make you look good, you should have said so.

- Right. - I'm serious.

I'll keep that in mind for next time.

Can I get in on those lower inset sutures?

Nope. Too close to the pedicle.

I know that we have disagreed on Corban's care,

but I need to know that you are fully on board

with the surgery and with me.

I was on board with the surgery yesterday.

- Still am. - And me?

- I'm a professional. - -That's not what I'm asking.

It's not just that you made the wrong call.

You flat out dismissed my opinion.

I didn't. I considered it fully.

Did you? 'Cause if you'd set your ego aside,

we may not be in this mess.

Or Corban would already be dead, and then that would be on both of us.

If something goes wrong in there, I need to know you hear me.

I will.

You have my word.

- Then I have your back. - -Let's go build an aorta.

Where is this guy?

- Hmm. - What are you doing?

I just thought I'd see what all the fuss is about.

Yeah, that's my Martin.

-Mm-hmm. -So, be careful.

This song is called... ..."This Is What Betrayal Feels Like."

Okay, I get your point. Can we put it back now?

Not until you apologize.

You know what? No.

What is wrong with me grabbing a few minutes

of alone time, so I can be better for you and the kids?

I had a heart pump keeping me alive

after delivering two other bodies out of my body.

I can't breastfeed, which I know is okay, but I still feel horrible about,

and hormones have turned me into someone that I would avoid on the OB floor.

I am not okay!

I am not me.

I am a hideous shell of my former self,

-and you don't see it... -No.

...because you're off in the man cave, which is actually an entire crappy house.

Plumber's here.

Here's a list of discharge summaries.

Stay away from Jeremy and don't leave

-until you get them done. -You punishing me?

-You were out of line. -That dude was walking all over

-our patient, man. -It doesn't matter.

It's not our job to get involved, and if you do it again,

-I'll have to tell Bailey. -Got it. So don't treat the whole person,

just be a robot checking boxes.

Yeah. That's not what I said.

I'd love to stay and chat, but I've got a whole bunch of discharge summaries

I need to go through. Thanks for the lesson, boss.

Thank you. I thought that Brent took it.

You have a condition called SIADH.

It can happen after a head trauma.

Usually resolves on its own.

Low sodium levels caused the seizure.

You'll need IV fluids and medication to correct it.

- Okay, thank you.

Boom.

Don't ever say I never did anything for you.

And I, um, also called Mom.

- Man get... Stop! - You should let Jeremy rest.

No, I've been wanting to say this to him for a long time.

I hate you. I mean, I love you.

You're my brother, and I wouldn't have been able to get through

this last year without you, but when you're mean about it,

it makes me hate you.

-We were just having fun. -It's not fun.

-Not for me. -Maybe we just take a breather.

I... I just always thought it rolled off your back.

I'll lay off.

Really? That's it?

Yeah, I'm not a monster.

I guess I should have said something years ago.

I'm gonna put in your orders.

You still gonna pay me back for the rent though?

This scar tissue is cemented in.

- Worse than Nora's? - By a mile.

You know what else is different this time?

- Blood flow? -All those people watching up there.

Stay focused.

I don't know if we're gonna be able to get through all this.

Altman.

If we give up now, he'll die.

- All right, um, 15 blade. - -What are you--

Using these scissors is like blunt dissection. It isn't working.

I'm gonna try working layer by layer,

see if I can find the correct surgical plane to orient myself.

Okay. I'm with you. Thank you, BokHee.

Guess who aced his burn consult?

Okay, tell me everything.

Well, thanks to my days as a firefighter...

- Okay. - ...I knew to mix and put a laxative

on the burn.

Yeah, the polyethylene glycol binds to the phenol

to stop the chemical burn from getting worse.

-Impressive. -And that is what Dr. Wright said.

Aw.

-Thank you for talking me up. -Someone had to.

You weren't doing yourself any favors.

- Okay, what can I do to help you? - -Oh.

Yeah. Call more hospitals about Katie's immunotherapy?

Handle bedtime so, you know, you can look into more options?

Yeah, I don't need any of those things, but, no, I appreciate the sentiment.

Hold on.

How's my favorite patient?

Well, nurse gave him

-some pretty strong pain meds. -Uh-huh.

So, he's a little loopy.

Love of my life over there.

I love her more than I love elephants.

Is something wrong?

Uh, the flap is dark and swollen.

I'm going to take a listen.

-Damn it. -What's happened?

-Everything okay? -There's no signal.

I'll call the OR and page Dr. Wright. Get him ready.

He needs to go to surgery again?

Well, there's no blood flow to his flap

so we need to get him to the OR to see what's happening ASAP.

Don't go visit the zebras without me.

Excuse me.

All right, graft is completed.

It's time.

All right, let's rapid pace the heart.

All right, clamp's off.

GIA stapler.

All right.

Ready to staple off the aorta?

Staple line is well approximated, looks intact.

We did it.

All right, let's take him off bypass.

Clamps.

It's amazing.

All right, I am gonna go update Leticia.

- You good? All right. - Yep, ready to close.

- Whoa, whoa, whoa. Ndugu! - Oh, my God!

Damn it! All right, get me a gown and gloves.

All right, I've got pressure on the defect.

Griffith, get in here and suction around my hand.

Come on.

All right, there.

A small defect on the leading edge of the staple line.

We didn't fire the staples all the way across.

Okay, put him back on bypass.

- Clamp on. - All right, I'm here.

- Okay, put your hand in here. - -Yeah.

Suction. Hang on, Corban.

Hang on.

Katie Rogers, 27, stage-four gastric cancer.

I already know that part.

Short of breath. Satting 89%.

-Abdomen's distended. -Dr. Bailey.

I can't breathe.

No, no. It's okay.

We've got you.

Well, don't just stand there. Let's move.

There's a stitch tied down over the pedicle cutting off its blood supply.

Nothing?

This is a serious mistake.

Warren and I left you to complete the inset and place the skin graft.

I expected it to be done not only successfully, but perfectly.

The flap looked viable when we left the OR.

We didn't see anything restrictive over the pedicle.

Save it. I don't have time for excuses.

Our patient now has no tissue coverage over his wound

and will most likely need many surgeries he might not survive.

Just go.

I'll clean up the wound and get the wound vac back on myself.

Almost finished closing this gap.

All right, last stitch.

And right there.

- Done. - Are we sure

the closure is going to be adequate?

Will the suture hold? - After watching

so much of Corban's blood volume spray all over this OR,

I am not sure of anything.

But I watched Ndugu tie these sutures, and they look great.

So, let's take him off bypass.

All right. Clamp's off.

We have a rhythm.

The pressures are coming up.

All right.

Altman, we did it.

Altman.

We did it.

Well done, everyone.

All right. Let's prep to close.

$400 and he has to come back tomorrow with a part.

Should've fixed it yourself.

You know, I'm sorry for hiding all this from you.

I guess I was afraid that you'd be madder if you knew.

Honestly, I'm more jealous than mad.

See, you need a place like this too.

You need someplace you can go for peace and quiet.

A woman cave.

-I feel guilty even thinking about it. -Why?

The patriarchy.

Mm-hmm.

You know, if we're gonna get through this,

we have both got to take care of ourselves.

-What would I even do in my-- -She shed?

-Dame den? -Mm-mmm.

Okay, I'll stop.

Lady lair.

You could take guitar lessons.

- Yeah, but I'm already a musical genius.

Honey, you look like you've seen a ghost.

Yeah.

The ghost of an omental flap that died at the hands of negligent residents.

You've got a lot going on.

We can chat tomorrow.

-I... -No, no. It's fine. Everything's fine.

It's all... It's all fine.

What's up?

Um...

I have a son, Scout.

He's five. He's adorable.

He splits his time between his dad and me, and I have him tonight.

And that is why I couldn't hang.

You were nervous to tell me about a cute kid?

It was kind of a deal-breaker in my last relationship and that kind of broke me.

And if it is a deal-breaker for you too,

I totally get it... But I would rather know before starting something.

That would make me a hypocrite.

So...

-This is Zachary. He's seven. -Oh, my...

Obsessed with trash compactors and, uh, synthesizers from '80s pop songs.

-Are you... -Single mom? Mm-hmm.

Uh, my sister lives with me.

She watches him when I reconnect with an old crush.

Which happens all the time?

Not really.

Rain check?

Rain check.

His pressures are holding without much inotropic support.

-That's great news. -Yeah.

Do you think that we will ever do this surgery without major complications?

Third time's a charm.

Somehow, I doubt it.

We're a team on this.

If we stay one, we could save way more patients than just Nora and Corban.

- You've been here for two days. - Yeah.

You should go home, and I'll keep an eye on him.

Thanks.

Poor thing. Must've had liters of fluid in her abdomen pushing up on her lungs.

Okay, so we'll need to do a paracentesis

if you can get me set up for that.

Adams. Adams.

She called and texted.

And I didn't respond because I was too busy following your rules.

This would have happened regardless.

No, she trusted me.

And she was scared and alone and...

I wasn't there.

I think you need to take a break from this case.

No, no, no. I...

-I will do whatever you need. I just need... -No, no.

It's not a punishment. I just... I...

I think you need to step back.

Breaking new ground is never easy.

-Yo. -Hey.

I just did the ventral aorta with Altman and Ndugu.

It was freaking epic.

-It was historic. -That's cool.

- I'm proud of you. - Something happen today or...

-My patient won the lottery. -By having you as their doctor?

No, no. He literally won the lottery, two million dollars.

Mmm. Did not see that coming.

I'm going out of town for a minute.

-Is everything okay? -My brother's epilepsy's gotten worse.

And he's in a coma.

I'm sorry.

You want to talk about it?

No, no, no, I just didn't want you wondering where your lap dances went.

Well, I mean, you sure? I've been told

-I'm a pretty good listener. -I said I'm good.

You have to pull the rug out from under people.

Have a good night.

Shatter their reality.

Ask more questions than you answer.

It takes what Dr. Harvey called a love of truth.

And a whole lot of intestinal fortitude.

Thank you for not saying anything. You didn't have to do that.

Look, I could tell that the Boston job is really important to you.

It is.

There will probably be an M&M soon.

I'll email you my op note and photos from the OR.

They'll want to review post-op imaging too.

Well, should I be worried?

The M&M will suck, but we'll be fine.

Get some sleep.

But it also requires faith.

That the world won't come crashing down around you.

That you won't be burned at the stake.

How'd it go?

Oh, well, it wasn't smooth sailing but our patient's stable.

That's great.

So, uh, Allison wanted to fall asleep with the lamp on,

so just make sure to turn it off before you go to bed.

Thank you for pinch-hitting.

I... I really appreciate it.

Always happy to get more time with the kids.

I'm sorry I bit your head off earlier.

You did nothing wrong. I was just in a panic spiral,

and I couldn't see it.

Well, I stand by it.

You are at your best when you're backed up against the wall.

A little mean sometimes.

But brilliant.

You are never gonna stop believing in me, are you?

Why would I?

And that this new reality is going to be better.

Or at least truer than the one that came before.