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These are the user uploaded subtitles that are being translated: 1 00:00:03,670 ---> 00:00:05,339 Those are yours. 2 00:00:05,339 ---> 00:00:08,091 We bought them together. 3 00:00:08,091 ---> 00:00:10,969 Because you "found the pattern soothing." 4 00:00:15,724 ---> 00:00:19,102 ♪♪ 5 00:00:19,102 ---> 00:00:21,688 I'm gonna miss you, Shaun. 6 00:00:21,688 ---> 00:00:23,398 I love Carly. 7 00:00:25,150 ---> 00:00:26,902 And that's great. 8 00:00:26,902 ---> 00:00:28,987 I am so happy for you. 9 00:00:28,987 ---> 00:00:32,199 Now you can hang the toilet paper incorrectly 10 00:00:32,199 ---> 00:00:34,201 anytime you want. 11 00:00:34,201 ---> 00:00:35,536 And Carly and I can go back 12 00:00:35,536 ---> 00:00:37,246 to the way things were before our fight. 13 00:00:38,997 ---> 00:00:42,292 Well, sometimes couples need a little time to recover. 14 00:00:42,292 ---> 00:00:43,377 We won't. 15 00:00:43,377 ---> 00:00:46,088 Carly asked for you to move out. 16 00:00:46,088 ---> 00:00:48,382 You are moving out. 17 00:00:48,382 ---> 00:00:51,218 ♪♪ 18 00:00:51,218 ---> 00:00:53,929 How many kidneys do I need in my body to attend prom? 19 00:00:53,929 ---> 00:00:55,055 [ Chuckling ] Ryan... 20 00:00:55,055 ---> 00:00:56,390 Even if the surgery removes my kidney, 21 00:00:56,390 ---> 00:00:57,975 it'll be laparoscopic, 22 00:00:57,975 ---> 00:01:01,103 so my inpatient time will be seven days, tops. 23 00:01:01,103 ---> 00:01:03,313 And then three more days of rest at home. 24 00:01:03,313 ---> 00:01:05,107 I can take my girlfriend to prom, right? 25 00:01:06,316 ---> 00:01:07,859 That's not a purely medical decision. 26 00:01:07,859 ---> 00:01:09,570 I have to draw some blood. 27 00:01:09,570 ---> 00:01:11,363 What are the chances Dr. Melendez might be able 28 00:01:11,363 ---> 00:01:13,323 to remove the tumor but spare Ryan's kidney? 29 00:01:13,323 ---> 00:01:15,200 Well, the MRI will let us know 30 00:01:15,200 ---> 00:01:17,119 how much the chemo shrunk the tumor, 31 00:01:17,119 ---> 00:01:19,496 but you shouldn't count on it. 32 00:01:19,496 ---> 00:01:22,624 One chili burger, extra mustard, extra pickles. 33 00:01:22,624 ---> 00:01:24,459 Hi. Morning, Mr. Cooper. 34 00:01:24,459 ---> 00:01:26,253 I'm not sure he can have that with his surgery ‐‐ 35 00:01:26,253 ---> 00:01:27,921 Oh, he's fine until about 6:30 tonight. 36 00:01:28,880 ---> 00:01:30,299 Claire:I know you. 37 00:01:30,299 ---> 00:01:32,926 Angie...Valens. 38 00:01:32,926 ---> 00:01:34,553 I helped put in your chemo port. 39 00:01:34,553 ---> 00:01:37,055 I owe you a big thank‐you. [ Chuckles ] 40 00:01:37,055 ---> 00:01:38,890 We met in chemo. 41 00:01:38,890 ---> 00:01:41,018 They should put us in a public service announcement or something. 42 00:01:41,018 ---> 00:01:43,145 Yeah ‐‐ "I lost a tumor and gained a boyfriend. 43 00:01:43,145 ---> 00:01:44,313 Thanks, chemo." 44 00:01:44,313 ---> 00:01:45,355 [ Laughter ] 45 00:01:48,734 ---> 00:01:50,235 James McDougall? 46 00:01:50,235 ---> 00:01:51,528 That's who we're here for, too. 47 00:01:51,528---> 00:01:53,905 All of you can head over to Bay 4. 48 00:01:53,905 ---> 00:01:56,158 Guy saw me six months ago for a stress fracture. 49 00:01:56,158 ---> 00:01:58,452 He's a lunatic ultra‐marathoner. 50 00:01:58,452 ---> 00:02:00,120 I just hope he didn't go too hard too soon 51 00:02:00,120 ---> 00:02:01,496 and break it again. 52 00:02:04,291 ---> 00:02:06,126 [ Breathes shakily ] 53 00:02:07,544 ---> 00:02:09,921 He didn't break it again. 54 00:02:09,921 ---> 00:02:11,923 ♪♪ 55 00:02:16,470 ---> 00:02:23,977 ♪♪ 56 00:02:23,977 ---> 00:02:26,605 Lim:Your GP was right to start you on ketoprofen for the swelling, 57 00:02:26,605 ---> 00:02:28,607 but clearly, it isn't working. 58 00:02:28,607 ---> 00:02:30,275 That's why Drs. Murphy and Reznick 59 00:02:30,275 ---> 00:02:32,277 are going to block off some of your lymphatic channels. 60 00:02:32,277 ---> 00:02:34,321 It should reduce production. 61 00:02:34,321 ---> 00:02:36,406 The more pressing concern is why. 62 00:02:36,406 ---> 00:02:38,575 Have you ever had surgery on your lymph nodes? 63 00:02:39,785 ---> 00:02:42,371 What about cancer or radiation treatment? 64 00:02:42,371 ---> 00:02:44,414 No. Physically, I've always been healthy. 65 00:02:44,414 ---> 00:02:45,832 Physically? 66 00:02:45,832 ---> 00:02:47,751 I was diagnosed with Persistent Depressive Disorder 67 00:02:47,751 ---> 00:02:49,711 when I was 16. 68 00:02:49,711 ---> 00:02:52,881 That's why you got to get me back out on the road, Doc. 69 00:02:52,881 ---> 00:02:54,925 Are antidepressants not effective for you? 70 00:02:54,925 ---> 00:02:56,718 I mean, they help. 71 00:02:56,718 ---> 00:02:59,388 But running really is key. 72 00:02:59,388 ---> 00:03:02,265 Saved my marriage and ‐‐ and my life. 73 00:03:02,265 ---> 00:03:04,810 Lymphedema can be caused by an infection. 74 00:03:04,810 ---> 00:03:07,062 He doesn't have a fever. 75 00:03:07,062 ---> 00:03:08,563 Ketoprofen can suppress fevers. 76 00:03:08,563 ---> 00:03:09,731 Let's get some cultures 77 00:03:09,731 ---> 00:03:11,817 and start him on broad‐spec antibiotics. 78 00:03:11,817 ---> 00:03:16,113 ♪♪ 79 00:03:16,113 ---> 00:03:19,741 As requested, your restock on enemas. 80 00:03:19,741 ---> 00:03:20,909 Nice cover. 81 00:03:22,411 ---> 00:03:23,620 How've you been feeling? 82 00:03:23,620 ---> 00:03:25,539 The methotrexate is working great. 83 00:03:25,539 ---> 00:03:27,791 No pain, no redness. 84 00:03:27,791 ---> 00:03:29,626 Stiffness, flu‐like symptoms? 85 00:03:29,626 ---> 00:03:30,919 No. All good. 86 00:03:30,919 ---> 00:03:32,546 [ Faucet handles squeak ] 87 00:03:32,546 ---> 00:03:34,339 How long are you planning to hide out 88 00:03:34,339 ---> 00:03:36,967 doing RA exams and clipping diabetics' toenails? 89 00:03:38,218 ---> 00:03:40,512 Dizziness, headaches, nausea? 90 00:03:40,512 ---> 00:03:43,306 I ‐‐ Sometimes I'm a little queasy after I eat. 91 00:03:44,516 ---> 00:03:46,476 You had to love neurosurgery. 92 00:03:48,019 ---> 00:03:49,771 How about we try to get you a medication 93 00:03:49,771 ---> 00:03:51,481 that doesn't irritate your stomach? 94 00:03:51,481 ---> 00:03:53,692 No. My hands feel great. That's all I care about. 95 00:03:55,110 ---> 00:03:58,321 You used to open up skulls and poke around people's brains. 96 00:03:58,321 ---> 00:04:00,532 There's no way this fulfills you. 97 00:04:00,532 ---> 00:04:02,492 I enjoy it. 98 00:04:02,492 ---> 00:04:05,454 Or, rather, I usually enjoy it. 99 00:04:05,454 ---> 00:04:07,205 [ Inhales sharply ] 100 00:04:07,205 ---> 00:04:08,623 I'll let you get back to it. 101 00:04:10,917 ---> 00:04:13,253 Maybe someone out there needs an enema. 102 00:04:13,253 ---> 00:04:15,839 [ Door closes ] 103 00:04:15,839 ---> 00:04:18,216 [ MRI machine humming ] 104 00:04:18,216 ---> 00:04:19,551 Got a measurement on the Wilms tumor? 105 00:04:19,551 ---> 00:04:21,887 Mm, not quite there yet. 106 00:04:21,887 ---> 00:04:24,639 You mentioned 7 centimeters as our limit 107 00:04:24,639 ---> 00:04:26,057 to doing this laparoscopically. 108 00:04:26,057 ---> 00:04:28,477 What if we pushed it to 7.2? 109 00:04:28,477 ---> 00:04:30,729 Would speed up recovery. 110 00:04:30,729 ---> 00:04:32,314 By a few days. 111 00:04:33,648 ---> 00:04:34,775 Forget I brought it up. 112 00:04:34,775 ---> 00:04:37,652 Ryan wanting to take his girlfriend to prom 113 00:04:37,652 ---> 00:04:41,072 should not factor into our surgical plan. 114 00:04:41,072 ---> 00:04:42,324 Is he nuts about her? 115 00:04:42,324 ---> 00:04:45,285 Ohh. Crazy, head over heels in love. 116 00:04:45,285 ---> 00:04:46,703 They both are. 117 00:04:46,703 ---> 00:04:47,704 Idiots. 118 00:04:47,704 ---> 00:04:49,623 [ Chuckles ] 119 00:04:49,623 ---> 00:04:53,001 I wouldn't mind being an idiot like that again. 120 00:04:53,001 ---> 00:04:56,379 Though, I'm not sure I ever felt that way ‐‐ 121 00:04:56,379 ---> 00:04:58,048 totally happy. 122 00:04:58,048 ---> 00:04:59,257 So therapy's going well? 123 00:04:59,257 ---> 00:05:01,009 [ Chuckles ] 124 00:05:01,009 ---> 00:05:02,677 No metastasis in the lungs. 125 00:05:04,513 ---> 00:05:05,889 Look at that. 126 00:05:05,889 ---> 00:05:11,728 ♪♪ 127 00:05:11,728 ---> 00:05:13,313 Your tumor is gone. 128 00:05:13,313 ---> 00:05:14,815 [ Gasps ] 129 00:05:14,815 ---> 00:05:16,149 Gone? 130 00:05:18,193 ---> 00:05:19,444 How's that possible? [ Chuckles ] 131 00:05:19,444 ---> 00:05:22,239 The chemotherapy worked better than we expected. 132 00:05:22,239 ---> 00:05:25,158 Wait, like, no tumor? Zero? 133 00:05:25,158 ---> 00:05:26,284 No need for surgery whatsoever? 134 00:05:26,284 ---> 00:05:27,619 Claire:That is right. 135 00:05:27,619 ---> 00:05:29,412 These are discharge forms. 136 00:05:29,412 ---> 00:05:30,997 [ Laughs ] 137 00:05:30,997 ---> 00:05:32,374 [ Squeals, giggles ] 138 00:05:32,374 ---> 00:05:34,793 Both of my kidneys are taking you to prom! 139 00:05:34,793 ---> 00:05:36,086 Aah! Hell, yeah, we are! 140 00:05:36,086 ---> 00:05:37,879 [ Laughs ] 141 00:05:37,879 ---> 00:05:39,130 [ Laughs ] 142 00:05:40,715 ---> 00:05:42,092 [ Clears throat ] 143 00:05:43,426 ---> 00:05:44,803 Angie? 144 00:05:47,055 ---> 00:05:48,014 Angie! 145 00:05:48,014 ---> 00:05:49,057 She's having a seizure! 146 00:05:49,057 ---> 00:05:50,725 [ Grunting ] 147 00:05:50,725 ---> 00:05:53,144 2 milligrams of lorazepam and portable oxygen, stat. 148 00:05:53,144 ---> 00:05:55,564 Let's get that under her head. 149 00:05:55,564 ---> 00:05:57,649 [ Alarm blaring ] 150 00:05:57,649 ---> 00:05:58,984 His lungs are filled with fluid. 151 00:06:00,777 ---> 00:06:03,738 I need a chest X‐ray and a bedside ultrasound. 152 00:06:03,738 ---> 00:06:05,991 And page Dr. Reznick. 153 00:06:07,617 ---> 00:06:09,411 [ Coughing ] 154 00:06:09,411 ---> 00:06:11,621 [ Pager beeping ] 155 00:06:11,621 ---> 00:06:15,834 ♪♪ 156 00:06:15,834 ---> 00:06:16,668 [ Beeping continues ] 157 00:06:19,921 ---> 00:06:21,590 Imaging has confirmed 158 00:06:21,590 ---> 00:06:23,383 a reoccurrence of your brain tumor. 159 00:06:23,383 ---> 00:06:24,968 What stage? 160 00:06:25,927 ---> 00:06:27,095 3. 161 00:06:28,722 ---> 00:06:32,058 The best approach is surgery ‐‐ a wide resection of the tumor, 162 00:06:32,058 ---> 00:06:34,603 followed by radiation and chemo to encourage full remission. 163 00:06:36,104 ---> 00:06:38,773 Sounds like a fun couple months. 164 00:06:38,773 ---> 00:06:42,444 Full recovery will probably take closer to eight. 165 00:06:44,195 ---> 00:06:45,071 [ Sighs ] 166 00:06:47,574 ---> 00:06:49,701 We can get through this, baby, just like last time. 167 00:06:52,162 ---> 00:06:54,247 W‐When will the surgery be? 168 00:06:54,247 ---> 00:06:56,166 We need to do some additional imaging, 169 00:06:56,166 ---> 00:06:57,667 and I'd like to consult a colleague 170 00:06:57,667 ---> 00:06:59,044 about the best surgical approach. 171 00:06:59,044 ---> 00:07:00,170 That'll take a few days. 172 00:07:02,005 ---> 00:07:03,048 Take your time. 173 00:07:05,300 ---> 00:07:06,468 Prom? 174 00:07:07,802 ---> 00:07:09,012 [ Chuckling ] Yeah. 175 00:07:09,012 ---> 00:07:10,805 Now that Ryan can go, I have to go. 176 00:07:10,805 ---> 00:07:14,100 Honey. This is your health we're talking about. 177 00:07:14,100 ---> 00:07:16,645 [ Voice breaking ] Mom, please. 178 00:07:16,645 ---> 00:07:20,565 I just want to do this one thing like a normal kid. 179 00:07:20,565 ---> 00:07:22,192 [ Sighs ] 180 00:07:22,192 ---> 00:07:24,152 Can you tell her it's okay? 181 00:07:25,362 ---> 00:07:26,571 Park:We can't. 182 00:07:26,571 ---> 00:07:28,198 Until we remove your tumor, you're at risk 183 00:07:28,198 ---> 00:07:29,616 of potentially fatal seizures. 184 00:07:32,369 ---> 00:07:33,828 After you're recovered, 185 00:07:33,828 ---> 00:07:35,455 you and Ryan can get all dressed up, 186 00:07:35,455 ---> 00:07:36,873 and we'll go have dinner at the Grandview. 187 00:07:36,873 ---> 00:07:37,707 Okay? 188 00:07:44,339 ---> 00:07:46,299 Prom sucks. 189 00:07:46,299 ---> 00:07:48,134 My buddy had a fake ID. 190 00:07:48,134 ---> 00:07:49,969 I got so drunk in the limo that I passed out 191 00:07:49,969 ---> 00:07:52,389 and never made it into the dance. 192 00:07:52,389 ---> 00:07:55,016 Maybe that wasn't everybody's experience. 193 00:07:55,016 ---> 00:07:56,893 I was prom king. My date was queen. 194 00:08:01,940 ---> 00:08:03,274 I had the dress, I had the date, 195 00:08:03,274 ---> 00:08:05,151 I had the mom who got arrested. 196 00:08:05,151 ---> 00:08:07,153 Spent the night picking her up from the drunk tank. 197 00:08:07,153 ---> 00:08:08,530 Did you see Park while you were there? 198 00:08:08,530 ---> 00:08:09,948 [ Laughs ] 199 00:08:09,948 ---> 00:08:12,325 Go to scheduling, get Angie's surgery set for Friday ‐‐ 200 00:08:12,325 ---> 00:08:14,160 with the best neurosurgery OR nurses. 201 00:08:16,871 ---> 00:08:18,289 Let's go see Glassman. 202 00:08:18,289 ---> 00:08:20,333 Andrews:Now I'm identifying 203 00:08:20,333 ---> 00:08:22,043 the submillimeter lymphatic vessels. 204 00:08:22,043 ---> 00:08:26,172 I need an 11‐0 micro suture and a 70 micron needle. 205 00:08:26,172 ---> 00:08:28,800 Instead of harvesting nodes to this area, 206 00:08:28,800 ---> 00:08:31,594 could we redirect lymphatics away from his lymph system? 207 00:08:31,594 ---> 00:08:32,929 We could. 208 00:08:32,929 ---> 00:08:35,056 If you identify an appropriate vessel, 209 00:08:35,056 ---> 00:08:36,641 you can make the connection. 210 00:08:36,641 ---> 00:08:39,102 Lim:We're clearly not dealing with an infection. 211 00:08:39,102 ---> 00:08:41,438 There must be a blockage somewhere in his lymph system. 212 00:08:41,438 ---> 00:08:43,231 Most likely cancer. 213 00:08:43,231 ---> 00:08:46,860 His CBC didn't show any abnormal cells. 214 00:08:46,860 ---> 00:08:48,695 Lymphoma doesn't always show up. 215 00:08:48,695 ---> 00:08:51,406 We need to run cytology on his lymphatic fluid. 216 00:08:57,203 ---> 00:08:59,539 It's either gonna be nasty or very nasty, 217 00:08:59,539 ---> 00:09:03,626 depending upon how it attaches to the thalamus and fornix. 218 00:09:03,626 ---> 00:09:07,839 Which no imaging or testing can possibly determine. 219 00:09:07,839 ---> 00:09:09,799 So, our options are? 220 00:09:09,799 ---> 00:09:12,802 Between an endoscopic approach or an open anterior one. 221 00:09:12,802 ---> 00:09:14,637 That is correct. 222 00:09:17,015 ---> 00:09:21,436 I'd run a stereotactic MRI with fiducials and DTI 223 00:09:21,436 ---> 00:09:24,355 to gauge how close the white matter tracts actually are. 224 00:09:25,648 ---> 00:09:26,775 You should scrub in. 225 00:09:26,775 ---> 00:09:28,359 [ Chuckles ] 226 00:09:28,359 ---> 00:09:30,195 Another doctor can cover the clinic. 227 00:09:31,529 ---> 00:09:34,657 I haven't been in an OR in over a year, 228 00:09:34,657 ---> 00:09:36,576 and then, as a patient. 229 00:09:36,576 ---> 00:09:38,620 I'm not asking you to cut. 230 00:09:38,620 ---> 00:09:40,955 But it'd be a huge value to have you there. 231 00:09:40,955 ---> 00:09:43,083 [ Chuckles softly ] 232 00:09:43,083 ---> 00:09:44,667 I appreciate that. 233 00:09:44,667 ---> 00:09:46,127 I'll consider it. 234 00:09:46,127 ---> 00:09:53,343 ♪♪ 235 00:09:53,343 ---> 00:09:55,428 [ Door opens ] 236 00:09:55,428 ---> 00:09:57,138 [ Door closes ] 237 00:10:00,558 ---> 00:10:03,770 Hello. We need to run cytology on this lymphatic fluid. 238 00:10:03,770 ---> 00:10:05,480 I would be happy to. 239 00:10:09,317 ---> 00:10:10,777 Lea moved out this morning. 240 00:10:13,947 ---> 00:10:14,948 Thank you. 241 00:10:14,948 ---> 00:10:16,199 You're welcome. 242 00:10:16,199 ---> 00:10:18,076 Can you come over tonight? 243 00:10:18,076 ---> 00:10:19,786 Uh, that probably won't work ‐‐ 244 00:10:19,786 ---> 00:10:21,329 Or we could go to your apartment? 245 00:10:22,789 ---> 00:10:24,082 I can't. 246 00:10:26,126 ---> 00:10:28,711 Lea said that it might take time 247 00:10:28,711 ---> 00:10:31,005 for us to recover from our fight. 248 00:10:31,005 ---> 00:10:32,715 But I told her that we were okay. 249 00:10:32,715 ---> 00:10:34,634 We are. 250 00:10:34,634 ---> 00:10:36,427 I made plans tonight. 251 00:10:36,427 ---> 00:10:40,056 To hang out with a friend who just got fired. 252 00:10:40,056 ---> 00:10:42,517 But I would love to come over tomorrow night. 253 00:10:42,517 ---> 00:10:45,019 Okay. 254 00:10:45,019 ---> 00:10:47,438 I'll put a rush on this test, too. 255 00:10:47,438 ---> 00:10:54,237 ♪♪ 256 00:10:54,237 ---> 00:10:57,282 Your lymphovenous anastomosis technique ‐‐ 257 00:10:57,282 ---> 00:10:59,075 I was impressed. 258 00:10:59,075 ---> 00:11:00,910 It's a little early in the morning 259 00:11:00,910 ---> 00:11:02,412 to be sucking up, Reznick. 260 00:11:02,412 ---> 00:11:04,622 Not for me. I like to get a jump on things. 261 00:11:04,622 ---> 00:11:06,708 I'm fascinated by the way you use plastic procedures, 262 00:11:06,708 ---> 00:11:09,711 like microsurgery, in other surgical specialties. 263 00:11:09,711 ---> 00:11:12,213 I thought it might make an interesting topic for a paper. 264 00:11:12,213 ---> 00:11:14,174 Want to write it with me? 265 00:11:15,300 ---> 00:11:16,801 Yes. 266 00:11:16,801 ---> 00:11:17,927 Let's talk and eat. 267 00:11:20,763 ---> 00:11:22,557 That's not breakfast. 268 00:11:23,808 ---> 00:11:25,476 I'm buying. 269 00:11:25,476 ---> 00:11:27,645 What publications do you want to target? 270 00:11:27,645 ---> 00:11:28,897 [ Sighs ] 271 00:11:30,273 ---> 00:11:32,609 Last time, Angie had bad post‐op vomiting. 272 00:11:32,609 ---> 00:11:34,110 Of course. I'll make note of it ‐‐ Excuse me. 273 00:11:35,612 ---> 00:11:38,615 She's asleep. She needs her rest. 274 00:11:38,615 ---> 00:11:40,158 I'll wait out here until she's awake. 275 00:11:40,158 ---> 00:11:42,285 Ryan, your immune system is weak. 276 00:11:42,285 ---> 00:11:43,995 It would be so easy for you to pick up a bug 277 00:11:43,995 ---> 00:11:45,455 and pass it to Angie. 278 00:11:45,455 ---> 00:11:47,248 I haven't been around anyone but my dad. I swear. 279 00:11:47,248 ---> 00:11:49,000 He could wear a mask. 280 00:11:52,921 ---> 00:11:54,339 After Angie's surgery, 281 00:11:54,339 ---> 00:11:56,424 we'll see about arranging a visit. 282 00:11:56,424 ---> 00:11:57,967 Please tell her Ryan came by. 283 00:12:00,929 ---> 00:12:03,681 I'm sorry if I overstepped. 284 00:12:03,681 ---> 00:12:05,475 I'd like to change Angie's status 285 00:12:05,475 ---> 00:12:07,101 to "No visitors" on her chart. 286 00:12:07,101 ---> 00:12:08,269 Yeah. 287 00:12:08,269 ---> 00:12:15,568 ♪♪ 288 00:12:15,568 ---> 00:12:17,111 Please take Mr. McDougall to his room. 289 00:12:17,111 ---> 00:12:18,738 I'll be there in a moment. 290 00:12:20,782 ---> 00:12:21,866 Is that James McDougall? 291 00:12:22,825 ---> 00:12:24,118 And the woman with him? 292 00:12:24,118 ---> 00:12:25,245 His wife. 293 00:12:25,245 ---> 00:12:27,080 Is it cancer? [ Sighs ] 294 00:12:27,080 ---> 00:12:28,248 No ‐‐ worse. 295 00:12:29,457 ---> 00:12:32,794 His lymphedema is caused by a genetic mutation. 296 00:12:32,794 ---> 00:12:35,046 If you don't find a medication he responds to, 297 00:12:35,046 ---> 00:12:37,548 he'll drown from the inside. 298 00:12:37,548 ---> 00:12:38,675 ♪♪ 299 00:12:42,136 ---> 00:12:44,305 The mutation is on James' ARAF gene ‐‐ 300 00:12:44,305 ---> 00:12:45,765 it makes an enzyme called kinase, 301 00:12:45,765 ---> 00:12:48,059 which can cause cells to overproliferate. 302 00:12:48,059 ---> 00:12:49,352 It's a genetic condition. 303 00:12:50,728 ---> 00:12:52,814 What set it off now? 304 00:12:52,814 ---> 00:12:54,399 Probably the stress fracture. 305 00:12:54,399 ---> 00:12:55,942 Sent his immune system into overdrive, 306 00:12:55,942 ---> 00:12:58,361 which fired up his lymphatic system. 307 00:12:58,361 ---> 00:13:00,405 What treatment protocol targets this mutation? 308 00:13:00,405 ---> 00:13:02,156 An MEK inhibitor. 309 00:13:02,156 ---> 00:13:03,658 The problem is, which one? 310 00:13:03,658 ---> 00:13:07,662 There are 41 possibilities, each with different side effects. 311 00:13:07,662 ---> 00:13:09,372 Good luck. 312 00:13:09,372 ---> 00:13:11,374 Well, I was hoping you could stay. 313 00:13:15,169 ---> 00:13:17,380 Okay. Sure. 314 00:13:18,881 ---> 00:13:20,091 [ MRI machine humming ] 315 00:13:20,091 ---> 00:13:22,885 We need you to stay completely still. 316 00:13:22,885 ---> 00:13:24,137 Not a problem. 317 00:13:26,180 ---> 00:13:28,266 You okay? 318 00:13:28,266 ---> 00:13:30,351 Ryan totally bailed. 319 00:13:30,351 ---> 00:13:31,978 He hasn't come back to see me. 320 00:13:34,981 ---> 00:13:36,983 If you tell her that her mom said he couldn't visit, 321 00:13:36,983 ---> 00:13:38,609 she'll be pissed at her mom. 322 00:13:38,609 ---> 00:13:39,819 How's that gonna help? 323 00:13:42,447 ---> 00:13:45,408 He's probably... busy catching up in school. 324 00:13:47,952 ---> 00:13:49,871 We had a pact ‐‐ 325 00:13:49,871 ---> 00:13:53,833 aslong as we were together, cancer wasn't gonna beat us. 326 00:13:53,833 ---> 00:13:55,626 He broke it. 327 00:13:55,626 ---> 00:13:57,045 Cancer wins. 328 00:13:57,045 ---> 00:14:02,425 ♪♪ 329 00:14:02,425 ---> 00:14:04,218 Do you mind finishing? 330 00:14:04,218 ---> 00:14:06,054 [ Sighs ] 331 00:14:06,054 ---> 00:14:15,938 ♪♪ 332 00:14:15,938 ---> 00:14:17,106 Imaging finished? 333 00:14:17,106 ---> 00:14:18,566 Not quite. 334 00:14:18,566 ---> 00:14:22,361 Mrs. Valens, Angie would really like to see Ryan. 335 00:14:22,361 ---> 00:14:24,030 I know you're concerned about infection, 336 00:14:24,030 ---> 00:14:25,531 but there is minimal risk. 337 00:14:25,531 ---> 00:14:28,743 Actually ‐‐ Actually, none, if they do a video chat. 338 00:14:28,743 ---> 00:14:30,912 Interesting idea. 339 00:14:30,912 ---> 00:14:32,288 I'll think about it. 340 00:14:34,916 ---> 00:14:36,793 Angie's depressed. 341 00:14:36,793 ---> 00:14:39,378 And studies have shown that that can have a negative impact 342 00:14:39,378 ---> 00:14:41,506 on her surgical outcome. 343 00:14:41,506 ---> 00:14:43,966 [ Laughs ] 344 00:14:43,966 ---> 00:14:47,303 Ryan doesn't always improve Angie's mood. 345 00:14:47,303 ---> 00:14:49,764 A couple of weeks ago, they had some silly fight, 346 00:14:49,764 ---> 00:14:52,266 and she cried for days. 347 00:14:52,266 ---> 00:14:53,976 Thank you for letting me know. 348 00:14:53,976 ---> 00:14:55,603 I'm gonna do my best to cheer her up. 349 00:14:55,603 ---> 00:14:57,688 She's a 16‐year‐old. 350 00:14:57,688 ---> 00:14:59,398 She wants her boyfriend. 351 00:14:59,398 ---> 00:15:00,650 Yeah. 352 00:15:00,650 ---> 00:15:02,985 And how smart were you when you were 16? 353 00:15:10,326 ---> 00:15:12,328 Morgan:Well, what about Selumetinib? 354 00:15:12,328 ---> 00:15:15,123 It's shown promising results on related conditions. 355 00:15:15,123 ---> 00:15:17,667 And a high occurrence of liver disease. 356 00:15:17,667 ---> 00:15:21,379 Binimetinib is similar, but has fewer complications. 357 00:15:21,379 ---> 00:15:23,464 Any objections? 358 00:15:26,134 ---> 00:15:27,885 Let's start James on that. 359 00:15:32,014 ---> 00:15:33,182 [ Door opens ] 360 00:15:35,810 ---> 00:15:39,397 This is exciting, working together. 361 00:15:39,397 ---> 00:15:41,149 It is. 362 00:15:41,149 ---> 00:15:43,693 Although, I'm used to samples and slides 363 00:15:43,693 ---> 00:15:44,944 instead of patients. 364 00:15:49,115 ---> 00:15:51,951 Patients can be difficult. 365 00:15:51,951 ---> 00:15:54,078 But you will be fine. 366 00:16:03,546 ---> 00:16:12,763 ♪♪ 367 00:16:12,763 ---> 00:16:14,724 Do you need something? 368 00:16:14,724 ---> 00:16:16,517 [ Sighs ] 369 00:16:16,517 ---> 00:16:19,437 I was curious how James was responding to the Binimetinib. 370 00:16:19,437 ---> 00:16:21,105 His urine output is up, 371 00:16:21,105 ---> 00:16:23,191 which suggests the lymphatic fluid i‐‐ 372 00:16:24,358 ---> 00:16:25,818 And his potassium is a little low. 373 00:16:25,818 ---> 00:16:27,570 Can you...give him this? 374 00:16:27,570 ---> 00:16:28,529 I wasn't really ‐‐ 375 00:16:28,529 ---> 00:16:37,205 ♪♪ 376 00:16:37,205 ---> 00:16:45,504 ♪♪ 377 00:16:45,504 ---> 00:16:46,589 Hi. 378 00:16:46,589 ---> 00:16:48,507 I'm Dr. Lever. 379 00:16:48,507 ---> 00:16:50,218 The tumor's abutting and possibly infiltrating 380 00:16:50,218 ---> 00:16:51,886 the white matter tracts of her fornix. 381 00:16:51,886 ---> 00:16:53,846 We'll likely have to remove a section. 382 00:16:53,846 ---> 00:16:56,265 That'll affect her ability to form memories. 383 00:16:56,265 ---> 00:16:57,642 With a lot of neuropsych rehab, 384 00:16:57,642 ---> 00:17:00,228 she may be able to compensate with other pathways. 385 00:17:00,228 ---> 00:17:02,146 Studies have shown that positive attitudes 386 00:17:02,146 ---> 00:17:03,940 lead to positive outcomes. 387 00:17:03,940 ---> 00:17:05,191 You're worried about her attitude? 388 00:17:05,191 ---> 00:17:06,651 She's worried about young love. 389 00:17:06,651 ---> 00:17:08,694 I'm worried about what Angie is facing after surgery ‐‐ 390 00:17:08,694 ---> 00:17:11,030 physical therapy, cognitive therapy, 391 00:17:11,030 ---> 00:17:12,406 one challenge after another. 392 00:17:12,406 ---> 00:17:14,075 And what she wants is so simple. 393 00:17:16,661 ---> 00:17:18,162 You want to make a sad kid happy? 394 00:17:19,538 ---> 00:17:20,915 I guess I do. 395 00:17:20,915 ---> 00:17:22,458 Which isn't my job, and I need to stop 396 00:17:22,458 ---> 00:17:24,168 getting sucked into people's personal issues. 397 00:17:24,168 ---> 00:17:26,545 Is there a way to do that without antagonizing the mother? 398 00:17:30,508 ---> 00:17:31,968 Maybe. 399 00:17:31,968 ---> 00:17:32,927 [ Elevator bell dings ] 400 00:17:32,927 ---> 00:17:34,679 Then make her happy. 401 00:17:38,015 ---> 00:17:40,351 [ Both breathing heavily ] 402 00:17:40,351 ---> 00:17:44,522 ♪♪ 403 00:17:44,522 ---> 00:17:45,481 [ Giggles ] 404 00:17:45,481 ---> 00:17:51,404 ♪♪ 405 00:17:51,404 ---> 00:17:53,948 We've never gotten this far before. 406 00:17:53,948 ---> 00:17:55,283 No. 407 00:17:55,283 ---> 00:17:56,701 We haven't. 408 00:17:56,701 ---> 00:17:59,453 And you're okay? 409 00:17:59,453 ---> 00:18:01,706 I am very okay. 410 00:18:01,706 ---> 00:18:09,630 ♪♪ 411 00:18:09,630 ---> 00:18:10,798 [ Gasps ] 412 00:18:10,798 ---> 00:18:11,799 Carly. 413 00:18:11,799 ---> 00:18:13,384 Ohh. 414 00:18:13,384 ---> 00:18:14,635 [ Laughs ] 415 00:18:14,635 ---> 00:18:20,558 ♪♪ 416 00:18:20,558 ---> 00:18:26,480 ♪♪ 417 00:18:26,480 ---> 00:18:28,232 Okay. 418 00:18:28,232 ---> 00:18:35,239 ♪♪ 419 00:18:35,239 ---> 00:18:38,993 Did...I do something wrong? 420 00:18:38,993 ---> 00:18:41,162 No, I'm sorry. It's me. 421 00:18:42,788 ---> 00:18:45,916 You said we were okay. 422 00:18:45,916 ---> 00:18:47,376 I thought we were. 423 00:18:47,376 ---> 00:18:49,003 I‐I want us to be. 424 00:18:49,003 ---> 00:18:50,671 You have no reason to still be mad. 425 00:18:50,671 ---> 00:18:52,089 I'm not mad. 426 00:18:52,089 ---> 00:18:53,341 I'm ‐‐ I'm just... 427 00:18:53,341 ---> 00:18:54,967 [ Cellphone beeping ] 428 00:18:59,680 ---> 00:19:01,098 It's Morgan. 429 00:19:01,098 ---> 00:19:04,101 The medication caused James an upper GI bleed. 430 00:19:04,101 ---> 00:19:07,063 ♪♪ 431 00:19:11,692 ---> 00:19:13,736 Have you localized the source of the bleeding? 432 00:19:13,736 ---> 00:19:15,029 Working on it. 433 00:19:15,029 ---> 00:19:17,323 Seems to be coming from the antrum of the stomach. 434 00:19:17,323 ---> 00:19:18,824 Morgan:We stopped the Binimetinib. 435 00:19:18,824 ---> 00:19:19,992 On top of causing this, 436 00:19:19,992 ---> 00:19:21,452 it hadn't done much to curtail the swelling. 437 00:19:21,452 ---> 00:19:22,495 Where's Dr. Lever? 438 00:19:22,495 ---> 00:19:24,830 There's the ulcerative lesion. Cautery. 439 00:19:27,875 ---> 00:19:29,960 Zebrafish. 440 00:19:29,960 ---> 00:19:31,128 They're used in medical research 441 00:19:31,128 ---> 00:19:32,630 because of their quick maturation, 442 00:19:32,630 ---> 00:19:35,216 and 84% of genes associated with human disease 443 00:19:35,216 ---> 00:19:37,468 have a zebrafish equivalent. 444 00:19:37,468 ---> 00:19:40,805 You think we should do a transgenic expression 445 00:19:40,805 ---> 00:19:44,684 of James' ARAF mutation into the zebrafish genome. 446 00:19:44,684 ---> 00:19:46,018 Translation for those of us 447 00:19:46,018 ---> 00:19:47,728 without a genetics textbook handy? 448 00:19:47,728 ---> 00:19:50,231 We make mini‐Jameses, as zebrafish, 449 00:19:50,231 ---> 00:19:51,691 all with the same disorder. 450 00:19:51,691 ---> 00:19:54,652 Then we test every conceivable drug on those fish. 451 00:19:54,652 ---> 00:19:56,529 How long before we can start testing? 452 00:19:56,529 ---> 00:19:58,197 If we implant the embryos now, 453 00:19:58,197 ---> 00:19:59,949 probably by late afternoon tomorrow. 454 00:19:59,949 ---> 00:20:01,492 Get going. 455 00:20:01,492 ---> 00:20:03,703 Shaun, go with her. You have Path experience. 456 00:20:03,703 ---> 00:20:05,788 ♪♪ 457 00:20:05,788 ---> 00:20:07,581 [ Door opens ] 458 00:20:07,581 ---> 00:20:09,959 ♪♪ 459 00:20:24,432 ---> 00:20:27,685 I understand no means no. 460 00:20:27,685 ---> 00:20:31,188 If you don't want to have sex, 461 00:20:31,188 ---> 00:20:33,315 I accept that. 462 00:20:33,315 ---> 00:20:35,985 But I am very confused. 463 00:20:35,985 ---> 00:20:38,195 So am I. 464 00:20:38,195 ---> 00:20:40,322 I thought I was fine u‐until I ‐‐ 465 00:20:40,322 ---> 00:20:44,368 I told Lea to move out, like you wanted. 466 00:20:44,368 ---> 00:20:47,663 You said that things were okay. 467 00:20:47,663 ---> 00:20:48,748 They aren't. 468 00:20:48,748 ---> 00:20:50,666 How do I make them okay? 469 00:20:50,666 ---> 00:20:54,503 I can't tell you, because I don't know. 470 00:20:54,503 ---> 00:21:03,679 ♪♪ 471 00:21:03,679 ---> 00:21:09,226 ♪♪ 472 00:21:18,152 ---> 00:21:19,570 When I was in chemo,473 00:21:19,570 ---> 00:21:22,031 the nurses used to force that stuff down my throat, 474 00:21:22,031 ---> 00:21:24,658 so I know you're not drinking it because of the taste. 475 00:21:24,658 ---> 00:21:25,785 [ Chuckles lightly ] 476 00:21:25,785 ---> 00:21:27,578 It's fast, easy nutrition. 477 00:21:27,578 ---> 00:21:30,331 That and you don't end up puking your guts out in the bathroom. 478 00:21:31,957 ---> 00:21:34,502 I was president of this hospital for over 10 years. 479 00:21:34,502 ---> 00:21:37,379 I made a few friends, including Jack the janitor ‐‐ 480 00:21:37,379 ---> 00:21:40,299 talks a lot, A's fan, horrible gossip. 481 00:21:40,299 ---> 00:21:42,760 If the methotrexate is making you sick, 482 00:21:42,760 ---> 00:21:44,136 we should try another medication. 483 00:21:47,223 ---> 00:21:49,850 How can you guarantee that you're not gonna throw up 484 00:21:49,850 ---> 00:21:51,894 in the middle of your next surgery? 485 00:21:51,894 ---> 00:21:53,354 It won't happen. 486 00:21:55,022 ---> 00:21:57,817 Because it only happens if I eat solid food. 487 00:21:57,817 ---> 00:21:59,026 And I stopped. 488 00:22:00,402 ---> 00:22:02,446 At least at work. 489 00:22:08,661 ---> 00:22:13,791 ♪♪ 490 00:22:13,791 ---> 00:22:15,626 That is a lot of fish tanks. 491 00:22:15,626 ---> 00:22:16,669 40. 492 00:22:16,669 ---> 00:22:18,420 So we can test 493 00:22:18,420 ---> 00:22:21,215 all of the possible medications for ‐‐ 494 00:22:21,215 ---> 00:22:23,050 Are you throwing a party? 495 00:22:23,050 ---> 00:22:24,218 Hope so. 496 00:22:37,022 ---> 00:22:39,441 How are you doing, Shaun? 497 00:22:39,441 ---> 00:22:41,235 Since your father passed away? 498 00:22:43,654 ---> 00:22:47,658 I don't think about him very much. 499 00:22:52,079 ---> 00:22:55,082 My mom...died recently. 500 00:22:55,082 ---> 00:22:56,876 I‐I don't know if you knew that. 501 00:22:58,878 ---> 00:23:01,005 She pops into my head all the time. 502 00:23:03,215 ---> 00:23:05,134 Not always the nicest thoughts. 503 00:23:05,134 ---> 00:23:12,099 ♪♪ 504 00:23:12,099 ---> 00:23:15,603 It's okay not to love them. 505 00:23:17,479 ---> 00:23:19,523 They didn't make us who we are. 506 00:23:19,523 ---> 00:23:24,904 ♪♪ 507 00:23:28,490 ---> 00:23:36,790 ♪♪ 508 00:23:36,790 ---> 00:23:45,507 ♪♪ 509 00:23:45,507 ---> 00:23:54,016 ♪♪ 510 00:23:56,310 ---> 00:23:58,103 Has your mom gone home? 511 00:24:00,439 ---> 00:24:03,817 There is one more thing we have to deal with tonight. 512 00:24:03,817 ---> 00:24:05,361 [ Scoffs ] 513 00:24:05,361 ---> 00:24:06,737 Come on. 514 00:24:06,737 ---> 00:24:09,073 How many more sets of imaging can you possibly do? 515 00:24:11,325 ---> 00:24:13,786 One of these is your prom dress. 516 00:24:13,786 ---> 00:24:17,873 I like the pink, but I think you'd look gorgeous in both. 517 00:24:17,873 ---> 00:24:21,627 ♪♪ 518 00:24:21,627 ---> 00:24:23,087 Hurry up and choose. 519 00:24:23,087 ---> 00:24:24,964 Your date'll be here soon. 520 00:24:26,715 ---> 00:24:28,133 [ Laughs ] 521 00:24:28,133 ---> 00:24:33,597 ♪♪ 522 00:24:38,102 ---> 00:24:40,646 All the medications are in. 523 00:24:40,646 ---> 00:24:44,692 Which means more waiting to see which medicine works. 524 00:24:44,692 ---> 00:24:46,485 It's hard to be patient. 525 00:24:51,782 ---> 00:24:55,619 Do you think the fish control how they react to the meds? 526 00:24:55,619 ---> 00:24:58,247 No. 527 00:24:58,247 ---> 00:25:00,833 It's just how their bodies respond. 528 00:25:03,794 ---> 00:25:06,046 That's how I felt last night. 529 00:25:08,215 ---> 00:25:12,302 I thought I was ready for us to be together, but... 530 00:25:12,302 ---> 00:25:14,888 my body had a different response. 531 00:25:16,682 ---> 00:25:18,434 I can't turn that response off 532 00:25:18,434 ---> 00:25:20,394 any more than these fish can control 533 00:25:20,394 ---> 00:25:23,063 how their mutation reacts to the medication. 534 00:25:23,063 ---> 00:25:29,611 ♪♪ 535 00:25:29,611 ---> 00:25:34,867 Was our mutation me going to Wyoming with Lea? 536 00:25:34,867 ---> 00:25:41,165 ♪♪ 537 00:25:41,165 ---> 00:25:45,586 Do you think we can find our right medication? 538 00:25:45,586 ---> 00:25:51,884 ♪♪ 539 00:25:51,884 ---> 00:25:58,432 ♪♪ 540 00:25:58,432 ---> 00:26:01,727 ♪ I found a love ♪ 541 00:26:01,727 ---> 00:26:04,271 ♪ For me ♪ 542 00:26:04,271 ---> 00:26:06,106 ♪♪ 543 00:26:06,106 ---> 00:26:09,985 ♪ Darling, just dive right in ♪ 544 00:26:09,985 ---> 00:26:12,112 ♪ Follow my lead ♪ 545 00:26:12,112 ---> 00:26:14,031 ♪♪ 546 00:26:14,031 ---> 00:26:17,534 ♪ I found a girl ♪ 547 00:26:17,534 ---> 00:26:19,828 ♪ Beautiful and sweet ♪ 548 00:26:19,828 ---> 00:26:21,622 You look amazing. 549 00:26:21,622 ---> 00:26:26,293 ♪ I never knew you were the someone waiting for me ♪ 550 00:26:26,293 ---> 00:26:28,170 So do you. 551 00:26:28,170 ---> 00:26:32,758 ♪ 'Cause we were just kids when we fell in love ♪ 552 00:26:32,758 ---> 00:26:36,637 ♪ Not knowing what it was ♪ 553 00:26:36,637 ---> 00:26:44,186 ♪ I will not give you up this time ♪ 554 00:26:44,186 ---> 00:26:47,856 ♪ Darling, just kiss me slow ♪ 555 00:26:47,856 ---> 00:26:51,693 ♪ Your heart is all I own ♪ 556 00:26:51,693 ---> 00:26:58,408 ♪ And in your eyes, you're holding mine ♪ 557 00:26:58,408 ---> 00:27:05,666 ♪ Baby, I'm dancing in the dark ♪ 558 00:27:05,666 ---> 00:27:09,711 ♪ With you between my arms ♪ 559 00:27:09,711 ---> 00:27:13,465 ♪ Barefoot on the grass ♪ 560 00:27:13,465 ---> 00:27:16,885 ♪ Listening to our favorite song ♪ 561 00:27:16,885 ---> 00:27:20,389 ♪ When you said you looked a mess ♪ 562 00:27:20,389 ---> 00:27:23,392 ♪ I whispered underneath my breath ♪ 563 00:27:23,392 ---> 00:27:25,143 Looks like you might be feeling 564 00:27:25,143 ---> 00:27:27,688 a little idiotic happiness right now. 565 00:27:27,688 ---> 00:27:29,648 Mm... 566 00:27:29,648 ---> 00:27:30,899 maybe a touch. 567 00:27:30,899 ---> 00:27:36,572 ♪♪ 568 00:27:36,572 ---> 00:27:38,115 ♪ No, no ♪ 569 00:27:38,115 ---> 00:27:40,284 Dance with a prom king? 570 00:27:40,284 ---> 00:27:42,244 Ohh. [ Laughs ] 571 00:27:42,244 ---> 00:27:45,664 ♪ You look perfect tonight ♪ 572 00:27:45,664 ---> 00:27:47,499 [ Laughs ] 573 00:27:47,499 ---> 00:27:53,297 ♪♪ 574 00:27:53,297 ---> 00:27:58,760 ♪♪ 575 00:27:58,760 ---> 00:28:00,470 [ Monitor beeping rapidly ] He's tachycardic. 576 00:28:02,389 ---> 00:28:04,224 We were talking, and then he just stopped. 577 00:28:04,224 ---> 00:28:05,767 We need to do a pericardial tap. 578 00:28:05,767 ---> 00:28:07,269 Call the cath lab. Tell them we're coming. 579 00:28:07,269 ---> 00:28:08,562 No time. We're doing it here. 580 00:28:08,562 ---> 00:28:09,855 James, the pain in your chest 581 00:28:09,855 ---> 00:28:11,440 is from too much fluid around your heart. 582 00:28:11,440 ---> 00:28:13,650 We're gonna put a tube into your chest to drain it. 583 00:28:13,650 ---> 00:28:15,402 Call Shaun and Carly. Tell them we're running out of time. 584 00:28:18,280 ---> 00:28:24,286 ♪ ...will be loving you till we're 70 ♪ 585 00:28:24,286 ---> 00:28:27,164 [ Camera shutter clicking ] 586 00:28:27,164 ---> 00:28:29,291 ♪♪ 587 00:28:29,291 ---> 00:28:37,633 ♪ And, baby, my heart could still fall as hard at 23 ♪ 588 00:28:37,633 ---> 00:28:39,593 ♪♪ 589 00:28:39,593 ---> 00:28:42,512 ♪ And I'm thinking about how ♪ 590 00:28:42,512 ---> 00:28:47,225 ♪ People fall in love in mysterious ways ♪ 591 00:28:47,225 ---> 00:28:48,894 I brought Angie's Bearfeet Bear. 592 00:28:48,894 ---> 00:28:50,312 It always makes her feel like sh‐‐ 593 00:28:54,441 ---> 00:28:57,152 It's...prom. 594 00:28:57,152 ---> 00:29:00,489 Ryan has been wearing his mask all night. 595 00:29:00,489 ---> 00:29:05,160 ♪ And I just want to tell you I am ♪ 596 00:29:05,160 ---> 00:29:07,913 ♪ So, honey, now ♪ 597 00:29:07,913 ---> 00:29:10,832 ♪♪ 598 00:29:10,832 ---> 00:29:14,878 ♪ Take me into your loving arms ♪ 599 00:29:14,878 ---> 00:29:16,880 Don't let her stay up too late. 600 00:29:16,880 ---> 00:29:21,218 ♪ Kiss me under the light of a thousand stars ♪ 601 00:29:21,218 ---> 00:29:22,886 ♪♪ 602 00:29:22,886 ---> 00:29:25,555 ♪ Place your hand on my beating heart ♪ 603 00:29:25,555 ---> 00:29:27,432 ♪♪ 604 00:29:27,432 ---> 00:29:29,393 [ Footsteps approach ] 605 00:29:31,812 ---> 00:29:34,439 Morgan called. James isn't doing well. 606 00:29:40,696 ---> 00:29:43,407 Cross SL‐327 off the list. 607 00:29:44,658 ---> 00:29:47,077 I see one ‐‐ 608 00:29:47,077 ---> 00:29:49,788 no, two tumors. 609 00:29:49,788 ---> 00:29:56,420 ♪♪ 610 00:29:56,420 ---> 00:30:02,884 ♪♪ 611 00:30:11,810 ---> 00:30:12,853 Okay. 612 00:30:12,853 ---> 00:30:15,355 This is my stop. 613 00:30:15,355 ---> 00:30:16,940 I'll see you after. 614 00:30:16,940 ---> 00:30:18,608 I love you. 615 00:30:18,608 ---> 00:30:20,152 I love you, too, Mom. 616 00:30:23,655 ---> 00:30:25,741 Don't worry. Okay? 617 00:30:25,741 ---> 00:30:27,492 I got this. 618 00:30:29,828 ---> 00:30:31,580 I know you do. 619 00:30:31,580 --->00:30:33,582 [ Chuckles ] 620 00:30:33,582 ---> 00:30:37,753 ♪♪ 621 00:30:37,753 ---> 00:30:39,129 [ Chuckles ] 622 00:30:39,129 ---> 00:30:40,130 Okay. 623 00:30:40,130 ---> 00:30:41,548 Okay. 624 00:30:41,548 ---> 00:30:46,887 ♪♪ 625 00:30:46,887 ---> 00:30:51,516 What if I wake up and don't remember Ryan at all? 626 00:30:54,561 ---> 00:30:56,938 Then... 627 00:30:56,938 ---> 00:30:58,774 you'll have the chance to fall in love with him 628 00:30:58,774 ---> 00:31:00,650 all over again. 629 00:31:00,650 ---> 00:31:04,696 ♪♪ 630 00:31:04,696 ---> 00:31:05,739 Okay. 631 00:31:07,199 ---> 00:31:08,200 Okay. 632 00:31:08,200 ---> 00:31:09,701 [ Breathes shakily ] 633 00:31:09,701 ---> 00:31:19,419 ♪♪ 634 00:31:19,419 ---> 00:31:21,797 We're down to five potential options. 635 00:31:21,797 ---> 00:31:24,132 I don't need five potential. I need one actual. 636 00:31:24,132 ---> 00:31:25,717 There are two that best curb ‐‐ 637 00:31:25,717 ---> 00:31:26,760 Choose one. 638 00:31:28,053 ---> 00:31:31,723 We should try Refametinib. 639 00:31:31,723 ---> 00:31:33,558 It caused abnormal cell growth. 640 00:31:33,558 ---> 00:31:35,185 Trametinib is safer. 641 00:31:35,185 ---> 00:31:37,270 Which doesn't mean it's safe. 642 00:31:37,270 ---> 00:31:38,480 Nothing's safe. 643 00:31:38,480 ---> 00:31:39,648 Which do you want us to do? 644 00:31:41,775 ---> 00:31:42,984 [ Sighs ] 645 00:31:44,653 ---> 00:31:45,821 Trametinib. 646 00:31:45,821 ---> 00:31:47,197 That's the one. 647 00:31:47,197 ---> 00:31:52,619 ♪♪ 648 00:31:52,619 ---> 00:31:54,496 Saline in. 649 00:31:54,496 ---> 00:31:57,040 Advancing scope toward the third ventricle. 650 00:31:57,040 ---> 00:31:59,000 Claire, hold gentle pressure on the tumor 651 00:31:59,000 ---> 00:32:01,086 while I cut off its blood supply. 652 00:32:01,086 ---> 00:32:03,421 [ Monitors beeping steadily ] 653 00:32:07,717 ---> 00:32:09,261 We've got some significant bleeding. 654 00:32:09,261 ---> 00:32:11,096 Adjust the scope and suction. 655 00:32:15,600 ---> 00:32:18,061 Look higher. 656 00:32:18,061 ---> 00:32:19,729 Septal vein ‐‐ there's your bleeder. 657 00:32:19,729 ---> 00:32:20,939 Cauterize away. 658 00:32:32,868 ---> 00:32:41,251 ♪♪ 659 00:32:41,251 ---> 00:32:49,467 ♪♪ 660 00:32:49,467 ---> 00:32:57,851 ♪♪ 661 00:32:57,851 ---> 00:33:06,443 ♪♪ 662 00:33:06,443 ---> 00:33:07,903 Micro dissector. 663 00:33:12,908 ---> 00:33:14,576 The tumor's immobile. 664 00:33:14,576 ---> 00:33:16,745 I can't resect it without injuring the nerve tracts. 665 00:33:16,745 ---> 00:33:18,705 She'd be comatose. 666 00:33:18,705 ---> 00:33:20,040 Try sharp dissection. 667 00:33:21,499 ---> 00:33:23,168 I can't get a plane. How bad? 668 00:33:23,168 ---> 00:33:25,253 It's completely invaded her thalamus. 669 00:33:25,253 ---> 00:33:28,882 Thin it out with a suction aspirator. 670 00:33:34,429 ---> 00:33:36,264 It's too adherent. 671 00:33:36,264 ---> 00:33:38,266 If I keep going, I'm gonna kill her. 672 00:33:40,185 ---> 00:33:41,686 Any ideas? 673 00:33:44,606 ---> 00:33:53,949 ♪♪ 674 00:33:53,949 ---> 00:34:03,625 ♪♪ 675 00:34:03,625 ---> 00:34:07,128 Tell ICU Angie will be coming sooner than we planned. 676 00:34:08,838 ---> 00:34:10,423 Let's close her up. 677 00:34:10,423 ---> 00:34:18,431 ♪♪ 678 00:34:18,431 ---> 00:34:26,273 ♪♪ 679 00:34:29,526 ---> 00:34:31,069 What's next? 680 00:34:31,069 ---> 00:34:32,570 Another round of radiation, chemo? 681 00:34:35,448 ---> 00:34:38,451 Her carcinoma is... 682 00:34:38,451 ---> 00:34:40,954 unlikely to respond to those therapies. 683 00:34:44,499 ---> 00:34:45,834 No. 684 00:34:45,834 ---> 00:34:47,877 We have to try. 685 00:34:47,877 ---> 00:34:49,296 Angie will want to fight. 686 00:34:49,296 ---> 00:34:50,547 [ Monitor beeping rapidly ] She's seizing. 687 00:34:50,547 ---> 00:34:51,923 Give me lorazepam and Dilantin, stat. 688 00:34:51,923 ---> 00:34:53,216 Phenobarb and propofol on deck. 689 00:34:53,216 ---> 00:35:02,642 ♪♪ 690 00:35:16,072 ---> 00:35:17,157 You're crying. 691 00:35:20,744 ---> 00:35:21,870 Yes. 692 00:35:25,665 ---> 00:35:27,083 Why? 693 00:35:29,502 ---> 00:35:31,838 I found James on Facebook. 694 00:35:31,838 ---> 00:35:33,632 [ Sniffles ] 695 00:35:33,632 ---> 00:35:36,301 He and Marjorie want to go to Costa Rica. 696 00:35:38,178 ---> 00:35:41,640 Their dog is a three‐legged rescue named Tripod. 697 00:35:41,640 ---> 00:35:46,102 ♪♪ 698 00:35:46,102 ---> 00:35:49,731 He's not a slide. He's a person. 699 00:35:49,731 ---> 00:35:51,191 He's a good person. 700 00:35:51,191 ---> 00:35:53,109 And he might die. 701 00:35:53,109 ---> 00:35:54,527 [ Sniffles ] 702 00:35:54,527 ---> 00:35:56,696 This is why I like to stay in the lab. 703 00:35:56,696 ---> 00:36:02,410 ♪♪ 704 00:36:02,410 ---> 00:36:04,579 That... 705 00:36:04,579 ---> 00:36:07,165 is a very dumb thing to say. 706 00:36:10,043 ---> 00:36:12,545 If you had stayed in the lab, 707 00:36:12,545 ---> 00:36:15,507 James would probably be dead already. 708 00:36:18,551 ---> 00:36:24,224 Your plan with the zebrafish gave him a chance. 709 00:36:24,224 ---> 00:36:29,437 It was a beautiful, perfect idea, 710 00:36:29,437 ---> 00:36:32,440 from a beautiful, almost perfect person. 711 00:36:32,440 ---> 00:36:38,279 ♪♪ 712 00:36:38,279 ---> 00:36:41,116 Your earlobes are lopsided. 713 00:36:41,116 ---> 00:36:42,909 [ Chuckles ] 714 00:36:42,909 ---> 00:36:50,250 ♪♪ 715 00:36:50,250 ---> 00:36:57,507 ♪♪ 716 00:36:57,507 ---> 00:37:04,180 ♪♪ 717 00:37:14,607 ---> 00:37:16,901 I'm so sorry. 718 00:37:16,901 ---> 00:37:18,903 We couldn't save her. 719 00:37:18,903 ---> 00:37:20,989 [ Breathing raggedly ] 720 00:37:20,989 ---> 00:37:30,540 ♪♪ 721 00:37:30,540 ---> 00:37:32,542 [ Crying ] 722 00:37:32,542 ---> 00:37:39,466 ♪♪ 723 00:37:39,466 ---> 00:37:40,967 Ms. Valens? 724 00:37:40,967 ---> 00:37:50,518 ♪♪ 725 00:37:50,518 ---> 00:37:59,861 ♪♪ 726 00:37:59,861 ---> 00:38:08,411 ♪♪ 727 00:38:13,541 ---> 00:38:14,793 Nice call on the zebrafish. 728 00:38:17,754---> 00:38:26,346 ♪♪ 729 00:38:26,346 ---> 00:38:35,021 ♪♪ 730 00:38:35,021 ---> 00:38:37,315 About our paper, let's meet weekly. 731 00:38:37,315 ---> 00:38:39,818 I'm thinking lunch every Tuesday in the cafeteria. 732 00:38:39,818 ---> 00:38:40,944 Perfect. 733 00:38:48,827 ---> 00:38:51,162 [ Knock on door ] 734 00:38:51,162 ---> 00:38:53,832 I heard about Melendez's patient. 735 00:38:57,085 ---> 00:38:58,086 Yeah. 736 00:39:08,513 ---> 00:39:10,098 You were right. 737 00:39:10,098 ---> 00:39:14,060 I should probably try another medication for my RA. 738 00:39:16,062 ---> 00:39:17,897 I need solid food. 739 00:39:29,492 ---> 00:39:31,202 Melendez:Claire? Wait up. 740 00:39:32,453 ---> 00:39:34,038 You okay? 741 00:39:34,038 ---> 00:39:36,124 Fine. I'm just tired. 742 00:39:38,126 ---> 00:39:40,336 You did an amazing thing for Angie. 743 00:39:40,336 ---> 00:39:43,006 You gave her mother a memory that she will have forever. 744 00:39:43,006 ---> 00:39:45,550 Well, it won't make up for the daughter she lost. 745 00:39:45,550 ---> 00:39:47,010 You're angry. 746 00:39:47,010 ---> 00:39:49,596 I'm not. I am sad. 747 00:39:49,596 ---> 00:39:51,556 Who are you angry at? I'm not. 748 00:39:51,556 ---> 00:39:53,892 Are you angry at me and Glassman because we couldn't save her? 749 00:39:53,892 ---> 00:39:55,476 No! At Angie? 750 00:39:55,476 ---> 00:39:58,813 No, you can't be mad at someone for dying! 751 00:39:58,813 ---> 00:40:01,274 That's not true. You know that. 752 00:40:01,274 ---> 00:40:03,735 ♪♪ 753 00:40:03,735 ---> 00:40:05,194 She was sick. 754 00:40:05,194 ---> 00:40:07,614 And she was trying to get better. 755 00:40:07,614 ---> 00:40:10,074 She failed and left you alone. 756 00:40:10,074 ---> 00:40:13,703 After you'd spent a lifetime trying to take care of her. 757 00:40:13,703 ---> 00:40:15,288 You have every reason to be mad at your mother. 758 00:40:17,165 ---> 00:40:19,167 I hate feeling this way. 759 00:40:19,167 ---> 00:40:21,002 My whole life, I've been angry at her, 760 00:40:21,002 ---> 00:40:23,796 and now it will never change. 761 00:40:23,796 ---> 00:40:25,840 I don't know how to stop. 762 00:40:29,218 ---> 00:40:31,721 Therapy will help. 763 00:40:31,721 ---> 00:40:33,473 Time will help. 764 00:40:35,350 ---> 00:40:38,102 There is one other thing that's worked for me. 765 00:40:38,102 ---> 00:40:45,401 ♪♪ 766 00:40:45,401 ---> 00:40:46,402 [ Keys clack ] 767 00:40:46,402 ---> 00:40:48,154 [ Giggles ] 768 00:40:48,154 ---> 00:40:50,198 ♪♪ 769 00:40:50,198 ---> 00:40:52,784 Did we fix our mutation? 770 00:40:52,784 ---> 00:40:56,496 ♪♪ 771 00:40:56,496 ---> 00:40:57,580 [ Laughs ] 772 00:40:57,580 ---> 00:41:05,755 ♪♪ 773 00:41:05,755 ---> 00:41:07,590 That the best you got? 774 00:41:07,590 ---> 00:41:17,016 ♪♪ 775 00:41:17,016 ---> 00:41:26,484 ♪♪ 776 00:41:26,484 ---> 00:41:35,702 ♪♪ 777 00:41:39,622 ---> 00:41:48,464 ♪♪ 778 00:41:48,464 ---> 00:41:57,598 ♪♪ 779 00:41:57,598 ---> 00:42:06,899 ♪♪ 780 00:42:09,736 ---> 00:42:11,946 [ Man laughs ] 781 00:42:11,946 ---> 00:42:15,283 ♪♪49437