1 00:00:00,000 --> 00:00:01,280 Previously on Doc. 2 00:00:01,600 --> 00:00:02,960 She's healing and healing fast. 3 00:00:03,220 --> 00:00:06,060 Well, that would explain the influx of new memories. I really hope you're not 4 00:00:06,060 --> 00:00:08,160 rushing this. I assure you, I can do this. 5 00:00:08,460 --> 00:00:10,080 Ruth Chen, this is Cal Ferguson. 6 00:00:10,380 --> 00:00:11,800 These are your co-chief residents. 7 00:00:12,240 --> 00:00:13,700 Ben, I heard you were coming. 8 00:00:14,140 --> 00:00:15,700 You want to replace Dr. Costa. 9 00:00:15,940 --> 00:00:18,580 If I'm coming to Westside, it'll only be to run surgery. 10 00:00:18,900 --> 00:00:20,680 So now that you're not working with Dr. 11 00:00:21,000 --> 00:00:24,380 Larson, figured why not give cardiology a shot? I'm happy to better myself. 12 00:00:24,720 --> 00:00:28,000 I saw you, Jake. I saw how you looked at her through her window. And you just 13 00:00:28,000 --> 00:00:29,000 pushed me away. 14 00:00:44,820 --> 00:00:45,820 Help! 15 00:00:46,500 --> 00:00:47,500 Help! 16 00:00:49,340 --> 00:00:50,340 Please, 17 00:00:51,440 --> 00:00:53,840 help. What happened? Are you hurt? Not me. 18 00:00:54,180 --> 00:00:55,960 My family's in there. You've got to help them. 19 00:01:25,450 --> 00:01:26,450 Ibuprofen? Mm-hmm. 20 00:01:27,370 --> 00:01:29,010 I didn't realize you were a nurse. 21 00:01:29,290 --> 00:01:30,290 Funny. 22 00:01:32,910 --> 00:01:33,910 And fun. 23 00:01:34,710 --> 00:01:37,990 That's a pretty sneaky martini you make, which is not fair. 24 00:01:38,550 --> 00:01:39,550 You want the recipe? 25 00:01:39,630 --> 00:01:40,730 Oh, God, no. 26 00:01:43,530 --> 00:01:44,530 How about my number? 27 00:01:49,590 --> 00:01:50,830 You're not gonna call me, are you? 28 00:01:53,580 --> 00:01:54,580 on my plate right now. 29 00:01:55,640 --> 00:01:56,760 Can't blame a girl for trying. 30 00:02:05,120 --> 00:02:07,080 Your lucky day, pal. You're with me again. 31 00:02:08,000 --> 00:02:10,100 Great. Call came from on high. 32 00:02:10,639 --> 00:02:13,420 Clearly, Dr. Mato sees some potential in you. 33 00:02:14,160 --> 00:02:15,720 Ooh, what you working on? 34 00:02:18,000 --> 00:02:19,000 Wait. 35 00:02:19,210 --> 00:02:21,010 Is that like Rachel, Rachel? 36 00:02:21,250 --> 00:02:24,270 It's new, okay? So I just need you to keep it to yourself, all right? 37 00:02:24,590 --> 00:02:25,529 Cardio code. 38 00:02:25,530 --> 00:02:26,530 Of course. 39 00:02:28,050 --> 00:02:29,370 Aw, you're nervous. 40 00:02:29,710 --> 00:02:32,250 No, that's not what I said. Right. 41 00:02:32,810 --> 00:02:35,210 Well, carpe diem. Let's go, grasshopper. 42 00:02:36,410 --> 00:02:37,410 Wait. 43 00:02:38,090 --> 00:02:39,510 Does this mean no more Amy? 44 00:02:43,270 --> 00:02:47,110 I had a few more memories last night, but nothing physical. So don't go 45 00:02:47,110 --> 00:02:48,110 running to Michael. 46 00:02:48,200 --> 00:02:52,100 He is the head of your department, and I'm out over my skis for you. So I will 47 00:02:52,100 --> 00:02:55,820 report back to him as soon as I understand what this is. So how is this 48 00:02:55,820 --> 00:03:01,180 different? They're not painful or disorienting. Just constant and 49 00:03:01,180 --> 00:03:05,360 intrusive. And the last thing I need when I'm trying not to look back. 50 00:03:06,100 --> 00:03:08,140 All the more reason to look ahead. 51 00:03:09,240 --> 00:03:10,240 Hey, me. 52 00:03:10,360 --> 00:03:11,360 Hey, Ben. 53 00:03:14,190 --> 00:03:15,230 So I guess you work here now. 54 00:03:15,430 --> 00:03:16,430 Looks that way. 55 00:03:16,630 --> 00:03:17,730 Double espresso, please. 56 00:03:18,970 --> 00:03:22,110 I think Joan would be glad that you're the one filling her position. 57 00:03:22,650 --> 00:03:24,190 Actually, I'm taking over the department. 58 00:03:24,730 --> 00:03:26,230 Does Dr. Costa know that? 59 00:03:26,910 --> 00:03:31,170 Yeah, he's pretty burnt out on the admin stuff and was happy to let that part go. 60 00:03:31,550 --> 00:03:32,550 Works out for everyone. 61 00:03:34,230 --> 00:03:36,270 You do background on everyone at the conference? 62 00:03:37,230 --> 00:03:38,230 Or just me? 63 00:03:40,330 --> 00:03:42,210 Well, I'm glad you're here. 64 00:03:42,670 --> 00:03:44,410 I'm excited to work with you. Same. 65 00:03:48,530 --> 00:03:51,210 Department rolling out the red carpet for Ben on his first day? 66 00:03:52,770 --> 00:03:55,630 So, whose team are you on? 67 00:03:56,010 --> 00:03:59,730 It's not dodgeball. No, it's not, and I'm asking where you stand. 68 00:04:01,370 --> 00:04:02,370 This is ridiculous. 69 00:04:02,630 --> 00:04:05,690 Because I heard you and Grant got pretty chummy during the contagion. 70 00:04:05,970 --> 00:04:07,990 Maybe you knew about the coup before it happened. 71 00:04:08,270 --> 00:04:09,270 What? Come on. 72 00:04:09,470 --> 00:04:10,790 All I know is... 73 00:04:10,990 --> 00:04:14,930 I've been a resident under Costa for four years, and he deserved better than 74 00:04:14,930 --> 00:04:15,930 this. 75 00:04:19,250 --> 00:04:21,010 Dr. Fox could use his annex. 76 00:04:21,430 --> 00:04:22,430 He may not be wrong. 77 00:04:23,690 --> 00:04:27,030 Ben is brilliant, but Costa's the one who hired me. 78 00:04:27,910 --> 00:04:29,510 Joan championed you. 79 00:04:30,290 --> 00:04:34,570 Costa went along, and that happened because you are really good. Yeah, I 80 00:04:34,570 --> 00:04:35,810 just don't like the way things went down. 81 00:04:36,170 --> 00:04:37,170 I get that. 82 00:04:37,440 --> 00:04:40,220 But you said yourself, Costa can be conservative. 83 00:04:41,260 --> 00:04:43,660 I think Ben will be better for the department. 84 00:04:44,220 --> 00:04:46,320 I guess I'll find out for myself soon enough. 85 00:04:46,540 --> 00:04:47,540 Yeah. 86 00:04:51,160 --> 00:04:52,160 Morning. 87 00:04:52,520 --> 00:04:53,520 Dr. Grant. 88 00:04:54,560 --> 00:04:56,700 I figured you'd want to discuss what happened. 89 00:04:56,960 --> 00:05:01,580 As the guy who recommended you for an opening in surgery, I would have 90 00:05:01,580 --> 00:05:05,690 appreciated a heads up that you were... planning to take it over. I'm sorry if 91 00:05:05,690 --> 00:05:07,250 that puts you in an uncomfortable situation. 92 00:05:07,670 --> 00:05:12,430 It did, and it does. I saw the potential in the department, and this was the only 93 00:05:12,430 --> 00:05:15,370 move that made sense for me. And apparently the board saw an opportunity 94 00:05:15,370 --> 00:05:16,329 to upgrade. 95 00:05:16,330 --> 00:05:19,930 I don't disagree with their decision or the direction you want to take things, 96 00:05:20,090 --> 00:05:24,690 but surgery and medicine have to work together, and I'd be lying if I said you 97 00:05:24,690 --> 00:05:25,910 haven't lost some trust. 98 00:05:27,230 --> 00:05:30,890 Well, I hope you'll give me a chance to earn it back. 99 00:05:31,880 --> 00:05:35,820 Dr. Grant, you're needed in surgery, and they want you in the ICU. 100 00:05:36,120 --> 00:05:38,640 Okay. Teenage son was driving. 101 00:05:38,940 --> 00:05:41,220 ER checked a mouth, scraped, sent a mild concussion. 102 00:05:41,560 --> 00:05:46,520 Mom's got rhabdo, causing renal failure and a subdural hematoma. Twelve-year-old 103 00:05:46,520 --> 00:05:51,240 sister has a liver lack from the seatbelt, a pelvic ring fracture, and 104 00:05:51,240 --> 00:05:53,780 DIC. They're on their way up. 105 00:05:54,880 --> 00:05:59,060 We should assign the interns to floor work. They're just going to get in the 106 00:05:59,060 --> 00:06:00,760 way today. My opportunities don't... 107 00:06:01,050 --> 00:06:02,850 come when you're ready. They come when they come. 108 00:06:04,070 --> 00:06:05,690 I think it's a mistake. Fine. 109 00:06:06,270 --> 00:06:07,910 You can have Kyle. I got Ruth. 110 00:06:08,750 --> 00:06:10,150 Try not to break her on day two. 111 00:06:13,010 --> 00:06:14,830 Anthony Evans, 48, NBA. 112 00:06:15,390 --> 00:06:16,650 Deer versus Otto. 113 00:06:17,070 --> 00:06:18,070 Riding shotgun. 114 00:06:18,610 --> 00:06:22,110 FD came to extricate after he was found impaled on the scene. 115 00:06:22,510 --> 00:06:24,170 Wife and daughter are in the ER. 116 00:06:24,550 --> 00:06:25,730 All right. Make them to OR1. 117 00:06:26,410 --> 00:06:29,730 Dr. Coleman, call radiology. I need a bedside chest fill. Got it. 118 00:06:36,140 --> 00:06:37,540 Can you tell me what happened? 119 00:06:41,300 --> 00:06:46,700 Last night, I was... I... Dr. 120 00:06:48,080 --> 00:06:51,300 Ferguson, can you get Mrs. Evans' latest files, please? Yep. 121 00:06:52,900 --> 00:06:57,280 Dr. Larson's latest files. Hey, I know how hard this must be, but we are going 122 00:06:57,280 --> 00:06:59,220 to do everything in our power to help your family. 123 00:06:59,640 --> 00:07:03,580 But in order to do that, I need you to tell me what happened. 124 00:07:06,210 --> 00:07:09,650 We went to Mestizo's to celebrate Harper's Middle School graduation. 125 00:07:10,530 --> 00:07:14,470 My sister could never decide between sushi and Mexican, so she was excited 126 00:07:14,470 --> 00:07:16,750 because, you know, it's both. 127 00:07:18,570 --> 00:07:21,170 After dinner, we went back to our cabin. 128 00:07:21,850 --> 00:07:24,170 I begged my parents to let me drive. 129 00:07:24,790 --> 00:07:30,650 My mom, she said no way because I had just gotten my license, but my dad, he 130 00:07:30,650 --> 00:07:32,210 said I had to learn sometime. 131 00:07:33,600 --> 00:07:36,700 I didn't see the deer. Before I knew what was happening, it crashed through 132 00:07:36,700 --> 00:07:37,519 the windshield. 133 00:07:37,520 --> 00:07:39,800 So your dad was in the passenger seat? Mom and Harper in the back. 134 00:07:40,460 --> 00:07:42,740 My airbag went off. We flipped into a ditch. 135 00:07:46,460 --> 00:07:50,000 The deer was kicking like crazy. It was freaking out. There was blood 136 00:07:50,000 --> 00:07:54,300 everywhere. BP 110 over 73. Heart rate's in the 90s and she's sat in 97. 137 00:07:54,660 --> 00:07:55,660 Oh, great. 138 00:07:56,400 --> 00:07:58,520 Theo, your mom's vitals are all normal, okay? 139 00:07:58,780 --> 00:08:02,490 Yeah. Thank you. During the accident, were you knocked out? 140 00:08:02,850 --> 00:08:06,870 Not for long. It was still dark when I came to, but there was no one else 141 00:08:06,870 --> 00:08:10,810 awake. I tried to get help, but there was no cell service. 142 00:08:11,450 --> 00:08:13,450 Seatbelt was jammed. The door was wedged shut. 143 00:08:13,870 --> 00:08:17,770 It took so long before I got out. When I finally got to the road, there was no 144 00:08:17,770 --> 00:08:18,790 one there for hours. 145 00:08:19,390 --> 00:08:25,170 After sunrise, a few people drove by, but I know they saw me, but they just 146 00:08:25,170 --> 00:08:26,049 kept going. 147 00:08:26,050 --> 00:08:27,050 It's okay. 148 00:08:27,290 --> 00:08:29,510 You're all here now. My dad's not here. 149 00:08:29,870 --> 00:08:33,909 I don't even know what's going on with him. He's gonna be in surgery for a 150 00:08:33,909 --> 00:08:36,990 while longer. We're waiting on his latest lab results. Can you check on 151 00:08:36,990 --> 00:08:38,030 them? Okay. 152 00:08:42,549 --> 00:08:43,549 Are you in? 153 00:08:44,410 --> 00:08:48,110 If you didn't get a flash, then you're not in the vein. Sorry, I've only done 154 00:08:48,110 --> 00:08:49,110 IVs on chicken thighs. 155 00:08:49,770 --> 00:08:51,650 Like, from the grocery store? 156 00:08:54,660 --> 00:08:56,540 What's wrong with her? Her heart rate's rising. 157 00:08:56,820 --> 00:08:57,699 It's okay, Theo. 158 00:08:57,700 --> 00:08:58,760 They'll take care of it. 159 00:08:59,940 --> 00:09:00,940 Liz. 160 00:09:01,540 --> 00:09:02,540 Okay. 161 00:09:02,920 --> 00:09:04,760 Harper has a grade four liver lack. 162 00:09:04,960 --> 00:09:08,360 Dr. Costa wanted to just monitor, but now BP's getting soft. 163 00:09:08,600 --> 00:09:10,180 She's hemodynamically unstable. 164 00:09:10,460 --> 00:09:11,460 She needs to go to the OR. 165 00:09:11,980 --> 00:09:15,080 Yeah, but DIC puts her at higher risk for bleeding out mid-surgery. 166 00:09:15,340 --> 00:09:19,520 Okay, so go with her and manage it while they operate on her liver. It has to 167 00:09:19,520 --> 00:09:20,339 happen now. 168 00:09:20,340 --> 00:09:21,340 Okay, got it? 169 00:09:21,860 --> 00:09:23,640 Okay. Okay, I got this. 170 00:09:28,110 --> 00:09:30,450 What's going on? We have to operate on your sister. 171 00:09:30,670 --> 00:09:31,670 Her too? 172 00:09:32,250 --> 00:09:33,350 Will she be okay? 173 00:09:38,550 --> 00:09:40,230 Did I miss something? Is it my fault? 174 00:09:40,650 --> 00:09:42,090 No, you did nothing wrong. 175 00:09:43,710 --> 00:09:45,310 This can't be happening. 176 00:09:45,790 --> 00:09:47,050 Can you start it? 177 00:09:48,310 --> 00:09:49,490 Hey, Theo. 178 00:09:51,690 --> 00:09:53,090 I know this is scary. 179 00:09:53,390 --> 00:09:55,030 You have to save my family. 180 00:09:55,810 --> 00:09:56,810 Please. 181 00:09:59,240 --> 00:10:02,940 So early wound management and antibiotics are everything. 182 00:10:03,500 --> 00:10:10,020 Any wound that doesn't heal in a diabetic patient is osteomyelitis 183 00:10:10,020 --> 00:10:11,480 until proven otherwise. 184 00:10:11,980 --> 00:10:16,840 Try to remember when we come across these patients, we're not just treating 185 00:10:16,840 --> 00:10:17,840 an infection. 186 00:10:18,260 --> 00:10:19,660 We're saving a limb. 187 00:10:21,440 --> 00:10:22,440 Thank you. 188 00:10:23,220 --> 00:10:27,900 I think it's time for QandA. Any questions? 189 00:10:31,260 --> 00:10:34,180 Yes? Yeah, with all due respect. 190 00:10:35,040 --> 00:10:39,120 I'd argue surgical intervention is more effective than non-operative wound 191 00:10:39,120 --> 00:10:40,580 management of diabetic ulcers. 192 00:10:40,800 --> 00:10:45,260 The well-worn dichotomy, surgery versus medicine? That's not about cutting for 193 00:10:45,260 --> 00:10:46,059 the sake of cutting. 194 00:10:46,060 --> 00:10:49,760 Never is. Studies have shown that patients who undergo early surgical 195 00:10:49,760 --> 00:10:52,360 debridement have a much higher rate of remission. So? 196 00:10:53,020 --> 00:10:54,520 It was one study. 197 00:10:55,080 --> 00:10:56,080 I saw it. 198 00:10:56,619 --> 00:11:02,620 And the rate of remission by patient was anywhere from 28 to 81%. That's hardly 199 00:11:02,620 --> 00:11:04,080 consistent enough to call evidence. 200 00:11:05,040 --> 00:11:08,520 I guess Harvard didn't teach you to read the footnotes, Dr. Grant? 201 00:11:11,680 --> 00:11:15,840 I have never seen anything like this. Neither have I, and I've got over 25 202 00:11:15,840 --> 00:11:16,840 years on you. 203 00:11:17,020 --> 00:11:20,520 And between the blood and the antlers, I could barely make out much of the 204 00:11:20,520 --> 00:11:22,220 highlamore lungs. We'll have to go in blind. 205 00:11:22,780 --> 00:11:24,320 Doesn't help that no one stopped for the kid. 206 00:11:24,720 --> 00:11:26,080 Caused the sours. No one stopped. 207 00:11:28,420 --> 00:11:29,740 Dr. Fox, ready to assist? 208 00:11:30,160 --> 00:11:30,839 Born ready. 209 00:11:30,840 --> 00:11:33,920 Good. We'll start by tying off any arterial injuries. 210 00:11:34,140 --> 00:11:35,280 That could be the source of the bleeding. 211 00:11:35,480 --> 00:11:36,780 What about removing the antlers? 212 00:11:37,000 --> 00:11:39,940 That's where Dr. Coleman comes in. If I'm right, they're acting like a fish 213 00:11:39,940 --> 00:11:43,220 hook wrapped around the pulmonary artery, vein, bronchi, which means? 214 00:11:43,540 --> 00:11:47,500 If we just pull him out, could rip out the entire vascular pedicle to his lung, 215 00:11:47,620 --> 00:11:48,960 making it possible to repair. 216 00:11:49,260 --> 00:11:50,440 Exactly. So no removal? 217 00:11:50,910 --> 00:11:53,910 Without more data, I need you to track down any case reports of similar 218 00:11:53,910 --> 00:11:54,910 penetrating injuries. 219 00:11:54,950 --> 00:11:57,670 Every operative solution you can find. Go. Fast. 220 00:12:00,030 --> 00:12:00,849 Scrub in. 221 00:12:00,850 --> 00:12:01,850 Yeah. 222 00:12:04,470 --> 00:12:08,450 He has severe acidosis. Given his massive pulmonary contusions, it makes 223 00:12:08,450 --> 00:12:09,730 sense his blood gas is abnormal. 224 00:12:10,010 --> 00:12:13,650 It's a mixed acidosis. The lung trauma alone wouldn't explain it. There's got 225 00:12:13,650 --> 00:12:15,910 to be something else going on. Guess you've got to figure it out, then. 226 00:12:16,490 --> 00:12:17,449 Excuse me? 227 00:12:17,450 --> 00:12:18,650 Medicine's your area of mind. 228 00:12:19,150 --> 00:12:21,250 It'll operate like hell before he bleeds out. 229 00:12:21,450 --> 00:12:22,450 Excuse me. 230 00:12:24,390 --> 00:12:25,690 Who sent him back out there? 231 00:12:29,270 --> 00:12:33,850 Serena, repeat the trauma panel and get a rotum to the lab stat. We need to look 232 00:12:33,850 --> 00:12:34,850 for everything. 233 00:12:37,010 --> 00:12:40,950 We're observing Mrs. Evans' hematoma for now. Kidneys are responding to IV 234 00:12:40,950 --> 00:12:46,710 hydration, but I think I saw PVCs on the monitor, so I want a second opinion. 235 00:12:47,530 --> 00:12:49,230 Dr. Heller, what is a PVC? 236 00:12:51,010 --> 00:12:54,050 Are you kidding me? You're a beginner in cardiology, so we start at the 237 00:12:54,050 --> 00:12:55,050 beginning. 238 00:12:56,390 --> 00:12:59,750 It is a premature beat arising from the ventricle. 239 00:13:00,150 --> 00:13:01,830 And how frequently does this occur? 240 00:13:02,190 --> 00:13:04,490 Can we socratically skip to the solution, please? 241 00:13:05,690 --> 00:13:10,190 We should check for any electrolyte abnormalities, get a 12-lead EKG and an 242 00:13:10,190 --> 00:13:11,710 echo. Correct, young Skywalker. 243 00:13:12,050 --> 00:13:14,950 Okay, you don't cut that out, I'm going to break out my lightsaber. Send you on 244 00:13:14,950 --> 00:13:15,950 a visit to Obi-Wan. 245 00:13:16,510 --> 00:13:18,550 Okay. Sorry, sir. 246 00:13:21,330 --> 00:13:25,450 Jamie, Sponge, there's a significant amount of bleeding from the liver. 247 00:13:25,910 --> 00:13:29,830 We're going to need to administer cryofibrinogen TXA to get this under 248 00:13:29,830 --> 00:13:31,930 control. Then you operate on the fracture? 249 00:13:32,310 --> 00:13:33,610 No, she can't handle that. 250 00:13:35,910 --> 00:13:40,290 He didn't stabilize the pelvic fracture surgically? Just put a binder on. Said 251 00:13:40,290 --> 00:13:41,690 she's too critically ill already. 252 00:13:42,870 --> 00:13:46,150 Too conservative, right? Even with borderline displacement, he should have 253 00:13:46,150 --> 00:13:48,830 operated. I had to keep an eye on her hematocrit. 254 00:13:49,710 --> 00:13:53,950 Any luck on your end? Turns out, antlers to the chest is a one-in-a-million kind 255 00:13:53,950 --> 00:13:55,910 of situation, and I am on the clock here. 256 00:13:56,870 --> 00:13:57,870 What is it? 257 00:13:58,710 --> 00:13:59,710 Improvise? Adapt? 258 00:14:01,110 --> 00:14:02,110 Overcome? 259 00:14:02,550 --> 00:14:03,550 That's the Marines. 260 00:14:04,350 --> 00:14:05,350 Whatever, Ranger. 261 00:14:05,430 --> 00:14:06,490 Think outside the box. 262 00:14:06,770 --> 00:14:07,790 Ben trusts you. 263 00:14:08,210 --> 00:14:09,210 Maybe trust yourself. 264 00:14:10,420 --> 00:14:12,240 I'm seeing some ventricular strain. 265 00:14:13,160 --> 00:14:14,160 We're in here now. 266 00:14:15,040 --> 00:14:16,040 No turning back. 267 00:14:17,580 --> 00:14:18,660 Keep scrolling, Karen. 268 00:14:18,900 --> 00:14:20,600 Show me the enzymes and lactate. 269 00:14:21,640 --> 00:14:22,640 What are you looking for? 270 00:14:22,700 --> 00:14:23,700 I'll know when I see it. 271 00:14:25,600 --> 00:14:26,980 Okay, this is unusual. 272 00:14:28,920 --> 00:14:29,920 Oh, God. 273 00:14:33,320 --> 00:14:37,340 Dr. Grant, Dr. Larson's on the phone for you. Now? She said the surgeon. 274 00:14:37,680 --> 00:14:38,680 Put her on speaker. 275 00:14:39,470 --> 00:14:43,670 What is it? His results came back. Troponin is a BNP and lactate are off 276 00:14:43,670 --> 00:14:44,249 the charts. 277 00:14:44,250 --> 00:14:45,570 You need to stop the surgery. 278 00:14:46,890 --> 00:14:50,750 Where am I? It's okay. It's okay. 279 00:14:51,030 --> 00:14:53,030 You're at Westside Hospital in Minneapolis. 280 00:14:56,450 --> 00:14:57,990 My head is killing me. 281 00:14:59,070 --> 00:15:00,070 What happened? 282 00:15:00,170 --> 00:15:02,650 You were in an accident. Your car hit a deer. 283 00:15:05,130 --> 00:15:06,350 Careful. Careful. 284 00:15:06,870 --> 00:15:07,870 Am I okay? 285 00:15:08,190 --> 00:15:11,370 This will sound worse than it is, but you have a bleed around your brain. 286 00:15:12,190 --> 00:15:15,510 Now... Mom, you're okay. 287 00:15:15,970 --> 00:15:18,070 I'm sorry. I don't know who you are. 288 00:15:20,050 --> 00:15:21,050 I'm your son. 289 00:15:23,290 --> 00:15:24,290 Theo. 290 00:15:25,170 --> 00:15:26,250 What is he talking about? 291 00:15:26,870 --> 00:15:28,350 I don't have a son. 292 00:15:32,330 --> 00:15:34,410 So, did I use up all my questions? 293 00:15:37,359 --> 00:15:39,080 Depends. Can you handle more of my answers? 294 00:15:39,560 --> 00:15:40,560 Oh, I think so. 295 00:15:41,120 --> 00:15:42,120 Okay, then. 296 00:15:42,320 --> 00:15:44,400 You do background on everyone at the conference? 297 00:15:45,320 --> 00:15:46,320 Or just me? 298 00:15:46,820 --> 00:15:48,740 Did you really come up here to ask me that? 299 00:15:48,960 --> 00:15:49,980 Or to eat crumb? 300 00:15:52,480 --> 00:15:53,480 Both. 301 00:15:54,280 --> 00:15:57,680 But I prefer to atone over a drink. 302 00:16:01,560 --> 00:16:02,560 What are you doing? 303 00:16:03,440 --> 00:16:04,820 I told you to stop. 304 00:16:05,210 --> 00:16:08,430 I heard you. The transfusions we've given him have caused fluid overload. 305 00:16:08,550 --> 00:16:11,590 He's in heart failure. I've controlled all the bleeders I can visualize, but 306 00:16:11,590 --> 00:16:14,670 there could be more hiding behind the antlers. I'm pretty sure if I stop, 307 00:16:14,870 --> 00:16:18,530 he'll bleed out. If you don't stop, he's going to die on your table. I have to 308 00:16:18,530 --> 00:16:20,130 fix the heart failure first. 309 00:16:20,470 --> 00:16:21,470 And how are you going to do that? 310 00:16:21,730 --> 00:16:23,050 Goal-directed diuresis. 311 00:16:23,550 --> 00:16:25,190 He can't handle single lung ventilation. 312 00:16:25,470 --> 00:16:26,510 I had to put him on BD ECMO. 313 00:16:26,810 --> 00:16:27,729 I'm aware. 314 00:16:27,730 --> 00:16:28,730 All right. 315 00:16:28,990 --> 00:16:32,570 I'll get him ready for you, but if he's not back in my OR in four hours, the 316 00:16:32,570 --> 00:16:34,410 circuit will clot and he'll die. 317 00:16:34,920 --> 00:16:35,920 In your ICU. 318 00:16:41,860 --> 00:16:43,840 Can you do that in four hours? 319 00:16:44,400 --> 00:16:45,440 We have no choice. 320 00:16:52,900 --> 00:16:55,340 ICU? Your sister should be waking up soon. 321 00:16:55,620 --> 00:16:57,900 Dr. Costa was able to get her bleeding under control. 322 00:16:58,860 --> 00:17:00,260 She looks so small. 323 00:17:01,500 --> 00:17:03,100 She's... she's strong. 324 00:17:03,760 --> 00:17:05,859 And stable, for now. That's good. 325 00:17:06,560 --> 00:17:08,020 Why doesn't my mom know me? 326 00:17:08,819 --> 00:17:11,640 It's not just you. She doesn't remember anyone, right? 327 00:17:14,460 --> 00:17:17,819 Um... We're not sure yet. 328 00:17:18,180 --> 00:17:19,159 Not yet. 329 00:17:19,160 --> 00:17:21,220 She's getting a repeat CT. 330 00:17:22,060 --> 00:17:24,579 It's a scan of her brain, so they can figure it out. 331 00:17:25,339 --> 00:17:26,500 What about my dad? 332 00:17:27,319 --> 00:17:28,560 Is he gonna be okay? 333 00:17:33,420 --> 00:17:39,680 We were doing what what we're doing everything we can 334 00:17:39,680 --> 00:17:43,100 for him Okay 335 00:17:43,100 --> 00:17:47,860 Sorry 336 00:17:47,860 --> 00:17:54,400 stay here and monitor Harper serial 337 00:17:54,400 --> 00:17:57,740 crits and drain output any changes let me know right away 338 00:18:06,280 --> 00:18:07,280 Wake up. 339 00:18:08,460 --> 00:18:09,460 Can she hear me? 340 00:18:10,000 --> 00:18:12,380 Probably. The anesthesia just took some time to wear off. 341 00:18:13,460 --> 00:18:15,560 If you wake up now, I'll show you how to code on Python. 342 00:18:17,360 --> 00:18:19,040 She's been bugging me to teach her. 343 00:18:22,580 --> 00:18:26,460 Theo, she needs to rest. I'm going to take you to the waiting room, okay? 344 00:18:27,120 --> 00:18:29,620 Why? What's going on? I need you to come with me. 345 00:18:30,280 --> 00:18:31,420 Is this about my mom? 346 00:18:31,960 --> 00:18:35,380 No. They took her away and they won't tell me why she doesn't remember. 347 00:18:35,770 --> 00:18:36,770 Remember what? Me. 348 00:18:37,210 --> 00:18:38,810 She doesn't know who I am. 349 00:18:40,370 --> 00:18:43,930 Um, I'm sorry I've been treating your father, but I'll get you an update. I 350 00:18:43,930 --> 00:18:45,530 need you to go to the waiting room, okay? 351 00:18:46,330 --> 00:18:47,430 Someone will be by soon. 352 00:18:48,810 --> 00:18:51,850 Why did he have to go? Did something happen? We're bringing his father up 353 00:18:51,850 --> 00:18:52,850 here now. 354 00:18:54,990 --> 00:18:56,750 Oh. Oh, my God. 355 00:18:57,010 --> 00:18:58,070 And they're still in him. 356 00:18:59,230 --> 00:19:01,450 We need more access. Get a second line going. 357 00:19:01,730 --> 00:19:05,030 He needs Rosaline, Stephapim, and Vancomycin. I can get it. 358 00:19:05,470 --> 00:19:06,610 Julie's got it. Stay back. 359 00:19:07,610 --> 00:19:08,790 You paid cardiology? 360 00:19:09,010 --> 00:19:11,990 Yeah, I need a transesophageal echo to monitor his cardiac function. 361 00:19:12,370 --> 00:19:13,269 Yeah, no problem. 362 00:19:13,270 --> 00:19:14,490 I need to get some more dressings. 363 00:19:14,710 --> 00:19:15,710 Yeah. 364 00:19:16,490 --> 00:19:21,170 Mrs. Evans doesn't remember what happened or recognize Theo or anyone in 365 00:19:21,170 --> 00:19:22,009 her family. 366 00:19:22,010 --> 00:19:23,530 Brain bleed must be getting worse. 367 00:19:23,750 --> 00:19:27,010 So we were wrong about it being stable enough to monitor? 368 00:19:27,370 --> 00:19:28,510 No, you weren't wrong. 369 00:19:28,850 --> 00:19:30,330 Her hematoma's getting smaller. 370 00:19:30,770 --> 00:19:32,730 Well, so what's causing her symptoms? 371 00:19:35,040 --> 00:19:37,420 Sorry to interrupt. Dr. Honda, can I have a word, please? 372 00:19:38,960 --> 00:19:40,080 EEG? MRI? 373 00:19:40,400 --> 00:19:42,740 Yeah, and I want to do some more advanced cognitive testing. 374 00:19:45,920 --> 00:19:49,180 What can I do for you? I just want to make sure you've been apprised of the 375 00:19:49,180 --> 00:19:50,220 situation with my patient. 376 00:19:50,420 --> 00:19:51,420 Your patient? 377 00:19:51,600 --> 00:19:53,240 The guy with the antler in his chest. 378 00:19:53,460 --> 00:19:54,439 Anthony Evans. 379 00:19:54,440 --> 00:19:58,880 What about him? Dr. Larson insisted that I stop mid-surgery so she can find a 380 00:19:58,880 --> 00:20:00,360 medical solution to his heart failure. 381 00:20:01,320 --> 00:20:04,380 And? And he was already at risk of dying from impalement. 382 00:20:04,860 --> 00:20:07,460 The longer we delay, she compounds that risk with the likelihood of eczema 383 00:20:07,460 --> 00:20:08,460 failure and infection. 384 00:20:08,640 --> 00:20:10,460 Are you implying she's not up to the task? 385 00:20:10,760 --> 00:20:14,440 I just checked on Evans' status, and they are no closer to an answer. So 386 00:20:14,440 --> 00:20:15,620 maybe you want to give her a hand. 387 00:20:18,360 --> 00:20:19,360 How is he? 388 00:20:19,620 --> 00:20:23,900 Still alive for the moment. Julie, get me updated on his nose and his latest 389 00:20:23,900 --> 00:20:25,560 ABG and tropes. Hold it. 390 00:20:27,140 --> 00:20:28,660 I heard about Mrs. Evans. 391 00:20:30,100 --> 00:20:31,260 Or Theo's a mess? 392 00:20:31,620 --> 00:20:33,580 He's actually handling it pretty well, considering. 393 00:20:34,240 --> 00:20:35,900 I guess you're an expert. 394 00:20:37,140 --> 00:20:40,360 When I woke up from my accident, I wasn't much fun either. 395 00:20:40,640 --> 00:20:41,960 At least you remembered me. 396 00:20:43,060 --> 00:20:44,060 What's your plan here? 397 00:20:44,140 --> 00:20:48,080 It's a tightrope. We gave him diuretics to get rid of the excess fluid, and the 398 00:20:48,080 --> 00:20:51,560 ECMO started chugging. Not enough blood flow to the pump. You dropped the RPM? 399 00:20:51,860 --> 00:20:54,820 Yeah, I did. But if that doesn't work, we're going to have to give him more 400 00:20:54,820 --> 00:20:58,260 fluids, and then we're back at square one. And his clotting's gotten worse. 401 00:20:58,400 --> 00:20:59,299 Just as Dr. 402 00:20:59,300 --> 00:21:00,300 Grant predicted. 403 00:21:00,590 --> 00:21:03,910 You talked to him? I did. He's wary about what you're attempting. 404 00:21:04,230 --> 00:21:05,230 But that tracks. 405 00:21:05,390 --> 00:21:07,270 Is there something I should know about you two? 406 00:21:08,490 --> 00:21:10,210 What did you sign up for? 407 00:21:12,510 --> 00:21:14,270 Did you just have another memory? 408 00:21:14,490 --> 00:21:15,490 I'm managing. 409 00:21:15,590 --> 00:21:16,590 I'm fine. 410 00:21:16,870 --> 00:21:20,190 We need to regain control of his fluid status. 411 00:21:26,910 --> 00:21:28,050 Don't take it personally. 412 00:21:30,000 --> 00:21:32,560 Thought I was doing pretty well, but suddenly she's acting like I'm in the 413 00:21:32,560 --> 00:21:35,440 way. Yeah, it's hard to predict which version you're gonna get. 414 00:21:35,740 --> 00:21:36,860 And today especially. 415 00:21:37,740 --> 00:21:41,180 Not sure what you know about her, but... Oh, we all know. 416 00:21:42,220 --> 00:21:43,220 Everything. 417 00:21:43,580 --> 00:21:46,040 Okay, well then, this should make sense. 418 00:21:46,620 --> 00:21:51,360 Car accident, woman losing her memory, family hanging in the balance. 419 00:21:51,620 --> 00:21:55,140 Right. But you can't control any of that. All you can do is just manage you. 420 00:21:55,880 --> 00:21:57,160 And try not to wake the beast. 421 00:21:58,570 --> 00:21:59,570 Thanks for the consult. 422 00:21:59,710 --> 00:22:00,710 Yeah. 423 00:22:01,290 --> 00:22:02,670 Jan Evans, coming in. 424 00:22:03,850 --> 00:22:05,110 Her face is drooping. 425 00:22:05,410 --> 00:22:06,510 Speech is slurred. 426 00:22:07,070 --> 00:22:08,070 She's getting worse. 427 00:22:08,470 --> 00:22:12,350 No signs in the imaging, but it looks like a stroke. I started a low-dose 428 00:22:12,350 --> 00:22:13,229 heparin drip. 429 00:22:13,230 --> 00:22:15,450 Hopefully it reverses the effects and the memory loss. 430 00:22:15,810 --> 00:22:17,070 Theo really wants an update. 431 00:22:17,370 --> 00:22:18,650 Yeah. Okay. 432 00:22:20,970 --> 00:22:23,850 Just text me the number. 433 00:22:25,950 --> 00:22:26,950 Thanks. 434 00:22:31,920 --> 00:22:36,940 That was Albert, my dad's friend. I'm glad you have someone to talk to. He's 435 00:22:36,940 --> 00:22:37,940 trying to find me a lawyer. 436 00:22:38,340 --> 00:22:40,400 Why would you need a lawyer? You think I don't know what's going on? 437 00:22:40,880 --> 00:22:42,160 The way you're all acting? 438 00:22:42,500 --> 00:22:44,000 My dad's not going to make it. 439 00:22:44,700 --> 00:22:47,960 My mom, she doesn't even know who we are. 440 00:22:48,600 --> 00:22:52,440 Look, we don't have anyone else. They'll put us in foster care. They'll separate 441 00:22:52,440 --> 00:22:54,260 us. Theo, you're getting ahead of yourself. 442 00:22:54,500 --> 00:22:55,500 Don't lie to me. 443 00:22:55,680 --> 00:22:57,920 You already sent your social worker to come talk to me. 444 00:22:59,129 --> 00:23:01,410 I'm sorry. They shouldn't... I don't get it. 445 00:23:02,270 --> 00:23:06,470 I'm old enough to drive, old enough to kill my parents, but I'm not old enough 446 00:23:06,470 --> 00:23:07,790 to take care of my sister? 447 00:23:12,830 --> 00:23:16,210 I'm sorry. I just... It's okay. 448 00:23:18,250 --> 00:23:23,090 She didn't want me to drive, but... I really thought I was ready. 449 00:23:26,150 --> 00:23:27,170 Dr. Mitra? 450 00:23:28,110 --> 00:23:32,170 What's going on? I know you said to watch her matter crit, but Harper's 451 00:23:32,170 --> 00:23:34,510 getting to Kipnick. I figured I should tell you 452 00:23:34,510 --> 00:23:43,290 Respiratory 453 00:23:43,290 --> 00:23:47,730 distress, I think it's a fat embolism from a pelvic fracture. I got it 454 00:23:47,730 --> 00:23:52,290 Decreasing rpm and giving volume isn't working BP still too low. 455 00:23:52,810 --> 00:23:55,010 I know that like well you think there's bleeding 456 00:23:55,840 --> 00:23:56,840 Sorry, I know you're busy. 457 00:23:56,940 --> 00:23:57,940 Not now, Kyle. 458 00:23:58,860 --> 00:24:00,820 Do you have any idea what you're doing? 459 00:24:01,800 --> 00:24:03,100 We got the labs back. 460 00:24:03,500 --> 00:24:05,580 His hemoglobin's 19. That's high, right? 461 00:24:05,940 --> 00:24:07,480 Very high. So he's not bleeding. 462 00:24:07,680 --> 00:24:08,680 Doesn't make sense. 463 00:24:10,660 --> 00:24:11,740 Stay, Kyle. 464 00:24:13,460 --> 00:24:14,840 It's capillary leak syndrome. 465 00:24:15,580 --> 00:24:19,040 The hemoglobin is falsely elevated because his blood vessels are leaking 466 00:24:19,040 --> 00:24:20,200 fluid into his tissues. 467 00:24:20,440 --> 00:24:21,840 It can happen after a trauma. 468 00:24:22,180 --> 00:24:24,940 Explains the heart failure and why nothing we've been doing has worked to 469 00:24:24,940 --> 00:24:25,739 raise his BP. 470 00:24:25,740 --> 00:24:28,880 What about hepastarch to pull the fluid back into his blood vessels? His kidneys 471 00:24:28,880 --> 00:24:30,840 still won't get rid of the excess fluid in time. 472 00:24:31,300 --> 00:24:35,680 What if we dialyze him via his ECMO to fix the fluid overload in the OR? 473 00:24:36,380 --> 00:24:37,380 What does that mean? 474 00:24:37,550 --> 00:24:42,030 His ECMO is letting us bypass his lungs. If we hooked up a dialysis machine to 475 00:24:42,030 --> 00:24:46,270 it, we could bypass his kidneys, taking the fluid off faster, but still keep it 476 00:24:46,270 --> 00:24:48,150 controlled. Which would allow Dr. 477 00:24:48,370 --> 00:24:49,750 Grant to proceed with the surgery. 478 00:24:51,650 --> 00:24:53,350 No journal articles, not one? 479 00:24:53,570 --> 00:24:55,090 All traditional lit was a bust. 480 00:24:55,290 --> 00:24:58,330 There's got to be something out there. Good for you if you can find it. The 481 00:24:58,330 --> 00:24:59,690 fact that I couldn't got me thinking. 482 00:25:00,520 --> 00:25:03,600 Docs who've dealt with this aren't the ones who write papers. They're the ones 483 00:25:03,600 --> 00:25:07,720 with real-life, hands-on experience. So, I called around to rural hospitals. 484 00:25:08,080 --> 00:25:10,980 Found a similar case in Grand Marais, another one in Drummond. 485 00:25:11,360 --> 00:25:14,200 Based on what those surgeons said, I worked out a strategy for us. 486 00:25:15,040 --> 00:25:16,040 Keep talking. 487 00:25:16,720 --> 00:25:19,120 We need to treat it like a tumor, not a trauma. 488 00:25:19,700 --> 00:25:23,640 Instead of trying to save the damaged blood vessels by taking out the antler 489 00:25:23,640 --> 00:25:26,600 piece by piece, we should remove the whole section of the antler. 490 00:25:27,160 --> 00:25:30,600 and the penetrated vessels, and the airway. And then what? Watch him die? 491 00:25:30,940 --> 00:25:33,800 Then we take what's left over from the artery and bronchus, put those two ends 492 00:25:33,800 --> 00:25:34,459 back together. 493 00:25:34,460 --> 00:25:36,780 He'll bleed like a stuck pig. It means we gotta move fast. 494 00:25:37,080 --> 00:25:38,500 Yeah. I like it. 495 00:25:38,900 --> 00:25:42,160 But it's on mood if Dr. Larson can't stabilize the patient for surgery. He's 496 00:25:42,160 --> 00:25:43,340 just... He's got an hour. 497 00:25:43,600 --> 00:25:45,640 Tops. Already checked in. Not ready yet. 498 00:25:46,720 --> 00:25:47,720 We've got Harper. 499 00:25:47,940 --> 00:25:51,380 Pelvic binder wasn't enough. She needs ORIF. Echo confirmed. The fracture's 500 00:25:51,380 --> 00:25:53,320 causing fat emboli. Should I pay you, Dr. Costa? 501 00:25:53,560 --> 00:25:54,560 No, I got this. 502 00:25:54,720 --> 00:25:55,860 Let's go, Dr. Fox. 503 00:25:56,440 --> 00:25:58,000 Tell Dr. Larson I'll be ready in 30. 504 00:25:58,220 --> 00:25:59,340 She won't be waiting on me. 505 00:25:59,560 --> 00:26:01,020 Prep OR2 right now. 506 00:26:04,080 --> 00:26:06,080 So how long have you been separated? 507 00:26:07,000 --> 00:26:11,300 Three months. We were together 26 years. 508 00:26:12,400 --> 00:26:14,540 Can't be easy, getting back out there. 509 00:26:14,880 --> 00:26:15,940 Who said I'm back out there? 510 00:26:17,020 --> 00:26:18,660 Yeah, I'm sure it's going well for you. 511 00:26:19,280 --> 00:26:20,640 Ask me again in an hour. 512 00:26:22,560 --> 00:26:25,120 Really? Does that work on the other women? 513 00:26:25,340 --> 00:26:26,340 There are no other women. 514 00:26:27,500 --> 00:26:29,980 As far as my ex knows, at least. 515 00:26:31,540 --> 00:26:34,060 Yeah, our divorce isn't exactly amicable. 516 00:26:34,440 --> 00:26:35,820 So you did something wrong. 517 00:26:36,140 --> 00:26:37,500 I did lots of things wrong. 518 00:26:37,920 --> 00:26:39,840 But if you're asking, was I unfaithful? 519 00:26:41,980 --> 00:26:43,920 No. We just disconnected. 520 00:26:44,200 --> 00:26:48,680 Kept it together for the kids, but once they were out of the house... Well, 521 00:26:48,680 --> 00:26:49,880 okay. 522 00:26:51,480 --> 00:26:52,480 Your turn. 523 00:26:55,030 --> 00:26:56,870 No. No, I didn't sign up for that. 524 00:26:58,830 --> 00:27:00,510 What did you sign up for? 525 00:27:03,130 --> 00:27:06,550 Fluoro shows excellent alignment and stabilization of the pelvic ring. 526 00:27:06,850 --> 00:27:07,709 She going to be okay? 527 00:27:07,710 --> 00:27:08,710 She will now. 528 00:27:09,590 --> 00:27:12,870 So, you would have operated on the pelvis this morning? After delivery? 529 00:27:13,570 --> 00:27:15,330 Yeah. You were wrong. 530 00:27:15,970 --> 00:27:17,370 I am waiting for you. 531 00:27:18,330 --> 00:27:19,450 Mr. Evans is ready. 532 00:27:21,210 --> 00:27:22,430 Dr. Fox, close up. 533 00:27:22,940 --> 00:27:27,260 Dr. Coleman, suit up and scrub in. Really? It's your plan. Let's go. 534 00:27:28,120 --> 00:27:29,120 Pickups. 535 00:27:31,940 --> 00:27:32,940 Drop in Larson. 536 00:27:33,420 --> 00:27:36,280 I'll need you to keep him stable so I can finish the surgery this time. 537 00:27:36,620 --> 00:27:37,620 I'll do my part. 538 00:27:38,200 --> 00:27:40,060 Curious how you plan to do yours. 539 00:27:40,840 --> 00:27:41,920 Ask Dr. Coleman. 540 00:27:44,280 --> 00:27:48,760 We'll follow sleeper section guidelines for antler removal and anastomosis, pull 541 00:27:48,760 --> 00:27:51,640 the whole thing out, and put the damaged vessels in the bronchi back together. 542 00:27:56,140 --> 00:27:57,140 What's happening? 543 00:27:57,600 --> 00:28:02,120 She's responding well to the heparin, but now she's got 102-degree fever. 544 00:28:02,380 --> 00:28:03,860 Well, maybe it wasn't the trauma. 545 00:28:04,140 --> 00:28:06,160 Could the stroke have been caused by an infection? 546 00:28:06,540 --> 00:28:09,440 I started her on broad-spectrum antibiotics just in case. 547 00:28:10,780 --> 00:28:12,880 Now she's tachycardic. She needs more fluids. 548 00:28:18,840 --> 00:28:19,940 Why is she getting worse? 549 00:28:20,660 --> 00:28:22,400 Theo, you can't be here right now. 550 00:28:22,620 --> 00:28:24,360 Liz, please help my mom. 551 00:28:24,800 --> 00:28:27,620 Yes, yes, they will. Theo, they will. Okay, but we gotta go now. 552 00:28:29,420 --> 00:28:30,420 Come on. 553 00:28:31,700 --> 00:28:33,220 Got a lot of bleeding here. 554 00:28:33,580 --> 00:28:34,580 What's the fluid status? 555 00:28:35,560 --> 00:28:36,560 Ultrafiltration is working. 556 00:28:36,880 --> 00:28:39,860 Got a coma. I need you to ligate that bleeder with an O-silk. 557 00:28:40,980 --> 00:28:43,140 I'm right here. You gotta learn sometime. Let's go. 558 00:28:59,980 --> 00:29:00,980 You alright? 559 00:29:03,860 --> 00:29:07,440 When I finished med school, they gave me a piece of paper that said, you know, 560 00:29:07,440 --> 00:29:08,460 I'm a doctor. 561 00:29:09,000 --> 00:29:13,300 But I don't feel like a doctor. I feel the exact same way I did a month ago. 562 00:29:14,640 --> 00:29:17,140 You helped save his sister's life. Yeah, what about his mom? 563 00:29:17,440 --> 00:29:21,120 His dad? What are we going to tell that poor kid? It's not easy, but you're 564 00:29:21,120 --> 00:29:23,040 going to need to learn to compartmentalize. 565 00:29:23,820 --> 00:29:26,100 Otherwise, you're just going to keep freezing like you did earlier. 566 00:29:29,450 --> 00:29:30,590 I'm going to get better at this. 567 00:29:31,830 --> 00:29:32,830 I promise. 568 00:29:34,150 --> 00:29:35,150 CBC is normal. 569 00:29:35,690 --> 00:29:39,850 RVP and blood culture is all negative. Still, the fever's going up. It's at 104 570 00:29:39,850 --> 00:29:43,750 now. This has to be an infection. Yeah, but from what? The antibiotics would 571 00:29:43,750 --> 00:29:45,070 have treated all the usual suspects. 572 00:29:47,090 --> 00:29:48,250 The deer carcass. 573 00:29:49,010 --> 00:29:50,310 It was bleeding everywhere. 574 00:29:50,510 --> 00:29:54,550 She had open wounds. The fever, stroke, cognitive impairment. 575 00:29:54,830 --> 00:29:57,490 It's brucellosis from the infected deer's blood. 576 00:29:59,469 --> 00:30:01,650 This is the point of no return. 577 00:30:02,030 --> 00:30:04,570 All right. I got proximal and distal control with clamps. 578 00:30:05,010 --> 00:30:08,930 As soon as this comes out, every millisecond counts. I'll reattach the 579 00:30:08,930 --> 00:30:11,990 artery and bronchi as fast as I can. The rest of you do whatever you need to do 580 00:30:11,990 --> 00:30:14,570 to control the blood and keep them stable. Understood? Everybody copy? 581 00:30:14,770 --> 00:30:15,770 Got it. Yeah? 582 00:30:16,810 --> 00:30:17,810 All right. 583 00:30:18,330 --> 00:30:19,330 We got this. 584 00:30:21,670 --> 00:30:22,670 One. 585 00:30:23,630 --> 00:30:24,630 Two. 586 00:30:26,570 --> 00:30:27,570 Three. 587 00:30:32,540 --> 00:30:33,540 Serena, goggles. 588 00:30:34,780 --> 00:30:35,780 TJ, suction. 589 00:30:39,080 --> 00:30:40,080 Dr. Grant. 590 00:30:40,460 --> 00:30:41,460 Dr. Grant. 591 00:30:42,060 --> 00:30:44,300 Ben, there's air in the circuit. 592 00:30:44,600 --> 00:30:45,600 Get it out. Now. 593 00:30:45,800 --> 00:30:48,040 Turn the ventilator to 100% FiO2. 594 00:30:49,360 --> 00:30:52,600 Dr. Ferguson, get me a 60cc syringe. 595 00:31:00,490 --> 00:31:03,550 Is the doctor just taking? She's not getting any. Just need a few more 596 00:31:03,550 --> 00:31:06,270 minutes to finish reconstructing the pulmonary artery anastomosis. 597 00:31:09,670 --> 00:31:10,670 Can you get the air out? 598 00:31:14,490 --> 00:31:15,490 Amy? 599 00:31:17,770 --> 00:31:18,770 You got this? 600 00:31:22,450 --> 00:31:25,750 So... How do we rate? 601 00:31:28,030 --> 00:31:29,030 What do you mean? 602 00:31:29,120 --> 00:31:32,160 My hospital hosted the conference. You report back how we did. 603 00:31:34,420 --> 00:31:36,220 Ask me again in an hour. 604 00:32:08,940 --> 00:32:10,560 You still questioning my skills? 605 00:32:10,840 --> 00:32:12,760 Hey, my focus was on the patient. 606 00:32:13,000 --> 00:32:14,060 And you came through. 607 00:32:14,540 --> 00:32:15,540 In the end. 608 00:32:16,900 --> 00:32:18,360 That's not an apology. 609 00:32:18,600 --> 00:32:19,319 No, listen. 610 00:32:19,320 --> 00:32:22,320 What we did in there today was impossible on paper. 611 00:32:22,740 --> 00:32:26,580 I needed a rock star to get it done, and I just wasn't sure you were the same 612 00:32:26,580 --> 00:32:27,840 doctor you used to be. 613 00:32:28,720 --> 00:32:29,780 Well, now you know. 614 00:32:30,260 --> 00:32:33,300 Just as good as I ever was. With all due respect, you'd be chief of medicine if 615 00:32:33,300 --> 00:32:34,300 that were true. 616 00:32:34,540 --> 00:32:37,520 I gotta say, this is really starting to feel personal. 617 00:32:39,090 --> 00:32:41,570 How could it? We barely know each other. 618 00:32:42,870 --> 00:32:46,530 I guess nobody told you. I get memories sometimes. 619 00:32:47,710 --> 00:32:50,550 Especially when I'm triggered emotionally. 620 00:32:54,490 --> 00:33:01,450 I started to text you the other day, but I wasn't sure when was 621 00:33:01,450 --> 00:33:03,610 the right time to tell you or how. 622 00:33:04,650 --> 00:33:06,030 Tell me what exactly? 623 00:33:09,840 --> 00:33:13,740 We had, um, a dalliance. 624 00:33:15,660 --> 00:33:19,840 A dalliance? After your divorce, and it was about four years ago, on and off, 625 00:33:20,020 --> 00:33:24,560 long distance, and we mostly wouldn't meet at conferences. 626 00:33:26,180 --> 00:33:29,260 Uh, so nothing serious? 627 00:33:29,960 --> 00:33:34,860 No. And you did a preliminary review of my clinical trials as a courtesy. 628 00:33:36,920 --> 00:33:38,020 I guess... 629 00:33:38,280 --> 00:33:39,980 You didn't read anything about that in your emails. 630 00:33:40,180 --> 00:33:41,500 It doesn't ring a bell. 631 00:33:43,840 --> 00:33:45,040 How did it end? 632 00:33:45,620 --> 00:33:46,620 Us? 633 00:33:46,980 --> 00:33:47,979 Petered out. 634 00:33:47,980 --> 00:33:49,040 With no hard feelings. 635 00:33:50,720 --> 00:33:53,780 I should have called after that last night in New York. 636 00:33:55,700 --> 00:33:57,760 So, uh, we're good. 637 00:33:58,660 --> 00:34:02,820 Absolutely. And Dr. Heller is a great guy. I'm happy for you. 638 00:34:08,270 --> 00:34:11,530 You were outstanding today back at you 639 00:34:11,530 --> 00:34:18,570 Yeah 640 00:34:18,570 --> 00:34:27,630 Harpo 641 00:34:27,630 --> 00:34:32,070 that's not my name it is if I say so 642 00:34:32,070 --> 00:34:37,050 Don't make me laugh it hurts 643 00:34:38,960 --> 00:34:40,880 Mom, is she okay? 644 00:34:42,580 --> 00:34:45,179 Doctors say she will be. What about Dad? 645 00:34:45,900 --> 00:34:47,139 He's still in surgery. 646 00:34:47,980 --> 00:34:49,120 Actually, he's out. 647 00:34:50,260 --> 00:34:52,940 He's stable and resting in the recovery room. 648 00:34:54,120 --> 00:34:58,360 Now, I'm not really supposed to do this, but you want to go see him? 649 00:34:59,200 --> 00:35:00,200 Yeah. 650 00:35:03,020 --> 00:35:07,220 Just want to warn you, surgery can cause swelling, discoloration. 651 00:35:08,230 --> 00:35:09,630 Your dad won't look like himself. 652 00:35:09,950 --> 00:35:10,950 I understand. 653 00:35:15,450 --> 00:35:16,690 Look what you did today. 654 00:35:17,690 --> 00:35:20,830 You fought with everything you had to get out of that car. 655 00:35:21,130 --> 00:35:23,910 To find help, to save your family, and you did it. 656 00:35:24,430 --> 00:35:25,470 You saved them. 657 00:35:26,630 --> 00:35:29,550 You said before you thought you were ready. 658 00:35:31,470 --> 00:35:34,130 Nobody's ever ready for anything until they do it. 659 00:35:34,870 --> 00:35:36,110 But after today... 660 00:35:37,360 --> 00:35:38,840 You can handle whatever's coming. 661 00:36:07,690 --> 00:36:08,890 Are you the one who operated? 662 00:36:13,670 --> 00:36:14,670 Thank you. 663 00:36:19,870 --> 00:36:21,050 You're welcome, my friend. 664 00:36:23,030 --> 00:36:26,270 What am I thanking you for? For accepting you into the secret society of 665 00:36:26,270 --> 00:36:27,270 saviors. 666 00:36:27,750 --> 00:36:31,890 Surgery loves to steal all the glory, but we cardio kings, we had a big part 667 00:36:31,890 --> 00:36:32,890 in saving that family today. 668 00:36:33,110 --> 00:36:35,950 To be fair, I think Dr. Grant gets the MVP, but... 669 00:36:36,220 --> 00:36:38,220 Yeah, we can take some of the credit. Yeah, we can. 670 00:36:39,080 --> 00:36:41,280 People only notice us when things go wrong. 671 00:36:41,520 --> 00:36:42,760 We're basically the FBI. 672 00:36:43,120 --> 00:36:46,420 You see right there? We almost had a moment, and you ruined it. 673 00:36:51,320 --> 00:36:52,320 Great work today. 674 00:36:53,240 --> 00:36:54,240 Yeah, you too. 675 00:36:58,240 --> 00:37:02,100 Go home to your soon-to-be non-ex wife and kid, my brave squire. 676 00:37:02,360 --> 00:37:05,520 And my pursuit of domestic bliss shall continue, as ever. 677 00:37:15,530 --> 00:37:20,170 He wasn't supposed to know about that. Well, it won't come from me, but it's 678 00:37:20,170 --> 00:37:21,650 gonna get out eventually. 679 00:37:22,750 --> 00:37:25,250 And it's not fair for Amy to be blindsided. 680 00:37:26,470 --> 00:37:27,470 Yeah. 681 00:37:30,230 --> 00:37:31,230 Dr. Costa. 682 00:37:32,970 --> 00:37:34,010 Good work today. 683 00:37:44,330 --> 00:37:45,550 I expect to be paged. 684 00:37:46,510 --> 00:37:47,510 Noted. 685 00:37:54,970 --> 00:37:56,490 You didn't mention the pelvic binder. 686 00:37:56,750 --> 00:37:57,990 He understands what happened. 687 00:37:58,610 --> 00:38:00,130 No reason to rub it in his face. 688 00:38:04,510 --> 00:38:05,530 Heard you killed it today. 689 00:38:06,650 --> 00:38:07,970 I don't know about that. 690 00:38:08,910 --> 00:38:10,730 You got the first sign of the Ambalai. 691 00:38:11,210 --> 00:38:12,330 Save that little girl's life. 692 00:38:12,880 --> 00:38:14,480 And you survived Dr. Maitre? 693 00:38:16,160 --> 00:38:17,160 Barely. 694 00:38:20,020 --> 00:38:21,220 How is Ruth today? 695 00:38:21,980 --> 00:38:25,420 She's still intact and she learned some lessons, so maybe you're right. 696 00:38:26,100 --> 00:38:27,100 Good. 697 00:38:34,720 --> 00:38:41,500 I know what my reputation is. 698 00:38:42,000 --> 00:38:47,140 from when I was chief of medicine, and I suspect some of my behavior today may 699 00:38:47,140 --> 00:38:48,140 have reinforced it. 700 00:38:50,100 --> 00:38:53,900 Yeah, I mean, you acted like I was in the way when I'm here to learn and 701 00:38:53,900 --> 00:38:54,900 contribute. 702 00:38:57,480 --> 00:38:58,480 Was that too honest? 703 00:38:58,900 --> 00:39:02,260 My folks say I can be that way. No, honesty can be underrated. 704 00:39:05,320 --> 00:39:06,980 Well, I saw a lot today, too. 705 00:39:07,880 --> 00:39:10,880 I learned a lot, so, you know, thanks for that. 706 00:39:14,920 --> 00:39:16,980 I'm sorry that I behaved badly. 707 00:39:17,460 --> 00:39:18,580 I just want to do well. 708 00:39:20,460 --> 00:39:22,260 It doesn't seem like it was really about me. 709 00:39:28,640 --> 00:39:31,780 Well, I'm hearing she hasn't changed very much. From who? 710 00:39:32,900 --> 00:39:35,360 I'm sure you know that these walls have ears. 711 00:39:36,160 --> 00:39:39,860 Apparently she went toe-to-toe with our new chief of surgery today. 712 00:39:40,200 --> 00:39:43,500 They managed to work it out and save the patient. 713 00:39:44,040 --> 00:39:46,660 But she's not exactly treading lightly. 714 00:39:47,100 --> 00:39:51,240 Well, I don't think she ever will, Max. Which is why you put some serious 715 00:39:51,240 --> 00:39:55,660 guardrails on her. Around the management of her TBI, of course. And what's your 716 00:39:55,660 --> 00:39:56,920 prognosis regarding that? 717 00:39:57,400 --> 00:40:01,420 Her brain's a wild card. You know, has been ever since the accident. What is 718 00:40:01,420 --> 00:40:05,700 this? You asked to be chief of medicine knowing it meant overseeing her. 719 00:40:06,760 --> 00:40:11,180 Yes. And you understand that your success or failure in that job will 720 00:40:11,180 --> 00:40:13,580 depend greatly on how you navigate the situation. 721 00:40:14,020 --> 00:40:17,640 You know, we've had this conversation a dozen times. We've had this conversation 722 00:40:17,640 --> 00:40:19,140 when you were sitting on this floor. 723 00:40:19,420 --> 00:40:21,080 Now you're running internal medicine. 724 00:40:21,640 --> 00:40:24,640 And I know what it means to stake out a new path for yourself. 725 00:40:25,440 --> 00:40:29,160 So, if you're thinking of giving her the kind of leeway you have in the past, 726 00:40:29,400 --> 00:40:34,060 everyone knows the history there. You just said it yourself, Max. 727 00:40:34,260 --> 00:40:35,260 It's history. 728 00:40:35,800 --> 00:40:37,340 There's nothing between us anymore. 729 00:40:37,720 --> 00:40:40,960 And everyone also knows my life would be easier if she wasn't here. 730 00:40:41,180 --> 00:40:43,800 Well, if you want her gone, just fire her. 731 00:40:44,300 --> 00:40:47,000 We'll back you. I won't do that without cause. 732 00:40:47,460 --> 00:40:53,360 But rest assured, she does anything to earn my distrust or to jeopardize this 733 00:40:53,360 --> 00:40:57,920 hospital's reputation, I'll be the first one showing her the door. 734 00:40:59,820 --> 00:41:03,320 Well, that's a hell of a thing to say about the woman you once loved. 735 00:41:04,280 --> 00:41:05,360 If you mean it. 736 00:41:10,280 --> 00:41:13,140 You could say it's all my fault. 737 00:41:14,420 --> 00:41:16,940 We just couldn't get along. 738 00:41:18,300 --> 00:41:22,080 And if anyone asks me, I'll say that's true. 739 00:41:22,920 --> 00:41:26,440 What are you doing up this late? She wouldn't go to sleep until she saw you. 740 00:41:42,589 --> 00:41:45,310 There's nothing left to fix. 741 00:41:46,130 --> 00:41:49,410 You could say I lost my grip. 742 00:41:50,190 --> 00:41:53,510 Say whatever feels better. Whatever. 743 00:41:53,890 --> 00:41:55,670 You can just say I'm crazy. 744 00:41:58,210 --> 00:42:01,490 You could say it's all my fault. 745 00:42:02,530 --> 00:42:05,450 We just couldn't get it along. 746 00:42:06,550 --> 00:42:08,190 And so you know. 747 00:42:10,570 --> 00:42:16,050 No one's gonna be asking me You 748 00:42:16,050 --> 00:42:31,770 could 749 00:42:31,770 --> 00:42:37,770 say it's all my fault We just couldn't get along