Original subtitles

Previously on Doc. I wasn't sure if you were the same doctor you used to be. Now

you know I'm as good as I was.

We had, um, dalliance. It petered out. No hard feelings.

I want to have a child.

We've wasted so much time. I know.

I'm sorry.

Which cologne are you wearing? What are you, pregnant?

Ruth, cross-collar coming.

That's the supply cart.

I don't feel like a doctor. Where is the chief, Dr. Larson? She has early onset

Alzheimer's. You see? It was your heart all along. You're going to get your life

back.

It was beyond frightening.

I actually thought I had Alzheimer's for almost a year.

But then my amazing doctor at Westside figured out it was an issue with my

heart. I wish you'd told me.

You thought you were so sick. What was I going to say?

I'm losing my mind? Come quick, let me apologize for all those things I screwed

up in our marriage?

Wouldn't have minded that.

Wouldn't mind it now either.

Since who knows how long I have.

Don't talk like that.

I have an inoperable tumor, Cece. What do you want me to say? That you're going

to fight. I am.

I have been. I know. But now that my own medical ordeal has been resolved, I want

to be there for whatever you need.

Dear Bonnie.

Bonnie.

Please talk to me.

I can't feel my arm.

I'm calling an ambulance.

Hey, got your text.

What are you doing here?

I'm having kind of a crisis.

I got that from the way you ran out last night. I've been worried.

I know. I'm sorry I didn't respond till now.

Okay, what's going on?

Nothing.

My OB couldn't get me in till next week.

And I didn't want to go downstairs, so I need an ultrasound.

I know this is weird and we're not friends, but I also know that I can

trust you.

Yes, you can.

There it is.

CRL suggests seven weeks.

Oh.

So we can hear the heartbeat.

Are you sure?

Yeah. I've been up all night, and I'm sure there are a million reasons why I

should just keep going with my life as it is. And thank God I have the right to

choose, but...

We see so much death here every day, and this just feels like I can do this. And

why not see this as a blessing?

I mean, I can do this, right? I have a great job and financial security and a

community. And TJ?

Yeah, yes, of course.

TJ.

You haven't told him yet.

We're having dinner tonight.

I just need the day, I think.

Then maybe you wait on the heartbeat.

So you can hear it together when it's time.

Yeah.

Dr. Shaw is running behind. We haven't even gone in yet.

Okay, we'll just take it one step at a time. Give my love to Wendy.

I'm the one who's going to need the love if this doesn't go how we hope.

Can you at least try to let yourself be excited?

This is incredible.

Some fine line between excitement and anxiety.

I'll check in later.

Okay, bye.

So I'm sure Dr. Major told you.

She thinks I have a problem with compartmentalization.

Look, we all have our stuff.

We just have to be aware of our blind spots and triggers and try to stay ahead

of them so they don't affect our work.

Well, I just want you to know that I've... been working on it and i feel

really confident that i'll be able to deal with whatever is thrown my way ruth

i'm glad that you're acknowledging this but i think you need to slow down and

hear me you are not going to solve this in one day i know you have a

relationship with dr larson but there are other internists i can bring in if

she's unavailable absolutely not she's the best and we will wait hi i'm

dr larson this is dr chan and we're cc Hi, finally.

Dr. Grant here was trying to pawn me off on one of your underlings.

Dr. Larson, meet Bonnie Carroll, tenured professor of archaeology at the U of M.

She was also once married to yours truly, but that's the least of her

accomplishments. Bonnie, this is Chief Larson, the brassy broad who saved my

life at least twice.

Chief Larson?

It is so good to see you, Cece, but I have a confession to make. I am

no longer chief.

They demoted you? No, not exactly. I had a car accident, and I was recovering

neurologically. So the last time I saw you, I was actually working as an

intern. You told me you were chief.

You were pretty unstable and insistent that you saw the doctor that you

remembered. Sounds like you, Cece.

So you lied.

I did.

To help you.

I've been promoted to chief resident.

But if you prefer, we can ask the new chief of medicine to come and see you.

Will you enlighten her, Dr. Grant?

Yes.

Miss Carol comes to us from Eastside, where she's being treated for an

unresectable pancoast tumor.

Biopsy confirmed, lung adenocarcinoma in the right upper lobe. She has weakness

in the right arm with near-complete paralysis.

In grip for 24 hours.

So the tumor has infiltrated the lower brachial plexus. Those insipid doctors

were trying to shrink it with chemo and radiation, and now they're saying that's

failed. They believe the tumor is inoperable given the invasion of the

subclavian artery.

They're recommending palliative care. And we refuse to accept it.

Present us with another option.

Dr. Chen, get full admissions labs and update the staging scans.

If there is another way, we will find it.

Morning. Morning. Heard you talking to Dr. Douglas here today, saying you want

a vanilla cake.

Ah, I am.

Thank you.

You're on clinic duty today.

Clinic duty.

That a problem?

Not at all.

Paige, Dr. Heller's yours today.

Full house down there. Get ready to move some meat.

Hey, listen, Doc, I am due back at work in an hour, so I would appreciate if we

kept this, you know, efficient.

Yes, sir, I'm going to try my best, but...

I guess I'm catching up to do. It looks like you missed all of your appointments

after your aortic valve replacement last year. Yeah, I am sorry about that.

Recovery took a lot of months, and I'm still paying that off, so I can't really

miss work.

Also, Dr. Swanson said that the surgery went well, so...

Have you been feeling sick lately?

Fatigued? I mean, yeah, but I've been working a ton of overtime at the site.

Okay, well, I need to run a few more tests, but it's all routine. I'll get

the procedure set up as soon as I can.

Are you serious? I know you're in a rush, but I've got to get this done.

Okay? Just sit tight.

I'm sorry.

I didn't know what you were stepping into earlier.

I hope not.

Because I kind of caught you enjoying it a bit too much.

I was just trying to figure out how you pulled it off with Cece. What do you

mean? What people tell me is that this version of you is pretty different than

the one back then.

Dr. Coleman, just in time.

Whoa, that tumor's a beast.

Yeah, it's infiltrating the subclavian artery, vein, and brachial plexus. It's

even growing around the vertebrae. I guess we know why Issa refused to cut

into it. Plus, her uncontrolled hypertension from the chemo puts her in

danger of having a stroke mid-operation.

They were right.

You can't get it.

They can't get it. I can.

How's that?

Most surgeons don't have the stomach or the stamina to resect it. You just have

to go at it with three different approaches at once.

We'll need to lower her BP before even considering this. Not at all. We can

handle ourselves in the OR.

A lot better if I find a medical solution first.

Now, we have been down this road before.

That man had antlers in his chest. Plus, we don't have to scramble with this

patient. It'll be risky no matter when we attempt it. You try to manage her

risk away and she'll die waiting.

Where are you going? I'm taking my solution to them. Now, if you have a

better idea, be my guest.

Pitch it.

I need some time.

Don't let him start cutting.

You sure you have to go?

My panel starts in an hour, and then it's straight to the airport.

I'm just saying we have the room till 11, and these panels, they never start

on time.

Or maybe we pick this up in Austin next month.

Assuming you're going to the Austin Med Conference.

Round three.

Only thing is, my divorce is getting kind of nasty, so if we can just keep

this on the down low.

Yeah, how about if we're in the same city?

If it makes sense.

There's no need to make it into something it's not.

Yeah, and let's say no texting.

To be safe, just calls.

Yeah.

So you've done this before?

Well, not this approach exactly, but I've dealt with a lot of complex

invasive tumors, and this will take more time. It's not impossible.

Still, you have not done this.

I'm not sure I love the sound of that. What choice do we have?

Palliative care? This is amazing news, Cece.

Sorry I'm late. I was doing my own assessment of Bonnie's condition.

Good, because he's selling us on a surgery he's never performed before.

The surgery's a legitimate solution, but Bonnie's blood pressure needs to be

stabilized first, and I have found a way to bring it under control with fewer

risks. He said he could manage the blood pressure, and he's the chief of surgery.

Everyone told me I had Alzheimer's, and look at me now.

What's your plan, Dr. Larson?

It's called carotid baroreflex stimulation.

I've done it before.

When?

Exactly. Three times last year.

I see, Dr. Larson.

A word?

I'll be right back.

When I said come up with something, I was hoping it would be a procedure you

remember, not one you had to find in your old notes.

My notes are thorough, and at least I've done the procedure.

Are you going to tell Bonnie and Cece that you never actually recovered

neurologically? My memory loss isn't an issue here.

Bonnie could die on the table if we do it your way. What I'm presenting is

lower risk, and if you actually read my notes, you will see that all three

patients were in much worse condition than Bonnie. Right now, her BP's high,

but it's predictable. If you destabilize it, then surgery is off the table, and

we're out of options.

Thank you for taking time today to come see what I've been doing.

Did you think I was a good doctor when you knew me before?

You're brilliant.

That hasn't changed.

So how about you trust me this time?

Okay.

I will.

Before I give you numbers, I want you to remember that you're an individual, not

a statistic.

We've done all the research and we know the odds. We're here because we know we

need your help. So you know that it could be very difficult. The important

thing is you came here today because at this point... Every day matters.

I've been taking really good care of myself.

And we have faith.

Well, I was honestly assuming we would test both of you.

Both of us?

Why not?

Um, I'm 48.

And I've had patients give birth to beautiful, healthy children as old as

51. You're here.

Might as well see what we're working with.

More doctors? I know you're anxious to get out of here, but unfortunately your

stress test results indicate you might need to be admitted to internal

medicine. Oh my God, I'm so sorry. It's my husband.

Hello?

What is this, a circus?

I'm sure that was important.

He's 13 months post-surgical aortic valve replacement of a congenital

bicuspid valve. Heard a new murmur on exam and he reports worsening fatigue

upon exertion. That's also because I'm on construction site 12 hours a day.

What's going on?

I'm afraid you're in heart failure again.

What? Dr. Swanson said this would be over after surgery. Now I need another

one?

I can't afford to miss two more months of work.

Let's just take this one step at a time.

We need to figure out how long his heart's been in failure.

That's the problem.

He missed all his follow-ups with Swanson, so there won't be any echoes.

So, what are you thinking?

We need valve gradients, leaflet motion, ventricular function, so let's start

with TE, then get CBC, CRP. Blood culture is to rule out endocarditis.

Be nice if your intern was available to manage that.

It's fine.

I'll order them myself.

Pete Grady and Sadie and the leaflets are barely moving.

Well, that valve's critically obstructed. No wonder he's back in heart

failure. I'll call surgery.

Thanks, Mike. We can take it from here.

Swanson didn't implant the valve correctly.

Well, a post-op echo would have showed that. He should never have been

discharged. It's not here.

He never ordered it? I don't know, but it's not here, and I need to find out

why.

So what we're doing here is using electrical pulses to trick your brain

into lowering your blood pressure. How are her vitals?

BP is 195 over 100, heart rate 85.

Hi, I'm Dr. Hamda, Chief of Internal Medicine.

Cece suggested I might pay a little visit.

She does love authority figures.

So, carotid baroreflex stimulation.

Did you want to supervise? I'll observe and assist if needed.

Great.

Are you ready? I trust Cece, and she trusts you.

You tell us if it gets too much for you, okay?

Increasing frequency to 80 hertz.

Systolic's down to 150.

So far, so good, Bonnie.

You doing okay?

Feels weird, but I'm fine.

120 is now almost there

systolic 190

and climbing it's all good increasing stimulation settings to compensate

I'm

feeling a bit

She's hypotensive with a weak post. She's losing consciousness.

Crash cart, now!

Bonnie?

Bonnie, can you hear me? Bonnie?

I'm on my own for my birthday this go-around. Actually, first time in three

decades. Yeah? How are you going to celebrate?

With this mess of a year, drinking whiskey and watching the Knicks.

That sounds heavenly.

Right? Ben!

Thought you were heading back last night.

Hey! Um, well, Dr. Larson...

Cornered me after my VATS talk and offered to lecture me on post-op pleural

effusion management over lukewarm omelets.

An offer he couldn't refuse.

Understandable. Your reputation precedes you. Elliot Norman.

A pleasure. Yeah, I feel like I know you from all of your acknowledgements in

JAMA. Angling for another one soon if Ben gets his way. Elliot is the chief

research officer overseeing my bridge heart trial at St. Mark's. I'd love to

get your read on it if you're going to be in New York anytime soon.

I'm not a cardiologist.

No, but there are a dozen medical comorbid factors that can complicate the

trial. Got to make sure he's not getting a home court advantage from our

internists. More than fine by me.

I'm actually passing through New York in a couple weeks.

I'd love to stop by.

Splendid. Ben can give you the details from my office.

I'll make sure your hotel and flights are covered.

Good to see you.

Couple of weeks?

Well, it seems like he really wants me there.

So, she is in a medically induced coma for hypertensive crisis.

The increase in stimulation was minimal. There's no way I could have bottomed out

her BP like this. What's the MRI show?

There's no anoxic brain damage.

I'm loading her on phenytoin. And an EEG.

I don't need her seizing on my table if you ever manage to get her there.

I'm sensing you had a stark difference of opinion about the correct course of

action. We did, yes.

Well, that should have been brought to me. I'm assuming if that were the

protocol, Dr. Larson would have done so. We sorted it out ourselves, and Dr.

Grant agreed that my idea was lower risk.

Obviously, I was wrong.

I just got off the phone with Eastside. I want her transferred there now. That's

not possible, Ms. Reinhold. She's in no condition to be moved.

There is a variable that we all missed, but as soon as I find it, we will

address it before there are any more complications. You need to trust me. I

already made that mistake.

Labs just came back.

BUN and creatinine are elevated, but TSH is normal. Okay, thank you, Ruth.

If Bonnie's going to stay here, I want you, the head of the department, taking

charge. And maybe you can figure out what Dr. Larson and this little intern

did that has backfired so disastrously.

Now, outcomes can't always be predicted, and Bonnie was in terrible shape when

she walked in our door.

But we hear you, and I'll be running point on this from here on out.

If you'll excuse me, I'll have to explain to her family why they may never

get to say goodbye to her.

I'll be standing by if you can ever find your way back from this.

Dr. Chen.

Tren, B-U-N, creatinine, and urine output.

And try to let that slide off of you.

Yeah, appreciate that.

I'm fine. I'm going to insert a central line so we can monitor her CVPs and

fluid status.

And get me your notes on those old cases.

Michael, I don't know yet what went wrong, but it was the right call.

So Dr.

Swanson's not here?

He is tied up in another surgery at the moment. But listen, Dr. Humphrey is

excellent. Okay, we're lucky that he was on call.

He reviewed your TEE, came up with an airtight game plan. I don't understand

what went wrong in the first place.

We're still trying to get to the bottom of that.

Okay, but listen, right now the important thing is that we solve this

problem once and for all, okay?

Thanks, Doc.

I do appreciate it.

See you in post-op.

Hey, Roger, you got a sec?

I got 60.

Listen, I wanted to give you a heads up that one of your patients was readmitted

with an improperly seated aortic valve.

Who was it?

Johnny Parsons.

Aortic valve stenosis, 33, worst obstruction, needed a SAVR.

I can't say I remember him, but I'm happy to get back in there and patch him

up after this.

Yeah, he's already in surgery. Humphrey was on call.

And I'm just hearing about it now?

I would have had a duty to disclose your potential negligence before allowing you

to operate on him again, so this just felt more expedient.

Negligence? I'm not talking about the valve. That could have happened to

anybody. I'm referring to the post-op echo that I can't seem to find.

That would have shown a gradient.

You never would have discharged him. Oh, so you're a detective now, or is it an

internal affairs?

Okay, well, I'm headed to radiologists. You're hoping they can find it.

Dr. Heller, the proper protocol.

Would have been to go to the head of the department.

Does Dr. Matos know you're running around like this?

First year fellow and a second week on the job.

You know, I was giving you the benefit of the doubt. Now I'm not so sure it was

her.

Dr. Swanson, we're ready for you.

So, none of your other patients had a BP spike like Bonnie's, even though they

were in the same hypertensive range?

No.

Which makes her reaction all the more puzzling.

I'm not sure how you could have ever liked her.

She uses anger to cover her grief, and I know a bit about that.

I'm sure you've heard.

Bonnie's EEG tracing continues to be within normal limits, but now her

temperature's all over the place, too. She's been as high as 102.

Do the fluctuations track with her blood pressure spikes?

Almost to the second.

We've been treating the tumor like an adenocarcinoma, but what if there's more

going on?

Divergent differentiation.

So the tumor consists of two different cell types, not just the one. Exactly.

So what kind of tumor cell could explain simultaneous spikes in both blood

pressure and body temperature, Dr. Chen?

One's recruiting calicholamines. Yeah. Go get plasma metanephrines. Yeah.

If you're right, delaying surgery saved her life.

Pharmacadia's device only lasts two years and a quarter of the patients die

waiting for transplants. This is going to blow them out of the water.

In terms of long-term durability?

Not just durability. This could be a permanent solution.

Oh, you're getting a little bit ahead of yourself.

Well, a man can dream.

So this is what the book's going to be about? No, no, no. I'm not publishing on

this yet.

The book is about my father and grandfather, both surgeons.

It's quite the legacy.

Both giants.

Dad still is.

Well, I'm sure this will make him very proud.

Well, he's a tough one. We'll see.

So what is it that Elliot wants me to look at?

A catecholamine-secreting tumor.

And Eastside had no reason to look for it after the initial biopsy. But

clearly, the chemo is not what was causing her BP spikes.

And if I'd resected her tumor the way I planned, the hormone secretion into her

bloodstream would have killed her. In all likelihood, yes.

In all certainty, but I appreciate you not rubbing it in my face.

Not really my style.

At least, not anymore.

I gave Cece the update and told her we're deciding best course of action.

Can you still operate?

Well, I was hoping to do a three-stage approach, but now I can't. I mean, I

would need to remove the hormone-secreting tumor first, which is

a whole different scale.

Did you do a paraganglioma resection last year?

You read that?

20 minutes ago.

I can do an in-block removal in my sleep, but her tumor's like an octopus

now. And it's in her lung, not her bladder, like in that surgery.

Plus the catecholamine release.

The second you touch it, she could stroke out. And we're talking six, maybe

eight hours poking around in there.

Phentolamine for any hypertensive surges, metirozine to suppress the

hormone production, and titrate minute to minute.

It would be on me.

I'm game if you are.

It's up to him.

Once Johnny's out of surgery, do a post-op exam and present your findings

to me. Till then, it's admissions H&Ps in 6-17, 6-21.

Your husband? I am so, so sorry. It's a sitter.

My husband's out of town and our little guy isn't feeling well.

Oh, um, it's okay.

Take it.

Hey, how's he doing?

So, radiology doesn't have the post-op echo.

Swanson never ordered one.

Unbelievable. That patient of yours a while back, I think he was a delivery

driver, was his name Abe? Yeah, what about him?

Didn't you tell me that Joan had to step in because Swanson closed up mid-surgery

or something to go on vacation?

Well, it wasn't quite that simple, but yeah.

What are you, building a case?

Well, I checked into the timing of Johnny's surgery last year. It was

Friday night at 7.

So you and I both know the Echo team would have been gone by then. So Swanson

would have had to call someone in, wait around for hours.

So you think he never ordered an Echo because it was inconvenient?

I don't know. Could be.

But can you give me the records on that case?

I can.

Okay. But you should tread lightly.

You're already on probation with Matos.

Email it to me, okay?

Okay.

Sorry to keep you waiting.

The results are showing a more complicated picture than we had hoped,

but ultimately there's a path forward here.

Okay.

So, Wendy, I know this will be disappointing, but your ovarian reserve

has become very low.

With Gina, however, there's good news.

Your eggs appear to still be viable.

Really? Well, as I said, you're an individual, not a statistic.

And we can get started with treatments as soon as tomorrow, which I would

recommend.

You made me wait.

Wendy. You made me wait and now you get to have everything that I wanted.

This is something we're going to do together.

Sorry, I just need a minute.

Check his electrolytes every 12 hours and keep an eye on his stats.

On it.

Hey. Thanks for being so understanding today, Dr. Mitra.

I know I need to leave my personal life at home. But you have a kid.

Some things can't wait.

No, I don't have a kid. That was about my dog.

I mean, he's a puppy and we're training, so it's a lot right now.

Excuse me?

He's my Wheaton Terrier.

Oh, God, a kid? Could you imagine?

Lots of doctors have kids.

Well, I would never.

I mean, climate change alone.

Okay, that is the most cynical thing I've ever heard. You just want to give

up on humanity?

It's just an opinion.

Kind of thought we were all entitled to one. Just get back to work, Claire, and

no more calls.

Oh, um, the nurses said you might have a second to talk, but it's a little

delicate, so I'll come back later. No, no, no. You're looking at the closest

thing I have to free time today, so shoot.

We need to talk about Swanson.

Tell me about your book.

Well,

my grandfather studied at Howard under the great Daniel Hale Williams.

No. Yeah, and by the time my father came around, living under the shadow of a man

who studied with the pioneer of open-heart surgery, he really had no

choice of what he was going to do.

And then the third generation just had to follow in their footsteps.

Well, if they had been cobblers, would I be mending souls?

Probably not.

No, what they did was inspiring.

I'm the first generation in my family to even go to college, so it's all upside

for me.

Thank you for taking time today to come see what I've been doing.

Heart rate's spiking.

Pushing esmolol.

You see that translucent area under my probe, Dr. Coleman?

Looks more like a cyst than a tumor.

That's a bag of adrenaline.

If we squeeze it or if we rupture it... Makes it very interesting for me.

Her BP's stable.

I'd appreciate you keeping it that way.

All right.

Retract very gently on your side.

Easy, easy.

It's a matter to the Pankow's tumor. Can you give me more blood pressure control,

Dr. Larson? I need to get aggressive.

Nicotipine. Fine-tuned as we go.

Smart. I try.

Okay. You need to time this perfectly.

You retract very slowly on your side, and I'll release the last editor in

part.

Let's pull this monster out.

Okay. Here we go.

Pressure crashing.

Pushing norepi.

Come on.

Stuck the landing.

All right, let's put it back together.

So everything went great. I haven't heard that one before. Yeah, I know.

Julie, you mind giving us a room?

Look, man, I know today's been a terrible day and you have every right to

be upset, but... The good news is we know you don't have something that's

going to put you back in the hospital a year from now.

How can you be sure of that?

Because the problem was surgeon error.

The valve that Swanson put in was placed incorrectly.

Now, they should have caught that with a post-op study, but he never ordered one.

That's why you went into heart failure again.

Was he supposed to order one? I mean, normally the surgeon would do that?

Yes. That is protocol. So that's about practice. I could sue, right? You can.

And between you and me, I'd be rooting for you.

But do I have a case? I don't know. Johnny, I'm not a lawyer.

Then talk to me like a human being.

All I can tell you is if I'm deposed, I will tell the truth.

You're saying he almost killed me.

So why isn't this a slam dunk?

The thing is, you did skip your follow-up visits.

And that delayed the diagnosis.

So this is on me?

That's what the hospital's going to argue.

Yeah. So he's going to get away with this and be able to do it to other

people. I've already talked to the chief of surgery.

I'm hopeful that he can have more eyes on him from now on.

That's supposed to be enough.

Tell me about Johnny Parsons.

Dr. Heller came to you.

Radiology says you never ordered a post-op echo.

Is that true?

Look.

I checked the date, and my wife had an event that night, so I... That's the

wrong answer, Roger.

I get it.

I intended to do it in the morning, but I must have gotten slammed.

It won't happen again.

Are you sure about that?

Excuse me?

Two months ago, a hotshot attorney needs a heart procedure, and you come in on a

Saturday and stay until midnight.

A real estate mogul the week before, where he gets a whole buffet of post-op

tests and the VIP treatment, but a delivery driver comes in a couple months

back, and you left him to catch a flight to the Bahamas. There were complications

in that situation. Which you are uninterested in resolving because of

your vacation.

You're cherry-picking a couple cases out of a 23-year career.

In my experience, where there's smoke, there's fire.

I don't like the way this smells, Roger.

Yeah, okay, so what is this?

Suspension? Because I'm not taking a demotion. No, there's no need. You're

fired.

Four months severance. Leave your badge in your locker.

Ah, excuse me.

Hey there.

Good timing. I just confirmed the hotel in Philly.

Ben, I'm reviewing some of your data. I don't love the trends in some of these

bicarbs. And serum creatinine levels are elevated.

I think you've got a big problem here.

Yeah, I get that, but they'll self-resolve in two weeks. I'll send you

the kidney numbers on the phase one trials, and you'll see.

You did the right thing bringing her here.

And trusting Dr. Grant.

And you.

I should have known you'd find what was overlooked.

I lost Bonnie once, and I was scared of it happening again.

Well, I appreciate that, but I get it.

What happened to you in your accident, the neurological issues?

I lost eight years of my memory.

When you came in here last year, I didn't even know who you were.

So it's all been an act even today? No, I'm all caught up on the medicine.

The memory loss doesn't affect how I do my job.

You sure about that?

How did I do today?

And the last time you were here?

Brilliance is brilliance, I suppose.

But you should have told me before.

I like to think it's my business.

If I told every patient who came through that door what I've been struggling

with, do you think they'd let me treat them?

I'm not giving up this gift I have, but I can do with it for others.

Well, I know what it's like to be forsaken.

This will stay between us.

I hope Cece said thank you.

She did.

And she apologized.

And I explained to her why I ran that charade on her a few months ago.

So you two are okay now?

We were okay then.

Conflict can be healthy.

Even sometimes when it looks unhealthy.

So what?

Embrace the mess?

I think you're learning.

I'm sorry that I made us wait.

I had accepted my life, and you dropped a bomb.

And I could only imagine how much that must hurt.

But I asked Dr. Shaw, you can carry the baby.

The child will be ours. We will do it together, and it will be incredible.

It's just not the vision that I had this morning.

It's okay if you want to be mad at me.

I can take it.

I don't want to be mad at you.

How you doing?

Long shift.

How's Ruth doing?

Learning by osmosis, I hope.

Claire told me that you snapped at her.

Well, there's a role reversal, huh?

So, you're still freaking out?

I think so, yeah.

About which part? Well, pretty soon I'm going to be waddling around trying to

train these people with all the street cred of someone about to go on maternity

leave. Oh, that can be handled, Sonia. Come on.

I know. I... It's TJ.

We've been together for four months.

Do you think this is what he signed up for?

He won't run from his responsibilities.

No, of course not. He's TJ.

He'll say all the right things. He'll do what needs to be done. But from this

point on, I'll never know if that's what he really wants.

Or if it's what I really want.

Do you love him?

I think we were on our way.

But now we'll never get a clean shot to figure it out.

And...

I don't want him to be with me out of obligation.

You know, look, you're right. He will say and do all the right things. But if

you obsess about whether or not you're both forcing it, the relationship will

be doomed. I know that. Trust me, I do.

Love is a risk.

Always.

You can't control what life is going to throw at you. All you can do is lean in.

I hear you caused quite the ruckus in surgery today and gave our general

counsel a liability scare.

I was just advocating for my patient.

And why wasn't I looped in? I wanted to come to you with a solution rather than

a problem. You didn't come to me at all.

I had to hear about it from Ben Grant.

I wanted to avoid putting you into a difficult situation. I know you and

Swanson have a long-standing relationship.

So now you're suggesting that I wouldn't have handled it objectively. No, no. Not

for nothing. But I thought that Swanson was a tool 20 years ago.

I think he's a tool now.

But he is a reasonably good doctor, and what you did today got him fired.

I think I can live with that.

I'm glad your conscience feels clear.

Dr. Grant can make whatever decision he wants in his department, but he should

have made it after talking to me, not to you.

That's the protocol.

Understood. Won't happen again.

I suppose you're learning how things work when you don't have special

privileges.

Excuse me? Well, I get the sense you had a very wide berth with Dr. Larson

because of your romantic relationship.

So that's what this is about?

It's a question of character, Dr. Heller. Character informs judgment.

And from what I've seen, yours is severely lacking across the board.

There you are.

Hey, we really can't be late. It took me forever to get us reservations to this

restaurant. I'm pregnant.

About seven weeks.

Okay.

Wow.

Wow. That is... I only found out yesterday.

And you already did the ultrasound?

This morning.

I'm keeping it, TJ.

Right, right, right, for sure.

We can handle it. You don't have to say that. Whatever you're thinking, if

you're freaking out, it's fine. I'm not, I'm not.

Okay?

This is beautiful.

And I'm going to take care of you.

No matter what, you don't have to worry.

Okay, I won't.

We can do this.

Hey.

Hey.

Bunny's doing well.

I hope we got it all.

Sorry to start the day going toe-to-toe like that and for not giving you the

benefit of the doubt when things went wrong.

I think maybe we're both used to being the smartest person in the room.

Oh, for sure.

Anyway, you'll have a couple days with me out of your hair. I'm headed to New

York tomorrow to... Checking on my clinical trial. I heard it's being

transferred here.

Yeah, that's what I'm organizing now.

Is that the trial that I consulted on?

It is.

And I'm happy to have you wander down to us whenever we get it up and running.

I don't love the trends in some of these bicarbs.

Look forward to it.

Good.