Original subtitles

Previously, on Doc.

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, a dalliance. Petered out. No hard feelings.

I want to have a child.

-We've wasted so much time. -I know.

-I'm sorry. -How much cologne are you wearing?

What are you, pregnant?

-Ruth, crash cart! -Coming!

That's the supply cart!

I don't feel like a doctor.

Where is the Chief, Dr. Larsen?

She has early-onset Alzheimer's.

Cece? 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.

When 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 wanna be there...

for whatever you need.

Oh! Dear!

Bonnie?

Bonnie!

Please talk to me!

I can't feel my arm.

I'm calling an ambulance.

Hey! Got your text.

What are we 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?

Yeah.

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

and I didn't want to go downstairs,

so I need an ultrasound.

I-I know this is weird and we're not friends, but...

I also know that I can trust you.

Yes, you can.

Um...

There.

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-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-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 wait on the heartbeat.

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

Yeah.

Dr. Shaw's running behind, we haven't even gone in yet.

Okay, well, just take it one step at a time.

And give my love to Wendy.

I'm the one who's gonna need the love

if this doesn't go how we hope.

Can you at least try to let yourself be excited?

This is incredible.

There's a fine line between excitement and anxiety.

I'll check in later.

Okay, bye.

So I'm sure Dr. Maitra 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's 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. Larsen,

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. Larsen, this is Dr. Chen, and we're...

-Cece! Hi! -Finally.

Dr. Grant here was trying to pawn me off

on one of your underlings.

Dr. Larsen, 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 Larsen.

The brassy broad who saved my life at least twice.

Chief Larsen?

I... 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.

Ms. Carroll comes to us from Eastside,

where she was 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 incipient doctors were trying to shrink it

with chemo and radiation,

and now they're saying that's failed.

They believe the tumor's 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.

Mm-hmm.

If there is another way, we will find it.

-Morning! -Morning.

Heard you talking to Dr. Douglas the other day,

saying you were on a vanilla kick.

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... -Yeah.

Appreciate if kept this, y'know, efficient.

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

but you got some 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.

Uh, 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-I know you're in a rush, but...

gotta get this done.

Okay? Just sit tight.

I'm sorry.

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

I hope not. 'Cause 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.

Yeah, I guess we know why Eastside 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.

Just have to go at it with three different approaches at once.

Wa... we'll need to lower her BP before even considering this.

Not at all. We can handle it 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.

Okay, it'll be risky no matter when we attempt it.

You try to manage a 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.

Ooh.

Or maybe we pick this up in Austin next month.

Assuming you're going to the AustinMed conference.

Round three.

Only thing is, um,

my divorce is getting kind of nasty,

so if we could 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. But 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. Larsen?

It's called carotid baroreflex stimulation,

-I've done it before... -When exactly?

Three times, last year.

I see. Dr. Larsen...

A word.

I'll be right back.

When I said come up with something,

I was hoping it'd 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.

And 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 were 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.

-Yeah. -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. -Mm-hmm.

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 brought into internal medicine.

Oh.

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

-Uh... -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 'cause I'm on a 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.

Okay...

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

That's the problem. He missed all of his follow-ups

with Swanson, so there won't be any echoes.

Oh. So, what are you thinking?

We need valve gradients, leaflet motion,

ventricular function, so let's start with the TE,

-then get CBCs... -Yeah.

-CRP... -Blood cultures

to rule out endocarditis.

Yep.

Be nice if your intern was available to manage that.

It's fine. I'll order them myself.

The peak gradient's 80

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?

Uh, 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. -Okay.

120s now... Almost there!

Uh, systolic's 190 and climbing?

It's all good.

Increasing stimulation settings to compensate.

I'm feeling a bit...

Uh...

She's hypotensive, with a weak pulse.

-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, the first time in three decades.

Yeah? How are you gonna celebrate?

With this mess of a year?

Drinking a whiskey and watching the Knicks.

That sounds heavenly.

-Right? -Ben!

Thought you were heading back last night?

Hey! Um, well, Dr. Larsen cornered me

after my VATs talk and offered to lecture me

on post-op pleural effusion management.

Over lukewarm omelettes.

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.

Eliot is the Chief Research Officer

overseeing my bridge heart trial

-at St. Mark's. -Oh.

Love to get your read on it,

if you're gonna be in New York any time soon.

I'm not a cardiologist.

No, but there are a dozen medical co-morbid factors

that can complicate the trial.

Gotta make sure he's not getting a home court advantage

from our internists.

Hey, it's more than fine by me.

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

I'd love to stop by.

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

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

-Good to see ya. -Thank 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 it could've 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've been

-brought to me. -I'm assuming if that

were the protocol, Dr. Larsen would've done so.

We sorted it out ourselves,

and Dr. Grant agreed that my idea was lower risk.

And 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. Larsen 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.

Trend BUN, creatinine and urine output,

and, uh, try to let that slide off of you.

Yeah, I 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, uh, 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, okay?

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-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 seeded aortic valve.

-Oh. Who was it? -Johnny Parsons.

Aortic valve stenosis, 33,

works construction, needed a SAVR?

I can't say I remember him,

but, uh, 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've happened to anybody.

I'm referring to the post-op echo

that I can't seem to find.

That would've shown a gradient.

You never would've discharged him.

Oh, so, you're a detective now?

Or is it Internal Affairs?

Okay, well, I'm headed to radiology.

Sure hoping they can find it.

Dr. Heller?

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 on second week on the job?

You know, I was giving you the benefit of the doubt.

Now I'm not so sure it was earned.

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've 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 secreting cat echo la mines.

-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 gonna blow them out of the water.

In terms of long-term durability?

No, 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, uh, this is what the book's gonna be about?

Wha... no, no, no, I'm not publishing on this yet.

Uh, the book is about my father.

And grandfather. Both surgeons.

-That'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 cat echo la mine-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've 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-I would need to remove

the hormone-secreting tumor first,

which is a whole different scale.

Didn't you do a paraganglioma resection last year?

-You read that? -20 minutes ago.

I can do an en bloc 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 cat echo la mine 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,

metyrosine 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 admission H&Ps in 617, 621...

Your husband?

I am so, so sorry. It's the 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 a post-op echo.

-Swanson never ordered one. -Unbelievable.

That patient of yours, awhile back, um,

I think he was a delivery driver,

-what 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 seven.

So, you and I both know the echo team

would've been gone by then, so Swanson would've 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 get 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? -M-kay.

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...

You made me wait.

Wendy.

You made me wait,

and now you get to have everything that I wanted.

This is something we're gonna do together.

Sorry, I just need a minute.

Check his electrolytes every 12 hours,

-and keep an eye on his sats. -On it.

Hey, thanks for being so understanding today,

Dr. Maitra. I know I need to leave

my personal life at home.

Well, you have a kid. Some things can't wait.

Uh, 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. -Uh, excuse me?

He's my Wheaten terrier!

Oh God, a kid,

-could you imagine? -Uh, 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 wanna 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. -Mm.

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, it just...

He really had no choice of what he was gonna do.

And then, the third generation just, what, had

to follow in their footsteps?

Well, if they had been cobblers,

would I be mending soles?

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...

Things get 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 matted to the Pancoast tumor.

Can you give me more blood pressure control, Dr. Larsen?

-We'll be getting aggressive. -Nicardipine.

Fine-tuned as we go.

-Smart. -I try.

Okay, we need to time this perfectly.

You retract very slowly on your side,

and I'll release the last adherent part.

Let's pull this monster out.

Okay. Here we go.

Pressure crashing. Pushing nor-epi.

Come on.

Stuck the landing.

Alright. Let's put her back together.

So everything went great.

-I have heard that one before. -Yeah, I know.

Julie, you mind giving us the 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 gonna put you

back in the hospital a year from now.

And 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've caught that with the post-op study,

but he never ordered one.

That's why you went into heart failure again.

What, was he, um...

supposed to order one? I mean, normally,

-the surgeon would do that? -Yes. That is protocol.

So that's malpractice I could sue, right?

You can. And between you and me,

I'd be rooting for you.

But do I have a case?

I-I don't know, Johnny, I'm not a lawyer.

Then talk to me like a human being.

All I can tell you is that 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 gonna 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.

And 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, uh, my wife had an event that night, so I had...

That's the wrong answer, Roger.

I get it.

I intended to do it in the morning,

but I must've 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 week before, well,

he gets a whole buffet of post-op tests and 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 were 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.

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

Yeah, okay, so... What is this?

Suspension? Because I'm not taking a demotion.

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.

I get that, but they...

they'll self-resolve in two weeks,

so... 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've 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?

Well, how did I do today?

And the last time you were here?

Brilliance is brilliance, I suppose.

But you should've 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.

What 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'd accepted my life, and you dropped a bomb.

And I can 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?

Uh, learning by osmosis, I hope.

Claire told me that you snapped at her.

Well, there's a role reversal, huh?

-Hmm. -So, you're still freaking out.

I think so, yeah.

About which part?

Well, pretty soon, I'm gonna 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, Sonya. 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.

And you can't control what life is gonna throw at you.

All you can do is lean in.

I hear you caused quite the ruckus in surgery today.

And gave our general council 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, that's not what...

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've 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. Larsen.

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?

Yeah, 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-I'm not.

Okay?

This is beautiful.

I'm gonna take care of you.

No matter what. You don't have to worry.

'Kay, I won't.

We can do this.

Hey.

Hey!

Bonnie's doing well.

I hope we got it all.

I'm 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 check in 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 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.