Original subtitles

Previously on Doc...

You having memory seizures? - Intense memories.

Go ahead and start on these.

What's the status of your transplant trial?

I'll be bringing in some of my New York people,

including Sasha.

Didn't Dr. Larsen consult with you on this

a few years ago?

We've got a big problem here.

She did, but she wouldn't remember that.

One of my donors just dropped out.

Anything I can do?

You want me to put in a good word with my father?

Nina's stepson is one of our most promising interns.

Did you antagonize her?

Just so you know, Dr. Larsen was down on the fourth floor.

I get the feeling they didn't clue you in.

What the hell is going on down here?

You're here to finalize your wedding registry?

Are these two not the cutest frickin' thing

you've ever seen?

So when's the big day?

You know, I really think we need a minute here.

Okay. Uh, but, you're running out of time.

You're not like, worried for real?

Well, he is windsurfing right now, and I'm here.

Yeah, well, he's a dude.

I gotta tell you,

the way he stormed out this morning,

I don't know if he's even coming back.

Hello? Is this Kat Keating?

Yes.

This is Dr. Walker calling from Westside Hospital.

You're the emergency contact for Rob Landis?

Yes. Is something wrong?

I'm sorry to tell you, but Rob was in an accident.

He was found unconscious at White Bear Lake.

Um... wait, um, what are you saying?

Unfortunately he's in a coma.

But he's gonna wake up, right?

He'll wake up, right?

A granuloma.

Forming around the bone fragment

and irritating the hippocampus.

Which is causing the memory seizures.

Most likely, yes.

I haven't had any since I started taking the medication.

Well, okay, but if the nodule keeps growing...

It's likely the seizures will return,

and they could become incapacitating.

Well, I can't have you performing procedures

until we understand what we're dealing with.

And I'll have to read the board in on all of this,

for everyone's protection.

As long as I can keep seeing patients and diagnose.

Absolutely.

Well, I'm sorry, Amy.

I know this isn't what you wanted to hear.

It's fine.

I'll get started on my rounds.

So, no procedures?

I can farm them out

to specialists as they come up.

Are you all right?

Temporary speed bump.

But now reason for the interns to know about it.

Just keep an eye out for Graham.

Still have no idea why he tried to turn us against each other.

He's a spoiled brat who is used to

pushing boundaries and getting his own way.

Mm. I'm afraid it's more than that.

I think he's a snake.

Go do your rounds, I will deal with him.

Trouble in paradise?

Do you have your assignments, Claire?

I do. Just waiting for Dr. Barrett.

Go find her.

'Kay.

What's up?

I think it's important you understand that Dr. Maitra

and I are entirely in alignment. - Glad to hear. Of course.

Good.

Dr. Park needs you in 618.

Great.

- And Graham? - Yeah?

I'd think twice before having your stepmother

interfere with our work here.

Hey, uh, Dr. Larsen said you needed me for something?

Perfect timing, just about to start his enema.

Enema?

You'll probably need to flush it through

several times.

Report back when it's clear. - Mm-hmm.

I hate to say it,

but I agree with Michael.

At least in the short term.

- I get it. I'm not pushing back, Gina.

Now, you asked for a consult?

29-year-old male.

He's had long-term life-supportive care.

Windsurfing accident four years ago.

Complete unresponsive state until last week.

That's when I saw the first BP spike.

BP spike doesn't indicate a change in cognitive status.

Second one was 10 minutes ago.

Both times they happened when I was reading to him.

I assume you've done a coma recovery scale periodically.

- Every three months. Nothing.

But this week, there's this change.

So, now you're thinking...

Emerging consciousness.

I want CMP, CBC, a full workup,

and then an fMRI.

It's a ten-point jump.

Humor me.

After six years of painstaking research,

we've reached the human phase

of our artificial heart trial.

Which represents hope to thousands of people.

When this proves successful,

the people who receive our artificial heart

will be tacking on years to their lives, yes,

but the ultimate goal, our holy grail,

will be for this to last long enough so that our patients

can live full lives without ever relying on an organ donor.

Our sentinel cohort of three patients

will arrive on separate Medevacs

taking off in the next hour or two.

Each one has a different form of end-stage heart failure.

Diverging symptoms, diverging risk profiles.

Which is why they were chosen after exhaustive reviews

by us and the IRB.

Now, those flights will likely create further complications,

so Dr. Douglas and Heller are on loan from Cardiology

to assist with managing them

and maintaining patient stability

in preparation for their surgeries.

The three-cohort mandate stipulates one surgery per week.

If one of them crashes,

the whole enterprise comes to a grinding halt.

Make no mistake.

This is gonna be a wild ride, so I need everybody here,

everybody... firing on all cylinders.

Such a fuss over a little wheezing.

You know the asthma's related to your EGPA.

So, like it or not,

you're gonna get the full workup.

I was supposed to see my grandbabies today.

They're like actual little people now!

They're beautiful.

Uh, any other symptoms flaring up?

Some numbness in my hands.

- Pulmonary function test? - Please.

Yeah.

So, we haven't talked about you.

I certainly hope you have a boyfriend by now.

Matter of fact, I do.

He's a doctor. - Don't tell me.

Dr. Heller? - Uh, no. Dr. Coleman.

TJ?

You've met him. He works here.

Show me a photo.

Oh, I remember him.

Yeah?

- He's a good egg. - Yes, he is. For sure.

What happened to the Wicked Witch of Westside?

Uh, still haunting the halls?

Hi, Rob.

It's Dr. Walker, I'm sure you know

my voice by now. I'm gonna ask you

a few questions, okay?

If your answer's yes, I want you

to think of swinging a hammer.

If your answer's no,

I want you to think of what your apartment looked like.

Do you live in California?

- Hippocampal activation. That's a "no"!

Reading you loud and clear, Rob.

Do you live in Minnesota?

- Motor area. Affirmative response.

Okay, how about your fiancée, Kat?

Motor, again, affirmative.

Okay, that is great, Rob.

Now, do you remember having an accident?

Nothing.

Do you remember having a windsurfing accident?

That's a negative.

But, even if he's conscious,

that could be just a black-out area.

These could be random bold fluctuations.

We could be reading the tea leaves.

Darrin, how long to switch to a vascular MRI?

15 minutes for the IV contrast.

Do it now.

You see this distorted vessel?

That's what's causing the BP spikes.

He's having an aneurysm.

So how are those study numbers looking?

I was right, wasn't I?

I thought they'd improve once the post-op inflammation...

No you didn't.

You're too smart for that.

You knew the study was flawed long before I pointed it out.

You're the only one that noticed.

Elliot wants me to do a report

for the Institutional Review Board.

He wants a formal assessment.

I didn't know that.

Well, I guess you're gonna need

my help fixing the problem, then.

I feel like the bionic man...

All these wires hanging off me.

He has been making that joke all day.

Wait 'till we get that titanium heart into him.

Then he'll really be off to see the wizard.

I think you might be mixing up your pop culture references

there, Dr. Douglas, but yes,

he's right, we're gonna take good care of you, okay?

Are the other patients here?

Not yet, but they're arriving today.

What's wrong?

So, he's got some fluid on his lungs,

probably just from the flight over.

Nothing to worry about yet. - Yet?

Babe, babe, just relax, okay?

They got a backup plan for the backup plan.

Ain't that right, doc?

- Of course. We're gonna get it figured out.

So, he's fluid overloaded.

Probably just from the low cabin oxygen pressure.

I'll get a nurse to draw a BNP.

Okay.

So, it's a sentinel bleed.

Needs to be treated in the next few hours,

and I'm afraid a surgical approach will invite

way too many complications.

Well, it'll be tricky,

but I think I can manage it intravascularly.

I'm not sure we should do that.

It's a heroic measure

for someone with no quality of life.

So you want to wait for it to rupture and let him die?

He's trapped in there, and now he's presenting

with a natural cause of death, we don't have to intervene.

I've been reading to him every week for four years

and this is the first time he's demonstrated consciousness

which means he could be coming out of his unresponsive state.

It's much more likely this activity is terminal lucidity.

Well, "much more likely" isn't good enough for me.

There's no advanced directive?

- No living will. No proxy, no DNR.

His parents died young.

He has a fiancée, but we haven't heard from her in months.

Darrin, reload the fMRI.

What are you doing?

Hi, Rob, this is Dr. Larsen.

You've been in an unresponsive state

for four years and now you have a brain aneurysm.

If we do nothing,

you will slip away peacefully and die.

If we operate, it's likely that it won't help

wake you up and you might live like this for years.

We believe that the decision should be yours.

So, if you want to live,

think of swinging a hammer.

And if you want us to let you pass away,

think of your apartment.

Hippocampus.

If he can hear us,

he is saying that he wants to die.

Okay. Step aside, please.

Hi, Rob, it's Dr. Walker.

I want to ask you again.

Never mind, Rob, we're gonna take care of you.

There's no way we're letting him make this decision

when we have no idea what his cognition level is.

Do the procedure.

We'll revisit the existential part of this later.

So we restore his physical health, and then what?

Debate euthanasia? You know we're not doing that.

Get him to the procedure room.

I'll start prepping.

Transferring surgeon says Lewis Pinachek's tucked in

and en route. - And Sam?

Got here about 20 minutes ago.

Dr. Heller's dealing with some fluid issues from the flight.

And this is Nancy Breyer. Excuse me.

Dr. Coleman.

Ah, there she is!

Welcome to Westside.

I seriously cannot believe you traded New York for this.

Can you manage to not be a snob for five minutes?

It comes with the accent, but I'll try to hide it

from your new gang from Fargo, doncha know?

Oh, that's not bad for a Brit.

We just lost Ward.

- What are you talking about? I spoke to him last night.

Some surgeon at Methodist sold him on a new med

that he says will keep him alive until he gets a real heart.

Did you explain that our protocol

dictates a cohort of three,

which means our other two patients can't move forward...

Of course.

All right.

Get the files on all the alternates.

Need a backup here in the next twelve hours.

Eliminate anyone with overlapping symptoms

or a clinical picture to Lewis and Sam.

We need medical diversity.

Got it.

So, Vera's in an assisted-living facility?

At her age?

Since she was 51.

It was a really difficult transition for her, obviously.

You seem to know her really well.

She was my first patient as an intern.

I kept making mistakes,

and even when some of the other doctors

were hard on me she was very kind and supportive,

which is not how it's supposed to be.

I was supposed to be there for her.

Results are in.

- Call the 6th floor. Code team to Vera's room.

What's wrong?

She's about to go into cardiac arrest.

I think you might've, uh, jumped the gun, Dr. Maitra.

Just get that EKG hooked up.

Vera, are you experiencing any pain or tightness in your chest?

No, I just feel really nauseous.

I think you may be having a heart attack.

That machine's gonna tell us if I'm right.

Tombstones on the inferior leads.

You're right.

Multivessel disease.

Activate the cath lab and call the shock team.

Oh, God, this is gross.

Oh, hey Nina. Took you long enough.

Sorry I don't jump at your every whim.

Yeah, well, thanks to you,

I got a problem with both Chiefs now.

- Thanks to me? - Yeah. Clearly you made a call

when I told you not to.

And now Larsen just threw it back in my face.

Oh, did she now?

Yeah, so what are you gonna do to fix it?

- Give me a beat. I'll get back to you.

So you haven't found a replacement yet?

It's a high-wire act,

but we're closing in on several candidates.

Well, the IRB does not like surprises.

And putting a gun to their heads at the 11th hour

after they've vetted your candidates for weeks

is a recipe for disaster.

Who's that with Dr. Grant?

That is our hospital administrator.

There a problem?

Important day. Everyone wants to make sure it runs smoothly.

- Got it. Thank you. - Okay, what do we got?

- Richardson died last week. We are down to the final four.

What about Frank Baldwin?

I thought his acute hepatitis was under control.

Liver enzymes have spiked to the thousands.

He's not stable enough to travel.

Dr. Heller just added a nitro drip on Sam,

so we have to consider his fluid overload

as an official complication now.

Which knocks out Deborah Palmer.

She's got the same profile.

We really need that level of medical diversity?

- That's the whole point. No overlapping diagnoses.

I think Ivy Oringer's our best shot.

Diabetic, cardiomyopathy from Milwaukee.

That's the one.

Her sugars are out of whack.

I think we can manage it with continuous

glucose monitoring and titrated insulin.

I don't want to think, Sasha.

We commit, she gets too unstable,

they shut down the whole trial. Come on, now.

We'll go in through the femoral artery,

guide a micro catheter up into the aneurysm

and then pack it with platinum coils.

Am I interrupting?

I was just checking in, anyway.

What's up? - Uh, déja vu.

I need to borrow that big brain of yours.

An issue with your trial?

Yeah. One of our patients dropped out.

But I have an alternate I need moved from Milwaukee,

Ivy Oringer, but her sugars are running in the high threes.

She's 34?

Yeah, and her mom's been fighting like hell

to find a way to save her.

I'm hopeful this is it.

Yeah, her C peptides are a little high.

Yeah, I wasn't sure what to make of that.

It's an upstream marker of insulin resistance.

Put her on metformin and ultra-rapid fiasp infusion.

That should get her through the Medevac flight.

But she'll have a much higher risk of hypoglycemia

once she lands.

How soon do you need her stabilized?

First surgery's supposed to be tomorrow,

but if I don't get the alternate in place,

I can't move forward with the other two.

Check her CGM the moment she lands,

and give her a little dextrose IV.

Thanks.

So what exactly is she working on?

She thinks the arteries aren't compensating properly.

And I'm only hearing about this now?

The point is, she thinks if we improve the flow

and block the vasoconstrictive response,

it'll solve the problem.

No, Ben, the point is you didn't inform your partner

of some pretty crucial information.

'Cause I was trying to protect you.

For our presentation.

Well, now the cat's out of the bag.

And I can't unknow what I know. - Sasha. She's gonna solve it.

They're in the mid-hundreds?

That's very encouraging.

All right. Let's talk then.

Lewis. - Hey.

You have no idea how great it is to see you.

Private plane.

Felt like a rock star.

And you are.

Now, let's get you situated in our CCU,

and then we should be ready to get things moving shortly.

Thank you.

So. Ivy Oringer's numbers are stabilizing.

If they hold, she'll be flying out in 20 minutes.

So someone came up with a new solution.

And that's what internal medicine is for.

You went to Amy.

She's the best one here.

Did you come here for her?

I moved here because my sister is sick,

and I had a chance to run surgery.

Sure.

Just remember you're rolling the dice

with my career, too.

- His numbers are fine. Blood pressure's stabilized.

Completely.

Even when I read to him.

I love that you never give up on people.

It's one of the best things about you.

He was so vibrant.

Before the accident.

I mean, look at him.

Rock climbing, sky-diving... he loved it all.

Amy!

He's tracking my movements.

He's awake!

Okay, Lewis,

we're just gonna run baseline echo EKG labs.

I'm sure you've been through this one too many times.

Poke and prod all you want.

I'm just grateful to have a chance here.

Well, I gotta confess,

I think we're all pretty pumped to be here.

Hey, there was an EMT on the flight

said somebody dropped out of the trial.

Doesn't that affect us?

Of course it does, you're a cohort.

They can't operate on anybody

unless all three of you are here and ready.

That was the problem with that administrator.

- All right, Sam. You already met Lewis?

Yeah.

- Is it true? Someone quit the trial?

EMTs were talking on the Medevac.

You know how many people wanted your spots?

We've already identified an alternate who's en route.

- So we are still on track? No delays?

No delays.

And it looks like Sam's fluids are under control.

We got a litre off his lungs.

See? Told you.

That man's a miracle worker.

It's the guys who invented the meds, but thank you,

I do appreciate the shout out.

Well, lungs are clear, you're good to go.

Doc, I'm feeling dizzy.

- Heart block. Low heart rate. One milligram Atropine.

- Pushing O2 to 50 percent. - Still bradycardic.

We gotta get a pacer in him.

That doesn't sound great.

Well, it's all under control, Lewis.

We expected complications.

What is happening with him?

He's fine, Marie, we got this.

I don't know.

Yes, yes, Dr. Grant will be in touch with instructions

on management during the transport.

I appreciate it.

You, too.

Oh! We finally got a replacement for the dropout this morning.

Oh, really?

Yeah. She's got some sugar imbalances,

and we have to make sure

the flight doesn't destabilize...

What if I had a patient who fit the bill?

Is this Vera?

It is.

And you're sure you're not reaching because it's her?

- Just get me in front of Ben. I won't embarrass you.

It's good to have you back

in the land of the living.

Was I really like that for four years?

So you could hear all of that?

I was in and out, but...

I heard enough.

Thank you for taking care of me.

Just doing my job.

- Why did I suddenly wake up? - We're not sure exactly.

We noticed an aneurysm developing on your brain...

Right. I remember.

You asked me if you should fix it.

I'm glad that you didn't listen

when I told you to let me die.

Us too.

I'm gonna look into this blood work,

see if we can get to the bottom of this miracle.

What about... my fiancée?

What about Kat?

Did you ever meet her?

I was the one who called her the day of your accident.

So, she was here?

Every day for a long time.

But then, she... she stopped?

I haven't seen her for seven months.

Did she tell you about the last time we saw each other?

About the fight?

She did.

And she left you a note the last time she was here.

I'll give you a minute.

I, I, I can't.

My vision... I can't read it.

- Oh, that's to be expected. It'll get better soon.

Can you?

Please?

"Dear Rob, I'm sitting here next to you writing this,

"watching you like I have been every day.

"I know that I loved you and I still do.

"But I'm stuck.

"Stuck in this room. Stuck watching over you.

"Stuck with all this guilt and pain and grief

"and I just don't think I can handle it anymore."

Stop, stop.

I get it. Please.

Should I call her?

I know she'd want to see you.

It's over.

It didn't work?

Everything I did to get here.

We could've saved so many lives.

There has to be a way.

We have a year or two before human trials...

Human trials?

We'll never make it to phase two with pigs.

They'll pull the funding once they hear your assessment.

Then it'll be seen as an abject failure

and I'll never put the pieces back again.

Is this gonna take me out of the trial?

This is what's gonna keep you in it.

Just try to relax.

Sure. Maybe some mindfulness exercises, right Marie?

No, we are praying for you, Lewis.

Yeah. That's exactly what I want to hear.

Hey, it's just a pace maker.

This man does it in his sleep.

You got that right, Sam.

Set rate at 70 beats per minute.

Copy.

- What about you, Dr. Heller? You have any kids?

- I do, in fact. One daughter. What about you two?

19 and 22.

Both girls in college. - Smart. Just like their momma.

Nah... he's plenty smart.

Just didn't get the same opportunities.

They coming to watch their dad make history?

Nah, I told them to, you know, focus on their studies.

Come time for the surgery,

they can hop on a flight, say their goodbyes.

Hey. You do not get to joke around like that.

Listen to your wife, Sam.

- Oh, hey, I do. - Yeah, except when you don't.

And we have capture.

Increase output.

You're gonna start feeling better almost immediately.

The rate's coming up.

Stabilizing.

Amazing.

- These things can be finicky. We'll probably need to

adjust a bit later, but we're in good shape now.

- His fluid status is neutral. He's stabilizing, too.

All right, people.

We are moving in the right direction!

Check in soon.

Ivy Oringer from Milwaukee. Dr. Ben Grant.

Feels unreal to meet you.

We've been following this trial since phase one.

Eight years she's been on that transplant list.

Could never get a real heart.

Wow, you must be Mom.

It's so great to have you both here.

- Great for you? I feel like I won the Powerball.

Well, you're very brave to volunteer for something

no one's ever done before.

But we still need to assess your viability,

and then get you past these pesky folks at the IRB.

Yeah, I understand.

I'm still tripping out on the idea you're gonna be

taking out half my heart,

dumping it in the trash,

and then what, inserting a shop-vac into me?

You get used to her sense of humor.

It's actually more like a sump pump.

Don't tell anyone we're essentially plumbers.

How's her sugar trending?

- She's in the 130s. Holding steady.

Excellent.

No promises, Ivy, but you're looking good.

Oh, Dr. Maitra's ready for you.

All her ducks are in a row.

Back soon.

Hey, it's gonna be okay, Ma.

It's gonna be okay if they accept you.

Yeah.

Your mom's heart's really weak,

but we're not out of options yet.

I'll call you back in a bit.

- Okay, Dr. Maitra. I'm all ears.

We have no definitive answer as to why he woke up?

No, but vitals are holding, coils stable in the brain,

perfusion is good, EEG readings in normal range...

But I think without an explanation,

we need to be careful.

I think we should slow-roll this.

Meaning sedate him?

Prevent any blood pressure spikes,

reduce any kind of stress,

neuroprotective meds... That's my position.

He's been immobilized for four years.

He needs stimulation, socialization, neuro-rehab...

Dr. Walker?

Hi!

I can't believe it, I just...

I can't believe it. - I know.

He's really awake?

Yes. He's awake and he's verbal.

Can I see him?

Of course.

Kat?

- Hi. - Hi.

She has massive infarct, bi-ventricular failure,

nothing left to revascularize.

Which means and LVAD only solves half her problem.

And my heart solves all of it.

But unlike your other two patients

with low-output cardiac failure and end-organ damage.

You understand how tenuous

each patient's condition is, yeah?

Of course.

And we discussed at great length this morning

that this trial demands medical diversity.

- I understand that. And Vera's heart failure

is autoimmune in origin, unlike...

It is irrelevant where the heart failure comes from.

What matters is what it is doing to her.

I'm not sure I follow.

Lewis has ascites and orthopnea, correct?

Yes. Biventricular failure.

And biventricular failure is virtually

always a factor with patients

with autoimmune myocardial infarction.

Which will make Lewis and Vera's post-op risk profiles

redundant.

- I guess I didn't realize... - You didn't realize?

Or you didn't do your research?

Because your girlfriend gave you the idea.

You gonna tell me that wasn't a factor?

It won't happen again.

And I will speak to her and tell her

that we're going with Ivy. - No, I don't want you anywhere near this conversation.

Not with her father's funding on the line.

I mean, I told you it's not like that with them.

Hey, I don't have the luxury of taking your word for it right now.

And I will tell Dr. Maitra myself.

It's the wrong day to waste my time.

I'd ask if you're okay, but, how could you be?

I told him I met someone.

Okay.

He seemed... relieved.

He smiled that goofy smile

and made a joke of it like he always did with everything.

Guess we're both unstuck.

Then we said goodbye.

So what's keeping you here?

She's a lawyer now.

And she has a career and a life.

And a new guy.

I'm so sorry.

She was always running circles around me.

And it made me act like a jackass.

- You were young. - I was an idiot.

The day of the accident,

she was trying to start our life together

and I stormed out to go windsurfing.

Who does that?

So what did you say to her today?

That even though we loved each other,

we wanted different lives.

The one thing I could do for her was to let her go.

That doesn't sound like a jackass to me.

What if he's just doing the noble thing?

I don't know if I can believe anything he's saying to me.

He didn't tell me one way or the other.

But, let me ask you something.

This new guy.

Do you love him?

I do. Yeah.

But I can feel part of me's holding back.

No matter how hard I try,

there's a piece of me still in that room with Rob.

So let's say he's setting you free.

When someone gives you a gift, receive it.

Go. Start your life.

You've waited long enough.

Thank you, Dr. Walker.

For being here when I couldn't be anymore.

And I'll be here for him now.

You can count on that.

Pressure's 88 over 52.

And he's feeling dizzy and nauseous.

- What happened? Can you rewind 5 minutes for me?

Yeah, I just started to feel, you know, kinda sick.

- And then he almost passed out. - I didn't pass out, Marie.

I got a little light... lightheaded.

Now, were you standing up or were you sitting down

when you started to feel dizzy? - He was standing.

I stood up for a second.

You might just be dehydrated.

Let me listen to your lungs.

You having any chest pain? - No. No, not at all.

BP 82 over 50.

Okay, give me that I-stat, Julie.

Just gonna check your electrolytes, okay.

- Pacemaker malfunction. - Okay, give me the magnet.

- Paging Dr. Douglas. - 250 saline bolus for Sam.

Stat, Julie! - Going as fast as I can, Jake.

- What's the status here? - Sam is dehydrated,

we might've overshot the diuretics.

Lewis is having a pacemaker malfunction.

- It's not resetting. Give it to me.

I'm right here, I got it.

Dr. Heller.

The hell just happened?

Pressure's rising.

110 over 70.

Well, that was interesting.

My God!

I don't know if my heart can take any more of this.

So?

Am I getting that heart?

I'm so sorry, Vera.

I tried.

I really tried.

I know you did all you could.

I'm sorry I pushed so hard this morning.

It is a miracle that he's alive,

and if it were up to me, he'd be gone.

Like you said, it was a miracle.

He's crashing!

Nothing.

He's braindead.

We should've sedated him like you wanted.

It was a catastrophic intracranial hemorrhage.

It wouldn't have made any difference, Gina.

This is collateral damage from his original injury.

He signed an advance directive an hour ago.

No heroic measures.

Today wasn't for nothing.

You gave him back his ability to make his own choices.

Sounds like you had a day, Graham.

Yeah, yeah, you could say that.

Any thoughts?

I will suffer the consequences of my choices

and you will not be influenced by any hospital donors.

So you did learn something, then.

I, uh... was tracking your case with Rob.

I'm sorry, must've been rough.

You know that piece of bone lodged in my brain?

An eight of an inch to the left, and I'd be like him.

Guess we should be grateful for what we have, huh?

Some people think I act like I always know better.

But I don't.

I just go confidently toward what I believe,

let the chips fall where they may,

and I admit when I'm wrong.

- For sure. - I see some of that in you.

The thinking you know better part.

The thing is, I have earned that right.

You haven't.

Understood.

So, how about you pretend that you don't know everything

and follow my lead for a while.

I'd welcome that.

Tomorrow's another day, then.

Dr. Heller.

Great work today.

Oh, thank you, but it was a team effort.

Humility can be a virtue, but not when you're in

a horse race for funding to keep your job.

Trust me when I say I know what that's like.

I'll put in a good word with Dr. Matos.

I appreciate that.

I heard Ivy cleared the IRB.

Barely.

And I'm sorry about Vera. Yeah.

I know how much she means to you.

Maybe you can put in a good word

in case you need an alternate.

I wouldn't make her any promises.

I know, but, anything can happen, right?

Any kind of complication can knock someone out...

I can't do it, Sonya.

I've already extended myself further than I should have.

Oh, well...

well, it seems like you have a late night.

Why don't I just see you at mine?

Sonya.

I know you tried.

I can figure this out.

If we only had more time.

Yeah, well, we don't have time,

and now you're just torturing me.

What if we only sent the August numbers to the IRB.

They don't know that you did another round

in November, do they?

I could never ask you to lie for me.

You didn't.

Look, I know you've thought about it.

That's why you were nervous about me

even coming to the lab to begin with.

Yeah, thinking about it and doing it

are two very different things.

In my wildest fantasy of breaking ethical boundaries

we've all lived by since med school,

it never involved anyone sitting next to me.

There are ethical boundaries,

and then there are bureaucratic burdens put on us

by corporate pencil-pushers who don't understand what we do.

And that's a rationalization you can live with?

A lie of omission about the efficacy of a trial

on pigs versus the potential to save thousands of lives

and usher in a ground-breaking era of technology

that can be extrapolated to every organ in the body?

I'm not gonna lose sleep over that grand bargain.

You'd be risking your career.

You'd be risking your legacy.

And I think it's worth it.

Bypass machine, perfusionists on call,

all blood typed and crossed?

Of course. Done. Hours ago.

It's game day tomorrow.

Here we go.

Hey.

It's amazing how well you're keeping it together.

- Well, I cried in the bathroom. - Oh.

We can feel everything.

But we just can't burden our patients with our feelings

or let them see when we're afraid.