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Hello. I'm Freddie Highmore.
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00:00:03,755 --> 00:00:06,901
The following episode
portrays our hope for the future,
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00:00:06,925 --> 00:00:08,970
a future where no one
will have to wear masks
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00:00:08,994 --> 00:00:11,939
or take other steps
to stay safe from COVID.
5
00:00:11,963 --> 00:00:15,245
Until then,
please protect yourself and others.
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00:00:18,270 --> 00:00:19,647
I'm Jordan Allen.
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00:00:19,671 --> 00:00:21,916
My first year in med school,
I designed an ankle brace
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00:00:21,940 --> 00:00:25,153
that monitors extent of
immobilization via a phone app.
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00:00:25,177 --> 00:00:26,687
When I licensed it to Bioventus,
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00:00:26,711 --> 00:00:28,946
I was able to pay off
over half my student loans.
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00:00:30,549 --> 00:00:32,093
John Lundberg.
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00:00:32,117 --> 00:00:34,962
I've worked every summer since I
was 16 at Camp Hope Heartland,
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00:00:34,986 --> 00:00:37,298
a summer program for kids
with cancer in Des Moines,
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00:00:37,322 --> 00:00:38,543
where I grew up.
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00:00:38,790 --> 00:00:40,301
Asher Wolke.
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00:00:40,325 --> 00:00:41,769
Uh, when I was 18,
17
00:00:41,793 --> 00:00:45,606
I left the Hasidic community
that I was raised in.
18
00:00:45,630 --> 00:00:47,308
I realized if there really was a God,
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00:00:47,332 --> 00:00:49,377
it had to be a cruel being
20
00:00:49,401 --> 00:00:51,635
that I felt nothing but contempt for.
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00:00:52,904 --> 00:00:54,949
That's also when I decided
to go to med school,
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00:00:54,973 --> 00:00:56,207
and start dating men.
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00:01:00,545 --> 00:01:04,058
I'm Olivia Jackson. I'm 25. From Chicago.
24
00:01:06,918 --> 00:01:09,253
I play ragtime piano
alone in my apartment.
25
00:01:11,990 --> 00:01:13,467
Is that interesting?
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00:01:13,491 --> 00:01:15,203
Will Hooper.
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00:01:15,227 --> 00:01:17,805
Technically, I'm a professional athlete.
28
00:01:17,829 --> 00:01:19,807
Although in a sport
nobody pays attention to,
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00:01:19,831 --> 00:01:22,376
and the stipend barely covers
our training expenses,
30
00:01:22,400 --> 00:01:25,102
but I'm on the US National Rowing team.
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00:01:25,837 --> 00:01:26,837
Men's Eight.
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00:01:28,340 --> 00:01:31,252
Hey, I'm Enrique.
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00:01:31,276 --> 00:01:33,521
I spent last summer in Costa Rica,
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00:01:33,545 --> 00:01:37,325
where I learned to surf, which I'm
totally obsessed with now.
35
00:01:37,349 --> 00:01:42,597
Uh, I had a pretty interesting
encounter with a saltwater crocodile.
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00:01:42,621 --> 00:01:44,065
I just thought it was a big...
37
00:01:44,089 --> 00:01:46,090
Why are you wearing a swimsuit?
38
00:01:48,894 --> 00:01:50,761
Oh, they're actually hybrid boardshorts.
39
00:01:51,563 --> 00:01:53,608
I like to work hard,
40
00:01:53,632 --> 00:01:55,286
and it's easier to do
when you're comfortable.
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00:01:56,401 --> 00:02:00,281
Plus, I think the casual
dress puts patients at ease.
42
00:02:04,976 --> 00:02:06,220
Uh...
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00:02:06,244 --> 00:02:07,478
And Dr. Lim said that the
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00:02:08,380 --> 00:02:09,380
shorts were fine.
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00:02:10,815 --> 00:02:14,128
Hospital policy
requires all residents to...
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00:02:14,152 --> 00:02:16,264
He's not a resident.
He's a resident applicant.
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00:02:16,288 --> 00:02:18,532
One of six finalists for four openings.
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00:02:18,556 --> 00:02:20,568
Now, they'll be shadowing for two days.
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00:02:20,592 --> 00:02:22,069
Give them the grand tour,
show them the ropes,
50
00:02:22,093 --> 00:02:23,404
feel free to turn up the heat a bit.
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00:02:23,428 --> 00:02:24,739
See how they react under pressure.
52
00:02:24,763 --> 00:02:27,141
You will be responsible
for supervising them,
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00:02:27,165 --> 00:02:28,976
so I want your totally honest input
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00:02:29,000 --> 00:02:30,478
before I make any final decisions.
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00:02:30,502 --> 00:02:31,646
Those shorts...
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00:02:31,670 --> 00:02:33,481
Let's call them strike one.
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00:02:33,505 --> 00:02:36,417
Oh, and in addition to being an Olympian,
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00:02:36,441 --> 00:02:37,985
Will Hooper is a Rhodes
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00:02:38,009 --> 00:02:40,421
and graduated top of
his class at Stanford.
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00:02:40,445 --> 00:02:42,223
He is very handsome.
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00:02:42,247 --> 00:02:43,658
He's very full of himself.
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00:02:43,682 --> 00:02:45,593
He's ranked first by every top program,
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00:02:45,617 --> 00:02:48,129
so whatever you can do
to recruit him to ours, do it.
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00:02:48,153 --> 00:02:50,298
I can already give you
my input on the sh...
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00:02:50,322 --> 00:02:51,689
Don't judge a book by its boardshorts.
66
00:03:02,834 --> 00:03:04,245
You wanted to see me?
67
00:03:04,269 --> 00:03:05,780
Good morning.
68
00:03:05,804 --> 00:03:07,782
Sorry. Good morning.
69
00:03:07,806 --> 00:03:09,450
What'd I do wrong?
70
00:03:09,474 --> 00:03:10,651
Just wanted to check in.
71
00:03:10,675 --> 00:03:12,142
See how the new role was coming along.
72
00:03:12,544 --> 00:03:13,544
Honestly?
73
00:03:16,047 --> 00:03:19,427
You could start our new supervisor-resident
relationship with a lie.
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00:03:19,451 --> 00:03:20,872
That's always fun.
75
00:03:22,487 --> 00:03:24,500
Internal medicine is
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00:03:25,536 --> 00:03:26,536
boring.
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00:03:27,192 --> 00:03:29,603
Between smokers and obese diabetics,
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00:03:29,627 --> 00:03:31,591
seems like all I'm doing is
protecting people from themselves.
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00:03:35,133 --> 00:03:36,711
As a surgical resident,
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00:03:36,735 --> 00:03:38,312
you never treated drunk drivers?
81
00:03:38,336 --> 00:03:40,314
Or extracted random objects from guys'...
82
00:03:40,338 --> 00:03:42,283
I get it. People are stupid.
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00:03:42,307 --> 00:03:43,686
Not my point, but true.
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00:03:46,344 --> 00:03:47,855
Not the same adrenaline rush,
85
00:03:47,879 --> 00:03:50,214
but internal medicine can be rewarding.
86
00:03:51,249 --> 00:03:53,821
Given time, if you're patient.
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Thanks.
88
00:03:58,950 --> 00:04:01,079
That is not how I thought
this meeting was gonna go.
89
00:04:02,494 --> 00:04:04,338
I thought one of the nurses
complained about me.
90
00:04:04,362 --> 00:04:06,125
Wasn't just one.
91
00:04:07,091 --> 00:04:08,146
And if it happens again,
92
00:04:08,170 --> 00:04:10,713
this meeting will go exactly
how you thought it would.
93
00:04:23,615 --> 00:04:24,925
Sorry.
94
00:04:24,949 --> 00:04:26,521
I should've just
canceled the appointment.
95
00:04:27,052 --> 00:04:28,329
You were right.
96
00:04:28,353 --> 00:04:29,764
Dizziness went away as soon as I stopped
97
00:04:29,788 --> 00:04:31,198
drinking coffee and Red Bull all day.
98
00:04:31,222 --> 00:04:32,222
No worries.
99
00:04:33,391 --> 00:04:34,602
Can you lie flat on your back, please?
100
00:04:34,626 --> 00:04:35,626
Yeah.
101
00:04:36,928 --> 00:04:38,572
You get that scar in a fire?
102
00:04:38,596 --> 00:04:39,774
Sort of.
103
00:04:39,798 --> 00:04:42,043
A homemade Roman candle when I was 12.
104
00:04:42,067 --> 00:04:43,711
You'd be surprised
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00:04:43,735 --> 00:04:46,547
how many of us at the
firehouse were pyros as kids.
106
00:04:46,571 --> 00:04:49,250
I made a potato gun for
my sixth-grade science fair.
107
00:04:49,274 --> 00:04:50,918
Almost got me kicked out of school.
108
00:04:50,942 --> 00:04:52,553
You'll have to come visit us sometime.
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00:04:52,577 --> 00:04:54,048
You'd fit right in.
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00:04:56,548 --> 00:04:57,758
You see something?
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00:04:57,782 --> 00:04:59,460
Don't talk. Just breathe normally.
112
00:05:07,725 --> 00:05:09,821
You have a large tumor
on the wall of your heart.
113
00:05:10,995 --> 00:05:12,073
Cancer?
114
00:05:12,097 --> 00:05:13,641
I don't know.
115
00:05:13,665 --> 00:05:15,361
But you're definitely gonna need surgery.
116
00:05:15,767 --> 00:05:16,988
As soon as possible.
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00:05:18,603 --> 00:05:26,605
Synced & corrected by -robtor-
www.addic7ed.com
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00:05:29,981 --> 00:05:32,064
I appreciate you letting me share
your case with the whole class.
119
00:05:32,095 --> 00:05:33,291
No problem.
120
00:05:33,315 --> 00:05:35,963
I stopped being shy after
the 100th time I had to do this.
121
00:05:35,987 --> 00:05:39,066
I'll be using a version of
Lejour's technique I've adapted.
122
00:05:39,090 --> 00:05:41,335
We'll divide the breast
into three pedicles,
123
00:05:41,359 --> 00:05:42,803
and then redistribute the tissue
124
00:05:42,827 --> 00:05:44,171
and insert saline implants
125
00:05:44,195 --> 00:05:46,006
to correct the tuberous breast deformity.
126
00:05:46,030 --> 00:05:48,809
Why would you want breast implants?
127
00:05:48,833 --> 00:05:51,612
You're beautiful. And your breasts
look fine just the way they are.
128
00:05:51,636 --> 00:05:53,447
No. No, they don't.
129
00:05:53,471 --> 00:05:55,583
The base is constricted,
130
00:05:55,607 --> 00:05:57,618
horizontal development is deficient,
131
00:05:57,642 --> 00:05:59,120
and the nipple-areola complex...
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00:05:59,144 --> 00:06:01,422
- Murphy.
- It's okay. He's right.
133
00:06:01,446 --> 00:06:02,825
That's why I'm here.
134
00:06:03,781 --> 00:06:05,369
Thank you.
135
00:06:05,783 --> 00:06:07,761
I know that you're trying to be nice.
136
00:06:07,785 --> 00:06:10,331
My friends and family have
been telling me for years,
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00:06:10,355 --> 00:06:12,166
"You're beautiful just the way you are."
138
00:06:12,190 --> 00:06:14,368
But I don't feel beautiful.
139
00:06:14,392 --> 00:06:16,670
You're 17.
140
00:06:16,694 --> 00:06:18,772
Every girl your age feels like that.
141
00:06:18,796 --> 00:06:20,541
That can't be true.
142
00:06:20,565 --> 00:06:23,010
Tuberous breast
deformity is a rare condition.
143
00:06:23,034 --> 00:06:24,778
We're not going to debate
144
00:06:24,802 --> 00:06:27,266
a personal decision
the patient's already made.
145
00:06:28,173 --> 00:06:31,152
I've been thinking
about this since I was 13.
146
00:06:31,176 --> 00:06:33,154
Every time I look in the mirror.
147
00:06:33,178 --> 00:06:34,989
I'm about to start college,
148
00:06:35,013 --> 00:06:37,558
and there is no way that I'm
gonna begin this new chapter
149
00:06:37,582 --> 00:06:39,195
until I'm fixed.
150
00:06:40,577 --> 00:06:41,577
Great.
151
00:06:44,822 --> 00:06:47,568
You thinking median
sternotomy or right thoracotomy?
152
00:06:47,592 --> 00:06:50,204
I'm thinking I should finish
my review of the imaging.
153
00:06:50,228 --> 00:06:51,791
Sure. No rush.
154
00:06:52,730 --> 00:06:54,542
Actually, there is a bit of a rush.
155
00:06:54,566 --> 00:06:56,911
But you know what I mean.
156
00:06:56,935 --> 00:06:59,213
So, newbies. What up? Where y'all from?
157
00:06:59,237 --> 00:07:00,247
Like hometowns, or...
158
00:07:00,271 --> 00:07:01,415
Med schools.
159
00:07:01,439 --> 00:07:02,416
Why would I care where you grew up?
160
00:07:02,440 --> 00:07:03,551
Stanford.
161
00:07:03,575 --> 00:07:04,985
- Uh, NYU.
- Harvard.
162
00:07:05,009 --> 00:07:06,222
Preferred specialties?
163
00:07:06,511 --> 00:07:08,088
Ortho. All the way.
164
00:07:08,112 --> 00:07:09,390
Neuro.
165
00:07:09,414 --> 00:07:10,858
I'm planning a dual specialty
166
00:07:10,882 --> 00:07:12,526
in neonatal and pediatric oncology.
167
00:07:12,550 --> 00:07:13,861
Impressive. Also unlikely.
168
00:07:13,885 --> 00:07:15,763
I know, it's a ton of work,
169
00:07:15,787 --> 00:07:17,231
but I'm pretty good at multi-tasking.
170
00:07:17,255 --> 00:07:19,200
In med school, I did a combined MD/PhD...
171
00:07:19,224 --> 00:07:21,145
- What's your mom do?
- My mom?
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00:07:21,192 --> 00:07:22,603
Don't stall. Just answer.
173
00:07:22,627 --> 00:07:24,156
She teaches high-school French.
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00:07:24,562 --> 00:07:25,773
Homemaker.
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00:07:25,797 --> 00:07:26,874
Surgeon.
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00:07:26,898 --> 00:07:28,542
Ouch. Dad?
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00:07:28,566 --> 00:07:29,710
Also a surgeon.
178
00:07:29,734 --> 00:07:31,011
Double ouch. And yours?
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00:07:31,035 --> 00:07:32,246
Hasidic rabbi.
180
00:07:32,270 --> 00:07:33,447
You've left the nest.
181
00:07:33,471 --> 00:07:35,916
Actually, the... the whole forest.
182
00:07:35,940 --> 00:07:37,785
And yours obviously works on Wall Street.
183
00:07:37,809 --> 00:07:39,587
But not a trader.
184
00:07:39,611 --> 00:07:41,722
I'm guessing... an M&A lawyer?
185
00:07:41,746 --> 00:07:42,890
How'd you know?
186
00:07:42,914 --> 00:07:44,124
She's read your resume,
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00:07:44,148 --> 00:07:45,459
researched your social media.
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00:07:45,483 --> 00:07:47,595
She's probably run a credit check, too.
189
00:07:47,619 --> 00:07:50,030
And you're under 50, but wear
Brooks Brothers button-downs.
190
00:07:50,054 --> 00:07:51,575
Are you done yet?
191
00:07:52,056 --> 00:07:53,534
Left thoracotomy
192
00:07:53,558 --> 00:07:56,237
with a possible incision
into the right atrium
193
00:07:56,261 --> 00:07:58,205
and inter-atrial septum as needed.
194
00:07:58,229 --> 00:08:00,040
Left atrial approach
through Sondergaard's groove
195
00:08:00,064 --> 00:08:01,064
makes more sense.
196
00:08:01,466 --> 00:08:02,466
Not to me.
197
00:08:04,402 --> 00:08:05,546
He's my patient.
198
00:08:05,570 --> 00:08:07,248
But you're not a surgeon.
199
00:08:07,272 --> 00:08:09,550
Which is why there is no
reason for you to be grilling them,
200
00:08:09,574 --> 00:08:11,118
or picking the approach.
201
00:08:11,142 --> 00:08:12,987
Stop worrying about protecting your turf.
202
00:08:13,011 --> 00:08:14,154
Stop stepping all over it.
203
00:08:14,178 --> 00:08:16,323
You're looking at tests
I did for my patient.
204
00:08:16,347 --> 00:08:17,958
How am I stepping all over your turf?
205
00:08:17,982 --> 00:08:20,294
I think what Dr. Browne
is trying to say is,
206
00:08:20,318 --> 00:08:22,096
given there's no perfect approach,
207
00:08:22,120 --> 00:08:23,297
maybe it's best to defer
208
00:08:23,321 --> 00:08:24,967
to the surgical department's
recommendation.
209
00:08:26,190 --> 00:08:27,595
Did he just mansplain?
210
00:08:28,493 --> 00:08:29,637
Not at all. I... I was just trying...
211
00:08:29,661 --> 00:08:30,971
So you're just gonna do it again?
212
00:08:30,995 --> 00:08:32,072
No, I'm just trying...
213
00:08:32,096 --> 00:08:33,096
Shut up.
214
00:08:35,000 --> 00:08:36,812
We're gonna go in
through a left thoracotomy.
215
00:08:37,602 --> 00:08:38,746
Not my preference,
216
00:08:38,770 --> 00:08:40,399
but it'll work.
217
00:08:42,206 --> 00:08:43,350
What were you thinking?
218
00:08:43,374 --> 00:08:45,085
You thought you'd impress me
219
00:08:45,109 --> 00:08:48,322
by undermining the patient's
confidence in my judgment?
220
00:08:48,346 --> 00:08:50,090
I'm sorry. That wasn't my intent.
221
00:08:50,114 --> 00:08:51,859
And you're supposed to be a mentor now,
222
00:08:51,883 --> 00:08:53,427
modeling professional behavior,
223
00:08:53,451 --> 00:08:55,496
not making it worse, Murphy.
224
00:08:55,520 --> 00:08:57,998
She questioned your surgical plan.
225
00:08:58,022 --> 00:08:59,300
I defended it.
226
00:08:59,324 --> 00:09:00,801
How can we both be wrong?
227
00:09:00,825 --> 00:09:02,505
I don't need you to defend me.
228
00:09:03,294 --> 00:09:06,674
And I never wanna have a
surgical debate in front of a patient.
229
00:09:06,698 --> 00:09:08,761
We're not in front of the patient now.
230
00:09:10,642 --> 00:09:13,287
The patient's breasts are
small and a bit asymmetrical,
231
00:09:13,312 --> 00:09:16,018
but no woman's breasts
are perfectly shaped.
232
00:09:17,008 --> 00:09:20,454
You're wearing Prada shoes
and a Dolce & Gabbana blouse,
233
00:09:20,478 --> 00:09:22,156
which cost more than
most med students' rent,
234
00:09:22,180 --> 00:09:24,291
so, clearly, you understand
235
00:09:24,315 --> 00:09:26,860
your appearance has a tremendous
impact on how people treat you.
236
00:09:26,884 --> 00:09:30,700
There's a difference between
nice clothes and a major surgery.
237
00:09:31,580 --> 00:09:34,134
And I also understand
the cosmetic surgery industry
238
00:09:34,158 --> 00:09:37,248
is dominated by male
physicians with a sexist bias.
239
00:09:44,435 --> 00:09:47,341
I've invited you to observe
as a learning opportunity.
240
00:09:48,439 --> 00:09:49,583
So I'd suggest
241
00:09:49,607 --> 00:09:50,818
less lecturing
242
00:09:50,842 --> 00:09:52,513
and more listening.
243
00:09:54,913 --> 00:09:57,057
We'll access the tumor via an incision
244
00:09:57,081 --> 00:09:58,826
in the chest wall between your ribs.
245
00:09:58,850 --> 00:10:00,060
It'll be an easier recovery
246
00:10:00,084 --> 00:10:01,595
than if we opened your sternum.
247
00:10:01,619 --> 00:10:04,164
Are you sure you don't
want us to call your family
248
00:10:04,188 --> 00:10:05,372
before we put you under?
249
00:10:05,396 --> 00:10:07,334
Why? So they can freak out and worry?
250
00:10:07,358 --> 00:10:09,155
I'd rather just give them
the good news when it's over.
251
00:10:10,628 --> 00:10:13,173
It is going to be good news, right?
252
00:10:13,197 --> 00:10:15,542
With a bit of cardiac rehab
and a positive attitude,
253
00:10:15,566 --> 00:10:17,177
which I know you have,
254
00:10:17,201 --> 00:10:19,248
you'll be back sliding
down the fire pole in no time.
255
00:10:19,537 --> 00:10:20,781
Our firehouse has stairs.
256
00:10:20,805 --> 00:10:22,251
Hmm. Bummer.
257
00:10:24,108 --> 00:10:25,452
It's a social media group
258
00:10:25,476 --> 00:10:27,173
where we all pretend to be ants.
259
00:10:27,912 --> 00:10:29,223
Why?
260
00:10:29,247 --> 00:10:32,793
Because ants don't care about politics,
sports teams,
261
00:10:32,817 --> 00:10:35,129
or anything else people
get so savage about.
262
00:10:35,153 --> 00:10:38,031
Male ants develop from unfertilized eggs,
263
00:10:38,055 --> 00:10:41,135
which means they don't have
a father and can't have sons.
264
00:10:41,159 --> 00:10:44,104
But they do have grandfathers
and can have grandsons.
265
00:10:44,128 --> 00:10:45,205
Interesting.
266
00:10:45,229 --> 00:10:46,540
And confusing.
267
00:10:46,564 --> 00:10:49,977
Is it just me,
or are those doctors watching us?
268
00:10:50,001 --> 00:10:52,413
They're the new resident applicants.
269
00:10:52,437 --> 00:10:55,951
They're here so Park, Claire,
and I can evaluate them for Dr. Lim.
270
00:10:56,407 --> 00:10:57,995
So, why are they standing over there?
271
00:10:58,843 --> 00:11:01,321
Park had a video chat with Kellan,
272
00:11:01,345 --> 00:11:03,457
and I had a real lunch with you.
273
00:11:03,481 --> 00:11:08,061
Shaun, you can't just have
them stand there while you eat.
274
00:11:08,085 --> 00:11:10,097
Part of being a good
boss is being a good host.
275
00:11:10,121 --> 00:11:11,755
You need to introduce them to people.
276
00:11:14,258 --> 00:11:15,792
Like me. Right now.
277
00:11:18,429 --> 00:11:19,429
Come here, please.
278
00:11:22,333 --> 00:11:24,645
Dr. Allen, Dr. Lundberg, Dr. Guerin,
279
00:11:24,669 --> 00:11:25,779
this is my girlfriend, Lea.
280
00:11:25,803 --> 00:11:27,374
She runs the IT department now.
281
00:11:27,505 --> 00:11:28,682
Okay.
282
00:11:28,706 --> 00:11:31,118
Nice to meet you all. Please join us.
283
00:11:31,142 --> 00:11:33,086
Shaun's been telling me all about you.
284
00:11:33,110 --> 00:11:36,490
Mmm. N... No. I haven't.
285
00:11:36,514 --> 00:11:39,760
So,
I hope Shaun's not being too hard on you.
286
00:11:39,784 --> 00:11:41,795
No, he's been great.
287
00:11:41,819 --> 00:11:44,031
And the case we're
observing is really interesting.
288
00:11:44,055 --> 00:11:47,301
We're correcting a 17-year-old
girl's tuberous breasts
289
00:11:47,325 --> 00:11:49,136
with saline implants.
290
00:11:49,160 --> 00:11:51,672
Dr. Allen told Dr. Andrews
it was unethical.
291
00:11:51,696 --> 00:11:53,106
He got mad.
292
00:11:53,130 --> 00:11:55,719
I didn't say it was unethical. I just...
293
00:11:57,134 --> 00:11:58,889
I suppose I shouldn't have interfered.
294
00:12:00,404 --> 00:12:02,883
Well, I don't know what
a tuberous breast is,
295
00:12:02,907 --> 00:12:05,396
but I think implants are way overrated.
296
00:12:06,477 --> 00:12:09,056
That's because your
breasts are excellent.
297
00:12:09,080 --> 00:12:10,526
Thank you.
298
00:12:11,082 --> 00:12:12,778
That's exactly my point.
299
00:12:13,251 --> 00:12:14,995
Mine aren't huge,
300
00:12:15,019 --> 00:12:17,331
but every guy who's ever
seen them up close and personal
301
00:12:17,355 --> 00:12:18,492
has been thrilled.
302
00:12:19,323 --> 00:12:21,468
I definitely was.
303
00:12:21,492 --> 00:12:24,415
I am thrilled by every part of your body.
304
00:12:26,831 --> 00:12:28,056
Sorry. My bad. Total TMI.
305
00:12:28,087 --> 00:12:32,579
I'm not even bothered
by your adenoidal voice.
306
00:12:32,603 --> 00:12:34,815
Except when you talk to
your mom on the phone.
307
00:12:34,839 --> 00:12:36,439
But I just put on headphones.
308
00:12:41,712 --> 00:12:44,881
At least you'll know he'll
be a totally honest boss.
309
00:12:51,589 --> 00:12:53,333
The incision's extended superiorly
310
00:12:53,357 --> 00:12:54,902
to meet the atriotomy,
311
00:12:54,926 --> 00:12:56,614
and then the inter-atrial
septum is opened up.
312
00:12:56,647 --> 00:12:57,771
Retractor.
313
00:12:57,795 --> 00:13:01,188
A Carpentier retractor is used
to visualize the mitral valve.
314
00:13:01,224 --> 00:13:03,010
That will allow a
clear view of the tumor.
315
00:13:03,034 --> 00:13:04,444
Can we turn the channel?
316
00:13:04,468 --> 00:13:06,436
Color commentary's
getting a bit annoying.
317
00:13:06,484 --> 00:13:08,271
With the right atrium opened obliq...
318
00:13:10,908 --> 00:13:13,453
How's Team Browne? Any early standouts?
319
00:13:13,477 --> 00:13:16,056
Jackson's a bit timid, but smart.
320
00:13:16,080 --> 00:13:18,392
Wolke is definitely enthusiastic.
321
00:13:18,416 --> 00:13:20,961
And your star recruit is...
322
00:13:22,453 --> 00:13:24,120
Pretty full of himself.
323
00:13:24,755 --> 00:13:26,934
I'm looking for surgeons,
and according to his recs,
324
00:13:26,958 --> 00:13:29,469
he can dissect and suture like a pro.
325
00:13:29,493 --> 00:13:31,939
I thought you were also
looking for our input.
326
00:13:31,963 --> 00:13:34,274
He's ranked first by every top program.
327
00:13:34,298 --> 00:13:36,090
You really think they're
all wrong and you're right?
328
00:13:39,150 --> 00:13:41,195
So, what brings you all to the biz?
329
00:13:41,339 --> 00:13:43,717
Had my ACL reconstructed in high school,
330
00:13:43,741 --> 00:13:45,391
both my rotators in college.
331
00:13:46,177 --> 00:13:48,155
I love the idea of fixing people,
332
00:13:48,179 --> 00:13:50,355
helping them be the best they can be.
333
00:13:51,422 --> 00:13:53,691
Surgeons are the ones
with the God complex, right?
334
00:13:56,287 --> 00:13:57,287
I have that.
335
00:13:59,404 --> 00:14:01,882
I spent my life speaking
Yiddish and studying the Talmud,
336
00:14:01,907 --> 00:14:03,785
and not shaving the sides of my hair,
337
00:14:03,810 --> 00:14:05,912
because someone up there
supposedly cares.
338
00:14:06,797 --> 00:14:08,206
Uh, but then I realized
339
00:14:09,967 --> 00:14:11,125
no one's up there.
340
00:14:12,336 --> 00:14:13,878
No one cares.
341
00:14:14,578 --> 00:14:18,158
No benevolent higher power
is going to save us, so...
342
00:14:20,111 --> 00:14:21,144
We have to save each other.
343
00:14:24,215 --> 00:14:25,926
Can you top that?
344
00:14:25,950 --> 00:14:27,934
- Definitely not.
- Try anyway.
345
00:14:28,466 --> 00:14:31,511
You're obviously smart. You've
got two degrees from Harvard.
346
00:14:31,570 --> 00:14:33,515
My parents are Harvard alums, so...
347
00:14:33,539 --> 00:14:34,850
I'm sure that helped me get in.
348
00:14:34,874 --> 00:14:36,734
You're not gonna get hired
by undermining your own...
349
00:14:38,010 --> 00:14:39,988
Something went wrong.
350
00:14:40,012 --> 00:14:41,356
Looks like they
nicked a pulmonary artery.
351
00:14:41,380 --> 00:14:43,625
No. If they had,
Browne would be suctioning
352
00:14:43,649 --> 00:14:44,682
instead of Lim reaching
in with her hands.
353
00:14:49,388 --> 00:14:50,522
What are they doing now?
354
00:14:51,423 --> 00:14:52,423
Nothing.
355
00:14:53,359 --> 00:14:54,669
We can't access the tumor
356
00:14:54,693 --> 00:14:56,905
without compromising his
entire cardiac outflow tract.
357
00:14:56,929 --> 00:14:59,574
What about going in the way I
suggested? The median sternotomy.
358
00:14:59,598 --> 00:15:01,634
The tumor's too far back.
We need to close him up.
359
00:15:08,565 --> 00:15:11,377
Proton beam radiation
would be too toxic to the heart.
360
00:15:11,401 --> 00:15:13,212
So is immunotherapy.
361
00:15:13,236 --> 00:15:15,481
We can't access the
entire tumor surgically,
362
00:15:15,505 --> 00:15:18,418
and we can't kill it without
killing his heart along with it.
363
00:15:18,442 --> 00:15:20,553
What if we cut out the
parts we can access
364
00:15:20,577 --> 00:15:23,590
and try our luck with
chemo on what's left?
365
00:15:23,614 --> 00:15:27,060
IV doxorubicin and ifosfamide
might slow the growth,
366
00:15:27,084 --> 00:15:28,661
give him a few more months.
367
00:15:28,685 --> 00:15:30,863
No, I'm not sending my patient
home with just a few extra months.
368
00:15:30,887 --> 00:15:31,998
It's better than nothing.
369
00:15:32,022 --> 00:15:33,533
What about a transplant?
370
00:15:33,557 --> 00:15:34,767
Not an option.
371
00:15:34,791 --> 00:15:37,003
Heart tumors are a contraindication.
372
00:15:37,027 --> 00:15:39,606
What if we transplant his own heart?
373
00:15:39,630 --> 00:15:41,407
If we take it totally out of his chest,
374
00:15:41,431 --> 00:15:43,242
we'd have access to the posterior heart.
375
00:15:43,266 --> 00:15:44,377
We could excise the tumor,
376
00:15:44,401 --> 00:15:45,545
fix the defect it left behind,
377
00:15:45,569 --> 00:15:47,080
- and then put it back in.
- Cool.
378
00:15:47,104 --> 00:15:48,414
Mmm. Not cool.
379
00:15:48,438 --> 00:15:50,083
At least with a normal heart transplant,
380
00:15:50,107 --> 00:15:51,884
you'd be getting a healthy heart.
381
00:15:51,908 --> 00:15:54,354
Her idea keeps the risk
of removing the heart,
382
00:15:54,378 --> 00:15:56,789
and adds the risk that the
heart we'd be putting back in
383
00:15:56,813 --> 00:15:58,424
has just been severely compromised
384
00:15:58,448 --> 00:16:00,120
having had a tumor cut out of it.
385
00:16:00,156 --> 00:16:01,597
He's young, and the part of his heart
386
00:16:01,621 --> 00:16:03,488
not infiltrated with tumor is strong.
387
00:16:06,657 --> 00:16:07,944
Do a cardiac MRA
388
00:16:07,968 --> 00:16:10,436
and see if the tumor's
infiltrated the coronary arteries.
389
00:16:10,460 --> 00:16:12,305
If it hasn't, Morgan's idea could work.
390
00:16:12,329 --> 00:16:13,706
I'll schedule it.
391
00:16:16,800 --> 00:16:18,911
Dr. Murphy is
dividing the breast parenchyma
392
00:16:18,935 --> 00:16:20,980
into three pedicles.
393
00:16:21,004 --> 00:16:23,049
Anyone know where this
technique is derived from?
394
00:16:23,073 --> 00:16:24,634
Breast reduction surgery.
395
00:16:25,008 --> 00:16:26,552
That's right.
396
00:16:26,576 --> 00:16:29,922
And why would I use a
breast reduction technique
397
00:16:29,946 --> 00:16:32,091
to make the patient's breasts larger?
398
00:16:32,115 --> 00:16:34,060
The technique frees up the tissue.
399
00:16:34,618 --> 00:16:36,329
You can bring the pedicles together
400
00:16:36,353 --> 00:16:37,730
to make the breasts smaller
401
00:16:37,754 --> 00:16:41,025
or spread them out over an
implant to make them larger.
402
00:16:41,925 --> 00:16:43,169
Very good.
403
00:16:43,193 --> 00:16:45,938
And now I'm going to turn the sound off.
404
00:16:45,962 --> 00:16:47,507
Don't worry. Nothing's wrong.
405
00:16:47,531 --> 00:16:49,909
I just wanna talk about you
behind your backs for a little bit.
406
00:16:52,169 --> 00:16:53,913
So, first impressions.
407
00:16:54,171 --> 00:16:55,448
Murphy?
408
00:16:55,472 --> 00:16:57,458
I like Dr. John Lundberg.
409
00:16:58,442 --> 00:17:00,153
I haven't even heard him speak yet.
410
00:17:00,177 --> 00:17:02,288
He has the highest U.S.M.L.E. scores.
411
00:17:02,312 --> 00:17:03,923
And that's important to you?
412
00:17:04,381 --> 00:17:05,633
Yes.
413
00:17:06,616 --> 00:17:09,637
It shows he has a broad
knowledge of medicine.
414
00:17:10,120 --> 00:17:12,832
What is important to you?
415
00:17:12,856 --> 00:17:15,802
Well, I'm more interested in what
they can do with their knowledge,
416
00:17:15,826 --> 00:17:19,005
which is why, so far,
I'm most impressed with Jordan Allen.
417
00:17:19,029 --> 00:17:23,042
No. No, you said she undermined you.
418
00:17:23,066 --> 00:17:27,346
Which takes courage and an
assertiveness that will serve her well.
419
00:17:27,370 --> 00:17:30,817
Then why did you tell her
to stop lecturing you?
420
00:17:30,841 --> 00:17:33,219
It's easier to teach an
aggressive resident restraint
421
00:17:33,243 --> 00:17:35,221
than a passive one to assert themselves.
422
00:17:35,245 --> 00:17:36,245
Oh.
423
00:17:38,348 --> 00:17:40,493
What about you, Park?
What's important to you?
424
00:17:40,517 --> 00:17:43,396
I wanna know who I can stand
to be around for 80 hours a week.
425
00:17:43,420 --> 00:17:44,831
One thing I learned as a cop,
426
00:17:44,855 --> 00:17:46,299
you don't really know a person
427
00:17:46,323 --> 00:17:48,134
until you've had a few drinks with them.
428
00:17:54,998 --> 00:17:56,642
LAD and circumflex look clean.
429
00:17:56,666 --> 00:17:58,711
What's with the right coronary?
430
00:17:58,735 --> 00:18:00,938
It looks narrowed at the origin.
431
00:18:01,538 --> 00:18:03,583
It's a bit narrow,
but looks like a normal variant.
432
00:18:03,607 --> 00:18:05,151
Yeah, but it seems hazy,
433
00:18:05,175 --> 00:18:08,070
like there could be
some tumor infiltration.
434
00:18:09,212 --> 00:18:10,212
What do you guys think?
435
00:18:10,614 --> 00:18:11,991
- Us?
- Yeah.
436
00:18:12,015 --> 00:18:13,200
Come take a look.
437
00:18:16,219 --> 00:18:17,396
I guess...
438
00:18:17,420 --> 00:18:18,454
- It's angiogenesis of the left...
- Stop.
439
00:18:20,257 --> 00:18:21,768
Interrupting a female coworker
440
00:18:21,792 --> 00:18:24,003
is almost as annoying as mansplaining.
441
00:18:24,027 --> 00:18:25,271
This isn't a rowing race.
442
00:18:25,295 --> 00:18:27,298
You don't always have to speak first.
443
00:18:28,598 --> 00:18:32,720
I... do not love the interruption.
444
00:18:34,169 --> 00:18:35,169
But...
445
00:18:35,805 --> 00:18:37,350
I like the enthusiasm.
446
00:18:39,055 --> 00:18:40,269
What were you gonna say?
447
00:18:41,611 --> 00:18:44,357
First, um, I'm not sexist.
448
00:18:45,358 --> 00:18:46,893
Of course not.
449
00:18:46,917 --> 00:18:49,228
He's shifting from right
to left dominant circulation
450
00:18:49,252 --> 00:18:50,763
to feed blood to the tumor.
451
00:18:50,787 --> 00:18:52,431
- Angiogenesis.
- I doubt it.
452
00:18:52,455 --> 00:18:54,367
Surgery already showed his tumor
extending to the right side, as well.
453
00:18:54,391 --> 00:18:55,701
What were you gonna say?
454
00:18:56,660 --> 00:18:58,954
The pulmonary artery is
right behind that vessel.
455
00:19:00,964 --> 00:19:03,576
It's causing radiographic
scatter in this area.
456
00:19:03,600 --> 00:19:05,211
The haze is just an artifact.
457
00:19:05,635 --> 00:19:06,921
His arteries are clean.
458
00:19:08,438 --> 00:19:09,632
I think she's right.
459
00:19:10,206 --> 00:19:11,206
Hmm.
460
00:19:13,443 --> 00:19:15,137
Your idea might just work.
461
00:19:19,828 --> 00:19:22,662
If you invert the
sutures and bury them under the skin,
462
00:19:22,686 --> 00:19:24,463
the scar will be invisible.
463
00:19:24,487 --> 00:19:26,399
No one will ever know we were here.
464
00:19:28,758 --> 00:19:29,758
Nice work, both of you.
465
00:19:32,195 --> 00:19:33,673
Her BP's dropping.
466
00:19:33,697 --> 00:19:35,975
Push fluids,
start IV pressors. Check for bleeding.
467
00:19:35,999 --> 00:19:37,378
She's in V-tach.
468
00:19:37,402 --> 00:19:38,869
Move in the crash cart.
469
00:19:40,337 --> 00:19:42,004
No bleeding. No hematomas.
470
00:19:43,373 --> 00:19:45,007
Charging.
471
00:19:45,709 --> 00:19:46,853
Clear.
472
00:19:55,318 --> 00:19:57,797
Sinus rhythm. Her BP is stabilizing.
473
00:20:00,657 --> 00:20:04,337
Get her to the ICU. I want post-op labs,
CTA chest,
474
00:20:04,361 --> 00:20:06,272
and full 24-hour cardiac telemetry.
475
00:20:07,697 --> 00:20:08,941
We need to figure out what just happened.
476
00:20:15,512 --> 00:20:17,323
She's stable,
477
00:20:17,347 --> 00:20:19,025
but diffuse delta wave slowing.
478
00:20:19,049 --> 00:20:21,060
Minimal brain activity.
479
00:20:21,084 --> 00:20:23,663
An undiagnosed metabolic
disorder could've caused
480
00:20:23,687 --> 00:20:25,298
an adverse reaction to the anesthesia.
481
00:20:25,322 --> 00:20:27,533
Yeah, but her pre-op labs
were all normal.
482
00:20:27,557 --> 00:20:29,837
It's gotta be some sort
of hidden heart condition.
483
00:20:30,399 --> 00:20:34,175
You're big on opinions. How are you
with ideas? What would you do next?
484
00:20:36,333 --> 00:20:37,910
I'd check train of fours
485
00:20:37,934 --> 00:20:40,880
and reverse the paralytics
with neostigmine.
486
00:20:40,904 --> 00:20:43,100
If Dr. Murphy's right,
she should wake up.
487
00:20:43,506 --> 00:20:45,484
Smart. But risky.
488
00:20:45,508 --> 00:20:47,420
The meds will stress her heart.
489
00:20:47,444 --> 00:20:49,537
If Park's right, she could arrest again.
490
00:20:51,281 --> 00:20:53,693
I saw a similar case
last year. In Borneo.
491
00:20:53,717 --> 00:20:55,528
You interned at a hospital in Borneo?
492
00:20:55,552 --> 00:20:59,658
Uh, no. I, uh, volunteered at
an orangutan rescue foundation.
493
00:21:00,523 --> 00:21:03,869
Our guide, a local villager,
fell out of a tree.
494
00:21:03,893 --> 00:21:05,338
He was, like, 80 feet up.
495
00:21:05,362 --> 00:21:08,107
How is falling out of a tree
similar to a patient arresting
496
00:21:08,131 --> 00:21:10,543
during breast reconstruction surgery?
497
00:21:10,567 --> 00:21:12,178
Well, he broke his back,
498
00:21:12,202 --> 00:21:13,679
uh, but when we got him to the hospital,
499
00:21:13,703 --> 00:21:15,681
I found he also had heart
damage from rheumatic fever
500
00:21:15,705 --> 00:21:19,385
and metabolic abnormality
from iodine deficiency.
501
00:21:19,409 --> 00:21:21,721
It's rare here, but it's common there.
502
00:21:21,745 --> 00:21:23,789
We only realized it when we
ran a nuclear profusion scan
503
00:21:23,813 --> 00:21:24,975
of his entire body.
504
00:21:25,448 --> 00:21:27,059
Good catch.
505
00:21:27,083 --> 00:21:30,396
But a scan that extensive
requires multiple radioactive tracers.
506
00:21:30,420 --> 00:21:31,732
You think her heart could handle that?
507
00:21:32,255 --> 00:21:33,933
Not tonight.
508
00:21:33,957 --> 00:21:35,819
I'll get consent from the mom.
509
00:21:36,226 --> 00:21:37,426
We'll do it first thing in the morning.
510
00:21:38,461 --> 00:21:40,206
Once we confirm atrial closure,
511
00:21:40,230 --> 00:21:42,041
we'll put the heart back in.
512
00:21:42,065 --> 00:21:43,909
Dr. Lim will reconnect the aorta
513
00:21:43,933 --> 00:21:45,745
and the superior venous connections,
514
00:21:45,769 --> 00:21:47,413
while I connect the inferior.
515
00:21:47,437 --> 00:21:49,148
During my sub-internship,
516
00:21:49,172 --> 00:21:51,384
I assisted on multiple heart transplants.
517
00:21:51,408 --> 00:21:52,962
Even sutured the atrial cuff in one.
518
00:21:54,411 --> 00:21:56,590
I got to scrub in on
a liver transplant once.
519
00:21:57,113 --> 00:21:58,424
The... The patient died.
520
00:21:58,448 --> 00:22:00,010
What'd you learn?
521
00:22:00,617 --> 00:22:03,262
That bile duct leaks are a lot
harder to detect than bleeds.
522
00:22:03,286 --> 00:22:04,730
Good. Next time, I'd lead with that
523
00:22:04,754 --> 00:22:06,225
instead of the patient's death.
524
00:22:10,126 --> 00:22:11,337
Are you all done yet?
525
00:22:11,361 --> 00:22:12,838
Why?
526
00:22:12,862 --> 00:22:16,110
Dr. Park wants everyone
to join him in the break room.
527
00:22:22,772 --> 00:22:24,483
I'm Alex Park.
528
00:22:24,507 --> 00:22:27,653
I'm a former amateur
martial arts competitor
529
00:22:27,677 --> 00:22:29,989
who once thought it'd be
fun to spar with a pro boxer
530
00:22:30,013 --> 00:22:31,690
visiting my dad's gym.
531
00:22:31,714 --> 00:22:34,837
And that guy was, uh, Mike Tyson.
532
00:22:37,467 --> 00:22:38,944
Who's Mike Tyson?
533
00:22:39,155 --> 00:22:41,700
He's a guy from The Hangover.
534
00:22:41,724 --> 00:22:43,804
With the tiger and
the tattoo on his face.
535
00:22:45,028 --> 00:22:47,641
Nice. You've just revealed
you're crazy and old.
536
00:22:51,401 --> 00:22:54,213
I've seen the musical
Wicked over 50 times.
537
00:22:54,237 --> 00:22:57,516
The San Francisco tryout,
Broadway, Chicago.
538
00:22:57,540 --> 00:22:59,852
I've even seen a friend's
boyfriend's niece play Glinda
539
00:22:59,876 --> 00:23:01,322
at Stagedoor summer camp.
540
00:23:01,845 --> 00:23:03,824
Nerd. Next.
541
00:23:06,916 --> 00:23:09,495
I'm Claire Browne.
542
00:23:09,519 --> 00:23:12,865
Um, I love music,
543
00:23:12,889 --> 00:23:16,368
but I hate musicals, and, um, I don't...
544
00:23:16,392 --> 00:23:19,465
I don't really like to talk about myself,
so it's Shaun's turn.
545
00:23:26,202 --> 00:23:28,414
My name is Dr. Shaun Murphy.
546
00:23:28,438 --> 00:23:30,316
I used to not like music,
547
00:23:30,340 --> 00:23:33,752
but my girlfriend, Lea,
she changed my mind.
548
00:23:33,776 --> 00:23:37,441
I also like to watch The
Weather Channel on TV.
549
00:23:37,947 --> 00:23:39,058
And...
550
00:23:41,117 --> 00:23:43,062
I think pickles are disgusting.
551
00:23:46,256 --> 00:23:47,733
Cops know how to manage up.
552
00:23:47,757 --> 00:23:49,201
Managing down's another story.
553
00:23:49,225 --> 00:23:51,537
Well, he's mature, thoughtful,
554
00:23:51,561 --> 00:23:53,040
doesn't have an ego.
555
00:23:53,530 --> 00:23:55,207
Neither does Murphy,
556
00:23:55,231 --> 00:23:57,795
but do you think that qualifies
him to supervise First Years?
557
00:23:58,535 --> 00:24:00,214
Well, Murphy's smart,
558
00:24:00,637 --> 00:24:02,681
brutally honest,
has no regard for social convention.
559
00:24:02,705 --> 00:24:04,049
Mmm.
560
00:24:04,073 --> 00:24:05,469
It works for Bill Belichick.
561
00:24:07,043 --> 00:24:09,221
The Patriots are the most corrupt,
dishonest organization
562
00:24:09,245 --> 00:24:10,516
in the history of the NFL.
563
00:24:11,214 --> 00:24:12,393
Well, the Seahawks suck.
564
00:24:14,083 --> 00:24:16,063
So, how's your experience been here?
565
00:24:16,886 --> 00:24:18,315
It's been good.
566
00:24:21,991 --> 00:24:23,903
Did you consider any other programs
567
00:24:23,927 --> 00:24:25,447
or was this your first choice?
568
00:24:25,895 --> 00:24:28,367
This was my only choice.
569
00:24:28,932 --> 00:24:30,411
Why do you hate God?
570
00:24:31,668 --> 00:24:33,979
Oh. Uh, actually,
571
00:24:34,003 --> 00:24:36,083
I don't believe there is a God.
572
00:24:37,273 --> 00:24:39,151
I thought maybe it was because
573
00:24:39,175 --> 00:24:41,453
you believed he hated homosexuals.
574
00:24:41,477 --> 00:24:43,589
I... I don't think this is something
575
00:24:43,613 --> 00:24:45,259
that we should be discussing at work.
576
00:24:47,917 --> 00:24:48,917
Why not?
577
00:24:51,354 --> 00:24:54,143
Well, because it's personal.
578
00:24:57,493 --> 00:24:59,138
Do you have a boyfriend?
579
00:24:59,162 --> 00:25:02,408
I... I'm sorry, but you can't ask
that question in a workplace.
580
00:25:02,432 --> 00:25:06,011
Dr. Park, he wants us to get to know you.
581
00:25:06,035 --> 00:25:10,082
How can I do that without
asking personal questions?
582
00:25:10,106 --> 00:25:13,452
I have a girlfriend,
and she is very important to me.
583
00:25:13,476 --> 00:25:15,372
It affects my life in every way.
584
00:25:16,613 --> 00:25:18,324
Probably should've thought
of that before you told her
585
00:25:18,348 --> 00:25:20,127
how much her voice annoyed you.
586
00:25:20,950 --> 00:25:24,129
I said it didn't bother me.
587
00:25:24,153 --> 00:25:25,965
It... It was a compliment.
588
00:25:25,989 --> 00:25:29,335
What I heard is you
criticizing her voice,
589
00:25:29,359 --> 00:25:30,826
and you bringing her mother into it.
590
00:25:33,329 --> 00:25:34,329
You're in trouble.
591
00:25:40,398 --> 00:25:42,610
What about Browne?
592
00:25:42,634 --> 00:25:45,045
She may have as much
problem being a leader as Murphy,
593
00:25:45,069 --> 00:25:46,361
and without his gifts.
594
00:25:46,738 --> 00:25:48,516
She has her own gifts.
595
00:25:48,540 --> 00:25:51,252
Yeah, dealing with patients
and their families.
596
00:25:51,276 --> 00:25:55,055
But with her colleagues,
she can be insecure.
597
00:25:55,079 --> 00:25:56,891
Her assertiveness has always
been a question mark for me.
598
00:25:56,915 --> 00:25:59,093
They've all got areas
that need improving,
599
00:25:59,117 --> 00:26:01,485
but I've gotten to know Browne a
bit better these past few months.
600
00:26:03,087 --> 00:26:04,838
She's stronger than she looks.
601
00:26:07,125 --> 00:26:09,370
When's the last time you saw
anyone digging a ditch in a suit and tie?
602
00:26:09,394 --> 00:26:11,405
Surgeons don't dig ditches.
603
00:26:11,429 --> 00:26:14,808
They help people at the most
vulnerable time in their life.
604
00:26:14,832 --> 00:26:17,711
And you shouldn't take
the responsibility on
605
00:26:17,735 --> 00:26:18,936
if you're not fully committed to it.
606
00:26:20,405 --> 00:26:22,249
You're entering a new
phase in your career,
607
00:26:22,273 --> 00:26:23,651
position of authority.
608
00:26:23,675 --> 00:26:25,484
Maybe my clothes are
making you feel disrespected.
609
00:26:25,677 --> 00:26:26,987
No.
610
00:26:27,011 --> 00:26:28,722
The truth is,
611
00:26:28,746 --> 00:26:30,906
I just hate wearing anything
that makes me feel like
612
00:26:32,175 --> 00:26:33,175
a suit.
613
00:26:34,619 --> 00:26:36,096
Great news.
614
00:26:36,120 --> 00:26:38,205
I was able to get Sowinski
on anesthesia for tomorrow.
615
00:26:38,489 --> 00:26:40,134
Uh, why? What happened to Foley?
616
00:26:40,158 --> 00:26:41,969
Nothing, I just think Sowinski's better.
617
00:26:41,993 --> 00:26:43,804
And we definitely need
the A-team on this.
618
00:26:43,828 --> 00:26:45,339
Yeah, I... I agree.
619
00:26:45,363 --> 00:26:48,342
Which is why I went out
of my way to get Foley.
620
00:26:48,366 --> 00:26:50,175
But Foley doesn't do well under pressure.
621
00:26:50,835 --> 00:26:52,302
- Remember that time...
- Morgan.
622
00:26:52,837 --> 00:26:55,305
You need to butt out. You're
not a surgeon. This is not your job.
623
00:26:56,841 --> 00:27:00,654
My job is to help my patient
through the entire treatment process.
624
00:27:00,678 --> 00:27:03,457
The best anesthesiologist for
transplant surgery is Sowinski.
625
00:27:03,481 --> 00:27:05,215
And I've already cleared it with Lim,
so that's who it's gonna be.
626
00:27:06,351 --> 00:27:07,351
Deal with it.
627
00:27:16,088 --> 00:27:18,120
Are you mad at me?
628
00:27:21,460 --> 00:27:24,835
I said your voice doesn't bother me.
629
00:27:25,097 --> 00:27:27,876
It was a compliment.
630
00:27:27,900 --> 00:27:31,212
Actually, what you said is that
you love my breasts so much
631
00:27:31,236 --> 00:27:34,382
that with the help of
noise-canceling headphones,
632
00:27:34,406 --> 00:27:36,972
you're willing to put up
with my annoying voice.
633
00:27:37,923 --> 00:27:38,923
Yes.
634
00:27:39,965 --> 00:27:41,393
Not a compliment.
635
00:27:42,147 --> 00:27:43,725
Oh.
636
00:27:43,749 --> 00:27:45,835
So you are mad at me?
637
00:27:45,859 --> 00:27:47,629
I'm not mad, Shaun. I'm just busy,
638
00:27:47,653 --> 00:27:49,898
trying to keep, like, a billion bots
and hackers out of our network.
639
00:27:51,991 --> 00:27:53,335
Actually, no. I'm not doing that.
640
00:27:53,359 --> 00:27:54,569
Gonna go home.
641
00:27:54,593 --> 00:27:57,739
You want to have some tequila, stat?
642
00:27:57,763 --> 00:27:59,774
We also have some pizza left.
643
00:27:59,798 --> 00:28:02,496
No, I don't want tequila or pizza.
644
00:28:02,520 --> 00:28:04,279
That must mean you're mad.
645
00:28:04,303 --> 00:28:06,752
I'm just... upset.
646
00:28:07,206 --> 00:28:09,284
And confused.
647
00:28:09,308 --> 00:28:12,187
And I really don't think there
is anything you can do about it,
648
00:28:12,211 --> 00:28:15,761
so you just need to stop
trying and leave me alone.
649
00:28:24,657 --> 00:28:26,868
She's not mad at me.
650
00:28:26,892 --> 00:28:28,536
She's definitely mad at you.
651
00:28:28,560 --> 00:28:31,306
She doesn't usually hide what she thinks.
652
00:28:31,330 --> 00:28:33,028
She's not mad at him.
653
00:28:33,999 --> 00:28:37,212
She knows how he is, how he talks.
654
00:28:37,236 --> 00:28:39,451
She's mad at herself. And scared.
655
00:28:40,639 --> 00:28:42,951
We all have stuff that
we're insecure about.
656
00:28:42,975 --> 00:28:44,748
That's why it's so risky falling in love.
657
00:28:47,482 --> 00:28:49,157
We all hope that when
we let our guard down,
658
00:28:49,181 --> 00:28:51,296
it's for the one person
that doesn't see our flaws.
659
00:28:55,421 --> 00:28:58,553
So, what do I do?
660
00:28:59,658 --> 00:29:02,804
You were being honest.
You can't apologize that away.
661
00:29:02,828 --> 00:29:03,949
You gotta figure out what she needs
662
00:29:03,973 --> 00:29:05,644
to feel secure in the relationship again.
663
00:29:08,901 --> 00:29:10,941
Don't look at me. I'm single.
664
00:29:16,041 --> 00:29:18,687
It's not my place to
comment on your personal life.
665
00:29:18,711 --> 00:29:20,784
You have an opinion. Let's hear it.
666
00:29:21,246 --> 00:29:22,246
Fine.
667
00:29:24,049 --> 00:29:25,894
Can you zoom in on her skull base?
668
00:29:25,918 --> 00:29:27,362
I can, but why?
669
00:29:27,386 --> 00:29:30,085
We're worried about her heart
and metabolic abnormalities.
670
00:29:30,556 --> 00:29:33,368
We shouldn't be. Not anymore.
671
00:29:33,392 --> 00:29:36,104
You and Dr. Murphy were both wrong.
672
00:29:36,128 --> 00:29:39,507
She doesn't have a
cardiac or metabolic issue.
673
00:29:39,531 --> 00:29:42,043
She has poor blood flow
in the artery supplying blood
674
00:29:42,067 --> 00:29:43,945
to the area of her brain
that controls consciousness.
675
00:29:43,969 --> 00:29:47,015
A small clot in her artery of Percheron.
676
00:29:47,039 --> 00:29:50,480
If we don't remove it fast,
she's never going to wake up.
677
00:30:02,454 --> 00:30:03,798
That's amazing.
678
00:30:03,822 --> 00:30:06,067
No, it's not.
679
00:30:06,091 --> 00:30:09,304
The heart's totally outside
of the body and still beating.
680
00:30:09,328 --> 00:30:11,239
It's like it has a mind of its own.
681
00:30:11,263 --> 00:30:13,742
She should've started
the reimplantation by now.
682
00:30:13,766 --> 00:30:15,643
Is everything okay, Dr. Lim?
683
00:30:15,667 --> 00:30:18,379
The tumor had tendrils
invading the right atrial wall.
684
00:30:18,403 --> 00:30:20,448
We took so much tissue
to get a clear margin,
685
00:30:20,472 --> 00:30:23,952
there's not enough left to
reconstruct his heart's inflow chambers.
686
00:30:23,976 --> 00:30:25,553
How about expanded PTFE graft?
687
00:30:25,577 --> 00:30:27,422
There's not enough atrial
remnant to attach the graft.
688
00:30:27,446 --> 00:30:28,923
You could use the septal wall.
689
00:30:28,947 --> 00:30:30,825
He's got dense conduction fibers there.
690
00:30:30,849 --> 00:30:32,660
- It could cause heart arrhythmias.
- Not if you use...
691
00:30:32,684 --> 00:30:34,566
He's got low arterial pressure.
692
00:30:35,120 --> 00:30:36,898
He's springing leaks
at the cannulation sites.
693
00:30:36,922 --> 00:30:38,833
It's a bleeding disorder
caused by prolonged bypass.
694
00:30:38,857 --> 00:30:40,468
You need to get his heart back in ASAP.
695
00:30:40,492 --> 00:30:43,658
Morgan, we can't put the heart
back in with two missing chambers.
696
00:30:50,087 --> 00:30:51,598
It's a rare complication,
697
00:30:51,622 --> 00:30:54,034
but a blood clot is
a risk in any surgery.
698
00:30:54,058 --> 00:30:55,902
It's too deep in
the brain for open surgery.
699
00:30:55,926 --> 00:30:57,371
If we go rooting around in there,
700
00:30:57,395 --> 00:31:00,307
we'd definitely damage
the PCA and kill her.
701
00:31:00,331 --> 00:31:02,743
We could inject a
dissolving agent into the clot.
702
00:31:02,767 --> 00:31:07,314
There's a 50% probability
it won't fully dissolve,
703
00:31:07,338 --> 00:31:08,872
which could leave her
with permanent weakness
704
00:31:08,896 --> 00:31:10,117
and cognitive difficulties.
705
00:31:10,141 --> 00:31:12,228
Assuming she wakes up at all.
706
00:31:16,614 --> 00:31:19,416
We need to remove the clot
with a stent retriever.
707
00:31:21,919 --> 00:31:23,964
If we rupture the
posterior cerebral artery,
708
00:31:23,988 --> 00:31:25,742
she'll die on the table.
709
00:31:27,691 --> 00:31:29,621
Or total recovery.
710
00:31:31,095 --> 00:31:32,973
That's how she came into this hospital.
711
00:31:32,997 --> 00:31:34,834
That's how she's leaving.
712
00:31:37,635 --> 00:31:39,214
Prep her for stent retrieval.
713
00:31:41,372 --> 00:31:44,151
I'm hanging platelets
and fresh frozen plasma.
714
00:31:44,175 --> 00:31:45,986
His pressure is still in the toilet,
715
00:31:46,010 --> 00:31:47,621
but the bleeding is slowing down.
716
00:31:47,645 --> 00:31:49,089
Not for long.
717
00:31:49,113 --> 00:31:51,358
Small intestine submucosa
has the right compliance
718
00:31:51,382 --> 00:31:53,193
to shape the chamber walls, but...
719
00:31:53,217 --> 00:31:54,795
There isn't enough to
cover that much area.
720
00:31:54,819 --> 00:31:57,164
Use too little and he'll
have heart failure in a month.
721
00:31:57,188 --> 00:31:59,166
I know. That's the "but."
722
00:31:59,190 --> 00:32:00,367
How thick is his deep fascia?
723
00:32:00,391 --> 00:32:01,368
If it's over 2 millimeters...
724
00:32:01,392 --> 00:32:02,392
Morgan.
725
00:32:03,227 --> 00:32:04,504
Get out.
726
00:32:04,528 --> 00:32:06,139
I'm sorry. I'll... I'll be quiet.
727
00:32:06,163 --> 00:32:07,340
No, you won't. You can't.
728
00:32:07,364 --> 00:32:08,702
So leave the OR gallery.
729
00:32:11,202 --> 00:32:12,202
Now.
730
00:32:18,676 --> 00:32:22,289
We need 2.6-millimeter-thick
tissue with perfect compliance
731
00:32:22,313 --> 00:32:24,791
for arterial filling
and contractile pressures.
732
00:32:24,815 --> 00:32:27,994
If it was just the valve,
we'd use a bovine pericardial graft.
733
00:32:28,018 --> 00:32:31,698
But cow heart tissue is not durable
enough to do an entire chamber.
734
00:32:31,722 --> 00:32:34,367
But pig bladder tissue is just right.
735
00:32:34,391 --> 00:32:37,671
I've used it for bladder reconstructive
surgeries, but never hearts.
736
00:32:37,695 --> 00:32:39,774
Let's rebuild the
entire atrial walls with it.
737
00:32:40,731 --> 00:32:42,209
Get down to the tissue procurement lab
738
00:32:42,233 --> 00:32:44,100
and get 200 centimeters
of porcine bladder tissue.
739
00:32:54,044 --> 00:32:56,523
Her EEG delta waves are slowing further.
740
00:32:56,547 --> 00:32:59,044
She only has
one vessel feeding her thalamus.
741
00:32:59,884 --> 00:33:02,095
That's why the clot landed where it did.
742
00:33:02,119 --> 00:33:05,265
I'm approaching the artery of Percheron.
743
00:33:05,289 --> 00:33:07,501
I'm one millimeter from the clot.
744
00:33:07,525 --> 00:33:08,803
Stop right there.
745
00:33:14,131 --> 00:33:15,375
If we disrupt this clot,
746
00:33:15,399 --> 00:33:17,395
we could cause a shower
of emboli into her brain.
747
00:33:41,125 --> 00:33:42,545
Deploying the retriever.
748
00:33:46,297 --> 00:33:47,607
EEG just went flatline.
749
00:33:47,631 --> 00:33:49,135
Calm down. I'm almost...
750
00:33:51,502 --> 00:33:52,722
Got it.
751
00:33:58,976 --> 00:34:01,121
Blood's flowing through the artery.
752
00:34:01,145 --> 00:34:03,123
Her brain tracing's looking better.
753
00:34:09,620 --> 00:34:13,600
This should fill the gap between
the inferior and superior vena cava
754
00:34:13,624 --> 00:34:15,537
when the new chambers get sewn in.
755
00:34:15,693 --> 00:34:17,837
Where's that graft?
756
00:34:17,861 --> 00:34:20,073
I need more sponges. The
bleeding is getting worse.
757
00:34:20,097 --> 00:34:21,474
Oh, he's tanking.
758
00:34:21,498 --> 00:34:22,609
Can you push epi?
759
00:34:22,633 --> 00:34:23,977
I already did. He's maxing out.
760
00:34:24,001 --> 00:34:25,713
I'm running out of ways
to keep his pressure up.
761
00:34:26,203 --> 00:34:27,447
I got it.
762
00:34:27,471 --> 00:34:29,092
They had 205 centimeters of it.
763
00:34:29,373 --> 00:34:31,010
Thank you.
764
00:34:31,642 --> 00:34:34,087
If you want to gown up,
you can watch from down here.
765
00:34:34,111 --> 00:34:35,640
Definitely. Thanks.
766
00:34:38,215 --> 00:34:40,126
I thought telling her how much I love her
767
00:34:40,150 --> 00:34:42,162
in front of other people
would make her feel good.
768
00:34:42,186 --> 00:34:46,067
But Dr. Guerin said I made
her feel insecure, and scared.
769
00:34:46,657 --> 00:34:48,027
Women are sensitive.
770
00:34:48,726 --> 00:34:51,004
When commenting on their flaws,
771
00:34:51,028 --> 00:34:53,473
total honesty is a high-risk procedure.
772
00:34:53,497 --> 00:34:54,975
That sounds sexist.
773
00:34:54,999 --> 00:34:57,510
Aren't men also
insecure about their flaws?
774
00:34:57,534 --> 00:34:59,012
Men are much, much worse.
775
00:34:59,036 --> 00:35:00,714
And also, we're really stupid.
776
00:35:00,738 --> 00:35:01,815
Okay.
777
00:35:01,839 --> 00:35:04,551
What can I do now?
778
00:35:04,575 --> 00:35:07,187
I've already said my stupid stuff.
779
00:35:07,211 --> 00:35:09,173
I don't want her to be upset with me.
780
00:35:11,415 --> 00:35:12,415
I have a thought.
781
00:35:14,692 --> 00:35:17,230
I think this run of sutures
will hold it to the annulus,
782
00:35:17,254 --> 00:35:18,665
but I'm worried about leaks.
783
00:35:18,689 --> 00:35:20,367
We can put a second
row of pledgeted sutures
784
00:35:20,391 --> 00:35:22,068
to make sure it's hemostatic.
785
00:35:22,092 --> 00:35:24,272
That is unreal.
786
00:35:25,362 --> 00:35:26,691
It's a work of art.
787
00:35:28,999 --> 00:35:30,343
Now let's get it back in
788
00:35:30,367 --> 00:35:32,155
while we can still get
him off bypass alive.
789
00:35:36,874 --> 00:35:38,453
Re-perfusing the heart.
790
00:35:40,177 --> 00:35:41,377
We've got a rhythm.
791
00:36:11,680 --> 00:36:12,680
Hey.
792
00:36:14,683 --> 00:36:16,061
There was a complication
793
00:36:16,085 --> 00:36:17,825
during the reconstruction surgery.
794
00:36:18,954 --> 00:36:21,663
A clot,
which caused you to lapse into a coma.
795
00:36:23,198 --> 00:36:25,310
We performed a second
surgery on your brain,
796
00:36:25,367 --> 00:36:26,668
which was successful.
797
00:36:27,062 --> 00:36:28,173
Um...
798
00:36:28,198 --> 00:36:29,508
You're gonna be fine.
799
00:36:29,533 --> 00:36:31,378
But my breasts...
800
00:36:31,403 --> 00:36:35,468
The clot occurred after we
finished inserting the implants.
801
00:36:38,468 --> 00:36:40,515
I think you're gonna be
very pleased with the results.
802
00:36:42,038 --> 00:36:43,226
Thank you.
803
00:36:43,640 --> 00:36:44,640
Yep.
804
00:36:51,281 --> 00:36:55,154
I... think I'm sorry.
805
00:36:58,989 --> 00:37:03,236
Dr. Guerin said I should never say
anything that might sound negative
806
00:37:03,260 --> 00:37:04,871
to a girlfriend.
807
00:37:04,895 --> 00:37:09,085
And Dr. Glassman said total
honesty is a high-risk procedure
808
00:37:09,733 --> 00:37:11,110
with a girlfriend.
809
00:37:11,134 --> 00:37:14,173
It's better to show my
love than try to explain it.
810
00:37:17,147 --> 00:37:22,598
But I want to be totally honest with you.
811
00:37:28,952 --> 00:37:33,599
I don't like your body
because it's excellent.
812
00:37:33,623 --> 00:37:35,737
I like it because it's yours.
813
00:37:38,161 --> 00:37:42,141
And I love hearing you talk.
814
00:37:42,165 --> 00:37:44,036
When I hear your voice,
815
00:37:44,534 --> 00:37:47,613
especially when I've had a difficult day,
816
00:37:47,637 --> 00:37:49,250
I find it comforting.
817
00:37:54,678 --> 00:37:57,258
Now I want to hug you. Can I?
818
00:37:57,948 --> 00:37:59,177
I'd like that.
819
00:38:10,026 --> 00:38:11,026
I love you.
820
00:38:12,729 --> 00:38:13,941
Thank you.
821
00:38:15,298 --> 00:38:17,403
For your total honesty.
822
00:38:24,674 --> 00:38:25,851
Your surgery went well.
823
00:38:25,875 --> 00:38:27,053
With some time in rehab,
824
00:38:27,077 --> 00:38:28,623
you should be back to work in a month.
825
00:38:29,207 --> 00:38:30,656
Thank you.
826
00:38:30,680 --> 00:38:32,835
Don't thank me. Thank your surgeon.
827
00:38:33,750 --> 00:38:35,463
She did all the important stuff.
828
00:38:40,090 --> 00:38:42,335
Lim's golden boy is in.
Nothing we can do about that.
829
00:38:42,359 --> 00:38:44,670
So that leaves three openings.
830
00:38:44,694 --> 00:38:47,673
The thought of working with Will
Hooper for the next two years...
831
00:38:47,697 --> 00:38:49,742
If Dr. Lim thinks he'll
be a good resident,
832
00:38:49,766 --> 00:38:51,978
I'm sure she has good reasons.
833
00:38:52,002 --> 00:38:55,581
She probably thinks arrogance
is helpful to a surgeon.
834
00:38:55,605 --> 00:38:57,516
Well, we could try to change her mind.
835
00:38:57,540 --> 00:38:59,752
Eh, she asked us to evaluate
the applicants, not her.
836
00:38:59,776 --> 00:39:02,722
She asked us to be totally honest.
837
00:39:02,746 --> 00:39:05,091
Eh, "totally honest" is a relative term
838
00:39:05,115 --> 00:39:07,411
when you're telling your
boss she's totally wrong.
839
00:39:11,221 --> 00:39:13,032
So, Hooper's in. Who else?
840
00:39:13,056 --> 00:39:16,602
Dr. Andrews likes Dr. Jordan Allen.
841
00:39:16,626 --> 00:39:19,262
Oh, I do, too. She's confident, driven.
842
00:39:19,295 --> 00:39:20,740
She won't take a lot of hand-holding,
843
00:39:20,764 --> 00:39:23,469
and keeping Andrews happy keeps us happy.
844
00:39:23,900 --> 00:39:26,264
That leaves two more. Who's next?
845
00:39:26,936 --> 00:39:31,050
Asher Wolke is very
up-front about who he is.
846
00:39:31,074 --> 00:39:33,619
- I like that.
- He's definitely eager.
847
00:39:33,643 --> 00:39:35,254
And he couldn't be more open to learning.
848
00:39:35,278 --> 00:39:36,722
Agree.
849
00:39:36,746 --> 00:39:37,984
That leaves one more.
850
00:39:39,282 --> 00:39:40,695
John Lundberg.
851
00:39:41,951 --> 00:39:43,863
Smart, professional, mature.
852
00:39:43,887 --> 00:39:45,116
He's a no-brainer.
853
00:39:45,889 --> 00:39:47,199
Lundberg's in.
854
00:39:47,223 --> 00:39:49,035
Lundberg's out.
855
00:39:49,059 --> 00:39:50,903
He stopped by my office before he left.
856
00:39:50,927 --> 00:39:53,249
Said he's no longer interested.
857
00:39:54,130 --> 00:39:57,378
He said you all were unprofessional.
858
00:39:57,901 --> 00:39:59,505
Drinking at work.
859
00:40:00,170 --> 00:40:02,341
Asking inappropriate questions.
860
00:40:02,731 --> 00:40:04,110
Dating drama.
861
00:40:05,398 --> 00:40:07,253
Mmm-hmm.
862
00:40:07,277 --> 00:40:10,725
So, who's your alt? Olivia
Jackson or Boardshorts?
863
00:40:11,948 --> 00:40:15,104
Olivia knows her stuff,
but she's a bit insecure.
864
00:40:15,618 --> 00:40:18,130
Her answers sound like questions.
865
00:40:18,154 --> 00:40:20,666
I like Boardshorts. He's sensitive.
866
00:40:20,690 --> 00:40:22,028
Like a woman.
867
00:40:27,597 --> 00:40:29,577
I vote for both of them.
868
00:40:30,366 --> 00:40:32,955
That's not an option.
We don't have the budget.
869
00:40:34,971 --> 00:40:36,626
Hooper is the worst.
870
00:40:37,507 --> 00:40:38,919
The person I said was the best?
871
00:40:39,642 --> 00:40:42,521
He is arrogant and obnoxious.
872
00:40:42,545 --> 00:40:44,924
If he works here, we'll hate him,
873
00:40:44,948 --> 00:40:48,294
the work will suffer,
and we'll either kill patients
874
00:40:48,318 --> 00:40:50,014
or we'll kill him.
875
00:40:56,192 --> 00:40:59,106
And there is no way that you don't
see that, which makes me think...
876
00:41:02,385 --> 00:41:03,527
You do.
877
00:41:04,567 --> 00:41:05,567
This was a test.
878
00:41:07,070 --> 00:41:10,868
You just wanted to see
if we'd be totally honest.
879
00:41:12,675 --> 00:41:14,987
Well done.
880
00:41:15,011 --> 00:41:17,656
Hooper is definitely the worst.
881
00:41:17,680 --> 00:41:20,159
I only let him shadow as
a favor to a board member.
882
00:41:20,183 --> 00:41:21,694
I figured I'd give him a second chance
883
00:41:21,718 --> 00:41:23,381
after his obnoxious interview.
884
00:41:23,853 --> 00:41:26,175
And also do a little experiment.
885
00:41:28,825 --> 00:41:29,825
So...
886
00:41:30,860 --> 00:41:35,241
It's Jordan, Asher,
887
00:41:35,265 --> 00:41:38,229
Olivia, and Enrique.
888
00:41:40,670 --> 00:41:43,315
To the next phase
of your surgical training.
889
00:41:43,339 --> 00:41:44,884
You helped pick them.
890
00:41:44,908 --> 00:41:47,753
As senior residents,
it's now your job to help train them.
891
00:41:47,777 --> 00:41:50,055
And don't take this
responsibility lightly,
892
00:41:50,079 --> 00:41:51,867
because if you don't train them well,
893
00:41:52,182 --> 00:41:53,411
people will die.
66033
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