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00:00:01,218 --> 00:00:03,654
Hello.
I'm Freddie Highmore.
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00:00:03,655 --> 00:00:06,924
The following episode portrays
our hope for the future,
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00:00:06,925 --> 00:00:09,026
a future where no one
will have to wear masks
4
00:00:09,027 --> 00:00:11,962
or take other steps
to stay safe from COVID.
5
00:00:11,963 --> 00:00:15,208
Until then, please protect
yourself and others.
6
00:00:18,236 --> 00:00:19,670
I'm Jordan Allen.
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00:00:19,671 --> 00:00:21,872
My first year in med school,
I designed an ankle brace
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00:00:21,873 --> 00:00:25,042
that monitors extent of
immobilization via a phone app.
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00:00:25,043 --> 00:00:26,677
When I licensed it to Bioventus,
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00:00:26,678 --> 00:00:29,013
I was able to pay off
over half my student loans.
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00:00:30,438 --> 00:00:31,804
John Lundberg.
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00:00:31,805 --> 00:00:34,985
I've worked every summer since I
was 16 at Camp Hope Heartland,
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00:00:34,986 --> 00:00:37,553
a summer program for kids
with cancer in Des Moines,
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00:00:37,554 --> 00:00:38,689
where I grew up.
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00:00:38,690 --> 00:00:40,515
Asher Wolke.
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00:00:40,516 --> 00:00:42,023
Uh, when I was 18,
17
00:00:42,024 --> 00:00:45,562
I left the Hasidic community
that I was raised in.
18
00:00:45,563 --> 00:00:47,330
I realized if there really was a God,
19
00:00:47,331 --> 00:00:49,332
it had to be a cruel being
20
00:00:49,333 --> 00:00:51,989
that I felt nothing but contempt for.
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00:00:52,904 --> 00:00:55,059
That's also when I decided
to go to med school,
22
00:00:55,060 --> 00:00:56,616
and start dating men.
23
00:01:00,478 --> 00:01:04,298
I'm Olivia Jackson.
I'm 25. From Chicago.
24
00:01:06,875 --> 00:01:09,718
I play ragtime piano
alone in my apartment.
25
00:01:11,890 --> 00:01:13,556
Is that interesting?
26
00:01:13,557 --> 00:01:15,292
Will Hooper.
27
00:01:15,293 --> 00:01:17,828
Technically,
I'm a professional athlete.
28
00:01:17,829 --> 00:01:19,876
Although in a sport
nobody pays attention to,
29
00:01:19,877 --> 00:01:22,299
and the stipend barely covers
our training expenses,
30
00:01:22,300 --> 00:01:25,397
but I'm on the US National Rowing team.
31
00:01:25,737 --> 00:01:26,937
Men's Eight.
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00:01:28,469 --> 00:01:31,208
Hey, I'm Enrique.
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00:01:31,209 --> 00:01:33,418
I spent last summer in Costa Rica,
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00:01:33,419 --> 00:01:37,184
where I learned to surf, which
I'm totally obsessed with now.
35
00:01:37,185 --> 00:01:42,652
Uh, I had a pretty interesting
encounter with a saltwater crocodile.
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00:01:42,653 --> 00:01:44,221
I just thought it was a big...
37
00:01:44,222 --> 00:01:46,338
Why are you wearing a swimsuit?
38
00:01:48,927 --> 00:01:51,218
Oh, they're actually
hybrid boardshorts.
39
00:01:51,595 --> 00:01:53,596
I like to work hard,
40
00:01:53,597 --> 00:01:55,397
and it's easier to do
when you're comfortable.
41
00:01:56,349 --> 00:02:00,644
Plus, I think the casual
dress puts patients at ease.
42
00:02:04,976 --> 00:02:06,176
Uh...
43
00:02:06,177 --> 00:02:07,820
And Dr. Lim said
that the
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00:02:08,265 --> 00:02:09,612
shorts were fine.
45
00:02:10,656 --> 00:02:13,853
Hospital policy requires
all residents to...
46
00:02:13,854 --> 00:02:16,229
He's not a resident. He's
a resident applicant.
47
00:02:16,230 --> 00:02:18,455
One of six finalists for four openings.
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00:02:18,456 --> 00:02:20,457
Now, they'll be shadowing for two days.
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00:02:20,458 --> 00:02:22,159
Give them the grand tour,
show them the ropes,
50
00:02:22,160 --> 00:02:23,326
feel free to turn up the heat a bit.
51
00:02:23,327 --> 00:02:24,810
See how they react under pressure.
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00:02:24,811 --> 00:02:27,297
You will be responsible
for supervising them,
53
00:02:27,298 --> 00:02:29,099
so I want your totally honest input
54
00:02:29,100 --> 00:02:30,600
before I make any final decisions.
55
00:02:30,601 --> 00:02:31,668
Those shorts...
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00:02:31,669 --> 00:02:33,370
Let's call them strike one.
57
00:02:33,371 --> 00:02:36,439
Oh, and in addition
to being an Olympian,
58
00:02:36,440 --> 00:02:38,008
Will Hooper is a Rhodes
59
00:02:38,009 --> 00:02:40,548
and graduated top of
his class at Stanford.
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00:02:40,549 --> 00:02:42,145
He is very handsome.
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00:02:42,146 --> 00:02:43,646
He's very full of himself.
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00:02:43,647 --> 00:02:45,682
He's ranked first by every top program,
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00:02:45,683 --> 00:02:47,950
so whatever you can do to
recruit him to ours, do it.
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00:02:47,951 --> 00:02:50,187
I can already give you
my input on the sh...
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00:02:50,188 --> 00:02:52,036
Don't judge a book by its boardshorts.
66
00:03:02,867 --> 00:03:04,234
You wanted to see me?
67
00:03:04,235 --> 00:03:05,869
Good morning.
68
00:03:05,870 --> 00:03:07,805
Sorry.
Good morning.
69
00:03:07,806 --> 00:03:09,472
What'd I do wrong?
70
00:03:09,473 --> 00:03:10,640
Just wanted to check in.
71
00:03:10,641 --> 00:03:12,364
See how the new role was coming along.
72
00:03:12,676 --> 00:03:13,876
Honestly?
73
00:03:15,980 --> 00:03:19,575
You could start our new supervisor
resident relationship with a lie.
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00:03:19,576 --> 00:03:20,905
That's always fun.
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00:03:22,587 --> 00:03:24,609
Internal medicine is
76
00:03:25,366 --> 00:03:26,566
boring.
77
00:03:27,218 --> 00:03:29,692
Between smokers and obese diabetics,
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00:03:29,693 --> 00:03:32,133
seems like all I'm doing is
protecting people from themselves.
79
00:03:35,033 --> 00:03:36,733
As a surgical resident,
80
00:03:36,734 --> 00:03:38,401
you never treated drunk drivers?
81
00:03:38,402 --> 00:03:40,563
Or extracted random
objects from guys'...
82
00:03:40,564 --> 00:03:42,239
I get it. People are stupid.
83
00:03:42,240 --> 00:03:43,830
Not my point, but true.
84
00:03:46,244 --> 00:03:47,878
Not the same adrenaline rush,
85
00:03:47,879 --> 00:03:50,537
but internal medicine can be rewarding.
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00:03:51,271 --> 00:03:53,845
Given time, if you're patient.
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00:03:55,219 --> 00:03:56,419
Thanks.
88
00:03:58,790 --> 00:04:01,097
That is not how I thought
this meeting was gonna go.
89
00:04:02,346 --> 00:04:04,361
I thought one of the nurses
complained about me.
90
00:04:04,362 --> 00:04:05,850
Wasn't just one.
91
00:04:07,180 --> 00:04:10,574
And if it happens again, this meeting
will go exactly how you thought it would.
92
00:04:23,747 --> 00:04:24,948
Sorry.
93
00:04:24,949 --> 00:04:26,589
I should've just canceled
the appointment.
94
00:04:26,857 --> 00:04:28,325
You were right.
95
00:04:28,326 --> 00:04:29,752
Dizziness went away
as soon as I stopped
96
00:04:29,753 --> 00:04:31,333
drinking coffee and Red Bull all day.
97
00:04:31,334 --> 00:04:32,534
No worries.
98
00:04:33,311 --> 00:04:34,757
Can you lie flat on your back, please?
99
00:04:34,758 --> 00:04:35,958
Yeah.
100
00:04:37,028 --> 00:04:38,661
You get that scar in a fire?
101
00:04:38,662 --> 00:04:39,762
Sort of.
102
00:04:39,763 --> 00:04:42,132
A homemade Roman candle when I was 12.
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00:04:42,133 --> 00:04:43,867
You'd be surprised
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00:04:43,868 --> 00:04:46,636
how many of us at the
firehouse were pyros as kids.
105
00:04:46,637 --> 00:04:49,372
I made a potato gun for my
sixth-grade science fair.
106
00:04:49,373 --> 00:04:50,908
Almost got me kicked out of school.
107
00:04:50,909 --> 00:04:52,611
You'll have to come visit us sometime.
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00:04:52,905 --> 00:04:54,105
You'd fit right in.
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00:04:56,480 --> 00:04:57,747
You see something?
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00:04:57,748 --> 00:04:59,750
Don't talk.
Just breathe normally.
111
00:05:07,624 --> 00:05:09,711
You have a large tumor
on the wall of your heart.
112
00:05:10,929 --> 00:05:11,995
Cancer?
113
00:05:11,996 --> 00:05:13,530
I don't know.
114
00:05:13,531 --> 00:05:15,199
But you're definitely
gonna need surgery.
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00:05:15,689 --> 00:05:16,999
As soon as possible.
116
00:05:29,414 --> 00:05:32,177
I appreciate you letting me share
your case with the whole class.
117
00:05:32,178 --> 00:05:33,224
No problem.
118
00:05:33,225 --> 00:05:35,852
I stopped being shy after the
100th time I had to do this.
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00:05:35,853 --> 00:05:38,928
I'll be using a version of
Lejour's technique I've adapted.
120
00:05:38,929 --> 00:05:41,224
We'll divide the breast
into three pedicles,
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00:05:41,225 --> 00:05:42,825
and then redistribute the tissue
122
00:05:42,826 --> 00:05:44,227
and insert saline implants
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00:05:44,228 --> 00:05:46,029
to correct the tuberous
breast deformity.
124
00:05:46,030 --> 00:05:48,592
Why would you want breast implants?
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00:05:48,593 --> 00:05:51,634
You're beautiful. And your breasts
look fine just the way they are.
126
00:05:51,635 --> 00:05:53,550
No.
No, they don't.
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00:05:53,551 --> 00:05:55,472
The base is constricted,
128
00:05:55,473 --> 00:05:57,540
horizontal development is deficient,
129
00:05:57,541 --> 00:05:59,176
and the nipple-areola complex...
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00:05:59,177 --> 00:06:01,378
Murphy. It's okay. He's right.
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00:06:01,379 --> 00:06:02,766
That's why I'm here.
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00:06:03,847 --> 00:06:05,047
Thank you.
133
00:06:05,620 --> 00:06:07,679
I know that you're trying to be nice.
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00:06:07,680 --> 00:06:10,453
My friends and family have
been telling me for years,
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00:06:10,454 --> 00:06:12,222
"You're beautiful
just the way you are."
136
00:06:12,223 --> 00:06:14,657
But I don't feel beautiful.
137
00:06:14,658 --> 00:06:16,659
You're 17.
138
00:06:16,660 --> 00:06:18,828
Every girl your age feels like that.
139
00:06:18,829 --> 00:06:20,663
That can't be true.
140
00:06:20,664 --> 00:06:23,066
Tuberous breast deformity
is a rare condition.
141
00:06:23,067 --> 00:06:24,667
We're not going to debate
142
00:06:24,668 --> 00:06:27,186
a personal decision
the patient's already made.
143
00:06:28,106 --> 00:06:30,647
I've been thinking about
this since I was 13.
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00:06:31,209 --> 00:06:33,142
Every time I look in the mirror.
145
00:06:33,143 --> 00:06:34,878
I'm about to start college,
146
00:06:34,879 --> 00:06:37,908
and there is no way that I'm
gonna begin this new chapter
147
00:06:37,909 --> 00:06:39,109
until I'm fixed.
148
00:06:40,430 --> 00:06:41,630
Great.
149
00:06:44,888 --> 00:06:47,690
You thinking median sternotomy
or right thoracotomy?
150
00:06:47,691 --> 00:06:50,396
I'm thinking I should finish
my review of the imaging.
151
00:06:50,397 --> 00:06:51,856
Sure. No rush.
152
00:06:52,854 --> 00:06:54,690
Actually, there is a bit of a rush.
153
00:06:54,691 --> 00:06:57,026
But you know what I mean.
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00:06:57,027 --> 00:06:59,102
So, newbies. What up? Where y'all from?
155
00:06:59,103 --> 00:07:00,237
Like hometowns, or...
156
00:07:00,238 --> 00:07:01,229
Med schools.
157
00:07:01,230 --> 00:07:02,439
Why would I care where you grew up?
158
00:07:02,440 --> 00:07:03,540
Stanford.
159
00:07:03,541 --> 00:07:05,075
Uh, NYU.
Harvard.
160
00:07:05,076 --> 00:07:06,443
Preferred specialties?
161
00:07:06,444 --> 00:07:08,045
Ortho. All the way.
162
00:07:08,046 --> 00:07:09,279
Neuro.
163
00:07:09,280 --> 00:07:10,813
I'm planning a dual specialty
164
00:07:10,814 --> 00:07:12,515
in neonatal and pediatric oncology.
165
00:07:12,516 --> 00:07:14,068
Impressive. Also unlikely.
166
00:07:14,069 --> 00:07:15,718
I know, it's a ton of work,
167
00:07:15,719 --> 00:07:17,287
but I'm pretty good at multi-tasking.
168
00:07:17,288 --> 00:07:19,289
In med school, I did
a combined MD/PhD...
169
00:07:19,290 --> 00:07:20,957
What's your mom do?
My mom?
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00:07:20,958 --> 00:07:22,559
Don't stall.
Just answer.
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00:07:22,560 --> 00:07:24,170
She teaches high-school French.
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00:07:24,562 --> 00:07:25,895
Homemaker.
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00:07:25,896 --> 00:07:26,963
Surgeon.
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00:07:26,964 --> 00:07:28,565
Ouch. Dad?
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00:07:28,566 --> 00:07:29,666
Also a surgeon.
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00:07:29,667 --> 00:07:31,134
Double ouch.
And yours?
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00:07:31,135 --> 00:07:32,402
Hasidic rabbi.
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00:07:32,403 --> 00:07:33,570
You've left the nest.
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00:07:33,571 --> 00:07:35,872
Actually, the...
the whole forest.
180
00:07:35,873 --> 00:07:37,840
And yours obviously
works on Wall Street.
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00:07:37,841 --> 00:07:39,542
But not a trader.
182
00:07:39,543 --> 00:07:41,778
I'm guessing...
an M&A lawyer?
183
00:07:41,779 --> 00:07:42,945
How'd you know?
184
00:07:42,946 --> 00:07:44,214
She's read your resume,
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00:07:44,215 --> 00:07:45,615
researched your social media.
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00:07:45,616 --> 00:07:47,617
She's probably run a credit check, too.
187
00:07:47,618 --> 00:07:50,290
And you're under 50, but wear
Brooks Brothers button-downs.
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00:07:50,291 --> 00:07:51,626
Are you done yet?
189
00:07:52,156 --> 00:07:53,623
Left thoracotomy
190
00:07:53,624 --> 00:07:56,293
with a possible incision
into the right atrium
191
00:07:56,294 --> 00:07:58,195
and inter-atrial septum as needed.
192
00:07:58,196 --> 00:08:00,163
Left atrial approach
through Sondergaard's groove
193
00:08:00,164 --> 00:08:01,464
makes more sense.
194
00:08:01,465 --> 00:08:02,665
Not to me.
195
00:08:04,335 --> 00:08:05,468
He's my patient.
196
00:08:05,469 --> 00:08:07,137
But you're not a surgeon.
197
00:08:07,138 --> 00:08:09,472
Which is why there is no reason
for you to be grilling them,
198
00:08:09,473 --> 00:08:11,108
or picking the approach.
199
00:08:11,109 --> 00:08:13,009
Stop worrying about
protecting your turf.
200
00:08:13,010 --> 00:08:14,177
Stop stepping all over it.
201
00:08:14,178 --> 00:08:16,413
You're looking at tests
I did for my patient.
202
00:08:16,414 --> 00:08:17,914
How am I stepping all over your turf?
203
00:08:17,915 --> 00:08:20,350
I think what Dr. Browne
is trying to say is,
204
00:08:20,351 --> 00:08:22,152
given there's no perfect approach,
205
00:08:22,153 --> 00:08:23,320
maybe it's best to defer
206
00:08:23,321 --> 00:08:25,041
to the surgical department's
recommendation.
207
00:08:26,174 --> 00:08:27,610
Did he just mansplain?
208
00:08:28,338 --> 00:08:29,626
Not at all. I...
I was just trying...
209
00:08:29,627 --> 00:08:31,027
So you're just gonna do it again?
210
00:08:31,028 --> 00:08:32,195
No, I'm just trying...
211
00:08:32,196 --> 00:08:33,396
Shut up.
212
00:08:34,779 --> 00:08:36,956
We're gonna go in through
a left thoracotomy.
213
00:08:37,535 --> 00:08:38,801
Not my preference,
214
00:08:38,802 --> 00:08:40,520
but it'll work.
215
00:08:41,971 --> 00:08:43,309
What were you thinking?
216
00:08:43,310 --> 00:08:44,974
You thought you'd impress me
217
00:08:44,975 --> 00:08:48,266
by undermining the patient's
confidence in my judgment?
218
00:08:48,267 --> 00:08:50,255
I'm sorry. That wasn't my intent.
219
00:08:50,256 --> 00:08:51,848
And you're supposed to be a mentor now,
220
00:08:51,849 --> 00:08:53,550
modeling professional behavior,
221
00:08:53,551 --> 00:08:55,515
not making it worse, Murphy.
222
00:08:55,516 --> 00:08:58,155
She questioned your surgical plan.
223
00:08:58,156 --> 00:08:59,422
I defended it.
224
00:08:59,423 --> 00:09:00,723
How can we both be wrong?
225
00:09:00,724 --> 00:09:03,198
I don't need you to defend me.
226
00:09:03,199 --> 00:09:06,039
And I never wanna have a surgical
debate in front of a patient.
227
00:09:06,616 --> 00:09:08,766
We're not in front of the patient now.
228
00:09:10,420 --> 00:09:13,403
The patient's breasts are
small and a bit asymmetrical,
229
00:09:13,404 --> 00:09:15,915
but no woman's breasts
are perfectly shaped.
230
00:09:16,950 --> 00:09:20,477
You're wearing Prada shoes
and a Dolce & Gabbana blouse,
231
00:09:20,478 --> 00:09:22,399
which cost more than
most med students' rent,
232
00:09:22,400 --> 00:09:24,181
so, clearly, you understand
233
00:09:24,182 --> 00:09:26,916
your appearance has a tremendous
impact on how people treat you.
234
00:09:26,917 --> 00:09:30,710
There's a difference between
nice clothes and a major surgery.
235
00:09:31,519 --> 00:09:34,023
And I also understand
the cosmetic surgery industry
236
00:09:34,024 --> 00:09:37,542
is dominated by male
physicians with a sexist bias.
237
00:09:44,402 --> 00:09:47,501
I've invited you to observe
as a learning opportunity.
238
00:09:48,406 --> 00:09:49,606
So I'd suggest
239
00:09:49,607 --> 00:09:50,841
less lecturing
240
00:09:50,842 --> 00:09:52,354
and more listening.
241
00:09:54,842 --> 00:09:57,046
We'll access the tumor via an incision
242
00:09:57,047 --> 00:09:58,781
in the chest wall between your ribs.
243
00:09:58,782 --> 00:10:00,049
It'll be an easier recovery
244
00:10:00,050 --> 00:10:01,651
than if we opened your sternum.
245
00:10:01,652 --> 00:10:04,221
Are you sure you don't
want us to call your family
246
00:10:04,222 --> 00:10:05,288
before we put you under?
247
00:10:05,289 --> 00:10:07,257
Why? So they can
freak out and worry?
248
00:10:07,258 --> 00:10:09,418
I'd rather just give them the
good news when it's over.
249
00:10:10,728 --> 00:10:13,095
It is going to be good news, right?
250
00:10:13,096 --> 00:10:15,465
With a bit of cardiac rehab
and a positive attitude,
251
00:10:15,466 --> 00:10:17,066
which I know you have,
252
00:10:17,067 --> 00:10:19,402
you'll be back sliding down
the fire pole in no time.
253
00:10:19,403 --> 00:10:20,870
Our firehouse has stairs.
254
00:10:20,871 --> 00:10:22,278
Hmm. Bummer.
255
00:10:23,885 --> 00:10:25,575
It's a social media group
256
00:10:25,576 --> 00:10:27,108
where we all pretend to be ants.
257
00:10:27,804 --> 00:10:29,139
Why?
258
00:10:29,140 --> 00:10:32,949
Because ants don't care
about politics, sports teams,
259
00:10:32,950 --> 00:10:35,084
or anything else people
get so savage about.
260
00:10:35,085 --> 00:10:37,917
Male ants develop
from unfertilized eggs,
261
00:10:37,918 --> 00:10:41,107
which means they don't have
a father and can't have sons.
262
00:10:41,108 --> 00:10:44,099
But they do have grandfathers
and can have grandsons.
263
00:10:44,100 --> 00:10:45,284
Interesting.
264
00:10:45,285 --> 00:10:46,563
And confusing.
265
00:10:46,564 --> 00:10:49,966
Is it just me, or are those
doctors watching us?
266
00:10:49,967 --> 00:10:52,299
They're the new resident applicants.
267
00:10:52,300 --> 00:10:56,004
They're here so Park, Claire, and
I can evaluate them for Dr. Lim.
268
00:10:56,248 --> 00:10:58,067
So, why are they standing over there?
269
00:10:58,742 --> 00:11:01,411
Park had a video chat with Kellan,
270
00:11:01,412 --> 00:11:03,413
and I had a real lunch with you.
271
00:11:03,414 --> 00:11:07,243
Shaun, you can't just have
them stand there while you eat.
272
00:11:07,782 --> 00:11:10,087
Part of being a good boss
is being a good host.
273
00:11:10,088 --> 00:11:12,089
You need to introduce them to people.
274
00:11:14,277 --> 00:11:15,907
Like me. Right now.
275
00:11:18,353 --> 00:11:19,729
Come here, please.
276
00:11:22,333 --> 00:11:24,534
Dr. Allen, Dr. Lundberg, Dr. Guerin,
277
00:11:24,535 --> 00:11:25,702
this is my girlfriend, Lea.
278
00:11:25,703 --> 00:11:27,595
She runs the IT department now.
279
00:11:27,596 --> 00:11:28,606
Okay.
280
00:11:28,607 --> 00:11:31,107
Nice to meet you all.
Please join us.
281
00:11:31,108 --> 00:11:33,284
Shaun's been telling me all about you.
282
00:11:33,285 --> 00:11:36,513
Mmm. N... No.
I haven't.
283
00:11:36,514 --> 00:11:39,948
So, I hope Shaun's not
being too hard on you.
284
00:11:39,949 --> 00:11:41,693
No, he's been great.
285
00:11:41,694 --> 00:11:44,153
And the case we're observing
is really interesting.
286
00:11:44,154 --> 00:11:47,390
We're correcting a 17-year-old
girl's tuberous breasts
287
00:11:47,391 --> 00:11:49,025
with saline implants.
288
00:11:49,026 --> 00:11:51,694
Dr. Allen told Dr. Andrews
it was unethical.
289
00:11:51,695 --> 00:11:53,029
He got mad.
290
00:11:53,030 --> 00:11:55,874
I didn't say it was
unethical. I just...
291
00:11:57,034 --> 00:11:59,195
I suppose I shouldn't have interfered.
292
00:12:00,371 --> 00:12:03,010
Well, I don't know what
a tuberous breast is,
293
00:12:03,011 --> 00:12:05,323
but I think implants are way overrated.
294
00:12:06,444 --> 00:12:09,373
That's because your
breasts are excellent.
295
00:12:09,374 --> 00:12:10,574
Thank you.
296
00:12:11,148 --> 00:12:12,828
That's exactly my point.
297
00:12:13,351 --> 00:12:15,051
Mine aren't huge,
298
00:12:15,052 --> 00:12:17,420
but every guy who's ever seen
them up close and personal
299
00:12:17,421 --> 00:12:18,621
has been thrilled.
300
00:12:19,539 --> 00:12:21,458
I definitely was.
301
00:12:21,459 --> 00:12:24,517
I am thrilled by
every part of your body.
302
00:12:26,764 --> 00:12:29,699
Sorry. My bad. Total TMI.
303
00:12:29,700 --> 00:12:32,569
I'm not even bothered
by your adenoidal voice.
304
00:12:32,570 --> 00:12:35,096
Except when you talk to
your mom on the phone.
305
00:12:35,097 --> 00:12:37,013
But I just put on headphones.
306
00:12:41,410 --> 00:12:45,019
At least you'll know he'll
be a totally honest boss.
307
00:12:51,522 --> 00:12:53,423
The incision's extended superiorly
308
00:12:53,424 --> 00:12:54,685
to meet the atriotomy,
309
00:12:54,686 --> 00:12:57,520
and then the inter-atrial septum
is opened up. Retractor.
310
00:12:57,521 --> 00:13:01,263
A Carpentier retractor is used
to visualize the mitral valve.
311
00:13:01,264 --> 00:13:02,965
That will allow a clear
view of the tumor.
312
00:13:02,966 --> 00:13:04,467
Can we turn the channel?
313
00:13:04,468 --> 00:13:06,503
Color commentary's
getting a bit annoying.
314
00:13:06,504 --> 00:13:08,217
With the right atrium opened obliq...
315
00:13:10,928 --> 00:13:13,543
How's Team Browne?
Any early standouts?
316
00:13:13,544 --> 00:13:15,978
Jackson's a bit timid, but smart.
317
00:13:15,979 --> 00:13:18,481
Wolke is definitely enthusiastic.
318
00:13:18,482 --> 00:13:21,138
And your star recruit is...
319
00:13:22,344 --> 00:13:24,051
pretty full of himself.
320
00:13:24,595 --> 00:13:27,023
I'm looking for surgeons,
and according to his recs,
321
00:13:27,024 --> 00:13:29,492
he can dissect and suture like a pro.
322
00:13:29,493 --> 00:13:31,661
I thought you were also
looking for our input.
323
00:13:31,662 --> 00:13:33,997
He's ranked first by every top program.
324
00:13:33,998 --> 00:13:36,310
You really think they're all
wrong and you're right?
325
00:13:39,236 --> 00:13:41,270
So, what brings you all to the biz?
326
00:13:41,271 --> 00:13:43,606
Had my ACL reconstructed
in high school,
327
00:13:43,607 --> 00:13:45,444
both my rotators in college.
328
00:13:46,143 --> 00:13:48,110
I love the idea of fixing people,
329
00:13:48,111 --> 00:13:50,405
helping them be the best they can be.
330
00:13:51,302 --> 00:13:53,694
Surgeons are the ones with
the God complex, right?
331
00:13:56,274 --> 00:13:57,474
I have that.
332
00:13:59,287 --> 00:14:01,889
I spent my life speaking Yiddish
and studying the Talmud,
333
00:14:01,890 --> 00:14:03,759
and not shaving the sides of my hair,
334
00:14:03,760 --> 00:14:05,749
because someone up there
supposedly cares.
335
00:14:06,664 --> 00:14:08,269
Uh, but then I realized
336
00:14:09,910 --> 00:14:11,167
no one's up there.
337
00:14:12,297 --> 00:14:13,750
No one cares.
338
00:14:14,540 --> 00:14:18,341
No benevolent higher power
is going to save us, so...
339
00:14:19,848 --> 00:14:21,283
We have to save each other.
340
00:14:24,281 --> 00:14:25,729
Can you top that?
341
00:14:25,730 --> 00:14:27,540
- Definitely not.
- Try anyway.
342
00:14:28,308 --> 00:14:30,959
You're obviously smart. You've
got two degrees from Harvard.
343
00:14:31,540 --> 00:14:33,383
My parents are Harvard alums, so...
344
00:14:33,384 --> 00:14:34,718
I'm sure that helped me get in.
345
00:14:34,719 --> 00:14:36,799
You're not gonna get hired
by undermining your own...
346
00:14:37,973 --> 00:14:39,932
Something went wrong.
347
00:14:39,933 --> 00:14:41,531
Looks like they nicked
a pulmonary artery.
348
00:14:41,532 --> 00:14:43,300
No. If they had, Browne
would be suctioning
349
00:14:43,301 --> 00:14:44,941
instead of Lim reaching
in with her hands.
350
00:14:49,393 --> 00:14:50,851
What are they doing now?
351
00:14:51,422 --> 00:14:52,622
Nothing.
352
00:14:53,168 --> 00:14:54,502
We can't access the tumor
353
00:14:54,503 --> 00:14:56,819
without compromising his
entire cardiac outflow tract.
354
00:14:56,820 --> 00:14:59,506
What about going in the way I
suggested? The median sternotomy.
355
00:14:59,507 --> 00:15:01,710
The tumor's too far back.
We need to close him up.
356
00:15:08,723 --> 00:15:11,425
Proton beam radiation would
be too toxic to the heart.
357
00:15:11,426 --> 00:15:13,394
So is immunotherapy.
358
00:15:13,395 --> 00:15:15,662
We can't access the
entire tumor surgically,
359
00:15:15,663 --> 00:15:18,465
and we can't kill it without
killing his heart along with it.
360
00:15:18,466 --> 00:15:20,759
What if we cut out the
parts we can access
361
00:15:20,760 --> 00:15:23,604
and try our luck with
chemo on what's left?
362
00:15:23,605 --> 00:15:27,274
IV doxorubicin and ifosfamide
might slow the growth,
363
00:15:27,275 --> 00:15:28,809
give him a few more months.
364
00:15:28,810 --> 00:15:31,045
No, I'm not sending my patient
home with just a few extra months.
365
00:15:31,046 --> 00:15:32,213
It's better than nothing.
366
00:15:32,214 --> 00:15:33,714
What about a transplant?
367
00:15:33,715 --> 00:15:34,792
Not an option.
368
00:15:34,793 --> 00:15:37,118
Heart tumors are a contraindication.
369
00:15:37,119 --> 00:15:39,686
What if we transplant his own heart?
370
00:15:39,687 --> 00:15:41,422
If we take it totally out of his chest,
371
00:15:41,423 --> 00:15:43,257
we'd have access
to the posterior heart.
372
00:15:43,258 --> 00:15:44,425
We could excise the tumor,
373
00:15:44,426 --> 00:15:45,592
fix the defect it left behind,
374
00:15:45,593 --> 00:15:47,094
and then put it back in. Cool.
375
00:15:47,095 --> 00:15:48,662
Mmm.
Not cool.
376
00:15:48,663 --> 00:15:50,264
At least with a normal
heart transplant,
377
00:15:50,265 --> 00:15:51,932
you'd be getting a healthy heart.
378
00:15:51,933 --> 00:15:54,435
Her idea keeps the risk
of removing the heart,
379
00:15:54,436 --> 00:15:56,937
and adds the risk that the
heart we'd be putting back in
380
00:15:56,938 --> 00:15:58,472
has just been severely compromised
381
00:15:58,473 --> 00:16:00,407
having had a tumor cut out of it.
382
00:16:00,408 --> 00:16:03,368
He's young, and the part of his heart
not infiltrated with tumor is strong.
383
00:16:06,601 --> 00:16:10,717
Do a cardiac MRA and see if the
tumor's infiltrated the coronary arteries.
384
00:16:10,718 --> 00:16:12,614
If it hasn't, Morgan's idea could work.
385
00:16:12,615 --> 00:16:13,815
I'll schedule it.
386
00:16:16,366 --> 00:16:19,193
Dr. Murphy is dividing
the breast parenchyma
387
00:16:19,194 --> 00:16:21,062
into three pedicles.
388
00:16:21,063 --> 00:16:23,264
Anyone know where this
technique is derived from?
389
00:16:23,265 --> 00:16:24,705
Breast reduction surgery.
390
00:16:24,999 --> 00:16:26,284
That's right.
391
00:16:26,675 --> 00:16:30,071
And why would I use a
breast reduction technique
392
00:16:30,072 --> 00:16:32,306
to make the patient's breasts larger?
393
00:16:32,307 --> 00:16:34,066
The technique frees up the tissue.
394
00:16:34,642 --> 00:16:36,377
You can bring the pedicles together
395
00:16:36,378 --> 00:16:37,778
to make the breasts smaller
396
00:16:37,779 --> 00:16:41,062
or spread them out over an
implant to make them larger.
397
00:16:42,084 --> 00:16:43,350
Very good.
398
00:16:43,351 --> 00:16:45,970
And now I'm going to
turn the sound off.
399
00:16:45,971 --> 00:16:47,505
Don't worry.
Nothing's wrong.
400
00:16:47,506 --> 00:16:49,986
I just wanna talk about you
behind your backs for a little bit.
401
00:16:52,316 --> 00:16:54,408
So, first impressions.
402
00:16:54,409 --> 00:16:55,644
Murphy?
403
00:16:55,645 --> 00:16:57,501
I like
Dr. John Lundberg.
404
00:16:58,423 --> 00:17:00,225
I haven't even heard him speak yet.
405
00:17:00,226 --> 00:17:02,653
He has the highest
U.S.M.L.E. scores.
406
00:17:02,654 --> 00:17:03,854
And that's important to you?
407
00:17:04,639 --> 00:17:05,839
Yes.
408
00:17:06,714 --> 00:17:09,661
It shows he has a broad
knowledge of medicine.
409
00:17:10,194 --> 00:17:12,896
What is important to you?
410
00:17:12,897 --> 00:17:15,793
Well, I'm more interested in what
they can do with their knowledge,
411
00:17:15,794 --> 00:17:18,931
which is why, so far, I'm most
impressed with Jordan Allen.
412
00:17:18,932 --> 00:17:23,069
No. No, you said
she undermined you.
413
00:17:23,070 --> 00:17:26,936
Which takes courage and an
assertiveness that will serve her well.
414
00:17:27,529 --> 00:17:30,831
Then why did you tell her
to stop lecturing you?
415
00:17:30,832 --> 00:17:33,434
It's easier to teach an
aggressive resident restraint
416
00:17:33,435 --> 00:17:35,369
than a passive one
to assert themselves.
417
00:17:35,370 --> 00:17:36,570
Oh.
418
00:17:38,308 --> 00:17:40,410
What about you, Park?
What's important to you?
419
00:17:40,411 --> 00:17:43,410
I wanna know who I can stand to
be around for 80 hours a week.
420
00:17:43,411 --> 00:17:44,978
One thing I learned as a cop,
421
00:17:44,979 --> 00:17:46,480
you don't really know a person
422
00:17:46,481 --> 00:17:48,221
until you've had a
few drinks with them.
423
00:17:54,914 --> 00:17:56,782
LAD and circumflex look clean.
424
00:17:56,783 --> 00:17:58,939
What's with the right coronary?
425
00:17:58,940 --> 00:18:01,084
It looks narrowed at the origin.
426
00:18:01,557 --> 00:18:03,830
It's a bit narrow, but looks
like a normal variant.
427
00:18:03,831 --> 00:18:05,299
Yeah, but it seems hazy,
428
00:18:05,300 --> 00:18:08,168
like there could be
some tumor infiltration.
429
00:18:09,404 --> 00:18:10,771
What do you guys think?
430
00:18:10,772 --> 00:18:12,206
Us?
Yeah.
431
00:18:12,207 --> 00:18:13,407
Come take a look.
432
00:18:16,407 --> 00:18:17,611
I guess...
433
00:18:17,612 --> 00:18:19,132
It's angiogenesis of the left... Stop.
434
00:18:20,313 --> 00:18:21,848
Interrupting a female coworker
435
00:18:21,849 --> 00:18:24,185
is almost as annoying as mansplaining.
436
00:18:24,186 --> 00:18:25,486
This isn't a rowing race.
437
00:18:25,487 --> 00:18:27,393
You don't always have to speak first.
438
00:18:28,590 --> 00:18:32,822
I... do not love
the interruption.
439
00:18:34,159 --> 00:18:35,359
But...
440
00:18:35,863 --> 00:18:37,561
I like the enthusiasm.
441
00:18:39,100 --> 00:18:40,300
What were you gonna say?
442
00:18:41,781 --> 00:18:44,339
First, um, I'm not sexist.
443
00:18:45,638 --> 00:18:46,907
Of course not.
444
00:18:46,908 --> 00:18:49,443
He's shifting from right to
left dominant circulation
445
00:18:49,444 --> 00:18:50,877
to feed blood to the tumor.
446
00:18:50,878 --> 00:18:52,339
Angiogenesis.
I doubt it.
447
00:18:52,340 --> 00:18:54,415
Surgery already showed his tumor
extending to the right side, as well.
448
00:18:54,416 --> 00:18:55,616
What were you gonna say?
449
00:18:56,630 --> 00:18:58,973
The pulmonary artery is
right behind that vessel.
450
00:19:00,988 --> 00:19:03,624
It's causing radiographic
scatter in this area.
451
00:19:03,625 --> 00:19:04,959
The haze is just an artifact.
452
00:19:05,760 --> 00:19:06,960
His arteries are clean.
453
00:19:08,595 --> 00:19:09,795
I think she's right.
454
00:19:10,115 --> 00:19:11,315
Hmm.
455
00:19:13,543 --> 00:19:15,151
Your idea might just work.
456
00:19:19,685 --> 00:19:22,743
If you invert the sutures
and bury them under the skin,
457
00:19:22,744 --> 00:19:24,625
the scar will be invisible.
458
00:19:24,626 --> 00:19:26,420
No one will ever know we were here.
459
00:19:28,750 --> 00:19:30,170
Nice work, both of you.
460
00:19:32,320 --> 00:19:33,854
Her BP's dropping.
461
00:19:33,855 --> 00:19:36,223
Push fluids, start IV pressors.
Check for bleeding.
462
00:19:36,669 --> 00:19:38,738
She's in V-tach.
Move in the crash cart.
463
00:19:40,562 --> 00:19:42,330
No bleeding.
No hematomas.
464
00:19:43,361 --> 00:19:44,561
Charging.
465
00:19:46,031 --> 00:19:47,231
Clear.
466
00:19:55,477 --> 00:19:58,231
Sinus rhythm.
Her BP is stabilizing.
467
00:20:00,699 --> 00:20:04,518
Get her to the ICU. I want
post-op labs, CTA chest,
468
00:20:04,519 --> 00:20:06,596
and full 24-hour cardiac telemetry.
469
00:20:07,465 --> 00:20:09,257
We need to figure out
what just happened.
470
00:20:15,461 --> 00:20:16,820
She's stable,
471
00:20:17,234 --> 00:20:19,063
but diffuse delta wave slowing.
472
00:20:19,064 --> 00:20:21,032
Minimal brain activity.
473
00:20:21,033 --> 00:20:23,705
An undiagnosed metabolic
disorder could've caused
474
00:20:23,706 --> 00:20:25,337
an adverse reaction to the anesthesia.
475
00:20:25,338 --> 00:20:27,462
Yeah, but her pre-op labs
were all normal.
476
00:20:27,463 --> 00:20:30,162
It's gotta be some sort of
hidden heart condition.
477
00:20:30,163 --> 00:20:32,884
You're big on opinions.
How are you with ideas?
478
00:20:32,885 --> 00:20:34,303
What would you do next?
479
00:20:36,314 --> 00:20:37,882
I'd check train of fours
480
00:20:37,883 --> 00:20:40,611
and reverse the paralytics
with neostigmine.
481
00:20:40,612 --> 00:20:43,112
If Dr. Murphy's right,
she should wake up.
482
00:20:43,456 --> 00:20:45,624
Smart. But risky.
483
00:20:45,625 --> 00:20:47,492
The meds will stress her heart.
484
00:20:47,493 --> 00:20:49,583
If Park's right,
she could arrest again.
485
00:20:51,264 --> 00:20:53,725
I saw a similar case
last year. In Borneo.
486
00:20:53,726 --> 00:20:55,721
You interned at a hospital in Borneo?
487
00:20:55,722 --> 00:20:59,651
Uh, no. I, uh, volunteered at an
orangutan rescue foundation.
488
00:21:00,540 --> 00:21:03,842
Our guide, a local
villager, fell out of a tree.
489
00:21:03,843 --> 00:21:05,277
He was, like, 80 feet up.
490
00:21:05,278 --> 00:21:08,298
How is falling out of a tree
similar to a patient arresting
491
00:21:08,299 --> 00:21:10,482
during breast reconstruction surgery?
492
00:21:10,483 --> 00:21:12,025
Well, he broke his back,
493
00:21:12,026 --> 00:21:13,594
uh, but when we got him
to the hospital,
494
00:21:13,595 --> 00:21:15,754
I found he also had heart
damage from rheumatic fever
495
00:21:15,755 --> 00:21:19,313
and metabolic abnormality
from iodine deficiency.
496
00:21:19,314 --> 00:21:21,521
It's rare here, but it's common there.
497
00:21:21,522 --> 00:21:23,828
We only realized it when we
ran a nuclear profusion scan
498
00:21:23,829 --> 00:21:25,029
of his entire body.
499
00:21:25,431 --> 00:21:26,847
Good catch.
500
00:21:26,848 --> 00:21:30,469
But a scan that extensive requires
multiple radioactive tracers.
501
00:21:30,470 --> 00:21:32,261
You think her heart could handle that?
502
00:21:32,262 --> 00:21:33,462
Not tonight.
503
00:21:33,938 --> 00:21:35,581
I'll get consent from the mom.
504
00:21:36,175 --> 00:21:37,735
We'll do it first thing in the morning.
505
00:21:38,391 --> 00:21:40,279
Once we confirm atrial closure,
506
00:21:40,280 --> 00:21:41,980
we'll put the heart back in.
507
00:21:41,981 --> 00:21:43,848
Dr. Lim will reconnect the aorta
508
00:21:43,849 --> 00:21:45,684
and the superior venous connections,
509
00:21:45,685 --> 00:21:47,684
while I connect the inferior.
510
00:21:47,685 --> 00:21:49,153
During my sub-internship,
511
00:21:49,154 --> 00:21:51,390
I assisted on multiple
heart transplants.
512
00:21:51,391 --> 00:21:53,116
Even sutured the atrial cuff in one.
513
00:21:54,315 --> 00:21:56,651
I got to scrub in on
a liver transplant once.
514
00:21:57,162 --> 00:21:58,616
The... The patient died.
515
00:21:58,617 --> 00:22:00,260
What'd you learn?
516
00:22:00,261 --> 00:22:03,302
That bile duct leaks are a lot
harder to detect than bleeds.
517
00:22:03,303 --> 00:22:04,825
Good. Next time,
I'd lead with that
518
00:22:04,826 --> 00:22:06,265
instead of the patient's death.
519
00:22:10,027 --> 00:22:11,456
Are you all done yet?
520
00:22:11,457 --> 00:22:12,579
Why?
521
00:22:12,580 --> 00:22:16,225
Dr. Park wants everyone to
join him in the break room.
522
00:22:22,512 --> 00:22:24,281
I'm Alex Park.
523
00:22:24,282 --> 00:22:27,418
I'm a former amateur
martial arts competitor
524
00:22:27,419 --> 00:22:30,028
who once thought it'd be
fun to spar with a pro boxer
525
00:22:30,029 --> 00:22:31,830
visiting my dad's gym.
526
00:22:31,831 --> 00:22:34,855
And that guy was, uh, Mike Tyson.
527
00:22:37,312 --> 00:22:38,845
Who's Mike Tyson?
528
00:22:39,244 --> 00:22:41,551
He's a guy from The Hangover.
529
00:22:41,552 --> 00:22:43,935
With the tiger and the
tattoo on his face.
530
00:22:44,919 --> 00:22:47,731
Nice. You've just revealed
you're crazy and old.
531
00:22:51,230 --> 00:22:54,218
I've seen the musical
Wicked over 50 times.
532
00:22:54,219 --> 00:22:57,333
The San Francisco tryout,
Broadway, Chicago.
533
00:22:57,334 --> 00:22:59,858
I've even seen a friend's
boyfriend's niece play Glinda
534
00:22:59,859 --> 00:23:01,251
at Stagedoor summer camp.
535
00:23:01,861 --> 00:23:03,842
Nerd. Next.
536
00:23:06,799 --> 00:23:09,434
I'm Claire Browne.
537
00:23:09,435 --> 00:23:12,755
Um, I love music,
538
00:23:12,756 --> 00:23:16,099
but I hate musicals,
and, um, I don't...
539
00:23:16,100 --> 00:23:19,604
I don't really like to talk about
myself, so it's Shaun's turn.
540
00:23:26,031 --> 00:23:28,487
My name is
Dr. Shaun Murphy.
541
00:23:28,488 --> 00:23:30,288
I used to not like music,
542
00:23:30,289 --> 00:23:33,601
but my girlfriend, Lea,
she changed my mind.
543
00:23:33,602 --> 00:23:37,498
I also like to watch The
Weather Channel on TV.
544
00:23:38,063 --> 00:23:39,263
And...
545
00:23:40,948 --> 00:23:43,035
I think pickles are disgusting.
546
00:23:46,271 --> 00:23:47,906
Cops know how to manage up.
547
00:23:47,907 --> 00:23:49,240
Managing down's another story.
548
00:23:49,241 --> 00:23:51,669
Well, he's mature, thoughtful,
549
00:23:51,670 --> 00:23:53,074
doesn't have an ego.
550
00:23:53,413 --> 00:23:54,958
Neither does Murphy,
551
00:23:54,959 --> 00:23:57,957
but do you think that qualifies
him to supervise First Years?
552
00:23:58,418 --> 00:24:00,325
Well, Murphy's smart,
553
00:24:00,326 --> 00:24:03,274
brutally honest, has no
regard for social convention.
554
00:24:03,275 --> 00:24:05,607
- Mmm.
- It works for Bill Belichick.
555
00:24:06,756 --> 00:24:09,293
The Patriots are the most
corrupt, dishonest organization
556
00:24:09,294 --> 00:24:10,494
in the history of the NFL.
557
00:24:11,053 --> 00:24:12,525
Well, the Seahawks suck.
558
00:24:13,999 --> 00:24:16,069
So, how's your experience been here?
559
00:24:16,836 --> 00:24:18,381
It's been good.
560
00:24:21,907 --> 00:24:23,842
Did you consider any other programs
561
00:24:23,843 --> 00:24:25,844
or was this your first choice?
562
00:24:25,845 --> 00:24:28,393
This was my only choice.
563
00:24:28,948 --> 00:24:30,464
Why do you hate God?
564
00:24:31,617 --> 00:24:33,952
Oh. Uh, actually,
565
00:24:33,953 --> 00:24:36,107
I don't believe there is a God.
566
00:24:37,098 --> 00:24:39,123
I thought maybe it was because
567
00:24:39,124 --> 00:24:41,460
you believed he hated homosexuals.
568
00:24:41,461 --> 00:24:43,662
I... I don't think
this is something
569
00:24:43,663 --> 00:24:45,390
that we should be discussing at work.
570
00:24:47,967 --> 00:24:49,167
Why not?
571
00:24:51,370 --> 00:24:54,260
Well, because it's personal.
572
00:24:57,358 --> 00:24:58,992
Do you have a boyfriend?
573
00:24:58,993 --> 00:25:02,380
I... I'm sorry, but you can't ask
that question in a workplace.
574
00:25:02,381 --> 00:25:06,117
Dr. Park, he wants us
to get to know you.
575
00:25:06,118 --> 00:25:09,892
How can I do that without
asking personal questions?
576
00:25:09,893 --> 00:25:13,343
I have a girlfriend, and she
is very important to me.
577
00:25:13,344 --> 00:25:15,431
It affects my life in every way.
578
00:25:16,376 --> 00:25:18,362
Probably should've thought
of that before you told her
579
00:25:18,363 --> 00:25:20,216
how much her voice annoyed you.
580
00:25:20,866 --> 00:25:24,168
I said it didn't bother me.
581
00:25:24,169 --> 00:25:26,037
It... It was a compliment.
582
00:25:26,038 --> 00:25:29,188
What I heard is you
criticizing her voice,
583
00:25:29,189 --> 00:25:31,094
and you bringing her mother into it.
584
00:25:33,114 --> 00:25:34,578
You're in trouble.
585
00:25:40,465 --> 00:25:42,534
What about Browne?
586
00:25:42,535 --> 00:25:45,003
She may have as much problem
being a leader as Murphy,
587
00:25:45,004 --> 00:25:46,390
and without his gifts.
588
00:25:46,759 --> 00:25:48,452
She has her own gifts.
589
00:25:48,453 --> 00:25:51,329
Yeah, dealing with patients
and their families.
590
00:25:51,330 --> 00:25:54,888
But with her colleagues,
she can be insecure.
591
00:25:54,889 --> 00:25:57,135
Her assertiveness has always
been a question mark for me.
592
00:25:57,136 --> 00:25:59,163
They've all got areas
that need improving,
593
00:25:59,164 --> 00:26:02,269
but I've gotten to know Browne a
bit better these past few months.
594
00:26:02,878 --> 00:26:04,909
She's stronger than she looks.
595
00:26:06,899 --> 00:26:09,548
When's the last time you saw anyone
digging a ditch in a suit and tie?
596
00:26:09,549 --> 00:26:11,616
Surgeons don't dig ditches.
597
00:26:11,617 --> 00:26:14,762
They help people at the most
vulnerable time in their life.
598
00:26:14,763 --> 00:26:17,889
And you shouldn't take
the responsibility on
599
00:26:17,890 --> 00:26:19,531
if you're not fully committed to it.
600
00:26:20,459 --> 00:26:22,426
You're entering a new
phase in your career,
601
00:26:22,427 --> 00:26:23,795
position of authority.
602
00:26:23,796 --> 00:26:25,797
Maybe my clothes are
making you feel disrespected.
603
00:26:25,798 --> 00:26:27,198
No.
604
00:26:27,199 --> 00:26:28,663
The truth is,
605
00:26:28,664 --> 00:26:31,138
I just hate wearing anything
that makes me feel like
606
00:26:32,174 --> 00:26:33,374
a suit.
607
00:26:34,516 --> 00:26:35,797
Great news.
608
00:26:35,798 --> 00:26:38,330
I was able to get Sowinski
on anesthesia for tomorrow.
609
00:26:38,331 --> 00:26:40,144
Uh, why? What happened to Foley?
610
00:26:40,145 --> 00:26:42,055
Nothing, I just think
Sowinski's better.
611
00:26:42,056 --> 00:26:43,848
And we definitely need
the A-team on this.
612
00:26:43,849 --> 00:26:45,416
Yeah, I... I agree.
613
00:26:45,417 --> 00:26:48,302
Which is why I went out
of my way to get Foley.
614
00:26:48,303 --> 00:26:50,462
But Foley doesn't do
well under pressure.
615
00:26:50,463 --> 00:26:52,042
- Remember that time...
- Morgan.
616
00:26:52,644 --> 00:26:55,452
You need to butt out. You're not
a surgeon. This is not your job.
617
00:26:56,851 --> 00:27:00,383
My job is to help my patient through
the entire treatment process.
618
00:27:00,384 --> 00:27:03,387
The best anesthesiologist for
transplant surgery is Sowinski.
619
00:27:03,388 --> 00:27:05,988
And I've already cleared it with
Lim, so that's who it's gonna be.
620
00:27:06,442 --> 00:27:07,642
Deal with it.
621
00:27:16,347 --> 00:27:18,199
Are you mad at me?
622
00:27:21,546 --> 00:27:24,908
I said your voice doesn't bother me.
623
00:27:25,339 --> 00:27:27,814
It was a compliment.
624
00:27:27,815 --> 00:27:31,344
Actually, what you said is that
you love my breasts so much
625
00:27:31,345 --> 00:27:34,441
that with the help of
noise-canceling headphones,
626
00:27:34,442 --> 00:27:37,197
you're willing to put up
with my annoying voice.
627
00:27:37,886 --> 00:27:39,086
Yes.
628
00:27:39,954 --> 00:27:41,449
Not a compliment.
629
00:27:42,280 --> 00:27:43,480
Oh.
630
00:27:43,892 --> 00:27:45,593
So you are mad at me?
631
00:27:45,594 --> 00:27:47,761
I'm not mad, Shaun.
I'm just busy,
632
00:27:47,762 --> 00:27:50,442
trying to keep, like, a billion bots
and hackers out of our network.
633
00:27:52,100 --> 00:27:53,501
Actually, no.
I'm not doing that.
634
00:27:53,502 --> 00:27:54,835
Gonna go home.
635
00:27:54,836 --> 00:27:57,871
You want to have some tequila, stat?
636
00:27:57,872 --> 00:27:59,873
We also have some pizza left.
637
00:27:59,874 --> 00:28:02,409
No, I don't want tequila or pizza.
638
00:28:02,410 --> 00:28:04,578
That must mean you're mad.
639
00:28:04,579 --> 00:28:06,972
I'm just... upset.
640
00:28:07,549 --> 00:28:09,313
And confused.
641
00:28:09,314 --> 00:28:12,396
And I really don't think there is
anything you can do about it,
642
00:28:12,397 --> 00:28:15,758
so you just need to stop
trying and leave me alone.
643
00:28:24,999 --> 00:28:27,000
She's not mad at me.
644
00:28:27,001 --> 00:28:28,836
She's definitely mad at you.
645
00:28:28,837 --> 00:28:31,539
She doesn't usually
hide what she thinks.
646
00:28:31,540 --> 00:28:33,162
She's not mad at him.
647
00:28:34,142 --> 00:28:37,410
She knows how he is, how he talks.
648
00:28:37,411 --> 00:28:39,493
She's mad at herself.
And scared.
649
00:28:40,668 --> 00:28:43,010
We all have stuff that
we're insecure about.
650
00:28:43,011 --> 00:28:44,877
That's why it's so
risky falling in love.
651
00:28:47,390 --> 00:28:49,380
We all hope that when
we let our guard down,
652
00:28:49,381 --> 00:28:51,381
it's for the one person that
doesn't see our flaws.
653
00:28:55,451 --> 00:28:58,609
So, what do I do?
654
00:28:59,628 --> 00:29:02,206
You were being honest. You
can't apologize that away.
655
00:29:02,778 --> 00:29:05,818
You gotta figure out what she needs to
feel secure in the relationship again.
656
00:29:08,970 --> 00:29:10,733
Don't look at me. I'm single.
657
00:29:16,104 --> 00:29:18,807
It's not my place to comment
on your personal life.
658
00:29:18,808 --> 00:29:20,829
You have an opinion.
Let's hear it.
659
00:29:21,297 --> 00:29:22,497
Fine.
660
00:29:23,985 --> 00:29:25,921
Can you zoom in on her skull base?
661
00:29:25,922 --> 00:29:27,356
I can, but why?
662
00:29:27,357 --> 00:29:30,200
We're worried about her heart
and metabolic abnormalities.
663
00:29:30,729 --> 00:29:33,062
We shouldn't be.
Not anymore.
664
00:29:33,539 --> 00:29:36,190
You and Dr. Murphy
were both wrong.
665
00:29:36,191 --> 00:29:38,750
She doesn't have a
cardiac or metabolic issue.
666
00:29:39,461 --> 00:29:42,185
She has poor blood flow in
the artery supplying blood
667
00:29:42,186 --> 00:29:44,077
to the area of her brain
that controls consciousness.
668
00:29:44,078 --> 00:29:46,880
A small clot in her
artery of Percheron.
669
00:29:47,265 --> 00:29:50,706
If we don't remove it fast,
she's never going to wake up.
670
00:30:02,697 --> 00:30:04,031
That's amazing.
671
00:30:04,032 --> 00:30:05,527
No, it's not.
672
00:30:06,143 --> 00:30:09,536
The heart's totally outside
of the body and still beating.
673
00:30:09,537 --> 00:30:11,337
It's like it has a mind of its own.
674
00:30:11,338 --> 00:30:13,874
She should've started the
reimplantation by now.
675
00:30:13,875 --> 00:30:15,731
Is everything okay,
Dr. Lim?
676
00:30:15,732 --> 00:30:18,434
The tumor had tendrils
invading the right atrial wall.
677
00:30:18,435 --> 00:30:20,672
We took so much tissue
to get a clear margin,
678
00:30:20,673 --> 00:30:24,051
there's not enough left to reconstruct
his heart's inflow chambers.
679
00:30:24,052 --> 00:30:25,719
How about expanded PTFE graft?
680
00:30:25,720 --> 00:30:27,688
There's not enough atrial
remnant to attach the graft.
681
00:30:27,689 --> 00:30:29,289
You could use the septal wall.
682
00:30:29,290 --> 00:30:31,058
He's got dense conduction fibers there.
683
00:30:31,059 --> 00:30:32,860
It could cause heart
arrhythmias. Not if you use...
684
00:30:32,861 --> 00:30:34,585
He's got low arterial pressure.
685
00:30:34,969 --> 00:30:36,890
He's springing leaks
at the cannulation sites.
686
00:30:36,891 --> 00:30:39,099
It's a bleeding disorder
caused by prolonged bypass.
687
00:30:39,100 --> 00:30:40,834
You need to get his heart back in ASAP.
688
00:30:40,835 --> 00:30:43,618
Morgan, we can't put the heart
back in with two missing chambers.
689
00:30:50,099 --> 00:30:51,600
It's a rare complication,
690
00:30:51,601 --> 00:30:54,068
but a blood clot is
a risk in any surgery.
691
00:30:54,069 --> 00:30:55,770
It's too deep in the brain
for open surgery.
692
00:30:55,771 --> 00:30:57,306
If we go rooting around in there,
693
00:30:57,307 --> 00:31:00,242
we'd definitely damage
the PCA and kill her.
694
00:31:00,243 --> 00:31:02,744
We could inject a dissolving
agent into the clot.
695
00:31:02,745 --> 00:31:07,126
There's a 50% probability
it won't fully dissolve,
696
00:31:07,127 --> 00:31:10,051
which could leave her with permanent
weakness and cognitive difficulties.
697
00:31:10,052 --> 00:31:12,263
Assuming she wakes up at all.
698
00:31:16,559 --> 00:31:19,662
We need to remove the clot
with a stent retriever.
699
00:31:21,820 --> 00:31:24,252
If we rupture the
posterior cerebral artery,
700
00:31:24,253 --> 00:31:25,906
she'll die on the table.
701
00:31:27,751 --> 00:31:29,703
Or total recovery.
702
00:31:30,940 --> 00:31:33,120
That's how she came into this hospital.
703
00:31:33,121 --> 00:31:34,936
That's how she's leaving.
704
00:31:37,595 --> 00:31:39,246
Prep her for stent retrieval.
705
00:31:41,246 --> 00:31:44,118
I'm hanging platelets
and fresh frozen plasma.
706
00:31:44,119 --> 00:31:45,920
His pressure is still in the toilet,
707
00:31:45,921 --> 00:31:47,864
but the bleeding is slowing down.
708
00:31:47,865 --> 00:31:48,923
Not for long.
709
00:31:48,924 --> 00:31:51,393
Small intestine submucosa
has the right compliance
710
00:31:51,394 --> 00:31:53,094
to shape the chamber walls, but...
711
00:31:53,095 --> 00:31:54,763
There isn't enough to
cover that much area.
712
00:31:54,764 --> 00:31:57,165
Use too little and he'll have
heart failure in a month.
713
00:31:57,166 --> 00:31:59,133
I know. That's the "but."
714
00:31:59,134 --> 00:32:00,369
How thick is his deep fascia?
715
00:32:00,370 --> 00:32:01,597
If it's over 2 millimeters...
716
00:32:01,598 --> 00:32:02,798
Morgan.
717
00:32:03,479 --> 00:32:04,573
Get out.
718
00:32:04,574 --> 00:32:06,004
I'm sorry. I'll...
I'll be quiet.
719
00:32:06,005 --> 00:32:07,342
No, you won't. You can't.
720
00:32:07,343 --> 00:32:08,861
So leave the OR gallery.
721
00:32:11,224 --> 00:32:12,424
Now.
722
00:32:18,621 --> 00:32:22,190
We need 2.6-millimeter-thick
tissue with perfect compliance
723
00:32:22,191 --> 00:32:24,693
for arterial filling
and contractile pressures.
724
00:32:24,694 --> 00:32:27,962
If it was just the valve, we'd
use a bovine pericardial graft.
725
00:32:27,963 --> 00:32:31,800
But cow heart tissue is not durable
enough to do an entire chamber.
726
00:32:31,801 --> 00:32:34,369
But pig bladder tissue is just right.
727
00:32:34,370 --> 00:32:37,639
I've used it for bladder reconstructive
surgeries, but never hearts.
728
00:32:37,640 --> 00:32:39,781
Let's rebuild the entire
atrial walls with it.
729
00:32:40,743 --> 00:32:42,076
Get down to the tissue procurement lab
730
00:32:42,077 --> 00:32:44,605
and get 200 centimeters
of porcine bladder tissue.
731
00:32:53,889 --> 00:32:56,391
Her EEG delta waves
are slowing further.
732
00:32:56,392 --> 00:32:59,151
She only has one vessel
feeding her thalamus.
733
00:32:59,717 --> 00:33:01,996
That's why the clot
landed where it did.
734
00:33:01,997 --> 00:33:05,233
I'm approaching the
artery of Percheron.
735
00:33:05,234 --> 00:33:07,554
I'm one millimeter from the clot.
736
00:33:07,555 --> 00:33:08,943
Stop right there.
737
00:33:14,241 --> 00:33:15,510
If we disrupt this clot,
738
00:33:15,511 --> 00:33:17,431
we could cause a shower
of emboli into her brain.
739
00:33:41,155 --> 00:33:42,736
Deploying the retriever.
740
00:33:46,275 --> 00:33:47,709
EEG just went flatline.
741
00:33:47,710 --> 00:33:49,300
Calm down.
I'm almost...
742
00:33:51,381 --> 00:33:52,581
Got it.
743
00:33:58,918 --> 00:34:01,153
Blood's flowing through the artery.
744
00:34:01,154 --> 00:34:03,089
Her brain tracing's looking better.
745
00:34:09,432 --> 00:34:13,602
This should fill the gap between
the inferior and superior vena cava
746
00:34:13,603 --> 00:34:15,604
when the new chambers get sewn in.
747
00:34:15,605 --> 00:34:16,987
Where's that graft?
748
00:34:17,840 --> 00:34:20,113
I need more sponges. The
bleeding is getting worse.
749
00:34:20,114 --> 00:34:21,510
Oh, he's tanking.
750
00:34:21,511 --> 00:34:22,644
Can you push epi?
751
00:34:22,645 --> 00:34:24,012
I already did.
He's maxing out.
752
00:34:24,013 --> 00:34:25,893
I'm running out of ways
to keep his pressure up.
753
00:34:26,248 --> 00:34:27,449
I got it.
754
00:34:27,450 --> 00:34:29,217
They had 205 centimeters of it.
755
00:34:29,218 --> 00:34:30,526
Thank you.
756
00:34:31,554 --> 00:34:33,988
If you want to gown up, you
can watch from down here.
757
00:34:33,989 --> 00:34:35,432
Definitely. Thanks.
758
00:34:38,093 --> 00:34:40,161
I thought telling her
how much I love her
759
00:34:40,162 --> 00:34:42,163
in front of other people
would make her feel good.
760
00:34:42,164 --> 00:34:46,079
But Dr. Guerin said I made
her feel insecure, and scared.
761
00:34:46,532 --> 00:34:48,020
Women are sensitive.
762
00:34:48,771 --> 00:34:50,839
When commenting on their flaws,
763
00:34:50,840 --> 00:34:53,508
total honesty is a high-risk procedure.
764
00:34:53,509 --> 00:34:54,976
That sounds sexist.
765
00:34:54,977 --> 00:34:57,512
Aren't men also insecure
about their flaws?
766
00:34:57,513 --> 00:34:58,880
Men are much, much worse.
767
00:34:58,881 --> 00:35:00,649
And also, we're really stupid.
768
00:35:00,650 --> 00:35:01,750
Okay.
769
00:35:01,751 --> 00:35:04,586
What can I do now?
770
00:35:04,587 --> 00:35:07,088
I've already said my stupid stuff.
771
00:35:07,089 --> 00:35:09,261
I don't want her to be upset with me.
772
00:35:11,461 --> 00:35:12,661
I have a thought.
773
00:35:14,583 --> 00:35:17,165
I think this run of sutures
will hold it to the annulus,
774
00:35:17,166 --> 00:35:18,567
but I'm worried about leaks.
775
00:35:18,568 --> 00:35:20,620
We can put a second
row of pledgeted sutures
776
00:35:20,621 --> 00:35:22,226
to make sure it's hemostatic.
777
00:35:22,227 --> 00:35:24,335
That is unreal.
778
00:35:25,254 --> 00:35:26,641
It's a work of art.
779
00:35:28,878 --> 00:35:30,278
Now let's get it back in
780
00:35:30,279 --> 00:35:32,214
while we can still get
him off bypass alive.
781
00:35:36,811 --> 00:35:38,307
Re-perfusing the heart.
782
00:35:40,087 --> 00:35:41,586
We've got a rhythm.
783
00:36:11,688 --> 00:36:12,888
Hey.
784
00:36:14,525 --> 00:36:16,025
There was a complication
785
00:36:16,026 --> 00:36:17,891
during the reconstruction surgery.
786
00:36:18,685 --> 00:36:21,728
A clot, which caused you
to lapse into a coma.
787
00:36:23,137 --> 00:36:25,401
We performed a second
surgery on your brain,
788
00:36:25,402 --> 00:36:26,603
which was successful.
789
00:36:26,604 --> 00:36:27,887
Um...
790
00:36:27,888 --> 00:36:29,263
You're gonna be fine.
791
00:36:29,606 --> 00:36:31,219
But my breasts...
792
00:36:31,220 --> 00:36:35,605
The clot occurred after we
finished inserting the implants.
793
00:36:38,404 --> 00:36:40,758
I think you're gonna be very
pleased with the results.
794
00:36:42,218 --> 00:36:43,418
Thank you.
795
00:36:44,020 --> 00:36:45,220
Yep.
796
00:36:51,389 --> 00:36:54,936
I... think I'm sorry.
797
00:36:58,908 --> 00:37:03,439
Dr. Guerin said I should never say
anything that might sound negative
798
00:37:03,440 --> 00:37:04,833
to a girlfriend.
799
00:37:04,834 --> 00:37:09,219
And Dr. Glassman said total
honesty is a high-risk procedure
800
00:37:09,450 --> 00:37:10,952
with a girlfriend.
801
00:37:10,953 --> 00:37:14,250
It's better to show my
love than try to explain it.
802
00:37:17,001 --> 00:37:22,713
But I want to be totally
honest with you.
803
00:37:28,935 --> 00:37:33,241
I don't like your body
because it's excellent.
804
00:37:33,663 --> 00:37:35,748
I like it because it's yours.
805
00:37:38,255 --> 00:37:42,259
And I love hearing you talk.
806
00:37:42,260 --> 00:37:43,991
When I hear your voice,
807
00:37:44,609 --> 00:37:47,511
especially when I've
had a difficult day,
808
00:37:47,731 --> 00:37:49,192
I find it comforting.
809
00:37:54,715 --> 00:37:57,215
Now I want to
hug you. Can I?
810
00:37:58,008 --> 00:37:59,494
I'd like that.
811
00:38:09,963 --> 00:38:11,163
I love you.
812
00:38:13,076 --> 00:38:14,276
Thank you.
813
00:38:15,646 --> 00:38:17,610
For your total honesty.
814
00:38:24,657 --> 00:38:25,992
Your surgery went well.
815
00:38:25,993 --> 00:38:27,295
With some time in rehab,
816
00:38:27,296 --> 00:38:28,816
you should be back to work in a month.
817
00:38:29,359 --> 00:38:30,724
Thank you.
818
00:38:30,725 --> 00:38:32,947
Don't thank me.
Thank your surgeon.
819
00:38:33,719 --> 00:38:35,531
She did all the important stuff.
820
00:38:39,985 --> 00:38:42,705
Lim's golden boy is in.
Nothing we can do about that.
821
00:38:42,706 --> 00:38:44,683
So that leaves three openings.
822
00:38:44,684 --> 00:38:47,898
The thought of working with Will
Hooper for the next two years...
823
00:38:47,899 --> 00:38:49,979
If Dr. Lim thinks he'll
be a good resident,
824
00:38:49,980 --> 00:38:52,002
I'm sure she has good reasons.
825
00:38:52,003 --> 00:38:55,674
She probably thinks arrogance
is helpful to a surgeon.
826
00:38:55,675 --> 00:38:57,585
Well, we could try to change her mind.
827
00:38:57,586 --> 00:38:59,989
Eh, she asked us to evaluate
the applicants, not her.
828
00:38:59,990 --> 00:39:02,847
She asked us to be totally honest.
829
00:39:02,848 --> 00:39:05,158
Eh, "totally honest" is a relative term
830
00:39:05,159 --> 00:39:07,502
when you're telling your
boss she's totally wrong.
831
00:39:11,296 --> 00:39:13,302
So, Hooper's in.
Who else?
832
00:39:13,303 --> 00:39:16,728
Dr. Andrews likes
Dr. Jordan Allen.
833
00:39:16,729 --> 00:39:19,174
Oh, I do, too. She's confident, driven.
834
00:39:19,175 --> 00:39:21,143
She won't take a lot of hand-holding,
835
00:39:21,144 --> 00:39:23,494
and keeping Andrews
happy keeps us happy.
836
00:39:23,884 --> 00:39:26,312
That leaves two more. Who's next?
837
00:39:26,926 --> 00:39:31,130
Asher Wolke is very
up-front about who he is.
838
00:39:31,131 --> 00:39:33,690
I like that.
He's definitely eager.
839
00:39:33,691 --> 00:39:35,457
And he couldn't be
more open to learning.
840
00:39:35,458 --> 00:39:36,926
Agree.
841
00:39:36,927 --> 00:39:38,127
That leaves one more.
842
00:39:39,412 --> 00:39:40,863
John Lundberg.
843
00:39:41,971 --> 00:39:43,973
Smart, professional, mature.
844
00:39:43,974 --> 00:39:45,174
He's a no-brainer.
845
00:39:45,896 --> 00:39:47,470
Lundberg's in.
846
00:39:47,471 --> 00:39:49,072
Lundberg's out.
847
00:39:49,073 --> 00:39:51,174
He stopped by my office before he left.
848
00:39:51,175 --> 00:39:53,323
Said he's no longer interested.
849
00:39:54,070 --> 00:39:57,429
He said you all were unprofessional.
850
00:39:57,987 --> 00:39:59,511
Drinking at work.
851
00:40:00,294 --> 00:40:02,575
Asking inappropriate questions.
852
00:40:02,576 --> 00:40:03,982
Dating drama.
853
00:40:05,342 --> 00:40:06,542
Mmm-hmm.
854
00:40:07,297 --> 00:40:10,707
So, who's your alt? Olivia
Jackson or Boardshorts?
855
00:40:11,936 --> 00:40:15,295
Olivia knows her stuff,
but she's a bit insecure.
856
00:40:15,647 --> 00:40:18,252
Her answers sound like questions.
857
00:40:18,253 --> 00:40:20,970
I like Boardshorts.
He's sensitive.
858
00:40:20,971 --> 00:40:22,171
Like a woman.
859
00:40:27,665 --> 00:40:29,553
I vote for both of them.
860
00:40:30,460 --> 00:40:32,894
That's not an option.
We don't have the budget.
861
00:40:35,230 --> 00:40:36,577
Hooper is the worst.
862
00:40:37,366 --> 00:40:39,094
The person I said was the best?
863
00:40:39,575 --> 00:40:42,925
He is arrogant and obnoxious.
864
00:40:42,926 --> 00:40:45,084
If he works here, we'll hate him,
865
00:40:45,085 --> 00:40:48,731
the work will suffer, and
we'll either kill patients
866
00:40:48,732 --> 00:40:49,932
or we'll kill him.
867
00:40:56,039 --> 00:40:59,186
And there is no way that you don't
see that, which makes me think...
868
00:41:02,403 --> 00:41:03,603
You do.
869
00:41:04,505 --> 00:41:05,981
This was a test.
870
00:41:06,968 --> 00:41:10,921
You just wanted to see
if we'd be totally honest.
871
00:41:12,856 --> 00:41:14,056
Well done.
872
00:41:15,148 --> 00:41:17,818
Hooper is definitely the worst.
873
00:41:17,819 --> 00:41:20,321
I only let him shadow as a
favor to a board member.
874
00:41:20,322 --> 00:41:21,882
I figured I'd give him a second chance
875
00:41:21,883 --> 00:41:23,342
after his obnoxious interview.
876
00:41:24,000 --> 00:41:26,526
And also do a little experiment.
877
00:41:28,881 --> 00:41:30,081
So...
878
00:41:30,972 --> 00:41:35,442
It's Jordan, Asher,
879
00:41:35,443 --> 00:41:38,169
Olivia, and Enrique.
880
00:41:40,624 --> 00:41:43,484
To the next phase
of your surgical training.
881
00:41:43,485 --> 00:41:44,797
You helped pick them.
882
00:41:44,798 --> 00:41:47,571
As senior residents, it's now
your job to help train them.
883
00:41:47,874 --> 00:41:50,043
And don't take this
responsibility lightly,
884
00:41:50,044 --> 00:41:51,821
because if you don't train them well,
885
00:41:52,175 --> 00:41:53,467
people will die.
65721
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