All language subtitles for tgdS04E17.720p.WEB.H264-STRONTiUM

Don't put any food
down the sink.

Garbage disposal's broken.

I'll call the landlord.
All right.

He took a week
to call the plumber

when we lost
the hot water,

but I guess
this doesn't matter
as much.

We'll just use
the regular trash.

Yes.

10% to 15%
of known pregnancies
end in miscarriage.

This wasn't unusual.

No. You're right.

We're not the only people
to go through this.

The best thing to do
is to just get back to normal.

Hmm.

I'm glad you're
going back into work.

Couple more days of rest,
and I'll be doing that, too.

Are you sure
you're all right?

"All right"
is stretching it,

but yeah.

We just need some time.

****

****

How you feeling?

All right.

How's Lea doing?

She thinks we need time.
I agree.

Hey, Shaun.
How are you feeling?

All right. And Lea thinks
we need time.

Well, I didn't expect
to see you here.

You have a few days leave.
I thought you'd be home.

I prefer to work.

Well, we respect
your judgment.

Bon appetit.

****

Gastric reflux causing
projectile vomiting.

****

I'm clearing your schedule for
the next... How many days?

Oh. Well, that
is up to my lovely
and talented doctors.

Welcome to
St. Bonaventure,
Senator Clark.

Oh, please. Marian.

Oh, Marian,
I am a huge supporter.

You had my vote
in the presidential primaries.

Thank you, Dr. Browne.

Oh, Claire.
Claire.

If only there'd been another
couple million like you.

Yeah.

It's okay. Nothing wrong
with a balanced ticket.

I was
in my hotel this morning,
going over my speech,

when this
started happening
to my face.

Whole left side went rogue,

blinking and twitching
like crazy.

Has it happened before?

This was the third time.

Fortunately,
all in private.

Needless to say,
I had to cancel
my appearance.

Can I see that again?

Oh. I'm sorry.
I just deleted it.

The only thing worse
than people seeing
my twitchy face in person

is them seeing
my twitchy face
on a hacked video.

Mm.

So, how do we go about
deleting it from my body?

It's a hemi-facial spasm.

We should do an MRI

to rule out the more serious
possible causes.

Which are?

Aneurysm, MS,
possibly a brain tumor.

What are
the less serious causes?

Stress, exhaustion,
too much coffee.

Well,
that's my job description.

Which can be
treated with Botox
injections and Ativan.

Ah. Sold.

We still need
to do the MRI.

Do both.

Oh. As Claire knows,
I always have to
control the agenda.

****

Hi. Artie Hill.

I have mild heart failure.

I'm Dr. Park.

How do you know

you have mild heart failure?

I'm tired, and I've been
having palpitations.

We'll run tests,
but if it makes
you feel better,

a lot of people
have palpitations,

and it doesn't usually mean
heart failure.

Yeah, but I was just talking
to my doctor on the phone,

and he told me
I have heart failure.

The doctor
who did my bypass.

Your bypass?

He told me I should
go to the nearest
emergency room.

I was in the park,
looking at the cherry trees,

and I started feeling funny,
so I called...

When was this bypass?

Um...
A month ago.

Paul Nakano.

I performed his surgery
at San Jose General.

Mr. Hill, I hope you took
a taxi, as I asked you to.

It was only three blocks.

If you don't mind,
I'd like to get a 12-lead EKG,

cardiac CT,
and bloodwork.

Ordinarily, I'd be
thinking about volume
overload as the cause...

But in this case, sodium
and B.U.N. are normal.

The next thing
I'd look at is a post-op
myocardial infarction.

But in this case,
the troponins are normal.

So you know
what I'm thinking?

Yes. You did your job
too damn well.

The heart's been
so strengthened
from the bypass

that it's revealed
a weakness in the valve.

It can't handle
the pump pressure.

Hmm.

Dr. Nakano was
my Chief of Surgery

when I was a resident.

Hmm.

So, when do you want
to open him up?

I'm hoping never.

Have either of you
ever done

a transcatheter aortic
valve replacement?

I've read about it.

It's minimally invasive
and way preferable

to opening up the patient
for the second time
in a month.

Well, I look forward
to learning from you again.

Hmm.

Oh. Excuse me! Sir?
Person in the hall?

Oh, sorry.

Hello. I am
Dr. Shaun Murphy.
I am a surgeon.

Uh, I-I can't find my socks.

And I can't find the button
to call someone.

Ah.

Now, why would
they put it there?

You can't even see it.

What about the socks?

I have mild
heart failure.

I was in the park,
looking at the cherry trees...

Cherry trees aren't in bloom
at this time of year.

Well, I can still
look at them, though.

They don't disappear
just because
the blossoms fall.

Mm. I can get you socks
from the pre-op supplies area.

Ah, yes. I remember those
crappy socks they give you.
I'll take 'em.

Why do you guys keep it
so cold in here?

My feet are freezing.

****

It's beautiful to look at

if you're inside
and don't have to
go anywhere.

And you might not want
to go anywhere if you don't...

Take care of Arthur.

But he lost his silly head
and shot Br...

Every night, we have
three clients a week

who think
I'm waiting tables...

****

We'll use a pigtail catheter
to place the guide wire,

then run a delivery catheter
through an 18 French sheath

to ferry the new valve
through the femoral artery
to the heart.

Then we inflate a balloon
that expands the new valve

and installs it
right inside his current one.

That would kill him.

He has cold feet.

Who are you?

I'm Dr. Shaun Murphy.

He's one of my residents.

Oh. Artie has cold feet?

He's afraid
of the procedure?

No, I think Dr. Murphy
means it literally.

The patient
has cold feet.

Is his body temperature
dropping?

No, his core body temperature
is stable at 98.5.

He rarely has cold feet.
I got him socks.

You're gonna need
to draw some
dotted lines here for me.

Okay. Cold feet means
impaired circulation,

which means constricted
blood flow from the heart,

which means
a damaged vessel.

If we try to push
the new valve through
the damaged area,

it will rip open,
killing him.

"Damaged vessel"?

Yes. You make a mistake
during the bypass,

most likely a tear
in the aorta.

I didn't make a mistake.

Mm, you caused
an aortic dissection.

Shaun, this man has
more cardiac experience

than everyone
in this room times ten.

A lot of people
have cold feet.
My wife has cold feet.

Everyone has cold feet
in a hospital.

Yes. We should perform
an angio on Mr. Hill.

That will show
the aortic dissection.

This man recently underwent
an open heart surgery.

He's gonna have
valve replacement.

We don't need to load him up
with yet another procedure

when there was
no mistake.

Studies show that
old people are less likely
to admit mistakes

because they are less aware
when they've made one.

Okay, Dr. Murphy,
you've told us your
thoughts on this case.

It's my understanding
that you have
a few days of leave.

I suggest you take them.

I prefer
to continue working.

Then do it
somewhere else.

****

You...

Will kill him.

****

You think
my surgeon is wrong?

Yes.

And you're, like,
a-a real doctor, right?

I am a real doctor.

No offense,
but best heart guy around

versus the guy who happened
to be passing my room
when I needed socks.

Why shouldn't I let Dr. Nakano
do what he thinks I need?

If anything goes wrong,
he can fix it.

It could be difficult.

The tip of the catheter
would be likely

to rupture
your weakened aorta,

ripping it open
and causing you

to hemorrhage
into your chest

and bleed out
in a matter of minutes.

If you survived,

you'd have severe
anoxic brain damage.

But it's unlikely
you'd survive.

****

Go home.

Is Mr. Hill
requesting the angio?

He's not just requesting.
He's demanding.

This is why you take
a leave of absence
when you need one.

You're not
thinking clearly

or you never would have
pulled a stunt like this.

I prefer to stay at work.

I could assist
with E.R. consults.

Dr. Murphy, because
I'm being professional,

you may not understand
how angry I am right now.

Will you do
what Mr. Hill wants?

What you want,
you mean?

Yes, we'll do it.
You've forced our hand.

Good.

****

I would have fired him.

Honey, when Freya
brings you a dead rat,

she's offering you
a gift.

I know.
I waited until she was gone

so she wouldn't
see me toss it away.

Wish you were here.

You could strike
the right balance

between enthusiasm
and discouragement.

Oh. Honey, I gotta go.
My doctors are here.

You sure everything
is okay there?

Absolutely. These shots
are working like a charm.

Love you!
Love you.

Mwah.

The shots are
not doing the job.

What else do you
have for me?

I had another episode.
It was shorter,
but still there.

The MRI shows a branch
off the basilar artery

that's compressing
the facial nerve.

Unfortunately, you have
a "tortuous" artery.

Where it should be straight,
it bends and twists.

Bad news is,
it'd be a nightmare

to try and address
this surgically.

Good news...

Is, other than
some twitching,

which is minimized
by the Botox,

it's not causing
any other problems.

Exactly.

Aside from
the complete destruction

of all I want to
achieve in life.

Melodramatic, yet true.

These episodes
keep happening,

eventually one of them
will get caught on video.

Ten minutes later,
it'll be all over
social media.

My opponents will
mock me relentlessly.

I think a lot of people
would have sympathy
for you.

We don't vote for people
we feel sympathy for.

We want strong leaders.

We want the symbol
more than the reality.

****

Please help me.

Unfortunately,
there's nothing we can do.

We'll see what
we can come up with.

****

** Last night I came out
I was so damn manic...

** I don't even know
Where I went wrong

** But I went wrong

****

** And it's times like these
That I swear to God

** Oh, that my mother can't
See me and if she did

** I don't know how
I would keep it together

** I don't know
How I would keep it **

Shaun?

You shouldn't be here.

Andrews is pissed at you,
with good reason.

There's no need
to make him any more angry.

That's why I'm hiding.

I couldn't
wait in the lounge

because the walls are glass
and people could see me.

"Wait"?
What are you waiting for?

When they see
that I was right,
they'll let me come back.

I want to be prepared.

I'm reading about options
in aortic dissection.

Shaun, no.
Yes.

Once they do the angio,
they'll see the evidence.

Dr. Andrews
won't be angry anymore.

They did the angio.

Mm.

Oh.

No. No, they...
They couldn't.

They did it.

I was there.
You were wrong.

But...

Cold feet...
It was a focused angio.

I saw the ascending aorta
and the aortic root.

There was no sign
of dissection.

****

They're giving the patient
a chance to rest

before scheduling
the TAVR.

We all make mistakes.

****

But I think you should
leave the building

while you're still
forgivable.

****

****

** There's a hole
In the drywall still not fixed

** I just haven't
Gotten around to it

** And besides

** I'm starting
To get used to the gaps

****

** Say you wish you could
Find some way to help

** Not to be so hard on myself

** So why is it easy
For everyone else?

** I'm not always like this

** There's always tomorrow
I guess **

****

Lea.
Yeah.

How are you?

I'm good.

It happened to me, too.

****

Twice.

We could bypass
the basilar artery.

A 25% mortality rate, sure.

How about stereotactic
radiosurgery?

No, she wouldn't like it.

It takes months
to see any kind
of improvement.

It's interesting.

The fact that you like
this person makes you willing

to make really
stupid decisions
that could kill her.

We could meet
in the middle.

Tortuous or not,
the main basilar
isn't causing the spasms.

So we leave it alone
and just sling up

the branch of the artery
that's applying the pressure.

Nice.

I have two predictions
to make.

One, she'll come up
with a rationalization

to justify not telling
her husband
about this surgery,

and two, you'll come up
with a rationalization

to justify
forgiving her for that.

You wouldn't have
fired him.

He's dealing with
some personal issues,

and I remember
you giving me
some slack once

when I screwed up.

Well, you were facing
a challenging surgery,

and your girlfriend,
who I never liked,
by the way,

dumped you, so...

You knew
about the dumping?

Oh, yeah.
I just didn't know why.

She wanted a commitment.
Said I didn't love her enough.

And I told her
I loved her,

but I didn't have time
to get into it

because I had an esophagus
to reconstruct.

Why did you help me?

I mean, why me
and not Penzer?

He was always number one
in our class.

I was always second.

Where's Penzer now?

What, you think I've been
following the guy's career
for the past 20 years?

He's at the NIH,
making policy.

That's Penzer.

Great mind, great hands,

but I knew
he'd never be a surgeon.

He didn't love it enough.

I can wait.
Oh, this can, too.

Just letting the phone
get to 10%,

then I'll run the gauntlet
of well-wishers and head out.

Yeah. I'm one of them.

When my grandma died,

I remember a whole relay

of the mothers of the church
bringing food to the house.

They all loved my grandma.

The older ladies got
their best hats and gloves out

for the service.

****

Pastor made a special prayer
at the gravesite.

We all told stories
about her.

There were rituals.

We said goodbye
to the past.

You're saying goodbye
to the future.

I'm sorry for your loss.

****

And how soon could
I get out of here?

If all goes well, a day,
maybe two at most.

Oh. You hear that, Cal?

Rebooking
for Thursday.

There was
an "if" there.

That's strange.
I heard a "when."

Now, I will be appointing Cal
as my healthcare surrogate
while I'm under.

Mm, uh, most people
appoint their spouse.

Or at least notify them.

He'll just try
to talk me out of this.

Because he loves me.

Whereas Cal is using me
to find a better position,

but knows exactly
what I want.

So... Let's fix
my broken brain.

****

I got your text.

I'm a good diagnostician.

Of course you are.

Sit down.
You... You want to sit?

No.

I accounted
for every symptom.

I listened to
the patient's history.

Someone's feet were cold.

Okay? Uh, just...
Sometimes that
means something.

Sometimes it doesn't.
This time, it didn't.

S-So what?

What are you still
doing here, Shaun?

Wh... Do you not
want to go home?

You gotta go home.
You suffered a loss.

You gotta...

You gotta deal with it.
You gotta face it.

Mm.

Why do I have
to "face it"?

What does that mean?
It happened.

****

Yeah.

It did happen.

It happened, okay?

Go home

and be with Lea.

****

Oh, Claire.
I'm happy to see you.

Uh, it seems the reporters
have discovered I'm here,

so poor Cal has
gone off to craft
a believable explanation.

So, what's something a person
might be hospitalized for

that says
"I'm an unstoppable force"?

You want me to provide you
with a good lie?

Yeah.

But you must be scared.

I'm terrified.

****

You know, when I'm scared,

I think about
Evvie Sinclair.

You were
the commencement speaker

at my high school
graduation.

Oh.

I was a bit
of a mess back then.

I had no idea what
I was gonna do with my life

or what I could
do with my life.

And you told us
about Evvie Sinclair,

born with Turner Syndrome,
small in stature,

facial abnormalities,
speech impairment.

But she just had

a desperate need
to learn.

And against
her parents' wishes,

she started high school.

And...

And I just
remember thinking...

If Evvie can
go through those doors

and walk down
those halls...

I went home that day,
and I applied to 11 colleges.

So, I am a doctor...

Because of you.

And Evvie.

Mm.

That was a great story.

Rickie Demarest.

He was
my campaign manager
before Cal.

He made up
some lovely stuff.

****

You're back early.

Dr. Andrews
sent me home,

and Dr. Glassman
thinks we should talk.

Dr. Glassman
is not a counselor.

He's a neurosurgeon.

And a sometimes
annoying person.

I'm gonna
make some tea.

Oh. It's your mother.

No, no, no, no, no.
Hello.

Hi, Shaun.
How are you?

I'm... Well.

Lea...

Can't talk to you now.

Oh, you're both home.
I wanted to ask
about strollers.

The one Lea likes,
I read a review

that said the front wheel
keeps coming off.

I'm sure she won't listen,
so I'm gonna send a link.

You should read it, too.

Yes. Thank you.

You don't want
your little girl

pitching headfirst
onto the sidewalk.

Oh, no.

No. We wouldn't.

Just hang up. Just...

Okay. I should go.

And now that
we know it's a girl,
I was wondering...

I already bought a onesie
with little dinosaurs on it.

Unbelievably cute.

Mm. Cute. Yes.

Okay, that sounds good.

I am due at the hospital.

Just a quick question.

Since it's not a boy,
the dinosaurs will have to go.

I'm...
What would be
nice for a girl?

I don't...
I don't know.

There's one
with ballet shoes.

That's stupid.

Why would you
have to change it?

A girl would like dinosaurs
just as much as a boy.

Dinosaurs are fascinating.
You need to shut up.

Um...

Shaun?

****

As you all know, Senator Clark
is a very competitive person.

She tore her meniscus
while charging the net

to return a drop shot.

For the record,
it was match point,
which she won.

She underwent...

I wonder if he negotiates
employment contracts.

And thanks to
the terrific doctors
here at St. Bonaventure,

she will be back fighting
for you before you know it.

Senator Clark
wanted to thank all...

Oh, did you hear that?
We're terrific.

You must be. You repaired
her meniscus through her head.

It's no one's business
why she's here.

And there's
the rationalization
I've been waiting for.

If this was
someone you didn't like,

these character flaws
would reveal
some deep problem

worthy of your
eternal judgment,
but since...

You're head
of department.

I'm sure you've had to
spin things sometimes.

"Spin things"? Sure.

Lie? No.

Just one more example of how
Senator Clark has been able...

And that was
an example of both.

Marian isn't waking up.

And to that end,
she's already making calls
and sending e-mails.

Oh. And texts.

She just told me
to wrap it up.

****

I yelled at your mother.

Yeah.

I misdiagnosed
a patient.

That's why
they sent me home.

I'm not behaving
normally.

Neither am I.

But maybe this is normal
for where we're at.

Dr. Glassman talked about
"facing my loss,"

but I don't know
what that means,

and even if
we could face it,

won't we just
hurt ourselves
for no reason?

I don't know.

I don't think grief
has an actual solution.

It has to.
I can't stay this way.

Claire told me
about this support group.

I'm not sure we can just
force ourselves past this.

The cold feet
are not a coincidence.

****

If they do
the TAVR procedure,
they'll kill the patient.

For a different reason.

****

****

The guide wire's in place.

I'm preparing
to deliver the valve.

Okay, you...
You have to stop.

If that valve
goes through...

Get out of here, Murphy.
No.

If that valve
goes through,
he'll die.

Call Security.
I thought it was an aortic
dissection, but I was wrong.

The cold feet are
from a coarctation... No.

No. No, no.
It's too close.

You're too close. Stop!

Stop! Stop, please! Stop!

B.P.'s spiking.
200 over 100.

Heart rate's up.
He's gonna stroke.

Give him nitro and cardene!

I'm pulling out.

B.P.'s dropping.

He's starting
to stabilize.

****

Okay.

Dr. Murphy?

Go on.

Dr. Nakano did not
make a mistake in the bypass.

He did everything right.

But Mr. Hill
has a congenital narrowing
of the abdominal aorta.

He's had that coarctation
for year, but never knew

because his body compensated
for the poor circulation

by raising
his blood pressure,

which caused his heart
to deteriorate,
requiring a bypass.

The stronger, repaired heart
put pressure on the valve,

and his blood pressure
dropped.

No more compensation.

His feet got cold.

And I could get
the guide wire up there,

but the valve delivery system
would be too big

to fit through the coarctation
without damaging the vessel.

Yes.

We'll have to open him up.

And the valve will have to
be replaced directly...

Through surgery.

I hope you'll
join us for that.

****

How's Cal
gonna spin this?

Her latest tennis match
went into extra sets?

Slinged branch
looks good,

no conflict
with the seventh nerve,

no bleeds, no strokes.

The basilar is dilated.

And compressing
her brain stem.

She's stopped breathing.

We need to intubate.
Get the airway cart.

****

Tell them
she's gonna be
at the conference.

And if they keep asking,
tell them the Senator believes

anyone not ready to commit
on climate change action

is on the wrong side
of history.

Just never use that phrase
more than once a month.

He has to run.

The sling procedure
went fine,

but the basilar artery
was less stable
than we hoped.

It's gotten
even more dilated

and is causing progressive
neurological deficits.

We have no choice
but to bypass the artery.

The last surgery
was dangerous.

This one way more so.

What do you need me
to sign?

We should inform
her husband.

There is
a one in four chance
that she could die.

****

If I told Pete that,
he'd be at the airport
in half an hour,

and everyone
would know that Marian
is in this hospital

for something
this serious.

She has a brain aneurysm.
That doesn't make her weak.

Even worse.
It makes her mortal.

Her husband has
a right to be here.

A moral right.
To destroy her career.

Which is what
I'm protecting her from.

This is just a game to you,
isn't it?

Yeah. The game
they make you play

before you can do
anything real.

****

Valve placed.
Leaflets mobile.

New valve is perfectly
seated in the annulus.

No regurgitation,
flow in both
coronary arteries.

I'm about to close up.

Looks like
we've got
a paravalvular leak.

We need to go back
and fix this.

Irrigate
and check the image.

****

No leak.

Slight excess from
the washing jets
in the mechanical valve.

Normal finding.

****

Wow. You're very good.

I think he knows that.

Still nice to hear.

Closing up now.

Two-oh Vicryl suture.

****

Retracting
temporal lobe
and cerebellum...

Very carefully.

Vascular anatomy
is fully exposed,

avoiding
the tortuous area.

Radial artery
graft length

looks to be
a perfect fit.

****

Anastomosing
with 9-0 Prolene.

Temporal lobe's swelling.

B.P.
and heart rate
are plummeting.

Drop her CO2,
full propofol
burst suppression.

Widen the craniotomy.

With the cerebellum
herniating outward?

We do that,
she may never
walk normally again.

If she didn't want
a twitch...

Drill.

Open the arachnoid plane
and release CSF collections.

Reduce the pressure
from the inside.

For her,
it's worth the risk.

Arachnoid dissector.

****

There was a patient
admitted this morning
I think you should see.

You thinking of
Mrs. Cavanaugh?

That's a good idea,
Dr. Park.

We'd welcome another take

as to whether she's
a good candidate
for inserting an ICD.

I'll consult just
on that question,
if you'd like me to.

But I won't join
in the O.R.

I'm quitting surgery.

****

I don't understand.
When did you decide...

Fifteen minutes ago.

I nearly closed up
without doing
a final antibiotic lavage.

But you didn't.

Nurse Barker prompted you
with the syringe.

It was a tiny error.

There was
no contamination
of the field.

Many surgeons don't even
do a final lavage.

I always told myself once
I started making tiny errors,

I'd stop before
I made a big one.

Paul,

we almost lost
a patient today.

You were still rattled.

Thank you, Marcus.

But I made this plan
years ago,

because I knew
that when the time came,

I'd look for reasons why
whatever I did wrong

was tiny, minor,
didn't count.

That's when
I made the rule.

Everything counts.

****

Dr. Murphy,
it was nice
sewing with you.

****

You gave us a scare.

But all good now.

You're mad at me.

About little Evvie.

Well, Evvie inspired me.

I took strength from her
for years.

Now it's all fiction.

Fictional lives
can save real lives.

Four years ago, I used that
story on the Senate floor.

I got my bill passed
by one vote.

That lie helped millions of
people with disabilities.

I'm really proud
of that lie.

****

I'm heading out
to have a drink
with Dr. Nakano.

Are you going
to try to talk him
out of leaving surgery?

No.

I'm going because
no one's meant
to shoulder loss alone.

And I'm the one
who should be
with him tonight.

Why?

Because we love
the same thing.

And he knows no one would
understand what he's lost
more than I would.

****

****

I have been thinking...

About all the people
you've helped,
including me.

And about not...

Sharing the danger
you were in
with your husband.

Probably not sharing
a lot of other things.

And it struck me
that...

Being in a marriage
like that must be lonely.

You can't
trust him to lie.

So you end up
sharing more of yourself
with a guy like Cal,

who is a hired gun
and who's gonna end up

working for somebody else
two years from now.

The fact that Pete and I
don't talk shop

doesn't make our marriage
less than wonderful.

Another lie?

****

Hey, hey!

How 'bout
those Devils, huh?

But before I go all fan girl
about last night's game,

let's talk about the upcoming
climate change conference.

I have to tell
you guys a story

about a little boy who lives
on the Outer Banks

of South Carolina,

whose home is about to
be washed away...

** I think if I fail again

** That I know
You're still listening

** Maybe it's all gonna
Turn out all right...

I could get another mug,
or I could wash these.

It's a tough decision.

Mm.

I should
probably tell you,

I didn't get to
calling the landlord.

And maybe
ten minutes ago,

I saw a couple fruit flies
near the drain, so...

** I have to believe that it is

** Have to believe...

So... Yeah.

Now it's my fault if we're...

If we get bugs.

****

** When I tell you that it is

** Oh, it's not for my benefit

** Maybe it's all gonna
Turn out all right

** Oh, I know that it's not

** But I have to believe
That it is **