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1
00:00:01,026 --> 00:00:02,890
Previously on The Good Doctor...
2
00:00:02,915 --> 00:00:04,330
You go going to the club or work?
3
00:00:04,355 --> 00:00:06,460
Yeah, these early calls are
gonna take some getting used to.
4
00:00:06,488 --> 00:00:07,799
Browne retractor.
5
00:00:07,834 --> 00:00:09,111
No Browne retractor.
6
00:00:09,146 --> 00:00:10,872
I thought I put it on
your tray from the supply room.
7
00:00:10,906 --> 00:00:12,321
Dr. Kalu is not your peer.
8
00:00:12,356 --> 00:00:14,082
He's your employee,
and you are his boss.
9
00:00:14,116 --> 00:00:17,050
I do not plan to give Jared
special treatment.
10
00:00:17,085 --> 00:00:19,881
And if I see it, it won't
be good for either of you.
11
00:00:19,915 --> 00:00:21,883
I'm not expecting
special treatment, Shaun,
12
00:00:21,917 --> 00:00:24,097
but I don't appreciate being
treated like an intern either.
13
00:00:24,132 --> 00:00:27,198
Dr. Andrews said he is judging my
performance off of your performance,
14
00:00:27,233 --> 00:00:29,097
and your performance is not good.
15
00:00:29,131 --> 00:00:31,346
You come in with your fancy car
16
00:00:31,370 --> 00:00:32,894
and your old tricks and think,
17
00:00:32,928 --> 00:00:35,517
"Ta-da, I'm a surgeon," but you're not.
18
00:00:35,551 --> 00:00:37,174
I just want to prove that I belong here.
19
00:00:37,208 --> 00:00:39,210
When I checked on Yara post-operatively,
20
00:00:39,245 --> 00:00:40,936
I noticed you only used
eight sutures when you closed,
21
00:00:40,971 --> 00:00:42,834
and she had a small bleed.
You should have used ten.
22
00:00:42,869 --> 00:00:45,113
Dr. Glassman closed the galea and skin.
23
00:00:45,147 --> 00:00:48,771
- Dr. Glassman skipped two sutures?
- Guess so.
24
00:00:54,812 --> 00:00:57,504
At what time did you wake up
yesterday morning?
25
00:00:57,539 --> 00:00:59,437
The usual, 5:30. Why?
26
00:00:59,472 --> 00:01:01,715
At lunch, you had a Cobb
salad with balsamic vinaigrette,
27
00:01:01,750 --> 00:01:04,003
so that's 450 calories ingested,
assuming you kept it down.
28
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Yes, I kept it down.
29
00:01:05,530 --> 00:01:07,691
Did you use a sauna,
engage in rigorous exercise,
30
00:01:07,715 --> 00:01:09,378
and/or experience diarrhea?
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No, I didn't do any of those things.
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00:01:11,070 --> 00:01:12,554
What's with the questions, Shaun?
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00:01:12,588 --> 00:01:14,866
You made an error
in yesterday's craniotomy.
34
00:01:14,900 --> 00:01:16,592
I'm trying to evaluate various factors
35
00:01:16,626 --> 00:01:18,594
that would negatively impact focus.
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I made an error?
37
00:01:19,768 --> 00:01:21,769
You closed with only eight sutures.
38
00:01:21,804 --> 00:01:23,634
The size of the wound required ten.
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00:01:23,668 --> 00:01:25,049
We need to figure out why.
40
00:01:25,084 --> 00:01:26,809
Why do we need to figure out why?
41
00:01:26,844 --> 00:01:28,742
Two sutures, it's a blip.
It's not a thing.
42
00:01:28,777 --> 00:01:32,125
It could be part of a more
troubling pattern needing attention.
43
00:01:32,160 --> 00:01:34,959
Shaun, the surgery was a success, right?
44
00:01:34,993 --> 00:01:36,647
- Yes.
- The patient had a great outcome.
45
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There is no pattern.
46
00:01:39,339 --> 00:01:40,650
Goodbye.
47
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I'm a surgeon, and I belong here.
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00:01:50,316 --> 00:01:53,215
I'm a surgeon, and I belong here.
49
00:01:58,634 --> 00:02:02,121
You are a surgeon, and you belong here.
50
00:02:03,950 --> 00:02:05,641
I just keep imagining you in the mirror
51
00:02:05,676 --> 00:02:08,629
like, "You have the hair of Tracee
Ellis Ross
52
00:02:08,653 --> 00:02:10,162
and the swag of Beyonce."
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00:02:10,197 --> 00:02:11,751
Do not shame my self-care.
54
00:02:13,856 --> 00:02:16,286
Affirmations are backed by research.
55
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fMRI evidence shows a correlation
56
00:02:18,827 --> 00:02:21,083
with positive changes in the brain.
57
00:02:21,588 --> 00:02:24,378
I've just put the finishing
touches on a surprise.
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Drum roll please.
59
00:02:28,733 --> 00:02:30,321
Or not.
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00:02:30,356 --> 00:02:31,702
Well, get your song lists ready
61
00:02:31,736 --> 00:02:34,049
because you are all
officially invited to...
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Star Karaoke, 7:00 p.m.
until question mark, question mark.
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00:02:40,504 --> 00:02:42,101
You know it's gonna be a party
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00:02:42,125 --> 00:02:43,714
when there's double punctuation
involved.
65
00:02:43,748 --> 00:02:45,409
Yeah, just the chance to unwind
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00:02:45,433 --> 00:02:46,889
and get to know you all a little better.
67
00:02:46,924 --> 00:02:48,822
Sounds fun. Thanks for the invite.
68
00:02:48,857 --> 00:02:52,274
Prepare to be destroyed.
My "Someone Like You" slays.
69
00:02:52,309 --> 00:02:55,346
Need a surgical consult for a clinic
patient with a dislocated patella.
70
00:02:55,381 --> 00:02:57,693
Mm, sorry, ER.
71
00:02:59,178 --> 00:03:02,215
You two are it. Room one.
72
00:03:07,154 --> 00:03:09,950
When did the chest pain start?
73
00:03:10,085 --> 00:03:11,811
I first noticed it Tuesday morning
74
00:03:11,845 --> 00:03:13,677
along with shortness of breath.
75
00:03:14,296 --> 00:03:16,505
Are you taking any medications?
76
00:03:16,540 --> 00:03:19,266
I started with one,
then switched a few times.
77
00:03:20,751 --> 00:03:22,891
These are used to treat ADHD.
78
00:03:22,925 --> 00:03:24,548
And brain fog.
79
00:03:24,582 --> 00:03:26,148
I'm a COVID long-hauler.
80
00:03:27,137 --> 00:03:31,934
Um, and I just started
guanfacine and N-acetylcysteine,
81
00:03:31,969 --> 00:03:35,386
which may actually be helping finally.
82
00:03:35,421 --> 00:03:38,044
- When was your initial infection?
- Eight months ago.
83
00:03:38,079 --> 00:03:41,012
It just felt like a mild flu,
but then it got worse,
84
00:03:41,047 --> 00:03:43,394
like someone poured molasses
on my brain.
85
00:03:43,428 --> 00:03:45,569
I've done cognitive therapy,
86
00:03:45,603 --> 00:03:47,502
memory exercises,
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00:03:47,536 --> 00:03:48,710
still am,
88
00:03:48,744 --> 00:03:50,884
whatever I can do
to get back in the field.
89
00:03:51,575 --> 00:03:53,759
- Which one?
- Clover.
90
00:03:54,750 --> 00:03:56,428
I'm an evolutionary biologist.
91
00:03:56,821 --> 00:03:58,375
- Oh.
- Wow.
92
00:03:58,409 --> 00:03:59,926
I have been studying how
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00:03:59,950 --> 00:04:03,118
white clover adapts
to environmental changes...
94
00:04:03,932 --> 00:04:07,591
And I'm on indefinite leave.
95
00:04:07,625 --> 00:04:08,940
Please stop talking now.
96
00:04:11,008 --> 00:04:14,045
Bluish skin, low O2 levels,
rapid heart rate.
97
00:04:14,080 --> 00:04:15,461
And increasingly labored breathing.
98
00:04:15,495 --> 00:04:17,152
Possible pulmonary embolism.
99
00:04:17,187 --> 00:04:19,430
Order a chest CTA and echo, stat.
100
00:04:19,464 --> 00:04:20,619
I have to go.
101
00:04:28,405 --> 00:04:29,406
Oh.
102
00:04:32,512 --> 00:04:33,686
You will need this.
103
00:04:33,720 --> 00:04:36,548
I sent one half of a high
volume order to your printer.
104
00:04:37,655 --> 00:04:40,520
These are Glassman's op reports?
105
00:04:40,555 --> 00:04:42,591
For the last three months.
January to March.
106
00:04:42,626 --> 00:04:45,594
October to December is printing
in Park's and my office.
107
00:04:45,629 --> 00:04:48,666
So you sent reports for, like,
100 surgeries to my printer?
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00:04:48,701 --> 00:04:51,013
No, 176 surgeries.
109
00:04:51,048 --> 00:04:52,808
473 pages.
110
00:04:52,843 --> 00:04:55,190
I've emailed Operations
to replace your toner.
111
00:04:55,225 --> 00:04:56,847
Many elements are in color.
112
00:04:56,881 --> 00:04:59,408
And why, exactly,
do you need all of this?
113
00:05:00,161 --> 00:05:02,786
To find out if his mistake was a blip.
114
00:05:08,315 --> 00:05:16,315
Synced & corrected by -robtor-
www.addic7ed.com
115
00:05:16,660 --> 00:05:18,558
Second time I've dislocated my knee.
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00:05:18,593 --> 00:05:21,975
Uh, first was a few months ago, I think.
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00:05:22,010 --> 00:05:24,185
- That was the sprained ankle.
- Ah.
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00:05:24,219 --> 00:05:26,014
The dislocation was last year.
119
00:05:26,048 --> 00:05:29,938
Your MRI shows no associated
damage to bones or ligaments.
120
00:05:30,674 --> 00:05:34,298
She's also been complaining
about dizziness,
121
00:05:34,333 --> 00:05:37,681
swollen ankles, maybe menopause-related.
122
00:05:37,715 --> 00:05:40,339
Dr. Reznick is looking to get her
on hormone replacement therapy.
123
00:05:40,373 --> 00:05:43,169
Orion insisted I come in
and get everything checked out
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00:05:43,204 --> 00:05:46,034
before she leaves
and moves 6,000 miles away
125
00:05:46,068 --> 00:05:47,829
to live alone.
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00:05:47,863 --> 00:05:50,832
I'm moving to Prague
next week for a new job,
127
00:05:50,866 --> 00:05:52,868
and you can come visit me
anytime you want, Mom.
128
00:05:52,903 --> 00:05:54,796
Not with a busted knee.
129
00:05:55,077 --> 00:05:56,665
To move forward with HRT,
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00:05:56,700 --> 00:05:58,357
I need to confirm all the medications
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00:05:58,391 --> 00:06:00,151
you've used over the last five years.
132
00:06:00,186 --> 00:06:04,501
Oh, uh, there was a purple triangle one,
133
00:06:04,535 --> 00:06:07,055
but they took me off that last year
134
00:06:07,089 --> 00:06:09,230
and an orange-shaped one.
135
00:06:09,264 --> 00:06:10,438
I'll review it with you.
136
00:06:12,198 --> 00:06:14,373
We need to see how your knee is moving.
137
00:06:14,407 --> 00:06:15,615
Lay back, please.
138
00:06:19,309 --> 00:06:21,414
Go ahead with the exam, Dr. Kalu.
139
00:06:22,415 --> 00:06:23,727
I thought I'd observe.
140
00:06:23,761 --> 00:06:24,866
It's a knee exam,
141
00:06:24,900 --> 00:06:27,144
not a multi-ligament reconstruction.
142
00:06:27,178 --> 00:06:29,631
You told me last time not
to assume I know everything.
143
00:06:29,666 --> 00:06:31,148
This is just making me do your job.
144
00:06:37,188 --> 00:06:40,525
That sounded like an apneic spell.
Check her tonsils.
145
00:06:40,778 --> 00:06:41,848
Ms. Garcia.
146
00:06:45,266 --> 00:06:46,543
Mm?
147
00:06:46,577 --> 00:06:49,270
Oh, did I fall asleep again?
148
00:06:49,304 --> 00:06:50,650
Yes.
149
00:06:50,685 --> 00:06:52,307
Can I take a quick look in your mouth?
150
00:06:52,342 --> 00:06:53,619
Mm-hmm.
151
00:06:56,622 --> 00:06:58,244
Kissing tonsils.
152
00:06:58,279 --> 00:06:59,763
They're so enlarged, they're touching
153
00:06:59,797 --> 00:07:02,283
and obstructing your airway,
causing severe apnea.
154
00:07:03,249 --> 00:07:05,158
You need a tonsillectomy right away.
155
00:07:09,945 --> 00:07:12,948
No pulmonary embolism,
but multiple cardiac issues.
156
00:07:12,983 --> 00:07:15,088
Severe narrowing of the pulmonic valve,
157
00:07:15,123 --> 00:07:16,642
hypertrophied right ventricle
158
00:07:16,676 --> 00:07:18,333
and opening between the lower chambers.
159
00:07:18,368 --> 00:07:20,991
This set of defects almost looks like
160
00:07:21,025 --> 00:07:23,176
- tetralogy of Fallot, but...
- It is.
161
00:07:24,719 --> 00:07:26,824
She has the fourth malformation,
162
00:07:26,859 --> 00:07:27,998
overriding aorta.
163
00:07:28,032 --> 00:07:30,715
I've never seen tet in an adult before.
164
00:07:32,382 --> 00:07:34,271
How is she still alive?
165
00:07:35,868 --> 00:07:36,972
Hang on a sec.
166
00:07:37,007 --> 00:07:38,441
I have to write everything down now.
167
00:07:40,735 --> 00:07:42,943
Tet is almost always
diagnosed in infancy.
168
00:07:42,978 --> 00:07:45,015
Doctors somehow missed it in your case.
169
00:07:45,049 --> 00:07:47,328
Oh, you have a rare presentation.
170
00:07:47,362 --> 00:07:49,330
The right ventricle obstruction
has been balanced
171
00:07:49,364 --> 00:07:51,608
by an increased flow
into the left ventricle.
172
00:07:51,642 --> 00:07:54,473
Damage from COVID disrupted the balance.
173
00:07:54,507 --> 00:07:55,888
The virus may have saved your life.
174
00:07:55,922 --> 00:07:57,544
Very few undiagnosed tet patients
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00:07:57,579 --> 00:07:58,787
survive past childhood.
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00:07:58,822 --> 00:08:00,927
A mere 2% make it to 40.
177
00:08:00,962 --> 00:08:02,308
You're saying
178
00:08:02,343 --> 00:08:03,965
I would have just dropped dead
at some point?
179
00:08:03,999 --> 00:08:05,967
It's very likely.
180
00:08:06,001 --> 00:08:09,660
We can remove that risk
with two separate procedures.
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00:08:09,695 --> 00:08:11,904
First, we'll close the extra vessels
182
00:08:11,938 --> 00:08:14,562
that have formed to compensate
for your heart defects.
183
00:08:14,596 --> 00:08:17,230
Then we'll do a surgery
to repair those defects.
184
00:08:19,567 --> 00:08:21,741
Is it possible the tet is connected
185
00:08:21,776 --> 00:08:23,294
to my long COVID symptoms?
186
00:08:23,329 --> 00:08:25,739
Could fixing my heart clear up my head,
187
00:08:26,884 --> 00:08:28,023
the brain?
188
00:08:28,990 --> 00:08:31,475
No. I'm sorry.
189
00:08:40,933 --> 00:08:42,106
You snagged our table.
190
00:08:43,176 --> 00:08:44,730
Beat Hawks and Nunez to it.
191
00:08:44,764 --> 00:08:46,594
You're a champion.
192
00:08:46,628 --> 00:08:49,251
One Splenda, half Sugar in the Raw,
light almond milk.
193
00:08:49,286 --> 00:08:50,356
Now who's the champion?
194
00:08:50,391 --> 00:08:51,392
Mm.
195
00:08:55,119 --> 00:08:56,728
I have something for you.
196
00:08:57,467 --> 00:08:58,778
- Really?
- Mm-hmm.
197
00:09:05,578 --> 00:09:08,581
An agreement acknowledging
a consensual relationship.
198
00:09:08,616 --> 00:09:10,894
I, Marcus Andrews,
would like to take you,
199
00:09:10,928 --> 00:09:13,621
Dalisay Villanueva, on a date.
200
00:09:13,655 --> 00:09:17,728
And as hospital president,
you know, I already signed it.
201
00:09:19,765 --> 00:09:21,127
This is so romantic.
202
00:09:21,939 --> 00:09:23,213
Give me the pen.
203
00:09:30,016 --> 00:09:32,605
- Dinner this weekend?
- Let me see.
204
00:09:32,640 --> 00:09:34,724
Oh, I'm needed on the ward.
205
00:09:35,180 --> 00:09:36,699
Sorry. Lock it down later?
206
00:09:36,781 --> 00:09:37,782
Sure.
207
00:09:45,584 --> 00:09:46,619
Iced coffee?
208
00:09:46,654 --> 00:09:48,238
I'm good.
209
00:09:48,966 --> 00:09:50,490
How about a hot coffee?
210
00:09:52,798 --> 00:09:56,042
In honor of Daphne's
successful tonsillectomy,
211
00:09:56,077 --> 00:09:57,789
I got a few options.
212
00:09:59,114 --> 00:10:00,599
Is that a latte?
213
00:10:00,633 --> 00:10:01,600
Mm.
214
00:10:03,671 --> 00:10:05,914
It was a routine tonsillectomy.
215
00:10:05,949 --> 00:10:08,216
Those were unusually large tonsils.
216
00:10:09,159 --> 00:10:10,844
A good thing her daughter
brought her in.
217
00:10:13,301 --> 00:10:14,958
You think Daphne was
better off not breathing?
218
00:10:14,992 --> 00:10:16,580
I don't think it's a daughter's job
219
00:10:16,615 --> 00:10:18,375
to make sure Mom goes to the doctor.
220
00:10:21,792 --> 00:10:22,828
It's Daphne.
221
00:10:25,555 --> 00:10:27,039
Heart rate spiked. She's hypoxic.
222
00:10:27,073 --> 00:10:28,695
Turn up oxygen to max flow.
223
00:10:32,838 --> 00:10:35,047
Loud murmur from
the right ventricle and atrium.
224
00:10:35,081 --> 00:10:36,876
Chronic damage from apnea
could have increased
225
00:10:36,911 --> 00:10:38,671
the pressure in her lungs,
causing right heart failure.
226
00:10:38,706 --> 00:10:40,466
BP's dropping.
227
00:10:40,501 --> 00:10:42,167
We need to get her to the cath lab.
228
00:10:47,473 --> 00:10:49,215
Positioning coiling system.
229
00:10:50,165 --> 00:10:51,650
Two vessels left to close.
230
00:10:53,203 --> 00:10:54,679
Deploying the coil.
231
00:10:57,172 --> 00:10:59,692
O2 sats are dropping.
232
00:10:59,727 --> 00:11:03,178
Her infundibular muscle
is clamping down.
233
00:11:03,213 --> 00:11:04,819
She is having a tet spell.
234
00:11:06,665 --> 00:11:08,977
Give phenylephrine and 100% oxygen.
235
00:11:09,012 --> 00:11:11,154
I have never seen one in-person before.
236
00:11:12,567 --> 00:11:14,293
We need to move blood up to the lungs.
237
00:11:14,327 --> 00:11:16,226
Give her a bolus and up the opiates.
238
00:11:20,575 --> 00:11:21,990
If we don't stop the spasm,
239
00:11:22,025 --> 00:11:23,750
she could have permanent brain damage.
240
00:11:34,762 --> 00:11:37,937
The chance of a future
infundibular spasm is very high.
241
00:11:39,525 --> 00:11:42,777
Her tet repair surgery
will be much more risky.
242
00:11:50,294 --> 00:11:52,745
Pressure in Daphne's lungs
is still critically high.
243
00:11:52,780 --> 00:11:54,656
Not a routine tonsillectomy at all.
244
00:11:55,576 --> 00:11:57,003
Puncturing the atrial septum.
245
00:11:58,648 --> 00:12:01,271
Right heart is decompressing.
246
00:12:01,305 --> 00:12:04,481
Give nitric oxide to relax
and dilate the vasculature.
247
00:12:04,515 --> 00:12:07,760
Her apnea really did a number
on her pulmonary vessels.
248
00:12:07,795 --> 00:12:10,038
No wonder she's clumsy and forgetful.
249
00:12:10,073 --> 00:12:12,799
She's been sleep- and
oxygen-deprived for decades.
250
00:12:13,352 --> 00:12:16,113
It still doesn't make her
her daughter's responsibility.
251
00:12:16,148 --> 00:12:19,097
Would you want Kellan to put
his life on hold to take care of you?
252
00:12:19,634 --> 00:12:21,843
Not his whole life, no,
253
00:12:21,878 --> 00:12:25,191
but I don't think being overly
devoted is the worst quality in a kid.
254
00:12:25,226 --> 00:12:26,563
Remove the catheters.
255
00:12:27,746 --> 00:12:30,300
I was one of six growing up, only girl.
256
00:12:30,334 --> 00:12:31,577
Mom and dad worked a lot,
257
00:12:31,612 --> 00:12:34,487
so I was basically
second mom since kindergarten.
258
00:12:35,616 --> 00:12:37,282
I love my brothers, but...
259
00:12:39,274 --> 00:12:41,483
there's a lot you miss out on
260
00:12:41,518 --> 00:12:43,727
if you're all about taking care
of someone else.
261
00:12:48,283 --> 00:12:50,251
She's throwing a lot of PVCs.
262
00:12:50,285 --> 00:12:51,880
Maybe an electrolyte issue.
263
00:12:54,600 --> 00:12:56,498
BP's dropping. Heart rate 172.
264
00:12:56,533 --> 00:12:59,432
We're barely getting a pulse.
She's in V-tach. Defib pads.
265
00:13:17,312 --> 00:13:19,107
BP and heart rate stabilizing.
266
00:13:21,178 --> 00:13:23,146
Get a new chemistry, chest X-ray, EKG.
267
00:13:23,180 --> 00:13:25,413
We need to figure out what else
is going on with her heart.
268
00:13:35,192 --> 00:13:37,367
Oh, please don't disturb my materials.
269
00:13:37,401 --> 00:13:40,404
Which are what, exactly?
270
00:13:40,439 --> 00:13:42,821
Dr. Glassman made an
uncharacteristic surgical error.
271
00:13:42,855 --> 00:13:44,650
I am determining if it was an anomaly
272
00:13:44,685 --> 00:13:46,410
or part of a pattern.
273
00:13:46,445 --> 00:13:48,447
Glassman must be
really pleased about that.
274
00:13:48,481 --> 00:13:49,729
He is not.
275
00:13:50,552 --> 00:13:51,795
You are being sarcastic.
276
00:13:51,830 --> 00:13:53,555
Performance review
is a standard practice
277
00:13:53,590 --> 00:13:55,212
and benefits both doctors and patients.
278
00:13:55,247 --> 00:13:57,046
I have identified three additional
errors
279
00:13:57,070 --> 00:13:58,319
made in the last four months.
280
00:13:58,353 --> 00:13:59,907
I don't see a pattern.
281
00:13:59,941 --> 00:14:02,392
A dural tear on scarred tissue,
282
00:14:02,426 --> 00:14:04,325
closing with a running nylon
instead of Monocryl...
283
00:14:04,359 --> 00:14:05,464
Is that even a mistake?
284
00:14:05,498 --> 00:14:08,536
Dr. Glassman has always used
subcutaneous Monocryl.
285
00:14:08,570 --> 00:14:10,780
These are variations, minor missteps.
286
00:14:10,814 --> 00:14:13,265
You pore through four months
of any surgeon's op reports,
287
00:14:13,299 --> 00:14:15,129
and you'll find discrepancies like this.
288
00:14:15,405 --> 00:14:17,579
- No.
- Yes.
289
00:14:17,826 --> 00:14:19,241
Not in mine.
290
00:14:19,685 --> 00:14:22,101
That's probably true.
291
00:14:22,136 --> 00:14:24,347
Eh, if you're not finding a pattern,
292
00:14:24,863 --> 00:14:26,391
maybe it's because there isn't one.
293
00:14:29,895 --> 00:14:31,270
My patient is awake.
294
00:14:32,974 --> 00:14:36,426
Does this mean you can't move
forward with the tet repair?
295
00:14:36,460 --> 00:14:38,359
There's a medication called propranolol
296
00:14:38,393 --> 00:14:40,119
that will significantly reduce the risk
297
00:14:40,154 --> 00:14:42,363
of having another spasm during surgery,
298
00:14:42,397 --> 00:14:44,020
but because of your long COVID,
299
00:14:44,054 --> 00:14:46,327
you're at risk for some
very rare side effects.
300
00:14:46,643 --> 00:14:48,645
- Are they serious?
- Yes.
301
00:14:48,679 --> 00:14:50,543
Well, some of them are not,
like nausea, vomiting,
302
00:14:50,578 --> 00:14:52,580
muscle aches, and dizziness, but others,
303
00:14:52,614 --> 00:14:54,789
such as hypoglycemia
or visual changes...
304
00:14:54,824 --> 00:14:56,204
We'll start you on the propranolol.
305
00:14:56,239 --> 00:14:59,138
There's a good chance you won't
experience the rare side effects,
306
00:14:59,173 --> 00:15:01,342
but we'll need to keep
a close eye on you.
307
00:15:03,142 --> 00:15:04,557
And are those patients ahead of her
308
00:15:04,592 --> 00:15:06,472
also seniors with diabetes?
309
00:15:07,284 --> 00:15:08,561
Do not hang up on me, Phillip,
310
00:15:08,596 --> 00:15:10,143
or I'll head down to do this in person.
311
00:15:11,006 --> 00:15:12,030
I'll wait.
312
00:15:13,392 --> 00:15:14,358
Hey.
313
00:15:16,259 --> 00:15:20,056
There is a great new
Portuguese spot I read about.
314
00:15:20,090 --> 00:15:23,573
I can make reservations for us
Friday or Saturday at 7:00?
315
00:15:24,785 --> 00:15:26,441
Uh, I'm working a double both days.
316
00:15:26,476 --> 00:15:28,650
It's been a nonstop scramble
since Baker and Linh left.
317
00:15:28,685 --> 00:15:30,825
Well, you have two new
travelers starting on Monday.
318
00:15:30,860 --> 00:15:32,137
We need staff nurses.
319
00:15:32,171 --> 00:15:33,517
These nurses are highly skilled. We...
320
00:15:33,552 --> 00:15:34,902
It doesn't matter how skilled
321
00:15:34,937 --> 00:15:36,935
they are.
Travel nurses disrupt workflow,
322
00:15:36,969 --> 00:15:38,522
don't build long-term relationships.
323
00:15:38,557 --> 00:15:40,308
Right now, we just don't have the
resources
324
00:15:40,332 --> 00:15:41,594
for permanent replacements.
325
00:15:41,629 --> 00:15:43,665
You just hired a new
full-time surgical resident
326
00:15:43,700 --> 00:15:45,460
to replace someone
who left way more recently.
327
00:15:45,495 --> 00:15:47,014
That was Lim's department. I...
328
00:15:47,877 --> 00:15:50,016
Yes, great. I'm sending her down.
329
00:15:50,880 --> 00:15:52,088
Sorry. We'll talk later?
330
00:15:52,122 --> 00:15:53,158
Of course.
331
00:15:56,195 --> 00:15:58,646
So you're watching to see if I throw up?
332
00:15:58,680 --> 00:16:01,027
Or faint, seize, or have muscle spasms.
333
00:16:05,687 --> 00:16:08,534
You know, before COVID, my brain was...
334
00:16:09,657 --> 00:16:12,591
I did evolutionary patterns,
335
00:16:12,625 --> 00:16:15,500
genetic, uh...
336
00:16:16,560 --> 00:16:19,337
how genes go together.
337
00:16:20,495 --> 00:16:21,839
The sequence.
338
00:16:24,120 --> 00:16:27,011
Now my brain can't handle the
sequence of brushing my teeth.
339
00:16:28,849 --> 00:16:32,475
My focus, my working memory,
all of the...
340
00:16:35,717 --> 00:16:37,996
The executive function.
341
00:16:40,343 --> 00:16:43,208
It's not always happening.
342
00:16:46,107 --> 00:16:49,179
Please page Dr. Wolke to
monitor her and stay until he comes.
343
00:16:51,285 --> 00:16:52,912
Push your hand against mine.
344
00:16:54,012 --> 00:16:56,255
The pattern is errors
in executive function.
345
00:16:56,290 --> 00:16:57,670
Shaun, I'm in the middle
of doing something.
346
00:16:57,705 --> 00:17:00,604
Your brain cancer may have returned.
347
00:17:06,921 --> 00:17:08,925
All errors are tied
to executive function.
348
00:17:08,949 --> 00:17:10,059
- Shaun...
- Specifically
349
00:17:10,083 --> 00:17:11,512
to working
and procedural memory governed
350
00:17:11,546 --> 00:17:13,169
by the dorsolateral prefrontal cortex,
351
00:17:13,203 --> 00:17:15,102
a common site for a recurrent glioma,
352
00:17:15,136 --> 00:17:18,276
which strongly suggests
your cancer has returned.
353
00:17:18,312 --> 00:17:21,383
My last scan came back
completely clear. I'm fine.
354
00:17:21,418 --> 00:17:23,006
Your last scan was six months ago.
355
00:17:23,041 --> 00:17:25,388
These errors all took place
in the last four months.
356
00:17:25,421 --> 00:17:26,907
So you need another scan.
357
00:17:26,940 --> 00:17:28,218
The evidence is very compelling.
358
00:17:28,253 --> 00:17:29,668
No, it's really not.
359
00:17:29,702 --> 00:17:32,119
I perform complex surgeries, Shaun,
360
00:17:32,153 --> 00:17:35,053
more so than any other doctor
on this staff, by the way.
361
00:17:35,087 --> 00:17:36,917
So yeah, the percentages would dictate
362
00:17:36,951 --> 00:17:41,059
that I might make more minor
and irrelevant missteps,
363
00:17:41,093 --> 00:17:43,095
if that's what you want
to call them, and...
364
00:17:43,130 --> 00:17:44,855
And the rate of errors has increased.
365
00:17:44,890 --> 00:17:47,410
Yeah, because I take on
the tougher cases,
366
00:17:47,444 --> 00:17:48,790
the ones no one else will.
367
00:17:48,825 --> 00:17:51,724
No, you need another MRI now.
368
00:17:51,759 --> 00:17:54,037
Shaun, what I need
is to get back to my patient.
369
00:17:54,072 --> 00:17:57,420
And you need to knock first next time.
370
00:18:02,011 --> 00:18:03,495
It's the greening of the...
371
00:18:05,083 --> 00:18:06,429
My turn.
372
00:18:08,603 --> 00:18:10,536
I'm trying to get some
of my cognitive exercises in.
373
00:18:10,823 --> 00:18:12,469
What are you memorizing?
374
00:18:12,504 --> 00:18:14,609
It's a poem from
The Carrying, Ada Limon.
375
00:18:14,644 --> 00:18:15,714
Hmm.
376
00:18:15,748 --> 00:18:17,663
The collection is mostly about...
377
00:18:19,683 --> 00:18:22,928
not having the life you
thought you'd have, I guess.
378
00:18:24,205 --> 00:18:28,899
The one I was just reading,
it's about spring coming,
379
00:18:29,193 --> 00:18:31,368
Instructions on Not Giving Up.
380
00:18:31,833 --> 00:18:33,801
- Sounds useful.
- Yeah.
381
00:18:33,835 --> 00:18:35,306
Too bad I can't read it all at once.
382
00:18:35,837 --> 00:18:38,357
I've just graduated from haikus.
383
00:18:38,392 --> 00:18:41,229
I never even thought to look
at a poem before I got sick.
384
00:18:42,568 --> 00:18:44,815
Didn't have the patience
for it at the time,
385
00:18:45,813 --> 00:18:47,526
but it's basically all I read now.
386
00:18:48,540 --> 00:18:50,024
I started writing, too.
387
00:18:50,059 --> 00:18:53,752
It's kind of a creative therapy.
388
00:18:53,786 --> 00:18:55,340
Mm.
389
00:18:55,374 --> 00:18:58,515
There was a kind of poetry
390
00:18:58,550 --> 00:19:01,656
to the genetic variations
in white clover too.
391
00:19:05,143 --> 00:19:06,921
I'd give anything to...
392
00:19:12,391 --> 00:19:14,048
Your blood pressure is going down,
393
00:19:14,083 --> 00:19:15,222
and your heart rate's climbing.
394
00:19:15,256 --> 00:19:16,326
I feel kind of dizzy.
395
00:19:16,361 --> 00:19:17,932
Let me check your glucose.
396
00:19:21,400 --> 00:19:23,782
She's having a seizure. Crash cart now!
397
00:19:26,026 --> 00:19:28,373
We thought something
else was going on with your heart,
398
00:19:28,407 --> 00:19:29,477
but it's a kidney issue.
399
00:19:29,512 --> 00:19:31,376
You have a narrowing
of your renal arteries,
400
00:19:31,410 --> 00:19:33,481
which was exacerbated
by the pulmonary hypertension,
401
00:19:33,516 --> 00:19:34,551
causing your kidneys to fail.
402
00:19:34,586 --> 00:19:37,002
And this is because of my sleep apnea?
403
00:19:37,037 --> 00:19:39,004
We believe so, yeah.
404
00:19:39,039 --> 00:19:41,903
Uh, can she get a transplant?
405
00:19:41,938 --> 00:19:44,044
I can do a test, see if I'm a match.
406
00:19:44,078 --> 00:19:47,599
Unfortunately, your other health
concerns rule out a transplant,
407
00:19:47,633 --> 00:19:49,551
but a renal artery bypass
408
00:19:49,575 --> 00:19:52,086
would
allow your kidneys to heal on their own.
409
00:19:52,121 --> 00:19:55,511
There's risk of complications,
some quite serious.
410
00:19:56,159 --> 00:20:00,888
But in success, you could live
a full, independent life.
411
00:20:00,922 --> 00:20:04,167
But... oh, but serious,
412
00:20:04,202 --> 00:20:06,928
as in I could die?
413
00:20:06,963 --> 00:20:10,035
Some complications can be fatal.
414
00:20:10,070 --> 00:20:12,069
But the risk is relatively low.
415
00:20:13,073 --> 00:20:15,281
Are there other options?
416
00:20:15,627 --> 00:20:17,007
Well, there's dialysis,
417
00:20:17,042 --> 00:20:19,211
but you'd need multiple sessions a week
418
00:20:19,235 --> 00:20:20,578
for the rest of your life.
419
00:20:22,496 --> 00:20:26,584
Um, that's less risky, but I...
420
00:20:27,259 --> 00:20:30,297
I don't think I could handle
all that on my own.
421
00:20:30,331 --> 00:20:35,217
Mom, Mom, if you want to choose
the dialysis, I'll stay in San Jose.
422
00:20:37,476 --> 00:20:38,721
I'm sorry.
423
00:20:39,651 --> 00:20:41,101
I don't want to keep you.
424
00:20:41,135 --> 00:20:44,104
No, you have nothing to be sorry for.
425
00:20:44,138 --> 00:20:47,313
All this time you've been sick
and struggling, and I...
426
00:20:48,315 --> 00:20:49,482
I judged you.
427
00:20:50,420 --> 00:20:51,901
But your new job.
428
00:20:54,286 --> 00:20:55,529
It's just a job.
429
00:21:04,043 --> 00:21:07,115
So the medication you gave me
430
00:21:07,265 --> 00:21:09,612
to make my surgery safer
431
00:21:09,646 --> 00:21:12,166
will actually make it more risky?
432
00:21:12,201 --> 00:21:13,167
That's right.
433
00:21:14,030 --> 00:21:15,583
But without that medication,
434
00:21:15,618 --> 00:21:18,414
I'm much more likely
to have another tet spell.
435
00:21:18,448 --> 00:21:22,245
Yes, and possibly more severe
than the last time.
436
00:21:22,280 --> 00:21:26,102
The brain fog, all my deficits...
437
00:21:27,388 --> 00:21:28,896
could get worse,
438
00:21:30,357 --> 00:21:31,979
for possibly forever?
439
00:21:33,222 --> 00:21:34,361
Yes.
440
00:21:36,052 --> 00:21:37,916
But if we don't do the tet repair,
441
00:21:37,950 --> 00:21:40,241
your heart will stop at some point.
442
00:21:43,335 --> 00:21:45,268
I've already been through
443
00:21:45,303 --> 00:21:48,789
losing my thoughts, my whole self.
444
00:21:53,034 --> 00:21:54,435
I can't do that again.
445
00:21:59,248 --> 00:22:01,095
Find another way to fix my heart.
446
00:22:19,199 --> 00:22:21,028
All right, new idea.
447
00:22:21,062 --> 00:22:23,513
We go back to the old idea
and just do the surgery.
448
00:22:23,548 --> 00:22:24,997
It's a non-starter.
449
00:22:25,032 --> 00:22:28,035
We need to present a way to
help her tet without triggering her tet.
450
00:22:28,069 --> 00:22:30,934
A percutaneous valve and VSD
closure could help with blood flow.
451
00:22:30,969 --> 00:22:32,522
That involves catheters in the heart,
452
00:22:32,557 --> 00:22:34,295
which would cause the muscle to spasm.
453
00:22:34,973 --> 00:22:37,389
All right. It's time for some WWSMD.
454
00:22:37,424 --> 00:22:40,012
Whatever you and Jerome do
on your own time is...
455
00:22:40,047 --> 00:22:41,552
It's "what would Shaun Murphy do?"
456
00:23:13,114 --> 00:23:16,359
? If a party is what you need ?
457
00:23:16,394 --> 00:23:17,947
? They're dancing ?
458
00:23:17,981 --> 00:23:19,215
What about a shunt?
459
00:23:20,225 --> 00:23:22,262
It would improve blood flow,
buy a few months
460
00:23:22,296 --> 00:23:23,918
to continue her cognitive recovery.
461
00:23:23,953 --> 00:23:26,127
Once she feels better
about where her brain's at,
462
00:23:26,162 --> 00:23:27,646
maybe she lets us fix her heart.
463
00:23:27,681 --> 00:23:30,200
Her tet will likely kill her
before that,
464
00:23:30,235 --> 00:23:34,170
but placing a shunt
won't trigger a spell,
465
00:23:34,204 --> 00:23:36,524
making it something
she'd actually accept.
466
00:23:40,035 --> 00:23:41,403
I'll take it to her.
467
00:23:42,420 --> 00:23:44,214
I can stay only 45 minutes.
468
00:23:44,249 --> 00:23:46,389
I have to review
Dr. Glassman's OR videos.
469
00:23:46,424 --> 00:23:47,666
Didn't you already review them?
470
00:23:47,701 --> 00:23:49,461
Not for symptoms of glioma recurrence.
471
00:23:49,496 --> 00:23:51,774
New evidence will convince
Dr. Glassman to get a scan.
472
00:23:51,808 --> 00:23:54,570
Okay, you binged months
of data in one day.
473
00:23:54,604 --> 00:23:55,916
You'll have a clearer head
in the morning.
474
00:23:55,950 --> 00:23:58,919
Until then, here we are, karaoke rager.
475
00:23:58,953 --> 00:24:00,507
- Yay.
- It is yay.
476
00:24:00,541 --> 00:24:02,785
We have song lists.
Plus Jared's our friend.
477
00:24:02,819 --> 00:24:04,927
He just moved back.
Celebration is in order.
478
00:24:05,719 --> 00:24:08,238
I will review the videos in the morning.
479
00:24:08,273 --> 00:24:09,274
Yay!
480
00:24:10,033 --> 00:24:11,483
It sounds pretty wild in there.
481
00:24:11,518 --> 00:24:15,142
? Because maybe ?
482
00:24:15,176 --> 00:24:19,215
? You're gonna be the one
That saves me ?
483
00:24:20,665 --> 00:24:22,529
? And after... ?
484
00:24:26,843 --> 00:24:29,052
I was just warming up.
485
00:24:29,087 --> 00:24:32,021
- Where is everyone?
- There is a lot of food.
486
00:24:32,055 --> 00:24:34,623
Yeah, I had it catered.
You're the first to arrive.
487
00:24:35,335 --> 00:24:38,199
And so far, last-minute rain checks
488
00:24:38,234 --> 00:24:40,788
from Morgan, Park, Asher, Danny.
489
00:24:42,134 --> 00:24:43,716
Oh, and Jerome.
490
00:24:45,655 --> 00:24:46,898
So it's just us four?
491
00:24:46,932 --> 00:24:50,626
Which means that all these snacks
492
00:24:50,660 --> 00:24:53,836
and song binders are for us.
493
00:24:53,870 --> 00:24:55,665
Oh. Yes.
494
00:24:55,700 --> 00:24:59,048
The low turnout is the perfect
opportunity to discuss symptoms.
495
00:25:00,739 --> 00:25:02,741
In your recent surgeries
with Dr. Glassman,
496
00:25:02,776 --> 00:25:04,467
do you recall observing
any balance issues,
497
00:25:04,502 --> 00:25:06,155
tremors, or motor weakness?
498
00:25:11,405 --> 00:25:13,329
That sounds like the perfect option.
499
00:25:14,339 --> 00:25:16,514
How soon can you do the shunt procedure?
500
00:25:16,753 --> 00:25:19,066
I'll try to schedule it for tomorrow.
501
00:25:23,681 --> 00:25:26,258
I've had a strange year myself.
502
00:25:29,112 --> 00:25:30,907
Eleven months ago,
503
00:25:30,942 --> 00:25:32,219
I was attacked
504
00:25:32,253 --> 00:25:34,475
and paralyzed from the waist down.
505
00:25:35,429 --> 00:25:38,228
I thought it was permanent.
Almost everyone did.
506
00:25:40,986 --> 00:25:45,611
At first, all I wanted
was to walk again.
507
00:25:46,613 --> 00:25:50,324
I was ready to risk my life
to get back to the old me.
508
00:25:51,480 --> 00:25:53,077
But as time went on,
509
00:25:53,930 --> 00:25:58,728
I started to appreciate
my new life, my new self.
510
00:26:01,455 --> 00:26:03,457
I started a new relationship
511
00:26:03,492 --> 00:26:05,297
that wouldn't have happened otherwise.
512
00:26:07,634 --> 00:26:09,677
In many ways, my life improved.
513
00:26:10,499 --> 00:26:13,018
You recognize you walked in
to tell me this story?
514
00:26:14,951 --> 00:26:16,574
I only agreed to do the surgery
515
00:26:16,608 --> 00:26:17,954
once I knew my life wasn't at risk.
516
00:26:17,989 --> 00:26:20,771
And even then, I had doubts.
517
00:26:22,338 --> 00:26:23,995
I liked who I'd become.
518
00:26:24,029 --> 00:26:25,818
I wanted to hold on to her.
519
00:26:29,966 --> 00:26:30,967
I'm not...
520
00:26:33,798 --> 00:26:35,144
losing my mind...
521
00:26:37,077 --> 00:26:38,288
all over again.
522
00:26:41,012 --> 00:26:43,669
You don't strike me
as someone who's lost her mind.
523
00:27:01,135 --> 00:27:02,999
That covers the thrombectomy.
524
00:27:03,034 --> 00:27:04,138
In February, you assisted on a...
525
00:27:04,173 --> 00:27:07,960
Okay, I'm playing
the pregnant lady card.
526
00:27:08,902 --> 00:27:10,248
We're going, Shaun.
527
00:27:10,282 --> 00:27:11,456
Okay.
528
00:27:12,664 --> 00:27:14,321
Thank you. Goodbye.
529
00:27:16,047 --> 00:27:17,703
I should head out, too.
530
00:27:18,981 --> 00:27:21,665
- Early morning.
- Yeah.
531
00:27:25,539 --> 00:27:28,784
Maybe focus on being
a first-year resident
532
00:27:28,818 --> 00:27:32,926
before adding party planner
to your resume.
533
00:27:35,100 --> 00:27:37,473
The catering may have been
a bridge too far.
534
00:27:38,034 --> 00:27:39,070
Yeah.
535
00:27:43,730 --> 00:27:45,397
I bounced around growing up.
536
00:27:47,043 --> 00:27:50,903
Different schools, cities, countries.
537
00:27:51,772 --> 00:27:55,741
But, um, wherever we were,
my parents had a big house,
538
00:27:56,536 --> 00:27:58,118
and I knew how to throw a party.
539
00:28:01,057 --> 00:28:04,583
Closest I'd get to feeling like I fit.
540
00:28:06,942 --> 00:28:08,712
Old habits die hard, I guess.
541
00:28:11,274 --> 00:28:13,173
Fitting in takes time.
542
00:28:14,243 --> 00:28:17,679
But I never have, anywhere.
543
00:28:21,802 --> 00:28:23,060
Maybe not everyone
544
00:28:24,476 --> 00:28:25,813
finds their place.
545
00:28:30,949 --> 00:28:33,020
Daphne is getting septic. We have to go.
546
00:28:41,106 --> 00:28:42,202
Morning.
547
00:28:42,236 --> 00:28:43,824
Hello.
548
00:28:43,859 --> 00:28:44,894
Mm.
549
00:28:46,620 --> 00:28:48,139
You should not have that.
550
00:28:48,173 --> 00:28:50,693
I'm permitted 12 ounces a day.
Experts agree.
551
00:28:50,728 --> 00:28:53,731
Yes, but that was brewed
when I woke up at 3:30 a.m.
552
00:28:56,457 --> 00:28:57,976
You make it through the videos?
553
00:28:58,011 --> 00:29:00,392
Yes, and integrated the observations
554
00:29:00,427 --> 00:29:02,153
Doctors Kalu and Allen made last night
555
00:29:02,187 --> 00:29:04,569
regarding possible glioma symptoms.
556
00:29:07,020 --> 00:29:10,126
I am now ready to present
Dr. Glassman with the revised evidence,
557
00:29:10,161 --> 00:29:12,094
which is very compelling.
558
00:29:12,128 --> 00:29:13,129
Mm.
559
00:29:16,201 --> 00:29:19,619
Thankfully, your infection is
responding to the antibiotics.
560
00:29:19,653 --> 00:29:22,656
The infection started
around your dialysis port.
561
00:29:22,691 --> 00:29:24,663
That could easily happen again.
562
00:29:25,763 --> 00:29:28,904
The renal artery bypass
is still an option.
563
00:29:28,938 --> 00:29:30,794
It's too risky.
564
00:29:30,975 --> 00:29:32,296
So is sepsis.
565
00:29:33,633 --> 00:29:36,808
Thank you, Doctor,
but I'll settle for being alive.
566
00:29:36,982 --> 00:29:38,358
You shouldn't.
567
00:29:40,156 --> 00:29:41,597
You deserve more than that.
568
00:29:42,642 --> 00:29:44,782
I know you've had a whole life
of feeling sick
569
00:29:44,816 --> 00:29:48,337
and stuck and repeating
the same old, bad patterns,
570
00:29:48,371 --> 00:29:51,273
but your past does not have
to tell your future where to go.
571
00:29:55,137 --> 00:29:57,415
You can choose a different path
572
00:29:57,449 --> 00:29:59,417
and who you're gonna be on it.
573
00:30:01,315 --> 00:30:03,493
And let your daughter do the same.
574
00:30:08,460 --> 00:30:10,014
Prague is beautiful in the spring.
575
00:30:47,568 --> 00:30:50,248
We've scheduled the shunt
placement for this afternoon.
576
00:30:51,676 --> 00:30:53,195
And that whole speech last night?
577
00:30:53,229 --> 00:30:56,505
I stand by it, but it's your decision.
578
00:31:02,031 --> 00:31:05,034
I've been waiting for the
old me to come back, and...
579
00:31:09,280 --> 00:31:11,395
That person may not exist anymore.
580
00:31:13,871 --> 00:31:14,906
And...
581
00:31:17,322 --> 00:31:19,277
maybe I should be okay with that.
582
00:31:24,916 --> 00:31:26,201
Do the tet repair.
583
00:31:41,139 --> 00:31:43,218
Releasing the proximal clamp.
584
00:31:45,109 --> 00:31:46,847
What made Daphne change her mind?
585
00:31:47,836 --> 00:31:50,142
Dr. Allen has a way
of getting through to people.
586
00:31:54,566 --> 00:31:56,534
Blood flow looks obstructed.
587
00:31:56,568 --> 00:31:57,941
There's a kink in the graft.
588
00:31:59,433 --> 00:32:01,624
We can undo it, but most likely,
it happens again.
589
00:32:05,439 --> 00:32:09,512
We could anchor the bypass
off of the aorta instead.
590
00:32:09,547 --> 00:32:11,747
At that angle, less chance of a kink.
591
00:32:14,751 --> 00:32:15,917
Could work.
592
00:32:28,048 --> 00:32:30,223
- Extending the incision.
- Sternal saw.
593
00:32:34,814 --> 00:32:36,816
Starting the sternotomy.
594
00:32:38,679 --> 00:32:40,067
O2 dropped to 78.
595
00:32:40,612 --> 00:32:42,442
- 65.
- She's having a tet spell.
596
00:32:42,476 --> 00:32:45,928
Give her 500 cc fluid bolus
and 100% oxygen.
597
00:32:45,963 --> 00:32:48,758
Giving a mini bolus
to increase pulmonary flow.
598
00:32:51,658 --> 00:32:55,041
O2 sats are 50.45.
599
00:32:55,075 --> 00:32:56,792
Come on, come on.
600
00:32:58,872 --> 00:33:00,943
Give her more oxygen and up the opiates.
601
00:33:02,324 --> 00:33:03,635
It has stopped registering.
602
00:33:22,033 --> 00:33:23,552
O2's rising.
603
00:33:25,761 --> 00:33:27,531
Heart rate's stabilizing.
604
00:33:30,076 --> 00:33:33,010
She was in prolonged gross hypoxia.
605
00:33:33,044 --> 00:33:36,206
That could extend cognitive deficits...
606
00:33:37,152 --> 00:33:38,912
or worse.
607
00:33:38,947 --> 00:33:40,396
We won't know until she wakes.
608
00:33:40,431 --> 00:33:42,796
Let's get her on bypass
before she has another one.
609
00:33:45,505 --> 00:33:46,883
- Okay.
- Mm-hmm.
610
00:33:47,748 --> 00:33:50,234
To a successful renal artery bypass.
611
00:33:50,268 --> 00:33:53,064
Cheers. Facilitated by moving speech
612
00:33:53,099 --> 00:33:54,824
from a wise and persuasive surgeon.
613
00:33:54,859 --> 00:33:57,862
Mm, with a great surgical save by a guy
614
00:33:57,897 --> 00:34:00,761
who's about to have
some life-changing tacos.
615
00:34:00,796 --> 00:34:01,797
Okay.
616
00:34:05,145 --> 00:34:07,216
Mm! Oh, my God.
617
00:34:07,251 --> 00:34:09,874
Okay, these are amaz... you're amazing!
618
00:34:09,908 --> 00:34:12,462
Told you. Blue corn tortillas.
619
00:34:12,497 --> 00:34:14,879
Mm-hmm. I can get used to this.
620
00:34:18,296 --> 00:34:21,196
- You have some lettuce there.
- Oh.
621
00:34:21,230 --> 00:34:23,923
- No, no, no, mirror image.
- Mm.
622
00:34:23,957 --> 00:34:25,131
Now?
623
00:34:25,165 --> 00:34:26,856
- No.
- No laughing.
624
00:34:26,891 --> 00:34:27,926
No, right, right, right. Very...
625
00:34:27,961 --> 00:34:29,583
Very serious matter.
626
00:34:34,278 --> 00:34:37,107
Here. Um, yeah.
627
00:34:37,143 --> 00:34:38,420
Oh.
628
00:34:38,453 --> 00:34:40,077
Just a little bit more.
629
00:34:51,467 --> 00:34:54,022
- We should go.
- Mm.
630
00:34:54,056 --> 00:34:55,558
- Yeah.
- Um,
631
00:34:55,582 --> 00:34:58,302
we need to get back early
for Daphne's post-op.
632
00:34:58,336 --> 00:35:00,248
Yeah, right. Um, let's go.
633
00:35:09,727 --> 00:35:12,761
The bypass went smoothly,
and post-op labs look good.
634
00:35:13,317 --> 00:35:14,930
We expect a full recovery.
635
00:35:15,940 --> 00:35:17,474
How are you feeling, Mom?
636
00:35:18,805 --> 00:35:19,909
I'm...
637
00:35:22,404 --> 00:35:23,672
Breathing.
638
00:35:23,706 --> 00:35:26,524
Kind of feels like
the first time in my life.
639
00:35:27,848 --> 00:35:31,714
The post-op swelling from the
tonsillectomy has gone down.
640
00:35:31,749 --> 00:35:34,407
You're finally breathing
without any obstruction.
641
00:35:34,441 --> 00:35:37,375
You'll need to stay on top of your
medications and follow-up visits,
642
00:35:37,410 --> 00:35:39,170
observe some dietary guidelines,
643
00:35:39,205 --> 00:35:41,915
but the discharge plan lays it all out.
644
00:35:42,863 --> 00:35:44,348
I'll be there to help, Mom.
645
00:35:47,316 --> 00:35:48,317
No.
646
00:35:50,319 --> 00:35:51,700
You won't.
647
00:35:56,015 --> 00:35:58,017
You need to live your own life.
648
00:36:01,537 --> 00:36:05,146
But I... I will accept FaceTime calls.
649
00:36:05,921 --> 00:36:07,509
And once I recover,
650
00:36:09,028 --> 00:36:10,546
I'll come visit.
651
00:36:14,895 --> 00:36:17,553
I hear that Prague
is beautiful in the spring.
652
00:36:21,661 --> 00:36:23,076
That sounds like a plan.
653
00:36:34,708 --> 00:36:37,159
Mm, things not go well with Glassy?
654
00:36:37,194 --> 00:36:39,403
He returned the files with a note saying
655
00:36:39,437 --> 00:36:42,544
he did not look at them
and does not intend to.
656
00:36:42,578 --> 00:36:44,891
I'm sorry. He probably...
657
00:36:44,925 --> 00:36:46,890
It was a mistake to leave
them for him to read on his own.
658
00:36:46,924 --> 00:36:48,406
Once I reorder the files,
659
00:36:48,430 --> 00:36:50,966
I will go to
his office to review with him in person.
660
00:36:51,000 --> 00:36:53,002
He made it pretty clear
he doesn't want to see them.
661
00:36:53,037 --> 00:36:55,350
But he doesn't know
about the new evidence.
662
00:36:55,384 --> 00:36:57,248
Maybe he doesn't want to know.
663
00:36:57,283 --> 00:37:00,111
Cancer survivors have to
live with that uncertainty that...
664
00:37:00,145 --> 00:37:02,245
Knowing is better than not knowing.
665
00:37:04,945 --> 00:37:07,258
If he's not ready to look at this,
666
00:37:07,293 --> 00:37:09,169
you can't force him.
667
00:37:10,330 --> 00:37:13,423
Maybe he's scared, Shaun.
668
00:37:13,989 --> 00:37:16,176
And I think maybe you're scared, too.
669
00:37:17,475 --> 00:37:20,029
We're about to have a baby,
670
00:37:20,064 --> 00:37:22,411
you're about to be a dad,
671
00:37:22,446 --> 00:37:24,931
and I think you're worried about family,
672
00:37:24,965 --> 00:37:26,603
and Glassman is a part of that.
673
00:37:28,245 --> 00:37:31,455
But if you keep pushing,
you risk damaging
674
00:37:31,489 --> 00:37:34,611
one of the most important
relationships in your life.
675
00:37:44,088 --> 00:37:45,089
Hey.
676
00:37:48,437 --> 00:37:49,834
- Hey.
- Hey.
677
00:37:52,959 --> 00:37:54,409
I've been thinking,
678
00:37:54,443 --> 00:37:56,483
and I need a break from our coffees.
679
00:37:56,687 --> 00:37:58,061
Dalisay...
680
00:37:58,095 --> 00:38:00,136
I don't think dinner's
a good idea either.
681
00:38:01,312 --> 00:38:03,659
So we have a different point
of view about hospital business.
682
00:38:03,694 --> 00:38:05,827
That doesn't change
the way I feel about you.
683
00:38:05,862 --> 00:38:08,019
On or off the clock,
I'm the same person.
684
00:38:08,837 --> 00:38:11,702
To me, if you don't value
what the nurses do
685
00:38:11,736 --> 00:38:14,739
enough to treat us
like a resource to invest in,
686
00:38:14,774 --> 00:38:16,444
not a line item to be cut,
687
00:38:17,639 --> 00:38:19,239
how much can you care about me?
688
00:38:20,780 --> 00:38:22,158
And to be honest,
689
00:38:22,851 --> 00:38:24,744
if that is your point of view...
690
00:38:27,304 --> 00:38:29,416
it undercuts the respect I have for you.
691
00:38:40,696 --> 00:38:43,458
Harper Louise Decrane,
692
00:38:43,492 --> 00:38:46,724
March 30, 1994.
693
00:38:47,151 --> 00:38:48,768
And do you know why you're here?
694
00:38:49,326 --> 00:38:50,854
For my heart issues.
695
00:38:53,675 --> 00:38:55,442
I had another tet spell, didn't I?
696
00:38:56,436 --> 00:38:57,989
We'll need to conduct more tests,
697
00:38:58,024 --> 00:39:00,233
but your speech and memory seem intact.
698
00:39:00,268 --> 00:39:03,374
And with regard to your heart,
we expect a full recovery.
699
00:39:03,409 --> 00:39:07,378
And with time, you may recover
your full cognitive abilities as well.
700
00:39:08,175 --> 00:39:09,176
Maybe.
701
00:39:10,416 --> 00:39:14,669
But for now,
I'll just focus on being here.
702
00:39:30,090 --> 00:39:32,312
"It's the greening of the trees
703
00:39:32,886 --> 00:39:34,405
That really gets to me
704
00:39:35,958 --> 00:39:38,927
When all the shock of white and taffy
705
00:39:38,961 --> 00:39:42,155
Leave the pavement strewn
With the confetti of aftermath
706
00:39:44,070 --> 00:39:45,492
The leaves come
707
00:39:46,452 --> 00:39:48,495
Patient, plodding
708
00:39:49,938 --> 00:39:53,541
A green skin growing over
Whatever winter did to us
709
00:39:55,840 --> 00:39:59,741
A return to the strange idea
Of continuous living
710
00:39:59,775 --> 00:40:01,260
Despite the mess of us
711
00:40:01,294 --> 00:40:03,092
The hurt, the empty..."
712
00:40:04,055 --> 00:40:05,553
Shaun, what?
713
00:40:06,437 --> 00:40:09,599
Lea thinks that because
I'm going to be a dad,
714
00:40:10,476 --> 00:40:12,478
I am worried about my family.
715
00:40:14,549 --> 00:40:15,826
Okay.
716
00:40:15,860 --> 00:40:19,234
She also thinks you are scared.
717
00:40:20,140 --> 00:40:21,797
I'm not scared, Shaun. I'm fine.
718
00:40:21,832 --> 00:40:25,114
She says if you don't want to
do the scan, I should let it go.
719
00:40:29,322 --> 00:40:30,392
She...
720
00:40:32,739 --> 00:40:34,154
is right.
721
00:40:35,949 --> 00:40:37,544
Good. Thank you.
722
00:40:39,677 --> 00:40:41,214
I am scared.
723
00:40:54,658 --> 00:40:55,937
Dr. Glassman...
724
00:41:00,491 --> 00:41:04,404
I am asking you to do the scan
725
00:41:05,634 --> 00:41:06,601
because...
726
00:41:08,534 --> 00:41:11,995
the data and the evidence are sound...
727
00:41:17,681 --> 00:41:19,002
and because...
728
00:41:26,414 --> 00:41:28,450
it would be hard to lose my father
729
00:41:28,485 --> 00:41:30,555
just as I am about to become one.
730
00:41:38,667 --> 00:41:40,315
Do the scan for me.
731
00:41:52,468 --> 00:41:55,204
Shaun, I'll do the scan.
732
00:42:13,530 --> 00:42:17,292
"'Fine then, I'll take it'
The tree seems to say
733
00:42:17,326 --> 00:42:21,105
A new slick leaf unfurling
Like a fist to an open palm
734
00:42:21,814 --> 00:42:23,229
'I'll take it all'"
54082
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