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1
00:00:02,219 --> 00:00:03,486
Good morning, Mr. Becker.
2
00:00:03,551 --> 00:00:04,951
Did you pass your drug test?
3
00:00:04,985 --> 00:00:06,586
With flying colors,
nurse Acosta.
4
00:00:06,620 --> 00:00:08,254
Scott Becker, 19.
5
00:00:08,289 --> 00:00:10,757
First evidence
of toxic effect on his heart:
6
00:00:10,791 --> 00:00:12,392
An MI at 17.
7
00:00:12,426 --> 00:00:15,762
That's a heart attack at 17
from cocaine use.
8
00:00:15,796 --> 00:00:17,597
This kid deserves
a second chance.
9
00:00:17,631 --> 00:00:19,766
I am a serious screwup.
10
00:00:19,800 --> 00:00:21,401
I can't take this heart.
11
00:00:21,435 --> 00:00:22,335
It's just not right.
12
00:00:22,370 --> 00:00:23,336
You know what, Scott?
13
00:00:23,371 --> 00:00:24,804
Maybe the old you
doesn't deserve
14
00:00:24,839 --> 00:00:26,606
this heart, but you do.
15
00:00:26,640 --> 00:00:28,441
We're taking you
to the O.R. soon.
16
00:00:28,476 --> 00:00:30,310
You nervous?
Kind of.
17
00:00:30,344 --> 00:00:31,711
I can understand that--
your new life
18
00:00:31,746 --> 00:00:33,546
starts today.
19
00:00:35,182 --> 00:00:36,383
Right.
20
00:00:36,417 --> 00:00:38,118
Well, that's exactly
what I told Cece.
21
00:00:38,152 --> 00:00:41,654
I said you don't call
a parent meeting
22
00:00:41,689 --> 00:00:44,991
unless all the committee chairs
are gonna be there.
23
00:00:45,025 --> 00:00:46,760
Right.
24
00:00:46,794 --> 00:00:48,061
Hey,
25
00:00:48,095 --> 00:00:49,763
is it true that we
can't send juice boxes
26
00:00:49,797 --> 00:00:51,498
with the kid's
snacks anymore?
27
00:00:52,133 --> 00:00:53,566
Really?
28
00:00:54,101 --> 00:00:56,770
Right.
29
00:00:56,804 --> 00:00:59,939
So, anyway, how did Thanksgiving
go with Rick's parents?
30
00:01:03,711 --> 00:01:04,944
Whoa!
Bill!
31
00:01:04,979 --> 00:01:06,045
Easy, Hailey.
Oh, my goodness!
32
00:01:06,080 --> 00:01:07,614
I gotcha.
I wasn't looking, and...
33
00:01:07,648 --> 00:01:08,882
Hailey, honey.
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00:01:08,916 --> 00:01:11,384
If you want something,
use your words and tell mommy.
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00:01:11,419 --> 00:01:13,052
Oh, thank you, seriously.
36
00:01:13,087 --> 00:01:15,155
I should have belted her in.
Here, uh,
37
00:01:15,189 --> 00:01:17,590
this should keep her busy.
38
00:01:17,625 --> 00:01:18,725
Nice moves, by the way.
39
00:01:18,759 --> 00:01:20,026
Not bad for a 40-year-old.
40
00:01:20,060 --> 00:01:21,394
Yeah, surprised myself.
41
00:01:21,429 --> 00:01:22,996
I'm still stiff from running
the Philly Marathon last week.
42
00:01:23,030 --> 00:01:25,465
Candace got tired of me
moaning on the couch,
43
00:01:25,499 --> 00:01:27,767
so she sent me out
to try and be useful.
44
00:01:27,802 --> 00:01:29,869
Well, you were
definitely that. Thank you.
45
00:01:29,904 --> 00:01:31,704
Don't worry about it. Hey.
46
00:01:31,739 --> 00:01:32,972
Take it easy, little daredevil.
47
00:01:33,007 --> 00:01:34,707
Mm-hmm.
Bye-bye.
48
00:01:34,742 --> 00:01:36,276
Aw...
49
00:01:36,310 --> 00:01:38,478
Just a few more minutes,
Hales, okay?
50
00:01:38,512 --> 00:01:39,479
Okay.
51
00:01:39,513 --> 00:01:40,780
Oh, you're such a good girl.
52
00:01:40,815 --> 00:01:42,348
You scared mommy.
53
00:01:43,884 --> 00:01:46,186
Hey, Bill...
54
00:01:48,189 --> 00:01:49,489
Bill! Oh, my God!
55
00:01:49,523 --> 00:01:51,891
Bill! Somebody
call an ambulance!
56
00:01:51,926 --> 00:01:53,193
Bill!
57
00:02:00,634 --> 00:02:01,868
Morning.
58
00:02:01,902 --> 00:02:03,136
Hi.
59
00:02:03,170 --> 00:02:04,270
Doctor.
60
00:02:04,305 --> 00:02:05,438
Hey, people.
61
00:02:05,473 --> 00:02:06,473
How's it going?
62
00:02:06,507 --> 00:02:07,841
Yo, Andy.
63
00:02:13,180 --> 00:02:15,315
That's very funny.
64
00:02:15,349 --> 00:02:18,418
Since you're taking over for Dr. Jordan
65
00:02:18,452 --> 00:02:20,687
as Department Head
while she's at the conference,
66
00:02:20,721 --> 00:02:22,188
we thought a gift was in order.
67
00:02:22,223 --> 00:02:23,623
Yeah, we all...
All pitched in.
68
00:02:23,657 --> 00:02:25,992
Try it on.
69
00:02:30,898 --> 00:02:32,465
Aye, aye, Captain.
70
00:02:32,500 --> 00:02:34,667
Nice. Whoo!
71
00:02:34,702 --> 00:02:35,902
Oh, oh, oh,
I'm sorry, Andy,
72
00:02:35,936 --> 00:02:38,271
I forgot to tell you,
um, Gilligan called.
73
00:02:38,305 --> 00:02:40,073
That's-that's hilarious.
74
00:02:41,575 --> 00:02:42,575
Seriously, there are, like,
75
00:02:42,610 --> 00:02:44,544
three people waiting
to talk to Dr. Jordan,
76
00:02:44,578 --> 00:02:46,379
and I transferred them
to your line.
77
00:02:46,413 --> 00:02:48,481
Great.
And you have an HR meeting
in ten minutes.
78
00:02:48,516 --> 00:02:50,250
Dr. Jordan told me that
you would cover for her.
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00:02:50,284 --> 00:02:51,751
I'm sure she did.
80
00:02:51,785 --> 00:02:53,653
Dude... really?
81
00:02:53,687 --> 00:02:54,821
Hey!
82
00:02:54,855 --> 00:02:56,289
Scott!
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00:02:56,323 --> 00:02:57,624
Ah...
84
00:02:59,860 --> 00:03:03,096
How long do I have to keep coming here
for these checkups?
85
00:03:03,130 --> 00:03:04,330
How's "for life" sound?
86
00:03:04,365 --> 00:03:06,366
Which I told you
before the transplant.
87
00:03:06,400 --> 00:03:07,667
Tried to forget.
Mm-hmm.
88
00:03:07,701 --> 00:03:08,768
So, how's it been
89
00:03:08,802 --> 00:03:10,136
living back with your folks?
90
00:03:10,170 --> 00:03:12,972
I know you guys weren't on
the best of terms for a while.
91
00:03:13,007 --> 00:03:14,340
We're getting along.
92
00:03:14,375 --> 00:03:15,942
And I got a job.
93
00:03:15,976 --> 00:03:18,912
I'm working at a substance
abuse program for teens.
94
00:03:18,946 --> 00:03:21,314
Check you out, giving back.
95
00:03:21,348 --> 00:03:24,217
That's great, I like it.
96
00:03:24,251 --> 00:03:26,419
It's a bummer about Brenda
moving to Oregon, huh?
97
00:03:26,453 --> 00:03:27,387
She get her transplant,
98
00:03:27,421 --> 00:03:29,122
and her dad landed a new job.
99
00:03:29,156 --> 00:03:31,991
With her medical bills,
they need the dough.
100
00:03:32,960 --> 00:03:34,827
We'll find a way to be together
101
00:03:34,862 --> 00:03:36,329
if it's meant to be.
102
00:03:36,363 --> 00:03:38,097
That's very Zen of you.
103
00:03:38,132 --> 00:03:40,433
Zen with a huge-ass
text-messaging bill.
104
00:03:42,836 --> 00:03:44,304
Okay.
105
00:03:44,338 --> 00:03:45,939
How you been feeling?
106
00:03:45,973 --> 00:03:48,841
Good.
Yeah? No aches, fever, coughs?
107
00:03:48,876 --> 00:03:52,045
Negative. I'm-I'm a picture of health.
Okay.
108
00:03:52,079 --> 00:03:54,013
Whoa.
109
00:03:54,048 --> 00:03:55,248
Is that sore?
110
00:03:55,282 --> 00:03:58,151
Not really. I-I fell
skateboarding last week.
111
00:04:00,154 --> 00:04:02,021
Other leg's swollen, too.
112
00:04:02,056 --> 00:04:03,423
I'll run some tests,
113
00:04:03,457 --> 00:04:04,557
check it out.
114
00:04:04,592 --> 00:04:06,859
Wait, isn't our president
trying to stop
115
00:04:06,894 --> 00:04:08,795
unnecessary medical tests?
116
00:04:08,829 --> 00:04:11,331
You had a heart transplant
six weeks ago.
117
00:04:11,365 --> 00:04:13,466
Trust me, it's necessary.
118
00:04:13,500 --> 00:04:15,668
I'll be back in a few minutes.
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00:05:04,852 --> 00:05:08,788
♫ Three Rivers 1x10 ♫
A Roll of the Dice
Original Air Date on June 12, 2010
120
00:05:08,822 --> 00:05:13,026
-- sync, corrected by elderman --
-- for www.addic7ed.Com --
121
00:05:30,265 --> 00:05:31,365
What do you got?
122
00:05:31,399 --> 00:05:32,366
23-year-old drowning Vic,
123
00:05:32,400 --> 00:05:33,367
name's Penelope Kirkell.
124
00:05:33,401 --> 00:05:34,368
Bystander CPR.
125
00:05:34,402 --> 00:05:36,236
We found her bradycardic
and hypotensive.
126
00:05:36,271 --> 00:05:38,038
Gave her atropine,
epi and intubated.
127
00:05:38,072 --> 00:05:39,539
Any respiratory effort?
Not yet.
128
00:05:39,574 --> 00:05:40,908
Bp 90 palp,
129
00:05:40,942 --> 00:05:42,709
pulse 110,
pulse ox 90.
130
00:05:42,744 --> 00:05:44,878
No breath sounds on right.
131
00:05:47,048 --> 00:05:48,348
All right, we have
a possible hemothorax.
132
00:05:48,383 --> 00:05:50,417
How did she get a hemothorax
from drowning?
No clue.
133
00:05:50,451 --> 00:05:52,853
Let's get prepped for a chest
tube, and get Andy down here.
134
00:05:52,887 --> 00:05:55,455
I don't like these breath sounds.
135
00:05:55,490 --> 00:05:57,391
Pulse is dropping fast.
136
00:05:58,626 --> 00:06:01,929
I'm sorry, I'm not quite sure
I understand how
137
00:06:01,963 --> 00:06:03,196
a perfectly healthy man collapses
138
00:06:03,231 --> 00:06:05,499
in a grocery store with kidney failure.
139
00:06:05,533 --> 00:06:07,301
He ran a marathon last week.
140
00:06:07,336 --> 00:06:10,271
Well, it seems that the running
has something to do with it.
141
00:06:10,705 --> 00:06:12,506
Now, what kind of training
did you do?
142
00:06:12,540 --> 00:06:14,574
Uh, around five miles a day.
143
00:06:14,609 --> 00:06:16,510
I just figured I'd...
144
00:06:16,544 --> 00:06:18,946
push it on race day,
see how far I could go.
145
00:06:18,980 --> 00:06:21,114
I made it the whole 26.
146
00:06:21,149 --> 00:06:22,749
Wow. Well,
147
00:06:22,784 --> 00:06:24,184
it seems that the extra exertion
148
00:06:24,218 --> 00:06:25,786
caused your muscles to break down,
149
00:06:25,820 --> 00:06:27,654
and the by-products
flooded your kidneys.
150
00:06:27,689 --> 00:06:29,589
It's called acute tubular necrosis.
151
00:06:29,624 --> 00:06:30,824
From running?
Basically, yeah.
152
00:06:30,858 --> 00:06:33,360
Your kidneys shut down,
and that's why
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00:06:33,394 --> 00:06:35,162
you collapsed.
154
00:06:35,196 --> 00:06:37,030
Now, what do either of you know
155
00:06:37,065 --> 00:06:38,332
about dialysis?
156
00:06:38,366 --> 00:06:39,700
Oh, tell me
157
00:06:39,734 --> 00:06:41,335
that's not where
we're headed here.
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00:06:41,369 --> 00:06:43,904
Candace's brother-in-law's
been on it for five years.
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00:06:43,938 --> 00:06:46,173
It's taken over his life.
Yeah, well,
160
00:06:46,207 --> 00:06:47,641
transplant is also an option.
161
00:06:47,675 --> 00:06:49,576
And we can get you
listed immediately,
162
00:06:49,610 --> 00:06:52,479
but you both should know that,
because of your condition
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00:06:52,513 --> 00:06:54,781
and the fact that dialysis
is still an option,
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00:06:54,816 --> 00:06:56,950
you will be low
on the priority list.
165
00:06:56,985 --> 00:06:58,652
Can I give him
one of my kidneys?
166
00:06:58,686 --> 00:07:00,120
Yeah. We just have to make sure
167
00:07:00,154 --> 00:07:01,421
the blood type and tissues match.
168
00:07:01,456 --> 00:07:03,657
We can send a nurse in
to do samples,
169
00:07:03,691 --> 00:07:04,624
if you're really interested.
170
00:07:04,659 --> 00:07:06,860
Candace, I...
Stop it. Yes.
171
00:07:06,894 --> 00:07:09,162
We're interested.
172
00:07:10,064 --> 00:07:11,765
Okay.
173
00:07:14,168 --> 00:07:15,969
Okay, doc, what do we got?
174
00:07:16,004 --> 00:07:18,305
This kid, who we transplanted
a couple months back...
175
00:07:18,339 --> 00:07:20,374
Yeah, Scott Becker.
Cardiac enzymes
176
00:07:20,408 --> 00:07:21,608
are elevated.
177
00:07:21,642 --> 00:07:22,909
Bnp and chest x Ray
178
00:07:22,944 --> 00:07:24,478
confirm congestive heart failure.
179
00:07:24,512 --> 00:07:26,513
Okay.
180
00:07:26,547 --> 00:07:28,248
Gonna have to do
a myocardial biopsy,
181
00:07:28,282 --> 00:07:29,850
and we'll go with pulse steroids,
182
00:07:29,884 --> 00:07:31,351
see if we can reverse this.
183
00:07:31,386 --> 00:07:32,586
Andy, Lisa needs you
184
00:07:32,620 --> 00:07:35,322
in the E.R.
okay, thanks. Thanks, doc.
185
00:07:35,356 --> 00:07:37,758
Please tell me that look on your face
isn't about Scott Becker.
186
00:07:37,792 --> 00:07:39,793
His body's rejecting the heart.
187
00:07:42,597 --> 00:07:43,697
Well, you were right--
188
00:07:43,731 --> 00:07:46,133
she's definitely got
a bleeder in her chest.
189
00:07:46,167 --> 00:07:49,736
Okay, let's advance the chest tube.
190
00:07:56,711 --> 00:07:58,812
Hooking up to pleurovac.
191
00:08:01,215 --> 00:08:03,383
Okay, people, she's got a massive
192
00:08:03,418 --> 00:08:04,918
arterial hemorrhage--
we're not gonna be able
193
00:08:04,952 --> 00:08:06,053
to stop the bleeding down here.
194
00:08:06,087 --> 00:08:08,188
Let's get her up to the O.R.
195
00:08:08,222 --> 00:08:09,523
Why is a drowning victim
bleeding like this?
196
00:08:09,557 --> 00:08:11,525
If you figure it out,
please let me know.
197
00:08:11,559 --> 00:08:13,693
Okay, come on, here we go.
198
00:08:16,264 --> 00:08:18,131
Okay, talk to me, Dr. Lee.
199
00:08:18,166 --> 00:08:20,167
Bleeding in the right chest
is continuous and diffuse,
200
00:08:20,201 --> 00:08:21,568
with no specific site.
201
00:08:21,602 --> 00:08:22,936
Pre-op labs?
202
00:08:22,970 --> 00:08:24,805
PT and PTT are both normal.
203
00:08:24,872 --> 00:08:26,173
Bleeding time's a bit elevated.
204
00:08:26,207 --> 00:08:28,141
A little water here, please, Pam?
Mm-hmm.
205
00:08:28,176 --> 00:08:29,876
So what's your call, doctor?
206
00:08:29,911 --> 00:08:32,293
I think we load her up
with platelets and plasma.
207
00:08:32,327 --> 00:08:33,494
So do I. Let's do it.
208
00:08:33,529 --> 00:08:35,430
Do we know if she's
on any blood thinners?
209
00:08:35,464 --> 00:08:37,064
Uh, University police
210
00:08:37,099 --> 00:08:39,100
haven't given us
any information on her yet.
211
00:08:39,134 --> 00:08:41,736
Do we know anything besides her name?
212
00:08:44,206 --> 00:08:46,474
Anybody?
213
00:08:46,508 --> 00:08:49,210
Pam, help a brother.
214
00:08:49,244 --> 00:08:52,346
This bleeding's not stopping.
215
00:09:03,225 --> 00:09:04,425
Andy needs...
216
00:09:04,460 --> 00:09:06,327
A fresh joke.
217
00:09:06,361 --> 00:09:08,563
Well, little buddy...
218
00:09:08,597 --> 00:09:09,997
I have some news for you.
219
00:09:10,032 --> 00:09:12,633
Call me "little buddy" again.
220
00:09:12,668 --> 00:09:13,901
Li...
221
00:09:13,936 --> 00:09:15,436
Sorry.
222
00:09:15,471 --> 00:09:17,438
Candace Dula isn't a
tissue match for Bill.
223
00:09:17,473 --> 00:09:20,007
So he can't have her kidney.
224
00:09:24,947 --> 00:09:26,981
The Struckmeyers.
225
00:09:27,816 --> 00:09:29,650
The Struckmeyers.
What?
226
00:09:29,685 --> 00:09:32,453
The Struckmeyers.
227
00:09:32,488 --> 00:09:34,589
Heather and Darren Struckmeyer.
228
00:09:34,623 --> 00:09:36,858
She's on dialysis,
and he wanted to donate,
229
00:09:36,892 --> 00:09:38,559
but he's not a match.
230
00:09:38,594 --> 00:09:41,095
However, Candace Dula
has the same blood type
231
00:09:41,129 --> 00:09:44,532
and HLA profile, which makes her
the ideal donor.
232
00:09:45,701 --> 00:09:48,236
So... what are you proposing?
233
00:09:48,270 --> 00:09:51,672
It... it's something
called a daisy chain.
234
00:09:51,707 --> 00:09:53,608
If you were to donate
your kidney to Heather,
235
00:09:53,642 --> 00:09:55,476
her husband would donate
his kidney to someone
236
00:09:55,511 --> 00:09:58,079
who matches his criteria, and so on.
That's how you find
237
00:09:58,113 --> 00:09:59,647
a kidney for me.
Exactly.
238
00:09:59,681 --> 00:10:01,616
Now, you both should
know this hasn't
239
00:10:01,650 --> 00:10:03,384
been approved
by the hospital just yet,
240
00:10:03,418 --> 00:10:05,286
but I do plan on bringing it up
241
00:10:05,320 --> 00:10:06,454
at the transplant committee meeting.
242
00:10:06,488 --> 00:10:08,256
How many couples will this take?
243
00:10:08,290 --> 00:10:09,590
If we're lucky, only one.
244
00:10:09,625 --> 00:10:12,193
But... it most certainly
won't be that easy.
245
00:10:15,230 --> 00:10:16,697
I'm in.
246
00:10:16,732 --> 00:10:18,399
I'll do it.
247
00:10:18,433 --> 00:10:19,734
But, honey, think about this.
248
00:10:19,768 --> 00:10:22,370
You... you're gonna go through
surgery for a stranger.
249
00:10:22,404 --> 00:10:25,106
If it means you're
gonna get a kidney, yes.
250
00:10:25,140 --> 00:10:29,076
And I'm praying that somebody'll
do the same thing for you.
251
00:10:29,111 --> 00:10:31,412
Okay.
252
00:10:31,446 --> 00:10:33,447
We'll give it a shot.
253
00:10:33,482 --> 00:10:36,017
I'll keep you posted. Great.
254
00:10:36,051 --> 00:10:38,252
I can't believe this--
I showed up at work,
255
00:10:38,287 --> 00:10:41,389
and the campus cops were there
asking questions about Penelope.
256
00:10:41,423 --> 00:10:42,990
Where do you work?
257
00:10:43,025 --> 00:10:44,725
At a medical research lab
on campus.
258
00:10:44,760 --> 00:10:46,394
We're in the biochem Phd program.
259
00:10:46,428 --> 00:10:49,597
Do you know of any medications
that Penelope was taking?
260
00:10:49,631 --> 00:10:52,433
She has asthma.
261
00:10:52,467 --> 00:10:53,868
She carries an inhaler.
262
00:10:53,902 --> 00:10:55,369
Any recent injuries
263
00:10:55,404 --> 00:10:57,238
that you know of?
No.
264
00:10:57,272 --> 00:10:59,373
She works out all the time though.
265
00:10:59,408 --> 00:11:01,242
She's been getting ready
for her wedding.
266
00:11:01,276 --> 00:11:02,376
Oh, she's getting married?
267
00:11:02,411 --> 00:11:04,278
Well, she was supposed to.
268
00:11:04,313 --> 00:11:07,048
I'm not sure what's going on now.
269
00:11:07,082 --> 00:11:10,084
She flew out to California
last week to visit her fiancé,
270
00:11:10,118 --> 00:11:11,786
but they got into a big fight,
271
00:11:11,820 --> 00:11:13,054
so she came back early.
272
00:11:13,088 --> 00:11:14,555
Do you know how to get
in touch with her fiancé?
273
00:11:14,590 --> 00:11:16,157
I'd like to ask him
a couple of questions.
274
00:11:16,191 --> 00:11:17,992
Sure. His name's Jared.
275
00:11:18,026 --> 00:11:19,093
He was in the undergrad
program with us.
276
00:11:19,127 --> 00:11:20,695
Hey, Pam?
277
00:11:20,729 --> 00:11:21,929
Do you have a second?
278
00:11:21,964 --> 00:11:24,665
Excuse me.
279
00:11:24,700 --> 00:11:26,200
Hey.
280
00:11:26,234 --> 00:11:27,501
How's she doing?
281
00:11:27,536 --> 00:11:29,337
Well, we did what we could,
but she lost a lot of blood.
282
00:11:29,371 --> 00:11:32,139
So, whoever her people are,
get them down here asap.
283
00:11:39,948 --> 00:11:41,816
Come on.
All this for a sprained ankle?
284
00:11:41,850 --> 00:11:46,721
Your ankles aren't swollen
because of skateboarding.
285
00:11:48,523 --> 00:11:50,691
Your heart is not pumping adequately,
286
00:11:50,726 --> 00:11:52,893
so fluid is collecting at the low point.
287
00:11:52,928 --> 00:11:55,630
It's a sign of congestive heart failure.
288
00:11:56,531 --> 00:11:59,500
I've been feeling fine.
289
00:11:59,534 --> 00:12:01,235
Yeah, but that could change overnight.
290
00:12:01,269 --> 00:12:03,237
We're going to need
to take a biopsy of your heart,
291
00:12:03,271 --> 00:12:05,239
then we're going to hit you
with a high dose of steroids.
292
00:12:05,273 --> 00:12:07,375
We've stopped rejection
with them before.
293
00:12:11,380 --> 00:12:14,115
Look, I swear,
I've been totally clean.
294
00:12:14,149 --> 00:12:17,585
I mean, no smoking weed
or anything like that.
295
00:12:17,619 --> 00:12:18,986
I know that, Scott.
296
00:12:19,021 --> 00:12:20,488
But this is not about lifestyle.
297
00:12:20,522 --> 00:12:22,423
Rejection can happen at any time.
298
00:12:22,457 --> 00:12:24,258
But you're young, you're in good health,
299
00:12:24,292 --> 00:12:26,160
so there's no reason why
we can't turn this around.
300
00:12:28,063 --> 00:12:29,730
Here come my folks.
301
00:12:29,765 --> 00:12:31,932
Take it easy with the
medical info, all right?
302
00:12:31,967 --> 00:12:33,501
They get scared real easy.
303
00:12:33,535 --> 00:12:37,138
All right.
Thanks.
304
00:12:38,473 --> 00:12:40,474
Hey, mom. Dad.
305
00:12:40,509 --> 00:12:42,376
Hi. Honey, are you okay?
306
00:12:42,411 --> 00:12:44,545
Yeah. I'm fine.
This is Dr. Yablonski.
307
00:12:44,579 --> 00:12:46,247
George Becker.
308
00:12:46,281 --> 00:12:47,515
How do you do?
This is my wife, Ronda.
309
00:12:47,549 --> 00:12:48,983
Pleasure.
310
00:12:49,017 --> 00:12:50,451
Nice to meet you.
311
00:12:50,485 --> 00:12:51,952
So, uh, we thought he was
just coming in for a checkup.
312
00:12:51,987 --> 00:12:53,320
But, uh...
313
00:12:53,355 --> 00:12:55,122
He called and said he needs
to stay for a couple of days.
314
00:12:55,157 --> 00:12:58,359
Yeah. Don't worry.
We, um, we got it under control.
315
00:12:58,393 --> 00:13:00,895
We have a plan now, don't we?
316
00:13:00,929 --> 00:13:02,830
We do.
317
00:13:02,864 --> 00:13:05,766
Uh, did you guys
bring the Backgammon?
318
00:13:05,801 --> 00:13:09,170
Oh.
Yeah. Mom's got it in her bag.
319
00:13:09,204 --> 00:13:11,072
If you hear screams from in here,
320
00:13:11,106 --> 00:13:13,340
don't be alarmed.
It's just the sound of victory.
321
00:13:13,375 --> 00:13:15,076
Okay.
322
00:13:15,110 --> 00:13:16,610
It's very nice to meet you both.
323
00:13:23,485 --> 00:13:24,719
Dr. Yablonski?
324
00:13:24,753 --> 00:13:25,820
Yes?
325
00:13:25,854 --> 00:13:27,188
I should have, um, called you
326
00:13:27,222 --> 00:13:28,456
or sent a note or
something to thank you
327
00:13:28,490 --> 00:13:30,624
for everything you've done
for Scott. I apologize.
328
00:13:30,659 --> 00:13:31,726
There's no need.
329
00:13:31,760 --> 00:13:33,194
I'm a huge fan of your son's.
330
00:13:33,228 --> 00:13:34,595
We are, too.
331
00:13:34,629 --> 00:13:38,032
But there were some years
there where we lost him.
332
00:13:38,066 --> 00:13:39,867
And when you went in
333
00:13:39,901 --> 00:13:41,402
and put the new heart
in him, it was like...
334
00:13:41,436 --> 00:13:43,404
It's like you went inside
and flipped a switch
335
00:13:43,438 --> 00:13:45,673
and you turned him back
into the Scott that we knew.
336
00:13:45,707 --> 00:13:47,408
Well, I'm glad to hear that.
337
00:13:47,442 --> 00:13:49,143
I'll check back soon,
see how he's doing.
338
00:13:49,177 --> 00:13:50,211
Great. Thank you.
339
00:13:50,245 --> 00:13:52,747
You're welcome.
340
00:13:56,952 --> 00:13:58,252
Okay.
341
00:14:18,103 --> 00:14:20,305
Hey, there, Penelope.
342
00:14:23,175 --> 00:14:24,542
I'm Pam Acosta.
343
00:14:24,576 --> 00:14:25,877
You're in Three Rivers Hospital.
344
00:14:25,911 --> 00:14:27,845
Can you understand me?
345
00:14:27,880 --> 00:14:29,147
You can just nod, okay?
346
00:14:29,181 --> 00:14:31,282
You had an accident
347
00:14:31,316 --> 00:14:33,151
yesterday morning,
when you were swimming.
348
00:14:33,185 --> 00:14:35,720
You were bleeding internally
and needed surgery.
349
00:14:35,754 --> 00:14:38,055
Do you know what could
have caused that?
350
00:14:38,090 --> 00:14:42,026
I fell... on my bike.
351
00:14:42,060 --> 00:14:43,995
I was riding to the pool.
352
00:14:44,029 --> 00:14:45,263
I lost my balance.
353
00:14:45,297 --> 00:14:47,899
Good. That could be what
caused your injury.
354
00:14:47,933 --> 00:14:50,601
Can you tell me what medication
you've been taking?
355
00:14:50,636 --> 00:14:54,238
Ambien, for sleeping.
Okay.
356
00:14:54,273 --> 00:14:56,240
I have an inhaler for my asthma.
357
00:14:56,275 --> 00:14:59,844
Um...
358
00:14:59,878 --> 00:15:02,580
Aspirin. A lot lately, for headaches.
359
00:15:02,614 --> 00:15:04,715
The aspirin could explain the bleeding.
360
00:15:04,750 --> 00:15:06,184
Your doctors infused you with platelets.
361
00:15:06,218 --> 00:15:07,618
That should help your body regain
362
00:15:07,653 --> 00:15:08,886
its ability to clot.
363
00:15:08,921 --> 00:15:10,321
The doctor's going
to come talk to you.
364
00:15:10,355 --> 00:15:11,923
We're going to keep you here
for a few days.
365
00:15:11,957 --> 00:15:13,024
I need to talk to Jared.
366
00:15:13,058 --> 00:15:14,659
Is that your fiancé?
367
00:15:14,693 --> 00:15:17,161
Your friend Jeni got a hold of him.
368
00:15:17,196 --> 00:15:18,696
She said he was flying out today.
369
00:15:18,730 --> 00:15:20,998
I can't believe he's going
to see me like this.
370
00:15:21,033 --> 00:15:23,634
I'm sure he'll be happy
just to see you alive.
371
00:15:26,939 --> 00:15:28,005
That's him.
372
00:15:28,040 --> 00:15:29,373
Oh, thank you.
373
00:15:29,408 --> 00:15:31,442
Dr. Lee?
Yes?
374
00:15:31,476 --> 00:15:32,476
I'm Andrew Gold.
375
00:15:32,511 --> 00:15:33,711
Penelope Kirkell works in my lab.
376
00:15:33,745 --> 00:15:35,346
I was told you could
tell me how she's doing.
377
00:15:35,380 --> 00:15:37,715
Um, well, she made a big
turnaround overnight.
378
00:15:37,749 --> 00:15:41,352
All in all, she's doing a lot
better than I thought she'd be.
379
00:15:41,386 --> 00:15:44,789
Did you determine why
she passed out in the pool?
380
00:15:44,823 --> 00:15:46,457
I really can't discuss that.
381
00:15:46,491 --> 00:15:47,625
Of course not.
382
00:15:47,659 --> 00:15:48,893
I understand.
383
00:15:48,927 --> 00:15:51,262
We're all just really worried
back at the lab.
384
00:15:51,296 --> 00:15:53,931
Well, I can show you to her room,
385
00:15:53,966 --> 00:15:55,499
if you'd like.
386
00:15:55,534 --> 00:15:58,135
Um... no. That's okay.
387
00:15:58,170 --> 00:15:59,670
She probably needs her rest.
388
00:15:59,705 --> 00:16:01,772
I'll, uh...
389
00:16:01,807 --> 00:16:03,741
No. I'll call back later.
390
00:16:03,775 --> 00:16:05,710
Okay.
391
00:16:05,744 --> 00:16:07,845
Thank you.
392
00:16:07,879 --> 00:16:09,280
Food services, call 316.
393
00:16:09,314 --> 00:16:11,115
Food services, call...
394
00:16:20,092 --> 00:16:22,059
There you are.
395
00:16:22,094 --> 00:16:25,730
Can't a man enjoy a meal alone?
396
00:16:25,764 --> 00:16:27,898
You're in a hospital.
397
00:16:27,933 --> 00:16:30,668
We make it our business
to invade your space.
398
00:16:30,702 --> 00:16:32,303
Where are your parents?
399
00:16:32,337 --> 00:16:34,171
Out on a walk.
400
00:16:34,206 --> 00:16:36,841
Hey, so the, uh...
401
00:16:36,908 --> 00:16:39,143
The results of your biopsy came back.
402
00:16:39,177 --> 00:16:42,213
You're having what's called
an antibody-mediated rejection.
403
00:16:44,082 --> 00:16:46,851
Well, that doesn't sound good.
404
00:16:46,885 --> 00:16:50,187
It means you won't respond
to the steroid treatment.
405
00:16:50,222 --> 00:16:51,555
We're going to put you
on a drug that's going
406
00:16:51,590 --> 00:16:53,391
to help boost
the contraction of your heart.
407
00:16:53,425 --> 00:16:56,427
And then we should start talking
about another transplant.
408
00:16:58,930 --> 00:17:01,666
Scott, listen.
You really need
409
00:17:01,700 --> 00:17:03,234
to let your parents know
what's going on here.
410
00:17:03,268 --> 00:17:05,736
You know?
411
00:17:05,771 --> 00:17:07,004
Yeah.
412
00:17:07,039 --> 00:17:09,440
I wish I had better news, buddy.
413
00:17:09,474 --> 00:17:13,177
Hey, I had
a freakin' heart transplant.
414
00:17:13,211 --> 00:17:14,879
These things happen, right?
415
00:17:14,913 --> 00:17:17,148
Yeah.
416
00:17:18,684 --> 00:17:21,319
I'm late. I got to go.
417
00:17:21,353 --> 00:17:23,487
Scott.
You okay?
418
00:17:23,522 --> 00:17:26,023
I'm good. Go.
Leave me in peace.
419
00:17:26,058 --> 00:17:28,192
Please.
420
00:17:40,505 --> 00:17:41,706
Wow. You're early.
421
00:17:41,740 --> 00:17:42,940
Yeah. Leading by example.
422
00:17:42,974 --> 00:17:44,008
Jordan would be proud of you.
423
00:17:44,042 --> 00:17:45,710
I'm proud just to know you.
424
00:17:45,744 --> 00:17:47,511
You, too, Dr. Lee.
Let's get started.
425
00:17:48,980 --> 00:17:50,648
First up, Scott Becker.
426
00:17:50,682 --> 00:17:54,085
Received a heart transplant
six weeks ago.
427
00:17:54,119 --> 00:17:56,987
Lab and echo suggest CHF.
428
00:17:57,022 --> 00:17:59,590
Biopsy shows acute
antibody-mediated rejection,
429
00:17:59,624 --> 00:18:01,559
so we added ATG.
430
00:18:01,593 --> 00:18:02,693
I think we should relist him,
431
00:18:02,728 --> 00:18:04,328
in case we can't stop this rejection.
432
00:18:04,363 --> 00:18:06,864
Anybody object?
433
00:18:06,898 --> 00:18:08,499
Good.
434
00:18:08,533 --> 00:18:09,800
On to the next order of business.
435
00:18:09,835 --> 00:18:11,268
Miranda?
436
00:18:11,336 --> 00:18:13,738
Okay.
437
00:18:13,772 --> 00:18:17,007
Patient's name is Bill Dula.
438
00:18:17,042 --> 00:18:19,543
Age 43, current diagnosis is ATN
439
00:18:19,578 --> 00:18:22,146
as a result of a marathon
he ran last week.
440
00:18:22,180 --> 00:18:23,447
Another reason
not to move to Philly.
441
00:18:23,482 --> 00:18:25,516
Bite your tongue.
442
00:18:26,651 --> 00:18:28,185
His kidney function studies,
443
00:18:28,220 --> 00:18:30,788
his bun and creatinine
are extremely elevated,
444
00:18:30,822 --> 00:18:31,989
and he's not making any urine,
445
00:18:32,023 --> 00:18:33,290
which means that he'll have
446
00:18:33,325 --> 00:18:35,159
to go on long-term dialysis
if things don't improve.
447
00:18:35,193 --> 00:18:36,360
But you want to list him anyway.
448
00:18:36,395 --> 00:18:37,395
Yes, I do.
449
00:18:37,429 --> 00:18:38,696
But he's a low priority,
450
00:18:38,730 --> 00:18:40,865
which is why I am suggesting
an alternate approach.
451
00:18:42,701 --> 00:18:44,735
Okay. His wife has offered
to donate her kidney,
452
00:18:44,770 --> 00:18:46,871
but she is not a tissue match.
453
00:18:46,905 --> 00:18:49,173
However, we have found
someone here who is,
454
00:18:49,207 --> 00:18:51,809
so we've constructed
a partial Daisy chain.
455
00:18:51,843 --> 00:18:52,910
With altruistic donors?
456
00:18:52,944 --> 00:18:55,446
Yes.
The board vetoed daisy chains
457
00:18:55,480 --> 00:18:57,548
because of the surgical risk
to altruistic donors.
458
00:18:57,582 --> 00:18:58,749
Well, there's also a risk
459
00:18:58,784 --> 00:19:01,152
of our patients dying,
waiting for a kidney.
460
00:19:01,186 --> 00:19:02,720
Have you done psych evals
on all your donors?
461
00:19:02,754 --> 00:19:05,523
This isn't 1972.
462
00:19:05,557 --> 00:19:07,625
These are consenting adults
who'd like to help.
463
00:19:07,659 --> 00:19:10,161
How do you know the family
members aren't being coerced?
464
00:19:10,195 --> 00:19:11,662
Because when a family member
doesn't want to donate,
465
00:19:11,696 --> 00:19:14,031
we tell the family
that they're not a match.
466
00:19:14,065 --> 00:19:15,132
What about children?
Are any of your donors
467
00:19:15,167 --> 00:19:16,300
under the age of consent?
468
00:19:16,334 --> 00:19:20,404
Like I said,
we have eight consenting adults
469
00:19:20,439 --> 00:19:22,273
who would like to save some lives.
470
00:19:22,307 --> 00:19:24,542
And I don't think anybody here
should get in their way.
471
00:19:24,576 --> 00:19:26,744
So, Dr. Acting Department Head,
472
00:19:26,778 --> 00:19:30,648
how would you suggest we proceed?
473
00:19:32,451 --> 00:19:35,085
Well, with Dr. Jordan absent,
474
00:19:35,120 --> 00:19:36,420
I'm not sure this is the best time
475
00:19:36,455 --> 00:19:38,055
to reverse our policies.
476
00:19:38,089 --> 00:19:40,391
I can't believe I'm
hearing you say this,
477
00:19:40,425 --> 00:19:43,461
considering you'd be making
the exact same argument
478
00:19:43,495 --> 00:19:44,862
if you weren't
sitting in that chair.
479
00:19:44,896 --> 00:19:46,764
All I'm saying is dialysis
is a safe option.
480
00:19:46,798 --> 00:19:47,598
Temporarily.
481
00:19:47,632 --> 00:19:48,833
Okay, so let's agree to disagree.
482
00:19:48,867 --> 00:19:51,302
Let's agree to vote.
483
00:19:53,104 --> 00:19:54,839
Okay.
484
00:19:55,774 --> 00:19:57,408
All of those in favor
485
00:19:57,442 --> 00:20:00,945
of enacting the daisy chain
procedure here, raise your hand.
486
00:20:00,979 --> 00:20:04,081
Good news.
487
00:20:04,115 --> 00:20:06,083
The committee approved
the daisy chain.
488
00:20:06,117 --> 00:20:07,952
But I have to say,
finding a donor for you
489
00:20:07,986 --> 00:20:09,119
was the hardest part.
490
00:20:09,154 --> 00:20:10,821
Until we found...
491
00:20:10,856 --> 00:20:12,690
DA, DA, DA, DA.
492
00:20:12,724 --> 00:20:15,059
There he is.
Mr. Wilkinson.
493
00:20:15,093 --> 00:20:17,528
See, Mr. Wilkinson wanted
to donate to his son Kevin,
494
00:20:17,562 --> 00:20:18,829
but they weren't a match.
495
00:20:18,864 --> 00:20:20,831
However, we did find someone
for Kevin through the chain,
496
00:20:20,866 --> 00:20:25,236
and Mr. Wilkinson
agreed to donate to you.
497
00:20:26,137 --> 00:20:27,571
What do you think, hon?
498
00:20:27,606 --> 00:20:31,742
You know, my grandfather
was a labor leader.
499
00:20:31,776 --> 00:20:33,611
A switchman on the railroad.
500
00:20:33,645 --> 00:20:38,015
He was always talking to me
about the greater good,
501
00:20:38,049 --> 00:20:40,317
and how one guy had to not
just think about himself,
502
00:20:40,352 --> 00:20:42,486
but about the bigger picture,
503
00:20:42,521 --> 00:20:44,255
and how we'd all be better
because of it.
504
00:20:44,289 --> 00:20:46,690
I was such a knucklehead
back then.
505
00:20:47,959 --> 00:20:50,528
Didn't think much
of what he was saying.
506
00:20:50,562 --> 00:20:53,731
When do you want
to do the surgery?
507
00:20:59,371 --> 00:21:01,372
You may be feeling better,
508
00:21:01,406 --> 00:21:03,774
but you're not out of the woods yet.
509
00:21:03,808 --> 00:21:05,342
Don't blame me.
510
00:21:05,377 --> 00:21:06,777
She told me to bring her work.
511
00:21:06,811 --> 00:21:10,848
And my favorite robe
and some of my things.
512
00:21:10,882 --> 00:21:15,085
Most people use major surgery
as an excuse not to work.
513
00:21:15,120 --> 00:21:17,288
Those people don't have
tenure track positions.
514
00:21:17,322 --> 00:21:19,590
You know what they say,
"publish or perish."
515
00:21:19,624 --> 00:21:20,691
You push it too far,
516
00:21:20,725 --> 00:21:22,393
and the perish part
might actually happen.
517
00:21:23,562 --> 00:21:24,995
Your boss came by.
518
00:21:25,030 --> 00:21:27,064
Dr. Gold?
Mm-hmm.
519
00:21:27,098 --> 00:21:28,832
He spoke to Dr. Lee.
Sounds like he had to run
520
00:21:28,867 --> 00:21:30,367
before he could see you.
521
00:21:30,402 --> 00:21:32,436
What's going on?
522
00:21:33,638 --> 00:21:35,606
Dr. Gold had
this minor obsession with Pen.
523
00:21:35,640 --> 00:21:37,174
His wife got wind of it,
524
00:21:37,208 --> 00:21:39,710
and now he just skulks around,
525
00:21:39,744 --> 00:21:40,978
barely talks to her.
526
00:21:41,846 --> 00:21:46,050
It's... creepy and uncomfortable.
527
00:21:46,084 --> 00:21:49,720
Well, for now, you can
hide out in here with us.
528
00:21:49,754 --> 00:21:51,722
Ten more minutes,
then it's pencils down.
529
00:21:51,756 --> 00:21:54,758
Chaplain to room 802.
530
00:21:54,793 --> 00:21:58,295
Chaplain to room 802.
531
00:22:00,165 --> 00:22:02,232
Dr. Foster said
there's some paperwork
532
00:22:02,267 --> 00:22:03,834
to fill out about my surgery.
533
00:22:03,868 --> 00:22:05,970
Candace Dula.
534
00:22:10,575 --> 00:22:11,742
Mrs. Dula?
535
00:22:11,776 --> 00:22:12,977
I'm Rick Wilkinson.
536
00:22:13,011 --> 00:22:15,245
I'm going to be your husband's donor.
537
00:22:15,280 --> 00:22:18,082
Oh, my God!
538
00:22:18,116 --> 00:22:19,917
Thank you so much!
539
00:22:19,951 --> 00:22:21,385
It's so nice to meet you.
540
00:22:21,419 --> 00:22:22,386
You, too.
541
00:22:24,255 --> 00:22:25,990
Can you believe this thing?
542
00:22:26,024 --> 00:22:28,425
Bunch of people you don't know
giving kidneys to each other.
543
00:22:28,460 --> 00:22:30,394
Well, kind of makes all the sense
544
00:22:30,428 --> 00:22:32,029
in the world though, right?
545
00:22:33,665 --> 00:22:37,434
I'd do anything to get
my boy back on track.
546
00:22:37,469 --> 00:22:39,737
His kidneys started failing
when he was 13.
547
00:22:39,771 --> 00:22:42,006
Affected his growth, his height.
548
00:22:42,040 --> 00:22:44,975
I mean, he was a teenager
549
00:22:45,010 --> 00:22:49,313
and his life just stopped
when he went on dialysis.
550
00:22:49,347 --> 00:22:52,182
I wish I was the one
helping your son.
551
00:22:53,685 --> 00:22:54,752
You are.
552
00:22:54,786 --> 00:22:57,621
We all are.
553
00:23:07,999 --> 00:23:09,266
Hey.
554
00:23:09,300 --> 00:23:11,735
Did Penelope Kirkell mention
anything about taking digoxin?
555
00:23:11,770 --> 00:23:13,170
No.
556
00:23:13,204 --> 00:23:16,306
There was no reason to run the
screen when she was admitted,
557
00:23:16,341 --> 00:23:18,842
but when I ordered the new
chem panels, it popped up.
558
00:23:18,877 --> 00:23:20,110
Her levels are through the roof.
559
00:23:20,145 --> 00:23:21,378
She doesn't have a heart condition,
560
00:23:21,413 --> 00:23:23,213
so I don't know why
it would be in her system.
561
00:23:24,993 --> 00:23:27,027
It's Penelope.
She's in fib.
562
00:23:27,061 --> 00:23:28,128
All right, call a code!
563
00:23:28,162 --> 00:23:30,564
Code Red.
564
00:23:30,598 --> 00:23:31,999
Code Red ICU.
565
00:23:47,911 --> 00:23:48,977
Amp of epi is in.
566
00:23:49,012 --> 00:23:50,913
Okay. Everybody clear.
567
00:24:01,524 --> 00:24:02,591
You got a rhythm.
568
00:24:02,625 --> 00:24:03,659
Good carotid pulse.
569
00:24:03,693 --> 00:24:05,260
Now let's make sure
she stays that way.
570
00:24:05,295 --> 00:24:07,563
Hang an amiodarone drip. Repeat
blood count and chem panel.
571
00:24:11,301 --> 00:24:12,701
What is going on with this girl?
572
00:24:12,735 --> 00:24:14,469
That's a good question, Pam.
573
00:24:14,504 --> 00:24:16,672
I mean, an internal bleed
wouldn't cause the v-fib, right?
574
00:24:16,706 --> 00:24:18,173
The digoxin would.
575
00:24:18,208 --> 00:24:20,609
And it would also
explain her bike fall.
576
00:24:20,643 --> 00:24:21,810
She could've had an arrhythmia
577
00:24:21,844 --> 00:24:23,579
from the high dig level
and blacked out.
578
00:24:23,613 --> 00:24:25,447
But how's it getting
into her system?
579
00:24:25,481 --> 00:24:27,015
I don't know.
580
00:24:27,050 --> 00:24:29,017
Excuse me. Is that Penelope?
Sorry, sir.
581
00:24:29,052 --> 00:24:29,985
W-who are you?
582
00:24:30,019 --> 00:24:31,320
I'm Jared Douglas.
I'm her fiancé.
583
00:24:31,354 --> 00:24:32,721
What's going on?
584
00:24:36,326 --> 00:24:38,193
Dr. Yablonski?
Yeah.
585
00:24:38,228 --> 00:24:40,462
I need you to sign off
on the organ donation
586
00:24:40,496 --> 00:24:43,398
for Dr. Foster's kidney patient.
587
00:24:43,433 --> 00:24:44,866
Uh, yeah.
588
00:24:44,901 --> 00:24:46,768
Yeah.
589
00:24:46,803 --> 00:24:48,337
Okay.
590
00:24:48,371 --> 00:24:49,838
Where?
591
00:24:49,872 --> 00:24:50,973
Uh, right there.
592
00:24:55,578 --> 00:24:56,878
That's it.
593
00:24:56,913 --> 00:24:58,013
That's great, thanks.
Okay.
594
00:24:58,047 --> 00:24:59,715
This is Ryan Abbott.
595
00:25:00,583 --> 00:25:02,451
Hey, Andy.
Yeah.
596
00:25:02,485 --> 00:25:04,886
Let's clear the air
about this afternoon, please.
597
00:25:04,921 --> 00:25:07,356
Yeah, if I sounded annoyed,
that's because I am.
598
00:25:07,390 --> 00:25:08,724
That's fairly obvious.
599
00:25:08,758 --> 00:25:09,725
It's not you.
600
00:25:09,759 --> 00:25:13,895
I... I could never do Jordan's job.
601
00:25:13,930 --> 00:25:16,565
I spend half my day
in stupid HR meetings
602
00:25:16,599 --> 00:25:18,867
and signing forms and making calls.
603
00:25:19,535 --> 00:25:21,703
I suck as an administrator.
604
00:25:21,738 --> 00:25:22,971
It's a good thing you only
605
00:25:23,006 --> 00:25:24,306
have to suck for a few more days.
606
00:25:24,340 --> 00:25:25,641
Yeah.
607
00:25:25,675 --> 00:25:26,975
Oh, God. If he's got
608
00:25:27,010 --> 00:25:28,610
another form for me to sign,
I'll kill myself.
609
00:25:28,645 --> 00:25:29,711
Just go, just go. What?
610
00:25:29,746 --> 00:25:31,146
UNOS just called with an offer
611
00:25:31,180 --> 00:25:32,514
for a kidney for Bill Dula.
612
00:25:32,548 --> 00:25:33,482
It's in Carbondale.
613
00:25:33,516 --> 00:25:35,017
We can send a team now.
614
00:25:36,252 --> 00:25:37,486
What are we going to tell him?
615
00:25:37,520 --> 00:25:40,289
We tell them a kidney
became available.
616
00:25:40,323 --> 00:25:42,424
His wife won't need
surgery if he takes it.
617
00:25:42,458 --> 00:25:43,458
That's right, she won't.
618
00:25:43,493 --> 00:25:44,793
Then for sure he's gonna take it.
619
00:25:44,827 --> 00:25:46,662
And that's gonna mess up
the whole daisy chain.
620
00:25:46,696 --> 00:25:48,397
And what about all those
people we signed up?
621
00:25:48,431 --> 00:25:49,698
They're not his problem, Ryan.
622
00:25:49,732 --> 00:25:51,833
Oh, s-so th-that's it?
623
00:25:53,703 --> 00:25:55,337
That's it.
624
00:25:59,909 --> 00:26:01,643
This is crazy.
625
00:26:01,678 --> 00:26:03,178
She doesn't have heart problems.
626
00:26:03,212 --> 00:26:04,346
She's super-healthy.
627
00:26:04,380 --> 00:26:07,316
We found a heart medicine in her system
628
00:26:07,350 --> 00:26:08,850
called digoxin.
629
00:26:08,885 --> 00:26:11,353
Did she ever mention taking it?
630
00:26:11,387 --> 00:26:13,088
No.
631
00:26:13,122 --> 00:26:16,625
But to be honest,
she hasn't been speaking to me.
632
00:26:16,659 --> 00:26:19,027
She came out to visit.
633
00:26:19,062 --> 00:26:21,897
We got into a stupid argument.
634
00:26:21,931 --> 00:26:23,665
It started with the wedding invitations.
635
00:26:23,700 --> 00:26:26,668
She wanted a card with glitter, I didn't.
636
00:26:26,703 --> 00:26:31,373
I mean, literally, it was that stupid.
637
00:26:31,407 --> 00:26:33,375
All the stress just came out.
638
00:26:33,409 --> 00:26:35,911
Then she left.
639
00:26:35,945 --> 00:26:38,246
That's the last time I talked to her.
640
00:26:38,281 --> 00:26:40,749
Look, what if
I'm the reason why she's...
641
00:26:40,783 --> 00:26:41,717
Don't...
642
00:26:41,751 --> 00:26:43,385
Don't go there, Jared.
643
00:26:43,419 --> 00:26:45,287
I'm not gonna lie to you,
644
00:26:45,321 --> 00:26:47,389
she's definitely not out of the woods.
645
00:26:47,423 --> 00:26:49,224
You need to stay positive.
646
00:26:49,258 --> 00:26:51,026
I've been where you are,
647
00:26:51,060 --> 00:26:53,228
sitting in a room like this,
waiting for news.
648
00:26:53,262 --> 00:26:55,063
And what happened?
649
00:26:55,098 --> 00:26:56,565
It just made me grateful
650
00:26:56,599 --> 00:26:58,767
for every second
the two of us had together.
651
00:27:15,351 --> 00:27:18,820
He told us about the heart rejecting.
652
00:27:18,855 --> 00:27:20,322
And he said that
653
00:27:20,356 --> 00:27:22,257
you feel positive about the options.
654
00:27:22,291 --> 00:27:23,258
I do.
655
00:27:23,292 --> 00:27:24,860
But I was coming to tell Scott
656
00:27:24,894 --> 00:27:27,462
that I'm not liking
his blood pressure.
657
00:27:27,497 --> 00:27:29,398
It's too low.
658
00:27:29,432 --> 00:27:31,533
And it's probably an indication
that the inotropic agents
659
00:27:31,567 --> 00:27:33,435
aren't working the way
I'd like them to.
660
00:27:33,469 --> 00:27:35,537
Is there something else you can do?
661
00:27:35,571 --> 00:27:38,140
Yes, there's a treatment where
we attack the white blood cells
662
00:27:38,174 --> 00:27:39,775
in Scott's lymph nodes
by exposing him
663
00:27:39,809 --> 00:27:42,277
to high doses of radiation.
664
00:27:42,311 --> 00:27:43,879
It can help stop the rejection.
665
00:27:43,913 --> 00:27:45,580
And if it doesn't?
666
00:27:45,615 --> 00:27:47,516
Well, I think
the best hope for him then
667
00:27:47,550 --> 00:27:48,984
is a new heart.
668
00:27:53,923 --> 00:27:55,624
Will the... the people
669
00:27:55,658 --> 00:27:57,225
who control the organs
670
00:27:57,260 --> 00:27:59,961
hold it against him that
he's already had a transplant?
671
00:27:59,996 --> 00:28:01,062
No, it's actually the opposite.
672
00:28:01,097 --> 00:28:02,964
The chance of Scott
getting a new heart
673
00:28:02,999 --> 00:28:06,735
is better now,
considering how sick he is.
674
00:28:07,937 --> 00:28:10,505
We just got
our little boy back, doctor.
675
00:28:10,540 --> 00:28:11,573
Please don't tell me
676
00:28:11,607 --> 00:28:13,475
that we're gonna lose him again.
677
00:28:13,509 --> 00:28:15,510
Hey, it's gonna be okay.
678
00:28:15,545 --> 00:28:17,145
We can still turn this around.
679
00:28:17,180 --> 00:28:19,281
Okay? I'm gonna do
everything in my power
680
00:28:19,315 --> 00:28:21,216
to make that happen.
681
00:28:21,250 --> 00:28:23,351
Thank you.
Thank you.
682
00:28:32,028 --> 00:28:33,228
Hey, Pam.
Mm-hmm?
683
00:28:33,262 --> 00:28:34,496
Want to get Penelope to Radiology,
684
00:28:34,530 --> 00:28:35,831
get a CT of her pancreas.
685
00:28:35,865 --> 00:28:37,799
How is her pancreas
causing a heart problem?
686
00:28:37,834 --> 00:28:39,768
Oh, I just got her
blood work back.
687
00:28:39,802 --> 00:28:41,536
She's got a blood sugar of 15.
688
00:28:41,571 --> 00:28:43,104
It's probably what
caused her to crash.
689
00:28:43,139 --> 00:28:44,039
Oh.
690
00:28:44,073 --> 00:28:45,874
Why are her Insulin levels so high?
691
00:28:45,908 --> 00:28:47,375
Could be a couple of reasons.
692
00:28:47,410 --> 00:28:48,610
Maybe a pancreatic tumor
693
00:28:48,644 --> 00:28:50,178
that's causing an increase
in Insulin production.
694
00:28:50,213 --> 00:28:51,813
That's why I want to get the CT.
695
00:28:51,848 --> 00:28:55,016
What's the other?
696
00:29:02,758 --> 00:29:04,826
Look, we didn't give her digoxin, right?
No.
697
00:29:04,861 --> 00:29:06,795
But the high levels
we found in her system
698
00:29:06,829 --> 00:29:09,364
could have caused her
to pass out in that pool.
699
00:29:09,398 --> 00:29:10,599
Now her Insulin is skyrocketing.
700
00:29:10,633 --> 00:29:12,234
Which we also didn't give her.
701
00:29:12,268 --> 00:29:13,535
But somebody did.
702
00:29:13,569 --> 00:29:15,136
While she's been in this hospital.
703
00:29:15,171 --> 00:29:16,738
Who would do that?
704
00:29:16,772 --> 00:29:18,406
I don't know.
705
00:29:18,441 --> 00:29:20,141
But if somebody's trying to kill her,
706
00:29:20,176 --> 00:29:23,011
it'd be a good way to do it.
707
00:29:35,081 --> 00:29:36,782
I'm a little surprised by this.
708
00:29:36,816 --> 00:29:37,749
Well, yeah.
709
00:29:37,784 --> 00:29:39,184
It usually takes a lot longer
710
00:29:39,219 --> 00:29:40,819
to get a kidney from UNOS.
711
00:29:40,853 --> 00:29:42,387
But you're a six-antigen match,
712
00:29:42,422 --> 00:29:44,189
and perfect matches get first dibs.
713
00:29:44,224 --> 00:29:47,459
The thing is, with the daisy chain,
714
00:29:47,493 --> 00:29:49,294
we already have a kidney, don't we?
715
00:29:49,329 --> 00:29:51,997
Absolutely. If you'd still
like to go that route.
716
00:29:52,031 --> 00:29:53,065
Yeah, but if I take this kidney,
717
00:29:53,099 --> 00:29:55,601
then you won't have to go
under the knife.
718
00:29:55,635 --> 00:29:58,303
What'll happen to the chain if
we pull out all of a sudden?
719
00:29:58,338 --> 00:30:00,639
We'll try to find a couple
to take your place.
720
00:30:03,876 --> 00:30:06,678
I'm going to take the kidney
from the UNOS list.
721
00:30:06,713 --> 00:30:09,581
I can't let Candace go through
major surgery if I can
722
00:30:09,616 --> 00:30:11,183
get a kidney another way.
723
00:30:11,217 --> 00:30:13,285
Well, I'm gonna let UNOS know,
724
00:30:13,319 --> 00:30:14,853
and we're gonna get you
725
00:30:14,887 --> 00:30:16,555
scheduled for surgery.
726
00:30:16,589 --> 00:30:18,690
And then you can schedule me.
727
00:30:18,725 --> 00:30:20,125
I'm sorry?
728
00:30:20,159 --> 00:30:21,593
I'm going through with the donation.
729
00:30:21,628 --> 00:30:22,527
Candace...
730
00:30:22,562 --> 00:30:23,895
I can't let this fall apart.
731
00:30:23,930 --> 00:30:24,997
It's not your responsibility.
732
00:30:25,031 --> 00:30:25,964
Of course it is.
733
00:30:25,999 --> 00:30:28,367
Those people are us, Bill.
734
00:30:28,401 --> 00:30:30,168
We know the fear they're living with,
735
00:30:30,203 --> 00:30:31,937
how it's crippling their lives.
736
00:30:31,971 --> 00:30:33,071
I can help.
737
00:30:33,106 --> 00:30:36,108
And I'm going to.
738
00:30:36,142 --> 00:30:37,142
All right, listen.
739
00:30:37,176 --> 00:30:39,945
There are no bad decisions here.
740
00:30:39,979 --> 00:30:41,647
You can take the kidney
from UNOS, and if you
741
00:30:41,681 --> 00:30:43,649
stayed on the chain,
four lives will be saved.
742
00:30:43,683 --> 00:30:46,184
But if I stay in the chain
and UNOS offers the kidney
743
00:30:46,219 --> 00:30:47,653
to the next person on the list...
744
00:30:47,687 --> 00:30:49,788
Five lives will be saved.
745
00:30:52,692 --> 00:30:54,393
Let's do it.
746
00:30:54,427 --> 00:30:57,596
Let's stay with the Daisy chain.
747
00:30:57,630 --> 00:31:01,133
Okay. Okay.
748
00:31:01,167 --> 00:31:02,768
So no tumor.
749
00:31:02,802 --> 00:31:04,636
Pancreas looks clean.
750
00:31:04,671 --> 00:31:06,305
Did you go over her chart again?
751
00:31:06,339 --> 00:31:07,539
She wasn't given any medication
752
00:31:07,573 --> 00:31:09,007
that would account for her Insulin spike.
753
00:31:09,042 --> 00:31:12,244
All right, so let's go back a few days.
754
00:31:12,278 --> 00:31:14,212
Let's say somebody did slip her digoxin.
755
00:31:14,247 --> 00:31:17,382
She gets dizzy, she
wipes out on her bike.
756
00:31:17,417 --> 00:31:20,886
That causes a bleed, which later
on takes her down in the pool.
757
00:31:20,920 --> 00:31:24,222
Then she comes to us
and we fix her up.
758
00:31:24,257 --> 00:31:26,391
Then she crashes again because
of high Insulin levels.
759
00:31:26,426 --> 00:31:28,827
So she recovers from the digoxin
760
00:31:28,861 --> 00:31:31,430
and someone shows up here
and juices her with Insulin?
761
00:31:31,464 --> 00:31:33,165
It's a pretty ballsy move, right?
762
00:31:34,634 --> 00:31:35,867
All right, so who's been here?
763
00:31:35,902 --> 00:31:37,769
Who's come to see her?
764
00:31:37,804 --> 00:31:40,172
Hmm.
765
00:31:40,206 --> 00:31:42,974
Her friend Jeni, the fiancé, the boss.
766
00:31:43,009 --> 00:31:45,277
They all have biochem training.
767
00:31:45,311 --> 00:31:48,380
And they all have the medical
knowledge to pull this off.
768
00:31:48,414 --> 00:31:50,015
They could have given
her an injection,
769
00:31:50,049 --> 00:31:52,384
they could've shot it
straight into her I.V.
770
00:31:52,418 --> 00:31:53,719
Yeah, but Penelope was awake.
771
00:31:53,753 --> 00:31:56,254
She would've noticed it.
772
00:31:56,289 --> 00:31:59,725
There's inhalable Insulin now, right?
773
00:31:59,759 --> 00:32:01,893
Yeah. Comes in little cartridges.
774
00:32:01,928 --> 00:32:02,928
Why?
775
00:32:02,962 --> 00:32:05,163
Because right after Penelope got here,
776
00:32:05,198 --> 00:32:07,332
her friend Jeni brought her an inhaler.
777
00:32:27,053 --> 00:32:28,186
Dr. Yablonski!
778
00:32:30,123 --> 00:32:32,958
You're never gonna believe this.
779
00:32:35,862 --> 00:32:37,496
Who's winning?
780
00:32:37,530 --> 00:32:39,264
My mom.
The woman's a shark.
781
00:32:39,298 --> 00:32:41,133
I mean, she seems
all sweet and everything,
782
00:32:41,167 --> 00:32:43,201
but she's beating me like a drum.
783
00:32:43,236 --> 00:32:46,338
Well, I got some good news.
784
00:32:46,372 --> 00:32:47,839
You've been offered a heart.
785
00:32:47,874 --> 00:32:50,575
Like, now?
786
00:32:50,610 --> 00:32:51,977
Yeah, like, right now.
787
00:32:52,011 --> 00:32:53,145
With your permission, I'm gonna send
788
00:32:53,179 --> 00:32:54,546
a team to Scranton
to procure the heart.
789
00:32:54,580 --> 00:32:56,314
They should be back in a few hours.
790
00:32:56,349 --> 00:32:59,351
In the meantime, we'll get you
prepped for surgery.
791
00:32:59,385 --> 00:33:02,320
When you wake up,
you'll have a new heart.
792
00:33:02,355 --> 00:33:05,657
Seems like we've had
this conversation before.
793
00:33:05,691 --> 00:33:08,226
Yeah, well, with any luck,
we won't have to have it again.
794
00:33:10,696 --> 00:33:12,731
You think it's going
to work this time?
795
00:33:12,765 --> 00:33:15,734
Dude, I thought it was going
to work the last time.
796
00:33:20,006 --> 00:33:22,808
If it was just up to me,
797
00:33:22,842 --> 00:33:24,910
I'd probably let nature run its course.
798
00:33:24,944 --> 00:33:28,613
But then I think about my folks.
799
00:33:30,850 --> 00:33:32,217
It's been a good year.
800
00:33:32,251 --> 00:33:34,453
Let's go get a few more.
801
00:33:34,487 --> 00:33:36,087
Hey.
802
00:33:37,123 --> 00:33:38,723
All right?
Thank you.
803
00:33:39,592 --> 00:33:41,760
I'll be back.
804
00:34:21,000 --> 00:34:25,637
♪ Lay down my head
by the wayside ♪
805
00:34:25,671 --> 00:34:30,408
♪ my worn out shoes ♪
806
00:34:30,443 --> 00:34:35,213
♪ quite why she went
I can't decide ♪
807
00:34:35,248 --> 00:34:39,985
♪ yeah, but I sure could use ♪
808
00:34:40,019 --> 00:34:44,823
♪ one plate of food
steaming and hot ♪
809
00:34:44,857 --> 00:34:49,628
♪ clean linen ironed ♪
810
00:34:49,662 --> 00:34:54,432
♪ on a fresh made bed,
but I ain't got ♪
811
00:34:54,467 --> 00:34:57,335
♪ one salty dime ♪
812
00:34:59,105 --> 00:35:02,641
♪ one salty dime ♪
813
00:35:11,183 --> 00:35:15,887
♪ just close your eyes,
it won't take long ♪
814
00:35:15,922 --> 00:35:19,958
♪ it won't hurt a bit... ♪
815
00:35:19,992 --> 00:35:23,595
I'm sure Mr. Dula would want
you to do the honors.
816
00:35:23,629 --> 00:35:25,363
♪ Telling myself
I could be strong ♪
817
00:35:25,398 --> 00:35:28,700
♪ or some such brave ... ♪
818
00:35:30,436 --> 00:35:35,106
♪ trucks are roaring by,
I'm a red ghost ♪
819
00:35:35,141 --> 00:35:39,711
♪ in their taillight gleam ♪
820
00:35:39,745 --> 00:35:44,683
♪ I'm a tumbleweed,
I'm a spit roast ♪
821
00:35:44,717 --> 00:35:49,888
♪ just turning in your flame ♪
822
00:35:49,922 --> 00:35:53,725
♪ oh, my darling Kathleen. ♪
823
00:36:06,706 --> 00:36:08,707
How we doing?
824
00:36:08,741 --> 00:36:10,475
Can't stop staring at her.
825
00:36:10,509 --> 00:36:14,713
I'm just so relieved she's okay.
826
00:36:14,747 --> 00:36:17,148
Was it really Jeni who did this?
827
00:36:17,183 --> 00:36:19,951
The police found digoxin
and vials of inhalable Insulin
828
00:36:19,986 --> 00:36:21,486
in Jeni's apartment.
829
00:36:22,421 --> 00:36:24,189
But why?
830
00:36:24,223 --> 00:36:26,524
Penny, she was always
jealous of you.
831
00:36:26,559 --> 00:36:30,228
She blamed you when she
got passed over for tenure.
832
00:36:30,262 --> 00:36:34,599
She thought if you weren't
there, she'd get the job.
833
00:36:34,667 --> 00:36:36,301
So she was poisoning me at work?
834
00:36:36,335 --> 00:36:38,603
Putting digoxin in her coffee.
835
00:36:38,638 --> 00:36:41,272
Once you were hospitalized
and being monitored,
836
00:36:41,307 --> 00:36:43,508
she switched to a different poison
837
00:36:43,542 --> 00:36:44,876
and hid it in your inhaler.
838
00:36:44,910 --> 00:36:46,578
All of this over tenure?
839
00:36:46,612 --> 00:36:47,779
Yeah.
840
00:36:47,813 --> 00:36:50,448
You may want to rethink
your career in academia.
841
00:36:50,483 --> 00:36:51,983
Go with something a little safer,
842
00:36:52,018 --> 00:36:53,451
like lion taming.
843
00:36:56,656 --> 00:36:59,157
How are my two favorite patients?
844
00:36:59,191 --> 00:37:01,660
I kind of feel like
I got run over by a truck.
845
00:37:01,694 --> 00:37:03,294
After it ran over me.
846
00:37:03,329 --> 00:37:05,597
But I've never felt better.
847
00:37:05,631 --> 00:37:07,332
Me, too.
848
00:37:07,366 --> 00:37:09,901
We got a couple of days in bed,
we got a TV,
849
00:37:09,935 --> 00:37:11,736
food coming to us three times a day.
850
00:37:11,771 --> 00:37:15,140
Well, I have to say, what you did--
851
00:37:15,174 --> 00:37:19,210
what you both did--
was just remarkable.
852
00:37:19,245 --> 00:37:20,512
Thank you.
853
00:37:20,546 --> 00:37:23,181
No, no.
Thank you.
854
00:37:23,215 --> 00:37:24,449
For the opportunity.
855
00:37:24,483 --> 00:37:25,583
It's probably the best thing
we'll ever do.
856
00:37:25,618 --> 00:37:26,785
Well, listen. Do me a favor.
857
00:37:26,819 --> 00:37:28,219
I want you to take it
easy with the running.
858
00:37:28,254 --> 00:37:30,121
Oh, don't you worry.
859
00:37:30,156 --> 00:37:32,357
From now on, he only runs
when something's chasing him.
860
00:37:33,826 --> 00:37:36,394
I'll check in on you later.
861
00:38:05,257 --> 00:38:07,459
♪ ♪
862
00:38:11,697 --> 00:38:15,500
Okay, the new heart is in.
863
00:38:15,534 --> 00:38:18,570
Suturing.
864
00:38:29,215 --> 00:38:31,116
Cut here, please, nurse.
865
00:38:32,184 --> 00:38:34,719
Excellent. Excellent. Looks great.
866
00:38:34,754 --> 00:38:37,255
Okay, cross-clamp coming off.
867
00:38:45,164 --> 00:38:46,931
Kind of weak beats.
868
00:38:46,966 --> 00:38:49,033
Look, it's changing color.
869
00:38:49,068 --> 00:38:51,603
It's hyperacute rejection syndrome.
870
00:38:51,637 --> 00:38:53,238
He's in trouble!
V-fib!
871
00:38:53,272 --> 00:38:54,906
Charge to 25.
872
00:38:54,940 --> 00:38:57,408
Amp of epi.
Milrinone .5 Mikes per kilo.
873
00:39:00,446 --> 00:39:01,846
Still in fib!
874
00:39:01,881 --> 00:39:02,947
Recharge. Recharge.
875
00:39:02,982 --> 00:39:05,049
Amiodarone 150 IV push.
876
00:39:05,084 --> 00:39:07,519
This heart's not going to work.
Prime the heart/lung.
877
00:39:07,553 --> 00:39:09,387
We're never going to get him
off bypass.
878
00:39:09,421 --> 00:39:10,655
Hurry up and prime that machine!
879
00:39:10,689 --> 00:39:12,090
We're going to have
to anticoagulate.
880
00:39:12,124 --> 00:39:14,626
5000 units heparin.
Charge again! Charge again!
881
00:39:14,660 --> 00:39:16,361
Thirty!
882
00:39:16,395 --> 00:39:18,763
Prime that machine!
883
00:39:18,798 --> 00:39:20,365
Damn it!
Charge to 40.
884
00:39:20,399 --> 00:39:21,633
We're going to defibrillate again.
885
00:39:21,667 --> 00:39:23,802
Here we go.
886
00:39:50,095 --> 00:39:52,530
Oh, no.
887
00:39:52,565 --> 00:39:54,966
Oh, no. No.
888
00:39:55,000 --> 00:39:57,202
Oh, no!
889
00:40:26,332 --> 00:40:30,401
It's times like these when you
wish hospitals served alcohol.
890
00:40:33,405 --> 00:40:36,474
I have a department meeting
in three hours.
891
00:40:49,922 --> 00:40:52,090
I've lost patients before.
892
00:40:55,361 --> 00:40:57,462
You can't do this work
and not lose patients.
893
00:40:57,496 --> 00:40:59,731
I mean, they're all
so close to death.
894
00:41:03,035 --> 00:41:04,335
But Scott...
895
00:41:06,972 --> 00:41:10,275
he was turning it all around.
896
00:41:10,309 --> 00:41:14,712
He was turning it all around,
but he didn't get enough time.
897
00:41:19,251 --> 00:41:22,887
It makes me want to walk away
and never do this work again.
898
00:41:43,309 --> 00:41:45,476
You should get some rest
before your meeting.
899
00:42:11,771 --> 00:42:15,903
-- sync, corrected by elderman --
-- for www.addic7ed.Com --
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