All language subtitles for The.Resident.S02E13.WEBRip.x264-ION10

Scrub in with The Resident.

This is a business.
It's not a charity.

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-Previously on The Resident...
-No pulse.

The strut in the valve
is shattered.

Seven QuoVadis heart valves.

I want to put them
through the pulse duplicator.

The valves aren't strong enough

for a younger, active patient.

Mark Truscott, FDA,
Product Regulation.

I know that my firm is engaged
in a wide-ranging fraud.

You are not a team player.

My sister, she OD'd on Oxy.

You almost died today, Jess.

You got to start making
better choices.

So let's start now.

-Go home!
-I can't.

Priya's there.

No wife and no home.

Now, use your ears
as well as your eyes.

You're more likely to hear
a bird before you see it.

Listen for the call
of a cerulean warbler.

I saw one the last time
I brought a group to this spot.

Most handsome
little blue fell...

Hello, juvenile blue heron.

And perhaps a wood duck as well.

Swerved right off
the road there.

Ran the plates.

Belong to a Julian Booth.

Open it up.

Car's empty.

Let's see if search and rescue
can find a body.

Did you check the perimeter?

Okay, one more thing.

Last question, I promise.
Hoop or stud?

Stud, hoop?

You pick.
They're both great.

You nervous?

My first job interview
since rehab?

Yeah.

I have your prep material.

Partner CVs and briefs

on high-profile cases
and clients at the firm.

And what they're looking for
in a paralegal.

Five hours till go time.

Thank you so much
for putting that together, Nic.

It's my pleasure.
This is exciting, Jess.

This could be the beginning
of a whole new life for you.

-Call me when it's done.
-I will. Yeah.

-Good luck.
-Bye, thanks.

You need to pull
all QuoVadis valves now.

Because of one resident's
science experiment?

The valves worked fine when
simulated for older patients,

but when I mimicked the blood
flow of active younger ones...

-Like Bradley.
-...they shattered like glass.

Look, it's very clear
that a defective QuoVadis valve

killed Bradley, not these hands.

Well, your mentor, Abe Benedict,
swears by them.

-Explain that.
-Easy.

He's on the QuoVadis payroll.

-What are you talking about?
-ProPublica.

It's a site you need
to make your home page, Bell.

They have a feature called
Dollars for Docs.

It lists every dime
every doctor takes

from medical device companies.

Every dime to every doctor.

Well, that-that...
that proves nothing.

Billions of dollars are given to
doctors every year by industry.

It's standard practice.

QuoVadis paid Dr. Benedict
a small fortune

to push products
that kill people.

Look, I know,
as a fellow surgeon,

you are not gonna stand around
and allow our doctors

to use products
that cause harm to our patients.

Okay, well, uh,
here's how I want to proceed.

I-I want to take you off
all high-risk procedures.

-High-risk procedures
are my thing, Bell.
-I understand,

but if you want to prove
it's the valve

that caused Bradley's death,

you need to keep
your record clean.

You need to take
the easy layups,

the bread and butter procedures.

And while I do that?

You have my word
I will look into this.

Here is your skinny latte.

Get me a meeting with Gordon
Page. Tell him it's urgent.

So?

What's so urgent that it
required a face-to-face meeting?

I received
some information today

suggesting your heart valve
may be defective.

Wh-What information? From where?

Well, one of our doctors
tested the valve,

and they're convinced
you have a significant problem.

It may cause sudden death.

Look, this is absurd.

-We do all our own testing.
-Right.

Have you done follow-ups
on patients

that have received
QuoVadis valves?

What's the mortality rate
at six months or a year?

Naturally, some of them die

due to underlying diseases
or surgical errors.

Well, and some
device manufacturers

use that fact
to hide device problems.

Is that what you're implying?

No, I'm-I'm-- no.
I'm not implying anything,

but I want to see data
on the safety of the valves.

And if it doesn't exist,

QuoVadis has to pull them
from the market.

I'm sorry, are you, are you
asking me to issue a recall

during the run up to our IPO?

Oh, yeah, while you do
more testing. Yes, yes.

Okay. Yeah, um, okay. I've heard

just about enough of this.

You can't tell me
how to run my business.

Who the hell
do you think you are?

You came to me
desperate for money,

so I made you an opinion leader.

I put you on my board.

I arranged speaking fees

to get you out of whatever
trouble you were in.

And I'm grateful.

I asked no questions.
I asked nothing in return

except for loyalty to me.

And to our product.

Ugh, this is an extremely
disappointing conversation.

I made an investment in you.

Earn it.

Hey, Jess.
What are you doing here?

Okay, all right, be honest:
do I look like a paralegal?

Right? It's just an interview
at this point,

but thank you. Wish me luck.

Good luck.

Hey, I got your text. What's up?

I just, I changed outfits
and I wanted to show you.

This, this is better, right?

What do you think?
It's-it's softer.

It's more approachable.

Well, yeah, I like it
'cause it's mine,

which you borrowed
without asking.

What are you doing?
You're supposed to be

at your interview.

Oh, yes, and I missed the bus.
Can I borrow 20 bucks for a cab?

-I'll pay you back. I promise.
-Yes, hurry up.

I'm sorry.
You're the best sister ever.

-I love you. Okay?
-Got it.

I'll call you after.

Hey.

She's very... happy.

What's that supposed to mean?

Opioids can cause euphoria.

I-Is Jessie being tested?

Unbelievable.

First, I'm codependent,
now I'm not doing enough.

Conrad, Jessie's fine.

We're actually
in a really good place.

Okay.

Take a deep breath.

Our time on this earth begins
and ends with a heartbeat.

It is the first sign of life
within the womb,

and it is the last organ
to stop functioning in death.

The best part is feeling
like you're actually there.

Is it the seat of our emotions?
No.

-Do I want you to be...
-Virtual reality lets me attend

all my med school classes
and practice virtual surgeries.

But I do miss seeing patients.

Eh, new lungs could
change all that.

You would finish
your fourth year of med school,

maybe even come here
as an intern.

I can't think
of anything more amazing.

Yeah, all right.
Here we go, here we go.

Take a big breath.
Blow it out forcefully, sweetie.

Conrad, these are
Eloise's parents.

Florence and Dan Camden,
this is Dr. Hawkins.

-Hello.
-I've asked him
to do a complete workup.

Before we can move forward,
we need to be certain Eloise

is still healthy enough
for a double lung transplant.

We heard the donor is already
here at Chastain.

Can I ask who she is?

She's a young woman

who died of an opioid overdose.

That's awful.

I'm sorry.
And here I am, so happy.

Oh, it's okay.

You can have sympathy for
the donor and still be grateful.

Because the donor was an addict,

there is a very small risk
of complications,

but don't worry, the organs

have been through testing
to ensure they're safe.

When we thought a donor
might not come through,

Dan and I were tested.

We're both a match

and we can each supply
a lobe of our own lungs.

-Would that be better?
Mom, we've been through this.

That would put
both of your lives at risk.

I've lived with CF
all of my life.

50 pills a day,
hours of breathing treatments.

Dad works three jobs to pay
for all my medical bills.

Mom has had
to take care of me 24/7.

Uh-- they have suffered enough.

The donor lungs are going
to work, I'm sure of it.

As you can no doubt tell,
this case is personal to me.

I've been Eloise's med school
mentor since her first year.

Oh, she's frail, Kit.

-I hope we're not too late.
-I know.

Without new lungs,
she won't live another year.

And that would break my heart.

They found Julian's car.

We now go live to the scene
of a breaking story.

Earlier this morning
birdwatchers stumbled

across a car submerged in water.

It's registered
to a local woman, Julian Booth,

who's been missing
for some time.

Dive teams are now looking
for a body.

Hey, Conrad, what's up?

They found Julian's car.

Where?

Pulled it out
of the Chattahoochee River.

Did they find her body?

Still searching.

Devon,

she could have made it out of
the car. Until we know more...

Then where is she?

-Why haven't I heard from her?
-Look,

no matter what happens,
we're all here for you.

Whatever you need.

Thanks for the call.

How long have you been
in the hospital?

Three weeks.

I know you're scared,
but you're not alone.

Look... that's me.

I was diagnosed
with cystic fibrosis

when I was six weeks old.

I need a new heart.

I heard. The nurses told me.

I need new lungs.

The doctors are gonna
help us both.

Eloise.

Hi, guys.

This is Jeannie.

Hello, Jeannie.

Can we borrow Eloise
for a few minutes?

Sure.

-Will you come back?
-Absolutely.

Let's take the limo, shall we?

Where to?

Your room.

Your parents want to hear
what we have to say.

I think, somehow, I'm going to
need more oxygen to handle this.

I don't like the look
on your faces.

We have the results
of the tests.

Unfortunately, your
previous labs have worsened.

You now have extremely
elevated liver enzymes,

clotting factors,
and blood sugar levels.

Okay, I've been in med school
long enough

to know what that means.

I'm no longer eligible
for a lung transplant.

Usually, that would be the case,

but we've found
a potential solution.

A lung, liver and pancreas
transplant.

A triple transplant?

How did this happen?

Eloise's cystic fibrosis
has caused liver failure

and pancreatic insufficiency, on
top of her respiratory failure.

A triple transplant...
sounds impossible.

It's dangerous, rare,
but not impossible.

This operation has been done
successfully before.

How many times?

Once, in Canada.

Without this surgery,
how long do I have?

Not long, Eloise.

Weeks?

Maybe a little bit more.

-It's okay.

-This isn't over.

We know what we have to do.

Can we get all three organs
from the donor we already have?

Yes.

Now, we just have to convince
the ethics committee.

Kit?

Come here.

You okay?

No.

This is awful.

I put a brave face on it
for the family.

Oh, but, my God, Conrad.

Where in the world are we gonna
find a surgeon

crazy enough to even
take this on?

A triple transplant?

Dr. Austin can't do it.
Bell assigned him

to low-risk surgeries.

We've been doing stents
all morning.

And you know
I am royally sick of it.

This quarterback is coming
off the bench.

There's no way.

Please, Randolph, as a friend,
just hear me out.

This is deeply important to me.

It's bad for Austin.
It's bad for Chastain.

I mean, I mean,
it looks like a--

just a crazy publicity stunt,

and the ethics committee
will never allow it.

You chair the committee, you can
persuade them. I'll help.

-We can double-team them.
-Kit, I'm-I'm sorry.

I--
It's-it's out of the question.

You go ahead and try
if you'd like.

But I-- I can't help you
on this one.

Mr. and Mrs. Basilico?

How are you doing?

Nicolette Nevin. Aw...

Jessie's older sister.
Do you remember, Eric?

Of course.
You had blue hair.

I did. Teen years.
How's Letty?

Maybe you'd like to see her.

She's gone, Nic.

Multiple doctors confirmed.

They're keeping her on the vent

because she wanted to be
an organ donor.

Apparently, she's donating
to a young woman here.

What happened?

Opioid overdose.

She's struggled with addiction

since her senior year
in high school.

I know that Letty tore her ACL
at the state championship.

Yeah, and her doctor
gave her Oxy.

They were handing it out
to everybody.

I know.

She never really got sober,

although we thought she did.

I really thought
she'd make it this time.

I didn't see any signs
she was using.

I did.

She wasn't eating much,
she'd lost weight.

Her moods were
all over the place.

She'd be anxious, on edge,

and then she'd be up, so up.

Why didn't you say anything?

I didn't want to see it.

What are you doing?

What'd you do with the money
I gave you, Jess?

I told you, I used it for a cab.

You're lying.

Did you even go
to that job interview?

So what if I didn't?
Whole thing was your idea.

I don't want to be a paralegal.

Stop going through my stuff,
Nic. Hey, quit it!

Quit lying to me!
I know you're using.

-God, I've been so stupid.
-You are insane.

You know that?
Completely insane.

I am not the problem here,
you are.

Hey! Give me that,
you controlling bitch!

Okay, I know what you think,
but it's not true, okay?

I-I keep these
in case I need them.

Stop. Just stop!

There is a huge amount
of pressure on me.

And you are in my face
day and night.

So, yes, I-I took a few.
Sometimes, okay?

Be-Because of you!
Y-You are driving me crazy!

This is my fault?

Unbelievable. Yeah, it's always
my fault with you, Jessie, huh?

Oh, poor little Nic.
Always a victim.

Jessie-- Jessie, stop.
Listen to me.

You are using,
and you are in trouble.

Remember your friend Letty
from high school?

She's at Chastain, Jess.

She's dead because she OD'd.

I don't want that to be you.

-No.
-It's true.

Come with me to Chastain.
I'll show you.

I don't believe you.

Fine. Fine.

Either way, pack your bags,

'cause you're going to rehab.

I'm not going anywhere.

Then get out.

Get out.

I'm done, Jess.

I'm done trying to save you.
I'm done enabling.

I'm done worrying.

That's enough.

And if you die...
I won't feel guilty...

'cause I gave you every chance.

So, here, you want your pills?

You need them that bad?
Take 'em.

Take 'em, Jess.

I can't stop you
from killing yourself

if that's what you want.

When I come home,
I don't want to find you here.

-Can I help you?
-Yeah, I'm a friend of Julian's.

Tell her she's a week
behind on her rent.

She's not returning my calls.

Um, when was the last time
you saw her?

I don't know. Over a week.

She left the cat all alone.

I've been feeding it,
but it's driving me crazy.

I bet.

That's actually why I'm here.

Julian asked me
to come pick up the cat, but

I forgot her key.

If you let me in,
I can take the cat home with me.

Here's the key.

Thank you.

All set.

-Thank you.

Hey.

Come on.

This, my friends, is
what you call a paracentesis.

It's pretty gross.
Look left, and you can see

Dr. Hawkins is removing fluid
that's collected in my abdomen.

You don't have
to stream this, Eloise.

People want
to know how I'm doing.

I've live-streamed all
my procedures for the last year

to med students and
the cystic fibrosis community.

As you can see,
my belly is shrinking.

Maybe I'll finally get some abs.

It also means that
I'm in severe liver failure.

I came in thinking
I was getting some lungs.

Now, we've learned that I need
a new liver and pancreas.

So, I will have a triple
transplant and make history.

Okay. Feel better?

-Yeah. Thank you, Dr. Hawkins.
-My pleasure.

Oh.

Dr. Austin and Dr. Okafor
are gonna be your surgeons.

Wow. We are honored.

It's Dr. AJ Austin in the flesh!

I love your lectures.

Thank you.

"Our time on this earth

begins and ends..."

And ends with a heartbeat.

Hi, Eloise.

I have a consent form
for you to read.

After the surgery, you'll be
on dozens of new drugs.

I'm sure you have concerns
about rejection and...

I may have a chest tube,
breathing tube, feeding tubes,

Foley catheter, and central line
for weeks, maybe months.

But I've got a life to live.

-I just have one question.

Can we livestream my surgery
to med students?

Not the best idea,

under these circumstances.

But... since it's so rare,

whether I live or die, isn't
there a lot to learn from this?

Tell you what.

We'll talk to the bigwigs.

And for the record...
I'm cool with it.

Okay.

Hang tight.
We're getting close.

Just one more hurdle left
to cross: the ethics committee.

Look, we can keep going

around and around
about this all day,

but the problem is,

two lungs, a liver,
and a pancreas

could go to four people
instead of just one,

all of whom have a far better
chance of survival.

This is an exceptional person.

She's a top medical student
who'll make a great doctor.

We understand how you feel.

But all of our patients
are equally deserving.

Of course they are.

And the other candidates
will get organs, too,

just not from this donor.
They'll have to wait

a little longer, but
they'll still be next in line.

You're talking about
a five percent success rate.

These odds may be long,
but they are not impossible.

And it doesn't account
for variables,

-like the skill of the surgeons.
-Eloise started a nonprofit

to empower children
with disabilities.

She works for access
to medications

for those who can't afford them.

She's touched so many lives.

Dr. Bell, we're deadlocked.

This is up to you,

and you are worried
if this doesn't succeed,

it will be a blow
to Chastain's reputation.

But no matter what,
we advance science

and we open new possibilities
for thousands in the future

who could benefit
from this kind of surgery.

We can't just give up
and say it's too difficult.

It will never be possible
if we don't try.

I remember a surgeon

who took on
the toughest surgeries

in the state of Georgia.

Who gave hope
to people who had none.

Who had no fear.

He would have jumped
at the chance

to advance the science
and make medical history.

We are taking
a really big risk here.

But we are gonna try
to save this life.

No second chance
when it comes to

a Donation after Cardiac Death.
When that heart stops,

those organs stop getting
perfused with blood

and quickly become unusable.

When we hit that OR, we got to
be lightning fast to save them.

I thought no surgery
could scare me anymore,

but my heart is
in my throat this time.

Letty's heart has stopped.

All right, let's get
this show on the road.

No, not so fast.

We still have the five-minute
buffer to make sure

-the heart's actually stopped.
-I think Dr. Austin

is aware of the IOM guidelines.

Just a reminder
to do the right thing.

Let's dance.

Luckily, the Raptor's fearless.

Thank God.
We need his courage.

-Sternal saw.
-10 blade.

Catheter.

Cannulate.

Preservation fluids.

Fast and furious, baby.

Checking the liver...

and the pancreas.

They both look viable. Yours?

Lungs are not viable.

There's black discoloration.
A rare complication.

The nodules must not have been
detected during imaging.

We can't use these lungs.

We're done.

Remove the liver and pancreas.

Put them on ice.

There's another option.

This can't be over
before it starts.

It's not.
You've already been established

as lung donor matches.

We are gonna use a lobe of lung
from each of you

and the liver and pancreas
we just procured.

-If you agree.
-Of course,

but she'll only have
two lobes of lung.

All she needs
is two lobes of lung.

And they will expand over time.

Better than her diseased ones.

Much better
than her diseased ones.

But they haven't been prepped
for surgery.

They haven't fasted, they could
aspirate when they go under.

Anesthesia can do
a rapid sequence intubation

to limit the risk of aspiration.

Let's get you both to pre-op.

If we don't move forward,

we may never have
another opportunity like this.

You're our daughter, Elo.

The board has agreed
to livestream the surgery,

but only to Eloise's
med school classmates,

-just a limited feed.
-Like she said,

no matter what, it will be
a great learning tool.

This just went
from an incredible long shot

to virtually impossible.

Well, then,
we'd better work a miracle.

There's an entire family
in there counting on us.

Hey, I'm on call for thoracic.

Said you guys could use a hand.

Welcome to the team, bro.

Diseased liver
and pancreas removed.

So far, so good.

Donor liver and pancreas,
ready for implantation.

Mom and Dad are stable.

Here we go.

How many people
are watching this?

Not many.

Probably just the gunners.

They're finishing
the liver and pancreas.

We need the right lower lobe
of lung.

The lobe's harder to remove
than we expected.

Mom has some adhesions
to the chest wall. Stapler.

Transecting
the segmental branches

off the pulmonary artery.

Get Dr. Austin. Now!

One order of lung to go.

-Mom's crashing. They need you.
-Get this to Okafor

and Bell to implant.

Page Dr. Weiss,
tell her to come close up.

Have we activated
massive transfusion protocol?

Yes. I've been trying
to repair the pulmonary artery,

but the damage is extensive.

Artery forceps to me.

Dr. Austin needs you
to implant the lung.

-Where's Dr. Austin?
-He's helping with the mom.

-She's bleeding out.
-What?

You stay. I'll go.

What's happening?

It's impossible to see anything.

We need to convert to open.

10 blade.

Retractor to Bell.

Put your finger
on that proximal P.A.

Getting the lung
out of the field

will give us a better view.

Looks like the lobe got damaged.

Implant the lung with Mina.
I'll fix the bleed.

3-0 Prolene.

On my mark, let go
and I'll sew this up.

-You ready?
-Yeah.

Go.

Suction. Lap.

Had to check on a patient.

-How we doing?
-Florence lost a lot of blood.

-They're working to save her.
-Eloise?

They're putting in Florence's
right lower lobe now,

but it may be damaged.

Eloise can't live
with only one lobe.

Dad's lobe on the left
looks good.

Mom's lobe on the right shows
some contusions.

Let's hope this works.

Dr. Chu, get the Ambu bag.

Pack up

Inflating the lungs.

I'm straight...

The moment of truth.

Oh, say, say, say

Oh, say,
say, say

Oh, say, say, say...

Again.

They don't love you
like I love you

Wait, they don't love you...

Again.

I'm getting a lot of resistance.

-Is something wrong
with the tube?
-CHU: No, no, I checked.

Maybe it's reperfusion injury.

Wait, they don't love you
like I love you...

-We should check her airway.
-All you.

Made off

Don't stray

My kind's your kind

I'll stay the same

Pack up

Don't stray...

Plug at the carina.

Say, say, oh, say, say...

Got it, try again.

Wait

They don't love you
like I love you...

Fingers crossed.

They don't love you
like I love you

Maps

Wait

They don't love you
like I love you, wait

Wait

They don't love you
like I love you

Maps

Wait, they don't love you
like I love you

Wait, they don't
love you like I love you

Wait

They don't love you
like I love you...

Mom's not out of the woods yet.

You go, I'll close.

Wait

Pack up

Don't stray

Enough.

-How do you feel?

Like I was just born.

Like I'm the luckiest person
in the world.

It's never been like this, ever,

just breathing.

My parents?

Hey, Elo.

Your dad's procedure went great.

Your mom...

There were some complications
with the pulmonary artery.

It can happen in difficult
surgeries like this.

-Recovery's not gonna be easy.
-MINA: But...

we believe she can make it.

Oh... Mom.

Mom, I'm here.

Right here, where you've
always been: beside me,

helping me.

Mom, can you hear me?

You're famous.

Just think how much more
insufferable you'll be.

I wouldn't count on it.

I have recently dined
on humble pie,

and it's a flavor
I will not soon forget.

That surgery was insane.

I mean, we're all proud
of the work we did

and are happy for Eloise
and her family,

but that could have ended
very badly.

A triple tragedy.

Skill certainly played
a large part, but so did luck.

-It was practically a miracle.

Check it out. Our next surgery.

What are you gonna do?

Uh,are going
to perform a flawless

aortic valve replacement.

-With a QuoVadis valve?
-A-A QuoVadis valve? Excuse me?

There are no QuoVadis valves
on Chastain shelves.

-Are you telling me...

-Bell pulled them?

Every last one.

We've got the old reliable
valves back for good.

-Well, today is
truly miraculous.
-Mm.

Bell, of all people,
did the right thing.

You pulled the valves.
Are you insane?

It was the right thing to do.

And I believe, eventually,
you'll agree with my decision.

This is way out of line.

Obviously,
there will be consequences.

You'll regret this, Dr. Bell.

Long day.

A great day.

I'm leaving, Dr. B. Uh, don't
forget you have that dinner

with the CEO
of Atlanta General at 8:00.

I canceled it. I have surgery.

Ah, that's a nice change.

See you tomorrow, boss.

To you.

Thank you for what you did.

Thank you.

Allow me.

It's a good look.

-Yeah, I just had it pressed.

You've reached Mark Truscott,

Director of the Center
of Devices at the FDA.

Leave a message.

You broke into Julian's place?

Not exactly.

The landlady let me in
to get Julian's cat.

Don't ask.

-And you just took
her phone bill.
-Yes.

Look at the last number
that Julian called.

On the 3rd,
the day I saw her in the park.

The day she disappeared.

I tried the number
about an hour ago

and I got an answering machine.

It was an office at the FDA.

Julian was a device rep.

She probably called them
all the time.

Or maybe she found something out

and she was trying
to blow the whistle.

Look, you said it yourself.

Bradley died because
of a defective valve.

He was my best friend.

Did QuoVadis know
the valve was bad?

If so, they killed him.

Julian told me that something
was wrong at work.

She felt like
everything was falling apart.

What do you think she meant?

I think she was in danger.

Did they kill her?
Did she run away?

I don't know.

Something is up with QuoVadis.

Let's figure out
what to do next.

All my worlds

And fault.

Captioned by
Media Access Group at WGBH