1
00:00:01,055 --> 00:00:02,656
Your primary doctor is right.
2
00:00:02,680 --> 00:00:04,447
The mass is on the smaller side.
3
00:00:04,515 --> 00:00:06,082
We'll confirm with the new images,
4
00:00:06,150 --> 00:00:07,917
but it should be
manageable with medication.
5
00:00:07,985 --> 00:00:09,786
No surgery needed.
6
00:00:09,854 --> 00:00:12,956
Well, my fiance will be so relieved.
7
00:00:13,024 --> 00:00:15,058
He's been worried I'll look like
Frankenstein in all our photos.
8
00:00:15,926 --> 00:00:17,705
Also that I might die.
9
00:00:17,828 --> 00:00:19,190
When's the big day?
10
00:00:19,597 --> 00:00:21,097
June.
11
00:00:21,165 --> 00:00:22,732
You've been dealing
with wedding planning
12
00:00:22,800 --> 00:00:24,904
on top of a pituitary tumor?
13
00:00:25,803 --> 00:00:27,137
You deserve a medal.
14
00:00:27,204 --> 00:00:29,139
Our medical record system,
on the other hand,
15
00:00:29,206 --> 00:00:31,369
it has you listed as female.
16
00:00:32,176 --> 00:00:33,910
Probably because of the Pap smears.
17
00:00:33,978 --> 00:00:36,813
Software clearly needs a
trans update. Deep breath.
18
00:00:36,881 --> 00:00:38,329
I'll fix it so everything is correct
19
00:00:38,353 --> 00:00:39,353
going forward.
20
00:00:39,383 --> 00:00:41,084
Please confirm your gender and pronouns.
21
00:00:41,152 --> 00:00:43,153
Male, he/him/his. Thanks for asking.
22
00:00:43,220 --> 00:00:45,488
We're the ones with
the messed-up software.
23
00:00:45,556 --> 00:00:48,636
Your scans from this
morning were just uploaded.
24
00:00:56,033 --> 00:00:59,189
In less than two weeks,
the tumor's doubled in size.
25
00:01:03,507 --> 00:01:06,042
♪ You're just too good to be true ♪
26
00:01:06,110 --> 00:01:08,445
♪ I can't take my eyes off of you ♪
27
00:01:08,512 --> 00:01:10,714
♪ You'd be like heaven to touch... ♪
28
00:01:10,781 --> 00:01:12,315
34-year-old female, Zara Norton.
29
00:01:12,383 --> 00:01:13,850
Tachycardic and delirious.
30
00:01:13,918 --> 00:01:15,852
Dr. Guerin, update vitals.
31
00:01:15,920 --> 00:01:17,387
Dr. Wolke,
draw blood for CBC and electrolytes.
32
00:01:17,455 --> 00:01:18,955
♪ Oh, pretty baby ♪
33
00:01:19,023 --> 00:01:20,523
♪ Now that I've found you, stay ♪
34
00:01:20,591 --> 00:01:22,859
Pupils are dilated, but reactive.
35
00:01:22,927 --> 00:01:25,695
Ms. Norton,
smells like you've had some marijuana?
36
00:01:25,763 --> 00:01:28,364
Mmm-mmm. I just unloaded
a shipment at the dispensary.
37
00:01:28,432 --> 00:01:29,999
Test for THC and a full tox screen.
38
00:01:30,067 --> 00:01:31,134
I am a peddler.
39
00:01:31,202 --> 00:01:33,636
♪ Not a user ♪
40
00:01:33,704 --> 00:01:34,771
Run it.
41
00:01:34,839 --> 00:01:36,673
BP's elevated, 180 over 115.
42
00:01:36,741 --> 00:01:38,074
That could explain the delirium.
43
00:01:38,142 --> 00:01:40,577
Ooh, that sound high.
Better take my meds.
44
00:01:40,644 --> 00:01:42,412
See, I never miss a... Oh, no.
45
00:01:43,881 --> 00:01:45,014
Oh, no, that's not it.
46
00:01:45,082 --> 00:01:46,549
BP's climbing, 210 over 120.
47
00:01:46,617 --> 00:01:48,918
Enalaprilat, 1.25 milligrams, IV.
48
00:01:48,986 --> 00:01:50,186
Ms. Norton, do you remember
the name of your medication?
49
00:01:50,254 --> 00:01:52,255
You can call me Zara.
50
00:01:52,323 --> 00:01:54,591
See? It say right here on the...
51
00:01:54,658 --> 00:01:56,693
Okay, forget about
the meds. She is not taking any.
52
00:01:56,761 --> 00:01:58,528
This is untreated chronic hypertension.
53
00:01:58,596 --> 00:02:00,663
What if you're wrong? What if she's
on a loop diuretic for her pressure?
54
00:02:00,731 --> 00:02:01,891
This could cause renal failure.
55
00:02:03,234 --> 00:02:04,796
She's heading into hypertensive crisis.
56
00:02:05,341 --> 00:02:06,770
What if we try an
angiotensin receptor blocker?
57
00:02:06,837 --> 00:02:08,138
No drug interaction.
58
00:02:08,205 --> 00:02:10,240
Angiotensin receptor
blockers work too slowly.
59
00:02:10,307 --> 00:02:11,341
I'm giving her the ACE inhibitor.
60
00:02:15,946 --> 00:02:17,080
BP's going down.
61
00:02:17,982 --> 00:02:19,185
Nice call.
62
00:02:25,300 --> 00:02:33,300
Synced & corrected by -robtor-
www.addic7ed.com
63
00:02:35,533 --> 00:02:37,267
Latest budget report.
64
00:02:37,334 --> 00:02:39,035
Yeah, the PDF's sitting in my inbox.
65
00:02:39,103 --> 00:02:40,970
I'm trying to ignore it.
66
00:02:41,038 --> 00:02:42,475
And thus...
67
00:02:45,109 --> 00:02:46,242
A sit-down visit?
68
00:02:46,310 --> 00:02:47,577
Just checking in, see how you're doing.
69
00:02:47,645 --> 00:02:49,546
Okay. You?
70
00:02:49,613 --> 00:02:52,719
Me? I'm... recovering from the year,
71
00:02:53,217 --> 00:02:54,317
like everybody else.
72
00:02:54,385 --> 00:02:56,452
Pandemic, the surge.
73
00:02:56,520 --> 00:02:58,254
You were here for every
minute of every day.
74
00:02:58,322 --> 00:02:59,789
It must have taken a toll.
75
00:02:59,857 --> 00:03:02,192
It... comes with the territory.
76
00:03:02,259 --> 00:03:05,315
You're not, uh, stressed or distracted?
77
00:03:06,163 --> 00:03:08,932
I'm... tired.
78
00:03:08,999 --> 00:03:12,001
Okay. Well,
maybe you should take some time off.
79
00:03:12,069 --> 00:03:13,114
No.
80
00:03:15,539 --> 00:03:17,410
But thank you. I'm fine.
81
00:03:21,812 --> 00:03:23,249
You don't seem fine.
82
00:03:28,352 --> 00:03:30,353
Are there issues with
my work performance?
83
00:03:30,421 --> 00:03:31,688
No, you do great work.
84
00:03:31,755 --> 00:03:33,256
Then I'm not sure why we're
having this conversation.
85
00:03:33,324 --> 00:03:35,053
Because I'm worried about you.
86
00:03:36,427 --> 00:03:38,848
Because other people
are worried about you.
87
00:03:39,563 --> 00:03:42,268
There's no shame in
struggling a little bit.
88
00:03:42,566 --> 00:03:44,100
You know, what would be weird is
89
00:03:44,168 --> 00:03:46,272
if you didn't struggle at all.
90
00:03:47,671 --> 00:03:50,807
If you need to see someone,
the hospital will cover the cost.
91
00:03:50,875 --> 00:03:53,738
Great. You'll pay my bills.
92
00:03:54,011 --> 00:03:56,741
And the damage to my reputation,
who takes care of that?
93
00:03:57,848 --> 00:04:00,350
I don't think that seeing a therapist
94
00:04:00,417 --> 00:04:02,997
will affect your career.
95
00:04:03,687 --> 00:04:05,124
Says the white guy.
96
00:04:08,092 --> 00:04:09,462
Okay.
97
00:04:11,562 --> 00:04:13,563
Privacy protections
are there for a reason.
98
00:04:13,631 --> 00:04:15,164
No one needs to know.
99
00:04:15,232 --> 00:04:17,136
Thank you for checking in.
100
00:04:33,250 --> 00:04:35,385
- How you feeling?
- Good.
101
00:04:35,452 --> 00:04:37,854
Be better when I understand
what landed me up in here.
102
00:04:37,922 --> 00:04:40,023
You had an acute hypertensive crisis.
103
00:04:40,090 --> 00:04:41,524
Oh, I know my blood pressure's high.
104
00:04:41,592 --> 00:04:42,659
I'm already on medication for it.
105
00:04:42,726 --> 00:04:44,288
You probably wanna know what it is.
106
00:04:44,595 --> 00:04:46,165
There's no medication.
107
00:04:47,307 --> 00:04:49,065
We need to do an echocardiogram
108
00:04:49,133 --> 00:04:50,900
to make sure your heart
wasn't damaged in the crisis.
109
00:04:50,968 --> 00:04:52,380
Fine by me.
110
00:04:53,404 --> 00:04:55,004
Here's 10% discount
111
00:04:55,072 --> 00:04:57,707
on any purchase over $50
or more at Z & B Naturals.
112
00:04:57,775 --> 00:05:00,555
I'm Z. B is my partner Bill.
113
00:05:01,000 --> 00:05:02,512
You're surrounded by pot
all day, every day,
114
00:05:02,579 --> 00:05:03,579
but you never touch the stuff?
115
00:05:03,614 --> 00:05:05,014
How? Why?
116
00:05:05,082 --> 00:05:06,769
It's just never been my thing.
117
00:05:09,453 --> 00:05:10,853
Ah.
118
00:05:10,921 --> 00:05:12,021
The name always trips me up.
119
00:05:12,089 --> 00:05:13,609
Chlorthalidone.
120
00:05:14,158 --> 00:05:15,391
That's for hypertension.
121
00:05:15,459 --> 00:05:17,694
Yeah, bottle seems pretty full.
How long have you been on this?
122
00:05:17,761 --> 00:05:19,738
About six months. Just refilled it.
123
00:05:19,763 --> 00:05:21,242
Take it every day.
124
00:05:26,370 --> 00:05:27,540
Smile.
125
00:05:28,305 --> 00:05:29,333
Head tilt.
126
00:05:30,574 --> 00:05:32,044
Now he smiles.
127
00:05:33,377 --> 00:05:34,644
Burst of laughter.
128
00:05:37,014 --> 00:05:38,014
Yeah.
129
00:05:45,222 --> 00:05:46,823
Rio Gutierrez, 29,
130
00:05:46,890 --> 00:05:48,825
pituitary mass went from
manageable with meds
131
00:05:48,892 --> 00:05:50,626
to likely surgery.
132
00:05:50,694 --> 00:05:54,230
So, talking to the new
radiology resident, huh?
133
00:05:54,298 --> 00:05:57,767
I wanted Dr. D'Souza's opinion
on an intriguing set of scans.
134
00:05:57,835 --> 00:05:59,614
She is very talented.
135
00:06:00,004 --> 00:06:01,491
You're crushing on her.
136
00:06:01,739 --> 00:06:02,909
N... No.
137
00:06:03,340 --> 00:06:05,074
I am not. I love Lea.
138
00:06:05,142 --> 00:06:07,246
Well, those two things
aren't mutually exclusive.
139
00:06:08,912 --> 00:06:11,914
Mr. Gutierrez's blood
has high levels of prolactin.
140
00:06:11,982 --> 00:06:14,117
Prolactin is produced
in the pituitary gland.
141
00:06:14,184 --> 00:06:15,752
The tumor could be secreting it.
142
00:06:15,819 --> 00:06:17,754
Or the tumor could be reacting
to the high levels of hormones
143
00:06:17,821 --> 00:06:19,717
being produced elsewhere in the body.
144
00:06:19,990 --> 00:06:22,303
The patient is a transgender man.
145
00:06:25,262 --> 00:06:26,474
Do an ultrasound.
146
00:06:28,365 --> 00:06:30,978
Advance the probe until
you see the cardiac chamber.
147
00:06:32,369 --> 00:06:33,970
Maybe Zara has secondary hypertension
148
00:06:34,038 --> 00:06:35,505
due to renal vascular disease.
149
00:06:35,572 --> 00:06:37,440
She doesn't. Her creatinine is 1.2.
150
00:06:37,508 --> 00:06:39,342
Her GFR is in normal range.
151
00:06:39,410 --> 00:06:41,677
Well, that would make it unlikely,
but not impossible.
152
00:06:41,745 --> 00:06:44,447
It'd also explain why her prescribed
hypertension meds weren't working
153
00:06:44,515 --> 00:06:46,549
and why she got better when
you gave her that ACE inhibitor.
154
00:06:46,617 --> 00:06:48,618
Mmm. Simpler explanation,
she's not taking her meds.
155
00:06:48,685 --> 00:06:49,986
Valve looks normal.
156
00:06:50,054 --> 00:06:51,921
Should I move on to
the two-chamber view?
157
00:06:51,989 --> 00:06:53,222
Yeah.
158
00:06:53,290 --> 00:06:55,358
We have no reason to
think that she's lying.
159
00:06:55,426 --> 00:06:57,527
She seems to be telling
the truth about her pot usage.
160
00:06:57,594 --> 00:06:59,529
No THC in her blood or urine.
161
00:06:59,596 --> 00:07:02,131
She couldn't possibly be
lying about something else.
162
00:07:02,199 --> 00:07:04,067
The left ventricle is thickened,
163
00:07:04,134 --> 00:07:06,502
which is consistent with
untreated hypertension.
164
00:07:08,072 --> 00:07:09,767
Heart rate's climbing.
165
00:07:10,808 --> 00:07:12,475
Cardiac output is dropping.
166
00:07:12,543 --> 00:07:13,843
Stroke volume as well.
167
00:07:13,911 --> 00:07:15,378
She's in cardiogenic shock.
168
00:07:19,149 --> 00:07:21,571
Would you mind if I did an
ultrasound on your abdomen?
169
00:07:21,885 --> 00:07:23,486
For a brain tumor?
170
00:07:23,554 --> 00:07:27,056
This is my fiance, Eli Simpson.
171
00:07:27,124 --> 00:07:28,324
When I heard about the new scans,
172
00:07:28,392 --> 00:07:30,121
I kind of stormed the castle.
173
00:07:30,661 --> 00:07:31,998
My hero.
174
00:07:32,763 --> 00:07:34,363
Your prolactin levels are very high,
175
00:07:34,431 --> 00:07:35,565
which might be caused by the tumor,
176
00:07:35,632 --> 00:07:37,433
unless another condition
raised your prolactin,
177
00:07:37,501 --> 00:07:39,088
encouraging more growth.
178
00:07:39,770 --> 00:07:41,966
What condition boosts prolactin?
179
00:07:42,873 --> 00:07:44,844
Do you think I'm pregnant?
180
00:07:45,463 --> 00:07:48,277
He can't be. He's on testosterone.
181
00:07:48,345 --> 00:07:50,213
Except for a few weeks last month.
182
00:07:50,280 --> 00:07:52,310
I forgot to take my shot
before our trip.
183
00:07:53,450 --> 00:07:54,450
But there's no way that...
184
00:07:54,485 --> 00:07:55,813
You're pregnant.
185
00:08:08,596 --> 00:08:10,063
You went into cardiogenic shock
186
00:08:10,131 --> 00:08:12,099
because your heart
wasn't pumping adequately.
187
00:08:12,166 --> 00:08:15,402
We did a minor procedure
and installed an Impella pump,
188
00:08:15,470 --> 00:08:17,471
but it's a short-term solution.
189
00:08:17,538 --> 00:08:19,272
I do feel a little out of breath.
190
00:08:19,340 --> 00:08:21,708
But that might be just 'cause of you,
Dr. Andrews.
191
00:08:21,776 --> 00:08:23,343
Ms. Norton,
I'm a married man and your doctor.
192
00:08:25,880 --> 00:08:27,247
You have a rare condition.
193
00:08:27,315 --> 00:08:29,049
Certain parts of your heart muscle
194
00:08:29,117 --> 00:08:31,051
have become abnormally thick.
195
00:08:31,119 --> 00:08:34,488
So, this wall in between the chambers,
that's the septum.
196
00:08:34,555 --> 00:08:35,953
That's a normal one.
197
00:08:36,858 --> 00:08:39,081
This is what yours looks like.
198
00:08:39,227 --> 00:08:40,260
Oh, wow.
199
00:08:40,328 --> 00:08:42,295
It's gonna require surgery.
200
00:08:42,363 --> 00:08:44,987
We're gonna run a few more tests
to determine the best approach.
201
00:08:46,167 --> 00:08:48,115
Wait. You gonna be
my surgeon, Dr. Andrews?
202
00:08:48,369 --> 00:08:49,575
I sure will.
203
00:08:50,471 --> 00:08:52,119
And y'all two gonna be with him?
204
00:08:52,440 --> 00:08:53,807
Yeah.
205
00:08:53,875 --> 00:08:56,176
My lucky day.
206
00:08:56,244 --> 00:08:58,812
Three doctors of color
taking care of me.
207
00:08:58,880 --> 00:09:01,081
Doctors who won't talk down to me.
208
00:09:01,149 --> 00:09:03,416
Not exactly what I'm used to.
209
00:09:03,484 --> 00:09:04,751
You guys know what I mean.
210
00:09:04,819 --> 00:09:06,453
My mother made me wear a suit and tie
211
00:09:06,521 --> 00:09:08,922
whenever we went to the pediatrician.
212
00:09:08,990 --> 00:09:12,159
Put on your Sunday best just to
get on the scale and touch your toes.
213
00:09:12,226 --> 00:09:15,701
Yeah. Made me so mad,
I wound up becoming a doctor.
214
00:09:17,732 --> 00:09:19,599
The testing confirmed
215
00:09:19,667 --> 00:09:22,351
your tumor is a
hormone-producing prolactinoma.
216
00:09:22,430 --> 00:09:25,305
And the pregnancy is
about six weeks along.
217
00:09:25,373 --> 00:09:27,738
Do you consider yourself gay?
218
00:09:29,043 --> 00:09:30,950
- I don't think that's...
- Yes.
219
00:09:31,445 --> 00:09:33,847
Because I am gay.
220
00:09:33,915 --> 00:09:36,883
But you have vaginal
intercourse with your fiance.
221
00:09:36,951 --> 00:09:39,886
- That is how he got pregnant...
- Dr. Murphy, that's enough.
222
00:09:39,954 --> 00:09:41,811
- I... I just want...
- I think you should leave.
223
00:09:50,932 --> 00:09:52,199
I'm sorry.
224
00:09:52,266 --> 00:09:55,016
That was completely inappropriate.
225
00:09:56,304 --> 00:09:57,838
Our treatment plan for your tumor
226
00:09:57,905 --> 00:10:00,146
depends on your plan for your pregnancy.
227
00:10:00,775 --> 00:10:01,869
So...
228
00:10:05,947 --> 00:10:07,581
We've talked about kids,
229
00:10:07,648 --> 00:10:11,240
but I always figured that
was way down the road.
230
00:10:12,720 --> 00:10:14,160
And not this way.
231
00:10:14,922 --> 00:10:16,579
I always assumed we'd adopt.
232
00:10:19,093 --> 00:10:22,168
I'd have go off T, and stay off.
233
00:10:23,464 --> 00:10:25,629
If Rio doesn't continue the pregnancy,
234
00:10:26,133 --> 00:10:27,423
then what happens?
235
00:10:27,816 --> 00:10:29,402
Your hormone levels would drop quickly,
236
00:10:29,470 --> 00:10:31,238
which would cause the tumor to shrink.
237
00:10:31,305 --> 00:10:34,972
After that, we'd use medication,
possibly a minor surgery.
238
00:10:37,645 --> 00:10:39,393
I'd like to terminate the pregnancy.
239
00:10:42,516 --> 00:10:44,384
I looked over all of Zara's labs.
240
00:10:44,452 --> 00:10:48,121
All signs point to her taking her
hypertension medicine regularly.
241
00:10:48,189 --> 00:10:52,492
Her MRIs show significant
ventricular septal thickness,
242
00:10:52,560 --> 00:10:54,116
bad turbulence jet flow.
243
00:10:54,929 --> 00:10:57,078
There's myocardial edema, too.
244
00:10:57,999 --> 00:11:00,734
The ACE inhibitors were a bad call.
245
00:11:00,801 --> 00:11:03,667
Which eventually sent our
patient into cardiogenic shock.
246
00:11:07,041 --> 00:11:09,173
Why'd you ignore
what she was telling us?
247
00:11:10,144 --> 00:11:11,678
I made a medical diagnosis
248
00:11:11,746 --> 00:11:14,080
based on pattern processing
249
00:11:14,148 --> 00:11:15,415
that we're taught in med school,
250
00:11:15,483 --> 00:11:20,287
which involves considering,
you know, race, education,
251
00:11:20,354 --> 00:11:23,056
occupation, BMI.
252
00:11:23,124 --> 00:11:25,272
Always sounded like profiling to me.
253
00:11:32,500 --> 00:11:34,134
Yes, we have the rain,
254
00:11:34,201 --> 00:11:36,002
but more impressively, the wind.
255
00:11:36,070 --> 00:11:37,804
That rain's going to be
coming in sideways.
256
00:11:37,872 --> 00:11:40,073
Just take a look at
how the wind increases
257
00:11:40,141 --> 00:11:41,608
as we progress throughout the day.
258
00:11:41,676 --> 00:11:43,243
So, this afternoon, we're talking about
259
00:11:43,311 --> 00:11:44,844
50-mile-per-hour gusts possible.
260
00:11:44,912 --> 00:11:46,377
Sorry for crashing.
261
00:11:46,714 --> 00:11:48,281
Radiology doesn't have a TV.
262
00:11:50,751 --> 00:11:52,591
You like The Weather Channel?
263
00:11:53,921 --> 00:11:55,678
I find it soothing.
264
00:11:57,291 --> 00:11:58,639
Would you like to join me?
265
00:12:00,528 --> 00:12:03,096
And we have more intense
rainfall coming through,
266
00:12:03,164 --> 00:12:05,699
and that's going to also
lead to some flood potential.
267
00:12:05,766 --> 00:12:07,434
All of us are going
to get into the action.
268
00:12:07,501 --> 00:12:09,035
You got the mountains.
269
00:12:09,103 --> 00:12:12,361
Would you mind if I lowered
the volume by four output levels?
270
00:12:13,441 --> 00:12:14,441
Oh.
271
00:12:15,242 --> 00:12:16,676
That would be perfect.
272
00:12:16,744 --> 00:12:18,778
All the areas around here
in Northern California,
273
00:12:18,846 --> 00:12:20,447
Modesto, Stockton, Sacramento.
274
00:12:20,514 --> 00:12:22,449
The northern part of San Francisco...
275
00:12:31,258 --> 00:12:34,133
I find the reflection on
the screen so distracting.
276
00:12:36,931 --> 00:12:38,345
So do I.
277
00:12:50,544 --> 00:12:51,544
Could I
278
00:12:53,981 --> 00:12:55,362
do this?
279
00:13:39,660 --> 00:13:41,033
Nurse paged me.
280
00:13:43,264 --> 00:13:44,620
Is something wrong?
281
00:13:45,933 --> 00:13:47,289
I've changed my mind.
282
00:13:50,137 --> 00:13:51,585
I want to keep the baby.
283
00:13:55,333 --> 00:13:56,967
Since you are continuing the pregnancy,
284
00:13:57,034 --> 00:13:59,510
we'll need to surgically
remove the prolactinoma.
285
00:14:00,004 --> 00:14:02,263
So, you'll cut into his brain?
286
00:14:02,673 --> 00:14:04,874
Our safest option is to go
in through the nasal cavity
287
00:14:04,942 --> 00:14:08,578
in what's known as a
transsphenoidal surgery, TSS for short.
288
00:14:08,646 --> 00:14:11,981
It's less invasive
than our other option.
289
00:14:12,316 --> 00:14:14,233
That still sounds dangerous.
290
00:14:14,518 --> 00:14:15,885
I've made up my mind.
291
00:14:15,953 --> 00:14:17,903
Do I get any say in this?
292
00:14:20,558 --> 00:14:23,126
I'm all for us having a family,
but I'm not ready to...
293
00:14:23,194 --> 00:14:25,061
No one's ever ready for kids.
294
00:14:25,129 --> 00:14:27,764
Yesterday, you said that you
never considered getting pregnant,
295
00:14:27,832 --> 00:14:30,374
and now you're willing
to risk your life for it.
296
00:14:34,071 --> 00:14:35,713
When I was about seven,
297
00:14:36,574 --> 00:14:39,008
I had this one refuge.
298
00:14:40,711 --> 00:14:42,979
I'd hang a quilt over a couple chairs
299
00:14:43,047 --> 00:14:46,098
and hide out with my two buds,
300
00:14:47,184 --> 00:14:49,435
Foxie the Fox and Fuzz the Lion,
301
00:14:50,554 --> 00:14:51,895
and I'd imagine,
302
00:14:52,590 --> 00:14:53,939
I was the dad.
303
00:14:56,894 --> 00:14:59,653
And they were my twin little guys,
304
00:15:00,164 --> 00:15:02,197
fraternal, obviously.
305
00:15:03,668 --> 00:15:05,075
We were a family.
306
00:15:08,072 --> 00:15:11,081
When I transitioned,
I put that dream aside.
307
00:15:11,776 --> 00:15:13,977
At least, as far as them coming from me.
308
00:15:14,045 --> 00:15:15,045
But now...
309
00:15:19,183 --> 00:15:20,841
Whether we planned it or not,
310
00:15:21,786 --> 00:15:22,886
this is our baby.
311
00:15:29,527 --> 00:15:31,528
How soon can you do the surgery?
312
00:15:31,595 --> 00:15:34,396
I'll order an image-guidance
MRI to get things started.
313
00:15:43,607 --> 00:15:46,309
Based on the
cardiac MRI and catheterization,
314
00:15:46,377 --> 00:15:48,011
there are two treatment options.
315
00:15:48,079 --> 00:15:50,513
Myectomy, basically open heart surgery,
316
00:15:50,581 --> 00:15:53,016
and alcohol septal ablation,
317
00:15:53,084 --> 00:15:56,919
where we use the alcohol to kill
targeted sections of the heart muscle.
318
00:15:57,421 --> 00:15:59,556
Well, what would you recommend?
319
00:15:59,623 --> 00:16:02,992
The surgery is more invasive,
tougher recovery,
320
00:16:03,060 --> 00:16:04,894
but better efficacy long-term.
321
00:16:04,962 --> 00:16:07,097
The ablation is less dangerous,
322
00:16:07,164 --> 00:16:11,058
but you're more likely to need
further medical interventions.
323
00:16:11,268 --> 00:16:13,069
Now, you call that a recommendation?
324
00:16:13,137 --> 00:16:15,338
There are pros and cons to both.
325
00:16:15,406 --> 00:16:17,340
Uh, you'll need to weigh them.
326
00:16:17,408 --> 00:16:19,066
I'll give you some time.
327
00:16:19,810 --> 00:16:21,778
You always want to take care of people,
Dr. Browne?
328
00:16:21,846 --> 00:16:22,986
Pretty much.
329
00:16:23,946 --> 00:16:25,448
Me, too.
330
00:16:25,516 --> 00:16:28,418
Oh. Well, you run
a marijuana dispensary.
331
00:16:28,486 --> 00:16:30,453
It's not all about getting people high.
332
00:16:30,521 --> 00:16:34,124
No, maybe not, but I'm
guessing most of your clientele...
333
00:16:34,191 --> 00:16:36,792
My Great-Aunt Lucy
had pancreatic cancer.
334
00:16:38,996 --> 00:16:40,546
A year, she hung on.
335
00:16:41,399 --> 00:16:42,756
In agony.
336
00:16:44,101 --> 00:16:47,704
Marijuana was the only thing
that helped her eat or sleep.
337
00:16:47,772 --> 00:16:49,847
Doctors didn't give her
anything for the pain?
338
00:16:50,207 --> 00:16:52,099
They suggested ibuprofen.
339
00:16:53,611 --> 00:16:55,578
Now, you know doctors
are 22% less likely
340
00:16:55,646 --> 00:16:57,614
to give pain meds to Black patients
341
00:16:57,681 --> 00:17:00,441
than to white patients
with the same symptoms.
342
00:17:01,819 --> 00:17:04,862
My point is, you and I,
we're a lot alike.
343
00:17:05,764 --> 00:17:08,124
We're both strong, Black women
finding our way in the world,
344
00:17:08,192 --> 00:17:11,294
but one of us knows more
about medicine than the other.
345
00:17:11,319 --> 00:17:15,622
So, I'd like to know,
what would you do in my situation?
346
00:17:19,670 --> 00:17:21,905
The open myectomy is a bigger risk
347
00:17:21,972 --> 00:17:25,132
but offers more long-term benefits.
348
00:17:27,044 --> 00:17:28,802
I've made my decision.
349
00:17:31,315 --> 00:17:32,973
I'm with you, Dr. Browne.
350
00:17:33,818 --> 00:17:35,434
Book the myectomy.
351
00:17:43,093 --> 00:17:45,795
Here's the Rio Gutierrez
imaging for your upcoming TSS.
352
00:17:45,863 --> 00:17:48,071
Set that on the table, please.
353
00:17:51,669 --> 00:17:53,436
I, um...
354
00:17:53,504 --> 00:17:55,705
I noted the tumor's
suprasellar expansion
355
00:17:55,773 --> 00:17:59,108
and surrounding edema
and splaying of circle of Willis.
356
00:17:59,176 --> 00:18:01,335
That is very helpful.
357
00:18:04,181 --> 00:18:05,464
Bye, Dr. Murphy.
358
00:18:08,686 --> 00:18:10,186
You're safe, Shaun. She's gone.
359
00:18:10,254 --> 00:18:11,845
Not really.
360
00:18:12,690 --> 00:18:14,724
Dr. D'Souza is still in my brain.
361
00:18:14,792 --> 00:18:16,058
I don't like it.
362
00:18:16,594 --> 00:18:18,018
We kissed.
363
00:18:18,863 --> 00:18:19,996
- When?
- What?
364
00:18:20,064 --> 00:18:22,065
I have so many thoughts about her,
365
00:18:22,132 --> 00:18:24,567
and I have so many
questions I want to ask Rio.
366
00:18:24,635 --> 00:18:26,135
Wouldn't he get more pleasure for...
367
00:18:26,203 --> 00:18:27,537
Questions you're not
supposed to ask him.
368
00:18:27,605 --> 00:18:29,105
The kiss, Shaun. When did you kiss?
369
00:18:29,173 --> 00:18:31,406
Last night. In my dream.
370
00:18:32,409 --> 00:18:36,579
If I can't ask questions,
how do I understand?
371
00:18:36,647 --> 00:18:38,581
My... My brain...
372
00:18:38,649 --> 00:18:41,684
My... My brain isn't behaving
the way I want it to.
373
00:18:41,752 --> 00:18:43,335
How do I make it stop?
374
00:18:47,291 --> 00:18:49,383
You're attracted to Dr. D'Souza.
375
00:18:49,827 --> 00:18:51,218
Why does that bother you?
376
00:18:53,464 --> 00:18:58,101
When I was with Carly
and had feelings for Lea,
377
00:18:58,168 --> 00:19:00,870
it meant I was supposed to be with Lea.
378
00:19:00,938 --> 00:19:03,573
What if this means I'm
supposed to be with Dr. D'Souza?
379
00:19:03,641 --> 00:19:06,109
No. You've loved Lea for years.
380
00:19:06,176 --> 00:19:09,528
This is just... attraction.
381
00:19:10,614 --> 00:19:14,408
But shouldn't loving Lea
make it go away?
382
00:19:15,686 --> 00:19:19,204
Relationships would be a
lot easier if it worked that way.
383
00:19:20,563 --> 00:19:21,996
You're feeling guilty.
384
00:19:22,021 --> 00:19:25,239
I say take Lea out for a nice dinner,
something special.
385
00:19:25,296 --> 00:19:27,597
And tell her about my crush.
386
00:19:27,665 --> 00:19:29,232
I need to let Lea know.
387
00:19:29,300 --> 00:19:30,757
- No, definitely not.
- No, you do not.
388
00:19:32,202 --> 00:19:34,604
I want to get your thoughts on the
suprasellar extension of the tumor
389
00:19:34,672 --> 00:19:36,039
- for this TSS.
- You remember Sarah Pepper?
390
00:19:36,106 --> 00:19:37,574
Runs nephrology at S.F. Regional?
391
00:19:38,609 --> 00:19:39,976
Always wears a shawl?
392
00:19:40,044 --> 00:19:43,546
So, during the staff meeting last week,
she fell apart.
393
00:19:43,614 --> 00:19:46,498
Screaming, crying in front of the
whole department. Totally nuts.
394
00:19:46,684 --> 00:19:49,118
Rough day at the office.
395
00:19:49,186 --> 00:19:51,862
Wonder how you'd approach and
resect without getting a CSF leak.
396
00:19:52,289 --> 00:19:53,828
Yeah.
397
00:19:53,853 --> 00:19:56,950
Place a lumbar drain, then infuse
saline and do Valsalva maneuver.
398
00:19:56,975 --> 00:19:58,342
Okay.
399
00:19:58,367 --> 00:20:01,116
Apparently,
Pepper's meltdown was so over the top,
400
00:20:01,140 --> 00:20:03,415
the hospital forced her to take a leave.
401
00:20:04,076 --> 00:20:06,460
- How long?
- Unspecified.
402
00:20:06,912 --> 00:20:09,414
She's always been a little crazy.
403
00:20:09,482 --> 00:20:12,784
Last I checked, eccentric and
emotional didn't qualify as crazy.
404
00:20:12,852 --> 00:20:14,593
Thanks for taking a look.
405
00:20:20,559 --> 00:20:21,926
I read that cisgender people
406
00:20:21,994 --> 00:20:24,896
often reduce transgender
people to their genitalia,
407
00:20:24,964 --> 00:20:26,521
and that that is offensive.
408
00:20:27,291 --> 00:20:29,533
Did I do that to you and Rio?
409
00:20:29,935 --> 00:20:31,451
Yes.
410
00:20:32,584 --> 00:20:33,862
I'm sorry.
411
00:20:36,542 --> 00:20:39,493
Rio will be going into surgery soon.
412
00:20:40,850 --> 00:20:42,751
He's been asking for you.
413
00:20:42,819 --> 00:20:44,748
You haven't been answering your phone.
414
00:20:45,254 --> 00:20:46,667
Thanks for letting me know.
415
00:20:51,194 --> 00:20:53,528
He is very confusing to me, too.
416
00:20:53,596 --> 00:20:55,931
Rio has worked so hard,
417
00:20:55,998 --> 00:20:58,767
he had a bilateral
subcutaneous mastectomy
418
00:20:58,835 --> 00:21:00,535
and takes hormone replacement therapy,
419
00:21:00,603 --> 00:21:06,019
but now he is choosing
the most female act.
420
00:21:08,277 --> 00:21:10,440
It's not female if Rio's doing it.
421
00:21:14,083 --> 00:21:16,318
Y... Yes.
422
00:21:16,385 --> 00:21:19,533
And he must have dealt
with a lot of prejudice
423
00:21:19,789 --> 00:21:21,256
during his transition.
424
00:21:21,324 --> 00:21:23,158
I dealt with prejudice.
425
00:21:23,226 --> 00:21:25,455
My brother helped me.
Does he have a brother?
426
00:21:27,163 --> 00:21:29,000
His family doesn't talk to him.
427
00:21:34,070 --> 00:21:37,592
And now Rio is having brain surgery.
428
00:21:40,409 --> 00:21:41,763
He is very brave.
429
00:21:43,045 --> 00:21:44,079
You can stay here.
430
00:21:49,218 --> 00:21:52,220
I have a patient, Zara Norton.
431
00:21:52,288 --> 00:21:54,389
We, uh... We diagnosed her with HOCM.
432
00:21:54,457 --> 00:21:56,124
I saw the file.
433
00:21:56,192 --> 00:21:58,860
Dr. Guerin expressed some concerns
434
00:21:58,928 --> 00:22:02,242
about my initial handling
of the case in the ER.
435
00:22:03,211 --> 00:22:07,214
He thinks I stereotyped her,
based on her race.
436
00:22:07,703 --> 00:22:08,832
Do you think you did?
437
00:22:10,606 --> 00:22:12,140
She was crashing.
438
00:22:12,208 --> 00:22:15,088
I had to make a call. I
didn't have a lot to go on.
439
00:22:17,280 --> 00:22:19,092
Glassman came to see me this morning.
440
00:22:19,916 --> 00:22:22,417
Someone told him I'm
unstable and need help.
441
00:22:22,485 --> 00:22:23,889
Any idea where he heard that?
442
00:22:26,122 --> 00:22:27,455
I asked for help. You can, too.
443
00:22:27,523 --> 00:22:29,811
You're a resident. No
one cares if you need help.
444
00:22:30,760 --> 00:22:32,861
I got this job in part
445
00:22:32,929 --> 00:22:36,665
because my main competition,
a man, backed me.
446
00:22:36,732 --> 00:22:39,201
The second anyone thinks
I can't handle this...
447
00:22:39,268 --> 00:22:40,368
No one is gonna think that...
448
00:22:40,436 --> 00:22:42,115
They will if you keep
telling them I'm a mess.
449
00:22:42,371 --> 00:22:44,573
You have PTSD.
450
00:22:44,640 --> 00:22:46,174
You shouldn't be ashamed.
451
00:22:46,242 --> 00:22:49,331
Says the women who just
profiled a Black female patient.
452
00:22:51,614 --> 00:22:53,001
You judged her,
453
00:22:53,449 --> 00:22:56,051
just like people will judge me
454
00:22:56,118 --> 00:22:58,186
and whisper that I've always
been a little intense,
455
00:22:58,254 --> 00:23:00,425
so no wonder I was asked to step down.
456
00:23:05,061 --> 00:23:06,431
Nobody needs to know.
457
00:23:09,131 --> 00:23:10,131
Exactly.
458
00:23:12,468 --> 00:23:14,369
You tell me that it doesn't matter.
459
00:23:14,437 --> 00:23:16,438
You tell me everyone will understand,
460
00:23:16,505 --> 00:23:18,840
and then you tell me
to keep it to myself.
461
00:23:18,908 --> 00:23:20,904
Should I be ashamed, or shouldn't I be?
462
00:23:22,445 --> 00:23:25,659
All right, Ms. Norton,
time to head to pre-op.
463
00:23:28,084 --> 00:23:29,351
What's in the bag, handsome?
464
00:23:29,418 --> 00:23:32,921
I like to know what goes into my body.
465
00:23:32,989 --> 00:23:36,191
Uh, cefazolin. It's a prophylactic
antibiotic we give before surgeries.
466
00:23:36,259 --> 00:23:37,587
Makes sense.
467
00:23:39,128 --> 00:23:41,925
Hey, what was the med y'all gave
me when I first got here to the ER?
468
00:23:42,665 --> 00:23:45,200
Enalaprilat. It's an ACE inhibitor.
469
00:23:45,268 --> 00:23:46,268
Isn't that for hypertension?
470
00:23:46,335 --> 00:23:47,597
Mmm-hmm.
471
00:23:49,171 --> 00:23:50,438
But I thought I already told y'all
472
00:23:50,506 --> 00:23:52,269
I was on meds for my blood pressure.
473
00:23:52,942 --> 00:23:54,242
You did.
474
00:23:54,310 --> 00:23:55,814
So, you figured I needed more?
475
00:23:59,248 --> 00:24:00,861
Or did you not believe me?
476
00:24:14,597 --> 00:24:15,876
I'm sorry.
477
00:24:19,502 --> 00:24:20,755
You must be scared.
478
00:24:22,171 --> 00:24:24,050
You shouldn't have to be scared alone.
479
00:24:26,208 --> 00:24:27,242
I love you.
480
00:24:28,144 --> 00:24:29,556
I love you, too.
481
00:24:34,250 --> 00:24:35,250
Eli.
482
00:24:37,553 --> 00:24:39,020
I can't see you.
483
00:24:39,088 --> 00:24:41,690
I'm right here, babe.
484
00:24:41,757 --> 00:24:43,862
Can you follow this with your eyes?
485
00:24:46,495 --> 00:24:47,929
It keeps disappearing.
486
00:24:47,997 --> 00:24:49,164
You've lost peripheral vision.
487
00:24:49,231 --> 00:24:51,199
The tumor is impinging
on the optic fibers.
488
00:24:51,267 --> 00:24:53,638
We can't perform the TSS surgery.
489
00:24:57,913 --> 00:25:00,048
With the tumor's continued growth,
490
00:25:00,116 --> 00:25:03,751
the best remaining option is
the open pterional craniotomy.
491
00:25:03,819 --> 00:25:07,255
But it is higher risk
with a lengthier recovery.
492
00:25:07,323 --> 00:25:10,158
All of which is on top of the
potential for gender dysphoria
493
00:25:10,226 --> 00:25:11,493
during pregnancy.
494
00:25:11,560 --> 00:25:13,767
Is that still a concern?
495
00:25:15,631 --> 00:25:17,687
I think back to before
I started taking T,
496
00:25:18,567 --> 00:25:20,273
how terrible that felt.
497
00:25:22,745 --> 00:25:25,278
The thought of feeling
that all over again...
498
00:25:28,811 --> 00:25:31,326
We could go back to the original plan.
499
00:25:33,616 --> 00:25:34,883
You mean terminate the pregnancy?
500
00:25:36,418 --> 00:25:38,625
The tumor should shrink on its own.
501
00:25:42,024 --> 00:25:45,882
After everything you've done
to get where you are in your life,
502
00:25:46,188 --> 00:25:49,511
it's scary to think about doing
something that would put that at risk.
503
00:25:53,269 --> 00:25:55,183
This is my next step.
504
00:25:56,412 --> 00:25:59,604
I'm ready to take it,
even if I'm scared.
505
00:26:02,211 --> 00:26:04,526
You have to take risks
sometimes, Dr. Lim.
506
00:26:14,302 --> 00:26:15,537
Thank you.
507
00:26:16,061 --> 00:26:17,895
Shouldn't you be
prepping Zara for surgery?
508
00:26:18,060 --> 00:26:19,661
It's canceled.
509
00:26:19,728 --> 00:26:21,918
She wants to be transferred
to a different hospital.
510
00:26:23,719 --> 00:26:27,132
One where she won't be
"racially profiled into heart failure."
511
00:26:35,477 --> 00:26:38,184
Shaun, you okay?
512
00:26:40,902 --> 00:26:43,604
I am having
thoughts I don't want to have.
513
00:26:43,638 --> 00:26:46,568
Both Park and Jordan
say I shouldn't tell you.
514
00:26:47,890 --> 00:26:49,654
But you're going to, aren't you?
515
00:26:51,760 --> 00:26:53,261
Yes, I am.
516
00:26:53,329 --> 00:26:55,196
I have a work crush.
517
00:26:55,264 --> 00:26:57,599
Also, my patient is
a pregnant trans man...
518
00:26:57,666 --> 00:26:59,039
Okay, one at a time, Shaun.
519
00:26:59,401 --> 00:27:02,270
About this... crush?
520
00:27:02,338 --> 00:27:03,972
Her name is Dr. Cintia D'Souza.
521
00:27:04,039 --> 00:27:05,974
She is a second-year radiology resident.
522
00:27:06,041 --> 00:27:08,209
Last night, I dreamed we
were in the Residents' Lounge,
523
00:27:08,277 --> 00:27:10,411
watching The Weather Channel,
and then we started kissing...
524
00:27:10,479 --> 00:27:11,479
Okay, I got it.
525
00:27:13,549 --> 00:27:15,350
Are you mad?
526
00:27:15,417 --> 00:27:17,640
Park and Jordan were right.
I shouldn't have told you.
527
00:27:18,187 --> 00:27:20,822
No. I'm not mad.
528
00:27:20,889 --> 00:27:24,522
A little surprised, but that's okay.
529
00:27:27,596 --> 00:27:29,069
I'm still attracted
530
00:27:29,765 --> 00:27:31,071
to other guys sometimes.
531
00:27:31,867 --> 00:27:32,867
N... No.
532
00:27:33,836 --> 00:27:35,270
No. What? Who?
533
00:27:35,337 --> 00:27:36,576
- It doesn't matter.
- Who?
534
00:27:37,773 --> 00:27:41,709
There... Okay, there is
this one physical therapist...
535
00:27:41,777 --> 00:27:42,777
N... No.
536
00:27:43,525 --> 00:27:44,525
No.
537
00:27:44,713 --> 00:27:45,713
No.
538
00:27:49,418 --> 00:27:53,354
What if we're attracted to other people
539
00:27:53,422 --> 00:27:56,888
because there is something
wrong with our relationship?
540
00:27:58,627 --> 00:28:01,629
You're not planning on
kissing Dr. D'Souza in real life?
541
00:28:01,697 --> 00:28:02,764
No.
542
00:28:02,831 --> 00:28:04,766
Or working late with her,
543
00:28:04,833 --> 00:28:07,101
doing some X-rays alone,
544
00:28:07,169 --> 00:28:10,371
where you might end up
leaning over the same light box.
545
00:28:10,439 --> 00:28:13,113
We don't use light boxes anymore.
546
00:28:17,780 --> 00:28:19,694
And I don't plan to work late with her.
547
00:28:19,764 --> 00:28:23,206
Then I don't think either of us
has anything to be worried about.
548
00:28:35,664 --> 00:28:38,138
I have to go prep for
a pterional craniotomy.
549
00:28:45,040 --> 00:28:47,564
I'm Dr. Glassman,
president of the hospital.
550
00:28:48,610 --> 00:28:50,445
Unless you're here to
drive me to S.F. Regional,
551
00:28:50,512 --> 00:28:52,110
you can head right back on out.
552
00:28:53,502 --> 00:28:56,837
I apologize for your experience
in the emergency room.
553
00:28:56,952 --> 00:28:58,419
That's mighty white of you.
554
00:29:01,890 --> 00:29:04,826
I don't recommend that you
transfer to S.F. Regional,
555
00:29:04,893 --> 00:29:06,427
or any other hospital, for that matter.
556
00:29:06,495 --> 00:29:08,683
I'm sure they got
the same fancy equipment,
557
00:29:08,760 --> 00:29:11,132
same shiny sets of
diplomas y'all got here,
558
00:29:11,200 --> 00:29:13,590
and maybe a few less racist doctors.
559
00:29:14,970 --> 00:29:17,772
Well, apparently,
that doesn't seem to be the case.
560
00:29:17,906 --> 00:29:21,931
I pulled data on comparable
hospitals within 100 miles,
561
00:29:22,678 --> 00:29:25,847
did numbers on surgical outcomes
562
00:29:25,914 --> 00:29:30,418
and patient satisfaction,
aggregated by race.
563
00:29:30,486 --> 00:29:34,736
Apparently, we're doing well,
comparatively.
564
00:29:37,979 --> 00:29:41,148
Your argument is that your
hospital may be racially biased,
565
00:29:41,173 --> 00:29:44,078
but it's less racially biased
than these other hospitals?
566
00:29:45,434 --> 00:29:47,165
Yeah. Pretty much.
567
00:29:48,504 --> 00:29:50,044
Stay at St. Bonaventure,
568
00:29:50,108 --> 00:29:53,838
the president of the hospital will
monitor your care every step of the way.
569
00:29:55,244 --> 00:29:56,507
For whatever it's worth,
570
00:29:57,780 --> 00:29:59,427
I don't think you can
do better than that.
571
00:30:09,858 --> 00:30:12,148
She's gonna stay, on one condition.
572
00:30:13,462 --> 00:30:14,901
That you're off the team.
573
00:30:24,618 --> 00:30:26,753
Dr. Park, please open Sylvian fissure.
574
00:30:26,821 --> 00:30:28,321
Arachnoid knife and Rhoton dissector.
575
00:30:30,658 --> 00:30:33,294
Tumor is visible.
576
00:30:34,395 --> 00:30:36,047
What makes someone a man?
577
00:30:37,965 --> 00:30:40,467
I thought it was just the chromosomes,
578
00:30:40,534 --> 00:30:42,235
but that must not be it,
579
00:30:42,303 --> 00:30:45,238
which makes things
confusing and difficult,
580
00:30:45,306 --> 00:30:47,040
and I know Rio was
uncomfortable when he...
581
00:30:47,107 --> 00:30:49,442
Life is uncomfortable.
582
00:30:49,510 --> 00:30:52,745
It hits you with tough situations
and you muscle through them.
583
00:30:52,813 --> 00:30:54,681
I see a tiny bleed
in the circular sinus.
584
00:30:54,748 --> 00:30:56,442
Pack it with Floseal.
585
00:31:02,756 --> 00:31:04,724
Someone give me an update.
586
00:31:04,792 --> 00:31:06,726
We got a drop in
end tidal CO2 and oxygen sat.
587
00:31:06,794 --> 00:31:08,628
See any evidence of exposed air cells?
588
00:31:08,696 --> 00:31:12,398
No. But waxing bone
edges just to be safe.
589
00:31:12,466 --> 00:31:16,269
But the tumor thinned the
sellar floor and sphenoid wall.
590
00:31:16,337 --> 00:31:18,840
Making it permeable to oxygen.
591
00:31:19,707 --> 00:31:21,241
It's an air embolism.
592
00:31:22,933 --> 00:31:24,220
BP's dropping.
593
00:31:26,881 --> 00:31:28,850
Dr. Lim, what should we do?
594
00:31:51,572 --> 00:31:53,139
Saline gauze,
595
00:31:53,207 --> 00:31:55,508
tilt the table to eliminate the
negative air pressure gradient,
596
00:31:55,576 --> 00:31:56,919
and place a central line.
597
00:31:58,145 --> 00:31:59,245
This will stop the air leak
598
00:31:59,313 --> 00:32:01,147
and allow us to access the air bubble.
599
00:32:01,215 --> 00:32:03,760
Inserting Bunegin air-aspirating cath.
600
00:32:05,886 --> 00:32:07,954
You are 2 centimeters
from the superior vena cava.
601
00:32:10,157 --> 00:32:12,810
Aspirate the right atrium until
you don't see any more air bubbles.
602
00:32:23,337 --> 00:32:25,198
Nice save, Dr. Lim.
603
00:32:26,273 --> 00:32:28,274
Let's get this tumor out.
604
00:32:28,342 --> 00:32:30,583
Make your transverse
aortotomy with Potts scissors,
605
00:32:30,607 --> 00:32:31,654
Dr. Wolke.
606
00:32:33,013 --> 00:32:36,616
Extending the muscular
incision down to the mid-ventricle.
607
00:32:36,684 --> 00:32:38,294
There's the myectomy site.
608
00:32:39,720 --> 00:32:41,672
There's the aberrant muscle bundle.
609
00:33:06,246 --> 00:33:07,313
Get her off bypass,
610
00:33:08,048 --> 00:33:09,325
see how she does.
611
00:33:22,329 --> 00:33:23,798
How's the cardiac output?
612
00:33:24,965 --> 00:33:26,634
Reduced and insufficient.
613
00:33:27,768 --> 00:33:31,104
Low output could mean we
need to further reduce the septum.
614
00:33:31,171 --> 00:33:32,939
Unless it means that
we reduced it too much.
615
00:33:33,007 --> 00:33:34,540
Damaged the cardiac
electrical conductors
616
00:33:34,608 --> 00:33:35,808
that control the heart rate.
617
00:33:35,876 --> 00:33:37,620
She's having third-degree heart block.
618
00:33:37,845 --> 00:33:39,021
Enrique's right.
619
00:33:39,680 --> 00:33:41,232
We took too much muscle.
620
00:33:41,915 --> 00:33:43,249
Put her back on bypass.
621
00:33:43,317 --> 00:33:45,585
We could augment the
wall with a bovine patch.
622
00:33:45,653 --> 00:33:47,387
Still wouldn't insulate
the electrical system.
623
00:33:47,454 --> 00:33:50,616
She'd still be at risk of complete
heart block and cardiac arrest.
624
00:33:53,827 --> 00:33:56,529
We could insert a dual chamber pacer.
625
00:33:56,597 --> 00:33:58,965
She won't need the conduction
system in the wall of her heart
626
00:33:59,033 --> 00:34:00,668
to control her heart rate.
627
00:34:03,003 --> 00:34:04,003
Let's go!
628
00:34:09,710 --> 00:34:11,262
How was the craniotomy?
629
00:34:11,478 --> 00:34:12,845
It went well.
630
00:34:12,913 --> 00:34:14,682
The patient is in recovery.
631
00:34:17,785 --> 00:34:20,286
Your text said you have good news.
632
00:34:20,354 --> 00:34:22,523
And by good news, I mean
bad news for Dr. D'Souza.
633
00:34:22,723 --> 00:34:25,693
Plenty of great stuff to crush a crush.
634
00:34:25,859 --> 00:34:27,528
First observation,
635
00:34:28,395 --> 00:34:30,448
she smells like cinnamon.
636
00:34:31,572 --> 00:34:32,572
Mmm.
637
00:34:34,001 --> 00:34:36,736
Which is more puzzling than irritating.
638
00:34:36,804 --> 00:34:40,006
Actually kind of nice. Which
is obviously not helpful.
639
00:34:40,074 --> 00:34:43,109
Oh, okay. She does this
weird self-grooming gesture
640
00:34:43,177 --> 00:34:45,379
where she tucks her hair behind her ear.
641
00:34:47,181 --> 00:34:49,148
And then sorta massages her ear.
642
00:34:49,216 --> 00:34:51,350
Also n... not helpful.
643
00:34:51,418 --> 00:34:53,297
Okay. I'm sorry. I'm sorry.
644
00:34:53,420 --> 00:34:54,554
Mmm-hmm.
645
00:34:54,621 --> 00:34:56,956
Okay. At the salad bar,
646
00:34:57,024 --> 00:35:00,311
she used the cucumber tongs
to reach for the cucumbers,
647
00:35:01,161 --> 00:35:02,772
and then the tomatoes.
648
00:35:05,999 --> 00:35:07,485
And the olives.
649
00:35:09,737 --> 00:35:11,447
And the pickles.
650
00:35:12,840 --> 00:35:14,116
- Ugh.
- Mmm.
651
00:35:14,775 --> 00:35:15,775
Mmm-hmm.
652
00:35:46,823 --> 00:35:47,823
Hey.
653
00:35:49,826 --> 00:35:50,826
Hey.
654
00:35:53,230 --> 00:35:54,657
I can see all of you.
655
00:36:00,137 --> 00:36:01,771
How'd... How'd we do?
656
00:36:01,838 --> 00:36:05,908
Great. We got all of the mass,
vision is restored.
657
00:36:05,933 --> 00:36:08,838
You have every reason
to expect a full recovery
658
00:36:09,179 --> 00:36:11,340
and a healthy pregnancy.
659
00:36:13,950 --> 00:36:15,344
We're gonna be dads.
660
00:36:19,463 --> 00:36:20,683
Are you ready?
661
00:36:23,026 --> 00:36:25,267
I've never been a pregnant man before.
662
00:36:27,531 --> 00:36:30,693
You'll always be the best
man that I've ever known.
663
00:36:44,281 --> 00:36:46,449
Came to see how you were doing.
664
00:36:46,516 --> 00:36:49,837
Dr. Andrews told me you was the
one who figured out how to save me.
665
00:36:54,391 --> 00:36:56,761
Still don't change what
went down earlier, though.
666
00:37:02,899 --> 00:37:04,769
When I got to med school,
667
00:37:08,472 --> 00:37:09,828
people took one look at me
668
00:37:09,852 --> 00:37:11,625
and they thought they
knew exactly who I was.
669
00:37:12,509 --> 00:37:14,737
Black girl on financial aid.
670
00:37:16,313 --> 00:37:17,947
She must not be that smart.
671
00:37:18,014 --> 00:37:20,910
She must have gotten a lot of breaks.
672
00:37:21,764 --> 00:37:23,665
She'll probably need a lot more.
673
00:37:28,612 --> 00:37:29,612
And I worked...
674
00:37:31,394 --> 00:37:34,096
I worked so hard
675
00:37:34,164 --> 00:37:35,800
to prove them wrong,
676
00:37:36,233 --> 00:37:37,666
that I wasn't who they thought I was,
677
00:37:37,734 --> 00:37:40,054
that I deserved to be there, that I...
678
00:37:40,337 --> 00:37:42,139
that I fit in.
679
00:37:47,878 --> 00:37:49,980
When you came into the ER,
680
00:37:52,582 --> 00:37:55,111
loud and messy,
681
00:37:57,087 --> 00:37:59,188
I saw...
682
00:37:59,256 --> 00:38:04,662
I saw everything I
have tried hard not to be.
683
00:38:08,377 --> 00:38:10,626
And I think it made me angry.
684
00:38:16,039 --> 00:38:17,717
And I'm ashamed of that.
685
00:38:20,764 --> 00:38:22,388
And I'm really sorry.
686
00:38:26,342 --> 00:38:28,018
I used to be that way.
687
00:38:30,921 --> 00:38:34,400
But I got tired of working that hard
to make white people comfortable.
688
00:38:50,273 --> 00:38:52,168
You two heading out for the night?
689
00:38:55,212 --> 00:38:56,912
We sure are.
690
00:38:56,980 --> 00:38:59,250
How did the craniotomy go, Shaun?
691
00:39:00,329 --> 00:39:02,762
Did you guys get all the prolactinoma?
692
00:39:03,866 --> 00:39:04,866
Yes.
693
00:39:06,022 --> 00:39:08,100
Is that cafeteria salad?
694
00:39:09,726 --> 00:39:11,437
Are there pickles in there?
695
00:39:13,196 --> 00:39:14,263
Did you want some?
696
00:39:14,331 --> 00:39:16,699
You know, I'm good. Thank you.
697
00:39:16,766 --> 00:39:18,569
Shaun, did you...
698
00:39:19,169 --> 00:39:22,364
- No, thank you.
- Mmm-hmm.
699
00:39:26,776 --> 00:39:29,678
It does help to focus on her
irresponsible salad bar practices
700
00:39:29,746 --> 00:39:31,313
and dietary preferences.
701
00:39:31,381 --> 00:39:34,460
I've got a ton of strategies
to manage discomfort.
702
00:39:34,784 --> 00:39:36,086
So do I.
703
00:39:39,322 --> 00:39:40,716
- Hey.
- Hey.
704
00:39:41,758 --> 00:39:43,719
To replenish your supply,
705
00:39:44,533 --> 00:39:45,875
and a peace offering.
706
00:39:46,296 --> 00:39:49,098
I wasn't aware we were at war.
707
00:39:49,165 --> 00:39:52,812
Well, seemed like my gossip
about Pepper kind of landed wrong.
708
00:39:54,271 --> 00:39:55,571
Bad day.
709
00:39:55,639 --> 00:39:57,139
Sorry to crash the party.
710
00:39:57,207 --> 00:40:00,528
Dr. Glassman wanted me
to show this to you two.
711
00:40:01,761 --> 00:40:04,914
I asked Lea to run some
numbers on various metrics by race,
712
00:40:04,981 --> 00:40:07,850
and the results are not great,
713
00:40:07,918 --> 00:40:09,752
especially when it comes
to pain management.
714
00:40:09,819 --> 00:40:13,289
We are under-treating
African-American and Latinx patients
715
00:40:13,356 --> 00:40:16,025
by a considerable margin.
716
00:40:16,092 --> 00:40:17,760
I think I need a little
of that peace offering.
717
00:40:17,827 --> 00:40:19,295
Help yourself.
718
00:40:19,362 --> 00:40:22,049
- Anyone else?
- No. Thank you.
719
00:40:23,600 --> 00:40:25,553
Uh... me, neither.
720
00:40:32,142 --> 00:40:33,142
I...
721
00:40:35,679 --> 00:40:37,690
Started taking sertraline.
722
00:40:39,149 --> 00:40:40,609
For PTSD.
723
00:40:43,119 --> 00:40:44,405
Sorry to hear that.
724
00:40:46,188 --> 00:40:47,575
You doing okay?
725
00:40:50,774 --> 00:40:51,774
Not really.
726
00:40:53,590 --> 00:40:54,590
But I'm
727
00:40:55,912 --> 00:40:56,912
working on it.
728
00:40:58,388 --> 00:40:59,388
Okay.
729
00:41:03,046 --> 00:41:05,801
Dr. Browne, good work.
730
00:41:07,871 --> 00:41:08,871
Thank you.
731
00:41:35,972 --> 00:41:37,750
I apologized to Zara.
732
00:41:40,977 --> 00:41:45,049
She pointed out I spent med school
733
00:41:46,049 --> 00:41:48,802
trying to make white people comfortable.
734
00:41:52,468 --> 00:41:53,468
I mean, she's right.
735
00:41:54,630 --> 00:41:56,268
It wasn't just med school.
736
00:41:58,788 --> 00:41:59,855
Exhausting, isn't it?
737
00:42:03,247 --> 00:42:04,480
But we had to do it, right?
738
00:42:06,236 --> 00:42:07,236
To be here?
739
00:42:27,753 --> 00:42:29,468
I tried tut in my code but
nothing happens
740
00:42:29,492 --> 00:42:30,492
Get out of the way
741
00:42:32,422 --> 00:42:34,916
The cyber attack is trying
to convince me to pay
742
00:42:34,940 --> 00:42:35,953
an exorbitant amount of money
743
00:42:35,978 --> 00:42:37,412
They've given 24 hours.
744
00:42:37,437 --> 00:42:40,486
If I'm wrong, all the imaging
machines in the entire hospital
745
00:42:40,510 --> 00:42:41,476
will self-destruct.
746
00:42:41,568 --> 00:42:42,630
I'm never
747
00:42:42,728 --> 00:42:44,927
100% sure
748
00:42:45,014 --> 00:42:47,646
the surgery is going to cure the patient
749
00:42:47,795 --> 00:42:48,995
but I still do the surgery.
750
00:42:49,096 --> 00:42:51,097
Get into new episode of THE GOOD DOCTOR