1 00:00:01,026 --> 00:00:02,890 Previously on The Good Doctor... 2 00:00:02,915 --> 00:00:04,330 You going to the club or work? 3 00:00:04,355 --> 00:00:06,460 Yeah, these early calls are gonna take some getting used to. 4 00:00:06,488 --> 00:00:07,799 Browne retractor. 5 00:00:07,834 --> 00:00:09,111 No Browne retractor. 6 00:00:09,146 --> 00:00:10,872 I thought I put it on your tray from the supply room. 7 00:00:10,906 --> 00:00:12,321 Dr. Kalu is not your peer. 8 00:00:12,356 --> 00:00:14,082 He's your employee, and you are his boss. 9 00:00:14,116 --> 00:00:17,050 I do not plan to give Jared special treatment. 10 00:00:17,085 --> 00:00:19,881 And if I see it, it won't be good for either of you. 11 00:00:19,915 --> 00:00:21,883 I'm not expecting special treatment, Shaun, 12 00:00:21,917 --> 00:00:24,097 but I don't appreciate being treated like an intern either. 13 00:00:24,132 --> 00:00:27,198 Dr. Andrews said he is judging my performance off of your performance, 14 00:00:27,233 --> 00:00:29,097 and your performance is not good. 15 00:00:29,131 --> 00:00:31,346 You come in with your fancy car 16 00:00:31,370 --> 00:00:32,894 and your old tricks and think, 17 00:00:32,928 --> 00:00:35,517 "Ta-da, I'm a surgeon," but you're not. 18 00:00:35,551 --> 00:00:37,174 I just want to prove that I belong here. 19 00:00:37,208 --> 00:00:39,210 When I checked on Yara post-operatively, 20 00:00:39,245 --> 00:00:40,936 I noticed you only used eight sutures when you closed, 21 00:00:40,971 --> 00:00:42,834 and she had a small bleed. You should have used ten. 22 00:00:42,869 --> 00:00:45,113 Dr. Glassman closed the galea and skin. 23 00:00:45,147 --> 00:00:48,771 - Dr. Glassman skipped two sutures? - Guess so. 24 00:00:54,812 --> 00:00:57,504 At what time did you wake up yesterday morning? 25 00:00:57,539 --> 00:00:59,437 The usual, 5:30. Why? 26 00:00:59,472 --> 00:01:01,715 At lunch, you had a Cobb salad with balsamic vinaigrette, 27 00:01:01,750 --> 00:01:04,003 so that's 450 calories ingested, assuming you kept it down. 28 00:01:04,037 --> 00:01:05,496 Yes, I kept it down. 29 00:01:05,530 --> 00:01:07,691 Did you use a sauna, engage in rigorous exercise, 30 00:01:07,715 --> 00:01:09,378 and/or experience diarrhea? 31 00:01:09,412 --> 00:01:11,035 No, I didn't do any of those things. 32 00:01:11,070 --> 00:01:12,554 What's with the questions, Shaun? 33 00:01:12,588 --> 00:01:14,866 You made an error in yesterday's craniotomy. 34 00:01:14,900 --> 00:01:16,592 I'm trying to evaluate various factors 35 00:01:16,626 --> 00:01:18,594 that would negatively impact focus. 36 00:01:18,629 --> 00:01:19,733 I made an error? 37 00:01:19,768 --> 00:01:21,769 You closed with only eight sutures. 38 00:01:21,804 --> 00:01:23,634 The size of the wound required ten. 39 00:01:23,668 --> 00:01:25,049 We need to figure out why. 40 00:01:25,084 --> 00:01:26,809 Why do we need to figure out why? 41 00:01:26,844 --> 00:01:28,742 Two sutures, it's a blip. It's not a thing. 42 00:01:28,777 --> 00:01:32,125 It could be part of a more troubling pattern needing attention. 43 00:01:32,160 --> 00:01:34,959 Shaun, the surgery was a success, right? 44 00:01:34,993 --> 00:01:36,647 - Yes. - The patient had a great outcome. 45 00:01:36,681 --> 00:01:37,915 There is no pattern. 46 00:01:39,339 --> 00:01:40,650 Goodbye. 47 00:01:47,346 --> 00:01:50,281 I'm a surgeon, and I belong here. 48 00:01:50,316 --> 00:01:53,215 I'm a surgeon, and I belong here. 49 00:01:58,634 --> 00:02:02,121 You are a surgeon, and you belong here. 50 00:02:03,950 --> 00:02:05,641 I just keep imagining you in the mirror 51 00:02:05,676 --> 00:02:08,629 like, "You have the hair of Tracee Ellis Ross 52 00:02:08,653 --> 00:02:10,162 and the swag of Beyonce." 53 00:02:10,197 --> 00:02:11,751 Do not shame my self-care. 54 00:02:13,856 --> 00:02:16,286 Affirmations are backed by research. 55 00:02:17,067 --> 00:02:18,792 fMRI evidence shows a correlation 56 00:02:18,827 --> 00:02:21,083 with positive changes in the brain. 57 00:02:21,588 --> 00:02:24,378 I've just put the finishing touches on a surprise. 58 00:02:25,006 --> 00:02:26,455 Drum roll please. 59 00:02:28,733 --> 00:02:30,321 Or not. 60 00:02:30,356 --> 00:02:31,702 Well, get your song lists ready 61 00:02:31,736 --> 00:02:34,049 because you are all officially invited to... 62 00:02:37,604 --> 00:02:40,469 Star Karaoke, 7:00 p.m. until question mark, question mark. 63 00:02:40,504 --> 00:02:42,101 You know it's gonna be a party 64 00:02:42,125 --> 00:02:43,714 when there's double punctuation involved. 65 00:02:43,748 --> 00:02:45,409 Yeah, just the chance to unwind 66 00:02:45,433 --> 00:02:46,889 and get to know you all a little better. 67 00:02:46,924 --> 00:02:48,822 Sounds fun. Thanks for the invite. 68 00:02:48,857 --> 00:02:52,274 Prepare to be destroyed. My "Someone Like You" slays. 69 00:02:52,309 --> 00:02:55,346 Need a surgical consult for a clinic patient with a dislocated patella. 70 00:02:55,381 --> 00:02:57,693 Mm, sorry, ER. 71 00:02:59,178 --> 00:03:02,215 You two are it. Room one. 72 00:03:07,154 --> 00:03:09,950 When did the chest pain start? 73 00:03:10,085 --> 00:03:11,811 I first noticed it Tuesday morning 74 00:03:11,845 --> 00:03:13,677 along with shortness of breath. 75 00:03:14,296 --> 00:03:16,505 Are you taking any medications? 76 00:03:16,540 --> 00:03:19,266 I started with one, then switched a few times. 77 00:03:20,751 --> 00:03:22,891 These are used to treat ADHD. 78 00:03:22,925 --> 00:03:24,548 And brain fog. 79 00:03:24,582 --> 00:03:26,148 I'm a COVID long-hauler. 80 00:03:27,137 --> 00:03:31,934 Um, and I just started guanfacine and N-acetylcysteine, 81 00:03:31,969 --> 00:03:35,386 which may actually be helping finally. 82 00:03:35,421 --> 00:03:38,044 - When was your initial infection? - Eight months ago. 83 00:03:38,079 --> 00:03:41,012 It just felt like a mild flu, but then it got worse, 84 00:03:41,047 --> 00:03:43,394 like someone poured molasses on my brain. 85 00:03:43,428 --> 00:03:45,569 I've done cognitive therapy, 86 00:03:45,603 --> 00:03:47,502 memory exercises, 87 00:03:47,536 --> 00:03:48,710 still am, 88 00:03:48,744 --> 00:03:50,884 whatever I can do to get back in the field. 89 00:03:51,575 --> 00:03:53,759 - Which one? - Clover. 90 00:03:54,750 --> 00:03:56,428 I'm an evolutionary biologist. 91 00:03:56,821 --> 00:03:58,375 - Oh. - Wow. 92 00:03:58,409 --> 00:03:59,926 I have been studying how 93 00:03:59,950 --> 00:04:03,118 white clover adapts to environmental changes... 94 00:04:03,932 --> 00:04:07,591 And I'm on indefinite leave. 95 00:04:07,625 --> 00:04:08,940 Please stop talking now. 96 00:04:11,008 --> 00:04:14,045 Bluish skin, low O2 levels, rapid heart rate. 97 00:04:14,080 --> 00:04:15,461 And increasingly labored breathing. 98 00:04:15,495 --> 00:04:17,152 Possible pulmonary embolism. 99 00:04:17,187 --> 00:04:19,430 Order a chest CTA and echo, stat. 100 00:04:19,464 --> 00:04:20,619 I have to go. 101 00:04:28,405 --> 00:04:29,406 Oh. 102 00:04:32,512 --> 00:04:33,686 You will need this. 103 00:04:33,720 --> 00:04:36,548 I sent one half of a high volume order to your printer. 104 00:04:37,655 --> 00:04:40,520 These are Glassman's op reports? 105 00:04:40,555 --> 00:04:42,591 For the last three months. January to March. 106 00:04:42,626 --> 00:04:45,594 October to December is printing in Park's and my office. 107 00:04:45,629 --> 00:04:48,666 So you sent reports for, like, 100 surgeries to my printer? 108 00:04:48,701 --> 00:04:51,013 No, 176 surgeries. 109 00:04:51,048 --> 00:04:52,808 473 pages. 110 00:04:52,843 --> 00:04:55,190 I've emailed Operations to replace your toner. 111 00:04:55,225 --> 00:04:56,847 Many elements are in color. 112 00:04:56,881 --> 00:04:59,408 And why, exactly, do you need all of this? 113 00:05:00,161 --> 00:05:02,786 To find out if his mistake was a blip. 114 00:05:08,315 --> 00:05:16,315 Synced & corrected by -robtor- www.addic7ed.com 115 00:05:16,660 --> 00:05:18,558 Second time I've dislocated my knee. 116 00:05:18,593 --> 00:05:21,975 Uh, first was a few months ago, I think. 117 00:05:22,010 --> 00:05:24,185 - That was the sprained ankle. - Ah. 118 00:05:24,219 --> 00:05:26,014 The dislocation was last year. 119 00:05:26,048 --> 00:05:29,938 Your MRI shows no associated damage to bones or ligaments. 120 00:05:30,674 --> 00:05:34,298 She's also been complaining about dizziness, 121 00:05:34,333 --> 00:05:37,681 swollen ankles, maybe menopause-related. 122 00:05:37,715 --> 00:05:40,339 Dr. Reznick is looking to get her on hormone replacement therapy. 123 00:05:40,373 --> 00:05:43,169 Orion insisted I come in and get everything checked out 124 00:05:43,204 --> 00:05:46,034 before she leaves and moves 6,000 miles away 125 00:05:46,068 --> 00:05:47,829 to live alone. 126 00:05:47,863 --> 00:05:50,832 I'm moving to Prague next week for a new job, 127 00:05:50,866 --> 00:05:52,868 and you can come visit me anytime you want, Mom. 128 00:05:52,903 --> 00:05:54,796 Not with a busted knee. 129 00:05:55,077 --> 00:05:56,665 To move forward with HRT, 130 00:05:56,700 --> 00:05:58,357 I need to confirm all the medications 131 00:05:58,391 --> 00:06:00,151 you've used over the last five years. 132 00:06:00,186 --> 00:06:04,501 Oh, uh, there was a purple triangle one, 133 00:06:04,535 --> 00:06:07,055 but they took me off that last year 134 00:06:07,089 --> 00:06:09,230 and an orange-shaped one. 135 00:06:09,264 --> 00:06:10,438 I'll review it with you. 136 00:06:12,198 --> 00:06:14,373 We need to see how your knee is moving. 137 00:06:14,407 --> 00:06:15,615 Lay back, please. 138 00:06:19,309 --> 00:06:21,414 Go ahead with the exam, Dr. Kalu. 139 00:06:22,415 --> 00:06:23,727 I thought I'd observe. 140 00:06:23,761 --> 00:06:24,866 It's a knee exam, 141 00:06:24,900 --> 00:06:27,144 not a multi-ligament reconstruction. 142 00:06:27,178 --> 00:06:29,631 You told me last time not to assume I know everything. 143 00:06:29,666 --> 00:06:31,148 This is just making me do your job. 144 00:06:37,188 --> 00:06:40,525 That sounded like an apneic spell. Check her tonsils. 145 00:06:40,778 --> 00:06:41,848 Ms. Garcia. 146 00:06:45,266 --> 00:06:46,543 Mm? 147 00:06:46,577 --> 00:06:49,270 Oh, did I fall asleep again? 148 00:06:49,304 --> 00:06:50,650 Yes. 149 00:06:50,685 --> 00:06:52,307 Can I take a quick look in your mouth? 150 00:06:52,342 --> 00:06:53,619 Mm-hmm. 151 00:06:56,622 --> 00:06:58,244 Kissing tonsils. 152 00:06:58,279 --> 00:06:59,763 They're so enlarged, they're touching 153 00:06:59,797 --> 00:07:02,283 and obstructing your airway, causing severe apnea. 154 00:07:03,249 --> 00:07:05,158 You need a tonsillectomy right away. 155 00:07:09,945 --> 00:07:12,948 No pulmonary embolism, but multiple cardiac issues. 156 00:07:12,983 --> 00:07:15,088 Severe narrowing of the pulmonic valve, 157 00:07:15,123 --> 00:07:16,642 hypertrophied right ventricle 158 00:07:16,676 --> 00:07:18,333 and opening between the lower chambers. 159 00:07:18,368 --> 00:07:20,991 This set of defects almost looks like 160 00:07:21,025 --> 00:07:23,176 - tetralogy of Fallot, but... - It is. 161 00:07:24,719 --> 00:07:26,824 She has the fourth malformation, 162 00:07:26,859 --> 00:07:27,998 overriding aorta. 163 00:07:28,032 --> 00:07:30,715 I've never seen tet in an adult before. 164 00:07:32,382 --> 00:07:34,271 How is she still alive? 165 00:07:35,868 --> 00:07:36,972 Hang on a sec. 166 00:07:37,007 --> 00:07:38,441 I have to write everything down now. 167 00:07:40,735 --> 00:07:42,943 Tet is almost always diagnosed in infancy. 168 00:07:42,978 --> 00:07:45,015 Doctors somehow missed it in your case. 169 00:07:45,049 --> 00:07:47,328 Oh, you have a rare presentation. 170 00:07:47,362 --> 00:07:49,330 The right ventricle obstruction has been balanced 171 00:07:49,364 --> 00:07:51,608 by an increased flow into the left ventricle. 172 00:07:51,642 --> 00:07:54,473 Damage from COVID disrupted the balance. 173 00:07:54,507 --> 00:07:55,888 The virus may have saved your life. 174 00:07:55,922 --> 00:07:57,544 Very few undiagnosed tet patients 175 00:07:57,579 --> 00:07:58,787 survive past childhood. 176 00:07:58,822 --> 00:08:00,927 A mere 2% make it to 40. 177 00:08:00,962 --> 00:08:02,308 You're saying 178 00:08:02,343 --> 00:08:03,965 I would have just dropped dead at some point? 179 00:08:03,999 --> 00:08:05,967 It's very likely. 180 00:08:06,001 --> 00:08:09,660 We can remove that risk with two separate procedures. 181 00:08:09,695 --> 00:08:11,904 First, we'll close the extra vessels 182 00:08:11,938 --> 00:08:14,562 that have formed to compensate for your heart defects. 183 00:08:14,596 --> 00:08:17,230 Then we'll do a surgery to repair those defects. 184 00:08:19,567 --> 00:08:21,741 Is it possible the tet is connected 185 00:08:21,776 --> 00:08:23,294 to my long COVID symptoms? 186 00:08:23,329 --> 00:08:25,739 Could fixing my heart clear up my head, 187 00:08:26,884 --> 00:08:28,023 the brain? 188 00:08:28,990 --> 00:08:31,475 No. I'm sorry. 189 00:08:40,933 --> 00:08:42,106 You snagged our table. 190 00:08:43,176 --> 00:08:44,730 Beat Hawks and Nunez to it. 191 00:08:44,764 --> 00:08:46,594 You're a champion. 192 00:08:46,628 --> 00:08:49,251 One Splenda, half Sugar in the Raw, light almond milk. 193 00:08:49,286 --> 00:08:50,356 Now who's the champion? 194 00:08:50,391 --> 00:08:51,392 Mm. 195 00:08:55,119 --> 00:08:56,728 I have something for you. 196 00:08:57,467 --> 00:08:58,778 - Really? - Mm-hmm. 197 00:09:05,578 --> 00:09:08,581 An agreement acknowledging a consensual relationship. 198 00:09:08,616 --> 00:09:10,894 I, Marcus Andrews, would like to take you, 199 00:09:10,928 --> 00:09:13,621 Dalisay Villanueva, on a date. 200 00:09:13,655 --> 00:09:17,728 And as hospital president, you know, I already signed it. 201 00:09:19,765 --> 00:09:21,127 This is so romantic. 202 00:09:21,939 --> 00:09:23,213 Give me the pen. 203 00:09:30,016 --> 00:09:32,605 - Dinner this weekend? - Let me see. 204 00:09:32,640 --> 00:09:34,724 Oh, I'm needed on the ward. 205 00:09:35,180 --> 00:09:36,699 Sorry. Lock it down later? 206 00:09:36,781 --> 00:09:37,782 Sure. 207 00:09:45,584 --> 00:09:46,619 Iced coffee? 208 00:09:46,654 --> 00:09:48,238 I'm good. 209 00:09:48,966 --> 00:09:50,490 How about a hot coffee? 210 00:09:52,798 --> 00:09:56,042 In honor of Daphne's successful tonsillectomy, 211 00:09:56,077 --> 00:09:57,789 I got a few options. 212 00:09:59,114 --> 00:10:00,599 Is that a latte? 213 00:10:00,633 --> 00:10:01,600 Mm. 214 00:10:03,671 --> 00:10:05,914 It was a routine tonsillectomy. 215 00:10:05,949 --> 00:10:08,216 Those were unusually large tonsils. 216 00:10:09,159 --> 00:10:10,844 A good thing her daughter brought her in. 217 00:10:13,301 --> 00:10:14,958 You think Daphne was better off not breathing? 218 00:10:14,992 --> 00:10:16,580 I don't think it's a daughter's job 219 00:10:16,615 --> 00:10:18,375 to make sure Mom goes to the doctor. 220 00:10:21,792 --> 00:10:22,828 It's Daphne. 221 00:10:25,555 --> 00:10:27,039 Heart rate spiked. She's hypoxic. 222 00:10:27,073 --> 00:10:28,695 Turn up oxygen to max flow. 223 00:10:32,838 --> 00:10:35,047 Loud murmur from the right ventricle and atrium. 224 00:10:35,081 --> 00:10:36,876 Chronic damage from apnea could have increased 225 00:10:36,911 --> 00:10:38,671 the pressure in her lungs, causing right heart failure. 226 00:10:38,706 --> 00:10:40,466 BP's dropping. 227 00:10:40,501 --> 00:10:42,167 We need to get her to the cath lab. 228 00:10:47,473 --> 00:10:49,215 Positioning coiling system. 229 00:10:50,165 --> 00:10:51,650 Two vessels left to close. 230 00:10:53,203 --> 00:10:54,679 Deploying the coil. 231 00:10:57,172 --> 00:10:59,692 O2 sats are dropping. 232 00:10:59,727 --> 00:11:03,178 Her infundibular muscle is clamping down. 233 00:11:03,213 --> 00:11:04,819 She is having a tet spell. 234 00:11:06,665 --> 00:11:08,977 Give phenylephrine and 100% oxygen. 235 00:11:09,012 --> 00:11:11,154 I have never seen one in-person before. 236 00:11:12,567 --> 00:11:14,293 We need to move blood up to the lungs. 237 00:11:14,327 --> 00:11:16,226 Give her a bolus and up the opiates. 238 00:11:20,575 --> 00:11:21,990 If we don't stop the spasm, 239 00:11:22,025 --> 00:11:23,750 she could have permanent brain damage. 240 00:11:34,762 --> 00:11:37,937 The chance of a future infundibular spasm is very high. 241 00:11:39,525 --> 00:11:42,777 Her tet repair surgery will be much more risky. 242 00:11:50,294 --> 00:11:52,745 Pressure in Daphne's lungs is still critically high. 243 00:11:52,780 --> 00:11:54,656 Not a routine tonsillectomy at all. 244 00:11:55,576 --> 00:11:57,003 Puncturing the atrial septum. 245 00:11:58,648 --> 00:12:01,271 Right heart is decompressing. 246 00:12:01,305 --> 00:12:04,481 Give nitric oxide to relax and dilate the vasculature. 247 00:12:04,515 --> 00:12:07,760 Her apnea really did a number on her pulmonary vessels. 248 00:12:07,795 --> 00:12:10,038 No wonder she's clumsy and forgetful. 249 00:12:10,073 --> 00:12:12,799 She's been sleep- and oxygen-deprived for decades. 250 00:12:13,352 --> 00:12:16,113 It still doesn't make her her daughter's responsibility. 251 00:12:16,148 --> 00:12:19,097 Would you want Kellan to put his life on hold to take care of you? 252 00:12:19,634 --> 00:12:21,843 Not his whole life, no, 253 00:12:21,878 --> 00:12:25,191 but I don't think being overly devoted is the worst quality in a kid. 254 00:12:25,226 --> 00:12:26,563 Remove the catheters. 255 00:12:27,746 --> 00:12:30,300 I was one of six growing up, only girl. 256 00:12:30,334 --> 00:12:31,577 Mom and dad worked a lot, 257 00:12:31,612 --> 00:12:34,487 so I was basically second mom since kindergarten. 258 00:12:35,616 --> 00:12:37,282 I love my brothers, but... 259 00:12:39,274 --> 00:12:41,483 there's a lot you miss out on 260 00:12:41,518 --> 00:12:43,727 if you're all about taking care of someone else. 261 00:12:48,283 --> 00:12:50,251 She's throwing a lot of PVCs. 262 00:12:50,285 --> 00:12:51,880 Maybe an electrolyte issue. 263 00:12:54,600 --> 00:12:56,498 BP's dropping. Heart rate 172. 264 00:12:56,533 --> 00:12:59,432 We're barely getting a pulse. She's in V-tach. Defib pads. 265 00:13:17,312 --> 00:13:19,107 BP and heart rate stabilizing. 266 00:13:21,178 --> 00:13:23,146 Get a new chemistry, chest X-ray, EKG. 267 00:13:23,180 --> 00:13:25,413 We need to figure out what else is going on with her heart. 268 00:13:35,192 --> 00:13:37,367 Oh, please don't disturb my materials. 269 00:13:37,401 --> 00:13:40,404 Which are what, exactly? 270 00:13:40,439 --> 00:13:42,821 Dr. Glassman made an uncharacteristic surgical error. 271 00:13:42,855 --> 00:13:44,650 I am determining if it was an anomaly 272 00:13:44,685 --> 00:13:46,410 or part of a pattern. 273 00:13:46,445 --> 00:13:48,447 Glassman must be really pleased about that. 274 00:13:48,481 --> 00:13:49,729 He is not. 275 00:13:50,552 --> 00:13:51,795 You are being sarcastic. 276 00:13:51,830 --> 00:13:53,555 Performance review is a standard practice 277 00:13:53,590 --> 00:13:55,212 and benefits both doctors and patients. 278 00:13:55,247 --> 00:13:57,046 I have identified three additional errors 279 00:13:57,070 --> 00:13:58,319 made in the last four months. 280 00:13:58,353 --> 00:13:59,907 I don't see a pattern. 281 00:13:59,941 --> 00:14:02,392 A dural tear on scarred tissue, 282 00:14:02,426 --> 00:14:04,325 closing with a running nylon instead of Monocryl... 283 00:14:04,359 --> 00:14:05,464 Is that even a mistake? 284 00:14:05,498 --> 00:14:08,536 Dr. Glassman has always used subcutaneous Monocryl. 285 00:14:08,570 --> 00:14:10,780 These are variations, minor missteps. 286 00:14:10,814 --> 00:14:13,265 You pore through four months of any surgeon's op reports, 287 00:14:13,299 --> 00:14:15,129 and you'll find discrepancies like this. 288 00:14:15,405 --> 00:14:17,579 - No. - Yes. 289 00:14:17,826 --> 00:14:19,241 Not in mine. 290 00:14:19,685 --> 00:14:22,101 That's probably true. 291 00:14:22,136 --> 00:14:24,347 Eh, if you're not finding a pattern, 292 00:14:24,863 --> 00:14:26,391 maybe it's because there isn't one. 293 00:14:29,895 --> 00:14:31,270 My patient is awake. 294 00:14:32,974 --> 00:14:36,426 Does this mean you can't move forward with the tet repair? 295 00:14:36,460 --> 00:14:38,359 There's a medication called propranolol 296 00:14:38,393 --> 00:14:40,119 that will significantly reduce the risk 297 00:14:40,154 --> 00:14:42,363 of having another spasm during surgery, 298 00:14:42,397 --> 00:14:44,020 but because of your long COVID, 299 00:14:44,054 --> 00:14:46,327 you're at risk for some very rare side effects. 300 00:14:46,643 --> 00:14:48,645 - Are they serious? - Yes. 301 00:14:48,679 --> 00:14:50,543 Well, some of them are not, like nausea, vomiting, 302 00:14:50,578 --> 00:14:52,580 muscle aches, and dizziness, but others, 303 00:14:52,614 --> 00:14:54,789 such as hypoglycemia or visual changes... 304 00:14:54,824 --> 00:14:56,204 We'll start you on the propranolol. 305 00:14:56,239 --> 00:14:59,138 There's a good chance you won't experience the rare side effects, 306 00:14:59,173 --> 00:15:01,342 but we'll need to keep a close eye on you. 307 00:15:03,142 --> 00:15:04,557 And are those patients ahead of her 308 00:15:04,592 --> 00:15:06,472 also seniors with diabetes? 309 00:15:07,284 --> 00:15:08,561 Do not hang up on me, Phillip, 310 00:15:08,596 --> 00:15:10,143 or I'll head down to do this in person. 311 00:15:11,006 --> 00:15:12,030 I'll wait. 312 00:15:13,392 --> 00:15:14,358 Hey. 313 00:15:16,259 --> 00:15:20,056 There is a great new Portuguese spot I read about. 314 00:15:20,090 --> 00:15:23,573 I can make reservations for us Friday or Saturday at 7:00? 315 00:15:24,785 --> 00:15:26,441 Uh, I'm working a double both days. 316 00:15:26,476 --> 00:15:28,650 It's been a nonstop scramble since Baker and Linh left. 317 00:15:28,685 --> 00:15:30,825 Well, you have two new travelers starting on Monday. 318 00:15:30,860 --> 00:15:32,137 We need staff nurses. 319 00:15:32,171 --> 00:15:33,517 These nurses are highly skilled. We... 320 00:15:33,552 --> 00:15:34,902 It doesn't matter how skilled 321 00:15:34,937 --> 00:15:36,935 they are. Travel nurses disrupt workflow, 322 00:15:36,969 --> 00:15:38,522 don't build long-term relationships. 323 00:15:38,557 --> 00:15:40,308 Right now, we just don't have the resources 324 00:15:40,332 --> 00:15:41,594 for permanent replacements. 325 00:15:41,629 --> 00:15:43,665 You just hired a new full-time surgical resident 326 00:15:43,700 --> 00:15:45,460 to replace someone who left way more recently. 327 00:15:45,495 --> 00:15:47,014 That was Lim's department. I... 328 00:15:47,877 --> 00:15:50,016 Yes, great. I'm sending her down. 329 00:15:50,880 --> 00:15:52,088 Sorry. We'll talk later? 330 00:15:52,122 --> 00:15:53,158 Of course. 331 00:15:56,195 --> 00:15:58,646 So you're watching to see if I throw up? 332 00:15:58,680 --> 00:16:01,027 Or faint, seize, or have muscle spasms. 333 00:16:05,687 --> 00:16:08,534 You know, before COVID, my brain was... 334 00:16:09,657 --> 00:16:12,591 I did evolutionary patterns, 335 00:16:12,625 --> 00:16:15,500 genetic, uh... 336 00:16:16,560 --> 00:16:19,337 how genes go together. 337 00:16:20,495 --> 00:16:21,839 The sequence. 338 00:16:24,120 --> 00:16:27,011 Now my brain can't handle the sequence of brushing my teeth. 339 00:16:28,849 --> 00:16:32,475 My focus, my working memory, all of the... 340 00:16:35,717 --> 00:16:37,996 The executive function. 341 00:16:40,343 --> 00:16:43,208 It's not always happening. 342 00:16:46,107 --> 00:16:49,179 Please page Dr. Wolke to monitor her and stay until he comes. 343 00:16:51,285 --> 00:16:52,912 Push your hand against mine. 344 00:16:54,012 --> 00:16:56,255 The pattern is errors in executive function. 345 00:16:56,290 --> 00:16:57,670 Shaun, I'm in the middle of doing something. 346 00:16:57,705 --> 00:17:00,604 Your brain cancer may have returned. 347 00:17:06,921 --> 00:17:08,925 All errors are tied to executive function. 348 00:17:08,949 --> 00:17:10,059 - Shaun... - Specifically 349 00:17:10,083 --> 00:17:11,512 to working and procedural memory governed 350 00:17:11,546 --> 00:17:13,169 by the dorsolateral prefrontal cortex, 351 00:17:13,203 --> 00:17:15,102 a common site for a recurrent glioma, 352 00:17:15,136 --> 00:17:18,276 which strongly suggests your cancer has returned. 353 00:17:18,312 --> 00:17:21,383 My last scan came back completely clear. I'm fine. 354 00:17:21,418 --> 00:17:23,006 Your last scan was six months ago. 355 00:17:23,041 --> 00:17:25,388 These errors all took place in the last four months. 356 00:17:25,421 --> 00:17:26,907 So you need another scan. 357 00:17:26,940 --> 00:17:28,218 The evidence is very compelling. 358 00:17:28,253 --> 00:17:29,668 No, it's really not. 359 00:17:29,702 --> 00:17:32,119 I perform complex surgeries, Shaun, 360 00:17:32,153 --> 00:17:35,053 more so than any other doctor on this staff, by the way. 361 00:17:35,087 --> 00:17:36,917 So yeah, the percentages would dictate 362 00:17:36,951 --> 00:17:41,059 that I might make more minor and irrelevant missteps, 363 00:17:41,093 --> 00:17:43,095 if that's what you want to call them, and... 364 00:17:43,130 --> 00:17:44,855 And the rate of errors has increased. 365 00:17:44,890 --> 00:17:47,410 Yeah, because I take on the tougher cases, 366 00:17:47,444 --> 00:17:48,790 the ones no one else will. 367 00:17:48,825 --> 00:17:51,724 No, you need another MRI now. 368 00:17:51,759 --> 00:17:54,037 Shaun, what I need is to get back to my patient. 369 00:17:54,072 --> 00:17:57,420 And you need to knock first next time. 370 00:18:02,011 --> 00:18:03,495 It's the greening of the... 371 00:18:05,083 --> 00:18:06,429 My turn. 372 00:18:08,603 --> 00:18:10,536 I'm trying to get some of my cognitive exercises in. 373 00:18:10,823 --> 00:18:12,469 What are you memorizing? 374 00:18:12,504 --> 00:18:14,609 It's a poem from The Carrying, Ada Limon. 375 00:18:14,644 --> 00:18:15,714 Hmm. 376 00:18:15,748 --> 00:18:17,663 The collection is mostly about... 377 00:18:19,683 --> 00:18:22,928 not having the life you thought you'd have, I guess. 378 00:18:24,205 --> 00:18:28,899 The one I was just reading, it's about spring coming, 379 00:18:29,193 --> 00:18:31,368 Instructions on Not Giving Up. 380 00:18:31,833 --> 00:18:33,801 - Sounds useful. - Yeah. 381 00:18:33,835 --> 00:18:35,306 Too bad I can't read it all at once. 382 00:18:35,837 --> 00:18:38,357 I've just graduated from haikus. 383 00:18:38,392 --> 00:18:41,229 I never even thought to look at a poem before I got sick. 384 00:18:42,568 --> 00:18:44,815 Didn't have the patience for it at the time, 385 00:18:45,813 --> 00:18:47,526 but it's basically all I read now. 386 00:18:48,540 --> 00:18:50,024 I started writing, too. 387 00:18:50,059 --> 00:18:53,752 It's kind of a creative therapy. 388 00:18:53,786 --> 00:18:55,340 Mm. 389 00:18:55,374 --> 00:18:58,515 There was a kind of poetry 390 00:18:58,550 --> 00:19:01,656 to the genetic variations in white clover too. 391 00:19:05,143 --> 00:19:06,921 I'd give anything to... 392 00:19:12,391 --> 00:19:14,048 Your blood pressure is going down, 393 00:19:14,083 --> 00:19:15,222 and your heart rate's climbing. 394 00:19:15,256 --> 00:19:16,326 I feel kind of dizzy. 395 00:19:16,361 --> 00:19:17,932 Let me check your glucose. 396 00:19:21,400 --> 00:19:23,782 She's having a seizure. Crash cart now! 397 00:19:26,026 --> 00:19:28,373 We thought something else was going on with your heart, 398 00:19:28,407 --> 00:19:29,477 but it's a kidney issue. 399 00:19:29,512 --> 00:19:31,376 You have a narrowing of your renal arteries, 400 00:19:31,410 --> 00:19:33,481 which was exacerbated by the pulmonary hypertension, 401 00:19:33,516 --> 00:19:34,551 causing your kidneys to fail. 402 00:19:34,586 --> 00:19:37,002 And this is because of my sleep apnea? 403 00:19:37,037 --> 00:19:39,004 We believe so, yeah. 404 00:19:39,039 --> 00:19:41,903 Uh, can she get a transplant? 405 00:19:41,938 --> 00:19:44,044 I can do a test, see if I'm a match. 406 00:19:44,078 --> 00:19:47,599 Unfortunately, your other health concerns rule out a transplant, 407 00:19:47,633 --> 00:19:49,551 but a renal artery bypass 408 00:19:49,575 --> 00:19:52,086 would allow your kidneys to heal on their own. 409 00:19:52,121 --> 00:19:55,511 There's risk of complications, some quite serious. 410 00:19:56,159 --> 00:20:00,888 But in success, you could live a full, independent life. 411 00:20:00,922 --> 00:20:04,167 But... oh, but serious, 412 00:20:04,202 --> 00:20:06,928 as in I could die? 413 00:20:06,963 --> 00:20:10,035 Some complications can be fatal. 414 00:20:10,070 --> 00:20:12,069 But the risk is relatively low. 415 00:20:13,073 --> 00:20:15,281 Are there other options? 416 00:20:15,627 --> 00:20:17,007 Well, there's dialysis, 417 00:20:17,042 --> 00:20:19,211 but you'd need multiple sessions a week 418 00:20:19,235 --> 00:20:20,578 for the rest of your life. 419 00:20:22,496 --> 00:20:26,584 Um, that's less risky, but I... 420 00:20:27,259 --> 00:20:30,297 I don't think I could handle all that on my own. 421 00:20:30,331 --> 00:20:35,217 Mom, Mom, if you want to choose the dialysis, I'll stay in San Jose. 422 00:20:37,476 --> 00:20:38,721 I'm sorry. 423 00:20:39,651 --> 00:20:41,101 I don't want to keep you. 424 00:20:41,135 --> 00:20:44,104 No, you have nothing to be sorry for. 425 00:20:44,138 --> 00:20:47,313 All this time you've been sick and struggling, and I... 426 00:20:48,315 --> 00:20:49,482 I judged you. 427 00:20:50,420 --> 00:20:51,901 But your new job. 428 00:20:54,286 --> 00:20:55,529 It's just a job. 429 00:21:04,043 --> 00:21:07,115 So the medication you gave me 430 00:21:07,265 --> 00:21:09,612 to make my surgery safer 431 00:21:09,646 --> 00:21:12,166 will actually make it more risky? 432 00:21:12,201 --> 00:21:13,167 That's right. 433 00:21:14,030 --> 00:21:15,583 But without that medication, 434 00:21:15,618 --> 00:21:18,414 I'm much more likely to have another tet spell. 435 00:21:18,448 --> 00:21:22,245 Yes, and possibly more severe than the last time. 436 00:21:22,280 --> 00:21:26,102 The brain fog, all my deficits... 437 00:21:27,388 --> 00:21:28,896 could get worse, 438 00:21:30,357 --> 00:21:31,979 for possibly forever? 439 00:21:33,222 --> 00:21:34,361 Yes. 440 00:21:36,052 --> 00:21:37,916 But if we don't do the tet repair, 441 00:21:37,950 --> 00:21:40,241 your heart will stop at some point. 442 00:21:43,335 --> 00:21:45,268 I've already been through 443 00:21:45,303 --> 00:21:48,789 losing my thoughts, my whole self. 444 00:21:53,034 --> 00:21:54,435 I can't do that again. 445 00:21:59,248 --> 00:22:01,095 Find another way to fix my heart. 446 00:22:19,199 --> 00:22:21,028 All right, new idea. 447 00:22:21,062 --> 00:22:23,513 We go back to the old idea and just do the surgery. 448 00:22:23,548 --> 00:22:24,997 It's a non-starter. 449 00:22:25,032 --> 00:22:28,035 We need to present a way to help her tet without triggering her tet. 450 00:22:28,069 --> 00:22:30,934 A percutaneous valve and VSD closure could help with blood flow. 451 00:22:30,969 --> 00:22:32,522 That involves catheters in the heart, 452 00:22:32,557 --> 00:22:34,295 which would cause the muscle to spasm. 453 00:22:34,973 --> 00:22:37,389 All right. It's time for some WWSMD. 454 00:22:37,424 --> 00:22:40,012 Whatever you and Jerome do on your own time is... 455 00:22:40,047 --> 00:22:41,552 It's "what would Shaun Murphy do?" 456 00:23:13,114 --> 00:23:16,359 ♪ If a party is what you need ♪ 457 00:23:16,394 --> 00:23:17,947 ♪ They're dancing ♪ 458 00:23:17,981 --> 00:23:19,215 What about a shunt? 459 00:23:20,225 --> 00:23:22,262 It would improve blood flow, buy a few months 460 00:23:22,296 --> 00:23:23,918 to continue her cognitive recovery. 461 00:23:23,953 --> 00:23:26,127 Once she feels better about where her brain's at, 462 00:23:26,162 --> 00:23:27,646 maybe she lets us fix her heart. 463 00:23:27,681 --> 00:23:30,200 Her tet will likely kill her before that, 464 00:23:30,235 --> 00:23:34,170 but placing a shunt won't trigger a spell, 465 00:23:34,204 --> 00:23:36,524 making it something she'd actually accept. 466 00:23:40,035 --> 00:23:41,403 I'll take it to her. 467 00:23:42,420 --> 00:23:44,214 I can stay only 45 minutes. 468 00:23:44,249 --> 00:23:46,389 I have to review Dr. Glassman's OR videos. 469 00:23:46,424 --> 00:23:47,666 Didn't you already review them? 470 00:23:47,701 --> 00:23:49,461 Not for symptoms of glioma recurrence. 471 00:23:49,496 --> 00:23:51,774 New evidence will convince Dr. Glassman to get a scan. 472 00:23:51,808 --> 00:23:54,570 Okay, you binged months of data in one day. 473 00:23:54,604 --> 00:23:55,916 You'll have a clearer head in the morning. 474 00:23:55,950 --> 00:23:58,919 Until then, here we are, karaoke rager. 475 00:23:58,953 --> 00:24:00,507 - Yay. - It is yay. 476 00:24:00,541 --> 00:24:02,785 We have song lists. Plus Jared's our friend. 477 00:24:02,819 --> 00:24:04,927 He just moved back. Celebration is in order. 478 00:24:05,719 --> 00:24:08,238 I will review the videos in the morning. 479 00:24:08,273 --> 00:24:09,274 Yay! 480 00:24:10,033 --> 00:24:11,483 It sounds pretty wild in there. 481 00:24:11,518 --> 00:24:15,142 ♪ Because maybe ♪ 482 00:24:15,176 --> 00:24:19,215 ♪ You're gonna be the one That saves me ♪ 483 00:24:20,665 --> 00:24:22,529 ♪ And after... ♪ 484 00:24:26,843 --> 00:24:29,052 I was just warming up. 485 00:24:29,087 --> 00:24:32,021 - Where is everyone? - There is a lot of food. 486 00:24:32,055 --> 00:24:34,623 Yeah, I had it catered. You're the first to arrive. 487 00:24:35,335 --> 00:24:38,199 And so far, last-minute rain checks 488 00:24:38,234 --> 00:24:40,788 from Morgan, Park, Asher, Danny. 489 00:24:42,134 --> 00:24:43,716 Oh, and Jerome. 490 00:24:45,655 --> 00:24:46,898 So it's just us four? 491 00:24:46,932 --> 00:24:50,626 Which means that all these snacks 492 00:24:50,660 --> 00:24:53,836 and song binders are for us. 493 00:24:53,870 --> 00:24:55,665 Oh. Yes. 494 00:24:55,700 --> 00:24:59,048 The low turnout is the perfect opportunity to discuss symptoms. 495 00:25:00,739 --> 00:25:02,741 In your recent surgeries with Dr. Glassman, 496 00:25:02,776 --> 00:25:04,467 do you recall observing any balance issues, 497 00:25:04,502 --> 00:25:06,155 tremors, or motor weakness? 498 00:25:11,405 --> 00:25:13,329 That sounds like the perfect option. 499 00:25:14,339 --> 00:25:16,514 How soon can you do the shunt procedure? 500 00:25:16,753 --> 00:25:19,066 I'll try to schedule it for tomorrow. 501 00:25:23,681 --> 00:25:26,258 I've had a strange year myself. 502 00:25:29,112 --> 00:25:30,907 Eleven months ago, 503 00:25:30,942 --> 00:25:32,219 I was attacked 504 00:25:32,253 --> 00:25:34,475 and paralyzed from the waist down. 505 00:25:35,429 --> 00:25:38,228 I thought it was permanent. Almost everyone did. 506 00:25:40,986 --> 00:25:45,611 At first, all I wanted was to walk again. 507 00:25:46,613 --> 00:25:50,324 I was ready to risk my life to get back to the old me. 508 00:25:51,480 --> 00:25:53,077 But as time went on, 509 00:25:53,930 --> 00:25:58,728 I started to appreciate my new life, my new self. 510 00:26:01,455 --> 00:26:03,457 I started a new relationship 511 00:26:03,492 --> 00:26:05,297 that wouldn't have happened otherwise. 512 00:26:07,634 --> 00:26:09,677 In many ways, my life improved. 513 00:26:10,499 --> 00:26:13,018 You recognize you walked in to tell me this story? 514 00:26:14,951 --> 00:26:16,574 I only agreed to do the surgery 515 00:26:16,608 --> 00:26:17,954 once I knew my life wasn't at risk. 516 00:26:17,989 --> 00:26:20,771 And even then, I had doubts. 517 00:26:22,338 --> 00:26:23,995 I liked who I'd become. 518 00:26:24,029 --> 00:26:25,818 I wanted to hold on to her. 519 00:26:29,966 --> 00:26:30,967 I'm not... 520 00:26:33,798 --> 00:26:35,144 losing my mind... 521 00:26:37,077 --> 00:26:38,288 all over again. 522 00:26:41,012 --> 00:26:43,669 You don't strike me as someone who's lost her mind. 523 00:27:01,135 --> 00:27:02,999 That covers the thrombectomy. 524 00:27:03,034 --> 00:27:04,138 In February, you assisted on a... 525 00:27:04,173 --> 00:27:07,960 Okay, I'm playing the pregnant lady card. 526 00:27:08,902 --> 00:27:10,248 We're going, Shaun. 527 00:27:10,282 --> 00:27:11,456 Okay. 528 00:27:12,664 --> 00:27:14,321 Thank you. Goodbye. 529 00:27:16,047 --> 00:27:17,703 I should head out, too. 530 00:27:18,981 --> 00:27:21,665 - Early morning. - Yeah. 531 00:27:25,539 --> 00:27:28,784 Maybe focus on being a first-year resident 532 00:27:28,818 --> 00:27:32,926 before adding party planner to your resume. 533 00:27:35,100 --> 00:27:37,473 The catering may have been a bridge too far. 534 00:27:38,034 --> 00:27:39,070 Yeah. 535 00:27:43,730 --> 00:27:45,397 I bounced around growing up. 536 00:27:47,043 --> 00:27:50,903 Different schools, cities, countries. 537 00:27:51,772 --> 00:27:55,741 But, um, wherever we were, my parents had a big house, 538 00:27:56,536 --> 00:27:58,118 and I knew how to throw a party. 539 00:28:01,057 --> 00:28:04,583 Closest I'd get to feeling like I fit. 540 00:28:06,942 --> 00:28:08,712 Old habits die hard, I guess. 541 00:28:11,274 --> 00:28:13,173 Fitting in takes time. 542 00:28:14,243 --> 00:28:17,679 But I never have, anywhere. 543 00:28:21,802 --> 00:28:23,060 Maybe not everyone 544 00:28:24,476 --> 00:28:25,813 finds their place. 545 00:28:30,949 --> 00:28:33,020 Daphne is getting septic. We have to go. 546 00:28:41,106 --> 00:28:42,202 Morning. 547 00:28:42,236 --> 00:28:43,824 Hello. 548 00:28:43,859 --> 00:28:44,894 Mm. 549 00:28:46,620 --> 00:28:48,139 You should not have that. 550 00:28:48,173 --> 00:28:50,693 I'm permitted 12 ounces a day. Experts agree. 551 00:28:50,728 --> 00:28:53,731 Yes, but that was brewed when I woke up at 3:30 a.m. 552 00:28:56,457 --> 00:28:57,976 You make it through the videos? 553 00:28:58,011 --> 00:29:00,392 Yes, and integrated the observations 554 00:29:00,427 --> 00:29:02,153 Doctors Kalu and Allen made last night 555 00:29:02,187 --> 00:29:04,569 regarding possible glioma symptoms. 556 00:29:07,020 --> 00:29:10,126 I am now ready to present Dr. Glassman with the revised evidence, 557 00:29:10,161 --> 00:29:12,094 which is very compelling. 558 00:29:12,128 --> 00:29:13,129 Mm. 559 00:29:16,201 --> 00:29:19,619 Thankfully, your infection is responding to the antibiotics. 560 00:29:19,653 --> 00:29:22,656 The infection started around your dialysis port. 561 00:29:22,691 --> 00:29:24,663 That could easily happen again. 562 00:29:25,763 --> 00:29:28,904 The renal artery bypass is still an option. 563 00:29:28,938 --> 00:29:30,794 It's too risky. 564 00:29:30,975 --> 00:29:32,296 So is sepsis. 565 00:29:33,633 --> 00:29:36,808 Thank you, Doctor, but I'll settle for being alive. 566 00:29:36,982 --> 00:29:38,358 You shouldn't. 567 00:29:40,156 --> 00:29:41,597 You deserve more than that. 568 00:29:42,642 --> 00:29:44,782 I know you've had a whole life of feeling sick 569 00:29:44,816 --> 00:29:48,337 and stuck and repeating the same old, bad patterns, 570 00:29:48,371 --> 00:29:51,273 but your past does not have to tell your future where to go. 571 00:29:55,137 --> 00:29:57,415 You can choose a different path 572 00:29:57,449 --> 00:29:59,417 and who you're gonna be on it. 573 00:30:01,315 --> 00:30:03,493 And let your daughter do the same. 574 00:30:08,460 --> 00:30:10,014 Prague is beautiful in the spring. 575 00:30:47,568 --> 00:30:50,248 We've scheduled the shunt placement for this afternoon. 576 00:30:51,676 --> 00:30:53,195 And that whole speech last night? 577 00:30:53,229 --> 00:30:56,505 I stand by it, but it's your decision. 578 00:31:02,031 --> 00:31:05,034 I've been waiting for the old me to come back, and... 579 00:31:09,280 --> 00:31:11,395 That person may not exist anymore. 580 00:31:13,871 --> 00:31:14,906 And... 581 00:31:17,322 --> 00:31:19,277 maybe I should be okay with that. 582 00:31:24,916 --> 00:31:26,201 Do the tet repair. 583 00:31:41,139 --> 00:31:43,218 Releasing the proximal clamp. 584 00:31:45,109 --> 00:31:46,847 What made Daphne change her mind? 585 00:31:47,836 --> 00:31:50,142 Dr. Allen has a way of getting through to people. 586 00:31:54,566 --> 00:31:56,534 Blood flow looks obstructed. 587 00:31:56,568 --> 00:31:57,941 There's a kink in the graft. 588 00:31:59,433 --> 00:32:01,624 We can undo it, but most likely, it happens again. 589 00:32:05,439 --> 00:32:09,512 We could anchor the bypass off of the aorta instead. 590 00:32:09,547 --> 00:32:11,747 At that angle, less chance of a kink. 591 00:32:14,751 --> 00:32:15,917 Could work. 592 00:32:28,048 --> 00:32:30,223 - Extending the incision. - Sternal saw. 593 00:32:34,814 --> 00:32:36,816 Starting the sternotomy. 594 00:32:38,679 --> 00:32:40,067 O2 dropped to 78. 595 00:32:40,612 --> 00:32:42,442 - 65. - She's having a tet spell. 596 00:32:42,476 --> 00:32:45,928 Give her 500 cc fluid bolus and 100% oxygen. 597 00:32:45,963 --> 00:32:48,758 Giving a mini bolus to increase pulmonary flow. 598 00:32:51,658 --> 00:32:55,041 O2 sats are 50.45. 599 00:32:55,075 --> 00:32:56,792 Come on, come on. 600 00:32:58,872 --> 00:33:00,943 Give her more oxygen and up the opiates. 601 00:33:02,324 --> 00:33:03,635 It has stopped registering. 602 00:33:22,033 --> 00:33:23,552 O2's rising. 603 00:33:25,761 --> 00:33:27,531 Heart rate's stabilizing. 604 00:33:30,076 --> 00:33:33,010 She was in prolonged gross hypoxia. 605 00:33:33,044 --> 00:33:36,206 That could extend cognitive deficits... 606 00:33:37,152 --> 00:33:38,912 or worse. 607 00:33:38,947 --> 00:33:40,396 We won't know until she wakes. 608 00:33:40,431 --> 00:33:42,796 Let's get her on bypass before she has another one. 609 00:33:45,505 --> 00:33:46,883 - Okay. - Mm-hmm. 610 00:33:47,748 --> 00:33:50,234 To a successful renal artery bypass. 611 00:33:50,268 --> 00:33:53,064 Cheers. Facilitated by moving speech 612 00:33:53,099 --> 00:33:54,824 from a wise and persuasive surgeon. 613 00:33:54,859 --> 00:33:57,862 Mm, with a great surgical save by a guy 614 00:33:57,897 --> 00:34:00,761 who's about to have some life-changing tacos. 615 00:34:00,796 --> 00:34:01,797 Okay. 616 00:34:05,145 --> 00:34:07,216 Mm! Oh, my God. 617 00:34:07,251 --> 00:34:09,874 Okay, these are amaz... you're amazing! 618 00:34:09,908 --> 00:34:12,462 Told you. Blue corn tortillas. 619 00:34:12,497 --> 00:34:14,879 Mm-hmm. I can get used to this. 620 00:34:18,296 --> 00:34:21,196 - You have some lettuce there. - Oh. 621 00:34:21,230 --> 00:34:23,923 - No, no, no, mirror image. - Mm. 622 00:34:23,957 --> 00:34:25,131 Now? 623 00:34:25,165 --> 00:34:26,856 - No. - No laughing. 624 00:34:26,891 --> 00:34:27,926 No, right, right, right. Very... 625 00:34:27,961 --> 00:34:29,583 Very serious matter. 626 00:34:34,278 --> 00:34:37,107 Here. Um, yeah. 627 00:34:37,143 --> 00:34:38,420 Oh. 628 00:34:38,453 --> 00:34:40,077 Just a little bit more. 629 00:34:51,467 --> 00:34:54,022 - We should go. - Mm. 630 00:34:54,056 --> 00:34:55,558 - Yeah. - Um, 631 00:34:55,582 --> 00:34:58,302 we need to get back early for Daphne's post-op. 632 00:34:58,336 --> 00:35:00,248 Yeah, right. Um, let's go. 633 00:35:09,727 --> 00:35:12,761 The bypass went smoothly, and post-op labs look good. 634 00:35:13,317 --> 00:35:14,930 We expect a full recovery. 635 00:35:15,940 --> 00:35:17,474 How are you feeling, Mom? 636 00:35:18,805 --> 00:35:19,909 I'm... 637 00:35:22,404 --> 00:35:23,672 Breathing. 638 00:35:23,706 --> 00:35:26,524 Kind of feels like the first time in my life. 639 00:35:27,848 --> 00:35:31,714 The post-op swelling from the tonsillectomy has gone down. 640 00:35:31,749 --> 00:35:34,407 You're finally breathing without any obstruction. 641 00:35:34,441 --> 00:35:37,375 You'll need to stay on top of your medications and follow-up visits, 642 00:35:37,410 --> 00:35:39,170 observe some dietary guidelines, 643 00:35:39,205 --> 00:35:41,915 but the discharge plan lays it all out. 644 00:35:42,863 --> 00:35:44,348 I'll be there to help, Mom. 645 00:35:47,316 --> 00:35:48,317 No. 646 00:35:50,319 --> 00:35:51,700 You won't. 647 00:35:56,015 --> 00:35:58,017 You need to live your own life. 648 00:36:01,537 --> 00:36:05,146 But I... I will accept FaceTime calls. 649 00:36:05,921 --> 00:36:07,509 And once I recover, 650 00:36:09,028 --> 00:36:10,546 I'll come visit. 651 00:36:14,895 --> 00:36:17,553 I hear that Prague is beautiful in the spring. 652 00:36:21,661 --> 00:36:23,076 That sounds like a plan. 653 00:36:34,708 --> 00:36:37,159 Mm, things not go well with Glassy? 654 00:36:37,194 --> 00:36:39,403 He returned the files with a note saying 655 00:36:39,437 --> 00:36:42,544 he did not look at them and does not intend to. 656 00:36:42,578 --> 00:36:44,891 I'm sorry. He probably... 657 00:36:44,925 --> 00:36:46,890 It was a mistake to leave them for him to read on his own. 658 00:36:46,924 --> 00:36:48,406 Once I reorder the files, 659 00:36:48,430 --> 00:36:50,966 I will go to his office to review with him in person. 660 00:36:51,000 --> 00:36:53,002 He made it pretty clear he doesn't want to see them. 661 00:36:53,037 --> 00:36:55,350 But he doesn't know about the new evidence. 662 00:36:55,384 --> 00:36:57,248 Maybe he doesn't want to know. 663 00:36:57,283 --> 00:37:00,111 Cancer survivors have to live with that uncertainty that... 664 00:37:00,145 --> 00:37:02,245 Knowing is better than not knowing. 665 00:37:04,945 --> 00:37:07,258 If he's not ready to look at this, 666 00:37:07,293 --> 00:37:09,169 you can't force him. 667 00:37:10,330 --> 00:37:13,423 Maybe he's scared, Shaun. 668 00:37:13,989 --> 00:37:16,176 And I think maybe you're scared, too. 669 00:37:17,475 --> 00:37:20,029 We're about to have a baby, 670 00:37:20,064 --> 00:37:22,411 you're about to be a dad, 671 00:37:22,446 --> 00:37:24,931 and I think you're worried about family, 672 00:37:24,965 --> 00:37:26,603 and Glassman is a part of that. 673 00:37:28,245 --> 00:37:31,455 But if you keep pushing, you risk damaging 674 00:37:31,489 --> 00:37:34,611 one of the most important relationships in your life. 675 00:37:44,088 --> 00:37:45,089 Hey. 676 00:37:48,437 --> 00:37:49,834 - Hey. - Hey. 677 00:37:52,959 --> 00:37:54,409 I've been thinking, 678 00:37:54,443 --> 00:37:56,483 and I need a break from our coffees. 679 00:37:56,687 --> 00:37:58,061 Dalisay... 680 00:37:58,095 --> 00:38:00,136 I don't think dinner's a good idea either. 681 00:38:01,312 --> 00:38:03,659 So we have a different point of view about hospital business. 682 00:38:03,694 --> 00:38:05,827 That doesn't change the way I feel about you. 683 00:38:05,862 --> 00:38:08,019 On or off the clock, I'm the same person. 684 00:38:08,837 --> 00:38:11,702 To me, if you don't value what the nurses do 685 00:38:11,736 --> 00:38:14,739 enough to treat us like a resource to invest in, 686 00:38:14,774 --> 00:38:16,444 not a line item to be cut, 687 00:38:17,639 --> 00:38:19,239 how much can you care about me? 688 00:38:20,780 --> 00:38:22,158 And to be honest, 689 00:38:22,851 --> 00:38:24,744 if that is your point of view... 690 00:38:27,304 --> 00:38:29,416 it undercuts the respect I have for you. 691 00:38:40,696 --> 00:38:43,458 Harper Louise Decrane, 692 00:38:43,492 --> 00:38:46,724 March 30, 1994. 693 00:38:47,151 --> 00:38:48,768 And do you know why you're here? 694 00:38:49,326 --> 00:38:50,854 For my heart issues. 695 00:38:53,675 --> 00:38:55,442 I had another tet spell, didn't I? 696 00:38:56,436 --> 00:38:57,989 We'll need to conduct more tests, 697 00:38:58,024 --> 00:39:00,233 but your speech and memory seem intact. 698 00:39:00,268 --> 00:39:03,374 And with regard to your heart, we expect a full recovery. 699 00:39:03,409 --> 00:39:07,378 And with time, you may recover your full cognitive abilities as well. 700 00:39:08,175 --> 00:39:09,176 Maybe. 701 00:39:10,416 --> 00:39:14,669 But for now, I'll just focus on being here. 702 00:39:30,090 --> 00:39:32,312 "It's the greening of the trees 703 00:39:32,886 --> 00:39:34,405 That really gets to me 704 00:39:35,958 --> 00:39:38,927 When all the shock of white and taffy 705 00:39:38,961 --> 00:39:42,155 Leave the pavement strewn With the confetti of aftermath 706 00:39:44,070 --> 00:39:45,492 The leaves come 707 00:39:46,452 --> 00:39:48,495 Patient, plodding 708 00:39:49,938 --> 00:39:53,541 A green skin growing over Whatever winter did to us 709 00:39:55,840 --> 00:39:59,741 A return to the strange idea Of continuous living 710 00:39:59,775 --> 00:40:01,260 Despite the mess of us 711 00:40:01,294 --> 00:40:03,092 The hurt, the empty..." 712 00:40:04,055 --> 00:40:05,553 Shaun, what? 713 00:40:06,437 --> 00:40:09,599 Lea thinks that because I'm going to be a dad, 714 00:40:10,476 --> 00:40:12,478 I am worried about my family. 715 00:40:14,549 --> 00:40:15,826 Okay. 716 00:40:15,860 --> 00:40:19,234 She also thinks you are scared. 717 00:40:20,140 --> 00:40:21,797 I'm not scared, Shaun. I'm fine. 718 00:40:21,832 --> 00:40:25,114 She says if you don't want to do the scan, I should let it go. 719 00:40:29,322 --> 00:40:30,392 She... 720 00:40:32,739 --> 00:40:34,154 is right. 721 00:40:35,949 --> 00:40:37,544 Good. Thank you. 722 00:40:39,677 --> 00:40:41,214 I am scared. 723 00:40:54,658 --> 00:40:55,937 Dr. Glassman... 724 00:41:00,491 --> 00:41:04,404 I am asking you to do the scan 725 00:41:05,634 --> 00:41:06,601 because... 726 00:41:08,534 --> 00:41:11,995 the data and the evidence are sound... 727 00:41:17,681 --> 00:41:19,002 and because... 728 00:41:26,414 --> 00:41:28,450 it would be hard to lose my father 729 00:41:28,485 --> 00:41:30,555 just as I am about to become one. 730 00:41:38,667 --> 00:41:40,315 Do the scan for me. 731 00:41:52,468 --> 00:41:55,204 Shaun, I'll do the scan. 732 00:42:13,530 --> 00:42:17,292 "'Fine then, I'll take it' The tree seems to say 733 00:42:17,326 --> 00:42:21,105 A new slick leaf unfurling Like a fist to an open palm 734 00:42:21,814 --> 00:42:23,229 'I'll take it all'"