1 00:00:03,307 --> 00:00:04,341 Those are yours. 2 00:00:05,176 --> 00:00:07,600 We bought them together. 3 00:00:07,624 --> 00:00:10,619 Because you "found the pattern soothing." 4 00:00:18,689 --> 00:00:20,504 I'm gonna miss you, Shaun. 5 00:00:21,359 --> 00:00:22,659 I love Carly. 6 00:00:24,996 --> 00:00:26,340 And that's great. 7 00:00:26,364 --> 00:00:28,566 I am so happy for you. 8 00:00:28,590 --> 00:00:33,680 Now you can hang the toilet paper incorrectly anytime you want. 9 00:00:33,704 --> 00:00:35,406 And Carly and I can go back 10 00:00:35,430 --> 00:00:37,479 to the way things were before our fight. 11 00:00:38,923 --> 00:00:42,155 Well, sometimes couples need a little time to recover. 12 00:00:42,179 --> 00:00:43,390 We won't. 13 00:00:43,414 --> 00:00:45,859 Carly asked for you to move out. 14 00:00:45,883 --> 00:00:48,085 You are moving out. 15 00:00:51,036 --> 00:00:53,439 How many kidneys do I need in my body to attend prom? 16 00:00:53,463 --> 00:00:54,631 Ryan... 17 00:00:54,655 --> 00:00:56,257 Even if the surgery removes my kidney, 18 00:00:56,281 --> 00:00:57,649 it'll be laparoscopic, 19 00:00:57,673 --> 00:01:00,676 so my inpatient time will be seven days, tops. 20 00:01:00,700 --> 00:01:02,876 And then three more days of rest at home. 21 00:01:02,900 --> 00:01:04,798 I can take my girlfriend to prom, right? 22 00:01:05,936 --> 00:01:07,648 That's not a purely medical decision. 23 00:01:07,672 --> 00:01:09,182 I have to draw some blood. 24 00:01:09,206 --> 00:01:11,151 What are the chances Dr. Melendez might be able 25 00:01:11,175 --> 00:01:13,220 to remove the tumor but spare Ryan's kidney? 26 00:01:13,244 --> 00:01:15,055 Well, the MRI will let us know 27 00:01:15,079 --> 00:01:16,690 how much the chemo shrunk the tumor, 28 00:01:16,714 --> 00:01:19,050 but you shouldn't count on it. 29 00:01:19,074 --> 00:01:22,229 One chili burger, extra mustard, extra pickles. 30 00:01:22,253 --> 00:01:24,031 Hi. Morning, Mr. Cooper. 31 00:01:24,055 --> 00:01:25,866 I'm not sure he can have that with his surgery... 32 00:01:25,890 --> 00:01:28,071 Oh, he's fine until about 6:30 tonight. 33 00:01:28,793 --> 00:01:30,003 I know you. 34 00:01:30,027 --> 00:01:32,739 Angie... Valens. 35 00:01:32,763 --> 00:01:34,241 I helped put in your chemo port. 36 00:01:34,265 --> 00:01:36,677 I owe you a big thank-you. 37 00:01:36,701 --> 00:01:38,578 We met in chemo. 38 00:01:38,602 --> 00:01:40,714 They should put us in a public service announcement or something. 39 00:01:40,738 --> 00:01:44,293 Yeah... "I lost a tumor and gained a boyfriend. Thanks, chemo." 40 00:01:48,546 --> 00:01:49,890 James McDougall? 41 00:01:49,914 --> 00:01:51,191 That's who we're here for, too. 42 00:01:51,215 --> 00:01:53,694 All of you can head over to Bay 4. 43 00:01:53,718 --> 00:01:55,896 Guy saw me six months ago for a stress fracture. 44 00:01:55,920 --> 00:01:58,298 He's a lunatic ultra-marathoner. 45 00:01:58,322 --> 00:02:01,021 I just hope he didn't go too hard too soon and break it again. 46 00:02:07,298 --> 00:02:09,776 He didn't break it again. 47 00:02:16,080 --> 00:02:24,091 Synced & corrected by -robtor- www.addic7ed.com 48 00:02:24,115 --> 00:02:26,513 Your GP was right to start you on ketoprofen for the swelling, 49 00:02:26,537 --> 00:02:28,373 but clearly, it isn't working. 50 00:02:28,397 --> 00:02:29,823 That's why Drs. Murphy and Reznick 51 00:02:29,847 --> 00:02:31,998 are going to block off some of your lymphatic channels. 52 00:02:32,022 --> 00:02:33,834 It should reduce production. 53 00:02:33,858 --> 00:02:36,064 The more pressing concern is why. 54 00:02:36,088 --> 00:02:38,558 Have you ever had surgery on your lymph nodes? 55 00:02:39,529 --> 00:02:41,975 What about cancer or radiation treatment? 56 00:02:41,999 --> 00:02:44,144 No. Physically, I've always been healthy. 57 00:02:44,168 --> 00:02:45,421 Physically? 58 00:02:45,445 --> 00:02:48,735 I was diagnosed with Persistent Depressive Disorder when I was 16. 59 00:02:50,040 --> 00:02:52,519 That's why you got to get me back out on the road, Doc. 60 00:02:52,543 --> 00:02:54,688 Are antidepressants not effective for you? 61 00:02:54,712 --> 00:02:56,289 I mean, they help. 62 00:02:56,313 --> 00:02:59,159 But running really is key. 63 00:02:59,183 --> 00:03:01,795 Saved my marriage and... And my life. 64 00:03:01,819 --> 00:03:04,047 Lymphedema can be caused by an infection. 65 00:03:04,071 --> 00:03:06,387 He doesn't have a fever. 66 00:03:06,411 --> 00:03:08,101 Ketoprofen can suppress fevers. 67 00:03:08,125 --> 00:03:09,292 Let's get some cultures 68 00:03:09,316 --> 00:03:11,352 and start him on broad-spec antibiotics. 69 00:03:15,900 --> 00:03:19,312 As requested, your restock on enemas. 70 00:03:19,336 --> 00:03:20,537 Nice cover. 71 00:03:22,072 --> 00:03:23,216 How've you been feeling? 72 00:03:23,240 --> 00:03:25,285 The methotrexate is working great. 73 00:03:25,309 --> 00:03:27,487 No pain, no redness. 74 00:03:27,511 --> 00:03:29,356 Stiffness, flu-like symptoms? 75 00:03:29,380 --> 00:03:30,792 No. All good. 76 00:03:32,316 --> 00:03:33,960 How long are you planning to hide out 77 00:03:33,984 --> 00:03:37,159 doing RA exams and clipping diabetics' toenails? 78 00:03:37,988 --> 00:03:40,233 Dizziness, headaches, nausea? 79 00:03:40,257 --> 00:03:43,749 I... Sometimes I'm a little queasy after I eat. 80 00:03:44,161 --> 00:03:46,752 You had to love neurosurgery. 81 00:03:47,665 --> 00:03:49,302 How about we try to get you a medication 82 00:03:49,326 --> 00:03:51,093 that doesn't irritate your stomach? 83 00:03:51,117 --> 00:03:53,717 No. My hands feel great. That's all I care about. 84 00:03:54,839 --> 00:03:57,984 You used to open up skulls and poke around people's brains. 85 00:03:58,008 --> 00:04:00,355 There's no way this fulfills you. 86 00:04:00,379 --> 00:04:02,189 I enjoy it. 87 00:04:02,213 --> 00:04:04,991 Or, rather, I usually enjoy it. 88 00:04:06,717 --> 00:04:08,398 I'll let you get back to it. 89 00:04:10,621 --> 00:04:12,682 Maybe someone out there needs an enema. 90 00:04:17,761 --> 00:04:19,372 Got a measurement on the Wilms tumor? 91 00:04:19,396 --> 00:04:21,508 Mm, not quite there yet. 92 00:04:21,532 --> 00:04:24,344 You mentioned 7 centimeters as our limit 93 00:04:24,368 --> 00:04:25,779 to doing this laparoscopically. 94 00:04:25,803 --> 00:04:27,914 What if we pushed it to 7.2? 95 00:04:27,938 --> 00:04:30,283 Would speed up recovery. 96 00:04:30,307 --> 00:04:31,755 By a few days. 97 00:04:33,277 --> 00:04:34,955 Forget I brought it up. 98 00:04:34,979 --> 00:04:37,457 Ryan wanting to take his girlfriend to prom 99 00:04:37,481 --> 00:04:40,055 should not factor into our surgical plan. 100 00:04:40,918 --> 00:04:42,095 Is he nuts about her? 101 00:04:42,119 --> 00:04:44,965 Ohh. Crazy, head over heels in love. 102 00:04:44,989 --> 00:04:46,032 They both are. 103 00:04:46,056 --> 00:04:47,200 Idiots. 104 00:04:49,326 --> 00:04:52,939 I wouldn't mind being an idiot like that again. 105 00:04:52,963 --> 00:04:56,142 Though, I'm not sure I ever felt that way, 106 00:04:56,166 --> 00:04:57,644 totally happy. 107 00:04:57,668 --> 00:04:59,095 So therapy's going well? 108 00:05:00,604 --> 00:05:02,786 No metastasis in the lungs. 109 00:05:04,308 --> 00:05:05,509 Look at that. 110 00:05:11,348 --> 00:05:12,893 Your tumor is gone. 111 00:05:15,130 --> 00:05:16,497 Gone? 112 00:05:17,588 --> 00:05:19,165 How's that possible? 113 00:05:19,189 --> 00:05:21,735 The chemotherapy worked better than we expected. 114 00:05:21,759 --> 00:05:24,671 Wait, like, no tumor? Zero? 115 00:05:24,695 --> 00:05:27,140 - No need for surgery whatsoever? - That is right. 116 00:05:27,164 --> 00:05:29,009 These are discharge forms. 117 00:05:32,169 --> 00:05:34,314 Both of my kidneys are taking you to prom! 118 00:05:34,338 --> 00:05:35,749 Aah! Hell, yeah, we are! 119 00:05:43,180 --> 00:05:44,514 Angie? 120 00:05:46,951 --> 00:05:48,695 - Angie! - She's having a seizure! 121 00:05:50,244 --> 00:05:52,599 2 milligrams of lorazepam and portable oxygen, stat. 122 00:05:52,623 --> 00:05:53,962 Let's get that under her head. 123 00:05:57,628 --> 00:05:59,092 His lungs are filled with fluid. 124 00:06:00,730 --> 00:06:03,366 I need a chest X-ray and a bedside ultrasound. 125 00:06:03,390 --> 00:06:04,848 And page Dr. Reznick. 126 00:06:17,824 --> 00:06:19,080 Imaging has confirmed 127 00:06:19,104 --> 00:06:21,239 a reoccurrence of your brain tumor. 128 00:06:22,181 --> 00:06:23,575 What stage? 129 00:06:24,517 --> 00:06:26,203 Three. 130 00:06:27,287 --> 00:06:30,598 The best approach is surgery, a wide resection of the tumor, 131 00:06:30,622 --> 00:06:33,543 followed by radiation and chemo to encourage full remission. 132 00:06:34,827 --> 00:06:36,796 Sounds like a fun couple months. 133 00:06:37,297 --> 00:06:41,092 Full recovery will probably take closer to eight. 134 00:06:46,139 --> 00:06:48,099 We can get through this, baby, just like last time. 135 00:06:50,476 --> 00:06:52,855 W-When will the surgery be? 136 00:06:52,879 --> 00:06:54,857 We need to do some additional imaging, 137 00:06:54,881 --> 00:06:56,358 and I'd like to consult a colleague 138 00:06:56,382 --> 00:06:57,826 about the best surgical approach. 139 00:06:57,850 --> 00:06:59,236 That'll take a few days. 140 00:07:00,900 --> 00:07:01,933 Take your time. 141 00:07:04,057 --> 00:07:05,057 Prom? 142 00:07:06,326 --> 00:07:07,536 Yeah. 143 00:07:07,560 --> 00:07:09,062 Now that Ryan can go, I have to go. 144 00:07:09,086 --> 00:07:10,688 Honey. 145 00:07:10,712 --> 00:07:12,580 This is your health we're talking about. 146 00:07:12,604 --> 00:07:15,273 Mom, please. 147 00:07:15,297 --> 00:07:17,599 I just want to do this one thing like a normal kid. 148 00:07:20,673 --> 00:07:22,259 Can you tell her it's okay? 149 00:07:24,010 --> 00:07:25,208 We can't. 150 00:07:25,232 --> 00:07:26,536 Until we remove your tumor, 151 00:07:26,560 --> 00:07:28,515 you're at risk of potentially fatal seizures. 152 00:07:30,883 --> 00:07:32,194 After you're recovered, 153 00:07:32,218 --> 00:07:33,920 you and Ryan can get all dressed up, 154 00:07:33,944 --> 00:07:36,356 and we'll go have dinner at the Grandview. Okay? 155 00:07:43,062 --> 00:07:45,040 Prom sucks. 156 00:07:45,064 --> 00:07:46,709 My buddy had a fake ID. 157 00:07:46,733 --> 00:07:48,510 I got so drunk in the limo that I passed out 158 00:07:48,534 --> 00:07:50,203 and never made it into the dance. 159 00:07:51,237 --> 00:07:53,290 Maybe that wasn't everybody's experience. 160 00:07:53,840 --> 00:07:55,834 I was prom king. My date was queen. 161 00:08:00,246 --> 00:08:01,787 I had the dress, I had the date, 162 00:08:01,811 --> 00:08:03,773 I had the mom who got arrested. 163 00:08:03,797 --> 00:08:05,928 Spent the night picking her up from the drunk tank. 164 00:08:05,952 --> 00:08:07,029 Did you see Park while you were there? 165 00:08:08,283 --> 00:08:11,066 Go to scheduling, get Angie's surgery set for Friday 166 00:08:11,090 --> 00:08:12,934 with the best neurosurgery OR nurses. 167 00:08:15,094 --> 00:08:16,395 Let's go see Glassman. 168 00:08:17,563 --> 00:08:18,798 Now I'm identifying 169 00:08:18,822 --> 00:08:20,590 the submillimeter lymphatic vessels. 170 00:08:20,614 --> 00:08:24,195 I need an 11-0 micro suture and a 70 micron needle. 171 00:08:24,898 --> 00:08:27,305 Instead of harvesting nodes to this area, 172 00:08:27,329 --> 00:08:30,252 could we redirect lymphatics away from his lymph system? 173 00:08:30,276 --> 00:08:31,420 We could. 174 00:08:31,444 --> 00:08:33,389 If you identify an appropriate vessel, 175 00:08:33,413 --> 00:08:35,257 you can make the connection. 176 00:08:35,281 --> 00:08:37,668 We're clearly not dealing with an infection. 177 00:08:37,692 --> 00:08:39,928 There must be a blockage somewhere in his lymph system. 178 00:08:39,952 --> 00:08:41,864 Most likely cancer. 179 00:08:41,888 --> 00:08:45,100 His CBC didn't show any abnormal cells. 180 00:08:45,124 --> 00:08:47,427 Lymphoma doesn't always show up. 181 00:08:47,451 --> 00:08:49,971 We need to run cytology on his lymphatic fluid. 182 00:08:55,621 --> 00:08:57,923 It's either gonna be nasty or very nasty, 183 00:08:57,947 --> 00:09:01,917 depending upon how it attaches to the thalamus and fornix. 184 00:09:01,941 --> 00:09:05,403 Which no imaging or testing can possibly determine. 185 00:09:06,579 --> 00:09:08,090 So, our options are? 186 00:09:08,114 --> 00:09:11,727 Between an endoscopic approach or an open anterior one. 187 00:09:11,751 --> 00:09:13,119 That is correct. 188 00:09:15,641 --> 00:09:20,002 I'd run a stereotactic MRI with fiducials and DTI 189 00:09:20,026 --> 00:09:23,004 to gauge how close the white matter tracts actually are. 190 00:09:24,263 --> 00:09:25,340 You should scrub in. 191 00:09:27,033 --> 00:09:28,843 Another doctor can cover the clinic. 192 00:09:30,136 --> 00:09:33,039 I haven't been in an OR in over a year, 193 00:09:33,063 --> 00:09:35,098 and then, as a patient. 194 00:09:35,122 --> 00:09:37,186 I'm not asking you to cut. 195 00:09:37,210 --> 00:09:39,511 But it'd be a huge value to have you there. 196 00:09:41,614 --> 00:09:43,325 I appreciate that. 197 00:09:43,349 --> 00:09:44,693 I'll consider it. 198 00:09:59,132 --> 00:10:02,177 Hello. We need to run cytology on this lymphatic fluid. 199 00:10:02,201 --> 00:10:04,170 I would be happy to. 200 00:10:08,074 --> 00:10:09,968 Lea moved out this morning. 201 00:10:12,879 --> 00:10:14,823 - Thank you. - You're welcome. 202 00:10:14,847 --> 00:10:16,725 Can you come over tonight? 203 00:10:16,749 --> 00:10:18,527 Uh, that probably won't work... 204 00:10:18,551 --> 00:10:20,145 Or we could go to your apartment? 205 00:10:21,554 --> 00:10:22,856 I can't. 206 00:10:24,924 --> 00:10:27,402 Lea said that it might take time 207 00:10:27,426 --> 00:10:29,371 for us to recover from our fight. 208 00:10:29,395 --> 00:10:31,140 But I told her that we were okay. 209 00:10:31,164 --> 00:10:33,266 We are. 210 00:10:33,290 --> 00:10:35,059 I made plans tonight. 211 00:10:35,083 --> 00:10:38,204 To hang out with a friend who just got fired. 212 00:10:38,604 --> 00:10:40,957 But I would love to come over tomorrow night. 213 00:10:41,440 --> 00:10:43,418 Okay. 214 00:10:43,442 --> 00:10:45,379 I'll put a rush on this test, too. 215 00:10:53,352 --> 00:10:56,064 Your lymphovenous anastomosis technique... 216 00:10:56,088 --> 00:10:58,066 I was impressed. 217 00:10:58,090 --> 00:10:59,535 It's a little early in the morning 218 00:10:59,559 --> 00:11:00,917 to be sucking up, Reznick. 219 00:11:00,941 --> 00:11:03,105 Not for me. I like to get a jump on things. 220 00:11:03,129 --> 00:11:05,407 I'm fascinated by the way you use plastic procedures, 221 00:11:05,431 --> 00:11:08,301 like microsurgery, in other surgical specialties. 222 00:11:08,325 --> 00:11:10,653 I thought it might make an interesting topic for a paper. 223 00:11:11,270 --> 00:11:12,537 Want to write it with me? 224 00:11:14,140 --> 00:11:15,250 Yes. 225 00:11:15,274 --> 00:11:16,441 Let's talk and eat. 226 00:11:19,612 --> 00:11:20,912 That's not breakfast. 227 00:11:22,415 --> 00:11:24,092 I'm buying. 228 00:11:24,116 --> 00:11:26,228 What publications do you want to target? 229 00:11:28,955 --> 00:11:31,157 Last time, Angie had bad post-op vomiting. 230 00:11:31,181 --> 00:11:32,447 - Of course. I'll make note of it... - Excuse me. 231 00:11:34,227 --> 00:11:37,206 She's asleep. She needs her rest. 232 00:11:37,230 --> 00:11:38,807 I'll wait out here until she's awake. 233 00:11:38,831 --> 00:11:40,742 Ryan, your immune system is weak. 234 00:11:40,766 --> 00:11:43,812 It would be so easy for you to pick up a bug and pass it to Angie. 235 00:11:43,836 --> 00:11:45,747 I haven't been around anyone but my dad. I swear. 236 00:11:45,771 --> 00:11:47,440 He could wear a mask. 237 00:11:51,744 --> 00:11:54,883 After Angie's surgery, we'll see about arranging a visit. 238 00:11:54,907 --> 00:11:56,449 Please tell her Ryan came by. 239 00:11:59,685 --> 00:12:01,663 I'm sorry if I overstepped. 240 00:12:02,355 --> 00:12:03,966 I'd like to change Angie's status 241 00:12:03,990 --> 00:12:05,334 to "No visitors" on her chart. 242 00:12:05,358 --> 00:12:06,525 Yeah. 243 00:12:14,166 --> 00:12:15,611 Please take Mr. McDougall to his room. 244 00:12:15,635 --> 00:12:17,053 I'll be there in a moment. 245 00:12:19,105 --> 00:12:20,890 Is that James McDougall? 246 00:12:21,707 --> 00:12:23,518 - And the woman with him? - His wife. 247 00:12:23,542 --> 00:12:25,454 Is it cancer? 248 00:12:25,478 --> 00:12:27,756 No... Worse. 249 00:12:27,780 --> 00:12:31,193 His lymphedema is caused by a genetic mutation. 250 00:12:31,217 --> 00:12:33,662 If you don't find a medication he responds to, 251 00:12:33,686 --> 00:12:36,031 he'll drown from the inside. 252 00:12:38,510 --> 00:12:41,322 The mutation is on James' ARAF gene... 253 00:12:41,346 --> 00:12:43,219 It makes an enzyme called kinase, 254 00:12:43,243 --> 00:12:45,426 which can cause cells to overproliferate. 255 00:12:45,450 --> 00:12:47,292 It's a genetic condition. 256 00:12:48,720 --> 00:12:50,362 What set it off now? 257 00:12:50,386 --> 00:12:51,829 Probably the stress fracture. 258 00:12:51,853 --> 00:12:53,401 Sent his immune system into overdrive, 259 00:12:53,425 --> 00:12:55,008 which fired up his lymphatic system. 260 00:12:55,868 --> 00:12:57,672 What treatment protocol targets this mutation? 261 00:12:57,696 --> 00:12:59,607 An MEK inhibitor. 262 00:12:59,631 --> 00:13:01,092 The problem is, which one? 263 00:13:01,116 --> 00:13:04,434 There are 41 possibilities, each with different side effects. 264 00:13:05,303 --> 00:13:06,437 Good luck. 265 00:13:06,936 --> 00:13:08,897 Well, I was hoping you could stay. 266 00:13:12,611 --> 00:13:14,611 Okay. Sure. 267 00:13:17,286 --> 00:13:19,115 We need you to stay completely still. 268 00:13:20,458 --> 00:13:21,701 Not a problem. 269 00:13:23,588 --> 00:13:24,655 You okay? 270 00:13:25,957 --> 00:13:27,802 Ryan totally bailed. 271 00:13:27,826 --> 00:13:29,208 He hasn't come back to see me. 272 00:13:32,557 --> 00:13:34,393 If you tell her that her mom said he couldn't visit, 273 00:13:34,417 --> 00:13:35,877 she'll be pissed at her mom. 274 00:13:35,901 --> 00:13:37,216 How's that gonna help? 275 00:13:39,738 --> 00:13:42,347 He's probably busy catching up in school. 276 00:13:45,577 --> 00:13:47,488 We had a pact. 277 00:13:47,512 --> 00:13:50,229 As long as we were together, cancer wasn't gonna beat us. 278 00:13:51,450 --> 00:13:53,227 He broke it. 279 00:13:53,251 --> 00:13:54,595 Cancer wins. 280 00:14:00,043 --> 00:14:01,211 Do you mind finishing? 281 00:14:13,472 --> 00:14:14,515 Imaging finished? 282 00:14:14,539 --> 00:14:15,917 Not quite. 283 00:14:15,941 --> 00:14:19,921 Mrs. Valens, Angie would really like to see Ryan. 284 00:14:19,945 --> 00:14:21,689 I know you're concerned about infection, 285 00:14:21,713 --> 00:14:23,048 but there is minimal risk. 286 00:14:23,072 --> 00:14:26,057 Actually... Actually, none, if they do a video chat. 287 00:14:26,952 --> 00:14:28,496 Interesting idea. 288 00:14:28,520 --> 00:14:29,769 I'll think about it. 289 00:14:32,524 --> 00:14:34,326 Angie's depressed. 290 00:14:34,350 --> 00:14:36,871 And studies have shown that that can have a negative impact 291 00:14:36,895 --> 00:14:38,403 on her surgical outcome. 292 00:14:41,500 --> 00:14:45,046 Ryan doesn't always improve Angie's mood. 293 00:14:45,070 --> 00:14:47,405 A couple of weeks ago, they had some silly fight, 294 00:14:47,429 --> 00:14:49,851 and she cried for days. 295 00:14:49,875 --> 00:14:51,619 Thank you for letting me know. 296 00:14:51,643 --> 00:14:53,154 I'm gonna do my best to cheer her up. 297 00:14:53,178 --> 00:14:55,156 She's a 16-year-old. 298 00:14:55,180 --> 00:14:56,557 She wants her boyfriend. 299 00:14:56,581 --> 00:14:58,226 Yeah. 300 00:14:58,250 --> 00:15:00,174 And how smart were you when you were 16? 301 00:15:07,759 --> 00:15:09,670 Well, what about Selumetinib? 302 00:15:09,694 --> 00:15:12,406 It's shown promising results on related conditions. 303 00:15:12,430 --> 00:15:15,042 And a high occurrence of liver disease. 304 00:15:15,066 --> 00:15:18,735 Binimetinib is similar, but has fewer complications. 305 00:15:19,504 --> 00:15:20,987 Any objections? 306 00:15:23,775 --> 00:15:25,116 Let's start James on that. 307 00:15:33,618 --> 00:15:36,697 This is exciting, working together. 308 00:15:36,721 --> 00:15:38,346 It is. 309 00:15:38,370 --> 00:15:42,925 Although, I'm used to samples and slides instead of patients. 310 00:15:46,765 --> 00:15:49,544 Patients can be difficult. 311 00:15:49,568 --> 00:15:51,017 But you will be fine. 312 00:16:10,255 --> 00:16:11,422 Do you need something? 313 00:16:13,825 --> 00:16:17,038 I was curious how James was responding to the Binimetinib. 314 00:16:17,062 --> 00:16:18,272 His urine output is up, 315 00:16:18,296 --> 00:16:20,880 which suggests the lymphatic fluid... 316 00:16:21,900 --> 00:16:23,444 And his potassium is a little low. 317 00:16:23,468 --> 00:16:25,003 Can you... give him this? 318 00:16:25,027 --> 00:16:26,047 I wasn't really... 319 00:16:42,921 --> 00:16:43,998 Hi. 320 00:16:44,022 --> 00:16:45,766 I'm Dr. Lever. 321 00:16:45,790 --> 00:16:47,692 The tumor's abutting and possibly infiltrating 322 00:16:47,716 --> 00:16:49,451 the white matter tracts of her fornix. 323 00:16:49,475 --> 00:16:51,305 We'll likely have to remove a section. 324 00:16:51,329 --> 00:16:53,741 That'll affect her ability to form memories. 325 00:16:53,765 --> 00:16:55,109 With a lot of neuropsych rehab, 326 00:16:55,133 --> 00:16:57,871 she may be able to compensate with other pathways. 327 00:16:57,895 --> 00:17:01,281 Studies have shown that positive attitudes lead to positive outcomes. 328 00:17:01,305 --> 00:17:02,406 You're worried about her attitude? 329 00:17:02,430 --> 00:17:03,831 She's worried about young love. 330 00:17:03,855 --> 00:17:05,957 I'm worried about what Angie is facing after surgery. 331 00:17:05,981 --> 00:17:08,350 Physical therapy, cognitive therapy, 332 00:17:08,374 --> 00:17:09,809 one challenge after another. 333 00:17:09,833 --> 00:17:11,472 And what she wants is so simple. 334 00:17:13,952 --> 00:17:15,434 You want to make a sad kid happy? 335 00:17:17,194 --> 00:17:18,362 I guess I do. 336 00:17:18,386 --> 00:17:20,187 Which isn't my job, and I need to stop 337 00:17:20,211 --> 00:17:21,679 getting sucked into people's personal issues. 338 00:17:21,703 --> 00:17:23,985 Is there a way to do that without antagonizing the mother? 339 00:17:27,899 --> 00:17:29,310 Maybe. 340 00:17:30,426 --> 00:17:31,701 Then make her happy. 341 00:17:48,920 --> 00:17:51,499 We've never gotten this far before. 342 00:17:51,523 --> 00:17:52,667 No. 343 00:17:52,691 --> 00:17:54,301 We haven't. 344 00:17:54,325 --> 00:17:55,359 And you're okay? 345 00:17:56,828 --> 00:17:58,352 I am very okay. 346 00:18:08,206 --> 00:18:09,250 Carly. 347 00:18:09,274 --> 00:18:10,851 Ohh. 348 00:18:24,422 --> 00:18:25,522 Okay. 349 00:18:32,697 --> 00:18:35,599 Did... I do something wrong? 350 00:18:36,868 --> 00:18:38,809 No, I'm sorry. It's me. 351 00:18:40,038 --> 00:18:43,517 You said we were okay. 352 00:18:43,541 --> 00:18:44,919 I thought we were. 353 00:18:44,943 --> 00:18:46,120 I-I want us to be. 354 00:18:46,144 --> 00:18:48,222 You have no reason to still be mad. 355 00:18:48,246 --> 00:18:49,523 I'm not mad. 356 00:18:49,547 --> 00:18:50,891 I'm... I'm just... 357 00:18:57,381 --> 00:18:58,582 It's Morgan. 358 00:18:58,606 --> 00:19:01,910 The medication caused James an upper GI bleed. 359 00:19:08,230 --> 00:19:09,875 Have you localized the source of the bleeding? 360 00:19:09,899 --> 00:19:11,116 Working on it. 361 00:19:11,140 --> 00:19:13,412 Seems to be coming from the antrum of the stomach. 362 00:19:13,436 --> 00:19:15,272 We stopped the Binimetinib. 363 00:19:15,296 --> 00:19:17,716 On top of causing this, it hadn't done much to curtail the swelling. 364 00:19:17,740 --> 00:19:19,117 Where's Dr. Lever? 365 00:19:19,141 --> 00:19:21,077 There's the ulcerative lesion. Cautery. 366 00:19:24,313 --> 00:19:26,224 Zebrafish. 367 00:19:26,248 --> 00:19:27,459 They're used in medical research 368 00:19:27,483 --> 00:19:28,984 because of their quick maturation, 369 00:19:29,008 --> 00:19:31,778 and 84% of genes associated with human disease 370 00:19:31,802 --> 00:19:33,637 have a zebrafish equivalent. 371 00:19:33,661 --> 00:19:37,031 You think we should do a transgenic expression 372 00:19:37,055 --> 00:19:41,158 of James' ARAF mutation into the zebrafish genome. 373 00:19:41,182 --> 00:19:42,441 Translation for those of us 374 00:19:42,465 --> 00:19:44,276 without a genetics textbook handy? 375 00:19:44,300 --> 00:19:46,611 We make mini-Jameses, as zebrafish, 376 00:19:46,635 --> 00:19:48,170 all with the same disorder. 377 00:19:48,194 --> 00:19:51,383 Then we test every conceivable drug on those fish. 378 00:19:51,407 --> 00:19:52,918 How long before we can start testing? 379 00:19:52,942 --> 00:19:54,586 If we implant the embryos now, 380 00:19:54,610 --> 00:19:56,388 probably by late afternoon tomorrow. 381 00:19:56,412 --> 00:19:57,577 Get going. 382 00:19:57,601 --> 00:19:59,658 Shaun, go with her. You have Path experience. 383 00:20:20,836 --> 00:20:24,015 I understand no means no. 384 00:20:24,039 --> 00:20:27,475 If you don't want to have sex, 385 00:20:27,877 --> 00:20:29,544 I accept that. 386 00:20:29,831 --> 00:20:32,214 But I am very confused. 387 00:20:32,548 --> 00:20:34,493 So am I. 388 00:20:34,517 --> 00:20:36,595 I thought I was fine u-until I... 389 00:20:36,619 --> 00:20:40,665 I told Lea to move out, like you wanted. 390 00:20:40,689 --> 00:20:43,809 You said that things were okay. 391 00:20:44,193 --> 00:20:46,854 They aren't. How do I make them okay? 392 00:20:47,696 --> 00:20:50,107 I can't tell you, because I don't know. 393 00:21:14,657 --> 00:21:16,091 When I was in chemo, 394 00:21:16,115 --> 00:21:18,384 the nurses used to force that stuff down my throat, 395 00:21:18,408 --> 00:21:21,006 so I know you're not drinking it because of the taste. 396 00:21:22,231 --> 00:21:23,875 It's fast, easy nutrition. 397 00:21:23,899 --> 00:21:26,852 That and you don't end up puking your guts out in the bathroom. 398 00:21:28,463 --> 00:21:30,999 I was president of this hospital for over 10 years. 399 00:21:31,023 --> 00:21:33,693 I made a few friends, including Jack the janitor... 400 00:21:33,717 --> 00:21:36,821 Talks a lot, A's fan, horrible gossip. 401 00:21:36,845 --> 00:21:39,281 If the methotrexate is making you sick, 402 00:21:39,305 --> 00:21:40,991 we should try another medication. 403 00:21:43,785 --> 00:21:46,388 How can you guarantee that you're not gonna throw up 404 00:21:46,412 --> 00:21:48,012 in the middle of your next surgery? 405 00:21:48,876 --> 00:21:50,277 It won't happen. 406 00:21:51,694 --> 00:21:54,206 Because it only happens if I eat solid food. 407 00:21:54,230 --> 00:21:55,714 And I stopped. 408 00:21:57,024 --> 00:21:58,291 At least at work. 409 00:22:10,079 --> 00:22:12,624 That is a lot of fish tanks. 410 00:22:12,648 --> 00:22:17,619 Forty. So we can test all of the possible medications for... 411 00:22:17,876 --> 00:22:19,444 Are you throwing a party? 412 00:22:19,468 --> 00:22:20,634 Hope so. 413 00:22:33,469 --> 00:22:34,636 How are you doing, Shaun? 414 00:22:36,105 --> 00:22:37,840 Since your father passed away? 415 00:22:40,109 --> 00:22:44,096 I don't think about him very much. 416 00:22:48,484 --> 00:22:51,630 My mom... died recently. 417 00:22:51,654 --> 00:22:53,647 I-I don't know if you knew that. 418 00:22:55,291 --> 00:22:57,735 She pops into my head all the time. 419 00:22:59,628 --> 00:23:01,655 Not always the nicest thoughts. 420 00:23:08,270 --> 00:23:12,124 It's okay not to love them. 421 00:23:14,143 --> 00:23:15,644 They didn't make us who we are. 422 00:23:52,848 --> 00:23:54,382 Has your mom gone home? 423 00:23:56,978 --> 00:24:00,115 There is one more thing we have to deal with tonight. 424 00:24:01,824 --> 00:24:03,335 Come on. 425 00:24:03,359 --> 00:24:05,803 How many more sets of imaging can you possibly do? 426 00:24:07,663 --> 00:24:10,542 One of these is your prom dress. 427 00:24:10,566 --> 00:24:14,312 I like the pink, but I think you'd look gorgeous in both. 428 00:24:18,040 --> 00:24:19,484 Hurry up and choose. 429 00:24:19,508 --> 00:24:21,068 Your date'll be here soon. 430 00:24:34,390 --> 00:24:36,333 All the medications are in. 431 00:24:37,076 --> 00:24:41,072 Which means more waiting to see which medicine works. 432 00:24:41,096 --> 00:24:42,715 It's hard to be patient. 433 00:24:48,303 --> 00:24:52,016 Do you think the fish control how they react to the meds? 434 00:24:52,474 --> 00:24:53,541 No. 435 00:24:54,877 --> 00:24:57,229 It's just how their bodies respond. 436 00:24:59,895 --> 00:25:01,900 That's how I felt last night. 437 00:25:04,486 --> 00:25:07,115 I thought I was ready for us to be together, 438 00:25:07,139 --> 00:25:11,035 but my body had a different response. 439 00:25:13,262 --> 00:25:14,939 I can't turn that response off 440 00:25:14,963 --> 00:25:16,808 any more than these fish can control 441 00:25:16,832 --> 00:25:19,577 how their mutation reacts to the medication. 442 00:25:25,841 --> 00:25:28,052 Was our mutation 443 00:25:28,076 --> 00:25:30,929 me going to Wyoming with Lea? 444 00:25:37,686 --> 00:25:41,857 Do you think we can find our right medication? 445 00:25:58,373 --> 00:26:00,919 ♪ For me ♪ 446 00:26:02,711 --> 00:26:06,424 ♪ Darling, just dive right in ♪ 447 00:26:06,448 --> 00:26:08,549 ♪ Follow my lead ♪ 448 00:26:10,452 --> 00:26:13,832 ♪ I found a girl ♪ 449 00:26:13,856 --> 00:26:16,134 ♪ Beautiful and sweet ♪ 450 00:26:16,158 --> 00:26:18,002 You look amazing. 451 00:26:18,026 --> 00:26:22,974 ♪ I never knew you were the someone waiting for me 452 00:26:22,998 --> 00:26:24,476 So do you. 453 00:26:24,500 --> 00:26:29,147 ♪ 'Cause we were just kids when we fell in love 454 00:26:29,171 --> 00:26:33,218 ♪ Not knowing what it was ♪ 455 00:26:33,242 --> 00:26:40,158 ♪ I will not give you up this time ♪ 456 00:26:40,182 --> 00:26:44,229 ♪ Darling, just kiss me slow ♪ 457 00:26:44,253 --> 00:26:48,500 ♪ Your heart is all I own ♪ 458 00:26:48,524 --> 00:26:54,706 ♪ And in your eyes, you're holding mine ♪ 459 00:26:54,730 --> 00:26:58,476 ♪ Baby, I'm ♪ 460 00:26:58,500 --> 00:27:02,146 ♪ Dancing in the dark ♪ 461 00:27:02,170 --> 00:27:06,351 ♪ With you between my arms ♪ 462 00:27:06,375 --> 00:27:09,988 ♪ Barefoot on the grass ♪ 463 00:27:10,012 --> 00:27:13,448 ♪ Listening to our favorite song ♪ 464 00:27:13,472 --> 00:27:16,842 ♪ When you said you looked a mess ♪ 465 00:27:16,866 --> 00:27:20,265 ♪ I whispered underneath my breath ♪ 466 00:27:20,289 --> 00:27:21,566 Looks like you might be feeling 467 00:27:21,590 --> 00:27:24,202 a little idiotic happiness right now. 468 00:27:24,226 --> 00:27:25,703 Mm... 469 00:27:25,727 --> 00:27:27,572 Maybe a touch. 470 00:27:32,901 --> 00:27:34,679 ♪ No, no ♪ 471 00:27:34,703 --> 00:27:36,681 Dance with a prom king? 472 00:27:36,705 --> 00:27:38,750 Ohh. 473 00:27:38,774 --> 00:27:42,053 ♪ You look perfect tonight ♪ 474 00:27:55,257 --> 00:27:56,490 He's tachycardic. 475 00:27:58,927 --> 00:28:00,471 We were talking, and then he just stopped. 476 00:28:00,495 --> 00:28:01,806 We need to do a pericardial tap. 477 00:28:01,830 --> 00:28:03,775 Call the cath lab. Tell them we're coming. 478 00:28:03,799 --> 00:28:05,209 No time. We're doing it here. 479 00:28:05,233 --> 00:28:06,477 James, the pain in your chest 480 00:28:06,501 --> 00:28:08,079 is from too much fluid around your heart. 481 00:28:08,103 --> 00:28:09,881 We're gonna put a tube into your chest to drain it. 482 00:28:09,905 --> 00:28:11,405 Call Shaun and Carly. Tell them we're running out of time. 483 00:28:15,577 --> 00:28:21,092 ♪ ...will be loving you till we're 70 ♪ 484 00:28:25,854 --> 00:28:32,526 ♪ And, baby, my heart could still fall as hard at 23 ♪ 485 00:28:35,964 --> 00:28:38,610 ♪ And I'm thinking about how ♪ 486 00:28:38,634 --> 00:28:43,815 ♪ People fall in love in mysterious ways ♪ 487 00:28:43,839 --> 00:28:45,416 I brought Angie's Bearfeet Bear. 488 00:28:45,440 --> 00:28:47,209 It always makes her feel like sh... 489 00:28:50,812 --> 00:28:53,424 It's... prom. 490 00:28:53,448 --> 00:28:55,616 Ryan has been wearing his mask all night. 491 00:28:57,219 --> 00:29:01,699 ♪ And I just want to tell you I am ♪ 492 00:29:01,723 --> 00:29:04,525 ♪ So, honey, now ♪ 493 00:29:07,162 --> 00:29:09,897 ♪ Take me into your loving arms ♪ 494 00:29:11,400 --> 00:29:13,311 Don't let her stay up too late. 495 00:29:13,335 --> 00:29:17,538 ♪ Kiss me under the light of a thousand stars ♪ 496 00:29:19,474 --> 00:29:22,009 ♪ Place your hand on my beating heart ♪ 497 00:29:28,250 --> 00:29:31,211 Morgan called. James isn't doing well. 498 00:29:37,192 --> 00:29:40,012 Cross SL-327 off the list. 499 00:29:40,862 --> 00:29:43,374 I see one... 500 00:29:43,398 --> 00:29:46,474 No, two tumors. 501 00:30:07,371 --> 00:30:08,473 Okay. 502 00:30:08,945 --> 00:30:10,657 This is my stop. 503 00:30:10,682 --> 00:30:12,426 I'll see you after. 504 00:30:12,451 --> 00:30:13,928 I love you. 505 00:30:13,953 --> 00:30:15,254 I love you, too, Mom. 506 00:30:19,002 --> 00:30:21,014 Don't worry. Okay? 507 00:30:21,238 --> 00:30:22,438 I got this. 508 00:30:24,989 --> 00:30:26,723 I know you do. 509 00:30:34,632 --> 00:30:35,709 Okay. 510 00:30:35,733 --> 00:30:36,777 Okay. 511 00:30:42,185 --> 00:30:46,370 What if I wake up and don't remember Ryan at all? 512 00:30:49,980 --> 00:30:51,181 Then... 513 00:30:52,516 --> 00:30:55,253 You'll have the chance to fall in love with him all over again. 514 00:30:59,990 --> 00:31:01,090 Okay. 515 00:31:02,626 --> 00:31:03,770 Okay. 516 00:31:14,725 --> 00:31:16,912 We're down to five potential options. 517 00:31:16,937 --> 00:31:19,316 I don't need five potential. I need one actual. 518 00:31:19,340 --> 00:31:21,017 There are two that best curb... 519 00:31:21,041 --> 00:31:22,008 Choose one. 520 00:31:23,143 --> 00:31:27,123 We should try Refametinib. 521 00:31:27,147 --> 00:31:28,959 It caused abnormal cell growth. 522 00:31:28,983 --> 00:31:30,288 Trametinib is safer. 523 00:31:31,118 --> 00:31:32,495 Which doesn't mean it's safe. 524 00:31:32,519 --> 00:31:33,830 Nothing's safe. 525 00:31:33,854 --> 00:31:34,960 Which do you want us to do? 526 00:31:39,460 --> 00:31:40,770 Trametinib. 527 00:31:40,794 --> 00:31:42,439 That's the one. 528 00:31:48,235 --> 00:31:49,736 Saline in. 529 00:31:49,760 --> 00:31:52,382 Advancing scope toward the third ventricle. 530 00:31:52,406 --> 00:31:54,351 Claire, hold gentle pressure on the tumor 531 00:31:54,375 --> 00:31:56,119 while I cut off its blood supply. 532 00:32:02,816 --> 00:32:04,494 We've got some significant bleeding. 533 00:32:04,518 --> 00:32:06,116 Adjust the scope and suction. 534 00:32:11,025 --> 00:32:12,456 Look higher. 535 00:32:13,494 --> 00:32:14,971 Septal vein... There's your bleeder. 536 00:32:14,995 --> 00:32:16,418 Cauterize away. 537 00:33:01,642 --> 00:33:03,006 Micro dissector. 538 00:33:08,115 --> 00:33:09,956 The tumor's immobile. 539 00:33:09,980 --> 00:33:12,028 I can't resect it without injuring the nerve tracts. 540 00:33:12,052 --> 00:33:13,797 She'd be comatose. 541 00:33:13,821 --> 00:33:15,185 Try sharp dissection. 542 00:33:16,957 --> 00:33:18,569 - I can't get a plane. - How bad? 543 00:33:18,593 --> 00:33:20,470 It's completely invaded her thalamus. 544 00:33:20,494 --> 00:33:24,069 Thin it out with a suction aspirator. 545 00:33:29,970 --> 00:33:31,481 It's too adherent. 546 00:33:31,505 --> 00:33:33,245 If I keep going, I'm gonna kill her. 547 00:33:35,409 --> 00:33:36,609 Any ideas? 548 00:33:58,759 --> 00:34:02,274 Tell ICU Angie will be coming sooner than we planned. 549 00:34:03,804 --> 00:34:05,171 Let's close her up. 550 00:34:22,885 --> 00:34:24,329 What's next? 551 00:34:24,353 --> 00:34:26,631 Another round of radiation, chemo? 552 00:34:29,625 --> 00:34:32,314 Her carcinoma is 553 00:34:32,338 --> 00:34:35,015 unlikely to respond to those therapies. 554 00:34:38,667 --> 00:34:41,021 No. We have to try. 555 00:34:42,004 --> 00:34:43,348 Angie will want to fight. 556 00:34:43,372 --> 00:34:44,683 She's seizing. 557 00:34:44,707 --> 00:34:45,951 Give me lorazepam and Dilantin, stat. 558 00:34:45,975 --> 00:34:47,285 Phenobarb and propofol on deck. 559 00:35:10,266 --> 00:35:11,426 You're crying. 560 00:35:14,937 --> 00:35:16,014 Yes. 561 00:35:19,708 --> 00:35:20,875 Why? 562 00:35:23,546 --> 00:35:26,024 I found James on Facebook. 563 00:35:27,683 --> 00:35:30,236 He and Marjorie want to go to Costa Rica. 564 00:35:32,087 --> 00:35:35,834 Their dog is a three-legged rescue named Tripod. 565 00:35:40,429 --> 00:35:42,540 He's not a slide. He's a person. 566 00:35:43,933 --> 00:35:45,377 He's a good person. 567 00:35:45,401 --> 00:35:47,179 And he might die. 568 00:35:48,871 --> 00:35:50,924 This is why I like to stay in the lab. 569 00:35:56,378 --> 00:35:57,973 That... 570 00:35:58,614 --> 00:36:01,267 Is a very dumb thing to say. 571 00:36:04,046 --> 00:36:06,564 If you had stayed in the lab, 572 00:36:06,822 --> 00:36:10,026 James would probably be dead already. 573 00:36:12,728 --> 00:36:17,943 Your plan with the zebrafish gave him a chance. 574 00:36:17,967 --> 00:36:23,748 It was a beautiful, perfect idea, 575 00:36:23,772 --> 00:36:26,451 from a beautiful, almost perfect person. 576 00:36:32,581 --> 00:36:35,393 Your earlobes are lopsided. 577 00:37:08,884 --> 00:37:11,129 I'm so sorry. 578 00:37:11,153 --> 00:37:12,831 We couldn't save her. 579 00:37:33,509 --> 00:37:35,076 Ms. Valens? 580 00:38:07,656 --> 00:38:09,437 Nice call on the zebrafish. 581 00:38:29,018 --> 00:38:31,129 About our paper, let's meet weekly. 582 00:38:31,154 --> 00:38:33,799 I'm thinking lunch every Tuesday in the cafeteria. 583 00:38:33,902 --> 00:38:35,069 Perfect. 584 00:38:45,581 --> 00:38:48,017 I heard about Melendez's patient. 585 00:38:51,453 --> 00:38:52,487 Yeah. 586 00:39:02,498 --> 00:39:04,242 You were right. 587 00:39:04,266 --> 00:39:08,413 I should probably try another medication for my RA. 588 00:39:10,105 --> 00:39:11,624 I need solid food. 589 00:39:23,619 --> 00:39:25,180 Claire? Wait up. 590 00:39:26,488 --> 00:39:27,999 You okay? 591 00:39:28,023 --> 00:39:30,101 Fine. I'm just tired. 592 00:39:32,101 --> 00:39:34,346 You did an amazing thing for Angie. 593 00:39:34,371 --> 00:39:37,483 You gave her mother a memory that she will have forever. 594 00:39:37,508 --> 00:39:39,402 Well, it won't make up for the daughter she lost. 595 00:39:40,102 --> 00:39:41,146 You're angry. 596 00:39:41,170 --> 00:39:43,648 I'm not. I am sad. 597 00:39:43,672 --> 00:39:45,650 - Who are you angry at? - I'm not. 598 00:39:45,674 --> 00:39:46,785 Are you angry at me and Glassman 599 00:39:46,809 --> 00:39:47,952 because we couldn't save her? 600 00:39:47,976 --> 00:39:49,687 - No! - At Angie? 601 00:39:49,711 --> 00:39:51,979 No, you can't be mad at someone for dying! 602 00:39:53,315 --> 00:39:55,293 That's not true. You know that. 603 00:39:57,686 --> 00:39:59,364 She was sick. 604 00:39:59,388 --> 00:40:01,633 And she was trying to get better. 605 00:40:01,657 --> 00:40:03,986 She failed and left you alone. 606 00:40:04,010 --> 00:40:07,639 After you'd spent a lifetime trying to take care of her. 607 00:40:07,663 --> 00:40:09,599 You have every reason to be mad at your mother. 608 00:40:11,306 --> 00:40:13,017 I hate feeling this way. 609 00:40:13,042 --> 00:40:14,920 My whole life, I've been angry at her, 610 00:40:14,945 --> 00:40:16,856 and now it will never change. 611 00:40:18,040 --> 00:40:19,609 I don't know how to stop. 612 00:40:23,512 --> 00:40:25,890 Therapy will help. 613 00:40:25,914 --> 00:40:27,215 Time will help. 614 00:40:29,605 --> 00:40:31,773 There is one other thing that's worked for me. 615 00:40:44,399 --> 00:40:46,367 Did we fix our mutation? 616 00:41:00,015 --> 00:41:01,659 That the best you got?