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 00:08:09,739 --> 00:08:11,206 You went into cardiogenic shock 186 00:08:11,274 --> 00:08:13,242 because your heart wasn't pumping adequately. 187 00:08:13,309 --> 00:08:16,545 We did a minor procedure and installed an Impella pump, 188 00:08:16,613 --> 00:08:18,614 but it's a short-term solution. 189 00:08:18,681 --> 00:08:20,415 I do feel a little out of breath. 190 00:08:20,483 --> 00:08:22,851 But that might be just 'cause of you, Dr. Andrews. 191 00:08:22,919 --> 00:08:24,486 Ms. Norton, I'm a married man and your doctor. 192 00:08:27,023 --> 00:08:28,390 You have a rare condition. 193 00:08:28,458 --> 00:08:30,192 Certain parts of your heart muscle 194 00:08:30,260 --> 00:08:32,194 have become abnormally thick. 195 00:08:32,262 --> 00:08:35,631 So, this wall in between the chambers, that's the septum. 196 00:08:35,698 --> 00:08:37,096 That's a normal one. 197 00:08:38,001 --> 00:08:40,224 This is what yours looks like. 198 00:08:40,370 --> 00:08:41,403 Oh, wow. 199 00:08:41,471 --> 00:08:43,438 It's gonna require surgery. 200 00:08:43,506 --> 00:08:46,130 We're gonna run a few more tests to determine the best approach. 201 00:08:47,310 --> 00:08:49,258 Wait. You gonna be my surgeon, Dr. Andrews? 202 00:08:49,512 --> 00:08:50,718 I sure will. 203 00:08:51,614 --> 00:08:53,262 And y'all two gonna be with him? 204 00:08:53,583 --> 00:08:54,950 Yeah. 205 00:08:55,018 --> 00:08:57,319 My lucky day. 206 00:08:57,387 --> 00:08:59,955 Three doctors of color taking care of me. 207 00:09:00,023 --> 00:09:02,224 Doctors who won't talk down to me. 208 00:09:02,292 --> 00:09:04,559 Not exactly what I'm used to. 209 00:09:04,627 --> 00:09:05,894 You guys know what I mean. 210 00:09:05,962 --> 00:09:07,596 My mother made me wear a suit and tie 211 00:09:07,664 --> 00:09:10,065 whenever we went to the pediatrician. 212 00:09:10,133 --> 00:09:13,302 Put on your Sunday best just to get on the scale and touch your toes. 213 00:09:13,369 --> 00:09:16,844 Yeah. Made me so mad, I wound up becoming a doctor. 214 00:09:18,875 --> 00:09:20,742 The testing confirmed 215 00:09:20,810 --> 00:09:23,494 your tumor is a hormone-producing prolactinoma. 216 00:09:23,573 --> 00:09:26,448 And the pregnancy is about six weeks along. 217 00:09:26,516 --> 00:09:28,881 Do you consider yourself gay? 218 00:09:30,186 --> 00:09:32,093 - I don't think that's... - Yes. 219 00:09:32,588 --> 00:09:34,990 Because I am gay. 220 00:09:35,058 --> 00:09:38,026 But you have vaginal intercourse with your fiance. 221 00:09:38,094 --> 00:09:41,029 - That is how he got pregnant... - Dr. Murphy, that's enough. 222 00:09:41,097 --> 00:09:42,954 - I... I just want... - I think you should leave. 223 00:09:52,075 --> 00:09:53,342 I'm sorry. 224 00:09:53,409 --> 00:09:56,159 That was completely inappropriate. 225 00:09:57,447 --> 00:09:58,981 Our treatment plan for your tumor 226 00:09:59,048 --> 00:10:01,289 depends on your plan for your pregnancy. 227 00:10:01,918 --> 00:10:03,012 So... 228 00:10:07,090 --> 00:10:08,724 We've talked about kids, 229 00:10:08,791 --> 00:10:12,383 but I always figured that was way down the road. 230 00:10:13,863 --> 00:10:15,303 And not this way. 231 00:10:16,065 --> 00:10:17,722 I always assumed we'd adopt. 232 00:10:20,236 --> 00:10:23,311 I'd have go off T, and stay off. 233 00:10:24,607 --> 00:10:26,772 If Rio doesn't continue the pregnancy, 234 00:10:27,276 --> 00:10:28,566 then what happens? 235 00:10:28,959 --> 00:10:30,545 Your hormone levels would drop quickly, 236 00:10:30,613 --> 00:10:32,381 which would cause the tumor to shrink. 237 00:10:32,448 --> 00:10:36,115 After that, we'd use medication, possibly a minor surgery. 238 00:10:38,788 --> 00:10:40,536 I'd like to terminate the pregnancy. 239 00:10:43,659 --> 00:10:45,527 I looked over all of Zara's labs. 240 00:10:45,595 --> 00:10:49,264 All signs point to her taking her hypertension medicine regularly. 241 00:10:49,332 --> 00:10:53,635 Her MRIs show significant ventricular septal thickness, 242 00:10:53,703 --> 00:10:55,259 bad turbulence jet flow. 243 00:10:56,072 --> 00:10:58,221 There's myocardial edema, too. 244 00:10:59,142 --> 00:11:01,877 The ACE inhibitors were a bad call. 245 00:11:01,944 --> 00:11:04,810 Which eventually sent our patient into cardiogenic shock. 246 00:11:08,184 --> 00:11:10,316 Why'd you ignore what she was telling us? 247 00:11:11,287 --> 00:11:12,821 I made a medical diagnosis 248 00:11:12,889 --> 00:11:15,223 based on pattern processing 249 00:11:15,291 --> 00:11:16,558 that we're taught in med school, 250 00:11:16,626 --> 00:11:21,430 which involves considering, you know, race, education, 251 00:11:21,497 --> 00:11:24,199 occupation, BMI. 252 00:11:24,267 --> 00:11:26,415 Always sounded like profiling to me. 253 00:11:33,643 --> 00:11:35,277 Yes, we have the rain, 254 00:11:35,344 --> 00:11:37,145 but more impressively, the wind. 255 00:11:37,213 --> 00:11:38,947 That rain's going to be coming in sideways. 256 00:11:39,015 --> 00:11:41,216 Just take a look at how the wind increases 257 00:11:41,284 --> 00:11:42,751 as we progress throughout the day. 258 00:11:42,819 --> 00:11:44,386 So, this afternoon, we're talking about 259 00:11:44,454 --> 00:11:45,987 50-mile-per-hour gusts possible. 260 00:11:46,055 --> 00:11:47,520 Sorry for crashing. 261 00:11:47,857 --> 00:11:49,424 Radiology doesn't have a TV. 262 00:11:51,894 --> 00:11:53,734 You like The Weather Channel? 263 00:11:55,064 --> 00:11:56,821 I find it soothing. 264 00:11:58,434 --> 00:11:59,782 Would you like to join me? 265 00:12:01,473 --> 00:12:04,041 And we have more intense rainfall coming through, 266 00:12:04,109 --> 00:12:06,644 and that's going to also lead to some flood potential. 267 00:12:06,711 --> 00:12:08,379 All of us are going to get into the action. 268 00:12:08,446 --> 00:12:09,980 You got the mountains. 269 00:12:10,048 --> 00:12:13,306 Would you mind if I lowered the volume by four output levels? 270 00:12:14,386 --> 00:12:15,386 Oh. 271 00:12:16,421 --> 00:12:17,855 That would be perfect. 272 00:12:17,923 --> 00:12:19,957 All the areas around here in Northern California, 273 00:12:20,025 --> 00:12:21,626 Modesto, Stockton, Sacramento. 274 00:12:21,693 --> 00:12:23,628 The northern part of San Francisco... 275 00:12:32,437 --> 00:12:35,312 I find the reflection on the screen so distracting. 276 00:12:38,110 --> 00:12:39,524 So do I. 277 00:12:51,723 --> 00:12:52,723 Could I 278 00:12:55,160 --> 00:12:56,541 do this? 279 00:13:40,839 --> 00:13:42,212 Nurse paged me. 280 00:13:44,443 --> 00:13:45,799 Is something wrong? 281 00:13:47,112 --> 00:13:48,468 I've changed my mind. 282 00:13:51,316 --> 00:13:52,764 I want to keep the baby. 283 00:13:57,754 --> 00:13:59,388 Since you are continuing the pregnancy, 284 00:13:59,455 --> 00:14:01,931 we'll need to surgically remove the prolactinoma. 285 00:14:02,425 --> 00:14:04,684 So, you'll cut into his brain? 286 00:14:05,094 --> 00:14:07,806 Our safest option is to go in through the nasal cavity 287 00:14:07,831 --> 00:14:10,999 in what's known as a transsphenoidal surgery, TSS for short. 288 00:14:11,067 --> 00:14:14,402 It's less invasive than our other option. 289 00:14:14,837 --> 00:14:16,754 That still sounds dangerous. 290 00:14:17,039 --> 00:14:18,406 I've made up my mind. 291 00:14:18,474 --> 00:14:20,424 Do I get any say in this? 292 00:14:23,079 --> 00:14:25,647 I'm all for us having a family, but I'm not ready to... 293 00:14:25,715 --> 00:14:27,582 No one's ever ready for kids. 294 00:14:27,650 --> 00:14:30,285 Yesterday, you said that you never considered getting pregnant, 295 00:14:30,353 --> 00:14:32,895 and now you're willing to risk your life for it. 296 00:14:36,592 --> 00:14:38,234 When I was about seven, 297 00:14:39,095 --> 00:14:41,529 I had this one refuge. 298 00:14:43,232 --> 00:14:45,500 I'd hang a quilt over a couple chairs 299 00:14:45,568 --> 00:14:48,619 and hide out with my two buds, 300 00:14:49,705 --> 00:14:51,956 Foxie the Fox and Fuzz the Lion, 301 00:14:53,075 --> 00:14:54,416 and I'd imagine, 302 00:14:55,111 --> 00:14:56,460 I was the dad. 303 00:14:59,297 --> 00:15:02,056 And they were my twin little guys, 304 00:15:02,685 --> 00:15:04,718 fraternal, obviously. 305 00:15:06,189 --> 00:15:07,596 We were a family. 306 00:15:10,311 --> 00:15:13,320 When I transitioned, I put that dream aside. 307 00:15:14,297 --> 00:15:16,498 At least, as far as them coming from me. 308 00:15:16,566 --> 00:15:17,566 But now... 309 00:15:21,704 --> 00:15:23,362 Whether we planned it or not, 310 00:15:24,307 --> 00:15:25,407 this is our baby. 311 00:15:32,048 --> 00:15:34,049 How soon can you do the surgery? 312 00:15:34,116 --> 00:15:36,917 I'll order an image-guidance MRI to get things started. 313 00:15:46,128 --> 00:15:48,830 Based on the cardiac MRI and catheterization, 314 00:15:48,898 --> 00:15:50,532 there are two treatment options. 315 00:15:50,600 --> 00:15:53,034 Myectomy, basically open heart surgery, 316 00:15:53,109 --> 00:15:55,544 and alcohol septal ablation, 317 00:15:55,605 --> 00:15:59,440 where we use the alcohol to kill targeted sections of the heart muscle. 318 00:15:59,942 --> 00:16:02,077 Well, what would you recommend? 319 00:16:02,151 --> 00:16:05,520 The surgery is more invasive, tougher recovery, 320 00:16:05,581 --> 00:16:07,415 but better efficacy long-term. 321 00:16:07,483 --> 00:16:09,618 The ablation is less dangerous, 322 00:16:09,685 --> 00:16:13,579 but you're more likely to need further medical interventions. 323 00:16:13,789 --> 00:16:15,590 Now, you call that a recommendation? 324 00:16:15,658 --> 00:16:17,859 There are pros and cons to both. 325 00:16:17,927 --> 00:16:19,861 Uh, you'll need to weigh them. 326 00:16:19,929 --> 00:16:21,587 I'll give you some time. 327 00:16:22,331 --> 00:16:24,299 You always want to take care of people, Dr. Browne? 328 00:16:24,367 --> 00:16:25,507 Pretty much. 329 00:16:26,467 --> 00:16:27,969 Me, too. 330 00:16:28,037 --> 00:16:30,939 Oh. Well, you run a marijuana dispensary. 331 00:16:31,007 --> 00:16:32,974 It's not all about getting people high. 332 00:16:33,042 --> 00:16:36,645 No, maybe not, but I'm guessing most of your clientele... 333 00:16:36,712 --> 00:16:39,313 My Great-Aunt Lucy had pancreatic cancer. 334 00:16:41,517 --> 00:16:43,067 A year, she hung on. 335 00:16:43,920 --> 00:16:45,277 In agony. 336 00:16:46,622 --> 00:16:50,225 Marijuana was the only thing that helped her eat or sleep. 337 00:16:50,293 --> 00:16:52,368 Doctors didn't give her anything for the pain? 338 00:16:52,728 --> 00:16:54,620 They suggested ibuprofen. 339 00:16:56,132 --> 00:16:58,099 Now, you know doctors are 22% less likely 340 00:16:58,167 --> 00:17:00,135 to give pain meds to Black patients 341 00:17:00,202 --> 00:17:02,962 than to white patients with the same symptoms. 342 00:17:04,340 --> 00:17:07,383 My point is, you and I, we're a lot alike. 343 00:17:08,285 --> 00:17:10,645 We're both strong, Black women finding our way in the world, 344 00:17:10,713 --> 00:17:13,815 but one of us knows more about medicine than the other. 345 00:17:13,840 --> 00:17:18,143 So, I'd like to know, what would you do in my situation? 346 00:17:22,191 --> 00:17:24,426 The open myectomy is a bigger risk 347 00:17:24,493 --> 00:17:27,653 but offers more long-term benefits. 348 00:17:29,565 --> 00:17:31,323 I've made my decision. 349 00:17:33,836 --> 00:17:35,494 I'm with you, Dr. Browne. 350 00:17:36,339 --> 00:17:37,955 Book the myectomy. 351 00:17:45,614 --> 00:17:48,316 Here's the Rio Gutierrez imaging for your upcoming TSS. 352 00:17:48,384 --> 00:17:50,592 Set that on the table, please. 353 00:17:54,190 --> 00:17:55,957 I, um... 354 00:17:56,025 --> 00:17:58,226 I noted the tumor's suprasellar expansion 355 00:17:58,294 --> 00:18:01,629 and surrounding edema and splaying of circle of Willis. 356 00:18:01,697 --> 00:18:03,856 That is very helpful. 357 00:18:06,702 --> 00:18:07,985 Bye, Dr. Murphy. 358 00:18:11,207 --> 00:18:12,707 You're safe, Shaun. She's gone. 359 00:18:12,775 --> 00:18:14,366 Not really. 360 00:18:15,211 --> 00:18:17,245 Dr. D'Souza is still in my brain. 361 00:18:17,313 --> 00:18:18,579 I don't like it. 362 00:18:19,115 --> 00:18:20,539 We kissed. 363 00:18:21,384 --> 00:18:22,517 - When? - What? 364 00:18:22,585 --> 00:18:24,586 I have so many thoughts about her, 365 00:18:24,653 --> 00:18:27,088 and I have so many questions I want to ask Rio. 366 00:18:27,156 --> 00:18:28,656 Wouldn't he get more pleasure for... 367 00:18:28,724 --> 00:18:30,058 Questions you're not supposed to ask him. 368 00:18:30,126 --> 00:18:31,626 The kiss, Shaun. When did you kiss? 369 00:18:31,694 --> 00:18:33,927 Last night. In my dream. 370 00:18:34,930 --> 00:18:39,100 If I can't ask questions, how do I understand? 371 00:18:39,168 --> 00:18:41,102 My... My brain... 372 00:18:41,170 --> 00:18:44,205 My... My brain isn't behaving the way I want it to. 373 00:18:44,273 --> 00:18:45,856 How do I make it stop? 374 00:18:49,812 --> 00:18:51,904 You're attracted to Dr. D'Souza. 375 00:18:52,348 --> 00:18:53,739 Why does that bother you? 376 00:18:55,985 --> 00:19:00,622 When I was with Carly and had feelings for Lea, 377 00:19:00,689 --> 00:19:03,391 it meant I was supposed to be with Lea. 378 00:19:03,459 --> 00:19:06,094 What if this means I'm supposed to be with Dr. D'Souza? 379 00:19:06,162 --> 00:19:08,630 No. You've loved Lea for years. 380 00:19:08,697 --> 00:19:12,049 This is just... attraction. 381 00:19:13,135 --> 00:19:16,929 But shouldn't loving Lea make it go away? 382 00:19:18,207 --> 00:19:21,725 Relationships would be a lot easier if it worked that way. 383 00:19:23,084 --> 00:19:24,517 You're feeling guilty. 384 00:19:24,542 --> 00:19:27,760 I say take Lea out for a nice dinner, something special. 385 00:19:27,817 --> 00:19:30,118 And tell her about my crush. 386 00:19:30,186 --> 00:19:31,753 I need to let Lea know. 387 00:19:31,821 --> 00:19:33,278 - No, definitely not. - No, you do not. 388 00:19:34,723 --> 00:19:37,125 I want to get your thoughts on the suprasellar extension of the tumor 389 00:19:37,193 --> 00:19:38,560 - for this TSS. - You remember Sarah Pepper? 390 00:19:38,627 --> 00:19:40,095 Runs nephrology at S.F. Regional? 391 00:19:41,130 --> 00:19:42,497 Always wears a shawl? 392 00:19:42,565 --> 00:19:46,067 So, during the staff meeting last week, she fell apart. 393 00:19:46,135 --> 00:19:49,019 Screaming, crying in front of the whole department. Totally nuts. 394 00:19:49,205 --> 00:19:51,639 Rough day at the office. 395 00:19:51,707 --> 00:19:54,383 Wonder how you'd approach and resect without getting a CSF leak. 396 00:19:54,810 --> 00:19:56,349 Yeah. 397 00:19:56,374 --> 00:19:59,471 Place a lumbar drain, then infuse saline and do Valsalva maneuver. 398 00:19:59,496 --> 00:20:00,863 Okay. 399 00:20:00,888 --> 00:20:03,637 Apparently, Pepper's meltdown was so over the top, 400 00:20:03,661 --> 00:20:05,936 the hospital forced her to take a leave. 401 00:20:06,597 --> 00:20:08,981 - How long? - Unspecified. 402 00:20:09,433 --> 00:20:11,935 She's always been a little crazy. 403 00:20:12,003 --> 00:20:15,305 Last I checked, eccentric and emotional didn't qualify as crazy. 404 00:20:15,373 --> 00:20:17,114 Thanks for taking a look. 405 00:20:23,080 --> 00:20:24,447 I read that cisgender people 406 00:20:24,515 --> 00:20:27,417 often reduce transgender people to their genitalia, 407 00:20:27,485 --> 00:20:29,042 and that that is offensive. 408 00:20:29,812 --> 00:20:32,054 Did I do that to you and Rio? 409 00:20:32,456 --> 00:20:33,972 Yes. 410 00:20:35,105 --> 00:20:36,383 I'm sorry. 411 00:20:39,063 --> 00:20:42,014 Rio will be going into surgery soon. 412 00:20:43,371 --> 00:20:45,272 He's been asking for you. 413 00:20:45,340 --> 00:20:47,269 You haven't been answering your phone. 414 00:20:47,775 --> 00:20:49,188 Thanks for letting me know. 415 00:20:53,715 --> 00:20:56,049 He is very confusing to me, too. 416 00:20:56,117 --> 00:20:58,452 Rio has worked so hard, 417 00:20:58,519 --> 00:21:01,288 he had a bilateral subcutaneous mastectomy 418 00:21:01,356 --> 00:21:03,056 and takes hormone replacement therapy, 419 00:21:03,124 --> 00:21:08,540 but now he is choosing the most female act. 420 00:21:10,798 --> 00:21:12,961 It's not female if Rio's doing it. 421 00:21:16,604 --> 00:21:18,839 Y... Yes. 422 00:21:18,906 --> 00:21:22,054 And he must have dealt with a lot of prejudice 423 00:21:22,310 --> 00:21:23,777 during his transition. 424 00:21:23,845 --> 00:21:25,679 I dealt with prejudice. 425 00:21:25,747 --> 00:21:27,976 My brother helped me. Does he have a brother? 426 00:21:29,504 --> 00:21:31,341 His family doesn't talk to him. 427 00:21:36,591 --> 00:21:40,113 And now Rio is having brain surgery. 428 00:21:42,930 --> 00:21:44,284 He is very brave. 429 00:21:45,566 --> 00:21:46,600 You can stay here. 430 00:21:51,739 --> 00:21:54,741 I have a patient, Zara Norton. 431 00:21:54,809 --> 00:21:56,910 We, uh... We diagnosed her with HOCM. 432 00:21:56,978 --> 00:21:58,645 I saw the file. 433 00:21:58,713 --> 00:22:01,381 Dr. Guerin expressed some concerns 434 00:22:01,449 --> 00:22:04,763 about my initial handling of the case in the ER. 435 00:22:05,724 --> 00:22:09,727 He thinks I stereotyped her, based on her race. 436 00:22:10,224 --> 00:22:11,353 Do you think you did? 437 00:22:13,127 --> 00:22:14,661 She was crashing. 438 00:22:14,729 --> 00:22:17,609 I had to make a call. I didn't have a lot to go on. 439 00:22:19,809 --> 00:22:21,621 Glassman came to see me this morning. 440 00:22:22,437 --> 00:22:24,938 Someone told him I'm unstable and need help. 441 00:22:25,006 --> 00:22:26,410 Any idea where he heard that? 442 00:22:28,643 --> 00:22:29,976 I asked for help. You can, too. 443 00:22:30,020 --> 00:22:32,308 You're a resident. No one cares if you need help. 444 00:22:33,281 --> 00:22:35,382 I got this job in part 445 00:22:35,450 --> 00:22:39,186 because my main competition, a man, backed me. 446 00:22:39,253 --> 00:22:41,722 The second anyone thinks I can't handle this... 447 00:22:41,789 --> 00:22:42,889 No one is gonna think that... 448 00:22:42,957 --> 00:22:44,636 They will if you keep telling them I'm a mess. 449 00:22:44,892 --> 00:22:47,094 You have PTSD. 450 00:22:47,161 --> 00:22:48,695 You shouldn't be ashamed. 451 00:22:48,763 --> 00:22:51,852 Says the women who just profiled a Black female patient. 452 00:22:54,135 --> 00:22:55,522 You judged her, 453 00:22:55,970 --> 00:22:58,572 just like people will judge me 454 00:22:58,639 --> 00:23:00,707 and whisper that I've always been a little intense, 455 00:23:00,775 --> 00:23:02,946 so no wonder I was asked to step down. 456 00:23:07,582 --> 00:23:08,952 Nobody needs to know. 457 00:23:11,652 --> 00:23:12,652 Exactly. 458 00:23:14,989 --> 00:23:16,890 You tell me that it doesn't matter. 459 00:23:16,958 --> 00:23:18,959 You tell me everyone will understand, 460 00:23:19,026 --> 00:23:21,361 and then you tell me to keep it to myself. 461 00:23:21,429 --> 00:23:23,425 Should I be ashamed, or shouldn't I be? 462 00:23:24,786 --> 00:23:28,000 All right, Ms. Norton, time to head to pre-op. 463 00:23:30,295 --> 00:23:31,872 What's in the bag, handsome? 464 00:23:31,939 --> 00:23:35,163 I like to know what goes into my body. 465 00:23:35,164 --> 00:23:38,366 Uh, cefazolin. It's a prophylactic antibiotic we give before surgeries. 466 00:23:38,434 --> 00:23:39,762 Makes sense. 467 00:23:41,303 --> 00:23:44,240 Hey, what was the med y'all gave me when I first got here to the ER? 468 00:23:44,840 --> 00:23:47,375 Enalaprilat. It's an ACE inhibitor. 469 00:23:47,443 --> 00:23:48,986 Isn't that for hypertension? 470 00:23:49,213 --> 00:23:49,974 Mmm-hmm. 471 00:23:51,664 --> 00:23:52,931 But I thought I already told y'all 472 00:23:52,999 --> 00:23:54,762 I was on meds for my blood pressure. 473 00:23:55,435 --> 00:23:56,735 You did. 474 00:23:56,803 --> 00:23:58,307 So, you figured I needed more? 475 00:24:01,741 --> 00:24:03,354 Or did you not believe me? 476 00:24:17,090 --> 00:24:18,369 I'm sorry. 477 00:24:21,995 --> 00:24:23,248 You must be scared. 478 00:24:24,664 --> 00:24:26,543 You shouldn't have to be scared alone. 479 00:24:28,701 --> 00:24:29,735 I love you. 480 00:24:30,637 --> 00:24:32,049 I love you, too. 481 00:24:36,743 --> 00:24:37,743 Eli. 482 00:24:40,046 --> 00:24:41,513 I can't see you. 483 00:24:41,581 --> 00:24:44,183 I'm right here, babe. 484 00:24:44,250 --> 00:24:46,355 Can you follow this with your eyes? 485 00:24:48,988 --> 00:24:50,422 It keeps disappearing. 486 00:24:50,490 --> 00:24:51,657 You've lost peripheral vision. 487 00:24:51,724 --> 00:24:53,692 The tumor is impinging on the optic fibers. 488 00:24:53,760 --> 00:24:56,131 We can't perform the TSS surgery. 489 00:25:01,599 --> 00:25:03,734 With the tumor's continued growth, 490 00:25:03,802 --> 00:25:07,437 the best remaining option is the open pterional craniotomy. 491 00:25:07,513 --> 00:25:10,949 But it is higher risk with a lengthier recovery. 492 00:25:11,009 --> 00:25:13,844 All of which is on top of the potential for gender dysphoria 493 00:25:13,912 --> 00:25:15,179 during pregnancy. 494 00:25:15,246 --> 00:25:17,541 Is that still a concern? 495 00:25:19,317 --> 00:25:21,373 I think back to before I started taking T, 496 00:25:22,253 --> 00:25:23,959 how terrible that felt. 497 00:25:26,431 --> 00:25:28,964 The thought of feeling that all over again... 498 00:25:32,497 --> 00:25:35,012 We could go back to the original plan. 499 00:25:37,302 --> 00:25:38,569 You mean terminate the pregnancy? 500 00:25:40,104 --> 00:25:42,311 The tumor should shrink on its own. 501 00:25:45,710 --> 00:25:49,568 After everything you've done to get where you are in your life, 502 00:25:49,874 --> 00:25:53,197 it's scary to think about doing something that would put that at risk. 503 00:25:56,955 --> 00:25:58,869 This is my next step. 504 00:26:00,098 --> 00:26:03,290 I'm ready to take it, even if I'm scared. 505 00:26:05,897 --> 00:26:08,212 You have to take risks sometimes, Dr. Lim. 506 00:26:17,988 --> 00:26:19,223 Thank you. 507 00:26:19,747 --> 00:26:21,581 Shouldn't you be prepping Zara for surgery? 508 00:26:21,746 --> 00:26:23,347 It's canceled. 509 00:26:23,414 --> 00:26:25,604 She wants to be transferred to a different hospital. 510 00:26:27,405 --> 00:26:30,818 One where she won't be "racially profiled into heart failure." 511 00:26:39,163 --> 00:26:41,870 Shaun, you okay? 512 00:26:44,588 --> 00:26:47,290 I am having thoughts I don't want to have. 513 00:26:47,324 --> 00:26:50,254 Both Park and Jordan say I shouldn't tell you. 514 00:26:51,576 --> 00:26:53,340 But you're going to, aren't you? 515 00:26:55,446 --> 00:26:56,947 Yes, I am. 516 00:26:57,015 --> 00:26:58,882 I have a work crush. 517 00:26:58,950 --> 00:27:01,285 Also, my patient is a pregnant trans man... 518 00:27:01,352 --> 00:27:02,725 Okay, one at a time, Shaun. 519 00:27:03,087 --> 00:27:05,956 About this... crush? 520 00:27:06,024 --> 00:27:07,658 Her name is Dr. Cintia D'Souza. 521 00:27:07,725 --> 00:27:09,660 She is a second-year radiology resident. 522 00:27:09,727 --> 00:27:11,895 Last night, I dreamed we were in the Residents' Lounge, 523 00:27:11,963 --> 00:27:14,097 watching The Weather Channel, and then we started kissing... 524 00:27:14,165 --> 00:27:15,165 Okay, I got it. 525 00:27:17,235 --> 00:27:19,036 Are you mad? 526 00:27:19,103 --> 00:27:21,326 Park and Jordan were right. I shouldn't have told you. 527 00:27:21,873 --> 00:27:24,508 No. I'm not mad. 528 00:27:24,575 --> 00:27:28,208 A little surprised, but that's okay. 529 00:27:31,282 --> 00:27:32,755 I'm still attracted 530 00:27:33,451 --> 00:27:34,757 to other guys sometimes. 531 00:27:35,553 --> 00:27:36,553 N... No. 532 00:27:37,522 --> 00:27:38,956 No. What? Who? 533 00:27:39,023 --> 00:27:40,262 - It doesn't matter. - Who? 534 00:27:41,459 --> 00:27:45,395 There... Okay, there is this one physical therapist... 535 00:27:45,463 --> 00:27:46,463 N... No. 536 00:27:47,211 --> 00:27:48,211 No. 537 00:27:48,399 --> 00:27:49,399 No. 538 00:27:53,104 --> 00:27:57,040 What if we're attracted to other people 539 00:27:57,108 --> 00:28:00,574 because there is something wrong with our relationship? 540 00:28:02,313 --> 00:28:05,315 You're not planning on kissing Dr. D'Souza in real life? 541 00:28:05,383 --> 00:28:06,450 No. 542 00:28:06,517 --> 00:28:08,452 Or working late with her, 543 00:28:08,519 --> 00:28:10,787 doing some X-rays alone, 544 00:28:10,855 --> 00:28:14,057 where you might end up leaning over the same light box. 545 00:28:14,125 --> 00:28:16,799 We don't use light boxes anymore. 546 00:28:21,466 --> 00:28:23,380 And I don't plan to work late with her. 547 00:28:23,450 --> 00:28:26,892 Then I don't think either of us has anything to be worried about. 548 00:28:39,350 --> 00:28:41,824 I have to go prep for a pterional craniotomy. 549 00:28:48,726 --> 00:28:51,250 I'm Dr. Glassman, president of the hospital. 550 00:28:52,296 --> 00:28:54,131 Unless you're here to drive me to S.F. Regional, 551 00:28:54,198 --> 00:28:55,796 you can head right back on out. 552 00:28:57,188 --> 00:29:00,523 I apologize for your experience in the emergency room. 553 00:29:00,638 --> 00:29:02,105 That's mighty white of you. 554 00:29:05,576 --> 00:29:08,512 I don't recommend that you transfer to S.F. Regional, 555 00:29:08,579 --> 00:29:10,113 or any other hospital, for that matter. 556 00:29:10,181 --> 00:29:12,369 I'm sure they got the same fancy equipment, 557 00:29:12,446 --> 00:29:14,818 same shiny sets of diplomas y'all got here, 558 00:29:14,886 --> 00:29:17,276 and maybe a few less racist doctors. 559 00:29:18,656 --> 00:29:21,458 Well, apparently, that doesn't seem to be the case. 560 00:29:21,592 --> 00:29:25,617 I pulled data on comparable hospitals within 100 miles, 561 00:29:26,364 --> 00:29:29,533 did numbers on surgical outcomes 562 00:29:29,600 --> 00:29:34,104 and patient satisfaction, aggregated by race. 563 00:29:34,172 --> 00:29:38,422 Apparently, we're doing well, comparatively. 564 00:29:41,665 --> 00:29:44,834 Your argument is that your hospital may be racially biased, 565 00:29:44,859 --> 00:29:47,764 but it's less racially biased than these other hospitals? 566 00:29:49,120 --> 00:29:50,851 Yeah. Pretty much. 567 00:29:51,917 --> 00:29:53,471 Stay at St. Bonaventure, 568 00:29:53,496 --> 00:29:57,587 the president of the hospital will monitor your care every step of the way. 569 00:29:58,930 --> 00:30:00,193 For whatever it's worth, 570 00:30:01,466 --> 00:30:03,113 I don't think you can do better than that. 571 00:30:13,544 --> 00:30:15,834 She's gonna stay, on one condition. 572 00:30:17,148 --> 00:30:18,587 That you're off the team. 573 00:30:29,519 --> 00:30:31,654 Dr. Park, please open Sylvian fissure. 574 00:30:31,722 --> 00:30:33,498 Arachnoid knife and Rhoton dissector. 575 00:30:35,792 --> 00:30:38,428 Tumor is visible. 576 00:30:39,529 --> 00:30:41,181 What makes someone a man? 577 00:30:43,242 --> 00:30:45,744 I thought it was just the chromosomes, 578 00:30:45,811 --> 00:30:47,512 but that must not be it, 579 00:30:47,580 --> 00:30:50,515 which makes things confusing and difficult, 580 00:30:50,583 --> 00:30:52,317 and I know Rio was uncomfortable when he... 581 00:30:52,384 --> 00:30:54,477 Life is uncomfortable. 582 00:30:54,478 --> 00:30:57,713 It hits you with tough situations and you muscle through them. 583 00:30:57,781 --> 00:30:59,901 I see a tiny bleed in the circular sinus. 584 00:30:59,926 --> 00:31:01,620 Pack it with Floseal. 585 00:31:07,724 --> 00:31:09,692 Someone give me an update. 586 00:31:09,760 --> 00:31:11,694 We got a drop in end tidal CO2 and oxygen sat. 587 00:31:11,762 --> 00:31:13,596 See any evidence of exposed air cells? 588 00:31:13,664 --> 00:31:17,366 No. But waxing bone edges just to be safe. 589 00:31:17,434 --> 00:31:21,237 But the tumor thinned the sellar floor and sphenoid wall. 590 00:31:21,305 --> 00:31:23,808 Making it permeable to oxygen. 591 00:31:24,675 --> 00:31:26,209 It's an air embolism. 592 00:31:27,901 --> 00:31:29,188 BP's dropping. 593 00:31:31,849 --> 00:31:33,818 Dr. Lim, what should we do? 594 00:31:56,340 --> 00:31:57,832 Saline gauze, 595 00:31:57,833 --> 00:32:00,476 tilt the table to eliminate the negative air pressure gradient, 596 00:32:00,544 --> 00:32:01,987 and place a central line. 597 00:32:03,463 --> 00:32:04,563 This will stop the air leak 598 00:32:04,631 --> 00:32:06,465 and allow us to access the air bubble. 599 00:32:06,533 --> 00:32:09,078 Inserting Bunegin air-aspirating cath. 600 00:32:10,836 --> 00:32:13,718 You are 2 centimeters from the superior vena cava. 601 00:32:14,883 --> 00:32:17,978 Aspirate the right atrium until you don't see any more air bubbles. 602 00:32:28,655 --> 00:32:30,516 Nice save, Dr. Lim. 603 00:32:31,199 --> 00:32:32,809 Let's get this tumor out. 604 00:32:33,268 --> 00:32:35,509 Make your transverse aortotomy with Potts scissors, 605 00:32:35,533 --> 00:32:36,580 Dr. Wolke. 606 00:32:37,939 --> 00:32:41,234 Extending the muscular incision down to the mid-ventricle. 607 00:32:41,610 --> 00:32:43,320 There's the myectomy site. 608 00:32:44,646 --> 00:32:46,698 There's the aberrant muscle bundle. 609 00:33:11,382 --> 00:33:12,769 Get her off bypass, 610 00:33:12,974 --> 00:33:14,251 see how she does. 611 00:33:27,255 --> 00:33:28,724 How's the cardiac output? 612 00:33:29,891 --> 00:33:31,560 Reduced and insufficient. 613 00:33:32,694 --> 00:33:36,030 Low output could mean we need to further reduce the septum. 614 00:33:36,097 --> 00:33:37,865 Unless it means that we reduced it too much. 615 00:33:37,933 --> 00:33:39,466 Damaged the cardiac electrical conductors 616 00:33:39,534 --> 00:33:40,994 that control the heart rate. 617 00:33:41,019 --> 00:33:42,763 She's having third-degree heart block. 618 00:33:42,988 --> 00:33:44,164 Enrique's right. 619 00:33:44,823 --> 00:33:46,375 We took too much muscle. 620 00:33:47,058 --> 00:33:48,392 Put her back on bypass. 621 00:33:48,460 --> 00:33:50,728 We could augment the wall with a bovine patch. 622 00:33:50,811 --> 00:33:52,298 Still wouldn't insulate the electrical system. 623 00:33:52,299 --> 00:33:55,759 She'd still be at risk of complete heart block and cardiac arrest. 624 00:33:58,970 --> 00:34:01,672 We could insert a dual chamber pacer. 625 00:34:01,740 --> 00:34:04,251 She won't need the conduction system in the wall of her heart 626 00:34:04,276 --> 00:34:05,911 to control her heart rate. 627 00:34:08,146 --> 00:34:09,146 Let's go! 628 00:34:14,853 --> 00:34:16,405 How was the craniotomy? 629 00:34:16,621 --> 00:34:17,988 It went well. 630 00:34:18,056 --> 00:34:19,825 The patient is in recovery. 631 00:34:22,928 --> 00:34:25,429 Your text said you have good news. 632 00:34:25,497 --> 00:34:27,666 And by good news, I mean bad news for Dr. D'Souza. 633 00:34:27,866 --> 00:34:30,836 Plenty of great stuff to crush a crush. 634 00:34:31,002 --> 00:34:32,671 First observation, 635 00:34:33,538 --> 00:34:35,591 she smells like cinnamon. 636 00:34:36,534 --> 00:34:37,534 Mmm. 637 00:34:39,144 --> 00:34:41,879 Which is more puzzling than irritating. 638 00:34:41,947 --> 00:34:45,149 Actually kind of nice. Which is obviously not helpful. 639 00:34:45,217 --> 00:34:48,252 Oh, okay. She does this weird self-grooming gesture 640 00:34:48,320 --> 00:34:50,522 where she tucks her hair behind her ear. 641 00:34:52,103 --> 00:34:54,291 And then sorta massages her ear. 642 00:34:54,359 --> 00:34:56,493 Also n... not helpful. 643 00:34:56,561 --> 00:34:58,345 Okay. I'm sorry. I'm sorry. 644 00:34:58,346 --> 00:34:59,556 Mmm-hmm. 645 00:34:59,764 --> 00:35:01,600 Okay. At the salad bar, 646 00:35:01,891 --> 00:35:05,454 she used the cucumber tongs to reach for the cucumbers, 647 00:35:06,304 --> 00:35:07,915 and then the tomatoes. 648 00:35:11,142 --> 00:35:12,628 And the olives. 649 00:35:14,880 --> 00:35:16,590 And the pickles. 650 00:35:17,983 --> 00:35:19,259 - Ugh. - Mmm. 651 00:35:19,918 --> 00:35:20,918 Mmm-hmm. 652 00:35:53,026 --> 00:35:54,026 Hey. 653 00:35:56,029 --> 00:35:57,029 Hey. 654 00:35:59,292 --> 00:36:00,719 I can see all of you. 655 00:36:06,122 --> 00:36:07,756 How'd... How'd we do? 656 00:36:07,823 --> 00:36:11,893 Great. We got all of the mass, vision is restored. 657 00:36:11,918 --> 00:36:14,823 You have every reason to expect a full recovery 658 00:36:15,164 --> 00:36:17,325 and a healthy pregnancy. 659 00:36:20,036 --> 00:36:21,430 We're gonna be dads. 660 00:36:25,549 --> 00:36:26,769 Are you ready? 661 00:36:29,112 --> 00:36:31,353 I've never been a pregnant man before. 662 00:36:33,625 --> 00:36:36,787 You'll always be the best man that I've ever known. 663 00:36:50,367 --> 00:36:52,535 Came to see how you were doing. 664 00:36:52,602 --> 00:36:55,923 Dr. Andrews told me you was the one who figured out how to save me. 665 00:37:00,477 --> 00:37:02,847 Still don't change what went down earlier, though. 666 00:37:09,000 --> 00:37:10,870 When I got to med school, 667 00:37:14,558 --> 00:37:15,914 people took one look at me 668 00:37:15,938 --> 00:37:17,711 and they thought they knew exactly who I was. 669 00:37:18,595 --> 00:37:20,823 Black girl on financial aid. 670 00:37:22,399 --> 00:37:24,033 She must not be that smart. 671 00:37:24,100 --> 00:37:26,996 She must have gotten a lot of breaks. 672 00:37:27,850 --> 00:37:29,751 She'll probably need a lot more. 673 00:37:34,698 --> 00:37:35,698 And I worked... 674 00:37:37,480 --> 00:37:40,182 I worked so hard 675 00:37:40,250 --> 00:37:41,886 to prove them wrong, 676 00:37:42,319 --> 00:37:43,752 that I wasn't who they thought I was, 677 00:37:43,820 --> 00:37:46,140 that I deserved to be there, that I... 678 00:37:46,423 --> 00:37:48,225 that I fit in. 679 00:37:53,964 --> 00:37:56,066 When you came into the ER, 680 00:37:58,668 --> 00:38:01,197 loud and messy, 681 00:38:03,173 --> 00:38:05,274 I saw... 682 00:38:05,342 --> 00:38:10,748 I saw everything I have tried hard not to be. 683 00:38:14,463 --> 00:38:16,712 And I think it made me angry. 684 00:38:22,125 --> 00:38:23,803 And I'm ashamed of that. 685 00:38:26,850 --> 00:38:28,474 And I'm really sorry. 686 00:38:32,428 --> 00:38:34,104 I used to be that way. 687 00:38:37,007 --> 00:38:40,486 But I got tired of working that hard to make white people comfortable. 688 00:38:56,359 --> 00:38:58,254 You two heading out for the night? 689 00:39:01,298 --> 00:39:02,998 We sure are. 690 00:39:03,066 --> 00:39:05,336 How did the craniotomy go, Shaun? 691 00:39:06,415 --> 00:39:08,848 Did you guys get all the prolactinoma? 692 00:39:09,952 --> 00:39:10,952 Yes. 693 00:39:12,108 --> 00:39:14,186 Is that cafeteria salad? 694 00:39:15,812 --> 00:39:17,523 Are there pickles in there? 695 00:39:19,282 --> 00:39:20,349 Did you want some? 696 00:39:20,417 --> 00:39:22,785 You know, I'm good. Thank you. 697 00:39:22,852 --> 00:39:24,655 Shaun, did you... 698 00:39:25,255 --> 00:39:28,450 - No, thank you. - Mmm-hmm. 699 00:39:32,862 --> 00:39:35,764 It does help to focus on her irresponsible salad bar practices 700 00:39:35,832 --> 00:39:37,399 and dietary preferences. 701 00:39:37,467 --> 00:39:40,546 I've got a ton of strategies to manage discomfort. 702 00:39:40,870 --> 00:39:42,172 So do I. 703 00:39:45,408 --> 00:39:46,802 - Hey. - Hey. 704 00:39:47,844 --> 00:39:49,805 To replenish your supply, 705 00:39:50,619 --> 00:39:51,961 and a peace offering. 706 00:39:52,382 --> 00:39:55,184 I wasn't aware we were at war. 707 00:39:55,251 --> 00:39:58,898 Well, seemed like my gossip about Pepper kind of landed wrong. 708 00:40:00,357 --> 00:40:01,657 Bad day. 709 00:40:01,725 --> 00:40:03,225 Sorry to crash the party. 710 00:40:03,293 --> 00:40:06,614 Dr. Glassman wanted me to show this to you two. 711 00:40:07,847 --> 00:40:11,000 I asked Lea to run some numbers on various metrics by race, 712 00:40:11,067 --> 00:40:13,936 and the results are not great, 713 00:40:14,004 --> 00:40:15,838 especially when it comes to pain management. 714 00:40:15,905 --> 00:40:19,375 We are under-treating African-American and Latinx patients 715 00:40:19,442 --> 00:40:22,111 by a considerable margin. 716 00:40:22,178 --> 00:40:23,846 I think I need a little of that peace offering. 717 00:40:23,913 --> 00:40:25,381 Help yourself. 718 00:40:25,448 --> 00:40:28,135 - Anyone else? - No. Thank you. 719 00:40:29,686 --> 00:40:31,639 Uh... me, neither. 720 00:40:38,228 --> 00:40:39,228 I... 721 00:40:41,765 --> 00:40:43,776 Started taking sertraline. 722 00:40:45,235 --> 00:40:46,695 For PTSD. 723 00:40:49,205 --> 00:40:50,491 Sorry to hear that. 724 00:40:52,274 --> 00:40:53,661 You doing okay? 725 00:40:56,860 --> 00:40:57,860 Not really. 726 00:40:59,676 --> 00:41:00,676 But I'm 727 00:41:01,998 --> 00:41:02,998 working on it. 728 00:41:04,474 --> 00:41:05,474 Okay. 729 00:41:09,132 --> 00:41:11,887 Dr. Browne, good work. 730 00:41:13,957 --> 00:41:14,957 Thank you. 731 00:41:42,058 --> 00:41:43,836 I apologized to Zara. 732 00:41:47,063 --> 00:41:51,135 She pointed out I spent med school 733 00:41:52,135 --> 00:41:54,888 trying to make white people comfortable. 734 00:41:58,554 --> 00:41:59,554 I mean, she's right. 735 00:42:00,716 --> 00:42:02,354 It wasn't just med school. 736 00:42:04,874 --> 00:42:06,343 Exhausting, isn't it? 737 00:42:09,333 --> 00:42:10,887 But we had to do it, right? 738 00:42:12,322 --> 00:42:13,431 To be here?