1
00:00:13,159 --> 00:00:14,659
What?
2
00:00:14,694 --> 00:00:16,027
It's time to wake up.
3
00:00:16,095 --> 00:00:18,463
Mnh-mnh. It's still dark outside.
4
00:00:18,488 --> 00:00:20,089
I'd like to have sex.
5
00:00:21,665 --> 00:00:24,007
As romantically as that was put,
6
00:00:24,032 --> 00:00:25,699
it's too early, Shaun.
7
00:00:27,065 --> 00:00:30,501
It's exactly early enough to have sex
8
00:00:30,535 --> 00:00:32,403
for the average duration it takes us
9
00:00:32,471 --> 00:00:34,071
and still allow precisely enough time
10
00:00:34,139 --> 00:00:36,040
to get ready for work.
11
00:00:37,600 --> 00:00:40,436
How long have you
been up figuring that out?
12
00:00:40,461 --> 00:00:42,429
Since 4:53.
13
00:00:42,454 --> 00:00:44,088
But it only took two minutes.
14
00:00:46,251 --> 00:00:49,753
You've been waiting
since then to propose this?
15
00:00:50,922 --> 00:00:53,724
I let you sleep as long as possible.
16
00:00:55,694 --> 00:00:59,663
That's... very considerate.
17
00:01:00,332 --> 00:01:01,832
Ohh.
18
00:01:25,290 --> 00:01:26,957
Sorry, I'm late.
19
00:01:27,025 --> 00:01:28,225
I'm Dr. Shaun Murphy.
20
00:01:28,260 --> 00:01:29,793
Kayley has a sore throat.
21
00:01:29,861 --> 00:01:31,128
More like this constant feeling
22
00:01:31,196 --> 00:01:32,630
like there's something
stuck in my throat.
23
00:01:32,697 --> 00:01:34,198
And I've fainted a couple times,
24
00:01:34,232 --> 00:01:36,508
which I first thought was just random.
25
00:01:36,533 --> 00:01:38,334
And I'm obviously losing my voice.
26
00:01:38,359 --> 00:01:39,860
Since I've only just met you,
27
00:01:39,885 --> 00:01:42,487
I have no idea what your
voice normally sounds like.
28
00:01:42,607 --> 00:01:44,041
Well, not this.
29
00:01:44,075 --> 00:01:47,611
Sometimes when swallowing,
I get a super intense pain,
30
00:01:47,646 --> 00:01:50,948
like, worse than an ice cream headache.
31
00:01:50,982 --> 00:01:53,951
My internist sent me to an
ear, nose, and throat guy,
32
00:01:53,985 --> 00:01:58,455
an orthopedic surgeon,
um, three gastroenterologists,
33
00:01:58,490 --> 00:02:00,558
a voice issues specialist dude.
34
00:02:00,592 --> 00:02:02,826
An otolaryngologist.
35
00:02:04,824 --> 00:02:07,941
...a-a neurosurgeon who thinks
it might be a messed up nerve
36
00:02:07,966 --> 00:02:09,800
connecting the throat to the brain.
37
00:02:09,834 --> 00:02:12,169
The ninth cranial nerve,
glossopharyngeal neuralgia.
38
00:02:12,194 --> 00:02:14,309
He recommended, like, brain surgery.
39
00:02:14,334 --> 00:02:16,568
Microvascular decompression.
40
00:02:16,593 --> 00:02:21,096
Which a second neurosurgeon
said I don't need.
41
00:02:21,313 --> 00:02:23,280
You're not happy with
the answers you're getting
42
00:02:23,315 --> 00:02:25,583
from a whole bunch
of recommended specialists,
43
00:02:25,617 --> 00:02:27,561
so you came to the ER?
44
00:02:27,652 --> 00:02:29,753
I ran out of recommended specialists.
45
00:02:29,778 --> 00:02:30,836
Hmm.
46
00:02:30,861 --> 00:02:34,234
It is an intriguing
combination of symptoms.
47
00:02:34,259 --> 00:02:36,762
We'll admit you and run some tests.
48
00:02:37,629 --> 00:02:38,973
Uh, Dr. Murphy?
49
00:02:40,865 --> 00:02:41,799
You're...
50
00:02:43,134 --> 00:02:44,168
Interesting.
51
00:02:44,202 --> 00:02:45,896
I have autism.
52
00:02:46,504 --> 00:02:47,605
That's so cool.
53
00:02:48,306 --> 00:02:49,640
Uh, I mean, no...
54
00:02:49,674 --> 00:02:51,942
Sor... Not... Not cool that you are.
55
00:02:51,977 --> 00:02:54,545
Be more insensitive, Kayley. Um...
56
00:02:55,547 --> 00:02:57,681
It's cool that you're this...
57
00:02:57,716 --> 00:03:00,985
Totally chill,
super knowledgeable medico.
58
00:03:03,054 --> 00:03:06,490
Compliments... are very awkward.
59
00:03:10,695 --> 00:03:12,296
Cute doctor who's gonna cure me.
60
00:03:16,295 --> 00:03:18,096
Severe abdominal discomfort.
61
00:03:18,121 --> 00:03:20,222
Fever, tachy, hypotensive.
62
00:03:21,840 --> 00:03:24,475
It's okay, sweetie.
63
00:03:24,509 --> 00:03:25,676
What's your name?
64
00:03:25,710 --> 00:03:27,678
That's Marla.
65
00:03:27,712 --> 00:03:29,580
No one to leave her with.
66
00:03:29,648 --> 00:03:31,582
We're gonna take care of your mommy.
67
00:03:32,817 --> 00:03:35,219
Abdomen tender and distended.
68
00:03:35,253 --> 00:03:36,353
Dehydrated.
69
00:03:37,589 --> 00:03:39,158
Delayed capillary refill.
70
00:03:39,724 --> 00:03:41,191
Rapid respiratory rate.
71
00:03:41,226 --> 00:03:43,427
Skin cool and bluish, looks cyanotic.
72
00:03:43,495 --> 00:03:44,828
She's going into shock.
73
00:03:44,863 --> 00:03:46,530
We need aggressive fluid resuscitation.
74
00:03:46,564 --> 00:03:47,765
Start broad spectrum antibiotics,
75
00:03:47,790 --> 00:03:49,391
place an NG to decompress
distended abdomen.
76
00:03:49,416 --> 00:03:52,184
Trend her lactates, initiate
complete sepsis bundle.
77
00:03:55,526 --> 00:03:56,926
Synced & corrected by -robtor-
www.addic7ed.com
78
00:04:06,500 --> 00:04:09,001
Her CBC, BMP autoimmune panel,
79
00:04:09,035 --> 00:04:11,203
nasal swab, and blood cultures.
80
00:04:11,238 --> 00:04:12,171
All normal.
81
00:04:13,106 --> 00:04:14,907
Ohh. That's exciting.
82
00:04:14,941 --> 00:04:16,742
Negative tests are exciting?
83
00:04:16,776 --> 00:04:20,012
No one's been able
to find out what she has.
84
00:04:20,046 --> 00:04:23,616
I'm going to get brain FIESTA
and time-of-flight MRI
85
00:04:23,683 --> 00:04:25,551
to assess the cranial nerves and vessels,
86
00:04:25,585 --> 00:04:26,886
and Doppler ultrasound to...
87
00:04:26,920 --> 00:04:29,288
I have to get back to work.
88
00:04:29,356 --> 00:04:33,092
Our pre-dawn romantic
interlude made me late.
89
00:04:33,126 --> 00:04:35,895
Yes. There was a flaw in my methodology.
90
00:04:35,929 --> 00:04:38,397
My calculation was based on
91
00:04:38,431 --> 00:04:41,066
the mean duration of our sex
overall, but generally,
92
00:04:41,101 --> 00:04:43,135
we take statistically
significantly longer
93
00:04:43,203 --> 00:04:46,869
in the morning
than at other times of day.
94
00:04:46,904 --> 00:04:48,774
Well, maybe we can discuss
95
00:04:48,808 --> 00:04:51,443
this whole timing-our-sex
thing at lunchtime.
96
00:04:52,021 --> 00:04:54,547
Mm. No, thank you.
97
00:04:54,581 --> 00:04:57,316
I can't have lunch today.
98
00:04:57,384 --> 00:04:58,886
Too much to do.
99
00:05:04,224 --> 00:05:05,758
Sorry I'm late.
100
00:05:05,792 --> 00:05:07,593
I was going to cancel our lunch.
101
00:05:07,627 --> 00:05:08,761
Let me guess.
102
00:05:08,795 --> 00:05:11,063
A patient more interesting than me.
103
00:05:11,565 --> 00:05:12,631
Exactly.
104
00:05:12,666 --> 00:05:13,966
Yeah.
105
00:05:14,000 --> 00:05:16,969
She has a mysterious condition.
106
00:05:17,003 --> 00:05:19,805
But I realized I could use our
lunch to help understand it.
107
00:05:19,839 --> 00:05:22,107
- I ordered you a salad.
- Thank you.
108
00:05:28,481 --> 00:05:31,016
How do I get an ice cream headache?
109
00:05:31,084 --> 00:05:32,284
I've never had one.
110
00:05:32,319 --> 00:05:34,588
You don't want one.
Brain freeze is horrible.
111
00:05:35,422 --> 00:05:36,789
The scientific term
112
00:05:36,823 --> 00:05:39,258
is sphenopalatine ganglioneuralgia.
113
00:05:39,292 --> 00:05:40,659
The trigeminal nerve reacts to
114
00:05:40,694 --> 00:05:42,461
rapid temperature change in the mouth,
115
00:05:42,495 --> 00:05:44,029
sending a signal to the brain,
116
00:05:44,054 --> 00:05:46,255
which responds with changes in
blood flow and dura irritation,
117
00:05:46,280 --> 00:05:49,972
which combats what it perceives
as a dangerous, noxious stimuli,
118
00:05:49,997 --> 00:05:52,241
but is just ice cream.
119
00:05:52,339 --> 00:05:53,939
I need to experience that.
120
00:05:54,867 --> 00:05:55,867
Okay.
121
00:05:55,892 --> 00:05:57,726
The technique I usually use is,
122
00:05:57,751 --> 00:05:59,285
eat way too much, way too fast.
123
00:06:04,718 --> 00:06:07,538
I'm quitting my job.
124
00:06:08,321 --> 00:06:10,456
The job you came back from Hershey for?
125
00:06:10,490 --> 00:06:13,225
Don't tell Glassy.
He already thinks I'm a flake.
126
00:06:13,785 --> 00:06:17,063
You kicking me out is just what I needed.
127
00:06:17,088 --> 00:06:18,155
Mm-hmm.
128
00:06:18,180 --> 00:06:19,708
I was in a complete rut.
129
00:06:19,733 --> 00:06:22,901
In my personal life,
at work, super stale.
130
00:06:22,926 --> 00:06:24,093
I mean, we weren't developing anything,
131
00:06:24,118 --> 00:06:26,853
just market testing designs...
132
00:06:26,973 --> 00:06:27,906
Ow.
133
00:06:28,375 --> 00:06:30,809
Ow! Ow, ow!
134
00:06:31,277 --> 00:06:32,344
That's awful!
135
00:06:32,369 --> 00:06:33,869
- What's the cure?
- Time.
136
00:06:33,894 --> 00:06:35,628
- How much time?
- Depends.
137
00:06:37,350 --> 00:06:40,486
Do you think I should include
my job in Hershey on my resume?
138
00:06:40,520 --> 00:06:42,688
It hurts so much!
139
00:06:43,690 --> 00:06:44,857
Or does it make me look like
140
00:06:44,891 --> 00:06:46,859
I'm unable to commit to anything?
141
00:06:46,893 --> 00:06:47,860
Ow!
142
00:06:49,896 --> 00:06:50,863
Okay.
143
00:06:52,365 --> 00:06:54,867
The ultrasound showed
your colon is distended.
144
00:06:54,901 --> 00:06:56,835
We placed a rectal tube and an NG
145
00:06:56,870 --> 00:06:58,313
to try to get that decompressed.
146
00:06:58,338 --> 00:07:00,072
Mommy, can we go home?
147
00:07:00,097 --> 00:07:01,130
Not yet, sweetie.
148
00:07:01,155 --> 00:07:02,522
It would be helpful to try to find out
149
00:07:02,547 --> 00:07:03,747
what could've triggered this.
150
00:07:03,772 --> 00:07:06,307
Any history of Crohn's
or ulcerative colitis?
151
00:07:06,332 --> 00:07:07,466
No.
152
00:07:08,548 --> 00:07:09,848
I, um...
153
00:07:09,883 --> 00:07:11,750
I have had some UTIs lately.
154
00:07:11,785 --> 00:07:13,218
That's likely not connected.
155
00:07:13,253 --> 00:07:14,920
- Okay.
- Diverticulitis?
156
00:07:14,954 --> 00:07:16,855
Any recent international travel?
157
00:07:16,890 --> 00:07:18,624
I have a three-year-old and no husband.
158
00:07:18,692 --> 00:07:21,451
Okay. We're gonna need
to keep you on IV antibiotics
159
00:07:21,476 --> 00:07:23,210
and monitor the distention.
160
00:07:23,463 --> 00:07:26,298
In the meantime, is there
anyone who can look after Marla?
161
00:07:26,366 --> 00:07:28,267
No one.
162
00:07:28,301 --> 00:07:31,403
My whole family's back east.
It's... It's just us.
163
00:07:31,438 --> 00:07:35,040
I'll get a social worker
to look after her.
164
00:07:35,075 --> 00:07:36,168
Thank you.
165
00:07:43,116 --> 00:07:44,616
Go ahead, honey.
166
00:07:59,499 --> 00:08:01,633
Why is my mom upset?
167
00:08:05,105 --> 00:08:08,474
If her anterior inferior
cerebellar artery
168
00:08:08,508 --> 00:08:10,509
is encroaching
on her glossopharyngeal nerve,
169
00:08:10,577 --> 00:08:11,677
it's very minor.
170
00:08:11,745 --> 00:08:12,911
Certainly not enough to justify
171
00:08:12,946 --> 00:08:14,346
microvascular decompression surgery.
172
00:08:14,414 --> 00:08:15,647
I agree.
173
00:08:15,682 --> 00:08:18,484
It could also be acid
reflux, temporal arteritis,
174
00:08:18,518 --> 00:08:21,854
laryngopharyngeal dysesthesia.
We need to...
175
00:08:21,921 --> 00:08:23,756
We need to do $50,000 of tests,
176
00:08:23,790 --> 00:08:25,676
and it might be acid reflux?
177
00:08:25,711 --> 00:08:28,102
Or temporal arteritis or...
178
00:08:28,170 --> 00:08:30,796
It's a constellation of
relatively insignificant symptoms.
179
00:08:30,830 --> 00:08:34,226
Have you ever had an ice cream
headache, Dr. Andrews?
180
00:08:35,201 --> 00:08:36,340
Yes.
181
00:08:36,374 --> 00:08:40,038
I believe it didn't require
brain surgery, Dr. Murphy.
182
00:08:40,106 --> 00:08:42,641
As a compromise, we could do an MRI
183
00:08:42,675 --> 00:08:44,676
and CT her neck and a swallow...
184
00:08:44,711 --> 00:08:46,645
Shaun.
185
00:08:46,679 --> 00:08:48,866
You don't compromise with your boss.
186
00:08:49,649 --> 00:08:52,217
Start her on dilantin for
her pain and send her home.
187
00:09:02,228 --> 00:09:03,462
Can I just leave her with you?
188
00:09:03,496 --> 00:09:05,464
I'm a receptionist, not a social worker.
189
00:09:05,498 --> 00:09:06,717
And I'm a surgeon.
190
00:09:09,169 --> 00:09:10,569
I didn't mean I'm more important.
191
00:09:10,637 --> 00:09:13,739
I just meant we both have
more important things to do.
192
00:09:13,764 --> 00:09:14,830
When will the social worker be here?
193
00:09:14,855 --> 00:09:15,988
She said half an hour.
194
00:09:16,013 --> 00:09:17,250
Can you page her again?
195
00:09:17,275 --> 00:09:19,474
I want my mama.
196
00:09:19,499 --> 00:09:22,901
Why don't you just go play
with the toys, okay?
197
00:09:22,926 --> 00:09:24,760
Do you have her number?
I'll call her myself.
198
00:09:25,585 --> 00:09:27,321
I made Mommy sick.
199
00:09:28,988 --> 00:09:30,989
No, sweetie. It's not your fault.
200
00:09:31,024 --> 00:09:32,524
Sometimes people just get sick.
201
00:09:32,559 --> 00:09:34,860
Mommy drawk ma poop.
202
00:09:36,496 --> 00:09:38,864
- Your mommy drew your poop?
- No!
203
00:09:38,898 --> 00:09:41,066
Drawk. Mommy drawk.
204
00:09:43,944 --> 00:09:44,944
Drank?
205
00:09:44,991 --> 00:09:45,924
Yes.
206
00:09:45,949 --> 00:09:49,184
Mommy drawnk my poop.
207
00:09:53,847 --> 00:09:56,782
The good news is, we've ruled
out glossopharyngeal neuralgia.
208
00:09:56,850 --> 00:09:58,183
You don't need brain surgery.
209
00:09:58,218 --> 00:10:00,519
Never any good news without bad news.
210
00:10:00,553 --> 00:10:03,222
We've got a list of
a few things you don't have,
211
00:10:03,256 --> 00:10:04,857
but we don't know what you do have.
212
00:10:05,859 --> 00:10:07,359
So you'll run more tests.
213
00:10:07,794 --> 00:10:09,127
We can't.
214
00:10:09,152 --> 00:10:12,054
There are 21 different things
this might be,
215
00:10:12,079 --> 00:10:15,576
but they don't want us
to run 37 more tests.
216
00:10:18,938 --> 00:10:20,138
Well, this is lame.
217
00:10:20,206 --> 00:10:23,542
I can afford the tests.
I make good money.
218
00:10:23,576 --> 00:10:25,975
I can't keep talking like this!
219
00:10:26,043 --> 00:10:27,112
I need a...
220
00:10:32,318 --> 00:10:33,418
She's hypotensive.
221
00:10:33,453 --> 00:10:34,888
Code stroke.
222
00:10:36,322 --> 00:10:38,290
We need stat brain CT and MRI.
223
00:10:38,324 --> 00:10:40,759
Call angio. She may need
mechanical thrombectomy.
224
00:10:46,065 --> 00:10:49,468
3 cc's of 2% lidocaine.
225
00:11:18,331 --> 00:11:20,032
Wow.
226
00:11:28,103 --> 00:11:30,658
I-I didn't drink it. I just...
227
00:11:30,718 --> 00:11:33,286
I just used her stool
to do a home fecal transfer.
228
00:11:33,311 --> 00:11:34,895
And you didn't think to mention that?
229
00:11:34,920 --> 00:11:37,171
You said my UTIs were unrelated.
230
00:11:39,124 --> 00:11:41,025
They didn't get better with antibiotics,
231
00:11:41,059 --> 00:11:43,361
so I did exactly
what I was supposed to do.
232
00:11:43,395 --> 00:11:46,464
The video swore that
it was completely safe.
233
00:11:46,531 --> 00:11:48,933
Make sure your friend
is completely healthy.
234
00:11:48,967 --> 00:11:50,868
I've had the best results with vegans,
235
00:11:50,902 --> 00:11:52,370
though if it were between
236
00:11:52,404 --> 00:11:55,272
an 18-year-old carnivore
and a 60-year-old vegan...
237
00:11:55,307 --> 00:11:56,440
Well, don't make me choose.
238
00:11:56,475 --> 00:11:58,442
We're gonna add the saline solution.
239
00:12:00,491 --> 00:12:03,093
Should be a one-to-one match,
more or less.
240
00:12:04,282 --> 00:12:07,485
Then, we're gonna puree...
241
00:12:09,221 --> 00:12:11,389
...puree, and then puree some more.
242
00:12:11,423 --> 00:12:12,890
While it's mixing...
243
00:12:14,126 --> 00:12:15,893
Let's talk enema bags.
244
00:12:18,063 --> 00:12:20,965
Marla must have seen her
using the blender,
245
00:12:20,999 --> 00:12:22,099
assumed she drank it.
246
00:12:22,134 --> 00:12:23,501
Yeah, that's the mystery here,
247
00:12:23,568 --> 00:12:25,236
not how anyone
this stupid is still alive.
248
00:12:25,270 --> 00:12:27,438
It's not completely irrational.
249
00:12:27,472 --> 00:12:30,107
The E. coli strain in drug-resistant UTIs
250
00:12:30,142 --> 00:12:31,575
can hide out in the gut.
251
00:12:31,610 --> 00:12:34,578
Repopulating the
colon microbiome using FMT
252
00:12:34,613 --> 00:12:36,080
has shown some success.
253
00:12:36,114 --> 00:12:38,482
In a hospital,
under controlled and sterile conditions.
254
00:12:39,117 --> 00:12:40,351
Prep her for surgery.
255
00:12:40,419 --> 00:12:41,819
Between the dilation and rigidity,
256
00:12:41,853 --> 00:12:44,422
there may be colon perforation.
257
00:12:44,456 --> 00:12:47,925
And test Marla's stool for
toxins and infectious bacteria.
258
00:12:50,028 --> 00:12:53,531
She was suffering a
mini-stroke, and I saved her.
259
00:12:53,598 --> 00:12:56,367
- I saved her. I need to celebrate.
- Outside?
260
00:12:56,435 --> 00:12:57,635
I want to celebrate by kissing you.
261
00:12:57,669 --> 00:12:59,136
A lot.
262
00:12:59,171 --> 00:13:01,272
I-Inside would be inappropriate.
263
00:13:04,042 --> 00:13:06,777
Eagle Syndrome is very rare.
264
00:13:06,812 --> 00:13:08,713
A longer-than-normal styloid bone
265
00:13:08,780 --> 00:13:10,347
coming off the base of the skull.
266
00:13:10,382 --> 00:13:11,849
- And...
- I only get a five-minute break.
267
00:13:13,652 --> 00:13:15,386
It impinged on her nerves,
268
00:13:15,454 --> 00:13:17,021
causing the confusing symptoms
269
00:13:17,055 --> 00:13:19,156
that baffled eight expert doctors.
270
00:13:19,191 --> 00:13:21,525
And then when she
turned her head suddenly,
271
00:13:21,560 --> 00:13:22,768
it pinched her carotid,
272
00:13:22,778 --> 00:13:24,631
causing her TIA.
273
00:13:25,197 --> 00:13:27,465
Yeah, it's him!
274
00:13:29,901 --> 00:13:31,535
It's Dr. Murphy!
275
00:13:34,072 --> 00:13:35,406
How do I know you?
276
00:13:35,474 --> 00:13:37,208
He is cute!
277
00:13:37,242 --> 00:13:39,076
Is that his girlfriend?
278
00:13:39,144 --> 00:13:40,421
Kayley's hotter.
279
00:13:44,683 --> 00:13:45,583
He's so cute!
280
00:13:54,559 --> 00:13:57,361
My personal... Chernobyl.
281
00:13:57,395 --> 00:13:58,362
What?
282
00:13:58,930 --> 00:13:59,997
Seriously, guys.
283
00:14:00,031 --> 00:14:01,665
Ohh, come on.
284
00:14:01,700 --> 00:14:03,901
A zone of exclusion should
be imposed around my kitchen.
285
00:14:05,670 --> 00:14:08,072
Millions of people have watched that?
286
00:14:08,106 --> 00:14:09,774
As of 9:00 a.m.
287
00:14:09,841 --> 00:14:11,408
You're an influencer.
288
00:14:11,443 --> 00:14:14,578
And you posted how I saved you?
289
00:14:14,613 --> 00:14:17,047
But I take it I'm not saved yet?
You still have to operate?
290
00:14:17,082 --> 00:14:19,182
A normal styloid process
291
00:14:19,217 --> 00:14:21,752
is 2.5 centimeters
in length. Yours measures...
292
00:14:21,787 --> 00:14:23,020
Don't do that.
293
00:14:24,122 --> 00:14:25,923
There are two surgical options.
294
00:14:28,727 --> 00:14:30,694
Transoral, where we go in
through your mouth.
295
00:14:30,729 --> 00:14:33,297
It's non-invasive, but
creates surgical challenges
296
00:14:33,365 --> 00:14:35,199
for physical and visual access.
297
00:14:35,233 --> 00:14:37,234
The alternative transcervical procedure
298
00:14:37,269 --> 00:14:39,236
involves an incision in your neck
299
00:14:39,271 --> 00:14:40,971
with none of those access issues,
300
00:14:41,039 --> 00:14:43,607
but with some post-operative scarring.
301
00:14:43,642 --> 00:14:46,410
So one way is safer,
but the other way, I'll look better?
302
00:14:46,444 --> 00:14:47,808
It's a pretty bad-ass scar.
303
00:14:49,614 --> 00:14:51,749
Can I take a bit to decide which?
304
00:14:51,783 --> 00:14:52,875
Of course.
305
00:14:56,313 --> 00:14:58,715
You had no right
to tell the world about me.
306
00:14:58,890 --> 00:15:00,224
It was flattering.
307
00:15:00,258 --> 00:15:03,127
Not everyone wants to be famous.
308
00:15:03,161 --> 00:15:06,063
Uh... If it's any consolation,
309
00:15:06,097 --> 00:15:08,693
you've had over 70 marriage proposals.
310
00:15:10,001 --> 00:15:11,235
It's not.
311
00:15:17,442 --> 00:15:20,311
Some of us are more comfortable
in the spotlight than others.
312
00:15:20,345 --> 00:15:21,912
I think you're great.
313
00:15:21,947 --> 00:15:23,280
Thanks.
314
00:15:28,320 --> 00:15:30,621
I don't have to poop.
315
00:15:31,156 --> 00:15:32,759
Be patient.
316
00:15:36,260 --> 00:15:38,561
I don't have to poop!
317
00:15:38,586 --> 00:15:40,788
Is there something your mom does
318
00:15:40,813 --> 00:15:42,380
to help you when you can't go?
319
00:15:42,534 --> 00:15:45,302
Sometimes she hold my hand.
320
00:15:46,171 --> 00:15:47,771
Would you like me to?
321
00:15:47,806 --> 00:15:49,306
You're not my mom.
322
00:15:49,341 --> 00:15:51,508
Well, just keep trying.
323
00:15:53,278 --> 00:15:54,478
Pbbbbbbht.
324
00:15:57,048 --> 00:16:00,517
Sweetie, we really need you to go.
325
00:16:00,552 --> 00:16:05,456
If you can't,
there is another way we can do this.
326
00:16:05,490 --> 00:16:06,357
How?
327
00:16:06,391 --> 00:16:09,159
Well, it's not fun.
328
00:16:09,194 --> 00:16:10,628
For either of us.
329
00:16:15,033 --> 00:16:18,263
Isolate and divide
middle colic artery and vein.
330
00:16:18,870 --> 00:16:20,170
It's an epidemic.
331
00:16:20,205 --> 00:16:21,739
People taking online medical advice.
332
00:16:21,806 --> 00:16:23,807
It's not the problem. It's the symptom.
333
00:16:23,842 --> 00:16:26,343
Medical care is a financial
stress for lots of people,
334
00:16:26,378 --> 00:16:29,046
not to mention physician arrogance,
335
00:16:29,080 --> 00:16:30,881
incompetence, impatience.
336
00:16:30,916 --> 00:16:32,716
So it's our fault?
337
00:16:32,751 --> 00:16:34,551
Resect and cut the colon
proximal and distal
338
00:16:34,586 --> 00:16:36,781
to the perforation with GIA stapler.
339
00:16:37,422 --> 00:16:39,023
A friend of a friend self-diagnosed
340
00:16:39,057 --> 00:16:41,558
her own Cushing's disease online
341
00:16:41,593 --> 00:16:44,862
after a series of doctors
barely listened to her,
342
00:16:44,896 --> 00:16:47,264
told her to get more rest.
343
00:16:47,332 --> 00:16:48,599
I'm guessing she didn't then perform
344
00:16:48,667 --> 00:16:50,100
do-it-yourself brain surgery at home.
345
00:16:51,836 --> 00:16:53,131
Claire's right.
346
00:16:54,539 --> 00:16:56,340
I was... supporting your point.
347
00:16:56,374 --> 00:16:58,509
She convinced me I was wrong.
348
00:16:58,543 --> 00:17:00,511
Divide mesentery with LigaSure.
349
00:17:06,451 --> 00:17:07,685
We have a bleed.
350
00:17:07,719 --> 00:17:08,786
It's major.
351
00:17:08,853 --> 00:17:10,220
Tension during mobilization
352
00:17:10,255 --> 00:17:11,255
must have caused a splenic capsule tear.
353
00:17:11,289 --> 00:17:12,356
We need to do a splenectomy.
354
00:17:12,390 --> 00:17:13,857
Cut the connecting attachments.
355
00:17:17,128 --> 00:17:18,195
Kidney.
356
00:17:18,229 --> 00:17:19,697
Diaphragm.
357
00:17:19,731 --> 00:17:21,465
Take the vascular pedicle
with a white load stapler.
358
00:17:21,533 --> 00:17:23,200
Do not get the tail of the pancreas.
359
00:17:33,578 --> 00:17:34,945
Dr. Melendez?
360
00:17:34,980 --> 00:17:36,913
- Can this wait?
- I'm not sure.
361
00:17:36,981 --> 00:17:39,116
The fecal sample
that your team sent me...
362
00:17:39,150 --> 00:17:42,419
It might be normal,
but was it mislabeled?
363
00:17:42,454 --> 00:17:44,455
It seems to be from a 70-year-old.
364
00:17:45,390 --> 00:17:46,991
It's from a three-year-old.
365
00:17:47,058 --> 00:17:52,523
SCFAs, elevated isobutyric
and isovaleric acid.
366
00:17:52,548 --> 00:17:55,550
She is at high risk
for serious cardiac problems.
367
00:18:18,290 --> 00:18:19,423
Oh, are you okay?
368
00:18:30,757 --> 00:18:33,526
Her social media posts
about Shaun have gone viral.
369
00:18:33,593 --> 00:18:35,594
I've got reporters clamoring to speak
370
00:18:35,629 --> 00:18:37,463
to the "twice-exceptional" Dr. Murphy.
371
00:18:37,497 --> 00:18:39,098
Bad idea. Luckily, he won't do it.
372
00:18:39,132 --> 00:18:41,500
He went off on Kayley about his privacy.
373
00:18:41,535 --> 00:18:43,035
The publicity would be good
for the hospital.
374
00:18:43,103 --> 00:18:46,172
And I'm sure Dr. Glassman can
make him see the wisdom of that.
375
00:18:46,206 --> 00:18:47,423
I'm with Andrews.
376
00:18:47,458 --> 00:18:49,041
It smacks of us
patting ourselves on the back.
377
00:18:49,109 --> 00:18:51,177
It could also come off as exploitative.
378
00:18:51,211 --> 00:18:53,512
But the bigger issue is,
it could blow up in our face.
379
00:18:53,547 --> 00:18:56,183
Shaun is a complete
communications wild card.
380
00:18:56,218 --> 00:18:57,850
Who knows what he'll say
about you, about me,
381
00:18:57,884 --> 00:18:59,552
about being demoted, about screw-ups.
382
00:18:59,619 --> 00:19:01,320
Well, we would have to coach him.
383
00:19:01,355 --> 00:19:03,990
Do we have six years before
they need to go to press?
384
00:19:04,024 --> 00:19:06,525
I can go with him, manage the situation.
385
00:19:06,560 --> 00:19:07,827
No, no, no.
386
00:19:08,795 --> 00:19:10,663
If we consider Shaun an asset,
387
00:19:10,697 --> 00:19:12,565
we shouldn't treat him like a liability.
388
00:19:14,527 --> 00:19:16,595
I'll talk to him, see what he says.
389
00:19:19,072 --> 00:19:22,041
You can see the proximity
of her elongated styloid
390
00:19:22,075 --> 00:19:23,676
to the nerves and carotid.
391
00:19:23,710 --> 00:19:25,745
The trick is to break off
the excess length
392
00:19:25,812 --> 00:19:28,014
without injury to local
neurovascular structures.
393
00:19:28,048 --> 00:19:30,082
If done transcervically,
entry point is key.
394
00:19:30,150 --> 00:19:33,219
Minimizes risk of a marginal
mandibular nerve injury.
395
00:19:33,253 --> 00:19:34,854
Has she made a decision?
396
00:19:34,888 --> 00:19:35,821
Not yet.
397
00:19:36,990 --> 00:19:37,990
I'd like to lead.
398
00:19:38,025 --> 00:19:39,925
Being that it's such a rare surgery,
399
00:19:39,993 --> 00:19:42,061
I may not get another chance
at it during residency.
400
00:19:42,095 --> 00:19:44,163
When I have the benefit of supervision.
401
00:19:44,197 --> 00:19:45,865
And it wouldn't have
anything to do with hoping
402
00:19:45,899 --> 00:19:48,000
Kayley might then post
glowingly about you?
403
00:19:48,035 --> 00:19:49,101
Not at all.
404
00:19:49,169 --> 00:19:51,437
Well, undoubtedly, a little.
405
00:19:51,505 --> 00:19:53,039
Given the attention this case has drawn,
406
00:19:53,073 --> 00:19:55,608
I think we should put our best,
most experienced choice forward.
407
00:19:56,877 --> 00:19:59,278
Well, this is a teaching hospital.
408
00:19:59,346 --> 00:20:02,448
It's exactly the type of surgery
we'd give to a third-year.
409
00:20:02,473 --> 00:20:03,706
The fact that she has an online presence
410
00:20:03,731 --> 00:20:04,998
shouldn't be a factor.
411
00:20:05,023 --> 00:20:07,057
And yet here you are,
the Chief of Surgery
412
00:20:07,082 --> 00:20:09,083
working a case you say
a third-year can handle.
413
00:20:09,222 --> 00:20:11,190
It also might reflect well on this place
414
00:20:11,224 --> 00:20:13,684
to have a young woman be the
face of Kayley's surgery.
415
00:20:13,718 --> 00:20:16,175
Assuming it goes well.
416
00:20:17,483 --> 00:20:19,351
Live by the Internet,
die by the Internet.
417
00:20:21,094 --> 00:20:22,181
You still want to lead?
418
00:20:23,103 --> 00:20:24,470
Yes.
419
00:20:24,538 --> 00:20:25,638
It's yours.
420
00:21:28,201 --> 00:21:29,135
Ann?
421
00:21:30,437 --> 00:21:31,604
Ann.
422
00:21:38,378 --> 00:21:39,745
Am I okay?
423
00:21:39,770 --> 00:21:41,171
You're fine.
424
00:21:41,196 --> 00:21:43,091
We had to wake you up a
little earlier than we'd like
425
00:21:43,116 --> 00:21:44,783
because we need to discuss
something with you.
426
00:21:44,818 --> 00:21:46,051
Do you understand?
427
00:21:47,554 --> 00:21:49,688
Your gut biome showed markers
for elevated cholesterol.
428
00:21:49,723 --> 00:21:51,524
Which you don't have.
429
00:21:51,558 --> 00:21:52,725
Your daughter does.
430
00:21:54,694 --> 00:21:56,862
Marla has high cholesterol?
431
00:21:56,897 --> 00:21:59,632
She has a genetic
condition: hyperlipidemia.
432
00:21:59,666 --> 00:22:01,967
Coronary testing showed 90% narrowing
433
00:22:02,002 --> 00:22:04,069
of the left main artery to her heart.
434
00:22:05,472 --> 00:22:08,841
I'm afraid your daughter
needs urgent heart surgery.
435
00:22:15,593 --> 00:22:17,867
I don't want to.
436
00:22:18,520 --> 00:22:21,448
Okay. I'll tell the reporters that.
437
00:22:21,473 --> 00:22:24,341
But can... can we talk about why?
438
00:22:24,989 --> 00:22:26,701
Your computer just beeped.
439
00:22:26,778 --> 00:22:28,123
I know.
440
00:22:28,157 --> 00:22:31,148
I can think of a few reasons
why you might be reticent.
441
00:22:31,183 --> 00:22:32,783
- You're shy.
- No, I'm not.
442
00:22:32,817 --> 00:22:35,672
Well, you do have trouble
with social interactions,
443
00:22:35,682 --> 00:22:37,216
and you have trouble anticipating
444
00:22:37,241 --> 00:22:39,642
what people might ask
and how you might respond.
445
00:22:39,667 --> 00:22:43,670
Yes, that is a problem when
I'm meeting with a patient
446
00:22:43,695 --> 00:22:46,563
or I'm at a job interview
or I'm on a date.
447
00:22:46,599 --> 00:22:48,067
Then my answers matter.
448
00:22:48,195 --> 00:22:50,296
But if I'm talking to a
reporter, they don't matter.
449
00:22:50,330 --> 00:22:51,864
It beeped again.
450
00:22:51,899 --> 00:22:53,900
Yes, I know. We're digitizing.
451
00:22:53,925 --> 00:22:56,093
Every time a patient
needs to take a drug,
452
00:22:56,118 --> 00:22:57,485
we send them a reminder.
453
00:22:57,510 --> 00:23:00,612
For some unknown reason,
they keep sending me one, too.
454
00:23:00,637 --> 00:23:02,105
I think stories do matter.
455
00:23:02,209 --> 00:23:05,378
I think what you do
and what you have done
456
00:23:05,412 --> 00:23:09,082
might be inspirational
for people to hear.
457
00:23:09,489 --> 00:23:11,446
- Okay.
- Okay, you'll do it?
458
00:23:11,471 --> 00:23:14,163
Okay, you've convinced me
I should be nervous about it.
459
00:23:14,188 --> 00:23:15,922
Now I have two reasons not to do it.
460
00:23:15,989 --> 00:23:17,239
What's the other reason?
461
00:23:17,273 --> 00:23:19,992
I'm very busy between doing
my job and having sex.
462
00:23:20,027 --> 00:23:21,761
I don't have a lot of free time.
463
00:23:24,031 --> 00:23:26,065
You should hire Lea.
464
00:23:26,100 --> 00:23:27,567
- No.
- Yes.
465
00:23:27,601 --> 00:23:30,336
She's very good at tech
466
00:23:30,370 --> 00:23:33,072
and isn't happy in her job right now.
467
00:23:35,709 --> 00:23:37,710
I'll tell you what, Shaun.
468
00:23:37,744 --> 00:23:40,279
You think about this,
you really think about this,
469
00:23:40,347 --> 00:23:43,549
how your story can benefit people,
470
00:23:43,584 --> 00:23:45,284
and I will...
471
00:23:47,341 --> 00:23:49,208
Interview Lea.
472
00:23:49,890 --> 00:23:51,057
Excellent.
473
00:23:52,459 --> 00:23:54,694
I'll think about it.
474
00:23:54,728 --> 00:23:58,231
I'll really think about it.
475
00:23:58,265 --> 00:23:59,365
Okay.
476
00:24:08,408 --> 00:24:10,643
Some people definitely thought
I would look amazeballs
477
00:24:10,711 --> 00:24:11,978
rocking a neck scar.
478
00:24:12,045 --> 00:24:14,580
But the consensus was,
479
00:24:14,615 --> 00:24:16,782
there's only so many
turtleneck days in a year.
480
00:24:16,817 --> 00:24:20,219
So I'm going with the no-scar approach.
481
00:24:20,254 --> 00:24:22,955
Which one did you vote for?
482
00:24:22,990 --> 00:24:25,825
Well, these are my people.
I mean, they know me.
483
00:24:25,850 --> 00:24:28,017
They know what's best for me
and my brand.
484
00:24:30,063 --> 00:24:31,664
"Wisdom of the crowd".
485
00:24:31,732 --> 00:24:34,133
My warrior goddess lead surgeon.
486
00:24:35,269 --> 00:24:36,502
We'll get you prepped for surgery.
487
00:24:38,492 --> 00:24:40,126
New blouse? It's nice.
488
00:24:41,408 --> 00:24:43,176
Dr. Murphy, do you have a minute?
489
00:24:50,184 --> 00:24:53,619
I really am sorry I upset you.
490
00:24:53,654 --> 00:24:55,321
And I really am grateful.
491
00:24:55,976 --> 00:24:57,209
Being sick was...
492
00:24:57,234 --> 00:24:59,034
You don't need to explain
493
00:24:59,059 --> 00:25:01,227
why you're grateful
we diagnosed your illness.
494
00:25:01,252 --> 00:25:03,420
Well, I do.
495
00:25:03,530 --> 00:25:06,165
You saved me and my career.
496
00:25:07,434 --> 00:25:09,936
At first, my followers were super into
497
00:25:09,970 --> 00:25:13,005
what I was going through,
but after a while,
498
00:25:13,040 --> 00:25:15,041
you just start being "the sick girl".
499
00:25:15,108 --> 00:25:17,810
You give up your privacy.
Doesn't that bother you?
500
00:25:17,844 --> 00:25:19,712
I have nothing to hide.
501
00:25:19,780 --> 00:25:20,947
No one should.
502
00:25:22,182 --> 00:25:24,884
We should all just be who we are.
503
00:25:29,122 --> 00:25:31,157
We are...
504
00:25:32,726 --> 00:25:35,727
The decisions we make.
505
00:25:36,463 --> 00:25:39,365
And you let other people
make them for you.
506
00:25:41,147 --> 00:25:43,215
So you're not being anyone.
507
00:25:54,748 --> 00:25:57,817
You know how you and I like
to do so many things together?
508
00:25:57,851 --> 00:25:59,685
We make clay mugs.
509
00:25:59,720 --> 00:26:01,020
That's right.
510
00:26:01,054 --> 00:26:05,091
Mommy was sick,
and she needed to be fixed.
511
00:26:05,158 --> 00:26:07,592
And you're sick, too.
512
00:26:07,617 --> 00:26:08,950
I don't feel sick.
513
00:26:09,363 --> 00:26:10,429
That's good.
514
00:26:10,497 --> 00:26:12,198
And the doctors just want to make sure
515
00:26:12,232 --> 00:26:13,766
everything is all better before you do.
516
00:26:13,834 --> 00:26:15,067
How?
517
00:26:16,069 --> 00:26:17,977
They're gonna go inside you and...
518
00:26:18,372 --> 00:26:19,372
How?
519
00:26:19,406 --> 00:26:20,740
They're gonna make a little cut...
520
00:26:20,774 --> 00:26:21,907
No!
521
00:26:21,942 --> 00:26:23,009
You're gonna be asleep.
522
00:26:23,043 --> 00:26:24,677
- No!
- Just like Mommy.
523
00:26:24,711 --> 00:26:26,712
- I...
- No, no, no, no, no!
524
00:26:26,747 --> 00:26:28,614
I'll be with you, Marla.
I'll take good care of you.
525
00:26:28,682 --> 00:26:29,882
- No, no, no, no, no!
- It's okay. Just breathe, sweetie.
526
00:26:29,916 --> 00:26:31,083
- Count to three.
- No!
527
00:26:31,118 --> 00:26:32,184
- No!
- Hey, sweetie, you have to be brave.
528
00:26:32,219 --> 00:26:33,185
No!
529
00:26:35,162 --> 00:26:36,162
Code blue!
530
00:26:37,971 --> 00:26:39,071
What's happening?
531
00:26:39,096 --> 00:26:40,630
Please help my baby.
532
00:26:40,655 --> 00:26:41,721
She's had a heart attack!
533
00:26:42,896 --> 00:26:44,030
Marla.
534
00:26:44,530 --> 00:26:45,463
Marla?
535
00:26:46,633 --> 00:26:47,733
Marla!
536
00:26:47,768 --> 00:26:50,536
Baby, I'm right here. Marla!
537
00:26:54,497 --> 00:26:57,311
Uh, would you like my CV?
538
00:26:57,336 --> 00:26:59,103
No...
539
00:26:59,128 --> 00:27:01,596
I know who you are.
I don't need to see a list.
540
00:27:04,450 --> 00:27:05,550
Where do I work?
541
00:27:07,560 --> 00:27:09,168
It's a tech company.
542
00:27:09,750 --> 00:27:10,783
You were there.
543
00:27:10,817 --> 00:27:13,252
Cars. Something about cars.
544
00:27:13,287 --> 00:27:16,022
You have no interest
in hiring me, do you?
545
00:27:16,089 --> 00:27:18,024
No. It's not personal.
546
00:27:18,091 --> 00:27:19,131
It's a little personal.
547
00:27:19,165 --> 00:27:22,161
I'm doing a favor for Shaun.
I don't really need anyone.
548
00:27:22,195 --> 00:27:24,130
Did he ask you to waste my time?
549
00:27:24,931 --> 00:27:26,198
Yeah... It's okay.
550
00:27:26,266 --> 00:27:28,167
I didn't really want
to work for you anyway.
551
00:27:28,201 --> 00:27:29,568
You're a bit of a grouch.
552
00:27:29,602 --> 00:27:33,005
But make sure whoever does do
the job shores up your firewall.
553
00:27:33,040 --> 00:27:34,440
A kindergartner can hack it.
554
00:27:34,474 --> 00:27:36,275
Thank you. I'm sure we'll be fine.
555
00:27:37,978 --> 00:27:39,111
And you're right, you know.
556
00:27:39,146 --> 00:27:41,180
We are not a good fit.
557
00:27:41,214 --> 00:27:43,149
And our mutual affection for Shaun
558
00:27:43,183 --> 00:27:45,371
isn't enough to stop us
from killing each other.
559
00:27:47,854 --> 00:27:49,789
I...
560
00:27:49,823 --> 00:27:52,024
Your Chronicle subscription
is about to expire
561
00:27:52,059 --> 00:27:54,226
because they don't have
your updated credit card.
562
00:27:54,294 --> 00:27:56,062
The coffee maker you ordered,
563
00:27:56,129 --> 00:27:57,997
third new one in the last six months,
564
00:27:58,031 --> 00:28:00,066
will be delivered Tuesday.
565
00:28:00,133 --> 00:28:02,230
And you're deducting way too much money
566
00:28:02,265 --> 00:28:03,869
out of Debbie's paycheck for FICA.
567
00:28:03,904 --> 00:28:06,005
Would you like to hear
about your Google searches?
568
00:28:08,508 --> 00:28:09,475
Thank you.
569
00:28:17,067 --> 00:28:19,251
Lea!
570
00:28:21,588 --> 00:28:24,724
Severe proximal LAD disease
with mid total occlusion.
571
00:28:24,758 --> 00:28:27,193
Angioplasty won't resolve that stenosis.
572
00:28:27,227 --> 00:28:29,261
High risk of rupture
in someone this young.
573
00:28:29,621 --> 00:28:30,821
A stent?
574
00:28:30,846 --> 00:28:33,147
Won't be enough
effective revascularization.
575
00:28:33,453 --> 00:28:37,465
She needs a left IMA to LAD anastomosis.
576
00:28:37,771 --> 00:28:40,740
I've never done a coronary
bypass on a three-year-old.
577
00:28:40,774 --> 00:28:42,341
Neither have I.
578
00:28:42,376 --> 00:28:43,676
I guess it was the right call
579
00:28:43,710 --> 00:28:45,378
to put her daughter's poop up her tush.
580
00:28:45,412 --> 00:28:46,946
Cost her a large chunk of her colon.
581
00:28:47,013 --> 00:28:48,948
- Saved her daughter's life.
- Yeah, lucky coincidence.
582
00:28:49,015 --> 00:28:51,384
I'm sure the mother
doesn't regret a thing.
583
00:28:51,418 --> 00:28:52,918
At least she shouldn't.
584
00:28:52,953 --> 00:28:53,953
I'm with Claire.
585
00:29:06,299 --> 00:29:08,567
Do you have time for lunch?
586
00:29:08,602 --> 00:29:10,790
And by "lunch", you mean...?
587
00:29:11,037 --> 00:29:12,204
Lunch.
588
00:29:12,873 --> 00:29:14,835
I need advice.
589
00:29:15,709 --> 00:29:19,412
I need to really think about something.
590
00:29:19,446 --> 00:29:20,413
Oh.
591
00:29:21,248 --> 00:29:22,615
Then yes, of course.
592
00:29:22,649 --> 00:29:24,917
It could be patronizing,
593
00:29:24,951 --> 00:29:29,088
being put up as some kind of
feel-good, human interest story.
594
00:29:29,122 --> 00:29:30,990
Or objectified and glorified
595
00:29:31,057 --> 00:29:34,126
as some kind of a symbol
for people who are different.
596
00:29:34,161 --> 00:29:37,763
But I also know that when I
told my sister your story,
597
00:29:37,798 --> 00:29:38,898
she cried.
598
00:29:39,733 --> 00:29:40,833
She was sad?
599
00:29:40,901 --> 00:29:43,469
No, she was inspired.
600
00:29:47,432 --> 00:29:51,969
I... don't know what your
advice is telling me.
601
00:29:52,078 --> 00:29:54,980
I don't know what you
think I'm supposed to do.
602
00:29:55,015 --> 00:29:58,150
Shaun, you aren't
supposed to do anything,
603
00:29:58,185 --> 00:30:00,419
except what you believe is right.
604
00:30:03,459 --> 00:30:04,802
Thank you.
605
00:30:06,660 --> 00:30:08,861
Now I'm going to go see what Lea thinks.
606
00:30:10,697 --> 00:30:12,114
I thought you had a surgery.
607
00:30:12,149 --> 00:30:13,502
I'm just going upstairs.
608
00:30:13,537 --> 00:30:16,101
Lea's meeting with
Dr. Glassman about a job.
609
00:30:16,136 --> 00:30:17,670
- A job here?
- Yes.
610
00:30:17,704 --> 00:30:19,505
Lea told me at lunch yesterday
611
00:30:19,539 --> 00:30:21,841
that she was looking
for different work, so...
612
00:30:21,875 --> 00:30:24,276
Wait, you... you had lunch
with Lea? Yesterday?
613
00:30:24,311 --> 00:30:25,678
And... And you kept it from me?
614
00:30:31,551 --> 00:30:34,653
I didn't keep it from you.
615
00:30:34,688 --> 00:30:36,689
There was no reason to mention it
616
00:30:36,723 --> 00:30:38,891
until just now, when I did.
617
00:30:39,693 --> 00:30:40,796
Shaun...
618
00:30:42,028 --> 00:30:43,462
You know how I feel
619
00:30:43,497 --> 00:30:46,465
about how Lea hovers
over our relationship.
620
00:30:46,500 --> 00:30:47,720
And...
621
00:30:48,301 --> 00:30:50,369
You're just sneaking around with her?
622
00:30:50,403 --> 00:30:51,837
Arranging for her to work here,
623
00:30:51,872 --> 00:30:54,406
where she'll just loom all the more.
624
00:30:55,475 --> 00:30:58,544
She won't be looming or hovering.
625
00:30:58,578 --> 00:31:00,940
She'll be on a whole other floor.
626
00:31:00,975 --> 00:31:03,082
Yeah, where you can go
and get her two cents
627
00:31:03,107 --> 00:31:05,943
whenever the advice given
by your actual girlfriend
628
00:31:05,968 --> 00:31:07,502
is deemed insufficient.
629
00:31:10,023 --> 00:31:11,056
Yes.
630
00:31:28,041 --> 00:31:29,008
Hey.
631
00:31:31,244 --> 00:31:32,244
What are you doing?
632
00:31:32,279 --> 00:31:33,879
Eh, fresh air.
633
00:31:33,914 --> 00:31:34,880
You?
634
00:31:39,953 --> 00:31:43,355
Shaun lied to me
about having lunch with Lea.
635
00:31:45,058 --> 00:31:46,320
No, he didn't.
636
00:31:47,527 --> 00:31:49,695
Shaun is incapable of deceit.
637
00:31:49,729 --> 00:31:52,264
He must have genuinely thought
that you wouldn't mind.
638
00:31:52,299 --> 00:31:55,634
Well, then, he is completely
tone deaf and insensitive,
639
00:31:55,702 --> 00:31:58,070
which are not better qualities
in a boyfriend.
640
00:31:58,104 --> 00:31:59,238
True.
641
00:31:59,272 --> 00:32:00,806
But not exactly unanticipated
642
00:32:00,874 --> 00:32:02,775
when you get into
a relationship with Shaun.
643
00:32:05,645 --> 00:32:07,580
And it's never really about the lie.
644
00:32:07,614 --> 00:32:09,481
It's what's underneath.
645
00:32:09,549 --> 00:32:10,883
You're jealous of Lea.
646
00:32:10,917 --> 00:32:13,052
I am not jealous.
647
00:32:13,086 --> 00:32:14,320
I am concerned...
648
00:32:14,387 --> 00:32:16,889
You don't need to justify.
I'm on team jealousy.
649
00:32:16,923 --> 00:32:19,892
It's flattering, stimulating, it...
650
00:32:19,926 --> 00:32:21,470
It means you're committed and you care.
651
00:32:21,505 --> 00:32:24,263
It's ugly and reflects
underlying trust issues
652
00:32:24,297 --> 00:32:25,397
that I don't want to...
653
00:32:25,432 --> 00:32:26,599
Yeah, yeah, yeah, like all things,
654
00:32:26,633 --> 00:32:28,696
a little is good,
and a lot will kill you.
655
00:32:29,488 --> 00:32:30,652
My advice...
656
00:32:31,405 --> 00:32:33,740
Admit you're jealous, give in to it,
657
00:32:34,007 --> 00:32:35,007
and then get over it.
658
00:32:42,649 --> 00:32:43,916
Finding the styloid
659
00:32:43,950 --> 00:32:46,986
via digital palpitation
of the tonsillar fossa.
660
00:32:48,021 --> 00:32:48,988
There.
661
00:32:51,291 --> 00:32:56,056
Making incision vertically
along the mucosa of mandible.
662
00:32:57,831 --> 00:32:59,198
Next?
663
00:32:59,265 --> 00:33:03,602
I will free the styloid
process from its muscle
664
00:33:03,637 --> 00:33:06,705
and ligament attachments.
665
00:33:08,021 --> 00:33:09,102
Done.
666
00:33:11,404 --> 00:33:14,783
Dissecting away from
the internal carotid medially,
667
00:33:16,116 --> 00:33:19,518
and external, laterally.
668
00:33:19,552 --> 00:33:21,916
Now fracture and excise the styloid.
669
00:33:29,165 --> 00:33:30,729
- Bradycardia.
- Hypotensive.
670
00:33:30,754 --> 00:33:32,788
Loss of EEG waveform. Cerebral ischemia.
671
00:33:32,866 --> 00:33:34,166
You may have injured the carotid.
672
00:33:34,200 --> 00:33:36,135
Or compressed it
by fracturing the styloid.
673
00:33:36,169 --> 00:33:38,064
See if the fragment
is impinging on the vessel.
674
00:33:38,089 --> 00:33:39,529
Dr. Murphy, extend her head.
675
00:33:48,014 --> 00:33:50,149
Yes. Found it. Easing it away.
676
00:33:54,387 --> 00:33:56,055
Carotid decompressed.
677
00:33:58,191 --> 00:34:00,926
EEG back to baseline normal.
678
00:34:06,933 --> 00:34:09,127
Resuming styloid extraction.
679
00:34:21,502 --> 00:34:23,238
Kayley's in ICU, stable.
680
00:34:23,272 --> 00:34:26,005
CT shows no signs
of any permanent damage.
681
00:34:26,040 --> 00:34:28,783
No reason to anticipate
any future problems.
682
00:34:28,818 --> 00:34:32,708
So, the question is, what do we tell her?
683
00:34:32,742 --> 00:34:35,007
That the surgery was a success.
684
00:34:35,041 --> 00:34:37,183
She had a cerebral ischemia.
On the table.
685
00:34:37,217 --> 00:34:39,585
That did no damage and that
there's no evidence of.
686
00:34:39,620 --> 00:34:41,754
Hospital policy is transparency...
687
00:34:41,789 --> 00:34:43,739
We don't tell them what music we played,
688
00:34:43,774 --> 00:34:44,979
what we talked about.
689
00:34:45,014 --> 00:34:47,685
This isn't relevant to the
outcome or to her prognosis.
690
00:34:47,720 --> 00:34:49,295
Would you be taking the same position
691
00:34:49,320 --> 00:34:51,521
if Kayley wasn't someone whose
criticism could go viral?
692
00:34:51,598 --> 00:34:52,714
I don't know.
693
00:34:52,748 --> 00:34:54,734
But it would be delusional
to think it's not relevant.
694
00:34:56,070 --> 00:34:57,182
Dr. Reznick.
695
00:34:57,825 --> 00:34:59,148
Any thoughts?
696
00:35:00,107 --> 00:35:02,420
I don't think I can
fairly offer an opinion,
697
00:35:02,445 --> 00:35:04,935
because my career
could hang in the balance.
698
00:35:05,045 --> 00:35:07,480
Yeah, well, none of us
are disinterested parties,
699
00:35:07,505 --> 00:35:10,117
given the hospital's
reputation is also at stake.
700
00:35:10,864 --> 00:35:12,398
Did you screw up?
701
00:35:12,423 --> 00:35:14,057
Could that crisis have been avoided?
702
00:35:17,037 --> 00:35:21,253
If it could have been,
then we are all responsible.
703
00:35:21,305 --> 00:35:23,206
We were watching
everything she was doing,
704
00:35:23,231 --> 00:35:25,232
and none of us told her to stop.
705
00:35:26,854 --> 00:35:28,488
This is an easy call.
706
00:35:28,635 --> 00:35:30,701
There's only one reason
to tell her everything,
707
00:35:30,736 --> 00:35:33,115
and that's you might
feel guilty if you don't.
708
00:35:33,140 --> 00:35:35,875
On the other hand, there's
the future of this hospital.
709
00:35:45,772 --> 00:35:46,705
Okay.
710
00:35:49,323 --> 00:35:52,859
Shaun, if the patient asks
for details about the surgery,
711
00:35:52,884 --> 00:35:54,986
can you limit your answers?
712
00:35:57,438 --> 00:35:59,875
I... don't know.
713
00:36:00,934 --> 00:36:02,077
Okay, we need to know if...
714
00:36:02,102 --> 00:36:03,378
No.
715
00:36:03,837 --> 00:36:07,373
Dr. Murphy, I hope
you will limit your answers.
716
00:36:07,398 --> 00:36:09,566
But I won't order you
to defy your conscience.
717
00:36:20,487 --> 00:36:24,557
We don't normally have
patients share rooms, but...
718
00:36:24,625 --> 00:36:27,085
- She's...?
- Gonna be completely fine.
719
00:36:27,110 --> 00:36:30,079
And once she's recuperated,
we'll begin her on statins and Ezetimibe,
720
00:36:30,104 --> 00:36:32,272
and she'll undergo lipid apheresis.
721
00:36:32,506 --> 00:36:33,906
It's kind of like dialysis,
722
00:36:33,931 --> 00:36:36,730
but it'll allow us to
extract LDL out of her blood.
723
00:36:36,755 --> 00:36:39,248
Should get her cholesterol
to within normal range.
724
00:36:40,814 --> 00:36:43,382
She'll need those drugs
and that other stuff
725
00:36:43,510 --> 00:36:44,544
for the rest of her life?
726
00:36:44,578 --> 00:36:48,014
Yes. But hopefully a very long one.
727
00:36:51,931 --> 00:36:53,637
Thank you so much.
728
00:36:54,689 --> 00:36:56,289
Thank God I did what I did.
729
00:37:12,172 --> 00:37:14,257
Everything went great?
730
00:37:14,534 --> 00:37:17,344
The repair was successful.
You should have no...
731
00:37:17,369 --> 00:37:20,004
Everything went great.
Say it. Say it to your fans.
732
00:37:21,748 --> 00:37:23,816
Everything went great.
733
00:37:23,851 --> 00:37:25,685
You rocked it.
734
00:37:25,719 --> 00:37:28,303
You'll be with us
another few days, and then you...
735
00:37:28,337 --> 00:37:30,173
She rocked it, right?
736
00:37:30,704 --> 00:37:33,673
She was lead surgeon in a successful...
737
00:37:33,698 --> 00:37:35,365
And how gorgeous is that hair?
738
00:37:35,390 --> 00:37:38,348
Dr. Morgan Reznick, take a bow!
739
00:37:41,851 --> 00:37:44,019
She was wrist-deep
all up in my mouth, y'all.
740
00:37:44,044 --> 00:37:45,711
She is a damn hero!
741
00:37:48,609 --> 00:37:50,210
You've got work to do.
742
00:37:50,235 --> 00:37:51,320
We're proud of you.
743
00:37:54,661 --> 00:37:56,529
Any reason you screwed up?
744
00:37:56,554 --> 00:37:58,789
I didn't. It could've happened to anyone.
745
00:37:58,814 --> 00:38:01,349
Not anyone suffers from arthritic pain.
746
00:38:01,374 --> 00:38:02,941
That didn't affect anything.
747
00:38:02,966 --> 00:38:04,433
You sure about that?
748
00:38:04,458 --> 00:38:05,692
'Cause I'm not.
749
00:38:22,302 --> 00:38:24,136
Did you speak to Lea?
750
00:38:24,344 --> 00:38:25,578
Yes.
751
00:38:29,416 --> 00:38:31,443
I know she's a good friend.
752
00:38:32,419 --> 00:38:33,886
And it would be unfair
753
00:38:33,911 --> 00:38:36,579
for me to expect you
to cut her out of your life.
754
00:38:37,093 --> 00:38:38,226
But...
755
00:38:38,251 --> 00:38:41,920
You going to ask her opinion
right after I had given mine,
756
00:38:41,988 --> 00:38:45,040
it just called up Wyoming all over again.
757
00:38:46,139 --> 00:38:48,841
That you preferred Lea to me.
758
00:38:53,580 --> 00:38:54,947
I was jealous.
759
00:38:56,956 --> 00:38:59,691
And it's something
that I have to work out.
760
00:39:02,476 --> 00:39:05,645
For the two of us to work out.
761
00:39:05,670 --> 00:39:06,804
Together.
762
00:39:18,178 --> 00:39:20,012
What was Lea's advice?
763
00:39:22,130 --> 00:39:25,765
That it'd be selfish not to
share my story with the world.
764
00:39:29,308 --> 00:39:31,143
I liked your advice better.
765
00:39:43,490 --> 00:39:44,657
Hey.
766
00:39:45,592 --> 00:39:47,660
Uh-oh.
767
00:39:48,375 --> 00:39:49,691
Actually, yeah.
768
00:39:50,430 --> 00:39:52,732
There's something awkward
we need to talk about.
769
00:39:53,834 --> 00:39:55,167
You and Claire.
770
00:39:57,871 --> 00:39:59,656
You can reopen the door.
771
00:40:00,408 --> 00:40:03,310
There's nothing
remotely improper going on.
772
00:40:05,952 --> 00:40:09,021
I received an anonymous
favoritism complaint.
773
00:40:10,190 --> 00:40:11,590
We need to deal with it.
774
00:40:19,038 --> 00:40:22,929
I don't want to talk to reporters.
775
00:40:23,516 --> 00:40:25,284
I know.
776
00:40:25,572 --> 00:40:29,275
So if I talked to reporters,
777
00:40:29,300 --> 00:40:32,202
it wouldn't be honest to who I really am.
778
00:40:33,113 --> 00:40:35,615
Well, sometimes, Shaun,
779
00:40:35,640 --> 00:40:38,241
people present a different
version of themselves
780
00:40:38,266 --> 00:40:40,033
depending upon the circumstances.
781
00:40:40,058 --> 00:40:43,594
Like, I'm not always
the same here as I am at home.
782
00:40:43,823 --> 00:40:44,857
I don't.
783
00:40:45,619 --> 00:40:47,162
No, you don't.
784
00:40:48,822 --> 00:40:51,657
I considered all the arguments.
785
00:40:55,147 --> 00:40:59,251
I want to be known as a good doctor.
786
00:41:00,280 --> 00:41:02,281
Not a good autistic doctor.