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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:05,440 --> 00:00:07,328 He's putting me on a renal diet. 2 00:00:07,353 --> 00:00:08,853 And if that doesn't turn things around, then... 3 00:00:08,878 --> 00:00:11,359 Dialysis? I'm so sorry. 4 00:00:11,402 --> 00:00:14,275 I don't advertise my immigration status, 5 00:00:14,318 --> 00:00:16,146 but I'm undocumented. 6 00:00:16,190 --> 00:00:19,323 My future always feels precarious. 7 00:00:19,367 --> 00:00:21,064 More money in our checks! 8 00:00:21,108 --> 00:00:23,110 We are essential! 9 00:00:23,153 --> 00:00:25,242 - You're striking? - It's very important 10 00:00:25,286 --> 00:00:27,549 that Liliana feels like I have her back. 11 00:00:27,592 --> 00:00:29,116 I'm going with my friends to celebrate. 12 00:00:29,159 --> 00:00:30,334 - Come! - Oh, no... 13 00:00:30,378 --> 00:00:32,467 You have to come. You're my boyfriend. 14 00:00:38,864 --> 00:00:40,127 Lil. 15 00:00:40,170 --> 00:00:41,563 Daniel. 16 00:00:41,606 --> 00:00:42,694 Oh, the time. 17 00:00:42,738 --> 00:00:44,696 I didn't realize. 18 00:00:44,740 --> 00:00:46,655 I... I'm almost finished. 19 00:00:46,698 --> 00:00:49,049 I'm usually done before you arrive. 20 00:00:49,092 --> 00:00:50,137 - I'm sorry. - Oh, no. 21 00:00:50,180 --> 00:00:51,312 No, let me get that. Let me get that. 22 00:00:51,355 --> 00:00:53,314 I'm the one who should be apologizing. 23 00:00:53,357 --> 00:00:56,273 No. No, I had the interns in for pizza last night. 24 00:00:56,317 --> 00:00:58,884 Then they dragged me out for a drink, and... and we just left. 25 00:00:58,928 --> 00:01:00,103 It's OK. I've got it. 26 00:01:00,147 --> 00:01:01,670 I apologize for the mess. Really, I do. 27 00:01:01,713 --> 00:01:05,507 It's OK. Compared to other offices, it's not that bad. 28 00:01:07,893 --> 00:01:10,635 Oh! 29 00:01:10,679 --> 00:01:12,855 Daniel, have a good day. 30 00:01:12,898 --> 00:01:14,204 You too. 31 00:01:19,408 --> 00:01:20,421 Ah. 32 00:01:20,446 --> 00:01:23,188 I think this belongs to you. 33 00:01:23,213 --> 00:01:25,128 Indeed, it does. Where did you find it? 34 00:01:25,172 --> 00:01:26,390 This time? Waiting room. 35 00:01:26,434 --> 00:01:28,218 - Top of the vending machine. - Mm. 36 00:01:28,262 --> 00:01:30,568 You know, maybe I should just put it 37 00:01:30,612 --> 00:01:32,570 in a little red-and-white striped shirt, 38 00:01:32,614 --> 00:01:34,616 put a bobble hat on it, black glasses, 39 00:01:34,658 --> 00:01:38,228 and call it my "Where's Waldo?" water bottle, huh? 40 00:01:38,271 --> 00:01:40,229 You get it? 41 00:01:40,274 --> 00:01:41,797 I get it. 42 00:01:41,840 --> 00:01:43,451 You have to stay hydrated. 43 00:01:44,277 --> 00:01:45,888 Thanks, Mom. 44 00:01:49,239 --> 00:01:50,545 Dr. Cuevas. 45 00:01:50,588 --> 00:01:53,287 - Ms. Goodwin, good morning. - Good morning. 46 00:01:53,330 --> 00:01:56,812 Do you have a moment to discuss your DACA renewal? 47 00:01:56,854 --> 00:01:59,423 Oh. Um, now? 48 00:01:59,467 --> 00:02:01,991 Well, the paperwork's not due for a few months, 49 00:02:02,034 --> 00:02:04,602 but I want to make sure we get everything filed early, 50 00:02:04,646 --> 00:02:07,170 just in case there's an unexpected policy change. 51 00:02:07,214 --> 00:02:09,738 Right, of course. I appreciate that. 52 00:02:09,781 --> 00:02:12,175 I just was about to dig into these overnight charts. 53 00:02:12,219 --> 00:02:13,785 Understood. 54 00:02:13,829 --> 00:02:16,527 How about we meet up at the end of the day? 55 00:02:16,571 --> 00:02:19,269 Yeah. Sure, that works. 56 00:02:19,313 --> 00:02:21,315 I will... I'll see you then. 57 00:02:24,187 --> 00:02:25,319 - Dr. Asher. - Mm-hmm? 58 00:02:25,344 --> 00:02:26,357 - Need you. - Oh, yeah. 59 00:02:26,382 --> 00:02:27,992 Come this way. 60 00:02:28,017 --> 00:02:29,366 Hi, I'm Dr. Asher. 61 00:02:29,410 --> 00:02:32,108 Leah, what's going on? 62 00:02:32,152 --> 00:02:33,762 Parents and their daughter. 63 00:02:33,805 --> 00:02:36,112 Came in a few minutes ago. They're terrified. 64 00:02:36,156 --> 00:02:38,767 - Even scared me. - Going to two. 65 00:02:38,810 --> 00:02:40,508 I didn't get a history. Just came for you. 66 00:02:40,551 --> 00:02:42,553 Excuse me, Doctor. We need your help. 67 00:02:42,597 --> 00:02:44,468 - Our daughter. - All right. 68 00:02:44,512 --> 00:02:46,862 Hi, I'm Dr. Halstead. What's your name? 69 00:02:46,905 --> 00:02:48,472 Maria. 70 00:02:48,516 --> 00:02:50,474 Her name is Maria. Very sick! 71 00:02:50,518 --> 00:02:53,564 Listen. 72 00:02:56,698 --> 00:02:58,874 I'm sorry. I don't speak Spanish. 73 00:02:58,917 --> 00:03:00,745 Get Dr. Cuevas. 74 00:03:00,789 --> 00:03:04,184 I'm just gonna feel your neck, OK? 75 00:03:05,246 --> 00:03:06,552 Does that hurt? 76 00:03:06,577 --> 00:03:07,883 ¿Malo? Bad? 77 00:03:17,980 --> 00:03:19,155 What are they saying? 78 00:03:19,199 --> 00:03:21,288 They're saying that she has the sickness, 79 00:03:21,331 --> 00:03:23,725 and if we don't help her, she will die. 80 00:03:26,056 --> 00:03:30,056 - Synced and corrected by synk - - www.addic7ed.com - 81 00:03:40,829 --> 00:03:42,744 Thank you. 82 00:03:42,787 --> 00:03:44,789 Hey. How's Maria doing? 83 00:03:44,833 --> 00:03:47,618 Still a bit groggy, but responding to questions in English. 84 00:03:47,662 --> 00:03:49,838 Whatever this is, it seems to be sporadic. 85 00:03:49,881 --> 00:03:51,709 - Any guesses? - I don't know. 86 00:03:51,753 --> 00:03:54,799 Maybe infectious encephalitis, but her vitals were normal. 87 00:03:54,843 --> 00:03:56,279 I'm hoping labs shed some light. 88 00:03:56,323 --> 00:03:57,976 What did Mom and Dad have to say? 89 00:03:58,020 --> 00:03:59,630 The sickness that they're referring to 90 00:03:59,674 --> 00:04:01,284 has to do with her older brother, Hugo. 91 00:04:01,328 --> 00:04:03,721 About a month ago, he came down with an illness, 92 00:04:03,765 --> 00:04:05,375 was admitted to Oakview Community Hospital, 93 00:04:05,419 --> 00:04:08,335 - and then died a few days later. - Oh, man. 94 00:04:08,378 --> 00:04:09,640 Yeah, and even worse, 95 00:04:09,684 --> 00:04:11,599 Oakview couldn't make a diagnosis. 96 00:04:11,642 --> 00:04:13,470 Well, explains why they're beating down our doors. 97 00:04:13,514 --> 00:04:15,907 They're afraid whatever ravaged Hugo is now attacking Maria. 98 00:04:15,951 --> 00:04:18,954 But a death in the family, no answers, 99 00:04:18,997 --> 00:04:21,478 plus the fear that she might have the same illness? 100 00:04:21,522 --> 00:04:23,872 Since nothing's jumping out, I think it's possible 101 00:04:23,915 --> 00:04:26,004 that her emotions could be manifesting physically. 102 00:04:26,048 --> 00:04:27,745 I want to talk to her, see if there could be 103 00:04:27,789 --> 00:04:29,138 - a psych explanation. - OK. 104 00:04:29,181 --> 00:04:30,705 Meantime, I'll reach out to Oakview, 105 00:04:30,748 --> 00:04:32,576 get Hugo's records and autopsy results. 106 00:04:32,620 --> 00:04:33,838 If Maria does have the same illness, 107 00:04:33,882 --> 00:04:36,493 - there could be a clue in there. - OK. 108 00:04:36,537 --> 00:04:40,323 OK, Layla, you're 7 centimeters dilated, 100% effaced. 109 00:04:40,367 --> 00:04:41,933 How long ago did your water break? 110 00:04:41,977 --> 00:04:44,675 About an hour, hour and a... 111 00:04:46,068 --> 00:04:48,200 7:02 a.m., I think. 112 00:04:48,244 --> 00:04:50,028 This baby is coming out sideways. 113 00:04:50,072 --> 00:04:51,334 No, it just feels like that. 114 00:04:51,378 --> 00:04:54,032 Your fetus is OP, meaning it's facing up instead of down. 115 00:04:54,076 --> 00:04:55,338 - Something's wrong? - No. 116 00:04:55,382 --> 00:04:56,948 Baby's just moving around, letting us know 117 00:04:56,992 --> 00:04:58,689 that it is time to come out. 118 00:04:58,733 --> 00:05:00,300 I'll have a nurse let L&D know. 119 00:05:00,343 --> 00:05:01,736 Oh, my God. 120 00:05:01,779 --> 00:05:03,564 Quentin, our son is coming. 121 00:05:03,607 --> 00:05:05,348 I'm gonna be a mom today. 122 00:05:05,392 --> 00:05:07,568 You know, I can't remember if I turned off the oven 123 00:05:07,611 --> 00:05:08,786 before we left the house. 124 00:05:08,830 --> 00:05:10,614 Quentin, we haven't cooked in days. 125 00:05:10,658 --> 00:05:12,050 The oven is off. 126 00:05:12,094 --> 00:05:13,269 I'm just gonna go home and check. 127 00:05:13,313 --> 00:05:14,488 Quentin, no! 128 00:05:14,531 --> 00:05:16,272 - Mr. Bell, please don't go. - You know what? 129 00:05:16,316 --> 00:05:17,969 Maybe you can have a neighbor check on it, 130 00:05:18,013 --> 00:05:19,406 or maybe it's just nervous energy 131 00:05:19,449 --> 00:05:21,233 that's making you think that you left it on. 132 00:05:21,277 --> 00:05:23,584 Yeah, I just don't feel like myself. 133 00:05:23,627 --> 00:05:25,586 I get it. It's a big day. 134 00:05:25,629 --> 00:05:28,066 You know, a lot of new experiences all happening at once. 135 00:05:28,110 --> 00:05:31,592 But, Quentin, this is not new for me. 136 00:05:31,635 --> 00:05:33,202 I have been here many, many times, 137 00:05:33,245 --> 00:05:36,945 and I know exactly how to help you and Layla get through this. 138 00:05:36,988 --> 00:05:38,207 Thank you. 139 00:05:39,426 --> 00:05:42,385 Sorry, Lay. I just lost my mind for a minute. 140 00:05:44,518 --> 00:05:47,259 - Nice save. - Mm-hmm. 141 00:05:48,826 --> 00:05:52,264 Hey, Sam. This is Dr. Tanaka-Reed. 142 00:05:52,308 --> 00:05:53,795 He's gonna be scrubbing in with me today. 143 00:05:53,820 --> 00:05:55,180 He's one of my surgical residents. 144 00:05:55,224 --> 00:05:58,314 Uh, technically I'm a resident but definitely not a beginner. 145 00:05:58,339 --> 00:05:59,435 OK. 146 00:05:59,460 --> 00:06:01,205 Anyway, like we discussed, 147 00:06:01,230 --> 00:06:02,840 it's a straight appendix removal. 148 00:06:02,884 --> 00:06:04,320 You're gonna be a bit sore afterwards, 149 00:06:04,364 --> 00:06:06,583 but in a week or two, you'll be back to full strength. 150 00:06:06,627 --> 00:06:08,193 Mm, perfect, 151 00:06:08,237 --> 00:06:10,152 because I've been itching to get back in the gym. 152 00:06:10,195 --> 00:06:11,893 Rugged Maniac is this summer. 153 00:06:11,936 --> 00:06:14,112 Rugged Maniac? The adventure race? 154 00:06:14,156 --> 00:06:15,853 - You know it? - Yeah, sort of. 155 00:06:15,897 --> 00:06:16,941 A couple of guys from the community 156 00:06:16,985 --> 00:06:18,247 are putting a team together. 157 00:06:18,290 --> 00:06:20,118 Community? You mean other doctors? 158 00:06:20,162 --> 00:06:23,121 No, CrossFit. 159 00:06:23,165 --> 00:06:25,428 From my Kalsu group. Kalsu's a workout. 160 00:06:25,472 --> 00:06:27,299 We do burpees and thrusters for time. 161 00:06:27,343 --> 00:06:28,866 Anyway, back to the task at hand. 162 00:06:28,910 --> 00:06:30,825 If you're ready, we're ready. 163 00:06:31,826 --> 00:06:33,610 - Let's do this. - Great. 164 00:06:33,654 --> 00:06:35,351 Nurse Trisha will be in to get the prep started. 165 00:06:35,395 --> 00:06:37,832 - Anesthesia after that. - Sounds good, Doc. 166 00:06:37,875 --> 00:06:39,877 See you on the other side, all right? 167 00:06:41,879 --> 00:06:44,447 Appendix removal... Pretty basic. 168 00:06:44,491 --> 00:06:46,144 Well, sorry Sam's not sick enough for you. 169 00:06:46,188 --> 00:06:47,450 Oh, you know what I mean. 170 00:06:47,494 --> 00:06:49,887 OR 2.0 is a Ferrari... Sexy surgery. 171 00:06:49,931 --> 00:06:52,020 But a lap appy? That's a minivan. 172 00:06:52,063 --> 00:06:54,065 Well, not even in that today. 173 00:06:54,109 --> 00:06:56,851 Sam had a sigmoid colon resection 18 months ago. 174 00:06:56,894 --> 00:06:58,287 Likely adhesions in his pelvis, 175 00:06:58,330 --> 00:07:00,942 so we're gonna do this appy open... 176 00:07:00,985 --> 00:07:02,683 Right lower quadrant incision. 177 00:07:02,726 --> 00:07:04,336 - OK? - Old school. 178 00:07:04,380 --> 00:07:07,339 Gee, hope I'm up to the challenge. 179 00:07:07,383 --> 00:07:09,994 For a resident, guy sure is full of himself. 180 00:07:10,038 --> 00:07:11,474 I'm not a fan. 181 00:07:14,521 --> 00:07:16,218 Hugo's gone. 182 00:07:18,046 --> 00:07:20,527 I'm oldest now. I need to be strong. 183 00:07:22,311 --> 00:07:25,662 For my other brothers and sisters. 184 00:07:25,706 --> 00:07:27,098 For my parents. 185 00:07:30,319 --> 00:07:34,062 They've been a wreck since Hugo died. 186 00:07:34,105 --> 00:07:35,933 They can't sleep. 187 00:07:35,977 --> 00:07:37,892 They can't eat. 188 00:07:37,935 --> 00:07:40,938 Now I'm putting them through it again. 189 00:07:42,810 --> 00:07:44,551 - I have it too. - No. 190 00:07:44,594 --> 00:07:46,727 Hey, we don't know that. 191 00:07:46,770 --> 00:07:50,207 All of the labs Dr. Halstead ran came back normal. 192 00:07:50,252 --> 00:07:52,950 Then what's wrong with me? 193 00:07:54,125 --> 00:07:56,432 In some cases, it's possible 194 00:07:56,476 --> 00:08:00,305 for grief and fear to lead to physical symptoms. 195 00:08:00,349 --> 00:08:02,960 No, I'm not imagining this. 196 00:08:03,004 --> 00:08:04,788 No, you're not. 197 00:08:04,832 --> 00:08:08,052 Your symptoms are very real. 198 00:08:08,096 --> 00:08:12,448 You suffered a devastating loss, a trauma. 199 00:08:15,103 --> 00:08:17,584 Hugo's tests were normal too. 200 00:08:20,587 --> 00:08:22,502 And then he died. 201 00:08:26,593 --> 00:08:28,332 I don't think we're looking at a psych condition. 202 00:08:28,377 --> 00:08:29,987 In conversion disorder, it's rare 203 00:08:30,031 --> 00:08:32,467 that patients can express their emotions the way Maria is. 204 00:08:32,511 --> 00:08:34,775 But her awareness of the situation, 205 00:08:34,818 --> 00:08:37,778 her acknowledgment of the fear, it doesn't fit. 206 00:08:37,821 --> 00:08:40,563 There's definitely something physical going on. 207 00:08:40,607 --> 00:08:41,999 I wish I knew what. 208 00:08:42,043 --> 00:08:43,827 Medical examiner said Hugo died of brain swelling 209 00:08:43,871 --> 00:08:45,655 but don't know what caused it. 210 00:08:45,699 --> 00:08:47,570 And here's the kicker: it was only three days 211 00:08:47,614 --> 00:08:49,703 from when Hugo was admitted to the time he died. 212 00:08:49,746 --> 00:08:53,358 OK, so whatever it is, it moved really fast. 213 00:08:55,317 --> 00:08:58,059 I think he's stuck. 214 00:08:58,102 --> 00:08:59,277 No, just a big head. 215 00:08:59,321 --> 00:09:01,279 That's all. 216 00:09:01,323 --> 00:09:02,542 Oh, my God. 217 00:09:02,585 --> 00:09:04,239 - Is he gonna fit? - Yes, he will. 218 00:09:04,282 --> 00:09:05,675 We just need to open up the birth canal a bit wider. 219 00:09:05,719 --> 00:09:07,068 - McRoberts? - Yes. 220 00:09:07,111 --> 00:09:08,939 Call the OB resident on call. 221 00:09:08,983 --> 00:09:11,463 Layla, we're gonna adjust you to a new position, OK? 222 00:09:11,507 --> 00:09:13,030 It makes it easier for the baby to come out. 223 00:09:13,074 --> 00:09:14,336 OK. 224 00:09:14,379 --> 00:09:16,077 - I'm right here. - All right, Quentin. 225 00:09:16,120 --> 00:09:17,905 Why don't you let him take over for you, OK? 226 00:09:17,948 --> 00:09:19,080 - And I can use some pressure. - Yep. 227 00:09:19,123 --> 00:09:21,473 I'm right here. 228 00:09:21,517 --> 00:09:23,214 OK, now on your next contraction, 229 00:09:23,258 --> 00:09:24,868 I want you to give me everything you've got. 230 00:09:24,912 --> 00:09:26,130 - Everything. - OK. 231 00:09:26,174 --> 00:09:27,479 - OK. - I can do this. 232 00:09:27,523 --> 00:09:29,307 - Yes, you can. - You got this. 233 00:09:29,351 --> 00:09:31,875 - You got this. You got this. - OK. 234 00:09:31,919 --> 00:09:33,790 Oh. 235 00:09:36,010 --> 00:09:38,012 I've got the head. 236 00:09:38,055 --> 00:09:39,230 Shoulder. 237 00:09:40,841 --> 00:09:42,407 I've got him. 238 00:09:42,451 --> 00:09:44,671 I got him. He's here. 239 00:09:44,714 --> 00:09:46,498 He's here. 240 00:09:47,499 --> 00:09:49,719 - He's here. - Oh, my God. 241 00:09:49,763 --> 00:09:52,156 Oh, my God. 242 00:09:52,200 --> 00:09:54,071 I'm a mom. 243 00:09:54,115 --> 00:09:56,813 Our baby, he's beautiful. 244 00:09:56,857 --> 00:09:58,510 He's perfect. 245 00:09:58,554 --> 00:10:00,861 Hey, Dad, do you want to cut the umbilical cord? 246 00:10:00,904 --> 00:10:02,776 Yeah. 247 00:10:02,819 --> 00:10:06,040 OK. Just right here in the middle, OK? 248 00:10:09,391 --> 00:10:11,175 I want to hold him. 249 00:10:11,219 --> 00:10:13,569 That's not my son. 250 00:10:14,962 --> 00:10:17,442 What? 251 00:10:17,486 --> 00:10:19,836 Layla, who's the father? 252 00:10:19,880 --> 00:10:21,751 You are, Quentin. 253 00:10:21,795 --> 00:10:23,579 You are. That's our baby. 254 00:10:23,623 --> 00:10:25,668 No, you're lying! You're lying! 255 00:10:25,712 --> 00:10:28,236 Hey, Quentin, it's OK. We'll figure this out, all right? 256 00:10:28,279 --> 00:10:29,933 - That's not my son. - That's our baby. 257 00:10:29,977 --> 00:10:31,674 - Of course it is! - No, get back! 258 00:10:31,718 --> 00:10:34,546 Of course it is! Of course it is! 259 00:10:34,590 --> 00:10:36,070 - I got to get out of here. - Hey, deep breaths, OK? 260 00:10:36,113 --> 00:10:37,245 Quentin, breathe with me. 261 00:10:37,288 --> 00:10:38,638 Breathe with me, Quentin. Deep breaths. 262 00:10:38,681 --> 00:10:40,378 - I got to get out of here! - Stay! Baby, stay! 263 00:10:40,422 --> 00:10:42,206 - Hey, call security. - Help! 264 00:10:42,250 --> 00:10:43,860 Oh, my God. What's happening? 265 00:10:43,904 --> 00:10:46,950 Hey! Hey, stop! 266 00:10:46,994 --> 00:10:49,039 Hey, guards! Quentin, stop! 267 00:10:50,954 --> 00:10:53,740 Why are you chasing me? Just leave me... leave me alone! 268 00:10:53,783 --> 00:10:56,656 - Hey, Quentin... - Stay back! Stay back! 269 00:10:56,699 --> 00:10:58,179 It's OK. It's OK. 270 00:10:58,222 --> 00:11:00,703 Deep breath. Please, just breathe. 271 00:11:00,747 --> 00:11:02,705 I just got to get out of here. 272 00:11:02,749 --> 00:11:04,794 - I just got to get out of here! - No, no, no, no, no! 273 00:11:09,930 --> 00:11:11,975 All right, Quentin. 274 00:11:12,019 --> 00:11:13,934 It's OK. 275 00:11:15,892 --> 00:11:19,243 Oh, my God, the scissors, they're pulsating. 276 00:11:19,287 --> 00:11:20,680 They're penetrating the carotid artery. 277 00:11:20,723 --> 00:11:22,029 I'll get someone to turn off the machine. 278 00:11:22,072 --> 00:11:24,858 No, the magnet is holding everything in place, 279 00:11:24,901 --> 00:11:26,207 including the scissors. 280 00:11:26,250 --> 00:11:28,035 If gravity takes over, it'll shift everything, 281 00:11:28,078 --> 00:11:31,299 and we'll have maybe 20 seconds before he bleeds out. 282 00:11:31,342 --> 00:11:33,257 OK, we need help. Call Dr. Archer. 283 00:11:33,301 --> 00:11:35,303 - Dr. Charles too. - Yeah. 284 00:11:37,044 --> 00:11:40,612 Do not touch the scissors, OK? 285 00:11:40,656 --> 00:11:42,919 We got you. 286 00:11:42,963 --> 00:11:44,790 Everything's gonna be OK. 287 00:11:49,839 --> 00:11:52,015 Coming through. Excuse me. 288 00:11:52,059 --> 00:11:53,582 Thank you guys for coming. 289 00:11:53,625 --> 00:11:55,627 Absolutely. 290 00:11:55,671 --> 00:11:57,325 - Hey, fellas. - Doctor. 291 00:11:59,719 --> 00:12:01,938 He's conscious and calm but out of it. 292 00:12:01,982 --> 00:12:03,853 He's not being crushed. He's able to breathe. 293 00:12:03,897 --> 00:12:06,073 - He's got to be in pain, though. - OK. 294 00:12:06,116 --> 00:12:09,032 So let's give him 50 mics of fentanyl IM. 295 00:12:09,076 --> 00:12:10,947 Syringe is plastic and the needle nonferrous, 296 00:12:10,991 --> 00:12:12,340 so it should be MRI safe. 297 00:12:12,383 --> 00:12:13,820 OK, I'll get it. 298 00:12:13,863 --> 00:12:15,735 Dr. Asher went back to be with his wife, Layla. 299 00:12:15,778 --> 00:12:17,780 - She's still in L&D. - OK. 300 00:12:17,824 --> 00:12:19,260 It's a rescue situation. 301 00:12:19,303 --> 00:12:20,652 I just don't really know where to start. 302 00:12:20,696 --> 00:12:22,306 All of our tools have metal. 303 00:12:22,350 --> 00:12:25,962 So nothing is usable as long as the MRI machine is running. 304 00:12:26,006 --> 00:12:28,791 All right, well, let's say we did turn the machine off. 305 00:12:28,835 --> 00:12:30,097 Everything falls to the floor. 306 00:12:30,140 --> 00:12:32,099 Bed alone is a couple hundred pounds. 307 00:12:32,142 --> 00:12:34,275 I can put two of my guys in there to try and catch it, 308 00:12:34,318 --> 00:12:36,103 then get it out of the way so you can get to Quentin. 309 00:12:36,146 --> 00:12:38,322 Scissors in his neck are magnetic too. 310 00:12:38,366 --> 00:12:40,107 Cut the MRI's power, they're gonna move. 311 00:12:40,150 --> 00:12:41,673 Quentin will bleed out fast. 312 00:12:41,717 --> 00:12:44,285 If you could go in there with clamps and stem the flow, 313 00:12:44,328 --> 00:12:46,766 - would that buy us some time? - Not enough. 314 00:12:46,809 --> 00:12:48,898 Odds of survival are less than 1%. 315 00:12:48,942 --> 00:12:51,161 I'm running outcome probabilities on our options, 316 00:12:51,205 --> 00:12:52,989 and turning off the machine cold turkey is the worst. 317 00:12:53,033 --> 00:12:54,991 So what's the best? 318 00:12:55,035 --> 00:12:57,385 If CFD can secure Quentin 319 00:12:57,428 --> 00:12:59,300 and ensure the bed won't displace him 320 00:12:59,343 --> 00:13:01,693 and Dr. Archer can stabilize the neck wound 321 00:13:01,737 --> 00:13:03,217 all before turning off the MRI machine, 322 00:13:03,260 --> 00:13:06,481 then the odds of survival are roughly 61%. 323 00:13:06,524 --> 00:13:09,049 OK, we've got a plan. Can it be done? 324 00:13:09,092 --> 00:13:11,834 Well, safest way to secure the patient 325 00:13:11,878 --> 00:13:14,228 would be to do a webbing harness. 326 00:13:14,271 --> 00:13:16,621 We can throw the ropes over the MRI machine, 327 00:13:16,665 --> 00:13:18,885 and then two of my guys can hold it on the other side. 328 00:13:18,928 --> 00:13:21,061 OK, the magnet's off, the bed falls. 329 00:13:21,104 --> 00:13:24,194 How do we ensure that Quentin doesn't go with it? 330 00:13:24,238 --> 00:13:26,240 We can create a buffer zone between him and the bed 331 00:13:26,283 --> 00:13:29,025 using wooden cribbing, wedges, and airbags. 332 00:13:29,069 --> 00:13:30,853 We can run some hoses and inflate them 333 00:13:30,897 --> 00:13:32,289 from a tank here in the hallway. 334 00:13:32,333 --> 00:13:33,856 All right, we're halfway there. 335 00:13:33,900 --> 00:13:35,553 - Dr. Archer? - Yeah. 336 00:13:35,597 --> 00:13:38,252 I just need to clamp the artery in order to control the bleeding. 337 00:13:38,295 --> 00:13:40,341 Then I could take the scissors out. 338 00:13:40,384 --> 00:13:43,300 But the issue is the tools needed to do it. 339 00:13:43,344 --> 00:13:45,346 I can make them plastic. 3D printers. 340 00:13:45,389 --> 00:13:46,564 There are four in the robotics lab. 341 00:13:46,608 --> 00:13:47,870 All right. Get on it. 342 00:13:47,914 --> 00:13:51,047 And get a few of the 2.0 engineers to help. 343 00:13:51,091 --> 00:13:53,963 - We'll get started too. - Good. 344 00:13:54,007 --> 00:13:55,399 OK, you're doing great. 345 00:13:55,443 --> 00:13:58,402 Gonna give you a little injection. Some pain meds, all right? 346 00:13:58,446 --> 00:14:01,579 To just make you a little more comfortable, OK? 347 00:14:01,623 --> 00:14:03,494 Little pinch. 348 00:14:08,238 --> 00:14:09,544 OK. 349 00:14:11,241 --> 00:14:13,896 Daniel? 350 00:14:13,940 --> 00:14:15,245 I'm just gonna step away for a second, 351 00:14:15,289 --> 00:14:16,551 have a little chat with my colleague. 352 00:14:16,594 --> 00:14:18,466 I'm not going anywhere, OK? 353 00:14:21,512 --> 00:14:23,819 How's he doing? 354 00:14:23,863 --> 00:14:28,171 Well, you know, I mean, he's pinned to an MRI machine, so... 355 00:14:28,215 --> 00:14:30,870 Do you have any theories on what sparked the break? 356 00:14:30,913 --> 00:14:33,307 I've been really focusing on trying to keep him calm. 357 00:14:33,350 --> 00:14:36,005 But how's the plan to get him off the thing going? 358 00:14:36,049 --> 00:14:37,441 Well, we've got one. 359 00:14:37,485 --> 00:14:39,617 But it's a possibility that it won't work, Daniel, 360 00:14:39,661 --> 00:14:43,012 so I've asked Dr. Asher to bring Quentin's wife down here 361 00:14:43,056 --> 00:14:45,928 to see him 'cause it may be the last time. 362 00:14:45,972 --> 00:14:47,887 OK, thank you. 363 00:14:50,237 --> 00:14:52,326 OK, making the incision. 364 00:14:54,197 --> 00:14:55,457 OK. 365 00:14:57,418 --> 00:14:59,986 OK, nice and easy. 366 00:15:02,249 --> 00:15:03,337 Lab cut. 367 00:15:08,168 --> 00:15:09,909 Yep. 368 00:15:09,952 --> 00:15:11,998 Definitely feeling some adhesions. 369 00:15:12,041 --> 00:15:15,349 Point taken. Open surgery was the right call. 370 00:15:15,392 --> 00:15:17,438 Go ahead, say it. "I told you so." 371 00:15:17,481 --> 00:15:19,048 Yeah, maybe later. 372 00:15:19,092 --> 00:15:21,746 For now, why don't you get some practice old-school style? 373 00:15:21,790 --> 00:15:23,618 Come around. 374 00:15:26,447 --> 00:15:28,095 OK. You got it? 375 00:15:28,120 --> 00:15:29,686 - Yeah. - All right. 376 00:15:29,711 --> 00:15:31,060 Babcock. 377 00:15:38,459 --> 00:15:40,156 You OK? 378 00:15:40,200 --> 00:15:41,897 Yeah, it's just a little heartburn. 379 00:15:41,941 --> 00:15:43,290 I'm fine. 380 00:15:44,726 --> 00:15:46,946 Oh, uh... 381 00:15:48,817 --> 00:15:51,124 Uh, God, excuse me. I'm sorry. 382 00:15:51,167 --> 00:15:53,387 Stop it. 383 00:15:53,430 --> 00:15:54,954 Stop. 384 00:15:54,997 --> 00:15:56,430 It's no big deal. 385 00:15:56,455 --> 00:16:00,155 It happens, OK? Just focus on the field. 386 00:16:01,569 --> 00:16:04,006 Stay focused. 387 00:16:05,529 --> 00:16:07,749 Uh-oh, here comes another one. 388 00:16:07,792 --> 00:16:09,142 Kai? 389 00:16:09,185 --> 00:16:11,492 Kai, talk to me. 390 00:16:11,535 --> 00:16:13,015 Hey, buddy! Hey! 391 00:16:13,059 --> 00:16:15,670 Angel. Angel, check him. 392 00:16:17,411 --> 00:16:18,890 - Got a pulse. - All right. 393 00:16:18,934 --> 00:16:20,892 Give me the babcock, please. 394 00:16:20,936 --> 00:16:22,416 - Maria! - Need some help in here! 395 00:16:22,459 --> 00:16:24,070 Maria! 396 00:16:24,113 --> 00:16:26,420 I was helping her to the bathroom, and she started seizing. 397 00:16:26,463 --> 00:16:28,030 OK, 4 milligrams of Ativan. 398 00:16:29,640 --> 00:16:31,120 Please help her. Please. 399 00:16:34,471 --> 00:16:36,212 Ativan's in. 400 00:16:41,043 --> 00:16:42,610 OK, she's gonna be postictal for a while. 401 00:16:42,653 --> 00:16:43,785 Put her on a foley. 402 00:16:43,828 --> 00:16:46,440 I don't want her getting out of the bed, not even for the bathroom. 403 00:16:54,100 --> 00:16:56,015 A seizure expands our differential tenfold. 404 00:16:56,058 --> 00:16:57,842 We got to widen our net... CT panscan, 405 00:16:57,886 --> 00:17:00,062 MRI brain, sed rate, autoimmune labs. 406 00:17:00,106 --> 00:17:01,237 - Let's rope in neurology. - Guys. 407 00:17:01,281 --> 00:17:02,412 Ms. Goodwin just called. 408 00:17:02,456 --> 00:17:03,935 She said stand down. No more treatment. 409 00:17:03,979 --> 00:17:05,067 What? What are you talking about? 410 00:17:05,111 --> 00:17:08,114 She's in the MRI suite. Be here as soon as she can, OK? 411 00:17:11,682 --> 00:17:13,641 - Hey, you OK? - This is overkill. 412 00:17:13,684 --> 00:17:15,425 I probably just had some bad oatmeal. 413 00:17:15,469 --> 00:17:18,950 Well, bad oatmeal doesn't drop you in the middle of surgery. 414 00:17:18,993 --> 00:17:21,736 So how about you let me check you out? 415 00:17:24,173 --> 00:17:26,262 How's Sam? Appendectomy go OK? 416 00:17:26,306 --> 00:17:28,656 Yeah, all good. Dr. Graham is finishing up. 417 00:17:28,699 --> 00:17:30,136 At least it's just an appendectomy. 418 00:17:30,179 --> 00:17:32,007 Not missing much. 419 00:17:35,010 --> 00:17:36,881 Oh, my chest. Pressure. 420 00:17:39,884 --> 00:17:41,495 Oh, God. I'm sorry. 421 00:17:43,149 --> 00:17:44,802 That was weird. 422 00:17:44,846 --> 00:17:46,804 Your heart rate plummeted, but as soon as you passed gas, 423 00:17:46,848 --> 00:17:48,023 it came back. 424 00:17:48,067 --> 00:17:50,025 Will you sit up for me? 425 00:17:52,854 --> 00:17:54,290 Take a deep breath. 426 00:17:56,553 --> 00:17:58,164 All right. Lean back for me. 427 00:17:58,207 --> 00:18:00,949 Hey, Mike. Let's get an X-ray in here. 428 00:18:00,992 --> 00:18:02,298 What, did you hear a murmur? 429 00:18:02,342 --> 00:18:04,039 Honestly, I'm not sure what I heard. 430 00:18:04,083 --> 00:18:05,475 You're joking, right? Come on. 431 00:18:05,519 --> 00:18:08,087 Has heartburn been an issue before today? 432 00:18:08,130 --> 00:18:09,610 I mean, I get it. 433 00:18:09,653 --> 00:18:11,873 Even when I was a kid, it would flare up here and there. 434 00:18:11,916 --> 00:18:14,267 But it's never been an issue. 435 00:18:14,310 --> 00:18:16,704 X-ray up. Clear. 436 00:18:22,840 --> 00:18:25,321 What the hell? That's my colon. 437 00:18:25,365 --> 00:18:26,801 It shouldn't be in my chest. 438 00:18:26,844 --> 00:18:29,108 No, it should not. 439 00:18:31,327 --> 00:18:33,590 Her brother. Hugo, was a patient treated at Oakview. 440 00:18:33,634 --> 00:18:34,809 So was Maria. 441 00:18:34,852 --> 00:18:37,203 She was admitted yesterday via ambulance, 442 00:18:37,246 --> 00:18:40,293 but this morning, her family just walked her out. 443 00:18:40,336 --> 00:18:41,729 They just left... absconded. 444 00:18:41,772 --> 00:18:43,339 Well, her brother died at Oakview, 445 00:18:43,383 --> 00:18:44,819 and they didn't get any answers. 446 00:18:44,862 --> 00:18:46,168 You see how scared they are. 447 00:18:46,212 --> 00:18:47,336 It's no wonder that they didn't want to stay. 448 00:18:47,361 --> 00:18:49,233 Look, I agree, but walking out 449 00:18:49,258 --> 00:18:51,608 is the same as leaving against medical advice. 450 00:18:51,652 --> 00:18:54,002 It's triggered an insurance nightmare 451 00:18:54,045 --> 00:18:55,612 with the family's HMO. 452 00:18:55,656 --> 00:18:57,832 They won't pay for any more treatment 453 00:18:57,875 --> 00:18:59,921 until Maria is placed back 454 00:18:59,964 --> 00:19:03,403 with their preferred network provider, Oakview. 455 00:19:03,446 --> 00:19:05,883 Are you kidding me? They're a community hospital. 456 00:19:05,927 --> 00:19:08,190 They don't have the resources to run the tests she needs. 457 00:19:08,234 --> 00:19:09,583 Well, I've already reached out 458 00:19:09,626 --> 00:19:12,020 to the director of patient services at Oakview, 459 00:19:12,063 --> 00:19:14,370 and she assured me they'll do the best they can. 460 00:19:14,414 --> 00:19:16,024 The best they can? 461 00:19:16,067 --> 00:19:19,027 Ms. Goodwin, can't you reason with the insurance company? 462 00:19:19,070 --> 00:19:21,334 Hector and Gloria aren't trying to take advantage of them. 463 00:19:21,377 --> 00:19:23,031 They're trying to save their daughter's life. 464 00:19:23,074 --> 00:19:24,554 Look, I know, and I share 465 00:19:24,598 --> 00:19:26,513 in your frustration, but they're... 466 00:19:26,556 --> 00:19:28,863 No. No, I don't care what the insurance company says. 467 00:19:28,906 --> 00:19:31,213 I'm not sending Maria back to Oakview until I get a guarantee 468 00:19:31,257 --> 00:19:32,867 she gets the treatment she needs in time. 469 00:19:32,910 --> 00:19:35,391 Dr. Halstead, the tests that you ordered 470 00:19:35,435 --> 00:19:37,306 will cost tens of thousands of dollars, 471 00:19:37,350 --> 00:19:39,656 and I know that's not coming out your pocket. 472 00:19:39,700 --> 00:19:43,269 The family has to decide how to proceed. 473 00:19:53,235 --> 00:19:54,976 OK, Quentin, so listen, 474 00:19:55,019 --> 00:19:57,152 we're gonna secure you to the machine 475 00:19:57,196 --> 00:19:59,285 while it's still running with a harness. 476 00:19:59,328 --> 00:20:01,330 So then, Dr. Archer, who is an excellent surgeon, 477 00:20:01,374 --> 00:20:02,940 is gonna come in here and clamp your artery, 478 00:20:02,984 --> 00:20:04,594 stabilize your neck wound, 479 00:20:04,638 --> 00:20:06,857 and make it safer when they pull out the scissors. 480 00:20:06,901 --> 00:20:09,120 All right? Then we turn off the machine. 481 00:20:09,164 --> 00:20:11,384 The idea is, bed falls to the side, 482 00:20:11,427 --> 00:20:14,691 you're held firmly in place by the harness, OK? 483 00:20:14,735 --> 00:20:16,563 Still with me? - Mm-hmm. 484 00:20:16,606 --> 00:20:18,173 Great. Last thing. 485 00:20:18,217 --> 00:20:20,784 Lower you onto a gurney, shoot you off the ER, 486 00:20:20,828 --> 00:20:23,004 and finish fixing up your neck. 487 00:20:23,047 --> 00:20:25,006 - How's that sound? - Mm-hmm. 488 00:20:34,624 --> 00:20:36,887 Am I gonna die? 489 00:20:36,931 --> 00:20:38,628 Look, this is a complicated situation. 490 00:20:38,672 --> 00:20:42,153 But some really skilled people have come up with this plan, 491 00:20:42,197 --> 00:20:44,025 and it's the best option we got. 492 00:20:44,068 --> 00:20:47,028 All you got to do: breathe in and out, 493 00:20:47,071 --> 00:20:51,162 stay as still as you possibly can, OK? 494 00:20:51,206 --> 00:20:52,729 All right. 495 00:20:52,773 --> 00:20:54,992 Take all the time you need. 496 00:20:57,256 --> 00:20:59,736 Hey, hold the work. Everybody, out. 497 00:21:07,657 --> 00:21:10,443 You're my everything. 498 00:21:10,486 --> 00:21:14,534 From our first date, I knew that I was in love. 499 00:21:14,577 --> 00:21:17,667 And now we're parents. 500 00:21:17,711 --> 00:21:19,190 Uh... 501 00:21:21,192 --> 00:21:23,282 The nurse took a picture of him. 502 00:21:26,110 --> 00:21:28,983 I named him Trevor, after your dad. 503 00:21:29,026 --> 00:21:31,115 I think he'd like that. 504 00:21:32,813 --> 00:21:35,729 Tell Trevor I love him. 505 00:21:35,772 --> 00:21:38,688 You're gonna tell him yourself. 506 00:21:38,732 --> 00:21:41,430 You're gonna be a great mother. 507 00:21:42,953 --> 00:21:44,999 I love you, Quentin. 508 00:21:45,042 --> 00:21:47,958 I will see you again, you hear me? 509 00:21:48,002 --> 00:21:50,396 I will see you again. 510 00:22:04,758 --> 00:22:06,629 Sorry. 511 00:22:06,673 --> 00:22:09,763 I didn't know what to say. 512 00:22:09,806 --> 00:22:12,418 How do you put into words when... 513 00:22:12,461 --> 00:22:14,463 You can't. 514 00:22:14,507 --> 00:22:16,770 But we could feel your love for each other. 515 00:22:16,813 --> 00:22:18,641 I just don't understand, 516 00:22:18,685 --> 00:22:21,601 because Quentin is my rock, 517 00:22:21,644 --> 00:22:25,956 and I don't even recognize the man that's in there. 518 00:22:26,736 --> 00:22:28,999 He just snapped. 519 00:22:29,043 --> 00:22:31,045 How does that happen all of a sudden? 520 00:22:31,088 --> 00:22:34,178 I mean, usually there are signs, you know? 521 00:22:34,222 --> 00:22:37,573 Extreme expressions of emotional frustration, 522 00:22:37,617 --> 00:22:39,619 anger, confusion, outbursts. 523 00:22:39,662 --> 00:22:43,057 You noticed anything like that in Quentin recently? 524 00:22:43,100 --> 00:22:46,147 - I don't think so. - How about physical changes? 525 00:22:46,190 --> 00:22:48,410 I noticed he had some lumps on the back of his neck. 526 00:22:48,454 --> 00:22:49,977 Have you... Do you know what those are? 527 00:22:50,020 --> 00:22:53,763 Lumps? I don't know. 528 00:22:53,807 --> 00:22:58,464 I just wanted to get to today and to have the baby. 529 00:22:58,507 --> 00:23:00,553 I've been so consumed by the pregnancy 530 00:23:00,596 --> 00:23:04,295 that I haven't noticed anything else. 531 00:23:04,339 --> 00:23:06,080 Oh, Quentin. 532 00:23:11,868 --> 00:23:13,653 Uh, give it to Spellman. 533 00:23:13,696 --> 00:23:14,784 Thanks, Lori. 534 00:23:14,828 --> 00:23:16,482 Mystery solved. Your chest CT. 535 00:23:16,525 --> 00:23:19,354 - Hiatal hernia. - No, diaphragmatic. 536 00:23:19,398 --> 00:23:22,009 Big enough that your colon migrated into your chest. 537 00:23:22,052 --> 00:23:24,490 So the gas moving through it, 538 00:23:24,533 --> 00:23:27,231 it puts pressure on the vagus nerve, drops your heartbeat. 539 00:23:27,275 --> 00:23:28,929 Breaking wind releases the pressure. 540 00:23:28,972 --> 00:23:30,496 - Heart returns to a normal rate. - Yeah. 541 00:23:30,539 --> 00:23:32,106 You said you had heartburn since you were a kid. 542 00:23:32,149 --> 00:23:34,064 Probably this: undiagnosed 543 00:23:34,108 --> 00:23:37,111 asymptomatic congenital diaphragmatic hernia. 544 00:23:37,154 --> 00:23:38,721 I've never passed out before, though. 545 00:23:38,765 --> 00:23:41,550 Well, my guess is it's been slowly expanding over time. 546 00:23:41,594 --> 00:23:45,380 But you do CrossFit now, so the thrusters, burpees, other workouts... 547 00:23:45,424 --> 00:23:48,035 Safe bet that they've exacerbated the condition. 548 00:23:48,078 --> 00:23:50,385 - Led to today. - Yeah, well, I'll own that. 549 00:23:50,429 --> 00:23:52,039 But I can't resist dropping in the OR again, 550 00:23:52,082 --> 00:23:54,215 - so let's fix this hernia. - OK. 551 00:23:54,258 --> 00:23:57,523 Well, you've got a few surgical options. 552 00:23:57,566 --> 00:23:58,915 - Open. - No. 553 00:23:58,959 --> 00:24:00,526 That's a huge incision. Lots of digging around. 554 00:24:00,569 --> 00:24:02,528 I'll be laid up in the ICU for weeks. 555 00:24:02,571 --> 00:24:03,877 Laparoscopic, then. 556 00:24:03,920 --> 00:24:05,661 Be more incisions for the scope and tools, 557 00:24:05,705 --> 00:24:08,055 - but less invasive... - No old-school approaches. 558 00:24:08,098 --> 00:24:09,709 Robotic assist in OR 2.0. 559 00:24:09,752 --> 00:24:11,580 Shortest recovery time. 560 00:24:13,321 --> 00:24:15,584 I just want this to be over with. 561 00:24:15,628 --> 00:24:18,282 OK, I'm gonna scrub in. 562 00:24:18,326 --> 00:24:20,132 I'll see you after, OK? 563 00:24:24,941 --> 00:24:27,204 Holy cow. Look at this place. 564 00:24:27,248 --> 00:24:29,206 It's like you guys are living in 2050 up here. 565 00:24:29,250 --> 00:24:31,818 So don't break anything. 566 00:24:31,861 --> 00:24:33,515 How's it going with the surgical tools? 567 00:24:33,559 --> 00:24:35,561 Almost there. Scalpel's printed. 568 00:24:35,604 --> 00:24:38,118 Two of the three angled peripheral vascular clamps are printed as well. 569 00:24:38,143 --> 00:24:39,540 One Weitlaner retractor printed. 570 00:24:39,565 --> 00:24:41,523 - One to go. - Oh, it's like the real thing. 571 00:24:41,567 --> 00:24:43,917 It is the real thing, just plastic. 572 00:24:43,960 --> 00:24:45,658 These tools, I think they can work. 573 00:24:45,701 --> 00:24:47,094 They'll have to. 574 00:24:47,137 --> 00:24:48,574 They're all we got. 575 00:24:54,144 --> 00:24:56,538 They never wanted to go to Oakview, 576 00:24:56,582 --> 00:24:58,497 but the ambulance took them there anyway. 577 00:24:58,540 --> 00:25:00,542 Because Maria didn't require specialty care, 578 00:25:00,586 --> 00:25:03,110 paramedics took her to the nearest hospital instead. 579 00:25:12,511 --> 00:25:15,949 I'm so sorry that you've been put in this situation. 580 00:25:15,992 --> 00:25:18,212 We can continue to treat Maria, 581 00:25:18,255 --> 00:25:21,215 but your insurance won't cover the costs. 582 00:25:31,660 --> 00:25:35,359 He said he'll sell the car. He can get a second job. 583 00:25:35,403 --> 00:25:37,100 His oldest son can get a job as well. 584 00:25:37,144 --> 00:25:38,798 No. Papa, no. 585 00:25:38,841 --> 00:25:40,451 No. 586 00:25:40,495 --> 00:25:42,323 I'll go back. 587 00:25:42,366 --> 00:25:44,586 No. 588 00:25:44,630 --> 00:25:46,806 Maria... 589 00:25:46,849 --> 00:25:49,156 Maria. 590 00:26:14,224 --> 00:26:18,054 You know, maybe Oakview will figure it out. 591 00:26:23,367 --> 00:26:24,539 All right. 592 00:26:24,583 --> 00:26:28,456 Um, I'll set up the transfer. 593 00:26:35,115 --> 00:26:36,595 What was Maria saying? 594 00:26:36,638 --> 00:26:38,858 If she lets her parents bankrupt the family 595 00:26:38,901 --> 00:26:41,643 paying for her medical care, then all of the opportunities 596 00:26:41,687 --> 00:26:45,212 they've worked so hard to give their children will be lost. 597 00:26:45,255 --> 00:26:47,040 She is risking her life. 598 00:26:47,083 --> 00:26:48,824 No. 599 00:26:48,868 --> 00:26:51,044 No, she's sacrificing it. 600 00:26:51,087 --> 00:26:54,874 And it's awful, 601 00:26:54,917 --> 00:26:57,528 but I get it. 602 00:27:06,363 --> 00:27:07,538 Ready to inflate? 603 00:27:10,498 --> 00:27:11,847 Up on blue. 604 00:27:13,588 --> 00:27:14,850 Hold. 605 00:27:16,417 --> 00:27:17,984 Up on red. 606 00:27:23,729 --> 00:27:24,991 Hold. 607 00:27:29,299 --> 00:27:31,954 How's, uh... How's Layla doing? 608 00:27:31,998 --> 00:27:35,044 She's in shock, full of grief, 609 00:27:35,088 --> 00:27:36,611 and a first-time mom all at the same time. 610 00:27:36,655 --> 00:27:39,701 It's a lot, but a psych resident is with her. 611 00:27:39,745 --> 00:27:43,009 Mm. And how about you? 612 00:27:43,052 --> 00:27:45,489 How are you doing? 613 00:27:45,533 --> 00:27:48,405 Honestly, I didn't see this coming. 614 00:27:48,449 --> 00:27:52,105 I just thought Quentin was a nervous first-time dad, 615 00:27:52,148 --> 00:27:54,673 like the ones I see every single day. 616 00:27:54,716 --> 00:27:56,413 Never suspected mental illness. 617 00:27:56,457 --> 00:27:58,372 You know, I'm not sure it is, per se. 618 00:27:58,415 --> 00:28:01,375 You know those lumps on the back of his neck? 619 00:28:01,418 --> 00:28:03,029 I have a very strong hunch that they're indicative 620 00:28:03,072 --> 00:28:04,770 of a physical issue that could very well 621 00:28:04,813 --> 00:28:07,729 be causing a sudden psychosis. 622 00:28:07,773 --> 00:28:09,296 It's physical, not psychological? 623 00:28:09,339 --> 00:28:11,037 Yeah, I'm leaning that way. 624 00:28:11,080 --> 00:28:13,822 I mean, can't be sure until we run some tests. 625 00:28:25,442 --> 00:28:27,140 Maria, this is a thumb drive 626 00:28:27,183 --> 00:28:29,316 with all the work we did here, along with our notes. 627 00:28:29,359 --> 00:28:32,711 You give this to the doctors as soon as you get there. 628 00:28:32,754 --> 00:28:34,016 Thank you. 629 00:28:37,846 --> 00:28:40,022 All right. Empty her foley. 630 00:28:47,769 --> 00:28:49,075 It's OK, Mama. 631 00:28:51,686 --> 00:28:53,862 Wait. 632 00:28:55,821 --> 00:28:57,126 Will? 633 00:29:00,956 --> 00:29:02,392 You smell that? 634 00:29:09,399 --> 00:29:10,661 We have to run one more test. 635 00:29:10,705 --> 00:29:12,881 I'll pay for it myself, if I have to. 636 00:29:18,452 --> 00:29:19,888 I'm scared. 637 00:29:19,932 --> 00:29:22,456 Well, you'll be less frightened if you can't see it, 638 00:29:22,499 --> 00:29:25,415 so I'm gonna drape your face, OK? 639 00:29:27,504 --> 00:29:28,810 Yeah. 640 00:29:28,854 --> 00:29:30,812 All right. 641 00:29:30,856 --> 00:29:32,379 Here we go. Careful. 642 00:29:34,033 --> 00:29:35,904 That's right. All right. 643 00:29:37,036 --> 00:29:38,864 All right. 644 00:29:38,907 --> 00:29:41,823 10cc's of lidocaine, please. 645 00:29:41,867 --> 00:29:43,869 OK. 646 00:29:43,912 --> 00:29:46,306 All right. 647 00:29:55,402 --> 00:29:56,620 OK. 648 00:29:56,664 --> 00:29:59,580 Scalpel. 649 00:29:59,623 --> 00:30:01,234 All right. Grab hold of those scissors. 650 00:30:01,277 --> 00:30:04,106 I don't want them flopping after I make the incisions. 651 00:30:07,588 --> 00:30:09,372 Here we go. 652 00:30:14,290 --> 00:30:16,640 OK. 653 00:30:16,684 --> 00:30:17,772 All right. 654 00:30:17,816 --> 00:30:19,295 Wheaties. 655 00:30:22,864 --> 00:30:24,300 All right. 656 00:30:24,344 --> 00:30:26,868 All right. Watch your fingers there. 657 00:30:26,912 --> 00:30:29,523 That's it. That's it. Don't move it. Don't move it. 658 00:30:29,566 --> 00:30:31,046 Clamp. 659 00:30:35,703 --> 00:30:36,704 All right. 660 00:30:45,974 --> 00:30:48,063 All right. 661 00:30:48,107 --> 00:30:50,283 Carotid clamps in place. CFD, you're up. 662 00:30:50,326 --> 00:30:51,850 All right. Spread out around the bed. 663 00:30:51,893 --> 00:30:54,113 When it falls down, we pull it away from the MRI machine. 664 00:30:54,156 --> 00:30:57,377 All right. And no slack at all, you understand? 665 00:30:57,420 --> 00:30:59,640 If there's any movement, his clamps could pop off, 666 00:30:59,683 --> 00:31:02,382 and then we'll have a problem we might not be able to fix. 667 00:31:02,425 --> 00:31:03,731 All right. 668 00:31:03,774 --> 00:31:06,777 On three, you're gonna cut the power to the MRI. 669 00:31:06,821 --> 00:31:07,996 We ready? Everybody, ready? 670 00:31:08,040 --> 00:31:09,084 Ready. 671 00:31:09,128 --> 00:31:12,435 One, two, three. 672 00:31:16,222 --> 00:31:18,311 All right. Clamps are holding. 673 00:31:18,354 --> 00:31:20,095 I'm gonna remove the scissors now. 674 00:31:23,794 --> 00:31:25,057 All right. 675 00:31:25,100 --> 00:31:26,928 All right, we're clear. OK, bed. 676 00:31:26,972 --> 00:31:29,670 Let's lower Quentin. 677 00:31:32,368 --> 00:31:35,023 - Lower him slowly. - One, two, three. 678 00:31:36,720 --> 00:31:38,070 Slack! 679 00:31:40,028 --> 00:31:41,638 All right. 680 00:31:43,379 --> 00:31:45,164 OK, ropes are free. 681 00:31:45,207 --> 00:31:47,731 All right. 682 00:31:47,775 --> 00:31:50,038 Incredible, Doc. Freaking incredible. 683 00:31:50,082 --> 00:31:53,215 Thanks. Can someone get me a bottle of water, please? 684 00:31:53,259 --> 00:31:55,435 Dr. Archer, you did it. 685 00:31:55,478 --> 00:31:57,524 - Dean, you all right? - Yeah. 686 00:31:57,567 --> 00:31:59,830 I got to get to the OR, so... 687 00:31:59,874 --> 00:32:01,441 Whoa, whoa, whoa, whoa, whoa. 688 00:32:01,484 --> 00:32:04,096 Page Dr. Lanik to take over with Quentin. 689 00:32:04,139 --> 00:32:06,326 I'm just feeling a little dizzy. That's all. 690 00:32:13,932 --> 00:32:15,324 Hernia fixed? 691 00:32:15,368 --> 00:32:17,239 I'd say you're as good as new. 692 00:32:17,283 --> 00:32:19,198 Yeah, not quite. 693 00:32:19,241 --> 00:32:20,764 I'm the fart doctor now. 694 00:32:20,808 --> 00:32:22,723 - A punchline. - No. 695 00:32:22,766 --> 00:32:24,681 What happened today was a result 696 00:32:24,725 --> 00:32:25,856 of a medical ailment, OK? 697 00:32:25,900 --> 00:32:27,119 Like anyone's gonna care about that. 698 00:32:27,162 --> 00:32:28,816 All they're gonna remember is the fart. 699 00:32:28,859 --> 00:32:30,992 Oh, come on. It'll blow over. 700 00:32:32,602 --> 00:32:34,953 Sorry. Poor choice of words, but it will. 701 00:32:34,996 --> 00:32:37,477 I doubt it. 702 00:32:37,520 --> 00:32:38,782 All right, look. 703 00:32:38,826 --> 00:32:41,176 I'll check on you a little later, OK? 704 00:32:41,201 --> 00:32:42,473 All right. 705 00:32:43,962 --> 00:32:47,095 - So his neck is fixed, then? - Yeah. 706 00:32:47,139 --> 00:32:49,184 The artery repair went very well. 707 00:32:49,228 --> 00:32:51,795 What about his mind? Because before... 708 00:32:51,839 --> 00:32:53,797 Well, I gave him a very small dose 709 00:32:53,841 --> 00:32:55,886 of an antipsychotic called risperidone, 710 00:32:55,930 --> 00:32:58,019 and he does seem to be thinking more clearly. 711 00:32:58,063 --> 00:33:01,196 And you think he'll stay that way? 712 00:33:01,240 --> 00:33:04,460 I don't think that what happened today is the result of mental illness. 713 00:33:04,504 --> 00:33:05,766 You know, tests are still pending, 714 00:33:05,809 --> 00:33:07,986 but all indications are is that Quentin has 715 00:33:08,029 --> 00:33:11,424 a genetic disease called neurofibromatosis type 2. 716 00:33:11,467 --> 00:33:13,600 - Is it curable? - It's not. 717 00:33:13,643 --> 00:33:15,950 But there are a lot of effective treatments out there. 718 00:33:15,994 --> 00:33:18,431 And the good news is that with a little luck, 719 00:33:18,474 --> 00:33:21,216 Quentin is gonna be the man you know again. 720 00:33:21,260 --> 00:33:23,566 Genetic means he's had it forever. 721 00:33:23,610 --> 00:33:25,612 Why'd it suddenly go berserk today? 722 00:33:25,655 --> 00:33:28,832 NF is thought to be an inflammatory ailment, right? 723 00:33:28,876 --> 00:33:31,835 So possibly triggered by changes in environment, 724 00:33:31,879 --> 00:33:33,446 you know, lifestyle, 725 00:33:33,489 --> 00:33:37,580 possibly diet, medication. 726 00:33:37,624 --> 00:33:40,670 Diet. 727 00:33:40,714 --> 00:33:42,368 Oh, my God. 728 00:33:42,411 --> 00:33:45,936 The minute I got pregnant, my hormones went crazy. 729 00:33:45,980 --> 00:33:47,634 Smells were intense, 730 00:33:47,677 --> 00:33:50,637 and Quentin's breath was the worst. 731 00:33:50,680 --> 00:33:53,466 Everything he ate made me throw up. 732 00:33:53,509 --> 00:33:55,685 So he gave up his entire diet. 733 00:33:55,729 --> 00:33:58,253 No more fruits, vegetables, fish. 734 00:33:58,297 --> 00:34:00,081 For the past nine months, he's been eating nothing 735 00:34:00,125 --> 00:34:02,823 but bland, processed crap for me. 736 00:34:02,866 --> 00:34:06,740 Mrs. Bell, Quentin's asking to see you. 737 00:34:17,359 --> 00:34:19,187 Hi, honey. 738 00:34:19,231 --> 00:34:22,016 Layla... 739 00:34:22,060 --> 00:34:23,931 I don't entirely understand 740 00:34:23,974 --> 00:34:27,674 what happened or why, 741 00:34:27,717 --> 00:34:29,545 but I know I put you in danger. 742 00:34:29,589 --> 00:34:30,851 I'm sorry. 743 00:34:30,893 --> 00:34:33,158 No, Quentin. 744 00:34:33,201 --> 00:34:35,856 I was so tied up in the pregnancy, 745 00:34:35,899 --> 00:34:38,424 I was oblivious to what was going on with you. 746 00:34:38,467 --> 00:34:41,992 I should've seen the signs. Forgive me. 747 00:34:42,036 --> 00:34:45,474 Oh, honey, there's nothing to forgive. 748 00:34:45,518 --> 00:34:46,909 I love you. 749 00:34:46,954 --> 00:34:49,652 I love you too. 750 00:34:49,696 --> 00:34:53,091 Someone's been missing you guys. 751 00:34:57,834 --> 00:35:00,881 Hi. 752 00:35:00,924 --> 00:35:03,101 Here you go. 753 00:35:04,885 --> 00:35:08,323 Hi, sweetheart. Look who's here. 754 00:35:08,367 --> 00:35:09,672 Hi. 755 00:35:09,716 --> 00:35:11,892 I'm your dad. 756 00:35:13,198 --> 00:35:16,026 I love you. 757 00:35:16,070 --> 00:35:19,900 - Shh, sweetheart. - Hi. 758 00:35:19,943 --> 00:35:22,772 - A metabolic condition? - Yeah. 759 00:35:22,816 --> 00:35:24,948 It's called maple syrup urine disease, 760 00:35:24,992 --> 00:35:27,081 and it's a rare condition that makes it difficult 761 00:35:27,125 --> 00:35:29,388 for the body to break down certain amino acids. 762 00:35:29,431 --> 00:35:32,739 The trademark symptom is a distinct maple syrup smell 763 00:35:32,782 --> 00:35:34,175 that shows up in urine. 764 00:35:34,219 --> 00:35:36,003 It usually presents in childhood, 765 00:35:36,046 --> 00:35:40,442 and it's almost unheard of to discover it in someone your age, 766 00:35:40,486 --> 00:35:42,009 or Hugo's. 767 00:35:42,052 --> 00:35:44,446 It's likely that he had it too. 768 00:35:44,490 --> 00:35:48,058 And I suspect this is why Oakview couldn't diagnose him in time. 769 00:35:48,102 --> 00:35:50,060 He didn't have a seizure or a foley catheter. 770 00:35:50,104 --> 00:35:52,062 It made his doctors' jobs even harder. 771 00:35:52,106 --> 00:35:55,631 Wait, this disease killed Hugo. 772 00:35:55,675 --> 00:35:56,937 Does that mean... 773 00:35:56,980 --> 00:35:59,331 No, you're gonna be OK. 774 00:35:59,374 --> 00:36:01,724 You have an intermittent form of the disease, 775 00:36:01,768 --> 00:36:04,510 which can be managed by closely monitoring protein levels. 776 00:36:04,553 --> 00:36:06,207 We've already reached out to nephrology 777 00:36:06,251 --> 00:36:08,209 to discuss treatment options. 778 00:36:08,253 --> 00:36:12,082 Maria. 779 00:36:23,006 --> 00:36:24,225 Gracias. 780 00:36:33,495 --> 00:36:35,323 - Hello, Daniel. - Ooh! 781 00:36:36,803 --> 00:36:39,690 Hey, you're, uh... You're a little early. 782 00:36:39,715 --> 00:36:42,112 Oh, I couldn't wait to see you. 783 00:36:42,156 --> 00:36:45,072 What's this? You cleaned your office? 784 00:36:45,115 --> 00:36:46,291 No, I didn't. 785 00:36:47,727 --> 00:36:49,729 I'm tidying up a little bit. 786 00:36:49,772 --> 00:36:51,905 Why? 787 00:36:53,602 --> 00:36:56,562 I was very embarrassed by what happened this morning. 788 00:36:56,605 --> 00:37:01,001 And um, you know, I just, uh... 789 00:37:01,044 --> 00:37:05,048 I don't ever want you to feel that I... 790 00:37:05,092 --> 00:37:08,269 I take for granted the job that you do, or... 791 00:37:08,313 --> 00:37:09,966 Or that I'm oblivious to how hard you work. 792 00:37:10,010 --> 00:37:12,099 I really don't want that to happen. 793 00:37:12,142 --> 00:37:14,188 You're very sweet. 794 00:37:15,755 --> 00:37:18,497 I care about you too, Daniel. 795 00:37:18,540 --> 00:37:19,848 A lot. 796 00:37:20,803 --> 00:37:22,327 - Yeah? - Mm-hmm. 797 00:37:22,370 --> 00:37:23,458 Huh. 798 00:37:33,599 --> 00:37:35,644 - Hey. - Hey. 799 00:37:35,688 --> 00:37:37,037 Ah! 800 00:37:37,080 --> 00:37:38,952 - Where'd you find it? - Nurses' station. 801 00:37:38,995 --> 00:37:40,475 Oh, makes sense. 802 00:37:40,519 --> 00:37:42,825 That's where I was when the call about Quentin came in. 803 00:37:42,869 --> 00:37:44,349 Yeah, I totally get it. 804 00:37:44,392 --> 00:37:47,177 I would have run off and left it behind too. 805 00:37:47,221 --> 00:37:51,181 But my kidneys can handle some mild dehydration. 806 00:37:51,225 --> 00:37:52,835 - Yours can't. - Yeah, yeah. 807 00:37:52,879 --> 00:37:56,143 Yeah, pretty sure there will be another emergency tomorrow, 808 00:37:56,186 --> 00:37:58,058 and the day after that, 809 00:37:58,101 --> 00:38:01,931 so I'm gonna give you something. 810 00:38:01,975 --> 00:38:04,412 - It is a tracking device. - Ah. 811 00:38:04,456 --> 00:38:06,066 App connects it to your phone. 812 00:38:06,109 --> 00:38:08,938 And I haven't lost my keys since I put it on, so... 813 00:38:08,982 --> 00:38:12,507 Well, keep it. I'm past water bottles. 814 00:38:12,551 --> 00:38:14,204 Nephrologist just left. 815 00:38:14,248 --> 00:38:17,556 Uh, my kidneys are getting worse. 816 00:38:22,865 --> 00:38:24,258 Dialysis? 817 00:38:33,789 --> 00:38:36,923 That was a big win today. 818 00:38:36,966 --> 00:38:39,708 You saved that family. 819 00:38:39,752 --> 00:38:42,494 Yeah. 820 00:38:42,537 --> 00:38:45,845 I suppose it's time to talk about my DACA renewal. 821 00:38:45,888 --> 00:38:47,716 I know I've been dragging my feet. 822 00:38:47,760 --> 00:38:50,893 It's been a long day. We can speak in the morning. 823 00:38:50,937 --> 00:38:53,026 No. No, I'm ready. 824 00:38:53,069 --> 00:38:55,420 Yeah? All right. 825 00:38:58,771 --> 00:39:01,948 Truth is, I've been thinking about leaving Med. 826 00:39:01,991 --> 00:39:03,819 Really? 827 00:39:03,863 --> 00:39:07,257 I've always been in school or protected by my residency, 828 00:39:07,301 --> 00:39:11,218 so my immigration status has always been stable. 829 00:39:11,261 --> 00:39:14,700 But my parents, despite them always having jobs, 830 00:39:14,743 --> 00:39:16,136 could never solidify theirs, 831 00:39:16,179 --> 00:39:18,356 so they moved to Canada. 832 00:39:18,399 --> 00:39:19,835 Hmm. 833 00:39:19,879 --> 00:39:23,491 But they can't enter the country to come visit me. 834 00:39:23,535 --> 00:39:27,626 And if I leave to go see them, I might be denied reentry. 835 00:39:27,669 --> 00:39:31,064 So... 836 00:39:31,107 --> 00:39:34,067 I haven't hugged my parents in a decade. 837 00:39:34,110 --> 00:39:36,025 Ugh. 838 00:39:36,069 --> 00:39:39,115 That's... that's heartbreaking. 839 00:39:39,159 --> 00:39:42,858 But Maria today, her bravery, 840 00:39:42,902 --> 00:39:47,602 what she was willing to sacrifice for her family, 841 00:39:47,646 --> 00:39:50,823 reminded me that 842 00:39:50,866 --> 00:39:53,521 "no one puts their child in a boat 843 00:39:53,565 --> 00:39:56,219 unless the water is safer than the land." 844 00:39:56,263 --> 00:39:58,961 Warsan Shire. 845 00:39:59,005 --> 00:40:01,660 Oh, that's a beautiful poem. 846 00:40:03,009 --> 00:40:04,663 So... 847 00:40:04,706 --> 00:40:09,145 my parents' sacrifice to get me here 848 00:40:09,189 --> 00:40:12,801 put me in this boat, 849 00:40:12,845 --> 00:40:15,325 which is why I have to stay. 850 00:40:16,631 --> 00:40:18,503 And Dr. Cuevas, 851 00:40:18,546 --> 00:40:22,855 I believe that you will find a way 852 00:40:22,898 --> 00:40:25,814 to see your parents again. 853 00:40:25,858 --> 00:40:28,295 But until that day, 854 00:40:28,338 --> 00:40:32,952 know that you have family here in us at Med. 855 00:40:32,995 --> 00:40:35,345 Thank you. 856 00:40:41,786 --> 00:40:45,786 - Synced and corrected by synk - - www.addic7ed.com -61438

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