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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
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