All language subtitles for Greys.Anatomy.S22E08.WEB

In college,
I was the hungover premed

who fell asleep
at her study carrel.

If you're
just joining our podcast,

my guests are doctors
Teddy Altman

and Winston Ndugu
from Grey-Sloan Memorial,

who pioneered the creation
of a ventral aorta surgery.

At what point did you think,
"We just broke new ground"?

Immediately .

- Really?
- Yeah. Once that staple held,
I knew.

Sometimes you just
have a feeling.

In med school, I was
the famous surgeon's daughter.

It wasn't
like that for you?

Honestly,
there was so much
going on that night,

I didn't have time
to process it all until later.

Now
I'm the famous surgeon.

- So you had doubts?
- Oh, yeah.

I was never certain
it would work,

but our patient
didn't have any other option.

I knew that we had to try.

In medicine,
your identity is
constantly changing.

It's your job to keep up.

Safe to say it worked out.
What's next for you both?

Well,
we're still monitoring
our patients' progress.

- And?
- So far so good.

They sound really good,
very competent.

Yeah.
I'd come to this hospital.

Well, speaking of...

I made an appointment for you.

We talked
about this, Catherine.
I don't need another opinion.

I like Dr. Freeman.

I know you do because he goes
along with whatever you want.

You don't think
doctors should listen
to their patients?

I think
you need objective advice

from someone
whose paycheck you don't sign.

It's just another opinion.

Who am I seeing?

Kaplan.

Laura Kaplan? In Boston?

I thought
you made an appointment here.

I sent for my plane.

She landed about an hour ago.

Morning.

-Hey.
-Hey.

Hey, nice job on that podcast.

I didn't realize you and Altman
came up with that
at our wedding.

Yeah, you never know
when an idea will strike.

- Mmm.
- Go ahead, Dr. Adams.

Uh, yes. Uh, Jo Wilson.

Post-op day seven
from emergency C-section
and Impella CP placement.

Now post-op day three
from a 5.5 placement

through
the right axillary artery.

Her heart function
continues to recover

with her EF up
another five percent,

and I heard she got
to meet her babies yesterday.

-How are they doing?
-Hmm.

Peyton's off of CPAP
but still fragile.

Hattie's bilirubin levels
are bad

every time
they pause phototherapy.

And you're all headed
in the right direction.

That's what matters.

I just...

really want the six of us
to finally be together.

Jo, you will never guess

- who Marcus walked out with last night.
- -Who?

- Dr. Ndugu.
- Hey.

-I didn't know
you were doing rounds.
-Yeah.

I'll come back later.

What was that?

-What was what?
-Did you sleep with
my favorite nurse?

-Jo...
-Uh, should I leave?

We've just gone out
a couple times.
That's all.

Well, are you gonna
take her out again?

Uh, just... Maybe.
It's new and--

And none of our business.

She is
the entire department's
favorite nurse.

Everybody loves her. Everyone.

- Hormones.
- Okay.

Uh, I-I need
to check on my next patient.
Are you gonna be okay?

-Yeah.
-Uh, page me
if you need anything.

Good morning.

Traitor.

-Trouble in paradise?
-I broke our pact.

-She's bitter.
-Then you should break it too.

What,
I can just snap my fingers?

Who am I
supposed to sleep with?

I ordered an X-ray
for Ms. Johnson's left arm.

It was the right arm,
wasn't it?

I will fix it.

An intern? Please.
I have dignity.

-Don't knock it
until you've tried it.
-Tried what?

Vegan sloppy joes.

You sleeping
with an intern too?

Wait. Who's
sleeping with an intern?

I am. Who are you texting?

Nobody.

-Doesn't look like nobody.
-Nah, she's just a patient.

Why are you texting a patient?

Yeah, well, Bailey made me
drive her an hour
to get treatment,

and now she's sending me
dumb memes.

-It's nothing.
-Wear a condom.

She's a cancer patient.

Hey. Did you see
that I admitted Mr. Howard?

You don't have to put
your phone down.

-It's fine.
-Sorry.

My phone has been blowing up
since the podcast dropped.

I listened. You sounded great.

Well, now I've got
doctors reaching out
about their patients,

and the department chief
from Mass General

has asked me
to do grand rounds.

Hmm. Sounds rough.

Well, it's not like I'm getting
a Nobel Prize.

I mean, MGH asks
everyone to guest lecture.

They never asked me,
and I went to Harvard.

Anyway, so, Mr. Howard,
his EKG shows
a conduction block.

-Do you want an echo?
-Um, yes.
Sorry, I have to take this.

Hi, this is Altman.

Hi, Janet, I'm, uh, Dr. Millin.
I hear you're having
some leg pain.

Yeah, and some heaviness.

I'm concerned
it might be a DVT.

I think
she should have an ultrasound.

I assume
you want a full work up.

CBC, D-dimer,
and a duplex ultrasound?

I'm Jules Millin.

I'm a second-year
surgical resident.

You're
internal medicine, right?

Oh, no. Oh. I'm not a doctor.
Sorry. Yeah.

-Oh, we were role-playing.
-Yeah.

The more medical terms,
the better it gets.

-Yeah.
-So, Hal does his homework.

-So do you have
leg pain or is this--
-Oh, no, that's real.

The pain started this morning
when we were trying

to squeeze in a quickie
before work.

- May I do an exam?
- Mm-hmm.

Um, how long
did the pain last for?

-Uh, a few hours?
-Yeah.

We've been trying
to spice things up lately,

so we just wanna
make sure we haven't,
uh, caused a problem.

Oh, um...

DVTs usually occur
with less, um, activity,

but it is better
to be safe than sorry,
so I will order some tests.

- All right.
- And get back to you.

-Okay. Thank you.
-Thank you.

Dr. Griffith.

A 38-year-old female with
a large mediastinal teratoma

- that has been resistant
to chemotherapy.

Presents with progressive
shortness of breath,

orthopnea, and angina.

It has to be
at least 35 pounds.

And, uh, 27 centimeters
for the longest diameter.

The tumor is displacing
the heart and great vessels.

The SVC is compressed,

and it's also indenting
the right lobe of the liver.

Hmm. How are the lungs?

Compressed with
near total collapse

of the mid-right
and lower lobes.

Has anyone tried to operate
on the thing?

Her name is London

and, yes, there have been
two attempts at Seattle Pres.

They had to abort both times
because she arrested
on the table.

But you believe you would have
a different outcome
if you tried?

Well, I have removed
extremely difficult
tumors before,

and this one is benign.

So, if we can
successfully remove it,
then she resumes a normal life.

Even if
you convinced anesthesia,

you could still encounter
catastrophic bleeding.

And that is why I'm here
at the tumor board,

where people
help their colleagues
to come up with a plan.

If anyone here thinks this
remotely is a possibility,
please speak up.

Yes.

It's a tragic case,
Dr. Bailey, but...

- It's a lawsuit
waiting to happen.

I'll do it with you.

- The alternative
is hospice, right?

Dr. Hunt,
it just can't be done.

Yeah, well,
you don't know
what we're capable of.

-Bye.
-I knew you'd have an idea.

Yeah, I got nothing.

What?

Well, look who's here.

How was your flight?

- Most quiet I've had
in months.
- Oh, great.

-Dr. Webber, it's a pleasure.
-Hi.

I've heard a lot about you.

All good things.

Catherine's thrilled you
joined the team in Boston.

She's thrilled she poached me
from Sloan Kettering.

You are at the forefront
of urologic oncology,
and that lecture that you gave

to the
American Urological Association
last month

brought the house down.

And she is developing
a program that uses AI
to study biomarkers.

We just received another grant
for it yesterday.

You bet you did.

Now, tell us about
my husband's prostate.

Catherine, please.

-If now's not a good time--
-Don't be ridiculous.

Come on, everybody. Sit down.

Have a seat. Come on.

Good news is
you caught it early.

Grade group two,
a seven Gleason.

Well, he knows all of that.
So tell us,
what do you suggest?

Well, given
the cancer's localized,

and you're
generally in good health,

I recommend
a radical prostatectomy.

I couldn't agree more.

If you're worried
about side effects,

urinary incontinence,
erectile dysfunction,
they are a risk.

-But for many men--
-What about infection?

It's unlikely but possible.

Blood clots, stroke,
injury to the rectum,
bladder, nerves?

They're all possible too,
right?

Yeah.

Thank you for your time,

but I've already selected
an option with my own doctor.

Watchful waiting.

I've got patients to see.

Not seeing abnormalities.

What's that wand called?

An ultrasound probe.

-Write that down.
-Okay.

Right,
the ultrasound is negative.

So, she doesn't have a clot?

Not that I can see.

Sounds like maybe
there still might be one...

Well, your D-dimer
was slightly elevated,

which is the marker
we look at for clots.

It doesn't necessarily
mean anything,
but it is reason

to come back
if you have any more pain.

Maybe I just need to stretch
before I go to the doctor.

- Mmm.
- Stretch?

Uh, don't ask any questions.

I'm gonna start your,
um, discharge paperwork.

What was that all about?

They like to role-play
doctor and patient in bed.

Good for them.

They're so cute.

Rustic cute?

Five reviews say
those rockers broke
within a year.

How's the lake house?

We've moved
from arguing over tile
to arguing over porch chairs.

How was the tumor board?

Uh, unfortunately,
they are concerned
about the risks

and recommend
that we don't proceed.

So naturally
I called in reinforcements.
This is Dr. Owen Hunt.

-He's one of
our trauma surgeons.
-Hi.

If it's okay with you,
I'd like to work
with Dr. Bailey

to make sure that we've
explored every possible option.

I want to help.

- I like him.
- Mmm.

If everyone else
has reservations,
why do you think you can do it?

Charlie, we've actually found
surgeons that are not
giving us a hard no.

And I've almost lost you twice.

I'm definitely not ready
to lose you today
from some botched operation.

-Neither are we.
-Hey, I'm still here.

They're just asking
if they can go work on a plan.

If their plan leads
to us growing old together,

looking at the water
from shoddy but very cute
rocking chairs...

I'm in. Aren't you?

You really think you can
figure out a way to keep

her heart from stopping
when she's on that table?

Look, if we can't
figure this out,
we won't proceed, right?

That was our deal
when you two came to me.

Okay, work on your plan.

-Okay.
-We'll be back.

Okay.

Hi, my cuties.

They look bigger.
Did they get bigger?

Hattie's put on a full ounce
in the last 24 hours,

-and Peyton isn't far behind.
-That's right.

Lincolns know how to bulk.

I gotta go to PT.
Sure you're okay?

-Yeah.
-Okay. You sure?

Yeah.

-All right.
-Okay.

-See you soon.
-Yeah.

You're Peyton and Hattie's mom?

Mm-hmm.

Sorry, it's just that, um...

That's the first time that
somebody's called me their mom.

Here.

Oh, wait, that one's not clean.

-Here.
-Thanks.

I'm an OB-GYN,
and I talk to my patients

all the time about
postpartum hormone drops,

but I had no idea it was
this intense and just random.

Yesterday, my boyfriend and I
were buying diapers for me
not the baby,

and the guy ringing me up
said, "Will that be all?"
And I burst into tears.

It's nice to know
that I'm not alone.

What?

You're my first mom friend.

Oh. I'm honored.

Did you tear or...
Can I ask you that?

Yeah, you can ask me anything,
but, um, no, I-I didn't tear.

I, uh...
...I had something called
a crash C-section.

Oh, tell me everything.

I'll be back.

Richard,
what the hell are you doing?

I'm about to check
Mr. Tolli's wound VAC.

You said
you would hear Kaplan out.

I did.

Is this because you're worried
about the bedroom?

Because you know
we'll figure that out.

Come on.

I'm not having
this conversation here.

Is this because
you prefer a male doctor?

Now that's insulting!

Well, I'm just trying
to understand why

you would dismiss
a top urologist
like she's an intern.

I moved mountains
to bring her here for you.

I didn't ask you to.

Now, my cancer
hasn't metastasized.

Watchful waiting is
a perfectly reasonable option.

I respected
your health care decisions
even when I didn't agree.

I need you
to do the same for me.

...1962.

-Who was the surgeon
at Seattle Pres?
-Collins.

Yeah, he actually
did his residency here
a couple of years behind me.

When his chief
wouldn't let him try again,
he sent London to me.

If she codes the minute
she lays on the table,

why didn't they try
a reverse Trendelenburg?

Keep her at an incline
to take the pressure off
some of the cardiac vessels?

Oh, no, they did.
Uh, but see how compressed
they are?

It wasn't enough.

Okay, what about
conscious sedation
instead of general anesthesia?

She'd continue
to breathe on her own,
which would help

blood return back to the heart
and minimize airway collapse.

I mean,
it might help some...

The tumor's matured
into its own ecosystem.

You can see the calcifications,

-fat, the cystic components.
-Yeah? What?

What if we drain it?
Shrink the mass
before we go in?

It's a good idea,
but the location
is just too risky.

We can't risk
the contents of the tumor
spilling into the chest.

It would just regrow.

I gotta run to a consult
in the pit,

but I will
keep thinking on this.

No promises though.

Adams, Griffith, let's look up
every case report published
on mediastinal teratomas.

Research patterns,
cross-reference solutions,
okay?

We all just listened
to a podcast this morning

about how our hospital
pulled off a miracle.

Who's to say
we can't do it again,
right? Go.

We're gonna
come up with something.

-Hey.
-Hi.

-Are you done with that tablet?
-Nope, get your own.

Bailey and Hunt have
a massive mediastinal teratoma.

If you sweet-talk Bailey,
you can get in on it with us.

They're looking for ideas.

I'm too swamped down here.

Hey, I'm sorry
about this morning.

- Jo's crying
about everything these days.
- It's fine.

But she loves Iris,
so she'll be happy
if you two are a thing.

-Why are you acting weird?
-I'm not acting weird.

Yeah, you are.

-Help. Help my wife! Help.
-Hal?

- Sir, you might
wanna button that.
- Oh, my God. Janet.

I'm getting weak pulses.

Janet, look at me.
I'm going to care of you, okay?

We need a gurney in here!

The plane won't be ready
for another couple of hours.

-Catherine said
I could work in here.
-Not a problem.

I owe you an apology.

I was led to believe
that you were the one
seeking a second opinion.

You couldn't have known.

I should have
at least suspected.

I think your wife
broke contract laws

to ensure my employment
at her hospital.

Don't feel bad.

You're not the first
to fall prey to her ways.

- I'm guessing
I won't be the last.

She does it 'cause she cares.

That's
what makes it infuriating.

Feel free to say no.

But I've got a patient with
a retroperitoneal tumor,

and I would be remiss
if I didn't ask Fox Hospitals'
Chief of Chiefs for a consult.

-No. Got a little time.
-Yeah.

How about we get
a couple of pastries
to go with this coffee?

- Thank you.
That would be great.

"Twenty-two-pound teratoma
in the abdomen.

San Francisco, 2018."
They started with
a CT-guided drainage.

Yeah, but look at
the picture of the CT.

Nowhere near the heart.

Another dead end.

Another dumb meme
from your patient?

No, she's asking
for movie recs.

She's stuck at home.

Not exactly
a doctor-patient
conversation topic.

She's Bailey's patient.
She has
stage four gastric cancer.

She can ask whatever she wants.

I mean, shouldn't you
keep it professional?

Look, you have no idea what
you're talking about. It's--

I'm just saying, you're young,
you're single. You...

You look like
you might be leading her on.

I'm her doctor.

And she's a vulnerable patient.

I don't...
I don't need this right now.

-I'm just trying
to look out for you.
-Yeah, try less.

Hunt's asking for an update.

- Okay, anything?
- Not yet. Thanks.

Why did you join this case
when everyone else
dismissed it?

It's like you said,
it's benign.

Once it's out,
she moves on with her life.

There's no worry
of mets or recurrence.

Yeah...
...I might be feeling
a little uninspired lately.

Uh-huh. Wouldn't have to do
with other people solving

cases at weddings
and doing podcasts, would it?

I see you at drop-off.

I know everything's falling
on you right now.

She's lecturing
and you're packing lunches.

I'm happy to do it,
and she deserves
all the attention.

I just think this tumor was...

I don't know.

My patient cannot be the fix
to get you out of this slump.

What have you got?

Ten cases, at least half of
them considered inoperable.

And none of the masses
are nearly the same size.

There's one case that reported
a similar arrest in the OR,

but the team
never tried it again

because they couldn't
safely find a way
around the heart and lungs.

Which is exactly what
happened with London.

As difficult as this is
for me to say...

I think we're out of options.

What about ECMO?

What about it?

We need to bypass
the pulmonary system,
so why don't we use ECMO?

The machine
oxygenates and pumps the blood

so her heart and lungs
don't have to.

There is no arrest
if the machine is acting
as her heart.

Don't say no yet.
I'm gonna go find Ndugu.

Okay.

Almost there, Janet.

If this is a clot,
you can fix it, right?

Blood clots are treatable
if you catch them in time,

so it's a good thing
you're here.

Weird but good.

I should
probably be embarrassed,
but I'm proud of us.

All my friends
got bored of their spouses

and filed for divorce,
but we got creative.

By coming to the hospital
and having sex.

Don't be jealous.
I'm sure other people
aren't getting any either.

All right, let me see.

Looks like there's
a left iliac vein thrombosis.

Hal was right. DVT.

If you look closely,
the iliac artery is
compressing the vein.

-May-Thurner syndrome.
-Mm-hmm.

All right, let's book
an angio suite

for a thrombectomy
and iliac vein stenting
and start practicing.

I'm gonna supervise
you doing the procedure.

-Me?
-She means me.

I don't care who it is
as long as you guys
are prepped and ready to go.

You really think
this will work?

The challenge, right,
has always been the pressure

that your tumor is
putting on your heart,

your lungs and major arteries
when you're positioned
for surgery.

And the ECMO machine
makes that irrelevant

because it oxygenates
and pumps your blood for you.

So no matter what happens,
your body will receive oxygen

and blood flow while we work.

I can't believe you
actually figured it out.

Have you done this before?
I mean, how common
is this ECMO?

Charlie, you said you were in
if they figured it out.

How common is it?

It's not common for this,
and it can be hard
to wean off ECMO

after removing something
that's compressed your lung
for so long,

but her heart is healthy.

I don't anticipate that
being a problem.

But it could be a problem.

You almost lost me twice.

If we do nothing,
this thing just keeps growing
inside me

until it squashes all my organs
and I'm definitely gone.

I don't wanna live like that.

Slowly suffocating.

I don't want you to have
to watch me live like that.

We asked them
to come up with a solution.

I'm taking it.

Okay,
Dr. Griffith and Dr. Adams
will get you prepped,

and we will see you
in the OR, okay?

Is it weird
that he's not blinking?

Newborn tear ducts
aren't fully developed.

It's so cool
that you know all this stuff.

Is it bad if I'm not, like,
feeling anything?

You mean you don't feel a bond?

-I'm already a terrible mom.
-No.

No, it's completely normal,
and you're exhausted,

and your hormones
are all over the place.

And to be honest,
newborns are kinda just blobs.

In a few weeks, he'll be
laughing and smiling,
and it just...

it gets so much better.

You're a really good doctor.

Are you taking new patients?

- Well, it's--
- Hey.

-How're my girls?
-Hey. Well, we made
a new friend--

-Whoa. Oh, my God.
-Oh. Oh. Someone call
a rapid response!

Right away, Doctor.

She's still seizing.

Someone give me IM midazolam.

She's seven days postpartum.
Check her blood pressure.

It's probably eclampsia.
She needs mag now.

Did she have any symptoms
before she started seizing?

No, she seemed completely fine.
It came out of nowhere.

We'll need
to get her up to OB.

Will you go up with her?

Whatever you want.

Call me when you get up there.

Scissors.

- Put two units of blood on standby.
- -Lap pad.

All right,
I secured the cannula.

Adams, are we ready
to remove the clamps?

Yeah, ECMO's ready.

Okay, the dark flow.

We have full flow.

Let's try lowering her down.

- At least that worked.
- -We're gonna make all of it work.

Griffith, Adams,
you may never see
another case like this again,

so keep your eyes on the field.

If you see any signs
of hemodynamic instability,
speak up.

This is not a race.
Our goal is not to finish fast.

It is to keep her safe.

- Understood?
- Mm-hmm.

Okay.

Okay, London.

Let's intubate.

It's a hormonally active
adrenal mass,

so you need to watch out
for sudden hypertension.

-I'm planning to use
alpha-blockers.
-Good.

Well, I assume
you're gonna do this open,
given the size?

That's the plan.
My colleague
will actually do it.

I usually stick to
robotic procedures.

Oh. You got something
against the old-fashioned way?

No, um...
...I have MS,

so standing for long periods
in the OR just isn't an option.

I didn't realize. I'm sorry.

No need to be sorry.

I mean, I was devastated
after I got the diagnosis.

I had put in so much work
my whole career,

and the thought of
no longer being in the OR
was soul-crushing...

to say the least.

But that's when I realized
it was just my fear talking.

And I looked at my symptoms,
muscle pain and leg weakness,
and I thought,

"If only there was
a way to operate

while sitting down
without having
to hold a scalpel."

Was it a difficult adjustment?

Adjusting to living
with a chronic illness
is never easy.

But over time,
I just turned MS into a pivot.

Not an ending.

Well, you seem
to be managing well.

Oh, well,
I have my ups and downs,
believe me.

But Catherine Fox is flying me
around on her private plane

and paying me more money
than I know what to do with.

And I still get to do
what I love.

Even if it is
in a different way.

Now they're gonna go ahead
with Bailey's giant teratoma
in OR two.

-Ndugu's gonna have to resect--
-Can we just focus, please?

It's a fake patient. Calm down.

Don't tell me to calm down.

What is wrong with you?

Is it about Simone
breaking that dumb pact?

No, and stop asking. I'm fine.

No, you don't seem fine.

Well, it's because you
are bothering me.

Well, that can't be it.
I always bother you.

I'm just...

I'm just tired.

Every day is the same.

It's the same people
and the same rooms
and the same conversations,

and I'm just sick of it.

Well, I am sorry
we are not good enough for you.

I didn't say that.

Yeah, you don't
have to defend yourself.
We all know you're aloof.

-You're leaving?
-Yeah, I've already done
a thrombectomy.

You can have it.

Dr. Prescott, please...

What's happening?
Who's the doctor?

-Uh... John Burnett.
-An intern?

-Let's get a CT.
-They're getting a CT.

No, she has eclampsia.

Tell him she needs magnesium .

-Really?
-Tell him.

I...

Excuse me,
I've got Jo Wilson
on the phone,

and she says it's eclampsia,
and you should start her
on magnesium.

Her BP is only 143 over 91.
It could be
an intracranial hemorrhage.

-Put me on speaker.
-Um...

Okay. You're on speaker.

I understand your concern,

but postpartum eclampsia
doesn't always present
with a really high BP.

Neither does a brain bleed.

-Barnett.
-It's-- It's Burnett.

Whatever.
I may be on leave,

but that doesn't mean
that I can't schedule you
to work every holiday

and make your life miserable.
So trust me when I tell you

to start the mag now.

Start IV magnesium.

Your mom's gonna be okay.

We're gonna have
to take part of the lower lobe.

Adams,
you wanna staple the lung?

Yep. Stapler.

Bailey, you ready
to start resecting
the adhered diaphragm?

Hey, ready when you are.

Griffith,
what should we be careful
to avoid?

Hepatic veins
and the retro-hepatic IVC.

Good. Let's get
the next stapler ready.

London thought
fixing up a summer house
was a lot of work.

-It's got nothing on
fixing up a torso.
-Reload, please.

-Uh, BP is bottoming out.
-Damn it.
I don't see any bleeding.

Neither do I.
The staple line looks clean.

Well, something's
got to be causing this.
What the hell is it?

- Does the ECMO
say anything?
- There's a suction event alarm.

Okay. Since we took
pressure off the lung,
could there be volume shifts?

That's definitely possible.
Yeah.

Okay, we need
to up her pressors
and flood her with fluids.

If we don't get flow back
right away, she's done.

Push fluids as hard as you can.

-I am.
-BP's still dropping.

She can't take this
much longer.

I should've
listened to that board.

- If I lose her--
- This is not on you.

Come on, come on, come on.
Come on.

BP's coming back up.

- Well, that was close.
- Okay, folks.

There's still
a lot of tumor left.

Griffith, you're on
the liver resection.

Adams, you're on
the superior mediastinum.

If that's okay with you?

Do what we say when we say it.

Stapler.

Contrast.

There's the occlusion
in the iliac vein.
Advance more.

Okay, pin the guide wire

and turn on
the thrombectomy catheter,
please.

It's a shame Janet
isn't awake to see this.

It would really turn her...

into a passionate fan of
biological science and anatomy.

Okay, I'm in. Turn it off.

I don't get it.
If you have to pretend
to be someone else

for your partner
to wanna sleep with you,

maybe you shouldn't
be together.

I've learned you never know
what's going on in
another person's relationship.

Ready.

Contrast.

Thrombus is gone.
The vein is patent.

Great work.

Now to stent.

Thanks again for the consult.
I see why Catherine
calls you legendary.

Well, she is prone
to exaggeration.

I know,
but in your case it's true.

Well, you live up
to your reputation as well.

Oh, but not enough to
consider my recommendation?

-I'm sorry,
I-I shouldn't have said that.
-No, it's okay.

Can I ask you about something?

Urosymphyseal fistulas.

They are an extremely rare
post-op complication
of radical prostatectomy.

But the odds aren't zero.

They're close.

What if it happened?

Chronic pain,
which often leads
to difficulty walking,

- possibly warranting
the use of opioids.

I can treat complications.

But if your cancer
grows and metastasizes,
that's when my hands are tied.

If you change your mind

or if you just
wanna talk more,
Catherine has my number.

-Done resecting the liver.
-Good.

Excellent hemostasis.

All right,
no bleeding on this side.

Okay, we are
in the home stretch.

Let's get ready
to get this tumor out.

Hold on, hold on.

-Do you hear that?
-What?

Okay, we're gonna need
more lap pads,
and hang blood.

Adams, quickly pack her.

Goddamn it! All right,
keep the suction coming.

Oh... ... wait, wait.

Okay, there's a tear
where the IVC passes

through the diaphragm
into the chest.

I'm trying to secure...
Let-Let me have a clamp.

Okay, I need visualization.

Put the suction
on the lap pads.

Not too harsh,
gentle steady pressure, okay?

I think I got it.

Oh, she's stabilizing.

Okay, everyone,
on the count of three.

Everyone needs to help
with the specimen.

Okay, ready?

One, two, three.

Okay.

Okay.

How do you all feel about
getting the hell out of here?

You don't
have to ask me twice. Bovie.

Two-O prolene.

You can stop here.

Iris.

Hey,
what are you doing up here?

So a mom from the NICU
is being treated
for postpartum eclampsia.

Can you look up her chart?
Her name is Gina...

I don't know her last name.

I'm sorry, I can't.
You're not her doctor.

I just wanna check on her.

Do you want me
to call Marcus for you?

No, what I want
is my friend's chart.

-I'm sorry, Jo.
-Stop saying you're sorry.

Sorry doesn't help me.
I'm this woman's
only friend right now

and the person
in charge of her care

has been a doctor
for about 90 days.

So, if you could just
please remove the stick from--

-Jo.
-All I want right now--

- I think we should go.
- -No, we're not gonna go.

-I-- No.
-Yeah.

You cannot move me
against my will.

Stop. I...

This is not okay.

Can you give me a minute?

-This is--
-Hey, hey, hey, hey.

Look,
I know you're scared,
okay? But...

Hey, she's just trying
to do her job.

It will take a few days
to wean her off ECMO.
She does have a long recovery.

- But she's gonna come home?
- Eventually.

That is the plan.

I don't know how to thank you.

I think you just did.

She's always been able
to see what I can't.

Her mind is filled
with these big ideas

that always seem impossible.

Our wedding, this lake house,
getting this tumor removed.

But she knew you could do it.

And she was right.

I almost...
...tried to stop her.

But I'm glad
I stayed out of it.

Hey, um, we'll let you both
get some rest.

Thank you.

Great work today, Griffith.

You and Adams,
you really stepped it up.

Thank you. I really appreciate
the opportunity.
I learned a lot.

We did a good thing today.

-Some might call it inspiring.
-Mmm.

Might be even something

you could lecture about.

Hey, I hope
I didn't overstep, you know,
jumping in with the residents.

Oh, no. I mean,
if I'm the only voice
that's teaching them,

they'll wind up tuning me out.

What do you think
about having the residents

do an ambulance ride-along
or EMS training?

Something that could
really get them thinking
on their feet, you know?

It could help them in the ER
or in situations like today
in the OR.

I think you should write up
a proposal and send it to me.

The surgery went well.

We were able
to clear the clot
and put in a stent.

Thank you.

You'll need to be
on anticoagulation

but after a while,
you'll be able to get
back to life as usual.

I'll get back to life
as usual right away or...

"When can I have sex?"
is what I'm asking.

Yeah, we know.

You need to elevate your leg
when resting

but other than that,
it is good to move it around.

I guess Trudy
can still see the doctor.

Trudy's always a good time.

But, honey,
I love you most
when you're just Janet.

Oh.

We'll give you some privacy.

I checked London's labs
before leaving.

Thanks.

Hey, I'm sorry about earlier.

How you interact
with your patients,
your business.

I'll stay out of it.

I appreciate that.

I do value your opinion though.

-You do?
-I do.

Just, uh,
not about relationships.
For obvious reasons.

Ouch.

Hey, look,
I'm, uh, putting together
a watch list for my patient.

What am I missing?

Mmm.

- Wait, she hasn't seen
any of these?

Hey.

Hi.

Did you make it
through your busy day?

Uh, I did.

Uh, I did a thrombectomy
and placed a stent.

Nice, Millin.

You still haven't told me
about that thoracotomy,
by the way.

It wasn't that big a deal.

Uh, you saved a man's life
with your hands.

Doesn't get
any bigger than that.

Do you think I'm aloof?

Aloof?
Thank you. Um...

No.

No, you're discerning,
you don't suffer any fools.

But...
...that's not aloof.

That's, um,
just protecting yourself
because you care.

It's funny you say that
because I-I have been...

I had the worst day.

I need the biggest vodka tonic
that they have.

Hi, I'm Iris.

Uh, this is Jules Millin,
a surgical resident.

-Nice to meet you.
-Nice to meet you.

Um, I should go
find my friends.

-Here.
-Thank you.

See you later.

It's jarring
when your identity shifts.

When you're suddenly
a doctor, a partner, a parent.

It helps if you focus
on the things
that haven't changed.

I'm gonna
have to change hospitals.

I've cried in front of
too many people at this one.

They understand.

I just feel like ever since
I was admitted, I just...

I just lost myself.

I can't take care of our kids.

I can't
take care of my patients.
I can't even shower.

It's temporary.

Your heart is recovering.

I know.

But for a few hours today,
I got to be a doctor again

and help this woman
navigate a difficult time

but then
when it really mattered,
someone else got to help her.

At least Gina is okay.

And I would bet that she'd
say what you did mattered too.

Maybe even more.

Oh, God.
It's happening again.

- No.
- I'll get the tissues.

Just...

The comfort of old friends.

Thirty-five pounds?
That's like
carrying four babies.

Yeah, or four bowling balls.

-Who carries
four bowling balls?
-People do weird things.

Gotta go.

Yeah, I'm out too.

See you tomorrow.

She's just a stop sign,
not a roadblock.

How did you...

Doesn't matter.
Wait, are you leaving me too?

Um, sorry.
Um, hey, have a drink on me.

Anyone sitting here?

The thrill
of trying something new.

Hi, I'm Sally.

Because even though you
may not recognize yourself.

Catherine.

I'm sorry. I am so sorry.

I got scared and I just
called the best that I knew.

I should've talked to you
before bringing Laura in.

Look, I thought a lot
about letting fear
cloud judgment today.

Whatever you wanna do,
I support--

I'm a surgeon.

I'm a senior member
of this hospital.

If something were to go wrong

and I couldn't stand
long enough
to do a simple appy,

I'd feel weak.

And I don't know
how to lead like that.

I don't know who I'd be.

But people adapt.

I wanna go ahead
with the surgery.

It's been you all along.