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In college,
I was the hungover premed
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00:00:08,759 --> 00:00:10,718
who fell asleep at her study carrel.
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00:00:10,719 --> 00:00:12,386
If you're
just joining our podcast,
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00:00:12,387 --> 00:00:14,305
my guests are doctors Teddy Altman
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00:00:14,306 --> 00:00:16,891
and Winston Ndugu
from Grey-Sloan Memorial,
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00:00:16,892 --> 00:00:20,144
who pioneered the creation
of a ventral aorta surgery.
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At what point did you think,
"We just broke new ground"?
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Immediately.
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- Really?
- Yeah. Once that staple held, I knew.
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Sometimes you just have a feeling.
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00:00:28,779 --> 00:00:31,489
In med school,
I was the famous surgeon's daughter.
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00:00:31,490 --> 00:00:33,533
It wasn't like that for you?
13
00:00:33,534 --> 00:00:35,409
Honestly,
there was so much going on that night,
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I didn't have time
to process it all until later.
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Now I'm the famous surgeon.
16
00:00:40,290 --> 00:00:41,666
- So you had doubts?
- Oh, yeah.
17
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I was never certain
it would work,
18
00:00:43,377 --> 00:00:45,211
but our patient
didn't have any other option.
19
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I knew that we had to try.
20
00:00:47,506 --> 00:00:51,384
In medicine, your identity
is constantly changing.
21
00:00:51,385 --> 00:00:53,302
It's your job to keep up.
22
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Safe to say it worked out.
What's next for you both?
23
00:00:55,889 --> 00:00:58,391
Well, we're still monitoring
our patients' progress.
24
00:00:58,392 --> 00:01:00,351
- And?
- So far so good.
25
00:01:00,352 --> 00:01:02,812
They sound really good, very competent.
26
00:01:02,813 --> 00:01:04,480
Yeah. I'd come to this hospital.
27
00:01:04,481 --> 00:01:06,274
Well, speaking of...
28
00:01:06,275 --> 00:01:08,110
I made an appointment for you.
29
00:01:09,194 --> 00:01:12,071
We talked about this, Catherine.
I don't need another opinion.
30
00:01:12,072 --> 00:01:13,364
I like Dr. Freeman.
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I know you do because he goes
along with whatever you want.
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00:01:16,410 --> 00:01:18,286
You don't think doctors
should listen to their patients?
33
00:01:18,287 --> 00:01:22,873
I think you need objective advice from
someone whose paycheck you don't sign.
34
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It's just another opinion.
35
00:01:27,504 --> 00:01:28,505
Who am I seeing?
36
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Kaplan.
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Laura Kaplan? In Boston?
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I thought you made an appointment here.
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I sent for my plane.
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She landed about an hour ago.
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Morning.
42
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- Hey.
- Hey.
43
00:01:45,814 --> 00:01:47,690
Hey, nice job on that podcast.
44
00:01:47,691 --> 00:01:50,234
I didn't realize you and Altman
came up with that at our wedding.
45
00:01:50,235 --> 00:01:52,529
Yeah, you never know
when an idea will strike.
46
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Go ahead, Dr. Adams.
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Uh, yes. Uh, Jo Wilson.
48
00:01:56,700 --> 00:02:01,203
Post-op day seven from emergency
C-section and Impella CP placement.
49
00:02:01,204 --> 00:02:03,873
Now post-op day three from a 5.5 placement
50
00:02:03,874 --> 00:02:05,374
through the right axillary artery.
51
00:02:05,375 --> 00:02:09,670
Her heart function continues to recover
with her EF up another five percent,
52
00:02:09,671 --> 00:02:12,381
and I heard she got
to meet her babies yesterday.
53
00:02:12,382 --> 00:02:14,300
- How are they doing?
- Um.
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00:02:14,301 --> 00:02:16,719
Peyton's off of CPAP but still fragile.
55
00:02:16,720 --> 00:02:21,182
Hattie's bilirubin levels are bad
every time they pause phototherapy.
56
00:02:21,183 --> 00:02:23,184
And you're all headed
in the right direction.
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That's what matters.
58
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I just...
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really want the six of us
to finally be together.
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00:02:29,608 --> 00:02:30,816
Jo, you will never guess
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00:02:30,817 --> 00:02:32,985
who Marcus walked out with last night.
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- Dr. Ndugu.
- Hey.
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00:02:34,529 --> 00:02:36,782
- I didn't know you were doing rounds.
- Yeah.
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I'll come back later.
65
00:02:42,954 --> 00:02:44,330
What was that?
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00:02:44,331 --> 00:02:47,708
- What was what?
- Did you sleep with my favorite nurse?
67
00:02:47,709 --> 00:02:49,293
- Jo...
- Uh, should I leave?
68
00:02:49,294 --> 00:02:50,961
We've just gone out a couple times.
That's all.
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00:02:50,962 --> 00:02:52,963
Well, are you gonna take her out again?
70
00:02:52,964 --> 00:02:55,341
Uh, just... Maybe. It's new.
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And none of our business.
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She is the entire department's
favorite nurse.
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00:03:01,181 --> 00:03:03,975
Everybody loves her. Everyone.
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00:03:08,355 --> 00:03:09,980
- Hormones.
- Okay.
75
00:03:09,981 --> 00:03:12,942
Uh, I-I need to check on my next patient.
Are you gonna be okay?
76
00:03:12,943 --> 00:03:16,196
- Yeah.
- Uh, page me if you need anything.
77
00:03:19,700 --> 00:03:20,866
Good morning.
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Traitor.
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00:03:22,077 --> 00:03:24,245
- Trouble in paradise?
- I broke our pact.
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- She's bitter.
- Then you should break it too.
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00:03:26,665 --> 00:03:29,375
What, I can just snap my fingers?
Who am I supposed to sleep with?
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00:03:29,376 --> 00:03:32,878
I ordered an X-ray
for Ms. Johnson's left arm.
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It was the right arm, wasn't it?
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00:03:35,048 --> 00:03:36,758
I will fix it.
85
00:03:37,801 --> 00:03:39,635
An intern? Please. I have dignity.
86
00:03:39,636 --> 00:03:42,304
- Don't knock it until you've tried it.
- Tried what?
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00:03:42,305 --> 00:03:43,556
Vegan sloppy joes.
88
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You sleeping with an intern too?
89
00:03:45,016 --> 00:03:47,101
Wait. Who's sleeping with an intern?
90
00:03:47,102 --> 00:03:48,894
I am. Who are you texting?
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00:03:48,895 --> 00:03:50,146
Nobody.
92
00:03:50,147 --> 00:03:52,273
- Doesn't look like nobody.
- Nah, she's just a patient.
93
00:03:52,274 --> 00:03:53,941
Why are you texting a patient?
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00:03:53,942 --> 00:03:56,068
Well, Bailey made me
drive her an hour to get treatment,
95
00:03:56,069 --> 00:03:57,570
and now she's sending me dumb memes.
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00:03:57,571 --> 00:03:59,196
- It's nothing.
- Wear a condom.
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She's a cancer patient.
98
00:04:01,116 --> 00:04:03,367
Hey. Did you see
that I admitted Mr. Howard?
99
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You don't have to put your phone down.
100
00:04:05,078 --> 00:04:06,245
- It's fine.
- Sorry.
101
00:04:06,246 --> 00:04:09,165
My phone has been blowing up
since the podcast dropped.
102
00:04:09,166 --> 00:04:10,416
I listened. You sounded great.
103
00:04:10,417 --> 00:04:12,960
Well, now I've got doctors
reaching out about their patients,
104
00:04:12,961 --> 00:04:15,754
and the department chief from Mass General
has asked me to do grand rounds.
105
00:04:15,755 --> 00:04:16,839
Hmm. Sounds rough.
106
00:04:16,840 --> 00:04:19,133
Well, it's not like I'm getting
a Nobel Prize.
107
00:04:19,134 --> 00:04:21,469
I mean, MGH asks
everyone to guest lecture.
108
00:04:21,470 --> 00:04:23,053
They never asked me,
and I went to Harvard.
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00:04:23,054 --> 00:04:26,307
Anyway, so, Mr. Howard,
his EKG shows a conduction block.
110
00:04:26,308 --> 00:04:30,728
- Do you want an echo?
- Um, yes. Sorry, I have to take this.
111
00:04:30,729 --> 00:04:32,229
Hi, this is Altman.
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00:04:32,230 --> 00:04:36,692
Hi, Janet, I'm, uh, Dr. Millin.
I hear you're having some leg pain.
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00:04:36,693 --> 00:04:38,194
Yeah, and some heaviness.
114
00:04:38,195 --> 00:04:40,988
I'm concerned it might be a DVT.
I think she should have an ultrasound.
115
00:04:40,989 --> 00:04:45,494
I assume you want a full workup.
CBC, D-dimer, and a duplex ultrasound?
116
00:04:46,495 --> 00:04:47,870
I'm Jules Millin.
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00:04:47,871 --> 00:04:52,583
I'm a second-year surgical resident.
You're internal medicine, right?
118
00:04:52,584 --> 00:04:55,169
Oh, no. Oh. I'm not a doctor.
Sorry. Yeah.
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00:04:55,170 --> 00:04:56,879
- Oh, we were role-playing.
- Yeah.
120
00:04:56,880 --> 00:04:58,756
The more medical terms,
the better it gets.
121
00:04:58,757 --> 00:05:01,218
- Yeah.
- So, Hal does his homework.
122
00:05:02,427 --> 00:05:05,012
- So do you have leg pain or is this--
- Oh, no, that's real.
123
00:05:05,013 --> 00:05:07,056
The pain started this morning
when we were trying
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00:05:07,057 --> 00:05:08,809
to squeeze in a quickie before work.
125
00:05:09,518 --> 00:05:11,061
- May I do an exam?
- Mm-hmm.
126
00:05:13,355 --> 00:05:16,524
Um, how long did the pain last for?
127
00:05:16,525 --> 00:05:18,609
- Uh, a few hours?
- Yeah.
128
00:05:18,610 --> 00:05:20,528
We've been trying
to spice things up lately,
129
00:05:20,529 --> 00:05:23,823
so we just wanna make sure we haven't,
uh, caused a problem.
130
00:05:23,824 --> 00:05:25,741
Oh, um...
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DVTs usually occur
with less, um, activity,
132
00:05:30,997 --> 00:05:35,084
but it is better to be safe than sorry,
so I will order some tests...
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00:05:35,085 --> 00:05:37,127
- All right.
- ...and get back to you.
134
00:05:37,128 --> 00:05:38,505
- Okay. Thank you.
- Thank you.
135
00:05:40,257 --> 00:05:41,882
Dr. Griffith.
136
00:05:41,883 --> 00:05:45,678
A 38-year-old female
with a large mediastinal teratoma
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that has been resistant to chemotherapy.
138
00:05:48,306 --> 00:05:50,182
Presents with progressive
shortness of breath,
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orthopnea, and angina.
140
00:05:51,476 --> 00:05:53,185
It has to be at least 35 pounds.
141
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And, uh, 27 centimeters
for the longest diameter.
142
00:05:56,356 --> 00:05:59,900
The tumor is displacing
the heart and great vessels.
143
00:05:59,901 --> 00:06:05,364
The SVC is compressed, and it's also
indenting the right lobe of the liver.
144
00:06:05,365 --> 00:06:06,866
Hmm. How are the lungs?
145
00:06:06,867 --> 00:06:09,577
Compressed with near total collapse
of the mid-right and lower lobes.
146
00:06:09,578 --> 00:06:11,537
Has anyone tried to operate on the thing?
147
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Her name is London
148
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and, yes, there have been
two attempts at Seattle Pres.
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They had to abort both times
because she arrested on the table.
150
00:06:20,839 --> 00:06:23,173
But you believe you would have
a different outcome if you tried?
151
00:06:23,174 --> 00:06:29,305
Well, I have removed extremely difficult
tumors before, and this one is benign.
152
00:06:29,306 --> 00:06:34,101
So, if we can successfully remove it,
then she resumes a normal life.
153
00:06:34,102 --> 00:06:36,145
Even if you convinced anesthesia,
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00:06:36,146 --> 00:06:38,939
you could still
encounter catastrophic bleeding.
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And that is why I'm here
at the tumor board,
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where people help their colleagues
to come up with a plan.
157
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If anyone here thinks this remotely
is a possibility, please speak up.
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Yes.
159
00:06:57,667 --> 00:06:59,586
It's a tragic case, Dr. Bailey, but...
160
00:07:00,837 --> 00:07:04,299
It's a lawsuit waiting to happen.
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00:07:05,967 --> 00:07:06,968
I'll do it with you.
162
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- The alternative is hospice, right?
- Mm-hmm.
163
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Dr. Hunt, it just can't be done.
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Yeah, well,
you don't know what we're capable of.
165
00:07:23,151 --> 00:07:25,361
- Bye.
- I knew you'd have an idea.
166
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Yeah, I got nothing.
167
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{\an8}Well, look who's here.
168
00:07:44,339 --> 00:07:45,673
{\an8}How was your flight?
169
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{\an8}- Most quiet I've had in months.
- Oh, great.
170
00:07:48,385 --> 00:07:51,136
{\an8}- Dr. Webber, it's a pleasure.
- Hi.
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00:07:51,137 --> 00:07:53,013
{\an8}I've heard a lot about you.
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{\an8}All good things. Catherine's thrilled you
joined the team in Boston.
173
00:07:56,476 --> 00:07:58,811
{\an8}She's thrilled she poached me
from Sloan Kettering.
174
00:07:58,812 --> 00:08:03,315
{\an8}You are at the forefront of urologic
oncology, and that lecture that you gave
175
00:08:03,316 --> 00:08:06,985
{\an8}to the American Urological Association
last month brought the house down.
176
00:08:06,986 --> 00:08:12,616
{\an8}And she is developing a program
that uses AI to study biomarkers.
177
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We just received another grant
for it yesterday.
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You bet you did.
179
00:08:15,995 --> 00:08:19,081
Now, tell us about my husband's prostate.
180
00:08:19,082 --> 00:08:20,250
Catherine, please.
181
00:08:21,626 --> 00:08:24,086
- If now's not a good time--
- Don't be ridiculous.
182
00:08:24,087 --> 00:08:25,713
Come on, everybody. Sit down.
183
00:08:25,714 --> 00:08:27,549
Have a seat. Come on.
184
00:08:29,134 --> 00:08:30,926
{\an8}Good news is you caught it early.
185
00:08:30,927 --> 00:08:32,594
{\an8}Grade group two, a seven Gleason.
186
00:08:32,595 --> 00:08:36,682
{\an8}Well, he knows all of that.
So tell us, what do you suggest?
187
00:08:36,683 --> 00:08:39,768
{\an8}Well, given the cancer's localized,
and you're generally in good health,
188
00:08:39,769 --> 00:08:42,187
{\an8}I recommend a radical prostatectomy.
189
00:08:42,188 --> 00:08:43,606
{\an8}I couldn't agree more.
190
00:08:44,399 --> 00:08:46,150
{\an8}If you're worried about side effects,
191
00:08:46,151 --> 00:08:49,945
{\an8}urinary incontinence,
erectile dysfunction, they are a risk.
192
00:08:49,946 --> 00:08:52,698
{\an8}- But for many men--
- What about infection?
193
00:08:52,699 --> 00:08:55,075
It's unlikely but possible.
194
00:08:55,076 --> 00:09:00,164
Blood clots, stroke, injury to the rectum,
bladder, nerves?
195
00:09:00,165 --> 00:09:01,624
They're all possible too, right?
196
00:09:04,878 --> 00:09:05,879
{\an8}Yeah.
197
00:09:07,338 --> 00:09:08,464
{\an8}Thank you for your time,
198
00:09:08,465 --> 00:09:12,426
{\an8}but I've already selected
an option with my own doctor.
199
00:09:12,427 --> 00:09:13,552
{\an8}Watchful waiting.
200
00:09:13,553 --> 00:09:15,180
{\an8}I've got patients to see.
201
00:09:21,770 --> 00:09:23,604
{\an8}I'm not seeing abnormalities.
202
00:09:23,605 --> 00:09:24,938
{\an8}What's that wand called?
203
00:09:24,939 --> 00:09:26,231
{\an8}An ultrasound probe.
204
00:09:26,232 --> 00:09:27,650
- Write that down.
- Okay.
205
00:09:28,777 --> 00:09:31,071
All right, the ultrasound is negative.
206
00:09:31,654 --> 00:09:33,197
So, she doesn't have a clot?
207
00:09:33,198 --> 00:09:34,573
Not that I can see.
208
00:09:34,574 --> 00:09:36,450
Sounds like maybe
there still might be one?
209
00:09:36,451 --> 00:09:40,120
{\an8}Well, your D-dimer was slightly elevated,
which is the marker we look at for clots.
210
00:09:40,121 --> 00:09:42,372
{\an8}It doesn't necessarily mean anything,
but it is reason
211
00:09:42,373 --> 00:09:44,041
{\an8}to come back if you have any more pain.
212
00:09:44,042 --> 00:09:47,294
{\an8}Maybe I just need to stretch
before I go to the doctor.
213
00:09:47,295 --> 00:09:48,629
{\an8}- Mmm.
- Stretch?
214
00:09:48,630 --> 00:09:49,755
{\an8}Don't ask any questions.
215
00:09:49,756 --> 00:09:52,716
{\an8}I'm gonna start your,
um, discharge paperwork.
216
00:09:52,717 --> 00:09:53,884
{\an8}What's that all about?
217
00:09:53,885 --> 00:09:56,011
{\an8}They like to role-play
doctor and patient in bed.
218
00:09:56,012 --> 00:09:57,430
{\an8}Good for them.
219
00:09:59,265 --> 00:10:02,267
{\an8}But they're so cute.
220
00:10:02,268 --> 00:10:03,560
{\an8}Rustic cute?
221
00:10:03,561 --> 00:10:05,729
{\an8}Five reviews say
those rockers broke within a year.
222
00:10:06,815 --> 00:10:07,898
{\an8}How's the lake house?
223
00:10:07,899 --> 00:10:12,069
{\an8}We've moved from arguing over tile
to arguing over porch chairs.
224
00:10:13,154 --> 00:10:14,238
{\an8}How was the tumor board?
225
00:10:14,239 --> 00:10:18,659
{\an8}Uh, unfortunately,
they are concerned about the risks
226
00:10:18,660 --> 00:10:21,411
{\an8}and recommend that we don't proceed.
227
00:10:21,412 --> 00:10:26,917
{\an8}So naturally I called in reinforcements.
This is Dr. Owen Hunt.
228
00:10:26,918 --> 00:10:29,545
{\an8}- He's one of our trauma surgeons.
- Hi.
229
00:10:29,546 --> 00:10:31,797
If it's okay with you,
I'd like to work with Dr. Bailey
230
00:10:31,798 --> 00:10:34,550
to make sure that we've
explored every possible option.
231
00:10:34,551 --> 00:10:36,051
I want to help.
232
00:10:36,052 --> 00:10:37,387
I like him.
233
00:10:38,638 --> 00:10:42,099
{\an8}If everyone else has reservations,
why do you think you can do it?
234
00:10:42,100 --> 00:10:48,147
Charlie, we've actually found surgeons
that are not giving us a hard no.
235
00:10:48,148 --> 00:10:50,357
And I've almost lost you twice.
236
00:10:50,358 --> 00:10:53,944
I'm definitely not ready to lose you today
from some botched operation.
237
00:10:53,945 --> 00:10:58,031
- Neither are we.
- Hey, I'm still here.
238
00:10:58,032 --> 00:11:00,326
They're just asking
if they can go work on a plan.
239
00:11:00,952 --> 00:11:04,538
If their plan leads
to us growing old together,
240
00:11:04,539 --> 00:11:10,252
{\an8}looking at the water from shoddy
but very cute rocking chairs...
241
00:11:11,337 --> 00:11:14,299
...I'm in. Aren't you?
242
00:11:18,553 --> 00:11:20,679
{\an8}You really think you can
figure out a way to keep
243
00:11:20,680 --> 00:11:22,472
{\an8}her heart from stopping
when she's on that table?
244
00:11:22,473 --> 00:11:25,517
{\an8}Look, if we can't figure this out,
we won't proceed, right?
245
00:11:25,518 --> 00:11:27,812
{\an8}That was our deal when you two came to me.
246
00:11:29,480 --> 00:11:31,440
{\an8}Okay, work on your plan.
247
00:11:31,441 --> 00:11:33,400
{\an8}- Okay.
- We'll be back.
248
00:11:33,401 --> 00:11:34,694
{\an8}Okay.
249
00:11:41,492 --> 00:11:44,704
{\an8}Hi, my cuties.
250
00:11:46,706 --> 00:11:48,832
{\an8}They look bigger. Did they get bigger?
251
00:11:48,833 --> 00:11:51,877
{\an8}Hattie's put on a full ounce
in the last 24 hours,
252
00:11:51,878 --> 00:11:54,129
{\an8}- and Peyton isn't far behind.
- That's right.
253
00:11:54,130 --> 00:11:55,839
{\an8}Lincolns know how to bulk.
254
00:11:58,968 --> 00:12:00,802
{\an8}I gotta go to PT. Sure you're okay?
255
00:12:00,803 --> 00:12:02,387
{\an8}- Yeah.
- Okay. You sure?
256
00:12:02,388 --> 00:12:03,473
{\an8}Yeah.
257
00:12:04,807 --> 00:12:06,559
{\an8}- All right.
- Okay.
258
00:12:08,019 --> 00:12:09,103
{\an8}See you soon.
259
00:12:12,023 --> 00:12:13,650
{\an8}You're Peyton and Hattie's mom?
260
00:12:14,400 --> 00:12:16,486
{\an8}Mm-hmm.
261
00:12:18,321 --> 00:12:21,073
{\an8}Sorry, it's just that, um...
262
00:12:21,074 --> 00:12:24,369
{\an8}That's the first time that
somebody's called me their mom.
263
00:12:25,620 --> 00:12:26,621
{\an8}Here.
264
00:12:28,748 --> 00:12:30,833
{\an8}Oh, wait, that one's not clean.
265
00:12:32,210 --> 00:12:33,211
{\an8}- Here.
- Thanks.
266
00:12:33,878 --> 00:12:37,422
{\an8}I'm an OB-GYN, and I talk to my patients
267
00:12:37,423 --> 00:12:40,133
{\an8}all the time about
postpartum hormone drops,
268
00:12:40,134 --> 00:12:44,554
{\an8}but I had no idea it was
this intense and just random.
269
00:12:44,555 --> 00:12:47,140
{\an8}Yesterday, my boyfriend and I were
buying diapers.
270
00:12:47,141 --> 00:12:48,892
{\an8}For me, not the baby.
271
00:12:48,893 --> 00:12:53,397
{\an8}And the guy ringing me up said, "Will
that be all?" And I burst into tears.
272
00:12:53,398 --> 00:12:55,400
It's nice to know that I'm not alone.
273
00:12:57,902 --> 00:12:59,653
What?
274
00:12:59,654 --> 00:13:01,447
You're my first mom friend.
275
00:13:02,073 --> 00:13:04,741
{\an8}Oh. I'm honored.
276
00:13:04,742 --> 00:13:07,494
{\an8}Did you tear or... Can I ask you that?
277
00:13:07,495 --> 00:13:10,914
{\an8}Yeah, you can ask me anything,
but, um, no, I-I didn't tear.
278
00:13:10,915 --> 00:13:14,876
{\an8}I, uh... ...I had something called
a crash C-section.
279
00:13:14,877 --> 00:13:17,046
{\an8}Oh, tell me everything.
280
00:13:19,382 --> 00:13:20,549
{\an8}I'll be back.
281
00:13:20,550 --> 00:13:23,343
{\an8}Richard, what the hell are you doing?
282
00:13:23,344 --> 00:13:27,889
{\an8}- I'm about to check Mr. Tolli's wound VAC.
- You said you would hear Kaplan out.
283
00:13:27,890 --> 00:13:29,725
{\an8}I did.
284
00:13:29,726 --> 00:13:31,852
{\an8}Is this because you're worried
about the bedroom?
285
00:13:31,853 --> 00:13:34,939
{\an8}Because you know we'll figure that out.
286
00:13:36,899 --> 00:13:37,942
{\an8}Come on.
287
00:13:44,032 --> 00:13:47,743
{\an8}- I'm not having this conversation here.
- Is this because you prefer a male doctor?
288
00:13:47,744 --> 00:13:49,119
{\an8}Now that's insulting!
289
00:13:49,120 --> 00:13:50,787
{\an8}Well, I'm just trying to understand why
290
00:13:50,788 --> 00:13:54,207
{\an8}you would dismiss a top urologist
like she's an intern.
291
00:13:54,208 --> 00:13:56,251
{\an8}I moved mountains
to bring her here for you.
292
00:13:56,252 --> 00:13:57,920
{\an8}I didn't ask you to.
293
00:13:58,629 --> 00:14:00,672
{\an8}Now, my cancer hasn't metastasized.
294
00:14:00,673 --> 00:14:03,800
Watchful waiting
is a perfectly reasonable option.
295
00:14:03,801 --> 00:14:07,637
I respected your health care decisions
even when I didn't agree.
296
00:14:07,638 --> 00:14:10,016
I need you to do the same for me.
297
00:14:13,978 --> 00:14:16,605
{\an8}- Who was the surgeon at Seattle Pres?
- Collins.
298
00:14:16,606 --> 00:14:20,358
{\an8}Yeah, he actually did his residency here
a couple of years behind me.
299
00:14:20,359 --> 00:14:23,945
{\an8}When his chief wouldn't let him try again,
he sent London to me.
300
00:14:23,946 --> 00:14:26,198
{\an8}If she codes the minute
she lays on the table,
301
00:14:26,199 --> 00:14:27,908
{\an8}why didn't they try
a reverse Trendelenburg?
302
00:14:27,909 --> 00:14:30,619
{\an8}Keep her at an incline to take the
pressure off some of the cardiac vessels?
303
00:14:30,620 --> 00:14:33,413
Oh, look, they did.
Uh, but see how compressed they are?
304
00:14:33,414 --> 00:14:34,498
It wasn't enough.
305
00:14:34,499 --> 00:14:37,334
Okay, what about conscious sedation
instead of general anesthesia?
306
00:14:37,335 --> 00:14:39,544
She'd continue to breathe on her own,
which would help
307
00:14:39,545 --> 00:14:42,422
blood return back to the heart
and minimize airway collapse.
308
00:14:42,423 --> 00:14:44,841
I mean, it might help some.
309
00:14:44,842 --> 00:14:46,843
The tumor's matured
into its own ecosystem.
310
00:14:46,844 --> 00:14:48,428
You can see the calcifications,
311
00:14:48,429 --> 00:14:52,474
- fat, the cystic components.
- What?
312
00:14:52,475 --> 00:14:54,935
What if we drain it?
Shrink the mass before we go in?
313
00:14:54,936 --> 00:14:57,020
It's a good idea,
but the location is just too risky.
314
00:14:57,021 --> 00:14:59,773
We can't risk the contents
of the tumor spilling into the chest.
315
00:14:59,774 --> 00:15:01,358
- It would just regrow.
- Yeah.
316
00:15:01,359 --> 00:15:04,736
I gotta run to a consult in the pit,
but I will keep thinking on this.
317
00:15:04,737 --> 00:15:06,614
No promises though.
318
00:15:07,198 --> 00:15:11,618
Adams, Griffith, let's look up every case
report published on mediastinal teratomas.
319
00:15:11,619 --> 00:15:14,330
Research patterns,
cross-reference solutions, okay?
320
00:15:15,289 --> 00:15:17,290
We all just listened to a podcast
this morning
321
00:15:17,291 --> 00:15:19,167
about how our hospital
pulled off a miracle.
322
00:15:19,168 --> 00:15:21,170
Who's to say we can't do it again,
right? Go.
323
00:15:24,173 --> 00:15:26,425
We're gonna come up with something.
324
00:15:28,136 --> 00:15:29,719
- Hey.
- Hi.
325
00:15:29,720 --> 00:15:32,305
- Are you done with that tablet?
- Nope, get your own.
326
00:15:32,306 --> 00:15:35,725
Bailey and Hunt have
a massive mediastinal teratoma.
327
00:15:35,726 --> 00:15:37,936
If you sweet-talk Bailey,
you can get in on it with us.
328
00:15:37,937 --> 00:15:39,062
They're looking for ideas.
329
00:15:39,063 --> 00:15:40,731
I'm too swamped down here.
330
00:15:41,524 --> 00:15:44,109
Hey, I'm sorry about this morning.
331
00:15:44,110 --> 00:15:46,486
- Jo's crying about everything these days.
- It's fine.
332
00:15:46,487 --> 00:15:50,741
But she loves Iris,
so she'll be happy if you two are a thing.
333
00:15:57,874 --> 00:16:00,041
- Why are you acting weird?
- I'm not acting weird.
334
00:16:00,042 --> 00:16:02,043
Yeah, you are.
335
00:16:02,044 --> 00:16:04,379
- Help. Help my wife! Help.
- Hal?
336
00:16:04,380 --> 00:16:06,214
- Sir, you might wanna button that.
- Oh, my God. Janet.
337
00:16:09,510 --> 00:16:10,719
Okay.
338
00:16:10,720 --> 00:16:12,345
I'm getting weak pulses.
339
00:16:12,346 --> 00:16:15,473
Okay. Janet, look at me.
I'm going to care of you, okay?
340
00:16:15,474 --> 00:16:16,976
We need a gurney in here!
341
00:16:23,941 --> 00:16:26,067
The plane won't be ready
for another couple of hours.
342
00:16:26,068 --> 00:16:29,614
- Catherine said I could work in here.
- Not a problem.
343
00:16:32,408 --> 00:16:34,701
I owe you an apology.
344
00:16:34,702 --> 00:16:37,621
I was led to believe that you were
the one seeking a second opinion.
345
00:16:37,622 --> 00:16:38,831
You couldn't have known.
346
00:16:39,457 --> 00:16:41,042
I should have at least suspected.
347
00:16:41,626 --> 00:16:44,920
I think your wife broke contract laws
to ensure my employment at her hospital.
348
00:16:44,921 --> 00:16:46,254
Don't feel bad.
349
00:16:46,255 --> 00:16:49,300
You're not
the first to fall prey to her ways.
350
00:16:49,884 --> 00:16:52,219
I'm guessing I won't be the last.
351
00:16:52,220 --> 00:16:53,888
She does it 'cause she cares.
352
00:16:54,931 --> 00:16:56,723
That's what makes it infuriating.
353
00:17:01,229 --> 00:17:02,230
Feel free to say no.
354
00:17:03,314 --> 00:17:06,316
But I've got a patient with
a retroperitoneal tumor,
355
00:17:06,317 --> 00:17:11,030
and I would be remiss if I didn't ask Fox
Hospitals' Chief of Chiefs for a consult.
356
00:17:12,531 --> 00:17:14,242
No. Got a little time.
357
00:17:15,159 --> 00:17:19,454
How about we get a couple of pastries
to go with this coffee?
358
00:17:19,455 --> 00:17:21,457
Thank you. That would be great.
359
00:17:22,750 --> 00:17:25,335
"Twenty-two-pound teratoma in the abdomen.
360
00:17:25,336 --> 00:17:29,714
San Francisco, 2018."
They started with a CT-guided drainage.
361
00:17:29,715 --> 00:17:31,341
Yeah, but look at the picture of the CT.
362
00:17:31,342 --> 00:17:32,801
Nowhere near the heart.
363
00:17:32,802 --> 00:17:35,346
Another dead end.
364
00:17:36,472 --> 00:17:38,014
Another dumb meme from your patient?
365
00:17:38,015 --> 00:17:40,183
No, she's asking for movie recs.
366
00:17:40,184 --> 00:17:41,269
She's stuck at home.
367
00:17:41,978 --> 00:17:45,188
Not exactly
a doctor-patient conversation topic.
368
00:17:45,189 --> 00:17:47,899
She's Bailey's patient.
She has stage four gastric cancer.
369
00:17:47,900 --> 00:17:50,026
She can ask whatever she wants.
370
00:17:50,027 --> 00:17:51,528
I mean, shouldn't you
keep it professional?
371
00:17:51,529 --> 00:17:53,488
Look, you have no idea what
you're talking about.
372
00:17:53,489 --> 00:17:56,116
I'm just saying, you're young,
you're single. You...
373
00:17:56,117 --> 00:17:58,494
You look like you,
you might be leading her on.
374
00:17:59,912 --> 00:18:01,204
I'm her doctor.
375
00:18:01,205 --> 00:18:02,707
And she's a vulnerable patient.
376
00:18:03,541 --> 00:18:05,375
I don't...
I don't need this right now.
377
00:18:05,376 --> 00:18:07,711
- No, I'm just trying to look out for you.
- Yeah, try less.
378
00:18:10,172 --> 00:18:11,923
Hunt's asking for an update.
379
00:18:14,468 --> 00:18:16,303
- Okay, anything?
- Not yet.
380
00:18:20,891 --> 00:18:24,561
Why did you join this case
when everyone else dismissed it?
381
00:18:24,562 --> 00:18:27,814
It's like you said, it's benign.
Once it's out, she moves on with her life.
382
00:18:27,815 --> 00:18:30,443
There's no worry of mets or recurrence.
383
00:18:33,529 --> 00:18:37,157
Yeah... ...I might be feeling
a little uninspired lately.
384
00:18:37,158 --> 00:18:40,910
Uh-huh. Wouldn't have to do
with other people solving
385
00:18:40,911 --> 00:18:43,122
cases at weddings
and doing podcasts, would it?
386
00:18:45,333 --> 00:18:46,833
I see you at drop-off.
387
00:18:46,834 --> 00:18:49,085
I know everything's falling
on you right now.
388
00:18:49,086 --> 00:18:52,547
She's lecturing
and you're packing lunches.
389
00:18:52,548 --> 00:18:56,217
I'm happy to do it,
and she deserves all the attention.
390
00:18:56,218 --> 00:18:58,387
I just think this tumor was...
391
00:19:00,097 --> 00:19:01,181
I don't know.
392
00:19:01,182 --> 00:19:04,810
My patient cannot be the fix
to get you out of this slump.
393
00:19:05,811 --> 00:19:06,936
What do we got?
394
00:19:06,937 --> 00:19:09,939
Ten cases, at least half of
them considered inoperable.
395
00:19:09,940 --> 00:19:12,317
And none of the masses
are nearly the same size.
396
00:19:12,318 --> 00:19:14,569
There's one case that reported
a similar arrest in the OR,
397
00:19:14,570 --> 00:19:16,071
but the team never tried it again
398
00:19:16,072 --> 00:19:19,074
because they couldn't safely
find a way around the heart and lungs.
399
00:19:19,075 --> 00:19:21,660
Which is exactly what
happened with London.
400
00:19:21,661 --> 00:19:24,121
As difficult as this is for me to say...
401
00:19:25,456 --> 00:19:27,624
I think we're out of options.
402
00:19:27,625 --> 00:19:29,042
What about ECMO?
403
00:19:29,043 --> 00:19:30,126
What about it?
404
00:19:30,127 --> 00:19:33,755
We need to bypass the pulmonary system,
so why don't we use ECMO?
405
00:19:33,756 --> 00:19:37,133
The machine oxygenates and pumps the blood
so her heart and lungs don't have to.
406
00:19:37,134 --> 00:19:42,431
There is no arrest
if the machine is acting as her heart.
407
00:19:43,557 --> 00:19:46,936
Don't say no yet. I'm gonna go find Ndugu.
408
00:19:50,231 --> 00:19:51,564
Almost there, Janet.
409
00:19:51,565 --> 00:19:54,026
If this is a clot,
you can fix it, right?
410
00:19:55,152 --> 00:19:57,570
Blood clots are treatable
if you catch them in time,
411
00:19:57,571 --> 00:19:59,407
so it's a good thing you're here.
412
00:20:00,783 --> 00:20:02,117
Weird but good.
413
00:20:02,118 --> 00:20:05,203
I should probably be embarrassed,
but I'm proud of us.
414
00:20:05,204 --> 00:20:07,497
All my friends got bored of their spouses
415
00:20:07,498 --> 00:20:11,167
and filed for divorce,
but we got creative.
416
00:20:11,168 --> 00:20:13,379
By coming to the hospital and having sex.
417
00:20:14,588 --> 00:20:17,424
Don't be jealous. I'm sure other people
aren't getting any either.
418
00:20:17,425 --> 00:20:19,218
All right, let me see.
419
00:20:22,054 --> 00:20:24,973
Looks like there's
a left iliac vein thrombosis.
420
00:20:24,974 --> 00:20:26,266
Hal was right. DVT.
421
00:20:26,267 --> 00:20:30,103
If you look closely,
the iliac artery is compressing the vein.
422
00:20:30,104 --> 00:20:32,105
- May-Thurner syndrome.
- Mm-hmm.
423
00:20:32,106 --> 00:20:33,773
All right, let's book an angio suite
424
00:20:33,774 --> 00:20:37,402
for a thrombectomy and iliac vein stenting
and start practicing.
425
00:20:37,403 --> 00:20:39,739
I'm gonna supervise
you doing the procedure.
426
00:20:41,323 --> 00:20:42,908
- Me?
- She means me.
427
00:20:43,701 --> 00:20:47,037
I don't care who it is as long as
you guys are prepped and ready to go.
428
00:20:51,083 --> 00:20:52,542
You really think this will work?
429
00:20:52,543 --> 00:20:55,712
The challenge, right,
has always been the pressure
430
00:20:55,713 --> 00:20:58,131
that your tumor is putting on your heart,
431
00:20:58,132 --> 00:21:01,718
your lungs and major arteries
when you're positioned for surgery.
432
00:21:01,719 --> 00:21:03,428
And the ECMO machine makes that irrelevant
433
00:21:03,429 --> 00:21:05,597
because it oxygenates
and pumps your blood for you.
434
00:21:05,598 --> 00:21:08,516
So no matter what happens,
your body will receive oxygen
435
00:21:08,517 --> 00:21:10,894
and blood flow while we work.
436
00:21:10,895 --> 00:21:13,146
I can't believe you
actually figured it out.
437
00:21:13,147 --> 00:21:16,399
Have you done this before?
I mean, how common is this ECMO?
438
00:21:16,400 --> 00:21:19,486
Charlie, you said you were in
if they figured it out.
439
00:21:19,487 --> 00:21:20,945
How common is it?
440
00:21:20,946 --> 00:21:24,365
It's not common for this,
and it can be hard to wean off ECMO
441
00:21:24,366 --> 00:21:27,243
after removing something that's
compressed your lung for so long,
442
00:21:27,244 --> 00:21:28,578
but her heart is healthy.
443
00:21:28,579 --> 00:21:30,371
I don't anticipate that being a problem.
444
00:21:30,372 --> 00:21:32,750
But it could be a problem.
445
00:21:35,753 --> 00:21:37,379
You almost lost me twice.
446
00:21:38,297 --> 00:21:42,217
If we do nothing,
this thing just keeps growing inside me
447
00:21:42,218 --> 00:21:47,598
until it squashes all my organs
and I'm definitely gone.
448
00:21:48,516 --> 00:21:49,934
I don't wanna live like that.
449
00:21:51,685 --> 00:21:54,103
Slowly suffocating.
450
00:21:54,104 --> 00:21:57,942
I don't want you to have
to watch me live like that.
451
00:21:58,651 --> 00:22:02,112
We asked them to come up with a solution.
452
00:22:04,198 --> 00:22:05,615
I'm taking it.
453
00:22:05,616 --> 00:22:07,867
Okay, Dr. Griffith and Dr. Adams
will get you prepped.
454
00:22:07,868 --> 00:22:10,162
We will see you in the OR, okay?
455
00:22:15,125 --> 00:22:16,626
Is it weird that he's not blinking?
456
00:22:16,627 --> 00:22:19,003
Newborn tear ducts aren't fully developed.
457
00:22:19,004 --> 00:22:20,923
It's so cool that you know all this stuff.
458
00:22:22,007 --> 00:22:25,426
Is it bad if I'm not, like,
feeling anything?
459
00:22:25,427 --> 00:22:27,471
You mean you don't feel a bond?
460
00:22:28,806 --> 00:22:30,682
- I'm already a terrible mom.
- No.
461
00:22:30,683 --> 00:22:34,310
No, it's completely normal,
and you're exhausted,
462
00:22:34,311 --> 00:22:36,479
and your hormones are all over the place.
463
00:22:36,480 --> 00:22:39,190
And to be honest,
newborns are kinda just blobs.
464
00:22:39,191 --> 00:22:42,652
In a few weeks, he'll be
laughing and smiling, and it just...
465
00:22:42,653 --> 00:22:44,445
it gets so much better.
466
00:22:44,446 --> 00:22:45,990
You're a really good doctor.
467
00:22:47,032 --> 00:22:48,992
Are you taking new patients?
468
00:22:48,993 --> 00:22:50,702
- Well, it's--
- Hey.
469
00:22:50,703 --> 00:22:53,788
- How're my girls?
- Hey. Well, we made a new friend--
470
00:22:53,789 --> 00:22:57,041
- Whoa. Oh, my God.
- Oh. Oh. Someone call a rapid response!
471
00:22:57,042 --> 00:22:59,127
Right away, Doctor.
472
00:23:06,802 --> 00:23:08,053
She's still seizing.
473
00:23:09,471 --> 00:23:11,389
Someone give me IM midazolam.
474
00:23:11,390 --> 00:23:13,975
She's seven days postpartum.
Check her blood pressure.
475
00:23:13,976 --> 00:23:16,060
It's probably eclampsia.
She needs mag now.
476
00:23:16,061 --> 00:23:18,688
Did she have any symptoms
before she started seizing?
477
00:23:18,689 --> 00:23:21,107
No, she seemed completely fine.
It came out of nowhere.
478
00:23:21,108 --> 00:23:23,318
- We'll need to get her up to OB.
- Will you go up with her?
479
00:23:23,319 --> 00:23:24,445
Whatever you want.
480
00:23:25,195 --> 00:23:27,448
Call me when you get up there. Okay.
481
00:23:31,619 --> 00:23:32,870
Scissors.
482
00:23:34,038 --> 00:23:37,458
- Put two units of blood on standby.
- Lap pad.
483
00:23:39,418 --> 00:23:43,922
All right, I secured the cannula.
Adams, are we ready to remove the clamps?
484
00:23:43,923 --> 00:23:45,424
Yeah, ECMO's ready.
485
00:23:50,054 --> 00:23:52,764
Okay, let dark flow.
486
00:23:52,765 --> 00:23:53,932
We have full flow.
487
00:23:53,933 --> 00:23:56,059
Let's try lowering her down.
488
00:24:02,524 --> 00:24:05,109
- At least that worked.
- We're gonna make all of it work.
489
00:24:05,110 --> 00:24:07,445
Griffith, Adams, you may never
see another case like this again,
490
00:24:07,446 --> 00:24:08,821
so keep your eyes on the field.
491
00:24:08,822 --> 00:24:12,492
If you see any signs of
hemodynamic instability, speak up.
492
00:24:12,493 --> 00:24:15,912
This is not a race.
Our goal is not to finish fast.
493
00:24:15,913 --> 00:24:18,331
It is to keep her safe.
494
00:24:18,332 --> 00:24:19,791
- Understood?
- Mm-hmm.
495
00:24:19,792 --> 00:24:20,793
Okay.
496
00:24:21,835 --> 00:24:23,252
Okay, London.
497
00:24:23,253 --> 00:24:26,131
Let's intubate.
498
00:24:29,593 --> 00:24:32,095
It's a hormonally active adrenal mass,
499
00:24:32,096 --> 00:24:34,555
so you need to watch out
for sudden hypertension.
500
00:24:34,556 --> 00:24:36,391
- I'm planning to use alpha-blockers.
- Good.
501
00:24:36,392 --> 00:24:39,686
Well, I assume you're gonna do this open,
given the size?
502
00:24:39,687 --> 00:24:42,814
That's the plan.
My colleague will actually do it.
503
00:24:42,815 --> 00:24:45,274
I usually stick to robotic procedures.
504
00:24:45,275 --> 00:24:48,277
Oh. You got something
against the old-fashioned way?
505
00:24:48,278 --> 00:24:52,407
No, um... ...I have MS,
506
00:24:52,408 --> 00:24:56,327
so standing for long periods
in the OR just isn't an option.
507
00:24:56,328 --> 00:24:58,871
I didn't realize. I'm sorry.
508
00:24:58,872 --> 00:25:00,206
No need to be sorry.
509
00:25:00,207 --> 00:25:04,043
I mean, I was devastated
after I got the diagnosis.
510
00:25:04,044 --> 00:25:06,421
I had put in so much work my whole career,
511
00:25:06,422 --> 00:25:10,050
and the thought of no longer
being in the OR was soul-crushing...
512
00:25:10,759 --> 00:25:12,094
to say the least.
513
00:25:12,845 --> 00:25:15,514
But that's when I realized
it was just my fear talking.
514
00:25:16,598 --> 00:25:21,561
And I looked at my symptoms, muscle pain
and leg weakness, and I thought,
515
00:25:21,562 --> 00:25:23,771
"If only there was a way to operate
516
00:25:23,772 --> 00:25:27,985
while sitting down
without having to hold a scalpel."
517
00:25:29,486 --> 00:25:31,821
Was it a difficult adjustment?
518
00:25:31,822 --> 00:25:35,033
Adjusting to living with
a chronic illness is never easy.
519
00:25:35,034 --> 00:25:39,079
But over time,
I just turned MS into a pivot.
520
00:25:40,080 --> 00:25:41,165
Not an ending.
521
00:25:42,166 --> 00:25:44,834
Well, you seem to be managing well.
522
00:25:44,835 --> 00:25:48,421
Oh, well, I have my ups and downs,
believe me.
523
00:25:48,422 --> 00:25:52,175
But Catherine Fox is flying me
around on her private plane
524
00:25:52,176 --> 00:25:54,720
and paying me more money
than I know what to do with.
525
00:25:56,305 --> 00:25:57,973
And I still get to do what I love.
526
00:25:58,766 --> 00:26:00,809
Even if it is in a different way.
527
00:26:03,020 --> 00:26:06,981
Now they're gonna go ahead with
Bailey's giant teratoma in OR two.
528
00:26:06,982 --> 00:26:10,276
- Ndugu's gonna have to resect--
- Can we just focus, please?
529
00:26:10,277 --> 00:26:11,986
It's a fake patient. Calm down.
530
00:26:11,987 --> 00:26:13,821
Don't tell me to calm down.
531
00:26:13,822 --> 00:26:16,074
What is wrong with you?
532
00:26:16,075 --> 00:26:19,619
Is it about Simone
breaking that dumb pact?
533
00:26:19,620 --> 00:26:22,371
No, and stop asking. I'm fine.
534
00:26:22,372 --> 00:26:24,332
No, you don't seem fine.
535
00:26:24,333 --> 00:26:27,376
Well, it's because you are bothering me.
536
00:26:27,377 --> 00:26:29,837
Well, that can't be it.
I always bother you.
537
00:26:29,838 --> 00:26:30,964
I'm just...
538
00:26:32,549 --> 00:26:35,259
I'm just tired.
539
00:26:35,260 --> 00:26:36,594
Every day is the same.
540
00:26:36,595 --> 00:26:41,390
It's the same people and the same rooms
and the same conversations,
541
00:26:41,391 --> 00:26:44,018
and I'm just sick of it.
542
00:26:44,019 --> 00:26:46,646
Well, I am sorry
we are not good enough for you.
543
00:26:46,647 --> 00:26:48,022
I didn't say that.
544
00:26:48,023 --> 00:26:51,443
Yeah, you don't have to defend yourself.
We all know you're aloof.
545
00:27:00,077 --> 00:27:03,121
- You're leaving?
- Yeah, I've already done a thrombectomy.
546
00:27:03,122 --> 00:27:04,665
You can have it.
547
00:27:10,796 --> 00:27:12,630
What's happening? Who's the doctor?
548
00:27:12,631 --> 00:27:16,342
- Uh... John Burnett.
- An intern?
549
00:27:16,343 --> 00:27:18,302
- Let's get a CT.
- They're getting a CT.
550
00:27:18,303 --> 00:27:19,929
No, she has eclampsia.
551
00:27:19,930 --> 00:27:21,973
Tell him she needs magnesium.
552
00:27:21,974 --> 00:27:23,683
- Really?
- Tell him.
553
00:27:23,684 --> 00:27:25,560
I...
554
00:27:25,561 --> 00:27:27,979
Excuse me,
I've got Jo Wilson on the phone,
555
00:27:27,980 --> 00:27:30,398
and she says it's eclampsia,
and you should start her on magnesium.
556
00:27:30,399 --> 00:27:33,818
Her BP is only 143 over 91.
It could be an intracranial hemorrhage.
557
00:27:33,819 --> 00:27:36,029
- Put me on speaker.
- Um...
558
00:27:37,364 --> 00:27:39,448
Okay. You're on speaker.
559
00:27:39,449 --> 00:27:40,908
I understand your concern,
560
00:27:40,909 --> 00:27:44,620
but postpartum eclampsia doesn't always
present with a really high BP.
561
00:27:44,621 --> 00:27:46,122
Neither does a brain bleed.
562
00:27:46,123 --> 00:27:48,165
- Barnett.
- It's-- It's Burnett.
563
00:27:48,166 --> 00:27:49,834
Whatever. I may be on leave,
564
00:27:49,835 --> 00:27:52,587
but that doesn't mean that I can't
schedule you to work every holiday
565
00:27:52,588 --> 00:27:55,214
and make your life miserable.
So trust me when I tell you
566
00:27:55,215 --> 00:27:57,634
to start the mag now.
567
00:28:00,012 --> 00:28:01,388
Start IV magnesium.
568
00:28:07,686 --> 00:28:09,438
Your mom's gonna be okay.
569
00:28:11,565 --> 00:28:13,149
We're gonna have
to take part of the lower lobe.
570
00:28:13,150 --> 00:28:14,525
Adams, you wanna staple the lung?
571
00:28:14,526 --> 00:28:15,610
Yep. Stapler.
572
00:28:15,611 --> 00:28:17,987
Bailey, you ready to start
resecting the adhered diaphragm?
573
00:28:17,988 --> 00:28:19,655
Hey, ready when you are.
574
00:28:19,656 --> 00:28:22,241
Griffith,
what should we be careful to avoid?
575
00:28:22,242 --> 00:28:24,118
Hepatic veins and the retro-hepatic IVC.
576
00:28:24,119 --> 00:28:25,786
Good. Let's get the next stapler ready.
577
00:28:25,787 --> 00:28:30,166
London thought fixing
up a summer house was a lot of work.
578
00:28:30,167 --> 00:28:33,336
- It's got nothing on fixing up a torso.
- Reload, please.
579
00:28:35,213 --> 00:28:39,133
- Uh, BP is bottoming out.
- Damn it. I don't see any bleeding.
580
00:28:39,134 --> 00:28:40,468
Neither do I. The staple line looks clean.
581
00:28:40,469 --> 00:28:42,595
Well, something's got to be causing this.
What the hell is it?
582
00:28:42,596 --> 00:28:46,557
- Does the ECMO say anything?
- There's a suction event alarm.
583
00:28:46,558 --> 00:28:50,061
Okay. Since we took pressure off the lung,
could there be volume shifts?
584
00:28:50,062 --> 00:28:51,520
That's definitely possible. Yeah.
585
00:28:51,521 --> 00:28:54,231
Okay, we need to up her pressors
and flood her with fluids.
586
00:28:54,232 --> 00:28:57,194
If we don't get flow back right away,
she's done.
587
00:29:02,950 --> 00:29:04,283
Push fluids as hard as you can.
588
00:29:04,284 --> 00:29:05,618
- I am.
- BP's still dropping.
589
00:29:05,619 --> 00:29:09,080
She can't take this much longer.
I should've listened to that board.
590
00:29:09,081 --> 00:29:10,873
- If I lose her--
- This is not on you.
591
00:29:10,874 --> 00:29:13,834
Come on, come on, come on. Come on.
592
00:29:13,835 --> 00:29:15,211
BP's coming back up.
593
00:29:16,755 --> 00:29:20,092
- Well, that was close.
- Okay, folks.
594
00:29:20,968 --> 00:29:23,761
There's still a lot of tumor left.
595
00:29:23,762 --> 00:29:28,224
Griffith, you're on the liver resection.
Adams, you're on the superior mediastinum.
596
00:29:28,225 --> 00:29:30,060
If that's okay with you?
597
00:29:31,395 --> 00:29:33,270
Do what we say when we say it.
598
00:29:33,271 --> 00:29:34,398
Stapler.
599
00:29:39,486 --> 00:29:40,696
Contrast.
600
00:29:43,115 --> 00:29:46,034
There's the occlusion in the iliac vein.
Advance more.
601
00:29:47,703 --> 00:29:51,623
Okay, pin the guide wire and turn
on the thrombectomy catheter, please.
602
00:29:53,750 --> 00:29:55,668
It's a shame Janet
isn't awake to see this.
603
00:29:55,669 --> 00:29:57,795
It would really turn her...
604
00:29:57,796 --> 00:30:03,300
into a passionate fan of
biological science and anatomy.
605
00:30:03,301 --> 00:30:04,760
Okay, I'm in. Turn it off.
606
00:30:04,761 --> 00:30:08,431
I don't get it. If you have to pretend
to be someone else for your partner
607
00:30:08,432 --> 00:30:11,017
to wanna sleep with you,
maybe you shouldn't be together.
608
00:30:11,018 --> 00:30:15,563
I've learned you never know what's
going on in another person's relationship.
609
00:30:15,564 --> 00:30:17,273
Ready.
610
00:30:17,274 --> 00:30:18,358
Contrast.
611
00:30:22,112 --> 00:30:25,781
Thrombus is gone. The vein is patent.
612
00:30:25,782 --> 00:30:27,658
Great work.
613
00:30:27,659 --> 00:30:28,994
Now to stent.
614
00:30:31,538 --> 00:30:35,791
Thanks again for the consult.
I see why Catherine calls you legendary.
615
00:30:35,792 --> 00:30:38,127
Well, she is prone to exaggeration.
616
00:30:38,128 --> 00:30:40,755
I know, but in your case, it's true.
617
00:30:40,756 --> 00:30:43,549
Well, you live up
to your reputation as well.
618
00:30:43,550 --> 00:30:46,219
Oh, but not enough to
consider my recommendation?
619
00:30:48,847 --> 00:30:53,184
- I'm sorry, I-I shouldn't have said that.
- No, it's okay.
620
00:30:53,185 --> 00:30:54,603
Can I ask you about something?
621
00:30:55,771 --> 00:30:57,522
Urosymphyseal fistulas.
622
00:30:59,483 --> 00:31:03,319
They are an extremely rare post-op
complication of radical prostatectomy.
623
00:31:03,320 --> 00:31:05,654
But the odds aren't zero.
624
00:31:05,655 --> 00:31:07,156
They're close.
625
00:31:07,157 --> 00:31:08,575
What if it happened?
626
00:31:09,242 --> 00:31:12,579
Chronic pain,
which often leads to difficulty walking,
627
00:31:13,288 --> 00:31:17,209
possibly warranting the use of opioids.
628
00:31:18,335 --> 00:31:20,712
I can treat complications.
629
00:31:21,463 --> 00:31:25,842
But if your cancer grows and metastasizes,
that's when my hands are tied.
630
00:31:30,097 --> 00:31:34,976
If you change your mind or if you just
wanna talk more, Catherine has my number.
631
00:31:48,156 --> 00:31:50,741
- Done resecting the liver.
- Good.
632
00:31:50,742 --> 00:31:52,201
Excellent hemeostasis.
633
00:31:55,956 --> 00:31:57,873
All right,
no bleeding on this side.
634
00:31:57,874 --> 00:32:01,920
Okay, we are in the home stretch.
Let's get ready to get this tumor out.
635
00:32:03,004 --> 00:32:04,964
Hold on, hold on.
636
00:32:04,965 --> 00:32:07,134
- Do you hear that?
- What?
637
00:32:09,678 --> 00:32:11,929
Okay, we're gonna need more lap pads,
and hang blood.
638
00:32:11,930 --> 00:32:13,640
Adams, quickly pack her.
639
00:32:14,432 --> 00:32:17,144
Goddamn it!
All right, keep the suction coming.
640
00:32:17,686 --> 00:32:19,353
Oh... ...wait, wait.
641
00:32:19,354 --> 00:32:24,859
Okay, there's a tear where the IVC passes
through the diaphragm into the chest.
642
00:32:24,860 --> 00:32:28,279
I'm trying to secure...
Let-Let me have a clamp.
643
00:32:28,280 --> 00:32:29,780
Okay, I need visualization.
644
00:32:29,781 --> 00:32:31,574
Put the suction on the lap pads.
645
00:32:31,575 --> 00:32:33,618
Not too harsh,
gentle steady pressure, okay?
646
00:32:36,913 --> 00:32:39,540
♪ And all of the time ♪
647
00:32:39,541 --> 00:32:41,041
I think I got it.
648
00:32:41,042 --> 00:32:42,961
♪ Through it all ♪
649
00:32:44,171 --> 00:32:47,006
Oh, she's stabilizing.
650
00:32:47,007 --> 00:32:49,175
Okay, everyone,
on the count of three.
651
00:32:49,176 --> 00:32:50,885
Everyone needs to help with the specimen.
652
00:32:50,886 --> 00:32:52,178
Okay, ready?
653
00:32:52,179 --> 00:32:55,556
One, two, three.
654
00:33:00,270 --> 00:33:01,271
Okay.
655
00:33:02,606 --> 00:33:07,776
♪ There is hope in another day ♪
656
00:33:07,777 --> 00:33:08,862
Okay.
657
00:33:09,362 --> 00:33:11,405
How do you all feel
about getting the hell out of here?
658
00:33:11,406 --> 00:33:13,575
You don't have to ask me twice. Bovie.
659
00:33:14,492 --> 00:33:16,494
Two-O prolene.
660
00:33:18,496 --> 00:33:23,000
♪ Never glowing differently... ♪
661
00:33:23,001 --> 00:33:24,044
You can stop here.
662
00:33:24,711 --> 00:33:25,754
Iris.
663
00:33:26,463 --> 00:33:27,838
Hey, what are you doing up here?
664
00:33:27,839 --> 00:33:31,508
So a mom from the NICU is being
treated for postpartum eclampsia.
665
00:33:31,509 --> 00:33:34,803
Can you look up her chart?
Her name is Gina...
666
00:33:34,804 --> 00:33:35,889
I don't know her last name.
667
00:33:36,473 --> 00:33:38,683
I'm sorry, I can't. You're not her doctor.
668
00:33:40,018 --> 00:33:41,311
I just wanna check on her.
669
00:33:42,270 --> 00:33:46,441
- Do you want me to call Marcus for you?
- No, what I want is my friend's chart.
670
00:33:47,609 --> 00:33:49,276
- I'm sorry, Jo.
- Stop saying you're sorry.
671
00:33:49,277 --> 00:33:51,737
Sorry doesn't help me.
I'm this woman's only friend right now
672
00:33:51,738 --> 00:33:54,698
and the person in charge of her care
has been a doctor for about 90 days.
673
00:33:54,699 --> 00:33:56,784
So, if you could just
please remove the stick from--
674
00:33:56,785 --> 00:33:58,786
- Jo.
- All I want right now--
675
00:33:58,787 --> 00:34:00,746
- I think we should go.
- No, we're not gonna go.
676
00:34:00,747 --> 00:34:01,830
- I-- No.
- Yeah.
677
00:34:01,831 --> 00:34:04,458
You cannot move me against my will.
678
00:34:04,459 --> 00:34:07,253
Stop! I...
679
00:34:07,254 --> 00:34:09,088
This is not okay.
680
00:34:09,089 --> 00:34:10,506
Can you give me a minute?
681
00:34:10,507 --> 00:34:11,966
- This is--
- Hey, hey, hey, hey.
682
00:34:11,967 --> 00:34:14,261
Look, I know you're scared, okay? But...
683
00:34:15,595 --> 00:34:17,889
Hey, she's just trying to do her job.
684
00:34:35,782 --> 00:34:39,451
It will take a few days to wean her
off ECMO. She does have a long recovery.
685
00:34:39,452 --> 00:34:41,745
- But she's gonna come home?
- Eventually.
686
00:34:41,746 --> 00:34:43,998
That is the plan.
687
00:34:43,999 --> 00:34:46,083
I don't know how to thank you.
688
00:34:46,084 --> 00:34:48,002
I think you just did.
689
00:34:50,171 --> 00:34:53,299
She's always been able
to see what I can't.
690
00:34:53,300 --> 00:34:59,221
Her mind is filled with these big ideas
that always seem impossible.
691
00:34:59,222 --> 00:35:04,352
Our wedding, this lake house,
getting this tumor removed.
692
00:35:05,979 --> 00:35:07,480
But she knew you could do it.
693
00:35:09,566 --> 00:35:11,067
And she was right.
694
00:35:12,277 --> 00:35:15,655
I almost... ...tried to stop her.
695
00:35:17,574 --> 00:35:19,492
But I'm glad I stayed out of it.
696
00:35:20,910 --> 00:35:24,246
Hey, um, we'll let you both get some rest.
697
00:35:24,247 --> 00:35:26,207
Thank you.
698
00:35:28,960 --> 00:35:30,836
Great work today, Griffith.
699
00:35:30,837 --> 00:35:33,631
You and Adams, you really stepped up.
700
00:35:33,632 --> 00:35:37,385
Thank you. I really appreciate
the opportunity. I learned a lot.
701
00:35:41,056 --> 00:35:46,268
We did a good thing today.
702
00:35:46,269 --> 00:35:49,730
- Some might call it inspiring.
- Mmm.
703
00:35:49,731 --> 00:35:51,398
Might be even something
704
00:35:51,399 --> 00:35:53,776
you could lecture about.
705
00:35:53,777 --> 00:35:57,446
Hey, I hope I didn't overstep, you know,
jumping in with the residents.
706
00:35:57,447 --> 00:36:00,741
Oh, no. I mean, if I'm the only voice
that's teaching them,
707
00:36:00,742 --> 00:36:02,285
they'll wind up tuning me out.
708
00:36:03,203 --> 00:36:04,828
What do you think
about having the residents
709
00:36:04,829 --> 00:36:07,331
do an ambulance ride-along
or EMS training?
710
00:36:07,332 --> 00:36:10,250
Something that could really get
them thinking on their feet, you know?
711
00:36:10,251 --> 00:36:15,464
It could help them in the ER
or in situations like today in the OR.
712
00:36:15,465 --> 00:36:19,636
I think you should write up
a proposal and send it to me.
713
00:36:23,431 --> 00:36:24,723
The surgery went well.
714
00:36:24,724 --> 00:36:27,059
We were able
to clear the clot and put in a stent.
715
00:36:27,060 --> 00:36:28,143
Thank you.
716
00:36:28,144 --> 00:36:29,812
You'll need to be on anticoagulation
717
00:36:29,813 --> 00:36:34,024
but after a while, you'll be able to get
back to life as usual.
718
00:36:34,025 --> 00:36:37,611
I'll get back to life
as usual right away or...
719
00:36:37,612 --> 00:36:39,238
"When can I have sex?" is what I'm asking.
720
00:36:39,239 --> 00:36:40,823
Yeah, we know.
721
00:36:40,824 --> 00:36:42,408
You need to elevate your leg when resting
722
00:36:42,409 --> 00:36:45,286
but other than that,
it is good to move it around.
723
00:36:47,122 --> 00:36:49,123
I guess Trudy can still see the doctor.
724
00:36:49,124 --> 00:36:51,834
Trudy's always a good time.
725
00:36:51,835 --> 00:36:55,964
But, honey,
I love you most when you're just Janet.
726
00:36:59,300 --> 00:37:00,759
We'll give you some privacy.
727
00:37:00,760 --> 00:37:04,848
♪ Let go for dear life
Just free fall ♪
728
00:37:06,015 --> 00:37:10,270
♪ Let go for dear life
Just free fall ♪
729
00:37:11,271 --> 00:37:12,479
♪ Let go... ♪
730
00:37:12,480 --> 00:37:14,357
I checked London's labs before leaving.
731
00:37:15,358 --> 00:37:16,442
Thanks.
732
00:37:16,443 --> 00:37:18,819
Hey, I'm sorry about earlier.
733
00:37:18,820 --> 00:37:22,156
How you interact with your patients,
your business. I'll stay out of it.
734
00:37:22,157 --> 00:37:23,700
I appreciate that.
735
00:37:24,826 --> 00:37:28,162
I do value your opinion though.
736
00:37:28,163 --> 00:37:29,872
- You do?
- I do.
737
00:37:29,873 --> 00:37:35,711
Just, uh, not about relationships.
For obvious reasons.
738
00:37:35,712 --> 00:37:38,130
Ouch.
739
00:37:38,131 --> 00:37:41,383
Hey, look, I'm, uh, putting together
a watch list for my patient.
740
00:37:41,384 --> 00:37:42,676
What am I missing?
741
00:37:42,677 --> 00:37:44,804
Mmm.
742
00:37:46,347 --> 00:37:48,516
Wait, she hasn't seen any of these?
743
00:37:51,102 --> 00:37:52,270
Thank you.
744
00:37:57,192 --> 00:37:59,026
Hey.
745
00:37:59,027 --> 00:38:00,235
Hi.
746
00:38:00,236 --> 00:38:02,070
Did you make it through your busy day?
747
00:38:02,071 --> 00:38:04,115
Uh, I did.
748
00:38:05,200 --> 00:38:07,910
Uh, I did a thrombectomy
and placed a stent.
749
00:38:07,911 --> 00:38:10,120
Nice, Millin.
750
00:38:10,121 --> 00:38:12,998
You still haven't told me
about that thoracotomy, by the way.
751
00:38:12,999 --> 00:38:15,209
It wasn't that big a deal.
752
00:38:15,210 --> 00:38:18,128
Uh, you saved a man's life
with your hands.
753
00:38:18,129 --> 00:38:19,631
Doesn't get any bigger than that.
754
00:38:22,467 --> 00:38:23,968
Do you think I'm aloof?
755
00:38:24,636 --> 00:38:29,473
Aloof? Thank you. Um...
756
00:38:29,474 --> 00:38:31,016
No.
757
00:38:31,017 --> 00:38:33,811
You're discerning,
you don't suffer any fools.
758
00:38:33,812 --> 00:38:36,688
But... ...that's not aloof.
759
00:38:36,689 --> 00:38:41,236
That's, um, that's protecting yourself
because you care.
760
00:38:43,696 --> 00:38:47,449
It's funny you say that
because I-I have been...
761
00:38:47,450 --> 00:38:50,118
I had the worst day.
762
00:38:50,119 --> 00:38:53,330
I need the biggest vodka tonic
that they have.
763
00:38:53,331 --> 00:38:55,249
Hi, I'm Iris.
764
00:38:55,250 --> 00:38:57,626
Uh, this is Jules Millin,
a surgical resident.
765
00:38:57,627 --> 00:38:59,253
- Nice to meet you.
- Nice to meet you.
766
00:38:59,254 --> 00:39:02,257
Um, I should go find my friends.
767
00:39:03,883 --> 00:39:05,467
- Here.
- Thank you.
768
00:39:05,468 --> 00:39:06,885
See you later.
769
00:39:06,886 --> 00:39:09,471
It's jarring
when your identity shifts.
770
00:39:09,472 --> 00:39:12,851
When you're suddenly
a doctor, a partner, a parent.
771
00:39:13,768 --> 00:39:16,520
It helps if you focus on
the things that haven't changed.
772
00:39:16,521 --> 00:39:18,231
I'm gonna have to change hospitals.
773
00:39:19,148 --> 00:39:21,525
I've cried in front of
too many people at this one.
774
00:39:21,526 --> 00:39:22,901
They understand.
775
00:39:25,530 --> 00:39:30,450
I just feel like
ever since I was admitted, I just...
776
00:39:30,451 --> 00:39:32,370
I just lost myself.
777
00:39:34,205 --> 00:39:36,081
I can't take care of our kids.
778
00:39:36,082 --> 00:39:40,210
I can't take care of my patients.
I can't even shower.
779
00:39:40,211 --> 00:39:42,212
It's temporary.
780
00:39:42,213 --> 00:39:43,755
Your heart is recovering.
781
00:39:43,756 --> 00:39:44,966
I know.
782
00:39:46,092 --> 00:39:52,431
But for a few hours today,
I got to be a doctor again
783
00:39:52,432 --> 00:39:54,766
and help this woman
navigate a difficult time
784
00:39:54,767 --> 00:40:01,024
but then when it really mattered,
someone else got to help her.
785
00:40:02,650 --> 00:40:04,110
At least Gina is okay.
786
00:40:04,986 --> 00:40:09,032
And I would bet that she'd
say what you did mattered too.
787
00:40:10,783 --> 00:40:12,118
Maybe even more.
788
00:40:14,329 --> 00:40:16,080
Oh, God. It's happening again.
789
00:40:16,915 --> 00:40:20,335
- No.
- I'll get the tissues.
790
00:40:22,837 --> 00:40:27,133
Just...
791
00:40:27,800 --> 00:40:29,468
The comfort of old friends.
792
00:40:29,469 --> 00:40:32,387
Thirty-five pounds?
That's like carrying four babies.
793
00:40:32,388 --> 00:40:34,306
Yeah, or four bowling balls.
794
00:40:34,307 --> 00:40:37,518
- Who carries four bowling balls?
- People do weird things.
795
00:40:38,811 --> 00:40:39,938
Gotta go.
796
00:40:44,567 --> 00:40:46,027
Yeah, I'm out too.
797
00:40:47,111 --> 00:40:48,320
See you tomorrow.
798
00:40:48,321 --> 00:40:51,240
♪ ...running off the track
Oh yeah ♪
799
00:40:53,451 --> 00:40:54,702
♪ Yeah ♪
800
00:40:56,329 --> 00:40:59,164
She's just a stop sign, not a roadblock.
801
00:40:59,165 --> 00:41:00,248
How did you...
802
00:41:02,085 --> 00:41:05,420
Doesn't matter.
Wait, are you leaving me too?
803
00:41:05,421 --> 00:41:09,092
Um, sorry. Um, hey, have a drink on me.
804
00:41:09,634 --> 00:41:12,470
♪ ...to feel the pressure ♪
805
00:41:13,429 --> 00:41:14,930
♪ Pressure ♪
806
00:41:14,931 --> 00:41:16,014
Anyone sitting here?
807
00:41:16,015 --> 00:41:21,436
♪ Yeah
Even if you stayed ♪
808
00:41:21,437 --> 00:41:23,313
The thrill of trying something new.
809
00:41:23,314 --> 00:41:24,773
Hi, I'm Sally.
810
00:41:24,774 --> 00:41:27,651
Because even though you
may not recognize yourself...
811
00:41:27,652 --> 00:41:28,695
Catherine.
812
00:41:29,654 --> 00:41:32,572
I'm sorry. I am so sorry.
813
00:41:32,573 --> 00:41:35,701
I got scared and I just
called the best that I knew.
814
00:41:35,702 --> 00:41:37,703
I should've talked to you
before bringing Laura in.
815
00:41:37,704 --> 00:41:43,291
Look, I thought a lot about
letting fear cloud judgment today.
816
00:41:43,292 --> 00:41:45,712
Whatever you wanna do, I support--
817
00:41:47,046 --> 00:41:48,463
I'm a surgeon.
818
00:41:48,464 --> 00:41:50,508
I'm a senior member of this hospital.
819
00:41:51,551 --> 00:41:52,843
If something were to go wrong
820
00:41:52,844 --> 00:41:59,434
and I couldn't stand long enough
to do a simple appy, I'd feel weak.
821
00:42:00,518 --> 00:42:02,145
And I don't know how to lead like that.
822
00:42:02,687 --> 00:42:04,188
I don't know who I'd be.
823
00:42:05,231 --> 00:42:06,607
But people adapt.
824
00:42:07,442 --> 00:42:09,276
I wanna go ahead with the surgery.
825
00:42:10,611 --> 00:42:14,532
♪ I'm under pressure
I feel pressure ♪
826
00:42:15,908 --> 00:42:17,744
...it's been you all along.
66185
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