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[Grey] In college,
I was the hungover premed
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who fell asleep at her study carrel.
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00:00:09,869 --> 00:00:11,536
[podcaster] If you're
just joining our podcast,
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00:00:11,537 --> 00:00:13,455
my guests are doctors Teddy Altman
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00:00:13,456 --> 00:00:16,041
and Winston Ndugu
from Grey-Sloan Memorial,
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00:00:16,042 --> 00:00:19,294
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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[Ndugu] Immediately.
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- [podcaster] Really?
- Yeah. Once that staple held, I knew.
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Sometimes you just have a feeling.
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[Grey] In med school,
I was the famous surgeon's daughter.
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[podcaster] It wasn't like that for you?
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[Altman] 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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[Grey] Now I'm the famous surgeon.
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- So you had doubts?
- [Ndugu] Oh, yeah.
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[Altman] I was never certain
it would work,
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but our patient
didn't have any other option.
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I knew that we had to try.
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[Grey] In medicine, your identity
is constantly changing.
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It's your job to keep up.
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[podcaster] Safe to say it worked out.
What's next for you both?
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[Altman] Well, we're still monitoring
our patients' progress.
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- [podcaster] And?
- [Ndugu] So far so good.
25
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They sound really good, very competent.
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Yeah. I'd come to this hospital.
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Well, speaking of...
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I made an appointment for you.
29
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We talked about this, Catherine.
I don't need another opinion.
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I like Dr. Freeman.
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I know you do because he goes
along with whatever you want.
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You don't think doctors
should listen to their patients?
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I think you need objective advice from
someone whose paycheck you don't sign.
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[sighs]
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It's just another opinion.
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Who am I seeing?
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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.
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- Hey.
- Hey.
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Hey, nice job on that podcast.
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I didn't realize you and Altman
came up with that at our wedding.
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Yeah, you never know
when an idea will strike. [chuckles]
47
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Go ahead, Dr. Adams.
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Uh, yes. Uh, Jo Wilson.
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Post-op day seven from emergency
C-section and Impella CP placement.
50
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Now post-op day three from a 5.5 placement
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00:02:03,024 --> 00:02:04,524
through the right axillary artery.
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Her heart function continues to recover
with her EF up another five percent,
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and I heard she got
to meet her babies yesterday.
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- How are they doing?
- Um.
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Peyton's off of CPAP but still fragile.
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Hattie's bilirubin levels are bad
every time they pause phototherapy.
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And you're all headed
in the right direction.
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That's what matters.
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I just...
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really want the six of us
to finally be together.
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Jo, you will never guess
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who Marcus walked out with last night.
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- Dr. Ndugu.
- [chuckling] Hey.
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- I didn't know you were doing rounds.
- Yeah.
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I'll come back later.
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What was that?
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- What was what?
- Did you sleep with my favorite nurse?
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- Jo...
- Uh, should I leave?
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We've just gone out a couple times.
That's all.
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Well, are you gonna take her out again?
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Uh, just... Maybe. It's new.
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And none of our business.
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[crying] She is the entire department's
favorite nurse.
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Everybody loves her. Everyone.
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[sniffles]
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[sobs]
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- [whispering] Hormones.
- Okay.
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Uh, I-I need to check on my next patient.
Are you gonna be okay?
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- Yeah.
- Uh, page me if you need anything.
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[both muttering]
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Good morning.
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Traitor.
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- Trouble in paradise?
- I broke our pact.
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- She's bitter.
- Then you should break it too.
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What, I can just snap my fingers?
Who am I supposed to sleep with?
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I ordered an X-ray
for Ms. Johnson's left arm.
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It was the right arm, wasn't it?
88
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I will fix it. [chuckles]
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An intern? Please. I have dignity.
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- Don't knock it until you've tried it.
- Tried what?
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Vegan sloppy joes.
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You sleeping with an intern too?
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Wait. Who's sleeping with an intern?
[chuckles]
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I am. Who are you texting?
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Nobody.
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- Doesn't look like nobody.
- Nah, she's just a patient.
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Why are you texting a patient?
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Well, Bailey made me
drive her an hour to get treatment,
99
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and now she's sending me dumb memes.
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- It's nothing.
- Wear a condom.
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She's a cancer patient.
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Hey. Did you see
that I admitted Mr. Howard?
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You don't have to put your phone down.
104
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- It's fine.
- Sorry.
105
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My phone has been blowing up
since the podcast dropped.
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I listened. You sounded great.
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00:04:09,567 --> 00:04:12,110
Well, now I've got doctors
reaching out about their patients,
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and the department chief from Mass General
has asked me to do grand rounds.
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Hmm. Sounds rough.
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Well, it's not like I'm getting
a Nobel Prize.
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I mean, MGH asks
everyone to guest lecture.
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They never asked me,
and I went to Harvard.
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Anyway, so, Mr. Howard,
his EKG shows a conduction block.
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- Do you want an echo?
- Um, yes. Sorry, I have to take this.
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Hi, this is Altman.
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Hi, Janet, I'm, uh, Dr. Millin.
I hear you're having some leg pain.
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Yeah, and some heaviness.
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I'm concerned it might be a DVT.
I think she should have an ultrasound.
119
00:04:40,139 --> 00:04:44,644
I assume you want a full workup.
CBC, D-dimer, and a duplex ultrasound?
120
00:04:45,645 --> 00:04:47,020
I'm Jules Millin.
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I'm a second-year surgical resident.
You're internal medicine, right?
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Oh, no. Oh. I'm not a doctor.
[chuckling] Sorry. Yeah.
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- Oh, we were role-playing.
- Yeah.
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The more medical terms,
the better it gets.
125
00:04:57,907 --> 00:05:00,368
- Yeah.
- So, Hal does his homework.
126
00:05:01,577 --> 00:05:04,162
- So do you have leg pain or is this...
- Oh, no, that's real.
127
00:05:04,163 --> 00:05:06,206
The pain started this morning
when we were trying
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00:05:06,207 --> 00:05:07,959
to squeeze in a quickie before work.
129
00:05:08,668 --> 00:05:10,211
- May I do an exam?
- [Janet] Mm-hmm.
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Um, how long did the pain last for?
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- Uh, a few hours?
- Yeah.
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We've been trying
to spice things up lately,
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so we just wanna make sure we haven't,
uh, caused a problem.
134
00:05:22,974 --> 00:05:24,891
Oh, um...
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00:05:24,892 --> 00:05:30,146
DVTs usually occur
with less, um, activity,
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but it is better to be safe than sorry,
so I will order some tests...
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- [Hal] All right.
- ...and get back to you.
138
00:05:36,278 --> 00:05:37,655
- Okay. Thank you.
- Thank you.
139
00:05:39,407 --> 00:05:41,032
[Bailey] Dr. Griffith.
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A 38-year-old female
with a large mediastinal teratoma
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- that has been resistant to chemotherapy.
- [doctors chattering]
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Presents with progressive
shortness of breath,
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orthopnea, and angina.
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It has to be at least 35 pounds.
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And, uh, 27 centimeters
for the longest diameter.
146
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The tumor is displacing
the heart and great vessels.
147
00:05:59,051 --> 00:06:04,514
The SVC is compressed, and it's also
indenting the right lobe of the liver.
148
00:06:04,515 --> 00:06:06,016
Hmm. How are the lungs?
149
00:06:06,017 --> 00:06:08,727
Compressed with near total collapse
of the mid-right and lower lobes.
150
00:06:08,728 --> 00:06:10,687
Has anyone tried to operate on the thing?
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00:06:10,688 --> 00:06:13,064
[stammers] Her name is London
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00:06:13,065 --> 00:06:15,859
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.
154
00:06:19,989 --> 00:06:22,323
But you believe you would have
a different outcome if you tried?
155
00:06:22,324 --> 00:06:28,455
Well, I have removed extremely difficult
tumors before, and this one is benign.
156
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So, if we can successfully remove it,
then she resumes a normal life.
157
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Even if you convinced anesthesia,
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you could still
encounter catastrophic bleeding.
159
00:06:38,090 --> 00:06:40,633
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.
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If anyone here thinks this remotely
is a possibility, please speak up.
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[chuckling] Yes.
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It's a tragic case, Dr. Bailey, but...
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- It's a lawsuit waiting to happen.
- [Bailey stammers, sighs]
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I'll do it with you.
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00:07:10,498 --> 00:07:13,124
- The alternative is hospice, right?
- Mm-hmm.
167
00:07:13,125 --> 00:07:14,793
Dr. Hunt, it just can't be done.
168
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Yeah, well,
you don't know what we're capable of.
169
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[Bailey chuckles]
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- Bye.
- I knew you'd have an idea.
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Yeah, I got nothing.
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[mouthing words]
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{\an8}Well, look who's here.
174
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{\an8}How was your flight?
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{\an8}- Most quiet I've had in months. [chuckles]
- Oh, great.
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{\an8}- Dr. Webber, it's a pleasure.
- Hi.
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{\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.
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00:07:55,626 --> 00:07:57,961
{\an8}She's thrilled she poached me
from Sloan Kettering.
180
00:07:57,962 --> 00:08:02,465
{\an8}You are at the forefront of urologic
oncology, and that lecture that you gave
181
00:08:02,466 --> 00:08:06,135
{\an8}to the American Urological Association
last month brought the house down.
182
00:08:06,136 --> 00:08:11,766
{\an8}And she is developing a program
that uses AI to study biomarkers.
183
00:08:11,767 --> 00:08:13,726
We just received another grant
for it yesterday.
184
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You bet you did.
185
00:08:15,145 --> 00:08:18,231
Now, tell us about my husband's prostate.
186
00:08:18,232 --> 00:08:19,400
Catherine, please.
187
00:08:20,776 --> 00:08:23,236
- If now's not a good time...
- Don't be ridiculous.
188
00:08:23,237 --> 00:08:24,863
Come on, everybody. Sit down.
189
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Have a seat. Come on.
190
00:08:28,284 --> 00:08:30,076
{\an8}Good news is you caught it early.
191
00:08:30,077 --> 00:08:31,744
{\an8}Grade group two, a seven Gleason.
192
00:08:31,745 --> 00:08:35,832
{\an8}Well, he knows all of that.
So tell us, what do you suggest?
193
00:08:35,833 --> 00:08:38,918
{\an8}Well, given the cancer's localized,
and you're generally in good health,
194
00:08:38,919 --> 00:08:41,337
{\an8}I recommend a radical prostatectomy.
195
00:08:41,338 --> 00:08:42,756
{\an8}I couldn't agree more.
196
00:08:43,549 --> 00:08:45,300
{\an8}If you're worried about side effects,
197
00:08:45,301 --> 00:08:49,095
{\an8}urinary incontinence,
erectile dysfunction, they are a risk.
198
00:08:49,096 --> 00:08:51,848
{\an8}- But for many men...
- What about infection?
199
00:08:51,849 --> 00:08:54,225
It's unlikely but possible.
200
00:08:54,226 --> 00:08:59,314
Blood clots, stroke, injury to the rectum,
bladder, nerves?
201
00:08:59,315 --> 00:09:00,774
They're all possible too, right?
202
00:09:04,028 --> 00:09:05,029
{\an8}[clicks tongue] Yeah.
203
00:09:06,488 --> 00:09:07,614
{\an8}Thank you for your time,
204
00:09:07,615 --> 00:09:11,576
{\an8}but I've already selected
an option with my own doctor.
205
00:09:11,577 --> 00:09:12,702
{\an8}Watchful waiting.
206
00:09:12,703 --> 00:09:14,330
{\an8}I've got patients to see.
207
00:09:19,835 --> 00:09:20,919
{\an8}[door closes]
208
00:09:20,920 --> 00:09:22,754
{\an8}[Altman] I'm not seeing abnormalities.
209
00:09:22,755 --> 00:09:24,088
{\an8}What's that wand called?
210
00:09:24,089 --> 00:09:25,381
{\an8}An ultrasound probe.
211
00:09:25,382 --> 00:09:26,800
- Write that down.
- Okay.
212
00:09:27,927 --> 00:09:30,221
All right, the ultrasound is negative.
213
00:09:30,804 --> 00:09:32,347
So, she doesn't have a clot?
214
00:09:32,348 --> 00:09:33,723
Not that I can see.
215
00:09:33,724 --> 00:09:35,600
Sounds like maybe
there still might be one?
216
00:09:35,601 --> 00:09:39,270
{\an8}Well, your D-dimer was slightly elevated,
which is the marker we look at for clots.
217
00:09:39,271 --> 00:09:41,522
{\an8}It doesn't necessarily mean anything,
but it is reason
218
00:09:41,523 --> 00:09:43,191
{\an8}to come back if you have any more pain.
219
00:09:43,192 --> 00:09:46,444
{\an8}Maybe I just need to stretch
before I go to the doctor.
220
00:09:46,445 --> 00:09:47,779
{\an8}- [Hal] Mmm. [chuckles]
- Stretch?
221
00:09:47,780 --> 00:09:48,905
{\an8}Don't ask any questions.
222
00:09:48,906 --> 00:09:51,866
{\an8}I'm gonna start your,
um, discharge paperwork.
223
00:09:51,867 --> 00:09:53,034
{\an8}[Altman] What's that all about?
224
00:09:53,035 --> 00:09:55,161
{\an8}They like to role-play
doctor and patient in bed.
225
00:09:55,162 --> 00:09:56,580
{\an8}Good for them.
226
00:09:58,415 --> 00:10:01,417
{\an8}But they're so cute.
227
00:10:01,418 --> 00:10:02,710
{\an8}Rustic cute?
228
00:10:02,711 --> 00:10:04,879
{\an8}Five reviews say
those rockers broke within a year.
229
00:10:04,880 --> 00:10:05,964
{\an8}[London chuckles]
230
00:10:05,965 --> 00:10:07,048
{\an8}How's the lake house?
231
00:10:07,049 --> 00:10:11,219
{\an8}We've moved from arguing over tile
to arguing over porch chairs.
232
00:10:11,220 --> 00:10:12,303
{\an8}[chuckling]
233
00:10:12,304 --> 00:10:13,388
{\an8}How was the tumor board?
234
00:10:13,389 --> 00:10:17,809
{\an8}Uh, unfortunately,
they are concerned about the risks
235
00:10:17,810 --> 00:10:20,561
{\an8}and recommend that we don't proceed.
236
00:10:20,562 --> 00:10:26,067
{\an8}So naturally I called in reinforcements.
This is Dr. Owen Hunt.
237
00:10:26,068 --> 00:10:28,695
{\an8}- He's one of our trauma surgeons.
- Hi.
238
00:10:28,696 --> 00:10:30,947
If it's okay with you,
I'd like to work with Dr. Bailey
239
00:10:30,948 --> 00:10:33,700
to make sure that we've
explored every possible option.
240
00:10:33,701 --> 00:10:35,201
I want to help.
241
00:10:35,202 --> 00:10:36,537
I like him.
242
00:10:37,788 --> 00:10:41,249
{\an8}If everyone else has reservations,
why do you think you can do it?
243
00:10:41,250 --> 00:10:47,297
Charlie, we've actually found surgeons
that are not giving us a hard no.
244
00:10:47,298 --> 00:10:49,507
And I've almost lost you twice.
245
00:10:49,508 --> 00:10:53,094
I'm definitely not ready to lose you today
from some botched operation.
246
00:10:53,095 --> 00:10:57,181
- Neither are we.
- Hey, I'm still here.
247
00:10:57,182 --> 00:10:59,476
They're just asking
if they can go work on a plan.
248
00:11:00,102 --> 00:11:03,688
If their plan leads
to us growing old together,
249
00:11:03,689 --> 00:11:09,402
{\an8}looking at the water from shoddy
but very cute rocking chairs...
250
00:11:09,403 --> 00:11:10,486
[sighs]
251
00:11:10,487 --> 00:11:13,449
...I'm in. Aren't you?
252
00:11:17,703 --> 00:11:19,829
{\an8}You really think you can
figure out a way to keep
253
00:11:19,830 --> 00:11:21,622
{\an8}her heart from stopping
when she's on that table?
254
00:11:21,623 --> 00:11:24,667
{\an8}Look, if we can't figure this out,
we won't proceed, right?
255
00:11:24,668 --> 00:11:26,962
{\an8}That was our deal when you two came to me.
256
00:11:28,630 --> 00:11:30,590
{\an8}Okay, work on your plan.
257
00:11:30,591 --> 00:11:32,550
{\an8}- Okay.
- We'll be back.
258
00:11:32,551 --> 00:11:33,844
{\an8}Okay.
259
00:11:37,222 --> 00:11:38,849
{\an8}[babies crying]
260
00:11:40,642 --> 00:11:43,854
{\an8}[gasps] Hi, my cuties.
261
00:11:45,856 --> 00:11:47,982
{\an8}They look bigger. Did they get bigger?
262
00:11:47,983 --> 00:11:51,027
{\an8}Hattie's put on a full ounce
in the last 24 hours,
263
00:11:51,028 --> 00:11:53,279
{\an8}- and Peyton isn't far behind.
- That's right.
264
00:11:53,280 --> 00:11:54,989
{\an8}Lincolns know how to bulk.
265
00:11:54,990 --> 00:11:55,991
{\an8}[chuckles]
266
00:11:58,118 --> 00:11:59,952
{\an8}I gotta go to PT. Sure you're okay?
267
00:11:59,953 --> 00:12:01,537
{\an8}- Yeah.
- Okay. You sure?
268
00:12:01,538 --> 00:12:02,623
{\an8}Yeah.
269
00:12:03,957 --> 00:12:05,709
{\an8}- All right.
- Okay.
270
00:12:07,169 --> 00:12:08,253
{\an8}See you soon.
271
00:12:11,173 --> 00:12:12,800
{\an8}You're Peyton and Hattie's mom?
272
00:12:13,550 --> 00:12:15,636
{\an8}Mm-hmm. [chuckling, crying]
273
00:12:17,471 --> 00:12:20,223
{\an8}Sorry, it's just that, um...
274
00:12:20,224 --> 00:12:23,519
{\an8}That's the first time that
somebody's called me their mom.
275
00:12:24,770 --> 00:12:25,771
{\an8}Here.
276
00:12:27,898 --> 00:12:29,983
{\an8}Oh, wait, that one's not clean.
277
00:12:31,360 --> 00:12:32,361
{\an8}- Here.
- Thanks.
278
00:12:33,028 --> 00:12:36,572
{\an8}I'm an OB-GYN, and I talk to my patients
279
00:12:36,573 --> 00:12:39,283
{\an8}all the time about
postpartum hormone drops,
280
00:12:39,284 --> 00:12:43,704
{\an8}but I had no idea it was
this intense and just random.
281
00:12:43,705 --> 00:12:46,290
{\an8}Yesterday, my boyfriend and I were
buying diapers.
282
00:12:46,291 --> 00:12:48,042
{\an8}For me, not the baby.
283
00:12:48,043 --> 00:12:52,547
{\an8}And the guy ringing me up said, "Will
that be all?" And I burst into tears.
284
00:12:52,548 --> 00:12:54,550
It's nice to know that I'm not alone.
285
00:12:57,052 --> 00:12:58,803
What?
286
00:12:58,804 --> 00:13:00,597
You're my first mom friend.
287
00:13:01,223 --> 00:13:03,891
{\an8}Oh. [chuckles] I'm honored.
288
00:13:03,892 --> 00:13:06,644
{\an8}Did you tear or... Can I ask you that?
289
00:13:06,645 --> 00:13:10,064
{\an8}Yeah, you can ask me anything,
but, um, no, I-I didn't tear.
290
00:13:10,065 --> 00:13:14,026
{\an8}I, uh... [sniffs] ...I had something called
a crash C-section.
291
00:13:14,027 --> 00:13:16,196
{\an8}Oh, tell me everything.
292
00:13:17,448 --> 00:13:18,531
{\an8}[Wilson chuckles]
293
00:13:18,532 --> 00:13:19,699
{\an8}I'll be back.
294
00:13:19,700 --> 00:13:22,493
{\an8}Richard, what the hell are you doing?
295
00:13:22,494 --> 00:13:27,039
{\an8}- I'm about to check Mr. Tolli's wound VAC.
- You said you would hear Kaplan out.
296
00:13:27,040 --> 00:13:28,875
{\an8}- I did.
- [sighs]
297
00:13:28,876 --> 00:13:31,002
{\an8}Is this because you're worried
about the bedroom?
298
00:13:31,003 --> 00:13:34,089
{\an8}Because you know we'll figure that out.
299
00:13:36,049 --> 00:13:37,092
{\an8}Come on.
300
00:13:38,719 --> 00:13:39,887
{\an8}[sighs]
301
00:13:43,182 --> 00:13:46,893
{\an8}- I'm not having this conversation here.
- Is this because you prefer a male doctor?
302
00:13:46,894 --> 00:13:48,269
{\an8}Now that's insulting!
303
00:13:48,270 --> 00:13:49,937
{\an8}Well, I'm just trying to understand why
304
00:13:49,938 --> 00:13:53,357
{\an8}you would dismiss a top urologist
like she's an intern.
305
00:13:53,358 --> 00:13:55,401
{\an8}I moved mountains
to bring her here for you.
306
00:13:55,402 --> 00:13:57,070
{\an8}I didn't ask you to.
307
00:13:57,779 --> 00:13:59,822
{\an8}Now, my cancer hasn't metastasized.
308
00:13:59,823 --> 00:14:02,950
Watchful waiting
is a perfectly reasonable option.
309
00:14:02,951 --> 00:14:06,787
I respected your health care decisions
even when I didn't agree.
310
00:14:06,788 --> 00:14:09,166
I need you to do the same for me.
311
00:14:13,128 --> 00:14:15,755
{\an8}- Who was the surgeon at Seattle Pres?
- Collins.
312
00:14:15,756 --> 00:14:19,508
{\an8}Yeah, he actually did his residency here
a couple of years behind me.
313
00:14:19,509 --> 00:14:23,095
{\an8}When his chief wouldn't let him try again,
he sent London to me.
314
00:14:23,096 --> 00:14:25,348
{\an8}If she codes the minute
she lays on the table,
315
00:14:25,349 --> 00:14:27,058
{\an8}why didn't they try
a reverse Trendelenburg?
316
00:14:27,059 --> 00:14:29,769
{\an8}Keep her at an incline to take the
pressure off some of the cardiac vessels?
317
00:14:29,770 --> 00:14:32,563
Oh, look, they did.
Uh, but see how compressed they are?
318
00:14:32,564 --> 00:14:33,648
It wasn't enough.
319
00:14:33,649 --> 00:14:36,484
Okay, what about conscious sedation
instead of general anesthesia?
320
00:14:36,485 --> 00:14:38,694
She'd continue to breathe on her own,
which would help
321
00:14:38,695 --> 00:14:41,572
blood return back to the heart
and minimize airway collapse.
322
00:14:41,573 --> 00:14:43,991
[stammers] I mean, it might help some.
323
00:14:43,992 --> 00:14:45,993
The tumor's matured
into its own ecosystem.
324
00:14:45,994 --> 00:14:47,578
You can see the calcifications,
325
00:14:47,579 --> 00:14:51,624
- fat, the cystic components.
- What?
326
00:14:51,625 --> 00:14:54,085
What if we drain it?
Shrink the mass before we go in?
327
00:14:54,086 --> 00:14:56,170
It's a good idea,
but the location is just too risky.
328
00:14:56,171 --> 00:14:58,923
We can't risk the contents
of the tumor spilling into the chest.
329
00:14:58,924 --> 00:15:00,508
- It would just regrow.
- Yeah.
330
00:15:00,509 --> 00:15:03,886
I gotta run to a consult in the pit,
but I will keep thinking on this.
331
00:15:03,887 --> 00:15:05,764
- No promises though.
- [Bailey sighs]
332
00:15:06,348 --> 00:15:10,768
Adams, Griffith, let's look up every case
report published on mediastinal teratomas.
333
00:15:10,769 --> 00:15:13,480
Research patterns,
cross-reference solutions, okay?
334
00:15:14,439 --> 00:15:16,440
We all just listened to a podcast
this morning
335
00:15:16,441 --> 00:15:18,317
about how our hospital
pulled off a miracle.
336
00:15:18,318 --> 00:15:20,320
Who's to say we can't do it again,
right? Go.
337
00:15:20,988 --> 00:15:22,489
[Hunt breathes deeply]
338
00:15:23,323 --> 00:15:25,575
We're gonna come up with something.
339
00:15:27,286 --> 00:15:28,869
- Hey.
- Hi.
340
00:15:28,870 --> 00:15:31,455
- Are you done with that tablet?
- Nope, get your own.
341
00:15:31,456 --> 00:15:34,875
Bailey and Hunt have
a massive mediastinal teratoma.
342
00:15:34,876 --> 00:15:37,086
If you sweet-talk Bailey,
you can get in on it with us.
343
00:15:37,087 --> 00:15:38,212
They're looking for ideas.
344
00:15:38,213 --> 00:15:39,881
I'm too swamped down here.
345
00:15:40,674 --> 00:15:43,259
Hey, I'm sorry about this morning.
346
00:15:43,260 --> 00:15:45,636
- Jo's crying about everything these days.
- It's fine.
347
00:15:45,637 --> 00:15:49,891
But she loves Iris,
so she'll be happy if you two are a thing.
348
00:15:57,024 --> 00:15:59,191
- Why are you acting weird?
- I'm not acting weird.
349
00:15:59,192 --> 00:16:01,193
- Yeah, you are.
- [Janet groans]
350
00:16:01,194 --> 00:16:03,529
- Help. Help my wife! Help.
- Hal?
351
00:16:03,530 --> 00:16:05,364
- Sir, you might wanna button that.
- [Millin] Oh, my God. Janet.
352
00:16:05,365 --> 00:16:06,491
[whimpering]
353
00:16:08,660 --> 00:16:09,869
[Millin] Okay.
354
00:16:09,870 --> 00:16:11,495
I'm getting weak pulses.
355
00:16:11,496 --> 00:16:14,623
Okay. Janet, look at me.
I'm going to care of you, okay?
356
00:16:14,624 --> 00:16:16,126
We need a gurney in here!
357
00:16:23,091 --> 00:16:25,217
The plane won't be ready
for another couple of hours.
358
00:16:25,218 --> 00:16:28,764
- Catherine said I could work in here.
- Not a problem.
359
00:16:31,558 --> 00:16:33,851
I owe you an apology.
360
00:16:33,852 --> 00:16:36,771
I was led to believe that you were
the one seeking a second opinion.
361
00:16:36,772 --> 00:16:37,981
You couldn't have known.
362
00:16:38,607 --> 00:16:40,192
I should have at least suspected.
363
00:16:40,776 --> 00:16:44,070
I think your wife broke contract laws
to ensure my employment at her hospital.
364
00:16:44,071 --> 00:16:45,404
Don't feel bad.
365
00:16:45,405 --> 00:16:48,450
You're not
the first to fall prey to her ways.
366
00:16:49,034 --> 00:16:51,369
- I'm guessing I won't be the last.
- [chuckles]
367
00:16:51,370 --> 00:16:53,038
She does it 'cause she cares.
368
00:16:54,081 --> 00:16:55,873
That's what makes it infuriating.
369
00:16:55,874 --> 00:16:57,250
[both chuckle]
370
00:17:00,379 --> 00:17:01,380
Feel free to say no.
371
00:17:02,464 --> 00:17:05,466
But I've got a patient with
a retroperitoneal tumor,
372
00:17:05,467 --> 00:17:10,180
and I would be remiss if I didn't ask Fox
Hospitals' Chief of Chiefs for a consult.
373
00:17:11,681 --> 00:17:13,392
No. Got a little time.
374
00:17:14,309 --> 00:17:18,604
How about we get a couple of pastries
to go with this coffee?
375
00:17:18,605 --> 00:17:20,607
- Thank you. That would be great.
- [chuckles]
376
00:17:21,900 --> 00:17:24,485
"Twenty-two-pound teratoma in the abdomen.
377
00:17:24,486 --> 00:17:28,864
San Francisco, 2018."
They started with a CT-guided drainage.
378
00:17:28,865 --> 00:17:30,491
Yeah, but look at the picture of the CT.
379
00:17:30,492 --> 00:17:31,951
Nowhere near the heart.
380
00:17:31,952 --> 00:17:34,496
- Another dead end.
- [phone chimes]
381
00:17:35,622 --> 00:17:37,164
Another dumb meme from your patient?
382
00:17:37,165 --> 00:17:39,333
No, she's asking for movie recs.
383
00:17:39,334 --> 00:17:40,419
She's stuck at home.
384
00:17:41,128 --> 00:17:44,338
Not exactly
a doctor-patient conversation topic.
385
00:17:44,339 --> 00:17:47,049
She's Bailey's patient.
She has stage four gastric cancer.
386
00:17:47,050 --> 00:17:49,176
She can ask whatever she wants.
387
00:17:49,177 --> 00:17:50,678
I mean, shouldn't you
keep it professional?
388
00:17:50,679 --> 00:17:52,638
Look, you have no idea what
you're talking about.
389
00:17:52,639 --> 00:17:55,266
I'm just saying, you're young,
you're single. You...
390
00:17:55,267 --> 00:17:57,644
You look like you,
you might be leading her on.
391
00:17:59,062 --> 00:18:00,354
I'm her doctor.
392
00:18:00,355 --> 00:18:01,857
And she's a vulnerable patient.
393
00:18:02,691 --> 00:18:04,525
[stammers] I don't...
I don't need this right now.
394
00:18:04,526 --> 00:18:06,861
- No, I'm just trying to look out for you.
- Yeah, try less.
395
00:18:06,862 --> 00:18:07,904
[phone chimes]
396
00:18:09,322 --> 00:18:11,073
Hunt's asking for an update.
397
00:18:11,074 --> 00:18:12,242
[Adams sighs]
398
00:18:13,618 --> 00:18:15,453
- Okay, anything?
- Not yet.
399
00:18:15,454 --> 00:18:16,538
[sighs]
400
00:18:20,041 --> 00:18:23,711
Why did you join this case
when everyone else dismissed it?
401
00:18:23,712 --> 00:18:26,964
It's like you said, it's benign.
Once it's out, she moves on with her life.
402
00:18:26,965 --> 00:18:29,593
There's no worry of mets or recurrence.
403
00:18:32,679 --> 00:18:36,307
Yeah... [sighs] ...I might be feeling
a little uninspired lately.
404
00:18:36,308 --> 00:18:40,060
Uh-huh. Wouldn't have to do
with other people solving
405
00:18:40,061 --> 00:18:42,272
cases at weddings
and doing podcasts, would it?
406
00:18:42,981 --> 00:18:44,482
[chuckles]
407
00:18:44,483 --> 00:18:45,983
[Bailey] I see you at drop-off.
408
00:18:45,984 --> 00:18:48,235
I know everything's falling
on you right now.
409
00:18:48,236 --> 00:18:51,697
She's lecturing
and you're packing lunches.
410
00:18:51,698 --> 00:18:55,367
I'm happy to do it,
and she deserves all the attention.
411
00:18:55,368 --> 00:18:57,537
I just think this tumor was...
412
00:18:59,247 --> 00:19:00,331
I don't know.
413
00:19:00,332 --> 00:19:03,960
My patient cannot be the fix
to get you out of this slump.
414
00:19:04,961 --> 00:19:06,086
What do we got?
415
00:19:06,087 --> 00:19:09,089
Ten cases, at least half of
them considered inoperable.
416
00:19:09,090 --> 00:19:11,467
And none of the masses
are nearly the same size.
417
00:19:11,468 --> 00:19:13,719
There's one case that reported
a similar arrest in the OR,
418
00:19:13,720 --> 00:19:15,221
but the team never tried it again
419
00:19:15,222 --> 00:19:18,224
because they couldn't safely
find a way around the heart and lungs.
420
00:19:18,225 --> 00:19:20,810
Which is exactly what
happened with London.
421
00:19:20,811 --> 00:19:23,271
As difficult as this is for me to say...
422
00:19:24,606 --> 00:19:26,774
I think we're out of options.
423
00:19:26,775 --> 00:19:28,192
What about ECMO?
424
00:19:28,193 --> 00:19:29,276
What about it?
425
00:19:29,277 --> 00:19:32,905
We need to bypass the pulmonary system,
so why don't we use ECMO?
426
00:19:32,906 --> 00:19:36,283
The machine oxygenates and pumps the blood
so her heart and lungs don't have to.
427
00:19:36,284 --> 00:19:41,581
[chuckles] There is no arrest
if the machine is acting as her heart.
428
00:19:42,707 --> 00:19:46,086
Don't say no yet. I'm gonna go find Ndugu.
429
00:19:49,381 --> 00:19:50,714
[Millin] Almost there, Janet.
430
00:19:50,715 --> 00:19:53,176
[Janet] If this is a clot,
you can fix it, right?
431
00:19:54,302 --> 00:19:56,720
Blood clots are treatable
if you catch them in time,
432
00:19:56,721 --> 00:19:58,557
so it's a good thing you're here.
433
00:19:59,933 --> 00:20:01,267
Weird but good.
434
00:20:01,268 --> 00:20:04,353
I should probably be embarrassed,
but I'm proud of us.
435
00:20:04,354 --> 00:20:06,647
All my friends got bored of their spouses
436
00:20:06,648 --> 00:20:10,317
and filed for divorce,
but we got creative.
437
00:20:10,318 --> 00:20:12,529
By coming to the hospital and having sex.
438
00:20:13,738 --> 00:20:16,574
Don't be jealous. I'm sure other people
aren't getting any either.
439
00:20:16,575 --> 00:20:18,368
All right, let me see. [sighs]
440
00:20:21,204 --> 00:20:24,123
Looks like there's
a left iliac vein thrombosis.
441
00:20:24,124 --> 00:20:25,416
Hal was right. DVT.
442
00:20:25,417 --> 00:20:29,253
If you look closely,
the iliac artery is compressing the vein.
443
00:20:29,254 --> 00:20:31,255
- May-Thurner syndrome.
- Mm-hmm.
444
00:20:31,256 --> 00:20:32,923
All right, let's book an angio suite
445
00:20:32,924 --> 00:20:36,552
for a thrombectomy and iliac vein stenting
and start practicing.
446
00:20:36,553 --> 00:20:38,889
I'm gonna supervise
you doing the procedure.
447
00:20:40,473 --> 00:20:42,058
- Me?
- She means me.
448
00:20:42,851 --> 00:20:46,187
I don't care who it is as long as
you guys are prepped and ready to go.
449
00:20:50,233 --> 00:20:51,692
You really think this will work?
450
00:20:51,693 --> 00:20:54,862
The challenge, right,
has always been the pressure
451
00:20:54,863 --> 00:20:57,281
that your tumor is putting on your heart,
452
00:20:57,282 --> 00:21:00,868
your lungs and major arteries
when you're positioned for surgery.
453
00:21:00,869 --> 00:21:02,578
And the ECMO machine makes that irrelevant
454
00:21:02,579 --> 00:21:04,747
because it oxygenates
and pumps your blood for you.
455
00:21:04,748 --> 00:21:07,666
So no matter what happens,
your body will receive oxygen
456
00:21:07,667 --> 00:21:10,044
and blood flow while we work.
457
00:21:10,045 --> 00:21:12,296
I can't believe you
actually figured it out.
458
00:21:12,297 --> 00:21:15,549
Have you done this before?
I mean, how common is this ECMO?
459
00:21:15,550 --> 00:21:18,636
Charlie, you said you were in
if they figured it out.
460
00:21:18,637 --> 00:21:20,095
How common is it?
461
00:21:20,096 --> 00:21:23,515
It's not common for this,
and it can be hard to wean off ECMO
462
00:21:23,516 --> 00:21:26,393
after removing something that's
compressed your lung for so long,
463
00:21:26,394 --> 00:21:27,728
but her heart is healthy.
464
00:21:27,729 --> 00:21:29,521
I don't anticipate that being a problem.
465
00:21:29,522 --> 00:21:31,900
- But it could be a problem.
- [London sighs]
466
00:21:34,903 --> 00:21:36,529
You almost lost me twice.
467
00:21:37,447 --> 00:21:41,367
If we do nothing,
this thing just keeps growing inside me
468
00:21:41,368 --> 00:21:46,748
until it squashes all my organs
and I'm definitely gone.
469
00:21:47,666 --> 00:21:49,084
I don't wanna live like that.
470
00:21:50,835 --> 00:21:53,253
Slowly suffocating.
471
00:21:53,254 --> 00:21:57,092
I don't want you to have
to watch me live like that.
472
00:21:57,801 --> 00:22:01,262
We asked them to come up with a solution.
473
00:22:03,348 --> 00:22:04,765
I'm taking it.
474
00:22:04,766 --> 00:22:07,017
Okay, Dr. Griffith and Dr. Adams
will get you prepped.
475
00:22:07,018 --> 00:22:09,312
We will see you in the OR, okay?
476
00:22:14,275 --> 00:22:15,776
Is it weird that he's not blinking?
477
00:22:15,777 --> 00:22:18,153
Newborn tear ducts aren't fully developed.
478
00:22:18,154 --> 00:22:20,073
It's so cool that you know all this stuff.
479
00:22:21,157 --> 00:22:24,576
Is it bad if I'm not, like,
feeling anything?
480
00:22:24,577 --> 00:22:26,621
You mean you don't feel a bond?
481
00:22:27,956 --> 00:22:29,832
- I'm already a terrible mom.
- No.
482
00:22:29,833 --> 00:22:33,460
No, it's completely normal,
and you're exhausted,
483
00:22:33,461 --> 00:22:35,629
and your hormones are all over the place.
484
00:22:35,630 --> 00:22:38,340
And to be honest,
newborns are kinda just blobs.
485
00:22:38,341 --> 00:22:41,802
In a few weeks, he'll be
laughing and smiling, and it just...
486
00:22:41,803 --> 00:22:43,595
it gets so much better.
487
00:22:43,596 --> 00:22:45,140
You're a really good doctor.
488
00:22:46,182 --> 00:22:48,142
- [chuckles]
- Are you taking new patients?
489
00:22:48,143 --> 00:22:49,852
- Well, it's...
- [Lincoln] Hey.
490
00:22:49,853 --> 00:22:52,938
- How're my girls?
- Hey. Well, we made a new friend...
491
00:22:52,939 --> 00:22:56,191
- Whoa. Oh, my God.
- Oh. Oh. Someone call a rapid response!
492
00:22:56,192 --> 00:22:58,277
[nurse] Right away, Doctor.
493
00:22:58,278 --> 00:23:01,740
[breathing heavily]
494
00:23:05,952 --> 00:23:07,203
She's still seizing.
495
00:23:08,621 --> 00:23:10,539
Someone give me IM midazolam.
496
00:23:10,540 --> 00:23:13,125
She's seven days postpartum.
Check her blood pressure.
497
00:23:13,126 --> 00:23:15,210
It's probably eclampsia.
She needs mag now.
498
00:23:15,211 --> 00:23:17,838
Did she have any symptoms
before she started seizing?
499
00:23:17,839 --> 00:23:20,257
No, she seemed completely fine.
It came out of nowhere.
500
00:23:20,258 --> 00:23:22,468
- We'll need to get her up to OB.
- Will you go up with her?
501
00:23:22,469 --> 00:23:23,595
Whatever you want.
502
00:23:24,345 --> 00:23:26,598
Call me when you get up there. Okay.
503
00:23:30,769 --> 00:23:32,020
[Ndugu] Scissors.
504
00:23:33,188 --> 00:23:36,608
- Put two units of blood on standby.
- [Griffith] Lap pad.
505
00:23:38,568 --> 00:23:43,072
All right, I secured the cannula.
Adams, are we ready to remove the clamps?
506
00:23:43,073 --> 00:23:44,574
Yeah, ECMO's ready.
507
00:23:49,204 --> 00:23:51,914
Okay, let dark flow.
508
00:23:51,915 --> 00:23:53,082
We have full flow.
509
00:23:53,083 --> 00:23:55,209
Let's try lowering her down.
510
00:23:55,210 --> 00:23:57,253
[steady beep]
511
00:24:00,340 --> 00:24:01,673
[beeping continues]
512
00:24:01,674 --> 00:24:04,259
- At least that worked.
- [Hunt] We're gonna make all of it work.
513
00:24:04,260 --> 00:24:06,595
Griffith, Adams, you may never
see another case like this again,
514
00:24:06,596 --> 00:24:07,971
so keep your eyes on the field.
515
00:24:07,972 --> 00:24:11,642
If you see any signs of
hemodynamic instability, speak up.
516
00:24:11,643 --> 00:24:15,062
This is not a race.
Our goal is not to finish fast.
517
00:24:15,063 --> 00:24:17,481
It is to keep her safe.
518
00:24:17,482 --> 00:24:18,941
- Understood?
- [Griffith] Mm-hmm.
519
00:24:18,942 --> 00:24:19,943
[Hunt] Okay.
520
00:24:20,985 --> 00:24:22,402
Okay, London.
521
00:24:22,403 --> 00:24:25,281
Let's intubate. [exhales]
522
00:24:28,743 --> 00:24:31,245
It's a hormonally active adrenal mass,
523
00:24:31,246 --> 00:24:33,705
so you need to watch out
for sudden hypertension.
524
00:24:33,706 --> 00:24:35,541
- I'm planning to use alpha-blockers.
- Good.
525
00:24:35,542 --> 00:24:38,836
Well, I assume you're gonna do this open,
given the size?
526
00:24:38,837 --> 00:24:41,964
That's the plan.
My colleague will actually do it.
527
00:24:41,965 --> 00:24:44,424
I usually stick to robotic procedures.
528
00:24:44,425 --> 00:24:47,427
Oh. You got something
against the old-fashioned way?
529
00:24:47,428 --> 00:24:51,557
No, um... [clicks tongue] ...I have MS,
530
00:24:51,558 --> 00:24:55,477
so standing for long periods
in the OR just isn't an option.
531
00:24:55,478 --> 00:24:58,021
I didn't realize. I'm sorry.
532
00:24:58,022 --> 00:24:59,356
No need to be sorry.
533
00:24:59,357 --> 00:25:03,193
I mean, I was devastated
after I got the diagnosis.
534
00:25:03,194 --> 00:25:05,571
I had put in so much work my whole career,
535
00:25:05,572 --> 00:25:09,200
and the thought of no longer
being in the OR was soul-crushing...
536
00:25:09,909 --> 00:25:11,244
to say the least.
537
00:25:11,995 --> 00:25:14,664
But that's when I realized
it was just my fear talking.
538
00:25:15,748 --> 00:25:20,711
And I looked at my symptoms, muscle pain
and leg weakness, and I thought,
539
00:25:20,712 --> 00:25:22,921
"If only there was a way to operate
540
00:25:22,922 --> 00:25:27,135
while sitting down
without having to hold a scalpel."
541
00:25:28,636 --> 00:25:30,971
Was it a difficult adjustment?
542
00:25:30,972 --> 00:25:34,183
Adjusting to living with
a chronic illness is never easy.
543
00:25:34,184 --> 00:25:38,229
But over time,
I just turned MS into a pivot.
544
00:25:39,230 --> 00:25:40,315
Not an ending.
545
00:25:41,316 --> 00:25:43,984
Well, you seem to be managing well.
546
00:25:43,985 --> 00:25:47,571
Oh, well, I have my ups and downs,
believe me. [chuckles]
547
00:25:47,572 --> 00:25:51,325
But Catherine Fox is flying me
around on her private plane
548
00:25:51,326 --> 00:25:53,870
and paying me more money
than I know what to do with.
549
00:25:55,455 --> 00:25:57,123
And I still get to do what I love.
550
00:25:57,916 --> 00:25:59,959
Even if it is in a different way.
551
00:26:02,170 --> 00:26:06,131
Now they're gonna go ahead with
Bailey's giant teratoma in OR two.
552
00:26:06,132 --> 00:26:09,426
- Ndugu's gonna have to resect...
- Can we just focus, please?
553
00:26:09,427 --> 00:26:11,136
It's a fake patient. Calm down.
554
00:26:11,137 --> 00:26:12,971
Don't tell me to calm down.
555
00:26:12,972 --> 00:26:15,224
What is wrong with you?
556
00:26:15,225 --> 00:26:18,769
[chuckles] Is it about Simone
breaking that dumb pact?
557
00:26:18,770 --> 00:26:21,521
No, and stop asking. I'm fine.
558
00:26:21,522 --> 00:26:23,482
No, you don't seem fine.
559
00:26:23,483 --> 00:26:26,526
Well, it's because you are bothering me.
560
00:26:26,527 --> 00:26:28,987
Well, that can't be it.
I always bother you.
561
00:26:28,988 --> 00:26:30,114
I'm just...
562
00:26:31,699 --> 00:26:34,409
[grunts] I'm just tired.
563
00:26:34,410 --> 00:26:35,744
Every day is the same.
564
00:26:35,745 --> 00:26:40,540
It's the same people and the same rooms
and the same conversations,
565
00:26:40,541 --> 00:26:43,168
and I'm just sick of it.
566
00:26:43,169 --> 00:26:45,796
Well, I am sorry
we are not good enough for you.
567
00:26:45,797 --> 00:26:47,172
I didn't say that.
568
00:26:47,173 --> 00:26:50,593
Yeah, you don't have to defend yourself.
We all know you're aloof.
569
00:26:59,227 --> 00:27:02,271
- You're leaving?
- Yeah, I've already done a thrombectomy.
570
00:27:02,272 --> 00:27:03,815
You can have it.
571
00:27:09,946 --> 00:27:11,780
What's happening? Who's the doctor?
572
00:27:11,781 --> 00:27:15,492
- Uh... John Burnett.
- An intern?
573
00:27:15,493 --> 00:27:17,452
- Let's get a CT.
- They're getting a CT.
574
00:27:17,453 --> 00:27:19,079
No, she has eclampsia.
575
00:27:19,080 --> 00:27:21,123
Tell him she needs magnesium.
576
00:27:21,124 --> 00:27:22,833
- Really?
- Tell him.
577
00:27:22,834 --> 00:27:24,710
I...
578
00:27:24,711 --> 00:27:27,129
[stammers] Excuse me,
I've got Jo Wilson on the phone,
579
00:27:27,130 --> 00:27:29,548
and she says it's eclampsia,
and you should start her on magnesium.
580
00:27:29,549 --> 00:27:32,968
Her BP is only 143 over 91.
It could be an intracranial hemorrhage.
581
00:27:32,969 --> 00:27:35,179
- Put me on speaker.
- Um...
582
00:27:36,514 --> 00:27:38,598
Okay. You're on speaker.
583
00:27:38,599 --> 00:27:40,058
[Wilson] I understand your concern,
584
00:27:40,059 --> 00:27:43,770
but postpartum eclampsia doesn't always
present with a really high BP.
585
00:27:43,771 --> 00:27:45,272
[stammers] Neither does a brain bleed.
586
00:27:45,273 --> 00:27:47,315
- Barnett.
- It's... It's Burnett.
587
00:27:47,316 --> 00:27:48,984
[Wilson] Whatever. I may be on leave,
588
00:27:48,985 --> 00:27:51,737
but that doesn't mean that I can't
schedule you to work every holiday
589
00:27:51,738 --> 00:27:54,364
and make your life miserable.
So trust me when I tell you
590
00:27:54,365 --> 00:27:56,784
to start the mag now.
591
00:27:59,162 --> 00:28:00,538
Start IV magnesium.
592
00:28:02,415 --> 00:28:03,708
[sighs]
593
00:28:06,836 --> 00:28:08,588
Your mom's gonna be okay.
594
00:28:10,715 --> 00:28:12,299
We're gonna have
to take part of the lower lobe.
595
00:28:12,300 --> 00:28:13,675
Adams, you wanna staple the lung?
596
00:28:13,676 --> 00:28:14,760
Yep. Stapler.
597
00:28:14,761 --> 00:28:17,137
Bailey, you ready to start
resecting the adhered diaphragm?
598
00:28:17,138 --> 00:28:18,805
Hey, ready when you are.
599
00:28:18,806 --> 00:28:21,391
Griffith,
what should we be careful to avoid?
600
00:28:21,392 --> 00:28:23,268
Hepatic veins and the retro-hepatic IVC.
601
00:28:23,269 --> 00:28:24,936
Good. Let's get the next stapler ready.
602
00:28:24,937 --> 00:28:29,316
[Miranda chuckles] London thought fixing
up a summer house was a lot of work.
603
00:28:29,317 --> 00:28:32,486
- It's got nothing on fixing up a torso.
- Reload, please.
604
00:28:32,487 --> 00:28:34,362
[machine beeping]
605
00:28:34,363 --> 00:28:38,283
- Uh, BP is bottoming out.
- Damn it. I don't see any bleeding.
606
00:28:38,284 --> 00:28:39,618
Neither do I. The staple line looks clean.
607
00:28:39,619 --> 00:28:41,745
Well, something's got to be causing this.
What the hell is it?
608
00:28:41,746 --> 00:28:45,707
- [sighs] Does the ECMO say anything?
- There's a suction event alarm.
609
00:28:45,708 --> 00:28:49,211
Okay. Since we took pressure off the lung,
could there be volume shifts?
610
00:28:49,212 --> 00:28:50,670
That's definitely possible. Yeah.
611
00:28:50,671 --> 00:28:53,381
Okay, we need to up her pressors
and flood her with fluids.
612
00:28:53,382 --> 00:28:56,344
If we don't get flow back right away,
she's done.
613
00:29:02,100 --> 00:29:03,433
Push fluids as hard as you can.
614
00:29:03,434 --> 00:29:04,768
- I am.
- BP's still dropping.
615
00:29:04,769 --> 00:29:08,230
She can't take this much longer.
I should've listened to that board.
616
00:29:08,231 --> 00:29:10,023
- If I lose her...
- [Hunt] This is not on you.
617
00:29:10,024 --> 00:29:12,984
Come on, come on, come on. Come on.
618
00:29:12,985 --> 00:29:14,361
BP's coming back up.
619
00:29:14,362 --> 00:29:15,904
[Hunt breathes heavily]
620
00:29:15,905 --> 00:29:19,242
- [sighs] Well, that was close.
- Okay, folks.
621
00:29:20,118 --> 00:29:22,911
There's still a lot of tumor left.
622
00:29:22,912 --> 00:29:27,374
Griffith, you're on the liver resection.
Adams, you're on the superior mediastinum.
623
00:29:27,375 --> 00:29:29,210
If that's okay with you?
624
00:29:30,545 --> 00:29:32,420
Do what we say when we say it.
625
00:29:32,421 --> 00:29:33,548
[Griffith] Stapler.
626
00:29:38,636 --> 00:29:39,846
[Millin] Contrast.
627
00:29:42,265 --> 00:29:45,184
There's the occlusion in the iliac vein.
Advance more.
628
00:29:46,853 --> 00:29:50,773
Okay, pin the guide wire and turn
on the thrombectomy catheter, please.
629
00:29:52,900 --> 00:29:54,818
[Kwan] It's a shame Janet
isn't awake to see this.
630
00:29:54,819 --> 00:29:56,945
It would really turn her...
631
00:29:56,946 --> 00:30:02,450
into a passionate fan of
biological science and anatomy.
632
00:30:02,451 --> 00:30:03,910
Okay, I'm in. Turn it off.
633
00:30:03,911 --> 00:30:07,581
I don't get it. If you have to pretend
to be someone else for your partner
634
00:30:07,582 --> 00:30:10,167
to wanna sleep with you,
maybe you shouldn't be together.
635
00:30:10,168 --> 00:30:14,713
I've learned you never know what's
going on in another person's relationship.
636
00:30:14,714 --> 00:30:16,423
Ready. [sighs]
637
00:30:16,424 --> 00:30:17,508
[Altman] Contrast.
638
00:30:21,262 --> 00:30:24,931
Thrombus is gone. The vein is patent.
639
00:30:24,932 --> 00:30:26,808
Great work.
640
00:30:26,809 --> 00:30:28,144
Now to stent.
641
00:30:30,688 --> 00:30:34,941
Thanks again for the consult.
I see why Catherine calls you legendary.
642
00:30:34,942 --> 00:30:37,277
Well, she is prone to exaggeration.
[chuckles]
643
00:30:37,278 --> 00:30:39,905
I know, but in your case, it's true.
644
00:30:39,906 --> 00:30:42,699
Well, you live up
to your reputation as well.
645
00:30:42,700 --> 00:30:45,369
Oh, but not enough to
consider my recommendation?
646
00:30:47,997 --> 00:30:52,334
- I'm sorry, I-I shouldn't have said that.
- No, it's okay.
647
00:30:52,335 --> 00:30:53,753
Can I ask you about something?
648
00:30:54,921 --> 00:30:56,672
Urosymphyseal fistulas.
649
00:30:58,633 --> 00:31:02,469
They are an extremely rare post-op
complication of radical prostatectomy.
650
00:31:02,470 --> 00:31:04,804
But the odds aren't zero.
651
00:31:04,805 --> 00:31:06,306
They're close.
652
00:31:06,307 --> 00:31:07,725
What if it happened?
653
00:31:08,392 --> 00:31:11,729
Chronic pain,
which often leads to difficulty walking,
654
00:31:12,438 --> 00:31:16,359
- possibly warranting the use of opioids.
- [sighs]
655
00:31:17,485 --> 00:31:19,862
I can treat complications.
656
00:31:20,613 --> 00:31:24,992
But if your cancer grows and metastasizes,
that's when my hands are tied.
657
00:31:26,118 --> 00:31:27,620
[elevator bell dings]
658
00:31:29,247 --> 00:31:34,126
If you change your mind or if you just
wanna talk more, Catherine has my number.
659
00:31:41,259 --> 00:31:44,095
[♪ "Other Side" plays]
660
00:31:47,306 --> 00:31:49,891
- Done resecting the liver.
- Good.
661
00:31:49,892 --> 00:31:51,351
Excellent hemeostasis.
662
00:31:51,352 --> 00:31:52,478
[suctions whirring]
663
00:31:55,106 --> 00:31:57,023
[Adams] All right,
no bleeding on this side.
664
00:31:57,024 --> 00:32:01,070
Okay, we are in the home stretch.
Let's get ready to get this tumor out.
665
00:32:02,154 --> 00:32:04,114
- Hold on, hold on.
- [flowing]
666
00:32:04,115 --> 00:32:06,284
- Do you hear that?
- What?
667
00:32:07,660 --> 00:32:08,827
[machine beeping]
668
00:32:08,828 --> 00:32:11,079
Okay, we're gonna need more lap pads,
and hang blood.
669
00:32:11,080 --> 00:32:12,790
Adams, quickly pack her.
670
00:32:13,582 --> 00:32:16,294
[Ndugu] Goddamn it!
All right, keep the suction coming.
671
00:32:16,836 --> 00:32:18,503
Oh... [stammers] ...wait, wait.
672
00:32:18,504 --> 00:32:24,009
Okay, there's a tear where the IVC passes
through the diaphragm into the chest.
673
00:32:24,010 --> 00:32:27,429
I'm trying to secure...
Let-Let me have a clamp.
674
00:32:27,430 --> 00:32:28,930
Okay, I need visualization.
675
00:32:28,931 --> 00:32:30,724
Put the suction on the lap pads.
676
00:32:30,725 --> 00:32:32,768
Not too harsh,
gentle steady pressure, okay?
677
00:32:33,853 --> 00:32:34,854
[suctions whirring]
678
00:32:36,063 --> 00:32:38,690
♪ And all of the time ♪
679
00:32:38,691 --> 00:32:40,191
[Bailey] I think I got it.
680
00:32:40,192 --> 00:32:42,111
♪ Through it all ♪
681
00:32:43,321 --> 00:32:46,156
Oh, she's stabilizing. [chuckles]
682
00:32:46,157 --> 00:32:48,325
[Hunt] Okay, everyone,
on the count of three.
683
00:32:48,326 --> 00:32:50,035
Everyone needs to help with the specimen.
684
00:32:50,036 --> 00:32:51,328
Okay, ready?
685
00:32:51,329 --> 00:32:54,706
One, two, three.
686
00:32:54,707 --> 00:32:57,543
[grunting, straining]
687
00:32:59,420 --> 00:33:00,421
Okay.
688
00:33:01,756 --> 00:33:06,926
♪ There is hope in another day ♪
689
00:33:06,927 --> 00:33:08,012
Okay.
690
00:33:08,512 --> 00:33:10,555
How do you all feel
about getting the hell out of here?
691
00:33:10,556 --> 00:33:12,725
You don't have to ask me twice. Bovie.
692
00:33:13,642 --> 00:33:15,644
[Bailey] Two-O prolene.
693
00:33:16,270 --> 00:33:17,645
[Bailey, Hunt chuckle]
694
00:33:17,646 --> 00:33:22,150
♪ Never glowing differently... ♪
695
00:33:22,151 --> 00:33:23,194
You can stop here.
696
00:33:23,861 --> 00:33:24,904
Iris.
697
00:33:25,613 --> 00:33:26,988
Hey, what are you doing up here?
698
00:33:26,989 --> 00:33:30,658
So a mom from the NICU is being
treated for postpartum eclampsia.
699
00:33:30,659 --> 00:33:33,953
Can you look up her chart?
Her name is Gina...
700
00:33:33,954 --> 00:33:35,039
I don't know her last name.
701
00:33:35,623 --> 00:33:37,833
I'm sorry, I can't. You're not her doctor.
702
00:33:39,168 --> 00:33:40,461
I just wanna check on her.
703
00:33:41,420 --> 00:33:45,591
- Do you want me to call Marcus for you?
- No, what I want is my friend's chart.
704
00:33:46,759 --> 00:33:48,426
- I'm sorry, Jo.
- Stop saying you're sorry.
705
00:33:48,427 --> 00:33:50,887
Sorry doesn't help me.
I'm this woman's only friend right now
706
00:33:50,888 --> 00:33:53,848
and the person in charge of her care
has been a doctor for about 90 days.
707
00:33:53,849 --> 00:33:55,934
So, if you could just
please remove the stick from...
708
00:33:55,935 --> 00:33:57,936
- Jo.
- All I want right now...
709
00:33:57,937 --> 00:33:59,896
- I think we should go.
- No, we're not gonna go.
710
00:33:59,897 --> 00:34:00,980
- I... No.
- Yeah.
711
00:34:00,981 --> 00:34:03,608
You cannot move me against my will.
712
00:34:03,609 --> 00:34:06,403
Stop! [crying] I...
713
00:34:06,404 --> 00:34:08,238
This is not okay.
714
00:34:08,239 --> 00:34:09,656
[Lincoln] Can you give me a minute?
715
00:34:09,657 --> 00:34:11,116
- This is...
- Hey, hey, hey, hey.
716
00:34:11,117 --> 00:34:13,411
[whispers]
Look, I know you're scared, okay? But...
717
00:34:14,745 --> 00:34:17,039
Hey, she's just trying to do her job.
718
00:34:34,932 --> 00:34:38,601
It will take a few days to wean her
off ECMO. She does have a long recovery.
719
00:34:38,602 --> 00:34:40,895
- But she's gonna come home?
- [Bailey] Eventually.
720
00:34:40,896 --> 00:34:43,148
That is the plan.
721
00:34:43,149 --> 00:34:45,233
I don't know how to thank you.
722
00:34:45,234 --> 00:34:47,152
I think you just did.
723
00:34:47,153 --> 00:34:49,320
[Charlie chuckles, cries]
724
00:34:49,321 --> 00:34:52,449
She's always been able
to see what I can't.
725
00:34:52,450 --> 00:34:58,371
Her mind is filled with these big ideas
that always seem impossible. [sniffles]
726
00:34:58,372 --> 00:35:03,502
Our wedding, this lake house,
getting this tumor removed.
727
00:35:05,129 --> 00:35:06,630
But she knew you could do it.
728
00:35:08,716 --> 00:35:10,217
And she was right. [chuckles]
729
00:35:11,427 --> 00:35:14,805
I almost... [sniffles]
...tried to stop her.
730
00:35:16,724 --> 00:35:18,642
But I'm glad I stayed out of it.
[chuckles]
731
00:35:20,060 --> 00:35:23,396
Hey, um, we'll let you both get some rest.
732
00:35:23,397 --> 00:35:25,357
- Thank you.
- [Bailey chuckles]
733
00:35:28,110 --> 00:35:29,986
Great work today, Griffith.
734
00:35:29,987 --> 00:35:32,781
You and Adams, you really stepped up.
735
00:35:32,782 --> 00:35:36,535
Thank you. I really appreciate
the opportunity. I learned a lot.
736
00:35:40,206 --> 00:35:45,418
- [sighs, chuckles]
- We did a good thing today.
737
00:35:45,419 --> 00:35:48,880
- Some might call it inspiring.
- Mmm.
738
00:35:48,881 --> 00:35:50,548
Might be even something
739
00:35:50,549 --> 00:35:52,926
- you could lecture about.
- [chuckles]
740
00:35:52,927 --> 00:35:56,596
Hey, I hope I didn't overstep, you know,
jumping in with the residents.
741
00:35:56,597 --> 00:35:59,891
Oh, no. I mean, if I'm the only voice
that's teaching them,
742
00:35:59,892 --> 00:36:01,435
they'll wind up tuning me out.
743
00:36:02,353 --> 00:36:03,978
What do you think
about having the residents
744
00:36:03,979 --> 00:36:06,481
do an ambulance ride-along
or EMS training?
745
00:36:06,482 --> 00:36:09,400
Something that could really get
them thinking on their feet, you know?
746
00:36:09,401 --> 00:36:14,614
It could help them in the ER
or in situations like today in the OR.
747
00:36:14,615 --> 00:36:18,786
I think you should write up
a proposal and send it to me.
748
00:36:20,955 --> 00:36:22,580
[♪ "Magic" plays]
749
00:36:22,581 --> 00:36:23,873
[Altman] The surgery went well.
750
00:36:23,874 --> 00:36:26,209
We were able
to clear the clot and put in a stent.
751
00:36:26,210 --> 00:36:27,293
Thank you.
752
00:36:27,294 --> 00:36:28,962
You'll need to be on anticoagulation
753
00:36:28,963 --> 00:36:33,174
but after a while, you'll be able to get
back to life as usual.
754
00:36:33,175 --> 00:36:36,761
I'll get back to life
as usual right away or...
755
00:36:36,762 --> 00:36:38,388
"When can I have sex?" is what I'm asking.
756
00:36:38,389 --> 00:36:39,973
- [Hal chuckles]
- Yeah, we know.
757
00:36:39,974 --> 00:36:41,558
You need to elevate your leg when resting
758
00:36:41,559 --> 00:36:44,436
but other than that,
it is good to move it around.
759
00:36:46,272 --> 00:36:48,273
I guess Trudy can still see the doctor.
760
00:36:48,274 --> 00:36:50,984
Trudy's always a good time.
761
00:36:50,985 --> 00:36:55,114
But, honey,
I love you most when you're just Janet.
762
00:36:56,031 --> 00:36:57,032
[chuckles]
763
00:36:58,450 --> 00:36:59,909
We'll give you some privacy.
764
00:36:59,910 --> 00:37:03,998
♪ Let go for dear life
Just free fall ♪
765
00:37:05,165 --> 00:37:09,420
♪ Let go for dear life
Just free fall ♪
766
00:37:10,421 --> 00:37:11,629
♪ Let go... ♪
767
00:37:11,630 --> 00:37:13,507
I checked London's labs before leaving.
768
00:37:14,508 --> 00:37:15,592
Thanks.
769
00:37:15,593 --> 00:37:17,969
Hey, I'm sorry about earlier.
770
00:37:17,970 --> 00:37:21,306
How you interact with your patients,
your business. I'll stay out of it.
771
00:37:21,307 --> 00:37:22,850
I appreciate that.
772
00:37:23,976 --> 00:37:27,312
I do value your opinion though.
773
00:37:27,313 --> 00:37:29,022
- You do?
- I do.
774
00:37:29,023 --> 00:37:34,861
Just, uh, not about relationships.
For obvious reasons.
775
00:37:34,862 --> 00:37:37,280
- Ouch.
- [both laugh]
776
00:37:37,281 --> 00:37:40,533
Hey, look, I'm, uh, putting together
a watch list for my patient.
777
00:37:40,534 --> 00:37:41,826
What am I missing?
778
00:37:41,827 --> 00:37:43,954
[smacks lips] Mmm.
779
00:37:45,497 --> 00:37:47,666
Wait, she hasn't seen any of these?
780
00:37:50,252 --> 00:37:51,420
Thank you.
781
00:37:56,342 --> 00:37:58,176
Hey.
782
00:37:58,177 --> 00:37:59,385
Hi.
783
00:37:59,386 --> 00:38:01,220
Did you make it through your busy day?
784
00:38:01,221 --> 00:38:03,265
Uh, I did.
785
00:38:04,350 --> 00:38:07,060
Uh, I did a thrombectomy
and placed a stent.
786
00:38:07,061 --> 00:38:09,270
Nice, Millin. [chuckles]
787
00:38:09,271 --> 00:38:12,148
You still haven't told me
about that thoracotomy, by the way.
788
00:38:12,149 --> 00:38:14,359
[stammers] It wasn't that big a deal.
789
00:38:14,360 --> 00:38:17,278
Uh, you saved a man's life
with your hands.
790
00:38:17,279 --> 00:38:18,781
Doesn't get any bigger than that.
791
00:38:21,617 --> 00:38:23,118
Do you think I'm aloof?
792
00:38:23,786 --> 00:38:28,623
[smacks lips] Aloof? Thank you. Um...
793
00:38:28,624 --> 00:38:30,166
No.
794
00:38:30,167 --> 00:38:32,961
You're discerning,
you don't suffer any fools.
795
00:38:32,962 --> 00:38:35,838
But... [chuckles] ...that's not aloof.
796
00:38:35,839 --> 00:38:40,386
That's, um, that's protecting yourself
because you care.
797
00:38:42,846 --> 00:38:46,599
It's funny you say that
because I-I have been...
798
00:38:46,600 --> 00:38:49,268
I had the worst day.
799
00:38:49,269 --> 00:38:52,480
I need the biggest vodka tonic
that they have.
800
00:38:52,481 --> 00:38:54,399
Hi, I'm Iris.
801
00:38:54,400 --> 00:38:56,776
Uh, this is Jules Millin,
a surgical resident.
802
00:38:56,777 --> 00:38:58,403
- Nice to meet you.
- Nice to meet you.
803
00:38:58,404 --> 00:39:01,407
Um, I should go find my friends.
804
00:39:03,033 --> 00:39:04,617
- Here.
- Thank you.
805
00:39:04,618 --> 00:39:06,035
See you later.
806
00:39:06,036 --> 00:39:08,621
[Grey] It's jarring
when your identity shifts.
807
00:39:08,622 --> 00:39:12,001
When you're suddenly
a doctor, a partner, a parent.
808
00:39:12,918 --> 00:39:15,670
It helps if you focus on
the things that haven't changed.
809
00:39:15,671 --> 00:39:17,381
I'm gonna have to change hospitals.
810
00:39:18,298 --> 00:39:20,675
I've cried in front of
too many people at this one.
811
00:39:20,676 --> 00:39:22,051
They understand.
812
00:39:22,052 --> 00:39:24,679
[♪ "Pressure" plays]
813
00:39:24,680 --> 00:39:29,600
I just feel like
ever since I was admitted, I just...
814
00:39:29,601 --> 00:39:31,520
I just lost myself.
815
00:39:33,355 --> 00:39:35,231
I can't take care of our kids.
816
00:39:35,232 --> 00:39:39,360
I can't take care of my patients.
I can't even shower.
817
00:39:39,361 --> 00:39:41,362
It's temporary.
818
00:39:41,363 --> 00:39:42,905
Your heart is recovering.
819
00:39:42,906 --> 00:39:44,116
I know.
820
00:39:45,242 --> 00:39:51,581
But for a few hours today,
I got to be a doctor again
821
00:39:51,582 --> 00:39:53,916
and help this woman
navigate a difficult time
822
00:39:53,917 --> 00:40:00,174
but then when it really mattered,
someone else got to help her.
823
00:40:01,800 --> 00:40:03,260
At least Gina is okay.
824
00:40:04,136 --> 00:40:08,182
And I would bet that she'd
say what you did mattered too.
825
00:40:09,933 --> 00:40:11,268
Maybe even more.
826
00:40:13,479 --> 00:40:15,230
Oh, God. [crying] It's happening again.
827
00:40:16,065 --> 00:40:19,485
- No. [sighs]
- I'll get the tissues.
828
00:40:20,486 --> 00:40:21,487
[groans]
829
00:40:21,987 --> 00:40:26,283
- Just... [chuckles, cries]
- [chuckles]
830
00:40:26,950 --> 00:40:28,618
[Grey] The comfort of old friends.
831
00:40:28,619 --> 00:40:31,537
Thirty-five pounds?
That's like carrying four babies.
832
00:40:31,538 --> 00:40:33,456
Yeah, or four bowling balls.
833
00:40:33,457 --> 00:40:36,668
- Who carries four bowling balls?
- People do weird things.
834
00:40:37,961 --> 00:40:39,088
Gotta go.
835
00:40:41,715 --> 00:40:42,716
[phone buzzes]
836
00:40:43,717 --> 00:40:45,177
Yeah, I'm out too.
837
00:40:46,261 --> 00:40:47,470
See you tomorrow.
838
00:40:47,471 --> 00:40:50,390
♪ ...running off the track
Oh yeah ♪
839
00:40:52,601 --> 00:40:53,852
♪ Yeah ♪
840
00:40:55,479 --> 00:40:58,314
She's just a stop sign, not a roadblock.
841
00:40:58,315 --> 00:40:59,398
How did you...
842
00:40:59,399 --> 00:41:00,526
[phone buzzes]
843
00:41:01,235 --> 00:41:04,570
Doesn't matter.
Wait, are you leaving me too?
844
00:41:04,571 --> 00:41:08,242
Um, sorry. Um, hey, have a drink on me.
845
00:41:08,784 --> 00:41:11,620
♪ ...to feel the pressure ♪
846
00:41:12,579 --> 00:41:14,080
♪ Pressure ♪
847
00:41:14,081 --> 00:41:15,164
Anyone sitting here?
848
00:41:15,165 --> 00:41:20,586
♪ Yeah
Even if you stayed ♪
849
00:41:20,587 --> 00:41:22,463
[Grey] The thrill of trying something new.
850
00:41:22,464 --> 00:41:23,923
Hi, I'm Sally.
851
00:41:23,924 --> 00:41:26,801
[Grey] Because even though you
may not recognize yourself...
852
00:41:26,802 --> 00:41:27,845
Catherine.
853
00:41:28,804 --> 00:41:31,722
I'm sorry. I am so sorry.
854
00:41:31,723 --> 00:41:34,851
I got scared and I just
called the best that I knew.
855
00:41:34,852 --> 00:41:36,853
I should've talked to you
before bringing Laura in.
856
00:41:36,854 --> 00:41:42,441
Look, I thought a lot about
letting fear cloud judgment today.
857
00:41:42,442 --> 00:41:44,862
Whatever you wanna do, I support...
858
00:41:46,196 --> 00:41:47,613
I'm a surgeon.
859
00:41:47,614 --> 00:41:49,658
I'm a senior member of this hospital.
860
00:41:50,701 --> 00:41:51,993
If something were to go wrong
861
00:41:51,994 --> 00:41:58,584
and I couldn't stand long enough
to do a simple appy, I'd feel weak.
862
00:41:59,668 --> 00:42:01,295
And I don't know how to lead like that.
863
00:42:01,837 --> 00:42:03,338
I don't know who I'd be.
864
00:42:04,381 --> 00:42:05,757
But people adapt.
865
00:42:06,592 --> 00:42:08,426
I wanna go ahead with the surgery.
866
00:42:08,427 --> 00:42:09,760
[whimpers]
867
00:42:09,761 --> 00:42:13,682
♪ I'm under pressure
I feel pressure ♪
868
00:42:15,058 --> 00:42:16,894
[Grey] ...it's been you all along.
69913
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