1 00:00:06,131 --> 00:00:08,758 In college, I was the hungover premed 2 00:00:08,759 --> 00:00:10,718 who fell asleep at her study carrel. 3 00:00:10,719 --> 00:00:12,386 If you're just joining our podcast, 4 00:00:12,387 --> 00:00:14,305 my guests are doctors Teddy Altman 5 00:00:14,306 --> 00:00:16,891 and Winston Ndugu from Grey-Sloan Memorial, 6 00:00:16,892 --> 00:00:20,144 who pioneered the creation of a ventral aorta surgery. 7 00:00:20,145 --> 00:00:23,356 At what point did you think, "We just broke new ground"? 8 00:00:23,357 --> 00:00:24,440 Immediately. 9 00:00:24,441 --> 00:00:27,068 - Really? - Yeah. Once that staple held, I knew. 10 00:00:27,069 --> 00:00:28,778 Sometimes you just have a feeling. 11 00:00:28,779 --> 00:00:31,489 In med school, I was the famous surgeon's daughter. 12 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, 14 00:00:35,410 --> 00:00:37,870 I didn't have time to process it all until later. 15 00:00:37,871 --> 00:00:40,289 Now I'm the famous surgeon. 16 00:00:40,290 --> 00:00:41,666 - So you had doubts? - Oh, yeah. 17 00:00:41,667 --> 00:00:43,376 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 00:00:45,212 --> 00:00:46,338 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 00:00:53,303 --> 00:00:55,888 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. 31 00:01:13,365 --> 00:01:16,409 I know you do because he goes along with whatever you want. 32 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 00:01:24,001 --> 00:01:26,295 It's just another opinion. 35 00:01:27,504 --> 00:01:28,505 Who am I seeing? 36 00:01:29,464 --> 00:01:30,756 Kaplan. 37 00:01:30,757 --> 00:01:32,842 Laura Kaplan? In Boston? 38 00:01:32,843 --> 00:01:34,677 I thought you made an appointment here. 39 00:01:34,678 --> 00:01:36,137 I sent for my plane. 40 00:01:36,138 --> 00:01:37,806 She landed about an hour ago. 41 00:01:43,186 --> 00:01:44,395 Morning. 42 00:01:44,396 --> 00:01:45,813 - 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 00:01:53,613 --> 00:01:54,989 Go ahead, Dr. Adams. 47 00:01:54,990 --> 00:01:56,699 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. 54 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. 57 00:02:23,185 --> 00:02:24,268 That's what matters. 58 00:02:24,269 --> 00:02:26,062 I just... 59 00:02:26,063 --> 00:02:28,982 really want the six of us to finally be together. 60 00:02:29,608 --> 00:02:30,816 Jo, you will never guess 61 00:02:30,817 --> 00:02:32,985 who Marcus walked out with last night. 62 00:02:32,986 --> 00:02:34,528 - Dr. Ndugu. - Hey. 63 00:02:34,529 --> 00:02:36,782 - I didn't know you were doing rounds. - Yeah. 64 00:02:37,824 --> 00:02:39,201 I'll come back later. 65 00:02:42,954 --> 00:02:44,330 What was that? 66 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. 69 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. 71 00:02:55,342 --> 00:02:56,634 And none of our business. 72 00:02:56,635 --> 00:03:01,180 She is the entire department's favorite nurse. 73 00:03:01,181 --> 00:03:03,975 Everybody loves her. Everyone. 74 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. 78 00:03:20,867 --> 00:03:22,076 Traitor. 79 00:03:22,077 --> 00:03:24,245 - Trouble in paradise? - I broke our pact. 80 00:03:24,246 --> 00:03:26,664 - She's bitter. - Then you should break it too. 81 00:03:26,665 --> 00:03:29,375 What, I can just snap my fingers? Who am I supposed to sleep with? 82 00:03:29,376 --> 00:03:32,878 I ordered an X-ray for Ms. Johnson's left arm. 83 00:03:32,879 --> 00:03:35,047 It was the right arm, wasn't it? 84 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? 87 00:03:42,305 --> 00:03:43,556 Vegan sloppy joes. 88 00:03:43,557 --> 00:03:45,015 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? 91 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? 94 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. 96 00:03:57,571 --> 00:03:59,196 - It's nothing. - Wear a condom. 97 00:03:59,197 --> 00:04:01,115 She's a cancer patient. 98 00:04:01,116 --> 00:04:03,367 Hey. Did you see that I admitted Mr. Howard? 99 00:04:03,368 --> 00:04:05,077 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. 109 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. 112 00:04:32,230 --> 00:04:36,692 Hi, Janet, I'm, uh, Dr. Millin. I hear you're having some leg pain. 113 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. 117 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. 119 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 124 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... 131 00:05:25,742 --> 00:05:30,996 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... 133 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 137 00:05:45,679 --> 00:05:48,305 that has been resistant to chemotherapy. 138 00:05:48,306 --> 00:05:50,182 Presents with progressive shortness of breath, 139 00:05:50,183 --> 00:05:51,475 orthopnea, and angina. 140 00:05:51,476 --> 00:05:53,185 It has to be at least 35 pounds. 141 00:05:53,186 --> 00:05:56,355 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 00:06:11,538 --> 00:06:13,914 Her name is London 148 00:06:13,915 --> 00:06:16,709 and, yes, there have been two attempts at Seattle Pres. 149 00:06:16,710 --> 00:06:20,838 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, 154 00:06:36,146 --> 00:06:38,939 you could still encounter catastrophic bleeding. 155 00:06:38,940 --> 00:06:41,483 And that is why I'm here at the tumor board, 156 00:06:41,484 --> 00:06:45,779 where people help their colleagues to come up with a plan. 157 00:06:45,780 --> 00:06:50,743 If anyone here thinks this remotely is a possibility, please speak up. 158 00:06:50,744 --> 00:06:51,870 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. 161 00:07:05,967 --> 00:07:06,968 I'll do it with you. 162 00:07:11,348 --> 00:07:13,974 - The alternative is hospice, right? - Mm-hmm. 163 00:07:13,975 --> 00:07:15,643 Dr. Hunt, it just can't be done. 164 00:07:15,644 --> 00:07:18,021 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 00:07:25,362 --> 00:07:26,696 Yeah, I got nothing. 167 00:07:42,128 --> 00:07:44,338 {\an8}Well, look who's here. 168 00:07:44,339 --> 00:07:45,673 {\an8}How was your flight? 169 00:07:45,674 --> 00:07:48,384 {\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. 171 00:07:51,137 --> 00:07:53,013 {\an8}I've heard a lot about you. 172 00:07:53,014 --> 00:07:56,475 {\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 00:08:12,617 --> 00:08:14,576 We just received another grant for it yesterday. 178 00:08:14,577 --> 00:08:15,994 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.