All language subtitles for Doc s02e20 The Big Chair.eng

[Michael] Dr. Larsen was in
a car accident,

she has no recollection
of the last eight years.

[Amy] Previously onDoc.

- Let me run Internal Medicine.
- Back to your roots.

When you need time to
work out things with Michael,

I accept it,
but when the shoe's on the other foot-

When the shoe's on
the other foot,

you have a hard time
telling me the truth.

Delayed decisions on his care

have been hurting him
a long time.

You don't have to tell me
the system's broken.

How much prednisone
does it take to get you through a shift?

You will flame out in weeks.

[Joan] It's time for you
to use your greatness

to pull the greatness
out of others.

I'm going to miss you.

[coughing]

Sorry. This guy
loves his sleep.

Oh, there he is.
Hey, can I have a hug?

Oh my goodness, this is yummy.

Ethan was sorry to miss you,
he had a really early meeting.

Well, Robbie's
the main event, right?

What fabulous holiday
have they cancelled school for this time?

It's Lunar New Year.

Oh, well.

[speaking Mandarin]

[Samantha in English]
Grandma's been all over the world.

You know, she could probably
teach you to say hello in 50 different languages.

Sixty-seven,
but who's counting?

I should be back around 6:00.

And thanks so much
for doing this.

Are you kidding?
The more time I get to spend

with this little man,
the better.

Oh. Brought you donuts,

your dad said
they're your favorite.

[Robbie] Thanks, Grandma.

[coughing]

Joan, you okay?

[coughing]
I'm fine.

[coughing and wheezing]

[Samantha] Robbie,
why don't you go upstairs?

Oh my God.

- Grandma!
- Joan?

- Joan?
- Grandma!

[coughing]

[theme music playing]

[chattering indistinctly]

[tense music playing]

Good morning, everyone.

[all] Morning.

This is going to be
an adjustment for all of us.

Dr. Ridley certainly left
some big shoes to fill,

and I know all these
leadership changes the past year

have probably been unsteadying.

There are a lot of reasons why

I wanted to practice
medicine again,

but I want to be very clear
about the reason I asked

to sit in that chair.

The past year as your CMO,

- I have seen what
every person... - [cell phone buzzes]

...standing in this room
is capable of.

Dr. Miller.

[Michael] Time and again,
you have risen to the occasion.

[man on phone]
We have a 62 year old female

in respiratory failure.

Complications from chronic MDS.

I'm on my way down.

I'm not here just to lead you,

I want to join you,
and help you do what you already do so well.

An issue, a problem,
a suggestion,

my door will always be open.

Before we go,
some congratulations are in order.

In two weeks, Dr. Maitra

and Dr. Larsen
will succeed Dr. Heller

as Chief Residents,

- as we welcome our
new class of interns. - Whoo!

[applauding]

Uh, now, if you both

could hang back for a moment
with Dr. Heller.

The rest of you, do good work.

I'd like our co-chiefs
to shadow you

before you start your
pediatric fellowship.

You can begin with Dr. Maitra

this morning,
and then alternate days.

- Yeah. Sounds like a plan.
- Great.

It's quite a move.

Well, it was either this

or a leather jacket
and a motorcycle.

[cell phone message chimes]

Joan's in the ER.

Paramedic said she was
extremely short of breath,

likely bilateral
pleural effusions.

So is she hypoxic?

Oxygenations
improved on the mask, but she's hypotensive.

Let's push Norepi MAP
goal above 65.

No, Richard,
that's not gonna work.

- I'm sorry?
- She's on prednisone.

Thirty milligrams
and she's tapered off, I read her chart.

No, her chart's wrong,
she's on way more than that.

[raspily] I've been using it
to get through the surgery.

You knew about this?

How much has she been taking?

Double that.

Triple to get through the ex...

vivo with Javi.

My natural cortisol
production's gotta be shot.

Okay. Lucy,
100 milligram bolus

of hydrocortisone
before pressors.

And run a complete lab workup.

We're all here
if you need anything, Joan.

Should I call Ethan?

He's on his way.

But, Amy,
I need you to remember,

I have a DNR.

Joan, no,
we're nowhere near that.

[wheezing]

Shh.

Good morning, Dr. Walker.

Good morning to you, Walter.
How's our rocket holding up?

Can't wait to launch it.

You think I can
still leave today?

Gotta examine you first,
can't let you out of here

till we're sure
you're all better.

I really want to
show the rocket to the kids at the house.

I bet. Looks like
that thing might actually make it to space.

Do you ever launch
rockets with your kids?

- I don't have any.
- Really?

I thought about it
when I was younger,

but decided to take
a different path.

- What do you mean?
- Well, being a parent's a big commitment.

But that's also true
for being a friend, a sister,

an aunt, especially a doctor.

Eventually, I figured
if I gave my best

to all those other things,
that'd be enough for me.

- You're a great doctor.
- Hmm.

That she is, buddy.
Sorry I'm late, how's he doing?

Well, breathing's much better.
Let's look at those knees.

Oh. How long has your leg
been moving like that?

Happens all the time
with my RA.

It shouldn't be now,
with the medication you're on.

- Yeah, I'll order a CT.
- Well, that's bad.

Just need to see
what's going on.

We'll get it
sorted out, though.

Time to find
your social worker.

Again?

Atlantoaxial instability
this severe will progress fast.

We have to operate now.

We don't have
the go ahead from his proxy.

Well, his C1 and C2 are compressing his spinal cord.
What's everybody waiting for?

The social worker
said he'd sign off on whatever we decide,

but he doesn't want
to get in the weeds.

Well, that makes things tricky,
'cause we have two surgical routes.

High risk, high reward, open
the neck, expose the vertebra,

place the corrective
hardware directly.

But you're concerned about
arterial or spinal cord trauma?

Not to mention stroke,
infection, ventral cord damage.

Plus, he's still recovering
from lung inflammation.

Definitely a concern.

And the second option is
minimally invasive fusion?

Far less trauma
and easier recovery.

But wouldn't we be relying
on CT for navigation?

Which means less precision
with the hardware?

Yeah, it may require
going back in, in six months or a year.

[TJ] And there's a high chance
for a screw misplacement.

At the C1-C2 spinal cord,
that could be severe.

- [sighs]
- Both have risks.

It's your call, Gina.

[soft music playing]

Do the minimally
invasive fusion.

I'll go explain to Walter.

So...

I've got full-blown leukemia.

May I see?

My belief is that
the steroids

artificially raised
your white blood cell count,

hiding the degree
of marrow infiltration,

and I spoke to Dr. Rose,
and he agrees.

Now, if this goes unchecked,
your decline will be rapid.

So, we'd like to start
induction chemotherapy,

which could buy you
a few extra months.

This shows
a pancytopenic picture

without any sign
of leukocytosis.

Yes. As I just said,
the steroids are complicating things.

Her leukemia has
an atypical presentation,

but we need to act fast
before it progresses.

Or her presentation
is atypical because it's not leukemia.

Amy.

Her counts are dropping
across every line.

That looks like marrow failure,
not marrow takeover.

You're reading too much
into the blast count.

No, I'm looking at
the facts in front of us.

She doesn't show cancer
on a peripheral smear.

If this is pancytopenia, we could give
platelets and plasma to raise her levels.

Blast proliferation
and dysplasia

are textbook signs of leukemia.

And delaying treatment
because of wishful thinking

will cost you significant time.

Or, if he's wrong,
the chemo will damage all your organs.

I believe this is
Joan's decision.

Start the chemo.

I'll put the orders in.

You're brilliant, Amy,

and I know you don't
want this to be true,

but I can't...

I can't lose any more
time with my family.

Yeah.

Mom, any soreness
in the incision?

Oh, it was routine
surgery, I'm fine.

Where's John?

[sighs] He's here,
having a smoke.

Surprised you
didn't go with him.

Believe me, if I thought
I could get away with it.

Not on my watch.

Oh, I know, Dr. Larsen.

Not yet, Mom.

Speaking of which,
you should get back to Minneapolis.

No, it's fine. Dr. Ridley
is away for a couple of weeks,

- so I finally get a little
bit of breathing room. - Who's that?

I've mentioned her,
like, six times.

Genius surgeon,
Doctors Without Borders,

- utterly terrifying-
- Alright. Her.

Everybody wants her
to be their mentor

but she travels around so much,

I don't think she ever
slows down enough to do that.

What do you even
need a mentor for?

You want something, you get it.

Always been that way,
barely even needed to push you.

Well, there were times
I could have used some pushing.

Amy.

- Hey.
- Hi.

I got here as fast as I could.

- She's stable now.
- Phew!

She's pretty drowsy
from the chemo meds.

Right. Okay.

- Amy, Joan's co-ag
panels came back. - Mmm-hmm.

She has DIC.

If we had pushed platelets
like you wanted,

the runaway clotting
could have caused a massive stroke.

I know how hard
this is for you,

but you're gonna have to
let me do my job.

Ethan. I'm Dr. Miller.

- Hi.
- It's good to meet you.

So, rounds are done.
What's next?

Well, your partner in crime's

sitting vigil for
a friend in the ICU.

Have you checked in on her?

I didn't want to
invade her space.

It's always better
to extend yourself.

Trust me, she's gonna
let you know if it's unwanted.

Oh, I'm sure she will.

So, as Chief Resident,

you've gotta be
able to work with anyone.

Is there anybody else,
anything you gotta get ahead of?

I don't know
if you ever noticed,

but Liz kind of had
a thing for TJ.

Yeah, she wasn't
exactly subtle about it. Why, what's the problem?

I...

So, you and TJ?

Wow, okay.

I guess I missed that.
How long has that been going on?

Not very, and you of all
people don't get to judge.

I'm just not sure how
everyone else will react.

Well, listen.

I mean, you can't control how
people feel about you, okay?

All you can do is show everyone that you're
gonna be there for them when things get tough.

Ah, Dr. Hamda.
Do you have a minute?

Of course, yeah.
Come in, have a seat.

Um...

I know I should have
said something sooner.

I think I was just too afraid

that no one was
gonna take me seriously.

It's okay, Liz. What is it?

Dr. Miller.

What he did to me.

Everyone's just pretending
like nothing happened,

but it was an abuse of power.

I appreciate your honesty,
and I understand how you feel.

Not how I feel.
It's what happened.

Nobody condones
what Dr. Miller did,

but an agreement was reached.

- What agreement?
- I'm afraid I can't discuss it.

So you won't tell me
what happened?

It was
a confidential settlement.

I'm sorry, Liz.

I guess this just proves why

I never should have
bothered coming forward in the first place.

[TJ] CT confirms location,

we're clear of
the vertebral artery.

[Dr. Costa] Advancing
cannula into position.

[cell phone buzzing]

Hey, babe.

Okay. So, I nearly had
to sell my body for it,

but Spoon and Stable
finally called me back.

- They had a cancellation?
- I told them it was our anniversary,

and they said they could
squeeze us in at 6:00.

Can you make that work?

Well, looks like
I'm gonna have to.

No way we're missing
out on those oysters.

So, there's a chance
I may need to swing back here.

Oh no. Is it that boy
you told me about?

Found a pretty
serious issue with his spine,

- he's in surgery now.
- Oh honey, that's terrible.

Are the social workers
being helpful?

Not really. I had to make
the decision myself

about what surgery
he should have.

Okay, I know it's not my lane,

and I love you for being
the person who cares this much.

But the last time you got
this invested in a case-

He has no one, Wendy.

I have no choice.

[Ethan] Well, she told me
about the prednisone,

said it landed her here
a lot sooner than she would have otherwise.

Yeah. She is strong-willed.

That's what we love about her.

She probably felt
like she had no choice.

You know, after I told her
I didn't want to see her,

what else did she
have besides work?

And now, Robbie may never
even get to know her.

She knew that
making things right with you was on her.

Not you.

All you can do now
is be there for each other.

[door opening]

[ominous music playing]

What did you do?

She was fine.
She was just fine an hour ago.

What did you do?

It's not their fault.
She had a heart attack.

Nobody could have
seen this coming.

Amy. Uh, how is Joan doing?

Um, she's stable for now.
On chemo.

I'm sure this
must be hard for you. If there's anything I can-

Something's escalating
in there.

[equipment beeping]

Her temperature's dropping.

Yeah, core temp can drop
after starting chemotherapy, it's normal.

But it can also be
a sign of sepsis.

No, all of her cultures
were negative.

Is that true?

Yes, of course that's true.

And you should know
that Dr. Larsen

recommended a course
of treatment earlier

that could have been
catastrophic for your mother.

So, I don't think that
it is a good idea

for friends
to treat each other.

I admire your mom, but I can be
objective, and that's what she needs.

He's right.

Sorry, Ethan.

- Hey.
- Hey.

Do you have
any of Joan Ridley's blood left over?

Yeah, we should
have some extra.

Can you run a beta-D-glucan?

All her cultures
came back negative.

What are you looking for?

I want to rule out
an invasive fungal infection.

Something in
the endothelial tissue.

You got it.

And uh, when you're done,
can you get me the results directly?

Says Dr. Miller's assigned.

He is.

I need this, Carin. Please.

Sure.

- [cell phone vibrates]
- Hey, how's it going?

Hey. I'm at the school,
apparently Mia got into a fight.

Let me guess, with Logan?

I haven't had a chance
to talk to her about it,

but figured we should
do it together.

Can I bring her by
the hospital?

Shouldn't take too long.

Yeah, yeah, of course.
Um, yeah, I'm here.

[young Amy]
She killed herself, Gina.

All those times I begged
her to quit smoking.

Her blood pressure
was through the roof,

it was only a matter of time.

You can't keep fixating
on what could have gone differently. Okay?

All you can do now is start
to process your pain.

What makes you think I haven't?

It's been a week and a half.
You still haven't cried.

Crying won't fix anything.

I'm not saying
force it, okay?

But just let yourself feel.

This is only gonna get worse
once you're an actual shrink, isn't it?

That's neuropsychiatrist,
thank you very much.

I just need to
focus on school.

And maybe that hot bartender
from Stanton.

I'm serious, Amy.

You're in grief
and mad at your mom.

You can't just
push all that away.

- Why not?
- 'Cause when it comes to feelings,

the piper has to get paid.

One way or another.

[cell phone vibrating]

Hey.

Just checking on you.
Joan's BP and O2 SATs are improving.

Chemo must be having an effect.

I guess Richard was right.
About the leukemia.

At least we have a diagnosis.
Where are you?

Uh, I'm in Radiology
with another patient.

- I'll be back soon.
- Okay.

We won't be mad, honey.

We just want you to
tell us what happened.

Logan was throwing
markers at me.

I thought we said when he did stuff
like that, you would tell the teacher.

I did. But he didn't stop.

So I took my chocolate pudding

and I dumped it on his head.

[giggling]

Um, so, what happened?

You told the teacher
and they didn't do anything about it?

They had him sit
in the big chair.

What's the big chair?

It's a big, comfy chair
in the corner,

where you sit and think
about what you did.

So, like a timeout.

Okay, but, uh, last week,
when you won the spelling bee,

you said you got to sit
in a big, comfy chair.

Yeah. You sit in it
if you do something good.

But then, sometimes,
you sit in it if you do something bad.

I want her out of
that school, Rache. Okay?

There's the public school,
there's the Hebrew school

we toured,
I don't care which one.

I just think that she needs
to be somewhere with more boundaries and grit,

and fewer
participation trophies and big chairs.

Okay.

- Okay what?
- Okay, you're right.

I'm wrong. Let's move her.

Hold it, did you just tell me
I was right about something?

[laughing]

And if you play
your cards right,

it might even happen again.

I'll take her home?

Yeah, yeah.

Are you alright?

[sobbing]

Uh... Yeah.

I'm just realizing
how little power I have here.

What happened?

There's nothing to
be done about it, Sonya.

No, no. I'm gonna be
Chief Resident,

which means I can advocate.

[sighs]

[Richard] And this is
unprofessional.

You were never going to
test for this, Richard, and it's positive.

You were not gonna
listen to me.

Well, that was my
call to make-

Do you wanna tell me
what's going on here?

- She ran a test behind my back.
- That is hardly the headline here.

Joan has a Candida
organ infection,

which he wouldn't have caught.

I'm assuming you're
interested in treating this,

even though I was
the one who found it.

Alright, alright.
That's enough.

Clearly, the chemo
lowered her immune response,

decrease the dosage for now
and treat the infection.

But we are still on
the right path here.

You know, I might be
more inclined to hear you,

if you weren't so concerned
with putting me in my place.

He was never gonna
order the panel. Out of spite.

- If you needed backup-
- Which is it, Michael?

I'm supposed to come to you
because you want to help?

Or I'm not supposed to come to

you because I put you
in a tough position,

because I've heard it
both ways.

I am Chief now,
of your department.

That's a lot different
than running two floors up to talk to the CMO.

And by the way, you lied.

Told me you were in Radiology,

on our first day
working together.

You're right. I'm sorry.

I'm, I'm uh...

Every time I look at Joan
in that bed, all I see is...

Your mom.

[sighs]

I wish you'd been there
for that.

I'm here now.

I know.

Try to hold on to that.

[moaning]

- Oh, I think he's waking up.
- Walter, can you hear me?

It hurts. Please, it hurts.

- Blood pressure's spiking.
- Walter, try to breathe.

- My neck, it hurts so bad!
- Two milligrams IV morphine, stat.

Where in the neck?

Why can't I move my hands?
What's happening?

It's okay, Walter. That can
sometimes happen with swelling.

He lost his Babinski.

So, the spinal cord's
not sending a signal?

[TJ] Costa's running
a CT to confirm,

but it seems
the cord swelling is causing compression.

He's on morphine for the pain,

but he's got serious
neurological deficits.

No movement below the neck.

The sooner we can get back
in and operate, the better.

But his lungs are
still inflamed from the RA.

He may not be able to take
another round of anesthesia.

Dr. Costa's booked an OR
for first thing in the morning.

Anything longer than that,

then he could have
serious neurological issues permanently.

We should have been
more aggressive.

We can't Monday morning
quarterback.

The surgeon gave you
two choices.

And I picked the safer one,
because I was worried

Walter doesn't have
the long term support

to go for what was
really needed.

- It was a coin toss, Gina.
- No, it wasn't.

You wanted to go
for the other option.

So Costa waffled. It should
not have been up to you.

No, it shouldn't have been.

So let me take this
off your plate now.

Tell Costa I want Walter

in reverse Trendelenburg
during the operation,

and to use lung
protective ventilation

with low tidal volume.

He may never
walk again, Michael.

Induction chemo
did a number on me.

Well, you're almost
through the first dose.

But we found an invasive
fungal infection,

presumptive Candida.

We're, we're treating it
with antifungals.

Candida.

Must have seeded in my liver.

No, not the liver.

It's likely diffused
endothelial,

given the high
beta-D-glucan level.

Did you finish your homework?

Is your father...
Is your father home yet?

- [Ethan] Mom?
- Joan? Look at me.

- [Ethan] What's wrong with her?
- Ethan, step back.

- [groaning]
- [Ethan] What's happening?

[Amy] She's seizing.

[Richard] Oxygen at 10 liters.

Altered mental status,
it's gotta be neurological.

Increased ICP,
her brain's swelling.

If she had leukemia,
this wouldn't be happening.

- Not this fast.
- You're right.

We're missing something.

Look, I know whatever
decisions were made

about bringing Dr. Miller back
are way above my pay grade,

but we can't just ask Liz
to forget what happened

'cause it'll make life
easier for everyone else.

I'm going to talk to Richard
once Joan is stabilized.

I'm sure he'll be willing
to apologize to Liz.

His apology is gonna be
hollow and meaningless.

And you should know,
when Dr. Miller was Chief,

he tried to use me
to find out mistakes Amy was making.

Look, I'm sorry you ended up
in the middle of that.

But, um, I know the board.

They'd rather find a way
to get rid of Liz

than reopen this can of worms.

Well, they can try,
but if Liz starts talking,

they're gonna get blowback
from the nurses

and potentially the union.

Is, uh... Is that a threat?

It's a reality.

I'm just trying to do
the right thing for her,

and protect the department,
which is part of my job now.

She bears responsibility
for her own decisions, Sonya.

As you said,
she has a very strong union

she could have gone to
when all this happened.

I think, maybe,
you're expecting too much,

or not understanding
the dynamic between an older man with power

and a young woman
at the start of her career.

It's blaming the victim,
and I don't think it'll be appreciated.

- I do hear you.
- Well, good.

Because you started the day
by saying your door was open,

but now it seems like
you're closing it on Liz.

[man speaking Spanish
over laptop]

The MDS is late-stage,

but it's obscured
by high steroid usage.

Pancytopenia,
pleural effusions,

DIC, elevated beta-D-glucan,

and now cerebral edema,
and she's getting worse.

Hey, just checked in on Joan.
How you holding up?

I've been going toe to toe
with Richard all day,

and now we're
running out of time.

Who's this?

Um, he's a doctor in Madrid

who has a case study
that might be relevant

and this translation app
keeps glitching.

Um, I mean,
I minored in Spanish,

- we could see
how rusty I am. - Okay.

[speaking Spanish]

Gracias.So, what he's saying

is that the symptoms
were similar,

but his patient had
dormant sarcoidosis,

so that was complicating
the clinical picture.

But once they found that,
everything else just fell into place.

So a patient
with MDS like Joan presented with these symptoms

because of a different
chronic issue.

And it went
undetected for years.

Okay, okay. Thanks.

Just remember
you gotta find a way

to work with Richard on this.

Your spinal tap
came back negative

and a full neuro panel too.

Well, her procalcitonin is low,

even though she just
had an infection.

I need total protein,

C-reactive protein
and complement levels.

- How fast can you do that?
- 20 minutes.

And if the results
can go to me, since I'm her doctor,

that'd be appreciated.

We've got a high
complement protein level,

and the prednisone
must have dropped her immune surveillance,

which means that
we're looking for something that's been there,

possibly for years,
like you said,

but that's been hiding
in plain sight.

When Joan woke up,

and I told her about
the Candida,

she asked if it seeded
in her liver.

[Richard] Well,
that wouldn't be uncommon.

But the beta-D-glucan
is so high,

the fungal load
would be too large

to be isolated to her liver.

Okay. We've been assuming that
the elevated liver enzymes

are caused by the MDS
and the prednisone,

but look at her blood work
going back to 2016.

[Richard] Higher range
than normal.

But low enough that
nobody would flag it.

2016,

that's a long time for her
to be carrying something.

Wait a minute.
One of the last memories I have of her,

2016, she was in Ecuador.

And she got sick,
and I told her that she should come back.

And she self-diagnosed,

she thought it was dysentery-

Which means she was
drinking unfiltered water.

So, if it was a parasite,

she could have been sick
while she was digesting it,

but by the time
it migrated to her liver, she was fine.

Then she could have been
fighting this quietly for years.

And the prednisone
weakened her immune system,

and unleashed it on her.

I think we have a path now.

[TJ] He's losing
sympathetic tone.

Surgery's set for 6:00 a.m,
can we up the steroids?

Too worried about
his blood pressure.

Think we just have
to stay the course

and hope that he's strong
enough to hold on.

I appreciate what
you said before.

Trying to let me off the hook.

You religious at all?

From time to time,

depending on how
I'm feeling about the world.

I remember going to
this sermon once.

The minister was talking about
how it can be a form of hubris

to think that
we can control things

that are out of our control.

'Cause that's
somebody else's domain?

[TJ] Doesn't mean
it's easy to accept it.

But I think
that's the idea, yeah.

I'll take that
under advisement, Dr. Coleman.

Good.

Your wife's here.

[gasps]

It's my anniversary
and I forgot.

You go. I am all over this,

hourly exams,
I will not go home.

I've been downstairs
15 minutes, tried calling you.

I'm sorry.
There were problems with Walter's surgery,

he needs another one tomorrow.

Why don't we have dinner
in your office tonight?

- [sighs]
- That way, if anything happens, you're close.

What did I do to deserve you?

I don't know.

I'm sure you'll find a way
to make it up to me.

I'm thinking
400 milligrams albendazole.

I'd go 300,

given the ALT/AST,

and 20 of Ampho B
to balance it out.

And 100 milligrams
of cimetidine

to cut the renal toxicity.

It's a tightrope.

Any idea where Liz is?

Uh, let's see.

[woman over PA]
Code Blue, ICU.

Joan's coding.

Code Blue, ICU.

Code Blue, ICU.

- [equipment beeping]
- No pulse.

He's in V-fib.
Push one milligram Epi. Get the defibrillator.

[defibrillator charging]

- [defibrillator beeps]
- Ready?

Clear.

[equipment beeping]

Restarting compressions.

Danny, Danny.
Someone call 911.

[Gina] Charge to 50.

Clear.

[ECG long beep]

Pushing another
milligram of Epi.

Fine V-fib, we're losing him.

Going up to 100.
Give me the paddles.

- Ready.
- Clear.

[equipment beeping]

Looks like Sinus.

We have a pulse. He's back.

Page Dr. Costa,
we can't wait on the surgery.

[soft music playing]

[Dr. Costa]
Cord is decompressed.

Screws are seated.
Let's secure the rods.

Hey.

That must have been
really difficult for you.

Yeah.

And a hell of a first day
for Michael.

Oh, it hit
pretty close to home.

How's it going in there?

Hardware's almost in place.

But even if it works,

no one's ever
gonna adopt him.

Not when he needs
this kind of support.

[sighs]

You're not thinking
of doing something drastic?

Go and be with Joan.

Gina.

I care about him,

but I know what
the boundaries are.

Now go, where you're needed.

[equipment beeping]

- But you've gotta quit smoking.
- [scoffs]

You know that's never
gonna happen, honey.

I don't know how much more
we can pump into her

before she starts
shutting down.

Her body's so fragile.

The chemo
didn't help with that.

She was only on it
for eight hours.

The parasite is causing this,

that and the prednisone,
it's not on you, Richard.

[somber music playing]

[sighs]

[imperceptible]

Hey. It's okay, buddy.

Can I see?

Aw, she's gonna love this.

Is she gonna wake up soon?

I really hope so.

[equipment beeping slowly]

[cell phone ringing]

Hello?

[Joan] Hi, Amy.
It's Dr. Ridley.

Oh. Hi.

I hope it's not
2:00 a.m. there,

I stopped tracking time zone
differences ages ago.

No, it's noon.
Is there a problem?

I spoke with Dr. Kelly this morning,
he told me about your mother.

I'm just so sorry, Amy.

- Thank you, Dr. Ridley.
- And I respect your tenacity,

already being back
in the hospital,

but I just wanted to make sure
you're taking care of yourself.

I think so.

It's...

It's been hard, obviously.

[Joan] Your world
shifted on its axis.

But you will come out
the other side.

I just...

didn't even think you liked me.

[Joan] Well,
that's by design, my dear.

And now you know the truth.

Not only do I like you,
I believe in you.

Thank you so much. I-

[Joan] I know how bad
this hurts right now,

but the best way that you can honor
your mother is to live a life with purpose.

You have greatness in you, Amy.

And I'll be there
to help you find it.

[murmuring indistinctly]

Joan.

Hey. Can you hear me?

Can you get her son?
He just went to get coffee.

Hey. It's okay.

Just go slow. Breathe.

- What happened?
- You had cerebral edema.

No.

It's not leukemia.

Not yet.

You had a parasite
in your liver.

From Ecuador.
Do you remember that?

You thought it was dysentery?

Oh my God.

Is that the one time
in my life I misdiagnosed?

[laughing]

You haven't
looked after yourself for a long time.

I know.

Promise me that stops now.

Ah.

- Mom. Hey.
- Hey.

[Ethan] Thanks so much, Amy.

I'll order CBC
and liver function tests.

The fact that she's conscious-

Yeah, we got her
some more time.

I appreciate you finding
a way to trust me today.

Yeah, it worked out today.

But I'm never gonna
trust you, Richard.

Hey, Walter. Welcome back.

Did you fix my spine?

We need to run some tests
over the next few days,

but it seems that way.

And I'll be able
to walk again?

[Gina] It's gonna be
a long recovery,

lots of physical therapy
as your body adjusts

to the hardware in your spine.

But yes, you will.

And I'll have to miss
the next adoption fair?

There'll be lots more.
I promise.

Thank you, Dr. Walker.

Nobody ever cared
the way you do.

[Gina] I am so sorry.

It's okay.
We'll do a raincheck.

[sighs]

Sometimes, I wonder
how you manage to leave it all here

when you come home.

It can be really hard.

Yeah.

[sighs]

Let's go get a drink, huh?

Yeah.

[sighs]

Hey. So, I spoke to Liz,

and told her if she wants
to come forward to HR,

we would both have her back.

Thank you.
Oh, and I'm sorry if I was too-

Sonya, speaking truth to power
takes courage.

I should be thanking you.

Sorry, I didn't mean
to interrupt.

Oh no, I was just leaving.

Actually, I was
hoping to speak to you.

I just wanted to thank you
for checking in earlier.

- Joan's improving.
- I heard, that's great news.

So we're gonna do this thing?
Together?

Well, it's what she wants.

She tends to get
what she wants.

Yeah.

I saw Joan,
she's spunky as ever.

Can't keep that lady down.

- Amen to that.
- Yeah.

- [TJ] Goodnight, Jake.
- Hey. Goodnight, man.

Hey, did you know
about him and Sonya?

What about them?

- No.
- Yeah.

[chuckling]

I guess we set a good example.

[chuckling]

I heard your family
was here today.

Yeah. Um...

Mia, she got in trouble
at school, it was,

uh, I don't know...
It was ridiculous.

Maybe you can tell me
all about it on the way home?

Yeah, sure thing, Chief.
I can do that.

It's Co-Chief.

Co-Chief. I'm sorry,
that's just so awkward to say.

[chuckles] I know,
tell me about it.

Co-Chief.

["Take Me Home" playing]

? Did that fancy college
Art school let you in? ?

? Well damn
it they'd be crazy ?

? If they never saw in you ?

? What I failed to see at 17 ?

? I must've missed it too ?

? Oh, kiss me ?

? Kiss me slowly ?

? Like you did
When we were young ?

? And hold me
Like you know me ?

? Like the old days ?

? Take me home ?

[theme music playing]

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