1 00:00:02,419 --> 00:00:05,130 When my mother was diagnosed with Alzheimer's disease, 2 00:00:05,214 --> 00:00:08,217 her cousin said she must've gotten it because she didn't take fish oil. 3 00:00:08,300 --> 00:00:13,222 I picked up everything on the list, except they ran out of Dijon, 4 00:00:13,305 --> 00:00:18,727 so I got whole grain instead, which-- yeah, I know-- is inferior, but... 5 00:00:19,937 --> 00:00:21,688 - Who are you? - Hey. 6 00:00:21,772 --> 00:00:23,815 Hey, you're, uh, back early. 7 00:00:23,899 --> 00:00:27,110 Yeah, I decided to do the groceries first and pick up your car after. Who's this? 8 00:00:27,194 --> 00:00:32,157 That's Elroy, the contractor I hired to babyproof for us. 9 00:00:32,241 --> 00:00:33,242 These stairs aren't safe. 10 00:00:34,034 --> 00:00:35,035 Naked sides. 11 00:00:35,911 --> 00:00:36,912 Don't worry. 12 00:00:37,454 --> 00:00:38,872 - I can fix them. - Okay. 13 00:00:38,956 --> 00:00:40,290 I told you I was gonna do that. 14 00:00:40,374 --> 00:00:42,417 Yeah, back when Scout and Luna were babies, 15 00:00:42,501 --> 00:00:44,211 and now we have two more babies. 16 00:00:47,506 --> 00:00:50,551 My patient with a myoelectric prosthesis was just brought into the ER. 17 00:00:50,634 --> 00:00:52,052 Mountain bike accident. 18 00:00:53,053 --> 00:00:55,138 - I should go. - Wait, wait, wait. What about my car? 19 00:00:56,598 --> 00:00:57,891 Ask Elroy. 20 00:00:59,851 --> 00:01:01,895 Her neighbor thought it was because my mother, 21 00:01:01,979 --> 00:01:05,566 a world renowned surgeon, didn't do enough crossword puzzles. 22 00:01:06,191 --> 00:01:08,193 ♪ Just where I'm gonna go ♪ 23 00:01:13,574 --> 00:01:15,993 Is this your way of thanking me for the coffee? 24 00:01:16,076 --> 00:01:18,704 I'm stressed about the MandM. 25 00:01:18,787 --> 00:01:20,414 Well, I am ready to help. 26 00:01:21,290 --> 00:01:23,917 ♪ Under the pressure They say I'm gonna break ♪ 27 00:01:28,589 --> 00:01:30,465 Shepherd. I'm on her service. 28 00:01:30,549 --> 00:01:32,259 ♪ Out here trying To get something worth having ♪ 29 00:01:32,342 --> 00:01:34,177 ♪ Ain't gonna happen here ♪ 30 00:01:34,261 --> 00:01:35,262 You better go. 31 00:01:35,345 --> 00:01:40,517 I'll ask her if I can sneak away to come watch, but if not, good luck. 32 00:01:41,310 --> 00:01:43,020 I told them to shove it. 33 00:01:43,103 --> 00:01:46,440 They always want to cast blame, something to fear and avoid. 34 00:01:47,566 --> 00:01:49,067 But the only thing to blame... 35 00:01:50,360 --> 00:01:51,361 is everything. 36 00:01:53,030 --> 00:01:55,490 Bless you. Oh. 37 00:01:55,574 --> 00:01:58,285 You left out the door so early, I figured you needed a pick-me-up. 38 00:01:58,368 --> 00:02:00,787 Well, I thought keeping busy would take my mind off things, 39 00:02:00,871 --> 00:02:03,999 but it just means I'm tired and hangry. 40 00:02:04,082 --> 00:02:05,584 Yeah. How's Katie doing? 41 00:02:06,376 --> 00:02:08,211 I'm waiting for her labs, 42 00:02:08,295 --> 00:02:14,092 but I'm guessing she has carcinomatosis and a partial obstruction. 43 00:02:14,176 --> 00:02:16,887 - Well, how often are they draining her? - Twice a day. 44 00:02:16,970 --> 00:02:19,723 Okay, well, listen, if there's anything I can do, just let me know-- 45 00:02:19,806 --> 00:02:20,807 Warren. 46 00:02:21,767 --> 00:02:23,894 You're with me. 47 00:02:23,977 --> 00:02:26,813 Okay, go. I'm okay. 48 00:02:26,897 --> 00:02:29,441 - Dr. Bailey. - Welcome back. 49 00:02:30,108 --> 00:02:33,236 First day back in the OR. How's it feel? 50 00:02:33,320 --> 00:02:35,656 Well, I'm working with my chief resident. 51 00:02:35,739 --> 00:02:40,202 I have an MandM later today, and the cafeteria is serving shepherd's pie. 52 00:02:40,285 --> 00:02:41,370 Feels like Christmas. 53 00:02:42,579 --> 00:02:44,122 Well, wait till you see our first consult. 54 00:02:44,206 --> 00:02:45,582 Good morning. 55 00:02:45,666 --> 00:02:48,710 Oh, Russell, this is Dr. Webber and Dr. Warren. 56 00:02:48,794 --> 00:02:50,420 These are the headliners. 57 00:02:50,504 --> 00:02:52,255 Russell's a community theater director. 58 00:02:52,339 --> 00:02:54,091 Right now, he's putting up a production of Hamlet. 59 00:02:54,174 --> 00:02:56,968 "When sorrows come, they come not single spies"... 60 00:02:57,052 --> 00:02:58,804 ..."but in battalions." 61 00:02:58,887 --> 00:03:01,390 - Yes, okay. - Yeah. 62 00:03:01,473 --> 00:03:04,810 You would demote my Claudius to an understudy. 63 00:03:04,893 --> 00:03:06,395 - Hamlet's my favorite Shakespeare. - Mmm. 64 00:03:06,478 --> 00:03:08,939 - Um, Dr. Meade? - Much Ado About Nothing. 65 00:03:09,731 --> 00:03:11,233 He wants you to present the case. 66 00:03:11,983 --> 00:03:13,110 Right. Sorry, um... 67 00:03:14,111 --> 00:03:17,114 "Russell West, 34, with history of beta thalassemia 68 00:03:17,197 --> 00:03:19,866 with blood transfusions every three months for anemia. 69 00:03:19,950 --> 00:03:23,078 Admitted for splenic sequestration crisis two weeks ago." 70 00:03:23,161 --> 00:03:25,789 His abdomen has been getting increasingly distended. 71 00:03:25,872 --> 00:03:28,291 Uh, we're consulting today for a splenectomy. 72 00:03:28,375 --> 00:03:31,044 I thought I was just gaining a little weight... 73 00:03:31,128 --> 00:03:33,630 ...but then my stomach just kept getting bigger and bigger. 74 00:03:33,713 --> 00:03:35,298 - Can I take a look? - Yeah. 75 00:03:35,382 --> 00:03:36,716 I'll call for an ultrasound. 76 00:03:36,800 --> 00:03:38,343 Oh, let's go old school while we wait. 77 00:03:38,427 --> 00:03:40,262 When was the last time you did percussion? 78 00:03:40,345 --> 00:03:42,305 Uh... 79 00:03:44,766 --> 00:03:47,018 All right, you hear that? It's hollow. That's his lung. 80 00:03:47,602 --> 00:03:51,773 Here. That's dull. That's the spleen from here... 81 00:03:54,025 --> 00:03:55,652 to here. 82 00:03:56,653 --> 00:03:59,281 Your spleen extends from the left upper quadrant 83 00:03:59,364 --> 00:04:01,199 all the way to the right lower quadrant. 84 00:04:01,283 --> 00:04:03,034 It's taking up your entire abdomen. 85 00:04:03,118 --> 00:04:04,786 This needs to come out immediately. 86 00:04:04,870 --> 00:04:07,414 I'm in the middle of tech week. I can't... 87 00:04:07,998 --> 00:04:09,332 Won't it just shrink on its own? 88 00:04:09,416 --> 00:04:13,086 It's unlikely in a case this severe. Plus, you'd run the risk of rupturing it. 89 00:04:13,170 --> 00:04:14,337 Okay, that sounds bad. 90 00:04:14,421 --> 00:04:16,923 Yeah, really bad. Instant death. 91 00:04:18,967 --> 00:04:21,052 You... You want to take care of this sooner rather than later. 92 00:04:21,136 --> 00:04:24,931 Dr. Meade can take you for a CT scan so we can plan a surgical approach. 93 00:04:25,015 --> 00:04:27,184 Yeah, could he do it instead? 94 00:04:27,267 --> 00:04:28,810 I'll go with you. 95 00:04:28,894 --> 00:04:29,895 Yeah. 96 00:04:32,230 --> 00:04:34,733 - Well? - It's better than Christmas. 97 00:04:36,193 --> 00:04:40,822 ...had been compromised. We then used 4-0 VICRYL sutures to inset the-- 98 00:04:40,906 --> 00:04:42,282 Are you reciting your presentation? 99 00:04:43,074 --> 00:04:46,369 You know how when you lie, your cheeks get flushed and your voice gets all high? 100 00:04:47,037 --> 00:04:49,956 You do both of those things, and so do I when I give presentations, 101 00:04:50,040 --> 00:04:54,044 and I also sweat and sometimes faint. 102 00:05:05,305 --> 00:05:07,808 - Interesting case? - Your sternal reconstruction patient. 103 00:05:07,891 --> 00:05:08,892 Scott Hill? 104 00:05:09,392 --> 00:05:11,228 Beckman's out. Someone has to check on him. 105 00:05:11,311 --> 00:05:14,898 Well, Dr. Wright is supposed to be attempting another flap tomorrow. 106 00:05:15,899 --> 00:05:16,900 Hope it takes. 107 00:05:18,860 --> 00:05:20,153 See you at the MandM. 108 00:05:23,448 --> 00:05:24,950 It'll be fine. 109 00:05:25,033 --> 00:05:28,328 I've successfully avoided him after lying to help his patient. 110 00:05:28,411 --> 00:05:31,498 Oh, that was weeks ago. He's probably forgotten. 111 00:05:33,375 --> 00:05:35,043 You truly are a terrible liar. 112 00:05:38,338 --> 00:05:40,757 Sorry for interrupting your parental leave. 113 00:05:40,841 --> 00:05:42,384 Was Jo annoyed? 114 00:05:42,467 --> 00:05:44,219 Yeah, but not because of that. 115 00:05:44,970 --> 00:05:46,388 Oh, here they are. 116 00:05:47,305 --> 00:05:50,350 Okay, "Jon Ellison, 40. Status post-mountain biking accident. 117 00:05:50,433 --> 00:05:52,143 No LOC or signs of head trauma. 118 00:05:52,227 --> 00:05:55,397 He has bruising on his chest, and X-rays show multiple rib fractures. 119 00:05:55,480 --> 00:05:57,649 He had targeted muscle reinnervation surgery 120 00:05:57,732 --> 00:05:59,693 a few months ago for an advanced arm prosthesis"-- 121 00:05:59,776 --> 00:06:00,777 I know. I did it. 122 00:06:00,861 --> 00:06:02,571 After I amputated his arm. 123 00:06:02,654 --> 00:06:03,822 Jon. 124 00:06:03,905 --> 00:06:04,906 Pauline. 125 00:06:05,448 --> 00:06:06,449 What happened? 126 00:06:06,533 --> 00:06:08,201 I was training at Tiger Mountain. 127 00:06:08,285 --> 00:06:09,703 The hand just let go. 128 00:06:09,786 --> 00:06:11,413 I lost my balance and fell. 129 00:06:11,496 --> 00:06:12,914 He crashed straight into a boulder. 130 00:06:13,498 --> 00:06:17,085 - Tell 'em about the last time. - Yeah, it did the same thing last month. 131 00:06:17,168 --> 00:06:20,839 I sideswiped a tree and almost missed qualifying for the World Championships. 132 00:06:20,922 --> 00:06:23,049 - When's the competition? - Three months. 133 00:06:23,133 --> 00:06:25,844 I can still compete though, right? I'm up for sponsorships. 134 00:06:25,927 --> 00:06:27,554 The nerve we rerouted to your upper arm 135 00:06:27,637 --> 00:06:30,223 should be sending precise signals to your hand. 136 00:06:30,307 --> 00:06:31,892 We'll get some scans. We'll check it out. 137 00:06:31,975 --> 00:06:33,852 Kwan, call CT. Let 'em know we're coming. 138 00:06:33,935 --> 00:06:34,936 Yeah. 139 00:06:38,690 --> 00:06:39,983 What are we playing? 140 00:06:40,066 --> 00:06:41,276 Five-card stud. 141 00:06:41,359 --> 00:06:43,570 - You play? - Uh, not anymore. 142 00:06:44,487 --> 00:06:47,324 But I ran a weekly poker night in med school. 143 00:06:47,407 --> 00:06:49,826 - Were you any good? - Graduated debt-free. 144 00:06:52,162 --> 00:06:53,371 How are you feeling today? 145 00:06:53,455 --> 00:06:55,123 They drained another liter this morning. 146 00:06:55,206 --> 00:06:58,418 She's still nauseous. We asked for ice chips 30 minutes ago. 147 00:06:58,501 --> 00:07:01,755 Oh, it must have gotten lost in the morning handoff. 148 00:07:01,838 --> 00:07:04,841 - I'll get them myself. - Can you grab some for my mom too? 149 00:07:04,924 --> 00:07:07,761 - She needs to chill. - You see how she treats me? 150 00:07:12,891 --> 00:07:15,226 Uh, I'll... I'll get you those ice chips. 151 00:07:18,563 --> 00:07:19,814 How bad? 152 00:07:20,398 --> 00:07:22,609 Katie's creatinine is elevated, albumin low. 153 00:07:22,692 --> 00:07:27,030 Her AST, ALT, and INR are through the roof. 154 00:07:27,947 --> 00:07:30,116 She's in multiple organ failure. 155 00:07:30,200 --> 00:07:32,744 The TPN is too hard on her liver. 156 00:07:33,286 --> 00:07:35,080 It's the only thing giving her nutrition. 157 00:07:39,292 --> 00:07:41,127 Call palliative care. 158 00:08:00,897 --> 00:08:02,273 {\an8}I thought I was late. 159 00:08:02,899 --> 00:08:05,694 {\an8}Bailey does not need another reason to yell at me. 160 00:08:05,777 --> 00:08:07,362 {\an8}- Hey, how's Katie? - Yes. 161 00:08:08,780 --> 00:08:13,159 {\an8}Her INR is getting worse. She needs two more units of FFP. Correct. 162 00:08:14,285 --> 00:08:15,704 {\an8}Thank you. 163 00:08:15,787 --> 00:08:18,081 {\an8}Katie? What, is her liver failing? 164 00:08:18,665 --> 00:08:19,999 {\an8}What did the repeat scans show? 165 00:08:24,421 --> 00:08:26,840 {\an8}She doesn't know yet. We're gonna tell her after the MandM. 166 00:08:26,923 --> 00:08:27,924 {\an8}I wanna be there. 167 00:08:28,007 --> 00:08:30,468 {\an8}You are not part of her care team. 168 00:08:30,552 --> 00:08:32,554 {\an8}Do I need to write you a reminder? 169 00:08:34,431 --> 00:08:36,891 {\an8}Hi. Good morning, everyone. 170 00:08:36,975 --> 00:08:38,768 {\an8}Are we ready to begin? 171 00:08:38,852 --> 00:08:41,104 {\an8}- Dr. Millin? - Yes. 172 00:08:46,901 --> 00:08:50,739 {\an8}Uh, Scott Hill, age 73, presented four months ago 173 00:08:50,822 --> 00:08:53,033 {\an8}with shortness of breath and chest pain. 174 00:08:54,451 --> 00:08:58,288 {\an8}See what I told you? The spleen has taken over the entire abdomen. 175 00:08:58,371 --> 00:09:00,707 {\an8}It has sequestered so much of his blood supply. 176 00:09:00,790 --> 00:09:03,293 {\an8}I mean, how would you even mobilize that? 177 00:09:04,544 --> 00:09:05,754 {\an8}You tell me. 178 00:09:06,504 --> 00:09:07,922 {\an8}Uh, well, um... 179 00:09:08,006 --> 00:09:11,301 {\an8}If it were a smaller spleen, I would enter the lesser sac, 180 00:09:11,384 --> 00:09:17,182 {\an8}take down attachments, and medially rotate it to access the pedicle, but this... 181 00:09:17,265 --> 00:09:19,017 {\an8}Yeah, I have no clue. 182 00:09:19,100 --> 00:09:20,977 {\an8}Plus, once we're in there, one nick to the organ 183 00:09:21,061 --> 00:09:22,353 {\an8}and Russell could bleed out in seconds. 184 00:09:24,731 --> 00:09:26,357 {\an8}When I was a resident, 185 00:09:26,441 --> 00:09:30,445 {\an8}I scrubbed in on a liver teratoma I thought was impossible to resect. 186 00:09:31,029 --> 00:09:32,906 {\an8}But I had an attending, Dr. Rathbone, 187 00:09:32,989 --> 00:09:37,786 {\an8}who did a total vascular exclusion of the liver to create a bloodless field. 188 00:09:37,869 --> 00:09:41,372 {\an8}It was brilliant, and it taught me to always keep an open mind. 189 00:09:42,123 --> 00:09:45,085 {\an8}I saved a piece of that tumor in a jar for years after. 190 00:09:46,002 --> 00:09:49,422 {\an8}Maybe after this you can, uh, save a piece of Russell's spleen, huh? 191 00:09:49,506 --> 00:09:51,674 {\an8}Do I have to? 192 00:09:53,134 --> 00:09:55,220 {\an8}Okay, let's take a page from Rathbone's playbook. 193 00:09:55,303 --> 00:09:58,640 {\an8}Let's call IR, have them embolize the splenic artery, 194 00:09:58,723 --> 00:10:00,308 {\an8}then we'll open him up and see what we got. 195 00:10:00,391 --> 00:10:02,477 {\an8}Uh, what about the MandM? We're already late. 196 00:10:02,560 --> 00:10:04,813 {\an8}No, MandMs happen every week. 197 00:10:06,064 --> 00:10:08,149 {\an8}But a spleen like this? 198 00:10:08,733 --> 00:10:10,860 {\an8}It happens once in a lifetime. 199 00:10:10,944 --> 00:10:15,949 {\an8}We then used interrupted 4-0 VICRYL sutures to inset the omental flap. 200 00:10:16,032 --> 00:10:18,284 {\an8}You can see the healthy flap here. 201 00:10:18,368 --> 00:10:23,164 {\an8}Did his pre-op scans show any sign for concern about pedicle tension? 202 00:10:23,248 --> 00:10:25,625 {\an8}No, the team agreed that the distance 203 00:10:25,708 --> 00:10:28,670 {\an8}between the epigastrium and the superior sternum was acceptable. 204 00:10:28,753 --> 00:10:31,005 {\an8}And at this point, "the team" was... 205 00:10:31,089 --> 00:10:32,715 {\an8}Me and Dr. Mohanty. 206 00:10:32,799 --> 00:10:34,968 {\an8}You had finished harvesting the omentum, 207 00:10:35,051 --> 00:10:37,887 {\an8}and Dr. Wright and Dr. Warren were needed on another case. 208 00:10:37,971 --> 00:10:42,559 {\an8}So, the, uh, the changes in the flap's appearance progressed rapidly post-op. 209 00:10:42,642 --> 00:10:46,312 {\an8}As you can see here, uh, it is dark and swollen. 210 00:10:46,396 --> 00:10:48,106 Did you check Doppler flow after inset? 211 00:10:48,189 --> 00:10:51,192 - Yes, there was biphasic signal. - And which one of you did that? 212 00:10:52,569 --> 00:10:55,780 Well, we can both confirm that there was a signal. 213 00:10:55,864 --> 00:10:58,283 {\an8}When we realized there was no blood flow to the flap-- 214 00:10:58,366 --> 00:11:02,287 {\an8}I'm sorry, so the two of you both heard the signal? 215 00:11:02,370 --> 00:11:04,622 {\an8}Were roles clearly defined during the inset? 216 00:11:04,706 --> 00:11:06,374 {\an8}- I believe so. - You believe so? 217 00:11:07,375 --> 00:11:09,878 {\an8}Who placed the stitch causing tension around the pedicle? 218 00:11:11,963 --> 00:11:16,259 {\an8}Look, this patient, my patient, hasn't left the hospital in weeks 219 00:11:16,342 --> 00:11:20,763 {\an8}due to a gaping hole in his chest, which I believed we had fixed. 220 00:11:21,514 --> 00:11:23,850 {\an8}He's still here because of someone's negligence 221 00:11:23,933 --> 00:11:26,144 {\an8}and it sure as hell isn't mine, so... 222 00:11:27,770 --> 00:11:29,397 {\an8}who placed the stitch? 223 00:11:32,859 --> 00:11:33,860 {\an8}That's on me. 224 00:11:35,069 --> 00:11:37,322 {\an8}I should have watched my resident more carefully. 225 00:11:37,405 --> 00:11:39,908 {\an8}I take full responsibility as her supervisor. 226 00:11:55,465 --> 00:11:57,383 {\an8}He is all set. 227 00:11:58,551 --> 00:12:01,262 {\an8}Would either of you mind if I catch the last part of the MandM? 228 00:12:01,346 --> 00:12:03,014 {\an8}- Start the scan, Kwan. - We do. 229 00:12:07,268 --> 00:12:08,978 {\an8}- Everything okay? - I'm a handy person. 230 00:12:09,812 --> 00:12:11,773 {\an8}Did I miss the first part of this conversation? 231 00:12:11,856 --> 00:12:15,443 {\an8}Jo's getting an estimate from a contractor to babyproof our place, 232 00:12:15,526 --> 00:12:17,987 {\an8}even though I told her I can do it. I want to do it. 233 00:12:19,197 --> 00:12:20,698 {\an8}Are you sure you still need me here? 234 00:12:20,782 --> 00:12:22,450 {\an8}The babies can't even roll over on their own. 235 00:12:22,533 --> 00:12:23,785 {\an8}They're nowhere close to crawling. 236 00:12:23,868 --> 00:12:26,412 {\an8}We have a minute before the stairs are an actual risk. 237 00:12:26,496 --> 00:12:29,082 {\an8}So, you'll just wait till Scout and Luna are teenagers? 238 00:12:30,500 --> 00:12:32,168 {\an8}- Kwan? - Yes, all right, 239 00:12:32,252 --> 00:12:35,546 {\an8}three right-sided rib fractures. He has a small pneumothorax. 240 00:12:35,630 --> 00:12:38,883 {\an8}He probably doesn't need a chest tube, but the muscle in the TMR looks good. 241 00:12:38,967 --> 00:12:40,885 {\an8}All right, admit him for observation 242 00:12:40,969 --> 00:12:43,263 {\an8}and then just do a follow-up X-ray with him later today. 243 00:12:44,013 --> 00:12:46,099 {\an8}I'm sorry you had to come in for rib fractures, 244 00:12:46,182 --> 00:12:48,643 {\an8}but maybe now you can go home and babyproof. 245 00:12:48,726 --> 00:12:51,020 {\an8}We should still check the signals to his bionic arm. 246 00:12:51,104 --> 00:12:53,690 {\an8}I mean, there's no hematoma or bleeding around the nerves in the TMR. 247 00:12:53,773 --> 00:12:54,816 The signals should be fine. 248 00:12:54,899 --> 00:12:56,317 Yeah, but he's still falling off his bike. 249 00:12:57,443 --> 00:13:00,655 Kwan, get Jon back to his room and set up for EMG testing. 250 00:13:00,738 --> 00:13:02,282 - Yeah. - Mm-hmm. 251 00:13:04,242 --> 00:13:08,079 {\an8}When a pedicle passes through narrow tunnels, we're essentially working blind. 252 00:13:08,162 --> 00:13:11,833 Uh, Dr. Millin, when you placed the stitch, did you use a lot of tension? 253 00:13:11,916 --> 00:13:13,710 Excuse me? 254 00:13:13,793 --> 00:13:16,462 I asked if you used a lot of tension when you placed the stitch. 255 00:13:16,546 --> 00:13:18,047 I-I didn't place the stitch. 256 00:13:19,215 --> 00:13:22,802 Dr. Mohanty, did you or did you not allow Dr. Millin to place the stitch? 257 00:13:22,885 --> 00:13:25,096 She specifically asked to do some of the suturing-- 258 00:13:25,179 --> 00:13:28,308 And you said no. Th-This is a huge miscommunication. 259 00:13:28,391 --> 00:13:29,976 Are you saying she's lying? 260 00:13:30,935 --> 00:13:32,061 I didn't say that. 261 00:13:32,145 --> 00:13:34,147 But you are denying that it was you. 262 00:13:34,230 --> 00:13:37,191 If you're both saying you didn't place the suture, 263 00:13:37,275 --> 00:13:38,609 one of you is not telling the truth. 264 00:13:39,193 --> 00:13:42,572 I only closed the abdomen. I wasn't anywhere near the pedicle. 265 00:13:42,655 --> 00:13:46,367 Dr. Millin, admitting your mistakes is an important part to learning. 266 00:13:46,451 --> 00:13:50,663 If you can't own up to them, we've got a much more serious problem. 267 00:13:58,129 --> 00:13:59,130 What the hell was that? 268 00:14:00,006 --> 00:14:02,008 - Dr. Millin. - You placed that stitch, and you know it. 269 00:14:02,091 --> 00:14:03,384 Can we talk about this, please? 270 00:14:03,468 --> 00:14:06,888 Oh, I'm sorry. Do you not want to get dragged in public? 271 00:14:06,971 --> 00:14:08,765 Sometimes MandMs go south. 272 00:14:08,848 --> 00:14:10,308 Everyone knows this. 273 00:14:10,391 --> 00:14:11,893 Is that supposed to be an apology? 274 00:14:11,976 --> 00:14:13,102 You're a resident. 275 00:14:13,186 --> 00:14:14,937 Residents are supposed to make mistakes. 276 00:14:15,021 --> 00:14:16,981 Well, I didn't screw up. 277 00:14:17,065 --> 00:14:20,026 You lied, and I got scorched for it. 278 00:14:20,109 --> 00:14:21,694 I have patients to see. 279 00:14:25,990 --> 00:14:28,785 Okay, let me know if you feel any discomfort. 280 00:14:28,868 --> 00:14:30,119 I'm used to it. 281 00:14:30,203 --> 00:14:32,371 Okay, Jon, I want you to imagine your phantom limb 282 00:14:32,455 --> 00:14:34,332 and start opening and closing your hand. 283 00:14:34,415 --> 00:14:36,584 That's a good sign, right? 284 00:14:36,667 --> 00:14:38,669 Yeah, the muscles are receiving signal. 285 00:14:38,753 --> 00:14:40,004 It's a really good sign. 286 00:14:40,088 --> 00:14:41,798 And how's the prosthesis treating you otherwise? 287 00:14:41,881 --> 00:14:45,843 If I was wearing it, I'd give you a thumbs up or the middle finger. 288 00:14:45,927 --> 00:14:47,053 Depends on my mood. 289 00:14:47,136 --> 00:14:49,597 Oh, he's painted the baby's room and started cooking again. 290 00:14:49,680 --> 00:14:51,265 It's changed his life at home. 291 00:14:51,349 --> 00:14:55,561 I just can't do the one thing I was really hoping for. 292 00:14:55,645 --> 00:14:57,814 Well, your signals are good. 293 00:14:57,897 --> 00:15:00,316 The TMR is not the problem. 294 00:15:00,399 --> 00:15:03,694 Jon, when you ride, do you experience a high level of stress? 295 00:15:03,778 --> 00:15:08,324 He's dodging trees and jumping rocks and trying not to fall off the trail. 296 00:15:08,407 --> 00:15:09,700 I actually find it relaxing. 297 00:15:09,784 --> 00:15:12,620 Right, but you're still encountering unexpected obstacles 298 00:15:12,703 --> 00:15:16,749 and changes in terrain that could cause a reflexive reaction 299 00:15:16,833 --> 00:15:19,001 in the muscles that send signal that could potentially 300 00:15:19,085 --> 00:15:20,670 make your hand do things you don't intend. 301 00:15:20,753 --> 00:15:22,839 - Like let go of the bike? - Exactly. 302 00:15:22,922 --> 00:15:26,050 Mountain biking's all about dealing with the unexpected. 303 00:15:26,134 --> 00:15:28,469 If I can't do that, I can't ride, 304 00:15:28,553 --> 00:15:31,430 and that means no sponsorships, no prize money. 305 00:15:31,514 --> 00:15:32,890 - Jon-- - And without that money, 306 00:15:32,974 --> 00:15:34,725 we can't afford repairs to my gear, 307 00:15:34,809 --> 00:15:36,811 my training time, part of our mortgage. 308 00:15:36,894 --> 00:15:39,605 I've been working for months to qualify for this race. 309 00:15:39,689 --> 00:15:41,190 Now you're telling me I could lose it all? 310 00:15:41,274 --> 00:15:44,193 If you're getting more exercise, your muscles are getting stronger, 311 00:15:44,277 --> 00:15:47,697 they might be sending a stronger signal than the prosthesis needs. 312 00:15:47,780 --> 00:15:50,575 Let's take a look at that, and we'll go from there. 313 00:16:01,252 --> 00:16:03,171 Curtis. Up for a visit? 314 00:16:05,131 --> 00:16:06,632 From the chief? 315 00:16:07,216 --> 00:16:08,676 Anytime. 316 00:16:10,136 --> 00:16:11,929 How are you? 317 00:16:12,013 --> 00:16:15,224 I told the nurses I was cancer-roommates with Richard Webber. 318 00:16:15,308 --> 00:16:17,727 Suddenly I got extra pillows. 319 00:16:17,810 --> 00:16:19,437 And unlimited applesauce. 320 00:16:19,520 --> 00:16:21,397 What's a fancy title for? 321 00:16:22,607 --> 00:16:24,400 You just missed my wife and kids. 322 00:16:26,027 --> 00:16:27,528 Really wish you would've met them. 323 00:16:27,612 --> 00:16:29,197 - Yeah, I would've loved that too. - Yeah. 324 00:16:29,280 --> 00:16:30,531 How old are your kids? 325 00:16:30,615 --> 00:16:31,824 Trevor's eight. 326 00:16:31,908 --> 00:16:33,409 He's my bookworm. 327 00:16:33,492 --> 00:16:35,953 And, uh, Amani's five. 328 00:16:36,037 --> 00:16:39,832 She's already running around on her bike like a bat out of hell. 329 00:16:39,916 --> 00:16:42,168 She'll be trouble. 330 00:16:43,961 --> 00:16:46,130 Now, that's the hardest part of all this. 331 00:16:47,465 --> 00:16:48,466 It's, uh... 332 00:16:49,675 --> 00:16:51,594 leaving them behind. 333 00:17:00,269 --> 00:17:01,270 Look, I'd... 334 00:17:01,354 --> 00:17:04,106 I'd love to stay, Curtis, but I'm needed in surgery. 335 00:17:04,899 --> 00:17:07,235 Thank you for stopping by, Dr. Webber. 336 00:17:09,028 --> 00:17:10,363 Just Richard. 337 00:17:23,918 --> 00:17:25,169 How long does she have? 338 00:17:25,253 --> 00:17:28,005 If I give you an answer, it... 339 00:17:28,089 --> 00:17:29,966 it's just my best guess. 340 00:17:30,049 --> 00:17:31,801 But I have more energy today. 341 00:17:31,884 --> 00:17:33,886 We removed the NG tube. 342 00:17:33,970 --> 00:17:36,180 I ate a Popsicle without throwing up. 343 00:17:36,264 --> 00:17:38,516 Yeah, it's common to have good days. 344 00:17:38,599 --> 00:17:42,186 Our focus now is on keeping you comfortable 345 00:17:42,270 --> 00:17:46,107 so you can have as many good days as possible. 346 00:17:46,190 --> 00:17:49,151 And if you do in-hospital hospice, we can manage your symptoms 347 00:17:49,235 --> 00:17:50,945 and pain here for as long as you need. 348 00:17:51,028 --> 00:17:52,655 No, I-I need to go home. 349 00:17:54,574 --> 00:17:56,576 I need to... to sleep in my own bed. 350 00:17:56,659 --> 00:18:02,707 I need to eat my own food, and maybe if we work with the PT, I'll improve. 351 00:18:02,790 --> 00:18:04,417 Then that's what we'll do. 352 00:18:06,043 --> 00:18:07,378 We... 353 00:18:07,461 --> 00:18:10,464 We can arrange home health and PT, 354 00:18:10,548 --> 00:18:13,217 but you'd only have someone a couple of hours a week, 355 00:18:13,301 --> 00:18:14,677 and you need more support. 356 00:18:15,303 --> 00:18:19,432 If you do in-home hospice care, well, they'll send you someone 24/7, 357 00:18:19,515 --> 00:18:22,476 but it could take a week to get started. 358 00:18:22,560 --> 00:18:24,770 I need to get out of here now. 359 00:18:24,854 --> 00:18:26,314 I need to get better. 360 00:18:26,397 --> 00:18:29,108 I'll take care of her until everything's arranged. 361 00:18:29,191 --> 00:18:34,113 She needs a hospital bed, an oxygen concentrator, a Hoyer lift-- 362 00:18:34,196 --> 00:18:35,615 I'll figure it out. 363 00:18:37,033 --> 00:18:38,534 I did it with my mom. 364 00:18:42,496 --> 00:18:45,291 If you do this, Katie will be leaving 365 00:18:45,374 --> 00:18:47,335 against medical advice. 366 00:18:47,418 --> 00:18:51,631 The insurance won't cover everything she needs at home if she does that. 367 00:18:52,673 --> 00:18:56,427 I've done everything you've asked. 368 00:18:58,304 --> 00:19:03,351 Every scan, every test, every infusion, and here I am. 369 00:19:04,769 --> 00:19:09,690 You... You don't know if I'm dying. 370 00:19:09,774 --> 00:19:11,400 You don't know anything. 371 00:19:12,068 --> 00:19:13,110 If I go home... 372 00:19:15,196 --> 00:19:16,364 I'll get better. 373 00:19:17,782 --> 00:19:19,116 You'll see. 374 00:19:25,247 --> 00:19:29,251 Okay. Then I will talk with social work, 375 00:19:29,335 --> 00:19:30,836 and we'll start the process. 376 00:19:36,676 --> 00:19:39,053 Bailey, are you sure AMA is the right move for Katie? 377 00:19:39,136 --> 00:19:41,305 I most certainly am not. 378 00:19:42,264 --> 00:19:44,642 Look, don't-don't make any moves yet. 379 00:19:44,725 --> 00:19:48,187 I know someone she might listen to. 380 00:19:55,027 --> 00:19:56,195 Hey, I'm still here. 381 00:19:56,278 --> 00:19:57,530 Did you read the estimate? 382 00:19:57,613 --> 00:19:59,448 I've been with my patient. 383 00:19:59,532 --> 00:20:01,742 Well, in order to fully babyproof the balcony, 384 00:20:01,826 --> 00:20:03,577 we have to put up a higher enclosure 385 00:20:03,661 --> 00:20:06,706 which costs more than I can say without throwing up. 386 00:20:06,789 --> 00:20:08,582 I told you I... I could do it. 387 00:20:08,666 --> 00:20:11,377 You know, I'm not even sure the HOA will allow it, so what do you want to do? 388 00:20:11,460 --> 00:20:12,878 Now you want my opinion? 389 00:20:12,962 --> 00:20:15,131 You really wanna get into it again? 390 00:20:15,214 --> 00:20:16,132 Look, I'm sorry. 391 00:20:16,215 --> 00:20:18,467 - I should go. - Same. 392 00:20:21,345 --> 00:20:23,013 - You gotta go? - No, it's fine. Let's continue. 393 00:20:23,097 --> 00:20:24,265 Okay. 394 00:20:24,348 --> 00:20:26,308 Okay, this should test the grip. 395 00:20:27,435 --> 00:20:28,894 Mm-hmm. 396 00:20:28,978 --> 00:20:31,439 Hmm. And now finger rolls. 397 00:20:33,858 --> 00:20:37,653 It's working well within normal EMG signals, 398 00:20:37,737 --> 00:20:40,322 and he says it works fine when he's not biking, so... 399 00:20:40,406 --> 00:20:42,616 - It's the stress. - Yeah. 400 00:20:43,200 --> 00:20:45,202 He's done with competitive racing. 401 00:20:48,789 --> 00:20:49,999 That was lunch. 402 00:20:50,624 --> 00:20:52,126 My life is over. 403 00:20:52,209 --> 00:20:55,004 Are your organs failing from stage-four gastric cancer? 404 00:20:55,087 --> 00:20:56,672 It'll work out. 405 00:20:56,756 --> 00:20:57,798 I've been there. 406 00:20:57,882 --> 00:21:00,760 - You got kicked out of your last program. - Still worked out. I'm here. 407 00:21:03,637 --> 00:21:06,807 Hey, your girlfriend is not only a sloppy surgeon, she's a liar. 408 00:21:07,767 --> 00:21:08,851 The MandM did not go well. 409 00:21:08,934 --> 00:21:12,188 She blamed me for her crappy suture that killed our patient's flap, 410 00:21:12,271 --> 00:21:14,440 and now none of the attendings will even look at me. 411 00:21:14,523 --> 00:21:17,026 Kavita is not a liar. Both her parents are doctors. 412 00:21:17,109 --> 00:21:19,320 And that makes her immune to being a horrible person? 413 00:21:19,403 --> 00:21:20,821 Hey, wait, she's not a horrible person. 414 00:21:20,905 --> 00:21:25,326 No, you told me to be nice to her, and I was, and look where that got me. 415 00:21:25,409 --> 00:21:26,827 Thrown under the freaking bus. 416 00:21:28,287 --> 00:21:29,914 - You love the bus. - Kwan. 417 00:21:31,874 --> 00:21:33,167 This isn't a joke. 418 00:21:33,250 --> 00:21:34,919 Hey! This is my career! 419 00:21:35,795 --> 00:21:38,881 And you know what makes it worse, is that you're automatically taking her side. 420 00:21:40,674 --> 00:21:42,092 Oh... Some friend you are. 421 00:21:43,093 --> 00:21:46,597 - Where are you going? - To... To fix this. 422 00:21:51,519 --> 00:21:52,728 Hey. 423 00:21:53,229 --> 00:21:54,438 Thank you. 424 00:21:58,108 --> 00:22:01,695 Anna Karenina? This is what you want to read right now? 425 00:22:01,779 --> 00:22:02,947 It's pretty depressing. 426 00:22:03,030 --> 00:22:07,201 Well, I'm making my way through a list of a hundred books you should read. 427 00:22:07,284 --> 00:22:09,119 Yeah, I've read these. You can skip them. 428 00:22:09,203 --> 00:22:11,413 You've read all 100 books? 429 00:22:11,497 --> 00:22:14,834 Uh, Moby Dick, a bunch of men yelling on a boat. 430 00:22:14,917 --> 00:22:16,544 Oh, and there's a whale. 431 00:22:16,627 --> 00:22:19,797 Uh, War and Peace, a lot of war, a little peace. 432 00:22:19,880 --> 00:22:22,424 That's two off your list. 433 00:22:25,803 --> 00:22:27,179 Let's get out of here. 434 00:22:27,263 --> 00:22:29,056 Let's go look at the houseboats. 435 00:22:31,934 --> 00:22:32,977 We can't just leave. 436 00:22:33,978 --> 00:22:36,272 - You're a patient. - Didn't stop you before. 437 00:22:36,772 --> 00:22:39,275 - And you were my doctor then. - Yeah, it's not that simple. 438 00:22:39,358 --> 00:22:40,818 You can't walk. 439 00:22:40,901 --> 00:22:42,945 We'd need portable oxygen. 440 00:22:43,028 --> 00:22:44,864 I can walk. Just give me your hand. 441 00:22:44,947 --> 00:22:46,407 Look, Katie, we just... 442 00:22:46,490 --> 00:22:48,450 Can... Can you get my bag? 443 00:22:48,534 --> 00:22:50,911 I can't. I don't even know if I can get you in my car. 444 00:22:53,372 --> 00:22:55,958 Okay. It's okay. It's okay, it's okay. I got you. 445 00:22:57,251 --> 00:22:59,169 This is it for me, isn't it? 446 00:23:01,005 --> 00:23:03,048 I really wanted to go home. 447 00:23:03,132 --> 00:23:04,800 I'm so sorry. 448 00:23:10,806 --> 00:23:12,057 Okay. 449 00:23:12,141 --> 00:23:13,517 Going through the fascia. 450 00:23:16,061 --> 00:23:17,605 - Metz. - You know, 451 00:23:17,688 --> 00:23:18,898 Meade here has been doing some research. 452 00:23:18,981 --> 00:23:24,069 Fact, the largest spleen ever recorded, 26 pounds and 17 inches. 453 00:23:24,153 --> 00:23:27,031 And based on our estimates, this one could beat it, sir. 454 00:23:27,114 --> 00:23:28,991 You ready to make history, Dr. Webber? 455 00:23:32,620 --> 00:23:36,707 Oh. [chuckles] Oh, my God. That is... 456 00:23:36,790 --> 00:23:38,626 Nothing but spleen. 457 00:23:38,709 --> 00:23:41,211 Look, I don't want to hear another word about records 458 00:23:41,295 --> 00:23:43,797 or history until Russell is on his way to post-op. 459 00:23:43,881 --> 00:23:46,258 Okay, our focus should be on this patient, on this surgery. 460 00:23:46,342 --> 00:23:48,010 - Understood? - Loud and clear, boss. 461 00:23:48,093 --> 00:23:50,554 We've got a lot of work ahead of us. And I need full visualization. 462 00:23:50,638 --> 00:23:52,264 Titan. 463 00:23:52,348 --> 00:23:54,058 Okay. 464 00:23:54,141 --> 00:23:55,935 All right, here we go. 465 00:24:00,147 --> 00:24:03,776 She'll stay here until her in-home hospice is set up. 466 00:24:03,859 --> 00:24:04,902 Okay. 467 00:24:04,985 --> 00:24:07,196 The social worker's on her way to get the process started. 468 00:24:07,279 --> 00:24:09,365 Did you mention we're hoping they can rush this? 469 00:24:09,448 --> 00:24:11,700 Yeah, and I might have dropped your name. 470 00:24:12,201 --> 00:24:14,328 All right, we'll see if it helps. 471 00:24:16,372 --> 00:24:17,373 Oh. 472 00:24:18,749 --> 00:24:19,833 So, what? 473 00:24:19,917 --> 00:24:21,502 Now you bring in the doctors 474 00:24:21,585 --> 00:24:24,129 with the sad smiles and quiet voices 475 00:24:24,213 --> 00:24:26,924 pretending to know what it's like to die before you're supposed to? 476 00:24:28,300 --> 00:24:33,138 Our team will do everything to make her more comfortable. 477 00:24:33,222 --> 00:24:38,519 They'll also move her into a room with more natural light, fewer machines. 478 00:24:39,061 --> 00:24:41,230 And the chaplain will come too, right? 479 00:24:41,939 --> 00:24:47,194 You had this same conversation 15 years ago about my mother. 480 00:24:47,861 --> 00:24:51,699 And now you have the gall to have it again about my daughter. 481 00:24:52,199 --> 00:24:53,617 She was doing better! 482 00:24:53,701 --> 00:24:54,910 I know. 483 00:24:55,577 --> 00:24:56,996 I am so sorry. 484 00:24:57,079 --> 00:24:58,747 Stop saying you're sorry! 485 00:25:00,457 --> 00:25:02,084 If this was one of your babies, 486 00:25:02,960 --> 00:25:05,921 and their life-saving medication was discontinued 487 00:25:06,005 --> 00:25:08,882 and you had to watch the life drain from their bodies, what would you do? 488 00:25:09,717 --> 00:25:12,970 I would fight. 489 00:25:13,053 --> 00:25:14,471 But you didn't, did you? 490 00:25:15,806 --> 00:25:17,641 Not for my baby. 491 00:25:33,115 --> 00:25:34,241 Dr. Bailey. 492 00:25:53,552 --> 00:25:54,553 Whoa! 493 00:25:54,636 --> 00:25:57,181 Come in, make yourself at home. What is this? 494 00:25:57,264 --> 00:25:59,641 I borrowed a few things from Dr. Salley. 495 00:25:59,725 --> 00:26:03,395 I wanted to see if adjusting the grip on a body-powered prosthesis helps. 496 00:26:04,229 --> 00:26:05,898 Jon talked you into finding another solution? 497 00:26:05,981 --> 00:26:08,233 I couldn't tell him that he can't use the robotic one. 498 00:26:08,317 --> 00:26:09,568 - Link. - After his car accident, 499 00:26:09,651 --> 00:26:11,779 he went really dark when he couldn't ride. 500 00:26:11,862 --> 00:26:15,240 I don't want him or Pauline to have to repeat that. 501 00:26:20,746 --> 00:26:22,206 Damn it, why can't I do this? 502 00:26:22,289 --> 00:26:24,416 Last time I checked, you're not a prosthetist. 503 00:26:25,250 --> 00:26:28,420 I have reconstructed fingers. I've replanted amputated hands. 504 00:26:28,504 --> 00:26:30,756 I've replaced every joint you can name. 505 00:26:30,839 --> 00:26:32,174 I fix things. 506 00:26:32,257 --> 00:26:33,842 It's what I do. 507 00:26:33,926 --> 00:26:39,223 Sounds like you're trying to fix things at home in my lab. 508 00:26:39,306 --> 00:26:42,643 My shoulder's still... bugging me. 509 00:26:42,726 --> 00:26:45,729 You had a major injury, and that's gonna take time. 510 00:26:45,813 --> 00:26:48,524 I know. I just I... 511 00:26:48,607 --> 00:26:50,859 ...I felt pain the last time I was in the OR. 512 00:26:50,943 --> 00:26:53,654 It's also why I'm behind on babyproofing. 513 00:26:53,737 --> 00:26:55,656 What does Jo think? 514 00:26:55,739 --> 00:26:56,824 You haven't told her. 515 00:26:56,907 --> 00:26:58,117 She's got her own stuff. 516 00:26:58,951 --> 00:27:02,538 I-I thought I was gonna be back to normal by the time the twins came. 517 00:27:02,621 --> 00:27:05,415 Instead, I'm just icing my shoulder 518 00:27:05,499 --> 00:27:09,545 and hoping nobody face-plants off the stairs. 519 00:27:12,714 --> 00:27:16,009 You are very handy, and you can fix a lot of things. 520 00:27:16,093 --> 00:27:18,011 But sometimes when you let go of expectations, 521 00:27:18,095 --> 00:27:20,472 you open yourself up to other possibilities. 522 00:27:23,892 --> 00:27:24,893 Yeah, you're right. 523 00:27:24,977 --> 00:27:26,520 - Does that mean I get my lab back? - Soon. 524 00:27:26,603 --> 00:27:27,646 Mm-hmm. 525 00:27:28,939 --> 00:27:30,566 You just gave me an idea. 526 00:27:33,318 --> 00:27:34,736 Hey, I got your text. 527 00:27:34,820 --> 00:27:36,405 I'm sorry I missed the MandM. 528 00:27:36,488 --> 00:27:37,739 That's old news. 529 00:27:37,823 --> 00:27:41,535 Wright said that Jackson Avery called to check my references. 530 00:27:41,618 --> 00:27:43,203 That's huge. 531 00:27:43,704 --> 00:27:44,746 Boston's in the bag. 532 00:27:44,830 --> 00:27:45,831 It gets even better. 533 00:27:46,373 --> 00:27:49,459 Apparently, she told him that Grey Sloan wouldn't give me up without a fight. 534 00:27:49,543 --> 00:27:51,003 So you could stay here? 535 00:27:51,086 --> 00:27:54,756 I don't have any formal offers yet, but as long as 536 00:27:54,840 --> 00:27:58,343 I don't majorly screw anything up, I'm gonna have options. 537 00:28:01,054 --> 00:28:02,055 Wow, um. 538 00:28:02,139 --> 00:28:03,473 Can I ask you something? 539 00:28:04,892 --> 00:28:09,354 Would stitching over the pedicle in an omentum be a major screwup? 540 00:28:09,438 --> 00:28:10,898 Why do you ask? 541 00:28:13,025 --> 00:28:16,069 Did you blame Jules for your suture in the MandM? 542 00:28:17,487 --> 00:28:21,658 I've been in school or residency or fellowship my entire life. 543 00:28:21,742 --> 00:28:24,036 I'm so close to it finally paying off. 544 00:28:24,953 --> 00:28:26,455 So you did lie. 545 00:28:26,538 --> 00:28:29,374 Surgery's cutthroat, especially plastics. 546 00:28:29,458 --> 00:28:32,044 Don't tell me you've never told a small mistruth to get what you needed. 547 00:28:32,127 --> 00:28:33,879 Yeah, but this is more than just a little white lie. 548 00:28:33,962 --> 00:28:36,048 Every MandM feels like the end of the world 549 00:28:36,131 --> 00:28:38,425 when you're a resident, but you get past them. 550 00:28:38,508 --> 00:28:40,385 No one will even remember this case tomorrow. 551 00:28:40,469 --> 00:28:43,180 And I'll figure something out to help Millin. 552 00:28:43,263 --> 00:28:46,725 If I take an attending job here, I can help her even more. 553 00:28:47,893 --> 00:28:49,394 Yeah, I guess that makes sense. 554 00:28:51,271 --> 00:28:54,900 So you're actually considering Grey Sloan over Boston? 555 00:28:54,983 --> 00:28:55,984 Maybe. 556 00:28:56,944 --> 00:29:00,072 As much as I love Boston, Seattle's also... 557 00:29:01,657 --> 00:29:02,741 growing on me. 558 00:29:06,912 --> 00:29:09,414 Sixteen inches. So close. 559 00:29:09,498 --> 00:29:11,041 Well, it's still pretty damn big. 560 00:29:11,124 --> 00:29:13,001 Hey, hey, stand next to it for scale. 561 00:29:14,419 --> 00:29:16,713 - Oh, uh, shouldn't it be Dr. Webber? - Yeah. 562 00:29:16,797 --> 00:29:17,839 Hey, what about it, Chief? 563 00:29:17,923 --> 00:29:20,050 You, uh... You want a picture with the mega spleen? 564 00:29:20,133 --> 00:29:21,635 Yeah, no pictures for me. 565 00:29:21,718 --> 00:29:22,719 We should weigh it. 566 00:29:22,803 --> 00:29:24,721 I mean, it's not the biggest ever, but it might be the heaviest. 567 00:29:24,805 --> 00:29:26,306 Come on, here we go. 568 00:29:27,349 --> 00:29:28,183 - Got it? - I got it. 569 00:29:28,266 --> 00:29:30,310 You know what? Hold on, let me... let me help you. 570 00:29:30,394 --> 00:29:31,395 You can just put it-- 571 00:29:33,355 --> 00:29:35,607 Oh, that's a damn shame. 572 00:29:36,650 --> 00:29:39,820 It... it looks even bigger on the floor. 573 00:29:40,904 --> 00:29:41,905 Hey, you know what? 574 00:29:41,989 --> 00:29:43,991 - Get down, get down. - Okay. 575 00:29:45,409 --> 00:29:46,618 - Yeah, yeah. - No, no, no. 576 00:29:46,702 --> 00:29:47,744 Look, that's enough. 577 00:29:47,828 --> 00:29:52,124 Now no more pictures or jokes or talking about bragging rights. 578 00:29:52,207 --> 00:29:54,835 Today was not a success of medicine, it was a failure. 579 00:29:55,794 --> 00:29:57,671 You think Russell wanted it to get that bad? 580 00:29:57,754 --> 00:29:59,715 It's a miracle it didn't kill him. 581 00:30:00,340 --> 00:30:01,508 You should be ashamed. 582 00:30:03,010 --> 00:30:04,511 I know I am. 583 00:30:05,846 --> 00:30:07,556 Clean this mess up. 584 00:30:10,142 --> 00:30:12,811 Yeah, of course. Got ya. 585 00:30:23,697 --> 00:30:27,701 No, I-I replay the steps in my head every night. 586 00:30:27,784 --> 00:30:30,162 Could I have operated earlier? 587 00:30:30,245 --> 00:30:32,748 Could I have pushed oncology harder? 588 00:30:32,831 --> 00:30:37,419 Could I have filed more appeals with the drug manufacturer? 589 00:30:39,254 --> 00:30:40,630 No, you did everything you could. 590 00:30:41,590 --> 00:30:44,801 I did everything I could 15 years ago for Katie's grandmother. 591 00:30:45,761 --> 00:30:48,138 But immunotherapies didn't exist then. 592 00:30:48,221 --> 00:30:51,808 She died from actual cancer, but Katie... 593 00:30:53,602 --> 00:30:57,564 No, Katie's dying from bureaucratic stupidity. 594 00:30:58,732 --> 00:31:01,318 Just years of hard work, 595 00:31:01,401 --> 00:31:03,904 finally developed a medicine that was working, 596 00:31:03,987 --> 00:31:10,869 and instead of helping people access it, our government is dismantling science. 597 00:31:11,787 --> 00:31:13,914 Just like that, clinical trial gone. 598 00:31:13,997 --> 00:31:15,874 And not just Katie, or cancer, 599 00:31:15,957 --> 00:31:21,838 it's maternal health, diabetes prevention, substance abuse programs. 600 00:31:23,298 --> 00:31:26,927 Space exploration is even on the damn chopping block. 601 00:31:27,010 --> 00:31:30,263 Just decades of groundbreaking work... 602 00:31:32,057 --> 00:31:38,230 without even a single thought to its cost in human lives. 603 00:31:40,565 --> 00:31:43,235 I can't even give Katie a chance to spend 604 00:31:43,318 --> 00:31:46,655 her last moments outside of these hospital walls. 605 00:31:47,447 --> 00:31:52,244 Well, we're setting her up with in-home hospice care and she'll... 606 00:31:53,245 --> 00:31:56,915 It'll be a miracle if she makes it that long. 607 00:31:59,209 --> 00:32:00,877 ♪ Stay ♪ 608 00:32:02,504 --> 00:32:05,173 ♪ And I will... ♪ 609 00:32:06,424 --> 00:32:08,635 - Hey, I spoke to Kavita-- - Now's not a good time. 610 00:32:10,178 --> 00:32:11,888 Uh, Dr. Wright. 611 00:32:12,597 --> 00:32:14,349 How is Scott doing? 612 00:32:14,432 --> 00:32:16,852 His heart's had minimal tissue coverage for two weeks. 613 00:32:16,935 --> 00:32:18,186 He's not great. 614 00:32:20,230 --> 00:32:21,231 Can I help you? 615 00:32:22,357 --> 00:32:26,862 I have worked really hard to build a good reputation for myself here, 616 00:32:26,945 --> 00:32:30,115 and I-I can't stand by and watch it all go down the drain. 617 00:32:31,616 --> 00:32:35,203 Dr. Mohanty lied in the MandM. I didn't stitch over the pedicle. 618 00:32:35,287 --> 00:32:37,455 I wanted to sew around the pedicle, but she wouldn't let me. 619 00:32:37,539 --> 00:32:42,460 And I don't know why she lied, but I promise you it wasn't me. 620 00:32:43,920 --> 00:32:45,672 That's quite the sob story you've got there. 621 00:32:45,755 --> 00:32:48,758 - I'm setting the record straight. - Look, hospitals are high school. 622 00:32:48,842 --> 00:32:50,510 Emotions are high. Status matters. 623 00:32:50,594 --> 00:32:54,514 People are competitive and desperate and insecure. 624 00:32:55,557 --> 00:32:58,518 I need my surgeons to be mature, to rise above, 625 00:32:58,602 --> 00:33:00,645 to not get sucked into the drama and the politics. 626 00:33:00,729 --> 00:33:02,105 Did you have a good outcome or a bad one? 627 00:33:02,189 --> 00:33:04,107 - That's all I care about. - Understood. 628 00:33:04,191 --> 00:33:07,694 I will make sure that Scott has his labs in the morning. 629 00:33:07,777 --> 00:33:09,696 You're not on his surgery anymore. 630 00:33:09,779 --> 00:33:12,365 Hey, Kwan, have you ever done a sternal reconstruction? 631 00:33:13,325 --> 00:33:14,326 No. 632 00:33:14,993 --> 00:33:16,244 You will tomorrow. 633 00:33:16,328 --> 00:33:19,623 Come with me, and I'll give you my notes on the case. 634 00:33:32,928 --> 00:33:34,054 Did you figure it out? 635 00:33:34,137 --> 00:33:37,766 Making the bionic hand work for competitive mountain biking? 636 00:33:38,558 --> 00:33:40,477 - No. - So that's it. 637 00:33:40,560 --> 00:33:41,561 I'm done. 638 00:33:42,771 --> 00:33:44,356 Not necessarily. 639 00:33:44,439 --> 00:33:46,524 I've come up with another option. 640 00:33:46,608 --> 00:33:49,194 Now, this is just a prototype, but the idea is 641 00:33:49,277 --> 00:33:51,905 that instead of your bionic hand gripping the handlebar, 642 00:33:51,988 --> 00:33:53,907 we build an attachment to the bike 643 00:33:53,990 --> 00:33:57,160 and a terminal device that you'd wear only while biking. 644 00:33:58,995 --> 00:33:59,996 Keep talking. 645 00:34:00,080 --> 00:34:04,167 We'd make a custom, activity-specific prosthetic 646 00:34:04,834 --> 00:34:07,671 that would snap into the bike attachment. 647 00:34:07,754 --> 00:34:11,883 And it'd be built so you could snap quickly out of the receiver for safety. 648 00:34:11,967 --> 00:34:15,720 If you like it, we could find a prosthetist to collaborate with 649 00:34:15,804 --> 00:34:18,223 and maybe even a sponsor will help cover the costs. 650 00:34:20,058 --> 00:34:21,601 This is, uh... 651 00:34:22,727 --> 00:34:24,521 This is amazing. 652 00:34:25,647 --> 00:34:27,107 You made this. How? 653 00:34:27,190 --> 00:34:30,735 No, no, this was all Dr. Lincoln. I know nothing about bikes. 654 00:34:30,819 --> 00:34:33,196 Man, thank you. 655 00:34:34,781 --> 00:34:36,408 I don't know what I would have done if I-- 656 00:34:36,491 --> 00:34:37,784 You're welcome. 657 00:34:40,203 --> 00:34:45,041 ♪ I wanna know what happens underneath ♪ 658 00:34:45,125 --> 00:34:46,501 Should I not ask? 659 00:34:47,002 --> 00:34:49,296 Dr. Wright said that I was being dramatic, 660 00:34:49,379 --> 00:34:51,089 and she doesn't want to work with me anymore. 661 00:34:52,048 --> 00:34:53,883 I'm sorry, I know the truth. 662 00:34:53,967 --> 00:34:55,969 I don't think you're being dramatic. 663 00:34:56,052 --> 00:34:57,971 Everyone who knows and loves you feels the same. 664 00:34:58,513 --> 00:34:59,931 I'm not so sure. 665 00:35:01,141 --> 00:35:02,559 Hey, hey, I need a favor. 666 00:35:02,642 --> 00:35:03,685 It's about Katie. 667 00:35:03,768 --> 00:35:05,854 You know I can't disclose her medical information, 668 00:35:05,937 --> 00:35:07,689 but nice job getting her to stick around. 669 00:35:07,772 --> 00:35:09,858 What if we took her to your place? 670 00:35:09,941 --> 00:35:11,735 To what, die at my house? 671 00:35:12,485 --> 00:35:14,195 You want her to die at my house. 672 00:35:14,279 --> 00:35:16,531 Well, okay, technically it's my Aunt Meredith's house. 673 00:35:16,615 --> 00:35:18,074 - All right? - She's gonna go to her own home next week. 674 00:35:18,158 --> 00:35:19,951 She doesn't have that long. 675 00:35:21,703 --> 00:35:23,330 You sure this is a good idea? 676 00:35:23,413 --> 00:35:24,748 She's dying. 677 00:35:25,707 --> 00:35:28,251 I'll ask for time off so I can take care of her myself. 678 00:35:28,335 --> 00:35:29,961 No. 679 00:35:30,045 --> 00:35:31,880 We'll take shifts. 680 00:35:32,756 --> 00:35:33,965 Thank you. 681 00:35:35,425 --> 00:35:36,676 Count Kwan in too. 682 00:35:36,760 --> 00:35:39,387 He owes me for putting up with Mohanty. 683 00:35:46,436 --> 00:35:48,188 Hey, uh, Chief, look, um... 684 00:35:49,898 --> 00:35:51,358 I just wanted to apologize. 685 00:35:51,441 --> 00:35:56,196 I-I got excited about a flashy case and I-I let things get out of hand. 686 00:35:56,821 --> 00:36:00,241 A few weeks ago, a case like that would've made my year. 687 00:36:00,325 --> 00:36:02,577 A spleen the size of a sandbag? 688 00:36:02,661 --> 00:36:04,621 I'd have taken photos too. 689 00:36:04,704 --> 00:36:06,790 But I'm feeling different now. 690 00:36:06,873 --> 00:36:08,708 Bad different? 691 00:36:08,792 --> 00:36:12,796 You know, I tried to push it down and return to work like nothing happened. 692 00:36:12,879 --> 00:36:17,384 These days, the patients that I can't stop thinking about 693 00:36:17,467 --> 00:36:19,427 are the ones we couldn't get to in time. 694 00:36:20,720 --> 00:36:23,973 And instead of addressing the problem, 695 00:36:24,057 --> 00:36:29,229 we're patting ourselves on the back for removing a massive spleen. 696 00:36:29,312 --> 00:36:32,482 Look, having a perspective shift after cancer... 697 00:36:32,565 --> 00:36:34,442 it's... it's natural. 698 00:36:34,526 --> 00:36:36,027 I mean, I've been there. 699 00:36:36,111 --> 00:36:37,821 But what if I can't unsee this? 700 00:36:37,904 --> 00:36:39,114 Would that be so bad? 701 00:36:39,906 --> 00:36:42,992 - Maybe it's time to start a new chapter. - Spoken like a younger man. 702 00:36:43,702 --> 00:36:48,415 You know, I'm, um, just a guy who has a lot of experience starting over. 703 00:36:49,833 --> 00:36:52,210 Look, I'm gonna go check on our patient. 704 00:36:54,629 --> 00:36:56,589 It really was quite a spleen, though, wasn't it? 705 00:36:56,673 --> 00:36:57,674 Lord have mercy. 706 00:36:59,342 --> 00:37:03,763 ♪ Gonna follow the moon Till I'm home again ♪ 707 00:37:03,847 --> 00:37:07,475 Okay, monitor her pain and oxygen requirements and page me 708 00:37:07,559 --> 00:37:09,602 if we need to take more fluid off of her abdomen. 709 00:37:09,686 --> 00:37:12,647 Hey, Dr. Bailey, can we run something by you? 710 00:37:13,314 --> 00:37:15,734 Why do I feel like I'm not gonna like this? 711 00:37:15,817 --> 00:37:19,446 Uh, well, uh, Griffith offered to take Katie to her home. 712 00:37:19,529 --> 00:37:22,323 We all know there's a good chance she won't make it to her own home 713 00:37:22,407 --> 00:37:24,075 if she waits for hospice to be set up. 714 00:37:24,576 --> 00:37:26,911 All she wants is to not die in a hospital. 715 00:37:26,995 --> 00:37:28,663 Yeah. What do you think? 716 00:37:28,747 --> 00:37:33,501 I think you two have lost your ever-loving minds. 717 00:37:33,585 --> 00:37:36,087 Katie is not a stray cat to take in. 718 00:37:36,171 --> 00:37:37,756 She needs 24/7 care. 719 00:37:37,839 --> 00:37:39,674 Adams, Kwan, and I would take shifts. 720 00:37:39,758 --> 00:37:41,885 Yeah, and... and her mom can stay in their spare bedroom. 721 00:37:41,968 --> 00:37:43,845 Sorry. 722 00:37:43,928 --> 00:37:45,263 What about pain management? 723 00:37:45,346 --> 00:37:47,849 We can get her scripts filled and administer them at the house. 724 00:37:47,932 --> 00:37:49,809 Yeah, and I can drain her abdomen when needed. 725 00:37:49,893 --> 00:37:51,519 Look, it's literally her dying wish. 726 00:37:51,603 --> 00:37:52,896 I hear you. 727 00:37:54,147 --> 00:37:58,610 But as her surgeon and a leader in this hospital, I... I cannot advise it. 728 00:37:59,110 --> 00:38:03,198 Okay, she would need a... a hospital bed, an oxygen concentrator. 729 00:38:03,281 --> 00:38:04,741 Are you writing this down? 730 00:38:04,824 --> 00:38:06,284 - Oh. - Yeah. 731 00:38:16,544 --> 00:38:20,089 Finally, I was about to go to Saigon Palace by myself. 732 00:38:20,173 --> 00:38:23,384 Yeah, I was looking over Dr. Wright's notes for the sternal reconstruction. 733 00:38:23,468 --> 00:38:25,637 I heard you were joining the case. 734 00:38:25,720 --> 00:38:27,263 I'll fill you in over pho. 735 00:38:27,931 --> 00:38:29,182 I can't do it. 736 00:38:29,265 --> 00:38:31,810 Banh mi. Whatever. I'm starving. Let's go. 737 00:38:31,893 --> 00:38:36,147 I told Wright to find another resident for the procedure tomorrow. 738 00:38:36,981 --> 00:38:39,234 - Why? - Jules is my friend. 739 00:38:40,777 --> 00:38:42,904 Turns out you and I aren't as alike as we thought. 740 00:38:44,531 --> 00:38:47,408 I already told Wright that I was committed to assist Altman tomorrow. 741 00:38:49,536 --> 00:38:50,787 You didn't tell her about me? 742 00:38:51,871 --> 00:38:54,082 I was going to give you a chance to do it yourself. 743 00:38:59,587 --> 00:39:01,089 I hope you get the job in Boston. 744 00:39:04,592 --> 00:39:08,054 We often place blame because it's easier than taking responsibility. 745 00:39:08,680 --> 00:39:11,516 If you always look outward, you never have to turn inward. 746 00:39:11,599 --> 00:39:13,059 Seriously? 747 00:39:13,935 --> 00:39:15,979 - I get to leave? - Yeah. 748 00:39:16,062 --> 00:39:19,983 We arranged medical transport, and Dr. Griffith 749 00:39:20,066 --> 00:39:22,277 is working to get you discharged right now. 750 00:39:22,360 --> 00:39:25,113 I'll stock the fridge, cook meals, whatever I need to do. 751 00:39:25,196 --> 00:39:26,531 No. That... That's not necessary. 752 00:39:26,614 --> 00:39:29,325 We, uh... We want to help. 753 00:39:31,703 --> 00:39:32,704 Thank you. 754 00:39:33,705 --> 00:39:36,291 None of this would have happened without you. 755 00:39:38,710 --> 00:39:41,880 But progress only comes when you shine the light on yourself. 756 00:39:47,260 --> 00:39:49,679 Didn't I fold all this laundry earlier? 757 00:39:49,762 --> 00:39:52,140 Hattie spit up everywhere, so did Peyton. 758 00:39:52,223 --> 00:39:54,225 Luna got the ketchup bottle and... 759 00:39:54,309 --> 00:39:56,394 You know what? I don't want to talk about it. 760 00:39:59,439 --> 00:40:01,441 My shoulder still hurts. 761 00:40:03,693 --> 00:40:06,154 I was hoping it'd get better, and I'd go back to work 762 00:40:08,031 --> 00:40:10,658 and build the safest staircase ever to exist, 763 00:40:10,742 --> 00:40:13,620 but obviously that hasn't happened. 764 00:40:13,703 --> 00:40:17,498 Well, you don't have to fix everything yourself. 765 00:40:17,582 --> 00:40:19,375 Yeah, I've realized that. 766 00:40:20,168 --> 00:40:22,795 But you might have to go back to work eventually 767 00:40:22,879 --> 00:40:25,006 so we can afford to pay Elroy to do it. 768 00:40:30,178 --> 00:40:31,304 - I was wondering... - Mm-hmm. 769 00:40:31,387 --> 00:40:35,224 ...what if Elroy didn't actually fix this place? 770 00:40:36,809 --> 00:40:39,812 We've really pushed our luck already with these stairs, 771 00:40:39,896 --> 00:40:43,441 the-the fireplace, the balcony, the glass doors. 772 00:40:43,524 --> 00:40:45,193 What if he fixed my rental instead? 773 00:40:45,276 --> 00:40:48,446 You want us to move into the man cave? 774 00:40:49,113 --> 00:40:53,201 It's in a great neighborhood, and it would be way easier to babyproof. 775 00:40:54,911 --> 00:40:57,622 This place just has so many memories. 776 00:40:57,705 --> 00:41:01,417 You know, movie nights on this couch, 777 00:41:01,501 --> 00:41:03,795 the Nicoletti's take-out dinners on that table. 778 00:41:03,878 --> 00:41:06,297 You proposed to me, right there. 779 00:41:08,758 --> 00:41:11,970 - Yeah. - Guess we'll have to make new memories. 780 00:41:16,349 --> 00:41:17,642 We will. 781 00:41:28,486 --> 00:41:29,654 What do you think? 782 00:41:30,697 --> 00:41:31,990 How do you feel? 783 00:41:32,073 --> 00:41:33,324 Millin. 784 00:41:34,117 --> 00:41:35,576 What are you doing here? 785 00:41:35,660 --> 00:41:38,037 Uh, your front driver's side tire is looking a little low. 786 00:41:38,121 --> 00:41:39,706 You're checking my tires? 787 00:41:40,540 --> 00:41:43,626 Today sucked in a lot of ways, 788 00:41:43,710 --> 00:41:47,046 but the worst part is that it confirmed what you think about me. 789 00:41:47,130 --> 00:41:48,756 - Millin-- - And I know that I've disappointed you. 790 00:41:48,840 --> 00:41:51,509 And you're not wrong, I haven't always been honest with you. 791 00:41:51,592 --> 00:41:54,220 Like, sometimes when I'm too tired, I don't dictate your op notes, 792 00:41:54,303 --> 00:41:55,763 I make my interns do it. 793 00:41:55,847 --> 00:41:58,224 And I know where you keep your secret stash of protein bars 794 00:41:58,307 --> 00:41:59,642 at the nurses' station, 795 00:41:59,726 --> 00:42:02,729 and I'll sneak one if I don't have time to get to the cafeteria. 796 00:42:06,441 --> 00:42:09,360 And I coached your patient behind your back 797 00:42:09,444 --> 00:42:11,279 to get around his insurance, 798 00:42:11,362 --> 00:42:14,157 so you would have to operate on him that day. 799 00:42:16,409 --> 00:42:17,493 He was in pain. 800 00:42:18,369 --> 00:42:22,373 I didn't know what else to do, so I lied, but I didn't lie today. 801 00:42:22,457 --> 00:42:25,209 I didn't sew over Scott's pedicle, 802 00:42:25,293 --> 00:42:30,048 and I wasn't trying to frame Mohanty or not take responsibility. 803 00:42:30,131 --> 00:42:33,551 I just didn't do it, and I need you to know that. 804 00:42:33,634 --> 00:42:35,636 It's not my department. I'm not the one you need to convince. 805 00:42:35,720 --> 00:42:38,389 I don't care what anyone else thinks. 806 00:42:45,688 --> 00:42:47,440 I believe you. 807 00:42:52,320 --> 00:42:54,030 I'll, uh... I'll see you tomorrow. 808 00:42:56,157 --> 00:42:57,617 Ask the questions, 809 00:42:58,743 --> 00:43:00,369 and the answers might surprise you.