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1
00:00:01,349 --> 00:00:02,785
Dr. Larsen was ina car accident,
2
00:00:02,828 --> 00:00:04,700
she has no recollection
of the last eight years.
3
00:00:04,743 --> 00:00:06,136
Previously onDoc.
4
00:00:06,180 --> 00:00:08,834
- Let me run Internal Medicine.
- Back to your roots.
5
00:00:08,878 --> 00:00:10,706
When you need time to
work out things with Michael,
6
00:00:10,749 --> 00:00:12,490
I accept it,
but when the shoe's on the other foot--
7
00:00:12,534 --> 00:00:13,709
When the shoe's on
the other foot,
8
00:00:13,752 --> 00:00:15,276
you have a hard time
telling me the truth.
9
00:00:15,319 --> 00:00:16,625
Delayed decisions on his care
10
00:00:16,668 --> 00:00:18,714
have been hurting him
a long time.
11
00:00:18,757 --> 00:00:20,977
You don't have to tell me
the system's broken.
12
00:00:21,021 --> 00:00:23,719
How much prednisone
does it take to get you through a shift?
13
00:00:23,762 --> 00:00:25,373
You will flame out in weeks.
14
00:00:25,416 --> 00:00:27,157
It's time for you
to use your greatness
15
00:00:27,201 --> 00:00:29,159
to pull the greatness
out of others.
16
00:00:29,203 --> 00:00:30,160
I'm going to miss you.
17
00:00:42,781 --> 00:00:45,349
Sorry. This guy
loves his sleep.
18
00:00:45,393 --> 00:00:50,050
Oh, there he is.
Hey, can I have a hug?
19
00:00:50,093 --> 00:00:52,748
Oh my goodness, this is yummy.
20
00:00:52,791 --> 00:00:54,924
Ethan was sorry to miss you,
he had a really early meeting.
21
00:00:54,967 --> 00:00:57,231
Well, Robbie's
the main event, right?
22
00:00:57,274 --> 00:01:00,364
What fabulous holiday
have they cancelled school for this time?
23
00:01:00,408 --> 00:01:01,496
It's Lunar New Year.
24
00:01:01,539 --> 00:01:03,324
Oh, well.
25
00:01:04,977 --> 00:01:06,979
Grandma's been all over the world.
26
00:01:07,023 --> 00:01:09,286
You know, she could probably
teach you to say hello in 50 different languages.
27
00:01:09,330 --> 00:01:11,506
Sixty-seven,
but who's counting?
28
00:01:11,549 --> 00:01:13,116
I should be back around 6:00.
29
00:01:13,160 --> 00:01:14,509
And thanks so much
for doing this.
30
00:01:14,552 --> 00:01:16,380
Are you kidding?
The more time I get to spend
31
00:01:16,424 --> 00:01:17,468
with this little man,
the better.
32
00:01:17,512 --> 00:01:19,296
Oh. Brought you donuts,
33
00:01:19,340 --> 00:01:20,863
your dad said
they're your favorite.
34
00:01:20,906 --> 00:01:22,256
Thanks, Grandma.
35
00:01:28,349 --> 00:01:29,654
Joan, you okay?
36
00:01:29,698 --> 00:01:31,656
I'm fine.
37
00:01:35,530 --> 00:01:37,097
Robbie,
why don't you go upstairs?
38
00:01:37,140 --> 00:01:38,968
Oh my God.
39
00:01:39,011 --> 00:01:41,057
- Grandma!
- Joan?
40
00:01:41,101 --> 00:01:42,145
- Joan?
- Grandma!
41
00:02:07,866 --> 00:02:09,041
Good morning, everyone.
42
00:02:09,085 --> 00:02:10,565
Morning.
43
00:02:10,608 --> 00:02:13,350
This is going to be
an adjustment for all of us.
44
00:02:13,394 --> 00:02:15,570
Dr. Ridley certainly left
some big shoes to fill,
45
00:02:15,613 --> 00:02:18,921
and I know all these
leadership changes the past year
46
00:02:18,964 --> 00:02:21,576
have probably been unsteadying.
47
00:02:21,619 --> 00:02:24,318
There are a lot of reasons why
48
00:02:24,361 --> 00:02:27,321
I wanted to practice
medicine again,
49
00:02:27,364 --> 00:02:29,323
but I want to be very clear
about the reason I asked
50
00:02:29,366 --> 00:02:31,455
to sit in that chair.
51
00:02:31,499 --> 00:02:33,849
The past year as your CMO,
52
00:02:33,892 --> 00:02:35,416
I have seen what
every person... -
53
00:02:35,459 --> 00:02:37,331
...standing in this room
is capable of.
54
00:02:37,374 --> 00:02:38,854
Dr. Miller.
55
00:02:38,897 --> 00:02:41,030
Time and again,
you have risen to the occasion.
56
00:02:41,073 --> 00:02:43,075
We have a 62 year old female
57
00:02:43,119 --> 00:02:44,468
in respiratory failure.
58
00:02:44,512 --> 00:02:46,209
Complications from chronic MDS.
59
00:02:46,253 --> 00:02:47,471
I'm on my way down.
60
00:02:47,515 --> 00:02:49,952
I'm not here just to lead you,
61
00:02:49,995 --> 00:02:54,130
I want to join you,
and help you do what you already do so well.
62
00:02:54,174 --> 00:02:57,742
An issue, a problem,
a suggestion,
63
00:02:57,786 --> 00:02:59,744
my door will always be open.
64
00:02:59,788 --> 00:03:03,357
Before we go,
some congratulations are in order.
65
00:03:03,400 --> 00:03:05,663
In two weeks, Dr. Maitra
66
00:03:05,707 --> 00:03:08,100
and Dr. Larsen
will succeed Dr. Heller
67
00:03:08,144 --> 00:03:09,493
as Chief Residents,
68
00:03:09,537 --> 00:03:12,409
as we welcome our
new class of interns. - Whoo!
69
00:03:15,804 --> 00:03:17,371
Uh, now, if you both
70
00:03:17,414 --> 00:03:19,242
could hang back for a moment
with Dr. Heller.
71
00:03:19,286 --> 00:03:21,505
The rest of you, do good work.
72
00:03:25,422 --> 00:03:28,338
I'd like our co-chiefs
to shadow you
73
00:03:28,382 --> 00:03:30,210
before you start your
pediatric fellowship.
74
00:03:30,253 --> 00:03:31,428
You can begin with Dr. Maitra
75
00:03:31,472 --> 00:03:33,038
this morning,
and then alternate days.
76
00:03:33,082 --> 00:03:35,171
- Yeah. Sounds like a plan.
- Great.
77
00:03:39,088 --> 00:03:40,785
It's quite a move.
78
00:03:40,829 --> 00:03:42,831
Well, it was either this
79
00:03:42,874 --> 00:03:44,136
or a leather jacket
and a motorcycle.
80
00:03:51,231 --> 00:03:53,494
Joan's in the ER.
81
00:03:53,537 --> 00:03:55,931
Paramedic said she was
extremely short of breath,
82
00:03:55,974 --> 00:03:57,976
likely bilateral
pleural effusions.
83
00:03:58,020 --> 00:03:59,891
So is she hypoxic?
84
00:03:59,935 --> 00:04:03,286
Oxygenations
improved on the mask, but she's hypotensive.
85
00:04:03,330 --> 00:04:05,897
Let's push Norepi MAP
goal above 65.
86
00:04:05,941 --> 00:04:07,508
No, Richard,
that's not gonna work.
87
00:04:07,551 --> 00:04:09,249
- I'm sorry?
- She's on prednisone.
88
00:04:09,292 --> 00:04:11,599
Thirty milligrams
and she's tapered off, I read her chart.
89
00:04:11,642 --> 00:04:13,862
No, her chart's wrong,
she's on way more than that.
90
00:04:16,125 --> 00:04:18,954
I've been using it
to get through the surgery.
91
00:04:20,042 --> 00:04:21,435
You knew about this?
92
00:04:23,088 --> 00:04:25,526
How much has she been taking?
93
00:04:26,570 --> 00:04:27,571
Double that.
94
00:04:30,661 --> 00:04:32,924
Triple to get through the ex...
95
00:04:32,968 --> 00:04:35,753
vivo with Javi.
96
00:04:35,797 --> 00:04:39,104
My natural cortisol
production's gotta be shot.
97
00:04:40,758 --> 00:04:43,631
Okay. Lucy,
100 milligram bolus
98
00:04:43,674 --> 00:04:45,676
of hydrocortisone
before pressors.
99
00:04:45,720 --> 00:04:47,591
And run a complete lab workup.
100
00:04:49,201 --> 00:04:51,291
We're all here
if you need anything, Joan.
101
00:04:55,120 --> 00:04:56,165
Should I call Ethan?
102
00:04:58,036 --> 00:04:59,211
He's on his way.
103
00:04:59,255 --> 00:05:03,128
But, Amy,
I need you to remember,
104
00:05:03,172 --> 00:05:05,087
I have a DNR.
105
00:05:05,130 --> 00:05:08,003
Joan, no,
we're nowhere near that.
106
00:05:12,529 --> 00:05:14,139
Shh.
107
00:05:19,144 --> 00:05:21,190
Good morning, Dr. Walker.
108
00:05:21,233 --> 00:05:24,280
Good morning to you, Walter.
How's our rocket holding up?
109
00:05:24,324 --> 00:05:25,977
Can't wait to launch it.
110
00:05:26,021 --> 00:05:27,414
You think I can
still leave today?
111
00:05:27,457 --> 00:05:29,285
Gotta examine you first,
can't let you out of here
112
00:05:29,329 --> 00:05:31,722
till we're sure
you're all better.
113
00:05:31,766 --> 00:05:34,508
I really want to
show the rocket to the kids at the house.
114
00:05:34,551 --> 00:05:37,380
I bet. Looks like
that thing might actually make it to space.
115
00:05:37,424 --> 00:05:39,948
Do you ever launch
rockets with your kids?
116
00:05:39,991 --> 00:05:42,733
- I don't have any.
- Really?
117
00:05:42,777 --> 00:05:44,648
I thought about it
when I was younger,
118
00:05:44,692 --> 00:05:46,476
but decided to take
a different path.
119
00:05:46,520 --> 00:05:49,087
- What do you mean?
- Well, being a parent's a big commitment.
120
00:05:49,131 --> 00:05:52,308
But that's also true
for being a friend, a sister,
121
00:05:52,352 --> 00:05:55,050
an aunt, especially a doctor.
122
00:05:55,093 --> 00:05:58,053
Eventually, I figured
if I gave my best
123
00:05:58,096 --> 00:06:00,447
to all those other things,
that'd be enough for me.
124
00:06:00,490 --> 00:06:02,449
- You're a great doctor.
- Hmm.
125
00:06:02,492 --> 00:06:06,017
That she is, buddy.
Sorry I'm late, how's he doing?
126
00:06:06,061 --> 00:06:08,759
Well, breathing's much better.
Let's look at those knees.
127
00:06:11,675 --> 00:06:15,070
Oh. How long has your leg
been moving like that?
128
00:06:15,113 --> 00:06:17,159
Happens all the time
with my RA.
129
00:06:17,202 --> 00:06:18,639
It shouldn't be now,
with the medication you're on.
130
00:06:18,682 --> 00:06:20,945
- Yeah, I'll order a CT.
- Well, that's bad.
131
00:06:20,989 --> 00:06:22,294
Just need to see
what's going on.
132
00:06:22,338 --> 00:06:24,384
We'll get it
sorted out, though.
133
00:06:24,427 --> 00:06:26,516
Time to find
your social worker.
134
00:06:26,560 --> 00:06:29,301
Again?
135
00:06:29,345 --> 00:06:32,000
Atlantoaxial instability
this severe will progress fast.
136
00:06:32,043 --> 00:06:33,567
We have to operate now.
137
00:06:33,610 --> 00:06:35,743
We don't have
the go ahead from his proxy.
138
00:06:35,786 --> 00:06:38,398
Well, his C1 and C2 are
compressing his spinal cord. What's everybody waiting for?
139
00:06:38,441 --> 00:06:41,575
The social worker
said he'd sign off on whatever we decide,
140
00:06:41,618 --> 00:06:43,968
but he doesn't want
to get in the weeds.
141
00:06:44,012 --> 00:06:46,754
Well, that makes things tricky,
'cause we have two surgical routes.
142
00:06:46,797 --> 00:06:49,887
High risk, high reward, open
the neck, expose the vertebra,
143
00:06:49,931 --> 00:06:51,672
place the corrective
hardware directly.
144
00:06:51,715 --> 00:06:53,978
But you're concerned about
arterial or spinal cord trauma?
145
00:06:54,022 --> 00:06:57,155
Not to mention stroke,
infection, ventral cord damage.
146
00:06:57,199 --> 00:06:59,027
Plus, he's still recovering
from lung inflammation.
147
00:06:59,070 --> 00:07:00,724
Definitely a concern.
148
00:07:00,768 --> 00:07:03,379
And the second option is
minimally invasive fusion?
149
00:07:03,423 --> 00:07:05,120
Far less trauma
and easier recovery.
150
00:07:05,163 --> 00:07:06,861
But wouldn't we be relying
on CT for navigation?
151
00:07:06,904 --> 00:07:09,124
Which means less precision
with the hardware?
152
00:07:09,167 --> 00:07:11,953
Yeah, it may require
going back in, in six months or a year.
153
00:07:11,996 --> 00:07:13,650
And there's a high chance
for a screw misplacement.
154
00:07:13,694 --> 00:07:15,696
At the C1-C2 spinal cord,
that could be severe.
155
00:07:15,739 --> 00:07:18,699
Both have risks.
156
00:07:19,351 --> 00:07:20,527
It's your call, Gina.
157
00:07:28,448 --> 00:07:30,580
Do the minimally
invasive fusion.
158
00:07:30,624 --> 00:07:31,886
I'll go explain to Walter.
159
00:07:34,932 --> 00:07:36,847
So...
160
00:07:38,283 --> 00:07:40,198
I've got full-blown leukemia.
161
00:07:41,373 --> 00:07:42,462
May I see?
162
00:07:46,117 --> 00:07:48,729
My belief is that
the steroids
163
00:07:48,772 --> 00:07:50,600
artificially raised
your white blood cell count,
164
00:07:50,644 --> 00:07:53,429
hiding the degree
of marrow infiltration,
165
00:07:53,473 --> 00:07:56,476
and I spoke to Dr. Rose,
and he agrees.
166
00:07:56,519 --> 00:08:00,088
Now, if this goes unchecked,
your decline will be rapid.
167
00:08:00,131 --> 00:08:02,220
So, we'd like to start
induction chemotherapy,
168
00:08:02,264 --> 00:08:04,484
which could buy you
a few extra months.
169
00:08:04,527 --> 00:08:06,398
This shows
a pancytopenic picture
170
00:08:06,442 --> 00:08:09,314
without any sign
of leukocytosis.
171
00:08:09,358 --> 00:08:12,100
Yes. As I just said,
the steroids are complicating things.
172
00:08:12,143 --> 00:08:15,016
Her leukemia has
an atypical presentation,
173
00:08:15,059 --> 00:08:17,758
but we need to act fast
before it progresses.
174
00:08:17,801 --> 00:08:20,891
Or her presentation
is atypical because it's not leukemia.
175
00:08:20,935 --> 00:08:22,110
Amy.
176
00:08:22,153 --> 00:08:24,852
Her counts are dropping
across every line.
177
00:08:24,895 --> 00:08:27,376
That looks like marrow failure,
not marrow takeover.
178
00:08:27,419 --> 00:08:29,465
You're reading too much
into the blast count.
179
00:08:29,509 --> 00:08:31,815
No, I'm looking at
the facts in front of us.
180
00:08:31,859 --> 00:08:34,949
She doesn't show cancer
on a peripheral smear.
181
00:08:34,992 --> 00:08:38,430
If this is pancytopenia,
we could give platelets and plasma to raise her levels.
182
00:08:38,474 --> 00:08:41,085
Blast proliferation
and dysplasia
183
00:08:41,129 --> 00:08:43,218
are textbook signs of leukemia.
184
00:08:43,261 --> 00:08:45,525
And delaying treatment
because of wishful thinking
185
00:08:45,568 --> 00:08:48,266
will cost you significant time.
186
00:08:48,310 --> 00:08:52,227
Or, if he's wrong,
the chemo will damage all your organs.
187
00:08:52,270 --> 00:08:54,142
I believe this is
Joan's decision.
188
00:08:59,060 --> 00:09:00,191
Start the chemo.
189
00:09:03,064 --> 00:09:04,761
I'll put the orders in.
190
00:09:10,027 --> 00:09:11,463
You're brilliant, Amy,
191
00:09:11,507 --> 00:09:12,987
and I know you don't
want this to be true,
192
00:09:13,030 --> 00:09:16,773
but I can't...
193
00:09:16,817 --> 00:09:20,037
I can't lose any more
time with my family.
194
00:09:22,953 --> 00:09:24,651
Yeah.
195
00:09:34,486 --> 00:09:36,619
Mom, any soreness
in the incision?
196
00:09:36,663 --> 00:09:39,013
Oh, it was routine
surgery, I'm fine.
197
00:09:39,056 --> 00:09:40,754
Where's John?
198
00:09:40,797 --> 00:09:43,539
He's here,
having a smoke.
199
00:09:43,583 --> 00:09:45,541
Surprised you
didn't go with him.
200
00:09:45,585 --> 00:09:47,587
Believe me, if I thought
I could get away with it.
201
00:09:47,630 --> 00:09:49,153
Not on my watch.
202
00:09:49,197 --> 00:09:51,678
Oh, I know, Dr. Larsen.
203
00:09:51,721 --> 00:09:53,854
Not yet, Mom.
204
00:09:53,897 --> 00:09:55,899
Speaking of which,
you should get back to Minneapolis.
205
00:09:55,943 --> 00:09:58,554
No, it's fine. Dr. Ridley
is away for a couple of weeks,
206
00:09:58,598 --> 00:10:01,644
so I finally get a little
bit of breathing room. - Who's that?
207
00:10:01,688 --> 00:10:04,429
I've mentioned her,
like, six times.
208
00:10:04,473 --> 00:10:06,997
Genius surgeon,
Doctors Without Borders,
209
00:10:07,041 --> 00:10:10,174
- utterly terrifying--
- Alright. Her.
210
00:10:10,218 --> 00:10:12,046
Everybody wants her
to be their mentor
211
00:10:12,089 --> 00:10:13,961
but she travels around so much,
212
00:10:14,004 --> 00:10:15,876
I don't think she ever
slows down enough to do that.
213
00:10:15,919 --> 00:10:17,573
What do you even
need a mentor for?
214
00:10:17,617 --> 00:10:19,706
You want something, you get it.
215
00:10:19,749 --> 00:10:21,795
Always been that way,
barely even needed to push you.
216
00:10:21,838 --> 00:10:24,058
Well, there were times
I could have used some pushing.
217
00:10:28,192 --> 00:10:29,672
Amy.
218
00:10:29,716 --> 00:10:31,674
- Hey.
- Hi.
219
00:10:31,718 --> 00:10:33,458
I got here as fast as I could.
220
00:10:33,502 --> 00:10:35,591
- She's stable now.
- Phew!
221
00:10:35,635 --> 00:10:38,638
She's pretty drowsy
from the chemo meds.
222
00:10:38,681 --> 00:10:40,988
Right. Okay.
223
00:10:43,294 --> 00:10:47,516
Amy, Joan's co-ag
panels came back. - Mmm-hmm.
224
00:10:48,343 --> 00:10:50,127
She has DIC.
225
00:10:50,171 --> 00:10:52,042
If we had pushed platelets
like you wanted,
226
00:10:52,086 --> 00:10:54,871
the runaway clotting
could have caused a massive stroke.
227
00:10:56,568 --> 00:10:58,701
I know how hard
this is for you,
228
00:10:58,745 --> 00:11:01,008
but you're gonna have to
let me do my job.
229
00:11:06,230 --> 00:11:08,842
Ethan. I'm Dr. Miller.
230
00:11:08,885 --> 00:11:10,670
- Hi.
- It's good to meet you.
231
00:11:15,631 --> 00:11:17,720
So, rounds are done.
What's next?
232
00:11:17,764 --> 00:11:19,722
Well, your partner in crime's
233
00:11:19,766 --> 00:11:21,419
sitting vigil for
a friend in the ICU.
234
00:11:21,463 --> 00:11:22,551
Have you checked in on her?
235
00:11:22,594 --> 00:11:24,814
I didn't want to
invade her space.
236
00:11:24,858 --> 00:11:27,295
It's always better
to extend yourself.
237
00:11:27,338 --> 00:11:29,166
Trust me, she's gonna
let you know if it's unwanted.
238
00:11:29,210 --> 00:11:30,951
Oh, I'm sure she will.
239
00:11:30,994 --> 00:11:32,735
So, as Chief Resident,
240
00:11:32,779 --> 00:11:34,302
you've gotta be
able to work with anyone.
241
00:11:34,345 --> 00:11:36,696
Is there anybody else,
anything you gotta get ahead of?
242
00:11:36,739 --> 00:11:38,698
I don't know
if you ever noticed,
243
00:11:38,741 --> 00:11:40,700
but Liz kind of had
a thing for TJ.
244
00:11:40,743 --> 00:11:43,224
Yeah, she wasn't
exactly subtle about it. Why, what's the problem?
245
00:11:44,051 --> 00:11:45,269
I...
246
00:11:46,531 --> 00:11:48,055
So, you and TJ?
247
00:11:49,578 --> 00:11:51,319
Wow, okay.
248
00:11:51,362 --> 00:11:53,321
I guess I missed that.
How long has that been going on?
249
00:11:53,364 --> 00:11:56,411
Not very, and you of all
people don't get to judge.
250
00:11:56,454 --> 00:11:58,718
I'm just not sure how
everyone else will react.
251
00:11:58,761 --> 00:12:00,458
Well, listen.
252
00:12:00,502 --> 00:12:02,765
I mean, you can't control how
people feel about you, okay?
253
00:12:02,809 --> 00:12:08,031
All you can do is show everyone
that you're gonna be there for them when things get tough.
254
00:12:08,075 --> 00:12:10,555
Ah, Dr. Hamda.
Do you have a minute?
255
00:12:10,599 --> 00:12:12,079
Of course, yeah.
Come in, have a seat.
256
00:12:15,038 --> 00:12:16,605
Um...
257
00:12:16,648 --> 00:12:19,521
I know I should have
said something sooner.
258
00:12:19,564 --> 00:12:22,219
I think I was just too afraid
259
00:12:22,263 --> 00:12:23,525
that no one was
gonna take me seriously.
260
00:12:23,568 --> 00:12:26,397
It's okay, Liz. What is it?
261
00:12:28,704 --> 00:12:29,966
Dr. Miller.
262
00:12:30,010 --> 00:12:31,402
What he did to me.
263
00:12:31,446 --> 00:12:33,970
Everyone's just pretending
like nothing happened,
264
00:12:34,014 --> 00:12:35,885
but it was an abuse of power.
265
00:12:38,670 --> 00:12:43,327
I appreciate your honesty,
and I understand how you feel.
266
00:12:43,371 --> 00:12:46,417
Not how I feel.
It's what happened.
267
00:12:48,071 --> 00:12:51,031
Nobody condones
what Dr. Miller did,
268
00:12:51,074 --> 00:12:52,684
but an agreement was reached.
269
00:12:52,728 --> 00:12:55,209
- What agreement?
- I'm afraid I can't discuss it.
270
00:12:55,252 --> 00:12:56,645
So you won't tell me
what happened?
271
00:12:59,387 --> 00:13:01,128
It was
a confidential settlement.
272
00:13:02,172 --> 00:13:03,783
I'm sorry, Liz.
273
00:13:05,132 --> 00:13:06,916
I guess this just proves why
274
00:13:06,960 --> 00:13:09,179
I never should have
bothered coming forward in the first place.
275
00:13:17,971 --> 00:13:19,407
CT confirms location,
276
00:13:19,450 --> 00:13:20,974
we're clear of
the vertebral artery.
277
00:13:21,017 --> 00:13:22,845
Advancing
cannula into position.
278
00:13:28,677 --> 00:13:30,026
Hey, babe.
279
00:13:30,070 --> 00:13:33,203
Okay. So, I nearly had
to sell my body for it,
280
00:13:33,247 --> 00:13:35,858
but Spoon and Stable
finally called me back.
281
00:13:35,902 --> 00:13:39,035
- They had a cancellation?
- I told them it was our anniversary,
282
00:13:39,079 --> 00:13:41,646
and they said they could
squeeze us in at 6:00.
283
00:13:41,690 --> 00:13:43,387
Can you make that work?
284
00:13:43,431 --> 00:13:45,085
Well, looks like
I'm gonna have to.
285
00:13:45,128 --> 00:13:46,564
No way we're missing
out on those oysters.
286
00:13:46,608 --> 00:13:50,177
So, there's a chance
I may need to swing back here.
287
00:13:50,220 --> 00:13:53,223
Oh no. Is it that boy
you told me about?
288
00:13:53,267 --> 00:13:55,486
Found a pretty
serious issue with his spine,
289
00:13:55,530 --> 00:13:58,663
- he's in surgery now.
- Oh honey, that's terrible.
290
00:13:58,707 --> 00:14:01,623
Are the social workers
being helpful?
291
00:14:01,666 --> 00:14:03,581
Not really. I had to make
the decision myself
292
00:14:03,625 --> 00:14:04,844
about what surgery
he should have.
293
00:14:04,887 --> 00:14:07,411
Okay, I know it's not my lane,
294
00:14:07,455 --> 00:14:10,371
and I love you for being
the person who cares this much.
295
00:14:10,414 --> 00:14:12,982
But the last time you got
this invested in a case--
296
00:14:13,026 --> 00:14:15,550
He has no one, Wendy.
297
00:14:15,593 --> 00:14:17,117
I have no choice.
298
00:14:19,554 --> 00:14:21,817
Well, she told me
about the prednisone,
299
00:14:21,861 --> 00:14:24,559
said it landed her here
a lot sooner than she would have otherwise.
300
00:14:25,516 --> 00:14:28,345
Yeah. She is strong-willed.
301
00:14:28,389 --> 00:14:31,261
That's what we love about her.
302
00:14:31,305 --> 00:14:33,916
She probably felt
like she had no choice.
303
00:14:33,960 --> 00:14:37,006
You know, after I told her
I didn't want to see her,
304
00:14:37,050 --> 00:14:39,791
what else did she
have besides work?
305
00:14:39,835 --> 00:14:43,230
And now, Robbie may never
even get to know her.
306
00:14:43,273 --> 00:14:45,928
She knew that
making things right with you was on her.
307
00:14:46,755 --> 00:14:47,756
Not you.
308
00:14:49,279 --> 00:14:51,629
All you can do now
is be there for each other.
309
00:15:16,219 --> 00:15:18,352
What did you do?
310
00:15:20,267 --> 00:15:23,661
She was fine.
She was just fine an hour ago.
311
00:15:23,705 --> 00:15:25,098
What did you do?
312
00:15:25,141 --> 00:15:27,013
It's not their fault.
She had a heart attack.
313
00:15:27,056 --> 00:15:29,319
Nobody could have
seen this coming.
314
00:15:34,498 --> 00:15:38,241
Amy. Uh, how is Joan doing?
315
00:15:38,285 --> 00:15:43,246
Um, she's stable for now.
On chemo.
316
00:15:43,290 --> 00:15:46,249
I'm sure this
must be hard for you. If there's anything I can--
317
00:15:46,293 --> 00:15:48,512
Something's escalating
in there.
318
00:15:50,862 --> 00:15:52,603
Her temperature's dropping.
319
00:15:52,647 --> 00:15:55,998
Yeah, core temp can drop
after starting chemotherapy, it's normal.
320
00:15:56,042 --> 00:15:58,392
But it can also be
a sign of sepsis.
321
00:15:58,435 --> 00:16:01,264
No, all of her cultures
were negative.
322
00:16:02,048 --> 00:16:03,527
Is that true?
323
00:16:03,571 --> 00:16:05,616
Yes, of course that's true.
324
00:16:05,660 --> 00:16:08,315
And you should know
that Dr. Larsen
325
00:16:08,358 --> 00:16:10,230
recommended a course
of treatment earlier
326
00:16:10,273 --> 00:16:12,101
that could have been
catastrophic for your mother.
327
00:16:12,145 --> 00:16:15,409
So, I don't think that
it is a good idea
328
00:16:15,452 --> 00:16:17,063
for friends
to treat each other.
329
00:16:20,805 --> 00:16:24,157
I admire your mom,
but I can be objective, and that's what she needs.
330
00:16:27,247 --> 00:16:28,335
He's right.
331
00:16:29,336 --> 00:16:30,990
Sorry, Ethan.
332
00:16:39,085 --> 00:16:40,477
- Hey.
- Hey.
333
00:16:40,521 --> 00:16:42,131
Do you have
any of Joan Ridley's blood left over?
334
00:16:42,175 --> 00:16:43,959
Yeah, we should
have some extra.
335
00:16:44,003 --> 00:16:45,178
Can you run a beta-D-glucan?
336
00:16:45,221 --> 00:16:47,354
All her cultures
came back negative.
337
00:16:47,397 --> 00:16:48,833
What are you looking for?
338
00:16:48,877 --> 00:16:51,358
I want to rule out
an invasive fungal infection.
339
00:16:51,401 --> 00:16:53,099
Something in
the endothelial tissue.
340
00:16:53,142 --> 00:16:54,926
You got it.
341
00:16:54,970 --> 00:16:58,582
And uh, when you're done,
can you get me the results directly?
342
00:16:58,626 --> 00:17:00,628
Says Dr. Miller's assigned.
343
00:17:00,671 --> 00:17:01,890
He is.
344
00:17:03,065 --> 00:17:06,329
I need this, Carin. Please.
345
00:17:07,330 --> 00:17:08,331
Sure.
346
00:17:10,290 --> 00:17:12,031
Hey, how's it going?
347
00:17:12,074 --> 00:17:15,947
Hey. I'm at the school,
apparently Mia got into a fight.
348
00:17:17,166 --> 00:17:18,559
Let me guess, with Logan?
349
00:17:18,602 --> 00:17:20,300
I haven't had a chance
to talk to her about it,
350
00:17:20,343 --> 00:17:21,518
but figured we should
do it together.
351
00:17:21,562 --> 00:17:23,346
Can I bring her bythe hospital?
352
00:17:23,390 --> 00:17:24,652
Shouldn't take too long.
353
00:17:24,695 --> 00:17:26,697
Yeah, yeah, of course.
Um, yeah, I'm here.
354
00:17:33,400 --> 00:17:35,837
She killed herself, Gina.
355
00:17:35,880 --> 00:17:38,622
All those times I begged
her to quit smoking.
356
00:17:38,666 --> 00:17:41,669
Her blood pressure
was through the roof,
357
00:17:41,712 --> 00:17:43,453
it was only a matter of time.
358
00:17:43,497 --> 00:17:46,674
You can't keep fixating
on what could have gone differently. Okay?
359
00:17:46,717 --> 00:17:48,850
All you can do now is start
to process your pain.
360
00:17:48,893 --> 00:17:50,678
What makes you think I haven't?
361
00:17:50,721 --> 00:17:53,202
It's been a week and a half.
You still haven't cried.
362
00:17:53,246 --> 00:17:56,162
Crying won't fix anything.
363
00:17:56,205 --> 00:17:58,686
I'm not saying
force it, okay?
364
00:17:58,729 --> 00:18:00,688
But just let yourself feel.
365
00:18:00,731 --> 00:18:04,344
This is only gonna get worse
once you're an actual shrink, isn't it?
366
00:18:04,387 --> 00:18:07,086
That's neuropsychiatrist,
thank you very much.
367
00:18:08,565 --> 00:18:10,306
I just need to
focus on school.
368
00:18:10,350 --> 00:18:14,180
And maybe that hot bartender
from Stanton.
369
00:18:14,223 --> 00:18:15,703
I'm serious, Amy.
370
00:18:15,746 --> 00:18:18,662
You're in grief
and mad at your mom.
371
00:18:18,706 --> 00:18:19,968
You can't just
push all that away.
372
00:18:20,011 --> 00:18:23,058
- Why not?
- 'Cause when it comes to feelings,
373
00:18:23,102 --> 00:18:24,668
the piper has to get paid.
374
00:18:24,712 --> 00:18:26,105
One way or another.
375
00:18:35,070 --> 00:18:36,941
Hey.
376
00:18:36,985 --> 00:18:39,118
Just checking on you.
Joan's BP and O2 SATs are improving.
377
00:18:39,161 --> 00:18:41,163
Chemo must be having an effect.
378
00:18:41,207 --> 00:18:43,948
I guess Richard was right.
About the leukemia.
379
00:18:43,992 --> 00:18:46,342
At least we have a diagnosis.
Where are you?
380
00:18:46,386 --> 00:18:49,650
Uh, I'm in Radiology
with another patient.
381
00:18:49,693 --> 00:18:51,826
- I'll be back soon.
- Okay.
382
00:18:54,481 --> 00:18:56,178
We won't be mad, honey.
383
00:18:56,222 --> 00:18:58,659
We just want you to
tell us what happened.
384
00:18:58,702 --> 00:19:01,618
Logan was throwing
markers at me.
385
00:19:01,662 --> 00:19:04,317
I thought we said when
he did stuff like that, you would tell the teacher.
386
00:19:04,360 --> 00:19:06,841
I did. But he didn't stop.
387
00:19:06,884 --> 00:19:10,105
So I took my chocolate pudding
388
00:19:10,149 --> 00:19:12,281
and I dumped it on his head.
389
00:19:14,327 --> 00:19:16,677
Um, so, what happened?
390
00:19:16,720 --> 00:19:18,461
You told the teacher
and they didn't do anything about it?
391
00:19:18,505 --> 00:19:20,202
They had him sit
in the big chair.
392
00:19:20,246 --> 00:19:21,812
What's the big chair?
393
00:19:21,856 --> 00:19:24,119
It's a big, comfy chair
in the corner,
394
00:19:24,163 --> 00:19:26,556
where you sit and think
about what you did.
395
00:19:26,600 --> 00:19:28,558
So, like a timeout.
396
00:19:28,602 --> 00:19:31,953
Okay, but, uh, last week,
when you won the spelling bee,
397
00:19:31,996 --> 00:19:34,085
you said you got to sit
in a big, comfy chair.
398
00:19:34,129 --> 00:19:36,784
Yeah. You sit in it
if you do something good.
399
00:19:36,827 --> 00:19:40,831
But then, sometimes,
you sit in it if you do something bad.
400
00:19:44,183 --> 00:19:45,749
I want her out of
that school, Rache. Okay?
401
00:19:45,793 --> 00:19:47,708
There's the public school,
there's the Hebrew school
402
00:19:47,751 --> 00:19:49,710
we toured,
I don't care which one.
403
00:19:49,753 --> 00:19:52,278
I just think that she needs
to be somewhere with more boundaries and grit,
404
00:19:52,321 --> 00:19:54,410
and fewer
participation trophies and big chairs.
405
00:19:55,194 --> 00:19:56,673
Okay.
406
00:19:56,717 --> 00:19:58,980
- Okay what?
- Okay, you're right.
407
00:19:59,023 --> 00:20:01,896
I'm wrong. Let's move her.
408
00:20:01,939 --> 00:20:04,507
Hold it, did you just tell me
I was right about something?
409
00:20:06,509 --> 00:20:08,207
And if you play
your cards right,
410
00:20:08,250 --> 00:20:10,078
it might even happen again.
411
00:20:12,689 --> 00:20:13,647
I'll take her home?
412
00:20:14,300 --> 00:20:15,518
Yeah, yeah.
413
00:20:24,875 --> 00:20:25,876
Are you alright?
414
00:20:29,097 --> 00:20:30,620
Uh... Yeah.
415
00:20:32,535 --> 00:20:37,018
I'm just realizing
how little power I have here.
416
00:20:41,588 --> 00:20:43,111
What happened?
417
00:20:45,113 --> 00:20:47,942
There's nothing to
be done about it, Sonya.
418
00:20:47,985 --> 00:20:50,510
No, no. I'm gonna be
Chief Resident,
419
00:20:50,553 --> 00:20:52,773
which means I can advocate.
420
00:21:01,695 --> 00:21:03,784
And this is
unprofessional.
421
00:21:03,827 --> 00:21:06,700
You were never going to
test for this, Richard, and it's positive.
422
00:21:06,743 --> 00:21:08,049
You were not gonna
listen to me.
423
00:21:08,092 --> 00:21:09,529
Well, that was my
call to make--
424
00:21:09,572 --> 00:21:11,357
Do you wanna tell me
what's going on here?
425
00:21:11,400 --> 00:21:14,098
- She ran a test behind my back.
- That is hardly the headline here.
426
00:21:14,142 --> 00:21:16,362
Joan has a Candida
organ infection,
427
00:21:16,405 --> 00:21:17,711
which he wouldn't have caught.
428
00:21:17,754 --> 00:21:20,061
I'm assuming you're
interested in treating this,
429
00:21:20,104 --> 00:21:21,889
even though I was
the one who found it.
430
00:21:21,932 --> 00:21:23,891
Alright, alright.
That's enough.
431
00:21:23,934 --> 00:21:26,067
Clearly, the chemo
lowered her immune response,
432
00:21:26,110 --> 00:21:28,069
decrease the dosage for now
and treat the infection.
433
00:21:28,112 --> 00:21:29,984
But we are still on
the right path here.
434
00:21:33,248 --> 00:21:36,904
You know, I might be
more inclined to hear you,
435
00:21:36,947 --> 00:21:39,863
if you weren't so concerned
with putting me in my place.
436
00:21:42,953 --> 00:21:46,914
He was never gonna
order the panel. Out of spite.
437
00:21:46,957 --> 00:21:48,916
- If you needed backup--
- Which is it, Michael?
438
00:21:48,959 --> 00:21:50,657
I'm supposed to come to you
because you want to help?
439
00:21:50,700 --> 00:21:52,876
Or I'm not supposed to come to
440
00:21:52,920 --> 00:21:55,052
you because I put you
in a tough position,
441
00:21:55,096 --> 00:21:56,315
because I've heard it
both ways.
442
00:21:56,358 --> 00:21:58,273
I am Chief now,
of your department.
443
00:21:58,317 --> 00:22:01,407
That's a lot different
than running two floors up to talk to the CMO.
444
00:22:01,450 --> 00:22:03,104
And by the way, you lied.
445
00:22:03,147 --> 00:22:04,235
Told me you were in Radiology,
446
00:22:04,279 --> 00:22:06,150
on our first day
working together.
447
00:22:10,677 --> 00:22:12,113
You're right. I'm sorry.
448
00:22:13,897 --> 00:22:15,899
I'm, I'm uh...
449
00:22:15,943 --> 00:22:20,077
Every time I look at Joan
in that bed, all I see is...
450
00:22:20,904 --> 00:22:22,210
Your mom.
451
00:22:26,910 --> 00:22:28,303
I wish you'd been there
for that.
452
00:22:28,956 --> 00:22:30,174
I'm here now.
453
00:22:31,350 --> 00:22:32,742
I know.
454
00:22:32,786 --> 00:22:34,657
Try to hold on to that.
455
00:22:40,097 --> 00:22:42,317
- Oh, I think he's waking up.
- Walter, can you hear me?
456
00:22:42,361 --> 00:22:44,101
It hurts. Please, it hurts.
457
00:22:44,145 --> 00:22:47,278
- Blood pressure's spiking.
- Walter, try to breathe.
458
00:22:47,322 --> 00:22:49,498
- My neck, it hurts so bad!
- Two milligrams IV morphine, stat.
459
00:22:49,542 --> 00:22:51,195
Where in the neck?
460
00:22:51,239 --> 00:22:53,328
Why can't I move my hands?
What's happening?
461
00:22:53,372 --> 00:22:55,591
It's okay, Walter. That can
sometimes happen with swelling.
462
00:22:57,376 --> 00:22:58,812
He lost his Babinski.
463
00:23:00,596 --> 00:23:02,119
So, the spinal cord's
not sending a signal?
464
00:23:02,163 --> 00:23:03,643
Costa's running
a CT to confirm,
465
00:23:03,686 --> 00:23:05,949
but it seems
the cord swelling is causing compression.
466
00:23:05,993 --> 00:23:07,777
He's on morphine for the pain,
467
00:23:07,821 --> 00:23:09,562
but he's got serious
neurological deficits.
468
00:23:09,605 --> 00:23:11,172
No movement below the neck.
469
00:23:11,215 --> 00:23:13,348
The sooner we can get back
in and operate, the better.
470
00:23:13,392 --> 00:23:15,872
But his lungs are
still inflamed from the RA.
471
00:23:15,916 --> 00:23:18,048
He may not be able to take
another round of anesthesia.
472
00:23:18,092 --> 00:23:20,007
Dr. Costa's booked an OR
for first thing in the morning.
473
00:23:20,050 --> 00:23:21,661
Anything longer than that,
474
00:23:21,704 --> 00:23:23,576
then he could have
serious neurological issues permanently.
475
00:23:23,619 --> 00:23:24,925
We should have been
more aggressive.
476
00:23:24,968 --> 00:23:26,883
We can't Monday morning
quarterback.
477
00:23:26,927 --> 00:23:28,276
The surgeon gave you
two choices.
478
00:23:28,319 --> 00:23:30,191
And I picked the safer one,
because I was worried
479
00:23:30,234 --> 00:23:31,801
Walter doesn't have
the long term support
480
00:23:31,845 --> 00:23:33,542
to go for what was
really needed.
481
00:23:33,586 --> 00:23:35,283
- It was a coin toss, Gina.
- No, it wasn't.
482
00:23:35,326 --> 00:23:37,154
You wanted to go
for the other option.
483
00:23:37,198 --> 00:23:39,330
So Costa waffled. It should
not have been up to you.
484
00:23:39,374 --> 00:23:40,506
No, it shouldn't have been.
485
00:23:40,549 --> 00:23:42,377
So let me take this
off your plate now.
486
00:23:42,421 --> 00:23:44,466
Tell Costa I want Walter
487
00:23:44,510 --> 00:23:46,207
in reverse Trendelenburg
during the operation,
488
00:23:46,250 --> 00:23:48,252
and to use lung
protective ventilation
489
00:23:48,296 --> 00:23:49,776
with low tidal volume.
490
00:23:53,170 --> 00:23:55,172
He may never
walk again, Michael.
491
00:23:58,611 --> 00:24:01,657
Induction chemo
did a number on me.
492
00:24:01,701 --> 00:24:03,964
Well, you're almost
through the first dose.
493
00:24:04,007 --> 00:24:06,357
But we found an invasive
fungal infection,
494
00:24:06,401 --> 00:24:07,794
presumptive Candida.
495
00:24:07,837 --> 00:24:09,230
We're, we're treating it
with antifungals.
496
00:24:09,839 --> 00:24:11,972
Candida.
497
00:24:12,015 --> 00:24:13,930
Must have seeded in my liver.
498
00:24:13,974 --> 00:24:16,367
No, not the liver.
499
00:24:16,411 --> 00:24:18,152
It's likely diffused
endothelial,
500
00:24:18,195 --> 00:24:20,241
given the high
beta-D-glucan level.
501
00:24:20,284 --> 00:24:23,157
Did you finish your homework?
502
00:24:23,200 --> 00:24:25,638
Is your father...
Is your father home yet?
503
00:24:25,681 --> 00:24:27,727
- Mom?
- Joan? Look at me.
504
00:24:27,770 --> 00:24:30,077
- What's wrong with her?
- Ethan, step back.
505
00:24:31,295 --> 00:24:32,601
What's happening?
506
00:24:32,645 --> 00:24:34,255
She's seizing.
507
00:24:34,298 --> 00:24:35,952
Oxygen at 10 liters.
508
00:24:35,996 --> 00:24:38,651
Altered mental status,
it's gotta be neurological.
509
00:24:38,694 --> 00:24:40,957
Increased ICP,
her brain's swelling.
510
00:24:41,001 --> 00:24:43,003
If she had leukemia,
this wouldn't be happening.
511
00:24:43,046 --> 00:24:44,570
- Not this fast.
- You're right.
512
00:24:44,613 --> 00:24:45,701
We're missing something.
513
00:24:50,750 --> 00:24:52,926
Look, I know whatever
decisions were made
514
00:24:52,969 --> 00:24:55,711
about bringing Dr. Miller back
are way above my pay grade,
515
00:24:55,755 --> 00:24:58,018
but we can't just ask Liz
to forget what happened
516
00:24:58,061 --> 00:25:00,020
'cause it'll make life
easier for everyone else.
517
00:25:00,063 --> 00:25:03,414
I'm going to talk to Richard
once Joan is stabilized.
518
00:25:03,458 --> 00:25:06,200
I'm sure he'll be willing
to apologize to Liz.
519
00:25:06,243 --> 00:25:10,204
His apology is gonna be
hollow and meaningless.
520
00:25:10,247 --> 00:25:12,206
And you should know,
when Dr. Miller was Chief,
521
00:25:12,249 --> 00:25:16,253
he tried to use me
to find out mistakes Amy was making.
522
00:25:16,297 --> 00:25:19,474
Look, I'm sorry you ended up
in the middle of that.
523
00:25:19,518 --> 00:25:22,172
But, um, I know the board.
524
00:25:22,216 --> 00:25:23,913
They'd rather find a way
to get rid of Liz
525
00:25:23,957 --> 00:25:25,654
than reopen this can of worms.
526
00:25:25,698 --> 00:25:28,483
Well, they can try,
but if Liz starts talking,
527
00:25:28,527 --> 00:25:30,354
they're gonna get blowback
from the nurses
528
00:25:30,398 --> 00:25:31,704
and potentially the union.
529
00:25:31,747 --> 00:25:33,619
Is, uh... Is that a threat?
530
00:25:33,662 --> 00:25:35,359
It's a reality.
531
00:25:35,403 --> 00:25:38,145
I'm just trying to do
the right thing for her,
532
00:25:38,188 --> 00:25:41,017
and protect the department,
which is part of my job now.
533
00:25:41,061 --> 00:25:44,151
She bears responsibility
for her own decisions, Sonya.
534
00:25:44,194 --> 00:25:46,283
As you said,
she has a very strong union
535
00:25:46,327 --> 00:25:48,198
she could have gone to
when all this happened.
536
00:25:48,242 --> 00:25:50,244
I think, maybe,
you're expecting too much,
537
00:25:50,287 --> 00:25:54,074
or not understanding
the dynamic between an older man with power
538
00:25:54,117 --> 00:25:56,903
and a young woman
at the start of her career.
539
00:25:56,946 --> 00:26:00,384
It's blaming the victim,
and I don't think it'll be appreciated.
540
00:26:00,428 --> 00:26:02,952
- I do hear you.
- Well, good.
541
00:26:04,693 --> 00:26:07,043
Because you started the day
by saying your door was open,
542
00:26:07,087 --> 00:26:09,568
but now it seems like
you're closing it on Liz.
543
00:26:16,662 --> 00:26:18,315
The MDS is late-stage,
544
00:26:18,359 --> 00:26:21,492
but it's obscured
by high steroid usage.
545
00:26:21,536 --> 00:26:23,886
Pancytopenia,
pleural effusions,
546
00:26:23,930 --> 00:26:26,454
DIC, elevated beta-D-glucan,
547
00:26:26,497 --> 00:26:29,979
and now cerebral edema,
and she's getting worse.
548
00:26:30,023 --> 00:26:33,069
Hey, just checked in on Joan.
How you holding up?
549
00:26:33,113 --> 00:26:35,985
I've been going toe to toe
with Richard all day,
550
00:26:36,029 --> 00:26:37,508
and now we're
running out of time.
551
00:26:37,552 --> 00:26:38,901
Who's this?
552
00:26:38,945 --> 00:26:40,381
Um, he's a doctor in Madrid
553
00:26:40,424 --> 00:26:42,992
who has a case study
that might be relevant
554
00:26:43,036 --> 00:26:45,560
and this translation app
keeps glitching.
555
00:26:45,604 --> 00:26:47,736
Um, I mean,
I minored in Spanish,
556
00:26:47,780 --> 00:26:50,173
we could see
how rusty I am. - Okay.
557
00:27:25,861 --> 00:27:27,994
Gracias.So, what he's saying
558
00:27:28,037 --> 00:27:29,560
is that the symptoms
were similar,
559
00:27:29,604 --> 00:27:31,737
but his patient had
dormant sarcoidosis,
560
00:27:31,780 --> 00:27:33,826
so that was complicating
the clinical picture.
561
00:27:33,869 --> 00:27:36,567
But once they found that,
everything else just fell into place.
562
00:27:36,611 --> 00:27:39,353
So a patient
with MDS like Joan presented with these symptoms
563
00:27:39,396 --> 00:27:41,921
because of a different
chronic issue.
564
00:27:41,964 --> 00:27:43,792
And it went
undetected for years.
565
00:27:43,836 --> 00:27:46,055
Okay, okay. Thanks.
566
00:27:46,099 --> 00:27:48,101
Just remember
you gotta find a way
567
00:27:48,144 --> 00:27:49,537
to work with Richard on this.
568
00:27:52,235 --> 00:27:54,107
Your spinal tap
came back negative
569
00:27:54,150 --> 00:27:55,717
and a full neuro panel too.
570
00:27:55,761 --> 00:27:58,024
Well, her procalcitonin is low,
571
00:27:58,067 --> 00:27:59,503
even though she just
had an infection.
572
00:27:59,547 --> 00:28:01,244
I need total protein,
573
00:28:01,288 --> 00:28:03,377
C-reactive protein
and complement levels.
574
00:28:03,420 --> 00:28:05,684
- How fast can you do that?
- 20 minutes.
575
00:28:05,727 --> 00:28:08,469
And if the results
can go to me, since I'm her doctor,
576
00:28:08,512 --> 00:28:09,775
that'd be appreciated.
577
00:28:12,342 --> 00:28:14,693
We've got a highcomplement protein level,
578
00:28:14,736 --> 00:28:17,565
and the prednisone
must have dropped her immune surveillance,
579
00:28:17,608 --> 00:28:20,263
which means that
we're looking for something that's been there,
580
00:28:20,307 --> 00:28:22,744
possibly for years,
like you said,
581
00:28:22,788 --> 00:28:24,224
but that's been hiding
in plain sight.
582
00:28:24,267 --> 00:28:26,139
When Joan woke up,
583
00:28:26,182 --> 00:28:27,444
and I told her about
the Candida,
584
00:28:27,488 --> 00:28:28,881
she asked if it seeded
in her liver.
585
00:28:28,924 --> 00:28:30,404
Well,
that wouldn't be uncommon.
586
00:28:30,447 --> 00:28:32,580
But the beta-D-glucan
is so high,
587
00:28:32,623 --> 00:28:34,060
the fungal load
would be too large
588
00:28:34,103 --> 00:28:35,714
to be isolated to her liver.
589
00:28:35,757 --> 00:28:38,325
Okay. We've been assuming that
the elevated liver enzymes
590
00:28:38,368 --> 00:28:42,024
are caused by the MDS
and the prednisone,
591
00:28:42,068 --> 00:28:44,635
but look at her blood work
going back to 2016.
592
00:28:46,376 --> 00:28:47,987
Higher range
than normal.
593
00:28:48,030 --> 00:28:49,553
But low enough that
nobody would flag it.
594
00:28:49,597 --> 00:28:51,773
2016,
595
00:28:51,817 --> 00:28:55,646
that's a long time for her
to be carrying something.
596
00:28:55,690 --> 00:28:59,128
Wait a minute.
One of the last memories I have of her,
597
00:28:59,172 --> 00:29:00,913
2016, she was in Ecuador.
598
00:29:00,956 --> 00:29:04,786
And she got sick,
and I told her that she should come back.
599
00:29:04,830 --> 00:29:08,007
And she self-diagnosed,
600
00:29:08,050 --> 00:29:09,922
she thought it was dysentery--
601
00:29:09,965 --> 00:29:11,793
Which means she was
drinking unfiltered water.
602
00:29:11,837 --> 00:29:14,274
So, if it was a parasite,
603
00:29:14,317 --> 00:29:16,711
she could have been sick
while she was digesting it,
604
00:29:16,755 --> 00:29:20,019
but by the time
it migrated to her liver, she was fine.
605
00:29:20,062 --> 00:29:22,195
Then she could have been
fighting this quietly for years.
606
00:29:22,238 --> 00:29:23,892
And the prednisone
weakened her immune system,
607
00:29:23,936 --> 00:29:25,633
and unleashed it on her.
608
00:29:28,157 --> 00:29:30,072
I think we have a path now.
609
00:29:34,294 --> 00:29:35,730
He's losingsympathetic tone.
610
00:29:35,774 --> 00:29:39,081
Surgery's set for 6:00 a.m,
can we up the steroids?
611
00:29:39,125 --> 00:29:40,648
Too worried about
his blood pressure.
612
00:29:40,691 --> 00:29:42,171
Think we just have
to stay the course
613
00:29:42,215 --> 00:29:43,912
and hope that he's strong
enough to hold on.
614
00:29:46,262 --> 00:29:48,482
I appreciate what
you said before.
615
00:29:48,525 --> 00:29:50,223
Trying to let me off the hook.
616
00:29:51,485 --> 00:29:53,313
You religious at all?
617
00:29:53,356 --> 00:29:54,967
From time to time,
618
00:29:55,010 --> 00:29:58,405
depending on how
I'm feeling about the world.
619
00:29:58,448 --> 00:30:00,842
I remember going to
this sermon once.
620
00:30:00,886 --> 00:30:04,715
The minister was talking about
how it can be a form of hubris
621
00:30:04,759 --> 00:30:06,369
to think that
we can control things
622
00:30:06,413 --> 00:30:08,415
that are out of our control.
623
00:30:09,982 --> 00:30:12,462
'Cause that's
somebody else's domain?
624
00:30:12,506 --> 00:30:14,334
Doesn't mean
it's easy to accept it.
625
00:30:14,377 --> 00:30:16,162
But I think
that's the idea, yeah.
626
00:30:17,859 --> 00:30:20,122
I'll take that
under advisement, Dr. Coleman.
627
00:30:20,166 --> 00:30:21,254
Good.
628
00:30:25,780 --> 00:30:26,781
Your wife's here.
629
00:30:31,003 --> 00:30:32,656
It's my anniversary
and I forgot.
630
00:30:32,700 --> 00:30:34,745
You go. I am all over this,
631
00:30:34,789 --> 00:30:36,835
hourly exams,
I will not go home.
632
00:30:43,015 --> 00:30:45,713
I've been downstairs
15 minutes, tried calling you.
633
00:30:45,756 --> 00:30:48,585
I'm sorry.
There were problems with Walter's surgery,
634
00:30:48,629 --> 00:30:51,110
he needs another one tomorrow.
635
00:30:51,153 --> 00:30:53,199
Why don't we have dinner
in your office tonight?
636
00:30:53,242 --> 00:30:57,638
That way, if anything happens, you're close.
637
00:30:57,681 --> 00:30:59,466
What did I do to deserve you?
638
00:30:59,509 --> 00:31:01,250
I don't know.
639
00:31:01,294 --> 00:31:03,209
I'm sure you'll find a way
to make it up to me.
640
00:31:05,037 --> 00:31:07,561
I'm thinking
400 milligrams albendazole.
641
00:31:08,301 --> 00:31:10,172
I'd go 300,
642
00:31:10,216 --> 00:31:12,783
given the ALT/AST,
643
00:31:12,827 --> 00:31:15,047
and 20 of Ampho B
to balance it out.
644
00:31:15,090 --> 00:31:17,092
And 100 milligrams
of cimetidine
645
00:31:17,136 --> 00:31:18,311
to cut the renal toxicity.
646
00:31:19,878 --> 00:31:21,227
It's a tightrope.
647
00:31:21,270 --> 00:31:23,185
Any idea where Liz is?
648
00:31:23,229 --> 00:31:24,621
Uh, let's see.
649
00:31:24,665 --> 00:31:26,536
Code Blue, ICU.
650
00:31:27,668 --> 00:31:28,756
Joan's coding.
651
00:31:29,844 --> 00:31:32,281
Code Blue, ICU.
652
00:31:32,325 --> 00:31:33,587
Code Blue, ICU.
653
00:31:33,630 --> 00:31:36,764
No pulse.
654
00:31:36,807 --> 00:31:38,940
He's in V-fib.
Push one milligram Epi. Get the defibrillator.
655
00:31:48,689 --> 00:31:50,256
Ready?
656
00:31:51,474 --> 00:31:52,998
Clear.
657
00:31:56,915 --> 00:31:58,786
Restarting compressions.
658
00:32:06,837 --> 00:32:09,623
Danny, Danny.
Someone call 911.
659
00:32:11,190 --> 00:32:12,321
Charge to 50.
660
00:32:13,975 --> 00:32:15,585
Clear.
661
00:32:20,460 --> 00:32:22,853
Pushing another
milligram of Epi.
662
00:32:29,512 --> 00:32:31,688
Fine V-fib, we're losing him.
663
00:32:31,732 --> 00:32:33,995
Going up to 100.
Give me the paddles.
664
00:32:38,478 --> 00:32:40,262
- Ready.
- Clear.
665
00:32:50,272 --> 00:32:51,491
Looks like Sinus.
666
00:32:51,534 --> 00:32:54,233
We have a pulse. He's back.
667
00:32:54,276 --> 00:32:56,931
Page Dr. Costa,
we can't wait on the surgery.
668
00:33:19,998 --> 00:33:21,782
Cord is decompressed.
669
00:33:21,825 --> 00:33:25,612
Screws are seated.
Let's secure the rods.
670
00:33:26,439 --> 00:33:27,831
Hey.
671
00:33:31,487 --> 00:33:34,099
That must have been
really difficult for you.
672
00:33:35,187 --> 00:33:36,492
Yeah.
673
00:33:37,798 --> 00:33:40,453
And a hell of a first day
for Michael.
674
00:33:40,496 --> 00:33:43,064
Oh, it hit
pretty close to home.
675
00:33:44,935 --> 00:33:46,372
How's it going in there?
676
00:33:46,415 --> 00:33:47,895
Hardware's almost in place.
677
00:33:47,938 --> 00:33:50,376
But even if it works,
678
00:33:50,419 --> 00:33:52,552
no one's ever
gonna adopt him.
679
00:33:52,595 --> 00:33:54,945
Not when he needs
this kind of support.
680
00:33:58,340 --> 00:34:01,561
You're not thinking
of doing something drastic?
681
00:34:03,215 --> 00:34:04,564
Go and be with Joan.
682
00:34:05,478 --> 00:34:06,957
Gina.
683
00:34:08,350 --> 00:34:11,005
I care about him,
684
00:34:11,049 --> 00:34:14,313
but I know what
the boundaries are.
685
00:34:14,356 --> 00:34:16,880
Now go, where you're needed.
686
00:34:30,894 --> 00:34:32,766
But you've gotta quit smoking.
687
00:34:32,809 --> 00:34:34,202
You know that's never
gonna happen, honey.
688
00:34:38,902 --> 00:34:41,340
I don't know how much more
we can pump into her
689
00:34:41,383 --> 00:34:43,690
before she starts
shutting down.
690
00:34:43,733 --> 00:34:46,127
Her body's so fragile.
691
00:34:48,521 --> 00:34:51,263
The chemo
didn't help with that.
692
00:34:51,306 --> 00:34:53,569
She was only on it
for eight hours.
693
00:34:55,441 --> 00:34:57,182
The parasite is causing this,
694
00:34:57,225 --> 00:35:00,098
that and the prednisone,
it's not on you, Richard.
695
00:35:38,310 --> 00:35:40,094
Hey. It's okay, buddy.
696
00:35:50,974 --> 00:35:52,933
Can I see?
697
00:35:55,762 --> 00:35:58,112
Aw, she's gonna love this.
698
00:36:01,463 --> 00:36:03,335
Is she gonna wake up soon?
699
00:36:03,378 --> 00:36:05,772
I really hope so.
700
00:36:21,527 --> 00:36:22,702
Hello?
701
00:36:22,745 --> 00:36:24,138
Hi, Amy.It's Dr. Ridley.
702
00:36:25,139 --> 00:36:27,881
Oh. Hi.
703
00:36:27,924 --> 00:36:29,752
I hope it's not
2:00 a.m. there,
704
00:36:29,796 --> 00:36:31,928
I stopped tracking time zone
differences ages ago.
705
00:36:31,972 --> 00:36:35,149
No, it's noon.
Is there a problem?
706
00:36:35,193 --> 00:36:38,196
I spoke with
Dr. Kelly this morning, he told me about your mother.
707
00:36:39,675 --> 00:36:42,678
I'm just so sorry, Amy.
708
00:36:42,722 --> 00:36:46,421
- Thank you, Dr. Ridley.
- And I respect your tenacity,
709
00:36:46,465 --> 00:36:48,249
already being back
in the hospital,
710
00:36:48,293 --> 00:36:50,425
but I just wanted to make sure
you're taking care of yourself.
711
00:36:51,252 --> 00:36:53,298
I think so.
712
00:36:55,343 --> 00:36:56,997
It's...
713
00:36:57,040 --> 00:37:00,087
It's been hard, obviously.
714
00:37:00,130 --> 00:37:02,437
Your worldshifted on its axis.
715
00:37:02,481 --> 00:37:04,570
But you will come out
the other side.
716
00:37:04,613 --> 00:37:06,180
I just...
717
00:37:07,486 --> 00:37:09,792
didn't even think you liked me.
718
00:37:09,836 --> 00:37:11,794
Well,that's by design, my dear.
719
00:37:11,838 --> 00:37:14,057
And now you know the truth.
720
00:37:14,101 --> 00:37:17,626
Not only do I like you,
I believe in you.
721
00:37:19,715 --> 00:37:22,892
Thank you so much. I--
722
00:37:22,936 --> 00:37:24,981
I know how badthis hurts right now,
723
00:37:25,025 --> 00:37:28,246
but the best way that
you can honor your mother is to live a life with purpose.
724
00:37:28,289 --> 00:37:31,336
You have greatness in you, Amy.
725
00:37:31,379 --> 00:37:33,860
And I'll be there
to help you find it.
726
00:37:44,871 --> 00:37:46,394
Joan.
727
00:37:46,438 --> 00:37:49,702
Hey. Can you hear me?
728
00:37:49,745 --> 00:37:53,009
Can you get her son?
He just went to get coffee.
729
00:37:54,446 --> 00:37:57,536
Hey. It's okay.
730
00:37:57,579 --> 00:38:00,234
Just go slow. Breathe.
731
00:38:02,932 --> 00:38:05,631
- What happened?
- You had cerebral edema.
732
00:38:05,674 --> 00:38:07,241
No.
733
00:38:07,285 --> 00:38:10,026
It's not leukemia.
734
00:38:10,070 --> 00:38:11,550
Not yet.
735
00:38:11,593 --> 00:38:14,074
You had a parasite
in your liver.
736
00:38:14,117 --> 00:38:17,338
From Ecuador.
Do you remember that?
737
00:38:17,382 --> 00:38:19,297
You thought it was dysentery?
738
00:38:19,949 --> 00:38:22,430
Oh my God.
739
00:38:22,474 --> 00:38:26,260
Is that the one time
in my life I misdiagnosed?
740
00:38:33,746 --> 00:38:36,139
You haven't
looked after yourself for a long time.
741
00:38:38,446 --> 00:38:39,752
I know.
742
00:38:39,795 --> 00:38:42,102
Promise me that stops now.
743
00:38:42,145 --> 00:38:44,017
Ah.
744
00:38:44,060 --> 00:38:47,325
- Mom. Hey.
- Hey.
745
00:38:48,282 --> 00:38:50,197
Thanks so much, Amy.
746
00:38:52,025 --> 00:38:55,898
I'll order CBC
and liver function tests.
747
00:38:59,162 --> 00:39:00,816
The fact that she's conscious--
748
00:39:00,860 --> 00:39:03,906
Yeah, we got her
some more time.
749
00:39:03,950 --> 00:39:06,779
I appreciate you finding
a way to trust me today.
750
00:39:08,998 --> 00:39:11,305
Yeah, it worked out today.
751
00:39:11,349 --> 00:39:13,873
But I'm never gonna
trust you, Richard.
752
00:39:21,576 --> 00:39:24,623
Hey, Walter. Welcome back.
753
00:39:24,666 --> 00:39:26,146
Did you fix my spine?
754
00:39:26,189 --> 00:39:29,018
We need to run some tests
over the next few days,
755
00:39:29,062 --> 00:39:31,064
but it seems that way.
756
00:39:31,107 --> 00:39:32,805
And I'll be able
to walk again?
757
00:39:32,848 --> 00:39:34,328
It's gonna be
a long recovery,
758
00:39:34,372 --> 00:39:37,157
lots of physical therapy
as your body adjusts
759
00:39:37,200 --> 00:39:39,072
to the hardware in your spine.
760
00:39:39,115 --> 00:39:41,117
But yes, you will.
761
00:39:44,904 --> 00:39:47,297
And I'll have to miss
the next adoption fair?
762
00:39:48,429 --> 00:39:51,563
There'll be lots more.
I promise.
763
00:39:51,606 --> 00:39:53,303
Thank you, Dr. Walker.
764
00:39:53,347 --> 00:39:55,828
Nobody ever cared
the way you do.
765
00:39:59,745 --> 00:40:01,834
I am so sorry.
766
00:40:01,877 --> 00:40:04,619
It's okay.
We'll do a raincheck.
767
00:40:12,279 --> 00:40:15,195
Sometimes, I wonder
how you manage to leave it all here
768
00:40:15,238 --> 00:40:17,110
when you come home.
769
00:40:19,242 --> 00:40:21,070
It can be really hard.
770
00:40:22,071 --> 00:40:23,116
Yeah.
771
00:40:33,169 --> 00:40:35,650
Let's go get a drink, huh?
772
00:40:35,694 --> 00:40:36,956
Yeah.
773
00:40:45,704 --> 00:40:48,576
Hey. So, I spoke to Liz,
774
00:40:48,620 --> 00:40:51,187
and told her if she wants
to come forward to HR,
775
00:40:51,231 --> 00:40:53,451
we would both have her back.
776
00:40:53,494 --> 00:40:56,671
Thank you.
Oh, and I'm sorry if I was too--
777
00:40:56,715 --> 00:40:59,848
Sonya, speaking truth to power
takes courage.
778
00:40:59,892 --> 00:41:01,850
I should be thanking you.
779
00:41:03,069 --> 00:41:05,332
Sorry, I didn't mean
to interrupt.
780
00:41:05,375 --> 00:41:07,029
Oh no, I was just leaving.
781
00:41:07,073 --> 00:41:09,336
Actually, I was
hoping to speak to you.
782
00:41:12,905 --> 00:41:15,211
I just wanted to thank you
for checking in earlier.
783
00:41:15,255 --> 00:41:18,388
- Joan's improving.
- I heard, that's great news.
784
00:41:20,347 --> 00:41:22,915
So we're gonna do this thing?
Together?
785
00:41:22,958 --> 00:41:24,656
Well, it's what she wants.
786
00:41:24,699 --> 00:41:26,614
She tends to get
what she wants.
787
00:41:26,658 --> 00:41:28,007
Yeah.
788
00:41:33,055 --> 00:41:36,058
I saw Joan,
she's spunky as ever.
789
00:41:36,102 --> 00:41:38,365
Can't keep that lady down.
790
00:41:39,932 --> 00:41:41,934
- Amen to that.
- Yeah.
791
00:41:41,977 --> 00:41:44,893
- Goodnight, Jake.
- Hey. Goodnight, man.
792
00:41:50,812 --> 00:41:53,467
Hey, did you know
about him and Sonya?
793
00:41:53,511 --> 00:41:54,642
What about them?
794
00:41:55,730 --> 00:41:57,819
- No.
- Yeah.
795
00:41:59,560 --> 00:42:01,431
I guess we set a good example.
796
00:42:07,525 --> 00:42:09,614
I heard your family
was here today.
797
00:42:09,657 --> 00:42:11,441
Yeah. Um...
798
00:42:11,485 --> 00:42:13,748
Mia, she got in trouble
at school, it was,
799
00:42:13,792 --> 00:42:15,489
uh, I don't know...
It was ridiculous.
800
00:42:17,099 --> 00:42:20,407
Maybe you can tell me
all about it on the way home?
801
00:42:22,191 --> 00:42:24,977
Yeah, sure thing, Chief.
I can do that.
802
00:42:26,065 --> 00:42:28,328
It's Co-Chief.
803
00:42:28,371 --> 00:42:31,157
Co-Chief. I'm sorry,
that's just so awkward to say.
804
00:42:31,200 --> 00:42:33,768
I know,
tell me about it.
805
00:42:33,812 --> 00:42:35,422
Co-Chief.
806
00:42:39,600 --> 00:42:43,343
โช Did that fancy collegeArt school let you in? โช
807
00:42:44,997 --> 00:42:47,565
โช Well damnit they'd be crazy โช
808
00:42:47,608 --> 00:42:50,132
โช If they never saw in you โช
809
00:42:50,176 --> 00:42:53,353
โช What I failed to see at 17 โช
810
00:42:53,396 --> 00:42:55,790
โช I must've missed it too โช
811
00:42:55,834 --> 00:42:58,227
โช Oh, kiss me โช
812
00:42:58,271 --> 00:43:00,839
โช Kiss me slowly โช
813
00:43:00,882 --> 00:43:05,583
โช Like you didWhen we were young โช
814
00:43:07,149 --> 00:43:11,545
โช And hold meLike you know me โช
815
00:43:11,589 --> 00:43:14,069
โช Like the old days โช
816
00:43:14,113 --> 00:43:18,813
โช Take me home โช
58595
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