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These are the user uploaded subtitles that are being translated: 1 00:00:01,391 --> 00:00:02,491 (KNOCKING ON DOOR) 2 00:00:02,493 --> 00:00:07,329 ♪ ♪ 3 00:00:09,129 --> 00:00:10,216 (KNOCKING CONTINUES) 4 00:00:10,241 --> 00:00:12,341 KENNY: Morning, Doc! 5 00:00:12,366 --> 00:00:14,549 Good morning, Kenny. 6 00:00:14,574 --> 00:00:17,669 ♪ ♪ 7 00:00:17,671 --> 00:00:19,237 Hey, hey, hey. 8 00:00:19,301 --> 00:00:22,468 ♪ ♪ 9 00:00:22,493 --> 00:00:25,226 Brosef, your cable's out. 10 00:00:25,251 --> 00:00:27,096 I don't have cable. 11 00:00:27,098 --> 00:00:29,331 I have a digital antenna. 12 00:00:29,333 --> 00:00:31,767 - Why? - Digital antennae 13 00:00:31,769 --> 00:00:35,938 receive superior picture and sound quality, 14 00:00:35,940 --> 00:00:37,473 and the channels are free. 15 00:00:37,475 --> 00:00:39,375 Yeah, but you get, like, 10 channels that way. 16 00:00:39,377 --> 00:00:40,676 I only watch three. 17 00:00:40,678 --> 00:00:42,445 You mind if I run a line to your tube? 18 00:00:43,980 --> 00:00:45,381 Cable guy can't fit me in till next week. 19 00:00:45,383 --> 00:00:47,883 Mm. 20 00:00:47,885 --> 00:00:49,185 Come on, 10 channels are better than none. 21 00:00:49,187 --> 00:00:51,487 Yes, they are. 22 00:00:51,489 --> 00:00:52,788 All right. 23 00:00:52,790 --> 00:00:54,457 Gracias, amigo. 24 00:00:54,459 --> 00:00:55,958 No hay na que agradecer. 25 00:00:55,960 --> 00:00:57,299 What? 26 00:00:57,324 --> 00:01:00,696 ♪ ♪ 27 00:01:00,698 --> 00:01:02,331 MELENDEZ: Dr. Reznick was orphaned 28 00:01:02,333 --> 00:01:03,866 once Dr. Coyle was transferred, 29 00:01:03,868 --> 00:01:05,501 so she'll be joining our team. 30 00:01:05,503 --> 00:01:06,502 Hi. I'm Claire. 31 00:01:06,504 --> 00:01:07,670 Nice to meet you. 32 00:01:09,740 --> 00:01:11,373 Are you the autistic one? 33 00:01:11,375 --> 00:01:13,008 No. 34 00:01:13,010 --> 00:01:14,210 That's me. 35 00:01:14,212 --> 00:01:15,778 Dr. Shaun Murphy. 36 00:01:15,780 --> 00:01:17,546 Hi. 37 00:01:17,548 --> 00:01:19,915 We've got two pretty straightforward cases, 38 00:01:19,917 --> 00:01:23,185 nice level playing field for an eager group. 39 00:01:23,187 --> 00:01:24,320 Not interested. 40 00:01:24,322 --> 00:01:26,188 Competition can foster teamwork, 41 00:01:26,190 --> 00:01:27,990 which can lead to a greater understanding 42 00:01:27,992 --> 00:01:29,458 and appreciation 43 00:01:29,460 --> 00:01:31,060 of residents' strengths and weaknesses 44 00:01:31,062 --> 00:01:32,495 and improve patient care. 45 00:01:32,497 --> 00:01:34,130 You're playing the same game Glassman had us do 46 00:01:34,132 --> 00:01:35,131 when we were interns. 47 00:01:35,133 --> 00:01:36,132 Not interested. 48 00:01:36,134 --> 00:01:38,412 Winning team gets first dibs 49 00:01:38,413 --> 00:01:40,379 on assisting on all surgeries next week. 50 00:01:40,404 --> 00:01:41,277 - In. - In. 51 00:01:41,302 --> 00:01:42,400 Out. 52 00:01:43,573 --> 00:01:45,141 Mm. 53 00:01:45,143 --> 00:01:48,210 ♪ ♪ 54 00:01:48,212 --> 00:01:49,879 I pick the boy genius. 55 00:01:49,881 --> 00:01:52,615 ♪ ♪ 56 00:01:52,617 --> 00:01:53,883 That's you. 57 00:01:53,885 --> 00:01:59,388 ♪ ♪ 58 00:01:59,390 --> 00:02:04,894 ♪ ♪ 59 00:02:04,896 --> 00:02:06,095 Dr. Browne. 60 00:02:06,097 --> 00:02:07,763 ♪ ♪ 61 00:02:07,765 --> 00:02:10,099 - Kalu. - MELENDEZ: Dr. Reznick. 62 00:02:10,667 --> 00:02:13,235 Thank you. I'm looking forward to it. 63 00:02:15,300 --> 00:02:16,534 Thank you. 64 00:02:16,559 --> 00:02:18,908 ♪ ♪ 65 00:02:18,910 --> 00:02:20,943 Same stakes as last time? 66 00:02:20,945 --> 00:02:22,411 Absolutely. 67 00:02:22,413 --> 00:02:26,749 ♪ ♪ 68 00:02:26,751 --> 00:02:27,817 LIM: Hi, Quinn. 69 00:02:27,819 --> 00:02:29,084 We hear you've had some stomach pain. 70 00:02:29,086 --> 00:02:30,085 Do you mind if we take a look? 71 00:02:30,087 --> 00:02:31,620 It doesn't hurt that bad. 72 00:02:31,622 --> 00:02:33,589 Poor thing says everything is okay, 73 00:02:33,591 --> 00:02:36,192 but when Quinnie didn't want to go swimming today, 74 00:02:36,194 --> 00:02:38,294 I knew that something must be wrong. 75 00:02:39,930 --> 00:02:42,097 We'll be as gentle with her as possible. 76 00:02:42,099 --> 00:02:43,966 (GROANS) 77 00:02:43,968 --> 00:02:45,401 Quinn's parents are out of town, 78 00:02:45,403 --> 00:02:48,103 so I'm... I flew in to babysit. 79 00:02:48,105 --> 00:02:49,205 Mm-hmm. 80 00:02:51,341 --> 00:02:52,708 (INHALES SHARPLY) 81 00:02:52,710 --> 00:02:54,410 Okay. 82 00:02:54,412 --> 00:02:56,011 Let's see. 83 00:02:56,813 --> 00:02:59,548 ♪ ♪ 84 00:02:59,550 --> 00:03:00,783 - That's a... - Penis. 85 00:03:02,352 --> 00:03:03,919 She's not a girl. 86 00:03:03,921 --> 00:03:05,120 He's a boy. 87 00:03:11,422 --> 00:03:16,068 ♪ ♪ 88 00:03:16,070 --> 00:03:17,036 It's just a phase. 89 00:03:17,038 --> 00:03:18,504 QUINN: Stop saying that. 90 00:03:18,506 --> 00:03:20,006 I'm not a boy. I'm a girl. 91 00:03:20,008 --> 00:03:21,674 - You're transgender? - Yes. 92 00:03:21,676 --> 00:03:22,875 SHAUN: No. 93 00:03:22,877 --> 00:03:25,978 Quinn has XY chromosomes like Jared and me, 94 00:03:25,980 --> 00:03:27,446 not XX like you. 95 00:03:27,448 --> 00:03:29,415 Science says he's male. 96 00:03:29,417 --> 00:03:31,651 No, Quinn has gender dysphoria. 97 00:03:31,653 --> 00:03:33,986 Her assigned gender is not the one she identifies with. 98 00:03:33,988 --> 00:03:35,922 She's mismatched, Dr. Murphy. 99 00:03:35,924 --> 00:03:37,189 But biologically... 100 00:03:37,191 --> 00:03:38,524 QUINN: Other than biologically, 101 00:03:38,526 --> 00:03:40,359 how do you know you're supposed to be a boy? 102 00:03:42,829 --> 00:03:44,830 Your question doesn't make sense. 103 00:03:44,832 --> 00:03:46,766 I'm not supposed to be anything. 104 00:03:46,768 --> 00:03:47,900 I am a boy. 105 00:03:47,902 --> 00:03:49,402 Biologically, that's it. 106 00:03:49,404 --> 00:03:52,104 ♪ ♪ 107 00:03:52,106 --> 00:03:53,372 (INHALES SHARPLY) 108 00:03:53,374 --> 00:03:55,174 Okay, deep tenderness at McBurney's point. 109 00:03:55,176 --> 00:03:56,509 Could be acute appendicitis. 110 00:03:56,511 --> 00:03:59,345 Murphy, get imaging to confirm. 111 00:03:59,347 --> 00:04:00,546 Mm. 112 00:04:00,548 --> 00:04:02,081 ♪ ♪ 113 00:04:02,083 --> 00:04:06,452 (BREATHING DEEPLY) 114 00:04:06,454 --> 00:04:08,321 Mr. Shaw, your chart says 115 00:04:08,323 --> 00:04:10,389 that you passed out in class. 116 00:04:10,391 --> 00:04:12,521 - What do you teach? - History. 117 00:04:12,546 --> 00:04:14,660 I got a little dizzy because I skipped breakfast. 118 00:04:14,662 --> 00:04:15,962 I-It's nothing. 119 00:04:15,964 --> 00:04:18,397 The school insisted on calling an ambulance. 120 00:04:18,399 --> 00:04:20,333 Taken any medications in the last few months? 121 00:04:21,401 --> 00:04:23,069 Uh, I took some Vicodin 122 00:04:23,071 --> 00:04:25,805 after I threw out my back six weeks ago, 123 00:04:25,807 --> 00:04:27,773 and then I had a stomach flu, 124 00:04:27,775 --> 00:04:29,342 so I took Ofloxacin. 125 00:04:29,344 --> 00:04:32,111 But the flu part didn't totally go away, 126 00:04:32,113 --> 00:04:34,714 so I took Azithromycin and Prednisone 127 00:04:34,716 --> 00:04:36,782 because my glands were swollen. 128 00:04:36,784 --> 00:04:39,685 But I still had a sore throat, so I took some Cipro. 129 00:04:41,788 --> 00:04:43,422 What doctor prescribed you all that? 130 00:04:43,424 --> 00:04:45,391 Uh, they were leftovers 131 00:04:45,393 --> 00:04:47,960 I had in my medicine cabinet. 132 00:04:47,962 --> 00:04:50,563 - Uh... - All right, lay back for me. 133 00:04:50,565 --> 00:04:52,498 (GROANS) 134 00:04:52,500 --> 00:04:54,667 Look, I'm a single dad with twins 135 00:04:54,669 --> 00:04:57,003 who bring home every disgusting germ 136 00:04:57,005 --> 00:04:59,271 they touch at preschool. 137 00:04:59,273 --> 00:05:01,173 I can't afford to miss work. 138 00:05:01,175 --> 00:05:02,375 (GROANS) 139 00:05:02,377 --> 00:05:04,310 You've got a fever 140 00:05:04,312 --> 00:05:05,611 and you've gone through two IVs 141 00:05:05,613 --> 00:05:07,446 which tells me that you're severely dehydrated. 142 00:05:07,448 --> 00:05:09,315 You can't stand me touching your stomach 143 00:05:09,317 --> 00:05:10,483 without wincing in pain. 144 00:05:10,485 --> 00:05:13,185 Dr. Reznick, let's get Mr. Shaw here an ultrasound. 145 00:05:13,187 --> 00:05:15,372 ♪ ♪ 146 00:05:15,397 --> 00:05:17,577 - We've been trying for a while. - Five months. 147 00:05:17,602 --> 00:05:19,736 I realize my prime egg days were two decades ago, 148 00:05:19,761 --> 00:05:21,093 but I've been vigilant. 149 00:05:21,095 --> 00:05:23,429 Ovulation kits, LH and FSH testing, 150 00:05:23,431 --> 00:05:24,530 basal body temp. 151 00:05:24,532 --> 00:05:27,199 I've checked my estradiol and AMH levels. 152 00:05:27,201 --> 00:05:29,168 The old-fashioned way wasn't working. 153 00:05:29,170 --> 00:05:32,338 Okay, well, there are a lot of possibilities to consider. 154 00:05:32,340 --> 00:05:34,874 Many benign, many easily corrected. 155 00:05:34,876 --> 00:05:37,176 So I will take some samples from you both, 156 00:05:37,178 --> 00:05:38,644 run some tests, we go from there. 157 00:05:38,646 --> 00:05:39,845 There's a clock. 158 00:05:39,847 --> 00:05:42,214 We need to know if we start with IUI or IVF... 159 00:05:42,216 --> 00:05:44,884 Both of you... You need to stop worrying. 160 00:05:44,886 --> 00:05:47,586 Isabel, you are not the first 40-something woman 161 00:05:47,588 --> 00:05:49,822 to come here and ask these questions. 162 00:05:49,824 --> 00:05:52,491 Myself included. 163 00:05:52,493 --> 00:05:54,326 You came to me because you trust me, yes? 164 00:05:54,328 --> 00:05:56,062 Right. 165 00:05:56,064 --> 00:05:57,630 So let me do what I do, 166 00:05:57,632 --> 00:05:59,131 and you two focus on each other. 167 00:05:59,133 --> 00:06:00,933 ♪ ♪ 168 00:06:00,935 --> 00:06:02,601 Hey. 169 00:06:02,603 --> 00:06:04,203 We're a team, babe. 170 00:06:04,205 --> 00:06:06,539 In this together, all right? 171 00:06:06,541 --> 00:06:07,973 Okay. 172 00:06:07,975 --> 00:06:12,778 ♪ ♪ 173 00:06:12,780 --> 00:06:17,516 ♪ ♪ 174 00:06:17,518 --> 00:06:18,684 I'm afraid, Howard, 175 00:06:18,686 --> 00:06:20,753 your appendix has already ruptured. 176 00:06:20,755 --> 00:06:23,106 Book an OR stat and page Melendez. 177 00:06:23,131 --> 00:06:24,489 Wait. I need to figure out 178 00:06:24,514 --> 00:06:25,707 who's gonna take care of my kids, 179 00:06:25,732 --> 00:06:28,036 call the school so they can get subs for my classes. 180 00:06:28,061 --> 00:06:30,129 Mr. Shaw, if we don't get you into surgery now, 181 00:06:30,131 --> 00:06:32,465 your infection could spread and you could become septic. 182 00:06:32,467 --> 00:06:34,467 Dr. Browne will make all the necessary phone calls 183 00:06:34,469 --> 00:06:36,035 I prep you for surgery. 184 00:06:36,037 --> 00:06:37,703 Isn't that so, Dr. Browne? 185 00:06:40,073 --> 00:06:41,440 You're in good hands, Mr. Shaw. 186 00:06:41,442 --> 00:06:42,541 We've got you covered. 187 00:06:42,543 --> 00:06:43,709 Let's go. 188 00:06:43,711 --> 00:06:51,684 ♪ ♪ 189 00:06:51,686 --> 00:06:53,552 SHAUN: Hello. 190 00:06:53,554 --> 00:06:54,520 Do you wear dresses? 191 00:06:54,522 --> 00:06:56,789 Murphy, don't. 192 00:06:56,791 --> 00:06:59,492 Quinn is a boy who thinks he's a girl. 193 00:06:59,494 --> 00:07:01,994 I want to know why he thinks that. 194 00:07:01,996 --> 00:07:04,130 Sometimes I wear dresses, but sometimes I wear leggings. 195 00:07:04,132 --> 00:07:07,433 Do you like the color pink? 196 00:07:07,435 --> 00:07:08,467 (CHUCKLES) 197 00:07:08,469 --> 00:07:10,035 I'm more of a purple girl. 198 00:07:10,037 --> 00:07:12,238 - Do you play with dolls? - Since I was 5, 199 00:07:12,240 --> 00:07:13,939 but I'm super into mermaids. 200 00:07:13,941 --> 00:07:14,974 Do you take dance... 201 00:07:14,976 --> 00:07:16,642 Murphy, 20 questions are up. 202 00:07:16,644 --> 00:07:18,177 I only asked four. 203 00:07:18,179 --> 00:07:19,678 - Do you wear perfume? - It doesn't matter. 204 00:07:19,680 --> 00:07:20,728 The CT's ready. Let's go. 205 00:07:20,753 --> 00:07:22,448 - Do you always paint your nails? - Let's go. 206 00:07:22,450 --> 00:07:32,358 ♪ ♪ 207 00:07:32,360 --> 00:07:34,493 MELENDEZ: Perforated appendix is out. 208 00:07:34,495 --> 00:07:36,362 Lavage or no lavage. 209 00:07:36,364 --> 00:07:37,630 Dr. Browne. 210 00:07:37,632 --> 00:07:39,365 Lavage before closing the wound 211 00:07:39,367 --> 00:07:41,367 decreases residual fluid accumulation 212 00:07:41,369 --> 00:07:44,570 - and minimizes residual contamination. - MORGAN: Claire's right. 213 00:07:44,572 --> 00:07:45,704 Although, a recent study 214 00:07:45,706 --> 00:07:47,339 documented a higher abscess rate 215 00:07:47,341 --> 00:07:49,775 when irrigation was used for perforated appendicitis. 216 00:07:49,777 --> 00:07:51,844 Well, someone did their homework. 217 00:07:51,846 --> 00:07:53,846 I'm partial to AMSURG since they published me. 218 00:07:53,848 --> 00:07:55,915 As a medical student? 219 00:07:55,917 --> 00:07:58,284 It was about the cost and stabilization of disease 220 00:07:58,286 --> 00:08:00,085 in patients undergoing transcatheter 221 00:08:00,087 --> 00:08:01,854 and surgical aortic valve replacement. 222 00:08:01,856 --> 00:08:03,989 Are you thinking of specializing in cardio-thoracic? 223 00:08:03,991 --> 00:08:05,824 A girl can dream. 224 00:08:06,927 --> 00:08:08,260 Staple up and close up. 225 00:08:11,464 --> 00:08:12,531 It's, uh... 226 00:08:12,533 --> 00:08:14,466 it's good to have you on board, Morgan. 227 00:08:14,468 --> 00:08:18,170 It's great to have another female surgeon. 228 00:08:18,172 --> 00:08:21,340 Oh, uh, I'm sorry, 229 00:08:21,342 --> 00:08:23,075 you and I are not gonna be friends, 230 00:08:23,077 --> 00:08:25,144 hanging out, having sleepovers, 231 00:08:25,146 --> 00:08:26,912 braiding each other's hair. 232 00:08:26,914 --> 00:08:30,182 That's not exactly where I was going with it. 233 00:08:30,184 --> 00:08:31,417 When residency's over, 234 00:08:31,419 --> 00:08:32,685 the hospital's likely only keeping two of us. 235 00:08:32,687 --> 00:08:35,387 Shaun is Glassman's pet project, so he's in. 236 00:08:35,389 --> 00:08:37,990 Jared is persona non grata, so he's out. 237 00:08:37,992 --> 00:08:40,192 Which means every time you win, I lose. 238 00:08:40,194 --> 00:08:42,094 And vice versa. 239 00:08:42,096 --> 00:08:45,464 ♪ ♪ 240 00:08:45,466 --> 00:08:47,032 Thanks for the heads up. 241 00:08:47,034 --> 00:08:49,535 ♪ ♪ 242 00:08:49,537 --> 00:08:57,543 (CT MACHINE WHIRS) 243 00:08:57,545 --> 00:09:01,714 Do you think he's complicated or confused? 244 00:09:01,716 --> 00:09:03,082 (SIGHS) 245 00:09:03,084 --> 00:09:05,384 Dude, you've got to quit calling her a "he." 246 00:09:05,386 --> 00:09:06,986 We're never going to win this competition 247 00:09:06,988 --> 00:09:08,207 with you disrespecting our patient. 248 00:09:08,232 --> 00:09:09,745 Don't they have transgender people in Wyoming? 249 00:09:09,770 --> 00:09:12,725 Okay. Transgender patient care 250 00:09:12,727 --> 00:09:16,061 was not part of my medical school curriculum. 251 00:09:16,063 --> 00:09:18,397 Was it part of yours? 252 00:09:18,399 --> 00:09:19,732 No. 253 00:09:19,734 --> 00:09:20,699 (MONITOR BEEPS) 254 00:09:24,504 --> 00:09:27,973 Quinn doesn't have appendicitis. 255 00:09:27,975 --> 00:09:31,010 He has testicular cancer. 256 00:09:31,074 --> 00:09:33,756 (SIGHS) 257 00:09:33,781 --> 00:09:34,813 She. 258 00:09:37,734 --> 00:09:40,951 We found a mass on Quinn's left testicle. 259 00:09:40,976 --> 00:09:42,509 She has cancer, but... 260 00:09:42,511 --> 00:09:44,025 - Am I gonna die? - LIM: No, no. 261 00:09:44,079 --> 00:09:45,412 Prognosis is very good. 262 00:09:45,414 --> 00:09:46,619 We've caught it before it spread, 263 00:09:46,651 --> 00:09:48,550 and we'll do surgery on the mass to remove it. 264 00:09:48,552 --> 00:09:51,787 The CT also showed he has osteopenia. 265 00:09:51,789 --> 00:09:53,956 - (SIGHS) - Murphy, stop with the "he." 266 00:09:53,958 --> 00:09:55,391 (CELLPHONE RINGING) 267 00:09:55,393 --> 00:09:57,960 Um, Quinnie, it's your mom. 268 00:09:57,962 --> 00:10:00,062 - I... I have to... - Of course. 269 00:10:03,133 --> 00:10:04,366 Osteopenia. 270 00:10:04,368 --> 00:10:06,201 - That's low bone density, right? - JARED: Yeah. 271 00:10:06,203 --> 00:10:07,469 How'd you know that? 272 00:10:07,471 --> 00:10:10,039 Do you know how I got cancer? 273 00:10:10,041 --> 00:10:12,207 There are several possible causes, but I... 274 00:10:12,209 --> 00:10:14,610 - Microlithiasis, mumps, hypospadias... - Murphy. 275 00:10:14,612 --> 00:10:16,478 Intraepithelial germ cell neoplasia, 276 00:10:16,480 --> 00:10:17,646 inguinal hernia, HIV... 277 00:10:17,648 --> 00:10:20,149 Murphy. Enough. 278 00:10:20,151 --> 00:10:22,785 Your parents are on their way here. 279 00:10:22,787 --> 00:10:25,220 Um, they just told me... 280 00:10:25,222 --> 00:10:27,089 Quinn, are you on puberty blockers? 281 00:10:28,658 --> 00:10:31,794 That's the likely cause of the osteopenia. 282 00:10:31,796 --> 00:10:33,996 Are you taking leuprorelin or histrelin? 283 00:10:33,998 --> 00:10:36,632 I've been leuprorelin for nine months. 284 00:10:36,634 --> 00:10:38,267 Why didn't you say anything earlier? 285 00:10:38,269 --> 00:10:41,503 Because my parents didn't want my grandma to know. 286 00:10:41,505 --> 00:10:46,008 ♪ ♪ 287 00:10:46,010 --> 00:10:47,976 Looks like he has an abscess. 288 00:10:47,978 --> 00:10:49,278 You have an infection. 289 00:10:49,280 --> 00:10:51,613 We'll drain it, put you on antibiotics. 290 00:10:51,615 --> 00:10:52,648 It's nothing to worry about. 291 00:10:52,650 --> 00:10:53,749 It just means you might be in the hospital 292 00:10:53,751 --> 00:10:54,750 a couple of extra nights. 293 00:10:54,752 --> 00:10:55,784 I... I can't spend 294 00:10:55,786 --> 00:10:56,885 a couple of extra nights. 295 00:10:56,887 --> 00:10:58,253 I need to get out of here. 296 00:10:58,255 --> 00:11:00,255 Are you worried about your kids? 297 00:11:00,257 --> 00:11:02,458 Well, they're with my sister, they're safe, 298 00:11:02,460 --> 00:11:04,259 but they've never spent a night without me 299 00:11:04,261 --> 00:11:05,327 since they were born. 300 00:11:05,329 --> 00:11:06,995 Well, then consider this a blessing. 301 00:11:06,997 --> 00:11:08,464 A free vacation from your kids. 302 00:11:08,466 --> 00:11:10,099 They're my life. 303 00:11:10,101 --> 00:11:14,103 ♪ ♪ 304 00:11:14,105 --> 00:11:17,439 My wife died of ovarian cancer last year. 305 00:11:17,441 --> 00:11:20,175 ♪ ♪ 306 00:11:20,177 --> 00:11:22,211 I... 307 00:11:22,213 --> 00:11:23,679 I hate hospitals. 308 00:11:23,681 --> 00:11:25,781 I'm so sorry. 309 00:11:25,783 --> 00:11:28,383 Why don't I find a laptop 310 00:11:28,385 --> 00:11:29,718 so you can Skype with them? 311 00:11:30,954 --> 00:11:33,689 And I'll rustle up a couple of toy bears from Peds 312 00:11:33,691 --> 00:11:35,424 for you to take home. 313 00:11:35,426 --> 00:11:36,692 Thank you. 314 00:11:36,694 --> 00:11:39,294 ♪ ♪ 315 00:11:39,296 --> 00:11:40,796 LIM: I want to reassure you 316 00:11:40,798 --> 00:11:42,231 that the puberty blockers 317 00:11:42,233 --> 00:11:44,733 are in no way responsible for causing cancer. 318 00:11:44,735 --> 00:11:47,569 SHAUN: The leuprorelin did cause your osteopenia. 319 00:11:47,571 --> 00:11:49,872 Does this mean I have to stop taking puberty blockers? 320 00:11:49,874 --> 00:11:50,973 Yes. 321 00:11:50,975 --> 00:11:52,307 JARED: We'll get you on dietary supplements 322 00:11:52,309 --> 00:11:53,542 to help regain your bone strength, 323 00:11:53,544 --> 00:11:54,843 but the puberty blockers are hurting you. 324 00:11:54,845 --> 00:11:55,878 You'll be fine without them. 325 00:11:57,080 --> 00:11:59,248 Fine? 326 00:11:59,250 --> 00:12:01,283 I... I don't want an Adam's apple 327 00:12:01,285 --> 00:12:03,852 or a deep voice or hair all over my body. 328 00:12:03,854 --> 00:12:05,888 You can't reverse that, can you? 329 00:12:05,890 --> 00:12:08,857 No, I'm afraid not. 330 00:12:08,859 --> 00:12:16,899 ♪ ♪ 331 00:12:16,901 --> 00:12:19,768 Girls have body hair, too. 332 00:12:19,770 --> 00:12:21,303 (SIGHS) 333 00:12:21,305 --> 00:12:25,240 ♪ ♪ 334 00:12:27,811 --> 00:12:30,379 Toy bears, Skype with kids... 335 00:12:30,381 --> 00:12:31,814 you've got game. 336 00:12:31,816 --> 00:12:34,283 (SCOFFS) "Game"? 337 00:12:34,285 --> 00:12:35,751 I believe the name for what I did 338 00:12:35,753 --> 00:12:38,687 is "basic human decency." 339 00:12:38,689 --> 00:12:40,389 Everyone has an agenda. 340 00:12:40,391 --> 00:12:42,658 Sometimes it's conscious, sometimes it's not, 341 00:12:42,660 --> 00:12:43,725 but it's always there. 342 00:12:43,727 --> 00:12:44,960 And you've got this whole 343 00:12:44,962 --> 00:12:46,728 "queen of kindness" thing down pat. 344 00:12:46,730 --> 00:12:49,131 Awfully cynical for someone so young. 345 00:12:49,133 --> 00:12:50,299 Mm, not cynical. 346 00:12:50,301 --> 00:12:51,466 Just the reality of how the world works. 347 00:12:51,468 --> 00:12:53,435 (ALARM BLARING) 348 00:12:53,437 --> 00:12:54,469 It's Howard. 349 00:12:54,471 --> 00:12:55,838 (MONITOR BEEPING RAPIDLY) 350 00:12:55,840 --> 00:12:57,973 NURSE DHANOA: He spiked a fever, temp's 105. 351 00:12:57,975 --> 00:12:59,408 BP's tanking, 80 over 40. 352 00:12:59,410 --> 00:13:01,176 - He's soiled his sheets. - MORGAN: Site's clean. 353 00:13:01,178 --> 00:13:02,644 Infection should be clearing by now. 354 00:13:02,646 --> 00:13:04,046 - What's going on? - I don't know. 355 00:13:04,048 --> 00:13:05,113 Page Melendez. 356 00:13:05,115 --> 00:13:06,715 Give me 500 milligrams acetaminophen, 357 00:13:06,717 --> 00:13:08,584 2 grams of meropenem IV infusion empirically. 358 00:13:08,586 --> 00:13:11,420 Run a chem panel, CBC, and get cultures ASAP. 359 00:13:12,155 --> 00:13:13,655 Hang in there, Howard. 360 00:13:13,657 --> 00:13:15,023 We're gonna figure this out. 361 00:13:15,025 --> 00:13:17,793 ♪ ♪ 362 00:13:22,230 --> 00:13:23,931 Any word on Quinn Darby's labs? 363 00:13:23,974 --> 00:13:25,848 Big backup today. Nothing much I can do. 364 00:13:25,880 --> 00:13:27,279 Text you when they're ready. 365 00:13:27,281 --> 00:13:28,347 Yeah. 366 00:13:29,816 --> 00:13:30,883 MORGAN: Hey, Gus. 367 00:13:30,885 --> 00:13:33,085 I saw raspberry and rose petal doughnuts 368 00:13:33,087 --> 00:13:34,487 in the cafeteria today. 369 00:13:34,489 --> 00:13:36,218 Got you the last one. 370 00:13:36,280 --> 00:13:37,790 You remembered. 371 00:13:37,792 --> 00:13:39,458 Thank you. 372 00:13:39,460 --> 00:13:41,594 Howard Shaw's labs. 373 00:13:41,596 --> 00:13:44,063 - I put a rush on them for you. - You're the best. 374 00:13:44,065 --> 00:13:45,131 ♪ ♪ 375 00:13:45,133 --> 00:13:49,001 Why did you give Gus a doughnut? 376 00:13:49,003 --> 00:13:50,202 I was being nice. 377 00:13:50,204 --> 00:13:52,705 I needed my patient's labs expedited. 378 00:13:52,707 --> 00:13:55,141 - Gus likes doughnuts. - It's called bribery. 379 00:13:55,143 --> 00:13:56,876 I call it "basic human decency." 380 00:13:58,678 --> 00:13:59,812 See you later. 381 00:14:04,985 --> 00:14:06,786 Howard has a superbug. 382 00:14:08,321 --> 00:14:09,555 A C. Diff infection? 383 00:14:09,557 --> 00:14:12,825 It's resistant to all medication. 384 00:14:12,827 --> 00:14:15,161 (SIGHS) 385 00:14:15,163 --> 00:14:16,729 LIM: Quinn's pre-op labs are normal, 386 00:14:16,731 --> 00:14:18,731 so we can do the surgery first thing in the morning. 387 00:14:18,733 --> 00:14:19,765 The procedure is called 388 00:14:19,767 --> 00:14:21,734 a radical inguinal orchiectomy. 389 00:14:21,736 --> 00:14:24,503 It's radical in that 390 00:14:24,505 --> 00:14:26,705 the entire cancerous testicle is removed. 391 00:14:26,707 --> 00:14:28,874 All functionality will remain the same. 392 00:14:28,876 --> 00:14:30,843 Quinn should be able to resume her normal activities 393 00:14:30,845 --> 00:14:31,844 in one or two weeks. 394 00:14:31,846 --> 00:14:33,846 See? Baby, that's good news. 395 00:14:33,848 --> 00:14:35,181 QUINN: No, not really. 396 00:14:35,183 --> 00:14:36,549 Without the puberty blockers, 397 00:14:36,551 --> 00:14:38,651 I'll be the freak in ballet with a mustache. 398 00:14:38,653 --> 00:14:40,953 Aren't there any other options? 399 00:14:40,955 --> 00:14:41,954 I wish there were... 400 00:14:41,956 --> 00:14:43,789 If we do a bilateral orchiectomy, 401 00:14:43,791 --> 00:14:44,824 Quinn will have 402 00:14:44,826 --> 00:14:46,458 the testosterone level of a girl. 403 00:14:46,460 --> 00:14:48,961 We are not removing both testicles. 404 00:14:48,963 --> 00:14:50,972 You want to castrate my grandson? 405 00:14:50,997 --> 00:14:52,064 - No. - No. 406 00:14:52,066 --> 00:14:53,232 (SIGHS) 407 00:14:53,234 --> 00:14:55,434 I'm so sorry for Dr. Murphy's outburst. 408 00:14:55,436 --> 00:14:58,103 I'm gonna have gender confirmation surgery 409 00:14:58,105 --> 00:14:59,805 when I'm 18 anyway. 410 00:14:59,807 --> 00:15:00,873 Why not just do it now. 411 00:15:00,875 --> 00:15:04,310 ♪ ♪ 412 00:15:04,312 --> 00:15:05,978 Quinn is a child 413 00:15:05,980 --> 00:15:09,982 who still plays dress-up and make-believe. 414 00:15:09,984 --> 00:15:12,255 He may want to have children of his own some day. 415 00:15:12,280 --> 00:15:13,219 Ew. 416 00:15:13,221 --> 00:15:14,086 ♪ ♪ 417 00:15:14,088 --> 00:15:15,588 We'll give you some privacy. 418 00:15:15,590 --> 00:15:16,755 DENISE: Thank you. 419 00:15:16,757 --> 00:15:21,527 ♪ ♪ 420 00:15:21,529 --> 00:15:23,762 - I will not allow you... - It's not up to you. 421 00:15:26,410 --> 00:15:28,886 You are making me doubt the wisdom of drafting you, Murphy. 422 00:15:28,911 --> 00:15:31,003 If you go around saying inflammatory things to people, 423 00:15:31,005 --> 00:15:32,705 it will only upset them. 424 00:15:32,707 --> 00:15:35,007 How will I know if I said something inflammatory 425 00:15:35,009 --> 00:15:36,375 until I say it? 426 00:15:36,377 --> 00:15:38,878 Test it on Kalu first. 427 00:15:38,880 --> 00:15:40,746 Which you can do 428 00:15:40,748 --> 00:15:43,349 the two of you prep an SDA for this case. 429 00:15:43,351 --> 00:15:45,251 An SDA? 430 00:15:45,253 --> 00:15:46,652 A Shared Decision Aid 431 00:15:46,654 --> 00:15:48,888 is a paper presenting the pros and cons 432 00:15:48,890 --> 00:15:50,689 - of making a difficult... - I know what it is, Murphy. 433 00:15:50,691 --> 00:15:52,057 But why am I being punished? 434 00:15:52,059 --> 00:15:53,525 It's not a punishment, it's necessary. 435 00:15:53,527 --> 00:15:54,660 It'll help Quinn's family 436 00:15:54,662 --> 00:15:57,596 understand all the options available to them for her care. 437 00:15:57,598 --> 00:16:00,232 - Understood? - Understood. 438 00:16:00,234 --> 00:16:03,969 ♪ ♪ 439 00:16:03,971 --> 00:16:05,437 The stool culture and sensitivity test 440 00:16:05,439 --> 00:16:06,605 indicate that you're resistant 441 00:16:06,607 --> 00:16:07,706 to every antibiotic. 442 00:16:07,708 --> 00:16:09,575 Which only happens when you've been exposed 443 00:16:09,577 --> 00:16:10,542 to every antibiotic. 444 00:16:10,544 --> 00:16:15,247 I... I did this to myself? 445 00:16:15,249 --> 00:16:16,749 But I've used those medications before 446 00:16:16,751 --> 00:16:17,750 without a problem. 447 00:16:17,752 --> 00:16:18,817 Why did this happen now? 448 00:16:20,921 --> 00:16:22,755 You weren't under a doctor's care, 449 00:16:22,757 --> 00:16:24,790 so you were likely taking the wrong medication 450 00:16:24,792 --> 00:16:25,958 for the wrong symptoms. 451 00:16:25,960 --> 00:16:27,860 But you can fix this, right? 452 00:16:27,862 --> 00:16:29,929 We're gonna have to perform a colostomy 453 00:16:29,931 --> 00:16:31,597 where we attach an ostomy pouching system 454 00:16:31,599 --> 00:16:32,798 to your abdomen 455 00:16:32,800 --> 00:16:34,300 to collect waste from your body. 456 00:16:34,302 --> 00:16:35,901 For how long? 457 00:16:35,903 --> 00:16:37,036 Well, with the level of damage 458 00:16:37,038 --> 00:16:38,304 we're seeing throughout the colon, 459 00:16:38,306 --> 00:16:39,371 indefinitely. 460 00:16:39,373 --> 00:16:42,041 ♪ ♪ 461 00:16:42,043 --> 00:16:44,043 I'm so sorry, Howard. 462 00:16:44,045 --> 00:16:52,651 ♪ ♪ 463 00:16:52,653 --> 00:16:53,786 I don't understand 464 00:16:53,788 --> 00:16:55,187 why you'd suggest the bilateral orchiectomy 465 00:16:55,189 --> 00:16:56,956 when you don't even believe Quinn's a girl. 466 00:16:56,958 --> 00:16:59,725 I was answering Dr. Lim's question. 467 00:16:59,727 --> 00:17:01,760 She said there were no other options, 468 00:17:01,762 --> 00:17:02,828 but I found one. 469 00:17:02,830 --> 00:17:05,064 And now we're here. 470 00:17:05,066 --> 00:17:07,499 Yes. 471 00:17:07,501 --> 00:17:09,201 You're actually enjoying this scut work, aren't you? 472 00:17:09,203 --> 00:17:11,270 Yes. We are being helpful. 473 00:17:13,073 --> 00:17:15,474 We're not doing this to be helpful, Murphy. 474 00:17:15,476 --> 00:17:17,443 We're doing this because you pissed off Lim, 475 00:17:17,445 --> 00:17:20,579 and I'm collateral damage. 476 00:17:20,581 --> 00:17:22,848 We're still being helpful. 477 00:17:26,386 --> 00:17:28,053 Doesn't matter. 478 00:17:28,055 --> 00:17:30,756 Doesn't matter, competition's over. 479 00:17:30,758 --> 00:17:32,424 Is it? 480 00:17:32,426 --> 00:17:34,059 We're in here and not with the patient. 481 00:17:34,061 --> 00:17:35,728 No face time plus you calling her a "he" 482 00:17:35,730 --> 00:17:37,930 equals crappy survey scores. 483 00:17:37,932 --> 00:17:39,365 (CHUCKLING) It's okay. It's a game. 484 00:17:39,367 --> 00:17:41,600 - It's not important. - It is to me. 485 00:17:45,505 --> 00:17:47,740 I'm a pariah. 486 00:17:47,742 --> 00:17:50,242 These scores are part of our resident evaluation. 487 00:17:50,244 --> 00:17:52,344 Our jobs depend on them. 488 00:17:52,346 --> 00:17:54,380 Mine does, at least. 489 00:17:54,382 --> 00:17:59,118 ♪ ♪ 490 00:17:59,120 --> 00:18:03,122 Then we should do this scut work very well. 491 00:18:03,124 --> 00:18:08,460 ♪ ♪ 492 00:18:08,462 --> 00:18:09,795 (DOOR CLOSES) 493 00:18:14,100 --> 00:18:15,634 Finola called. 494 00:18:15,636 --> 00:18:17,736 She found an irregularity with one of the tests 495 00:18:17,738 --> 00:18:19,338 but wants to re-run it to be sure. 496 00:18:19,340 --> 00:18:24,076 Okay, so we wait until she re-runs it. 497 00:18:24,078 --> 00:18:27,246 Marcus, we're both doctors. 498 00:18:27,248 --> 00:18:28,781 The results aren't gonna change. 499 00:18:32,852 --> 00:18:36,088 I waited too long. 500 00:18:36,090 --> 00:18:37,456 It's all my fault. 501 00:18:41,327 --> 00:18:42,828 This is the part where you say, 502 00:18:42,830 --> 00:18:43,896 "No, babe, it isn't." 503 00:18:43,898 --> 00:18:48,033 You had goals, other priorities. 504 00:18:48,035 --> 00:18:50,736 You said you supported my career choices, 505 00:18:50,738 --> 00:18:52,404 just like I supported yours. 506 00:18:52,406 --> 00:18:54,840 I do support you. Always. 507 00:18:54,842 --> 00:18:56,375 And I am so proud of you. 508 00:18:56,377 --> 00:18:58,277 But it came at a cost 509 00:18:58,279 --> 00:19:00,279 that we both knew was possible. 510 00:19:00,304 --> 00:19:03,015 - We should have started trying sooner. - When? 511 00:19:03,017 --> 00:19:05,350 When you were 3,000 miles away teaching at Dartmouth? 512 00:19:05,352 --> 00:19:07,419 Or, what, when you were chasing down head of surgery? 513 00:19:07,421 --> 00:19:09,922 - We would have figured it out. - "Figuring it out" 514 00:19:09,924 --> 00:19:11,590 would have meant me and a nanny raising a baby. 515 00:19:11,592 --> 00:19:12,658 I didn't want that. 516 00:19:12,660 --> 00:19:13,859 I tried to bring it up four years ago, 517 00:19:13,861 --> 00:19:15,394 but you wanted to get your practice up and running. 518 00:19:15,396 --> 00:19:16,695 A baby didn't fit in that picture, either. 519 00:19:16,697 --> 00:19:18,597 It is not the same. 520 00:19:18,599 --> 00:19:20,365 How many pregnant women get hired for anything? 521 00:19:20,367 --> 00:19:22,434 Or when they find out a woman's got a child at home, 522 00:19:22,436 --> 00:19:23,435 suddenly it's all 523 00:19:23,437 --> 00:19:24,870 "Who's gonna take care of the baby?" 524 00:19:24,872 --> 00:19:26,538 No one asks men that question. 525 00:19:26,540 --> 00:19:29,108 Yeah, well, none of it matters now. 526 00:19:29,110 --> 00:19:30,909 Right? Because it's probably too late. 527 00:19:30,911 --> 00:19:31,977 And I knew it. 528 00:19:31,979 --> 00:19:33,378 I knew this was gonna happen. 529 00:19:35,582 --> 00:19:37,983 You've been stewing over this. 530 00:19:37,985 --> 00:19:40,018 Resenting me. For how long? 531 00:19:40,020 --> 00:19:42,454 I don't resent you, Is. 532 00:19:42,456 --> 00:19:45,390 But, you know, if you want me to sit here 533 00:19:45,392 --> 00:19:47,926 and tell you that it's not your fault, 534 00:19:47,928 --> 00:19:51,196 I... I can't do that, I'm sorry. 535 00:19:51,198 --> 00:19:58,437 ♪ ♪ 536 00:19:58,439 --> 00:20:06,678 (ALL SPEAKING SPANISH ON TV) 537 00:20:06,680 --> 00:20:08,280 (SLIDING DOOR OPENS) 538 00:20:08,882 --> 00:20:11,049 Hey. You like? 539 00:20:11,051 --> 00:20:13,519 That door was locked. 540 00:20:13,521 --> 00:20:15,220 Oh, I know. 541 00:20:15,222 --> 00:20:16,755 The cable guy had a cancellation, 542 00:20:16,757 --> 00:20:19,358 so he hooked me up, got us a two-for-one. 543 00:20:19,360 --> 00:20:20,959 Little thanks for being so chill earlier. 544 00:20:20,961 --> 00:20:23,395 Gracias, amigo. 545 00:20:23,397 --> 00:20:30,402 (INDISTINCT CONVERSATIONS ON TV) 546 00:20:30,404 --> 00:20:31,870 So, what kind of doctor are you? 547 00:20:34,707 --> 00:20:35,908 I'm a surgeon. 548 00:20:35,910 --> 00:20:37,543 A surgeon? 549 00:20:37,545 --> 00:20:40,546 Your stuff doesn't say surgeon, does it? 550 00:20:40,548 --> 00:20:42,714 It's like, uh, Selena and Justin. 551 00:20:44,450 --> 00:20:47,052 It doesn't really go together. 552 00:20:47,054 --> 00:20:48,554 Furniture's from, like, a dozen different places. 553 00:20:48,556 --> 00:20:50,422 14. 554 00:20:50,424 --> 00:20:51,857 14. 555 00:20:51,859 --> 00:20:54,960 The people in Casper knew I didn't have any money, 556 00:20:54,962 --> 00:20:57,062 so they gave me things to make a home. 557 00:20:57,064 --> 00:20:59,965 The bookshelf is from Jennifer, 558 00:20:59,967 --> 00:21:01,900 the town librarian. 559 00:21:01,902 --> 00:21:05,370 My table and chairs are from Mr. Grady's diner. 560 00:21:05,372 --> 00:21:06,972 The lamp is from Sheryl 561 00:21:06,974 --> 00:21:09,308 who teaches Sunday school at Highland Church. 562 00:21:09,310 --> 00:21:11,710 Dr. Glassman, he got me my bed. 563 00:21:11,712 --> 00:21:14,379 Well, you don't have to tell me the whole list, but... 564 00:21:15,915 --> 00:21:17,950 Okay. Yes. 565 00:21:17,952 --> 00:21:19,418 Everything I have works. 566 00:21:19,420 --> 00:21:21,353 There is no need to change it. 567 00:21:21,355 --> 00:21:22,921 Respect. 568 00:21:31,397 --> 00:21:33,165 (MUFFLED SCREAMING ON TV) 569 00:21:33,167 --> 00:21:34,566 (WOMAN SPEAKING SPANISH) 570 00:21:37,870 --> 00:21:39,071 (SPEAKING SPANISH) 571 00:21:42,075 --> 00:21:43,875 Hi. 572 00:21:43,877 --> 00:21:45,577 - I'm Dr. Glassman. - Hi. 573 00:21:45,579 --> 00:21:46,945 I'm the president of the hospital. 574 00:21:46,947 --> 00:21:47,946 Is everything okay? 575 00:21:47,948 --> 00:21:48,981 Sit down. 576 00:21:51,351 --> 00:21:53,986 There has been no change in Quinn's condition. 577 00:21:53,988 --> 00:21:56,455 However, her grandmother 578 00:21:56,457 --> 00:21:58,824 has made a claim of child abuse 579 00:21:58,826 --> 00:22:01,827 against you and your husband. 580 00:22:01,829 --> 00:22:02,894 She's claiming that 581 00:22:02,896 --> 00:22:06,531 putting Quinn on puberty blockers... 582 00:22:06,533 --> 00:22:08,533 and these are her words, 583 00:22:08,535 --> 00:22:12,271 "making her think that being trans is okay"... 584 00:22:12,273 --> 00:22:16,208 is a form of emotional and physical abuse. 585 00:22:16,210 --> 00:22:17,676 ♪ ♪ 586 00:22:17,678 --> 00:22:20,045 Now, just to be clear, 587 00:22:20,047 --> 00:22:21,913 we don't believe any of these allegations 588 00:22:21,915 --> 00:22:23,448 have any merit whatsoever. 589 00:22:23,450 --> 00:22:24,683 I know my mom, okay? 590 00:22:24,685 --> 00:22:26,184 She's not gonna drop this. 591 00:22:26,186 --> 00:22:27,753 She'll go to court. 592 00:22:27,755 --> 00:22:29,087 Could she get custody? 593 00:22:29,089 --> 00:22:33,592 Well, she could try, but, uh, Dr. Lim would testify. 594 00:22:33,594 --> 00:22:36,662 - They could put her in a foster home. - Hey. 595 00:22:36,664 --> 00:22:38,363 Ty, she won't make it. 596 00:22:38,365 --> 00:22:40,899 If we let Quinn do the surgery she wants now, 597 00:22:40,901 --> 00:22:42,034 it'll all be over. 598 00:22:42,036 --> 00:22:44,970 There will be no reason for Ruth to fight us. 599 00:22:44,972 --> 00:22:48,707 ♪ ♪ 600 00:22:48,709 --> 00:22:51,109 (SNIFFLES) 601 00:22:51,111 --> 00:22:52,827 Do what Quinn wants. 602 00:22:52,913 --> 00:22:54,561 Do the bilateral surgery. 603 00:22:54,615 --> 00:22:59,551 ♪ ♪ 604 00:23:03,043 --> 00:23:04,510 FINOLA: There is an issue. 605 00:23:05,121 --> 00:23:06,894 Your tests confirmed 606 00:23:06,933 --> 00:23:09,816 abnormalities in the semen parameters. 607 00:23:13,324 --> 00:23:14,524 I beg your pardon? 608 00:23:14,526 --> 00:23:16,581 The semen analysis. It showed that you have 609 00:23:16,606 --> 00:23:18,562 a low sperm count and low motility. 610 00:23:19,561 --> 00:23:21,325 - It's my fault? - No. 611 00:23:21,327 --> 00:23:23,661 We... we do not speak in terms of fault. 612 00:23:23,663 --> 00:23:26,197 (EXHALES SHARPLY) 613 00:23:26,199 --> 00:23:28,866 15% of all couples struggle with infertility, 614 00:23:28,868 --> 00:23:31,769 and of those, 50% have a male factor component. 615 00:23:33,372 --> 00:23:35,778 It's not great news, but it's not a dead end. 616 00:23:35,808 --> 00:23:37,341 So what's the next step? 617 00:23:37,343 --> 00:23:39,744 I'm gonna refer you to Dr. Arjun Dhillon. 618 00:23:39,746 --> 00:23:41,479 He's an excellent urologist, 619 00:23:41,481 --> 00:23:43,748 and he'll give Marcus a... a full physical, 620 00:23:43,750 --> 00:23:46,159 do some blood work, and an ultrasound. 621 00:23:46,184 --> 00:23:47,583 That can't be right. 622 00:23:47,585 --> 00:23:49,085 - Marcus. - It can't be right. 623 00:23:49,087 --> 00:23:50,486 Marcus. We got this. 624 00:23:50,488 --> 00:23:51,687 Okay? 625 00:23:51,689 --> 00:23:52,955 We're gonna get through this together. 626 00:23:52,957 --> 00:24:00,596 ♪ ♪ 627 00:24:00,598 --> 00:24:02,264 Hey. Hey! 628 00:24:02,266 --> 00:24:03,899 Why didn't you tell me Howard's labs came back? 629 00:24:03,901 --> 00:24:06,268 I should have been there when you broke the bad news to him. 630 00:24:06,270 --> 00:24:09,271 So Melendez could see your touching bedside manner. 631 00:24:09,273 --> 00:24:10,706 It doesn't matter anyway. 632 00:24:10,708 --> 00:24:12,575 Oh, it doesn't? How the hell not? 633 00:24:13,610 --> 00:24:15,277 The poor guy's getting a colostomy. 634 00:24:15,279 --> 00:24:17,380 There's no way we're winning this competition. 635 00:24:19,116 --> 00:24:20,750 You really have no sympathy 636 00:24:20,752 --> 00:24:22,051 for what Howard's going through? 637 00:24:22,053 --> 00:24:23,919 It's a major bummer, no doubt. 638 00:24:23,921 --> 00:24:25,788 But we don't have time to get emotionally invested 639 00:24:25,790 --> 00:24:27,056 in every patient that we treat. 640 00:24:27,058 --> 00:24:29,625 Our job is to go in, do the surgery, 641 00:24:29,627 --> 00:24:30,893 and get out. 642 00:24:30,895 --> 00:24:34,130 Afterwards... his poop, someone else's poop... 643 00:24:34,132 --> 00:24:35,398 it's not our problem. 644 00:24:36,466 --> 00:24:37,700 Hey, well, wait. 645 00:24:39,102 --> 00:24:40,236 What if we could get Howard 646 00:24:40,238 --> 00:24:41,470 a fecal microbiota transplant? 647 00:24:43,306 --> 00:24:45,041 FMT for a surgical case? 648 00:24:45,043 --> 00:24:47,543 Theoretically, we transfer healthy feces to him, 649 00:24:47,545 --> 00:24:49,211 it restores good flora to the body, 650 00:24:49,213 --> 00:24:50,179 kills off the CDI, 651 00:24:50,181 --> 00:24:52,048 and he avoids surgery all together. 652 00:24:53,483 --> 00:24:55,117 We could actually win this thing. 653 00:24:55,119 --> 00:24:56,685 (SIGHS) 654 00:24:56,687 --> 00:24:57,920 I'm gonna pull all the research 655 00:24:57,922 --> 00:25:00,089 before pitching it to Melendez. 656 00:25:00,091 --> 00:25:02,625 ♪ ♪ 657 00:25:02,627 --> 00:25:04,427 GLASSMAN: So, this meeting is called 658 00:25:04,429 --> 00:25:07,463 a Challenging Patient Consultation Process. 659 00:25:07,465 --> 00:25:08,597 The name sucks, 660 00:25:08,599 --> 00:25:11,000 but there are things about it I do like. 661 00:25:11,002 --> 00:25:15,471 All you got to do is talk and listen 662 00:25:15,473 --> 00:25:17,273 and try to understand each other. 663 00:25:17,275 --> 00:25:18,407 What's to understand? 664 00:25:18,409 --> 00:25:20,543 Ruth accused us of being child abusers. 665 00:25:20,545 --> 00:25:21,877 DENISE: And what's to discuss? 666 00:25:21,879 --> 00:25:23,145 We are Quinn's parents. 667 00:25:23,147 --> 00:25:24,880 We get to make her medical decisions. 668 00:25:24,882 --> 00:25:26,816 What if Quinnie's better off as a boy? 669 00:25:26,818 --> 00:25:29,985 You have no idea what Quinn has been through. 670 00:25:29,987 --> 00:25:32,888 Every kid goes through rough patches. 671 00:25:32,890 --> 00:25:34,723 Every kid is confused. 672 00:25:34,725 --> 00:25:36,625 Quinn has always told us exactly who she was, 673 00:25:36,627 --> 00:25:37,827 ever since she was 3. 674 00:25:37,829 --> 00:25:39,295 So you let Quinn play with dolls. 675 00:25:39,297 --> 00:25:40,596 Big deal. 676 00:25:40,598 --> 00:25:42,665 You don't make life-altering decisions 677 00:25:42,667 --> 00:25:45,167 because a child wants to be a princess. 678 00:25:49,773 --> 00:25:52,741 We used to let Quinn do whatever she wanted at home. 679 00:25:52,743 --> 00:25:55,511 But when she went out in public, 680 00:25:55,513 --> 00:25:57,580 we made her present as a boy. 681 00:25:59,049 --> 00:26:01,083 It felt false to her. 682 00:26:01,085 --> 00:26:03,419 She hated it. 683 00:26:03,421 --> 00:26:04,553 She hated herself. 684 00:26:04,555 --> 00:26:07,957 She became reclusive, depressed. 685 00:26:07,959 --> 00:26:10,726 And then a year ago, Quinn tried to kill herself. 686 00:26:10,728 --> 00:26:17,099 ♪ ♪ 687 00:26:17,101 --> 00:26:18,267 Sorry I'm late. 688 00:26:18,269 --> 00:26:23,906 ♪ ♪ 689 00:26:23,908 --> 00:26:29,512 ♪ ♪ 690 00:26:29,514 --> 00:26:31,380 Howard might not need the colostomy 691 00:26:31,382 --> 00:26:36,185 if we give him a fecal microbiota transplant. 692 00:26:36,187 --> 00:26:37,953 Hasn't the FDA gone back and forth on that? 693 00:26:37,955 --> 00:26:40,656 We could be introducing new bacteria into his system 694 00:26:40,658 --> 00:26:41,824 that could kill him. 695 00:26:41,826 --> 00:26:42,925 The likelihood of that is low. 696 00:26:42,927 --> 00:26:43,959 But not zero. 697 00:26:43,961 --> 00:26:45,327 But if we do the colostomy, 698 00:26:45,329 --> 00:26:46,695 we may not really be helping him. 699 00:26:46,697 --> 00:26:48,364 15% to 30% of patients 700 00:26:48,366 --> 00:26:50,757 get recurrent CDI after the initial bout. 701 00:26:50,782 --> 00:26:51,800 That's a good point. 702 00:26:51,802 --> 00:26:54,069 I believe 65% of that time, 703 00:26:54,071 --> 00:26:55,437 recurrent CDI becomes chronic, 704 00:26:55,439 --> 00:26:57,306 which can lead to repeated hospitalizations and death. 705 00:26:57,308 --> 00:27:00,242 ♪ ♪ 706 00:27:00,244 --> 00:27:01,744 Are my numbers right, Claire? 707 00:27:01,746 --> 00:27:03,279 Yes. 708 00:27:03,281 --> 00:27:05,548 But recent studies 709 00:27:05,550 --> 00:27:09,685 show better than a 95% success rate with FMTs. 710 00:27:09,687 --> 00:27:11,620 Howard is a good candidate. 711 00:27:11,622 --> 00:27:12,721 We should try it 712 00:27:12,723 --> 00:27:14,123 before he develops a toxic megacolon. 713 00:27:14,125 --> 00:27:16,258 Don't we owe it to him, to his twins, 714 00:27:16,260 --> 00:27:18,194 to at least try an experimental treatment 715 00:27:18,196 --> 00:27:19,795 before doing an invasive surgery 716 00:27:19,797 --> 00:27:21,463 which will alter his life forever? 717 00:27:21,465 --> 00:27:22,965 You're right. 718 00:27:22,967 --> 00:27:24,667 Prep him for the procedure. 719 00:27:24,669 --> 00:27:26,869 I appreciate your passionate advocacy 720 00:27:26,871 --> 00:27:27,903 for your patient. 721 00:27:27,905 --> 00:27:29,505 Good work, both of you. 722 00:27:32,909 --> 00:27:34,677 Oh, now you're a team player. 723 00:27:34,679 --> 00:27:35,911 When it benefits me, yes. 724 00:27:35,913 --> 00:27:37,680 Speaking of which, 725 00:27:37,682 --> 00:27:38,981 you were doing your research, 726 00:27:38,983 --> 00:27:40,482 I found Howard a match at the stool bank. 727 00:27:40,484 --> 00:27:41,817 Sample arrives in a couple of hours. 728 00:27:41,819 --> 00:27:42,918 Great. 729 00:27:42,920 --> 00:27:44,687 I let them know you'd be the designated doctor 730 00:27:44,689 --> 00:27:46,121 to handle the medical chain of custody 731 00:27:46,123 --> 00:27:47,356 when the sample arrives. 732 00:27:47,358 --> 00:27:49,091 So...? 733 00:27:49,093 --> 00:27:51,760 So you're the only person who can handle the sample. 734 00:27:51,762 --> 00:27:53,262 You'll have to dilute it, blend it, strain it 735 00:27:53,264 --> 00:27:54,530 all on your own. 736 00:27:54,532 --> 00:27:56,498 To safeguard against cross-contamination, of course. 737 00:27:56,500 --> 00:27:58,200 Of course. 738 00:27:58,202 --> 00:28:05,074 ♪ ♪ 739 00:28:06,776 --> 00:28:09,945 Your temperature and BP are normal. 740 00:28:09,947 --> 00:28:10,946 QUINN: Normal. 741 00:28:10,948 --> 00:28:12,848 Whatever that means. 742 00:28:12,850 --> 00:28:15,618 Typical. Usual. 743 00:28:15,620 --> 00:28:17,419 Expected. 744 00:28:17,421 --> 00:28:20,389 Yeah, I don't feel like any of those things. 745 00:28:20,391 --> 00:28:22,758 What does it feel like to be a girl? 746 00:28:27,497 --> 00:28:28,831 Are you angry? 747 00:28:28,833 --> 00:28:31,400 Was that an inflammatory question? 748 00:28:31,402 --> 00:28:32,434 I'd rather people ask questions 749 00:28:32,436 --> 00:28:33,502 instead of pointing and staring. 750 00:28:35,739 --> 00:28:37,773 When I used to look like a boy, 751 00:28:37,775 --> 00:28:40,075 I felt... different. 752 00:28:40,077 --> 00:28:43,479 The kids at school didn't understand me, 753 00:28:43,481 --> 00:28:44,947 so they picked on me. 754 00:28:44,949 --> 00:28:46,915 I spent a lot of time alone. 755 00:28:46,917 --> 00:28:48,884 ♪ ♪ 756 00:28:48,886 --> 00:28:52,121 When my parents let me be me, 757 00:28:52,123 --> 00:28:53,956 I felt... 758 00:28:53,958 --> 00:28:55,658 like I didn't have to pretend anymore. 759 00:28:57,594 --> 00:28:58,494 I felt free, 760 00:28:58,496 --> 00:29:00,296 like when you're in a pool 761 00:29:00,298 --> 00:29:02,197 and you just let go and float. 762 00:29:02,199 --> 00:29:06,568 ♪ ♪ 763 00:29:06,570 --> 00:29:09,038 I'm not a very good swimmer. 764 00:29:09,040 --> 00:29:10,773 (CHUCKLES) 765 00:29:10,775 --> 00:29:18,580 ♪ ♪ 766 00:29:18,582 --> 00:29:20,949 I don't know what it feels like 767 00:29:20,951 --> 00:29:23,185 to be anyone but me. 768 00:29:23,187 --> 00:29:26,021 ♪ ♪ 769 00:29:26,023 --> 00:29:27,956 Me, too. 770 00:29:27,958 --> 00:29:29,491 ♪ ♪ 771 00:29:29,493 --> 00:29:32,294 Is the bilateral more risky 772 00:29:32,296 --> 00:29:34,496 than the unilateral surgery? 773 00:29:34,498 --> 00:29:36,131 The big issue with the bilateral 774 00:29:36,133 --> 00:29:38,467 is Quinn will never be able to have biological children. 775 00:29:38,469 --> 00:29:40,602 If Quinn's parents think that Quinn's mature enough 776 00:29:40,604 --> 00:29:42,137 and strong enough in her beliefs, 777 00:29:42,139 --> 00:29:43,238 then they should do it now. 778 00:29:43,240 --> 00:29:45,774 It's an elective surgery on a child. 779 00:29:45,776 --> 00:29:47,943 There is no medical necessity. 780 00:29:47,945 --> 00:29:49,978 Except with a previous suicide attempt, 781 00:29:49,980 --> 00:29:51,046 she's still at risk. 782 00:29:51,048 --> 00:29:52,614 Her situation is different now. 783 00:29:52,616 --> 00:29:55,484 She's socially transitioned and living as a girl. 784 00:29:55,486 --> 00:29:57,786 But there just isn't enough good data 785 00:29:57,788 --> 00:29:59,488 on trans kids and their outcomes. 786 00:29:59,490 --> 00:30:01,623 On the other hand, there's very good reason 787 00:30:01,625 --> 00:30:02,991 to preserve future fertility. 788 00:30:02,993 --> 00:30:05,194 GLASSMAN: Dr. Lim and Dr. Andrews 789 00:30:05,196 --> 00:30:06,495 are both very excellent surgeons, 790 00:30:06,497 --> 00:30:08,030 and they very clearly have 791 00:30:08,032 --> 00:30:09,331 some passionate points of view, 792 00:30:09,333 --> 00:30:10,833 but their views are their own. 793 00:30:10,835 --> 00:30:14,069 You all need to decide what's best for Quinn. 794 00:30:15,572 --> 00:30:17,506 Whatever we decide, 795 00:30:17,508 --> 00:30:19,441 Quinn is still gonna be a girl. 796 00:30:22,612 --> 00:30:25,047 I don't know if I'll ever be able to accept that. 797 00:30:26,649 --> 00:30:29,118 I know that makes me sound horrible. 798 00:30:29,120 --> 00:30:33,622 I know what it's like to not put your family first, 799 00:30:33,624 --> 00:30:35,457 and it cost me. 800 00:30:35,459 --> 00:30:38,827 It cost me a great deal. 801 00:30:38,829 --> 00:30:41,730 And if I had to do it all over again, 802 00:30:41,732 --> 00:30:42,965 I'd ask myself... 803 00:30:42,967 --> 00:30:45,667 is it really worth sacrificing a life 804 00:30:45,669 --> 00:30:47,403 with someone I love 805 00:30:47,405 --> 00:30:51,607 over an idea that may never be? 806 00:30:51,609 --> 00:30:57,212 ♪ ♪ 807 00:30:57,214 --> 00:30:58,781 Why don't we give them the room? 808 00:30:58,783 --> 00:31:07,289 ♪ ♪ 809 00:31:07,291 --> 00:31:09,324 - (MONITOR BEEPING RAPIDLY) - Hey. I got the page. What's going on. 810 00:31:09,326 --> 00:31:11,193 She started screaming in pain and vomiting. 811 00:31:11,195 --> 00:31:12,161 Temp's 104. 812 00:31:12,163 --> 00:31:13,529 SHAUN: Increased groin pain 813 00:31:13,531 --> 00:31:15,230 could be attributed to epididymitis, 814 00:31:15,232 --> 00:31:16,832 kidney stones, inguinal hernia... 815 00:31:16,834 --> 00:31:17,997 The extra weight of the tumor 816 00:31:18,022 --> 00:31:19,635 could be causing the testicle to twist on itself. 817 00:31:19,637 --> 00:31:22,204 There'd be no blood flow. 818 00:31:22,206 --> 00:31:26,108 ♪ ♪ 819 00:31:26,110 --> 00:31:27,643 QUINN: (RETCHES) 820 00:31:28,411 --> 00:31:31,313 She has a testicular torsion. She needs surgery now. 821 00:31:31,315 --> 00:31:32,648 ♪ ♪ 822 00:31:38,694 --> 00:31:40,461 Excuse me. Have you made a decision? 823 00:31:40,463 --> 00:31:42,730 Not yet. I mean, there's a lot to... 824 00:31:42,732 --> 00:31:43,998 We need one now. 825 00:31:44,000 --> 00:31:45,500 Quinn has testicular torsion. 826 00:31:45,524 --> 00:31:47,139 The spermatic cord is twisted 827 00:31:47,164 --> 00:31:48,676 and cutting off blood supply. 828 00:31:48,701 --> 00:31:50,069 We need to operate. 829 00:31:50,094 --> 00:31:52,273 ♪ ♪ 830 00:31:52,275 --> 00:31:56,420 If you want Quinn to live the way she wants, 831 00:31:56,579 --> 00:31:58,446 don't limit her future now. 832 00:32:00,990 --> 00:32:02,529 You heard her when my mom said 833 00:32:02,554 --> 00:32:04,252 she might want kids some day. 834 00:32:04,254 --> 00:32:05,820 She can't even fathom the thought 835 00:32:05,822 --> 00:32:07,855 because she's just a child. 836 00:32:07,880 --> 00:32:13,652 ♪ ♪ 837 00:32:13,738 --> 00:32:15,663 Just do what's medically necessary. 838 00:32:18,834 --> 00:32:20,001 (SIGHS) 839 00:32:20,903 --> 00:32:24,593 (MONITOR BEEPING) 840 00:32:24,618 --> 00:32:27,986 ANDREWS: Doesn't appear to be any palpable lymphadenopathy. 841 00:32:28,044 --> 00:32:30,507 It's likely a stromal tumor, 842 00:32:30,532 --> 00:32:32,907 - but get that to pathology right away. - Yes, sir. 843 00:32:34,550 --> 00:32:37,785 (MONITOR BEEPING RAPIDLY) 844 00:32:37,787 --> 00:32:41,756 Quinn has tachycardia and hypotension. 845 00:32:41,758 --> 00:32:42,890 I'm not seeing any bleeding. 846 00:32:42,892 --> 00:32:44,425 EKG's normal. It's not coronary. 847 00:32:44,427 --> 00:32:46,894 CO2 and O2 are normal, so it's not a P.E. 848 00:32:46,896 --> 00:32:48,629 It must be a reaction to the anesthesia. 849 00:32:48,631 --> 00:32:50,898 I'm already pushing fluids and vasoconstrictors. 850 00:32:50,900 --> 00:32:53,601 ♪ ♪ 851 00:32:58,841 --> 00:33:02,110 Six syringes in, and no sign of leakage. 852 00:33:02,112 --> 00:33:03,544 Okay, we're wrapped up here. 853 00:33:03,546 --> 00:33:04,812 Let's get Howard into recovery. 854 00:33:04,814 --> 00:33:07,014 - Well done. - Thanks. 855 00:33:07,016 --> 00:33:09,851 I was thinking of writing up the procedure, 856 00:33:09,853 --> 00:33:11,552 possibly submit it for publication. 857 00:33:11,554 --> 00:33:13,254 I'd be happy to assist, 858 00:33:13,256 --> 00:33:15,423 seeing as I've done it before. 859 00:33:15,425 --> 00:33:17,425 Thanks, but I think I can... 860 00:33:17,427 --> 00:33:19,594 I read your paper in AMSURG, Dr. Reznick. 861 00:33:19,596 --> 00:33:20,895 You continue to impress. 862 00:33:20,897 --> 00:33:21,863 Coming from you, 863 00:33:21,865 --> 00:33:23,431 I take that as a huge compliment. 864 00:33:25,134 --> 00:33:26,959 When you get a chance, Dr. Browne, 865 00:33:27,030 --> 00:33:28,102 you should read it. 866 00:33:28,104 --> 00:33:29,637 Will do. 867 00:33:29,639 --> 00:33:37,712 ♪ ♪ 868 00:33:37,714 --> 00:33:39,247 J.L.: I've given vasopressors 869 00:33:39,249 --> 00:33:41,182 and reduced her meds as much as I can. 870 00:33:41,184 --> 00:33:42,817 She's losing volume somewhere. 871 00:33:42,819 --> 00:33:44,952 It was dry when we ligated the spermatic cord. 872 00:33:44,954 --> 00:33:46,354 I'm still not seeing the bleed. 873 00:33:46,356 --> 00:33:49,123 SHAUN: Could be vagal stimulation from the severed nerve. 874 00:33:49,125 --> 00:33:50,391 But she's not responding to epi. 875 00:33:50,393 --> 00:33:52,493 - Sepsis? - It's too early for an infection. 876 00:33:54,263 --> 00:33:56,564 Her MAP is 20. She's barely profusing. 877 00:33:56,566 --> 00:33:59,834 ♪ ♪ 878 00:33:59,836 --> 00:34:01,169 Okay, excuse me, guys. 879 00:34:01,171 --> 00:34:02,804 - You're breaking scrub. - I'm so sorry. 880 00:34:03,639 --> 00:34:05,072 Grey-Turner sign. 881 00:34:05,074 --> 00:34:07,041 Could be a retroperitoneal hemorrhage. 882 00:34:07,043 --> 00:34:13,080 ♪ ♪ 883 00:34:13,082 --> 00:34:19,120 ♪ ♪ 884 00:34:19,122 --> 00:34:21,222 Jared could be right. 885 00:34:21,224 --> 00:34:24,525 It is possible that there's internal bleeding. 886 00:34:24,527 --> 00:34:26,360 The testicular artery 887 00:34:26,362 --> 00:34:28,596 can retract up into the pelvis. 888 00:34:28,598 --> 00:34:30,665 It's rare, but it can happen. 889 00:34:30,667 --> 00:34:32,600 Rare is an understatement. Dr. Andrews? 890 00:34:35,037 --> 00:34:36,804 I don't think we have any other choice. 891 00:34:36,806 --> 00:34:38,472 We need to do an ex-lap. 10 blade. 892 00:34:38,474 --> 00:34:48,482 ♪ ♪ 893 00:34:48,484 --> 00:34:49,784 Murphy, retract. 894 00:34:57,993 --> 00:34:59,627 Internal bleeding. 895 00:34:59,629 --> 00:35:00,928 Jared was right. 896 00:35:02,497 --> 00:35:04,298 Nice call, Dr. Kalu. 897 00:35:04,300 --> 00:35:05,466 Thank you, sir. 898 00:35:06,602 --> 00:35:08,769 Kalu, suction. We need a clear view of the field. 899 00:35:08,771 --> 00:35:10,705 ♪ ♪ 900 00:35:13,547 --> 00:35:16,092 Fever's down, and the flora in your system 901 00:35:16,117 --> 00:35:17,449 seems to be returning to normal. 902 00:35:17,451 --> 00:35:20,166 - We expect a full recovery. - Thank you. 903 00:35:20,191 --> 00:35:21,824 For everything. 904 00:35:21,849 --> 00:35:23,515 Do you know when I can have visitors? 905 00:35:23,544 --> 00:35:25,536 I thought you might ask that question. 906 00:35:25,561 --> 00:35:27,394 There are a couple of eager preschoolers 907 00:35:27,419 --> 00:35:28,852 who'd like to say hi. 908 00:35:28,933 --> 00:35:29,899 Oh. 909 00:35:29,901 --> 00:35:31,323 - Daddy! - Keira! 910 00:35:31,348 --> 00:35:34,069 Sammy! Oh! 911 00:35:34,071 --> 00:35:36,372 Oh, I think you guys have grown! 912 00:35:36,374 --> 00:35:38,169 - (CHUCKLES) - Hey. 913 00:35:38,194 --> 00:35:40,576 Hey, these are the doctors that saved Daddy. 914 00:35:40,578 --> 00:35:43,544 Dr. Reznick and this is, uh... 915 00:35:43,677 --> 00:35:45,560 Uh, I'm sorry, I forgot your name. 916 00:35:46,069 --> 00:35:48,348 Dr. Browne. 917 00:35:48,350 --> 00:35:50,050 - Thank you. - Thank you. 918 00:35:50,052 --> 00:35:51,585 You're welcome. 919 00:35:51,587 --> 00:35:52,614 (CHUCKLES) 920 00:35:52,639 --> 00:35:53,854 Blah! 921 00:35:53,856 --> 00:35:55,989 (LAUGHTER) 922 00:35:55,991 --> 00:35:57,291 Okay. 923 00:35:59,043 --> 00:36:00,227 MORGAN: Who's this guy? 924 00:36:00,229 --> 00:36:01,261 - Bear Bear. - Bear Bear? 925 00:36:10,638 --> 00:36:11,772 Did you do it? 926 00:36:11,774 --> 00:36:12,906 Did you remove both? 927 00:36:14,309 --> 00:36:15,409 No. 928 00:36:15,411 --> 00:36:16,543 Just the cancerous one. 929 00:36:16,545 --> 00:36:18,412 What? Why not? 930 00:36:19,697 --> 00:36:21,099 That's on me. 931 00:36:21,124 --> 00:36:23,317 I couldn't, in good conscience, remove a healthy organ. 932 00:36:28,404 --> 00:36:30,071 Quinnie. 933 00:36:30,096 --> 00:36:31,529 This was our decision. 934 00:36:31,569 --> 00:36:33,446 No! You said you were on my side! 935 00:36:33,471 --> 00:36:36,218 Hey, we are. Always. 936 00:36:36,243 --> 00:36:38,198 We haven't had enough time to talk, 937 00:36:38,200 --> 00:36:40,767 not with each other, with your therapist, 938 00:36:40,769 --> 00:36:42,208 with your doctors. 939 00:36:42,233 --> 00:36:43,837 So I'm gonna turn into a boy. 940 00:36:43,839 --> 00:36:45,772 Well, not right away. 941 00:36:45,774 --> 00:36:47,474 Your endocrinologist will talk to you 942 00:36:47,476 --> 00:36:48,475 about the right timeline 943 00:36:48,477 --> 00:36:50,444 for starting feminizing hormones. 944 00:36:50,446 --> 00:36:53,580 (SIGHS) 945 00:36:53,582 --> 00:36:54,961 You know... 946 00:36:55,918 --> 00:36:58,352 the thought of having your own kids someday 947 00:36:58,354 --> 00:36:59,987 is a big decision, 948 00:36:59,989 --> 00:37:01,855 but you never know what you will or will not want 949 00:37:01,857 --> 00:37:03,023 once you get older. 950 00:37:03,025 --> 00:37:05,092 Cis people are always so worked up 951 00:37:05,094 --> 00:37:06,527 about having bio kids. 952 00:37:06,529 --> 00:37:08,362 If I really want a kid that bad, 953 00:37:08,364 --> 00:37:09,830 I can just adopt. 954 00:37:13,234 --> 00:37:14,701 You know, I'll be back when I'm 18 955 00:37:14,703 --> 00:37:16,603 for my gender confirmation surgery. 956 00:37:16,605 --> 00:37:20,541 And when you do, I'll be here to help you. 957 00:37:20,543 --> 00:37:25,345 ♪ ♪ 958 00:37:28,249 --> 00:37:30,450 Patient satisfaction survey scores are in, 959 00:37:30,452 --> 00:37:31,952 and it was very close. 960 00:37:31,954 --> 00:37:33,654 Not really. She's being kind. 961 00:37:33,656 --> 00:37:37,691 Congratulations go to Dr. Reznick and Dr. Browne. 962 00:37:37,693 --> 00:37:39,493 - Yes. - Thank you. 963 00:37:41,062 --> 00:37:43,063 Congratulations. 964 00:37:43,065 --> 00:37:44,131 Thank you, Shaun. 965 00:37:44,133 --> 00:37:46,066 Claire and I make a nice team. 966 00:37:49,370 --> 00:37:50,871 You should be psyched. 967 00:37:50,873 --> 00:37:52,639 Yeah. I should be. 968 00:37:55,253 --> 00:37:57,711 To the victor belong the spoils. 969 00:37:57,713 --> 00:37:59,212 Pay up. 970 00:37:59,214 --> 00:38:01,815 Oh, humility was never your strong suit. 971 00:38:03,751 --> 00:38:05,819 - Thank you, Mortimer. - Mm. 972 00:38:05,821 --> 00:38:07,988 Don't spend it all in one place. 973 00:38:07,990 --> 00:38:09,423 Spend it? 974 00:38:09,425 --> 00:38:11,024 I'm gonna frame it. 975 00:38:11,026 --> 00:38:13,393 ♪ ♪ 976 00:38:13,395 --> 00:38:15,896 What made you think of a retroperitoneal hemorrhage? 977 00:38:15,898 --> 00:38:16,863 Homework. 978 00:38:16,865 --> 00:38:17,931 You were right. 979 00:38:17,933 --> 00:38:19,700 Prepping for an SDA was important. 980 00:38:19,702 --> 00:38:21,435 We make a good team. 981 00:38:24,706 --> 00:38:26,873 Quinn doesn't like pink. 982 00:38:26,875 --> 00:38:28,141 Oh. 983 00:38:28,143 --> 00:38:30,877 Uh, I think she will like these. 984 00:38:30,879 --> 00:38:33,146 I hope so. 985 00:38:35,350 --> 00:38:38,151 She's more of a purple girl. 986 00:38:38,153 --> 00:38:45,592 ♪ ♪ 987 00:38:45,594 --> 00:38:47,661 Did you read Morgan's AMSURG article yet? 988 00:38:47,663 --> 00:38:48,762 (SCOFFS) 989 00:38:48,764 --> 00:38:51,331 It is on the top of my to-do list. 990 00:38:51,333 --> 00:38:53,600 I didn't tell you to read it to rub it in. 991 00:38:53,602 --> 00:38:56,236 ♪ ♪ 992 00:38:56,238 --> 00:38:58,271 I told you to read it so you knew what you'd be up against. 993 00:38:58,273 --> 00:39:00,340 You think I need to be more cutthroat? 994 00:39:00,342 --> 00:39:01,354 No. 995 00:39:01,379 --> 00:39:03,913 That's Morgan's M.O. You're different. 996 00:39:03,979 --> 00:39:05,812 You're smart, you're special. 997 00:39:05,814 --> 00:39:09,750 Rise up, play the game on your own terms. 998 00:39:09,752 --> 00:39:11,184 Don't wait for it. 999 00:39:11,186 --> 00:39:16,890 ♪ A year from now we'll all be gone ♪ 1000 00:39:16,892 --> 00:39:21,128 ♪ All our friends will move away ♪ 1001 00:39:21,130 --> 00:39:22,496 ♪ ♪ 1002 00:39:22,498 --> 00:39:27,901 ♪ And they're goin' to better places ♪ 1003 00:39:27,903 --> 00:39:32,372 ♪ But our friends will be gone away ♪ 1004 00:39:36,778 --> 00:39:39,346 ♪ Nothin' is as it has been ♪ 1005 00:39:39,348 --> 00:39:42,049 I heard you saved Quinn's life. 1006 00:39:42,051 --> 00:39:44,785 Jared and I did. 1007 00:39:44,787 --> 00:39:46,453 I like her. 1008 00:39:46,455 --> 00:39:47,554 "Her." 1009 00:39:47,556 --> 00:39:49,189 ♪ And I guess it's just as well ♪ 1010 00:39:49,191 --> 00:39:53,727 So you get that she is a "she." 1011 00:39:53,729 --> 00:39:55,729 I have lots of questions. 1012 00:39:55,731 --> 00:39:58,699 Yeah, well, questions are good. 1013 00:39:58,701 --> 00:40:01,802 Leads to awareness and understanding. 1014 00:40:01,804 --> 00:40:04,004 And, who knows, maybe even acceptance. 1015 00:40:05,860 --> 00:40:07,235 Being a kid is tough enough, 1016 00:40:07,260 --> 00:40:09,810 But being a trans kid? Oh, man, that's... 1017 00:40:09,812 --> 00:40:11,111 that's off the chart. 1018 00:40:11,113 --> 00:40:13,547 ♪ ♪ 1019 00:40:13,549 --> 00:40:15,849 I can't imagine how it must feel 1020 00:40:15,851 --> 00:40:19,119 to be so different on the outside 1021 00:40:19,121 --> 00:40:20,320 than you are on the inside. 1022 00:40:20,322 --> 00:40:23,924 ♪ Oh, oh, oh ♪ 1023 00:40:23,926 --> 00:40:27,294 ♪ Oh, oh ♪ 1024 00:40:27,296 --> 00:40:29,229 Hey, Shaun. 1025 00:40:29,231 --> 00:40:32,032 I can give you a lift. 1026 00:40:32,034 --> 00:40:33,667 We could grab a bite. 1027 00:40:33,669 --> 00:40:36,136 ♪ Oh ♪ 1028 00:40:36,138 --> 00:40:39,506 You said you can't be my friend. 1029 00:40:39,508 --> 00:40:41,241 So, no, thank you. 1030 00:40:42,810 --> 00:40:46,246 ♪ Been talking 'bout ♪ 1031 00:40:46,248 --> 00:40:47,447 Okay. 1032 00:40:47,449 --> 00:40:49,015 ♪ The way things change ♪ 1033 00:40:49,017 --> 00:40:50,951 ♪ ♪ 1034 00:40:50,953 --> 00:40:55,856 ♪ If you don't know what to make of this ♪ 1035 00:40:55,858 --> 00:40:57,224 Hey, amigo. What's up? 1036 00:40:57,226 --> 00:40:59,760 ♪ Then we will not relate ♪ - I need your help. 1037 00:40:59,762 --> 00:41:01,261 (SCOFFS) 1038 00:41:02,430 --> 00:41:04,898 ♪ Rivers and roads ♪ 1039 00:41:04,900 --> 00:41:07,901 ♪ Rivers and roads ♪ 1040 00:41:07,903 --> 00:41:11,438 ♪ Rivers till I reach you ♪ 1041 00:41:13,107 --> 00:41:15,976 ♪ Rivers and roads ♪ 1042 00:41:15,978 --> 00:41:18,445 ♪ Oh, rivers and roads ♪ 1043 00:41:18,447 --> 00:41:22,482 ♪ Oh, rivers till I reach you ♪ 1044 00:41:22,484 --> 00:41:24,584 ♪ ♪ 1045 00:41:24,586 --> 00:41:27,020 ♪ Rivers and roads ♪ 1046 00:41:27,022 --> 00:41:29,656 ♪ Rivers and roads ♪ 1047 00:41:29,658 --> 00:41:32,993 ♪ Rivers till I reach you ♪ 1048 00:41:34,896 --> 00:41:37,631 ♪ Rivers and roads ♪ 1049 00:41:37,633 --> 00:41:40,133 ♪ Rivers and roads ♪ 1050 00:41:40,135 --> 00:41:43,603 ♪ Rivers till I reach you ♪ 1051 00:41:43,605 --> 00:41:47,474 You're not gonna do any laps or nothing? 1052 00:41:47,476 --> 00:41:48,742 No. 1053 00:41:48,744 --> 00:41:51,411 ♪ ♪ 1054 00:41:51,413 --> 00:41:52,712 Then what are you doing? 1055 00:41:55,183 --> 00:41:57,417 Understanding. 1056 00:41:57,419 --> 00:42:01,922 ♪ ♪ 1057 00:42:01,924 --> 00:42:04,891 ♪ Oh ♪ ♪ Rivers and roads ♪ 1058 00:42:04,893 --> 00:42:07,761 ♪ Rivers and roads ♪ 1059 00:42:07,763 --> 00:42:12,365 ♪ Rivers till I reach you ♪79148

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