1 00:00:07,174 --> 00:00:09,544 Until recently, Western medicine held 2 00:00:09,677 --> 00:00:12,346 that our bodies have only two circulatory systems. 3 00:00:13,615 --> 00:00:18,051 The cardiovascular, which pumps blood, and the lymphatic, which drains fluids. 4 00:00:20,454 --> 00:00:22,256 But in 2021, 5 00:00:22,389 --> 00:00:25,827 scientists discovered that tattoo ink somehow travels from the skin 6 00:00:25,960 --> 00:00:27,862 -down into the fascia. - Oh. 7 00:00:28,462 --> 00:00:30,063 Hey. 8 00:00:30,999 --> 00:00:32,132 Why are they still damp? 9 00:00:32,266 --> 00:00:33,902 Well, we needed the dryer. You were not home. 10 00:00:34,034 --> 00:00:36,571 Yeah, because I was up late prepping your elective cases for the week. 11 00:00:36,704 --> 00:00:38,405 What was Lucy Miller's ICP this morning? 12 00:00:38,540 --> 00:00:42,142 -I'm not on the floor yet, so-- -She's also going to need a follow-up CT. 13 00:00:42,276 --> 00:00:43,978 Wait, wait, are we rounding now? 14 00:00:44,111 --> 00:00:45,747 Just, please, will you try to read the notes? 15 00:00:45,880 --> 00:00:47,582 Um, okay, last bites and sips. 16 00:00:47,715 --> 00:00:49,182 -Mama... -Mm-hmm? 17 00:00:49,316 --> 00:00:52,219 Can Daddy use the baby spray on you so I can have a brother? 18 00:00:53,387 --> 00:00:56,824 Yeah, I meant to tell you, uh, this guy asked me where babies come from. 19 00:00:56,958 --> 00:00:58,660 -And you went with baby spray? -Yeah, yeah. 20 00:00:58,793 --> 00:01:00,093 You know, like Spider-Man. 21 00:01:02,630 --> 00:01:05,399 Yeah, I was trying to work with, uh, what he knows. 22 00:01:05,533 --> 00:01:08,268 -I... I'm gonna... ICP? Got it. -Mm-hmm. 23 00:01:09,403 --> 00:01:12,941 This finding suggested a third circulatory system 24 00:01:13,073 --> 00:01:16,276 connecting the skin to the fascia and organs beneath. 25 00:01:16,410 --> 00:01:17,946 Hey, how's your group paper going? 26 00:01:18,078 --> 00:01:21,649 You'd think having more people writing would make it easier. 27 00:01:21,783 --> 00:01:25,218 It's due tomorrow though, right? I'm just saying, at least it's over. 28 00:01:25,352 --> 00:01:27,889 Mmm. If only I could finish my part. 29 00:01:29,023 --> 00:01:30,792 -Hey, hey. I will take care of that. -I-- 30 00:01:30,925 --> 00:01:32,627 You just go on and get back to work, okay? 31 00:01:32,760 --> 00:01:35,763 -You just call me Dish Daddy. -I most certainly will not. 32 00:01:38,700 --> 00:01:41,569 What... you know that silverware won't get clean like that? 33 00:01:42,469 --> 00:01:46,574 Uh, yes, it will, and I won't stab myself when I go to unload it. 34 00:01:46,708 --> 00:01:50,578 But... Do you do it blindfolded? See, this is why I do the dishes. 35 00:01:50,712 --> 00:01:55,016 No, move over, but see, look, this needs to be up like this, up. 36 00:01:55,148 --> 00:01:56,985 And all those bowls need to come down. 37 00:01:57,150 --> 00:01:58,820 It's called the interstitium, 38 00:01:58,953 --> 00:02:02,624 and the function is, well, we're still figuring that out. 39 00:02:03,156 --> 00:02:05,258 Hey, have you seen my tramadol? 40 00:02:05,392 --> 00:02:06,460 Well, I threw it out. 41 00:02:07,361 --> 00:02:09,196 Well, I thought that you weren't in pain anymore. 42 00:02:09,329 --> 00:02:12,967 Well, I just... I get sore after operating sometimes, 43 00:02:13,101 --> 00:02:15,135 and I've got that spinal tumor patient today. 44 00:02:15,268 --> 00:02:17,105 -Okay. -You wanna meet up after your meeting? 45 00:02:17,237 --> 00:02:19,007 I wasn't planning on sticking around. 46 00:02:19,139 --> 00:02:21,274 It's annoying that I even have to go in at all. 47 00:02:21,408 --> 00:02:23,511 When I said I quit, I meant it. 48 00:02:23,645 --> 00:02:25,013 You spent years training. 49 00:02:25,145 --> 00:02:26,948 - They just want to make sure you're sure. 50 00:02:27,081 --> 00:02:29,984 I was sure two weeks ago. You know, can you take over? 51 00:02:30,118 --> 00:02:31,119 -I have to go change. -Yeah. 52 00:02:31,919 --> 00:02:33,186 - Okay. - But we know this much: 53 00:02:33,855 --> 00:02:35,489 When it comes to support systems, 54 00:02:36,090 --> 00:02:38,793 life is a lot more complicated than we thought. 55 00:02:46,734 --> 00:02:48,435 Good morning. 56 00:02:48,569 --> 00:02:51,706 They didn't have ginger, so I got you mint and something called "rooibose" 57 00:02:51,839 --> 00:02:53,975 or "roo-ee..." I still don't know how to say it. 58 00:02:54,108 --> 00:02:55,543 - Thank you. - You're welcome. 59 00:02:56,443 --> 00:02:58,278 You sure you shouldn't take the day off? 60 00:02:58,412 --> 00:03:01,049 I'm fine. A little crampy, but that's to be expected after the pills, you know. 61 00:03:01,181 --> 00:03:06,888 -Okay. And how are you feeling about the-- -I'm okay. I'll be okay. 62 00:03:07,021 --> 00:03:09,524 -I know it was the right decision. -Okay. 63 00:03:09,657 --> 00:03:11,726 -There you go. -I can open my own door. 64 00:03:11,859 --> 00:03:13,528 I don't know what to tell you. I'm a gentleman, okay. 65 00:03:13,661 --> 00:03:15,195 -I'm seeing you later, yes? -Yes. 66 00:03:15,328 --> 00:03:16,363 Okay. 67 00:03:18,900 --> 00:03:20,134 What are you doing? 68 00:03:20,735 --> 00:03:24,404 Some people punch punching bags, I stab suture trainers. 69 00:03:24,539 --> 00:03:31,579 And now, on his first day back from Central Michigan, Benson Kwan. 70 00:03:32,180 --> 00:03:33,681 -You should take this. -Mm-hmm. 71 00:03:33,815 --> 00:03:36,283 Do you know any apartments for rent not at a retirement home? 72 00:03:36,416 --> 00:03:37,618 Then no. 73 00:03:37,752 --> 00:03:39,987 Good morning, everyone. Good morning. 74 00:03:40,888 --> 00:03:43,057 Uh, so for those of you considering sub specialties, 75 00:03:43,191 --> 00:03:44,592 it is time to look for research opportunities. 76 00:03:44,726 --> 00:03:46,359 If you want to be competitive for fellowships, 77 00:03:46,493 --> 00:03:48,563 you'll need to line something up within the next few weeks. 78 00:03:48,696 --> 00:03:50,698 I just posted open positions to the portal. 79 00:03:50,832 --> 00:03:53,601 If you have any questions or you need anything at all, just come find me. 80 00:03:54,502 --> 00:03:55,970 Let's have a good day. 81 00:03:57,038 --> 00:03:58,906 Great. One more thing to do. 82 00:03:59,040 --> 00:04:01,609 -Still thinking cardiothoracic? -I'm thinking it's none of your business. 83 00:04:02,643 --> 00:04:05,713 -She's just having a bad-- -Personality? Yeah. 84 00:04:10,985 --> 00:04:13,821 You want to cancel the weekly chiefs' meetings? 85 00:04:13,955 --> 00:04:16,624 If you do the math, 14 people in a two-hour meeting, 86 00:04:16,758 --> 00:04:20,260 that's 28 man hours wasted each week on something that could be an email. 87 00:04:21,428 --> 00:04:23,931 -I'll, uh, I'll think about it. -Okay. 88 00:04:24,065 --> 00:04:27,969 Morning. It appears that I'm on your service, Dr. Webber. 89 00:04:29,469 --> 00:04:31,639 -Sir. -He requested you. 90 00:04:32,206 --> 00:04:34,474 Oh. Well, I saw that you had a Whipple on your schedule. 91 00:04:34,609 --> 00:04:36,511 I've been practicing my hepatico-J technique at home and-- 92 00:04:36,644 --> 00:04:37,912 Uh, that won't be necessary. 93 00:04:38,045 --> 00:04:40,615 I've got a VIP patient that needs post-op monitoring. 94 00:04:40,748 --> 00:04:44,317 No problem. I-I can... I can do that before I scrub in. 95 00:04:44,451 --> 00:04:46,087 I don't think you understand. 96 00:04:46,721 --> 00:04:48,488 There is no scrubbing in. 97 00:04:48,623 --> 00:04:51,125 You will not set a foot in my OR. 98 00:04:51,259 --> 00:04:55,096 You will monitor my post-op patient on the VIP floor. 99 00:04:55,229 --> 00:04:56,531 End of assignment. 100 00:04:58,533 --> 00:05:01,636 Give him time, or expensive chocolate works too. 101 00:05:03,104 --> 00:05:06,073 Dr. Shepherd, Dr. Adams, meet Pauline Darnold. 102 00:05:06,207 --> 00:05:07,542 Please call me Polly Dart. 103 00:05:07,675 --> 00:05:10,645 -She is a Dolly Parton impersonator. -You don't say. 104 00:05:10,778 --> 00:05:12,146 Uh, what brings you in? 105 00:05:12,280 --> 00:05:14,515 Oh. It feels like my head's heavier than my hair. 106 00:05:14,649 --> 00:05:16,551 -Can you be more specific? -Worst headache of my life. 107 00:05:16,684 --> 00:05:19,654 -When did it start? -This morning during my sound check. 108 00:05:19,787 --> 00:05:22,123 A tech company hired me for their corporate retreat. 109 00:05:22,256 --> 00:05:25,325 It hurt so much I could barely see, but I'd already cashed the check 110 00:05:25,458 --> 00:05:27,728 so I put on my lashes, hiked up my boobs, 111 00:05:27,862 --> 00:05:29,496 and sang the best I could. 112 00:05:29,630 --> 00:05:31,632 Well, hopefully, we can get to the bottom of this 113 00:05:31,766 --> 00:05:33,000 and get you some relief. 114 00:05:33,134 --> 00:05:34,969 Dr. Adams, why don't you start on the exam? 115 00:05:35,102 --> 00:05:37,038 Mind if I take a look? All right. 116 00:05:39,540 --> 00:05:41,175 All right, a little slower. 117 00:05:44,278 --> 00:05:46,280 All right, follow my finger. 118 00:05:48,115 --> 00:05:51,719 -Extraocular muscles are intact. -Mm-hmm. 119 00:05:52,520 --> 00:05:54,121 Symmetric smile. 120 00:05:54,255 --> 00:05:56,958 Puff your cheeks. Raise your eyebrows. Any ringing in your ears? 121 00:05:57,091 --> 00:05:58,693 -Not a peep. -Okay. 122 00:05:58,826 --> 00:06:01,662 Uh, cranial nerve seems stable, no facial weakness 123 00:06:01,796 --> 00:06:03,463 which rules out a stroke or a bleed. 124 00:06:03,598 --> 00:06:06,399 -Let's start with a non-contrast head CT. -All right, call the order in. 125 00:06:06,534 --> 00:06:07,568 Okay. 126 00:06:08,302 --> 00:06:09,537 He's a keeper. 127 00:06:11,138 --> 00:06:14,008 The app says the water purifying kits arrived yesterday. 128 00:06:14,141 --> 00:06:17,245 Well, there's a village in Sierra Leone who would argue otherwise. 129 00:06:17,377 --> 00:06:18,846 -Will you-- -So either I'm... 130 00:06:19,412 --> 00:06:21,716 -Sorry for interrupting. -Don't be. 131 00:06:21,849 --> 00:06:23,184 We're just talking about work. 132 00:06:23,317 --> 00:06:26,587 Ken started a nonprofit that brings clean drinking water 133 00:06:26,721 --> 00:06:28,256 to developing countries. 134 00:06:28,388 --> 00:06:32,927 I'm Jasmine, cofounder of said nonprofit/Ken's ride/ex-wife. 135 00:06:33,060 --> 00:06:34,862 We like to keep things complicated. 136 00:06:34,996 --> 00:06:38,065 -Are you taking me to surgery? -Soon. 137 00:06:39,166 --> 00:06:41,636 Griffith. We're on a schedule here. 138 00:06:41,769 --> 00:06:46,540 Ken Nguyen, 37, history of osteosarcoma in the spine at L3, 139 00:06:46,674 --> 00:06:48,408 here for a vertebral resection and spinal reconstruction. 140 00:06:48,542 --> 00:06:50,878 I will replace the cancerous vertebrae 141 00:06:51,012 --> 00:06:53,314 with a titanium cage filled with bone graft material. 142 00:06:53,446 --> 00:06:55,616 And then I will cover it with paraspinous muscle 143 00:06:55,750 --> 00:06:58,786 to make sure that the spinal cord and implant are protected. 144 00:06:58,920 --> 00:07:01,622 How long is the recovery? When will he be back to his old self? 145 00:07:01,756 --> 00:07:03,423 What's that supposed to mean? 146 00:07:03,925 --> 00:07:05,293 It's a normal question. 147 00:07:05,425 --> 00:07:06,928 You mean, when can I get back to work? 148 00:07:07,061 --> 00:07:08,996 - I didn't say that. - You didn't have to. 149 00:07:09,130 --> 00:07:12,233 All you care about is work. You're controlling and overbearing and-- 150 00:07:12,366 --> 00:07:15,369 Okay, you need to be calm right now, and clearly I'm an impediment to that. 151 00:07:15,503 --> 00:07:18,739 So I'm gonna go answer some emails. Call me if he croaks. 152 00:07:20,708 --> 00:07:23,210 -Should I get him prepped? -Yeah, feels right. 153 00:07:27,882 --> 00:07:29,083 Have you looked 154 00:07:29,216 --> 00:07:30,718 -at the open research positions yet? -Mm-mmm. 155 00:07:30,851 --> 00:07:33,087 Saliman's studying mitral regurgitation in dogs. 156 00:07:33,220 --> 00:07:34,922 I could get paid to pet dogs, 157 00:07:35,056 --> 00:07:37,158 which frankly, is something I could use. 158 00:07:37,725 --> 00:07:39,427 -Something wrong? -It's just cramps. 159 00:07:39,560 --> 00:07:42,563 You shouldn't still be in this much pain after a medication abortion. 160 00:07:42,697 --> 00:07:44,999 -Have you followed up with your OB? -When am I supposed to do that? 161 00:07:45,132 --> 00:07:46,534 Hey, uh, are you okay? 162 00:07:46,667 --> 00:07:48,468 -Fine, yeah, just a little discomfort. -You're sure? 163 00:07:48,602 --> 00:07:50,972 -Mm-hmm. -Okay. Well, you missed an epic battle. 164 00:07:51,105 --> 00:07:53,274 It's just like, why get a divorce if you're gonna keep working together? 165 00:07:53,407 --> 00:07:54,675 -Does it-- -Oh, catch her, catch her. 166 00:07:54,809 --> 00:07:55,876 -Oh. Simone. -I'm... I'm good. 167 00:07:56,010 --> 00:07:57,511 -We need to get her to a room. -I'm okay. 168 00:07:57,645 --> 00:07:58,679 Come on, okay. 169 00:07:59,180 --> 00:08:00,681 Let's go in here. 170 00:08:15,963 --> 00:08:19,567 Ms. Bromley in room 1409 needs a bolus of LR, okay. 171 00:08:19,700 --> 00:08:21,702 I'll be in the conference room if anyone needs me. 172 00:08:21,836 --> 00:08:23,404 Uh, Dr. Bailey, can I ask you a quick question? 173 00:08:23,537 --> 00:08:26,040 - Besides that one? - Yeah, it's about the schedule. 174 00:08:26,173 --> 00:08:30,311 Um, have you ever extended a rotation to cover a request for bereavement leave? 175 00:08:32,146 --> 00:08:34,215 Rarely, uh, but let me see. 176 00:08:35,082 --> 00:08:36,550 Wait, what am I looking at? 177 00:08:36,684 --> 00:08:39,253 What... what happened to my spreadsheet that I gave you? 178 00:08:39,387 --> 00:08:40,821 Oh, uh, a med school friend recommended this app. 179 00:08:40,955 --> 00:08:42,256 Residents input their requests, 180 00:08:42,390 --> 00:08:44,525 and it optimizes the schedule for everyone. 181 00:08:44,658 --> 00:08:45,693 Mmm. 182 00:08:45,826 --> 00:08:50,231 Well, does this magic app account for, 183 00:08:50,364 --> 00:08:52,767 you know, who needs protected time for research, 184 00:08:52,900 --> 00:08:55,369 or who's behind on their case logs, 185 00:08:55,504 --> 00:08:59,774 or whose uncle, coincidentally, needs to be driven to dialysis 186 00:08:59,907 --> 00:09:01,675 whenever the Mariners make the play-offs? 187 00:09:01,809 --> 00:09:03,377 -Probably not. -Yeah. 188 00:09:03,512 --> 00:09:07,782 See, no computer can optimize better than a residency director 189 00:09:07,915 --> 00:09:10,751 who knows her or his residents. 190 00:09:10,885 --> 00:09:13,421 Try my spreadsheet. You'll never go back. 191 00:09:14,588 --> 00:09:16,223 I will take a look. 192 00:09:18,859 --> 00:09:21,262 Here. If you're ever in an accident 193 00:09:21,395 --> 00:09:24,432 or suspect you might have been in an accident, call me. 194 00:09:26,233 --> 00:09:28,002 Hey, you're that lawyer with the ads. 195 00:09:28,569 --> 00:09:33,340 "If you're injured and you need a pro called Lloyd Fazio, lawyer." 196 00:09:33,474 --> 00:09:36,877 Guilty. And you are Dr... 197 00:09:37,011 --> 00:09:40,881 Kwan. I am assigned to you today. May I take a look at your incision? 198 00:09:41,015 --> 00:09:42,883 I'd love an Arnold Palmer first. 199 00:09:43,584 --> 00:09:46,287 Well, I'm a doctor, but I will check with patient services. 200 00:09:46,420 --> 00:09:49,390 Yesterday, the head doctor up here mixed it for me himself. 201 00:09:50,591 --> 00:09:51,560 I'll see what I can find. 202 00:09:51,692 --> 00:09:53,227 But first, may I take a look? 203 00:09:53,360 --> 00:09:55,229 -Fine, have at it. -All right. 204 00:09:55,963 --> 00:09:57,731 So how are you feeling? 205 00:09:57,865 --> 00:09:59,233 Any pain? 206 00:09:59,366 --> 00:10:02,336 Only the kind that comes with having your stomach cut open. 207 00:10:05,906 --> 00:10:08,109 Don't worry, I won't sue you. 208 00:10:08,242 --> 00:10:11,412 Fortunately, everything looks good. 209 00:10:11,546 --> 00:10:14,815 Do you have to put that back on? It's so uncomfortable. 210 00:10:14,949 --> 00:10:17,184 It supports recovery. You want it on. Trust me. 211 00:10:17,318 --> 00:10:19,286 All right, I will be back. 212 00:10:20,555 --> 00:10:22,591 -Sixty-forty. -What? 213 00:10:22,723 --> 00:10:25,292 60% iced tea, 40% lemonade. 214 00:10:26,127 --> 00:10:27,161 Right. 215 00:10:31,899 --> 00:10:32,833 Oh, it's Lincoln. 216 00:10:32,967 --> 00:10:34,668 -You should go. -But what about you? 217 00:10:34,802 --> 00:10:36,403 I'm sure everything is fine, 218 00:10:36,538 --> 00:10:38,973 and no offense, but I don't want you here for this part anyway. 219 00:10:39,106 --> 00:10:41,442 -You sure? -Please just go. 220 00:10:41,576 --> 00:10:43,310 -All right. -Thank you. 221 00:10:46,380 --> 00:10:48,550 Okay. 222 00:10:48,682 --> 00:10:51,085 -Scoot down. -Do we really have to do this? 223 00:10:51,218 --> 00:10:53,854 Make sure that you don't have any residual tissue making you septic? 224 00:10:53,988 --> 00:10:55,022 Yes, we do. 225 00:10:57,424 --> 00:10:58,759 Just kill me, you know. 226 00:10:58,893 --> 00:11:00,094 Get over it. 227 00:11:00,227 --> 00:11:01,563 Light touch, 228 00:11:01,695 --> 00:11:03,864 - and you'll feel a bit of pressure. - Mm-hmm. 229 00:11:05,099 --> 00:11:06,635 Aren't you in plastics today? 230 00:11:06,767 --> 00:11:10,404 I told them I ate a bad salad and maybe had that diarrhea thing. 231 00:11:10,539 --> 00:11:13,741 Let's see what we have. 232 00:11:14,775 --> 00:11:15,876 What is that? 233 00:11:16,810 --> 00:11:17,978 I don't know. 234 00:11:18,112 --> 00:11:20,347 It's not normal. 235 00:11:20,481 --> 00:11:21,849 - We should get OB. - No. 236 00:11:21,982 --> 00:11:23,518 We can figure it out. Just get a textbook. 237 00:11:23,652 --> 00:11:27,054 Please, I don't want more of my coworkers looking inside of me. 238 00:11:27,788 --> 00:11:30,057 Okay. 239 00:11:30,191 --> 00:11:31,626 Don't go anywhere. 240 00:11:38,866 --> 00:11:40,167 How's she doing? 241 00:11:40,301 --> 00:11:42,571 Mad. She did not want to take this wig off. 242 00:11:42,703 --> 00:11:44,838 Yeah, I'm looking at the application for your lab. 243 00:11:44,972 --> 00:11:46,273 Where it says past experience, 244 00:11:46,407 --> 00:11:48,543 does that just mean neuro research or any research? 245 00:11:48,677 --> 00:11:50,545 -You're applying to my lab? -Yeah. 246 00:11:51,513 --> 00:11:53,814 -Uh, is... is that a problem? -I'm just surprised. 247 00:11:53,948 --> 00:11:55,816 I didn't.. I didn't realize that you were still thinking 248 00:11:55,950 --> 00:11:57,284 about switching to neurosurgery. 249 00:11:57,418 --> 00:11:59,987 Yeah, I'm just keeping my options open, yeah? 250 00:12:00,120 --> 00:12:03,057 You know, it's not like casually scrolling on a dating app. 251 00:12:03,190 --> 00:12:06,060 It's a commitment. I mean, neurosurgery is incredibly demanding. 252 00:12:06,193 --> 00:12:08,028 You'd be starting over at seven more years, 253 00:12:08,162 --> 00:12:10,231 and there's just no room for error or doubt. 254 00:12:10,364 --> 00:12:13,535 You need to have the skill and the desire, or you just can't make it. 255 00:12:13,668 --> 00:12:15,704 Thanks for the TED Talk. 256 00:12:15,836 --> 00:12:17,672 I'm not saying you shouldn't do it. I'm just, I'm just saying-- 257 00:12:17,805 --> 00:12:19,507 Wait, is this because I told your kid 258 00:12:19,641 --> 00:12:21,141 that human beings were made with baby spray? 259 00:12:21,275 --> 00:12:22,376 The scans are up! 260 00:12:22,510 --> 00:12:24,378 Sorry, uh, the scans are up. 261 00:12:25,879 --> 00:12:28,282 - You see that? - Damn it, grade-four AVM. 262 00:12:28,415 --> 00:12:30,884 -What's the fix? -Endovascular coiling. 263 00:12:31,018 --> 00:12:34,388 That works for me. Okay, let's get Polly out and give her the news. 264 00:12:38,959 --> 00:12:40,562 - Bryant, you're late. - Sorry. 265 00:12:40,695 --> 00:12:43,998 Hand me a basin. Vertebra is removed. 266 00:12:44,131 --> 00:12:45,567 Let's prep for the cage. 267 00:12:45,700 --> 00:12:46,767 Take this. 268 00:12:47,468 --> 00:12:48,769 Hey, here's a question: 269 00:12:48,902 --> 00:12:50,404 If you're putting a scalpel in the dishwasher, 270 00:12:50,538 --> 00:12:52,574 would you put it in handle side up or down? 271 00:12:52,707 --> 00:12:54,174 Why am I washing the scalpel? 272 00:12:54,308 --> 00:12:56,944 I have a spine in my hands. Let's cut the chatter. 273 00:13:05,019 --> 00:13:06,153 Something wrong? 274 00:13:09,423 --> 00:13:11,058 I've never seen this before. 275 00:13:13,762 --> 00:13:15,329 Is that more tumor? 276 00:13:15,829 --> 00:13:18,132 Well, it's extended to the vertebral bodies above and below. 277 00:13:18,265 --> 00:13:19,400 You didn't see this in the scans? 278 00:13:19,534 --> 00:13:20,968 The MRI was last month. 279 00:13:21,101 --> 00:13:23,772 -It must've spread fast. -Well, can't we just use a larger cage? 280 00:13:23,904 --> 00:13:26,741 We can't replace a defect this large with just a cage. 281 00:13:26,874 --> 00:13:30,110 It's too big and it carries too high a risk of not healing or failure. 282 00:13:31,178 --> 00:13:32,179 What do you want to do? 283 00:13:37,585 --> 00:13:38,653 I-I don't know yet. 284 00:13:39,219 --> 00:13:40,655 Well, we already did the resection. 285 00:13:40,789 --> 00:13:42,456 We can't just close him and send him to the ICU-- 286 00:13:42,590 --> 00:13:44,458 - You think I don't know that? - -Lincoln. 287 00:13:45,727 --> 00:13:51,498 Look, we're not closing. I just, um... I just need a damn minute. 288 00:14:03,444 --> 00:14:05,780 I have a tangle of blood vessels in my brain? 289 00:14:05,913 --> 00:14:07,881 Yeah, that's what's causing your headaches. 290 00:14:08,015 --> 00:14:10,851 I'm supposing it doesn't go away with a couple of ibuprofen. 291 00:14:10,984 --> 00:14:12,052 No. 292 00:14:12,554 --> 00:14:14,855 And because it could rupture at any moment, 293 00:14:14,988 --> 00:14:17,024 I would urge you to get it fixed right away. 294 00:14:17,157 --> 00:14:20,260 I'm supposed to go to a festival in Nashville tomorrow. 295 00:14:20,394 --> 00:14:22,162 - Can I think about it? - Sure. 296 00:14:23,497 --> 00:14:24,699 Uh, it's a lot to process. 297 00:14:24,833 --> 00:14:26,668 If you need a little time, we can give it to you, 298 00:14:26,801 --> 00:14:28,268 let you consider all the options. 299 00:14:28,402 --> 00:14:32,072 But I would strongly encourage you to make a decision today. 300 00:14:32,206 --> 00:14:34,241 AVMs are impossible to predict. 301 00:14:34,375 --> 00:14:37,211 You could bleed out or have a catastrophic stroke. 302 00:14:37,344 --> 00:14:38,646 You could die. 303 00:14:41,014 --> 00:14:42,851 The three of you would do my surgery? 304 00:14:44,084 --> 00:14:46,086 Today, if you like. 305 00:14:47,689 --> 00:14:48,989 I just might. 306 00:14:49,123 --> 00:14:52,527 -Like the Dolly Parton song. -Exactly. You a Dolly fan? 307 00:14:52,660 --> 00:14:55,262 My mom, she used to make me sing "Islands in the Stream" with her 308 00:14:55,396 --> 00:14:56,897 at karaoke at the... 309 00:14:57,866 --> 00:15:00,033 You know, it-it wasn't really appropriate. 310 00:15:00,167 --> 00:15:02,069 -Book an OR. Mm-hmm. -Yep. 311 00:15:09,309 --> 00:15:11,445 -Hey, hey, do these look the same to you? -Huh? 312 00:15:11,579 --> 00:15:13,748 Uh, I don't know what part of the body I'm looking at. 313 00:15:13,882 --> 00:15:16,584 We're in OB. Take a guess. What are you doing here? 314 00:15:16,718 --> 00:15:19,621 My VIP patient wants socks with fuzzy grips. 315 00:15:19,754 --> 00:15:22,256 So you're stealing them from pre and postpartum mothers? 316 00:15:22,389 --> 00:15:25,794 No, Webber exiled me to the Olympic Floor. 317 00:15:25,926 --> 00:15:27,762 I think he's waiting it out to see if I quit. 318 00:15:27,896 --> 00:15:29,564 Hey, what do you know about the new chief? 319 00:15:29,697 --> 00:15:32,266 - Ivy League, great hair, loves money. 320 00:15:32,399 --> 00:15:34,435 Probably has a hobby where he swims in a pool of cash. 321 00:15:34,569 --> 00:15:37,471 Uh... well, duty calls. 322 00:15:38,305 --> 00:15:41,810 Oh, uh, Dr. Wilson, thank God. 323 00:15:41,942 --> 00:15:43,912 Um, could I have you look at something for me, please? 324 00:15:44,044 --> 00:15:45,245 I don't work here anymore. 325 00:15:45,379 --> 00:15:47,247 But you have your Grey Sloan ID badge. 326 00:15:47,381 --> 00:15:48,583 Yeah, I'm about to hand it in. 327 00:15:48,716 --> 00:15:51,318 Well, before you do, can you please, please look? 328 00:15:53,053 --> 00:15:54,121 Is this your patient? 329 00:15:54,254 --> 00:15:55,389 It... 330 00:15:56,558 --> 00:15:59,426 It's Dr. Griffith. She made me promise not to get anyone to help, 331 00:15:59,561 --> 00:16:01,629 and I don't know what to do. 332 00:16:04,398 --> 00:16:06,433 Anesthesia's wondering how much longer you wanna keep Ken under. 333 00:16:06,568 --> 00:16:10,037 If I knew, I'd be operating. - Just the messenger. 334 00:16:14,007 --> 00:16:16,711 I keep staring at these screens hoping for an answer. 335 00:16:18,312 --> 00:16:21,950 You know, this guy brings safe water to people all around the planet 336 00:16:22,082 --> 00:16:23,450 while the rest of us destroy it. 337 00:16:23,585 --> 00:16:25,820 Because of me, he could spend the rest of his life sedated 338 00:16:25,954 --> 00:16:27,421 and flat on his back. 339 00:16:27,555 --> 00:16:29,122 Well, can you use the cage you have and try chemo 340 00:16:29,256 --> 00:16:31,659 - to shrink the remaining cancer? - -That's not a cure. 341 00:16:31,793 --> 00:16:33,795 The cancer could spread even more and then he's no better off. 342 00:16:33,928 --> 00:16:36,129 - Yeah, clearly, it's spread fast before. - -Exactly. 343 00:16:36,965 --> 00:16:38,332 No good options. 344 00:16:39,032 --> 00:16:40,334 Damn it. 345 00:16:40,467 --> 00:16:42,704 And this is why I like plastics. Soft tissue. 346 00:16:42,837 --> 00:16:45,005 We can move it around to restore form and function. 347 00:16:45,138 --> 00:16:46,473 Bones aren't skin. 348 00:16:46,608 --> 00:16:48,743 It's harder to get them to do the job of other bones. 349 00:16:48,877 --> 00:16:50,377 Well, don't we do fibula grafts all the time? 350 00:16:50,512 --> 00:16:51,746 A fibula's too small. 351 00:16:51,880 --> 00:16:54,582 You'd need a much bigger bone for a defect this... 352 00:16:57,150 --> 00:16:58,620 Bryant, run down and tell the nurses 353 00:16:58,753 --> 00:17:01,421 to bring back a few frozen cadaveric femoral grafts. 354 00:17:01,556 --> 00:17:03,390 -On it. -Isn't a femur too big? 355 00:17:03,525 --> 00:17:05,894 Not if I can sculpt it to the size we need. 356 00:17:10,130 --> 00:17:12,165 Her temp is 38 and she's tachycardiac. 357 00:17:12,299 --> 00:17:13,701 - I said get a textbook. - I know. 358 00:17:13,835 --> 00:17:16,738 -I'm sorry, but I don't speak OB. And-- -Okay, okay. 359 00:17:16,871 --> 00:17:20,407 Dr. Millin showed me your ultrasound. You need to get checked out right away. 360 00:17:20,542 --> 00:17:21,843 What'd you see? 361 00:17:23,176 --> 00:17:25,780 - Okay, um... - Sorry. 362 00:17:29,383 --> 00:17:30,618 -Do you see this? -Mm-hmm. 363 00:17:30,752 --> 00:17:33,888 We call that "The snowstorm sign." 364 00:17:34,022 --> 00:17:35,055 What does that mean? 365 00:17:35,557 --> 00:17:37,025 It's a molar pregnancy. 366 00:17:37,157 --> 00:17:40,360 A mass of aberrant cells where a fetus would be. 367 00:17:40,494 --> 00:17:42,730 It's rare, but it does happen. 368 00:17:45,098 --> 00:17:46,968 I was never actually pregnant? 369 00:17:48,002 --> 00:17:49,737 Not with a viable pregnancy. 370 00:17:49,871 --> 00:17:53,041 So when I was agonizing over what to do about this baby... 371 00:17:54,742 --> 00:17:55,810 No baby? 372 00:17:55,944 --> 00:17:57,879 No. I'm sorry. 373 00:18:02,349 --> 00:18:03,551 What do we do now? 374 00:18:04,251 --> 00:18:06,654 -May I feel? Okay. -Mm-hmm. 375 00:18:06,788 --> 00:18:12,259 So, the medication that you took, mifepristone, only targets pregnancy. 376 00:18:12,392 --> 00:18:15,128 But you still have trophoblastic tissue in your uterus 377 00:18:15,262 --> 00:18:16,931 and you're getting septic. 378 00:18:19,067 --> 00:18:20,902 Okay. Ready? 379 00:18:22,336 --> 00:18:24,104 If we don't remove it... 380 00:18:24,237 --> 00:18:26,507 I could die. 381 00:18:26,641 --> 00:18:28,743 Luckily, we've caught it early. 382 00:18:29,376 --> 00:18:32,614 I'm gonna call someone from OB to give you a DandC. 383 00:18:32,747 --> 00:18:34,414 Oh, you can't... you can't do it? 384 00:18:36,050 --> 00:18:39,621 I'm not working today, but Dr. Collins is, and she's very good. 385 00:18:39,754 --> 00:18:42,122 Is there any way you can do it? 386 00:18:42,255 --> 00:18:46,094 I don't know, Dr. Collins, but I'm comfortable with you. 387 00:18:50,798 --> 00:18:52,767 Okay. Okay. 388 00:18:54,234 --> 00:18:55,570 I'm gonna change into my scrubs. 389 00:18:56,104 --> 00:18:57,639 -You get her prepped. -Okay. 390 00:18:57,772 --> 00:18:58,873 Thank you. 391 00:19:02,944 --> 00:19:05,479 S-Sorry, it took me a minute to find a warm blanket. 392 00:19:05,613 --> 00:19:07,915 - I missed that day in medical school. - -I appreciate that. 393 00:19:08,049 --> 00:19:10,652 But does this look like a problem? 394 00:19:13,320 --> 00:19:14,555 I need sterile towels. 395 00:19:14,689 --> 00:19:16,024 Page Dr. Webber! 396 00:19:24,498 --> 00:19:27,802 Do you all have a favorite Dolly Parton song? 397 00:19:27,935 --> 00:19:29,336 "Jolene," obviously. 398 00:19:29,469 --> 00:19:30,972 What, you don't think there's other good answers? 399 00:19:31,105 --> 00:19:33,173 It's a perfect song. 400 00:19:33,306 --> 00:19:37,277 Make sure you pull back on the syringe as you get close to the artery. 401 00:19:37,411 --> 00:19:39,346 - What do you see? - Bright red blood. I'm in. 402 00:19:39,479 --> 00:19:44,184 Grab the guide wire at the skin as soon as the needle comes out. 403 00:19:44,317 --> 00:19:45,887 - You don't want to lose it. - Yeah, I know. 404 00:19:46,020 --> 00:19:48,188 This isn't the first time I've accessed a femoral artery. 405 00:19:48,321 --> 00:19:49,757 Just making sure. 406 00:19:49,891 --> 00:19:52,325 - Now nick the skin and place the dilator. - -Yep. 407 00:19:57,932 --> 00:19:58,966 All right. 408 00:20:00,001 --> 00:20:04,271 All right, insert the sheath. Make sure not to advance too aggressively. 409 00:20:04,404 --> 00:20:06,339 - Do you want to do it? - Keep going. 410 00:20:06,473 --> 00:20:08,976 Some might say "9 to 5" is a pretty perfect song too. 411 00:20:09,110 --> 00:20:11,679 Isn't that from a movie where they kill their overbearing boss? 412 00:20:11,813 --> 00:20:13,313 Huh. Imagine that. 413 00:20:15,382 --> 00:20:17,284 All right. You think you wanna be a neurosurgeon? 414 00:20:17,417 --> 00:20:19,087 Let's see how far you can get. 415 00:20:20,054 --> 00:20:23,390 Just follow the femoral artery and take your time. 416 00:20:26,894 --> 00:20:28,096 Fluoro. 417 00:20:31,899 --> 00:20:33,568 These towels weren't warmed. 418 00:20:33,701 --> 00:20:36,938 Your insides are on the outside. The towels are the least of your worries. 419 00:20:37,772 --> 00:20:39,473 Kwan, do I need to remind you 420 00:20:39,607 --> 00:20:42,510 that part of the draw to this floor is that it's quiet? Shut the door. 421 00:20:42,643 --> 00:20:44,011 The nurse said that you were screaming. 422 00:20:44,145 --> 00:20:46,614 He removed his binder and his incision dehisced. 423 00:20:47,280 --> 00:20:48,549 Those things are uncomfortable. 424 00:20:48,683 --> 00:20:50,383 -That's what I said. -I paged Dr. Webber. 425 00:20:50,518 --> 00:20:53,221 Webber's in surgery, so you've got me. Can I see? 426 00:20:54,254 --> 00:20:57,792 Mr. Fazio, you didn't have to go to all this trouble to get my attention. 427 00:20:57,925 --> 00:21:01,028 -Don't make me laugh. -No, really, don't make him laugh. 428 00:21:01,162 --> 00:21:03,598 We're gonna have to get you to the OR. Kwan, prep the patient. 429 00:21:03,731 --> 00:21:06,500 You heard what Webber said. I'm not supposed to operate. 430 00:21:06,634 --> 00:21:09,237 Webber's not here. Get him down there. 431 00:21:14,542 --> 00:21:17,979 Ndugu. Glad I caught up with you. You have a moment? 432 00:21:18,112 --> 00:21:19,514 Uh, actually, I was about to-- 433 00:21:19,647 --> 00:21:23,751 I just heard that you're considering group feedback sessions. 434 00:21:23,885 --> 00:21:28,421 Uh, yeah, my residency director did them and they're, you know, interactive. 435 00:21:28,556 --> 00:21:30,457 I found it useful to learn from peers. 436 00:21:30,591 --> 00:21:32,660 Ah. 437 00:21:32,794 --> 00:21:36,130 'Cause personally, I find that doing things in groups 438 00:21:36,264 --> 00:21:38,533 can be more difficult than doing them individually. 439 00:21:38,666 --> 00:21:40,668 Noted. 440 00:21:40,802 --> 00:21:41,836 To be continued. 441 00:21:42,904 --> 00:21:43,938 Mm-hmm. 442 00:21:52,345 --> 00:21:54,215 Uh, how you doing? You okay? 443 00:21:54,347 --> 00:21:56,651 Just worried about a patient. 444 00:21:58,119 --> 00:22:00,688 -What's going on? -Can we not do this, please? 445 00:22:01,421 --> 00:22:02,990 -Do what? -This. 446 00:22:03,124 --> 00:22:05,193 The thing where I tell you my deepest, darkest feelings, 447 00:22:05,325 --> 00:22:08,162 and then you look at... you look at me like that, like you care, 448 00:22:08,296 --> 00:22:10,064 and then I feel like everything's going to be okay 449 00:22:10,198 --> 00:22:13,301 when in reality everything's a nightmare. 450 00:22:13,433 --> 00:22:15,536 I need this elevator to move faster. 451 00:22:17,972 --> 00:22:19,874 I do care about you-- 452 00:22:20,007 --> 00:22:21,976 Please don't. 453 00:22:26,346 --> 00:22:27,715 I hope your patient's okay. 454 00:22:27,849 --> 00:22:29,116 Me too. 455 00:22:33,654 --> 00:22:34,856 I changed my mind. 456 00:22:34,989 --> 00:22:37,859 My favorite song is "My Tennessee Mountain Home." 457 00:22:38,626 --> 00:22:40,194 Glad you cleared that up. 458 00:22:41,062 --> 00:22:42,530 How's it going? 459 00:22:42,663 --> 00:22:44,497 I'm passing the left internal carotid artery... 460 00:22:44,632 --> 00:22:45,733 - Contrast. - What do you see? 461 00:22:45,867 --> 00:22:48,336 I see the middle cerebral artery. 462 00:22:48,468 --> 00:22:50,671 I don't... I don't think I can make this turn. 463 00:22:51,539 --> 00:22:52,640 What are your options? 464 00:22:52,773 --> 00:22:54,342 Uh, I could keep advancing the coil... 465 00:22:54,474 --> 00:22:56,911 And risk her stroking out if you damage the vessel. 466 00:22:57,044 --> 00:22:58,445 I could use a more rigid catheter. 467 00:22:58,579 --> 00:23:00,915 Congratulations, another stroke. Try again. 468 00:23:05,286 --> 00:23:06,520 Uh... 469 00:23:07,088 --> 00:23:08,289 Dr. Adams? 470 00:23:09,924 --> 00:23:11,893 Okay, I'll take over from here. 471 00:23:14,161 --> 00:23:15,997 Okay, I'm gonna come around 472 00:23:16,130 --> 00:23:20,001 through the anterior communicating vessel 473 00:23:20,134 --> 00:23:24,305 and catheterize the AVM feeder retrograde. 474 00:23:33,848 --> 00:23:36,083 - It's too big. - -Looks like a perfect fit to me. 475 00:23:36,217 --> 00:23:39,153 No, his defect is too big for a dead bone to heal in it. 476 00:23:39,287 --> 00:23:41,188 It might stabilize him for now, 477 00:23:41,322 --> 00:23:44,258 but the chances of failure are too high without a blood supply. 478 00:23:44,392 --> 00:23:46,426 So all form no function. - Yeah. 479 00:23:47,395 --> 00:23:50,631 It's too bad we can't use a fibula. It's got a great blood supply. 480 00:23:50,765 --> 00:23:53,034 - It's Wright's to go-to. - -What if we could use it? 481 00:23:53,167 --> 00:23:55,002 - I thought you said it's too small. - -No, no, what... 482 00:23:55,903 --> 00:23:58,839 What if we take Ken's fibula and we put it inside the femur 483 00:23:58,973 --> 00:24:01,809 to vascularize the graft, throw in a little BMP. 484 00:24:03,577 --> 00:24:05,813 A bone in a bone like an orthopedic turducken. 485 00:24:05,947 --> 00:24:07,248 - Yeah. - Yes. 486 00:24:07,882 --> 00:24:09,216 Warren? 487 00:24:09,350 --> 00:24:12,286 Well, I mean, it's absurd, but it might work. 488 00:24:16,123 --> 00:24:17,425 Okay. 489 00:24:28,502 --> 00:24:30,671 -Hey, is she ready? -Uh, yeah. 490 00:24:30,805 --> 00:24:32,440 Um, I'm just gonna make a call. 491 00:24:32,573 --> 00:24:35,910 Can you have, um, anesthesia give a second dose of antibiotics, please? 492 00:24:36,043 --> 00:24:37,078 Sure. 493 00:24:40,915 --> 00:24:43,951 Hi, you've reached Atticus Lincoln. Leave a message. Thanks. 494 00:24:49,090 --> 00:24:51,491 Okay, how can I help you? 495 00:24:51,625 --> 00:24:54,295 Do you want to talk about it or... 496 00:24:54,962 --> 00:24:56,831 -do you want me to distract you? -Distract me. 497 00:24:56,964 --> 00:24:58,032 Okay. 498 00:25:00,634 --> 00:25:02,470 Okay, this is a good one. 499 00:25:02,603 --> 00:25:06,440 I looked into all of the cardiothoracic research programs, 500 00:25:06,574 --> 00:25:11,579 and the one that gives me the best chance of getting a top fellowship is Ndugu's. 501 00:25:11,712 --> 00:25:14,148 What about the dogs? - I was lying to myself. 502 00:25:14,281 --> 00:25:15,316 I'm a cat person. 503 00:25:15,883 --> 00:25:18,352 Simone, how are you feeling? 504 00:25:18,486 --> 00:25:19,653 The morphine's helping. 505 00:25:19,787 --> 00:25:21,389 Okay, it'll be over soon. 506 00:25:21,522 --> 00:25:23,891 Okay, let's have two units of blood ready. 507 00:25:25,259 --> 00:25:26,861 It's just a precaution. 508 00:25:28,162 --> 00:25:31,365 It's been a while since my med school OB rotation. 509 00:25:31,499 --> 00:25:33,601 What are the chances of uterine perforation? 510 00:25:33,734 --> 00:25:36,337 Low. Less than 1%. 511 00:25:36,470 --> 00:25:38,539 Molar pregnancy can increase risk slightly, 512 00:25:38,672 --> 00:25:40,509 but overall, it's very safe. 513 00:25:40,641 --> 00:25:43,911 -And you've done a lot of these? -Tons. I'm not worried. 514 00:25:46,515 --> 00:25:49,016 Hmm. Okay. 515 00:25:49,150 --> 00:25:51,085 If you're ready, we'll start sedation. 516 00:26:02,229 --> 00:26:04,698 No, take it off! Take it off! I'm sorry. I can't. I can't do this. 517 00:26:04,832 --> 00:26:07,001 Please don't make me do this. I can't do it. Please don't make me do it. 518 00:26:07,134 --> 00:26:10,404 Please, I can't, I can't. I can't do it. 519 00:26:10,539 --> 00:26:12,541 -Okay. Okay. -I can't, I can't. 520 00:26:13,240 --> 00:26:15,643 I can't do it. 521 00:26:20,081 --> 00:26:21,949 Femur's ready for the fibular graft. 522 00:26:26,521 --> 00:26:27,788 Can I get a brow wipe? 523 00:26:32,426 --> 00:26:33,828 Okay. Take two. 524 00:26:38,165 --> 00:26:40,701 Perfect alignment. - You did it. 525 00:26:40,835 --> 00:26:41,869 It's not over yet. 526 00:26:42,603 --> 00:26:45,940 Let's secure the spine, and then we can begin the anastomosis. 527 00:26:57,017 --> 00:26:58,052 You know you want to. 528 00:27:05,626 --> 00:27:07,529 - Lawyer. - Lawyer. 529 00:27:07,661 --> 00:27:09,997 All right, fascia looks good. 530 00:27:10,731 --> 00:27:15,269 Kwan, how about you help me dissect the lateral plane. 531 00:27:16,036 --> 00:27:17,304 Well, I probably shouldn't. 532 00:27:17,438 --> 00:27:18,672 Are you still worried about Webber? 533 00:27:18,806 --> 00:27:20,107 Yeah, he's the chief of the whole system. 534 00:27:20,241 --> 00:27:22,042 Yeah, because he's married to it. 535 00:27:22,176 --> 00:27:25,279 This morning you said you wanted to cut. Are you a surgical resident or not? 536 00:27:27,314 --> 00:27:28,682 Bovie. 537 00:27:32,653 --> 00:27:35,890 All right, release the external oblique above the fascia. That's it. 538 00:27:36,525 --> 00:27:37,725 That's right. 539 00:27:37,858 --> 00:27:39,628 What the hell is going on? 540 00:27:39,760 --> 00:27:44,098 Kwan, I told you no surgeries. Put that bovie down now. 541 00:27:44,231 --> 00:27:45,933 Dr. Norton. I thought I made myself clear. 542 00:27:46,066 --> 00:27:48,537 My resident has been out of commission for more than a month. 543 00:27:48,669 --> 00:27:50,905 He needs time to work his way back into the OR. 544 00:27:51,038 --> 00:27:53,908 Dr. Kwan was there when your VIP patient's bowel eviscerated. 545 00:27:54,041 --> 00:27:56,877 He called for help and applied pressure to keep it from further eviscerating 546 00:27:57,011 --> 00:27:59,813 while you were occupied elsewhere. I'd say he has worked his way back. 547 00:27:59,947 --> 00:28:03,317 And by the way, he's doing an adequate job with this sublay placement, 548 00:28:03,450 --> 00:28:06,053 which is about as good of a compliment as a resident gets from me. 549 00:28:06,187 --> 00:28:08,189 I'll take over from here. - Won't be necessary. 550 00:28:08,322 --> 00:28:10,391 - I'm about ready to close. - -I see my patients through. 551 00:28:10,525 --> 00:28:11,626 You can step out. 552 00:28:17,865 --> 00:28:19,500 Uh, do you still need me to-- 553 00:28:19,634 --> 00:28:22,203 Which residents are on general today? 554 00:28:22,336 --> 00:28:23,871 Baxter, Ford, Goodwin-- 555 00:28:24,004 --> 00:28:25,540 Page Baxter on your way out. 556 00:28:35,883 --> 00:28:39,086 -Oh, Dr. Ndugu. Dr. Ndugu? -Yes? 557 00:28:39,220 --> 00:28:42,657 Yeah, so I was looking at the residency portal, and I-- 558 00:28:42,790 --> 00:28:45,560 Okay, if this is about me doing away with resident office hours, 559 00:28:45,694 --> 00:28:47,562 -let me stop you right now. -I... 560 00:28:47,696 --> 00:28:50,764 I will meet with them by appointment, but I don't have time to sit in my office, 561 00:28:50,898 --> 00:28:55,869 because in addition to doing my own job, I'm covering for Altman, Hunt, and you. 562 00:28:56,937 --> 00:29:00,741 You, you have no idea how much this favor I'm doing for you has cost me. 563 00:29:00,874 --> 00:29:03,377 So if you take issue with how I'm doing things, 564 00:29:03,511 --> 00:29:05,045 find someone else to do them. 565 00:29:06,880 --> 00:29:08,617 Did you have something to tell me? 566 00:29:09,517 --> 00:29:12,286 No, I... ... I was... 567 00:29:13,688 --> 00:29:14,723 Carry on. 568 00:29:18,693 --> 00:29:20,894 - I can't do it. - -Okay, just look at me. 569 00:29:21,028 --> 00:29:25,432 - All right? I got you. - I got you, okay? 570 00:29:25,567 --> 00:29:28,235 I know what it's like to be the doctor on the table. 571 00:29:29,336 --> 00:29:30,572 You know too much. 572 00:29:30,705 --> 00:29:33,040 It's impossible to let go, but I need you to try 573 00:29:33,173 --> 00:29:35,776 so that I can be in control and you can go to sleep. 574 00:29:35,909 --> 00:29:37,077 But what if I don't wake up? 575 00:29:37,211 --> 00:29:38,979 What if there's a complication? 576 00:29:39,113 --> 00:29:41,282 If there is one, I'll know how to fix it, 577 00:29:41,415 --> 00:29:44,251 and if I need help, my colleagues are right outside. 578 00:29:50,625 --> 00:29:51,792 Okay. 579 00:29:52,459 --> 00:29:53,961 -Okay? -Okay. 580 00:29:58,132 --> 00:29:59,300 Okay. 581 00:30:12,479 --> 00:30:14,516 -No, I can't, sorry. -Okay. 582 00:30:14,649 --> 00:30:15,650 Okay. 583 00:30:15,784 --> 00:30:16,917 I'm sorry. 584 00:30:17,051 --> 00:30:18,520 - I can't. - Okay. 585 00:30:20,789 --> 00:30:23,290 Simone, you need this procedure. 586 00:30:23,424 --> 00:30:25,125 I can't. I can't. 587 00:30:26,528 --> 00:30:29,830 Okay. What if I did it without general anesthesia? 588 00:30:29,963 --> 00:30:31,865 Does that make any difference to you? 589 00:30:33,467 --> 00:30:35,503 -I'd be awake? -Is that safe? 590 00:30:35,637 --> 00:30:38,506 It's usually more comfortable for patients if they're asleep, 591 00:30:38,640 --> 00:30:42,009 but we could use a local nerve block if that's what you want. 592 00:30:42,142 --> 00:30:45,079 You'll be awake and know what's happening the entire time. 593 00:30:46,914 --> 00:30:48,482 And I'll be with you the whole time. 594 00:30:50,351 --> 00:30:52,520 -Yeah. -Yeah? 595 00:30:52,654 --> 00:30:54,288 Yeah. Yeah, I want that. 596 00:30:54,421 --> 00:30:55,824 Okay. 597 00:30:56,890 --> 00:30:58,593 All right, everyone, change of plans. 598 00:30:58,727 --> 00:31:00,494 We're going to do a paracervical block. 599 00:31:00,628 --> 00:31:03,497 I need 20 cc's of 1% lidocaine. 600 00:31:03,631 --> 00:31:05,399 -I'm gonna go scrub. -Thank you. 601 00:31:05,999 --> 00:31:07,334 Okay. 602 00:31:10,505 --> 00:31:11,905 -All right. -Okay. 603 00:31:12,039 --> 00:31:13,240 You'll be awake the whole time. 604 00:31:16,343 --> 00:31:19,480 The torquer's tricky. Don't beat yourself up. 605 00:31:19,614 --> 00:31:21,215 You set me up to fail. 606 00:31:22,182 --> 00:31:24,084 Well, I gave you an opportunity to try. 607 00:31:24,218 --> 00:31:25,352 Is that how you see it? 608 00:31:25,486 --> 00:31:27,054 You're a resident. 609 00:31:27,187 --> 00:31:29,923 I didn't expect you to get it right on your first try. 610 00:31:30,057 --> 00:31:32,627 Yeah, you don't seem to expect me to do anything right, ever. 611 00:31:33,394 --> 00:31:35,730 That's not true. I think you're very talented. 612 00:31:35,864 --> 00:31:38,533 Yeah, but you don't think I have what it takes to clean up my crap, 613 00:31:38,666 --> 00:31:41,870 or-or answer your kid's questions, or do my job, or be a neurosurgeon. 614 00:31:42,002 --> 00:31:45,406 I didn't say that. The people who have what it takes to pursue neuro 615 00:31:45,540 --> 00:31:48,409 don't keep their options open. They zero in. 616 00:31:48,543 --> 00:31:50,612 They think about it every minute of the day. 617 00:31:50,745 --> 00:31:52,547 Derek did. I did. You're not-- 618 00:31:52,680 --> 00:31:55,215 Because I'm not you. Or him. 619 00:31:55,349 --> 00:31:57,619 And maybe I don't want to be, okay? 620 00:31:58,686 --> 00:32:03,323 My way isn't wrong or defective just because it's different from yours. 621 00:32:04,925 --> 00:32:07,428 You know, for someone who claims she was an underdog growing up, 622 00:32:07,562 --> 00:32:09,396 you sure like to tear people down. 623 00:32:18,573 --> 00:32:19,874 It could be the drugs, 624 00:32:20,007 --> 00:32:22,544 but it sounded like you said the cancer has spread, 625 00:32:22,677 --> 00:32:24,779 so I have a leg bone in my spine. 626 00:32:24,913 --> 00:32:28,182 We removed all the cancer, but, um... 627 00:32:28,315 --> 00:32:29,950 Well, yeah, that's basically what happened. 628 00:32:30,083 --> 00:32:33,521 I'm still here, so, thank you. 629 00:32:33,655 --> 00:32:35,189 I placed an order for physical therapy. 630 00:32:35,322 --> 00:32:37,224 Now it'll take some time and a lot of work, 631 00:32:37,357 --> 00:32:38,893 but you should be able to walk again. 632 00:32:39,026 --> 00:32:40,762 And we'll monitor you for a couple more days 633 00:32:40,895 --> 00:32:42,095 and keep a close eye on the pain, 634 00:32:42,229 --> 00:32:44,465 and then you can get back to saving the world. 635 00:32:44,599 --> 00:32:46,534 Is there anyone else that we should be speaking with? 636 00:32:46,668 --> 00:32:48,670 No. Just me's fine. 637 00:32:52,406 --> 00:32:55,442 -You came back? -I never left. 638 00:32:55,577 --> 00:32:58,178 I know you. You lash out when you're scared. 639 00:32:58,312 --> 00:33:02,115 I forget you're doing it every time until I remember. 640 00:33:03,283 --> 00:33:05,352 King of the jungle to help you with your strength. 641 00:33:07,287 --> 00:33:08,656 You know I'm allergic to cats? 642 00:33:08,790 --> 00:33:11,325 Just take the dumb stuffed animal and say thank you. 643 00:33:11,458 --> 00:33:13,661 We--We'll give you some privacy. 644 00:33:13,795 --> 00:33:15,128 -Yeah. -Uh, thanks. 645 00:33:15,262 --> 00:33:16,664 -What am I supposed to do? -Can't you just say thank you? 646 00:33:16,798 --> 00:33:18,499 -Is it that hard? Just, "Thank you." -Come on. 647 00:33:18,633 --> 00:33:21,335 How does clean water come from such a toxic relationship? 648 00:33:21,468 --> 00:33:23,638 No one knows how other people's relationships work. 649 00:33:23,771 --> 00:33:25,507 -True, true. -Okay. 650 00:33:25,640 --> 00:33:28,543 I've got to go handle something, but, uh, I'll check on him in an hour or so. 651 00:33:28,676 --> 00:33:29,711 Yeah. 652 00:33:31,646 --> 00:33:32,580 It's a big win today. 653 00:33:32,714 --> 00:33:34,248 We got lucky. 654 00:33:34,381 --> 00:33:36,483 I should have scanned Ken yesterday. 655 00:33:36,618 --> 00:33:37,919 I was stupid and careless. 656 00:33:38,051 --> 00:33:40,354 You still found a solution. 657 00:33:40,487 --> 00:33:42,122 You know, let's, uh, let's grab a beer at Joe's. 658 00:33:44,526 --> 00:33:47,529 Uh, no. I got to catch up on some charts. 659 00:33:50,632 --> 00:33:53,066 How long till I can get back on stage? 660 00:33:53,200 --> 00:33:55,202 Oh, it'll be a few weeks. I'm sorry. 661 00:33:55,335 --> 00:33:58,573 It'll give me time to work on my act. Always room for improvement. 662 00:33:58,706 --> 00:33:59,908 How do you work on your act? 663 00:34:00,040 --> 00:34:02,877 Do you have to perfect all of Dolly's mannerisms? 664 00:34:03,011 --> 00:34:06,548 I did at first, but the reviews were terrible. 665 00:34:06,681 --> 00:34:11,051 Then finally, I realized audiences think they want a good mimic 666 00:34:11,184 --> 00:34:13,487 but what they really want is a good character. 667 00:34:13,621 --> 00:34:15,255 And that comes from me, 668 00:34:15,389 --> 00:34:18,225 knowing who I am and what I bring to the stage. 669 00:34:18,860 --> 00:34:19,994 What do you bring? 670 00:34:20,127 --> 00:34:23,196 I'm a kindergarten teacher with roots, a mom, 671 00:34:23,330 --> 00:34:27,301 I volunteer at the food bank, and I've got killer gams. 672 00:34:27,434 --> 00:34:30,404 When you are recovered, I would love to come and see you perform. 673 00:34:30,538 --> 00:34:34,074 Now Dr. Adams is gonna to be in shortly to take your post-op labs. 674 00:34:36,511 --> 00:34:38,012 You did great. 675 00:34:38,145 --> 00:34:42,050 We completely evacuated the molar pregnancy with minimal bleeding. 676 00:34:42,182 --> 00:34:43,350 Think I can go home soon? 677 00:34:43,483 --> 00:34:45,753 Well, they are going to monitor you overnight, 678 00:34:45,887 --> 00:34:47,922 but you should be discharged in the morning. 679 00:34:48,056 --> 00:34:51,291 And I gave them strict instructions, no unwanted guests. 680 00:34:51,425 --> 00:34:52,459 Thank you. 681 00:34:53,061 --> 00:34:55,930 And thanks for letting me stay awake. 682 00:34:56,064 --> 00:34:59,601 It meant... it meant more than you know. 683 00:35:00,200 --> 00:35:03,972 My mom had a complication here years ago. 684 00:35:04,572 --> 00:35:05,607 I just... 685 00:35:06,239 --> 00:35:09,043 just needed to know what was happening to me. 686 00:35:09,911 --> 00:35:11,079 I get it. 687 00:35:13,213 --> 00:35:15,083 I'm glad it all worked out. 688 00:35:15,215 --> 00:35:16,718 - Get some rest. - Yeah. 689 00:35:31,131 --> 00:35:33,868 Sorry you didn't get to see the surgery through. 690 00:35:34,002 --> 00:35:35,837 -I tried. -It's okay. 691 00:35:35,970 --> 00:35:38,673 -His JP output looks good though. -Ah, that's what matters. 692 00:35:39,272 --> 00:35:41,075 Hey, help me with this, will you? 693 00:35:42,275 --> 00:35:44,746 -You know he can't tell that it's warm. -He's VIP. 694 00:35:44,879 --> 00:35:48,448 He gets what he wants even when he's asleep. 695 00:35:48,583 --> 00:35:50,685 - Sounds like one of his ads. - -I'll pitch it to him. 696 00:35:50,818 --> 00:35:54,055 You think he'd be more successful if he spent more time on his cases 697 00:35:54,187 --> 00:35:55,990 and less time filming commercials? 698 00:35:56,124 --> 00:35:57,491 You don't think he's successful? 699 00:35:58,291 --> 00:36:02,030 The guy owns a ginormous house in Laurelhurst, plus two boats. 700 00:36:02,162 --> 00:36:07,869 He may be a tacky ambulance chaser with an annoyingly catchy ad, 701 00:36:08,002 --> 00:36:11,271 but he doesn't take a dime unless his client wins. 702 00:36:11,939 --> 00:36:15,208 You know, say what you will about his tactics but he fights for them. 703 00:36:16,176 --> 00:36:17,879 And gets them what they want. 704 00:36:25,385 --> 00:36:28,556 Dr. Berse, it's Atticus Lincoln. 705 00:36:30,024 --> 00:36:32,026 Well, I'm, uh... 706 00:36:32,160 --> 00:36:35,029 I'm having some pain again and, uh... 707 00:36:35,163 --> 00:36:37,732 Yeah, I'm trying to push through, but, uh... 708 00:36:40,168 --> 00:36:41,536 Could you... 709 00:36:42,036 --> 00:36:43,403 call in a refill? 710 00:36:47,141 --> 00:36:48,509 Hey, Lucas. 711 00:36:49,309 --> 00:36:50,578 Stop. 712 00:36:50,712 --> 00:36:53,014 Just stop walking. 713 00:36:55,049 --> 00:36:56,551 You're not a failure. 714 00:36:57,085 --> 00:36:58,553 Is that an apology? 715 00:36:59,687 --> 00:37:01,388 I was the underdog in my family. 716 00:37:03,423 --> 00:37:04,692 What am I saying? 717 00:37:05,660 --> 00:37:08,261 I don't have to tell you that, you know the stories. 718 00:37:08,863 --> 00:37:11,331 But now I am an accomplished surgeon. 719 00:37:11,999 --> 00:37:15,937 And your mom and your aunts still treat me like I can't get anything right. 720 00:37:16,070 --> 00:37:17,205 You don't deserve that. 721 00:37:17,739 --> 00:37:21,175 It is true. You don't do things the way I would. 722 00:37:21,308 --> 00:37:24,879 But that doesn't mean you wouldn't make an excellent neurosurgeon. 723 00:37:26,914 --> 00:37:29,083 I want to help you find your path. 724 00:37:29,884 --> 00:37:31,719 Even if it doesn't end up being mine. 725 00:37:31,853 --> 00:37:33,654 So come work in my lab. 726 00:37:34,522 --> 00:37:37,959 I will be more open-minded, I promise. 727 00:37:40,895 --> 00:37:43,030 -I'll think about it. -Okay. 728 00:37:43,998 --> 00:37:45,465 And I'm moving out. 729 00:37:47,001 --> 00:37:48,268 It's time. 730 00:38:02,617 --> 00:38:04,317 Dr. Webber. 731 00:38:04,451 --> 00:38:07,121 Look, if you're here to make excuses about what happened, don't bother. 732 00:38:07,255 --> 00:38:09,123 I wasn't planning to. 733 00:38:09,257 --> 00:38:12,660 I thought I made myself clear about my expectations for you today. 734 00:38:12,794 --> 00:38:15,428 -Yeah, you definitely did. -Good. You're dismissed for the day. 735 00:38:20,067 --> 00:38:22,737 Kwan, I just said you could go. 736 00:38:23,370 --> 00:38:26,240 -I know, but the Chief said that-- -The Chief... 737 00:38:27,008 --> 00:38:29,476 -The Chief? -Chief Norton. 738 00:38:29,610 --> 00:38:32,847 He said that I could scrub in on his latissimus flap tomorrow 739 00:38:32,980 --> 00:38:35,683 and to put my name under his. 740 00:38:45,293 --> 00:38:47,028 Good night, Dr. Webber. 741 00:39:00,608 --> 00:39:01,642 Hi. 742 00:39:02,442 --> 00:39:03,476 Hi. 743 00:39:04,712 --> 00:39:07,248 - Everything go okay with your patient? - -Yeah. 744 00:39:08,015 --> 00:39:09,050 She's doing fine. 745 00:39:11,986 --> 00:39:13,486 Good. I'm glad to hear it. 746 00:39:13,621 --> 00:39:15,857 Our lives are full of mysteries. 747 00:39:16,624 --> 00:39:20,493 You could round a corner and meet your soul mate or your death. 748 00:39:21,629 --> 00:39:23,831 - I'm home. - How'd it go? 749 00:39:23,965 --> 00:39:26,667 Well, the paper is done. 750 00:39:26,801 --> 00:39:28,870 Plus, I got a reminder of what it's like 751 00:39:29,003 --> 00:39:32,340 to cram five people into a studio apartment. 752 00:39:32,472 --> 00:39:34,542 -Did you at least get some cheap pizza? -You know, I did. 753 00:39:37,078 --> 00:39:39,881 And I'm sorry about this morning. 754 00:39:40,014 --> 00:39:44,185 You have taken on more around here to help me, 755 00:39:44,318 --> 00:39:48,222 and I micromanaged the way you were doing it. 756 00:39:48,356 --> 00:39:51,325 - Whoa. - I just... Stop. No, look, 757 00:39:51,458 --> 00:39:56,330 oh, just going back to school is making me feel like I don't know what I'm doing. 758 00:39:57,397 --> 00:40:00,101 You know, viral disease trends, 759 00:40:00,234 --> 00:40:03,604 descriptive epidemiology, like everyone's speaking another language. 760 00:40:03,738 --> 00:40:06,274 I'm just racing to catch up. 761 00:40:06,406 --> 00:40:11,478 I think I just wanted to feel like I was an expert at something. 762 00:40:12,513 --> 00:40:14,782 When I should have just said thank you. 763 00:40:16,550 --> 00:40:17,518 You're welcome. 764 00:40:17,652 --> 00:40:19,687 Mmm. 765 00:40:20,821 --> 00:40:22,924 And I got something for you. 766 00:40:23,057 --> 00:40:24,358 -For me? -Mm-hmm. 767 00:40:27,228 --> 00:40:28,763 Bam. 768 00:40:28,896 --> 00:40:31,232 No children were involved in the loading of this dishwasher. 769 00:40:31,365 --> 00:40:32,800 Well then, how did you know-- 770 00:40:32,934 --> 00:40:35,937 Because I am an expert in you, Miranda Bailey. 771 00:40:36,070 --> 00:40:39,073 Expert in me. 772 00:40:39,607 --> 00:40:42,009 There's no way to predict what's waiting around the bend. 773 00:40:46,914 --> 00:40:48,481 Your meeting ran late? 774 00:40:51,953 --> 00:40:53,587 The meeting never happened. 775 00:40:54,522 --> 00:40:58,559 I got pulled into a DandC that was more complicated than expected. 776 00:40:59,427 --> 00:41:01,062 -Are you okay? -No. 777 00:41:02,430 --> 00:41:06,000 I'm sorry. You never should have gone into that meeting. 778 00:41:06,133 --> 00:41:09,203 -You wouldn't have gotten pulled in-- -No, it's not that. I'm just... 779 00:41:10,638 --> 00:41:12,606 I'm really good at this. 780 00:41:13,341 --> 00:41:15,643 I'm extremely skilled at these procedures. 781 00:41:15,776 --> 00:41:19,013 I listen to my patients, I treat their heartbreak and their pain. 782 00:41:19,146 --> 00:41:22,016 And this field needs every doctor that they can get and I love it. 783 00:41:22,149 --> 00:41:25,987 I really love what I do, but I can't practice medicine anymore 784 00:41:26,120 --> 00:41:28,789 without reliving something that almost killed me. 785 00:41:29,957 --> 00:41:33,461 -Do you think it'll get better with time? -I don't know. 786 00:41:38,833 --> 00:41:40,468 I just want to go home. 787 00:41:42,103 --> 00:41:43,804 Yeah, let's get out of here. 788 00:41:47,508 --> 00:41:50,344 All you can do is put one foot in front of the other 789 00:41:51,112 --> 00:41:52,813 and lean on what supports you. 790 00:42:09,063 --> 00:42:11,065 And trust it's there... 791 00:42:14,168 --> 00:42:16,203 even when you can't see it.