All language subtitles for The.Resident.S04E11.720p.WEB.H264-CAKES

Previously on The Resident...

My entire life,
I've wanted

to be a surgeon,
despite knowing

- I have one big obstacle to overcome.
- You're dyslexic.

Tina's baby will go
to a traditional family.

I'm so sorry.

I don't know
what's going on with you,

but I'm gonna go to Waylon's.

Big world outside of the OR.

If you want to see it,
that's where I'll be.

I'd like that.

Your mother has lung cancer.

You cannot come
to Nigeria

with me.

- You are my sister.
- And you are mine.

I wish things
didn't have to be this way.

I wish I didn't have
to leave Chastain.

The National
Weather Service has issued a tornado watch

for Fulton County...

I think Fritz got a little wet,

but otherwise we are all okay.

Good. Here.

Thank you.

Hi, buddy.

- Hey, buddy.
- Hey, little wet? That's okay.

Look at you getting all wet.

Hey... how about you don't
go into work today?

Fritz needs you.

Well, the tornado's not supposed
to touch down

anywhere near us.

Anyway, we're just as safe
at Chastain as we are here.

Yeah, I was just thinking,

with all of your extra shifts,
it's been a while since

I've seen you stand still.

Got to keep busy,
otherwise all I think about

are all of the ways in which
we could have kept Mina here.

We did everything we could.

Doesn't feel like it.

What's that?

It's from Mina.

She told me to give it to you
if you started...

- Spinning out?
- No. Yeah.

Very funny.

"Dear Nic...

"Please stop doing that thing
you do when you feel guilty

"where you can't sit still.

"I know you need permission
to let things go, so here,

"unclench your fist,
let it go.

Last thing I want is to be an
anchor around your neck. Mina."

She knows you almost as well
as I do.

We better get going.

Bye, guys.

The tornado has changed course

and is now just outside
metro Atlanta.

We're expecting a mass increase
of catastrophic injuries.

Pull out the disaster carts.

Prepare the portable monitors.

- Clear the hallways.
- Let's move, people!

We have incoming.

Hey, Piper, Wes,
let's take her to Bay Four.

Seven-year-old girl,
severe abdominal pain,

nausea, vomiting.

Slightly hypertensive. 400cc's
normal saline given en route.

We wouldn't have brought her in
because of the tornado,

but she collapsed;
We didn't know what to do.

Uh, Dr. Bell is our doctor.

- We left him a message.
- I can let him know you're here.

- Thank you.
- On my count.

One, two, three.

Hey, I'm Dr. Feldman.

I'm gonna listen to
your heart and lungs, okay?

- Hi. - Hey.
- Hey.

What's going on, Sammie?

Ni hao, Dr. Bell.

It's her stomach pain.
It's never been this bad.

And she's been having
constant nosebleeds

these past few days.

Is it the tumors?
Do you think they're getting worse?

Maybe, but we'll admit her

and look into why
this is happening.

Sammie has a history
of abdominal cancer.

The Ackermanns recently
adopted her from China.

So let's finish the exam
and I'll get a hold of Dr. Wong

for an urgent ENT consult.

Problems with parking?

So far so good.

Please have a seat, Dr. Cain.

Dr. Sutton is your
new resident.

No, she isn't.
I work alone.

It's my call.
You've had residents before.

Yes, and they almost
killed me on the table.

Now you want me
to mentor someone

who's gunning for my job.
No, thank you.

There's a lot I can learn
from you.

I'm not looking
to take your job.

Either you're lying
or you lack ambition.

Either way, pass.

I haven't had a good
run with attendings either.

They seem hellbent
on ending my career.

Is this you selling yourself?

This is me being truthful.
It's how I roll.

Make it work.

Both of you.

Oh, God.

It's a tornado.

It's coming right at us.

Code Yellow.
Please seek immediate shelter.

Sir, we need to go.

What's going on?

Leela, we have to go.
We're in the path of a tornado.

I know, I know.

I'm just trying
to get him to come down.

Just gotta finish one thing.

Get down!

Everyone move quickly and
safely, everyone take cover!

Come on, come on, hurry!

Everyone take cover, take cover!

- Safely and quickly, please.
- Come on. Com e on.

- Let's go, let's go, let's go!
- Are you sure everyone's okay?

- Here, take these.
- Here.

- Here we go.
- Take these.

- Get away from the glass.
- Get away from the glass!

- Come on, hurry!
- Check everyone's okay

- in that direction. Thank you.
- Get in the corner.

This way. Go this way.

Thank you.

Get away from the glass!

Get away from the glass!

Hey, hey, hey! Guys, hey!

- Got to get away from there.
- Get away from the glass!

Get away from the glass!

The Resident
[04x11]

- You all right?
- Yeah.

- You okay?
- I'm good.

Hang on. Okay...

Okay, I'm gonna need you
to stay really still, okay?

Cervical spine's exposed.

All right, I'm gonna

switch you out.
You're gonna be fine.

All right, I'm gonna need you
to stay really still, okay?

Mary Ann,

- can you give us a hand?
- I'll take his feet.

Okay.

- Ready?
- Yep.

All right.

We should take a look at those.

Later. It's not that bad.

Are you guys okay?

We have an open spinal injury
over here.

Let's get this boy to the OR.

I'll call and let them know
you're coming.

- Stay really still, okay?
- Thank you.

- These guys are gonna take care of you.
- Yeah.

- It's like a war zone down here.
- Is everyone safe?

How's the rest of the hospital?

Still assessing, but it seems
like most of the medicine

and surgery floors
were left unharmed.

Let's triage the red critical
patients to the PACU.

Yellows to the atrium,
greens to the cafeteria.

We're gonna need more hands.

Hey. You okay?

I think so. Are you?

Yeah. We got lucky.

Where's the guy that was
working on the lights?

He was right behind us.

- Wait.
- Oh, my God.

- Headache...
- Okay.

- Can you tell me your name?
- Ted.

Okay, Ted, listen to me

and just take it easy, okay?

You have a metal rod
lodged in your skull,

so I need to gently
elevate your head.

We need to elevate his head.

Okay, right here. Here.

All right. Ready?

One, two...

- Okay.
- There we go.

All right, Ted, look at me.
Good, good, good.

Deep breath.

Damn. He needs surgery.

We need to get him
out of here.

We're gonna get you out of here.

Damn it.

We're trapped.

No one even knows we're here.

Conrad, Nic.

The ambulance bay roof
collapsed.

I was out for a beat,
but Piper's hurt real bad.

Her leg is trapped under
the wall; I couldn't free her.

- Piper, I got help.
- This isn't good.

Hey, Wes, we need a tourniquet,
an IV kit and some fluids.

All right?

Weak radial pulse.

- Anything else hurt?
- Just my leg.

She's going
into hemorrhagic shock.

She can't afford to lose
any more blood.

- Tourniquet.
- You are gonna be fine.

Worst-case scenario,
you get some well-deserved

time off with pay.

Wes can find the upside
to anything.

It's nauseating.

I could use a little time
away from you, Pollyanna.

I mean, you guys
have been working together

for about a decade now.

Tourniquet's on,
but it's not stopping the bleed.

We've done
everything we can out here.

We need to get her inside.

Wes, give me a hand?

Help me get this thing
off of her.

Damn it, the cell service
is still down.

He's having a seizure.

We need Cain or he's gonna die.

Damn it.

We should reduce the fracture.

That might buy us
some more time.

- Wes, you ready?
- You are now officially

the most needy patient
I've ever had.

Mm. Last thing
I wanted to do is die needy.

Not gonna happen, Pipe.

All right, you ready?

Okay. One,

two...

It's better,
but she's losing a lot of blood.

Guys, I don't feel so good.

We lost the pulse.

Grab the defibrillator.

Starting compressions.

We have to amputate
her leg before she bleeds out.

Wes, have someone page Dr. Voss.

We need her now.

Damage could've been much worse.

Guess only one side
of the hospital got hit.

Tell me about the patient.

I got a ridiculous consult
about a woman with sickle cell

who's here for myeloablative
chemo prior to gene therapy.

Rose Williams?

Yeah. How do you know her?

- What happened?
- She fell and bonked her head.

I told them maybe don't call

unless there's an actual
neurosurgical problem, but...

No. We'll see her.

Dr. Ward,
please come to admitting

for a new patient assessment.

Rose.

This is Dr. Sutton, my resident.

Tell us what happened.

Oh, it's so stupid.

I fell in the bathroom
and hit my head.

I'm sure I'm fine.

Okay, well, we'll just see.

Full power's back on.

I see you started chemo.

Yeah. They're blasting my marrow

and preparing me
for gene therapy.

I knew it'd be tough, but...

...this is really doing
a number on me.

Well, if anyone
can handle it, it's you.

Pupils are equal,
round and reactive.

Can you follow my finger?

I haven't seen you
since Waylon's.

Yeah, I'm sorry, I've just been,
been really busy.

Listen, given the effects
that the chemo

is having on your bone marrow,
I want to get you a head CT.

Dr. Sutton can finish the exam.

- Squeeze my fingers, please?
- Uh...

So, Sammie's nose just started
bleeding on its own?

Yeah, apparently,
it's been happening

- like this a lot lately.
- Okay, just...

All right, just let me know
if this hurts, okay?

Oh, I'm sorry, she might
not have understood you.

We've only had her six months,
and, uh, she hasn't really

picked up English
as quickly as we'd hoped.

It's a big adjustment.

Um, what happened
to her biological parents?

We didn't ask.

Well, they didn't tell us.

We were just so thrilled
there was a healthy little girl

waiting for us, and...

the first moment we met her,

- we fell in love with her.
- She passed out

a couple of days
after we got her home.

We took her to the ER
and found out

she had tumors
everywhere in her body.

They told us to take
her home, make her comfortable

- for her last few months.
- That's when we found Dr. Bell,

and he said he could treat her.

Well, I said

I might be able to perform
a very risky surgery

that's only been done
a few times before.

There's, uh, t-there's a lot
we need to go over

- before we proceed.
- Yeah, uh,

this is more than just
an ordinary nosebleed.

- Yeah, I thought so.
- Sammie? - Oh, my God.

- Sammie, baby, are you okay?
- You okay?

It's a bit cramped.

I've amputated limbs

- under worse circumstances.
- All right.

Please, save her.

We're gonna do
everything we can.

Saline.

One, two, three.
Let's go. Yep, yep.

Code Yellow. All visitors,

remain in the hospital.

Do not attempt to leave
the hospital.

Dude, sorry about Mina.

Must be rough.

How you holding up?

On the bright side,
maybe we can go get

that drink we were talking
about getting, you know?

Do some sharing.

Go on about your business,
Nolan.

Yep... That thing? Okay.

Yeah, I feel you, man.
I have had it up to here

with the sad looks
from people

about losing the baby
we were gonna adopt.

I loathe pity.

- Yeah, me, too.
- Look, I'm thinking

you can both
use a distraction.

This is imaging of my
seven-year-old patient Sammie.

Tumor in the pancreas
wrapped around the stomach,

liver, spleen,
large and small intestines.

This is inoperable.

It's an inflammatory
myofibroblastic tumor.

It's a death sentence.

Unless we can tag you in.

Are you talking
auto-transplantation?

Pioneered by
the legendary Dr. Kato

at Columbia Presbyterian.

You want to take out
all of her abdominal organs,

extract the tumors and then
put the organs back in her body?

Yeah, this is
the highest-risk surgery

any of us will ever perform.

And I wanted to wait,

but the tumors have occluded

the spleno-mesenteric junction.

Her liver is failing,
clotting factors are low

and she's bleeding
uncontrollably.

That means she has
to have the surgery today.

We're the only chance she's got.

Well, say no more.
Let's go save a life.

She likes you.

She seems lovely.

You like her?

I'm only asking

because she couldn't
take her eyes off you,

and you couldn't bolt
out of there fast enough.

Geez. Patients fall
for their doctors all the time,

and vice versa.
What's the big deal?

First off, she's not
actually my patient.

Second, mind your own business.

When you tell someone
to mind their own business,

it just confirms what it is
you don't want them to think.

How I feel about Rose,
and how I choose

to interact with her
is not something

I need to explain to a resident.

Mind your business.

I don't see anything. You?

No bleeds.

We'll need to monitor her.

Dr. Cain?

Thank God. I'm with Dr. Devi
in the sim lab.

We're trapped with a patient who
has a penetrating head trauma.

He's status
post-grand mal seizure

and he's decompensating.

I just sent you a photo.

Okay, by the locations,

my money's on
an epidural hematoma

with middle meningeal
artery laceration.

You need to get him
to an OR immediately.

There's significant debris from
the tornado blocking the door.

We won't be able to get out.

From Kit. ER's overwhelmed.

I got to get down there.

I'll have a crew send someone
to free them, okay?

Dr. Devi, you are
a surgical intern.

I need you to start cutting now.

- This can't wait.
- Here in the sim lab?

Yes. Find any type of surgical
equipment that you can use.

What's the status
on the patient?

He's unresponsive
to painful stimuli.

What else have you got,
equipment-wise?

Sutures and gloves.
Scalpels and surgical equipment

are in the cabinet
but we can't get to it.

Okay, listen to me,
you cannot do this

- without the right tools.
- We do have sheets

- and pillowcases.
- Okay, great.

Great, great.
Lay those around the patient.

How about sterilization?

- Hand sanitizer.
- Okay.

So here's the deal.
If you remove that rod,

he could die of exsanguination.

If you don't,
he can die of herniation.

I want to do whatever gives him
the best shot at survival.

Just tell us what to do,
Dr. Cain.

And speak fast
before we lose you.

Okay, remove that rod.
But then you'll need to remove

a section of the skull around
the impalement.

Do you have anything else
in that room that you can use?

We have a toolbox.

Power drill.

Pliers.

X-Acto.

Okay, that's not ideal,
but it's gonna have to work.

Once you take out that rod,

you have to stop the bleeding
inside the cranial vault.

Fingers crossed that
that artery's still intact.

Then you're gonna remove

all of those bone fragments.

You have to be very...

Dr. Cain.

Damn it. We lost him.

We're on our own.

Hi. Hey, uh, why don't you go

scrub and I'll catch up.

Okay.

Okay.

It has to be you.

I haven't been in surgery
since med school.

Hey, can you hear me?

Whole wall's collapsed.

At least an hour, maybe more.

Oh, God.

Listen, I know you're scared,

but you have to do this now.

I'm not scared of anything.

But rushing me won't help.

Leela, what's happening?

Tell me what to do, come on.

My brain needs more time
to process one new thing

and this is... many.

Okay.

Visualize a quadrant
around the rod.

Imagine drilling a hole
in all four corners.

And then we cut open the bone.

We get underneath it.

And...

Extract the rod
and stop the bleeding.

Vascular clamping complete.

Yeah, let's remove the organs.

I know as a surgeon,
we're supposed to play it cool.

But this is insane.

Yeah, the clock is ticking.
Let's resect

the tumors on the back table,
then...

get the organs
back inside her body.

I'll begin
the portal vein reconstruction.

Dr. Austin, are you okay?

What about me suggests
that I'm not okay, Jessica?

Am I not elbow deep
in a child's abdominal cavity

doing the work of gods?

- Am I sad?
- Yes.

Do I feel as empty
as this poor child?

Yes.

Do I need people
constantly reminding me

that I've been mortally wounded
by the loss of love?

No!

my bad, Jessica.

I'm fine.

Okay. Bovie?

- Thank you.
- You're welcome.

Piper's blood pressure's
failing.

- I think I see the source.
- I'll keep transfusing,

but her body's starting
to shut down.

She can't afford
to lose any more blood.

There goes another one.

We didn't amputate Piper's leg

just to let her die
on the table.

She's going into V tach.

We need to speed this up.

Okay, let's get the bar
out of his head.

Steady hands.

You move it even one millimeter
in the wrong direction,

it could be catastrophic.

Look, you got this.

I'll hold his head.

No major bleeding.

Okay, now we have to remove

the remaining bone fragments.

The tumors are resected.

Yeah, we're running out of time.

She needs these organs
re-implanted now.

The bad news is
the tumors eviscerated

her pancreas,
spleen and stomach.

The good news is
we still have enough healthy

liver and intestine.

You ready for re-implantation?

No. I just came across

a smattering of malignant growth

in her abdominal wall.

They must've been
undetected on imaging.

These are going to prevent us
from closing.

Okay, we are gonna have
to rebuild her

quickly from the inside out,
starting with

the GI reconstruction, then
the abdominal reconstruction.

It's a good thing we have
a plastic surgeon in our midst.

Nice and slow.

Okay.

Let's do this.

All right, I think
that's the last fragment.

I don't see any more.

Oh, it's the artery...
He's bleeding out.

Apply pressure.

It's not working. We need
something to seal it off.

All right, I'll look.
Leela, keep applying pressure.

Okay.

The patient is
becoming unstable.

The instability is related
to a bleeding vessel.

We need to achieve homeostasis.

We don't have clips or wax.

What else?

We need to burn it.

We don't have electrocautery.

Does he have a soldering iron?

It might work. Give it a shot.

You did it.

Now let's hope
they get us out in time.

Time of death 17:41.

Hey.

We tried everything.

Amputation was her only chance,
but she lost too much blood.

She was one of us.

We'll tell Wes.

I know how close
you and Piper were.

We're so sorry.

She saw the world as it is.

I saw...

like I wished it was.

We were two halves of a piece

that were better
than either of us alone.

You'll always carry
that part of her with you.

How am I gonna get back

into the ambulance without her?

You will.

When you're ready,
just one step at a time.

And she wouldn't want you
to stop helping people.

And the last thing
she would want is to be

an anchor around your neck.

Thank you for that.

Oh, man.

I have to pick up her dog.

I made her rescue him.

Dog's a total jerk.

And the only relationship
that she had

besides me.

We'll see you soon, Wes.

Hardest part of our job.

Never gets easier.

No one does it better than you.

Get him to the OR.

Dr. Chan is waiting.

He had a bleed,
and we almost lost him,

but Dr. Devi cauterized it
with a soldering iron.

Well done.

I bet you didn't expect
to perform brain surgery

with power tools
when you woke up this morning.

Or any morning.

- Ever.
- Well, now you know what it feels like

to exceed your own expectations.

I have always been confident
in my abilities.

It's always been other people
who have doubted me.

That being said, I'm happy
Dr. Pravesh was with me today.

No, no. This is your moment.

Again, well done.

Let's go.

These are worse than
you made them out to be.

Per usual.

Better me than you.

Look...

I know you want to work
right up until you go to labor

and I will support
whatever you decide.

But given everything
that we have been through...

I'm ready.

Home sounds really good
right about now.

For me and for her.

Look, we knew this
was going to be hard,

but the recovery is going to be
more challenging

- than we anticipated.
- Yeah.

Sammie will require ongoing
care with constant follow-ups.

- For how long?
- Years.

The truth is, Sammie's
operations may not be over.

We will need to continually
monitor her organs.

And at some point, more
surgeries might be required.

Uh, w-we are so glad
she has a chance.

But I don't know how
we're gonna swing this.

The cost alone.

What about her at home care?

We will
provide you with resources

to help with her dietary
requirements

and her ongoing
physical therapy.

And she may need
to be home-schooled

- for the next 12 months.
- I'll-I'll send up a social worker

that will speak to you
about all of it.

No.

No, no social workers.

I'm really thankful for you
all saving her life,

- it's just that the truth is that...
- We have, uh,

two other kids at home.

We care about Sammie
and we want her to be okay.

But this is so overwhelming.

Look, our family
is falling apart.

I don't know if
we're the best people for her.

I don't understand.
She's your daughter.

There... are options
for situations like this.

We'll have to relinquish her.

Are you saying
you're gonna give her back?

You're Sammie's parents.

She has no other home
in this country.

She'll be better
with a family who's equipped

to do this sort of thing. Sorry.

Doctors, why don't you get some air?

I can finish
with the Ackermanns.

Want to go grab a drink?

Yeah. Just give me a minute?

Did it work?

Okay, that's it. That's it.

Good shot. Okay.

Yes, baby!
Let's go.

- You were phenomenal today.
- Thank you.

Did you tell your father
what you did?

- Yep.
- And was he appropriately impressed?

He was more excited
by the fact that there was

a single male,
Indian doctor trapped with me.

That must have been infuriating.

I'm used to being the imperfect
child with the screwy brain.

He's convinced dyslexia
will cause me to kill someone,

or lose my job, so a husband

is insurance
against the inevitable collapse

Of my medical career.

Well, you have
the inalienable right

to feel like
a medical god tonight.

Don't let anyone take that away.

I won't.

- Cheers.
- Cheers.

Next round's on me.

Hey.

Just so you know, this
area has been officially designated

a pity-free zone.

You got that right.

Noted. Again.

Well, Bell, I want to say thank
you for letting me be part

of this auto-transplantation.

Brother, it's going
on my highlight reel

for the long haul.

I'll never forget it, either.

To Sammie.

To Sammie.

Another beer?

Thanks.

Well, this is a super sad
tableau over here.

Point in fact,
couldn't be happier.

Isn't there some
small part of you

that wants to blow off
some steam?

You know, have a drink
with your colleagues?

Eh, drunken small talk
is not my jam. I'm good.

Look, the truth is,
I do want your job.

Of course you do.

I wouldn't want
a resident who didn't.

We're cut from the same cloth.

No hidden agendas.

- Can I ask you something personal?
- No.

You want to know if there's
something between Rose and me.

The answer's no.

Like you said, she's not
your patient, she's Devon's.

Wouldn't be out of bounds.

She could die at any time.

She could. Anyone could.

You almost did.

About a year ago,
my college girlfriend

shows up to Chastain.

It's been decades.

Lots of wheels start turning.

Thinking about
what could have been.

What still could be.

Then she dies on my table.

Damn.

I'm so sorry.

No one really knew
how it affected me, but...

...I just don't think
I can go through that again.

Okay, I get that.

But it's a dangerous
way to live, man.

Maybe you avoid
heartbreak, but...

you end up where you are
right now,

alone at the bar.

Just warming up.
There it is, all right.

Just warming up.

- Oh. Yeah, uh...
- Oh, yeah. That's what you get.

I'm a say me,

- Jake and Leela.
- I got you.

That's not gonna be fair.

All right, I get it.

The three of us are surgeons,
we are precise, competitive,

finely-tuned,
highly-performing

- individuals.
- Yeah.

So I understand
the intimidation factor.

You and Jake are so drunk
you can't even see the board.

Well, it appears to me
that Drs. Hawkins, Pravesh

and Sutton over there

may have a point.

However, I am too inebriated
to control my ego,

- so what do you say?
- I think we'll be fine.

Let's go.

Fine. Put your money
where your mouth is.

Yes. There we go.

Now we're talking.
Now we're talking.

I'm just curious.

Why do you think we'll be fine?

Trust me.

- Dollar a point?
- All right.

We good with that?

- Bring it. - Yes, we're good with that.
- Yeah?

Okay.

- Awesome, man.
- Yes.

Sneaky. This one's sneaky.

Good work.

- Put 'er there.
- All right, all right, all right.

- Cheers.
- Yes.

Well done, well done.