All language subtitles for TGD.S04E16.720p.WEB.H264

You said the pain
was intense?

Yeah, it was sharp
on both sides.

And it didn't
last long?

Just a few minutes.

And nothing in
the 24 hours since then?

Mnh-mnh.
My O.B. said it was probably
round ligament pain.

Yeah, that's basically
growing pains.

Your uterus is expanding.
So do your ligaments.

Normal fetal heart rate
and movement.

Your B.P. is perfect.

Everything seems normal.

Complications and miscarriage
are also normal.

Lea's O.B. did not consider
every possibility.

Which is why we're here.

Shaun made a list.

And I'm pretty sure
he's not going to sleep

until every possibility
is ruled out.

I categorized every
medical complication

that could negatively
impact Lea or the baby

and sorted by
Case Fatality Risk.

I'll get started
on the tests.

Shortness of breath,
pulse ox and respiratory
rate are dropping.

She needs oxygen.

Maxine Stanley,
87 years young.

She passed out on the dance
floor at a cocktail fundraiser
for the Art Deco Society.

Art-- Art Nouveau.

Oh!

She's in v-fib.

Getting
the crash cart.

No, look at
her bracelet.

The vintage Lalique?
It's stunning.

Other wrist.
Her medical bracelet.

She signed a DNR.

If we don't do anything,
she's gonna go asystolic.

I know.

But can't we just--
No.

Epinephrine?

Epinephrine doesn't qualify
as extraordinary
lifesaving measures.

She has a DNR
for a reason.

Time of death,

two twe--

She still has no heartbeat,
but her pressure is rising.

Could the machines
be screwing up?
All of them?

Her oxygen levels
are climbing to over 90.

I'm hearing
blood flow.

Oh.

I'm alive?

Which one of you bozos
did this?

Debbie asked me
to bring this for the baby.

Stuffed toys aren't safe for
infants under 12 months old.

They increase the risk
of suffocation.

I'll tell her
you said thank you.

You should be at work.

Yeah.

But you're not.

So you must be here
for a reason.

Claire must have
called you.

She's worried about Lea.

You got some of that
right.

Except that Lea is fine.

You're not.

Shaun,
you gotta relax.

N-No one expecting
a baby should relax.

There are many things
that could go wrong.

Okay,
so after the baby's born,
then you can relax?

N-No.

The baby will be helpless,
need us for everything.

So, once the baby
learns how to feed itself
and dress itself,

then you can relax?
No.

Is my point becoming
at all obvious?

That I'm never going to
relax ever again?

Kinda, yeah.

Shaun, this should be the most
amazing moment of your life.

Every parent'll tell you
the same thing.

If you blink,
you're gonna miss it,

and you're blinking.

You're-- You're-- You're
nervous and you're scared

when you s-should be
excited.

No signs of
preterm labor,

and tests on your liver
ruled out
obstetric cholestatis,

and it's not twin-twin
transfusion,

because you're officially
not having twins.

Turns out having a baby
with a medical genius
has a downside.

But if there
is a problem,

I'd rather be here
than anywhere else.

Gotta take care of
this little girl.

Is the transducer
secure?

I just checked it.
Why?

Baby's heart rate is
mildly bradycardic.

Um, heart rate fluctuates
with activity,

and you've been
off your feet for awhile.

But if Shaun were here,

he would check
a transvaginal ultrasound.

Let's get it set up.

Good news.

The arrhythmia didn't
do a lot of damage--

Three things
I can't tolerate,

lactose, cargo pants,

and my wishes
being ignored.

Mrs. Stanley,
I can assure you, we did not
disregard your DNR.

Then who did?
It wasn't a "who."

You were treated for
lung cancer recently?

Didn't work.

All chemo did was make me
puke up any decent meal I ate.

You also had a lobectomy
to remove the tumors.

They implanted
a cardiac device.

A pacemaker.

So I wouldn't die
on the table.

It's not a pacemaker.

It's basically
a miniature pump
inside your heart,

and if your heart stops,
it takes over.

Can you turn it off?

Then take it out.

Mm, I love it.

It's too big for
an infant to swallow,

which means it's only
moderately hazardous.

Most good things
in life are.

Someday
we'll tell our daughter

how Dr. Ted and Dr. Dad
both kept her safe.

We have
found something.

You have
Type 2 vasa previa.

It's when the fetal blood
vessels run across the cervix,

making them
extremely vulnerable.

Now, they could rupture
at any time,

definitely when
your water breaks,

but also under
other added stress.

And if that were to happen,
how bad would it be?

We...

Would lose the baby.

There's a small, secondary
placental lobe and multiple
vessels at risk.

Gestational age?

22 weeks.
Two weeks short
of viability.

C-section is
not an option.

I suggest fetoscopic
laser ablation

to stabilize the vessels
and avoid
fetal exsanguination.

It's very risky, but has
the highest potential

to avoid
elective prematurity.

I wrote a preliminary
surgical plan.

Should we review it?

Well, I'm familiar
with the procedure.
Good.

Since you're the head of
surgery, you can take
the lead.

I will assist.

And Claire showed
excellent judgment

ordering the ultrasound,
so I would like her
to join us.

Also, Jordan has
a calming bedside manner.

This is a good team.

I don't disagree.

Except you can't be on it.

Y-Yes, I can.

I reviewed the rules.

It is a conflict of interest

for doctors to operate
on family members.

Lea and I are not married,
so, mm-- is no conflict.

Shaun, Lea is
carrying your child.

We aren't operating
on the child.

You're citing
technicalities.

I am citing
the rules.

And why are those rules
in place?

So that people with emotional
conflicts don't get--

Then the rule
should have said that.

It doesn't.
It just says--

Shaun.

I care about you and Lea
too much

to put your baby's life
at risk just to make you
feel useful.

You are the president
of the hospital.

You can overrule Dr. Lim.

I agree with Lim.

Everyone, including you,
is always telling me

I'm not emotional enough,

and now you are saying
that I am too emotional?

Are you not angry
right now, Shaun?

Are you not scared?

You're as emotional
as anyone.

Maybe you don't
have access to it,

maybe you don't understand--
well, nobody understands it.

It's just that
that's not the issue.

If I hadn't been scared,
we wouldn't be here.

I wouldn't have
ordered the tests,

and Lea would have
lost the baby.

My emotion helped.

Dr. Lim made
the right call.

Considering
Maxine's age,

stopping her heart
and placing her on bypass

is way too risky.

What about
robotic-assisted surgery?

Adapt the approach
used in cardiac tumors

to remove the device while
her heart's still beating.

I'm sorry,
but should we really

be operating on
this woman at all?

A DNR is one thing,
but now we're considering

an experimental
elective surgery
for the sole purpose

of facilitating
the patient's death.

The patient
agreed to the device
to save her life,

not prolong her death.

Is that what we're doing
when we treat
terminally ill patients?

She's making
a mistake.

She's making
a choice.

Which is hers
to make.

But it doesn't
make sense.

She's more
full of life

than any patient
I've treated this month.

So talk to her.

Make her
change her mind.

Or maybe she'll
change yours.

I love you, too.

Pong.

I've been waiting for
that Red Dragon.

You're ready
for your close-up,
Ms. Stanley.

A "Sunset Boulevard"
reference.

And you were born, what,
10 years ago?

I've never seen it,

but my Bubbe--
uh, grandmother,

used to say it
all the time.

She's the one
who taught me Mah Jong.

Well, was she as naive
as you think I am?

You have better things
to do, young man.

And at this point in my life,
I don't need any new friends.

Do you want to die?

Something
only the young would ask.

Thinking there's
actually an option.

Well, sometimes,
if you're lucky,

there's a choice
about when.

And sometimes,
if you're really lucky,

there's a choice
about how.

I want to die
on the dance floor

with a song in my heart,
drink in my hand.

You want me to die
a few months later,

in pain, not knowing
who I am or where I am.

Forgive me for not saying
thanks for the opportunity.

Ah!

Mah jongg.

Feels weird, right?

Watching other people
do your job

is like being the understudy
in a Broadway show.

Or a couple
college musicals.

Basically
the same thing.

I should be part of
the surgical team.

I have studied every aspect of
this surgery extensively.

You know, I never expected
to take you seriously
as a surgeon.

I never saw you
as competition

until that aortic dissection
our second year.

There was surprise clotting
in the false lumen.

Which you performed
flawlessly.

That's when I realized
I'd underestimated you.

Just like Dr. Lim
is underestimating me now.

No, Shaun.

You didn't become
a better doctor

because of that surgery
with Melendez.

I became less of an idiot
and finally realized

I wasn't the only person here
capable of doing great work.

Lea's in good hands.

Even if they're not
your hands.

The baby is fine.

Dr. Lim did
an excellent job.

So did Claire
and Dr. Allen.

The vessel is healing,
but still vulnerable.

Also, the baby needs steroids
to speed lung development.

We will recheck the ultrasound
in 24 and 48 hours.

Until then, all we can do
is watch and wait.

At least I know the password
to the good Wi-Fi.

You okay?

If you're researching

which steroid
is most effective--

I'm not.

I'm trying to take my mind
off of the baby

and what can go wrong

and all the other things
I can do nothing about

and focus on something
I can do well-- my job.

Is that helping?

It could be.

Go do your job.

Robotic-assisted
left anterior

thoracoscopic removal
of a cardiac device.

Who wants to write
the paper with me?

Assuming it works.

Shaun.

Wasn't aware
you'd be joining us.

This surgery is interesting
and very complicated,

and I don't care
about the patient at all.

It seems like
an excellent distraction.

Can always use
another set of eyes.

I'm sorry about Lea.
If there's anything I can do--

No, you can't.

As a first-year
resident,

you're one of the
least-qualified doctors here.

There's more scarring
around the device

than the imaging
showed.

We're gonna need to free it
before we can remove it.

Clamp is loaded.

Let's begin with
the outflow cannula.

We'll see if our patient
can tolerate it.

Vitals are stable.

EKG is good.

EKG is good.
This is excellent.

I am completely
focused,

not thinking about Lea or
how we could lose the baby.

Fetal heart rate is 125.

Mom's B.P. is 110 over 60.
Vitals are normal.

There was some fluid leakage,
so Dr. Allen checked for PROM.

Negative,
and no contractions.

Let's confirm
it's amniotic fluid,

then test for
an L&S ratio

to see how the lungs are
responding to the steroids.

How do you feel?

I don't speak "doctor,"
but if I were a car,

fluid leakage
would be a problem.

Amniotic fluid can leak
slightly after surgery.

It's just something
for us to keep an eye on.

Right.

Wait and see.

Where is Dr. Ted?
Who?

The toy Shaun brought
for the baby.
It was right here.

What kind of mother loses
her baby's first teddy bear?

Lea, it's fine. One of
the nurses probably--
No, it's not.

It's fine, it's just--
He's right here.

Thank you.

Being in the hospital
trying to protect your child

is a terrifying,
awful, lonely feeling,

and there's nothing
as a doctor I can say
to make it better.

But as your friend,

I can let you know
you're not alone.

Isabel and I
have been
trying to have a family.

I've almost lost track of
how many IVF cycles.

People come over
and ask how it's going.

We say, "Getting close,"
whatever that means.

Mostly, it's just
an answer designed

to get people to
stop asking questions.

I've been scared
since I was a kid.

If I could just be
better,

a better--
better daughter,

better student,
a better doctor,

then I could stop bad things
from happening.

But when Melendez died,
I finally realized

that life is not something
you're supposed to control.

It's something
you're supposed to share.

Eight months pregnant,

Mia and I had
everything planned.

Bags packed, alternate
routes to the hospital.

Mia's water breaks
at the mall.

Nothing went the way
it was supposed to go.

And it was the best
day of my life.

I thought I was ready,
but when I lost Junior...

It took a long time for me
to stop blaming myself.

A year later,
I got a cat.

That helped.

You-- You lost a child,
and you got a cat?

Junior was
my tortoise.

Oh.

First pet
I ever owned.

That should've been at
the beginning of the story,

Dr. Allen.

I wasn't the one
who left the gate open.

Your tortoise ran away?

Your amniotic fluid
levels are stable.

That is good.

We need a plan in case
your water breaks at the mall.

I take it that's a specific
concern you heard about
from...?

Dr. Park says
his wife--

Stop talking
to people.

Okay.

There are three surgeries
I'm thinking of using
to distract me next.

One is a gallbladder
removal...

...which sounds very boring,
but it --
Shaun.

Wha-- What...?

Lower extremity swelling
and shortness of breath

are symptoms of
a pulmonary embolism.

Page Dr. Browne!

Congratulations,
Mrs. Stanley.

The surgery
was a success.

Success feels like
I've been run over by a truck.

Surgery takes a toll.

You'll get a set of
instructions for post-op care.

Healthy food choices,
limiting activities...

And I can throw
those instructions

in the trash for you,
or you can do that yourself.

We'll give you something for
the pain and some antibiotics

for a small infection
around the surgical site.

Then you'll be back
to the dance floor,

low blood pressure and erratic
heart rhythm be damned.

Let me.

I-I don't turn over Rouge Dior
to just anyone.

Thank you for the vote
of confidence.

Mm.

Nice job.

Same bubbe.

So, Dr. Wolke,

what's on your agenda
this time?

This time...

I just like you.

So, what are you
gonna do?

You gonna keep going to
Art Nouveau parties?

You say that
like it's a bad thing.

It's not a bad thing.

It's just not a...
meaningful thing.

My bubbe died
when I was in med school.

I can't tell you what I'd give
for a little more time
with her.

May her memories
be a blessing.

Family is important.

I have a favorite nephew.

It'll be nice to
spend more time with him.

And a few others.

There.

The clot is in the lower
right pulmonary artery.

It's small.

Could we use TPA
to dissolve it?

Anticoagulants are too risky
during pregnancy.

Maybe we just
keep an eye on the clot

and hope it breaks up
on its own.

Bed rest increases
the likelihood of more clots.

I think we should insert
an IVC filter.

That would trap future clots
before they get to the lungs.

It's hard to know
what the stress

of another procedure
will do,

but I think
we should risk it.

Shaun,
what do you think?

I...

Trust your judgment.

Hey.

Have you seen
Dr. Andrews?

I want to see if he'll talk
to our oncology group

about enrolling Mrs. Stanley
into a clinical trial.

What happened to dancing
and drinking until she dies?

Well, I think I sold her
on a little pain

for a little more life.

That's...great.

Which one of your patients
rented the gourmet taco truck

that's blocking
the clinic entrance?

If they're serving
carnitas, I want in.

** I'm gonna live till I die

** I'm gonna laugh
'stead of cry

** I'm gonna take the town
and turn it upside down

Doctors, welcome to
my going-away soiree.

If you want some beads,

you're going to
have to show a little--

Not happening,
Maxine.

And as much as
we understand your desire

to get back to partying,
we have hospital rules about--

Oh, sue me.

Or, more accurately,
sue my estate.

I am sorry about your
grandmother, Asher,

but what you missed
isn't more time.

It was a chance
to say goodbye.

** I'll be a devil...

Thank you for
giving me that chance.

I've decided to refuse
the antibiotics.

** Gonna dance**

Without antibiotics,
you'll develop sepsis

and be in cardiogenic shock
in as little as 24 hours.

I don't understand.

Why are you
doing this?

Because it's my life.

All of it...

Including the ending.

Placing an IVC filter
is a safe procedure

with a very low
complication rate,

and Claire is
an excellent doctor.

Shaun.

It's okay to be scared.

But it's not helpful.

I want to
make things better.

I don't know how.

Look.

That's going to be us.

You don't need to
fix things, Shaun.

Just believe with me that
we're gonna get through this

and that the three of us
are going home.

Somebody needs to
check your oxygen, young lady,

because you're not
making any sense.

I told you.

I am not delirious,
Dr. Glassman.

I just happen to have
my own opinion.

It's not a matter
of opinion.

It's a matter
of absolute fact.

Ted Williams was the greatest
baseball player of all time.

End of discussion,
full stop.

Ted Williams
was good.

Not exactly
a hot take,

but John Paciorek beat
Ted Williams like a drum.

Only player to bat a thousand
in Major League Baseball.

Now you're gonna say...
I am.

..."But John Paciorek
only played one game."
Played one game!

That's right.
And I'm gonna say,

baseball wasn't fully
integrated until 1959,

a year before
Williams retired.

Numbers aren't everything,
Dr. Glassman.

More does not mean
better.

Not in life,
not in baseball,

maybe in tacos.

Alright, why are we talking
baseball and tacos?

Have you had one?

I've had four,
and they're wonderful.
Mm.

And you would make
an excellent lawyer.

You know, I haven't had
this much tongue in my mouth

since Woodstock.

Well, some of us think that
you might be a little crazy.

A little.

Some people can't
tell the difference

between crazy and happy.

Either way,
you're perfectly capable

of making
your own decision.

Now, I'm gonna leave
this lovely party.

Excuse me.

Just do me one favor,
will you?

Keep the volume down.

It was a pleasure
to meet you.

Pleasure to
meet you.

Are those Maxine's
new ABG results?

No.

If you want
to talk--

Why are you so upset about
Mrs. Stanley
refusing treatment?

She has terminal cancer.
She is dying.

Doctors can't fix that.

I know my family
loved me,

but they didn't...
see me.

Except my grandmother.

She'd catch my eye
at Shabbat dinner

and make
some ridiculous face

so I'd laugh
and get sent to my room,

and that's where
I'd find it.

A book or music

or something verboten
she thought I'd like.

She passed away
a few years ago.

More time would've
meant... everything.

Time is hope.

ABG results for
Mrs. Maxine Stanley.

Right before inserting
the IVC filter,

I ordered
a non-stress test

to make sure the baby could
tolerate the procedure.

That's when I noticed
the heart rate

had been getting
progressively slower.

So, after we
implanted the filter,

I ordered
a Doppler ultrasound.

The tracing of
the umbilical artery

was dampened
with flow reversal.

There wasn't just
one clot, Shaun,
there were two.

One we couldn't see

because it was lodged
in the umbilical artery.

Maybe I made a mistake
or I missed something.

I-I really, really want to
be wrong about this, Shaun.

You aren't wrong.

I saw the test results
on the amniotic fluid.

The lungs aren't responding
to the steroids.

The baby can't survive.

I'm sorry.

Did you talk to Lea?

No.

I couldn't protect Lea.

The only thing
I can do for her now
is give her more time...

To hope.

I don't think
you're doing this for Lea.

I think you're
protecting yourself

from the pain of
watching her pain.

Would you like me
to be there?

No. Thank you.

Crap.

There was nothing
anyone could have done

that would have made
any difference.

And nothing about this
affects your chances

of having
a healthy baby later.

What do we do now?

Medically,
you have two choices.

You can be sedated
and have a D&C.

Or some people
decide to induce labor

so they can
hold their child.

Uh, c-could you
give us a minute?

Of course.

Do you want to discuss
risks and benefits?

No.

I don't need
any more information.

We've lost her.

We lost her,

and this isn't about
medical questions anymore.

I can't go into labor
and not leave here
with our baby.

Remarkable.

Swelling's down,
trends are improving.

Your infection appears to
be clearing on its own.

Apparently, life isn't done
with you yet.

Yesterday was
one of the,

the best days I've had
in a long time.

Not because
of the party.

Because of the memories.

Midnight taco runs
with my college roommates.

My sister messing up
the words to my favorite song.

Arguing with my husband,

who served
the best margaritas.

I--
I've had a wonderful life

and with wonderful people.

Maxine, there's no reason
you can't have more of that.

They're gone.

And now I, uh...

I have to go home alone.

Pretty incredible
that a woman of her age,

ravaged by cancer,

could fight off
an infection overnight.

If I were a religious man,
I'd say,

"Wow, that's--
that's a miracle."

So, either I should go join a
church or a temple
or a mosque,

or someone slipped antibiotics
into Maxine Stanley's I.V.,

antibiotics which she
specifically asked us
not to give her.

Don't say anything.
Not a word.

Say something stupid
like a confession,

and I'm gonna have to
fire you right on the spot.

Not to mention
fending off a lawsuit,

which we would, and most
certainly should, lose.

More importantly, none of this
helps Maxine, does it?

So what happens now?

I don't know.

Let's just say
for the sake of it
that you know this doctor.

Would they feel
at all guilty?

Yes.

Why?

Because she's
a good woman, and...

It was her decision.

You knew it was
her decision.

You were told it was
her decision.

You didn't listen.

What makes you think next time
will be any different?

Because I saw her
this morning,
and for the first time,

I saw...Her pain.

Okay.

You're gonna have to
make this right.

Hey.

I'm sorry things didn't
turn out like you wanted.

That's okay.

Lots of great books have
final lousy chapters.

This is
an aid-in-dying request.

There are procedures
that allow you

to end things when you
want to end things.

It can be complicated.

Quite a few
regulatory hoops.

I'll get you
through them.

** Ooh-ooh, child

** Things are
gonna get easier

** Ooh-ooh, child

** Things'll be brighter

** Ooh-ooh, child

** Things are
gonna get easier

** Ooh-ooh, child

** Things'll get brighter

** Someday, yeah

** We'll put it together
and we'll get it undone

** Someday when your head
is much lighter

** Someday, yeah

** We'll walk in the rays
of a beautiful sun

** Someday when the world
is much brighter

Did I ever tell you about
the day Kellan was--

You did.

** Ooh-ooh, child

But tell me again.

** Things are
gonna get easier

** Ooh-ooh,
things'll be brighter

Hey, Deb--

No, I-I'm not gonna be late.

I just, um...

I just
wanted to hear your voice.

** Someday, yeah

** We'll walk in the rays
of a beautiful sun

** Someday when the world
is much brighter

** Ooh-ooh, child

** Things are
gonna get easier**

** Ooh-ooh,
things'll be brighter