Original subtitles

Think of thesenot as a report card,

but a window into the mindsof your clients,

their familiesand support persons,

and also as a windowinto yourselves.

To see your greatest strengths

and the areas where you have

the greatest opportunityfor growth.

First round of resultsis already in your inbox.

Regular updates to follow.

[CLEARS THROAT]

Third highestin the department.

Pretty good.

Second.

How'd you do?

Fine.

[SIGHS]

"Dr. Reznickcares deeply about people."

"Sweet." "Kind."

[CHUCKLES]"Thoughtful."

What do I have to doto get that level of service?

Let me bill your insurance.

You have six comments.

Four "OKs." Two "Goods."

I have 46.

It's hard to livein your long, sweet shadow.

I'll give you some pointers.We could role play.

You could be the shirtlessand eager-to-please doctor,

and I'll be thesexy-but-demanding patient

with a nastyfungal infection.

Top five. Nice work.

Thank you.

But as Chief of Surgery,wouldn't hurt to aim higher.

Speaking of which,where's my numero uno?

Dr. Rendon.Top of the class.

Oh, he was called away on

a medical missionin Guatemala.

It was urgent.

Huh. Heroic.

When will he be back?

Should be justa few more days.

In the future,please let me know

about any extendedabsences, hmm?

He can't makeour clients happy

if he's not in the country.

[CELL PHONE VIBRATING]

I have to go.

I had the lowest ranking in

the entiresurgical department.

I made five people"very uncomfortable."

Seven patientssaid I talked weird,

and one woman was "a littlecreeped out" by my manner.

The algorithm hassome major blind spots.

I can make it better.I'll talk to Salen.

No. The data reflectsactual opinions.

I will learn how to makepeople feel comfortable

and improve my scores.

[DOOR OPENS]

Rosa Castillo, 35,needs immediate bypass surgery

for acute kidney failure.

She was treatedfor renal artery stenosis

three years ago.

Looks like the stent failed.Mm-hmm.

This imaging is barelyreadable. It's from 1985.

Try Guatemala.Mateo sent her here.

They don't have the equipmentfor a bypass.

Ms. Castillo.

I am Dr. Lim.This is Dr. Wolke.

I heardso much about you.

The Chief. La Jefa.

Oh. Well, hopefully,we can have you in the O.R.

in the next couple of hours.

We already haveyour medical history

from Dr. Rendon, which helps.

Teo told me I wouldbe in good hands here.

Uh, is that what all hispatients call him back home?

Probably justthe ones who dated him.

[MONITOR BEEPING]

Bruising of the jaw,sublingual hematoma,

most likelya parasymphyseal fracture.

It's just a little bump.I'm fine.

You're not fine, Dad.How did it happen?

Ah, some kids were horsingaround outside

when I was opening up.

He runs a hardware shop.They attacked him.

It was an accident.

I fell off the sidewalk intosomeone's side-view mirror.

Your jaw's broken.

They pushed youoff the sidewalk,

told youto not get them sick.

They were justbeing stupid.

[SCOFFS]She's so sensitive.

Checking for abnormal movementof the mandible

or any malocclusion.

Okay, we needto file a report.

A report?Why would I--

[GASPING]

[ALARM BEEPING]

The fractured bone andtongue are sliding backwards,

blocking his oropharynx.

We need to securethe airway, now!

[GASPING]

ANDREWS: Placing the lasttwo-millimeter miniplate.

He must have beenin a lot of pain.

PARK:[SIGHS] Good for you

if you can stay positiveafter a hate crime.

Satisfactory occlusionand fragment reduction.

Doctors Allen and Murphy,

let's removethe temporary MMF.

SHAUN:Mr. Song and his daughter

see the same situationvery differently.

[ALARM BEEPING]

He's bradycardic.Heart rate dropped to 35.

And hypotensive,73 over 42.

Let's dial backthe sedation and opiates,

push one milligramI.V. atropine.

[ALARM STOPS,MONITOR BEEPING STEADILY]

Jordan: Maybe an adversereaction to the anesthesia?

We need to figure outif there's

an underlying cardiac problem.

Get a post-op EKG,echo in recovery,

and check for electrolytes.

SHAUN:And I need to figure out

how to get a good reviewfrom both of them.

SALEN:How's the water pressure?

Fine.I decreased output by 5%.

Saves 150 gallons a month,$17,000 annually.

Which, in three yearsand five months,

will make up forwhat you're about to spend

operating onthis new client,

whom Dr. Rendon gifted us.

Mateo's commitmentto patients

is the reason he's numero unoin the department.

My concern isn't Mateo.

You allowed him to fly inan uninsured patient

without informing me.

Do I still have the autonomyto run my own department?

I hope you see yourself

as more than justthe head of one department.

You are a vital memberof the Ethicure family.

[WATER RUNNING]We have to work together,

all of us,or we will all...

...falter.

LEA:The colors on these are wild.

Mm-hmm.

That yellow would look greatwith your complexion.

Full-cresteddouble gerbera daisies.

Mr. Song has sinus rhythmon his EKG.

Normal electrolytes, andno abnormalities on the echo.

Which rules out a lot,

but not a P.E.or small cardiac contusion.

Get a CTA chest.

Gerberas produceexcessive amounts of pollen,

which cantrigger migraines.

You don't needto be here for this.

Text me.Yeah.

Excellent pointabout the gerberas.

Lucky me, working with such

a fabulous,knowledgeable couple.

Mm, gerberas are notoriouslybig pollen producers.

It's an obvious point,not an excellent one.

You called Lea and me"fabulous."

Are you using hyperboliclanguage to make us like you?

Mm, I think the language waspretty accurate, actually.

Hmm.I'm trying to improve

my own clientsatisfaction scores,

which are poor.

You received 97%five-star reviews on Yelp.

Your methods must bevery effective.

Are you using hyperboliclanguage to make us like you?

It's all aboutappeasing and affirming.

Appease. Give the customerswhat they want.

And affirm. Make them feel

that what they wantis wise and good,

which in your case,it is very much so.

LIM:Rotating everything medially

to expose the renal vessels.

ANDREWS:I got three lap choles

waiting for Dr. Rendonon Wednesday,

little thank-you gift

for letting us operateon his patient.

Well, might be Thursdaybefore he's back.

Sorry the humanitarian crisisis screwing up your schedule.

There's a massive aneurysmcutting off blood flow.

There's no way to get vascularcontrol for reconstruction.

We might be ableto do a bypass

from the aorta or iliacs.

ASHER: There are severalaneurysmal segments

along the abdominal aorta.

This one's abnormal, too.

All of her arteriesare defective.

[ANDREWS SIGHS]

You should take meon a date tonight.

Okay.It's a lecture

on leadership in medicineby Dr. Chandra.

Recipient of twoNIH grants.

That's not a date.That's homework.

Starting the scan.

There's a cocktailparty after.

How about we spend our time

doing that role playingyou suggested?

You know, minus the fungus.

The infection was the wholemotivation for my character.

Your guy's heart is fine.

Make sureyoubreak the good news.

Should bump upyour scores a notch.

The tests showyour heart function

and anatomy are normal.

The episode during surgery

was probably justa minor anesthesia reaction.

You should begood to go very soon.

[SIGHS]Thank you, Dr. Allen.

We can stop by the policestation on the way home

so you can make a statement.

I told you,no reports, no statements.

BP is 133 over 70.

Checking O2 sat.

Appa,these thingsare underreported.

Our relatives,our friends,

our peopleare getting hurt out there.

[SIGHS]"Our people."

It's not us versus them.

That doesn't help anyone.

You don't thinkwe're seen as different?

You wantto be seenas different.

You rub people'sfaces in it.

That's why you aren'tgetting anywhere.

You don't havea real job--

Community organizingis a real job.

I am lucky to have such

fabulous,knowledgeable clients.

Emily, you're right

about the importanceof recognizing problems.

Mr. Song, it is wise

to be concerned for your

daughter'sprofessional future.

Please, Appa.

Go with meto make a statement.

It's important.

Not to me.

You're right.

Community organizing doesnot sound like a real job.

It's a real job.

Heart rate dropped.[ALARM BEEPING]

A-line shows a widenedpulse pressure reading.

[BREATHING HEAVILY] Somethingis wrong with my heart?

Respiration rate down,trending apneic.

Cushing's Triad.

75 grams of mannitol.

Your heart is fine.

There's something wrongwith your brain.

It's invadedthe motor strip,

left temporal,anterior corpus callosum.

Severe necrosis and edema,

and no way to see wheretumor ends and brain begins.

[SIGHS]It's inoperable.

I will definitelyget a bad review.

I need more timeto find a surgical solution.

[CELLPHONE CHIMES]

But we also need to leavefor our tux fitting.

[CELLPHONE CHIMES]

We were able tobypass the renal artery

using one of your veins.

But new imaging showed

you have a condition calledFibromuscular Dysplasia.

It's caused areasof stenosis and aneurysm

in your heart, brain,and other major vessels.

We can give you medication

to managethe underlying condition,

but we'll have to doanother surgery

to repaireach of the aneurysms.

There are risks of stroke,or major hemorrhage.

But without it,it's only a matter of time

before one of theseaneurysms ruptures.

[EXHALES SHAKILY]Um,

if anything goes wrong,

can you please letTeo know?

He should be the oneto tell my family.

I wouldn't want themto hear it from a stranger.

Of course.

We could use intraoperativestimulated raman histology

to determine tumor tissueversus normal.

PARK: Eh, if weresect normal tissue,

we can't put it back in.

Drape is perfectwith your physique.

IntraoperativeMRI guidance

would help us achievegross total resection.

And risk resecting eloquentcortex, with major deficits.

[SIGHS]You look like a little boy.

The shoulder sag is awful.Take it off.

That was neither appeasingnor affirming.

But your reviewsare exceptional.

You can't just tell peoplewhat they want to hear.

You've got to give themthe cold, hard truth.

I always do that, and peopledon't give me good reviews.

You have to follow itwith a compliment,

which now,thanks to your honesty,

they'll believe.

Very strikingwith those eyes.

I...do believe you.

GLASSMAN: Yeah, hey, Shaun.

Um, sorry for not replying.

You're latefor the tux fitting.

Oh, yeah, um...

I'm in Montana?

We need to rescheduleyour appointment.

When will you be back?

Well, I'm not so sure.

I'm heading towardsa little town called Paradise,

and I'm--

I'm thinking of hunkering downthere for a little while.

How about Wednesday,12:00 p.m.?

Will you be donehunkering by then?

Sure. [SCOFFS]I'll see what I can do.

[LIGHTS BUZZING]

You are confirmed.Goodbye.

We have to get back to thehospital and talk to Mr. Song.

With only chemo and radiation,you would die soon.

But I've found a wayto remove the tumor

using fluorescent light.

If we administer5-ALA before surgery,

the cancer cells will turnpink under the light.

Then we can resect those cells

and leave healthytissue unharmed.

You will likely have paralysison your right side,

but no cognitiveor speech impairment.

[SIGHS]

No.

I've alwaystaken care of myself.

Without this procedure,you'd have a year at most.

I'd bettermake it count, then.

No surgery.

Chicken pepian, from the placedown the street.

Mateo saysit reminds him of home.

Funny.When he was "home,"

his favorite foodwas pizza.

[BOTH CHUCKLE]

You're very kind.

I'm not sureI would be this nice

to the ex-girlfriendof my current boyfriend.

Mateo told you about us?

No, but you're his type.

Beautiful.Smarter than he is.

And Dr. Wolkelet something slip.

Ah.

I can't quitepicture Teo here.

Everything is very

nice.

And shiny.

Mm.

Did you meet here?

No.

We met in Guatemala.

And thenhe decided to move.

[CHUCKLES]It was a little--

Romantic?

Crazy.[CHUCKLES] Yes.

He moves fastwhen he knows what he wants.

We were practically livingtogether by our third date.

Were you togethera long time?

Six months, maybe less.

Long enough for meto start imagining

what our kidswould be like.

But then there wasa war in Congo

or an earthquake in Haiti.

Someone, somewhereneeded him.

But I am glad he's founda place to settle down.

I wasn't sure that wouldever happen for him.

You left me.At the party?

I was tired and bored.I went home.

Without saying goodbye.

I was about to introduce youto Dr. Chandra.

I didn't ask youto do that.

And I didn't ask youto tell that guy from Stanford

that I've doneover 50 robotic surgeries,

or give that research fellowmy ABSITE scores.

It's calling mingling.

Felt more likebeing pimped out.

What can I say?You're a stud.

I'm fine. I'm good.My scores are average,

and it's driving you crazy.

You're not average, but youshy away from the spotlight.

You're a hot Koreanmartial artist surgeon,

and your faceisn't on a poster.

Why do you think that is?

I just want you to reachyour full potential.

I mean, don't you want thatfor yourself?

ASHER: Rough night?

Not really.Oh.

You know,when I don't sleep well,

it's usuallyanxiety about work

or why some hot guyisn't texting me back,

or, oh, he sent hisex-girlfriend to me for help.

I was up lateprepping for this surgery.

Yeah. Me, too.

I have moisturizer in my bag,just, if you want it.

Where is she?

Rosa was stable,so I transferred her

to County Hospitalthis morning.

She's my patient,and I'm your boss.

This is the right callfor our department.

She'll get the care she needs,and as a non-profit--

Their team hasfar less experience

with this kind of surgery.

I know this patientis important to Mateo,

and he's important to you,

but we cannot allocateour limited resources

based on personal feelings.

Oh, this hasnothing to do with Mateo.

You are riskinga woman's life

so you can crawlfurther up Salen's ass.

I'm protectingthis department,

which is actuallyyour job.

Pedes just hiredthree new nurses.

I got approvalfor a portable X-ray.

When's the last time Salenapproved one of your requests?

This is a hospital,not a swap meet.

It's her hospital.

I'm contacting County.

You can'tbring her back here.

I know.

What about a limitedtemporal lobe resection?

Lower the riskof future brain herniation?

Good for preservingmotor function,

but he'd likely lose speech.

Why is my dad still here?

He isn'ttelling me anything.

Emily, the break room isfor surgical residents only.

Your presence is not onlyprohibited, it is unwelcome.

You're distracting us from

trying to changeyour dad's mind

and save his life.

That sweater is very strikingwith your eyes.

You should talk to him.

So he can tell meeverything's fine?

He needs you.

I used to be a cop.

In part to tryand please my dad.

He was all aboutbeing tough.

He always had this, uh,

wall up, you know?

He came over with nothing.

Didn't know the language.

He got by on very littlefor a long time.

It took a whilefor me to realize it,

but being toughwas just a survival strategy.

My dad came herewhen he was 19

and went "from a socket wrenchand a couple bolts

to Number One ConvenienceHardware in the Bay,

no problem."

I get that he's strongbecause he had to be.

And I get

that it helps him to deny howthe world sees us as "other."

But when you do that,

it can make peoplewho are struggling feel

messed-up and...

Alone.

Maybe he's protecting you

not because he thinksyou're weak

but because he'd rather takeon the world all by himself

than see you get hurt.

Your dad's a fighter,Emily.

But so are you.

And he needs youto fight for him right now.

Why haven't youtold your daughter

what you're going through?

When she was a little girl,she'd help out at the shop.

[CHUCKLES]

Make a mess, more like,

disappear in the middleof stocking fasteners.

I'd find herhiding behind the counter.

Someone saidsomething mean,

made her feel bad.

That's... That's the world.

I sell hammersto people who hate me.

I get their money,they get their hammers.

I kept my head down,

built a life for our family,for her.

So, when I'd see her upset,I'd tell her, "Hey,

forget that guy.

Focus onthe next customer."

I don't want her to hurt.

I need to be strongfor her.

Mr. Song,

the best way to show yourdaughter what strength is...

Tell her whatyou're going through.

She's not the little girl

hiding behindthe counter anymore.

[KNOCK ON DOOR]Mm.

I heard you're doingRosa's surgery at County.

I would like to assist.

You don't have any surgicalprivileges at County.

And unless you wantto piss off the CEO,

you shouldn't do it anyway.

Maybe you shouldn't,either.

You don't know when Dr. Rendonis coming back, do you?

Before I gotinto this program,

I had heard so much about you,

how you were smartand talented and

tough and fair.

And at first, I was like,"Oh, my God. Stop. I get it."

But...

But I didn't.

Until I met you.

Everyone who works for you

is a better doctorbecause of it.

And I would hate

to see you put everythingyou've worked for on the line

for someone who

isn't willingto do the same for you.

Thank you.

Don't evergive me advice again.

Whatever you and Jordan saidhas improved the situation.

How did you do it?

I just affirmedwhere Emily was coming from

and helped her see whereher dad was coming from, too.

That's what Itried to do,

and it made themboth angry.

There's someshared experiences.

Because you're both Asian.

American, yeah.

Both second generation,similar fathers.

You're both outsiders.

Yeah.I guess that's, uh...

Um, my dad

told me about the tumor.

Did you convince himto accept the surgery?

The thought

of losing him terrifies me.

But he needs my support now.

Which means supportinghis decision.

Thank you forhelping me see that.

I was wrong.

What you and Jordan saidhas made the situation worse.

SHAUN: My clients are finallyin agreement with each other.

But against me.

I'm sorry, Shaun.

I love the tuxes,but where's Glassman?

Oh, he is "hunkering down"in Paradise.

Dr. Park, Emily, and Iare all outsiders,

but I failedto connect with her,

and Dr. Park succeeded.

To connect with people,

I need them to like me,which they do not.

I need new strategies.

Shaun, I know you grew upnot feeling accepted,

you didn't havemany friends--

No. I did nothave any friends.

Maybe the scoresare bringing up

some of thoseold, painful feelings?

The scores areproviding useful data

to help metrack my progress.

Many people like you.Why do you think that is?

Shaun,

obsessing overwhether or not people like you

is a guaranteed tripto Crazytown.

That is very easy to saywhen you are likeable.

You're an amazing doctor,

which any functioning, decentalgorithm should recognize.

If I just talkedto Salen, I--

No. I don't want youto do that.

It might be simpler.

Do you think I can'timprove my scores?

Of course not.

I know you can.

[CELLPHONE VIBRATING]

Mm. I have to go.

[ALARM BEEPING]

PARK: Securing the airway.

Give another two milligramsLorazepam.

What's happening?

The seizures and brainherniation will only get worse

as the tumor grows.

All we can do now is keep himin a medically induced coma.

Until the tumor kills him.

Without waking up first?

There's nothingyou can do?

You are his medical proxy.

Now, your dadrejected surgery

when he thoughthe still had time.

It's possible he'd makea different choice now.

He made it clearhe didn't want

to live weakened in any way.

He'd hate me for choosingthe surgery for him.

I can't.

That is a very bad,very irrational decision.

It doesn't matterif your father hates you.

Being liked doesn't matter,

and worrying about that is

a guaranteed tripto Crazytown.

What matters issaving your dad's life.

Your watch isa very nice shade of orange.

Teo's lucky to have you.

I told him he better notscrew this one up.

You talked to him?

Mm. Earlier today.

Only for a minute.

He saidhe'll be back soon.

Hopefully.

The nurse will come byin a couple minutes

to take you to the O.R.

[VOICEMAIL BEEPS]Hello, Dr. Glassman,

you haven't acceptedthe calendar invite

for the rescheduledtux fitting.

Should I send another one?

Also, in attempting to improve

my performancewith my clients,

I have not many progress,even though--

EMILY: Dr. Murphy?

You were right.

Nothing mattersexcept saving my dad.

Do the surgery.

Ignore the part aboutnot making progress,

but please respond aboutthe calendar invite.

[CELLPHONE BEEPS]

We got over 98%of the tumor,

and your prognosisis very good.

As expected,we weren't able

to preservefull motor strength

in your left arm and leg.

Who--

I told them to.

Appa,

I couldn't standto lose you.

I know you maynever forgive me

or speak to me again,

but at least I knowyou're still here

on the planet with me.

That decision...

...took a lot of strength.

Good thingmy daughter's so tough.

Wonder whereI got that from.

Everything went well.

I was able to repaireach of the aneurysms.

We should have you homein a week, maybe less.

Thank you.Yeah.

How did it end,between you and Mateo?

It's none of my business.[CHUCKLES]

You don't have to answer thatif you don't want to.

He would go on medicalmissions all the time,

sometimes with no notice.

I would wake upand find a little gift,

like a bookor a bottle of wine,

and a sweet note.

After a few days,or weeks,

he would come back,and everything would be good.

And then one time,he didn't.

I waited for a long time.

Too long.

Thank you.

You want toget some dinner?

I make a fairlyaverage lasagna.

Ah, I have to finish this

proposal forDr. Chandra's lab.

Unless you wantto work on it together.

I'm good.

You know, the dayI handed in my badge,

my dad told meI was weak.

And then he didn't say

anything else to mefor a year.

I was only able to do itbecause of him.

I'd watched him maketough choices my whole life.

It cost me a lotto get here,

but I'm finallyin a good place.

I love my work

and my pain-in-the-assgirlfriend.

I don't know if that's"reaching my full potential,"

but I'm happy.

And I foughttoo hard for that

to let anyone tell meit's not enough.

Even the personwho makes me the happiest.

I'll eat the lasagna.

[EXHALES SHARPLY]

[SIGHS]I need to know

at some point "good"is gonna be good enough.

For you. For us.

[EXHALES SHARPLY]

I'm ambitious.That doesn't mean I'm broken.

I think you're unhappy.

As longas I've known you,

you've been reaching forthe next rung of the ladder.

Will it ever be enough?

[CELLPHONE CLICKING]

GLASSMAN: Hi. You haven'treached Aaron Glassman.

So I'll call you back.Sometime.

[VOICEMAIL BEEPS]Hi. It's Lea. Call me back.

And call Shaun. He needs you.

[CELLPHONE THUDS]

[SIGHS]

Did transferring thatyoung woman make you feel

crappy?

It was the right call.

Yeah.

Pretty crappy.

A few years ago,a colleague made me take

one of those online tests that

tells youif you're a sociopath.

Mm.

Oh.[CHUCKLES]

I'm not.[BOTH CHUCKLE]

I'm just committed.

Allowing feelings to influencebusiness decisions leads to--

Bad decisions.

Yes. Exactly.

You think like somebodywho knows how to be in charge.

So why aren't you anymore?

I made a good call.The board made a bad one.

Would you like to have dinner?With me.

Before you answer, you shouldknow that going out with me

will not benefit youprofessionally in any way.

Or personally, maybe.

Who's to say?

And turning me downwill have no repercussions.

Feelings do notinfluence business.

I can sign somethingto that effect.

[SIGHS]

I'd loveto have dinner with you.

Excellent.

Do you like shawarma?

I know the bestshawarma place.

Oh, I love their chicken,

but I hear their lamb is alsovery good,

though I don't eat lambanymore.

It makes me sad.

[SIGHS]

[CELLPHONE CLICKING]

[CELLPHONE BEEPS]

AUTOMATED FEMALE VOICE:You have reached

the voicemail box of...

MATEO: Dr. Mateo Rendon.

AUTOMATED FEMALE VOICE:Please record your message.

[VOICEMAIL BEEPS]Hi. It's me.

If you're coming backfor work,

I'll see you Thursday.

If you're coming backfor me...

[VOICE BREAKING]...don't.

SHAUN: Ranunculus.

They have very low pollen,

and the colorsare also..."wild."

These are Delano Yellow.

Gorgeous,

allergen-free,they're perfect, Shaun.

Yes, we are celebratingmy success.

I receiveda new batch of scores,

and they are elevated2.3 points.

That's great.

Yes. It is.

My effortsto improve my performance

have been effectiveafter all.

And no one saidI was weird.