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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:04,482 --> 00:00:06,528 Previously onGood Sam... 2 00:00:06,571 --> 00:00:08,530 I have been trying to keep up with you in a game 3 00:00:08,573 --> 00:00:11,228 that you've had rigged the entire time. 4 00:00:11,272 --> 00:00:13,143 I'm going to go and tell Sam everything. 5 00:00:13,187 --> 00:00:14,666 I think I'm all caught up. 6 00:00:14,710 --> 00:00:17,017 Ambulance has just landed. Step back, Dr. Trulie. 7 00:00:17,060 --> 00:00:18,516 You don't need to worry about your best friend 8 00:00:18,540 --> 00:00:19,454 being with your dad because 9 00:00:19,497 --> 00:00:21,021 you and I are not friends. 10 00:00:21,064 --> 00:00:22,718 It was me. I called your mother. 11 00:00:22,761 --> 00:00:24,937 Her vote could be the key. 12 00:00:24,981 --> 00:00:26,069 This is not personal. 13 00:00:26,113 --> 00:00:27,549 She is my mother! I told you 14 00:00:27,592 --> 00:00:29,464 I didn't even want to think about her! 15 00:00:29,507 --> 00:00:31,248 I have to end this war. 16 00:00:31,292 --> 00:00:32,858 You ended something, all right. 17 00:00:32,902 --> 00:00:34,860 I want you to know that you can talk to me. 18 00:00:35,818 --> 00:00:37,646 I think I lost my way. 19 00:01:02,627 --> 00:01:03,889 Morning. 20 00:01:03,933 --> 00:01:06,240 Thank you for letting me sleep here last night 21 00:01:06,283 --> 00:01:07,850 and letting me talk your ear off. 22 00:01:07,893 --> 00:01:09,721 Of course. 23 00:01:10,679 --> 00:01:14,204 So, uh, how you feeling, other than tired? 24 00:01:14,248 --> 00:01:18,252 Uh... Hmm. I feel like... 25 00:01:18,295 --> 00:01:20,123 a bulldozer ran over everyone 26 00:01:20,167 --> 00:01:21,777 and everything that I care about. 27 00:01:21,820 --> 00:01:24,171 All around me, I see destruction. 28 00:01:24,214 --> 00:01:26,477 And in the cold light of day, I realize 29 00:01:26,521 --> 00:01:29,785 that it was not a bulldozer that destroyed everything. 30 00:01:29,828 --> 00:01:31,613 It was me.Hmm. 31 00:01:31,656 --> 00:01:33,876 I think you're being a little hard on yourself. 32 00:01:33,919 --> 00:01:35,965 Nah. 33 00:01:36,008 --> 00:01:38,446 You should've seen the look on Malcolm's face. 34 00:01:38,489 --> 00:01:40,970 And what Lex said to me... not that I blame her. 35 00:01:41,013 --> 00:01:44,669 And my mother? I accused my own mother of not being on my side. 36 00:01:44,713 --> 00:01:47,846 Because of what? This vote for chief? 37 00:01:47,890 --> 00:01:49,631 I am a human bulldozer. 38 00:01:49,674 --> 00:01:51,067 You don't have to do that. Uh... 39 00:01:51,111 --> 00:01:52,851 No, it's fine. I want to. I just... 40 00:01:52,895 --> 00:01:55,158 I didn't expect anyone, so it's a mess. 41 00:01:55,202 --> 00:01:58,335 Compared to my life, this is nothing. 42 00:01:58,379 --> 00:02:01,251 Hey, you remember the last thing you said last night? 43 00:02:01,295 --> 00:02:03,297 Uh, was it something along the lines of, 44 00:02:03,340 --> 00:02:05,299 "I've become a power-crazed monster 45 00:02:05,342 --> 00:02:06,909 who hurts the people she loves"? 46 00:02:06,952 --> 00:02:09,999 No. It was, "I'm gonna make this right." 47 00:02:10,042 --> 00:02:11,957 And I said, 48 00:02:12,001 --> 00:02:13,959 "If anyone can do it, it's you." 49 00:02:14,003 --> 00:02:17,093 Did I happen to say how I was planning on doing that? 50 00:02:17,137 --> 00:02:20,662 No. At that point, you started snoring like a baby rhino. 51 00:02:20,705 --> 00:02:23,969 I do not snore. Caleb! 52 00:02:24,013 --> 00:02:26,494 I do not snore! 53 00:02:26,537 --> 00:02:29,671 I'm gonna... I'm gonna make this right. 54 00:02:29,714 --> 00:02:31,412 I'm gonna try. 55 00:02:32,456 --> 00:02:35,198 Well, uh, guess we better get to work. 56 00:02:35,242 --> 00:02:38,070 Yeah. Hey. 57 00:02:38,114 --> 00:02:39,550 Oh. 58 00:02:39,594 --> 00:02:42,031 I'm really glad you opened the door last night. 59 00:02:42,074 --> 00:02:44,555 Yeah, well, glad you knocked. 60 00:02:48,385 --> 00:02:51,388 I'm gonna get dressed. I love you. 61 00:02:51,432 --> 00:02:53,738 Yeah, get dressed. Me, too. 62 00:02:53,782 --> 00:02:56,088 I'm gonna brush my teeth, then I'm gonna... Yup.Yeah. 63 00:02:56,132 --> 00:02:57,829 Sounds good. 64 00:03:12,540 --> 00:03:14,890 I never should have called your mom. 65 00:03:14,933 --> 00:03:16,718 Okay. 66 00:03:17,545 --> 00:03:19,000 You told me that she was on the board, 67 00:03:19,024 --> 00:03:21,113 and all I could think about was her vote. 68 00:03:21,157 --> 00:03:24,073 But all I should've been thinking about was you. 69 00:03:24,116 --> 00:03:26,684 And how reaching out to her would make you feel. 70 00:03:26,728 --> 00:03:29,383 I'm... 71 00:03:29,426 --> 00:03:31,036 Damn it. It's the ER. 72 00:03:31,080 --> 00:03:32,429 You should go. 73 00:03:40,437 --> 00:03:41,917 What do we have? 74 00:03:41,960 --> 00:03:43,571 Violet Stein. 18. 75 00:03:43,614 --> 00:03:45,703 She fell at her high school track event. 76 00:03:45,747 --> 00:03:49,054 She was in first place, too. Okay, just gonna take a listen. 77 00:03:49,925 --> 00:03:52,275 There's a lot of turbulence 78 00:03:52,319 --> 00:03:53,755 between atrioventricular valves. 79 00:03:53,798 --> 00:03:55,757 Is that because of her broken rib? 80 00:03:55,800 --> 00:03:57,106 They said she has a broken rib. 81 00:03:57,149 --> 00:03:58,344 Looks like this is the third bone 82 00:03:58,368 --> 00:03:59,563 you've broken at a track meet. 83 00:03:59,587 --> 00:04:00,825 A lot of kids fall at these things. 84 00:04:00,849 --> 00:04:02,807 Well, three fractures is unusual. 85 00:04:02,851 --> 00:04:04,505 Are you getting enough vitamin D, calcium? 86 00:04:04,548 --> 00:04:06,768 We're very good about supplements. 87 00:04:06,811 --> 00:04:08,552 You have to be, on a vegan diet. 88 00:04:08,596 --> 00:04:11,860 Does this vegan diet include a lot of soy products? 89 00:04:11,903 --> 00:04:13,035 Yes. Why? 90 00:04:13,078 --> 00:04:15,255 No air entry left side. 91 00:04:15,298 --> 00:04:16,473 And vital signs are unstable. 92 00:04:16,517 --> 00:04:17,561 Violet, can you breathe? 93 00:04:17,605 --> 00:04:19,389 Tension pneumothorax. 94 00:04:19,433 --> 00:04:21,130 14 gauge needle. Three and a quarter inch. 95 00:04:21,173 --> 00:04:22,436 Excuse me. Quickly, please! 96 00:04:22,479 --> 00:04:24,220 What's happening? It's all right. 97 00:04:24,264 --> 00:04:25,502 Just hold on. Her rib is stabbing 98 00:04:25,526 --> 00:04:27,068 into her lung, and we need to clear the air 99 00:04:27,092 --> 00:04:28,331 that's trapped in her chest cavity. 100 00:04:28,355 --> 00:04:29,965 It's all right. 101 00:04:30,008 --> 00:04:31,227 Try to relax. 102 00:04:32,359 --> 00:04:33,664 It's okay. 103 00:04:33,708 --> 00:04:35,666 Straight into the trauma bay. 104 00:04:35,710 --> 00:04:38,930 Who's the patient? April Krane, 25, hypothermic. 105 00:04:38,974 --> 00:04:40,691 I'm told her dry suit ripped while scuba diving. 106 00:04:40,715 --> 00:04:42,325 Scuba diving? In the middle of winter? 107 00:04:42,369 --> 00:04:43,544 All the lakes are frozen. 108 00:04:43,587 --> 00:04:44,869 They cut a hole in the ice, I guess. 109 00:04:44,893 --> 00:04:46,851 Water under the surface is about 39 degrees. 110 00:04:46,895 --> 00:04:48,462 She lost consciousness on the way over. 111 00:04:48,505 --> 00:04:49,656 Okay, let's get these wet clothes off of her. 112 00:04:49,680 --> 00:04:50,875 Breathing is shallow, pulse is weak. 113 00:04:50,899 --> 00:04:51,769 All right. 114 00:04:51,813 --> 00:04:52,964 We need to get her core temp up. 115 00:04:52,988 --> 00:04:54,357 Bring a Bair Hugger in here, please. 116 00:04:54,381 --> 00:04:55,338 We could warm up her IV fluids. 117 00:04:55,382 --> 00:04:57,645 Good idea. I'll grab a bag. 118 00:05:03,607 --> 00:05:05,479 Hi.Hey. 119 00:05:05,522 --> 00:05:07,089 Still on trauma? 120 00:05:08,133 --> 00:05:10,222 Is that because of me? Not everything is about you. 121 00:05:10,266 --> 00:05:12,616 I am sorry that I threw you off that patient. 122 00:05:12,660 --> 00:05:14,009 I was out of line. 123 00:05:14,052 --> 00:05:16,316 If you want to come off trauma, 124 00:05:16,359 --> 00:05:17,534 it will not happen again. 125 00:05:17,578 --> 00:05:19,406 I like trauma. 126 00:05:30,417 --> 00:05:32,506 Oh, if I broke that many bones running track, 127 00:05:32,549 --> 00:05:34,377 I would take up chess.Mm. 128 00:05:34,421 --> 00:05:35,789 We should also check her B12 levels. 129 00:05:35,813 --> 00:05:38,642 Oh, it's not B12. Cadmium is the problem. 130 00:05:38,686 --> 00:05:40,644 Cadmium? Yeah, heavy metal, 131 00:05:40,688 --> 00:05:42,646 chemically similar to zinc and mercury.Yeah. 132 00:05:42,690 --> 00:05:44,692 Toxic levels linked to fragile bone syndrome 133 00:05:44,735 --> 00:05:46,563 and often found in... In soy products. 134 00:05:46,607 --> 00:05:48,609 Doesn't explain the mid-diastolic murmur you heard, 135 00:05:48,652 --> 00:05:50,108 but does address the fractures, at least. 136 00:05:50,132 --> 00:05:52,090 Okay, I'll run the labs. Dad, one more thing. 137 00:05:52,134 --> 00:05:54,179 Hmm? 138 00:05:55,920 --> 00:05:58,706 I'm done fighting you for the chief job. 139 00:05:58,749 --> 00:06:00,882 The job is yours. 140 00:06:00,925 --> 00:06:03,275 Uh, the vote's not for 42 days. 141 00:06:03,319 --> 00:06:04,581 They don't need to vote. 142 00:06:04,625 --> 00:06:08,019 What are you...? You quitting? 143 00:06:08,063 --> 00:06:10,457 Yeah. I'm out. 144 00:06:10,500 --> 00:06:12,459 Why? 145 00:06:12,502 --> 00:06:14,939 When you put so much into it? 146 00:06:14,983 --> 00:06:17,899 Too much, and that's the problem. I'm... 147 00:06:17,942 --> 00:06:20,075 I just want to focus on my patients, 148 00:06:20,118 --> 00:06:21,792 and I want to get you through your proctorship. 149 00:06:21,816 --> 00:06:24,427 Uh-huh. And speaking of which, 150 00:06:24,471 --> 00:06:26,908 we do have a double bypass on the schedule for later today. 151 00:06:26,951 --> 00:06:28,692 I'm aware. I am making you primary. 152 00:06:28,736 --> 00:06:30,955 You've aced every step so far, 153 00:06:30,999 --> 00:06:33,567 and it's time you do your first solo surgery. 154 00:06:33,610 --> 00:06:35,873 I'll see you in the OR. 155 00:06:36,700 --> 00:06:38,093 How do you 156 00:06:38,136 --> 00:06:40,356 accidentally say "I love you"? It just slipped out. 157 00:06:40,400 --> 00:06:42,837 I mean, I spent the whole night listening to her talk 158 00:06:42,880 --> 00:06:44,491 about making up with Malcolm. 159 00:06:44,534 --> 00:06:45,946 And then, right at the end, I blew it. 160 00:06:45,970 --> 00:06:48,320 Making up? Are they in a fight? 161 00:06:48,364 --> 00:06:49,626 I heard all about it 162 00:06:49,670 --> 00:06:51,672 right before dropping the "L" bomb on her. 163 00:06:51,715 --> 00:06:53,456 I mean, who does that? 164 00:06:53,500 --> 00:06:54,762 And she didn't say anything? 165 00:06:54,805 --> 00:06:56,590 Maybe she didn't hear me. 166 00:06:56,633 --> 00:06:59,941 Maybe she thought I said "I love the view," or, "I shove you." 167 00:06:59,984 --> 00:07:02,465 I just... I've never said it before. 168 00:07:02,509 --> 00:07:04,772 Never to Sam? Never to anyone. 169 00:07:04,815 --> 00:07:06,948 You've never said "I love you" to someone? 170 00:07:06,991 --> 00:07:08,621 You don't tell your mother you love her? Okay, yeah. 171 00:07:08,645 --> 00:07:09,951 My mom, sure, but... 172 00:07:09,994 --> 00:07:11,537 Why? How many people have you said it to? 173 00:07:11,561 --> 00:07:14,477 Hundreds. Hundreds? 174 00:07:14,521 --> 00:07:15,783 I'm very comfortable saying it. 175 00:07:15,826 --> 00:07:18,307 It's easier than you think. 176 00:07:18,350 --> 00:07:19,961 I love you, Caleb. 177 00:07:20,004 --> 00:07:21,876 See? Now you say it to me. 178 00:07:21,919 --> 00:07:24,139 Oh. No.Come on. Tell me you love me. 179 00:07:25,270 --> 00:07:27,229 You can do it, Dr. Tucker. 180 00:07:30,406 --> 00:07:31,929 I love... 181 00:07:32,843 --> 00:07:34,018 balloon angioplasty. 182 00:07:34,062 --> 00:07:35,106 And, look. 183 00:07:35,150 --> 00:07:37,631 There's one now in, uh, room 2115. 184 00:07:37,674 --> 00:07:40,111 So... 185 00:07:52,907 --> 00:07:54,648 Everything okay, Dr. Griffith? 186 00:07:54,691 --> 00:07:56,780 Yeah, fine. I just, uh... 187 00:07:56,824 --> 00:07:59,130 I just started thinking about my office. 188 00:07:59,174 --> 00:08:02,351 Maybe the desk should go here, huh? 189 00:08:02,394 --> 00:08:04,135 Wait. Your office? 190 00:08:04,179 --> 00:08:06,573 Yeah, well, it's not official till the vote, obviously, 191 00:08:06,616 --> 00:08:09,532 but, uh, now that I'm running unopposed, it's not exactly 192 00:08:09,576 --> 00:08:11,142 a nail biter. 193 00:08:11,186 --> 00:08:12,946 What-what do you mean, you're running unopposed? 194 00:08:12,970 --> 00:08:14,276 What happened to Sam? 195 00:08:14,319 --> 00:08:17,192 Well, she wants me back in charge. 196 00:08:17,235 --> 00:08:20,587 Back in surgery, back to normal. 197 00:08:20,630 --> 00:08:22,327 S-So she dropped out? 198 00:08:22,371 --> 00:08:23,807 Did she say why? 199 00:08:23,851 --> 00:08:25,330 I think that ultimately, she realized 200 00:08:25,374 --> 00:08:27,202 I'm the leader this department needed, 201 00:08:27,245 --> 00:08:29,030 that my world-class 202 00:08:29,073 --> 00:08:31,336 reputation... 203 00:08:38,561 --> 00:08:40,520 Well, I'm not saying it was easy, 204 00:08:40,563 --> 00:08:42,522 you two fighting all the time, 205 00:08:42,565 --> 00:08:44,828 but is dropping out the solution? 206 00:08:44,872 --> 00:08:46,830 Yes. And ever since this whole battle started, 207 00:08:46,874 --> 00:08:48,223 I haven't been myself. 208 00:08:48,266 --> 00:08:50,617 I haven't been there for you as a friend. 209 00:08:50,660 --> 00:08:52,706 Sure you have. What about your lawsuit? 210 00:08:52,749 --> 00:08:56,231 The lawsuit settled. And I wasn't there for you. 211 00:08:56,274 --> 00:08:58,973 Caleb sat up with me all night, just listening, 212 00:08:59,016 --> 00:09:01,584 and it made all the difference. 213 00:09:01,628 --> 00:09:04,282 It made all the difference? 214 00:09:04,326 --> 00:09:05,588 Labs on your track star. 215 00:09:05,632 --> 00:09:07,285 Thanks, Bernie. 216 00:09:10,071 --> 00:09:12,290 Your dad was right about the cadmium. 217 00:09:12,334 --> 00:09:15,250 The heavy metals, we can flush, but look at her troponin levels. 218 00:09:15,293 --> 00:09:19,210 BNP's elevated, too. Her cardiac enzymes are through the roof. 219 00:09:19,254 --> 00:09:21,386 How does a teenage track star have the biomarkers 220 00:09:21,430 --> 00:09:24,128 of an 85-year-old in advanced heart failure? 221 00:09:31,571 --> 00:09:33,529 Hey, there. You look a little lost. 222 00:09:33,573 --> 00:09:34,835 Yeah, I'm looking for my son. 223 00:09:34,878 --> 00:09:36,488 Apparently, he's in cardiothoracics. 224 00:09:36,532 --> 00:09:37,881 Oh, well, that's where I'm headed. 225 00:09:37,925 --> 00:09:39,579 Thank you, Doctor. 226 00:09:39,622 --> 00:09:41,145 Sure. Oh, if you want, 227 00:09:41,189 --> 00:09:43,931 I can look him up for you, tell you what room he's in. 228 00:09:43,974 --> 00:09:46,934 Oh, no, no. My son's not a patient. He works here. 229 00:09:52,679 --> 00:09:54,158 Hi. 230 00:09:54,202 --> 00:09:56,030 Hey. 231 00:09:56,073 --> 00:09:59,120 I didn't expect to see you here, not that 232 00:09:59,163 --> 00:10:01,383 you're here to see me. I shouldn't make that assumption. 233 00:10:01,426 --> 00:10:04,952 Not everything is about me. I saw your dad earlier. 234 00:10:04,995 --> 00:10:06,301 He-he was in your office. 235 00:10:06,344 --> 00:10:09,652 Oh. Well, was he measuring for drapes? 236 00:10:09,696 --> 00:10:11,741 So it is true. 237 00:10:11,785 --> 00:10:14,309 You dropped out of the race. 238 00:10:14,352 --> 00:10:16,441 Mm-hmm. 239 00:10:17,573 --> 00:10:20,881 Hurting you was a wake-up call for me, Malcolm. 240 00:10:20,924 --> 00:10:22,883 And I know that I can't undo the past, 241 00:10:22,926 --> 00:10:25,363 but I am not going to repeat it. 242 00:10:27,148 --> 00:10:30,107 For what it's worth, I think you would've beat him. 243 00:10:30,151 --> 00:10:32,196 With or without my mom. 244 00:10:32,240 --> 00:10:33,197 To be honest, 245 00:10:33,241 --> 00:10:34,459 I'm just hoping 246 00:10:34,503 --> 00:10:36,636 we can put the stuff with your mom behind us. 247 00:10:36,679 --> 00:10:38,812 Oh, it's definitely behind you. 248 00:10:41,771 --> 00:10:43,730 Hello, Malcolm. 249 00:10:45,732 --> 00:10:47,690 What are you doing here, Mom? 250 00:10:47,734 --> 00:10:49,866 Mom? 251 00:11:00,268 --> 00:11:01,225 Malcolm, please talk to me. 252 00:11:01,269 --> 00:11:02,531 You shouldn't have come. 253 00:11:02,574 --> 00:11:04,359 It wasn't my idea. Dr. Griffith called. 254 00:11:04,402 --> 00:11:06,013 Yes, and I am very sorry 255 00:11:06,056 --> 00:11:08,276 that you came all this way, Mrs. Kingsley. 256 00:11:08,319 --> 00:11:10,887 But everything has been resolved. 257 00:11:10,931 --> 00:11:12,889 My father will take over again soon. 258 00:11:12,933 --> 00:11:14,543 Your father can't even perform surgery. 259 00:11:14,586 --> 00:11:16,240 Why do you care? 260 00:11:16,284 --> 00:11:18,852 This isn't your concern. Of course it is. 261 00:11:18,895 --> 00:11:21,463 I mean, I don't do the day-to-day. 262 00:11:21,506 --> 00:11:23,465 That's supposed to be your father's job. 263 00:11:23,508 --> 00:11:25,467 But I do run this foundation. 264 00:11:25,510 --> 00:11:27,053 And should this hospital fall into disarray, 265 00:11:27,077 --> 00:11:29,732 well, that would make my job much harder. 266 00:11:29,776 --> 00:11:31,691 Everything is under control here. 267 00:11:31,734 --> 00:11:34,084 If that were true, you never would have called me. 268 00:11:34,128 --> 00:11:38,132 Dr. Griffith, you know, bad leadership leads to chaos. 269 00:11:38,175 --> 00:11:40,569 And chaos is bad for business... yours and mine. 270 00:11:40,612 --> 00:11:42,919 Order must be restored. 271 00:11:48,751 --> 00:11:50,710 You look like you're feeling better, April. 272 00:11:50,753 --> 00:11:52,799 I am. Super glad I'm not dead. 273 00:11:52,842 --> 00:11:54,931 Why were you diving down there in the first place? 274 00:11:54,975 --> 00:11:57,629 Are you kidding? The Great Lakes are full of shipwrecks. 275 00:11:57,673 --> 00:11:58,761 There's so much to explore. 276 00:11:58,805 --> 00:12:00,328 Why not explore in the summer 277 00:12:00,371 --> 00:12:02,199 when the risk of hypothermic death 278 00:12:02,243 --> 00:12:03,679 is just a little bit lower? 279 00:12:03,723 --> 00:12:05,028 The risk is why I do it. 280 00:12:05,072 --> 00:12:06,614 The bigger the risk, the bigger the rush. 281 00:12:06,638 --> 00:12:08,118 Hmm. Adrenaline junkie. 282 00:12:08,162 --> 00:12:10,077 You're like my fiancรฉe. 283 00:12:10,120 --> 00:12:11,774 What happened, exactly? 284 00:12:11,818 --> 00:12:14,298 I was inside one of the wrecks. 285 00:12:14,342 --> 00:12:16,126 So awesome. And... 286 00:12:16,170 --> 00:12:19,477 But then my hand cramped, and I dropped my flashlight, 287 00:12:19,521 --> 00:12:21,175 snagged my suit going after it. 288 00:12:21,218 --> 00:12:22,538 Wait. Y-Your hand cramped so badly 289 00:12:22,567 --> 00:12:23,849 that you couldn't hold on to your flashlight? 290 00:12:23,873 --> 00:12:26,267 Has that ever happened before? 291 00:12:26,310 --> 00:12:28,486 Yeah. All the time, actually. 292 00:12:28,530 --> 00:12:30,488 That can be a, uh, sign 293 00:12:30,532 --> 00:12:33,143 of a neurological condition called "focal dystonia." 294 00:12:33,187 --> 00:12:34,579 Neurological? 295 00:12:34,623 --> 00:12:36,494 Is there something wrong with my brain? 296 00:12:36,538 --> 00:12:39,541 It's more like, um, the way that your brain 297 00:12:39,584 --> 00:12:41,761 and your muscles talk to each other. 298 00:12:42,849 --> 00:12:45,765 We'll know more after the test. 299 00:12:45,808 --> 00:12:49,377 Violet Stein. That is one of the ugliest valves I've ever seen. 300 00:12:49,420 --> 00:12:51,858 Mitral deterioration is very advanced. 301 00:12:51,901 --> 00:12:54,164 There's no family history of heart disease? 302 00:12:54,208 --> 00:12:55,775 No. 303 00:12:55,818 --> 00:12:58,255 She's a typical teenager with no preexisting conditions. 304 00:12:58,299 --> 00:13:00,344 What about the cadmium toxicity? 305 00:13:00,388 --> 00:13:02,825 Well, explains the bones, but not the heart. And she's had 306 00:13:02,869 --> 00:13:04,479 no symptoms of valve disease? 307 00:13:04,522 --> 00:13:07,743 No. None. We only caught it because she fell. 308 00:13:07,787 --> 00:13:10,398 Although, the falling could be a symptom. 309 00:13:10,441 --> 00:13:12,356 Cardiovascular syncope. 310 00:13:12,400 --> 00:13:13,856 Blood flow to her brain is getting cut off during exertion. 311 00:13:13,880 --> 00:13:15,403 Like during a track event. 312 00:13:15,446 --> 00:13:18,493 She's broken multiple ribs. 313 00:13:18,536 --> 00:13:20,321 Because she's fallen during multiple races. 314 00:13:20,364 --> 00:13:23,193 She's gonna keep falling unless we replace this valve. 315 00:13:23,237 --> 00:13:26,370 We can do it today... after Dr. Griffith's 316 00:13:26,414 --> 00:13:28,242 bypass. 317 00:13:28,285 --> 00:13:30,026 Back-to-back surgeries. 318 00:13:30,070 --> 00:13:31,462 I love it. Yeah? 319 00:13:31,506 --> 00:13:32,875 Then why are you still standing here? 320 00:13:32,899 --> 00:13:35,292 Get to the OR, man your stations. 321 00:13:35,336 --> 00:13:37,425 Let's go, people. 322 00:13:49,176 --> 00:13:50,655 Byron. 323 00:13:50,699 --> 00:13:52,875 You know, after 324 00:13:52,919 --> 00:13:56,879 all these years, I still don't like this tie. 325 00:13:57,924 --> 00:13:59,969 What are you doing here, Tina? 326 00:14:00,013 --> 00:14:02,754 I was called, and now that I'm here, 327 00:14:02,798 --> 00:14:04,191 I have no intention 328 00:14:04,234 --> 00:14:06,149 of rubber-stamping the reinstatement 329 00:14:06,193 --> 00:14:08,064 of Rob Griffith as chief. 330 00:14:08,108 --> 00:14:10,893 I had reservations about him the first time around. 331 00:14:10,937 --> 00:14:13,940 You said you'd stay out of hospital business. 332 00:14:13,983 --> 00:14:15,943 And you said you'd stay out of our son's business. 333 00:14:15,985 --> 00:14:18,094 Yet, I see he's running around like your little clone. 334 00:14:18,118 --> 00:14:20,511 It was his decision to come here. It's not good 335 00:14:20,555 --> 00:14:22,098 for him to live in your shadow like this. 336 00:14:22,122 --> 00:14:24,211 Don't talk to me about what's good for him. 337 00:14:24,254 --> 00:14:26,996 You're the one who turned your back on this family. 338 00:14:27,040 --> 00:14:28,911 Which makes you, what? The blameless victim? 339 00:14:28,955 --> 00:14:30,434 Is that how you remember it? 340 00:14:30,478 --> 00:14:32,262 It's how it went down. 341 00:14:32,306 --> 00:14:34,177 Clearly, what our son thinks, too. 342 00:14:34,221 --> 00:14:36,092 You turned him against me. 343 00:14:36,136 --> 00:14:38,181 No. 344 00:14:38,225 --> 00:14:40,444 No, Tina. 345 00:14:40,488 --> 00:14:42,664 You did that all by yourself. 346 00:14:42,707 --> 00:14:46,886 Well, here's hoping I can undo it. 347 00:14:46,929 --> 00:14:49,236 See you at the next board meeting. 348 00:14:56,460 --> 00:14:59,594 A mechanical valve? 349 00:14:59,637 --> 00:15:01,161 Yes. 350 00:15:01,204 --> 00:15:03,903 They're strong, reliable. 351 00:15:03,946 --> 00:15:05,817 It should last you the rest of your life. 352 00:15:05,861 --> 00:15:07,950 How can she have heart disease? 353 00:15:07,994 --> 00:15:09,430 We're vegans. 354 00:15:09,473 --> 00:15:11,780 Our diets are very healthy. 355 00:15:13,347 --> 00:15:16,437 Your diet may not have caused your valve disease, 356 00:15:16,480 --> 00:15:20,136 but all of that soy and cadmium did contribute 357 00:15:20,180 --> 00:15:21,529 to your broken ribs. 358 00:15:21,572 --> 00:15:25,794 Now, a new valve will help your heart get stronger, 359 00:15:25,837 --> 00:15:28,101 but you'll likely need to make some dietary changes 360 00:15:28,144 --> 00:15:30,625 to help your bones get stronger, too. 361 00:15:30,668 --> 00:15:32,540 What kind of changes? 362 00:15:33,367 --> 00:15:36,239 Have you ever considered eating any fish or meat? 363 00:15:36,283 --> 00:15:37,893 No.No. 364 00:15:37,937 --> 00:15:40,678 Violet has never had so much as a glass of milk in her life. 365 00:15:40,722 --> 00:15:42,332 We are diligent about supplements, 366 00:15:42,376 --> 00:15:45,553 and getting all the nutrients we need from non-animal sources. 367 00:15:45,596 --> 00:15:46,922 If we need to cut back on soy, we will, 368 00:15:46,946 --> 00:15:48,860 but meat is not an option. 369 00:15:52,429 --> 00:15:54,954 Why don't we get you started with a new valve, 370 00:15:54,997 --> 00:15:57,217 and we'll take the rest from there? 371 00:16:02,570 --> 00:16:04,615 Your EMG results are in. 372 00:16:04,659 --> 00:16:07,053 Your motor unit recruitment is perfect. 373 00:16:07,096 --> 00:16:09,577 What does that mean? It means whatever's causing the cramp 374 00:16:09,620 --> 00:16:10,970 is probably not neurological. 375 00:16:11,013 --> 00:16:14,364 Oh. Well, does that mean I can go? 376 00:16:14,408 --> 00:16:16,168 We still haven't found the cause of the cramp. 377 00:16:16,192 --> 00:16:18,020 Hey, as long as my brain's okay, 378 00:16:18,064 --> 00:16:20,153 I can live with a few dropped flashlights 379 00:16:20,196 --> 00:16:21,719 and the occasional charley horse. 380 00:16:21,763 --> 00:16:23,112 Charley horse. 381 00:16:23,156 --> 00:16:24,698 Peripheral artery disease would explain the hand 382 00:16:24,722 --> 00:16:26,681 and the claudication in the lower extremities. 383 00:16:26,724 --> 00:16:28,639 She needs a stress test. 384 00:16:28,683 --> 00:16:31,077 You can't go just yet, April. 385 00:16:34,080 --> 00:16:35,516 So... 386 00:16:35,559 --> 00:16:38,736 Malcolm's mom is here. 387 00:16:38,780 --> 00:16:40,869 Yes. 388 00:16:46,266 --> 00:16:48,920 But you shouldn't feel guilty or anything. It's not like 389 00:16:48,964 --> 00:16:51,358 you told her to come. 390 00:16:51,401 --> 00:16:54,665 And... Hmm. I need to get my head in the game. 391 00:16:56,450 --> 00:16:57,842 I blew it. 392 00:16:57,886 --> 00:16:59,385 You didn't blow it. It was one "I love you." 393 00:16:59,409 --> 00:17:02,021 No. She's never gonna talk to me again. 394 00:17:02,064 --> 00:17:05,720 She said talking to you made all the difference. 395 00:17:05,763 --> 00:17:07,722 She said that? 396 00:17:07,765 --> 00:17:09,506 Mm-hmm. 397 00:17:09,550 --> 00:17:11,291 All right, gentlemen, 398 00:17:11,334 --> 00:17:14,598 are you ready to be reminded how a bypass should be done? 399 00:17:23,303 --> 00:17:25,261 You have an audience. 400 00:17:25,305 --> 00:17:27,002 It's good to be home. 401 00:17:27,046 --> 00:17:29,352 Right this way, Dr. Griffith. 402 00:17:29,396 --> 00:17:32,268 I know where the patient's head is, Dr. Shah. 403 00:17:33,661 --> 00:17:35,010 Ah. 404 00:17:35,054 --> 00:17:37,491 Let's see if we can get him to the heart. 405 00:17:37,534 --> 00:17:38,840 Okay. 406 00:17:38,883 --> 00:17:40,537 It's all for you, Dad. 407 00:17:40,581 --> 00:17:42,017 Ten blade to me. 408 00:17:45,542 --> 00:17:47,066 Hit it. 409 00:18:04,170 --> 00:18:05,736 Loupes? 410 00:18:20,534 --> 00:18:22,144 All right. 411 00:18:23,841 --> 00:18:25,800 Remove the clamp. 412 00:18:31,632 --> 00:18:33,416 Aortic clamp is off. 413 00:18:33,460 --> 00:18:36,027 Electrical activity is restored. Perfect. 414 00:18:36,071 --> 00:18:37,701 Not so fast. There is excess tissue 415 00:18:37,725 --> 00:18:39,988 over the proximal anastomosis. 416 00:18:47,038 --> 00:18:48,344 Now it's perfect. 417 00:19:00,356 --> 00:19:02,967 : Well done, Dad. 418 00:19:16,590 --> 00:19:17,982 Hey, is everything okay? 419 00:19:21,769 --> 00:19:23,771 Yeah. Just, uh, the light 420 00:19:23,814 --> 00:19:25,251 was angled towards my eyes. 421 00:19:25,294 --> 00:19:27,122 Let's watch that next time. 422 00:19:27,166 --> 00:19:29,820 Close up, Dr. Tucker. 423 00:19:40,266 --> 00:19:42,920 Nice bypass, everyone. We owe Violet a mechanical valve. 424 00:19:42,964 --> 00:19:44,705 Next, back-to-back surgeries today. 425 00:19:44,748 --> 00:19:46,097 Back-to-backs.Back-to-backs. 426 00:19:46,141 --> 00:19:48,230 Uh, I hate to miss out on all the fun, 427 00:19:48,274 --> 00:19:50,556 but I think I should probably go and dictate an operative report 428 00:19:50,580 --> 00:19:52,234 on that bypass, don't you? 429 00:19:52,278 --> 00:19:53,888 Sooner you can sign off on this step 430 00:19:53,931 --> 00:19:55,933 the better, right? 431 00:19:55,977 --> 00:19:57,805 Yeah, sure.Okay. 432 00:19:57,848 --> 00:20:00,024 One step closer, Dad. 433 00:20:00,938 --> 00:20:02,505 One step closer. 434 00:20:17,564 --> 00:20:19,261 What is all this? 435 00:20:19,305 --> 00:20:21,568 We think there's a blockage in your arteries 436 00:20:21,611 --> 00:20:23,787 restricting blood flow to your extremities. 437 00:20:23,831 --> 00:20:25,267 This is gonna help us find it. 438 00:20:25,311 --> 00:20:27,138 I just start running? Mm-hmm. 439 00:20:27,182 --> 00:20:29,445 This IV has a radioactive tracer in it. 440 00:20:29,489 --> 00:20:31,447 So we're gonna get your heart pumping 441 00:20:31,491 --> 00:20:33,144 and let the tracer lead us to the problem. 442 00:20:33,188 --> 00:20:34,798 Take her to four. 443 00:20:34,842 --> 00:20:36,496 How fast does it go? 444 00:20:36,539 --> 00:20:38,933 Most people get up to about a six. 445 00:20:38,976 --> 00:20:41,805 Take me to seven. You sure? 446 00:20:45,374 --> 00:20:47,637 Heart rate's at 140. 447 00:20:47,681 --> 00:20:50,292 All right, her hand's cramping. Are you okay, April? 448 00:20:50,336 --> 00:20:51,772 It hurts. What hurts? 449 00:20:51,815 --> 00:20:53,469 Everything. Take her down. 450 00:20:53,513 --> 00:20:54,818 No! Take me higher. 451 00:20:54,862 --> 00:20:56,448 April... Please, you have to. Going faster is 452 00:20:56,472 --> 00:20:58,344 the only way to make it stop. Make what stop? 453 00:20:58,387 --> 00:21:00,476 The pain! All right, all right. I'm pulling it. 454 00:21:00,520 --> 00:21:02,478 All right, all right. 455 00:21:07,918 --> 00:21:10,573 Mind telling me what happened in that bypass? 456 00:21:10,617 --> 00:21:12,053 What are you talking about? 457 00:21:12,096 --> 00:21:13,291 Your father dropped an instrument 458 00:21:13,315 --> 00:21:14,925 in the middle of surgery. 459 00:21:14,969 --> 00:21:16,318 The surgery was over, 460 00:21:16,362 --> 00:21:17,904 and surgeons drop instruments all the time. 461 00:21:17,928 --> 00:21:20,017 When was the last time he dropped one? 462 00:21:20,061 --> 00:21:21,497 I'm due in another surgery soon. 463 00:21:21,541 --> 00:21:23,673 He was in a coma for six months. Now he can't 464 00:21:23,717 --> 00:21:25,434 get through a routine surgery without incident. 465 00:21:25,458 --> 00:21:27,590 There was no incident. I know what I saw. 466 00:21:27,634 --> 00:21:29,810 With all due respect, I am Dr. Griffith's proctor. 467 00:21:29,853 --> 00:21:31,159 I am the only person 468 00:21:31,202 --> 00:21:33,030 who is authorized to assess his progress, 469 00:21:33,074 --> 00:21:35,337 and I am telling you that there is no issue 470 00:21:35,381 --> 00:21:37,687 or concern regarding his performance. 471 00:21:38,558 --> 00:21:42,213 Well, I guess that's all there is to say. 472 00:21:48,132 --> 00:21:50,700 Stress test shows her arteries are clear. 473 00:21:50,744 --> 00:21:52,876 We know her nerve and muscle function are normal. 474 00:21:52,920 --> 00:21:54,487 So, what's with the hand cramp? 475 00:21:54,530 --> 00:21:57,272 It only happens during extreme activity. My guess: 476 00:21:57,316 --> 00:21:59,361 involuntary response to stress hormones. 477 00:21:59,405 --> 00:22:01,189 So, she stops the extreme sports 478 00:22:01,232 --> 00:22:02,538 and the hand cramp goes away. 479 00:22:02,582 --> 00:22:04,540 But she's not gonna stop. Why not? 480 00:22:04,584 --> 00:22:06,890 I see it with Tim, too. He'll do anything for a rush. 481 00:22:06,934 --> 00:22:08,370 Except with April, it's even 482 00:22:08,414 --> 00:22:10,285 more intense. What if the hand cramp 483 00:22:10,329 --> 00:22:12,200 is actually a small price to pay for the upside 484 00:22:12,243 --> 00:22:13,767 of all of those stress hormones? 485 00:22:13,810 --> 00:22:15,986 The adrenaline, the cortisol, all of those endorphins 486 00:22:16,030 --> 00:22:18,293 that act as natural painkillers? 487 00:22:18,337 --> 00:22:21,383 She's not chasing a high. She's self-medicating. 488 00:22:21,427 --> 00:22:23,429 The hand cramp isn't the problem. It's... 489 00:22:23,472 --> 00:22:25,605 it's the solution to the problem, 490 00:22:25,648 --> 00:22:29,217 Which is... chronic pain. 491 00:22:29,260 --> 00:22:31,350 Okay, let's get an MRI. 492 00:22:31,393 --> 00:22:33,917 Whatever's causing this pain, jumping out of a airplane 493 00:22:33,961 --> 00:22:36,180 can't be the only way to treat it. 494 00:22:36,224 --> 00:22:38,966 I'm on it. Thank you. 495 00:22:51,152 --> 00:22:53,372 Hey.Mm. Hey. 496 00:22:53,415 --> 00:22:55,678 You want some company? 497 00:22:55,722 --> 00:22:58,202 Sure. 498 00:22:59,639 --> 00:23:01,597 I thought you were in the valve replacement. 499 00:23:01,641 --> 00:23:03,643 Yeah, uh, so, Sam gave me the, uh, 500 00:23:03,686 --> 00:23:05,688 bypass surgery at the last minute. 501 00:23:05,732 --> 00:23:07,516 You were primary? 502 00:23:09,039 --> 00:23:11,041 Oh, that's great. How do you feel? 503 00:23:11,085 --> 00:23:13,392 Yeah, good. I, uh, 504 00:23:13,435 --> 00:23:15,829 just need to, um, come down 505 00:23:15,872 --> 00:23:17,613 a bit from the adrenaline rush. 506 00:23:17,657 --> 00:23:19,441 Mm. 507 00:23:23,489 --> 00:23:27,667 All right. Well, uh, you do that, 508 00:23:27,710 --> 00:23:30,234 and come find me later. 509 00:23:30,278 --> 00:23:31,801 Mm-hmm. All right. 510 00:23:31,845 --> 00:23:33,673 Hey, do me a favor. Hmm? 511 00:23:33,716 --> 00:23:36,240 Just slip that back in the charger, 512 00:23:36,284 --> 00:23:38,634 preferably when Donna's not looking. 513 00:23:38,678 --> 00:23:40,810 What did you do? 514 00:23:40,854 --> 00:23:43,160 Did you drop it? 515 00:23:43,204 --> 00:23:44,945 No. It was like that when I found it. 516 00:23:44,988 --> 00:23:46,555 Liar. 517 00:23:46,599 --> 00:23:48,427 And what if Donna thinks I broke it? 518 00:23:48,470 --> 00:23:50,298 You say it was like that when you found it. 519 00:24:02,658 --> 00:24:04,704 What are you doing with the quarterly reports? 520 00:24:04,747 --> 00:24:06,532 Reading them. 521 00:24:06,575 --> 00:24:09,448 I would have used your father's office, but I couldn't find it. 522 00:24:09,491 --> 00:24:11,493 Uh, he doesn't have one. Doesn't have one? 523 00:24:11,537 --> 00:24:14,496 What, does he do... skulk around like Phantom of the Opera? 524 00:24:14,540 --> 00:24:17,194 I have work. Whatever you're doing, 525 00:24:17,238 --> 00:24:19,153 can you do it somewhere else, please? 526 00:24:24,245 --> 00:24:26,377 We never talked about my leaving. 527 00:24:26,421 --> 00:24:28,249 What is there to say? 528 00:24:29,903 --> 00:24:31,557 You left. The end. 529 00:24:31,600 --> 00:24:32,819 I left him. 530 00:24:32,862 --> 00:24:35,517 I didn't leave you. 531 00:24:35,561 --> 00:24:37,258 And I didn't leave because I wanted to. 532 00:24:37,301 --> 00:24:38,825 I left because I had to. 533 00:24:38,868 --> 00:24:42,655 You had to? There's only one way with your father. 534 00:24:42,698 --> 00:24:45,701 If you can be what he wants you to be, 535 00:24:45,745 --> 00:24:47,703 if you can stay within those lines 536 00:24:47,747 --> 00:24:49,879 that he draws for you, then you're good. 537 00:24:49,923 --> 00:24:52,012 But I couldn't do it, Malcolm. 538 00:24:52,055 --> 00:24:54,318 I knew that if I chose to be myself, 539 00:24:54,362 --> 00:24:56,538 it would cost me the marriage. 540 00:24:56,582 --> 00:24:59,759 But I never imagined it would cost me my son. 541 00:25:00,760 --> 00:25:02,370 And I hope 542 00:25:02,413 --> 00:25:04,720 it's not too late to get him back. 543 00:25:04,764 --> 00:25:06,722 How can I trust you 544 00:25:06,766 --> 00:25:08,594 after all this time? I... 545 00:25:08,637 --> 00:25:11,379 I'm not asking for your trust. 546 00:25:11,422 --> 00:25:15,383 I'm asking you to give me a chance to earn your trust. 547 00:25:17,472 --> 00:25:19,692 I-I need to get to work. 548 00:25:21,781 --> 00:25:25,567 Yeah. Yeah, me too. 549 00:25:26,612 --> 00:25:28,527 Um, you know, 550 00:25:28,570 --> 00:25:31,791 I know this hospital better than you think. 551 00:25:31,834 --> 00:25:33,880 I could do some... some good around here. 552 00:25:33,923 --> 00:25:36,143 With your blessing, of course. But, um, 553 00:25:36,186 --> 00:25:37,971 if you want me to leave, I... 554 00:25:38,014 --> 00:25:40,364 I can be on the next flight. 555 00:25:59,427 --> 00:26:02,604 Ready for the valve, Dr. Shah.Mm-hmm. 556 00:26:02,648 --> 00:26:05,955 A new valve in healthy 18-year-old? 557 00:26:05,999 --> 00:26:07,827 You don't see that every day. 558 00:26:11,221 --> 00:26:13,789 Hold on. Something's not right here. 559 00:26:13,833 --> 00:26:15,182 I need more light. 560 00:26:17,488 --> 00:26:19,882 Look at this. 561 00:26:19,926 --> 00:26:21,536 Annular calcification. 562 00:26:21,580 --> 00:26:23,558 But that didn't show up in the echo. No, it did not. 563 00:26:23,582 --> 00:26:26,541 The annulus is supposed to be firm. This is like Jell-O. 564 00:26:26,585 --> 00:26:29,196 Liquefactive necrosis. I can't attach 565 00:26:29,239 --> 00:26:31,154 the metal to this tissue. It's too viscous. 566 00:26:31,198 --> 00:26:32,547 I... 567 00:26:32,591 --> 00:26:34,636 There's literally nothing for me to sew into. 568 00:26:34,680 --> 00:26:36,507 You need something more pliable. 569 00:26:36,551 --> 00:26:38,771 BP and O2 sats are trending down. 570 00:26:38,814 --> 00:26:42,165 Call down for a bioprosthetic valve, stat.Wh... 571 00:26:42,209 --> 00:26:43,384 A pig valve? 572 00:26:43,427 --> 00:26:44,820 Well, it's not a vegan option, 573 00:26:44,864 --> 00:26:47,693 but it'll keep her alive. 574 00:26:50,043 --> 00:26:52,654 Telling a vegan mother you put a pig valve 575 00:26:52,698 --> 00:26:55,526 in her vegan daughter's heart? Not the high point of my day. 576 00:26:55,570 --> 00:26:57,156 Well, that valve is also keeping her alive. 577 00:26:58,747 --> 00:26:59,835 Oh. 578 00:26:59,879 --> 00:27:02,838 Thanks, man. I appreciate it.Mm-hmm. 579 00:27:02,882 --> 00:27:05,667 And also... I love you. 580 00:27:05,711 --> 00:27:07,321 What? 581 00:27:07,364 --> 00:27:09,410 Nothing. You did it! 582 00:27:09,453 --> 00:27:11,020 Good for you, Dr. Tucker. 583 00:27:11,064 --> 00:27:14,023 What? He accidentally said "I love you" to Sam. 584 00:27:14,067 --> 00:27:16,373 We're trying to normalize it so it's not such a big deal. 585 00:27:16,417 --> 00:27:18,506 That advice is why some of us are engaged 586 00:27:18,549 --> 00:27:20,247 and why others are going to die alone. 587 00:27:20,290 --> 00:27:21,683 Look, I'm desperate, man, okay? 588 00:27:21,727 --> 00:27:23,554 I cannot let things get weird with me and Sam. 589 00:27:23,598 --> 00:27:25,382 So, this is the not-weird solution? 590 00:27:25,426 --> 00:27:26,862 Just go with it. 591 00:27:26,906 --> 00:27:28,864 Fine. 592 00:27:28,908 --> 00:27:31,475 Say it again. 593 00:27:33,086 --> 00:27:34,565 I love you. 594 00:27:34,609 --> 00:27:35,958 You're not my type. 595 00:27:37,786 --> 00:27:40,310 That stung a little. 596 00:27:43,749 --> 00:27:46,969 Operative report... dotted the I's, crossed the T's. 597 00:27:47,013 --> 00:27:49,450 Does that report mention the scalpel that you dropped? 598 00:27:49,493 --> 00:27:51,147 Why would it? 599 00:27:51,191 --> 00:27:53,672 Because I've never seen you drop an instrument. 600 00:27:53,715 --> 00:27:55,412 I told you, it was the lights. 601 00:27:55,456 --> 00:27:57,763 I've also never heard you complain about the lights. 602 00:27:57,806 --> 00:27:59,590 I'm worried that I put you in too soon, 603 00:27:59,634 --> 00:28:01,157 and I want to sign off on this, 604 00:28:01,201 --> 00:28:02,744 but I need to understand what happened in there. 605 00:28:02,768 --> 00:28:04,378 A successful bypass is what happened. 606 00:28:04,421 --> 00:28:05,901 Who cares about a scalpel? 607 00:28:05,945 --> 00:28:08,077 I'll tell you who cares. 608 00:28:08,121 --> 00:28:09,296 Dad. 609 00:28:09,339 --> 00:28:11,820 Tina Kingsley cares. 610 00:28:11,864 --> 00:28:14,040 She's raising questions about your competency 611 00:28:14,083 --> 00:28:15,694 after what she saw. 612 00:28:15,737 --> 00:28:18,566 I told you she never liked me. I covered for you. 613 00:28:18,609 --> 00:28:21,961 I said there was nothing to worry about. Is that true? 614 00:28:22,004 --> 00:28:24,050 It was the lights. 615 00:28:34,103 --> 00:28:36,279 I heard what happened with the scalpel. 616 00:28:36,323 --> 00:28:37,890 Scrub nurses like to gossip. 617 00:28:37,933 --> 00:28:39,979 And what, you think I'm being too hard on him? 618 00:28:40,022 --> 00:28:42,024 Because it was my idea to put him back in surgery. 619 00:28:42,068 --> 00:28:43,809 I know. This is just due diligence. 620 00:28:43,852 --> 00:28:45,288 I want to clear him. 621 00:28:45,332 --> 00:28:46,855 I don't think you should. 622 00:28:46,899 --> 00:28:49,902 You don't think he's ready? I think 623 00:28:49,945 --> 00:28:53,296 he should be ready. I think he thinks he's ready. 624 00:28:53,340 --> 00:28:54,776 But? 625 00:28:54,820 --> 00:28:57,823 That scalpel's not the only thing he's dropped. 626 00:29:08,877 --> 00:29:11,097 Her hands are ice-cold and she won't wake up. 627 00:29:11,140 --> 00:29:12,141 Heart rate's 140. 628 00:29:12,185 --> 00:29:13,447 Why is she so tachycardic? 629 00:29:13,490 --> 00:29:15,362 And hypotensive. 630 00:29:15,405 --> 00:29:16,643 Blood pressure's 90/40 and dropping. 631 00:29:16,667 --> 00:29:17,930 Maybe she's turning septic. 632 00:29:17,973 --> 00:29:19,540 Have we gotten another H and H? 633 00:29:19,583 --> 00:29:20,822 There's no fever, she hasn't lost any blood volume. 634 00:29:20,846 --> 00:29:21,997 Could she be rejecting the valve? 635 00:29:22,021 --> 00:29:23,128 No, acute and chronic rejection 636 00:29:23,152 --> 00:29:24,458 takes weeks to occur. 637 00:29:24,501 --> 00:29:26,155 She's been out of surgery about an hour. 638 00:29:26,199 --> 00:29:27,548 Could be hyperacute. SAM: No. 639 00:29:27,591 --> 00:29:28,549 Then we would've known before we closed up. 640 00:29:28,592 --> 00:29:29,550 This is something else. 641 00:29:29,593 --> 00:29:30,769 What's happening? 642 00:29:30,812 --> 00:29:32,727 Her heart is failing. 643 00:29:32,771 --> 00:29:34,705 I need you to increase her Levophed, get another pressor. 644 00:29:34,729 --> 00:29:37,166 We got to get her pressure up, and I want a cardiac MRI 645 00:29:37,210 --> 00:29:38,994 as soon as she is stable. 646 00:29:39,038 --> 00:29:42,041 Her body hates this valve. I want to know why. 647 00:29:43,564 --> 00:29:45,218 Postoperative ultrasound confirmed 648 00:29:45,261 --> 00:29:46,654 the graft was seamless. 649 00:29:46,697 --> 00:29:48,525 Well, installation's not the problem. 650 00:29:48,569 --> 00:29:51,224 Maybe it's a defect in the valve? Well... 651 00:29:51,267 --> 00:29:53,748 I'm gonna check the production lot for reported problems. 652 00:29:56,620 --> 00:29:58,840 Look at the leaflets on the mitral valve. 653 00:30:01,538 --> 00:30:03,845 They're so stiff.Uh-huh. 654 00:30:03,889 --> 00:30:06,021 And what are those spots? 655 00:30:06,065 --> 00:30:07,414 They look like goosebumps. 656 00:30:07,457 --> 00:30:09,459 Or hives. 657 00:30:09,503 --> 00:30:11,418 Can we see if there's inflammation, please? 658 00:30:13,768 --> 00:30:15,422 Ah. 659 00:30:15,465 --> 00:30:16,858 Lit up like a Christmas tree. 660 00:30:16,902 --> 00:30:18,251 That is an allergic reaction. 661 00:30:18,294 --> 00:30:20,253 But to what? 662 00:30:20,296 --> 00:30:21,689 Anesthesia's out of her system. 663 00:30:21,732 --> 00:30:23,691 The only thing she could be reacting to... 664 00:30:23,734 --> 00:30:25,911 The valve itself. 665 00:30:30,350 --> 00:30:32,308 She's allergic to meat? 666 00:30:32,352 --> 00:30:34,397 To animal protein, yes. 667 00:30:34,441 --> 00:30:37,923 I've never heard of this. What did you say it's called? 668 00:30:37,966 --> 00:30:39,881 Alpha-gal syndrome. 669 00:30:39,925 --> 00:30:42,623 It's a reaction to the sugar molecule in most mammals. 670 00:30:42,666 --> 00:30:44,407 It is a severe allergy, 671 00:30:44,451 --> 00:30:48,324 but because Violet's never eaten meat, she was never diagnosed. 672 00:30:48,368 --> 00:30:50,109 She was fine. 673 00:30:50,152 --> 00:30:53,068 She had a broken rib, but she was fine. 674 00:30:53,112 --> 00:30:55,636 How did things get so bad so fast? 675 00:30:55,679 --> 00:30:58,204 I know that she seemed fine, 676 00:30:58,247 --> 00:31:02,338 but something has been damaging her heart. 677 00:31:02,382 --> 00:31:03,731 But you don't know what it is. 678 00:31:03,774 --> 00:31:05,298 The mechanical valve didn't work. 679 00:31:05,341 --> 00:31:07,909 The pig valve isn't working. Her heart is failing. 680 00:31:07,953 --> 00:31:10,607 Which is why we need to give her a new one. 681 00:31:16,439 --> 00:31:19,878 Your MRI shows that you have spinal stenosis. 682 00:31:21,749 --> 00:31:24,099 It's the narrowing of your spinal cavity 683 00:31:24,143 --> 00:31:26,580 that's compressing your nerves and causing your chronic pain. 684 00:31:26,623 --> 00:31:27,973 Well, can you fix it? 685 00:31:28,016 --> 00:31:30,671 Mm-hmm. It's called a laminectomy. 686 00:31:30,714 --> 00:31:32,673 We remove part of your vertebra 687 00:31:32,716 --> 00:31:34,588 to ease the pressure on your nerves. 688 00:31:34,631 --> 00:31:36,546 Sounds complicated. 689 00:31:36,590 --> 00:31:38,200 There are risks, but 690 00:31:38,244 --> 00:31:41,856 the bigger the risk, the bigger the rush, right? 691 00:31:44,511 --> 00:31:46,992 Look, April, 692 00:31:47,035 --> 00:31:50,560 I know you found a way to cope with your pain, 693 00:31:50,604 --> 00:31:52,867 but it's just temporary. 694 00:31:52,911 --> 00:31:55,304 Problems like these do not go away on their own. 695 00:31:55,348 --> 00:31:58,612 In fact, they usually get worse. 696 00:32:09,710 --> 00:32:11,973 Lying down in the middle of a shift? 697 00:32:12,017 --> 00:32:13,670 This is another first, Dad. 698 00:32:13,714 --> 00:32:15,020 It's low blood sugar. 699 00:32:15,063 --> 00:32:17,979 Or post-exertional malaise. 700 00:32:18,023 --> 00:32:19,676 Is that why you ducked out of 701 00:32:19,720 --> 00:32:21,852 the valve replacement surgery? I'll have some 702 00:32:21,896 --> 00:32:23,854 trail mix, I'll be fine. 703 00:32:23,898 --> 00:32:26,335 I want to run a blood panel on you, a full workup. 704 00:32:26,379 --> 00:32:27,684 Whoa! Why? 705 00:32:27,728 --> 00:32:29,860 Because I know about the headaches 706 00:32:29,904 --> 00:32:31,514 and the ringing in your ears, 707 00:32:31,558 --> 00:32:34,256 the photosensitivity. 708 00:32:34,300 --> 00:32:37,694 And I hear you dropped a tablet in addition to that scalpel. 709 00:32:39,392 --> 00:32:41,872 Et tu, Brute? 710 00:32:41,916 --> 00:32:43,439 I'm worried about you. 711 00:32:43,483 --> 00:32:45,548 Ignoring this isn't gonna make it go away. SAM: I can't 712 00:32:45,572 --> 00:32:47,922 clear you for surgery unless we address these symptoms. 713 00:32:47,966 --> 00:32:49,576 Symptoms? It's nothing. 714 00:32:49,619 --> 00:32:51,360 It's a little bit of anemia or something. 715 00:32:51,404 --> 00:32:54,146 Maybe. But the headaches could be a sentinel bleed, 716 00:32:54,189 --> 00:32:55,549 or a subarachnoid hemorrhage, or... 717 00:32:55,582 --> 00:32:57,192 Or a tumor.Mm. 718 00:32:57,236 --> 00:33:00,108 I see no cause for alarm. 719 00:33:00,152 --> 00:33:04,025 Neither did our patient until her heart started to fail. 720 00:33:04,069 --> 00:33:06,549 You need bloodwork and scans. 721 00:33:06,593 --> 00:33:07,811 I'm not having a scan. 722 00:33:07,855 --> 00:33:08,987 Dad, this is serious. 723 00:33:09,030 --> 00:33:10,727 So am I. Word gets out... 724 00:33:10,771 --> 00:33:12,468 Tina Kingsley finds out... It's all over. 725 00:33:12,512 --> 00:33:14,470 Forget it. 726 00:33:14,514 --> 00:33:16,907 Okay, fine. Just bloodwork for now. 727 00:33:16,951 --> 00:33:18,735 I can get around Bernie. 728 00:33:20,520 --> 00:33:22,261 Yeah, I think I prefer it 729 00:33:22,304 --> 00:33:24,959 when you two don't talk to each other. 730 00:33:34,490 --> 00:33:36,362 Uh... Going down? 731 00:33:36,405 --> 00:33:37,885 Uh, yeah, to the lab. 732 00:33:40,453 --> 00:33:42,803 Thanks.Yeah. 733 00:33:45,110 --> 00:33:47,677 How are things going with your mom? 734 00:33:47,721 --> 00:33:51,072 Mm. She wants a fresh start. 735 00:33:51,116 --> 00:33:53,727 Not that she has any right to ask for that. 736 00:33:54,641 --> 00:33:56,643 You're probably right. 737 00:33:56,686 --> 00:33:59,167 But you could still give her one. 738 00:33:59,211 --> 00:34:02,910 Sometimes people just need a second chance, 739 00:34:02,953 --> 00:34:05,869 you know, before it's too late. 740 00:34:15,749 --> 00:34:17,707 I've got some bloodwork for you, Bernie. 741 00:34:17,751 --> 00:34:19,144 Who's the patient? 742 00:34:19,187 --> 00:34:22,234 Um, I didn't put a name. Say it's me? 743 00:34:22,277 --> 00:34:23,800 Is it you? 744 00:34:23,844 --> 00:34:25,715 How about we say yes and I'll owe you one. 745 00:34:25,759 --> 00:34:30,024 You and everybody else. It's death by a thousand cuts. 746 00:34:35,508 --> 00:34:37,640 Hang on. Bernie, can you run labs 747 00:34:37,684 --> 00:34:39,729 on something that isn't human? 748 00:34:43,168 --> 00:34:45,146 Why did you want to see all the supplements we take? 749 00:34:45,170 --> 00:34:46,997 So that our lab could test them. 750 00:34:47,041 --> 00:34:49,217 Test them for what? We know 751 00:34:49,261 --> 00:34:50,349 Violet has alpha-gal. 752 00:34:50,392 --> 00:34:52,655 The meat allergy. Yes, which explains 753 00:34:52,699 --> 00:34:54,004 your reaction to the pig valve. 754 00:34:54,048 --> 00:34:55,223 What it doesn't explain is 755 00:34:55,267 --> 00:34:56,746 the heart condition you came in with, 756 00:34:56,790 --> 00:34:58,835 because you are a lifelong vegan. 757 00:34:58,879 --> 00:35:00,750 Whatever's been damaging Violet's heart, 758 00:35:00,794 --> 00:35:03,231 we assumed it had to be something other than meat. 759 00:35:03,275 --> 00:35:06,147 But she has no other conditions, no other factors 760 00:35:06,191 --> 00:35:08,410 that could explain the damage to her heart. 761 00:35:08,454 --> 00:35:10,282 It had to be the alpha-gal. 762 00:35:10,325 --> 00:35:11,326 Which means you had 763 00:35:11,370 --> 00:35:12,675 to be consuming meat. 764 00:35:12,719 --> 00:35:14,286 Your vitamin B-12 765 00:35:14,329 --> 00:35:18,159 supplements are encased in a capsule 766 00:35:18,203 --> 00:35:20,335 derived from animal proteins. 767 00:35:20,379 --> 00:35:23,164 Now, the amount in each capsule is too small 768 00:35:23,208 --> 00:35:24,600 to trigger an outward reaction. 769 00:35:24,644 --> 00:35:26,559 But the chronic insult 770 00:35:26,602 --> 00:35:29,779 to your system damaged your heart over time. 771 00:35:29,823 --> 00:35:32,217 The label says they're vegan.Yes. 772 00:35:32,260 --> 00:35:34,871 But supplements are not regulated by the FDA. 773 00:35:34,915 --> 00:35:36,699 The-the labels, the ingredients... 774 00:35:36,743 --> 00:35:38,895 They're not verified the way the prescription medications are. 775 00:35:38,919 --> 00:35:41,878 So, I-I've been taking meat pills? 776 00:35:43,010 --> 00:35:44,403 The good news is that you are at 777 00:35:44,446 --> 00:35:46,013 the top of the transplant list, 778 00:35:46,056 --> 00:35:48,320 and it is not too late for a new start. 779 00:35:48,363 --> 00:35:50,757 We're gonna get a nutritionist. We'll make meal plans. 780 00:35:50,800 --> 00:35:53,107 We're gonna be okay. Stop saying "we." 781 00:35:53,151 --> 00:35:54,935 What? 782 00:35:54,978 --> 00:35:57,024 We're not the same person. 783 00:35:57,067 --> 00:36:01,724 If it were up to me, maybe I wouldn't even be vegan. 784 00:36:01,768 --> 00:36:03,093 I might have eaten a hamburger by now 785 00:36:03,117 --> 00:36:05,075 and found out about this sooner. 786 00:36:05,119 --> 00:36:06,599 None of this would've happened 787 00:36:06,642 --> 00:36:09,167 if you had just let me make my own decisions. 788 00:36:09,210 --> 00:36:11,130 Violet, I was just trying to do what I thought... 789 00:36:11,169 --> 00:36:12,953 Well, you were wrong. 790 00:36:18,698 --> 00:36:20,221 Donor match for Violet Stein. 791 00:36:20,265 --> 00:36:22,223 We got a hit? Yeah. She'll have a new heart 792 00:36:22,267 --> 00:36:24,225 by tomorrow. CALEB: I'll get her on the schedule. 793 00:36:24,269 --> 00:36:26,880 Okay, great, and I'll notify the family. Okay. 794 00:36:26,923 --> 00:36:29,056 Oh. Sorry. 795 00:36:29,926 --> 00:36:32,015 You know what? Uh, after you. 796 00:36:32,059 --> 00:36:33,582 You go.I... 797 00:36:33,626 --> 00:36:35,236 Okay, I'll go. 798 00:36:37,325 --> 00:36:39,109 What was that? 799 00:36:39,153 --> 00:36:42,591 That was... awkward. 800 00:36:42,635 --> 00:36:44,114 Mm. 801 00:36:44,941 --> 00:36:46,508 I accidentally said "I love you." 802 00:36:46,552 --> 00:36:48,554 I've been trying to undo it, but... 803 00:36:48,597 --> 00:36:50,469 Why, because you don't love her? 804 00:37:03,003 --> 00:37:04,831 Everything okay? 805 00:37:04,874 --> 00:37:06,659 Yeah. Uh... Well, 806 00:37:06,702 --> 00:37:08,138 I can do this if you want 807 00:37:08,182 --> 00:37:09,638 to join Dr. Griffith and tell the family 808 00:37:09,662 --> 00:37:11,098 about the transplant. 809 00:37:11,141 --> 00:37:14,232 No. I got to, uh, get to the lab, anyway, so... 810 00:37:14,275 --> 00:37:16,277 Okay. 811 00:37:21,674 --> 00:37:24,329 Dad says once you break trust, it's gone. 812 00:37:24,372 --> 00:37:27,723 I know he'd say this is a mistake, 813 00:37:27,767 --> 00:37:30,726 but if you want to stay... 814 00:37:30,770 --> 00:37:34,339 I won't stop you. 815 00:37:35,165 --> 00:37:37,167 Thank you for this chance. 816 00:37:37,211 --> 00:37:39,866 I hope I don't regret it. 817 00:37:41,215 --> 00:37:44,000 All I want is to make things better 818 00:37:44,044 --> 00:37:47,221 for us and for this hospital. 819 00:37:48,048 --> 00:37:49,310 Starting with 820 00:37:49,354 --> 00:37:51,573 the cardiothoracic department. 821 00:38:00,756 --> 00:38:02,280 Hey. 822 00:38:02,323 --> 00:38:03,455 Hey. 823 00:38:03,498 --> 00:38:05,152 Look, I know you're out of the race, 824 00:38:05,195 --> 00:38:07,154 but I just want to let you know 825 00:38:07,197 --> 00:38:09,765 that my mom has some plans for your department. 826 00:38:09,809 --> 00:38:10,853 What do you mean? 827 00:38:10,897 --> 00:38:11,917 Well, she's opening the position 828 00:38:11,941 --> 00:38:13,160 to outside candidates. 829 00:38:13,203 --> 00:38:15,336 Thought your dad might like to know 830 00:38:15,380 --> 00:38:17,686 that he won't be running unopposed for too long. 831 00:38:17,730 --> 00:38:20,776 Um... I'll tell him. 832 00:38:20,820 --> 00:38:23,039 Yeah. 833 00:38:23,083 --> 00:38:24,171 So... 834 00:38:24,214 --> 00:38:27,653 she's sticking around, then? 835 00:38:27,696 --> 00:38:29,524 Yeah. 836 00:38:29,568 --> 00:38:33,223 Uh, I'm gonna try this whole second chance thing. 837 00:38:35,269 --> 00:38:37,140 I'm still so sorry. 838 00:38:37,184 --> 00:38:39,969 No, no, don't. Hey, it's okay. 839 00:38:40,013 --> 00:38:42,537 It's just, I-I got to figure out 840 00:38:42,581 --> 00:38:44,539 this stuff with my mom right now, and... 841 00:38:44,583 --> 00:38:48,064 I get it. You don't have to explain. 842 00:38:49,283 --> 00:38:51,677 I will see you around. 843 00:38:52,678 --> 00:38:54,593 I'll see you around. 844 00:38:54,636 --> 00:38:56,682 Okay. 845 00:39:04,254 --> 00:39:05,255 Hey. 846 00:39:05,299 --> 00:39:06,909 How'd it go in there? 847 00:39:06,953 --> 00:39:08,389 Oh, yeah, she's stable. 848 00:39:08,433 --> 00:39:10,411 Um, I just finished the paperwork for the transplant. 849 00:39:10,435 --> 00:39:14,874 Her mom was just doing what she thought was best, wasn't she? 850 00:39:14,917 --> 00:39:16,658 She didn't know what her daughter needed. 851 00:39:16,702 --> 00:39:21,228 This morning, what I said, um, 852 00:39:21,271 --> 00:39:23,752 is probably the last thing you need. 853 00:39:23,796 --> 00:39:26,407 It was probably the worst possible time to say it, 854 00:39:26,451 --> 00:39:28,670 but I did, and I don't want to pretend like I didn't. 855 00:39:28,714 --> 00:39:30,498 What did you say? 856 00:39:31,325 --> 00:39:33,196 I said "I love you." 857 00:39:34,023 --> 00:39:36,069 Which you clearly didn't hear. 858 00:39:36,112 --> 00:39:40,116 Um, but that's-that's good, because it just 859 00:39:40,160 --> 00:39:43,119 slipped out. It was an accident, and it shouldn't have happened. 860 00:39:43,946 --> 00:39:46,558 At least, not like that. 861 00:39:46,601 --> 00:39:49,517 What are you saying? 862 00:39:49,561 --> 00:39:53,129 I... love you. 863 00:39:54,870 --> 00:39:57,220 I love you. 864 00:39:57,264 --> 00:39:59,788 Oh. That's how it should've happened. 865 00:39:59,832 --> 00:40:02,095 Because that's how I feel. 866 00:40:02,138 --> 00:40:04,184 And now you know. 867 00:40:16,936 --> 00:40:18,459 What are you doing in here? 868 00:40:18,503 --> 00:40:20,069 I always used to come down here 869 00:40:20,113 --> 00:40:22,071 before surgery and after. 870 00:40:22,115 --> 00:40:26,293 Your mother would say, "He's in church." 871 00:40:27,076 --> 00:40:29,122 Me too. 872 00:40:29,165 --> 00:40:30,950 Hmm. 873 00:40:31,777 --> 00:40:35,520 Tina Kingsley is widening the search for chief. 874 00:40:35,563 --> 00:40:37,652 She's not gonna make it easy for me, is she? 875 00:40:37,696 --> 00:40:39,175 You'll be fine. 876 00:40:39,219 --> 00:40:43,005 Your history and relationships. 877 00:40:43,049 --> 00:40:44,920 No one can compete with you. 878 00:40:44,964 --> 00:40:47,923 I know one person who can. 879 00:40:47,967 --> 00:40:49,490 I told you I'm out, Dad. 880 00:40:49,534 --> 00:40:51,187 Well, maybe you should reconsider. 881 00:40:51,231 --> 00:40:54,103 Better you than an outsider, right? 882 00:40:54,147 --> 00:40:57,063 What about you? 883 00:40:58,543 --> 00:41:02,547 You got your test results. 884 00:41:02,590 --> 00:41:04,026 Not anemia. 885 00:41:04,070 --> 00:41:05,593 Okay. 886 00:41:05,637 --> 00:41:08,030 That doesn't mean it's a worst-case scenario. 887 00:41:08,074 --> 00:41:09,467 Doesn't rule it out, either. 888 00:41:11,207 --> 00:41:12,513 This race may be decided for me. 889 00:41:12,557 --> 00:41:14,515 If it is, I would prefer you to be the one... 890 00:41:14,559 --> 00:41:18,388 Stop. We're not talking about work. We're going to imaging. 891 00:41:19,999 --> 00:41:21,522 No arguments. 892 00:41:27,354 --> 00:41:30,270 Thanks for telling me about this. 893 00:41:32,272 --> 00:41:34,666 Thanks for telling me about his symptoms. 894 00:41:36,276 --> 00:41:38,800 I'm really glad you're here. 895 00:41:39,801 --> 00:41:41,542 Me too. 896 00:41:41,586 --> 00:41:45,328 Just want to remind you of a little thing called 897 00:41:45,372 --> 00:41:47,592 doctor-patient confidentiality. 898 00:41:47,635 --> 00:41:49,550 A-And Sam? 899 00:41:50,377 --> 00:41:53,467 Don't worry. I'm not gonna tell Mom. 900 00:41:58,603 --> 00:42:02,258 Captioning sponsored by CBS 901 00:42:02,302 --> 00:42:05,479 Captioned by Media Access Group at WGBH access.wgbh.org 60908

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