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Previously onGood Sam...
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I have been trying to
keep up with you in a game
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00:00:08,573 --> 00:00:11,228
that you've had rigged
the entire time.
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00:00:11,272 --> 00:00:13,143
I'm going to go
and tell Sam everything.
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00:00:13,187 --> 00:00:14,666
I think I'm all
caught up.
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00:00:14,710 --> 00:00:17,017
Ambulance has just landed.
Step back, Dr. Trulie.
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00:00:17,060 --> 00:00:18,516
You don't need to worry
about your best friend
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00:00:18,540 --> 00:00:19,454
being with your dad because
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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.
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00:00:32,902 --> 00:00:34,860
I want you to know that
you can talk to me.
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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.
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00:01:07,893 --> 00:01:09,721
Of course.
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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.
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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.
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00:01:29,828 --> 00:01:31,613
It was me.Hmm.
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00:01:31,656 --> 00:01:33,876
I think you're being a
little hard on yourself.
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00:01:33,919 --> 00:01:35,965
Nah.
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00:01:36,008 --> 00:01:38,446
You should've seen the
look on Malcolm's face.
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00:01:38,489 --> 00:01:40,970
And what Lex said to me...
not that I blame her.
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00:01:41,013 --> 00:01:44,669
And my mother? I accused my own
mother of not being on my side.
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00:01:44,713 --> 00:01:47,846
Because of what?
This vote for chief?
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00:01:47,890 --> 00:01:49,631
I am a human bulldozer.
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00:01:49,674 --> 00:01:51,067
You don't have
to do that. Uh...
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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.
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00:01:55,202 --> 00:01:58,335
Compared to my life,
this is nothing.
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00:01:58,379 --> 00:02:01,251
Hey, you remember the last
thing you said last night?
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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,
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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!
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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.
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00:02:42,074 --> 00:02:44,555
Yeah, well, glad you knocked.
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00:02:48,385 --> 00:02:51,388
I'm gonna get
dressed. I love you.
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00:02:51,432 --> 00:02:53,738
Yeah, get dressed. Me, too.
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00:02:53,782 --> 00:02:56,088
I'm gonna brush my teeth,
then I'm gonna... Yup.Yeah.
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00:02:56,132 --> 00:02:57,829
Sounds good.
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00:03:12,540 --> 00:03:14,890
I never should have
called your mom.
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00:03:14,933 --> 00:03:16,718
Okay.
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00:03:17,545 --> 00:03:19,000
You told me that she
was on the board,
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00:03:19,024 --> 00:03:21,113
and all I could think
about was her vote.
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00:03:21,157 --> 00:03:24,073
But all I should've been
thinking about was you.
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00:03:24,116 --> 00:03:26,684
And how reaching out to
her would make you feel.
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00:03:26,728 --> 00:03:29,383
I'm...
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00:03:29,426 --> 00:03:31,036
Damn it. It's the ER.
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00:03:31,080 --> 00:03:32,429
You should go.
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00:03:40,437 --> 00:03:41,917
What do we have?
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00:03:41,960 --> 00:03:43,571
Violet Stein. 18.
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00:03:43,614 --> 00:03:45,703
She fell at her high
school track event.
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00:03:45,747 --> 00:03:49,054
She was in first place, too.
Okay, just gonna take a listen.
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00:03:49,925 --> 00:03:52,275
There's a lot of turbulence
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00:03:52,319 --> 00:03:53,755
between atrioventricular valves.
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00:03:53,798 --> 00:03:55,757
Is that because
of her broken rib?
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00:03:55,800 --> 00:03:57,106
They said she has a broken rib.
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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.
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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.
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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.
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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.
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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
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