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1
00:00:01,277 --> 00:00:02,894
He's putting me on a renal diet.
2
00:00:02,895 --> 00:00:04,576
And if that doesn't turn
things around, then...
3
00:00:04,577 --> 00:00:05,576
Dialysis?
4
00:00:05,577 --> 00:00:07,379
I'm so sorry.
5
00:00:07,380 --> 00:00:10,173
I don't advertise
my immigration status,
6
00:00:10,174 --> 00:00:11,896
but I'm undocumented.
7
00:00:11,897 --> 00:00:15,066
My future always
feels precarious.
8
00:00:15,067 --> 00:00:16,806
More money in our checks!
9
00:00:16,807 --> 00:00:18,856
We are essential!
10
00:00:18,857 --> 00:00:20,986
- You're striking?
- It's very important
11
00:00:20,987 --> 00:00:23,296
that Liliana feels
like I have her back.
12
00:00:23,297 --> 00:00:24,856
I'm going with my
friends to celebrate.
13
00:00:24,857 --> 00:00:26,076
- Come!
- Oh, no...
14
00:00:26,077 --> 00:00:28,167
- You have to come.
- You're my boyfriend.
15
00:00:34,567 --> 00:00:35,876
Lil.
16
00:00:35,877 --> 00:00:37,306
Daniel.
17
00:00:37,307 --> 00:00:38,436
Oh, the time.
18
00:00:38,437 --> 00:00:40,446
I didn't realize.
19
00:00:40,447 --> 00:00:42,396
I... I'm almost finished.
20
00:00:42,397 --> 00:00:44,796
I'm usually done
before you arrive.
21
00:00:44,797 --> 00:00:45,886
- I'm sorry.
- Oh, no.
22
00:00:45,887 --> 00:00:47,056
No, let me get that.
Let me get that.
23
00:00:47,057 --> 00:00:49,056
I'm the one who
should be apologizing.
24
00:00:49,057 --> 00:00:52,016
No. No, I had the interns
in for pizza last night.
25
00:00:52,017 --> 00:00:52,976
Then they dragged
me out for a drink,
26
00:00:52,977 --> 00:00:54,626
and... and we just left.
27
00:00:54,627 --> 00:00:55,846
It's OK. I've got it.
28
00:00:55,847 --> 00:00:57,416
I apologize for the
mess. Really, I do.
29
00:00:57,417 --> 00:00:58,716
It's OK.
30
00:00:58,717 --> 00:01:00,987
Compared to other offices,
it's not that bad.
31
00:01:03,597 --> 00:01:06,376
Oh!
32
00:01:06,377 --> 00:01:08,596
Daniel, have a good day.
33
00:01:08,597 --> 00:01:09,907
You too.
34
00:01:15,127 --> 00:01:16,126
Ah.
35
00:01:16,127 --> 00:01:18,916
I think this belongs to you.
36
00:01:18,917 --> 00:01:20,876
- Indeed, it does.
- Where did you find it?
37
00:01:20,877 --> 00:01:22,136
This time? Waiting room.
38
00:01:22,137 --> 00:01:23,966
- Top of the vending machine.
- Mm.
39
00:01:23,967 --> 00:01:26,316
You know, maybe I
should just put it
40
00:01:26,317 --> 00:01:28,316
in a little red-and-white
striped shirt,
41
00:01:28,317 --> 00:01:30,356
put a bobble hat on
it, black glasses,
42
00:01:30,357 --> 00:01:33,976
and call it my "Where's
Waldo?" water bottle, huh?
43
00:01:33,977 --> 00:01:35,976
You get it?
44
00:01:35,977 --> 00:01:37,546
I get it.
45
00:01:37,547 --> 00:01:39,157
You have to stay hydrated.
46
00:01:39,977 --> 00:01:41,587
Thanks, Mom.
47
00:01:44,937 --> 00:01:46,286
Dr. Cuevas.
48
00:01:46,287 --> 00:01:49,036
- Ms. Goodwin, good morning.
- Good morning.
49
00:01:49,037 --> 00:01:52,556
Do you have a moment to
discuss your DACA renewal?
50
00:01:52,557 --> 00:01:55,166
Oh. Um, now?
51
00:01:55,167 --> 00:01:57,736
Well, the paperwork's
not due for a few months,
52
00:01:57,737 --> 00:02:00,346
but I want to make sure we
get everything filed early,
53
00:02:00,347 --> 00:02:02,916
just in case there's an
unexpected policy change.
54
00:02:02,917 --> 00:02:05,486
- Right, of course.
- I appreciate that.
55
00:02:05,487 --> 00:02:07,916
I just was about to dig
into these overnight charts.
56
00:02:07,917 --> 00:02:09,526
Understood.
57
00:02:09,527 --> 00:02:12,276
How about we meet up
at the end of the day?
58
00:02:12,277 --> 00:02:15,016
Yeah. Sure, that works.
59
00:02:15,017 --> 00:02:17,017
I will...
I'll see you then.
60
00:02:19,887 --> 00:02:21,066
- Dr. Asher.
- Mm-hmm?
61
00:02:21,067 --> 00:02:22,066
- Need you.
- Oh, yeah.
62
00:02:22,067 --> 00:02:23,716
Come this way.
63
00:02:23,717 --> 00:02:25,116
Hi, I'm Dr. Asher.
64
00:02:25,117 --> 00:02:27,856
Leah, what's going on?
65
00:02:27,857 --> 00:02:29,506
Parents and their daughter.
66
00:02:29,507 --> 00:02:31,856
Came in a few minutes
ago. They're terrified.
67
00:02:31,857 --> 00:02:34,516
- Even scared me.
- Going to two.
68
00:02:34,517 --> 00:02:36,256
- I didn't get a history.
- Just came for you.
69
00:02:36,257 --> 00:02:38,296
- Excuse me, Doctor.
- We need your help.
70
00:02:38,297 --> 00:02:40,216
- Our daughter.
- All right.
71
00:02:40,217 --> 00:02:42,606
Hi, I'm Dr. Halstead.
What's your name?
72
00:02:42,607 --> 00:02:44,216
Maria.
73
00:02:44,217 --> 00:02:46,216
Her name is Maria. Very sick!
74
00:02:46,217 --> 00:02:49,267
Listen.
75
00:02:52,397 --> 00:02:54,616
I'm sorry. I
don't speak Spanish.
76
00:02:54,617 --> 00:02:56,486
Get Dr. Cuevas.
77
00:02:56,487 --> 00:02:59,887
I'm just gonna
feel your neck, OK?
78
00:03:00,927 --> 00:03:02,276
Does that hurt?
79
00:03:02,277 --> 00:03:03,587
ยฟMalo? Bad?
80
00:03:13,687 --> 00:03:14,896
What are they saying?
81
00:03:14,897 --> 00:03:17,036
They're saying that
she has the sickness,
82
00:03:17,037 --> 00:03:19,427
and if we don't help
her, she will die.
83
00:03:34,527 --> 00:03:36,448
Thank you.
84
00:03:36,449 --> 00:03:38,450
Hey. How's Maria doing?
85
00:03:38,451 --> 00:03:39,542
Still a bit groggy,
86
00:03:39,543 --> 00:03:41,366
but responding to
questions in English.
87
00:03:41,367 --> 00:03:43,586
Whatever this is, it
seems to be sporadic.
88
00:03:43,587 --> 00:03:45,456
- Any guesses?
- I don't know.
89
00:03:45,457 --> 00:03:48,546
Maybe infectious encephalitis,
but her vitals were normal.
90
00:03:48,547 --> 00:03:50,026
I'm hoping labs shed some light.
91
00:03:50,027 --> 00:03:51,626
What did Mom and
Dad have to say?
92
00:03:51,627 --> 00:03:53,276
The sickness that
they're referring to
93
00:03:53,277 --> 00:03:54,926
has to do with her
older brother, Hugo.
94
00:03:54,927 --> 00:03:57,266
About a month ago, he
came down with an illness,
95
00:03:57,267 --> 00:03:58,916
was admitted to Oakview
Community Hospital,
96
00:03:58,917 --> 00:04:01,876
- and then died a few days later.
- Oh, man.
97
00:04:01,877 --> 00:04:03,186
Yeah, and even worse,
98
00:04:03,187 --> 00:04:05,146
Oakview couldn't
make a diagnosis.
99
00:04:05,147 --> 00:04:07,016
Well, explains why they're
beating down our doors.
100
00:04:07,017 --> 00:04:09,456
They're afraid whatever ravaged
Hugo is now attacking Maria.
101
00:04:09,457 --> 00:04:12,496
But a death in the
family, no answers,
102
00:04:12,497 --> 00:04:15,126
plus the fear that she
might have the same illness?
103
00:04:15,127 --> 00:04:17,516
Since nothing's jumping
out, I think it's possible
104
00:04:17,517 --> 00:04:19,646
that her emotions could
be manifesting physically.
105
00:04:19,647 --> 00:04:21,386
I want to talk to her,
see if there could be
106
00:04:21,387 --> 00:04:22,686
- a psych explanation.
- OK.
107
00:04:22,687 --> 00:04:24,246
Meantime, I'll reach
out to Oakview,
108
00:04:24,247 --> 00:04:26,126
get Hugo's records
and autopsy results.
109
00:04:26,127 --> 00:04:27,486
If Maria does have
the same illness,
110
00:04:27,487 --> 00:04:30,236
- there could be a clue in there.
- OK.
111
00:04:30,237 --> 00:04:32,416
OK, Layla, you're 7
centimeters dilated,
112
00:04:32,417 --> 00:04:34,066
100% effaced.
113
00:04:34,067 --> 00:04:35,676
How long ago did
your water break?
114
00:04:35,677 --> 00:04:38,377
About an hour, hour and a...
115
00:04:39,767 --> 00:04:41,946
7:02 a.m., I think.
116
00:04:41,947 --> 00:04:43,776
This baby is
coming out sideways.
117
00:04:43,777 --> 00:04:45,076
No, it just feels like that.
118
00:04:45,077 --> 00:04:46,206
Your fetus is OP,
119
00:04:46,207 --> 00:04:47,776
meaning it's facing
up instead of down.
120
00:04:47,777 --> 00:04:49,086
- Something's wrong?
- No.
121
00:04:49,087 --> 00:04:50,696
Baby's just moving
around, letting us know
122
00:04:50,697 --> 00:04:52,436
that it is time to come out.
123
00:04:52,437 --> 00:04:54,046
I'll have a nurse let L&D know.
124
00:04:54,047 --> 00:04:55,476
Oh, my God.
125
00:04:55,477 --> 00:04:57,306
Quentin, our son is coming.
126
00:04:57,307 --> 00:04:59,096
I'm gonna be a mom today.
127
00:04:59,097 --> 00:05:01,316
You know, I can't remember
if I turned off the oven
128
00:05:01,317 --> 00:05:02,536
before we left the house.
129
00:05:02,537 --> 00:05:04,356
Quentin, we haven't
cooked in days.
130
00:05:04,357 --> 00:05:05,796
The oven is off.
131
00:05:05,797 --> 00:05:07,016
I'm just gonna
go home and check.
132
00:05:07,017 --> 00:05:08,236
Quentin, no!
133
00:05:08,237 --> 00:05:10,016
- Mr. Bell, please don't go.
- You know what?
134
00:05:10,017 --> 00:05:11,716
Maybe you can have a
neighbor check on it,
135
00:05:11,717 --> 00:05:13,146
or maybe it's just
nervous energy
136
00:05:13,147 --> 00:05:14,976
that's making you think
that you left it on.
137
00:05:14,977 --> 00:05:17,326
Yeah, I just don't
feel like myself.
138
00:05:17,327 --> 00:05:19,326
I get it. It's a big day.
139
00:05:19,327 --> 00:05:20,546
You know, a lot
of new experiences
140
00:05:20,547 --> 00:05:21,816
all happening at once.
141
00:05:21,817 --> 00:05:25,336
But, Quentin, this
is not new for me.
142
00:05:25,337 --> 00:05:26,946
I have been here
many, many times,
143
00:05:26,947 --> 00:05:28,426
and I know exactly how
to help you and Layla
144
00:05:28,427 --> 00:05:30,686
get through this.
145
00:05:30,687 --> 00:05:31,907
Thank you.
146
00:05:33,127 --> 00:05:34,176
Sorry, Lay.
147
00:05:34,177 --> 00:05:36,087
I just lost my
mind for a minute.
148
00:05:38,217 --> 00:05:40,957
- Nice save.
- Mm-hmm.
149
00:05:42,527 --> 00:05:46,006
Hey, Sam. This
is Dr. Tanaka-Reed.
150
00:05:46,007 --> 00:05:47,406
He's gonna be scrubbing
in with me today.
151
00:05:47,407 --> 00:05:48,926
He's one of my
surgical residents.
152
00:05:48,927 --> 00:05:50,496
Uh, technically I'm a resident
153
00:05:50,497 --> 00:05:52,056
but definitely not a beginner.
154
00:05:52,057 --> 00:05:52,976
OK.
155
00:05:52,977 --> 00:05:54,936
Anyway, like we discussed,
156
00:05:54,937 --> 00:05:56,586
it's a straight
appendix removal.
157
00:05:56,587 --> 00:05:58,066
You're gonna be a
bit sore afterwards,
158
00:05:58,067 --> 00:06:00,326
but in a week or two, you'll
be back to full strength.
159
00:06:00,327 --> 00:06:01,936
Mm, perfect,
160
00:06:01,937 --> 00:06:03,896
because I've been itching
to get back in the gym.
161
00:06:03,897 --> 00:06:05,636
Rugged Maniac is this summer.
162
00:06:05,637 --> 00:06:07,856
- Rugged Maniac?
- The adventure race?
163
00:06:07,857 --> 00:06:09,596
- You know it?
- Yeah, sort of.
164
00:06:09,597 --> 00:06:10,686
A couple of guys
from the community
165
00:06:10,687 --> 00:06:11,996
are putting a team together.
166
00:06:11,997 --> 00:06:13,866
Community? You
mean other doctors?
167
00:06:13,867 --> 00:06:16,866
No, CrossFit.
168
00:06:16,867 --> 00:06:19,176
From my Kalsu group.
Kalsu's a workout.
169
00:06:19,177 --> 00:06:21,046
We do burpees and
thrusters for time.
170
00:06:21,047 --> 00:06:22,616
Anyway, back to
the task at hand.
171
00:06:22,617 --> 00:06:24,527
If you're ready, we're ready.
172
00:06:25,327 --> 00:06:27,156
- Let's do this.
- Great.
173
00:06:27,157 --> 00:06:28,896
Nurse Trisha will be in
to get the prep started.
174
00:06:28,897 --> 00:06:31,376
- Anesthesia after that.
- Sounds good, Doc.
175
00:06:31,377 --> 00:06:33,377
See you on the
other side, all right?
176
00:06:35,577 --> 00:06:38,196
- Appendix removal...
- Pretty basic.
177
00:06:38,197 --> 00:06:39,886
Well, sorry Sam's not
sick enough for you.
178
00:06:39,887 --> 00:06:41,196
Oh, you know what I mean.
179
00:06:41,197 --> 00:06:43,636
OR 2.0 is a Ferrari...
Sexy surgery.
180
00:06:43,637 --> 00:06:45,766
But a lap appy?
That's a minivan.
181
00:06:45,767 --> 00:06:47,806
Well, not even in that today.
182
00:06:47,807 --> 00:06:50,596
Sam had a sigmoid colon
resection 18 months ago.
183
00:06:50,597 --> 00:06:52,036
Likely adhesions in his pelvis,
184
00:06:52,037 --> 00:06:54,686
so we're gonna do
this appy open...
185
00:06:54,687 --> 00:06:56,426
Right lower quadrant incision.
186
00:06:56,427 --> 00:06:58,086
- OK?
- Old school.
187
00:06:58,087 --> 00:07:01,086
Gee, hope I'm up
to the challenge.
188
00:07:01,087 --> 00:07:03,736
For a resident, guy
sure is full of himself.
189
00:07:03,737 --> 00:07:05,177
I'm not a fan.
190
00:07:08,227 --> 00:07:09,917
Hugo's gone.
191
00:07:11,647 --> 00:07:14,127
I'm oldest now. I
need to be strong.
192
00:07:15,917 --> 00:07:17,838
For my other
brothers and sisters.
193
00:07:19,307 --> 00:07:20,697
For my parents.
194
00:07:23,590 --> 00:07:25,695
They've been a wreck
since Hugo died.
195
00:07:27,707 --> 00:07:29,576
They can't sleep.
196
00:07:29,577 --> 00:07:31,536
They can't eat.
197
00:07:31,537 --> 00:07:34,537
Now I'm putting them
through it again.
198
00:07:36,339 --> 00:07:38,196
- I have it too.
- No.
199
00:07:38,197 --> 00:07:40,376
Hey, we don't know that.
200
00:07:40,377 --> 00:07:43,856
All of the labs Dr. Halstead
ran came back normal.
201
00:07:43,857 --> 00:07:46,557
Then what's wrong with me?
202
00:07:47,727 --> 00:07:50,076
In some cases, it's possible
203
00:07:50,077 --> 00:07:53,946
for grief and fear to
lead to physical symptoms.
204
00:07:53,947 --> 00:07:56,606
No, I'm not imagining this.
205
00:07:56,607 --> 00:07:58,436
No, you're not.
206
00:07:58,437 --> 00:08:01,696
Your symptoms are very real.
207
00:08:01,697 --> 00:08:05,565
You suffered a devastating
loss, a trauma.
208
00:08:08,707 --> 00:08:11,187
Hugo's tests were normal too.
209
00:08:14,187 --> 00:08:16,107
And then he died.
210
00:08:20,197 --> 00:08:21,976
I don't think we're
looking at a psych condition.
211
00:08:21,977 --> 00:08:23,636
In conversion
disorder, it's rare
212
00:08:23,637 --> 00:08:26,116
that patients can express their
emotions the way Maria is.
213
00:08:26,117 --> 00:08:28,416
But her awareness
of the situation,
214
00:08:28,417 --> 00:08:31,426
her acknowledgment of
the fear, it doesn't fit.
215
00:08:31,427 --> 00:08:34,206
There's definitely
something physical going on.
216
00:08:34,207 --> 00:08:35,646
I wish I knew what.
217
00:08:35,647 --> 00:08:37,476
Medical examiner said Hugo
died of brain swelling
218
00:08:37,477 --> 00:08:39,296
but don't know what caused it.
219
00:08:39,297 --> 00:08:41,216
It was only three days
220
00:08:41,217 --> 00:08:43,346
from when Hugo was admitted
to the time he died.
221
00:08:43,347 --> 00:08:46,957
OK, so whatever it is,
it moved really fast.
222
00:08:48,917 --> 00:08:51,706
I think he's stuck.
223
00:08:51,707 --> 00:08:52,926
No, just a big head.
224
00:08:52,927 --> 00:08:54,926
That's all.
225
00:08:54,927 --> 00:08:56,186
Oh, my God.
226
00:08:56,187 --> 00:08:57,886
- Is he gonna fit?
- Yes, he will.
227
00:08:57,887 --> 00:08:59,316
We just need to open up the
birth canal a bit wider.
228
00:08:59,317 --> 00:09:00,716
- McRoberts?
- Yes.
229
00:09:00,717 --> 00:09:02,586
Call the OB resident on call.
230
00:09:02,587 --> 00:09:05,106
Layla, we're gonna adjust
you to a new position, OK?
231
00:09:05,107 --> 00:09:06,676
It makes it easier for
the baby to come out.
232
00:09:06,677 --> 00:09:07,976
OK.
233
00:09:07,977 --> 00:09:09,726
- I'm right here.
- All right, Quentin.
234
00:09:09,727 --> 00:09:11,546
Why don't you let him
take over for you, OK?
235
00:09:11,547 --> 00:09:12,726
- And I can use some pressure.
- Yep.
236
00:09:12,727 --> 00:09:15,116
I'm right here.
237
00:09:15,117 --> 00:09:16,856
OK, now on your
next contraction,
238
00:09:16,857 --> 00:09:18,516
I want you to give me
everything you've got.
239
00:09:18,517 --> 00:09:19,776
- Everything.
- OK.
240
00:09:19,777 --> 00:09:21,126
- OK.
- I can do this.
241
00:09:21,127 --> 00:09:22,956
- Yes, you can.
- You got this.
242
00:09:22,957 --> 00:09:25,516
- You got this. You got this.
- OK.
243
00:09:25,517 --> 00:09:27,397
Oh.
244
00:09:29,617 --> 00:09:31,656
I've got the head.
245
00:09:31,657 --> 00:09:32,857
Shoulder.
246
00:09:34,447 --> 00:09:36,056
I've got him.
247
00:09:36,057 --> 00:09:38,316
I got him. He's here.
248
00:09:38,317 --> 00:09:40,097
He's here.
249
00:09:41,097 --> 00:09:43,366
- He's here.
- Oh, my God.
250
00:09:43,367 --> 00:09:45,806
Oh, my God.
251
00:09:45,807 --> 00:09:47,716
I'm a mom.
252
00:09:47,717 --> 00:09:50,456
Our baby, he's beautiful.
253
00:09:50,457 --> 00:09:52,156
He's perfect.
254
00:09:52,157 --> 00:09:54,506
Hey, Dad, do you want
to cut the umbilical cord?
255
00:09:54,507 --> 00:09:56,416
Yeah.
256
00:09:56,417 --> 00:09:59,179
OK. Just right here
in the middle, OK?
257
00:10:02,997 --> 00:10:04,816
I want to hold him.
258
00:10:04,817 --> 00:10:06,646
That's not my son.
259
00:10:08,567 --> 00:10:11,086
What?
260
00:10:11,087 --> 00:10:13,486
Layla, who's the father?
261
00:10:13,487 --> 00:10:15,396
You are, Quentin.
262
00:10:15,397 --> 00:10:17,226
You are. That's our baby.
263
00:10:17,227 --> 00:10:19,316
- No, you're lying!
- You're lying!
264
00:10:19,317 --> 00:10:20,316
Hey, Quentin, it's OK.
265
00:10:20,317 --> 00:10:21,876
We'll figure this
out, all right?
266
00:10:21,877 --> 00:10:23,576
- That's not my son.
- That's our baby.
267
00:10:23,577 --> 00:10:25,316
- Of course it is!
- No, get back!
268
00:10:25,317 --> 00:10:28,196
- Of course it is!
- Of course it is!
269
00:10:28,197 --> 00:10:29,716
- I got to get out of here.
- Hey, deep breaths, OK?
270
00:10:29,717 --> 00:10:30,886
Quentin, breathe with me.
271
00:10:30,887 --> 00:10:32,286
Breathe with me,
Quentin. Deep breaths.
272
00:10:32,287 --> 00:10:34,026
- I got to get out of here!
- Stay! Baby, stay!
273
00:10:34,027 --> 00:10:35,856
- Hey, call security.
- Help!
274
00:10:35,857 --> 00:10:37,506
Oh, my God. What's happening?
275
00:10:37,507 --> 00:10:40,596
Hey! Hey, stop!
276
00:10:40,597 --> 00:10:42,637
Hey, guards! Quentin, stop!
277
00:10:44,557 --> 00:10:47,386
Why are you chasing me? Just
leave me... leave me alone!
278
00:10:47,387 --> 00:10:50,296
- Hey, Quentin...
- Stay back! Stay back!
279
00:10:50,297 --> 00:10:51,826
It's OK. It's OK.
280
00:10:51,827 --> 00:10:54,346
Deep breath. Please,
just breathe.
281
00:10:54,347 --> 00:10:56,346
I just got to get out of here.
282
00:10:56,347 --> 00:10:58,467
- I just got to get out of here!
- No, no, no, no, no!
283
00:11:03,537 --> 00:11:05,616
All right, Quentin.
284
00:11:05,617 --> 00:11:07,537
It's OK.
285
00:11:09,297 --> 00:11:12,686
Oh, my God, the scissors,
they're pulsating.
286
00:11:12,687 --> 00:11:14,126
They're penetrating
the carotid artery.
287
00:11:14,127 --> 00:11:15,476
I'll get someone to
turn off the machine.
288
00:11:15,477 --> 00:11:18,306
No, the magnet is holding
everything in place,
289
00:11:18,307 --> 00:11:19,656
including the scissors.
290
00:11:19,657 --> 00:11:21,476
If gravity takes over,
it'll shift everything,
291
00:11:21,477 --> 00:11:24,746
and we'll have maybe 20
seconds before he bleeds out.
292
00:11:24,747 --> 00:11:26,706
OK, we need help.
Call Dr. Archer.
293
00:11:26,707 --> 00:11:28,707
- Dr. Charles too.
- Yeah.
294
00:11:30,547 --> 00:11:34,156
Do not touch the scissors, OK?
295
00:11:34,157 --> 00:11:36,466
We got you.
296
00:11:36,467 --> 00:11:38,297
Everything's gonna be OK.
297
00:11:42,653 --> 00:11:45,056
Coming through. Excuse me.
298
00:11:45,057 --> 00:11:46,626
Thank you guys for coming.
299
00:11:46,627 --> 00:11:48,676
Absolutely.
300
00:11:48,677 --> 00:11:50,327
- Hey, fellas.
- Doctor.
301
00:11:52,717 --> 00:11:54,986
He's conscious and
calm but out of it.
302
00:11:54,987 --> 00:11:56,896
He's not being crushed.
He's able to breathe.
303
00:11:56,897 --> 00:11:59,116
- He's got to be in pain, though.
- OK.
304
00:11:59,117 --> 00:12:02,076
So let's give him 50
mics of fentanyl IM.
305
00:12:02,077 --> 00:12:03,996
Syringe is plastic and
the needle nonferrous,
306
00:12:03,997 --> 00:12:05,386
so it should be MRI safe.
307
00:12:05,387 --> 00:12:06,866
OK, I'll get it.
308
00:12:06,867 --> 00:12:08,776
Dr. Asher went back to
be with his wife, Layla.
309
00:12:08,777 --> 00:12:10,826
- She's still in L&D.
- OK.
310
00:12:10,827 --> 00:12:12,306
It's a rescue situation.
311
00:12:12,307 --> 00:12:13,696
I just don't really
know where to start.
312
00:12:13,697 --> 00:12:15,356
All of our tools have metal.
313
00:12:15,357 --> 00:12:19,006
So nothing is usable as long
as the MRI machine is running.
314
00:12:19,007 --> 00:12:21,836
All right, well, let's say
we did turn the machine off.
315
00:12:21,837 --> 00:12:23,146
Everything falls to the floor.
316
00:12:23,147 --> 00:12:25,146
Bed alone is a couple
hundred pounds.
317
00:12:25,147 --> 00:12:27,316
I can put two of my guys
in there to try and catch it,
318
00:12:27,317 --> 00:12:29,146
then get it out of the way
so you can get to Quentin.
319
00:12:29,147 --> 00:12:31,366
Scissors in his
neck are magnetic too.
320
00:12:31,367 --> 00:12:33,156
Cut the MRI's power,
they're gonna move.
321
00:12:33,157 --> 00:12:34,716
Quentin will bleed out fast.
322
00:12:34,717 --> 00:12:37,326
If you could go in there
with clamps and stem the flow,
323
00:12:37,327 --> 00:12:39,806
- would that buy us some time?
- Not enough.
324
00:12:39,807 --> 00:12:41,946
Odds of survival
are less than 1%.
325
00:12:41,947 --> 00:12:44,206
I'm running outcome
probabilities on our options,
326
00:12:44,207 --> 00:12:46,036
and turning off the machine
cold turkey is the worst.
327
00:12:46,037 --> 00:12:48,036
So what's the best?
328
00:12:48,037 --> 00:12:50,426
If CFD can secure Quentin
329
00:12:50,427 --> 00:12:52,346
and ensure the bed
won't displace him
330
00:12:52,347 --> 00:12:54,736
and Dr. Archer can
stabilize the neck wound
331
00:12:54,737 --> 00:12:56,266
all before turning
off the MRI machine,
332
00:12:56,267 --> 00:12:59,526
then the odds of
survival are roughly 61%.
333
00:12:59,527 --> 00:13:02,096
OK, we've got a
plan. Can it be done?
334
00:13:02,097 --> 00:13:04,876
Well, safest way
to secure the patient
335
00:13:04,877 --> 00:13:07,276
would be to do a
webbing harness.
336
00:13:07,277 --> 00:13:09,666
We can throw the ropes
over the MRI machine,
337
00:13:09,667 --> 00:13:11,926
and then two of my guys can
hold it on the other side.
338
00:13:11,927 --> 00:13:14,106
OK, the magnet's
off, the bed falls.
339
00:13:14,107 --> 00:13:17,236
How do we ensure that
Quentin doesn't go with it?
340
00:13:17,237 --> 00:13:19,286
We can create a buffer
zone between him and the bed
341
00:13:19,287 --> 00:13:22,066
using wooden cribbing,
wedges, and airbags.
342
00:13:22,067 --> 00:13:23,896
We can run some
hoses and inflate them
343
00:13:23,897 --> 00:13:25,336
from a tank here in the hallway.
344
00:13:25,337 --> 00:13:26,906
All right, we're halfway there.
345
00:13:26,907 --> 00:13:28,596
- Dr. Archer?
- Yeah.
346
00:13:28,597 --> 00:13:30,206
I just need to clamp the artery
347
00:13:30,207 --> 00:13:31,296
in order to control
the bleeding.
348
00:13:31,297 --> 00:13:33,386
Then I could take
the scissors out.
349
00:13:33,387 --> 00:13:36,346
But the issue is the
tools needed to do it.
350
00:13:36,347 --> 00:13:38,386
I can make them
plastic. 3D printers.
351
00:13:38,387 --> 00:13:39,606
There are four in
the robotics lab.
352
00:13:39,607 --> 00:13:40,916
All right. Get on it.
353
00:13:40,917 --> 00:13:44,096
And get a few of the
2.0 engineers to help.
354
00:13:44,097 --> 00:13:47,006
- We'll get started too.
- Good.
355
00:13:47,007 --> 00:13:48,446
OK, you're doing great.
356
00:13:48,447 --> 00:13:50,056
Gonna give you a
little injection.
357
00:13:50,057 --> 00:13:51,446
Some pain meds, all right?
358
00:13:51,447 --> 00:13:54,626
To just make you a little
more comfortable, OK?
359
00:13:54,627 --> 00:13:56,497
Little pinch.
360
00:14:01,323 --> 00:14:02,633
OK.
361
00:14:04,247 --> 00:14:06,946
Daniel?
362
00:14:06,947 --> 00:14:08,286
I'm just gonna step
away for a second,
363
00:14:08,287 --> 00:14:09,596
have a little chat
with my colleague.
364
00:14:09,597 --> 00:14:11,467
I'm not going anywhere, OK?
365
00:14:14,517 --> 00:14:16,866
How's he doing?
366
00:14:16,867 --> 00:14:21,216
Well, you know, I mean, he's
pinned to an MRI machine, so...
367
00:14:21,217 --> 00:14:23,916
Do you have any theories
on what sparked the break?
368
00:14:23,917 --> 00:14:26,356
I've been really focusing
on trying to keep him calm.
369
00:14:26,357 --> 00:14:29,046
But how's the plan to get
him off the thing going?
370
00:14:29,047 --> 00:14:30,486
Well, we've got one.
371
00:14:30,487 --> 00:14:32,666
But it's a possibility
that it won't work, Daniel,
372
00:14:32,667 --> 00:14:36,056
so I've asked Dr. Asher to
bring Quentin's wife down here
373
00:14:36,057 --> 00:14:38,976
to see him 'cause it
may be the last time.
374
00:14:38,977 --> 00:14:40,887
OK, thank you.
375
00:14:43,357 --> 00:14:45,447
OK, making the incision.
376
00:14:47,250 --> 00:14:48,450
OK.
377
00:14:50,417 --> 00:14:52,987
OK, nice and easy.
378
00:14:54,867 --> 00:14:56,067
Lab cut.
379
00:15:01,167 --> 00:15:02,956
Yep.
380
00:15:02,957 --> 00:15:05,046
Definitely feeling
some adhesions.
381
00:15:05,047 --> 00:15:06,216
Point taken.
382
00:15:06,217 --> 00:15:08,396
Open surgery was the right call.
383
00:15:08,397 --> 00:15:10,486
Go ahead, say it.
"I told you so."
384
00:15:10,487 --> 00:15:12,096
Yeah, maybe later.
385
00:15:12,097 --> 00:15:14,796
For now, why don't you get
some practice old-school style?
386
00:15:14,797 --> 00:15:16,617
Come around.
387
00:15:19,447 --> 00:15:21,106
OK. You got it?
388
00:15:21,107 --> 00:15:22,716
- Yeah.
- All right.
389
00:15:22,717 --> 00:15:24,067
Babcock.
390
00:15:31,457 --> 00:15:33,206
You OK?
391
00:15:33,207 --> 00:15:34,946
Yeah, it's just
a little heartburn.
392
00:15:34,947 --> 00:15:36,297
I'm fine.
393
00:15:37,727 --> 00:15:39,947
Oh, uh...
394
00:15:41,817 --> 00:15:44,166
Uh, God, excuse me. I'm sorry.
395
00:15:44,167 --> 00:15:46,436
Stop it.
396
00:15:46,437 --> 00:15:47,996
Stop.
397
00:15:47,997 --> 00:15:49,346
It's no big deal.
398
00:15:49,347 --> 00:15:53,047
It happens, OK? Just
focus on the field.
399
00:15:54,567 --> 00:15:57,007
Stay focused.
400
00:15:58,527 --> 00:16:00,796
Uh-oh, here comes another one.
401
00:16:00,797 --> 00:16:02,186
Kai?
402
00:16:02,187 --> 00:16:04,536
Kai, talk to me.
403
00:16:04,537 --> 00:16:06,056
Hey, buddy! Hey!
404
00:16:06,057 --> 00:16:08,677
Angel. Angel, check him.
405
00:16:10,417 --> 00:16:11,936
- Got a pulse.
- All right.
406
00:16:11,937 --> 00:16:13,936
Give me the babcock, please.
407
00:16:13,937 --> 00:16:15,456
- Maria!
- Need some help in here!
408
00:16:15,457 --> 00:16:17,116
Maria!
409
00:16:17,117 --> 00:16:18,546
I was helping her
to the bathroom,
410
00:16:18,547 --> 00:16:19,466
and she started seizing.
411
00:16:19,467 --> 00:16:21,037
OK, 4 milligrams of Ativan.
412
00:16:22,647 --> 00:16:24,127
Please help her. Please.
413
00:16:27,477 --> 00:16:29,217
Ativan's in.
414
00:16:34,047 --> 00:16:35,656
OK, she's gonna be
postictal for a while.
415
00:16:35,657 --> 00:16:36,826
Put her on a foley.
416
00:16:36,827 --> 00:16:37,876
I don't want her
getting out of the bed,
417
00:16:37,877 --> 00:16:39,447
not even for the bathroom.
418
00:16:47,107 --> 00:16:49,056
A seizure expands our
differential tenfold.
419
00:16:49,057 --> 00:16:50,886
We got to widen our
net... CT panscan,
420
00:16:50,887 --> 00:16:53,106
MRI brain, sed rate,
autoimmune labs.
421
00:16:53,107 --> 00:16:54,286
- Let's rope in neurology.
- Guys.
422
00:16:54,287 --> 00:16:55,456
Ms. Goodwin just called.
423
00:16:55,457 --> 00:16:56,976
She said stand down.
No more treatment.
424
00:16:56,977 --> 00:16:58,116
What? What are
you talking about?
425
00:16:58,117 --> 00:16:59,116
She's in the MRI suite.
426
00:16:59,117 --> 00:17:01,117
Be here as soon as she can, OK?
427
00:17:04,687 --> 00:17:06,686
- Hey, you OK?
- This is overkill.
428
00:17:06,687 --> 00:17:08,466
I probably just had
some bad oatmeal.
429
00:17:08,467 --> 00:17:10,606
Well, bad oatmeal
doesn't drop you
430
00:17:10,607 --> 00:17:11,996
in the middle of surgery.
431
00:17:11,997 --> 00:17:14,737
So how about you let
me check you out?
432
00:17:17,177 --> 00:17:19,306
- How's Sam?
- Appendectomy go OK?
433
00:17:19,307 --> 00:17:21,696
- Yeah, all good.
- Dr. Graham is finishing up.
434
00:17:21,697 --> 00:17:23,176
At least it's just
an appendectomy.
435
00:17:23,177 --> 00:17:25,007
Not missing much.
436
00:17:28,017 --> 00:17:29,887
Oh, my chest. Pressure.
437
00:17:32,887 --> 00:17:34,497
Oh, God. I'm sorry.
438
00:17:36,147 --> 00:17:37,846
That was weird.
439
00:17:37,847 --> 00:17:39,846
Your heart rate plummeted,
but as soon as you passed gas,
440
00:17:39,847 --> 00:17:41,066
it came back.
441
00:17:41,067 --> 00:17:43,027
Will you sit up for me?
442
00:17:45,857 --> 00:17:47,297
Take a deep breath.
443
00:17:49,557 --> 00:17:51,206
All right. Lean back for me.
444
00:17:51,207 --> 00:17:53,996
Hey, Mike. Let's get
an X-ray in here.
445
00:17:53,997 --> 00:17:55,346
What, did you hear a murmur?
446
00:17:55,347 --> 00:17:57,086
Honestly, I'm not
sure what I heard.
447
00:17:57,087 --> 00:17:58,516
You're joking,
right? Come on.
448
00:17:58,517 --> 00:18:01,136
Has heartburn been
an issue before today?
449
00:18:01,137 --> 00:18:02,656
I mean, I get it.
450
00:18:02,657 --> 00:18:04,916
Even when I was a kid, it
would flare up here and there.
451
00:18:04,917 --> 00:18:07,316
But it's never been an issue.
452
00:18:07,317 --> 00:18:09,707
X-ray up. Clear.
453
00:18:15,847 --> 00:18:18,366
- What the hell?
- That's my colon.
454
00:18:18,367 --> 00:18:19,846
It shouldn't be in my chest.
455
00:18:19,847 --> 00:18:22,107
No, it should not.
456
00:18:24,327 --> 00:18:26,636
Her brother. Hugo, was a
patient treated at Oakview.
457
00:18:26,637 --> 00:18:27,856
So was Maria.
458
00:18:27,857 --> 00:18:30,246
She was admitted
yesterday via ambulance,
459
00:18:30,247 --> 00:18:33,336
but this morning, her
family just walked her out.
460
00:18:33,337 --> 00:18:34,776
They just left... absconded.
461
00:18:34,777 --> 00:18:36,386
Well, her brother
died at Oakview,
462
00:18:36,387 --> 00:18:37,866
and they didn't get any answers.
463
00:18:37,867 --> 00:18:39,216
You see how scared they are.
464
00:18:39,217 --> 00:18:40,346
It's no wonder that they
didn't want to stay.
465
00:18:40,347 --> 00:18:42,256
Look, I agree, but walking out
466
00:18:42,257 --> 00:18:44,656
is the same as leaving
against medical advice.
467
00:18:44,657 --> 00:18:47,046
It's triggered an
insurance nightmare
468
00:18:47,047 --> 00:18:48,656
with the family's HMO.
469
00:18:48,657 --> 00:18:50,876
They won't pay for
any more treatment
470
00:18:50,877 --> 00:18:52,966
until Maria is placed back
471
00:18:52,967 --> 00:18:56,446
with their preferred
network provider, Oakview.
472
00:18:56,447 --> 00:18:58,926
- Are you kidding me?
- They're a community hospital.
473
00:18:58,927 --> 00:19:01,236
They don't have the resources
to run the tests she needs.
474
00:19:01,237 --> 00:19:02,626
Well, I've already reached out
475
00:19:02,627 --> 00:19:05,066
to the director of patient
services at Oakview,
476
00:19:05,067 --> 00:19:07,416
and she assured me they'll
do the best they can.
477
00:19:07,417 --> 00:19:09,066
The best they can?
478
00:19:09,067 --> 00:19:12,076
Ms. Goodwin, can't you reason
with the insurance company?
479
00:19:12,077 --> 00:19:14,376
Hector and Gloria aren't trying
to take advantage of them.
480
00:19:14,377 --> 00:19:16,076
They're trying to save
their daughter's life.
481
00:19:16,077 --> 00:19:17,596
Look, I know, and I share
482
00:19:17,597 --> 00:19:19,556
in your frustration,
but they're...
483
00:19:19,557 --> 00:19:21,906
No. No, I don't care what
the insurance company says.
484
00:19:21,907 --> 00:19:24,256
I'm not sending Maria back to
Oakview until I get a guarantee
485
00:19:24,257 --> 00:19:25,916
she gets the treatment
she needs in time.
486
00:19:25,917 --> 00:19:28,436
Dr. Halstead, the
tests that you ordered
487
00:19:28,437 --> 00:19:30,356
will cost tens of
thousands of dollars,
488
00:19:30,357 --> 00:19:32,706
and I know that's not
coming out your pocket.
489
00:19:32,707 --> 00:19:36,267
The family has to
decide how to proceed.
490
00:19:45,437 --> 00:19:47,384
OK, Quentin, so listen,
491
00:19:47,385 --> 00:19:49,696
we're gonna secure
you to the machine
492
00:19:49,697 --> 00:19:51,826
while it's still
running with a harness.
493
00:19:51,827 --> 00:19:53,876
So then, Dr. Archer, who
is an excellent surgeon,
494
00:19:53,877 --> 00:19:55,486
is gonna come in here
and clamp your artery,
495
00:19:55,487 --> 00:19:57,136
stabilize your neck wound,
496
00:19:57,137 --> 00:19:59,406
and make it safer when
they pull out the scissors.
497
00:19:59,407 --> 00:20:01,666
All right? Then we
turn off the machine.
498
00:20:01,667 --> 00:20:03,926
The idea is, bed
falls to the side,
499
00:20:03,927 --> 00:20:07,236
you're held firmly in
place by the harness, OK?
500
00:20:07,237 --> 00:20:09,106
- Still with me?
- Mm-hmm.
501
00:20:09,107 --> 00:20:10,716
Great. Last thing.
502
00:20:10,717 --> 00:20:13,326
Lower you onto a gurney,
shoot you off the ER,
503
00:20:13,327 --> 00:20:15,546
and finish fixing up your neck.
504
00:20:15,547 --> 00:20:17,507
- How's that sound?
- Mm-hmm.
505
00:20:27,127 --> 00:20:29,436
Am I gonna die?
506
00:20:29,437 --> 00:20:31,176
Look, this is a
complicated situation.
507
00:20:31,177 --> 00:20:34,696
But some really skilled people
have come up with this plan,
508
00:20:34,697 --> 00:20:36,566
and it's the best option we got.
509
00:20:36,567 --> 00:20:39,576
Breathe in and out,
510
00:20:39,577 --> 00:20:43,706
stay as still as you
possibly can, OK?
511
00:20:43,707 --> 00:20:45,276
All right.
512
00:20:45,277 --> 00:20:47,497
Take all the time you need.
513
00:20:49,757 --> 00:20:52,237
Hey, hold the
work. Everybody, out.
514
00:21:00,157 --> 00:21:02,986
You're my everything.
515
00:21:02,987 --> 00:21:06,577
From our first date, I
knew that I was in love.
516
00:21:06,578 --> 00:21:08,349
And now we're parents.
517
00:21:10,368 --> 00:21:11,576
Uh...
518
00:21:13,557 --> 00:21:15,647
The nurse took a picture of him.
519
00:21:18,617 --> 00:21:21,526
I named him Trevor,
after your dad.
520
00:21:21,527 --> 00:21:23,617
I think he'd like that.
521
00:21:25,317 --> 00:21:28,276
Tell Trevor I love him.
522
00:21:28,277 --> 00:21:31,236
You're gonna tell him yourself.
523
00:21:31,237 --> 00:21:33,937
You're gonna be a great mother.
524
00:21:35,457 --> 00:21:37,546
I love you, Quentin.
525
00:21:37,547 --> 00:21:40,506
I will see you
again, you hear me?
526
00:21:40,507 --> 00:21:42,897
I will see you again.
527
00:21:57,257 --> 00:21:59,176
Sorry.
528
00:21:59,177 --> 00:22:02,306
I didn't know what to say.
529
00:22:02,307 --> 00:22:04,966
How do you put
into words when...
530
00:22:04,967 --> 00:22:07,006
You can't.
531
00:22:07,007 --> 00:22:09,316
But we could feel your
love for each other.
532
00:22:09,317 --> 00:22:11,186
I just don't understand,
533
00:22:11,187 --> 00:22:14,146
because Quentin is my rock,
534
00:22:14,147 --> 00:22:19,236
and I don't even recognize
the man that's in there.
535
00:22:19,237 --> 00:22:21,546
He just snapped.
536
00:22:21,547 --> 00:22:23,586
How does that happen
all of a sudden?
537
00:22:23,587 --> 00:22:26,726
I mean, usually there
are signs, you know?
538
00:22:26,727 --> 00:22:30,116
Extreme expressions of
emotional frustration,
539
00:22:30,117 --> 00:22:32,166
anger, confusion, outbursts.
540
00:22:32,167 --> 00:22:35,606
You noticed anything like
that in Quentin recently?
541
00:22:35,607 --> 00:22:38,696
- I don't think so.
- How about physical changes?
542
00:22:38,697 --> 00:22:40,956
I noticed he had some lumps
on the back of his neck.
543
00:22:40,957 --> 00:22:42,526
Have you... Do you
know what those are?
544
00:22:42,527 --> 00:22:46,306
Lumps? I don't know.
545
00:22:46,307 --> 00:22:51,006
I just wanted to get to
today and to have the baby.
546
00:22:51,007 --> 00:22:53,096
I've been so consumed
by the pregnancy
547
00:22:53,097 --> 00:22:56,836
that I haven't
noticed anything else.
548
00:22:56,837 --> 00:22:58,587
Oh, Quentin.
549
00:23:04,367 --> 00:23:06,196
Uh, give it to Spellman.
550
00:23:06,197 --> 00:23:07,326
Thanks, Lori.
551
00:23:07,327 --> 00:23:09,026
Mystery solved. Your chest CT.
552
00:23:09,027 --> 00:23:11,896
- Hiatal hernia.
- No, diaphragmatic.
553
00:23:11,897 --> 00:23:14,556
Big enough that your colon
migrated into your chest.
554
00:23:14,557 --> 00:23:17,036
So the gas moving through it,
555
00:23:17,037 --> 00:23:19,776
it puts pressure on the vagus
nerve, drops your heartbeat.
556
00:23:19,777 --> 00:23:21,476
Breaking wind
releases the pressure.
557
00:23:21,477 --> 00:23:23,036
- Heart returns to a normal rate.
- Yeah.
558
00:23:23,037 --> 00:23:24,646
You said you had heartburn
since you were a kid.
559
00:23:24,647 --> 00:23:26,606
Undiagnosed
560
00:23:26,607 --> 00:23:29,656
asymptomatic congenital
diaphragmatic hernia.
561
00:23:29,657 --> 00:23:31,266
I've never passed
out before, though.
562
00:23:31,267 --> 00:23:34,096
Well, my guess is it's been
slowly expanding over time.
563
00:23:34,097 --> 00:23:35,576
But you do CrossFit now,
564
00:23:35,577 --> 00:23:37,926
so the thrusters,
burpees, other workouts...
565
00:23:37,927 --> 00:23:40,576
Safe bet that they've
exacerbated the condition.
566
00:23:40,577 --> 00:23:42,926
- Led to today.
- Yeah, well, I'll own that.
567
00:23:42,927 --> 00:23:44,586
But I can't resist
dropping in the OR again,
568
00:23:44,587 --> 00:23:46,756
- so let's fix this hernia.
- OK.
569
00:23:46,757 --> 00:23:50,066
Well, you've got a
few surgical options.
570
00:23:50,067 --> 00:23:51,456
- Open.
- No.
571
00:23:51,457 --> 00:23:53,066
That's a huge incision.
Lots of digging around.
572
00:23:53,067 --> 00:23:55,076
I'll be laid up in
the ICU for weeks.
573
00:23:55,077 --> 00:23:56,426
Laparoscopic, then.
574
00:23:56,427 --> 00:23:58,206
Be more incisions for
the scope and tools,
575
00:23:58,207 --> 00:24:00,596
- but less invasive...
- No old-school approaches.
576
00:24:00,597 --> 00:24:02,256
Robotic assist in OR 2.0.
577
00:24:02,257 --> 00:24:04,087
Shortest recovery time.
578
00:24:05,827 --> 00:24:08,126
I just want this
to be over with.
579
00:24:08,127 --> 00:24:10,826
OK, I'm gonna scrub in.
580
00:24:10,827 --> 00:24:12,087
I'll see you after, OK?
581
00:24:17,447 --> 00:24:19,746
Holy cow. Look
at this place.
582
00:24:19,747 --> 00:24:21,756
It's like you guys are
living in 2050 up here.
583
00:24:21,757 --> 00:24:24,366
So don't break anything.
584
00:24:24,367 --> 00:24:26,056
How's it going with
the surgical tools?
585
00:24:26,057 --> 00:24:28,106
- Almost there.
- Scalpel's printed.
586
00:24:28,107 --> 00:24:29,716
Two of the three angled
peripheral vascular clamps
587
00:24:29,717 --> 00:24:30,806
are printed as well.
588
00:24:30,807 --> 00:24:32,066
One Weitlaner retractor printed.
589
00:24:32,067 --> 00:24:34,066
- One to go.
- Oh, it's like the real thing.
590
00:24:34,067 --> 00:24:36,466
It is the real
thing, just plastic.
591
00:24:36,467 --> 00:24:38,206
These tools, I
think they can work.
592
00:24:38,207 --> 00:24:39,636
They'll have to.
593
00:24:39,637 --> 00:24:41,077
They're all we got.
594
00:24:46,647 --> 00:24:49,086
They never wanted
to go to Oakview,
595
00:24:49,087 --> 00:24:51,046
but the ambulance took
them there anyway.
596
00:24:51,047 --> 00:24:53,086
Because Maria didn't
require specialty care,
597
00:24:53,087 --> 00:24:55,617
paramedics took her to the
nearest hospital instead.
598
00:25:05,017 --> 00:25:08,496
I'm so sorry that you've
been put in this situation.
599
00:25:08,497 --> 00:25:10,756
We can continue to treat Maria,
600
00:25:10,757 --> 00:25:13,717
but your insurance
won't cover the costs.
601
00:25:24,167 --> 00:25:27,906
He said he'll sell the
car. He can get a second job.
602
00:25:27,907 --> 00:25:29,646
His oldest son can
get a job as well.
603
00:25:29,647 --> 00:25:31,346
No. Papa, no.
604
00:25:31,347 --> 00:25:32,996
No.
605
00:25:32,997 --> 00:25:34,866
I'll go back.
606
00:25:34,867 --> 00:25:37,136
No.
607
00:25:37,137 --> 00:25:39,346
Maria...
608
00:25:39,347 --> 00:25:41,657
Maria.
609
00:26:06,727 --> 00:26:10,557
You know, maybe Oakview
will figure it out.
610
00:26:16,087 --> 00:26:17,086
All right.
611
00:26:17,087 --> 00:26:20,957
Um, I'll set up the transfer.
612
00:26:27,617 --> 00:26:29,136
What was Maria saying?
613
00:26:29,137 --> 00:26:31,406
If she lets her parents
bankrupt the family
614
00:26:31,407 --> 00:26:34,186
paying for her medical care,
then all of the opportunities
615
00:26:34,187 --> 00:26:37,756
they've worked so hard to give
their children will be lost.
616
00:26:37,757 --> 00:26:39,586
She is risking her life.
617
00:26:39,587 --> 00:26:41,366
No.
618
00:26:41,367 --> 00:26:43,586
No, she's sacrificing it.
619
00:26:43,587 --> 00:26:45,898
And it's awful,
620
00:26:47,120 --> 00:26:48,605
but I get it.
621
00:26:58,167 --> 00:26:59,367
Ready to inflate?
622
00:27:02,297 --> 00:27:03,647
Up on blue.
623
00:27:05,387 --> 00:27:06,657
Hold.
624
00:27:08,217 --> 00:27:09,787
Up on red.
625
00:27:15,527 --> 00:27:16,797
Hold.
626
00:27:21,097 --> 00:27:23,796
- How's, uh...
- how's Layla doing?
627
00:27:23,797 --> 00:27:26,886
She's in shock, full of grief,
628
00:27:26,887 --> 00:27:28,456
and a first-time mom
all at the same time.
629
00:27:28,457 --> 00:27:31,546
It's a lot, but a psych
resident is with her.
630
00:27:31,547 --> 00:27:34,856
Mm. And how about you?
631
00:27:34,857 --> 00:27:37,336
How are you doing?
632
00:27:37,337 --> 00:27:40,246
Honestly, I didn't
see this coming.
633
00:27:40,247 --> 00:27:43,946
I just thought Quentin was
a nervous first-time dad,
634
00:27:43,947 --> 00:27:46,516
like the ones I see
every single day.
635
00:27:46,517 --> 00:27:48,256
Never suspected mental illness.
636
00:27:48,257 --> 00:27:50,216
You know, I'm not
sure it is, per se.
637
00:27:50,217 --> 00:27:53,216
You know those lumps on
the back of his neck?
638
00:27:53,217 --> 00:27:54,876
I have a very strong hunch
that they're indicative
639
00:27:54,877 --> 00:27:56,616
of a physical issue
that could very well
640
00:27:56,617 --> 00:27:59,576
be causing a sudden psychosis.
641
00:27:59,577 --> 00:28:01,136
It's physical,
not psychological?
642
00:28:01,137 --> 00:28:02,886
Yeah, I'm leaning that way.
643
00:28:02,887 --> 00:28:05,627
I mean, can't be sure
until we run some tests.
644
00:28:17,247 --> 00:28:18,986
Maria, this is a thumb drive
645
00:28:18,987 --> 00:28:21,156
with all the work we did
here, along with our notes.
646
00:28:21,157 --> 00:28:24,556
You give this to the doctors
as soon as you get there.
647
00:28:24,557 --> 00:28:25,817
Thank you.
648
00:28:29,647 --> 00:28:31,827
All right. Empty her foley.
649
00:28:39,567 --> 00:28:40,877
It's OK, Mama.
650
00:28:43,487 --> 00:28:45,667
Wait.
651
00:28:47,627 --> 00:28:48,927
Will?
652
00:28:52,757 --> 00:28:54,197
You smell that?
653
00:29:01,197 --> 00:29:02,506
We have to run one more test.
654
00:29:02,507 --> 00:29:04,687
I'll pay for it
myself, if I have to.
655
00:29:10,257 --> 00:29:11,736
I'm scared.
656
00:29:11,737 --> 00:29:14,296
Well, you'll be less
frightened if you can't see it,
657
00:29:14,297 --> 00:29:17,217
so I'm gonna drape
your face, OK?
658
00:29:19,307 --> 00:29:20,656
Yeah.
659
00:29:20,657 --> 00:29:22,656
All right.
660
00:29:22,657 --> 00:29:24,177
Here we go. Careful.
661
00:29:25,837 --> 00:29:27,707
That's right. All right.
662
00:29:28,837 --> 00:29:30,706
All right.
663
00:29:30,707 --> 00:29:33,666
10cc's of lidocaine, please.
664
00:29:33,667 --> 00:29:35,716
OK.
665
00:29:35,717 --> 00:29:38,107
All right.
666
00:29:47,207 --> 00:29:48,466
OK.
667
00:29:48,467 --> 00:29:51,426
Scalpel.
668
00:29:51,427 --> 00:29:53,076
All right. Grab hold
of those scissors.
669
00:29:53,077 --> 00:29:55,907
I don't want them flopping
after I make the incisions.
670
00:29:59,387 --> 00:30:01,177
Here we go.
671
00:30:06,097 --> 00:30:08,486
OK.
672
00:30:08,487 --> 00:30:09,616
All right.
673
00:30:09,617 --> 00:30:11,097
Wheaties.
674
00:30:14,667 --> 00:30:16,146
All right.
675
00:30:16,147 --> 00:30:18,716
All right. Watch
your fingers there.
676
00:30:18,717 --> 00:30:21,366
That's it. That's it. Don't
move it. Don't move it.
677
00:30:21,367 --> 00:30:22,847
Clamp.
678
00:30:27,507 --> 00:30:28,707
All right.
679
00:30:37,777 --> 00:30:39,906
All right.
680
00:30:39,907 --> 00:30:42,126
Carotid clamps in
place. CFD, you're up.
681
00:30:42,127 --> 00:30:43,696
All right. Spread
out around the bed.
682
00:30:43,697 --> 00:30:45,956
When it falls down, we pull
it away from the MRI machine.
683
00:30:45,957 --> 00:30:49,226
All right. And no slack
at all, you understand?
684
00:30:49,227 --> 00:30:51,486
If there's any movement,
his clamps could pop off,
685
00:30:51,487 --> 00:30:54,226
and then we'll have a problem
we might not be able to fix.
686
00:30:54,227 --> 00:30:55,576
All right.
687
00:30:55,577 --> 00:30:58,626
On three, you're gonna
cut the power to the MRI.
688
00:30:58,627 --> 00:30:59,846
We ready? Everybody, ready?
689
00:30:59,847 --> 00:31:00,926
Ready.
690
00:31:00,927 --> 00:31:04,237
One, two, three.
691
00:31:08,027 --> 00:31:10,156
All right. Clamps are holding.
692
00:31:10,157 --> 00:31:11,897
I'm gonna remove
the scissors now.
693
00:31:15,597 --> 00:31:16,906
All right.
694
00:31:16,907 --> 00:31:18,776
All right, we're
clear. OK, bed.
695
00:31:18,777 --> 00:31:21,477
Let's lower Quentin.
696
00:31:24,167 --> 00:31:26,827
- Lower him slowly.
- One, two, three.
697
00:31:28,527 --> 00:31:29,877
Slack!
698
00:31:31,827 --> 00:31:33,437
All right.
699
00:31:35,177 --> 00:31:37,006
OK, ropes are free.
700
00:31:37,007 --> 00:31:39,576
All right.
701
00:31:39,577 --> 00:31:41,886
- Incredible, Doc.
- Freaking incredible.
702
00:31:41,887 --> 00:31:45,056
Thanks. Can someone get me
a bottle of water, please?
703
00:31:45,057 --> 00:31:47,276
Dr. Archer, you did it.
704
00:31:47,277 --> 00:31:49,366
- Dean, you all right?
- Yeah.
705
00:31:49,367 --> 00:31:51,676
I got to get to the OR, so...
706
00:31:51,677 --> 00:31:53,286
Whoa, whoa, whoa, whoa, whoa.
707
00:31:53,287 --> 00:31:55,936
Page Dr. Lanik to
take over with Quentin.
708
00:31:55,937 --> 00:31:56,856
I'm just feeling a little dizzy.
709
00:31:56,857 --> 00:31:58,077
That's all.
710
00:32:05,076 --> 00:32:06,506
Hernia fixed?
711
00:32:06,507 --> 00:32:08,686
I'd say you're as good as new.
712
00:32:08,687 --> 00:32:10,646
Yeah, not quite.
713
00:32:10,647 --> 00:32:12,206
I'm the fart doctor now.
714
00:32:12,207 --> 00:32:14,166
- A punchline.
- No.
715
00:32:14,167 --> 00:32:16,126
What happened today was a result
716
00:32:16,127 --> 00:32:17,306
of a medical ailment, OK?
717
00:32:17,307 --> 00:32:18,566
Like anyone's gonna
care about that.
718
00:32:18,567 --> 00:32:20,256
All they're gonna
remember is the fart.
719
00:32:20,257 --> 00:32:22,397
- Oh, come on.
- It'll blow over.
720
00:32:24,007 --> 00:32:26,396
Sorry. Poor choice of
words, but it will.
721
00:32:26,397 --> 00:32:28,926
I doubt it.
722
00:32:28,927 --> 00:32:30,226
All right, look.
723
00:32:30,227 --> 00:32:32,626
I'll check on you
a little later, OK?
724
00:32:32,627 --> 00:32:33,827
All right.
725
00:32:35,367 --> 00:32:38,536
- So his neck is fixed, then?
- Yeah.
726
00:32:38,537 --> 00:32:40,626
The artery repair
went very well.
727
00:32:40,627 --> 00:32:43,236
- What about his mind?
- Because before...
728
00:32:43,237 --> 00:32:45,246
Well, I gave him
a very small dose
729
00:32:45,247 --> 00:32:47,336
of an antipsychotic
called risperidone,
730
00:32:47,337 --> 00:32:49,466
and he does seem to be
thinking more clearly.
731
00:32:49,467 --> 00:32:52,646
And you think
he'll stay that way?
732
00:32:52,647 --> 00:32:54,076
I don't think that
what happened today
733
00:32:54,077 --> 00:32:55,906
is the result of mental illness.
734
00:32:55,907 --> 00:32:57,206
You know, tests
are still pending,
735
00:32:57,207 --> 00:32:59,426
but all indications
are is that Quentin has
736
00:32:59,427 --> 00:33:02,866
a genetic disease called
neurofibromatosis type 2.
737
00:33:02,867 --> 00:33:05,046
- Is it curable?
- It's not.
738
00:33:05,047 --> 00:33:07,396
But there are a lot of
effective treatments out there.
739
00:33:07,397 --> 00:33:09,876
And the good news is
that with a little luck,
740
00:33:09,877 --> 00:33:12,666
Quentin is gonna be
the man you know again.
741
00:33:12,667 --> 00:33:15,016
Genetic means
he's had it forever.
742
00:33:15,017 --> 00:33:17,056
Why'd it suddenly
go berserk today?
743
00:33:17,057 --> 00:33:20,276
NF is thought to be an
inflammatory ailment, right?
744
00:33:20,277 --> 00:33:23,276
So possibly triggered by
changes in environment,
745
00:33:23,277 --> 00:33:24,886
you know, lifestyle,
746
00:33:24,887 --> 00:33:29,026
possibly diet, medication.
747
00:33:29,027 --> 00:33:32,116
Diet.
748
00:33:32,117 --> 00:33:33,816
Oh, my God.
749
00:33:33,817 --> 00:33:37,386
The minute I got pregnant,
my hormones went crazy.
750
00:33:37,387 --> 00:33:39,076
Smells were intense,
751
00:33:39,077 --> 00:33:42,086
and Quentin's breath
was the worst.
752
00:33:42,087 --> 00:33:44,906
Everything he ate
made me throw up.
753
00:33:44,907 --> 00:33:47,126
So he gave up his entire diet.
754
00:33:47,127 --> 00:33:49,696
No more fruits,
vegetables, fish.
755
00:33:49,697 --> 00:33:51,526
For the past nine months,
he's been eating nothing
756
00:33:51,527 --> 00:33:54,266
but bland, processed
crap for me.
757
00:33:54,267 --> 00:33:58,147
Mrs. Bell, Quentin's
asking to see you.
758
00:34:08,757 --> 00:34:10,636
Hi, honey.
759
00:34:10,637 --> 00:34:13,466
Layla...
760
00:34:13,467 --> 00:34:15,376
I don't entirely understand
761
00:34:15,377 --> 00:34:19,116
what happened or why,
762
00:34:19,117 --> 00:34:20,986
but I know I put you in danger.
763
00:34:20,987 --> 00:34:22,296
I'm sorry.
764
00:34:22,297 --> 00:34:24,606
No, Quentin.
765
00:34:24,607 --> 00:34:27,296
I was so tied up
in the pregnancy,
766
00:34:27,297 --> 00:34:29,866
I was oblivious to what
was going on with you.
767
00:34:29,867 --> 00:34:33,436
I should've seen the
signs. Forgive me.
768
00:34:33,437 --> 00:34:36,916
Oh, honey, there's
nothing to forgive.
769
00:34:36,917 --> 00:34:38,356
I love you.
770
00:34:38,357 --> 00:34:41,096
I love you too.
771
00:34:41,097 --> 00:34:44,497
Someone's been missing you guys.
772
00:34:49,237 --> 00:34:52,326
Hi.
773
00:34:52,327 --> 00:34:54,507
Here you go.
774
00:34:56,287 --> 00:34:59,766
- Hi, sweetheart.
- Look who's here.
775
00:34:59,767 --> 00:35:01,116
Hi.
776
00:35:01,117 --> 00:35:03,297
I'm your dad.
777
00:35:04,597 --> 00:35:07,476
I love you.
778
00:35:07,477 --> 00:35:11,346
- Shh, sweetheart.
- Hi.
779
00:35:11,347 --> 00:35:14,216
- A metabolic condition?
- Yeah.
780
00:35:14,217 --> 00:35:16,396
It's called maple
syrup urine disease,
781
00:35:16,397 --> 00:35:18,526
and it's a rare condition
that makes it difficult
782
00:35:18,527 --> 00:35:20,836
for the body to break
down certain amino acids.
783
00:35:20,837 --> 00:35:24,186
The trademark symptom is
a distinct maple syrup smell
784
00:35:24,187 --> 00:35:25,616
that shows up in urine.
785
00:35:25,617 --> 00:35:27,446
It usually presents
in childhood,
786
00:35:27,447 --> 00:35:29,146
and it's almost unheard of
787
00:35:29,147 --> 00:35:31,886
to discover it in
someone your age,
788
00:35:31,887 --> 00:35:33,456
or Hugo's.
789
00:35:33,457 --> 00:35:35,896
It's likely that he had it too.
790
00:35:35,897 --> 00:35:37,106
And I suspect this is why
791
00:35:37,107 --> 00:35:39,506
Oakview couldn't
diagnose him in time.
792
00:35:39,507 --> 00:35:41,506
He didn't have a seizure
or a foley catheter.
793
00:35:41,507 --> 00:35:43,506
It made his doctors'
jobs even harder.
794
00:35:43,507 --> 00:35:47,076
Wait, this disease killed Hugo.
795
00:35:47,077 --> 00:35:48,386
Does that mean...
796
00:35:48,387 --> 00:35:50,776
No, you're gonna be OK.
797
00:35:50,777 --> 00:35:53,166
You have an intermittent
form of the disease,
798
00:35:53,167 --> 00:35:55,956
which can be managed by closely
monitoring protein levels.
799
00:35:55,957 --> 00:35:57,656
We've already reached
out to nephrology
800
00:35:57,657 --> 00:35:59,656
to discuss treatment options.
801
00:35:59,657 --> 00:36:03,487
Maria.
802
00:36:14,407 --> 00:36:15,627
Gracias.
803
00:36:24,897 --> 00:36:26,727
- Hello, Daniel.
- Ooh!
804
00:36:28,207 --> 00:36:30,776
Hey, you're, uh...
You're a little early.
805
00:36:30,777 --> 00:36:33,556
Oh, I couldn't wait to see you.
806
00:36:33,557 --> 00:36:36,516
What's this? You
cleaned your office?
807
00:36:36,517 --> 00:36:37,717
No, I didn't.
808
00:36:39,127 --> 00:36:41,176
I'm tidying up a little bit.
809
00:36:41,177 --> 00:36:43,307
Why?
810
00:36:45,007 --> 00:36:48,006
I was very embarrassed by
what happened this morning.
811
00:36:48,007 --> 00:36:52,446
And um, you know, I just, uh...
812
00:36:52,447 --> 00:36:56,496
I don't ever want
you to feel that I...
813
00:36:56,497 --> 00:36:59,716
I take for granted the
job that you do, or...
814
00:36:59,717 --> 00:37:01,416
Or that I'm oblivious
to how hard you work.
815
00:37:01,417 --> 00:37:03,546
I really don't want
that to happen.
816
00:37:03,547 --> 00:37:05,587
You're very sweet.
817
00:37:07,157 --> 00:37:09,946
I care about you too, Daniel.
818
00:37:09,947 --> 00:37:11,147
A lot.
819
00:37:12,207 --> 00:37:13,776
- Yeah?
- Mm-hmm.
820
00:37:13,777 --> 00:37:14,977
Huh.
821
00:37:24,997 --> 00:37:27,086
- Hey.
- Hey.
822
00:37:27,087 --> 00:37:28,486
Ah!
823
00:37:28,487 --> 00:37:30,396
- Where'd you find it?
- Nurses' station.
824
00:37:30,397 --> 00:37:31,916
Oh, makes sense.
825
00:37:31,917 --> 00:37:34,266
That's where I was when the
call about Quentin came in.
826
00:37:34,267 --> 00:37:35,796
Yeah, I totally get it.
827
00:37:35,797 --> 00:37:38,626
I would have run off
and left it behind too.
828
00:37:38,627 --> 00:37:42,626
But my kidneys can handle
some mild dehydration.
829
00:37:42,627 --> 00:37:44,276
- Yours can't.
- Yeah, yeah.
830
00:37:44,277 --> 00:37:47,586
Yeah, pretty sure there will
be another emergency tomorrow,
831
00:37:47,587 --> 00:37:49,506
and the day after that,
832
00:37:49,507 --> 00:37:53,376
so I'm gonna give you something.
833
00:37:53,377 --> 00:37:55,856
- It is a tracking device.
- Ah.
834
00:37:55,857 --> 00:37:57,506
App connects it to your phone.
835
00:37:57,507 --> 00:38:00,386
And I haven't lost my keys
since I put it on, so...
836
00:38:00,387 --> 00:38:03,956
Well, keep it. I'm
past water bottles.
837
00:38:03,957 --> 00:38:05,646
Nephrologist just left.
838
00:38:05,647 --> 00:38:08,957
Uh, my kidneys
are getting worse.
839
00:38:14,267 --> 00:38:15,657
Dialysis?
840
00:38:25,187 --> 00:38:28,366
That was a big win today.
841
00:38:28,367 --> 00:38:31,156
You saved that family.
842
00:38:31,157 --> 00:38:33,936
Yeah.
843
00:38:33,937 --> 00:38:37,286
I suppose it's time to
talk about my DACA renewal.
844
00:38:37,287 --> 00:38:39,166
I know I've been
dragging my feet.
845
00:38:39,167 --> 00:38:42,336
It's been a long day. We
can speak in the morning.
846
00:38:42,337 --> 00:38:44,466
No. No, I'm ready.
847
00:38:44,467 --> 00:38:46,827
Yeah? All right.
848
00:38:50,177 --> 00:38:53,396
Truth is, I've been
thinking about leaving Med.
849
00:38:53,397 --> 00:38:55,266
Really?
850
00:38:55,267 --> 00:38:58,706
I've always been in school
or protected by my residency,
851
00:38:58,707 --> 00:39:02,666
so my immigration status
has always been stable.
852
00:39:02,667 --> 00:39:06,146
But my parents, despite
them always having jobs,
853
00:39:06,147 --> 00:39:07,576
could never solidify theirs,
854
00:39:07,577 --> 00:39:09,796
so they moved to Canada.
855
00:39:09,797 --> 00:39:11,276
Hmm.
856
00:39:11,277 --> 00:39:14,936
But they can't enter the
country to come visit me.
857
00:39:14,937 --> 00:39:19,066
And if I leave to go see them,
I might be denied reentry.
858
00:39:19,067 --> 00:39:22,506
So...
859
00:39:22,507 --> 00:39:25,516
I haven't hugged my
parents in a decade.
860
00:39:25,517 --> 00:39:27,466
Ugh.
861
00:39:27,467 --> 00:39:30,556
That's... that's heartbreaking.
862
00:39:30,557 --> 00:39:34,306
But Maria today, her bravery,
863
00:39:34,307 --> 00:39:39,046
what she was willing to
sacrifice for her family,
864
00:39:39,047 --> 00:39:42,266
reminded me that
865
00:39:42,267 --> 00:39:44,966
"no one puts their
child in a boat
866
00:39:44,967 --> 00:39:47,666
unless the water is
safer than the land."
867
00:39:47,667 --> 00:39:50,406
Warsan Shire.
868
00:39:50,407 --> 00:39:53,067
Oh, that's a beautiful poem.
869
00:39:54,407 --> 00:39:56,106
So...
870
00:39:56,107 --> 00:40:00,586
my parents' sacrifice
to get me here
871
00:40:00,587 --> 00:40:04,246
put me in this boat,
872
00:40:04,247 --> 00:40:06,727
which is why I have to stay.
873
00:40:08,037 --> 00:40:09,946
And Dr. Cuevas,
874
00:40:09,947 --> 00:40:14,296
I believe that you
will find a way
875
00:40:14,297 --> 00:40:17,256
to see your parents again.
876
00:40:17,257 --> 00:40:19,736
But until that day,
877
00:40:19,737 --> 00:40:23,706
know that you have
family here in us at Med.
878
00:40:24,856 --> 00:40:26,067
Thank you.
62273
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