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1
00:00:05,527 --> 00:00:07,833
He's putting me
on a renal diet.
2
00:00:07,833 --> 00:00:08,834
And if that doesn't turn
things around, then...
3
00:00:08,834 --> 00:00:09,835
Dialysis?
4
00:00:09,835 --> 00:00:11,359
I'm so sorry.
5
00:00:11,359 --> 00:00:14,275
I don't advertise
my immigration status,
6
00:00:14,275 --> 00:00:16,146
but I'm undocumented.
7
00:00:16,146 --> 00:00:19,323
My future always
feels precarious.
8
00:00:19,323 --> 00:00:21,064
all:
More money in our checks!
9
00:00:21,064 --> 00:00:23,110
We are essential!
10
00:00:23,110 --> 00:00:25,242
- You're striking?
- It's very important
11
00:00:25,242 --> 00:00:27,549
that Liliana
feels like I have her back.
12
00:00:27,549 --> 00:00:29,116
I'm going with my friends
to celebrate.
13
00:00:29,116 --> 00:00:30,334
Come!
- Oh, no--
14
00:00:30,334 --> 00:00:32,467
You have to come.
You're my boyfriend.
15
00:00:38,864 --> 00:00:40,127
Lil.
16
00:00:40,127 --> 00:00:41,563
Daniel.
17
00:00:41,563 --> 00:00:42,694
Oh, the time.
18
00:00:42,694 --> 00:00:44,696
I didn't realize.
19
00:00:44,696 --> 00:00:46,655
I--I'm almost finished.
20
00:00:46,655 --> 00:00:49,049
I'm usually done
before you arrive.
21
00:00:49,049 --> 00:00:50,137
I'm sorry.
- Oh, no.
22
00:00:50,137 --> 00:00:51,312
No, let me get that.
Let me get that.
23
00:00:51,312 --> 00:00:53,314
I'm the one
who should be apologizing.
24
00:00:53,314 --> 00:00:56,273
No. No, I had the interns in
for pizza last night.
25
00:00:56,273 --> 00:00:57,231
Then they dragged me out
for a drink,
26
00:00:57,231 --> 00:00:58,884
and--and we just left.
27
00:00:58,884 --> 00:01:00,103
It's OK.
I've got it.
28
00:01:00,103 --> 00:01:01,670
I apologize for the mess.
Really, I do.
29
00:01:01,670 --> 00:01:02,975
It's OK.
30
00:01:02,975 --> 00:01:05,282
Compared to other offices,
it's not that bad.
31
00:01:07,893 --> 00:01:10,635
Oh!
32
00:01:10,635 --> 00:01:12,855
Daniel, have a good day.
33
00:01:12,855 --> 00:01:14,204
You too.
34
00:01:19,383 --> 00:01:20,384
Ah.
35
00:01:20,384 --> 00:01:23,170
I think this belongs to you.
36
00:01:23,170 --> 00:01:25,128
Indeed, it does.
Where did you find it?
37
00:01:25,128 --> 00:01:26,390
This time?
Waiting room.
38
00:01:26,390 --> 00:01:28,218
Top of the vending machine.
- Mm.
39
00:01:28,218 --> 00:01:30,568
You know,
maybe I should just put it
40
00:01:30,568 --> 00:01:32,570
in a little
red-and-white striped shirt,
41
00:01:32,570 --> 00:01:34,616
put a bobble hat on it,
black glasses,
42
00:01:34,616 --> 00:01:38,228
and call it my "Where's Waldo?"
water bottle, huh?
43
00:01:38,228 --> 00:01:40,230
You get it?
44
00:01:40,230 --> 00:01:41,797
I get it.
45
00:01:41,797 --> 00:01:43,451
You have to stay hydrated.
46
00:01:44,278 --> 00:01:45,888
Thanks, Mom.
47
00:01:49,239 --> 00:01:50,545
Dr. Cuevas.
48
00:01:50,545 --> 00:01:53,287
- Ms. Goodwin, good morning.
- Good morning.
49
00:01:53,287 --> 00:01:56,812
Do you have a moment
to discuss your DACA renewal?
50
00:01:56,812 --> 00:01:59,423
Oh. Um, now?
51
00:01:59,423 --> 00:02:01,991
Well, the paperwork's
not due for a few months,
52
00:02:01,991 --> 00:02:04,602
but I want to make sure
we get everything filed early,
53
00:02:04,602 --> 00:02:07,170
just in case there's
an unexpected policy change.
54
00:02:07,170 --> 00:02:09,738
Right, of course.
I appreciate that.
55
00:02:09,738 --> 00:02:12,175
I just was about to dig
into these overnight charts.
56
00:02:12,175 --> 00:02:13,785
Understood.
57
00:02:13,785 --> 00:02:16,527
How about we meet up
at the end of the day?
58
00:02:16,527 --> 00:02:19,269
Yeah.
Sure, that works.
59
00:02:19,269 --> 00:02:21,315
I will--I'll see you then.
60
00:02:24,187 --> 00:02:25,319
- Dr. Asher.
- Mm-hmm?
61
00:02:25,319 --> 00:02:26,320
- Need you.
- Oh, yeah.
62
00:02:26,320 --> 00:02:27,973
Come this way.
63
00:02:27,973 --> 00:02:29,366
Hi, I'm Dr. Asher.
64
00:02:29,366 --> 00:02:32,108
Leah, what's going on?
65
00:02:32,108 --> 00:02:33,762
Parents and their daughter.
66
00:02:33,762 --> 00:02:36,112
Came in a few minutes ago.
They're terrified.
67
00:02:36,112 --> 00:02:38,767
Even scared me.
- Going to two.
68
00:02:38,767 --> 00:02:40,508
I didn't get a history.
Just came for you.
69
00:02:40,508 --> 00:02:42,553
Excuse me, Doctor.
We need your help.
70
00:02:42,553 --> 00:02:44,468
Our daughter.
- All right.
71
00:02:44,468 --> 00:02:46,862
Hi, I'm Dr. Halstead.
What's your name?
72
00:02:46,862 --> 00:02:48,472
Maria.
73
00:02:48,472 --> 00:02:50,474
Her name is Maria.
Very sick!
74
00:02:50,474 --> 00:02:53,564
Listen.
75
00:02:56,698 --> 00:02:58,874
I'm sorry.
I don't speak Spanish.
76
00:02:58,874 --> 00:03:00,745
Get Dr. Cuevas.
77
00:03:00,745 --> 00:03:04,184
I'm just gonna
feel your neck, OK?
78
00:03:05,185 --> 00:03:06,534
Does that hurt?
79
00:03:06,534 --> 00:03:07,883
¿Malo? Bad?
80
00:03:17,980 --> 00:03:19,155
What are they saying?
81
00:03:19,155 --> 00:03:21,288
They're saying
that she has the sickness,
82
00:03:21,288 --> 00:03:23,725
and if we don't help her,
she will die.
83
00:03:40,829 --> 00:03:42,744
Thank you.
84
00:03:42,744 --> 00:03:44,789
Hey.
How's Maria doing?
85
00:03:44,789 --> 00:03:45,921
Still a bit groggy,
86
00:03:45,921 --> 00:03:47,618
but responding
to questions in English.
87
00:03:47,618 --> 00:03:49,838
Whatever this is,
it seems to be sporadic.
88
00:03:49,838 --> 00:03:51,709
- Any guesses?
- I don't know.
89
00:03:51,709 --> 00:03:54,799
Maybe infectious encephalitis,
but her vitals were normal.
90
00:03:54,799 --> 00:03:56,279
I'm hoping labs
shed some light.
91
00:03:56,279 --> 00:03:57,976
What did Mom and Dad
have to say?
92
00:03:57,976 --> 00:03:59,630
The sickness
that they're referring to
93
00:03:59,630 --> 00:04:01,284
has to do
with her older brother, Hugo.
94
00:04:01,284 --> 00:04:03,721
About a month ago,
he came down with an illness,
95
00:04:03,721 --> 00:04:05,375
was admitted
to Oakview Community Hospital,
96
00:04:05,375 --> 00:04:08,335
and then died a few days later.
- Oh, man.
97
00:04:08,335 --> 00:04:09,640
Yeah, and even worse,
98
00:04:09,640 --> 00:04:11,599
Oakview couldn't
make a diagnosis.
99
00:04:11,599 --> 00:04:13,470
Well, explains why
they're beating down our doors.
100
00:04:13,470 --> 00:04:15,907
They're afraid whatever ravaged
Hugo is now attacking Maria.
101
00:04:15,907 --> 00:04:18,954
But a death in the family,
no answers,
102
00:04:18,954 --> 00:04:21,478
plus the fear that she might
have the same illness?
103
00:04:21,478 --> 00:04:23,872
Since nothing's jumping out,
I think it's possible
104
00:04:23,872 --> 00:04:26,004
that her emotions could be
manifesting physically.
105
00:04:26,004 --> 00:04:27,745
I want to talk to her,
see if there could be
106
00:04:27,745 --> 00:04:29,138
a psych explanation.
- OK.
107
00:04:29,138 --> 00:04:30,705
Meantime,
I'll reach out to Oakview,
108
00:04:30,705 --> 00:04:32,576
get Hugo's records
and autopsy results.
109
00:04:32,576 --> 00:04:33,838
If Maria does have
the same illness,
110
00:04:33,838 --> 00:04:36,493
there could be a clue in there.
- OK.
111
00:04:36,493 --> 00:04:38,669
OK, Layla,
you're 7 centimeters dilated,
112
00:04:38,669 --> 00:04:40,323
100% effaced.
113
00:04:40,323 --> 00:04:41,933
How long ago
did your water break?
114
00:04:41,933 --> 00:04:44,675
About an hour,
hour and a--
115
00:04:46,024 --> 00:04:48,200
7:02 a.m., I think.
116
00:04:48,200 --> 00:04:50,028
This baby
is coming out sideways.
117
00:04:50,028 --> 00:04:51,334
No, it just feels like that.
118
00:04:51,334 --> 00:04:52,466
Your fetus is OP,
119
00:04:52,466 --> 00:04:54,032
meaning it's facing up
instead of down.
120
00:04:54,032 --> 00:04:55,338
- Something's wrong?
- No.
121
00:04:55,338 --> 00:04:56,948
Baby's just moving around,
letting us know
122
00:04:56,948 --> 00:04:58,689
that it is time to come out.
123
00:04:58,689 --> 00:05:00,300
I'll have a nurse
let L know.
124
00:05:00,300 --> 00:05:01,736
Oh, my God.
125
00:05:01,736 --> 00:05:03,564
Quentin, our son is coming.
126
00:05:03,564 --> 00:05:05,348
I'm gonna be a mom today.
127
00:05:05,348 --> 00:05:07,568
You know, I can't remember
if I turned off the oven
128
00:05:07,568 --> 00:05:08,786
before we left the house.
129
00:05:08,786 --> 00:05:10,614
Quentin,
we haven't cooked in days.
130
00:05:10,614 --> 00:05:12,050
The oven is off.
131
00:05:12,050 --> 00:05:13,269
I'm just gonna
go home and check.
132
00:05:13,269 --> 00:05:14,488
Quentin, no!
133
00:05:14,488 --> 00:05:16,272
- Mr. Bell, please don't go.
- You know what?
134
00:05:16,272 --> 00:05:17,969
Maybe you can have a neighbor
check on it,
135
00:05:17,969 --> 00:05:19,406
or maybe
it's just nervous energy
136
00:05:19,406 --> 00:05:21,233
that's making you think
that you left it on.
137
00:05:21,233 --> 00:05:23,584
Yeah, I just don't
feel like myself.
138
00:05:23,584 --> 00:05:25,586
I get it.
It's a big day.
139
00:05:25,586 --> 00:05:26,804
You know,
a lot of new experiences
140
00:05:26,804 --> 00:05:28,066
all happening at once.
141
00:05:28,066 --> 00:05:31,592
But, Quentin,
this is not new for me.
142
00:05:31,592 --> 00:05:33,202
I have been here
many, many times,
143
00:05:33,202 --> 00:05:34,682
and I know exactly
how to help you and Layla
144
00:05:34,682 --> 00:05:36,945
get through this.
145
00:05:36,945 --> 00:05:38,207
Thank you.
146
00:05:39,426 --> 00:05:40,427
Sorry, Lay.
147
00:05:40,427 --> 00:05:42,385
I just lost my mind
for a minute.
148
00:05:44,474 --> 00:05:47,259
- Nice save.
- Mm-hmm.
149
00:05:48,783 --> 00:05:52,264
Hey, Sam.
This is Dr. Tanaka-Reed.
150
00:05:52,264 --> 00:05:53,657
He's gonna be scrubbing in
with me today.
151
00:05:53,657 --> 00:05:55,180
He's one
of my surgical residents.
152
00:05:55,180 --> 00:05:56,747
Uh, technically
I'm a resident
153
00:05:56,747 --> 00:05:58,314
but definitely not a beginner.
154
00:05:58,314 --> 00:05:59,228
OK.
155
00:05:59,228 --> 00:06:01,186
Anyway, like we discussed,
156
00:06:01,186 --> 00:06:02,840
it's a straight
appendix removal.
157
00:06:02,840 --> 00:06:04,320
You're gonna be
a bit sore afterwards,
158
00:06:04,320 --> 00:06:06,583
but in a week or two, you'll
be back to full strength.
159
00:06:06,583 --> 00:06:08,193
Mm, perfect,
160
00:06:08,193 --> 00:06:10,152
because I've been itching
to get back in the gym.
161
00:06:10,152 --> 00:06:11,893
Rugged Maniac is this summer.
162
00:06:11,893 --> 00:06:14,112
Rugged Maniac?
The adventure race?
163
00:06:14,112 --> 00:06:15,853
- You know it?
- Yeah, sort of.
164
00:06:15,853 --> 00:06:16,941
A couple of guys
from the community
165
00:06:16,941 --> 00:06:18,247
are putting a team together.
166
00:06:18,247 --> 00:06:20,118
Community?
You mean other doctors?
167
00:06:20,118 --> 00:06:23,121
No, CrossFit.
168
00:06:23,121 --> 00:06:25,428
From my Kalsu group.
Kalsu's a workout.
169
00:06:25,428 --> 00:06:27,299
We do burpees and thrusters
for time.
170
00:06:27,299 --> 00:06:28,866
Anyway,
back to the task at hand.
171
00:06:28,866 --> 00:06:30,825
If you're ready,
we're ready.
172
00:06:31,826 --> 00:06:33,610
- Let's do this.
- Great.
173
00:06:33,610 --> 00:06:35,351
Nurse Trisha will be in
to get the prep started.
174
00:06:35,351 --> 00:06:37,832
Anesthesia after that.
- Sounds good, Doc.
175
00:06:37,832 --> 00:06:39,877
See you on the other side,
all right?
176
00:06:41,879 --> 00:06:44,447
Appendix removal--
pretty basic.
177
00:06:44,447 --> 00:06:46,144
Well, sorry Sam's
not sick enough for you.
178
00:06:46,144 --> 00:06:47,450
Oh, you know what I mean.
179
00:06:47,450 --> 00:06:49,887
OR 2.0 is a Ferrari--
sexy surgery.
180
00:06:49,887 --> 00:06:52,020
But a lap appy?
That's a minivan.
181
00:06:52,020 --> 00:06:54,065
Well, not even in that today.
182
00:06:54,065 --> 00:06:56,851
Sam had a sigmoid colon
resection 18 months ago.
183
00:06:56,851 --> 00:06:58,287
Likely adhesions in his pelvis,
184
00:06:58,287 --> 00:07:00,942
so we're gonna do
this appy open--
185
00:07:00,942 --> 00:07:02,683
right lower quadrant incision.
186
00:07:02,683 --> 00:07:04,336
OK?
- Old school.
187
00:07:04,336 --> 00:07:07,339
Gee, hope I'm up
to the challenge.
188
00:07:07,339 --> 00:07:09,994
For a resident,
guy sure is full of himself.
189
00:07:09,994 --> 00:07:11,474
I'm not a fan.
190
00:07:14,521 --> 00:07:16,218
Hugo's gone.
191
00:07:18,046 --> 00:07:20,527
I'm oldest now.
I need to be strong.
192
00:07:22,311 --> 00:07:25,662
For my other brothers
and sisters.
193
00:07:25,662 --> 00:07:27,098
For my parents.
194
00:07:30,319 --> 00:07:34,062
They've been a wreck
since Hugo died.
195
00:07:34,062 --> 00:07:35,933
They can't sleep.
196
00:07:35,933 --> 00:07:37,892
They can't eat.
197
00:07:37,892 --> 00:07:40,938
Now I'm putting them
through it again.
198
00:07:42,810 --> 00:07:44,551
I have it too.
- No.
199
00:07:44,551 --> 00:07:46,727
Hey, we don't know that.
200
00:07:46,727 --> 00:07:50,208
All of the labs Dr. Halstead
ran came back normal.
201
00:07:50,208 --> 00:07:52,950
Then what's wrong with me?
202
00:07:54,125 --> 00:07:56,432
In some cases,
it's possible
203
00:07:56,432 --> 00:08:00,305
for grief and fear
to lead to physical symptoms.
204
00:08:00,305 --> 00:08:02,960
No, I'm not imagining this.
205
00:08:02,960 --> 00:08:04,788
No, you're not.
206
00:08:04,788 --> 00:08:08,052
Your symptoms are very real.
207
00:08:08,052 --> 00:08:12,448
You suffered
a devastating loss, a trauma.
208
00:08:15,103 --> 00:08:17,584
Hugo's tests
were normal too.
209
00:08:20,587 --> 00:08:22,502
And then he died.
210
00:08:26,593 --> 00:08:28,333
I don't think we're looking
at a psych condition.
211
00:08:28,333 --> 00:08:29,987
In conversion disorder,
it's rare
212
00:08:29,987 --> 00:08:32,468
that patients can express their
emotions the way Maria is.
213
00:08:32,468 --> 00:08:34,775
But her awareness
of the situation,
214
00:08:34,775 --> 00:08:37,778
her acknowledgment of the fear,
it doesn't fit.
215
00:08:37,778 --> 00:08:40,563
There's definitely
something physical going on.
216
00:08:40,563 --> 00:08:41,999
I wish I knew what.
217
00:08:41,999 --> 00:08:43,827
Medical examiner said
Hugo died of brain swelling
218
00:08:43,827 --> 00:08:45,655
but don't know
what caused it.
219
00:08:45,655 --> 00:08:47,570
And here's the kicker:
it was only three days
220
00:08:47,570 --> 00:08:49,703
from when Hugo was admitted
to the time he died.
221
00:08:49,703 --> 00:08:53,358
OK, so whatever it is,
it moved really fast.
222
00:08:55,317 --> 00:08:58,059
I think he's stuck.
223
00:08:58,059 --> 00:08:59,277
No, just a big head.
224
00:08:59,277 --> 00:09:01,279
That's all.
225
00:09:01,279 --> 00:09:02,542
Oh, my God.
226
00:09:02,542 --> 00:09:04,239
Is he gonna fit?
- Yes, he will.
227
00:09:04,239 --> 00:09:05,675
We just need to open up
the birth canal a bit wider.
228
00:09:05,675 --> 00:09:07,068
- McRoberts?
- Yes.
229
00:09:07,068 --> 00:09:08,939
Call the OB resident on call.
230
00:09:08,939 --> 00:09:11,463
Layla, we're gonna adjust you
to a new position, OK?
231
00:09:11,463 --> 00:09:13,030
It makes it easier
for the baby to come out.
232
00:09:13,030 --> 00:09:14,336
OK.
233
00:09:14,336 --> 00:09:16,077
- I'm right here.
- All right, Quentin.
234
00:09:16,077 --> 00:09:17,905
Why don't you let him
take over for you, OK?
235
00:09:17,905 --> 00:09:19,080
And I can use some pressure.
- Yep.
236
00:09:19,080 --> 00:09:21,473
I'm right here.
237
00:09:21,473 --> 00:09:23,214
OK,
now on your next contraction,
238
00:09:23,214 --> 00:09:24,868
I want you to give me
everything you've got.
239
00:09:24,868 --> 00:09:26,130
Everything.
- OK.
240
00:09:26,130 --> 00:09:27,479
- OK.
- I can do this.
241
00:09:27,479 --> 00:09:29,307
- Yes, you can.
- You got this.
242
00:09:29,307 --> 00:09:31,875
You got this. You got this.
- OK.
243
00:09:31,875 --> 00:09:33,790
Oh.
244
00:09:35,966 --> 00:09:38,012
I've got the head.
245
00:09:38,012 --> 00:09:39,230
Shoulder.
246
00:09:40,797 --> 00:09:42,407
I've got him.
247
00:09:42,407 --> 00:09:44,671
I got him.
He's here.
248
00:09:44,671 --> 00:09:46,498
He's here.
249
00:09:47,499 --> 00:09:49,719
He's here.
- Oh, my God.
250
00:09:49,719 --> 00:09:52,156
Oh, my God.
251
00:09:52,156 --> 00:09:54,071
I'm a mom.
252
00:09:54,071 --> 00:09:56,813
Our baby, he's beautiful.
253
00:09:56,813 --> 00:09:58,510
He's perfect.
254
00:09:58,510 --> 00:10:00,861
Hey, Dad, do you want
to cut the umbilical cord?
255
00:10:00,861 --> 00:10:02,776
Yeah.
256
00:10:02,776 --> 00:10:06,040
OK. Just right here
in the middle, OK?
257
00:10:09,391 --> 00:10:11,175
I want to hold him.
258
00:10:11,175 --> 00:10:13,569
That's not my son.
259
00:10:14,962 --> 00:10:17,442
What?
260
00:10:17,442 --> 00:10:19,836
Layla, who's the father?
261
00:10:19,836 --> 00:10:21,751
You are, Quentin.
262
00:10:21,751 --> 00:10:23,579
You are.
That's our baby.
263
00:10:23,579 --> 00:10:25,668
No, you're lying!
You're lying!
264
00:10:25,668 --> 00:10:26,669
Hey, Quentin, it's OK.
265
00:10:26,669 --> 00:10:28,236
We'll figure this out,
all right?
266
00:10:28,236 --> 00:10:29,933
- That's not my son.
- That's our baby.
267
00:10:29,933 --> 00:10:31,674
Of course it is!
- No, get back!
268
00:10:31,674 --> 00:10:34,546
Of course it is!
Of course it is!
269
00:10:34,546 --> 00:10:36,070
- I got to get out of here.
- Hey, deep breaths, OK?
270
00:10:36,070 --> 00:10:37,245
Quentin, breathe with me.
271
00:10:37,245 --> 00:10:38,638
Breathe with me, Quentin.
Deep breaths.
272
00:10:38,638 --> 00:10:40,378
- I got to get out of here!
- Stay! Baby, stay!
273
00:10:40,378 --> 00:10:42,206
- Hey, call security.
- Help!
274
00:10:42,206 --> 00:10:43,860
Oh, my God.
What's happening?
275
00:10:43,860 --> 00:10:46,950
Hey! Hey, stop!
276
00:10:46,950 --> 00:10:49,039
Hey, guards!
Quentin, stop!
277
00:10:50,911 --> 00:10:53,740
Why are you chasing me?
Just leave me--leave me alone!
278
00:10:53,740 --> 00:10:56,656
- Hey, Quentin--
- Stay back! Stay back!
279
00:10:56,656 --> 00:10:58,179
It's OK. It's OK.
280
00:10:58,179 --> 00:11:00,703
Deep breath.
Please, just breathe.
281
00:11:00,703 --> 00:11:02,705
I just got
to get out of here.
282
00:11:02,705 --> 00:11:04,794
I just got to get out of here!
- No, no, no, no, no!
283
00:11:09,930 --> 00:11:11,975
All right, Quentin.
284
00:11:11,975 --> 00:11:13,934
It's OK.
285
00:11:15,849 --> 00:11:19,243
Oh, my God, the scissors,
they're pulsating.
286
00:11:19,243 --> 00:11:20,680
They're penetrating
the carotid artery.
287
00:11:20,680 --> 00:11:22,029
I'll get someone
to turn off the machine.
288
00:11:22,029 --> 00:11:24,858
No, the magnet
is holding everything in place,
289
00:11:24,858 --> 00:11:26,207
including the scissors.
290
00:11:26,207 --> 00:11:28,035
If gravity takes over,
it'll shift everything,
291
00:11:28,035 --> 00:11:31,299
and we'll have maybe 20 seconds
before he bleeds out.
292
00:11:31,299 --> 00:11:33,257
OK, we need help.
Call Dr. Archer.
293
00:11:33,257 --> 00:11:35,303
Dr. Charles too.
- Yeah.
294
00:11:37,044 --> 00:11:40,612
Do not touch
the scissors, OK?
295
00:11:40,612 --> 00:11:42,919
We got you.
296
00:11:42,919 --> 00:11:44,791
Everything's gonna be OK.
297
00:11:49,839 --> 00:11:52,015
Coming through.
Excuse me.
298
00:11:52,015 --> 00:11:53,582
Thank you guys for coming.
299
00:11:53,582 --> 00:11:55,627
Absolutely.
300
00:11:55,627 --> 00:11:57,325
- Hey, fellas.
- Doctor.
301
00:11:59,719 --> 00:12:01,938
He's conscious and calm
but out of it.
302
00:12:01,938 --> 00:12:03,853
He's not being crushed.
He's able to breathe.
303
00:12:03,853 --> 00:12:06,073
He's got to be in pain, though.
- OK.
304
00:12:06,073 --> 00:12:09,032
So let's give him
50 mics of fentanyl IM.
305
00:12:09,032 --> 00:12:10,947
Syringe is plastic
and the needle nonferrous,
306
00:12:10,947 --> 00:12:12,340
so it should be MRI safe.
307
00:12:12,340 --> 00:12:13,820
OK, I'll get it.
308
00:12:13,820 --> 00:12:15,735
Dr. Asher went back
to be with his wife, Layla.
309
00:12:15,735 --> 00:12:17,780
She's still in L
- OK.
310
00:12:17,780 --> 00:12:19,260
It's a rescue situation.
311
00:12:19,260 --> 00:12:20,652
I just don't really know
where to start.
312
00:12:20,652 --> 00:12:22,306
All of our tools have metal.
313
00:12:22,306 --> 00:12:25,962
So nothing is usable as long
as the MRI machine is running.
314
00:12:25,962 --> 00:12:28,791
All right, well, let's say
we did turn the machine off.
315
00:12:28,791 --> 00:12:30,097
Everything falls
to the floor.
316
00:12:30,097 --> 00:12:32,099
Bed alone is
a couple hundred pounds.
317
00:12:32,099 --> 00:12:34,275
I can put two of my guys
in there to try and catch it,
318
00:12:34,275 --> 00:12:36,103
then get it out of the way
so you can get to Quentin.
319
00:12:36,103 --> 00:12:38,322
Scissors in his neck
are magnetic too.
320
00:12:38,322 --> 00:12:40,107
Cut the MRI's power,
they're gonna move.
321
00:12:40,107 --> 00:12:41,673
Quentin will bleed out fast.
322
00:12:41,673 --> 00:12:44,285
If you could go in there
with clamps and stem the flow,
323
00:12:44,285 --> 00:12:46,766
would that buy us some time?
- Not enough.
324
00:12:46,766 --> 00:12:48,898
Odds of survival
are less than 1%.
325
00:12:48,898 --> 00:12:51,161
I'm running outcome
probabilities on our options,
326
00:12:51,161 --> 00:12:52,989
and turning off the machine
cold turkey is the worst.
327
00:12:52,989 --> 00:12:54,991
So what's the best?
328
00:12:54,991 --> 00:12:57,385
If CFD can secure Quentin
329
00:12:57,385 --> 00:12:59,300
and ensure
the bed won't displace him
330
00:12:59,300 --> 00:13:01,693
and Dr. Archer can
stabilize the neck wound
331
00:13:01,693 --> 00:13:03,217
all before turning off
the MRI machine,
332
00:13:03,217 --> 00:13:06,481
then the odds of survival
are roughly 61%.
333
00:13:06,481 --> 00:13:09,049
OK, we've got a plan.
Can it be done?
334
00:13:09,049 --> 00:13:11,834
Well, safest way
to secure the patient
335
00:13:11,834 --> 00:13:14,228
would be to do
a webbing harness.
336
00:13:14,228 --> 00:13:16,621
We can throw the ropes
over the MRI machine,
337
00:13:16,621 --> 00:13:18,885
and then two of my guys
can hold it on the other side.
338
00:13:18,885 --> 00:13:21,061
OK, the magnet's off,
the bed falls.
339
00:13:21,061 --> 00:13:24,194
How do we ensure that
Quentin doesn't go with it?
340
00:13:24,194 --> 00:13:26,240
We can create a buffer zone
between him and the bed
341
00:13:26,240 --> 00:13:29,025
using wooden cribbing,
wedges, and airbags.
342
00:13:29,025 --> 00:13:30,853
We can run some hoses
and inflate them
343
00:13:30,853 --> 00:13:32,289
from a tank here
in the hallway.
344
00:13:32,289 --> 00:13:33,856
All right,
we're halfway there.
345
00:13:33,856 --> 00:13:35,553
Dr. Archer?
- Yeah.
346
00:13:35,553 --> 00:13:37,164
I just need to clamp the artery
347
00:13:37,164 --> 00:13:38,252
in order
to control the bleeding.
348
00:13:38,252 --> 00:13:40,341
Then I could
take the scissors out.
349
00:13:40,341 --> 00:13:43,300
But the issue is
the tools needed to do it.
350
00:13:43,300 --> 00:13:45,346
I can make them plastic.
3D printers.
351
00:13:45,346 --> 00:13:46,564
There are four
in the robotics lab.
352
00:13:46,564 --> 00:13:47,870
All right.
Get on it.
353
00:13:47,870 --> 00:13:51,047
And get a few
of the 2.0 engineers to help.
354
00:13:51,047 --> 00:13:53,963
- We'll get started too.
- Good.
355
00:13:53,963 --> 00:13:55,399
OK, you're doing great.
356
00:13:55,399 --> 00:13:57,010
Gonna give you
a little injection.
357
00:13:57,010 --> 00:13:58,402
Some pain meds, all right?
358
00:13:58,402 --> 00:14:01,579
To just make you
a little more comfortable, OK?
359
00:14:01,579 --> 00:14:03,494
Little pinch.
360
00:14:08,238 --> 00:14:09,544
OK.
361
00:14:11,241 --> 00:14:13,896
Daniel?
362
00:14:13,896 --> 00:14:15,245
I'm just gonna step away
for a second,
363
00:14:15,245 --> 00:14:16,551
have a little chat
with my colleague.
364
00:14:16,551 --> 00:14:18,466
I'm not going anywhere, OK?
365
00:14:21,512 --> 00:14:23,819
How's he doing?
366
00:14:23,819 --> 00:14:28,171
Well, you know, I mean, he's
pinned to an MRI machine, so...
367
00:14:28,171 --> 00:14:30,870
Do you have any theories
on what sparked the break?
368
00:14:30,870 --> 00:14:33,307
I've been really focusing
on trying to keep him calm.
369
00:14:33,307 --> 00:14:36,005
But how's the plan
to get him off the thing going?
370
00:14:36,005 --> 00:14:37,441
Well, we've got one.
371
00:14:37,441 --> 00:14:39,617
But it's a possibility
that it won't work, Daniel,
372
00:14:39,617 --> 00:14:43,012
so I've asked Dr. Asher to
bring Quentin's wife down here
373
00:14:43,012 --> 00:14:45,928
to see him
'cause it may be the last time.
374
00:14:45,928 --> 00:14:47,887
OK, thank you.
375
00:14:50,237 --> 00:14:52,326
OK, making the incision.
376
00:14:54,197 --> 00:14:55,155
OK.
377
00:14:57,418 --> 00:14:59,986
OK, nice and easy.
378
00:15:02,249 --> 00:15:03,337
Lab cut.
379
00:15:08,168 --> 00:15:09,909
Yep.
380
00:15:09,909 --> 00:15:11,998
Definitely feeling
some adhesions.
381
00:15:11,998 --> 00:15:13,173
Point taken.
382
00:15:13,173 --> 00:15:15,349
Open surgery
was the right call.
383
00:15:15,349 --> 00:15:17,438
Go ahead, say it.
"I told you so."
384
00:15:17,438 --> 00:15:19,048
Yeah, maybe later.
385
00:15:19,048 --> 00:15:21,746
For now, why don't you get
some practice old-school style?
386
00:15:21,746 --> 00:15:23,618
Come around.
387
00:15:26,447 --> 00:15:28,057
OK. You got it?
388
00:15:28,057 --> 00:15:29,667
- Yeah.
- All right.
389
00:15:29,667 --> 00:15:31,060
Babcock.
390
00:15:38,415 --> 00:15:40,156
You OK?
391
00:15:40,156 --> 00:15:41,897
Yeah, it's just
a little heartburn.
392
00:15:41,897 --> 00:15:43,290
I'm fine.
393
00:15:44,726 --> 00:15:46,946
Oh, uh--
394
00:15:48,817 --> 00:15:51,124
Uh, God, excuse me.
I'm sorry.
395
00:15:51,124 --> 00:15:53,387
Stop it.
396
00:15:53,387 --> 00:15:54,954
Stop.
397
00:15:54,954 --> 00:15:56,303
It's no big deal.
398
00:15:56,303 --> 00:16:00,046
It happens, OK?
Just focus on the field.
399
00:16:01,569 --> 00:16:04,006
Stay focused.
400
00:16:05,486 --> 00:16:07,749
Uh-oh,
here comes another one.
401
00:16:07,749 --> 00:16:09,142
Kai?
402
00:16:09,142 --> 00:16:11,492
Kai, talk to me.
403
00:16:11,492 --> 00:16:13,015
Hey, buddy! Hey!
404
00:16:13,015 --> 00:16:15,670
Angel. Angel, check him.
405
00:16:17,411 --> 00:16:18,890
- Got a pulse.
- All right.
406
00:16:18,890 --> 00:16:20,892
Give me the babcock, please.
407
00:16:20,892 --> 00:16:22,416
- Maria!
- Need some help in here!
408
00:16:22,416 --> 00:16:24,070
Maria!
409
00:16:24,070 --> 00:16:25,506
I was helping her
to the bathroom,
410
00:16:25,506 --> 00:16:26,420
and she started seizing.
411
00:16:26,420 --> 00:16:28,030
OK, 4 milligrams of Ativan.
412
00:16:29,597 --> 00:16:31,120
Please help her. Please.
413
00:16:34,428 --> 00:16:36,212
Ativan's in.
414
00:16:41,043 --> 00:16:42,610
OK, she's gonna be
postictal for a while.
415
00:16:42,610 --> 00:16:43,785
Put her on a foley.
416
00:16:43,785 --> 00:16:44,829
I don't want her
getting out of the bed,
417
00:16:44,829 --> 00:16:46,440
not even for the bathroom.
418
00:16:54,100 --> 00:16:56,015
A seizure expands
our differential tenfold.
419
00:16:56,015 --> 00:16:57,842
We got to widen our net--
CT panscan,
420
00:16:57,842 --> 00:17:00,062
MRI brain, sed rate,
autoimmune labs.
421
00:17:00,062 --> 00:17:01,237
Let's rope in neurology.
- Guys.
422
00:17:01,237 --> 00:17:02,412
Ms. Goodwin just called.
423
00:17:02,412 --> 00:17:03,935
She said stand down.
No more treatment.
424
00:17:03,935 --> 00:17:05,067
What?
What are you talking about?
425
00:17:05,067 --> 00:17:06,068
She's in the MRI suite.
426
00:17:06,068 --> 00:17:08,114
Be here as soon as she can, OK?
427
00:17:11,682 --> 00:17:13,641
- Hey, you OK?
- This is overkill.
428
00:17:13,641 --> 00:17:15,425
I probably
just had some bad oatmeal.
429
00:17:15,425 --> 00:17:17,558
Well, bad oatmeal
doesn't drop you
430
00:17:17,558 --> 00:17:18,950
in the middle of surgery.
431
00:17:18,950 --> 00:17:21,736
So how about
you let me check you out?
432
00:17:24,173 --> 00:17:26,262
How's Sam?
Appendectomy go OK?
433
00:17:26,262 --> 00:17:28,656
Yeah, all good.
Dr. Graham is finishing up.
434
00:17:28,656 --> 00:17:30,136
At least
it's just an appendectomy.
435
00:17:30,136 --> 00:17:32,007
Not missing much.
436
00:17:34,966 --> 00:17:36,881
Oh, my chest. Pressure.
437
00:17:39,841 --> 00:17:41,495
Oh, God.
I'm sorry.
438
00:17:43,149 --> 00:17:44,802
That was weird.
439
00:17:44,802 --> 00:17:46,804
Your heart rate plummeted,
but as soon as you passed gas,
440
00:17:46,804 --> 00:17:48,023
it came back.
441
00:17:48,023 --> 00:17:50,025
Will you sit up for me?
442
00:17:52,854 --> 00:17:54,290
Take a deep breath.
443
00:17:56,510 --> 00:17:58,164
All right.
Lean back for me.
444
00:17:58,164 --> 00:18:00,949
Hey, Mike.
Let's get an X-ray in here.
445
00:18:00,949 --> 00:18:02,298
What, did you hear a murmur?
446
00:18:02,298 --> 00:18:04,039
Honestly,
I'm not sure what I heard.
447
00:18:04,039 --> 00:18:05,475
You're joking, right?
Come on.
448
00:18:05,475 --> 00:18:08,087
Has heartburn
been an issue before today?
449
00:18:08,087 --> 00:18:09,610
I mean, I get it.
450
00:18:09,610 --> 00:18:11,873
Even when I was a kid, it
would flare up here and there.
451
00:18:11,873 --> 00:18:14,267
But it's never been an issue.
452
00:18:14,267 --> 00:18:16,704
X-ray up. Clear.
453
00:18:22,840 --> 00:18:25,321
What the hell?
That's my colon.
454
00:18:25,321 --> 00:18:26,801
It shouldn't be in my chest.
455
00:18:26,801 --> 00:18:29,108
No, it should not.
456
00:18:31,327 --> 00:18:33,590
Her brother. Hugo, was
a patient treated at Oakview.
457
00:18:33,590 --> 00:18:34,809
So was Maria.
458
00:18:34,809 --> 00:18:37,203
She was admitted yesterday
via ambulance,
459
00:18:37,203 --> 00:18:40,293
but this morning,
her family just walked her out.
460
00:18:40,293 --> 00:18:41,729
They just left--absconded.
461
00:18:41,729 --> 00:18:43,339
Well,
her brother died at Oakview,
462
00:18:43,339 --> 00:18:44,819
and they didn't
get any answers.
463
00:18:44,819 --> 00:18:46,168
You see how scared they are.
464
00:18:46,168 --> 00:18:47,300
It's no wonder
that they didn't want to stay.
465
00:18:47,300 --> 00:18:49,215
Look, I agree,
but walking out
466
00:18:49,215 --> 00:18:51,608
is the same as leaving
against medical advice.
467
00:18:51,608 --> 00:18:54,002
It's triggered
an insurance nightmare
468
00:18:54,002 --> 00:18:55,612
with the family's HMO.
469
00:18:55,612 --> 00:18:57,832
They won't pay
for any more treatment
470
00:18:57,832 --> 00:18:59,921
until Maria is placed back
471
00:18:59,921 --> 00:19:03,403
with their preferred network
provider, Oakview.
472
00:19:03,403 --> 00:19:05,883
Are you kidding me?
They're a community hospital.
473
00:19:05,883 --> 00:19:08,190
They don't have the resources
to run the tests she needs.
474
00:19:08,190 --> 00:19:09,583
Well,
I've already reached out
475
00:19:09,583 --> 00:19:12,020
to the director
of patient services at Oakview,
476
00:19:12,020 --> 00:19:14,370
and she assured me
they'll do the best they can.
477
00:19:14,370 --> 00:19:16,024
The best they can?
478
00:19:16,024 --> 00:19:19,027
Ms. Goodwin, can't you reason
with the insurance company?
479
00:19:19,027 --> 00:19:21,334
Hector and Gloria aren't trying
to take advantage of them.
480
00:19:21,334 --> 00:19:23,031
They're trying
to save their daughter's life.
481
00:19:23,031 --> 00:19:24,554
Look, I know,
and I share
482
00:19:24,554 --> 00:19:26,513
in your frustration,
but they're--
483
00:19:26,513 --> 00:19:28,863
No. No, I don't care what
the insurance company says.
484
00:19:28,863 --> 00:19:31,213
I'm not sending Maria back to
Oakview until I get a guarantee
485
00:19:31,213 --> 00:19:32,867
she gets the treatment
she needs in time.
486
00:19:32,867 --> 00:19:35,391
Dr. Halstead,
the tests that you ordered
487
00:19:35,391 --> 00:19:37,306
will cost
tens of thousands of dollars,
488
00:19:37,306 --> 00:19:39,656
and I know that's not
coming out your pocket.
489
00:19:39,656 --> 00:19:43,269
The family has to decide
how to proceed.
490
00:19:53,235 --> 00:19:54,976
OK, Quentin,
so listen,
491
00:19:54,976 --> 00:19:57,152
we're gonna secure you
to the machine
492
00:19:57,152 --> 00:19:59,285
while it's still running
with a harness.
493
00:19:59,285 --> 00:20:01,330
So then, Dr. Archer,
who is an excellent surgeon,
494
00:20:01,330 --> 00:20:02,940
is gonna come in here
and clamp your artery,
495
00:20:02,940 --> 00:20:04,594
stabilize your neck wound,
496
00:20:04,594 --> 00:20:06,857
and make it safer when
they pull out the scissors.
497
00:20:06,857 --> 00:20:09,120
All right?
Then we turn off the machine.
498
00:20:09,120 --> 00:20:11,384
The idea is,
bed falls to the side,
499
00:20:11,384 --> 00:20:14,691
you're held firmly in place
by the harness, OK?
500
00:20:14,691 --> 00:20:16,563
Still with me?
- Mm-hmm.
501
00:20:16,563 --> 00:20:18,173
Great.
Last thing.
502
00:20:18,173 --> 00:20:20,784
Lower you onto a gurney,
shoot you off the ER,
503
00:20:20,784 --> 00:20:23,004
and finish fixing up your neck.
504
00:20:23,004 --> 00:20:25,006
How's that sound?
- Mm-hmm.
505
00:20:34,624 --> 00:20:36,887
Am I gonna die?
506
00:20:36,887 --> 00:20:38,628
Look, this is
a complicated situation.
507
00:20:38,628 --> 00:20:42,153
But some really skilled people
have come up with this plan,
508
00:20:42,153 --> 00:20:44,025
and it's
the best option we got.
509
00:20:44,025 --> 00:20:47,028
All you got to do:
breathe in and out,
510
00:20:47,028 --> 00:20:51,162
stay as still
as you possibly can, OK?
511
00:20:51,162 --> 00:20:52,729
All right.
512
00:20:52,729 --> 00:20:54,992
Take all the time you need.
513
00:20:57,256 --> 00:20:59,736
Hey, hold the work.
Everybody, out.
514
00:21:07,657 --> 00:21:10,443
You're my everything.
515
00:21:10,443 --> 00:21:14,534
From our first date,
I knew that I was in love.
516
00:21:14,534 --> 00:21:17,667
And now we're parents.
517
00:21:17,667 --> 00:21:19,190
Uh...
518
00:21:21,192 --> 00:21:23,282
The nurse
took a picture of him.
519
00:21:26,110 --> 00:21:28,983
I named him Trevor,
after your dad.
520
00:21:28,983 --> 00:21:31,115
I think he'd like that.
521
00:21:32,813 --> 00:21:35,729
Tell Trevor I love him.
522
00:21:35,729 --> 00:21:38,688
You're gonna
tell him yourself.
523
00:21:38,688 --> 00:21:41,430
You're gonna be
a great mother.
524
00:21:42,953 --> 00:21:44,999
I love you, Quentin.
525
00:21:44,999 --> 00:21:47,958
I will see you again,
you hear me?
526
00:21:47,958 --> 00:21:50,396
I will see you again.
527
00:22:04,758 --> 00:22:06,629
Sorry.
528
00:22:06,629 --> 00:22:09,763
I didn't know what to say.
529
00:22:09,763 --> 00:22:12,418
How do you
put into words when--
530
00:22:12,418 --> 00:22:14,463
You can't.
531
00:22:14,463 --> 00:22:16,770
But we could feel
your love for each other.
532
00:22:16,770 --> 00:22:18,641
I just don't understand,
533
00:22:18,641 --> 00:22:21,601
because Quentin is my rock,
534
00:22:21,601 --> 00:22:26,693
and I don't even recognize
the man that's in there.
535
00:22:26,693 --> 00:22:28,999
He just snapped.
536
00:22:28,999 --> 00:22:31,045
How does that happen
all of a sudden?
537
00:22:31,045 --> 00:22:34,178
I mean, usually
there are signs, you know?
538
00:22:34,178 --> 00:22:37,573
Extreme expressions
of emotional frustration,
539
00:22:37,573 --> 00:22:39,619
anger, confusion, outbursts.
540
00:22:39,619 --> 00:22:43,057
You noticed anything like that
in Quentin recently?
541
00:22:43,057 --> 00:22:46,147
- I don't think so.
- How about physical changes?
542
00:22:46,147 --> 00:22:48,410
I noticed he had some lumps
on the back of his neck.
543
00:22:48,410 --> 00:22:49,977
Have you--
do you know what those are?
544
00:22:49,977 --> 00:22:53,763
Lumps? I don't know.
545
00:22:53,763 --> 00:22:58,464
I just wanted to get to today
and to have the baby.
546
00:22:58,464 --> 00:23:00,553
I've been so consumed
by the pregnancy
547
00:23:00,553 --> 00:23:04,295
that I haven't noticed
anything else.
548
00:23:04,295 --> 00:23:06,080
Oh, Quentin.
549
00:23:11,868 --> 00:23:13,653
Uh, give it to Spellman.
550
00:23:13,653 --> 00:23:14,784
Thanks, Lori.
551
00:23:14,784 --> 00:23:16,482
Mystery solved.
Your chest CT.
552
00:23:16,482 --> 00:23:19,354
- Hiatal hernia.
- No, diaphragmatic.
553
00:23:19,354 --> 00:23:22,009
Big enough that your colon
migrated into your chest.
554
00:23:22,009 --> 00:23:24,490
So the gas moving through it,
555
00:23:24,490 --> 00:23:27,231
it puts pressure on the vagus
nerve, drops your heartbeat.
556
00:23:27,231 --> 00:23:28,929
Breaking wind
releases the pressure.
557
00:23:28,929 --> 00:23:30,496
Heart returns to a normal rate.
- Yeah.
558
00:23:30,496 --> 00:23:32,106
You said you had heartburn
since you were a kid.
559
00:23:32,106 --> 00:23:34,064
Probably this: undiagnosed
560
00:23:34,064 --> 00:23:37,111
asymptomatic congenital
diaphragmatic hernia.
561
00:23:37,111 --> 00:23:38,721
I've never passed out before, though.
562
00:23:38,721 --> 00:23:41,550
Well, my guess is it's been
slowly expanding over time.
563
00:23:41,550 --> 00:23:43,030
But you do CrossFit now,
564
00:23:43,030 --> 00:23:45,380
so the thrusters,
burpees, other workouts--
565
00:23:45,380 --> 00:23:48,035
safe bet that they've
exacerbated the condition.
566
00:23:48,035 --> 00:23:50,385
Led to today.
- Yeah, well, I'll own that.
567
00:23:50,385 --> 00:23:52,039
But I can't resist
dropping in the OR again,
568
00:23:52,039 --> 00:23:54,215
so let's fix this hernia.
- OK.
569
00:23:54,215 --> 00:23:57,523
Well, you've got
a few surgical options.
570
00:23:57,523 --> 00:23:58,915
Open.
- No.
571
00:23:58,915 --> 00:24:00,526
That's a huge incision.
Lots of digging around.
572
00:24:00,526 --> 00:24:02,528
I'll be laid up
in the ICU for weeks.
573
00:24:02,528 --> 00:24:03,877
Laparoscopic, then.
574
00:24:03,877 --> 00:24:05,661
Be more incisions
for the scope and tools,
575
00:24:05,661 --> 00:24:08,055
but less invasive--
- No old-school approaches.
576
00:24:08,055 --> 00:24:09,709
Robotic assist in OR 2.0.
577
00:24:09,709 --> 00:24:11,580
Shortest recovery time.
578
00:24:13,321 --> 00:24:15,584
I just want this
to be over with.
579
00:24:15,584 --> 00:24:18,282
OK, I'm gonna scrub in.
580
00:24:18,282 --> 00:24:19,588
I'll see you after, OK?
581
00:24:24,941 --> 00:24:27,204
Holy cow.
Look at this place.
582
00:24:27,204 --> 00:24:29,206
It's like you guys are living
in 2050 up here.
583
00:24:29,206 --> 00:24:31,818
So don't break anything.
584
00:24:31,818 --> 00:24:33,515
How's it going
with the surgical tools?
585
00:24:33,515 --> 00:24:35,561
Almost there.
Scalpel's printed.
586
00:24:35,561 --> 00:24:37,171
Two of the three angled
peripheral vascular clamps
587
00:24:37,171 --> 00:24:38,259
are printed as well.
588
00:24:38,259 --> 00:24:39,521
One Weitlaner retractor printed.
589
00:24:39,521 --> 00:24:41,523
One to go.
- Oh, it's like the real thing.
590
00:24:41,523 --> 00:24:43,917
It is the real thing,
just plastic.
591
00:24:43,917 --> 00:24:45,658
These tools,
I think they can work.
592
00:24:45,658 --> 00:24:47,094
They'll have to.
593
00:24:47,094 --> 00:24:48,574
They're all we got.
594
00:24:54,101 --> 00:24:56,538
They never wanted
to go to Oakview,
595
00:24:56,538 --> 00:24:58,497
but the ambulance
took them there anyway.
596
00:24:58,497 --> 00:25:00,542
Because Maria
didn't require specialty care,
597
00:25:00,542 --> 00:25:03,110
paramedics took her to
the nearest hospital instead.
598
00:25:12,467 --> 00:25:15,949
I'm so sorry that you've
been put in this situation.
599
00:25:15,949 --> 00:25:18,212
We can continue to treat Maria,
600
00:25:18,212 --> 00:25:21,215
but your insurance
won't cover the costs.
601
00:25:31,660 --> 00:25:35,359
He said he'll sell the car.
He can get a second job.
602
00:25:35,359 --> 00:25:37,100
His oldest son
can get a job as well.
603
00:25:37,100 --> 00:25:38,798
No. Papa, no.
604
00:25:38,798 --> 00:25:40,451
No.
605
00:25:40,451 --> 00:25:42,323
I'll go back.
606
00:25:42,323 --> 00:25:44,586
No.
607
00:25:44,586 --> 00:25:46,806
Maria--
608
00:25:46,806 --> 00:25:49,156
Maria.
609
00:26:14,224 --> 00:26:18,054
You know, maybe Oakview
will figure it out.
610
00:26:23,582 --> 00:26:24,539
All right.
611
00:26:24,539 --> 00:26:28,456
Um, I'll set up the transfer.
612
00:26:35,115 --> 00:26:36,595
What was Maria saying?
613
00:26:36,595 --> 00:26:38,858
If she lets her parents
bankrupt the family
614
00:26:38,858 --> 00:26:41,643
paying for her medical care,
then all of the opportunities
615
00:26:41,643 --> 00:26:45,212
they've worked so hard to give
their children will be lost.
616
00:26:45,212 --> 00:26:47,040
She is risking her life.
617
00:26:47,040 --> 00:26:48,824
No.
618
00:26:48,824 --> 00:26:51,044
No, she's sacrificing it.
619
00:26:51,044 --> 00:26:54,874
And it's awful,
620
00:26:54,874 --> 00:26:57,528
but I get it.
621
00:27:06,363 --> 00:27:07,538
Ready to inflate?
622
00:27:10,498 --> 00:27:11,847
Up on blue.
623
00:27:13,544 --> 00:27:14,850
Hold.
624
00:27:16,417 --> 00:27:17,984
Up on red.
625
00:27:23,729 --> 00:27:24,991
Hold.
626
00:27:29,299 --> 00:27:31,954
How's, uh--
how's Layla doing?
627
00:27:31,954 --> 00:27:35,044
She's in shock,
full of grief,
628
00:27:35,044 --> 00:27:36,611
and a first-time mom
all at the same time.
629
00:27:36,611 --> 00:27:39,701
It's a lot, but
a psych resident is with her.
630
00:27:39,701 --> 00:27:43,009
Mm.
And how about you?
631
00:27:43,009 --> 00:27:45,489
How are you doing?
632
00:27:45,489 --> 00:27:48,405
Honestly,
I didn't see this coming.
633
00:27:48,405 --> 00:27:52,105
I just thought Quentin
was a nervous first-time dad,
634
00:27:52,105 --> 00:27:54,673
like the ones
I see every single day.
635
00:27:54,673 --> 00:27:56,413
Never suspected mental illness.
636
00:27:56,413 --> 00:27:58,372
You know,
I'm not sure it is, per se.
637
00:27:58,372 --> 00:28:01,375
You know those lumps
on the back of his neck?
638
00:28:01,375 --> 00:28:03,029
I have a very strong hunch
that they're indicative
639
00:28:03,029 --> 00:28:04,770
of a physical issue
that could very well
640
00:28:04,770 --> 00:28:07,729
be causing a sudden psychosis.
641
00:28:07,729 --> 00:28:09,296
It's physical,
not psychological?
642
00:28:09,296 --> 00:28:11,037
Yeah, I'm leaning that way.
643
00:28:11,037 --> 00:28:13,822
I mean, can't be sure
until we run some tests.
644
00:28:25,442 --> 00:28:27,140
Maria,
this is a thumb drive
645
00:28:27,140 --> 00:28:29,316
with all the work we did here,
along with our notes.
646
00:28:29,316 --> 00:28:32,711
You give this to the doctors
as soon as you get there.
647
00:28:32,711 --> 00:28:34,016
Thank you.
648
00:28:37,846 --> 00:28:40,022
All right.
Empty her foley.
649
00:28:47,769 --> 00:28:49,075
It's OK, Mama.
650
00:28:51,686 --> 00:28:53,862
Wait.
651
00:28:55,821 --> 00:28:57,126
Will?
652
00:29:00,956 --> 00:29:02,392
You smell that?
653
00:29:09,356 --> 00:29:10,661
We have to run one more test.
654
00:29:10,661 --> 00:29:12,881
I'll pay for it myself,
if I have to.
655
00:29:18,408 --> 00:29:19,888
I'm scared.
656
00:29:19,888 --> 00:29:22,456
Well, you'll be less
frightened if you can't see it,
657
00:29:22,456 --> 00:29:25,415
so I'm gonna
drape your face, OK?
658
00:29:27,504 --> 00:29:28,810
Yeah.
659
00:29:28,810 --> 00:29:30,812
All right.
660
00:29:30,812 --> 00:29:32,379
Here we go. Careful.
661
00:29:34,033 --> 00:29:35,904
That's right.
All right.
662
00:29:37,036 --> 00:29:38,864
All right.
663
00:29:38,864 --> 00:29:41,823
10cc's of lidocaine, please.
664
00:29:41,823 --> 00:29:43,869
OK.
665
00:29:43,869 --> 00:29:46,306
All right.
666
00:29:55,402 --> 00:29:56,620
OK.
667
00:29:56,620 --> 00:29:59,580
Scalpel.
668
00:29:59,580 --> 00:30:01,234
All right.
Grab hold of those scissors.
669
00:30:01,234 --> 00:30:04,106
I don't want them flopping
after I make the incisions.
670
00:30:07,588 --> 00:30:09,372
Here we go.
671
00:30:14,290 --> 00:30:16,640
OK.
672
00:30:16,640 --> 00:30:17,772
All right.
673
00:30:17,772 --> 00:30:19,295
Wheaties.
674
00:30:22,864 --> 00:30:26,868
All right.
Watch your fingers there.
675
00:30:26,868 --> 00:30:29,523
That's it. That's it.
Don't move it. Don't move it.
676
00:30:29,523 --> 00:30:31,046
Clamp.
677
00:30:35,703 --> 00:30:36,704
All right.
678
00:30:45,974 --> 00:30:48,063
All right.
679
00:30:48,063 --> 00:30:50,283
Carotid clamps in place.
CFD, you're up.
680
00:30:50,283 --> 00:30:51,850
All right.
Spread out around the bed.
681
00:30:51,850 --> 00:30:54,113
When it falls down, we pull it
away from the MRI machine.
682
00:30:54,113 --> 00:30:57,377
All right. And no slack
at all, you understand?
683
00:30:57,377 --> 00:30:59,640
If there's any movement,
his clamps could pop off,
684
00:30:59,640 --> 00:31:02,382
and then we'll have a problem
we might not be able to fix.
685
00:31:02,382 --> 00:31:03,731
All right.
686
00:31:03,731 --> 00:31:06,777
On three, you're gonna
cut the power to the MRI.
687
00:31:06,777 --> 00:31:07,996
We ready?
Everybody, ready?
688
00:31:07,996 --> 00:31:09,084
Ready.
689
00:31:09,084 --> 00:31:12,435
One, two, three.
690
00:31:16,222 --> 00:31:18,311
All right.
Clamps are holding.
691
00:31:18,311 --> 00:31:20,095
I'm gonna remove
the scissors now.
692
00:31:23,794 --> 00:31:25,057
All right.
693
00:31:25,057 --> 00:31:26,928
All right, we're clear.
OK, bed.
694
00:31:26,928 --> 00:31:29,670
Let's lower Quentin.
695
00:31:32,368 --> 00:31:35,023
Lower him slowly.
- One, two, three.
696
00:31:36,720 --> 00:31:38,070
Slack!
697
00:31:40,028 --> 00:31:41,638
All right.
698
00:31:43,379 --> 00:31:45,164
OK, ropes are free.
699
00:31:45,164 --> 00:31:47,731
All right.
700
00:31:47,731 --> 00:31:50,038
Incredible, Doc.
Freaking incredible.
701
00:31:50,038 --> 00:31:53,215
Thanks. Can someone get me
a bottle of water, please?
702
00:31:53,215 --> 00:31:55,435
Dr. Archer, you did it.
703
00:31:55,435 --> 00:31:57,524
- Dean, you all right?
- Yeah.
704
00:31:57,524 --> 00:31:59,830
I got to get to the OR, so...
705
00:31:59,830 --> 00:32:01,441
Whoa, whoa, whoa, whoa, whoa.
706
00:32:01,441 --> 00:32:04,096
Page Dr. Lanik
to take over with Quentin.
707
00:32:04,096 --> 00:32:05,010
I'm just feeling
a little dizzy.
708
00:32:05,010 --> 00:32:06,272
That's all.
709
00:32:13,932 --> 00:32:15,324
Hernia fixed?
710
00:32:15,324 --> 00:32:17,239
I'd say
you're as good as new.
711
00:32:17,239 --> 00:32:19,198
Yeah, not quite.
712
00:32:19,198 --> 00:32:20,764
I'm the fart doctor now.
713
00:32:20,764 --> 00:32:22,723
A punchline.
- No.
714
00:32:22,723 --> 00:32:24,681
What happened today
was a result
715
00:32:24,681 --> 00:32:25,856
of a medical ailment, OK?
716
00:32:25,856 --> 00:32:27,119
Like anyone's
gonna care about that.
717
00:32:27,119 --> 00:32:28,816
All they're gonna
remember is the fart.
718
00:32:28,816 --> 00:32:30,992
Oh, come on.
It'll blow over.
719
00:32:32,602 --> 00:32:34,953
Sorry. Poor choice of words,
but it will.
720
00:32:34,953 --> 00:32:37,477
I doubt it.
721
00:32:37,477 --> 00:32:38,782
All right, look.
722
00:32:38,782 --> 00:32:41,176
I'll check on you
a little later, OK?
723
00:32:41,176 --> 00:32:42,134
All right.
724
00:32:43,962 --> 00:32:47,095
- So his neck is fixed, then?
- Yeah.
725
00:32:47,095 --> 00:32:49,184
The artery repair
went very well.
726
00:32:49,184 --> 00:32:51,795
What about his mind?
Because before--
727
00:32:51,795 --> 00:32:53,797
Well, I gave him
a very small dose
728
00:32:53,797 --> 00:32:55,886
of an antipsychotic
called risperidone,
729
00:32:55,886 --> 00:32:58,019
and he does seem
to be thinking more clearly.
730
00:32:58,019 --> 00:33:01,196
And you think
he'll stay that way?
731
00:33:01,196 --> 00:33:02,632
I don't think
that what happened today
732
00:33:02,632 --> 00:33:04,460
is the result
of mental illness.
733
00:33:04,460 --> 00:33:05,766
You know,
tests are still pending,
734
00:33:05,766 --> 00:33:07,986
but all indications are
is that Quentin has
735
00:33:07,986 --> 00:33:11,424
a genetic disease called
neurofibromatosis type 2.
736
00:33:11,424 --> 00:33:13,600
- Is it curable?
- It's not.
737
00:33:13,600 --> 00:33:15,950
But there are a lot of
effective treatments out there.
738
00:33:15,950 --> 00:33:18,431
And the good news is
that with a little luck,
739
00:33:18,431 --> 00:33:21,216
Quentin is gonna be
the man you know again.
740
00:33:21,216 --> 00:33:23,566
Genetic means
he's had it forever.
741
00:33:23,566 --> 00:33:25,612
Why'd it suddenly
go berserk today?
742
00:33:25,612 --> 00:33:28,832
NF is thought to be
an inflammatory ailment, right?
743
00:33:28,832 --> 00:33:31,835
So possibly triggered
by changes in environment,
744
00:33:31,835 --> 00:33:33,446
you know, lifestyle,
745
00:33:33,446 --> 00:33:37,580
possibly diet, medication.
746
00:33:37,580 --> 00:33:40,670
Diet.
747
00:33:40,670 --> 00:33:42,368
Oh, my God.
748
00:33:42,368 --> 00:33:45,936
The minute I got pregnant,
my hormones went crazy.
749
00:33:45,936 --> 00:33:47,634
Smells were intense,
750
00:33:47,634 --> 00:33:50,637
and Quentin's breath
was the worst.
751
00:33:50,637 --> 00:33:53,466
Everything he ate
made me throw up.
752
00:33:53,466 --> 00:33:55,685
So he gave up his entire diet.
753
00:33:55,685 --> 00:33:58,253
No more fruits,
vegetables, fish.
754
00:33:58,253 --> 00:34:00,081
For the past nine months,
he's been eating nothing
755
00:34:00,081 --> 00:34:02,823
but bland,
processed crap for me.
756
00:34:02,823 --> 00:34:06,740
Mrs. Bell,
Quentin's asking to see you.
757
00:34:17,359 --> 00:34:19,187
Hi, honey.
758
00:34:19,187 --> 00:34:22,016
Layla...
759
00:34:22,016 --> 00:34:23,931
I don't entirely understand
760
00:34:23,931 --> 00:34:27,674
what happened or why,
761
00:34:27,674 --> 00:34:29,545
but I know I put you in danger.
762
00:34:29,545 --> 00:34:30,851
I'm sorry.
763
00:34:30,851 --> 00:34:33,158
No, Quentin.
764
00:34:33,158 --> 00:34:35,856
I was so tied up
in the pregnancy,
765
00:34:35,856 --> 00:34:38,424
I was oblivious
to what was going on with you.
766
00:34:38,424 --> 00:34:41,992
I should've seen the signs.
Forgive me.
767
00:34:41,992 --> 00:34:45,474
Oh, honey,
there's nothing to forgive.
768
00:34:45,474 --> 00:34:46,910
I love you.
769
00:34:46,910 --> 00:34:49,652
I love you too.
770
00:34:49,652 --> 00:34:53,091
Someone's been
missing you guys.
771
00:34:57,834 --> 00:35:00,881
Hi.
772
00:35:00,881 --> 00:35:03,101
Here you go.
773
00:35:04,885 --> 00:35:08,323
Hi, sweetheart.
Look who's here.
774
00:35:08,323 --> 00:35:09,672
Hi.
775
00:35:09,672 --> 00:35:11,892
I'm your dad.
776
00:35:13,198 --> 00:35:16,026
I love you.
777
00:35:16,026 --> 00:35:19,900
- Shh, sweetheart.
- Hi.
778
00:35:19,900 --> 00:35:22,772
- A metabolic condition?
- Yeah.
779
00:35:22,772 --> 00:35:24,948
It's called
maple syrup urine disease,
780
00:35:24,948 --> 00:35:27,081
and it's a rare condition
that makes it difficult
781
00:35:27,081 --> 00:35:29,388
for the body to break down
certain amino acids.
782
00:35:29,388 --> 00:35:32,739
The trademark symptom is
a distinct maple syrup smell
783
00:35:32,739 --> 00:35:34,175
that shows up in urine.
784
00:35:34,175 --> 00:35:36,003
It usually presents
in childhood,
785
00:35:36,003 --> 00:35:37,700
and it's almost unheard of
786
00:35:37,700 --> 00:35:40,442
to discover it
in someone your age,
787
00:35:40,442 --> 00:35:42,009
or Hugo's.
788
00:35:42,009 --> 00:35:44,446
It's likely that he had it too.
789
00:35:44,446 --> 00:35:45,665
And I suspect this is why
790
00:35:45,665 --> 00:35:48,058
Oakview couldn't
diagnose him in time.
791
00:35:48,058 --> 00:35:50,060
He didn't have a seizure
or a foley catheter.
792
00:35:50,060 --> 00:35:52,062
It made his doctors' jobs
even harder.
793
00:35:52,062 --> 00:35:55,631
Wait,
this disease killed Hugo.
794
00:35:55,631 --> 00:35:56,937
Does that mean--
795
00:35:56,937 --> 00:35:59,331
No, you're gonna be OK.
796
00:35:59,331 --> 00:36:01,724
You have an intermittent form
of the disease,
797
00:36:01,724 --> 00:36:04,510
which can be managed by closely
monitoring protein levels.
798
00:36:04,510 --> 00:36:06,207
We've already reached out
to nephrology
799
00:36:06,207 --> 00:36:08,209
to discuss treatment options.
800
00:36:08,209 --> 00:36:12,082
Maria.
801
00:36:23,006 --> 00:36:24,225
Gracias.
802
00:36:33,495 --> 00:36:35,323
- Hello, Daniel.
- Ooh!
803
00:36:36,803 --> 00:36:39,327
Hey, you're, uh--
you're a little early.
804
00:36:39,327 --> 00:36:42,112
Oh, I couldn't wait
to see you.
805
00:36:42,112 --> 00:36:45,072
What's this?
You cleaned your office?
806
00:36:45,072 --> 00:36:46,291
No, I didn't.
807
00:36:47,727 --> 00:36:49,729
I'm tidying up a little bit.
808
00:36:49,729 --> 00:36:51,905
Why?
809
00:36:53,602 --> 00:36:56,562
I was very embarrassed
by what happened this morning.
810
00:36:56,562 --> 00:37:01,001
And um, you know, I just, uh--
811
00:37:01,001 --> 00:37:05,048
I don't ever want you
to feel that I--
812
00:37:05,048 --> 00:37:08,269
I take for granted
the job that you do, or--
813
00:37:08,269 --> 00:37:09,966
or that I'm oblivious
to how hard you work.
814
00:37:09,966 --> 00:37:12,099
I really don't want that
to happen.
815
00:37:12,099 --> 00:37:14,188
You're very sweet.
816
00:37:15,755 --> 00:37:18,497
I care about you too, Daniel.
817
00:37:18,497 --> 00:37:19,498
A lot.
818
00:37:20,803 --> 00:37:22,327
- Yeah?
- Mm-hmm.
819
00:37:22,327 --> 00:37:23,458
Huh.
820
00:37:33,599 --> 00:37:35,644
- Hey.
- Hey.
821
00:37:35,644 --> 00:37:37,037
Ah!
822
00:37:37,037 --> 00:37:38,952
Where'd you find it?
- Nurses' station.
823
00:37:38,952 --> 00:37:40,475
Oh, makes sense.
824
00:37:40,475 --> 00:37:42,825
That's where I was when
the call about Quentin came in.
825
00:37:42,825 --> 00:37:44,349
Yeah, I totally get it.
826
00:37:44,349 --> 00:37:47,177
I would have run off
and left it behind too.
827
00:37:47,177 --> 00:37:51,181
But my kidneys can handle
some mild dehydration.
828
00:37:51,181 --> 00:37:52,835
Yours can't.
- Yeah, yeah.
829
00:37:52,835 --> 00:37:56,143
Yeah, pretty sure there will
be another emergency tomorrow,
830
00:37:56,143 --> 00:37:58,058
and the day after that,
831
00:37:58,058 --> 00:38:01,931
so I'm gonna
give you something.
832
00:38:01,931 --> 00:38:04,412
It is a tracking device.
- Ah.
833
00:38:04,412 --> 00:38:06,066
App connects it
to your phone.
834
00:38:06,066 --> 00:38:08,938
And I haven't lost my keys
since I put it on, so...
835
00:38:08,938 --> 00:38:12,507
Well, keep it.
I'm past water bottles.
836
00:38:12,507 --> 00:38:14,204
Nephrologist just left.
837
00:38:14,204 --> 00:38:17,556
Uh, my kidneys
are getting worse.
838
00:38:22,865 --> 00:38:24,258
Dialysis?
839
00:38:33,789 --> 00:38:36,923
That was a big win today.
840
00:38:36,923 --> 00:38:39,708
You saved that family.
841
00:38:39,708 --> 00:38:42,494
Yeah.
842
00:38:42,494 --> 00:38:45,845
I suppose it's time
to talk about my DACA renewal.
843
00:38:45,845 --> 00:38:47,716
I know
I've been dragging my feet.
844
00:38:47,716 --> 00:38:50,893
It's been a long day.
We can speak in the morning.
845
00:38:50,893 --> 00:38:53,026
No. No, I'm ready.
846
00:38:53,026 --> 00:38:55,420
Yeah? All right.
847
00:38:58,771 --> 00:39:01,948
Truth is, I've been
thinking about leaving Med.
848
00:39:01,948 --> 00:39:03,819
Really?
849
00:39:03,819 --> 00:39:07,257
I've always been in school
or protected by my residency,
850
00:39:07,257 --> 00:39:11,218
so my immigration status
has always been stable.
851
00:39:11,218 --> 00:39:14,700
But my parents, despite
them always having jobs,
852
00:39:14,700 --> 00:39:16,136
could never solidify theirs,
853
00:39:16,136 --> 00:39:18,356
so they moved to Canada.
854
00:39:18,356 --> 00:39:19,835
Hmm.
855
00:39:19,835 --> 00:39:23,491
But they can't enter
the country to come visit me.
856
00:39:23,491 --> 00:39:27,626
And if I leave to go see them,
I might be denied reentry.
857
00:39:27,626 --> 00:39:31,064
So...
858
00:39:31,064 --> 00:39:34,067
I haven't hugged my parents
in a decade.
859
00:39:34,067 --> 00:39:36,025
Ugh.
860
00:39:36,025 --> 00:39:39,115
That's--that's heartbreaking.
861
00:39:39,115 --> 00:39:42,858
But Maria today,
her bravery,
862
00:39:42,858 --> 00:39:47,602
what she was willing
to sacrifice for her family,
863
00:39:47,602 --> 00:39:50,823
reminded me that
864
00:39:50,823 --> 00:39:53,521
"no one puts their child
in a boat
865
00:39:53,521 --> 00:39:56,219
unless the water is safer
than the land."
866
00:39:56,219 --> 00:39:58,961
Warsan Shire.
867
00:39:58,961 --> 00:40:01,660
Oh, that's a beautiful poem.
868
00:40:03,009 --> 00:40:04,663
So...
869
00:40:04,663 --> 00:40:09,145
my parents' sacrifice
to get me here
870
00:40:09,145 --> 00:40:12,801
put me in this boat,
871
00:40:12,801 --> 00:40:15,325
which is why I have to stay.
872
00:40:16,631 --> 00:40:18,503
And Dr. Cuevas,
873
00:40:18,503 --> 00:40:22,855
I believe
that you will find a way
874
00:40:22,855 --> 00:40:25,814
to see your parents again.
875
00:40:25,814 --> 00:40:28,295
But until that day,
876
00:40:28,295 --> 00:40:32,952
know that you have family here
in us at Med.
877
00:40:32,952 --> 00:40:35,345
Thank you.
62199
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