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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:05,527 --> 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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