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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:05,570 --> 00:00:07,876 He's putting me on a renal diet. 2 00:00:07,876 --> 00:00:08,877 And if that doesn't turn things around, then... 3 00:00:08,877 --> 00:00:09,878 Dialysis? 4 00:00:09,878 --> 00:00:11,402 I'm so sorry. 5 00:00:11,402 --> 00:00:14,318 I don't advertise my immigration status, 6 00:00:14,318 --> 00:00:16,189 but I'm undocumented. 7 00:00:16,189 --> 00:00:19,366 My future always feels precarious. 8 00:00:19,366 --> 00:00:21,107 all: More money in our checks! 9 00:00:21,107 --> 00:00:23,153 We are essential! 10 00:00:23,153 --> 00:00:25,285 - You're striking? - It's very important 11 00:00:25,285 --> 00:00:27,592 that Liliana feels like I have her back. 12 00:00:27,592 --> 00:00:29,159 I'm going with my friends to celebrate. 13 00:00:29,159 --> 00:00:30,377 Come! - Oh, no-- 14 00:00:30,377 --> 00:00:32,510 You have to come. You're my boyfriend. 15 00:00:38,907 --> 00:00:40,170 Lil. 16 00:00:40,170 --> 00:00:41,606 Daniel. 17 00:00:41,606 --> 00:00:42,737 Oh, the time. 18 00:00:42,737 --> 00:00:44,739 I didn't realize. 19 00:00:44,739 --> 00:00:46,698 I--I'm almost finished. 20 00:00:46,698 --> 00:00:49,092 I'm usually done before you arrive. 21 00:00:49,092 --> 00:00:50,180 I'm sorry. - Oh, no. 22 00:00:50,180 --> 00:00:51,355 No, let me get that. Let me get that. 23 00:00:51,355 --> 00:00:53,357 I'm the one who should be apologizing. 24 00:00:53,357 --> 00:00:56,316 No. No, I had the interns in for pizza last night. 25 00:00:56,316 --> 00:00:57,274 Then they dragged me out for a drink, 26 00:00:57,274 --> 00:00:58,927 and--and we just left. 27 00:00:58,927 --> 00:01:00,146 It's OK. I've got it. 28 00:01:00,146 --> 00:01:01,713 I apologize for the mess. Really, I do. 29 00:01:01,713 --> 00:01:03,018 It's OK. 30 00:01:03,018 --> 00:01:05,325 Compared to other offices, it's not that bad. 31 00:01:07,936 --> 00:01:10,678 Oh! 32 00:01:10,678 --> 00:01:12,898 Daniel, have a good day. 33 00:01:12,898 --> 00:01:14,247 You too. 34 00:01:19,426 --> 00:01:20,427 Ah. 35 00:01:20,427 --> 00:01:23,213 I think this belongs to you. 36 00:01:23,213 --> 00:01:25,171 Indeed, it does. Where did you find it? 37 00:01:25,171 --> 00:01:26,433 This time? Waiting room. 38 00:01:26,433 --> 00:01:28,261 Top of the vending machine. - Mm. 39 00:01:28,261 --> 00:01:30,611 You know, maybe I should just put it 40 00:01:30,611 --> 00:01:32,613 in a little red-and-white striped shirt, 41 00:01:32,613 --> 00:01:34,659 put a bobble hat on it, black glasses, 42 00:01:34,659 --> 00:01:38,271 and call it my "Where's Waldo?" water bottle, huh? 43 00:01:38,271 --> 00:01:40,273 You get it? 44 00:01:40,273 --> 00:01:41,840 I get it. 45 00:01:41,840 --> 00:01:43,494 You have to stay hydrated. 46 00:01:44,321 --> 00:01:45,931 Thanks, Mom. 47 00:01:49,282 --> 00:01:50,588 Dr. Cuevas. 48 00:01:50,588 --> 00:01:53,330 - Ms. Goodwin, good morning. - Good morning. 49 00:01:53,330 --> 00:01:56,855 Do you have a moment to discuss your DACA renewal? 50 00:01:56,855 --> 00:01:59,466 Oh. Um, now? 51 00:01:59,466 --> 00:02:02,034 Well, the paperwork's not due for a few months, 52 00:02:02,034 --> 00:02:04,645 but I want to make sure we get everything filed early, 53 00:02:04,645 --> 00:02:07,213 just in case there's an unexpected policy change. 54 00:02:07,213 --> 00:02:09,781 Right, of course. I appreciate that. 55 00:02:09,781 --> 00:02:12,218 I just was about to dig into these overnight charts. 56 00:02:12,218 --> 00:02:13,828 Understood. 57 00:02:13,828 --> 00:02:16,570 How about we meet up at the end of the day? 58 00:02:16,570 --> 00:02:19,312 Yeah. Sure, that works. 59 00:02:19,312 --> 00:02:21,358 I will--I'll see you then. 60 00:02:24,230 --> 00:02:25,362 - Dr. Asher. - Mm-hmm? 61 00:02:25,362 --> 00:02:26,363 - Need you. - Oh, yeah. 62 00:02:26,363 --> 00:02:28,016 Come this way. 63 00:02:28,016 --> 00:02:29,409 Hi, I'm Dr. Asher. 64 00:02:29,409 --> 00:02:32,151 Leah, what's going on? 65 00:02:32,151 --> 00:02:33,805 Parents and their daughter. 66 00:02:33,805 --> 00:02:36,155 Came in a few minutes ago. They're terrified. 67 00:02:36,155 --> 00:02:38,810 Even scared me. - Going to two. 68 00:02:38,810 --> 00:02:40,551 I didn't get a history. Just came for you. 69 00:02:40,551 --> 00:02:42,596 Excuse me, Doctor. We need your help. 70 00:02:42,596 --> 00:02:44,511 Our daughter. - All right. 71 00:02:44,511 --> 00:02:46,905 Hi, I'm Dr. Halstead. What's your name? 72 00:02:46,905 --> 00:02:48,515 Maria. 73 00:02:48,515 --> 00:02:50,517 Her name is Maria. Very sick! 74 00:02:50,517 --> 00:02:53,607 Listen. 75 00:02:56,741 --> 00:02:58,917 I'm sorry. I don't speak Spanish. 76 00:02:58,917 --> 00:03:00,788 Get Dr. Cuevas. 77 00:03:00,788 --> 00:03:04,227 I'm just gonna feel your neck, OK? 78 00:03:05,228 --> 00:03:06,577 Does that hurt? 79 00:03:06,577 --> 00:03:07,926 ¿Malo? Bad? 80 00:03:18,023 --> 00:03:19,198 What are they saying? 81 00:03:19,198 --> 00:03:21,331 They're saying that she has the sickness, 82 00:03:21,331 --> 00:03:23,768 and if we don't help her, she will die. 83 00:03:40,872 --> 00:03:42,787 Thank you. 84 00:03:42,787 --> 00:03:44,832 Hey. How's Maria doing? 85 00:03:44,832 --> 00:03:45,964 Still a bit groggy, 86 00:03:45,964 --> 00:03:47,661 but responding to questions in English. 87 00:03:47,661 --> 00:03:49,881 Whatever this is, it seems to be sporadic. 88 00:03:49,881 --> 00:03:51,752 - Any guesses? - I don't know. 89 00:03:51,752 --> 00:03:54,842 Maybe infectious encephalitis, but her vitals were normal. 90 00:03:54,842 --> 00:03:56,322 I'm hoping labs shed some light. 91 00:03:56,322 --> 00:03:58,019 What did Mom and Dad have to say? 92 00:03:58,019 --> 00:03:59,673 The sickness that they're referring to 93 00:03:59,673 --> 00:04:01,327 has to do with her older brother, Hugo. 94 00:04:01,327 --> 00:04:03,764 About a month ago, he came down with an illness, 95 00:04:03,764 --> 00:04:05,418 was admitted to Oakview Community Hospital, 96 00:04:05,418 --> 00:04:08,378 and then died a few days later. - Oh, man. 97 00:04:08,378 --> 00:04:09,683 Yeah, and even worse, 98 00:04:09,683 --> 00:04:11,642 Oakview couldn't make a diagnosis. 99 00:04:11,642 --> 00:04:13,513 Well, explains why they're beating down our doors. 100 00:04:13,513 --> 00:04:15,950 They're afraid whatever ravaged Hugo is now attacking Maria. 101 00:04:15,950 --> 00:04:18,997 But a death in the family, no answers, 102 00:04:18,997 --> 00:04:21,521 plus the fear that she might have the same illness? 103 00:04:21,521 --> 00:04:23,915 Since nothing's jumping out, I think it's possible 104 00:04:23,915 --> 00:04:26,047 that her emotions could be manifesting physically. 105 00:04:26,047 --> 00:04:27,788 I want to talk to her, see if there could be 106 00:04:27,788 --> 00:04:29,181 a psych explanation. - OK. 107 00:04:29,181 --> 00:04:30,748 Meantime, I'll reach out to Oakview, 108 00:04:30,748 --> 00:04:32,619 get Hugo's records and autopsy results. 109 00:04:32,619 --> 00:04:33,881 If Maria does have the same illness, 110 00:04:33,881 --> 00:04:36,536 there could be a clue in there. - OK. 111 00:04:36,536 --> 00:04:38,712 OK, Layla, you're 7 centimeters dilated, 112 00:04:38,712 --> 00:04:40,366 100% effaced. 113 00:04:40,366 --> 00:04:41,976 How long ago did your water break? 114 00:04:41,976 --> 00:04:44,718 About an hour, hour and a-- 115 00:04:46,067 --> 00:04:48,243 7:02 a.m., I think. 116 00:04:48,243 --> 00:04:50,071 This baby is coming out sideways. 117 00:04:50,071 --> 00:04:51,377 No, it just feels like that. 118 00:04:51,377 --> 00:04:52,509 Your fetus is OP, 119 00:04:52,509 --> 00:04:54,075 meaning it's facing up instead of down. 120 00:04:54,075 --> 00:04:55,381 - Something's wrong? - No. 121 00:04:55,381 --> 00:04:56,991 Baby's just moving around, letting us know 122 00:04:56,991 --> 00:04:58,732 that it is time to come out. 123 00:04:58,732 --> 00:05:00,343 I'll have a nurse let L know. 124 00:05:00,343 --> 00:05:01,779 Oh, my God. 125 00:05:01,779 --> 00:05:03,607 Quentin, our son is coming. 126 00:05:03,607 --> 00:05:05,391 I'm gonna be a mom today. 127 00:05:05,391 --> 00:05:07,611 You know, I can't remember if I turned off the oven 128 00:05:07,611 --> 00:05:08,829 before we left the house. 129 00:05:08,829 --> 00:05:10,657 Quentin, we haven't cooked in days. 130 00:05:10,657 --> 00:05:12,093 The oven is off. 131 00:05:12,093 --> 00:05:13,312 I'm just gonna go home and check. 132 00:05:13,312 --> 00:05:14,531 Quentin, no! 133 00:05:14,531 --> 00:05:16,315 - Mr. Bell, please don't go. - You know what? 134 00:05:16,315 --> 00:05:18,012 Maybe you can have a neighbor check on it, 135 00:05:18,012 --> 00:05:19,449 or maybe it's just nervous energy 136 00:05:19,449 --> 00:05:21,276 that's making you think that you left it on. 137 00:05:21,276 --> 00:05:23,627 Yeah, I just don't feel like myself. 138 00:05:23,627 --> 00:05:25,629 I get it. It's a big day. 139 00:05:25,629 --> 00:05:26,847 You know, a lot of new experiences 140 00:05:26,847 --> 00:05:28,109 all happening at once. 141 00:05:28,109 --> 00:05:31,635 But, Quentin, this is not new for me. 142 00:05:31,635 --> 00:05:33,245 I have been here many, many times, 143 00:05:33,245 --> 00:05:34,725 and I know exactly how to help you and Layla 144 00:05:34,725 --> 00:05:36,988 get through this. 145 00:05:36,988 --> 00:05:38,250 Thank you. 146 00:05:39,469 --> 00:05:40,470 Sorry, Lay. 147 00:05:40,470 --> 00:05:42,428 I just lost my mind for a minute. 148 00:05:44,517 --> 00:05:47,302 - Nice save. - Mm-hmm. 149 00:05:48,826 --> 00:05:52,307 Hey, Sam. This is Dr. Tanaka-Reed. 150 00:05:52,307 --> 00:05:53,700 He's gonna be scrubbing in with me today. 151 00:05:53,700 --> 00:05:55,223 He's one of my surgical residents. 152 00:05:55,223 --> 00:05:56,790 Uh, technically I'm a resident 153 00:05:56,790 --> 00:05:58,357 but definitely not a beginner. 154 00:05:58,357 --> 00:05:59,271 OK. 155 00:05:59,271 --> 00:06:01,229 Anyway, like we discussed, 156 00:06:01,229 --> 00:06:02,883 it's a straight appendix removal. 157 00:06:02,883 --> 00:06:04,363 You're gonna be a bit sore afterwards, 158 00:06:04,363 --> 00:06:06,626 but in a week or two, you'll be back to full strength. 159 00:06:06,626 --> 00:06:08,236 Mm, perfect, 160 00:06:08,236 --> 00:06:10,195 because I've been itching to get back in the gym. 161 00:06:10,195 --> 00:06:11,936 Rugged Maniac is this summer. 162 00:06:11,936 --> 00:06:14,155 Rugged Maniac? The adventure race? 163 00:06:14,155 --> 00:06:15,896 - You know it? - Yeah, sort of. 164 00:06:15,896 --> 00:06:16,984 A couple of guys from the community 165 00:06:16,984 --> 00:06:18,290 are putting a team together. 166 00:06:18,290 --> 00:06:20,161 Community? You mean other doctors? 167 00:06:20,161 --> 00:06:23,164 No, CrossFit. 168 00:06:23,164 --> 00:06:25,471 From my Kalsu group. Kalsu's a workout. 169 00:06:25,471 --> 00:06:27,342 We do burpees and thrusters for time. 170 00:06:27,342 --> 00:06:28,909 Anyway, back to the task at hand. 171 00:06:28,909 --> 00:06:30,868 If you're ready, we're ready. 172 00:06:31,869 --> 00:06:33,653 - Let's do this. - Great. 173 00:06:33,653 --> 00:06:35,394 Nurse Trisha will be in to get the prep started. 174 00:06:35,394 --> 00:06:37,875 Anesthesia after that. - Sounds good, Doc. 175 00:06:37,875 --> 00:06:39,920 See you on the other side, all right? 176 00:06:41,922 --> 00:06:44,490 Appendix removal-- pretty basic. 177 00:06:44,490 --> 00:06:46,187 Well, sorry Sam's not sick enough for you. 178 00:06:46,187 --> 00:06:47,493 Oh, you know what I mean. 179 00:06:47,493 --> 00:06:49,930 OR 2.0 is a Ferrari-- sexy surgery. 180 00:06:49,930 --> 00:06:52,063 But a lap appy? That's a minivan. 181 00:06:52,063 --> 00:06:54,108 Well, not even in that today. 182 00:06:54,108 --> 00:06:56,894 Sam had a sigmoid colon resection 18 months ago. 183 00:06:56,894 --> 00:06:58,330 Likely adhesions in his pelvis, 184 00:06:58,330 --> 00:07:00,985 so we're gonna do this appy open-- 185 00:07:00,985 --> 00:07:02,726 right lower quadrant incision. 186 00:07:02,726 --> 00:07:04,379 OK? - Old school. 187 00:07:04,379 --> 00:07:07,382 Gee, hope I'm up to the challenge. 188 00:07:07,382 --> 00:07:10,037 For a resident, guy sure is full of himself. 189 00:07:10,037 --> 00:07:11,517 I'm not a fan. 190 00:07:14,564 --> 00:07:16,261 Hugo's gone. 191 00:07:18,089 --> 00:07:20,570 I'm oldest now. I need to be strong. 192 00:07:22,354 --> 00:07:25,705 For my other brothers and sisters. 193 00:07:25,705 --> 00:07:27,141 For my parents. 194 00:07:30,362 --> 00:07:34,105 They've been a wreck since Hugo died. 195 00:07:34,105 --> 00:07:35,976 They can't sleep. 196 00:07:35,976 --> 00:07:37,935 They can't eat. 197 00:07:37,935 --> 00:07:40,981 Now I'm putting them through it again. 198 00:07:42,853 --> 00:07:44,594 I have it too. - No. 199 00:07:44,594 --> 00:07:46,770 Hey, we don't know that. 200 00:07:46,770 --> 00:07:50,251 All of the labs Dr. Halstead ran came back normal. 201 00:07:50,251 --> 00:07:52,993 Then what's wrong with me? 202 00:07:54,168 --> 00:07:56,475 In some cases, it's possible 203 00:07:56,475 --> 00:08:00,348 for grief and fear to lead to physical symptoms. 204 00:08:00,348 --> 00:08:03,003 No, I'm not imagining this. 205 00:08:03,003 --> 00:08:04,831 No, you're not. 206 00:08:04,831 --> 00:08:08,095 Your symptoms are very real. 207 00:08:08,095 --> 00:08:12,491 You suffered a devastating loss, a trauma. 208 00:08:15,146 --> 00:08:17,627 Hugo's tests were normal too. 209 00:08:20,630 --> 00:08:22,545 And then he died. 210 00:08:26,636 --> 00:08:28,376 I don't think we're looking at a psych condition. 211 00:08:28,376 --> 00:08:30,030 In conversion disorder, it's rare 212 00:08:30,030 --> 00:08:32,511 that patients can express their emotions the way Maria is. 213 00:08:32,511 --> 00:08:34,818 But her awareness of the situation, 214 00:08:34,818 --> 00:08:37,821 her acknowledgment of the fear, it doesn't fit. 215 00:08:37,821 --> 00:08:40,606 There's definitely something physical going on. 216 00:08:40,606 --> 00:08:42,042 I wish I knew what. 217 00:08:42,042 --> 00:08:43,870 Medical examiner said Hugo died of brain swelling 218 00:08:43,870 --> 00:08:45,698 but don't know what caused it. 219 00:08:45,698 --> 00:08:47,613 And here's the kicker: it was only three days 220 00:08:47,613 --> 00:08:49,746 from when Hugo was admitted to the time he died. 221 00:08:49,746 --> 00:08:53,401 OK, so whatever it is, it moved really fast. 222 00:08:55,360 --> 00:08:58,102 I think he's stuck. 223 00:08:58,102 --> 00:08:59,320 No, just a big head. 224 00:08:59,320 --> 00:09:01,322 That's all. 225 00:09:01,322 --> 00:09:02,585 Oh, my God. 226 00:09:02,585 --> 00:09:04,282 Is he gonna fit? - Yes, he will. 227 00:09:04,282 --> 00:09:05,718 We just need to open up the birth canal a bit wider. 228 00:09:05,718 --> 00:09:07,111 - McRoberts? - Yes. 229 00:09:07,111 --> 00:09:08,982 Call the OB resident on call. 230 00:09:08,982 --> 00:09:11,506 Layla, we're gonna adjust you to a new position, OK? 231 00:09:11,506 --> 00:09:13,073 It makes it easier for the baby to come out. 232 00:09:13,073 --> 00:09:14,379 OK. 233 00:09:14,379 --> 00:09:16,120 - I'm right here. - All right, Quentin. 234 00:09:16,120 --> 00:09:17,948 Why don't you let him take over for you, OK? 235 00:09:17,948 --> 00:09:19,123 And I can use some pressure. - Yep. 236 00:09:19,123 --> 00:09:21,516 I'm right here. 237 00:09:21,516 --> 00:09:23,257 OK, now on your next contraction, 238 00:09:23,257 --> 00:09:24,911 I want you to give me everything you've got. 239 00:09:24,911 --> 00:09:26,173 Everything. - OK. 240 00:09:26,173 --> 00:09:27,522 - OK. - I can do this. 241 00:09:27,522 --> 00:09:29,350 - Yes, you can. - You got this. 242 00:09:29,350 --> 00:09:31,918 You got this. You got this. - OK. 243 00:09:31,918 --> 00:09:33,833 Oh. 244 00:09:36,009 --> 00:09:38,055 I've got the head. 245 00:09:38,055 --> 00:09:39,273 Shoulder. 246 00:09:40,840 --> 00:09:42,450 I've got him. 247 00:09:42,450 --> 00:09:44,714 I got him. He's here. 248 00:09:44,714 --> 00:09:46,541 He's here. 249 00:09:47,542 --> 00:09:49,762 He's here. - Oh, my God. 250 00:09:49,762 --> 00:09:52,199 Oh, my God. 251 00:09:52,199 --> 00:09:54,114 I'm a mom. 252 00:09:54,114 --> 00:09:56,856 Our baby, he's beautiful. 253 00:09:56,856 --> 00:09:58,553 He's perfect. 254 00:09:58,553 --> 00:10:00,904 Hey, Dad, do you want to cut the umbilical cord? 255 00:10:00,904 --> 00:10:02,819 Yeah. 256 00:10:02,819 --> 00:10:06,083 OK. Just right here in the middle, OK? 257 00:10:09,434 --> 00:10:11,218 I want to hold him. 258 00:10:11,218 --> 00:10:13,612 That's not my son. 259 00:10:15,005 --> 00:10:17,485 What? 260 00:10:17,485 --> 00:10:19,879 Layla, who's the father? 261 00:10:19,879 --> 00:10:21,794 You are, Quentin. 262 00:10:21,794 --> 00:10:23,622 You are. That's our baby. 263 00:10:23,622 --> 00:10:25,711 No, you're lying! You're lying! 264 00:10:25,711 --> 00:10:26,712 Hey, Quentin, it's OK. 265 00:10:26,712 --> 00:10:28,279 We'll figure this out, all right? 266 00:10:28,279 --> 00:10:29,976 - That's not my son. - That's our baby. 267 00:10:29,976 --> 00:10:31,717 Of course it is! - No, get back! 268 00:10:31,717 --> 00:10:34,589 Of course it is! Of course it is! 269 00:10:34,589 --> 00:10:36,113 - I got to get out of here. - Hey, deep breaths, OK? 270 00:10:36,113 --> 00:10:37,288 Quentin, breathe with me. 271 00:10:37,288 --> 00:10:38,681 Breathe with me, Quentin. Deep breaths. 272 00:10:38,681 --> 00:10:40,421 - I got to get out of here! - Stay! Baby, stay! 273 00:10:40,421 --> 00:10:42,249 - Hey, call security. - Help! 274 00:10:42,249 --> 00:10:43,903 Oh, my God. What's happening? 275 00:10:43,903 --> 00:10:46,993 Hey! Hey, stop! 276 00:10:46,993 --> 00:10:49,082 Hey, guards! Quentin, stop! 277 00:10:50,954 --> 00:10:53,783 Why are you chasing me? Just leave me--leave me alone! 278 00:10:53,783 --> 00:10:56,699 - Hey, Quentin-- - Stay back! Stay back! 279 00:10:56,699 --> 00:10:58,222 It's OK. It's OK. 280 00:10:58,222 --> 00:11:00,746 Deep breath. Please, just breathe. 281 00:11:00,746 --> 00:11:02,748 I just got to get out of here. 282 00:11:02,748 --> 00:11:04,837 I just got to get out of here! - No, no, no, no, no! 283 00:11:09,973 --> 00:11:12,018 All right, Quentin. 284 00:11:12,018 --> 00:11:13,977 It's OK. 285 00:11:15,892 --> 00:11:19,286 Oh, my God, the scissors, they're pulsating. 286 00:11:19,286 --> 00:11:20,723 They're penetrating the carotid artery. 287 00:11:20,723 --> 00:11:22,072 I'll get someone to turn off the machine. 288 00:11:22,072 --> 00:11:24,901 No, the magnet is holding everything in place, 289 00:11:24,901 --> 00:11:26,250 including the scissors. 290 00:11:26,250 --> 00:11:28,078 If gravity takes over, it'll shift everything, 291 00:11:28,078 --> 00:11:31,342 and we'll have maybe 20 seconds before he bleeds out. 292 00:11:31,342 --> 00:11:33,300 OK, we need help. Call Dr. Archer. 293 00:11:33,300 --> 00:11:35,346 Dr. Charles too. - Yeah. 294 00:11:37,087 --> 00:11:40,655 Do not touch the scissors, OK? 295 00:11:40,655 --> 00:11:42,962 We got you. 296 00:11:42,962 --> 00:11:44,834 Everything's gonna be OK. 297 00:11:49,882 --> 00:11:52,058 Coming through. Excuse me. 298 00:11:52,058 --> 00:11:53,625 Thank you guys for coming. 299 00:11:53,625 --> 00:11:55,670 Absolutely. 300 00:11:55,670 --> 00:11:57,368 - Hey, fellas. - Doctor. 301 00:11:59,762 --> 00:12:01,981 He's conscious and calm but out of it. 302 00:12:01,981 --> 00:12:03,896 He's not being crushed. He's able to breathe. 303 00:12:03,896 --> 00:12:06,116 He's got to be in pain, though. - OK. 304 00:12:06,116 --> 00:12:09,075 So let's give him 50 mics of fentanyl IM. 305 00:12:09,075 --> 00:12:10,990 Syringe is plastic and the needle nonferrous, 306 00:12:10,990 --> 00:12:12,383 so it should be MRI safe. 307 00:12:12,383 --> 00:12:13,863 OK, I'll get it. 308 00:12:13,863 --> 00:12:15,778 Dr. Asher went back to be with his wife, Layla. 309 00:12:15,778 --> 00:12:17,823 She's still in L - OK. 310 00:12:17,823 --> 00:12:19,303 It's a rescue situation. 311 00:12:19,303 --> 00:12:20,695 I just don't really know where to start. 312 00:12:20,695 --> 00:12:22,349 All of our tools have metal. 313 00:12:22,349 --> 00:12:26,005 So nothing is usable as long as the MRI machine is running. 314 00:12:26,005 --> 00:12:28,834 All right, well, let's say we did turn the machine off. 315 00:12:28,834 --> 00:12:30,140 Everything falls to the floor. 316 00:12:30,140 --> 00:12:32,142 Bed alone is a couple hundred pounds. 317 00:12:32,142 --> 00:12:34,318 I can put two of my guys in there to try and catch it, 318 00:12:34,318 --> 00:12:36,146 then get it out of the way so you can get to Quentin. 319 00:12:36,146 --> 00:12:38,365 Scissors in his neck are magnetic too. 320 00:12:38,365 --> 00:12:40,150 Cut the MRI's power, they're gonna move. 321 00:12:40,150 --> 00:12:41,716 Quentin will bleed out fast. 322 00:12:41,716 --> 00:12:44,328 If you could go in there with clamps and stem the flow, 323 00:12:44,328 --> 00:12:46,809 would that buy us some time? - Not enough. 324 00:12:46,809 --> 00:12:48,941 Odds of survival are less than 1%. 325 00:12:48,941 --> 00:12:51,204 I'm running outcome probabilities on our options, 326 00:12:51,204 --> 00:12:53,032 and turning off the machine cold turkey is the worst. 327 00:12:53,032 --> 00:12:55,034 So what's the best? 328 00:12:55,034 --> 00:12:57,428 If CFD can secure Quentin 329 00:12:57,428 --> 00:12:59,343 and ensure the bed won't displace him 330 00:12:59,343 --> 00:13:01,736 and Dr. Archer can stabilize the neck wound 331 00:13:01,736 --> 00:13:03,260 all before turning off the MRI machine, 332 00:13:03,260 --> 00:13:06,524 then the odds of survival are roughly 61%. 333 00:13:06,524 --> 00:13:09,092 OK, we've got a plan. Can it be done? 334 00:13:09,092 --> 00:13:11,877 Well, safest way to secure the patient 335 00:13:11,877 --> 00:13:14,271 would be to do a webbing harness. 336 00:13:14,271 --> 00:13:16,664 We can throw the ropes over the MRI machine, 337 00:13:16,664 --> 00:13:18,928 and then two of my guys can hold it on the other side. 338 00:13:18,928 --> 00:13:21,104 OK, the magnet's off, the bed falls. 339 00:13:21,104 --> 00:13:24,237 How do we ensure that Quentin doesn't go with it? 340 00:13:24,237 --> 00:13:26,283 We can create a buffer zone between him and the bed 341 00:13:26,283 --> 00:13:29,068 using wooden cribbing, wedges, and airbags. 342 00:13:29,068 --> 00:13:30,896 We can run some hoses and inflate them 343 00:13:30,896 --> 00:13:32,332 from a tank here in the hallway. 344 00:13:32,332 --> 00:13:33,899 All right, we're halfway there. 345 00:13:33,899 --> 00:13:35,596 Dr. Archer? - Yeah. 346 00:13:35,596 --> 00:13:37,207 I just need to clamp the artery 347 00:13:37,207 --> 00:13:38,295 in order to control the bleeding. 348 00:13:38,295 --> 00:13:40,384 Then I could take the scissors out. 349 00:13:40,384 --> 00:13:43,343 But the issue is the tools needed to do it. 350 00:13:43,343 --> 00:13:45,389 I can make them plastic. 3D printers. 351 00:13:45,389 --> 00:13:46,607 There are four in the robotics lab. 352 00:13:46,607 --> 00:13:47,913 All right. Get on it. 353 00:13:47,913 --> 00:13:51,090 And get a few of the 2.0 engineers to help. 354 00:13:51,090 --> 00:13:54,006 - We'll get started too. - Good. 355 00:13:54,006 --> 00:13:55,442 OK, you're doing great. 356 00:13:55,442 --> 00:13:57,053 Gonna give you a little injection. 357 00:13:57,053 --> 00:13:58,445 Some pain meds, all right? 358 00:13:58,445 --> 00:14:01,622 To just make you a little more comfortable, OK? 359 00:14:01,622 --> 00:14:03,537 Little pinch. 360 00:14:08,281 --> 00:14:09,587 OK. 361 00:14:11,284 --> 00:14:13,939 Daniel? 362 00:14:13,939 --> 00:14:15,288 I'm just gonna step away for a second, 363 00:14:15,288 --> 00:14:16,594 have a little chat with my colleague. 364 00:14:16,594 --> 00:14:18,509 I'm not going anywhere, OK? 365 00:14:21,555 --> 00:14:23,862 How's he doing? 366 00:14:23,862 --> 00:14:28,214 Well, you know, I mean, he's pinned to an MRI machine, so... 367 00:14:28,214 --> 00:14:30,913 Do you have any theories on what sparked the break? 368 00:14:30,913 --> 00:14:33,350 I've been really focusing on trying to keep him calm. 369 00:14:33,350 --> 00:14:36,048 But how's the plan to get him off the thing going? 370 00:14:36,048 --> 00:14:37,484 Well, we've got one. 371 00:14:37,484 --> 00:14:39,660 But it's a possibility that it won't work, Daniel, 372 00:14:39,660 --> 00:14:43,055 so I've asked Dr. Asher to bring Quentin's wife down here 373 00:14:43,055 --> 00:14:45,971 to see him 'cause it may be the last time. 374 00:14:45,971 --> 00:14:47,930 OK, thank you. 375 00:14:50,280 --> 00:14:52,369 OK, making the incision. 376 00:14:54,240 --> 00:14:55,198 OK. 377 00:14:57,461 --> 00:15:00,029 OK, nice and easy. 378 00:15:02,292 --> 00:15:03,380 Lab cut. 379 00:15:08,211 --> 00:15:09,952 Yep. 380 00:15:09,952 --> 00:15:12,041 Definitely feeling some adhesions. 381 00:15:12,041 --> 00:15:13,216 Point taken. 382 00:15:13,216 --> 00:15:15,392 Open surgery was the right call. 383 00:15:15,392 --> 00:15:17,481 Go ahead, say it. "I told you so." 384 00:15:17,481 --> 00:15:19,091 Yeah, maybe later. 385 00:15:19,091 --> 00:15:21,789 For now, why don't you get some practice old-school style? 386 00:15:21,789 --> 00:15:23,661 Come around. 387 00:15:26,490 --> 00:15:28,100 OK. You got it? 388 00:15:28,100 --> 00:15:29,710 - Yeah. - All right. 389 00:15:29,710 --> 00:15:31,103 Babcock. 390 00:15:38,458 --> 00:15:40,199 You OK? 391 00:15:40,199 --> 00:15:41,940 Yeah, it's just a little heartburn. 392 00:15:41,940 --> 00:15:43,333 I'm fine. 393 00:15:44,769 --> 00:15:46,989 Oh, uh-- 394 00:15:48,860 --> 00:15:51,167 Uh, God, excuse me. I'm sorry. 395 00:15:51,167 --> 00:15:53,430 Stop it. 396 00:15:53,430 --> 00:15:54,997 Stop. 397 00:15:54,997 --> 00:15:56,346 It's no big deal. 398 00:15:56,346 --> 00:16:00,089 It happens, OK? Just focus on the field. 399 00:16:01,612 --> 00:16:04,049 Stay focused. 400 00:16:05,529 --> 00:16:07,792 Uh-oh, here comes another one. 401 00:16:07,792 --> 00:16:09,185 Kai? 402 00:16:09,185 --> 00:16:11,535 Kai, talk to me. 403 00:16:11,535 --> 00:16:13,058 Hey, buddy! Hey! 404 00:16:13,058 --> 00:16:15,713 Angel. Angel, check him. 405 00:16:17,454 --> 00:16:18,933 - Got a pulse. - All right. 406 00:16:18,933 --> 00:16:20,935 Give me the babcock, please. 407 00:16:20,935 --> 00:16:22,459 - Maria! - Need some help in here! 408 00:16:22,459 --> 00:16:24,113 Maria! 409 00:16:24,113 --> 00:16:25,549 I was helping her to the bathroom, 410 00:16:25,549 --> 00:16:26,463 and she started seizing. 411 00:16:26,463 --> 00:16:28,073 OK, 4 milligrams of Ativan. 412 00:16:29,640 --> 00:16:31,163 Please help her. Please. 413 00:16:34,471 --> 00:16:36,255 Ativan's in. 414 00:16:41,086 --> 00:16:42,653 OK, she's gonna be postictal for a while. 415 00:16:42,653 --> 00:16:43,828 Put her on a foley. 416 00:16:43,828 --> 00:16:44,872 I don't want her getting out of the bed, 417 00:16:44,872 --> 00:16:46,483 not even for the bathroom. 418 00:16:54,143 --> 00:16:56,058 A seizure expands our differential tenfold. 419 00:16:56,058 --> 00:16:57,885 We got to widen our net-- CT panscan, 420 00:16:57,885 --> 00:17:00,105 MRI brain, sed rate, autoimmune labs. 421 00:17:00,105 --> 00:17:01,280 Let's rope in neurology. - Guys. 422 00:17:01,280 --> 00:17:02,455 Ms. Goodwin just called. 423 00:17:02,455 --> 00:17:03,978 She said stand down. No more treatment. 424 00:17:03,978 --> 00:17:05,110 What? What are you talking about? 425 00:17:05,110 --> 00:17:06,111 She's in the MRI suite. 426 00:17:06,111 --> 00:17:08,157 Be here as soon as she can, OK? 427 00:17:11,725 --> 00:17:13,684 - Hey, you OK? - This is overkill. 428 00:17:13,684 --> 00:17:15,468 I probably just had some bad oatmeal. 429 00:17:15,468 --> 00:17:17,601 Well, bad oatmeal doesn't drop you 430 00:17:17,601 --> 00:17:18,993 in the middle of surgery. 431 00:17:18,993 --> 00:17:21,779 So how about you let me check you out? 432 00:17:24,216 --> 00:17:26,305 How's Sam? Appendectomy go OK? 433 00:17:26,305 --> 00:17:28,699 Yeah, all good. Dr. Graham is finishing up. 434 00:17:28,699 --> 00:17:30,179 At least it's just an appendectomy. 435 00:17:30,179 --> 00:17:32,050 Not missing much. 436 00:17:35,009 --> 00:17:36,924 Oh, my chest. Pressure. 437 00:17:39,884 --> 00:17:41,538 Oh, God. I'm sorry. 438 00:17:43,192 --> 00:17:44,845 That was weird. 439 00:17:44,845 --> 00:17:46,847 Your heart rate plummeted, but as soon as you passed gas, 440 00:17:46,847 --> 00:17:48,066 it came back. 441 00:17:48,066 --> 00:17:50,068 Will you sit up for me? 442 00:17:52,897 --> 00:17:54,333 Take a deep breath. 443 00:17:56,553 --> 00:17:58,207 All right. Lean back for me. 444 00:17:58,207 --> 00:18:00,992 Hey, Mike. Let's get an X-ray in here. 445 00:18:00,992 --> 00:18:02,341 What, did you hear a murmur? 446 00:18:02,341 --> 00:18:04,082 Honestly, I'm not sure what I heard. 447 00:18:04,082 --> 00:18:05,518 You're joking, right? Come on. 448 00:18:05,518 --> 00:18:08,130 Has heartburn been an issue before today? 449 00:18:08,130 --> 00:18:09,653 I mean, I get it. 450 00:18:09,653 --> 00:18:11,916 Even when I was a kid, it would flare up here and there. 451 00:18:11,916 --> 00:18:14,310 But it's never been an issue. 452 00:18:14,310 --> 00:18:16,747 X-ray up. Clear. 453 00:18:22,883 --> 00:18:25,364 What the hell? That's my colon. 454 00:18:25,364 --> 00:18:26,844 It shouldn't be in my chest. 455 00:18:26,844 --> 00:18:29,151 No, it should not. 456 00:18:31,370 --> 00:18:33,633 Her brother. Hugo, was a patient treated at Oakview. 457 00:18:33,633 --> 00:18:34,852 So was Maria. 458 00:18:34,852 --> 00:18:37,246 She was admitted yesterday via ambulance, 459 00:18:37,246 --> 00:18:40,336 but this morning, her family just walked her out. 460 00:18:40,336 --> 00:18:41,772 They just left--absconded. 461 00:18:41,772 --> 00:18:43,382 Well, her brother died at Oakview, 462 00:18:43,382 --> 00:18:44,862 and they didn't get any answers. 463 00:18:44,862 --> 00:18:46,211 You see how scared they are. 464 00:18:46,211 --> 00:18:47,343 It's no wonder that they didn't want to stay. 465 00:18:47,343 --> 00:18:49,258 Look, I agree, but walking out 466 00:18:49,258 --> 00:18:51,651 is the same as leaving against medical advice. 467 00:18:51,651 --> 00:18:54,045 It's triggered an insurance nightmare 468 00:18:54,045 --> 00:18:55,655 with the family's HMO. 469 00:18:55,655 --> 00:18:57,875 They won't pay for any more treatment 470 00:18:57,875 --> 00:18:59,964 until Maria is placed back 471 00:18:59,964 --> 00:19:03,446 with their preferred network provider, Oakview. 472 00:19:03,446 --> 00:19:05,926 Are you kidding me? They're a community hospital. 473 00:19:05,926 --> 00:19:08,233 They don't have the resources to run the tests she needs. 474 00:19:08,233 --> 00:19:09,626 Well, I've already reached out 475 00:19:09,626 --> 00:19:12,063 to the director of patient services at Oakview, 476 00:19:12,063 --> 00:19:14,413 and she assured me they'll do the best they can. 477 00:19:14,413 --> 00:19:16,067 The best they can? 478 00:19:16,067 --> 00:19:19,070 Ms. Goodwin, can't you reason with the insurance company? 479 00:19:19,070 --> 00:19:21,377 Hector and Gloria aren't trying to take advantage of them. 480 00:19:21,377 --> 00:19:23,074 They're trying to save their daughter's life. 481 00:19:23,074 --> 00:19:24,597 Look, I know, and I share 482 00:19:24,597 --> 00:19:26,556 in your frustration, but they're-- 483 00:19:26,556 --> 00:19:28,906 No. No, I don't care what the insurance company says. 484 00:19:28,906 --> 00:19:31,256 I'm not sending Maria back to Oakview until I get a guarantee 485 00:19:31,256 --> 00:19:32,910 she gets the treatment she needs in time. 486 00:19:32,910 --> 00:19:35,434 Dr. Halstead, the tests that you ordered 487 00:19:35,434 --> 00:19:37,349 will cost tens of thousands of dollars, 488 00:19:37,349 --> 00:19:39,699 and I know that's not coming out your pocket. 489 00:19:39,699 --> 00:19:43,312 The family has to decide how to proceed. 490 00:19:53,278 --> 00:19:55,019 OK, Quentin, so listen, 491 00:19:55,019 --> 00:19:57,195 we're gonna secure you to the machine 492 00:19:57,195 --> 00:19:59,328 while it's still running with a harness. 493 00:19:59,328 --> 00:20:01,373 So then, Dr. Archer, who is an excellent surgeon, 494 00:20:01,373 --> 00:20:02,983 is gonna come in here and clamp your artery, 495 00:20:02,983 --> 00:20:04,637 stabilize your neck wound, 496 00:20:04,637 --> 00:20:06,900 and make it safer when they pull out the scissors. 497 00:20:06,900 --> 00:20:09,163 All right? Then we turn off the machine. 498 00:20:09,163 --> 00:20:11,427 The idea is, bed falls to the side, 499 00:20:11,427 --> 00:20:14,734 you're held firmly in place by the harness, OK? 500 00:20:14,734 --> 00:20:16,606 Still with me? - Mm-hmm. 501 00:20:16,606 --> 00:20:18,216 Great. Last thing. 502 00:20:18,216 --> 00:20:20,827 Lower you onto a gurney, shoot you off the ER, 503 00:20:20,827 --> 00:20:23,047 and finish fixing up your neck. 504 00:20:23,047 --> 00:20:25,049 How's that sound? - Mm-hmm. 505 00:20:34,667 --> 00:20:36,930 Am I gonna die? 506 00:20:36,930 --> 00:20:38,671 Look, this is a complicated situation. 507 00:20:38,671 --> 00:20:42,196 But some really skilled people have come up with this plan, 508 00:20:42,196 --> 00:20:44,068 and it's the best option we got. 509 00:20:44,068 --> 00:20:47,071 All you got to do: breathe in and out, 510 00:20:47,071 --> 00:20:51,205 stay as still as you possibly can, OK? 511 00:20:51,205 --> 00:20:52,772 All right. 512 00:20:52,772 --> 00:20:55,035 Take all the time you need. 513 00:20:57,299 --> 00:20:59,779 Hey, hold the work. Everybody, out. 514 00:21:07,700 --> 00:21:10,486 You're my everything. 515 00:21:10,486 --> 00:21:14,577 From our first date, I knew that I was in love. 516 00:21:14,577 --> 00:21:17,710 And now we're parents. 517 00:21:17,710 --> 00:21:19,233 Uh... 518 00:21:21,235 --> 00:21:23,325 The nurse took a picture of him. 519 00:21:26,153 --> 00:21:29,026 I named him Trevor, after your dad. 520 00:21:29,026 --> 00:21:31,158 I think he'd like that. 521 00:21:32,856 --> 00:21:35,772 Tell Trevor I love him. 522 00:21:35,772 --> 00:21:38,731 You're gonna tell him yourself. 523 00:21:38,731 --> 00:21:41,473 You're gonna be a great mother. 524 00:21:42,996 --> 00:21:45,042 I love you, Quentin. 525 00:21:45,042 --> 00:21:48,001 I will see you again, you hear me? 526 00:21:48,001 --> 00:21:50,439 I will see you again. 527 00:22:04,801 --> 00:22:06,672 Sorry. 528 00:22:06,672 --> 00:22:09,806 I didn't know what to say. 529 00:22:09,806 --> 00:22:12,461 How do you put into words when-- 530 00:22:12,461 --> 00:22:14,506 You can't. 531 00:22:14,506 --> 00:22:16,813 But we could feel your love for each other. 532 00:22:16,813 --> 00:22:18,684 I just don't understand, 533 00:22:18,684 --> 00:22:21,644 because Quentin is my rock, 534 00:22:21,644 --> 00:22:26,736 and I don't even recognize the man that's in there. 535 00:22:26,736 --> 00:22:29,042 He just snapped. 536 00:22:29,042 --> 00:22:31,088 How does that happen all of a sudden? 537 00:22:31,088 --> 00:22:34,221 I mean, usually there are signs, you know? 538 00:22:34,221 --> 00:22:37,616 Extreme expressions of emotional frustration, 539 00:22:37,616 --> 00:22:39,662 anger, confusion, outbursts. 540 00:22:39,662 --> 00:22:43,100 You noticed anything like that in Quentin recently? 541 00:22:43,100 --> 00:22:46,190 - I don't think so. - How about physical changes? 542 00:22:46,190 --> 00:22:48,453 I noticed he had some lumps on the back of his neck. 543 00:22:48,453 --> 00:22:50,020 Have you-- do you know what those are? 544 00:22:50,020 --> 00:22:53,806 Lumps? I don't know. 545 00:22:53,806 --> 00:22:58,507 I just wanted to get to today and to have the baby. 546 00:22:58,507 --> 00:23:00,596 I've been so consumed by the pregnancy 547 00:23:00,596 --> 00:23:04,338 that I haven't noticed anything else. 548 00:23:04,338 --> 00:23:06,123 Oh, Quentin. 549 00:23:11,911 --> 00:23:13,696 Uh, give it to Spellman. 550 00:23:13,696 --> 00:23:14,827 Thanks, Lori. 551 00:23:14,827 --> 00:23:16,525 Mystery solved. Your chest CT. 552 00:23:16,525 --> 00:23:19,397 - Hiatal hernia. - No, diaphragmatic. 553 00:23:19,397 --> 00:23:22,052 Big enough that your colon migrated into your chest. 554 00:23:22,052 --> 00:23:24,533 So the gas moving through it, 555 00:23:24,533 --> 00:23:27,274 it puts pressure on the vagus nerve, drops your heartbeat. 556 00:23:27,274 --> 00:23:28,972 Breaking wind releases the pressure. 557 00:23:28,972 --> 00:23:30,539 Heart returns to a normal rate. - Yeah. 558 00:23:30,539 --> 00:23:32,149 You said you had heartburn since you were a kid. 559 00:23:32,149 --> 00:23:34,107 Probably this: undiagnosed 560 00:23:34,107 --> 00:23:37,154 asymptomatic congenital diaphragmatic hernia. 561 00:23:37,154 --> 00:23:38,764 I've never passed out before, though. 562 00:23:38,764 --> 00:23:41,593 Well, my guess is it's been slowly expanding over time. 563 00:23:41,593 --> 00:23:43,073 But you do CrossFit now, 564 00:23:43,073 --> 00:23:45,423 so the thrusters, burpees, other workouts-- 565 00:23:45,423 --> 00:23:48,078 safe bet that they've exacerbated the condition. 566 00:23:48,078 --> 00:23:50,428 Led to today. - Yeah, well, I'll own that. 567 00:23:50,428 --> 00:23:52,082 But I can't resist dropping in the OR again, 568 00:23:52,082 --> 00:23:54,258 so let's fix this hernia. - OK. 569 00:23:54,258 --> 00:23:57,566 Well, you've got a few surgical options. 570 00:23:57,566 --> 00:23:58,958 Open. - No. 571 00:23:58,958 --> 00:24:00,569 That's a huge incision. Lots of digging around. 572 00:24:00,569 --> 00:24:02,571 I'll be laid up in the ICU for weeks. 573 00:24:02,571 --> 00:24:03,920 Laparoscopic, then. 574 00:24:03,920 --> 00:24:05,704 Be more incisions for the scope and tools, 575 00:24:05,704 --> 00:24:08,098 but less invasive-- - No old-school approaches. 576 00:24:08,098 --> 00:24:09,752 Robotic assist in OR 2.0. 577 00:24:09,752 --> 00:24:11,623 Shortest recovery time. 578 00:24:13,364 --> 00:24:15,627 I just want this to be over with. 579 00:24:15,627 --> 00:24:18,325 OK, I'm gonna scrub in. 580 00:24:18,325 --> 00:24:19,631 I'll see you after, OK? 581 00:24:24,984 --> 00:24:27,247 Holy cow. Look at this place. 582 00:24:27,247 --> 00:24:29,249 It's like you guys are living in 2050 up here. 583 00:24:29,249 --> 00:24:31,861 So don't break anything. 584 00:24:31,861 --> 00:24:33,558 How's it going with the surgical tools? 585 00:24:33,558 --> 00:24:35,604 Almost there. Scalpel's printed. 586 00:24:35,604 --> 00:24:37,214 Two of the three angled peripheral vascular clamps 587 00:24:37,214 --> 00:24:38,302 are printed as well. 588 00:24:38,302 --> 00:24:39,564 One Weitlaner retractor printed. 589 00:24:39,564 --> 00:24:41,566 One to go. - Oh, it's like the real thing. 590 00:24:41,566 --> 00:24:43,960 It is the real thing, just plastic. 591 00:24:43,960 --> 00:24:45,701 These tools, I think they can work. 592 00:24:45,701 --> 00:24:47,137 They'll have to. 593 00:24:47,137 --> 00:24:48,617 They're all we got. 594 00:24:54,144 --> 00:24:56,581 They never wanted to go to Oakview, 595 00:24:56,581 --> 00:24:58,540 but the ambulance took them there anyway. 596 00:24:58,540 --> 00:25:00,585 Because Maria didn't require specialty care, 597 00:25:00,585 --> 00:25:03,153 paramedics took her to the nearest hospital instead. 598 00:25:12,510 --> 00:25:15,992 I'm so sorry that you've been put in this situation. 599 00:25:15,992 --> 00:25:18,255 We can continue to treat Maria, 600 00:25:18,255 --> 00:25:21,258 but your insurance won't cover the costs. 601 00:25:31,703 --> 00:25:35,402 He said he'll sell the car. He can get a second job. 602 00:25:35,402 --> 00:25:37,143 His oldest son can get a job as well. 603 00:25:37,143 --> 00:25:38,841 No. Papa, no. 604 00:25:38,841 --> 00:25:40,494 No. 605 00:25:40,494 --> 00:25:42,366 I'll go back. 606 00:25:42,366 --> 00:25:44,629 No. 607 00:25:44,629 --> 00:25:46,849 Maria-- 608 00:25:46,849 --> 00:25:49,199 Maria. 609 00:26:14,267 --> 00:26:18,097 You know, maybe Oakview will figure it out. 610 00:26:23,625 --> 00:26:24,582 All right. 611 00:26:24,582 --> 00:26:28,499 Um, I'll set up the transfer. 612 00:26:35,158 --> 00:26:36,638 What was Maria saying? 613 00:26:36,638 --> 00:26:38,901 If she lets her parents bankrupt the family 614 00:26:38,901 --> 00:26:41,686 paying for her medical care, then all of the opportunities 615 00:26:41,686 --> 00:26:45,255 they've worked so hard to give their children will be lost. 616 00:26:45,255 --> 00:26:47,083 She is risking her life. 617 00:26:47,083 --> 00:26:48,867 No. 618 00:26:48,867 --> 00:26:51,087 No, she's sacrificing it. 619 00:26:51,087 --> 00:26:54,917 And it's awful, 620 00:26:54,917 --> 00:26:57,571 but I get it. 621 00:27:06,406 --> 00:27:07,581 Ready to inflate? 622 00:27:10,541 --> 00:27:11,890 Up on blue. 623 00:27:13,587 --> 00:27:14,893 Hold. 624 00:27:16,460 --> 00:27:18,027 Up on red. 625 00:27:23,772 --> 00:27:25,034 Hold. 626 00:27:29,342 --> 00:27:31,997 How's, uh-- how's Layla doing? 627 00:27:31,997 --> 00:27:35,087 She's in shock, full of grief, 628 00:27:35,087 --> 00:27:36,654 and a first-time mom all at the same time. 629 00:27:36,654 --> 00:27:39,744 It's a lot, but a psych resident is with her. 630 00:27:39,744 --> 00:27:43,052 Mm. And how about you? 631 00:27:43,052 --> 00:27:45,532 How are you doing? 632 00:27:45,532 --> 00:27:48,448 Honestly, I didn't see this coming. 633 00:27:48,448 --> 00:27:52,148 I just thought Quentin was a nervous first-time dad, 634 00:27:52,148 --> 00:27:54,716 like the ones I see every single day. 635 00:27:54,716 --> 00:27:56,456 Never suspected mental illness. 636 00:27:56,456 --> 00:27:58,415 You know, I'm not sure it is, per se. 637 00:27:58,415 --> 00:28:01,418 You know those lumps on the back of his neck? 638 00:28:01,418 --> 00:28:03,072 I have a very strong hunch that they're indicative 639 00:28:03,072 --> 00:28:04,813 of a physical issue that could very well 640 00:28:04,813 --> 00:28:07,772 be causing a sudden psychosis. 641 00:28:07,772 --> 00:28:09,339 It's physical, not psychological? 642 00:28:09,339 --> 00:28:11,080 Yeah, I'm leaning that way. 643 00:28:11,080 --> 00:28:13,865 I mean, can't be sure until we run some tests. 644 00:28:25,485 --> 00:28:27,183 Maria, this is a thumb drive 645 00:28:27,183 --> 00:28:29,359 with all the work we did here, along with our notes. 646 00:28:29,359 --> 00:28:32,754 You give this to the doctors as soon as you get there. 647 00:28:32,754 --> 00:28:34,059 Thank you. 648 00:28:37,889 --> 00:28:40,065 All right. Empty her foley. 649 00:28:47,812 --> 00:28:49,118 It's OK, Mama. 650 00:28:51,729 --> 00:28:53,905 Wait. 651 00:28:55,864 --> 00:28:57,169 Will? 652 00:29:00,999 --> 00:29:02,435 You smell that? 653 00:29:09,399 --> 00:29:10,704 We have to run one more test. 654 00:29:10,704 --> 00:29:12,924 I'll pay for it myself, if I have to. 655 00:29:18,451 --> 00:29:19,931 I'm scared. 656 00:29:19,931 --> 00:29:22,499 Well, you'll be less frightened if you can't see it, 657 00:29:22,499 --> 00:29:25,458 so I'm gonna drape your face, OK? 658 00:29:27,547 --> 00:29:28,853 Yeah. 659 00:29:28,853 --> 00:29:30,855 All right. 660 00:29:30,855 --> 00:29:32,422 Here we go. Careful. 661 00:29:34,076 --> 00:29:35,947 That's right. All right. 662 00:29:37,079 --> 00:29:38,907 All right. 663 00:29:38,907 --> 00:29:41,866 10cc's of lidocaine, please. 664 00:29:41,866 --> 00:29:43,912 OK. 665 00:29:43,912 --> 00:29:46,349 All right. 666 00:29:55,445 --> 00:29:56,663 OK. 667 00:29:56,663 --> 00:29:59,623 Scalpel. 668 00:29:59,623 --> 00:30:01,277 All right. Grab hold of those scissors. 669 00:30:01,277 --> 00:30:04,149 I don't want them flopping after I make the incisions. 670 00:30:07,631 --> 00:30:09,415 Here we go. 671 00:30:14,333 --> 00:30:16,683 OK. 672 00:30:16,683 --> 00:30:17,815 All right. 673 00:30:17,815 --> 00:30:19,338 Wheaties. 674 00:30:22,907 --> 00:30:26,911 All right. Watch your fingers there. 675 00:30:26,911 --> 00:30:29,566 That's it. That's it. Don't move it. Don't move it. 676 00:30:29,566 --> 00:30:31,089 Clamp. 677 00:30:35,746 --> 00:30:36,747 All right. 678 00:30:46,017 --> 00:30:48,106 All right. 679 00:30:48,106 --> 00:30:50,326 Carotid clamps in place. CFD, you're up. 680 00:30:50,326 --> 00:30:51,893 All right. Spread out around the bed. 681 00:30:51,893 --> 00:30:54,156 When it falls down, we pull it away from the MRI machine. 682 00:30:54,156 --> 00:30:57,420 All right. And no slack at all, you understand? 683 00:30:57,420 --> 00:30:59,683 If there's any movement, his clamps could pop off, 684 00:30:59,683 --> 00:31:02,425 and then we'll have a problem we might not be able to fix. 685 00:31:02,425 --> 00:31:03,774 All right. 686 00:31:03,774 --> 00:31:06,820 On three, you're gonna cut the power to the MRI. 687 00:31:06,820 --> 00:31:08,039 We ready? Everybody, ready? 688 00:31:08,039 --> 00:31:09,127 Ready. 689 00:31:09,127 --> 00:31:12,478 One, two, three. 690 00:31:16,265 --> 00:31:18,354 All right. Clamps are holding. 691 00:31:18,354 --> 00:31:20,138 I'm gonna remove the scissors now. 692 00:31:23,837 --> 00:31:25,100 All right. 693 00:31:25,100 --> 00:31:26,971 All right, we're clear. OK, bed. 694 00:31:26,971 --> 00:31:29,713 Let's lower Quentin. 695 00:31:32,411 --> 00:31:35,066 Lower him slowly. - One, two, three. 696 00:31:36,763 --> 00:31:38,113 Slack! 697 00:31:40,071 --> 00:31:41,681 All right. 698 00:31:43,422 --> 00:31:45,207 OK, ropes are free. 699 00:31:45,207 --> 00:31:47,774 All right. 700 00:31:47,774 --> 00:31:50,081 Incredible, Doc. Freaking incredible. 701 00:31:50,081 --> 00:31:53,258 Thanks. Can someone get me a bottle of water, please? 702 00:31:53,258 --> 00:31:55,478 Dr. Archer, you did it. 703 00:31:55,478 --> 00:31:57,567 - Dean, you all right? - Yeah. 704 00:31:57,567 --> 00:31:59,873 I got to get to the OR, so... 705 00:31:59,873 --> 00:32:01,484 Whoa, whoa, whoa, whoa, whoa. 706 00:32:01,484 --> 00:32:04,139 Page Dr. Lanik to take over with Quentin. 707 00:32:04,139 --> 00:32:05,053 I'm just feeling a little dizzy. 708 00:32:05,053 --> 00:32:06,315 That's all. 709 00:32:13,975 --> 00:32:15,367 Hernia fixed? 710 00:32:15,367 --> 00:32:17,282 I'd say you're as good as new. 711 00:32:17,282 --> 00:32:19,241 Yeah, not quite. 712 00:32:19,241 --> 00:32:20,807 I'm the fart doctor now. 713 00:32:20,807 --> 00:32:22,766 A punchline. - No. 714 00:32:22,766 --> 00:32:24,724 What happened today was a result 715 00:32:24,724 --> 00:32:25,899 of a medical ailment, OK? 716 00:32:25,899 --> 00:32:27,162 Like anyone's gonna care about that. 717 00:32:27,162 --> 00:32:28,859 All they're gonna remember is the fart. 718 00:32:28,859 --> 00:32:31,035 Oh, come on. It'll blow over. 719 00:32:32,645 --> 00:32:34,996 Sorry. Poor choice of words, but it will. 720 00:32:34,996 --> 00:32:37,520 I doubt it. 721 00:32:37,520 --> 00:32:38,825 All right, look. 722 00:32:38,825 --> 00:32:41,219 I'll check on you a little later, OK? 723 00:32:41,219 --> 00:32:42,177 All right. 724 00:32:44,005 --> 00:32:47,138 - So his neck is fixed, then? - Yeah. 725 00:32:47,138 --> 00:32:49,227 The artery repair went very well. 726 00:32:49,227 --> 00:32:51,838 What about his mind? Because before-- 727 00:32:51,838 --> 00:32:53,840 Well, I gave him a very small dose 728 00:32:53,840 --> 00:32:55,929 of an antipsychotic called risperidone, 729 00:32:55,929 --> 00:32:58,062 and he does seem to be thinking more clearly. 730 00:32:58,062 --> 00:33:01,239 And you think he'll stay that way? 731 00:33:01,239 --> 00:33:02,675 I don't think that what happened today 732 00:33:02,675 --> 00:33:04,503 is the result of mental illness. 733 00:33:04,503 --> 00:33:05,809 You know, tests are still pending, 734 00:33:05,809 --> 00:33:08,029 but all indications are is that Quentin has 735 00:33:08,029 --> 00:33:11,467 a genetic disease called neurofibromatosis type 2. 736 00:33:11,467 --> 00:33:13,643 - Is it curable? - It's not. 737 00:33:13,643 --> 00:33:15,993 But there are a lot of effective treatments out there. 738 00:33:15,993 --> 00:33:18,474 And the good news is that with a little luck, 739 00:33:18,474 --> 00:33:21,259 Quentin is gonna be the man you know again. 740 00:33:21,259 --> 00:33:23,609 Genetic means he's had it forever. 741 00:33:23,609 --> 00:33:25,655 Why'd it suddenly go berserk today? 742 00:33:25,655 --> 00:33:28,875 NF is thought to be an inflammatory ailment, right? 743 00:33:28,875 --> 00:33:31,878 So possibly triggered by changes in environment, 744 00:33:31,878 --> 00:33:33,489 you know, lifestyle, 745 00:33:33,489 --> 00:33:37,623 possibly diet, medication. 746 00:33:37,623 --> 00:33:40,713 Diet. 747 00:33:40,713 --> 00:33:42,411 Oh, my God. 748 00:33:42,411 --> 00:33:45,979 The minute I got pregnant, my hormones went crazy. 749 00:33:45,979 --> 00:33:47,677 Smells were intense, 750 00:33:47,677 --> 00:33:50,680 and Quentin's breath was the worst. 751 00:33:50,680 --> 00:33:53,509 Everything he ate made me throw up. 752 00:33:53,509 --> 00:33:55,728 So he gave up his entire diet. 753 00:33:55,728 --> 00:33:58,296 No more fruits, vegetables, fish. 754 00:33:58,296 --> 00:34:00,124 For the past nine months, he's been eating nothing 755 00:34:00,124 --> 00:34:02,866 but bland, processed crap for me. 756 00:34:02,866 --> 00:34:06,783 Mrs. Bell, Quentin's asking to see you. 757 00:34:17,402 --> 00:34:19,230 Hi, honey. 758 00:34:19,230 --> 00:34:22,059 Layla... 759 00:34:22,059 --> 00:34:23,974 I don't entirely understand 760 00:34:23,974 --> 00:34:27,717 what happened or why, 761 00:34:27,717 --> 00:34:29,588 but I know I put you in danger. 762 00:34:29,588 --> 00:34:30,894 I'm sorry. 763 00:34:30,894 --> 00:34:33,201 No, Quentin. 764 00:34:33,201 --> 00:34:35,899 I was so tied up in the pregnancy, 765 00:34:35,899 --> 00:34:38,467 I was oblivious to what was going on with you. 766 00:34:38,467 --> 00:34:42,035 I should've seen the signs. Forgive me. 767 00:34:42,035 --> 00:34:45,517 Oh, honey, there's nothing to forgive. 768 00:34:45,517 --> 00:34:46,953 I love you. 769 00:34:46,953 --> 00:34:49,695 I love you too. 770 00:34:49,695 --> 00:34:53,134 Someone's been missing you guys. 771 00:34:57,877 --> 00:35:00,924 Hi. 772 00:35:00,924 --> 00:35:03,144 Here you go. 773 00:35:04,928 --> 00:35:08,366 Hi, sweetheart. Look who's here. 774 00:35:08,366 --> 00:35:09,715 Hi. 775 00:35:09,715 --> 00:35:11,935 I'm your dad. 776 00:35:13,241 --> 00:35:16,069 I love you. 777 00:35:16,069 --> 00:35:19,943 - Shh, sweetheart. - Hi. 778 00:35:19,943 --> 00:35:22,815 - A metabolic condition? - Yeah. 779 00:35:22,815 --> 00:35:24,991 It's called maple syrup urine disease, 780 00:35:24,991 --> 00:35:27,124 and it's a rare condition that makes it difficult 781 00:35:27,124 --> 00:35:29,431 for the body to break down certain amino acids. 782 00:35:29,431 --> 00:35:32,782 The trademark symptom is a distinct maple syrup smell 783 00:35:32,782 --> 00:35:34,218 that shows up in urine. 784 00:35:34,218 --> 00:35:36,046 It usually presents in childhood, 785 00:35:36,046 --> 00:35:37,743 and it's almost unheard of 786 00:35:37,743 --> 00:35:40,485 to discover it in someone your age, 787 00:35:40,485 --> 00:35:42,052 or Hugo's. 788 00:35:42,052 --> 00:35:44,489 It's likely that he had it too. 789 00:35:44,489 --> 00:35:45,708 And I suspect this is why 790 00:35:45,708 --> 00:35:48,101 Oakview couldn't diagnose him in time. 791 00:35:48,101 --> 00:35:50,103 He didn't have a seizure or a foley catheter. 792 00:35:50,103 --> 00:35:52,105 It made his doctors' jobs even harder. 793 00:35:52,105 --> 00:35:55,674 Wait, this disease killed Hugo. 794 00:35:55,674 --> 00:35:56,980 Does that mean-- 795 00:35:56,980 --> 00:35:59,374 No, you're gonna be OK. 796 00:35:59,374 --> 00:36:01,767 You have an intermittent form of the disease, 797 00:36:01,767 --> 00:36:04,553 which can be managed by closely monitoring protein levels. 798 00:36:04,553 --> 00:36:06,250 We've already reached out to nephrology 799 00:36:06,250 --> 00:36:08,252 to discuss treatment options. 800 00:36:08,252 --> 00:36:12,125 Maria. 801 00:36:23,049 --> 00:36:24,268 Gracias. 802 00:36:33,538 --> 00:36:35,366 - Hello, Daniel. - Ooh! 803 00:36:36,846 --> 00:36:39,370 Hey, you're, uh-- you're a little early. 804 00:36:39,370 --> 00:36:42,155 Oh, I couldn't wait to see you. 805 00:36:42,155 --> 00:36:45,115 What's this? You cleaned your office? 806 00:36:45,115 --> 00:36:46,334 No, I didn't. 807 00:36:47,770 --> 00:36:49,772 I'm tidying up a little bit. 808 00:36:49,772 --> 00:36:51,948 Why? 809 00:36:53,645 --> 00:36:56,605 I was very embarrassed by what happened this morning. 810 00:36:56,605 --> 00:37:01,044 And um, you know, I just, uh-- 811 00:37:01,044 --> 00:37:05,091 I don't ever want you to feel that I-- 812 00:37:05,091 --> 00:37:08,312 I take for granted the job that you do, or-- 813 00:37:08,312 --> 00:37:10,009 or that I'm oblivious to how hard you work. 814 00:37:10,009 --> 00:37:12,142 I really don't want that to happen. 815 00:37:12,142 --> 00:37:14,231 You're very sweet. 816 00:37:15,798 --> 00:37:18,540 I care about you too, Daniel. 817 00:37:18,540 --> 00:37:19,541 A lot. 818 00:37:20,846 --> 00:37:22,370 - Yeah? - Mm-hmm. 819 00:37:22,370 --> 00:37:23,501 Huh. 820 00:37:33,642 --> 00:37:35,687 - Hey. - Hey. 821 00:37:35,687 --> 00:37:37,080 Ah! 822 00:37:37,080 --> 00:37:38,995 Where'd you find it? - Nurses' station. 823 00:37:38,995 --> 00:37:40,518 Oh, makes sense. 824 00:37:40,518 --> 00:37:42,868 That's where I was when the call about Quentin came in. 825 00:37:42,868 --> 00:37:44,392 Yeah, I totally get it. 826 00:37:44,392 --> 00:37:47,220 I would have run off and left it behind too. 827 00:37:47,220 --> 00:37:51,224 But my kidneys can handle some mild dehydration. 828 00:37:51,224 --> 00:37:52,878 Yours can't. - Yeah, yeah. 829 00:37:52,878 --> 00:37:56,186 Yeah, pretty sure there will be another emergency tomorrow, 830 00:37:56,186 --> 00:37:58,101 and the day after that, 831 00:37:58,101 --> 00:38:01,974 so I'm gonna give you something. 832 00:38:01,974 --> 00:38:04,455 It is a tracking device. - Ah. 833 00:38:04,455 --> 00:38:06,109 App connects it to your phone. 834 00:38:06,109 --> 00:38:08,981 And I haven't lost my keys since I put it on, so... 835 00:38:08,981 --> 00:38:12,550 Well, keep it. I'm past water bottles. 836 00:38:12,550 --> 00:38:14,247 Nephrologist just left. 837 00:38:14,247 --> 00:38:17,599 Uh, my kidneys are getting worse. 838 00:38:22,908 --> 00:38:24,301 Dialysis? 839 00:38:33,832 --> 00:38:36,966 That was a big win today. 840 00:38:36,966 --> 00:38:39,751 You saved that family. 841 00:38:39,751 --> 00:38:42,537 Yeah. 842 00:38:42,537 --> 00:38:45,888 I suppose it's time to talk about my DACA renewal. 843 00:38:45,888 --> 00:38:47,759 I know I've been dragging my feet. 844 00:38:47,759 --> 00:38:50,936 It's been a long day. We can speak in the morning. 845 00:38:50,936 --> 00:38:53,069 No. No, I'm ready. 846 00:38:53,069 --> 00:38:55,463 Yeah? All right. 847 00:38:58,814 --> 00:39:01,991 Truth is, I've been thinking about leaving Med. 848 00:39:01,991 --> 00:39:03,862 Really? 849 00:39:03,862 --> 00:39:07,300 I've always been in school or protected by my residency, 850 00:39:07,300 --> 00:39:11,261 so my immigration status has always been stable. 851 00:39:11,261 --> 00:39:14,743 But my parents, despite them always having jobs, 852 00:39:14,743 --> 00:39:16,179 could never solidify theirs, 853 00:39:16,179 --> 00:39:18,399 so they moved to Canada. 854 00:39:18,399 --> 00:39:19,878 Hmm. 855 00:39:19,878 --> 00:39:23,534 But they can't enter the country to come visit me. 856 00:39:23,534 --> 00:39:27,669 And if I leave to go see them, I might be denied reentry. 857 00:39:27,669 --> 00:39:31,107 So... 858 00:39:31,107 --> 00:39:34,110 I haven't hugged my parents in a decade. 859 00:39:34,110 --> 00:39:36,068 Ugh. 860 00:39:36,068 --> 00:39:39,158 That's--that's heartbreaking. 861 00:39:39,158 --> 00:39:42,901 But Maria today, her bravery, 862 00:39:42,901 --> 00:39:47,645 what she was willing to sacrifice for her family, 863 00:39:47,645 --> 00:39:50,866 reminded me that 864 00:39:50,866 --> 00:39:53,564 "no one puts their child in a boat 865 00:39:53,564 --> 00:39:56,262 unless the water is safer than the land." 866 00:39:56,262 --> 00:39:59,004 Warsan Shire. 867 00:39:59,004 --> 00:40:01,703 Oh, that's a beautiful poem. 868 00:40:03,052 --> 00:40:04,706 So... 869 00:40:04,706 --> 00:40:09,188 my parents' sacrifice to get me here 870 00:40:09,188 --> 00:40:12,844 put me in this boat, 871 00:40:12,844 --> 00:40:15,368 which is why I have to stay. 872 00:40:16,674 --> 00:40:18,546 And Dr. Cuevas, 873 00:40:18,546 --> 00:40:22,898 I believe that you will find a way 874 00:40:22,898 --> 00:40:25,857 to see your parents again. 875 00:40:25,857 --> 00:40:28,338 But until that day, 876 00:40:28,338 --> 00:40:32,995 know that you have family here in us at Med. 877 00:40:32,995 --> 00:40:35,388 Thank you. 62199

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