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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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