All language subtitles for Chicago.Med.S09E01.720p.HDTV.x264-SYNCOPY.Sdh

- OR 2.0 is the fruit
of years of development.

I know the tech.

I promise you, it
won't let you down.

- You know tech, but
you don't know surgery.

- Are you having an affair?
- No.

Never.

I don't know if Ben and I
are on a path to divorce.

- Dayton has bought
controlling interest

in the Gaffney Medical Group.

- So I guess he's in charge now.

- We will be
livestreaming a surgery

for the entire world to watch.

- This is not a simulation.

There's a human
being on that table.

- I know, and you're
gonna save his life.

- And what if I don't?

What if he dies?

- I'm officially in end
stage renal disease.

- Sean is your best
possible donor match.

- I'm not taking my
son's kidney, Hannah.

- Warning, warning.
[alarm blaring]

- The platform is defective.

We gotta shut it down.

- I'm ruined, Sharon.

I have to sell the hospital.

[dramatic music]

- Come on, Brice.

Brice, move your feet
for me. [machine beeping]

Squeeze my fingers.
Come on, buddy.

Squeeze 'em.

On extrication, he was
moving all his limbs.

- There's nothing now.
- Listen up, everybody.

Listen up.

Multi-vehicle crash
on the interstate.

Mass casualties en route.

Ambos are about
to land right now.

Hannah, I'm gonna need you
for more than OB today, okay?

- Yeah.
- Okay, thanks.

- Need to secure his
airway before he crashes.

0.2 mgs per kg etomidate,
0.6 mgs per kg roc.

- Got it.

- Tube.
- Ready.

- I'm in.

Bag him.

- Peter, I'm gonna
have to cut this short.

Take care.

Thank you.

- 25-year-old male.

Heart rate 115. BP 75/50.

GCS 13. Arterial bleed.

Tourniquet placed in the field.

- Ripley, with me in six.

- You got it.

- Dr. Marcel? ETA in five.

♪ ♪

- Joshua, you got
enough with this.

That's a red tag. You're good.

Tracy, I'll be right back.

Oh, I'm sorry,
hold for a second.

That is a green tag.

Non-emergency for now, sir.

We're gonna have you wait
in the waiting room, okay?

Let's go back. You, too.

I'm so sorry.

That is a green tag also.

Everyone with a green tag,

you have to wait in
the waiting room.

Green tag in the waiting room.

Thank you.

- Check his arm, please.

♪ ♪

Chest is clear.

What are you doing?

- Making sure this
is an arterial bleed.

Cuff works as a
secondary tourniquet.

Release it slowly,

and if the bleeding
has stopped...

- It's not an arterial bleed.

Not everybody knows that trick.

Very nice.

- So I pass?

[helicopter blades whirring]

- [sobbing] Oh, God.

It all happened so fast.

I didn't mean it.

I tried not to hit
them. I couldn't stop.

- It wasn't your fault.
- Oh, my God.

- It's not your fault.
- Oh, my God.

- Let's see if we can find
somebody to take a look at you.

- We're doing our best
right now to get everyone.

All the information...

- Dolores Williams, is she here?

- Robbie. Robbie Wilson.

- Please, please, everyone,
go to the waiting room,

and someone will be out soon
to answer all your questions.

To the waiting room, please.

That's it. Cesar, talk to me.

- Ivy Vance, 30s.

Hit her head against the
interior of her vehicle.

Complaining of
headache, disoriented.

GCS 12.

- You're going to
treatment three.

- I got no movement
through the limbs.

- Got you.
- Coming in.

- I've got it.

- Easy.
- Yep, yep.

- Keep him steady.

All right, let's move. Ready?

- Hey, Maggie, you need
an extra pair of hands,

I could put the gloves on.

- I might take you up on that.

- Maggie, need ortho in there.

- Got it.

Oh, and you're going
to treatment three.

- Got it.

Zach, what do we got?

- Ivy Vance.

Few lacerations,
closed head injury.

- Okay. Hi, Ivy.

I'm Dr. Asher.

I'm gonna ask you
some questions, okay?

Okay.

So you hit your head.

- Uh-huh.

- Do you know where you are?

- Hospital.

- What day is today?

- Um...

Wednesday.

- Okay, everything's good.

We just need to check that
head bump out, get a CT.

Sound okay?

- Transport.

- What's that?

- Hamster.

Came in with her.

- Yep. Maggie.
- Yeah?

You're going to Baghdad.
- I got a ten-year-old boy.

Brice Morgan. GCS 7.

Vehicle was crushed
under a semi.

Father died at the scene.
Mike, X-ray. Let's go.

- Got it.

- Jimmy, take over.

Mike, give me a
cross-table C-spine.

- Yep.

- Clear.

- The ligaments.

Is that even possible?

- Yeah. He's
internally decapitated.

- The only thing holding
his head on is his skin.

- Jack.
- Hey.

Eight-year-old boy
with a head lac.

- He's my son.
- We'll take good care of him.

Keep that compress on his head.
You're going to treatment two.

Thanks, Jack.
- Mm-hmm.

- Dean. Hey.

You're getting a
new kidney tomorrow.

Take it easy.
- Yeah, I'm fine.

Dr. Marcel.
- Yeah?

- The boy's mother's here.

- Okay.

- Ms. Morgan, I'm Dr. Marcel.

I know you lost your
husband. I'm very sorry.

- My son, Brice, please
just tell me he's alive.

- He is.

But he has been
critically injured.

Here.

- [sobs] Oh, my God.

No, no, no, no!

- Look, I'm gonna do my
very best to help your son.

Okay, but I don't wanna
minimize the severity

of Brice's condition.

He suffered what's called

a bilateral atlanto-occipital
dislocation.

What that means is that the
ligaments from his skull

have separated from
his spinal column.

- Oh, no. No.

- We're gonna do
a CT and an MRI,

and that's gonna
help us determine

how to proceed surgically, okay?

- Surgically.

- Yes.

It's necessary in
order to stabilize

the head to the spine.

And let's page
Dr. Abrams, please, okay?

- Liz, Dr. Abrams is
a great neurosurgeon.

Okay?

- All right.

Why don't you come be with him?

Come on.

[somber music]

- Hey, baby.

It's okay, Mommy's here.

Mommy's here.

- Maggie.

- Matt.
- Harris Shorr, 40s.

Injured in that accident.

His right arm is
swollen and bruised.

Complained of
dizziness on the scene.

GCS 15. Heart rate 110.

Respiratory rate 25 per minute.

- All right, you're
going to treatment four.

I'll have a doctor in
there as soon as possible.

- Are you done yet?

- Almost.

Decision time, AJ.

We got two types of bandages.

We've got Wolverine
or Spider-Man.

What's your poison?

- Poison? I don't want poison.
- [laughs]

No, honey, he's asking
which one you want.

- Oh. Spider-Man.

- All right.

My friend here will fix you
up. I'll catch you later, AJ.

- Dr. Asher, here's Ivy's CT.

I got in touch with
her emergency contact,

a woman she works with.

- No family?

- It doesn't seem like it.

The woman explained
about the hamster.

She said it's probably a rescue.

She says Ivy likes to
find homes for things.

- Aw.

Well, it looks like she
can continue to do so.

I'm just seeing a
small contusion.

Nothing serious.
- Yeah, that's what I thought.

- Yeah, well, I
will let her know.

Hey, Ivy.

How you feeling?

- Better.
- Good.

Well, good news, your CT didn't
show any concerning injuries,

so we're gonna give
you a neuro check

every couple hours just to
make sure everything's okay.

- Thank you.

- Your work friend said that
you like to rescue animals.

- They're family.

- Yeah. I guess I
can understand that.

I mean, we are all related,
from fish, to hamsters,

to us, so...

- And we all need a home.

- That we do.

- I was rescued.

[pensive music]

I was in a very bad place,
and someone took care of me.

- Yeah.

I can relate to that.

It is a good thing that people
like you are in the world.

♪ ♪

- [sighs]

Hey, Archer.
- Yeah.

- Who is that?

- That's the new ED
attending. Name's Ripley.

- Ripley?
- Yeah.

- Huh. Look so familiar to me.
- Yeah?

- What do you, uh, what
do you know about him?

- Ah, he's really smart.

Got a full ride to Columbia.

Got great references.

- Hmm.

- Dr. Ripley, help me
with a patient in four.

I just sent you the chart.

- Mr. Shorr.

- [breathless] Harris is fine.

This is my wife, Audrey.

- I'm Dr. Ripley,
and this is, um,

Maggie Lockwood,
our charge nurse.

- Mrs. Ben.

- Excuse me?

- Oh, our son Michael was
your husband's student.

We met last year at
parent-teacher night.

- Oh.

- So you two were
in that pile-up?

- Tried to avoid it.

Harris lost control of the car.

- I don't know what happened.

I got dizzy.

Also, I think I broke my arm.

- X-ray.
- Yup.

- Let's get AP and lateral views

of the right upper
arm and forearm.

You say you got dizzy?

- That's been happening a lot.

- And you're short of breath?

- A little bit.

- Clear.
[machine beeps]

- Non-displaced fracture
of the distal radius.

Afraid you do have
a busted wing.

- Get ortho down
here to take a look?

- Please.

Your blood pressure's high.

Did you know that?
- No.

- It says here you're on lithium

as well as quetiapine
and lamotrigine.

- Yeah, I'm bipolar.

- He's been managing very well.

- That's good.

But I am concerned
about your breathing,

blood pressure, the dizziness.

I'd like to do more of a workup.

- I wish you would. I've
been worried about him.

- But you're okay,
Audrey? Nothing hurts?

- No.
- Okay.

- Please give our
regards to Mr. Ben.

- Let's start with
standard blood work.

I'll come back
soon and follow up.

- Thanks, Doc.

- Since Mr. Shorr is
on mood stabilizers,

shouldn't we have psychiatry
take a look at him?

Dr. Charles is on call.

- I don't wanna
bother him just yet.

Let's just see
what the labs show.

- All right.

[pensive music]

- Oh. How's she doing?

- Emotionally, she's a wreck.
Thinks it's all her fault.

Physically, I don't know yet.

I found a bruise on her scalp,

so I'm ordering
a non-contrast CT

to see if there's
something there.

- Okay. Keep me posted.
- Sure.

[alarm beeping]

- She's in V-fib.

- Set up the paddles.
Start bagging.

- On it.

- Charge to 120.

[suspenseful music]

- Charging.

- Clear.

- No pulse. 1 epi milligram.

- Coming.

- What happened... gotta
be the head trauma, right?

I mean, she doesn't even...

she doesn't have
any other injuries.

- No, it shouldn't be happening.

- Charge to 200.

- Charging.

- Clear.

- Another 1 of epi.

- 200 again.

Charging.

- Clear.

- Okay, okay.

[machine beeping]

I got a pulse.

♪ ♪

[sighs]

- Her, um... her
pupils are blown.

- No. No, no, no, no, no.

Watch out, watch out.

She's brain dead, isn't she?

- Let's, um, let's intubate.

Put her on a vent
until we confirm

and hear from her contact.

- What, did I miss something?

Is there something
else I could have done?

- I sincerely doubt that.

- I'm OB/GYN. This
isn't what I do.

- Probably a pseudoaneurysm
the CT didn't pick up.

- Or I didn't see it.

- Hannah, nobody did.

All right?

This kind of thing
happens. Not your fault.

- Really?

Hardly your area of
expertise, either.

♪ ♪

- It's true. I can
perform miracles.

But this?

I mean, I've never
seen such distraction

and dislocation
of skull to spine

and still have
the patient alive.

- Yeah. I've been thinking.

It doesn't seem like we
could take the standard

posterior approach, not
with all the massive

scalp and neck lacerations.
- Yeah.

And an occipital bone only
a few millimeters thick.

- Yeah. So what do we do?

Go in through the mouth?

- Yeah.

Transoral.

- Are you serious?

- It's the only
option for anterior

atlanto-occipital
screw fixation.

But it's not a good one.

- Has it ever been done before?

- Once or twice in
cadaver studies.

- Cadaver.

Never on a live patient.
- That's correct.

And they were adult cadavers.

I have no idea if it
could work on a child.

[apprehensive music]

- Survival rate for this
kind of injury is, what, 50%?

What do you give this kid?

- 5%, best.

- We gotta increase those odds.

♪ ♪

- Dennis, the ED is overwhelmed
and has got to clear rooms.

Every department needs to
find beds for more patients.

Well, double up the private
rooms if you have to.

[knocking on door] Come in.

- Ms. Goodwin.

We have a ten-year-old boy with
atlanto-occipital dislocation.

- I'm sorry to hear that.

- Yeah, well, the thing
is, we can't attempt

the standard surgical approach.

We have to try going
in through the mouth.

- Whoa.

- And why are you
bringing this to me?

- Because this has never
been done before on a child.

In fact, it's only been
done on adult cadavers.

I need you to
authorize my using 2.0.

- 2.0? No.

Come on, it's a disaster.

It hallucinated data.

You can't use the hybrid OR?

- Not up to the task.

- And you've managed to
put up guardrails on 2.0?

I think I have.
- Oh, you think?

- I've run simulations,

and the platform's
performed very well.

- Yeah, but not
with a real patient.

- No, not since...

- It sent this hospital
into bankruptcy.

- Look, 2.0's tech
is more advanced

than anything else
in this hospital.

I believe in it.

And I believe it's
that boy's only hope.

- Sharon, come on.

I mean, the liability,
potential lawsuits...

- Peter.

If it's the boy's only hope,
what choice do we have?

You have my authorization.

- Thank you.

- Dr. Marcel.
- Yeah?

Our new owners...
they're business people.

The surgery goes south,
they're gonna want your head.

- I hear you.

- And they're gonna
want your head too.

- What else is new?

- Dean, did you get Sean's text?

He was admitted to pre-op
for tomorrow's surgery.

- Oh. No.

- Hey, why don't you
go up and see him?

We'll manage.

- I'm sorry about your patient.

Are you gonna be okay?

- You mean, am I gonna
head to the ladies room

and shoot up?
- Oh, stop it.

- Sorry. Sorry.

Yeah.

- All right.
- I'll be fine.

- Okay.

- Dr. Ripley.

I'm Dan Charles.

We've met before.

Haven't we? We
know each other.

- Good memory.

It was 20 years ago.

I looked a little different.

- Dr. Ripley, take a look.
Mr. Shorr's labs are in.

- Excuse me.

[knocks on window]

Harris, Audrey.

- Hey, Doc.

- So...

your blood work shows
elevated glucose, LDL...

inflammatory markers.

Have you experienced
unusual weight gain?

- [scoffs] Uh, yeah.

Look at this gut.

- These are all
metabolic symptoms,

which can be associated with
the mood stabilizers you're on.

- Is that serious?

- It can be life threatening.

- Oh, my God.

I knew something was wrong.

You think that his mood
stabilizers are the problem?

- What I think is that your
husband is overmedicated.

Too many medications and at
unnecessarily high doses.

They're putting him at risk.

- But his doctor
prescribed them.

- Doctors can be wrong, honey.

No offense.

[apprehensive music]

What do we do?

- I wanna try taking you off

one of your meds,
the quetiapine,

and see if your metabolic
symptoms improve.

- Take him off?

- Just while he's
here in the hospital

where we can keep him
under observation.

If there is a problem, we
can put him right back on.

- [sighs]

Yeah, okay.

Let's do it.

- Okay.

♪ ♪

- Archer.

I just started the intake on a
little girl from the accident.

Maybe you wanna weigh in.

- All right, Hannah.

You've had a tough loss, and
I have every faith that...

- I'm asking because she's
a recent kidney recipient.

- Oh.

Hello, Kayla.

I'm Dr. Archer.
- Hi.

- Hi.
- I'm her dad, Tom.

- Yes.

I understand you got
a new kidney, huh?

- Uh-huh.
- Yeah.

- About three months ago.

- We're waiting on labs,
but Kayla is not showing

any obvious signs of
injury from the accident.

But her X-rays were good.

- I told you I was fine, Dad.

- She didn't wanna come in,

but, you know, I
worry about her.

- Of course.

BP's a little soft.

- She's tachy.

- I don't feel bad, really.

- All right, I'm gonna
touch your tummy, okay?

This hurt?
- No.

- No? How about here?

- Uh-uh.

- Here?

- Ow.
- Hmm.

- Uh, just hurts a little bit.
- Yeah?

Did this start today
after the accident?

- Maybe.

- Were you wearing
your seatbelt, Kayla?

- Dad doesn't drive
me if I don't.

- What are you getting at?

- When your car
stopped abruptly,

if the seatbelt was riding high,

it might have pulled across her
abdomen instead of her hips.

- So it could have
damaged her kidney?

- Well, possibly.

But let's not get
ahead of ourselves.

We're gonna send Kayla
for a CT to check, okay?

- It's okay. I'll be fine.

- Her kidney's
bleeding, isn't it?

- She could lose it, yeah.

♪ ♪

- Hey. Daniel.

We are swamped. I'm
looking for beds.

Can you see if anyone
qualifies for early discharge

in the psych unit?

- From... yeah. Yep.

- Yeah?
- Yeah.

- Hey.

What's the matter?

- I ran into a
patient of mine...

well, actually, somebody
who was a patient of mine,

like, 20 years ago, when
they were a teenager.

- And?

- They were violent back then.

You know, put another
kid in the hospital.

I mean, they're... seemed to
really turn their life around.

Fancy college,
fancy... fancy job.

I mean, it's actually a
great story is what it is.

- So... so it's good?
- It's good.

It's really good. Yeah. Good.
- Okay.

Now you can help me out?
- Okay.

- Find me some beds?
- I'll look, yeah. I'll look.

- Okay. Thank you.

- Thanks, Dr. Cameron.
Appreciate it.

- Hey.
- Hey.

Dr. Cameron says
I'm good to go.

- Oh, yeah?

- Bloodwork,
imaging, all perfect.

Congratulations.

- Yeah.

Congratulations.

You don't have to
do this, you know.

- What are you talking
about? I want to do this.

I'm just sorry it
hasn't happened sooner.

I'm sorry about a lot of things.

- You're sorry?

What are you sorry about?

'Cause if anybody's got
something to be sorry for,

that's me.
- Dad, please stop.

Hey.

Do you remember that family
that lived next door?

The Barns?

- Yeah.
- Well, they had a daughter.

Sarah.

Just a couple years
younger than me.

Anyway, she lost her cat.

And she was crying
and everything.

Like, really upset.

So I went to look for it.

And weirdly enough, I
found it under our porch.

So I got it and I
brought it back to her.

And she was so...

[chuckles]

Happy.

And it was, like, the
best day of my life.

Best day of my life.

Till now.

[sentimental music]

♪ ♪

[suspenseful music]

- I've often thought your
judgment was suspect,

but this, this might be your
most boneheaded idea yet.

- You know 2.0 is
Brice's best chance.

- Of what, dying on the table?

- So what you wanna do, Sam?

You want me to find
another neurosurgeon?

- No.

I'm the only one
who might be able

to save you from yourself.

But how in God's name are
you gonna be able to verify

what the AI is telling us?

- Oh, I won't be alone.

I'll be working with
the best neurosurgeon

on the planet, right?

♪ ♪

- Tom, Kayla, this
is Dr. Cameron.

He's our chief of
kidney transplant.

- Hello.

Dr. Archer shared Kayla's
CT and labs with me.

- So, Kayla, your labs indicate
that even before the accident,

your kidney was not doing well.

- And the CAT scan shows
what we call an active blush,

which means the
kidney is bleeding.

It's... well, it's not
working at all now.

- Oh, God.

- It failed?

- Yes.

- So it's back on
dialysis, I guess.

- I'm afraid so.

- Yes, but first we
need to send you to IR.

That's Interventional Radiology

to embolize the kidney
to stop the bleeding.

- Okay.
- All right.

We need this done right away.
I'll go get things moving.

- Thank you.

- Dr. Cameron is gonna
take very good care of you.

Okay? He's the best.

And I know this because
he's my doctor too.

- You have kidney disease?

- Yes, I do.

- I'm really sorry.

[sentimental music]

- Oh, thanks.

[draws shaky breath]

Um, all right, there's
somebody gonna come, uh,

take you down to IR soon, okay?

♪ ♪

Hey, Mark.

By any chance, is Sean
a match for Kayla?

- I'm sorry?

- Could Sean, you know,
donate his kidney to Kayla?

- Sean is donating
his kidney to you.

Why would you even ask that?

No.

He's not a match.

- Dean, can I talk to you?

- Yeah?
- What the hell?

You'd have Sean give
his kidney to Kayla?

- Hey, it's not your
business, Hannah.

- [laughing] Not my business.

Okay, that's pretty
cold, even for you.

- You've had a lousy
day. It's not my problem.

- No. Hey, hey.

All this time, I thought
that you were worried

about Sean giving up his kidney.

But that's not it at all.

What really bothers you is
that he's giving it up to you.

- Yeah, well, maybe because
there's a 13-year-old girl

out there who needs a kidney.

- And you don't?

Look at you.

- Listen, this is my son.

And he wants to sacrifice
a piece of himself for me.

- Yeah, he does.

- Look, I don't...

I don't deserve it.

All right? I was
a terrible father.

Do you get that?
- I get it.

- Do you get that?

- [softly] I get it.

I get it. I get it.

You feel unworthy.

Yeah.

I'm an addict.

Okay, I... no, I know.

I know what it feels
like to be unworthy.

So does Sean.

And he knows about loneliness

and about being cut
off from everybody.

And take it from me,
drugs are a great way

to fill that space.
- Hannah, please.

- No, now you listen to me.

Your son doesn't
want drugs anymore.

He wants connection.

And he wants it
with his father...

his father, whom he loves.

You feel unworthy.

But if you deny Sean this,
you will destroy him.

♪ ♪

- [sighs

[indistinct yelling]

- I don't wanna be
here. Let me go!

- What's going on?
- I don't know.

- No, I'm gonna go.

You gotta let me get
out of here, okay?

Let me out of here!
- Security!

- I said let me out of here!

Let me... I'm getting out.

No! They're gonna kill me!

They're gonna kill me. No!

Get me out of here!
- Okay, okay.

- No! No, why did
you bring me here?

- I'm good.

There you go.

There you go.

I'm good, guys. Thank you.

- Can I have a little quick
look at his chart, please?

Dr. Ripley, can I, um...

could I get a
quick word, please?

So you took Mr. Harris
off his quetiapine.

I'm just curious
why you did that.

- He's a bomb about to go off.

Did you look at his chart?

Dyspnea, high BP, blood sugar,
low HDL, central obesity.

I need to find out if
that's from his meds.

- And it didn't
occur to you to maybe

just call in psych
for a little consult?

I mean, I've been here all day.

- He's not your patient.

- He's looking an awful lot
like a psych patient to me.

- Not today.

Today, he's an ED patient
with metabolic syndrome.

- Who just flipped out 'cause
you took him off his meds.

- To keep him from having
a coronary or stroking out.

He is overmedicated.

- You can't know that.

- Quetiapine,
lithium, lamotrigine?

All neurotransmitter modulators.

They overlap.
They're redundant.

- They are not redundant.

The two mood stabilizers
are actually complementary.

Okay? And quetiapine...

- Yeah, yeah. You
guys love to medicate.

- You can't just stop it.

I mean, honestly, Dr. Ripley, I
think what you did today was...

a little reckless.

- Reckless?

- Reckless.

- Well, come on, Dr. Charles.
Why don't you just say it?

"Impulse control disorder."

Isn't that what you
called it back then?

- Oh, so you took him off
his meds 'cause of me?

- I took Mr. Shorr
off one drug,

the one most likely
to be causing

his metabolic
symptoms, and I did so

in a controlled
clinical setting.

Now, I'm an attending
physician at this hospital.

Do not treat me like the
boy you knew 20 years ago.

[soft tense music]

♪ ♪

- [sighs]

- Dissecting soft
tissue to prepare

the anterior C1 ring for the
AO transarticular screws.

2.0, what is the ideal
screw entry point?

- Ideal entry point
is lower one third

of midline of C1 lateral mass,

just above C1-2 joint capsule.

- Yeah, that's what
the cadaver studies

in our simulation suggested.

Drill.

Okay.

Starting with the left
side, drilling laterally,

posteriorly, and upwardly.

- The kid's end tidal
CO2 just dipped.

- 2.0, assess.

- Based on baseline
and trending vitals,

there is high likelihood
of venous air embolism.

- Is that really the case?

Slight dip could
be bronchospasm,

poor tissue perfusion,
or nothing at all.

- Yeah, 2.0, verify venous
air embolism, please.

- Verified.

There is a greater than
75% chance of mortality

or catastrophic outcome.

Address immediately.

- I don't know, maybe the damn
thing's hallucinating again.

- Yeah.

- BP's just a tad low. 85/49.

- Hey, we need to
finish this surgery.

Get this kid off the table.
- No, hold on.

Lower his head.

Place a precordial doppler

and set up for a
transesophageal echo.

- Crockett.

- An air embolism
could kill him.

We have to know what
we're dealing with.

[suspenseful music]

[soft rumbling]

- That sound from the doppler...

it's air bubbles.

- Yeah, I think when we
drilled into the bone,

it got sucked into
the vascular system

directly to the heart.
[machine beeping]

- BP is dropping more now.

65/33.

And heart rate, too, at 36.

- There it is.

Significant air bubbles.

- Yeah, they're embolizing
into the pulmonary artery,

causing right heart strain.

- Yeah, 2.0 was correct.

Marty, give the kid
100% O2 and bag him up.

- Coming.

But I'm having trouble
ventilating and oxygenating.

80% sat.
- Confirmed.

Critically significant hypoxia
and poor systemic perfusion.

- We're gonna have to suction
the air out of the kid's heart.

Give me the Swan-Ganz catheter.

- Seeing ST segment
changes on EKG.

- Got about a minute before
complete cardiac collapse.

- We're gonna float
the existing cordis

right into the pulmonary artery.

- Vitals are tanking.

Systolics in the 40s.
- Get a crash cart.

- In the right
ventricle. Balloon up.

- Balloon's up. Go ahead.

- Okay, advancing.

♪ ♪

- Any day now, Crockett.

- Almost.

Okay, I'm in the
pulmonary artery.

Syringe?
- On it.

[alarm beeping, blaring]

- No air.

- Barely seeing
an arterial trace.

He's bradying down.

- Cardiac arrest is imminent.

- Push a milligram
of atropine now.

- Advancing further.
Balloon down.

♪ ♪

Come on.

[alarm stops] Got air.

- BP, heart rate.

- Pulmonary air embolism
successfully addressed.

- Audrey?

- Thank you.
- You're welcome.

- Poor Harris.

He works so hard to stay well.

- It's a rough illness.

- I wish more people
saw it that way

and not as some kind of failing.

Your husband's one of the
rare ones who understands.

He was always so
good to our son.

There was a time that Harris
had to be hospitalized.

Michael was so scared and upset,

and Mr. Ben really
helped him through it.

Made him see that people can
get sick in different ways.

And that his daddy
was gonna be okay.

- He will be, Audrey.

He will be.

- That was nice... what
she said about Ben.

- Yeah, to tell you
the truth, Doris,

I really don't wanna
hear about Ben.

- Okay.

- Hey, Doris, what's
happening with the hamster?

- No one wants it. I
called animal control.

- Dean, I saw tomorrow's
surgical schedule.

Looks like you're
getting that transplant.

- Yeah.

- Dr. Charles.

Judith's CT showed an
acute subdural hematoma.

Her doctor has her
on blood thinners,

so it could get worse.

- So she needs surgery?
- Yeah.

Thing is, she's
refusing treatment.

Says she wants to die.

She's suicidal.

We could hold her?

- Uh, we could.

But let me, um, let
me have a chat first.

- Yeah.

- Judith, I'm Dr. Charles.

We, uh, we met earlier today.

I don't know if
you remember that.

I am being told that
you don't want us

to treat your hematoma.

It's just important for me
that I know that you understand

that, if left untreated,
that it could kill you.

- I don't deserve to live.

[crying]

- Okay.

Can I ask you a question?

If somebody that you knew
and that you cared about

were in exactly
the same situation,

is that what you'd say to them?

Would you say that they
didn't deserve to live?

I mean, I... I don't think so.

I mean, you wouldn't, would you?

What you'd say to
them, probably, is...

"It wasn't your fault."

- But this was my fault.

I hit the brakes, and the
car just started spinning,

and I crashed first,

and then all of the other cars
started to crash behind me.

If it hadn't been for me,

none of this would
have happened.

- You hit some black
ice. It was an accident.

You didn't hurt all
those people on purpose.

[apprehensive music]

One of the hardest
moments in life

is when we figure out

how little control
we actually have

over the things that
happen to us, right?

But... but what we can control
is how we respond to them.

And I just know that
with a little time,

clarity will come, you know?

And maybe, just
maybe, you might even

get around to doing one
of the hardest things

that a human being can
learn how to do, which is...

to forgive yourself.

But if you don't...

let us help you,
there's just no chance

that that's gonna happen.

♪ ♪

So would you let us help you?

Okay.

- Okay, Brice, squeeze
my hands for me.

Good. Good.

Can you wiggle your
feet back and forth?

Okay, now stick your
tongue straight out.

Even the hypoglossal's
working well.

I think your son's
gonna be fine.

- Thank you.
- Okay.

- Thank you.

- We'll give you some
time with your boy.

- You're gonna be okay, okay?

[soft sentimental music]

- Did you hear? Ivy
was an organ donor.

- Oh?

- Yeah. Dr. Archer
had her typed.

Turns out she's a match
for a little girl here

who needs a kidney.

- Archer?

No, I hadn't heard.

- Just thought it might make
you feel a little better.

♪ ♪

- Mags, grab your coat, and
I will walk you to your car.

- [chuckles] No.

Janine's running a
couple hours late,

and I said that I'd cover
for her until she gets here.

- No. You've been
working nonstop all day.

Have somebody else cover.
- That's okay. I don't mind.

- No. You need to
go home to Ben.

He's probably wondering
where his wife is.

- Ben's just fine.

- Mm, if I had a guy like
Ben waiting for me...

- Just stop.

[quietly] Stop, okay?

Stop.

Everybody keeps on talking
about my wonderful Ben.

Well, my wonderful
husband wants a divorce.

- No.

♪ ♪

- Mitch.

- If this is about Mr. Shorr,
he is rational again.

Back on his full
panoply of meds.

We still need to address his
metabolic issues, and soon.

- Of course.

But, um, you know, what
I really came up here

to tell you is
how impressed I am

with how you turned
your life around.

You know, truly. I
mean, you've done...

you've done so well.

- Better than you expected?

- Well, I mean, you
had a lot to overcome.

- Yeah.

Top of the list,
maybe county juvenile.

My psych care, remember?

Haldol, Zyprexa...
the whole candy store.

- I do. I remember.

I remember that
you were violent,

and you were aggressive.

It was a big place,
a lot of kids.

You know, we had
to protect them.

- Chemical restraints.

They worked.

I couldn't move, couldn't sleep.

Couldn't pee, either.

It's fun times.

- Look, we know a whole lot
more about those meds now

than we did then.

You know, we've gotten
much better at dosing.

I mean, frankly, you
probably were overmedicated.

You were.

- And then you booked.

- I booked?

- You took off. You left.

- Well, I mean, I imagine
that's because I had a...

that my... my rotation
was probably...

- Okay.

[soft tense music]

♪ ♪

[dramatic music]

♪ ♪

[wolf howls]