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1
00:00:04,076 --> 00:00:06,744
I'm incising the uterine wall.
2
00:00:06,746 --> 00:00:09,580
You're doing great, really great.
3
00:00:09,582 --> 00:00:10,914
It's gonna be okay.
4
00:00:10,916 --> 00:00:13,049
You promise?
5
00:00:14,086 --> 00:00:17,662
- Baby's out.
- Umbilical clip. Suction.
6
00:00:17,664 --> 00:00:18,920
Please...
7
00:00:18,922 --> 00:00:20,590
can I see my daughter?
8
00:00:20,592 --> 00:00:21,824
Yes.
9
00:00:21,826 --> 00:00:23,226
Of course.
10
00:00:26,215 --> 00:00:27,381
Sorry.
11
00:00:27,383 --> 00:00:29,049
We'll need to get her into surgery.
12
00:00:29,051 --> 00:00:30,818
We'll take good care of her.
13
00:00:32,000 --> 00:00:38,074
14
00:00:43,833 --> 00:00:47,134
Your New Chief is fashionably late.
15
00:00:47,136 --> 00:00:48,601
Our Chief.
16
00:00:48,603 --> 00:00:51,405
Just because I endorsed
Dr. Han to the Board
17
00:00:51,407 --> 00:00:52,772
doesn't mean I don't have any concerns.
18
00:00:52,774 --> 00:00:55,442
Connections like Dr. Han's
come at a premium
19
00:00:55,444 --> 00:00:57,344
and, he assures me, will be well worth it
20
00:00:57,346 --> 00:00:59,246
given our current predicament
with the Medical Board.
21
00:00:59,248 --> 00:01:01,949
I'm not just worried about the money.
22
00:01:01,951 --> 00:01:03,583
When you pay that much,
23
00:01:03,585 --> 00:01:05,632
they tend to think they're worth it.
24
00:01:06,341 --> 00:01:08,221
Makes a person think
they don't have to show up
25
00:01:08,223 --> 00:01:10,131
for their own welcome brunch.
26
00:01:21,902 --> 00:01:23,269
The baby's bowel protrusion
27
00:01:23,271 --> 00:01:26,005
seemed less severe
on the prenatal imaging.
28
00:01:26,007 --> 00:01:27,539
And it'll have to wait until
29
00:01:27,541 --> 00:01:29,241
we're done with her heart problem.
30
00:01:29,243 --> 00:01:33,079
Now that I'm in here, her septum
looks more like Swiss cheese.
31
00:01:35,783 --> 00:01:38,684
Page the on-call
neonatal cardiac surgeon.
32
00:01:38,686 --> 00:01:40,719
That won't be necessary. I'll scrub in.
33
00:01:40,721 --> 00:01:42,754
And who are you?
34
00:01:42,756 --> 00:01:44,357
I'm Jackson Han.
35
00:01:44,359 --> 00:01:46,092
Your new Chief of Surgery.
36
00:01:50,298 --> 00:01:58,308
Synced & corrected by -robtor-
www.addic7ed.com
37
00:02:02,576 --> 00:02:04,610
Echo probe, please.
38
00:02:05,946 --> 00:02:07,779
And let's turn that music on.
39
00:02:12,452 --> 00:02:14,052
Advance the delivery sheath.
40
00:02:16,690 --> 00:02:18,356
It's in the patient's heart, Dr. Murphy.
41
00:02:18,358 --> 00:02:21,626
I think the music
is a little distracting.
42
00:02:21,628 --> 00:02:23,961
I feel the same way about
operating without music.
43
00:02:24,864 --> 00:02:26,664
I'll take a longer sheath,
44
00:02:26,666 --> 00:02:28,866
and Dr. Murphy will need some forceps.
45
00:02:34,206 --> 00:02:37,542
5-second rule.
46
00:02:40,513 --> 00:02:43,881
It was a joke.
47
00:02:44,918 --> 00:02:46,350
What about her bowels?
48
00:02:46,352 --> 00:02:49,286
Why isn't Dr. Lim inserting it
into the abdomen right now?
49
00:02:49,288 --> 00:02:51,755
There is not enough room.
50
00:02:51,757 --> 00:02:54,258
There's... There's not enough room
51
00:02:54,260 --> 00:02:56,060
without increasing abdominal pressure,
52
00:02:56,062 --> 00:02:59,263
which would critically decrease
blood flow to the bowel.
53
00:02:59,265 --> 00:03:01,798
According to what
hemodynamic principle...
54
00:03:01,800 --> 00:03:03,140
Dr. Browne?
55
00:03:03,142 --> 00:03:05,169
Vascular impedance...
blood flow is driven
56
00:03:05,171 --> 00:03:06,670
by the force induced
by the pressure gradient.
57
00:03:06,672 --> 00:03:08,138
And how do you calculate it?
58
00:03:10,192 --> 00:03:12,008
Uh. Um...
59
00:03:12,010 --> 00:03:13,577
I-I'd have to look it up.
60
00:03:15,381 --> 00:03:18,248
8 times L.Nu. divided by Pi.R.4.
61
00:03:18,250 --> 00:03:20,650
Very good, Dr. Murphy.
62
00:03:20,652 --> 00:03:22,619
That's also why this occluder won't work.
63
00:03:22,621 --> 00:03:24,420
It won't hold up against
the huge pressure gradient
64
00:03:24,422 --> 00:03:26,556
- in her heart.
- Is there a fix?
65
00:03:26,558 --> 00:03:28,291
Long-term, I don't have one.
66
00:03:28,293 --> 00:03:31,094
Right now, I need umbilical tape
and PE tubing.
67
00:03:38,451 --> 00:03:41,237
You're making a pulmonary artery band.
68
00:03:41,239 --> 00:03:42,739
That should buy us some time
69
00:03:42,741 --> 00:03:45,500
to come up with a plan
before we lose this baby.
70
00:03:51,860 --> 00:03:53,682
Lab technician to O.R. 6.
71
00:03:53,684 --> 00:03:55,084
Lab technician to O.R. 6.
72
00:03:58,055 --> 00:04:00,422
You canceled my hernia repair?
73
00:04:00,424 --> 00:04:03,325
With no advance notice. Sorry about that.
74
00:04:03,327 --> 00:04:04,627
But so great to meet you.
75
00:04:04,629 --> 00:04:05,828
Jackson Han.
76
00:04:05,830 --> 00:04:07,395
- Neil Melendez.
- Oh, I know.
77
00:04:07,397 --> 00:04:09,898
You did great work on
that piggyback heart transplant.
78
00:04:09,900 --> 00:04:11,199
Huh.
79
00:04:11,201 --> 00:04:13,401
I need a consult on Minesh Goyal.
80
00:04:13,403 --> 00:04:14,837
He's the founding CEO of a company...
81
00:04:14,839 --> 00:04:17,172
- What's his diagnosis?
- He doesn't have one.
82
00:04:17,174 --> 00:04:20,242
He's here for a full physical,
complete diagnostic workup.
83
00:04:20,244 --> 00:04:22,978
I have a long-standing
Executive Wellness...
84
00:04:22,980 --> 00:04:25,647
I'm a surgeon, not an internist.
85
00:04:25,649 --> 00:04:27,616
I don't do preventative medicine.
86
00:04:27,618 --> 00:04:30,170
No matter how rich the patient is.
87
00:04:30,654 --> 00:04:33,355
You know what's great
about rich patients?
88
00:04:33,357 --> 00:04:35,759
They allow us to treat poor patients.
89
00:04:36,527 --> 00:04:38,260
Also, I promised Minesh the very best.
90
00:04:38,262 --> 00:04:40,447
So, really, who else am I gonna get?
91
00:04:42,132 --> 00:04:43,831
Dr. Johansen to pre-op.
92
00:04:43,833 --> 00:04:46,000
Dr. Johansen to pre-op.
93
00:04:47,371 --> 00:04:49,070
BP's 110 over 70.
94
00:04:50,106 --> 00:04:52,541
Uh, Jackson... Dr. Han...
95
00:04:52,543 --> 00:04:54,242
says great things about you.
96
00:04:55,745 --> 00:04:57,447
That's very kind.
97
00:04:58,482 --> 00:05:00,748
Normal EKG, optimal BMI,
98
00:05:00,750 --> 00:05:02,483
heart and lungs sound good.
99
00:05:02,485 --> 00:05:03,918
Any reason you're worried
enough about your health
100
00:05:03,920 --> 00:05:06,087
to endure an entire day of tests?
101
00:05:06,089 --> 00:05:08,022
I'm not worried.
102
00:05:09,759 --> 00:05:11,592
Knowledge is power.
103
00:05:11,594 --> 00:05:13,494
Whenever I enter a new market,
104
00:05:13,496 --> 00:05:16,097
I learn everything I can
about the landscape...
105
00:05:16,099 --> 00:05:18,966
consumer needs, target market,
competitors.
106
00:05:18,968 --> 00:05:20,534
You're aware your body isn't a business.
107
00:05:22,238 --> 00:05:24,205
I know I sound like a rich lunatic
108
00:05:24,207 --> 00:05:27,519
with fantasies about controlling
every aspect of my life.
109
00:05:28,664 --> 00:05:30,197
And I guess I kind of am.
110
00:05:33,583 --> 00:05:36,111
My dad was in good shape, too.
111
00:05:36,719 --> 00:05:39,322
Until he dropped dead on his daily jog.
112
00:05:50,399 --> 00:05:52,132
Hi.
113
00:05:52,134 --> 00:05:55,502
Dr. Markiel, please
come to the mental health unit.
114
00:05:55,504 --> 00:05:59,540
Dr. Markiel, please come
to the mental health unit.
115
00:06:10,132 --> 00:06:11,531
Hi.
116
00:06:12,587 --> 00:06:15,088
Hi. I'm Larry Childs.
117
00:06:15,090 --> 00:06:16,890
I'd shake your hand, but, you know,
118
00:06:16,892 --> 00:06:18,458
no functioning immune system.
119
00:06:19,628 --> 00:06:21,762
- Aaron. Hi.
- Good to meet you.
120
00:06:21,764 --> 00:06:23,396
What flavor cancer do you have?
121
00:06:25,000 --> 00:06:26,900
- What flavor?
- Yeah.
122
00:06:26,902 --> 00:06:28,368
Glioma.
123
00:06:28,370 --> 00:06:29,870
Shut the front door.
124
00:06:29,872 --> 00:06:31,666
Brain or spine?
125
00:06:32,007 --> 00:06:33,673
- Brain.
- Dude...
126
00:06:33,675 --> 00:06:34,841
we're tumor twins.
127
00:06:34,843 --> 00:06:37,911
Wh-What do they have you on?
128
00:06:37,913 --> 00:06:39,246
Ooh. Vincristine.
129
00:06:39,248 --> 00:06:40,445
I hear that's intense.
130
00:06:40,447 --> 00:06:42,447
My doc thought it would wipe me out.
131
00:06:42,449 --> 00:06:44,817
You doing okay or longing for death?
132
00:06:44,819 --> 00:06:46,986
I am hanging in there. Thank you.
133
00:06:47,432 --> 00:06:49,955
I'm on my third round of temozolomide.
134
00:07:00,514 --> 00:07:02,381
I've seen you in here a few times.
135
00:07:04,638 --> 00:07:05,838
I've seen you in here a few times.
136
00:07:05,840 --> 00:07:07,953
You kind of keep to yourself, huh?
137
00:07:09,076 --> 00:07:10,409
Yeah.
138
00:07:10,411 --> 00:07:11,911
Well, I'm happy to introduce you around.
139
00:07:11,913 --> 00:07:13,245
It's a really friendly group.
140
00:07:13,247 --> 00:07:14,378
I'm okay. Thank you.
141
00:07:14,380 --> 00:07:16,014
You have a support group you go to?
142
00:07:17,050 --> 00:07:18,713
I do not.
143
00:07:19,352 --> 00:07:21,341
Everyone needs a cancer community.
144
00:07:54,554 --> 00:07:56,253
And try to hold still.
145
00:07:57,757 --> 00:07:59,045
Thank you.
146
00:07:59,525 --> 00:08:00,825
For bringing us in.
147
00:08:00,827 --> 00:08:03,193
This is the new Chief's patient.
It's a great opportunity.
148
00:08:03,195 --> 00:08:05,663
Or it's a bunch of pointless tests.
149
00:08:07,933 --> 00:08:10,368
Uh, for which I thank you.
150
00:08:10,370 --> 00:08:12,035
Tell us about Dr. Han.
151
00:08:12,037 --> 00:08:14,705
He's direct, charming,
152
00:08:14,707 --> 00:08:15,939
very sure of himself.
153
00:08:15,941 --> 00:08:17,608
Big ego.
154
00:08:21,513 --> 00:08:24,848
There's nothing wrong with
an ego if you can back it up.
155
00:08:24,850 --> 00:08:26,783
And Dr. Han's arterial switch technique
156
00:08:26,785 --> 00:08:28,818
is performed all over the world.
157
00:08:28,820 --> 00:08:30,820
The tests aren't all pointless.
158
00:08:30,822 --> 00:08:32,589
Way to stand firm, Park.
159
00:08:32,591 --> 00:08:34,090
No, look at the monitor.
160
00:08:34,092 --> 00:08:35,425
He has a tumor.
161
00:09:00,885 --> 00:09:02,618
Percy's stable?
162
00:09:02,620 --> 00:09:05,621
We're naming her Persephone.
163
00:09:05,623 --> 00:09:09,158
Yes. I put in a central line
for nutrition.
164
00:09:09,160 --> 00:09:10,526
Percy is stable right now.
165
00:09:10,528 --> 00:09:13,662
We're looking for solutions
to her problems.
166
00:09:13,664 --> 00:09:15,998
W-Wh-Why does...
167
00:09:16,000 --> 00:09:18,401
Why does she have
all these birth defects?
168
00:09:18,403 --> 00:09:19,793
Diane.
169
00:09:20,271 --> 00:09:21,737
We spoke to our obstetrician.
170
00:09:21,739 --> 00:09:24,297
She said these defects can
happen for no reason, right?
171
00:09:25,943 --> 00:09:27,142
That's true.
172
00:09:27,144 --> 00:09:29,978
Over 50% have no known cause.
173
00:09:32,182 --> 00:09:36,717
I was taking paroxetine
for clinical depression.
174
00:09:36,719 --> 00:09:37,986
And you went off the meds
175
00:09:37,988 --> 00:09:39,554
as soon as you found out
you were pregnant.
176
00:09:39,556 --> 00:09:42,190
She was five, six weeks at most.
177
00:09:42,192 --> 00:09:43,858
My OB told me studies show
178
00:09:43,860 --> 00:09:46,527
antidepressants are safe
to take during pregnancy.
179
00:09:46,529 --> 00:09:47,829
But is that true,
180
00:09:47,831 --> 00:09:49,530
or is she protecting me?
181
00:09:51,801 --> 00:09:55,036
There was a study that
associated paroxetine
182
00:09:55,038 --> 00:09:56,671
with these kinds of defects.
183
00:09:56,673 --> 00:09:59,040
It is a possibility.
184
00:10:10,467 --> 00:10:12,663
You can't tell whether
it's cancerous or benign?
185
00:10:12,688 --> 00:10:13,953
Not until we do the biopsy,
186
00:10:13,955 --> 00:10:15,855
which I've scheduled for later.
187
00:10:15,857 --> 00:10:17,424
We'll know what's going on
by the morning.
188
00:10:19,327 --> 00:10:20,593
Good.
189
00:10:20,595 --> 00:10:22,062
That's good.
190
00:10:24,833 --> 00:10:27,333
Maybe you'd like to call someone?
191
00:10:27,335 --> 00:10:29,502
A family member, a friend?
192
00:10:29,504 --> 00:10:31,504
I'll worry when I know it's cancer.
193
00:10:41,149 --> 00:10:43,850
We could use a transcatheter route
194
00:10:43,852 --> 00:10:46,504
and patch each hole individually.
195
00:10:47,055 --> 00:10:48,588
Her heart's the size of a walnut.
196
00:10:48,590 --> 00:10:51,224
It's too small to maneuver inside.
197
00:10:51,226 --> 00:10:53,525
A single large patch to close the holes
198
00:10:53,527 --> 00:10:54,793
would withstand the pressure.
199
00:10:54,795 --> 00:10:56,128
Yes.
200
00:10:58,099 --> 00:11:00,465
It would also block
electrical conduction,
201
00:11:00,467 --> 00:11:02,735
causing deadly arrhythmias.
202
00:11:02,737 --> 00:11:04,522
Dr. Murphy...
203
00:11:05,405 --> 00:11:08,340
did you tell the mom that she
caused her baby's birth defect?
204
00:11:08,342 --> 00:11:12,655
No. I said that
her antidepressants could have.
205
00:11:13,547 --> 00:11:15,180
Why did you tell her that?
206
00:11:15,658 --> 00:11:17,616
It's the truth.
207
00:11:17,618 --> 00:11:20,497
And is that relevant to
her current medical situation?
208
00:11:21,588 --> 00:11:22,821
No.
209
00:11:24,491 --> 00:11:27,559
And how did you think
that answer would make her feel?
210
00:11:27,561 --> 00:11:29,466
What did you think would happen?
211
00:11:31,197 --> 00:11:33,364
The mother is devastated.
212
00:11:33,366 --> 00:11:34,966
The father is furious.
213
00:11:34,968 --> 00:11:36,300
I would be, too.
214
00:11:36,302 --> 00:11:38,102
Shaun is a resident.
215
00:11:38,104 --> 00:11:39,670
Residents make mistakes.
216
00:11:40,774 --> 00:11:42,807
Managing these parents'
emotional concerns
217
00:11:42,809 --> 00:11:45,609
is as much a part of this job
as operating on their daughter.
218
00:11:45,611 --> 00:11:48,012
Social cues are hard for Shaun,
219
00:11:48,014 --> 00:11:49,413
but we've been working with him...
220
00:11:49,415 --> 00:11:51,415
You should be focused
on your own shortcomings,
221
00:11:51,417 --> 00:11:54,322
like retaining the formula
for vascular impedance.
222
00:11:55,054 --> 00:11:56,420
Dr. Han.
223
00:11:59,159 --> 00:12:01,793
We could patch each
individual hole in the heart
224
00:12:01,795 --> 00:12:03,661
if we cut open the ventricle...
225
00:12:03,663 --> 00:12:05,328
Don't change the subject, Dr. Murphy.
226
00:12:05,330 --> 00:12:06,830
I didn't, Dr. Han.
227
00:12:06,832 --> 00:12:09,232
We were talking about the baby.
228
00:12:09,234 --> 00:12:10,713
Really?
229
00:12:11,503 --> 00:12:13,770
You don't see a difference
in the nature of your discussion
230
00:12:13,772 --> 00:12:15,705
before I arrived and after?
231
00:12:17,375 --> 00:12:21,111
We were talking about the baby.
232
00:12:26,618 --> 00:12:29,452
They tried the approach you
suggested at L.A. Children's.
233
00:12:29,454 --> 00:12:31,288
The baby died a week later.
234
00:12:31,290 --> 00:12:34,691
The suture line didn't hold,
and the cardiac wall ruptured.
235
00:12:34,693 --> 00:12:35,758
Keep looking.
236
00:12:35,760 --> 00:12:37,994
Dr. Murphy,
237
00:12:37,996 --> 00:12:40,743
do not talk with those parents again.
238
00:12:44,368 --> 00:12:45,767
I'll walk with you.
239
00:12:49,273 --> 00:12:51,106
You're pretty tough on my residents.
240
00:12:51,108 --> 00:12:52,441
Rebuking them in public,
241
00:12:52,443 --> 00:12:55,010
pimping them with questions
during surgery.
242
00:12:55,012 --> 00:12:56,645
Shame-based learning isn't my style.
243
00:12:56,647 --> 00:12:58,714
I'll bear that in mind.
244
00:12:58,716 --> 00:13:00,716
But this isn't about
my treatment of "the residents."
245
00:13:00,718 --> 00:13:02,384
You're concerned about Dr. Murphy.
246
00:13:02,386 --> 00:13:04,920
Well, a lot of doctors have
less than ideal bedside manner.
247
00:13:04,922 --> 00:13:06,755
- He's young...
- Would you ever have said
248
00:13:06,757 --> 00:13:08,824
something like that
to a patient as a resident?
249
00:13:08,826 --> 00:13:10,459
As a med student?
250
00:13:10,461 --> 00:13:11,593
And Murphy doesn't even understand
251
00:13:11,595 --> 00:13:12,895
he did anything wrong.
252
00:13:12,897 --> 00:13:14,363
Shaun has hard-wired differences
253
00:13:14,365 --> 00:13:16,531
- in the way he perceives things.
- Exactly.
254
00:13:16,533 --> 00:13:17,733
No matter how hard he works,
255
00:13:17,735 --> 00:13:20,502
no matter how hard you try and help him,
256
00:13:20,504 --> 00:13:23,104
his limitations are not going to change.
257
00:13:23,106 --> 00:13:26,441
He's going to continue to
inflict them on our patients...
258
00:13:26,443 --> 00:13:29,143
all in the name of diversity
and inclusion.
259
00:13:31,682 --> 00:13:33,415
Shaun deserves to be here.
260
00:13:34,551 --> 00:13:37,619
Once you see what he's
capable of, you'll agree.
261
00:13:37,621 --> 00:13:39,386
I look forward to being proven wrong.
262
00:13:45,016 --> 00:13:46,795
Stay seated for 20 minutes.
263
00:13:46,797 --> 00:13:48,323
Don't want you passing out in the lobby.
264
00:13:48,325 --> 00:13:49,963
I know, I know. Thank you.
265
00:13:55,318 --> 00:13:57,070
This disease changed my relationships,
266
00:13:57,072 --> 00:13:59,874
changed my priorities, changed...
267
00:13:59,876 --> 00:14:01,241
who I am.
268
00:14:01,243 --> 00:14:02,574
Cancer is an identity.
269
00:14:02,576 --> 00:14:04,712
Cancer is cellular mutation.
270
00:14:04,714 --> 00:14:06,881
The people in this room are my people.
271
00:14:06,883 --> 00:14:09,983
What are you... 20 years old?
I'm triple your age.
272
00:14:09,985 --> 00:14:11,285
I don't think you're my "people."
273
00:14:11,287 --> 00:14:13,533
The last time I hung out with
my law-school friends...
274
00:14:13,535 --> 00:14:14,523
epic fail.
275
00:14:14,548 --> 00:14:16,413
The fact that you use
the phrase "epic fail,"
276
00:14:16,415 --> 00:14:17,558
kind of case in point.
277
00:14:17,560 --> 00:14:19,460
They're all focused on what firm
they're gonna land at,
278
00:14:19,462 --> 00:14:21,562
and I'm all about whether...
279
00:14:21,564 --> 00:14:23,330
Candice's leukemia is responding
280
00:14:23,332 --> 00:14:25,032
to her new chemo regimen.
281
00:14:25,034 --> 00:14:26,599
By the way, she has this peppermint oil
282
00:14:26,601 --> 00:14:28,393
that is great for headaches.
283
00:14:32,741 --> 00:14:34,874
Ooh, I know that look.
284
00:14:34,876 --> 00:14:36,317
Here, here.
285
00:14:41,750 --> 00:14:43,583
Got you, brother...
286
00:14:43,585 --> 00:14:45,052
whether you like it or not.
287
00:14:49,458 --> 00:14:51,358
Show me where we are.
288
00:14:51,360 --> 00:14:54,127
That angle runs pretty close
to the sacral nerve roots.
289
00:14:55,697 --> 00:14:57,063
How are we doing?
290
00:14:57,065 --> 00:14:58,497
Tumor's abutting the iliac artery.
291
00:14:58,499 --> 00:15:00,299
I'm trying not to disrupt
the entire blood supply
292
00:15:00,301 --> 00:15:01,600
to his lower body.
293
00:15:01,602 --> 00:15:03,302
Dr. Han, I'm Morgan Reznick.
294
00:15:03,304 --> 00:15:05,604
I really enjoyed your article on Myotomy
295
00:15:05,606 --> 00:15:08,641
for infantile hypertrophic
pyloric stenosis.
296
00:15:09,444 --> 00:15:12,578
I appreciate the thorough
research behind your sucking up.
297
00:15:12,580 --> 00:15:14,380
And you are?
298
00:15:14,382 --> 00:15:15,848
Alex Park.
299
00:15:15,850 --> 00:15:18,317
Park... you were a cop.
300
00:15:18,319 --> 00:15:20,919
Medicine as a second career...
good stuff.
301
00:15:20,921 --> 00:15:22,989
Tends to bring a fresh perspective.
302
00:15:25,593 --> 00:15:28,127
I hit an artery. Take the needle.
303
00:15:28,129 --> 00:15:29,294
Blood's pooling in the pelvis.
304
00:15:29,296 --> 00:15:30,958
- Should we open him up?
- No.
305
00:15:30,960 --> 00:15:32,530
Prep the femoral artery.
Get me an art cath set.
306
00:15:32,532 --> 00:15:34,550
- Pressure's dropping.
- Platinum coil.
307
00:15:41,441 --> 00:15:43,718
Nice save.
308
00:15:44,344 --> 00:15:45,943
Next time, don't hit the vessel.
309
00:15:47,447 --> 00:15:49,614
There is no next time.
310
00:15:49,616 --> 00:15:51,449
The biopsy's too dangerous.
311
00:15:57,190 --> 00:16:00,558
It is likely that it's
a benign notochord cell tumor.
312
00:16:00,560 --> 00:16:02,343
They look like chordomas,
313
00:16:02,345 --> 00:16:03,828
but they're harmless and way more common.
314
00:16:03,830 --> 00:16:05,162
But you don't know.
315
00:16:05,164 --> 00:16:07,231
Since we can't do the biopsy, no.
316
00:16:08,300 --> 00:16:10,286
This is the problem with broad testing.
317
00:16:11,103 --> 00:16:12,637
Everyone has abnormalities.
318
00:16:12,639 --> 00:16:14,171
Most of them are nothing.
319
00:16:14,173 --> 00:16:15,840
But when we do find them,
320
00:16:16,125 --> 00:16:17,942
we have to make some tough choices.
321
00:16:19,178 --> 00:16:22,212
So, what exactly is my tough choice?
322
00:16:23,841 --> 00:16:25,516
We could remove the tumor.
323
00:16:25,518 --> 00:16:27,151
This is a very risky surgery.
324
00:16:27,153 --> 00:16:29,353
There's a chance of paralysis or worse...
325
00:16:29,355 --> 00:16:31,140
you may not make it off the table.
326
00:16:31,724 --> 00:16:33,434
Or you do nothing.
327
00:16:33,760 --> 00:16:35,360
We'd continue to monitor it,
328
00:16:35,362 --> 00:16:36,726
do imaging every few weeks.
329
00:16:36,728 --> 00:16:38,828
But chordomas move very quickly.
330
00:16:38,830 --> 00:16:40,931
By the time any change
showed up on imaging,
331
00:16:40,933 --> 00:16:43,433
it's most likely metastasized
throughout your body.
332
00:16:45,537 --> 00:16:49,039
So it probably isn't cancer,
333
00:16:49,041 --> 00:16:52,576
but if it is and I wait, then I'll die.
334
00:16:52,578 --> 00:16:54,044
That's true.
335
00:16:54,046 --> 00:16:57,948
And if I don't wait
and I get the surgery,
336
00:16:57,950 --> 00:16:59,849
then there's a good chance I'll die.
337
00:16:59,851 --> 00:17:00,951
Yes.
338
00:17:06,324 --> 00:17:08,491
I'm gonna need to think this over.
339
00:17:23,442 --> 00:17:27,577
This is the May
Annals of Neonatal Surgery.
340
00:17:27,579 --> 00:17:30,779
I just finished March.
I need to read April now.
341
00:17:30,781 --> 00:17:32,448
Oh, I have April, Shaun.
342
00:17:32,450 --> 00:17:34,016
No.
343
00:17:34,018 --> 00:17:36,210
No, you're supposed to be reading
344
00:17:36,212 --> 00:17:38,673
New Approaches in Neonatal Surgery.
345
00:17:38,675 --> 00:17:41,419
Claire has the British Journal
of Neonatology...
346
00:17:49,500 --> 00:17:51,533
Shaun...
347
00:17:51,846 --> 00:17:54,802
I think maybe you should
be quiet around Han
348
00:17:54,804 --> 00:17:57,018
for a little while.
349
00:17:57,641 --> 00:18:00,074
But then how will I answer his questions?
350
00:18:01,897 --> 00:18:04,646
Direct questions, absolutely answer.
351
00:18:04,648 --> 00:18:06,914
Otherwise, outside of the O.R.,
352
00:18:06,916 --> 00:18:08,683
you should stay out of his way.
353
00:18:11,588 --> 00:18:14,189
If someone had convinced Shaun
to do that with Dr. Melendez,
354
00:18:14,191 --> 00:18:16,558
he would still be on suction.
355
00:18:20,230 --> 00:18:22,464
Code blue... NICU, Bed 4.
356
00:18:22,466 --> 00:18:25,133
Code blue... NICU, Bed 4.
357
00:18:27,937 --> 00:18:30,604
O2 SATs dropped and central
venous pressure shot up.
358
00:18:30,606 --> 00:18:32,239
The Pulmonary Artery Band is failing.
359
00:18:32,241 --> 00:18:34,275
- Eight of dopamine.
- Let's get a mask on her.
360
00:18:34,277 --> 00:18:36,577
She won't last much longer.
We need other options.
361
00:18:36,579 --> 00:18:38,345
I'll update the parents.
362
00:18:39,983 --> 00:18:41,961
Let's get her on full cardiac support.
363
00:18:57,028 --> 00:18:59,134
What have you got? Anything?
364
00:18:59,180 --> 00:19:01,079
This Cleveland group
365
00:19:01,081 --> 00:19:03,715
repaired a bowel protrusion
using enterolysis.
366
00:19:03,717 --> 00:19:06,251
I could cut out this excess
inflammatory tissue
367
00:19:06,253 --> 00:19:07,717
and segment of bowel atresia.
368
00:19:07,719 --> 00:19:09,829
Might make her intestines
small enough to fit.
369
00:19:09,831 --> 00:19:11,089
Promising.
370
00:19:11,091 --> 00:19:12,691
Given the size of her abdomen,
371
00:19:12,693 --> 00:19:14,059
I need to remove a lot of bowel.
372
00:19:14,061 --> 00:19:16,562
There's a good chance she
wouldn't be able to absorb food.
373
00:19:16,564 --> 00:19:18,319
We'll have to find the right balance.
374
00:19:18,319 --> 00:19:20,285
It's our only workable plan.
375
00:19:20,287 --> 00:19:22,253
Best bet on the heart is
to cut through the ventricle,
376
00:19:22,255 --> 00:19:24,055
like Murphy suggested.
377
00:19:24,057 --> 00:19:26,891
Uh, you were concerned about
the suture line holding.
378
00:19:26,893 --> 00:19:28,493
Well, I still am.
379
00:19:28,495 --> 00:19:30,761
Hopefully, horizontal
mattress sutures will work.
380
00:19:30,763 --> 00:19:32,097
They should be able
to withstand the tension
381
00:19:32,099 --> 00:19:33,598
at the suture line.
382
00:19:33,600 --> 00:19:35,900
There's still
a risk of an aneurysm forming
383
00:19:35,902 --> 00:19:37,935
in the tissue underneath.
384
00:19:40,773 --> 00:19:42,456
Dr. Lim?
385
00:19:42,876 --> 00:19:45,210
I have an idea I'd like to share,
386
00:19:45,212 --> 00:19:47,879
even though Dr. Han
didn't ask me a question.
387
00:19:52,085 --> 00:19:54,151
Yeah, go ahead, Shaun.
388
00:19:54,153 --> 00:19:56,020
If we go in through the atrium,
389
00:19:56,022 --> 00:19:57,854
we wouldn't have to worry
about the suture line...
390
00:19:57,856 --> 00:19:59,689
It's the same issue we discussed.
391
00:19:59,691 --> 00:20:01,691
There's not enough room
inside the baby's heart
392
00:20:01,693 --> 00:20:03,193
to stitch the patches in the place.
393
00:20:03,195 --> 00:20:05,695
Oh, we don't need to, Dr. Han.
394
00:20:05,697 --> 00:20:08,198
We can make a plug
small enough for her heart...
395
00:20:08,200 --> 00:20:10,600
a PTFE disc with a stem like a mushroom.
396
00:20:10,602 --> 00:20:12,403
Then we can insert the stem
through one of the holes
397
00:20:12,405 --> 00:20:14,104
until the disc presses against the wall,
398
00:20:14,106 --> 00:20:15,656
covering all the holes.
399
00:20:16,575 --> 00:20:20,444
L-Like a stopper in a bathtub.
400
00:20:20,446 --> 00:20:21,711
Yes.
401
00:20:21,713 --> 00:20:23,580
The higher pressure on
the left side of her heart
402
00:20:23,582 --> 00:20:24,948
would keep it in place.
403
00:20:24,950 --> 00:20:26,883
We wouldn't even need to stitch.
404
00:20:28,421 --> 00:20:30,353
Great idea.
405
00:20:30,355 --> 00:20:32,088
We should take this to the parents.
406
00:20:32,090 --> 00:20:33,889
Great idea for the heart.
407
00:20:33,891 --> 00:20:36,459
But we need to tell them that
our current plan
408
00:20:36,461 --> 00:20:37,493
for the abdominal repair
409
00:20:37,495 --> 00:20:39,929
is considerably more of a long shot.
410
00:20:39,931 --> 00:20:42,516
And that fixing the heart
takes an option off the table.
411
00:20:43,368 --> 00:20:45,234
Withdrawing care.
412
00:20:54,645 --> 00:20:56,447
You can't move that card.
413
00:20:56,948 --> 00:20:58,414
Excuse me?
414
00:20:58,416 --> 00:20:59,615
Who cheats at solitaire?
415
00:20:59,617 --> 00:21:01,184
You're literally only cheating yourself.
416
00:21:01,186 --> 00:21:02,552
Again.
417
00:21:02,554 --> 00:21:03,919
Good morning, Larry.
418
00:21:03,921 --> 00:21:05,754
Is it a macho thing?
419
00:21:05,756 --> 00:21:07,522
Like a real man should
be able to make it through
420
00:21:07,524 --> 00:21:10,025
without leaning on a label
or the people who go with it?
421
00:21:12,129 --> 00:21:14,096
Embracing cancer as an identity
422
00:21:14,098 --> 00:21:16,364
is the last thing
any one of us should be doing.
423
00:21:16,366 --> 00:21:19,534
It underscores everything
horrible right now.
424
00:21:20,437 --> 00:21:22,370
We're in a daily battle for our lives.
425
00:21:22,372 --> 00:21:24,573
I see no value in dwelling on that.
426
00:21:28,946 --> 00:21:30,512
Candice is late.
427
00:21:31,816 --> 00:21:34,182
Which means either her niece
forgot to pick her up.
428
00:21:34,184 --> 00:21:36,278
Again.
429
00:21:36,821 --> 00:21:38,697
Or she got some bad news.
430
00:21:39,590 --> 00:21:41,256
Or she's already dead.
431
00:21:43,494 --> 00:21:46,261
We are in a daily battle.
432
00:21:49,166 --> 00:21:51,454
I'd rather have some company.
433
00:22:07,217 --> 00:22:09,117
I spoke to my mother and brother,
434
00:22:09,119 --> 00:22:11,730
and they both think
I shouldn't do the surgery.
435
00:22:12,389 --> 00:22:14,322
Apparently they're more scared
of your surgical skills
436
00:22:14,324 --> 00:22:15,985
than they are of this tumor.
437
00:22:17,194 --> 00:22:19,093
And where do you stand?
438
00:22:19,095 --> 00:22:21,062
I need numbers.
439
00:22:21,064 --> 00:22:22,363
Please.
440
00:22:25,869 --> 00:22:28,872
The stats on something like this, it...
441
00:22:29,472 --> 00:22:30,738
there are a lot of variables.
442
00:22:30,740 --> 00:22:32,807
What are the odds
I make it through the surgery
443
00:22:32,809 --> 00:22:35,129
without any complications?
444
00:22:35,745 --> 00:22:37,945
It's a challenging procedure.
445
00:22:37,947 --> 00:22:40,782
Zero complications, I'd say 80%.
446
00:22:42,351 --> 00:22:45,452
But it is very unlikely
this tumor is malignant.
447
00:22:45,454 --> 00:22:47,182
Give me a number.
448
00:22:47,924 --> 00:22:50,558
About 5% chance it's a chordoma.
449
00:22:57,900 --> 00:23:00,067
The numbers agree with your family.
450
00:23:00,069 --> 00:23:01,569
So do I.
451
00:23:10,313 --> 00:23:11,878
I've always been
more comfortable with action
452
00:23:11,880 --> 00:23:13,447
than inaction.
453
00:23:16,885 --> 00:23:19,286
I want you to do the surgery.
454
00:23:22,658 --> 00:23:24,786
Certainty comes at a price.
455
00:23:33,535 --> 00:23:36,369
She'll be able to get off
the life support machines?
456
00:23:36,371 --> 00:23:38,238
If everything goes well, yes.
457
00:23:38,240 --> 00:23:39,972
She'll have a strong heart.
458
00:23:39,974 --> 00:23:41,807
How soon can you do it?
459
00:23:43,478 --> 00:23:45,144
You should know we feel less confident
460
00:23:45,146 --> 00:23:47,201
about our plan for her bowel.
461
00:23:47,582 --> 00:23:50,316
The chance of failure is quite high.
462
00:23:50,318 --> 00:23:51,784
How high?
463
00:23:51,786 --> 00:23:54,721
I put it at 90%
that the repair won't work.
464
00:23:54,723 --> 00:23:57,823
Which would lead
to irreversible malnutrition.
465
00:23:57,825 --> 00:24:01,340
Your daughter would slowly
starve to death over months.
466
00:24:02,029 --> 00:24:04,130
Right now, her body is working very hard
467
00:24:04,132 --> 00:24:05,397
just to stay alive.
468
00:24:08,702 --> 00:24:11,003
If we were to turn off the machines...
469
00:24:11,005 --> 00:24:12,958
Turn off the machines?
470
00:24:15,743 --> 00:24:18,816
...she would pass quickly.
And peacefully.
471
00:24:19,346 --> 00:24:21,680
If the heart surgery is a success,
472
00:24:21,682 --> 00:24:23,783
that won't be an option.
473
00:24:23,785 --> 00:24:25,617
Oh.
474
00:24:25,619 --> 00:24:27,519
Why not try to fix the bowel first
475
00:24:27,521 --> 00:24:28,720
to see if it works?
476
00:24:28,722 --> 00:24:30,522
We won't know if the bowel is viable
477
00:24:30,524 --> 00:24:32,258
until after the heart is.
478
00:24:33,460 --> 00:24:35,874
We have to do the surgery.
479
00:24:36,229 --> 00:24:38,530
But if this doesn't work,
she could starve to death.
480
00:24:38,532 --> 00:24:41,433
- It's worth the risk...
- It's not our risk. It's hers.
481
00:24:41,435 --> 00:24:44,803
So, instead, you're ready
to give up on our daughter?
482
00:24:44,805 --> 00:24:47,339
I mean, it's like we're
right back at the ultrasound.
483
00:24:47,341 --> 00:24:49,941
We decided together
to continue this pregnancy.
484
00:24:49,943 --> 00:24:51,910
So this is as much
my fault as it is yours.
485
00:24:51,912 --> 00:24:53,312
My fault?
486
00:24:53,314 --> 00:24:55,280
Because of the medication?
487
00:24:56,917 --> 00:25:00,315
I cannot turn off that machine.
488
00:25:01,021 --> 00:25:03,855
Your guilt is stopping you from
admitting what we need to do.
489
00:25:03,857 --> 00:25:06,490
My guilt has nothing to do with this.
490
00:25:06,492 --> 00:25:09,227
- I am fighting for my daughter.
- So am I.
491
00:25:11,675 --> 00:25:13,676
Since the parents can't agree,
the decision
492
00:25:13,678 --> 00:25:15,960
about the baby's care
will be made by a judge
493
00:25:15,962 --> 00:25:17,814
who will rely on our recommendation.
494
00:25:18,399 --> 00:25:20,032
So we make the choice,
495
00:25:20,034 --> 00:25:21,600
but the parents live with it?
496
00:25:24,131 --> 00:25:25,804
Well, maybe that's a good thing.
497
00:25:27,474 --> 00:25:29,507
For parents to have to decide between
498
00:25:29,509 --> 00:25:31,243
letting their daughter die
499
00:25:31,245 --> 00:25:34,980
or fighting for her life,
knowing she may suffer horribly,
500
00:25:34,982 --> 00:25:37,477
maybe it's better
if we carry that burden.
501
00:25:40,221 --> 00:25:41,820
Dr. Lim?
502
00:25:41,822 --> 00:25:43,322
Your decision would be?
503
00:25:44,791 --> 00:25:46,491
Take her off life support.
504
00:25:46,493 --> 00:25:48,660
The odds are stacked against
the bowel repair working.
505
00:25:48,662 --> 00:25:51,696
Those numbers reflect the
general population of doctors.
506
00:25:51,698 --> 00:25:54,102
I think Dr. Lim and I
are better than that.
507
00:25:54,703 --> 00:25:56,163
We can beat the odds.
508
00:26:03,921 --> 00:26:05,562
One of the things I'm not going to miss
509
00:26:05,564 --> 00:26:07,245
about being Chief of Surgery
510
00:26:07,247 --> 00:26:10,135
is being responsible
for choices like this.
511
00:26:12,852 --> 00:26:15,219
Dr. Han, it's your department...
512
00:26:15,221 --> 00:26:16,888
it's your call.
513
00:26:24,430 --> 00:26:26,230
You've been here all night?
514
00:26:26,735 --> 00:26:28,165
I've been working on a case
515
00:26:28,167 --> 00:26:30,768
with the new Chief of Surgery, Dr. Han.
516
00:26:30,770 --> 00:26:33,388
- How's that going?
- Not very well.
517
00:26:33,390 --> 00:26:35,405
He plays music in the operating room.
518
00:26:35,407 --> 00:26:36,889
Oh, geez. One of those.
519
00:26:36,891 --> 00:26:38,191
And he says I need to focus on
520
00:26:38,193 --> 00:26:40,290
our patients' emotional needs.
521
00:26:40,745 --> 00:26:42,845
Well, that's a tough assignment for you.
522
00:26:43,708 --> 00:26:45,175
Mm.
523
00:26:49,466 --> 00:26:53,167
You ever wish you had, you know,
524
00:26:53,169 --> 00:26:55,892
friends, co-workers on the spectrum?
525
00:26:56,264 --> 00:26:57,860
Not usually.
526
00:26:57,862 --> 00:27:00,773
But maybe Dr. Han
wouldn't notice me as much
527
00:27:00,775 --> 00:27:03,105
if I weren't the only doctor with ASD.
528
00:27:06,204 --> 00:27:08,103
There's this kid in chemo,
529
00:27:08,105 --> 00:27:11,288
just obsessed with having cancer.
530
00:27:11,315 --> 00:27:12,615
It's all he talks about.
531
00:27:12,617 --> 00:27:14,254
He wants to be friends
with everybody in the ward.
532
00:27:14,256 --> 00:27:15,926
That's very smart of him.
533
00:27:15,928 --> 00:27:19,121
Speigel et Al. showed
an increase in overall survival
534
00:27:19,123 --> 00:27:21,491
and quality of life measures
in breast cancer patients
535
00:27:21,493 --> 00:27:24,527
who formed social bonds with
others battling the disease.
536
00:27:25,430 --> 00:27:27,430
What should I do about Dr. Han?
537
00:27:29,901 --> 00:27:32,735
I don't know. Um...
538
00:27:32,737 --> 00:27:34,404
just do your work,
539
00:27:34,406 --> 00:27:36,706
be a good surgeon,
be an excellent surgeon.
540
00:27:36,708 --> 00:27:38,941
Over time, he'll forget about the autism.
541
00:27:38,943 --> 00:27:40,342
Why would that happen?
542
00:27:40,344 --> 00:27:43,345
He'll see that you have
the skill, you have dedication.
543
00:27:43,347 --> 00:27:45,680
I have autism.
544
00:27:45,682 --> 00:27:47,449
It's part of who I am.
545
00:27:58,129 --> 00:27:59,761
The judge...?
546
00:27:59,763 --> 00:28:01,463
Accepted our recommendation
547
00:28:01,465 --> 00:28:03,373
and ruled in favor of surgery.
548
00:28:04,001 --> 00:28:05,479
Thank you, Doctor.
549
00:28:11,042 --> 00:28:12,441
Okay, Percy.
550
00:28:14,278 --> 00:28:16,145
Momma loves you.
551
00:28:19,149 --> 00:28:20,458
I love you, Percy.
552
00:28:55,995 --> 00:28:57,661
Should we remove more bowel?
553
00:28:57,663 --> 00:28:58,863
That would take us to the ilium.
554
00:28:58,865 --> 00:29:01,032
She won't gain enough weight to thrive.
555
00:29:01,429 --> 00:29:03,128
Her abdominal muscles are tight
556
00:29:03,130 --> 00:29:05,393
from developing around an empty cavity.
557
00:29:07,968 --> 00:29:10,635
They're cinched around
her tummy like a corset.
558
00:29:10,637 --> 00:29:12,037
What if we unbuttoned it?
559
00:29:12,039 --> 00:29:13,205
Released the muscle
560
00:29:13,207 --> 00:29:15,473
and increased the abdominal
circumference.
561
00:29:15,475 --> 00:29:16,782
Those muscles are part
of her abdominal wall.
562
00:29:16,807 --> 00:29:18,310
Not if we separate the layers...
563
00:29:18,312 --> 00:29:21,113
create a plane between
the skin and the muscle.
564
00:29:22,950 --> 00:29:24,817
You good if Murphy and I
start on the heart?
565
00:29:25,652 --> 00:29:28,220
Dr. Browne, you're with me
on the abdomen.
566
00:29:29,623 --> 00:29:30,923
Clearing the field.
567
00:29:30,925 --> 00:29:32,925
Han is on the call schedule next weekend.
568
00:29:32,927 --> 00:29:35,160
Maybe Carmen will switch with me
so I can cover with him?
569
00:29:35,162 --> 00:29:38,262
Or maybe you shouldn't try so hard.
570
00:29:38,264 --> 00:29:39,761
Retractor.
571
00:29:40,634 --> 00:29:42,567
Some of us don't have
a cool former career...
572
00:29:42,569 --> 00:29:44,235
or an easy-going, mellow demeanor.
573
00:29:44,237 --> 00:29:45,603
People are never gonna crowd in my corner
574
00:29:45,605 --> 00:29:46,871
because I'm just so likable.
575
00:29:46,873 --> 00:29:48,906
Well, you could try being nice to them.
576
00:29:48,908 --> 00:29:50,642
- Well, this is easier.
- There it is.
577
00:29:53,347 --> 00:29:55,046
Does it look like cancer?
578
00:29:55,048 --> 00:29:56,815
It's not labeled.
579
00:29:56,817 --> 00:29:59,155
We're all gonna have to wait
for the pathologist's report.
580
00:30:01,020 --> 00:30:02,587
Probe.
581
00:30:07,594 --> 00:30:09,227
The artery is in the way.
582
00:30:09,229 --> 00:30:11,529
We can't get at the tumor
without him bleeding out.
583
00:30:16,469 --> 00:30:17,969
We're gonna have
to take it from the back.
584
00:30:17,971 --> 00:30:21,072
- But the S1 nerve root...
- Is something he can live without.
585
00:30:21,074 --> 00:30:22,606
Dissecting scissors.
586
00:30:26,512 --> 00:30:27,912
Pledget anchor.
587
00:30:43,129 --> 00:30:44,262
The plug is in position.
588
00:30:44,264 --> 00:30:46,244
You ready to test the bowel repair?
589
00:30:48,000 --> 00:30:49,566
Let's take her off cardiac support.
590
00:30:49,568 --> 00:30:51,368
Dr. Murphy, it was your idea.
591
00:30:51,370 --> 00:30:52,969
You do the honors.
592
00:31:03,749 --> 00:31:06,683
Abdominal pressure is normal.
593
00:31:06,685 --> 00:31:09,052
The intestines are perfusing.
594
00:31:12,257 --> 00:31:14,324
Pulmonary pressure's spiking.
595
00:31:14,326 --> 00:31:15,526
Prostacyclin and nitric oxide...
596
00:31:15,528 --> 00:31:16,727
we need to get her lung pressure down.
597
00:31:16,729 --> 00:31:18,295
Oxygen SATs are dropping.
598
00:31:18,297 --> 00:31:20,563
No response to pulmonary vasodilators.
599
00:31:20,565 --> 00:31:23,299
Now the heart's too strong.
It's overpowering her lungs.
600
00:31:23,301 --> 00:31:25,367
She needs to go back on cardiac support.
601
00:31:33,645 --> 00:31:37,045
Persephone won't starve to death...
602
00:31:37,615 --> 00:31:39,949
but she will drown in her own fluids.
603
00:31:54,665 --> 00:31:56,197
I'll talk to the parents.
604
00:31:56,199 --> 00:31:57,566
May I come?
605
00:32:09,112 --> 00:32:11,713
Now that Persephone's heart
is pumping at full power,
606
00:32:11,715 --> 00:32:13,448
her lungs are overwhelmed.
607
00:32:15,185 --> 00:32:16,885
The humane thing to do
608
00:32:16,887 --> 00:32:19,554
is to turn off the machines
and let her go.
609
00:32:20,724 --> 00:32:22,632
No, I-I can't...
610
00:32:22,960 --> 00:32:24,493
I can't give up on her.
611
00:32:27,564 --> 00:32:29,389
Because you fought for her
612
00:32:30,366 --> 00:32:32,633
every minute since she was born.
613
00:32:32,635 --> 00:32:34,935
Before that, when you were
taking your medication
614
00:32:34,937 --> 00:32:36,069
for the depression,
615
00:32:36,071 --> 00:32:37,897
you were fighting to keep going
616
00:32:38,407 --> 00:32:40,140
so you could bring her into the world.
617
00:32:56,458 --> 00:32:59,527
But letting go of Percy
is not giving up on her.
618
00:33:01,597 --> 00:33:04,397
It's listening to what
her body is telling us.
619
00:33:09,203 --> 00:33:10,537
She's hit her limit.
620
00:33:27,789 --> 00:33:29,622
Okay.
621
00:34:03,875 --> 00:34:05,708
I want Persephone to look
as good as possible
622
00:34:05,710 --> 00:34:07,243
for the parents.
623
00:34:12,216 --> 00:34:14,149
Let's turn off cardiac support.
624
00:34:19,256 --> 00:34:20,823
Ventilator.
625
00:34:22,225 --> 00:34:23,792
Let's take a minute.
626
00:35:07,104 --> 00:35:08,769
Check valve.
627
00:35:13,110 --> 00:35:15,543
Every time the heart contracted,
628
00:35:15,545 --> 00:35:17,778
blood went into the opposite
side of the heart
629
00:35:17,780 --> 00:35:19,680
and raised lung pressure.
630
00:35:19,682 --> 00:35:22,416
The hole reduced the pressure
when it got too high
631
00:35:22,418 --> 00:35:23,817
because it allowed backflow.
632
00:35:23,819 --> 00:35:27,254
But our repair of the defect
blocked this backwards flow.
633
00:35:27,256 --> 00:35:29,656
What if we made it so
she still had a heart defect,
634
00:35:29,658 --> 00:35:31,558
but only when she needed it?
635
00:35:31,560 --> 00:35:35,529
It'd be like an unlatched door
in the wall of the heart.
636
00:35:35,531 --> 00:35:37,731
When the pressure gets too high
on the right side,
637
00:35:37,733 --> 00:35:40,600
the door swings open, releasing
the pressure on the lungs.
638
00:35:40,602 --> 00:35:42,503
The rest of the time, it stays shut.
639
00:35:42,505 --> 00:35:45,372
It should reduce lung pressure
by a third. Is that enough?
640
00:35:45,374 --> 00:35:46,507
It depends on how high
641
00:35:46,509 --> 00:35:48,509
her pulmonary vascular resistance is.
642
00:35:48,511 --> 00:35:50,877
PVR is pulmonary artery pressure
643
00:35:50,879 --> 00:35:53,980
minus wedge pressure divided
by cardiac output times 80.
644
00:36:04,846 --> 00:36:06,725
The last time I saw my doctor,
645
00:36:06,727 --> 00:36:09,628
he told me I had six months to live.
646
00:36:09,630 --> 00:36:11,431
He also told me I should
marry an accountant
647
00:36:11,433 --> 00:36:12,765
and move to North Dakota.
648
00:36:12,767 --> 00:36:14,367
You don't say.
649
00:36:14,369 --> 00:36:16,869
When I asked if it would
help my cancer, he said no,
650
00:36:16,871 --> 00:36:19,672
just make the six months
seem much longer.
651
00:36:23,010 --> 00:36:26,679
What's the difference between
a Neo-Nazi and cancer?
652
00:36:26,681 --> 00:36:28,274
Cancer doesn't discriminate.
653
00:36:31,519 --> 00:36:33,285
I knew a guy once...
654
00:36:33,287 --> 00:36:35,720
his Zodiac sign was Cancer.
655
00:36:35,722 --> 00:36:38,890
It was really ironic how he died.
656
00:36:40,260 --> 00:36:42,027
Uh, uh, how's that?
657
00:36:42,029 --> 00:36:43,962
He was eaten by a giant crab.
658
00:36:43,964 --> 00:36:47,832
Oh, geez.
659
00:36:49,269 --> 00:36:51,503
Aaron, glioma.
660
00:36:51,505 --> 00:36:54,038
Candice, leukemia.
661
00:36:54,040 --> 00:36:55,307
Gin rummy or blackjack?
662
00:36:55,309 --> 00:36:57,342
How fast do you want to take my money?
663
00:36:57,344 --> 00:36:58,843
Blackjack.
664
00:36:58,845 --> 00:37:00,326
Cut 'em.
665
00:37:12,243 --> 00:37:14,310
Did you get it all?
666
00:37:17,396 --> 00:37:18,829
Yes...
667
00:37:18,831 --> 00:37:20,764
totally clear margins.
668
00:37:20,766 --> 00:37:22,433
But the only way to achieve that
669
00:37:22,435 --> 00:37:24,935
involved removing the nerve
that controls your left foot.
670
00:37:26,572 --> 00:37:29,873
Rehab and an advanced orthotic may help,
671
00:37:29,875 --> 00:37:32,676
but you will walk with a limp.
672
00:37:32,678 --> 00:37:34,978
Final pathology will let us know
if it was worth it.
673
00:37:39,157 --> 00:37:40,984
I'll let you know when it comes in.
674
00:37:43,215 --> 00:37:45,481
It doesn't matter anymore.
675
00:37:48,412 --> 00:37:50,645
It's not like you can
put the tumor back in.
676
00:38:05,777 --> 00:38:08,344
Is she... okay?
677
00:38:09,447 --> 00:38:13,683
She still has a surgery or two
in her future, but, yes.
678
00:38:13,685 --> 00:38:15,276
She's gonna be great.
679
00:38:18,889 --> 00:38:20,422
Can I hold her?
680
00:38:20,424 --> 00:38:22,617
I think that would be very nice.
681
00:38:23,227 --> 00:38:25,093
For both of you.
682
00:38:40,010 --> 00:38:42,377
Hi, angel.
683
00:38:44,415 --> 00:38:47,249
Oh, my baby.
684
00:38:50,487 --> 00:38:52,019
Come hold her.
685
00:38:58,428 --> 00:39:00,928
You were fighting for her, too.
686
00:39:06,135 --> 00:39:08,569
She's beautiful.
687
00:39:15,712 --> 00:39:17,296
Nice work.
688
00:39:18,514 --> 00:39:20,132
Thank you.
689
00:39:21,050 --> 00:39:23,917
She's beautiful.
690
00:39:23,919 --> 00:39:25,486
Listen to her. Oh.
691
00:39:36,866 --> 00:39:38,398
Thank you.
692
00:39:43,538 --> 00:39:45,705
Minesh's biopsy results?
693
00:39:55,751 --> 00:39:57,050
You don't want to know
if we wasted our time
694
00:39:57,052 --> 00:39:58,462
almost killing him?
695
00:39:59,621 --> 00:40:01,488
Can't put the tumor back.
696
00:40:17,506 --> 00:40:19,692
Hello, Dr. Han.
697
00:40:20,208 --> 00:40:22,442
You take the bus, too?
698
00:40:22,444 --> 00:40:23,843
No, Shaun.
699
00:40:23,845 --> 00:40:26,282
I just wanted to talk to you.
700
00:40:29,017 --> 00:40:33,218
You really do have
remarkable diagnostic skills.
701
00:40:33,220 --> 00:40:36,188
I have to admit, you're an
asset to this hospital.
702
00:40:36,626 --> 00:40:38,390
Yes, I am.
703
00:40:41,061 --> 00:40:44,383
I spoke to the Residency
Director of Pathology.
704
00:40:45,032 --> 00:40:48,012
And we both agree
you'll be a great fit there.
705
00:40:50,438 --> 00:40:53,706
I'm a surgical resident.
706
00:40:53,708 --> 00:40:55,808
As a pathology resident,
707
00:40:55,810 --> 00:40:58,677
you'll touch cases and lives
708
00:40:58,679 --> 00:41:02,247
across all the medical departments.
709
00:41:02,249 --> 00:41:04,483
It's an opportunity
for you to help patients
710
00:41:04,485 --> 00:41:07,490
without having to deal with patients.
711
00:41:08,616 --> 00:41:12,457
Given your difficulties with
communication and social cues,
712
00:41:12,459 --> 00:41:14,955
I think it will be a much better fit.
713
00:41:15,795 --> 00:41:17,458
No, thank you.
714
00:41:18,292 --> 00:41:21,198
I have been working very hard
715
00:41:21,200 --> 00:41:24,006
at my communication skills.
716
00:41:24,571 --> 00:41:26,759
Hard work isn't enough.
717
00:41:27,507 --> 00:41:29,273
You have to do the job.
718
00:41:31,811 --> 00:41:36,080
I am a surgical resident.
719
00:41:37,884 --> 00:41:39,522
You were.
720
00:41:40,787 --> 00:41:43,520
And you're gonna do
great work in pathology.
721
00:41:44,305 --> 00:41:50,206
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