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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:01,407 --> 00:00:04,074 - [MONITOR BEEPING] - [BREATHING HEAVILY] 2 00:00:04,076 --> 00:00:06,744 DR. GARCIA: I'm incising the uterine wall. 3 00:00:06,746 --> 00:00:09,580 [SNIFFLES] You're doing great, really great. 4 00:00:09,582 --> 00:00:10,914 It's gonna be okay. 5 00:00:10,916 --> 00:00:13,049 You promise? 6 00:00:13,051 --> 00:00:14,084 [SMOOCHES] 7 00:00:14,086 --> 00:00:17,662 - Baby's out. - Umbilical clip. Suction. 8 00:00:17,664 --> 00:00:18,920 - [BABY CRYING] - Please... 9 00:00:18,922 --> 00:00:20,590 can I see my daughter? 10 00:00:20,592 --> 00:00:21,824 Yes. 11 00:00:21,826 --> 00:00:23,226 Of course. 12 00:00:26,215 --> 00:00:27,381 LIM: Sorry. 13 00:00:27,383 --> 00:00:29,049 We'll need to get her into surgery. 14 00:00:29,051 --> 00:00:30,818 We'll take good care of her. 15 00:00:30,820 --> 00:00:32,553 ♪♪ 16 00:00:32,555 --> 00:00:34,455 [BABY CRYING] 17 00:00:34,457 --> 00:00:43,831 ♪♪ 18 00:00:43,833 --> 00:00:47,134 Your New Chief is fashionably late. 19 00:00:47,136 --> 00:00:48,601 Our Chief. 20 00:00:48,603 --> 00:00:51,405 Just because I endorsed Dr. Han to the Board 21 00:00:51,407 --> 00:00:52,772 doesn't mean I don't have any concerns. 22 00:00:52,774 --> 00:00:55,442 Connections like Dr. Han's come at a premium 23 00:00:55,444 --> 00:00:57,344 and, he assures me, will be well worth it 24 00:00:57,346 --> 00:00:59,246 given our current predicament with the Medical Board. 25 00:00:59,248 --> 00:01:01,949 I'm not just worried about the money. 26 00:01:01,951 --> 00:01:03,583 When you pay that much, 27 00:01:03,585 --> 00:01:05,632 they tend to think they're worth it. 28 00:01:06,341 --> 00:01:08,221 Makes a person think they don't have to show up 29 00:01:08,223 --> 00:01:10,131 for their own welcome brunch. 30 00:01:10,133 --> 00:01:12,625 [INDISTINCT CONVERSATIONS] 31 00:01:13,795 --> 00:01:15,662 [BREATHES SHARPLY] 32 00:01:20,534 --> 00:01:21,900 [MONITOR BEEPING] 33 00:01:21,902 --> 00:01:23,269 CLAIRE: The baby's bowel protrusion 34 00:01:23,271 --> 00:01:26,005 seemed less severe on the prenatal imaging. 35 00:01:26,007 --> 00:01:27,539 LIM: And it'll have to wait until 36 00:01:27,541 --> 00:01:29,241 we're done with her heart problem. 37 00:01:29,243 --> 00:01:33,079 Now that I'm in here, her septum looks more like Swiss cheese. 38 00:01:33,081 --> 00:01:35,781 [MONITOR BEEPING] 39 00:01:35,783 --> 00:01:38,684 Page the on-call neonatal cardiac surgeon. 40 00:01:38,686 --> 00:01:40,719 That won't be necessary. I'll scrub in. 41 00:01:40,721 --> 00:01:42,754 LIM: And who are you? 42 00:01:42,756 --> 00:01:44,357 I'm Jackson Han. 43 00:01:44,359 --> 00:01:46,092 Your new Chief of Surgery. 44 00:01:46,094 --> 00:01:48,294 ♪♪ 45 00:01:50,298 --> 00:01:58,308 Synced & corrected by -robtor- www.addic7ed.com 46 00:02:00,240 --> 00:02:02,574 [MONITOR BEEPING STEADILY] 47 00:02:02,576 --> 00:02:04,610 Echo probe, please. 48 00:02:05,946 --> 00:02:07,779 And let's turn that music on. 49 00:02:09,850 --> 00:02:12,450 [LORD HURON'S "ANCIENT NAMES (PART 1)" PLAYS] 50 00:02:12,452 --> 00:02:14,052 Advance the delivery sheath. 51 00:02:14,054 --> 00:02:16,688 ♪♪ 52 00:02:16,690 --> 00:02:18,356 It's in the patient's heart, Dr. Murphy. 53 00:02:18,358 --> 00:02:21,626 I think the music is a little distracting. 54 00:02:21,628 --> 00:02:23,961 I feel the same way about operating without music. 55 00:02:24,864 --> 00:02:26,664 I'll take a longer sheath, 56 00:02:26,666 --> 00:02:28,866 and Dr. Murphy will need some forceps. 57 00:02:28,868 --> 00:02:30,668 ♪♪ 58 00:02:30,670 --> 00:02:32,503 - [FORCEPS CLATTER] - ♪ Well, the neon lights ♪ 59 00:02:32,505 --> 00:02:34,204 ♪ Glowed red and gold ♪ 60 00:02:34,206 --> 00:02:37,542 - ♪ I came to hear my fortune told ♪ - 5-second rule. 61 00:02:37,544 --> 00:02:40,511 ♪ I can't imagine what she saw ♪ 62 00:02:40,513 --> 00:02:43,881 - ♪ While gazing in her crystal ball ♪ - It was a joke. 63 00:02:43,883 --> 00:02:44,916 ♪♪ 64 00:02:44,918 --> 00:02:46,350 What about her bowels? 65 00:02:46,352 --> 00:02:49,286 Why isn't Dr. Lim inserting it into the abdomen right now? 66 00:02:49,288 --> 00:02:51,755 There is not enough room. 67 00:02:51,757 --> 00:02:54,258 There's... There's not enough room 68 00:02:54,260 --> 00:02:56,060 without increasing abdominal pressure, 69 00:02:56,062 --> 00:02:59,263 which would critically decrease blood flow to the bowel. 70 00:02:59,265 --> 00:03:01,798 According to what hemodynamic principle... 71 00:03:01,800 --> 00:03:03,140 Dr. Browne? 72 00:03:03,142 --> 00:03:05,169 Vascular impedance... blood flow is driven 73 00:03:05,171 --> 00:03:06,670 by the force induced by the pressure gradient. 74 00:03:06,672 --> 00:03:08,138 And how do you calculate it? 75 00:03:08,140 --> 00:03:10,190 ♪♪ 76 00:03:10,192 --> 00:03:12,008 Uh. Um... 77 00:03:12,010 --> 00:03:13,577 I-I'd have to look it up. 78 00:03:15,381 --> 00:03:18,248 8 times L.Nu. divided by Pi.R.4. 79 00:03:18,250 --> 00:03:20,650 Very good, Dr. Murphy. 80 00:03:20,652 --> 00:03:22,619 That's also why this occluder won't work. 81 00:03:22,621 --> 00:03:24,420 It won't hold up against the huge pressure gradient 82 00:03:24,422 --> 00:03:26,556 - in her heart. - Is there a fix? 83 00:03:26,558 --> 00:03:28,291 Long-term, I don't have one. 84 00:03:28,293 --> 00:03:31,094 Right now, I need umbilical tape and PE tubing. 85 00:03:31,096 --> 00:03:34,130 ♪ I gotta get away from here ♪ 86 00:03:34,132 --> 00:03:37,233 ♪ I'll never see the golden sunrise ♪ 87 00:03:37,235 --> 00:03:38,449 ♪ Oh, I gotta get away from her ♪ 88 00:03:38,451 --> 00:03:41,237 You're making a pulmonary artery band. 89 00:03:41,239 --> 00:03:42,739 That should buy us some time 90 00:03:42,741 --> 00:03:45,500 to come up with a plan before we lose this baby. 91 00:03:46,444 --> 00:03:47,944 ♪ Oh, if I leave this place alive ♪ 92 00:03:47,946 --> 00:03:49,679 ♪♪ 93 00:03:50,782 --> 00:03:51,835 [BEEPS] 94 00:03:51,860 --> 00:03:53,682 WOMAN ON P.A.: Lab technician to O.R. 6. 95 00:03:53,684 --> 00:03:55,084 Lab technician to O.R. 6. 96 00:03:55,086 --> 00:03:58,053 [DOOR OPENS] 97 00:03:58,055 --> 00:04:00,422 You canceled my hernia repair? 98 00:04:00,424 --> 00:04:03,325 With no advance notice. Sorry about that. 99 00:04:03,327 --> 00:04:04,627 But so great to meet you. 100 00:04:04,629 --> 00:04:05,828 Jackson Han. 101 00:04:05,830 --> 00:04:07,395 - Neil Melendez. - Oh, I know. 102 00:04:07,397 --> 00:04:09,898 You did great work on that piggyback heart transplant. 103 00:04:09,900 --> 00:04:11,199 Huh. 104 00:04:11,201 --> 00:04:13,401 I need a consult on Minesh Goyal. 105 00:04:13,403 --> 00:04:14,837 He's the founding CEO of a company... 106 00:04:14,839 --> 00:04:17,172 - What's his diagnosis? - He doesn't have one. 107 00:04:17,174 --> 00:04:20,242 He's here for a full physical, complete diagnostic workup. 108 00:04:20,244 --> 00:04:22,978 I have a long-standing Executive Wellness... 109 00:04:22,980 --> 00:04:25,647 I'm a surgeon, not an internist. 110 00:04:25,649 --> 00:04:27,616 I don't do preventative medicine. 111 00:04:27,618 --> 00:04:30,170 No matter how rich the patient is. 112 00:04:30,654 --> 00:04:33,355 You know what's great about rich patients? 113 00:04:33,357 --> 00:04:35,759 They allow us to treat poor patients. 114 00:04:36,527 --> 00:04:38,260 Also, I promised Minesh the very best. 115 00:04:38,262 --> 00:04:40,447 So, really, who else am I gonna get? 116 00:04:41,031 --> 00:04:42,130 [BEEPS] 117 00:04:42,132 --> 00:04:43,831 WOMAN ON P.A.: Dr. Johansen to pre-op. 118 00:04:43,833 --> 00:04:46,000 Dr. Johansen to pre-op. 119 00:04:46,002 --> 00:04:47,369 [VELCRO TEARS] 120 00:04:47,371 --> 00:04:49,070 BP's 110 over 70. 121 00:04:50,106 --> 00:04:52,541 Uh, Jackson... Dr. Han... 122 00:04:52,543 --> 00:04:54,242 says great things about you. 123 00:04:55,745 --> 00:04:57,447 That's very kind. 124 00:04:58,482 --> 00:05:00,748 Normal EKG, optimal BMI, 125 00:05:00,750 --> 00:05:02,483 heart and lungs sound good. 126 00:05:02,485 --> 00:05:03,918 Any reason you're worried enough about your health 127 00:05:03,920 --> 00:05:06,087 to endure an entire day of tests? 128 00:05:06,089 --> 00:05:08,022 I'm not worried. 129 00:05:09,759 --> 00:05:11,592 Knowledge is power. 130 00:05:11,594 --> 00:05:13,494 Whenever I enter a new market, 131 00:05:13,496 --> 00:05:16,097 I learn everything I can about the landscape... 132 00:05:16,099 --> 00:05:18,966 consumer needs, target market, competitors. 133 00:05:18,968 --> 00:05:20,534 You're aware your body isn't a business. 134 00:05:20,536 --> 00:05:22,236 [CHUCKLES] 135 00:05:22,238 --> 00:05:24,205 I know I sound like a rich lunatic 136 00:05:24,207 --> 00:05:27,519 with fantasies about controlling every aspect of my life. 137 00:05:28,664 --> 00:05:30,197 And I guess I kind of am. 138 00:05:33,583 --> 00:05:36,111 My dad was in good shape, too. 139 00:05:36,719 --> 00:05:39,322 Until he dropped dead on his daily jog. 140 00:05:41,724 --> 00:05:46,493 ♪♪ 141 00:05:46,495 --> 00:05:48,229 [INDISTINCT CONVERSATIONS] 142 00:05:48,231 --> 00:05:50,397 ♪♪ 143 00:05:50,399 --> 00:05:52,132 Hi. 144 00:05:52,134 --> 00:05:55,502 WOMAN ON P.A.: Dr. Markiel, please come to the mental health unit. 145 00:05:55,504 --> 00:05:59,540 Dr. Markiel, please come to the mental health unit. 146 00:05:59,542 --> 00:06:01,642 [CONVERSATIONS CONTINUE] 147 00:06:01,644 --> 00:06:03,310 [TELEPHONE RINGING] 148 00:06:05,648 --> 00:06:07,147 [EXHALES SHARPLY] 149 00:06:10,132 --> 00:06:11,531 Hi. 150 00:06:12,587 --> 00:06:15,088 Hi. I'm Larry Childs. 151 00:06:15,090 --> 00:06:16,890 I'd shake your hand, but, you know, 152 00:06:16,892 --> 00:06:18,458 no functioning immune system. 153 00:06:18,460 --> 00:06:19,626 [CHUCKLES] 154 00:06:19,628 --> 00:06:21,762 - Aaron. Hi. - Good to meet you. 155 00:06:21,764 --> 00:06:23,396 What flavor cancer do you have? 156 00:06:23,398 --> 00:06:24,998 [CHUCKLES] 157 00:06:25,000 --> 00:06:26,900 - What flavor? - Yeah. 158 00:06:26,902 --> 00:06:28,368 Glioma. 159 00:06:28,370 --> 00:06:29,870 Shut the front door. 160 00:06:29,872 --> 00:06:31,666 Brain or spine? 161 00:06:32,007 --> 00:06:33,673 - Brain. - Dude... 162 00:06:33,675 --> 00:06:34,841 we're tumor twins. 163 00:06:34,843 --> 00:06:37,911 Wh-What do they have you on? 164 00:06:37,913 --> 00:06:39,246 Ooh. Vincristine. 165 00:06:39,248 --> 00:06:40,445 I hear that's intense. 166 00:06:40,447 --> 00:06:42,447 My doc thought it would wipe me out. 167 00:06:42,449 --> 00:06:44,817 You doing okay or longing for death? 168 00:06:44,819 --> 00:06:46,986 I am hanging in there. Thank you. 169 00:06:47,432 --> 00:06:49,955 I'm on my third round of temozolomide. 170 00:07:00,514 --> 00:07:02,381 I've seen you in here a few times. 171 00:07:04,638 --> 00:07:05,838 I've seen you in here a few times. 172 00:07:05,840 --> 00:07:07,953 You kind of keep to yourself, huh? 173 00:07:09,076 --> 00:07:10,409 Yeah. 174 00:07:10,411 --> 00:07:11,911 Well, I'm happy to introduce you around. 175 00:07:11,913 --> 00:07:13,245 It's a really friendly group. 176 00:07:13,247 --> 00:07:14,378 I'm okay. Thank you. 177 00:07:14,380 --> 00:07:16,014 You have a support group you go to? 178 00:07:17,050 --> 00:07:18,713 I do not. 179 00:07:19,352 --> 00:07:21,341 Everyone needs a cancer community. 180 00:07:25,926 --> 00:07:28,726 [PAPER RUSTLES] 181 00:07:28,728 --> 00:07:32,931 ♪♪ 182 00:07:32,933 --> 00:07:42,473 ♪♪ 183 00:07:42,475 --> 00:07:48,579 ♪♪ 184 00:07:48,581 --> 00:07:54,552 ♪♪ 185 00:07:54,554 --> 00:07:56,253 - And try to hold still. - [CLICKS] 186 00:07:57,757 --> 00:07:59,045 Thank you. 187 00:07:59,525 --> 00:08:00,825 For bringing us in. 188 00:08:00,827 --> 00:08:03,193 This is the new Chief's patient. It's a great opportunity. 189 00:08:03,195 --> 00:08:05,663 Or it's a bunch of pointless tests. 190 00:08:05,665 --> 00:08:06,697 [SIGHS] 191 00:08:07,933 --> 00:08:10,368 Uh, for which I thank you. 192 00:08:10,370 --> 00:08:12,035 Tell us about Dr. Han. 193 00:08:12,037 --> 00:08:14,705 He's direct, charming, 194 00:08:14,707 --> 00:08:15,939 very sure of himself. 195 00:08:15,941 --> 00:08:17,608 Big ego. 196 00:08:21,513 --> 00:08:24,848 There's nothing wrong with an ego if you can back it up. 197 00:08:24,850 --> 00:08:26,783 And Dr. Han's arterial switch technique 198 00:08:26,785 --> 00:08:28,818 is performed all over the world. 199 00:08:28,820 --> 00:08:30,820 The tests aren't all pointless. 200 00:08:30,822 --> 00:08:32,589 Way to stand firm, Park. 201 00:08:32,591 --> 00:08:34,090 No, look at the monitor. 202 00:08:34,092 --> 00:08:35,425 He has a tumor. 203 00:08:35,427 --> 00:08:40,764 ♪♪ 204 00:08:40,766 --> 00:08:42,098 [SIGHS] 205 00:08:42,100 --> 00:08:45,268 [MONITOR BEEPING] 206 00:08:45,270 --> 00:08:53,075 ♪♪ 207 00:08:53,077 --> 00:09:00,883 ♪♪ 208 00:09:00,885 --> 00:09:02,618 NIGEL: Percy's stable? 209 00:09:02,620 --> 00:09:05,621 We're naming her Persephone. 210 00:09:05,623 --> 00:09:09,158 Yes. I put in a central line for nutrition. 211 00:09:09,160 --> 00:09:10,526 Percy is stable right now. 212 00:09:10,528 --> 00:09:13,662 We're looking for solutions to her problems. 213 00:09:13,664 --> 00:09:15,998 W-Wh-Why does... 214 00:09:16,000 --> 00:09:18,401 Why does she have all these birth defects? 215 00:09:18,403 --> 00:09:19,793 Diane. 216 00:09:20,271 --> 00:09:21,737 We spoke to our obstetrician. 217 00:09:21,739 --> 00:09:24,297 She said these defects can happen for no reason, right? 218 00:09:25,943 --> 00:09:27,142 That's true. 219 00:09:27,144 --> 00:09:29,978 Over 50% have no known cause. 220 00:09:32,182 --> 00:09:36,717 I was taking paroxetine for clinical depression. 221 00:09:36,719 --> 00:09:37,986 And you went off the meds 222 00:09:37,988 --> 00:09:39,554 as soon as you found out you were pregnant. 223 00:09:39,556 --> 00:09:42,190 She was five, six weeks at most. 224 00:09:42,192 --> 00:09:43,858 My OB told me studies show 225 00:09:43,860 --> 00:09:46,527 antidepressants are safe to take during pregnancy. 226 00:09:46,529 --> 00:09:47,829 But is that true, 227 00:09:47,831 --> 00:09:49,530 or is she protecting me? 228 00:09:51,801 --> 00:09:55,036 There was a study that associated paroxetine 229 00:09:55,038 --> 00:09:56,671 with these kinds of defects. 230 00:09:56,673 --> 00:09:59,040 It is a possibility. 231 00:09:59,042 --> 00:10:00,608 [EXHALES SHARPLY] 232 00:10:00,610 --> 00:10:08,015 ♪♪ 233 00:10:10,467 --> 00:10:12,663 You can't tell whether it's cancerous or benign? 234 00:10:12,688 --> 00:10:13,953 Not until we do the biopsy, 235 00:10:13,955 --> 00:10:15,855 which I've scheduled for later. 236 00:10:15,857 --> 00:10:17,424 We'll know what's going on by the morning. 237 00:10:17,426 --> 00:10:19,325 ♪♪ 238 00:10:19,327 --> 00:10:20,593 Good. 239 00:10:20,595 --> 00:10:22,062 That's good. 240 00:10:22,064 --> 00:10:24,831 ♪♪ 241 00:10:24,833 --> 00:10:27,333 Maybe you'd like to call someone? 242 00:10:27,335 --> 00:10:29,502 A family member, a friend? 243 00:10:29,504 --> 00:10:31,504 I'll worry when I know it's cancer. 244 00:10:31,506 --> 00:10:41,147 ♪♪ 245 00:10:41,149 --> 00:10:43,850 We could use a transcatheter route 246 00:10:43,852 --> 00:10:46,504 and patch each hole individually. 247 00:10:47,055 --> 00:10:48,588 Her heart's the size of a walnut. 248 00:10:48,590 --> 00:10:51,224 It's too small to maneuver inside. 249 00:10:51,226 --> 00:10:53,525 A single large patch to close the holes 250 00:10:53,527 --> 00:10:54,793 would withstand the pressure. 251 00:10:54,795 --> 00:10:56,128 Yes. 252 00:10:58,099 --> 00:11:00,465 It would also block electrical conduction, 253 00:11:00,467 --> 00:11:02,735 causing deadly arrhythmias. 254 00:11:02,737 --> 00:11:04,522 Dr. Murphy... 255 00:11:05,405 --> 00:11:08,340 did you tell the mom that she caused her baby's birth defect? 256 00:11:08,342 --> 00:11:12,655 No. I said that her antidepressants could have. 257 00:11:13,547 --> 00:11:15,180 Why did you tell her that? 258 00:11:15,658 --> 00:11:17,616 It's the truth. 259 00:11:17,618 --> 00:11:20,497 And is that relevant to her current medical situation? 260 00:11:21,588 --> 00:11:22,821 No. 261 00:11:24,491 --> 00:11:27,559 And how did you think that answer would make her feel? 262 00:11:27,561 --> 00:11:29,466 What did you think would happen? 263 00:11:29,468 --> 00:11:31,195 ♪♪ 264 00:11:31,197 --> 00:11:33,364 The mother is devastated. 265 00:11:33,366 --> 00:11:34,966 The father is furious. 266 00:11:34,968 --> 00:11:36,300 I would be, too. 267 00:11:36,302 --> 00:11:38,102 LIM: Shaun is a resident. 268 00:11:38,104 --> 00:11:39,670 Residents make mistakes. 269 00:11:40,774 --> 00:11:42,807 Managing these parents' emotional concerns 270 00:11:42,809 --> 00:11:45,609 is as much a part of this job as operating on their daughter. 271 00:11:45,611 --> 00:11:48,012 [SIGHS] Social cues are hard for Shaun, 272 00:11:48,014 --> 00:11:49,413 but we've been working with him... 273 00:11:49,415 --> 00:11:51,415 You should be focused on your own shortcomings, 274 00:11:51,417 --> 00:11:54,322 like retaining the formula for vascular impedance. 275 00:11:55,054 --> 00:11:56,420 Dr. Han. 276 00:11:56,422 --> 00:11:59,157 ♪♪ 277 00:11:59,159 --> 00:12:01,793 We could patch each individual hole in the heart 278 00:12:01,795 --> 00:12:03,661 if we cut open the ventricle... 279 00:12:03,663 --> 00:12:05,328 Don't change the subject, Dr. Murphy. 280 00:12:05,330 --> 00:12:06,830 I didn't, Dr. Han. 281 00:12:06,832 --> 00:12:09,232 We were talking about the baby. 282 00:12:09,234 --> 00:12:10,713 Really? 283 00:12:11,503 --> 00:12:13,770 You don't see a difference in the nature of your discussion 284 00:12:13,772 --> 00:12:15,705 before I arrived and after? 285 00:12:17,375 --> 00:12:21,111 We were talking about the baby. 286 00:12:21,113 --> 00:12:24,514 ♪♪ 287 00:12:26,618 --> 00:12:29,452 They tried the approach you suggested at L.A. Children's. 288 00:12:29,454 --> 00:12:31,288 The baby died a week later. 289 00:12:31,290 --> 00:12:34,691 The suture line didn't hold, and the cardiac wall ruptured. 290 00:12:34,693 --> 00:12:35,758 Keep looking. 291 00:12:35,760 --> 00:12:37,994 Dr. Murphy, 292 00:12:37,996 --> 00:12:40,743 do not talk with those parents again. 293 00:12:44,368 --> 00:12:45,767 I'll walk with you. 294 00:12:49,273 --> 00:12:51,106 LIM: You're pretty tough on my residents. 295 00:12:51,108 --> 00:12:52,441 Rebuking them in public, 296 00:12:52,443 --> 00:12:55,010 pimping them with questions during surgery. 297 00:12:55,012 --> 00:12:56,645 Shame-based learning isn't my style. 298 00:12:56,647 --> 00:12:58,714 I'll bear that in mind. 299 00:12:58,716 --> 00:13:00,716 But this isn't about my treatment of "the residents." 300 00:13:00,718 --> 00:13:02,384 You're concerned about Dr. Murphy. 301 00:13:02,386 --> 00:13:04,920 Well, a lot of doctors have less than ideal bedside manner. 302 00:13:04,922 --> 00:13:06,755 - He's young... - Would you ever have said 303 00:13:06,757 --> 00:13:08,824 something like that to a patient as a resident? 304 00:13:08,826 --> 00:13:10,459 As a med student? 305 00:13:10,461 --> 00:13:11,593 And Murphy doesn't even understand 306 00:13:11,595 --> 00:13:12,895 he did anything wrong. 307 00:13:12,897 --> 00:13:14,363 Shaun has hard-wired differences 308 00:13:14,365 --> 00:13:16,531 - in the way he perceives things. - Exactly. 309 00:13:16,533 --> 00:13:17,733 No matter how hard he works, 310 00:13:17,735 --> 00:13:20,502 no matter how hard you try and help him, 311 00:13:20,504 --> 00:13:23,104 his limitations are not going to change. 312 00:13:23,106 --> 00:13:26,441 He's going to continue to inflict them on our patients... 313 00:13:26,443 --> 00:13:29,143 all in the name of diversity and inclusion. 314 00:13:31,682 --> 00:13:33,415 Shaun deserves to be here. 315 00:13:34,551 --> 00:13:37,619 Once you see what he's capable of, you'll agree. 316 00:13:37,621 --> 00:13:39,386 I look forward to being proven wrong. 317 00:13:39,388 --> 00:13:40,471 [ELEVATOR BELL DINGS] 318 00:13:40,473 --> 00:13:42,691 [ELEVATOR DOORS OPEN] 319 00:13:45,016 --> 00:13:46,795 Stay seated for 20 minutes. 320 00:13:46,797 --> 00:13:48,323 Don't want you passing out in the lobby. 321 00:13:48,325 --> 00:13:49,963 I know, I know. Thank you. 322 00:13:55,318 --> 00:13:57,070 This disease changed my relationships, 323 00:13:57,072 --> 00:13:59,874 changed my priorities, changed... 324 00:13:59,876 --> 00:14:01,241 who I am. 325 00:14:01,243 --> 00:14:02,574 Cancer is an identity. 326 00:14:02,576 --> 00:14:04,712 Cancer is cellular mutation. 327 00:14:04,714 --> 00:14:06,881 The people in this room are my people. 328 00:14:06,883 --> 00:14:09,983 What are you... 20 years old? I'm triple your age. 329 00:14:09,985 --> 00:14:11,285 I don't think you're my "people." 330 00:14:11,287 --> 00:14:13,533 The last time I hung out with my law-school friends... 331 00:14:13,535 --> 00:14:14,523 epic fail. 332 00:14:14,548 --> 00:14:16,413 The fact that you use the phrase "epic fail," 333 00:14:16,415 --> 00:14:17,558 kind of case in point. 334 00:14:17,560 --> 00:14:19,460 They're all focused on what firm they're gonna land at, 335 00:14:19,462 --> 00:14:21,562 and I'm all about whether... 336 00:14:21,564 --> 00:14:23,330 Candice's leukemia is responding 337 00:14:23,332 --> 00:14:25,032 to her new chemo regimen. 338 00:14:25,034 --> 00:14:26,599 By the way, she has this peppermint oil 339 00:14:26,601 --> 00:14:28,393 that is great for headaches. 340 00:14:32,741 --> 00:14:34,874 Ooh, I know that look. 341 00:14:34,876 --> 00:14:36,317 Here, here. 342 00:14:37,212 --> 00:14:38,778 [VOMITING] 343 00:14:38,780 --> 00:14:41,748 [COUGHING] 344 00:14:41,750 --> 00:14:43,583 Got you, brother... 345 00:14:43,585 --> 00:14:45,052 whether you like it or not. 346 00:14:45,054 --> 00:14:46,619 [CHUCKLES] 347 00:14:49,458 --> 00:14:51,358 Show me where we are. 348 00:14:51,360 --> 00:14:54,127 That angle runs pretty close to the sacral nerve roots. 349 00:14:55,697 --> 00:14:57,063 How are we doing? 350 00:14:57,065 --> 00:14:58,497 MELENDEZ: Tumor's abutting the iliac artery. 351 00:14:58,499 --> 00:15:00,299 I'm trying not to disrupt the entire blood supply 352 00:15:00,301 --> 00:15:01,600 to his lower body. 353 00:15:01,602 --> 00:15:03,302 Dr. Han, I'm Morgan Reznick. 354 00:15:03,304 --> 00:15:05,604 I really enjoyed your article on Myotomy 355 00:15:05,606 --> 00:15:08,641 for infantile hypertrophic pyloric stenosis. 356 00:15:09,444 --> 00:15:12,578 I appreciate the thorough research behind your sucking up. 357 00:15:12,580 --> 00:15:14,380 And you are? 358 00:15:14,382 --> 00:15:15,848 Alex Park. 359 00:15:15,850 --> 00:15:18,317 Park... you were a cop. 360 00:15:18,319 --> 00:15:20,919 Medicine as a second career... good stuff. 361 00:15:20,921 --> 00:15:22,989 Tends to bring a fresh perspective. 362 00:15:24,158 --> 00:15:25,591 [ALARM BEEPING RAPIDLY] 363 00:15:25,593 --> 00:15:28,127 I hit an artery. Take the needle. 364 00:15:28,129 --> 00:15:29,294 Blood's pooling in the pelvis. 365 00:15:29,296 --> 00:15:30,958 - Should we open him up? - No. 366 00:15:30,960 --> 00:15:32,530 Prep the femoral artery. Get me an art cath set. 367 00:15:32,532 --> 00:15:34,550 - Pressure's dropping. - Platinum coil. 368 00:15:34,552 --> 00:15:36,968 [BEEPING CONTINUES] 369 00:15:41,441 --> 00:15:43,718 - [BEEPING STOPS] - Nice save. 370 00:15:44,344 --> 00:15:45,943 Next time, don't hit the vessel. 371 00:15:47,447 --> 00:15:49,614 There is no next time. 372 00:15:49,616 --> 00:15:51,449 The biopsy's too dangerous. 373 00:15:54,888 --> 00:15:57,188 [SIGHS] 374 00:15:57,190 --> 00:16:00,558 MELENDEZ: It is likely that it's a benign notochord cell tumor. 375 00:16:00,560 --> 00:16:02,343 They look like chordomas, 376 00:16:02,345 --> 00:16:03,828 but they're harmless and way more common. 377 00:16:03,830 --> 00:16:05,162 But you don't know. 378 00:16:05,164 --> 00:16:07,231 Since we can't do the biopsy, no. 379 00:16:08,300 --> 00:16:10,286 This is the problem with broad testing. 380 00:16:11,103 --> 00:16:12,637 Everyone has abnormalities. 381 00:16:12,639 --> 00:16:14,171 Most of them are nothing. 382 00:16:14,173 --> 00:16:15,840 But when we do find them, 383 00:16:16,125 --> 00:16:17,942 we have to make some tough choices. 384 00:16:19,178 --> 00:16:22,212 So, what exactly is my tough choice? 385 00:16:23,841 --> 00:16:25,516 We could remove the tumor. 386 00:16:25,518 --> 00:16:27,151 This is a very risky surgery. 387 00:16:27,153 --> 00:16:29,353 There's a chance of paralysis or worse... 388 00:16:29,355 --> 00:16:31,140 you may not make it off the table. 389 00:16:31,724 --> 00:16:33,434 Or you do nothing. 390 00:16:33,760 --> 00:16:35,360 We'd continue to monitor it, 391 00:16:35,362 --> 00:16:36,726 do imaging every few weeks. 392 00:16:36,728 --> 00:16:38,828 But chordomas move very quickly. 393 00:16:38,830 --> 00:16:40,931 By the time any change showed up on imaging, 394 00:16:40,933 --> 00:16:43,433 it's most likely metastasized throughout your body. 395 00:16:45,537 --> 00:16:49,039 So it probably isn't cancer, 396 00:16:49,041 --> 00:16:52,576 but if it is and I wait, then I'll die. 397 00:16:52,578 --> 00:16:54,044 That's true. 398 00:16:54,046 --> 00:16:57,948 And if I don't wait and I get the surgery, 399 00:16:57,950 --> 00:16:59,849 then there's a good chance I'll die. 400 00:16:59,851 --> 00:17:00,951 Yes. 401 00:17:06,324 --> 00:17:08,491 I'm gonna need to think this over. 402 00:17:08,493 --> 00:17:16,065 ♪♪ 403 00:17:16,067 --> 00:17:21,571 ♪♪ 404 00:17:23,442 --> 00:17:27,577 This is the May Annals of Neonatal Surgery. 405 00:17:27,579 --> 00:17:30,779 I just finished March. I need to read April now. 406 00:17:30,781 --> 00:17:32,448 LIM: Oh, I have April, Shaun. 407 00:17:32,450 --> 00:17:34,016 No. 408 00:17:34,018 --> 00:17:36,210 No, you're supposed to be reading 409 00:17:36,212 --> 00:17:38,673 New Approaches in Neonatal Surgery. 410 00:17:38,675 --> 00:17:41,419 Claire has the British Journal of Neonatology... 411 00:17:49,500 --> 00:17:51,533 Shaun... 412 00:17:51,846 --> 00:17:54,802 I think maybe you should be quiet around Han 413 00:17:54,804 --> 00:17:57,018 for a little while. 414 00:17:57,641 --> 00:18:00,074 But then how will I answer his questions? 415 00:18:01,897 --> 00:18:04,646 Direct questions, absolutely answer. 416 00:18:04,648 --> 00:18:06,914 Otherwise, outside of the O.R., 417 00:18:06,916 --> 00:18:08,683 you should stay out of his way. 418 00:18:11,588 --> 00:18:14,189 If someone had convinced Shaun to do that with Dr. Melendez, 419 00:18:14,191 --> 00:18:16,558 he would still be on suction. 420 00:18:19,029 --> 00:18:20,228 [BEEP] 421 00:18:20,230 --> 00:18:22,464 MAN ON P.A.: Code blue... NICU, Bed 4. 422 00:18:22,466 --> 00:18:25,133 Code blue... NICU, Bed 4. 423 00:18:25,135 --> 00:18:26,534 [DOOR OPENS] 424 00:18:26,536 --> 00:18:27,935 [ALARM BEEPING RAPIDLY] 425 00:18:27,937 --> 00:18:30,604 O2 SATs dropped and central venous pressure shot up. 426 00:18:30,606 --> 00:18:32,239 The Pulmonary Artery Band is failing. 427 00:18:32,241 --> 00:18:34,275 - Eight of dopamine. - Let's get a mask on her. 428 00:18:34,277 --> 00:18:36,577 She won't last much longer. We need other options. 429 00:18:36,579 --> 00:18:38,345 I'll update the parents. 430 00:18:38,347 --> 00:18:39,981 [BEEPING CONTINUES] 431 00:18:39,983 --> 00:18:41,961 LIM: Let's get her on full cardiac support. 432 00:18:41,963 --> 00:18:43,651 ♪♪ 433 00:18:43,653 --> 00:18:46,154 [MACHINE BEEPING] 434 00:18:46,156 --> 00:18:48,156 [RESPIRATOR HISSING] 435 00:18:48,158 --> 00:18:54,261 ♪♪ 436 00:18:57,028 --> 00:18:59,134 What have you got? Anything? 437 00:18:59,180 --> 00:19:01,079 This Cleveland group 438 00:19:01,081 --> 00:19:03,715 repaired a bowel protrusion using enterolysis. 439 00:19:03,717 --> 00:19:06,251 I could cut out this excess inflammatory tissue 440 00:19:06,253 --> 00:19:07,717 and segment of bowel atresia. 441 00:19:07,719 --> 00:19:09,829 Might make her intestines small enough to fit. 442 00:19:09,831 --> 00:19:11,089 Promising. 443 00:19:11,091 --> 00:19:12,691 Given the size of her abdomen, 444 00:19:12,693 --> 00:19:14,059 I need to remove a lot of bowel. 445 00:19:14,061 --> 00:19:16,562 There's a good chance she wouldn't be able to absorb food. 446 00:19:16,564 --> 00:19:18,319 We'll have to find the right balance. 447 00:19:18,319 --> 00:19:20,285 It's our only workable plan. 448 00:19:20,287 --> 00:19:22,253 Best bet on the heart is to cut through the ventricle, 449 00:19:22,255 --> 00:19:24,055 like Murphy suggested. 450 00:19:24,057 --> 00:19:26,891 Uh, you were concerned about the suture line holding. 451 00:19:26,893 --> 00:19:28,493 Well, I still am. 452 00:19:28,495 --> 00:19:30,761 Hopefully, horizontal mattress sutures will work. 453 00:19:30,763 --> 00:19:32,097 They should be able to withstand the tension 454 00:19:32,099 --> 00:19:33,598 at the suture line. 455 00:19:33,600 --> 00:19:35,900 [FADING] There's still a risk of an aneurysm forming 456 00:19:35,902 --> 00:19:37,935 in the tissue underneath. 457 00:19:37,937 --> 00:19:40,771 [INDISTINCT TALKING] 458 00:19:40,773 --> 00:19:42,456 Dr. Lim? 459 00:19:42,876 --> 00:19:45,210 I have an idea I'd like to share, 460 00:19:45,212 --> 00:19:47,879 even though Dr. Han didn't ask me a question. 461 00:19:52,085 --> 00:19:54,151 Yeah, go ahead, Shaun. 462 00:19:54,153 --> 00:19:56,020 If we go in through the atrium, 463 00:19:56,022 --> 00:19:57,854 we wouldn't have to worry about the suture line... 464 00:19:57,856 --> 00:19:59,689 It's the same issue we discussed. 465 00:19:59,691 --> 00:20:01,691 There's not enough room inside the baby's heart 466 00:20:01,693 --> 00:20:03,193 to stitch the patches in the place. 467 00:20:03,195 --> 00:20:05,695 Oh, we don't need to, Dr. Han. 468 00:20:05,697 --> 00:20:08,198 We can make a plug small enough for her heart... 469 00:20:08,200 --> 00:20:10,600 a PTFE disc with a stem like a mushroom. 470 00:20:10,602 --> 00:20:12,403 Then we can insert the stem through one of the holes 471 00:20:12,405 --> 00:20:14,104 until the disc presses against the wall, 472 00:20:14,106 --> 00:20:15,656 covering all the holes. 473 00:20:16,575 --> 00:20:20,444 L-Like a stopper in a bathtub. 474 00:20:20,446 --> 00:20:21,711 Yes. 475 00:20:21,713 --> 00:20:23,580 The higher pressure on the left side of her heart 476 00:20:23,582 --> 00:20:24,948 would keep it in place. 477 00:20:24,950 --> 00:20:26,883 We wouldn't even need to stitch. 478 00:20:28,421 --> 00:20:30,353 Great idea. 479 00:20:30,355 --> 00:20:32,088 We should take this to the parents. 480 00:20:32,090 --> 00:20:33,889 Great idea for the heart. 481 00:20:33,891 --> 00:20:36,459 But we need to tell them that our current plan 482 00:20:36,461 --> 00:20:37,493 for the abdominal repair 483 00:20:37,495 --> 00:20:39,929 is considerably more of a long shot. 484 00:20:39,931 --> 00:20:42,516 And that fixing the heart takes an option off the table. 485 00:20:43,368 --> 00:20:45,234 Withdrawing care. 486 00:20:54,645 --> 00:20:56,447 LARRY: You can't move that card. 487 00:20:56,948 --> 00:20:58,414 Excuse me? 488 00:20:58,416 --> 00:20:59,615 Who cheats at solitaire? 489 00:20:59,617 --> 00:21:01,184 You're literally only cheating yourself. 490 00:21:01,186 --> 00:21:02,552 Again. 491 00:21:02,554 --> 00:21:03,919 Good morning, Larry. 492 00:21:03,921 --> 00:21:05,754 Is it a macho thing? 493 00:21:05,756 --> 00:21:07,522 Like a real man should be able to make it through 494 00:21:07,524 --> 00:21:10,025 without leaning on a label or the people who go with it? 495 00:21:12,129 --> 00:21:14,096 Embracing cancer as an identity 496 00:21:14,098 --> 00:21:16,364 is the last thing any one of us should be doing. 497 00:21:16,366 --> 00:21:19,534 It underscores everything horrible right now. 498 00:21:20,437 --> 00:21:22,370 We're in a daily battle for our lives. 499 00:21:22,372 --> 00:21:24,573 I see no value in dwelling on that. 500 00:21:28,946 --> 00:21:30,512 Candice is late. 501 00:21:31,816 --> 00:21:34,182 Which means either her niece forgot to pick her up. 502 00:21:34,184 --> 00:21:36,278 Again. 503 00:21:36,821 --> 00:21:38,697 Or she got some bad news. 504 00:21:39,590 --> 00:21:41,256 Or she's already dead. 505 00:21:43,494 --> 00:21:46,261 - [OBJECT THUDS, BAG ZIPS] - We are in a daily battle. 506 00:21:49,166 --> 00:21:51,454 I'd rather have some company. 507 00:21:51,456 --> 00:21:59,107 ♪♪ 508 00:21:59,109 --> 00:22:07,215 ♪♪ 509 00:22:07,217 --> 00:22:09,117 I spoke to my mother and brother, 510 00:22:09,119 --> 00:22:11,730 and they both think I shouldn't do the surgery. 511 00:22:12,389 --> 00:22:14,322 Apparently they're more scared of your surgical skills 512 00:22:14,324 --> 00:22:15,985 than they are of this tumor. 513 00:22:17,194 --> 00:22:19,093 And where do you stand? 514 00:22:19,095 --> 00:22:21,062 I need numbers. 515 00:22:21,064 --> 00:22:22,363 Please. 516 00:22:22,365 --> 00:22:25,867 ♪♪ 517 00:22:25,869 --> 00:22:28,872 The stats on something like this, it... 518 00:22:29,472 --> 00:22:30,738 there are a lot of variables. 519 00:22:30,740 --> 00:22:32,807 What are the odds I make it through the surgery 520 00:22:32,809 --> 00:22:35,129 without any complications? 521 00:22:35,745 --> 00:22:37,945 It's a challenging procedure. 522 00:22:37,947 --> 00:22:40,782 Zero complications, I'd say 80%. 523 00:22:42,351 --> 00:22:45,452 But it is very unlikely this tumor is malignant. 524 00:22:45,454 --> 00:22:47,182 Give me a number. 525 00:22:47,924 --> 00:22:50,558 About 5% chance it's a chordoma. 526 00:22:57,900 --> 00:23:00,067 The numbers agree with your family. 527 00:23:00,069 --> 00:23:01,569 So do I. 528 00:23:05,708 --> 00:23:07,808 [BREATHES DEEPLY] 529 00:23:10,313 --> 00:23:11,878 I've always been more comfortable with action 530 00:23:11,880 --> 00:23:13,447 than inaction. 531 00:23:16,885 --> 00:23:19,286 I want you to do the surgery. 532 00:23:21,490 --> 00:23:22,656 [BREATHES DEEPLY] 533 00:23:22,658 --> 00:23:24,786 Certainty comes at a price. 534 00:23:24,788 --> 00:23:33,533 ♪♪ 535 00:23:33,535 --> 00:23:36,369 DIANE: She'll be able to get off the life support machines? 536 00:23:36,371 --> 00:23:38,238 HAN: If everything goes well, yes. 537 00:23:38,240 --> 00:23:39,972 She'll have a strong heart. 538 00:23:39,974 --> 00:23:41,807 How soon can you do it? 539 00:23:43,478 --> 00:23:45,144 You should know we feel less confident 540 00:23:45,146 --> 00:23:47,201 about our plan for her bowel. 541 00:23:47,582 --> 00:23:50,316 The chance of failure is quite high. 542 00:23:50,318 --> 00:23:51,784 How high? 543 00:23:51,786 --> 00:23:54,721 LIM: I put it at 90% that the repair won't work. 544 00:23:54,723 --> 00:23:57,823 Which would lead to irreversible malnutrition. 545 00:23:57,825 --> 00:24:01,340 Your daughter would slowly starve to death over months. 546 00:24:02,029 --> 00:24:04,130 Right now, her body is working very hard 547 00:24:04,132 --> 00:24:05,397 just to stay alive. 548 00:24:05,399 --> 00:24:08,700 ♪♪ 549 00:24:08,702 --> 00:24:11,003 If we were to turn off the machines... 550 00:24:11,005 --> 00:24:12,958 Turn off the machines? 551 00:24:12,960 --> 00:24:15,741 ♪♪ 552 00:24:15,743 --> 00:24:18,816 ...she would pass quickly. And peacefully. 553 00:24:19,346 --> 00:24:21,680 If the heart surgery is a success, 554 00:24:21,682 --> 00:24:23,783 that won't be an option. 555 00:24:23,785 --> 00:24:25,617 Oh. [BREATHES DEEPLY] 556 00:24:25,619 --> 00:24:27,519 Why not try to fix the bowel first 557 00:24:27,521 --> 00:24:28,720 to see if it works? 558 00:24:28,722 --> 00:24:30,522 We won't know if the bowel is viable 559 00:24:30,524 --> 00:24:32,258 until after the heart is. 560 00:24:33,460 --> 00:24:35,874 We have to do the surgery. 561 00:24:36,229 --> 00:24:38,530 But if this doesn't work, she could starve to death. 562 00:24:38,532 --> 00:24:41,433 - It's worth the risk... - It's not our risk. It's hers. 563 00:24:41,435 --> 00:24:44,803 So, instead, you're ready to give up on our daughter? 564 00:24:44,805 --> 00:24:47,339 I mean, it's like we're right back at the ultrasound. 565 00:24:47,341 --> 00:24:49,941 We decided together to continue this pregnancy. 566 00:24:49,943 --> 00:24:51,910 So this is as much my fault as it is yours. 567 00:24:51,912 --> 00:24:53,312 My fault? 568 00:24:53,314 --> 00:24:55,280 Because of the medication? 569 00:24:56,917 --> 00:25:00,315 I cannot turn off that machine. 570 00:25:01,021 --> 00:25:03,855 Your guilt is stopping you from admitting what we need to do. 571 00:25:03,857 --> 00:25:06,490 My guilt has nothing to do with this. 572 00:25:06,492 --> 00:25:09,227 - I am fighting for my daughter. - So am I. 573 00:25:11,675 --> 00:25:13,676 Since the parents can't agree, the decision 574 00:25:13,678 --> 00:25:15,960 about the baby's care will be made by a judge 575 00:25:15,962 --> 00:25:17,814 who will rely on our recommendation. 576 00:25:18,399 --> 00:25:20,032 So we make the choice, 577 00:25:20,034 --> 00:25:21,600 but the parents live with it? 578 00:25:24,131 --> 00:25:25,804 Well, maybe that's a good thing. 579 00:25:27,474 --> 00:25:29,507 For parents to have to decide between 580 00:25:29,509 --> 00:25:31,243 letting their daughter die 581 00:25:31,245 --> 00:25:34,980 or fighting for her life, knowing she may suffer horribly, 582 00:25:34,982 --> 00:25:37,477 maybe it's better if we carry that burden. 583 00:25:40,221 --> 00:25:41,820 Dr. Lim? 584 00:25:41,822 --> 00:25:43,322 Your decision would be? 585 00:25:44,791 --> 00:25:46,491 Take her off life support. 586 00:25:46,493 --> 00:25:48,660 The odds are stacked against the bowel repair working. 587 00:25:48,662 --> 00:25:51,696 Those numbers reflect the general population of doctors. 588 00:25:51,698 --> 00:25:54,102 I think Dr. Lim and I are better than that. 589 00:25:54,703 --> 00:25:56,163 We can beat the odds. 590 00:26:03,921 --> 00:26:05,562 One of the things I'm not going to miss 591 00:26:05,564 --> 00:26:07,245 about being Chief of Surgery 592 00:26:07,247 --> 00:26:10,135 is being responsible for choices like this. 593 00:26:12,852 --> 00:26:15,219 Dr. Han, it's your department... 594 00:26:15,221 --> 00:26:16,888 it's your call. 595 00:26:22,962 --> 00:26:24,428 [INDISTINCT CONVERSATIONS] 596 00:26:24,430 --> 00:26:26,230 GLASSMAN: You've been here all night? 597 00:26:26,735 --> 00:26:28,165 I've been working on a case 598 00:26:28,167 --> 00:26:30,768 with the new Chief of Surgery, Dr. Han. 599 00:26:30,770 --> 00:26:33,388 - How's that going? - Not very well. 600 00:26:33,390 --> 00:26:35,405 He plays music in the operating room. 601 00:26:35,407 --> 00:26:36,889 Oh, geez. One of those. 602 00:26:36,891 --> 00:26:38,191 And he says I need to focus on 603 00:26:38,193 --> 00:26:40,290 our patients' emotional needs. 604 00:26:40,745 --> 00:26:42,845 Well, that's a tough assignment for you. 605 00:26:43,708 --> 00:26:45,175 Mm. 606 00:26:49,466 --> 00:26:53,167 You ever wish you had, you know, 607 00:26:53,169 --> 00:26:55,892 friends, co-workers on the spectrum? 608 00:26:56,264 --> 00:26:57,860 Not usually. 609 00:26:57,862 --> 00:27:00,773 But maybe Dr. Han wouldn't notice me as much 610 00:27:00,775 --> 00:27:03,105 if I weren't the only doctor with ASD. 611 00:27:06,204 --> 00:27:08,103 There's this kid in chemo, 612 00:27:08,105 --> 00:27:11,288 just [CHUCKLES] obsessed with having cancer. 613 00:27:11,315 --> 00:27:12,615 It's all he talks about. 614 00:27:12,617 --> 00:27:14,254 He wants to be friends with everybody in the ward. 615 00:27:14,256 --> 00:27:15,926 That's very smart of him. 616 00:27:15,928 --> 00:27:19,121 Speigel et al. showed an increase in overall survival 617 00:27:19,123 --> 00:27:21,491 and quality of life measures in breast cancer patients 618 00:27:21,493 --> 00:27:24,527 who formed social bonds with others battling the disease. 619 00:27:25,430 --> 00:27:27,430 What should I do about Dr. Han? 620 00:27:29,901 --> 00:27:32,735 [EXHALES DEEPLY] I don't know. Um... 621 00:27:32,737 --> 00:27:34,404 just do your work, 622 00:27:34,406 --> 00:27:36,706 be a good surgeon, be an excellent surgeon. 623 00:27:36,708 --> 00:27:38,941 Over time, he'll forget about the autism. 624 00:27:38,943 --> 00:27:40,342 Why would that happen? 625 00:27:40,344 --> 00:27:43,345 He'll see that you have the skill, you have dedication. 626 00:27:43,347 --> 00:27:45,680 I have autism. 627 00:27:45,682 --> 00:27:47,449 It's part of who I am. 628 00:27:47,451 --> 00:27:49,451 [CONVERSATIONS CONTINUE] 629 00:27:54,358 --> 00:27:58,127 [RESPIRATOR HISSING, MONITOR BEEPING] 630 00:27:58,129 --> 00:27:59,761 The judge...? 631 00:27:59,763 --> 00:28:01,463 Accepted our recommendation 632 00:28:01,465 --> 00:28:03,373 and ruled in favor of surgery. 633 00:28:04,001 --> 00:28:05,479 Thank you, Doctor. 634 00:28:05,481 --> 00:28:09,604 ♪♪ 635 00:28:09,606 --> 00:28:11,040 [SIGHS] 636 00:28:11,042 --> 00:28:12,441 Okay, Percy. 637 00:28:12,443 --> 00:28:14,276 ♪♪ 638 00:28:14,278 --> 00:28:16,145 [VOICE BREAKING] Momma loves you. 639 00:28:16,147 --> 00:28:19,147 ♪♪ 640 00:28:19,149 --> 00:28:20,458 I love you, Percy. 641 00:28:20,460 --> 00:28:28,757 ♪♪ 642 00:28:28,759 --> 00:28:36,397 ♪♪ 643 00:28:36,399 --> 00:28:44,005 ♪♪ 644 00:28:44,007 --> 00:28:53,647 ♪♪ 645 00:28:55,995 --> 00:28:57,661 CLAIRE: Should we remove more bowel? 646 00:28:57,663 --> 00:28:58,863 That would take us to the ilium. 647 00:28:58,865 --> 00:29:01,032 She won't gain enough weight to thrive. 648 00:29:01,429 --> 00:29:03,128 Her abdominal muscles are tight 649 00:29:03,130 --> 00:29:05,393 from developing around an empty cavity. 650 00:29:06,100 --> 00:29:07,966 ♪ But the days, girl, just slip away, oh, yeah ♪ 651 00:29:07,968 --> 00:29:10,635 They're cinched around her tummy like a corset. 652 00:29:10,637 --> 00:29:12,037 What if we unbuttoned it? 653 00:29:12,039 --> 00:29:13,205 Released the muscle 654 00:29:13,207 --> 00:29:15,473 and increased the abdominal circumference. 655 00:29:15,475 --> 00:29:16,782 Those muscles are part of her abdominal wall. 656 00:29:16,807 --> 00:29:18,310 Not if we separate the layers... 657 00:29:18,312 --> 00:29:21,113 create a plane between the skin and the muscle. 658 00:29:21,115 --> 00:29:22,948 ♪♪ 659 00:29:22,950 --> 00:29:24,817 You good if Murphy and I start on the heart? 660 00:29:25,652 --> 00:29:28,220 Dr. Browne, you're with me on the abdomen. 661 00:29:29,623 --> 00:29:30,923 Clearing the field. 662 00:29:30,925 --> 00:29:32,925 Han is on the call schedule next weekend. 663 00:29:32,927 --> 00:29:35,160 Maybe Carmen will switch with me so I can cover with him? 664 00:29:35,162 --> 00:29:38,262 Or maybe you shouldn't try so hard. 665 00:29:38,264 --> 00:29:39,761 Retractor. 666 00:29:40,634 --> 00:29:42,567 Some of us don't have a cool former career... 667 00:29:42,569 --> 00:29:44,235 or an easy-going, mellow demeanor. 668 00:29:44,237 --> 00:29:45,603 People are never gonna crowd in my corner 669 00:29:45,605 --> 00:29:46,871 because I'm just so likable. 670 00:29:46,873 --> 00:29:48,906 Well, you could try being nice to them. 671 00:29:48,908 --> 00:29:50,642 - Well, this is easier. - There it is. 672 00:29:53,347 --> 00:29:55,046 Does it look like cancer? 673 00:29:55,048 --> 00:29:56,815 It's not labeled. 674 00:29:56,817 --> 00:29:59,155 We're all gonna have to wait for the pathologist's report. 675 00:29:59,720 --> 00:30:01,018 [MONITOR BEEPING] 676 00:30:01,020 --> 00:30:02,587 Probe. 677 00:30:02,589 --> 00:30:04,288 [BEEPING CONTINUES] 678 00:30:07,594 --> 00:30:09,227 The artery is in the way. 679 00:30:09,229 --> 00:30:11,529 We can't get at the tumor without him bleeding out. 680 00:30:11,531 --> 00:30:16,467 ♪♪ 681 00:30:16,469 --> 00:30:17,969 We're gonna have to take it from the back. 682 00:30:17,971 --> 00:30:21,072 - But the S1 nerve root... - Is something he can live without. 683 00:30:21,074 --> 00:30:22,606 Dissecting scissors. 684 00:30:22,608 --> 00:30:26,510 ♪♪ 685 00:30:26,512 --> 00:30:27,912 HAN: Pledget anchor. 686 00:30:27,914 --> 00:30:30,514 ♪ You'll be leaving me soon, like hell you will ♪ 687 00:30:30,516 --> 00:30:34,919 ♪ The owl gazing at the moon ♪ 688 00:30:34,921 --> 00:30:39,123 ♪ Is the feeling that I get when I'm lookin' at you ♪ 689 00:30:39,125 --> 00:30:43,127 ♪ The sun will rise and fade the stars ♪ 690 00:30:43,129 --> 00:30:44,262 The plug is in position. 691 00:30:44,264 --> 00:30:46,244 You ready to test the bowel repair? 692 00:30:46,832 --> 00:30:47,998 ♪ And you're leaving me soon, like hell you are ♪ 693 00:30:48,000 --> 00:30:49,566 Let's take her off cardiac support. 694 00:30:49,568 --> 00:30:51,368 Dr. Murphy, it was your idea. 695 00:30:51,370 --> 00:30:52,969 You do the honors. 696 00:30:52,971 --> 00:30:58,208 ♪♪ 697 00:30:58,210 --> 00:30:59,510 [CLICKS] 698 00:30:59,512 --> 00:31:00,878 [MONITOR BEEPING STEADILY] 699 00:31:00,880 --> 00:31:03,747 ♪♪ 700 00:31:03,749 --> 00:31:06,683 Abdominal pressure is normal. 701 00:31:06,685 --> 00:31:09,052 The intestines are perfusing. 702 00:31:09,054 --> 00:31:12,255 ♪♪ 703 00:31:12,257 --> 00:31:14,324 - [ALARM BEEPING RAPIDLY] - HAN: Pulmonary pressure's spiking. 704 00:31:14,326 --> 00:31:15,526 Prostacyclin and nitric oxide... 705 00:31:15,528 --> 00:31:16,727 we need to get her lung pressure down. 706 00:31:16,729 --> 00:31:18,295 Oxygen SATs are dropping. 707 00:31:18,297 --> 00:31:20,563 No response to pulmonary vasodilators. 708 00:31:20,565 --> 00:31:23,299 Now the heart's too strong. It's overpowering her lungs. 709 00:31:23,301 --> 00:31:25,367 She needs to go back on cardiac support. 710 00:31:25,369 --> 00:31:26,502 [BEEPING CONTINUES] 711 00:31:26,504 --> 00:31:28,504 [CLICKS, BEEPING STEADIES] 712 00:31:28,506 --> 00:31:33,643 ♪♪ 713 00:31:33,645 --> 00:31:37,045 Persephone won't starve to death... 714 00:31:37,615 --> 00:31:39,949 but she will drown in her own fluids. 715 00:31:39,951 --> 00:31:42,452 ♪♪ 716 00:31:42,454 --> 00:31:47,924 ♪♪ 717 00:31:47,926 --> 00:31:54,663 ♪♪ 718 00:31:54,665 --> 00:31:56,197 I'll talk to the parents. 719 00:31:56,199 --> 00:31:57,566 May I come? 720 00:31:57,568 --> 00:32:03,404 ♪♪ 721 00:32:03,406 --> 00:32:09,110 ♪♪ 722 00:32:09,112 --> 00:32:11,713 Now that Persephone's heart is pumping at full power, 723 00:32:11,715 --> 00:32:13,448 her lungs are overwhelmed. 724 00:32:15,185 --> 00:32:16,885 The humane thing to do 725 00:32:16,887 --> 00:32:19,554 is to turn off the machines and let her go. 726 00:32:20,724 --> 00:32:22,632 No, I-I can't... 727 00:32:22,960 --> 00:32:24,493 I can't give up on her. [BREATHES SHARPLY] 728 00:32:24,495 --> 00:32:27,562 ♪♪ 729 00:32:27,564 --> 00:32:29,389 Because you fought for her 730 00:32:30,366 --> 00:32:32,633 every minute since she was born. 731 00:32:32,635 --> 00:32:34,935 Before that, when you were taking your medication 732 00:32:34,937 --> 00:32:36,069 for the depression, 733 00:32:36,071 --> 00:32:37,897 you were fighting to keep going 734 00:32:38,407 --> 00:32:40,140 so you could bring her into the world. 735 00:32:40,142 --> 00:32:42,510 [BREATHING SHAKILY] 736 00:32:42,512 --> 00:32:46,580 ♪♪ 737 00:32:46,582 --> 00:32:56,456 ♪♪ 738 00:32:56,458 --> 00:32:59,527 But letting go of Percy is not giving up on her. 739 00:32:59,529 --> 00:33:01,595 ♪♪ 740 00:33:01,597 --> 00:33:04,397 It's listening to what her body is telling us. 741 00:33:04,399 --> 00:33:09,201 ♪♪ 742 00:33:09,203 --> 00:33:10,537 She's hit her limit. 743 00:33:10,539 --> 00:33:14,440 ♪♪ 744 00:33:14,442 --> 00:33:16,009 [EXHALES SHARPLY] 745 00:33:16,011 --> 00:33:23,783 ♪♪ 746 00:33:23,785 --> 00:33:27,787 ♪♪ 747 00:33:27,789 --> 00:33:29,622 Okay. 748 00:33:29,624 --> 00:33:39,297 ♪♪ 749 00:33:39,299 --> 00:33:45,571 ♪♪ 750 00:33:45,573 --> 00:33:48,006 ♪♪ 751 00:33:48,008 --> 00:33:49,741 [SOBS] 752 00:33:49,743 --> 00:33:53,178 ♪♪ 753 00:33:53,180 --> 00:33:54,680 [CRYING] 754 00:33:54,682 --> 00:33:58,116 ♪♪ 755 00:34:00,633 --> 00:34:02,901 [MONITOR BEEPING STEADILY] 756 00:34:03,875 --> 00:34:05,708 HAN: I want Persephone to look as good as possible 757 00:34:05,710 --> 00:34:07,243 for the parents. 758 00:34:07,245 --> 00:34:10,547 ♪♪ 759 00:34:10,549 --> 00:34:12,214 [SIGHS] 760 00:34:12,216 --> 00:34:14,149 Let's turn off cardiac support. 761 00:34:14,151 --> 00:34:16,518 ♪♪ 762 00:34:16,520 --> 00:34:19,254 [CLICKS, BEEPING] 763 00:34:19,256 --> 00:34:20,823 Ventilator. 764 00:34:20,825 --> 00:34:22,223 ♪♪ 765 00:34:22,225 --> 00:34:23,792 Let's take a minute. 766 00:34:23,794 --> 00:34:26,194 [MONITOR BEEPING STEADILY] 767 00:34:26,196 --> 00:34:33,602 ♪♪ 768 00:34:33,604 --> 00:34:42,110 ♪♪ 769 00:34:42,112 --> 00:34:48,916 ♪♪ 770 00:34:48,918 --> 00:34:52,187 [LOUD, RHYTHMIC BEEPING] 771 00:34:52,189 --> 00:34:53,621 ♪♪ 772 00:34:53,623 --> 00:35:00,362 ♪♪ 773 00:35:00,364 --> 00:35:07,102 ♪♪ 774 00:35:07,104 --> 00:35:08,769 Check valve. 775 00:35:08,771 --> 00:35:13,108 ♪♪ 776 00:35:13,110 --> 00:35:15,543 Every time the heart contracted, 777 00:35:15,545 --> 00:35:17,778 blood went into the opposite side of the heart 778 00:35:17,780 --> 00:35:19,680 and raised lung pressure. 779 00:35:19,682 --> 00:35:22,416 The hole reduced the pressure when it got too high 780 00:35:22,418 --> 00:35:23,817 because it allowed backflow. 781 00:35:23,819 --> 00:35:27,254 But our repair of the defect blocked this backwards flow. 782 00:35:27,256 --> 00:35:29,656 What if we made it so she still had a heart defect, 783 00:35:29,658 --> 00:35:31,558 but only when she needed it? 784 00:35:31,560 --> 00:35:35,529 It'd be like an unlatched door in the wall of the heart. 785 00:35:35,531 --> 00:35:37,731 When the pressure gets too high on the right side, 786 00:35:37,733 --> 00:35:40,600 the door swings open, releasing the pressure on the lungs. 787 00:35:40,602 --> 00:35:42,503 The rest of the time, it stays shut. 788 00:35:42,505 --> 00:35:45,372 It should reduce lung pressure by a third. Is that enough? 789 00:35:45,374 --> 00:35:46,507 It depends on how high 790 00:35:46,509 --> 00:35:48,509 her pulmonary vascular resistance is. 791 00:35:48,511 --> 00:35:50,877 PVR is pulmonary artery pressure 792 00:35:50,879 --> 00:35:53,980 minus wedge pressure divided by cardiac output times 80. 793 00:35:53,982 --> 00:35:59,419 ♪♪ 794 00:35:59,421 --> 00:36:04,844 ♪♪ 795 00:36:04,846 --> 00:36:06,725 CANDICE: The last time I saw my doctor, 796 00:36:06,727 --> 00:36:09,628 he told me I had six months to live. 797 00:36:09,630 --> 00:36:11,431 He also told me I should marry an accountant 798 00:36:11,433 --> 00:36:12,765 and move to North Dakota. 799 00:36:12,767 --> 00:36:14,367 LARRY: You don't say. 800 00:36:14,369 --> 00:36:16,869 When I asked if it would help my cancer, he said no, 801 00:36:16,871 --> 00:36:19,672 just make the six months seem much longer. 802 00:36:19,674 --> 00:36:22,275 [BOTH LAUGH] 803 00:36:23,010 --> 00:36:26,679 What's the difference between a Neo-Nazi and cancer? 804 00:36:26,681 --> 00:36:28,274 Cancer doesn't discriminate. 805 00:36:28,276 --> 00:36:29,515 [LAUGHS] 806 00:36:29,517 --> 00:36:31,517 [LAUGHS] 807 00:36:31,519 --> 00:36:33,285 I knew a guy once... 808 00:36:33,287 --> 00:36:35,720 his Zodiac sign was Cancer. 809 00:36:35,722 --> 00:36:38,890 It was really ironic how he died. 810 00:36:40,260 --> 00:36:42,027 Uh, uh, how's that? 811 00:36:42,029 --> 00:36:43,962 He was eaten by a giant crab. 812 00:36:43,964 --> 00:36:47,832 - [LAUGHTER] - Oh, geez. 813 00:36:47,834 --> 00:36:49,267 [LAUGHS] 814 00:36:49,269 --> 00:36:51,503 Aaron, glioma. 815 00:36:51,505 --> 00:36:54,038 Candice, leukemia. 816 00:36:54,040 --> 00:36:55,307 Gin rummy or blackjack? 817 00:36:55,309 --> 00:36:57,342 How fast do you want to take my money? 818 00:36:57,344 --> 00:36:58,843 Blackjack. 819 00:36:58,845 --> 00:37:00,326 Cut 'em. 820 00:37:12,243 --> 00:37:14,310 Did you get it all? 821 00:37:17,396 --> 00:37:18,829 Yes... 822 00:37:18,831 --> 00:37:20,764 totally clear margins. 823 00:37:20,766 --> 00:37:22,433 But the only way to achieve that 824 00:37:22,435 --> 00:37:24,935 involved removing the nerve that controls your left foot. 825 00:37:26,572 --> 00:37:29,873 Rehab and an advanced orthotic may help, 826 00:37:29,875 --> 00:37:32,676 but you will walk with a limp. 827 00:37:32,678 --> 00:37:34,978 Final pathology will let us know if it was worth it. 828 00:37:39,157 --> 00:37:40,984 I'll let you know when it comes in. 829 00:37:43,215 --> 00:37:45,481 It doesn't matter anymore. 830 00:37:48,412 --> 00:37:50,645 It's not like you can put the tumor back in. 831 00:37:58,303 --> 00:38:00,570 [BABY CRYING] 832 00:38:05,777 --> 00:38:08,344 Is she... okay? 833 00:38:09,447 --> 00:38:13,683 She still has a surgery or two in her future, but, yes. 834 00:38:13,685 --> 00:38:15,276 She's gonna be great. 835 00:38:16,120 --> 00:38:18,887 - [BREATHES SHARPLY] - [SNIFFLES] 836 00:38:18,889 --> 00:38:20,422 Can I hold her? 837 00:38:20,424 --> 00:38:22,617 I think that would be very nice. 838 00:38:23,227 --> 00:38:25,093 For both of you. 839 00:38:25,095 --> 00:38:34,069 ♪♪ 840 00:38:34,071 --> 00:38:35,904 [BABY CRYING] 841 00:38:35,906 --> 00:38:40,008 ♪♪ 842 00:38:40,010 --> 00:38:42,377 [CRYING] Hi, angel. 843 00:38:42,379 --> 00:38:43,278 ♪♪ 844 00:38:43,280 --> 00:38:44,413 [BABY COOS] 845 00:38:44,415 --> 00:38:47,249 Oh, my baby. [SMOOCHES] 846 00:38:47,251 --> 00:38:50,485 ♪♪ 847 00:38:50,487 --> 00:38:52,019 Come hold her. 848 00:38:52,021 --> 00:38:58,426 ♪♪ 849 00:38:58,428 --> 00:39:00,928 You were fighting for her, too. 850 00:39:00,930 --> 00:39:04,131 ♪♪ 851 00:39:04,133 --> 00:39:06,133 [SNIFFLES] 852 00:39:06,135 --> 00:39:08,569 - [BOTH CHUCKLE] - She's beautiful. 853 00:39:08,571 --> 00:39:15,710 ♪♪ 854 00:39:15,712 --> 00:39:17,296 Nice work. 855 00:39:18,514 --> 00:39:20,132 Thank you. 856 00:39:21,050 --> 00:39:23,917 - [BABY CRYING] - She's beautiful. 857 00:39:23,919 --> 00:39:25,486 Listen to her. Oh. 858 00:39:25,488 --> 00:39:28,122 [CRYING] 859 00:39:28,124 --> 00:39:35,262 ♪♪ 860 00:39:36,866 --> 00:39:38,398 Thank you. 861 00:39:38,400 --> 00:39:41,568 [SIGHS DEEPLY] 862 00:39:43,538 --> 00:39:45,705 Minesh's biopsy results? 863 00:39:50,512 --> 00:39:52,980 [SIGHS] 864 00:39:55,751 --> 00:39:57,050 You don't want to know if we wasted our time 865 00:39:57,052 --> 00:39:58,462 almost killing him? 866 00:39:59,621 --> 00:40:01,488 Can't put the tumor back. 867 00:40:17,506 --> 00:40:19,692 Hello, Dr. Han. 868 00:40:20,208 --> 00:40:22,442 You take the bus, too? 869 00:40:22,444 --> 00:40:23,843 No, Shaun. 870 00:40:23,845 --> 00:40:26,282 I just wanted to talk to you. 871 00:40:26,948 --> 00:40:29,015 [INHALES SHARPLY] 872 00:40:29,017 --> 00:40:33,218 You really do have remarkable diagnostic skills. 873 00:40:33,220 --> 00:40:36,188 I have to admit, you're an asset to this hospital. 874 00:40:36,626 --> 00:40:38,390 Yes, I am. 875 00:40:41,061 --> 00:40:44,383 I spoke to the Residency Director of Pathology. 876 00:40:45,032 --> 00:40:48,012 And we both agree you'll be a great fit there. 877 00:40:50,438 --> 00:40:53,706 I'm a surgical resident. 878 00:40:53,708 --> 00:40:55,808 As a pathology resident, 879 00:40:55,810 --> 00:40:58,677 you'll touch cases and lives 880 00:40:58,679 --> 00:41:02,247 across all the medical departments. 881 00:41:02,249 --> 00:41:04,483 It's an opportunity for you to help patients 882 00:41:04,485 --> 00:41:07,490 without having to deal with patients. 883 00:41:08,616 --> 00:41:12,457 Given your difficulties with communication and social cues, 884 00:41:12,459 --> 00:41:14,955 I think it will be a much better fit. 885 00:41:15,795 --> 00:41:17,458 No, thank you. 886 00:41:18,292 --> 00:41:21,198 I have been working very hard 887 00:41:21,200 --> 00:41:24,006 at my communication skills. 888 00:41:24,571 --> 00:41:26,759 Hard work isn't enough. 889 00:41:27,507 --> 00:41:29,273 You have to do the job. 890 00:41:31,811 --> 00:41:36,080 I am a surgical resident. 891 00:41:37,884 --> 00:41:39,522 You were. 892 00:41:40,787 --> 00:41:43,520 And you're gonna do great work in pathology. 893 00:41:45,358 --> 00:41:48,859 [WYLDER'S "AT THE END PT. 1" PLAYS] 894 00:41:48,861 --> 00:41:52,162 ♪ Oh, and when the storms come ♪ 895 00:41:52,164 --> 00:41:55,465 ♪ Flooding through the hall ♪ 896 00:41:55,467 --> 00:41:57,734 ♪ Rising to the landing ♪ 897 00:41:57,736 --> 00:42:01,671 ♪ Tearing pictures from the walls ♪ 898 00:42:01,673 --> 00:42:04,508 ♪ The currents pull us underneath ♪ 899 00:42:04,510 --> 00:42:08,145 ♪ That bright tide rips us out ♪ 900 00:42:08,147 --> 00:42:11,181 ♪ Into a tangled coral reef ♪ 901 00:42:11,183 --> 00:42:14,985 ♪ Where we could never drown ♪ 902 00:42:14,987 --> 00:42:17,921 ♪ Now that ♪ 903 00:42:17,923 --> 00:42:20,557 ♪ We're at the end ♪ 62422

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