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Previously on The Resident…
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I hope it's okay that I'm here.
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-[Hannah] How dare you?
-What happened here?
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If you stepped out of line, it won't
just be Pravesh who comes for you.
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Surgery is a dangerous place.
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Especially considering your condition.
7
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You mean my dyslexia?
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Tell me why you aren't a scientist yet.
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This is obviously your future.
Got to go for it.
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I would like to start
shifting my professional focus
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to clinical trials.
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Have a proposal on my desk by Monday.
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["The Weight" by The Band playing]
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[phone chiming]
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[exhales]
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♪ I pulled into Nazareth… ♪
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No eggs, Daddy, please, no eggs.
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I want cereal. And a banana.
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Whoa, whoa, excuse me.
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Coming right up.
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[pager beeping]
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♪ Hey, mister, can you tell me ♪
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♪ Where a man might find a bed? ♪
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♪ He just grinned and shook my hand… ♪
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Daddy, did you forget
to go to the market again?
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♪ Take a load off… ♪
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I did.
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I am a bad daddy.
29
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No, you're not.
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♪ Take a load off, Fanny… ♪
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Let's grab your backpack.
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We'll get something great for you.
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Takeout on the way to school.
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♪ You put the load right on me ♪
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♪ Ooh-ooh-ooh-ooh ♪
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♪ I picked up my bag ♪
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♪ I went looking for a place to hide ♪
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-[sighs]
-♪ When I saw Carmen ♪
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♪ And the devil walking side by side… ♪
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Another all-nighter. This has got to stop.
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-I know.
-You're wearing yourself out.
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I know.
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But I don't know how to stop.
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♪ I got to go, but my friend
Can stick around ♪
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[grunts]
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♪ Take a load off, Fanny ♪
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♪ Take a load for free ♪
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♪ Take a load off, Fanny ♪
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♪ And, and ♪
50
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♪ And you put the load right on me ♪
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♪ You put the load right on me ♪
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[phone chimes]
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♪ Crazy Chester followed me ♪
54
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♪ And he caught me in the fog ♪
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[phone chimes]
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♪ He said, I will fix your rack ♪
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♪ If you'll take Jack my dog" ♪
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♪ I said wait a minute, Chester ♪
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♪ You know I'm a peaceful man ♪
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♪ He said that's okay, boy ♪
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[phone chimes]
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♪ Won't you feed him when you can? ♪
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♪ Yeah, take a load off, Fanny ♪
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♪ Take a load for free ♪
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♪ Take a load off, Fanny ♪
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♪ And, and ♪
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♪ And you put the load right on me ♪
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♪ Put the load right on me… ♪
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[birds chirping]
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[Janice] Dude,
I lanced this massive abscess,
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and the pus exploded all over Dr. Feldman.
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-Ah.
-He was pissed.
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-Pus-wise, better him than you.
-Definitely.
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Trevor, we know
you made the highlight reel.
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[Trevor] Yeah, yeah.
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No eruptions of bodily fluids, though.
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You had that awesome spinal tap.
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-Hello. Beer-gate? Legendary.
-[laughter]
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Okay, Pravesh almost cut me, so…
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Sure, but then Hawkins swooped in
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and took you under his wing.
Please, golden boy.
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"Golden boy."
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I don't think anyone has
strong feelings about me.
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I'd like to put in a central line.
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Hey. Five-car pileup on Peachtree,
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multiple injuries headed our way.
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All hands on deck. It's game time.
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[theme music playing]
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Dr. Hawkins, Bay 2.
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-On it.
-All right, let's get him to Bay 4.
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-Zach, with me.
-Gemma, Bay 9.
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Pravesh, Bay 10. We're gonna need
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-another set of hands.
-Okay,
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Janice, Trevor, you come with me.
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Pravesh!
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-Give me Trevor.
-Go see what he needs.
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[Conrad] Grab the ultrasound.
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Right.
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Assess her for internal injuries,
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then we'll deal with
the lower-extremity lacerations.
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Got it.
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Whoa.
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-Ma'am, what's wrong?
-It's not my stomach. I'm okay.
104
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But he's not.
105
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I watched him turn his bike
and drive right into traffic.
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He caused all of this.
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There's something
definitely wrong with him.
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Hey, Zach.
I need you to do a quick FAST exam
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and suture up some lacs.
Trevor, come with me.
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The X-rays showed a fractured rib,
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but fortunately no broken ankle.
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You're gonna be fine.
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-You're in good hands here.
-Thank you.
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You're welcome.
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I-I really don't know what happened.
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One minute I'm riding my bike,
next I'm on the ground
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and cars are skidding and crashing.
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I feel terrible.
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Might have passed out?
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You got lucky. You could've been killed.
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Getting lucky is kind of my thing.
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Yeah? How's that?
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I was on a charter boat once. It sunk.
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Everyone drowned except me.
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00:05:33,499 --> 00:05:35,918
-I won the lottery twice.
-[Trevor] Cool.
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Maybe look at the numbers
I've been playing.
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Happy to, Doc. [chuckles]
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Wow, you got the odds
of the gods on your side.
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I have always felt protected
in an otherworldly way.
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A-And those are just the highlights.
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I also got diagnosed
with this thing, sarcoid?
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Mm-hmm.
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Supposed to be bad,
but it's never been a problem.
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[Trevor] Sarcoid?
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00:05:55,313 --> 00:05:57,732
What medications are you taking for that?
136
00:05:57,815 --> 00:06:00,735
None. I'm not one
to take meds I don't need.
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Too many side effects.
138
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-Whoa, whoa.
-Oh, Wyatt.
139
00:06:05,073 --> 00:06:06,365
Wyatt?
140
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We need to get him on the monitor now.
141
00:06:09,077 --> 00:06:10,620
-Hey.
-Hey.
142
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Sorry you had to come in.
143
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It's killing me.
I've got to get my grant proposal done.
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-How are you?
-Surgery went long. Don't ask.
145
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Man, it's crazy in here today.
146
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I know. Hi, Brit.
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-[pager beeping]
-This is Dr. Devi.
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She's the surgical consultant
I told you about.
149
00:06:27,762 --> 00:06:29,931
Uh, I'm so sorry. Hi, Brit.
150
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I probably shouldn't have come.
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I've had this pain on and off for months.
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But I realized I'd lost ten pounds.
153
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Without trying, really,
so I'm a little spooked.
154
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I'm probably overreacting, right?
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[Leela] Let's just start with an exam.
156
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Ow! Right there.
157
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-Can you describe your pain?
-Throbbing.
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Or maybe stabbing.
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Are you having any nausea or vomiting?
160
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I thought I was just nervous,
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you know, existential angst,
which I am prone to,
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and it is kind of my
occupational wheelhouse.
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I'm a cartoonist.
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Life's a Joke.
165
00:07:04,590 --> 00:07:06,217
-That's my strip.
-Hmm.
166
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So, yes to the nausea and vomiting?
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Oh, right, yes.
Krakatoa, east of Java, man.
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Just keeps on coming up.
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We'll start with a CT scan
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and we can admit you
to get control over your pain
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and go from there.
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-Okay?
-Cool.
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[Devon] All right, we'll be back.
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It's a large hepatic hemangioma.
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That's a good catch, Dr. Devi.
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[Leela]
I haven't seen one of these before.
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They're more common than you think.
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They're benign tumors made up of clusters
of blood-filled cavities.
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And usually they don't cause symptoms.
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Well, I'm relieved it's benign.
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My patient will be, too.
She's a little kooky.
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Sweet, though.
183
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Should I book an OR for this afternoon?
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00:07:48,426 --> 00:07:50,887
Oh, not so fast.
Surgery's not a slam dunk here.
185
00:07:51,971 --> 00:07:53,598
A benign tumor causing pain?
186
00:07:53,681 --> 00:07:55,725
Well, surgery on the liver
is always high-risk,
187
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even in the best hands,
and pain can be managed.
188
00:07:57,894 --> 00:07:59,896
Okay, so I tell her we're not operating,
189
00:07:59,979 --> 00:08:02,482
and I need a repeat scan in two months.
190
00:08:02,565 --> 00:08:04,150
And that's not the answer, either.
191
00:08:04,734 --> 00:08:06,736
This is not something we can decide here.
192
00:08:06,819 --> 00:08:08,279
You need to talk to your patient,
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00:08:08,362 --> 00:08:11,407
get a sense of her risk tolerance
and seriousness of her symptoms,
194
00:08:11,491 --> 00:08:14,202
and then you tell me what
path you think makes sense.
195
00:08:16,204 --> 00:08:18,122
All right. Can you come with?
196
00:08:18,206 --> 00:08:20,041
Nope. She's your patient, you handle it.
197
00:08:20,124 --> 00:08:23,711
Then meet me in OR 3,
an, uh, emergent splenectomy.
198
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Uh, 15 minutes.
199
00:08:28,090 --> 00:08:29,342
[Leela] You have two options.
200
00:08:29,425 --> 00:08:30,676
If the surgery goes well,
201
00:08:30,760 --> 00:08:32,970
-your symptoms go away.
-Awesome.
202
00:08:33,054 --> 00:08:35,223
But surgery on the liver
is never an easy call to make.
203
00:08:35,306 --> 00:08:37,099
It's an organ with
many large blood vessels,
204
00:08:37,183 --> 00:08:39,310
which means we could
run into significant bleeding.
205
00:08:39,393 --> 00:08:40,520
Oh. Not awesome.
206
00:08:40,603 --> 00:08:42,188
And that circumstance would require
207
00:08:42,271 --> 00:08:45,691
a much larger surgery with complications
and a long recovery.
208
00:08:47,693 --> 00:08:48,694
Are you with me?
209
00:08:48,778 --> 00:08:49,946
Uh, sort of.
210
00:08:50,029 --> 00:08:52,865
Uh, you understand, right?
I'm not a doctor.
211
00:08:52,949 --> 00:08:54,534
I'm a cartoonist.
212
00:08:55,284 --> 00:08:56,244
Right.
213
00:08:56,327 --> 00:08:57,370
Um…
214
00:08:59,455 --> 00:09:00,581
Do you take risks?
215
00:09:00,665 --> 00:09:03,042
If you do, then we go with the surgery.
216
00:09:03,125 --> 00:09:05,628
Are you cautious?
Then we hold off for now,
217
00:09:05,711 --> 00:09:07,380
so long as your pain is tolerable.
218
00:09:08,130 --> 00:09:09,507
[sighs]
219
00:09:09,590 --> 00:09:10,925
I don't know, Dr. Devi.
220
00:09:11,008 --> 00:09:13,177
Okay, you know what? Look.
221
00:09:13,261 --> 00:09:15,555
It's okay. Big decision.
222
00:09:15,638 --> 00:09:17,390
Think about it, and I will check in
223
00:09:17,473 --> 00:09:19,016
as soon as I'm back from surgery.
224
00:09:19,100 --> 00:09:20,059
Okay.
225
00:09:24,355 --> 00:09:26,941
Heart block. What is that?
226
00:09:27,024 --> 00:09:29,193
Because of the sarcoid,
your heart's electric circuit
227
00:09:29,277 --> 00:09:31,445
isn't working correctly, so your heartbeat
228
00:09:31,529 --> 00:09:33,197
slows to a dangerously low rate.
229
00:09:33,322 --> 00:09:35,032
In some cases, it can stop completely.
230
00:09:35,116 --> 00:09:37,076
Which, to state the obvious, is fatal.
231
00:09:37,159 --> 00:09:39,537
This morning,
your heartbeat slowed so much
232
00:09:39,620 --> 00:09:41,789
that you fainted
and you crashed your bike.
233
00:09:41,872 --> 00:09:43,541
[Austin] But there is some good news.
234
00:09:43,624 --> 00:09:44,834
Told you guys.
235
00:09:44,917 --> 00:09:47,169
The solution to your problem
236
00:09:47,253 --> 00:09:48,546
is safe and simple.
237
00:09:48,629 --> 00:09:50,006
We put in a pacemaker,
238
00:09:50,089 --> 00:09:52,049
and your heart
goes back to beating normally.
239
00:09:52,133 --> 00:09:53,676
So you're saying I need a surgery?
240
00:09:53,759 --> 00:09:55,344
It's just an outpatient procedure.
241
00:09:55,428 --> 00:09:57,263
No general anesthesia, no operating room.
242
00:09:57,346 --> 00:09:59,348
It's super simple.
243
00:09:59,432 --> 00:10:02,810
Another narrow escape from death.
The Wyatt Barnes legend grows.
244
00:10:02,893 --> 00:10:05,146
-Hey.
-[laughter]
245
00:10:05,229 --> 00:10:07,481
I'd like to admit you
for observation, and then
246
00:10:07,565 --> 00:10:09,525
we'll schedule the procedure
as soon as possible.
247
00:10:09,609 --> 00:10:10,985
Oh, I don't want the pacemaker.
248
00:10:12,194 --> 00:10:14,280
A-Admit me, fine, but, you know, finish
249
00:10:14,363 --> 00:10:16,741
fixing me up and…
[tongue clicks] send me home.
250
00:10:16,824 --> 00:10:17,825
No, you don't understand.
251
00:10:17,908 --> 00:10:20,995
If we don't put the pacemaker in,
you will almost certainly die.
252
00:10:21,078 --> 00:10:21,996
Almost?
253
00:10:23,497 --> 00:10:24,749
I'll take those odds.
254
00:10:25,875 --> 00:10:27,043
[Austin] We are doctors,
255
00:10:27,126 --> 00:10:30,004
advising you on a procedure
that will save your life.
256
00:10:30,087 --> 00:10:34,342
Sorry, but it's my body, my decision.
257
00:10:34,425 --> 00:10:36,344
No pacemaker.
258
00:10:37,553 --> 00:10:38,846
No, thanks.
259
00:10:44,226 --> 00:10:46,020
-We need a cart!
-Now that you're spending
260
00:10:46,103 --> 00:10:48,189
more time on research and clinical trials,
261
00:10:48,272 --> 00:10:49,815
we need a new ER doctor.
262
00:10:49,899 --> 00:10:51,901
And I'd like you
to do the interviews today.
263
00:10:51,984 --> 00:10:53,694
I would, of course,
but I'm only filling in
264
00:10:53,778 --> 00:10:55,112
for a few hours today.
265
00:10:55,196 --> 00:10:57,239
And I didn't set aside time for that.
266
00:10:57,323 --> 00:10:59,033
There must be someone else who can help.
267
00:10:59,158 --> 00:11:00,868
There's no one. I worked all night.
268
00:11:00,951 --> 00:11:03,746
I'm sorry. Here are the candidates.
269
00:11:03,829 --> 00:11:06,999
Dr. Voss, I have to get
my grant proposal in by 6:00 p.m.
270
00:11:07,083 --> 00:11:09,085
Your proposal will have to wait.
271
00:11:09,168 --> 00:11:11,712
I don't need to remind you why
we're short-staffed in the ER.
272
00:11:13,714 --> 00:11:15,091
Yeah. I get it.
273
00:11:15,174 --> 00:11:16,425
-[pager beeping]
-Thank you.
274
00:11:16,509 --> 00:11:18,094
I'm counting on you.
275
00:11:18,844 --> 00:11:20,388
Happy to help.
276
00:11:20,471 --> 00:11:22,473
[phone chiming and buzzing]
277
00:11:43,119 --> 00:11:45,621
So, our Mr. Lucky has complete AV block
278
00:11:45,704 --> 00:11:47,623
with wide ventricular escape.
279
00:11:47,706 --> 00:11:49,375
He won't live long enough to cash in
280
00:11:49,458 --> 00:11:51,210
his third lotto ticket
without a pacemaker.
281
00:11:51,293 --> 00:11:52,211
[sighs]
282
00:11:52,294 --> 00:11:54,213
I mean, you think he wants to die?
283
00:11:54,296 --> 00:11:55,631
[phone ringing]
284
00:11:55,714 --> 00:11:59,635
Yeah, the guy's super cheerful.
It's bizarre.
285
00:11:59,718 --> 00:12:01,887
Mom, listen, I'm in the middle of…
286
00:12:04,014 --> 00:12:05,808
Well, is-is the cough getting any better?
287
00:12:06,475 --> 00:12:08,102
Did you call the oncologist?
288
00:12:09,228 --> 00:12:11,605
Mom, just do it now, please.
289
00:12:11,689 --> 00:12:14,024
Yes, I will see you
before I go to the airport.
290
00:12:16,318 --> 00:12:18,279
Tell Carol I'll call her,
291
00:12:18,362 --> 00:12:21,031
talk her through some options
for her respiratory symptoms.
292
00:12:22,199 --> 00:12:23,659
Appreciate it, man.
293
00:12:25,077 --> 00:12:27,204
Look, I-I wish I could engage.
294
00:12:27,288 --> 00:12:29,540
All right?
I-If there were 28 hours in the day,
295
00:12:29,623 --> 00:12:31,542
I would gladly wax poetic with the patient
296
00:12:31,625 --> 00:12:33,169
about the benefits of a pacemaker,
297
00:12:33,252 --> 00:12:35,129
but I do not have the time.
298
00:12:35,212 --> 00:12:38,507
I have way too many patients
who would kill for an easy cure.
299
00:12:38,591 --> 00:12:41,385
I got too many, too many obligations.
300
00:12:41,469 --> 00:12:42,803
You get him to see reason,
301
00:12:42,887 --> 00:12:44,430
I have no doubt that you will,
302
00:12:44,513 --> 00:12:46,724
then I will come back,
I'll put in the pacer.
303
00:12:49,894 --> 00:12:51,270
[exhales]
304
00:12:51,353 --> 00:12:53,355
Okay. Have you, uh…
305
00:12:53,439 --> 00:12:54,732
you seen this problem before?
306
00:12:54,815 --> 00:12:57,151
All the time during the pandemic.
307
00:12:58,611 --> 00:13:01,155
We had a lot of patients
who died claiming COVID was made up.
308
00:13:01,238 --> 00:13:03,032
Well, what do we do next?
309
00:13:03,115 --> 00:13:06,452
He agreed to a brief admission,
so we bring him up to the ICU,
310
00:13:06,535 --> 00:13:09,663
start him on isoproterenol
to raise his heart rate
311
00:13:09,747 --> 00:13:11,832
while I figure out a way to
get him to see reason.
312
00:13:12,583 --> 00:13:14,168
I will watch and learn.
313
00:13:15,544 --> 00:13:17,421
Hey, Brit, have you had some time
314
00:13:17,505 --> 00:13:19,173
to review your options?
315
00:13:22,510 --> 00:13:24,803
She was here a minute ago.
She should be back soon.
316
00:13:34,021 --> 00:13:38,234
And if you had to change one thing
about emergency medicine,
317
00:13:38,317 --> 00:13:39,443
what would it be?
318
00:13:39,527 --> 00:13:40,903
We're letting money walk out.
319
00:13:40,986 --> 00:13:42,363
That's for sure.
320
00:13:42,446 --> 00:13:44,949
Uh, I personally would deploy
a-a number of strategies
321
00:13:45,032 --> 00:13:47,076
that would be more lucrative
for the hospital.
322
00:13:47,159 --> 00:13:48,285
Uh, I mean, you can't fix
323
00:13:48,369 --> 00:13:50,246
all the inefficiencies at once, you know?
324
00:13:50,329 --> 00:13:53,874
You got to let this, uh,
this pig work its way through
325
00:13:53,958 --> 00:13:56,168
the-the boa constrictor, so to speak.
326
00:13:56,252 --> 00:13:59,046
So, I created some slides here,
uh, with ideas
327
00:13:59,129 --> 00:14:01,715
for how to capitalize
on low-hanging fruit.
328
00:14:01,840 --> 00:14:03,175
I'll talk you through it.
329
00:14:03,259 --> 00:14:05,302
Uh, shouldn't be more than, uh, an hour.
330
00:14:06,345 --> 00:14:07,555
Or two.
331
00:14:10,349 --> 00:14:11,725
Brit?
332
00:14:12,935 --> 00:14:15,145
I've been looking everywhere for you.
333
00:14:16,397 --> 00:14:18,816
Has your abdominal pain gotten worse?
334
00:14:18,899 --> 00:14:21,443
You shouldn't be out here.
We should get you back inside.
335
00:14:21,527 --> 00:14:23,779
It's not that, Dr. Devi.
336
00:14:23,863 --> 00:14:26,073
I had to get some air so I could think.
337
00:14:26,156 --> 00:14:27,366
Okay.
338
00:14:29,952 --> 00:14:31,996
I can't decide about the surgery.
339
00:14:32,079 --> 00:14:33,706
I tell myself, "Go for it."
340
00:14:34,707 --> 00:14:36,709
Then I think it's too dangerous.
341
00:14:37,459 --> 00:14:41,005
What if I bleed to death in the OR
and my cat dies alone?
342
00:14:41,088 --> 00:14:44,717
Or I go home and die and no
one finds me and Tinkerbell eats me.
343
00:14:44,800 --> 00:14:46,969
-You have to take it easy, Brit.
-Sometimes I wake up
344
00:14:47,052 --> 00:14:48,971
and she's staring at me
like I'm a goldfish.
345
00:14:49,054 --> 00:14:50,556
There's a darkness in her.
346
00:14:51,432 --> 00:14:52,516
I'm indecisive.
347
00:14:53,517 --> 00:14:55,853
Even about things that don't matter.
348
00:14:55,936 --> 00:14:58,606
My cartoons poke fun at people like me.
349
00:15:00,816 --> 00:15:01,650
Brit.
350
00:15:03,736 --> 00:15:06,363
What can I do to help you
make this decision?
351
00:15:08,240 --> 00:15:09,658
Make it for me?
352
00:15:10,868 --> 00:15:12,578
Just be my doctor.
353
00:15:12,661 --> 00:15:14,371
I'll do whatever you say.
354
00:15:16,916 --> 00:15:18,918
[monitor beeping steadily]
355
00:15:22,546 --> 00:15:23,797
How am I doing?
356
00:15:24,798 --> 00:15:27,134
[Conrad]
Your heart rate is dangerously slow.
357
00:15:27,217 --> 00:15:29,178
38.
358
00:15:29,261 --> 00:15:31,889
Meds helped transiently,
but they can't fix this,
359
00:15:31,972 --> 00:15:33,140
and it's getting worse.
360
00:15:33,223 --> 00:15:34,475
I feel fine.
361
00:15:34,558 --> 00:15:35,935
That's impossible, okay?
362
00:15:36,018 --> 00:15:37,645
You have to be tired, light-headed…
363
00:15:37,728 --> 00:15:38,729
Not really.
364
00:15:39,897 --> 00:15:41,023
I'm hungry.
365
00:15:41,106 --> 00:15:42,775
This place have ice cream?
366
00:15:44,151 --> 00:15:46,320
Yes… [chuckles]
367
00:15:46,403 --> 00:15:48,280
…but let's finish talking first.
368
00:15:49,239 --> 00:15:50,866
A pacemaker is a simple device.
369
00:15:50,950 --> 00:15:53,243
It is not dangerous to put in,
370
00:15:53,327 --> 00:15:56,163
and it will keep you from falling
in the middle of traffic.
371
00:15:56,246 --> 00:15:57,998
Or dying today.
372
00:15:58,666 --> 00:16:00,000
Which could happen.
373
00:16:01,627 --> 00:16:02,836
It's not gonna happen.
374
00:16:02,920 --> 00:16:05,214
-What are you afraid of, Wyatt?
-[scoffs]
375
00:16:05,339 --> 00:16:07,299
I'm not afraid. I just don't like the idea
376
00:16:07,383 --> 00:16:09,385
of having a foreign object
put into my body.
377
00:16:09,468 --> 00:16:11,553
Do you know anyone with type 1 diabetes?
378
00:16:11,637 --> 00:16:13,263
Yeah. My old boss.
379
00:16:13,347 --> 00:16:15,015
Did your boss use an insulin pump?
380
00:16:15,099 --> 00:16:17,393
She does, but what you're talking about
381
00:16:17,518 --> 00:16:19,353
is putting something
in to control my heart.
382
00:16:19,436 --> 00:16:20,562
That's different.
383
00:16:20,646 --> 00:16:21,814
No. Not really.
384
00:16:21,939 --> 00:16:23,732
Complications from pacemakers are rare.
385
00:16:23,816 --> 00:16:26,110
[Wyatt]
I'm sorry, but I do my own research.
386
00:16:26,193 --> 00:16:28,070
I'm part of this Facebook group.
387
00:16:28,153 --> 00:16:29,613
-Here we go.
-They published a list
388
00:16:29,697 --> 00:16:31,490
of unsafe products from China.
389
00:16:31,573 --> 00:16:34,535
Know what's on top? Pacemakers.
390
00:16:34,618 --> 00:16:36,286
Now, they're assembled here,
391
00:16:36,370 --> 00:16:38,288
but guess where the parts come from.
392
00:16:38,372 --> 00:16:41,875
Yep. Guy in the group
got poisoned by some bad metals.
393
00:16:41,959 --> 00:16:44,712
Those posts aren't truthful, Wyatt.
394
00:16:44,795 --> 00:16:48,132
They are propaganda
from unqualified people
395
00:16:48,215 --> 00:16:49,967
who have politicized health and medicine.
396
00:16:50,050 --> 00:16:51,927
They either want
to sow distrust in science
397
00:16:52,011 --> 00:16:53,137
or sell you snake oil.
398
00:16:53,220 --> 00:16:54,430
[Trevor] The truth, Wyatt?
399
00:16:54,513 --> 00:16:58,058
Bad metal is not a thing. Dr. Hawkins is
who you want giving you advice.
400
00:16:58,142 --> 00:16:59,601
He's an actual expert.
401
00:16:59,685 --> 00:17:01,395
I form my own opinions, okay?
402
00:17:01,478 --> 00:17:04,356
-You have yours.
-Okay, this isn't an opinion.
403
00:17:04,440 --> 00:17:05,899
It's fact versus fiction.
404
00:17:05,983 --> 00:17:07,401
-Understand?
-[Conrad] All right.
405
00:17:09,028 --> 00:17:10,195
We hear you, Wyatt.
406
00:17:10,279 --> 00:17:11,864
Okay?
407
00:17:14,158 --> 00:17:16,368
Be back to check on you in a bit.
408
00:17:16,452 --> 00:17:18,037
Thanks, Doc.
409
00:17:20,039 --> 00:17:21,623
He was getting more and more dug in.
410
00:17:21,707 --> 00:17:23,459
-Have to take a step back.
-If Wyatt dies,
411
00:17:23,542 --> 00:17:24,793
it won't be sarcoid.
412
00:17:24,877 --> 00:17:27,546
it'll be i-irrational fear
and misinformation.
413
00:17:27,629 --> 00:17:29,882
And those are
difficult conditions to cure.
414
00:17:29,965 --> 00:17:31,675
-I…
-Some people only accept information
415
00:17:31,759 --> 00:17:33,093
that confirms their beliefs.
416
00:17:33,177 --> 00:17:35,179
You have to give them the facts,
417
00:17:35,262 --> 00:17:37,014
tell them how important the science is,
418
00:17:37,097 --> 00:17:39,808
-but then if you push too hard…
-I get that, but if…
419
00:17:39,892 --> 00:17:43,062
…we lose what little trust
we may have earned.
420
00:17:43,145 --> 00:17:45,564
Even when you're 1,000% right.
421
00:17:45,647 --> 00:17:48,442
-Uh… He's gonna…
-Gentlemen.
422
00:17:48,525 --> 00:17:51,361
So I don't see your patient
on my cath lab schedule.
423
00:17:51,445 --> 00:17:53,947
-What happened? No pacemaker?
-Uh, not yet.
424
00:17:54,031 --> 00:17:55,824
We were getting ready
to discuss next steps.
425
00:17:55,908 --> 00:17:57,951
The guy actually believes in luck.
426
00:17:58,035 --> 00:17:59,578
As in, he's too lucky to die.
427
00:18:00,204 --> 00:18:02,247
He did tell us he's always felt protected
428
00:18:02,331 --> 00:18:04,333
in an "otherworldly" way.
429
00:18:04,416 --> 00:18:06,710
We could argue
that he doesn't have the capacity
430
00:18:06,794 --> 00:18:08,962
to make medical decisions for himself.
431
00:18:09,046 --> 00:18:10,339
If he's making his decision on
432
00:18:10,422 --> 00:18:12,216
otherworldly information,
you may be right.
433
00:18:12,299 --> 00:18:14,093
I'll call Dr. Malco
in the psych department.
434
00:18:14,176 --> 00:18:17,346
Let's hope this works.
Wyatt's running out of time.
435
00:18:27,022 --> 00:18:29,566
Wyatt, why don't you tell me
in your own words
436
00:18:29,650 --> 00:18:31,527
what's going on with your health?
437
00:18:31,610 --> 00:18:32,778
It's pretty simple.
438
00:18:33,904 --> 00:18:35,030
I've never liked hospitals,
439
00:18:35,114 --> 00:18:37,658
but I came here
because of a bike accident.
440
00:18:37,741 --> 00:18:40,244
They escalated the whole thing
by threatening
441
00:18:40,327 --> 00:18:42,121
to put in a pacemaker.
442
00:18:42,204 --> 00:18:44,706
Do you know how many people
get a pacemaker?
443
00:18:44,790 --> 00:18:47,376
They're slapping them
into everybody these days.
444
00:18:47,459 --> 00:18:49,169
Why don't you trust your doctors?
445
00:18:49,253 --> 00:18:51,338
I make up my own mind.
446
00:18:51,421 --> 00:18:53,048
And, look, I'm not crazy.
447
00:18:53,132 --> 00:18:55,050
You know, agreeing
to have doctors I just met
448
00:18:55,134 --> 00:18:58,679
implant something
into my body is what's crazy.
449
00:18:58,762 --> 00:19:01,890
We just need to make sure
that you understand the consequences
450
00:19:01,974 --> 00:19:03,934
of the decision you're making here.
451
00:19:04,017 --> 00:19:06,520
I've been listening to those two all day.
452
00:19:06,603 --> 00:19:08,188
Of course I understand.
453
00:19:08,856 --> 00:19:12,109
And there's something
you need to understand about me.
454
00:19:12,192 --> 00:19:13,986
And what is that?
455
00:19:14,069 --> 00:19:16,113
You're not gonna change my mind.
456
00:19:16,196 --> 00:19:18,824
And if I do die, I don't want anyone
457
00:19:18,907 --> 00:19:22,161
going wild and pounding on my chest, okay?
458
00:19:22,786 --> 00:19:24,746
Write that down in your little notepad.
459
00:19:26,123 --> 00:19:27,457
We all have to die someday.
460
00:19:28,542 --> 00:19:30,669
And I am not going out like that.
461
00:19:36,341 --> 00:19:38,177
-Dr. Bell?
-Yeah.
462
00:19:38,260 --> 00:19:41,054
-Do you have a second?
-Mm-hmm.
463
00:19:41,138 --> 00:19:42,973
[exhales]
464
00:19:44,057 --> 00:19:45,893
Please tell me this gets easier.
465
00:19:45,976 --> 00:19:47,644
Is this about a life-or-death decision
466
00:19:47,728 --> 00:19:50,230
-for a person you just met?
-Yes.
467
00:19:51,523 --> 00:19:53,984
It should never be easy. This is the job.
468
00:19:54,067 --> 00:19:57,821
It's not irrational for a patient to think
we know more and should decide for them.
469
00:19:57,905 --> 00:20:01,450
-What if I can't figure out the best way?
-You will, because you have to.
470
00:20:02,576 --> 00:20:04,328
That's what your patient needs.
471
00:20:04,411 --> 00:20:06,288
So go with your gut, Dr. Devi,
472
00:20:06,371 --> 00:20:09,750
informed by your experience
and your schooling.
473
00:20:10,626 --> 00:20:12,961
-Okay?
-Okay.
474
00:20:17,966 --> 00:20:19,134
[Padma] Dr. Voss.
475
00:20:19,218 --> 00:20:21,136
Tell me what you need. I'm here to help.
476
00:20:21,678 --> 00:20:24,348
Well, I'm realizing that all our doctors
477
00:20:24,431 --> 00:20:26,600
are in danger of burnout.
478
00:20:26,683 --> 00:20:29,686
The stress at times can be unrelenting.
479
00:20:29,770 --> 00:20:32,439
Maybe your program can help.
480
00:20:32,522 --> 00:20:33,941
I would love that.
481
00:20:34,024 --> 00:20:36,568
I offer yoga sessions, meditation,
482
00:20:36,652 --> 00:20:38,570
sleep counseling
and positive affirmations.
483
00:20:38,654 --> 00:20:43,367
Plus, fresh-baked resiliency cookies.
Gluten-free.
484
00:20:43,450 --> 00:20:48,622
I think I could make everybody
10% happier, at least.
485
00:20:48,705 --> 00:20:50,999
I would invest in 10% happier.
486
00:20:51,083 --> 00:20:53,001
When can you start?
487
00:20:53,085 --> 00:20:54,086
Shall we start now?
488
00:20:54,169 --> 00:20:56,672
Yes. [laughs] Sign me up.
489
00:20:56,755 --> 00:20:58,340
-Come sit down.
-Oh.
490
00:20:59,091 --> 00:21:00,133
Just five minutes.
491
00:21:03,845 --> 00:21:06,390
-Lie down, put your feet up.
-Oh, wait, I can't. I'd be…
492
00:21:06,473 --> 00:21:09,059
[laughing] All right. Okay.
493
00:21:09,142 --> 00:21:11,019
[clears throat]
494
00:21:11,603 --> 00:21:12,980
Close your eyes.
495
00:21:13,897 --> 00:21:18,652
And now just take
a deep, cleansing breath.
496
00:21:18,735 --> 00:21:20,153
[pager beeping]
497
00:21:20,237 --> 00:21:21,530
Ooh, sorry.
498
00:21:24,116 --> 00:21:25,450
-Later. I promise.
-Okay.
499
00:21:27,160 --> 00:21:28,453
[laughs softly]
500
00:21:32,749 --> 00:21:34,751
[speaking Spanish]
501
00:21:38,797 --> 00:21:40,882
-Do you speak Spanish?
-[chuckles] No.
502
00:21:40,966 --> 00:21:43,010
I don't think there's room in my head
503
00:21:43,093 --> 00:21:45,387
for any more words
I'm supposed to understand.
504
00:21:46,138 --> 00:21:48,765
Do you mind turning it down?
I promise to keep this simple.
505
00:21:48,849 --> 00:21:50,392
[TV turns off]
506
00:21:51,977 --> 00:21:54,813
Based on the size of your hemangioma
and your symptoms,
507
00:21:54,896 --> 00:21:57,607
if it were me,
I would go with the surgery.
508
00:21:57,691 --> 00:21:59,443
[exhales]
509
00:21:59,526 --> 00:22:01,903
Surgery it is. When?
510
00:22:01,987 --> 00:22:03,488
Well, we can operate later today.
511
00:22:03,572 --> 00:22:06,074
But I would like to take you
through the consent.
512
00:22:08,952 --> 00:22:10,537
There are risks.
513
00:22:10,620 --> 00:22:14,374
Bleeding, infection, damage to your liver.
514
00:22:14,458 --> 00:22:16,877
It's possible but unlikely
that we'll have trouble
515
00:22:16,960 --> 00:22:18,879
getting you off the ventilator.
516
00:22:18,962 --> 00:22:21,214
And as with any surgery,
there is a risk of death.
517
00:22:21,298 --> 00:22:23,633
Have you done this operation often?
518
00:22:23,717 --> 00:22:26,011
Uh, no, I haven't, but the senior surgeon
519
00:22:26,094 --> 00:22:28,764
I work with has, and he'll be there.
520
00:22:28,847 --> 00:22:30,891
[exhales]
521
00:22:31,391 --> 00:22:32,517
Pen.
522
00:22:33,185 --> 00:22:34,603
All right.
523
00:22:36,188 --> 00:22:37,898
[Brit] Thank you.
524
00:22:49,910 --> 00:22:51,411
He's clear and consistent.
525
00:22:51,495 --> 00:22:53,080
I don't find him to be influenced
526
00:22:53,163 --> 00:22:55,791
by untreated depression,
and he's not suicidal.
527
00:22:55,874 --> 00:22:57,751
His choice isn't one I'd make for myself
528
00:22:57,834 --> 00:23:01,046
or someone I love,
but it's one he has a right to make.
529
00:23:01,129 --> 00:23:04,049
What do you make of his belief
that he's cosmically protected?
530
00:23:04,132 --> 00:23:06,593
Hearing celestial voices is one thing,
531
00:23:06,676 --> 00:23:09,096
but it's human nature to search
532
00:23:09,179 --> 00:23:11,306
for explanations for our experiences.
533
00:23:11,389 --> 00:23:13,475
Just describing them
in ways that are fantastical
534
00:23:13,558 --> 00:23:15,894
doesn't signify a lack of capacity.
535
00:23:15,977 --> 00:23:17,729
Um, I'm sorry, it makes no sense.
536
00:23:17,813 --> 00:23:21,316
I mean, look how young he is,
and he even requested a DNR?
537
00:23:21,399 --> 00:23:24,736
Which is a sign that
he's-he's clear and coherent.
538
00:23:24,861 --> 00:23:26,863
Look, lack of capacity is a high bar,
539
00:23:26,947 --> 00:23:28,740
and Wyatt doesn't reach it.
540
00:23:28,824 --> 00:23:30,659
I'm sorry.
541
00:23:30,742 --> 00:23:33,578
-You have to respect his wishes.
-All right, thank you, Leslie.
542
00:23:37,124 --> 00:23:38,542
Uh…
543
00:23:38,625 --> 00:23:40,418
Is that really it?
544
00:23:40,502 --> 00:23:43,046
If he has capacity,
we can't force him to be treated.
545
00:23:43,130 --> 00:23:44,548
I thought you were the renegade.
546
00:23:45,173 --> 00:23:47,843
You drilled into a guy's head
and you're not even a surgeon.
547
00:23:47,926 --> 00:23:49,928
But you're gonna sit here
and let this man die?
548
00:23:50,011 --> 00:23:52,013
If the guy would've said,
"Whatever you do,
549
00:23:52,097 --> 00:23:53,557
don't drill into my head,"
550
00:23:54,474 --> 00:23:55,475
I wouldn't have.
551
00:23:56,977 --> 00:23:58,812
It's pretty simple.
552
00:23:58,895 --> 00:24:02,065
You can't do
what the patient doesn't want.
553
00:24:02,149 --> 00:24:04,526
Okay, this is what we're gonna do.
554
00:24:04,609 --> 00:24:06,778
I did a deep dive into temporary pacers.
555
00:24:06,862 --> 00:24:09,281
Wyatt passes out, we get the pads on him,
556
00:24:09,364 --> 00:24:11,116
shock him if we need to, slip it in
557
00:24:11,199 --> 00:24:12,492
-at his bedside.
-Hey.
558
00:24:12,576 --> 00:24:13,660
[Wyatt shouting]
559
00:24:19,374 --> 00:24:20,709
[Conrad] Let's get him some O2.
560
00:24:20,792 --> 00:24:22,502
I'm nauseous. My stomach hurts.
561
00:24:22,586 --> 00:24:24,254
What's going on?
562
00:24:24,337 --> 00:24:26,965
Gut ischemia from poor perfusion.
563
00:24:27,048 --> 00:24:28,842
Your heart rate's too low.
564
00:24:28,925 --> 00:24:30,385
Let's get him some pain meds.
565
00:24:30,468 --> 00:24:31,761
Page Bell.
566
00:24:31,845 --> 00:24:33,305
-Okay.
-[panting]
567
00:24:35,724 --> 00:24:36,892
[crying softly]
568
00:24:40,395 --> 00:24:41,438
[Bell] Okay.
569
00:24:47,068 --> 00:24:49,821
Yeah, he's-he's calmer now
with the pain meds on board.
570
00:24:49,905 --> 00:24:52,574
It's highly likely he has dying bowel,
571
00:24:52,657 --> 00:24:54,868
but he's not a viable candidate
for surgery.
572
00:24:55,744 --> 00:24:57,954
Unless we get him to agree to a pacer.
573
00:24:58,038 --> 00:25:00,874
And, yeah, if you do, tell me,
and I'll take him to the OR.
574
00:25:00,957 --> 00:25:02,709
As of now, all the complications
575
00:25:02,792 --> 00:25:05,212
from his untreated
heart condition are fixable,
576
00:25:05,295 --> 00:25:07,589
-but I don't know for how long.
-[pager beeping]
577
00:25:09,799 --> 00:25:11,676
He's refusing all intervention.
578
00:25:13,637 --> 00:25:15,263
Is there anything else I can do for you?
579
00:25:15,347 --> 00:25:16,723
I wish there were.
580
00:25:22,229 --> 00:25:24,564
Okay, just… just hear me out.
581
00:25:24,648 --> 00:25:27,359
All right, you know
the Dax Cowart case, right?
582
00:25:27,442 --> 00:25:30,362
He wanted to die
after suffering catastrophic burns.
583
00:25:30,445 --> 00:25:32,739
He was in pain,
terribly disfigured, went blind.
584
00:25:32,822 --> 00:25:34,658
And he was ruled to have capacity, too,
585
00:25:34,741 --> 00:25:38,703
but his doctors
disregarded his wishes and saved his life.
586
00:25:40,121 --> 00:25:41,414
Mm-hmm.
587
00:25:41,498 --> 00:25:44,626
Yeah, he had a career, he had a family,
588
00:25:44,709 --> 00:25:47,254
I mean, he lived until he was 71.
589
00:25:47,337 --> 00:25:50,173
Wyatt can have the same thing.
590
00:25:50,257 --> 00:25:52,592
Dax Cowart became a lawyer
and built a career
591
00:25:52,676 --> 00:25:54,219
on fighting for patients' rights.
592
00:25:54,302 --> 00:25:57,055
He used his own case
to show what the doctors did,
593
00:25:57,138 --> 00:26:00,350
what you want to do to Wyatt,
was a betrayal of those rights.
594
00:26:00,475 --> 00:26:01,935
It's not a betrayal of his rights.
595
00:26:02,018 --> 00:26:03,395
I'm as frustrated as you are.
596
00:26:04,729 --> 00:26:06,523
As doctors, our purpose is to help.
597
00:26:06,606 --> 00:26:08,066
And you got that part right.
598
00:26:09,067 --> 00:26:10,694
But Wyatt needs to want to be helped.
599
00:26:10,777 --> 00:26:12,320
Until he's dead, I'm not giving up.
600
00:26:18,451 --> 00:26:19,869
Then neither am I.
601
00:26:20,870 --> 00:26:22,414
[washing hands]
602
00:26:22,497 --> 00:26:23,623
[door opens]
603
00:26:23,707 --> 00:26:24,958
[Bell] Sorry I'm late.
604
00:26:26,376 --> 00:26:28,920
Had a rough consult with Conrad's patient.
605
00:26:29,004 --> 00:26:30,714
The exact opposite of Brit.
606
00:26:30,797 --> 00:26:33,091
He doesn't trust Conrad,
for all the wrong reasons.
607
00:26:33,675 --> 00:26:35,176
And here I am tied up in knots
608
00:26:35,260 --> 00:26:37,846
over a patient who trusts me too much.
609
00:26:37,929 --> 00:26:41,141
You made the best decision you could
with the information you have.
610
00:26:41,224 --> 00:26:43,226
[water running]
611
00:26:46,313 --> 00:26:48,481
You have a very unusual career path.
612
00:26:48,565 --> 00:26:51,151
What brought you from oncology
to emergency medicine?
613
00:26:51,234 --> 00:26:52,944
So much suffering and death.
614
00:26:53,028 --> 00:26:55,655
The patients call you weeping at all hours
615
00:26:55,739 --> 00:26:56,990
of the day and night.
616
00:26:58,074 --> 00:27:01,286
I-I was worn out from the stress.
617
00:27:01,369 --> 00:27:04,122
Those days ruined me. And now?
618
00:27:04,205 --> 00:27:06,499
Just off a shift, look at me--
I'm still fresh.
619
00:27:06,583 --> 00:27:08,585
Well, it must have been
a challenge to go back
620
00:27:08,668 --> 00:27:11,129
to residency and learn
all the ER procedures.
621
00:27:11,212 --> 00:27:13,506
Hmm, I'm not one for new techniques.
622
00:27:13,590 --> 00:27:16,176
I pretty much slept
through that residency.
623
00:27:16,259 --> 00:27:19,095
-It was no big deal.
-I see.
624
00:27:19,179 --> 00:27:20,722
[monitor beeping steadily]
625
00:27:20,805 --> 00:27:22,140
[Wyatt] I told you, Doc.
626
00:27:22,807 --> 00:27:25,602
If God wants me to live, I'll live.
627
00:27:27,479 --> 00:27:29,981
He'll reach His hand down to me.
628
00:27:32,025 --> 00:27:34,486
He's always been so good to me.
629
00:27:34,569 --> 00:27:36,654
[Trevor] Is this about luck now, Wyatt?
630
00:27:36,738 --> 00:27:37,822
Or God?
631
00:27:39,783 --> 00:27:43,203
He can't save you right now. We can.
632
00:27:44,204 --> 00:27:45,538
Leave me alone, Doc.
633
00:27:48,124 --> 00:27:51,127
No. Wyatt…
634
00:27:51,211 --> 00:27:53,880
-Trevor.
-You just, you got to listen to what I'm…
635
00:27:53,963 --> 00:27:55,840
Trevor. Trevor, take a walk now.
636
00:28:08,228 --> 00:28:09,396
He's young.
637
00:28:11,940 --> 00:28:13,566
But he cares deeply.
638
00:28:16,194 --> 00:28:18,279
And I respect your faith in God's will.
639
00:28:20,115 --> 00:28:21,574
I'm in His hands now.
640
00:28:21,658 --> 00:28:24,953
And you always have been, right?
641
00:28:27,622 --> 00:28:31,126
How do you know
He is not using us to save you?
642
00:28:33,503 --> 00:28:36,047
You think he wasn't sitting
beside Rune Elmqvist in Sweden
643
00:28:36,131 --> 00:28:38,717
half a century ago when
he invented the pacemaker?
644
00:28:38,800 --> 00:28:41,511
He is sending you
one lifeline after another.
645
00:28:45,724 --> 00:28:46,933
Hey.
646
00:28:50,437 --> 00:28:51,604
I'll ask Him.
647
00:28:54,107 --> 00:28:55,233
Wyatt?
648
00:29:11,124 --> 00:29:12,292
Wyatt.
649
00:29:13,752 --> 00:29:16,880
[laughs]
650
00:29:16,963 --> 00:29:18,840
[ragged breathing]
651
00:29:29,017 --> 00:29:30,977
[Bell] Yeah, the liver is exposed.
652
00:29:31,060 --> 00:29:32,645
[Leela] Ready to begin the enucleation.
653
00:29:32,729 --> 00:29:34,731
[Bell] The beauty
of this technique is that we,
654
00:29:34,814 --> 00:29:37,442
we work along existing planes
to pop the mass out
655
00:29:37,525 --> 00:29:39,152
and we leave the liver intact.
656
00:29:39,235 --> 00:29:40,820
That's how we avoid massive bleeding.
657
00:29:41,654 --> 00:29:44,073
And note the vessels
extending into the liver.
658
00:29:44,657 --> 00:29:46,284
Divide and ligate.
659
00:29:47,368 --> 00:29:48,369
Be careful.
660
00:29:50,121 --> 00:29:51,915
[Leela] Ugh, I have a tiny bleeder.
661
00:29:51,998 --> 00:29:52,999
Cautery.
662
00:29:56,127 --> 00:29:57,587
And another one.
663
00:29:57,670 --> 00:29:58,797
Okay, suction.
664
00:30:04,719 --> 00:30:06,054
Okay, that's arterial. Clamp.
665
00:30:08,723 --> 00:30:10,809
[Jessica] Dr. Bell? Here's the clamp.
666
00:30:16,064 --> 00:30:17,148
[Leela] Are you okay?
667
00:30:18,566 --> 00:30:19,692
[Bell] Uh, no.
668
00:30:19,776 --> 00:30:21,152
[Leela] Jessica, I'll take it.
669
00:30:22,487 --> 00:30:24,239
[Bell] I have to leave.
670
00:30:24,322 --> 00:30:25,573
[Leela] What?
671
00:30:26,658 --> 00:30:29,118
[Bell] I'll find someone to cover.
As soon as possible.
672
00:30:33,206 --> 00:30:34,374
[Leela] Dr. Bell.
673
00:30:40,964 --> 00:30:42,340
[Jessica] You can do this.
674
00:30:50,723 --> 00:30:53,226
[Leela] I've got the mass
on the last vascular pedicle.
675
00:30:53,309 --> 00:30:54,769
Any word from Bell?
676
00:30:54,894 --> 00:30:58,481
[Jessica] Nothing. You'll probably
get this out of here before anyone comes.
677
00:30:59,774 --> 00:31:01,109
[monitor beeping rapidly]
678
00:31:01,609 --> 00:31:03,611
[Chu] Pressure's drifting down, Dr. Devi.
679
00:31:03,695 --> 00:31:06,656
[Leela] Losing blood.
Let's get some blood products in her.
680
00:31:06,781 --> 00:31:07,907
[Jessica] What do you need?
681
00:31:07,991 --> 00:31:10,118
Lap pads and suction.
I'm operating underwater here.
682
00:31:10,201 --> 00:31:12,328
If I can't find the source,
I can't fix it.
683
00:31:12,412 --> 00:31:13,663
[Chu] Two units in. Activated
684
00:31:13,746 --> 00:31:15,748
massive transfusion protocol.
Maxed on norepi.
685
00:31:15,832 --> 00:31:17,292
[Leela] Found it.
686
00:31:17,417 --> 00:31:20,837
[Chu] Gotta get control. Won't tolerate
this blood loss much longer.
687
00:31:20,920 --> 00:31:22,463
[Leela] I need to remove the portion
688
00:31:22,589 --> 00:31:24,215
the vessel's feeding. Hepatectomy.
689
00:31:24,299 --> 00:31:26,467
[Jessica] That's
a serious change in plans.
690
00:31:26,551 --> 00:31:27,468
Call Dr. Bell.
691
00:31:27,552 --> 00:31:29,220
[Leela] No time. Clamp, now.
692
00:31:29,304 --> 00:31:32,640
Chu, give her 1:1:1 resuscitation
to keep up.
693
00:31:32,724 --> 00:31:34,767
-Do not stop that suction.
-[Jessica] Got it.
694
00:31:40,982 --> 00:31:41,816
[Leela] Got it.
695
00:31:43,109 --> 00:31:45,111
[Chu] We've got a stable pressure.
696
00:31:45,194 --> 00:31:47,488
-[chuckles]
-[Chu] Strong work, Dr. Devi.
697
00:31:47,572 --> 00:31:49,741
[Leela sighs]
698
00:31:49,824 --> 00:31:51,159
[Jessica] You did it.
699
00:31:51,242 --> 00:31:53,453
-[chuckles]
-[Leela] Let's get her closed up
700
00:31:53,536 --> 00:31:55,246
and off this table.
701
00:32:02,086 --> 00:32:05,423
What do you think the evidence is
behind cookies for stress relief?
702
00:32:05,506 --> 00:32:06,883
[Nolan] Anecdotal
703
00:32:06,966 --> 00:32:09,093
-but robust.
-I'm really feeling
704
00:32:09,177 --> 00:32:10,970
-the chocolate chip.
-[Hundley] Dr. Austin?
705
00:32:11,054 --> 00:32:12,388
Of all people.
706
00:32:12,472 --> 00:32:14,390
Do raptors do yoga?
707
00:32:14,474 --> 00:32:17,894
I'm only here because my CEO
told me I had to be here.
708
00:32:17,977 --> 00:32:19,145
But I won't be here for long.
709
00:32:19,228 --> 00:32:20,730
I have to round on the post-ops again
710
00:32:20,813 --> 00:32:22,398
before I fly to Manhattan tonight
711
00:32:22,482 --> 00:32:24,484
-for talk shows tomorrow.
-[Devon] Well, I'm stiff,
712
00:32:24,567 --> 00:32:25,610
my back is in knots.
713
00:32:25,693 --> 00:32:27,195
I've been in interviews all day,
714
00:32:27,278 --> 00:32:30,323
looking for an actual doctor
who likes actual doctoring.
715
00:32:30,406 --> 00:32:32,033
Welcome, health care heroes.
716
00:32:32,742 --> 00:32:34,619
Uh, listen, I am not a man
717
00:32:34,702 --> 00:32:36,537
that you will find in Child's Pose.
718
00:32:36,621 --> 00:32:38,373
So I'm just gonna be on my way to…
719
00:32:38,456 --> 00:32:39,999
AJ, I know from personal experience
720
00:32:40,083 --> 00:32:42,710
that you could really benefit
from a little extra flexibility.
721
00:32:42,794 --> 00:32:46,255
-[laughter]
-All right, come lie down and grab a mat.
722
00:32:48,091 --> 00:32:50,969
-Close your eyes.
-[grunting]
723
00:32:51,636 --> 00:32:55,390
Let the world fade away and just relax.
724
00:32:55,473 --> 00:32:57,058
-[pager beeps]
-It's the ER.
725
00:32:57,141 --> 00:32:58,101
[pagers beeping]
726
00:32:58,184 --> 00:32:59,477
Oh, that's my next interview.
727
00:32:59,560 --> 00:33:01,187
Med-surg floor.
728
00:33:01,270 --> 00:33:03,106
My mother's having another complication.
729
00:33:06,317 --> 00:33:08,027
-[beeping stops]
-I mean, I feel
730
00:33:08,111 --> 00:33:09,278
so blissed out right now.
731
00:33:09,362 --> 00:33:11,572
I feel like I'm back to zero.
I feel great.
732
00:33:11,656 --> 00:33:14,325
You know, after this is all done,
733
00:33:14,409 --> 00:33:17,245
I think that you and I should
go to this great little vegan place
734
00:33:17,328 --> 00:33:18,413
that I know in Inman Park.
735
00:33:18,496 --> 00:33:19,872
It-It's wonderful.
736
00:33:19,956 --> 00:33:22,000
It's the best tempeh à la King
you will ever have.
737
00:33:22,083 --> 00:33:25,294
You're cute. Not a chance.
738
00:33:26,379 --> 00:33:27,588
[sighs]
739
00:33:29,215 --> 00:33:31,509
-That's a, that's a no, then?
-[pager beeps]
740
00:33:34,804 --> 00:33:37,181
Okay, Wyatt Barnes'
heart rate is in the 20s.
741
00:33:37,265 --> 00:33:39,100
He has gut ischemia,
his kidneys are failing.
742
00:33:39,183 --> 00:33:40,309
Without a pacer, he's dying.
743
00:33:40,393 --> 00:33:42,103
We're running out of time,
and he's waiting
744
00:33:42,186 --> 00:33:43,396
for the hand of God to
745
00:33:43,479 --> 00:33:44,772
-save him from…
-Back up.
746
00:33:44,856 --> 00:33:46,274
You're in my personal space.
747
00:33:46,357 --> 00:33:48,693
And you have intern coffee breath,
which I do not like.
748
00:33:48,776 --> 00:33:50,278
Okay, look. With all due respect,
749
00:33:50,361 --> 00:33:52,488
Dr. Hawkins seems to have lost his edge,
750
00:33:52,572 --> 00:33:54,198
it's gonna cost a young dude his life.
751
00:33:54,282 --> 00:33:55,533
Can you please put in a pacer?
752
00:33:55,616 --> 00:33:57,535
-I have one right here, come on.
-Put that away.
753
00:33:57,618 --> 00:33:59,120
You are a green recruit
754
00:33:59,203 --> 00:34:01,205
questioning the general on the field.
755
00:34:01,289 --> 00:34:02,915
If someone came into this hospital
756
00:34:02,999 --> 00:34:05,835
after slitting their wrists
or taking pills, we'd save them.
757
00:34:05,918 --> 00:34:07,420
Wyatt Barnes is doing the same thing.
758
00:34:07,503 --> 00:34:09,172
This is not a suicide.
759
00:34:09,255 --> 00:34:12,383
This is a man
with capacity refusing intervention.
760
00:34:12,467 --> 00:34:14,135
That's a right we cannot abridge.
761
00:34:14,218 --> 00:34:17,388
His recalcitrance is not jeopardizing
anyone else's health.
762
00:34:17,472 --> 00:34:19,390
-He's only hurting himself.
-But he is.
763
00:34:19,474 --> 00:34:20,767
Trevor, stop.
764
00:34:20,850 --> 00:34:24,020
Now you go back to your patient's room.
765
00:34:24,103 --> 00:34:28,066
You watch Dr. Hawkins
and you do what he says.
766
00:34:28,775 --> 00:34:30,860
Stop second-guessing him.
767
00:34:30,943 --> 00:34:32,528
You might learn something.
768
00:34:37,950 --> 00:34:40,828
[monitor beeping steadily]
769
00:34:40,912 --> 00:34:43,748
Please let me save you, Wyatt.
770
00:34:46,793 --> 00:34:49,253
I have everything we need.
You just say the word.
771
00:34:53,091 --> 00:34:54,842
Think of all the beautiful things
772
00:34:54,926 --> 00:34:57,178
you'll never be able to experience again.
773
00:34:58,054 --> 00:35:00,515
I don't know what happens when you die,
774
00:35:01,599 --> 00:35:03,601
but I bet you don't get to kiss a woman…
775
00:35:05,353 --> 00:35:08,356
and know you want to be
with her for the rest of your life.
776
00:35:10,191 --> 00:35:13,611
Don't you want to wake up
on the first day of fall?
777
00:35:13,694 --> 00:35:15,196
Eat a peach?
778
00:35:15,279 --> 00:35:17,365
[laughs]
779
00:35:17,448 --> 00:35:19,826
Laugh your ass off with your best friends?
780
00:35:19,909 --> 00:35:21,994
You don't have to give up any of that.
781
00:35:22,995 --> 00:35:24,622
Think of how lucky that makes you.
782
00:35:24,705 --> 00:35:26,916
[laughs softly]
783
00:35:45,226 --> 00:35:46,644
Is he still saying no?
784
00:35:57,655 --> 00:35:59,782
[exhales]
785
00:35:59,866 --> 00:36:01,033
Do it.
786
00:36:02,410 --> 00:36:03,578
Please.
787
00:36:18,217 --> 00:36:20,094
What are we here for, anyway, huh?
788
00:36:21,888 --> 00:36:23,472
To watch people we could save just…
789
00:36:25,183 --> 00:36:26,475
just die?
790
00:36:26,559 --> 00:36:28,436
I was here to save him.
791
00:36:32,148 --> 00:36:34,942
Now we're just here
to make sure he doesn't die alone.
792
00:36:38,112 --> 00:36:39,655
[sniffles]
793
00:36:53,628 --> 00:36:55,630
[flatlining]
794
00:37:15,399 --> 00:37:16,901
He's your first death.
795
00:37:21,530 --> 00:37:22,782
Yeah.
796
00:37:24,116 --> 00:37:26,077
Not how I imagined it would go down.
797
00:37:27,536 --> 00:37:30,122
You pictured a different kind of heroism,
798
00:37:30,998 --> 00:37:33,251
blood spattered all over your white coat.
799
00:37:35,920 --> 00:37:37,088
[scoffs]
800
00:37:39,006 --> 00:37:40,383
Do you ever get used to it?
801
00:37:42,385 --> 00:37:44,262
It never gets easier. It just…
802
00:37:45,805 --> 00:37:47,056
It just gets different.
803
00:37:49,350 --> 00:37:51,435
But today was no small accomplishment…
804
00:37:53,020 --> 00:37:54,438
Dr. Daniels.
805
00:38:00,236 --> 00:38:03,364
We allowed him to live and die
according to his principles,
806
00:38:03,447 --> 00:38:05,533
and because of that,
we managed to keep ours.
807
00:38:14,667 --> 00:38:17,545
Look, again, I'm-I'm sorry
about what happened in there.
808
00:38:17,628 --> 00:38:19,380
Well, I'm relieved you're okay.
809
00:38:19,463 --> 00:38:21,590
No, I-I'll be fine, it's just…
810
00:38:21,674 --> 00:38:23,009
It's a pinched nerve and…
811
00:38:24,093 --> 00:38:25,886
little bit of vertigo
that came on suddenly.
812
00:38:25,970 --> 00:38:28,639
I think, you know, I-I overreacted,
813
00:38:28,723 --> 00:38:31,892
but in the moment,
I-I thought if I stayed in the OR,
814
00:38:31,976 --> 00:38:34,562
you'd have two patients to deal with, so…
815
00:38:34,645 --> 00:38:36,814
Well, then, you did the right thing.
816
00:38:36,897 --> 00:38:37,940
So did you.
817
00:38:39,525 --> 00:38:40,568
This time.
818
00:38:41,110 --> 00:38:43,362
But, to be honest,
it could have gone either way.
819
00:38:51,412 --> 00:38:53,789
-Hi.
-So?
820
00:38:53,873 --> 00:38:56,334
Did you find
anything else horrible inside me?
821
00:38:56,417 --> 00:38:58,669
I'm vaguely optimistic
822
00:38:58,753 --> 00:39:02,089
because I have a familiar
sense of existential dread,
823
00:39:02,173 --> 00:39:04,800
and I'm pretty sure
that can't be removed surgically.
824
00:39:04,884 --> 00:39:06,635
The surgery went great.
825
00:39:06,719 --> 00:39:07,970
You're going to be fine.
826
00:39:08,054 --> 00:39:09,638
Thanks to Dr. Devi.
827
00:39:10,514 --> 00:39:12,308
There was a complication during surgery.
828
00:39:12,391 --> 00:39:16,145
We had to remove a small piece of
your liver. But it will grow back.
829
00:39:16,228 --> 00:39:17,772
And the hemangioma is gone for good.
830
00:39:17,855 --> 00:39:20,983
Thank you. I mean, really, thank you.
831
00:39:21,067 --> 00:39:23,986
And you made
the right decision for me, too.
832
00:39:24,070 --> 00:39:26,739
Can I call you next time
I'm buying a new car?
833
00:39:26,822 --> 00:39:28,324
Or don't know what to do
834
00:39:28,407 --> 00:39:29,825
when I get in a fight with my mom?
835
00:39:29,950 --> 00:39:32,912
I actually am a triple board-certified
mother vanquisher.
836
00:39:32,995 --> 00:39:34,246
[chuckles]
837
00:39:39,335 --> 00:39:40,336
[Devon] So…
838
00:39:41,587 --> 00:39:42,755
it's a no.
839
00:39:44,757 --> 00:39:46,467
Even the former oncologist?
840
00:39:46,550 --> 00:39:47,676
He's burnt out.
841
00:39:48,511 --> 00:39:50,429
He's not interested
in learning anything new.
842
00:39:50,513 --> 00:39:52,848
H-He doesn't love medicine.
843
00:39:52,932 --> 00:39:54,183
None of them do.
844
00:39:54,308 --> 00:39:56,227
Keep looking. It's just the first round.
845
00:39:56,310 --> 00:39:57,937
No need to be discouraged.
846
00:39:58,020 --> 00:39:59,605
And the thing is, Dr. Voss,
847
00:39:59,688 --> 00:40:01,565
when I was talking to them, I realized
848
00:40:02,358 --> 00:40:03,943
I might not be so different.
849
00:40:05,069 --> 00:40:06,445
Of course you are, Dr. Pravesh.
850
00:40:07,947 --> 00:40:11,117
I am judging people
for not loving medicine enough
851
00:40:11,200 --> 00:40:13,744
while trying to cut down on clinical time
852
00:40:13,828 --> 00:40:14,995
to go do research.
853
00:40:15,079 --> 00:40:17,081
I think about being in the ER
854
00:40:17,164 --> 00:40:21,585
year after year after year,
with no outlet for research,
855
00:40:21,669 --> 00:40:24,713
and I don't know how we
don't drown in the sickness,
856
00:40:24,797 --> 00:40:28,217
the sadness, the pressure, the paperwork.
857
00:40:28,300 --> 00:40:29,969
[sighs]
858
00:40:30,469 --> 00:40:33,556
Half of my med school class
isn't doing medicine anymore.
859
00:40:35,933 --> 00:40:37,518
That means something.
860
00:40:38,644 --> 00:40:39,478
Yes.
861
00:40:41,230 --> 00:40:42,440
I think it does.
862
00:40:59,373 --> 00:41:00,583
[Bell] Hey.
863
00:41:05,296 --> 00:41:06,881
Hell of a day.
864
00:41:07,506 --> 00:41:08,799
Yeah, I heard.
865
00:41:09,758 --> 00:41:11,927
So, how tempted were you
to put in the pacer
866
00:41:12,011 --> 00:41:15,306
-against the patient's wishes?
-More than I'd like to admit.
867
00:41:16,098 --> 00:41:18,100
But there are some rules we can't break.
868
00:41:18,934 --> 00:41:20,811
Do I know I made the right choice? Yeah.
869
00:41:20,895 --> 00:41:23,814
Do I wish I'd made the wrong one? Maybe.
870
00:41:23,898 --> 00:41:25,524
I know my intern thinks so.
871
00:41:26,317 --> 00:41:30,029
I heard Dr. Daniels
has a hard time with the rules.
872
00:41:30,112 --> 00:41:32,740
But maybe the example you set
saved his medical career.
873
00:41:32,823 --> 00:41:34,992
To say nothing of your responsibility
to your patient.
874
00:41:35,075 --> 00:41:37,703
Yeah, he's a bright kid, that Trevor,
875
00:41:37,786 --> 00:41:39,538
but too much confidence and passion,
876
00:41:39,622 --> 00:41:41,040
not nearly enough restraint.
877
00:41:46,754 --> 00:41:48,088
He learned something today.
878
00:41:55,387 --> 00:41:56,722
If I'd have saved Wyatt,
879
00:41:56,805 --> 00:41:59,391
would he have come back in ten years
880
00:41:59,475 --> 00:42:01,602
with an armload of kids,
881
00:42:02,645 --> 00:42:04,688
grateful that we didn't listen to him?
882
00:42:08,108 --> 00:42:09,276
[exhales]
883
00:42:12,196 --> 00:42:15,074
And now I realize
none of this is why you are here.
884
00:42:17,576 --> 00:42:18,953
Nope.
885
00:42:20,454 --> 00:42:22,289
I got a favor to ask you.
886
00:42:27,670 --> 00:42:28,671
What?
887
00:42:28,754 --> 00:42:31,465
But, look, before
I even-even spell it out,
888
00:42:31,549 --> 00:42:34,969
can I count on you
for full confidentiality?
889
00:42:35,803 --> 00:42:36,679
Go on.
890
00:42:39,306 --> 00:42:42,351
Something's wrong with me,
a-and I'm not quite sure what.
891
00:42:44,353 --> 00:42:46,146
But I think it may be serious.
892
00:42:47,231 --> 00:42:48,941
You want me to examine you?
893
00:42:49,024 --> 00:42:50,484
I'll clear my schedule tomorrow.
894
00:42:50,568 --> 00:42:52,528
Let's come in early.
895
00:42:52,611 --> 00:42:56,240
And the fact that I'm being tested at all,
896
00:42:56,323 --> 00:42:58,492
the results, all under the radar.
897
00:42:59,827 --> 00:43:01,912
So, is that something you can do?
898
00:43:01,996 --> 00:43:04,164
[sighs]
899
00:43:06,125 --> 00:43:08,127
Okay. Great, thanks.
900
00:43:19,972 --> 00:43:22,141
[closing theme music playing]
61960
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