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Reality Realm US
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Short filmTranscript
00:00This week has been great, I mean, really, really great, but I work with your husband.
00:10Isn't it going to be weird if we show up together?
00:12No.
00:13People carpool for all kinds of reasons.
00:20It is better for the environment.
00:27By inducing a hypothermic state.
00:30The surgical team created a window of several minutes to close a hole in the heart of a five-year-old girl.
00:35The predominant perforator should be in the medial row.
00:38He still got it.
00:41You want eggs?
00:43Uh, I'm not hungry.
00:45I have to tell my patient she's stage four.
00:47I'm sorry.
00:49Want to talk about it?
00:51No.
00:51You want pancakes?
00:56Yes.
00:57That one surgery changed the entire course of human history.
01:04You here late last night?
01:06Max and Irvin had an engagement party.
01:09Losing bingo and I lost both.
01:11Wait, Max, you just getting married?
01:12Yes, and I am a bridesmaid.
01:14I have to choose my dress today, so if anybody wants to weigh in...
01:19Oh, yeah, I'll be too busy working with Jackson Avery.
01:22Wait, you're scrubbing in on the deep flat reconstruction?
01:24I've been asking to be on that for a week now.
01:26Oh, well, if it helps, it comes with a plastics fellow who rage hates me.
01:30Yeah, that does help.
01:33But as they watched her tiny heart, desperate for it to beat again, it could have gone either way.
01:39All they could do was hope.
01:41You don't have to wait with me.
01:42I'm just here for the chair.
01:44Take it.
01:45I am over recovery.
01:47Yeah, but don't forget PT and a lot more rest.
01:50Tell that to my kids.
01:51Hey, look who it is.
01:55Morning.
01:57Hi.
01:59Uh, are you, are you, uh...
02:02Officially discharged.
02:04Congratulations.
02:07Hi.
02:08Cass, back then.
02:10I remember.
02:10It's nice to see you.
02:12Likewise.
02:13Yeah.
02:14We're going to the risk management class.
02:17Yeah, that's why we carpooled.
02:18Mm-hmm.
02:19Well, you know, we should get going.
02:21Got to get those CME hours in.
02:23Well, um, enjoy being home, Link.
02:25Hmm.
02:30Didn't realize you lived close to the Beckmans.
02:32Yeah, that's true we do.
02:35Did Anne Schroeder's colleague get, uh, rescheduled?
02:38Uh, we did that yesterday.
02:39Well, I should say Kwan did most of it.
02:42He did a good job.
02:43Patient did well also.
02:44Teresa Gomez's hernia repair.
02:46Well, now that OR2 is back, we can fit her in on Wednesday?
02:50Well, she'll be happy.
02:52Okay.
02:55You know, I want you to know how grateful I am that you're back here.
02:59I mean, between the surgeries and the teachings.
03:02Happy to do it.
03:05I know you are.
03:06But thanks.
03:07You've got to be kidding me.
03:14Well, is everything okay?
03:21Our water bill doubled this month.
03:23Everyone likes long showers.
03:24Have you suggested he and Maxine shower together?
03:28Move in with us.
03:30Free rent.
03:30We split utilities.
03:32You want me to live with you?
03:33Thanks, but no.
03:34All right, step it up.
03:35A patient from an equestrian accident just came in.
03:37Now, a horse can inflict severe injuries on a person.
03:41Jonah Nolan.
03:41Yeah?
03:42I hear you fell off your horse during competition.
03:45Me and Vince were warming up together.
03:46Vince, is your horse?
03:47No, it's me.
03:48My horse got a fence and went down.
03:50Jonah was right behind me.
03:51Gash is head on Mojo's parietal.
03:53Mojo's his horse.
03:55All right, can you take a look?
03:56Yeah.
03:57Thanks.
03:57And what about you?
03:58Are you feeling okay?
03:59Just a little sore.
03:59I'm going to finish competing, which Jonah's okay.
04:02You should still get checked out.
04:03I mean, falling off a horse can do serious damage.
04:05They're powerful animals.
04:06No, Carrot's very gentle.
04:10That's the horse you fell off?
04:13Uh, let me guess.
04:14The other one is Mojo?
04:16Yeah.
04:17Thank God they're both okay.
04:20Yeah.
04:21Um, okay.
04:21Well, uh, it looks like it's just lacerations and abrasions.
04:25So, you're going to be fine.
04:27I'm feeling a little dizzy.
04:28Oh, well, um, Mellon, let's, uh, request a neuroconsult, just to be safe.
04:35Okay?
04:35I'll close him and clean them up.
04:37Thanks.
04:38Um, Drusash starts in 20 minutes.
04:41Do you think we can make it back by then?
04:43I'm going to say nay.
04:46Remember when Avery gets to the venous anastomosis?
04:49He likes to use an anastomotic coupler.
04:51You've mentioned it twice.
04:52I applied for an attending position in his department in Boston after this fellowship.
04:58You and probably a hundred others.
05:00My parents live near there, and they could really use my help, so this is my chance to
05:04impress him.
05:05I won't let you screw this up.
05:07Happy to work with you again, too.
05:10Oh?
05:11Did you invite to all the hospital?
05:12Um, we don't get to see a lot of deep flaps.
05:15The patient's cool with it, though.
05:16Good morning.
05:17Who can walk me through a Millard repair on a cleft lip?
05:20Use a curvilinear incision with the rotation flap from the medial lip element and the advancement
05:24flap from the lateral element.
05:26That's correct, Dr., um...
05:27Mohandy.
05:28Kavita Mohandy.
05:29Plastics fellow.
05:30End of fellow.
05:31Perfect.
05:32I got a five-year-old, no R4, who's going to be very lucky to have you.
05:34I'm sorry.
05:35I ran into Dr. Camden in the lounge, and he needs an assist, so enjoy.
05:39Everybody else.
05:39You're with me.
05:40Let's go.
05:41Dr. Richard.
05:42Dr. Richard.
05:44Morning, Perry.
05:49Good morning.
05:51I see you brought the surgical army.
05:53Well, they'll mostly observe.
05:54Well, the more the merrier.
05:56And you must be the infamous Dr. Avery.
05:59Well, I understand you're the one with the reputation.
06:01Training firefighters is very impressive.
06:02Oh, not officially.
06:04A few of them take my cycle warrior spin class.
06:06She's being modest.
06:07Half the department's only in shape because she kicks their butts.
06:09Okay, well, please don't kick mine.
06:11All right, Warren, you want to do the honors?
06:13Yeah.
06:14Perionical, 50.
06:15With past medical history of ERPR, positive invasive lobular carcinoma of the left breast.
06:20Status, post-bilateral mastectomy.
06:22Completed chemotherapy and radiation.
06:24Disease in remission.
06:26Here today for a deep inferior epigastric perforator flap for breast reconstruction.
06:32Sorry.
06:33I'm just very happy to hear those words.
06:35Well, so are we.
06:36Do you know how this is all going to work?
06:38I was kind of hoping you did.
06:39Fair enough.
06:40All right, well, we will begin by removing pieces of your skin, fat, and blood vessels
06:45from your lower abdomen here, transplanting those up into your chest.
06:48Who can tell me where we connect the flap?
06:51You connect it to the internal memory.
06:52That's correct.
06:54Not all plastic surgeons do this.
06:55You're in very good hands.
06:57He's right.
06:57You ready?
06:59For a new rack and a tummy tuck and one surgery?
07:03Bring it on.
07:03All right.
07:04We'll get you started with some new scans right away.
07:06Dr. Gray.
07:12Dr. Gray.
07:13Morning.
07:14You let Karasik publish his Alzheimer's results?
07:17Technically, that was the Journal of American Medicine.
07:20It's good to see you, by the way.
07:22He only studied male mice.
07:23I did the same experiment with female mice, and when I gave them antibiotics, there was no
07:28decrease in Alzheimer's.
07:29May I?
07:30Don't start with me, please.
07:31So now, because he's gone public, people will assume that what's true for male mice
07:35is true for all mice.
07:36This is exactly the kind of thinking that I'm trying to change.
07:39Yet, your lab is apparently completely unused, and you haven't published anything.
07:43Why is that, Meredith?
07:45That's a cop-out.
07:46Okay.
07:46So then, why don't you explain it to me?
07:48Why is it that antibiotics don't work on female mice?
07:51I'm still working on my hypothesis.
07:52I don't know yet.
07:53Maybe instead of hiding out here all summer, you could be figuring this out.
07:56I have a surgery.
07:57Have a nice day.
08:00So you...
08:15So you race hobby horses?
08:21Well, not just race.
08:22Um, show jumping, hunter-jumper, puissance.
08:27Piaf.
08:27Passage.
08:32You on a team?
08:33It's an individual sport.
08:35Pretty niche.
08:36Mostly girls.
08:37A whole lot of the competitions, uh, Vince and I were, like, the only guys, so eventually
08:41we became friends.
08:42Uh, Nero is on their way.
08:44They were busy with another patient.
08:45Did you tell them there's a championship trophy on the line?
08:48I did not.
08:49I'll be fine.
08:50You should go back before Evie wins first in dressage.
08:52She'll be insufferable.
08:53No, it's not that.
08:55It's my chest.
08:59Oh, my God!
09:00Oh, we need some help!
09:04How can I be stage four?
09:07My scans.
09:07I thought the tumors were shrinking.
09:09Yeah, but unfortunately, sometimes tumors learn how to evade chemotherapy.
09:17Okay, well, if my cancer wants to fight, I'll fight harder.
09:24So, what now?
09:26Well, first things first, um, you have to recover from your splenectomy, and then we
09:34will start a new chemo regimen.
09:37Great.
09:38Really wasn't a fan of the old one.
09:40And, and, and we'll also look into clinical trials.
09:43There's a lot of new promising therapies out there.
09:46We just have to find the right one.
09:49Okay.
09:50Sounds good to me.
09:51I, I, I haven't seen anyone visit.
09:59Have you told friends, family, that you're in the hospital?
10:02If I tell them, they'll get upset.
10:04And then I'll get upset, and I just need to fight.
10:10Oh.
10:11Well, I, I don't know your mom, but I am a mom.
10:15And we are really good at fighting, too.
10:21Yeah.
10:23Once we know more, I will tell her.
10:28I promise.
10:32All right, I'll be back.
10:43I need your full attention on Katie Rogers.
10:46I thought we were just advancing her diet.
10:48We're full of fluids, right?
10:49No, she needs a clinical trial.
10:52Um, and I don't have time to search a database today.
10:56So, I need you to find options.
10:59See what's active, and then call, uh, around to see what's in the pipeline.
11:04Okay.
11:05I was gonna observe Dr. Avery's surgery, but I can carve out some time after.
11:10Uh, Mead will check on her every half hour.
11:11You can carve out some time for our patient with metastatic cancer.
11:16Well, how generous are you?
11:18Uh, you keep telling me to teach, and you told all of us to study Dr. Avery's deep flap.
11:23Katie is giving this her all, so we need to give our all.
11:27Do you think taking a break and watching a surgery is giving it your all, Dr. Adams?
11:33Uh, I'll skip it.
11:36Uh, leave no stone unturned.
11:49What is taking so long?
11:51All right, Avery's gonna want those scans to evaluate perforators.
11:54You worked with him before?
11:55Yeah.
11:56Yeah, I can read and anticipate him pretty well.
11:59Yeah.
11:59Used to be part of his, uh, his plastics posse.
12:01I don't know what that is, but I want in.
12:05You interested in plastics?
12:08Uh, don't have the extra three years.
12:10Too many things on my plate right now.
12:11Just, yeah, I just, uh, enjoy every case that I can.
12:15Oh, the scans are in.
12:18How do you anticipate Avery's gonna feel about his deep flap patient having an inguinal hernia?
12:27There he is.
12:28Hey, I read, uh, Karasik's article.
12:32Bold.
12:33Yeah, a study yielded interesting results.
12:35Yeah.
12:35I meant bold on your part.
12:38So I've been told.
12:40Hey, are you, are you busy?
12:41I've got a patient CT showing a right-sided inguinal hernia.
12:44Is it reducible?
12:45Uh, it is.
12:46Yeah, simple, fat-containing.
12:47Hoping you could do it.
12:49Uh, I wish I could, but I'm in budget meetings all day.
12:52Okay.
12:52Anybody else?
12:53Um, good luck.
12:55Don't.
12:56Hey.
12:57No.
12:58It's for a patient.
12:59Call Tom Karasik.
13:00She's a breast cancer survivor, I'm here.
13:03Right?
13:03And she's got a hernia.
13:04As long as she has that hernia, I can't give her the breast reconstruction that she needs.
13:08I can come back another time and I can do the flap, but she needs a repair done, like, ideally today.
13:12Call someone else.
13:13She's had a year from hell.
13:15Today was supposed to be her first step back.
13:17She deserves the best, and you can help her a lot better than I can.
13:19Please.
13:23Send me the scans.
13:27What happened?
13:28He was complaining of increasing chest pain, and now he requires four liters nasal cannula.
13:33I'm supposed to take golden dressage.
13:35Where's Karen?
13:36What are you doing here?
13:37One of Joe's patients went into premature labor.
13:39She's upstairs checking on her.
13:41I didn't want to wait in the car.
13:43You need a consult?
13:43You can consult.
13:44You can't even work yet.
13:45I haven't approved it.
13:47His vitals are stable.
13:48I was going to check his spine.
13:49Yeah, let's go.
13:51Let me know if anywhere hurts.
13:54Can't you just give me meds for the pain so I can go back to competing?
13:57Like they do in the Olympics.
13:58What's competition?
13:59Not the Olympics.
14:01Washington hobby or so again.
14:03Well, I work with professional athletes, and I wouldn't advise it.
14:05Ow.
14:06Ow.
14:06Okay, around T4.
14:08No step off.
14:11Let's take that x-ray.
14:13Or, you know, whatever Han wants.
14:15Okay.
14:16All right.
14:17Clear for x-ray.
14:21Okay.
14:22Ribs four to six are fractured on the left side.
14:24Some haziness, probably a lung contusion.
14:26No one asked you.
14:27Maybe you should.
14:28The guy said he worked with pro athletes.
14:30We need to scan you to get a better idea of what's going on, okay?
14:33Well, then can you come?
14:34This is my last shot at stake before college, and if I'm going to have a chance of competing,
14:38I want the best.
14:40Guess I'm back.
14:43Damn.
14:49Sorry to page you out of the seminar.
14:50Oh, please.
14:50I've never been closer to napping in public.
14:53Well, the patient's complaining of chest pain.
14:54She asked for Ndugu, but your name's also under charge.
14:57Okay, great.
15:04Nora, hey.
15:06What's going on?
15:07Um, I woke up with some chest pain, and I thought it might go away, but it hasn't, and
15:12I'm really freaked out.
15:13Okay.
15:15Uh, is it sharp, or does it feel like pressure?
15:18It's more like a dull ache.
15:20Okay, let's work you up.
15:27The reconstruction is off?
15:28Postponed.
15:29Dr. Gray will repair the hernia today, and then once you're healed up, I'll come right
15:32back and do the flat.
15:33Can't you just do both today?
15:34It's a much longer and more complicated procedure.
15:37You will recover quicker if we do them separately.
15:39Depends on how you define recover.
15:46What do you mean?
15:47I'm not ashamed of how I look, but at work, I am surrounded by mirrors, and when I see
15:54my reflection, it is a constant reminder of all the pain and waiting and exhaustion of
16:01not knowing if I'd live.
16:02I want people to recover until I can look in the mirror and see me, not my cancer.
16:15We understand, but...
16:16We'll do both surgeries today.
16:18Will we?
16:19She'll go under anesthesia once, which is not a bad idea, considering all her body has
16:23been through.
16:23But that is much more time under anesthesia, and I'm concerned about the post-operative pain.
16:29I will gladly take on the risk if it means waking up tomorrow and feeling like myself
16:32again.
16:38I'll prep.
16:46Hey, you hear about the fellows that kicked off the D-flap?
16:49How would I hear that?
16:50Guess who gets a scrubbing on the D-flap and a hernia repair now.
16:53I'm going to go with Warren.
16:55Well, you still got to come check it out.
16:56Bailey put me on research while she's in the OR.
16:58Well, so she demoted you back to an intern?
17:01Trax.
17:03That's where I got to go.
17:05You would want to live with me, right?
17:07I should live with you.
17:09I don't have, like, a smell or a weird habit.
17:11Am I allowed to?
17:13What is this about?
17:14I asked Jules to move in with us.
17:16Without asking me?
17:17You yelled at me when I did that.
17:18Doesn't matter.
17:19She said no.
17:20That doesn't let you off the hook.
17:21Why wouldn't she want to live with me?
17:23I'm a good roommate.
17:24Maybe she doesn't want to live with me.
17:26No, she specifically said live with you, meaning me.
17:28Then she took a hard pass.
17:30Hmm.
17:31What?
17:32I'm not done freaking out.
17:33Maybe the two of you just aren't as close as you thought.
17:37Hey, you need something?
17:50Yeah, I just had a question for Dr. Bailey.
17:52Well, she's in surgery.
17:54You can try me.
17:55Do you think I'll be healed enough to start my new chemotherapy before I'm discharged?
18:01That would be more like three weeks.
18:03A month with no treatments.
18:05Well, we want to give your body time to heal after surgery.
18:08But Dr. Bailey and Dr. Sugihara will meet later to talk next steps, and I'll be looking at clinical trials.
18:13You're in charge of finding clinical trials.
18:17Is that a problem?
18:21I thought we were okay.
18:22Well, when you were checking my incision, that was one thing.
18:25But clinical trials have serious ramifications for me, and I don't know anything about you.
18:32What do you want to know?
18:33Where did you go to medical school?
18:36Cornell.
18:37Did you get good grades?
18:38I'm a surgeon, so yeah.
18:40Did you ever kill anybody?
18:41By accident.
18:42I mean, if you murdered someone, I'd rather not know.
18:45Look, we could do this all day, but it's in your best interest if I'm researching therapies.
18:49So I'll be out there, and if you need something other than my social security number, give me a shot.
19:01All right, what do we got?
19:03Uh, x-rays shows a hemothorax and some broken ribs.
19:06And what's the mechanism?
19:08Hobby horse injury.
19:10Hey, didn't I just sign off on your discharge papers?
19:13Yeah, don't ask.
19:14Okay.
19:17Uh, hobby horse, like a stick horse?
19:19No, you can't call it stick horses for children.
19:21Hobby horsing is far more sophisticated.
19:23There's a whole league, apparently, and you cannot call it stick horses.
19:27Very offensive.
19:30I looked it up in the elevator.
19:33Okay, uh, just a little longer, Vince.
19:36Guess I'm missing the barrel race.
19:37I know it sounds weird.
19:40No, no.
19:41Seems fun.
19:43Most people don't get it, but that's what's cool about it.
19:45Being part of a community that loves something and doesn't care what anybody else thinks.
19:49But I'm going to college in Colorado, and there's no hobby horse thing there.
19:53So, pretty soon, I hope I won't be part of anything.
19:56Just be a guy who fell off a big horse and...
20:00Mr. Stalk's in the 60s.
20:01His stats are tanking.
20:03He's got a code.
20:03Okay, let's get a chest tube train.
20:04I'm prepared to intubate right now.
20:06I'll notify the U.R.
20:15Getting ready to secure the mesh to the shelving edge.
20:18Dr. Corn, hold tension on my suture.
20:21How's that?
20:22Good.
20:24I am scrubbed and ready.
20:26Hope you're happy.
20:27Last time I checked, I was doing you a favor.
20:29You're welcome.
20:29You encouraged her to take a bigger risk.
20:32No, I listen to her.
20:33There's a difference.
20:33With all due respect, I spend the majority of my clinic hours listening to female patients.
20:38Oh.
20:39Do a lot of deep flaps?
20:40Fair amount.
20:41Let me guess.
20:42Not as many as you'd expect.
20:44Well, no, because most people don't know that the law requires insurance companies to cover
20:47breast reconstruction after cancer.
20:49Yet somehow everyone knows you can get a vasectomy.
20:52You see a pattern here, Dr. Avery?
20:54I see several, Dr. Gray.
20:55You made your point.
20:56Too bad he can't publish that.
20:58I'm done here, Dr. Kwan.
21:04You can close the fascia.
21:11So, this should just take a few minutes.
21:13Try to hold still.
21:14I'm not going anywhere.
21:16And then I'd like to review your daily routine, your diet, just to make sure that you're not
21:20inadvertently putting any strain on the repair.
21:23Hey.
21:29We're on a break.
21:31Do you want to grab a bite after this?
21:33Oh, um, now's not a good time.
21:35Are you okay?
21:36Yeah, I just, I have a really complicated patient.
21:40Well, I'm happy to bounce some ideas around.
21:42You want me to consult?
21:44Or just support?
21:46You know what?
21:47Um, the scan should be coming up soon.
21:49You should probably go.
21:49Is this because we ran into Owen earlier?
21:53No.
21:54Are you sure?
21:55Because you seemed fine at the hotel.
21:57More than fine.
21:58And now?
21:59And now I am treating an extremely risky patient who requires my full attention and I'm not
22:04in a hotel bad name at work.
22:09Well, then I will leave you to it.
22:11Okay.
22:11He has a lower lobe injury.
22:19I'm seeing multiple lacerations of his lung.
22:21I'll do a wedger section.
22:21How much do you have to take?
22:23Can someone page Wilson and see how much longer she's going to be?
22:27You know, I had a hobby horse when I was a kid.
22:29Scared the crap out of me.
22:30I couldn't sleep unless it was facing the wall.
22:32You know, I wasn't going to say anything.
22:34It's weird, right?
22:35That's a bunch of people jumping around on toy animals.
22:37There's a website where you can customize your horse's head.
22:41Okay, enough.
22:43I'm not here to judge.
22:44We're here to fix it.
22:44If you can't just focus on the job, then you should go.
22:46This kid loves his sport and after today, he might not be able to do it anymore.
22:49Haven't you ever loved something and lost it?
22:50Let's show some respect.
22:52I'm sorry.
22:53Need to suction?
23:00This is lining up perfectly.
23:03Dr. Warren, why don't you go ahead and grab that clamp?
23:07Beautiful.
23:08Very nice.
23:09Is there something you need, Dr. Mahonti?
23:12I'm done with the Millard repair.
23:13Thought I'd see if you need more hands here.
23:15Oh, we're good, but thank you.
23:17Understood.
23:18Warren, when I'm done with the arterial and asemosis, you want to give me a hand with the
23:22venous coupling?
23:24Absolutely.
23:25Dr. Avery, may I be excused?
23:28I'm really not feeling well.
23:29You were fine ten seconds ago.
23:30Well, I think I might have questionable leftovers for lunch.
23:37I might come out of both ends.
23:39No need to elaborate, Dr. Korn.
23:41Mahonti looks like it's your lucky day.
23:45I'll go scrub.
23:46Okay.
23:46Dr. Avery just finished the microvascular anastomosis and made it look easy.
23:56It's insane.
23:57Reed?
23:57Yeah.
23:58Go somewhere else.
23:59Oh.
24:00Okay.
24:04You need something?
24:06Yes.
24:07What is PD-L1?
24:09Program cell death ligand.
24:11It's a protein that helps your cells more effectively kill cancer cells.
24:15Okay.
24:16And CTLA-4?
24:18It's an immune checkpoint inhibitor.
24:20Another mechanism that clinical trials are exploring for treating cancers like yours.
24:24Why?
24:25Yeah, no, I'm searching clinical trials.
24:27It's all fairly overwhelming.
24:29Yeah.
24:29Most of the possible side effects aren't that bad.
24:32May cause dry mouth nausea or death.
24:35Yeah, death seems pretty bad.
24:38Yeah, that's just lawyers making sure nobody gets sued.
24:41Oh, that doesn't make me feel any better.
24:43Oh.
24:44Ouch.
24:46You okay?
24:47No, my leg hurts.
24:49I'm not used to being on my feet.
24:51Let me take a look.
24:54Ow.
24:55Ow.
24:56Ow, stop, please.
24:57Grab a wheelchair.
24:58Right away, Dr. Adams.
24:59Wait.
25:00No, what's going on?
25:01What's happening?
25:02I think you have a blood clot.
25:03Let's get you back to your room.
25:04We need to ultrasound your leg ASAP.
25:08Dr. Brasington to the ER.
25:12Dr. Eden Brasington to the ER.
25:15Sorry, I know that you said no screens with a concussion.
25:17I just wanted to watch Vince in last year's pre-sense.
25:20Whoa, how high is that bar?
25:26Four feet.
25:27They raise it after every round.
25:29That's pretty impressive.
25:31It's not even his best event.
25:34People don't realize how much strength and precision it actually takes.
25:39When I would tell the other kids, they would just laugh, so I stopped talking about it.
25:43I would just say that my mom wouldn't let me go to the movies instead of saying that I had practice.
25:47But then I met Vince.
25:50I didn't have to lie anymore.
25:52Everything changed.
25:54He got me.
25:58I'll put this away.
25:59No, actually, Nero, clear to you.
26:00You can go.
26:01Really?
26:01Mm-hmm.
26:02We might make it back for Hunter Jumper.
26:04That's Vince's best event.
26:05He's going to be so slight.
26:06Actually, Vince can't go.
26:07He's in surgery.
26:08For real?
26:09I can't say more because of privacy laws, but it shouldn't be more than...
26:11Oh, you can't see him yet, but I'll let you know when he's out.
26:14I have to make it back to the competition, and I finally have a shot at winning Hunter Jumper.
26:18Your friend is in surgery.
26:19Vince would want me to go.
26:21Can you shut the curtain so I can change?
26:27What is wrong with people?
26:34Hey, am I interrupting?
26:36My five-year-old lost a tooth.
26:38Cute.
26:38Well, it's because his brother knocked him off a swing, but still cute.
26:43He's fine.
26:44That makes two of you.
26:45I'm okay?
26:46All your tests came back clear.
26:47Oh, my God.
26:48Okay.
26:51So, the pain is...
26:53I'm guessing indigestion, so I'm going to put you on an N-acid.
26:56I can't believe I bothered you with this.
26:58No, it's okay.
26:59I am still your doctor.
27:01You know, I used to be one of those moms who would put a handwritten note in her kids' lunches every day.
27:06And since the divorce, and then the surgery, I'm lucky if I can get them to school on time, in clothes that they didn't also wear to bed.
27:16Can't seem to get myself to the right place in the right time anymore, and I'm sorry I dragged you into it.
27:21I get it more than you know.
27:27Owen and I are looking at divorce.
27:31I'm so sorry.
27:32I didn't know.
27:33Are you okay?
27:34It's taking some getting used to.
27:37If I had anything to...
27:39No, it was all us.
27:41It's okay.
27:42I mean, it will be okay.
27:45We're not there yet.
27:46I definitely have a long way to go.
27:49But I'm just hoping that we both have a chance to find what makes us happy.
27:58Yep, here it is.
28:00A small clot in the distal popliteal vein.
28:02Does that mean I'm going to have, like, a stroke or something?
28:05Well, we still need to scan you to make sure you don't have one in your lung, but looks like we caught it early.
28:10I'll put in an order for heparin drip, and then I'll update Dr. Bailey.
28:15It's always something.
28:20Cancer, unfortunately, makes your blood more prone to clots.
28:23I haven't told any of my friends that I'm here.
28:29They wouldn't get it.
28:31Their biggest problems are passive-aggressive co-workers and where to get drinks on a Thursday night.
28:38I'm not mad.
28:39I want that, too.
28:40I want to hang out in wine bars, go to Europe, watch my friends get married and have kids.
28:49And, um, this might sound really dumb, but I really want to try a slice of New York cheesecake.
28:56Well, I'm from New York.
29:03I bet I could help you with that.
29:06Mostly, I just want to fight.
29:08There's nothing I can do except sit here and think about my cancer cells multiplying until I die.
29:14And I really don't want to die.
29:34All right, let's prep for the venous anastomosis, please.
29:39Don't we need the hockey stick?
29:40Already got it.
29:41I like the teamwork.
29:42Well, Auntie, why don't you do the venous coupling?
29:44You ever done one before?
29:46Of course.
29:48Wait, look at the other flap.
29:50Does it look like it's turning blue?
29:54It looks like congestion in the venous outflow.
29:56Well, what do we do?
29:57The flap's not viable without good outflow.
29:59Yeah, we don't have any options in terms of the reconstruction.
30:02Was there bleeding when Gray repaired the hernia?
30:04All right.
30:05So she probably sacrificed a superficial epigastric vein.
30:08Carrie's probably superficial dominant, so the vein's too short.
30:10That would explain the decreased outflow to the flap.
30:13All right.
30:13Now how are we going to resolve this?
30:15It's too short to connect to the retrograde IMB, so a cephalic turndown would give the buildup of blood a place to go.
30:20Very good.
30:21So we will begin by isolating the cephalic vein.
30:24I'll do the turndown, and then we can get back to work on the other flap.
30:27Nice work.
30:28Welcome to the plastics, Posse, Monty.
30:30I asked Millen to update me on Vince's recovery tomorrow.
30:38I hope you don't mind.
30:39Sure.
30:40Yeah, kind of got a soft spot for the guy.
30:42I really wanted to compete in the National Marble Tournament when I was a kid.
30:46Crushed me when I lost my lucky hazer.
30:51You okay?
30:52I'm fine.
30:52Joe told me about you and Teddy, if you ever want to talk.
31:01About what?
31:02Like, you're going to help me process the end of my marriage, get over the loss of my wife and my best friend,
31:06and you say, what, you can relate because you lost a marble once?
31:10I'm just here to support.
31:12I shouldn't be here at all.
31:13Well, unless that mouse needs an appendectomy, this is not official hospital business.
31:32How's Perry?
31:33She's great.
31:34I mean, I did have to perform an entire cephalic turndown thanks to you, but...
31:38Me?
31:40Oh, the superficial epigastric.
31:42Sorry.
31:42No, it's fine.
31:43It's pretty standard during her knee repair.
31:45I should have expected it, honestly.
31:47Look, I am sorry, Mayor.
31:49You were right.
31:50It was the right move.
31:51Perry is super happy.
31:53And after all she's been through with chemo and hormone therapy and radiation, she deserves it.
31:58She does.
32:04It's the estrogen, you know.
32:06You and Perry have estrogen, yes.
32:08No, the difference between the male and female lives.
32:11Why the antibiotic affects one and not the other.
32:14How do you figure that?
32:15I don't know that yet.
32:16I have to revise the study and measure the hormone levels.
32:20Okay.
32:21Anyway.
32:22You want a ride back to Boston?
32:23Sure.
32:25I have to go take care of something first.
32:36Hey.
32:37How'd I do?
32:39We were able to stop bleeding in your chest.
32:41You're going to be fine.
32:42What about the broken ribs?
32:44Do I need a cast or something?
32:46I'm just going to take some time to heal.
32:48No more hobby-horsing for a while, okay?
32:53It's okay.
32:55I probably outgrew it a while ago.
32:57I'll still miss it in college.
32:59And Jonah.
33:00I think you're trying ultimate frisbee.
33:02Huh.
33:03Sounds like fun.
33:05Or theater.
33:07Or college newspaper.
33:08I'm looking forward to trying something new.
33:13That's a good answer.
33:16Your mom and dad are in the waiting area.
33:17I'll go tell them that you're at work, okay?
33:24Hey.
33:25I found a clinical trial for Katie.
33:27A new immunotherapy targeting checkpoint inhibitors.
33:31Oh, that could be promising.
33:33Now read the fine print tonight.
33:34Her right leg was swollen earlier, so I got an ultrasound and showed a DVT.
33:40But no PE on the CT, so I started her on a heparin drip.
33:44It's going to be an uphill battle.
33:46I'd like to see her chase through, if that's okay.
33:50That might mean missing more big surgeries.
33:54They say more paperwork duty.
33:56More me.
33:58That's okay.
33:59I, um, I think I need more experience in surgical oncology.
34:05Well, yeah, I'll let everyone know.
34:11Dr. Technos in technology.
34:14Dr. Cargway, Technos in technology.
34:17Your hand's unstable.
34:25You just made me kill my patient.
34:27How'd the surgery go?
34:32Perry's got new breasts, and I was inducted into Avery's plastic spalsy.
34:38For whatever that's worth.
34:40Wow.
34:40Sounds like you impressed.
34:43What did you eat for lunch?
34:45Chips.
34:46You got food poisoning from chips?
34:50Chips and a sandwich.
34:52Uh, a vending machine sandwich.
34:57The vending machines have sandwiches?
35:00They shouldn't.
35:03Well, thank you.
35:07I now know to stay away from the sandwiches.
35:09The trick with microsuturing is finding something to stabilize your hand.
35:29Uh, could you please tell your hobby horse patient that his friend wants to see him?
35:33I would, but his supposed friend ditched him to go back to the competition.
35:38Okay.
35:39Well, why don't you want to live with me?
35:41What?
35:42I'm neat, considerate, responsible.
35:44I'm catch.
35:45Plus, I thought we were friends.
35:46Oh, uh, I'm a really hard sleeper.
35:50Do you know what that means, Fab?
35:53Every morning, I wake up to three alarms on my phone at full volume.
35:58I have a vintage clock radio across the room as a backup.
36:03I've not only been kicked out by roommates, but I've lost friends over it.
36:07And the only reason that it works with Max is because she can't hear anything without her hearing aids in.
36:12I mean, it's not that I don't want to live with you.
36:16It's just, historically, I haven't had a lot of friends.
36:22And I don't want to risk that with you.
36:26You want to come over and watch Trash TV today?
36:30And miss watching High Noon for the 18th time with Max and Irvin?
36:34Hell yes.
36:36Hey, hey, um, can we talk?
36:39I can't.
36:40Apparently, I'm only capable of pillow talk.
36:42Okay, that was deserved.
36:43Listen, I am really sorry about earlier.
36:46You were pretty harsh.
36:48I know.
36:48And I lied.
36:49Running into Owen this morning, it rattled me.
36:51And then I had this particular patient come back in who I have saved multiple times.
36:55Teddy, it's fine.
36:56No, it's not.
36:57Listen, when I was stationed in Iraq,
37:00there was once this competition that they held for the most precise hospital corners,
37:04or bedsheet corners.
37:05Guess who won first place?
37:06If I had my way, I would run my whole life like a tight ship.
37:13Order and stability and having control give me comfort.
37:17Always have.
37:18But right now, I am as far away from that in my personal life and at work than I have ever been.
37:25But when you and I are alone, I forget what a mess everything is.
37:35And I think I'm scared being out of our bubble will take that away.
37:40It could.
37:42Or it could give you more space to claim as your own.
37:49I like that.
37:49It might take me a little while to get there,
37:54so I'll understand if you have to move on.
37:58I would, but I think I need to see those tight bedsheet corners.
38:07Maybe we can find an empty patient room.
38:11Oh.
38:11I was thinking I'd just go to your hotel.
38:17When you encounter a new beginning, there's no announcement on a loudspeaker.
38:23Blink and you could miss it.
38:26I ran into Jackson.
38:28He said you excelled today.
38:30Well, actually, he said you kicked ass, but I interpreted.
38:32Oh, it was an amazing case.
38:34You know, I had everything I love about surgery.
38:36Um, abdominal tissue and microvascular surgery.
38:39Challenging anatomy, teamwork, meaningful outcome for our patients.
38:44You're beaming.
38:45But aren't they always a bright light?
38:47Look, so why aren't you doing a plastic specialty?
38:53It's three more years of residency.
38:55Three years of you doing the lion's share of work at home.
38:58Three years would be worth every second if plastics lights you up like this.
39:04Really?
39:06What, you need it in writing?
39:08Yes.
39:10Oh.
39:13You know, sometimes I feel like you understand me before I do.
39:20But you know what else would really light me up?
39:23What?
39:23Give me 15 minutes of change and I'll take you home and show you.
39:31Or worse, ignore it.
39:33Hey.
39:34I didn't see any more patients.
39:35I'm just waiting for Joe.
39:37I owe you an apology.
39:39I've been feeling lost and that's not on you.
39:45You might actually be the only person who's asked how I'm doing, so...
39:50We've all been there.
39:54And hey, I'm around if you want to talk.
39:57Grab a beer.
39:58Yeah.
39:59But not right now because Joe's pulling the car around and she wants ice cream.
40:05Oh yeah, don't let me stop you.
40:06Here you go.
40:12Hey stranger.
40:14Nora?
40:14Nora, what are you doing here?
40:16Do you...
40:17I have bad chest pain.
40:18Turns out I have plain old indigestion like everyone else.
40:21Okay, so you're...
40:23I mean, you're good.
40:24Okay.
40:25Just trying to figure out this whole new normal.
40:29You talk to Teddy, it sounds like you're doing the same thing.
40:31Yeah, you know, taking it one day at a time.
40:34Yeah.
40:38Would you...
40:39I mean, do you...
40:40Do you want to talk and get a coffee or...
40:41I don't think that's a good idea.
40:44I mean, if I have coffee now, I won't sleep for two days.
40:48Dinner?
40:50That would be...
40:51That'd be really great.
40:53Yeah.
40:56New beginnings can be scary.
41:00But they can also be deeply fulfilling.
41:04I think it's made a breakthrough in my research.
41:06Oh, that's wonderful.
41:08And I know I said I would stay a while,
41:09but the longer I stay here,
41:12the longer it is until I get to the root of Alzheimer's disease.
41:15There are too many people counting on me,
41:16so I think it's time I go back to Boston.
41:21What are you doing?
41:23I'm finishing rescheduling your patients.
41:27The second I read Karasik's article,
41:29I knew it'd be only a matter of time
41:31before you decided to go back.
41:33Then you should.
41:36What, Meredith?
41:38You can tell.
41:39So let go and dive in.
41:41Transcription by CastingWords
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