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00:00Previously, on Doc.
00:01He's back.
00:02I made mistakes.
00:03Actually, you leveraged an incredibly painful situation
00:06to your advantage.
00:07And how are things with Nora now?
00:10Over.
00:10I found a lump.
00:12Please don't tell anyone about this.
00:13Do you have a minute?
00:14I'm in radiology right now with a patient.
00:16What if she's sick?
00:17Yeah, she's trying to hide it.
00:18It's progressing quickly.
00:20I suggest you reach out to Ethan.
00:21Get a support system in place.
00:23You went into her desk?
00:24We had no other choice.
00:25I'm afraid that you might be sick.
00:27We gotta talk about Joan.
00:43Dr. Ridley.
00:44Oh, they're here?
00:45Heading up now.
00:46OR3 is clear and the blood banks on standby.
00:48Good.
00:49And we are ready.
00:52Bay 4, breathing in.
00:53Penetrating abdominal wound, initial stabilizing surgery on site,
00:56but multiple retained foreign bodies cannot be removed.
00:59Open wound pack for transport.
01:00How do you do on the flight?
01:01Hypertensive and tacky.
01:02Started norepi and fluid resource on route.
01:04Conscious?
01:04In and out.
01:05I'm asking for you.
01:07On my count.
01:08Three, two, one.
01:12Hang TXA to a bone egg.
01:14I want him on the table in half an hour.
01:16Ridley?
01:18Is that you?
01:19If you missed me this much, you could have just called.
01:23You know I'd love to make an entrance.
01:25Well, you are here now, Javi, and I am gonna take care of you.
01:38I thought you were coming in later.
01:41Yeah, well, so did I, but I gotta review all of Amy's cases by end of day.
01:46Is she doing the same for yours?
01:47She handed hers in already. Not that it matters anymore.
01:50Okay, why do you say that?
01:51Don't you think Joan's gonna figure out we were the ones who told Jake about her?
01:54She was hazing me yesterday as if she already knew.
01:57I'm pretty sure Jake passed that baton to Amy today, so I'm sure you're on equal footing now.
02:01I heard she's prepping another surgery, and clearly she hasn't invited you to audit.
02:07We did the right thing. Can't overthink the consequences.
02:13This should hold him for now, but prep the team for massive transfusion protocol.
02:18Damn generator exploded. We worked medical missions together for 22 years, but why don't you go ahead and say what
02:24you need to say?
02:26Uh, I thought maybe we could step away.
02:30Is your boyfriend hiding out there somewhere to double-team me?
02:33Joan.
02:35It's MDS.
02:38Oh, God.
02:39Please, don't.
02:41Uh, I was diagnosed a few weeks ago. It's mostly indolent.
02:45I haven't had a chance to tell Michael yet, so I'd appreciate if you let me do that.
02:49Yeah, of course.
02:50And before you ask, Javi knows he came here anyway.
02:53He has Addison's. He needed a surgeon he could trust.
02:59Does he know that your hand's been shaking?
03:05That happened once, Amy, after a very difficult surgery.
03:08Which this will be.
03:16I'm medicated and I'm fine.
03:20You could use an extra set of hands to manage his cortisol and electrolyte levels.
03:24Is that you offering?
03:27I'll get him started on a TTE.
03:33Thank you, Ray.
03:35Mr. Boyd.
03:35Who are you? Supposed to be seeing Dr. Ridley.
03:38Dr. Ridley had an emergency, but I can assure you...
03:40And Dr. Humda was supposed to be joining us as well.
03:42Uh, his whereabouts I can't speak to, but I'm Dr. Miller.
03:46First name?
03:47Uh, Richard.
03:48And you are?
03:49Fiona, Xander's COO.
03:51And my wife.
03:52You're an internist?
03:53Board-certified in oncology as well.
03:54Pulmonary subspecialty.
03:56Where?
03:56St. Egericus.
03:57And he used to be chief of internal medicine here for just two months.
04:00I didn't love the admin, so I took a little hiatus and I came back to work with patients,
04:05which is what I do love.
04:07Okay, continue.
04:08I understand you have a suspicious mass in your right lung.
04:11I get regular full body scans in Palo Alto, but I was here at a conference when the Apollo DX
04:15flagged it.
04:17It's an AI diagnostic program.
04:1817% better than humans at early cancer detection.
04:21It's also far more likely to give you a false positive.
04:24Well, that's the hope, but I won't wait to get home to find out.
04:28Hi, I'm Dr. Coleman.
04:29I'll be assisting Dr. Miller.
04:31Uh, yeah.
04:31That's, uh, Theodore Coleman.
04:33He's an intern, Columbia Med School, Army Ranger Medic.
04:36He is highly skilled, very ambitious, and an extremely hard worker.
04:41Are we being interviewed?
04:42Vetted.
04:43It's gonna be on him anyway.
04:44Steiner vouches.
04:45Oh, I'm flattered.
04:46Great.
04:46I want the tissue removed and studied, so how'd you do that, Dr. Coleman?
04:51Uh, bronchoscopic biopsy in a PET scan.
04:54Is that correct?
04:55It is.
04:55Then let's do that, huh?
04:57Stat.
05:00I want to thank you both for being here today.
05:03My role is not to judge or to take sides,
05:05but to facilitate a productive, respectful conversation.
05:11I'm so sorry.
05:13It's Max.
05:13Fine, Michael.
05:16I told you I had a personal matter to attend to today.
05:19You also told me Joan would be taking care of Xander Voight.
05:22Well, she has a patient who has a higher priority.
05:24Than a tech tycoon who can fund our entire capital campaign with what he makes while brushing his teeth?
05:30Well, Dr. Miller's on the case.
05:32I hear he's excellent.
05:33Why else would you have hired him back?
05:34Not funny, Michael.
05:35No, it's not.
05:36I'll deal with this in a few hours when I get back to the hospital.
05:39Goodbye, Max.
05:41So she took this job and she didn't tell Michael?
05:44No, she was diagnosed after she was offered the job.
05:48And she still hasn't told him?
05:50She's getting her head around it.
05:51And in the meantime, what?
05:52You're aiding and abetting, risking a patient?
05:54The patient knows.
05:55And he chose her anyway.
05:57Besides, there's no time to move in.
05:59I don't know.
06:00Something doesn't feel right.
06:01She's working you.
06:02No, she isn't.
06:03You...
06:03You just don't know her the way I do.
06:06Yeah, you don't know her either.
06:07Not in the last eight years.
06:12I'm sorry.
06:13But that's the truth.
06:15And you know you can't justify any of this.
06:23How long has it been like this?
06:24Mom says a week.
06:26They thought it would heal on its own, but...
06:27I don't know.
06:28She's too malnourished.
06:29Fighting and goma cut off the food supply.
06:40So I got saline,
06:42debridement kit,
06:43McPearson.
06:45Please trade with me.
06:46What's wrong with your case?
06:48Oh, Marcus keeps sending me lumps, bumps and dumps.
06:50That's what you get for sleeping with him
06:52and not calling him back.
06:54Dr. Ridley.
06:55Mm-hmm.
06:55It's your son.
06:56What?
06:57It's...
06:58It's 2am in Minneapolis.
07:02Ethan?
07:03Hey, what's wrong?
07:07No, no, no.
07:08Uh, forget the pediatrician.
07:09Get to Westside.
07:10Ask for Amy.
07:11I'll...
07:11I'll make sure she's waiting for you.
07:19Thank you for doing this.
07:21I'm here for you.
07:22But keeping this a secret won't do you or our patients any favors.
07:26You giving me an ultimatum?
07:27I'm asking you to tell Michael today.
07:30We both know that this disease will take things from you.
07:34Your legacy shouldn't be one of them.
07:42We'll see you in there.
07:50I can't do dinner.
07:52I'm too tired.
07:56But we're still facing resistance from regulators on the new build.
08:00So find a new country or grease the wheels.
08:02I don't care which.
08:03Look, I gotta go.
08:04But one way or another, I want movement by next week.
08:06Hi.
08:07Mr. Boyd.
08:07Max Garner, CEO of the hospital.
08:09Just wanted to say that we will do everything in our power
08:12to give you what you need today.
08:14My test results would be nice.
08:20Unfortunately, I'm going to have to eat my words.
08:23The biopsy confirmed you have small cell lung cancer.
08:27Lung cancer?
08:28Yes.
08:29He hasn't smoked a day in his life.
08:30And he's meticulous about his health.
08:32Fiona, we're not gonna argue this away.
08:34But I'm sure if you couldn't see the mass, we caught it early, right?
08:39Yes, but genetic sequencing indicates it's an aggressive variant.
08:44And the PET scan shows micrometastases in your brain, abdomen, and bones.
08:50So it's already spread?
08:52So what now?
08:53Well, we can try chemo and molecular therapy, but those treatments are very painful.
08:58And even then...
08:59So how long do I have?
09:01Best guess, we can get you four to six months.
09:07Personally, I'd consider palliative care.
09:10I'm getting Dr. Steiner.
09:11We'd be happy to interface with any of your own specialists.
09:14Well, we've already conferred with our chief of oncology, and he agrees with our assessment.
09:18Well, of course he does.
09:19He works in a bureaucracy and can't think out of the box.
09:22I wish we could do more.
09:23We could try CAR-T.
09:26No, we cannot.
09:27What is CAR-T?
09:29Chimeric antigen receptor T-cell therapy.
09:31It reprograms your white cells.
09:33And has absolutely no efficacy on this type of cancer.
09:36I don't think anyone knows that for sure. There's not enough data.
09:38Steiner is fielding second opinions and wants to teleconference in an hour.
09:42The plane will be ready to take you to Sloan or Hutch or Oxford if we have to.
09:46Wait a minute. Anything any of those places can do, we can do, and we'll be completely transparent with your
09:52team.
09:52Your team is not even on the same page.
09:54We will get there, I assure you.
09:56Then come back to me with a plan. If I'm still here, I'm all ears.
10:03One centimeter fragment in segment six, two-suture repair.
10:12Hey, any news?
10:14No. I'm freaking out.
10:16Listen, I told you, just because you're taking longer to get the results, that doesn't mean anything.
10:20I know, I know. I thought I'd be okay with this, but I am really not.
10:23Maybe stay away from work today and just try and distract yourself.
10:27Funny you should say that.
10:28Because I'm kind of at the cafe around the corner.
10:31Uh, from the hospital right now?
10:34Look, is there any way you can come down for a minute? I'm really not handling this well.
10:37Yeah, yeah, I'll be right there.
10:41BP's dropping 91 over 59.
10:43Amy?
10:43Pushing 100, high to cortisone.
10:45Normal saline, wide open.
10:47What's this, sodium?
10:48It's fine, 134.
10:49It's not me.
10:50You have a bleeder.
10:51My field is clear.
10:54Unless...
10:54Dammit.
10:55Suction.
10:56You're counting?
10:59I can't clear the field fast enough.
11:01Want another clamp for a Pringle maneuver?
11:03No time.
11:03I'll do it blind.
11:05Micro-suture on a needle driver.
11:28BP's rising.
11:32That was amazing.
11:34Piece of cake.
11:55Yeah, yeah, no, we're here with Amy now.
11:57She's checking his lungs.
11:59Stop, stop.
12:00I can't, I can't hear anything you're saying.
12:02Robbie feels rising.
12:02You have to find someone with a better seat.
12:05Mom?
12:06Mom?
12:11So, the albuterol is working, but his oxygen is still low.
12:17If it drops anymore, we're...
12:18Don't tell me you have to intubate.
12:20Oh, my God.
12:20No, we're not there yet.
12:22Let's, let's just try to stay calm.
12:25I never thought I'd say this, but I wish my mother were here.
12:28There's nothing she would do that I'm not already doing.
12:31You think I want her here for medical expertise?
12:33No.
12:35You know, when I had meningitis in college, she at least offered to fly home.
12:40Ethan, she's doing the best.
12:41Don't, don't defend her, Amy, alright? Please.
13:02John?
13:03Yeah?
13:05You okay?
13:06I'm fine.
13:08I just had to splash a little water on my face.
13:12I'll be right out.
13:24Okay, let's bump his methamazole up to 20 and then recheck his TSH.
13:28And can you have Dr. Park give me a call on labs, come back on 6-12?
13:32Okay, thanks.
13:33Thanks.
13:38Thanks.
14:04All handled?
14:05Yeah.
14:06I think they can survive without me.
14:07Apparently, I can't.
14:09Hey, it's fine.
14:10Okay?
14:12I'm not going anywhere until the labs come back.
14:15What is this?
14:16This is the Mia treatment.
14:18And you thought this would distract me from my impending doom?
14:20I've seen you around a Sunday.
14:29I want primary custody for as long as I'm breastfeeding.
14:32Absolutely.
14:33I'll take regular visitation rights for the first year.
14:36And after this first period, we'll transition to the 50-50 custody?
14:41Yes.
14:42Agreed.
14:42Now on to assets.
14:44First, the family home.
14:46It's in Michael's name.
14:47I'm prepared to sell it and give Nora half the proceeds.
14:50I can't let you do that, Michael.
14:52Why not?
14:53I know what it means to you.
14:54And what about Katie?
14:56She's fine with it.
14:57She's off to college soon.
14:58And I think it's the least I can...
15:00Oh, God.
15:00Don't you dare be kind to me right now.
15:04What else would I...
15:09I need to hate you, Michael.
15:10And you need to let me.
15:17Hey.
15:18Hi.
15:18How's our patient?
15:20Strong vitals.
15:21Strong vitals.
15:21No sign of infection.
15:23Emptied his drains.
15:24Hung post-op antibiotics.
15:26Wow.
15:27We're gonna put our nurses out of business.
15:29I can handle post-op if you just wanna sit with him.
15:34That's a hell of a bedside manner you've got there.
15:39You all right?
15:41Amy.
15:43Hey.
15:45I'm good.
15:47I...
15:47I...
15:48I have another patient I should check on.
15:51But Javi needs post-op lights and hourly labs.
15:54I'll take care of it.
16:01We talked about this.
16:02I don't want you back in that chair until we have...
16:04I know.
16:05Until I've had two months of normal EEGs.
16:07I know.
16:08But I've had four clean studies and I need this memory now.
16:12Look, I know you're going for chief resident and recovering your medical knowledge is important.
16:16No, it's not that.
16:17When my brain does this, it's because it's trying to tell me something.
16:22My friend needs help and this memory may be the only way that I can help her.
16:27Any headaches or nosebleeds and I'm pulling the plug?
16:30Of course.
16:32I want to be clear that the treatment protocol that I'm proposing will be risky and painful.
16:37Pain is irrelevant.
16:38Will it work?
16:39I found one successful case.
16:40But as your team will tell you, cancer involves many mutations.
16:43The treatment has to be as unique as the disease.
16:46That is where CAR-T comes in.
16:48We take your own T cells and re-engineer them to target the specific markers of your illness.
16:54Which antigen will you use?
16:55His cancer cells exhibit a large number of DLL3 surface proteins.
16:59And which viral factor for delivery?
17:01The case I'm referencing used a lentivirus model.
17:03The case he's referencing was so much less aggressive, it shouldn't even be considered a comp.
17:07Mr. Voight's immuno-response will almost certainly be catastrophic.
17:11There's a very good chance this treatment will kill you.
17:14By tomorrow.
17:15Or it could add years to his life.
17:17Team, some feedback would be nice.
17:20Give us a moment, please.
17:22I thought you were getting on the same page.
17:24So did I.
17:26Okay.
17:27The only other option we can see here is Ludo's team in Zurich.
17:31They have a vaccine model that's had some limited success in mice.
17:34Limited? And only with mice? No.
17:36That's out. What else?
17:37I'm sorry, but there's nothing we can stand behind.
17:40So Dr. Coleman's idea is the best option?
17:42It would be, yes.
17:44Elise?
17:45With more time, we could dig deeper, but...
17:48Big things don't happen overnight in the cancer game.
17:51Okay, so...
17:52We have no choice.
17:54Okay then, let's get the ball rolling with whatever we need to do next.
17:58I'm sorry, but clearly these people on your payroll don't know how to say no to you.
18:02Dr. Miller...
18:03And I gotta say, if you were anyone else, this hospital wouldn't even be considering this course of treatment.
18:08Mr. Voigt has an appetite for risk.
18:10An appetite for risk is one thing.
18:11This is trying to kill a lion with a toothpick.
18:20Sometimes we fly too close to the sun, but we get nowhere if we don't try to fly.
18:26Right, Dr. Coleman?
18:29Well, I sincerely hope this works.
18:33But respectfully, I won't be a part of it.
18:46I, uh...
18:47I didn't mean what I said before.
18:51I mean...
18:53I don't wanna hate you.
18:55I wouldn't blame you if you did.
18:59I hope that selling the house will be a fresh start for you.
19:05I think you really need that.
19:09Okay, I've drafted an agreement.
19:11Why don't we give it a once-over?
19:16And focus.
19:19Ground yourself in the memory.
19:21What can you smell?
19:22Hear?
19:24See?
19:30Okay, let it rip.
19:41So just stay out of it.
19:43What are you not telling me?
19:45It's...
19:45It's MDS.
19:46So there's a good chance it'll turn into leukemia.
19:53What is it, Amy?
19:54I have to go.
20:02You can't perform surgery anymore.
20:11Place a vast cath.
20:12Prepping for temporary human dialysis.
20:14What happened?
20:16BP spike.
20:17Acute renal failure.
20:19But that makes no sense.
20:20Addison should prevent BP spikes.
20:22And his renal function was normal pre-op.
20:25Well, clearly we're missing something.
20:27Blood cultures, auto-antibodies, and a pan-CT scan.
20:30That's a good idea.
20:31It was even better when Dr. Matra had it five minutes ago.
20:34Where were you?
20:37I was in TMS.
20:39I love your sense of timing.
20:41I remembered.
20:43You were diagnosed months ago,
20:44and the disease certainly wasn't indolent.
20:46So you're off chasing unreliable memories
20:48while our patient's life hangs in the balance?
20:50You're gonna look me in the eye
20:51and tell me that was a false memory?
20:54It was a bad day.
20:55I was emotional, and I'm fine now.
20:58You took this job knowing that you couldn't handle it.
21:01I am handling it.
21:03Really?
21:03Where did you get this bruise?
21:05And what about the edema in your wrist?
21:07How much prednisone does it take to get you through a shift?
21:10You know what?
21:10Dr. Matra and I will take it from here.
21:15I would never do anything to jeopardize a patient,
21:19and I don't need you to tell me that.
21:44Let me ask you something.
21:46You went up against Dr. Miller.
21:48Was that for my sake, or were you just...
21:50pandering to your CEO?
21:53Oh, come on.
21:54Don't pretend you don't have a lot riding on this, too.
21:56I don't do anything I don't believe in.
21:59Man of conviction.
22:00Guess I'm not surprised.
22:02Four years in Afghanistan.
22:03Took a bullet during that hostage crisis.
22:05Okay, you guys gotta ease up on the background checks.
22:08It's getting weird.
22:10Honest, too, huh?
22:12Look, this idea is out of the box.
22:14But you push boundaries for a living.
22:16Controversial, but necessary to a society.
22:21I've just...
22:24I've never been in the lab rat before.
22:44Dr. Ridley?
22:45He has tuberculosis.
22:48I saw some nonspecific areas lighting up on CT,
22:51figured they were artifact,
22:52but his sed rate was up,
22:54so I ordered an ultrasound with Doppler.
22:56And found a cavitus lesion in his hepatic artery.
23:00Add that to his chronic inflammation,
23:02milky drain fluid, travel exposure,
23:04extra pulmonary TB explains it all.
23:06Even the Addison's.
23:08He must have a lesion on his adrenal gland.
23:10And who knows where else?
23:11We need a full body MRI with contrast
23:13and surgery to remove infection.
23:16Good.
23:17I'll take him to radiology.
23:19You can grab a few protein bars, Dr. Nature.
23:20We're going back in.
23:26Feeling okay?
23:27I feel like crap.
23:29I guess that's what we want though, right?
23:33It means it's working.
23:34Yeah.
23:35Well, your BP's a little low.
23:36I'm going to start your oppressors.
23:39Mr. Voight?
23:40Mr. Voight?
23:43Two milligrams IV lorazepam stat.
23:45When did you inject the CAR T cells?
23:47An hour ago.
23:48It's a cytokine storm.
23:49When I premedicated with Benatril and menthol penicillin.
23:52Well, it wasn't enough.
23:58Prenez le medicament deux fois par jour.
24:01D'accord?
24:02Mais faites bien un beau diolo pour éviter réinfection.
24:04C'est très important.
24:07Oui?
24:08Oui, oui.
24:09Au revoir.
24:10What else we got?
24:12Dinner.
24:12Oh, no.
24:13I'm going to eat later.
24:14You can't help them if you can't stand.
24:17Ridley, eat.
24:23Can we talk about the real reason you won't slow down?
24:26Have you had Terry's moambe?
24:30Your grandson's going to be fine.
24:32From everything you said about Amy, he's in the best possible hands.
24:37Not mine, though.
24:38You can't be everywhere.
24:43When Harry and I were first married, I tried to stay put.
24:48Be the doting wife and mother and have a regular nine-to-five.
24:54The truth is, I just wasn't cut out for it.
25:00Maybe you were right to never settle down.
25:04Or maybe I just never found a man who could put up with me.
25:09Well, it makes two of us.
25:17Hello?
25:18It's me.
25:20Albuterol and high full oxygen are keeping his numbers in the 80s.
25:23So no need to intubate?
25:25No, he's stabilized.
25:27But they've got an intense recovery ahead of them.
25:30If you could come home, I would.
25:36I'm trying to do my job.
25:38At what cost?
25:39Joan, 60 milligrams.
25:41At that rate, you will flame out in weeks.
25:43That's my choice.
25:44Does Javi know what you're doing?
25:45I'm not killing myself, Amy.
25:47I am trying to make the most of the time I have left.
25:51And he would respect that.
25:53Well, what does Ethan think?
25:56I don't know.
25:57He doesn't know?
25:58He doesn't return my calls.
26:00What?
26:01What?
26:01How long have things been like that?
26:03You know what?
26:03I think you've dredged up enough bad memories for one day.
26:06And if you'll excuse me, I have a patient who needs me.
26:12What do we got?
26:14Granulomas in the liver, kidney, adrenals, bowel.
26:16They're everywhere.
26:24Tell the on-call surgeons to drop what they're doing and meet us in the OR.
26:27We're going to need all the hands we can get.
26:30I commend you, my dear brother, to almighty God, and entrust you to your creator.
26:36May you return to him who made you from the dust of the earth.
26:41May Holy Mary, the angels, and all the saints come to greet you.
26:44I am so sorry, Mrs. Voight.
26:50I never should have let him go through with this.
26:55Excuse me.
27:09Care to explain how this went so wrong?
27:13We tried CAR-T.
27:15No, I read the report.
27:16I know what was attempted.
27:17I'm wondering how that was allowed to happen.
27:18You'd have to ask the CEO about that.
27:21He was pushing medical decisions.
27:24We could have used you here.
27:27So what are you proposing now?
27:29I'm thinking IL-6 blockers.
27:32The COVID treatment?
27:33CAR-T triggers a similar inflammatory cascade.
27:37And I don't think that the standard protocol will get the inflammation under control.
27:41He's been right all along.
27:46We should follow his lead.
27:51Your patient, your call.
27:56Go ahead.
27:56Okay, okay, okay.
27:58Our Thailand trip.
27:59You got booted off the karaoke stage.
28:00Bohemian Rhapsody.
28:01Yes, it's a...
28:05And for the record, it wasn't my performance that people hated.
28:08It was just that that song is too long.
28:21Diane?
28:24I can't let you do it.
28:37It's negative.
28:39I don't have cancer.
28:40You don't have cancer?
28:56Saddle up, everyone.
28:58For the next 11 hours, we're doing an ex vivo.
29:02That's right.
29:03The thing you learned about in med school but never thought you'd actually do.
29:06We're removing every damaged organ, repairing it, and then putting it back where we found it.
29:12We'll run two full operating fields side by side.
29:15My team will be the one removing organs and keeping Javi alive.
29:19That means controlling bleeding, managing perfusion, oxygenating his heart and brain.
29:24Team two is on ex vivo work.
29:27When we pass off an organ, you strip the granulomas and adhesions, repair what you can, then it comes straight
29:35back to us in working order.
29:37Precision is everything.
29:39We lose focus.
29:40We lose an organ.
29:41We lose an organ.
29:42We lose an organ.
29:43We lose the man.
29:47No mistakes.
29:49Let's go.
29:51God, I cannot believe I'm seeing this.
29:53All right.
29:54I brought nourishments.
29:55Yeah, great.
29:57Thanks.
29:59Did she just do a rapid artery reconstruct on the fly?
30:02Yeah.
30:03It's unreal.
30:04She's a friggin' rock star.
30:06She's something, that's for sure.
30:08You wonder why I didn't want to tell you.
30:10Look, the way she's managing everyone, she's like a maestro.
30:15Okay, so what exactly is her endgame here?
30:17Is she just gonna keep operating until she drops?
30:19I can't believe what she's doing to herself.
30:21I know that you don't want to go behind her back, but I don't think she's really leaving as many
30:25options here.
30:27Just give me a couple hours.
30:29Till the end of the day.
30:39Ethan, it's Amy.
30:41Uh, give me a call back when you can.
30:44There's...
30:44There's something going on with your mom.
30:47Okay, liver's coming out.
30:50Subhepetic space is clear.
30:51Put a retractor in there, Carol.
30:53Sponge.
30:56Okay.
31:00That granuloma's wrapped around the inferior vena cava.
31:03We can clamp, take it out, then reconstruct with dacron graft?
31:06No, we've made enough compromises today.
31:08I'll dissect it off the wall, leave the vein intact scalpel.
31:11Uh, isn't it safer to do a graft?
31:14One slip and he could bleed out in seconds.
31:17I know.
31:17I wrote that chapter in your vascular surgery textbook.
31:21Suction Dr. Maitra.
31:24Clamp ready in case it goes south.
31:33My name is Captain Maitra.
31:39I'm securing the vena cava now.
31:43Dr. Maitra, get that lump out of my hair, please.
31:53I'm securing the vena cava now.
31:54Dr. Maitra, get that lump out of my hair, please.
31:58hi hi what are you doing here mom i wanted to check on robbie i came as soon as i
32:04could
32:05well we both know that's not true okay okay i came as soon as i could responsibly leave
32:10and why is it you feel a greater sense of responsibility to a group of strangers than
32:14your own family robbie was fine he didn't need no i needed you
32:22you know for once i actually let myself believe that you'd be here i was on my way and and
32:27then
32:28we got the call fighting broke out in sake we were inundated it's always something mom
32:37and what would you have me do let those people die so i can come and hold your hand no
32:42you're right no
32:42you had to do what you thought was right and now i have to do the same so you know
32:48what i'm i'm
32:48done what does that mean you're done that means i'm just i'm done you know at some point i only
32:53have myself to blame for letting you disappoint me
33:01if you can't see i made the only choice i could in that moment then i didn't raise the man
33:09i thought
33:12you barely raised me at all
33:29welcome back
33:33must have been a close one
33:35turns out your addisons was a symptom of indolent tb you had a lesion on your adrenal gland
33:43wrong with 14 others but we cleared the damage and you'll make a full recovery
33:49but so no more addisons
33:53no more addisons
34:00you saved my life
34:03i wish there were more i could do for you
34:05are you kidding
34:07that was a career making surgery you begged me i'm gonna live forever in these halls
34:13so um
34:17when can i get back out there
34:19well in the last 12 hours most of your organs have been outside your body so maybe you want
34:24to give it a few weeks
34:27hey we go where we're needed right
34:52hi stranger
34:54i've got nothing but love for you
34:56love for you
34:59love for you
35:01love for you
35:16unfortunately the car t hit you harder than your cancer
35:20We've retested your blood,
35:22and your small cell tumor markers only dropped 3%.
35:25Meaning it didn't make a dent.
35:27Right.
35:30Well, then, what's next?
35:33We're back where we started.
35:36Chemo and molecular therapy.
35:38So you're right.
35:39My yes-men almost killed me for nothing.
35:43I'm just glad you're still here.
35:44I'll be dead by the end of the year.
35:46I'm sorry.
35:48But there's plenty you can do with the time you have left.
35:50No, I won't slowly degenerate.
35:52If you can't cure me, I will wait.
35:56Xander, no.
35:57What better time to do it than now?
35:58I'm sorry, what are we talking about?
35:59There's a Swiss cryogenics company that will freeze me until further notice.
36:03When there's a cure for this in 10, 20, 30 years, I'll be first in line.
36:07If they find a way to reverse the freezing process.
36:11We can do it with embryos.
36:13It's only a matter of time, and I won't...
36:17...exactly be in a rush.
36:25She knew who she married, and I still have way too much to do in this world.
36:31The man needs a psych consult.
36:33We should put him on a 72-hour home.
36:34On what grounds?
36:36He's not depressed or pathological.
36:38He's got a God complex.
36:41And I flew too close to the sun.
36:44CEO's watching.
36:45You got a billionaire setting you up to be a hero.
36:48You got carried away.
36:49You're right.
36:51Sorry.
36:53I know you think I don't have a leg to stand on here.
36:56But what happened with Mr. Voight was unethical.
36:59And there isn't always going to be someone more senior around to push back.
37:03You're not a rookie anymore, TJ.
37:05Time to start acting like it.
37:15Hey.
37:16Oh.
37:17Hey.
37:19So...
37:21I need to tell you where it was yesterday.
37:25Okay.
37:27Rachel had a mammogram, and they found a mass.
37:30Oh, no.
37:31Is she okay?
37:32Yeah, yeah.
37:33She's fine now.
37:33The biopsy results finally came back negative.
37:35But the past week has been kind of tough.
37:38So I just...
37:39I wanted to be there for her.
37:41So that's why you left early?
37:43Yeah.
37:44Yeah.
37:44She was spiraling.
37:47And that patient you were with in radiology last week,
37:51when you didn't want to talk to her, that was her?
37:54She asked me not to tell anyone.
38:00Um...
38:00When I see the look on your face,
38:02clearly I went about this all wrong.
38:04No, you were in a tough spot.
38:06I'm just glad she's okay.
38:09Yeah?
38:09Yeah.
38:11Yeah.
38:18Okay.
38:21It was pretty sneaky, you calling Ethan.
38:26Dare I ask how it went?
38:29Well, uh, we have a lot to clean up.
38:33But...
38:35he's here.
38:37So thank you.
38:39There's one thing this year has taught me.
38:42It's that family finds a way to forgive.
38:46Let's hope.
38:49He certainly thinks I have a lot to answer for.
38:56We need to figure out what you're going to do, Joan.
39:00Oh, I know what I'm going to do.
39:04I didn't think it could get any worse than being schooled by Richard Miller and knowing he was right.
39:09Try this.
39:11Try this.
39:11I spent all of last week trying to sideline Dr. Ridley,
39:13and the second she asked me to scrub in for a big operation,
39:17I leap at the chance.
39:19So we're hypocrites?
39:21Or maybe we're just doing the best we can in a job that has a lot of gray areas.
39:27Maybe we are.
39:30So?
39:31Want to give our date another shot?
39:34Dinner?
39:36That.
39:37An Italian place on the corner?
39:39Or we could just go to mine.
39:41For dinner?
39:42That too.
39:57Dr. Ridley would like all of internal medicine to report to the office for an all-hands.
40:06Excuse me.
40:10Any idea what this is about?
40:12Uh, nope, no idea, but I guess we're about to find out.
40:26Wow.
40:27That was fast.
40:29Am I that scary?
40:30Yes!
40:34This is not a conversation I ever wanted to have,
40:40so forgive me if I'm not exactly sure where to start.
40:46I know there's been concern about my health,
40:50and I truly appreciate it.
40:53And it turns out it was warranted.
40:57I have MDS.
40:59It's advanced,
41:00and it's time for me to accept that
41:05it's not something I can outrun.
41:07So?
41:13Last night will be my final surgery,
41:19and next week will be my last as your chief.
41:27I've spoken to Dr. Hamda, and he has agreed to facilitate a smooth transition.
41:33And never fear, you will all receive your long-awaited evaluations before I go.
41:40I like to think, um, that I, I still have some wisdom
41:48to impart on the next generation.
41:52Even you, Peter.
41:55So, um, as my friend reminded me today,
42:00uh,
42:02we go where we're needed.
42:04And right now,
42:06there are more important places for me to be
42:08than inside an OR or behind a desk.
42:14Being a doctor
42:18has been the privilege of my life.
42:23Being your chief
42:26has meant more to me than I expected.
42:36All of you.
42:42And I'll see you tomorrow.
42:50Yeah.
43:18I'll see you tomorrow.
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