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00:00When my mother was diagnosed with Alzheimer's disease, her cousin said she must have gotten it because she didn't take
00:05fish oil.
00:06I picked up everything on the list, except they ran out of Dijon, so I got whole grain instead, which,
00:14yeah, I know is inferior, but who are you?
00:18Hey! Hey, you're back early.
00:22Yeah, I decided to do the groceries first and pick up your car after. Who's this?
00:25No, not that. Elroy, the contractor I hired to baby-proof for us.
00:30These stairs aren't safe. Naked sides. Don't worry. I can fix them.
00:36Okay.
00:37Told you I was gonna do that.
00:38Yeah, back when Scout and Luna were babies, and now we have two more babies.
00:45My patient with a Meyer electric prosthesis was just brought into the ER in a mountain bike accident. I should
00:51go.
00:52Wait, wait, wait. What about my car?
00:54Ask Elroy.
00:58Her neighbor thought it was because my mother, a world-renowned surgeon, didn't do enough crossword puzzles.
01:11Is this your way of thanking you for the coffee?
01:14I'm stressed about the M&M.
01:16Well, I am ready to help.
01:26Shepard, I'm on her service.
01:32You better go.
01:33I'll ask her if I can sneak away to come watch, but if not, good luck.
01:39I told them to shove it.
01:40They always want to cast blame.
01:42Something to fear and avoid.
01:45But the only thing to blame
01:48is everything.
01:52Bless you.
01:53You looked at the door so early, I figured you needed to pick me up.
01:55Well, I thought keeping busy would take my mind off things, but it just means I'm tired and hangry.
02:02How's Katie doing?
02:04I'm waiting for her labs, but I'm guessing she has carcinomatosis and a partial obstruction.
02:12Well, how often are they draining her?
02:13Twice a day.
02:15Okay, well, listen, if there's anything I can do, just, you know.
02:19You're with me.
02:21Okay, go.
02:22I'm okay.
02:24Dr. Bailey.
02:25Welcome back.
02:28First day back in the O.R.
02:29How's it feel?
02:31Well, I'm working with my chief resident.
02:33I have an M&M later today, and the cafeteria is serving shepherd's pie.
02:38Feels like Christmas.
02:40Well, wait till you see our first consult.
02:42Good morning.
02:42Good morning.
02:44Oh, Russell, this is Dr. Weber and Dr. Warren.
02:46These are the headliners.
02:48Russell's a community theater director.
02:50Right now he's putting up a production of Hamlet.
02:51When sorrows come, they come not single spies.
02:55But in battalions.
02:56Yes, okay.
02:59You would demote my Claudius to an understudy.
03:02Well, Hamlet's my favorite Shakespeare.
03:05Dr. Meade?
03:06Much ado about nothing.
03:07He wants you to present the case.
03:09Right.
03:11Russell West.
03:1234 with history of beta thalassemia with blood transfusions every three months for anemia.
03:17Admitted for splenic sequestration crisis two weeks ago.
03:21His abdomen has been getting increasingly distended.
03:24We're consulting today for a splenectomy.
03:26I thought I was just gaining a little weight, but then my stomach just kept getting bigger and bigger.
03:31Can I take a look?
03:33Yeah.
03:33I'll call for an ultrasound.
03:34Well, let's go old school while we wait.
03:37When's the last time you did percussion?
03:38Uh, you hear that?
03:43It's hollow.
03:44That's his lung.
03:45Here?
03:46No, that's dull.
03:47That's his spleen.
03:48From here...
03:52To here.
03:54Your spleen extends from the left upper quadrant all the way to the right lower quadrant.
03:59It's taking up your entire abdomen.
04:01This needs to come out immediately.
04:02I'm in the middle of tech week.
04:04I can't...
04:05Walter just shrank on its own.
04:07It's unlikely in a case this severe.
04:09Plus, you've run the risk of rupturing it.
04:11Okay, that sounds bad.
04:12Yeah, really bad.
04:13Instant death.
04:16You want to take care of this sooner rather than later?
04:19Dr. Meade can take you for a CT scan so we can plan a surgical approach.
04:23Yeah.
04:23Could he do it instead?
04:25Yeah, I'll go with you.
04:27Yeah.
04:30Well?
04:31It's better than Christmas.
04:33Well, I have been compromised within you.
04:36For a vehicle...
04:37For a vehicle to just do.
04:38Inside me...
04:39You reciting your presentation?
04:40You know how when you lie or your cheeks get flushed and your voice gets all high?
04:44You do both of those things.
04:46And so do I when I give presentations.
04:47And I also sweat and sometimes faint.
04:54Dr. Jennifer Ripley.
04:55I love you, Jane.
04:56Dr. Jennifer Ripley.
04:57I love you, Jane.
04:58I love you, Jane.
04:59I love you, Jane.
04:59I love you, Jane.
04:59I love you, Jane.
05:01I love you, Jane.
05:01I love you, Jane.
05:01I love you, Jane.
05:02I love you, Jane.
05:03Interesting case?
05:04Your sternal reconstruction patient.
05:06Scott Hill?
05:07Beckman's out.
05:08Someone has to check on him.
05:09Well, Dr. Wright is supposed to be attempting another flat tomorrow.
05:13Hope it takes.
05:16See you at the M&M.
05:21It'll be fine.
05:23Successfully avoided him after lying to help his patient.
05:26Oh, that was weeks ago.
05:28He's probably forgotten.
05:31You truly are a terrible liar.
05:36Sorry for interrupting your parental leave.
05:38Was Joe annoyed?
05:40Yeah, but not because of that.
05:42Oh, here they are.
05:45Okay, John Ellison.
05:46Forty, status post, mountain biking accident.
05:48No LOC or signs of head trauma.
05:50He has bruising on his chest, and x-rays show multiple rib fractures.
05:53He had targeted muscle re-innervation surgery a few months ago for an advanced arm prosthesis.
05:58I know.
05:58I did it.
05:59After I amputated his arm.
06:00John.
06:01Pauline?
06:03What happened?
06:04I was training at Tiger Mountain.
06:06The hand just let go.
06:07I lost my balance and fell.
06:09Well, he crashed straight into a boulder.
06:11Tell him about the last time.
06:12Yeah, it did the same thing last month.
06:15I sideswiped a tree and almost missed qualifying for the world championships.
06:19When's the competition?
06:20Three months.
06:21I can still compete, though, right?
06:22I'm up for sponsorships.
06:24Now, the nerve we rerouted to your upper arm should be sending precise signals to your hand.
06:28We'll get some scans.
06:29We'll check it out.
06:30Juan, call CT.
06:31Let them know we're coming.
06:36What are we playing?
06:38Five-card stud.
06:39You play?
06:40Uh, not anymore.
06:42But I ran a weekly poker night in med school.
06:45Were you any good?
06:46Graduated debt-free.
06:50How are you feeling today?
06:51They drained another liter this morning.
06:53She's still nauseous.
06:54We asked for ice chips 30 minutes ago.
06:56Oh, I must have gotten lost in the morning handoff.
06:59I'll get them myself.
07:00Can you grab some for my mom, too?
07:03She needs to chew.
07:04You see how she treats me?
07:11I'll get you those ice chips.
07:16How bad?
07:18Katie's creatinine's elevated, albumin low.
07:20Her AST, ALT, and INR are through the roof.
07:25She's a multiple organ failure.
07:28The TPN is too hard on her liver.
07:31What's the only thing giving her nutrition?
07:36Call palliative care.
07:39Call palliative care.
07:56I thought I was late.
07:58Bailey does not need another reason to yell at me.
08:00Hey, how's Katie?
08:01Yes.
08:03Her INR is getting worse.
08:05She needs two more units of FFP.
08:07Correct.
08:10Katie?
08:11Wait, is her liver failing?
08:13What did the repeat scan show?
08:19She doesn't know yet.
08:20We're going to tell her after the M&M.
08:22I want to be there.
08:23You are not part of her care team.
08:25Do I need to write you a reminder?
08:29Hi.
08:30Good morning, everyone.
08:32Are we ready to begin?
08:34Dr. Millen?
08:35Yes.
08:42Scott Hill, age 73.
08:44Presented four months ago with shortness of breath and chest pain.
08:49See what I told you?
08:50The spleen has taken over the entire abdomen.
08:53It has sequestered so much of its blood supply.
08:55I mean, how would you even mobilize that?
08:59You tell me.
09:01Uh, well, um...
09:03If it were a smaller spleen, I would enter the lesser sac,
09:06take down attachments, and immediately rotate it to access the pedicle.
09:10But this...
09:12Yeah, I have no clue.
09:14Plus, once we're in there, one nick to the organ and Russell could bleed out in seconds.
09:19When I was a resident, I scrubbed in on a liver teratoma I thought was impossible to resect.
09:25But I had an attending, Dr. Rathbone, who did a total vascular exclusion of the liver
09:30to create a bloodless field.
09:32It was brilliant.
09:33And it taught me to always keep an open mind.
09:37I saved a piece of that tumor in a jar for years after.
09:41Maybe after this, you can save a piece of Russell's spleen, huh?
09:44Oh.
09:46Do I have to?
09:48Okay, let's take a page from Rathbone's playbook.
09:50Let's call IR, have them embolize the splenic artery.
09:53Then we'll open them up and see what we got.
09:55Uh, what about the M&M?
09:57We're already late.
09:57No, M&Ms happen every week.
10:01But a spleen like this?
10:03It happens once in a lifetime.
10:06We then used interrupted 4-0 vicryl sutures to inset the mental flap.
10:11And you can see the healthy flap here.
10:13Did his pre-op scans show any sign for concern about pedicle tension?
10:18No, the team agreed that the distance between the epigastrum and the superior sternum was acceptable.
10:23And at this point, the team was?
10:26Uh, me and Dr. Mahanti.
10:27You had finished harvesting the omentum, and Dr. Wright and Dr. Warren were needed on another case.
10:33So the, uh, the changes in the flap's appearance progressed rapidly post-op.
10:37As you can see here, uh, it is dark and swollen.
10:41Did you check Doppler flow after inset?
10:43Yes, there was biphasic signal.
10:44And which one of you did that?
10:47Uh, well, we can both confirm that there was a signal.
10:51When we realized there was no blood flow to the flap, we...
10:53I'm sorry, so the two of you both heard the signal.
10:57Were roles clearly defined during the inset?
10:59I believe so.
11:00You believe so?
11:02Who placed the stitch causing tension around the pedicle?
11:07Look, this patient, my patient, hasn't left the hospital in weeks due to a gaping hole in his chest, which
11:14I believed we had fixed.
11:16He's still here because of someone's negligence, and it sure as hell isn't mine.
11:20So, who placed the stitch?
11:27That's on me.
11:29I should have watched my resident more carefully.
11:32I take full responsibility as her supervisor.
11:50He is all set.
11:53Would either of you mind if I catch the last part of the M&M?
11:56We do.
11:57Start the scan, Kwon.
12:02Everything okay?
12:02I'm a handy person.
12:04Did I miss the first part of this conversation?
12:07Joe's getting an estimate from a contractor to baby-proof our place, even though I told her I can do
12:12it.
12:12I want to do it.
12:14Are you sure you still need me here?
12:15The babies can't even go over on their own.
12:17They're nowhere close to crawling.
12:19We have a minute before the stairs are an actual risk.
12:21So you'll just wait till Scout Moon are teenagers?
12:25Go on.
12:26Yes.
12:27All right.
12:27Three right-sided rib fractures.
12:29He has a small pneumothorax.
12:30He probably doesn't need a chest tube.
12:32But the muscle in the TMR looks good.
12:34All right.
12:34Admit him for observation and then just do a follow-up x-ray with him later today.
12:39Well, sorry he had to come in for rib fractures, but maybe now you can go home and baby-proof.
12:43You should still check the signals to his bionic arm.
12:46I mean, there's no hematoma or bleeding around the nerves in the TMR.
12:49The signal should be fine.
12:50Yeah, but he's still falling off his bike.
12:52Kwon, get John back to his room and set up for EMG testing.
12:55Yeah.
12:59When a pedicle passes through narrow tunnels, we're essentially working blind.
13:03Dr. Mellon, when you placed the stitch, did you use a lot of tension?
13:07Excuse me?
13:08I asked if you used a lot of tension when you placed the stitch.
13:11I didn't place the stitch.
13:14Dr. Mahanti, did you or did you not allow Dr. Mellon to place the stitch?
13:18She specifically asked to do some of the suturing.
13:20And you said no.
13:21This is a huge miscommunication.
13:22Are you saying she's lying?
13:25I didn't say that.
13:27But you are denying that it was you.
13:29If you're both saying you didn't place the suture, one of you is not telling the truth.
13:34I only closed the abdomen.
13:35I wasn't anywhere near the pedicle.
13:37Dr. Mellon, admitting your mistakes is an important part to learning.
13:41If you can't own up to them, we've got a much more serious problem.
13:50What the hell was that?
13:52Dr. Mellon, you placed that stitch and you know it.
13:54Can we talk about this, please?
13:56Oh, I'm sorry.
13:56Do you not want to get dragged in public?
13:59Sometimes M&Ms go south.
14:01Everyone knows this.
14:02Is that supposed to be an apology?
14:04You're a resident.
14:05Residents are supposed to make mistakes.
14:07Why didn't screw up?
14:09You lied and I got scorched for it.
14:12I have patience to see.
14:18Okay, let me know if you feel any discomfort.
14:21I'm used to it.
14:22Okay, John, I want you to imagine your phantom limb and start opening and closing your hand.
14:27That's a good sign, right?
14:29Yeah.
14:29The muscles are receiving signal.
14:31It's a really good sign.
14:32How's the prosthesis treating you otherwise?
14:34If I was wearing it, I'd give you a thumbs up.
14:37Or the middle finger.
14:38Depends on the mood.
14:39Oh, he's painted the baby's room and started cooking again.
14:42It's changed his life at home.
14:44I just can't do the one thing I was really hoping for.
14:48Well, your signals are good.
14:49The TMR is not the problem.
14:52John, when you ride, do you experience a high level of stress?
14:56He's dodging trees and jumping rocks and trying not to fall off the trail.
15:00I actually find it relaxing.
15:02Right, but you're still encountering unexpected obstacles and changes in terrain that could
15:07cause a reflexive reaction in the muscles that send signal that could potentially make
15:11your hand do things you don't intend, like let go of the bike.
15:14Exactly.
15:16Mountain biking is all about dealing with the unexpected.
15:18If I can't do that, I can't ride.
15:21And that means no sponsorships, no prize money.
15:24John.
15:24Without that money, we can't afford repairs to my gear, my training time, part of our mortgage.
15:29I've been working for months to qualify for this race.
15:32Now you're telling me I could lose it all.
15:33If you're getting more exercise, your muscles are getting stronger, they might be sending
15:38a stronger signal than the prosthesis needs.
15:40Let's take a look at that and we'll go from there.
15:53Curtis?
15:54Up for a visit?
15:57From the chief?
15:59Anytime.
16:02How are you?
16:03I told the nurses I was cancer roommates with Richard Weber.
16:07Suddenly I got extra pillows and unlimited applesauce.
16:11What's a fancy title for?
16:14I just miss my wife and kids.
16:18I really wish you'd have met them.
16:20I would have loved that too.
16:21How old are your kids?
16:23Trevor is eight.
16:24It's my bookworm.
16:25And, uh, Mandy's five.
16:28She's already running around on her bike like a bat out of hell.
16:32And she'll be trouble.
16:36You know, that's the hardest part of all this.
16:39So, leaving them behind.
16:52Look, I'd, uh, I'd love this stay, Curtis, but, uh, we need it in surgery.
16:57Thank you for stopping by, Dr. Weber.
17:01Just Richard.
17:16How long does she have?
17:17If I give you an answer, it's just my best guess.
17:22But I have more energy today.
17:24We removed the NG tube.
17:26I ate a popsicle without throwing up.
17:28Yeah.
17:29It's common to have good days.
17:31Our focus now is on keeping you comfortable so you can have as many good days as possible.
17:38And if you do in-hospital hospice, we can manage your symptoms and pain here for as long as you
17:43need.
17:43No, I need to go home.
17:46I need to sleep in my own bed.
17:49I need to eat my own food.
17:50And maybe if we work with the PT, I'll improve.
17:55Then that's what we'll do.
17:59We, we could arrange home health and PT, but you'd only have someone a couple of hours a week, and
18:05you need more support.
18:07If you do in-home hospice care, well, they'll send you someone 24-7,
18:11but it could take a week to get started.
18:15I need to get out of here now.
18:17I need to get better.
18:19I'll take care of her until everything's arranged.
18:21If she needs a hospital bed, an oxygen concentrator, a Hoyer lift...
18:26I'll figure it out.
18:29I did it with my mom.
18:34If you do this, Katie will be leaving against medical advice.
18:40The insurance won't cover everything she needs at home if she does that.
18:44I've done everything you've asked.
18:50Every scan, every test, every infusion.
18:54And here I am.
18:58You don't know if I'm dying.
19:02You don't know anything.
19:03If I go home, I'll get better.
19:09You'll see.
19:17Then I will talk with social work, and we'll start the process.
19:28Bailey, are you sure AMA is the right move for Katie?
19:32I most certainly am not.
19:34I don't make any moves yet.
19:37I know someone she might listen to.
19:44Hey, I'm still here.
19:46Did you read the estimate?
19:47I've been with my patient.
19:48Well, in order to fully baby-proof the balcony, we have to put up a higher enclosure,
19:53which costs more than I can say without throwing up.
19:56I told you I could do it.
19:58You know, I'm not even sure the HOA will allow it.
20:00So what do you want to do?
20:01Now you want my opinion?
20:02You really want to get into it again?
20:05I'm sorry.
20:05I should go.
20:07Same.
20:11You gotta go?
20:12No, it's fine.
20:12Let's continue.
20:13Okay.
20:14Okay, this should test the grip.
20:17No.
20:19And now finger rolls?
20:23It's working well within normal EMG signals, and he says it works fine when he's not biking,
20:29so...
20:30It's the stress.
20:31Yeah.
20:32He's done with competitive racing.
20:38That was lunch.
20:40My life is over.
20:41Are your organs failing from stage four gastric cancer?
20:44That'll work out.
20:46I've been there.
20:47You got kicked out of your last program.
20:49Still worked out.
20:50I'm here.
20:53Hey, your girlfriend is not only a sloppy surgeon, she's a liar.
20:57The M&M did not go well.
20:58She blamed me for her crappy suture that killed our patients, flapping up.
21:02None of the attendings will even look at me.
21:04Kavita is not a liar.
21:05Both her parents are doctors.
21:06And that makes her immune to being a horrible person?
21:09Wait, wait.
21:09She's not a horrible person.
21:11You told me to be nice to her, and I was.
21:13And look where that got me.
21:15Thrown under the freaking bus.
21:17You love the bus.
21:19Kwan.
21:21This isn't a joke.
21:23This is my career.
21:25And you know what makes it worse?
21:26Is that you're automatically taking her side.
21:30Oh, Zomfren, you are.
21:32Where are you going?
21:34To...
21:34To fix this.
21:41Hey.
21:48Anna Karenina?
21:49This is what you want to read right now?
21:51It's pretty depressing.
21:53Oh, I'm making my way through a list.
21:55A hundred books you should read.
21:57Yeah, I've read these.
21:58You can skip them.
21:59You've read all the hundred books.
22:01Uh, Moby Dick.
22:02A bunch of men yelling on a boat.
22:04Oh, and there's a whale.
22:06Uh, War and Peace.
22:07A lot of war.
22:08Little peace.
22:10That's too off your list.
22:15Let's get out of here.
22:17Let's go look at the houseboat.
22:21We can't just leave.
22:23You're a patient.
22:24Didn't stop you before.
22:26You were my doctor then.
22:27Yeah, it's not that simple.
22:29You can't walk.
22:30We need portable oxygen.
22:32You can't walk.
22:33Just give me your hand.
22:34Look, Katie, we just...
22:36Can you give me my back?
22:38I can't even...
22:39I don't even know if I can get you in my car.
22:42I...
22:42Oh.
22:43Okay.
22:43It's okay.
22:44It's okay.
22:44It's okay.
22:45I got you.
22:47This is it for me, isn't it?
22:50I really wanted to go home.
22:52I'm so sorry.
23:01going through the fascia.
23:06Matt, your meat here has been doing some research.
23:09In fact, the largest spleen ever recorded.
23:1226 pounds and 17 inches.
23:14And based on our estimates, this one could beat it, sir.
23:16You ready to make history, Dr. Weber?
23:24Oh, my God.
23:25That is...
23:26Nothing but spleen.
23:28Look, I don't want to hear another word about records or history until Russell is on his
23:32later post-op.
23:33Okay, our focus should be on this patient, on this surgery.
23:36You understood?
23:36Loud and clear, boss.
23:37We've got a lot of work ahead of us, and I need full visualization.
23:41Tighten.
23:42Okay.
23:43All right.
23:44Here we go.
23:47All right.
23:49She'll stay here until her at-home hospice is set up.
23:54The social worker's on her way to get the process started.
23:56Did you mention we're hoping they can rush this?
23:59Yeah, and I might have dropped her name.
24:02All right.
24:03We'll see if it helps.
24:05Oh.
24:08So what?
24:09Now you bring in the doctors with the sad smiles and quiet voices pretending to know what
24:15it's like to die before it's supposed to?
24:18Our team will do everything to make her more comfortable.
24:23They'll also move her into a room with more natural light.
24:26Fewer machines.
24:28And the chaplain will come too, right?
24:31You had this same conversation 15 years ago about my mother.
24:37And now you have the gall to have it again about my daughter?
24:41She was doing better.
24:43I know.
24:45I am so sorry.
24:46Stop saying you're sorry.
24:49If this was one of your babies, and their life-saving medication was discontinued, and you
24:55had to watch the life drain from their bodies, what would you do?
24:58I would fight.
25:02But you didn't, did you?
25:05Not for my baby.
25:22Dr. Bailey?
25:26Dr. Bailey?
25:40Whoa.
25:41Come in.
25:42Make yourself at home.
25:43What is this?
25:44I borrowed a few things from Dr. Sally.
25:46I wanted to see if adjusting the grip on a body-powered prosthesis helps.
25:50Don't talk to you into finding another solution?
25:52I couldn't tell him that he can't use the robotic one.
25:55Link.
25:55After his car accident, he went really dark when he couldn't ride.
25:58I don't want him or Pauline to have to repeat that.
26:03No.
26:07Damn it.
26:07Why can't I do this?
26:09Last time I checked, you're not a prosthetist.
26:11I have reconstructed fingers.
26:13I've replanted amputated hands.
26:15I've replaced every joint you can name.
26:17I fix things.
26:18It's what I do.
26:21Sounds like you're trying to fix things at home in my lab.
26:25My shoulder's still bugging me.
26:29You had a major injury.
26:31I mean, that's going to take time.
26:32I know.
26:32I just...
26:35I felt pain the last time I was in the OR.
26:37It's also why I'm behind on baby-proofing.
26:40What does Joe think?
26:42You haven't told her.
26:43She's got her own stuff.
26:44I thought I was going to be back to normal by the time the twins came.
26:49Instead, I'm just icing my shoulder and hoping nobody face plants off the stairs.
26:59You are very handy.
27:00And you can fix a lot of things.
27:02But sometimes when you let go of expectations, you open yourself up to other possibilities.
27:10Yeah, you're right.
27:11Does that mean I get my lab back?
27:13Soon.
27:15You just gave me an idea.
27:19Hey, I got your text.
27:21I'm sorry I missed the M&M.
27:23That's old news.
27:25Wright said that Jackson Avery called to check my references.
27:28That's huge.
27:30Boston's in the bag.
27:31It gets even better.
27:33Apparently, she told them that Gray Sloan wouldn't give me up without a fight.
27:36So you could stay here?
27:37I don't have any formal offers yet.
27:39But as long as I don't majorly screw anything up, I'm going to have options.
27:47Wow.
27:48Um, can I ask you something?
27:52Would stitching over the pedicle in a momentum be a major screw-up?
27:56Why do you ask?
27:59Did you blame Jules for your suture in the M&M?
28:04I've been in school or residency or fellowship my entire life.
28:08I'm so close to it finally paying off.
28:11So you did lie?
28:13Surgery's cutthroat.
28:15Especially plastics.
28:16Don't tell me you've never told a small mistruth to get what you needed.
28:18Yeah, but it's more than just a little white lie.
28:20Every M&M feels like the end of the world when you're a resident.
28:23But you get past them, no one will even remember this case tomorrow.
28:27And I'll figure something out to help Millen.
28:30If I take an attending job here, I can help her even more.
28:34Yeah, I guess that makes sense.
28:37So you're actually considering Gray Sloan over Boston?
28:41Maybe.
28:43As much as I love Boston, Seattle's also...
28:48growing on me.
28:5416 inches.
28:55So close.
28:56Well, it's still pretty damn big.
28:58Stay next, super scale.
29:01Well, shouldn't it be Dr. Weber?
29:03Yeah.
29:03Hey, what about it, Chief?
29:04You want a picture with the mega spleen?
29:06Yeah, no pictures for me.
29:08We should weigh it.
29:09I mean, it's not the biggest ever, but it might be the heaviest.
29:11Come on.
29:12Here we go.
29:13Got it?
29:14Got it.
29:15Hold on.
29:15Let me help you.
29:17You can just put it...
29:19Oh, that's a damn shame.
29:23It looks even bigger on the floor.
29:27Hey, you know what?
29:28Get down.
29:29Get down.
29:29All right.
29:31Yeah, yeah.
29:32Hey, no, no, no.
29:33Look, that's enough.
29:34No more pictures or jokes or talking about bragging rights.
29:39Today was not a success of medicine.
29:40It was a failure.
29:42You think Russell wanted it to get that bad?
29:44It's a miracle it didn't kill him.
29:47You should be ashamed.
29:49I know I am.
29:52Clean this mess up.
29:56Yeah.
30:10I replayed the steps in my head every night.
30:14Could I have operated earlier?
30:17Could I have pushed oncology harder?
30:19Could I have filed more appeals with the drug manufacturer?
30:25No, you did everything you could.
30:27I did everything I could 15 years ago for Katie's grandmother.
30:31But immunotherapies didn't exist then.
30:34She died from actual cancer.
30:37But Katie?
30:39No, Katie's dying from bureaucratic stupidity.
30:45Just years of hard work finally developed a medicine that was working.
30:51And instead of helping people access it, our government is dismantling science.
30:57Just like that clinical trial guard.
31:00Not just Katie.
31:01Cancer.
31:02Maternal health.
31:04Diabetes prevention.
31:06Substance abuse programs.
31:09Space exploration is even on the damn chopping block.
31:13Just decades of groundbreaking work.
31:18Without even a single thought to its cost in human lives.
31:26I can't even give Katie a chance to spend her last moment outside of these hospital walls.
31:34Uh, well, we're setting her up with in-home hospice care and she'll...
31:39It'll be a miracle if she makes it that long.
31:52Hey, I spoke to Katie there.
31:54Now's not a good time.
31:56Uh, Dr. Wright?
31:59How is Scott doing?
32:00Well, his heart's had minimal tissue coverage for two weeks.
32:03He's not great.
32:06Can I help you?
32:08I have worked really hard to build a good reputation for myself here and I can't stand by and watch
32:15it all go down the drain.
32:18Dr. Mahanti lied in the M&M.
32:20I didn't stitch over the pedicle.
32:22I wanted to sew around the pedicle, but she wouldn't let me.
32:24And I don't know why she lied, but I promise you, it wasn't me.
32:30That's quite the slap story you've got there.
32:32I'm setting the record straight.
32:34Look, hospitals are high school.
32:35Emotions are high.
32:36Status matters.
32:37People are competitive and desperate and insecure.
32:41I need my surgeons to be mature, to rise above, to not get sucked into the drama and the politics.
32:47Did you have a good outcome or a bad one?
32:48That's all I care about.
32:50Understood.
32:51I will make sure that Scott has his labs in the morning.
32:54You're not on his surgery anymore.
32:56Hey, Kwan, have you ever done a sternal reconstruction?
32:59No.
33:01You will tomorrow.
33:03Come with me and I'll give you my notes on the case.
33:17Did you figure it out?
33:18Making the bionic hand work for competitive mountain biking?
33:22No.
33:24So that's it.
33:25I'm done.
33:27Not necessarily.
33:29I've come up with another option.
33:31Now, this is just a prototype.
33:32But the idea is that instead of your bionic hand gripping the handlebar, we built an attachment to the bike
33:38and a terminal device that you'd wear only while biking.
33:43Keep talking.
33:44Keep talking.
33:44We'd make a custom, activity-specific prosthetic that would snap into the bike attachment.
33:52It'd be built so you could snap quickly out of the receiver for safety.
33:56If you like it, we could find a prosthetist to collaborate with and maybe even a sponsor will help cover
34:01the costs.
34:04This is, uh, this is amazing.
34:09You made this, Hano.
34:11No, no.
34:12This is all Dr. Lincoln.
34:13I know nothing about bikes.
34:15Man.
34:19I don't know what I would have done if...
34:21You're welcome.
34:24I want to know what happens underneath.
34:29Should I not ask?
34:31Dr. Wright said that I was being dramatic and she doesn't want to work with me anymore.
34:36I'm sorry.
34:37I know the truth.
34:38I don't think you're being dramatic.
34:40Everyone who knows and loves you feels the same.
34:42I'm not so sure.
34:45Hey, I need a favor.
34:47It's about Katie.
34:47You know, I can't disclose her medical information, but nice job getting her to stick around.
34:52What if we took her to your place?
34:54To what?
34:54Die at my house?
34:56You want her to die at my house?
34:58Well, okay, technically it's my Aunt Meredith's house.
35:01She's gonna go to her own home next week.
35:02She doesn't have that long.
35:06You sure this is a good idea?
35:08She's dying.
35:10I'll ask for time off so I can take care of her myself.
35:13No.
35:14We'll take shifts.
35:19Count Kwan in, too.
35:21He owes me for putting up with Lohan, too.
35:30Hey, uh, Chief, um, I just wanted to apologize.
35:35I got excited about a flashy case and I let things get out of hand.
35:41A few weeks ago, a case like that would have made my year.
35:44A spleen the size of a sandbag.
35:47I had taken photos, too.
35:48But I'm feeling different now.
35:51That different?
35:52No, I tried to push it down and return to work like nothing happened these days.
35:59The patients that I can't stop thinking about are the ones we couldn't get to in time.
36:04And instead of addressing the problem, we're patting ourselves on the back for removing a massive spleen.
36:13Look, having a perspective shift after cancer, it's natural.
36:19I've been there.
36:20Well, what if I can't unsee this?
36:22That'd be so bad.
36:24Maybe it's time to start a new chapter.
36:26Spoken like a younger man.
36:27You know, I, uh, just a guy who has a lot of experience starting over.
36:34Look, I'm gonna go check on our patient.
36:39It really was quite a spleen, though, wasn't it?
36:41More than a mercy.
36:48We monitor her pain and oxygen requirements.
36:51And page me if we need to take more fluid off of her abdomen.
36:53Hey, Dr. Bailey, can we run something by you?
36:57Why do I feel like I'm not gonna like this?
37:00Well, uh, Griffith offered to take Katie to her home.
37:03We all know there's a good chance she won't make it to her own home if she waits for hospice
37:07to be set up.
37:08All she wants is to not die in a hospital.
37:11Yeah, yeah, what do you think?
37:13I think you two have lost your ever-loving minds.
37:18Katie is not a stray cat to take in.
37:20She needs 24-7 care.
37:22Adam's, Quan, and I would take shifts.
37:24Yeah, and her mom can stay in their spare bedroom.
37:27Sorry.
37:28What about pain management?
37:29We can get her scripts filled and administer them at the house.
37:32Yeah, and I can drain her abdomen when needed.
37:34Look, it's literally her dying wish.
37:36I hear you.
37:38But as her surgeon and a leader in this hospital, I cannot advise it.
37:43Okay, she would need a hospital bed, an oxygen concentrator.
37:47Are you writing this down?
37:49Oh.
37:50Yeah.
38:00Finally, I was about to go to Saigon Palace by myself.
38:04Yeah, I was looking over Dr. Wright's notice for the Cyrano reconstruction.
38:08I heard you were joining the case.
38:10I'll fill you in over.
38:12I can't do it.
38:13On me?
38:14Whatever, I'm starving.
38:15Let's go.
38:16I told Wright to find another resident for the procedure tomorrow.
38:21Why?
38:22Jules is my friend.
38:24It turns out you and I aren't as alike as we thought.
38:28I already told Wright that I was committed to assist Altman tomorrow.
38:33You didn't tell her about me.
38:36I was going to give you a chance to do it yourself.
38:43I hope you get the job in Boston.
38:48We often place blame because it's easier than taking responsibility.
38:52If you always look outward, you never have to turn inward.
38:56Seriously?
38:58I get to leave.
38:59Yeah.
39:00We arranged medical transport and Dr. Griffith is working to get you discharged right now.
39:06I'll stock the fridge, cook meals, whatever I need to do.
39:09That's not necessary.
39:11We, uh, we want to help.
39:18None of this would have happened without you.
39:23But progress only comes when you shine the light on yourself.
39:31Didn't I fold all this laundry earlier?
39:34Patty spit up everywhere, sort of patent.
39:36Luna got the ketchup bottle.
39:38And you know what?
39:39I don't want to talk about it.
39:41Thanks.
39:43My shoulder still hurts.
39:47I was hoping it'd get better and I'd go back to work and build the safest staircase ever to exist.
39:55But obviously, that hasn't happened.
39:58Well, you don't have to fix everything yourself.
40:02Yeah, I've realized that.
40:04But you might have to go back to work eventually so you can afford to pay Elroy to do it.
40:13I was wondering, what if Elroy didn't actually fix this place?
40:20We've really pushed our luck already with these stairs.
40:24The fireplace, the balcony, the glass doors.
40:28What if he fixed my rental instead?
40:30You want us to move into the man cave?
40:33It's in a great neighborhood, and it would be way easier to baby-proof.
40:39This place just has so many memories.
40:42You know, movie nights on its couch, the Nicoletti's takeout dinners on that table.
40:48You proposed to me right there.
40:53I guess we'll have to make new memories.
41:00We will.
41:12What do you think?
41:14How do you feel?
41:16Mellon, what are you doing here?
41:19Your front driver's side tire's looking a little low.
41:22Checking my tires?
41:24Today sucked in a lot of ways, but the worst part is that it confirmed what you think about me.
41:31Mellon.
41:31And I know that I've disappointed you, and you're not wrong.
41:34I haven't always been honest with you.
41:36Like, sometimes when I'm too tired, I don't dictate your up notes.
41:38I make my interns do it.
41:40And I know where you keep your secret stash of protein bars at the nurse's station,
41:43and I'll sneak one if I don't have time to get to the cafeteria.
41:50And I coached your patient behind your back to get around his insurance so you would have to operate on
41:57him that day.
42:00He was in pain.
42:02I didn't know what else to do, so I lied, but I didn't lie today.
42:07I didn't sew over Scott's pedicle, and I wasn't trying to frame Mohanty or not take responsibility.
42:14I just didn't do it.
42:16And I need you to know that.
42:18It's not my department.
42:19I'm not the one you need to convince.
42:20I don't care what anyone else thinks.
42:30I believe you.
42:36I'll, uh, I'll see you tomorrow.
42:40Ask the questions, and the answers might surprise you.
43:13Ask for questions.
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