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00:02Until the 17th century, scientists thought blood was a one-way street.
00:07Corbin's labs are in. His white count's 22 and his acidosis is getting worse.
00:12He's septic. All he wanted was to meet his nephew.
00:17Should we consider comfort care measures?
00:20No.
00:21Paige and Dugu and tell the OR desk that I want the same team from Nora Young's ventral aorta surgery.
00:27You're doing the ventral aortic reconstruction?
00:28Between his sepsis and the bleeding, it's our only option.
00:32Assuming that I can get the consent from his sister.
00:36You want me to talk to her?
00:37I was the one who convinced him to do the T-bar. It should be me.
00:40They believe blood was produced by the liver and consumed like food by the body's tissues.
00:46Until British physician William Harvey published a treatise so explosive it was banned in England.
00:52I spent a lot of time imagining this in med school instead of studying microbiology.
00:58Is the real thing measure up?
01:00I wouldn't want to inflate your ego.
01:04Well, I'm a neurosurgeon so...
01:07That should pass soon.
01:11Hey.
01:13This is going to sound crazy, but, um...
01:18Do you want to, like, go on a proper date?
01:22Get dinner tomorrow night?
01:23Yeah, I'd love to.
01:25But I have my sun...
01:27Um...
01:28My sunrise hiking club.
01:31Uh, in the morning, you hike.
01:33Yeah, I just started.
01:34You know, there's nothing like fresh air in the morning.
01:37Right.
01:39Um...
01:41I should go.
01:42I should probably change before else.
01:44He posited that blood was part of a circulatory system.
01:48Continuously pumped through the body and recycled by the heart.
01:55In other words, when it comes to blood, what goes around, comes around.
01:59Oh, no.
01:59Okay.
02:00What?
02:00Why do you have to leave so early?
02:02I have to prep for a sternal reconstruction.
02:04Dr. Wright wants to work with me more before she'll write me a letter of recommendation for that attending position
02:09in Boston.
02:10You're still on this Boston thing?
02:11What do they have that we don't?
02:12My parents.
02:13Nieces and nephews.
02:15Cream pie.
02:16Oh, I forgot about the pie.
02:22Uh, did you forget how to knock?
02:25The door was open.
02:26Millen, you're on my service today.
02:28Thought you'd be at work by now.
02:29I'll be in time for rounds.
02:30I expect you to bring your A-game.
02:31It's an important case.
02:33I always do.
02:35I'll see you both later.
02:37Yeah.
02:39Simone!
02:40Would it kill you to be nice?
02:41She is trying to tell me what to do before I've had coffee.
02:43Where is Simone?
02:44We're supposed to be going over fertility stuff on the way in.
02:46Fertility stuff?
02:47Yeah, we're freezing her eggs.
02:49I mean, I am.
02:50I can't speak for her.
02:52Pretty sure you just did.
02:53Simone never made it back last night.
02:55Critical patient.
02:56Oh, then can I get a ride?
02:57Oh, me too?
02:58Please?
02:59Do I look like a soccer mom to you?
03:11She's texting me.
03:13I didn't say anything.
03:14Look.
03:15I muted her.
03:17Focusing on my other patients like you told me to.
03:20You must have really handed it to him.
03:22I gave him constructive feedback.
03:24At least he knows where he stands.
03:25It's the same with me and Dr. Wright.
03:26I know what I need to improve on.
03:28See, he thinks that I don't care, but I've been searching high and low for more infusion
03:33treatments for Katie.
03:35Any luck?
03:35Just a bunch of unentered emails and dead ends.
03:40Sugihara wants to put her on her prior immunotherapy regimen.
03:44Oh, I'm sorry.
03:46Hey, what's on your schedule today?
03:49Um, consults, meetings, residency, admin.
03:53Push him.
03:54Dr. Goldberg is out sick today and needs somebody to take his procedures.
03:59Oh, come on.
04:02Save some lives with me.
04:05Save some lives.
04:07Luna and Hattie are still napping.
04:10Uh, the baby monitors on the coffee table.
04:13You already mentioned that.
04:14Um, extra diapers are upstairs in the linen closet and the, the, the pediatrician's number
04:21is on the fridge.
04:22We're not going to Siberia.
04:23I know that.
04:24And we need to find a dresser big enough for the twins today.
04:27I've been fasting in anticipation for the Swedish meatballs.
04:29So I would love to get there before I go into a hypoglycemia coma.
04:33If you have any issues at all, please don't hesitate to call.
04:37We'll do.
04:38Okay.
04:43I think you're supposed to hand over the baby now.
04:45Oh, yeah.
04:45Okay.
04:48Okay.
04:48Okay.
04:49Don't wake your sister then.
04:53Is it weird that we're handing our babies over to someone else for the first time?
04:58And all I feel is.
05:00Unbridled joy.
05:05No, there might be a leak at my rental property.
05:09Where I lived before I moved in here with you.
05:11Oh, wow.
05:12I always forget that you own that dump.
05:14I installed a water sensor when the last tenants moved out.
05:17And I should probably check on this.
05:19Well, just call a plumber.
05:21Oh, no.
05:22They'll charge an arm and a leg just for showing up.
05:23It won't take long to fix.
05:24Okay.
05:24I'll come.
05:27Ugh.
05:27Are you sure you really want to hang out at that dump?
05:29Yeah.
05:30I'll just sit in the car.
05:31First day of freedom.
05:35Hey, so I haven't gotten to officially welcome you back yet.
05:38You go somewhere tropical?
05:39Do Chicago or Boston count?
05:41Well, sabbatical looks good on you.
05:44What do we got?
05:4542-year-old male.
05:47Head trauma after colliding with a glass door.
05:49GCS 15.
05:50No LOC.
05:51Presented with epistaxis and a small forehead lack.
05:53VPs 130 over 80.
05:55Nasal bandage was applied at the scene.
05:57Okay, sir.
05:57Welcome to Grace Sloan.
05:58I am Dr. Hunt.
05:59This is Dr. Shepard.
06:00Yeah, yeah.
06:00Do you have a safe?
06:01What are you doing?
06:01I'm sorry.
06:02My little brother could get hospitalized running into a door.
06:06That happens more than you think.
06:07We were brunching with my work buds.
06:09Finally got this VP promotion.
06:11Hey, I don't know what happened.
06:12I must have blacked out when I won the...
06:14Won what?
06:15Won Biggest Loser?
06:17We've got a possible head trauma here?
06:20What's that?
06:22It's a lottery ticket.
06:24It says you won $2 million.
06:26What?
06:27You won $2 million?
06:30Uh-uh.
06:32He's out.
06:32Trauma 3's free.
06:33Let's move.
06:34Hey, hey, hands off.
06:36Okay.
06:38Hey, Griffith said you're doing the ventral aorta.
06:41I said she must have misheard.
06:43Yeah, first I need to come up with a plan to present to Leticia,
06:46who is understandably skeptical.
06:48Wait, you said the T-bar went well?
06:49Well, it did.
06:50And then he coded.
06:52His pseudo-aneurysm degenerated.
06:55How badly?
06:56Ugh.
06:57The aorta is unsalvageable.
07:04Great glass in case of emergency.
07:06The T-bar could have worked.
07:07I had to try.
07:08But we should have done this yesterday when he was more stable.
07:11We don't have time for hindsight.
07:13That's on you.
07:14You were so afraid to try this surgery again that you wasted his best shot.
07:17Nor was just as bad, if not worse.
07:19That was a miracle.
07:20You said it yourself.
07:21If this doesn't work on Corbin, that's it.
07:23We'll never try this surgery again.
07:24Now you've made that almost certain here.
07:26What do you want me to apologize and say that I was wrong?
07:29I made the right call with the information that I had at the time,
07:32and it was a bad outcome.
07:33And now Corbin is dying.
07:35So either you can help me come up with a plan to save him,
07:38or stop wasting my time.
07:59Dr. Millen.
08:00Mr. Hill didn't want to start without you.
08:03I'm starting to think you abandoned me.
08:05No, I was just finishing a chest tube.
08:07I would never abandon my favorite patient or his better half.
08:09Oh, I bet you say that to all the old folks.
08:13I didn't realize you all knew each other.
08:15I scrubbed in on Scott's cabbage with Dr. Beckman a couple months ago.
08:18Then by all means, take it away.
08:20Scott Hill, 73.
08:22Status post cabbage complicated by osteomyelitis.
08:25Now status post multiple debridements to the sternum and costal cartilage,
08:28resulting in a 12 by 10 centimeter wound.
08:30Today we are starting his reconstruction.
08:32Yeah, I thought the cabbage would help me be more active in retirement.
08:36We're in our world traveler era, as the kids say.
08:39Love that for you guys.
08:41We did have to cancel our safari in Tanzania.
08:44Fortunately, the tour company let us reschedule.
08:48She did what you told her to do, Dr. Millen.
08:50What, you sweet-talked them and then cried?
08:52Mm-hmm.
08:52The tears did them in.
08:54Or that, or describing this gaping hole in my chest.
08:58Okay, we're gonna try and close that up today, okay?
09:01Millen, Mohanty, taking for a repeat CT to confirm her surgical plan.
09:05You got the full refund, right?
09:07Yes.
09:07The full refund.
09:08Every time.
09:09Every time.
09:10I was crying and crying.
09:12I can't believe he won two mil.
09:15It's almost as much as I've loaned the poor bastard.
09:17You should wait outside.
09:18Okay, let's get ready for rapid sequence intubation.
09:20I love his broke ass, but he's a sad, bottomless money pick.
09:23You know what I'm saying?
09:24Whoa, whoa, hold the paralytic. He's waking up, Shepard.
09:27Hey, look right here.
09:30Okay, do you know your name and where you are?
09:33Jeremy, I'm in the hospital.
09:35Hey, I'm right here with you, bro.
09:37Anything of note happen today, Jeremy?
09:40Yeah, my boy got paid, y'all.
09:42Okay, let's do a fast exam and get that bleeding under control.
09:44I want to get a head CT right away.
09:47You know, I could hold on to that.
09:48No, I think he's got it.
09:49His sweat might melt off the numbers, bro.
09:51Okay, I'm not seeing any free fluid.
09:53We need to get him upstairs.
09:54We will update you when we can.
09:55Can you please leave the room, sir?
09:57Please.
09:57Thank you so much.
09:58Goodbye.
10:00Thank you, Brian.
10:01Let's get off the CT.
10:04I gave your sex friend a ride to work this morning.
10:07You're welcome.
10:08I hope you were normal.
10:10Griffith, you had that?
10:10I was.
10:11Yeah, we got him.
10:13Wish I could say the same from Millen.
10:15Oh, crap.
10:16I was supposed to meet her.
10:17But you didn't.
10:18And now, Brian may or may not think that you're trying to have a baby.
10:21What?
10:22I'm just a messenger.
10:24We will dissect away the part of Corbin's reconstructed esophagus
10:28that's behind the sternum.
10:30And that should give us the access that we need.
10:32It should?
10:32It's hard for us to know, given Corbin's scar tissue.
10:37He wanted the surgery yesterday.
10:39You talked him out of it.
10:40It was an unnecessary risk then.
10:43And now?
10:44His aorta is too damaged.
10:47It has to come out.
10:54What do you think?
10:59I know it's scary.
11:02But this surgery is Corbin's only chance of survival.
11:06And Dr. Altman and Dr. Ndugo are the only surgeons who can and have done it.
11:12Yeah, after they drew it on a napkin.
11:14If it helps, I assisted on the first one.
11:17I've seen it save someone's life.
11:22If I say yes, and he dies...
11:25He will die for sure if you say no.
11:36Do it.
11:42Please don't make me regret it.
11:47Did you check Scott for scars at possible donor sites?
11:50Lots of moles, but no sign of scarring on the arms, back, abdomen, or legs.
11:55Did you measure the depth of his wound?
11:58Same as when I staffed it with you.
12:00Four centimeters.
12:01How's it looking, team?
12:04The internal mammary arteries must have been sacrificed in the debridements.
12:08There's no local blood supply to plug a flap into,
12:11but we could connect it with the axilla or lateral chest.
12:14What about tunneling omentum from the abdomen?
12:18It's interesting.
12:19Mahanti, thoughts?
12:22It's a nice idea in theory,
12:23but a free flap offers thicker, soft tissue coverage over the heart,
12:27and it looks so much better.
12:29Oh, Scott doesn't care how it looks.
12:30He just wants to go on safari.
12:32He'll care when he sees it. Trust me.
12:34Maybe, but that's if he survives a 10-hour surgery.
12:37I mean, omentum must be less.
12:40And it comes with a built-in blood supply.
12:42This is lifelong coverage.
12:44It's what I would want on my chest.
12:46Sometimes the correct approach just takes longer.
12:48Yeah.
12:50Okay.
12:50If Scott were a 20-year-old bodybuilder, we'd do the free flap,
12:53but omentum is the right call.
12:55Way to jump in, Ellen.
12:56I'll page general surgery.
12:58That's the spirit.
13:02What's your problem?
13:03I don't have one now that we're doing omentum.
13:05You're a second year.
13:06I'm a fellow.
13:06We're not even running the same race.
13:11Hey.
13:12Nardi just fed Hattie, and now Peyton's down.
13:15I gotta pee.
13:16Ooh.
13:17How's it going?
13:18The pipe is completely corroded.
13:20Why don't you take the car, and you go without me?
13:21God, the place is an explosion of linoleum and wood paneling.
13:26Yeah, well, you've been here before.
13:27Who thought popcorn stealings were a good idea?
13:29Hmm.
13:29I wonder your tenants fled.
13:32Wow.
13:33Isn't it crazy they left this?
13:34Hmm.
13:36What's with all the packages?
13:37Oh, I ordered a few things that got delivered here by mistake.
13:40Uh-huh.
13:46Oh.
13:47Um, have you been spending time here?
13:52Only when I have to check on something.
13:56Okay.
13:57When was the last time?
14:01Uh, Tuesday?
14:02When you went to get diapers, and you left me with screaming twins for two hours.
14:08I did stop here briefly.
14:10I had to check on the mailbox, and then I just needed a little time to decompress.
14:16Oh, yeah.
14:18You really need to stop talking right now.
14:21Joe.
14:22You know what?
14:23You want to decompress?
14:24You want a little space?
14:26Be my guest.
14:27Ah!
14:27Joe!
14:34You made that Coley look easy.
14:36Can't believe how quickly you got the critical views.
14:39Yeah.
14:42You still thinking about Katie?
14:45I just feel like I failed her.
14:47Mm-mm.
14:48Mm-mm.
14:48The federal government failed her.
14:50Saving her life doesn't align with their priorities.
14:53I am her doctor.
14:55I'm supposed to figure it out.
14:57Consult requests for external reconstruction for Dr. Wright.
15:03Right?
15:05Uh...
15:06You know, if you're not feeling up to it, I'm sure they can find somebody else.
15:11You know, I can't help Katie, but I can help you get in with Wright.
15:15Let's show plastics what you're made of.
15:21Put your hands out for me.
15:23Would you go out with someone who has kids?
15:26Are you trying to set me up?
15:27Just answer the question.
15:29No, thanks.
15:30Hey.
15:30You have kids.
15:32When do you tell people that you're saying about them?
15:35Only person of data so far.
15:37I already knew about them.
15:38You two are useless.
15:38Told him security could hold on to his ticket, but he won't let go of it.
15:41Would you?
15:43All right, Jeremy. Hold still.
15:45Okay.
15:45Hey, while it's just us...
15:48I'm sorry about my brother.
15:51Uh, no need.
15:52He's fine.
15:52He's a jerk.
15:53I'd tell him off for you, but he's been keeping me afloat since I lost my job,
15:56and I don't want him to cut me off.
15:58Didn't you just win the lottery?
16:00Yeah.
16:01I guess I did.
16:02He has a small contusion on the left temporal lobe, Brian.
16:06Monitor him for any change in clinical status and give prophylactic Keppra.
16:10I'll let you take it from here.
16:11Okay.
16:15It's time.
16:17You can go to the waiting room.
16:21Can he hear me?
16:22He's heavily sedated.
16:24But it can't hurt to try.
16:40I hope my son is just like you.
16:45We've decided to name him Corbin.
16:48And if you don't want us to, make it through surgery and tell me yourself.
16:57Love.
16:58Love you.
17:02The second that you know anything.
17:05I will come and tell you.
17:07Okay.
17:14Can you come out so I can explain?
17:20How long has this been going on?
17:23I don't know.
17:24A few months.
17:25What about your tenants?
17:28I told you they moved out.
17:30A few months ago?
17:32My God.
17:33This is worse than I thought.
17:34You've been cheating on me with your house.
17:36It's platonic, I swear.
17:39It's not like I was coming here when you were in the hospital with the girls.
17:42Oh.
17:42How thoughtful of you.
17:44We can't fit any of this stuff at our place and music is how I relax.
17:49Crying in the shower like a normal person.
17:51You know what?
17:52I'll go shopping and you can stay here and jam.
17:55Fine.
17:56Got a new reverb pedal I can try out.
17:58Great.
18:02I'll call the plumber.
18:03No, I can fix it myself.
18:05No, you've lost that privilege.
18:14I thought I saw signs of life in here.
18:17I'm not back to work until next week.
18:18I'm just grabbing a few things.
18:20Aren't you supposed to be resting?
18:21I'll rest when I'm dead.
18:23Which I'm not unless Catherine finds me.
18:25Well, I won't tell.
18:28Oh, tell Altman good luck for me.
18:31What?
18:31The Ventral A Order?
18:32I assume you knew they were doing it again.
18:37Richard, Teddy and I, we just signed divorce papers.
18:41Yeah, I'm sorry to hear that.
18:42Honestly, I'm not sure how he ended up here.
18:44Well, sometimes things just don't work out.
18:46More often than not in my case.
18:48Oh, he'll get back on your feet.
18:50I'd stay for the surgery, but Catherine's at the dentist.
18:52If I'm not back before she is, there'll be hell to pay.
18:55You should go.
18:56Yeah, I'll see you if I have time.
18:57It's good to see you, Richard.
19:03Someone order a general surgeon?
19:05Dr. Bailey, thanks for joining.
19:07Dr. Warren, good to see you again.
19:08At your service.
19:09Or rather, on your service.
19:11Her service, actually.
19:13So I took a look at your patient's scans,
19:15and, you know, should be relatively straightforward.
19:19As long as the right gastroepiploic vessel
19:22is enough to supply the omentum.
19:24Looks sufficient to me.
19:26We'll see you in the OR.
19:27We are going to harvest that omentum like you've never seen.
19:29Okay.
19:32I panicked.
19:33Oh, this is going to be harder than I thought.
19:41Oh, Juan was right.
19:42You are in the supply closet.
19:43Why are you in the supply closet?
19:45We're doing another ventral aorta.
19:46I heard.
19:47Big day.
19:48Can you watch the kids for you tonight?
19:49Of course.
19:50I just wanted to say good luck.
19:53What if we can't do it again?
19:54What if Nora was just an anomaly?
19:55There was a lot of skill involved.
19:57If this doesn't work out, then Corbin never meets his nephew,
20:00and I am a fraud.
20:01When you were backed into a corner,
20:02that is when you rise.
20:03I've seen it in war zones.
20:05I've seen it in the OR.
20:06I see it with our kids.
20:07Don't put more pressure on me right now.
20:09I am just saying you can do this.
20:10You're just in your head.
20:11You need to take a breath.
20:12Don't tell me what I need.
20:13That's not your job anymore.
20:14And frankly, it was infuriating when it was.
20:19Okay, well, I'll get the kids from school.
20:24And good luck.
20:34That was excellent technique with the Dermatone, Dr. Mahanti.
20:39Want to do the honors with the mesher?
20:41Absolutely.
20:50Pull the omentum through for me.
20:53Okay, no twisting on its pedicle.
20:56And the main vascular arcade remains intact.
21:01Well done, Dr. Warren.
21:03You're one of our best and brightest.
21:05I'd hate to lose you to plastics, but I know that's where your heart is.
21:09Especially with your interest in burn patients and experience as a firefighter.
21:14Firefighter?
21:15And an anesthesiologist?
21:16How many lives have you had?
21:17I like to think they all led me here.
21:19Well, that should do it for me.
21:22Thanks to Dr. Warren's dissection, your flap should cover everything you need.
21:25Hey, do you call him Dr. Warren at home too?
21:31Okay, that looks great.
21:33Now we just need to finish the inset and get the graft on.
21:36This is OR2.
21:38Dr. Wright, they're asking for you an urgent burn case in the pit.
21:43Warren, want to join me?
21:45I'd love to.
21:46Great.
21:47Dr. Mahante, you and Millen here good to finish up?
21:50Of course.
21:57Come on, now, y'all can't keep him here.
21:59We gotta go pop some bottles, celebrate on him for once.
22:02Yeah, no, sorry, doctor's orders.
22:05All right, let's talk dollars and cents.
22:07Of course you're gonna hit me back for the car and the back rent, right?
22:10You're a millionaire, you're a millionaire, you're a millionaire.
22:11Okay, why don't we table this until after your brother's out at the hospital?
22:15Dr. J-Dawg would be face down in a ditch if it wasn't for me.
22:18You know, I've hated that nickname since I was eight.
22:20Well, I've hated picking up your tab for the last 12 months,
22:22but that's what brothers are for, right?
22:24Hey, if you don't wanna do it, I will.
22:26We got a problem here?
22:26Uh, that depends.
22:28Are you gonna keep being a total...
22:29You should go.
22:31Him or me?
22:32Brian out.
22:34Now.
22:38Sorry about that.
22:39Yeah, it's...
22:40Philips.
22:43What's that?
22:44What's he seizing?
22:45Adams, help roll him.
22:46We need some diazepam and alert CT.
22:52Oh, hey, what you heard this morning isn't true.
22:56Okay.
22:56I am not actively trying to have a baby.
22:58I'm just freezing my eggs in case I want one someday.
23:01Got it.
23:02Which I might not want one.
23:03Just an insurance policy.
23:04Congrats.
23:04Also none of my business.
23:05Oh, I just didn't want you to think I was withholding
23:08some critical information.
23:10Great.
23:10Because what we're doing right now doesn't have to stop.
23:12I mean, there might be a few days here and there
23:13where we shouldn't...
23:14You know?
23:15But overall, we can keep doing...
23:17Understood.
23:18But right now, I'm trying to do my job,
23:19and I'm mostly failing, so I really can't talk.
23:22How about drink at Joe's later?
23:23If they ever let me leave?
23:24Sure.
23:25Okay.
23:26Yeah.
23:28Okay, so...
23:28I'm sorry.
23:29Yeah.
23:39I can cut the sutures for you.
23:41I've got it.
23:43Maybe they don't mind.
23:44I said no.
23:47Should I call for another resident since you clearly don't want me to help you?
23:51Not if your idea of helping is making me look ridiculous in front of our attending.
23:54You told me to be on my A-game.
23:56So that I can impress Dr. Wright.
23:59I applied for an attending position at the Fox flagship in Boston.
24:03It's perfect.
24:04Great benefits.
24:05Grant money.
24:05Close to my family.
24:07And I needed her recommendation, which I was supposed to lock down today.
24:11If you wanted me to make you look good, you should have said so.
24:14Right.
24:15I'm serious.
24:18I'll keep that in mind for next time.
24:25Can I get in on those lower inset sutures?
24:27Nope.
24:28Too close to the pedicle.
24:30I know that we have disagreed on Corbin's care.
24:34But I need to know that you are fully on board with the surgery and with me.
24:39I was on board with the surgery yesterday.
24:41Still am.
24:41And me?
24:42I'm a professional.
24:43That's not what I'm asking.
24:46It's not just that you made the wrong call.
24:48You flat out dismissed my opinion.
24:50I didn't.
24:51I considered it fully.
24:52Did you?
24:52Because if you'd set your ego aside, we may not be in this mess.
24:55Or Corbin would already be dead.
24:57And then that would be on both of us.
24:59If something goes wrong in there, I need to know you hear me.
25:04I will.
25:05You have my word.
25:08Then I have your back.
25:10Let's go build an aorta.
25:17Yeah.
25:19Where is this guy?
25:23What are you doing?
25:25I just thought I'd see what all the fuss is about.
25:28That's my Martin.
25:31Mm-hmm.
25:32So be careful.
25:33This song is called, this is what betrayal feels like.
25:40Okay.
25:41I get your point.
25:42Can we put it back now?
25:42Not until you apologize.
25:49You know what? No.
25:51What is wrong with me grabbing a few minutes of alone time so I can be better for you and
25:56the kids?
25:56I had a heart pump keeping me alive after delivering two other bodies out of my body.
26:03I can't breastfeed, which I know is okay, but I still feel horrible about.
26:06And hormones have turned me into someone that I would avoid on the OB floor.
26:09I am not okay.
26:11I am not me.
26:14I am a hideous shell of my former self.
26:17And you don't see it because you're off in the man cave, which is actually an entire crappy house.
26:26Plummer is here.
26:35Here's a list of discharge summaries.
26:37Stay away from Jeremy and don't leave until you get him done.
26:39You punishing me?
26:40You were out of line.
26:41That dude was walking all over our patient.
26:42It doesn't matter.
26:43It's not our job to get involved.
26:44And if you do it again, I'll have to tell Bailey.
26:46Got it.
26:46So don't treat the whole person.
26:48Just be a robot checking boxes.
26:50Yeah, that's not what I said.
26:51I'd love to stay in chat, but I got a whole bunch of discharge summaries I need to go with.
26:53Thanks for the lesson, boss.
27:02I thought that Brent took it.
27:04You have a condition called SIADH.
27:07It can happen after a head trauma.
27:09Usually resolves on its own.
27:10Low sodium levels cause the seizure.
27:11You'll need IV fluids and medication to correct it.
27:14Okay.
27:15Boom!
27:17Don't ever say I never did anything for you.
27:19And I also called mom.
27:23Stop.
27:24You should let Jeremy rest.
27:25You know, I've been wanting to say this to him for a long time.
27:29I hate you.
27:30I mean, I love you.
27:31You're my brother.
27:32And I wouldn't have been able to get through this last year without you.
27:34But when you're mean about it, it makes me hate you.
27:37We were just having fun.
27:38It's not fun.
27:39Not for me.
27:39Maybe we just take a breather.
27:41I just always thought it rolled off your back.
27:45I'll lay off.
27:47Really?
27:48That's it?
27:49Yeah.
27:49I'm not a monster.
27:53I guess I should have said something years ago.
27:57I'm gonna put in your orders.
27:59He's still gonna pay me back for the ring though.
28:04This scar tissue is cemented in.
28:07Worse than Norris?
28:08By a mile.
28:09You know what else is different this time?
28:11Blood flow.
28:12All those people watching up there.
28:16Stay focused.
28:17I don't know if we're gonna be able to get through all this.
28:23Altman.
28:26If we give up now, he'll die.
28:31All right.
28:3315 blade.
28:34What are you-
28:34Using the scissors is like blunt dissection.
28:36It isn't working.
28:37I'm gonna try working layer by layer.
28:39See if I can find the correct surgical plane to orient myself.
28:45Okay.
28:45I'm with you.
28:46Thank you both, Kate.
28:57Guess who aced his burn consult?
29:00Okay, tell me everything.
29:02Well, thanks to my days as a firefighter,
29:05I knew to mix and put a laxative on the burn.
29:08Yeah, the polyethylene glycol binds to the phenol
29:10to stop the chemical burn from getting worse.
29:13Impressive.
29:14What's that?
29:14And that is what Dr. Wright said.
29:17Thank you for talking me up.
29:19But someone had to.
29:20You weren't doing yourself any favors.
29:24Okay, what can I do to help you?
29:26Oh.
29:27Call more hospitals about Katie's immunotherapy?
29:29Mm-hmm.
29:30Handle bed time so you can look into more options?
29:33Yeah, I don't need any of those things, but no,
29:35I appreciate the sentiment.
29:37Hold on.
29:46How's my favorite patient?
29:49Well, nurse gave him some pretty strong pain meds,
29:53so he's a little loopy.
29:54Love of my life over there.
29:56I love her more than I love elephants.
30:00Something wrong?
30:02Uh, the flap is dark and swollen.
30:04I'm going to take a listen.
30:09Damn it.
30:11What's happened?
30:12Everything okay?
30:12There's no signal.
30:18I'll call the OR on page Dr. Wright.
30:20Get him ready.
30:21He needs to go to surgery again?
30:22But there's no blood flow to his flap,
30:24so we need to get him to the OR to see what's happening ASAP.
30:27Don't go visit the zebras without me.
30:30Excuse me.
30:34All right, graft is completed.
30:36It's time.
30:38All right, let's rapid pace the heart.
30:42All right, clamps off.
30:44GIA stapler.
30:47All right, ready to staple off the aorta?
30:55Staple line is well approximated, mixed intact.
31:01You did it.
31:07All right, let's take him off bypass.
31:10Clamps.
31:21That's amazing.
31:23All right, I am going to go update Leticia.
31:25You good?
31:26Yep, ready to close.
31:29All right.
31:30Oh, oh, oh, I do go.
31:31Oh, my God.
31:31I need labs.
31:32Where is it?
31:33There's too much blood.
31:34All right, I've got pressure on the defect.
31:36Griffith, get in here and suction around my hand.
31:42Hang on.
31:45All right, there.
31:46A small defect on the leading edge of the staple line.
31:49We didn't fire the staples all the way across.
31:51Okay, put him back on bypass.
31:53Rinsky.
31:54Clamp on?
31:54All right, I'm here.
31:55Okay, get your hand in here.
31:57Yep.
31:57Suction.
31:58Hang on, Corbin.
31:59Hang on.
32:06Katie Rogers, 27, stage four gastric cancer.
32:09I already know that part.
32:10Short of breath, satting 89%, abdomen's distended.
32:13It's alien.
32:14I can't breathe.
32:16No, no.
32:16It's okay.
32:17We've got you.
32:18Well, don't just stand there.
32:20Let's move.
32:39There's a stitch tied down over the pedicle, cutting off its blood supply.
32:45Nothing?
32:46This is a serious mistake.
32:48Warren and I left you to complete the inset and place the skin graft.
32:52I expected it to be done not only successfully, but perfectly.
33:00The flap looked viable when we left the OR.
33:02But we didn't see anything restrictive over the pedicle.
33:05Save it.
33:05I don't have time for excuses.
33:08Our patient now has no tissue coverage over his wound and will most likely need many surgeries.
33:13He might not survive.
33:18Just go.
33:20I'll clean up the wound and get the wound back back on myself.
33:32Almost finished closing this gap.
33:34All right.
33:35Last stitch.
33:43And right there.
33:45Done.
33:46Are we sure the closure is going to be adequate?
33:48Will the suture hold?
33:49After watching so much of Corbin's blood volume spray all over this OR, I am not sure of anything.
33:56But I watched Ndugu tie these sutures and they look great.
34:01All right.
34:02So, let's take him off bypass.
34:07All right.
34:08Lamps off.
34:17We have a rhythm.
34:19Pressures are coming up.
34:23All right.
34:24All right.
34:25Altman, we did it.
34:29Altman.
34:32We did it.
34:33Altman.
34:35Well done, everyone.
34:38All right.
34:39Let's prep to close.
34:45$400 and he has to come back tomorrow with a part.
34:49You should have fixed it yourself.
34:55You know, I'm sorry for hiding all this from you.
34:59I guess I was afraid that you'd be madder if you knew.
35:06Honestly, I'm more jealous than mad.
35:11See, you need a place like this too.
35:13You need a place you can go for peace and quiet.
35:16A woman cave.
35:18I feel guilty even thinking about it.
35:22Why?
35:22The patriarchy.
35:26Mm-hmm.
35:28You know, if we're going to get through this, we have both got to take care of ourselves.
35:32What would I even do in my...
35:34She should.
35:37Dame did.
35:38Mm-mm.
35:39Okay.
35:40I'll stop.
35:43Lady Lair.
35:50You could take guitar lessons.
35:52Yeah, but I'm already a musical genius.
36:08You look like you've seen a ghost.
36:10Yeah.
36:11The ghost of an omental thought that died at the hands of negligent residents.
36:17You've got a lot going on.
36:18We can chat tomorrow.
36:20I...
36:20No, no.
36:21It's fine.
36:22Everything's fine.
36:23It's all...
36:24It's all fine.
36:26What's up?
36:29Um...
36:31I have a son.
36:32Scout.
36:33He's five.
36:34He's adorable.
36:35He splits his time between his dad and me and I have him tonight.
36:39And that is why I couldn't hang.
36:43You were nervous to tell me about a cute kid.
36:45It was kind of a deal breaker in my last relationship.
36:49And that kind of broke me.
36:51And if it is a deal breaker for you two, I totally get it.
36:54But I would rather know before starting something.
36:57That would make me a hypocrite.
36:58I had him just misplaced.
37:01So...
37:03This is Zachary.
37:05He's seven.
37:06Obsessed with trash compactors and, uh, synthesizers from 80s pop songs.
37:12Are you single mom?
37:14Mm-hmm.
37:14My sister lives with me.
37:16She watches him when I reconnect with an old crush.
37:20Which happens all the time.
37:21Yeah.
37:23Not really.
37:28Brain check.
37:32Brain check.
37:44His pressures are holding without much inotropic support.
37:49It's great news.
37:50Yeah.
37:52Do you think that we will ever do this surgery without major complications?
37:57Third time's the charm.
38:00Somehow I doubt it.
38:05We're a team on this.
38:07If we stay one, we could save way more patients than just Nora and Corbin.
38:13You've been here for two days.
38:14Yeah.
38:15You should go home.
38:16And I'll keep an eye on him.
38:18Thanks.
38:21Dr. Caivano to the ER.
38:23Dr. Sando Caivano to the ER.
38:28Poor thing.
38:29Must have liters of fluid in her abdomen pushing it up on her lungs.
38:33Okay, so we'll need to do a paracentesis if you can get me set up for that.
38:37Adams.
38:39Adams.
38:39She called and texted and I didn't respond because I was too busy following your rules.
38:45This would have happened regardless.
38:47She trusted me and she was scared and alone and I wasn't there.
38:56I think you need to take a break from this case.
39:00I don't know why.
39:01I would do whatever you need.
39:03I just think-
39:03No, no, it's not a punishment.
39:04I just-
39:04I think you need to step back.
39:21Keep the storm behind me.
39:24Breaking new ground is never easy.
39:27Give me peace to the heart and-
39:29Yeah, I'm too.
39:31Yo.
39:31Hey.
39:32I just did the ventral aorta with Altman and Ndugu.
39:36It was freaking epic.
39:38It was historic.
39:38That's cool.
39:39I'm proud of you.
39:40Something happened today or-
39:43My patient won the lottery.
39:44By having you as their doctor.
39:46No, no.
39:46He literally won the lottery.
39:47Two million dollars.
39:48Did not see that coming.
39:53I'm going out of town for a minute.
39:55Is everything okay?
39:56My brother's epilepsy's gotten worse.
39:59And he's in a coma.
40:02I'm sorry.
40:03You want to talk about it?
40:05No, no.
40:06I just-
40:07I didn't want you wondering where your lap dances went.
40:09Well, I mean, are you sure?
40:11I've been told I'm a pretty good listener.
40:12I said I'm good.
40:13You have to pull the rug out from under people.
40:15Have a good night.
40:16Shatter their reality.
40:18Ask more questions than you answer.
40:20It takes what Dr. Harvey called a love of truth.
40:23And a whole lot of intestinal fortitude.
40:28Thank you for not saying anything.
40:30You didn't have to do that.
40:32I could tell that the Boston job is really important to you.
40:36It is.
40:39There will probably be an M&M soon.
40:41I'll email you my op note and photos from the OR.
40:45They'll want to review post-op imaging too.
40:46Should I be worried?
40:51The M&M will suck.
40:52But we'll be fine.
40:54Get some sleep.
41:00But it also requires faith.
41:03That the world won't come crashing down around you.
41:05That you won't be burned at the stake.
41:09How'd it go?
41:10Oh, well, it wasn't smooth sailing, but our patient is stable.
41:15That's great.
41:17So, uh, Alison wanted to fall asleep with the lamp on.
41:21So just be sure to turn it off before you go to bed.
41:24Thank you for pinch hitting.
41:26I really appreciate it.
41:28I'm always happy to get more time with the kids.
41:31I'm sorry I bit your head off earlier.
41:34You did nothing wrong.
41:34I was just in a panic spiral and I couldn't see it.
41:39Well, I stand by it.
41:40You are at your best when you're backed up against the wall.
41:42Little?
41:43Mean?
41:43Sometimes?
41:45But brilliant.
41:47You are never going to stop believing in me, are you?
41:53Why would I?
42:01And that this new reality is going to be better.
42:12Or at least, truer than the one that came before.
42:24In the worst at least, don't you stay?
42:43I was like, oh wow.
42:44Good luck.
42:45Let's end up.
42:45I don't remember.
42:46When you get older you don't fall asleep.
42:46You can take a look at it.
42:46You are not going to be better.
42:46I'm not going to be better at this point.
42:46You can take a look at it.
42:46You are a little bit.
42:47I'm not going to be better because of the big stuff.
42:48I'm still feeling bad.
42:49You are not good at that.
42:50And I'm sorry.
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