- 4 hours ago
Category
📺
TVTranscript
00:01Previously on Doc.
00:02He's back.
00:03I made mistakes.
00:04Actually, you leveraged an incredibly painful situation to your advantage.
00:08And how are things with Nora now?
00:11Over.
00:11I found a lump.
00:13Please don't tell anyone about this.
00:14Do you have a minute?
00:15I'm in radiology right now with a patient.
00:17What if she's sick?
00:18I guess she's trying to hide it.
00:19It's progressing quickly.
00:20I suggest you reach out to Ethan.
00:22Get a support system in place.
00:24You went into her desk?
00:25We had no other choice.
00:26I'm afraid that you might be sick.
00:28We gotta talk about Joan.
00:44Dr. Ridley.
00:45Oh, they're here?
00:46Heading up now.
00:47OR3 is clearing the blood banks on standby.
00:49Good.
00:50Then we are ready.
00:53Bay 4.
00:54Breathe me in.
00:54Penetrating abdominal wound.
00:55Initial stabilizing surgery on site, but multiple retained foreign bodies could not be removed.
01:00Open wound pack for transport.
01:01How do you do on the flight?
01:02Hypertensive and tacky.
01:03Started norepi and fluid recess en route.
01:05Conscious?
01:05In and out.
01:06I'm asking for you.
01:08On my count.
01:09Three, two, one.
01:13Hang TXA to a bone egg.
01:14I want him on the table in half an hour.
01:17Ridley?
01:19Is that you?
01:19If you missed me this much, you could have just called.
01:24You know I left to make an entrance.
01:27Well, you are here now, Javi, and I am gonna take care of you.
01:31I don't know.
01:39I thought you were coming in later.
01:42Well, so did I.
01:44But I gotta review all of Amy's cases by end of day.
01:47Is she doing the same for yours?
01:48She handed hers in already.
01:49Not that it matters anymore.
01:51Okay, why do you say that?
01:52Don't you think Joan's gonna figure out we were the ones who told Jake about her?
01:55She was hazing me yesterday as if she already knew.
01:58I'm pretty sure Jake passed that baton to Amy today, so I'm sure you're on equal footing now.
02:02I heard she's prepping another surgery, and clearly she hasn't invited you to audit.
02:08We did the right thing.
02:10Can't overthink the consequences.
02:14This should hold him for now, but prep the team for massive transfusion protocol.
02:19Damn generator exploded.
02:21We worked medical missions together for 22 years, but why don't you go ahead and say what you need to
02:26say?
02:27Uh, I thought maybe we could step away.
02:31Is your boyfriend hiding out there somewhere to double-team me?
02:34Joan.
02:36It's MDS.
02:39Oh, God.
02:40Please, don't.
02:42I was diagnosed a few weeks ago.
02:44It's mostly indolent.
02:46I haven't had a chance to tell Michael yet, so I'd appreciate it if you let me do that.
02:50Yeah, of course.
02:51And before you ask, Javi knows he came here anyway.
02:54He has Addison's.
02:55He needed a surgeon he could trust.
03:00Does he know that your hand's been shaking?
03:06That happened once, Amy, after a very difficult surgery.
03:09Which this will be.
03:17I'm medicated and I'm fine.
03:21You could use an extra set of hands to manage his cortisol and electrolyte levels.
03:25Is that you offering?
03:27I'll get him started on a TTE.
03:34Thank you, Ray.
03:36Mr. Boyd.
03:36Who are you?
03:37Supposed to be seeing Dr. Ridley.
03:38Dr. Ridley had an emergency, but I can assure you...
03:41And Dr. Humda was supposed to be joining us as well.
03:43Uh, his whereabouts I can't speak to.
03:46But I'm Dr. Miller.
03:47First name?
03:48Uh, Richard.
03:49And you are...
03:50Fiona, Xander's COO.
03:52And my wife.
03:53You're an internist?
03:54Ford certified in oncology as well.
03:55Pulmonary subspecialty.
03:57Where?
03:57St. Ejuricus.
03:58And he used to be chief of internal medicine here for just two months.
04:01I didn't love the admin.
04:03So I took a little hiatus and I came back to work with patients, which is what I do love.
04:08Okay. Continue.
04:09I understand you have a suspicious mass in your right lung.
04:12I get regular full body scans in Palo Alto, but I was here at a conference when the Apollo DX
04:16flagged it.
04:17It's an AI diagnostic program.
04:1917% better than humans at early cancer detection.
04:22It's also far more likely to give you a false positive.
04:25Well, that's the hope, but I won't wait to get home to find out.
04:29Hi, I'm Dr. Coleman. I'll be assisting Dr. Miller.
04:32Uh, yeah, that's, uh, Theodore Coleman.
04:34He's an intern, Columbia Med School, Army Ranger Medic.
04:38He is highly skilled, very ambitious, and an extremely hard worker.
04:42Are we being interviewed?
04:43Vetted.
04:44It's gonna be on him anyway.
04:45Steiner vouches.
04:46Oh, I'm flattered.
04:47Great. I want the, uh, tissue removed and studied.
04:49So, how'd you do that, Dr. Coleman?
04:52Uh, bronchoscopic biopsy and a PET scan.
04:55Is that correct?
04:56It is.
04:57Then let's do that, huh?
04:58Stat.
05:01I want to thank you both for being here today.
05:04My role is not to judge or to take sides, but to facilitate a productive, respectful conversation.
05:12I'm so sorry. It's Max.
05:14Fine, Michael.
05:17I told you I had a personal matter to attend to today.
05:20You also told me Joan would be taking care of Xander Voight.
05:23Well, she has a patient who is a higher priority.
05:25Than a tech tycoon who can fund our entire capital campaign with what he makes while brushing his teeth?
05:31Well, Dr. Miller's on the case. I hear he's excellent. Why else would you have hired him back?
05:35Not funny, Michael.
05:36No, it's not.
05:37I'll deal with this in a few hours when I get back to the hospital. Goodbye, Max.
05:42So she took this job and she didn't tell Michael?
05:45No, she was diagnosed after she was offered the job.
05:49And she still hasn't told him?
05:51She's getting her head around it.
05:52And in the meantime, what, you're aiding and abetting, risking a patient?
05:55The patient knows, and he chose her anyway.
05:58Besides, there's no time to move him.
06:00I don't know if something doesn't feel right. She's working you.
06:03No, she isn't. You just don't know her the way I do.
06:07Yeah, you don't know her either. Not in the last eight years.
06:12I'm sorry, but that's the truth. And you know you can't justify any of this.
06:26How long has it been like this?
06:27Mom says a week. They thought it would heal on its own, but...
06:30No, she's too malnourished.
06:32Fighting in Goma cut off the food supply.
06:37Yeah.
06:37We're going to clean you a little bit and find something to eat.
06:41That's it?
06:42Yeah.
06:43So I got saline, degreedment kit, McPearson.
06:47Please trade with me.
06:49What's wrong with your case?
06:51Oh, Marcus keeps sending me lumps, bumps and dumps.
06:53That's what you get for sleeping with him and not calling him back.
06:57Dr. Ridley.
06:58Mm-hmm.
06:58It's your son.
06:59What?
07:00It's...
07:01It's 2am in Minneapolis.
07:05Ethan?
07:06Hey, what's wrong?
07:09No.
07:10No, no, no.
07:11Uh, forget the pediatrician.
07:12Get to Westside.
07:13Ask for Amy.
07:13I'll...
07:14I'll make sure she's waiting for you.
07:22Thank you for doing this.
07:23I'm here for you.
07:24But keeping this a secret won't do you or our patients any favors.
07:29You're giving me an ultimatum?
07:30I'm asking you to tell Michael today.
07:33We both know that this disease will take things from you.
07:37Your legacy shouldn't be one of them.
07:45We'll see you in there.
07:53I can't do dinner.
07:55I'm too tired.
07:59But we're still facing resistance from regulators on the new build.
08:03So find a new country or grease the wheels.
08:05I don't care which.
08:06Look, I gotta go.
08:07But one way or another, I want movement by next week.
08:09Hi, Mr. Boyd.
08:10Max Garner, CEO of the hospital.
08:12Just wanted to say that we will do everything in our power
08:15to give you what you need today.
08:17My test results would be nice.
08:23Unfortunately, I'm going to have to eat my words.
08:25The biopsy confirmed you have small cell lung cancer.
08:30Lung cancer?
08:31Yes.
08:31He hasn't smoked a day in his life.
08:33And he's meticulous about his health.
08:35Fiona, we're not going to argue this away.
08:37But I'm sure if you couldn't see the mass, we caught it early.
08:40Right?
08:42Yes.
08:43But genetic sequencing indicates it's an aggressive variant.
08:47And the PET scan shows micrometastases in your brain, abdomen, and bones.
08:52So it's already spread?
08:55So what now?
08:56Well, we can try chemo and molecular therapy, but those treatments are very painful.
09:01And even then...
09:02So, how long do I have?
09:04Best guess, we can get you four to six months.
09:10Personally, I'd consider palliative care.
09:12I'm getting Dr. Steiner.
09:14We'd be happy to interface with any of your own specialists.
09:17Well, we've already conferred with our chief of oncology and he agrees with our assessment.
09:21Well, of course he does.
09:22He works in a bureaucracy and can't think out of the box.
09:25I wish we could do more.
09:26We could try CAR-T.
09:29No, we cannot.
09:30What is CAR-T?
09:32Chimeric antigen receptor T cell therapy.
09:34It reprograms your white cells.
09:36And has absolutely no efficacy on this type of cancer.
09:39I don't think anyone knows that for sure.
09:40There's not enough data.
09:41Steiner is fielding second opinions and wants to teleconference in an hour.
09:44The plane will be ready to take you to Sloan or Hutch or Oxford if we have to.
09:48Wait a minute.
09:49Anything any of those places can do, we can do and we'll be completely transparent with your team.
09:55Your team is not even on the same page.
09:57We will get there.
09:58I assure you.
09:59Then come back to me with a plan.
10:00Like, if I'm still here, I'm all ears.
10:05One centimeter fragment in segment six.
10:09Two suture repair.
10:15Hey, any news?
10:16No.
10:17I'm freaking out.
10:19Listen, I told you.
10:20Just because they're taking longer to get the results, that doesn't mean anything.
10:23I know, I know.
10:23I thought I'd be okay with this, but I am really not.
10:26Maybe stay away from work today and just try and distract yourself.
10:29Funny you should say that.
10:31Because I'm kind of at the cafe around the corner.
10:34Uh, from the hospital right now?
10:36Look, is there any way you can come down for a minute?
10:38I'm really not handling this well.
10:40Yeah, yeah.
10:40Be right there.
10:44BP's dropping.
10:4491 over 59.
10:45Amy.
10:46Imagine 100 had a cortisone.
10:48Normal saline, wide open.
10:49What's this?
10:50Sodium?
10:50It's fine, 134.
10:52It's not me.
10:53You have a bleeder.
10:54My field is clear.
10:56Unless...
10:57Damn it.
10:58Suction.
10:58Lender sees things lost already.
11:01You're counting?
11:02I can't clear the field fast enough.
11:04Want another clamp for a Pringle maneuver?
11:05No time.
11:06I'll do it blind.
11:07Micro switcher on a needle driver.
11:11Whatever....
11:11haha.
11:31...
11:31What if he's rising?
11:33Maybe he's rising.
11:35That was amazing. Piece of cake.
12:00Yeah, we're here with Amy now.
12:02She's checking his lungs.
12:03Stop, stop. I can't hear anything you're saying.
12:07You have to find someone with a better seat.
12:09Mom? Mom?
12:16So, the albuterol is working.
12:19But his oxygen is still low.
12:21If it drops any more...
12:23Don't tell me you have to intubate.
12:24No, we're not there yet.
12:26Let's just try to stay calm.
12:30I never thought I'd say this, but I wish my mother were here.
12:33There's nothing she would do that I'm not already doing.
12:35You think I want her here for medical expertise?
12:38No.
12:40You know, when I had meningitis in college, she at least offered to fly home.
12:44Ethan, she's doing the best.
12:46Don't defend her, Amy. All right, please.
13:07John?
13:08Yeah?
13:09You okay?
13:10I'm fine.
13:12I just had to splash a little water on my face.
13:16I'll be right out.
13:29Okay, let's bump his methamazole up to 20 and then recheck his TSH.
13:33And can you have Dr. Park give me a call on labs? Come back on 6-12.
13:36Okay, thanks.
14:08All handled?
14:09Yeah.
14:10I think they can survive without me.
14:12Apparently, I can't.
14:13Hey, it's fine, okay?
14:16I'm not going anywhere until the labs come back.
14:19What is this?
14:20This is the Mia treatment.
14:22And you thought this would distract me from my impending doom?
14:25I've seen you around a Sunday.
14:33I want primary custody for as long as I'm breastfeeding.
14:36Absolutely.
14:37I'll take regular visitation rights for the first year.
14:40And after this first period, we'll transition to the 50-50 custody.
14:46Yes.
14:46Agreed.
14:47Now on to assets.
14:49First, the family home.
14:51It's in Michael's name.
14:52I'm prepared to sell it and give Nora half the proceeds.
14:55I can't let you do that, Michael.
14:57Why not?
14:57I-I know what it means to you.
14:59And what about Katie?
15:00She's fine with it.
15:01She's off to college soon, and I think it's the least I can-
15:04Oh, God.
15:05Don't you dare be kind to me right now.
15:09What-what else would I-
15:13I need to hate you, Michael, and you need to let me.
15:21Hey.
15:22Hey.
15:23How's our patient?
15:24Well, strong vitals, no sign of infection, emptied his drains, hung post-op antibiotics.
15:31Wow, we're going to put our nurses out of business.
15:33Ha ha.
15:34I can handle post-op if you just want to sit with him.
15:39That's a hell of a bedside manner you've got there.
15:44You all right?
15:45Amy.
15:47Hey.
15:49I'm good.
15:52I-I have another patient I should check on, but Hari needs post-op lights and hourly labs.
15:59I'll take care of it.
16:05We talked about this.
16:07I don't want you back in that chair until we have-
16:09I know, until I've had two months of normal EEGs. I know.
16:13But I've had four clean studies and I need this memory now.
16:17Look, I know you're going for chief resident and recovering your medical knowledge is important.
16:20No, it's not that.
16:21When my brain does this, it's because it's trying to tell me something.
16:26My friend needs help and this memory may be the only way that I can help her.
16:32Any headaches or nosebleeds and I'm pulling the plug?
16:35Of course.
16:37I want to be clear that the treatment protocol that I'm proposing will be risky and painful.
16:42Pain is irrelevant. Will it work?
16:43I found one successful case.
16:45But as your team will tell you, cancer involves many mutations.
16:48The treatment has to be as unique as a disease.
16:51That is where CAR T comes in.
16:53We take your own T cells and re-engineer them to target the specific markers of your illness.
16:58Which antigen will you use?
16:59His cancer cells exhibit a large number of DLL3 surface proteins.
17:03And which viral vector for delivery?
17:05The case I'm referencing used a lentivirus model.
17:08The case he's referencing was so much less aggressive, it shouldn't even be considered a comp.
17:12Mr. Voight's immuno response will almost certainly be catastrophic.
17:16There's a very good chance this treatment will kill you. By tomorrow.
17:20Or it could add years to his life.
17:22Team, some feedback would be nice.
17:25Give us a moment, please.
17:26I thought you were getting on the same page.
17:28So did I.
17:31Okay.
17:31The only other option we can see here is Ludo's team in Zurich.
17:35They have a vaccine model that's had some limited success in mice.
17:39Limited? And only with mice? No.
17:40That's out. What else?
17:42I'm sorry, but there's nothing we can stand behind.
17:44So Dr. Coleman's idea is the best option?
17:47It would be, yes.
17:48Elise?
17:49With more time, we could dig deeper.
17:51But big things don't happen overnight in the cancer game.
17:55Okay, so, we have no choice.
17:58Okay then, let's get the ball rolling with whatever we need to do next.
18:02I'm sorry, but clearly these people on your payroll don't know how to say no to you.
18:07Dr. Miller.
18:07And I gotta say.
18:08If you were anyone else, this hospital wouldn't even be considering this course of treatment.
18:12Mr. Voight has an appetite for risk.
18:14An appetite for risk is one thing. This is trying to kill a lion with a toothpick.
18:24Look, sometimes we fly too close to the sun, but we get nowhere if we don't try to fly.
18:31Right, Dr. Coleman?
18:34Well, I sincerely hope this works. But respectfully, I won't be a part of it.
18:52I, uh, I didn't mean what I said before. I mean, I don't want to hate you.
19:01I wouldn't blame you if you did.
19:06I hope that selling the house will be a fresh start for you.
19:12I think you really need that.
19:15Okay, I've drafted an agreement. Why don't we give it a once-over?
19:23And focus. Ground yourself in the memory. What can you smell? Hear? See?
19:36Okay, let it rip.
19:48So just stay out of it. What are you not telling me?
19:51It's, it's MDS.
19:53So there's a good chance it'll turn into leukemia.
20:00What is it, Amy?
20:01I have to go.
20:08You can't perform surgery anymore.
20:17Place a vast cath, prepping for temporary human dialysis.
20:21What happened?
20:22BP spike, acute renal failure.
20:26But that makes no sense. Addison should prevent BP spikes.
20:29And his renal function was normal pre-op.
20:32Well, clearly we're missing something.
20:34Blood cultures, auto-antibodies, and a PAN CT scan.
20:37That's a good idea. It was even better when Dr. Matra had it five minutes ago.
20:41Where were you?
20:43I was in TMS.
20:45I love your sense of timing.
20:47I remembered.
20:49You were diagnosed months ago, and the disease certainly wasn't indolent.
20:53So you're off chasing unreliable memories while our patient's life hangs in the balance?
20:57You're gonna look me in the eye and tell me that was a false memory?
21:00It was a bad day. I was emotional, and I'm fine now.
21:04You took this job knowing that you couldn't handle it.
21:08I am handling it.
21:09Really? Where did you get this bruise?
21:11And what about the edema in your wrist?
21:13How much prednisone does it take to get you through a shift?
21:16You know what? Dr. Matra and I will take it from here.
21:22I would never do anything to jeopardize a patient, and I don't need you to tell me that.
21:51Let me ask you something.
21:52You went up against Dr. Miller. Was that for my sake, or were you just...
21:57...pandering to your CEO?
21:59Oh, come on. Don't pretend you don't have a lot riding on this, too.
22:03I don't do anything I don't believe in.
22:05Man of conviction. I guess I'm not surprised.
22:08Four years in Afghanistan. Took a bullet during that hostage crisis.
22:12Okay, you guys gotta ease up on the background checks. It's getting weird.
22:16Honest, too.
22:18Look, this idea is out of the box. But you push boundaries for a living.
22:23Controversial, but necessary to a society.
22:28I've just...
22:31Never been in the lab rat before.
22:50Dr. Ridley, he has tuberculosis.
22:54I saw some nonspecific areas lighting up on CT. Figured they were artifact.
22:59But his sed rate was up, so I ordered an ultrasound with Doppler.
23:03And found a cavitus lesion in his hepatic artery.
23:06Add that to his chronic inflammation, milky drain fluid, travel exposure.
23:11Extrapulmonary TB explains it all. Even the Addison's.
23:14He must have a lesion on his adrenal gland.
23:16And who knows where else?
23:17We need a full-body MRI with contrast and surgery to remove infection.
23:22Good.
23:23I'll take him to radiology.
23:25You can grab a few protein bars, Dr. Maitre. We're going back in.
23:32Feeling okay?
23:34I feel like crap.
23:36I guess that's what we want, though, right?
23:39It means it's working.
23:40Yeah. Well, your BP's a little low. I'm going to start your oppressors.
23:46Mr. Voight?
23:47Mr. Voight?
23:49Two milligrams IV lorazepam.
23:51Stat.
23:52When did you inject the CAR T-cells?
23:53An hour ago.
23:55It's a cytokine storm.
23:56But I premedicated with Benatryl and Methopenicillum.
23:58Well, it wasn't enough.
24:06I'm not.
24:07Prenez le medicament deux fois par jour. D'accord?
24:10Faites bien le bouillot pour éviter les infestions. C'est très important.
24:15Oui?
24:16Oui, oui.
24:17Au revoir.
24:18What else we got?
24:20Dinner.
24:21Oh, no. I'm going to eat later.
24:22You can't help them if you can't stand.
24:25Ridley, eat.
24:32Can we talk about the real reason you won't slow down?
24:34Have you had Terry's moambe?
24:38Your grandson's going to be fine.
24:40From everything you said about Amy, he's in the best possible hands.
24:45Not mine, though.
24:47You can't be everywhere.
24:51When Harry and I were first married,
24:54I tried to stay put,
24:56be the doting wife and mother,
24:58and have a regular nine-to-five.
25:02The truth is, I just wasn't cut out for it.
25:09Maybe you were right to never settle down.
25:12Or maybe I just never found a man who could put up with me.
25:17Well, it makes two of us.
25:21Hello.
25:27It's me.
25:28Albuterol and high full oxygen are keeping his numbers in the 80s.
25:32So no need to intubate?
25:34No, he's stabilized.
25:35But they've got an intense recovery ahead of them.
25:38If you could come home, I would.
25:44I'm trying to do my job.
25:46I'm trying to do my job.
25:46At what cost?
25:47Joan, 60 milligrams.
25:49At that rate, you will flame out in weeks.
25:51That's my choice.
25:52Does Javi know what you're doing?
25:54I'm not killing myself, Amy.
25:56I am trying to make the most of the time I have left.
25:59And he would respect that.
26:02Well, what does Ethan think?
26:04I don't know.
26:06He doesn't know?
26:07He doesn't return my calls.
26:08What?
26:09How long have things been like that?
26:11I think you've dredged up enough bad memories for one day.
26:14And if you'll excuse me, I have a patient who needs me.
26:19Just...
26:20What do we got?
26:21Uh, granulomas in the liver, kidney, adrenals, bowel.
26:25They're everywhere.
26:32Tell the on-call surgeons to drop what they're doing and meet us in the O.R.
26:36We're going to need all the hands we can get.
26:38I commend you, my dear brother, to Almighty God,
26:42and entrust you to your creator.
26:45May you return to him who made you from the dust of the earth.
26:49May Holy Mary, the angels, and all the saints come to greet you.
26:53I am so sorry, Mrs. Voight.
26:59I never should have let him go through with this.
27:03Excuse me.
27:17You care to explain how this went so wrong?
27:22We tried cartoon.
27:23I read the report.
27:24I know what was attempted.
27:25I'm wondering how that was allowed to happen.
27:26You'd have to ask the CEO about that.
27:29He was pushing medical decisions.
27:32We could have used you here.
27:36So what are you proposing now?
27:38I'm thinking IL-6 blockers.
27:41The COVID treatment?
27:42CAR-T triggers a similar inflammatory cascade.
27:45And I don't think that the standard protocol will get the inflammation under control.
27:50He's been right all along.
27:54We should follow his lead.
28:00You're patient, you're call.
28:04Okay, okay, okay.
28:06Our Thailand trip, you got booted off the karaoke stage.
28:08Bohemian Rhapsody.
28:09Yes, it's a...
28:13And for the record, it wasn't my performance that people hated.
28:16It was just that that song is too long.
28:30Diane?
28:33I can't let you do it.
28:34I can't let you do it.
28:46It's negative.
28:47I don't have cancer.
28:49You don't have cancer?
29:04Saddle up, everyone.
29:06For the next 11 hours, we're doing an ex vivo.
29:10That's right.
29:11The thing you learned about in med school but never thought you'd actually do.
29:15We're removing every damaged organ, repairing it, and then putting it back where we found it.
29:20We'll run two full operating fields side by side.
29:24My team will be the one removing organs and keeping Javi alive.
29:27That means controlling bleeding, managing perfusion, oxygenating his heart and brain.
29:32Team two is on ex vivo work.
29:35When we pass off an organ, you strip the granulomas and adhesions, repair what you can, then it comes straight
29:43back to us in working order.
29:46Precision is everything.
29:47We lose focus.
29:48We lose an organ.
29:50We lose an organ.
29:51We lose the man.
29:56No mistakes.
29:58Let's go.
30:00God, I cannot believe I'm seeing this.
30:02All right, I brought nourishments.
30:03Yeah, great.
30:05Thanks.
30:07Did she just do a rapid order to reconstruct on the fly?
30:11Yeah.
30:12It's unreal.
30:13She's a friggin' rock star.
30:14She's something, that's for sure.
30:17You wonder why I didn't want to tell you.
30:19Look, the way she's managing everyone, she's like a maestro.
30:23Okay, so what exactly is her endgame here?
30:25Is she just going to keep operating until she drops?
30:27I can't believe what she's doing to herself.
30:30I know that you don't want to go by on her back, but I don't think she's really leaving as
30:33many options here.
30:35Just give me a couple hours.
30:37Until the end of the day.
30:47Ethan, it's Amy.
30:50Give me a call back when you can.
30:52There's something going on with your mom.
30:55Okay, liver's coming out.
30:58Sub-hepetic space is clear.
30:59Put a retractor in there, Carol.
31:01Sponge.
31:04Okay.
31:08That granuloma's wrapped around the inferior vena cava.
31:11We can clamp, take it out, then reconstruct with Dacron graft?
31:14No, we've made enough compromises today.
31:16I'll dissect it off the wall, leave the vein intact, Scalpel.
31:20Uh, isn't it safer to do a graft?
31:23One slip and he could bleed out in seconds.
31:25I know.
31:26I wrote that chapter in your vascular surgery textbook.
31:29Suction, Dr. Matra.
31:32Clamp ready in case it goes south.
31:47Mets.
31:49I'm securing the vena cava now.
31:51Dr. Matra, get that lump out of my hair, please.
31:58You know what they say about me.
32:01Hands of stone.
32:08Hi.
32:09Hi.
32:10What are you doing here, Mom?
32:12I wanted to check on Robbie.
32:13I came as soon as I could.
32:15Well, we both know that's not true.
32:17Okay, okay.
32:18I came as soon as I could responsibly leave.
32:21And why is it you feel a greater sense of responsibility to a group of strangers than your own family?
32:26Robbie was fine.
32:27He didn't need...
32:28No, I needed you.
32:32You know, for once, I actually let myself believe that you'd be here.
32:35I was on my way.
32:37And then we got the call.
32:39Fighting broke out in sake.
32:40We were inundated.
32:42It's always something, Mom.
32:47And what would you have me do?
32:49Let those people die so I can come and hold your hand?
32:52No, you're right.
32:52No, you had to do what you thought was right.
32:55And now I have to do the same.
32:56So, you know what?
32:58I'm done.
32:59What does that mean, you're done?
33:01That means I'm just...
33:02I'm done.
33:03You know, at some point, I only have myself to blame for letting you disappoint me.
33:12If you can't see, I made the only choice I could in that moment.
33:16Then I didn't raise the man I thought.
33:22You barely raised me at all.
33:40Welcome back.
33:43Must have been a close one.
33:45Turns out your Addison's was a symptom of indolent TB.
33:51You had a lesion on your adrenal gland.
33:54Along with 14 others.
33:55But we cleared the damage and you'll make a full recovery.
34:00What's the...
34:01So, no more Addison's?
34:04No more Addison's.
34:10You saved my life.
34:13I wish there were more I could do for you.
34:15Are you kidding?
34:17That was a career-making surgery you begged me.
34:20I'm going to live forever in these halls.
34:25So, um...
34:27When can I get back out there?
34:29Well, in the last 12 hours, most of your organs have been outside your body.
34:33So, maybe you want to give it a few weeks.
34:38Hey, we go where we're needed, right?
34:40And it will help you, right?
34:42And it will help you, right?
34:43It would be why it was disaster.
34:45I try not to panic.
34:49In a mirror, I'm fine, but inside all the glass in me shattered.
34:53You know what kills me the most.
34:55I still got nothing but love for you.
34:58Love for you.
35:00Love for you.
35:02You know what kills me the most.
35:04Hi, stranger.
35:05I still got nothing but love for you.
35:27Unfortunately, the CAR-T hit you harder than your cancer.
35:31We've retested your blood, and your small cell tumor markers only dropped 3%.
35:35Meaning it didn't make a dent.
35:38Right.
35:40Well then, what's next?
35:43We're back where we started.
35:46Chemo and molecular therapy.
35:48So you're right.
35:49My yes-men almost killed me for nothing.
35:53I'm just glad you're still here.
35:55I'll be dead by the end of the year.
35:57I'm sorry, but there's plenty you can do with the time you have left.
36:01No, I won't slowly degenerate.
36:03If you can't cure me, I will wait.
36:06Xander, no.
36:07What better time to do it than now?
36:08I'm sorry, what are we talking about?
36:10There's a Swiss cryogenics company that will freeze me until further notice.
36:13When there's a cure for this in 10, 20, 30 years, I'll be first in line.
36:17If they find a way to reverse the freezing process.
36:21We can do it with embryos.
36:23It's only a matter of time, and I won't exactly be in a rush.
36:35She knew who she married, and I still have way too much to do in this world.
36:41The man needs a psych consult.
36:43We should put him on a 72-hour hold.
36:45On what grounds?
36:46He's not depressed or pathological.
36:48He's got a God complex.
36:51And I flew too close to the sun.
36:54CEO is watching.
36:55You got a billionaire setting you up to be a hero.
36:58You got carried away.
36:59You're right.
37:01Sorry.
37:03I know you think I don't have a leg to stand on here, but what happened with Mr. Voight was
37:08unethical.
37:09And there isn't always going to be someone more senior around to push back.
37:13You're not a rookie anymore, TJ.
37:16Time to start acting like it.
37:25Hey.
37:27Oh, hey.
37:31So, I need to tell you where I was yesterday.
37:35Okay.
37:37Rachel had a mammogram, and they found a mass.
37:40Oh, no.
37:41Is she okay?
37:42Yeah, yeah, she's fine now.
37:44The biopsy results finally came back negative, but the past week has been kind of tough, so I just, I
37:49wanted to be there for her.
37:51So that's why you left early?
37:54Yeah, yeah, she was spiraling.
37:57And that patient you were with in radiology last week, when you, you didn't want to talk, that, that, that
38:03was her?
38:05She asked me not to tell anyone.
38:07Um, when I see the look on your face, and clearly I, I went about this all wrong.
38:14No, you, you were in a tough spot.
38:16I'm, I'm just glad she's okay.
38:19Yeah?
38:20Yeah.
38:22Yeah.
38:28Okay.
38:31It was pretty sneaky, you calling Ethan.
38:36Dare I ask how it went?
38:39Well, uh, we have a lot to clean up, but he's here, so thank you.
38:49There's one thing this year has taught me.
38:52It's that family finds a way to forgive.
38:56Let's hope.
39:00He certainly thinks I have a lot to answer for.
39:06We need to figure out what you're going to do, Joan.
39:10Oh, I know what I'm going to do.
39:14I didn't think it could get any worse than being schooled by Richard Miller and knowing he was right.
39:19Try this.
39:21I spent all of last week trying to sideline Dr. Ridley, and the second she asked me to scrub in
39:26for a big operation, I leap at the chance.
39:30So we're hypocrites?
39:31Or maybe we're just doing the best we can in a job that has a lot of gray areas.
39:38Maybe we are.
39:41So, want to give our date another shot?
39:44Dinner?
39:46That Italian place on the corner?
39:49Or we could just go to mine.
39:51For dinner?
39:53That too.
40:07Dr. Ridley would like all of internal medicine to report to the office for an all-hands.
40:16Excuse me.
40:20Any idea what this is about?
40:22Uh, no, no idea, but I guess we're about to find out.
40:36Wow.
40:37That was fast.
40:39Am I that scary?
40:40Yes!
40:44This is not a conversation I ever wanted to have, so...
40:51Forgive me if I'm not exactly sure where to start.
40:56I know there's been concern about my health, and I truly appreciate it.
41:03And it turns out it was warranted.
41:08I have MDS.
41:09It's advanced.
41:11And it's time for me to accept that...
41:14It's not something I can outrun.
41:19So...
41:22Last night...
41:24Will be my final surgery.
41:29And next week will be my last as your chief.
41:37I've spoken to Dr. Hamda, and he has agreed to facilitate a smooth transition.
41:43And never fear.
41:45You will all receive your long-awaited evaluations before I go.
41:50I like to think, um...
41:53That I...
41:54I still have some wisdom...
41:58To impart on the next generation.
42:02Even you, Peter.
42:06So, um...
42:08As my friend reminded me today...
42:11Um...
42:12We go where we're needed.
42:14And right now, there are more important places for me to be than inside an O.R. or behind a
42:21desk.
42:25Being a doctor...
42:28Has been the privilege of my life.
42:33Being your chief...
42:37Has meant more to me than I expected.
42:47All of you.
42:53And I'll see you tomorrow.
43:24And I'll see you tomorrow.
Comments