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00:00Dr. Larsen was in a car accident.
00:02She has no recollection of the last eight years.
00:04Previously on Doc.
00:06Let me run internal medicine.
00:07Back to your roots.
00:08When you need time to work out things with Michael, I accept it.
00:11But when the shoe's on the other foot...
00:12When the shoe's on the other foot, you have a hard time telling me the truth.
00:15Delayed decisions on his care have been hurting him a long time.
00:18You don't have to tell me the system's broken.
00:20How much prednisone does it take to get you through a shift?
00:23You will flame out in weeks.
00:25It's time for you to use your greatness to pull the greatness out of others.
00:29I'm gonna miss you.
00:42Sorry.
00:43This guy loves his sleep.
00:45Oh, there he is.
00:47Hey, can I have a hug?
00:50Oh, my goodness.
00:51This is yummy.
00:52Ethan was sorry to miss you.
00:53He had a really early meeting.
00:55Well, Robbie's the main event, right?
00:56What fabulous holiday have they canceled school for this time?
01:00It's Lunar New Year.
01:01Oh, well.
01:04Grandma's been all over the world.
01:06You know, she can probably teach you how to say hello in 50 different languages.
01:0967, but who's counting?
01:11I should be back around 6.
01:13Thanks so much for doing this.
01:14Are you kidding?
01:15The more time I get to spend with this little man, the better.
01:17Oh, I brought you donuts.
01:19Your dad said they're your favorite.
01:20Thanks, Grandma.
01:28John, you okay?
01:30I'm fine.
01:35Robbie, why don't you go upstairs?
01:37Oh, my God.
01:39Grandma!
01:39John?
01:40Oh, this is Grandma!
01:42Oh, this is Grandma!
02:07Good morning, everyone.
02:08Good morning.
02:09Good morning.
02:10This is going to be an adjustment for all of us.
02:13Dr. Ridley certainly left some big shoes to fill.
02:15And I know all these leadership changes the past year have probably been unsteadying.
02:21There are a lot of reasons why I wanted to practice medicine again.
02:26But I want to be very clear about the reason I asked to sit in that chair.
02:31The past year, as your CMO, I have seen what every person standing in this room is capable of.
02:37Dr. Miller?
02:38Time and again, you have risen to the occasion.
02:41We have a 62-year-old female in respiratory failure, complications from chronic MDS.
02:45I'm on my way down.
02:46I'm not here just to lead you.
02:49I want to join you and help you do what you already do so well.
02:53An issue, a problem, a suggestion, my door will always be open.
02:59Before we go, some congratulations are in order.
03:03In two weeks, Dr. Matra and Dr. Larson will succeed Dr. Heller as chief resident.
03:09As we welcome our new class of interns.
03:15Now, if you both could hang back for a moment with Dr. Heller, the rest of you, do good work.
03:25I'd like our co-chiefs to shadow you before you start your pediatric fellowship.
03:29You can begin with Dr. Matra this morning and then alternate days?
03:33Yeah, sounds like a plan.
03:34Great.
03:38It's quite a move.
03:40Well, it was either this or a leather jacket and a motorcycle.
03:51Joan's in the ER.
03:53Paramedics said she was extremely short of breath, likely bilateral pleural effusions.
03:57So is she hypoxic?
04:00Oxygenation's improved on the mask, but she's hypotensive.
04:03Let's push norepimab goal above 65.
04:05No, Richard, that's not gonna work.
04:07I'm sorry?
04:08She's on prednisone.
04:0930 milligrams and she's tapered off. I read her chart.
04:11No, her chart's wrong. She's on way more than that.
04:15I've been using it to get through a surgery.
04:19You knew about this.
04:22How much has she been taking?
04:26Double that.
04:30Triple to get through the X.
04:33Vivo with Javi.
04:35My natural cortisol reduction's got me shot.
04:40Okay, Lucy, a hundred milligram bolus of hydrocortisone before pressers and run a complete lab workout.
04:48We're all here if you need anything, Joan.
04:54Should I call Ethan?
04:57He's on his way.
05:00Amy, I need you to remember who I am.
05:04A deonor.
05:05Joan, no. We're nowhere near that.
05:18Good morning, Dr. Walker.
05:20Good morning to you, Walter. How's our rocket holding up?
05:24Can't wait to launch it.
05:25You think I can still leave today?
05:27Got to examine you first. Can't let you out of here until we're sure you're all better.
05:31I really want to show the rocket to the kids at the house.
05:34I bet.
05:35Looks like that thing might actually make it to space.
05:37Do you ever launch rockets with your kids?
05:39I don't have any.
05:41Really?
05:42I thought about it when I was younger, but decided to take a different path.
05:46What do you mean?
05:47Well, being a parent's a big commitment.
05:49But that's also true for being a friend, a sister, an aunt, especially a doctor.
05:54Eventually, I figured if I gave my best to all those other things, that'd be enough for me.
06:00You're a great doctor.
06:01Mm-hmm.
06:02That she is, buddy.
06:04Sorry I'm late. How's he doing?
06:05Well, breathing's much better. Let's look at those knees.
06:11Oh.
06:13How long has your leg been moving like that?
06:14It happens all the time with Myra.
06:16Shouldn't be now with the medication you're on.
06:18Yeah, I'll order a CT.
06:19Well, that's bad.
06:20Just need to see what's going on. We'll get it sorted out, though.
06:24It's time to find your social worker.
06:26Again?
06:28Atalanto actual instability this severe will progress fast.
06:31We have to operate now.
06:33We don't have the go-ahead from his proxy.
06:34Well, his C1 and C2 are compressing his spinal cord.
06:36What's everybody waiting for?
06:38The social worker said he'd sign off on whatever we decide, but he doesn't want to get in the weeds.
06:43Well, that makes things tricky, because we have two surgical routes.
06:46High risk, high reward. Open the neck, expose the vertebrae, place the corrective hardware directly.
06:51But you're concerned about arterial or spinal cord trauma.
06:53Not to mention stroke, infection, ventral cord damage.
06:56Plus, he's still recovering from lung inflammation.
06:59Definitely a concern.
07:00And the second option is minimally invasive fusion.
07:02Far less trauma and easier recovery.
07:04But wouldn't we be relying on CT for navigation, which means less precision with the hardware?
07:08Yeah. It may require going back in in six months or a year.
07:11And there's a higher chance for a screw misplacement.
07:13At the C1, C2 spinal cord, that could be severe.
07:16Both have risks.
07:18It's your call, Gina.
07:28Do the minimally invasive fusion.
07:30I'll go explain to Walter.
07:36So...
07:38I've got full-blown leukemia.
07:41Missy.
07:45My belief is that the steroids artificially raised your white blood cell count, hiding the degree of marrow infiltration.
07:53And I spoke to Dr. Rose, and he agrees.
07:56Now, if this goes unchecked, your decline will be rapid.
07:59So we'd like to start induction chemotherapy, which could buy you a few extra months.
08:04This shows a pan-psychopenic picture without any sign of leukocytosis.
08:08Yes.
08:09As I just said, the steroids are complicating things.
08:11Her leukemia has an atypical presentation, but we need to act fast before it progresses.
08:17Or her presentation is atypical because it's not leukemia.
08:21Amy.
08:21Her counts are dropping across every line.
08:24That looks like marrow failure, not marrow takeover.
08:27You're reading too much into the blast count.
08:28No.
08:29I'm looking at the facts in front of us.
08:31She doesn't show cancer on the peripheral smear.
08:34If this is pan-psychopenia, we could give platelets and plasma to raise her levels.
08:38Blast proliferation and dysplasia are textbook signs of leukemia.
08:42And delaying treatment because of wishful thinking will cost you significant time.
08:47Or if he's wrong, the chemo will damage all your organs.
08:51I believe this is Joan's decision.
08:58Start the chemo.
09:02I'll put the orders in.
09:09You're brilliant, Amy, and I know you don't want this to be true, but...
09:15I can't...
09:16I can't lose any more time with my family.
09:23Yeah.
09:32Mom, any soreness in the incision?
09:34Oh, it was a routine surgery. I'm fine.
09:37Where's John?
09:39He's here.
09:40Having a smoke.
09:41Surprised you didn't go with him.
09:44Believe me, if I thought I could get away with it.
09:46Not on my watch.
09:47Oh, I know.
09:48Dr. Larson.
09:50Not yet.
09:51Mom.
09:52Speaking of which, you should get back to Minneapolis.
09:54No, it's fine.
09:55Dr. Ridley is away for a couple weeks, so I finally get a little bit of breathing room.
09:59Who's that?
10:00I've mentioned her, like, six times.
10:03Genius surgeon.
10:04Doctors without borders.
10:05Utterly terrifying.
10:07Oh, right.
10:08Her.
10:08Everyone wants her to be their mentor, but she travels around so much, I don't think she ever slows down
10:13enough to do that.
10:14What do you even need a mentor for?
10:16You want something, you get it.
10:18I've always been that way.
10:19Barely even needed to push you.
10:20Well, there were times I could have used some pushing.
10:27Amy.
10:28Hey.
10:29Hey.
10:29Hi.
10:30I got here as fast as I could.
10:32She's stable now.
10:33Ooh.
10:34She's pretty drowsy from the chemo meds.
10:37Right.
10:38Okay.
10:41Amy.
10:43Joan's coag panels came back?
10:45Yeah.
10:46She has DIC.
10:48If we had pushed platelets like you wanted, the runaway clotting could have caused a massive stroke.
10:55I know how hard this is for you.
10:57But you're going to have to let me do my job.
11:04Ethan.
11:05Dr. Miller.
11:06Hey.
11:07It's good to meet you.
11:14So, rounds are done.
11:15What's next?
11:16Uh, well, your partner in crime is sitting vigil for a friend in the ICU.
11:20Have you checked in on her?
11:20I didn't want to invade her space.
11:24It's always better to extend yourself.
11:25Trust me.
11:26She's going to let you know if it's unwanted.
11:27I'm sure she will.
11:29So, as chief president, you've got to be able to work with anyone.
11:32Is there anybody else?
11:33Anything you've got to get ahead of?
11:34I don't know if you ever noticed, but Liz kind of had a thing for TJ.
11:39Yeah.
11:39She wasn't exactly subtle about it.
11:41Why?
11:41What's the problem?
11:45So, you and TJ?
11:48Wow.
11:49Okay.
11:49Um, I guess I missed that.
11:51How long has that been going on?
11:52Not very.
11:52And you, of all people, don't get to judge.
11:55I'm just not sure how everyone else will react.
11:57Well, listen.
11:58I mean, you can't control how people feel about you.
12:00Okay?
12:00All you can do is show everyone that you're going to be there for them when things get tough.
12:06Uh, Dr. Hamda, do you have a minute?
12:08Of course.
12:09Yeah.
12:09Come in.
12:10Have a seat.
12:15Um, I know I should have said something sooner.
12:18I think I was just too afraid that no one was going to take me seriously.
12:22It's okay, Liz.
12:24What is it?
12:26Dr. Miller, what he did to me.
12:30Everyone's just pretending like nothing happened, but it was an abuse of power.
12:36I appreciate your honesty, and I understand how you feel.
12:41Not how I feel.
12:43It's what happened.
12:46Nobody condones what Dr. Miller did, but an agreement was reached.
12:51What agreement?
12:52I'm afraid I can't discuss it.
12:53So you won't tell me what happened?
12:57It was a confidential settlement.
13:00I'm sorry, Liz.
13:03I guess this just proves why I never should have bothered coming forward in the first place.
13:16CT confirms location. We're clear of the vertebral artery.
13:19Advancing cannula into position.
13:26Hey, babe.
13:28Okay, so I nearly had to sell my body for it, but Spoon and Stable finally called me back.
13:34They had a cancellation?
13:35I told them it was our anniversary, and they said they could squeeze us in at six.
13:40Can you make that work?
13:41Oh, looks like I'm going to have to. No way we're missing out on those oysters.
13:45Bo, there's a chance I may need to swing back here.
13:48Oh, no. Is it that boy you told me about?
13:52Found a pretty serious issue with his spine. He's in surgery now.
13:55Oh, honey, that's terrible.
13:57Are the social workers being helpful?
13:59Not really.
14:00I had to make the decision myself about what surgery he should have.
14:03Okay, I know it's not my lane, and I love you for being a person who cares this much.
14:08But the last time you got this invested in a cave...
14:12He has no one, Wendy. I have no choice.
14:18Well, she told me about the prednisone.
14:20Said I landed her here a lot sooner than she would have otherwise.
14:23Yeah. She is strong-willed. That's what we love about her.
14:29She probably felt like she had no choice.
14:32You know, I...
14:33After I told her I didn't want to see her,
14:36what else did she have besides work?
14:38And how Robbie and me didn't even get to know her.
14:41She knew that making things right with you was on her.
14:45Not you.
14:47All you can do now is be there for each other.
15:15What did you do?
15:18She was fine.
15:19She was just fine an hour ago.
15:22What did you do?
15:23It's not their fault.
15:24She had a heart attack.
15:25Nobody could have seen this coming.
15:32Amy.
15:34Uh, how's Joan doing?
15:37Uh, she's still stable for now.
15:39Mom came home.
15:41I'm sure this must be hard for you.
15:43If there's anything I can do...
15:44Something's escalating in there.
15:49Your temperature's dropping.
15:51Yeah, core temp can drop after starting chemotherapy.
15:53It's normal.
15:54But it can also be a sign of sepsis.
15:56No, all of her cultures were negative.
16:00Is that true?
16:01Yes, of course that's true.
16:03And you should know that Dr. Larson recommended a course of treatment earlier
16:08that could have been catastrophic for your mother.
16:10So, I don't think that it is a good idea for friends to treat each other.
16:19I admire your mom, but I can be objective.
16:21And that's what she needs.
16:26He's right.
16:28I'm sorry, Ethan.
16:34Yeah, we should have some extra.
16:36Can you run a beta-D glucan?
16:38Her cultures came back negative.
16:39What are you looking for?
16:40I want to rule out an invasive fungal infection.
16:43Something in the endothelial tissue.
16:45You got it.
16:47And, uh, when you're done, could you get me the results?
16:50Directly?
16:51It says Dr. Miller's assigned.
16:53He is.
16:55I need this, Karen.
16:58Please.
17:00Sure.
17:03Hey, how's it going?
17:04Hey, I'm at the school.
17:06Apparently, Nia got into a fight.
17:09Let me guess with Logan.
17:10I haven't had a chance to talk to her about it, but figured we should do it together.
17:14Can I bring her by the hospital?
17:15Shouldn't take too long.
17:16Yeah, yeah, of course.
17:17Um, yeah.
17:18I'm here.
17:25She killed herself, Gina.
17:28All those times I begged her to quit smoking.
17:30Her blood pressure was through the roof.
17:33It was only a matter of time.
17:35You can't keep fixating on what could have gone differently.
17:38Okay?
17:38All you can do now is start to process your pain.
17:41What makes you think I haven't?
17:42It's been a week and a half.
17:44You still haven't cried.
17:46Crying won't fix anything.
17:48I'm not saying force it, okay?
17:50But just let yourself feel.
17:53This is only going to get worse once you're an actual shrink, isn't it?
17:56That's neuropsychiatrist, thank you very much.
18:00I just need to focus on school.
18:02And maybe that hot bartender from Stanton.
18:06I'm serious, Amy.
18:08You're in grief.
18:09And you're mad at your mom.
18:11You can't just push all that away.
18:12Why not?
18:13Because when it comes to feelings, the piper has to get paid.
18:17One way or another.
18:27Hey.
18:28Just checking on you.
18:29Joan's BP and O2 sets are improving.
18:31Chemo must be having an effect.
18:33So I guess Richard was right about the leukemia.
18:36At least we have a diagnosis.
18:37Where are you?
18:39I'm in radiology with another patient.
18:42I'll be back soon.
18:43Okay.
18:46We won't be mad, honey.
18:48We just want you to tell us what happened.
18:51Look at most of the markers at me.
18:53I thought we said when he did stuff like that you would tell the teacher.
18:56It did, but it didn't stop.
18:59So I took my chocolate pudding and I jumped it on his head.
19:06Um, so what happened?
19:09You told the teacher and they didn't do anything about it?
19:11They had him sit in the big chair.
19:12What's the big chair?
19:13It's a big comfy chair in the corner where you sit and think about what you did.
19:19So like a time out?
19:21Okay, but last week when you won the spelling bee you said you got to sit in a big comfy
19:25chair.
19:26Yeah.
19:26You sit in it if you do something good.
19:29But then sometimes you sit in it if you do something bad.
19:36I want her out of that school, Rach.
19:37Okay?
19:38There's the public school.
19:39There's the Hebrew school we toured.
19:40I don't care which one.
19:41I just think that she needs to be somewhere with more boundaries and grit
19:44and fewer participation trophies and big chairs.
19:47Okay.
19:49Okay what?
19:50Okay, you're right.
19:52I'm wrong.
19:53Let's move her.
19:54What?
19:54Hold on.
19:55Did you just tell me I was right about something?
19:59And if you play your cards right, it might even happen again.
20:04I'll take her home.
20:06Yeah.
20:07Yeah.
20:16Are you alright?
20:21Yeah.
20:25I'm just realizing how little power I have here.
20:33What happened?
20:37There's nothing to be done about it, Sonia.
20:40No, no, no.
20:40I'm going to be chief resident, which means I can advocate.
20:53And this is unprofessional.
20:55You were never going to test for this, Richard, and it's positive.
20:59You were not going to listen to me.
21:00Well, that was my call to make you.
21:01And it's positive.
21:01You want to tell me what's going on here?
21:02She ran a test behind my back.
21:04That is hardly the headline here.
21:06Joan has a candida organ infection, which he wouldn't have caught.
21:09I'm assuming you're interested in treating this, even though I was the one who found it.
21:14All right, all right.
21:15That's enough.
21:16Clearly the chemo lowered her immune response.
21:18Decrease the dosage for now and treat the infection.
21:20But we are still on the right path here.
21:25You know, I might be more inclined to hear you if you weren't so concerned with putting me in my
21:31place.
21:35He was never going to order the panel out of spite.
21:38If you needed backup.
21:40Which is it, Michael?
21:41I'm supposed to come to you because you want to help?
21:43Or I'm not supposed to come to you because I put you in a tough position?
21:47Because I've heard it both ways.
21:48I am chief now of your department.
21:50That's a lot different than running two floors up to talk to the CMO.
21:53And by the way, you lied.
21:55Told me you were in radiology on our first day working together.
22:02You're right.
22:03I'm sorry.
22:06I'm, I'm, uh, every time I look at Joan in that bed, all I see is...
22:13Your mom.
22:18I wish you'd been there for that.
22:21I'm here now.
22:23I know.
22:25Try to hold on to that.
22:31I think he's waking up.
22:33Walter, can you hear me?
22:34It hurts.
22:35Please, it hurts.
22:36Blood pressure spiking.
22:38Walter, try to breathe.
22:39My neck.
22:39It hurts so bad.
22:40Two milligrams IV working steps.
22:42Where in the neck?
22:43Why can't I move my hands?
22:44What's happening?
22:45It's okay, Walter.
22:46That can sometimes happen with swelling.
22:49He lost his Babinski.
22:52So the spinal cord's not sending a signal.
22:54Costa's running a CT to confirm, but it seems the cord swelling is causing compression.
22:58He's on morphine for the pain, but he's got serious neurological deficits.
23:02No movement below the neck.
23:03The sooner we can get back in and operate, the better.
23:05But his lungs are still inflamed from the RA.
23:08He may not be able to take another round of anesthesia.
23:10Dr. Costa's booked an offer first thing in the morning.
23:12Anything longer than that, then he could have serious neurological issues permanently.
23:16We should have been more aggressive.
23:17We can't Monday morning quarterback.
23:18The surgeon gave you two choices.
23:20And I picked the safer one because I was worried Walter doesn't have the long-term support to go for
23:24what was really needed.
23:25It was a coin toss, Gina.
23:27No, it wasn't.
23:27You wanted to go for the other option.
23:29But Costa waffled.
23:30It should not have been up to you.
23:31No, it shouldn't have been.
23:32So let me take this off your plate now.
23:34Tell Costa I want Walter in reverse Trendelenburg during the operation.
23:38And to use lung protective ventilation with low tidal volume.
23:45He may never walk again, Michael.
23:51Induction chemo did a number on me.
23:54Well, you're almost through the first dose.
23:56We found an invasive fungal infection, presumptive candida.
23:59We're treating it with antifungals.
24:03Candida must have seeded in my liver.
24:06No, well, not the liver.
24:08It's likely diffuse endothelial, given the high beta-D-glucan level.
24:12Did you finish your homework?
24:15Is your father, is your father home yet?
24:18Mom?
24:18Joan, look at me.
24:19Hey, what's wrong with her?
24:20Ethan, step back.
24:24What's happening?
24:25She sees it.
24:26Oxygen at 10 meters.
24:28Alternative mental status?
24:29It's gotta be neurological.
24:31Increased ICP, her brain is swelling.
24:33If she had leukemia, this wouldn't be happening.
24:34Not this fast.
24:35You're right.
24:36We're missing something.
24:41Oh, whatever decisions were made about bringing Dr. Miller back are way above my pay grade,
24:46but we can't just ask Liz to forget what happened, because it'll make life easier for everyone else.
24:50I'm going to talk to Richard once Joan is stabilized.
24:53I'm sure he'll be willing to apologize to Liz.
24:56His apology is going to be hollow and meaningless.
25:00And you should know when Dr. Miller was chief, he tried to use me to find out mistakes Amy was
25:05making.
25:06Look, I'm sorry you ended up in the middle of that, but I know the board.
25:12They'd rather find a way to get rid of Liz than reopen this can of worms.
25:15Well, they can try, but if Liz starts talking, they're going to get blowback from the nurses and potentially the
25:21union.
25:22Is that a threat?
25:24It's a reality.
25:25I'm just trying to do the right thing for her and protect the department, which is part of my job
25:30now.
25:31She bears responsibility for her own decisions, Sonia.
25:34As you said, she has a very strong union she could have gone to when all this happened.
25:37I think maybe you're expecting too much or not understanding the dynamic between an older man with power and a
25:45young woman at the start of her career.
25:46It's blaming the victim and I don't think it'll be appreciated.
25:50I do hear you.
25:51Well, good.
25:54Because you started the day by saying your door was open, but now it seems like you're closing it on
25:59Liz.
26:06The MDS is late stage, but it's obscured by high steroid usage, pancytopenia, pleural effusions, DIC, elevated beta-D-glucan,
26:16and now cerebral edema.
26:18And she's getting worse.
26:20Hey, just checked in on Joan. How are you holding up?
26:23I've been going toe-to-toe with Richard all day, and now we're running out of time.
26:27Who's this?
26:28He's a doctor in Madrid who has a case study that might be relevant.
26:33And this translation app keeps glitching.
26:36I mean, I minored in Spanish. We can see how rusty I am.
26:39Okay.
27:16So what he's saying is that the symptoms were similar, but his patient had dormant sarcoidosis, so that was complicating
27:23the clinical picture, but once they found that, everything else just fell into place.
27:25So a patient with MDS like Joan presented with these symptoms because of a different chronic issue?
27:32And it went undetected for years.
27:34Okay. Okay. Thanks.
27:36Just remember, you've got to find a way to work with Richard on this.
27:42Your spinal tap came back negative and a full neuropanel tube.
27:45Well, her procalcitonin is low, even though she just had an infection.
27:50I need total protein, C-reactive protein, and complement levels. How fast can you do that?
27:5520 minutes.
27:55And if the results could go to me, since I'm her doctor, that'd be appreciated.
28:02We've got a high complement protein level, and the prednisone must have dropped her immune surveillance, which means that we're
28:09looking for something that's been there, possibly for years, like you said, that's been hiding in plain sight.
28:14When Joan woke up and I told her about the candidate, she asked if it's seated in her liver.
28:19Well, that wouldn't be uncommon, but the beta-D-glucan is so high that the fungal load would be too
28:23large to be isolated to her liver.
28:25Okay, we've been assuming that the elevated liver enzymes are caused by the MDS and the prednisone, but look at
28:32her blood work going back to 2016.
28:36Higher range of normal.
28:38But low enough that nobody would flag it.
28:402016.
28:42It's a long time for her to be carrying something.
28:45Wait a minute. One of my last memories of her, 2016, she was in Ecuador, and she got sick, and
28:52I told her that she should come back.
28:54And she self-diagnosed. She thought it was dysentery.
29:00Which means that she was drinking unfiltered water.
29:02So, if it was a parasite, she could have been sick while she was digesting it, but by the time
29:07it migrated to her liver, she was fine.
29:09And she could have been fighting this quietly for years.
29:12And then the prednisone weakened her immune system and unleashed it on her.
29:18I think we have a path now.
29:22He's losing sympathetic tone.
29:24Surgery's set for 6am. Can we up the steroids?
29:28I'm too worried about his blood pressure.
29:29I think we just have to stay the course and hope that he's strong enough to hold on.
29:34I appreciate what you said before, trying to let me off the hook.
29:40You religious at all?
29:41From time to time, depending on how I'm feeling about the world.
29:46I remember going to this sermon once.
29:49The minister was talking about how it can be a form of hubris to think that we can control things
29:55that are out of our control.
29:58Because that's somebody else's domain?
30:01Doesn't mean it's easy to accept it, but I think that's the idea. Yeah.
30:06I'll take that under advisement, Dr. Coleman.
30:09Good.
30:14Your wife's here.
30:19It's my anniversary and I forgot.
30:21You go. I am all over this. Hourly exams. I will not go home.
30:31I've been downstairs 15 minutes. Try calling you.
30:34I'm sorry. There were problems with Walter's surgery. He needs another one tomorrow.
30:39Why don't we have dinner in your office tonight?
30:42And that way, if anything happens, you're close.
30:46What did I do to deserve you?
30:48I don't know. I'm sure you'll find a way to make it up to me.
30:53I'm thinking 400 milligrams of endazole.
30:56I'd go 300, given the ALT, AST, and 20 of Amphobee to balance it out.
31:03And 100 milligrams of Cimetidine to cut the renal toxicity.
31:08It's a tightrope.
31:10Any idea where Liz is?
31:11Let's see.
31:13Code blue, ICU. Code blue, ICU.
31:16Joe's coding.
31:18Code blue, ICU. Code blue, ICU.
31:23No pulse.
31:24He's in V-fib. Push one milligram epi. Get the defibrillator.
31:37Ready?
31:40Clear.
31:45Restarting compressions.
31:55Danny, Danny.
31:57Someone call 9-1-1.
32:00Charge to 50.
32:02Clear.
32:09Wishing another milligram of epi?
32:18Find V-fib. We're losing him.
32:20Going up to 100.
32:21Give me the paddles.
32:27Ready.
32:28Clear.
32:39Looks like sinus.
32:40We have a pulse.
32:41He's back.
32:43Paige, Dr. Costa, we can't wait on the surgery.
33:08Cord is decompressed.
33:10Screws are seated.
33:12Let's secure the rods.
33:15Hey.
33:20That must have been really difficult for you.
33:23Yeah.
33:26And the hell of a first day for Michael.
33:29Oh, I hit pretty close to home.
33:33How's it going in there?
33:35Hardware's almost in place, but even if it works,
33:39no one's ever gonna adopt him.
33:41Not when he needs this kind of support.
33:46You're not thinking of doing something drastic.
33:51I'll be with Joan.
33:54Gina?
33:56I care about him.
33:59But I know what the boundaries are.
34:02Now go where you're needed.
34:19But you've gotta quit smoking.
34:21You know that's never gonna happen, honey.
34:27I don't know how much more we can pump into her before she starts shutting down.
34:32Her body's so fragile.
34:37Chemo didn't help with that.
34:39She was only on it for eight hours.
34:43The parasite is causing this, that, and the prednisone.
34:47It's not on you, Richard.
35:16So what I need to do, nine hard times.
35:26Hey, it's okay, buddy.
35:39Can I see?
35:44Oh, she's gonna love this.
35:50Is she gonna wake up soon?
35:52I really hope so.
36:07Hello?
36:08Hi, Amy. It's Dr. Ridley.
36:11Oh.
36:13Hi.
36:14I hope it's not 2 a.m. there.
36:15I stopped tracking time zone differences ages ago.
36:17No, it's noon. Is there a problem?
36:21I spoke with Dr. Kelly this morning. He told me about your mother.
36:25I'm just so sorry, Amy.
36:28Thank you, Dr. Ridley.
36:31I respect your tenacity already being back in the hospital, but I just wanted to make sure that you're taking
36:35care of yourself.
36:36I think so.
36:42It's been hard, obviously.
36:46Your world shifted on its axis, but you will come out the other side.
36:51I just didn't even think you liked me.
36:55Well, that's by design, my dear.
36:57And now you know the truth.
37:00Not only do I like you, I believe in you.
37:06So much.
37:08I...
37:08I know how bad this hurts right now.
37:10But the best way you can honor your mother is to live a life with purpose.
37:14You have greatness in you, Amy.
37:17And I'll be there to help you find it.
37:30Jo.
37:33Hey.
37:34Can you hear me?
37:36Can you get her son?
37:37He just went to get coffee.
37:40Hey.
37:41It's okay.
37:44Just go slow.
37:45Just breathe.
37:48What happened?
37:50You had cerebral edema.
37:53It's not leukemia.
37:56Not yet.
37:57You had a parasite in your liver from Ecuador.
38:02Do you remember that?
38:03You thought it was dysentery?
38:05Oh, my God.
38:08Is that the one time in my life I misdiagnosed?
38:19You haven't looked after yourself for a long time.
38:24I know.
38:26Promise me that stops now.
38:29Mom.
38:34Thanks so much, Amy.
38:38I'll order CBC and liver function tests.
38:44But the fact that she's conscious.
38:46Yeah, we got her some more time.
38:50I appreciate you finding a way to trust me today.
38:54Yeah, it worked out today.
38:57But I'm never going to trust you, Richard.
39:07Hey, Walter.
39:09Welcome back.
39:10Did you fix my spine?
39:12We'll need to run some tests over the next few days.
39:14But it seems that way.
39:17And I'll be able to walk again?
39:18Well, it's going to be a long recovery.
39:20Lots of physical therapy as your body adjusts to the hardware in your spine.
39:24But, yes, you will.
39:30And I'll have to miss the next adoption, Farrah?
39:34There'll be lots more.
39:36I promise.
39:37Thank you, Dr. Walker.
39:39Nobody ever killed the way you do.
39:45I am so sorry.
39:48It's okay.
39:49We'll do a rain check.
39:58Sometimes, I wonder how you manage to leave it all here when you come home.
40:04It can be really hard.
40:08Yeah.
40:19Let's go get a drink, huh?
40:21Yeah.
40:31Hey.
40:32So, I spoke to Liz.
40:34Told her if she wants to come forward to HR, we would both have her back.
40:40Oh, and I'm sorry if I was too...
40:42Sonia, speaking truth to power takes courage.
40:46I should be thanking you.
40:49Sorry.
40:49I didn't mean to interrupt.
40:51Oh, no.
40:51I was just leaving.
40:52Actually, I was hoping to speak to you.
40:58I just wanted to thank you for checking in earlier.
41:01Joan's improving.
41:02I heard.
41:03That's great news.
41:06So, are we going to do this thing together?
41:08Well, it's what she wants.
41:11She tends to get what she wants.
41:12Yeah.
41:18I saw Joan.
41:20She's spunky as ever.
41:22Can't keep that lady down.
41:25Amen to that.
41:26Yeah.
41:28Good night, Jake.
41:29Hey, good night, man.
41:37Hey, did you know about her, Ms. Sonia?
41:40What about them?
41:42No.
41:43Yeah.
41:43No.
41:45I guess we set a good example.
41:53They heard your family was here today.
41:55Yeah.
41:56Um, Mia, she got in trouble at school.
41:59It was, I don't know, I don't know.
42:00It was ridiculous.
42:03Maybe you can tell me all about it on the way home?
42:07Yeah, you think, Chief, I can do that.
42:12It's co-chief.
42:13Co-chief.
42:14I'm sorry.
42:15That's just so awkward to say.
42:16No, you don't.
42:18Tell me about it.
42:19Co-chief.
42:21Let's go on a walk.
42:22How have you been?
42:24Did that fancy college art school let you in?
42:30Well, damn it, they'd be crazy if they never saw you.
42:35What I failed to see at 17, I must have missed it too.
42:42Oh, kiss me, kiss me slowly, like you did when we were young.
42:52And hold me like you know me, like the old days take me home.
43:07Amy Larson, Dr. Ben Grant.
43:09I saw you speak in New York three years ago.
43:12Hold it!
43:13Get me out of here!
43:15I've never seen anything like it.
43:17We are going to figure this out.
43:19We have this under control.
43:21We don't.
43:23We tried everything we could.
43:25I'm so scared.
43:26I need to be tested.
43:28Start compressions.
43:32Amy, step back.
43:34Doc, two hour finale.
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