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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.
11:30No time.
11:31Easy.
11:32Maybe.
11:32Maybe.
11:34That was amazing, a piece of cake.
12:00Yeah, we're here with Amy now, she's checking his lungs.
12:03Stop, stop, I can't hear anything you're saying.
12:06I said you have to find someone with a better seat.
12:09Mom? Mom?
12:16So, the albuterol is working, but his oxygen is still low.
12:21If it drops any more...
12:23Don't tell me you have to intubate.
12:24Oh my God. No, we're not there yet.
12:26Let's just try to stay calm.
12:29I 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, don't defend her, Amy.
12:47Alright, please.
12:56Ethan.
13:07John?
13:08Yeah?
13:09You okay?
13:10I'm fine.
13:13I 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 lapse? Come back on 6-12.
13:36Okay, thanks.
13:37TSH.
13:37.
13:38.
13:39.
14:08All handled?
14:09Yeah. I 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. Thank you.
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. I'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. First, the family home. It'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 know what it means to you. And what about Katie?
15:00She's fine with it. She's off to college soon, and I think it's the least I can...
15:04Oh, God. Don't you dare be kind to me right now.
15:09What 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.
15:34I 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? Amy.
15:47Hey.
15:49I'm good.
15:51I...
15:52I 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. I 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. When 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.
16:52We 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 immunoresponse will almost certainly be catastrophic.
17:16There's a very good chance this treatment will kill you.
17:19By tomorrow.
17:20Or it could add years to his life.
17:21Team, some feedback would be nice.
17:25Give us a moment, please.
17:27I 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, but 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. And I gotta say, if you were anyone else, this hospital wouldn't even be considering this course of
18:12treatment.
18:12Mr. Voigt has an appetite for risk.
18:14An appetite for risk is one thing.
18:16This 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.
18:38But respectfully, I won't be a part of it.
18:52I, uh, I didn't mean what I said before.
18:57I 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.
19:17Why don't we give it a once-over?
19:23And focus.
19:25Ground yourself in the memory.
19:27What can you smell, hear, see?
19:36Okay, let it rip.
19:48So just stay out of it.
19:49What are you not telling me?
19:51It's, it's home to us.
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.
20:20What happened?
20:22BP spike, acute renal failure.
20:26But that makes no sense.
20:27Addison should prevent BP spikes.
20:29And his renal function was normal pre-op.
20:32Well, clearly we're missing something.
20:34Blood cultures, autoantibodies, and a pan-CT scan.
20:37That's a good idea.
20:38It was even better when Dr. Matra had it five minutes ago.
20:40Where 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 going to look me in the eye and tell me that was a false memory?
21:00It was a bad day.
21:02I 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?
21:10Where 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?
21:17Dr. Matra and I will take it from here.
21:22I would never do anything to jeopardize a patient.
21:25And I don't need you to tell me that.
21:51Let me ask you something.
21:52You went up against Dr. Miller.
21:54Was that for my sake, or were you just pandering to your CEO?
22:00Come 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.
22:07I guess I'm not surprised.
22:08Four years in Afghanistan.
22:10Took a bullet during that hostage crisis.
22:12Okay, you guys got to ease up on a background check.
22:14It's getting weird.
22:16Honest, too.
22:18Look, this idea is out of the box.
22:21But you push boundaries for a living.
22:23Controversial, but necessary to a society.
22:28I've just...
22:31I've never been in the lab rat before.
22:47I've never been in the lab rat before.
22:50Dr. Ridley, he has tuberculosis.
22:54I saw some nonspecific areas lighting up on CT.
22:58Figured 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.
23:13Even 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. Matra.
23:27We'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.
23:41Yeah, well, your BP's a little low.
23:42I'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'm premedicated with Benatryl and Methopenicillin.
23:58Well, there wasn't enough.
24:06No.
24:07Prenez le médicament deux fois par jour, d'accord?
24:10Fait bien une bonne urine pour éviter les infections.
24:14C'est très important.
24:15Oui?
24:16Oui, oui.
24:17Au revoir.
24:18what else we got dinner oh no i'm gonna eat later you 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 have you had terry's mohambe
24:39your grandson's gonna be fine from everything you said about amy he's in the best possible hands
24:45not mine though you can't be everywhere
24:51when harry and i were first married i tried to stay put be the doting wife and mother and
24:58have 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
25:26hello it's me albuterol and high full oxygen are keeping his numbers in the 80s
25:32so no no need to intubate no he's stabilized but 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 at what cost joe 60 milligrams at that rate you will flame out in
25:51weeks that's my choice does javi know what you're doing i'm not killing myself amy i am trying to
25:57make the most of the time i have left and he would respect that well what does ethan think
26:04i don't know he doesn't know he doesn't return my calls what wait how long have you know what i
26:12think you've dredged up enough bad memories for one day and if you'll excuse me i have a patient who
26:16needs me
26:20what do we got uh granulomas in the liver kidney adrenals bowel they're everywhere
26:32tell the on-call surgeons to drop what they're doing and meet us in the or
26:35we're gonna need all the hands we can get
26:38i commend you my dear brother to almighty god and entrust you to your creator may you return to
26:46him who made you from the dust of the earth may holy mary the angels and all the saints come
26:52to
26:52greet you i am so sorry mrs voight
26:56christ he was crucified i never should have let him go through with this excuse me
27:17you care to explain how this went so wrong
27:22we tried cartoon i read the report i know what was attempted i'm wondering how that was allowed to
27:26happen you'd have to ask the ceo about that he was pushing medical decisions we could have used you
27:33so what are you proposing now i'm thinking il6 blockers the covid treatment car t triggers a
27:43similar inflammatory cascade and i don't think that the standard protocol will get the inflammation
27:49under control he's been right all along
27:54we should follow his lead
28:00you're patient your call
28:04okay okay okay it's uh our our thailand trip you got boot off the karaoke stage bohemian rhapsody yes
28:13and for the record it wasn't my performance that people hated it was just that that song is too long
28:29okay
28:30okay
28:30okay i can't like you do it
28:34okay
28:45it's negative i don't have cancer don't have cancer
28:52okay
29:04saddle up everyone for the next 11 hours we're doing an ex vivo
29:10that's right the thing you learned about in med school but never thought you'd actually do
29:14we're removing every damaged organ repairing it and then putting it back where we found it we'll run
29:21two full operating fields side by side my team will be the one removing organs and keeping javi
29:27alive that means controlling bleeding managing profusion oxygenating his heart and brain team two is on ex vivo
29:35work when we pass off an organ you strip the granulomas and adhesions repair what you can then it comes
29:43straight back to us in working order precision is everything we lose focus we lose an organ we lose an
29:50organ we lose the man
29:56no mistakes
29:58let's go
29:59god i cannot believe i'm seeing this all right i brought nourishments yeah great thank you
30:05oh thanks
30:07did she just do a rapid order to reconstruct on the fly yeah it's unreal she's a freaking rock star
30:14she's something that's for sure you wonder why i didn't want to tell you look the way she's managing
30:20everyone she's like a maestro okay so what exactly is her end game here is she just going to keep
30:26operating until she drops i can't believe what she's doing to herself i know that you don't want to go
30:31wind her back but i don't think she's really leaving as many options here just give me a couple hours
30:37till the end of the day
30:48ethan it's amy uh give me a call back when you can there's there's something going on with your mom
30:55okay liver's coming out subhepetic space is clear put a retractor in there carol sponge
31:04okay
31:08that granuloma is wrapped around the inferior vena cava we can clamp take it out then reconstruct with
31:13dacron graft no we've made enough compromises today i'll dissect it off the wall leave the vein
31:18intact scalpel uh isn't it safer to do a graft one slip and he could bleed out in seconds i
31:25know
31:25i wrote that chapter in your vascular surgery textbook suction dr matra plant ready in case it goes south
31:58you know what they say about me hands of stone
32:05so
32:08hi hi what are you doing here mom i wanted to check on robbie i came as soon as i
32:14could
32:15well we both know that's not true okay okay i came as soon as i could responsibly leave
32:20and why is it you feel a greater sense of responsibility to a group of strangers than
32:24your own family robbie was fine he didn't need no i needed you
32:32you know for once i actually let myself believe that you'd be here
32:35i was on my way and and what then we got the call fighting broke out in sake we were
32:40inundated
32:42it's always something mom
32:47and what would you have me do let those people die so i can come and hold your hand
32:52no you're right no you had to do what you thought was right and now i have to do the
32:56same so
32:57you know what i'm i'm done what does that mean you're done that means i'm just i'm done
33:02you 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 then i
33:18didn't raise the man i thought you barely raised me at all
33:40welcome back
33:43it must have been a close one turns out your addisons was a symptom of indolent tb you had a
33:51lesion on your adrenal gland along with 14 others but we cleared the damage and you'll make a full
33:57recovery what's it no more addisons no more addisons
34:10you saved my life i wish there were more i could do for you are you kidding that was a
34:18career
34:18making surgery you begged me i'm gonna live forever in these halls
34:24so um
34:27when can i get back out there well in the last 12 hours most of your organs have been outside
34:33your body
34:33so maybe you want to give it a few weeks hey we go where we're needed right
34:52you know what kills me the most i still got nothing but love for you
35:01you know what kills me the most
35:04hi stranger
35:27unfortunately the car t hit you harder than your cancer we've retested your blood
35:32and your small cell tumor markers only dropped three percent meaning it didn't make a dent right
35:40well then what's next we're back where we started chemo and molecular therapy so you're right my yes
35:50men almost killed me for nothing i'm just glad you're still here i'll be dead by the end of the
35:56year
35:56i'm sorry but there's plenty you can do with the time you have left no i won't slowly degenerate if
36:03you can't cure me i will wait
36:05xander no what better time to do it than now i'm sorry what are we talking about there's a swiss
36:10cryogenics company that will freeze me until further notice when there's a cure for this in 10 20 30 years
36:16i'll be first in line if they find a way to reverse the freezing process we can do it with
36:22embryos
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 we should put him on a 72-hour hold on what grounds
36:46he's not depressed or pathological he's got a god complex and i flew too close to the sun
36:54ceo's watching you got a billionaire setting you up to be a hero you got carried away you're right
37:03sorry i know you think i don't have a leg to stand on here but what happened with mr voight
37:08was
37:08unethical and there isn't always going to be someone more senior around the pushback
37:13you're not a rookie anymore tj time to start acting like it
37:26hey oh hey so
37:31i need to tell you where i was yesterday okay
37:37rachel had a mammogram and they found a mass oh no is she okay yeah yeah she's fine now the
37:44biopsy
37:44results finally came back negative but the past week has been kind of tough so i just i wanted to
37:49be there for her so that's why you left early yeah yeah she was spiraling and that patient you were
37:59with in
38:00radiology last week when you you didn't want to talk that that that was her she asked me not to
38:06tell
38:06anyone um when i see the look on your face and clearly i i went about this all wrong no
38:15you you were
38:15in a tough spot i'm i'm just glad she's okay yeah yeah yeah okay
38:31it was pretty sneaky you calling ethan dare i ask how it went
38:40well uh we have a lot to clean up but
38:45he's here so thank you there's one thing this year has taught me it's that family finds a way to
38:54forgive
38:56let's hope
38:59he certainly thinks i have a lot to answer for
39:06we need to figure out what you're gonna do joan oh i know what i'm gonna do
39:14i didn't think it could get any worse than being schooled by richard miller and knowing he was right
39:20try this i spent all of last week trying to sideline dr ridley and the second she asked me to
39:25scrub in
39:26for a big operation i leap at the chance so we're hypocrites or maybe we're just doing the best we
39:34can in a job that has a lot of gray areas maybe we are so want to give our date
39:43another shot dinner
39:47that italian place on the corner or we could just go to mine for dinner that too
40:07dr ridley would like all of internal medicine to report to the office for an all-hands
40:36that was fast am i that scary yes
40:44uh this is uh 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
41:07i have mds it's advanced and it's time for me to accept that
41:15it's not something i can outrun so
41:23last night
41:26will be my final surgery
41:29and next week will be my last as your chief
41:37i've spoken to dr hamna and he has agreed to facilitate a smooth transition
41:43and never fear you will all receive your long-awaited evaluations before i go
41:50i like to think um that i i still have some wisdom
41:58to impart on the next generation
42:02even you peter
42:06so um as my friend reminded me today uh
42:12we go where we're needed and right now
42:16there are more important places for me to be than inside an or or behind a desk
42:24being a doctor
42:28has been the privilege of my life
42:33being your chief
42:37has meant more to me than i expected
42:41thank you
42:47all of you
42:53and i'll see you tomorrow
43:03you
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