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00:01Previously on Doc...
00:02I lost a lot of my memory.
00:03You saved Charlie after everything they did to you.
00:06Chief resident is up soon.
00:08Considered throwing your hat in the ring?
00:09I should at least be considered.
00:11I heard you had the chance to saw me down the river.
00:13Jake is sick of us fighting.
00:15Frankly, so am I.
00:16I like you, Liz.
00:17A workplace relationship can really twist things up.
00:19All I care about is do you want to be with me?
00:21She's had to grow up fast.
00:22Sometimes she thinks she can handle too much.
00:24Some maniac sends you a recording of what my ex-wife's therapist says
00:28and off of that, you're leaving me?
00:32I'm hoping you're going to change him.
00:34Thank you so, so much.
00:35It's an important vote.
00:36Thank you very much.
00:38Say yes and we're good.
00:39Fine, we're even.
00:40But don't ask me for anything else.
00:42Ever.
00:45We still don't have the votes.
00:47Tell Connor to bring in the cavalry.
00:52Ready?
00:53Action.
00:57Oh, seriously, Will?
00:59That's how you're going to play this?
01:00Uh, Representative Troy Willis here, folks,
01:02just outside the city council chambers.
01:05My good friend Will Archer doesn't want to help me pass a law
01:08that would allow me to get up these stairs to talk to him.
01:11The same law which means people with disabilities don't die
01:15inside a burning building because a ramp was too expensive,
01:18which actually only goes to prove my point.
01:22Was a good thing.
01:23I brought some friends with me.
01:25Both access.
01:25Full rights.
01:26Full rights.
01:29Full access.
01:30Full rights.
01:31Full rights.
01:33Full access.
01:34Full rights.
01:35Full rights for access.
01:36Full rights.
01:37Full access.
01:38quick.
01:39Jav?
01:43Node-9-1!
01:50Vomona Sieger-1.
01:57Hey, good morning.
01:59What is this?
02:01Nightmare's over, baby.
02:03And I get French toast.
02:05Yeah, your French toast.
02:06There's your coffee.
02:07I got you turkey bacon, extra crispy.
02:10So just sit down, enjoy, focus on becoming the next chief resident at Westside.
02:15Next, not best?
02:17I don't know what to tell you.
02:19Best is already taken.
02:24I advised you when I found you the job, that working with your ex-wife would be complicated.
02:29This isn't just about Amy.
02:30We've only been there eight months.
02:32The scandal in your hospital, this doctor getting arrested, it's not a great look.
02:36I understand.
02:37What's out there?
02:39Are you willing to take a pay cut?
02:43Excuse me.
02:45Hey, Dad, everything okay?
02:46Michael, where's our ride?
02:49Tell him there's no car here.
02:50I told him, Samira.
02:51He says he's there.
02:53The driver's name is Dwayne.
02:54How does that help?
02:55Just wave your hand.
02:58Who are you waving at?
02:59Dwayne, the driver.
03:00Where is he?
03:01No idea.
03:02Then why are you waving at you?
03:04I don't know, Samira.
03:05Just wait there.
03:06He's coming to you.
03:07All right.
03:08All right.
03:09We'll wait.
03:09We've been waiting.
03:11Tell him to let Nora know we're excited to see her.
03:13She knows that, Samira.
03:15Of course she knows that.
03:17My God, they're looking at serious jail time.
03:20Well, yeah, after what they did?
03:21It's crazy.
03:23She seems so nice.
03:24That's what people always say about the serial killer next door.
03:27TJ's patient from yesterday needs to be discharged.
03:30Can you handle?
03:31Sure.
03:32Where is he?
03:33Cousin's wedding.
03:35Ooh, eligible doctor.
03:36All those desperate bridesmaids.
03:38Candy from a baby.
03:40Classy as always, Peter.
03:43Nurses station, this is Julie.
03:48Yeah, she's right here.
03:56Yeah.
04:00I'll tell her.
04:01Okay.
04:02Sonia, Dr. Ridley wants to see you in our office.
04:07I need to properly assess you both.
04:08To determine who's better suited to be chief resident.
04:11Part of that job requires giving constructive feedback to your colleagues.
04:15Clearly, you can't do that while you're working together.
04:17So today, you will each have your own cases.
04:22And we will meet back here at the end of the day.
04:25Go over the details.
04:26And you'll critique each other's work.
04:29Sounds great to me.
04:33Good.
04:34And get on with it.
04:40Give me the skinny.
04:41Female, 44.
04:43Mild pancreatitis.
04:44She mentioned having a glass of wine most nights, which usually means a bottle, right?
04:47So, that's our likely culprit.
04:49All right.
04:49Thanks.
04:50I'll admit her.
04:51Just a heads up.
04:52She's a frequent flyer with vague abdominal pain.
04:54Over 20 CTs past few years and nothing.
04:57You're saying drug-seeking behavior?
05:00You said it.
05:00Not me.
05:04Whenever I come, damn ER gives me the same meds.
05:07And they don't work.
05:09I'm sorry, J-Lo.
05:11How long have you had the pain?
05:12It's on my chart.
05:13Well, I have to ask anyway.
05:16On and off for six years.
05:19Okay.
05:19Um, and are you still ovulating?
05:21Oh my God.
05:22Read the chart.
05:23Y'all ask me that every time I come.
05:24We have a system of checks and balances, so nothing falls through the cracks.
05:28I think you need a new system.
05:30Been in menopause two years.
05:33All right.
05:33We'll start you off with fluids and pancreatic enzyme replacement.
05:38And for the pain.
05:39Probably Toradol.
05:39That doesn't work for me.
05:41I need something stronger.
05:46Have you ever used anything outside the hospital for your pain?
05:49So I'm a druggie?
05:50A druggie looking for a fix, huh?
05:52I am just trying to get all the information so I can help you.
05:55You want to help.
05:56Tell me why I have pancreatitis.
05:59The wine you drink at night could explain it.
06:02It's one glass to ease the pain.
06:05One glass?
06:06If you can't help me, find me somebody who will.
06:09I am not going to pass you along, Jayla.
06:11But I would like to bring in a neuropsychiatrist.
06:14A shrink.
06:15Because you think I'm crazy.
06:16No.
06:17No.
06:18But your mental health has been neglected.
06:21And I want to break the cycle, so I will be right back.
06:29So he has a T2 spinal cord injury from a skiing accident?
06:34Three years ago, he developed a cystic cavity in his spinal cord.
06:38We've been managing it best we can, but obviously it's flaring up.
06:42The mucus plug blocked his airway, and that's why he turned blue.
06:47That's never happened before.
06:48Does that mean it's getting worse?
06:51Mr. Willis.
06:53Oh, okay.
06:54Hey, try not to fight it.
06:56There's still some fluid in your airway.
06:57Let's see if I can clear it.
07:01Great.
07:02Take this off.
07:07Good.
07:14What's happening to me?
07:16Unfortunately, the imaging shows that the syrinx has progressed, and it's pressing on the nerves that control your diaphragm.
07:24So that's what caused the lung damage.
07:26So what do we do about it?
07:28I spoke to your neurologist at Eastside, and he agrees that we manage the symptoms, and we support your breathing
07:35to make you comfortable.
07:38So the damage is permanent?
07:41Depending on how today goes, I think we're looking at a few weeks to a month before he's on a
07:47ventilator.
07:51For good.
07:53Connor, I'm sorry.
07:55Yes.
07:58Connor.
07:59Connor.
08:00Connor.
08:01Connor.
08:02Honey.
08:04We knew this day would come.
08:07I'll do everything I can to get you as much time as possible.
08:11Hey.
08:13I'm going to take time off work, and we still got four things left on my bucket list.
08:19Come here, Connor, please.
08:21Come, honey, come.
08:23Come on.
08:25Come on.
08:25I'll bring it in.
08:27It's all right.
08:33I'm going to get some medication to help clear the fluid.
08:37Dr. Larson, I need to be out of here in a few hours.
08:43He's a legislator.
08:45He's been working on a bill that votes today, and without him...
08:48It'll never happen.
08:49He has to be at City Hall by 5 p.m. somehow.
08:53Can't someone else do that?
08:55He sponsored the bill, and without him, it doesn't have a chance.
08:59He's been working on it for nine months.
09:01I have, too.
09:05Whatever you need to do, please.
09:15Being early won't help with her.
09:17I'm always early.
09:19Will it hurt?
09:20Probably, somehow.
09:23Dr. Larson, I'm Sonia Matra, the med student assigned to you today.
09:28I've listened to you in grand rounds.
09:30You have so many med students, you probably have no idea who I am.
09:32Uh, I know who you are.
09:34Really?
09:34Uh, I just want to say what an honor it is to get to work with you, and I hear
09:38you're going
09:38to be chief, so...
09:39Are you done?
09:41Good.
09:41Because we have a patient.
09:48Hi, Jayla.
09:49I'm Dr. Walker.
09:52Nice to meet you, Doc.
09:54But no offense.
09:55I ain't crazy.
09:57I want to describe most of my patients as crazy.
09:59Yeah, because you can't say that.
10:00Oh, no, I'll say it.
10:01Some of them are completely out of their minds.
10:04It says here you've had pain for six years in your stomach, and whatever they give you
10:08doesn't seem to work.
10:10Huh.
10:11You're the first doctor who actually read the damn chart.
10:15You've had a lot of conflict with doctors?
10:16Because it's like...
10:18It's like they blame me for my pain, you know what I'm saying?
10:24Well, that doesn't feel good.
10:25So, let's talk about the pain.
10:29Uh, it comes and goes.
10:31Does it keep you up at night?
10:33Sometimes.
10:34And what are you doing for it?
10:35I've tried everything.
10:36They got cold compress, heating pad, acupuncture, hypnosis.
10:41And all of that doesn't work?
10:43No.
10:44Any medications?
10:45Advil, usually.
10:47Nothing stronger?
10:49Oh.
10:53All right, I'm going to tell you something, okay?
10:56When I was 16, I took my mom to the hospital.
11:00She was in excruciating pain, and they sent her home.
11:06A few hours later, her appendix burst, and she almost died.
11:10I know what it's like to be ignored by the healthcare system.
11:14You can tell me anything, Jaila.
11:15There's no judgment here.
11:21My girl, Cheryl, gave me her old Vicodin, and for a while, that helped.
11:27And that was how many times?
11:28She got me a refill, so twice, or three times, maybe.
11:33And is there any history of addiction in your family?
11:35Doc, come on, man.
11:36I don't want pain meds.
11:41I want the pain to go away.
11:46I called the treatment center.
11:48They have a spot for her.
11:50She's not an addict, Sonya.
11:52You rushed to judgment, and you're still doing it now.
11:54I'm sorry, what are you implying here?
11:57I'm raising the possibility that your biases are affecting how you approach this patient.
12:00She had every indicated test, and there was nothing there.
12:03Do you know how often black women are dismissed when they enter the hospital?
12:06Why do you think I referred her to you?
12:11I saw the ER doc had some pretty strong opinions.
12:14It looks like he set the expectations, and you followed, possibly based on your own biases.
12:19I think maybe you're the one who's biased, or maybe your best friend clouded your judgment about me.
12:24Dr. Matra, you're missing something, medically.
12:26So what are you going to do about it?
12:33An artificial cough can feel strange.
12:36Are you ready?
12:37Let's try it.
12:52That was weird.
12:53I may have undersold how weird.
12:57I think I'm good now.
13:00Give me my chair.
13:08Your oxygen is dropping.
13:11I just, I'm good.
13:12Just give me a second.
13:13I don't think you're ready.
13:14I got it.
13:14I got it.
13:23What's happening?
13:24His breathing muscles are spent.
13:26Why does it only happen when he sits up?
13:28His lower lung is collapsed, and when he sits up, it forces the blood to that area, but there's no
13:33air there.
13:34Can't they postpone this vote?
13:36I don't know.
13:36I don't think so.
13:37We're about to go into recess.
13:39I'll be dead by the time they're back in session.
13:41What is this bill that it's so important?
13:45About three years ago, right after my accident, Connor was rehearsing for the school play, and he started feeling sick,
13:53and he called me to come get him.
13:54I got there fast, and he was walking out to me, and he fainted.
14:00He ate his head, and he broke his nose.
14:04He was right there.
14:06He was bleeding.
14:08He was scared.
14:10But that part of the school had no ramp.
14:13It had no elevator.
14:14And I couldn't get to him.
14:15It was three steps, and I couldn't get to my son when he needed me.
14:19And it's not just that.
14:20Floods, fires, people get left behind not because they can't move, but because no one built a way out.
14:25The new law would require hundreds of buildings like that to do the right thing.
14:29Any building before 1992 is grandfathered in, and they don't have to do anything.
14:33It's wrong.
14:36And we can fix it.
14:41Can I get you a coffee or something?
14:43No, we want to say hello first.
14:45Where's Nora and the baby?
14:47I wanted to talk to you first.
14:50Can you have a seat?
14:52I don't like the sound of this.
14:56I'd hoped to sort things out before you came.
14:58But Nora's been staying at her mother's house.
15:05For how long?
15:06A few weeks.
15:07With Simon?
15:10Michael, what did you do?
15:11It's not something I'm going to talk about.
15:13But I can handle this.
15:15You didn't with Amy.
15:16Okay, let's not go there, Omi.
15:18Well, we don't want you making the same mistake twice, Michael.
15:21I didn't make any mistakes with Amy.
15:23She lost her son.
15:25Your job was to support her.
15:26I said I'm not doing this.
15:28Fine.
15:30How are we going to see our grandson?
15:32Nora's bringing him over in a few minutes.
15:35Please, don't make this difficult.
15:45I need a really smart sounding board.
15:48Okay.
15:49What's the case?
15:50High spinal cord injury.
15:52Syrinx.
15:53Progressive respiratory failure.
15:55Lung scarring.
15:56Bronchiectasis.
15:57I mean, end stage.
15:59Yeah.
16:00And I need him up.
16:03Uh, okay.
16:04Drake in full vent.
16:05He needs to speak.
16:07Neural assisted ventilation would allow for that.
16:09Plus bronchodilators.
16:10And drying agents for the secretions.
16:12Those would kill his speech.
16:13What about Botox with the salivary glands?
16:16That'll buy him some time.
16:17How much do you think?
16:18After a couple days to stabilize him.
16:20Uh, maybe a month.
16:22He wants up today.
16:23Today?
16:25I...
16:26We can't help every patient the way they want.
16:31That's odd.
16:32Good?
16:33Odd?
16:35You have a memory?
16:36Yeah, an old case.
16:38The details are hazy, but I know how my brain works now.
16:41It must be relevant to this situation.
16:44Another spinal patient?
16:45Uh, I'm not sure, but I saw an unusual EMG reading.
16:50Low amplitude, but high diaphragmatic pressure.
16:53Yeah, that would be unusual.
16:54Something's got to be driving the muscle contraction.
16:56Yeah, but what?
16:57A drug, maybe?
16:59I mean, I can't think of one.
17:01What else?
17:02Uh, something about the patient or something in the room?
17:07Mm-hmm.
17:12Yes.
17:14Sonia was there.
17:20This is a new calcium sensitizing agent for heart failure.
17:23I want you to monitor his cardiac output.
17:26So, it improves output without risking an arrhythmia.
17:30How?
17:32You need to read the REVIVE trial.
17:33I did.
17:34It was complicated.
17:37We need calcium to stimulate muscle contraction.
17:39Drugs that spike it also cause arrhythmia.
17:41So, this drug utilizes the calcium that's already in the body.
17:44Stronger contractions, same calcium.
17:47Right.
17:48Heart rate steady.
17:49Okay, now we just wait and see if his heart improves enough to get off the ventilator.
17:54That's odd.
17:56Good?
17:57Odd?
17:57Must be.
17:58His cardiac output's improving.
18:00No, Sonia, it's not.
18:02But his heart's getting stronger.
18:04He must be fighting the ventilator.
18:06Maybe we should remove the tube?
18:07Oh, that's good.
18:09Right?
18:09No, it's not.
18:10Don't listen to her.
18:11She doesn't know what she's talking about.
18:13I need you out of here.
18:15Now!
18:23Yeah, I was a med student, I remember.
18:26I'm just surprised.
18:27That was five years ago.
18:29Yeah, well, you kicked me off the case, so it kind of stuck with me.
18:32We were using a brand new drug you were studying, lavazamendin.
18:37I've never heard of it.
18:38It's an orphan drug.
18:40Expensive, esoteric, low efficacy, didn't justify mass production.
18:44You come in or what?
18:46It's been over an hour.
18:47I'll be right there.
18:48What was the patient's problem?
18:50Cardiac issues.
18:51The problem with the drug was that it helped the heart, but drove the diaphragm too far.
18:55That's exactly what I need.
18:57Do you know the patient's name?
18:58I need to see their file.
18:59I don't, but I have to get back to my own patient.
19:04So, she's back.
19:05I am.
19:06I wanted to start again.
19:08Oh, God.
19:10All right, then.
19:12Ask your questions.
19:15Hey.
19:17Thanks for doing this.
19:19He's their grandson.
19:25I fed him in the car, and there's enough milk here for two more feedings, and he's due for a
19:30nap in an hour.
19:31Don't worry, Nora.
19:32I remembered.
19:34Well, I should go.
19:36It was so nice to see you both.
19:38You don't have to rush out, Mara.
19:40Thanks, but I should really go.
19:42So, when are you moving back home?
19:46Don't do this.
19:47Farouk and I had our tough times, too, you know.
19:49Every family does, but we worked through it.
19:52What we didn't do was give up.
19:54Mom, you're here to see Simon.
19:56Farouk and I have been married 52 years.
19:58I know, Samira.
20:00We threw your anniversary party.
20:01Then you know I know what I'm talking about.
20:04These days, everybody wants things to be easy.
20:07All due respect, you have no idea what you're talking about.
20:10Well, nobody seems to want to explain it to us.
20:14I don't think that Katie really needs to be a part of this, do you?
20:20Oh, he's still hungry.
20:21It's okay.
20:22We can feed him with the bottle.
20:24I've got this, Samira.
20:25Thanks.
20:26Come on.
20:36Okay.
20:37Um, any specific foods trigger the abdominal pain?
20:41Not that I can think of.
20:43Sometimes fast food can-
20:45I don't eat fast food.
20:46I eat healthy.
20:48Sorry.
20:49Okay.
20:49How about exercise?
20:50Oh.
20:51It hurts on the days I run.
20:53Hurts on the days I don't.
20:55Oh!
20:55Jayla?
20:56It's my foot!
20:57Oh!
20:59What is that?
21:01What's happening to me?
21:03Hey!
21:05Call radiology.
21:06I need a stat doppler and an angio.
21:08I need a patient transport now!
21:10Okay.
21:12I need your sign-off on a thrombolysis for my patient.
21:16Angio showed a clot in the popliteal artery supplying her foot.
21:20Diagnosis?
21:21I haven't sorted that out yet, but I need to restore blood flow.
21:25How many of these have you done?
21:2728, but never so low.
21:30Until now.
21:31Great.
21:32Thanks.
21:33Oh, whoa.
21:36Are you okay?
21:38Yeah.
21:40I skipped.
21:41I skipped breakfast and lunch.
21:44I need to eat.
21:48Yeah.
21:49Yeah.
21:57It's, uh, Sonia, right?
22:00Yeah, uh, Dr. Heller.
22:01I've seen you around.
22:02Uh, just call me Jake.
22:05So, I hear you're, uh, applying to the program.
22:07Who isn't?
22:08West Side's the tertiary referral center for the upper Midwest.
22:13And, uh, how's your rotation going?
22:15Uh, great.
22:18Really?
22:19Okay, not great.
22:21Yeah, yeah, I saw you're working with Dr. Larson today.
22:23I was, and I'm hoping to turn that around.
22:26With Dr. Larson, uh, she is the last person to throw anybody a lifeline.
22:30I know her reputation, but honestly, she's a big part of why I want to come here.
22:35I mean, she is a total badass.
22:37I'm pretty sure she thinks I'm just bad.
22:40Well, I hear she's going to be the new chief.
22:42I'm not looking forward to that.
22:44Uh, sorry I overstepped, Dr. Larson, but I re-read the Revive trial, and it led me to a JAMA
22:51article.
22:52Emerson used a guanylate cyclase stimulator on his heart patients.
22:56It's got more kick out of the myocardium without diaphragm cross-reactivity.
23:01Hmm.
23:02Okay.
23:03I'll take a look at it.
23:10So the first thing you did was call in a psych consult?
23:13She checked a lot of boxes.
23:15We're prepping her now for a thrombolysis, but I'm thinking Ray knows.
23:18Ray knows?
23:19With this presentation?
23:20Well, I'm running auto-antibodies, too.
23:24So, you ordered the Lavazamendin.
23:27Yeah, it'll be here within the hour.
23:28And you're seriously considering using it on a patient with a perfectly healthy heart?
23:33He needs to be able to sit up.
23:35Have you investigated the side effects?
23:37I just got off the phone with a lead researcher in Barcelona.
23:41It'll burn out his diaphragm in six hours.
23:44I don't see how this is a course of action you can even present.
23:47He has his reasons. I've got to respect them.
23:51What does his family think?
23:53I don't know yet.
23:55So what? It's like steroids for my diaphragm?
23:58It would get you what you need for today.
24:00But if we push the muscle that hard, it's going to burn it out completely.
24:05What does that mean?
24:09Most likely, he would be on a ventilator by tonight.
24:14Then why are we even discussing this?
24:16I am obligated, as his physician, to present all the options, and you all seemed pretty determined.
24:23No!
24:25If not, it means we only have a few more hours with him.
24:28And there's no other way to get me there tonight?
24:31I'm afraid not.
24:40No, Troy.
24:43No way.
24:53We need to think about this.
24:56Sure.
25:04Okay.
25:05Okay.
25:07All right.
25:08Okay.
25:09There we go.
25:10Oh, yeah.
25:10I'm sorry about my mother.
25:13I didn't think you'd want her to know the details.
25:15Well, you have no idea what I want, clearly.
25:19Well, I've been talking to a headhunter.
25:21Because you have to get away from her?
25:23Because the situation there has been nothing but a mess.
25:26I am not a consolation prize.
25:28It's not like that.
25:29I want our family back.
25:31I know you think you do.
25:34Nora.
25:35Nora.
25:41Hey, Mom.
25:43Hey.
25:43How's the visit so far?
25:44Is it okay?
25:45Honestly, it's all pretty intense.
25:48I really wish you didn't have to be there.
25:51You know how Gato and Tate are.
25:54And Dad needs a backup.
25:55That's not your role, sweetheart.
25:59Gato asks about you.
26:00He sends his love.
26:01He does?
26:02I would have thought they hated me after the way things ended.
26:06Actually, no.
26:07They blame Dad.
26:09And they're blaming him now.
26:10Wow.
26:11They are pretty traditional that way.
26:14I should get back.
26:16Okay.
26:16Call me later.
26:17Let me know how it goes.
26:18I will.
26:19Bye.
26:31Where's your family?
26:33Connor stormed out.
26:35Maya went after him.
26:37It's going to be hard to do this without their support.
26:42I spent my career playing politics.
26:46Chasing donors.
26:48Power.
26:50I turned on friends.
26:52I lied to people who trusted me.
26:55I killed legislation that I believed in to get endorsements.
27:01I was an arrogant jackass.
27:05Concerned more with winning than helping people.
27:09It's hard to picture you like that.
27:14Spinal cord injury was the worst thing that ever happened to me.
27:22But it also gave me clarity.
27:26I've always loved my family.
27:30But this is...
27:35But I wasted my life chasing the wrong things.
27:39And this is my last chance to make up for...
27:42To do something that actually matters.
27:46But I need them.
27:47And I need them to understand.
27:53I understand.
27:57Could you talk to them?
27:59Please.
28:07Hey, Connor.
28:08Where's your mom?
28:09Call my uncle.
28:11See if you can get here in time to say goodbye.
28:15Do you want to talk about it?
28:19You don't know anything about me.
28:20I know that you've been through a lot for someone your age.
28:24My daughter has too.
28:25She's 18, just a little younger than you.
28:28So what?
28:29Are you trying to bond with me now?
28:30No, I'm just trying to help.
28:33You want to help?
28:33Tell my dad not to do it.
28:37That's not my role.
28:40But maybe I can help you understand.
28:42I understand.
28:44That he's obsessed with his legacy.
28:45It's not that simple, Connor.
28:48I think you know that.
28:50Oh, yeah?
28:53He told me you took a leave from Georgetown
28:55to spend the year with him.
28:58I'm sure that makes it even harder
28:59to understand why he would give up any time with you.
29:04I think he's trying to show you
29:06how to live with purpose,
29:07even when it costs you.
29:10How to be brave when it counts.
29:16Noble.
29:17Yeah.
29:22Well, I think that's easy for you to say.
29:24Because he's not your father.
29:33Last one's down to Jeff Alden and Sonia Maitra.
29:37Maitra's solid, but she doesn't have much research published,
29:40and I'm not excited about her pedigree.
29:41She got into Yale at Hopkins.
29:44She just didn't want to take her parents' money.
29:46She took a financial aid package from the U of M.
29:48I admire her principals, but...
29:51Halton actually trained Yale.
29:52And she's relentless.
29:54She takes a hit, she learns from it,
29:56she comes back fighting.
29:58You can't teach that kind of grit.
30:00I think I might want to run this one by Numerov.
30:02Numerov's out the door.
30:03I'm going to lead his department.
30:05That's why we're here, right?
30:08You better push her.
30:10I will.
30:12There's the clot.
30:13Pop was teal artery.
30:14So, you actually found something.
30:18Yes, she did.
30:20She's tachycardic.
30:21Could be a contrast reaction.
30:23No, it's too late in the procedure for that.
30:25What?
30:25What's happening?
30:26Your heart rate's spiking.
30:27And you don't know why.
30:28Gotta bring it down, Dr. Maitra.
30:29I'm giving her 15 milligrams ketamine.
30:33Heart rate's spiking more.
30:34BP's dropping.
30:35O2-sats.
30:35Can't be.
30:36This is the opposite of what should be happening.
30:37The ketamine's making her worse.
30:39Why would that be?
30:39It induces P450 enzymes.
30:41Your chart said you had a history of anemia.
30:43How long ago was that?
30:45It stopped.
30:46When I went into menopause.
30:49Show me the urine fully back.
30:53Her urine's purple.
30:55She has porphyria.
30:56The anemia masted it.
30:57The ketamine's bringing on an acute attack.
30:59Start IV heme and glucose.
31:01Order a confirmatory porphyrin panel.
31:02Am I all right?
31:04We got this.
31:05Okay.
31:08Please, please go get him.
31:10I'm running out of time.
31:11He's not coming, Troy.
31:13I tried.
31:15He listened.
31:17I'm not sure he heard.
31:19You have nothing else to prove.
31:22I promised all those people, Maya,
31:25that I'd fight for them.
31:26And you did.
31:27So my last decision in life
31:28will be to quit on the five-yard line?
31:38You're really going through with this?
31:40You know I want to.
31:42But I won't.
31:43If it's going to hurt you this much.
31:46That's not fair.
31:48Because now I'm hurting you.
31:49That's what life's about, son.
31:52Hard choices.
31:54And sacrifices.
31:56Accomplishing anything that matters
31:58always comes with a price.
31:59No, don't do that.
32:00Don't put this on him.
32:07This is his life.
32:09No matter when you lose him,
32:10it's going to be unbearable.
32:14But believe me,
32:15you don't want to add guilt to your grief.
32:18Because guilt is what you're going to feel
32:20if you don't let him live his last moments
32:22the way he wants to.
32:26Hey, these past nine months,
32:29all that campaigning we did,
32:31the flyers,
32:32those posters,
32:34all those meetings
32:35and the speeches,
32:37were you proud of me?
32:40Yeah.
32:42Were you proud of yourself?
32:45Then let's finish what we started.
32:55Do it.
32:58Yeah.
32:59Yeah.
33:01Yeah.
33:13We all want access for people in need,
33:16but we have to choose our priorities.
33:19We just can't afford to spend this much money
33:21to help such a small group of people.
33:24Don't let me interrupt.
33:25Uh, no, please.
33:28Councilman, the floor is yours.
33:38You all know me.
33:40Who I am.
33:43Who I was.
33:47One...
33:49One in nine people
33:51have some kind of mobility challenge.
33:55One in nine people see...
33:59People see ramps.
34:01People see parking spots
34:02and assume that accessibility is a done deal.
34:06I used to.
34:10But when you live it...
34:17Let's try a bronch or dilator.
34:31When you...
34:33I can't...
34:35I can't...
34:37Sorry.
34:39Sorry.
34:43I can do it, Mom.
34:47My son would love to say something.
34:58Our world changed.
34:59The day of my father's accident.
35:04So many of the things we took for granted were gone.
35:08A couple steps.
35:09Or a narrow doorway.
35:12That's all it takes to shut him out.
35:15And to keep him from me.
35:21My father chose...
35:23To give up his last few weeks of his life.
35:26His final moments with the people he loves.
35:28To be here today.
35:29Because he knows...
35:30We can do better.
35:35I don't know.
35:36I don't know.
35:37I don't know.
35:38I don't know.
35:38I don't know.
35:38I don't know.
35:39I don't know.
35:39I don't know.
35:41What would you do to fix that?
35:51Seems like the right time to call a vote.
35:56Those in favor?
36:14Looks like the eyes have it.
36:18them.
36:24Oh.
36:26Oh my god.
36:28Oh my god.
36:30No.
36:31That's so silly.
36:33Wow, thank you guys.
36:34Yes, thank you.
36:36Ah!
36:43so your menopause started two years ago but you were in perimenopause for several years before
36:48that which is when my pain started less bleeding means you lose less iron and it built up in your
36:55body and triggered your porphyria it's an inherited condition and it's invisible on
37:01all imaging and labs and to anyone who doesn't look close enough how she tolerating the new meds so
37:10far so good pain so much butter thanks to both of you this was a rough one and you found
37:24a way to turn
37:24it around thank you for pushing me may have learned something about you too that i'm not judgmental and
37:30bias i hate to break it to you but you are judgmental and of course you have biases we all
37:36do
37:37what do you do with yours try to be aware of them keep an open mind and then
37:44every so often take my foot out of my mouth
37:50and i will tell dr ridley how well you did today thank you
38:11dr larsen
38:13hi sonia i don't know if you know but i got in
38:19congratulations
38:20uh i just wanted to tell you how excited i am to come here and learn from you
38:25well you have two months before residency starts so use it wisely
38:31you barely made the cut you have a lot to prove
38:37i get it and i will
38:41you did thrombolysis that was to avoid the bypass
38:44why post-op plavix aspirin allergy
38:48and no post-op stress echoes stress is a trigger for porphyria i'm doing a prosantene in the morning
38:56vague symptoms atypical presentation i hate to admit it but this is excellent work
39:06uh it's a little bit harder for me to evaluate yours
39:10he did a lot of good for a lot of people today
39:13but i guess you can't really put that in a chart
39:17so feels like we fought to a draw
39:21you're waiting for dr ridley
39:23yeah
39:24yeah she left early
39:25oh did she say why
39:28no sorry
39:30okay
39:36i guess it's definitely a draw then
40:03you're leaving your job
40:06yeah
40:08dad maybe
40:09i thought you liked it
40:11i do
40:11now you're lucky
40:12i hated my job
40:14but i did it
40:16it's what you do
40:22just say what you want to say
40:25you need to fight for your wife
40:27because that's also what you do
40:29i appreciate your advice
40:30she doesn't care where you work
40:32she cares you love her
40:33what do you know about love
40:34you and mom spent years barely talking
40:36at least i stayed
40:37you're walking away mister
40:39i'm not the one leaving
40:40what do you want from me
40:41convince nora you love her
40:43i can't
40:45because i don't
40:47not the way she needs
40:48i thought i did but then
40:50amy came back
40:52oh please michael
40:53life isn't some fairy tale
40:55stop it
40:55just stop fighting
40:57honey
40:59katie it's okay
41:00no it isn't
41:02i need to
41:04katie
41:06katie
41:13so how'd it go
41:14at city hall
41:15he passed the bill
41:16yeah
41:17it was something to see
41:18yeah i bet
41:19so how long before he's gonna get back on the ventilator
41:21tomorrow morning
41:24yeah
41:24yeah they have one more night together as a family
41:27i guess that puts the whole battle royale with sonia in the perspective doesn't it
41:32yeah
41:34she's actually giving me a run for my money
41:36huh
41:38i guess somebody wants to talk her well
41:46hi
41:46katie wants to come to your place
41:48yeah okay send her over
41:50no i think i should bring her
41:51is everything okay
41:53i'm not sure
41:54uh okay
41:56uh yeah bring her over
41:58see you soon
42:00what's going on
42:01i don't know
42:02something with katie
42:03i think i gotta go
42:05um
42:06yeah yeah yeah of course
42:08just uh
42:09just
42:10keep me posted
42:12yeah
42:13yeah
42:21hey
42:23hello what's going on
42:25you okay
42:27uh let's sit down
42:28no no i can't
42:29i
42:29what is it honey
42:32what's going on
42:39no royale
42:40i can't
42:41i can't
42:42i can't
42:42i can't
42:43i can't
42:45i can't
42:46i am
42:47i am
42:47i am
42:47toooo
43:02happy
43:03i can't
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