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الطبيب الجيد 1 - Episode 14
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00:09¡Suscríbete al canal!
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00:37Yeah, but you only get like 10 channels that way.
00:39I only watch three.
00:41You mind if I run a line of your tube?
00:44Cable guy can't fit me until next week.
00:47My 10 channels are better than none.
00:49Yes, they are.
00:52All right. Gracias, amigo.
00:54No hay nada que agradecer.
00:56What?
01:00Dr. Resnick was orphaned once Dr. Coyle was transferred, so she'll be joining our team.
01:05Hi, I'm Claire. Nice to meet you.
01:10Are you the autistic one?
01:11No.
01:13That's me, Dr. Sean Murphy.
01:17We've got two pretty straightforward cases.
01:20Nice level playing field for an eager group.
01:23Not interested.
01:24Competition can foster teamwork, which can lead to a greater understanding and appreciation
01:28of residents' strengths and weaknesses, and improve patient care.
01:32You're playing the same game Glassman had us do when we were interns.
01:35Not interested.
01:36Winning team gets first dibs on assisting on all surgeries next week.
01:40In.
01:41Out.
01:48I pick the boy genius.
01:52That's you.
02:05Dr. Brown.
02:08Kalou.
02:09Dr. Resnick.
02:10Thank you.
02:11I'm looking forward to it.
02:15Thank you.
02:18Same mistakes as last time?
02:21Absolutely.
02:27Hi, Quinn.
02:28We hear you've had some stomach pain.
02:29Do you mind if we take a look?
02:30It doesn't hurt that bad.
02:31Poor thing says everything is okay, but when Quinny didn't want to go swimming today, I knew
02:36that something must be wrong.
02:39We'll be as gentle with her as possible.
02:44Quinn's parents are out of town, so I'm, I'm, flew in to babysit.
02:48Mm-hmm.
02:53Okay.
02:59That's a...
03:00Penis.
03:02She's not a girl.
03:04He's a boy.
03:06Okay.
03:16It's just a phase.
03:17Stop saying that.
03:18I'm not a boy.
03:19I'm a girl.
03:20You're transgender?
03:21Yes.
03:22No, Quinn has XY chromosomes like Jared and me, not XX like you.
03:27Science says he's male.
03:29No, Quinn has gender dysphoria.
03:32Her assigned gender is not the one she identifies with.
03:34She's mismatched, Dr. Murphy.
03:36But biologically...
03:37Other than biologically, how do you know you're supposed to be a boy?
03:43Your question doesn't make sense.
03:45I'm not supposed to be anything.
03:46I am a boy.
03:48Biologically, that's it.
03:53Okay, deep tenderness at McBurney's point.
03:55Could be acute appendicitis.
03:57Murphy, get imaging to confirm.
04:07Mr. Shaw, your chart says that you passed out in class.
04:10What do you teach?
04:11History.
04:12I got a little dizzy because I skipped breakfast.
04:15It's nothing.
04:16The school insisted on calling an ambulance.
04:18You've taken any medications in the last few months?
04:21Uh, I took some Vicodin after I threw out my back six weeks ago.
04:25And then I had a stomach flu, so I took ofloxacin.
04:29But the flu part didn't totally go away,
04:31so I took azithromycin and prednisone
04:34because my glands were swollen.
04:36But I still had a sore throat, so I took some Cipro.
04:41What doctor prescribed you all that?
04:44They were leftovers I had in my medicine cabinet.
04:48Uh.
04:48All right, lay back for me.
04:52Look, I'm a single dad with twins
04:55who bring home every disgusting germ they touch.
04:58Preschool.
04:59I can't afford to miss work.
05:03You've got a fever.
05:04And you've gone through two IVs,
05:05which tells me that you're severely dehydrated.
05:07And you can't stand me touching your stomach
05:09without wincing in pain.
05:10Dr. Resnick, let's get Mr. Shaw here an ultrasound.
05:15We've been trying for a while.
05:16Five months.
05:17I realize my prime egg days were two decades ago,
05:20but I've been vigilant.
05:21Ovulation kits, LH and FSH testing,
05:23basal body temp.
05:24I've checked my estradiol and AMH levels.
05:27The old-fashioned way wasn't working.
05:29Okay, well, there are a lot of possibilities to consider.
05:32Many benign.
05:33Many easily corrected.
05:35So I will take some samples from you both,
05:37run some tests, we go from there.
05:38There's a clock.
05:40We need to know if we start with IUI or IVF.
05:42Both of you, you need to stop worrying.
05:45Isabel, you are not the first 40-something woman
05:48to come here and ask these questions,
05:50myself included.
05:52You came to me because you trust me, yes?
05:55Right.
05:55So let me do what I do,
05:57and you two focus on each other.
06:01Hey.
06:02We're a team, babe.
06:04In this together.
06:05All right?
06:06Okay.
06:18I'm afraid Howard,
06:19your appendix has already ruptured.
06:21We'll go to our stat and Paige Melendez.
06:23Wait, I need to figure out
06:24who's going to take care of my kids,
06:26call the school so they can get subs for my classes.
06:28Mr. Shah, if we don't get you into surgery now,
06:30your infection could spread
06:31and you could become septic.
06:32Dr. Brown will make all the necessary phone calls
06:34while I prep you for surgery.
06:36Isn't that so, Dr. Brown?
06:40You're in good hands, Mr. Shah.
06:41We've got you covered.
06:42Let's go.
06:51Hello.
06:53Do you wear dresses?
06:54Buffy, don't.
06:56Quinn is a boy who thinks he's a girl.
06:59I want to know why he thinks that.
07:01Sometimes I wear dresses,
07:03but sometimes I wear leggings.
07:04Do you like the color pink?
07:08I'm more of a purple girl.
07:10Do you play with dolls?
07:11Since I was five,
07:12but I'm super into mermaids.
07:14Do you take dance?
07:15Murphy, 20 questions are up.
07:17I only asked four.
07:18Do you wear perfume?
07:19It doesn't matter.
07:19The CT's ready.
07:20Let's go.
07:20Do you always paint your nails?
07:21Let's go.
07:32Perforated appendix is out.
07:34Lavage or no lavage?
07:36Dr. Brown.
07:37Lavage before closing the wound
07:39decreases residual fluid accumulation
07:41and minimizes residual contamination.
07:44Claire's right.
07:44Although a recent study documented
07:46a higher abscess rate
07:47when irrigation was used
07:48for perforated appendicitis.
07:50Someone did their homework?
07:51I'm partial to AMSURG
07:53since they published me.
07:55As a medical student?
07:56It was about the cost
07:57and stabilization of disease
07:58in patients undergoing
07:59transcatheter
08:00and surgical erotic valve replacement.
08:02Are you thinking of specializing
08:03in cardiothoracic?
08:04A girl can dream.
08:07Staple up and close up.
08:12It's good to have you on board, Morgan.
08:15It's great to have another female surgeon.
08:19Oh, uh, I'm sorry.
08:21You and I are not going to be friends.
08:23Hanging out, having sleepovers,
08:25braiding each other's hair.
08:27That's not exactly where I was going with it.
08:30When residency's over,
08:31the hospital's likely only keeping two of us.
08:33Sean has Glassman's vet project,
08:35so he's in.
08:35Jared is persona non grata,
08:37so he's out.
08:38Which means every time you win,
08:39I lose.
08:40And vice versa.
08:45Thanks for the heads up.
08:57Do you think he's complicated
08:59or confused?
09:02Dude, you've got to quit calling her a he.
09:05We're never going to win this competition
09:06if you're disrespecting our patient.
09:08Don't they have transgender people in Wyoming?
09:10Okay.
09:11Transgender patient care
09:12was not part of my medical school curriculum.
09:16Was it part of yours?
09:18No.
09:25Quinn doesn't have appendicitis.
09:28He has testicular cancer.
09:33She.
09:38We found a mass on Quinn's left testicle.
09:42She has cancer, but...
09:43Am I going to die?
09:44No, no.
09:45Prognosis is very good.
09:46We've caught it before it's spread,
09:48and we'll do surgery on the mass to remove it.
09:50The CT also showed he has osteopenia.
09:53Murphy, stop with the he.
09:56Um,
09:58Quinny, it's your mom.
09:59I have to...
10:00Of course.
10:04Osteopenia,
10:05that's low bone density, right?
10:06Yeah.
10:08How'd you know that?
10:09Do you know how I got cancer?
10:11There are several possible causes,
10:12but I would...
10:13Mycrolithiasis, mumps,
10:15hypospadias,
10:15Murphy.
10:16Epithelial germ cell,
10:17neoplasia,
10:17anguinal hernia,
10:18HIV.
10:19Murphy?
10:20Enough.
10:22Your parents are on their way here.
10:24Um,
10:24they just told me,
10:26Quinn,
10:26are you on puberty blockers?
10:31That's the likely cause of the osteopenia.
10:33Are you taking leproilin or histaline?
10:35I've been on leproilin for nine months.
10:38Well, why didn't you say anything earlier?
10:40Because my parents didn't want my grandma to know.
10:47Looks like he has an abscess.
10:49You have an infection.
10:50We'll drain it,
10:51put you on antibiotics.
10:52It's nothing to worry about.
10:53Just means you might be in the hospital
10:54a couple extra nights.
10:56I can't spend a couple of extra nights.
10:58I need to get out of here.
10:59Are you worried about your kids?
11:01Well,
11:01they're with my sister.
11:03They're safe,
11:03but they've never spent a night without me
11:05since they were born.
11:06Well,
11:07then consider this a blessing,
11:08a free vacation from your kids.
11:10They're my life.
11:15My wife died of ovarian cancer last year.
11:22I,
11:22I hate hospitals.
11:25I'm so sorry.
11:26Why don't I find a laptop
11:29so you can Skype with them
11:31and I'll rustle up
11:33a couple of toy bears from Peds
11:34for you to take home.
11:36Thank you.
11:40I want to reassure you
11:41that the puberty blockers
11:43are in no way responsible
11:44for causing cancer.
11:46The leproilin did cause your osteopenia.
11:48Does this mean
11:49I have to stop taking puberty blockers?
11:51Yes.
11:51We'll get you on dietary supplements
11:53to help regain your bone strength,
11:54but the puberty blockers are hurting you.
11:56You'll be fine without them.
11:58Fine?
12:00I,
12:00I don't want an Adam's apple
12:02or a deep voice or hair
12:03all over my body.
12:04You can't reverse that,
12:06can you?
12:07No,
12:08I'm afraid not.
12:17Girls have body hair, too.
12:28Toy bears?
12:30Skype with kids?
12:31You've got game.
12:33Game?
12:35I believe the name for what I did
12:37is basic human decency.
12:39Everyone has an agenda.
12:41Sometimes it's conscious,
12:42sometimes it's not,
12:43but it's always there.
12:44And you've got this whole
12:45queen of kindness thing down pat.
12:48How can you cynical
12:49for someone so young?
12:50Not cynical,
12:51just the reality
12:51of how the world works.
12:54It's Howard.
12:56Spike to fever.
12:58Tempts 105.
12:59BP's tanking to 80 or 40.
13:00He's sold his sheets.
13:01Sight's clean.
13:02Infections should be clearing by now.
13:04What's going on?
13:04I don't know.
13:05Paige Melendez.
13:06Give me 500 milligrams
13:07of acetaminophen,
13:08two grams of meropenem,
13:08IV infusion empirically.
13:10Run a full chem panel,
13:11CBC,
13:11and get cultures ASAP.
13:13Hang in there, Howard.
13:15We're going to figure this out.
13:24Any word on Quinn Darby's labs?
13:26Big backup today.
13:27Nothing much I can do.
13:28Text you when they're ready?
13:29Yeah.
13:32Hey, Gus.
13:32I saw raspberry and rose petal donuts
13:35in the cafeteria today.
13:36Got you the last one.
13:38You remembered.
13:40Thank you.
13:41Howard Shaw's labs.
13:43I put a rush on them for you.
13:44You're the best.
13:47Why did you give Gus a donut?
13:51I was being nice.
13:53I needed my patients' labs expedited.
13:55Gus likes donuts.
13:56That's cool bribery.
13:57I call it basic human decency.
14:00See you later.
14:07Howard has a superbug.
14:10A C. diff infection?
14:11It's resistant to all medication.
14:17Quinn's pre-op labs are normal,
14:19so we can do the surgery
14:19first thing in the morning.
14:20The procedure is called
14:21a radical inguinal orchiectomy.
14:24It's radical in that
14:26the entire cancerous testicle is removed.
14:29All functionality will remain the same.
14:31Quinn should be able to resume
14:32her normal activities
14:33in one or two weeks.
14:34See?
14:35Baby, that's good news.
14:36No, not really.
14:37Without the puberty blockers,
14:38there'll be the freaking ballet
14:39with a mustache.
14:40Aren't there any other options?
14:43I wish there were.
14:44If we do a bilateral orchiectomy,
14:46Quinn will have the testosterone
14:47level of a girl.
14:48We are not removing both testicles.
14:51You want to castrate my grandson?
14:53No.
14:54I'm so sorry for Dr. Murphy's outburst.
14:58I'm going to have
14:59gender confirmation surgery
15:00when I'm 18 anyway.
15:01Why not just do it now?
15:06Quinn is a child
15:08who still plays dress-up
15:10and make-believe.
15:11He may want to have
15:13children of his own someday.
15:14Ew.
15:16We'll give you some privacy.
15:17Thank you.
15:23I will not allow you to-
15:25It's not up to you.
15:28You are making me doubt
15:29the wisdom of drafting you, Murphy.
15:31If you go around
15:31saying inflammatory things
15:32to people,
15:33it will only upset them.
15:34How will I know
15:35if I said something inflammatory
15:37until I say it?
15:39Test it on Kalou first.
15:41Which you can do
15:42while the two of you
15:43prep an SDA for this case.
15:45An SDA?
15:46A shared decision aid
15:48is a paper presenting
15:50the pros and cons
15:51of making the-
15:51I know what it is, Murphy.
15:52But why am I being punished?
15:54It's not a punishment.
15:54It's necessary.
15:55It'll help Quinn's family
15:56understand all the options
15:57available to them
15:58for her care.
15:59Understood?
16:01I understood.
16:05The soul culture
16:06and sensitivity tests
16:07indicate that you're
16:08resistant to every antibiotic.
16:10Which only happens
16:10when you've been exposed
16:11to every antibiotic.
16:12I-
16:13I did this to myself?
16:17When I've used
16:18those medications before
16:19without a problem,
16:20why did this happen now?
16:23You weren't under
16:24a doctor's care,
16:25so you were likely
16:25taking the wrong medication
16:26for the wrong symptoms.
16:28But you can fix this, right?
16:29We're gonna have
16:30to perform a colostomy
16:31where we attach
16:32an ostomy pouching system
16:34to your abdomen
16:34to collect waste
16:35from your body.
16:37For how long?
16:38Oh, with the level of damage
16:39we're seeing
16:40throughout the colon
16:40indefinitely.
16:44I'm so sorry, Howard.
16:54I don't understand
16:55why you'd suggest
16:56a bilateral orchiectomy
16:57when you don't even
16:58believe Quinn's a girl.
16:59I was answering
17:00Dr. Lim's question.
17:01She said there were
17:02no other options,
17:04but I found one.
17:05And now we're here?
17:07Yes.
17:09You're actually enjoying
17:10this Scott work, aren't you?
17:11Yes, we are being helpful.
17:15We're not doing this
17:16to be helpful, Murphy.
17:17We're doing this
17:18because you pissed off Lim
17:19and I'm collateral damage.
17:22We're still being helpful.
17:28Doesn't matter.
17:30Doesn't matter.
17:31Competition's over.
17:32Is it?
17:34We're in here
17:35not with a patient.
17:36No FaceTime plus
17:36you calling Harry.
17:37He equals crappy survey scores.
17:39It's okay.
17:40It's a game.
17:41It's not important.
17:42It is to me.
17:47I'm a pariah.
17:49These scores are part
17:50of our resident evaluation.
17:52Our jobs depend on them.
17:54Mine does at least.
18:01Then we should do
18:03this Scott work very well.
18:10No.
18:11No.
18:12No.
18:16Finola called.
18:17She found an irregularity
18:19with one of the tests
18:20but wants to rerun it
18:20to be sure.
18:21Okay.
18:22So
18:24we wait until
18:25she reruns it.
18:26Marcus,
18:27we're both doctors.
18:29The results
18:30aren't going to change.
18:34I waited too long.
18:38It's all my fault.
18:43This is the part
18:44where you say
18:45no babe
18:45it isn't.
18:46You had goals
18:48other priorities.
18:50You said you supported
18:51my career choices
18:52just like I supported yours.
18:54I do support you
18:55always.
18:56I'm so proud of you
18:58but it came at a cost
19:00that we both knew
19:01was possible.
19:02We should have
19:02started trying sooner.
19:04When?
19:05When you were
19:053,000 miles away
19:06teaching at Dartmouth
19:07or what when you were
19:08chasing down
19:08head of surgery.
19:10I would have
19:10figured it out.
19:11Figuring it out
19:11would have meant
19:12me and a nanny
19:12raising a baby.
19:13I didn't want that.
19:14I tried to bring it up
19:15four years ago
19:15but you wanted to get
19:16your practice up and running
19:17a baby didn't fit
19:18in that picture either.
19:19It is not the same.
19:20How many pregnant women
19:21get hired for anything
19:22or when they find out
19:23a woman's got a child
19:24at home suddenly
19:25it's all
19:25who's going to take
19:26care of the baby?
19:27No one asks men
19:28that question.
19:28Well none of it
19:29matters now.
19:31Right?
19:32Because it's probably
19:32too late
19:33and I knew it.
19:34I knew this was
19:35going to happen.
19:37You've been stewing
19:38over this.
19:40Resenting me
19:41for how long?
19:42I don't resent you
19:43Iz
19:44but
19:45you know
19:46if you want me
19:47to sit here
19:47and tell you
19:48that it's not
19:49your fault
19:51I can't do that.
19:52I'm sorry.
20:01I love you
20:02my friend!
20:02I love you
20:04I love you
20:05I love you
20:08I love you
20:08I love you
20:12You like?
20:13That door was locked
20:15Oh I know
20:17Cable guy had a cancellation
20:18so he hooked me up
20:19got us a two for one
20:21Little thanks for being
20:22so chill earlier
20:24Gracias amigo
20:32So what kind of doctor
20:33are you?
20:36I'm a surgeon
20:37A surgeon?
20:39Your stuff doesn't say
20:40surgeon does it?
20:42It's like Selena and Justin
20:46doesn't really go together
20:49furniture's from like a dozen
20:50different places
20:50Fourteen
20:53Fourteen
20:53The people in Casper
20:55knew I didn't have any money
20:57so they gave me things
20:58to make a home
20:59The bookshelf
21:00is from Jennifer
21:02the town librarian
21:03My table and chairs are for
21:06Mr. Grady's diner
21:07The lamp is from Cheryl
21:09who teaches Sunday school
21:10at Highland Church
21:11Dr. Glassman
21:12he got me my bed
21:13Well you don't have to
21:14tell me the whole list
21:16but
21:17I don't have to
21:19Yes
21:20Everything I have works
21:21there is no need
21:22to change it
21:23Respect
21:43Hi
21:45I'm Dr. Glassman
21:47I'm the president of the hospital
21:48Is everything okay?
21:50Sit down
21:53There has been no change
21:55in Quinn's condition
21:56However, her grandmother
21:58has made a claim
21:59of child abuse
22:00against you
22:02and your husband
22:03She's claiming that
22:05putting Quinn
22:05on puberty blockers
22:08and these are her words
22:10making her think
22:11that being trans
22:12is okay
22:14as a form of emotional
22:15and physical abuse
22:20Now just to be clear
22:21we don't believe
22:22any of these allegations
22:24have any merit whatsoever
22:25I know my mom
22:26Okay, she's not gonna drop this
22:28She'll go to court
22:29Could she get custody?
22:31Well she could try
22:32but, uh, Dr. Lim would testify
22:36They could put her in a foster home
22:37Ty, she won't make it
22:40If we let Quinn do the surgery
22:42she wants now
22:43it'll all be over
22:45There'll be no reason
22:46for Ruth to fight us
22:53Do what Quinn wants
22:54Do the bilateral surgery
23:05There is an issue
23:08Your test confirmed
23:09abnormalities
23:10in the semen parameters
23:16Beg your pardon?
23:17The semen analysis
23:18it showed that you have
23:19a low sperm count
23:20and low motility
23:22It's my fault
23:23No, we do not speak
23:25in terms of fault
23:2915% of all couples
23:30struggle with infertility
23:31and of those
23:3250% have a male factor component
23:36It's not great news
23:37but it's not a dead end
23:38So what's the next step?
23:40I'm gonna refer you to
23:41Dr. Arjun Dillon
23:43He's an excellent urologist
23:44and he'll give Marcus
23:45a full physical
23:46do some blood work
23:47and an ultrasound
23:49It can't be right
23:50Marcus
23:51It can't be right
23:51Marcus, we got this
23:53Okay?
23:54We're gonna get through
23:55this together
24:03Hey
24:04Hey
24:05Why didn't you tell me
24:06how his labs came back?
24:07I should have been there
24:08when you broke
24:08the bad news to him
24:09So Melinda's gets you
24:10a touching bedside manner?
24:12It doesn't matter anyway
24:13Oh, it doesn't?
24:14How the hell not?
24:16Poor guy's getting
24:17a colostomy
24:18There's no way
24:19we're winning
24:19this competition
24:22You really have
24:23no sympathy
24:23for what Howard's
24:24going through
24:25It's a major bummer
24:26no doubt
24:26But we don't have time
24:27to get emotionally invested
24:28in every patient
24:29that we treat
24:30Our job is to go in
24:32do the surgery
24:32and get out
24:33Afterwards
24:34his poop
24:35someone else's poop
24:37It's not our problem
24:39Hey, wait
24:41What if we could get
24:42Howard a fecal microbiota
24:44transplant?
24:46FMT for a surgical case?
24:48Theoretically
24:48we transfer healthy feces
24:49to him
24:50restores good flora
24:51to the body
24:52kills off the CDI
24:53and he avoids
24:54surgery altogether
24:56We could actually win this thing
24:59I'm going to pull all the research
25:00before pitching it to Melendez
25:05This meeting is called
25:07Challenging Patient Consultation Process
25:10The name sucks
25:11but there are things about it
25:12I do like
25:14All you got to do is talk
25:16and listen
25:17and try to understand each other
25:20What's to understand?
25:21Ruth accused us of being child abusers
25:23And what's to discuss?
25:24We are Quinn's parents
25:26We get to make her medical decisions
25:27What if Quinn is better off as a boy?
25:29You have no idea
25:31what Quinn has been through
25:33Every kid goes through rough patches
25:35Every kid is confused
25:37Quinn has always told us
25:38exactly who she was
25:39ever since she was 30
25:40So you let Quinn play with dolls
25:42Big deal
25:43You don't make life-altering decisions
25:45because a child wants to be a princess
25:52We used to let Quinn do whatever she wanted
25:54at home
25:55But when she went out in public
25:57we made her present as a boy
26:02It felt false to her
26:04She hated it
26:06She hated herself
26:07She became reclusive
26:09depressed
26:10And then a year ago
26:11Quinn tried to count herself
26:20Sorry, I'm late
26:32Howard might not need the colostomy
26:34if we give him a fecal microbiota transplant
26:39Hasn't the FDA gone back and forth on that?
26:41We could be introducing new bacteria into his system
26:43that could kill him
26:44Likelihood of that is low
26:45But not zero
26:46But if we do the colostomy
26:48we may not really be helping him
26:4915 to 30% of patients get recurrent CDI
26:52after the initial bout
26:53That's a good point
26:54I believe 65% of the time
26:56recurrent CDI becomes chronic
26:58which can lead to repeated hospitalizations and death
27:03Are my numbers right, Claire?
27:04Yes, but recent studies show better than a 95% success rate with FMTs
27:12Howard is a good candidate
27:14We should try it before he develops a toxic megacolon
27:17Don't we owe it to him?
27:18His twins
27:19To at least try an experimental treatment
27:21before doing an invasive surgery
27:23which will alter his life forever
27:25You're right
27:25Prepping for the procedure
27:28I appreciate your passionate advocacy for your patient
27:30Good work, both of you
27:35Oh, now you're a team player
27:37When it benefits me, yes
27:39Speaking of which
27:40While you were doing your research
27:41I found Howard a match at the stool bank
27:43Sample arrives in a couple hours
27:44Great
27:45I let them know you'd be the designated doctor
27:47to handle the medical chain of custody
27:49when the sample arrives
27:51So?
27:51So
27:52You're the only person who can handle the sample
27:54You'll have to dilute it, blend it, strain it all on your own
27:57To safeguard against cross-contamination, of course
28:00Of course
28:10Your temperature and BP are normal
28:13Normal, whatever that means
28:15Typical
28:17Usual
28:19Expected
28:20Yeah, I don't feel like any of those things
28:23What does it feel like to be a girl?
28:30Are you angry?
28:31Was that an inflammatory question?
28:33I'd rather people ask questions
28:35instead of pointing and staring
28:38When I used to look like a boy
28:40I felt
28:42different
28:44The kids at school didn't understand me
28:46so they picked on me
28:48I spent a lot of time alone
28:51When my parents let me be me
28:55I felt
28:56like I didn't have to pretend anymore
29:00I felt free
29:01like
29:02when you're in a pool
29:03and you just let go and float
29:09I'm not a very good swimmer
29:20I don't know what it feels like
29:23to be anyone but me
29:28Me too
29:32Is the bilateral more risky than the unilateral surgery?
29:37The big issue with the bilateral is Quinn will never be able to have biological children
29:41If Quinn's parents think that Quinn's mature enough and strong enough in her beliefs then they should do it now
29:46It's an elective surgery on a child
29:49There is no medical necessity
29:50Except with a previous suicide attempt
29:53She's still at risk
29:54Her situation is different now
29:55She's socially transitioned and living as a girl
29:58But there just isn't enough good data on trans kids and their outcomes
30:02On the other hand
30:02There's very good reason to preserve future fertility
30:06Dr. Lam and Dr. Andrews are both very excellent surgeons
30:09And they very clearly have some passionate points of view
30:12But their views are their own
30:13You all need to decide what's best for Quinn
30:18Whatever we decide
30:20Quinn is still going to be a girl
30:25I don't know if I'll ever be able to accept that
30:29I know that makes me sound horrible
30:32I know what it's like to not put your family first
30:36And it cost me
30:38It cost me a great deal
30:41And if I had to do it all over again
30:44I'd ask myself
30:45Is it really worth sacrificing a life
30:48With someone I love
30:51Over an idea that may never be?
31:00Why don't we give them the room?
31:09Hey, I've got the page
31:11What's going on?
31:12She started screaming in pain and vomiting
31:14Temps 104
31:15Increased groin pain could be attributed to
31:17Epididemitis, kidneys, stones, inguinal hernia
31:20The extra weight of the tumor
31:21Could be causing a testicle to twist on herself
31:23There'd be no blood flow
31:26Thank you
31:31She has a testicular torsion
31:33She needs surgery now
31:43Excuse me, have you made a decision?
31:45Not yet, I mean there's a lot to work
31:47We need one now
31:48Quinn has testicular torsion
31:50The spermatic cord is twisted
31:51And cutting off blood supply
31:53We need to operate
31:57If you want Quinn to live the way she wants
32:00Don't limit her future now
32:05You heard her when my mom said she might want kids someday
32:08She can't even fathom the thought
32:10Because she's just a child
32:18Just do what's medically necessary
32:28There doesn't appear to be any palpable in thadenopathy
32:33It's likely a stromal tumor
32:34But get that to pathology right away
32:36Yes, sir
32:41Quinn has tachycardia and hypotension
32:45Not seeing any bleeding
32:47BKG is normal, it's not coronary
32:49CO2 and O2 are normal, so it's not a PE
32:51Must be a reaction to the anesthesia
32:52I'm already pushing fluids and basal constrictors
33:03Six syringes in and no sign of leakage
33:06Okay, we're wrapped up here
33:07Let's get Howard into recovery
33:09Well done
33:10Thanks
33:11I was thinking of writing up the procedure
33:14Possibly submit it for publication
33:16I'd be happy to assist
33:17Seeing as I've done it before
33:20Thanks, but I think I can
33:21I read your paper in Amsearch, Dr. Resnick
33:23You continue to impress
33:25Coming from you, I take that as a huge compliment
33:29When you get a chance, Dr. Brown
33:31You should read it
33:32Will do
33:41I've given vasopressors and reduced her meds as much as I can
33:45She's losing volume somewhere
33:47It was dry when we ligated the spermatic cord
33:49Until not seeing the bleed
33:50Could be vagal stimulation from this severed nerve
33:53She's not responding to epi
33:54Sepsis
33:55Too early for an infection
33:58Her map is 20
33:59She's barely perfusing
34:03Okay, excuse me, guys
34:05You're breaking scrub
34:06I'm so sorry
34:07Great to end a sign
34:09Could be a retroperitoneal hemorrhage
34:23Jared could be right
34:24It is possible that there is internal bleeding
34:28The testicular artery can retract up into the pelvis
34:32It's rare, but it can happen
34:34Rare is an understatement
34:36Dr. Andrews?
34:39I don't think we have any other choice
34:41You need to do an X-lap 10 blade?
34:52Murphy retract
35:02Internal bleeding
35:03Jared was right
35:07Nice call, Dr. Kalou
35:08Thank you, sir
35:10Kalou, suction
35:11We need a clear view of the field
35:19Fevers down
35:20And the flora in your system seems to be returning to normal
35:23We expect a full recovery
35:24Thank you
35:26For everything
35:27Do you know when I can have visitors?
35:29I thought you might ask that question
35:30There are a couple of eager preschoolers who'd like to say hi
35:35Sammie
35:36Sammie
35:36Kara, Sammie
35:38Oh, I think you guys have grown
35:43Hey, hey, these are the doctors that saved daddy
35:46Dr. Resnick
35:47And this is, uh, uh, I'm sorry I forgot your name
35:52Dr. Brown
35:53Thank you
35:54Thank you
35:55Thank you
35:56You're welcome
36:04Who's this guy?
36:06Beaver
36:15Beaver
36:16Did you do it?
36:17Did you remove both?
36:20No
36:21Just the cancerous one
36:22Why?
36:23Why not?
36:25That's on me
36:26I couldn't in good conscience remove a healthy organ
36:34Quinny
36:35This was our decision
36:37No, you said you were on my side
36:39Hey, we are
36:41Always
36:41We haven't had enough time to talk
36:44With each other
36:45With your therapists
36:46With your doctors
36:48So I'm gonna turn into a boy
36:49Not right away
36:51Your endocrinologist will talk to you about the right timeline for starting feminizing hormones
36:59You know
37:01The thought of having your own kids someday is a big decision
37:05But you never know what you will or will not want once you get older
37:08Cis people are always so worked up about having bio kids
37:12If I really want a kid that bad, I can just adopt
37:18You know, I'll be back when I'm 18 for my gender confirmation surgery
37:23And when you do, I'll be here to help you
37:33Patient satisfaction survey scores are in and it was very close
37:37Not really, she's being kind
37:40Congratulations go to Dr. Resnick and Dr. Brown
37:43Yes
37:44Thank you
37:47Congratulations
37:48Thank you, Sean
37:49Claire and I make a nice team
37:54Thank you
37:55Should we psyched?
37:56Yeah, I should be
38:00To the victor belong the spoils
38:04Yep
38:04Oh, humility was never your strong suit
38:09Thank you, Mortimer
38:11Don't spend it all in one place
38:14Spend it?
38:15I'm gonna frame it
38:18What made you think of a retroperitoneal hemorrhage?
38:21Homework? You're right
38:23Prepping for an SDA was important
38:25We make a good team
38:30Quinn doesn't like pink
38:32Oh
38:33Uh, I think she will like these
38:36I hope so
38:41She's more of a purple girl
38:51Did you read Morgan's hemorrhage article yet?
38:54It is on the top of my to-do list
38:57I didn't tell you to read it to rub it in
39:01I told you to read it so you knew what you'd be up against
39:03You think I need to be more cutthroat?
39:06No
39:06That's Morgan's MO
39:07You're different
39:09We're smart
39:10Special
39:12Rise up
39:13Play the game on your own terms
39:14Don't wait for it
39:16Don't wait for it
39:17Don't wait for it
39:17A year from now
39:19We'll all be gone
39:22All our friends will move away
39:26And they're going to better places
39:32But our friends will be gone away
39:44I heard you saved Quinn's life
39:48Jared and I did
39:50I like her
39:52Her
39:55You get that she is a she
39:57I have lots of questions
40:01Yeah well questions are good
40:04Leads to awareness and understanding
40:07And who knows maybe even acceptance
40:11Being a kid is tough enough but being a trans kid
40:14Oh man that's
40:15That's off the chart
40:19But I can't imagine how it must feel to be so
40:23Different on the outside than you are on the inside
40:34Hey Sean
40:35I can give you a lift
40:37We could grab a bite
40:41You said you can't be my friend
40:45So no thank you
40:46I've been talking about the way things change
41:00Hey amigo, what's up?
41:03I need your help
41:30Then you're going to be moving on and watch
41:48No, no, no, no, no.
42:23No, no, no, no.
42:53No, no, no, no.
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