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Doc - Season 2 (2025) - Episode 20: The Big Chair
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00:00Dr. Larson was in a car accident.
00:02She has no recollection of the last eight years.
00:05Previously on Doc.
00:06Let me run internal medicine.
00:08Back to your roots.
00:09When you need time to work out things with Michael, I accept it.
00:11But when the shoe's on the other foot...
00:12When the shoe's on the other foot, you have a hard time telling me the truth.
00:15Delayed decisions on his care have been hurting him a long time.
00:18You don't have to tell me the system's broken.
00:21How much prednisone does it take to get you through a shift?
00:23You will flame out in weeks.
00:25It's time for you to use your greatness to pull the greatness out of others.
00:28I'm going to miss you.
00:42Sorry.
00:43This guy loves his sleep.
00:45Oh, there he is.
00:47Hey, can I have a hug?
00:50Oh my goodness.
00:51This is yummy.
00:52Ethan was sorry to miss you.
00:54He had a really early meeting.
00:55Well, Robbie's the main event, right?
00:56What fabulous holiday have they canceled school for this time?
01:00It's Lunar New Year.
01:01Oh, well.
01:04Grandma's been all over the world.
01:06You know, she can probably teach you how to say hello in 50 different languages.
01:0967, but who's counting?
01:11I should be back around 6.
01:13Thanks so much for doing this.
01:14Are you kidding?
01:15The more time I get to spend with this little man, the better.
01:17Oh, I brought you donuts.
01:19Your dad said they're your favorite.
01:20Thanks, Grandma.
01:28Jonah, you okay?
01:30I'm fine.
01:35Robbie, why don't you go upstairs?
01:37Oh my God.
01:39Grandma!
01:40Jonah?
01:40Jonah?
02:07Good morning, everyone.
02:09Good morning.
02:10This is going to be an adjustment for all of us.
02:13Dr. Ridley certainly left some big shoes to fill.
02:15And I know all these leadership changes the past year have probably been unsteadying.
02:21There are a lot of reasons why I wanted to practice medicine again.
02:26But I want to be very clear about the reason I asked to sit in that chair.
02:31The past year, as your CMO, I have seen what every person standing in this room is capable of.
02:37Dr. Miller?
02:38Time and again, you have risen to the occasion.
02:41We have a 62-year-old female in respiratory failure, complications from chronic MDS.
02:46I'm on my way down.
02:47I'm not here just to lead you.
02:50I want to join you and help you do what you already do so well.
02:54An issue, a problem, a suggestion, my door will always be open.
03:00Before we go, some congratulations are in order.
03:03In two weeks, Dr. Matra and Dr. Larson will succeed Dr. Heller as chief resident.
03:09As we welcome our new class of interns.
03:16Now, if you both could hang back for a moment with Dr. Heller, the rest of you, do good work.
03:25I'd like our co-chiefs to shadow you before you start your pediatric fellowship.
03:30You can begin with Dr. Matra this morning and then alternate days.
03:33Yeah, sounds like a plan.
03:34Great.
03:39It's quite a move.
03:40Well, it was either this or a leather jacket and a motorcycle.
03:51Joan's in the ER.
03:53Paramedics said she was extremely short of breath, likely bilateral pleural effusions.
03:58So is she hypoxic?
04:00Oxygenation's improved on the mask, but she's hypotensive.
04:03Let's push norepimab goal above 65.
04:06No, Richard, that's not going to work.
04:07I'm sorry?
04:08She's on prednisone.
04:0930 milligrams and she's tapered off.
04:10I read her chart.
04:11No, her chart's wrong.
04:12She's on way more than that.
04:16I've been using it to get through a surgery.
04:20You knew about this.
04:23How much has she been taking?
04:26Double that.
04:31Turpol to get through the X.
04:32Vivo with Javi.
04:35My natural cortisone reduction's got me shot.
04:40Okay.
04:41Lucy, 100 milligram bolus of hydrocortisone before pressers and run a complete lab workup.
04:48We're all here, if you need anything, Joan.
04:54Should I call Ethan?
04:58He's on his way.
05:00Amy, I need you to remember where I am at the Anwar.
05:05Joan, no.
05:06We're nowhere near that.
05:19Good morning, Dr. Walker.
05:20Good morning to you, Walter.
05:22How's our rocket holding up?
05:24Can't wait to launch it.
05:25You think I can still leave today?
05:27Got to examine you first.
05:28Can't let you out of here until we're sure you're all better.
05:31I really want to show the rocket to the kids at the house.
05:34I bet.
05:35Looks like that thing might actually make it to space.
05:37Do you ever launch rockets with their kids?
05:39I don't have any.
05:41Really?
05:42I thought about it when I was younger, but decided to take a different path.
05:46What do you mean?
05:47Well, being a parent's a big commitment.
05:49But that's also true for being a friend, a sister, an aunt, especially a doctor.
05:55Eventually, I figured if I gave my best to all those other things, that'd be enough for me.
06:00You're a great doctor.
06:02That she is, buddy.
06:04Sorry I'm late.
06:05How's he doing?
06:06Well, breathing's much better.
06:07Let's look at those knees.
06:12Oh.
06:13How long has your leg been moving like that?
06:15It happens all the time with my RA.
06:16Shouldn't it be now with the medication you're on?
06:18Yeah, I'll order a CT.
06:20Well, that's bad.
06:20Just need to see what's going on.
06:22We'll get it sorted out, though.
06:24Time to find your social worker.
06:26Again?
06:29Atlanta actual instability this severe will progress fast.
06:32We have to operate now.
06:33We don't have to go ahead from his proxy.
06:34Well, his C1 and C2 are compressing his spinal cord.
06:37What's everybody waiting for?
06:38The social worker said he'd sign off on whatever we decide.
06:41But he doesn't want to get in the beads.
06:43Well, that makes things tricky, because we have two surgical routes.
06:46High risk, high reward.
06:48Open the neck, expose the vertebra, place the corrective hardware directly.
06:51But you're concerned about arterial or spinal cord trauma.
06:54Not to mention stroke, infection, ventral cord damage.
06:57Plus, he's still recovering from lung inflammation.
06:59Definitely a concern.
07:00And the second option is minimally invasive fusion.
07:02Far less trauma and easier recovery.
07:04But wouldn't we be relying on CT for navigation?
07:06Which means less precision with the hardware.
07:08Yeah, it may require going back in in six months or a year.
07:11And there's a higher chance for a screw misplacement.
07:13At the C1, C2 spinal cord, that could be severe.
07:16Both have risks.
07:19It's your call, Gina.
07:28Do the minimally invasive fusion.
07:30I'll go explain to Walter.
07:37So, I've got full-blown leukemia.
07:41Is he?
07:45My belief is that the steroids artificially raised your white blood cell count,
07:50hiding the degree of marrow infiltration.
07:53And I spoke to Dr. Rose, and he agrees.
07:56Now, if this goes unchecked, your decline will be rapid.
07:59So, we'd like to start induction chemotherapy,
08:01which could buy you a few extra months.
08:04This shows a pan-psychopenic picture without any sign of leukocytosis.
08:09Yes.
08:09As I just said, the steroids are complicating things.
08:12Her leukemia has an atypical presentation.
08:14But we need to act fast before it progresses.
08:17Or her presentation is atypical because it's not leukemia.
08:21Amy.
08:21Her counts are dropping across every line.
08:24That looks like marrow failure, not marrow takeover.
08:27You're reading too much into the blast count.
08:28No, I'm looking at the facts in front of us.
08:32She doesn't show cancer on the peripheral smear.
08:34If this is pan-psychopenia, we could give platelets and plasma to raise her levels.
08:38Blast proliferation and dysplasia are textbook signs of leukemia.
08:43And delaying treatment because of wishful thinking will cost you significant time.
08:48Or, if he's wrong, the chemo will damage all your organs.
08:52I believe this is Joan's decision.
08:59Start the chemo.
09:03I'll put the orders in.
09:10You're brilliant, Amy, and I know you don't want this to be true, but I can't.
09:17I can't lose any more time with my family.
09:23Yeah.
09:34Mom, any soreness in the incision?
09:36Oh, it was routine surgery.
09:37I'm fine.
09:39Where's John?
09:41He's here.
09:42Having a smoke.
09:43Surprised you didn't go with him.
09:45Believe me, if I thought I could get away with it.
09:48Not on my watch.
09:49Oh, I know.
09:50Dr. Larson.
09:52Not yet.
09:53Mom.
09:53Speaking of which, you should get back to Minneapolis.
09:56No, it's fine.
09:56But Dr. Ridley is away for a couple weeks, so I finally get a little bit of breathing room.
10:01Who's that?
10:01I've mentioned her, like, six times.
10:04Genius surgeon.
10:05Doctors without borders.
10:07Utterly terrifying.
10:08Oh, right.
10:09Her.
10:10Everyone wants her to be their mentor, but she travels around so much, I don't think she ever slows down
10:15enough to do that.
10:16What do you even need a mentor for?
10:17You want something, you get it.
10:19I've always been that way.
10:20Barely even needed to push you.
10:22Well, there were times I could have used some pushing.
10:28Amy.
10:29Hey.
10:30Hi.
10:31I got air spous as I could.
10:33She's stable now.
10:35Ooh.
10:36She's pretty drowsy from the chemo meds.
10:38Right.
10:40Okay.
10:43Amy.
10:45Joan's coag panels came back?
10:47Mm-hmm.
10:48She has DIC.
10:50If we had pushed platelets like you wanted, the runaway clowning could have caused a massive stroke.
10:56I know how hard this is for you, but you're going to have to let me do my job.
11:06Ethan.
11:07I'm Dr. Miller.
11:08Hey, it's good to meet you.
11:10It's good.
11:10It's good.
11:11It's good.
11:15It's good.
11:16It's good.
11:16are done what's next uh well your partner in crime's sitting vigil for a friend in the icu
11:21you checked in on her i didn't want to invade her space it's always better to extend yourself
11:27trust me she's gonna let you know if it's unwanted oh i'm sure she will so as chief
11:32resident you gotta be able to work with anyone is there anybody else anything you gotta get
11:35ahead of i don't know if you ever noticed but liz kind of had a thing for tj yeah she
11:41wasn't exactly subtle about it why what's the problem
11:47so you and tj wow okay um i guess i missed that how long has that been going on not
11:53very and you
11:54of all people don't get to judge i'm just not sure how everyone else will react well listen i mean
12:00you can't control how people feel about you okay all you can do is show everyone that you're gonna
12:04be there for them when things get tough uh dr honda do you have a minute of course yeah come
12:11in have a
12:12seat um i know i should have said something sooner i think i was just too afraid that no one
12:22was
12:22going to take me seriously it's okay liz what is it
12:28dr miller what he did to me everyone's just pretending like nothing happened but it was an
12:35abuse of power
12:38i appreciate your honesty and i understand how you feel not how i feel it's what happened
12:48nobody condones what dr miller did but an agreement was reached
12:52what agreement i'm afraid i can't discuss it so you won't tell me what happened
12:59it was a confidential settlement i'm sorry liz
13:05i guess this just proves why i never should have bothered coming forward in the first place
13:17ct confirms location we're clear the vertebral artery advancing cannula into position
13:28hey babe okay so i nearly had to sell my body for it but spoon and stable finally called me
13:35back
13:36they had a cancellation i told them it was our anniversary and they said they could squeeze us in
13:41six can you make that work oh looks like i'm gonna have to no way we're missing out on those
13:46oysters
13:46so there's a chance i may need to swing back here
13:50oh no is it that boy you told me about found a pretty serious issue with his spine he's in
13:56surgery now
13:56oh honey that's terrible are the social workers being helpful
14:00not really i had to make the decision myself about what surgery he should have
14:04okay i know it's not my lane and i love you for being a person who cares this much
14:10but the last time you got this invested in a case
14:13he has no one wendy i have no choice
14:19oh she told me about the prednisone said i landed her here a lot sooner than she would have otherwise
14:26yeah she is strong-willed that's what we love about her
14:31she probably felt like she had no choice
14:34you know i uh after i told her i didn't want to see her
14:37what else did she have besides work
14:39and how robbie may never even get to know her
14:43she knew that making things right with you was on her
14:46not you
14:49all you can do now is be there for each other
15:16What did you do?
15:20She was fine. She was just fine an hour ago. What did you do?
15:24It's not their fault. She had a heart attack. Nobody could have seen this coming.
15:34Amy. Uh, how's Joan doing?
15:38Oh, she's so stable for now. On chemo.
15:43I'm sure this must be hard for you, if there's anything I can do.
15:46Something's escalating in there.
15:50Your temperature's dropping.
15:52Yeah, core temp can drop after starting chemotherapy. It's normal.
15:56But it can also be a sign of sepsis.
15:58No, all of her cultures were negative.
16:02Is that true?
16:03Yes, of course that's true. And you should know that Dr. Larson recommended a course of treatment earlier
16:09that could have been catastrophic for your mother. So I don't think that it is a good idea for friends
16:15to treat each other.
16:20I admire your mom, but I can be objective. And that's what she needs.
16:27He's right. I'm sorry, Ethan.
16:38Hey. Do you have any of Joan Ridley's blood left over?
16:42Yeah, we should have some extra.
16:43Can you run a beta-D-glucan?
16:45Her cultures came back negative. What are you looking for?
16:48I want to rule out an invasive fungal infection. Something in the endothelial tissue.
16:53You got it.
16:54And when you're done, could you get me the results directly?
16:58It says Dr. Miller's assigned. He is. I need this, Karen. Please.
17:07Sure.
17:10Hey, how's it going?
17:12Hey, I'm at the school. Apparently Nia got into a fight.
17:17Let me guess, with Logan?
17:18I haven't had a chance to talk to her about it, but I figured we should do it together.
17:22Can I bring her by the hospital? It shouldn't take too long.
17:24Yeah, yeah, of course. Um, yeah, I'm here.
17:33She killed herself, Gina. All those times I begged her to quit smoking.
17:38Her blood pressure was through the roof. It was only a matter of time.
17:42You can't keep fixating on what could have gone differently, okay? All you can do now is start to process
17:48your pain.
17:49What makes you think I haven't?
17:50It's been a week and a half. I still haven't cried.
17:53Crying won't fix anything.
17:56I'm not saying force it, okay? But just let yourself feel.
18:00This is only going to get worse once you're an actual shrink, isn't it?
18:04That's neuropsychiatrist, thank you very much.
18:08I just need to focus on school. And maybe that hot bartender from Stanton.
18:14I'm serious, Amy. You're in grief. And you're mad at your mom. You can't just push all that away.
18:20Why not?
18:20Because when it comes to feelings, the piper has to get paid. One way or another.
18:34Hey.
18:36Just checking on you. Joan's BP and O2 sets are improving.
18:39Chemo must be having an effect.
18:41So I guess Richard was right about the leukemia.
18:44At least we have a diagnosis. Where are you?
18:47I'm in radiology with another patient. I'll be back soon.
18:51Okay.
18:54We won't be mad, honey. We just want you to tell us what happened.
18:59Look at those silly markers at me.
19:01I thought we said when he did stuff like that, you would tell the teacher.
19:04I did, but it didn't stop. So I took my chocolate pudding and I dumped it on his head.
19:14Um, so what happened? You told the teacher and they didn't do anything about it?
19:18They had him sit in the big chair. What's the big chair?
19:21It's a big comfy chair in the corner where you sit and think about what you did.
19:27So like a time out?
19:28Okay, but last week when you won the spelling bee, you said you got to sit in a big comfy
19:33chair.
19:34Yeah, you sit in it if you do something good. But then sometimes you sit in it if you do
19:39something bad.
19:43I want her out of that school, Rach. Okay? There's the public school. There's the Hebrew school we toured. I
19:48don't care which one. I just think that she needs to be somewhere with more boundaries and grit and fewer
19:52participation trophies and big chairs.
19:55Okay.
19:56Okay what?
19:57Okay, you're right. I'm wrong. Let's move her.
20:01What? Hold on. Did you just tell me I was right about something?
20:07And if you play your cards right, it might even happen again.
20:13I'll take her home.
20:14Yeah, yeah.
20:24Are you all right?
20:29Yeah.
20:33I'm just realizing how little power I have here.
20:41What happened?
20:45There's nothing to be done about it, Sonia.
20:47No, no, no. I'm going to be chief resident, which means I can advocate.
21:01And this is unprofessional.
21:03You were never going to test for this, Richard, and it's positive.
21:06You were not going to listen to me.
21:07Well, that was my call to make you.
21:09You want to tell me what's going on here?
21:10She ran a test behind my back.
21:12That is hardly the headline here.
21:14Joan has a candida organ infection, which he wouldn't have caught.
21:17I'm assuming you're interested in treating this, even though I was the one who found it.
21:22All right. All right. That's enough.
21:23Clearly, the chemo lowered her immune response.
21:26Decrease the dosage for now and treat the infection.
21:28But we are still on the right path here.
21:33You know, I might be more inclined to hear you
21:36if you weren't so concerned with putting me in my place.
21:43He was never going to order the panel out of spite.
21:46If you needed backup.
21:48Which is it, Michael? I'm supposed to come to you because you want to help?
21:51Or I'm not supposed to come to you because I put you in a tough position?
21:54Because I've heard it both ways.
21:56I am chief now of your department.
21:58That's a lot different than running two floors up to talk to the CMO.
22:01And by the way, you lied.
22:03Told me you were in radiology on our first day working together.
22:10You're right. I'm sorry.
22:14I'm, I'm, uh, every time I look at Joan in that bed, all I see is...
22:21Your mom.
22:26I wish you'd been there for that.
22:28I'm here now.
22:31I know.
22:32Try to hold on to that.
22:39I think he's waking up.
22:40Walter, can you hear me?
22:42It hurts. Please, it hurts.
22:44The blood pressure spiking.
22:45Walter, try to breathe.
22:47My neck, it hurts so bad.
22:48Two milligrams of IV morphine stats.
22:50Where in the neck?
22:50Why can't I move my hands? What's happening?
22:53It's okay, Walter. That can sometimes happen with swelling.
22:57He lost his Babinski.
23:00So the spinal cord's not sending a signal.
23:02Costa's running a CT to confirm, but it seems the cord swelling is causing compression.
23:06He's on morphine for the pain, but he's got serious neurological deficits.
23:10No movement below the neck.
23:11The sooner we can get back in and operate, the better.
23:13But his lungs are still inflamed from the RA.
23:15He may not be able to take another round of anesthesia.
23:18Dr. Costa's booked an offer first thing in the morning.
23:20Anything longer than that, then he could have serious neurological issues permanently.
23:23We should have been more aggressive.
23:24We can't Monday morning quarterback.
23:26The surgeon gave you two choices.
23:28And I picked the safer one because I was worried Walter doesn't have the long-term support
23:31to go for what was really needed.
23:33It was a coin toss, Gina.
23:34No, it wasn't.
23:35You wanted to go for the other option.
23:36But Costa waffled.
23:38It should not have been up to you.
23:39No, it shouldn't have been.
23:40So let me take this off your plate now.
23:42Tell Costa I want Walter in reverse Trendelenburg during the operation,
23:46and to use lung protective ventilation with low tidal volume.
23:53He may never walk again, Michael.
23:59Induction chemo did a number on me.
24:02Well, you're almost through the first dose, but we found an invasive fungal infection,
24:06presumptive Candida. We're treating it with antifungals.
24:11Candida must have seeded in my liver.
24:13No, well, not the liver. It's likely diffuse endothelial given the high beta-d-glucan level.
24:20Did you finish your homework? Is your father, is your father home yet?
24:26Mom?
24:26Joan, look at me.
24:27Hey, what's wrong with her?
24:28Ethan, step back.
24:31What's happening?
24:32She sees him.
24:34Oxygen to 10 meters.
24:35Alternative mental status, it's got to be neurological.
24:38Increased ICP, her brain is swelling.
24:40If she had leukemia, this wouldn't be happening. Not this fast.
24:43You're right.
24:44We're missing something.
24:50Look, I know whatever decisions were made about bringing Dr.
24:53Miller back are way above my pay grade, but we can't just ask Liz to forget what happened,
24:58because it'll make life easier for everyone else.
25:00I'm going to talk to Richard once Joan is stabilized.
25:03I'm sure he'll be willing to apologize to Liz.
25:06His apology is going to be hollow and meaningless. And you should know, when Dr. Miller was chief,
25:12he tried to use me to find out mistakes Amy was making.
25:16Look, I'm sorry you ended up in the middle of that, but I know the board. They'd rather find
25:23a way to get rid of Liz than reopen this can of worms.
25:25Well, they can try, but if Liz starts talking, they're going to get blowback from the nurses
25:30and potentially the union.
25:31Is that a threat?
25:34It's a reality. I'm just trying to do the right thing for her and protect the department,
25:39which is part of my job now.
25:41She bears responsibility for her own decisions, Sonia.
25:44As you said, she has a very strong union she could have gone to when all this happened.
25:47I think maybe you're expecting too much or not understanding the dynamic between an older
25:53man with power and a young woman at the start of her career. It's blaming the victim,
25:58and I don't think it'll be appreciated.
26:00I do hear you.
26:01Well, good.
26:04Because you started the day by saying your door was open,
26:06but now it seems like you're closing it on Liz.
26:15The MDS is late stage, but it's obscured by high steroid usage, pancytopenia, pleural effusions,
26:24DIC, elevated beta-diglucan, and now cerebral edema, and she's getting worse.
26:30Hey, just checked in on John. How are you holding up?
26:33I've been going toe-to-toe with Richard all day, and now we're running out of time.
26:37Who's this?
26:38Um, he's a doctor in Madrid who has a case study that might be relevant,
26:43and this translation app keeps glitching.
26:45Um, I mean, I minored in Spanish. We can see how rusty I am.
26:49Okay.
26:52Hello, Doctor.
26:53Um, let me see if I can give you a hand and translate.
26:56Ah, yes, thank you.
26:57I was trying to understand your colleague.
27:00Does your patient have leucemia?
27:04Uh, no, no.
27:05No, todavía no. Eso parecía, pero solo tenía un edema cerebral.
27:09Entonces, pues, hay algo que no nos cuadra.
27:11Ah, el caso que tratamos era un poco diferente de lo que ella explica,
27:16pero la clave fue sarcoidosis latente.
27:18Todo lo demás eran pistas falsas.
27:20Entonces, no sabían qué buscar.
27:23Exacto. Ese factor lo cambió todo.
27:25Gracias.
27:26Um, so, what he's saying is that the symptoms were similar,
27:29but his patient had dormant sarcoidosis,
27:31so that was complicating the clinical picture,
27:33but once they found that, everything else just fell into place.
27:35So, a patient with MDS like Joel presented with these symptoms
27:39because of a different chronic issue?
27:41And it went undetected for years.
27:44Okay. Okay. Thanks.
27:46Just remember, you gotta find a way to work with Richard on this.
27:52Your spinal tap came back negative and a full neuropanel, too.
27:56Well, her procalcitonin is low, even though she just had an infection.
27:59I need total protein, C-reactive protein, and complement levels.
28:03How fast can you do that?
28:05Twenty minutes.
28:05And if the results could go to me, since I'm her doctor, that'd be appreciated.
28:12We've got a high complement protein level,
28:14and the prednisone must have dropped her immune surveillance,
28:17which means that we're looking for something that's been there,
28:20possibly for years, like you said, but that's been hiding in plain sight.
28:24When Joan woke up and I told her about the candidate,
28:27she asked if it's seated in her liver.
28:29Well, that wouldn't be uncommon, but the beta-D glucan is so high
28:32that the fungal load would be too large to be isolated to her liver.
28:35Okay, we've been assuming that the elevated liver enzymes
28:38are caused by the MDS and the prednisone,
28:41but look at her blood work going back to 2016.
28:46Higher range of normal.
28:47But low enough that nobody would flag it.
28:502016.
28:52That's a long time for her to be carrying something.
28:55Wait a minute.
28:56One of my last memories of her, 2016, she was in Ecuador,
29:00and she got sick, and I told her that she should come back.
29:04And she self-diagnosed.
29:08She thought it was dysentery.
29:09Which means that she was drinking unfiltered water.
29:11So if it was a parasite, she could have been sick while she was digesting it,
29:17but by the time it migrated to her liver, she was fine.
29:19And she could have been fighting this quietly for years.
29:22And then the prednisone weakened her immune system and unleashed it on her.
29:28I think we have a pass now.
29:34He's losing sympathetic tone.
29:36Surgery's set for 6 a.m. Can we up the steroids?
29:39I'm too worried about his blood pressure.
29:41Think we just have to stay the course and hope that he's strong enough to hold on.
29:46I appreciate what you said before, trying to let me off the hook.
29:51You religious at all?
29:53From time to time, depending on how I'm feeling about the world.
29:58I remember going to this sermon once.
30:00The minister was talking about how it can be a form of hubris
30:04to think that we can control things that are out of our control.
30:10Because that's somebody else's domain?
30:12Doesn't mean it's easy to accept it, but I think that's the idea.
30:15Yeah.
30:17I'll take that under advisement, Dr. Coleman.
30:20Good.
30:25Your wife's here.
30:30It's my anniversary and I forgot.
30:32You go.
30:33I am all over this.
30:34Hourly exams, I will not go home.
30:42I've been downstairs 15 minutes.
30:44Tried calling you.
30:45I'm sorry.
30:46There were problems with Walter's surgery.
30:48He needs another one tomorrow.
30:51Why don't we have dinner in your office tonight?
30:53And that way, if anything happens, you're close.
30:57What did I do to deserve you?
30:59I don't know.
31:01I'm sure you'll find a way to make it up to me.
31:05I'm thinking 400 milligrams of bendazole.
31:08I'd go 300, given the ALT, AST, and 20 of AMFO beta balance.
31:14And 100 milligrams of cimitidine to cut the renal toxicity.
31:19It's a tightrope.
31:21Any idea where Liz is?
31:23Ah, let's see.
31:24Code blue, ICU.
31:26Code blue, ICU.
31:27Joan's coding.
31:29Code blue, ICU.
31:31Code blue, ICU.
31:34No pulse.
31:36He's in V-fib.
31:37Push one milligram epi.
31:38Get the defibrillator.
31:48Ready?
31:51Clear.
31:57Restarting compressions.
32:06Danny, Danny, someone call 9-1-1.
32:11Charge to 50.
32:13Clear.
32:20Pushing another milligram of epi?
32:29Find V-fib.
32:30We're losing him.
32:31Going up to 100.
32:32Give me the paddles.
32:38Ready.
32:39Clear.
32:50Looks like sinus.
32:51We have a pulse.
32:53He's back.
32:54Paige, Dr. Costa, we can't wait on the surgery.
33:20Cores decompressed.
33:22Screws are seated.
33:23Let's secure the rods.
33:26Hey.
33:31That must have been really difficult for you.
33:35Yeah.
33:37And the hell of a first day for Michael.
33:40Oh, I hit pretty close to home.
33:44How's it going in there?
33:46Hardware's almost in place.
33:48But even if it works, no one's ever gonna adopt him.
33:52Not when he needs this kind of support.
33:57You're not thinking of doing something drastic.
34:03Go be with Joan.
34:05Gina?
34:08I care about him.
34:11But I know what the boundaries are.
34:14Now go where you're needed.
34:30But you've gotta quit smoking.
34:32You know that's never gonna happen, honey.
34:38I don't know how much more we can pump into her before she starts shutting down.
34:43Her body's so fragile.
34:48Chemo didn't help with that.
34:51She was only on it for eight hours.
34:55The parasite is causing this, that, and the prednisone.
34:58It's not on you, Richard.
35:00Yes.
35:10Yeah.
35:13Yeah.
35:20Yeah.
35:37Hey, it's okay, buddy.
35:51Can I see?
35:56Oh, she's gonna love this.
36:01Is she gonna wake up soon?
36:03I really hope so.
36:21Hello?
36:22Hi, Amy.
36:23It's Dr. Ridley.
36:25Oh.
36:27Hi.
36:28I hope it's not 2am there.
36:29I stopped tracking time zone differences ages ago.
36:32Now it's noon.
36:33Is there a problem?
36:35I spoke with Dr. Kelly this morning.
36:36He told me about your mother.
36:39I'm just so sorry, Amy.
36:42Thank you, Dr. Ridley.
36:45I respect your tenacity already being back in the hospital, but I just wanted to make sure that you're taking
36:49care of yourself.
36:51I think so.
36:56It's been hard, obviously.
37:00Your world shifted on its axis, but you will come out the other side.
37:05I just didn't even think you liked me.
37:09Well, that's by design, my dear. And now you know the truth.
37:14Not only do I like you, I believe in you.
37:20So much.
37:22I...
37:22I know how bad this hurts right now.
37:24But the best way you can honor your mother is to live a life with purpose.
37:28You have greatness in you, Amy.
37:31And I'll be there to help you find it.
37:45Jo.
37:47Hey.
37:48Can you hear me?
37:50Can you get her son?
37:51He just went to get coffee.
37:53Hey.
37:55It's okay.
37:58Just go slow.
37:59Just breathe.
38:02What happened?
38:04You had cerebral edema.
38:07It's not leukemia.
38:10Not yet.
38:11You had a parasite in your liver.
38:14From Ecuador.
38:16Do you remember that?
38:17What?
38:17You thought it was dysentery?
38:20Oh, my God.
38:22Is that the one time in my life I misdiagnosed?
38:33You haven't looked after yourself for a long time.
38:39I know.
38:40Promise me that stops now.
38:42No.
38:42No.
38:43Mom.
38:48Thanks so much, Amy.
38:52I'll order CBC and liver function tests.
38:58The fact that she's conscious.
39:00Yeah, we got her some more time.
39:04I appreciate you finding a way to trust me today.
39:08Yeah, it worked out today.
39:11But I'm never gonna trust you, Richard.
39:21Hey, Walter.
39:23Welcome back.
39:24Did you fix my spine?
39:26We'll need to run some tests over the next few days,
39:28but it seems that way.
39:31And I'll be able to walk again?
39:32Well, it's gonna be a long recovery.
39:34Lots of physical therapy as your body adjusts
39:37to the hardware in your spine.
39:38But yes, you will.
39:44And I'll have to miss the next adoption fair?
39:48There'll be lots more.
39:50I promise.
39:51Thank you, Dr. Walker.
39:53Nobody ever killed the way you do.
39:59I am so sorry.
40:02It's okay.
40:03We'll do a rain check.
40:12Sometimes I wonder how you manage to leave it all here when you come home.
40:19It can be really hard.
40:20Yeah.
40:32Let's go get a drink, huh?
40:35Yeah.
40:45Hey.
40:46So, I spoke to Liz, told her if she wants to come forward to HR, we would both have her
40:52back.
40:54Oh, and I'm sorry if I was too-
40:56Sonia, speaking truth to power takes courage.
41:00I should be thanking you.
41:03Sorry, I didn't mean to interrupt.
41:05Oh, no, I was just leaving.
41:06Actually, I was hoping to speak to you.
41:12I just wanted to thank you for checking in earlier.
41:15Joan's improving.
41:16I heard.
41:17That's great news.
41:20So, are we going to do this thing together?
41:22Well, it's what she wants.
41:25She tends to get what she wants.
41:26Yeah.
41:32I saw Joan.
41:34She's spunky as ever.
41:36Can't keep that lady down.
41:39Amen to that.
41:41Good night, Jake.
41:43Hey, good night, man.
41:51Hey, did you know about her and Sonia?
41:53What about them?
41:56No.
41:57Yeah.
41:59I guess we set a good example.
42:07I heard your family was here today.
42:09Yeah.
42:10Um, Mia, she got in trouble at school.
42:13It was, I don't know, it was ridiculous.
42:17Maybe you can tell me all about it on the way home.
42:22Yeah.
42:22What's your thing, Chief? I can do that.
42:26It's co-chief.
42:27Co-chief.
42:28I'm sorry.
42:29That's just so awkward to say.
42:30No, you don't.
42:31Tell me about it.
42:33Co-chief.
42:34Let's go on a walk.
42:36How have you been?
42:38Did that fancy college art school let you in?
42:44Well, damn it, they'd be crazy if they never saw in you.
42:50What I failed to see at 17, I must have missed it too.
42:55Oh, kiss me, kiss me slowly, like you did when we were young.
43:06And hold me, like you know me, like the old days take me home.
43:44Well, no, girl, I am still here for those days alone.
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