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Greys Anatomy - Season 22 - Episode 04: Goodbye Horses
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00:08In 1952, Dr. F. John Lewis performed the first successful open-heart surgery using hypothermia.
00:14Oh, the, um, risk management workshop got moved to the third floor lecture hall.
00:19Mm-hmm. Not worth the interruption.
00:22I don't know. We're gonna, um, we're gonna be late if we don't go soon.
00:27We'll take the carpool lane.
00:33This week has been great. I mean, really, really great.
00:38But I work with your husband. Is it gonna be weird if we show up together?
00:42No. People carpool for all kinds of reasons.
00:50It is better for the environment.
00:57By inducing a hypothermic state, the surgical team created a window of several minutes to close a hole in the
01:03heart of a five-year-old girl.
01:05The predominant perperator should be in the medial row.
01:09He still got it.
01:11You want eggs?
01:12Uh, I'm not hungry.
01:14I have to tell my patient she's stage four.
01:17I'm sorry.
01:19Want to talk about it?
01:20No.
01:22You want pancakes?
01:26Yes.
01:27Yeah.
01:28Yeah.
01:31At one surgery, James changed the entire course of human history.
01:34You here late last night?
01:36Max and Irvin had an engagement party.
01:39Losing bingo and I lost both.
01:41Wait, Max, you just getting married?
01:42Yes.
01:42And I am a bridesmaid.
01:45I have to choose my dress today, so if anybody wants to weigh in...
01:49Hell yeah, I'll be too busy working with Jackson Avery.
01:51Wait, you're scrubbing in on the deep flat reconstruction?
01:54I've been asking to be on that for a week now.
01:56Oh, well, if it helps, it comes with a plastics fellow who rage-hates me.
02:01Yeah, that does help.
02:02But as they watched her tiny heart, desperate for it to beat again, it could have gone either way.
02:09All they could do is hope.
02:11You don't have to wait with me.
02:12I'm just here for the chair.
02:14Take it.
02:15I am over recovery.
02:17Yeah, but don't forget PT and a lot more rest.
02:20Tell that to my kids.
02:23Hey, look who it is.
02:25Morning.
02:27Hi.
02:29Uh...
02:30Are you...
02:32Are you, uh...
02:32Officially discharged.
02:34Congratulations.
02:37Hi.
02:38Cass.
02:39Beckman.
02:39I remember.
02:40It's nice to see you.
02:41Likewise.
02:42Yeah.
02:44We're going to the risk management class.
02:47Yeah.
02:47That's why we carpooled.
02:48Mm-hmm.
02:49Well, you know, we should get going.
02:51Gotta get those CME hours in.
02:53Well, um, enjoy being home, Link.
02:55Hmm.
03:00Didn't realize you lived close to the Beckmans.
03:02Yeah.
03:03That's true we do.
03:05Did Ann Schroeder's Coley get, uh, rescheduled?
03:08Uh, we did that yesterday.
03:09Well, I should say Quan did most of it.
03:12He did a good job.
03:13Patient did well also.
03:14Teresa Gomez's hernia repair.
03:16Well, now that OR2 is back, we can fit her in on Wednesday?
03:20Well, she'll be happy.
03:22Okay.
03:25You know, I want you to know how grateful I am that you're back here.
03:29I mean, between the surgeries and the teachings and...
03:32Happy to do it.
03:34I know you are.
03:36But thanks.
03:42You've got to be kidding me.
03:44Was everything okay?
03:51Our water bill doubled this month.
03:53Irvin likes long showers.
03:54Have you suggested he and Maxine shower together?
03:58Move in with us.
04:00Free rent.
04:00We split utilities.
04:01You want me to live with you?
04:03Thanks, but no.
04:04All right, step it up.
04:05A patient from an equestrian accident just came in.
04:07Now a horse can inflict severe injuries on a person.
04:10Jonah Nolan.
04:11Yeah?
04:12I hear you fell off your horse.
04:14You're in competition?
04:15Me and Vince were warming up together.
04:16Vince, is your horse?
04:17No, it's me.
04:18My horse caught a fence and went down.
04:20Jonah was right behind me.
04:21Gashed his head on Mojo's bridle.
04:23Mojo's his horse.
04:25All right, can you take a look?
04:26Yeah.
04:27Thanks.
04:27And what about you?
04:28Are you feeling okay?
04:29Just a little sore.
04:30I'm going to finish competing once Jonah's okay.
04:32You should still get checked out.
04:33I mean, falling off a horse can do serious damage.
04:35They're powerful animals.
04:36No, Carrot's very gentle.
04:40That's the horse you fell off?
04:43Uh, let me guess.
04:44The other one is Mojo?
04:46Yeah.
04:47Thank God they're both okay.
04:50Yeah.
04:51Um, okay.
04:51Well, uh, it looks like it's just lacerations and abrasions.
04:55So you're going to be fine.
04:57I'm feeling a little dizzy.
04:59Oh, well, um, Mellon, let's, uh, request a neuro consult just to be safe.
05:05Okay?
05:05I'll close him and clean them up.
05:07Thanks.
05:08Um, Drusash starts in 20 minutes.
05:11Do you think we can make it back by then?
05:12I'm going to say nay.
05:16Remember when Avery gets to the venous anastomosis?
05:19He likes to use an anastomotic coupler.
05:21You've mentioned it twice.
05:23I applied for an attending position in his department in Boston after this fellowship.
05:28You and probably a hundred others.
05:30My parents live near there, and they could really use my help, so this is my chance to impress him.
05:35I won't let you screw this up.
05:37Happy to work with you again, too.
05:40Oh, did you invite to home a hospital?
05:43We don't get to see a lot of deep flaps.
05:45Patient's cool with it, though.
05:46Good morning.
05:47Who can walk me through a Millard repair on a cleft lip?
05:50Use a curvilinear incision with the rotation flap from the medial lip element and the advancement flap from the lateral
05:55element.
05:56That's correct.
05:56Dr., um...
05:57Mohanty.
05:58Kavita Mohanty.
05:59Plastics fellow.
06:00And a fellow.
06:01Perfect.
06:02I got a five-year-old, an OR4, who's going to be very lucky to have you.
06:04I'm sorry.
06:05I ran into Dr. Camden in the lounge, and he needs an assist, so enjoy.
06:09Everybody else, you're with me.
06:10Let's go.
06:10Dr. Richard's call a cleft.
06:12Dr. Richard's call a cleft.
06:18Morning, Perry.
06:19Good morning.
06:21So you brought the surgical army.
06:23Well, they'll mostly observe.
06:24Well, the more the merrier.
06:26And you must be the infamous Dr. Avery.
06:29Well, I understand you're the one with the reputation.
06:31Training firefighters is very impressive.
06:32Oh, not officially.
06:34A few of them take my psycho warrior spin class.
06:36She's being modest.
06:37Half the department's only in shape because she kicks their butts.
06:39Okay, well, please don't kick mine.
06:41All right, Warren, you want to do the honors?
06:43Yeah.
06:43Perionicle 50 with past medical history of ERPR positive invasive lobular carcinoma of the left breast.
06:50Status post-bilateral mastectomy.
06:52Completed chemotherapy and radiation disease in remission.
06:56Here today for a deep inferior epigastric perforator flap for breast reconstruction.
07:02Sorry.
07:03I'm just very happy to hear those words.
07:05Well, so are we.
07:06Do you know how this is all going to work?
07:08I was kind of hoping you did.
07:09Fair enough.
07:10All right, well, we will begin by removing pieces of your skin, fat, and blood vessels from your lower abdomen
07:16here,
07:16transplanting those up into your chest.
07:18Who can tell me where we connect the flap?
07:21You connect it to the internal memory?
07:22That's correct.
07:24Not all plastic surgeons do this.
07:25You're in very good hands.
07:26He's right.
07:27You ready?
07:29For a new rack and a tummy tuck and one surgery, bring it on.
07:33All right, we'll get you started with some new scans right away.
07:40Dr. Gray.
07:42Dr. Gray.
07:43Morning.
07:44You're like Karasik publishes Alzheimer's results?
07:47Technically, that was the Journal of American Medicine.
07:50It's good to see you, by the way.
07:51He only studied male mice.
07:53I did the same experiment with female mice, and when I gave them antibiotics, there was no decrease in Alzheimer's.
07:59Mayor, don't start with me, please.
08:01So now because he's gone public, people will assume that what's true for male mice is true for all mice.
08:06This is exactly the kind of thinking that I'm trying to change.
08:09Yet, your lab is apparently completely unused, and you haven't published anything.
08:13Why is that, Meredith?
08:15That's a cop-out.
08:16Okay, so then why don't you explain it to me?
08:18Why is it that antibiotics don't work on female mice?
08:21I'm still working on my hypothesis.
08:22I don't know yet.
08:24Maybe instead of hiding out here all summer, you could be figuring this out.
08:26I have a surgery.
08:27Have a nice day.
08:44So you race hobby horses?
08:50Well, not just race.
08:52Um, show jumping, hunter jumper, puissance.
08:57Piaf.
08:59Passage.
09:02You on a team?
09:03It's an individual sport.
09:05Pretty niche.
09:06Mostly girls.
09:06A lot of the competitions, Vince and I were like the only guys, so eventually we became friends.
09:12Uh, Nero is on their way.
09:14We were busy with another patient.
09:15Did you tell them there's a championship trophy on the line?
09:18I did not.
09:19I'll be fine.
09:20You should go back before Evie wins first in dressage.
09:22She'll be insufferable.
09:23No, it's not that.
09:25It's my chest.
09:29Oh my God!
09:30Oh, we need some help!
09:34How can I be stage four?
09:36My scans.
09:37I thought the tumors were shrinking.
09:40And fortunately, sometimes tumors learn how to evade chemotherapy.
09:48Okay, well, if my cancer wants to fight, I'll fight harder.
09:55So, what now?
09:58Well, first things first, um, you have to recover from your splenectomy.
10:03And then we will start a new chemo regimen.
10:07Great.
10:08Really wasn't a fan of the old one.
10:10And, and we'll also look into clinical trials.
10:12There's a lot of new, promising therapies out there.
10:16We just have to find the right one.
10:19Okay.
10:20Sounds good to me.
10:25I, I, I haven't seen anyone visit.
10:29Have you told friends, family that you're in the hospital?
10:32If I tell them, they'll get upset.
10:34And then I'll get upset.
10:35And I just need to fight.
10:39Oh.
10:41Well, I, I don't know your mom.
10:43But I am a mom.
10:45And we are really good at fighting, too.
10:51Yeah.
10:53Once we know more, I will tell her.
10:58I promise.
11:02All right, I'll be back.
11:12I need your full attention on Katie Rogers.
11:16I thought we were just advancing her diet.
11:18We're full of fluids, right?
11:19No.
11:20She needs a clinical trial.
11:22Um, and I don't have time to search a database today.
11:26So, I need you to find options.
11:29See what's active.
11:31And then call, uh, around to see what's in the pipeline.
11:34Okay.
11:35I was gonna observe Dr. Avery's surgery.
11:37But I can carve out some time after.
11:40Mead will check on her every half hour.
11:42You can carve out some time for our patient with metastatic cancer.
11:46Well, how generous are you?
11:48Uh, you keep telling me to teach.
11:50And you told all of us to study Dr. Avery's deep flap.
11:53Katie is giving this her all.
11:55So, we need to give our all.
11:57Do you think taking a break and watching a surgery is giving it your all, Dr. Adams?
12:03Uh, I'll skip it.
12:06Leave no stone unturned.
12:19What is taking so long, all right?
12:21Avery's gonna want those scans to evaluate perforators.
12:24You work with him before?
12:26Yeah.
12:26Yeah, I can read and anticipate him pretty well.
12:29Yeah.
12:29Used to be part of his, uh, his plastics posse.
12:32I don't know what that is, but I want in.
12:35You interested in plastics?
12:38Uh, don't have the extra three years.
12:40Too many things on my plate right now.
12:42Just, yeah, I just, uh, enjoy every case that I can.
12:45Oh, the scans are in.
12:48How do you anticipate Avery's gonna feel about his deep flap patient having an inguinal hernia?
12:57There he is.
12:58Hey.
12:59I read, uh, Karasic's article.
13:02Bold.
13:02Yeah, his study yielded interesting results.
13:05Yeah.
13:05I meant bold on your part.
13:08So I've been told.
13:10Hey, are you, are you busy?
13:11I've got a patient CT showing a right-sided inguinal hernia.
13:14Is it reducible?
13:15Uh, it is.
13:16Yeah, simple, fat-containing.
13:17Hoping you could do it.
13:19I wish I could, but I'm in budget meetings all day.
13:22Okay, anybody else?
13:23Um, good luck.
13:25Don't.
13:26Hey.
13:27No.
13:28It's for a patient.
13:29Call Tom Karasic.
13:31She's a breast cancer survivor, Amir.
13:33All right, and she's got a hernia.
13:34As long as she has that hernia, I can't give her the breast reconstruction that she needs.
13:38I can come back another time and I can do the flap, but she needs a repair done, like, ideally
13:41today.
13:42Call someone else.
13:44She's had a year from hell.
13:45Today was supposed to be her first step back.
13:47She deserves the best, and you can help her a lot better than I can.
13:49Please.
13:53Send me the scans.
13:57What happened?
13:58He was complaining of increasing chest pain, and now he requires four liters nasal cannula.
14:03I'm supposed to take golden dressage.
14:05Where's Karen?
14:06What are you doing here?
14:07One of Joe's patients went into premature labor.
14:10She's upstairs checking on her.
14:11I didn't want to wait in the car.
14:13You need a consult?
14:13You can't consult.
14:14You can't even work yet.
14:15I haven't approved it.
14:17All right, his vitals are stable.
14:18I was going to check his spine.
14:19Let's go.
14:21Let me know if anywhere hurts.
14:24Can't you just give me meds for the pain so I can go back to competing like they do in
14:28the Olympics?
14:28What's the competition?
14:29Not the Olympics.
14:31Washington hobby or so again.
14:33Well, I work with professional athletes, and I wouldn't advise it.
14:35Ow.
14:36Ow.
14:36Okay, around T4, and no step-off.
14:41Let's take that x-ray.
14:43Or, you know, whatever Hunt wants.
14:46Okay.
14:46Clear for x-ray.
14:51Okay.
14:52Yeah, ribs four to six are fractured on the left side.
14:54Some haziness, probably a lung contusion.
14:56No one asked you.
14:57Maybe you should.
14:58The guy said he worked with pro athletes.
15:00We need to scan you to get a better idea of what's going on, okay?
15:03Well, then can he come?
15:04This is my last shot at the state before college, and if I'm going to have a chance of competing,
15:08I want the best.
15:10Guess I'm back.
15:13Okay.
15:19Sorry to pay to all the seminars.
15:20Oh, please.
15:21I've never been closer to napping in public.
15:23Well, the patient's complaining of chest pain.
15:24She asked for a n'doo goo, but your name's also on her chart.
15:27Okay, great.
15:33Nora, hey.
15:36What's going on?
15:37Um, I woke up with some chest pain, and I thought it might go away, but it hasn't, and I'm
15:42really freaked out.
15:43Okay.
15:45Uh, is it sharp, or does it feel like pressure?
15:48It's more like a dull ache.
15:50Okay.
15:50Let's work you up.
15:57The reconstruction is off?
15:58Postponed.
15:59Dr. Gray will repair the hernia today, and then once you're healed up, I'll come right back and do the
16:03flat.
16:03Can't you just do both today?
16:04It's a much longer and more complicated procedure.
16:07You will recover quicker if we do them separately.
16:10Depends on how you define recover.
16:17What do you mean?
16:18I'm not ashamed of how I look, but at work, I am surrounded by mirrors, and when I see my
16:24reflection, it is a constant reminder of all the pain and waiting and exhaustion of not knowing if I'd live.
16:35I won't be fully recovered until I can look in the mirror and see me, not my cancer.
16:45We understand, but-
16:46We'll do both surgeries today.
16:48Will we?
16:49She'll go under anesthesia once, which is not a bad idea considering all her body has been through.
16:53But that is much more time under anesthesia, and I'm concerned about the postoperative pain.
16:58I will gladly take on the risk if it means waking up tomorrow and feeling like myself again.
17:08I'll prep.
17:16Hey, you hear about the fellow who got kicked off the D-flap?
17:18How would I hear that?
17:20Guess who gets a scrubbing on a D-flap and a hernia repair now?
17:23I'm gonna go with Warren.
17:25You still gotta come check it out?
17:26Now, Bailey put me on research while she's in the O.R.
17:29Well, so she demoted you back to an intern?
17:31Trax.
17:33That's her.
17:33I gotta go.
17:35You would want to live with me, right?
17:37I do live with you.
17:39I don't have, like, a smell or a weird habit.
17:41Am I allowed to?
17:43What is this about?
17:44I asked Jules to move in with us.
17:46Without asking me?
17:47You yelled at me when I did that.
17:48Doesn't matter.
17:49She said no.
17:50That doesn't let you off the hook.
17:51Why wouldn't you want to live with me?
17:53I'm a good roommate.
17:54Maybe she doesn't want to live with me.
17:55No, she specifically said live with you, meaning me.
17:58Then she took a hard pass.
18:00Hmm.
18:01What?
18:01I'm not done freaking out.
18:04Maybe the two of you just aren't as close as you thought.
18:09Promise me.
18:11Promise me.
18:12I do.
18:18Hey, you need something?
18:20Yeah, I just had a question for Dr. Bailey.
18:22Well, she's in surgery.
18:24You can try me.
18:26Do you think I'll be healed enough to start my new chemotherapy before I'm discharged?
18:31It'll be more like three weeks.
18:33A month with no treatments.
18:34Well, we want to give your body time to heal after surgery.
18:38But Dr. Bailey and Dr. Sugihara will meet later to talk next steps, and I'll be looking at clinical trials.
18:43You're in charge of finding clinical trials.
18:47Is that a problem?
18:51I thought we were okay.
18:52Well, when you were checking my incision, that was one thing.
18:55But clinical trials have serious ramifications for me, and I don't know anything about you.
19:02What do you want to know?
19:03Where did you go to medical school?
19:06Cornell.
19:07Did you get good grades?
19:08I'm a surgeon, so yeah.
19:10Did you ever kill anybody?
19:11By accident.
19:12I mean, if you murdered someone, I'd rather not know.
19:15Look, we could do this all day, but it's in your best interest if I'm researching therapy.
19:19So I'll be out there.
19:21And if you need something other than my social security number, give me a shot.
19:31All right, what do we got?
19:33Uh, x-rays shows a hemothorax and some broken ribs.
19:36And what's the mechanism?
19:38Hobby horse injury.
19:40Hey, didn't I just sign off on your discharge papers?
19:43Yeah, don't ask.
19:45Okay.
19:46Uh, hobby horse, like a stick horse?
19:49No, you can't call it stick horses for children.
19:51Hobby horsing is far more sophisticated.
19:53There's a whole league, apparently, and you cannot call it stick horses.
19:57Very offensive.
20:00I looked it up in the elevator.
20:03Okay, uh, just a little longer, Vince.
20:06Guess I'm missing the barrel race.
20:08I know it sounds weird.
20:11No, no.
20:12Seems fun.
20:13Most people don't get it, but that's what's cool about it.
20:15Being part of a community that loves something and doesn't care what anybody else thinks.
20:19But I'm going to college in Colorado, and there's no hobby worse than there.
20:23So, pretty soon, I hope I won't be part of anything.
20:26Just be a guy who fell off a big horse and...
20:30Mr. Stolick's in the 60s.
20:31His sats are tanking.
20:33He's got a code.
20:33Okay, let's get a chest tube train.
20:35I'm prepared to intubate right now.
20:36And I'll notify the OR.
20:45Getting ready to secure the mesh to the shelving edge.
20:48Dr. Korn, hold attention on my suture.
20:50Okay.
20:51How's that?
20:52Good.
20:54I am scrubbed and ready.
20:56Hope you're happy.
20:57Last time I checked, I was doing you a favor.
20:59You're welcome.
20:59You encouraged her to take a bigger risk.
21:02No, I listen to her.
21:03There's a difference.
21:03With all due respect, I spend the majority of my clinic hours listening to female patients.
21:08Oh.
21:09Do a lot of deep flaps?
21:10Fair amount.
21:11Let me guess.
21:12Not as many as you'd expect.
21:14Well, no, because most people don't know that the law requires insurance companies to cover
21:17breast reconstruction after cancer.
21:19Yet somehow everyone knows you can get a vasectomy.
21:22You see a pattern here, Dr. Avery?
21:24I see several, Dr. Gray.
21:25You made your point.
21:26Too bad he can't publish that.
21:33I'm done here, Dr. Kwan.
21:34You can close the fascia.
21:41So this should just take a few minutes.
21:43Try to hold still.
21:44I'm not going anywhere.
21:46And then I'd like to review your daily routine, your diet, just to make sure that you're not
21:50inadvertently putting any strain on the repair.
21:58Hey.
21:59We're on a break.
22:01Do you want to grab a bite after this?
22:03Oh, um, now's not a good time.
22:05Are you okay?
22:07Yeah, I just, I have a really complicated patient.
22:10Well, I'm happy to bounce some ideas around.
22:12Want me to consult?
22:14Or just support?
22:16You know what?
22:17Um, the scan should be coming up soon.
22:19You should probably go.
22:21Is this because we ran into Owen earlier?
22:23No.
22:24Are you sure?
22:25Because you seemed fine at the hotel.
22:27More than fine.
22:28And now?
22:29And now I am treating an extremely risky patient who requires my full attention, and I'm not
22:34in a hotel bad name at work.
22:39Well, then I will leave you to it.
22:41Okay.
22:47He has a lower lobe injury.
22:49I'm seeing multiple lacerations of his lung.
22:51I'll do a wedger section.
22:52How much do you have to take?
22:53Can someone page Wilson and see how much longer she's going to be?
22:57You know, I had a hobby horse when I was a kid.
22:59Scared the crap out of me.
23:00I couldn't sleep unless it was facing the wall.
23:02You know, I wasn't going to say anything.
23:04It's weird, right?
23:05That's a bunch of people jumping around on toy animals.
23:08There's a website where you can customize your horse's head.
23:11Okay, enough.
23:13I'm not here to judge.
23:14We're here to fix it.
23:14If you can't just focus on the job, then you should go.
23:16This kid loves his sport, and after today, he might not be able to do it anymore.
23:19Haven't you ever loved something and lost it?
23:20Let's show some respect.
23:22I'm sorry.
23:23Me too.
23:24Suction.
23:30This is lining up perfectly.
23:33Dr. Warren, why don't you go ahead and grab that clamp.
23:37Beautiful.
23:38Very nice.
23:40Is there something you need, Dr. Mahonti?
23:42I'm done with the Millard repair.
23:43Thought I'd see if you need more hands here.
23:45Oh, we're good, but thank you.
23:48Understood.
23:48Warren, when I'm done with the arterial anastomosis,
23:51you want to give me a hand with the venous coupling?
23:54Absolutely.
23:55Dr. Avery, may I be excused?
23:57I'm really not feeling well.
23:59You were fine ten seconds ago.
24:01I think I might have had questionable leftovers for lunch.
24:07Might come out of both ends.
24:09No need to elaborate, Dr. Kwan.
24:11Mahonti, looks like it's your lucky day.
24:15I'll go scrub him.
24:16Okay.
24:21Dr. Avery, just finished the microvascular anastomosis and made it look easy.
24:26It's insane.
24:27Mead?
24:27Yeah.
24:28Go somewhere else.
24:30Oh.
24:30Okay.
24:34You need something?
24:36Yes.
24:37What is PD-L1?
24:40Program cell death ligand.
24:41It's a protein that helps your cells more effectively kill cancer cells.
24:45Okay.
24:46And CTLA-4?
24:48It's an immune checkpoint inhibitor.
24:50Another mechanism that clinical trials are exploring for treating cancers like yours.
24:54Why?
24:55Yeah, no, I'm searching clinical trials.
24:57It's all fairly overwhelming.
24:59Yeah, most of the possible side effects aren't that bad.
25:02May cause dry mouth nausea or death.
25:05Yeah, death seems pretty bad.
25:08Yeah, that's just lawyers making sure nobody gets sued.
25:11Oh, that doesn't make me feel any better.
25:13Oh.
25:14Ouch.
25:16You okay?
25:17No, my leg hurts.
25:19I'm not used to being on my feet.
25:21Let me take a look.
25:24Ow.
25:26Ow.
25:26Ow, stop, please.
25:27Grab a wheelchair.
25:28Right away, Dr. Adams.
25:30Wait.
25:30No, what's going on?
25:31What's happening?
25:32I think you have a blood clot.
25:33Let's get you back to your room.
25:34We need to ultrasound your leg ASAP.
25:41Dr. Brasington to the ER.
25:43Dr. Eden Brasington to the ER.
25:45Sorry, I know that you said no screens with a concussion.
25:47I just wanted to watch Vince in last year's puissance.
25:55Whoa, how high is that bar?
25:56Four feet.
25:57They raise it after every round.
25:59That's pretty impressive.
26:01It's not even his best event.
26:04People don't realize how much strength and precision it actually takes.
26:09When I would tell the other kids, they would just laugh, so I stopped talking about it.
26:13I would just say that my mom wouldn't let me go to the movies instead of saying that I had
26:16practice.
26:18But then I met Vince.
26:20I didn't have to lie anymore.
26:22Everything changed.
26:24He got me.
26:28I'll put this away.
26:29No, actually, Nero cleared you.
26:30You can go.
26:31Really?
26:31Mm-hmm.
26:32We might make it back for Hunter Jumper.
26:34That's Vince's best event.
26:35He's going to be so psyched.
26:36Actually, Vince can't go.
26:37He's in surgery.
26:38For real?
26:39I can't say more because of privacy laws, but it shouldn't be more than...
26:42Oh, you can't see him yet, but I'll let you know when he's out.
26:44I have to make it back to the competition.
26:46I finally have a shot at winning Hunter Jumper.
26:48Your friend is in surgery.
26:49Vince would want me to go.
26:51Can you shut the curtain so I can change?
26:57What is wrong with people?
27:04Hey, am I interrupting?
27:06My five-year-old lost a tooth.
27:08Cute.
27:09Well, it's because his brother knocked him off his swing, but still cute.
27:13He's fine.
27:14That makes two of you.
27:15I'm okay?
27:16All your tests came back clear.
27:17Oh, my God.
27:18Okay.
27:21So the pain is...
27:23I'm guessing indigestion, so I'm going to put you on an antacid?
27:26I can't believe I bothered you with this.
27:28No, it's okay.
27:29I am still your doctor.
27:31You know, I used to be one of those moms who would put a handwritten note in her kids'
27:35lunches every day.
27:37And since the divorce, and then the surgery, I'm lucky if I can get them to school on time
27:43in clothes that they didn't also wear to bed.
27:46I can't seem to get myself to the right place at the right time anymore, and I'm sorry I dragged
27:50you into it.
27:51I get it more than you know.
27:57Owen and I are looking at divorce.
28:01I'm so sorry.
28:02I didn't know.
28:03Are you okay?
28:04It's taking some getting used to.
28:07If I had anything to...
28:09No, it was all us.
28:11It's okay.
28:12I mean, it will be okay.
28:15We're not there yet.
28:16I definitely have a long way to go.
28:19But I'm just...
28:20I'm just hoping that we both have a chance to find what makes us happy.
28:28Yep, there it is.
28:30A small clot in the distal popliteal vein.
28:33Does that mean I'm gonna have like a stroke or something?
28:35Well, we still need to scan you to make sure you don't have one in your lung, but looks
28:39like we caught it early.
28:40I'll put in an order for heparin drip, and then I'll update Dr. Bailey.
28:48It's always something.
28:51Cancer, unfortunately, makes your blood more prone to cold.
28:53I don't know what's going on in your thoughts.
28:56I haven't told any of my friends that I'm here.
28:59They wouldn't get it.
29:01Their biggest problems are passive-aggressive co-workers and where to get drinks on a Thursday
29:07night.
29:08I'm not mad.
29:09I want that, too.
29:11I want to hang out in wine bars, go to Europe, watch my friends get married and have kids.
29:19And, um, this might sound really dumb, but I really want to try a slice of New York cheesecake.
29:29Well, I'm from New York.
29:33I bet I could help you with that.
29:36Mostly, I just want to fight.
29:38There's nothing I can do except sit here and think about my cancer cells multiplying until
29:44I die.
29:46And I really don't want to die.
30:04All right, let's prep for the venous anastomosis, please.
30:09Don't we need the hockey stick?
30:10Already got it.
30:11I like the teamwork.
30:13Well, auntie, why don't you do the venous coupling?
30:15You ever done one before?
30:16Of course.
30:19Wait, look at the other flap.
30:20Does it look like it's turning blue?
30:24It looks like congestion in the venous outflow.
30:26Well, what do we do?
30:27The flap's not viable without good outflow.
30:29And we don't have any options in terms of the reconstruction.
30:32Was there bleeding when Gray repaired the hernia?
30:34All right.
30:35So she probably sacrificed a superficial epigastric vein.
30:38Perry's probably superficial dominant, so the vein's too short.
30:41That would explain the decreased outflow to the flap.
30:43All right.
30:43How are we going to resolve this?
30:45It's too short to connect to the retrogrid IMV, so a cephalic turndown would give the buildup
30:49of blood a place to go.
30:50Very good.
30:51So we will begin by isolating the cephalic vein.
30:54I'll do the turndown, and then we can get back to work on the other flap.
30:57Nice work.
30:58Welcome to the plastics, posse, auntie.
31:05I asked Millen to update me on Vince's recovery tomorrow.
31:08Hope you don't mind.
31:09Sure.
31:09Yeah, kind of got a soft spot for the guy.
31:12I really wanted to compete in the National Marble Tournament when I was a kid.
31:16Crushed me when I lost my lucky hazer.
31:21You okay?
31:22I'm fine.
31:27Joe told me about you and Teddy.
31:30If you ever want to talk.
31:31About what?
31:32Like, you're going to help me process the end of my marriage, get over the loss of my wife
31:36and my best friend, and you say, what, you can relate because you lost a marble once?
31:41I'm just here to support.
31:42I shouldn't be here at all.
31:57Unless that mouse needs an appendectomy, this is not official hospital business.
32:02How's Perry?
32:03She's great.
32:04I mean, I did have to perform an entire cephalic turndown thanks to you, but...
32:08Me?
32:10Oh, the superficial epigastric.
32:12Sorry.
32:12No, it's fine.
32:13It's pretty standard during an army repair.
32:15I should have expected it, honestly.
32:17Look, I am sorry, Mayor.
32:19You were right.
32:20It was the right move.
32:22Perry is super happy.
32:23And after all she's been through with chemo and hormone therapy and radiation, she deserves it.
32:28She does.
32:34It's the estrogen, you know.
32:36You and Perry have estrogen, yes.
32:38No, the difference between the male and female mice.
32:41Why the antibiotic affects one and not the other.
32:44How do you figure that?
32:45I don't know that yet.
32:46I have to revise the study and measure the hormone levels.
32:50Okay.
32:51Anyway.
32:53You want a ride back to Boston?
33:00Sure.
33:01I have to go take care of something first.
33:06Hey.
33:07How would I do?
33:09We were able to stop bleeding in your chest.
33:11You're going to be fine.
33:13What about the broken ribs?
33:14Do I need a cast or something?
33:17I'm just going to take some time to heal.
33:18No more hobby horsing for a while, okay?
33:23It's okay.
33:25I probably outgrew it a while ago.
33:27I'll still miss it in college.
33:29And Jonah.
33:30I'm thinking of trying ultimate frisbee.
33:33Sounds like fun.
33:35Or theater.
33:37Or college newspaper.
33:39I'm looking forward to trying something new.
33:43It's a good attitude.
33:46Your mom and dad are in the waiting area.
33:47I'll go tell them that you're up, okay?
33:55Hey.
33:55I found a clinical trial for Katie.
33:57A new immunotherapy targeting checkpoint inhibitors.
34:01Oh, that could be promising.
34:03Now read the fine print tonight.
34:05Her right leg was swollen earlier,
34:07so I got an ultrasound and showed a DVT.
34:10But no PE on the CT,
34:12so I started her on a heparin drip.
34:14It's going to be an uphill battle.
34:16I'd like to see her case through, if that's okay.
34:20That might mean missing more big surgeries.
34:24Facing more paperwork duty.
34:26More me.
34:28That's okay.
34:29I think I need more experience in surgical.
34:34Oncology.
34:35Well, I'll let everyone know.
34:52Your hand's unstable.
34:55You just made me kill my patient.
34:59How'd the surgery go?
35:02Perry's got new breasts,
35:03and I was inducted into Avery's plastics policy.
35:08For whatever that's worth.
35:10Wow.
35:10Sounds like you impressed.
35:13What did you eat for lunch?
35:15Chips.
35:16You got food poisoning from chips?
35:20Chips and a sandwich.
35:24A vending machine sandwich.
35:27The vending machines have sandwiches?
35:30They shouldn't.
35:34Well, thank you.
35:37I now know to stay away from the sandwiches.
35:43The trick with microsuturing is finding something to stabilize your hand.
35:59Uh, could you please tell your hobby horse patient that his friend wants to see him?
36:04I would, but his supposed friend ditched him to go back to the competition.
36:08Okay.
36:09Why don't you want to live with me?
36:11What?
36:12I'm neat, considerate, responsible.
36:14I'm catch.
36:15Plus, I thought we were friends.
36:17Oh, uh, I'm a really hard sleeper.
36:20Do you know what that means, Fab?
36:24Every morning, I wake up to three alarms on my phone at full volume.
36:28I have a vintage clock radio across the room as a backup.
36:33I've not only been kicked out by roommates, but I've lost friends over it.
36:37And the only reason that it works with Max is because she can't hear anything without her hearing aids in.
36:43It's not that I don't want to live with you.
36:46It's just, historically, I haven't had a lot of friends.
36:52And I don't want to risk that with you.
36:57You want to come over and watch Trash TV today?
37:00And miss watching High Noon for the 18th time with Max and Irvin?
37:04Hell yes.
37:06Hey, hey, um, can we talk?
37:10Can't.
37:11Apparently, I'm only capable of pillow talk.
37:13Okay, that was deserved.
37:13Listen, I am really sorry about earlier.
37:17You were pretty harsh.
37:18I know, and I lied.
37:19Running into Owen this morning, it rattled me.
37:22And then I had this particular patient come back in who I have saved multiple times.
37:25Danny, it's fine.
37:26No, it's not.
37:27Listen, when I was stationed in Iraq, there was once this competition that they held for the most precise hospital
37:34corners and bedsheet corners.
37:35Guess who won first place?
37:37If I had my way, I would run my whole life like a tight ship.
37:43Order and stability and having control.
37:46Give me comfort.
37:47Always have.
37:48But right now, I am as far away from that in my personal life and at work than I have
37:55ever been.
37:57But when you and I are alone, I forget what a mess everything is.
38:05And I think I'm scared being out of our bubble will take that away.
38:10It could.
38:12Or it could give you more space to claim as your own.
38:19I like that.
38:22It might take me a little while to get there, so I'll understand if you have to move on.
38:28I would, but I think I need to see those tight bedsheet corners.
38:37Maybe we can find an empty patient room.
38:41Oh.
38:42I was thinking we'd just go to your hotel.
38:47When you encounter a new beginning, there's no announcement on a loudspeaker.
38:53Blank and you could miss it.
38:56I ran into Jackson.
38:58He said you excelled today.
39:00Well, actually, he said you kicked ass, but I interpreted.
39:03Oh, it was an amazing case.
39:05You know, I had everything I love about surgery.
39:07Abdominal tissue and microvascular surgery.
39:10Challenging anatomy, teamwork, meaningful outcome for our patient.
39:14You're beaming.
39:16Aren't I always a bright light?
39:19So why aren't you doing a plastic specialty?
39:23It's three more years of residency.
39:25Three years of you doing the lion's share of work at home.
39:28Three years would be worth every second if plastics lights you up like this.
39:35Really?
39:36What, you need it in writing?
39:38Yes.
39:40Oh.
39:44You know, sometimes I feel like you understand me before I do.
39:51But you know what else would really light me up?
39:53What?
39:54Give me 15 minutes to change and I'll take you home and show you.
39:58I don't know.
40:01Or worse, ignore it.
40:03Hey.
40:04I didn't see any more patients.
40:06I'm just waiting for Joe.
40:07I owe you an apology.
40:10I've been feeling lost and that's not on you.
40:15You might actually be the only person who's asked how I'm doing, so.
40:22We've all been there.
40:24And hey, I'm around if you want to talk.
40:27Grab a beer.
40:28Yeah.
40:29But not right now because Joe's pulling the car around and she wants ice cream.
40:35Yeah, don't let me stop you.
40:42Hey, stranger.
40:44Nora?
40:45Nora, what are you doing here?
40:46You...
40:47I've had chest pain.
40:48Turns out I have plain old indigestion like everyone else.
40:52Okay.
40:52So you're...
40:53I mean, you're good.
40:54Okay.
40:55Just trying to figure out this whole new normal.
40:59You talk to Teddy, it sounds like you're doing the same thing.
41:02Yeah, you know, taking it one day at a time.
41:04Yeah.
41:09Would you...
41:09I mean, do you...
41:10Do you want to talk and get a coffee or...?
41:12I don't think that's a good idea.
41:14I mean, if I have coffee now, I won't sleep for two days.
41:18Dinner?
41:20That would be...
41:22That'd be really great.
41:24Yeah.
41:26New beginnings can be scary.
41:30But they can also be deeply fulfilling.
41:34I think I've made a breakthrough in my research.
41:37Oh, that's wonderful.
41:38And I know I said I would stay a while, but...
41:40The longer I stay here, the longer it is until I get to the root of Alzheimer's disease.
41:45There are too many people counting on me, so I think it's time I go back to Boston.
41:51What are you doing?
41:53I'm finishing rescheduling your patients.
41:57The second I read Karasik's article, I knew it'd be only a matter of a time before you decided to
42:02go back.
42:04Then you're short.
42:07What a matter.
42:08You're from hell.
42:10So let go and dive in.
42:12You're from hell.
42:29You're from hell.
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