- 6 hours ago
Grey's Anatomy Season 22 Episode 8
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🎥
Short filmTranscript
00:00Sometimes you just have a feeling.
00:01In med school, I was the famous surgeon's daughter.
00:04It wasn't like that for you?
00:06Honestly, there was so much going on that night, I didn't have time to process it all until later.
00:10Now, I'm the famous surgeon.
00:12So you had doubts?
00:13Oh, yeah.
00:13I was never certain it would work, but our patient didn't have any other option I knew that we had
00:18to try.
00:19In medicine, your identity is constantly changing.
00:22It's your job to keep up.
00:24Safe to say it worked out.
00:26What's next for you both?
00:27Well, we're still monitoring our patient's progress.
00:29And?
00:30So far, so good.
00:31They sound really good. Very competent.
00:34Yeah, I come to this hospital.
00:35Well, speaking of, I made an appointment for you.
00:39We talked about this, Catherine. I don't need another opinion. I like Dr. Freeman.
00:44I know you do, because it goes along with whatever you want.
00:46You don't think doctors should listen to their patients?
00:48I think you need objective advice from someone whose paycheck you don't sign.
00:54It's just another opinion.
00:57What am I saying?
00:59Kaplan.
01:00Laura Kaplan in Boston.
01:02I thought you made an appointment here.
01:04I sent for my plane. She landed about an hour ago.
01:12Morning.
01:13Hey.
01:14Hey.
01:14Hey.
01:15Hey.
01:15Hey, nice job on that podcast. I didn't realize you and Altman came up with that at our wedding.
01:19Yeah, you never know when an idea will strike. Go ahead, Dr. Adams.
01:23Uh, yes. Joe Wilson, post-op day seven from emergency section and Impella CP placement, now post-op day three
01:30from a 5.5 placement through the right axillary artery.
01:33Her heart function continues to recover with her EF up another 5%, and I heard she got to meet her
01:38babies yesterday. How are they doing?
01:41Oh, Peyton's off of CPAP is still fragile. Addie's bilirubin levels are bad every time they pause phototherapy.
01:48And you're all headed in the right direction. That's what matters.
01:52I just really want the six of us to finally be together.
01:56Joe, you will never guess who Marcus walked out with last night.
01:59Dr. Ndugu, I didn't know you were doing rounds.
02:03Yeah?
02:04I'll come back later.
02:09What was that?
02:10What was what?
02:11Did you sleep with my favorite nurse?
02:14Uh, should I leave?
02:15We've just gone out a couple times, that's all.
02:17Well, are you going to take her out again?
02:18Uh, maybe. It's new.
02:21And none of our business.
02:22She is the entire department's favorite nurse.
02:26Everybody loves her. Everyone.
02:35I need to check on my next patient. Are you going to be okay?
02:38Yeah.
02:38Uh, Paige, me, if you need anything.
02:42Read.
02:43Good morning.
02:45Traitor.
02:46Trouble in paradise?
02:47I grow a guard packed. She's bitter.
02:49No, you should break it, too.
02:50What, like I can just snap my fingers? Who am I supposed to sleep with?
02:53I ordered an x-ray for Ms. Johnson's left arm.
02:56That was the right arm, wasn't it?
02:58I will fix it.
03:01An intern, please. I have dignity.
03:03Don't knock it till you've tried it.
03:04Tried what?
03:05Vegan sloppy joes.
03:07You sleeping with an intern, too?
03:08Who was sleeping with an intern?
03:10I am.
03:11Who are you texting?
03:12Nobody. Doesn't look like nobody.
03:14Nah, she's just a patient.
03:15Why are you texting a patient?
03:17Yeah, well, Bailey made me drive her an hour to get treatment, and now she's sending me dumb memes or
03:20something.
03:20Wear a condom.
03:21She's a cancer patient.
03:23Hey, did you see that I admitted Mr. Howard?
03:26You don't have to put your phone down. It's fine.
03:28Oh, sorry. My phone has been blowing off since the podcast dropped.
03:31Yeah, listen, you sounded great.
03:32Well, now I've got doctors reaching out about their patients, and the department chief from Mass General has asked me
03:36to do grand rounds.
03:37Huh, sounds rough.
03:38Well, it's not like I'm getting a Nobel Prize. I mean, MGH asks everyone to guest lecture.
03:43Well, they never asked me, and I went to Harvard.
03:44Anyway, so, Mr. Howard, his EKG shows a conduction block. Do you want an echo?
03:48Um, yes. Sorry, I have to take this.
03:51Hi, this is Altman.
03:53Hi, Janet.
03:55I'm Dr. Millen. I hear you're having some leg pain?
03:57Yeah, and some heaviness. I'm concerned it might be a DVT. I think she should have an ultrasound.
04:01I assume you want a full workup of CBC, D-dimer, and a duplex ultrasound?
04:06I'm Jules Millen. I'm a second-year surgical resident. You're internal medicine, right?
04:12Oh, no. Oh, I'm not a doctor. Sorry.
04:15Oh, we were role-playing. The more medical terms, the better it gets.
04:18Yeah.
04:19So, Hal does his homework.
04:22So, do you have leg pain, or is this...
04:23Oh, no, that's real. The pain started this morning when we were trying to squeeze in a quickie before work.
04:28May I do an exam?
04:29Please.
04:33How long did the pain last for?
04:35Uh, a few hours.
04:37Yeah, we've been trying to spice things up lately, so we just want to make sure we haven't caused a
04:40problem.
04:42Well, um, DVTs usually occur with less, um, activity, but it is better to be safe than sorry.
04:51So, I will order some tests.
04:53All right.
04:53And get back to you.
04:55Okay.
04:58Dr. Griffith.
04:5938-year-old female with a large medias dinoteratoma that has been resistant to chemotherapy,
05:05presents with progressive shortness of breath, orthopnea, and angina.
05:08Well, that has to be at least 35 pounds.
05:10And, uh, 27 centimeters for the longest diameter.
05:13The tumor is displacing the heart and great vessels.
05:17The SVC is compressed, and it's also indenting the right lobe of the liver.
05:22How are the lungs?
05:23Compressed, with near total collapse of the mid-right and lower lobes.
05:26Has anyone tried to operate on the thing?
05:27Her name is London, and yes, there have been two attempts at Seattle Prez.
05:33They had to abort both times because she arrested on the table.
05:36But you believe you would have a different outcome if you tried?
05:39Well, I have removed extremely difficult tumors before, and this one is benign.
05:44So if we can successfully remove it, then she resumes a normal life.
05:49Even if you convinced anesthesia, you could still encounter catastrophic bleeding.
05:54And that is why I'm here at the tumor board, where people help their colleagues to come up with a
05:59plan.
06:00If anyone here thinks this remotely is a possibility, please speak up.
06:05Yes.
06:11It's a tragic case, Dr. Bailey, but it's a lawsuit waiting to happen.
06:19I'll do it with you.
06:24You'll turn in this hospice, right?
06:27Dr. Hunt, it just can't be done.
06:29Yeah, well, you don't know what we are capable of.
06:36I knew you'd have an idea.
06:38Yeah, I got nothing.
06:50Well, look who's here.
06:53How was your flight?
06:54Most quiet I've had in months.
06:56Great.
06:57Dr. Weber, it's a pleasure.
06:59I've heard a lot about you.
07:01All good things.
07:02Catherine's thrilled you joined a team in Boston.
07:04She's thrilled she poached me from Sloan Kettering.
07:06You are at the forefront of urologic oncology.
07:09And that lecture that you gave to the American Urological Association last month brought the house down.
07:14And she is developing a program that uses AI to study biomarkers.
07:20We just received another grant for it yesterday.
07:22You bet you did.
07:23Now, tell us about my husband's prostate.
07:26Catherine, please.
07:28If now's not a good time.
07:30Don't be ridiculous.
07:31Come on, everybody, sit down.
07:32Have a seat.
07:33Come on.
07:35Good news is you caught it early.
07:37Gray Group 2 with 7 Gleason.
07:39He knows all of that.
07:40So tell us, what do you suggest?
07:43Well, given the cancer's localized and you're generally in good health, I recommend a radical prostatectomy.
07:48I couldn't agree more.
07:50If you're worried about side effects, urinary incontinence, erectile dysfunction, they are a risk.
07:55But for many men...
07:56What about infection?
07:58It's unlikely, but possible.
08:00Blood clots, stroke, injury to the rectum, bladder, nerves, they're all possible too, right?
08:11Thank you for your time, but I've already selected an option with my own doctor.
08:17Watchful waiting.
08:18I've got patients to see.
08:25I'm not seeing abnormalities.
08:27What's that line called?
08:28An ultrasound probe.
08:30Write that down.
08:30Okay.
08:32All right, the ultrasound is negative.
08:35So, she doesn't have a clot?
08:36Not that I can see.
08:38Sounds like maybe there still might be one.
08:40Well, your D-dimer was slightly elevated, which is the marker we look at for clots.
08:43It doesn't necessarily mean anything, but it is reason to come back if you have any more pain.
08:47Maybe I just need to stretch before I go to the doctor.
08:50Ooh.
08:50Stretch?
08:51I don't ask any questions.
08:52I'm going to start your discharge paperwork.
08:55What was that all about?
08:56I like to roll with the doctor and patient in bed.
08:58Good for them.
09:01But they're so cute.
09:04Rustic cute.
09:05Five of you said those rockers broke within a year.
09:08How's the lake house?
09:10We've moved from arguing over tile to arguing over porch chairs.
09:14How was the tumor board?
09:17Unfortunately, they are concerned about the risks and recommend that we don't proceed.
09:23So, naturally, I call them reinforcements.
09:26This is Dr. Owen Hunt.
09:28He's one of our trauma surgeons.
09:30If it's okay with you, I'd like to work with Dr. Bailey
09:32to make sure that we've explored every possible option.
09:35I want to help.
09:36I like him.
09:39If everyone else has reservations, why do you think you can do it?
09:42Charlie, we've actually found surgeons that are not giving us a hard no.
09:47I've almost lost you twice.
09:50I'm definitely not ready to lose you today from some botched operation.
09:53Neither are we.
09:54Hey.
09:55I'm still here.
09:57They're just asking if they can go work on a plan.
10:00If their plan leads to us growing old together, looking at the water from shoddy but very cute rocking chairs.
10:09Holmes, I'm in.
10:12Aren't you?
10:16You really think you can figure out a way to keep her heart from stopping when she's on that table?
10:21Look, if we can't figure this out, we won't proceed.
10:23That was our deal when you two came to me.
10:27Okay.
10:28Work on your plan.
10:29Okay.
10:30We'll be back.
10:31Okay.
10:40Hi, my beauties.
10:43They look bigger.
10:45Did they get bigger?
10:46Patty's put on a full ounce in the last 24 hours, and Peyton isn't far behind.
10:50That's right.
10:51Lincolns know how to bulk.
10:55Hey, I gotta go to PT.
10:56You sure you're okay?
10:57Okay.
10:58You sure?
10:59Yeah.
11:00All right.
11:01Okay.
11:04See you soon.
11:07You're Peyton and Hattie's mom?
11:10Mm-hmm.
11:14Sorry.
11:15It's just that, um, that's the first time that somebody's called me their mom.
11:21Here.
11:23Oh, wait.
11:24That one's not clean.
11:27Here.
11:28I'm an OBGYN, and I talk to my patients all the time about postpartum hormone drops,
11:34but I had no idea it was this intense and just random.
11:39Yesterday, my boyfriend and I were buying diapers for me, not the baby.
11:42Mm-hmm.
11:43And the guy ringing me up said, will that be all?
11:45And I burst into tears.
11:47It's nice to know that I'm not alone.
11:51What?
11:53You're my first mom friend.
11:56Oh, I'm honored.
11:58Did you tear?
11:59Can I ask you that?
12:01Yeah, you can ask me anything, but, um, no, I didn't tear.
12:04I, uh, I had something called a crash C-section.
12:08Oh, tell me everything.
12:12I'll be back.
12:13Richard, what the hell are you doing?
12:15I'm about to check Mr. Tolley's womb back.
12:18You said you would hear Kaplan out.
12:20I did.
12:21Is this because you're worried about the bedroom?
12:24Because you know we'll figure that out.
12:29Doctor, I'm not having this conversation here.
12:37Is this because you prefer a male doctor?
12:39Now, that's insulting.
12:40Well, I'm just trying to understand why you would dismiss a top urologist like she's an intern.
12:45I moved mountains to bring her here for you.
12:47I didn't ask you to.
12:49Now, my cancer has a metastasize.
12:51Watchful waiting is a perfectly reasonable option.
12:54I respected your health care decisions, even when I didn't agree.
12:58I need you to do the same for me.
13:04Who is the surgeon in Seattle Press?
13:06Collins, yeah.
13:07He actually did his residency here a couple of years behind me.
13:10When his chief wouldn't let him try again, he sent London to me.
13:13If she codes the minute she lays on the table, why didn't he try to reverse June Dellenberg,
13:17keep her in an incline to take the pressure off some of the cardiac vessels?
13:20Look, they didn't.
13:21But see how compressed they are?
13:23It wasn't enough.
13:23Okay, what about conscious sedation instead of general anesthesia?
13:26She'd continue to breathe on her own,
13:27which would help blood return back to the heart and minimize airway collapse.
13:31I mean, it might help some.
13:33The tumor's matured into its own ecosystem.
13:35You can see the calcifications, that, the cystic components.
13:40What if we drain it, shrink the mass before we go in?
13:43It's a good idea, but the location is just too risky.
13:45We can't risk the contents of the tumor spilling into the chest.
13:48It will just regrow.
13:49Yeah.
13:49All right, I got to run to a consult in the pit, but I will keep thinking on this.
13:52No promises, though.
13:55Adams, Griffith, let's look up every case report published on mediastinal teratomas.
13:59Research patterns, cross-reference solutions, okay?
14:02We all just listened to a podcast this morning about how our hospital pulled off a miracle.
14:06Who's to say we can't do it again, right?
14:07Go.
14:11You're going to come off the cell thing.
14:15Hey.
14:15Hi.
14:16Are you done with that tablet?
14:17Nope, get your own.
14:18Bailey and Hunt have a massive mediastinal teratoma.
14:22If you sweet-talk Bailey, you can get in on it with us.
14:24They're looking for ideas.
14:25I'm too swamped down here.
14:27Hey, I'm sorry about this morning.
14:30Joe's crying about everything these days.
14:31It's fun.
14:32But she loves Iris, so she'll be happy if you two are a thing.
14:43Are you acting weird?
14:44I'm not acting weird.
14:45Yeah, you are.
14:47Help!
14:48Whoa!
14:48I want to tell her.
14:49You might want to button that.
14:50Oh, my God, Janet.
14:55I'm getting weak pulses.
14:57Okay, Janet, look at me.
14:58I'm going to take care of you, okay?
14:59We need a gurney in here!
15:05The plane won't be ready for another couple hours.
15:07Catherine said I could work you in here.
15:09Not a problem.
15:13I owe you an apology.
15:15I owe you an apology.
15:16I was led to believe that you were the one seeking a second opinion.
15:18You couldn't have known.
15:20I should have at least suspected.
15:22I think your wife broke contract laws to ensure my employment at her hospital.
15:25Don't feel bad.
15:26You're not the first to fall prey to her ways.
15:29Well, guessing I won't be the last.
15:32She does it because she cares.
15:35That's what makes it infuriating.
15:41Feel free to say no, but I've got a patient with a retroperitoneal tumor, and I would be remiss if
15:48I didn't ask Fox Hospital's chief of chiefs for a consult.
15:51No.
15:52Got a little time.
15:54How about we get a couple pastries to go with this coffee?
15:59That would be great.
16:0122-pound teratoma in the abdomen.
16:03San Francisco, 2018.
16:06They started with a CT-guided drainage.
16:08Yeah, but look at the picture of the CT.
16:10Nowhere near the heart, another dead end.
16:14Another dumb meme from your patient?
16:16Uh, she's asking for movie recs.
16:18She's stuck at home.
16:19Not exactly a doctor-patient conversation topic.
16:23She's Bailey's patient.
16:24She has stage four gastric cancer.
16:25She can ask whatever she wants.
16:27Hey, Michelle, you keep it professional?
16:29Okay, I have no idea what you're talking about.
16:30I'm just saying you're young or single.
16:32You look like you.
16:34You might be leading her on.
16:36I'm her doctor.
16:38And she's a vulnerable patient.
16:40I don't need this right now.
16:42No, I'm just trying to look out for you.
16:43Yeah, try less.
16:46I'm just asking for an update.
16:50Okay, anything?
16:51Not yet.
16:56Why'd you join this case when everyone else dismissed it?
17:00It's like you said.
17:01It's benign.
17:01Once it's out, she moves on with her life.
17:03There's no worry of mats or recurrence.
17:08Yeah, I might be feeling a little uninspired lately.
17:12Uh-huh.
17:13Wouldn't have to do with other people solving cases at weddings and doing podcasts, would it?
17:19I see you at drop-off.
17:21I know everything's falling on you right now.
17:23She's lecturing and you're packing lunches.
17:26I'm happy to do it.
17:27And she deserves all the attention.
17:30I just think this tumor was...
17:34I don't know.
17:35My patient cannot be the fix to get you out of this slump.
17:39What do we got?
17:40Ten cases.
17:41At least half of them considered inoperable.
17:43And none of the masses are nearly the same size.
17:45There's one case that reported a similar arrest in EOR, but the team never tried it again because they couldn't
17:50safely find a way around the heart and lungs.
17:51Which is exactly what happened with London.
17:54As difficult as this is for me to say, I think we're out of options.
18:00What about ECMO?
18:01What about it?
18:02We need to bypass the pulmonary system, so why don't we use ECMO?
18:06The machine oxygenates and pumps the blood so her heart and lungs don't have to.
18:10There is no arrest if the machine is acting as her heart.
18:15Don't say no yet.
18:17I'm gonna go find Endugo.
18:21Almost there, Janet.
18:23If this is a clot, you can fix it, right?
18:26Blood clots are treatable if you catch them in time, so it's a good thing you were here.
18:31Weird, but good.
18:33I should probably be embarrassed, but I'm proud of us.
18:36All my friends got bored of their spouses and filed for divorce, but we got creative by coming to the
18:42hospital and having sex.
18:45Don't be jealous. I'm sure other people aren't getting any either.
18:48Alright, let me see.
18:52Looks like there's a left iliac vein thrombosis.
18:55How's right, DBT?
18:56If you look closely, the iliac artery is compressing the vein.
19:00May thunder syndrome.
19:01Mhm.
19:02Alright, let's book an angio suite for a thrombectomy and iliac vein stenting and start practicing.
19:06I am gonna supervise you doing the procedure.
19:10Me?
19:11She means me.
19:12I don't care who it is.
19:14As long as you guys are prepped and ready to go.
19:19You really think this will work?
19:21The challenge, right, has always been the pressure that your tumor is putting on your heart, your lungs, major arteries
19:28when you're positioned for surgery.
19:30The ECMO machine makes that irrelevant because it oxygenates and pumps your blood for you.
19:33So no matter what happens, your body will receive oxygen and blood flow while we work.
19:38I can't believe you actually figured it out.
19:41Have you done this before?
19:42How common is this ECMO?
19:44Charlie, you said you were in if they figured it out.
19:47How common is it?
19:48It's not common for this.
19:49And it can be hard to wean off ECMO after removing something that's compressed your lung for so long, but
19:54her heart is healthy.
19:55I don't anticipate that being a problem.
19:57But it could be a problem.
20:02You almost lost me twice.
20:04If we do nothing, this thing just keeps growing inside me until it squashes all my organs.
20:11And I'm definitely gone.
20:14I don't want to live like that.
20:17Slowly suffocating.
20:19And I don't want you to have to watch me live like that.
20:24We asked them to come up with a solution.
20:29I'm taking it.
20:30Okay.
20:31Dr. Griffin and Dr. Adams will get you prepped.
20:33We will see you in the OR, okay?
20:39Is it weird that he's not blinking?
20:41Newborn tear ducts aren't fully developed.
20:43It's so cool that you know all this stuff.
20:46Is it bad if I'm not like feeling anything?
20:49You mean you don't feel a bond?
20:52I'm already a terrible mom.
20:54No.
20:54No.
20:55It's completely normal.
20:56And you're exhausted and your hormones are all over the place.
21:00And to be honest, newborns are kind of just blobs.
21:03In a few weeks, he'll be laughing and smiling and it just gets so much better.
21:07You're a really good doctor.
21:10Are you taking new patients?
21:11Wow.
21:13How are my girls?
21:15Hey.
21:15Well, we made a new friend.
21:17Whoa.
21:17Whoa.
21:18Someone call a rapid response.
21:20Right away, doctor.
21:26She's still seizing.
21:29Someone give me IM midazolam.
21:31She's seven days postpartum.
21:32Check her blood pressure.
21:33It's probably eclampsia.
21:34She needs mag now.
21:36Does she have any symptoms before she started seizing?
21:37No, she's been completely fine.
21:39It came out of nowhere.
21:40We'll need to get her up to OB.
21:41Will you go up with her?
21:42Whatever you want.
21:44Call me when you get up there.
21:45Okay?
21:50Scissors.
21:52Put two units of blood on standby.
21:55Lap pad.
21:57All right.
21:58I secured the cannula.
22:00Adam is already ready to remove the clamps.
22:02Yeah, ECMO's ready.
22:08Okay.
22:08You're a dark flow.
22:10We have full flow.
22:11Let's try lowering her down.
22:20At least that worked.
22:21We're going to make all of it work.
22:22Griffith Adams, you may never see another case like this again.
22:24So keep your eyes on the field.
22:26If you see any signs of hemodynamic instability, speak up.
22:29This is not a race.
22:30Our goal is not to finish fast.
22:32It is to keep her safe.
22:35Understood?
22:35Okay.
22:38Okay, London.
22:39Let's intubate.
22:45It's a hormonally active adrenal mass, so you need to watch out for sudden hypertension.
22:49I'm planning to use alpha blockers.
22:52Oh, good.
22:52Well, I assume you're going to do this open, given the size.
22:55That's the plan.
22:56My colleague will actually do it.
22:58I usually stick to robotic procedures.
23:00Oh.
23:01You got something against the old fashioned way?
23:03No.
23:04Um, I have MS.
23:07So standing for long periods in the OR just isn't an option.
23:11I didn't realize it.
23:12I'm sorry.
23:13No need to be sorry.
23:15I mean, I was devastated after I got the diagnosis.
23:18I had put in so much work on my whole career and the thought of no longer being in the
23:22OR was soul crushing.
23:24To say the least.
23:26But that's when I realized it was just my fear talking.
23:30And I looked at my symptoms, muscle pain and leg weakness, and I thought, if only there was a way
23:36to operate while sitting down without having to hold the scalpel.
23:42Was it a difficult adjustment?
23:45Adjusting to living with a chronic illness is never easy.
23:48But over time, I just turned MS into a pivot.
23:52Not an ending.
23:55Well, you seem to be managing well.
23:57Oh, well, I have my ups and downs, believe me.
24:01But Catherine Fox is flying me around on her private plane and paying me more money than I know what
24:06to do with.
24:07And I still get to do what I love.
24:10Even if it ends in a different way.
24:14Well, they're gonna go ahead with Bailey's giant teratoma and OR, too.
24:18And Dugu's gonna have to recycle.
24:19Can we just focus, please?
24:21It's a fake patient. Calm down.
24:23Oh, don't tell me to calm down.
24:25What is wrong with you?
24:27Is it about Simone breaking that dumb pact?
24:30No, and stop asking. I'm fine.
24:33No, you don't seem fine.
24:35It's because you are bothering me.
24:37Well, that can't be it.
24:38I always bother you.
24:40I'm just...
24:42I'm just tired.
24:45Every day is the same.
24:46It's the same people and the same rooms and the same conversations.
24:51And I'm just... sick of it.
24:53Well, I am sorry we are not good enough for you.
24:56I didn't say that.
24:57Yeah, you don't have to defend yourself.
24:59We all know you're aloof.
25:08You're leaving?
25:09Yeah, I've already done a thrombectomy.
25:11You can have it.
25:12Dr. Cardinals to the ICU.
25:15Dr. Maria Cardinals to the ICU.
25:18What's happening?
25:19Who's the doctor?
25:21Uh...
25:22John Burnett.
25:23An intern?
25:24Let's get a CT.
25:25They're getting a CT.
25:26No, she has eclampsia.
25:28Tell him she needs magnesium.
25:29Really?
25:30Tell him.
25:33Excuse me.
25:33I've got Jill Wilson on the phone and she says it's eclampsia and you should start her own magnesium.
25:37Her BP is only 143 over 91.
25:39It could be an intracranial leverage.
25:41Put me on speaker.
25:44Um...
25:45You're on speaker.
25:46I understand your concerns, but postpartum eclampsia doesn't always present with a really high BP.
25:51Neither does the brain bleed.
25:53Barnett?
25:53It's... it's Barnett.
25:54Whatever.
25:55I may be only you, but that doesn't mean that I can schedule you to work every holiday and make
25:59your life miserable.
26:00So trust me when I tell you to start the mag now.
26:06Should I be magnesium?
26:13Your mom's gonna be okay.
26:16All right, we're gonna have to take part of the lower lobe.
26:18Adams, you want to staple the lung?
26:20Yep.
26:20Let's staple it.
26:21Bailey, you ready to start resecting the adhered diaphragm?
26:23I'm ready when you are.
26:25Griffith, what should we be careful to avoid?
26:27Hepatic veins and retrohepatic IVC.
26:29Good.
26:29Let's get the next stapler ready.
26:31Huh.
26:31London thought.
26:32Fixing up a summer house was a lot of work.
26:35It's got nothing.
26:35I'm fixing up a torso.
26:36Reload, please.
26:39Uh...
26:40BP is bobbing out.
26:41Damn it.
26:42I don't see any bleeding.
26:43I need to do a while.
26:43The staple line looks clean.
26:44Well, something's gotta be causing this.
26:46What the hell is it?
26:47Does the ECMO say anything?
26:48There's a suction event alarm.
26:50Okay.
26:51Since we took pressure off the lung, could there be volume shifts?
26:53That's definitely possible, yeah.
26:55Okay, we need to up her pressors and flood it with fluids.
26:57If you don't get flowed back right away, she's done.
27:03Push fluids as hard as you can.
27:05I am.
27:05BP's still dropping.
27:06She can't take this longer.
27:07And I should've listened to that board.
27:09But if I lose her...
27:10This is not on you.
27:11Come on, come on, come on.
27:12Come on.
27:14BP's coming back up.
27:16Well, that was close.
27:18Okay, folks.
27:20There's still a lot of tumor left.
27:23Griffith, you're on the livery section.
27:25Adams, you're on the superior media Steinem.
27:27If that's okay with you.
27:30Do what we say when we say it.
27:32Stickling.
27:38Contrast.
27:41There's the occlusion and the iliac vein.
27:43Advance more.
27:45Okay, pin the guide wire and turn on the thrombectomy catheter, please.
27:51It's a shame Jenna isn't awake to see this.
27:53It would really turn her into a passionate fan of biological science and anatomy.
28:01Okay, I'm gonna turn it off?
28:02I don't get it.
28:03If you have to pretend to be someone else for your partner to want to sleep with you,
28:06maybe you shouldn't be together.
28:08Well, I've learned you never know what's going on in another person's relationship.
28:12Ready?
28:14Contrast.
28:18Thrombus is gone.
28:20The vein is patent.
28:22Great work.
28:23Now to stent.
28:27Thanks again for the consult.
28:29I see why Katherine calls you legendary.
28:31Oh, she is prone to exaggeration.
28:34I know.
28:34But in your case, it's true.
28:36Well, you live up to your reputation as well.
28:39Oh, but not enough to consider my recommendation.
28:43I'm sorry.
28:44I shouldn't have said that.
28:46No, it's okay.
28:48Can I ask you about something?
28:51Urocynfacil fistules.
28:53They are an extremely rare post-op complication of radical prostatectomy.
28:58But the odds aren't zero.
28:59They're close.
29:01What if it happened?
29:03Chronic pain, which often leads to difficulty walking, possibly warranting the use of opioids.
29:12I can treat complications.
29:15But if your cancer grows and metastasizes, that's when my hands are tied.
29:23If you change your mind, or if you just want to talk more, Katherine has my number.
29:40Done resecting the liver.
29:42Good.
29:43Excellent hemostasis.
29:48No bleeding on this side.
29:50Okay.
29:50We are in the home stretch.
29:52Let's get ready to get this tumor out.
29:54Hold on, hold on.
29:56Did you hear that?
29:57What?
30:00Okay, we're gonna need more lap pads and hang blood.
30:03Adams, quickly pack her.
30:05Ah, dammit.
30:06Alright, keep the suction coming.
30:08Oh, wait, wait.
30:10Ah, okay, there's a tear where the IVC passes through the diaphragm into the chest.
30:15I'm trying to secure...
30:17Let me have a clamp.
30:19Okay, I need visualization.
30:20Put the suction on the lap pads.
30:21Not too harsh.
30:23Gentle, steady pressure, okay?
30:29I think I got it.
30:33Ah, she's stabilizing.
30:36Okay, everyone, on the count of three.
30:38Everyone needs to help with this specimen.
30:40Okay, ready?
30:41One.
30:42Two.
30:43Three.
30:44Oh, dear.
30:45It's underneath it.
30:48Okay.
30:52Okay.
30:55Oh.
30:56Hey.
30:58How do you all feel about getting the hell out of here?
30:59Yeah, you don't like to ask me twice.
31:01Bobby?
31:03Two.
31:03Two.
31:03Oh, proline.
31:11It's doctor.
31:12Iris.
31:14Oh.
31:14Hey, what are you doing up here?
31:15So, a mom from the NICU is being treated for postpartum eclampsia.
31:19Can you look up her chart?
31:20Her name is Gina...
31:22I don't know her last name.
31:23I'm sorry, I can't.
31:25You're not her doctor.
31:27I just want to check on her.
31:29Do you want me to call Marcus?
31:31No, what I want is my friend's chart.
31:34I'm sorry.
31:35Stop saying we're sorry.
31:36Sorry doesn't help me.
31:36I'm this woman's only friend right now,
31:38and the person in charge of her care has been a doctor for about 90 days.
31:41If you could just please remove the stick from me.
31:43Joe.
31:44All I want right now...
31:45I think we should go.
31:46No, we're not gonna go.
31:47I...no.
31:47You cannot move me against my will.
31:50Stop!
31:52I...
31:53This is not okay.
31:55Can you give me a minute?
31:56Hey, hey, hey, hey.
31:57Hey, hey, hey.
31:57Look, I know you're scared.
31:59Okay, but...
32:01I think she's just trying to do her job.
32:17It will take a few days to wean her off, Emma.
32:20She does have a long recovery.
32:21But she's gonna come home.
32:23Eventually.
32:23That is the plan.
32:25I don't know how to thank you.
32:27I think you just did.
32:31She's always been able to see what I can.
32:34Her mind is filled with these big ideas that always seem impossible.
32:40Our wedding.
32:41Our wedding.
32:41This lake house.
32:43Getting this tumor removed.
32:46But she knew you could do it.
32:49And she was right.
32:52I almost tried to stop her.
32:57But I'm glad I stayed out of it.
33:01We'll let you both get some rest.
33:05Mm-hmm.
33:08Great work today here with you and Adams.
33:11You really stepped up.
33:13I really appreciate the opportunity.
33:15I learned a lot.
33:20We did a good thing today.
33:25Some might call it inspiring.
33:27Mm-hmm.
33:28Might be even something you could lecture about.
33:32Hey, I hope I didn't overstep, you know, jumping into the residence.
33:35Oh, no.
33:36I mean, if I'm the only voice that's teaching them, they'll wind up tuning me out.
33:41What do you think about having the residents do in an ambulance ride-along or EMS training?
33:45Something that could really get them thinking on their front team.
33:48How it could help them in the ER or in situations like today in the OR.
33:52I think you should write up a proposal and send it to me.
34:00The surgery went well.
34:01We were able to clear the clot and put in a stent.
34:04You'll need to be on anticoagulation, but after a while, you'll be able to get back to life as usual.
34:10I'll get back to life as usual right away?
34:13Or when can I have sex is what I'm asking.
34:16Yeah, I know.
34:17You need to elevate your leg when resting, but other than that, it is good to move it around.
34:23Miss Trudy can still see the doctor.
34:25Trudy's always a good time, but honey, I love you most when you're just Janet.
34:34We'll give you some privacy.
34:46I checked London's labs before leaving.
34:50Thanks.
34:50Hey, I'm sorry about earlier.
34:52How you interact with your patients, your business.
34:55I'll stay out of it.
34:56I appreciate that.
34:58I do value your opinion, though.
35:02You do?
35:03I do.
35:03Just, uh, about relationships for obvious reasons.
35:09What?
35:11Hey, look, I'm, uh, putting together a watch list for my patient.
35:14What am I missing?
35:19Um...
35:19Well, she hasn't seen any of these?
35:29Hey.
35:31Hi.
35:32She didn't make it through your busy day?
35:34Oh, I...
35:35I did.
35:37Um...
35:37I did a thrombectomy and placed a stent.
35:40Nice, Mellon.
35:41You still haven't told me about that thoracotomy, by the way.
35:45It wasn't that very good, y'all.
35:46You saved a man's life with your hands.
35:49It doesn't get any bigger than that.
35:53Do you think I'm aloof?
35:56Aloof.
35:59Um...
36:00No.
36:02You're discerning.
36:03You don't suffer any fools, but...
36:05That's not aloof.
36:07That's, um...
36:09That's protecting yourself.
36:10Because you care.
36:13It's funny you say that.
36:15Because I...
36:16I have been...
36:17I've had the worst day.
36:20I need the biggest vodka tonic that they have.
36:23Hi.
36:23I'm Iris.
36:24Ah, this is Jules Millen, uh, surgical resident.
36:27Nice to meet you.
36:28Nice to meet you.
36:29Um...
36:29I should go and find my friends.
36:34See you later.
36:36It's jarring when your identity shifts.
36:38When you're suddenly a doctor.
36:40A partner.
36:40A parent.
36:42It helps if you focus on the things that haven't changed.
36:45I'm gonna have to change hospitals.
36:47I've cried in front of too many people at this one.
36:50They understand.
36:53I just...
36:55feel like ever since I was admitted, I've just...
36:58I've just lost myself.
37:01I can't take care of our kids.
37:04I can't take care of my patients.
37:05I can't even shower.
37:07It's temporary.
37:09Your heart is recovering.
37:11I know.
37:13But...
37:15For a few hours today, I got to be a doctor again and help this woman navigate a difficult time.
37:22But then, when it really mattered, someone else got to help her.
37:29At least Gina's okay.
37:31And I would bet...
37:33that she'd say what you did matter too.
37:36Maybe even more.
37:40Oh, God.
37:41It's happening again.
37:42Oh, God.
37:44It's happening again.
37:45I can't do that.
37:48Just...
37:53The comfort of old friends.
37:5435 pounds.
37:56That's like carrying four babies.
37:58Yeah.
37:58Or four bowling balls.
37:59Who carries four bowling balls?
38:00People do weird things.
38:03Gotta go.
38:08Yeah, I'm out too.
38:11See you tomorrow.
38:20She's just a stop sign.
38:21Not a roadblock.
38:23How did...
38:25Doesn't matter.
38:27Wait, are you leaving me too?
38:29Um, sorry.
38:31Hey, have a drink on me.
38:38Anyone sitting here?
38:44The thrill of trying something new.
38:46Hi, I'm Sally.
38:47Because even though you may not recognize yourself...
38:50Catherine?
38:51I'm sorry.
38:53I am so sorry.
38:55I got scared.
38:56And I just called the best that I knew.
38:57I should have talked to you before I heard Laura in.
38:59Look, I thought a lot...
39:01About letting fear cloud judgment today.
39:05Whatever you want to do, I support...
39:08I'm a surgeon.
39:09I'm a senior member of this hospital.
39:12If something were to go wrong and I couldn't stand long enough to do a simple appy...
39:18I'd feel...
39:19Weak.
39:21And I don't know how to lead like that.
39:22I don't know who I'd be.
39:25But people adapt.
39:27I want to go ahead with a surgeon.
39:29I'm a depression.
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