- 14 hours ago
Grey's Anatomy Season 22 Episode 11
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🎥
Short filmTranscript
00:00I'm practicing healthy boundaries. If they need me, they can pick up the phone.
00:06It's not just like medicine you'll practice. It's your whole life.
00:10Should I pull the drains on Mr. Sherwood before we round?
00:12No, Adams can do that.
00:14Um, Tony Wright is down a resident, so I took the liberty of moving you to her service. I hope
00:20that's okay.
00:22Dr. Tony Wright.
00:23Yes.
00:24NIH grant recipient for research on myovibroblast for wound healing, pioneer in lymphedema, Dr. Tony.
00:30Yes.
00:31Yeah, okay, yeah. I may have read up on it.
00:33Play it cool.
00:34Yeah, yeah, I gotta go prep.
00:36Ben, why?
00:37Hey, hey, hey, come on. I was born cool.
00:40Okay.
00:42Oh, my God.
00:44I'm playing. I'm playing.
00:47Who you'll work with, whether you'll be home in time for dinner or never see your kids.
00:51I love how they think we have time to go to the doctor.
00:54Last year, I had a dental student pull one of my teeth in the cath lab.
00:58Have you considered egg freezing?
01:00Have I considered giving myself a series of shots and screwing up my hormones and then going through an uncomfortable
01:04procedure
01:05and then paying forever to store my eggs in a freezer and the chance that I might want kids?
01:09You could have just said no.
01:12I might do it. I want to keep my options up there.
01:15Why do they need to know when your mom had her first period?
01:18Oh, I hope they don't because I have no idea and no way to ask.
01:22Oh, smoothies.
01:23The choice is yours.
01:25And so are the consequences.
01:29Hey.
01:30Hey.
01:32Hey, so my lawyer wanted to check in.
01:35They still haven't received any papers to sign.
01:38Yeah, I still have them.
01:40Your lawyer mentioned wanting to file before the end of the month.
01:43I just, I've been slammed with work.
01:46If we don't do it soon, they're going to make us pay additional containers.
01:49I'm aware. I'm sorry. I have a consult, but I will get to them as soon as I can.
01:53Dr. Morales to the ICU.
01:55Dr. Martha Morales to the ICU.
01:59Dr. Wright.
02:00Hey.
02:01Ben Ward.
02:01Thrilled to be on your service.
02:02Nice to meet you, Benson. Back on my service again?
02:05Yeah, can't get enough. And people call me blue.
02:07After the Joni Mitchell album?
02:08No.
02:09Oh, well, that's too bad.
02:11It's one of the all-time greats.
02:12I applied to three colleges in California solely because I thought it'd be cool to sing that line about coming
02:17home there
02:17and literally mean us.
02:19Do either of you play guitar?
02:21Uh, not really.
02:22A little.
02:23Well, yeah.
02:25So now, feel free to push me.
02:28I like to work hard, and I'm actually applying for a plastics fellowship.
02:31Good for you.
02:34You should have told her you play guitar.
02:38Five minutes to answer, Paige.
02:40Paige, you could have died in that time.
02:41Did somebody die?
02:42Oh, that's irrelevant.
02:46What do we got?
02:47Randall Lutton, 62.
02:48He has scrotal swelling and severe pain after blunt trauma.
02:51Beef key is slightly elevated.
02:52Gate two of morphine and route work.
02:54Ah, God, it hurts like hell.
02:57Okay, we're gonna get you more inside, okay?
02:58Got up to use the bathroom in the middle of the night and walked right into the dresser.
03:02I'm gonna need an ultrasound and some gel.
03:04Are you a doctor?
03:05Urologist.
03:06No need to comment on the irony.
03:07Okay, let's get him to trauma one.
03:14Hey, Corbin.
03:15Just double-checking.
03:15You're getting your IV antibiotics before rounds with Dr. Altman.
03:18Do you think you could slip me the staff Wi-Fi password?
03:21I know the guest Wi-Fi is spotty, but ours is used for things like imaging and staff messaging,
03:26so they're pretty strict about it.
03:28Could you make an exception?
03:29I just, I really want to see my cousin get married in Big Sur today.
03:32Second cousin, second marriage, and he's not that great.
03:40You didn't get it from me.
03:44Somehow, I am always in the hospital for my friends and family's big life events.
03:48This is the second aortic graft to get infected in a year.
03:51No offense to Dr. Altman, but if this one doesn't take, we need a second opinion.
03:56Well, Dr. Altman's extremely skilled.
03:58She's even kind of famous now.
03:59She invented a new surgery.
04:01Yeah, but like a difficult one?
04:03Don't look at me like that.
04:05I already know I'm becoming mom.
04:07Surgery's incredibly complicated.
04:09She's on a podcast.
04:10You can look it up.
04:12Told you.
04:13I just had bad luck.
04:14Well, hopefully the new T-bar gives your aorta a break, so the antibiotics can do their job.
04:18That's what you said last time.
04:21I'll be back soon.
04:27Welcome back, Dr. Shepard.
04:28Have you met a new plastics attending, Dr. Tony Wright?
04:31Relatively new.
04:32Nice to meet you.
04:33We should get started.
04:34It's a Lafort fracture.
04:35I'm sure there will be questions.
04:38Did you see that?
04:39Uh, yes.
04:40Um, yeah, I don't know.
04:41I don't think she remembers me.
04:43Should she?
04:44Well, we went to med school together.
04:45We're in the same study group.
04:46She hated me.
04:47Oh, well, maybe it's better she doesn't remember.
04:52Teresa Daniels, 49, post-op day 5 from a hemicraniectomy for subdural hematoma after auto versus pedestrian.
04:59Concomitant Lefort 1 fractures.
05:01Please say you're fixing my mom's face today.
05:03That's up to Dr. Shepard.
05:05She'll tell us if your mom's head bleed is healed enough for us to proceed.
05:07I'll do a neuro exam on her now and make sure the EBD is working.
05:11So, uh, what are you studying?
05:13Data science.
05:14I was going to major in it, but the intro course is hard.
05:17I'm a freshman at UC Davis.
05:19Do you have a study group?
05:22I haven't found the right people.
05:23It does make a big difference.
05:25My mom says to stick with it.
05:27I was complaining to her about it on the phone when she got hit by that idiot driver.
05:32That's awful.
05:33I'm so sorry.
05:34She'll be happy to see you when she wakes up.
05:35ICP is 12 and subdural is stable.
05:38Great.
05:38So we're good to go.
05:39Let's order a CT Max face before bringing her to the O.R.
05:49Hey.
05:50Sorry I'm late.
05:51How was cousin Frank's wedding?
05:52Were you able to stream it?
05:55Still no contractions.
05:56Don't jinx it.
05:59Okay.
06:00Dr. Me.
06:01Corbin Gregory, 28-year-old male, status post-coarctation repair when he was two.
06:06He subsequently had two graft repairs.
06:08Both became infected.
06:09Has now developed a pseudo-aneurysm and is here today for his second T-bar.
06:13You made somebody a new aorta?
06:16He's stalking you online.
06:17I told him it was weird.
06:18And it said that the patient had two repeat graft infections too.
06:23Can I get this?
06:23A T-bar is still a solution for you.
06:25It's less invasive and less risky.
06:27For me?
06:28Or for you?
06:30Corbin, the patient that you're reading about was much sicker.
06:33I don't want another band-aid if there's a permanent fix.
06:36I don't want to diminish what you're going through, but...
06:38You think you know what I'm going through?
06:40My favorite thing is running, but I can't remember the last time I had a runner's high.
06:44I won't be able to lift my baby nephew.
06:46I can't travel.
06:47I can't visit my friends.
06:48I have spent more time in the CCU than my own house in the last year.
06:51Is that not sick enough for you?
06:54What, you just don't care?
06:55That's not true.
06:56Then why won't you fix me?
06:57I wish there was an easy fix.
07:00Just get out.
07:02Get out!
07:03Okay.
07:19It's a larger patient load than usual, but with two of you, Adams,
07:24please tell me that you are at the Benefits Fair or Rounding or anything but late.
07:28Sorry, I was on the phone with Boise General.
07:30They don't have Katie Rogers Immunotherapy either.
07:33Well, the government cut off funding.
07:34You're not going to find it.
07:35Okay, what about cytoreduction surgery with HiPEC?
07:38What about it?
07:39Well, could Katie be a candidate for it?
07:41I emailed you the case report.
07:43Okay, now, I appreciate your initiative, and I will look at it,
07:46but right now, I need you to focus on patients that are currently admitted to the hospital.
07:50But we're down two residents due to illness and a family wedding,
07:54so I need you and Spencer to get started on the floor, okay?
07:59Ms. Hayes needs a Dobhoff tube for two feet.
08:02Oh!
08:03Well, I've never inserted an NG tube on a real person, or a fake one, so...
08:08Well, um, Adams will help.
08:10Hey, don't forget to check your email.
08:12I...
08:14Just keep taking deep breaths.
08:16New pain medication should kick in any second.
08:18Can I take a look?
08:20Yeah.
08:22Wow.
08:23That looks painful.
08:25Last I checked, it measured 20 centimeters.
08:27I suspect a bleeding testicular artery.
08:29Do you see anything?
08:30Uh, it looks like it's expanding.
08:32Let's get an ultrasound and pay durology.
08:34Was the dresser sharp?
08:35I mean, I do see a couple of small lesions.
08:37Must have just snagged a drawer pull.
08:39Huh, okay.
08:40Well, let's get him some more fluids and a full set of labs.
08:43Ugh!
08:43Okay.
08:45Well, the testicles are intact, and they're in the correct position, but I do see some free fluid in the
08:50scrotum.
08:51Oh, my God, Randall!
08:53Is it his heart?
08:54Uh, no, my heart's just fine.
08:56Doctors, this is my wife, Kimmy.
08:57Okay.
09:01Is that one of your...
09:03Yeah, I walked into the dresser.
09:05Probably just a hematoma.
09:07Is this gonna jack your fertility?
09:09I ovulate next week.
09:10We're going to give you some practice here.
09:12Ugh.
09:15Dr. Martin, I don't like how to keep you.
09:17Dr. Martin, I don't like how to keep you.
09:18Hmm.
09:19You've been back three hours, and you've already requested a new 3D microscope with AR tech?
09:24Why are you reading emails?
09:25So when you are supposed to be on leave?
09:27The captain finally left the house.
09:28If that woman makes me take one more nap, I'm gonna lose my mind.
09:31Um, when did you hire Tony Wright?
09:35A few months ago.
09:36I'm surprised we got her.
09:37Jackson says she's the go-to for facial reconstruction.
09:40Well, you know, Jackson is the go-to for facial reconstruction.
09:44Is there a problem?
09:45I just spent the last few months getting to a really good place.
09:48I took scout camping.
09:50I went to the grocery store during normal hours.
09:52I slept.
09:53You need to get to the point.
09:55Wright and I have a history in that historically, she pushes my buttons.
10:02If I hired people based on whose buttons they push, no one could work at this damn hospital.
10:07And your request for a microscope is denied.
10:20You know, I read that you won the Goldstein Award for excellence in teaching.
10:25Huh?
10:26Uh, um, no, wait.
10:37So, you must be an excellent teacher.
10:40That's the name of the award.
10:44She is all set?
10:46Okay.
10:56Yeah.
10:57Well, her nasal frontal and zeal sutures are broken.
11:01Good.
11:02What else?
11:02Her zygomatic arch is comminuted.
11:04And it's a 4-3, not a 4-1.
11:06I am.
11:06It's just got a lot more complicated.
11:08Yeah.
11:09Should I call the OR?
11:10A little more that we're going to push the surgery?
11:12Our daughter's going to be crushed.
11:13No, we're not pushing anything.
11:15Every day that she's intubated, it makes it tougher for her to recover.
11:18We're just going to have to come up with a new plan.
11:22Quickly.
11:27Is he asleep?
11:29Just resting.
11:31Did you get my scans back?
11:33Everything looks stable, so you're all set for the T-bar.
11:37Corbin.
11:39He was hoping you'd say that he got worse, so he could get that new aorta business.
11:45The T-bar really might work.
11:46A new aorta would definitely work.
11:48If you survived it.
11:52I want to talk to the other guy.
11:54The doctor that did the new surgery with Dr. Altman.
11:56Dr. Ndugu.
11:57He could give me a second opinion, right?
11:59Dr. Altman should be in shortly.
12:00You can ask her any questions or you can...
12:01I'm asking for Ndugu.
12:03This is my life.
12:04I'm not going to ask permission to hear about all my options.
12:07Would you?
12:09Just give me ten minutes with him, please.
12:12I'll talk to him.
12:13No promises.
12:16Catherine, I didn't know you were here today.
12:18Oh, I had to get out of that house.
12:20For ten days, I've been taking care of my husband.
12:23I don't know how these nurses do it.
12:25All right, where's my consult?
12:27Randall?
12:29Randall, what are you doing here?
12:31Good to see you.
12:32Oh, we missed you at the last AUA conference.
12:35We were on our honeymoon.
12:36Oh, that's right.
12:37So, what brings you in?
12:39Uh, you have more important things to do.
12:42I can see a resident.
12:44Nonsense.
12:44I am here.
12:45Dr. Hunt, what we got?
12:46Blunt trauma now experiencing severe scrotal swelling.
12:49It's the size of a coconut.
12:51Thank you, Dr. Miller, for that wonderful assessment.
12:54Randall, may I...
12:56Uh...
12:57You don't have to be here for this.
12:58Why don't you just go eat?
12:59I'm sure you're starving after Pilates.
13:01I'm not leaving your side.
13:04How does it look?
13:05For blunt trauma, it doesn't seem to follow the typical injury pattern.
13:10Will this mess up a sperm count?
13:11Yes, it will.
13:12From walking into a dresser?
13:14How is it this bad?
13:15I'll let Dr. Lutner answer that.
13:21I didn't walk into anything.
13:24Okay.
13:26Please don't hate me.
13:27I gave myself a vasectomy last night.
13:32While I was at book club?
13:34What the hell?
13:36I'm a page site.
13:42Keep swallowing.
13:44It pushes the tube down your esophagus to your intestine.
13:49Does that look great?
13:50Yeah.
13:51Keep going until the mark we measured on the tube.
13:53You sure you know what you're doing?
13:55Uh...
13:56She does.
13:56Keep stepping.
13:58Chin down.
13:58Is that mine?
13:59My cat's just supposed to be calling.
14:02Excuse me.
14:03Hi.
14:04It's Dr. Adams.
14:05Yeah.
14:06Actually, I'm with a patient right now.
14:07Can I call you back?
14:12Okay.
14:13I'm done.
14:14That looks good.
14:15All right.
14:16Pull out the stylet.
14:16Secure the tube and start trickle-tube feeds.
14:18Then we've got to do research for Dr. Bailey.
14:20She didn't mention anything about research.
14:22It's for her patient.
14:23Oh.
14:23Well, she's in luck.
14:24I'm really good at research.
14:26In med school, I presented a poster...
14:29Finish off here, and I'm going to get started.
14:31Where are you going?
14:33I'll text you.
14:35I'll text you.
14:37I'll text you.
14:40Hey.
14:41How's it going with right?
14:43I have no idea.
14:44Did you change services?
14:46No.
14:47I'm just getting zero vibe.
14:49Because you're over-vibing?
14:51No, no, no, no.
14:52Okay.
14:52I've been cool.
14:53No excessive praise.
14:54No impulsive moves.
14:55Give it time.
14:58Hey.
14:58If it makes you feel better, I hear your residency director is very impressed.
15:03It does.
15:05What were you even thinking?
15:06Psych is on their way.
15:07That man doesn't need a psychiatrist.
15:09He needs a marriage counselor.
15:11You think he was successful doing that on himself?
15:13We'll find out.
15:14I've got to get him in the law and evacuate that hematoma.
15:17Can I scrub in?
15:18I've never operated on that DIY vasectomy before.
15:21He'll be my second.
15:22Wait.
15:22You know somebody else who tried to do their own vasectomy?
15:25Another urologist said he was embarrassed.
15:27I don't know why these boys are just picking for fun.
15:30They call me.
15:31It's just a hollow tube filled with sperm.
15:33In fact, if you ever want one.
15:35I'm good.
15:35Down here.
15:36Go scrub in.
15:37I'll wait.
15:38We should let Kimmy get in another few rounds and then go prep him.
15:46Can't even count how many fractures she has.
15:48Yeah, the number doesn't matter.
15:49Okay, so how do we plate her zygomatic arch?
15:51It's like tempered glass.
15:53There's nothing solid to screw into.
15:55Warren, any ideas?
15:57Uh, create a scaffold of cadaver bone paste and BMP.
16:00You've studied this.
16:02No, I saw it once.
16:03Years ago.
16:03I was an anesthesiologist before I went into surgery.
16:08Interesting.
16:09Okay, so our first step is going to be to wire her jaw with her bite in the proper place.
16:13We won't be able to have her orally intubated for anesthesia.
16:16Warren, trach, or submental intubation?
16:19Not trach.
16:19It's a straight shot into the airway.
16:21Less risky than going through the chin and the mouth.
16:23Spoken like an anesthesiologist.
16:24A plastic surgeon thinks it'll take her three months to heal from a trach.
16:27A submental incision will heal in a week.
16:30Kwan, what are the steps of a submental intubation?
16:34You make an incision under the chin, and honestly, I don't know.
16:39Of course not.
16:40You're a Gen Surge resident.
16:41You'll learn today.
16:42Cool.
16:43It is.
16:44Take a look at this.
16:48So we would create a large segment of a aorta with a synthetic graft, rerouting it from the chest to
16:53your abdomen, and then we would staple off the infected piece here and remove it at a later time.
16:57So then no more T-bar procedures?
16:59If the surgery is successful, yes, that's the idea.
17:01And you really think this could be a success for me?
17:03I would need to further study your case before I could answer that, so shoot me his latest imaging, and
17:08I want to do another echo before we...
17:10Dr. Andugo, excuse me.
17:11May I have a word, please?
17:12Sure.
17:13Yeah.
17:13Excuse us.
17:22Someone talk fast.
17:23Orban Esfersa.
17:24Not you.
17:25You're talking to my patient behind my back about a procedure that I've already said no to.
17:29Okay.
17:30I assumed you were aware.
17:31Don't do that.
17:32Don't put it on the resident to have the uncomfortable conversation with her attending.
17:36The patient asked if he was a good candidate for a ventral aorta.
17:38I simply explained what it was.
17:40No, you got his hopes up.
17:42And if you had come to me first, I would have explained that unlike Nora, Corbin has major scarring from
17:47a previous esophageal reconstruction.
17:48He is a bad candidate for it.
17:50How do we know who's a good candidate?
17:51We've done this once.
17:52And that might be all we ever do if we kill Corbin with it.
17:55Nora hasn't even hit the six-month mark.
17:58We need more time to see how she does.
18:00Okay.
18:00All right.
18:03Dr. Allman, I'm sorry.
18:04I wasn't sure.
18:05How did Corbin even know about the ventral aorta in the first place?
18:09If you shut me out again, you are off this case.
18:14I'm her boss.
18:16All right.
18:16Didn't she make you chief while she was chief?
18:20Okay.
18:20Well, so what did I owe her?
18:22If I made someone chief and they gave my patient a second opinion behind my back, I would blow my
18:27sec, too.
18:29Yeah, yeah.
18:29That part was bad.
18:31But I'm not wrong.
18:32This surgery could cure all kinds of aortic disease.
18:37Okay, Tonya Wright just gave me the cold shoulder again.
18:40It's okay, I was pretty much done.
18:42Look, she can do a super micro-surgery in a 30X magnified field, but she can't say hi to me.
18:47Oh, Amelia, don't.
18:49I can't watch this.
18:51Nope.
18:53Hi.
18:54Hi.
18:55We went to med school together.
18:57You hated me.
18:58How?
18:59I didn't hate you.
19:02So you do remember me?
19:04Yeah.
19:08What?
19:10She thought this through.
19:11I don't really know what happened next.
19:14Why did you think I hated you?
19:16You ran out of your own birthday party when I showed up uninvited.
19:19Oh, my God.
19:19You changed study groups and actively avoided me in labs.
19:24Because I liked you.
19:26What?
19:26I tried to kiss you in the mission during orientation.
19:30You were drunk.
19:31I thought you stumbled into me.
19:34No, I had a huge crush on you.
19:37I mean, I thought you were queer, but then I wasn't sure, so I didn't want to get burned, so
19:41I kept my distance.
19:43But you have nothing to worry about.
19:45This is all way in the past, and frankly, you're not my type.
19:51My OR's ready.
19:55For some reason, I froze when I saw you earlier.
19:58I'm glad you cleared beer.
20:02I'm pretty sure Altman hates me.
20:04Yeah, if he didn't kick you off the case, it's probably fine.
20:06Let's talk about something else.
20:08My patient tried to give himself a vasectomy.
20:10Wow, we will always have jobs.
20:12Everyone thinks they can do anything themselves.
20:14They watch enough videos on social media.
20:16Are you the board-certified urologist?
20:18You know what?
20:19That actually seems doable with some lidocaine and a mirror.
20:23Our OR's ready.
20:24I'm out.
20:28How come women in their 20s have to shell out big bucks to preserve their fertility,
20:31but men in their 60s are so worried about pregnancy, they are giving themselves a vasectomy?
20:37Evolution failed us.
20:38Do it with me.
20:40Our future and less fertile selves will thank us.
20:42So we can both be hormonal at the same time?
20:44It's a hard pass.
20:45But I will do your shots.
20:47I am very good at giving injections.
20:50Don't ask why.
20:57You can have the other half of my sandwich if you're hungry.
21:00I brought it from home.
21:01Yeah, I'm good.
21:02Did you email me the results for the immunotherapy study from San Francisco?
21:06I included it in the Chicago study at the bottom.
21:08Okay.
21:09I like to cook.
21:10Do you?
21:11It makes me happy following directions and...
21:14I wonder if we could follow a compassionate use application for her meds?
21:18Or maybe we could get it off-label directly from the manufacturer.
21:23Why is this particular patient's research so important?
21:26I mean, I just meant, weren't there others in the trial?
21:29What about them?
21:30Look, I care about all the patients.
21:32I do.
21:33I just...
21:35How Katie...
21:36She's in her late 20s just like us.
21:38She feels like a classmate.
21:39More like a friend.
21:41We've just spent a lot of time together.
21:44So she is now kind of a friend.
21:47I get it?
21:48It's like when you meet someone and you feel like you've already met them before.
21:54Like they're supposed to be in your life.
22:00Oh, no.
22:01It's Wendy.
22:07Hey, may I come in?
22:14She wanted me to apologize?
22:16Unbelievable.
22:17It's okay.
22:19Can we have a minute?
22:20Sure.
22:22Don't say anything stupid.
22:24You're stressing me and the baby out enough.
22:30If you want Dr. Anduga to replace your aorta, I won't stand in your way.
22:33But I do need you to hear me out first.
22:36Okay.
22:37Talk.
22:37Okay.
22:42We have done this once on a person with very, very different anatomy
22:47who could have a complication at any moment.
22:50So it's not just a risk.
22:51It's a complete unknown.
22:53There is no way to know what will happen if we staple your aorta shut.
22:56And it's irreversible.
22:58If the staples don't hold and you hemorrhage, you'll die.
23:05I don't want to do this surgery on you because I want you to be able to meet your nephew
23:09and see your sister become a mom and go running again and visit your friends.
23:14And I know the idea of going through this again is infuriating.
23:18But at least, at least you'll still be alive.
23:31I'll give you more time.
23:39Thanks.
23:47Well, nice.
23:48You didn't skive at all.
23:49And now I will lift the scalp flap to expose the face.
23:56Hold up.
23:56What have you got there?
23:57A beaver blade.
23:58What are you trying to get this here all day?
23:59Plastic surgeons use this to make delicate decisions.
24:01Yeah, sure, if we're working on a cleft lip or somewhere where every millimeter counts.
24:05The scalp's robust.
24:06Get him the 15 blade.
24:14Make sure to stay in the same plane.
24:18Good.
24:20Oh, there's some fluid.
24:28Give me a specimen tube.
24:36Paper towel.
24:44It's a halo sign.
24:45Dammit, she's leaking CSF.
24:46We need Neuro now.
24:53Wait, what happened?
24:54She was fine.
24:54I started the trickle feeds and her sats dropped.
24:56What's wrong?
24:57Hold on.
24:57We're going to find out.
24:58Just don't move.
24:59Oh.
25:01The tube is in her alone.
25:03Wait.
25:03You didn't see that on the x-ray?
25:04What x-ray?
25:05Let me see.
25:05Look, you have to get an x-ray after you insert a dog puff.
25:07And most importantly, before you start feeds.
25:10Okay, let's pull it out.
25:10Quickly now.
25:11I'm sorry.
25:12This is my first one.
25:13I didn't know.
25:13No, it's okay.
25:14And we can fix this.
25:16Prepare for a bronchoscopy to suction the feeds out.
25:18Okay.
25:25Suction?
25:28Is it weird operating on your friend's scrotum?
25:31My dear, you've seen one testicle.
25:33You've seen them all.
25:35But ask me if I think the man has a screw loose.
25:37Ooh.
25:38They must really not want kids.
25:39Of course not.
25:40He's a grandfather.
25:41That's when all the fun starts.
25:43Raising a child is hard.
25:45This coming from the chairwoman of the National Hospital System.
25:48I don't know how you did it.
25:49Me neither.
25:50But I will tell you this.
25:51As proud as I am of all my accomplishments,
25:53the best job I've ever had is being Jackson's mom.
25:58And the biggest surprise.
25:59I didn't think I wanted to be a parent.
26:01I just never had that pull.
26:05But life is full of surprises.
26:08May I just ask Kimmy?
26:09No.
26:10She's going to make sure that lawyer is looking over that prenup.
26:12Okay, let us finish this vasectomy in the right way.
26:15I've palpated the vas deferens and isolated it now.
26:18What is next?
26:20Exteriorize, ligate both ends, then divide and send a path.
26:23Mm-hmm.
26:24After you.
26:27Uh, four over I go.
26:34All right, what happened?
26:35She has a CSF leak.
26:37Can you show me where the fluid's coming from?
26:38Do you think it's from the cranial base?
26:40I can't see.
26:41Let's light it up.
26:42Dilute fluorescein, please.
26:43Inject it into the EVD and clamp it.
26:46Injecting now.
26:48All right, now we wait.
26:49Lights, please.
26:50For what?
26:51The drain is in her ventricle, which is filled with CSF.
26:55If this is a leak, we should see...
26:57Oh.
26:57Yeah, the fluorescence is coming from the location of the dural tear.
27:00Is it weird that I think that's beautiful?
27:03Not at all.
27:04All right, let's sew this up.
27:055-0 nylon.
27:07Actually, the dura is friable.
27:09It's not going to hold a stitch.
27:11And the paracranium is too scarred to harvest for a patch.
27:14You want some fasciolata?
27:15I think that might be our only option.
27:16Cook the thigh.
27:17Not the only option.
27:18Instead of another incision, I can harvest fascia from the existing field.
27:22You think you'll have enough bite to hold the dura?
27:24Give me three minutes.
27:25I'll show you.
27:26Scalpel?
27:34Okay, Mom.
27:35What?
27:35Whatever.
27:36I'll let you know when I know what he's decided.
27:39Hey, everything okay?
27:43Everything's fine.
27:44I'm just a terrible person.
27:46I have a hard time believing that.
27:47You're spending your third trimester with your brother in the CCU.
27:51My mom's a wreck
27:53because her son is having another big surgery
27:56while she's recovering from pneumonia.
27:58And I just yelled at her
27:59because she didn't have an opinion on the paint color for the nursery.
28:03Yeah, you want your mom's help.
28:04It doesn't make you terrible.
28:07I'm just overwhelmed.
28:08Yeah, of course you are.
28:09There's a lot coming on.
28:11I'm not so stupid.
28:13I am 36 years old.
28:15I'm about to have a kid.
28:18But I still just want my mom.
28:21I know that feeling.
28:25I should call her and apologize.
28:28I'll see you up there.
28:39Hey, Corbin made his decision.
28:44He wants a T-bar.
28:45Okay.
28:48I paid someone else, but we're down residence today.
28:50I'm good.
28:52Do you need a minute?
28:53Not at all.
28:54I'll go prep him.
28:55Okay.
28:59Dr. Bailey, I am so sorry.
29:01I take full responsibility.
29:02I should have told Spencer to check the KUB before starting fees.
29:05Yeah, damn right.
29:06And you better have a good reason you didn't.
29:08Yeah, a pharmaceutical company called with the lead on Katie's infusion,
29:11so I just wanted to...
29:12No, the last time I checked, I asked you to focus on your patients admitted in the hospital.
29:17I only picked up long enough to let them know that I was serious.
29:19Wendy could have died of chemical pneumonitis or pneumonia.
29:22She didn't.
29:23And Katie could die if we don't fight for her.
29:25I know.
29:26I am fighting for her, too.
29:28Are you?
29:28Because what options have you found?
29:30What research have you done?
29:31Have you exhausted your contact list?
29:33It's because it feels like you've given up.
29:35Oh, so you think after Katie sobbed in my arms,
29:40I shrugged and said good luck,
29:43and I gave her a goodie bag and sent her on her way?
29:45She's dying, okay?
29:46And I think about it every single day.
29:50And I also think about my 65-year-old with decompensated cirrhosis,
29:55who's treatment-resistant,
29:57and the 17-year-old, that septic, and I can't figure out why.
30:00Don't forget about John Doe in the ICU,
30:02whose abdomen I had to leave open.
30:06Yeah, he's also keeping me off at night.
30:08And now I guess you can add Wendy to my list.
30:11See, I haven't given up on Katie,
30:13but I also haven't given up on the rest of my patients,
30:17and that is where you and I are different.
30:22Get it together.
30:39Hi.
30:40Randall did great.
30:42He is recovering now,
30:43and they will call you when he's ready for visitors.
30:45Is it bad if I don't answer?
30:47No one would hold it against you.
30:50I really do love him.
30:52That's what makes this hurt so much.
30:55I mean, it's his body,
30:56and he can do whatever he wants.
30:59But if I want to stay married to him,
31:02I don't get a say whether I have a baby.
31:05Well, you could always ask him to reverse it.
31:07What's the point?
31:09He obviously doesn't want to have kids with me.
31:12Uh.
31:14Well, can you get a puppy?
31:17I'm allergic.
31:19That's unfortunate.
31:20I don't know if I want to stay married to him.
31:25Hey.
31:27Hey.
31:28I did Corbin's T-var.
31:29He did great.
31:30His numbers are improving.
31:32Okay.
31:34Look, I'm sorry if I came across as harsh earlier.
31:38I still maintain that the ventral aorta
31:41wasn't the right call for this patient.
31:43What about the next one?
31:45You were more than happy to talk about this surgery
31:48on podcasts, publish abstracts, present it.
31:51You were the one who came up with it.
31:53What's the point if you never do it again?
31:55It's a break the glass in case of emergency surgery.
31:58But does it have to be?
31:59Think of the number of people suffering from aortic disease
32:02with no options.
32:04We might have something that could help them.
32:06Why don't you want to use it?
32:15She looks terrible.
32:18She'll look more like herself when the swelling goes down.
32:21And we'll keep monitoring her brain function
32:23to see what's intact.
32:24Her intracranial pressure is stable
32:25and she's not re-deeking any fluid from her nose.
32:28That's good.
32:30I think I have to drop out of school.
32:32I can't leave her like this.
32:34It's always been me and her.
32:37Have you thought about contacting the school?
32:40Maybe take a leave of absence
32:41or do your coursework remotely?
32:44You think they'd do that?
32:45Yeah, you've worked really hard.
32:47And if you stop now,
32:48then it's going to be a lot harder to start back up again.
32:50Never heard it's to ask.
32:55Excuse me.
32:58Dr. Wright,
33:00I ordered Teresa's post-op imaging,
33:01but it probably won't happen overnight,
33:03so I'll make sure it's done for first thing tomorrow.
33:04Good.
33:07All due respect,
33:08I don't want to be just good.
33:10I want you to see me as excellent,
33:12so I'm asking,
33:13what would that take?
33:14Tell me what you need me to do,
33:15and I will do it.
33:17There's your problem.
33:18That I'm not anticipating you well enough?
33:20You're trying to anticipate me
33:21when you should be trying to anticipate the medicine.
33:24Look, over the years,
33:25I've found that the most successful residents
33:27focus on patient care and surgical technique.
33:30They're confident in who they are,
33:32which translates into them being confident in what they do,
33:34and that is what leads to excellence in plastics.
33:38I didn't see that from you today.
33:41Maybe next time.
33:49Hey, did you update Miss Cahill's outfit for Baxter?
33:56He's on tonight.
34:00You okay?
34:01Super.
34:03Look, Bailey was mad at me, not you,
34:05and she was way out of line.
34:06Bailey?
34:07Bailey wasn't the problem.
34:11Spencer.
34:11I thought you were going to apologize to me.
34:13For what?
34:14Look, you might have taken the heat
34:16because you're the second year,
34:17but I fed the tube into Wendy's lungs,
34:18and if you had told me to get a KUB,
34:20I would have taken a damn x-ray,
34:22not initiated feeds.
34:23Okay, well, we managed it.
34:24She's fine.
34:24She had food in her lungs!
34:30Oh, okay.
34:36I wasn't cool.
34:38Oh, you're being hard on yourself.
34:40Oh, she said in no uncertain terms
34:42that she did not see excellence in me today.
34:46I'm sorry.
34:47You know what makes it worse?
34:48She wasn't even mean about it.
34:49She just said it like it was a fact.
34:51No.
34:52Well, you think it's a fact?
34:54Oh, no, no, no.
34:55I was thinking about how I yelled at Adams.
34:58Ah, what'd he do now?
34:59Well, his concern for one patient
35:02got in the way of his care for other patients.
35:05Katie Rogers.
35:06Yeah.
35:07I mean, truth is,
35:08if she was our only patient,
35:10his dedication would be admirable.
35:13I hope I wasn't too hard on him.
35:15Oh, I guess we gotta have thick skin
35:17if we're gonna do this thing.
35:19Wanna go home?
35:20Let's go home.
35:29Hey.
35:30Everyone okay?
35:35I haven't signed the papers yet.
35:40But getting a divorce was your idea.
35:43I know.
35:44I know.
35:46You mean I have your second thoughts?
35:48No.
35:51I keep taking the papers out to sign
35:53and then I don't do it
35:54and now they're just sitting in my bag
35:56with crumbs and crayon marks on them.
36:01Just because it was my idea
36:02doesn't mean that I'm not scared.
36:06What are you scared of?
36:08I don't know.
36:09Not everything will just explode
36:10and fall apart.
36:13But...
36:13doesn't that happen already?
36:25I don't know.
36:26I mean, I'll take out another returner.
36:29We don't have to work with this.
36:30I have to do it sometime.
36:39my sixth grade teacher said your actions plus your choices equals your life this is mostly true
36:46I can do a whole vasectomy start to finish it's pretty straightforward why are you looking at me
36:56wait did you mind yeah today looking at questions about my mom thinking about being a mom just brought
37:01up a lot of old feelings I don't have time to deal with I need to focus on work
37:07what if I did it with you I don't have to be here for this right no but you didn't
37:12want kids
37:13I don't think I do but I also don't want to wake up one day and my eggs are all
37:19shriveled and dusty
37:19and realize that I do and it's too late and then if we if we do it together I I
37:26could be there
37:26for you if you think about your mom you'd do that yeah yeah and then I can tell you about
37:33my mom
37:33which would make you feel better fertility friends don't call it that
37:41open us up we all be the same no no but what it doesn't account for it's luck what is
37:48going on
37:49you have to wait outside someone tell me what's going on please it's gonna be okay no it'll be okay
37:54what happened I got him back after one round of epi but he's still hypotensive with a narrow pulse
37:57pressure did you get an x-ray I'm right here good work we just found a widening the leak is
38:03expanding
38:04page altman we need to get him back to the angio suite
38:10let's go
38:13sometimes we encounter unexpected twists of fate
38:19thanks for today you're the only neurosurgeon that's ever responded to my page in under an hour
38:26yeah well it was my first day back so I didn't have a lot going on
38:31I'm not not to say that I'm not always prompt
38:34right meet me again I will come just as fast
38:38okay
38:40uh I I made it weird
38:42no I swear to you the crush is all in the past I've had many crushes since then
38:47succeeded at several changed programs when others have failed
38:52you used to laugh more
38:59I also had a crush on you
39:01I mean I didn't understand what I was feeling but you know I wish I had known
39:07sorry that that is this is I'm not hitting on you and the attendings lounge
39:13this is work
39:15do you want to go somewhere get a coffee
39:22and the best things in life fall out of thin air
39:35all you have to do is catch it
39:42looks steamy right
39:44mark slow
39:45oh this is awkward
39:48look at the dirty mistresses
39:50I suppose we are
39:52I'll show you the slow method
39:53how many nurses have you slept with this week
39:55that's not a problem but that's an adventure
39:57a plastic's posse
39:59kicking surgical ass and taking names
40:01a plastic's posse
40:02people don't come to me to fix what's on the outside
40:04they come to me to fix what's on the inside
40:05if that means giving someone a straighter nose or a bigger breast
40:09if that helps a person get by
40:10I don't run
40:11I don't hide
40:12I don't take space
40:14I'm a dad
40:15I'm a fairy
40:15I'm a fairy
40:16I'm a baby
40:17why are you telling me to give a time when there's no guarantee that time is gonna be there
40:22if you love someone
40:24you tell them
40:25even if you're scared that it's not the right thing
40:27even if you're scared that it will burn your life to the ground
40:31you say it
40:32you say it loud
40:37don't waste one single minute
40:39would you lie with me and just forget the world
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