In 1952, Dr. F. John Lewis
performed the first successful open-heart surgery using hypothermia.
Oh, the, um, risk management workshop got moved to
- the third floor lec... lecture hall. - Mmm.
- Mm-hmm. - Oh.
Not worth the interruption.
I don't know. We're gonna, um...
We're gonna be late if we don't go soon.
We'll take the carpool lane.
This week has been great.
- I mean, really, really great. - Mmm.
But I work with your husband.
Is it gonna be weird if we show up together?
No.
People carpool for all kinds of reasons.
Hmm?
I mean, it is better for the environment.
By inducing a hypothermic state,
the surgical team created a window of several minutes
to close a hole in the heart of a five-year-old girl.
The predominant perforator should be in the medial row.
He's still got it.
- You want eggs? - Uh, I'm not hungry.
I have to tell my patient she's stage four.
I'm sorry.
- Wanna talk about it? - No.
Want pancakes?
- Yes. - Yeah.
That one surgery changed the entire course of human history.
Were you here late last night?
Max and Irvin had an engagement party.
Booze and bingo, and I lost both.
- Maxine's getting married? - Yes.
And I am a bridesmaid.
I have to choose my dress today, so if anybody wants to weigh in.
Hell, yeah, I'll be too busy working with Jackson Avery.
Wait, you're scrubbing in on the DIEP flap reconstruction?
I've been asking to be on that for a week now.
Oh, well, if it helps, it comes with
a plastics fellow who rage-hates me.
That does help.
But as they watched her tiny heart,
desperate for it to beat again, it could have gone either way.
All they could do was hope.
- You don't have to wait with me. - I'm just here for the chair.
Take it. I am over recovery.
Yeah, don't forget PT and a lot more rest.
Tell that to my kids.
Hey, look who it is.
Morning.
Hi.
Uh...
- Are you... Are you, uh... - I'm officially discharged.
Congratulations.
Hi. Cass Beckman.
I remember. It's nice to see you again.
- Likewise. - Yeah.
We're going to the risk management class.
- Yeah. That's why we carpooled. - Mm-hmm.
- Hmm. - Well, you know, we should get going.
- Gotta get those CME hours in. - Yeah.
- Well, um, enjoy being home, Link. - Hmm.
Didn't realize you lived close to the Beckmans.
Yeah. Not sure we do.
Did Ann Schroeder's chole get rescheduled?
Oh, we did that yesterday.
Well, I should say Kwan did most of it.
He did a good job. Patient did well also.
Teresa Gomez's hernia repair?
Well, now that OR two is back, we can fit her in on Wednesday?
- Well, she'll be happy. - Okay.
You know, I want you to know how grateful I am that you're back here.
I mean, between the surgeries and the teachings...
Happy to do it.
I know you are. But thanks.
- You've gotta be kidding me. - What? Is everything okay?
Our water bill doubled this month. Irvin likes long showers.
Have you suggested he and Maxine shower together?
Move in with us.
Free rent. We split utilities.
You want me to live with you? Thanks, but no.
All right. Step it up.
A patient from an equestrian accident just came in.
Now, a horse can inflict severe injuries on a person.
- Jonah Nolan? - Yeah.
I hear you fell off your horse during a competition?
Me and Vince were warming up together.
- Vince is your horse? - No, it's me.
My horse caught a fence and went down. Jonah was right behind me.
Gashed his head on Mojo's bridle. Mojo's his horse.
All right. Let me take a look.
- Yeah. - Thanks.
- And what about you? Are you feeling okay? - Just a little sore.
Uh, I'm gonna finish competing once Jonah's okay.
You should still get checked out.
I mean, falling off a horse can do serious damage.
They're powerful animals.
No, Carrot's very gentle.
That's the horse you fell off?
Uh, let me guess, the other one is Mojo?
Yeah. Thank God they're both okay.
Yeah. Um... Okay. Well, it looks like
it's just lacerations and abrasions.
So, you're gonna be fine.
I'm feeling a little dizzy.
Oh. Well, um, Millin, let's request
a neuro consult just to be safe. Okay.
- I'll close him and clean them up. - Thanks.
Um, dressage starts in 20 minutes.
Do you think we can make it back by then?
I'm gonna say neigh.
Remember when Avery gets to the venous anastomosis...
He likes to use an anastomotic coupler. You've mentioned it twice.
I applied for an attending position
in his department in Boston after this fellowship.
You and probably a hundred others.
My parents live near there, and they could really use my help.
So this is my chance to impress him.
I won't let you screw this up.
Happy to work with you again too.
Oh. Did you invite the whole hospital?
We don't get to see a lot of DIEP flaps.
Patient's cool with it though.
Good morning. Who can walk me through a Millard repair on a cleft lip?
Use a curvilinear incision with the rotation flap
from the medial lip element
and the advancement flap from the lateral element.
- That's correct, Dr. um... - Mohanty.
Kavita Mohanty, plastics fellow.
And a fellow. Perfect.
I got a five-year-old in OR four
who's gonna be very lucky to have you.
- I'm sorry? - I ran into Dr. Camden in the lounge
and he needs an assist. So, enjoy.
Everybody else, you're with me. Let's go.
Dr. Emily Richards, call Recovery.
- Morning, Perry. - Good morning.
Looks like you brought the surgical army.
Well, they'll mostly observe.
Well, the more the merrier.
And you must be the infamous Dr. Avery.
Well, I understand you're the one with the reputation.
Training firefighters is very impressive.
Oh. Not officially.
A few of them take my cycle warriors spin class.
She's being modest.
Half the department's only in shape because she kicks their butts.
Okay, well, please don't kick mine.
All right, Warren, you wanna do the honors?
Yeah. Perry Onikul, 50.
With past medical history
of ER/PR-positive, invasive lobular carcinoma of the left breast.
Status post bilateral mastectomy:
Completed chemotherapy and radiation.
Disease in remission.
Here today for a deep inferior epigastric
perforator flap for breast reconstruction.
Sorry. I'm just very happy to hear those words.
Well, so are we.
Do you know how this is all gonna work?
I was kinda hoping you did.
Fair enough.
All right, well, we will begin by removing pieces
of your skin, fat and blood vessels from your lower abdomen here,
transplanting those up into your chest.
Who can tell me where we connect the flap?
You connect it to the internal mammary.
That's correct.
Not all plastic surgeons do this.
- You're in very good hands. - He's right.
You ready?
For a new rack and a tummy tuck in one surgery?
Bring it on.
All right, we'll get you started with some new scans right away.
- Dr. Grey. - Dr. Grey.
Morning.
You let Koracick publish his Alzheimer's results?
Technically that was The Journal of American Medicine.
It's good to see you, by the way.
He only studied male mice.
I did the same experiment with female mice
and when I gave them antibiotics,
there was no decrease in Alzheimer's.
Mer, don't start with me, please.
So, now because he's gone public,
people will assume that what's true
for male mice is true for all mice.
This is exactly the kind of thinking that I'm trying to change.
Yet your lab is apparently completely
unused and you haven't published anything.
Why is that, Meredith?
- That's a cop-out. - Okay.
So then why don't you explain it to me?
Why is it that antibiotics don't work on female mice?
I'm still working on my hypothesis. I don't know yet.
Maybe instead of hiding out here all
summer, you could be figuring this out.
I have a surgery. Have a nice day.
- Synced and corrected by ChrisKe - — for www.addic7ed.com —
So you...
so you race hobby horses?
Well, not just race. Um...
Show jumping, hunter/jumper, puissance.
Piaffe.
Passage.
- You on a team? - It's an individual sport.
Pretty niche. Mostly girls.
A lot of the competitions,
Vince and I were, like, the only
guys, so eventually we became friends.
Neuro is on their way. They were busy with another patient.
Did you tell them there's a championship trophy on the line?
- I did not. - I'll be fine.
You should go back before Evie wins first in dressage.
She'll be insufferable.
No, it's not that. It's my chest.
- Oh, my God. - Oh, we need some help.
How can I be stage four?
My scans, I thought the tumors were shrinking?
Yeah. Right, unfortunately, sometimes...
tumors learn how to evade chemotherapy.
Okay, well, if my cancer wants to fight, I'll fight harder.
So, what now?
Well, first things first, um, you
have to recover from your splenectomy.
And then we will start a new chemo regimen.
Great. Really wasn't a fan of the old one.
And-And we'll also look into clinical trials. There's a lot of new
- promising therapies out there. - Mm-hmm.
Uh, w-we just have to find the right one.
Okay. Sounds good to me.
I haven't seen anyone visit.
Have you told friends, family that you're in the hospital?
If I tell them, they'll get upset.
And then I'll get upset and I just need to... fight.
Oh.
Well, I... I don't know your mom, but I am a mom.
And we are really good at fighting too.
Yeah.
Once we know more, I will tell her.
- I promise. - Mmm.
All right. I'll be back.
I need your full attention on Katie Rogers.
I thought we were just advancing her diet?
- Full fluids, right? - No, she needs a clinical trial.
Um... And I don't have time to search a database today,
so I need you to find options.
See what's active and then call around to see what's in the pipeline.
Okay. I was gonna observe Dr. Avery's surgery
but I can carve out some time after.
Meade will check on her every half hour.
You can "carve out some time" for our patient with metastatic cancer?
How generous of you.
You keep telling me to teach
and you told all of us to study Dr. Avery's DIEP flap.
Katie is giving this her all, so we need to give our all.
Do you think taking a break and watching a surgery
is giving it your all, Dr. Adams?
- I'll skip it. - Leave no stone unturned.
Okay, what is taking so long?
All right, Avery's gonna want those scans to evaluate perforators.
You work with him before?
Yeah, yeah, I can read and anticipate him pretty well.
I used to be part of his, uh... his Plastics Posse.
I don't know what that is, but I want in.
You interested in plastics?
I... don't have the extra three years.
Too many things on my plate right now. Just...
Yeah, I just enjoy every case that I can.
Oh. The scans are in.
How do you anticipate Avery's gonna feel about his DIEP flap patient
having an inguinal hernia?
There he is.
Hey. I read Koracick's article. Bold.
Yeah, his study yielded interesting results.
- I meant bold on your part. - So I've been told.
Hey, are you busy?
I've got a patient CT showing a right-sided inguinal hernia.
- Is it reducible? - It is, yeah.
Simple, fat containing. Hoping you could do it.
Uh, wish I could, but I'm in budget meetings all day.
- Okay. Anybody else... - Um... Good luck.
Don't...
- Hey. - No.
- It's for a patient. - Call Tom Koracick.
She's a breast cancer survivor, Mer.
All right? And she's got a hernia.
As long as she has that hernia,
I can't give her the breast reconstruction that she needs.
Now, I can come back another time and I can do the flap,
but she needs the repair done, like, ideally today.
Call someone else.
She's had a year from hell.
Today was supposed to be her first step back.
She deserves the best and you can help
her a lot better than I can. Please.
Send me the scans.
- What happened? - He was complaining
of increasing chest pain and now he
requires four liters nasal cannula.
I was supposed to take gold in dressage. Where's Carrot?
What are you doing here?
One of Jo's patients went into premature labor.
She's upstairs checking on her.
I didn't wanna wait in the car. You need a consult?
You can't consult. You can't even work yet.
I haven't approved it.
His vitals are stable, I was going to check his spine.
Yeah, let's go.
Let me know if anywhere hurts.
Can't you just give me meds for the
pain so I can go back to competing?
Like they do in the Olympics.
- What's the competition? - Not the Olympics.
The Washington Hobby Horse Open.
Well, I work with professional athletes, and I wouldn't advise it.
- Ow. Ow, ow! - Okay, around T4, and no step-off.
Let's take that X-ray.
Or, you know, whatever Hunt wants.
Okay. All right. Clear for X-ray.
Okay, yeah. Ribs four to six are fractured on the left side.
Some haziness, probably a lung contusion.
No one asked you.
Maybe you should. The guy said he worked with pro athletes.
We need to scan you to get a better idea of what's going on. Okay?
Well, then, can he come? This is my last shot at state before college
and if I'm gonna have a chance at competing, I want the best.
Guess I'm back.
Okay.
Sorry to page you out of the seminar.
Oh, please. I've never been closer to napping in public.
Okay. Well, the patient's complaining of chest pain.
She asked for Ndugu, but your name's also in her chart.
Okay, great. Thank you.
Nora, hey.
What's going on?
Um, I woke up with some chest pain and I thought it might go away,
but it hasn't, and I'm really freaked out.
Okay.
Uh, is it sharp, or does it feel like pressure?
It's more like a dull ache.
Okay, let's work you up.
- The reconstruction is off? - Postponed.
Dr. Grey will repair the hernia today, and then once you're healed up,
I'll come right back and do the flap.
Can't you just do both today?
It's a much longer and more complicated procedure.
You'll recover quicker if we do them separately.
Depends on how you define "recover."
What do you mean?
I'm not ashamed of how I look, but
at work, I am surrounded by mirrors.
And when I see my reflection, it is a constant reminder
of all the pain and waiting and exhaustion of not knowing if I'd live.
I won't be fully recovered
until I can look in the mirror and see me, not my cancer.
- We understand, but... - We'll do both surgeries today.
- Will we? - She'll go under anesthesia once,
which is not a bad idea considering all her body has been through.
But that is much more time under anesthesia.
And I'm concerned about the post-operative pain.
I will gladly take on the risk
if it means waking up tomorrow and feeling like myself again.
I'll prep.
Hey, you hear about the fellow who got kicked off the DIEP flap?
How would I hear that?
Guess who gets to scrub in on a DIEP flap and a hernia repair now.
I'm gonna go with Warren.
Well, you still gonna come check it out?
Bailey put me on research while she's in the OR.
So she's demoted you back to an intern?
- Tracks. - That's her. I gotta go.
- You would wanna live with me, right? - I do live with you.
I don't have, like, a smell or a weird habit?
Am I a loud chewer?
- What is this about? - I asked Jules to move in with us.
Without asking me? You yelled at me when I did that.
Doesn't matter. She said no.
That doesn't let you off the hook.
Why wouldn't she wanna live with me? I'm a good roommate.
Maybe she doesn't wanna live with me.
No, she specifically said "live with you," meaning me,
- then she took a hard pass. - Hmm.
Wait, I'm not done freaking out.
Maybe the two of you just aren't as close as you thought.
Trauma team to ICU. Trauma team to ICU.
Hey, you need something?
Yeah, I just had a question for Dr. Bailey.
Well, she's in surgery. You can try me.
Do you think I'll be healed enough
to start my new chemotherapy before I'm discharged?
It'll be more like three weeks.
A month with no treatments?
Well, we wanna give your body time to heal after surgery.
But Dr. Bailey and Dr. Sugihara will meet later to talk next steps,
and I'll be looking at clinical trials.
You're in charge of finding clinical trials?
Is that a problem?
I thought we were okay.
Well, when you were checking my incision, that was one thing.
But clinical trials have serious ramifications for me,
and I don't know anything about you.
What do you wanna know?
Where did you go to medical school?
Cornell.
- Did you get good grades? - I'm a surgeon, so yeah.
Did you ever kill anybody? By accident, I mean.
If you murdered someone, I'd rather not know.
Look, we can do this all day,
but it's in your best interest if I'm researching therapies, so...
I'll be out there.
And if you need something other than my
social security number, give me a shout.
All right, what do we got?
Uh, X-ray shows a hemothorax and some broken ribs.
What's the mechanism?
Hobby horse injury.
Hey, didn't I just sign off on your discharge papers?
Yeah, don't ask.
Okay. All right. Uh...
- Hobby horse, like a stick horse? - No, you can't call...
A stick horse is for children. Hobby horsing is far more sophisticated.
There's a whole league, apparently.
And you cannot call it stick horsing. It's very offensive.
Hmm.
I looked it up in the elevator.
Okay. Uh... Just a little longer, Vince.
Guess I'm missing the barrel race.
I know it sounds weird.
- No, no. - Seems fun.
Most people don't get it, but that's what's cool about it.
Being part of a community that loves something
and doesn't care what anybody else thinks.
But I'm going to college in Colorado,
and there's no hobby horsing there.
So, pretty soon, I won't be part of anything.
I'll just be a guy who fell off a fake horse and failed.
His systolic's in the sixties.
- His sats are tanking. - He's gonna code.
Okay, let's get a chest tube tray and prepare to intubate right now.
I'll notify the OR.
Getting ready to secure the mesh to the shelving edge.
Dr. Kwan, hold tension on my suture.
- Okay. How's that? - Good.
I am scrubbed and ready. Hope you're happy.
Last time I checked,
I was doing you a favor. You're welcome.
You encouraged her to take a bigger risk.
No, I listened to her. There's a difference.
With all due respect, I spend the majority of my clinic hours
listening to female patients.
- Oh. Do a lot of DIEP flaps? - Fair amount.
Let me guess: Not as many as you'd expect.
Well, no, because most people don't know that the law
requires insurance companies to cover
breast reconstruction after cancer.
Yet somehow everyone knows you can get a vasectomy.
You see a pattern here, Dr. Avery?
I see several, Dr. Grey. You made your point.
Too bad you can't publish that.
I'm done here, Dr. Kwan. You can close the fascia.
So, this should just take a few minutes. Try to hold still.
I am not going anywhere.
And then I'd like to review your daily routine, your diet,
just to make sure that you're not inadvertently putting any strain
on the repair.
Hey. We're on a break.
- Do you wanna grab a bite after this? - Oh, now's not a good time.
- Are you okay? - Yeah, I just...
I have a really complicated patient.
Well, I'm happy to bounce some ideas around.
You want me to consult? Or just support?
You know what, um...
The scan should be coming up soon. You should probably go.
Is this because we ran into Owen earlier?
- No. - Are you sure?
Because you seemed fine at the hotel. More than fine. And now...
And now I am treating an extremely risky
patient who requires my full attention.
And I'm not in a hotel bed. I am at work.
- Well, then I will leave you to it. - Okay.
He has a lower lobe injury.
I'm seeing multiple lacerations of his lung.
I'll do a wedge resection.
How much do you have to take?
Can someone page Wilson and see how much longer she's gonna be?
You know, I had a hobby horse when I was a kid.
It scared the crap out of me.
I couldn't sleep unless it was facing the wall.
You know, I wasn't gonna say anything, but it's weird, right?
It's a bunch of people jumping around on toy animals.
There's a website where you can customize your horse's head.
Enough. We're not here to judge. We're here to fix.
If you can't just focus on the job, then you should go.
This kid loves his sport, and after today,
he might not be able to do it anymore.
Haven't you ever loved something and lost it?
- Let's show some respect. - I'm sorry.
- Me too. - Suction.
This is lining up perfectly.
Dr. Warren, why don't you go ahead and grab that clamp.
Beautiful. Very nice.
Is there something you need, Dr. Mohanty?
I am done with the Millard repair.
I thought I'd see if you need more hands here.
- Oh, we're good, but thank you. - Understood.
Warren, when I'm done with the arterial anastomosis,
you wanna give me a hand with the venous coupling?
Absolutely.
Dr. Avery, may I be excused?
I'm really not feeling well.
You were fine ten seconds ago.
I think I might have had questionable leftovers for lunch.
Might come out of both ends.
No need to elaborate, Dr. Kwan.
Mohanty, looks like it's your lucky day.
- I'll go scrub. - Okay.
Dr. Avery just finished the microvascular anastomosis
and made it look easy.
- It's insane. - Meade?
- Yeah? - Go somewhere else.
Oh. Okay.
You need something?
Yes. What is PD-L1?
Programmed cell death ligand.
It's a protein that helps your cells more effectively kill cancer cells.
Okay, and CTLA-4?
It's an immune checkpoint inhibitor.
Another mechanism that clinical trials
are exploring for treating cancers like yours.
- Why? - Yeah, no, I'm searching clinical trials.
It's all fairly overwhelming.
Yeah, most of the possible side-effects aren't that bad.
"May cause dry mouth, nausea, or death." Yeah, death seems pretty bad.
Yeah, that's just lawyers making sure nobody gets sued.
Oh, that doesn't make me feel any better.
- Ouch. - You okay?
No, my leg hurts.
- I'm not used to being on my feet. - Yeah. Let me take a look.
Ow. Stop. Please.
- Grab a wheelchair. - Right away, Dr. Adams.
Wait. What's going on? What's happening?
I think you have a blood clot. Let's get you back to your room.
We need to ultrasound your leg ASAP.
Sorry, I know that you said no screens with a concussion.
I just wanted to watch Vince in last year's puissance.
- Whoa. How high is that bar? - Four feet.
They raise it after every round.
- That's pretty impressive. - It's not even his best event.
People don't realize how much strength
and precision it actually takes.
- Hmm. - When I would tell the other kids,
they would just laugh, so I stopped talking about it.
I would just say that my mom wouldn't let me go to the movies
instead of saying that I had practice.
But then I met Vince. I didn't have to lie anymore.
Everything changed.
He got me.
I'll put this away.
Actually, neuro cleared you. You can go.
- Really? - Mm-hmm.
We might make it back for hunter/jumper.
That's Vince's best event. He's gonna be so psyched.
Actually, Vince can't go.
- He's in surgery. - For real?
I can't say more because of privacy laws,
but it shouldn't be more than...
You can't see him yet, but I'll let you know when he's out.
I have to make it back to the competition.
I finally have a shot at winning hunter/jumper.
- Your friend is in surgery. - Vince would want me to go.
Can you shut the curtain so I can change? Thank you.
What is wrong with people?
Hey, am I interrupting?
- My five-year-old lost a tooth. - Cute.
Well, it's because his brother knocked
him off his swing, but still cute.
- He's fine. - That makes two of you.
I'm okay?
- All your tests came back clear. - Oh, my God. Okay. Thank you.
So, the pain is...
I'm guessing indigestion, so I'm gonna put you on an antacid.
I can't believe I bothered you with this.
No, it's okay.
I am still your doctor.
You know, I used to be one of those moms
who would put a handwritten note in her kids' lunches every day.
And since the divorce, and then the surgery...
I'm lucky if I can get them to school on time
in clothes that they didn't also wear to bed.
Can't seem to get myself to the right
place and the right time anymore,
and I'm sorry I dragged you into it.
I get it more than you know.
Owen and I are looking at divorce.
Oh. I'm so sorry. I-I-I didn't know.
- Are you okay? - It's taking some getting used to.
If I had anything to do with this...
No, it was all us. It's okay.
I mean, it-it will be okay. We're not there yet.
I definitely have a long way to go,
but I'm just... I'm just hoping that we both have a chance
to find what makes us happy.
Yep, there it is. A small clot in the distal popliteal vein.
Does it mean I'm gonna have, like, a stroke or something?
Well, we'll still need to scan you to make sure
you don't have one in your lung, but it looks like we caught it early.
I'll put in an order for a heparin
drip, and then I'll update Dr. Bailey.
It's always something.
Cancer unfortunately makes your blood more prone to clots.
I haven't told any of my friends that I'm here.
They wouldn't get it.
Their biggest problems are passive-aggressive coworkers
and where to get drinks on a Thursday night.
I'm not mad. I want that too.
I want to hang out in wine bars,
go to Europe, watch my friends get married and have kids.
And, um, this might sound really dumb,
but I really wanna try a slice of New York cheesecake.
Well, I'm from New York.
I bet I could help you with that.
Mostly, I just wanna fight, but there's nothing I can do
except sit here and think about my
cancer cells multiplying until I die.
And I really don't want to die.
All right, let's prep for the venous anastomosis, please.
We need the hockey stick.
Already got it.
I like the teamwork.
Mohanty, why don't you do the venous coupling?
- You ever done one before? - Of course.
Wait, look at the other flap. Does it look like it's turning blue?
It looks like congestion in the venous outflow.
Well, what do we do? The flap's not viable without good outflow.
And we don't have many options in terms of the reconstruction.
Was there bleeding when Grey repaired the hernia?
Uh-huh. So she probably sacrificed the superficial epigastric vein.
Perry's probably superficial dominant, so the vein's too short.
That would explain the decreased outflow to the flap.
All right, how are we gonna resolve this?
It's too short to connect to the retrograde IMV,
so a cephalic turndown would give the buildup of blood a place to go.
Very good. So, we will begin by isolating the cephalic vein.
I'll do the turndown, and then we can
get back to work on the other flap.
Nice work. Welcome to the Plastics Posse, Mohanty.
I asked Millin to update me on Vince's recovery tomorrow.
- Hope you don't mind. - Sure.
I kinda got a soft spot for the guy.
I really wanted to compete in the national
marble tournament when I was a kid.
Crushed me when I lost my lucky hazer.
- You okay? - I'm fine.
Jo told me about you and Teddy. If you ever want to talk...
About what, Link? You're gonna help me process the end of my marriage,
get over the loss of my wife and my best friend?
And you say, you what, you can relate because you lost a marble once?
- I'm just here to support. - You shouldn't be here at all.
Well, unless that mouse needs an appendectomy,
this is not official hospital business.
- How's Perry? - She's great.
I mean, I did have to perform an entire
cephalic turndown thanks to you, but...
Me?
- Oh, the superficial epigastric. Sorry. - Nah, it's fine.
It's pretty standard during a hernia repair.
I should have expected it, honestly.
Look, I am sorry, Mer. You were right. It was the right move.
Perry is super happy. And after all she's been through with chemo,
and hormone therapy and radiation, she deserves it.
- She does. - Thank you.
- It's the estrogen, you know. - You and Perry have estrogen. Yes.
No, the difference between the male and female mice.
Why the antibiotic affects one and not the other.
- How do you figure that? - I don't know that yet.
I'll have to revise the study and measure the hormone levels.
- Okay. - Anyway.
You want a ride back to Boston?
Sure. I have to go take care of something first.
- Hey. - How'd I do?
We were able to stop the bleeding in your chest.
- You're going to be fine. - What about the broken ribs?
Don't I need a cast or something?
They're just gonna take some time to heal.
No more hobby horsing for a while, okay?
It's okay. I probably outgrew it a while ago.
I'll still miss it in college. And Jonah.
I'm thinking of trying ultimate frisbee.
Sounds like fun.
Or theater. Or the college newspaper.
I'm looking forward to trying something new.
That's a good attitude.
Your mom and dad are in the waiting area.
I'll go tell them that you're up, okay?
Hey. I found a clinical trial for Katie.
A new immunotherapy targeting checkpoint inhibitors.
Oh, that could be promising.
Yeah, I'll read the fine print tonight. Hmm.
Uh, her right leg was swollen earlier so
I got an ultrasound and it showed a DVT.
But, uh, no PE on the CT, so I started her on a heparin drip.
It's gonna be an uphill battle.
I'd like to see her case through, if that's okay.
Um, that might mean missing more big surgeries,
facing more paperwork duty, more me.
Um... That's okay.
I, um... I think I need more experience in surgical oncology.
All right, I'll let everyone know.
Your hand's unstable.
You just made me kill my patient.
How'd the surgery go?
Perry's got new breasts, and I was inducted
into Avery's Plastics Posse...
for whatever that's worth.
Wow, sounds like you impressed.
- What did you eat for lunch? - Chips.
You got food poisoning from chips?
Chips and a sandwich.
A... A vending machine sandwich.
The vending machines have sandwiches?
They... shouldn't.
Well, thank you.
I now know to stay away from the sandwiches.
The trick with micro-suturing is finding something to stabilize your hand.
Uh, could you please tell your hobby horse
patient that his friend wants to see him?
I would, but his supposed friend ditched
him to go back to the competition.
- Okay. - Why don't you want to live with me?
- What? - I'm neat, considerate, responsible.
I'm a catch. Plus, I thought we were friends.
Oh. Uh...
I'm a really hard sleeper. Do you know what that means?
Every morning I wake up to three alarms on my phone at full volume,
I have a-a vintage clock radio across the room as a backup.
I've not only been kicked out by
roommates, but I've lost friends over it,
and the only reason that it works with Max
is because she can't hear anything without her hearing aids in.
It's not that I don't want to live with you.
It's just...
historically, I haven't had a lot of friends,
and I don't want to risk that with you.
You wanna come over and watch trash TV tonight?
And miss watching High Noon for the 18th time with Max and Irvin?
Hell yes.
Hey, hey. Um... Can we talk?
Can't. Apparently, I'm only capable of pillow talk.
Okay, that was deserved. Listen, I am really sorry about earlier.
- You were pretty harsh. - I know. And I lied.
Running into Owen this morning, it-it rattled me,
and then I had this particular patient come back in,
- who I have saved multiple times... - Teddy, it's fine.
No, it's not. Listen.
When I was stationed in Iraq, there was once this competition
that they held for the most precise
hospital corners, bedsheet corners.
Guess who won first place.
If I had my way, I would run my whole life like a tight ship.
Order and stability and having control give me comfort, always have.
But right now, I am as far away from that
in my personal life and-and-and at work than I have ever been.
But when you and I are alone, I forget what a mess everything is.
And I think I'm scared being out of our bubble will take that away.
It could.
Or it could give you more space to claim as your own.
I like that.
It might take me a little while to get there,
so I'll understand if you have to move on.
I would but I think I need to see those tight bedsheet corners.
Maybe we could find an empty patient room.
Oh.
I was thinking we'd just go to your hotel.
When you encounter a new beginning,
there's no announcement on a loudspeaker.
Blink and you could miss it.
I ran into Jackson. He said you excelled today.
Well, actually, he said you kicked ass, but I interpreted.
Oh. It was an amazing case. It had everything I love about surgery.
Um, abdominal tissue and microvascular suturing?
Challenging anatomy. Teamwork. Meaningful outcome for our patient.
- You're beaming. - What? Aren't I always a bright light?
So, why aren't you doing a plastics specialty?
It's three more years of residency.
Three years of you doing the lion's share of work at home.
Three years that would be worth every second
if plastics lights you up like this.
- Really? - What, you need it in writing?
- Yes. - Uh...
You know, sometimes I feel like you understand me before I do.
But you know what else would really light me up?
- What? - Give me 15 minutes to change
and I'll take you home and show you.
Or worse, ignore it.
- Hey. - I didn't see any more patients.
- I'm just waiting for Jo. - I owe you an apology.
I've been feeling lost, and that's not on you.
You might actually be the only
person who's asked how I'm doing, so...
We've all been there.
And hey, I'm around if you want to talk, grab a beer...
Yeah.
But not right now, because Jo's pulling the car around,
and she wants ice cream.
Yeah. Don't let me stop you.
- Hey, stranger. - Nora? Nora, what are you...
- What are you doing here? Are you... - I had chest pain.
Turns out I have plain old indigestion like everyone else.
Okay. So, you're... I mean, you're good?
Just trying to figure out this whole new normal.
I talked to Teddy. Sounds like you're doing the same thing.
Yeah. You know, taking it one day at a time.
Yeah.
Would you... I mean, do you wanna talk and get a coffee? Or...
I don't think that's a good idea.
I mean, if I have coffee now, I won't sleep for two days.
Dinner?
That would be...
- That'd be really great. - Yeah?
New beginnings can be scary.
But they can also be deeply fulfilling.
I think I've made a breakthrough in my research.
Oh. That's wonderful.
And I know I said I would stay awhile, but the longer I stay here,
the longer it is until I get to the root of Alzheimer's Disease.
There are too many people counting on me,
so I think it's time I go back to Boston.
- What are you doing? - I'm finishing rescheduling your patients.
The second I read Koracick's article,
I knew it would be only a matter of
time before you decided to go back.
- And you should. - Thank you.
Oh, and Meredith?
Give 'em hell.
So let go, and dive in.
- Synced and corrected by ChrisKe - — for www.addic7ed.com —