In college, I was the hungover premed
who fell asleep at her study carrel.
If you're just joining our podcast,
my guests are doctors Teddy Altman
and Winston Ndugu from Grey-Sloan Memorial,
who pioneered the creation of a ventral aorta surgery.
At what point did you think, "We just broke new ground"?
- Immediately. - Really?
Yeah. Once that staple held, I knew.
Sometimes you just have a feeling.
In med school, I was the famous surgeon's daughter.
It wasn't like that for you?
Honestly, there was so much going on that night,
I didn't have time to process it all until later.
Now I'm the famous surgeon.
- So you had doubts? - Oh, yeah.
I was never certain it would work,
but our patient didn't have any other option.
I knew that we had to try.
In medicine, your identity is constantly changing.
It's your job to keep up.
Safe to say it worked out. What's next for you both?
Well, we're still monitoring our patients' progress.
- And? - So far so good.
They sound really good, very competent.
Yeah. I'd come to this hospital.
Well, speaking of...
I made an appointment for you.
We talked about this, Catherine. I don't need another opinion.
I like Dr. Freeman.
I know you do because he goes along with whatever you want.
You don't think doctors should listen to their patients?
I think you need objective advice
from someone whose paycheck you don't sign.
It's just another opinion.
- Who am I seeing? - Kaplan.
Laura Kaplan? In Boston?
I thought you made an appointment here.
I sent for my plane.
She landed about an hour ago.
Morning.
- Hey. - Hey.
Hey, nice job on that podcast.
I didn't realize you and Altman came up with that at our wedding.
Yeah, you never know when an idea will strike.
- Mmm. - Go ahead, Dr. Adams.
Uh, yes. Uh, Jo Wilson.
Post-op day seven from emergency C-section and Impella CP placement.
Now post-op day three from a 5.5 placement
through the right axillary artery.
Her heart function continues to recover
with her EF up another five percent,
and I heard she got to meet her babies yesterday.
- How are they doing? - Hmm.
Peyton's off of CPAP but still fragile.
Hattie's bilirubin levels are bad
every time they pause phototherapy.
And you're all headed in the right direction.
- That's what matters. - I just...
really want the six of us to finally be together.
Jo, you will never guess
- who Marcus walked out with last night. - Who?
- Dr. Ndugu. - Hey.
- I didn't know you were doing rounds. - Yeah.
I'll come back later.
What was that?
- What was what? - Did you sleep with my favorite nurse?
- Jo... - Uh, should I leave?
We've just gone out a couple times. That's all.
Well, are you gonna take her out again?
- Uh, just... Maybe. It's new and... - And none of our business.
She is the entire department's favorite nurse.
Everybody loves her. Everyone.
- Hormones. - Okay.
Uh, I-I need to check on my next patient. Are you gonna be okay?
- Yeah. - Uh, page me if you need anything.
- Good morning. - Traitor.
- Trouble in paradise? - I broke our pact.
- She's bitter. - Then you should break it too.
What, I can just snap my fingers? Who am I supposed to sleep with?
I ordered an X-ray for Ms. Johnson's left arm.
It was the right arm, wasn't it?
I will fix it.
An intern? Please. I have dignity.
- Don't knock it until you've tried it. - Tried what?
Vegan sloppy joes.
You sleeping with an intern too?
Wait. Who's sleeping with an intern?
- I am. Who are you texting? - Nobody.
- Doesn't look like nobody. - Nah, she's just a patient.
Why are you texting a patient?
Yeah, well, Bailey made me drive her an hour to get treatment,
and now she's sending me dumb memes.
- It's nothing. - Wear a condom.
She's a cancer patient.
Hey. Did you see that I admitted Mr. Howard?
You don't have to put your phone down.
- It's fine. - Sorry.
My phone has been blowing up since the podcast dropped.
I listened. You sounded great.
Well, now I've got doctors reaching out about their patients,
and the department chief from Mass General
has asked me to do grand rounds.
Hmm. Sounds rough.
Well, it's not like I'm getting a Nobel Prize.
I mean, MGH asks everyone to guest lecture.
They never asked me, and I went to Harvard.
Anyway, so, Mr. Howard, his EKG shows a conduction block.
- Do you want an echo? - Um, yes. Sorry, I have to take this.
Hi, this is Altman.
Hi, Janet, I'm, uh, Dr. Millin. I hear you're having some leg pain.
Yeah, and some heaviness.
I'm concerned it might be a DVT.
I think she should have an ultrasound.
I assume you want a full work up.
CBC, D-dimer, and a duplex ultrasound?
I'm Jules Millin.
I'm a second-year surgical resident.
You're internal medicine, right?
Oh, no. Oh. I'm not a doctor. Sorry. Yeah.
- Oh, we were role-playing. - Yeah.
The more medical terms, the better it gets.
- Yeah. - So, Hal does his homework.
- So do you have leg pain or is this... - Oh, no, that's real.
The pain started this morning when we were trying
to squeeze in a quickie before work.
- May I do an exam? - Mm-hmm.
Um, how long did the pain last for?
- Uh, a few hours? - Yeah.
We've been trying to spice things up lately,
so we just wanna make sure we haven't, uh, caused a problem.
Oh, um...
DVTs usually occur with less, um, activity,
but it is better to be safe than sorry, so I will order some tests.
- All right. - And get back to you.
- Okay. Thank you. - Thank you.
Dr. Griffith.
A 38-year-old female with a large mediastinal teratoma
that has been resistant to chemotherapy.
Presents with progressive shortness of breath,
orthopnea, and angina.
It has to be at least 35 pounds.
And, uh, 27 centimeters for the longest diameter.
The tumor is displacing the heart and great vessels.
The SVC is compressed,
and it's also indenting the right lobe of the liver.
- Hmm. How are the lungs? - Compressed with near total collapse
of the mid-right and lower lobes.
Has anyone tried to operate on the thing?
Her name is London
and, yes, there have been two attempts at Seattle Pres.
They had to abort both times because she arrested on the table.
But you believe you would have a different outcome if you tried?
Well, I have removed extremely difficult tumors before,
and this one is benign.
So, if we can successfully remove it, then she resumes a normal life.
Even if you convinced anesthesia,
you could still encounter catastrophic bleeding.
And that is why I'm here at the tumor board,
where people help their colleagues to come up with a plan.
If anyone here thinks this remotely is a possibility, please speak up.
Yes.
It's a tragic case, Dr. Bailey, but...
It's a lawsuit waiting to happen.
I'll do it with you.
The alternative is hospice, right?
Dr. Hunt, it just can't be done.
Yeah, well, you don't know what we're capable of.
- Bye. - I knew you'd have an idea.
Yeah, I got nothing.
What?
- Synced and corrected by ChrisKe - — for www.addic7ed.com —
Well, look who's here. How was your flight?
Most quiet I've had in months.
- Oh, great.
- Dr. Webber, it's a pleasure. - Hi.
I've heard a lot about you.
All good things.
Catherine's thrilled you joined the team in Boston.
She's thrilled she poached me from Sloan Kettering.
You are at the forefront of urologic
oncology, and that lecture that you gave
to the American Urological Association last month
brought the house down.
And she is developing a program that uses AI to study biomarkers.
We just received another grant for it yesterday.
You bet you did.
Now, tell us about my husband's prostate.
Catherine, please.
- If now's not a good time... - Don't be ridiculous.
Come on, everybody. Sit down.
Have a seat. Come on.
Good news is you caught it early.
Grade group two, a seven Gleason.
Well, he knows all of that. So tell us, what do you suggest?
Well, given the cancer's localized,
and you're generally in good health,
I recommend a radical prostatectomy.
I couldn't agree more.
If you're worried about side effects,
urinary incontinence, erectile dysfunction, they are a risk.
- But for many men... - What about infection?
It's unlikely but possible.
Blood clots, stroke, injury to the rectum, bladder, nerves?
They're all possible too, right?
Yeah.
Thank you for your time,
but I've already selected an option with my own doctor.
Watchful waiting.
I've got patients to see.
Not seeing abnormalities.
What's that wand called?
An ultrasound probe.
- Write that down. - Okay.
Right, the ultrasound is negative.
So, she doesn't have a clot?
Not that I can see.
Sounds like maybe there still might be one...
Well, your D-dimer was slightly elevated,
which is the marker we look at for clots.
It doesn't necessarily mean anything, but it is reason
to come back if you have any more pain.
Maybe I just need to stretch before I go to the doctor.
- Mmm. - Stretch?
Uh, don't ask any questions.
I'm gonna start your, um, discharge paperwork.
What was that all about?
They like to role-play doctor and patient in bed.
Good for them.
They're so cute.
Rustic cute?
Five reviews say those rockers broke within a year.
How's the lake house?
We've moved from arguing over tile to arguing over porch chairs.
How was the tumor board?
Uh, unfortunately, they are concerned about the risks
and recommend that we don't proceed.
So naturally I called in reinforcements. This is Dr. Owen Hunt.
- He's one of our trauma surgeons. - Hi.
If it's okay with you, I'd like to work with Dr. Bailey
to make sure that we've explored every possible option.
I want to help.
- I like him. - Mmm.
If everyone else has reservations, why do you think you can do it?
Charlie, we've actually found surgeons
that are not giving us a hard no.
And I've almost lost you twice.
I'm definitely not ready to lose you
today from some botched operation.
- Neither are we. - Hey, I'm still here.
They're just asking if they can go work on a plan.
If their plan leads to us growing old together,
looking at the water from shoddy but very cute rocking chairs...
I'm in. Aren't you?
You really think you can figure out a way to keep
her heart from stopping when she's on that table?
Look, if we can't figure this out, we won't proceed, right?
That was our deal when you two came to me.
Okay, work on your plan.
- Okay. - We'll be back.
Okay.
Hi, my cuties.
They look bigger. Did they get bigger?
Hattie's put on a full ounce in the last 24 hours,
- and Peyton isn't far behind. - That's right.
Lincolns know how to bulk.
I gotta go to PT. Sure you're okay?
- Yeah. - Okay. You sure?
Yeah.
- All right. - Okay.
- See you soon. - Yeah.
You're Peyton and Hattie's mom?
Mm-hmm.
Sorry, it's just that, um...
That's the first time that somebody's called me their mom.
Here.
Oh, wait, that one's not clean.
- Here. - Thanks.
I'm an OB-GYN, and I talk to my patients
all the time about postpartum hormone drops,
but I had no idea it was this intense and just... random.
Yesterday, my boyfriend and I were buying diapers for me not the baby,
and the guy ringing me up said, "Will that be all?"
And I burst into tears.
It's nice to know that I'm not alone.
What?
You're my first mom friend.
Oh. I'm honored.
Did you tear or... Can I ask you that?
Yeah, you can ask me anything, but, um, no, I-I didn't tear.
I, uh... ... I had something called a crash C-section.
Oh, tell me everything.
I'll be back.
Richard, what the hell are you doing?
I'm about to check Mr. Tolli's wound VAC.
You said you would hear Kaplan out.
I did.
Is this because you're worried about the bedroom?
Because you know we'll figure that out.
Come on.
I'm not having this conversation here.
Is this because you prefer a male doctor?
Now that's insulting!
Well, I'm just trying to understand why
you would dismiss a top urologist like she's an intern.
I moved mountains to bring her here for you.
I didn't ask you to.
Now, my cancer hasn't metastasized.
Watchful waiting is a perfectly reasonable option.
I respected your health care decisions even when I didn't agree.
I need you to do the same for me.
1962.
- Who was the surgeon at Seattle Pres? - Collins.
Yeah, he actually did his residency here a couple of years behind me.
When his chief wouldn't let him try again, he sent London to me.
If she codes the minute she lays on the table,
why didn't they try a reverse Trendelenburg?
Keep her at an incline to take the
pressure off some of the cardiac vessels?
Oh, no, they did. Uh, but see how compressed they are?
It wasn't enough.
Okay, what about conscious sedation instead of general anesthesia?
She'd continue to breathe on her own, which would help
blood return back to the heart and minimize airway collapse.
I mean, it might help some...
The tumor's matured into its own ecosystem.
You can see the calcifications,
- fat, the cystic components. - Yeah? What?
What if we drain it? Shrink the mass before we go in?
It's a good idea, but the location is just too risky.
We can't risk the contents of the tumor spilling into the chest.
It would just regrow.
I gotta run to a consult in the pit,
but I will keep thinking on this.
No promises though.
Adams, Griffith, let's look up every case
report published on mediastinal teratomas.
Research patterns, cross-reference solutions, okay?
We all just listened to a podcast this morning
about how our hospital pulled off a miracle.
Who's to say we can't do it again, right? Go.
We're gonna come up with something.
- Hey. - Hi.
- Are you done with that tablet? - Nope, get your own.
Bailey and Hunt have a massive mediastinal teratoma.
If you sweet-talk Bailey, you can get in on it with us.
They're looking for ideas.
I'm too swamped down here.
Hey, I'm sorry about this morning.
Jo's crying about everything these days.
- It's fine. - But she loves Iris, so...
she'll be happy if you two are a thing.
- Why are you acting weird? - I'm not acting weird.
Yeah, you are.
- Help. Help my wife! Help. - Hal?
- Sir, you might wanna button that. - Oh, my God. Janet.
I'm getting weak pulses.
Janet, look at me. I'm going to care of you, okay?
We need a gurney in here!
The plane won't be ready for another couple of hours.
- Catherine said I could work in here. - Not a problem.
I owe you an apology.
I was led to believe that you were the one seeking a second opinion.
You couldn't have known.
I should have at least suspected.
I think your wife broke contract laws
to ensure my employment at her hospital.
Don't feel bad.
You're not the first to fall prey to her ways.
I'm guessing I won't be the last.
She does it 'cause she cares.
That's what makes it infuriating.
Feel free to say no.
But I've got a patient with a retroperitoneal tumor,
and I would be remiss if I didn't ask Fox
Hospitals' Chief of Chiefs for a consult.
- No. Got a little time. - Yeah.
How about we get a couple of pastries to go with this coffee?
Thank you. That would be great.
"Twenty-two-pound teratoma in the abdomen.
San Francisco, 2018." They started with a CT-guided drainage.
Yeah, but look at the picture of the CT.
Nowhere near the heart.
Another dead end.
Another dumb meme from your patient?
No, she's asking for movie recs.
She's stuck at home.
Not exactly a doctor-patient conversation topic.
She's Bailey's patient. She has stage four gastric cancer.
She can ask whatever she wants.
I mean, shouldn't you keep it professional?
Look, you have no idea what you're talking about. It's...
I'm just saying, you're young, you're single. You...
You look like you might be leading her on.
- I'm her doctor. - And she's a vulnerable patient.
I don't... I don't need this right now.
- I'm just trying to look out for you. - Yeah, try less.
Hunt's asking for an update.
- Okay, anything? - Not yet. Thanks.
Why did you join this case when everyone else dismissed it?
It's like you said, it's benign.
Once it's out, she moves on with her life.
There's no worry of mets or recurrence.
Yeah... ... I might be feeling a little uninspired lately.
Uh-huh. Wouldn't have to do with other people solving
cases at weddings and doing podcasts, would it?
I see you at drop-off.
I know everything's falling on you right now.
She's lecturing and you're packing lunches.
I'm happy to do it, and she deserves all the attention.
I just think this tumor was...
I don't know.
My patient cannot be the fix to get you out of this slump.
What have you got?
Ten cases, at least half of them considered inoperable.
And none of the masses are nearly the same size.
There's one case that reported a similar arrest in the OR,
but the team never tried it again
because they couldn't safely find a way around the heart and lungs.
Which is exactly what happened with London.
As difficult as this is for me to say...
I think we're out of options.
- What about ECMO? - What about it?
We need to bypass the pulmonary system, so why don't we use ECMO?
The machine oxygenates and pumps the blood
so her heart and lungs don't have to.
There is no arrest if the machine is acting as her heart.
Don't say no yet. I'm gonna go find Ndugu.
Okay.
Almost there, Janet.
If this is a clot, you can fix it, right?
Blood clots are treatable if you catch them in time,
so it's a good thing you're here.
Weird but good.
I should probably be embarrassed, but I'm proud of us.
All my friends got bored of their spouses
and filed for divorce, but we got creative.
By coming to the hospital and having sex.
Don't be jealous. I'm sure other people aren't getting any either.
All right, let me see.
Looks like there's a left iliac vein thrombosis.
Hal was right. DVT.
If you look closely, the iliac artery is compressing the vein.
- May-Thurner syndrome. - Mm-hmm.
All right, let's book an angio suite
for a thrombectomy and iliac vein stenting and start practicing.
I'm gonna supervise you doing the procedure.
- Me? - She means me.
I don't care who it is... as long as
you guys are prepped and ready to go.
You really think this will work?
The challenge, right, has always been the pressure
that your tumor is putting on your heart,
your lungs and major arteries when you're positioned for surgery.
And the ECMO machine makes that irrelevant
because it oxygenates and pumps your blood for you.
So no matter what happens, your body will receive oxygen
and blood flow while we work.
I can't believe you actually figured it out.
Have you done this before? I mean, how common is this ECMO?
Charlie, you said you were in if they figured it out.
How common is it?
It's not common for this, and it can be hard to wean off ECMO
after removing something that's compressed your lung for so long,
but her heart is healthy.
I don't anticipate that being a problem.
But it could be a problem.
You almost lost me twice.
If we do nothing, this thing just keeps growing inside me
until it squashes all my organs... and I'm definitely gone.
I don't wanna live like that.
Slowly suffocating.
I don't want you to have to watch me live like that.
We asked them to come up with a solution.
I'm taking it.
Okay, Dr. Griffith and Dr. Adams will get you prepped,
and we will see you in the OR, okay?
Is it weird that he's not blinking?
Newborn tear ducts aren't fully developed.
It's so cool that you know all this stuff.
Is it bad if I'm not, like, feeling anything?
You mean you don't feel a bond?
- I'm already a terrible mom. - No.
No, it's completely normal, and you're exhausted,
and your hormones are all over the place.
And to be honest, newborns are kinda just blobs.
In a few weeks, he'll be laughing and smiling, and it just...
it gets so much better.
You're a really good doctor.
Are you taking new patients?
- Well, it's... - Hey.
- How're my girls? - Hey. Well, we made a new friend...
- Whoa. Oh, my God. - Oh. Oh. Someone call a rapid response!
Right away, Doctor.
She's still seizing.
Someone give me IM midazolam.
She's seven days postpartum. Check her blood pressure.
It's probably eclampsia. She needs mag now.
Did she have any symptoms before she started seizing?
No, she seemed completely fine. It came out of nowhere.
We'll need to get her up to OB.
- Will you go up with her? - Whatever you want.
Call me when you get up there.
Scissors.
- Put two units of blood on standby. - Lap pad.
All right, I secured the cannula.
Adams, are we ready to remove the clamps?
Yeah, ECMO's ready.
Okay, the dark flow.
We have full flow.
Let's try lowering her down.
At least that worked.
We're gonna make all of it work.
Griffith, Adams, you may never see another case like this again,
so keep your eyes on the field.
If you see any signs of hemodynamic instability, speak up.
This is not a race. Our goal is not to finish fast.
It is to keep her safe.
Understood? - Mm-hmm.
Okay.
Okay, London.
Let's intubate.
It's a hormonally active adrenal mass,
so you need to watch out for sudden hypertension.
- I'm planning to use alpha-blockers. - Good.
Well, I assume you're gonna do this open, given the size?
That's the plan. My colleague will actually do it.
I usually stick to robotic procedures.
Oh. You got something against the old-fashioned way?
No, um... I have MS,
so standing for long periods in the OR just isn't an option.
- I didn't realize. I'm sorry. - No need to be sorry.
I mean, I was devastated after I got the diagnosis.
I had put in so much work my whole career,
and the thought of no longer being in the OR... was soul-crushing...
to say the least.
But that's when I realized it was just my fear talking.
And I looked at my symptoms,
muscle pain and leg weakness, and I thought,
"If only there was a way to operate
while sitting down without having to hold a scalpel."
Was it a difficult adjustment?
Adjusting to living with a chronic illness is never easy.
But over time, I just turned MS into a pivot.
Not an ending.
Well, you seem to be managing well.
Oh, well, I have my ups and downs, believe me.
But Catherine Fox is flying me around on her private plane
and paying me more money than I know what to do with.
And I still get to do what I love.
Even if it is in a different way.
Now they're gonna go ahead with Bailey's giant teratoma in OR two.
- Ndugu's gonna have to resect... - Can we just focus, please?
It's a fake patient. Calm down.
Don't tell me to calm down.
What is wrong with you?
Is it about Simone breaking that dumb pact?
No, and stop asking. I'm fine.
No, you don't seem fine.
Well, it's because you are bothering me.
Well, that can't be it. I always bother you.
I'm just...
I'm just tired.
Every day is the same.
It's the same people and the same rooms and the same conversations,
and I'm just... sick of it.
Well, I am sorry we are not good enough for you.
I didn't say that.
Yeah, you don't have to defend yourself. We all know you're aloof.
You're leaving?
Yeah, I've already done a thrombectomy.
You can have it.
Dr. Prescott, please...
What's happening? Who's the doctor?
- Uh... John Burnett. - An intern?
- Let's get a CT. - They're getting a CT.
No, she has eclampsia.
Tell him she needs magnesium.
- Really? - Tell him.
I...
Excuse me, I've got Jo Wilson on the phone,
and she says it's eclampsia, and you should start her on magnesium.
Her BP is only 143 over 91. It could be an intracranial hemorrhage.
- Put me on speaker. - Um...
Okay. You're on speaker.
I understand your concern,
but postpartum eclampsia doesn't always present with a really high BP.
Neither does a brain bleed.
- Barnett. - It's... It's Burnett.
Whatever. I may be on leave,
but that doesn't mean that I can't schedule you to work every holiday
and make your life miserable. So trust me when I tell you
to start the mag now.
Start IV magnesium.
Your mom's gonna be okay.
We're gonna have to take part of the lower lobe.
- Adams, you wanna staple the lung? - Yep. Stapler.
Bailey, you ready to start resecting the adhered diaphragm?
Hey, ready when you are.
Griffith, what should we be careful to avoid?
Hepatic veins and the retro-hepatic IVC.
Good. Let's get the next stapler ready.
London thought fixing up a summer house was a lot of work.
- It's got nothing on fixing up a torso. - Reload, please.
- Uh, BP is bottoming out. - Damn it. I don't see any bleeding.
Neither do I. The staple line looks clean.
Well, something's got to be causing this. What the hell is it?
- Does the ECMO say anything? - There's a suction event alarm.
Okay. Since we took pressure off the
lung, could there be volume shifts?
That's definitely possible. Yeah.
Okay, we need to up her pressors and flood her with fluids.
If we don't get flow back right away, she's done.
Push fluids as hard as you can.
- I am. - BP's still dropping.
She can't take this much longer.
I should've listened to that board.
- If I lose her... - This is not on you.
Come on, come on, come on. Come on.
BP's coming back up.
- Well, that was close. - Okay, folks.
There's still a lot of tumor left.
Griffith, you're on the liver resection.
Adams, you're on the superior mediastinum.
If that's okay with you?
Do what we say when we say it.
Stapler.
Contrast.
There's the occlusion in the iliac vein. Advance more.
Okay, pin the guide wire
and turn on the thrombectomy catheter, please.
It's a shame Janet isn't awake to see this.
It would really turn her...
into a passionate fan of biological science and anatomy.
Okay, I'm in. Turn it off.
I don't get it. If you have to pretend to be someone else
for your partner to wanna sleep with you,
maybe you shouldn't be together.
I've learned you never know what's going
on in another person's relationship.
Ready.
Contrast.
Thrombus is gone. The vein is patent.
Great work.
Now to stent.
Thanks again for the consult. I see why Catherine calls you legendary.
Well, she is prone to exaggeration.
I know, but in your case it's true.
Well, you live up to your reputation as well.
Oh, but not enough to consider my recommendation?
I'm sorry, I-I shouldn't have said that.
No, it's okay.
Can I ask you about something?
Urosymphyseal fistulas.
They are an extremely rare post-op
complication of radical prostatectomy.
But the odds aren't zero.
They're close.
What if it happened?
Chronic pain, which often leads to difficulty walking,
possibly warranting the use of opioids.
I can treat complications.
But if your cancer grows and metastasizes,
that's when my hands are tied.
If you change your mind
or if you just wanna talk more, Catherine has my number.
- Done resecting the liver. - Good.
Excellent hemostasis.
All right, no bleeding on this side.
Okay, we are in the home stretch.
Let's get ready to get this tumor out.
Hold on, hold on.
- Do you hear that? - What?
Okay, we're gonna need more lap pads, and hang blood.
Adams, quickly pack her.
Goddamn it! All right, keep the suction coming.
Oh... ... wait, wait.
Okay, there's a tear where the IVC passes
through the diaphragm into the chest.
I'm trying to secure... Let-Let me have a clamp.
Okay, I need visualization.
Put the suction on the lap pads.
Not too harsh, gentle steady pressure, okay?
I think I got it.
Oh, she's stabilizing.
Okay, everyone, on the count of three.
Everyone needs to help with the specimen.
Okay, ready? One, two, three.
Okay.
How do you all feel about getting the hell out of here?
You don't have to ask me twice. Bovie.
Two-O prolene.
You can stop here.
Iris.
Hey, what are you doing up here?
So a mom from the NICU is being treated for postpartum eclampsia.
Can you look up her chart? Her name is Gina...
I don't know her last name.
I'm sorry, I can't. You're not her doctor.
I just wanna check on her.
Do you want me to call Marcus for you?
No, what I want is my friend's chart.
- I'm sorry, Jo. - Stop saying you're sorry.
Sorry doesn't help me. I'm this woman's only friend right now
and the person in charge of her care
has been a doctor for about 90 days.
So, if you could just please remove the stick from...
- Jo. - All I want right now...
- I think we should go. - No, we're not gonna go.
- I... No. - Yeah.
You cannot move me against my will.
Stop. I...
- This is not okay. - Can you give me a minute?
- This is... - Hey, hey, hey, hey.
Look, I know you're scared, okay? But...
Hey, she's just trying to do her job.
It will take a few days to wean her off ECMO.
She does have a long recovery.
- But she's gonna come home? - Eventually.
That is the plan.
I don't know how to thank you.
I think you just did.
She's always been able to see what I can't.
Her mind is filled with these big ideas
that always seem impossible.
Our wedding, this lake house, getting this tumor removed.
But she knew you could do it.
And she was right.
I almost... tried to stop her.
But I'm glad I stayed out of it.
Hey, um, we'll let you both get some rest.
Thank you.
Great work today, Griffith.
You and Adams, you really stepped it up.
Thank you. I really appreciate the opportunity. I learned a lot.
We did a good thing today.
- Some might call it inspiring. - Mmm.
Might be even something
you could lecture about.
Hey, I hope I didn't overstep, you
know, jumping in with the residents.
Oh, no. I mean, if I'm the only voice that's teaching them,
they'll wind up tuning me out.
What do you think about having the residents
do an ambulance ride-along or EMS training?
Something that could really get them thinking on their feet, you know?
It could help them in the ER or in situations like today in the OR.
I think you should write up a proposal and send it to me.
The surgery went well.
We were able to clear the clot and put in a stent.
Thank you.
You'll need to be on anticoagulation
but after a while, you'll be able to get back to life as usual.
I'll get back to life as usual right away or...
"When can I have sex?" is what I'm asking.
Yeah, we know.
You need to elevate your leg when resting
but other than that, it is good to move it around.
I guess Trudy can still see the doctor.
Trudy's always a good time.
But, honey, I love you most when you're just Janet.
Oh.
We'll give you some privacy.
I checked London's labs before leaving.
Thanks.
Hey, I'm sorry about earlier.
How you interact with your patients, your business.
I'll stay out of it.
I appreciate that.
I do value your opinion though.
- You do? - I do.
Just, uh, not about relationships. For obvious reasons.
Ouch.
Hey, look, I'm, uh, putting together a watch list for my patient.
What am I missing?
Mmm.
Wait, she hasn't seen any of these?
Hey.
Hi.
Did you make it through your busy day?
Uh, I did.
Uh, I did a thrombectomy and placed a stent.
Nice, Millin.
You still haven't told me about that thoracotomy, by the way.
It wasn't that big a deal.
Uh, you saved a man's life with your hands.
Doesn't get any bigger than that.
Do you think I'm aloof?
Aloof? Thank you. Um...
No.
No, you're discerning, you don't suffer any fools.
But... ... that's not aloof.
That's, um, just protecting yourself because you care.
It's funny you say that because I-I have been...
I had the worst day.
I need the biggest vodka tonic that they have.
Hi, I'm Iris.
Uh, this is Jules Millin, a surgical resident.
- Nice to meet you. - Nice to meet you.
Um, I should go find my friends.
- Here. - Thank you.
See you later.
It's jarring when your identity shifts.
When you're suddenly a doctor, a partner, a parent.
It helps if you focus on the things that haven't changed.
I'm gonna have to change hospitals.
I've cried in front of too many people at this one.
They understand.
I just feel like ever since I was admitted, I just...
I just lost myself.
I can't take care of our kids.
I can't take care of my patients. I can't even shower.
It's temporary.
Your heart is recovering.
I know.
But... for a few hours today, I got to be a doctor again
and help this woman navigate a difficult time
but then when it really mattered... someone else got to help her.
At least Gina is okay.
And I would bet that she'd say what you did mattered too.
Maybe even more.
Oh, God. It's happening again.
- No. - I'll get the tissues.
Just...
The comfort of old friends.
Thirty-five pounds? That's like carrying four babies.
Yeah, or four bowling balls.
- Who carries four bowling balls? - People do weird things.
- Gotta go.
Yeah, I'm out too.
See you tomorrow.
She's just a stop sign, not a roadblock.
How did you...
Doesn't matter. Wait, are you leaving me too?
Um, sorry. Um, hey, have a drink on me.
Anyone sitting here?
The thrill of trying something new.
Hi, I'm Sally.
Because even though you may not recognize yourself.
- Catherine. - I'm sorry. I am so sorry.
I got scared and I just called the best that I knew.
I should've talked to you before bringing Laura in.
Look, I thought a lot about letting fear cloud judgment today.
Whatever you wanna do, I support...
I'm a surgeon.
I'm a senior member of this hospital.
If something were to go wrong
and I couldn't stand long enough to do a simple appy,
I'd feel... weak.
And I don't know how to lead like that.
I don't know who I'd be.
But people adapt.
I wanna go ahead with the surgery.
It's been you all along.
- Synced and corrected by ChrisKe - — for www.addic7ed.com —