1 00:00:06,291 --> 00:00:08,811 In college, I was the hungover premed 2 00:00:08,836 --> 00:00:10,596 who fell asleep at her study carrel. 3 00:00:10,621 --> 00:00:12,366 If you're just joining our podcast, 4 00:00:12,391 --> 00:00:14,221 my guests are doctors Teddy Altman 5 00:00:14,246 --> 00:00:17,141 and Winston Ndugu from Grey-Sloan Memorial, 6 00:00:17,166 --> 00:00:20,280 who pioneered the creation of a ventral aorta surgery. 7 00:00:20,305 --> 00:00:23,343 At what point did you think, "We just broke new ground"? 8 00:00:23,368 --> 00:00:24,931 - Immediately. - Really? 9 00:00:24,956 --> 00:00:27,072 Yeah. Once that staple held, I knew. 10 00:00:27,096 --> 00:00:28,649 Sometimes you just have a feeling. 11 00:00:28,674 --> 00:00:31,263 In med school, I was the famous surgeon's daughter. 12 00:00:31,514 --> 00:00:33,447 It wasn't like that for you? 13 00:00:33,472 --> 00:00:35,389 Honestly, there was so much going on that night, 14 00:00:35,414 --> 00:00:37,761 I didn't have time to process it all until later. 15 00:00:37,786 --> 00:00:39,978 Now I'm the famous surgeon. 16 00:00:40,003 --> 00:00:41,671 - So you had doubts? - Oh, yeah. 17 00:00:41,696 --> 00:00:43,364 I was never certain it would work, 18 00:00:43,388 --> 00:00:45,148 but our patient didn't have any other option. 19 00:00:45,173 --> 00:00:46,626 I knew that we had to try. 20 00:00:47,595 --> 00:00:50,840 In medicine, your identity is constantly changing. 21 00:00:51,357 --> 00:00:52,806 It's your job to keep up. 22 00:00:52,962 --> 00:00:55,843 Safe to say it worked out. What's next for you both? 23 00:00:56,030 --> 00:00:58,412 Well, we're still monitoring our patients' progress. 24 00:00:58,437 --> 00:01:00,345 - And? - So far so good. 25 00:01:00,370 --> 00:01:02,830 They sound really good, very competent. 26 00:01:02,855 --> 00:01:04,444 Yeah. I'd come to this hospital. 27 00:01:04,469 --> 00:01:05,642 Well, speaking of... 28 00:01:06,288 --> 00:01:08,152 I made an appointment for you. 29 00:01:09,241 --> 00:01:11,933 We talked about this, Catherine. I don't need another opinion. 30 00:01:12,072 --> 00:01:13,318 I like Dr. Freeman. 31 00:01:13,343 --> 00:01:16,349 I know you do because he goes along with whatever you want. 32 00:01:16,374 --> 00:01:18,053 You don't think doctors should listen to their patients? 33 00:01:18,078 --> 00:01:20,678 I think you need objective advice 34 00:01:20,762 --> 00:01:22,729 from someone whose paycheck you don't sign. 35 00:01:22,875 --> 00:01:25,973 It's just another opinion. 36 00:01:27,621 --> 00:01:30,203 - Who am I seeing? - Kaplan. 37 00:01:30,537 --> 00:01:32,826 Laura Kaplan? In Boston? 38 00:01:32,960 --> 00:01:34,651 I thought you made an appointment here. 39 00:01:34,680 --> 00:01:35,992 I sent for my plane. 40 00:01:36,262 --> 00:01:37,953 She landed about an hour ago. 41 00:01:43,206 --> 00:01:44,276 Morning. 42 00:01:44,301 --> 00:01:45,578 - Hey. - Hey. 43 00:01:45,781 --> 00:01:47,542 Hey, nice job on that podcast. 44 00:01:47,886 --> 00:01:50,257 I didn't realize you and Altman came up with that at our wedding. 45 00:01:50,395 --> 00:01:52,604 Yeah, you never know when an idea will strike. 46 00:01:52,629 --> 00:01:54,838 - Mmm. - Go ahead, Dr. Adams. 47 00:01:54,976 --> 00:01:56,702 Uh, yes. Uh, Jo Wilson. 48 00:01:56,727 --> 00:02:00,973 Post-op day seven from emergency C-section and Impella CP placement. 49 00:02:01,224 --> 00:02:03,857 Now post-op day three from a 5.5 placement 50 00:02:03,882 --> 00:02:05,489 through the right axillary artery. 51 00:02:05,514 --> 00:02:07,826 Her heart function continues to recover 52 00:02:07,851 --> 00:02:09,543 with her EF up another five percent, 53 00:02:09,618 --> 00:02:12,207 and I heard she got to meet her babies yesterday. 54 00:02:12,329 --> 00:02:14,089 - How are they doing? - Hmm. 55 00:02:14,114 --> 00:02:16,810 Peyton's off of CPAP but still fragile. 56 00:02:16,835 --> 00:02:18,665 Hattie's bilirubin levels are bad 57 00:02:18,690 --> 00:02:21,298 every time they pause phototherapy. 58 00:02:21,323 --> 00:02:23,152 And you're all headed in the right direction. 59 00:02:23,257 --> 00:02:25,317 - That's what matters. - I just... 60 00:02:26,056 --> 00:02:28,955 really want the six of us to finally be together. 61 00:02:29,632 --> 00:02:31,081 Jo, you will never guess 62 00:02:31,106 --> 00:02:32,876 - who Marcus walked out with last night. - Who? 63 00:02:32,901 --> 00:02:34,508 - Dr. Ndugu. - Hey. 64 00:02:34,658 --> 00:02:36,936 - I didn't know you were doing rounds. - Yeah. 65 00:02:37,847 --> 00:02:39,193 I'll come back later. 66 00:02:42,885 --> 00:02:44,042 What was that? 67 00:02:44,515 --> 00:02:47,518 - What was what? - Did you sleep with my favorite nurse? 68 00:02:47,832 --> 00:02:49,316 - Jo... - Uh, should I leave? 69 00:02:49,341 --> 00:02:50,974 We've just gone out a couple times. That's all. 70 00:02:50,998 --> 00:02:52,975 Well, are you gonna take her out again? 71 00:02:53,000 --> 00:02:56,718 - Uh, just... Maybe. It's new and... - And none of our business. 72 00:02:56,743 --> 00:03:00,815 She is the entire department's favorite nurse. 73 00:03:01,111 --> 00:03:03,492 Everybody loves her. Everyone. 74 00:03:08,281 --> 00:03:09,869 - Hormones. - Okay. 75 00:03:09,894 --> 00:03:12,926 Uh, I-I need to check on my next patient. Are you gonna be okay? 76 00:03:13,302 --> 00:03:16,063 - Yeah. - Uh, page me if you need anything. 77 00:03:19,621 --> 00:03:21,858 - Good morning. - Traitor. 78 00:03:22,043 --> 00:03:24,079 - Trouble in paradise? - I broke our pact. 79 00:03:24,226 --> 00:03:26,401 - She's bitter. - Then you should break it too. 80 00:03:26,426 --> 00:03:29,349 What, I can just snap my fingers? Who am I supposed to sleep with? 81 00:03:29,416 --> 00:03:32,384 I ordered an X-ray for Ms. Johnson's left arm. 82 00:03:33,066 --> 00:03:34,480 It was the right arm, wasn't it? 83 00:03:34,971 --> 00:03:36,317 I will fix it. 84 00:03:37,783 --> 00:03:39,642 An intern? Please. I have dignity. 85 00:03:39,667 --> 00:03:41,707 - Don't knock it until you've tried it. - Tried what? 86 00:03:42,220 --> 00:03:43,359 Vegan sloppy joes. 87 00:03:43,384 --> 00:03:45,027 You sleeping with an intern too? 88 00:03:45,165 --> 00:03:47,063 Wait. Who's sleeping with an intern? 89 00:03:47,088 --> 00:03:50,117 - I am. Who are you texting? - Nobody. 90 00:03:50,142 --> 00:03:52,533 - Doesn't look like nobody. - Nah, she's just a patient. 91 00:03:52,558 --> 00:03:53,967 Why are you texting a patient? 92 00:03:53,992 --> 00:03:56,073 Yeah, well, Bailey made me drive her an hour to get treatment, 93 00:03:56,097 --> 00:03:57,497 and now she's sending me dumb memes. 94 00:03:57,522 --> 00:03:59,006 - It's nothing. - Wear a condom. 95 00:03:59,032 --> 00:04:00,482 She's a cancer patient. 96 00:04:01,137 --> 00:04:03,469 Hey. Did you see that I admitted Mr. Howard? 97 00:04:03,494 --> 00:04:05,047 You don't have to put your phone down. 98 00:04:05,072 --> 00:04:06,418 - It's fine. - Sorry. 99 00:04:06,443 --> 00:04:09,154 My phone has been blowing up since the podcast dropped. 100 00:04:09,179 --> 00:04:10,667 I listened. You sounded great. 101 00:04:10,692 --> 00:04:12,951 Well, now I've got doctors reaching out about their patients, 102 00:04:12,976 --> 00:04:14,402 and the department chief from Mass General 103 00:04:14,426 --> 00:04:15,706 has asked me to do grand rounds. 104 00:04:15,731 --> 00:04:16,745 Hmm. Sounds rough. 105 00:04:16,770 --> 00:04:19,130 Well, it's not like I'm getting a Nobel Prize. 106 00:04:19,155 --> 00:04:21,330 I mean, MGH asks everyone to guest lecture. 107 00:04:21,355 --> 00:04:22,987 They never asked me, and I went to Harvard. 108 00:04:23,170 --> 00:04:26,242 Anyway, so, Mr. Howard, his EKG shows a conduction block. 109 00:04:26,267 --> 00:04:30,547 - Do you want an echo? - Um, yes. Sorry, I have to take this. 110 00:04:30,572 --> 00:04:32,229 Hi, this is Altman. 111 00:04:32,548 --> 00:04:36,956 Hi, Janet, I'm, uh, Dr. Millin. I hear you're having some leg pain. 112 00:04:36,981 --> 00:04:38,183 Yeah, and some heaviness. 113 00:04:38,208 --> 00:04:39,488 I'm concerned it might be a DVT. 114 00:04:39,513 --> 00:04:40,979 I think she should have an ultrasound. 115 00:04:41,004 --> 00:04:42,571 I assume you want a full work up. 116 00:04:42,596 --> 00:04:45,688 CBC, D-dimer, and a duplex ultrasound? 117 00:04:46,461 --> 00:04:47,738 I'm Jules Millin. 118 00:04:47,763 --> 00:04:50,428 I'm a second-year surgical resident. 119 00:04:50,566 --> 00:04:51,846 You're internal medicine, right? 120 00:04:52,559 --> 00:04:55,166 Oh, no. Oh. I'm not a doctor. Sorry. Yeah. 121 00:04:55,191 --> 00:04:56,744 - Oh, we were role-playing. - Yeah. 122 00:04:56,769 --> 00:04:58,756 The more medical terms, the better it gets. 123 00:04:58,781 --> 00:05:01,231 - Yeah. - So, Hal does his homework. 124 00:05:02,587 --> 00:05:05,038 - So do you have leg pain or is this... - Oh, no, that's real. 125 00:05:05,063 --> 00:05:06,765 The pain started this morning when we were trying 126 00:05:06,789 --> 00:05:08,189 to squeeze in a quickie before work. 127 00:05:09,382 --> 00:05:11,142 - May I do an exam? - Mm-hmm. 128 00:05:13,334 --> 00:05:16,438 Um, how long did the pain last for? 129 00:05:16,463 --> 00:05:18,133 - Uh, a few hours? - Yeah. 130 00:05:18,158 --> 00:05:20,348 We've been trying to spice things up lately, 131 00:05:20,373 --> 00:05:23,168 so we just wanna make sure we haven't, uh, caused a problem. 132 00:05:23,691 --> 00:05:25,314 Oh, um... 133 00:05:25,714 --> 00:05:30,995 DVTs usually occur with less, um, activity, 134 00:05:31,020 --> 00:05:34,955 but it is better to be safe than sorry, so I will order some tests. 135 00:05:34,980 --> 00:05:37,139 - All right. - And get back to you. 136 00:05:37,164 --> 00:05:38,510 - Okay. Thank you. - Thank you. 137 00:05:40,290 --> 00:05:41,429 Dr. Griffith. 138 00:05:41,986 --> 00:05:45,679 A 38-year-old female with a large mediastinal teratoma 139 00:05:45,704 --> 00:05:48,224 that has been resistant to chemotherapy. 140 00:05:48,249 --> 00:05:50,152 Presents with progressive shortness of breath, 141 00:05:50,177 --> 00:05:51,351 orthopnea, and angina. 142 00:05:51,489 --> 00:05:53,189 It has to be at least 35 pounds. 143 00:05:53,214 --> 00:05:56,411 And, uh, 27 centimeters for the longest diameter. 144 00:05:56,436 --> 00:05:59,819 The tumor is displacing the heart and great vessels. 145 00:05:59,911 --> 00:06:02,198 The SVC is compressed, 146 00:06:02,223 --> 00:06:05,340 and it's also indenting the right lobe of the liver. 147 00:06:05,365 --> 00:06:08,343 - Hmm. How are the lungs? - Compressed with near total collapse 148 00:06:08,368 --> 00:06:09,586 of the mid-right and lower lobes. 149 00:06:09,610 --> 00:06:11,518 Has anyone tried to operate on the thing? 150 00:06:11,656 --> 00:06:13,900 Her name is London 151 00:06:13,925 --> 00:06:16,975 and, yes, there have been two attempts at Seattle Pres. 152 00:06:17,000 --> 00:06:20,872 They had to abort both times because she arrested on the table. 153 00:06:20,897 --> 00:06:23,298 But you believe you would have a different outcome if you tried? 154 00:06:23,323 --> 00:06:27,016 Well, I have removed extremely difficult tumors before, 155 00:06:27,041 --> 00:06:29,329 and this one is benign. 156 00:06:29,354 --> 00:06:33,979 So, if we can successfully remove it, then she resumes a normal life. 157 00:06:34,004 --> 00:06:36,163 Even if you convinced anesthesia, 158 00:06:36,188 --> 00:06:39,038 you could still encounter catastrophic bleeding. 159 00:06:39,063 --> 00:06:41,479 And that is why I'm here at the tumor board, 160 00:06:41,504 --> 00:06:45,681 where people help their colleagues to come up with a plan. 161 00:06:45,706 --> 00:06:50,504 If anyone here thinks this remotely is a possibility, please speak up. 162 00:06:50,989 --> 00:06:52,128 Yes. 163 00:06:57,579 --> 00:06:59,547 It's a tragic case, Dr. Bailey, but... 164 00:07:00,915 --> 00:07:03,570 It's a lawsuit waiting to happen. 165 00:07:06,109 --> 00:07:07,110 I'll do it with you. 166 00:07:11,309 --> 00:07:13,960 The alternative is hospice, right? 167 00:07:13,985 --> 00:07:15,651 Dr. Hunt, it just can't be done. 168 00:07:15,676 --> 00:07:18,267 Yeah, well, you don't know what we're capable of. 169 00:07:23,314 --> 00:07:25,316 - Bye. - I knew you'd have an idea. 170 00:07:25,341 --> 00:07:26,722 Yeah, I got nothing. 171 00:07:29,322 --> 00:07:30,357 What? 172 00:07:30,381 --> 00:07:35,381 - Synced and corrected by ChrisKe - — for www.addic7ed.com — 173 00:07:42,151 --> 00:07:45,810 Well, look who's here. How was your flight? 174 00:07:45,835 --> 00:07:47,557 Most quiet I've had in months. 175 00:07:47,581 --> 00:07:48,373 - Oh, great. 176 00:07:48,398 --> 00:07:50,331 - Dr. Webber, it's a pleasure. - Hi. 177 00:07:51,160 --> 00:07:52,516 I've heard a lot about you. 178 00:07:52,654 --> 00:07:53,896 All good things. 179 00:07:53,921 --> 00:07:56,485 Catherine's thrilled you joined the team in Boston. 180 00:07:56,510 --> 00:07:58,719 She's thrilled she poached me from Sloan Kettering. 181 00:07:58,744 --> 00:08:00,847 You are at the forefront of urologic 182 00:08:00,872 --> 00:08:03,319 oncology, and that lecture that you gave 183 00:08:03,344 --> 00:08:05,770 to the American Urological Association last month 184 00:08:05,795 --> 00:08:07,417 brought the house down. 185 00:08:07,442 --> 00:08:12,790 And she is developing a program that uses AI to study biomarkers. 186 00:08:12,815 --> 00:08:14,572 We just received another grant for it yesterday. 187 00:08:14,597 --> 00:08:16,100 You bet you did. 188 00:08:16,125 --> 00:08:19,059 Now, tell us about my husband's prostate. 189 00:08:19,084 --> 00:08:20,532 Catherine, please. 190 00:08:21,571 --> 00:08:24,017 - If now's not a good time... - Don't be ridiculous. 191 00:08:24,042 --> 00:08:25,687 Come on, everybody. Sit down. 192 00:08:25,712 --> 00:08:27,541 Have a seat. Come on. 193 00:08:29,163 --> 00:08:31,012 Good news is you caught it early. 194 00:08:31,037 --> 00:08:32,625 Grade group two, a seven Gleason. 195 00:08:32,704 --> 00:08:36,121 Well, he knows all of that. So tell us, what do you suggest? 196 00:08:36,688 --> 00:08:38,010 Well, given the cancer's localized, 197 00:08:38,034 --> 00:08:39,770 and you're generally in good health, 198 00:08:39,795 --> 00:08:41,555 I recommend a radical prostatectomy. 199 00:08:42,312 --> 00:08:43,727 I couldn't agree more. 200 00:08:44,420 --> 00:08:46,155 If you're worried about side effects, 201 00:08:46,180 --> 00:08:49,805 urinary incontinence, erectile dysfunction, they are a risk. 202 00:08:49,958 --> 00:08:52,236 - But for many men... - What about infection? 203 00:08:52,704 --> 00:08:55,048 It's unlikely but possible. 204 00:08:55,073 --> 00:09:00,169 Blood clots, stroke, injury to the rectum, bladder, nerves? 205 00:09:00,194 --> 00:09:01,868 They're all possible too, right? 206 00:09:04,912 --> 00:09:05,913 Yeah. 207 00:09:07,339 --> 00:09:08,833 Thank you for your time, 208 00:09:08,858 --> 00:09:11,689 but I've already selected an option with my own doctor. 209 00:09:12,319 --> 00:09:13,528 Watchful waiting. 210 00:09:13,631 --> 00:09:15,287 I've got patients to see. 211 00:09:21,825 --> 00:09:23,482 Not seeing abnormalities. 212 00:09:23,644 --> 00:09:24,852 What's that wand called? 213 00:09:24,877 --> 00:09:26,195 An ultrasound probe. 214 00:09:26,220 --> 00:09:27,256 - Write that down. - Okay. 215 00:09:28,618 --> 00:09:31,044 Right, the ultrasound is negative. 216 00:09:31,640 --> 00:09:33,089 So, she doesn't have a clot? 217 00:09:33,227 --> 00:09:34,470 Not that I can see. 218 00:09:34,495 --> 00:09:36,561 Sounds like maybe there still might be one... 219 00:09:36,586 --> 00:09:38,622 Well, your D-dimer was slightly elevated, 220 00:09:38,647 --> 00:09:40,107 which is the marker we look at for clots. 221 00:09:40,245 --> 00:09:42,626 It doesn't necessarily mean anything, but it is reason 222 00:09:42,651 --> 00:09:44,042 to come back if you have any more pain. 223 00:09:44,179 --> 00:09:47,285 Maybe I just need to stretch before I go to the doctor. 224 00:09:47,310 --> 00:09:48,598 - Mmm. - Stretch? 225 00:09:48,622 --> 00:09:49,840 Uh, don't ask any questions. 226 00:09:49,865 --> 00:09:51,832 I'm gonna start your, um, discharge paperwork. 227 00:09:52,857 --> 00:09:54,051 What was that all about? 228 00:09:54,076 --> 00:09:55,985 They like to role-play doctor and patient in bed. 229 00:09:56,024 --> 00:09:57,473 Good for them. 230 00:09:59,370 --> 00:10:01,545 They're so cute. 231 00:10:02,256 --> 00:10:03,603 Rustic cute? 232 00:10:03,628 --> 00:10:05,718 Five reviews say those rockers broke within a year. 233 00:10:06,768 --> 00:10:08,390 How's the lake house? 234 00:10:08,415 --> 00:10:12,069 We've moved from arguing over tile to arguing over porch chairs. 235 00:10:12,094 --> 00:10:14,240 How was the tumor board? 236 00:10:14,265 --> 00:10:18,548 Uh, unfortunately, they are concerned about the risks 237 00:10:18,687 --> 00:10:21,310 and recommend that we don't proceed. 238 00:10:21,561 --> 00:10:26,911 So naturally I called in reinforcements. This is Dr. Owen Hunt. 239 00:10:26,936 --> 00:10:29,456 - He's one of our trauma surgeons. - Hi. 240 00:10:29,594 --> 00:10:31,714 If it's okay with you, I'd like to work with Dr. Bailey 241 00:10:31,739 --> 00:10:34,505 to make sure that we've explored every possible option. 242 00:10:34,643 --> 00:10:36,058 I want to help. 243 00:10:36,083 --> 00:10:37,809 - I like him. - Mmm. 244 00:10:38,609 --> 00:10:41,927 If everyone else has reservations, why do you think you can do it? 245 00:10:42,158 --> 00:10:45,204 Charlie, we've actually found surgeons 246 00:10:45,228 --> 00:10:48,026 that are not giving us a hard no. 247 00:10:48,051 --> 00:10:50,157 And I've almost lost you twice. 248 00:10:50,408 --> 00:10:52,105 I'm definitely not ready to lose you 249 00:10:52,129 --> 00:10:53,825 today from some botched operation. 250 00:10:53,963 --> 00:10:57,311 - Neither are we. - Hey, I'm still here. 251 00:10:58,036 --> 00:11:00,466 They're just asking if they can go work on a plan. 252 00:11:01,072 --> 00:11:04,524 If their plan leads to us growing old together, 253 00:11:04,560 --> 00:11:10,083 looking at the water from shoddy but very cute rocking chairs... 254 00:11:11,760 --> 00:11:14,383 I'm in. Aren't you? 255 00:11:18,574 --> 00:11:20,689 You really think you can figure out a way to keep 256 00:11:20,714 --> 00:11:22,485 her heart from stopping when she's on that table? 257 00:11:22,509 --> 00:11:25,521 Look, if we can't figure this out, we won't proceed, right? 258 00:11:25,546 --> 00:11:27,825 That was our deal when you two came to me. 259 00:11:29,481 --> 00:11:31,311 Okay, work on your plan. 260 00:11:31,336 --> 00:11:33,357 - Okay. - We'll be back. 261 00:11:33,382 --> 00:11:34,694 Okay. 262 00:11:41,352 --> 00:11:44,771 Hi, my cuties. 263 00:11:46,568 --> 00:11:48,968 They look bigger. Did they get bigger? 264 00:11:48,993 --> 00:11:51,858 Hattie's put on a full ounce in the last 24 hours, 265 00:11:51,883 --> 00:11:54,023 - and Peyton isn't far behind. - That's right. 266 00:11:54,274 --> 00:11:55,828 Lincolns know how to bulk. 267 00:11:58,818 --> 00:12:00,911 I gotta go to PT. Sure you're okay? 268 00:12:00,936 --> 00:12:02,351 - Yeah. - Okay. You sure? 269 00:12:02,376 --> 00:12:03,515 Yeah. 270 00:12:04,566 --> 00:12:06,360 - All right. - Okay. 271 00:12:07,842 --> 00:12:09,257 - See you soon. - Yeah. 272 00:12:11,978 --> 00:12:13,998 You're Peyton and Hattie's mom? 273 00:12:14,423 --> 00:12:16,528 Mm-hmm. 274 00:12:18,561 --> 00:12:20,563 Sorry, it's just that, um... 275 00:12:21,087 --> 00:12:24,366 That's the first time that somebody's called me their mom. 276 00:12:25,528 --> 00:12:26,564 Here. 277 00:12:28,503 --> 00:12:30,936 Oh, wait, that one's not clean. 278 00:12:32,281 --> 00:12:33,282 - Here. - Thanks. 279 00:12:33,891 --> 00:12:37,421 I'm an OB-GYN, and I talk to my patients 280 00:12:37,446 --> 00:12:40,035 all the time about postpartum hormone drops, 281 00:12:40,068 --> 00:12:44,272 but I had no idea it was this intense and just... random. 282 00:12:44,591 --> 00:12:48,743 Yesterday, my boyfriend and I were buying diapers for me not the baby, 283 00:12:48,768 --> 00:12:51,622 and the guy ringing me up said, "Will that be all?" 284 00:12:51,647 --> 00:12:53,402 And I burst into tears. 285 00:12:53,427 --> 00:12:55,429 It's nice to know that I'm not alone. 286 00:12:57,915 --> 00:12:59,502 What? 287 00:12:59,527 --> 00:13:01,553 You're my first mom friend. 288 00:13:02,005 --> 00:13:04,559 Oh. I'm honored. 289 00:13:04,822 --> 00:13:07,410 Did you tear or... Can I ask you that? 290 00:13:07,510 --> 00:13:10,824 Yeah, you can ask me anything, but, um, no, I-I didn't tear. 291 00:13:10,849 --> 00:13:14,838 I, uh... ... I had something called a crash C-section. 292 00:13:14,863 --> 00:13:16,934 Oh, tell me everything. 293 00:13:19,384 --> 00:13:20,454 I'll be back. 294 00:13:20,479 --> 00:13:22,756 Richard, what the hell are you doing? 295 00:13:23,401 --> 00:13:25,331 I'm about to check Mr. Tolli's wound VAC. 296 00:13:25,356 --> 00:13:27,772 You said you would hear Kaplan out. 297 00:13:27,797 --> 00:13:29,523 I did. 298 00:13:29,766 --> 00:13:31,855 Is this because you're worried about the bedroom? 299 00:13:31,880 --> 00:13:34,717 Because you know we'll figure that out. 300 00:13:36,802 --> 00:13:37,838 Come on. 301 00:13:43,857 --> 00:13:45,283 I'm not having this conversation here. 302 00:13:45,307 --> 00:13:47,698 Is this because you prefer a male doctor? 303 00:13:47,723 --> 00:13:49,113 Now that's insulting! 304 00:13:49,138 --> 00:13:50,805 Well, I'm just trying to understand why 305 00:13:50,830 --> 00:13:54,187 you would dismiss a top urologist like she's an intern. 306 00:13:54,212 --> 00:13:56,224 I moved mountains to bring her here for you. 307 00:13:56,249 --> 00:13:57,745 I didn't ask you to. 308 00:13:58,665 --> 00:14:00,676 Now, my cancer hasn't metastasized. 309 00:14:00,701 --> 00:14:03,628 Watchful waiting is a perfectly reasonable option. 310 00:14:03,843 --> 00:14:06,846 I respected your health care decisions even when I didn't agree. 311 00:14:07,674 --> 00:14:09,365 I need you to do the same for me. 312 00:14:11,333 --> 00:14:13,887 1962. 313 00:14:14,025 --> 00:14:16,623 - Who was the surgeon at Seattle Pres? - Collins. 314 00:14:16,648 --> 00:14:20,386 Yeah, he actually did his residency here a couple of years behind me. 315 00:14:20,411 --> 00:14:23,863 When his chief wouldn't let him try again, he sent London to me. 316 00:14:23,888 --> 00:14:26,185 If she codes the minute she lays on the table, 317 00:14:26,210 --> 00:14:28,049 why didn't they try a reverse Trendelenburg? 318 00:14:28,074 --> 00:14:29,190 Keep her at an incline to take the 319 00:14:29,214 --> 00:14:30,505 pressure off some of the cardiac vessels? 320 00:14:30,530 --> 00:14:33,675 Oh, no, they did. Uh, but see how compressed they are? 321 00:14:33,700 --> 00:14:35,090 It wasn't enough. 322 00:14:35,115 --> 00:14:36,921 Okay, what about conscious sedation instead of general anesthesia? 323 00:14:36,945 --> 00:14:39,430 She'd continue to breathe on her own, which would help 324 00:14:39,455 --> 00:14:42,408 blood return back to the heart and minimize airway collapse. 325 00:14:42,433 --> 00:14:44,745 I mean, it might help some... 326 00:14:44,884 --> 00:14:46,939 The tumor's matured into its own ecosystem. 327 00:14:46,964 --> 00:14:48,414 You can see the calcifications, 328 00:14:48,439 --> 00:14:52,374 - fat, the cystic components. - Yeah? What? 329 00:14:52,399 --> 00:14:54,938 What if we drain it? Shrink the mass before we go in? 330 00:14:54,963 --> 00:14:57,147 It's a good idea, but the location is just too risky. 331 00:14:57,172 --> 00:14:59,529 We can't risk the contents of the tumor spilling into the chest. 332 00:14:59,553 --> 00:15:01,358 It would just regrow. 333 00:15:01,383 --> 00:15:02,774 I gotta run to a consult in the pit, 334 00:15:02,798 --> 00:15:04,051 but I will keep thinking on this. 335 00:15:04,075 --> 00:15:06,146 No promises though. 336 00:15:07,251 --> 00:15:09,362 Adams, Griffith, let's look up every case 337 00:15:09,386 --> 00:15:11,609 report published on mediastinal teratomas. 338 00:15:11,634 --> 00:15:14,700 Research patterns, cross-reference solutions, okay? 339 00:15:15,430 --> 00:15:17,132 We all just listened to a podcast this morning 340 00:15:17,157 --> 00:15:18,859 about how our hospital pulled off a miracle. 341 00:15:18,883 --> 00:15:21,161 Who's to say we can't do it again, right? Go. 342 00:15:24,081 --> 00:15:26,324 We're gonna come up with something. 343 00:15:28,247 --> 00:15:29,731 - Hey. - Hi. 344 00:15:29,869 --> 00:15:32,285 - Are you done with that tablet? - Nope, get your own. 345 00:15:32,310 --> 00:15:35,559 Bailey and Hunt have a massive mediastinal teratoma. 346 00:15:35,584 --> 00:15:37,912 If you sweet-talk Bailey, you can get in on it with us. 347 00:15:37,937 --> 00:15:38,977 They're looking for ideas. 348 00:15:39,162 --> 00:15:40,646 I'm too swamped down here. 349 00:15:41,436 --> 00:15:44,125 Hey, I'm sorry about this morning. 350 00:15:44,150 --> 00:15:45,408 Jo's crying about everything these days. 351 00:15:45,432 --> 00:15:48,672 - It's fine. - But she loves Iris, so... 352 00:15:49,077 --> 00:15:50,917 she'll be happy if you two are a thing. 353 00:15:57,922 --> 00:16:00,003 - Why are you acting weird? - I'm not acting weird. 354 00:16:00,028 --> 00:16:02,005 Yeah, you are. 355 00:16:02,030 --> 00:16:04,421 - Help. Help my wife! Help. - Hal? 356 00:16:04,446 --> 00:16:06,217 - Sir, you might wanna button that. - Oh, my God. Janet. 357 00:16:10,805 --> 00:16:12,083 I'm getting weak pulses. 358 00:16:12,826 --> 00:16:15,070 Janet, look at me. I'm going to care of you, okay? 359 00:16:15,529 --> 00:16:17,014 We need a gurney in here! 360 00:16:24,226 --> 00:16:26,098 The plane won't be ready for another couple of hours. 361 00:16:26,123 --> 00:16:29,367 - Catherine said I could work in here. - Not a problem. 362 00:16:32,334 --> 00:16:33,749 I owe you an apology. 363 00:16:34,752 --> 00:16:37,860 I was led to believe that you were the one seeking a second opinion. 364 00:16:37,885 --> 00:16:39,093 You couldn't have known. 365 00:16:39,481 --> 00:16:41,289 I should have at least suspected. 366 00:16:41,655 --> 00:16:43,243 I think your wife broke contract laws 367 00:16:43,268 --> 00:16:44,910 to ensure my employment at her hospital. 368 00:16:44,934 --> 00:16:46,143 Don't feel bad. 369 00:16:46,168 --> 00:16:49,386 You're not the first to fall prey to her ways. 370 00:16:49,905 --> 00:16:52,080 I'm guessing I won't be the last. 371 00:16:52,577 --> 00:16:54,268 She does it 'cause she cares. 372 00:16:54,944 --> 00:16:58,120 That's what makes it infuriating. 373 00:17:01,227 --> 00:17:02,542 Feel free to say no. 374 00:17:03,187 --> 00:17:06,345 But I've got a patient with a retroperitoneal tumor, 375 00:17:06,370 --> 00:17:08,937 and I would be remiss if I didn't ask Fox 376 00:17:08,962 --> 00:17:11,280 Hospitals' Chief of Chiefs for a consult. 377 00:17:12,431 --> 00:17:14,784 - No. Got a little time. - Yeah. 378 00:17:15,136 --> 00:17:18,933 How about we get a couple of pastries to go with this coffee? 379 00:17:19,259 --> 00:17:21,261 Thank you. That would be great. 380 00:17:22,726 --> 00:17:24,933 "Twenty-two-pound teratoma in the abdomen. 381 00:17:25,302 --> 00:17:29,713 San Francisco, 2018." They started with a CT-guided drainage. 382 00:17:29,738 --> 00:17:31,298 Yeah, but look at the picture of the CT. 383 00:17:31,473 --> 00:17:32,819 Nowhere near the heart. 384 00:17:32,844 --> 00:17:34,743 Another dead end. 385 00:17:36,409 --> 00:17:37,809 Another dumb meme from your patient? 386 00:17:37,834 --> 00:17:39,714 No, she's asking for movie recs. 387 00:17:40,275 --> 00:17:41,379 She's stuck at home. 388 00:17:41,991 --> 00:17:44,442 Not exactly a doctor-patient conversation topic. 389 00:17:45,236 --> 00:17:47,756 She's Bailey's patient. She has stage four gastric cancer. 390 00:17:47,781 --> 00:17:50,044 She can ask whatever she wants. 391 00:17:50,069 --> 00:17:51,529 I mean, shouldn't you keep it professional? 392 00:17:51,553 --> 00:17:53,496 Look, you have no idea what you're talking about. It's... 393 00:17:53,521 --> 00:17:55,561 I'm just saying, you're young, you're single. You... 394 00:17:56,081 --> 00:17:58,558 You look like you might be leading her on. 395 00:17:59,906 --> 00:18:02,736 - I'm her doctor. - And she's a vulnerable patient. 396 00:18:03,410 --> 00:18:05,405 I don't... I don't need this right now. 397 00:18:05,429 --> 00:18:07,638 - I'm just trying to look out for you. - Yeah, try less. 398 00:18:10,192 --> 00:18:11,849 Hunt's asking for an update. 399 00:18:14,448 --> 00:18:17,141 - Okay, anything? - Not yet. Thanks. 400 00:18:20,825 --> 00:18:24,346 Why did you join this case when everyone else dismissed it? 401 00:18:24,371 --> 00:18:25,872 It's like you said, it's benign. 402 00:18:25,897 --> 00:18:27,805 Once it's out, she moves on with her life. 403 00:18:27,830 --> 00:18:30,454 There's no worry of mets or recurrence. 404 00:18:33,560 --> 00:18:37,046 Yeah... ... I might be feeling a little uninspired lately. 405 00:18:37,071 --> 00:18:40,922 Uh-huh. Wouldn't have to do with other people solving 406 00:18:40,947 --> 00:18:43,384 cases at weddings and doing podcasts, would it? 407 00:18:43,718 --> 00:18:46,824 I see you at drop-off. 408 00:18:46,963 --> 00:18:49,103 I know everything's falling on you right now. 409 00:18:49,241 --> 00:18:52,392 She's lecturing and you're packing lunches. 410 00:18:52,417 --> 00:18:55,876 I'm happy to do it, and she deserves all the attention. 411 00:18:56,238 --> 00:18:58,378 I just think this tumor was... 412 00:18:59,994 --> 00:19:01,119 I don't know. 413 00:19:01,144 --> 00:19:04,833 My patient cannot be the fix to get you out of this slump. 414 00:19:05,690 --> 00:19:06,736 What have you got? 415 00:19:06,761 --> 00:19:09,951 Ten cases, at least half of them considered inoperable. 416 00:19:09,976 --> 00:19:12,333 And none of the masses are nearly the same size. 417 00:19:12,358 --> 00:19:14,543 There's one case that reported a similar arrest in the OR, 418 00:19:14,567 --> 00:19:16,371 but the team never tried it again 419 00:19:16,396 --> 00:19:18,995 because they couldn't safely find a way around the heart and lungs. 420 00:19:19,019 --> 00:19:21,505 Which is exactly what happened with London. 421 00:19:21,737 --> 00:19:24,257 As difficult as this is for me to say... 422 00:19:25,388 --> 00:19:27,425 I think we're out of options. 423 00:19:27,978 --> 00:19:30,142 - What about ECMO? - What about it? 424 00:19:30,167 --> 00:19:33,733 We need to bypass the pulmonary system, so why don't we use ECMO? 425 00:19:33,758 --> 00:19:35,415 The machine oxygenates and pumps the blood 426 00:19:35,440 --> 00:19:37,358 so her heart and lungs don't have to. 427 00:19:37,421 --> 00:19:41,908 There is no arrest if the machine is acting as her heart. 428 00:19:43,287 --> 00:19:46,697 Don't say no yet. I'm gonna go find Ndugu. 429 00:19:46,903 --> 00:19:47,938 Okay. 430 00:19:50,019 --> 00:19:51,544 Almost there, Janet. 431 00:19:51,569 --> 00:19:53,675 If this is a clot, you can fix it, right? 432 00:19:55,146 --> 00:19:57,550 Blood clots are treatable if you catch them in time, 433 00:19:57,575 --> 00:19:58,855 so it's a good thing you're here. 434 00:20:00,547 --> 00:20:02,025 Weird but good. 435 00:20:02,050 --> 00:20:05,213 I should probably be embarrassed, but I'm proud of us. 436 00:20:05,238 --> 00:20:07,378 All my friends got bored of their spouses 437 00:20:07,759 --> 00:20:11,185 and filed for divorce, but we got creative. 438 00:20:11,389 --> 00:20:13,563 By coming to the hospital and having sex. 439 00:20:14,557 --> 00:20:17,244 Don't be jealous. I'm sure other people aren't getting any either. 440 00:20:17,704 --> 00:20:19,499 All right, let me see. 441 00:20:22,003 --> 00:20:24,957 Looks like there's a left iliac vein thrombosis. 442 00:20:24,982 --> 00:20:26,604 Hal was right. DVT. 443 00:20:26,629 --> 00:20:30,100 If you look closely, the iliac artery is compressing the vein. 444 00:20:30,125 --> 00:20:31,989 - May-Thurner syndrome. - Mm-hmm. 445 00:20:32,240 --> 00:20:33,862 All right, let's book an angio suite 446 00:20:33,887 --> 00:20:37,270 for a thrombectomy and iliac vein stenting and start practicing. 447 00:20:37,295 --> 00:20:39,883 I'm gonna supervise you doing the procedure. 448 00:20:41,194 --> 00:20:42,782 - Me? - She means me. 449 00:20:43,650 --> 00:20:45,261 I don't care who it is... as long as 450 00:20:45,286 --> 00:20:47,073 you guys are prepped and ready to go. 451 00:20:51,024 --> 00:20:52,571 You really think this will work? 452 00:20:52,596 --> 00:20:55,599 The challenge, right, has always been the pressure 453 00:20:55,624 --> 00:20:58,128 that your tumor is putting on your heart, 454 00:20:58,153 --> 00:21:01,718 your lungs and major arteries when you're positioned for surgery. 455 00:21:01,743 --> 00:21:03,445 And the ECMO machine makes that irrelevant 456 00:21:03,469 --> 00:21:05,618 because it oxygenates and pumps your blood for you. 457 00:21:05,643 --> 00:21:08,370 So no matter what happens, your body will receive oxygen 458 00:21:08,395 --> 00:21:10,305 and blood flow while we work. 459 00:21:11,150 --> 00:21:13,256 I can't believe you actually figured it out. 460 00:21:13,281 --> 00:21:16,422 Have you done this before? I mean, how common is this ECMO? 461 00:21:16,447 --> 00:21:19,460 Charlie, you said you were in if they figured it out. 462 00:21:19,485 --> 00:21:20,998 How common is it? 463 00:21:21,023 --> 00:21:24,361 It's not common for this, and it can be hard to wean off ECMO 464 00:21:24,386 --> 00:21:27,113 after removing something that's compressed your lung for so long, 465 00:21:27,138 --> 00:21:28,572 but her heart is healthy. 466 00:21:28,710 --> 00:21:30,402 I don't anticipate that being a problem. 467 00:21:30,427 --> 00:21:32,774 But it could be a problem. 468 00:21:35,714 --> 00:21:37,302 You almost lost me twice. 469 00:21:38,417 --> 00:21:41,731 If we do nothing, this thing just keeps growing inside me 470 00:21:42,273 --> 00:21:47,623 until it squashes all my organs... and I'm definitely gone. 471 00:21:48,548 --> 00:21:49,963 I don't wanna live like that. 472 00:21:51,689 --> 00:21:53,381 Slowly suffocating. 473 00:21:54,140 --> 00:21:57,454 I don't want you to have to watch me live like that. 474 00:21:58,489 --> 00:22:01,457 We asked them to come up with a solution. 475 00:22:04,219 --> 00:22:05,783 I'm taking it. 476 00:22:05,807 --> 00:22:07,854 Okay, Dr. Griffith and Dr. Adams will get you prepped, 477 00:22:07,878 --> 00:22:10,190 and we will see you in the OR, okay? 478 00:22:15,161 --> 00:22:16,521 Is it weird that he's not blinking? 479 00:22:16,645 --> 00:22:18,889 Newborn tear ducts aren't fully developed. 480 00:22:19,074 --> 00:22:20,938 It's so cool that you know all this stuff. 481 00:22:22,030 --> 00:22:25,388 Is it bad if I'm not, like, feeling anything? 482 00:22:25,507 --> 00:22:27,200 You mean you don't feel a bond? 483 00:22:28,775 --> 00:22:30,669 - I'm already a terrible mom. - No. 484 00:22:30,694 --> 00:22:34,214 No, it's completely normal, and you're exhausted, 485 00:22:34,239 --> 00:22:35,768 and your hormones are all over the place. 486 00:22:35,793 --> 00:22:39,194 And to be honest, newborns are kinda just blobs. 487 00:22:39,332 --> 00:22:42,646 In a few weeks, he'll be laughing and smiling, and it just... 488 00:22:42,671 --> 00:22:43,983 it gets so much better. 489 00:22:44,606 --> 00:22:46,125 You're a really good doctor. 490 00:22:46,937 --> 00:22:48,766 Are you taking new patients? 491 00:22:49,305 --> 00:22:50,723 - Well, it's... - Hey. 492 00:22:50,748 --> 00:22:53,682 - How're my girls? - Hey. Well, we made a new friend... 493 00:22:53,820 --> 00:22:56,927 - Whoa. Oh, my God. - Oh. Oh. Someone call a rapid response! 494 00:22:56,952 --> 00:22:58,360 Right away, Doctor. 495 00:23:06,833 --> 00:23:08,076 She's still seizing. 496 00:23:09,558 --> 00:23:11,173 Someone give me IM midazolam. 497 00:23:11,537 --> 00:23:13,953 She's seven days postpartum. Check her blood pressure. 498 00:23:13,978 --> 00:23:16,093 It's probably eclampsia. She needs mag now. 499 00:23:16,118 --> 00:23:18,096 Did she have any symptoms before she started seizing? 500 00:23:18,120 --> 00:23:20,679 No, she seemed completely fine. It came out of nowhere. 501 00:23:20,704 --> 00:23:22,098 We'll need to get her up to OB. 502 00:23:22,123 --> 00:23:24,530 - Will you go up with her? - Whatever you want. 503 00:23:25,157 --> 00:23:26,345 Call me when you get up there. 504 00:23:31,702 --> 00:23:32,979 Scissors. 505 00:23:34,168 --> 00:23:37,206 - Put two units of blood on standby. - Lap pad. 506 00:23:39,452 --> 00:23:41,143 All right, I secured the cannula. 507 00:23:41,168 --> 00:23:43,111 Adams, are we ready to remove the clamps? 508 00:23:43,798 --> 00:23:46,180 Yeah, ECMO's ready. 509 00:23:49,911 --> 00:23:51,879 Okay, the dark flow. 510 00:23:52,776 --> 00:23:53,924 We have full flow. 511 00:23:53,949 --> 00:23:55,330 Let's try lowering her down. 512 00:24:02,448 --> 00:24:03,503 At least that worked. 513 00:24:03,527 --> 00:24:05,142 We're gonna make all of it work. 514 00:24:05,167 --> 00:24:07,422 Griffith, Adams, you may never see another case like this again, 515 00:24:07,446 --> 00:24:08,964 so keep your eyes on the field. 516 00:24:08,989 --> 00:24:12,381 If you see any signs of hemodynamic instability, speak up. 517 00:24:12,520 --> 00:24:15,799 This is not a race. Our goal is not to finish fast. 518 00:24:15,937 --> 00:24:18,433 It is to keep her safe. 519 00:24:18,458 --> 00:24:19,778 Understood? - Mm-hmm. 520 00:24:19,803 --> 00:24:20,804 Okay. 521 00:24:21,839 --> 00:24:23,116 Okay, London. 522 00:24:23,558 --> 00:24:24,935 Let's intubate. 523 00:24:29,606 --> 00:24:32,100 It's a hormonally active adrenal mass, 524 00:24:32,125 --> 00:24:34,341 so you need to watch out for sudden hypertension. 525 00:24:34,549 --> 00:24:36,269 - I'm planning to use alpha-blockers. - Good. 526 00:24:36,294 --> 00:24:39,694 Well, I assume you're gonna do this open, given the size? 527 00:24:39,719 --> 00:24:42,801 That's the plan. My colleague will actually do it. 528 00:24:42,826 --> 00:24:45,173 I usually stick to robotic procedures. 529 00:24:45,198 --> 00:24:48,063 Oh. You got something against the old-fashioned way? 530 00:24:48,466 --> 00:24:52,224 No, um... I have MS, 531 00:24:52,661 --> 00:24:56,297 so standing for long periods in the OR just isn't an option. 532 00:24:56,322 --> 00:25:00,138 - I didn't realize. I'm sorry. - No need to be sorry. 533 00:25:00,377 --> 00:25:03,139 I mean, I was devastated after I got the diagnosis. 534 00:25:04,116 --> 00:25:06,394 I had put in so much work my whole career, 535 00:25:06,419 --> 00:25:09,708 and the thought of no longer being in the OR... was soul-crushing... 536 00:25:10,668 --> 00:25:12,014 to say the least. 537 00:25:12,890 --> 00:25:15,514 But that's when I realized it was just my fear talking. 538 00:25:16,555 --> 00:25:18,369 And I looked at my symptoms, 539 00:25:18,394 --> 00:25:21,017 muscle pain and leg weakness, and I thought, 540 00:25:21,616 --> 00:25:23,756 "If only there was a way to operate 541 00:25:23,878 --> 00:25:27,564 while sitting down without having to hold a scalpel." 542 00:25:29,532 --> 00:25:31,120 Was it a difficult adjustment? 543 00:25:31,905 --> 00:25:34,942 Adjusting to living with a chronic illness is never easy. 544 00:25:35,260 --> 00:25:38,564 But over time, I just turned MS into a pivot. 545 00:25:39,909 --> 00:25:41,013 Not an ending. 546 00:25:42,086 --> 00:25:44,863 Well, you seem to be managing well. 547 00:25:44,888 --> 00:25:48,111 Oh, well, I have my ups and downs, believe me. 548 00:25:48,513 --> 00:25:52,137 But Catherine Fox is flying me around on her private plane 549 00:25:52,162 --> 00:25:54,579 and paying me more money than I know what to do with. 550 00:25:56,190 --> 00:25:57,847 And I still get to do what I love. 551 00:25:58,670 --> 00:26:00,706 Even if it is in a different way. 552 00:26:03,039 --> 00:26:06,665 Now they're gonna go ahead with Bailey's giant teratoma in OR two. 553 00:26:07,013 --> 00:26:09,637 - Ndugu's gonna have to resect... - Can we just focus, please? 554 00:26:10,292 --> 00:26:11,880 It's a fake patient. Calm down. 555 00:26:11,986 --> 00:26:13,823 Don't tell me to calm down. 556 00:26:13,848 --> 00:26:15,297 What is wrong with you? 557 00:26:16,091 --> 00:26:19,474 Is it about Simone breaking that dumb pact? 558 00:26:19,725 --> 00:26:22,348 No, and stop asking. I'm fine. 559 00:26:22,373 --> 00:26:24,237 No, you don't seem fine. 560 00:26:24,262 --> 00:26:26,876 Well, it's because you are bothering me. 561 00:26:27,413 --> 00:26:29,928 Well, that can't be it. I always bother you. 562 00:26:29,953 --> 00:26:31,092 I'm just... 563 00:26:32,525 --> 00:26:34,775 I'm just tired. 564 00:26:35,166 --> 00:26:36,823 Every day is the same. 565 00:26:36,848 --> 00:26:41,367 It's the same people and the same rooms and the same conversations, 566 00:26:41,392 --> 00:26:43,912 and I'm just... sick of it. 567 00:26:43,937 --> 00:26:46,781 Well, I am sorry we are not good enough for you. 568 00:26:46,806 --> 00:26:48,040 I didn't say that. 569 00:26:48,065 --> 00:26:51,195 Yeah, you don't have to defend yourself. We all know you're aloof. 570 00:26:59,650 --> 00:27:00,969 You're leaving? 571 00:27:00,994 --> 00:27:02,913 Yeah, I've already done a thrombectomy. 572 00:27:03,052 --> 00:27:04,260 You can have it. 573 00:27:04,884 --> 00:27:09,474 Dr. Prescott, please... 574 00:27:10,801 --> 00:27:12,527 What's happening? Who's the doctor? 575 00:27:12,665 --> 00:27:16,333 - Uh... John Burnett. - An intern? 576 00:27:16,358 --> 00:27:18,188 - Let's get a CT. - They're getting a CT. 577 00:27:18,310 --> 00:27:19,923 No, she has eclampsia. 578 00:27:19,948 --> 00:27:21,847 Tell him she needs magnesium. 579 00:27:21,872 --> 00:27:23,651 - Really? - Tell him. 580 00:27:23,676 --> 00:27:24,884 I... 581 00:27:25,609 --> 00:27:27,887 Excuse me, I've got Jo Wilson on the phone, 582 00:27:27,912 --> 00:27:30,230 and she says it's eclampsia, and you should start her on magnesium. 583 00:27:30,255 --> 00:27:33,686 Her BP is only 143 over 91. It could be an intracranial hemorrhage. 584 00:27:33,711 --> 00:27:36,151 - Put me on speaker. - Um... 585 00:27:37,290 --> 00:27:39,292 Okay. You're on speaker. 586 00:27:39,317 --> 00:27:40,886 I understand your concern, 587 00:27:40,911 --> 00:27:44,524 but postpartum eclampsia doesn't always present with a really high BP. 588 00:27:44,549 --> 00:27:46,009 Neither does a brain bleed. 589 00:27:46,034 --> 00:27:48,158 - Barnett. - It's... It's Burnett. 590 00:27:48,183 --> 00:27:50,116 Whatever. I may be on leave, 591 00:27:50,141 --> 00:27:52,576 but that doesn't mean that I can't schedule you to work every holiday 592 00:27:52,601 --> 00:27:55,200 and make your life miserable. So trust me when I tell you 593 00:27:55,225 --> 00:27:57,676 to start the mag now. 594 00:28:00,132 --> 00:28:01,512 Start IV magnesium. 595 00:28:07,748 --> 00:28:09,508 Your mom's gonna be okay. 596 00:28:11,253 --> 00:28:13,150 We're gonna have to take part of the lower lobe. 597 00:28:13,174 --> 00:28:15,605 - Adams, you wanna staple the lung? - Yep. Stapler. 598 00:28:15,630 --> 00:28:17,982 Bailey, you ready to start resecting the adhered diaphragm? 599 00:28:18,007 --> 00:28:19,673 Hey, ready when you are. 600 00:28:19,698 --> 00:28:22,227 Griffith, what should we be careful to avoid? 601 00:28:22,252 --> 00:28:24,204 Hepatic veins and the retro-hepatic IVC. 602 00:28:24,229 --> 00:28:25,920 Good. Let's get the next stapler ready. 603 00:28:25,945 --> 00:28:30,279 London thought fixing up a summer house was a lot of work. 604 00:28:30,304 --> 00:28:33,341 - It's got nothing on fixing up a torso. - Reload, please. 605 00:28:35,152 --> 00:28:39,106 - Uh, BP is bottoming out. - Damn it. I don't see any bleeding. 606 00:28:39,131 --> 00:28:40,764 Neither do I. The staple line looks clean. 607 00:28:40,788 --> 00:28:42,593 Well, something's got to be causing this. What the hell is it? 608 00:28:42,617 --> 00:28:46,103 - Does the ECMO say anything? - There's a suction event alarm. 609 00:28:46,586 --> 00:28:48,249 Okay. Since we took pressure off the 610 00:28:48,273 --> 00:28:49,935 lung, could there be volume shifts? 611 00:28:50,127 --> 00:28:51,645 That's definitely possible. Yeah. 612 00:28:51,670 --> 00:28:54,427 Okay, we need to up her pressors and flood her with fluids. 613 00:28:54,452 --> 00:28:57,421 If we don't get flow back right away, she's done. 614 00:29:02,948 --> 00:29:04,269 Push fluids as hard as you can. 615 00:29:04,294 --> 00:29:05,502 - I am. - BP's still dropping. 616 00:29:05,527 --> 00:29:07,203 She can't take this much longer. 617 00:29:07,228 --> 00:29:08,954 I should've listened to that board. 618 00:29:09,092 --> 00:29:10,863 - If I lose her... - This is not on you. 619 00:29:10,887 --> 00:29:13,717 Come on, come on, come on. Come on. 620 00:29:13,855 --> 00:29:15,098 BP's coming back up. 621 00:29:16,789 --> 00:29:20,103 - Well, that was close. - Okay, folks. 622 00:29:20,872 --> 00:29:22,750 There's still a lot of tumor left. 623 00:29:23,909 --> 00:29:25,600 Griffith, you're on the liver resection. 624 00:29:25,625 --> 00:29:27,455 Adams, you're on the superior mediastinum. 625 00:29:28,319 --> 00:29:30,148 If that's okay with you? 626 00:29:31,377 --> 00:29:33,263 Do what we say when we say it. 627 00:29:33,288 --> 00:29:34,427 Stapler. 628 00:29:39,170 --> 00:29:40,412 Contrast. 629 00:29:42,785 --> 00:29:46,070 There's the occlusion in the iliac vein. Advance more. 630 00:29:47,567 --> 00:29:49,141 Okay, pin the guide wire 631 00:29:49,166 --> 00:29:51,065 and turn on the thrombectomy catheter, please. 632 00:29:53,549 --> 00:29:55,630 It's a shame Janet isn't awake to see this. 633 00:29:55,655 --> 00:29:56,967 It would really turn her... 634 00:29:58,049 --> 00:30:02,881 into a passionate fan of biological science and anatomy. 635 00:30:03,431 --> 00:30:04,916 Okay, I'm in. Turn it off. 636 00:30:04,941 --> 00:30:07,850 I don't get it. If you have to pretend to be someone else 637 00:30:07,875 --> 00:30:09,266 for your partner to wanna sleep with you, 638 00:30:09,290 --> 00:30:10,945 maybe you shouldn't be together. 639 00:30:10,970 --> 00:30:12,910 I've learned you never know what's going 640 00:30:12,934 --> 00:30:14,502 on in another person's relationship. 641 00:30:15,435 --> 00:30:16,505 Ready. 642 00:30:17,454 --> 00:30:18,524 Contrast. 643 00:30:22,130 --> 00:30:25,168 Thrombus is gone. The vein is patent. 644 00:30:25,828 --> 00:30:26,950 Great work. 645 00:30:27,434 --> 00:30:28,435 Now to stent. 646 00:30:31,548 --> 00:30:35,655 Thanks again for the consult. I see why Catherine calls you legendary. 647 00:30:35,680 --> 00:30:38,121 Well, she is prone to exaggeration. 648 00:30:38,146 --> 00:30:40,631 I know, but in your case it's true. 649 00:30:40,656 --> 00:30:43,380 Well, you live up to your reputation as well. 650 00:30:43,405 --> 00:30:46,262 Oh, but not enough to consider my recommendation? 651 00:30:48,826 --> 00:30:51,328 I'm sorry, I-I shouldn't have said that. 652 00:30:51,352 --> 00:30:52,516 No, it's okay. 653 00:30:53,208 --> 00:30:54,611 Can I ask you about something? 654 00:30:55,781 --> 00:30:57,576 Urosymphyseal fistulas. 655 00:30:59,453 --> 00:31:01,153 They are an extremely rare post-op 656 00:31:01,178 --> 00:31:03,319 complication of radical prostatectomy. 657 00:31:03,457 --> 00:31:05,148 But the odds aren't zero. 658 00:31:05,477 --> 00:31:06,651 They're close. 659 00:31:07,145 --> 00:31:08,146 What if it happened? 660 00:31:09,281 --> 00:31:12,594 Chronic pain, which often leads to difficulty walking, 661 00:31:13,285 --> 00:31:16,954 possibly warranting the use of opioids. 662 00:31:18,398 --> 00:31:20,779 I can treat complications. 663 00:31:21,534 --> 00:31:23,999 But if your cancer grows and metastasizes, 664 00:31:24,023 --> 00:31:25,884 that's when my hands are tied. 665 00:31:30,039 --> 00:31:31,350 If you change your mind 666 00:31:31,474 --> 00:31:34,954 or if you just wanna talk more, Catherine has my number. 667 00:31:48,232 --> 00:31:50,683 - Done resecting the liver. - Good. 668 00:31:50,849 --> 00:31:52,195 Excellent hemostasis. 669 00:31:55,983 --> 00:31:57,777 All right, no bleeding on this side. 670 00:31:57,916 --> 00:31:59,710 Okay, we are in the home stretch. 671 00:31:59,848 --> 00:32:01,920 Let's get ready to get this tumor out. 672 00:32:02,990 --> 00:32:04,819 Hold on, hold on. 673 00:32:05,066 --> 00:32:07,241 - Do you hear that? - What? 674 00:32:09,479 --> 00:32:11,906 Okay, we're gonna need more lap pads, and hang blood. 675 00:32:11,930 --> 00:32:13,655 Adams, quickly pack her. 676 00:32:14,495 --> 00:32:16,655 Goddamn it! All right, keep the suction coming. 677 00:32:17,663 --> 00:32:18,913 Oh... ... wait, wait. 678 00:32:18,938 --> 00:32:23,019 Okay, there's a tear where the IVC passes 679 00:32:23,044 --> 00:32:24,770 through the diaphragm into the chest. 680 00:32:24,795 --> 00:32:27,694 I'm trying to secure... Let-Let me have a clamp. 681 00:32:28,291 --> 00:32:29,785 Okay, I need visualization. 682 00:32:29,809 --> 00:32:31,089 Put the suction on the lap pads. 683 00:32:31,114 --> 00:32:33,834 Not too harsh, gentle steady pressure, okay? 684 00:32:39,351 --> 00:32:40,732 I think I got it. 685 00:32:43,925 --> 00:32:47,009 Oh, she's stabilizing. 686 00:32:47,034 --> 00:32:49,036 Okay, everyone, on the count of three. 687 00:32:49,061 --> 00:32:50,840 Everyone needs to help with the specimen. 688 00:32:50,865 --> 00:32:55,086 Okay, ready? One, two, three. 689 00:33:00,139 --> 00:33:01,140 Okay. 690 00:33:07,801 --> 00:33:08,940 Okay. 691 00:33:09,401 --> 00:33:11,413 How do you all feel about getting the hell out of here? 692 00:33:11,437 --> 00:33:13,636 You don't have to ask me twice. Bovie. 693 00:33:14,517 --> 00:33:16,174 Two-O prolene. 694 00:33:23,001 --> 00:33:24,036 You can stop here. 695 00:33:24,722 --> 00:33:25,634 Iris. 696 00:33:26,487 --> 00:33:28,153 Hey, what are you doing up here? 697 00:33:28,178 --> 00:33:31,388 So a mom from the NICU is being treated for postpartum eclampsia. 698 00:33:31,413 --> 00:33:34,220 Can you look up her chart? Her name is Gina... 699 00:33:34,941 --> 00:33:36,021 I don't know her last name. 700 00:33:36,559 --> 00:33:38,768 I'm sorry, I can't. You're not her doctor. 701 00:33:40,088 --> 00:33:41,365 I just wanna check on her. 702 00:33:42,282 --> 00:33:44,549 Do you want me to call Marcus for you? 703 00:33:44,574 --> 00:33:46,403 No, what I want is my friend's chart. 704 00:33:47,611 --> 00:33:49,279 - I'm sorry, Jo. - Stop saying you're sorry. 705 00:33:49,303 --> 00:33:51,663 Sorry doesn't help me. I'm this woman's only friend right now 706 00:33:51,688 --> 00:33:53,109 and the person in charge of her care 707 00:33:53,134 --> 00:33:54,697 has been a doctor for about 90 days. 708 00:33:54,722 --> 00:33:56,802 So, if you could just please remove the stick from... 709 00:33:56,827 --> 00:33:58,804 - Jo. - All I want right now... 710 00:33:58,829 --> 00:34:00,704 - I think we should go. - No, we're not gonna go. 711 00:34:00,728 --> 00:34:01,729 - I... No. - Yeah. 712 00:34:01,754 --> 00:34:04,205 You cannot move me against my will. 713 00:34:04,674 --> 00:34:06,814 Stop. I... 714 00:34:07,306 --> 00:34:10,416 - This is not okay. - Can you give me a minute? 715 00:34:10,441 --> 00:34:12,025 - This is... - Hey, hey, hey, hey. 716 00:34:12,050 --> 00:34:14,259 Look, I know you're scared, okay? But... 717 00:34:15,605 --> 00:34:17,365 Hey, she's just trying to do her job. 718 00:34:35,832 --> 00:34:37,791 It will take a few days to wean her off ECMO. 719 00:34:37,816 --> 00:34:39,431 She does have a long recovery. 720 00:34:39,569 --> 00:34:41,709 - But she's gonna come home? - Eventually. 721 00:34:41,866 --> 00:34:43,489 That is the plan. 722 00:34:44,012 --> 00:34:45,428 I don't know how to thank you. 723 00:34:46,084 --> 00:34:47,430 I think you just did. 724 00:34:50,191 --> 00:34:52,745 She's always been able to see what I can't. 725 00:34:53,298 --> 00:34:56,552 Her mind is filled with these big ideas 726 00:34:56,577 --> 00:34:59,244 that always seem impossible. 727 00:34:59,269 --> 00:35:04,378 Our wedding, this lake house, getting this tumor removed. 728 00:35:05,816 --> 00:35:07,335 But she knew you could do it. 729 00:35:09,261 --> 00:35:11,021 And she was right. 730 00:35:12,317 --> 00:35:15,540 I almost... tried to stop her. 731 00:35:17,598 --> 00:35:19,496 But I'm glad I stayed out of it. 732 00:35:20,946 --> 00:35:23,604 Hey, um, we'll let you both get some rest. 733 00:35:24,307 --> 00:35:26,240 Thank you. 734 00:35:28,954 --> 00:35:30,827 Great work today, Griffith. 735 00:35:30,852 --> 00:35:33,545 You and Adams, you really stepped it up. 736 00:35:33,570 --> 00:35:37,594 Thank you. I really appreciate the opportunity. I learned a lot. 737 00:35:41,217 --> 00:35:46,257 We did a good thing today. 738 00:35:46,282 --> 00:35:49,743 - Some might call it inspiring. - Mmm. 739 00:35:49,768 --> 00:35:51,365 Might be even something 740 00:35:51,390 --> 00:35:53,703 you could lecture about. 741 00:35:53,728 --> 00:35:55,589 Hey, I hope I didn't overstep, you 742 00:35:55,614 --> 00:35:57,475 know, jumping in with the residents. 743 00:35:57,500 --> 00:36:00,606 Oh, no. I mean, if I'm the only voice that's teaching them, 744 00:36:00,631 --> 00:36:02,219 they'll wind up tuning me out. 745 00:36:03,230 --> 00:36:04,828 What do you think about having the residents 746 00:36:04,852 --> 00:36:07,347 do an ambulance ride-along or EMS training? 747 00:36:07,372 --> 00:36:10,168 Something that could really get them thinking on their feet, you know? 748 00:36:10,193 --> 00:36:14,896 It could help them in the ER or in situations like today in the OR. 749 00:36:15,556 --> 00:36:19,698 I think you should write up a proposal and send it to me. 750 00:36:23,375 --> 00:36:24,756 The surgery went well. 751 00:36:24,781 --> 00:36:27,021 We were able to clear the clot and put in a stent. 752 00:36:27,046 --> 00:36:28,082 Thank you. 753 00:36:28,107 --> 00:36:29,886 You'll need to be on anticoagulation 754 00:36:29,911 --> 00:36:33,329 but after a while, you'll be able to get back to life as usual. 755 00:36:34,083 --> 00:36:37,535 I'll get back to life as usual right away or... 756 00:36:37,560 --> 00:36:39,206 "When can I have sex?" is what I'm asking. 757 00:36:39,231 --> 00:36:40,715 Yeah, we know. 758 00:36:40,740 --> 00:36:42,470 You need to elevate your leg when resting 759 00:36:42,495 --> 00:36:45,360 but other than that, it is good to move it around. 760 00:36:47,193 --> 00:36:49,022 I guess Trudy can still see the doctor. 761 00:36:49,137 --> 00:36:51,726 Trudy's always a good time. 762 00:36:51,879 --> 00:36:56,136 But, honey, I love you most when you're just Janet. 763 00:36:58,017 --> 00:36:59,225 Oh. 764 00:36:59,250 --> 00:37:00,665 We'll give you some privacy. 765 00:37:12,553 --> 00:37:14,417 I checked London's labs before leaving. 766 00:37:15,371 --> 00:37:16,371 Thanks. 767 00:37:16,557 --> 00:37:18,352 Hey, I'm sorry about earlier. 768 00:37:18,748 --> 00:37:20,903 How you interact with your patients, your business. 769 00:37:20,928 --> 00:37:22,032 I'll stay out of it. 770 00:37:22,310 --> 00:37:23,864 I appreciate that. 771 00:37:24,835 --> 00:37:27,562 I do value your opinion though. 772 00:37:28,204 --> 00:37:29,826 - You do? - I do. 773 00:37:29,902 --> 00:37:35,598 Just, uh, not about relationships. For obvious reasons. 774 00:37:35,623 --> 00:37:38,127 Ouch. 775 00:37:38,152 --> 00:37:40,879 Hey, look, I'm, uh, putting together a watch list for my patient. 776 00:37:41,459 --> 00:37:42,632 What am I missing? 777 00:37:42,739 --> 00:37:44,845 Mmm. 778 00:37:46,402 --> 00:37:49,750 Wait, she hasn't seen any of these? 779 00:37:57,022 --> 00:37:58,334 Hey. 780 00:37:58,898 --> 00:38:00,037 Hi. 781 00:38:00,391 --> 00:38:02,047 Did you make it through your busy day? 782 00:38:02,150 --> 00:38:04,187 Uh, I did. 783 00:38:04,931 --> 00:38:07,915 Uh, I did a thrombectomy and placed a stent. 784 00:38:07,940 --> 00:38:10,011 Nice, Millin. 785 00:38:10,036 --> 00:38:12,396 You still haven't told me about that thoracotomy, by the way. 786 00:38:12,913 --> 00:38:15,029 It wasn't that big a deal. 787 00:38:15,101 --> 00:38:17,591 Uh, you saved a man's life with your hands. 788 00:38:18,219 --> 00:38:19,704 Doesn't get any bigger than that. 789 00:38:22,393 --> 00:38:23,877 Do you think I'm aloof? 790 00:38:25,124 --> 00:38:29,024 Aloof? Thank you. Um... 791 00:38:29,370 --> 00:38:30,440 No. 792 00:38:31,145 --> 00:38:33,803 No, you're discerning, you don't suffer any fools. 793 00:38:33,828 --> 00:38:36,590 But... ... that's not aloof. 794 00:38:36,782 --> 00:38:40,927 That's, um, just protecting yourself because you care. 795 00:38:43,777 --> 00:38:47,056 It's funny you say that because I-I have been... 796 00:38:47,525 --> 00:38:50,079 I had the worst day. 797 00:38:50,104 --> 00:38:52,706 I need the biggest vodka tonic that they have. 798 00:38:53,307 --> 00:38:55,136 Hi, I'm Iris. 799 00:38:55,161 --> 00:38:57,284 Uh, this is Jules Millin, a surgical resident. 800 00:38:57,688 --> 00:38:59,208 - Nice to meet you. - Nice to meet you. 801 00:38:59,233 --> 00:39:02,549 Um, I should go find my friends. 802 00:39:03,877 --> 00:39:05,327 - Here. - Thank you. 803 00:39:05,441 --> 00:39:06,718 See you later. 804 00:39:07,009 --> 00:39:09,494 It's jarring when your identity shifts. 805 00:39:09,519 --> 00:39:12,902 When you're suddenly a doctor, a partner, a parent. 806 00:39:13,834 --> 00:39:16,388 It helps if you focus on the things that haven't changed. 807 00:39:16,557 --> 00:39:18,283 I'm gonna have to change hospitals. 808 00:39:19,144 --> 00:39:21,353 I've cried in front of too many people at this one. 809 00:39:21,644 --> 00:39:22,887 They understand. 810 00:39:25,570 --> 00:39:29,815 I just feel like ever since I was admitted, I just... 811 00:39:30,437 --> 00:39:32,370 I just lost myself. 812 00:39:34,233 --> 00:39:35,959 I can't take care of our kids. 813 00:39:36,097 --> 00:39:40,067 I can't take care of my patients. I can't even shower. 814 00:39:40,205 --> 00:39:41,482 It's temporary. 815 00:39:42,207 --> 00:39:43,954 Your heart is recovering. 816 00:39:43,979 --> 00:39:45,222 I know. 817 00:39:46,107 --> 00:39:52,320 But... for a few hours today, I got to be a doctor again 818 00:39:52,459 --> 00:39:54,890 and help this woman navigate a difficult time 819 00:39:54,915 --> 00:40:01,162 but then when it really mattered... someone else got to help her. 820 00:40:02,641 --> 00:40:04,125 At least Gina is okay. 821 00:40:04,988 --> 00:40:09,061 And I would bet that she'd say what you did mattered too. 822 00:40:10,857 --> 00:40:12,203 Maybe even more. 823 00:40:14,215 --> 00:40:16,225 Oh, God. It's happening again. 824 00:40:17,048 --> 00:40:20,500 - No. - I'll get the tissues. 825 00:40:22,868 --> 00:40:27,114 Just... 826 00:40:27,905 --> 00:40:29,458 The comfort of old friends. 827 00:40:29,496 --> 00:40:32,483 Thirty-five pounds? That's like carrying four babies. 828 00:40:32,508 --> 00:40:34,303 Yeah, or four bowling balls. 829 00:40:34,328 --> 00:40:36,986 - Who carries four bowling balls? - People do weird things. 830 00:40:37,010 --> 00:40:39,859 - Gotta go. 831 00:40:44,580 --> 00:40:46,029 Yeah, I'm out too. 832 00:40:47,099 --> 00:40:48,273 See you tomorrow. 833 00:40:56,248 --> 00:40:58,906 She's just a stop sign, not a roadblock. 834 00:40:58,931 --> 00:40:59,931 How did you... 835 00:41:02,114 --> 00:41:05,359 Doesn't matter. Wait, are you leaving me too? 836 00:41:05,384 --> 00:41:09,335 Um, sorry. Um, hey, have a drink on me. 837 00:41:15,025 --> 00:41:16,026 Anyone sitting here? 838 00:41:21,505 --> 00:41:23,145 The thrill of trying something new. 839 00:41:23,170 --> 00:41:24,723 Hi, I'm Sally. 840 00:41:24,900 --> 00:41:27,181 Because even though you may not recognize yourself. 841 00:41:27,673 --> 00:41:32,490 - Catherine. - I'm sorry. I am so sorry. 842 00:41:32,741 --> 00:41:35,709 I got scared and I just called the best that I knew. 843 00:41:35,734 --> 00:41:37,712 I should've talked to you before bringing Laura in. 844 00:41:37,736 --> 00:41:43,303 Look, I thought a lot about letting fear cloud judgment today. 845 00:41:43,328 --> 00:41:45,953 Whatever you wanna do, I support... 846 00:41:46,994 --> 00:41:48,305 I'm a surgeon. 847 00:41:48,599 --> 00:41:50,601 I'm a senior member of this hospital. 848 00:41:51,652 --> 00:41:53,067 If something were to go wrong 849 00:41:53,096 --> 00:41:56,341 and I couldn't stand long enough to do a simple appy, 850 00:41:56,479 --> 00:41:59,482 I'd feel... weak. 851 00:42:00,552 --> 00:42:02,174 And I don't know how to lead like that. 852 00:42:02,606 --> 00:42:04,125 I don't know who I'd be. 853 00:42:05,282 --> 00:42:06,663 But people adapt. 854 00:42:07,400 --> 00:42:09,057 I wanna go ahead with the surgery. 855 00:42:15,435 --> 00:42:17,265 It's been you all along. 856 00:42:18,155 --> 00:42:23,155 - Synced and corrected by ChrisKe - — for www.addic7ed.com —