1 00:00:06,790 --> 00:00:09,172 If you think choosing a college major is hard, 2 00:00:09,388 --> 00:00:12,066 wait until you have to choose your medical specialty. 3 00:00:12,573 --> 00:00:15,680 How late were you up researching treatments for that patient? 4 00:00:15,910 --> 00:00:18,027 - Late. - You need sleep. 5 00:00:18,052 --> 00:00:19,053 I'll get right on that. 6 00:00:19,304 --> 00:00:21,134 You have no idea how many emails you get 7 00:00:21,159 --> 00:00:24,265 until you come back from a three-month sabbatical. 8 00:00:24,403 --> 00:00:25,922 Delete all. 9 00:00:26,060 --> 00:00:27,700 Wait. What if some of those are important? 10 00:00:27,725 --> 00:00:29,520 I'm practicing healthy boundaries. 11 00:00:29,649 --> 00:00:31,941 If they need me, they can pick up the phone. 12 00:00:34,319 --> 00:00:36,390 It's not just what medicine you'll practice, 13 00:00:36,426 --> 00:00:37,945 it's your whole life. 14 00:00:37,970 --> 00:00:40,050 Hey, should I pull the drains on Mr. Sherwood before we round? 15 00:00:40,074 --> 00:00:41,834 Uh, no, Adams can do that. 16 00:00:41,972 --> 00:00:45,148 Um, Toni Wright is down a resident, 17 00:00:45,286 --> 00:00:48,462 so I took the liberty of moving you to her service. 18 00:00:48,600 --> 00:00:49,877 I hope that's okay. 19 00:00:50,431 --> 00:00:52,329 - Dr. Toni Wright? - Yeah. 20 00:00:52,436 --> 00:00:56,065 NIH grant recipient for research on myofibroblasts for wound healing, 21 00:00:56,090 --> 00:00:59,059 - pioneer in lymphedema, Dr. Toni Wright? - Oh. 22 00:00:59,197 --> 00:01:00,385 Yes. 23 00:01:00,784 --> 00:01:02,314 Okay, yeah. I may have read up on her. 24 00:01:02,338 --> 00:01:04,512 - Play it cool. - Yeah, I gotta go prep. 25 00:01:04,650 --> 00:01:07,308 - Ben Warren? - Hey, hey, hey. Come on. I... 26 00:01:07,446 --> 00:01:09,103 Look, I was born cool. 27 00:01:09,452 --> 00:01:10,522 Uh, okay. 28 00:01:11,450 --> 00:01:12,520 Oh, my God. 29 00:01:13,355 --> 00:01:15,633 I'm playing. I'm playing. 30 00:01:16,593 --> 00:01:18,119 Who you'll work with, 31 00:01:18,144 --> 00:01:21,435 whether you'll be home in time for dinner or never see your kids. 32 00:01:21,460 --> 00:01:23,773 I love how they think we have time to go to the doctor. 33 00:01:24,182 --> 00:01:25,754 Last year, I had a dental student 34 00:01:25,778 --> 00:01:27,648 pull one of my teeth in the cath lab. 35 00:01:27,673 --> 00:01:30,124 Have you considered egg freezing? 36 00:01:30,987 --> 00:01:32,533 Have I considered giving myself a series 37 00:01:32,557 --> 00:01:34,138 of shots and screwing up my hormones 38 00:01:34,163 --> 00:01:36,037 and then going through an uncomfortable procedure 39 00:01:36,062 --> 00:01:38,832 and then paying forever to store my eggs in a freezer 40 00:01:38,857 --> 00:01:40,376 on the chance that I might want kids? 41 00:01:40,529 --> 00:01:41,806 You could have just said, "No." 42 00:01:43,448 --> 00:01:46,184 I might do it. I wanna keep my options open. 43 00:01:46,209 --> 00:01:49,523 Why do they need to know when your mom had her first period? 44 00:01:49,548 --> 00:01:51,396 Oh. I hope they don't, 45 00:01:51,421 --> 00:01:53,428 'cause I have no idea and no way to ask. 46 00:01:53,452 --> 00:01:54,838 Oh, smoothies. 47 00:01:54,863 --> 00:01:58,885 The choice is yours, and so are the consequences. 48 00:02:00,913 --> 00:02:01,983 - Hey. - Hey. 49 00:02:04,607 --> 00:02:07,196 Hey, so my lawyer wanted to check in. 50 00:02:07,447 --> 00:02:10,243 I still haven't received any papers to sign. 51 00:02:10,268 --> 00:02:11,822 Yeah, I still have them. 52 00:02:11,847 --> 00:02:13,811 Your lawyer mentioned wanting 53 00:02:13,835 --> 00:02:15,445 to file before the end of the month. 54 00:02:16,377 --> 00:02:18,621 I-I just... I-I've been slammed with work. 55 00:02:18,759 --> 00:02:20,155 If we don't do it soon, they're gonna 56 00:02:20,179 --> 00:02:21,496 make us pay additional retainers. 57 00:02:21,520 --> 00:02:23,228 I am aware. I'm... I'm sorry. 58 00:02:23,253 --> 00:02:25,776 I-I have a consult, but I will... I will get to them as soon as I can. 59 00:02:25,800 --> 00:02:27,561 Okay. 60 00:02:27,699 --> 00:02:29,552 Dr. Morales to the ICU. 61 00:02:29,576 --> 00:02:31,047 Dr. Martha Morales to the ICU. 62 00:02:33,014 --> 00:02:34,715 - Dr. Wright, Ben Warren. - Hey. 63 00:02:34,740 --> 00:02:36,373 - Thrilled to be on your service. - Nice to meet you. 64 00:02:36,397 --> 00:02:38,349 Benson, back on my service again? 65 00:02:38,374 --> 00:02:40,342 Yeah, I can't get enough, and people call me Blue. 66 00:02:40,367 --> 00:02:43,163 - After the Joni Mitchell album? - No. 67 00:02:43,188 --> 00:02:46,175 Oh. Well, that's too bad. It's one of the all-time greats. 68 00:02:46,200 --> 00:02:48,123 I applied to three colleges in California 69 00:02:48,148 --> 00:02:49,868 solely because I thought it'd be cool 70 00:02:49,893 --> 00:02:53,182 to sing that line about coming home there and literally mean it. 71 00:02:53,207 --> 00:02:54,691 Do either of you play guitar? 72 00:02:54,961 --> 00:02:56,963 - Um, not really. - A little. 73 00:02:57,384 --> 00:02:59,455 - Well... - Um... 74 00:03:00,154 --> 00:03:03,468 Uh, listen, um, feel free to push me. You know, I like to work hard, 75 00:03:03,493 --> 00:03:05,830 and I'm actually applying for a plastics fellowship. 76 00:03:06,238 --> 00:03:07,239 Good for you. 77 00:03:09,030 --> 00:03:10,630 You should have told her you play guitar. 78 00:03:14,159 --> 00:03:16,799 Five minutes to answer a page? Patient could have died in that time. 79 00:03:16,824 --> 00:03:19,010 - Did somebody die? - That's irrelevant. 80 00:03:21,822 --> 00:03:23,755 - What do we got? - Randall Lutton, 62. 81 00:03:23,780 --> 00:03:26,767 He has scrotal swelling and severe pain after blunt trauma. 82 00:03:26,792 --> 00:03:29,922 BP is slightly elevated. Gave two of morphine en route. 83 00:03:30,513 --> 00:03:32,343 Oh, God, it hurts like hell. 84 00:03:32,532 --> 00:03:34,465 Yeah, we're gonna get you more inside, okay? 85 00:03:34,490 --> 00:03:36,261 I got up to use the bathroom in the middle of the night 86 00:03:36,285 --> 00:03:37,907 and walked right into the dresser. 87 00:03:38,372 --> 00:03:40,273 I'm gonna need an ultrasound and some gel. 88 00:03:40,298 --> 00:03:42,429 - Are you a doctor? - Urologist. 89 00:03:42,567 --> 00:03:44,293 No need to comment on the irony. 90 00:03:44,318 --> 00:03:47,493 Okay. Let's get him to trauma one. 91 00:03:51,157 --> 00:03:53,898 Hey, Corban, just double-checking you're getting your IV antibiotics 92 00:03:53,923 --> 00:03:55,338 before rounds with Dr. Altman. 93 00:03:55,554 --> 00:03:58,488 Um, do you think you could slip me the staff Wi-Fi password? 94 00:03:59,135 --> 00:04:00,723 I know the guest Wi-Fi is spotty, 95 00:04:00,748 --> 00:04:03,804 but ours is used for things like imaging and staff messaging, 96 00:04:03,829 --> 00:04:05,175 so they're pretty strict about it. 97 00:04:05,314 --> 00:04:06,660 Well, could you make an exception? 98 00:04:07,385 --> 00:04:09,984 I just... I really want to see my cousin get married in Big Sur today. 99 00:04:10,008 --> 00:04:12,208 Second cousin, second marriage, and he's not that great. 100 00:04:18,428 --> 00:04:22,079 - You didn't get it from me. - Thank you. 101 00:04:22,337 --> 00:04:24,856 Somehow, I am always in the hospital for 102 00:04:24,880 --> 00:04:26,897 my friends' and family's big life events. 103 00:04:26,922 --> 00:04:30,063 This is his second aortic graft to get infected in a year. 104 00:04:30,580 --> 00:04:31,970 No offense to Dr. Altman, 105 00:04:31,995 --> 00:04:34,904 but if this one doesn't take, we need a second opinion. 106 00:04:34,929 --> 00:04:37,207 Well, Dr. Altman's extremely skilled. 107 00:04:37,232 --> 00:04:40,040 She's even kind of famous now. She invented a new surgery. 108 00:04:40,456 --> 00:04:41,914 Yeah, but like a difficult one? 109 00:04:42,878 --> 00:04:46,320 Don't look at me like that. I already know I'm becoming Mom. 110 00:04:46,345 --> 00:04:48,692 Surgery's incredibly complicated. 111 00:04:49,569 --> 00:04:51,345 She's on a podcast. You can look it up. 112 00:04:52,292 --> 00:04:53,820 Told you. I just have bad luck. 113 00:04:53,845 --> 00:04:56,245 Well, hopefully the new TEVAR gives your aorta a break 114 00:04:56,270 --> 00:04:58,307 so... the antibiotics can do their job. 115 00:04:58,386 --> 00:05:00,043 That's what you said last time. 116 00:05:01,614 --> 00:05:02,788 I'll be back soon. 117 00:05:03,106 --> 00:05:05,591 Dr. Miley Tokugawa to the ER. 118 00:05:08,273 --> 00:05:09,704 Welcome back, Dr. Shepherd. 119 00:05:09,729 --> 00:05:12,115 Have you met our new plastics attending, Dr. Toni Wright? 120 00:05:12,252 --> 00:05:14,116 Relatively new. Nice to meet you. 121 00:05:14,254 --> 00:05:16,463 We should get started. It's a LeFort fracture. 122 00:05:16,488 --> 00:05:18,145 I'm sure there will be questions. 123 00:05:19,111 --> 00:05:22,356 - Did you see that? - Uh, yes. Um, yeah, I don't know. 124 00:05:22,494 --> 00:05:25,571 - I don't think she remembers me. - Should she? 125 00:05:25,596 --> 00:05:28,071 We went to med school together. We were in the same study group. 126 00:05:28,096 --> 00:05:29,373 She hated me. 127 00:05:29,398 --> 00:05:31,318 Oh, well, maybe it's better she doesn't remember. 128 00:05:34,403 --> 00:05:36,980 Teresa Daniels, 49, post-op day five from 129 00:05:37,004 --> 00:05:39,693 a hemicraniectomy for subdural hematoma 130 00:05:39,718 --> 00:05:41,695 after auto versus pedestrian. 131 00:05:41,720 --> 00:05:43,663 Concomitant LeFort I fractures. 132 00:05:43,688 --> 00:05:45,768 Please say you're fixing my mom's face today. 133 00:05:45,793 --> 00:05:47,588 Well, that's up to Dr. Shepherd. 134 00:05:47,613 --> 00:05:49,030 She'll tell us if your mom's head bleed 135 00:05:49,055 --> 00:05:50,134 has healed enough for us to proceed. 136 00:05:50,159 --> 00:05:53,007 I'll do a neuro exam on her now and make sure the EVD's working. 137 00:05:54,146 --> 00:05:57,564 - So, uh, what are you studying? - Uh, data science. 138 00:05:57,702 --> 00:06:00,256 I was going to major in it, but the intro course is hard. 139 00:06:00,281 --> 00:06:02,490 I'm a freshman at UC Davis. 140 00:06:02,741 --> 00:06:04,774 Do you have a study group? 141 00:06:05,168 --> 00:06:07,342 - I haven't found the right people. - Oh. 142 00:06:07,367 --> 00:06:09,156 Does make a big difference. 143 00:06:09,189 --> 00:06:10,915 My mom says to stick with it. 144 00:06:10,940 --> 00:06:12,969 I was complaining to her about it on the phone 145 00:06:12,993 --> 00:06:15,685 when she got... hit by that idiot driver. 146 00:06:16,373 --> 00:06:17,904 That's awful. I'm so sorry. 147 00:06:17,929 --> 00:06:19,724 She'll be happy to see you when she wakes up. 148 00:06:19,791 --> 00:06:22,069 ICP is 12 and subdural is stable. 149 00:06:22,219 --> 00:06:23,910 Great. So we're good to go. 150 00:06:23,935 --> 00:06:27,317 Let's order a CT max/face before bringing her to the OR. 151 00:06:34,146 --> 00:06:35,749 Hey. Sorry I'm late. 152 00:06:35,774 --> 00:06:38,294 How was Cousin Frank's wedding? Were you able to stream it? 153 00:06:40,330 --> 00:06:41,514 Still no contractions? 154 00:06:41,672 --> 00:06:43,774 Don't jinx it. 155 00:06:44,749 --> 00:06:46,233 - Okay. - Uh, Dr. Meade. 156 00:06:46,785 --> 00:06:48,935 Corban Gregory, 28-year-old male. 157 00:06:48,960 --> 00:06:51,903 Status, post-coarctation repair when he was two. 158 00:06:51,928 --> 00:06:55,000 He subsequently had two graft repairs, both became infected. 159 00:06:55,025 --> 00:06:56,977 Has now developed a pseudoaneurysm 160 00:06:57,002 --> 00:06:58,590 and is here today for his second TEVAR. 161 00:06:59,417 --> 00:07:01,695 You made somebody a new aorta? 162 00:07:01,904 --> 00:07:04,631 He's stalking you online. I told him it was weird. 163 00:07:04,656 --> 00:07:08,048 And it said that the patient had two repeat graft infections too. 164 00:07:09,265 --> 00:07:12,096 - Can I get this? - A TEVAR is still a solution for you. 165 00:07:12,121 --> 00:07:13,916 It's less invasive and less risky. 166 00:07:14,585 --> 00:07:16,103 For me or for you? 167 00:07:16,726 --> 00:07:20,345 Corban, the patient that you're reading about was much sicker. 168 00:07:20,370 --> 00:07:22,796 I don't want another Band-Aid if there's a permanent fix. 169 00:07:22,821 --> 00:07:25,316 I don't want to diminish what you're going through, but... 170 00:07:25,341 --> 00:07:27,067 You think you know what I'm going through? 171 00:07:27,585 --> 00:07:28,931 My favorite thing is running, 172 00:07:28,956 --> 00:07:31,407 but I can't remember the last time I had a runner's high. 173 00:07:31,771 --> 00:07:33,600 I won't be able to lift my baby nephew. 174 00:07:33,738 --> 00:07:35,844 I can't travel. I can't visit my friends. 175 00:07:35,869 --> 00:07:38,640 I have spent more time in the CCU than my own house in the last year. 176 00:07:38,665 --> 00:07:40,460 Is that not sick enough for you? 177 00:07:41,880 --> 00:07:44,084 - What, you just don't care? - That's not true. 178 00:07:44,109 --> 00:07:47,743 - Then why won't you fix me? - I wish there was an easy fix. 179 00:07:47,881 --> 00:07:49,123 Just get out. 180 00:07:50,893 --> 00:07:53,127 - Get out! - Okay. 181 00:08:01,018 --> 00:08:06,018 - Synced and corrected by ChrisKe - — for www.addic7ed.com — 182 00:08:11,685 --> 00:08:14,165 It's a larger patient load than usual, 183 00:08:14,190 --> 00:08:15,368 but with two of you... 184 00:08:15,399 --> 00:08:19,232 Adams, please tell me that you were at the benefits fair 185 00:08:19,257 --> 00:08:21,381 or rounding or anything but late. 186 00:08:21,406 --> 00:08:23,167 Sorry, I was on the phone with Boise General. 187 00:08:23,192 --> 00:08:25,539 They don't have Katie Rogers's immunotherapy either. 188 00:08:25,564 --> 00:08:27,101 Well, the government cut off funding. 189 00:08:27,126 --> 00:08:28,344 You're not going to find it. 190 00:08:28,369 --> 00:08:31,081 Okay, what about cytoreduction surgery with HIPEC? 191 00:08:31,106 --> 00:08:32,107 What about it? 192 00:08:32,132 --> 00:08:34,203 Well, could Katie be a candidate for it? 193 00:08:34,364 --> 00:08:36,352 I-I emailed you the case report. 194 00:08:36,377 --> 00:08:39,494 Okay, no. I appreciate your initiative, and I will look at it. 195 00:08:39,519 --> 00:08:42,523 But right now, I need you to focus on patients that are currently 196 00:08:42,547 --> 00:08:44,316 - admitted to the hospital. - Okay. 197 00:08:44,341 --> 00:08:48,995 We're down two residents due to illness and a family wedding, 198 00:08:49,020 --> 00:08:53,310 so I need you and Spencer to get started on the floor, okay? 199 00:08:53,335 --> 00:08:56,580 Ms. Hayes needs a Dobhoff tube for tube feeds. 200 00:08:57,019 --> 00:09:01,101 Ooh. Well, I've never inserted an NG tube on a real person 201 00:09:01,196 --> 00:09:04,993 - o-or a fake one, so... - Well, um, Adams will help you. 202 00:09:05,061 --> 00:09:07,719 - Don't forget to check your email. - I... 203 00:09:09,627 --> 00:09:11,422 Just keep taking deep breaths. 204 00:09:11,447 --> 00:09:13,311 New pain medication should kick in any second. 205 00:09:13,675 --> 00:09:15,090 Can I take a look? 206 00:09:15,451 --> 00:09:17,453 Yeah. 207 00:09:17,591 --> 00:09:20,490 Wow, that looks painful. 208 00:09:20,515 --> 00:09:22,689 Last I checked, it measured 20 centimeters. 209 00:09:22,941 --> 00:09:25,565 I suspect a bleeding testicular artery. Do you see anything? 210 00:09:25,816 --> 00:09:28,011 I, uh... It looks like it's expanding. 211 00:09:28,036 --> 00:09:30,441 Let's get an ultrasound and page urology. 212 00:09:30,466 --> 00:09:32,927 Was the dresser sharp? I mean, I do see a couple of small lesions. 213 00:09:32,951 --> 00:09:34,901 I-I must have just snagged a drawer pull. 214 00:09:34,926 --> 00:09:39,692 Oh, okay. Well, let's get him some more fluids and a full set of labs. 215 00:09:39,717 --> 00:09:41,442 Okay. 216 00:09:41,581 --> 00:09:42,903 Well, the testicles are intact and 217 00:09:42,927 --> 00:09:44,831 - they're in the correct position... - Okay. 218 00:09:44,856 --> 00:09:47,517 but I do see some free fluid in the scrotum. 219 00:09:48,277 --> 00:09:49,830 Oh, my God, Randall. 220 00:09:50,081 --> 00:09:51,427 Is it his heart? 221 00:09:51,452 --> 00:09:53,132 Uh, no, no. My heart's just fine. 222 00:09:53,178 --> 00:09:54,628 Doctors, this is my wife Kimmy. 223 00:09:54,653 --> 00:09:55,861 - Hey. - Hi. 224 00:09:58,701 --> 00:10:00,097 Is that one of your... 225 00:10:00,122 --> 00:10:03,229 Yeah, I walked into the dresser. 226 00:10:03,543 --> 00:10:05,027 Probably just a hematoma. 227 00:10:05,052 --> 00:10:07,961 Is this gonna jack your fertility? I ovulate next week. 228 00:10:07,986 --> 00:10:09,885 We're going to give you some privacy. 229 00:10:13,435 --> 00:10:15,402 Dr. Neil, dial radiology. 230 00:10:15,427 --> 00:10:17,177 Oh. 231 00:10:17,202 --> 00:10:18,997 You've been back three hours 232 00:10:19,022 --> 00:10:22,750 and you've already requested a new 3D microscope with AR tech? 233 00:10:23,001 --> 00:10:25,797 Why are you reading emails when you are supposed to be on leave? 234 00:10:25,822 --> 00:10:27,479 Catherine finally left the house. 235 00:10:27,504 --> 00:10:30,233 If that woman makes me take one more nap, I'm going to lose my mind. 236 00:10:30,258 --> 00:10:31,466 Um... 237 00:10:31,665 --> 00:10:34,323 When did you hire Toni Wright? 238 00:10:34,575 --> 00:10:35,610 A few months ago. 239 00:10:35,635 --> 00:10:37,084 I was surprised we got her. 240 00:10:37,109 --> 00:10:39,260 Jackson says she's the go-to for facial reconstruction. 241 00:10:39,285 --> 00:10:42,564 Well... Jackson is the go-to for facial reconstruction. 242 00:10:43,391 --> 00:10:46,544 - Is there a problem? - I just... I just spent the last few 243 00:10:46,568 --> 00:10:47,761 months getting to a really good place. 244 00:10:47,785 --> 00:10:49,658 I took Scout camping. 245 00:10:49,683 --> 00:10:52,705 I went to the grocery store during normal hours. I slept... 246 00:10:52,730 --> 00:10:54,249 You need to get to the point. 247 00:10:54,387 --> 00:10:58,149 Wright and I have a history, in that... 248 00:10:58,174 --> 00:11:02,178 in that, historically, she... pushes my buttons. 249 00:11:02,316 --> 00:11:05,561 If I hired people based on whose buttons they pushed, 250 00:11:05,699 --> 00:11:07,651 no one could work at this damn hospital. 251 00:11:07,676 --> 00:11:10,161 And your request for a microscope is denied. 252 00:11:10,186 --> 00:11:13,086 Oh. 253 00:11:21,384 --> 00:11:22,790 You know, I, uh... 254 00:11:22,815 --> 00:11:26,202 I read that you won the Goldstein Award for excellence in teaching. 255 00:11:27,204 --> 00:11:29,724 - Mmm? - Um... 256 00:11:29,986 --> 00:11:31,263 No. 257 00:11:38,490 --> 00:11:42,425 So, you know, you must be an excellent teacher. 258 00:11:42,641 --> 00:11:44,471 That's the name of the award. 259 00:11:47,287 --> 00:11:49,116 - She is all set. - Okay. 260 00:11:57,882 --> 00:11:59,781 Oh. Yeah. 261 00:12:00,998 --> 00:12:04,622 Oh, her nasofrontal and ZF sutures are broken. 262 00:12:04,840 --> 00:12:05,944 Good. What else? 263 00:12:06,035 --> 00:12:08,003 Her zygomatic arch is comminuted. 264 00:12:08,028 --> 00:12:09,970 And it's a LeFort III, not a LeFort I. 265 00:12:09,995 --> 00:12:12,051 Yeah. This just got a lot more complicated. 266 00:12:12,076 --> 00:12:13,212 Yeah. 267 00:12:13,237 --> 00:12:16,056 Should I call the OR? Let them know that we're gonna push the surgery? 268 00:12:16,080 --> 00:12:17,440 Her daughter's going to be crushed. 269 00:12:17,465 --> 00:12:19,165 No, we're not pushing anything. 270 00:12:19,456 --> 00:12:22,751 Every day that she's intubated, it makes it tougher for her to recover. 271 00:12:22,908 --> 00:12:27,533 We're just going to have to come up with a new plan, quickly. 272 00:12:28,851 --> 00:12:31,785 Dr. Traversa to radiology. Dr. Valentina Traversa... 273 00:12:32,036 --> 00:12:35,893 - Is he asleep? - Just resting. 274 00:12:36,445 --> 00:12:37,826 Did you get my scans back? 275 00:12:37,979 --> 00:12:40,809 Everything looks stable, so you're all set for the TEVAR. 276 00:12:42,451 --> 00:12:44,039 Corban. 277 00:12:44,694 --> 00:12:47,305 He was hoping you'd say that he got worse, 278 00:12:47,330 --> 00:12:50,399 so he could get that new aorta business. 279 00:12:50,424 --> 00:12:51,874 The TEVAR really might work. 280 00:12:51,899 --> 00:12:54,058 A new aorta would definitely work. 281 00:12:54,169 --> 00:12:57,086 If you survive it. 282 00:12:58,156 --> 00:12:59,744 I want to talk to the other guy, 283 00:12:59,769 --> 00:13:02,250 the doctor that did the new surgery with Dr. Altman. 284 00:13:02,275 --> 00:13:03,326 Dr. Ndugu? 285 00:13:03,351 --> 00:13:05,449 He could give me a second opinion, right? 286 00:13:05,474 --> 00:13:07,521 Dr. Altman should be in shortly. You can ask her any questions, 287 00:13:07,545 --> 00:13:09,271 - or you can... - I'm asking for Ndugu. 288 00:13:09,296 --> 00:13:10,897 This is my life. I'm not gonna ask 289 00:13:10,922 --> 00:13:12,707 permission to hear about all my options. 290 00:13:14,000 --> 00:13:15,054 Would you? 291 00:13:15,693 --> 00:13:17,937 Just give me ten minutes with him, please. 292 00:13:19,294 --> 00:13:20,968 I'll talk to him. No promises. 293 00:13:23,699 --> 00:13:25,494 Catherine, I didn't know you were here today. 294 00:13:25,519 --> 00:13:27,747 Oh. I had to get out of that house. 295 00:13:27,772 --> 00:13:30,602 For ten days, I've been taking care of my husband. 296 00:13:30,627 --> 00:13:32,131 I don't know how these nurses do it. 297 00:13:32,156 --> 00:13:34,710 All right, where's my consult? 298 00:13:35,098 --> 00:13:36,099 Randall? 299 00:13:36,470 --> 00:13:38,990 Randall, what are you doing here? 300 00:13:39,015 --> 00:13:40,120 Good to see ya. 301 00:13:40,145 --> 00:13:42,737 Oh. We missed you at the last AUA conference. 302 00:13:42,762 --> 00:13:45,351 - We were on our honeymoon. - Oh, that's right. 303 00:13:45,376 --> 00:13:47,673 So what... what brings you in? 304 00:13:47,698 --> 00:13:50,666 Uh, you... you have more important things to do. 305 00:13:50,691 --> 00:13:52,038 I can see a resident. 306 00:13:52,289 --> 00:13:53,600 Nonsense. I am here. 307 00:13:53,625 --> 00:13:54,903 Dr. Hunt, what we got? 308 00:13:54,928 --> 00:13:58,174 Blunt trauma. Now experiencing severe scrotal swelling. 309 00:13:58,199 --> 00:13:59,786 - Hmm. - It's the size of a coconut. 310 00:14:00,218 --> 00:14:02,669 Thank you, Dr. Millin, for that wonderful assessment. 311 00:14:02,783 --> 00:14:04,026 Randall, may I? 312 00:14:04,542 --> 00:14:05,716 Uh... 313 00:14:05,948 --> 00:14:07,501 You don't have to be here for this. 314 00:14:07,526 --> 00:14:10,686 Why don't you just go eat? I'm sure you're starving after Pilates. 315 00:14:10,711 --> 00:14:13,300 I'm not leaving your side. 316 00:14:13,551 --> 00:14:17,202 - How does it look? - Well, for a blunt trauma, it doesn't 317 00:14:17,339 --> 00:14:19,592 seem to follow the typical injury pattern. 318 00:14:19,617 --> 00:14:21,274 Will this mess up his sperm count? 319 00:14:21,412 --> 00:14:22,620 Yes, it will. 320 00:14:22,645 --> 00:14:25,253 From walking into a dresser? How is it this bad? 321 00:14:25,278 --> 00:14:28,148 I'll let Dr. Lutton answer that. 322 00:14:31,698 --> 00:14:34,287 I didn't walk into anything. 323 00:14:35,219 --> 00:14:38,015 Okay, please don't hate me. 324 00:14:38,739 --> 00:14:40,776 I gave myself a vasectomy last night. 325 00:14:40,801 --> 00:14:41,802 Oh. 326 00:14:43,365 --> 00:14:45,367 While I was at book club? 327 00:14:46,170 --> 00:14:48,448 - What the hell? - I will page psych. 328 00:14:48,473 --> 00:14:49,923 Mm-hmm. Yeah. 329 00:14:57,413 --> 00:14:58,593 - Keep swallowing. - Mmm, mmm. 330 00:14:58,618 --> 00:14:59,662 It pushes the tube 331 00:14:59,687 --> 00:15:01,165 - down your esophagus... - Mmm. 332 00:15:01,190 --> 00:15:03,744 - ... to your intestine. - Okay. 333 00:15:04,110 --> 00:15:05,630 - Does that look right? - Yeah. 334 00:15:05,663 --> 00:15:07,903 Keep going until you hit the mark we measured on the tube. 335 00:15:08,390 --> 00:15:10,910 - You sure you know what you're doing? - Uh... 336 00:15:10,935 --> 00:15:13,040 She does. Keep sipping. 337 00:15:13,291 --> 00:15:14,879 - Chin down. - Is-Is that mine? 338 00:15:15,130 --> 00:15:17,063 My catsitter's supposed to be calling. 339 00:15:17,189 --> 00:15:18,294 Uh, excuse me. 340 00:15:18,848 --> 00:15:20,133 Hi, this is Dr. Adams. 341 00:15:20,158 --> 00:15:23,069 Uh, yeah. Uh, actually, I'm with a patient right now. 342 00:15:23,094 --> 00:15:24,958 Can I call you back? 343 00:15:28,553 --> 00:15:30,421 Okay, I'm done. 344 00:15:30,446 --> 00:15:31,922 All right, looks good. 345 00:15:31,947 --> 00:15:33,477 All right, pull out the stylet, secure 346 00:15:33,501 --> 00:15:34,530 the tube and start trickle tube feeds. 347 00:15:34,554 --> 00:15:36,521 Then we gotta do research for Dr. Bailey. 348 00:15:36,772 --> 00:15:38,671 She didn't mention anything about research. 349 00:15:38,696 --> 00:15:40,180 - It's for her patient. - Oh. 350 00:15:40,205 --> 00:15:43,124 Well, she's in luck. I'm really good at research. 351 00:15:43,149 --> 00:15:45,543 In med school, I-I presented a poster... 352 00:15:45,568 --> 00:15:48,129 Great. Finish up here and, uh, I'm gonna get started. 353 00:15:48,154 --> 00:15:49,672 Where you going? 354 00:15:49,942 --> 00:15:50,978 I'll text you. 355 00:15:52,424 --> 00:15:54,781 I'll text him. 356 00:15:56,937 --> 00:15:59,802 Hey. How's it going with Wright? 357 00:16:00,649 --> 00:16:03,462 - I have no idea. - Did you change services? 358 00:16:03,486 --> 00:16:06,206 No, I-I'm just getting zero vibe. 359 00:16:06,724 --> 00:16:08,873 Because you're over-vibing? 360 00:16:08,898 --> 00:16:10,885 No, no, no, no, no. Okay, I've been cool. 361 00:16:10,910 --> 00:16:13,809 No excessive praise, no impulsive moves. 362 00:16:13,834 --> 00:16:15,491 Well, just give it time. 363 00:16:16,665 --> 00:16:18,356 Hey, if it makes you feel better, 364 00:16:18,381 --> 00:16:21,817 I hear your residency director is very impressed. 365 00:16:22,005 --> 00:16:23,006 It does. 366 00:16:23,913 --> 00:16:25,900 - What were you even thinking? - Psych is on their way. 367 00:16:25,925 --> 00:16:29,273 That man doesn't need a psychiatrist. He needs a marriage counselor. 368 00:16:29,298 --> 00:16:31,931 You think he was successful doing it on himself? 369 00:16:31,956 --> 00:16:33,164 We'll find out. 370 00:16:33,189 --> 00:16:36,660 I gotta get him in an OR and evacuate that hematoma. 371 00:16:36,685 --> 00:16:40,206 Can I scrub in? I've never operated on a DIY vasectomy before. 372 00:16:40,231 --> 00:16:41,853 It'll be my second. 373 00:16:41,878 --> 00:16:44,229 Wait, you know somebody else who tried to do their own vasectomy? 374 00:16:44,254 --> 00:16:47,395 Another urologist. Said he was embarrassed. 375 00:16:47,420 --> 00:16:50,526 I don't know why these boys don't just pick up the phone and call me. 376 00:16:50,664 --> 00:16:53,115 It's just a hollow tube filled with sperm. 377 00:16:53,159 --> 00:16:56,059 - In fact, if you ever want one... - I-I'm good down here. 378 00:16:56,163 --> 00:16:58,603 - Go scrub in. - Uh, wait. 379 00:16:58,628 --> 00:17:02,548 Just let Kimmy get in another few rounds, then go prep him. 380 00:17:02,573 --> 00:17:05,231 laughingstock, and you'll be to blame. 381 00:17:06,818 --> 00:17:08,579 Can't even count how many fractures she has. 382 00:17:08,717 --> 00:17:10,167 Yeah, the number doesn't matter. 383 00:17:10,305 --> 00:17:12,532 Okay, so how-how do we plate her zygomatic arch? 384 00:17:12,557 --> 00:17:16,320 It's like tempered glass. There's nothing solid to screw into. 385 00:17:16,345 --> 00:17:17,549 Warren, any ideas? 386 00:17:18,074 --> 00:17:21,565 Uh, create a scaffold of cadaveric bone paste and BMP. 387 00:17:22,086 --> 00:17:23,086 You've studied this. 388 00:17:23,111 --> 00:17:25,398 No, I saw it once, years ago. I... 389 00:17:25,423 --> 00:17:28,702 I was an anesthesiologist before I went into surgery. Mmm. 390 00:17:29,669 --> 00:17:30,980 Interesting. 391 00:17:31,005 --> 00:17:33,751 Okay, so our first step is gonna be to wire her jaw 392 00:17:33,776 --> 00:17:35,778 with her bite in the proper place. 393 00:17:35,803 --> 00:17:38,727 We won't be able to have her orally intubated for anesthesia. 394 00:17:38,752 --> 00:17:41,138 Warren, trach or submental intubation? 395 00:17:41,163 --> 00:17:43,554 Oh, trach. It's a straight shot into the airway, 396 00:17:43,579 --> 00:17:45,350 less risky than going through the chin into the mouth. 397 00:17:45,374 --> 00:17:47,100 Spoken like an anesthesiologist. 398 00:17:47,125 --> 00:17:48,388 A plastic surgeon thinks it'll take 399 00:17:48,413 --> 00:17:49,734 her three months to heal from a trach. 400 00:17:49,758 --> 00:17:52,278 A submental incision will heal in a week. 401 00:17:52,627 --> 00:17:56,120 Kwan, what are the steps of a submental intubation? 402 00:17:57,607 --> 00:18:00,495 You make an incision under the chin and... 403 00:18:01,656 --> 00:18:02,795 Honestly, I-I don't know. 404 00:18:03,068 --> 00:18:04,748 Of course not. You're a gen surge resident. 405 00:18:04,773 --> 00:18:06,775 - You'll learn today. - Cool. 406 00:18:06,807 --> 00:18:08,932 It is. Take a look at this. 407 00:18:11,885 --> 00:18:15,172 So we would create a large segment of aorta with a synthetic graft, 408 00:18:15,197 --> 00:18:18,062 rerouting it from your chest to your abdomen, 409 00:18:18,087 --> 00:18:20,177 and then we would staple off the infected piece here 410 00:18:20,202 --> 00:18:21,617 and remove it at a later time. 411 00:18:21,642 --> 00:18:23,422 So then no more TEVAR procedures? 412 00:18:23,447 --> 00:18:26,105 If the surgery's successful, yes. That's the idea. 413 00:18:26,130 --> 00:18:28,427 And you really think this could be a success for me? 414 00:18:28,452 --> 00:18:29,533 I'd need to further study 415 00:18:29,557 --> 00:18:30,844 your case before I could answer that. 416 00:18:30,868 --> 00:18:33,040 So shoot me his latest imaging, and 417 00:18:33,065 --> 00:18:34,699 I want to do another echo. Before we... 418 00:18:34,724 --> 00:18:37,125 Dr. Ndugu? Excuse me, may I have a word, please? 419 00:18:37,150 --> 00:18:39,081 Sure. Yeah. Excuse us. 420 00:18:47,487 --> 00:18:48,660 Someone talk fast. 421 00:18:48,685 --> 00:18:50,645 - Corban asked for a second... - Not you. 422 00:18:51,095 --> 00:18:53,003 You're talking to my patient behind my back 423 00:18:53,028 --> 00:18:55,375 about a procedure that I've already said no to. 424 00:18:55,513 --> 00:18:57,170 Okay, I assumed you were aware. 425 00:18:57,195 --> 00:18:59,561 Don't do that. Don't put it on the resident 426 00:18:59,586 --> 00:19:02,046 to have the uncomfortable conversation with her attending. 427 00:19:02,071 --> 00:19:04,631 Your patient asked if he was a good candidate for a ventral aorta. 428 00:19:04,808 --> 00:19:06,499 I simply explained what it was. 429 00:19:06,524 --> 00:19:08,043 No, you got his hopes up. 430 00:19:08,294 --> 00:19:09,847 And if you had come to me first, 431 00:19:09,872 --> 00:19:11,978 I would have explained that, unlike Nora, 432 00:19:12,116 --> 00:19:15,533 Corban has major scarring from a previous esophageal reconstruction. 433 00:19:15,558 --> 00:19:17,178 He is a bad candidate for it. 434 00:19:17,203 --> 00:19:19,306 How do we know who's a good candidate? We've done this once. 435 00:19:19,330 --> 00:19:22,299 And that might be all we ever do if we kill Corban with it. 436 00:19:22,860 --> 00:19:25,006 Nora hasn't even hit the six-month mark. 437 00:19:25,031 --> 00:19:27,206 We need more time to see how she does. 438 00:19:27,231 --> 00:19:29,371 Okay. All right. 439 00:19:31,041 --> 00:19:32,698 Dr. Altman, I'm sorry. I wasn't sure... 440 00:19:32,723 --> 00:19:35,691 How did Corban even know about the ventral aorta in the first place? 441 00:19:36,554 --> 00:19:39,316 If you shut me out again, you are off this case. 442 00:19:45,400 --> 00:19:46,436 I'm her boss. 443 00:19:46,990 --> 00:19:50,923 Didn't she make you chief while she was chief? 444 00:19:50,948 --> 00:19:53,709 Okay, well... Okay, so what? Now I owe her? 445 00:19:53,734 --> 00:19:55,081 If I made someone chief, 446 00:19:55,332 --> 00:19:58,414 and they gave my patient a second opinion behind my back, 447 00:19:58,439 --> 00:19:59,479 I would blow my stack too. 448 00:19:59,543 --> 00:20:00,923 Okay, yeah, yeah... 449 00:20:00,948 --> 00:20:03,503 that part was bad, but I'm not wrong. 450 00:20:03,754 --> 00:20:07,689 This surgery could cure all kinds of aortic disease, you know? 451 00:20:09,035 --> 00:20:12,211 Wait, Toni Wright just gave me the cold shoulder again. 452 00:20:12,700 --> 00:20:14,020 It's okay. I was pretty much done. 453 00:20:14,523 --> 00:20:18,364 Okay, she can do a supermicrosurgery in a 30x magnified field, 454 00:20:18,389 --> 00:20:19,692 but she can't say hi to me? 455 00:20:19,716 --> 00:20:21,944 Oh. Amelia, don't... 456 00:20:22,649 --> 00:20:24,916 I can't watch this. Nope. 457 00:20:26,052 --> 00:20:28,098 - Hi. - Hi. 458 00:20:28,123 --> 00:20:31,264 We went to med school together. You hated me. 459 00:20:31,565 --> 00:20:34,637 No. I didn't hate you. 460 00:20:35,331 --> 00:20:37,195 So you do remember me? 461 00:20:38,057 --> 00:20:39,093 Yeah. 462 00:20:42,319 --> 00:20:44,356 Wow. I should have thought this through. 463 00:20:44,381 --> 00:20:46,705 I don't really know what happens next. 464 00:20:47,729 --> 00:20:49,455 Why did you think I hated you? 465 00:20:49,706 --> 00:20:53,088 You ran out of your own birthday party when I showed up uninvited. 466 00:20:53,113 --> 00:20:55,081 - Oh, my God. - You changed study groups 467 00:20:55,219 --> 00:20:57,946 and actively avoided me in labs. 468 00:20:58,232 --> 00:20:59,751 Because I liked you. 469 00:21:00,397 --> 00:21:02,132 - What? - I tried to kiss you 470 00:21:02,157 --> 00:21:03,710 in The Mission during orientation. 471 00:21:04,263 --> 00:21:06,561 No, you were drunk. I thought... 472 00:21:06,586 --> 00:21:09,104 I thought you stumbled into... into me. 473 00:21:09,129 --> 00:21:12,280 No, I had a huge crush on you. 474 00:21:12,418 --> 00:21:15,041 I mean, I thought you were queer, but then I wasn't sure, 475 00:21:15,066 --> 00:21:18,035 so I didn't want to get burned, so I kept my distance. 476 00:21:18,399 --> 00:21:20,297 But you have nothing to worry about. 477 00:21:20,322 --> 00:21:24,741 This is all way in the past, and, um, frankly, you're not my type. 478 00:21:26,984 --> 00:21:28,157 My OR is ready. 479 00:21:31,324 --> 00:21:34,327 For some reason, I froze when I saw you earlier. 480 00:21:34,566 --> 00:21:35,981 I'm glad we cleared the air. 481 00:21:38,610 --> 00:21:40,163 I'm pretty sure Altman hates me. 482 00:21:40,333 --> 00:21:42,553 If she didn't kick you off the case, you're probably fine. 483 00:21:42,690 --> 00:21:44,070 Let's talk about something else. 484 00:21:44,208 --> 00:21:46,901 Uh, my patient tried to give himself a vasectomy. 485 00:21:46,926 --> 00:21:49,145 - Wow, we will always have jobs. - Mm-hmm. 486 00:21:49,169 --> 00:21:51,156 Everyone thinks they can do anything themselves 487 00:21:51,181 --> 00:21:53,597 if they watch enough videos on social media. 488 00:21:53,622 --> 00:21:55,417 He's a board-certified urologist. 489 00:21:55,641 --> 00:21:58,713 You know, that actually seems doable with some lidocaine and a mirror. 490 00:21:59,870 --> 00:22:02,448 OR's ready. I'm out. 491 00:22:05,669 --> 00:22:08,070 How come women in their 20s have to shell out big bucks 492 00:22:08,095 --> 00:22:09,372 to preserve their fertility, 493 00:22:09,397 --> 00:22:12,054 but men in their 60s are so worried about pregnancy, 494 00:22:12,079 --> 00:22:13,840 they are giving themselves vasectomies? 495 00:22:14,588 --> 00:22:15,893 Evolution failed us. 496 00:22:16,714 --> 00:22:20,408 Do it with me. Our future and less fertile selves will thank us. 497 00:22:20,659 --> 00:22:22,661 So we can both be hormonal at the same time? 498 00:22:22,686 --> 00:22:25,629 It's a hard pass, but I will do your shots. 499 00:22:25,654 --> 00:22:27,651 I am very good at giving injections. 500 00:22:28,552 --> 00:22:29,587 Don't ask why. 501 00:22:36,621 --> 00:22:39,175 You can have the other half of my sandwich if you're hungry. 502 00:22:39,391 --> 00:22:41,024 - I brought it from home. - Yeah, I'm good. 503 00:22:41,162 --> 00:22:43,026 Did you email me the results 504 00:22:43,051 --> 00:22:45,778 for the immunotherapy study from San Francisco? 505 00:22:45,803 --> 00:22:47,962 I included it in the Chicago study, at the bottom. 506 00:22:47,994 --> 00:22:49,616 - Okay. - I like to cook. 507 00:22:50,161 --> 00:22:53,347 Do you? It-It makes me happy following directions and... 508 00:22:53,372 --> 00:22:55,234 I wonder if we could file a compassionate 509 00:22:55,258 --> 00:22:57,181 use application for her meds. 510 00:22:57,494 --> 00:23:01,978 Or maybe we could get it off-label directly from the manufacturer. 511 00:23:03,138 --> 00:23:06,383 Why is this particular patient's research so important? 512 00:23:06,845 --> 00:23:09,777 I just meant, weren't there others in the trial? 513 00:23:09,802 --> 00:23:10,986 What about them? 514 00:23:11,011 --> 00:23:14,349 Look, I-I-I care about all the patients. I do. I just... 515 00:23:15,532 --> 00:23:18,889 I don't know. Katie... She's in her late twenties just like us. 516 00:23:18,914 --> 00:23:22,262 She feels like a classmate or more like a friend. 517 00:23:22,424 --> 00:23:27,670 We've just spent a lot of time together, so she is now kind of a friend. 518 00:23:29,028 --> 00:23:30,087 I get it. 519 00:23:30,439 --> 00:23:32,709 It's like when you meet someone and you 520 00:23:32,857 --> 00:23:34,502 feel like you've already met them before, 521 00:23:35,135 --> 00:23:38,207 like they're supposed to be in your life. 522 00:23:42,699 --> 00:23:44,493 Oh, no, it's-it's Wendy. 523 00:23:50,267 --> 00:23:51,752 Hey, may I come in? 524 00:23:56,133 --> 00:23:59,033 She wanted me to apologize. 525 00:23:59,103 --> 00:24:01,503 - Unbelievable. - It's okay. 526 00:24:01,938 --> 00:24:03,999 - Can we have a minute? - Sure. 527 00:24:05,616 --> 00:24:07,480 Don't say anything stupid. 528 00:24:07,618 --> 00:24:10,310 You're stressing me and the baby out enough. 529 00:24:13,659 --> 00:24:15,981 If you want Dr. Ndugu to replace your aorta, 530 00:24:16,006 --> 00:24:19,250 I won't stand in your way, but I do need you to hear me out first. 531 00:24:20,424 --> 00:24:21,494 Okay, talk. 532 00:24:21,569 --> 00:24:23,019 Okay. 533 00:24:26,393 --> 00:24:31,445 We have done this once on a person with very, very different anatomy 534 00:24:31,470 --> 00:24:34,344 who could have a complication at any moment. 535 00:24:34,482 --> 00:24:37,416 So it's not just a risk, it's a complete unknown. 536 00:24:37,441 --> 00:24:41,480 There is no way to know what will happen if we staple your aorta shut. 537 00:24:41,618 --> 00:24:43,136 And it is irreversible. 538 00:24:43,897 --> 00:24:48,254 If the staples don't hold and you hemorrhage, you'll die. 539 00:24:50,530 --> 00:24:53,615 I don't want to do this surgery on you because I want you to be able 540 00:24:53,640 --> 00:24:56,539 to meet your nephew and see your sister become a mom 541 00:24:56,564 --> 00:24:58,911 and go running again and visit your friends. 542 00:25:00,015 --> 00:25:04,399 And I know the idea of going through this again is infuriating, 543 00:25:04,424 --> 00:25:09,049 but at least... at least you'll still be alive. 544 00:25:18,125 --> 00:25:19,286 I'll give you more time. 545 00:25:25,830 --> 00:25:26,831 Thanks. 546 00:25:34,542 --> 00:25:37,200 Oh. Nice. You didn't skive at all. 547 00:25:37,225 --> 00:25:42,333 And now I will lift the scalp flap to expose the face. 548 00:25:43,491 --> 00:25:45,077 Hold up. What have you got there? 549 00:25:45,102 --> 00:25:46,138 A beaver blade. 550 00:25:46,163 --> 00:25:47,625 What, are you trying to keep us here all day? 551 00:25:47,649 --> 00:25:49,869 Plastic surgeons use this to make delicate incisions. 552 00:25:49,893 --> 00:25:51,664 Yeah, sure, if we're working on a cleft lip 553 00:25:51,688 --> 00:25:53,906 or somewhere where every millimeter counts. 554 00:25:53,931 --> 00:25:56,209 The scalp's robust. Get him the 15 blade. 555 00:26:03,492 --> 00:26:05,614 Make sure to stay in the same plane. 556 00:26:07,100 --> 00:26:08,205 Good. 557 00:26:09,276 --> 00:26:10,899 Oh, there's some fluid. 558 00:26:18,236 --> 00:26:19,721 Give me a specimen tube. 559 00:26:26,029 --> 00:26:27,341 Paper towel? 560 00:26:34,714 --> 00:26:37,040 - It's a halo sign. - Damn it, she's leaking CSF. 561 00:26:37,065 --> 00:26:38,514 We need neuro, now. 562 00:26:46,199 --> 00:26:47,312 What happened? 563 00:26:47,337 --> 00:26:49,653 She was fine. I started the trickle feeds and her sats dropped. 564 00:26:49,677 --> 00:26:50,648 What's wrong? 565 00:26:50,673 --> 00:26:52,517 Hold on, we're gonna find out. Just don't move. 566 00:26:55,614 --> 00:26:57,902 The tube is in her lung. Wait, you didn't see that on the X-ray? 567 00:26:57,926 --> 00:26:59,272 - What X-ray? - Let me see. 568 00:26:59,297 --> 00:27:01,595 Look, you have to get an X-ray after you insert a Dobhoff 569 00:27:01,620 --> 00:27:03,838 and most importantly, before you start feeds. 570 00:27:03,863 --> 00:27:05,783 Okay, let's pull it out, quickly now. 571 00:27:05,865 --> 00:27:07,825 I'm s-sorry, this is my first one. I-I didn't know. 572 00:27:07,850 --> 00:27:09,867 It's okay, and we can fix this. 573 00:27:10,120 --> 00:27:12,813 Uh, prepare for a bronchoscopy to suction the feeds out. 574 00:27:12,838 --> 00:27:14,460 Okay. 575 00:27:19,505 --> 00:27:20,865 - Suction. - Okay. 576 00:27:23,365 --> 00:27:26,196 Is it... Is it weird operating on your friend's scrotum? 577 00:27:26,221 --> 00:27:27,952 My dear, you've seen 578 00:27:27,977 --> 00:27:30,047 one testicle, you've seen them all. 579 00:27:30,072 --> 00:27:33,696 But ask me if I think the man has a screw loose, ooh, mmm. 580 00:27:33,721 --> 00:27:35,515 He must really not want kids. 581 00:27:35,540 --> 00:27:37,385 Of course not, he's a grandfather. 582 00:27:37,410 --> 00:27:38,760 That's when all the fun starts. 583 00:27:38,921 --> 00:27:41,096 Raising a child is hard, 584 00:27:41,121 --> 00:27:44,292 this coming from the chairwoman of a national hospital system. 585 00:27:44,317 --> 00:27:45,640 I don't know how you did it. 586 00:27:45,664 --> 00:27:47,596 Me neither, but I will tell you this. 587 00:27:47,621 --> 00:27:50,022 As proud as I am of all my accomplishments, 588 00:27:50,047 --> 00:27:54,086 the best job I've ever had is being Jackson's mom. 589 00:27:54,673 --> 00:27:58,193 And the biggest surprise, I didn't think I wanted to be a parent. 590 00:27:58,221 --> 00:28:01,689 I... I just never had that pull. 591 00:28:01,827 --> 00:28:05,141 But life is full of surprises. 592 00:28:05,166 --> 00:28:06,857 Yeah, just ask Kimmy. 593 00:28:06,995 --> 00:28:08,371 Oh. She better make sure that 594 00:28:08,395 --> 00:28:09,733 lawyer's looking over that prenup. 595 00:28:09,757 --> 00:28:12,380 Okay, let us finish this vasectomy in the right way. 596 00:28:12,405 --> 00:28:17,222 I've palpated the vas deferens and isolated it. Now, what is next? 597 00:28:17,247 --> 00:28:20,595 Exteriorize, ligate both ends, then divide and send path. 598 00:28:20,620 --> 00:28:21,759 Mm-hmm. 599 00:28:22,150 --> 00:28:23,358 After you. 600 00:28:24,961 --> 00:28:27,128 Uh, 4-0 VICRYL. 601 00:28:32,434 --> 00:28:35,068 - All right, what happened? - She has a CSF leak. 602 00:28:35,092 --> 00:28:37,277 Can you show me where the fluid's coming from? 603 00:28:37,301 --> 00:28:39,372 Do you think it's from the cranial base? 604 00:28:39,397 --> 00:28:42,159 I can't see. Let's light it up. Dilute fluorescein, please. 605 00:28:42,293 --> 00:28:44,905 Inject it into the EVD and clamp it. 606 00:28:44,930 --> 00:28:46,656 Injecting now. 607 00:28:46,932 --> 00:28:49,348 All right, now we wait. Lights please. 608 00:28:49,373 --> 00:28:50,585 For what? 609 00:28:50,610 --> 00:28:54,249 The drain is in her ventricle which is filled with CSF. 610 00:28:54,274 --> 00:28:56,863 If this is a leak, we should see... Oh. 611 00:28:57,114 --> 00:29:00,255 Yeah, the fluorescence is coming from the location of the dural tear. 612 00:29:00,280 --> 00:29:02,835 Is it weird that I think that's beautiful? 613 00:29:02,860 --> 00:29:04,171 Not at all. 614 00:29:04,196 --> 00:29:06,507 All right, let's sew this up. 5-0 nylon. 615 00:29:07,284 --> 00:29:10,736 Actually, the dura is friable. It's not gonna hold a stitch. 616 00:29:11,508 --> 00:29:14,392 And the pericranium is too scarred to harvest for a patch. 617 00:29:14,417 --> 00:29:16,005 You want some fascia lata? 618 00:29:16,030 --> 00:29:17,593 I think that might be our only option. Prep the thigh. 619 00:29:17,632 --> 00:29:19,324 Not the only option. 620 00:29:19,349 --> 00:29:20,713 Instead of another incision, I can 621 00:29:20,738 --> 00:29:22,795 harvest fascia from the existing field. 622 00:29:22,932 --> 00:29:24,807 You think it'll have enough bite to hold the dura? 623 00:29:24,832 --> 00:29:26,326 Give me three minutes, I'll show you. 624 00:29:26,350 --> 00:29:28,111 - Mm-hmm. - Scalpel. 625 00:29:35,204 --> 00:29:37,400 Okay, Mom. Whatever. 626 00:29:38,113 --> 00:29:40,236 I'll let you know when I know what he's decided. 627 00:29:40,980 --> 00:29:42,756 Hey. Everything okay? 628 00:29:44,635 --> 00:29:48,037 Everything's fine. I'm just... a terrible person. 629 00:29:48,062 --> 00:29:49,718 I have a hard time believing that. 630 00:29:49,743 --> 00:29:53,367 You're spending your third trimester with your brother in the CCU. 631 00:29:54,206 --> 00:29:58,382 My mom's a wreck because her son is having another big surgery 632 00:29:58,407 --> 00:30:00,755 while she's recovering from pneumonia. 633 00:30:01,006 --> 00:30:03,287 And I just yelled at her because she didn't have an opinion 634 00:30:03,318 --> 00:30:04,941 on the paint color for the nursery. 635 00:30:05,591 --> 00:30:08,525 Hey, you want your mom's help. That doesn't make you terrible. 636 00:30:10,048 --> 00:30:11,291 I'm just overwhelmed. 637 00:30:11,569 --> 00:30:14,227 Yeah. Of course you are. There's a lot going on. 638 00:30:14,465 --> 00:30:15,884 It's so stupid. 639 00:30:16,642 --> 00:30:19,438 I am 36 years old. I'm about to have a kid... 640 00:30:21,992 --> 00:30:23,822 but I still just want my mom. 641 00:30:25,409 --> 00:30:26,410 I know the feeling. 642 00:30:28,550 --> 00:30:31,795 I should call her and apologize. 643 00:30:31,933 --> 00:30:33,107 I'll see you up there. 644 00:30:47,855 --> 00:30:50,099 Hey, Corban made his decision. He wants a TEVAR. 645 00:30:50,124 --> 00:30:51,125 Okay. 646 00:30:53,161 --> 00:30:55,281 I'd page someone else, but we're down residents today. 647 00:30:55,381 --> 00:30:56,416 I'm good. 648 00:30:57,485 --> 00:30:59,892 - Do you need a minute? - Not at all. I'll go prep him. 649 00:31:00,030 --> 00:31:01,031 Okay. 650 00:31:05,208 --> 00:31:08,703 - Dr. Bailey, I am so sorry. - I take full responsibility. 651 00:31:08,728 --> 00:31:11,052 I should have told Spencer to check the KUB before starting feeds... 652 00:31:11,076 --> 00:31:13,802 Yeah. Damn right. And you better have a good reason you didn't. 653 00:31:13,827 --> 00:31:16,069 Yeah, a pharmaceutical company called with 654 00:31:16,093 --> 00:31:18,221 a lead on Katie's infusion. So I just... 655 00:31:18,246 --> 00:31:22,131 No, the last time I checked, I asked you to focus on your patients 656 00:31:22,156 --> 00:31:23,709 admitted in the hospital. 657 00:31:23,734 --> 00:31:26,323 I only picked up long enough to let them know that I was serious. 658 00:31:26,348 --> 00:31:29,310 Wendy could have died of chemical pneumonitis or pneumonia. 659 00:31:29,335 --> 00:31:31,890 She didn't, and Katie could die if we don't fight for her. 660 00:31:31,915 --> 00:31:34,350 I know. I am fighting for her too. 661 00:31:34,375 --> 00:31:35,730 Are you? 662 00:31:35,755 --> 00:31:38,655 Because what options have you found? What research have you done? 663 00:31:38,680 --> 00:31:40,592 Have you exhausted your contact list? 664 00:31:40,617 --> 00:31:42,417 Because it feels like you've given up. 665 00:31:43,211 --> 00:31:47,422 Oh, so you think after Katie sobbed in my arms, 666 00:31:47,447 --> 00:31:51,106 I... shrugged and said, "Good luck"? 667 00:31:51,357 --> 00:31:53,497 That I gave her a goody bag and sent her on her way? 668 00:31:53,522 --> 00:31:58,355 - She's dying, okay? We... - And I think about it every single day. 669 00:31:58,606 --> 00:32:03,783 And I also think about my 65-year-old with decompensated cirrhosis, 670 00:32:03,808 --> 00:32:05,464 who's treatment resistant 671 00:32:05,489 --> 00:32:08,902 and-and the 17-year-old that's septic and I can't figure out why. 672 00:32:08,927 --> 00:32:11,446 Don't forget about John Doe in the 673 00:32:11,470 --> 00:32:14,449 ICU whose abdomen I had to leave open. 674 00:32:14,889 --> 00:32:17,393 Yeah, he's also keeping me up at night. 675 00:32:17,418 --> 00:32:20,145 And now I guess you can add Wendy to my list. 676 00:32:20,990 --> 00:32:22,854 See, I haven't given up on Katie, 677 00:32:22,879 --> 00:32:26,543 but I also haven't given up on the rest of my patients, 678 00:32:26,568 --> 00:32:30,327 and that is where you and I are different. 679 00:32:31,645 --> 00:32:33,268 Get it together. 680 00:32:49,622 --> 00:32:53,178 Dr. Brooks to oncology. Dr. Brooks to oncology. 681 00:32:53,203 --> 00:32:55,500 Hi. Randall did great. 682 00:32:55,525 --> 00:32:57,233 He is recovering now, and they will 683 00:32:57,257 --> 00:32:59,218 call you when he's ready for visitors. 684 00:32:59,243 --> 00:33:01,161 Is it bad if I don't answer? 685 00:33:01,186 --> 00:33:02,966 No one would hold it against you. 686 00:33:04,380 --> 00:33:05,726 I really do love him. 687 00:33:06,947 --> 00:33:08,742 That's what makes this hurt so much. 688 00:33:10,078 --> 00:33:13,724 I mean, it's his body and he can do whatever he wants. 689 00:33:14,544 --> 00:33:16,786 But if I want to stay married to him, 690 00:33:17,205 --> 00:33:19,587 I don't get a say in whether I have a baby. 691 00:33:20,101 --> 00:33:22,448 Well, you could always ask him to reverse it. 692 00:33:22,765 --> 00:33:23,801 What's the point? 693 00:33:24,485 --> 00:33:26,537 He obviously doesn't want to have kids with me. 694 00:33:26,562 --> 00:33:28,552 Uh... 695 00:33:29,869 --> 00:33:31,147 Well, can you get a puppy? 696 00:33:33,252 --> 00:33:34,253 I'm allergic. 697 00:33:35,013 --> 00:33:36,083 That's unfortunate. 698 00:33:36,876 --> 00:33:38,085 Yeah. 699 00:33:41,867 --> 00:33:44,135 - Hey. - Hey. 700 00:33:44,160 --> 00:33:45,920 I did Corban's TEVAR. He did great. 701 00:33:46,268 --> 00:33:47,959 His numbers are improving. 702 00:33:49,304 --> 00:33:50,443 Okay. 703 00:33:50,468 --> 00:33:54,493 I'm-I'm sorry if I came across as harsh earlier. 704 00:33:55,343 --> 00:33:58,415 I-I still maintain that the ventral aorta 705 00:33:58,440 --> 00:34:00,668 wasn't the right call for this patient. 706 00:34:00,693 --> 00:34:02,902 What about the next one? 707 00:34:03,041 --> 00:34:06,147 You were more than happy to talk about this surgery on podcasts 708 00:34:06,285 --> 00:34:09,081 and publish abstracts, present it. 709 00:34:09,106 --> 00:34:10,816 You were the one who came up with it. 710 00:34:10,841 --> 00:34:12,474 What's the point if you never do it again? 711 00:34:12,498 --> 00:34:15,260 It's a break-the-glass- in-case-of-emergency surgery. 712 00:34:15,285 --> 00:34:16,759 But does it have to be? 713 00:34:17,607 --> 00:34:19,746 Think of the number of people suffering 714 00:34:19,770 --> 00:34:21,852 from aortic disease with no options. 715 00:34:21,990 --> 00:34:23,727 We might have something that could help them. 716 00:34:23,751 --> 00:34:25,063 Why don't you want to use it? 717 00:34:34,252 --> 00:34:35,908 She looks terrible. 718 00:34:37,010 --> 00:34:40,117 She'll look more like herself when the swelling goes down. 719 00:34:40,216 --> 00:34:42,539 And we'll keep monitoring her brain function to see what's intact. 720 00:34:42,563 --> 00:34:44,229 Her intracranial pressure is stable 721 00:34:44,254 --> 00:34:46,394 and she's not re-leaking any fluid from her nose. 722 00:34:46,419 --> 00:34:48,012 And that's good. 723 00:34:49,328 --> 00:34:51,365 I think I have to drop out of school. 724 00:34:52,159 --> 00:34:55,610 I can't leave her like this. It's always been me and her. 725 00:34:57,578 --> 00:34:59,889 Have you thought about contacting the school? 726 00:34:59,914 --> 00:35:03,082 Maybe take a leave of absence? Or do your coursework remotely. 727 00:35:04,067 --> 00:35:05,067 You think they'd do that? 728 00:35:05,167 --> 00:35:06,686 Yeah, you've worked really hard. 729 00:35:07,277 --> 00:35:08,575 And if you stop now, then it's gonna 730 00:35:08,599 --> 00:35:10,084 be a lot harder to start back up again. 731 00:35:10,428 --> 00:35:12,084 Never hurts to ask. 732 00:35:15,295 --> 00:35:16,917 Um, excuse me. 733 00:35:19,324 --> 00:35:22,267 Uh, Dr. Wright, uh, I ordered Teresa's post-op imaging, 734 00:35:22,292 --> 00:35:23,752 but it probably won't happen overnight, 735 00:35:23,776 --> 00:35:25,823 so I'll make sure it's done for first thing tomorrow. 736 00:35:25,847 --> 00:35:27,140 Good, thank you. 737 00:35:28,045 --> 00:35:31,911 Uh, all due respect, uh, I don't want to be just good. 738 00:35:32,026 --> 00:35:33,383 I want you to see me as excellent. 739 00:35:33,408 --> 00:35:35,547 So I'm asking, what would that take? 740 00:35:35,724 --> 00:35:37,829 Tell me what you need me to do, and I will do it. 741 00:35:38,469 --> 00:35:39,505 There's your problem. 742 00:35:39,878 --> 00:35:41,638 That I'm not anticipating you well enough? 743 00:35:41,705 --> 00:35:43,288 You're trying to anticipate me 744 00:35:43,313 --> 00:35:45,971 when you should be trying to anticipate the medicine. 745 00:35:46,222 --> 00:35:49,297 Look, over the years I've found that the most successful residents 746 00:35:49,322 --> 00:35:52,184 focus on patient care and surgical technique. 747 00:35:52,209 --> 00:35:54,127 - Mm-hmm. - They're confident in who they are, 748 00:35:54,152 --> 00:35:57,051 which translates into them being confident in what they do. 749 00:35:57,076 --> 00:36:00,351 And that is what leads to excellence in plastics. 750 00:36:00,955 --> 00:36:02,984 I didn't see that from you today. 751 00:36:03,822 --> 00:36:05,272 Maybe next time. 752 00:36:16,967 --> 00:36:20,143 Hey. Did you update, uh, Ms. Cahill's output for Baxter? 753 00:36:20,168 --> 00:36:21,169 He's on tonight. 754 00:36:23,658 --> 00:36:24,658 You okay? 755 00:36:24,776 --> 00:36:25,915 Super. 756 00:36:26,943 --> 00:36:30,188 Look, Bailey was mad at me, not you, and she was way out of line. 757 00:36:30,213 --> 00:36:31,455 Bailey? 758 00:36:31,737 --> 00:36:32,980 Bailey wasn't the problem. 759 00:36:34,517 --> 00:36:35,587 Spencer. 760 00:36:35,612 --> 00:36:37,332 I thought you were going to apologize to me. 761 00:36:37,722 --> 00:36:39,413 For what? 762 00:36:39,438 --> 00:36:41,520 Look, you might have taken the heat because you're the second year, 763 00:36:41,544 --> 00:36:43,462 but I fed the tube into Wendy's lungs. 764 00:36:43,487 --> 00:36:45,247 And if you had told me to get a KUB, 765 00:36:45,272 --> 00:36:47,757 I would have taken a damn X-ray and not initiated feeds. 766 00:36:47,782 --> 00:36:50,982 - Okay, but we managed it. She's fine. - She had food in her lungs! 767 00:36:55,627 --> 00:36:57,974 Uh, okay. Thank you. 768 00:36:58,370 --> 00:36:59,405 Thank you. 769 00:37:02,047 --> 00:37:03,324 I wasn't cool. 770 00:37:04,187 --> 00:37:05,725 Oh, you're being hard on yourself. 771 00:37:05,750 --> 00:37:08,131 Oh, she said in no uncertain terms 772 00:37:08,156 --> 00:37:11,574 that she did not see excellence in me today. 773 00:37:11,599 --> 00:37:13,290 I'm sorry. 774 00:37:13,314 --> 00:37:14,902 You know what makes it worse? 775 00:37:14,927 --> 00:37:17,363 She wasn't even mean about it. She just said it like it was a fact. 776 00:37:17,388 --> 00:37:18,389 Huh. 777 00:37:19,320 --> 00:37:21,455 What, you think it's a fact? 778 00:37:21,480 --> 00:37:22,667 Oh, no, no, no. I was... 779 00:37:22,691 --> 00:37:24,252 thinking about how I yelled at Adams. 780 00:37:24,276 --> 00:37:25,967 Oh. What did he do now? 781 00:37:26,110 --> 00:37:29,130 Well, his concern for one patient got in 782 00:37:29,155 --> 00:37:31,801 the way of his care for other patients. 783 00:37:32,127 --> 00:37:33,680 - Katie Rogers. - Yeah. 784 00:37:34,252 --> 00:37:37,841 I mean, truth is, if she was our only patient, 785 00:37:37,979 --> 00:37:39,774 his dedication would be admirable. 786 00:37:39,912 --> 00:37:42,432 - Mmm. - I hope I wasn't too hard on him. 787 00:37:42,570 --> 00:37:44,534 Um, I guess we got to have thick 788 00:37:44,558 --> 00:37:46,471 skin if we're going to do this thing. 789 00:37:47,294 --> 00:37:48,468 Want to go home? 790 00:37:48,493 --> 00:37:50,875 Mmm, let's go home. 791 00:37:57,646 --> 00:37:58,785 Hey. 792 00:37:59,384 --> 00:38:00,730 Everything okay? 793 00:38:04,451 --> 00:38:06,004 I haven't signed the papers yet. 794 00:38:09,015 --> 00:38:12,190 But getting a divorce was your idea. 795 00:38:12,215 --> 00:38:13,354 I know. 796 00:38:13,637 --> 00:38:14,638 I know. 797 00:38:15,995 --> 00:38:19,216 - Are you having second thoughts? - No. 798 00:38:20,953 --> 00:38:23,759 I keep taking the papers out to sign and then I don't do it 799 00:38:23,784 --> 00:38:25,938 and now... they're just sitting in my bag 800 00:38:25,963 --> 00:38:28,004 with crumbs and crayon marks on them. 801 00:38:30,882 --> 00:38:33,713 Just because it was my idea doesn't mean that I'm not scared. 802 00:38:36,765 --> 00:38:38,725 - What are you scared of? - I don't know. 803 00:38:39,386 --> 00:38:42,147 That everything will just explode and-and fall apart. 804 00:38:43,107 --> 00:38:46,496 But hasn't that happened already? 805 00:38:56,057 --> 00:38:57,947 You don't have to do them right now. 806 00:38:57,972 --> 00:38:59,871 I mean, I'll-I'll-I'll take out another retainer. 807 00:38:59,895 --> 00:39:01,068 We don't have to rush this. 808 00:39:01,093 --> 00:39:03,026 I have to do it sometime. 809 00:39:04,070 --> 00:39:05,312 Okay. 810 00:39:11,487 --> 00:39:12,936 My sixth-grade teacher said, 811 00:39:12,961 --> 00:39:16,247 "Your actions plus your choices equals your life." 812 00:39:16,743 --> 00:39:18,503 This is mostly true. 813 00:39:18,642 --> 00:39:22,404 I can do a whole vasectomy, start to finish. 814 00:39:22,429 --> 00:39:25,036 - It's pretty straightforward. - Why you looking at me? 815 00:39:28,235 --> 00:39:29,616 What? You changed your mind? 816 00:39:30,368 --> 00:39:33,276 Yeah, today, looking at questions about my mom, 817 00:39:33,301 --> 00:39:35,763 thinking about being a mom just brought up a lot of old feelings 818 00:39:35,787 --> 00:39:37,987 I don't have time to deal with. I need to focus on work. 819 00:39:39,743 --> 00:39:41,917 What if I did it with you? 820 00:39:41,942 --> 00:39:43,230 I don't have to be here for this, right? 821 00:39:43,255 --> 00:39:44,256 No. 822 00:39:45,147 --> 00:39:46,321 Thought you didn't want kids. 823 00:39:47,260 --> 00:39:48,598 I don't think I do. 824 00:39:49,387 --> 00:39:51,377 But I also don't want to wake up one day 825 00:39:51,401 --> 00:39:53,391 and my eggs are all shriveled and dusty 826 00:39:53,416 --> 00:39:57,263 and realize that I do, and it's too late. 827 00:39:57,823 --> 00:39:59,820 And then if we... if we do it together, I... 828 00:39:59,845 --> 00:40:03,884 I could be there for you if you think about your mom. 829 00:40:04,988 --> 00:40:06,793 - You'd do that? - Yeah, yeah. 830 00:40:06,818 --> 00:40:08,068 And then I can tell you about my 831 00:40:08,092 --> 00:40:09,579 mom, which would make you feel better. 832 00:40:11,305 --> 00:40:13,445 Fertility friends. 833 00:40:14,011 --> 00:40:15,288 Don't call it that. 834 00:40:18,692 --> 00:40:19,831 No, no. 835 00:40:21,108 --> 00:40:23,085 But what it doesn't account for is luck. 836 00:40:23,110 --> 00:40:25,226 - What is going on? - Leticia, you have to wait outside. 837 00:40:25,250 --> 00:40:26,952 - Someone tell me what's going on. - Get her out, please. 838 00:40:26,976 --> 00:40:28,953 - It's gonna be okay. It's gonna be okay. - No. 839 00:40:28,978 --> 00:40:30,138 - No, please. - What happened? 840 00:40:30,220 --> 00:40:31,681 I got him back after one round of epi, 841 00:40:31,705 --> 00:40:33,476 but he's still hypotensive with a narrow pulse pressure. 842 00:40:33,500 --> 00:40:35,502 - Did you get an X-ray? - Uh, right here. 843 00:40:35,640 --> 00:40:37,055 Good work. 844 00:40:37,500 --> 00:40:39,895 Mediastinal widening. The leak is expanding. 845 00:40:39,920 --> 00:40:41,059 Page Altman. 846 00:40:41,084 --> 00:40:43,032 We need to get him back to the angio suite. 847 00:40:47,050 --> 00:40:48,085 Let's move. 848 00:40:49,649 --> 00:40:52,652 Sometimes we encounter unexpected twists of fate. 849 00:40:53,727 --> 00:40:55,660 - Hey. - Hey. 850 00:40:57,075 --> 00:40:58,517 Thanks for today. 851 00:40:58,542 --> 00:41:01,083 You're the only neurosurgeon that's ever 852 00:41:01,108 --> 00:41:03,194 responded to my page in under an hour. 853 00:41:03,234 --> 00:41:07,065 Yeah, well, it was my first day back, so I didn't have a lot going on. 854 00:41:08,522 --> 00:41:11,513 Not... Not to say that I'm not always prompt. 855 00:41:11,538 --> 00:41:12,860 Right. 856 00:41:12,885 --> 00:41:15,095 You need me again, I will come just as fast. 857 00:41:15,662 --> 00:41:16,663 Okay. 858 00:41:17,475 --> 00:41:18,475 Uh... 859 00:41:18,500 --> 00:41:21,089 - I... I made it weird. - No. 860 00:41:21,114 --> 00:41:23,594 I swear to you, the crush is all in the past. 861 00:41:23,619 --> 00:41:25,709 I've had many crushes since then, 862 00:41:25,734 --> 00:41:27,149 succeeded at several, 863 00:41:27,174 --> 00:41:29,477 changed programs when others have failed. 864 00:41:31,252 --> 00:41:32,806 You used to laugh more. 865 00:41:37,717 --> 00:41:40,780 I also had a crush on you. 866 00:41:40,805 --> 00:41:43,225 I mean, I didn't understand what I was feeling, but, 867 00:41:43,250 --> 00:41:45,528 you know, I wish I had known. 868 00:41:46,883 --> 00:41:48,885 Sorry, that-that is... this is... 869 00:41:49,136 --> 00:41:51,522 I'm not hitting on you in the attending's lounge. 870 00:41:51,547 --> 00:41:52,547 Right. 871 00:41:52,572 --> 00:41:53,952 This is work. 872 00:41:54,981 --> 00:41:58,561 Do you wanna go somewhere, get a coffee? 873 00:42:02,010 --> 00:42:05,202 And the best things in life fall out of thin air. 874 00:42:16,382 --> 00:42:17,928 All you have to do is catch it. 875 00:42:17,952 --> 00:42:22,952 - Synced and corrected by ChrisKe - — for www.addic7ed.com — 876 00:42:23,442 --> 00:42:25,617 McSteamy, right? 877 00:42:25,646 --> 00:42:26,646 Mark Sloan. 878 00:42:26,671 --> 00:42:29,522 Oh, this is awkward. 879 00:42:29,679 --> 00:42:30,990 We're the dirty mistresses. 880 00:42:32,032 --> 00:42:33,447 I suppose we are. 881 00:42:33,472 --> 00:42:34,803 I'll show you the Sloan Method. 882 00:42:34,828 --> 00:42:36,628 How many nurses have you slept with this week? 883 00:42:36,657 --> 00:42:38,970 That's not a problem, man. That's an adventure. 884 00:42:39,221 --> 00:42:43,052 The Plastics Posse, kicking surgical ass and taking names. 885 00:42:43,077 --> 00:42:44,389 The Plastics Posse? 886 00:42:44,414 --> 00:42:46,262 People don't come to me to fix what's on the outside. 887 00:42:46,287 --> 00:42:48,117 They come to me to fix what's on the inside. 888 00:42:48,142 --> 00:42:51,283 If that means giving someone a straighter nose or bigger breasts, 889 00:42:51,308 --> 00:42:53,210 if that helps a person get by... 890 00:42:53,235 --> 00:42:56,721 I don't run. I don't hide. I don't take space. 891 00:42:56,746 --> 00:42:59,922 I'm a dad. We're parents. Of a baby! 892 00:42:59,947 --> 00:43:02,693 Why are you telling me to give it time when there's no guarantee 893 00:43:02,718 --> 00:43:04,823 that time is gonna be there? 894 00:43:04,848 --> 00:43:08,077 If you love someone, you tell 'em. 895 00:43:08,102 --> 00:43:10,484 Even if you're scared that it's not the right thing, 896 00:43:10,622 --> 00:43:14,384 even if you're scared that it will burn your life to the ground, 897 00:43:14,522 --> 00:43:16,904 you say it, and you say it loud. 898 00:43:20,952 --> 00:43:22,954 Don't waste one single minute.