1 00:00:02,450 --> 00:00:05,108 When my mother was diagnosed with Alzheimer's disease, 2 00:00:05,246 --> 00:00:06,719 her cousin said she must've gotten 3 00:00:06,743 --> 00:00:08,215 it because she didn't take fish oil. 4 00:00:08,353 --> 00:00:13,333 I picked up everything on the list, except they ran out of Dijon, 5 00:00:13,358 --> 00:00:16,058 so, I got whole grain instead, which... 6 00:00:16,082 --> 00:00:18,821 Yeah, I know... is inferior, but... 7 00:00:20,098 --> 00:00:21,755 - Who are you? - Hey. 8 00:00:21,893 --> 00:00:23,929 Hey, you're, uh, back early. 9 00:00:23,954 --> 00:00:25,787 Yeah, I decided to do the groceries first 10 00:00:25,812 --> 00:00:27,322 and pick up your car after. Who's this? 11 00:00:27,347 --> 00:00:32,214 That's Elroy, the contractor I hired to babyproof for us. 12 00:00:32,239 --> 00:00:33,453 These stairs aren't safe. 13 00:00:33,932 --> 00:00:34,933 Naked sides. 14 00:00:35,819 --> 00:00:36,855 Don't worry. 15 00:00:37,375 --> 00:00:38,721 - I can fix them. - Okay. 16 00:00:39,082 --> 00:00:40,360 I told you I was gonna do that. 17 00:00:40,385 --> 00:00:42,500 Yeah, back when Scout and Luna were babies, 18 00:00:42,525 --> 00:00:44,216 and now we have two more babies. 19 00:00:47,665 --> 00:00:50,731 My patient with a myoelectric prosthesis was just brought into the ER. 20 00:00:50,756 --> 00:00:52,137 Mountain bike accident. 21 00:00:53,001 --> 00:00:55,437 - I should go. - Wait, wait, wait. What about my car? 22 00:00:56,416 --> 00:00:57,762 Ask Elroy. 23 00:01:00,054 --> 00:01:01,967 Her neighbor thought it was because my mother, 24 00:01:01,992 --> 00:01:05,687 a world renowned surgeon, didn't do enough crossword puzzles. 25 00:01:13,652 --> 00:01:15,999 Is this your way of thanking me for the coffee? 26 00:01:16,024 --> 00:01:18,429 I'm stressed about the M&M. 27 00:01:18,825 --> 00:01:20,448 Well, I am ready to help. 28 00:01:28,370 --> 00:01:30,582 Shepherd. I'm on her service. 29 00:01:34,266 --> 00:01:35,476 You better go. 30 00:01:35,501 --> 00:01:40,295 I'll ask her if I can sneak away to come watch, but if not, good luck. 31 00:01:41,221 --> 00:01:42,912 I told them to shove it. 32 00:01:43,137 --> 00:01:46,451 They always want to cast blame, something to fear and avoid. 33 00:01:47,645 --> 00:01:49,164 But the only thing to blame... 34 00:01:50,249 --> 00:01:51,250 is everything. 35 00:01:53,156 --> 00:01:55,498 Bless you. Oh. 36 00:01:55,523 --> 00:01:58,181 You left out the door so early, I figured you needed a pick-me-up. 37 00:01:58,428 --> 00:02:00,854 Well, I thought keeping busy would take my mind off things, 38 00:02:00,879 --> 00:02:03,951 but... it just means I'm tired and hangry. 39 00:02:03,976 --> 00:02:05,607 Yeah. How's Katie doing? 40 00:02:06,371 --> 00:02:08,310 I'm waiting for her labs, 41 00:02:08,335 --> 00:02:14,178 but I'm guessing she has carcinomatosis and a partial obstruction. 42 00:02:14,203 --> 00:02:16,743 - Well, how often are they draining her? - Twice a day. 43 00:02:16,768 --> 00:02:18,389 Okay, well, listen, if there's 44 00:02:18,414 --> 00:02:19,770 anything I can do, just let me know... 45 00:02:19,794 --> 00:02:20,830 Warren. 46 00:02:21,725 --> 00:02:23,796 You're with me. 47 00:02:24,005 --> 00:02:26,880 Okay, go. I'm okay. 48 00:02:26,905 --> 00:02:29,494 - Dr. Bailey. - Welcome back. 49 00:02:30,150 --> 00:02:33,187 First day back in the OR. How's it feel? 50 00:02:33,212 --> 00:02:35,559 Well, I'm working with my chief resident. 51 00:02:35,584 --> 00:02:37,747 I have an M&M later today, and the 52 00:02:37,850 --> 00:02:40,013 cafeteria is serving shepherd's pie. 53 00:02:40,133 --> 00:02:41,203 Feels like Christmas. 54 00:02:42,576 --> 00:02:44,174 Well, wait till you see our first consult. 55 00:02:44,198 --> 00:02:45,544 Good morning. 56 00:02:45,795 --> 00:02:48,798 Oh, Russell, this is Dr. Webber and Dr. Warren. 57 00:02:48,823 --> 00:02:50,491 These are the headliners. 58 00:02:50,515 --> 00:02:52,241 Russell's a community theater director. 59 00:02:52,266 --> 00:02:53,837 Right now, he's putting up a production of Hamlet. 60 00:02:53,862 --> 00:02:57,013 "When sorrows come, they come not single spies"... 61 00:02:57,038 --> 00:02:58,764 "but in battalions." 62 00:02:58,789 --> 00:03:01,466 - Yes, okay. - Yeah. 63 00:03:01,491 --> 00:03:04,770 You would demote my Claudius to an understudy. 64 00:03:04,795 --> 00:03:06,742 - Hamlet's my favorite Shakespeare. - Mmm. 65 00:03:06,767 --> 00:03:09,252 - Um, Dr. Meade? - Much Ado About Nothing. 66 00:03:09,889 --> 00:03:11,373 He wants you to present the case. 67 00:03:11,898 --> 00:03:13,360 Right. Sorry, um... 68 00:03:14,002 --> 00:03:17,206 "Russell West, 34, with history of beta thalassemia 69 00:03:17,231 --> 00:03:19,751 with blood transfusions every three months for anemia. 70 00:03:19,883 --> 00:03:23,178 Admitted for splenic sequestration crisis two weeks ago." 71 00:03:23,203 --> 00:03:25,757 His abdomen has been getting increasingly distended. 72 00:03:25,895 --> 00:03:28,277 Uh, we're consulting today for a splenectomy. 73 00:03:28,415 --> 00:03:31,003 I thought I was just gaining a little weight... 74 00:03:31,141 --> 00:03:33,592 but then my stomach just kept getting bigger and bigger. 75 00:03:33,730 --> 00:03:35,362 - Can I take a look? - Yeah. 76 00:03:35,387 --> 00:03:36,664 I'll call for an ultrasound. 77 00:03:36,689 --> 00:03:38,650 Oh, let's go old school while we wait. 78 00:03:38,675 --> 00:03:40,333 When was the last time you did percussion? 79 00:03:40,490 --> 00:03:42,737 Uh... 80 00:03:44,776 --> 00:03:47,054 All right, you hear that? It's hollow. That's his lung. 81 00:03:47,606 --> 00:03:51,783 Here. That's dull. That's the spleen from here... 82 00:03:54,135 --> 00:03:55,792 to here. 83 00:03:56,658 --> 00:03:59,281 Your spleen extends from the left upper quadrant 84 00:03:59,306 --> 00:04:01,191 all the way to the right lower quadrant. 85 00:04:01,216 --> 00:04:03,227 It's taking up your entire abdomen. 86 00:04:03,252 --> 00:04:04,874 This needs to come out immediately. 87 00:04:04,899 --> 00:04:07,454 I'm in the middle of tech week. I can't... 88 00:04:08,006 --> 00:04:09,667 Won't it just shrink on its own? 89 00:04:09,692 --> 00:04:11,298 It's unlikely in a case this severe. 90 00:04:11,323 --> 00:04:13,158 Plus, you'd run the risk of rupturing it. 91 00:04:13,183 --> 00:04:14,401 Okay, that sounds bad. 92 00:04:14,426 --> 00:04:16,877 Yeah, really bad. Instant death. 93 00:04:18,982 --> 00:04:21,133 You... You want to take care of this sooner rather than later. 94 00:04:21,157 --> 00:04:23,009 Dr. Meade can take you for a CT scan 95 00:04:23,033 --> 00:04:25,112 so we can plan a surgical approach. 96 00:04:25,137 --> 00:04:27,242 Yeah, could he do it instead? 97 00:04:27,267 --> 00:04:28,751 I'll go with you. 98 00:04:28,776 --> 00:04:29,811 Yeah. 99 00:04:32,249 --> 00:04:34,766 - Well? - It's better than Christmas. 100 00:04:36,093 --> 00:04:37,347 had been compromised. 101 00:04:37,372 --> 00:04:40,754 We then used 4-0 VICRYL sutures to inset the... 102 00:04:40,779 --> 00:04:42,195 Are you reciting your presentation? 103 00:04:43,144 --> 00:04:44,668 You know how when you lie, your cheeks 104 00:04:44,692 --> 00:04:46,651 get flushed and your voice gets all high? 105 00:04:47,079 --> 00:04:49,910 You do both of those things, and so do I when I give presentations, 106 00:04:49,935 --> 00:04:53,939 and I also sweat and sometimes faint. 107 00:05:05,339 --> 00:05:07,834 - Interesting case? - Your sternal reconstruction patient. 108 00:05:08,078 --> 00:05:09,148 Scott Hill? 109 00:05:09,412 --> 00:05:11,207 Beckman's out. Someone has to check on him. 110 00:05:11,232 --> 00:05:14,822 Well, Dr. Wright is supposed to be attempting another flap tomorrow. 111 00:05:15,901 --> 00:05:18,687 Hope it takes. 112 00:05:18,712 --> 00:05:20,023 See you at the M&M. 113 00:05:23,351 --> 00:05:24,597 It'll be fine. 114 00:05:25,248 --> 00:05:28,406 I've successfully avoided him after lying to help his patient. 115 00:05:28,431 --> 00:05:31,784 Oh, that was weeks ago. He's probably forgotten. 116 00:05:33,367 --> 00:05:35,058 You truly are a terrible liar. 117 00:05:38,434 --> 00:05:40,781 Sorry for interrupting your parental leave. 118 00:05:40,806 --> 00:05:42,291 Was Jo annoyed? 119 00:05:42,480 --> 00:05:44,240 Yeah, but not because of that. 120 00:05:44,944 --> 00:05:46,325 Oh, here they are. 121 00:05:47,347 --> 00:05:50,315 Okay, "Jon Ellison, 40. Status post-mountain biking accident. 122 00:05:50,340 --> 00:05:52,223 No LOC or signs of head trauma. 123 00:05:52,361 --> 00:05:55,615 He has bruising on his chest, and X-rays show multiple rib fractures. 124 00:05:55,640 --> 00:05:57,711 He had targeted muscle reinnervation surgery 125 00:05:57,736 --> 00:05:59,736 a few months ago for an advanced arm prosthesis"... 126 00:05:59,773 --> 00:06:00,773 I know. I did it. 127 00:06:00,877 --> 00:06:02,534 After I amputated his arm. 128 00:06:02,559 --> 00:06:03,629 Jon. 129 00:06:03,825 --> 00:06:04,826 Pauline. 130 00:06:05,513 --> 00:06:06,513 What happened? 131 00:06:06,538 --> 00:06:08,273 I was training at Tiger Mountain. 132 00:06:08,298 --> 00:06:09,792 The hand just let go. 133 00:06:09,817 --> 00:06:11,371 I lost my balance and fell. 134 00:06:11,396 --> 00:06:13,276 He crashed straight into a boulder. 135 00:06:13,545 --> 00:06:14,965 Tell 'em about the last time. 136 00:06:14,989 --> 00:06:17,100 Yeah, it did the same thing last month. 137 00:06:17,238 --> 00:06:19,004 I sideswiped a tree and almost missed 138 00:06:19,028 --> 00:06:21,016 qualifying for the World Championships. 139 00:06:21,041 --> 00:06:23,112 - When's the competition? - Three months. 140 00:06:23,141 --> 00:06:25,912 I can still compete though, right? I'm up for sponsorships. 141 00:06:25,937 --> 00:06:27,638 The nerve we rerouted to your upper arm 142 00:06:27,663 --> 00:06:30,182 should be sending precise signals to your hand. 143 00:06:30,207 --> 00:06:31,807 We'll get some scans. We'll check it out. 144 00:06:32,012 --> 00:06:33,772 Kwan, call CT. Let 'em know we're coming. 145 00:06:33,797 --> 00:06:34,833 Yeah. 146 00:06:38,567 --> 00:06:39,775 What are we playing? 147 00:06:40,116 --> 00:06:41,290 Five-card stud. 148 00:06:41,483 --> 00:06:43,727 - You play? - Uh, not anymore. 149 00:06:44,424 --> 00:06:47,416 But I ran a weekly poker night in med school. 150 00:06:47,554 --> 00:06:49,901 - Were you any good? - Graduated debt-free. 151 00:06:52,431 --> 00:06:53,570 How are you feeling today? 152 00:06:53,595 --> 00:06:55,217 They drained another liter this morning. 153 00:06:55,242 --> 00:06:58,496 She's still nauseous. We asked for ice chips 30 minutes ago. 154 00:06:58,521 --> 00:07:01,731 Oh, it must have gotten lost in the morning handoff. 155 00:07:01,756 --> 00:07:04,916 - I'll get them myself. - Can you grab some for my mom too? 156 00:07:05,054 --> 00:07:07,850 - She needs to chill. - You see how she treats me? 157 00:07:12,828 --> 00:07:15,175 Uh, I'll... I'll get you those ice chips. 158 00:07:18,427 --> 00:07:19,704 How bad? 159 00:07:20,440 --> 00:07:22,693 Katie's creatinine is elevated, albumin low. 160 00:07:22,718 --> 00:07:27,067 Her AST, ALT, and INR are... through the roof. 161 00:07:27,964 --> 00:07:29,722 She's in multiple organ failure. 162 00:07:30,124 --> 00:07:32,679 The TPN is too hard on her liver. 163 00:07:33,228 --> 00:07:35,023 It's the only thing giving her nutrition. 164 00:07:39,114 --> 00:07:40,978 Call palliative care. 165 00:07:43,657 --> 00:07:48,657 - Synced and corrected by ChrisKe - — for www.addic7ed.com — 166 00:08:00,987 --> 00:08:02,402 I thought I was late. 167 00:08:02,766 --> 00:08:05,243 Bailey does not need another reason to yell at me. 168 00:08:05,677 --> 00:08:07,265 - Hey, how's Katie? - Yes. 169 00:08:08,715 --> 00:08:13,064 Her INR is getting worse. She needs two more units of FFP. Correct. 170 00:08:14,258 --> 00:08:15,780 Thank you. 171 00:08:15,805 --> 00:08:18,118 Katie? What, is her liver failing? 172 00:08:18,661 --> 00:08:20,007 What did the repeat scans show? 173 00:08:24,434 --> 00:08:26,896 She doesn't know yet. We're gonna tell her after the M&M. 174 00:08:26,920 --> 00:08:27,920 I wanna be there. 175 00:08:28,070 --> 00:08:30,038 You are not part of her care team. 176 00:08:30,466 --> 00:08:32,468 Do I need to write you a reminder? 177 00:08:34,355 --> 00:08:36,974 Hi. Good morning, everyone. 178 00:08:36,999 --> 00:08:38,725 Are we ready to begin? 179 00:08:39,074 --> 00:08:41,352 - Dr. Millin? - Yes. 180 00:08:46,905 --> 00:08:50,815 Uh, Scott Hill, age 73, presented four months ago 181 00:08:50,840 --> 00:08:53,049 with shortness of breath and chest pain. 182 00:08:54,499 --> 00:08:58,374 See what I told you? The spleen has taken over the entire abdomen. 183 00:08:58,399 --> 00:09:00,756 It has sequestered so much of his blood supply. 184 00:09:00,781 --> 00:09:03,335 I mean, how would you even mobilize that? 185 00:09:04,458 --> 00:09:05,666 You tell me. 186 00:09:06,624 --> 00:09:08,005 Uh, well, um... 187 00:09:08,030 --> 00:09:11,500 If it were a smaller spleen, I would enter the lesser sac, 188 00:09:11,525 --> 00:09:14,080 take down attachments, and medially rotate it 189 00:09:14,105 --> 00:09:17,062 to access the pedicle, but this... 190 00:09:17,201 --> 00:09:18,624 Yeah, I have no clue. 191 00:09:18,649 --> 00:09:20,990 Plus, once we're in there, one nick to the organ 192 00:09:21,015 --> 00:09:22,535 and Russell could bleed out in seconds. 193 00:09:24,563 --> 00:09:26,289 When I was a resident, 194 00:09:26,435 --> 00:09:30,081 I scrubbed in on a liver teratoma I thought was impossible to resect. 195 00:09:31,053 --> 00:09:33,030 But I had an attending, Dr. Rathbone, 196 00:09:33,055 --> 00:09:35,408 who did a total vascular exclusion of 197 00:09:35,432 --> 00:09:37,588 the liver to create a bloodless field. 198 00:09:37,613 --> 00:09:41,295 It was brilliant, and it taught me to always keep an open mind. 199 00:09:42,047 --> 00:09:45,050 I saved a piece of that tumor in a jar for years after. 200 00:09:46,002 --> 00:09:49,350 Maybe after this you can, uh, save a piece of Russell's spleen, huh? 201 00:09:49,375 --> 00:09:51,995 Do I have to? 202 00:09:53,065 --> 00:09:55,293 Okay, let's take a page from Rathbone's playbook. 203 00:09:55,318 --> 00:09:58,745 Let's call IR, have them embolize the splenic artery, 204 00:09:58,770 --> 00:10:00,403 then we'll open him up and see what we got. 205 00:10:00,427 --> 00:10:02,542 Uh, what about the M&M? We're already late. 206 00:10:02,567 --> 00:10:04,811 No, M&Ms happen every week. 207 00:10:05,955 --> 00:10:08,026 But a spleen like this? 208 00:10:08,652 --> 00:10:10,757 It happens once in a lifetime. 209 00:10:10,902 --> 00:10:16,004 We then used interrupted 4-0 VICRYL sutures to inset the omental flap. 210 00:10:16,052 --> 00:10:18,261 You can see the healthy flap here. 211 00:10:18,286 --> 00:10:23,556 Did his pre-op scans show any sign for concern about pedicle tension? 212 00:10:23,581 --> 00:10:25,703 No, the team agreed that the distance 213 00:10:25,728 --> 00:10:28,628 between the epigastrium and the superior sternum was acceptable. 214 00:10:28,766 --> 00:10:31,201 And at this point, "the team" was... 215 00:10:31,226 --> 00:10:32,779 Me and Dr. Mohanty. 216 00:10:32,804 --> 00:10:35,057 You had finished harvesting the omentum, 217 00:10:35,082 --> 00:10:37,991 and Dr. Wright and Dr. Warren were needed on another case. 218 00:10:38,016 --> 00:10:40,265 So, the, uh, the changes in the flap's 219 00:10:40,289 --> 00:10:42,538 appearance progressed rapidly post-op. 220 00:10:42,563 --> 00:10:46,208 As you can see here, uh, it is dark and swollen. 221 00:10:46,233 --> 00:10:48,095 Did you check Doppler flow after inset? 222 00:10:48,120 --> 00:10:51,450 - Yes, there was biphasic signal. - And which one of you did that? 223 00:10:52,594 --> 00:10:55,871 Well, we can both confirm that there was a... signal. 224 00:10:55,896 --> 00:10:58,243 When we realized there was no blood flow to the flap... 225 00:10:58,268 --> 00:11:02,473 I'm sorry, so the two of you... both... heard the signal? 226 00:11:02,498 --> 00:11:04,673 Were roles clearly defined during the inset? 227 00:11:04,698 --> 00:11:06,389 - I believe so. - You believe so? 228 00:11:07,304 --> 00:11:10,239 Who placed the stitch causing tension around the pedicle? 229 00:11:11,922 --> 00:11:16,374 Look, this patient, my patient, hasn't left the hospital in weeks 230 00:11:16,399 --> 00:11:20,989 due to a gaping hole in his chest, which I believed we had fixed. 231 00:11:21,487 --> 00:11:23,934 He's still here because of someone's negligence 232 00:11:23,959 --> 00:11:26,168 and it sure as hell isn't mine, so... 233 00:11:27,709 --> 00:11:29,365 who placed the stitch? 234 00:11:32,832 --> 00:11:33,833 That's on me. 235 00:11:35,026 --> 00:11:37,235 I should have watched my resident more carefully. 236 00:11:37,599 --> 00:11:40,085 I take full responsibility as her supervisor. 237 00:11:55,581 --> 00:11:57,514 He is all set. 238 00:11:58,579 --> 00:12:01,350 Would either of you mind if I catch the last part of the M&M? 239 00:12:01,375 --> 00:12:03,076 - Start the scan, Kwan. - We do. 240 00:12:07,267 --> 00:12:09,038 - Everything okay? - I'm a handy person. 241 00:12:09,725 --> 00:12:11,878 Did I miss the first part of this conversation? 242 00:12:11,903 --> 00:12:15,537 Jo's getting an estimate from a contractor to babyproof our place, 243 00:12:15,562 --> 00:12:18,013 even though I told her I can do it. I want to do it. 244 00:12:19,221 --> 00:12:20,784 Are you sure you still need me here? 245 00:12:20,809 --> 00:12:22,545 The babies can't even roll over on their own. 246 00:12:22,569 --> 00:12:23,889 They're nowhere close to crawling. 247 00:12:23,914 --> 00:12:26,513 We have a minute before the stairs are an actual risk. 248 00:12:26,538 --> 00:12:29,237 So, you'll just wait till Scout and Luna are teenagers? 249 00:12:30,621 --> 00:12:32,278 - Kwan? - Yes, all right, 250 00:12:32,303 --> 00:12:35,626 three right-sided rib fractures. He has a small pneumothorax. 251 00:12:35,651 --> 00:12:37,096 He probably doesn't need a chest tube, 252 00:12:37,121 --> 00:12:38,940 but the muscle in the TMR looks good. 253 00:12:38,965 --> 00:12:40,863 All right, admit him for observation 254 00:12:40,888 --> 00:12:43,620 and then just do a follow-up X-ray with him later today. 255 00:12:44,039 --> 00:12:46,154 I'm sorry you had to come in for rib fractures, 256 00:12:46,179 --> 00:12:48,743 but maybe now you can go home and babyproof. 257 00:12:48,768 --> 00:12:51,011 We should still check the signals to his bionic arm. 258 00:12:51,149 --> 00:12:53,749 I mean, there's no hematoma or bleeding around the nerves in the TMR. 259 00:12:53,773 --> 00:12:54,877 The signals should be fine. 260 00:12:54,902 --> 00:12:56,542 Yeah, but he's still falling off his bike. 261 00:12:57,579 --> 00:13:00,720 Kwan, get Jon back to his room and set up for EMG testing. 262 00:13:00,745 --> 00:13:02,298 - Yeah. - Mm-hmm. 263 00:13:04,315 --> 00:13:06,018 When a pedicle passes through narrow 264 00:13:06,042 --> 00:13:08,063 tunnels, we're essentially working blind. 265 00:13:08,214 --> 00:13:10,228 Uh, Dr. Millin, when you placed the 266 00:13:10,253 --> 00:13:11,904 stitch, did you use a lot of tension? 267 00:13:12,042 --> 00:13:13,802 Excuse me? 268 00:13:13,940 --> 00:13:16,529 I asked if you used a lot of tension when you placed the stitch. 269 00:13:16,554 --> 00:13:18,175 I-I didn't place the stitch. 270 00:13:19,281 --> 00:13:21,012 Dr. Mohanty, did you or did you not 271 00:13:21,036 --> 00:13:22,767 allow Dr. Millin to place the stitch? 272 00:13:22,792 --> 00:13:25,045 She specifically asked to do some of the suturing... 273 00:13:25,070 --> 00:13:28,403 And you said no. Th-This is a huge miscommunication. 274 00:13:28,428 --> 00:13:30,315 Are you saying she's lying? 275 00:13:30,948 --> 00:13:32,131 I didn't say that. 276 00:13:32,156 --> 00:13:34,315 But you are denying that it was you. 277 00:13:34,340 --> 00:13:37,274 If you're both saying you didn't place the suture, 278 00:13:37,299 --> 00:13:38,699 one of you is not telling the truth. 279 00:13:39,232 --> 00:13:42,545 I only closed the abdomen. I wasn't anywhere near... the pedicle. 280 00:13:42,570 --> 00:13:46,331 Dr. Millin, admitting your mistakes is an important part to learning. 281 00:13:46,356 --> 00:13:50,206 If you can't own up to them, we've got a much more serious problem. 282 00:13:58,022 --> 00:13:59,058 What the hell was that? 283 00:13:59,882 --> 00:14:02,170 - Dr. Millin. - You placed that stitch, and you know it. 284 00:14:02,195 --> 00:14:03,541 Can we talk about this, please? 285 00:14:03,566 --> 00:14:06,959 Oh, I'm sorry. Do you not want to get dragged in public? 286 00:14:06,984 --> 00:14:08,709 Sometimes M&Ms go south. 287 00:14:08,961 --> 00:14:10,376 Everyone knows this. 288 00:14:10,401 --> 00:14:11,993 Is that supposed to be an apology? 289 00:14:12,018 --> 00:14:13,172 You're a resident. 290 00:14:13,197 --> 00:14:15,071 Residents are supposed to make mistakes. 291 00:14:15,096 --> 00:14:16,995 Well, I didn't screw up. 292 00:14:17,020 --> 00:14:19,919 You lied, and I got scorched for it. 293 00:14:19,998 --> 00:14:21,620 I have patients to see. 294 00:14:25,958 --> 00:14:28,843 Okay, let me know if you feel any discomfort. 295 00:14:28,868 --> 00:14:30,110 I'm used to it. 296 00:14:30,135 --> 00:14:32,467 Okay, Jon, I want you to imagine your phantom limb 297 00:14:32,492 --> 00:14:34,400 and start opening and closing your hand. 298 00:14:34,425 --> 00:14:36,678 That's a good sign, right? 299 00:14:36,703 --> 00:14:38,752 Yeah, the muscles are receiving signal. 300 00:14:38,777 --> 00:14:39,986 It's a really good sign. 301 00:14:40,011 --> 00:14:41,890 And how's the prosthesis treating you otherwise? 302 00:14:41,915 --> 00:14:45,781 If I was wearing it, I'd give you a thumbs up or the middle finger. 303 00:14:45,806 --> 00:14:47,187 Depends on my mood. 304 00:14:47,212 --> 00:14:50,015 Oh, he's painted the baby's room and started cooking again. 305 00:14:50,040 --> 00:14:51,348 It's changed his life at home. 306 00:14:51,373 --> 00:14:55,662 I just can't do the one thing I was... really hoping for. 307 00:14:55,687 --> 00:14:57,872 Well, your signals are good. 308 00:14:57,897 --> 00:15:00,313 The TMR is not the problem. 309 00:15:00,338 --> 00:15:03,774 Jon, when you ride, do you experience a high level of stress? 310 00:15:03,799 --> 00:15:06,500 He's dodging trees and jumping rocks 311 00:15:06,525 --> 00:15:08,399 and trying not to fall off the trail. 312 00:15:08,424 --> 00:15:09,814 I actually find it relaxing. 313 00:15:09,839 --> 00:15:12,486 Right, but you're still encountering unexpected obstacles 314 00:15:12,511 --> 00:15:16,743 and... changes in terrain that could cause a reflexive reaction 315 00:15:16,768 --> 00:15:19,065 in the muscles that send signal that could potentially 316 00:15:19,090 --> 00:15:20,730 make your hand do things you don't intend. 317 00:15:20,781 --> 00:15:22,818 - Like let go of the bike? - Exactly. 318 00:15:23,069 --> 00:15:26,107 Mountain biking's all about dealing with the unexpected. 319 00:15:26,132 --> 00:15:28,557 If I can't do that, I can't ride, 320 00:15:28,582 --> 00:15:31,526 and that means no sponsorships, no prize money. 321 00:15:31,551 --> 00:15:32,871 - Jon... - And without that money, 322 00:15:32,896 --> 00:15:34,805 we can't afford repairs to my gear, 323 00:15:34,830 --> 00:15:36,797 my training time, part of our mortgage. 324 00:15:36,822 --> 00:15:39,706 I've been working for months to qualify for this race. 325 00:15:39,731 --> 00:15:41,423 Now you're telling me I could lose it all? 326 00:15:41,448 --> 00:15:44,297 If you're getting more exercise, your muscles are getting stronger, 327 00:15:44,322 --> 00:15:47,670 they might be sending a stronger signal than the prosthesis needs. 328 00:15:47,695 --> 00:15:50,614 Let's take a look at that, and we'll go from there. 329 00:16:01,270 --> 00:16:03,285 Curtis. Up for a visit? 330 00:16:05,041 --> 00:16:06,560 From the chief? 331 00:16:07,074 --> 00:16:08,558 Anytime. 332 00:16:10,141 --> 00:16:11,901 How are you? 333 00:16:12,040 --> 00:16:15,181 I told the nurses I was cancer-roommates with Richard Webber. 334 00:16:15,319 --> 00:16:17,666 Suddenly I got extra pillows. 335 00:16:17,804 --> 00:16:19,392 And unlimited applesauce. 336 00:16:19,850 --> 00:16:21,748 What's a fancy title for? 337 00:16:22,636 --> 00:16:24,397 You just missed my wife and kids. 338 00:16:26,054 --> 00:16:27,503 Really wish you would've met them. 339 00:16:27,641 --> 00:16:29,241 - Yeah, I would've loved that too. - Yeah. 340 00:16:29,411 --> 00:16:30,585 How old are your kids? 341 00:16:30,610 --> 00:16:31,896 Trevor's eight. 342 00:16:31,921 --> 00:16:33,484 He's my bookworm. 343 00:16:33,509 --> 00:16:35,925 And, uh, Amani's five. 344 00:16:35,950 --> 00:16:37,916 She's already running around on her 345 00:16:37,940 --> 00:16:40,006 bike like a bat out of hell. 346 00:16:40,031 --> 00:16:42,275 She'll be trouble. 347 00:16:44,018 --> 00:16:46,158 Now, that's the hardest part of all this. 348 00:16:47,489 --> 00:16:48,490 It's, uh... 349 00:16:49,698 --> 00:16:51,631 leaving them behind. 350 00:17:00,295 --> 00:17:01,572 Look, I'd... 351 00:17:01,597 --> 00:17:04,443 I'd love to stay, Curtis, but I'm needed in surgery. 352 00:17:04,958 --> 00:17:07,271 Thank you for stopping by, Dr. Webber. 353 00:17:08,957 --> 00:17:10,303 Just Richard. 354 00:17:24,130 --> 00:17:25,339 How long does she have? 355 00:17:25,364 --> 00:17:28,056 If I give you an answer, it... 356 00:17:28,081 --> 00:17:29,910 it's just my best guess. 357 00:17:30,162 --> 00:17:31,853 But I have more energy today. 358 00:17:31,991 --> 00:17:33,993 We removed the NG tube. 359 00:17:34,018 --> 00:17:36,237 I ate a Popsicle without throwing up. 360 00:17:36,262 --> 00:17:38,584 Yeah, it's common to have good days. 361 00:17:38,881 --> 00:17:42,243 Our focus now is on keeping you comfortable 362 00:17:42,268 --> 00:17:46,099 so you can have as many good days as possible. 363 00:17:46,237 --> 00:17:49,102 And if you do in-hospital hospice, we can manage your symptoms 364 00:17:49,127 --> 00:17:51,010 and pain here for as long as you need. 365 00:17:51,136 --> 00:17:52,793 No, I-I need to go home. 366 00:17:54,590 --> 00:17:56,671 I need to... to sleep in my own bed. 367 00:17:56,696 --> 00:17:59,139 I need to eat my own food, and maybe 368 00:17:59,164 --> 00:18:02,780 if we... work with the PT, I'll improve. 369 00:18:03,140 --> 00:18:04,763 Then that's what we'll do. 370 00:18:05,855 --> 00:18:07,132 We... 371 00:18:07,465 --> 00:18:10,434 We can arrange home health and PT, 372 00:18:10,572 --> 00:18:13,161 but you'd only have someone a couple of hours a week, 373 00:18:13,259 --> 00:18:14,857 and you need more support. 374 00:18:15,240 --> 00:18:19,521 If you do in-home hospice care, well, they'll send you someone 24/7, 375 00:18:19,546 --> 00:18:22,446 but it could take a week to get started. 376 00:18:22,471 --> 00:18:24,611 I need to get out of here now. 377 00:18:25,088 --> 00:18:26,538 I need to get better. 378 00:18:26,563 --> 00:18:29,186 I'll take care of her until everything's arranged. 379 00:18:29,553 --> 00:18:34,157 She needs a hospital bed, an oxygen concentrator, a Hoyer lift... 380 00:18:34,182 --> 00:18:35,631 I'll figure it out. 381 00:18:36,850 --> 00:18:38,755 I did it with my mom. 382 00:18:42,500 --> 00:18:45,340 If you do this, Katie will be leaving 383 00:18:45,365 --> 00:18:47,333 against medical advice. 384 00:18:47,358 --> 00:18:49,529 The insurance won't cover everything 385 00:18:49,554 --> 00:18:51,613 she needs at home if she does that. 386 00:18:52,683 --> 00:18:56,445 I've done everything you've asked. 387 00:18:58,211 --> 00:19:03,506 Every scan, every test, every infusion, and here I am. 388 00:19:05,429 --> 00:19:09,778 You... You don't know if I'm dying. 389 00:19:10,053 --> 00:19:11,676 You don't know anything. 390 00:19:12,003 --> 00:19:13,074 If I go home... 391 00:19:15,242 --> 00:19:16,416 I'll get better. 392 00:19:17,612 --> 00:19:18,993 You'll see. 393 00:19:25,302 --> 00:19:29,315 Okay. Then I will talk with social work, 394 00:19:29,340 --> 00:19:30,859 and we'll start the process. 395 00:19:36,637 --> 00:19:39,118 Bailey, are you sure AMA is the right move for Katie? 396 00:19:39,143 --> 00:19:41,318 I most certainly am not. 397 00:19:42,174 --> 00:19:44,710 Look, don't-don't make any moves yet. 398 00:19:44,735 --> 00:19:48,187 I... know someone she might listen to. 399 00:19:54,958 --> 00:19:56,097 Hey, I'm still here. 400 00:19:56,313 --> 00:19:59,018 - Did you read the estimate? - I've been with my patient. 401 00:19:59,043 --> 00:20:01,717 Well, in order to fully babyproof the balcony, 402 00:20:01,742 --> 00:20:03,660 we have to put up a higher enclosure 403 00:20:03,685 --> 00:20:06,766 which costs more than I can say without throwing up. 404 00:20:06,791 --> 00:20:08,586 I told you I... I could do it. 405 00:20:08,724 --> 00:20:09,937 You know, I'm not even sure the HOA 406 00:20:09,961 --> 00:20:11,462 will allow it, so what do you want to do? 407 00:20:11,599 --> 00:20:12,979 Now you want my opinion? 408 00:20:13,004 --> 00:20:15,110 You really wanna get into it again? 409 00:20:15,248 --> 00:20:18,206 - Look, I'm sorry. I should go. - Same. 410 00:20:21,358 --> 00:20:23,059 - You gotta go? - No, it's fine. Let's continue. 411 00:20:23,083 --> 00:20:24,223 Okay. 412 00:20:24,361 --> 00:20:26,328 Okay, this should test the grip. 413 00:20:27,386 --> 00:20:28,835 Mm-hmm. 414 00:20:28,973 --> 00:20:31,495 Hmm. And now finger rolls. 415 00:20:33,887 --> 00:20:37,615 It's working well within normal EMG signals, 416 00:20:37,640 --> 00:20:40,386 and he says it works fine when he's not biking, so... 417 00:20:40,411 --> 00:20:42,620 - It's the stress. - Yeah. 418 00:20:43,164 --> 00:20:45,166 He's done with competitive racing. 419 00:20:48,775 --> 00:20:50,261 That was lunch. 420 00:20:50,565 --> 00:20:52,049 My life is over. 421 00:20:52,251 --> 00:20:54,943 Are your organs failing from stage-four gastric cancer? 422 00:20:55,194 --> 00:20:56,747 It'll work out. 423 00:20:56,772 --> 00:20:57,868 I've been there. 424 00:20:57,893 --> 00:20:59,477 You got kicked out of your last program. 425 00:20:59,502 --> 00:21:01,142 Still worked out. I'm here. 426 00:21:03,676 --> 00:21:07,181 Hey, your girlfriend is not only a sloppy surgeon, she's a liar. 427 00:21:07,673 --> 00:21:09,296 The M&M did not go well. 428 00:21:09,321 --> 00:21:12,393 She blamed me for her crappy suture that killed our patient's flap, 429 00:21:12,418 --> 00:21:14,558 and now none of the attendings will even look at me. 430 00:21:14,583 --> 00:21:16,999 Kavita is not a liar. Both her parents are doctors. 431 00:21:17,137 --> 00:21:19,278 And that makes her immune to being a horrible person? 432 00:21:19,486 --> 00:21:21,211 Hey, wait, she's not a horrible person. 433 00:21:21,236 --> 00:21:23,102 No, you told me to be nice to her, 434 00:21:23,127 --> 00:21:25,284 and I was, and look where that got me. 435 00:21:25,484 --> 00:21:26,899 Thrown under the freaking bus. 436 00:21:28,185 --> 00:21:30,204 - You love the bus. - Kwan. 437 00:21:31,746 --> 00:21:33,232 This isn't a joke. 438 00:21:33,257 --> 00:21:34,983 Hey! This is my career! 439 00:21:35,689 --> 00:21:37,059 And you know what makes it worse, is 440 00:21:37,084 --> 00:21:39,197 that you're automatically taking her side. 441 00:21:40,756 --> 00:21:42,206 Oh... Some friend you are. 442 00:21:43,379 --> 00:21:46,865 - Where are you going? - To... to fix this. 443 00:21:51,548 --> 00:21:52,756 Hey. 444 00:21:53,153 --> 00:21:54,396 Thank you. 445 00:21:58,018 --> 00:22:01,539 Anna Karenina? This is what you want to read right now? 446 00:22:01,803 --> 00:22:05,326 - It's pretty depressing. - Well, I'm making my way through a list 447 00:22:05,463 --> 00:22:07,187 of a hundred books you should read. 448 00:22:07,212 --> 00:22:09,164 Yeah, I've read these. You can skip them. 449 00:22:09,302 --> 00:22:11,512 You've read all 100 books? 450 00:22:11,650 --> 00:22:14,744 Uh, Moby Dick, a bunch of men yelling on a boat. 451 00:22:14,769 --> 00:22:16,655 Oh, and there's a whale. 452 00:22:16,680 --> 00:22:19,752 Uh, War and Peace, a lot of war, a little peace. 453 00:22:19,777 --> 00:22:22,297 That's two off your list. 454 00:22:25,671 --> 00:22:26,982 Let's get out of here. 455 00:22:27,389 --> 00:22:29,115 Let's go look at the houseboats. 456 00:22:31,971 --> 00:22:33,006 We can't just leave. 457 00:22:33,936 --> 00:22:36,249 - You're a patient. - Didn't stop you before. 458 00:22:36,662 --> 00:22:39,446 - And you were my doctor then. - Yeah, it's not that simple. 459 00:22:39,471 --> 00:22:40,886 You can't walk. 460 00:22:40,911 --> 00:22:42,913 We'd need portable oxygen. 461 00:22:42,938 --> 00:22:44,733 I can walk. Just give me your hand. 462 00:22:44,898 --> 00:22:46,279 Look, Katie, we just... 463 00:22:46,456 --> 00:22:48,389 Can... can you get my bag? 464 00:22:48,574 --> 00:22:50,852 I can't. I don't even know if I can get you in my car. 465 00:22:53,406 --> 00:22:55,960 Okay. It's okay. It's okay, it's okay. I got you. 466 00:22:57,338 --> 00:22:59,306 This is it for me, isn't it? 467 00:23:01,096 --> 00:23:04,780 - I really wanted to go home. - I'm so sorry. 468 00:23:10,803 --> 00:23:12,011 Okay. 469 00:23:12,036 --> 00:23:13,811 Going through the fascia. 470 00:23:16,084 --> 00:23:17,568 - Metz. - You know, 471 00:23:17,593 --> 00:23:19,256 Meade here has been doing some research. 472 00:23:19,281 --> 00:23:21,878 Fact, the largest spleen ever recorded, 473 00:23:22,015 --> 00:23:24,136 26 pounds and 17 inches. 474 00:23:24,161 --> 00:23:26,991 And based on our estimates, this one could beat it, sir. 475 00:23:27,016 --> 00:23:28,880 You ready to make history, Dr. Webber? 476 00:23:32,423 --> 00:23:36,769 Oh. Oh, my God. That is... 477 00:23:36,794 --> 00:23:38,624 Nothing but spleen. 478 00:23:38,649 --> 00:23:41,291 Look, I don't want to hear another word about records 479 00:23:41,316 --> 00:23:43,914 or history until Russell is on his way to post-op. 480 00:23:43,939 --> 00:23:46,365 Okay, our focus should be on this patient, on this surgery. 481 00:23:46,390 --> 00:23:47,978 - Understood? - Loud and clear, boss. 482 00:23:48,003 --> 00:23:50,611 We've got a lot of work ahead of us. And I need full visualization. 483 00:23:50,826 --> 00:23:52,223 Titan. 484 00:23:52,361 --> 00:23:54,018 Okay. 485 00:23:54,043 --> 00:23:55,838 All right, here we go. 486 00:24:00,014 --> 00:24:03,865 She'll stay here until her in-home hospice is set up. 487 00:24:03,890 --> 00:24:05,271 Okay. 488 00:24:05,296 --> 00:24:07,170 The social worker's on her way to get the process started. 489 00:24:07,195 --> 00:24:09,457 Did you mention we're hoping they can rush this? 490 00:24:09,482 --> 00:24:11,726 Yeah, and I might have dropped your name. 491 00:24:12,326 --> 00:24:14,466 All right, we'll see if it helps. 492 00:24:16,163 --> 00:24:17,233 Oh. 493 00:24:18,641 --> 00:24:19,677 So, what? 494 00:24:20,054 --> 00:24:21,573 Now you bring in the doctors 495 00:24:21,598 --> 00:24:24,230 with the sad smiles and quiet voices 496 00:24:24,255 --> 00:24:27,293 pretending to know what it's like to die before you're supposed to? 497 00:24:28,218 --> 00:24:33,051 Our team will do everything to make her more comfortable. 498 00:24:33,298 --> 00:24:35,676 They'll also move her into a room with 499 00:24:35,701 --> 00:24:38,546 more natural light, fewer machines. 500 00:24:38,902 --> 00:24:41,076 And the chaplain will come too, right? 501 00:24:41,910 --> 00:24:47,157 You had this same conversation 15 years ago about my mother. 502 00:24:47,868 --> 00:24:51,833 And now you have the gall to have it again about my daughter. 503 00:24:52,135 --> 00:24:54,749 - She was doing better! - I know. 504 00:24:55,597 --> 00:24:58,625 - I am so sorry. - Stop saying you're sorry! 505 00:25:00,464 --> 00:25:02,086 If this was one of your babies, 506 00:25:02,984 --> 00:25:06,031 and their life-saving medication was discontinued 507 00:25:06,056 --> 00:25:07,464 and you had to watch the life drain 508 00:25:07,488 --> 00:25:09,153 from their bodies, what would you do? 509 00:25:09,582 --> 00:25:13,038 I would fight. 510 00:25:13,234 --> 00:25:14,684 But you didn't, did you? 511 00:25:15,706 --> 00:25:17,536 Not for my baby. 512 00:25:32,973 --> 00:25:34,146 Dr. Bailey. 513 00:25:53,380 --> 00:25:54,484 Whoa! 514 00:25:54,509 --> 00:25:57,254 Come in, make yourself at home. What is this? 515 00:25:57,279 --> 00:25:59,740 I borrowed a few things from Dr. Salley. 516 00:25:59,765 --> 00:26:01,582 I wanted to see if adjusting the grip 517 00:26:01,606 --> 00:26:03,423 on a body-powered prosthesis helps. 518 00:26:04,252 --> 00:26:05,988 Jon talked you into finding another solution? 519 00:26:06,012 --> 00:26:08,334 I couldn't tell him that he can't use the robotic one. 520 00:26:08,359 --> 00:26:09,639 - Link. - After his car accident, 521 00:26:09,664 --> 00:26:11,855 he went really dark when he couldn't ride. 522 00:26:11,880 --> 00:26:15,263 I don't want him or Pauline to have to repeat that. 523 00:26:20,751 --> 00:26:22,166 Damn it, why can't I do this? 524 00:26:22,304 --> 00:26:24,444 Last time I checked, you're not a prosthetist. 525 00:26:25,155 --> 00:26:28,527 I have reconstructed fingers. I've replanted amputated hands. 526 00:26:28,552 --> 00:26:30,805 I've replaced every joint you can name. 527 00:26:30,830 --> 00:26:32,107 I fix things. 528 00:26:32,132 --> 00:26:33,720 It's what I do. 529 00:26:34,084 --> 00:26:39,296 Sounds like you're trying to fix things at home in my lab. 530 00:26:39,321 --> 00:26:42,748 My shoulder's still... bugging me. 531 00:26:42,773 --> 00:26:45,786 You had a major injury, and that's gonna take time. 532 00:26:45,811 --> 00:26:48,503 I know. I just I... 533 00:26:48,687 --> 00:26:51,042 I felt pain the last time I was in the OR. 534 00:26:51,067 --> 00:26:53,725 It's also why I'm behind on babyproofing. 535 00:26:53,750 --> 00:26:55,171 What does Jo think? 536 00:26:55,989 --> 00:26:57,024 You haven't told her. 537 00:26:57,049 --> 00:26:58,292 She's got her own stuff. 538 00:26:58,675 --> 00:27:02,630 I-I thought I was gonna be back to normal by the time the twins came. 539 00:27:02,655 --> 00:27:05,495 Instead, I'm just icing my shoulder 540 00:27:05,520 --> 00:27:09,593 and hoping nobody face-plants off the stairs. 541 00:27:12,769 --> 00:27:15,979 You are very handy, and you can fix a lot of things. 542 00:27:16,117 --> 00:27:18,094 But sometimes when you let go of expectations, 543 00:27:18,119 --> 00:27:20,500 you open yourself up to other possibilities. 544 00:27:23,937 --> 00:27:25,076 Yeah, you're right. 545 00:27:25,101 --> 00:27:26,585 - Does that mean I get my lab back? - Soon. 546 00:27:26,610 --> 00:27:27,646 Mm-hmm. 547 00:27:28,910 --> 00:27:30,567 You just gave me an idea. 548 00:27:33,192 --> 00:27:34,800 Hey, I got your text. 549 00:27:34,938 --> 00:27:36,457 I'm sorry I missed the M&M. 550 00:27:36,482 --> 00:27:37,932 That's old news. 551 00:27:37,957 --> 00:27:41,600 Wright said that Jackson Avery called to check my references. 552 00:27:41,625 --> 00:27:43,213 That's huge. 553 00:27:43,743 --> 00:27:44,744 Boston's in the bag. 554 00:27:44,769 --> 00:27:46,219 It gets even better. 555 00:27:46,244 --> 00:27:48,177 Apparently, she told him that Grey Sloan 556 00:27:48,202 --> 00:27:49,617 wouldn't give me up without a fight. 557 00:27:49,642 --> 00:27:51,092 So you could stay here? 558 00:27:51,230 --> 00:27:54,855 I don't have any formal offers yet, but as long as 559 00:27:54,880 --> 00:27:59,116 I don't majorly screw anything up, I'm gonna have options. 560 00:28:01,177 --> 00:28:02,177 Wow, um. 561 00:28:02,335 --> 00:28:03,681 Can I ask you something? 562 00:28:04,924 --> 00:28:09,479 Would... stitching over the pedicle in an omentum be a major screwup? 563 00:28:09,504 --> 00:28:10,989 Why do you ask? 564 00:28:12,997 --> 00:28:16,499 Did you blame Jules for your suture in the M&M? 565 00:28:17,460 --> 00:28:21,744 I've been in school, or residency, or fellowship my entire life. 566 00:28:21,769 --> 00:28:24,047 I'm so close to it finally paying off. 567 00:28:25,057 --> 00:28:26,541 So you... did lie. 568 00:28:26,566 --> 00:28:29,475 Surgery's cutthroat, especially plastics. 569 00:28:29,500 --> 00:28:30,675 Don't tell me you've never told a 570 00:28:30,699 --> 00:28:32,134 small mistruth to get what you needed. 571 00:28:32,158 --> 00:28:33,964 Yeah, but this is more than just a little white lie. 572 00:28:33,988 --> 00:28:36,103 Every M&M feels like the end of the world 573 00:28:36,128 --> 00:28:38,406 when you're a resident, but you get past them. 574 00:28:38,431 --> 00:28:40,452 No one will even remember this case tomorrow. 575 00:28:40,590 --> 00:28:43,248 And I'll figure something out to help Millin. 576 00:28:43,405 --> 00:28:46,857 If I take an attending job here, I can help her even more. 577 00:28:47,898 --> 00:28:49,417 Yeah, I guess that makes sense. 578 00:28:51,281 --> 00:28:54,949 So you're actually considering Grey Sloan over Boston? 579 00:28:54,974 --> 00:28:56,010 Maybe. 580 00:28:56,882 --> 00:29:00,652 As much as I love Boston, Seattle's also... 581 00:29:01,630 --> 00:29:02,701 growing on me. 582 00:29:06,917 --> 00:29:09,368 Sixteen inches. So close. 583 00:29:09,506 --> 00:29:10,990 Well, it's still pretty damn big. 584 00:29:11,088 --> 00:29:13,354 Hey, hey, stand next to it for scale. 585 00:29:14,340 --> 00:29:16,549 - Oh, uh, shouldn't it be Dr. Webber? - Yeah. 586 00:29:16,574 --> 00:29:18,179 Hey, what about it, Chief? 587 00:29:18,204 --> 00:29:20,113 You, uh... You want a picture with the mega spleen? 588 00:29:20,137 --> 00:29:21,587 Yeah, no pictures for me. 589 00:29:21,647 --> 00:29:23,269 We should weigh it. 590 00:29:23,294 --> 00:29:24,772 I mean, it's not the biggest ever, but it might be the heaviest. 591 00:29:24,797 --> 00:29:26,316 Come on, here we go. 592 00:29:27,386 --> 00:29:28,786 - Got it? You know what? - I got it. 593 00:29:28,811 --> 00:29:30,226 Hold on, let me... let me help you. 594 00:29:30,400 --> 00:29:31,401 You can just put it... 595 00:29:33,392 --> 00:29:35,635 Oh, that's a damn shame. 596 00:29:36,647 --> 00:29:39,788 It... it looks even bigger on the floor. 597 00:29:40,917 --> 00:29:41,917 Hey, you know what? 598 00:29:41,942 --> 00:29:43,944 - Get down, get down. - Okay. 599 00:29:45,438 --> 00:29:46,690 - Yeah, yeah. - No, no, no. 600 00:29:46,715 --> 00:29:47,948 Look, that's enough. 601 00:29:47,973 --> 00:29:52,179 Now no more pictures, or jokes, or talking about bragging rights. 602 00:29:52,204 --> 00:29:55,159 Today was not a success of medicine, it was a failure. 603 00:29:55,757 --> 00:29:57,979 You think Russell wanted it to get that bad? 604 00:29:58,100 --> 00:29:59,998 It's a miracle it didn't kill him. 605 00:30:00,459 --> 00:30:01,632 You should be ashamed. 606 00:30:02,906 --> 00:30:04,424 I know I am. 607 00:30:05,658 --> 00:30:07,418 Clean this mess up. 608 00:30:10,153 --> 00:30:12,811 Yeah, of course. Got ya. 609 00:30:23,616 --> 00:30:27,766 No, I-I replay the steps in my head every night. 610 00:30:27,791 --> 00:30:30,417 Could I have operated earlier? 611 00:30:30,492 --> 00:30:32,977 Could I have pushed oncology harder? 612 00:30:33,224 --> 00:30:37,815 Could I have filed more appeals with the drug manufacturer? 613 00:30:39,094 --> 00:30:40,846 No, you did everything you could. 614 00:30:41,489 --> 00:30:44,905 I did everything I could 15 years ago for Katie's grandmother. 615 00:30:45,719 --> 00:30:48,032 But immunotherapies didn't exist then. 616 00:30:48,287 --> 00:30:51,912 She died from actual cancer, but Katie... 617 00:30:53,440 --> 00:30:57,788 No, Katie's dying from... bureaucratic stupidity. 618 00:30:58,718 --> 00:31:01,386 Just years of hard work, 619 00:31:01,411 --> 00:31:04,584 finally developed a medicine that was working, 620 00:31:04,609 --> 00:31:06,788 and instead of helping people access it, 621 00:31:06,813 --> 00:31:10,903 our government... is dismantling science. 622 00:31:11,761 --> 00:31:13,833 Just like that, clinical trial gone. 623 00:31:14,010 --> 00:31:15,839 And not just Katie, or cancer, 624 00:31:15,977 --> 00:31:21,880 it's maternal health, diabetes prevention, substance abuse programs. 625 00:31:23,329 --> 00:31:26,885 Space exploration is even on the damn chopping block. 626 00:31:26,910 --> 00:31:30,717 Just decades of groundbreaking work... 627 00:31:32,174 --> 00:31:38,318 without even a single thought to its cost in human lives. 628 00:31:40,588 --> 00:31:43,290 I can't even give Katie a chance to spend 629 00:31:43,315 --> 00:31:46,697 her last moments outside of these hospital walls. 630 00:31:47,491 --> 00:31:49,861 Well, we're setting her up 631 00:31:49,885 --> 00:31:52,255 with in-home hospice care and she'll... 632 00:31:53,256 --> 00:31:56,845 It'll be a miracle if she makes it that long. 633 00:32:06,315 --> 00:32:08,524 - Hey, I spoke to Kavita... - Now's not a good time. 634 00:32:10,001 --> 00:32:11,727 Uh, Dr. Wright. 635 00:32:12,541 --> 00:32:14,232 How is Scott doing? 636 00:32:14,257 --> 00:32:16,910 His heart's had minimal tissue coverage for two weeks. 637 00:32:16,935 --> 00:32:18,177 He's not great. 638 00:32:20,341 --> 00:32:21,377 Can I help you? 639 00:32:22,423 --> 00:32:26,841 I have worked really hard to build a good reputation for myself here, 640 00:32:26,866 --> 00:32:30,478 and I-I can't stand by and watch it all go down the drain. 641 00:32:31,639 --> 00:32:35,194 Dr. Mohanty lied in the M&M. I didn't stitch over the pedicle. 642 00:32:35,219 --> 00:32:37,551 I wanted to sew around the pedicle, but she wouldn't let me. 643 00:32:37,576 --> 00:32:42,751 And I don't know why she lied, but I promise you it wasn't me. 644 00:32:43,962 --> 00:32:45,682 That's quite the sob story you've got there. 645 00:32:45,791 --> 00:32:47,517 I'm setting the record straight. 646 00:32:47,542 --> 00:32:49,770 Look, hospitals are high school. Emotions are high. 647 00:32:49,795 --> 00:32:54,524 Status matters. People are competitive, and desperate, and insecure. 648 00:32:55,422 --> 00:32:58,606 I need my surgeons to be mature, to rise above, 649 00:32:58,631 --> 00:33:00,712 to not get sucked into the drama and the politics. 650 00:33:00,737 --> 00:33:02,163 Did you have a good outcome or a bad one? 651 00:33:02,188 --> 00:33:04,086 - That's all I care about. - Understood. 652 00:33:04,176 --> 00:33:07,628 I will make sure that Scott has his labs in the morning. 653 00:33:07,735 --> 00:33:09,599 You're not on his surgery anymore. 654 00:33:09,752 --> 00:33:12,756 Hey, Kwan, have you ever done a sternal reconstruction? 655 00:33:13,211 --> 00:33:14,212 No. 656 00:33:15,340 --> 00:33:16,582 You will tomorrow. 657 00:33:16,607 --> 00:33:19,886 Come with me, and I'll give you my notes on the case. 658 00:33:32,907 --> 00:33:34,247 Did you figure it out? 659 00:33:34,272 --> 00:33:38,177 Making the bionic hand work for competitive mountain biking? 660 00:33:38,681 --> 00:33:40,611 - No. - So that's it. 661 00:33:40,636 --> 00:33:41,672 I'm done. 662 00:33:42,779 --> 00:33:44,558 Not necessarily. 663 00:33:44,583 --> 00:33:46,585 I've come up with another option. 664 00:33:46,610 --> 00:33:49,278 Now, this is just a prototype, but the idea is 665 00:33:49,303 --> 00:33:51,891 that instead of your bionic hand gripping the handlebar, 666 00:33:51,916 --> 00:33:53,779 we build an attachment to the bike 667 00:33:54,539 --> 00:33:57,161 and a terminal device that you'd wear only while biking. 668 00:33:59,115 --> 00:34:00,323 Keep talking. 669 00:34:00,348 --> 00:34:04,309 We'd make a custom, activity-specific prosthetic 670 00:34:04,870 --> 00:34:07,666 that would snap into the bike attachment. 671 00:34:07,691 --> 00:34:09,550 And it'd be built so you could snap 672 00:34:09,575 --> 00:34:11,919 quickly out of the receiver for safety. 673 00:34:12,128 --> 00:34:15,821 If you like it, we could find a prosthetist to collaborate with 674 00:34:15,846 --> 00:34:18,228 and maybe even a sponsor will help cover the costs. 675 00:34:20,058 --> 00:34:21,611 This is, uh... 676 00:34:22,542 --> 00:34:24,372 This is amazing. 677 00:34:25,649 --> 00:34:27,203 You made this. How? 678 00:34:27,228 --> 00:34:30,767 No, no, this was all Dr. Lincoln. I know nothing about bikes. 679 00:34:30,792 --> 00:34:33,427 Man, thank you. 680 00:34:34,796 --> 00:34:36,476 I don't know what I would have done if I... 681 00:34:36,501 --> 00:34:37,778 You're welcome. 682 00:34:45,004 --> 00:34:46,454 Should I not ask? 683 00:34:46,995 --> 00:34:49,372 Dr. Wright said that I was being dramatic, 684 00:34:49,397 --> 00:34:51,157 and she doesn't want to work with me anymore. 685 00:34:51,945 --> 00:34:53,963 I'm sorry, I know the truth. 686 00:34:53,988 --> 00:34:55,955 I don't think you're being dramatic. 687 00:34:55,980 --> 00:34:57,860 Everyone who knows and loves you feels the same. 688 00:34:58,314 --> 00:34:59,763 I'm not so sure. 689 00:35:01,133 --> 00:35:02,514 Hey, hey, I need a favor. 690 00:35:02,652 --> 00:35:03,894 It's about Katie. 691 00:35:03,919 --> 00:35:05,940 You know I can't disclose her medical information, 692 00:35:05,965 --> 00:35:07,657 but nice job getting her to stick around. 693 00:35:07,682 --> 00:35:09,684 What if we took her to your place? 694 00:35:09,864 --> 00:35:11,693 To what, die at my house? 695 00:35:12,489 --> 00:35:14,294 You want her to die at my house. 696 00:35:14,319 --> 00:35:16,493 Well, okay, technically it's my Aunt Meredith's house. 697 00:35:16,631 --> 00:35:18,126 - All right? - She's gonna go to her own home next week. 698 00:35:18,150 --> 00:35:19,979 She doesn't have that long. 699 00:35:21,665 --> 00:35:23,335 You sure this is a good idea? 700 00:35:23,735 --> 00:35:25,081 She's dying. 701 00:35:26,007 --> 00:35:28,308 I'll ask for time off so I can take care of her myself. 702 00:35:28,333 --> 00:35:29,886 No. 703 00:35:30,249 --> 00:35:31,647 We'll take shifts. 704 00:35:32,618 --> 00:35:33,860 Thank you. 705 00:35:35,443 --> 00:35:36,651 Count Kwan in too. 706 00:35:36,676 --> 00:35:39,300 He owes me for putting up with Mohanty. 707 00:35:46,438 --> 00:35:48,270 Hey, uh, Chief, look, um... 708 00:35:49,862 --> 00:35:51,403 I just wanted to apologize. 709 00:35:51,582 --> 00:35:53,966 I-I got excited about a flashy case 710 00:35:53,991 --> 00:35:56,188 and I-I let things get out of hand. 711 00:35:56,844 --> 00:36:00,192 A few weeks ago, a case like that would've made my year. 712 00:36:00,443 --> 00:36:02,652 A spleen the size of a sandbag? 713 00:36:02,677 --> 00:36:04,576 I'd have taken photos too. 714 00:36:04,691 --> 00:36:06,693 But I'm feeling different now. 715 00:36:06,718 --> 00:36:08,582 Bad different? 716 00:36:08,856 --> 00:36:10,794 You know, I tried to push it down and 717 00:36:10,818 --> 00:36:12,756 return to work like nothing happened. 718 00:36:12,894 --> 00:36:17,347 These days, the patients that I can't stop thinking about 719 00:36:17,485 --> 00:36:19,453 are the ones we couldn't get to in time. 720 00:36:20,730 --> 00:36:23,940 And instead of addressing the problem, 721 00:36:23,965 --> 00:36:29,334 we're patting ourselves on the back for removing a massive spleen. 722 00:36:29,359 --> 00:36:32,431 Look, having a perspective shift after cancer... 723 00:36:32,456 --> 00:36:34,454 it's... it's natural. 724 00:36:34,479 --> 00:36:36,065 I mean, I've been there. 725 00:36:36,090 --> 00:36:37,781 But what if I can't unsee this? 726 00:36:37,919 --> 00:36:39,162 Would that be so bad? 727 00:36:39,811 --> 00:36:41,529 Maybe it's time to start a new chapter. 728 00:36:41,553 --> 00:36:42,952 Spoken like a younger man. 729 00:36:43,682 --> 00:36:45,996 You know, I'm, um, just a guy who 730 00:36:46,021 --> 00:36:48,569 has a lot of experience starting over. 731 00:36:49,947 --> 00:36:52,295 Look, I'm gonna go check on our patient. 732 00:36:54,739 --> 00:36:56,672 It really was quite a spleen, though, wasn't it? 733 00:36:56,697 --> 00:36:58,134 Lord have mercy. 734 00:37:03,876 --> 00:37:07,545 Okay, monitor her pain and oxygen requirements and page me 735 00:37:07,570 --> 00:37:09,685 if we need to take more fluid off of her abdomen. 736 00:37:09,710 --> 00:37:12,713 Hey, Dr. Bailey, can we run something by you? 737 00:37:13,259 --> 00:37:15,606 Why do I feel like I'm not gonna like this? 738 00:37:15,631 --> 00:37:19,444 Uh, well, uh, Griffith offered to take Katie to her home. 739 00:37:19,597 --> 00:37:22,289 We all know there's a good chance she won't make it to her own home 740 00:37:22,314 --> 00:37:24,005 if she waits for hospice to be set up. 741 00:37:24,446 --> 00:37:26,689 All she wants is to not die in a hospital. 742 00:37:26,859 --> 00:37:28,516 Yeah. What do you think? 743 00:37:28,763 --> 00:37:33,458 I think you two have lost your ever-loving minds. 744 00:37:33,596 --> 00:37:36,125 Katie is not a stray cat to take in. 745 00:37:36,150 --> 00:37:37,703 She needs 24/7 care. 746 00:37:37,728 --> 00:37:39,749 Adams, Kwan, and I would take shifts. 747 00:37:39,774 --> 00:37:41,959 Yeah, and... and her mom can stay in their spare bedroom. 748 00:37:41,983 --> 00:37:43,813 Sorry. 749 00:37:43,838 --> 00:37:45,329 What about pain management? 750 00:37:45,354 --> 00:37:47,931 We can get her scripts filled and administer them at the house. 751 00:37:47,955 --> 00:37:49,784 Yeah, and I can drain her abdomen when needed. 752 00:37:50,035 --> 00:37:51,589 Look, it's literally her dying wish. 753 00:37:51,614 --> 00:37:52,891 I hear you. 754 00:37:54,168 --> 00:37:56,184 But as her surgeon and a leader in 755 00:37:56,208 --> 00:37:58,655 this hospital, I... I cannot advise it. 756 00:37:59,138 --> 00:38:03,142 Okay, she would need a... a hospital bed, an oxygen concentrator. 757 00:38:03,281 --> 00:38:04,696 Are you writing this down? 758 00:38:04,834 --> 00:38:06,284 - Oh. - Yeah. 759 00:38:16,495 --> 00:38:19,947 Finally, I was about to go to Saigon Palace by myself. 760 00:38:20,194 --> 00:38:21,753 Yeah, I was looking over Dr. Wright's 761 00:38:21,777 --> 00:38:23,335 notes for the sternal reconstruction. 762 00:38:23,705 --> 00:38:25,424 I heard you were joining the case. 763 00:38:25,618 --> 00:38:27,172 I'll fill you in over pho. 764 00:38:27,879 --> 00:38:29,121 I can't do it. 765 00:38:29,151 --> 00:38:31,905 Banh mi. Whatever. I'm starving. Let's go. 766 00:38:32,039 --> 00:38:36,250 I told Wright to find another resident for the procedure tomorrow. 767 00:38:36,918 --> 00:38:39,161 - Why? - Jules is my friend. 768 00:38:40,801 --> 00:38:42,906 Turns out you and I aren't as alike as we thought. 769 00:38:44,563 --> 00:38:47,499 I already told Wright that I was committed to assist Altman tomorrow. 770 00:38:49,463 --> 00:38:50,740 You didn't tell her about me? 771 00:38:51,748 --> 00:38:53,991 I was going to give you a chance to do it yourself. 772 00:38:59,491 --> 00:39:01,280 I hope you get the job in Boston. 773 00:39:04,617 --> 00:39:06,207 We often place blame because 774 00:39:06,232 --> 00:39:08,104 it's easier than taking responsibility. 775 00:39:08,740 --> 00:39:11,467 If you always look outward, you never have to turn inward. 776 00:39:11,535 --> 00:39:13,019 Seriously? 777 00:39:13,831 --> 00:39:16,052 - I get to leave? - Yeah. 778 00:39:16,077 --> 00:39:20,056 We arranged medical transport, and Dr. Griffith 779 00:39:20,081 --> 00:39:22,256 is working to get you discharged right now. 780 00:39:22,394 --> 00:39:25,199 I'll stock the fridge, cook meals, whatever I need to do. 781 00:39:25,224 --> 00:39:26,504 No. That... that's not necessary. 782 00:39:26,529 --> 00:39:29,256 We, uh... We want to help. 783 00:39:31,252 --> 00:39:32,506 Thank you. 784 00:39:33,778 --> 00:39:35,592 None of this would have happened without you. 785 00:39:38,950 --> 00:39:42,091 But progress only comes when you shine the light on yourself. 786 00:39:47,156 --> 00:39:49,503 Didn't I fold all this laundry earlier? 787 00:39:49,734 --> 00:39:52,226 Hattie spit up everywhere, so did Peyton. 788 00:39:52,251 --> 00:39:54,332 Luna got the ketchup bottle and... 789 00:39:54,357 --> 00:39:56,535 You know what? I don't want to talk about it. 790 00:39:59,392 --> 00:40:01,394 My shoulder still hurts. 791 00:40:03,683 --> 00:40:06,434 I was hoping it'd get better, and I'd go back to work 792 00:40:07,966 --> 00:40:10,728 and build the safest staircase ever to exist, 793 00:40:10,753 --> 00:40:13,583 but obviously, that hasn't happened. 794 00:40:13,721 --> 00:40:17,449 Well, you don't have to fix everything yourself. 795 00:40:17,587 --> 00:40:19,417 Yeah, I've realized that. 796 00:40:20,210 --> 00:40:22,765 But you might have to go back to work eventually 797 00:40:22,903 --> 00:40:24,939 so we can afford to pay Elroy to do it. 798 00:40:29,462 --> 00:40:31,380 - I was wondering... - Mm-hmm. 799 00:40:31,405 --> 00:40:35,236 what if Elroy didn't actually fix this place? 800 00:40:36,769 --> 00:40:39,895 We've really pushed our luck already with these stairs, 801 00:40:39,920 --> 00:40:43,485 the-the fireplace, the balcony, the glass doors. 802 00:40:43,510 --> 00:40:45,166 What if he fixed my rental instead? 803 00:40:45,437 --> 00:40:48,648 You want us to move into the man cave? 804 00:40:49,061 --> 00:40:53,134 It's in a great neighborhood, and it would be way easier to babyproof. 805 00:40:54,935 --> 00:40:57,820 This place just has so many memories. 806 00:40:57,845 --> 00:41:01,259 You know, movie nights on this couch, 807 00:41:01,284 --> 00:41:03,737 the Nicoletti's take-out dinners on that table. 808 00:41:03,762 --> 00:41:06,548 You proposed to me, right there. 809 00:41:08,670 --> 00:41:11,845 - Yeah. - Guess we'll have to make new memories. 810 00:41:16,163 --> 00:41:17,475 We will. 811 00:41:28,329 --> 00:41:29,502 What do you think? 812 00:41:30,647 --> 00:41:31,889 How do you feel? 813 00:41:32,161 --> 00:41:33,438 Millin. 814 00:41:34,044 --> 00:41:35,460 What are you doing here? 815 00:41:35,485 --> 00:41:38,125 Uh, your front driver's side tire is looking a little low. 816 00:41:38,243 --> 00:41:39,762 You're checking my tires? 817 00:41:40,532 --> 00:41:43,717 Today sucked in a lot of ways, 818 00:41:43,742 --> 00:41:47,021 but the worst part is that it confirmed what you think about me. 819 00:41:47,046 --> 00:41:48,748 - Millin... - And I know that I've disappointed you. 820 00:41:48,773 --> 00:41:51,622 And you're not wrong, I haven't always been honest with you. 821 00:41:51,647 --> 00:41:54,207 Like, sometimes when I'm too tired, I don't dictate your op notes, 822 00:41:54,232 --> 00:41:55,867 I make my interns do it. 823 00:41:55,892 --> 00:41:58,313 And I know where you keep your secret stash of protein bars 824 00:41:58,338 --> 00:41:59,892 at the nurses' station, 825 00:41:59,917 --> 00:42:02,644 and I'll sneak one if I don't have time to get to the cafeteria. 826 00:42:06,290 --> 00:42:09,398 And I coached your patient... behind your back 827 00:42:09,423 --> 00:42:11,252 to get around his insurance, 828 00:42:11,343 --> 00:42:14,139 so you would have to operate on him that day. 829 00:42:16,293 --> 00:42:17,433 He was in pain. 830 00:42:18,335 --> 00:42:22,593 I didn't know what else to do, so I lied, but I didn't lie today. 831 00:42:22,618 --> 00:42:25,310 I didn't sew over Scott's pedicle, 832 00:42:25,335 --> 00:42:30,143 and I wasn't trying to frame Mohanty or not take responsibility. 833 00:42:30,168 --> 00:42:33,551 I just didn't do it, and I need you to know that. 834 00:42:33,576 --> 00:42:35,700 It's not my department. I'm not the one you need to convince. 835 00:42:35,725 --> 00:42:38,417 I don't care what anyone else thinks. 836 00:42:45,739 --> 00:42:47,086 I believe you. 837 00:42:52,119 --> 00:42:53,811 I'll, uh... I'll see you tomorrow. 838 00:42:56,279 --> 00:42:57,660 Ask the questions, 839 00:42:58,732 --> 00:43:00,389 and the answers might surprise you. 840 00:43:02,443 --> 00:43:07,443 - Synced and corrected by ChrisKe - — for www.addic7ed.com —