1. Previously on "The Good Doctor"...
Copy !req
2. Is there something you're not telling me? When we're in meetings together,
Copy !req
3. don't ever call my ideas "ridiculous."
Copy !req
4. Come on. I'm being serious.
Copy !req
5. So am I.
Copy !req
6. Merrill's son asked for personal advice.
Copy !req
7. And he picked you. I know, right?
Copy !req
8. A surgeon needs to communicate. Can Dr. Murphy do that?
Copy !req
9. Can he do that under stress?
Copy !req
10. Can he do that knowing that a human life
Copy !req
11. literally hangs in the balance?
Copy !req
12. Thank you, Dr. Kalu.
Copy !req
13. You're welcome. It's a special blend.
Copy !req
14. I roast the beans myself.
Copy !req
15. Smells like leather.
Copy !req
16. Then none for you, Murphy.
Copy !req
17. I don't drink coffee.
Copy !req
18. It is dead in here.
Copy !req
19. That's why they call it the graveyard shift.
Copy !req
20. Oh, well, I call it paradise. You my trauma virgins?
Copy !req
21. Ah, Doctors Murphy, Kalu, Browne —
Copy !req
22. meet Dr. Audrey Lim,
Copy !req
23. your attending for the evening.
Copy !req
24. Hey. Coffee?
Copy !req
25. He roasts the beans himself.
Copy !req
26. Oh. Kiss ass.
Copy !req
27. E.R.
Copy !req
28. How long? Got it.
Copy !req
29. Listen up, everybody!
Copy !req
30. We got a mass cas coming in.
Copy !req
31. It's a bus crash, two dozen passengers.
Copy !req
32. Transfer all patients waiting for beds
Copy !req
33. up to the nursing units.
Copy !req
34. Have maintenance bring down cots.
Copy !req
35. We're gonna convert the waiting room into triage.
Copy !req
36. No one goes home till we're all clear!
Copy !req
37. Dr. Page everyone on call. I don't care what department they are.
Copy !req
38. Tonight, everybody's trauma. Glove up and line up.
Copy !req
39. EMTs will have triaged onsite,
Copy !req
40. so the patients are gonna come in tagged.
Copy !req
41. I love these blank faces right before Armageddon.
Copy !req
42. Trauma color coding — who knows it?
Copy !req
43. Green — walking wounded. Yellow — observation.
Copy !req
44. Red needs immediate attention.
Copy !req
45. And black go straight to the morgue.
Copy !req
46. All right, red tags, front of the line!
Copy !req
47. Red tags, front of the line.
Copy !req
48. Wedding bus blew a tire and flipped!
Copy !req
49. 26-year-old female.
Copy !req
50. Second- and third-degree burns
Copy !req
51. to her neck, chest, and left arm.
Copy !req
52. Kalu, you're up.
Copy !req
53. Trauma Six.
Copy !req
54. Guy was ejected 30 feet from the vehicle.
Copy !req
55. Multiple chest contusions,
Copy !req
56. acute respiratory distress on the scene,
Copy !req
57. sluggish pupillary response.
Copy !req
58. How long have you been doing CPR? 12 minutes.
Copy !req
59. Have you shocked him? Three times.
Copy !req
60. We got to crack him. Dr. Browne, I got this.
Copy !req
61. You take the next one. All right, Bay Five.
Copy !req
62. We secured the foreign object and staunched the bleeding,
Copy !req
63. but didn't want to touch it otherwise.
Copy !req
64. Good thing. It nicked her carotid. What is it?
Copy !req
65. Right now it's a little Dutch boy
Copy !req
66. keeping her from bleeding out.
Copy !req
67. Pulse ox is dropping. She's at 87.
Copy !req
68. O2 sats down to 83.
Copy !req
69. Forget about the neck, Claire.
Copy !req
70. Treat her like any other patient.
Copy !req
71. What are the first steps?
Copy !req
72. Airway, breathing, circulation.
Copy !req
73. Good. Grab a kit.
Copy !req
74. I need help here! Somebody, help!
Copy !req
75. Murphy, go!
Copy !req
76. Let's go.
Copy !req
77. Trauma Three.
Copy !req
78. I can't stop the bleeding.
Copy !req
79. He's bleeding out. Do something.
Copy !req
80. I need a urinary catheter, 14-gauge needle,
Copy !req
81. arterial guide wire, occlusion balloon,
Copy !req
82. and 20 cc of saline, stat.
Copy !req
83. — Captions by VITAC —
Copy !req
84. Well, you don't have one, so I'm making a REBOA.
Copy !req
85. A what?
Copy !req
86. A REBOA.
Copy !req
87. Is that even a word?
Copy !req
88. A REBOA will occlude the damaged artery
Copy !req
89. and stop the bleeding.
Copy !req
90. Release the pressure.
Copy !req
91. BP is stabilizing. 90 over 60.
Copy !req
92. Nice work, Dr. Murphy.
Copy !req
93. I made a REBOA.
Copy !req
94. Oxygen is dropping to 89.
Copy !req
95. All right. Light.
Copy !req
96. Open wide for me.
Copy !req
97. Throat's swollen from smoke inhalation.
Copy !req
98. Cric kit.
Copy !req
99. Do you see soot in her mouth or nose? No.
Copy !req
100. She doesn't need a cric. She needs an escharotomy.
Copy !req
101. Sats are going back up. 92 and rising.
Copy !req
102. Circumferential neck burns.
Copy !req
103. The shrinking charred skin is acting like a noose.
Copy !req
104. Escharotomy relieves the constriction.
Copy !req
105. Are you getting enough air now, ma'am?
Copy !req
106. Yes. Thank you.
Copy !req
107. Now get her out of this petri dish
Copy !req
108. and into an isolation ward in the burn unit ASAP.
Copy !req
109. Yes, sir.
Copy !req
110. Your heart's a bit muffled.
Copy !req
111. Am I having a heart attack?
Copy !req
112. No, but it's not completely good news.
Copy !req
113. Cardiac tamponade.
Copy !req
114. He needs a pericardiocentesis.
Copy !req
115. Yes, I'm aware of that.
Copy !req
116. 18-gauge and 55 cc syringe, please.
Copy !req
117. We need a FAST ultrasound in here.
Copy !req
118. They're both in use.
Copy !req
119. You don't have imaging. You could puncture his heart.
Copy !req
120. Is the xiphoid in the same place as it was 20 years ago?
Copy !req
121. A REBOA.
Copy !req
122. Ballsy.
Copy !req
123. Could've gone really wrong.
Copy !req
124. Yes, well, it didn't.
Copy !req
125. It's a cowboy move —
Copy !req
126. something you would never even dream of trying.
Copy !req
127. How many times is Shaun gonna have to prove himself
Copy !req
128. before you give him a shot?
Copy !req
129. Woman overDr. Rolendez, O.R. 6.
Copy !req
130. What happened in the E.R.?
Copy !req
131. Swan girl came in and you hesitated.
Copy !req
132. I wasn't hesitating. I was thinking of a game plan.
Copy !req
133. Murphy was thinking of the game plan.
Copy !req
134. You got overwhelmed.
Copy !req
135. I wasn't.
Copy !req
136. First trauma — it happens.
Copy !req
137. You have to think clearly, quickly, methodically.
Copy !req
138. You need to think a little more like Shaun.
Copy !req
139. A little more. Not identically.
Copy !req
140. How you doing?
Copy !req
141. Sorry.
Copy !req
142. Sorry. That's a stupid question.
Copy !req
143. You're maxed out on morphine.
Copy !req
144. I'll hold off until it reloads.
Copy !req
145. How bad is it?
Copy !req
146. We're making good progress.
Copy !req
147. I'll have to, uh, debride any deroofed blisters
Copy !req
148. to prevent a secondary nosocomial and then —
Copy !req
149. I need a mirror.
Copy !req
150. It's the least you can do
Copy !req
151. since you can't even look me in the eye.
Copy !req
152. Oh, my God.
Copy !req
153. Do you know how many hideous $300 bridesmaid dresses
Copy !req
154. I've had to buy in the last two years?
Copy !req
155. I decided that when I got married,
Copy !req
156. my bridesmaids are gonna wear black cocktail dresses
Copy !req
157. so they can use them again, you know?
Copy !req
158. But now...
Copy !req
159. now I-I'm Freddy Krueger.
Copy !req
160. Who's gonna want to marry this?
Copy !req
161. I'm gonna find a nurse,
Copy !req
162. have her adjust your, uh — your morphine drip.
Copy !req
163. Okay.
Copy !req
164. You hit your face.
Copy !req
165. Your jaw got stuck. It hurts.
Copy !req
166. So, this shot I just gave you is gonna knock you out
Copy !req
167. so that I can fix that.
Copy !req
168. Hang tight.
Copy !req
169. Crash patients status check? 23 people total.
Copy !req
170. One fatality on site, lost one in the E.R.
Copy !req
171. Examined all the red tags.
Copy !req
172. Got 13 yellow and green still in the waiting room.
Copy !req
173. I'll take whoever's up next. Marco Magallenes —
Copy !req
174. severed femoral artery, crushed femur.
Copy !req
175. I did the REBOA and then installed a temporary shunt.
Copy !req
176. Here are his CT and MRI results.
Copy !req
177. Find someone else for whoever's up next.
Copy !req
178. Oh, finally.
Copy !req
179. Excuse me. Are you Marco's family?
Copy !req
180. Yes.
Copy !req
181. We just found out that my cousin didn't survive the accident.
Copy !req
182. I'm sorry.
Copy !req
183. It's a bit much. I'm so sorry.
Copy !req
184. I'm Dr. Melendez, and this is Dr. Murphy.
Copy !req
185. I'm Ricardo.
Copy !req
186. I'm M-Marco's father.
Copy !req
187. This is, uh, his mother, Lorena, and this is Sonia.
Copy !req
188. They were getting married tonight.
Copy !req
189. How's my son?
Copy !req
190. Marco's femur was completely shattered,
Copy !req
191. and his lower leg isn't getting enough blood.
Copy !req
192. Can you save his leg?
Copy !req
193. Marco suffered too much bone fragmentation.
Copy !req
194. We can't fix it.
Copy !req
195. Our only choice is to amputate.
Copy !req
196. Mija.
Copy !req
197. Bay Five needs a grade three hyphema.
Copy !req
198. Head CT and page ophthalmology?
Copy !req
199. You read my mind.
Copy !req
200. Been a while.
Copy !req
201. How you holding up pulling an all-nighter?
Copy !req
202. I'll manage, but if you can find me a caffeine IV,
Copy !req
203. it'd be helpful. Please move!
Copy !req
204. - Tough night. - Yeah.
Copy !req
205. Thanks for coming.
Copy !req
206. It's part of the job.
Copy !req
207. So, when's the big day?
Copy !req
208. Uh, we haven't set it yet.
Copy !req
209. Oh, where is it gonna be?
Copy !req
210. We'll figure it out.
Copy !req
211. Maybe a beach somewhere.
Copy !req
212. We should talk about this later.
Copy !req
213. What? I like beaches.
Copy !req
214. If you have a more romantic idea...
Copy !req
215. My family likes churches.
Copy !req
216. We should talk about this later.
Copy !req
217. Dr. Lim, I think one of your yellows is about to turn red.
Copy !req
218. Hey.
Copy !req
219. I've got my wedding all planned out.
Copy !req
220. I've got the dress, and I've got the flowers.
Copy !req
221. All I need is a groom.
Copy !req
222. You available, Dr. Murphy?
Copy !req
223. No.
Copy !req
224. You don't want some love?
Copy !req
225. No. No, I don't. I don't want love.
Copy !req
226. Dr. Glassman, neural consult, bay three.
Copy !req
227. Thank you.
Copy !req
228. Hey!
Copy !req
229. I was here first.
Copy !req
230. Shaun.
Copy !req
231. Shaun!
Copy !req
232. My patient's scans are very important.
Copy !req
233. Well, my patient's important, too.
Copy !req
234. I need to see my patient's scans.
Copy !req
235. Is your patient pre-op or post-op?
Copy !req
236. Pre-op.
Copy !req
237. Okay, I'll give you the computer,
Copy !req
238. but you need to apologize first.
Copy !req
239. Okay, I'm sorry. Turn it on.
Copy !req
240. Why was Marco's family crying when Dr. Melendez
Copy !req
241. told them his leg would need to be amputated?
Copy !req
242. Well, their son's leg is about to be cut off.
Copy !req
243. It's sad. Crying is normal.
Copy !req
244. But when your options are amputation or death,
Copy !req
245. amputation is good news.
Copy !req
246. People need time to adjust to big changes.
Copy !req
247. Marco's family didn't even get a chance to pray for a miracle.
Copy !req
248. Mm. It's not possible.
Copy !req
249. The bone damage is too severe.
Copy !req
250. A rod implantation won't work.
Copy !req
251. There's nothing to anchor into,
Copy !req
252. and the shunt won't last long enough
Copy !req
253. to do reconstruction.
Copy !req
254. There are no other options.
Copy !req
255. What if we could replace the entire femur?
Copy !req
256. We're making him a new femur.
Copy !req
257. With a 3D printer?
Copy !req
258. 3D-printed bones have only successfully
Copy !req
259. been done with the mandible. We know.
Copy !req
260. That's a fairly small bone. We know.
Copy !req
261. A femur has to support the weight of the entire body.
Copy !req
262. This one will be titanium. It can work.
Copy !req
263. It's an interesting idea...
Copy !req
264. but I need to think on it.
Copy !req
265. Right now we still got seven yellow tags waiting.
Copy !req
266. What do you have to think about?
Copy !req
267. It's a good idea. It's a brilliant idea.
Copy !req
268. The kid has brilliant ideas. That doesn't mean —
Copy !req
269. No, it was my idea, and I'm aware of the risks —
Copy !req
270. infection, clotting, hardware failure...
Copy !req
271. Death.
Copy !req
272. It wasn't your idea. It was my idea!
Copy !req
273. And the risks are significant, but isn't that their call?
Copy !req
274. Don't we have to — Maybe he said something,
Copy !req
275. and then you said something, and together, you —
Copy !req
276. My idea. Completely my idea.
Copy !req
277. The "brilliant" idea is 100% my brilliant idea.
Copy !req
278. Why is that a problem for you?
Copy !req
279. Maybe because I've known you for six months.
Copy !req
280. Every day we learn new things.
Copy !req
281. Today, you learned I'm brilliant.
Copy !req
282. The idea was brilliant.
Copy !req
283. And it was mine.
Copy !req
284. And if anyone can do this brilliant surgery, it's you.
Copy !req
285. Flattery —
Copy !req
286. also brilliant.
Copy !req
287. Sleeping on the job?
Copy !req
288. Just needed some fresh air.
Copy !req
289. Feels like I'm suffocating in there.
Copy !req
290. She's in pain, spilling her guts out,
Copy !req
291. and every time I open my mouth, I sound like an idiot.
Copy !req
292. Dr. Kalu — unable to talk to women.
Copy !req
293. There's a first.
Copy !req
294. If you're not gonna be helpful, Claire, just leave.
Copy !req
295. You don't need to talk. Just listen to her.
Copy !req
296. You get to come out here, clear your head.
Copy !req
297. She's trapped in there, alone with her thoughts, her fears.
Copy !req
298. You don't think she wants to get out?
Copy !req
299. You are her escape.
Copy !req
300. You want to put a fake femur into Marco's leg?
Copy !req
301. It's not fake. It's real.
Copy !req
302. It's not a real bone. We're making it out of titanium.
Copy !req
303. It's still real.
Copy !req
304. That's incredible.
Copy !req
305. And Marco will be able to walk, run, climb?
Copy !req
306. And swim.
Copy !req
307. Hopefully. That's the intention.
Copy !req
308. Well, have you done the surgery before?
Copy !req
309. I haven't. We'll be the first.
Copy !req
310. Well, nobody has ever attempted this surgery
Copy !req
311. with a bone as large as the femur.
Copy !req
312. I believe it's a viable option, but there are risks.
Copy !req
313. Risks? Could Marco die?
Copy !req
314. In my estimation, there's a 10% chance
Copy !req
315. he won't make it. Then no.
Copy !req
316. I'm not losing my son.
Copy !req
317. Wait. If there's a chance we can save Marco's leg,
Copy !req
318. we should at least discuss this some more.
Copy !req
319. That's what he'd want.
Copy !req
320. He'd want to live.
Copy !req
321. He'd want to have a life.
Copy !req
322. I know him.
Copy !req
323. He'd want to take the chance.
Copy !req
324. I will never forgive myself if Marco died
Copy !req
325. because I made a reckless decision.
Copy !req
326. Whose decision is this?
Copy !req
327. Does he have a healthcare proxy?
Copy !req
328. I don't know what that is.
Copy !req
329. When the accident happened,
Copy !req
330. were you on the way to your wedding or on the way back?
Copy !req
331. We were headed to the wedding.
Copy !req
332. Marco's parents are the next of kin.
Copy !req
333. They decide.
Copy !req
334. Please...
Copy !req
335. amputate our son's leg.
Copy !req
336. Murphy.
Copy !req
337. Why is the primary closure on the stump
Copy !req
338. so vital in amputation surgery? For a proper prosthetic fitting.
Copy !req
339. Why are you marrying Jessica?
Copy !req
340. Why does anyone get married?
Copy !req
341. I don't know.
Copy !req
342. I love her.
Copy !req
343. I don't understand why having someone to love
Copy !req
344. is so important to everyone.
Copy !req
345. You have to stand down.
Copy !req
346. You can't amputate Marco's leg. Why not?
Copy !req
347. I filed an emergency injunction to stop the surgery.
Copy !req
348. You were in a car accident.
Copy !req
349. Your neck was punctured.
Copy !req
350. The repair surgery went well.
Copy !req
351. You're gonna have to stay put for a week
Copy !req
352. before we can release you.
Copy !req
353. You're very lucky to be alive.
Copy !req
354. My wife, Jenna Hensel — is she okay?
Copy !req
355. Can I see her?
Copy !req
356. She's not listed.
Copy !req
357. That's a good thing.
Copy !req
358. She's probably still in the waiting room.
Copy !req
359. I'll find her and bring her up.
Copy !req
360. She'll be relieved to know you're okay.
Copy !req
361. Okay.
Copy !req
362. What the hell am I supposed to do with
Copy !req
363. an unconscious patient
Copy !req
364. whose leg is a ticking time bomb?
Copy !req
365. Judge Singh is en route.
Copy !req
366. She wants to hear from both parties
Copy !req
367. and the doctors on the case.
Copy !req
368. I have to testify?
Copy !req
369. Hopefully not. Hopefully not.
Copy !req
370. I thought you would be happy.
Copy !req
371. You thought you could save the leg,
Copy !req
372. and I didn't want that not happening because the parents
Copy !req
373. are afraid to make a tough call.
Copy !req
374. It's their call to make.
Copy !req
375. And if the accident happened an hour later,
Copy !req
376. it would be the wife's.
Copy !req
377. And she wants the fake leg.
Copy !req
378. It's not fake.
Copy !req
379. I thought you didn't believe
Copy !req
380. in just blindly following protocol.
Copy !req
381. He's their son.
Copy !req
382. Nobody's gonna love him more than them.
Copy !req
383. Seriously?
Copy !req
384. All parents love all children
Copy !req
385. more than anybody else?
Copy !req
386. People get divorced all the time.
Copy !req
387. How often do they give up their kids?
Copy !req
388. So, if this was us,
Copy !req
389. you'd want your parents to decide over me?
Copy !req
390. I didn't say that. You kind of did.
Copy !req
391. I was saying, there needs to be rules,
Copy !req
392. that there needs to be bright red lines telling us
Copy !req
393. who gets to make these calls.
Copy !req
394. It's the parents' call.
Copy !req
395. Not anymore.
Copy !req
396. Now it's the judge's.
Copy !req
397. How much time does Marco have left on the temporary shunt?
Copy !req
398. Three hours,
Copy !req
399. and then his leg will die.
Copy !req
400. Okay. Mm.
Copy !req
401. Dr. Torture returns.
Copy !req
402. Thought I'd scared you off for good.
Copy !req
403. Pick a movie.
Copy !req
404. You deserve to get out of this room for a little while, too.
Copy !req
405. You think "Groundhog Day" is gonna make a difference?
Copy !req
406. "I'm torturing you, but, hey, you get to watch a funny movie."
Copy !req
407. That is sort of what I was going for, yeah.
Copy !req
408. I'm sorry.
Copy !req
409. I wish there was something else I could do.
Copy !req
410. How do you know there isn't?
Copy !req
411. This is protocol. This is what they teach us.
Copy !req
412. I lucked out.
Copy !req
413. I got the world's greatest expert on burn victims?
Copy !req
414. You know everything that can be done.
Copy !req
415. He loves to rock-climb, scuba dive, bungee-jump.
Copy !req
416. This is insane.
Copy !req
417. His leg is literally dying while we sit here reminiscing.
Copy !req
418. Please. We're trying to figure out what your son would want.
Copy !req
419. He would want to live. I want that, too,
Copy !req
420. but if there's a way that we can save Marco's leg,
Copy !req
421. he'd want me to do it.
Copy !req
422. Mija, Do you know what he wanted most of all?
Copy !req
423. He wanted to marry you.
Copy !req
424. He wanted to spend his life with you, have children with you.
Copy !req
425. Now, he can do all that.
Copy !req
426. He can be happy with a prosthetic leg.
Copy !req
427. He's young, and he's strong.
Copy !req
428. Mija, he can get through this.
Copy !req
429. When we met — I don't care about your stories.
Copy !req
430. I don't care that you met rock-climbing
Copy !req
431. or kayaking or whatever.
Copy !req
432. I just want — We met in rehab.
Copy !req
433. Hey, are either of you Jenna Hensel?
Copy !req
434. I haven't seen Jenna
Copy !req
435. since we took pictures at the hotel.
Copy !req
436. But she got on the bus?
Copy !req
437. Yeah, she was sitting with Noomi.
Copy !req
438. I think she's still out there.
Copy !req
439. Hey, guys! We've got to go back. Where?
Copy !req
440. To the crash site. Now.
Copy !req
441. He never wanted you to know.
Copy !req
442. He's an addict.
Copy !req
443. He replaced one addiction for another one — a healthier one.
Copy !req
444. But he needs — What?
Copy !req
445. He needs to wakeboard or he'll drink himself to death?
Copy !req
446. This is ridiculous.
Copy !req
447. No, it's not!
Copy !req
448. We talked about it a lot.
Copy !req
449. It's pretty much all you do in rehab.
Copy !req
450. Marco has clarity for the first time in his life.
Copy !req
451. He knows what makes him happy.
Copy !req
452. He knows his weaknesses.
Copy !req
453. He's not as strong as you think.
Copy !req
454. And that's okay, but —
Copy !req
455. Marco cheated on you.
Copy !req
456. It was about a month ago.
Copy !req
457. He was overwhelmed with the wedding and the planning.
Copy !req
458. He ran into an ex-girlfriend.
Copy !req
459. It only happened once.
Copy !req
460. You're lying.
Copy !req
461. You're upset that he had secrets from you, so —
Copy !req
462. No, she's not lying.
Copy !req
463. Mija, he — he was — he was so upset.
Copy !req
464. He does love you.
Copy !req
465. Okay, maybe we're digressing here a little bit.
Copy !req
466. And we really don't have the time.
Copy !req
467. It matters.
Copy !req
468. She doesn't know him like —
Copy !req
469. maybe none of us do, but...
Copy !req
470. but we are his parents, and you're not his wife.
Copy !req
471. Yet.
Copy !req
472. Okay. Get the cops. Check everywhere —
Copy !req
473. other side of the road, bushes, trees.
Copy !req
474. If she was ejected from the bus, she could be 40, 50 feet
Copy !req
475. in any direction.
Copy !req
476. Jenna!
Copy !req
477. I found her! I need some help!
Copy !req
478. Okay, she's got a brain bleed.
Copy !req
479. We need to get her out of here now!
Copy !req
480. Dr. Andrews.
Copy !req
481. I think Celez may be eligible
Copy !req
482. for an experimental bone treatment.
Copy !req
483. Sell it to me.
Copy !req
484. Well, I've been doing some digging.
Copy !req
485. San Diego Community Hospital's burn unit
Copy !req
486. has been following a Brazilian hospital's protocol
Copy !req
487. to wrap burns in tilapia skins.
Copy !req
488. Now — Now, I know fish skins sound a bit crazy,
Copy !req
489. but — but I was thinking we could do the same thing here.
Copy !req
490. Dr. Kalu, I applaud your thinking.
Copy !req
491. But we — Tilapia skins contain more collagen proteins —
Copy !req
492. both types 1 and 3 — than even human skin,
Copy !req
493. which aids in tissue repair, negating the need for grafts. Dr. Kalu.
Copy !req
494. It's shown to accelerate healing, would reduce... Dr. Kalu.
Copy !req
495. the risk of infection and cut down on
Copy !req
496. the patient's physical pain.
Copy !req
497. Are you finished, or would you like to cut me off again?
Copy !req
498. Okay, let's follow this through, shall we?
Copy !req
499. You have to come up with a proposal
Copy !req
500. for the experimental treatment,
Copy !req
501. get it approved by our institutional review board,
Copy !req
502. get your hands on medical-grade tilapia skins,
Copy !req
503. and then we — Well, I thought you could help expedite the process.
Copy !req
504. You think I could bring it down from three months to two hours?
Copy !req
505. You finish the debridement?
Copy !req
506. Okay, I'll take over from here.
Copy !req
507. Okay. Hey.
Copy !req
508. Keep thinking outside the box.
Copy !req
509. Initiative is good.
Copy !req
510. I'm in. Bag her.
Copy !req
511. Did you get me the drill?
Copy !req
512. The fire truck had one. What's going on?
Copy !req
513. Her pupil's blown.
Copy !req
514. She has a subdural hematoma,
Copy !req
515. causing increased intracranial pressure.
Copy !req
516. If I don't alleviate it now,
Copy !req
517. there's no way she makes it to the hospital alive.
Copy !req
518. Okay.
Copy !req
519. Unconscious female. Flail chest.
Copy !req
520. I had to do a burr hole in field.
Copy !req
521. Her sats are in the low 70s.
Copy !req
522. She's good to go to the O.R.
Copy !req
523. Subdural hematoma?
Copy !req
524. She had decerebrate posturing, a blown left pupil.
Copy !req
525. When I passed the drill bit through her skull,
Copy !req
526. a whole lot of blood pooled out.
Copy !req
527. Good call.
Copy !req
528. Uh, San Diego Community Hospital called.
Copy !req
529. They're sending the tilapia skins.
Copy !req
530. They're medevacing them in.
Copy !req
531. Should be here within the hour.
Copy !req
532. Celez...
Copy !req
533. you meet the criteria for an experimental treatment
Copy !req
534. that I think will prevent you
Copy !req
535. from having to undergo skin grafts.
Copy !req
536. Hold up. How did this even happen?
Copy !req
537. Well, I found out San Diego's trial
Copy !req
538. allows for multi-site collaborations.
Copy !req
539. So, there's no need for us to get our own I.R.B.
Copy !req
540. They give us the skins, we provide the patient data.
Copy !req
541. Fish skins?
Copy !req
542. The tilapia skins have been cleaned and sterilized.
Copy !req
543. They're perfectly safe.
Copy !req
544. You'll do it?
Copy !req
545. I'll do it.
Copy !req
546. Well done, Dr. Kalu.
Copy !req
547. Well done.
Copy !req
548. so help you God?
Copy !req
549. Yes.
Copy !req
550. Dr. Melendez can tell you — He has.
Copy !req
551. But the fake femur is yours, though, right?
Copy !req
552. How confident are you in its design? It's not fake!
Copy !req
553. Shaun, she needs to know — I know what she needs to know.
Copy !req
554. She needs to know will it work.
Copy !req
555. She needs to know how long it will last.
Copy !req
556. Yes.
Copy !req
557. Okay.
Copy !req
558. He's his doctor?
Copy !req
559. He is a surgical resident. He's very gifted.
Copy !req
560. Is he going to answer my questions?
Copy !req
561. Shaun, I really need you to focus.
Copy !req
562. Marco is running out of time! Just let him answer!
Copy !req
563. No, we already know the answer. They don't know.
Copy !req
564. This thing has never been done before.
Copy !req
565. Be quiet!
Copy !req
566. His toes are changing color.
Copy !req
567. He's clotting. That's bad. Page Dr. Melendez stat!
Copy !req
568. Murphy, what do we got? The shunt is clotting.
Copy !req
569. It's restricting blood flow. It is failing.
Copy !req
570. All right, we need a decision now.
Copy !req
571. Are we cutting off the leg or replacing the bone?
Copy !req
572. There's no doubt in my mind that Marco's parents
Copy !req
573. and fiancée all love Marco, but it's become clear —
Copy !req
574. Now. I need a decision now.
Copy !req
575. His parents know him as their child.
Copy !req
576. Sonia knows him as a man.
Copy !req
577. Replace the femur.
Copy !req
578. Let's go!
Copy !req
579. Thank you! Thank you.
Copy !req
580. And there's the bleed. See it? Yes, sir.
Copy !req
581. You ever clip an intracranial artery before?
Copy !req
582. No, sir.
Copy !req
583. Go for it.
Copy !req
584. Just like every first time —
Copy !req
585. you're a little excited, a little nauseous.
Copy !req
586. Hopefully nobody gets hurt.
Copy !req
587. Is it good to go?
Copy !req
588. It's very good.
Copy !req
589. Forceps.
Copy !req
590. You ready?
Copy !req
591. Yes.
Copy !req
592. Be careful the clip blades don't catch
Copy !req
593. any perforated arteries.
Copy !req
594. I don't seen any vessels in the way.
Copy !req
595. Then what are you waiting for?
Copy !req
596. Very nice.
Copy !req
597. Thank you.
Copy !req
598. Everything's dry.
Copy !req
599. Say goodbye and close the roof.
Copy !req
600. We need to get blood back into his leg
Copy !req
601. in the next minute or so,
Copy !req
602. or I'm gonna have to amputate after all.
Copy !req
603. Insulin's hanging, loaded him with calcium.
Copy !req
604. Best I can do.
Copy !req
605. Let's release the clamps.
Copy !req
606. Check for capillary refill.
Copy !req
607. Blood flow is restored.
Copy !req
608. EKG is normal.
Copy !req
609. Okay. Kim, I want to hear words like
Copy !req
610. "variability" and "Delta".
Copy !req
611. Give them to me.
Copy !req
612. I'm waiting patiently.
Copy !req
613. I'm not getting anything.
Copy !req
614. Show me.
Copy !req
615. Check the leads.
Copy !req
616. Still nothing.
Copy !req
617. Maybe there will be some neuroplasticity.
Copy !req
618. Her brain — I-it could rewire itself.
Copy !req
619. No.
Copy !req
620. Zero brain activity.
Copy !req
621. I don't know why, but she's gone.
Copy !req
622. What?
Copy !req
623. Your neurosurgery patient that died tonight —
Copy !req
624. there's something you should know.
Copy !req
625. What?
Copy !req
626. Now, Marco, I want you to try and move your toes.
Copy !req
627. I can't.
Copy !req
628. Is he okay?
Copy !req
629. We're not sure if the bone —
Copy !req
630. He's not gonna die?
Copy !req
631. H-He's not gonna get an infection?
Copy !req
632. His body's not gonna reject — No, no. We're monitoring him very closely.
Copy !req
633. The biggest threat is behind — He moved.
Copy !req
634. He moved.
Copy !req
635. It worked.
Copy !req
636. You'll have a long recovery ahead —
Copy !req
637. months of physical therapy.
Copy !req
638. But for now, all you have to do is rest.
Copy !req
639. Thank you.
Copy !req
640. Thank you for saving my life — for saving my leg.
Copy !req
641. Thank you. You're welcome, sir.
Copy !req
642. Are you ready to finish what we started?
Copy !req
643. Get well first.
Copy !req
644. There's plenty of time for a wedding.
Copy !req
645. Thank you. You're welcome, sir.
Copy !req
646. Thank you.
Copy !req
647. You look good.
Copy !req
648. Tough. Like Aquaman.
Copy !req
649. Mm. I look like sushi.
Copy !req
650. Everybody loves sushi.
Copy !req
651. It's only for six months.
Copy !req
652. Your new skin should have completely grown in by then.
Copy !req
653. Should have minor scarring.
Copy !req
654. Thank you.
Copy !req
655. I misjudged you.
Copy !req
656. You judged me just right.
Copy !req
657. Is she still sleeping?
Copy !req
658. You haven't told her yet?
Copy !req
659. No.
Copy !req
660. Can I have a moment please?
Copy !req
661. Of course.
Copy !req
662. How soon after you found Jenna at the crash site
Copy !req
663. did you intubate her?
Copy !req
664. Almost immediately.
Copy !req
665. I did a sternal rub.
Copy !req
666. Uh, she had decerebrate posturing.
Copy !req
667. Her left pupil was blown.
Copy !req
668. I knew she had a subdural hematoma,
Copy !req
669. so I intubated, did the burr hole.
Copy !req
670. She also had a flail chest.
Copy !req
671. Did you check her breathing after you intubated her?
Copy !req
672. Yes.
Copy !req
673. Well, at least I-I think I did.
Copy !req
674. Dr. Lim told me that when Jenna came into the E.R.,
Copy !req
675. she wasn't ventilating properly.
Copy !req
676. You inserted the tube too deep
Copy !req
677. into her right main stem bronchus
Copy !req
678. of her injured lung.
Copy !req
679. We had no way of knowing
Copy !req
680. how long she was hypoxic before we gave her the EEG.
Copy !req
681. I drilled a perfect burr hole into her skull
Copy !req
682. on the side of the road in the middle of the night,
Copy !req
683. and I-I-I screw up her intubation?
Copy !req
684. Yes. It was tough conditions for anyone — resident or not.
Copy !req
685. Any one of us could have made the same mistake.
Copy !req
686. I had a woman come into the E.R. once...
Copy !req
687. a mother, 51 years old.
Copy !req
688. Francine Parker.
Copy !req
689. She had two boys.
Copy !req
690. She had a cough —
Copy !req
691. a bad one — but a cough.
Copy !req
692. I checked her out, gave her some antibiotics, sent her home.
Copy !req
693. Six hours later, she was rolled into the E.R.
Copy !req
694. She had had a heart attack, and I missed it, and...
Copy !req
695. she died.
Copy !req
696. Not one day... goes by when I don't think about her.
Copy !req
697. She was your first.
Copy !req
698. My fourth, actually.
Copy !req
699. You're not gonna forget this.
Copy !req
700. You never forget.
Copy !req
701. But I don't know, maybe we're better off for it
Copy !req
702. the next time around.
Copy !req
703. You got to find a way to keep going.
Copy !req
704. Yeah.
Copy !req
705. Go home. Get some rest.
Copy !req
706. I haven't even told her yet.
Copy !req
707. You're not going to.
Copy !req
708. You made a mistake. You're too close to this.
Copy !req
709. I'm not gonna allow you to talk to the family
Copy !req
710. or anyone else outside this hospital about this.
Copy !req
711. Do we understand each other?
Copy !req
712. Yes, sir.
Copy !req
713. I called San Diego Community Hospital and thanked them
Copy !req
714. for including us in their study.
Copy !req
715. They said they were happy to do it.
Copy !req
716. And they asked that I pass along their thanks to you
Copy !req
717. for your very generous donation to their burn unit.
Copy !req
718. I know you come from a wealthy family.
Copy !req
719. I don't begrudge that, but you...
Copy !req
720. can't open your wallet every time a patient's in need.
Copy !req
721. The lines can get real blurry real fast.
Copy !req
722. Yes, sir.
Copy !req
723. What's this?
Copy !req
724. My healthcare proxy.
Copy !req
725. Jess, nothing's gonna happen.
Copy !req
726. Really? That's good to know.
Copy !req
727. Well, that was quite a night.
Copy !req
728. Been a doctor for a long while —
Copy !req
729. don't remember a night quite like that one.
Copy !req
730. Why did Nurse Farrar ask if I wanted love?
Copy !req
731. 'Cause she's a nosy...
Copy !req
732. Shaun, you really don't want love?
Copy !req
733. I loved Steve and my rabbit.
Copy !req
734. Not anymore.
Copy !req
735. You don't love them anymore?
Copy !req
736. No, I don't. They're dead.
Copy !req
737. You can't love someone if they're dead.
Copy !req
738. Well, I've lost people I love.
Copy !req
739. I miss them, and it hurts, but I still love them.
Copy !req
740. I don't want love.
Copy !req
741. Okay.
Copy !req
742. You want breakfast?
Copy !req
743. Can I have four pancakes instead of three?
Copy !req
744. You can have five.
Copy !req
745. I only want four.
Copy !req
746. Okay.
Copy !req
747. Okay.
Copy !req