1. I'm Dr. Browne.
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2. I'll be performing
your surgery today.
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3. I'm Dr. Browne.
I'll be performing
your surgery today.
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4. Dr. Browne…
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5. I'll be performing
your surgery today.
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6. It's a very simple procedure.
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7. It's a straightforward
procedure.
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8. It was a successful surgery.
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9. The surgery was a success.
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10. We expect a full recovery.
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11. I expect a full recovery.
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12. Baby.
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13. Where do you want this?
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14. Uh, thanks, Mom.
Uh, put it by my bag.
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15. I'll have the hospital lab
run it.
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16. Nausea and severe
abdominal pain after eating.
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17. This patient could need
a lap chole.
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18. That would be
an ideal first surgery.
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19. Let's not get
ahead of ourselves.
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20. She may just need
an antacid.
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21. Hi, Michelle.
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22. I understand your mother
is on her way in.
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23. - I'm Dr. Browne.
- And I'm Dr. Shaun Murphy.
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24. You need to fix my sister.
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25. What's your name?
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26. - Tisha.
- Hi, Tisha.
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27. Well, that is exactly
why we're here…
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28. To help your sister.
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29. Foster sister.
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30. When did the pain start?
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31. About an hour ago.
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32. It was on the bus.
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33. My sister rides with me
every day to school and back.
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34. My brother and I
used to live on a bus.
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35. Cool.
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36. Have you felt
like this before?
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37. A few times.
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38. Ow.
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39. She has extreme upper-right
quadrant tenderness.
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40. That's consistent
with cholecystitis.
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41. As is her fever
and elevated white count.
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42. Your gallbladder probably
needs to be removed.
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43. You must be excited, Claire.
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44. This is going to be
your first surgery.
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45. Has your urine changed color?
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46. Gotten darker?
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47. I hear Dr. Browne might have
landed her first lap chole.
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48. It's not exactly
a straightforward case.
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49. The duct is massively dilated,
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50. the wall's inflamed,
this scarring…
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51. It's gonna limit visibility.
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52. Well, the thickness
of the gallbladder wall
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53. does pose a challenge.
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54. What do you think?
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55. It's not her decision.
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56. It's mine, as the attending.
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57. Doesn't mean she shouldn't
offer her opinion.
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58. I think that, um,
Dr. Melendez is right.
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59. With the limited visibility,
I shouldn't be…
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60. Only with a laparoscopic
cholecystectomy.
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61. Which I don't think
we should do.
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62. An open procedure
would provide a clearer view
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63. of the gallbladder
and the surrounding anatomy
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64. despite the inflammation.
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65. Carly and I went
on another date last night.
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66. Mm. What did you do?
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67. Dinner, movie…
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68. We walked 12 minutes to a deli
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69. and had some food and talked.
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70. Where are we going?
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71. Andrews is starting
an open chole.
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72. Sounds like it's going well
with you and Carly.
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73. Oh, yes.
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74. She answered
all of my questions.
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75. How many did you ask?
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76. Eighty-three, although some had
multiple parts.
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77. "Do you want to have children?
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78. If yes,
how many and when?
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79. Where do you plan
to raise them?
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80. In what religious tradition?"
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81. Those are pretty intense.
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82. They're good questions,
Claire, about important topics.
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83. Early on, people usually stick
with lighter stuff…
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84. Favorite movies, bands,
hometowns.
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85. Small talk.
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86. Put some LAPs
in the upper-right quadrant.
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87. Here's the Bovie,
Dr. Andrews.
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88. Isn't the point of dating
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89. to gather information
to determine compatibility?
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90. Retract the omentum.
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91. Sure.
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92. Isn't that best achieved
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93. by finding out what's important
to the other person?
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94. - Hemostats.
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95. It's a…
It's a process, Shaun,
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96. like peeling an onion.
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97. People are more comfortable
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98. revealing their layers
gradually,
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99. as opposed to getting sliced
right down the middle.
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100. I heard Dr. Lim
selected you
for the first lead.
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101. I'm guessing you drew
a cholecystectomy.
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102. Sponge on a stick.
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103. What's your approach
to dissecting…
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104. Retrograde or antegrade?
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105. Antegrade.
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106. Once I've located
the porta hepatis.
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107. I think Carly was comfortable.
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108. Why does it matter
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109. what kind of questions
are asked when?
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110. Aren't the answers
what's important?
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111. - I'm sure you're right.
- Yes.
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112. What is the plan
for the next date?
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113. Hmm.
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114. We didn't make another date.
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115. Then I grasp
gallbladder fundus
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116. - and elevate it which way?
- Superiorly.
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117. Is that significant?
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118. No follow-up date?
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119. Not necessarily.
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120. How did the night end?
Good-night kiss?
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121. I've exposed
the triangle of Calot
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122. and ligated the cystic duct
and artery.
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123. What is the risk
at this juncture?
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124. - Lacerating the liver
during dissection.
- Correct.
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125. We didn't kiss.
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126. Ironically, a complication
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127. which I've inadvertently
just demonstrated.
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128. Hold direct pressure.
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129. I need better exposure.
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130. I sliced instead of peeled.
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131. You are familiar
with the Pringle procedure,
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132. Dr. Browne?
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133. Yes, although I've never…
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134. Clamp down the portal triad
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135. with an atraumatic
hemostat clamp,
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136. then use a number two
catgut suture.
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137. Shaun, just go to her
and explain.
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138. If what I said
made her uncomfortable,
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139. then saying more could make her
more uncomfortable.
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140. I sliced instead of peeled.
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141. After Michelle's surgery,
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142. I will go and talk to Carly.
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143. Good.
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144. You can talk to her soon.
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145. OR 2 had a cancellation.
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146. Your surgery is in 45 minutes.
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147. Hi, I'm Dr. Browne.
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148. I will be performing
Michelle's surgery.
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149. I will be removing
her gallbladder.
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150. It is a simple procedure.
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151. We're gonna make sure
your daughter
is well taken care of.
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152. - Ow!
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153. Sir,
we need to decapitate it.
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154. No, don't.
I'm begging you.
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155. Don't.
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156. Please.
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157. I can't
get an image.
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158. How did that…
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159. I— Is that a swordfish?
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160. With that dorsal fin?
It's a marlin.
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161. I hooked him
with a naked ballyhoo.
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162. Battled me for over an hour.
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163. Suddenly, he just
leapt out of the water.
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164. He came right at me.
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165. Save the story
for the bar, Quint.
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166. Right now, we need to cut
the damn thing in half.
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167. No. 40-plus years
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168. I've been
chasing a fish like this.
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169. You can't just behead him!
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170. Can't leave his nose
in your leg, either.
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171. His bill.
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172. Can't you just…
pull him out gently?
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173. I'll sign a waiver.
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174. The pull-out method
never works.
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175. If any of your blood vessels
are damaged, it gets messy.
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176. Congrats. I hear your surgery
is on the schedule.
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177. How's his distal pulse?
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178. A little thready,
but still there.
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179. We need to get him
to an MRI.
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180. I'm not going anywhere
without Franklin.
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181. I named him after my father.
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182. You and Franklin
both won't fit.
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183. - Oh! Oh!
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184. - How? You said he was dead!
- I didn't take a pulse.
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185. Go get something
to kill it.
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186. - No, it's dead!
- It's moving!
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187. It's a postmortem response.
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188. You guys are doctors.
Don't people do this?
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189. No!
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190. I'll help you review at lunch.
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191. Surgery's in 20 minutes.
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192. - Good luck.
- You, too.
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193. "I want to…"
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194. No, no,
I haven't looked.
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195. "I want to be…"
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196. - Great.
- "…great…"
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197. Okay.
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198. - "…or nothing."
- Nothing.
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199. Got it. I'll be back
as soon as I can.
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200. Hi. You must be
Michelle's mother.
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201. I'm Dr. Browne. I'll be…
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202. Yeah. How long will
she have to stay in here?
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203. Hospitals
make me nervous.
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204. Three days to a week,
depending on…
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205. Well, she's gonna miss
a lot of school.
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206. And she watches Tisha
and her brothers
in the afternoon.
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207. Your daughter
has a serious infection
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208. in her gallbladder.
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209. She's been
experiencing symptoms
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210. on and off for a while now.
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211. She never told me that.
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212. Why didn't you tell me that?
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213. - Mama…
- My point is,
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214. she's been ill for a while,
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215. so her recovery may take…
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216. Mom.
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217. Mom?
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218. Please, my…my chest hurts.
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219. - What's wrong?
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220. Her oxygen levels are dropping.
She's tachycardic.
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221. I need a chest CT, stat.
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222. You had a blood clot
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223. in the artery
that feeds your lungs.
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224. It's called
a pulmonary embolism.
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225. This medicine broke it up.
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226. How could that happen?
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227. According to our scan,
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228. it was part of a larger clot
in your leg
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229. that broke off
and traveled there.
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230. As for why
the larger one formed,
Copy !req
231. when I asked you if you were
taking birth control pills,
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232. you said 'no."
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233. Was that the truth?
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234. You asked me
in front of Tisha.
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235. I'm doing it with my boyfriend,
and I don't want babies,
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236. so I'm taking
birth control pills.
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237. How long have you been
taking them?
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238. I don't know. A year?
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239. I'm prescribing condoms
for your boyfriend.
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240. You need to go off the pill
to prevent further clots.
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241. Dr. Browne is gonna
place an IVC filter
via your femoral vein,
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242. in case other parts
of the clot break off.
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243. Your gallbladder surgery's
gonna have to wait
till tomorrow.
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244. What are you doing?
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245. This is where
the catheter goes in.
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246. How did you get these scars?
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247. I cut myself climbing a fence.
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248. Those scars…
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249. They're straight, in a row,
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250. all the same length.
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251. I don't believe you got them
from a fence.
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252. I don't care what you believe.
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253. Kids who cut,
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254. most of them are really sad,
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255. in a lot of pain,
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256. and they say cutting
makes them feel better.
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257. Is that how it is with you?
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258. I don't want to talk about it.
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259. Okay.
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260. My life sucks, okay?
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261. Tell me how.
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262. Why?
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263. It won't change anything.
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264. Talking might
make you feel better,
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265. and maybe I can help.
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266. I live in a foster home,
but I'm not a foster kid.
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267. I'm a whole mother,
but I've never had a baby.
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268. My mom brought three kids
in our home,
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269. and now it's my job
to take care of them…
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270. Make breakfast,
get the kids dressed,
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271. take them to school,
go to school,
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272. pick them up,
dinner, homework, laundry.
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273. Repeat.
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274. I barely ever leave the house
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275. without a kid attached to me.
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276. Can you help me with that?
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277. Michelle wouldn't
hurt herself on purpose.
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278. Michelle is unhappy.
She feels pressure
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279. to look after
her foster siblings,
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280. help out at home…
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281. Yeah, her home life is fine.
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282. I'll talk to her.
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283. It might be helpful
to have her speak
with a psychiatrist.
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284. My daughter is not crazy.
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285. We… We don't do psychiatrists.
You know that.
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286. That needs to change.
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287. When are you doing
her surgery?
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288. - Tomorrow.
- Thank you.
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289. I will speak to my daughter.
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290. Don't.
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291. It's your job
to fix her gallbladder,
not her life.
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292. It's your first surgery.
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293. Don't get distracted.
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294. Have you talked to Carly?
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295. No.
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296. Blood pressure is 62/31.
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297. Your patient
is in cardiac arrest.
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298. I know.
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299. You're practicing
the Pringle maneuver
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300. in the event of a liver bleed?
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301. Yes.
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302. - That was better.
- Thanks.
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303. Now you can talk to Carly.
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304. I need to practice.
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305. Dr. Lim says
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306. getting away from things
every now and again,
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307. having balance in our lives
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308. can be just as important
to our performance
as practice.
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309. Maybe you should
get some balance
by talking to Carly.
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310. I don't know.
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311. I'm nervous about
my surgery, Shaun.
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312. Practice will make me
less nervous.
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313. That will improve
my performance.
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314. Okay.
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315. Okay.
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316. You should also practice
not causing a liver bleed.
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317. Planning on it.
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318. Also, how you will recover
if you cut the portal vein…
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319. That's potentially fatal.
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320. Or if you perforate
the small bowel,
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321. which could cause sepsis,
leading to death.
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322. Or if you cut
the common bile duct,
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323. - which would cause…
- I'm gonna go talk to Carly.
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324. - Right now?
- Right now.
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325. - Aren't you still nervous?
- Nope, all better.
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326. What blade
for the Kocher?
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327. What?
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328. Incision for the chole…
what blade?
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329. Uh…
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330. - Ten.
- Mm-hmm.
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331. No, they won't both
fit in the MRI.
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332. Fish Boy doesn't buy it.
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333. Location of the incision.
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334. Why are you trying to help me?
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335. Lim picked you
for the first surgery.
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336. Everyone knows that makes you
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337. the front-runner
for Chief Resident.
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338. This is me sucking up.
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339. I've never been big
on pretense…
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340. Are you okay?
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341. What the hell just happened?
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342. The marlin must have had
metal in his body…
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343. Lures and stuff.
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344. I think a license plate
flew by me.
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345. Franklin!
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346. Oh, no!
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347. Franklin!
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348. Oh, it's okay.
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349. Franklin's okay.
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350. It all came out one side.
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351. It won't show
when I mount him.
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352. Well, thank goodness
for small miracles.
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353. - Ooh.
- Oh!
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354. Ow!
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355. - Oh!
- Ah!
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356. - I've got his femoral.
- Call the OR. We're coming.
Copy !req
357. Hang on, Dr. Browne.
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358. Just need to make an incision
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359. above and below
the arterial injury site.
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360. We need to clamp the femoral
proximal to the bleed
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361. without clipping
the femoral nerve.
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362. Got it. I feel the nerve
right above my index finger.
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363. One down.
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364. My hand is starting to cramp.
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365. Lean over
this way a little bit.
Rotate your wrist.
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366. - Just a little bit more.
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367. Let's see if that holds.
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368. Go get cleaned up.
We'll take it from here.
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369. I wanted to check
the patient's bloodwork.
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370. He's negative
for HIV, Hep B and C.
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371. You don't need
prophylactic meds.
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372. I'm nervous about my surgery.
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373. You'll be fine.
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374. And don't ever say that again.
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375. Why?
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376. Weren't you nervous
before your first lead?
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377. If I was,
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378. I didn't volunteer that
to the Chief of Surgery…
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379. Or anyone.
Copy !req
380. We're women, we're not white,
and we're surgeons.
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381. Unicorns consider us
a fabled species.
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382. We don't get the luxury
of public insecurity.
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383. I will aspire to repressed
stoicism in the future.
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384. We don't need to be insecure,
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385. because every step of the way,
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386. we've had to be twice as good
as everybody else.
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387. Suck it up.
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388. You got this.
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389. Don't forget
we have our session
with Dr. Donovan today.
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390. I won't.
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391. - Your patient.
- Mm-hmm.
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392. What are they like?
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393. Man, woman, young, old?
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394. Woman.
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395. Girl, actually.
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396. She's tough, smart… really sad.
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397. Her mom has her taking care
of three foster kids.
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398. At least you were only stuck
looking after me.
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399. How old?
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400. Fourteen.
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401. Although she acts a lot older.
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402. She's been having sex
for almost a year.
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403. Well, you were about that age
when you were with Wayne.
Copy !req
404. - I didn't have sex with Wayne.
- What?
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405. He was in love with you
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406. always sniffing
around our place.
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407. Maybe. He didn't get any.
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408. So, who?
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409. Junior prom guy… Derek.
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410. Der… No.
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411. I didn't lose my virginity
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412. until sophomore year
of college.
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413. What were you hoping for,
a proposal?
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414. No.
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415. I wanted it to be special.
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416. - Oh, good for you.
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417. I mean,
I wouldn't have held out.
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418. - No.
- …but good for you.
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419. I thought for sure
you and Wayne were doing it.
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420. You were okay with that?
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421. You were so serious.
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422. So restrained.
Copy !req
423. We talked about
birth control.
Copy !req
424. I figured, "Good for her.
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425. She's finally relaxing,
having some fun."
Copy !req
426. Well, I was so restrained
and serious
Copy !req
427. 'cause I never knew
when you were gonna fall apart.
Copy !req
428. Got to get to work.
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429. I'll be back before
Michelle goes into surgery.
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430. Have you had a chance
to talk to her
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431. about her cutting?
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432. Oh, yeah, some fool friend
of hers gave her the idea.
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433. She's not unhappy.
It's just peer pressure.
Copy !req
434. She sounded unhappy to me.
Copy !req
435. She's upset I didn't let her
go hang out with her friends.
Copy !req
436. It's typical teen drama.
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437. She promised me
she's done cutting.
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438. Self-harming behavior
doesn't just stop.
Copy !req
439. - Michelle might need…
- Dr. Browne.
Copy !req
440. My daughter
needs to have surgery
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441. and get out of this hospital.
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442. You didn't tell your mom
the truth
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443. about why you cut yourself,
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444. about how unhappy you are.
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445. I tried.
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446. She didn't want to hear it,
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447. just said that things
aren't always gonna go my way
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448. and I need to be
more responsible.
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449. Like I'm not already.
Copy !req
450. Growing up, I had
to take care of my mom.
Copy !req
451. - What was wrong with her?
- She's mentally ill.
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452. Bipolar disorder
Copy !req
453. and a drinking problem, pills.
Copy !req
454. When things were bad,
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455. she'd forget to buy groceries
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456. or clean the trailer
or pick me up.
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457. Or she'd spend all our rent
on something stupid.
Copy !req
458. - And I thought
Copy !req
459. if I could make her life
easy enough…
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460. If I cooked and cleaned
and got good grades…
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461. Then she'd get better.
Copy !req
462. But she never did.
Copy !req
463. And for the longest time,
Copy !req
464. I thought it was my fault
she was sick.
Copy !req
465. And I probably still would
Copy !req
466. if a psychiatrist
hadn't refused to believe me
Copy !req
467. when I said I was fine.
Copy !req
468. You've been to a psychiatrist?
Copy !req
469. But you're, like,
a fancy surgeon.
Copy !req
470. I could have a therapist
come by and see you
Copy !req
471. before your surgery.
Copy !req
472. Okay.
Copy !req
473. He should be
getting better.
Copy !req
474. It's got to be an infection
from the marlin.
Copy !req
475. Aeromonas
or mycobacterium marinum.
Copy !req
476. Would've responded
to the antibiotics.
Copy !req
477. Guys, I'm trying to focus.
Copy !req
478. What if he has an underlying
autoimmune disorder?
Copy !req
479. It could've been triggered
by the surgery
Copy !req
480. or even the initial
fish stabbing.
Copy !req
481. It would explain why
the leg ulcerations
are progressing
Copy !req
482. despite good arterial flow.
Copy !req
483. We could see
if he responds to steroids.
Copy !req
484. Which could kill him
if it is an infection.
Copy !req
485. But we could run an ANA,
see if he's positive.
Copy !req
486. What about a parasite?
Copy !req
487. Rhinosporidium seeberi
or a gill worm.
Copy !req
488. Have you talked to Carly?
Copy !req
489. Sorry.
Copy !req
490. I got sidetracked by a marlin.
Copy !req
491. Come in.
Copy !req
492. You wanted to see me?
Copy !req
493. Ms. Reynolds tells me
that you went
against her wishes
Copy !req
494. and had her daughter
speak with a psychiatrist.
Copy !req
495. Uh, Michelle asked
to see a therapist.
Copy !req
496. Only after
you talked her into it.
Copy !req
497. I'm gonna report you
to the medical board.
Copy !req
498. You had no right…
Copy !req
499. Dr. Browne,
were you concerned
Copy !req
500. that Michelle might be
a serious danger to herself?
Copy !req
501. Yes.
Copy !req
502. In that case,
the consult was required.
Copy !req
503. That said,
Copy !req
504. Dr. Browne's failure
to inform you
was inappropriate.
Copy !req
505. You're off the case.
Copy !req
506. Dr. Melendez
will perform the surgery.
Copy !req
507. How are you doing?
Copy !req
508. Claire?
Copy !req
509. I understand today's
a big day for you.
Copy !req
510. Your first surgery.
Copy !req
511. We don't need
to talk about that.
Copy !req
512. Hmm, I think we do.
Copy !req
513. You've been taking care
of your mother for a long time.
Copy !req
514. That's a pattern you both
need to break out of.
Copy !req
515. I know I haven't always
been there for you,
Copy !req
516. and I just… I…
Copy !req
517. I'm trying to change that.
Copy !req
518. I know, Mom.
Copy !req
519. I'm good.
Everything is fine.
Copy !req
520. And your first surgery?
Copy !req
521. Is that this afternoon?
Copy !req
522. It's…
Copy !req
523. Actually, it's not.
Copy !req
524. Um…
Copy !req
525. I arranged a psych consult
Copy !req
526. without
the mother's permission,
Copy !req
527. so I got thrown off the case.
Copy !req
528. How could the hospital
allow that?
Copy !req
529. What is wrong with them?
Copy !req
530. After how hard
you've worked, I just…
Copy !req
531. It's okay, Mom.
They kind of had to.
Copy !req
532. That must be
a big disappointment…
Copy !req
533. It is.
Copy !req
534. Anything else, Claire?
Copy !req
535. I'm upset, humiliated,
Copy !req
536. so, so mad
at my patient's mother
Copy !req
537. for not taking care
of her daughter.
Copy !req
538. And I… I'm relieved.
Copy !req
539. I'm so, so relieved
to have that weight off of me,
Copy !req
540. and that makes me
feel like a fraud.
Copy !req
541. Don't you say that.
Copy !req
542. How can I be so scared
Copy !req
543. to do something
I've wanted for so long?
Copy !req
544. Because things that matter
are scary.
Copy !req
545. That's how I feel
about coming here,
Copy !req
546. talking about my life
and our relationship.
Copy !req
547. What if I can't fix it?
Copy !req
548. What if I can't make up
Copy !req
549. for all the times
I've let you down?
Copy !req
550. And then I think…
Copy !req
551. "Just be like Claire."
Copy !req
552. Because nothing
stops you… ever.
Copy !req
553. You see what you want,
Copy !req
554. and you go after it
with everything you've got.
Copy !req
555. You are an inspiration.
Copy !req
556. You're my inspiration.
Copy !req
557. Carly?
Copy !req
558. Hi. Do you have a second?
Copy !req
559. OR 2 is waiting to learn
Copy !req
560. the patient's mass
wasn't cancerous
so they can close.
Copy !req
561. - I can come back after.
- I'll be at the cafe?
Copy !req
562. - Mm-hmm.
- Okay.
Copy !req
563. Anesthesiology, line 271.
Copy !req
564. Anesthesiology, call line 271.
Copy !req
565. Cancer.
Copy !req
566. The marlin guy has cancer.
Copy !req
567. CT chest, abdomen, and pelvis
showed no masses.
Copy !req
568. - It's in his leg.
Copy !req
569. It explains
progressive ulcerations
Copy !req
570. despite good arterial flow.
Copy !req
571. - And why the antibiotics
aren't working.
Copy !req
572. We'll send a tissue sample
from the ulcerated area.
Copy !req
573. And when I'm Chief Resident,
I'll remember this.
Copy !req
574. There's a problem
with Michelle.
Copy !req
575. I'm not doing it!
Copy !req
576. You need to calm down.
Copy !req
577. You don't get
to tell me what to do!
Copy !req
578. I want Dr. Browne!
Copy !req
579. Michelle?
What's going on?
Copy !req
580. I want you to do my surgery.
Copy !req
581. I want her, Mama,
not somebody else.
Copy !req
582. Dr. Melendez
is gonna do your surgery.
Copy !req
583. He is a great doctor.
Copy !req
584. He's not you.
You care about me.
Copy !req
585. Everybody here cares
about you, Michelle.
Copy !req
586. Now, please sit down.
You could rupture
your gallbladder.
Copy !req
587. I— I don't want to get better.
Copy !req
588. - Don't say that.
- It's the truth!
Copy !req
589. Michelle,
you need this surgery.
Copy !req
590. That is all that matters…
not whether I do it.
Copy !req
591. I'm gonna be there.
Copy !req
592. I will be watching
from the gallery
Copy !req
593. the whole time.
Copy !req
594. You just… You need…
You need to sit down.
Copy !req
595. The kid okay?
Copy !req
596. I had to pull you off.
Copy !req
597. If you made even the tiniest
misstep during surgery,
Copy !req
598. that mom would go
from threat to lawsuit.
Copy !req
599. Is Patricia okay with me
watching from the gallery?
Copy !req
600. No.
Copy !req
601. You can't remove
her gallbladder
from the gallery.
Copy !req
602. What?
Copy !req
603. You're doing
Michelle's surgery.
Copy !req
604. How'd you get the mom
to change her mind?
Copy !req
605. I explained that,
given Dr. Browne's
commitment to her daughter,
Copy !req
606. she's the perfect choice
to lead the surgery.
Copy !req
607. Especially with me
over her shoulder
the whole time.
Copy !req
608. Thank you for fighting for me.
Copy !req
609. That's what bosses do.
Let's go.
Copy !req
610. - You stood me up.
- Sorry about that.
Copy !req
611. What's up?
Copy !req
612. Shaun's a little worried
he may have freaked you out
Copy !req
613. with his… questionnaire
the other night.
Copy !req
614. Oh, I thought it was cool.
Copy !req
615. Small talk
bores the hell out of me.
Copy !req
616. Well, then, great.
I'll tell him.
Copy !req
617. Shaun got worried about that
all on his own?
Copy !req
618. That doesn't seem like him.
Copy !req
619. I may have mentioned
Copy !req
620. that people don't usually ask
deeply personal questions
Copy !req
621. on an early date.
Copy !req
622. Claire, I like you,
Copy !req
623. but we don't really know
each other.
Copy !req
624. And yet you decided
Copy !req
625. how I was going to react
to Shaun's questions,
Copy !req
626. which isn't your business.
Copy !req
627. And you were wrong…
Copy !req
628. Totally, totally wrong.
Copy !req
629. Shaun and I don't need you
or anyone else
Copy !req
630. to run interference
on our relationship.
Copy !req
631. Butt out.
Copy !req
632. Is everybody ready
for a Time Out?
Copy !req
633. Dr. Claire Browne,
lead surgeon.
Copy !req
634. Dr. Neil Melendez,
attending surgeon.
Copy !req
635. Dr. Shaun Murphy,
assisting.
Copy !req
636. Dr. Jan Lancaster,
anesthesia.
Copy !req
637. Donna Petringa, scrub nurse.
Copy !req
638. Shani Walden,
circulating nurse.
Copy !req
639. Patient is Michelle Reynolds.
Copy !req
640. We will be performing
an open cholecystectomy.
Copy !req
641. All tools I need
are confirmed to be present.
Copy !req
642. Estimated blood loss, 100 cc.
Copy !req
643. Patient will go to the ICU
after surgery.
Copy !req
644. Is everybody in agreement?
Copy !req
645. Dr. Murphy, have you
ChloraPrepped the site?
Copy !req
646. I have.
Copy !req
647. 10 blade.
Copy !req
648. Sponge.
Copy !req
649. Top layer of abdominal muscle
is exposed.
Copy !req
650. I'll need a Bovie
to cut through.
Copy !req
651. Nice work, Dr. Browne.
Copy !req
652. Bookwalter Retractor.
Copy !req
653. I see the liver,
Copy !req
654. and I need to better expose
the inferior surface.
Copy !req
655. Retract the duodenum
inferiorly, please.
Copy !req
656. Gallbladder exposed.
Copy !req
657. Dr. Browne?
Copy !req
658. There is more scarring
than the imaging suggested.
Copy !req
659. True.
Copy !req
660. Talk through your approach.
Copy !req
661. I… grasp
the gallbladder fundus forward
Copy !req
662. and use a right-angle clamp
in my suction
Copy !req
663. to develop a plane
around the gallbladder.
Copy !req
664. Kelly clamp,
Copy !req
665. a right-angle clamp,
and suction.
Copy !req
666. That was elegant use
of the Kelly clamp.
Copy !req
667. I see the cystic duct
Copy !req
668. and, behind it,
the cystic artery.
Copy !req
669. I need my first assist
to confirm
Copy !req
670. that I have identified
the common bile duct
Copy !req
671. and it is out of the way.
Copy !req
672. Yes.
Copy !req
673. Cutting the duct would be…
Copy !req
674. Very, very bad.
Copy !req
675. Move the gallbladder
cranially a little bit.
Copy !req
676. Titanium clip applier.
Copy !req
677. You sure you have a clear view?
Copy !req
678. Making the cut.
Copy !req
679. She's hemorrhaging.
Copy !req
680. I can't see
the source of the bleeding.
Copy !req
681. MAP is 45 and dropping.
Copy !req
682. What do you think
is happening?
Copy !req
683. Most likely,
Copy !req
684. my scissors' tip nicked
the right hepatic artery.
Copy !req
685. It happens.
Copy !req
686. It's happened to me.
Copy !req
687. I need to clamp
the common hepatic artery,
Copy !req
688. repair the arterial wall
Copy !req
689. with running
6-0 Prolene sutures.
Copy !req
690. That's what I would do.
Copy !req
691. Hey, hey, hey.
Slow down. Slow down.
Copy !req
692. No running. No running.
Copy !req
693. Dr. Browne,
how's my daughter?
Copy !req
694. The surgery was a success,
Copy !req
695. and we expect a full recovery.
Copy !req
696. I wanna see her!
Copy !req
697. Is that okay?
Copy !req
698. - Yay!
- Okay.
Copy !req
699. Michelle says
she wants to be a doctor.
Copy !req
700. She would be a great one.
Copy !req
701. Uh, that therapist
Michelle talked to…
Copy !req
702. …could I get her card?
Copy !req
703. - Hi, baby.
- Hey.
Copy !req
704. Okay.
Copy !req
705. Three, two, one.
Copy !req
706. You were right.
Copy !req
707. He had angiosarcoma of the leg.
Copy !req
708. Had to amputate,
but the margins were clean.
Copy !req
709. Hmm.
What happened to the…
Copy !req
710. Franklin!
Copy !req
711. Oh!
Copy !req
712. Franklin, you amazing fish!
Copy !req
713. You saved my life.
Copy !req
714. Come on, bring him…
Bring him here.
Copy !req
715. Bring him… Bring him in.
Copy !req
716. Oh.
Copy !req
717. Thank you, guys.
Copy !req
718. Group hug.
Copy !req
719. Do you prefer
to work in a team
Copy !req
720. or do you prefer to lead
or follow command?
Copy !req
721. Team… and to lead.
Copy !req
722. What machine
or appliance in your house
Copy !req
723. aggravates you the most?
Copy !req
724. The dishwasher.
Copy !req
725. Hey, I'm just leaving.
Copy !req
726. Who is this?
Copy !req
727. Message received
Copy !req
728. at30 p.m. from Mom.
Copy !req
729. Hey, baby, I got your text.
Copy !req
730. See, I knew it was just
a temporary setback.
Copy !req
731. We're gonna celebrate.
I made dinner.
Copy !req
732. And I'm gonna
go get some dessert.
Copy !req
733. I'll see you soon.
Copy !req
734. I'm so proud of you, baby.
Copy !req