1. Naughty thought.
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2. How about we don't wait 12 minutes for our next kiss?
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3. We would never see the end of the movie.
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4. Oh.
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5. Mm.
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6. It's better if we stick to the schedule.
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7. Sure.
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8. Didn't hear you come in last night.
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9. So I'm guessing it went well at Carly's.
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10. The end of the movie was very predictable.
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11. Not the question I was asking,
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12. but you still managed to answer it.
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13. Carly touches me when we kiss.
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14. You don't like her touching you?
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15. Oh, I... I do. Oh.
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16. But I prefer to touch only one thing at a time.
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17. Have you told her you prefer to touch only one thing at a time?
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18. In those exact words?
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19. Oh!
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20. Whatever it is, I'm definitely in.
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21. My first lead surgery!
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22. Oh! Oh!
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23. Shaun! That is awesome!
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24. I am going to rock it!
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25. Oh, hells to the yeah you are!
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26. Oh!
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27. How you doing?
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28. I'm good.
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29. Thank you for helping me with the sea lions.
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30. I'll never say no to a caper.
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31. But I'd like to keep my mother's death between the two of us.
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32. I just... I can't deal with people's platitudes right now.
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33. Okay, but that kinda suggests you're not good.
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34. This is textbook denial.
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35. It's only going to inhibit your grief process.
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36. Denial is the first step in the grief process,
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37. so I'd say I'm right on track.
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38. But thank you for your platitudes.
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39. This is Curtis.
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40. He decided to fix his chimney without a safety harness.
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41. He has open bilateral tib-fib fractures.
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42. They wanted $1,200 for a two-hour job.
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43. And I can still do a Hurricane Grind.
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44. It's a skateboard move that builds off a 180 Ollie.
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45. I got great balance.
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46. Pupils are slow to react.
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47. Unfortunately, balance is less great after a few cocktails.
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48. Not me.
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49. Clean and sober six years, three months,
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50. and... And 24 days.
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51. Get him on IV antibiotics and to OR Level One.
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52. And run a BAC.
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53. I'm Dr. Shaun Murphy.
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54. Your surgeon.
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55. Esophageal cancer is a serious condition.
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56. However, you don't have any remote
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57. or metastatic disease
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58. and responded well to chemoradiation,
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59. so a resection of the esophagus
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60. should render you cancer-free.
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61. You look awfully young.
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62. I always say, the younger they are,
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63. the smarter they must be.
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64. Oh, oh, yes.
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65. We will pull the stomach up and attach it to the remains
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66. of your esophagus,
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67. keeping your GI system connected,
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68. so you will not need a permanent feeding tube.
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69. My oncologist told me all this,
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70. but I refused to believe it,
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71. that it was all gonna be okay,
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72. until I heard it from my surgeon.
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73. Oh!
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74. I'm sorry, it's just...
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75. I've been through a divorce and a career change,
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76. and I finally bought my own cafe,
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77. three days before I got my diagnosis.
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78. And I thought it was a sign I was making a mistake.
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79. But it was just the opposite.
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80. I wasn't done.
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81. Oh, I'm sorry...
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82. I have to inform you of the risks of this procedure.
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83. There is a 7% chance of heart and lung problems,
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84. a 12% chance of infection, a 0.5% of death, among others.
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85. Bring it, Dr. Murphy.
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86. Shaun got very lucky.
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87. Landed the world's most genial patient for his first case.
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88. Nice. Of you.
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89. You picked that patient for him...
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90. I heard it was Park's chart before you stepped in.
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91. Shaun's weakness is patient management.
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92. You shouldn't be coddling him.
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93. We challenge him too much, we lose him.
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94. Murphy?
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95. He perseveres. He's annoyingly resilient.
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96. I agree that some failures don't seem to faze him at all.
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97. But it's his lifelong dream.
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98. So, yes, I think we could lose him.
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99. I'll tough-love his ass next week.
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100. Okay, Curtis, we're good to go.
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101. Curtis, my God. Are you okay?
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102. I'm thinking I should've gone with the contractor.
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103. His thinking was impaired.
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104. He had a blood alcohol level of.09.
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105. Your test must be wrong.
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106. You were quite inebriated when you came in.
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107. That's impossible. Curtis doesn't drink.
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108. We'll make a note of it in his chart.
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109. We've got to get him to the O.R.
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110. You play softball?
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111. Uh, my junior year in high school,
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112. I had an ERA of 2.95.
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113. My wife's got an arm.
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114. I can't believe you're my wife.
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115. Till death do us part.
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116. Yeah.
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117. Oh, you found Wally.
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118. You have a name for it?
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119. Yeah, he's my Walther PPK.32.
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120. He and I go way back.
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121. Is it loaded?
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122. I mean, is this a problem?
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123. 'Cause I... I just... I keep it in my bedside table,
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124. in my gun safe, combination 7-3-5-9.
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125. I'm not gonna remember that.
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126. I don't want to remember that.
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127. If we're gonna live together,
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128. we're gonna need to make some compromises.
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129. You nervous?
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130. How badly are you freaking out?
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131. I'm not badly freaking out.
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132. I've assisted in six esophageal resections,
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133. all of which were free of complications.
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134. So you're overdue for a blow-up.
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135. Sorry.
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136. I'm just a bit annoyed 'cause I had my hand on this case first,
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137. and now I'm third out of four, at best.
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138. But I'm happy for you.
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139. Really.
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140. I'm happy for me, too.
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141. She has extensive scar tissue.
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142. And it's plastered her stomach
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143. to her anterior abdominal wall.
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144. I told her she wouldn't need a permanent feeding tube.
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145. But she will.
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146. We've got to tell a budding chef she'll never eat again.
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147. How will she react?
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148. Don't know.
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149. Badly. But the specifics...
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150. You should tell her.
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151. She's your patient, it's your job.
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152. I'm bad at patient communication.
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153. If I make her very unhappy,
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154. she may not want me to do the surgery.
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155. If you're not willing to take that risk,
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156. then you should hand the case over to Park.
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157. No. I don't want to hand the case over to Dr. Park.
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158. Park will tell Beth.
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159. And, Shaun, it's still your surgery.
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160. DR. Drill.
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161. Do you see his heart rhythm?
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162. DR. Rate controlled A-fib.
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163. Wasn't on his record.
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164. Ask his wife about it post-op.
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165. Probably a symptom of binge drinking.
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166. Which he'll lie to us about and she'll tell us she believes.
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167. She's in denial?
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168. You had surgery as a child.
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169. As a baby. I don't even remember it.
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170. There's considerable scar tissue,
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171. more than we'd typically expect to find.
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172. Which has affected our surgical plan.
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173. How?
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174. Dr. Murphy will field that question.
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175. No, Dr. Lim s-said...
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176. Proceed, Dr. Murphy.
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177. Somebody please tell me.
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178. We can't move your stomach up,
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179. so you will need a feeding tube.
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180. For the rest of your life.
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181. The good news is that this surgery is simpler,
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182. so your recovery time will be shorter by three to five days.
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183. Hey.
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184. Do any of you own a gun?
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185. Is there someone you'd like "taken care of"?
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186. Ah. I still have my service pistol.
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187. I have a Sig P365.
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188. Do any of you have, or have you ever had,
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189. issues about it with your significant others?
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190. After our son was born,
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191. my wife suddenly hated having a firearm in the house.
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192. And one night, I came home late to a...
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193. PowerPoint presentation.
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194. Ninety minutes of horrifying statistics.
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195. Now it's in a locker at my gun range.
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196. Lotta set up but I like that.
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197. I had a boyfriend who felt very weird about me having a gun.
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198. He wasn't big on logic, so I took the emotional approach.
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199. Told him it's not for the firepower,
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200. it's for the confidence it gives me as a woman when I carry it.
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201. I lived with a guy who had a gun.
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202. Had to use the nuclear option.
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203. It goes or he goes.
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204. It worked... They both went.
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205. Well, that's just wonderful.
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206. I heard your news.
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207. It's pretty exciting.
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208. I jumped seven times.
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209. How's the anxiety level?
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210. Why do people keep asking me that?
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211. Everyone has doubts, Shaun.
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212. I'm excited.
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213. You can be excited. And nervous.
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214. Usually they go together.
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215. Speaking of, uh, I'm sorry if I was a bit
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216. too assertive last night.
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217. Lea said it must be tricky for you.
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218. So now Lea is also privy to the intimacies of our intimacy?
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219. Great. Yes.
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220. Oh.
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221. Lea said to tell you
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222. that I prefer to touch only thing at a time.
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223. Located upper esophageal sphincter.
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224. You have a good tumor margin...
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225. Resecting above or below?
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226. Below. Mm-hmm.
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227. Shaun gave the news to his patient after all.
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228. Shaun did what I expected.
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229. He upset her, but the news is upsetting.
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230. She'll deal with it, he'll learn how to... She wants him off the case.
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231. Shaun... No...
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232. Shaun, I will find you another case.
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233. This is my case.
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234. I prepared for this case.
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235. I don't want another case.
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236. Dr. Murphy...
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237. You're learning, Shaun.
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238. That's what you do at a teaching hospital.
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239. I'm learning, too.
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240. Going from attending to Chief of Surgery
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241. is... a big deal.
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242. Every day, every decision, every mistake...
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243. I learn something.
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244. So do you.
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245. No, I don't.
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246. I have a developmental disorder.
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247. Come with me.
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248. I'm waiting for my bus.
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249. You can take a later one.
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250. I'm sure I mentioned I was Chief.
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251. Hi, Beth.
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252. I'm sorry for what you're going through.
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253. And Dr. Murphy's phrasing was unfortunate.
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254. But there's been no deceit or negligence.
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255. He's an excellent surgeon who has my full confidence in the O.R.
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256. And if you don't trust him, you don't trust me.
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257. So, I would recommend you have your surgery at a different hospital.
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258. I can make arrangements.
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259. However, if you reconsider, we can proceed as scheduled
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260. first thing tomorrow morning.
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261. If you don't want people to know your mother died,
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262. stop acting like someone whose mother died.
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263. I'm gonna move on to the second stage of grief... Anger.
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264. I'm not acting depressed.
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265. No, you're acting bitchy.
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266. But you're not a bitch, so that looks weird on you,
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267. and people are gonna know something's up.
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268. So, do you want me happier or sadder?
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269. Let me know, because I'm really looking for your approval.
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270. Bitchy...
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271. You really think this guy's still on the wagon?
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272. Just because he's a drunk doesn't mean he's not sick.
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273. But all you can see is an addict married to an enabler,
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274. so all roads lead to rum.
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275. C'mon, that was cute.
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276. No LV wall motion abnormalities.
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277. No valvular disease or dysfunction.
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278. Ruling out any structural cause for the arrhythmia.
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279. You win. Congratulations.
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280. Hey! DR. Hey.
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281. How was your day?
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282. Good, good.
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283. Pensive.
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284. I was thinking about your gun and why you need it...
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285. Oh, Aaron, I... I don't... No, no, no.
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286. I was an idiot and a guy, I get it.
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287. You walking alone in a garage late at night,
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288. you walking alone on the street late at night...
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289. Or getting into my own car, or even my own house.
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290. Exactly.
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291. That's why I got you a surprise.
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292. Yeah?
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293. Right outside the back door.
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294. We have exactly 10 seconds to punch in the code
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295. before S.E.A.L. Team Six arrives.
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296. 7-3-5-9.
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297. Every door, every window, every vent over 36 inches.
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298. This is your security fob.
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299. Works in all 48 contiguous states and Canada.
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300. You have no idea how much extra comfort this is gonna give me.
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301. Actually, I was hoping it would be
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302. your primary source of comfort.
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303. You were thinking that this would mean I would give up my gun?
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304. That's exactly what I was thinking.
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305. Well, the first rule of security systems is redundancy.
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306. By that logic, we should get a tank for the garage.
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307. Aaron, it shouldn't matter why I want a gun...
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308. Whether it's because it makes me feel more secure,
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309. or it was a memento of my dad's
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310. or just because it's fun to shoot.
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311. All that matters is I'm a grown-up,
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312. and I'm responsible, and I want it.
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313. You're ruining Shaun.
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314. Maybe you got him over the hump of patient management,
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315. but what about surgical management?
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316. Taking charge of the O.R.,
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317. keeping lines of communication open, everyone cooperating.
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318. You're throwing him into the deep end,
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319. and that's unfair to him.
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320. Unless you plan to scrub in as a lifeguard.
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321. He'll be fine.
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322. You handpicked his surgical team?
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323. You're ruining him.
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324. The tests prove his arrhythmia is associated
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325. with excessive ethanol consumption.
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326. But there's no permanent damage
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327. and his rhythm will return to normal
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328. in the absence of any further drinking.
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329. We met when we were 15.
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330. I was first clarinet, he was second.
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331. We were at a band festival in Anaheim when he found out
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332. his parents died in a plane crash.
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333. We grieved together and fell in love.
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334. Then he started drinking.
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335. It wasn't until I threatened to leave that he finally woke up.
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336. The day he received his two-year recovery chip
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337. was the day we got married.
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338. The day he vowed to me,
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339. and a church full of our family and friends,
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340. that he would never drink again.
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341. Our marriage is built on his sobriety.
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342. I believe him.
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343. Teal, we ran the BAC three times,
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344. and the results were consistent.
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345. I believe in my husband.
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346. I have to.
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347. His BP is dropping.
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348. Temp is normal.
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349. Check for causes of shock.
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350. Upper GI bleed... Need stat hematocrits and transfuse blood.
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351. Surgery's the easy-peasy part.
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352. You wanted this, enjoy it.
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353. I can't.
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354. If I get distracted, if I get upset...
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355. If you do, Andrews has your back.
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356. If Dr. Andrews has to take over,
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357. then I have failed.
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358. I have failed, and I have endangered a patient's life,
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359. and if I'm no good at the easy-peasy part,
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360. then what part am I good at?
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361. What do we do when we get all nutty like this?
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362. Blow out the candles.
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363. How many do you need?
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364. Three.
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365. Hey. I was looking for you.
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366. Big day, huh?
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367. How are your nerves holding up?
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368. I'm not nervous.
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369. Of course you're nervous. Everybody's nervous.
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370. It just means that you care.
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371. Being nervous means I feel inadequate and unprepared,
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372. and if I am either of those things,
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373. it doesn't matter whether I care or not.
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374. You are more than adequate, and you're very prepared.
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375. You remind me of a... A young surgeon I knew once.
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376. The day he got his first lead, he was thrilled,
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377. but he was a mess, trying to remember a million things,
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378. imagining a million things that could go wrong.
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379. But then he remembered the birth process,
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380. how moms are asked to pick a focal point,
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381. let everything filter through that.
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382. Hmm. So, he chose the color orange to focus on.
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383. This is the cap that he focused on,
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384. and he got through it with flying colors.
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385. Maybe it'll help.
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386. Why do you have the young surgeon's cap?
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387. I was being coy.
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388. The young surgeon was me.
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389. Konnichiwa.
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390. That's Japanese for hello.
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391. Konnichiwa. I have surgery in 42 minutes.
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392. Which is why I'm here, to wish you luck.
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393. I don't need luck.
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394. Everyone needs luck.
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395. That was a good luck kiss.
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396. How can a kiss give you...
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397. So was that.
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398. I am feeling a bit lucky.
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399. You know the thing that Lea told you to tell me?
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400. Yes.
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401. That was actually great advice.
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402. It's important that we tell each other
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403. exactly what we like and what we don't.
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404. I also don't like pickles, sirens, anything wool...
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405. I was thinking more in the romantic area.
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406. And right now, we are not going to touch lips anymore.
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407. Because there's something else I want you to touch.
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408. So, what do you think?
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409. You don't have any lumps.
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410. Win-win.
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411. Lab and imaging tests rule out Crohn's,
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412. gastroenteritis, C-diff colitis, and even H pylori.
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413. Leaving bleeding ulcers.
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414. Caused by alcohol abuse.
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415. He needs to be on a proton pump inhibitor
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416. and octreotide to prevent any further blood loss.
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417. No.
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418. He loves you.
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419. That's why he hasn't been honest.
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420. Doesn't make it right,
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421. but it's that same love
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422. that kept you together through everything.
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423. And it'll get you through this, too.
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424. He's telling the truth.
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425. We'll run more tests.
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426. Your faith in your husband is impressive.
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427. But it may have just killed him.
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428. Ten blade, please.
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429. Located lower end of esophageal lesion.
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430. Linear cutting stapler.
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431. Resecting the esophagus from the stomach...
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432. I'm now at the upper end of the lesion.
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433. Hemoclips.
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434. Dr. Murphy?
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435. No.
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436. No...
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437. What's the matter?
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438. No, no, no...
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439. DR. Shaun, what are you seeing?
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440. Can't... Can't do this!
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441. What... What can't you do?
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442. No! DR. Don't... No.
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443. No! No! No! No!
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444. Dr. Murphy! No!
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445. Dr. Murphy!
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446. Go, go!
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447. Page Dr. Lim. Keep her stable.
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448. No. No. No.
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449. Yur...
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450. No.
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451. No.
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452. No.
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453. Yur... What happened?
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454. No, no, no. He lost it, walked out mid-procedure.
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455. Yuri... Yu...
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456. Yuri kucho saiken. Shaun?
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457. Yur... Yuri... Yur...
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458. Okay, Park, take over the surgery.
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459. Y... No!
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460. Dr. Park.
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461. Y...
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462. No. He obviously can't.
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463. I don't think he lost it.
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464. He was in complete charge of that room.
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465. I don't think this is a meltdown.
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466. He said he can't do it.
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467. He said, "Can't do it." Maybe he meant we can't do it.
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468. I think he's seeing something...
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469. We have a patient open on the table.
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470. Shaun, you have to tell us what you're seeing.
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471. It's okay, Shaun.
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472. Breathe.
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473. That's it. Now slowly.
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474. What are you thinking?
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475. When...
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476. Okay. When I examined the upper portion...
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477. When I examined the upper portion,
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478. there was a much larger area
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479. of tumor-free esophagus than anticipated...
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480. That's correct, but not nearly enough to reach the stomach.
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481. But there is enough to accept a jejunum free flap,
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482. using a portion of the small intestine
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483. to replace the resected esophagus.
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484. We don't do jejunum free flaps.
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485. They do in Japan.
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486. They do in Japan.
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487. I've been studying their technique...
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488. Yuri kucho saiken.
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489. They have had great success.
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490. It would mean Beth wouldn't need a feeding tube.
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491. But...
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492. It is v-very complex.
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493. It's too complex for you to lead.
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494. So you'll lose your case.
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495. Yes...
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496. I haven't done a transposition graft like that before.
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497. Think you can walk us through it?
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498. Yes.
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499. I'll scrub in.
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500. Stomach is perfect.
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501. Check the duodenum.
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502. The only way Teal will accept the treatment
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503. is if we give her no room for denial.
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504. Did you really believe what you said?
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505. That their love is enough to get them through this?
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506. Such BS, the belief that love is enough.
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507. Even worse, it's corollary that a lack of love is the real problem.
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508. If only they had someone in their life
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509. who had enough faith in them, had enough love for them,
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510. they could've pulled through.
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511. It's wrong and it's mean.
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512. What's that?
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513. Flush the area.
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514. There's our bleed.
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515. But it's not coming from an ulcer...
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516. It's coming from a tumor.
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517. It's obstructing his digestive tract.
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518. I'm paging Melendez to the O.R.
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519. Okay.
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520. Actually, I'm... I'm gonna need an extra shot.
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521. Rough day?
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522. Had to help out in the E.R. with an eight-year-old boy
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523. who was accidentally shot by his sister.
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524. He'll survive, but with brain damage.
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525. That's horrible.
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526. Yes, it is.
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527. And quite coincidental.
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528. Like so many other coincidences.
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529. You know how many kids are shot every day in this country? 19.
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530. You know you're three times more likely to be shot
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531. if you have access to guns than if you don't?
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532. Here's another fact...
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533. One in four women are victims
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534. of violence at the hands of their intimate partner.
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535. No, no, no. I'm not afraid of you.
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536. This isn't about you.
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537. Did something happen?
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538. 'Cause if it did, I want to know about it.
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539. You figure something horrible must have happened to drive me
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540. to such an irrational, fear-driven choice?
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541. I'm sorry. Hi.
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542. The ends of the harvested jejunum have been matched
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543. for caliber size for the attachment sites.
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544. You should begin proximal attachment at the neck incision,
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545. using layer-to-layer technique on the esophagus
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546. and microvascular anastomosis of the vessels.
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547. You wanted to know when Dr. Semler was heading to O.R. 3.
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548. Dr. Park, scrub out and join Semler.
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549. I-if it's all right, I'd rather stay here.
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550. You're needed where you're needed.
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551. Tumor is free.
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552. Bag it, tag it, and get it to Path.
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553. Do you smell that?
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554. Smells like a distillery.
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555. But we know he couldn't have touched a drop for at least 24 hours.
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556. Final stitch is yours.
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557. It's completely symbolic, but symbols can be powerful.
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558. Easy-peasy.
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559. You had something called Auto-Brewery Syndrome.
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560. The tumor we found was blocking your intestinal tract.
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561. So carbs weren't being digested,
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562. they were being trapped and fermented.
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563. Your stomach was actually creating its own alcohol.
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564. You were drunk, but not from drinking.
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565. With the removal of the tumor, which was benign,
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566. you're all good.
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567. And the arrhythmia's gone, too.
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568. I never doubted you.
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569. Her faith in you saved your life.
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570. Thank you.
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571. I was so pissed when Lim kicked me out,
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572. until I found Semler had an appendectomy waiting for me.
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573. Got my first lead after all.
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574. I'm happy for you. Really.
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575. I'm happy for me, too.
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576. You earned it.
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577. And you'll get your chance again soon, Shaun.
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578. So that's it? All's well that ends well?
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579. Your surgeon walked out on his case.
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580. That's your takeaway? That he failed?
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581. A chef can eat.
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582. Well, as a diagnostician,
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583. he did something wonderful, but as a surgeon?
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584. Yes, he failed.
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585. We don't work alone, Marcus.
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586. Every time we have a good outcome,
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587. it's because everyone in the room did something right.
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588. Shaun came up with the idea, Park got it out of him,
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589. I approved the surgery, and you?
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590. The only reason Shaun is working here
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591. is because you believed in him.
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592. Yay, team.
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593. Are you still having a gun fight?
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594. Oh, yeah.
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595. Second day of my marriage and we are at an impasse.
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596. Tried the logical approach,
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597. I tried the emotional approach,
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598. no compromise.
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599. Only thing left is the nuclear option, which really sucks.
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600. The thought of having a gun in my house makes me sick...
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601. Has Debbie let you touch her breast?
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602. What?
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603. Has Debbie let you touch her breast?
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604. Yeah.
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605. Then you shouldn't worry about anything else.
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606. I was wrong...
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607. This time.
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608. But 99.9% of cases, I would be right.
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609. If... If someone acts like an addict,
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610. lies like an addict,
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611. smells like an addict, then they are an addict.
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612. And just because we stumbled across
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613. the one ridiculously fluky exception,
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614. that isn't going to change my attitude moving forward.
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615. I respect you, Claire.
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616. Might even go as far as to say I like you.
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617. And I know you're angry right now.
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618. At your mother.
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619. The world.
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620. Yourself.
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621. Eventually, that'll go away.
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622. Or... At least some of it will.
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623. But until then, giving up on that 0.1%
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624. means giving up on something else.
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625. Hope.
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626. Hope...
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627. Killed my mother.
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628. We need to talk.
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629. About the 800-pound gun in the room.
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630. I'm working on my compromise skills.
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631. Okay.
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632. Looks like your first lead surgery went well.
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633. I didn't have a first lead surgery.
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634. Yes. It went very well.
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635. Can I check your other breast?
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