1. Nira is half-blind
because of you.
Copy !req
2. You think I control Salen?
How about taking a stand?
Copy !req
3. You could've worked with me
to make things right.
Copy !req
4. Instead, you had to
burn the building down.
Copy !req
5. She lit the match.
Copy !req
6. If you're gonna
go through with this deal,
Copy !req
7. you're gonna
have to destroy me.
Copy !req
8. Good luck.
Copy !req
9. 'Cause now this is all
your problem.
Copy !req
10. Your
"Unsave-the-date" card.
Copy !req
11. You're... uninviting us
to your wedding?
Copy !req
12. We decided
there will be no wedding
Copy !req
13. for the
foreseeable future.
Copy !req
14. We've canceled
everything.
Copy !req
15. The way
you're smiling,
Copy !req
16. I feel like I should be
congratulating you.
Copy !req
17. We're happy. We just want
to enjoy being happy.
Copy !req
18. We've had enough stress
in our lives.
Copy !req
19. We're living
in the moment.
Copy !req
20. Mm-hmm. Good morning, everyone.
Copy !req
21. Thanks for coming.
Copy !req
22. As the new President,
I'd like to acknowledge
Copy !req
23. we've been through
a challenging time,
Copy !req
24. but St. Bon's has never
been about a logo
Copy !req
25. or a fancy
coffee selection.
Copy !req
26. We've always been about
the people in this room
Copy !req
27. and how we can help the people
who come through these doors.
Copy !req
28. So we're gonna get
back to what we've
always done the best,
Copy !req
29. and that's
putting patients first.
Copy !req
30. You know what a world-class
surgical center needs?
Copy !req
31. It needs a world-class
Chief of Surgery.
Copy !req
32. And that's why
I am reinstating
Dr. Audrey Lim.
Copy !req
33. I'll also be hiring
three new oncology nurses,
Copy !req
34. so if you know
some good people,
let me know, okay?
Copy !req
35. You okay
with all this?
Copy !req
36. No more board meetings.
Are you kidding?
Copy !req
37. Plus, I get a lot more time
with the clinic.
Copy !req
38. Doctors Reznick,
Glassman, can I have
a word with you two?
Copy !req
39. We lost
a clinic contract.
Copy !req
40. Our biggest.
Copy !req
41. Thanks to your confession
of borderline malpractice
Copy !req
42. to the person who runs
their health plan.
Copy !req
43. Nira had the right
to know the truth.
Copy !req
44. You're lucky it was
an experimental procedure.
Copy !req
45. She's not pursuing
a lawsuit.
Copy !req
46. But I'm closing
the clinic.
Copy !req
47. I'm sorry.
Copy !req
48. I just can't
justify the expense
of keeping it open.
Copy !req
49. People need a way
to get healthcare
Copy !req
50. they otherwise
can't afford.
Copy !req
51. How's this
for justification...
Copy !req
52. We can,
and so we should.
Exactly.
Copy !req
53. I've arranged
for Bay Area Medical
to take over their care.
Copy !req
54. Can I talk to you
for one second?
Copy !req
55. If I can just
take a look at the budget,
Copy !req
56. I can figure out a way
to keep this clinic open.
Copy !req
57. I'm afraid you're gonna be
busy in the O.R.
Copy !req
58. Aaron, you're
a gifted surgeon.
Copy !req
59. This hospital
needs those skills.
Copy !req
60. Wow. Okay.
Copy !req
61. Uh, let's talk trade.
Copy !req
62. I'll give you
20 hours a week,
Copy !req
63. and we figure out a way
to keep this clinic open.
Copy !req
64. So you can keep freezing
plantar warts?
Copy !req
65. See? Someone must need
a really good neurosurgeon.
Copy !req
66. Family of three
in a head-on collision.
Copy !req
67. Another ambulance
is behind us
Copy !req
68. with the occupant
of the other vehicle.
Park, you're with me.
Copy !req
69. Bryan Liu.
40 years old.
Copy !req
70. Hypotensive in the field.
GCS ten.
Copy !req
71. Abdominal bruising,
Copy !req
72. some distention,
internal bleeding.
How's that leg look?
Copy !req
73. We might be able
to save his arm.
I need a vascular clamp.
Copy !req
74. Elaine hit her head
on the dash.
Copy !req
75. GCS 15.
Vomited twice.
Copy !req
76. Elaine, I'm Dr. Glassman.
Copy !req
77. How bad
was your headache?
Really bad.
Copy !req
78. Is my daughter okay?
Copy !req
79. She was wearing her seatbelt.
She has pain and bruising
in her chest.
Copy !req
80. I'm right here, honey.
Spleen's ruptured.
Copy !req
81. He's got about two liters
of blood in his abdomen.
Copy !req
82. What's going on
with my dad?
Copy !req
83. Please don't talk.
Copy !req
84. Those doctors
are taking care of him.
Copy !req
85. She has decreased
left-sided breath sounds.
Copy !req
86. We need
to insert a chest tube.
Copy !req
87. W-Why?
What's wrong?
Copy !req
88. A broken rib
punctured her lung.
Copy !req
89. Left pupil's dilated.
Copy !req
90. Subdural?
Copy !req
91. Elaine, you may
have some bleeding
around your brain.
Copy !req
92. We're gonna have to
take you to the O.R.
Copy !req
93. Mommy?
I-I'm okay, sweetie.
Copy !req
94. We're all gonna be
just fine.
Copy !req
95. You just need to...
Copy !req
96. Oh!
Copy !req
97. His BP's tanking.
Copy !req
98. We have to get him
to the O.R. now.
Copy !req
99. Mommy.
Copy !req
100. Daddy.
Copy !req
101. Splenic hilum
is clamped.
Copy !req
102. His pressure's holding.
Copy !req
103. Below-knee
amputation is complete.
Copy !req
104. The stump is covered
and healthy.
Copy !req
105. Start working on
his arm.
Copy !req
106. I'm not
getting any circulation
to his hand.
Copy !req
107. We could use
Andrews' vascular
reconstruction skills.
Copy !req
108. Try reducing the fracture
to restore blood flow.
Copy !req
109. It's not helping.
Copy !req
110. I've got too much
bleeding to help.
Copy !req
111. Try fasciotomies
to relieve pressure.
Copy !req
112. There's too much
upstream damage.
Copy !req
113. Page Andrews.
Copy !req
114. She has an SSS tear.
Copy !req
115. We'll have to
open up her skull
to find a fix,
Copy !req
116. which I do not
want to do.
Copy !req
117. I can stop the leak
with a dural flap,
Copy !req
118. wait till
the swelling goes down,
Copy !req
119. find a better fix.
Copy !req
120. Pressure's still dropping.
Copy !req
121. I got a tight seal.
No leaks.
Copy !req
122. Maybe we're looking
in the wrong place.
Copy !req
123. I hear an
early-diastolic murmur.
Copy !req
124. It's her heart.
Copy !req
125. Get me an echo.
Copy !req
126. Contact social work.
Copy !req
127. Make sure the daughter's
not alone today.
Copy !req
128. She may be losing
both her parents.
Copy !req
129. How bad are they?
Copy !req
130. We won't know
anything for sure
Copy !req
131. until your parents
get out of surgery.
Copy !req
132. The chest tube
was successful.
Copy !req
133. That doctor said my mom
was bleeding in her brain.
Copy !req
134. Did he stop it?
Copy !req
135. They're trying.
Copy !req
136. She has one of the best
neurosurgeons in the state.
Copy !req
137. Did they fix
my dad's leg?
Copy !req
138. I don't know yet.
Copy !req
139. And I understand how scary
and confusing it must be
Copy !req
140. not to have
all the answers.
Copy !req
141. I just want to know
what's happening.
Copy !req
142. Your dad's leg
is likely unsalvageable.
Copy !req
143. He also had
a severe splenic injury
Copy !req
144. that caused catastrophic
internal bleeding
and hypovolemic shock.
Copy !req
145. Removing his spleen
may stop the bleeding,
Copy !req
146. but if not, they may need
to remove his kidney, as well.
Copy !req
147. He may also lose
his lower arm.
Copy !req
148. Dr. Murphy, maybe Isla and I
Copy !req
149. should chat alone
for a few minutes.
Copy !req
150. It's okay. You can stay.
Copy !req
151. You can go.
Copy !req
152. Thank you
for talking to me.
Copy !req
153. Are you sure?
Copy !req
154. Okay.
Copy !req
155. I'll check in later.
Copy !req
156. You can always
have a nurse page me.
Copy !req
157. Could my parents... die?
Copy !req
158. It is too soon to say
Copy !req
159. if either of them
will survive their injuries.
Copy !req
160. I'll round
on Asher's patients,
Copy !req
161. and the night nurse
said Mr. Jones
is ready for discharge.
Copy !req
162. Um, my bowel obstruction
- in 4
- C, did he pass gas?
Copy !req
163. Why do you think the nurses
want him discharged?
Copy !req
164. I'm hungry.
Copy !req
165. The nurse gave me a sandwich,
but it has pickles.
Copy !req
166. They're gross.
Copy !req
167. They are.
Copy !req
168. I'd like
something else, please.
Copy !req
169. I gotta discharge
your windbag in 4C.
Copy !req
170. Nurse.
Copy !req
171. Will you find
this patient
Copy !req
172. something to eat
without pickles?
Copy !req
173. Sure.
Copy !req
174. She isn't just hungry.
Copy !req
175. She's scared.
Copy !req
176. She wants
to spend time with you
Copy !req
177. so she doesn't feel
all alone.
Copy !req
178. Doctors need to maintain
professional boundaries.
Copy !req
179. Convenient,
since you don't want
Copy !req
180. to get close to patients.
Copy !req
181. I think it's
the most rewarding
part of our job.
Copy !req
182. Oh, no.
Copy !req
183. Minimally invasive
microvascular surgery
Copy !req
184. is the most rewarding part.
Copy !req
185. I already treated
her pneumothorax.
She's fine.
Copy !req
186. Subclavian artery's
also damaged.
Copy !req
187. Yeah,
brachial plexus nerves, too.
Copy !req
188. Thought you'd be
a little more excited
about being Chief again.
Copy !req
189. Hard to get too jubilant
about being given a job
Copy !req
190. I never should have lost
in the first place.
Copy !req
191. One you were happy
to step into.
Copy !req
192. BP's stabilizing.
Copy !req
193. This arm's a mess.
Copy !req
194. There's no
distal blood supply,
Copy !req
195. nerves shot,
hand showing signs
of ischemia.
Copy !req
196. I think
I can save it.
Copy !req
197. I need
to open up his chest,
Copy !req
198. get access to proximal vessel
for graft bypass.
Copy !req
199. That's a big,
lengthy surgery
Copy !req
200. with a catastrophic
risk of bleeding.
Copy !req
201. Yeah, which may
save his arm.
Copy !req
202. He's already lost
too much blood
from his other injuries.
Copy !req
203. We have to amputate.
Copy !req
204. Sorry to interrupt.
Copy !req
205. Dr. Lim, there's major damage
to Elaine's heart valve.
Copy !req
206. We need
a trauma surgeon.
Copy !req
207. Go. Dr. Park
can close up
the abdomen.
Copy !req
208. Put a wound vac
on the arm stump
Copy !req
209. and run antibiotics
post-op.
Copy !req
210. What are you doing?
Copy !req
211. Practicing mindfulness.
Copy !req
212. I... don't know
what that means.
Copy !req
213. It helps you let go,
not be self-obsessed,
Copy !req
214. stressed out,
utterly career-driven.
Copy !req
215. I still don't understand.
Copy !req
216. You're being mindful
right now.
Copy !req
217. By letting go
of your wedding plan.
Copy !req
218. Being "in the moment"
with Lea.
Oh.
Copy !req
219. N-No, Lea and I are still
getting married.
Copy !req
220. We're only
"enjoying the moment" for now.
Copy !req
221. Good for you.
Copy !req
222. I suck
at "the moment."
Copy !req
223. I like making a plan,
Copy !req
224. having a plan...
Copy !req
225. Following a plan.
Copy !req
226. Do you want my apple?
Copy !req
227. You're acting
very strangely.
Copy !req
228. Isla's hemoglobin
dropped to nine,
Copy !req
229. and there's blood
in her chest tube.
Copy !req
230. Oh. That's not good.
Copy !req
231. We'll take a few
pictures to find out
where the problem is.
Copy !req
232. Won't hurt at all.
Copy !req
233. Then you can
stop the bleeding?
Copy !req
234. Probably.
Copy !req
235. But it will likely
require something
that does hurt.
Copy !req
236. You need to remove that
before the M.R. Angiogram.
Copy !req
237. No. I can't.
Copy !req
238. It's a gum wrapper.
Copy !req
239. My dad gave it to me.
Copy !req
240. I wanted my birthstone,
sapphire.
Copy !req
241. But we couldn't afford it.
So my dad made me this.
Copy !req
242. He called it
a placeholder.
Copy !req
243. That's really sweet.
Copy !req
244. An MRI
is a powerful magnet.
Copy !req
245. It will destroy
your gum-wrapper ring,
Copy !req
246. and it could
burn your finger.
Copy !req
247. Promise you won't
lose it?
Copy !req
248. I promise.
Copy !req
249. Okay.
Copy !req
250. She damaged
her aortic valve.
Copy !req
251. We'll need
to open her up.
Copy !req
252. CP bypass is generally
not a good chaser
to a brain bleed.
Copy !req
253. She needs
a functional valve.
Copy !req
254. You'll need
to figure out a way
to give her one
Copy !req
255. without turning her
into a vegetable.
Copy !req
256. I brought you here
for your expertise.
Copy !req
257. Or would you rather I try
to figure it out for you?
Copy !req
258. Throwing up your hands
and making someone else
Copy !req
259. solve the problem
is not leadership.
Copy !req
260. I'm gonna guess
we're not talking
about a heart valve.
Copy !req
261. When Ethicure took over,
Copy !req
262. you just walked out,
headed for Paradise.
Copy !req
263. I know you were
going through
a rough patch,
Copy !req
264. but we were going
through it here, too.
Copy !req
265. And you didn't bother
to step up
Copy !req
266. until it became
a problem for Shaun.
Copy !req
267. You want me to apologize
for my commitment to Shaun?
That's not gonna happen.
Copy !req
268. I would never
ask you to do that.
Copy !req
269. I just didn't realize
how little the rest of us
matter to you.
Copy !req
270. I can insert an aortic pump
to support her heart.
Copy !req
271. That should buy me
some time to fix her valve.
Copy !req
272. The chest trauma
damaged a branch
of her pulmonary artery.
Copy !req
273. The bleeding has stopped,
Copy !req
274. but her artery could
re-bleed at any time.
Copy !req
275. How do we get to it?
Copy !req
276. It's surrounded
by vital organs.
Copy !req
277. Thoracotomy, dissect from
proximal to distal hilum,
Copy !req
278. isolate the vessel,
and reconstruct the vessel.
Copy !req
279. That's a big surgery
for a small injury.
Copy !req
280. It's almost as risky
as are-rupture.
Copy !req
281. We need a safer plan.
Copy !req
282. I don't have one.
Copy !req
283. I need time
to figure it out.
Copy !req
284. I'll need to monitor her
around the clock
Copy !req
285. in case she bleeds again.
Copy !req
286. Looks like Isla's
getting some QT
Copy !req
287. with Dr. Murphy
after all.
Copy !req
288. Are we done?
Copy !req
289. I'm bored.
Copy !req
290. Who's your friend?
She's not my friend.
She's my patient.
Copy !req
291. Isla Liu,
10-year-old female
Copy !req
292. with a pseudo-aneurysm
of a segmental branch
Copy !req
293. of the left
pulmonary artery.
Copy !req
294. I need to monitor her
closely
Copy !req
295. to make sure she
does not bleed out.
Copy !req
296. This is my fiancee, Lea.
She's Head of
the I.T. Department.
Copy !req
297. I need you
to talk to her
Copy !req
298. while I figure out
how to fix her.
Copy !req
299. She talks a lot.
Copy !req
300. I do.
Copy !req
301. Where's your ring?
He said you were his fiancee.
Copy !req
302. I proposed to him,
Copy !req
303. and it was
a spur of the moment
kinda thing, so no ring.
Copy !req
304. Very modern.
Mm.
Copy !req
305. I asked out my last boyfriend,
but it didn't work out.
Copy !req
306. When's your wedding?
Copy !req
307. We don't have a date.
Did you pick a cake?
Copy !req
308. My aunt had red velvet.
It was really good.
Copy !req
309. And her gown was super long.
They call it a train.
Copy !req
310. Do you have
one of those?
Copy !req
311. Trains can lead to tripping
and orthopedic injuries.
Copy !req
312. I don't want a dress
with a train.
Copy !req
313. You have no cake, no ring,
no dress, and no date?
Copy !req
314. We have a cake.
Copy !req
315. Then how are you
his fiancee?
Copy !req
316. Isn't it just, like,
boyfriend and girlfriend?
Copy !req
317. What's I.T.?
Copy !req
318. Well, I.T. stands for
"information technology,"
Copy !req
319. so I work with
a lot of computers.
Copy !req
320. Increase the flow to P-eight
and get a CT of her heart.
Copy !req
321. We need exact
valve measurements.
Copy !req
322. Got some good news.
Copy !req
323. I restored blood flow
to Bryan's arm.
Copy !req
324. You were supposed
to amputate.
Copy !req
325. I didn't open his chest.
Copy !req
326. I rebuilt his vessels
from under the clavicle.
Copy !req
327. Still got
a large tissue defect,
Copy !req
328. but I can cover that
with a tissue flap.
Copy !req
329. I know a great neurosurgeon
for the nerve repairs.
Copy !req
330. More surgery?
He could bleed again.
Copy !req
331. I can handle that.
Copy !req
332. And what about
the potential
Copy !req
333. for post-transfusion
clotting issues?
Copy !req
334. Removing his arm
is the only way
Copy !req
335. to guarantee
we save his life.
Copy !req
336. Losing two limbs
would be devastating.
Copy !req
337. It's such a high cost to avoid
a relatively small risk.
Copy !req
338. But it's not small
to that little girl,
Copy !req
339. whom you could orphan
to serve your own ego.
Copy !req
340. Pretty harsh assessment,
Copy !req
341. especially considering
I just rescued you
and our colleagues
Copy !req
342. from your suicide mission.
Copy !req
343. You want a medal for finding
your moral compass
Copy !req
344. at the last
possible moment?
Copy !req
345. I was there
when it counted.
Copy !req
346. You did her bidding,
even after the baby died,
Copy !req
347. and then leveraged
the situation
Copy !req
348. so you came out in charge.
Copy !req
349. I am in charge.
Copy !req
350. I'm saving
this man's arm.
Copy !req
351. Hmm.
Copy !req
352. Are you stealing
from children now?
Copy !req
353. This stuff's been in here
Copy !req
354. since my first year
of residency.
Copy !req
355. Aren't you supposed
to be in peer review?
Copy !req
356. I'm tied up
on this trauma case.
Copy !req
357. I thought you might want
to sit in on it for me.
Copy !req
358. Dr. Farber's leading it.
Copy !req
359. Chair of the Executive Ops
Committee.
Copy !req
360. If you want to run
a hospital one day...
Copy !req
361. Gotta go.
Copy !req
362. But thanks for
thinking of me.
Copy !req
363. How can I resect
a pseudo-aneurysm
Copy !req
364. without cutting off blood flow
to the upper lobe?
Copy !req
365. What about
arterial bypass?
Copy !req
366. Isla's 10 years old.
Copy !req
367. The bypassed artery
wouldn't grow with her lungs.
Copy !req
368. Do you think Lea and I
Copy !req
369. are just boyfriend
and girlfriend?
Copy !req
370. No?
Copy !req
371. Me neither.
Copy !req
372. But if we're not
planning a wedding,
then what are we doing?
Copy !req
373. Are we
moving backwards?
Copy !req
374. Shaun, a wedding
is just a symbol.
Copy !req
375. A very nice,
very expensive one,
Copy !req
376. but real stability
comes from committing
to each other every day.
Copy !req
377. What should I do?
Copy !req
378. Uh, you and Lea will need
to figure that out.
Copy !req
379. The older I get,
the less everyone
seems to know.
Copy !req
380. That's probably true.
Copy !req
381. Oh, have you considered
an endovascular embolization
for Isla's pseudo-aneurysm?
Copy !req
382. Your medical advice
is much better
than your personal advice.
Copy !req
383. Self-retaining retractor.
Copy !req
384. Stay out of
my nerve field,
please.
Copy !req
385. I need
better vessel exposure.
Copy !req
386. This muscle needs a nerve.
Copy !req
387. I feel bad about
closing the clinic,
Copy !req
388. but we can't help anyone
Copy !req
389. if we can't keep
the lights on.
Copy !req
390. It's not about
helping anyone.
Copy !req
391. It's about making sure
you can put your feet up
Copy !req
392. on the biggest desk
in the building.
Copy !req
393. You look down on me
'cause I want the big job,
Copy !req
394. but it was your
apathy towards it
that made us vulnerable
Copy !req
395. to Ethicure
in the first place.
Copy !req
396. Nerves are attached.
Copy !req
397. Reconstructed vessel's
blown.
Copy !req
398. You want me to...
No, I got it.
Copy !req
399. The embolization
will be short.
Copy !req
400. It should prevent further
bleeding in your chest.
Copy !req
401. Dr. Park thinks
you're wrong.
Copy !req
402. Lea is still my fiancee
Copy !req
403. and a wedding
is just a symbol.
Copy !req
404. Symbols are
a super big deal.
Copy !req
405. They remind us
what's important.
Copy !req
406. That's what my mom said
when I wanted
Copy !req
407. to return
my confirmation cross
Copy !req
408. and use the money
to get my ears pierced.
Copy !req
409. Lie down.
Copy !req
410. I need to inject
the anesthetic.
Copy !req
411. I hate needles.
Copy !req
412. I still make my mom
hold my hand
when I get shots.
Copy !req
413. You can squeeze my hand
as hard as you want.
Copy !req
414. I practiced when Lea
was pregnant.
Copy !req
415. You two have a baby?
Copy !req
416. No.
Copy !req
417. Why not?
Copy !req
418. There was a clot
in the umbilical cord.
Copy !req
419. The baby died.
Copy !req
420. I'm injecting
the anesthetic.
Copy !req
421. You can let go
of my hand now.
Copy !req
422. That hardly hurt
at all.
Copy !req
423. You're very good
at your job.
Copy !req
424. Isla, the doctors are still
taking care of your mom,
Copy !req
425. but your dad's
out of surgery.
Copy !req
426. He lost his leg,
Copy !req
427. but he's gonna
be okay.
Copy !req
428. You can see him as soon
as you're done.
Copy !req
429. I don't want
to see him.
Copy !req
430. Fluid's backed up
in Elaine's brain.
Copy !req
431. 75 mannitol.
Hopefully, that'll
take the pressure off.
Copy !req
432. Elaine needs a shunt.
Can her heart take it?
Copy !req
433. Not with just a pump
keeping her alive,
Copy !req
434. but she's got
another problem.
Copy !req
435. She's got a big tear
in her trachea
Copy !req
436. and she could lose
her airway any minute.
Copy !req
437. Know of any experts
in tracheal reconstruction?
Copy !req
438. Time to call
the President.
Copy !req
439. This is Donald Adler.
Copy !req
440. He's had chest pain
for the past few weeks.
Copy !req
441. I'm fine.
Copy !req
442. My son's taking me
to the doctor.
Copy !req
443. The one who's postponed
three times already?
Copy !req
444. I tried to contact his GP.
No luck.
Copy !req
445. We need to rule out
coronary artery disease.
Copy !req
446. Is he your patient?
Copy !req
447. She's my chess partner
at the home.
Copy !req
448. I beat her
three times in a row.
Copy !req
449. Impressive.
She always kicks my ass.
Copy !req
450. He's much better
than you are.
Copy !req
451. How long
is this gonna take?
Copy !req
452. We're having
arts and crafts
tonight.
Copy !req
453. She's teaching us
how to decoupage.
Copy !req
454. Let's, uh,
get you a cardiac CT.
Copy !req
455. Help Mr. Adler
into a gown.
Copy !req
456. You look a lot like
my girlfriend,
Copy !req
457. but she doesn't
decoupage.
Copy !req
458. She mocks people
who decoupage.
Copy !req
459. Well, she sounds like
a real piece of work.
Copy !req
460. Hey. I got this for Isla.
Copy !req
461. How is she?
Hello.
Copy !req
462. I'm waiting on labs to see
if the embolization
Copy !req
463. repaired the artery
in her chest.
Copy !req
464. I meant emotionally.
Copy !req
465. She's refusing
to see her father.
Copy !req
466. We don't know why.
Copy !req
467. Well, shouldn't
you find out?
Copy !req
468. I am waiting on labs.
Jordan is talking to her.
Copy !req
469. I think we should
pick a date
Copy !req
470. for when we're going
to start planning
our wedding again.
Copy !req
471. June 8th?
Copy !req
472. What happened to
enjoying the moment?
Copy !req
473. I'm not enjoying it.
Copy !req
474. Okay.
Copy !req
475. We had a plan.
Copy !req
476. Now, we don't have a plan,
Copy !req
477. and you're okay with that,
but I'm not.
Copy !req
478. We will figure it out,
Shaunie.
Copy !req
479. How?
Copy !req
480. I don't know yet.
Copy !req
481. No one has
good advice anymore.
Copy !req
482. Isla's not talking to me.
Copy !req
483. We should page
the social worker.
Copy !req
484. She's not going to open up
to the social worker, Shaun.
Copy !req
485. Isla trusts you.
Copy !req
486. I can use
a transcervical approach
Copy !req
487. to reconstruct
the airway.
Copy !req
488. If you use a retractor
in her neck,
Copy !req
489. I'll lose drainage
from her brain.
Copy !req
490. I need to start her
on heparin
Copy !req
491. so I can get working
on her heart.
Copy !req
492. You can't use heparin
until I've placed the shunt.
Copy !req
493. Not while
I'm working on her neck.
Copy !req
494. One wrong move,
she'll need
a lifelong trach.
Copy !req
495. If she bleeds again
from her sagittal sinus,
Copy !req
496. she'll be brain dead.
Copy !req
497. If she has
catastrophic heart failure,
she'll be dead-dead.
Copy !req
498. Okay.
Airway's priority one.
Copy !req
499. Once it's secure,
you can fix the valve.
Copy !req
500. You're overruling
my judgment again?
Copy !req
501. Overruling? We...
Copy !req
502. Elaine's pump failed.
She's in total heart failure.
Copy !req
503. I'm prepping an O.R.
Copy !req
504. Mm.
Copy !req
505. That is a very accurate
drawing of a horse.
Copy !req
506. It's my dog, Abigail.
Copy !req
507. Oh.
Copy !req
508. She must
look like a horse.
Copy !req
509. Is my dad
in a lot of pain?
Copy !req
510. No.
Copy !req
511. He is on
very strong narcotics.
Copy !req
512. Why don't you
want to see him?
Copy !req
513. His residual limb
is heavily bandaged,
Copy !req
514. so you won't be able
to see any...
Copy !req
515. Blood or tissue
or bones.
Copy !req
516. I'm not afraid of that.
Copy !req
517. Okay.
Copy !req
518. I was kicking
the back of the seat.
Copy !req
519. The driver's seat,
which my dad hates.
Copy !req
520. He missed my choir concert,
which made me mad,
Copy !req
521. so I kicked his seat.
Copy !req
522. And he told me to stop,
Copy !req
523. but I kept kicking
and kicking,
Copy !req
524. and then he turned around,
Copy !req
525. told me to cut it out,
Copy !req
526. and then I heard
Mom scream,
Copy !req
527. and there were sirens,
and then we were here.
Copy !req
528. He's going to hate me
Copy !req
529. because I'm selfish and stupid
and it was all my fault.
Copy !req
530. It was...
Copy !req
531. My fault
my brother Steve died.
Copy !req
532. But it was
Steve's fault, too.
Copy !req
533. It was his idea to hide
on the roof of the train.
Copy !req
534. He fell.
Copy !req
535. He broke his neck.
Copy !req
536. Your dad took his eyes
off the road,
Copy !req
537. and a car ran a red light
and the airbags didn't deploy.
Copy !req
538. Those things
are not your fault.
Copy !req
539. And even if it were...
Copy !req
540. Your parents would
probably still love you,
Copy !req
541. because of your shared
experience in combination
Copy !req
542. with the parental
bonding hormone oxytocin.
Copy !req
543. Although, in my case,
it wasn't enough.
Copy !req
544. My parents
didn't like me.
Copy !req
545. I'm sorry
about your brother.
Copy !req
546. And your parents.
Copy !req
547. And your baby.
Copy !req
548. You've had
a lot of bad things
happen to you.
Copy !req
549. I've had
a lot of good things
happen, too.
Copy !req
550. Okay.
Copy !req
551. I want to go see my dad.
Copy !req
552. Aah.
Copy !req
553. Isla?
Copy !req
554. I need a rapid response team,
stat.
Copy !req
555. She's bleeding
in her chest!
Copy !req
556. BP is 65 over palp.
Give another
unit of blood.
Copy !req
557. We have to
open her up, Shaun.
Copy !req
558. We could
injure her bronchi
Copy !req
559. and cause
chronic respiratory failure
Copy !req
560. or rupture her
pulmonary artery.
Copy !req
561. She could bleed out.
Copy !req
562. If we don't operate now,
she's gonna die.
Copy !req
563. Prep an O.R.
for stat thoracotomy,
and page Dr. Lim.
Copy !req
564. The old fart
needs angioplasty and a stent.
Copy !req
565. You may have just saved
this guy's life.
Copy !req
566. I'm gonna be late
for arts and crafts.
Copy !req
567. Does this have anything
to do with Nira?
Copy !req
568. Hey, you made one bad call.
You're not a bad person.
Copy !req
569. Uh, that is not what
you said last week.
Copy !req
570. I may have overreacted.
Copy !req
571. I've woken up
every morning
my whole life
Copy !req
572. wanting to conquer the world,
and then I hurt someone,
Copy !req
573. and I almost lost...
Copy !req
574. I almost lost everything.
Copy !req
575. So now,
I am going to cultivate
virtuous intentions
Copy !req
576. and... generally
not be so awful.
Copy !req
577. If you want to meditate
and volunteer
Copy !req
578. and save random old guys,
go ahead.
Copy !req
579. But don't become
a totally different person.
Copy !req
580. I would miss you.
Copy !req
581. The world needs people
who wake up every morning
Copy !req
582. wanting to conquer it.
Copy !req
583. Those kinds of people
land on the moon
Copy !req
584. and cure cancer and...
Copy !req
585. Drag grumpy, old men
into the E.R.
Copy !req
586. And trample innocent souls
along the way.
Copy !req
587. Yeah, don't do that part.
Copy !req
588. I'll be around
to remind you.
Copy !req
589. I'll prep a suite
for Old Fart.
Copy !req
590. Take much longer and she'll
have a cardiac arrest.
Copy !req
591. Trach is secure.
Go ahead.
Copy !req
592. Advancing the catheter
to the ascending aorta.
Copy !req
593. Bring down her CO2.
Copy !req
594. Retract the neck muscles
so there's...
Copy !req
595. Yeah, no, I got it.
Copy !req
596. The death of that baby
kept me up at night.
Copy !req
597. It still does.
Copy !req
598. I should have
taken a stand then,
Copy !req
599. but Salen told me
it kept her up at night, too.
Copy !req
600. She promised
to make changes
Copy !req
601. to ensure that
it never would
happen again,
Copy !req
602. and I believed her
because I cared for her.
Copy !req
603. A lot.
Copy !req
604. But my eyes were closed,
Copy !req
605. and I should have
stepped up sooner.
Copy !req
606. Because this place
is my home,
Copy !req
607. and you pains-in-the-ass
are my family.
Copy !req
608. Together, we can fix
this woman's heart,
Copy !req
609. her brain, and neck.
Copy !req
610. We can do great things
for all our patients...
Copy !req
611. If we don't
kill each other first.
Copy !req
612. Shunt's through.
Copy !req
613. You can go ahead
with the trach repair.
Copy !req
614. She's crashing.
Copy !req
615. Dr. Cain will be here
in 20 minutes.
Copy !req
616. We don't have
20 minutes.
Copy !req
617. I have to
open her chest now.
Copy !req
618. Get an attending
out of surgery.
Copy !req
619. She has
critical bradycardia,
Copy !req
620. but the valve
is well-positioned.
Copy !req
621. Drain two cc's of CSF
every minute.
Copy !req
622. That should buy me
ten minutes.
Copy !req
623. I'll remove
the delivery valve.
Copy !req
624. I'll put in
a temporary pacer.
Copy !req
625. But I still don't know
what's tanking her heart rate.
Copy !req
626. I do.
Copy !req
627. The tracheal injury
compressed her carotid.
Copy !req
628. It's lowering
her heart rate.
Copy !req
629. Try removing
the retractor.
Copy !req
630. Push atropine.
Copy !req
631. No good.
Copy !req
632. Heart rate's in the 30s.
She's gonna arrest.
Copy !req
633. Gonna try to decompress
the carotid bulb.
Copy !req
634. Shaun needs one of you
in O.R. three.
Copy !req
635. Isla's
pulmonary vessel ruptured.
He's cracking her chest.
Copy !req
636. I need ten minutes.
Tell Shaun to use every
bit of his Shaun-ness
Copy !req
637. to keep her alive
till I get there.
Copy !req
638. Andrews can be here
in ten minutes.
Copy !req
639. I've located
the bleeding vessel.
Copy !req
640. If I clamp too close
to the pulmonary artery,
Copy !req
641. I'll extend the injury
and she will bleed out.
Copy !req
642. If I get too close
to the hilum,
Copy !req
643. I could cause
a pulmonary infarct.
Copy !req
644. She'd need a ventilator
for the rest of her life.
Copy !req
645. I need Andrews' help.
Copy !req
646. She's going into shock.
Copy !req
647. You can do this, Shaun.
Copy !req
648. I need Metz, stay sutures,
and a needle driver.
Copy !req
649. BP's climbing.
Copy !req
650. Well done, Dr. Murphy.
Want me to take over?
Copy !req
651. Yes.
Copy !req
652. We're all going to be okay.
Copy !req
653. Except for
the severe chest pain
Copy !req
654. you will both experience
for several weeks.
Copy !req
655. And there is a 1% chance of
a recurrent pseudo-aneurysm.
Copy !req
656. But yes, you will
most likely be okay.
Copy !req
657. Thank you, Dr. Murphy.
Copy !req
658. We'll give you all
some time.
Copy !req
659. I didn't lose it.
Copy !req
660. Thank you, Dr. Murphy.
Copy !req
661. Personal connections
aren't so bad, are they?
Copy !req
662. Mm. No.
Copy !req
663. They are not so bad.
Copy !req
664. But I do not
want to do it again.
Copy !req
665. I have to go home.
Copy !req
666. I think I can
save the clinic.
Copy !req
667. Dr. Reznick,
it's been a long day.
Copy !req
668. I talk fast.
Old people.
Copy !req
669. They need care the most
Copy !req
670. and they have
the least access.
Copy !req
671. Telemedicine services
for nursing homes.
Copy !req
672. I just brought in a patient
who needed a $100,000 angio,
Copy !req
673. entirely paid for
by Medicare.
Copy !req
674. That alone would
cover the cost
Copy !req
675. of three uninsured
clinic patients.
Copy !req
676. It's a good idea, but ideas
aren't your problem.
Copy !req
677. I know.
I made a mistake...
Copy !req
678. And followed it up
with another.
Copy !req
679. You've bungled
your opportunity
from every direction.
Copy !req
680. I know.
Copy !req
681. Which is why
Dr. Glassman should
be in charge of the clinic.
Copy !req
682. I'm not ready,
but I will be.
Copy !req
683. Someday.
Copy !req
684. And you're gonna need
people like me
Copy !req
685. if you're gonna
save this place.
Copy !req
686. And you know I'm right,
Copy !req
687. because you wake up
every morning
Copy !req
688. wanting to
conquer the world, too.
Copy !req
689. What is all of this?
Copy !req
690. I got you something.
Copy !req
691. I made it myself.
Copy !req
692. Lea Dilallo...
Copy !req
693. will you
Copy !req
694. make a bond
of shared experience
and oxytocin...
Copy !req
695. and love with me
for the rest of our lives?
Copy !req
696. Of course.
Copy !req
697. It's a placeholder.
Copy !req
698. It's perfect.
Copy !req
699. I left a bottle of Scotch
around here somewhere
Copy !req
700. after the first time
you stole my job.
Copy !req
701. Did you drink
all my fizzy water?
Copy !req
702. There's a cucumber one
left in the back.
They're disgusting.
Copy !req
703. It's refreshing
and delicious.
Copy !req
704. Agree to disagree.
Copy !req
705. Yep.
Copy !req
706. Found it.
Copy !req
707. Why not?
Copy !req