1. Ohh.
Copy !req
2. Sorry.
Copy !req
3. Did I wake you?
Copy !req
4. Yes.
Copy !req
5. The baby's pressing
on my bladder,
Copy !req
6. so I have to pee approximately
78 times every night.
Copy !req
7. We can talk about baby names
since we are both awake.
Copy !req
8. I keep coming back
to one name, Kelly.
Copy !req
9. It reminds me
of a Kelly clamp,
Copy !req
10. and I will think about
grasping onto tissue or vessels
Copy !req
11. every time
I'm holding our son.
Copy !req
12. What about Addison?
Copy !req
13. Addison Murphy.
Copy !req
14. Addison is the name
of a disease.
Copy !req
15. I'll worry our son is not
producing enough cortisol
Copy !req
16. or aldosterone.
Copy !req
17. You can go
back to sleep.
Copy !req
18. I have to go pee again anyway.
Copy !req
19. Morning!
Copy !req
20. Pancakes, anyone?
Copy !req
21. They are not just
ordinary pancakes.
Copy !req
22. They are
Dutch baby pancakes.
Copy !req
23. Also known as Bismarcks,
Dutch puffs,
Copy !req
24. and even Hootenannies.
Copy !req
25. - I looked it up.
- That is correct.
Copy !req
26. They are baked in an oven,
not fried.
Copy !req
27. I was up very early.
Copy !req
28. Oh, sorry if my frequent
bathroom trips kept you up.
Copy !req
29. Oh, don't be silly.
You're making a human.
Copy !req
30. Thank you.
Copy !req
31. So, Kelly and Addison
are out.
Copy !req
32. I don't disagree.
Copy !req
33. How about Munchausen?
Copy !req
34. Shaun.
Copy !req
35. - Or Parkinson?
- Oh. Ohh.
Copy !req
36. Our bedroom conversations
are meant to be private.
Copy !req
37. All of them?
Copy !req
38. Well, it's not like
you were talking about...
Copy !req
39. Never mind.
Copy !req
40. Let's eat.
Copy !req
41. A friend on the San Jose
school board reached out.
Copy !req
42. They're looking for someone
to give a series
of online talks
Copy !req
43. to high schoolers
about careers in medicine,
Copy !req
44. specifically
to young women of color.
Copy !req
45. That's great.
Copy !req
46. I thought
you'd be perfect.
Copy !req
47. Oh.
Copy !req
48. That wasn't the reaction
I was expecting.
Copy !req
49. Maybe Dr. Tooks
can do it.
Copy !req
50. Tooks is a mom.
Copy !req
51. These high school kids
don't see themselves in her.
Copy !req
52. There's gotta be
someone else.
Copy !req
53. There isn't,
which is the whole point.
Copy !req
54. Only 2% of surgeons
in the U.S. are Black.
Copy !req
55. Don't be afraid to
step into the spotlight.
Copy !req
56. I'm not afraid.
I'm just very busy.
Copy !req
57. Okay. It will only take
a couple hours of your time.
Copy !req
58. "If you can see it,
you can be it" is a real thing.
Copy !req
59. It is not my responsibility
to be the one they see.
Copy !req
60. Okay.
Copy !req
61. Nathan hit his head
on the trampoline frame
Copy !req
62. at his birthday party
two days ago.
Copy !req
63. He got a bump,
but he seemed fine.
Copy !req
64. Where's Daddy?
Copy !req
65. I told you.
He's away for work
helping people.
Copy !req
66. He'll be back
in a few days, okay?
Copy !req
67. Is it possible to develop
a concussion two days later?
Copy !req
68. Well, let's see if we can
find out what's going on.
Copy !req
69. Nathan,
what's your puppy's name?
Copy !req
70. Patches.
Copy !req
71. Can I look into Patches' eyes
with this little light,
Copy !req
72. make sure he's okay?
Copy !req
73. Or you can do it?
Copy !req
74. Just look in here.
Copy !req
75. Can you pick this back up
and give it to the doctor?
Copy !req
76. I can't.
Where's Daddy?
Copy !req
77. Can you give me
a high five, bud?
Copy !req
78. Good.
Now high ten.
Copy !req
79. What's happening?
Is— Is this a concussion?
Copy !req
80. It's not a concussion.
Your son is having a stroke.
Copy !req
81. You are late.
Copy !req
82. No, I'm not.
Copy !req
83. It's 8:01 a.m.
Copy !req
84. Oh, it— It is now,
Copy !req
85. but I'm pretty sure
it was still 8:00
Copy !req
86. when I walked through
the door.
Copy !req
87. Were you getting
your hair cut?
Copy !req
88. No.
Copy !req
89. Are you using drugs again?
Copy !req
90. No.
Copy !req
91. You are on probation,
and I am responsible for you.
Copy !req
92. Common signs of drug abuse
Copy !req
93. include ignoring responsibilities
Copy !req
94. and secretive behavior.
Copy !req
95. I promise you,
I'm clean.
Copy !req
96. I'll pee in a cup if you want.
Copy !req
97. Okay.
Copy !req
98. I'm going to assist Dr. Park.
Copy !req
99. You can join the case if your
sample comes back clean.
Copy !req
100. I wasn't even late.
Copy !req
101. Sorry, a chance to help
young, diverse women
Copy !req
102. and kiss the hospital
president's ass
Copy !req
103. at the same time?
Copy !req
104. There's only
one answer to that.
Copy !req
105. It starts with a "Y,"
ends with a "Yes."
Copy !req
106. - That didn't work.
- I know, I should've bailed.
Copy !req
107. But I stand by my point.
Copy !req
108. Aren't we busy enough?
Copy !req
109. And why do I have the burden
of extra homework
Copy !req
110. just because I have
more melanin than you?
Copy !req
111. And why is my Grandma E
texting me right now?
Copy !req
112. You shouldn't think of it
as homework,
Copy !req
113. and you definitely shouldn't
think of it as a burden.
Copy !req
114. And you shouldn't think
you know
what it's like to be me.
Copy !req
115. Point taken.
Copy !req
116. Hm.
Copy !req
117. What the...?
Copy !req
118. Okay, can we just focus on
our patients, please?
Copy !req
119. Thank you.
Copy !req
120. Quinque, there you are.
Copy !req
121. Grandma E,
what are you doing here?
Copy !req
122. I was told they have
doctors here.
Copy !req
123. I've got tightness
in the chest,
Copy !req
124. shortness of breath,
swollen ankles.
Copy !req
125. Why didn't you go see
your doctors in Oakland?
Copy !req
126. Those idiots said
that my ascites indicated
Copy !req
127. I had "cirrhosis of the liver"
like I'm some kind of a drunk.
Copy !req
128. And I figured,
with my family connections,
Copy !req
129. I could get some
top-shelf care here.
Copy !req
130. I can't be involved
in any of your—
Copy !req
131. But I can.
Copy !req
132. Delighted to meet you,
Grandma E.
Copy !req
133. I'm Dr. Wolke.
Copy !req
134. Okay.
Jordan, baby, you stay
Copy !req
135. and keep an eye
on little mister here.
Copy !req
136. He might try to skate by
on his good looks.
Copy !req
137. Ah.
Copy !req
138. Can you lean back for me?
Copy !req
139. Jordan, you never mentioned
having a sister.
Copy !req
140. See? I like him.
Copy !req
141. Distended jugular veins
with increased JVP.
Copy !req
142. Kussmaul's sign
and pulsus paradoxus.
Copy !req
143. Maybe I don't like you
so much now.
Copy !req
144. She does have a history
of chest radiation.
Copy !req
145. Echo-brightness
of the pericardium.
Copy !req
146. What does that mean?
Copy !req
147. The sac around your heart
is inflamed.
Copy !req
148. There are
calcium deposits.
Copy !req
149. Grandma?
Copy !req
150. All right,
those are faint pulses.
Copy !req
151. Okay, if we don't do something,
she's gonna arrest.
Copy !req
152. Set up an OR stat
for a pericardiotomy.
Copy !req
153. No, Rick, stay.
Copy !req
154. I-I promise
I've got this.
Copy !req
155. Sorry to interrupt.
We're ready.
Copy !req
156. Can you please
talk to my husband?
Copy !req
157. Of course.
Copy !req
158. This is Dr. Park.
Copy !req
159. How does a four-year-old
end up with a stroke
from bumping his head?
Copy !req
160. Head trauma's
one of the main causes.
Copy !req
161. Well, I feel like I should
get on a plane now,
Copy !req
162. but Linda's telling me
to stay.
Copy !req
163. How far are you?
Copy !req
164. Alabama.
We still have people missing
Copy !req
165. after the tornado
ripped through.
Copy !req
166. I can't tell you
how to prioritize,
Copy !req
167. but I can tell you I'm hoping
to make your son better
Copy !req
168. well before
you could get here.
Copy !req
169. Thank you.
Copy !req
170. We're okay.
Copy !req
171. You'll be back
in a few days anyway,
Copy !req
172. so just stay
and keep helping.
Copy !req
173. Okay.
Copy !req
174. Evacuating
the hematoma.
Copy !req
175. I saw on the Weather Channel
that the Alabama tornado
Copy !req
176. was the 15th to reach a 4
on the Enhanced Fujita Scale
Copy !req
177. in the last 3 years.
Copy !req
178. Together, they have caused
116 fatalities.
Copy !req
179. Luckily, we have people
like his dad
Copy !req
180. who run towards
a crisis.
Copy !req
181. But he also has a crisis
right here with his son.
Copy !req
182. He didn't know that
when he left.
Copy !req
183. I'm not seeing
an active bleeder.
Copy !req
184. There is a hyper-vascularized
brain parenchyma
Copy !req
185. in this resection cavity.
Copy !req
186. Oh, the major named vessels
are all smaller than usual
Copy !req
187. and look scarred in.
Copy !req
188. The hemorrhage was not
from hitting his head.
Copy !req
189. This boy and his brain are even
sicker than we thought.
Copy !req
190. Widening
the sternal retractor.
Copy !req
191. So, why does she call you
Queen K?
Copy !req
192. It's Quinque.
Copy !req
193. Latin for five because
I'm the fifth child of six.
Copy !req
194. So does she call
your little brother "Sex"?
Copy !req
195. Please focus so you don't
kill my grandmother.
Copy !req
196. Cauterizing the edges
of the sternal periosteum.
Copy !req
197. She's so charming.
Copy !req
198. Why didn't you get
any of those genes?
Copy !req
199. Charm is one of the many layers
of a very complicated woman.
Copy !req
200. Grandma E drove me
like a drill sergeant
from the day I was born.
Copy !req
201. Ensure the pericardium is free
from both the pleurae
and the diaphragm.
Copy !req
202. 15 blade.
Copy !req
203. Oh.
Copy !req
204. We need a new 15 blade.
Copy !req
205. What's happening?
Copy !req
206. I can't pierce it.
Copy !req
207. Never seen constrictive
pericarditis this severe.
Copy !req
208. It's completely calcified.
Copy !req
209. Your grandma has what's known
as a coconut heart.
Copy !req
210. Your son has a rare
auto-immune disorder called
primary CNS vasculitis.
Copy !req
211. It's causing inflammation
of his blood vessels
throughout his brain.
Copy !req
212. Okay, um...
Copy !req
213. Wh-What are
the next steps?
Copy !req
214. Cyclophosphamide
infusions.
Copy !req
215. That's chemo.
Copy !req
216. My mother had that
when she had breast cancer.
Copy !req
217. And she— she lost her hair,
she threw up, she got sores
all over her mouth.
Copy !req
218. Letting this go untreated
is far worse—
Copy !req
219. Recurrent brain bleeds,
possibly large
territory strokes.
Copy !req
220. It could be fatal.
Copy !req
221. Nathan will be on
some form of immunosuppression
his whole life.
Copy !req
222. I'm sorry.
Copy !req
223. Thank you, Doctor.
Copy !req
224. How do you
crack open a coconut
Copy !req
225. without puncturing
what's underneath?
Copy !req
226. Constrictive pericarditis.
Copy !req
227. Please stop
saying "coconut."
Copy !req
228. It's my grandmother
and it's serious.
Copy !req
229. Not your case.
Copy !req
230. I'm just having a snack.
And trying to help.
Copy !req
231. Mm-hmm.
Copy !req
232. We need ideas.
Copy !req
233. Left anterior thoracotomy
Copy !req
234. and partial excision
of the pericardium.
Copy !req
235. Avoids sternal infection
and seems likely
the safest route.
Copy !req
236. It will require
more surgeries.
Copy !req
237. Please go away.
Copy !req
238. What— What are you
advocating for?
Copy !req
239. Complete removal.
Copy !req
240. Hear me out.
Copy !req
241. A median sternotomy
gives us clear access
to the diseased pericardium
Copy !req
242. from phrenic nerve
to phrenic nerve.
Copy !req
243. That's way too risky.
Copy !req
244. Complete decortication fixes
her heart... completely.
Copy !req
245. You are advocating
for an extensive,
high-risk surgery.
Copy !req
246. Meanwhile, a partial
removal offers your
70-year-old grandmother
Copy !req
247. a shot at full health
for what will likely amount
to the rest of her life.
Copy !req
248. Shouldn't you let
the patient decide?
Copy !req
249. No.
Copy !req
250. I don't present something
if it's not a viable option.
Copy !req
251. I think it is viable.
Copy !req
252. Her surgeon doesn't.
Copy !req
253. Jordan,
go be a granddaughter.
Copy !req
254. If I hadn't
become a surgeon, I think
I would've been a writer.
Copy !req
255. I would've...
Copy !req
256. You never told me
your grandmother
worked at Marcus Books.
Copy !req
257. Was I supposed to?
Copy !req
258. I was just
a lowly clerk.
Copy !req
259. It came up when I heard
his name was Marcus.
Copy !req
260. There is nothing lowly
about being at the center
of a cultural landmark.
Copy !req
261. My Auntie Winn used to
take me to author readings
Copy !req
262. by Toni Morrison,
Maya Angelou.
Copy !req
263. And you were there
every day!
Copy !req
264. I probably served you
some cookies.
Copy !req
265. You ever meet
James Baldwin?
Copy !req
266. - I did.
- What?
Copy !req
267. Okay.
Copy !req
268. She can probably use
some rest.
Copy !req
269. Yes. Absolutely.
Copy !req
270. If you need anything at all,
Miss Evelyn,
you know where to find me.
Copy !req
271. - Thank you, Marcus.
- Yes, ma'am.
Copy !req
272. Marcus Books.
Wow!
Copy !req
273. That was weird.
Copy !req
274. Not as weird as you refusing
to do his mentorship program.
Copy !req
275. Let's talk about you...
Copy !req
276. and your heart.
Copy !req
277. Your pericardium
has become hardened,
Copy !req
278. likely from
your cancer treatments.
Copy !req
279. So what happens now?
Copy !req
280. Dr. Lim has decided on
a partial removal.
Copy !req
281. And— And you think
that's best?
Copy !req
282. Jordan Jacqueline Allen,
you look at me and you tell me
Copy !req
283. if you think it's best.
Copy !req
284. Wow. It took you guys a while
to get home, huh?
Copy !req
285. We went out to dinner
because Lea thought that—
Copy !req
286. Why are you
on the floor?
Copy !req
287. What's with
the high chairs?
Copy !req
288. I stopped at Costco
on the way home.
Copy !req
289. Surprisingly diverse
selection of wines.
Copy !req
290. There's an open bottle
if you— if you guys want,
Copy !req
291. although that might
be empty.
Copy !req
292. Danger.
Copy !req
293. Oh, I remember wine.
Copy !req
294. Are you drunk?
Copy !req
295. No. Maybe a little.
Copy !req
296. I'm baby-proofing.
Copy !req
297. Danger.
Copy !req
298. Are you okay?
Copy !req
299. Oh, you guys
gotta get down here
and check this out.
Copy !req
300. From the baby's
perspective,
Copy !req
301. this place is
a frickin' death trap...
Copy !req
302. for Nicholas.
Copy !req
303. Placeholder name.
Copy !req
304. We can call him
Nick or Nicky.
Copy !req
305. I like Nicky.
Copy !req
306. Okay, why did you buy
three highchairs?
Copy !req
307. Well, one's a gift
for you, and the other two
I'll take back.
Copy !req
308. Danger.
Copy !req
309. That could be dangerous.
Copy !req
310. Y-You don't have
to buy us anything.
Copy !req
311. I also got you
a nanny cam.
Copy !req
312. It's a— it's—
it's a teddy bear,
Copy !req
313. but you wouldn't
believe it,
there's a camera inside.
Copy !req
314. That is very practical.
And cute.
Copy !req
315. Ugh, okay. We will not
need a highchair
or baby-proofing for a year.
Copy !req
316. And we will not name our son
Nick, Nicholas, or Nicky,
Copy !req
317. or any variation thereof.
Copy !req
318. Okay.
Copy !req
319. Okay, well,
that's fair enough.
Copy !req
320. But you— you're
gonna want this.
Copy !req
321. It's a book by Dr. Spock
on parenting.
Copy !req
322. Everyone read this book
back in the day.
Copy !req
323. He was so popular,
he ran for president.
Copy !req
324. Danger.
Copy !req
325. I'm going to bed.
Copy !req
326. Yeah, but you're gonna want
to r-read this
Copy !req
327. before the baby comes
and you get exhausted.
Copy !req
328. Already there.
Copy !req
329. Danger!
Copy !req
330. What were you thinking?
Copy !req
331. That my grandmother deserved
the good muffin?
Copy !req
332. She told me she will only agree
to complete decortication,
Copy !req
333. which she shouldn't even
know about.
Copy !req
334. You do not present a patient
with an option
Copy !req
335. that I have deemed unsafe
and wouldn't even perform.
Copy !req
336. - It's unacceptable.
- You're right.
Copy !req
337. I felt like your plan was
a little conservative, but I—
Copy !req
338. You are a resident.
Copy !req
339. Your feelings
about my decisions
are not relevant.
Copy !req
340. I'll let her know
I was wrong.
Copy !req
341. And convince her
I'm right.
Copy !req
342. Or find her
another hospital.
Copy !req
343. Yes, ma'am.
Copy !req
344. Um, your muffins
are ready.
Copy !req
345. How's he handling
the chemo?
Copy !req
346. You doing okay, bud?
Copy !req
347. Nathan, can you answer
Dr. Park, please?
Copy !req
348. Is everything okay?
Copy !req
349. No.
Copy !req
350. You're right.
It's not okay.
Copy !req
351. Okay,
these aren't toys.
Copy !req
352. We okay, Mom?
Copy !req
353. He got dozens of new toys
for his birthday.
Copy !req
354. He shouldn't have to be
building castles
with pill bottles.
Copy !req
355. I'm sorry.
Copy !req
356. Maybe you shouldn't be
trying to do all of this alone.
Copy !req
357. My husband's saving lives.
I can't pull him
away from that.
Copy !req
358. I can.
Copy !req
359. Give me your phone.
Copy !req
360. Hi, Rick.
Copy !req
361. Dr. Park.
Copy !req
362. Mm.
Copy !req
363. You okay?
Copy !req
364. Yeah, I'm fine.
Copy !req
365. But you're not.
Copy !req
366. What happened?
Copy !req
367. I was wrong to question
Dr. Lim's surgical advice.
Copy !req
368. She's the best.
Copy !req
369. I hope to be her someday.
Copy !req
370. And if she thinks the partial
removal of the pericardium
Copy !req
371. is the best course of action,
then I agree with her.
Copy !req
372. Okay.
Copy !req
373. Then that's
what I'll do.
Copy !req
374. But why did you go against
her advice in the first place?
Copy !req
375. I felt like I needed
to do extra, to be a hero.
Copy !req
376. Why?
Copy !req
377. Since I was little, you told me
I had to work twice as hard,
Copy !req
378. be twice as good
as everybody else.
Copy !req
379. After all these years,
Copy !req
380. I'm still striving
to be good enough for you.
Copy !req
381. Yeah, see,
that's a lot of pressure.
Copy !req
382. But it's what
the world requires
Copy !req
383. from people that look
like you and me.
Copy !req
384. When's my daddy coming?
Copy !req
385. Your daddy's getting
on a plane.
He's gonna be back soon.
Copy !req
386. But now, we have to see if
the medicine's working, okay?
Copy !req
387. If it is,
can I stop taking it?
Copy !req
388. I'm so sorry.
Copy !req
389. You still need it.
Copy !req
390. I hate it.
Copy !req
391. I know.
Copy !req
392. Let's play a game,
like hide-and-seek, okay?
Copy !req
393. Okay, lie down.
Copy !req
394. You get to go
in the tunnel.
Copy !req
395. And stay very still
so nobody can find you.
Copy !req
396. I'll come back and get you
when the coast is clear.
Sound good?
Copy !req
397. You are very good
with him.
Copy !req
398. Starting the imaging.
Copy !req
399. Thanks.
Copy !req
400. Nathan, you're about to hear
some banging.
Copy !req
401. It's just the machine.
Copy !req
402. But remember to
stay really still, okay?
Copy !req
403. I am.
Copy !req
404. Try a little harder,
okay, bud?
Copy !req
405. Ah, motion artifact.
Copy !req
406. We might have to
sedate him.
Copy !req
407. Those are not artifacts.
Copy !req
408. He does not have
CNS vasculitis.
Copy !req
409. He has
moyamoya disease.
Copy !req
410. What the heck is that?
Copy !req
411. A narrow carotid artery
is reducing blood flow
to his brain.
Copy !req
412. This area here,
looks like a puff of smoke?
Copy !req
413. That's what moyamoya means
in Japanese.
Copy !req
414. A bunch of new, tiny vessels
have developed
to circumvent the blockage.
Copy !req
415. But because the vessels
are abnormal,
they're prone to bleeds.
Copy !req
416. We can fix the problem
with a very interesting
brain surgery.
Copy !req
417. Well, so— so now
that you're done
Copy !req
418. poisoning our son with chemo
that he didn't need,
Copy !req
419. we should trust you
to crack open his skull?
Copy !req
420. We will use a small craniotomy
to access—
Copy !req
421. I get why
you're frustrated.
Copy !req
422. Moyamoya is rare and
notoriously hard to diagnose.
Copy !req
423. Many kids get chemo they
don't need for a lot longer.
Copy !req
424. We're hoping to do Nathan's
first brain surgery tomorrow.
Copy !req
425. He needs more than one?
Copy !req
426. What's brain surgery?
Copy !req
427. Hey.
Copy !req
428. It's how we're gonna
make you all better.
Copy !req
429. No more chemo?
Copy !req
430. No more chemo.
Copy !req
431. Are you gonna be here?
Copy !req
432. My plane got cancelled, buddy.
Copy !req
433. But, uh— but, look,
I-I promise
Copy !req
434. I'm gonna be there
as soon as I can, okay?
Copy !req
435. Can Patches get
brain surgery, too?
Copy !req
436. N-No.
Copy !req
437. Patches is
a stuffed animal.
Copy !req
438. It does not
have a brain.
Copy !req
439. Oh.
Copy !req
440. Ohh!
Copy !req
441. Oh!
Copy !req
442. I just peed
in our bathtub.
Copy !req
443. Glassman has to go.
Copy !req
444. Aah!
Copy !req
445. - Sorry!
- Hey!
Copy !req
446. Sorry!
Copy !req
447. First years.
Copy !req
448. You are late again.
Copy !req
449. Come on.
Like one minute.
Copy !req
450. And last time...
Copy !req
451. Your drug test from yesterday
was negative.
Copy !req
452. You are not using.
Copy !req
453. So what is causing
your tardiness?
Copy !req
454. Look, I'm sorry.
Copy !req
455. I've been doing
really well.
Copy !req
456. And the reason
I'm doing so well...
Copy !req
457. is my daily meeting.
Copy !req
458. Sets my mind right.
Copy !req
459. It's kinda far,
and there's morning traffic.
Copy !req
460. Support is
very important.
Copy !req
461. And so is punctuality.
Copy !req
462. I'm going to map a complex
double-barrel vascular bypass.
Copy !req
463. Mnh! Dang it!
Copy !req
464. That's the sixth time
you've killed my grandmother.
Copy !req
465. It wasn't working
with the rongeur.
Copy !req
466. I'm trying to sell Lim
on a little more power.
Copy !req
467. I just need to find
the right torque.
Copy !req
468. That's reassuring.
Copy !req
469. Stop hovering.
Go visit, visitor.
Copy !req
470. Convincing Evelyn Allen
to do a surgery,
Copy !req
471. after convincing her not to,
was a little bumpy.
Copy !req
472. Details, please.
Copy !req
473. I took the opportunity to
explain how much pressure
she's put on me over the years,
Copy !req
474. and she took
that opportunity
Copy !req
475. to make me feel inadequate
once again.
Copy !req
476. I never thought of you
as someone who lacks
for confidence.
Copy !req
477. Fake it
'til you make it.
Copy !req
478. You're a resident in one
of the top surgical programs.
Copy !req
479. You've already made it.
Copy !req
480. All I see is the ground
I've still got to cover.
Copy !req
481. Mnh!
Copy !req
482. How's it going?
Copy !req
483. Not ready
for prime time.
Copy !req
484. This STA anatomy is ideal
as a donor vessel
to bypass the blockage.
Copy !req
485. So, we'll reroute
the scalp vessel
into the brain here.
Copy !req
486. Gonna give you
a little tip.
Copy !req
487. Next time a child asks
if you could do surgery
Copy !req
488. on his stuffed animal
so that he feels less scared?
Copy !req
489. Say yes.
Copy !req
490. I was only
telling him the truth.
Copy !req
491. Oh.
Copy !req
492. This branch of
the middle cerebral artery
Copy !req
493. looks like
an ideal recipient.
Copy !req
494. You're about to be a father.
Children are illogical.
Copy !req
495. And we can place
temporary clips
for vascular control,
Copy !req
496. and then anastomose the STA
to the MCA using 10-0 Prolenes.
Copy !req
497. I was very logical
as a child.
Copy !req
498. I did not like being talked to
like I was dumb,
Copy !req
499. and I definitely did not like
being lied to.
Copy !req
500. That child there felt that
if his Dalmatian
Copy !req
501. went through this scary thing
with him,
he'd be less scared.
Copy !req
502. If can embrace another person's
thought process,
Copy !req
503. it can strengthen
the relationship.
Copy !req
504. Lea thinks she should not
have to pee in the tub...
Copy !req
505. which I understand.
Copy !req
506. No kidnapping
my grandmother.
Copy !req
507. I asked him to do a lap
around the floor.
Copy !req
508. I needed
a change of scenery.
Copy !req
509. Well, you've had your lap,
now back to your cell.
Copy !req
510. Thanks for the tour, Speedy.
Copy !req
511. Speedy?
Copy !req
512. I'm guessing it's because
I was sprinting through here
this morning.
Copy !req
513. Yeah, I was late.
Copy !req
514. Second time this week.
Copy !req
515. Snooze buttons—
the devil's plaything.
Copy !req
516. I was actually at
a Narcotics Anonymous
meeting this morning.
Copy !req
517. I go every day.
Copy !req
518. "Confess your sins
to each other
Copy !req
519. and pray for each other
so you may be healed."
Copy !req
520. James 5:16.
Copy !req
521. Amen to that.
Copy !req
522. Good for you,
young man.
Copy !req
523. There's gotta be
a closer meeting.
Copy !req
524. I've tried
the closer one.
Copy !req
525. The hard-liners who run it
think that
Copy !req
526. wearing a suit and tie
is the key to staying sober.
Copy !req
527. Start your own meeting,
here at the hospital.
Copy !req
528. Set your own tone.
Copy !req
529. And you're never
late for work again.
Copy !req
530. I'm not—
Copy !req
531. I'm not qualified
to be a leader.
Copy !req
532. No such thing.
Copy !req
533. Leaders lead.
Copy !req
534. Simple as that.
Copy !req
535. Hm.
Copy !req
536. You are annoying.
Copy !req
537. Well, nice to see you,
too, Shaun.
Copy !req
538. Not to me,
but to Lea.
Copy !req
539. And I want to keep
our relationship strong.
Copy !req
540. She feels your presence
has taken over our apartment,
Copy !req
541. and she wants
her space back.
Copy !req
542. I overstepped with
the baby-proofing?
Copy !req
543. And suggesting names.
Copy !req
544. And the Dr. Spock thing?
Copy !req
545. And there's more.
The nanny cam—
Copy !req
546. Okay, okay, okay.
Copy !req
547. It was fun
thinking about your baby
Copy !req
548. and the future, and...
Copy !req
549. Maybe it has been
a nice distraction.
Copy !req
550. Yes, it was.
Copy !req
551. Which you've needed
since your house burned down
Copy !req
552. and you lost
all of your belongings
Copy !req
553. and you have
no place to live.
Copy !req
554. Yes.
Thank you, Shaun.
Copy !req
555. Dr. Glassman,
you are not exactly my family.
Copy !req
556. I get it.
I-I know, Shaun.
Copy !req
557. But I consider you to be
the baby's grandfather.
Copy !req
558. Wow.
Copy !req
559. Thank you.
Copy !req
560. I never thought that
would happen for me.
Copy !req
561. Thank you.
Copy !req
562. You can stay.
Copy !req
563. I will tell Lea,
and she will change her mind.
Copy !req
564. No, no, no.
I'm going to go.
Copy !req
565. Where?
Copy !req
566. I don't know.
Copy !req
567. Can I get you
a magazine?
Copy !req
568. No, thank you.
Copy !req
569. Are your pillows
positioned okay?
Copy !req
570. Okay,
you're doing it again.
Copy !req
571. What?
Copy !req
572. That thing you've been doing
since you were little
Copy !req
573. where you're just
fussing over people,
Copy !req
574. when it's you
that's in need.
Copy !req
575. Okay, come on.
Copy !req
576. Tell me.
Copy !req
577. You just met Dr. Perez,
Copy !req
578. and you were so nice
and supportive.
Copy !req
579. Do you know how long
I've waited for you to say,
Copy !req
580. "Good job" to me,
or, "Wow, you're a doctor"?
Copy !req
581. Do you know
who Rebecca Crumpler is?
Copy !req
582. No.
Copy !req
583. She was the first
Black female doctor.
Copy !req
584. And when I read about her,
I wanted to be just like her.
Copy !req
585. But, unfortunately, I didn't
know who she was, either...
Copy !req
586. until you were
in med school.
Copy !req
587. Quinque, I have been
impressed by you
Copy !req
588. since you were
in kindergarten.
Copy !req
589. Grandma?
Copy !req
590. What's going on?
Copy !req
591. She's having trouble breathing.
Copy !req
592. She's hypotensive.
Copy !req
593. Jugular vein distention
has increased.
Copy !req
594. Her heart is failing.
Copy !req
595. Tell me you got through
a practice run.
Copy !req
596. I was coming to say
we were
postponing the surgery
Copy !req
597. so we could practice more.
Copy !req
598. What are you hanging?
Copy !req
599. Uh, it's...
Copy !req
600. You can read, obviously.
Copy !req
601. Is this okay?
I'm sorry.
Copy !req
602. I should've cleared it
with you first.
Copy !req
603. Yes, you should have.
Copy !req
604. Because I would've
told you to use the small
conference room up on 6.
Copy !req
605. It's quieter up there,
and the room has blinds...
Copy !req
606. to help with
the "anonymous" part.
Copy !req
607. Thanks.
Copy !req
608. This is Park.
Copy !req
609. I had to fly to San Francisco.
I'm just grabbing a cab now.
Copy !req
610. Can you— Can you hold
the surgery until I get there?
Copy !req
611. We can't.
Copy !req
612. If he hemorrhages again...
Copy !req
613. Well, can— can— Can you
put him on the phone?
Copy !req
614. He's already sedated.
Copy !req
615. But what if— what if
this was my last chance
Copy !req
616. to talk to him?
Copy !req
617. I'll treat Nathan
like my own son, I promise.
Copy !req
618. Thank you.
Copy !req
619. Try to puncture
the pericardium
Copy !req
620. and grab an edge so we can
start to peel the shell.
Copy !req
621. Mm!
Copy !req
622. Apply more pressure.
Copy !req
623. We might need to use
another tool to pierce it.
Let's try the rongeur.
Copy !req
624. - Ah!
- Perforation of the myocardium.
Copy !req
625. Manually tamponading
the hole.
Copy !req
626. Pledgeted sutures.
Copy !req
627. The pericardium's
just too calcified.
Copy !req
628. It's adherent
to the myocardium.
Copy !req
629. So what do we do?
Copy !req
630. Repair the perforation.
After that,
I'm open to ideas.
Copy !req
631. We could put her
on bypass.
Copy !req
632. Gently peel off the calcified
pericardium bit by bit.
Copy !req
633. And then repair the damage
as we go?
Copy !req
634. That's like poking holes
in a bucket
Copy !req
635. and then hoping
we can plug them before
all the water leaks out.
Copy !req
636. I have an idea.
Copy !req
637. Go ahead.
Copy !req
638. It's called
the waffle procedure.
Copy !req
639. I found a novel study that said
dense calcified plaques
Copy !req
640. can be scored into multiple
cross-hatched sections.
Copy !req
641. No removal at all?
Copy !req
642. Exactly.
The shell stays in its place,
Copy !req
643. but the heart
has room to expand
and contract as it beats.
Copy !req
644. Mortality rate?
Copy !req
645. Under 8%.
Copy !req
646. Talk me through it.
Copy !req
647. Okay.
Ultrasonic scalpel.
Copy !req
648. Start by incising
the calcified pericardium.
Copy !req
649. ICG angio looks great.
Copy !req
650. Dr. Perez,
you may do the dural closure,
then replace the skull flap.
Copy !req
651. Before we close...
Copy !req
652. We're almost a full hour
ahead of schedule.
Copy !req
653. Why not go ahead
with the bypass
in his other hemisphere?
Copy !req
654. Mm, that is
not the plan.
Copy !req
655. Simultaneous
bilateral surgery
Copy !req
656. risks altering brain flow
too much.
Copy !req
657. It could cause
another bleed.
Copy !req
658. But maybe there's a way
to reduce that risk.
Copy !req
659. The wait for
the follow-up surgery
will be hell on the parents,
Copy !req
660. the whole time knowing
their son's brain...
Copy !req
661. The parents' stress
is not medically relevant.
Copy !req
662. I know, Shaun,
but, please...
Copy !req
663. Can you think
of any other way?
Copy !req
664. An
encephaloduroarteriosynangiosis
Copy !req
665. of the left side
would be relatively low risk.
Copy !req
666. We could safely
do that now.
Copy !req
667. Thank you.
Copy !req
668. Rick, Linda.
Copy !req
669. The surgery went well.
Copy !req
670. There she is.
Copy !req
671. Right on schedule.
Copy !req
672. How do you feel?
Copy !req
673. Like I can breathe,
for the first time
in a long time.
Copy !req
674. Thank Dr. Lim for me.
Copy !req
675. I will.
Copy !req
676. Somebody's
all puffed up.
Copy !req
677. Uh...
Copy !req
678. You did something.
Copy !req
679. The surgical team got
a little stuck.
Copy !req
680. I just gave them
a new idea.
Copy !req
681. Good job.
Copy !req
682. Wow!
You're a doctor.
Copy !req
683. Wow. Okay.
Copy !req
684. You're just laying it on
a little too thick now.
Copy !req
685. Looking good.
Copy !req
686. How are you feeling?
Copy !req
687. Okay.
Copy !req
688. Can you give me
a high five?
Copy !req
689. High ten?
Copy !req
690. - Hey, good job!
- Good job, buddy!
Copy !req
691. Good boy, buddy.
Copy !req
692. Where's Patches?
Copy !req
693. He is right here.
Copy !req
694. You did do the brain surgery
on him.
Copy !req
695. No, I just put bandages
on its head
to make you feel better.
Copy !req
696. I do.
Copy !req
697. Uh, I'm sorry.
There's a meeting.
Copy !req
698. I know. NA, right?
Copy !req
699. Uh, yeah.
Copy !req
700. It took me a few minutes
to get the courage
to come in.
Copy !req
701. It's just us. Sorry.
Copy !req
702. Where two or more
are gathered...
Copy !req
703. Oh, um,
have a seat, please.
Copy !req
704. Hm.
Copy !req
705. Um, hi.
Copy !req
706. I'm Danny. Um...
Copy !req
707. I am an addict.
Copy !req
708. Almost show time.
Copy !req
709. Don't say it
like that.
Copy !req
710. You're making me nervous.
Copy !req
711. Be yourself.
That's more than enough.
Copy !req
712. Hi, everybody.
Copy !req
713. There's so many of you.
Copy !req
714. That's so good to see.
Copy !req
715. I'm Dr. Jordan Allen,
Copy !req
716. and I am a third-year
surgical resident
at St. Bonaventure Hospital.
Copy !req
717. Where's Glassy?
Copy !req
718. He will not be staying
with us anymore.
Copy !req
719. He moved out?
Copy !req
720. Yes. We had a talk
and decided it was best.
Copy !req
721. Did you tell him
I was complaining about him?
Copy !req
722. Yes.
Copy !req
723. Oh, Shaun!
Copy !req
724. Now I feel horrible.
Copy !req
725. Oh.
You don't need to.
Copy !req
726. He found a vacant apartment
just down the hall.
Copy !req
727. In this building?
Copy !req
728. - Yes.
- He's our next-door neighbor?
Copy !req
729. Our next-door neighbor's
next-door neighbor.
Copy !req