1 00:00:01,702 --> 00:00:02,770 [ Knocking on door ] 2 00:00:02,803 --> 00:00:09,210 ** 3 00:00:09,243 --> 00:00:10,411 [ Knocking continues ] 4 00:00:10,444 --> 00:00:12,780 Kenny: Morning, doc! 5 00:00:12,813 --> 00:00:14,448 Good morning, Kenny. 6 00:00:14,482 --> 00:00:17,485 ** 7 00:00:17,518 --> 00:00:19,187 Hey, hey, hey. 8 00:00:19,220 --> 00:00:22,590 ** 9 00:00:22,623 --> 00:00:25,559 Brosef, your cable's out. 10 00:00:25,593 --> 00:00:27,228 I don't have cable. 11 00:00:27,261 --> 00:00:29,297 I have a digital antenna. 12 00:00:29,330 --> 00:00:30,231 Why? 13 00:00:30,264 --> 00:00:32,133 Digital antennae 14 00:00:32,166 --> 00:00:36,204 receive superior picture and sound quality, 15 00:00:36,237 --> 00:00:37,738 and the channels are free. 16 00:00:37,771 --> 00:00:39,640 Yeah, but you get, like, 10 channels that way. 17 00:00:39,673 --> 00:00:41,175 I only watch three. 18 00:00:41,209 --> 00:00:42,576 You mind if I run a line to your tube? 19 00:00:44,312 --> 00:00:45,513 Cable guy can't fit me in till next week. 20 00:00:45,546 --> 00:00:48,349 Mm. 21 00:00:48,382 --> 00:00:49,483 Come on, 10 channels are better than none. 22 00:00:49,517 --> 00:00:51,585 Yes, they are. 23 00:00:51,619 --> 00:00:53,154 All right. 24 00:00:53,187 --> 00:00:54,855 Gracias, amigo. 25 00:00:54,888 --> 00:00:56,390 No hay nada que agradecer. 26 00:00:56,424 --> 00:00:57,225 What? 27 00:00:57,258 --> 00:01:00,128 ** 28 00:01:00,161 --> 00:01:01,629 Melendez: Dr. Reznick was orphaned 29 00:01:01,662 --> 00:01:03,164 once Dr. Coyle was transferred, 30 00:01:03,197 --> 00:01:04,598 so she'll be joining our team. 31 00:01:04,632 --> 00:01:05,599 Hi. I'm Claire. 32 00:01:05,633 --> 00:01:06,800 Nice to meet you. 33 00:01:08,869 --> 00:01:10,471 Are you the autistic one? 34 00:01:10,504 --> 00:01:12,306 No. 35 00:01:12,340 --> 00:01:13,507 That's me. 36 00:01:13,541 --> 00:01:14,875 Dr. Shaun Murphy. 37 00:01:14,908 --> 00:01:16,844 Hi. 38 00:01:16,877 --> 00:01:19,413 We've got two pretty straightforward cases, 39 00:01:19,447 --> 00:01:22,483 nice level playing field for an eager group. 40 00:01:22,516 --> 00:01:23,617 Not interested. 41 00:01:23,651 --> 00:01:25,519 Competition can foster teamwork, 42 00:01:25,553 --> 00:01:27,321 which can lead to a greater understanding 43 00:01:27,355 --> 00:01:28,789 and appreciation 44 00:01:28,822 --> 00:01:30,358 of residents' strengths and weaknesses 45 00:01:30,391 --> 00:01:31,792 and improve patient care. 46 00:01:31,825 --> 00:01:33,461 You're playing the same game Glassman had us do 47 00:01:33,494 --> 00:01:34,462 when we were interns. 48 00:01:34,495 --> 00:01:35,463 Not interested. 49 00:01:35,496 --> 00:01:37,765 Winning team gets first dibs 50 00:01:37,798 --> 00:01:39,733 on assisting on all surgeries next week. 51 00:01:39,767 --> 00:01:40,401 -In. -In. 52 00:01:40,434 --> 00:01:41,202 Out. 53 00:01:42,770 --> 00:01:44,505 Mm. 54 00:01:44,538 --> 00:01:47,575 ** 55 00:01:47,608 --> 00:01:49,243 I pick the boy genius. 56 00:01:49,277 --> 00:01:51,779 ** 57 00:01:51,812 --> 00:01:53,247 That's you. 58 00:01:53,281 --> 00:01:58,552 ** 59 00:01:58,586 --> 00:02:04,325 ** 60 00:02:04,358 --> 00:02:05,526 Dr. Browne. 61 00:02:05,559 --> 00:02:07,195 ** 62 00:02:07,228 --> 00:02:07,861 Kalu. 63 00:02:07,895 --> 00:02:09,563 Melendez: Dr. Reznick. 64 00:02:10,331 --> 00:02:12,500 Thank you. I'm looking forward to it. 65 00:02:13,934 --> 00:02:15,369 Thank you. 66 00:02:15,403 --> 00:02:18,339 ** 67 00:02:18,372 --> 00:02:20,341 Same stakes as last time? 68 00:02:20,374 --> 00:02:21,609 Absolutely. 69 00:02:21,642 --> 00:02:25,946 ** 70 00:02:25,979 --> 00:02:27,448 Lim: Hi, Quinn. 71 00:02:27,481 --> 00:02:28,482 We hear you've had some stomach pain. 72 00:02:28,516 --> 00:02:29,517 Do you mind if we take a look? 73 00:02:29,550 --> 00:02:31,252 It doesn't hurt that bad. 74 00:02:31,285 --> 00:02:33,221 Poor thing says everything is okay, 75 00:02:33,254 --> 00:02:35,689 but when Quinnie didn't want to go swimming today, 76 00:02:35,723 --> 00:02:37,591 I knew that something must be wrong. 77 00:02:39,427 --> 00:02:41,562 We'll be as gentle with her as possible. 78 00:02:41,595 --> 00:02:43,431 [ Groans ] 79 00:02:43,464 --> 00:02:44,865 Quinn's parents are out of town, 80 00:02:44,898 --> 00:02:47,601 so I'm -- I flew in to babysit. 81 00:02:47,635 --> 00:02:48,536 Mm-hmm. 82 00:02:50,838 --> 00:02:51,972 [ Inhales sharply ] 83 00:02:52,005 --> 00:02:53,707 Okay. 84 00:02:53,741 --> 00:02:55,309 Let's see. 85 00:02:56,344 --> 00:02:59,213 ** 86 00:02:59,247 --> 00:03:00,281 That's a... Penis. 87 00:03:01,949 --> 00:03:03,451 She's not a girl. 88 00:03:03,484 --> 00:03:04,485 He's a boy. 89 00:03:05,619 --> 00:03:08,589 -- Captions by VITAC -- 90 00:03:08,622 --> 00:03:15,596 ** 91 00:03:15,629 --> 00:03:16,597 It's just a phase. 92 00:03:16,630 --> 00:03:18,266 Quinn: Stop saying that. 93 00:03:18,299 --> 00:03:19,567 I'm not a boy. I'm a girl. 94 00:03:19,600 --> 00:03:21,235 You're transgender? Yes. 95 00:03:21,269 --> 00:03:22,636 Shaun: No. 96 00:03:22,670 --> 00:03:25,539 Quinn has XY chromosomes like Jared and me, 97 00:03:25,573 --> 00:03:27,007 not XX like you. 98 00:03:27,040 --> 00:03:28,976 Science says he's male. 99 00:03:29,009 --> 00:03:31,412 No, Quinn has gender dysphoria. 100 00:03:31,445 --> 00:03:33,547 Her assigned gender is not the one she identifies with. 101 00:03:33,581 --> 00:03:35,516 She's mismatched, Dr. Murphy. 102 00:03:35,549 --> 00:03:36,817 But biologically -- 103 00:03:36,850 --> 00:03:38,352 Quinn: Other than biologically, 104 00:03:38,386 --> 00:03:39,820 how do you know you're supposed to be a boy? 105 00:03:42,656 --> 00:03:44,425 Your question doesn't make sense. 106 00:03:44,458 --> 00:03:46,360 I'm not supposed to be anything. 107 00:03:46,394 --> 00:03:47,495 I am a boy. 108 00:03:47,528 --> 00:03:48,796 Biologically, that's it. 109 00:03:48,829 --> 00:03:51,699 ** 110 00:03:51,732 --> 00:03:52,966 [ Inhales sharply ] 111 00:03:53,000 --> 00:03:54,768 Okay, deep tenderness at McBurney's point. 112 00:03:54,802 --> 00:03:56,304 Could be acute appendicitis. 113 00:03:56,337 --> 00:03:58,772 Murphy, get imaging to confirm. 114 00:03:58,806 --> 00:03:59,973 Mm. 115 00:04:00,007 --> 00:04:01,775 ** 116 00:04:01,809 --> 00:04:06,347 [ Breathing deeply ] 117 00:04:06,380 --> 00:04:08,015 Mr. Shaw, your chart says 118 00:04:08,048 --> 00:04:10,318 that you passed out in class. 119 00:04:10,351 --> 00:04:12,553 What do you teach? History. 120 00:04:12,586 --> 00:04:14,388 I got a little dizzy because I skipped breakfast. 121 00:04:14,422 --> 00:04:15,889 I-It's nothing. 122 00:04:15,923 --> 00:04:18,326 The school insisted on calling an ambulance. 123 00:04:18,359 --> 00:04:19,893 Taken any medications in the last few months? 124 00:04:21,362 --> 00:04:22,796 Uh, I took some Vicodin 125 00:04:22,830 --> 00:04:25,533 after I threw out my back six weeks ago, 126 00:04:25,566 --> 00:04:27,501 and then I had a stomach flu, 127 00:04:27,535 --> 00:04:29,069 so I took Ofloxacin. 128 00:04:29,102 --> 00:04:31,839 But the flu part didn't totally go away, 129 00:04:31,872 --> 00:04:34,642 so I took Azithromycin and Prednisone 130 00:04:34,675 --> 00:04:36,744 because my glands were swollen. 131 00:04:36,777 --> 00:04:39,480 But I still had a sore throat, so I took some Cipro. 132 00:04:41,782 --> 00:04:43,417 What doctor prescribed you all that? 133 00:04:43,451 --> 00:04:45,386 Uh, they were leftovers 134 00:04:45,419 --> 00:04:47,955 I had in my medicine cabinet. 135 00:04:47,988 --> 00:04:50,358 Uh... All right, lay back for me. 136 00:04:50,391 --> 00:04:52,493 [ Groans ] 137 00:04:52,526 --> 00:04:54,662 Look, I'm a single dad with twins 138 00:04:54,695 --> 00:04:56,764 who bring home every disgusting germ 139 00:04:56,797 --> 00:04:59,032 they touch at preschool. 140 00:04:59,066 --> 00:05:00,968 I can't afford to miss work. 141 00:05:01,001 --> 00:05:02,436 [ Groans ] 142 00:05:02,470 --> 00:05:04,372 You've got a fever 143 00:05:04,405 --> 00:05:05,673 and you've gone through two IVs 144 00:05:05,706 --> 00:05:07,508 which tells me that you're severely dehydrated. 145 00:05:07,541 --> 00:05:09,377 You can't stand me touching your stomach 146 00:05:09,410 --> 00:05:10,411 without wincing in pain. 147 00:05:10,444 --> 00:05:13,013 Dr. Reznick, let's get Mr. Shaw here an ultrasound. 148 00:05:13,046 --> 00:05:15,683 ** 149 00:05:15,716 --> 00:05:17,685 We've been trying for while. Five months. 150 00:05:17,718 --> 00:05:19,620 I realize my prime egg days were two decades ago, 151 00:05:19,653 --> 00:05:20,954 but I've been vigilant. 152 00:05:20,988 --> 00:05:23,491 Ovulation kits, LH and FSH testing, 153 00:05:23,524 --> 00:05:24,425 basal body temp. 154 00:05:24,458 --> 00:05:27,060 I've checked my estradiol and AMH levels. 155 00:05:27,094 --> 00:05:29,430 The old-fashioned way wasn't working. 156 00:05:29,463 --> 00:05:32,433 Okay, well, there are a lot of possibilities to consider. 157 00:05:32,466 --> 00:05:34,935 Many benign, many easily corrected. 158 00:05:34,968 --> 00:05:37,037 So I will take some samples from you both, 159 00:05:37,070 --> 00:05:38,572 run some tests, we go from there. 160 00:05:38,606 --> 00:05:39,940 There's a clock. 161 00:05:39,973 --> 00:05:42,109 We need to know if we start with IUI or IVF... 162 00:05:42,142 --> 00:05:44,978 Both of you -- You need to stop worrying. 163 00:05:45,012 --> 00:05:47,648 Isabel, you are not the first 40-something woman 164 00:05:47,681 --> 00:05:49,683 to come here and ask these questions. 165 00:05:49,717 --> 00:05:52,553 Myself included. 166 00:05:52,586 --> 00:05:54,054 You came to me because you trust me, yes? 167 00:05:54,087 --> 00:05:55,989 Right. 168 00:05:56,023 --> 00:05:57,725 So let me do what I do, 169 00:05:57,758 --> 00:05:59,059 and you two focus on each other. 170 00:05:59,092 --> 00:06:00,861 ** 171 00:06:00,894 --> 00:06:02,563 Hey. 172 00:06:02,596 --> 00:06:04,398 We're a team, babe. 173 00:06:04,432 --> 00:06:06,534 In this together, all right? 174 00:06:06,567 --> 00:06:07,968 Okay. 175 00:06:08,001 --> 00:06:12,740 ** 176 00:06:12,773 --> 00:06:17,511 ** 177 00:06:17,545 --> 00:06:18,846 I'm afraid, Howard, 178 00:06:18,879 --> 00:06:20,948 your appendix has already ruptured. 179 00:06:20,981 --> 00:06:23,083 Book an OR stat and page Melendez. 180 00:06:23,116 --> 00:06:23,951 Wait. 181 00:06:23,984 --> 00:06:24,785 I need to figure out 182 00:06:24,818 --> 00:06:25,886 who's gonna take care of my kids, 183 00:06:25,919 --> 00:06:28,121 call the school so they can get subs for my classes. 184 00:06:28,155 --> 00:06:30,524 Mr. Shaw, if we don't get you into surgery now, 185 00:06:30,558 --> 00:06:32,660 your infection could spread and you could become septic. 186 00:06:32,693 --> 00:06:34,662 Dr. Browne will make all the necessary phone calls 187 00:06:34,695 --> 00:06:36,063 while I prep you for surgery. 188 00:06:36,096 --> 00:06:37,765 Isn't that so, Dr. Browne? 189 00:06:40,133 --> 00:06:41,669 You're in good hands, Mr. Shaw. 190 00:06:41,702 --> 00:06:42,570 We've got you covered. 191 00:06:42,603 --> 00:06:43,737 Let's go. 192 00:06:43,771 --> 00:06:51,712 ** 193 00:06:51,745 --> 00:06:53,581 Shaun: Hello. 194 00:06:53,614 --> 00:06:54,548 Do you wear dresses? 195 00:06:54,582 --> 00:06:57,050 Murphy, don't. 196 00:06:57,084 --> 00:06:59,753 Quinn is a boy who thinks he's a girl. 197 00:06:59,787 --> 00:07:02,456 I want to know why he thinks that. 198 00:07:02,490 --> 00:07:04,458 Sometimes I wear dresses, but sometimes I wear leggings. 199 00:07:04,492 --> 00:07:07,561 Do you like the color pink? 200 00:07:07,595 --> 00:07:08,796 [ Chuckles ] 201 00:07:08,829 --> 00:07:10,163 I'm more of a purple girl. 202 00:07:10,197 --> 00:07:12,566 Do you play with dolls? Since I was 5, 203 00:07:12,600 --> 00:07:14,067 but I'm super into mermaids. 204 00:07:14,101 --> 00:07:15,102 Do you take dance -- 205 00:07:15,135 --> 00:07:16,770 Murphy, 20 questions are up. 206 00:07:16,804 --> 00:07:18,506 I only asked four. 207 00:07:18,539 --> 00:07:20,007 Do you wear perfume? It doesn't matter. 208 00:07:20,040 --> 00:07:20,974 The CT's ready. Let's go. 209 00:07:21,008 --> 00:07:22,576 Do you always paint your nails? Let's go. 210 00:07:22,610 --> 00:07:32,720 ** 211 00:07:32,753 --> 00:07:34,655 Melendez: Perforated appendix is out. 212 00:07:34,688 --> 00:07:36,524 Lavage or no lavage. 213 00:07:36,557 --> 00:07:37,991 Dr. Browne. 214 00:07:38,025 --> 00:07:39,760 Lavage before closing the wound 215 00:07:39,793 --> 00:07:41,762 decreases residual fluid accumulation 216 00:07:41,795 --> 00:07:44,765 and minimizes residual contamination. Morgan: Claire's right. 217 00:07:44,798 --> 00:07:46,099 Although, a recent study 218 00:07:46,133 --> 00:07:47,735 documented a higher abscess rate 219 00:07:47,768 --> 00:07:50,170 when irrigation was used for perforated appendicitis. 220 00:07:50,203 --> 00:07:52,239 Well, someone did their homework. 221 00:07:52,272 --> 00:07:54,041 I'm partial to AMSURG since they published me. 222 00:07:54,074 --> 00:07:56,544 As a medical student? 223 00:07:56,577 --> 00:07:58,712 It was about the cost and stabilization of disease 224 00:07:58,746 --> 00:08:00,514 in patients undergoing transcatheter 225 00:08:00,548 --> 00:08:02,516 and surgical aortic valve replacement. 226 00:08:02,550 --> 00:08:04,518 Are you thinking of specializing in cardio-thoracic? 227 00:08:04,552 --> 00:08:06,186 A girl can dream. 228 00:08:07,254 --> 00:08:08,589 Staple up and close up. 229 00:08:11,792 --> 00:08:13,026 It's, uh -- 230 00:08:13,060 --> 00:08:14,962 it's good to have you on board, Morgan. 231 00:08:14,995 --> 00:08:18,699 It's great to have another female surgeon. 232 00:08:18,732 --> 00:08:21,869 Oh, uh, I'm sorry, 233 00:08:21,902 --> 00:08:23,571 you and I are not gonna be friends, 234 00:08:23,604 --> 00:08:25,639 hanging out, having sleepovers, 235 00:08:25,673 --> 00:08:27,608 braiding each other's hair. 236 00:08:27,641 --> 00:08:30,678 That's not exactly where I was going with it. 237 00:08:30,711 --> 00:08:31,712 When residency's over, 238 00:08:31,745 --> 00:08:33,180 the hospital's likely only keeping two of us. 239 00:08:33,213 --> 00:08:35,916 Shaun is Glassman's pet project, so he's in. 240 00:08:35,949 --> 00:08:38,318 Jared is persona non grata, so he's out. 241 00:08:38,351 --> 00:08:40,754 Which means every time you win, I lose. 242 00:08:40,788 --> 00:08:42,656 And vice versa. 243 00:08:42,690 --> 00:08:46,026 ** 244 00:08:46,059 --> 00:08:47,595 Thanks for the heads up. 245 00:08:47,628 --> 00:08:49,897 ** 246 00:08:49,930 --> 00:08:58,105 [ CT machine whirs ] 247 00:08:58,138 --> 00:09:02,142 Do you think he's complicated or confused? 248 00:09:02,175 --> 00:09:03,711 [ Sighs ] 249 00:09:03,744 --> 00:09:06,013 Dude, you've got to quit calling her a "he." 250 00:09:06,046 --> 00:09:07,615 We're never going to win this competition 251 00:09:07,648 --> 00:09:09,049 with you disrespecting our patient. 252 00:09:09,082 --> 00:09:10,951 Don't they have transgender people in Wyoming? Okay. 253 00:09:10,984 --> 00:09:13,621 Transgender patient care 254 00:09:13,654 --> 00:09:16,724 was not part of my medical school curriculum. 255 00:09:16,757 --> 00:09:18,859 Was it part of yours? 256 00:09:18,892 --> 00:09:20,193 No. 257 00:09:20,227 --> 00:09:21,194 [ Monitor beeps ] 258 00:09:25,232 --> 00:09:28,636 Quinn doesn't have appendicitis. 259 00:09:28,669 --> 00:09:31,705 He has testicular cancer. 260 00:09:31,739 --> 00:09:34,241 [ Sighs ] 261 00:09:34,274 --> 00:09:35,275 She. 262 00:09:39,780 --> 00:09:41,715 We found a mass on Quinn's left testicle. 263 00:09:41,749 --> 00:09:43,250 She has cancer, but -- 264 00:09:43,283 --> 00:09:44,818 Am I gonna die? Lim: No, no. 265 00:09:44,852 --> 00:09:46,186 Prognosis is very good. 266 00:09:46,219 --> 00:09:47,154 We've caught it before it spread, 267 00:09:47,187 --> 00:09:49,256 and we'll do surgery on the mass to remove it. 268 00:09:49,289 --> 00:09:52,259 The CT also showed he has osteopenia. 269 00:09:52,292 --> 00:09:53,627 [ Sighs ] 270 00:09:53,661 --> 00:09:54,662 Murphy, stop with the "he." 271 00:09:54,695 --> 00:09:56,096 [ Cellphone ringing ] 272 00:09:56,129 --> 00:09:58,632 Um, Quinnie, it's your mom. 273 00:09:58,666 --> 00:09:59,733 I -- I have to -- 274 00:09:59,767 --> 00:10:00,600 Of course. 275 00:10:03,871 --> 00:10:05,072 Osteopenia. 276 00:10:05,105 --> 00:10:06,907 That's low bone density, right? Jared: Yeah. 277 00:10:06,940 --> 00:10:08,175 How'd you know that? 278 00:10:08,208 --> 00:10:10,744 Do you know how I got cancer? 279 00:10:10,778 --> 00:10:12,913 There are several possible causes, but I -- 280 00:10:12,946 --> 00:10:15,348 Microlithiasis, mumps, hypospadias -- Murphy. 281 00:10:15,382 --> 00:10:17,217 Intraepithelial germ cell neoplasia, 282 00:10:17,250 --> 00:10:18,185 inguinal hernia, HIV -- 283 00:10:18,218 --> 00:10:20,888 Murphy. Enough. 284 00:10:20,921 --> 00:10:23,323 Your parents are on their way here. 285 00:10:23,356 --> 00:10:25,959 Um, they just told me -- 286 00:10:25,993 --> 00:10:27,661 Quinn, are you on puberty blockers? 287 00:10:29,429 --> 00:10:32,733 That's the likely cause of the osteopenia. 288 00:10:32,766 --> 00:10:34,735 Are you taking leuprorelin or histrelin? 289 00:10:34,768 --> 00:10:37,370 I've been leuprorelin for nine months. 290 00:10:37,404 --> 00:10:39,006 Why didn't you say anything earlier? 291 00:10:39,039 --> 00:10:42,042 Because my parents didn't want my grandma to know. 292 00:10:42,075 --> 00:10:46,780 ** 293 00:10:46,814 --> 00:10:48,782 Looks like he has an abscess. 294 00:10:48,816 --> 00:10:50,083 You have an infection. 295 00:10:50,117 --> 00:10:52,219 We'll drain it, put you on antibiotics. 296 00:10:52,252 --> 00:10:53,453 It's nothing to worry about. 297 00:10:53,486 --> 00:10:54,354 It just means you might be in the hospital 298 00:10:54,387 --> 00:10:55,355 a couple of extra nights. 299 00:10:55,388 --> 00:10:56,389 I -- I can't spend 300 00:10:56,423 --> 00:10:57,691 a couple of extra nights. 301 00:10:57,725 --> 00:10:59,059 I need to get out of here. 302 00:10:59,092 --> 00:11:01,061 Are you worried about your kids? 303 00:11:01,094 --> 00:11:03,296 Well, they're with my sister, they're safe, 304 00:11:03,330 --> 00:11:05,098 but they've never spent a night without me 305 00:11:05,132 --> 00:11:05,966 since they were born. 306 00:11:05,999 --> 00:11:07,835 Well, then consider this a blessing. 307 00:11:07,868 --> 00:11:09,102 A free vacation from your kids. 308 00:11:09,136 --> 00:11:10,938 They're my life. 309 00:11:10,971 --> 00:11:14,942 ** 310 00:11:14,975 --> 00:11:18,078 My wife died of ovarian cancer last year. 311 00:11:18,111 --> 00:11:20,848 ** 312 00:11:20,881 --> 00:11:23,083 I... 313 00:11:23,116 --> 00:11:24,351 I hate hospitals. 314 00:11:24,384 --> 00:11:26,453 I'm so sorry. 315 00:11:26,486 --> 00:11:29,256 Why don't I find a laptop 316 00:11:29,289 --> 00:11:30,423 so you can Skype with them? 317 00:11:32,059 --> 00:11:34,361 And I'll rustle up a couple of toy bears from Peds 318 00:11:34,394 --> 00:11:36,096 for you to take home. 319 00:11:36,129 --> 00:11:37,397 Thank you. 320 00:11:37,430 --> 00:11:40,200 ** 321 00:11:40,233 --> 00:11:41,501 Lim: I want to reassure you 322 00:11:41,534 --> 00:11:43,136 that the puberty blockers 323 00:11:43,170 --> 00:11:45,873 are in no way responsible for causing cancer. 324 00:11:45,906 --> 00:11:48,508 Shaun: The leuprorelin did cause your osteopenia. 325 00:11:48,541 --> 00:11:50,778 Does this mean I have to stop taking puberty blockers? 326 00:11:50,811 --> 00:11:51,912 Yes. 327 00:11:51,945 --> 00:11:53,246 Jared: We'll get you on dietary supplements 328 00:11:53,280 --> 00:11:54,514 to help regain your bone strength, 329 00:11:54,547 --> 00:11:55,816 but the puberty blockers are hurting you. 330 00:11:55,849 --> 00:11:56,884 You'll be fine without them. 331 00:11:58,085 --> 00:12:00,220 Fine? 332 00:12:00,253 --> 00:12:02,255 I -- I don't want an Adam's apple 333 00:12:02,289 --> 00:12:04,892 or a deep voice or hair all over my body. 334 00:12:04,925 --> 00:12:06,927 You can't reverse that, can you? 335 00:12:06,960 --> 00:12:09,897 No, I'm afraid not. 336 00:12:09,930 --> 00:12:17,938 ** 337 00:12:17,971 --> 00:12:20,808 Girls have body hair, too. 338 00:12:20,841 --> 00:12:22,342 [ Sighs ] 339 00:12:22,375 --> 00:12:26,113 ** 340 00:12:28,916 --> 00:12:31,451 Toy bears, Skype with kids -- 341 00:12:31,484 --> 00:12:32,853 you've got game. 342 00:12:32,886 --> 00:12:35,322 [ Scoffs ] "Game"? 343 00:12:35,355 --> 00:12:36,790 I believe the name for what I did 344 00:12:36,824 --> 00:12:39,559 is "basic human decency." 345 00:12:39,592 --> 00:12:41,461 Everyone has an agenda. 346 00:12:41,494 --> 00:12:43,496 Sometimes it's conscious, sometimes it's not, 347 00:12:43,530 --> 00:12:44,798 but it's always there. 348 00:12:44,832 --> 00:12:46,033 And you've got this whole 349 00:12:46,066 --> 00:12:48,001 "queen of kindness" thing down pat. 350 00:12:48,035 --> 00:12:50,237 Awfully cynical for someone so young. 351 00:12:50,270 --> 00:12:51,171 Mm, not cynical. 352 00:12:51,204 --> 00:12:52,372 Just the reality of how the world works. 353 00:12:52,405 --> 00:12:54,307 [ Alarm blaring ] 354 00:12:54,341 --> 00:12:55,542 It's Howard. 355 00:12:55,575 --> 00:12:57,110 [ Monitor beeping rapidly ] 356 00:12:57,144 --> 00:12:59,046 Nurse Dhanoa: He spiked a fever, temp's 105. 357 00:12:59,079 --> 00:13:00,513 BP's tanking, 80 over 40. 358 00:13:00,547 --> 00:13:02,282 He's soiled his sheets. Morgan: Site's clean. 359 00:13:02,315 --> 00:13:04,051 Infection should be clearing by now. 360 00:13:04,084 --> 00:13:05,218 What's going on? I don't know. 361 00:13:05,252 --> 00:13:06,086 Page Melendez. 362 00:13:06,119 --> 00:13:08,088 Give me 500 milligrams acetaminophen, 363 00:13:08,121 --> 00:13:09,990 2 grams of meropenem IV infusion empirically. 364 00:13:10,023 --> 00:13:12,459 Run a chem panel, CBC, and get cultures ASAP. 365 00:13:13,360 --> 00:13:15,062 Hang in there, Howard. 366 00:13:15,095 --> 00:13:16,196 We're gonna figure this out. 367 00:13:16,229 --> 00:13:19,032 ** 368 00:13:24,604 --> 00:13:26,239 Any word on Quinn Darby's labs? 369 00:13:26,273 --> 00:13:28,075 Big backup today. Nothing much I can do. 370 00:13:28,108 --> 00:13:29,309 Text you when they're ready. 371 00:13:29,342 --> 00:13:30,377 Yeah. 372 00:13:32,045 --> 00:13:33,280 Morgan: Hey, Gus. 373 00:13:33,313 --> 00:13:35,282 I saw raspberry and rose petal doughnuts 374 00:13:35,315 --> 00:13:36,884 in the cafeteria today. 375 00:13:36,917 --> 00:13:37,885 Got you the last one. 376 00:13:37,918 --> 00:13:40,020 You remembered. 377 00:13:40,053 --> 00:13:41,889 Thank you. 378 00:13:41,922 --> 00:13:44,024 Howard Shaw's labs. 379 00:13:44,057 --> 00:13:46,326 I put a rush on them for you. You're the best. 380 00:13:46,359 --> 00:13:47,394 ** 381 00:13:47,427 --> 00:13:51,264 Why did you give Gus a doughnut? 382 00:13:51,298 --> 00:13:52,465 I was being nice. 383 00:13:52,499 --> 00:13:55,168 I needed my patient's labs expedited. 384 00:13:55,202 --> 00:13:57,404 Gus likes doughnuts. It's called bribery. 385 00:13:57,437 --> 00:13:59,172 I call it "basic human decency." 386 00:14:00,941 --> 00:14:02,075 See you later. 387 00:14:07,314 --> 00:14:09,116 Howard has a superbug. 388 00:14:10,650 --> 00:14:12,052 A C. Diff infection? 389 00:14:12,085 --> 00:14:15,122 It's resistant to all medication. 390 00:14:15,155 --> 00:14:17,457 [ Sighs ] 391 00:14:17,490 --> 00:14:19,226 Lim: Quinn's pre-op labs are normal, 392 00:14:19,259 --> 00:14:21,028 so we can do the surgery first thing in the morning. 393 00:14:21,061 --> 00:14:22,062 The procedure is called 394 00:14:22,095 --> 00:14:24,031 a radical inguinal orchiectomy. 395 00:14:24,064 --> 00:14:27,000 It's radical in that 396 00:14:27,034 --> 00:14:29,202 the entire cancerous testicle is removed. 397 00:14:29,236 --> 00:14:31,371 All functionality will remain the same. 398 00:14:31,404 --> 00:14:33,140 Quinn should be able to resume her normal activities 399 00:14:33,173 --> 00:14:34,141 in one or two weeks. 400 00:14:34,174 --> 00:14:36,143 See? Baby, that's good news. 401 00:14:36,176 --> 00:14:37,477 Quinn: No, not really. 402 00:14:37,510 --> 00:14:39,046 Without the puberty blockers, 403 00:14:39,079 --> 00:14:41,148 I'll be the freak in ballet with a mustache. 404 00:14:41,181 --> 00:14:43,250 Aren't there any other options? 405 00:14:43,283 --> 00:14:44,251 I wish there were -- 406 00:14:44,284 --> 00:14:46,086 If we do a bilateral orchiectomy, 407 00:14:46,119 --> 00:14:47,354 Quinn will have 408 00:14:47,387 --> 00:14:48,989 the testosterone level of a girl. 409 00:14:49,022 --> 00:14:51,291 We are not removing both testicles. 410 00:14:51,324 --> 00:14:53,526 You want to castrate my grandson? 411 00:14:53,560 --> 00:14:54,394 No. No. 412 00:14:54,427 --> 00:14:55,562 [ Sighs ] 413 00:14:55,595 --> 00:14:57,965 I'm so sorry for Dr. Murphy's outburst. 414 00:14:57,998 --> 00:15:00,433 I'm gonna have gender confirmation surgery 415 00:15:00,467 --> 00:15:02,135 when I'm 18 anyway. 416 00:15:02,169 --> 00:15:03,203 Why not just do it now. 417 00:15:03,236 --> 00:15:06,706 ** 418 00:15:06,739 --> 00:15:08,375 Quinn is a child 419 00:15:08,408 --> 00:15:12,579 who still plays dress-up and make-believe. 420 00:15:12,612 --> 00:15:14,514 He may want to have children of his own some day. 421 00:15:14,547 --> 00:15:15,615 Ew. 422 00:15:15,648 --> 00:15:16,316 ** 423 00:15:16,349 --> 00:15:17,951 We'll give you some privacy. 424 00:15:17,985 --> 00:15:19,119 Denise: Thank you. 425 00:15:19,152 --> 00:15:24,091 ** 426 00:15:24,124 --> 00:15:25,225 I will not allow you -- 427 00:15:25,258 --> 00:15:26,159 It's not up to you. 428 00:15:29,596 --> 00:15:31,498 You are making me doubt the wisdom of drafting you, Murphy. 429 00:15:31,531 --> 00:15:33,333 If you go around saying inflammatory things to people, 430 00:15:33,366 --> 00:15:35,235 it will only upset them. 431 00:15:35,268 --> 00:15:37,337 How will I know if I said something inflammatory 432 00:15:37,370 --> 00:15:38,705 until I say it? 433 00:15:38,738 --> 00:15:41,208 Test it on Kalu first. 434 00:15:41,241 --> 00:15:43,276 Which you can do 435 00:15:43,310 --> 00:15:45,678 while the two of you prep an SDA for this case. 436 00:15:45,712 --> 00:15:47,580 An SDA? 437 00:15:47,614 --> 00:15:49,216 A Shared Decision Aid 438 00:15:49,249 --> 00:15:51,451 is a paper presenting the pros and cons 439 00:15:51,484 --> 00:15:53,253 of making a difficult -- I know what it is, Murphy. 440 00:15:53,286 --> 00:15:54,421 But why am I being punished? 441 00:15:54,454 --> 00:15:56,123 It's not a punishment, it's necessary. 442 00:15:56,156 --> 00:15:57,090 It'll help Quinn's family 443 00:15:57,124 --> 00:15:58,658 understand all the options available to them 444 00:15:58,691 --> 00:15:59,759 for her care. 445 00:15:59,792 --> 00:16:00,660 Understood? 446 00:16:00,693 --> 00:16:02,629 Understood. 447 00:16:02,662 --> 00:16:06,433 ** 448 00:16:06,466 --> 00:16:08,068 The stool culture and sensitivity test 449 00:16:08,101 --> 00:16:09,036 indicate that you're resistant 450 00:16:09,069 --> 00:16:10,337 to every antibiotic. 451 00:16:10,370 --> 00:16:12,039 Which only happens when you've been exposed 452 00:16:12,072 --> 00:16:13,206 to every antibiotic. 453 00:16:13,240 --> 00:16:17,677 I -- I did this to myself? 454 00:16:17,710 --> 00:16:19,212 But I've used those medications before 455 00:16:19,246 --> 00:16:20,213 without a problem. 456 00:16:20,247 --> 00:16:21,314 Why did this happen now? 457 00:16:23,416 --> 00:16:25,385 You weren't under a doctor's care, 458 00:16:25,418 --> 00:16:27,220 so you were likely taking the wrong medication 459 00:16:27,254 --> 00:16:28,421 for the wrong symptoms. 460 00:16:28,455 --> 00:16:30,490 But you can fix this, right? 461 00:16:30,523 --> 00:16:32,592 We're gonna have to perform a colostomy 462 00:16:32,625 --> 00:16:34,061 where we attach an ostomy pouching system 463 00:16:34,094 --> 00:16:35,428 to your abdomen 464 00:16:35,462 --> 00:16:36,763 to collect waste from your body. 465 00:16:36,796 --> 00:16:38,331 For how long? 466 00:16:38,365 --> 00:16:39,499 Well, with the level of damage 467 00:16:39,532 --> 00:16:40,767 we're seeing throughout the colon, 468 00:16:40,800 --> 00:16:41,634 indefinitely. 469 00:16:41,668 --> 00:16:44,504 ** 470 00:16:44,537 --> 00:16:46,473 I'm so sorry, Howard. 471 00:16:46,506 --> 00:16:55,115 ** 472 00:16:55,148 --> 00:16:56,449 I don't understand 473 00:16:56,483 --> 00:16:57,650 why you'd suggest the bilateral orchiectomy 474 00:16:57,684 --> 00:16:59,419 when you don't even believe Quinn's a girl. 475 00:16:59,452 --> 00:17:02,389 I was answering Dr. Lim's question. 476 00:17:02,422 --> 00:17:04,291 She said there were no other options, 477 00:17:04,324 --> 00:17:05,358 but I found one. 478 00:17:05,392 --> 00:17:07,594 And now we're here. 479 00:17:07,627 --> 00:17:10,230 Yes. 480 00:17:10,263 --> 00:17:11,731 You're actually enjoying this scut work, aren't you? 481 00:17:11,764 --> 00:17:13,600 Yes. We are being helpful. 482 00:17:15,568 --> 00:17:18,138 We're not doing this to be helpful, Murphy. 483 00:17:18,171 --> 00:17:20,107 We're doing this because you pissed off Lim, 484 00:17:20,140 --> 00:17:23,243 and I'm collateral damage. 485 00:17:23,276 --> 00:17:25,345 We're still being helpful. 486 00:17:28,881 --> 00:17:30,517 Doesn't matter. 487 00:17:30,550 --> 00:17:33,220 Doesn't matter, competition's over. 488 00:17:33,253 --> 00:17:35,088 Is it? 489 00:17:35,122 --> 00:17:36,523 We're in here and not with the patient. 490 00:17:36,556 --> 00:17:38,225 No face time plus you calling her a "he" 491 00:17:38,258 --> 00:17:40,427 equals crappy survey scores. 492 00:17:40,460 --> 00:17:41,861 [ Chuckling ] It's okay. It's a game. 493 00:17:41,894 --> 00:17:44,131 It's not important. It is to me. 494 00:17:47,834 --> 00:17:50,470 I'm a pariah. 495 00:17:50,503 --> 00:17:52,772 These scores are part of our resident evaluation. 496 00:17:52,805 --> 00:17:54,874 Our jobs depend on them. 497 00:17:54,907 --> 00:17:56,709 Mine does, at least. 498 00:17:56,743 --> 00:18:01,648 ** 499 00:18:01,681 --> 00:18:05,718 Then we should do this scut work very well. 500 00:18:05,752 --> 00:18:10,857 ** 501 00:18:10,890 --> 00:18:12,425 [ Door closes ] 502 00:18:16,729 --> 00:18:18,431 Finola called. 503 00:18:18,465 --> 00:18:20,533 She found an irregularity with one of the tests 504 00:18:20,567 --> 00:18:21,901 but wants to re-run it to be sure. 505 00:18:21,934 --> 00:18:26,639 Okay, so we wait until she re-runs it. 506 00:18:26,673 --> 00:18:29,809 Marcus, we're both doctors. 507 00:18:29,842 --> 00:18:31,378 The results aren't gonna change. 508 00:18:35,448 --> 00:18:38,651 I waited too long. 509 00:18:38,685 --> 00:18:39,852 It's all my fault. 510 00:18:43,890 --> 00:18:45,358 This is the part where you say, 511 00:18:45,392 --> 00:18:46,426 "No, babe, it isn't." 512 00:18:46,459 --> 00:18:50,563 You had goals, other priorities. 513 00:18:50,597 --> 00:18:53,500 You said you supported my career choices, 514 00:18:53,533 --> 00:18:55,168 just like I supported yours. 515 00:18:55,202 --> 00:18:57,404 I do support you. Always. 516 00:18:57,437 --> 00:18:58,938 And I am so proud of you. 517 00:18:58,971 --> 00:19:00,840 But it came at a cost 518 00:19:00,873 --> 00:19:03,176 that we both knew was possible. 519 00:19:03,210 --> 00:19:05,845 We should have started trying sooner. When? 520 00:19:05,878 --> 00:19:08,181 When you were 3,000 miles away teaching at Dartmouth? 521 00:19:08,215 --> 00:19:10,250 Or, what, when you were chasing down head of surgery? 522 00:19:10,283 --> 00:19:12,752 We would have figured it out. "Figuring it out" 523 00:19:12,785 --> 00:19:14,221 would have meant me and a nanny raising a baby. 524 00:19:14,254 --> 00:19:15,488 I didn't want that. 525 00:19:15,522 --> 00:19:16,556 I tried to bring it up four years ago, 526 00:19:16,589 --> 00:19:18,225 but you wanted to get your practice up and running. 527 00:19:18,258 --> 00:19:19,326 A baby didn't fit in that picture, either. 528 00:19:19,359 --> 00:19:21,428 It is not the same. 529 00:19:21,461 --> 00:19:23,196 How many pregnant women get hired for anything? 530 00:19:23,230 --> 00:19:25,265 Or when they find out a woman's got a child at home, 531 00:19:25,298 --> 00:19:26,098 suddenly it's all 532 00:19:26,132 --> 00:19:27,500 "Who's gonna take care of the baby?" 533 00:19:27,534 --> 00:19:29,369 No one asks men that question. 534 00:19:29,402 --> 00:19:31,771 Yeah, well, none of it matters now. 535 00:19:31,804 --> 00:19:33,540 Right? Because it's probably too late. 536 00:19:33,573 --> 00:19:34,607 And I knew it. 537 00:19:34,641 --> 00:19:35,842 I knew this was gonna happen. 538 00:19:38,445 --> 00:19:40,647 You've been stewing over this. 539 00:19:40,680 --> 00:19:42,682 Resenting me. For how long? 540 00:19:42,715 --> 00:19:45,318 I don't resent you, Is. 541 00:19:45,352 --> 00:19:48,288 But, you know, if you want me to sit here 542 00:19:48,321 --> 00:19:50,590 and tell you that it's not your fault, 543 00:19:50,623 --> 00:19:53,860 I -- I can't do that, I'm sorry. 544 00:19:53,893 --> 00:20:01,334 ** 545 00:20:01,368 --> 00:20:09,376 [ All speaking Spanish on TV ] 546 00:20:09,409 --> 00:20:10,810 [ Sliding door opens ] 547 00:20:11,578 --> 00:20:13,713 Hey. You like? 548 00:20:13,746 --> 00:20:16,015 That door was locked. 549 00:20:16,048 --> 00:20:17,917 Oh, I know. 550 00:20:17,950 --> 00:20:19,652 The cable guy had a cancellation, 551 00:20:19,686 --> 00:20:22,255 so he hooked me up, got us a two-for-one. 552 00:20:22,289 --> 00:20:23,656 Little thanks for being so chill earlier. 553 00:20:23,690 --> 00:20:26,293 Gracias, amigo. 554 00:20:26,326 --> 00:20:33,266 [ Indistinct conversations on TV ] 555 00:20:33,300 --> 00:20:34,567 So, what kind of doctor are you? 556 00:20:37,437 --> 00:20:38,605 I'm a surgeon. 557 00:20:38,638 --> 00:20:40,440 A surgeon? 558 00:20:40,473 --> 00:20:43,443 Your stuff doesn't say surgeon, does it? 559 00:20:43,476 --> 00:20:45,445 It's like, uh, Selena and Justin. 560 00:20:47,380 --> 00:20:49,949 It doesn't really go together. 561 00:20:49,982 --> 00:20:51,050 Furniture's from, like, a dozen different places. 562 00:20:51,083 --> 00:20:52,919 14. 563 00:20:52,952 --> 00:20:54,787 14. 564 00:20:54,821 --> 00:20:57,690 The people in Casper knew I didn't have any money, 565 00:20:57,724 --> 00:20:59,792 so they gave me things to make a home. 566 00:20:59,826 --> 00:21:02,695 The bookshelf is from Jennifer, 567 00:21:02,729 --> 00:21:04,797 the town librarian. 568 00:21:04,831 --> 00:21:08,335 My table and chairs are from Mr. Grady's diner. 569 00:21:08,368 --> 00:21:09,936 The lamp is from Sheryl 570 00:21:09,969 --> 00:21:12,071 who teaches Sunday school at Highland Church. 571 00:21:12,104 --> 00:21:14,674 Dr. Glassman, he got me my bed. 572 00:21:14,707 --> 00:21:16,976 Well, you don't have to tell me the whole list, but... 573 00:21:18,678 --> 00:21:20,680 Okay. Yes. 574 00:21:20,713 --> 00:21:22,349 Everything I have works. 575 00:21:22,382 --> 00:21:23,883 There is no need to change it. 576 00:21:23,916 --> 00:21:25,685 Respect. 577 00:21:34,126 --> 00:21:35,862 [ Muffled screaming on TV ] 578 00:21:35,895 --> 00:21:37,296 [ Woman speaking Spanish ] 579 00:21:40,600 --> 00:21:41,601 [ Speaking Spanish ] 580 00:21:44,804 --> 00:21:46,573 Hi. 581 00:21:46,606 --> 00:21:48,475 I'm Dr. Glassman. Hi. 582 00:21:48,508 --> 00:21:49,642 I'm the president of the hospital. 583 00:21:49,676 --> 00:21:50,643 Is everything okay? 584 00:21:50,677 --> 00:21:51,511 Sit down. 585 00:21:54,080 --> 00:21:56,716 There has been no change in Quinn's condition. 586 00:21:56,749 --> 00:21:59,386 However, her grandmother 587 00:21:59,419 --> 00:22:01,554 has made a claim of child abuse 588 00:22:01,588 --> 00:22:04,624 against you and your husband. 589 00:22:04,657 --> 00:22:05,892 She's claiming that 590 00:22:05,925 --> 00:22:09,128 putting Quinn on puberty blockers -- 591 00:22:09,161 --> 00:22:11,498 and these are her words, 592 00:22:11,531 --> 00:22:15,034 "making her think that being trans is okay" -- 593 00:22:15,067 --> 00:22:18,971 is a form of emotional and physical abuse. 594 00:22:19,005 --> 00:22:20,440 ** 595 00:22:20,473 --> 00:22:22,809 Now, just to be clear, 596 00:22:22,842 --> 00:22:24,677 we don't believe any of these allegations 597 00:22:24,711 --> 00:22:26,413 have any merit whatsoever. 598 00:22:26,446 --> 00:22:27,447 I know my mom, okay? 599 00:22:27,480 --> 00:22:28,948 She's not gonna drop this. 600 00:22:28,981 --> 00:22:30,517 She'll go to court. 601 00:22:30,550 --> 00:22:32,051 Could she get custody? 602 00:22:32,084 --> 00:22:36,556 Well, she could try, but, uh, Dr. Lim would testify. 603 00:22:36,589 --> 00:22:39,426 They could put her in a foster home. Hey. 604 00:22:39,459 --> 00:22:41,127 Ty, she won't make it. 605 00:22:41,160 --> 00:22:43,696 If we let Quinn do the surgery she wants now, 606 00:22:43,730 --> 00:22:44,664 it'll all be over. 607 00:22:44,697 --> 00:22:47,700 There will be no reason for Ruth to fight us. 608 00:22:47,734 --> 00:22:51,438 ** 609 00:22:51,471 --> 00:22:53,840 [ Sniffles ] 610 00:22:53,873 --> 00:22:55,642 Do what Quinn wants. 611 00:22:55,675 --> 00:22:57,176 Do the bilateral surgery. 612 00:22:57,209 --> 00:23:02,381 ** 613 00:23:06,719 --> 00:23:08,154 Finola: There is an issue. 614 00:23:08,187 --> 00:23:09,656 Your tests confirmed 615 00:23:09,689 --> 00:23:12,158 abnormalities in the semen parameters. 616 00:23:16,162 --> 00:23:17,129 I beg your pardon? 617 00:23:17,163 --> 00:23:18,498 The semen analysis. 618 00:23:18,531 --> 00:23:19,799 It showed that you have 619 00:23:19,832 --> 00:23:21,167 a low sperm count and low motility. 620 00:23:21,200 --> 00:23:22,835 It's my fault? 621 00:23:22,869 --> 00:23:23,770 No. 622 00:23:23,803 --> 00:23:26,138 We -- we do not speak in terms of fault. 623 00:23:26,172 --> 00:23:28,875 [ Exhales sharply ] 624 00:23:28,908 --> 00:23:31,711 15% of all couples struggle with infertility, 625 00:23:31,744 --> 00:23:34,481 and of those, 50% have a male factor component. 626 00:23:36,048 --> 00:23:38,451 It's not great news, but it's not a dead end. 627 00:23:38,485 --> 00:23:39,986 So what's the next step? 628 00:23:40,019 --> 00:23:42,622 I'm gonna refer you to Dr. Arjun Dhillon. 629 00:23:42,655 --> 00:23:44,190 He's an excellent urologist, 630 00:23:44,223 --> 00:23:46,659 and he'll give Marcus a -- a full physical, 631 00:23:46,693 --> 00:23:48,828 do some blood work, and an ultrasound. 632 00:23:48,861 --> 00:23:50,229 That can't be right. 633 00:23:50,262 --> 00:23:51,698 Marcus. It can't be right. 634 00:23:51,731 --> 00:23:52,932 Marcus. We got this. 635 00:23:52,965 --> 00:23:54,534 Okay? 636 00:23:54,567 --> 00:23:55,568 We're gonna get through this together. 637 00:23:55,602 --> 00:24:03,075 ** 638 00:24:03,109 --> 00:24:05,011 Hey. Hey! 639 00:24:05,044 --> 00:24:06,646 Why didn't you tell me Howard's labs came back? 640 00:24:06,679 --> 00:24:07,814 I should have been there 641 00:24:07,847 --> 00:24:09,215 when you broke the bad news to him. 642 00:24:09,248 --> 00:24:12,018 So Melendez could see your touching bedside manner. 643 00:24:12,051 --> 00:24:13,653 It doesn't matter anyway. 644 00:24:13,686 --> 00:24:15,154 Oh, it doesn't? How the hell not? 645 00:24:16,556 --> 00:24:17,990 The poor guy's getting a colostomy. 646 00:24:18,024 --> 00:24:19,926 There's no way we're winning this competition. 647 00:24:21,861 --> 00:24:23,663 You really have no sympathy 648 00:24:23,696 --> 00:24:24,764 for what Howard's going through? 649 00:24:24,797 --> 00:24:26,833 It's a major bummer, no doubt. 650 00:24:26,866 --> 00:24:28,701 But we don't have time to get emotionally invested 651 00:24:28,735 --> 00:24:29,769 in every patient that we treat. 652 00:24:29,802 --> 00:24:32,138 Our job is to go in, do the surgery, 653 00:24:32,171 --> 00:24:33,806 and get out. 654 00:24:33,840 --> 00:24:36,843 Afterwards -- his poop, someone else's poop -- 655 00:24:36,876 --> 00:24:37,944 it's not our problem. 656 00:24:39,211 --> 00:24:40,246 Hey, well, wait. 657 00:24:41,848 --> 00:24:42,949 What if we could get Howard 658 00:24:42,982 --> 00:24:44,016 a fecal microbiota transplant? 659 00:24:46,052 --> 00:24:47,954 FMT for a surgical case? 660 00:24:47,987 --> 00:24:50,256 Theoretically, we transfer healthy feces to him, 661 00:24:50,289 --> 00:24:51,924 it restores good flora to the body, 662 00:24:51,958 --> 00:24:52,725 kills off the CDI, 663 00:24:52,759 --> 00:24:54,794 and he avoids surgery all together. 664 00:24:56,228 --> 00:24:57,830 We could actually win this thing. 665 00:24:57,864 --> 00:24:59,632 [ Sighs ] 666 00:24:59,666 --> 00:25:00,667 I'm gonna pull all the research 667 00:25:00,700 --> 00:25:02,835 before pitching it to Melendez. 668 00:25:02,869 --> 00:25:05,638 ** 669 00:25:05,672 --> 00:25:07,239 Glassman: So, this meeting is called 670 00:25:07,273 --> 00:25:10,276 a Challenging Patient Consultation Process. 671 00:25:10,309 --> 00:25:11,210 The name sucks, 672 00:25:11,243 --> 00:25:13,813 but there are things about it I do like. 673 00:25:13,846 --> 00:25:18,284 All you got to do is talk and listen 674 00:25:18,317 --> 00:25:20,086 and try to understand each other. 675 00:25:20,119 --> 00:25:21,020 What's to understand? 676 00:25:21,053 --> 00:25:23,556 Ruth accused us of being child abusers. 677 00:25:23,590 --> 00:25:24,691 Denise: And what's to discuss? 678 00:25:24,724 --> 00:25:25,958 We are Quinn's parents. 679 00:25:25,992 --> 00:25:27,894 We get to make her medical decisions. 680 00:25:27,927 --> 00:25:29,829 What if Quinnie's better off as a boy? 681 00:25:29,862 --> 00:25:32,999 You have no idea what Quinn has been through. 682 00:25:33,032 --> 00:25:35,702 Every kid goes through rough patches. 683 00:25:35,735 --> 00:25:37,704 Every kid is confused. 684 00:25:37,737 --> 00:25:39,606 Quinn has always told us exactly who she was, 685 00:25:39,639 --> 00:25:40,807 ever since she was 3. 686 00:25:40,840 --> 00:25:42,041 So you let Quinn play with dolls. 687 00:25:42,074 --> 00:25:43,342 Big deal. 688 00:25:43,375 --> 00:25:45,612 You don't make life-altering decisions 689 00:25:45,645 --> 00:25:47,747 because a child wants to be a princess. 690 00:25:52,752 --> 00:25:55,688 We used to let Quinn do whatever she wanted at home. 691 00:25:55,722 --> 00:25:58,257 But when she went out in public, 692 00:25:58,290 --> 00:26:00,159 we made her present as a boy. 693 00:26:01,894 --> 00:26:03,863 It felt false to her. 694 00:26:03,896 --> 00:26:06,265 She hated it. 695 00:26:06,298 --> 00:26:07,634 She hated herself. 696 00:26:07,667 --> 00:26:11,003 She became reclusive, depressed. 697 00:26:11,037 --> 00:26:13,372 And then a year ago, Quinn tried to kill herself. 698 00:26:13,405 --> 00:26:19,946 ** 699 00:26:19,979 --> 00:26:21,147 Sorry I'm late. 700 00:26:21,180 --> 00:26:26,753 ** 701 00:26:26,786 --> 00:26:32,391 ** 702 00:26:32,424 --> 00:26:34,226 Howard might not need the colostomy 703 00:26:34,260 --> 00:26:39,231 if we give him a fecal microbiota transplant. 704 00:26:39,265 --> 00:26:41,000 Hasn't the FDA gone back and forth on that? 705 00:26:41,033 --> 00:26:43,335 We could be introducing new bacteria into his system 706 00:26:43,369 --> 00:26:44,871 that could kill him. 707 00:26:44,904 --> 00:26:45,772 The likelihood of that is low. 708 00:26:45,805 --> 00:26:46,806 But not zero. 709 00:26:46,839 --> 00:26:48,174 But if we do the colostomy, 710 00:26:48,207 --> 00:26:49,375 we may not really be helping him. 711 00:26:49,408 --> 00:26:51,243 15% to 30% of patients 712 00:26:51,277 --> 00:26:53,846 get recurrent CDI after the initial bout. 713 00:26:53,880 --> 00:26:54,847 That's a good point. 714 00:26:54,881 --> 00:26:56,916 I believe 65% of that time, 715 00:26:56,949 --> 00:26:58,084 recurrent CDI becomes chronic, 716 00:26:58,117 --> 00:27:00,219 which can lead to repeated hospitalizations and death. 717 00:27:00,252 --> 00:27:03,155 ** 718 00:27:03,189 --> 00:27:04,724 Are my numbers right, Claire? 719 00:27:04,757 --> 00:27:06,258 Yes. 720 00:27:06,292 --> 00:27:08,728 But recent studies 721 00:27:08,761 --> 00:27:12,832 show better than a 95% success rate with FMTs. 722 00:27:12,865 --> 00:27:14,366 Howard is a good candidate. 723 00:27:14,400 --> 00:27:15,835 We should try it 724 00:27:15,868 --> 00:27:17,069 before he develops a toxic megacolon. 725 00:27:17,103 --> 00:27:19,205 Don't we owe it to him, to his twins, 726 00:27:19,238 --> 00:27:21,140 to at least try an experimental treatment 727 00:27:21,173 --> 00:27:22,942 before doing an invasive surgery 728 00:27:22,975 --> 00:27:24,210 which will alter his life forever? 729 00:27:24,243 --> 00:27:25,878 You're right. 730 00:27:25,912 --> 00:27:27,814 Prep him for the procedure. 731 00:27:27,847 --> 00:27:29,816 I appreciate your passionate advocacy 732 00:27:29,849 --> 00:27:30,850 for your patient. 733 00:27:30,883 --> 00:27:32,251 Good work, both of you. 734 00:27:36,088 --> 00:27:37,824 Oh, now you're a team player. 735 00:27:37,857 --> 00:27:38,891 When it benefits me, yes. 736 00:27:38,925 --> 00:27:40,860 Speaking of which, 737 00:27:40,893 --> 00:27:42,161 while you were doing your research, 738 00:27:42,194 --> 00:27:43,462 I found Howard a match at the stool bank. 739 00:27:43,495 --> 00:27:44,797 Sample arrives in a couple of hours. 740 00:27:44,831 --> 00:27:46,098 Great. 741 00:27:46,132 --> 00:27:47,867 I let them know you'd be the designated doctor 742 00:27:47,900 --> 00:27:49,101 to handle the medical chain of custody 743 00:27:49,135 --> 00:27:50,336 when the sample arrives. 744 00:27:50,369 --> 00:27:52,271 So...? 745 00:27:52,304 --> 00:27:54,941 So you're the only person who can handle the sample. 746 00:27:54,974 --> 00:27:56,242 You'll have to dilute it, blend it, strain it 747 00:27:56,275 --> 00:27:57,309 all on your own. 748 00:27:57,343 --> 00:27:59,278 To safeguard against cross-contamination, of course. 749 00:27:59,311 --> 00:28:01,213 Of course. 750 00:28:01,247 --> 00:28:07,987 ** 751 00:28:10,089 --> 00:28:13,025 Your temperature and BP are normal. 752 00:28:13,059 --> 00:28:14,026 Quinn: Normal. 753 00:28:14,060 --> 00:28:15,928 Whatever that means. 754 00:28:15,962 --> 00:28:18,497 Typical. Usual. 755 00:28:18,530 --> 00:28:20,499 Expected. 756 00:28:20,532 --> 00:28:23,469 Yeah, I don't feel like any of those things. 757 00:28:23,502 --> 00:28:25,872 What does it feel like to be a girl? 758 00:28:30,810 --> 00:28:32,111 Are you angry? 759 00:28:32,144 --> 00:28:34,480 Was that an inflammatory question? 760 00:28:34,513 --> 00:28:35,514 I'd rather people ask questions 761 00:28:35,547 --> 00:28:36,415 instead of pointing and staring. 762 00:28:39,018 --> 00:28:40,820 When I used to look like a boy, 763 00:28:40,853 --> 00:28:43,322 I felt...different. 764 00:28:43,355 --> 00:28:46,525 The kids at school didn't understand me, 765 00:28:46,558 --> 00:28:47,994 so they picked on me. 766 00:28:48,027 --> 00:28:49,962 I spent a lot of time alone. 767 00:28:49,996 --> 00:28:51,931 ** 768 00:28:51,964 --> 00:28:55,167 When my parents let me be me, 769 00:28:55,201 --> 00:28:57,003 I felt... 770 00:28:57,036 --> 00:28:58,737 like I didn't have to pretend anymore. 771 00:29:00,472 --> 00:29:01,540 I felt free, 772 00:29:01,573 --> 00:29:03,342 like when you're in a pool 773 00:29:03,375 --> 00:29:05,311 and you just let go and float. 774 00:29:05,344 --> 00:29:09,882 ** 775 00:29:09,916 --> 00:29:12,151 I'm not a very good swimmer. 776 00:29:12,184 --> 00:29:13,886 [ Chuckles ] 777 00:29:13,920 --> 00:29:21,928 ** 778 00:29:21,961 --> 00:29:24,096 I don't know what it feels like 779 00:29:24,130 --> 00:29:26,332 to be anyone but me. 780 00:29:26,365 --> 00:29:29,168 ** 781 00:29:29,201 --> 00:29:31,103 Me, too. 782 00:29:31,137 --> 00:29:32,839 ** 783 00:29:32,872 --> 00:29:35,441 Is the bilateral more risky 784 00:29:35,474 --> 00:29:37,844 than the unilateral surgery? 785 00:29:37,877 --> 00:29:39,478 The big issue with the bilateral 786 00:29:39,511 --> 00:29:41,814 is Quinn will never be able to have biological children. 787 00:29:41,848 --> 00:29:43,950 If Quinn's parents think that Quinn's mature enough 788 00:29:43,983 --> 00:29:45,284 and strong enough in her beliefs, 789 00:29:45,317 --> 00:29:46,418 then they should do it now. 790 00:29:46,452 --> 00:29:49,121 It's an elective surgery on a child. 791 00:29:49,155 --> 00:29:51,290 There is no medical necessity. 792 00:29:51,323 --> 00:29:53,125 Except with a previous suicide attempt, 793 00:29:53,159 --> 00:29:54,193 she's still at risk. 794 00:29:54,226 --> 00:29:55,962 Her situation is different now. 795 00:29:55,995 --> 00:29:58,831 She's socially transitioned and living as a girl. 796 00:29:58,865 --> 00:30:01,133 But there just isn't enough good data 797 00:30:01,167 --> 00:30:02,835 on trans kids and their outcomes. 798 00:30:02,869 --> 00:30:05,004 On the other hand, there's very good reason 799 00:30:05,037 --> 00:30:06,138 to preserve future fertility. 800 00:30:06,172 --> 00:30:08,374 Glassman: Dr. Lim and Dr. Andrews 801 00:30:08,407 --> 00:30:09,876 are both very excellent surgeons, 802 00:30:09,909 --> 00:30:11,177 and they very clearly have 803 00:30:11,210 --> 00:30:12,511 some passionate points of view, 804 00:30:12,544 --> 00:30:14,213 but their views are their own. 805 00:30:14,246 --> 00:30:17,249 You all need to decide what's best for Quinn. 806 00:30:18,985 --> 00:30:20,887 Whatever we decide, 807 00:30:20,920 --> 00:30:22,454 Quinn is still gonna be a girl. 808 00:30:26,025 --> 00:30:28,260 I don't know if I'll ever be able to accept that. 809 00:30:30,062 --> 00:30:32,498 I know that makes me sound horrible. 810 00:30:32,531 --> 00:30:36,602 I know what it's like to not put your family first, 811 00:30:36,635 --> 00:30:38,637 and it cost me. 812 00:30:38,670 --> 00:30:42,208 It cost me a great deal. 813 00:30:42,241 --> 00:30:44,911 And if I had to do it all over again, 814 00:30:44,944 --> 00:30:46,312 I'd ask myself -- 815 00:30:46,345 --> 00:30:49,015 is it really worth sacrificing a life 816 00:30:49,048 --> 00:30:50,549 with someone I love 817 00:30:50,582 --> 00:30:54,586 over an idea that may never be? 818 00:30:54,620 --> 00:31:00,392 ** 819 00:31:00,426 --> 00:31:01,961 Why don't we give them the room? 820 00:31:01,994 --> 00:31:10,970 ** 821 00:31:11,003 --> 00:31:12,604 [ Monitor beeping rapidly ] Hey. I got the page. What's going on. 822 00:31:12,638 --> 00:31:14,473 She started screaming in pain and vomiting. 823 00:31:14,506 --> 00:31:15,441 Temp's 104. 824 00:31:15,474 --> 00:31:17,009 Shaun: Increased groin pain 825 00:31:17,043 --> 00:31:18,510 could be attributed to epididymitis, 826 00:31:18,544 --> 00:31:20,312 kidney stones, inguinal hernia... 827 00:31:20,346 --> 00:31:21,413 The extra weight of the tumor 828 00:31:21,447 --> 00:31:23,115 could be causing the testicle to twist on itself. 829 00:31:23,149 --> 00:31:25,484 There'd be no blood flow. 830 00:31:25,517 --> 00:31:29,388 ** 831 00:31:29,421 --> 00:31:30,957 Quinn: [ Retches ] 832 00:31:31,723 --> 00:31:33,592 She has a testicular torsion. 833 00:31:33,625 --> 00:31:34,560 She needs surgery now. 834 00:31:34,593 --> 00:31:35,928 ** 835 00:31:43,535 --> 00:31:45,271 Excuse me. Have you made a decision? 836 00:31:45,304 --> 00:31:47,339 Not yet. I mean, there's a lot to -- 837 00:31:47,373 --> 00:31:48,607 We need one now. 838 00:31:48,640 --> 00:31:50,309 Quinn has testicular torsion. 839 00:31:50,342 --> 00:31:51,610 The spermatic cord is twisted 840 00:31:51,643 --> 00:31:53,145 and cutting off blood supply. 841 00:31:53,179 --> 00:31:54,146 We need to operate. 842 00:31:54,180 --> 00:31:57,083 ** 843 00:31:57,116 --> 00:32:01,387 If you want Quinn to live the way she wants, 844 00:32:01,420 --> 00:32:03,089 don't limit her future now. 845 00:32:06,425 --> 00:32:07,626 You heard her when my mom said 846 00:32:07,659 --> 00:32:09,161 she might want kids some day. 847 00:32:09,195 --> 00:32:10,529 She can't even fathom the thought 848 00:32:10,562 --> 00:32:12,564 because she's just a child. 849 00:32:12,598 --> 00:32:18,504 ** 850 00:32:18,537 --> 00:32:20,406 Just do what's medically necessary. 851 00:32:23,575 --> 00:32:24,543 [ Sighs ] 852 00:32:25,644 --> 00:32:29,581 [ Monitor beeping ] 853 00:32:29,615 --> 00:32:32,718 Andrews: Doesn't appear to be any palpable lymphadenopathy. 854 00:32:32,751 --> 00:32:35,121 It's likely a stromal tumor, 855 00:32:35,154 --> 00:32:37,423 but get that to pathology right away. Yes, sir. 856 00:32:39,458 --> 00:32:42,661 [ Monitor beeping rapidly ] 857 00:32:42,694 --> 00:32:46,432 Quinn has tachycardia and hypotension. 858 00:32:46,465 --> 00:32:47,566 I'm not seeing any bleeding. 859 00:32:47,599 --> 00:32:49,301 EKG's normal. It's not coronary. 860 00:32:49,335 --> 00:32:51,770 CO2 and O2 are normal, so it's not a P.E. 861 00:32:51,803 --> 00:32:53,505 It must be a reaction to the anesthesia. 862 00:32:53,539 --> 00:32:55,574 I'm already pushing fluids and vasoconstrictors. 863 00:32:55,607 --> 00:32:58,310 ** 864 00:33:03,715 --> 00:33:07,053 Six syringes in, and no sign of leakage. 865 00:33:07,086 --> 00:33:08,520 Okay, we're wrapped up here. 866 00:33:08,554 --> 00:33:09,555 Let's get Howard into recovery. 867 00:33:09,588 --> 00:33:11,757 Well done. Thanks. 868 00:33:11,790 --> 00:33:14,593 I was thinking of writing up the procedure, 869 00:33:14,626 --> 00:33:16,295 possibly submit it for publication. 870 00:33:16,328 --> 00:33:18,197 I'd be happy to assist, 871 00:33:18,230 --> 00:33:20,399 seeing as I've done it before. 872 00:33:20,432 --> 00:33:22,401 Thanks, but I think I can -- 873 00:33:22,434 --> 00:33:24,370 I read your paper in AMSURG, Dr. Reznick. 874 00:33:24,403 --> 00:33:25,637 You continue to impress. 875 00:33:25,671 --> 00:33:26,438 Coming from you, 876 00:33:26,472 --> 00:33:28,207 I take that as a huge compliment. 877 00:33:30,109 --> 00:33:32,044 When you get a chance, Dr. Browne, 878 00:33:32,078 --> 00:33:33,045 you should read it. 879 00:33:33,079 --> 00:33:34,380 Will do. 880 00:33:34,413 --> 00:33:42,454 ** 881 00:33:42,488 --> 00:33:44,190 J.L.: I've given vasopressors 882 00:33:44,223 --> 00:33:46,125 and reduced her meds as much as I can. 883 00:33:46,158 --> 00:33:47,759 She's losing volume somewhere. 884 00:33:47,793 --> 00:33:49,695 It was dry when we ligated the spermatic cord. 885 00:33:49,728 --> 00:33:50,896 I'm still not seeing the bleed. 886 00:33:50,929 --> 00:33:54,100 Shaun: Could be vagal stimulation from the severed nerve. 887 00:33:54,133 --> 00:33:55,367 But she's not responding to epi. 888 00:33:55,401 --> 00:33:57,269 Sepsis? It's too early for an infection. 889 00:33:59,271 --> 00:34:01,340 Her MAP is 20. She's barely profusing. 890 00:34:01,373 --> 00:34:04,610 ** 891 00:34:04,643 --> 00:34:06,145 Okay, excuse me, guys. 892 00:34:06,178 --> 00:34:07,479 You're breaking scrub. I'm so sorry. 893 00:34:08,547 --> 00:34:10,149 Grey-Turner sign. 894 00:34:10,182 --> 00:34:12,084 Could be a retroperitoneal hemorrhage. 895 00:34:12,118 --> 00:34:18,157 ** 896 00:34:18,190 --> 00:34:24,196 ** 897 00:34:24,230 --> 00:34:26,298 Jared could be right. 898 00:34:26,332 --> 00:34:29,401 It is possible that there's internal bleeding. 899 00:34:29,435 --> 00:34:31,403 The testicular artery 900 00:34:31,437 --> 00:34:33,639 can retract up into the pelvis. 901 00:34:33,672 --> 00:34:35,707 It's rare, but it can happen. 902 00:34:35,741 --> 00:34:37,476 Rare is an understatement. Dr. Andrews? 903 00:34:39,911 --> 00:34:41,647 I don't think we have any other choice. 904 00:34:41,680 --> 00:34:43,315 We need to do an ex-lap. 10 blade. 905 00:34:43,349 --> 00:34:53,325 ** 906 00:34:53,359 --> 00:34:54,660 Murphy, retract. 907 00:35:02,868 --> 00:35:04,470 Internal bleeding. 908 00:35:04,503 --> 00:35:05,671 Jared was right. 909 00:35:07,439 --> 00:35:09,441 Nice call, Dr. Kalu. 910 00:35:09,475 --> 00:35:10,442 Thank you, sir. 911 00:35:11,577 --> 00:35:12,778 Kalu, suction. 912 00:35:12,811 --> 00:35:13,712 We need a clear view of the field. 913 00:35:13,745 --> 00:35:15,681 ** 914 00:35:20,752 --> 00:35:22,354 Fever's down, and the flora in your system 915 00:35:22,388 --> 00:35:23,689 seems to be returning to normal. 916 00:35:23,722 --> 00:35:25,291 We expect a full recovery. Thank you. 917 00:35:25,324 --> 00:35:26,925 For everything. 918 00:35:26,958 --> 00:35:28,594 Do you know when I can have visitors? 919 00:35:28,627 --> 00:35:30,762 I thought you might ask that question. 920 00:35:30,796 --> 00:35:32,598 There are a couple of eager preschoolers 921 00:35:32,631 --> 00:35:33,832 who'd like to say hi. 922 00:35:33,865 --> 00:35:35,201 Oh. 923 00:35:35,234 --> 00:35:36,568 -Daddy! -Keira! 924 00:35:36,602 --> 00:35:39,371 Sammy! Oh! 925 00:35:39,405 --> 00:35:41,473 Oh, I think you guys have grown! 926 00:35:41,507 --> 00:35:43,742 [ Chuckles ] Hey. 927 00:35:43,775 --> 00:35:45,677 Hey, these are the doctors that saved Daddy. 928 00:35:45,711 --> 00:35:48,814 Dr. Reznick and this is, uh... 929 00:35:48,847 --> 00:35:50,716 Uh, I'm sorry, I forgot your name. 930 00:35:50,749 --> 00:35:53,452 Dr. Browne. 931 00:35:53,485 --> 00:35:54,953 Thank you. Thank you. 932 00:35:54,986 --> 00:35:56,655 You're welcome. 933 00:35:56,688 --> 00:35:57,623 [ Chuckles ] 934 00:35:57,656 --> 00:35:58,724 Blah! 935 00:35:58,757 --> 00:36:00,859 [ Laughter ] 936 00:36:00,892 --> 00:36:02,394 Okay. 937 00:36:04,330 --> 00:36:05,297 Morgan: Who's this guy? 938 00:36:05,331 --> 00:36:06,332 -Bear Bear. -Bear Bear? 939 00:36:15,841 --> 00:36:16,942 Did you do it? 940 00:36:16,975 --> 00:36:17,909 Did you remove both? 941 00:36:19,511 --> 00:36:20,579 No. 942 00:36:20,612 --> 00:36:21,747 Just the cancerous one. 943 00:36:21,780 --> 00:36:23,415 What? Why not? 944 00:36:25,551 --> 00:36:26,718 That's on me. 945 00:36:26,752 --> 00:36:28,520 I couldn't, in good conscience, remove a healthy organ. 946 00:36:33,892 --> 00:36:35,694 Quinnie. 947 00:36:35,727 --> 00:36:37,329 This was our decision. 948 00:36:37,363 --> 00:36:38,864 No! You said you were on my side! 949 00:36:38,897 --> 00:36:41,533 Hey, we are. Always. 950 00:36:41,567 --> 00:36:43,569 We haven't had enough time to talk, 951 00:36:43,602 --> 00:36:45,937 not with each other, with your therapist, 952 00:36:45,971 --> 00:36:47,539 with your doctors. 953 00:36:47,573 --> 00:36:49,007 So I'm gonna turn into a boy. 954 00:36:49,040 --> 00:36:50,976 Well, not right away. 955 00:36:51,009 --> 00:36:52,644 Your endocrinologist will talk to you 956 00:36:52,678 --> 00:36:53,679 about the right timeline 957 00:36:53,712 --> 00:36:55,647 for starting feminizing hormones. 958 00:36:55,681 --> 00:36:58,750 [ Sighs ] 959 00:36:58,784 --> 00:37:01,320 You know... 960 00:37:01,353 --> 00:37:03,555 the thought of having your own kids someday 961 00:37:03,589 --> 00:37:05,357 is a big decision, 962 00:37:05,391 --> 00:37:07,293 but you never know what you will or will not want 963 00:37:07,326 --> 00:37:08,494 once you get older. 964 00:37:08,527 --> 00:37:10,329 Cis people are always so worked up 965 00:37:10,362 --> 00:37:11,797 about having bio kids. 966 00:37:11,830 --> 00:37:13,665 If I really want a kid that bad, 967 00:37:13,699 --> 00:37:14,966 I can just adopt. 968 00:37:18,537 --> 00:37:19,971 You know, I'll be back when I'm 18 969 00:37:20,005 --> 00:37:21,907 for my gender confirmation surgery. 970 00:37:21,940 --> 00:37:25,844 And when you do, I'll be here to help you. 971 00:37:25,877 --> 00:37:30,482 ** 972 00:37:33,785 --> 00:37:35,721 Patient satisfaction survey scores are in, 973 00:37:35,754 --> 00:37:37,456 and it was very close. 974 00:37:37,489 --> 00:37:38,957 Not really. She's being kind. 975 00:37:38,990 --> 00:37:42,961 Congratulations go to Dr. Reznick and Dr. Browne. 976 00:37:42,994 --> 00:37:44,630 Yes. Thank you. 977 00:37:46,398 --> 00:37:48,367 Congratulations. 978 00:37:48,400 --> 00:37:49,635 Thank you, Shaun. 979 00:37:49,668 --> 00:37:51,403 Claire and I make a nice team. 980 00:37:54,706 --> 00:37:56,375 You should be psyched. 981 00:37:56,408 --> 00:37:57,776 Yeah. I should be. 982 00:38:00,746 --> 00:38:03,014 To the victor belong the spoils. 983 00:38:03,048 --> 00:38:04,716 Pay up. 984 00:38:04,750 --> 00:38:07,018 Oh, humility was never your strong suit. 985 00:38:09,355 --> 00:38:11,390 Thank you, Mortimer. Mm. 986 00:38:11,423 --> 00:38:13,392 Don't spend it all in one place. 987 00:38:13,425 --> 00:38:14,826 Spend it? 988 00:38:14,860 --> 00:38:16,428 I'm gonna frame it. 989 00:38:16,462 --> 00:38:18,997 ** 990 00:38:19,030 --> 00:38:21,099 What made you think of a retroperitoneal hemorrhage? 991 00:38:21,132 --> 00:38:22,067 Homework. 992 00:38:22,100 --> 00:38:23,535 You were right. 993 00:38:23,569 --> 00:38:25,103 Prepping for an SDA was important. 994 00:38:25,136 --> 00:38:26,672 We make a good team. 995 00:38:30,141 --> 00:38:32,077 Quinn doesn't like pink. 996 00:38:32,110 --> 00:38:33,745 Oh. 997 00:38:33,779 --> 00:38:36,081 Uh, I think she will like these. 998 00:38:36,114 --> 00:38:38,584 I hope so. 999 00:38:40,786 --> 00:38:43,555 She's more of a purple girl. 1000 00:38:43,589 --> 00:38:50,996 ** 1001 00:38:51,029 --> 00:38:53,064 Did you read Morgan's AMSURG article yet? 1002 00:38:53,098 --> 00:38:54,366 [ Scoffs ] 1003 00:38:54,400 --> 00:38:56,735 It is on the top of my to-do list. 1004 00:38:56,768 --> 00:38:59,004 I didn't tell you to read it to rub it in. 1005 00:38:59,037 --> 00:39:01,840 ** 1006 00:39:01,873 --> 00:39:03,875 I told you to read it so you knew what you'd be up against. 1007 00:39:03,909 --> 00:39:05,744 You think I need to be more cutthroat? 1008 00:39:05,777 --> 00:39:06,912 No. 1009 00:39:06,945 --> 00:39:09,648 That's Morgan's M.O. You're different. 1010 00:39:09,681 --> 00:39:11,483 You're smart, you're special. 1011 00:39:11,517 --> 00:39:15,454 Rise up, play the game on your own terms. 1012 00:39:15,487 --> 00:39:16,888 Don't wait for it. 1013 00:39:16,922 --> 00:39:22,561 * A year from now we'll all be gone * 1014 00:39:22,594 --> 00:39:26,598 * All our friends will move away * 1015 00:39:26,632 --> 00:39:27,966 ** 1016 00:39:27,999 --> 00:39:33,572 * And they're goin' to better places * 1017 00:39:33,605 --> 00:39:37,676 * But our friends will be gone away * 1018 00:39:42,481 --> 00:39:44,816 * Nothin' is as it has been * 1019 00:39:44,850 --> 00:39:47,519 I heard you saved Quinn's life. 1020 00:39:47,553 --> 00:39:50,456 Jared and I did. 1021 00:39:50,489 --> 00:39:51,923 I like her. 1022 00:39:51,957 --> 00:39:53,024 "Her." 1023 00:39:53,058 --> 00:39:54,660 * And I guess it's just as well * 1024 00:39:54,693 --> 00:39:59,197 So you get that she is a "she." 1025 00:39:59,230 --> 00:40:01,199 I have lots of questions. 1026 00:40:01,232 --> 00:40:04,169 Yeah, well, questions are good. 1027 00:40:04,202 --> 00:40:07,473 Leads to awareness and understanding. 1028 00:40:07,506 --> 00:40:09,541 And, who knows, maybe even acceptance. 1029 00:40:11,577 --> 00:40:12,978 Being a kid is tough enough, 1030 00:40:13,011 --> 00:40:15,547 But being a trans kid? Oh, man, that's -- 1031 00:40:15,581 --> 00:40:16,648 that's off the chart. 1032 00:40:16,682 --> 00:40:19,050 ** 1033 00:40:19,084 --> 00:40:21,553 I can't imagine how it must feel 1034 00:40:21,587 --> 00:40:24,656 to be so different on the outside 1035 00:40:24,690 --> 00:40:25,824 than you are on the inside. 1036 00:40:25,857 --> 00:40:29,227 * Oh, oh, oh 1037 00:40:29,260 --> 00:40:32,831 * Oh, oh 1038 00:40:32,864 --> 00:40:34,766 Hey, Shaun. 1039 00:40:34,800 --> 00:40:37,536 I can give you a lift. 1040 00:40:37,569 --> 00:40:39,170 We could grab a bite. 1041 00:40:39,204 --> 00:40:41,873 * Oh 1042 00:40:41,907 --> 00:40:45,010 You said you can't be my friend. 1043 00:40:45,043 --> 00:40:46,812 So, no, thank you. 1044 00:40:48,547 --> 00:40:51,783 * Been talking 'bout 1045 00:40:51,817 --> 00:40:52,984 Okay. 1046 00:40:53,018 --> 00:40:54,553 * The way things change 1047 00:40:54,586 --> 00:40:56,688 ** 1048 00:40:56,722 --> 00:41:01,593 * If you don't know what to make of this * 1049 00:41:01,627 --> 00:41:02,928 Hey, amigo. What's up? 1050 00:41:02,961 --> 00:41:05,263 * Then we will not relate I need your help. 1051 00:41:05,296 --> 00:41:06,865 [ Scoffs ] 1052 00:41:08,066 --> 00:41:10,702 * Rivers and roads 1053 00:41:10,736 --> 00:41:13,705 * Rivers and roads 1054 00:41:13,739 --> 00:41:16,875 * Rivers till I reach you 1055 00:41:18,777 --> 00:41:21,813 * Rivers and roads 1056 00:41:21,847 --> 00:41:24,082 * Oh, rivers and roads 1057 00:41:24,115 --> 00:41:28,119 * Oh, rivers till I reach you 1058 00:41:28,153 --> 00:41:30,221 ** 1059 00:41:30,255 --> 00:41:32,858 * Rivers and roads 1060 00:41:32,891 --> 00:41:35,293 * Rivers and roads 1061 00:41:35,326 --> 00:41:38,664 * Rivers till I reach you 1062 00:41:40,766 --> 00:41:43,268 * Rivers and roads 1063 00:41:43,301 --> 00:41:45,971 * Rivers and roads 1064 00:41:46,004 --> 00:41:49,240 * Rivers till I reach you 1065 00:41:49,274 --> 00:41:53,111 You're not gonna do any laps or nothing? 1066 00:41:53,144 --> 00:41:54,580 No. 1067 00:41:54,613 --> 00:41:57,048 ** 1068 00:41:57,082 --> 00:41:58,183 Then what are you doing? 1069 00:42:00,852 --> 00:42:03,054 Understanding. 1070 00:42:03,088 --> 00:42:07,826 ** 1071 00:42:07,859 --> 00:42:10,796 * Oh * Rivers and roads 1072 00:42:10,829 --> 00:42:13,665 * Rivers and roads 1073 00:42:13,699 --> 00:42:17,903 * Rivers till I reach you 1074 00:42:22,340 --> 00:42:30,616 ** 1075 00:42:30,649 --> 00:42:38,724 ** 1076 00:42:38,757 --> 00:42:46,865 ** 1077 00:42:46,898 --> 00:42:55,040 **