1 00:00:02,970 --> 00:00:05,773 (MONITOR BEEPING) (BREATHING HEAVILY) 2 00:00:05,806 --> 00:00:08,342 DR. GARCIA: I'm incising the uterine wall. 3 00:00:08,376 --> 00:00:09,443 (SNIFFLES) 4 00:00:09,477 --> 00:00:11,145 You're doing great, really great. 5 00:00:11,179 --> 00:00:12,313 It's gonna be okay. 6 00:00:12,346 --> 00:00:14,482 You promise? 7 00:00:14,515 --> 00:00:15,783 (SMOOCHES) 8 00:00:15,816 --> 00:00:18,686 Baby's out. Umbilical clip. Suction. 9 00:00:18,719 --> 00:00:20,121 (BABY CRYING) Please, 10 00:00:20,154 --> 00:00:21,922 can I see my daughter? 11 00:00:21,955 --> 00:00:23,191 Yes. 12 00:00:23,224 --> 00:00:24,392 Of course. 13 00:00:27,328 --> 00:00:28,496 DR. LIM: Sorry. 14 00:00:28,529 --> 00:00:30,098 We'll need to get her into surgery. 15 00:00:30,131 --> 00:00:31,799 We'll take good care of her. 16 00:00:31,832 --> 00:00:33,467 ** 17 00:00:33,501 --> 00:00:35,336 (BABY CRYING) 18 00:00:35,369 --> 00:00:37,705 ** 19 00:00:44,845 --> 00:00:48,182 Your New Chief is fashionably late. 20 00:00:48,216 --> 00:00:49,783 Our Chief. 21 00:00:49,817 --> 00:00:52,520 Just because I endorsed Dr. Han to the Board 22 00:00:52,553 --> 00:00:53,987 doesn't mean I don't have any concerns. 23 00:00:54,021 --> 00:00:56,557 Connections like Dr. Han's come at a premium 24 00:00:56,590 --> 00:00:58,459 and, he assures me, will be well worth it 25 00:00:58,492 --> 00:01:00,494 given our current predicament with the Medical Board. 26 00:01:00,528 --> 00:01:03,030 I'm not just worried about the money. 27 00:01:03,063 --> 00:01:04,832 When you pay that much, 28 00:01:04,865 --> 00:01:07,101 they tend to think they're worth it. 29 00:01:07,135 --> 00:01:09,370 Makes a person think they don't have to show up 30 00:01:09,403 --> 00:01:11,839 for their own welcome brunch. 31 00:01:11,872 --> 00:01:13,707 (INDISTINCT CONVERSATIONS) 32 00:01:14,875 --> 00:01:16,710 (BREATHES SHARPLY) 33 00:01:21,849 --> 00:01:22,983 (MONITOR BEEPING) 34 00:01:23,016 --> 00:01:24,418 CLAIRE: The baby's bowel protrusion 35 00:01:24,452 --> 00:01:27,087 seemed less severe on the prenatal imaging. 36 00:01:27,121 --> 00:01:28,756 DR. LIM: And it'll have to wait until 37 00:01:28,789 --> 00:01:30,391 we're done with her heart problem. 38 00:01:30,424 --> 00:01:34,195 Now that I'm in here, her septum looks more like Swiss cheese. 39 00:01:34,228 --> 00:01:36,830 (MONITOR BEEPING) 40 00:01:36,864 --> 00:01:39,933 Page the on-call neonatal cardiac surgeon. 41 00:01:39,967 --> 00:01:41,735 That won't be necessary. I'll scrub in. 42 00:01:41,769 --> 00:01:43,103 DR. LIM: And who are you? 43 00:01:43,804 --> 00:01:45,539 I'm Jackson Han. 44 00:01:45,573 --> 00:01:47,208 Your new Chief of Surgery. 45 00:01:47,241 --> 00:01:49,577 ** 46 00:01:49,610 --> 00:01:51,745 ** 47 00:02:01,422 --> 00:02:03,624 (MONITOR BEEPING STEADILY) 48 00:02:03,657 --> 00:02:05,726 DR. HAN: Echo probe, please. 49 00:02:07,127 --> 00:02:08,662 And let's turn that music on. 50 00:02:11,265 --> 00:02:13,734 ( LORD HURON'S "ANCIENT NAMES ( PART 1 ) " PLAYS) 51 00:02:13,767 --> 00:02:15,236 Advance the delivery sheath. 52 00:02:15,269 --> 00:02:17,705 ** 53 00:02:17,738 --> 00:02:19,607 It's in the patient's heart, Dr. Murphy. 54 00:02:19,640 --> 00:02:22,776 I think the music is a little distracting. 55 00:02:22,810 --> 00:02:24,745 I feel the same way about operating without music. 56 00:02:26,013 --> 00:02:27,781 I'll take a longer sheath, 57 00:02:27,815 --> 00:02:29,983 and Dr. Murphy will need some forceps. 58 00:02:30,017 --> 00:02:31,985 ** 59 00:02:32,019 --> 00:02:33,787 (FORCEPS CLATTER) * Well, the neon lights 60 00:02:33,821 --> 00:02:35,656 * Glowed red and gold 61 00:02:35,689 --> 00:02:38,826 * I came to hear my fortune told Five-second rule. 62 00:02:38,859 --> 00:02:41,795 * I can't imagine what she saw 63 00:02:41,829 --> 00:02:44,765 * While gazing in her crystal ball It was a joke. 64 00:02:44,798 --> 00:02:46,066 ** 65 00:02:46,099 --> 00:02:47,601 What about her bowels? 66 00:02:47,635 --> 00:02:50,504 Why isn't Dr. Lim inserting it into the abdomen right now? 67 00:02:50,538 --> 00:02:53,106 There is not enough room. 68 00:02:53,140 --> 00:02:55,476 There's... There's not enough room 69 00:02:55,509 --> 00:02:57,245 without increasing abdominal pressure, 70 00:02:57,278 --> 00:03:00,481 which would critically decrease blood flow to the bowel. 71 00:03:00,514 --> 00:03:02,983 DR. HAN: According to what hemodynamic principle... 72 00:03:03,016 --> 00:03:04,184 Dr. Browne? 73 00:03:04,218 --> 00:03:06,454 Vascular impedance. Blood flow is driven 74 00:03:06,487 --> 00:03:07,821 by the force induced by the pressure gradient. 75 00:03:07,855 --> 00:03:09,423 And how do you calculate it? 76 00:03:09,457 --> 00:03:10,858 ** 77 00:03:10,891 --> 00:03:13,261 Uh. Um... 78 00:03:13,294 --> 00:03:14,728 I... I'd have to look it up. 79 00:03:16,730 --> 00:03:19,533 Eight times L.Nu. divided by Pi.R.4. 80 00:03:19,567 --> 00:03:21,702 Very good, Dr. Murphy. 81 00:03:21,735 --> 00:03:23,737 DR. HAN: That's also why this occluder won't work. 82 00:03:23,771 --> 00:03:25,773 It won't hold up against the huge pressure gradient 83 00:03:25,806 --> 00:03:27,941 in her heart. Is there a fix? 84 00:03:27,975 --> 00:03:29,610 DR. HAN: Long-term, I don't have one. 85 00:03:29,643 --> 00:03:32,346 Right now, I need umbilical tape and PE tubing. 86 00:03:32,380 --> 00:03:35,483 * I gotta get away from here 87 00:03:35,516 --> 00:03:38,218 * I'll never see the golden sunrise 88 00:03:38,252 --> 00:03:39,687 * Oh, I gotta get away from her... 89 00:03:39,720 --> 00:03:42,523 You're making a pulmonary artery band. 90 00:03:42,556 --> 00:03:43,724 That should buy us some time 91 00:03:43,757 --> 00:03:47,795 to come up with a plan before we lose this baby. 92 00:03:47,828 --> 00:03:49,162 * Oh, if I leave this place alive* 93 00:03:49,196 --> 00:03:50,864 ** 94 00:03:52,232 --> 00:03:53,301 (BEEPS) 95 00:03:53,334 --> 00:03:54,835 WOMAN ON P.A.: Lab technician to OR 6. 96 00:03:54,868 --> 00:03:56,337 Lab technician to OR 6. 97 00:03:56,370 --> 00:03:58,071 (DOOR OPENS) 98 00:03:59,340 --> 00:04:01,742 You canceled my hernia repair? 99 00:04:01,775 --> 00:04:04,412 With no advance notice. Sorry about that. 100 00:04:04,445 --> 00:04:05,846 But so great to meet you. 101 00:04:05,879 --> 00:04:07,080 Jackson Han. 102 00:04:07,114 --> 00:04:08,816 Neil Melendez. Oh, I know. 103 00:04:08,849 --> 00:04:09,883 You did great work 104 00:04:09,917 --> 00:04:11,184 on that piggyback heart transplant. 105 00:04:11,218 --> 00:04:12,553 Huh. 106 00:04:12,586 --> 00:04:14,822 I need a consult on Minesh Goyal. 107 00:04:14,855 --> 00:04:16,357 He's the founding CEO of a company... 108 00:04:16,390 --> 00:04:18,526 What's his diagnosis? He doesn't have one. 109 00:04:18,559 --> 00:04:21,595 He's here for a full physical, complete diagnostic workup. 110 00:04:21,629 --> 00:04:24,264 I have a long-standing Executive Wellness... 111 00:04:24,298 --> 00:04:26,934 I'm a surgeon, not an internist. 112 00:04:26,967 --> 00:04:28,902 I don't do preventative medicine. 113 00:04:28,936 --> 00:04:31,939 No matter how rich the patient is. 114 00:04:31,972 --> 00:04:34,575 You know what's great about rich patients? 115 00:04:34,608 --> 00:04:36,410 They allow us to treat poor patients. 116 00:04:37,778 --> 00:04:39,413 Also, I promised Minesh the very best. 117 00:04:39,447 --> 00:04:42,350 So, really, who else am I gonna get? 118 00:04:42,383 --> 00:04:43,451 (BEEPS) 119 00:04:43,484 --> 00:04:45,085 WOMAN ON P.A.: Dr. Johansen to pre-op. 120 00:04:45,118 --> 00:04:47,287 Dr. Johansen to pre-op. 121 00:04:47,321 --> 00:04:48,522 (VELCRO TEARS) 122 00:04:48,556 --> 00:04:50,157 BP's 110 over 70. 123 00:04:51,258 --> 00:04:53,761 Uh, Jackson... Dr. Han 124 00:04:53,794 --> 00:04:55,162 says great things about you. 125 00:04:56,997 --> 00:04:58,499 That's very kind. 126 00:04:59,667 --> 00:05:02,135 Normal EKG, optimal BMI, 127 00:05:02,169 --> 00:05:03,537 heart and lungs sound good. 128 00:05:03,571 --> 00:05:05,105 Any reason you're worried enough about your health 129 00:05:05,138 --> 00:05:07,307 to endure an entire day of tests? 130 00:05:07,341 --> 00:05:09,009 I'm not worried. 131 00:05:10,844 --> 00:05:12,880 Knowledge is power. 132 00:05:12,913 --> 00:05:14,982 Whenever I enter a new market, 133 00:05:15,015 --> 00:05:17,284 I learn everything I can about the landscape... 134 00:05:17,317 --> 00:05:20,120 Consumer needs, target market, competitors. 135 00:05:20,153 --> 00:05:21,589 You're aware your body isn't a business. 136 00:05:21,622 --> 00:05:23,457 (CHUCKLES) 137 00:05:23,491 --> 00:05:25,426 I know I sound like a rich lunatic 138 00:05:25,459 --> 00:05:28,295 with fantasies about controlling every aspect of my life. 139 00:05:29,963 --> 00:05:31,131 And I guess I kind of am. 140 00:05:35,135 --> 00:05:38,271 My dad was in good shape, too. 141 00:05:38,305 --> 00:05:40,107 Until he dropped dead on his daily jog. 142 00:05:42,776 --> 00:05:44,512 ** 143 00:05:47,815 --> 00:05:49,182 (INDISTINCT CONVERSATIONS) 144 00:05:49,216 --> 00:05:51,419 ** 145 00:05:51,452 --> 00:05:53,787 Hi. 146 00:05:53,821 --> 00:05:56,990 WOMAN ON P.A.: Dr. Markiel, please come to the mental health unit. 147 00:05:57,024 --> 00:06:00,794 Dr. Markiel, please come to the mental health unit. 148 00:06:00,828 --> 00:06:02,996 (CONVERSATIONS CONTINUE) 149 00:06:03,030 --> 00:06:04,632 (TELEPHONE RINGING) 150 00:06:07,034 --> 00:06:08,402 (EXHALES SHARPLY) 151 00:06:11,472 --> 00:06:12,706 Hi. 152 00:06:13,807 --> 00:06:16,376 Hi. I'm Larry Childs. 153 00:06:16,410 --> 00:06:18,145 I'd shake your hand, but, you know, 154 00:06:18,178 --> 00:06:19,613 no functioning immune system. 155 00:06:19,647 --> 00:06:20,814 (CHUCKLES) 156 00:06:20,848 --> 00:06:22,983 Aaron. Hi. Good to meet you. 157 00:06:23,016 --> 00:06:24,518 What flavor cancer do you have? 158 00:06:24,552 --> 00:06:26,153 (CHUCKLES) 159 00:06:26,186 --> 00:06:28,021 What flavor? Yeah. 160 00:06:28,055 --> 00:06:29,356 Glioma. 161 00:06:29,389 --> 00:06:30,991 Shut the front door. 162 00:06:31,024 --> 00:06:33,160 Brain or spine? 163 00:06:33,193 --> 00:06:34,862 Brain. Dude, 164 00:06:34,895 --> 00:06:36,063 we're tumor twins. 165 00:06:36,096 --> 00:06:38,999 Wh... What do they have you on? 166 00:06:39,032 --> 00:06:40,400 Ooh. Vincristine. 167 00:06:40,434 --> 00:06:41,669 I hear that's intense. 168 00:06:41,702 --> 00:06:43,671 My doc thought it would wipe me out. 169 00:06:43,704 --> 00:06:45,873 You doing okay or longing for death? 170 00:06:45,906 --> 00:06:48,542 I am hanging in there. Thank you. 171 00:06:48,576 --> 00:06:51,278 I'm on my third round of temozolomide. 172 00:07:01,755 --> 00:07:03,423 I've seen you in here a few times. 173 00:07:06,093 --> 00:07:07,327 I've seen you in here a few times. 174 00:07:07,360 --> 00:07:08,929 You kind of keep to yourself, huh? 175 00:07:10,397 --> 00:07:11,699 Yeah. 176 00:07:11,732 --> 00:07:13,400 Well, I'm happy to introduce you around. 177 00:07:13,433 --> 00:07:14,502 It's a really friendly group. 178 00:07:14,535 --> 00:07:15,669 I'm okay. Thank you. 179 00:07:15,703 --> 00:07:16,970 You have a support group you go to? 180 00:07:18,205 --> 00:07:19,239 I do not. 181 00:07:20,574 --> 00:07:22,442 Everyone needs a cancer community. 182 00:07:27,447 --> 00:07:30,183 (PAPER RUSTLES) 183 00:07:30,217 --> 00:07:32,285 ** 184 00:07:34,454 --> 00:07:36,456 ** 185 00:07:43,897 --> 00:07:46,066 ** 186 00:07:50,003 --> 00:07:52,172 ** 187 00:07:55,943 --> 00:07:57,611 And try to hold still. (CLICKS) 188 00:07:58,746 --> 00:07:59,747 Thank you. 189 00:08:00,948 --> 00:08:02,115 For bringing us in. 190 00:08:02,149 --> 00:08:04,818 This is the new Chief's patient. It's a great opportunity. 191 00:08:04,852 --> 00:08:07,154 Or it's a bunch of pointless tests. 192 00:08:07,187 --> 00:08:08,255 (SIGHS) 193 00:08:09,289 --> 00:08:11,792 Uh, for which I thank you. 194 00:08:11,825 --> 00:08:13,160 Tell us about Dr. Han. 195 00:08:13,193 --> 00:08:15,763 He's direct, charming, 196 00:08:15,796 --> 00:08:17,064 very sure of himself. 197 00:08:17,097 --> 00:08:18,098 Big ego. 198 00:08:22,970 --> 00:08:26,106 There's nothing wrong with an ego if you can back it up. 199 00:08:26,139 --> 00:08:28,008 And Dr. Han's arterial switch technique 200 00:08:28,041 --> 00:08:30,143 is performed all over the world. 201 00:08:30,177 --> 00:08:32,145 DR. PARK: The tests aren't all pointless. 202 00:08:32,179 --> 00:08:33,614 Way to stand firm, Park. 203 00:08:33,647 --> 00:08:35,248 No, look at the monitor. 204 00:08:35,282 --> 00:08:36,316 He has a tumor. 205 00:08:36,349 --> 00:08:38,351 ** 206 00:08:42,155 --> 00:08:43,523 (SIGHS) 207 00:08:43,557 --> 00:08:46,493 (MONITOR BEEPING) 208 00:08:46,526 --> 00:08:48,996 ** 209 00:08:54,702 --> 00:08:56,970 ** 210 00:09:02,242 --> 00:09:03,877 NIGEL: Percy's stable? 211 00:09:03,911 --> 00:09:06,814 We're naming her Persephone. 212 00:09:06,847 --> 00:09:10,350 Yes. I put in a central line for nutrition. 213 00:09:10,383 --> 00:09:11,819 Percy is stable right now. 214 00:09:11,852 --> 00:09:14,722 We're looking for solutions to her problems. 215 00:09:14,755 --> 00:09:17,157 (STAMMERS) Why does... 216 00:09:17,190 --> 00:09:19,392 Why does she have all these birth defects? 217 00:09:19,426 --> 00:09:21,494 Diane. 218 00:09:21,528 --> 00:09:23,063 We spoke to our obstetrician. 219 00:09:23,096 --> 00:09:25,165 She said these defects can happen for no reason, right? 220 00:09:27,100 --> 00:09:28,335 That's true. 221 00:09:28,368 --> 00:09:30,904 Over 50% have no known cause. 222 00:09:33,406 --> 00:09:37,811 I was taking paroxetine for clinical depression. 223 00:09:37,845 --> 00:09:39,146 And you went off the meds 224 00:09:39,179 --> 00:09:40,848 as soon as you found out you were pregnant. 225 00:09:40,881 --> 00:09:43,383 She was five, six weeks at most. 226 00:09:43,416 --> 00:09:44,985 My OB told me studies show 227 00:09:45,018 --> 00:09:47,554 antidepressants are safe to take during pregnancy. 228 00:09:47,587 --> 00:09:48,922 But is that true, 229 00:09:48,956 --> 00:09:50,590 or is she protecting me? 230 00:09:53,193 --> 00:09:56,196 There was a study that associated paroxetine 231 00:09:56,229 --> 00:09:57,731 with these kinds of defects. 232 00:09:57,765 --> 00:10:00,200 It is a possibility. 233 00:10:00,233 --> 00:10:01,434 (EXHALES SHARPLY) 234 00:10:01,468 --> 00:10:03,637 ** 235 00:10:12,079 --> 00:10:14,114 You can't tell whether it's cancerous or benign? 236 00:10:14,147 --> 00:10:15,783 Not until we do the biopsy, 237 00:10:15,816 --> 00:10:17,651 which I've scheduled for later. 238 00:10:17,685 --> 00:10:19,119 We'll know what's going on by the morning. 239 00:10:19,152 --> 00:10:21,021 ** 240 00:10:21,054 --> 00:10:22,355 Good. 241 00:10:22,389 --> 00:10:23,691 That's good. 242 00:10:23,724 --> 00:10:26,626 ** 243 00:10:26,660 --> 00:10:29,029 Maybe you'd like to call someone? 244 00:10:29,062 --> 00:10:31,231 A family member, a friend? 245 00:10:31,264 --> 00:10:33,233 I'll worry when I know it's cancer. 246 00:10:33,266 --> 00:10:35,335 ** 247 00:10:42,810 --> 00:10:45,645 We could use a transcatheter route 248 00:10:45,679 --> 00:10:48,916 and patch each hole individually. 249 00:10:48,949 --> 00:10:50,317 Her heart's the size of a walnut. 250 00:10:50,350 --> 00:10:52,886 It's too small to maneuver inside. 251 00:10:52,920 --> 00:10:55,255 A single large patch to close the holes 252 00:10:55,288 --> 00:10:56,323 would withstand the pressure. 253 00:10:56,356 --> 00:10:57,791 Yes. 254 00:10:59,592 --> 00:11:02,262 It would also block electrical conduction, 255 00:11:02,295 --> 00:11:04,331 causing deadly arrhythmias. 256 00:11:04,364 --> 00:11:07,100 Dr. Murphy, 257 00:11:07,134 --> 00:11:10,103 did you tell the mom that she caused her baby's birth defect? 258 00:11:10,137 --> 00:11:13,941 No. I said that her antidepressants could have. 259 00:11:15,375 --> 00:11:16,910 Why did you tell her that? 260 00:11:16,944 --> 00:11:19,446 It's the truth. 261 00:11:19,479 --> 00:11:21,949 And is that relevant to her current medical situation? 262 00:11:23,016 --> 00:11:24,317 No. 263 00:11:26,319 --> 00:11:29,356 And how did you think that answer would make her feel? 264 00:11:29,389 --> 00:11:31,024 What did you think would happen? 265 00:11:31,058 --> 00:11:32,926 ** 266 00:11:32,960 --> 00:11:35,128 The mother is devastated. 267 00:11:35,162 --> 00:11:36,629 The father is furious. 268 00:11:36,663 --> 00:11:38,131 I would be, too. 269 00:11:38,165 --> 00:11:39,933 DR. LIM: Shaun is a resident. 270 00:11:39,967 --> 00:11:41,401 Residents make mistakes. 271 00:11:42,669 --> 00:11:44,671 Managing these parents' emotional concerns 272 00:11:44,704 --> 00:11:47,440 is as much a part of this job as operating on their daughter. 273 00:11:47,474 --> 00:11:49,910 (SIGHS) Social cues are hard for Shaun, 274 00:11:49,943 --> 00:11:51,444 but we've been working with him... 275 00:11:51,478 --> 00:11:53,280 You should be focused on your own shortcomings, 276 00:11:53,313 --> 00:11:56,549 like retaining the formula for vascular impedance. 277 00:11:56,583 --> 00:11:57,885 SHAUN: Dr. Han. 278 00:11:57,918 --> 00:12:00,854 ** 279 00:12:00,888 --> 00:12:03,490 We could patch each individual hole in the heart 280 00:12:03,523 --> 00:12:05,392 if we cut open the ventricle... 281 00:12:05,425 --> 00:12:06,994 Don't change the subject, Dr. Murphy. 282 00:12:07,027 --> 00:12:08,796 I didn't, Dr. Han. 283 00:12:08,829 --> 00:12:10,998 We were talking about the baby. 284 00:12:11,031 --> 00:12:12,032 Really? 285 00:12:13,400 --> 00:12:15,702 You don't see a difference in the nature of your discussion 286 00:12:15,735 --> 00:12:17,404 before I arrived and after? 287 00:12:19,239 --> 00:12:22,876 We were talking about the baby. 288 00:12:22,910 --> 00:12:24,878 ** 289 00:12:28,548 --> 00:12:31,318 They tried the approach you suggested at L.A. Children's. 290 00:12:31,351 --> 00:12:32,886 The baby died a week later. 291 00:12:32,920 --> 00:12:35,455 The suture line didn't hold, and the cardiac wall ruptured. 292 00:12:36,389 --> 00:12:37,424 Keep looking. 293 00:12:37,457 --> 00:12:39,960 Dr. Murphy, 294 00:12:39,993 --> 00:12:41,895 do not talk with those parents again. 295 00:12:46,233 --> 00:12:47,467 I'll walk with you. 296 00:12:51,104 --> 00:12:52,973 DR. LIM: You're pretty tough on my residents. 297 00:12:53,006 --> 00:12:54,274 Rebuking them in public, 298 00:12:54,307 --> 00:12:56,877 pimping them with questions during surgery. 299 00:12:56,910 --> 00:12:58,545 Shame-based learning isn't my style. 300 00:12:58,578 --> 00:13:00,613 I'll bear that in mind. 301 00:13:00,647 --> 00:13:02,715 But this isn't about my treatment of "the residents." 302 00:13:02,749 --> 00:13:04,251 You're concerned about Dr. Murphy. 303 00:13:04,284 --> 00:13:06,686 Well, a lot of doctors have less than ideal bedside manner. 304 00:13:06,719 --> 00:13:08,455 He's young... Would you ever have said 305 00:13:08,488 --> 00:13:10,590 something like that to a patient as a resident? 306 00:13:10,623 --> 00:13:12,059 As a med student? 307 00:13:12,092 --> 00:13:13,226 And Murphy doesn't even understand 308 00:13:13,260 --> 00:13:14,727 he did anything wrong. 309 00:13:14,761 --> 00:13:16,063 Shaun has hard-wired differences 310 00:13:16,096 --> 00:13:18,465 in the way he perceives things. Exactly. 311 00:13:18,498 --> 00:13:19,732 No matter how hard he works, 312 00:13:19,766 --> 00:13:22,435 no matter how hard you try and help him, 313 00:13:22,469 --> 00:13:24,905 his limitations are not going to change. 314 00:13:24,938 --> 00:13:28,241 He's going to continue to inflict them on our patients, 315 00:13:28,275 --> 00:13:30,911 all in the name of diversity and inclusion. 316 00:13:33,480 --> 00:13:34,915 Shaun deserves to be here. 317 00:13:36,516 --> 00:13:39,419 Once you see what he's capable of, you'll agree. 318 00:13:39,452 --> 00:13:40,620 I look forward to being proven wrong. 319 00:13:40,653 --> 00:13:41,688 (ELEVATOR BELL DINGS) 320 00:13:41,721 --> 00:13:44,191 (ELEVATOR DOORS OPEN) 321 00:13:46,493 --> 00:13:48,661 Stay seated for 20 minutes. 322 00:13:48,695 --> 00:13:49,762 Don't want you passing out in the lobby. 323 00:13:49,796 --> 00:13:51,664 I know, I know. Thank you. 324 00:13:57,137 --> 00:13:58,838 This disease changed my relationships, 325 00:13:58,872 --> 00:14:01,441 changed my priorities, changed, 326 00:14:01,474 --> 00:14:02,876 who I am. 327 00:14:02,910 --> 00:14:04,011 Cancer is an identity. 328 00:14:04,044 --> 00:14:06,513 Cancer is a cellular mutation. 329 00:14:06,546 --> 00:14:08,681 The people in this room are my people. 330 00:14:08,715 --> 00:14:11,818 What are you, 20 years old? I'm triple your age. 331 00:14:11,851 --> 00:14:13,186 I don't think you're my "people." 332 00:14:13,220 --> 00:14:15,122 The last time I hung out with my law-school friends, 333 00:14:15,155 --> 00:14:17,958 epic fail. The fact that you use the phrase "epic fail," 334 00:14:17,991 --> 00:14:19,192 kind of case in point. 335 00:14:19,226 --> 00:14:21,061 They're all focused on what firm they're gonna land at, 336 00:14:21,094 --> 00:14:23,596 and I'm all about whether 337 00:14:23,630 --> 00:14:25,298 Candice's leukemia is responding 338 00:14:25,332 --> 00:14:27,167 to her new chemo regimen. 339 00:14:27,200 --> 00:14:28,635 By the way, she has this peppermint oil 340 00:14:28,668 --> 00:14:29,802 that is great for headaches. 341 00:14:34,707 --> 00:14:36,609 Ooh, I know that look. 342 00:14:36,643 --> 00:14:38,011 Here, here. 343 00:14:38,711 --> 00:14:40,147 (VOMITING) 344 00:14:40,180 --> 00:14:42,415 (COUGHING) 345 00:14:43,483 --> 00:14:45,618 Got you, brother, 346 00:14:45,652 --> 00:14:46,954 whether you like it or not. 347 00:14:46,987 --> 00:14:48,421 (CHUCKLES) 348 00:14:50,958 --> 00:14:53,060 Show me where we are. 349 00:14:53,093 --> 00:14:55,562 That angle runs pretty close to the sacral nerve roots. 350 00:14:57,364 --> 00:14:58,798 How are we doing? 351 00:14:58,831 --> 00:15:00,300 DR. MELENDEZ: Tumor's abutting the iliac artery. 352 00:15:00,333 --> 00:15:02,102 I'm trying not to disrupt the entire blood supply 353 00:15:02,135 --> 00:15:03,503 to his lower body. 354 00:15:03,536 --> 00:15:05,138 Dr. Han, I'm Morgan Reznick. 355 00:15:05,172 --> 00:15:07,507 I really enjoyed your article on Myotomy 356 00:15:07,540 --> 00:15:11,244 for infantile hypertrophic pyloric stenosis. 357 00:15:11,278 --> 00:15:14,181 I appreciate the thorough research behind your sucking up. 358 00:15:14,214 --> 00:15:15,915 And you are? 359 00:15:15,949 --> 00:15:17,517 Alex Park. 360 00:15:17,550 --> 00:15:20,153 Park... You were a cop. 361 00:15:20,187 --> 00:15:22,289 Medicine as a second career, good stuff. 362 00:15:22,322 --> 00:15:24,191 Tends to bring a fresh perspective. 363 00:15:26,159 --> 00:15:27,694 (ALARM BEEPING RAPIDLY) 364 00:15:27,727 --> 00:15:29,829 I hit an artery. Take the needle. 365 00:15:29,862 --> 00:15:31,031 Blood's pooling in the pelvis. 366 00:15:31,064 --> 00:15:32,599 DR. PARK: Should we open him up? No. 367 00:15:32,632 --> 00:15:34,501 Prep the femoral artery. Get me an art cath set. 368 00:15:34,534 --> 00:15:36,236 DR. PARK: Pressure's dropping. Platinum coil. 369 00:15:36,269 --> 00:15:38,805 (BEEPING CONTINUES) 370 00:15:43,276 --> 00:15:46,113 (BEEPING STOPS) Nice save. 371 00:15:46,146 --> 00:15:47,314 Next time, don't hit the vessel. 372 00:15:49,549 --> 00:15:51,451 There is no next time. 373 00:15:51,484 --> 00:15:53,053 The biopsy's too dangerous. 374 00:15:56,823 --> 00:15:59,159 (SIGHS) 375 00:15:59,192 --> 00:16:02,462 DR. MELENDEZ: It is likely that it's a benign notochord cell tumor. 376 00:16:02,495 --> 00:16:04,031 They look like chordomas, 377 00:16:04,064 --> 00:16:05,565 but they're harmless and way more common. 378 00:16:05,598 --> 00:16:06,966 But you don't know. 379 00:16:07,000 --> 00:16:08,835 Since we can't do the biopsy, no. 380 00:16:09,902 --> 00:16:11,604 This is the problem with broad testing. 381 00:16:13,073 --> 00:16:14,474 Everyone has abnormalities. 382 00:16:14,507 --> 00:16:15,908 Most of them are nothing. 383 00:16:15,942 --> 00:16:17,744 But when we do find them, 384 00:16:17,777 --> 00:16:19,346 we have to make some tough choices. 385 00:16:21,014 --> 00:16:23,816 So, what exactly is my tough choice? 386 00:16:25,485 --> 00:16:27,254 We could remove the tumor. 387 00:16:27,287 --> 00:16:29,056 This is a very risky surgery. 388 00:16:29,089 --> 00:16:31,058 There's a chance of paralysis or worse, 389 00:16:31,091 --> 00:16:33,493 you may not make it off the table. 390 00:16:33,526 --> 00:16:35,562 Or you do nothing. 391 00:16:35,595 --> 00:16:36,996 We'd continue to monitor it, 392 00:16:37,030 --> 00:16:38,798 do imaging every few weeks. 393 00:16:38,831 --> 00:16:40,567 But chordomas move very quickly. 394 00:16:40,600 --> 00:16:42,802 By the time any change showed up on imaging, 395 00:16:42,835 --> 00:16:44,971 it's most likely metastasized throughout your body. 396 00:16:47,307 --> 00:16:50,643 So it probably isn't cancer, 397 00:16:50,677 --> 00:16:54,081 but if it is and I wait, then I'll die. 398 00:16:54,114 --> 00:16:55,648 That's true. 399 00:16:55,682 --> 00:16:59,519 And if I don't wait and I get the surgery, 400 00:16:59,552 --> 00:17:01,254 then there's a good chance I'll die. 401 00:17:01,288 --> 00:17:02,389 Yes. 402 00:17:08,228 --> 00:17:10,430 I'm gonna need to think this over. 403 00:17:10,463 --> 00:17:12,699 ** 404 00:17:18,205 --> 00:17:20,807 ** 405 00:17:25,512 --> 00:17:29,382 This is the May Annals of Neonatal Surgery. 406 00:17:29,416 --> 00:17:32,652 I just finished March. I need to read April now. 407 00:17:32,685 --> 00:17:34,221 DR. LIM: Oh, I have April, Shaun. 408 00:17:34,254 --> 00:17:35,955 No. 409 00:17:35,988 --> 00:17:37,757 No, you're supposed to be reading 410 00:17:37,790 --> 00:17:40,227 New Approaches in Neonatal Surgery. 411 00:17:40,260 --> 00:17:42,595 Claire has the British Journal of Neonatology... 412 00:17:51,404 --> 00:17:53,506 Shaun... 413 00:17:53,540 --> 00:17:56,676 I think maybe you should be quiet around Han 414 00:17:56,709 --> 00:17:59,346 for a little while. 415 00:17:59,379 --> 00:18:01,748 But then how will I answer his questions? 416 00:18:03,716 --> 00:18:06,419 Direct questions, absolutely answer. 417 00:18:06,453 --> 00:18:08,755 Otherwise, outside of the OR, 418 00:18:08,788 --> 00:18:10,257 you should stay out of his way. 419 00:18:13,426 --> 00:18:15,895 If someone had convinced Shaun to do that with Dr. Melendez, 420 00:18:15,928 --> 00:18:18,131 he would still be on suction. 421 00:18:20,633 --> 00:18:22,101 (BEEP) 422 00:18:22,135 --> 00:18:24,171 MAN ON P.A.: Code blue. NICU, Bed 4. 423 00:18:24,204 --> 00:18:26,939 Code blue. NICU, Bed 4. 424 00:18:26,973 --> 00:18:28,441 (DOOR OPENS) 425 00:18:28,475 --> 00:18:29,942 (ALARM BEEPING RAPIDLY) 426 00:18:29,976 --> 00:18:32,545 O2 SATs dropped and central venous pressure shot up. 427 00:18:32,579 --> 00:18:34,080 The Pulmonary Artery Band is failing. 428 00:18:34,113 --> 00:18:36,383 Eight of dopamine. Let's get a mask on her. 429 00:18:36,416 --> 00:18:38,285 DR. HAN: She won't last much longer. We need other options. 430 00:18:38,318 --> 00:18:39,986 I'll update the parents. 431 00:18:40,019 --> 00:18:41,788 (BEEPING CONTINUES) 432 00:18:41,821 --> 00:18:43,223 DR. LIM: Let's get her on full cardiac support. 433 00:18:43,256 --> 00:18:45,392 ** 434 00:18:45,425 --> 00:18:47,760 (MACHINE BEEPING) 435 00:18:47,794 --> 00:18:49,762 (RESPIRATOR HISSING) 436 00:18:49,796 --> 00:18:51,931 ** 437 00:18:59,005 --> 00:19:01,374 What have you got? Anything? 438 00:19:01,408 --> 00:19:02,975 This Cleveland group 439 00:19:03,009 --> 00:19:05,512 repaired a bowel protrusion using enterolysis. 440 00:19:05,545 --> 00:19:07,947 I could cut out this excess inflammatory tissue 441 00:19:07,980 --> 00:19:09,749 and segment of bowel atresia. 442 00:19:09,782 --> 00:19:11,751 Might make her intestines small enough to fit. 443 00:19:11,784 --> 00:19:12,819 Promising. 444 00:19:12,852 --> 00:19:14,454 Given the size of her abdomen, 445 00:19:14,487 --> 00:19:15,922 I need to remove a lot of bowel. 446 00:19:15,955 --> 00:19:18,325 There's a good chance she wouldn't be able to absorb food. 447 00:19:18,358 --> 00:19:20,293 We'll have to find the right balance. 448 00:19:20,327 --> 00:19:22,262 It's our only workable plan. 449 00:19:22,295 --> 00:19:24,197 Best bet on the heart is to cut through the ventricle, 450 00:19:24,231 --> 00:19:25,965 like Murphy suggested. 451 00:19:25,998 --> 00:19:28,801 Uh, you were concerned about the suture line holding. 452 00:19:28,835 --> 00:19:30,570 Well, I still am. 453 00:19:30,603 --> 00:19:32,905 Hopefully, horizontal mattress sutures will work. 454 00:19:32,939 --> 00:19:34,040 They should be able to withstand the tension 455 00:19:34,073 --> 00:19:35,675 at the suture line. 456 00:19:35,708 --> 00:19:37,810 (FADING) There's still a risk of an aneurysm forming 457 00:19:37,844 --> 00:19:39,846 in the tissue underneath. 458 00:19:39,879 --> 00:19:42,782 (INDISTINCT TALKING) 459 00:19:42,815 --> 00:19:44,751 Dr. Lim? 460 00:19:44,784 --> 00:19:46,986 I have an idea I'd like to share, 461 00:19:47,019 --> 00:19:49,622 even though Dr. Han didn't ask me a question. 462 00:19:53,993 --> 00:19:56,028 Yeah, go ahead, Shaun. 463 00:19:56,062 --> 00:19:58,130 If we go in through the atrium, 464 00:19:58,164 --> 00:19:59,532 we wouldn't have to worry about the suture line... 465 00:19:59,566 --> 00:20:01,701 It's the same issue we discussed. 466 00:20:01,734 --> 00:20:03,703 There's not enough room inside the baby's heart 467 00:20:03,736 --> 00:20:05,104 to stitch the patches in the place. 468 00:20:05,137 --> 00:20:07,707 Oh, we don't need to, Dr. Han. 469 00:20:07,740 --> 00:20:10,076 We can make a plug small enough for her heart, 470 00:20:10,109 --> 00:20:12,612 a PTFE disc with a stem like a mushroom. 471 00:20:12,645 --> 00:20:14,347 Then we can insert the stem through one of the holes 472 00:20:14,381 --> 00:20:15,882 until the disc presses against the wall, 473 00:20:15,915 --> 00:20:18,551 covering all the holes. 474 00:20:18,585 --> 00:20:21,988 L-Like a stopper in a bathtub. 475 00:20:22,021 --> 00:20:23,556 Yes. 476 00:20:23,590 --> 00:20:25,392 The higher pressure on the left side of her heart 477 00:20:25,425 --> 00:20:26,993 would keep it in place. 478 00:20:27,026 --> 00:20:28,695 We wouldn't even need to stitch. 479 00:20:30,397 --> 00:20:32,299 Great idea. 480 00:20:32,332 --> 00:20:33,933 We should take this to the parents. 481 00:20:33,966 --> 00:20:35,968 Great idea for the heart. 482 00:20:36,002 --> 00:20:38,405 But we need to tell them that our current plan 483 00:20:38,438 --> 00:20:39,539 for the abdominal repair 484 00:20:39,572 --> 00:20:42,008 is considerably more of a long shot. 485 00:20:42,041 --> 00:20:45,312 And that fixing the heart takes an option off the table. 486 00:20:45,345 --> 00:20:46,913 Withdrawing care. 487 00:20:56,689 --> 00:20:58,758 LARRY: You can't move that card. 488 00:20:58,791 --> 00:21:00,360 Excuse me? 489 00:21:00,393 --> 00:21:01,594 Who cheats at solitaire? 490 00:21:01,628 --> 00:21:03,162 You're literally only cheating yourself. 491 00:21:03,195 --> 00:21:04,364 Again. 492 00:21:04,397 --> 00:21:05,798 Good morning, Larry. 493 00:21:05,832 --> 00:21:07,867 Is it a macho thing? 494 00:21:07,900 --> 00:21:09,569 Like a real man should be able to make it through 495 00:21:09,602 --> 00:21:11,738 without leaning on a label or the people who go with it? 496 00:21:14,106 --> 00:21:16,275 Embracing cancer as an identity 497 00:21:16,309 --> 00:21:18,378 is the last thing any one of us should be doing. 498 00:21:18,411 --> 00:21:21,381 It underscores everything horrible right now. 499 00:21:22,482 --> 00:21:24,384 We're in a daily battle for our lives. 500 00:21:24,417 --> 00:21:26,419 I see no value in dwelling on that. 501 00:21:30,890 --> 00:21:32,325 Candice is late. 502 00:21:33,960 --> 00:21:36,128 Which means either her niece forgot to pick her up. 503 00:21:36,162 --> 00:21:38,931 Again. 504 00:21:38,965 --> 00:21:41,368 Or she got some bad news. 505 00:21:41,401 --> 00:21:42,735 Or she's already dead. 506 00:21:45,538 --> 00:21:48,007 (OBJECT THUDS, BAG ZIPS) We are in a daily battle. 507 00:21:51,143 --> 00:21:53,546 I'd rather have some company. 508 00:21:53,580 --> 00:21:55,682 ** 509 00:22:01,087 --> 00:22:03,289 ** 510 00:22:09,295 --> 00:22:11,364 I spoke to my mother and brother, 511 00:22:11,398 --> 00:22:14,467 and they both think I shouldn't do the surgery. 512 00:22:14,501 --> 00:22:16,403 Apparently, they're more scared of your surgical skills 513 00:22:16,436 --> 00:22:18,805 than they are of this tumor. 514 00:22:18,838 --> 00:22:20,507 And where do you stand? 515 00:22:20,540 --> 00:22:22,442 I need numbers. 516 00:22:23,109 --> 00:22:24,444 Please. 517 00:22:24,477 --> 00:22:26,546 ** 518 00:22:28,080 --> 00:22:31,584 The stats on something like this, it... 519 00:22:31,618 --> 00:22:32,885 There are a lot of variables. 520 00:22:32,919 --> 00:22:34,754 What are the odds I make it through the surgery 521 00:22:34,787 --> 00:22:37,924 without any complications? 522 00:22:37,957 --> 00:22:39,892 It's a challenging procedure. 523 00:22:39,926 --> 00:22:42,729 Zero complications, I'd say 80%. 524 00:22:44,330 --> 00:22:47,266 But it is very unlikely this tumor is malignant. 525 00:22:47,299 --> 00:22:49,569 Give me a number. 526 00:22:49,602 --> 00:22:52,171 About 5% chance it's a chordoma. 527 00:22:59,912 --> 00:23:01,948 The numbers agree with your family. 528 00:23:01,981 --> 00:23:03,349 So do I. 529 00:23:07,720 --> 00:23:09,856 (BREATHES DEEPLY) 530 00:23:12,425 --> 00:23:13,893 I've always been more comfortable with action 531 00:23:13,926 --> 00:23:15,394 than inaction. 532 00:23:18,931 --> 00:23:21,200 I want you to do the surgery. 533 00:23:23,703 --> 00:23:24,871 (BREATHES DEEPLY) 534 00:23:24,904 --> 00:23:27,173 Certainty comes at a price. 535 00:23:27,206 --> 00:23:29,241 ** 536 00:23:35,548 --> 00:23:38,317 DIANE: She'll be able to get off the life support machines? 537 00:23:38,350 --> 00:23:40,152 DR. HAN: If everything goes well, yes. 538 00:23:40,186 --> 00:23:41,788 She'll have a strong heart. 539 00:23:41,821 --> 00:23:43,189 How soon can you do it? 540 00:23:45,424 --> 00:23:46,993 You should know we feel less confident 541 00:23:47,026 --> 00:23:49,762 about our plan for her bowel. 542 00:23:49,796 --> 00:23:52,031 The chance of failure is quite high. 543 00:23:52,064 --> 00:23:53,600 How high? 544 00:23:53,633 --> 00:23:56,836 DR. LIM: I put it at 90% that the repair won't work. 545 00:23:56,869 --> 00:23:59,939 Which would lead to irreversible malnutrition. 546 00:23:59,972 --> 00:24:03,776 Your daughter would slowly starve to death over months. 547 00:24:03,810 --> 00:24:06,012 Right now, her body is working very hard 548 00:24:06,045 --> 00:24:07,279 just to stay alive. 549 00:24:07,313 --> 00:24:09,582 ** 550 00:24:10,550 --> 00:24:12,619 If we were to turn off the machines... 551 00:24:12,652 --> 00:24:15,087 Turn off the machines? 552 00:24:15,121 --> 00:24:17,557 ** 553 00:24:17,590 --> 00:24:20,459 ...she would pass quickly. And peacefully. 554 00:24:21,260 --> 00:24:23,630 If the heart surgery is a success, 555 00:24:23,663 --> 00:24:25,532 that won't be an option. 556 00:24:25,565 --> 00:24:27,567 Oh. (BREATHES DEEPLY) 557 00:24:27,600 --> 00:24:29,569 Why not try to fix the bowel first 558 00:24:29,602 --> 00:24:30,803 to see if it works? 559 00:24:30,837 --> 00:24:32,572 We won't know if the bowel is viable 560 00:24:32,605 --> 00:24:34,006 until after the heart is. 561 00:24:35,441 --> 00:24:38,110 We have to do the surgery. 562 00:24:38,144 --> 00:24:40,479 But if this doesn't work, she could starve to death. 563 00:24:40,513 --> 00:24:43,382 It's worth the risk... It's not our risk. It's hers. 564 00:24:43,415 --> 00:24:46,819 So, instead, you're ready to give up on our daughter? 565 00:24:46,853 --> 00:24:49,556 I mean, it's like we're right back at the ultrasound. 566 00:24:49,589 --> 00:24:51,824 We decided together to continue this pregnancy. 567 00:24:51,858 --> 00:24:53,726 So this is as much my fault as it is yours. 568 00:24:53,760 --> 00:24:55,227 My fault? 569 00:24:55,261 --> 00:24:56,796 Because of the medication? 570 00:24:59,031 --> 00:25:01,801 I cannot turn off that machine. 571 00:25:03,102 --> 00:25:05,838 Your guilt is stopping you from admitting what we need to do. 572 00:25:05,872 --> 00:25:08,608 My guilt has nothing to do with this. 573 00:25:08,641 --> 00:25:11,477 I am fighting for my daughter. So am I. 574 00:25:13,780 --> 00:25:15,815 Since the parents can't agree, the decision 575 00:25:15,848 --> 00:25:18,350 about the baby's care will be made by a judge 576 00:25:18,384 --> 00:25:20,452 who will rely on our recommendation. 577 00:25:21,153 --> 00:25:22,689 So we make the choice, 578 00:25:22,722 --> 00:25:23,956 but the parents live with it? 579 00:25:26,292 --> 00:25:27,960 Well, maybe that's a good thing. 580 00:25:30,229 --> 00:25:32,031 For parents to have to decide between 581 00:25:32,064 --> 00:25:33,700 letting their daughter die 582 00:25:33,733 --> 00:25:37,369 or fighting for her life, knowing she may suffer horribly, 583 00:25:37,403 --> 00:25:39,305 maybe it's better if we carry that burden. 584 00:25:42,742 --> 00:25:44,210 Dr. Lim? 585 00:25:44,243 --> 00:25:45,645 Your decision would be? 586 00:25:47,246 --> 00:25:49,115 Take her off life support. 587 00:25:49,148 --> 00:25:51,317 The odds are stacked against the bowel repair working. 588 00:25:51,350 --> 00:25:54,120 Those numbers reflect the general population of doctors. 589 00:25:54,153 --> 00:25:56,555 I think Dr. Lim and I are better than that. 590 00:25:56,589 --> 00:25:58,557 We can beat the odds. 591 00:26:06,232 --> 00:26:07,834 One of the things I'm not going to miss 592 00:26:07,867 --> 00:26:09,969 about being Chief of Surgery 593 00:26:10,002 --> 00:26:12,271 is being responsible for choices like this. 594 00:26:15,507 --> 00:26:17,677 Dr. Han, it's your department, 595 00:26:17,710 --> 00:26:19,278 it's your call. 596 00:26:25,551 --> 00:26:26,853 (INDISTINCT CONVERSATIONS) 597 00:26:26,886 --> 00:26:28,220 DR. GLASSMAN: You've been here all night? 598 00:26:28,988 --> 00:26:30,723 I've been working on a case 599 00:26:30,757 --> 00:26:33,660 with the new Chief of Surgery, Dr. Han. 600 00:26:33,693 --> 00:26:35,928 How's that going? Not very well. 601 00:26:35,962 --> 00:26:37,764 He plays music in the operating room. 602 00:26:37,797 --> 00:26:39,031 Oh, geez. One of those. 603 00:26:39,065 --> 00:26:40,332 And he says I need to focus on 604 00:26:40,366 --> 00:26:41,968 our patients' emotional needs. 605 00:26:43,135 --> 00:26:45,037 Well, that's a tough assignment for you. 606 00:26:45,938 --> 00:26:47,273 Mmm. 607 00:26:51,711 --> 00:26:55,414 You ever wish you had, you know, 608 00:26:55,447 --> 00:26:57,717 friends, co-workers on the spectrum? 609 00:26:58,584 --> 00:27:00,352 Not usually. 610 00:27:00,386 --> 00:27:02,955 But maybe Dr. Han wouldn't notice me as much 611 00:27:02,989 --> 00:27:05,224 if I weren't the only doctor with ASD. 612 00:27:08,627 --> 00:27:10,697 There's this kid in chemo, 613 00:27:10,730 --> 00:27:13,399 just... (CHUCKLES) obsessed with having cancer. 614 00:27:13,432 --> 00:27:14,767 It's all he talks about. 615 00:27:14,801 --> 00:27:16,703 He wants to be friends with everybody in the ward. 616 00:27:16,736 --> 00:27:18,104 That's very smart of him. 617 00:27:18,137 --> 00:27:20,940 Speigel et al. showed an increase in overall survival 618 00:27:20,973 --> 00:27:23,409 and quality of life measures in breast cancer patients 619 00:27:23,442 --> 00:27:26,245 who formed social bonds with others battling the disease. 620 00:27:27,513 --> 00:27:29,281 What should I do about Dr. Han? 621 00:27:32,151 --> 00:27:34,653 (EXHALES DEEPLY) I don't know. Um... 622 00:27:34,687 --> 00:27:36,488 Just do your work, 623 00:27:36,522 --> 00:27:39,091 be a good surgeon, be an excellent surgeon. 624 00:27:39,125 --> 00:27:41,127 Over time, he'll forget about the autism. 625 00:27:41,160 --> 00:27:42,628 Why would that happen? 626 00:27:42,661 --> 00:27:45,497 He'll see that you have the skill, you have dedication. 627 00:27:45,531 --> 00:27:47,666 I have autism. 628 00:27:47,700 --> 00:27:49,601 It's part of who I am. 629 00:27:50,369 --> 00:27:52,138 (CONVERSATIONS CONTINUE) 630 00:27:56,542 --> 00:28:00,079 (RESPIRATOR HISSING) (MONITOR BEEPING) 631 00:28:00,112 --> 00:28:01,680 The judge...? 632 00:28:01,714 --> 00:28:03,582 Accepted our recommendation 633 00:28:03,615 --> 00:28:05,151 and ruled in favor of surgery. 634 00:28:05,785 --> 00:28:07,586 Thank you, Doctor. 635 00:28:07,619 --> 00:28:09,822 ** 636 00:28:11,623 --> 00:28:13,125 (SIGHS) 637 00:28:13,159 --> 00:28:14,360 Okay, Percy. 638 00:28:14,393 --> 00:28:16,628 ** 639 00:28:16,662 --> 00:28:18,464 (VOICE BREAKING) Momma loves you. 640 00:28:18,497 --> 00:28:21,167 ** 641 00:28:21,200 --> 00:28:23,169 I love you, Percy. 642 00:28:23,202 --> 00:28:25,204 ** 643 00:28:31,410 --> 00:28:33,846 ** 644 00:28:38,818 --> 00:28:41,020 ** 645 00:28:46,558 --> 00:28:48,727 ** 646 00:28:58,737 --> 00:29:00,706 CLAIRE: Should we remove more bowel? 647 00:29:00,739 --> 00:29:01,974 DR. HAN: That would take us to the ilium. 648 00:29:02,008 --> 00:29:04,076 She won't gain enough weight to thrive. 649 00:29:04,110 --> 00:29:05,978 Her abdominal muscles are tight 650 00:29:06,012 --> 00:29:07,847 from developing around an empty cavity. 651 00:29:09,115 --> 00:29:10,917 * But the days, girl just slip away, oh, yeah * 652 00:29:10,950 --> 00:29:13,519 They're cinched around her tummy like a corset. 653 00:29:13,552 --> 00:29:14,753 What if we unbuttoned it? 654 00:29:14,787 --> 00:29:15,855 Released the muscle 655 00:29:15,888 --> 00:29:18,057 and increased the abdominal circumference. 656 00:29:18,090 --> 00:29:19,525 Those muscles are part of her abdominal wall. 657 00:29:19,558 --> 00:29:20,827 DR. LIM: Not if we separate the layers, 658 00:29:20,860 --> 00:29:23,495 create a plane between the skin and the muscle. 659 00:29:23,529 --> 00:29:25,531 ** 660 00:29:25,564 --> 00:29:27,133 You good if Murphy and I start on the heart? 661 00:29:28,467 --> 00:29:30,937 DR. LIM: Dr. Browne, you're with me on the abdomen. 662 00:29:32,304 --> 00:29:33,672 DR. PARK: Clearing the field. 663 00:29:33,705 --> 00:29:35,574 DR. REZNICK: Han is on the call schedule next weekend. 664 00:29:35,607 --> 00:29:38,010 Maybe Carmen will switch with me, so I can cover with him? 665 00:29:38,044 --> 00:29:40,880 DR. PARK: Or maybe you shouldn't try so hard. 666 00:29:40,913 --> 00:29:43,082 Retractor. 667 00:29:43,115 --> 00:29:45,217 Some of us don't have a cool former career, 668 00:29:45,251 --> 00:29:47,053 or an easy-going, mellow demeanor. 669 00:29:47,086 --> 00:29:48,254 People are never gonna crowd in my corner 670 00:29:48,287 --> 00:29:49,588 because I'm just so likable. 671 00:29:49,621 --> 00:29:51,623 Well, you could try being nice to them. 672 00:29:51,657 --> 00:29:53,159 Well, this is easier. There it is. 673 00:29:55,962 --> 00:29:57,296 Does it look like cancer? 674 00:29:58,130 --> 00:29:59,465 It's not labeled. 675 00:29:59,498 --> 00:30:01,567 We're all gonna have to wait for the pathologist's report. 676 00:30:02,501 --> 00:30:03,602 (MONITOR BEEPING) 677 00:30:03,635 --> 00:30:04,803 Probe. 678 00:30:04,837 --> 00:30:06,472 (BEEPING CONTINUES) 679 00:30:10,142 --> 00:30:11,911 The artery is in the way. 680 00:30:11,944 --> 00:30:14,280 We can't get at the tumor without him bleeding out. 681 00:30:14,313 --> 00:30:16,415 ** 682 00:30:18,918 --> 00:30:20,486 We're gonna have to take it from the back. 683 00:30:20,519 --> 00:30:21,921 But the S1 nerve root... 684 00:30:21,954 --> 00:30:23,389 Is something he can live without. 685 00:30:23,422 --> 00:30:25,057 Dissecting scissors. 686 00:30:25,091 --> 00:30:27,426 ** 687 00:30:29,261 --> 00:30:30,729 DR. HAN: Pledget anchor. 688 00:30:30,762 --> 00:30:33,232 * You'll be leaving me soon like hell you will 689 00:30:33,265 --> 00:30:37,736 * The owl gazing at the moon 690 00:30:37,769 --> 00:30:41,974 * Is the feeling that I get when I'm lookin' at you 691 00:30:42,008 --> 00:30:45,978 * The sun will rise and fade the stars 692 00:30:46,012 --> 00:30:47,146 The plug is in position. 693 00:30:47,179 --> 00:30:48,714 You ready to test the bowel repair? 694 00:30:48,747 --> 00:30:50,816 * And you're leaving me soon like hell you are 695 00:30:50,849 --> 00:30:52,284 Let's take her off cardiac support. 696 00:30:52,318 --> 00:30:54,020 Dr. Murphy, it was your idea. 697 00:30:54,053 --> 00:30:55,521 You do the honors. 698 00:30:55,554 --> 00:30:57,656 ** 699 00:31:00,859 --> 00:31:02,294 (CLICKS) 700 00:31:02,328 --> 00:31:03,495 (MONITOR BEEPING STEADILY) 701 00:31:03,529 --> 00:31:06,198 ** 702 00:31:06,232 --> 00:31:09,135 Abdominal pressure is normal. 703 00:31:09,168 --> 00:31:11,603 The intestines are perfusing. 704 00:31:11,637 --> 00:31:13,672 ** 705 00:31:15,241 --> 00:31:17,043 (ALARM BEEPING RAPIDLY) DR. HAN: Pulmonary pressure's spiking. 706 00:31:17,076 --> 00:31:18,310 Prostacyclin and nitric oxide... 707 00:31:18,344 --> 00:31:19,545 We need to get her lung pressure down. 708 00:31:19,578 --> 00:31:21,147 Oxygen SATs are dropping. 709 00:31:21,180 --> 00:31:23,215 No response to pulmonary vasodilators. 710 00:31:23,249 --> 00:31:26,152 DR. HAN: Now the heart's too strong. It's overpowering her lungs. 711 00:31:26,185 --> 00:31:27,987 DR. LIM: She needs to go back on cardiac support. 712 00:31:28,020 --> 00:31:29,155 (BEEPING CONTINUES) 713 00:31:29,188 --> 00:31:31,157 (CLICKS, BEEPING STEADIES) 714 00:31:31,190 --> 00:31:33,425 ** 715 00:31:36,495 --> 00:31:40,199 Persephone won't starve to death, 716 00:31:40,232 --> 00:31:42,368 but she will drown in her own fluids. 717 00:31:42,401 --> 00:31:45,004 ** 718 00:31:45,037 --> 00:31:47,273 ** 719 00:31:50,376 --> 00:31:52,544 ** 720 00:31:57,516 --> 00:31:58,884 DR. HAN: I'll talk to the parents. 721 00:31:58,917 --> 00:32:00,352 May I come? 722 00:32:00,386 --> 00:32:02,554 ** 723 00:32:06,258 --> 00:32:08,394 ** 724 00:32:11,897 --> 00:32:14,366 Now that Persephone's heart is pumping at full power, 725 00:32:14,400 --> 00:32:15,801 her lungs are overwhelmed. 726 00:32:17,970 --> 00:32:19,838 The humane thing to do 727 00:32:19,871 --> 00:32:22,141 is to turn off the machines and let her go. 728 00:32:23,375 --> 00:32:25,611 No, I... I can't... 729 00:32:25,644 --> 00:32:27,046 I can't give up on her. (BREATHES SHARPLY) 730 00:32:27,079 --> 00:32:30,116 ** 731 00:32:30,149 --> 00:32:32,884 Because you fought for her 732 00:32:32,918 --> 00:32:35,221 every minute since she was born. 733 00:32:35,254 --> 00:32:37,589 Before that, when you were taking your medication 734 00:32:37,623 --> 00:32:38,757 for the depression, 735 00:32:38,790 --> 00:32:40,926 you were fighting to keep going 736 00:32:40,959 --> 00:32:42,894 so you could bring her into the world. 737 00:32:42,928 --> 00:32:45,364 (BREATHING SHAKILY) 738 00:32:45,397 --> 00:32:47,433 ** 739 00:32:49,468 --> 00:32:51,637 ** 740 00:32:59,011 --> 00:33:01,913 But letting go of Percy is not giving up on her. 741 00:33:01,947 --> 00:33:03,982 ** 742 00:33:04,016 --> 00:33:06,752 It's listening to what her body is telling us. 743 00:33:06,785 --> 00:33:08,854 ** 744 00:33:11,757 --> 00:33:13,125 She's hit her limit. 745 00:33:13,159 --> 00:33:15,361 ** 746 00:33:17,363 --> 00:33:18,797 (EXHALES SHARPLY) 747 00:33:18,830 --> 00:33:20,866 ** 748 00:33:26,538 --> 00:33:28,674 ** 749 00:33:30,209 --> 00:33:32,311 Okay. 750 00:33:32,344 --> 00:33:34,780 ** 751 00:33:42,188 --> 00:33:44,723 ** 752 00:33:48,527 --> 00:33:50,796 ** 753 00:33:50,829 --> 00:33:52,698 (SOBS) 754 00:33:52,731 --> 00:33:56,001 ** 755 00:33:56,034 --> 00:33:57,469 (CRYING) 756 00:33:57,503 --> 00:33:59,638 ** 757 00:34:04,143 --> 00:34:06,678 (MONITOR BEEPING STEADILY) 758 00:34:06,712 --> 00:34:08,514 DR. HAN: I want Persephone to look as good as possible 759 00:34:08,547 --> 00:34:10,182 for the parents. 760 00:34:10,216 --> 00:34:13,552 ** 761 00:34:13,585 --> 00:34:15,154 (SIGHS) 762 00:34:15,187 --> 00:34:17,055 Let's turn off cardiac support. 763 00:34:17,089 --> 00:34:19,525 ** 764 00:34:19,558 --> 00:34:21,927 (CLICKS, BEEPING) 765 00:34:21,960 --> 00:34:23,395 Ventilator. 766 00:34:23,429 --> 00:34:25,164 ** 767 00:34:25,197 --> 00:34:26,865 Let's take a minute. 768 00:34:26,898 --> 00:34:29,135 (MONITOR BEEPING STEADILY) 769 00:34:29,168 --> 00:34:31,403 ** 770 00:34:36,608 --> 00:34:38,744 ** 771 00:34:45,251 --> 00:34:47,453 ** 772 00:34:52,023 --> 00:34:54,059 (LOUD, RHYTHMIC BEEPING) 773 00:34:54,092 --> 00:34:57,363 ** 774 00:34:57,396 --> 00:34:59,398 ** 775 00:35:03,635 --> 00:35:05,771 ** 776 00:35:09,775 --> 00:35:11,343 SHAUN: Check valve. 777 00:35:11,377 --> 00:35:13,445 ** 778 00:35:15,881 --> 00:35:18,384 Every time the heart contracted, 779 00:35:18,417 --> 00:35:20,686 blood went into the opposite side of the heart 780 00:35:20,719 --> 00:35:22,554 and raised lung pressure. 781 00:35:22,588 --> 00:35:25,224 The hole reduced the pressure when it got too high 782 00:35:25,257 --> 00:35:26,725 because it allowed backflow. 783 00:35:26,758 --> 00:35:30,061 But our repair of the defect blocked this backwards flow. 784 00:35:30,095 --> 00:35:32,298 What if we made it so she still had a heart defect, 785 00:35:32,331 --> 00:35:33,999 but only when she needed it? 786 00:35:34,032 --> 00:35:38,437 It'd be like an unlatched door in the wall of the heart. 787 00:35:38,470 --> 00:35:40,706 When the pressure gets too high on the right side, 788 00:35:40,739 --> 00:35:43,542 the door swings open, releasingthe pressure on the lungs. 789 00:35:43,575 --> 00:35:45,644 The rest of the time, it stays shut. 790 00:35:45,677 --> 00:35:48,347 It should reduce lung pressure by a third. Is that enough? 791 00:35:48,380 --> 00:35:49,548 It depends on how high 792 00:35:49,581 --> 00:35:51,550 her pulmonary vascular resistance is. 793 00:35:51,583 --> 00:35:53,985 PVR is pulmonary artery pressure 794 00:35:54,019 --> 00:35:56,588 minus wedge pressure divided by cardiac output times 80. 795 00:35:56,622 --> 00:35:58,790 ** 796 00:36:02,261 --> 00:36:04,330 ** 797 00:36:07,333 --> 00:36:09,635 CANDICE: The last time I saw my doctor, 798 00:36:09,668 --> 00:36:12,338 he told me I had six months to live. 799 00:36:12,371 --> 00:36:14,105 He also told me I should marry an accountant 800 00:36:14,139 --> 00:36:15,507 and move to North Dakota. 801 00:36:15,541 --> 00:36:17,008 LARRY: You don't say. 802 00:36:17,042 --> 00:36:19,811 When I asked if it would help my cancer, he said no, 803 00:36:19,845 --> 00:36:22,314 just make the six months seem much longer. 804 00:36:22,348 --> 00:36:24,316 (BOTH LAUGH) 805 00:36:25,884 --> 00:36:29,455 What's the difference between a Neo-Nazi and cancer? 806 00:36:29,488 --> 00:36:30,822 Cancer doesn't discriminate. 807 00:36:30,856 --> 00:36:32,424 (CANDICE LAUGHS) 808 00:36:32,458 --> 00:36:34,426 (LARRY LAUGHS) 809 00:36:34,460 --> 00:36:36,127 I knew a guy once, 810 00:36:36,161 --> 00:36:38,664 his Zodiac sign was Cancer. 811 00:36:38,697 --> 00:36:41,667 It was really ironic how he died. 812 00:36:43,134 --> 00:36:44,836 Uh, uh, how's that? 813 00:36:44,870 --> 00:36:46,705 He was eaten by a giant crab. 814 00:36:46,738 --> 00:36:50,542 (LAUGHTER) Oh, geez. 815 00:36:50,576 --> 00:36:52,110 (LAUGHS) 816 00:36:52,143 --> 00:36:54,212 Aaron, glioma. 817 00:36:54,246 --> 00:36:56,815 Candice, leukemia. 818 00:36:56,848 --> 00:36:58,149 Gin rummy or blackjack? 819 00:36:58,183 --> 00:37:00,185 How fast do you want to take my money? 820 00:37:00,218 --> 00:37:01,653 Blackjack. 821 00:37:01,687 --> 00:37:02,988 Cut 'em. 822 00:37:14,700 --> 00:37:16,768 Did you get it all? 823 00:37:20,372 --> 00:37:21,640 Yes, 824 00:37:21,673 --> 00:37:23,809 totally clear margins. 825 00:37:23,842 --> 00:37:25,644 But the only way to achieve that 826 00:37:25,677 --> 00:37:27,779 involved removing the nerve that controls your left foot. 827 00:37:29,581 --> 00:37:32,918 Rehab and an advanced orthotic may help, 828 00:37:32,951 --> 00:37:35,521 but you will walk with a limp. 829 00:37:35,554 --> 00:37:37,689 Final pathology will let us know if it was worth it. 830 00:37:42,093 --> 00:37:43,862 I'll let you know when it comes in. 831 00:37:45,897 --> 00:37:47,899 It doesn't matter anymore. 832 00:37:51,102 --> 00:37:53,138 It's not like you can put the tumor back in. 833 00:38:01,246 --> 00:38:03,415 (BABY CRYING) 834 00:38:08,654 --> 00:38:12,223 Is she...okay? 835 00:38:12,257 --> 00:38:15,794 She still has a surgery or two in her future, but, yes. 836 00:38:15,827 --> 00:38:17,396 She's gonna be great. 837 00:38:18,697 --> 00:38:21,333 (BREATHES SHARPLY) (SNIFFLES) 838 00:38:21,800 --> 00:38:23,101 Can I hold her? 839 00:38:23,134 --> 00:38:25,871 I think that would be very nice. 840 00:38:25,904 --> 00:38:27,706 For both of you. 841 00:38:27,739 --> 00:38:29,975 ** 842 00:38:37,015 --> 00:38:38,784 (BABY CRYING) 843 00:38:38,817 --> 00:38:40,852 ** 844 00:38:42,954 --> 00:38:45,056 (CRYING) Hi, angel. 845 00:38:45,090 --> 00:38:46,257 ** 846 00:38:46,291 --> 00:38:47,426 (BABY COOS) 847 00:38:47,459 --> 00:38:50,228 Oh, my baby. (SMOOCHES) 848 00:38:50,261 --> 00:38:53,131 ** 849 00:38:53,164 --> 00:38:54,566 Come hold her. 850 00:38:54,600 --> 00:38:56,702 ** 851 00:39:01,106 --> 00:39:03,509 You were fighting for her, too. 852 00:39:03,542 --> 00:39:05,644 ** 853 00:39:06,378 --> 00:39:08,346 (SNIFFLES) 854 00:39:08,380 --> 00:39:10,649 (BOTH CHUCKLE) She's beautiful. 855 00:39:10,682 --> 00:39:13,118 ** 856 00:39:18,356 --> 00:39:20,125 Nice work. 857 00:39:21,359 --> 00:39:23,429 Thank you. 858 00:39:23,462 --> 00:39:26,197 (BABY CRYING) She's beautiful. 859 00:39:26,898 --> 00:39:28,600 Listen to her. Oh. 860 00:39:28,634 --> 00:39:31,102 (CRYING) 861 00:39:31,136 --> 00:39:33,171 ** 862 00:39:39,845 --> 00:39:41,480 Thank you. 863 00:39:41,513 --> 00:39:43,749 (SIGHS DEEPLY) 864 00:39:46,384 --> 00:39:48,353 Minesh's biopsy results? 865 00:39:53,391 --> 00:39:55,594 (SIGHS) 866 00:39:58,764 --> 00:39:59,865 You don't want to know if we wasted our time 867 00:39:59,898 --> 00:40:00,899 almost killing him? 868 00:40:02,400 --> 00:40:04,002 Can't put the tumor back. 869 00:40:20,251 --> 00:40:22,053 Hello, Dr. Han. 870 00:40:23,121 --> 00:40:24,923 You take the bus, too? 871 00:40:24,956 --> 00:40:27,025 No, Shaun. 872 00:40:27,058 --> 00:40:28,560 I just wanted to talk to you. 873 00:40:29,928 --> 00:40:31,830 (INHALES SHARPLY) 874 00:40:31,863 --> 00:40:35,767 You really do have remarkable diagnostic skills. 875 00:40:36,267 --> 00:40:37,435 I have to admit, 876 00:40:37,469 --> 00:40:38,904 you're an asset to this hospital. 877 00:40:38,937 --> 00:40:41,039 Yes, I am. 878 00:40:43,942 --> 00:40:47,879 I spoke to the Residency Director of Pathology. 879 00:40:47,913 --> 00:40:50,415 And we both agree you'll be a great fit there. 880 00:40:53,184 --> 00:40:56,121 I'm a surgical resident. 881 00:40:56,888 --> 00:40:58,957 As a pathology resident, 882 00:40:58,990 --> 00:41:01,392 you'll touch cases and lives 883 00:41:01,426 --> 00:41:04,930 across all the medical departments. 884 00:41:04,963 --> 00:41:07,232 It's an opportunity for you to help patients 885 00:41:07,265 --> 00:41:10,101 without having to deal with patients. 886 00:41:11,637 --> 00:41:15,473 Given your difficulties with communication and social cues, 887 00:41:15,507 --> 00:41:18,644 I think it will be a much better fit. 888 00:41:18,677 --> 00:41:21,146 No, thank you. 889 00:41:21,179 --> 00:41:24,149 I have been working very hard 890 00:41:24,182 --> 00:41:27,318 at my communication skills. 891 00:41:27,352 --> 00:41:30,255 Hard work isn't enough. 892 00:41:30,288 --> 00:41:31,757 You have to do the job. 893 00:41:34,459 --> 00:41:38,530 I am a surgical resident. 894 00:41:40,498 --> 00:41:42,333 You were. 895 00:41:43,602 --> 00:41:46,004 And you're gonna do great work in pathology. 896 00:41:48,506 --> 00:41:51,843 (WYLDER'S "AT THE END PT. 1" PLAYS) 897 00:41:51,877 --> 00:41:54,980 * Oh, and when the storms come 898 00:41:55,013 --> 00:41:58,349 * Flooding through the hall 899 00:41:58,383 --> 00:42:00,686 * Rising to the landing 900 00:42:00,719 --> 00:42:04,055 * Tearing pictures from the walls 901 00:42:04,089 --> 00:42:07,759 * The currents pull us underneath 902 00:42:07,793 --> 00:42:10,962 * That bright tide rips us out 903 00:42:10,996 --> 00:42:13,999 * Into a tangled coral reef 904 00:42:14,032 --> 00:42:17,769 * Where we could never drown 905 00:42:17,803 --> 00:42:20,672 * Now that 906 00:42:20,706 --> 00:42:23,241 * We're at the end * 907 00:42:25,510 --> 00:42:27,713 ** 908 00:42:35,386 --> 00:42:37,756 ** 909 00:42:43,561 --> 00:42:45,764 ** 910 00:42:51,703 --> 00:42:54,072 **