In 1963, Dr. Thomas Starzl performed the first five liver transplants.
We know it is a departure
from existing Alzheimer's research,
but we believe it is worth pursuing.
Evidence already suggests that changes in the gut's microbiome
is correlated with Parkinson's.
If the same proves true for Alzheimer's,
it could completely transform the search for a cure.
One patient bled to death on the operating table.
- Uh. We're happy to answer questions. - Not necessary.
In fact, I'm sorry we dragged you all the way from Boston for this.
But it's just that our board will ask if we met Dr. Grey in person
when we recommend they fund the project.
The other four died within days.
- You are asking for money, right? - Yes.
We didn't expect an answer so soon, but...
The board still has to vote.
But frankly, it's more of a formality,
especially given Dr. Grey's affiliation with the Fox Foundation.
Should we set up a meeting with Dr. Fox to discuss next steps?
As a result, the operation was considered
too dangerous to be performed on humans
and liver transplantation was suspended
worldwide for the next four years.
Hey, you almost hit me when you pulled into the parking lot.
Maybe you should consider running against traffic.
Thanks for the tip.
I need to do a wound vac change before rounds.
- I'll see you inside. - Yeah.
I'm still mad at you for getting us banned from the OR.
I didn't ask for your thoughts.
Can you not be a tool right now? I'm trying to be nice.
- This is you being nice? - Yes.
I'm declaring a momentary truce.
You got us in trouble, but you're still my roommate,
kind of my friend and you were just dumped so...
- Are you okay? - I wasn't dumped.
- Mutual breakup, whatever. But... - I'm fine.
You are making it really hard to be Team Skywalker!
Wasn't exactly an auspicious start for
a surgery that has saved countless lives.
From now on, I'm waiting in the car when we do these meetings.
Everybody knows my affiliation with Catherine, and somebody will talk.
Should we give up now? Or can we hold out
until one thing in my life is on track?
My flight is not until 6:00, so I can make some calls from your lab.
Our lab.
- Ooh, space. - I think she's waiting.
- Uh, or she's on her phone. - What about Westerly Science?
They're small and new, but they have deep research pockets.
Did you get a cat?
I've given up on finding a human soulmate.
Oh.
Hey, I was waiting for that spot.
- Well, you were on your phone. - Answering an important text.
On your phone.
There's an overflow lo...
Dr. Lewis to oncology. Dr. Lewis to oncology.
Hey. Uh, and you can erase Dorian's abdominal washout.
How's he doing?
Uh. He's stable for now. The poor kid's got a ways to go.
- Okay. Let's hear it. - What?
You've been complaining about my changes
to the residency program nonstop.
So, I've got time before my next surgery.
Maybe get all that negativity out now
instead of sprinkling it throughout my day, like you've been doing.
No negativity today.
I'm going on vacation.
Seems early in your new position to be...
Going someplace warm?
- Chicago. - Oh. Say hello to Maggie for me.
I will. I will. But, uh, when I get back,
I do wanna discuss an idea for the interns.
Don't you have a plane to catch?
Griffith, Millin, take the pit.
I'm visualizing a multi-car crash or a construction accident.
- I need chest tubes. - I need intubations.
And I need a foot massage.
- Kwan, you're with Beltran. - The new peds attending?
Yeah, you know what they say about peds without the OR? Babysitting.
Don't care. Beltran was on the team
that pioneered single-port surgery.
Way to brag about reading the hospital newsletter.
- Just trying to stay ahead. - Yasuda, Adams, ICU.
Uh. Millin, wanna trade? There are a lot of chest tubes in the ICU.
- I already have most of those... - No trading, negotiating or complaining.
Unless one of you picked up a vanilla latte on the way?
Didn't think so.
Go!
Hmm.
This won't hurt, okay?
Good morning.
I'm Dr. Shepherd. You must be Malan.
I'm her mom, Maria Flor.
- It's nice to meet you both. - Nice to meet you.
Good morning. I'm Dr. Beltran, pediatric surgeon.
I'm sorry I'm a little late.
I had an... unexpected delay.
- Who's presenting? - I'm the chief of neurosurgery.
Good for you.
Uh, Malan Vasconcelos, eight years old,
diagnosed with congenital hydrocephalus at birth.
She's had five VP shunts to control the CSF build up.
All vitals look good. No signs of infection.
She's here today because her mom says
that Malan's not acting like herself.
Would you mind if I take a look?
So, Miss Vasconcelos, have you noticed
any change in her motor skills?
No, she's just, um, she's just tired,
like something's off. Something's not right.
She's normally full of energy,
running around the house dancing and kicking.
Not dancing and kicking. It's ginga and meia-lua.
- She does capoeira. - I got my orange belt last month.
Yeah.
Dr. Shepherd, do you see anything?
- No... - But that doesn't mean anything.
Well, it means I wasn't finished with my sentence.
Uh, Maria Flor, I'd like to take her for some scans.
She's already gone through four shunt revisions
and they all malfunctioned.
I don't want her to have to go through another surgery.
No, I know. I know, but let's hold off
worrying until we see the scans.
Agreed. No need to exacerbate an already stressful situation.
Kwan, uh, why don't you
get her to radiology for a shunt series?
Okay.
Hey, big trauma coming into the back lot.
I need everyone that does not have a patient.
- Let's grab gowns. - Dibs on the airway.
Chest tube.
Uh, how big? I have to leave for the airport in a couple hours.
I'll take what I can get. Let's go.
- Steady. - Wow.
- What is this thing? - Nate Ardilla, 34.
His watercraft was hit by a container ship.
He's got crush injuries to his pelvis and right upper extremity.
Couldn't fully extricate at the scene,
but Jaws of Life are on the way.
Easy. Easy.
Is this part of a boat?
No, it's a self-propelled floating bubble.
- I made it myself. It's cool, right? - That's one word for it.
Mr. Ardilla, I'm gonna need to check your injuries, okay?
Steel rims seemed like a good idea at the time,
but now, not so much.
You can get me out of this, right?
Let's take a look at you.
- Synced and corrected by ChrisKe - ... for www.addic7ed.com ...
I've been working around the clock to keep this kid alive,
and I've got a full day in the OR, so try not to disappoint me.
Yasuda.
Dorian Cardenas, post-op day six
from ex lap with splenectomy.
Small and large bowel repair and ostomy creation.
In stable condition after abdominal washout and closure today.
Keep track of his coags, acid-based electrolytes and renal functions.
And what ventilator alarms are we watching for?
Elevated peak and plateau pressures.
And if only the peak pressure alarm goes off?
- Tubes dislodged, or kinking. - Which means?
Don't page me. Fix it yourself.
Wait, so you just want us to monitor him?
Oh, you want something less boring
than keeping an entire unit of patients alive?
Including a young man recovering from multiple gunshot wounds?
I meant you also want us to log procedures so that we...
It's-It's good. We're good. Thank you.
- Truce is off! - Ow!
What the hell was that?
Don't be a smart-ass to the person who holds all the cards.
Literally.
Um, truce back on.
What's the MRN for the chart?
I really thought I was gonna make it this time.
- You've done this before? - Fourth try.
- Where were you headed? Bainbridge? - Hong Kong.
It needs to sound more impressive
than Rich Doyle's record.
He set a solo record rowing from San Francisco to Hawaii.
Wait, Rich Doyle the, uh, tech billionaire?
Didn't he fund that floating clinic in Tanzania?
Is he your boss or something?
My wife's ex-boyfriend.
And to be clear, she would say he's a non-issue,
but I know she thinks about him. I mean, I would.
I'd think every day about what my life would be like
if I married a billionaire adventurer rather than a pharmacist
with a 401[K] and ten days of paid vacation.
Nate.
Am I almost out? This really hurts.
It's definitely a vascular injury in the upper extremity.
If we don't get him out of there soon, he's gonna lose that arm.
Assuming he doesn't have massive internal hemorrhage.
Okay, I'm ready to get out now.
Get me out of here. Please get me out.
Nate, Nate. Hey, hey, Nate, look at me, look at me.
- I'm Dr. Hunt, okay? - Uh-huh. Okay.
Now, the pressure from these metal bars
might be the only thing stopping you from bleeding out.
So we need to be mindful how we get you out.
We stopped the bleeding in your arm with the tourniquet.
Next, we need to remove this bar from your pelvis.
Then we're gonna get you straight to an OR,
but I need you to stay still, okay?
Good.
Millin, Griffith, put another IV.
We're gonna need a gurney and trauma supplies.
- On it. - Can someone call my wife? Please.
Just tell her I'm here.
But maybe don't mention the part about the bars or the bleeding.
Yeah.
- Do you hate me? - Sometimes.
- What? Why would you say that? - Why would you ask me that?
Because when certain people show up at the hospital,
I'd think you'd give me a heads-up.
You get the hospital alerts.
Plus if we hurry, we can probably still see him.
What are you talking about?
The insane guy with the pedal boat.
Guy tried to paddle across the Pacific and then he trashed his appa...
- Wait, what are you talking about? - Well, I was talking about Nico.
- Who? - Nico. My ex.
I saw you having a whole conversation with him.
Why is he here?
I can't tell you.
- Because it's about me? - Because HIPAA.
Look, I gotta go. Just stop freaking out.
HIPAA? He's your patient?
Oh. You're in black scrubs.
Why does Nico need an ob-gyn, Jo?
Bye.
Meredith.
- Hey. - Hey.
I'm so surprised to see you here.
Well, I could say the same for you. Are you back already?
Physical therapy.
But I'm feeling so much better.
- Are you here for a consult? - Uh, yeah, something like that.
No one tells me anything.
Ndugu has locked me out of the cardio charts,
and Owen refuses to tell me that Leo is acting up
even though I am on the same emails.
And Richard... Well, he's telling me that I should hang in there
even though I have offered to help with admin.
He says that I-I need to rest.
Well, you know, Richard's usually right.
Yeah, well, no one seems to be minding me walking on a treadmill
for a mind-numbing hour.
I'd do it. I no longer have time to walk or be bored.
You should come with me.
- To PT? - Yeah.
You can get in your steps, I can get in mine,
and you can catch me up on life in Boston.
- You're busy. I get it. - Yeah.
- It's always such a pleasure to see you. - Yeah.
- You know what? I would love to come. - Great.
Yes.
You were at UT Medical Center?
Is that where you did your residency?
Nope, that was Penn. Also where I went to medical school.
I was lured to Texas by the promise of good weather.
- Dr. Shepherd, you were in LA? - Uh, for private practice.
Residency was in Baltimore and med school was Boston.
Just say Harvard. They think if they say Boston
it sounds less pretentious.
- Where'd you go? - St. Kitts.
Hmm. Balmy.
- Scans are up. - Mom was right.
Malan's shunt is no longer working.
- We'll have to replace it. - Well, it's not working.
She's too active, and she's gonna keep growing.
- It's gonna keep getting disconnected. - That's the standard of care.
But we can talk to the mom about Malan's level of physical activity.
What about an endoscopic ventriculostomy?
You insert a scope into the ventricles of the brain
and create a shunt using a balloon.
It's far less invasive, and there's nothing to get disconnected.
No, I know what it is,
but I also know that she is not a candidate.
She's had ventriculitis, and she has an aberrant basilar artery.
So getting a scope in would be near impossible.
Why don't you take a minute then?
Excuse me?
If you can't figure it out, take a minute.
Well, it's not about figuring it out. The procedure won't work.
And I can explain that to you four different ways,
but I have three other consults, a meningioma to remove
and a research meeting.
- Ah. So, impatience is your thing. - Should I leave?
No.
I have a colectomy for an eight-year-old,
a Wilms' tumor consult for a 14-year-old,
and a palliative care visit for a baby in the NICU.
You wanna swap?
I'll tell Malan's mom you're gonna look into another option.
He is stable and alert, but please call back as soon as you get this.
We're already out of lap pads?
Nice hair, by the way.
Needed a change.
Yeah? What happened with you and Adams?
We're roommates, because apparently I'm selfish.
This is where you say, "He doesn't know what he's talking about."
Oh, I shouldn't speak for him.
What happened with you and Kwan?
- You knew about that? - Everyone knew about that.
You know, we don't have to do this. We've got everything. Let's go.
You asked first.
NaCl. Right.
Dr. Wells to peds ICU.
Dr. Robin Wells to peds ICU.
They look like a nice family.
- You have... sisters, right? - We don't have to talk.
I know we don't have to talk, but I was just thinking that...
- Where are you going? - Uh. To do anything else.
Bailey gave us explicit instructions to...
Sit here and do math?
Well, she also said to do about a zillion procedures
if we ever want to set foot in the OR again, so...
- Yeah, I'ma do that. - Well, I'm not leaving him.
Well, I'm not letting Kwan get back in the OR before I do,
so, uh, page me if he codes.
Gurney coming through.
You need to head to the airport?
No, let's just get this guy out.
- Splint looks good. - Okay, everybody get ready.
We need a intubation tray,
- blood and bicarb on standby. - On it.
Nate, it's time to try extricating you now.
Okay. Everybody, on my count. One, two...
- Wait! Wait. - Hold up.
Tell me what happens when you lift the bar.
We can't be totally sure, Nate.
But we have a whole team of people ready for almost anything.
What if I die?
What if I die without ever getting to...
You're never getting to Hong Kong in a bubble.
All you succeeded in doing
is taking away resources from the coast guard when they rescued you.
Not to mention the paramedics.
Not everyone gets to go where they wanna go.
I was gonna say, "Without ever getting to see my wife again."
I wanna talk to her.
I need to talk to her.
- Is she here? - She didn't answer. I left a voicemail.
- We don't have much time. - Can wait a few minutes.
Try her again.
Okay.
Dr. Kwan.
Uh, Dr. Beltran will be back soon.
No... Malan's extremely sensitive to hospital sounds.
Would it be possible to get her some headphones?
The ones that block out the noise, you know?
Sometimes the radiology department has those.
- They don't loan those out. - I'm sure we can find them.
If it'll make Malan more comfortable, then it's no problem.
- Thank you so much. - Yeah.
Uh, radiology doesn't let those out of their sight. It's a thing.
I guess you're gonna have to ask nicely.
That won't make a difference.
That woman's daughter is going through something terrifying.
If she thinks headphones will help, then get her headphones.
And after you do that, find Shepherd. I need an update.
Everything okay?
These are not hospital pencils. I bring them from home.
I've had worse habits.
Well, sometimes I pop bubble wrap.
Wanna tell me what's bothering you?
No.
This new ped surgeon is pushing me to consider an alternate procedure
- to the one that I already know works. - Will the alternate work?
I me... It's more risk than I'd recommend.
- But will it work? - It's beside the point.
Are you irritated with the suggestion or the suggester?
Beltran aggravates a lot of people.
- How do you know? - I hired her.
She was known as a boundary pusher.
Kinda like you.
Hey.
- Levi. - Nico. Hi.
How are you?
- Good. - How's, uh, work going at the hospital?
You'd think a hospital vending machine would have healthier options.
- Here. - Ah. He doesn't like raisins.
- I know. - They're not for me.
- Oh. - They're for our surrogate.
He's a stickler about her diet.
Can't bring myself to think what he's gonna feed our son.
Our kitchen's already full of baby food gadgets.
- Oh. - I'm Jason.
Are... Did you and Nico work together?
Um, yeah. Yeah.
- I'm Levi. - Nice to meet you.
Are you also in ortho?
No. No. I'm, uh, I'm general surgery chief resident.
- Oh, wow. - Okay. Cool.
- Uh... We should go. - Yeah.
Erin's probably wondering what happened to us.
- It was nice seeing you. - Mm-hmm.
Nice meeting you, Levon.
Levon?
I mean, it's almost easier coming to work.
I mean, try explaining to a four-year-old why Mommy can't carry him.
- Right? - And Owen has been a champion,
but he's had extra trauma shifts.
His mom's helping out,
but she's not really the type to play the floor is lava.
She's more into giving them a snack and turning on the TV.
I remember during COVID, a very smart doctor once told me
to get some rest and ask for help when I needed it.
Look at you throwing my words back at me.
How's Boston?
- Oh! - Teddy!
Teddy, are you okay?
Dr. Lincoln said to tell you he's scrubbing in.
- Millin's helping him prep. - Is Jessica on her way?
- She's still not answering. - He's getting more hypotensive.
Nate, the longer you're up here,
the more likely you are to have a complication.
If you wanna give yourself the best shot at seeing your wife again,
we should go now.
Tell me. Whatever you wanna say to her, say it to me.
I'll tell her as soon as she arrives.
I love her.
That's all that matters.
I love her so much.
Everything I do is for her. All of this was for her.
I know she married me and not Rich, but I want her to be proud of me.
Tell her that I know she has doubts,
and I don't want her to spend another second of her life
questioning her choosing me.
Tell her that... I'll never give up trying to do right by her.
- I will. - Okay.
Okay then. I'm ready.
Okay.
Okay. On my count. One, two, three.
Okay, he's bleeding out.
Prepare to intubate. Come on, come on, come on.
- Hang two units of blood. - Let's go. Get him on the gurney.
Okay, let's pack the wound and apply pressure.
Let's make sure we have a clear path to the OR.
He's not gonna make it to the OR. Give me your shears.
Bring me a REBOA.
We'll slow the bleeding, and it'll buy us some time to transport.
Come on, Nate. Come on. Stay with me now. Stay with me.
All right. Glove me. Let's go, let's go, let's go.
Stay with us, Nate. Come on now.
He didn't know who I was.
You guys dated for a really long time. He's faking.
Not Nico. Jason.
They live together. They're having a baby.
- Surely they've discussed... - You?
Significant prior relationships.
It's like I didn't exist.
Do you wanna get back together with Nico?
I'm not sure I know him anymore.
He never talked about kids when we were together.
He didn't even want a fake Sims family.
But apparently it's different with Jason.
You haven't mentioned Nico in months,
and now all of a sudden you're all,
"Oh, why didn't he do that with me?"
I don't sound like that.
- Well... - And I don't wanna get back together.
- I... - Okay.
Then you're just upset that his life has moved further along than yours.
I am?
He is living with someone. They're having a kid together.
You've barely dated.
You're living in a loft with your coworker
with a twin sheet hanging between your beds for privacy.
- You really do hate me. - No, I'm just...
There are two main reasons that people get upset
when they run into an ex.
And yours is, "I am losing at life."
- Are you trying to make this worse? - I'm just saying.
You talk about wanting to meet someone,
and you deleted your dating apps.
You talk about wanting to get into peds,
and you haven't turned in the application.
You wanna win?
Get in the game.
Finally. You do know we were waiting for you, right?
You told me to take a minute.
- All right. Show us what you got. - Okay. As you can see,
Malan's aberrant basilar artery at the floor of the third ventricle
- is a huge problem. - And why is that, Dr. Kwan?
Because in order to insert the sheath into the third ventricle...
No, no, no. Start again but like you're explaining it to a parent.
Malan has a blood vessel that is blocking the way,
which would make it difficult to pass the balloon into that area
to create the shunt.
Now, difficult is an understatement.
The vessel is positioned such
that a fraction of a millimeter left or right
could result in major bleeding, stroke or worse.
But you've found an alternative route?
No... but we might be able to combine this computer system
with the intraoperative imaging technology
that we use for mapping brain tumors.
We would program it to provide us with a real-time guide,
with ultra precision in the OR.
So it's like a GPS system of Malan's brain
- to make sure you're on the right path? - The safest path.
- And she wouldn't need a VP shunt. - Hmm.
How long would it take you to build this technology?
Me? Forever. But I talked to our tech team
and they have it working now.
I would be willing to try it... if the mom agrees.
What are you thinking?
I'm thinking you're much more effective when you take your time.
Find another elevator! We have a trauma coming!
Move out! Make way for the gurney!
Either hug the wall or get out of the hall!
- We found his wife yet? - Not yet.
- Let's try again. - Yeah.
Let's go, let's go, let's go.
- You take over pressure? - Yep.
Type and cross him. Let's get the blood cooler in here.
Let's raise the temp in this room and find this man's wife.
Gown and glove me. No time to scrub.
All right. On three.
One, two... ... three.
Let's get this wet suit off of him now.
Let's run a TEG.
Somebody find his wife.
Let's go, let's go.
Yeah. "Small dark lesions of the lips and oral mucosa.
Abdominal pain.
CT scan shows small bowel mass with concentric rings.
What is the most likely cause?
Intestinal lipoma or hamartomatous polyp?"
Thoughts?
Dorian?
Oh. Is your tube dislodged?
Hey, don't be embarrassed. It happens to the best of us.
Oh, no. Wait, no, no, no, no, no.
No, no, no, no, no, no, no. Dorian?
Hey, I-I need help in here.
It's just a bad sprain.
It can't hurt to take a look.
Injured during PT? I'm a cliché.
All right.
- All right. - Okay.
Oh, crap.
What happened? Are you okay?
Oh, I'm fine. I just misstepped.
Take it easy.
Dr. Grey, I didn't know you were in town.
- Well, it's just a quick trip. - For a consult?
Yeah. I-I asked her, uh,
for a second opinion on one of my old patients.
And you had that thing with the house, right?
Yes. Uh... Insurance issues.
Well, it's always good to have you here.
And I am really looking forward to hearing
the update on your research next month.
- Take care, Altman. - Thank you.
So it's probably nothing, but we should have it x-rayed.
I'm gonna have to run. I can have a nurse take you to radiology.
I'm good. But I do wanna hear why you're actually here.
I see multiple serosal tears.
Would you rather marry a soulless tech millionaire
or the eccentric pharmacist?
- Neither. - No, you have to pick one.
Lap pads.
We have an expanding retroperitoneal...
I don't have that much tension with my roommates.
Your roommate is a hundred.
Maxine is a young 82.
- Levi. - Hey.
- You're still here. - Uh, yeah.
Erin might have gestational diabetes,
so they're testing her.
How far along is she?
Twenty-three weeks.
- Have you picked a name? - Yeah.
Levon.
Really?
- No, I'm just kidding. - Okay.
Hey, I'm sorry about earlier.
I corrected him in the elevator. He felt awful about it.
He seems nice.
Have you been together long?
- Nine months. - Oh.
If he had in his dating profile that he was in the process
of interviewing surrogates, I probably wouldn't have swiped.
When he told me, I freaked out.
I literally snuck out the back
at Parkside Pizza in the middle of dinner.
You left the pizza?
I was really freaked out.
I think I never realized that I wanted to be a dad.
Maybe I felt that I wasn't ready for it,
but Jason knew all along that he wanted to have kids.
And the thought of not having him in my life...
I...
I've never met anyone in my life like him.
He sees light in everything.
And these days no one does, you know?
Losing him just seemed a lot scarier
than the idea of having a family with him.
So...
here we are.
I'm happy for you.
Good luck.
Thanks.
- You too. - Hmm.
Just so I'm clear... You told the woman
whose name is on the building of where you work
that you stopped doing research at her request,
- but you're still doing it? - Trying to.
I am bored at home,
and you are living in... in, like, a medical thriller book.
And no one else knows?
- Except Amelia. - Amelia?
We're not actually... in a medical thriller.
It's just so bold and exciting.
- And about to be over. - You found a cure?
I might still be in a medical thriller.
No, we, um...
We have no money.
We had a plan and it fell through.
Was it Seagrade Tech? They are pulling back on everything.
No, actually, and it doesn't even matter who we ask
because that's the problem with secret research.
Everybody wants to talk about it.
- Well, I wouldn't. - You wouldn't what?
Talk about it. Not that I have many
people to talk to these days. Thanks.
Listen, Grey-Sloan has a discretionary fund.
It wouldn't be enough to fund your whole project,
but you could publish an initial report,
and that would open more doors.
You would do that? But... I mean,
don't you have to say where the money is going? What about Catherine?
A breakthrough in an Alzheimer's cure
would go down in medical history,
like a smallpox vaccine or antibiotics.
You just have to get far enough along
that she couldn't deny its value,
and I'm willing to take that risk on you.
- Oh. You go ahead. - Um, you go.
Really, it's okay.
I will grab another one.
Okay.
Dr. Shepherd, Dr. Beltran.
I know I can't scrub in, but can I observe?
Sit with her mother.
You're letting her mom watch the surgery?
- No. - Oh.
Maybe we should let him watch.
Even if it's just from the gallery.
I don't do this surgery very often.
He's on my service.
You can let him watch when he's on yours.
Where have you been?
Peak and plateau alarms are both going off.
- You checked for obstructions? - I did. It's clear.
And that wouldn't explain elevated plateau pressure.
Uh... BP's plummeting.
Should we start pressors?
Low urine output, elevated peak and plateau pressures,
low BP, increased bladder pressure.
It's abdominal compartment syndrome.
Are you sure he's not bleeding out somewhere?
We need a cut down tray.
Don't let him die while I'm gone.
Come on. Stay with me, Dorian.
Okay, if you pulled me out of the OR for a dislodged tube...
I think it's abdominal compartment syndrome.
Uh, low urine output, uh, elevated peak and plateau pressures,
BP falling, increased bladder pressure.
Should I book an OR?
No. He'll die before he gets there.
We need to open him up right here.
Crash cart!
Well, thank you for joining us, Yasuda.
Sorry if we're interrupting your break.
- Oh, no. Dr. Bailey, I was just asking... - Not now, Yasuda.
Adams, gown and glove.
Okay.
More lap pads.
I need suction.
He's crashing.
Starting compressions.
Come on, Nate.
- Come on, Nate. - Come on, come on, come on.
Time of death... 18:45.
Is... is she...
- Is my... is my baby... - She's okay.
We will need to monitor her,
but we were able to create a space
for the fluid to drain without putting in a new shunt.
- And the old shunt? - I removed it.
She'll be able to go back to capoeira without it.
Thank you.
- After she recovers, of course. - Okay.
Thank you. Thank you so much.
I mean, all of you. Thank you. Really.
Can... Can I see her?
- Dr. Kwan, can you... - Absolutely.
You two are a wonderful team.
Hmm. That was pretty great.
- Mrs. Ardilla? - Hey.
I'm Dr. Ndugu. This is Dr. Hunt, Dr. Griffith.
We were part of the team that cared for your husband.
We are so sorry.
No. Please... Please don't say...
Once we removed the bars
from his watercraft, he started to bleed.
We rushed him to the operating room, but it was too late.
We did everything in our power to save your husband.
No. No, that's not... that's not possible.
You know, I-I'm... I'm making salmon and rice for dinner.
Uh, he's supposed to come home.
Like, he always sets sail in the morning
and then... and then by lunchtime something's gone wrong
and he... and he comes home.
He always comes home.
You know, I spent all this time calling him ridiculous and paranoid
when I should've just been telling him that I loved him.
You know, I've-I've always loved him.
I didn't want Rich Doyle.
I've-I've always wanted Nate.
I-I should've done something.
I-I should've convinced him that... that all that mattered was us.
And it's all my fault.
It's... It's all my fault that he's gone.
No. No.
He knew.
He knew that you loved him. He told me.
He said the floating to Hong Kong in the bubble,
none of that was about you.
He wanted to prove to himself he could do it.
And he told me if he didn't make it
to tell you that he loved you so much.
It's no one's fault.
He loved you.
You loved him. That's what matters.
Dr. Beltran, I finished inputting your progress notes.
I need another post-op check on Clayton Yung.
Okay.
Yale.
I went to Yale. Almost a full year.
And then my mom got sick, I moved
home and then one thing led to another.
Look, I-I may not have the fancy pedigree,
but I can assure you I am a quick study,
I work hard and I aim to be the best.
When you're not suspended from the OR.
I am capable of more than hand-holding a patient's mom.
If you think that assignment was punitive
because of where you were educated, you're wrong.
- It wasn't punitive? - Of course it was.
Do you know who really saved Malan from severe complications today?
Dr. Shepherd. You.
You and Dr. Shepherd?
Malan's mom knew that something was wrong and brought her here.
Whether they have a medical degree or not, moms know.
You never bet against them.
I don't care where you went to school.
What matters is how you treat patients, and in peds, their families.
I'm gonna need you to understand
that if you're gonna be on my service tomorrow.
Well, they don't make the assignments until the morning.
I requested you.
See you tomorrow, Dr. Kwan.
Rough day.
I was going to the airport
because I was supposed to meet Maggie.
But she canceled on me.
And then I took it out on a patient, and he died.
We did everything we could, Winston.
And we both knew
from the second we saw those bars crushing him
this was never going to be an easy case.
I'm sorry about Maggie.
We were supposed to talk about what's next for us.
Just like we were supposed to do last week... and the week before.
But there's always a consult, or a class, paper.
At what point do I stop trying?
I'm not sure there's a good answer to that question,
but maybe the better question is, "Why?"
Why are you trying?
That might tell you what you need to know.
Good night.
That ex lap was mine.
Hey!
I made the diagnosis.
You didn't even know what it was.
Is there a rule that says
the person who makes the diagnosis does the procedure?
- Not that I know of. - Shut up!
I was trying to be a good friend to you,
and you repaid me by lying to Bailey?
- I didn't tell her anything. - Exactly.
You could've told her I was looking for the cut down tray
or that I sat by Dorian's bedside all day like she told us to
while you went looking for procedures!
Maybe give him a chance to explain before you rip into him.
He sharked me. No explanation.
It's his fault that we're all
stuck in the ICU and not in the OR anyway.
You know? And why are you defending him?
- He was a jerk to you too. - All right. Stop! Just stop.
I'm tired of the blame and the finger-pointing.
It is all our faults.
I was there too. So were you.
Kwan didn't do us any favors.
We all screwed up.
There's nothing we can do except put it behind us and move on.
We are all trying.
Why can't you?
I'm done. I don't wanna be your friend anymore. Find another way home.
Progress doesn't happen overnight.
And setbacks are all but inevitable.
I need a drink.
Yeah, me too.
Your idea. You're buying.
Sometimes it can make you feel like Sisyphus...
Let's go.
endlessly pushing the same boulder up the same hill.
- Okay. - Dr. Beltran. I'm Levi Schmitt.
Oh. Are you the person I talk to about assigned parking?
Um, no. I'm chief resident.
I'm applying for a peds fellowship.
I-I wanted to see if I could maybe buy you coffee sometime.
Pick your brain.
I can't right now.
But can you still help me with that parking pass?
But where would we be if Dr. Starzl hadn't persevered
to perfect the liver transplant...
Ah.
If he had let the setbacks win?
Johnny?
Jaden. Jared? Jaden?
Can I, uh, please have another one?
And her too.
It's his card, okay? Thank you.
As tempting as it can be to throw in the towel...
sometimes you have to take the obstacles as they come...
Hey. I got your text. What's happening?
We have to keep going.
How many of these have you had?
Maybe one too many.
But I still don't think we should quit.
Look, I know that it is gonna be hard for us to find the money,
but what if we could find a cure?
We gotta keep trying.
I'm happy to hear you say that because I think
I may have found us some money.
So, I just left Teddy...
Lucas, you awake?
Can we talk?
Lucas?
... And find a new path forward.
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