08x17 - Know When to Hold and When to Fold
Posted: 03/30/23 16:25
Here at Gaffney Chicago
Medical Center...
We'll want to get as
much press as possible.
They're doing infomercials for . now?
When you were a kid, you
started having your problems,
and I wasn't there for you.
You're here now.
[TENSE MUSIC]
I could construct a neural network
and compare it against tens of
thousands of known mutations.
I wonder if you might train me
on that new program
you were talking about.
Dr. Halstead, can you
give Dr. Song a hand?
♪
You can't play with the bumpers up.
So what? I'm not embarrassed.
How are you supposed to improve?
Who said anything about improving?
I'm here for the drinks.
[CHUCKLES]
Maggie's buying first round?
That's what I heard.
This is why I don't invite you two out,
because you're cheap.
Where's Ben?
The science fair is tomorrow.
He's prepping the gym
for a mass eruption
of baking soda volcanoes.
But don't you worry, I got a fourth.
Oh, yeah? Who?
Hey, Grace. Over here.
Word is she's single.
What, you're trying to set us up?
- Mm-hmm.
- Hi.
- Hey.
- Hey.
- We're hitting the bar.
- Can we get you anything?
Oh, my gosh, yeah.
Guinness. Anything dark, really.
Anything dark. Just like Halstead.
Go figure.
Well, be back in a flash.
Didn't know you bowled.
Neither did I, until undergrad.
It's the least physically
demanding gym credit
I could get away with.
Not too analog for your taste?
It's not gonna do much
for my street cred,
but I fell in love with it.
The physics of the game,
it's just really elegant.
Besides, Jack has me all over
the place these past few years,
and it's easy to find an alley
pretty much anywhere in the world.
It's comforting,
finding something familiar
when you travel all the time.
Maybe it's the smell.
Floor wax, sweaty shoes, and old beer.
It's the sweaty shoes that do it for me.
[LAUGHTER]
You gonna have to tell me
if I'm any good, though.
Rarely in one place long
enough to see how I stack up.
All right.
Dr. Berger said placement went smoothly.
- So I can get out of here?
- I'd say so.
Remember to keep the
site sterile every time
- you connect to the cycler.
- Yeah, spare me the speech.
I've placed hundreds of PD catheters.
You sure? It's a pretty good speech.
Just take it easy on yourself.
Peritoneal dialysis will
let you keep working,
but you won't be feeling
% anytime soon.
I'll take it under advisement.
[KNOCKS AT DOOR]
Hey, sweetie. Still at it?
Yeah.
Well, I just have one
more. I'm almost done.
But Notre Dame, Northwestern,
and the University of
Chicago are all finished.
I just need to submit them.
Wow.
So proud of you, sweetie,
how hard you've worked.
What's the last one?
- Stanford.
- Stanford?
Well, their school of sustainability
has all these research
groups on everything
from decommissioning combustion
engines to carbon storage.
The opportunities are unreal.
And I think I'd actually
have a decent shot at it.
I guess I just thought
that you were planning
to stay closer to Chicago.
Well, yeah, I mean, obviously I do.
I mean, I was just
considering all the options.
As well you should.
Um, honey, I don't
want to slow your roll,
so keep up the good work.
And just give me a shout
if you need anything.
What can you tell us
about Kuan-yu's journey?
Kuan-yu has a condition
called ankylosing spondylitis.
It's an inflammatory disease.
As it progresses, it fuses
the vertebrae of the spine.
I took him many places,
but no one fixed him.
No, it didn't work at all.
We always hoped that it would stop,
but he got more bent over.
Kuan-yu, how long have
you been in this position?
I have not laid on my back in years.
It must be hard to function,
to do everyday things.
Yes, but my mother helps me in all ways.
She keeps my hope alive.
Can you tell us how
they came to Chicago Med?
An international aid organization
tried to pair Kuan-yu with a
number of renowned surgeons,
but they all declined his case.
They were too scared.
Yeah, there are significant
technical challenges
to a surgery like this.
A similar procedure was performed
in China a few years ago,
but it was spaced out
over several months.
Not everywhere is equipped
for something like this.
But thankfully, social
media jumped to the rescue
and tagged Dr. Marcel.
Yeah, I knew we should and could help,
so I presented Kuan-yu's
case to Jack Dayton,
and he immediately agreed.
Mr. Dayton flew us
here, paid everything.
He asked nothing but to make this film.
Mr. Dayton and Dr. Marcel are my angels.
Kuan-yu has candidly
discussed the risks,
and he's mentally prepared.
But are you concerned?
Tomorrow's surgery has been
meticulously planned for months,
and I have full faith in
our doctors and nurses.
And we have OR . .
Because Kuan-yu's spine
is one long, rigid bone,
there are severe risks involved
in separating and reconstructing it,
which is where . is a gamechanger,
allowing us to be more precise
as we perform a series
of osteotomies, meaning...
Sorry to interrupt the infomercial,
but would you rather
hear this from the surgeon
who's actually performing the procedure?
This is Dr. Abrams, our
chief of neurosurgery
and lead surgeon on Kuan-yu's surgery.
Yes, and Dr. Marcel, our esteemed
general surgeon, will be assisting.
Yes, I will be helping Dr. Abrams
gain access to Kuan-yu's
spine via anterior approaches.
So as we discussed,
we'll be placing screws along
every level of the spine,
connected by at least four rods
from the skull to the pelvis,
along with multiple pedicle
subtraction osteotomies
and cerebral column resections.
Dr. Abrams, this is wonderful,
but could you turn and face the camera
and give us that information
again in layman's terms
for our documentary audience?
Your show pony's right there.
Yes, I'll be happy to translate.
♪
Hey, Sharon.
- How was filming last night?
- Fine.
I'm relieved my part is over.
And the filming will be completed
after the surgery today.
You don't sound too happy
about the documentary.
Well, I think Jack has a unique
and commendable understanding
of the power of PR.
Go on. I'm listening for the "but."
Having cameras in the hospital
doesn't exactly create a
therapeutic environment.
Yeah, I hear you.
But, Sharon, this is the kind of case
that puts Gaffney on
par with the Mayo Clinic.
Well, I can't pretend that I
don't like the sound of that.
So for everyone's sake,
let's hope that there's a good outcome.
Now that sounds like a plan.
So that four-bagger earn me
a spot on the practice team?
I think you had us all outclassed.
You held your own.
Maybe we could square
off sometime, you and me.
Sure. Sounds good.
Got to run. Big day in . .
Good luck.
Kind of flat-footed, Halstead.
What?
Will and Grace.
It has a nice, familiar ring to it.
If I'm correct, they were just friends.
OK, come on.
You can't talk to your
ex about your new crush?
I think you misread the situation.
- Hey.
- Hey.
- Mornin'.
- Whoa, whoa.
What's with the jacket?
- I work here now.
- Yeah, that much I guessed.
Wow.
You all right?
Yeah, I slept funny.
So you're parking cars.
Hannah... Dr. Asher hooked me up.
Sent over the job opening.
- Put in a good word.
- How considerate of her.
Well, I wanted to surprise you.
Hey, you think I should, like,
write her a thank you note?
Is that weird?
Maybe I'll buy her a cup of coffee.
- I'll pass along your
regards. Hustle up.
You don't want to be written
up for loitering on the job.
Dr. Archer, good morning.
- How are you?
- Fine.
- Why would you ask me that?
- No reason.
Anything you need? Water or...
Yeah, I need residents to talk less.
Hey.
- Hey, how'd the PD cath go?
- OK.
Why would you get Sean a job here?
Excuse me?
Every person in this place
knows what's going on with me.
How long do you think it'll be
before he finds out the news?
Wait. He doesn't know
about your renal failure?
And I had planned to keep it that way.
Listen, I just got this
kid back, all right?
With his sobriety, I don't want
to burden him with my stuff.
OK, Dean, I'm sorry
if I'm butting in here,
but sobriety depends on
both of you being honest.
If you really want that
real relationship with Sean,
he needs to know.
You are butting in, all right?
And I'll tell him when he's ready.
OK, hey.
If you need a hand
with anything, I'm here.
I know that the first
few nights of dialysis
can be really rough.
Yeah, I'm not in the
market for a nursemaid.
[SIGHS]
I can help. His veins roll.
Oh, I've got it. Thank you.
- He can't keep it?
- No, I'm sorry.
He can't wear anything during surgery.
Hey, Dan. Everything good?
Yeah. Ms. Goodwin asked me to come down,
you know, check up on your patient.
Big, stressful day, even
without the damn cameras.
But he seems to be doing great,
you know, focused on the positives.
Well, looks like we're ready to go.
Exciting day, huh?
- Good luck.
- Thanks, buddy.
Hey, Kuan-yu.
It's Dr. Marcel.
Ready to see the world?
I am born ready.
Oh, that's the spirit.
Good, buddy. Great. All right.
I'm gonna have you guys
step back for a moment.
Thank you.
Can I give you a hand?
Did you need an extra bag or anything?
I can't keep still.
Worse today.
Perfectly normal to be worried.
Every day, I get older, less strong,
and he gets worse.
So yes, I am worried today.
But I am also hopeful.
Good.
- Maybe I go into surgery now.
- You know what?
I'm afraid that that's
not gonna be possible.
It's against hospital policy.
No. No, I must be there.
I'm so sorry that this wasn't
made clear to you earlier,
but it's actually for Kuan-yu's safety.
But I can be useful.
Maybe they have questions
or need help moving him.
Mrs. Wu, your son is in
the best possible hands.
Look, how about if I
find you a place to wait
right next to the operating room?
That way, you can be
as close as possible.
Would that make you feel better?
Dr. Archer, incoming
MVC. Going to Trauma .
Zach, you're going with them.
- Court!
- Vincent Jones, s.
T-boned at Cermak and Clark.
GCS .
Sats have been hovering in the high s.
- Pressure?
- over .
Heart rate's .
All right, let's go.
Get ready to transfer on my count.
Should we get an extra set of
hands so you don't have to...
No.
Ready? One, two, three.
- [GROANS]
- Dr. Archer, are you...
Yeah, just worry about
your patient, all right?
What's the first order of business?
- Airway.
- Airway, right.
Trini, I need ET kit, RSI dr*gs.
I need X-ray in here, please!
All right.
Feeling some instability in the pelvis.
- What is taking so long?
- I think I've got it.
- You think?
- I'm in.
Breath sounds bilateral.
Sats rising. Pressure still soft.
All right. What's next, Zach?
X-ray chest and pelvis, and then a fast.
You want to resuscitate this guy
or just let him die
while you order stuff?
Right. Two units whole blood.
Negative fast.
All right. Where's my X-ray?
All right, clear!
Let's see it.
Left-sided posterior hip dislocation.
- Got it in one. And?
- We'll need to reduce.
Set the scoreboard back to zero.
He needs a panscan.
Rule out cavitary hemorrhage.
He might need surgery
before we reduce him.
All right, let's move.
[GROANS]
Here we go.
Kuan-yu's ready, and
the cameras are in place.
I had the one at the head
of the table moved back.
Better if you moved them
all the way out of the room.
What, are you afraid
they're gonna throw you off?
Nothing throws me off.
I just don't think publicity
has a place in my OR.
I'm surprised you took this case then.
Well, I thought about refusing,
but any other neurosurgeon
would probably paralyze the poor guy.
Now, sadly, at the end of the day,
you and I are just shilling
for a billionaire padding his pockets.
Well, if you want to
look at it that way, OK.
But this surgery never would
have happened without . ,
and it never would have
happened without Jack.
Right. In other words,
your participation in it.
Ms. Wallace, I'm Dr. Halstead.
My mom's looking after my son.
Trying to explain
how to swaddle a
six-week-old via text.
Take your time.
She'll manage.
I turned out OK.
So what brings you in today?
Oh, here it comes.
- [RETCHES]
- Asked and answered.
How long you been feeling this way?
A few days now.
I thought maybe it was food poisoning,
but it shouldn't last this long, right?
Could be viral gastroenteritis.
Stomach bug. Easily treatable.
But we'll start with
some labs and IV fluids.
I can also prescribe
you something for nausea.
That would be much appreciated.
All right.
Here we go.
[GROANS]
You know, I did the whole
single-mom IVF thing.
Everyone warned me about the
risks of a geriatric pregnancy.
I didn't know the effects
would last postpartum.
Well, we're gonna get you sorted out
and back to your son
as soon as possible.
All right, CBC, BMP, KUB, and
bolus a liter of normal saline.
- You got it.
- Thanks, Doc.
Of course.
Hey, can I get your eyes on this?
Yeah, sure. What's up?
-year-old IVF primip came in
with nausea and vomiting,
but her labs are normal.
- Tox?
- Clean.
OK, yeah, her BP is up. over .
Yeah, been that way since intake.
- Could be preeclampsia?
- This far out?
Yeah, it's rare, but it happens.
I'd check a CMP and PC ratio
and consider mag, just in case.
I can do the order if you want.
- Sure. Thanks.
- Yeah.
Hey, Will, about earlier,
you know, you and Grace...
- Hannah...
- No.
I never should have teased you.
Obviously, men and women can be friends.
OK, look, even if I
were interested in her,
Grace is a nomad.
Jack has her all over the world.
It's tough to start something
with someone like that.
Yeah.
I'll let you know when
these labs come back.
[MONITORS BEEPING]
Cervicothoracic PSOs look good.
I think so.
Let's see if . agrees.
I don't need another opinion.
Well, it could only help us, Sam.
Standby.
OK, so . would determine
if the osteotomy is at the
ideal depth, height, and angles
to achieve correction.
Acceptable C and T osteotomies.
Acceptable? It's perfect.
Can you explain how those lasers
are helpful for the surgeons?
Yeah, Dr. Marcel,
could you explain that?
Uh, sure. Yeah. Could you move over?
In fact, direct your camera
towards the screen there.
You'll see that .
will superimpose lines
onto the spine to help guide
the surgeon where to drill
and the extent of bone to remove.
Dr. Abrams, I'm seeing
% decreases in amplitude
and increased latency in both legs.
Running a motor.
Put the evoked potential
response on screen.
Dr. Marcel, is there a problem?
Are we concerned with cord
injury and compression?
Yeah, 'cause I'm assuming
that our patient's goal
wasn't to become paralyzed.
Push his MAPs.
Reverse everything that's reversible.
Find out if this IOM change is real.
And if it is, close him up and
get him down for an MRI stat.
MRI? No, hold on.
We don't have to move him.
. can do an intraop CT.
Yeah, which won't show me anything
about cord edema or
ligamentous buckling.
But if I can merge a CT with
an intraoperative ultrasound,
you'd have everything
you'd need right here.
That would work, and we
wouldn't have to move Kuan-yu.
Look, experiment with this
thing on another patient.
I want to be % sure.
Sam, there are a hundred reasons
why we should not move him.
Pick one. Infection risk.
Prolonged time under anesthesia.
Hell, he could even be
unstable after the move
to even continue surgery.
Do it.
Let's hope you're right.
Otherwise, you're committing a
career-ending mistake to film.
You sure there's nothing we can get you?
- Maybe something to eat?
- No.
How are we doing?
- Any updates?
- Not yet.
[PHONE BUZZING] Oh, excuse me.
You know, that's a lovely stone.
I was noticing it earlier
when I was talking to your son.
From the river.
Kuan-yu found this as a child.
It was smooth and shiny.
He thought it was a gem.
It was one of the last
times he was able to move,
to play.
I made this to give him hope
that one day he would play again.
I promised I would help him.
Well, you have certainly
kept that promise.
What's going on?
- I need to talk to Da-xia.
- About what?
There's been a complication,
something about a cord compression.
I've got to get her point of view.
Now is not the time.
[CHUCKLES]
Ms. Goodwin, this is
one of the major risks
they knew he was facing.
Narratively, that's
important to their story.
Well, this is not about a story.
It's a complicated medical
procedure involving real people.
I have a directive from Mr. Dayton.
She signed a contract to be filmed.
You film at my discretion,
not Jack Dayton's.
And you can speak to Da-xia
after the doctors provide
an update and not before.
Well, I need to call Mr. Dayton.
Well, you just do that.
Did he need to speak to me?
Did he have news?
No, nothing concrete.
But the surgeons will
check in with you soon.
Why don't we go wait in my office?
It's right upstairs, and, you know,
we'll be more comfortable there.
- Thank you, Dr. Charles.
- You bet.
I'm not seeing any
obvious cord compression.
That's why I'm also checking.
His evoked potentials look better.
All right, I'm satisfied
that the cord was merely
compressed, not injured.
We can continue.
- Dr. Marcel?
- Yeah?
Would you ask . to prepare
the next osteotomy, please?
Certainly. Grace?
Will?
I'll call you back.
Results for your patient, Cara.
Good news: doesn't look
like postpartum preeclampsia.
Bad news is nothing definitive
to explain her symptoms.
Yeah, I'm thinking stress.
I mean, she did just
give birth six weeks ago,
and pregnancy puts the
body at the literal limit
of human endurance for nine months.
Makes sense that stress
would manifest physically.
Yeah, I'll look into
anything else to test her for,
but I think you're right.
Dr. Archer, do you want my seat?
Uh, I'm good.
I got to turn six over anyway,
- so it's not a big deal.
- Oh, for crying out loud.
Listen, I'm not an invalid.
I'm fine!
- Dr. Archer?
- What?
I have Vincent's CT results.
He has a pelvic hematoma with a blush.
- We need to embolize him.
Now we can reduce his hip.
Send him up to IR.
You ever done an Allis reduction?
- I've observed one.
- All right.
Well, you're assisting me.
Oh, what now?
I just know an Allis reduction
can be physically taxing.
And?
I just don't think it's the best idea
for you to do this procedure.
Yeah, I'm an attending physician
and the chief of this department.
I will not be advised by some resident
who barely knows what the
hell he's talking about!
- I'm sorry.
- Yeah, you know what?
Go get yourself another case, man.
- I'm sorry.
- Yeah, you said that!
Go! Go!
I have another patient for you in two.
Need a hand with a hip reduction?
Uh-uh.
Dr. Archer, I will not have you
speaking to residents like that.
Can we just get this done?
Murphy, will you assist, please?
Sure. No problem.
Over here. Push down on the pelvis
and give Dr. Archer counter traction.
All right, we're gonna do this in three.
Ready? One, two, three.
- [CRACKING]
- That's good. It's in.
- [GROANING]
- Whoa. Are you OK?
- I'm OK.
- No, you're not.
I just got to get him up to IR.
Stop talking. Murphy, you take him up.
We need to get you in a bed. Come on.
All right. All right.
So you think this was all stress?
We could not find any
other clinical explanation.
Stress takes a real physical toll...
nausea, vomiting, hypertension.
All common and treatable presentations,
even in the case of happy stress.
We'll prescribe you a
low-dose antihypertensive
for your blood pressure.
But the best thing you could do
for yourself right now is find ways
to reduce your stress levels.
I waited so long to become a mother,
probably too long, if I'm being honest.
I naively thought the perfect moment
would just waltz into my life.
Now that my little Lee is here,
I don't want to miss anything.
Well, he's a lucky boy.
Don't forget to take
care of yourself too.
Thank you.
[CRASH]
- [MOANING]
- Cara?
- You OK?
- Floor... sliding.
- OK.
- Help me.
- Aphasia.
- Yeah.
Stroke alert! Need some help in here!
[MOANING]
You're OK. Just breathe,
breathe, breathe.
OK, try to relax.
All right.
Nope. No, no, back away.
Let's close up the lumbar PSO.
Compressor and set screws.
So Dr. Abrams and Gottfried are placing
the final bit of instrumentation.
Then they will collapse
Kuan-yu's spine,
which will correct his
posture to an upright...
[MONITORS BEEPING RAPIDLY]
His sats are dropping. Heart
rate and BP are down too.
- Airway pressures?
- Peaks are s.
Still dropping. Sats at %.
It must be due to his position.
Well, there's not much
we can do about that
in the middle of a spine surgery.
It's got to be a tension pneumothorax.
- Stethoscope?
- Hey.
This isn't a trauma
case. Just bronch him.
And check the tube's position.
Kuan-yu's chest and abdominal muscles
are probably atrophied.
When we straightened him,
we likely cracked a rib,
punctured the lung.
There.
Diminished breath sounds on the right.
Chest tube kit for Dr. Marcel.
- French.
- No, he needs a rescue now.
What's happening? Has
Kuan-yu stopped breathing?
I need to needle decompress him.
Chest tube later.
Can you reach the anterior chest?
I've got no other option.
Just get it done.
Heart rate's . Sats at s.
Running out of time here, Crockett.
Yeah, I don't want to stick his heart.
Not a ton of room to work.
Dr. Marcel, can you explain...
Be quiet!
OK, needle's in.
Oxygen saturation climbing. %.
Airway pressure's down to .
BP's back up to systolic.
OK.
Let's finish up the spine.
I need you to back up. Back up.
Doesn't look like you tore the stitch.
Probably just overexerted yourself.
Ah, wonderful.
- There.
- Thank you.
[GROANS]
Who do you think you're kidding
with this tough guy act?
[SCOFFS]
Everyone here knows what
you're going through.
Oh, well, see, that's the problem.
That's all they see:
a sick, weak old man.
"Let me get that for
you." "Take my seat."
"Should you be doing
that?" I can't stand that.
There's no shame in having an illness.
Listen, I'm the doctor
in this ED, all right?
I'm not a patient.
Oh.
You know, I once thought like you.
After my cancer diagnosis.
I thought folks would only
see what was wrong with me,
that every kind word or offer to help
was just an act of pity.
Then someone who lived
through my experience
made me realize how far
from the truth that was,
that I was the only one
defining myself by my illness.
My friends, my family, my community,
all they wanted to do was support me.
And all I needed to do was let them.
It's not weakness to let people be kind.
It's strength.
OK.
Oh.
And Zach's a good doctor.
He just needs to be encouraged.
And that's our job.
Message received.
One chamomile tea.
My mom drinks this to help her sleep
because she insists on drinking coffee
till late in the afternoon.
- Go figure.
- [PHONE BUZZING]
Oh.
Yes?
OK.
Well, good. I will tell her.
Thank you. Thank you very much.
So the surgery is complete,
and Kuan-yu came through it very well.
As a matter of fact, the
next time you see him,
he will probably be sitting up.
You mean he'll stand?
- He'll walk?
- Yeah.
With time, rehabilitation,
he should live a pretty normal life.
[SOBBING]
Oh.
Oh, my.
[STAMMERING] I'm so sorry.
No, you have absolutely
nothing to apologize for.
There's a lot to take in.
This is the day we've been waiting for.
All these years, I
take good care of him.
And now, what will happen now?
This surgery has upended
a life that you and your son have known
for, what, almost years?
And it makes perfect sense
that you would grieve
the loss of that life
and be apprehensive about the future.
But this is not right, these feelings.
How can I think of me at such a time?
How can I be so selfish...
- Oh, no, no.
- And not be happy?
No, no, no. You are not selfish.
Every parent in the world
understands what you're
feeling right now.
From the moment our kids are born,
they start to move away from us.
And when they finally leave,
it's only because we've
actually done our jobs well.
But this, I can promise you:
you will always be his mother.
Always.
One half of the same stone.
[TENDER MUSIC]
♪
As you can see...
That's in my head?
It's a condition
called Moyamoya disease.
Moyamoya literally means
"puff of smoke" in Japanese.
It's a progressive disorder
which blocks blood flow
to your brain's arteries.
So to compensate, your body created
all these smaller vessels,
which are prone to bleeding.
So your symptoms were
caused by small strokes.
Progressive.
So this is going to get worse?
Keeping you on aspirin and
calcium channel blockers
will help reduce the
risk of another stroke.
Just reduce but not prevent.
It'll keep you stable for
the foreseeable future.
There is a surgical option,
but we don't think
that you're there yet.
Surgery?
I want the surgery.
It's an invasive
neurosurgical procedure.
You have a newborn.
You've been through a lot.
The surgery can wait
for a more ideal time.
I don't want this cloud hanging over me.
I've waited for ideal times before.
They don't come.
Please, the surgery.
We'll have neurosurgery
come speak to you.
Thank you.
Yeah.
Dr. Hudgins.
Yes?
I hear our patient, Mr. Jones,
is resting comfortably in the ICU
after successful embolization.
Oh, good.
There's a sim dummy in seven.
I'm gonna show you how to reduce a hip.
You said it was a physically
demanding procedure,
so you're gonna do it.
Mama.
I can see you.
Yes.
And you look so beautiful.
Mm-mm, I'm so old.
No. No.
[SOBBING]
I'll see you.
A word, please.
- Yes?
- Look.
It's one thing to bar them
from filming her during surgery,
but, Sharon, this is what
audiences would want to see.
And you've stopped
them from capturing it.
After all they've been through, George,
they deserve this time without cameras.
They wouldn't even have had
a chance to get this surgery
if it wasn't for Jack's generosity.
Yes, and I still have to
look out for my patients.
George, you're a doctor. You know that.
I do.
But I also believe in Jack's
vision for this hospital.
He wants us to be the leader
in cutting-edge healthcare.
Sharon, this film tells the
world exactly who we are.
And who are we, George,
if we forget about our
patients and their loved ones?
But Jack is a man who's not
used to hearing the word "no."
Well, maybe it's time he did.
Yeah.
Hey, neurosurgery is getting
ready to operate on Cara.
That's great.
Woman's braver than I am.
And me.
Hey, you weren't wrong.
I am interested in Grace.
OK.
So why did you give her
the brush-off this morning?
And don't give me that stuff
about her being a nomad.
I mean, look at my
dating track record here.
- Hasn't been exactly stellar.
- [SCOFFS]
- No offense.
- Yeah.
[LAUGHS]
Well, I might be crazy or out of line,
but I wonder if all of these excuses
are really just about one reason,
or rather one person.
Natalie.
Natalie?
You know, it did always feel like
you were still carrying a torch for her.
Yeah, maybe.
Maybe I still was.
But now, I mean, it's just
me trying to get it right.
Good.
[LAUGHTER]
You're a really great guy, Will.
You deserve to be happy.
Thanks, Hannah.
Now, what was particularly difficult
about this operation?
Well, the angle was slightly unusual.
But fortunately, we were
able to relieve the pressure
and reinflate his lung.
You were basically folded over yourself,
- and alarms were blaring, so...
- Right.
Why don't you tell us what
you felt in that moment?
I guess the real headline here
is successfully
aligning Kuan-yu's spine.
You saw firsthand a
revolution in medicine,
thanks in part to OR . .
I mean, this is just the beginning
of what this Dayton partnership can...
can produce.
Yeah.
Hell of a day, huh?
Hope you're off to celebrate.
You know, you're not a terrible surgeon,
but you do have awful taste in heroes.
Heroes? Come on, Sam.
At least he's using his
billions for some good, right?
Oh, yeah, confident that's
why he amassed his fortune.
Point is, we can help
so many more people
with Jack's vision and
money in our corner.
No, his vision of whom to help
seems a bit more narrow than yours.
- What does that mean?
- I just found out.
Dayton says from now on, .
is for paying customers only.
- Wait, what?
- You heard me.
No more subsidized care.
Well, if that's true, then your fight's
with the insurance companies.
[TENSE MUSIC]
♪
We're all out of the good stuff.
Radiology's got a secret stash, though.
Thanks for the tip.
Or maybe I could buy
you a cup of coffee.
I don't think that's a good idea.
OK. Have a good night.
What about a drink instead?
Guinness, right?
Mm-hmm.
Guess that made you happy, huh?
I don't know what you're talking about.
Ah.
- I gather you told him.
- More or less.
Told him I needed dialysis.
Left it pretty vague.
But I don't want to
make him a caretaker.
He doesn't need that right now.
It's a good thing you told him, though,
not just for his sake.
Good night, Dean.
Wait, hold on.
I have a favor to ask.
[KNOCKS AT DOOR]
Hey, Dad. There's pizza in the fridge.
- I promise it's not Hawaiian.
- Wait.
Are you finished with your applications?
Yeah.
All proofed, agonized
over, and submitted.
And I chose early decision
to University of Chicago.
- What happened to Stanford?
- Nothing.
I wasn't really all
that serious about it.
Plus, I'm not exactly a California girl.
I don't really know what that means,
but, I mean, you seemed
pretty serious about it to me.
There's other schools
with sustainability stuff.
Plus, I would miss
Italian beef too much.
And, you know, and maybe you.
You know what? I'd miss you too.
But the right school
is the right school.
Why go so far and leave you all alone
when I have great options at home?
OK, first of all, I'm
not gonna be all alone.
And guess what?
It's actually not your
job to worry about me.
Anna, when you've accomplished
what you have in school,
you get to go to whatever
school you want to.
I don't care where it is.
And honestly, I've really
started to kind of look forward
to having an excuse to go
to California in February.
So, you know, don't step on my dreams.
Thank you, Dad.
I'm gonna apply.
Why not?
Yeah.
Let's see.
OK.
All set.
Is that all right? Are you in any pain?
No, it's fine. Thanks.
OK.
Front door sticks, so just
lift up when you close it.
I know it's late.
Actually, I'm a...
I'm a bit of a night owl.
Occupational hazard of being an OB-GYN:
always on call.
Oh, Hannah, you don't have to stay.
There is a quiz in here,
and I have always wanted to know
which classic car matches
my sparkling personality.
Oh, easy.
- You're a Prius.
- [LAUGHTER]
[TENSE MUSIC]
♪
[WOLF HOWL]
Medical Center...
We'll want to get as
much press as possible.
They're doing infomercials for . now?
When you were a kid, you
started having your problems,
and I wasn't there for you.
You're here now.
[TENSE MUSIC]
I could construct a neural network
and compare it against tens of
thousands of known mutations.
I wonder if you might train me
on that new program
you were talking about.
Dr. Halstead, can you
give Dr. Song a hand?
♪
You can't play with the bumpers up.
So what? I'm not embarrassed.
How are you supposed to improve?
Who said anything about improving?
I'm here for the drinks.
[CHUCKLES]
Maggie's buying first round?
That's what I heard.
This is why I don't invite you two out,
because you're cheap.
Where's Ben?
The science fair is tomorrow.
He's prepping the gym
for a mass eruption
of baking soda volcanoes.
But don't you worry, I got a fourth.
Oh, yeah? Who?
Hey, Grace. Over here.
Word is she's single.
What, you're trying to set us up?
- Mm-hmm.
- Hi.
- Hey.
- Hey.
- We're hitting the bar.
- Can we get you anything?
Oh, my gosh, yeah.
Guinness. Anything dark, really.
Anything dark. Just like Halstead.
Go figure.
Well, be back in a flash.
Didn't know you bowled.
Neither did I, until undergrad.
It's the least physically
demanding gym credit
I could get away with.
Not too analog for your taste?
It's not gonna do much
for my street cred,
but I fell in love with it.
The physics of the game,
it's just really elegant.
Besides, Jack has me all over
the place these past few years,
and it's easy to find an alley
pretty much anywhere in the world.
It's comforting,
finding something familiar
when you travel all the time.
Maybe it's the smell.
Floor wax, sweaty shoes, and old beer.
It's the sweaty shoes that do it for me.
[LAUGHTER]
You gonna have to tell me
if I'm any good, though.
Rarely in one place long
enough to see how I stack up.
All right.
Dr. Berger said placement went smoothly.
- So I can get out of here?
- I'd say so.
Remember to keep the
site sterile every time
- you connect to the cycler.
- Yeah, spare me the speech.
I've placed hundreds of PD catheters.
You sure? It's a pretty good speech.
Just take it easy on yourself.
Peritoneal dialysis will
let you keep working,
but you won't be feeling
% anytime soon.
I'll take it under advisement.
[KNOCKS AT DOOR]
Hey, sweetie. Still at it?
Yeah.
Well, I just have one
more. I'm almost done.
But Notre Dame, Northwestern,
and the University of
Chicago are all finished.
I just need to submit them.
Wow.
So proud of you, sweetie,
how hard you've worked.
What's the last one?
- Stanford.
- Stanford?
Well, their school of sustainability
has all these research
groups on everything
from decommissioning combustion
engines to carbon storage.
The opportunities are unreal.
And I think I'd actually
have a decent shot at it.
I guess I just thought
that you were planning
to stay closer to Chicago.
Well, yeah, I mean, obviously I do.
I mean, I was just
considering all the options.
As well you should.
Um, honey, I don't
want to slow your roll,
so keep up the good work.
And just give me a shout
if you need anything.
What can you tell us
about Kuan-yu's journey?
Kuan-yu has a condition
called ankylosing spondylitis.
It's an inflammatory disease.
As it progresses, it fuses
the vertebrae of the spine.
I took him many places,
but no one fixed him.
No, it didn't work at all.
We always hoped that it would stop,
but he got more bent over.
Kuan-yu, how long have
you been in this position?
I have not laid on my back in years.
It must be hard to function,
to do everyday things.
Yes, but my mother helps me in all ways.
She keeps my hope alive.
Can you tell us how
they came to Chicago Med?
An international aid organization
tried to pair Kuan-yu with a
number of renowned surgeons,
but they all declined his case.
They were too scared.
Yeah, there are significant
technical challenges
to a surgery like this.
A similar procedure was performed
in China a few years ago,
but it was spaced out
over several months.
Not everywhere is equipped
for something like this.
But thankfully, social
media jumped to the rescue
and tagged Dr. Marcel.
Yeah, I knew we should and could help,
so I presented Kuan-yu's
case to Jack Dayton,
and he immediately agreed.
Mr. Dayton flew us
here, paid everything.
He asked nothing but to make this film.
Mr. Dayton and Dr. Marcel are my angels.
Kuan-yu has candidly
discussed the risks,
and he's mentally prepared.
But are you concerned?
Tomorrow's surgery has been
meticulously planned for months,
and I have full faith in
our doctors and nurses.
And we have OR . .
Because Kuan-yu's spine
is one long, rigid bone,
there are severe risks involved
in separating and reconstructing it,
which is where . is a gamechanger,
allowing us to be more precise
as we perform a series
of osteotomies, meaning...
Sorry to interrupt the infomercial,
but would you rather
hear this from the surgeon
who's actually performing the procedure?
This is Dr. Abrams, our
chief of neurosurgery
and lead surgeon on Kuan-yu's surgery.
Yes, and Dr. Marcel, our esteemed
general surgeon, will be assisting.
Yes, I will be helping Dr. Abrams
gain access to Kuan-yu's
spine via anterior approaches.
So as we discussed,
we'll be placing screws along
every level of the spine,
connected by at least four rods
from the skull to the pelvis,
along with multiple pedicle
subtraction osteotomies
and cerebral column resections.
Dr. Abrams, this is wonderful,
but could you turn and face the camera
and give us that information
again in layman's terms
for our documentary audience?
Your show pony's right there.
Yes, I'll be happy to translate.
♪
Hey, Sharon.
- How was filming last night?
- Fine.
I'm relieved my part is over.
And the filming will be completed
after the surgery today.
You don't sound too happy
about the documentary.
Well, I think Jack has a unique
and commendable understanding
of the power of PR.
Go on. I'm listening for the "but."
Having cameras in the hospital
doesn't exactly create a
therapeutic environment.
Yeah, I hear you.
But, Sharon, this is the kind of case
that puts Gaffney on
par with the Mayo Clinic.
Well, I can't pretend that I
don't like the sound of that.
So for everyone's sake,
let's hope that there's a good outcome.
Now that sounds like a plan.
So that four-bagger earn me
a spot on the practice team?
I think you had us all outclassed.
You held your own.
Maybe we could square
off sometime, you and me.
Sure. Sounds good.
Got to run. Big day in . .
Good luck.
Kind of flat-footed, Halstead.
What?
Will and Grace.
It has a nice, familiar ring to it.
If I'm correct, they were just friends.
OK, come on.
You can't talk to your
ex about your new crush?
I think you misread the situation.
- Hey.
- Hey.
- Mornin'.
- Whoa, whoa.
What's with the jacket?
- I work here now.
- Yeah, that much I guessed.
Wow.
You all right?
Yeah, I slept funny.
So you're parking cars.
Hannah... Dr. Asher hooked me up.
Sent over the job opening.
- Put in a good word.
- How considerate of her.
Well, I wanted to surprise you.
Hey, you think I should, like,
write her a thank you note?
Is that weird?
Maybe I'll buy her a cup of coffee.
- I'll pass along your
regards. Hustle up.
You don't want to be written
up for loitering on the job.
Dr. Archer, good morning.
- How are you?
- Fine.
- Why would you ask me that?
- No reason.
Anything you need? Water or...
Yeah, I need residents to talk less.
Hey.
- Hey, how'd the PD cath go?
- OK.
Why would you get Sean a job here?
Excuse me?
Every person in this place
knows what's going on with me.
How long do you think it'll be
before he finds out the news?
Wait. He doesn't know
about your renal failure?
And I had planned to keep it that way.
Listen, I just got this
kid back, all right?
With his sobriety, I don't want
to burden him with my stuff.
OK, Dean, I'm sorry
if I'm butting in here,
but sobriety depends on
both of you being honest.
If you really want that
real relationship with Sean,
he needs to know.
You are butting in, all right?
And I'll tell him when he's ready.
OK, hey.
If you need a hand
with anything, I'm here.
I know that the first
few nights of dialysis
can be really rough.
Yeah, I'm not in the
market for a nursemaid.
[SIGHS]
I can help. His veins roll.
Oh, I've got it. Thank you.
- He can't keep it?
- No, I'm sorry.
He can't wear anything during surgery.
Hey, Dan. Everything good?
Yeah. Ms. Goodwin asked me to come down,
you know, check up on your patient.
Big, stressful day, even
without the damn cameras.
But he seems to be doing great,
you know, focused on the positives.
Well, looks like we're ready to go.
Exciting day, huh?
- Good luck.
- Thanks, buddy.
Hey, Kuan-yu.
It's Dr. Marcel.
Ready to see the world?
I am born ready.
Oh, that's the spirit.
Good, buddy. Great. All right.
I'm gonna have you guys
step back for a moment.
Thank you.
Can I give you a hand?
Did you need an extra bag or anything?
I can't keep still.
Worse today.
Perfectly normal to be worried.
Every day, I get older, less strong,
and he gets worse.
So yes, I am worried today.
But I am also hopeful.
Good.
- Maybe I go into surgery now.
- You know what?
I'm afraid that that's
not gonna be possible.
It's against hospital policy.
No. No, I must be there.
I'm so sorry that this wasn't
made clear to you earlier,
but it's actually for Kuan-yu's safety.
But I can be useful.
Maybe they have questions
or need help moving him.
Mrs. Wu, your son is in
the best possible hands.
Look, how about if I
find you a place to wait
right next to the operating room?
That way, you can be
as close as possible.
Would that make you feel better?
Dr. Archer, incoming
MVC. Going to Trauma .
Zach, you're going with them.
- Court!
- Vincent Jones, s.
T-boned at Cermak and Clark.
GCS .
Sats have been hovering in the high s.
- Pressure?
- over .
Heart rate's .
All right, let's go.
Get ready to transfer on my count.
Should we get an extra set of
hands so you don't have to...
No.
Ready? One, two, three.
- [GROANS]
- Dr. Archer, are you...
Yeah, just worry about
your patient, all right?
What's the first order of business?
- Airway.
- Airway, right.
Trini, I need ET kit, RSI dr*gs.
I need X-ray in here, please!
All right.
Feeling some instability in the pelvis.
- What is taking so long?
- I think I've got it.
- You think?
- I'm in.
Breath sounds bilateral.
Sats rising. Pressure still soft.
All right. What's next, Zach?
X-ray chest and pelvis, and then a fast.
You want to resuscitate this guy
or just let him die
while you order stuff?
Right. Two units whole blood.
Negative fast.
All right. Where's my X-ray?
All right, clear!
Let's see it.
Left-sided posterior hip dislocation.
- Got it in one. And?
- We'll need to reduce.
Set the scoreboard back to zero.
He needs a panscan.
Rule out cavitary hemorrhage.
He might need surgery
before we reduce him.
All right, let's move.
[GROANS]
Here we go.
Kuan-yu's ready, and
the cameras are in place.
I had the one at the head
of the table moved back.
Better if you moved them
all the way out of the room.
What, are you afraid
they're gonna throw you off?
Nothing throws me off.
I just don't think publicity
has a place in my OR.
I'm surprised you took this case then.
Well, I thought about refusing,
but any other neurosurgeon
would probably paralyze the poor guy.
Now, sadly, at the end of the day,
you and I are just shilling
for a billionaire padding his pockets.
Well, if you want to
look at it that way, OK.
But this surgery never would
have happened without . ,
and it never would have
happened without Jack.
Right. In other words,
your participation in it.
Ms. Wallace, I'm Dr. Halstead.
My mom's looking after my son.
Trying to explain
how to swaddle a
six-week-old via text.
Take your time.
She'll manage.
I turned out OK.
So what brings you in today?
Oh, here it comes.
- [RETCHES]
- Asked and answered.
How long you been feeling this way?
A few days now.
I thought maybe it was food poisoning,
but it shouldn't last this long, right?
Could be viral gastroenteritis.
Stomach bug. Easily treatable.
But we'll start with
some labs and IV fluids.
I can also prescribe
you something for nausea.
That would be much appreciated.
All right.
Here we go.
[GROANS]
You know, I did the whole
single-mom IVF thing.
Everyone warned me about the
risks of a geriatric pregnancy.
I didn't know the effects
would last postpartum.
Well, we're gonna get you sorted out
and back to your son
as soon as possible.
All right, CBC, BMP, KUB, and
bolus a liter of normal saline.
- You got it.
- Thanks, Doc.
Of course.
Hey, can I get your eyes on this?
Yeah, sure. What's up?
-year-old IVF primip came in
with nausea and vomiting,
but her labs are normal.
- Tox?
- Clean.
OK, yeah, her BP is up. over .
Yeah, been that way since intake.
- Could be preeclampsia?
- This far out?
Yeah, it's rare, but it happens.
I'd check a CMP and PC ratio
and consider mag, just in case.
I can do the order if you want.
- Sure. Thanks.
- Yeah.
Hey, Will, about earlier,
you know, you and Grace...
- Hannah...
- No.
I never should have teased you.
Obviously, men and women can be friends.
OK, look, even if I
were interested in her,
Grace is a nomad.
Jack has her all over the world.
It's tough to start something
with someone like that.
Yeah.
I'll let you know when
these labs come back.
[MONITORS BEEPING]
Cervicothoracic PSOs look good.
I think so.
Let's see if . agrees.
I don't need another opinion.
Well, it could only help us, Sam.
Standby.
OK, so . would determine
if the osteotomy is at the
ideal depth, height, and angles
to achieve correction.
Acceptable C and T osteotomies.
Acceptable? It's perfect.
Can you explain how those lasers
are helpful for the surgeons?
Yeah, Dr. Marcel,
could you explain that?
Uh, sure. Yeah. Could you move over?
In fact, direct your camera
towards the screen there.
You'll see that .
will superimpose lines
onto the spine to help guide
the surgeon where to drill
and the extent of bone to remove.
Dr. Abrams, I'm seeing
% decreases in amplitude
and increased latency in both legs.
Running a motor.
Put the evoked potential
response on screen.
Dr. Marcel, is there a problem?
Are we concerned with cord
injury and compression?
Yeah, 'cause I'm assuming
that our patient's goal
wasn't to become paralyzed.
Push his MAPs.
Reverse everything that's reversible.
Find out if this IOM change is real.
And if it is, close him up and
get him down for an MRI stat.
MRI? No, hold on.
We don't have to move him.
. can do an intraop CT.
Yeah, which won't show me anything
about cord edema or
ligamentous buckling.
But if I can merge a CT with
an intraoperative ultrasound,
you'd have everything
you'd need right here.
That would work, and we
wouldn't have to move Kuan-yu.
Look, experiment with this
thing on another patient.
I want to be % sure.
Sam, there are a hundred reasons
why we should not move him.
Pick one. Infection risk.
Prolonged time under anesthesia.
Hell, he could even be
unstable after the move
to even continue surgery.
Do it.
Let's hope you're right.
Otherwise, you're committing a
career-ending mistake to film.
You sure there's nothing we can get you?
- Maybe something to eat?
- No.
How are we doing?
- Any updates?
- Not yet.
[PHONE BUZZING] Oh, excuse me.
You know, that's a lovely stone.
I was noticing it earlier
when I was talking to your son.
From the river.
Kuan-yu found this as a child.
It was smooth and shiny.
He thought it was a gem.
It was one of the last
times he was able to move,
to play.
I made this to give him hope
that one day he would play again.
I promised I would help him.
Well, you have certainly
kept that promise.
What's going on?
- I need to talk to Da-xia.
- About what?
There's been a complication,
something about a cord compression.
I've got to get her point of view.
Now is not the time.
[CHUCKLES]
Ms. Goodwin, this is
one of the major risks
they knew he was facing.
Narratively, that's
important to their story.
Well, this is not about a story.
It's a complicated medical
procedure involving real people.
I have a directive from Mr. Dayton.
She signed a contract to be filmed.
You film at my discretion,
not Jack Dayton's.
And you can speak to Da-xia
after the doctors provide
an update and not before.
Well, I need to call Mr. Dayton.
Well, you just do that.
Did he need to speak to me?
Did he have news?
No, nothing concrete.
But the surgeons will
check in with you soon.
Why don't we go wait in my office?
It's right upstairs, and, you know,
we'll be more comfortable there.
- Thank you, Dr. Charles.
- You bet.
I'm not seeing any
obvious cord compression.
That's why I'm also checking.
His evoked potentials look better.
All right, I'm satisfied
that the cord was merely
compressed, not injured.
We can continue.
- Dr. Marcel?
- Yeah?
Would you ask . to prepare
the next osteotomy, please?
Certainly. Grace?
Will?
I'll call you back.
Results for your patient, Cara.
Good news: doesn't look
like postpartum preeclampsia.
Bad news is nothing definitive
to explain her symptoms.
Yeah, I'm thinking stress.
I mean, she did just
give birth six weeks ago,
and pregnancy puts the
body at the literal limit
of human endurance for nine months.
Makes sense that stress
would manifest physically.
Yeah, I'll look into
anything else to test her for,
but I think you're right.
Dr. Archer, do you want my seat?
Uh, I'm good.
I got to turn six over anyway,
- so it's not a big deal.
- Oh, for crying out loud.
Listen, I'm not an invalid.
I'm fine!
- Dr. Archer?
- What?
I have Vincent's CT results.
He has a pelvic hematoma with a blush.
- We need to embolize him.
Now we can reduce his hip.
Send him up to IR.
You ever done an Allis reduction?
- I've observed one.
- All right.
Well, you're assisting me.
Oh, what now?
I just know an Allis reduction
can be physically taxing.
And?
I just don't think it's the best idea
for you to do this procedure.
Yeah, I'm an attending physician
and the chief of this department.
I will not be advised by some resident
who barely knows what the
hell he's talking about!
- I'm sorry.
- Yeah, you know what?
Go get yourself another case, man.
- I'm sorry.
- Yeah, you said that!
Go! Go!
I have another patient for you in two.
Need a hand with a hip reduction?
Uh-uh.
Dr. Archer, I will not have you
speaking to residents like that.
Can we just get this done?
Murphy, will you assist, please?
Sure. No problem.
Over here. Push down on the pelvis
and give Dr. Archer counter traction.
All right, we're gonna do this in three.
Ready? One, two, three.
- [CRACKING]
- That's good. It's in.
- [GROANING]
- Whoa. Are you OK?
- I'm OK.
- No, you're not.
I just got to get him up to IR.
Stop talking. Murphy, you take him up.
We need to get you in a bed. Come on.
All right. All right.
So you think this was all stress?
We could not find any
other clinical explanation.
Stress takes a real physical toll...
nausea, vomiting, hypertension.
All common and treatable presentations,
even in the case of happy stress.
We'll prescribe you a
low-dose antihypertensive
for your blood pressure.
But the best thing you could do
for yourself right now is find ways
to reduce your stress levels.
I waited so long to become a mother,
probably too long, if I'm being honest.
I naively thought the perfect moment
would just waltz into my life.
Now that my little Lee is here,
I don't want to miss anything.
Well, he's a lucky boy.
Don't forget to take
care of yourself too.
Thank you.
[CRASH]
- [MOANING]
- Cara?
- You OK?
- Floor... sliding.
- OK.
- Help me.
- Aphasia.
- Yeah.
Stroke alert! Need some help in here!
[MOANING]
You're OK. Just breathe,
breathe, breathe.
OK, try to relax.
All right.
Nope. No, no, back away.
Let's close up the lumbar PSO.
Compressor and set screws.
So Dr. Abrams and Gottfried are placing
the final bit of instrumentation.
Then they will collapse
Kuan-yu's spine,
which will correct his
posture to an upright...
[MONITORS BEEPING RAPIDLY]
His sats are dropping. Heart
rate and BP are down too.
- Airway pressures?
- Peaks are s.
Still dropping. Sats at %.
It must be due to his position.
Well, there's not much
we can do about that
in the middle of a spine surgery.
It's got to be a tension pneumothorax.
- Stethoscope?
- Hey.
This isn't a trauma
case. Just bronch him.
And check the tube's position.
Kuan-yu's chest and abdominal muscles
are probably atrophied.
When we straightened him,
we likely cracked a rib,
punctured the lung.
There.
Diminished breath sounds on the right.
Chest tube kit for Dr. Marcel.
- French.
- No, he needs a rescue now.
What's happening? Has
Kuan-yu stopped breathing?
I need to needle decompress him.
Chest tube later.
Can you reach the anterior chest?
I've got no other option.
Just get it done.
Heart rate's . Sats at s.
Running out of time here, Crockett.
Yeah, I don't want to stick his heart.
Not a ton of room to work.
Dr. Marcel, can you explain...
Be quiet!
OK, needle's in.
Oxygen saturation climbing. %.
Airway pressure's down to .
BP's back up to systolic.
OK.
Let's finish up the spine.
I need you to back up. Back up.
Doesn't look like you tore the stitch.
Probably just overexerted yourself.
Ah, wonderful.
- There.
- Thank you.
[GROANS]
Who do you think you're kidding
with this tough guy act?
[SCOFFS]
Everyone here knows what
you're going through.
Oh, well, see, that's the problem.
That's all they see:
a sick, weak old man.
"Let me get that for
you." "Take my seat."
"Should you be doing
that?" I can't stand that.
There's no shame in having an illness.
Listen, I'm the doctor
in this ED, all right?
I'm not a patient.
Oh.
You know, I once thought like you.
After my cancer diagnosis.
I thought folks would only
see what was wrong with me,
that every kind word or offer to help
was just an act of pity.
Then someone who lived
through my experience
made me realize how far
from the truth that was,
that I was the only one
defining myself by my illness.
My friends, my family, my community,
all they wanted to do was support me.
And all I needed to do was let them.
It's not weakness to let people be kind.
It's strength.
OK.
Oh.
And Zach's a good doctor.
He just needs to be encouraged.
And that's our job.
Message received.
One chamomile tea.
My mom drinks this to help her sleep
because she insists on drinking coffee
till late in the afternoon.
- Go figure.
- [PHONE BUZZING]
Oh.
Yes?
OK.
Well, good. I will tell her.
Thank you. Thank you very much.
So the surgery is complete,
and Kuan-yu came through it very well.
As a matter of fact, the
next time you see him,
he will probably be sitting up.
You mean he'll stand?
- He'll walk?
- Yeah.
With time, rehabilitation,
he should live a pretty normal life.
[SOBBING]
Oh.
Oh, my.
[STAMMERING] I'm so sorry.
No, you have absolutely
nothing to apologize for.
There's a lot to take in.
This is the day we've been waiting for.
All these years, I
take good care of him.
And now, what will happen now?
This surgery has upended
a life that you and your son have known
for, what, almost years?
And it makes perfect sense
that you would grieve
the loss of that life
and be apprehensive about the future.
But this is not right, these feelings.
How can I think of me at such a time?
How can I be so selfish...
- Oh, no, no.
- And not be happy?
No, no, no. You are not selfish.
Every parent in the world
understands what you're
feeling right now.
From the moment our kids are born,
they start to move away from us.
And when they finally leave,
it's only because we've
actually done our jobs well.
But this, I can promise you:
you will always be his mother.
Always.
One half of the same stone.
[TENDER MUSIC]
♪
As you can see...
That's in my head?
It's a condition
called Moyamoya disease.
Moyamoya literally means
"puff of smoke" in Japanese.
It's a progressive disorder
which blocks blood flow
to your brain's arteries.
So to compensate, your body created
all these smaller vessels,
which are prone to bleeding.
So your symptoms were
caused by small strokes.
Progressive.
So this is going to get worse?
Keeping you on aspirin and
calcium channel blockers
will help reduce the
risk of another stroke.
Just reduce but not prevent.
It'll keep you stable for
the foreseeable future.
There is a surgical option,
but we don't think
that you're there yet.
Surgery?
I want the surgery.
It's an invasive
neurosurgical procedure.
You have a newborn.
You've been through a lot.
The surgery can wait
for a more ideal time.
I don't want this cloud hanging over me.
I've waited for ideal times before.
They don't come.
Please, the surgery.
We'll have neurosurgery
come speak to you.
Thank you.
Yeah.
Dr. Hudgins.
Yes?
I hear our patient, Mr. Jones,
is resting comfortably in the ICU
after successful embolization.
Oh, good.
There's a sim dummy in seven.
I'm gonna show you how to reduce a hip.
You said it was a physically
demanding procedure,
so you're gonna do it.
Mama.
I can see you.
Yes.
And you look so beautiful.
Mm-mm, I'm so old.
No. No.
[SOBBING]
I'll see you.
A word, please.
- Yes?
- Look.
It's one thing to bar them
from filming her during surgery,
but, Sharon, this is what
audiences would want to see.
And you've stopped
them from capturing it.
After all they've been through, George,
they deserve this time without cameras.
They wouldn't even have had
a chance to get this surgery
if it wasn't for Jack's generosity.
Yes, and I still have to
look out for my patients.
George, you're a doctor. You know that.
I do.
But I also believe in Jack's
vision for this hospital.
He wants us to be the leader
in cutting-edge healthcare.
Sharon, this film tells the
world exactly who we are.
And who are we, George,
if we forget about our
patients and their loved ones?
But Jack is a man who's not
used to hearing the word "no."
Well, maybe it's time he did.
Yeah.
Hey, neurosurgery is getting
ready to operate on Cara.
That's great.
Woman's braver than I am.
And me.
Hey, you weren't wrong.
I am interested in Grace.
OK.
So why did you give her
the brush-off this morning?
And don't give me that stuff
about her being a nomad.
I mean, look at my
dating track record here.
- Hasn't been exactly stellar.
- [SCOFFS]
- No offense.
- Yeah.
[LAUGHS]
Well, I might be crazy or out of line,
but I wonder if all of these excuses
are really just about one reason,
or rather one person.
Natalie.
Natalie?
You know, it did always feel like
you were still carrying a torch for her.
Yeah, maybe.
Maybe I still was.
But now, I mean, it's just
me trying to get it right.
Good.
[LAUGHTER]
You're a really great guy, Will.
You deserve to be happy.
Thanks, Hannah.
Now, what was particularly difficult
about this operation?
Well, the angle was slightly unusual.
But fortunately, we were
able to relieve the pressure
and reinflate his lung.
You were basically folded over yourself,
- and alarms were blaring, so...
- Right.
Why don't you tell us what
you felt in that moment?
I guess the real headline here
is successfully
aligning Kuan-yu's spine.
You saw firsthand a
revolution in medicine,
thanks in part to OR . .
I mean, this is just the beginning
of what this Dayton partnership can...
can produce.
Yeah.
Hell of a day, huh?
Hope you're off to celebrate.
You know, you're not a terrible surgeon,
but you do have awful taste in heroes.
Heroes? Come on, Sam.
At least he's using his
billions for some good, right?
Oh, yeah, confident that's
why he amassed his fortune.
Point is, we can help
so many more people
with Jack's vision and
money in our corner.
No, his vision of whom to help
seems a bit more narrow than yours.
- What does that mean?
- I just found out.
Dayton says from now on, .
is for paying customers only.
- Wait, what?
- You heard me.
No more subsidized care.
Well, if that's true, then your fight's
with the insurance companies.
[TENSE MUSIC]
♪
We're all out of the good stuff.
Radiology's got a secret stash, though.
Thanks for the tip.
Or maybe I could buy
you a cup of coffee.
I don't think that's a good idea.
OK. Have a good night.
What about a drink instead?
Guinness, right?
Mm-hmm.
Guess that made you happy, huh?
I don't know what you're talking about.
Ah.
- I gather you told him.
- More or less.
Told him I needed dialysis.
Left it pretty vague.
But I don't want to
make him a caretaker.
He doesn't need that right now.
It's a good thing you told him, though,
not just for his sake.
Good night, Dean.
Wait, hold on.
I have a favor to ask.
[KNOCKS AT DOOR]
Hey, Dad. There's pizza in the fridge.
- I promise it's not Hawaiian.
- Wait.
Are you finished with your applications?
Yeah.
All proofed, agonized
over, and submitted.
And I chose early decision
to University of Chicago.
- What happened to Stanford?
- Nothing.
I wasn't really all
that serious about it.
Plus, I'm not exactly a California girl.
I don't really know what that means,
but, I mean, you seemed
pretty serious about it to me.
There's other schools
with sustainability stuff.
Plus, I would miss
Italian beef too much.
And, you know, and maybe you.
You know what? I'd miss you too.
But the right school
is the right school.
Why go so far and leave you all alone
when I have great options at home?
OK, first of all, I'm
not gonna be all alone.
And guess what?
It's actually not your
job to worry about me.
Anna, when you've accomplished
what you have in school,
you get to go to whatever
school you want to.
I don't care where it is.
And honestly, I've really
started to kind of look forward
to having an excuse to go
to California in February.
So, you know, don't step on my dreams.
Thank you, Dad.
I'm gonna apply.
Why not?
Yeah.
Let's see.
OK.
All set.
Is that all right? Are you in any pain?
No, it's fine. Thanks.
OK.
Front door sticks, so just
lift up when you close it.
I know it's late.
Actually, I'm a...
I'm a bit of a night owl.
Occupational hazard of being an OB-GYN:
always on call.
Oh, Hannah, you don't have to stay.
There is a quiz in here,
and I have always wanted to know
which classic car matches
my sparkling personality.
Oh, easy.
- You're a Prius.
- [LAUGHTER]
[TENSE MUSIC]
♪
[WOLF HOWL]