02x07 - Trial & Error

[bunniefuu]

Previously on The Resident...

Medical devices gave me my life back.

Total hip replacement.

It made me a true believer.

Have you arranged for someone to teach you Bhangra?

You studying up to do a Bollywood dance?

My fiancée insists, but I've two left feet.

Well, maybe I can help.

I was a dancer.

I've been thinking about creating my own medical device.

Watching what you do gave me the idea.

- What am I doing here?

- Oh, I'm assigning you to Ortho.

- Okafor belongs to me.

- I belong to no one.

My sister.

She OD'd on Oxy.

I'm not just doing this for me anymore, - I'm staying clean for both of us.

- I'm not worried.

Do I look worried?

Perhaps you should let go of kitty's leash.

Camping for a bachelor party weekend?

Really?

What I want to know is who sleeps in the middle?

Was this Devon's idea?

He was fine with a couple beers at Waylon's.

But Irving...

Is making up for getting kicked out of Boy Scouts.

Hey, the nurses are planning a girls' night tonight.

- We're thinking bowling.

- Oh, I do not like sports where I have to wear other people's shoes.

Okay, fine.

Karaoke?

Come on.

Jessica's in Savannah for the weekend.

I have zero obligations.

This is the first time I've been free since she got out of rehab.

It's Conrad.

Hey, what's up?

You're kidding me.

Okay, yeah.

I'll be right there.

What's going on?

Jess is not in Savannah.

I'm burning up.

What's wrong with me?

Jess...

You okay?

I'm fine.

I told Conrad not to call you, but clearly, he can't keep a promise.

I made no promise.

And, Jess, she needed to know.

Since when does Chastain do drug trials?

Since Bell discovered they're a cash cow, I imagine.

- What kind of trial is this?

- It's for cancer.

Healthy people volunteered.

Half of us got a cancer drug, half of us got a placebo.

- Do we know who got the placebo?

- No.

It's a double-blind.

Jessie's fine right now, but John isn't.

Fever and vomiting.

Why didn't you just tell me?

Because I knew you would lecture me.

This is my fault.

I told Jess it'd be a good way to make some money.

I've done them before.

I've never had a reaction like this.

Excuse me.

Who authorized this?

- Who are you?

- Who are you?

What...

What are you doing here?

I'm a doctor.

She's an NP.

And John, here, is in significant distress.

He's having a normal reaction for a Phase 1 first-in-human clinical trial.

Reactions are what we're here to document.

Now, I'm gonna have to ask you to go.

Oh, you don't have to ask.

Jess, come on.

No, I'm not gonna leave John.

Uh, you will lose your fee if you quit.

I want to go.

I don't care about the money.

- What?

- Call rapid response!

We need to get him to the ER now!

John Losurdo.

30 years old.

Fever, vomiting, a syncopal episode.

A suspected reaction to an immunotherapy trial drug.

- We do drug trials now?

- Apparently so.

Uh, BP's 90/55.

Hang 1 liter of normal saline and give him four Ondansetron to help with the vomiting.

One, two, three.

- Is John gonna be okay?

- I hope so; we don't know enough about the drug, or his health when he took it.

- How do you know him, Jess?

- Rehab.

He's such a great guy.

Every time I wanted to bail, he convinced me to stay.

I'm supposed to have a consult with Mina right now, - but I want to stay here with you.

- No.

It's fine.

Go.

- Are you sure?

- We've got this.

Go.

Steth.

Let's get a second line and some blood work.

Babe, when you check the time, this tiny little camera, it scans your retina, and it sends your vitals to me like that.

That is so cool.

I can't believe you designed that.

Yeah.

If my dad had been wearing this, I could have caught his heart att*ck before it happened.

Now wait, there is just one more thing that I need.

Priya Nair, would you do me the honor of being my first trial participant?

My beta tester?

Oh, yes.

Yes, yes.

Um.

First, there is actually something I need to talk to you about.

All right.

Listen, If this is about who's sitting where, - honestly, whatever you want...

- No, nothing about the wedding.

Um, Devon, I've been offered a spot on an investigative journalism team.

That's amazing.

Babe, I'm so proud of you.

It's at the San Francisco Chronicle.

If I take it, I have to move there.

Soon.

When?

Because we're getting married in two weeks.

How would that even happen?

A lot of couples live in different cities.

We could make it work.

Nothing is decided yet.

Let's talk more when you get back from your bachelor weekend, okay?

I'm late.

You need to stop the trial now.

Are all your nurses this dramatic, Dr. Bell?

Oh, I hear that one of your participants is in our ER with life-threatening symptoms.

One of our participants got sick to his stomach and a bit dehydrated.

- Nothing life-threatening about it.

- Oh, please.

Two more are deteriorating as we speak.

Cancer is a ferocious enemy.

We fight it with strong dr*gs.

Please get your staff to back down, or Chastain won't see a dime.

Oh, and what's a lawsuit gonna cost if one of these patients dies?

Your trial can continue, but I expect you to notify me right away if any of your participants have reactions outside the range of normal.

One of them's my sister.

Perfect vacation: mountain, desert or sea?

Uh, desert.

When you're done with this charade, I need to talk with you.

Okafor, you are my ex-resident.

I'm looking for my next resident.

And as you can see, it's an embarrassment of riches.

Or just embarrassing.

Next!

Here.

What are you doing here?

I need a consult from you and Conrad on a patient.

His name is Ernest LeVasseur.

Ernie?

Oh, woman, you should've led with that.

He owns the Grill and Gumbo and makes the best ribs in Atlanta.

No, not anymore, he doesn't.

Why?

What's wrong with him?

The better question is "What isn't?" Mr. and Mrs. LeVasseur?

This is the brilliant Dr. Hawkins.

He's one of our top diagnosticians here at Chastain.

Oh, and this is Dr. Austin.

Cardiothoracic.

I'm just a smidge above average.

Ernie, it is an honor to meet you, brother.

I am a huge fan of your dry rub.

Oh, he's nearly blind, and his hearing's almost gone.

The doctor loves your dry rub, Ernie.

- I had an egg with some bacon.

- Honey, they don't care what you had for breakfast.

He talks nonsense like this all the time.

My brother-in-law says it's early onset dementia.

Neurology doesn't think so.

When did he lose his vision?

About six months ago, and then hearing went next.

Like, every other day, another part of him was gone.

Mind if I have a look?

First, he developed hypothyroidism, and then reflux esophagitis.

His echocardiogram shows heart failure due to cardiomyopathy.

Some kind of rash around his neck, warm to the touch.

Let's get another thyroid and renal panel, and let's add on an RPR, folate and B12.

Medical history?

Left hip replacement in 2012.

Kidney stones last year, but that's about it.

Any complaints of pain?

No, he doesn't complain about anything.

He never has.

Ernie's always been the happiest, most optimistic...

You know, it's like he's here, but he's not.

There's almost nothing left of him.

We understand how difficult this must be.

Oh, I doubt it.

I get up at 6:00 every morning and I change his diaper and then I shower him, and after he's fed and dressed, I do it all over again with the kids.

And after they're fed and they're dressed and I send them off to school...

Oh, my God.

I can't do it anymore.

Janine?

Darling?

W-Where are you?

I'm right here!

At least he still remembers my name.

Sometimes, I...

I really wish that he didn't.

No one takes care of the caretaker.

We're going to take care of him here.

You go home, rest.

I will call you as soon as we know more.

She needs help.

She's close to breaking.

I've notified social services.

They're scheduling a home visit.

A year ago, Ernest was the life of the party.

What do you think is wrong with him?

I think he's being poisoned.

I...

made...

T-shirts.

I'm not wearing that, bud.

Campsite's booked, rafts are rented.

f*ring up the minivan at 6:00 p.m.

sharp.

Snack situation's on point.

I got ten flavors of chips, including Nacho Mamma's Nachos.

Don't be late.

I already told Conrad we have a hard out.

Hey, guys.

- How's the dance coming along?

- Oh, uh, we're crushing it.

You still want to practice when you get back?

Please, never do that again.

Wait, is that what I think it is?

Beta version 1.0.

How's the retina scan function?

That's what makes it so unique.

Yeah.

So far, so good.

- Sends the data directly to the...

- Smartphone app.

I remember.

Yeah.

Some of my friends in Silicon Valley have been troubleshooting it for weeks and it seems to be working well.

Well, you can't test it on yourself.

You need a beta.

I'll drop an obvious hint one more time.

You need a beta.

You?

- Really?

- Yeah.

Why not?

Okay, so, um...

It tests for - your heart rhythm...

- Uh-huh.

uh, blood pressure and, um, your pulse.

Oh, and it's also gonna tell me I'm late for surgery.

I got to go.

Keep an eye on me, Pravesh.

- How are you feeling, John?

- Not great.

His back is k*lling him.

Well, it'll take time to metabolize the drug they gave you, but we can up your pain meds, manage the symptoms in the meantime.

Is that your family?

Yeah.

Ingrid, light of my life.

My wife, Sarah.

She keeps giving me chances, you know?

They live in South Carolina.

This last stint in rehab was the first I did on my own 'cause I want to get better, for me and for them.

This drug trial was just a way to come home with some cash in my pocket.

Help pay the bills, Ingrid's music lessons.

Love her to death, but she cannot play her recorder so well.

At all, really.

Jess, you okay?

Yeah, yeah, I think it's just a stress headache or something.

Hey, where was that?

Right here?

- Yeah.

- You all right?

Jess?

Devon!

Irving!

Jessie didn't get the placebo.

Come on, let's get her on a bed.

We're gonna take care of you, Jess.

Nic, what's happening?

I'm scared.

- I know.

I'm here.

- Oxygen sats are dropping.

- John?

Hey, John!

- He can't breathe.

We need to intubate him.

Hurry.

Page Conrad to the East Wing.

Tell him to check the other trial patients.

Get them to the ICU.

Again?

I-I told Dr.

Bell...

Two of your trial patients are in the ICU with complications.

It cannot be from of our drug.

This dose was scaled back 500 fold for what was proven safe in monkeys.

Monkeys?

Really?

Hey.

Hey, hold up.

What do you think you're doing?

Clearing the room.

Get these two to the ER for observation.

- I am beginning to lose my patience.

- And mine's long gone.

Trust me, you don't want to push me any further.

I'm calling Bell.

I already did.

Give me an update.

Adele and Mauricio have a fever, pain and vomiting.

Jessie is having trouble breathing, so we have her on oxygen, and John is on a vent, with multisystem organ failure.

I don't have to tell you your trial is over, and Chastain is not responsible if anyone dies from whatever the hell - you gave them.

- I am telling you, it is sepsis from an infection they caught here.

The drug vials were prepared by your company.

- If there's any contamination...

- The blame game can wait.

We need information on this drug.

That's not happening because it's not the drug.

Look, you don't know that.

I want every bit of data you have in my hands in the next ten minutes.

I'm not asking.

It's really deep in there.

Well, it's only a quadruple bypass, but I'm sure your inability to get deep enough will be just fine with the family after their loved one has...

Wait, wait.

I think I got it.

Yup.

Sam's dead, and so are you.

Allow me to demonstrate.

I'm starting to get the feeling you miss me, but your position's almost filled.

Ernest's tests are in.

The levels of cobalt in his blood are 200 times normal.

He has metallosis.

So you were right.

He is being poisoned, but from what?

Here's the culprit, his metal-on-metal hip replacement.

When the metal ball and metal cup slide against each other, tiny particles can flake off and enter the bloodstream, sending cobalt and chromium to every major organ.

And causing muscle and tissue atrophy, acetabular and femoral osteolysis, - and pseudo-tumors.

- I don't get it.

Why would anyone sell a hip implant that could leak poison?

Imagine the lawsuits.

Oh, pennies to their profits.

The question is, how does something this flawed get FDA approval to begin with?

The 510 process.

This lets companies fast-track a device, if a device is similar to an existing device.

Which helps lifesaving devices get on the market fast.

Even if that existing device was recalled for defects.

Surely there are protections in place that stop people from taking advantage.

Not when medical device executives sit on the board of the FDA.

The fox is guarding the henhouse.

Well, let's focus on what we can fix.

Mr. LeVasseur is going to need a left ceramic on polyethylene hip prosthesis to get the metal poison out of his system.

- Does QuoVadis carry one of those?

- We do.

I'll have it couriered.

Well, the good news is when leaking metal hips are replaced, most patients make a full recovery.

I don't think he'll ever regain his eyesight.

No, but surgery will certainly help all of his other problems.

If it doesn't k*ll him.

Atlanta was never iya's first choice, but I'm finally feeling settled, like my life is on track.

So move, or deal with living apart.

You're not so great at this, are you?

I'm exceptional at it, actually.

I made you face the stark reality of your choice.

If you want hand-holding, go elsewhere.

Well, Julian's got a healthy pulse.

Her vitals are impressive.

You are taking stalking to a whole new level.

I'm just testing my device, Mina.

Hm.

Keep telling yourself that.

- Is that our new hip?

- It is.

Safe and tested...

Okay.

Is she always so...

Yeah, yeah.

She's, uh, she's very consistent.

So how are my numbers?

Beautiful.

I mean, they're, you know...

They're-they're good.

They're great.

Your device is working.

So far, it is.

But less coffee, more water.

You're a little dehydrated.

So a fourth latte is overdoing it?

Fourth?

Are you being serious?

Do not even judge.

I saw you in the residents' lounge, chugging what I'm pretty sure was a can of grape soda.

Okay, don't knock it until you try it.

Oh, I tried it, when I was six.

All right, you know what?

The residents' lounge is for residents, not device reps, so...

Oh, so that's how it's gonna be, huh?

Yeah, it's gonna be just like that.

Okay.

I saw this really cute apartment in Inman Park.

Landlord wanted a cash deposit, so...

I'm too old to live with my sister.

Way too old.

I shouldn't have lied to you about Savannah.

I'm sorry.

I just...

I wanted to show you I could do something on my own.

I thought maybe things could go back to the way they were when...

- when we were close.

- Hey.

We're close now.

We're, like, too close.

You're like a barnacle.

Stop.

It hurts.

- I'll be right back.

- Okay.

What's going on?

We have information on the drug.

It's an agonist for the CD28 receptor.

So the drug targets the immune system to fight cancer.

Kisic claims the participants all have a massive infection.

- Septic shock fits the symptoms.

- I don't think it's septic shock.

I think it's a systemic inflammatory response from a cytokine storm.

There's no way to know for sure.

There's no quick test - for a cytokine storm.

- They both have the same presentation, but cytokine is caused by an immunotherapy drug.

If there is any hope of stopping this att*ck on their organs, we need to at least start John and Jessie on high dose steroids now.

But if it is a massive infection, high dose steroids could k*ll them.

We can't wait, we have to act now.

My mom d*ed from a bad judgment call.

We need to be certain.

You know that's not possible.

My gut tells me this is right.

Okay.

So let's start steroid treatment on John and Jessie with your permission.

And the others, we wait until we know for sure that you've made the right call, and hope like hell it is.

Ernest can't make this decision.

You are his medical proxy.

Without the surgery, how long does he have?

Another year maybe, but he will continue to deteriorate.

But the surgery could k*ll him today?

Yes, but if he survives, he can finally be himself again.

Janine?

I'm Korean.

He learned to speak Korean so we could speak it together.

Ernest has always been so romantic.

Don't cry.

Don't.

It's okay.

I said I couldn't stand to take care of him anymore, and now, I can't bear to lose him.

Will you both be in the surgery?

Oh, Dr. Okafor will be assisting Dr. Voss, who is an exceptional...

But-but what if something happens with his weak heart?

I'll sign the consent form.

If you'll both be in the room with him.

- Nic, I'm drowning.

- Your...

your lungs aren't getting enough oxygen.

We're bringing in a ventilator to help you breathe.

- Okay?

- I'll take it from here, Nic.

The steroids aren't working.

- What if it is sepsis?

- Steroids take time.

But, Nic, you know there are no guarantees.

- God, why did she do this?

- We can't think about that right now.

Nic.

If you have something you need to say to Jessie...

now would be a good time.

Jessie, I need you to be strong, okay?

I need you to fight for me.

All right?

I'm gonna be right here - the whole time.

- Ready to intubate.

I love you, okay?

I'm right here.

Patient Ernest LeVasseur in for a left hip revision.

One ceramic-on-polyethylene hip device.

Left.

Correct.

Time-out complete.

Surgical field prepped.

It's showtime, party people.

And don't worry, Dr. Voss.

I'm just here monitoring Monsieur LeVasseur's poor heart.

I promised your resident that I would be quiet.

It will be hard for him.

Let's relish it, ladies.

10 blade.

Dr. Okafor, retract the subcutaneous tissue.

Retractors.

Oh, crap.

The metal particles have caused the soft tissue around the joint to harden.

When I cut into it, it liquefies.

The necrotic tissue is completely encompassing the hip joint.

Gross.

I-I've never seen...

Anything like it.

Suction.

If you're going to hurl, best to not do it - in a sterile environment.

- Yeah.

I'll be right back.

What were you chopping?

Carrots.

They kind of looked like my pinky.

Irving!

- Somebody dying over here?

- I only cut my pinky.

Wait, am I dying?

Take over for me.

Julian's having a heart att*ck.

You're not dying.

- Are you all right?

- Yeah.

I was just feeling faint.

The surgery...

it got kind of ugly.

Tachycardia.

Not a heart att*ck.

Safe to say that my device overreacted.

Big-time.

It'll get there.

- Thank you for checking on me.

- Of course.

You should have seen that hip implant.

That poor guy, his whole life is ruined.

And who knows if it's the same one that's in me?

You have to call your ortho and find out.

I will.

Thank you, Devon.

Jessie's stable on the vent and vasopressors.

That's...

That's good news.

Go to the lounge.

Lie down.

I'll come get you if anything changes.

Thank you.

She's gonna get better.

And I'm a thousand percent not going river rafting with Devon and Irving, which means I'm here and I'm here with you and I'm here with Jessie.

I always thought, if we ended up here, it would be because of an overdose, but a drug trial?

I can't even imagine how difficult this must be for you.

He's in V tach.

Get a crash cart in here!

His pulse is thready.

I need one of epi and an amp of bicarb.

Lost his pulse.

Starting compressions.

John got the steroids too late.

He was 30 years old.

His poor wife and little girl.

What if we didn't give Jess the steroids on time?

She could be next.

Okay.

I'll call you back.

This is unbelievable.

This is a disaster.

You can expect an independent investigation.

- I am gonna have you...

- Of Chastain.

The wing you leased us is clearly not up to code.

I would think hard before you thr*aten us with malpractice.

A man is dead.

A lawsuit is the least of your problems.

You could be facing manslaughter charges.

Me?

He misdiagnosed and didn't treat for what they actually have: sepsis.

We need to stop steroids and start an aggressive course of antibiotics.

Antibiotics alone will k*ll them.

What we need to do is up the steroids.

And when they die, that's on you.

Just...

give us a minute.

No, no, no.

Uh-uh-uh-uh-uh.

I need to be privy to any and all conversations.

Yeah.

In your mind.

This is my hospital.

Back off.

So why, exactly, are you so sure it's a cytokine storm?

Well, we've seen no improvements in patients on antibiotics alone.

We have seen some in Jessie since we gave her the steroids.

And John was the first one to get the drug, so the cytokine storm had already done irreversible harm to his organs.

It wasn't that the steroids were the wrong call.

It's that we were too late for John.

- But maybe not for the others.

- And the longer we wait...

Yeah, the less likely the steroids will work.

Hawkins, just try talking to me like I've been practicing medicine for almost as long as you've been alive.

It'll prove useful in these situations.

All right.

Stay the course.

Up the steroids on Jessie.

Start steroids on the other two.

I'll handle Kisic.

- You okay?

- Yes.

My apologies.

That's never happened before.

Hey, things are a little shaky over here, people.

This is taking way too long for his heart.

The structural damage is extensive.

Removing the old acetabular component took out some of the bone and created pelvic discontinuity.

I'm not sure we're going to be able to complete the surgery.

So you're just going to close him up?

We'll put in a temporary spacer, close, then open him up again once we get the proper revision components.

I did some research before the surgery, and I brought a triflange cup as backup, just in case.

Yeah, that works.

It's not something we typically stock, but...

good call.

Glad you made it back to join us.

Bloody hell.

The deteriorated hip caused me to hit the exterior iliac artery.

- Pressure's dropping fast.

- We need to repair the artery.

- Austin, scrub in.

- Not enough time.

Okafor is sterile.

I need you, not a third-year resident.

I've converted a right ventricle to the center ventricle in a heart the size of a walnut.

Performed an emergency tracheotomy in 30 seconds flat.

- I'm not just any third-year.

- What she said.

Suction.

Pressure's still dropping.

- We're losing him.

- Clamp.

There's too much damage.

It's too risky even to bypass it.

When I took over and made the incision, you put his life in my hands.

I can do it.

I'll use the patch.

What she said.

Adele and Mauricio are improving on the steroids.

We were right.

The trial drug caused the cytokine storm.

Yeah, but Jessie isn't getting much better.

She's breathing on her own, but her kidneys are getting worse.

She's in acute kidney failure.

We're gonna have to put her on dialysis - until her kidneys recover.

- Yeah, that's if they recover.

Hey.

Hey.

Oh, my God, I was so worried about you.

How's everybody else?

Mauricio and Adele are doing great.

And John?

I'm so sorry, Jess.

Oh, no.

John didn't make it.

No, don't tell me that.

- No.

- I'm sorry.

No, no.

Is, uh...

is this a bad time?

No.

I talked to my orthopedic surgeon.

My hip isn't metal-on-metal.

It's safe.

It's tested.

All good.

Well, that must be a huge relief.

Yeah, but I just looked up how many people have metal-on-metal hips.

It's well over a million.

This is my industry.

How do I not know this is going on?

It's impossible to know everything we should know.

All we can do is the best we can.

About earlier...

There are no excuses for what I did, so I...

I pulled you into a dark room, and I threw my arms around you.

I'd say that we share the blame.

As far as I'm concerned, what happened never happened.

Okay?

Could have been worse.

Not for John.

Every medicine, surgical procedure or intervention ever prescribed or performed is because of a clinical trial.

Without them, medicine cannot advance.

Without them...

we'd still have polio.

But does everyone who volunteers, do they understand the risk?

- They signed the forms.

- Because they're desperate.

They needed the money.

A student trying to pay for his tuition, underpaid school teacher, recovering addict...

dad trying to provide for his little girl.

And now...

that child has no father.

Mrs. Losurdo.

- Can I see John now?

Is he okay?

- Would you like to sit down?

No, I...

I-I want to see John.

How is he?

Well, when we spoke earlier, on the phone, John was already experiencing serious side effects.

And during the course of the day, he worsened, and although we did everything we could, we were unable to save him.

And he d*ed a little while ago.

I don't understand what you're talking about.

He was fine.

When you called me, he was fine.

No, he was already in distress.

Please, have a seat.

Have a seat.

- I'm sorry.

- Mom, is Dad okay?

Mom?

You know, John always reminded me to be grateful for the people that don't give up on us.

Not every recovering addict has that person, but I do.

And I am so grateful.

When the phone rings at night, Jess, my heart stops.

Is it gonna be someone calling to say that you're in trouble again?

Or that you're in jail?

Or dead?

So I hover.

And I worry.

And yes, I do too much, but here we are again.

You almost d*ed today, Jess.

You got to start making better choices.

I know.

You're right.

I promise I will try to make sure this is the last time that you have to go through this.

So let's start now.

Okay?

Get out of here.

Go sing and dance and do whatever the hell you want.

I'm safe.

And I'm gonna be okay.

- You're touching me.

- Mm-hmm.

- And you're smiling.

- Ah.

Which is more offensive - to your delicate sensibilities?

- What the hell are you doing?

I am guiding you toward victory.

You put together a team of doctors.

You expertly stepped up in the OR to repair an exterior iliac artery.

Mina, you saved Ernest's life.

Now, we do what we do for moments like this.

So go ahead.

Finish the job, princess.

Don't call me princess.

Ernest should make a full recovery.

In a few months, he may even get his vision and hearing back.

His mind will clear.

He will barbecue again.

I'm sorry you both had to go through this, but it's over.

Thank you.

- Really, thank you.

- Oh, yes.

Of course.

Thank you.

Camping, rafting isn't gonna happen because we all realized we don't really raft, or do things outdoors that involve water, animals or bugs.

I'm not even certain I can swim.

Well, I can swim, but spending two hours in the car with this guy, after this day, is not my idea of a good time.

Are you inviting yourselves to girls' night?

Well, we're hoping to get invited.

We'll be on our best behavior.

What if I don't want your best behavior?

♪ Mailman, mailman ♪ ♪ Tell me what you got for me... ♪ What would you do if you were no longer free to be a surgeon?

Uh, I don't know really.

a lumberjack?

Well, I have to cut up something.

I miss the OR.

I just think about it all the time.

You've been kicked upstairs.

I moved myself upstairs, and now it's just hell.

I'm trying to get back down.

Some days are better than others.

Today, not one of them.

I sense a bit of a crisis here.

You know what would help?

Buy a Porsche.

It's parked outside.

- Sailboat, then.

- Just sold it.

High-end prost*tute?

I won't judge.

I like you.

I like you.

Even though you are a bit of a bastard.

Cheers.

♪ Been looking every which way... ♪ ♪ Making love with each other, ah-ha ♪ ♪ Islands in the stream ♪ - Devon.

- ♪ That is what we are ♪ ♪ No one in between ♪ - Yeah!

Let's go.

- Let's go, Devon.

♪ To another world ♪ ♪ And we rely on each other, ah-ha ♪ You look...

Like I just had one of the worst days of my life?

I was gonna say "amazing." With a good outcome for Jessie.

This time.

Come back to me, Mina.

I hate working alone.

- You are never alone in the OR.

- Yeah, well, without you, I am.

Say it.

- You are irreplaceable.

- Mm-mm.

Use the bass in your voice.

Say it like you mean it.

You...

are...

irreplaceable.

I'll work with you and Dr. Voss.

I get to choose the surgeries.

And I get to cut.

The queen has spoken.

The king bows down.

You are no king, and I am not your queen.

- I am your mentee.

- No.

You are my partner.

Speech!

Yes.

Everybody having a good time tonight?

I hope so, because it is a really great chance to practice the wedding dance.

What do you all think?

Let's do it!

And, thankfully, a dancer who is way better than me helped me put this thing together, and that is Julian Booth.

Let's do this!

Follow along.

You got it.

All right!

Yeah!

That was...

that was tough.

But amazing.

It really was.

Thank you.

♪ The garbageman left all the trash... ♪ I guess, uh, it's a bad idea for us to dance.

Just for tonight...

Last dance.