Previously on The Resident...
- Incoming multi-vehicle accident. - It's Cain.
Normally this is the part
- where he stabilizes. - There's no way to know
if his brain was adequately perfused for those 15 minutes.
We wanted you to be the first to know.
It's a girl.
Red Rock has had to make some very difficult decisions.
They're turning Chastain into luxury condos.
Wow.
You keep coming through for me, Dad.
One text and you hop on a plane.
Yeah. I would do anything for you.
Well, there's good news and bad news.
Bad news first.
Chastain's been sold.
The plan is to turn it into condos.
Given that the hospital loses millions,
I think Red Rock made a smart decision.
With terrible human consequences.
Atlanta needs Chastain.
The other hospitals can't possibly absorb
all of our patients.
And thousands of Chastain employees will lose their jobs.
And two people I love.
I can't stand by and watch it happen.
Would you consider putting together
a group of individuals to buy back the hospital?
You're the king of takeovers,
and if you're willing to front some of the cash,
I can handle the medical side of the pitch.
Conrad, my resources are completely tied up right now.
I'm sorry, son. I know what this means to you.
We're both fix-it people,
but not everything in life can be fixed.
I understand, but I'm not giving up.
Let's just keep thinking about it, okay?
Of course. So what's the good news?
How do you feel about being a grandfather?
- Oh... - Ah?
You mean Nic and you...
Oh...
Conrad, that is wonderful.
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Save Chastain!
You look like I feel.
You know how long this has been my home?
30 years.
I interned here.
It's like a death in the family.
How many patients are left?
Just a handful.
They'll all be gone by tomorrow.
You want to count your blessings?
I can make you feel like a lucky man.
Will he ever wake up?
No way to know.
He can't stay here. Where's he being taken?
There's only one option.
I can't believe it's ending, man.
This is insane.
Come on, let's take a photo.
- It's a thing. - _
- Everyone's doing it. - Well, I'm not giving up
until Conrad does, and he's still fighting, so...
- He's in denial. - Well, so are some of the patients.
What is this?
The ER can't be closed. I need to see a doctor.
I'm afraid you'll have to try Atlanta General.
No, I was just there. I waited ten hours.
The ER line is out the door.
You're a doctor. Take care of me.
I can't anymore. I'm so sorry.
We're shutting down.
Come on, man.
You're kidding. Another package?
Well...
I'll take it to his room.
I have bad news and it's time to tell him.
Henry.
It's my wide-eyed children figurine.
I bet it's Peppy Pete.
Henry, that's gonna be your last delivery, okay?
Don't order anything else to this address.
The hospital is closing down. You know that.
It is. It's Peppy Pete.
Ooh, aren't you a little rascal?
Don't you love him?
Um, y-you're not listening, Henry.
Oh, Chastain's closing.
Blah, blah, blah.
Dr. Pravesh, I'm not blind.
I can see everybody being wheeled out of here.
But I've got an inoperable AVM on my heart.
You told me so yourself.
I can't leave here until I get a heart transplant.
About that, Henry.
Look, I know that you've waited a long time.
But the committee took another look at your case.
And given your age and your medical history,
they're worried that you're not gonna survive the operation.
They've taken you off the list, Henry.
I'm so sorry.
But I-I need a new heart.
I'll die.
I want to recommend hospice.
You'll be comfortable, well cared for...
I-I've lived at Chastain for six months
waiting for a transplant.
I... My-my wife passed ten years ago.
I-I gave up the apartment.
This is my home.
I understand, trust me.
We're all sad to go.
- But we have to. - Dr. Pravesh,
I-I know everyone said that a transplant was my only option.
But there must be something else we can try.
I want to talk to Dr. Austin.
- Thanks for doing this, Gabbi. - No problem.
Only hard part was finding an ultrasound
that hadn't been shipped to Atlanta General.
Let's see how much our girl has grown.
I can't wait to see her.
15-week-old baby Hawkins/Nevin.
Placenta is well-developed.
Uterus is in the normal position.
There's a leg, an arm.
Two of each.
Well, that...
- Good. - That is good.
And here's her heartbeat.
Wow.
Can we do Nic's routine bloodwork today as well?
Just to put our minds at ease?
Yeah. I think I can do that under the wire.
After today, you'll see me at Atlanta General.
Crazy.
We'll come see you there.
Thank you.
Of course.
What about Cleo?
No.
Jasmine? Petunia?
Hell to the no.
All right, so right there,
there's your arteriovenous malformation.
It's in the left ventricle.
And you see how completely enmeshed it is
in that heart wall? If we cut that AVM out,
you won't have any heart left to keep you alive.
I'll risk it.
It's not a risk, Mr. Schultz,
it's a certainty.
You would die in the OR.
Now, you can still have a decent quality of life
for who knows how long in hospice.
I'm really sorry I don't have better news.
Hey. Online shopping?
I do need some new Louboutins,
but no, I'm actually e-mailing my new employer.
New employer?
You got a new residency?
- Yeah. - Nice.
Yeah. I heard from Mass General.
They want me.
That's fantastic. Right?
Boston.
Oh, wow, well, um...
What does that do to us?
The band's breaking up already?
You could be there, too.
A lot of fantastic hospitals in Boston.
Yeah, but you know I already got accepted to Atlanta General.
You know, plus, I-I have family here.
A prestigious hospital like this could get me my 01 visa.
It would solve all my problems.
You haven't committed yet.
Boston is a fantastic medical town.
Come with me.
I-I can see us in a little house on the Back Bay.
Snow falling down... ah, a fireplace.
Sounds like heaven.
Uh... all right.
I'll check my contacts and I'll see what's up.
Okay? But hey.
Regardless, congratulations.
You know, I couldn't be more proud of you.
Yeah.
Thank you.
_
Dr. Cain.
Barrett, Barrett, calm down.
Calm down.
It's Dr. Voss. You're okay.
No, no, we can't take you off the vent yet.
It's too early in your recovery.
No, stop.
Stop. It's... You can't breathe on your own.
Sorry, Barrett, but I have to sedate you.
It's for your own good.
Pack it up. We got to go.
One last sample just came in.
It's for Nic Nevin, nurse on the fourth floor?
_
So everything turned out great, yeah?
I mean, we're past the first trimester,
so a little less scared, getting excited.
I'm so happy for you.
And I am happy for you. Mass General, Mina, wow.
Yeah, it's a pretty big deal.
I get to operate with Marcella Crayton,
one of the best general surgeons in the country.
Amazing.
What am I gonna do without you?
- Mm, I'll miss you, too. - What about Austin?
Hopefully he'll find a spot and come with me.
My head fricking hurts!
I need to see someone now!
I'm sorry, but Chastain has stopped seeing any new patients.
Useless! What are you even doing here?
Sir, a little respect, all right? There's nothing she can do.
Well, then you do something. All right? You're a doctor.
I need... I need fricking help. Okay? I've been up for days.
Are you on any medication right now?
Yes. Ativan. For-for months. The doctors got me hooked.
Okay? But I'm clean now. All right? Two days.
- Okay, you're in withdrawal. - Wait, what are you doing?
- Are you calling the cops? - I'm not calling the cops,
I'm just calling for help.
- No, don't call the cops! - Hey, hey, hey!
Sir, you need to calm down, okay?
Get out of here!
Hey, hey. No, no, no, no, no.
Okay, Nic, stay with me, stay with me. Call for help.
Call for help!
Hurry! Stay with me.
- We need a gurney! - All right!
- We need a crash cart right now. - And some gauze!
- Yes, doctor! - Hold on. Hold on, Nic.
- What happened? - She was stabbed.
I got you. It's okay.
I'm here. No, stay with me. Stay with me, stay with me.
It's okay. I got you.
Stay with me, stay with me.
- Pulse is thready. - I got you.
- Stay with me, stay with me. - Okay, let's get her to the ER.
- Lift her up. One, two, three. - Nic. Nic...
- It's Nic! - Over there.
- We need backup. - Page any available doctor.
Mina, she needs access.
I'll grab a central line kit.
I'll grab the IV bags.
I'll look for blood.
- Found one. - Devon, we need drugs. What have you got?
Nothing yet. Still waiting on that crash cart.
We got this.
You can't. Okay?
- Mina, your arm. - This is all we got.
Mina, you're bleeding. You need sutures.
Done.
- There's free fluid everywhere. - She's in V tach.
Lost a pulse. Get the defibrillator.
They're gone. We don't have one.
Hold on.
Back up!
- Sinus tach, but she's still hypotensive. - She'll bleed out.
She's gonna bleed out. She's gonna bleed out.
- We got to get her to the OR. - Do we have a functioning OR?
- We'll put one together. - Ellen, call the staff back in.
You got it.
I'm 15 minutes out. On my way.
Hey, I need that cart.
I'm sorry, man, Red Rock's orders.
- Everything's got to go. - I said I need the cart now!
- What happened to Nic? - She got stabbed. Mina did, too.
Mina's okay. I don't know about Nic.
Jessica, we need this room prepped stat.
I've got instruments and sterile drapes,
but the suction cannisters are gone.
On it. I know where there's a stash of extra supplies
that haven't been packed yet.
Conrad... the baby...
It's gonna be okay. You're both gonna be okay.
We've got her.
What can I do?
Call my dad and Nic's father. They need to get here now.
I've got the laparotomy.
Left thoracotomy for me.
Three, two, one. We're good.
- 10-blade. - 10-blade.
Retractor.
Laps. Suction. Get the cell saver.
She's bleeding out.
There it is. Aorta's clamped.
You find the source of the bleeding?
The lac in the right renal vein.
- Controlled for now. - We'll need to release the clamp
to give blood flow back to the baby.
You ready?
She's still hemorrhaging.
Must be another source.
I see a liver lac. Cautery.
- You see anything? - No.
We're running out of time.
- There. There's a tear in the IVC. - I'll hold retraction.
Damn it, this can't be the way it ends!
Where's Nic?
- Where's Nic? How is she? - Still in surgery.
- How bad is it? - We don't know yet.
- I'm sorry. - It's okay.
- Yeah. - Come on.
Come on. We're all upset.
Believe me, I'm beside myself.
I just recently learned that Nic's pregnant, so...
She... ?
- Oh! - God, I'm so, I'm so sorry.
I... I thought you knew.
I didn't know.
Take a breath.
How-How's the baby?
We don't know yet.
My daughter...
and now my grandchild, I could lose them both?
Don't go there.
There's a lot of heartbreak in this hospital right now.
We have to stay strong for our kids.
Nothing else matters.
She made it.
The next 12 hours are going to be crucial to her recovery.
I'll close.
It's Nic... it has to be perfect.
Just give it to me straight.
She lost a lot of blood
and was down for a long time.
We won't know her neurological status
until we wake her up.
They're moving her to the ICU.
I'll order a stat set of labs as soon as we get her to the ICU.
We need to courier them to another hospital.
No one's left in the labs here.
We need to work on getting her to Atlanta General.
We need to stabilize her here first.
Then we move her.
I'll call the transfer center, see what's available.
_
- Okay. - Grab a tube.
I've got you. Okay.
Barrett, it won't work. You can't breathe on your own.
You do this again,
we're gonna have to strap you in.
Um...
So it doesn't look like Nic is gonna wake up any time soon.
We don't know what's wrong.
Could be she suffered a catastrophic
brain injury in the ER.
We don't know, but it's not good.
We'll check on Henry.
I spoke to the transfer center.
All the beds in the city are taken.
Overflow from Chastain.
We can take care of her here today,
but she needs specialists we no longer have.
She needs a functioning hospital.
This puts it in perspective.
The loss of Chastain was a body blow,
it's just nothing compared to this.
Hey.
You want me to get Conrad out of there
for ten minutes so you can do a quick ultrasound
and check on the baby?
If something's wrong with the baby,
I don't want Conrad to know.
I don't want to know, either.
That guy was mad and agitated.
And I tried to deescalate,
but I put my hands on him and he attacked me.
Nic stepped in to help and he turned on her.
She risked her life and the life of her baby for my sake.
Mina, Mina, listen to me.
There is no way this is your fault. You hear me?
I feel responsible.
I can't imagine how hard this is for you.
But the surgery went as well as could be expected.
When will she wake up?
When the sedation wears off.
Are you okay?
Yeah, I have to be.
For Nic.
We're losing our jobs,
we're losing our home.
But we can't lose each other.
U-Uh, Dr. Feldman, please,
- I want to see that one. - Oh.
Uh, yeah, here you go, Henry.
But if we're going to reminisce again, let's make it quick.
Pickup for hospice is in about an hour.
- Sunshine Sara. - Mm-hmm.
I picked her up at the Decatur flea market for a song.
- She always brought me good luck. - Ah.
How's Nic?
No change yet.
You guys aren't as far along as I'd hoped.
We'd be all the way packed up if a certain someone
didn't interrupt with constant commentary.
Each figurine holds a special memory for Henry
and he would like to share them all with us.
Henry, Piedmont Park is a nice place.
Lovely garden, not far from here.
- Will you visit me? - I will...
come by as soon as you're settled.
Dr. Feldman and Jessica told me about Nic.
It's awful news.
This is a dark day indeed.
She's so lovely.
She dropped by practically every day
for the six months I was here to visit me.
Would you give Sunshine Sara to Nic?
Maybe she'll give her good luck, too.
Or maybe you can give Sunshine Sara to Nic yourself.
Thank you.
You know, your emergency stapling skills
could use a little work.
You, on the other hand, would make a fine tailor.
Yeah, I guess I missed my calling, eh?
No, you're doing exactly what you were meant to do.
Hey.
I made up my mind.
I'll find work in Boston.
Good.
'Cause I can't lose you.
Not when we can lose Nic.
_
Hasn't woken up yet. We're worried.
She's been off sedation long enough.
She should've woken up by now.
_
We all do.
She's gonna wake up tomorrow, right?
We hope.
Hey.
All day long we fix people.
I've never had to fix Nic.
Nic fixed me.
I don't know what's happening.
How can I not know this?
I know her better than anyone and...
I just, I can barely think. I'm just like...
Take a step back.
Right now, you are not the husband,
you are a doctor.
Okay? We can figure this out.
I should've moved her to Atlanta General
when we had the chance.
It wouldn't matter, even if you wanted to.
There were no beds.
Listen, focus. What are the differentials?
I've run them all.
Eliminated everything in my head.
Well, here's what you taught me:
to find a cure, you need the right diagnosis.
The key to the right diagnosis is... ?
T-The patient's history and the physical exam.
Right.
What are we doing, man?
What are we doing?
Wait.
Come here. Watch this.
Delayed deep tendon reflexes.
Did they check her thyroid levels?
Gabbi ran a battery of tests,
but her thyroid never resulted.
Hey, Conrad, what's going on?
How can I help? What can I do? I got to do something.
- What can I do? - Stay with her, okay? We got to go to the lab.
- You got this. - Wait...
Let's go.
Hey.
Baby girl.
I'm right here. I'm right here.
All right, look-look for anything with Nic's name on it.
We need to find her thyroid results.
Anything?
No.
Found it. Lab tech must have left
before they finished running them.
Look at Nic's TSH and T4.
She's floridly hypothyroid.
That can happen during pregnancy.
It's why she's not clearing the anesthesia.
- We can treat that. - We need to get her on
thyroid replacement and steroids now.
How long until it takes effect?
Could be hours. Could be days.
Let's just hope it works.
Henry's going to hospice.
He wanted to say goodbye.
I, um, I-I brought this for Nic...
... to bring her luck.
Would you give it to her?
Sure thing.
Want to thank you all, for everything.
I don't know what I'll do without you.
You've been my family.
Let's go.
I-I thought that Nic and I were the last patients at Chastain.
Uh, well, he'll be leaving soon.
Do you think that he'd like a figurine?
I-I've got an extra Reckless Randy.
Yeah, I don't think that's his jam.
Might cheer him up.
You never know.
Yeah, sure.
Why not, right?
Hmm.
Patient wanted to leave you this.
Come on, bruh, it's Reckless Randy.
Yeah. Figured as much.
Henry Schultz. 70-year-old male.
Inoperable AVM on his left ventricle.
Delisted for a heart transplant. Lovely man.
We all wanted to fix him, but we can't.
So he's headed to hospice.
It's kind of sad.
Hey, look at this.
- This is Cain's idea about Henry. - _
Treat his AVM like a brain tumor?
AJ, this means nothing.
You cut out a brain tumor or you shrink it with radiation.
But not a vascular tumor.
Right, with those you cut off the blood supply
and you shrink 'em with surgical glue.
Th... That's radical.
- Yeah. - But brilliant.
Cain may be down, but he's definitely not out.
The patient could die on the table. Will he accept that risk?
Yeah. He's been begging for anything
that might give him a fighting chance.
The question is do we have an interventional radiology suite
that's still intact?
On the second floor, yeah.
I'll get Mina. One last surgery
before we wrap our careers at Chastain.
The baby?
Rest.
- The baby? - It's okay.
It's okay. Rest.
Rest.
It looks like the supply to the AVM
is coming from the obtuse marginal.
So you target the OM1.
But delicately, now.
If it's not positioned properly,
this glue can travel to Henry's brain
and leave him with a stroke.
- In position. - All right.
Now... inject the glue.
Look at that.
See how it flows and fills the vessel?
It's like lava from a volcano.
And here I thought we'd done
everything there was to do together.
Hey, darling.
I'm so glad you were here, Dad.
Why didn't you...
why didn't you tell me about the baby?
I was just about to.
Conrad?
I'm ready.
I need to know.
Of course.
One of the last ones left.
There's no heartbeat.
Come on.
Yeah?
Looks like your granddaughter's alive.
Okay.
Oh, we need to get Nic to another hospital right away...
a functioning hospital.
There's nothing available.
Every ICU bed in the city is taken.
I called in a favor.
Atlanta General can take her first thing tomorrow morning.
Conrad warned me this would happen.
There just aren't enough beds without Chastain.
Atlanta needs this hospital.
Have we given up too easily?
We can't just quit on Chastain.
Now, the escrow on the sale
hasn't closed yet, I checked.
So there's still time for a Hail Mary pass.
We may have a powerful ally
in the state capitol,
since Randall is governor now
and she was a patient here.
Is there any chance the county would take over the hospital?
Well, our budget would be much tighter.
And you'd be legally obligated
to take on every new patient that came through our doors.
We would be managed and funded by the state.
Going public could be the perfect solution.
You know, I can't believe it's come to this.
Chastain saved my life.
Our patients are flooding other hospitals,
they're filling every bed,
and ambulances are being turned away. I...
Now, Red Rock Medical
could sell the hospital to the county for a dollar,
but then you would have to assume all of Chastain's debts.
But I've done some research, and in Miami,
they voted to institute a half-penny sales tax
to fund their public hospital,
and it was massively popular,
worked like gangbusters.
Who-who would run the hospital?
The doctors.
Now, I mean, we can tighten our belts
and still deliver the best care.
Okay.
I will talk to my advisors,
run the numbers, do the research,
- I'll get back to... - No, it's just, there isn't, there isn't time.
You are one of the few leaders
who can act fast in a crisis,
and if you do this,
you'll be saving lives and...
and-and making Atlanta a leader in reform.
And, although I'm sure
this isn't your first consideration,
you would have a crack platform to run on
in your special election campaign.
Well, Mr. Schultz, your AVM has gotten smaller.
Yeah, the glue is doing exactly what it's supposed to.
No hospice for you.
We'll transfer you to a skilled nursing facility to recover,
but then, after that, you'll have many years of life ahead of you.
What about the hospital?
No, we won't be here.
For Chastain, there is no happy ending.
I think there is.
Marshall and Bell pulled it off.
They got the governor to agree to make Chastain a public hospital,
and the staff will return immediately.
This place could actually
be a model for health care.
Yes, the doctors will be in charge.
Wow, I can't believe it.
It's amazing, right? Conrad didn't give up,
so neither did Bell or Marshall.
I'll see you guys. Gonna make some calls.
We're going public. Means we're still alive.
And that also means you can't leave.
You know, you can't change residencies
unless the hospital goes out of business.
Mass General's off the table.
So now I have just to call my lawyer about my visa.
Mina, listen to me.
We are going to work this out. Do you hear me?
I promise.
This has been such a roller coaster.
Well, look,
it's a happy ending for Henry,
and Nic, Conrad and baby Hawkins.
Not so happy for Barrett Cain.
EMTs transferred him this morning.
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