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Previously on The Resident...

2
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Hope it's okay that I'm here.

3
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- How dare you?
- What happened here?

4
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If you stepped out of line,

5
00:00:07,618 --> 00:00:09,579
then it won't just be Pravesh
who comes for you.

6
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Surgery is a dangerous place.

7
00:00:12,423 --> 00:00:14,320
Especially considering your condition.

8
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You mean my dyslexia?

9
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Tell me why you aren't a scientist yet.

10
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This is obviously your future.
You just got to go for it.

11
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I would like to start shifting
my professional focus

12
00:00:22,102 --> 00:00:23,198
to clinical trials.

13
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Have a proposal on my desk by Monday.

14
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No eggs, Daddy, please, no eggs.

15
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I want cereal. And a banana.

16
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Whoa, whoa, excuse me.

17
00:00:45,022 --> 00:00:46,723
Coming right up.

18
00:00:56,901 --> 00:01:00,900
Daddy, did you forget
to go to the market again?

19
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I did.

20
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I am a bad daddy.

21
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No, you're not.

22
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Let's grab your backpack.

23
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We'll get something great for you...

24
00:01:14,485 --> 00:01:16,616
takeout on the way to school.

25
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That's another all-nighter.
This has got to stop.

26
00:01:38,976 --> 00:01:41,207
- I know.
- You're wearing yourself out.

27
00:01:41,212 --> 00:01:42,612
I know.

28
00:01:43,314 --> 00:01:45,077
But I don't know how to stop.

29
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_

30
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_

31
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_

32
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_

33
00:02:38,202 --> 00:02:43,269
_

34
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Dude, I lanced this massive abscess,

35
00:03:08,666 --> 00:03:10,529
and the pus exploded
all over Dr. Feldman.

36
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- Ah.
- He was pissed.

37
00:03:12,336 --> 00:03:14,666
- Pus-wise, better him than you.
- Definitely.

38
00:03:14,671 --> 00:03:16,702
Trevor, we know you made
the highlight reel.

39
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Yeah, yeah.

40
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No eruptions of bodily fluids, though.

41
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You had that awesome spinal tap.

42
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Hello. Beer-gate? Legendary.

43
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Okay, Pravesh almost cut me, so...

44
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Sure, but then Hawkins swooped in

45
00:03:27,284 --> 00:03:29,914
and took you under his wing.
Please, golden boy.

46
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- "Golden boy".
- I don't think anyone has any strong feelings

47
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about me either way.

48
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All right, well, I'd really like
to put in a central line.

49
00:03:35,092 --> 00:03:37,623
Hey. Five-car pileup on Peachtree,

50
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multiple injuries headed our way.

51
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All hands on deck. It's game time.

52
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- Synced and corrected by Firefly -
- www.addic7ed.com -

53
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Dr. Hawkins, Bay 2.

54
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- On it.
- All right, let's get him to Bay 4.

55
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- Zach, with me.
- Gemma, Bay 9.

56
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Pravesh, Bay 10. We're gonna need

57
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- another set of hands in there.
- Okay,

58
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Janice, Trevor, you come with me.

59
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Pravesh!

60
00:04:12,863 --> 00:04:15,632
- Give me Trevor.
- Go see what he needs.

61
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Grab the ultrasound.

62
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Right.

63
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Assess her for internal injuries,

64
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then we'll deal with the
lower-extremity lacerations.

65
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Got it.

66
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Whoa.

67
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- Ma'am, what's wrong?
- It's not my stomach. I'm okay.

68
00:04:37,621 --> 00:04:39,451
But he's not.

69
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I watched him turn his bike
and drive right into traffic.

70
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He caused all of this.

71
00:04:44,061 --> 00:04:46,363
There's something
definitely wrong with him.

72
00:04:48,299 --> 00:04:51,063
Hey, Zach. I need you
to do a quick FAST exam

73
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and suture up some lacs.
Trevor, come with me.

74
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The X-rays showed a fractured rib

75
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but fortunately no broken ankle.

76
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You're gonna be fine.

77
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- You're in good hands here.
- Thank you.

78
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You're welcome.

79
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I-I really don't know what happened.

80
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One minute I'm riding my bike,
next I'm on the ground

81
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and cars are skidding and crashing.

82
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I feel terrible.

83
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Sounds like you might have passed out?

84
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You got lucky. You could've been killed.

85
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Getting lucky is kind of my thing.

86
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Yeah? How's that?

87
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I was on a charter boat once, it sunk.

88
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Everyone drowned except me.

89
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- I won the lottery twice.
- Cool.

90
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Maybe you take a look at
the numbers I've been playing.

91
00:05:38,383 --> 00:05:40,079
Happy to, Doc.

92
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Wow, you got the odds
of the gods on your side.

93
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I have always felt protected
in an otherworldly way.

94
00:05:46,256 --> 00:05:47,786
A-And those are just the highlights.

95
00:05:47,791 --> 00:05:50,930
I also got diagnosed
with this thing, sarcoid?

96
00:05:50,935 --> 00:05:52,310
- Mm-hmm.
- Supposed to be bad,

97
00:05:52,314 --> 00:05:54,133
but it's never been a problem.

98
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Sarcoid?

99
00:05:55,472 --> 00:05:57,870
What medications
are you taking for that?

100
00:05:57,875 --> 00:06:01,073
None. I'm not one to
take meds I don't need.

101
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Too many side effects.

102
00:06:02,780 --> 00:06:05,177
- Whoa, whoa.
- Oh, Wyatt.

103
00:06:05,182 --> 00:06:06,612
Wyatt?

104
00:06:06,617 --> 00:06:09,281
We need to get him on the monitor now.

105
00:06:09,286 --> 00:06:10,983
- Hey.
- Hey.

106
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Sorry you had to come in
on your day off.

107
00:06:12,656 --> 00:06:15,521
It's killing me. I've got to get
my grant proposal done.

108
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- How are you?
- Surgery went long. Don't ask.

109
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Man, it's crazy in here today.

110
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I know. Hi, Brit.

111
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This is Dr. Devi.

112
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She's the surgical consultant
I told you about.

113
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Uh, I'm so sorry. Hi, Brit.

114
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I probably shouldn't have come.

115
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I've had this pain
on and off for months.

116
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But I realized I'd lost ten pounds.

117
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Without trying, really,
so I'm a little spooked.

118
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I'm probably overreacting, right?

119
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Let's just start with an exam.

120
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Ow! Right there.

121
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Can you describe your pain for me?

122
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Throbbing.

123
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Or maybe stabbing.

124
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Are you having any nausea or vomiting?

125
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I thought I was just nervous at first,

126
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you know, existential angst,
which I am prone to,

127
00:06:58,635 --> 00:07:00,799
and it is kind of
my occupational wheelhouse.

128
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I'm a cartoonist.

129
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Life's a Joke.

130
00:07:04,408 --> 00:07:06,472
- That's my strip.
- Hmm.

131
00:07:06,477 --> 00:07:08,340
So, yes to the nausea and vomiting?

132
00:07:08,345 --> 00:07:11,477
Oh, right, yes. Krakatoa,
east of Java, man.

133
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Just keeps on coming up.

134
00:07:13,684 --> 00:07:15,548
We'll start with a CT scan
to take a closer look,

135
00:07:15,552 --> 00:07:17,750
and we can admit you
to get control over your pain

136
00:07:17,755 --> 00:07:18,984
and we'll go from there.

137
00:07:18,989 --> 00:07:20,720
- Okay?
- Cool.

138
00:07:20,725 --> 00:07:22,692
All right, we'll be back.

139
00:07:27,431 --> 00:07:29,228
It's a large hepatic hemangioma.

140
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That's a good catch, Dr. Devi.

141
00:07:30,768 --> 00:07:32,698
I haven't seen one of these before.

142
00:07:32,703 --> 00:07:34,433
Well, they're more common
than you'd think.

143
00:07:34,438 --> 00:07:36,101
They're benign tumors
made up of clusters

144
00:07:36,106 --> 00:07:37,436
of blood-filled cavities.

145
00:07:37,441 --> 00:07:39,071
And usually they don't cause symptoms.

146
00:07:39,076 --> 00:07:41,540
Well, I'm relieved it's benign.

147
00:07:41,545 --> 00:07:44,643
My patient will be, too.
She's a little kooky.

148
00:07:44,648 --> 00:07:46,845
Sweet, though.

149
00:07:46,850 --> 00:07:48,680
Should I book an OR for us
this afternoon?

150
00:07:48,685 --> 00:07:51,221
Oh, not so fast. Surgery's
not a slam dunk here.

151
00:07:52,056 --> 00:07:53,786
A benign tumor causing pain?

152
00:07:53,791 --> 00:07:55,888
Well, surgery on the liver
is always high-risk,

153
00:07:55,893 --> 00:07:58,157
even in the best hands,
and pain can be managed.

154
00:07:58,162 --> 00:08:00,225
Okay, so I tell her we're not operating,

155
00:08:00,230 --> 00:08:02,695
and I need a repeat scan in two months.

156
00:08:02,700 --> 00:08:04,363
And that's not the answer, either.

157
00:08:04,368 --> 00:08:06,899
This is not something
we can decide here.

158
00:08:06,904 --> 00:08:08,234
You need to talk to your patient

159
00:08:08,239 --> 00:08:09,669
and get a sense of her risk tolerance

160
00:08:09,673 --> 00:08:11,370
and the seriousness of her symptoms,

161
00:08:11,375 --> 00:08:14,444
and then you tell me what
path you think makes sense.

162
00:08:16,213 --> 00:08:18,210
All right. Can you come with?

163
00:08:18,215 --> 00:08:20,145
Nope. She's your patient, you handle it.

164
00:08:20,150 --> 00:08:25,184
Then meet me in OR 3...
an, uh, emergent splenectomy.

165
00:08:25,189 --> 00:08:26,589
Uh, 15 minutes.

166
00:08:28,025 --> 00:08:29,388
So, you have two options.

167
00:08:29,393 --> 00:08:31,091
If you go with the surgery
and it goes well,

168
00:08:31,095 --> 00:08:33,092
- your symptoms go away.
- Awesome.

169
00:08:33,097 --> 00:08:35,494
But surgery on the liver
is never an easy call to make.

170
00:08:35,499 --> 00:08:37,396
It's an organ with many
large blood vessels,

171
00:08:37,401 --> 00:08:39,465
which means we could run
into significant bleeding.

172
00:08:39,470 --> 00:08:40,766
Oh. Not awesome.

173
00:08:40,771 --> 00:08:42,301
And that circumstance would require

174
00:08:42,306 --> 00:08:44,404
a much larger abdominal
surgery with complications

175
00:08:44,408 --> 00:08:46,442
and a long recovery.

176
00:08:48,011 --> 00:08:49,074
Are you with me?

177
00:08:49,079 --> 00:08:50,442
Uh, sort of.

178
00:08:50,447 --> 00:08:53,012
Uh, you understand, right?
I'm not a doctor.

179
00:08:53,017 --> 00:08:54,947
I'm a cartoonist.

180
00:08:54,952 --> 00:08:56,715
Right.

181
00:08:56,720 --> 00:08:58,721
Um...

182
00:08:59,823 --> 00:09:00,953
Do you take risks?

183
00:09:00,958 --> 00:09:03,355
If you do, then we go with the surgery.

184
00:09:03,360 --> 00:09:05,824
Are you cautious?
Then we hold off for now,

185
00:09:05,829 --> 00:09:07,826
so long as your pain is tolerable.

186
00:09:09,233 --> 00:09:11,163
I don't know, Dr. Devi.

187
00:09:11,168 --> 00:09:13,365
Okay, you know what? Look.

188
00:09:13,370 --> 00:09:15,768
It's okay. Big decision.

189
00:09:15,773 --> 00:09:17,636
Think about it, and I will check in

190
00:09:17,641 --> 00:09:19,238
as soon as I'm back from surgery, okay?

191
00:09:19,243 --> 00:09:20,744
Okay.

192
00:09:24,548 --> 00:09:27,079
Heart block. What is that?

193
00:09:27,084 --> 00:09:29,648
Because of the sarcoid,
your heart's electric circuit

194
00:09:29,653 --> 00:09:31,550
isn't working correctly,
so your heartbeat

195
00:09:31,555 --> 00:09:33,219
slows to a dangerously low rate.

196
00:09:33,224 --> 00:09:35,254
In some cases, it can stop completely.

197
00:09:35,259 --> 00:09:37,289
Which, to state the obvious, is fatal.

198
00:09:37,294 --> 00:09:39,958
This morning,
your heartbeat slowed so much

199
00:09:39,963 --> 00:09:41,960
that you fainted and
you crashed your bike.

200
00:09:41,965 --> 00:09:43,962
But there is some good news.

201
00:09:43,967 --> 00:09:45,197
Told you guys.

202
00:09:45,202 --> 00:09:46,766
The solution to your problem

203
00:09:46,771 --> 00:09:48,267
is safe and simple.

204
00:09:48,272 --> 00:09:49,736
We put in a pacemaker,

205
00:09:49,741 --> 00:09:52,072
and your heart goes back
to beating normally again.

206
00:09:52,077 --> 00:09:53,573
So you're saying I need a surgery?

207
00:09:53,578 --> 00:09:55,607
Yeah, and it's just
an outpatient procedure.

208
00:09:55,612 --> 00:09:57,843
No general anesthesia,
no operating room.

209
00:09:57,848 --> 00:09:58,945
It's super simple.

210
00:09:58,950 --> 00:10:01,014
Another narrow escape from death.

211
00:10:01,018 --> 00:10:03,182
The Wyatt Barnes legend grows.

212
00:10:03,187 --> 00:10:05,451
Hey.

213
00:10:05,456 --> 00:10:07,686
I'd like to admit you
for observation, and then

214
00:10:07,691 --> 00:10:09,755
we'll schedule the procedure
as soon as possible.

215
00:10:09,760 --> 00:10:11,461
Oh, I don't want the pacemaker.

216
00:10:12,129 --> 00:10:14,260
A-Admit me, fine, but, you know, finish

217
00:10:14,265 --> 00:10:16,529
- fixing me up and...
- send me home.

218
00:10:16,534 --> 00:10:17,930
No, you don't understand.

219
00:10:17,935 --> 00:10:19,432
If we don't put the pacemaker in,

220
00:10:19,436 --> 00:10:21,133
you will almost certainly die.

221
00:10:21,138 --> 00:10:22,338
Almost?

222
00:10:23,407 --> 00:10:25,704
I'll take those odds.

223
00:10:25,709 --> 00:10:27,239
We are doctors,

224
00:10:27,244 --> 00:10:30,342
advising you on a procedure
that will save your life.

225
00:10:30,347 --> 00:10:34,813
Sorry, but it's my body, my decision.

226
00:10:34,818 --> 00:10:36,819
No pacemaker.

227
00:10:37,621 --> 00:10:39,120
No, thanks.

228
00:10:44,200 --> 00:10:46,200
- Hey, we need a cart over here!
- Now that you're spending

229
00:10:46,204 --> 00:10:48,300
more time on research
and clinical trials,

230
00:10:48,305 --> 00:10:49,935
we need a new ER doctor.

231
00:10:49,940 --> 00:10:51,971
And I'd like you to do
the interviews today.

232
00:10:51,976 --> 00:10:54,007
I would, of course,
but I'm only filling in

233
00:10:54,012 --> 00:10:55,341
for a few hours today.

234
00:10:55,346 --> 00:10:57,443
And I didn't set aside time for that.

235
00:10:57,448 --> 00:10:58,813
There must be someone else who can help.

236
00:10:58,817 --> 00:11:00,948
There's no one.
And I worked here all night.

237
00:11:00,953 --> 00:11:03,651
I'm sorry. Here are the candidates.

238
00:11:04,553 --> 00:11:07,251
Dr. Voss, I have to get my
grant proposal in by 6:00 p.m.

239
00:11:07,256 --> 00:11:08,887
Your proposal will have to wait.

240
00:11:08,892 --> 00:11:10,455
And I don't need to remind you why

241
00:11:10,460 --> 00:11:12,128
we're short-staffed in the ER.

242
00:11:13,963 --> 00:11:15,326
Yeah. I get it.

243
00:11:15,331 --> 00:11:16,794
Thank you.

244
00:11:16,799 --> 00:11:18,863
I'm counting on you.

245
00:11:18,868 --> 00:11:20,365
Happy to help.

246
00:11:43,092 --> 00:11:45,956
So, our Mr. Lucky has complete AV block

247
00:11:45,961 --> 00:11:47,758
with wide ventricular escape.

248
00:11:47,763 --> 00:11:49,560
He's not gonna live
long enough to cash in

249
00:11:49,565 --> 00:11:51,562
his third lotto ticket
without a pacemaker.

250
00:11:52,701 --> 00:11:54,632
I mean, you think he wants to die?

251
00:11:55,805 --> 00:11:59,604
Yeah, the guy's super
cheerful. It's bizarre.

252
00:11:59,609 --> 00:12:02,244
Mom, listen, I'm in the middle of...

253
00:12:04,213 --> 00:12:06,310
Well, is-is the cough
getting any better?

254
00:12:06,315 --> 00:12:08,546
Did you call the oncologist?

255
00:12:08,551 --> 00:12:11,749
Mom, just do it now, please.

256
00:12:11,754 --> 00:12:14,489
Yes, I will see you
before I go to the airport.

257
00:12:16,459 --> 00:12:18,289
Tell Carol I'll call her,

258
00:12:18,294 --> 00:12:22,360
talk her through some options
for her respiratory symptoms.

259
00:12:22,365 --> 00:12:23,999
Appreciate it, man.

260
00:12:25,168 --> 00:12:27,331
Look, I-I wish I could engage.

261
00:12:27,336 --> 00:12:29,800
All right? I-If there were
28 hours in the day,

262
00:12:29,805 --> 00:12:31,902
I would gladly wax poetic
with the patient

263
00:12:31,907 --> 00:12:33,404
about the benefits of a pacemaker,

264
00:12:33,409 --> 00:12:35,272
but I do not have the time.

265
00:12:35,277 --> 00:12:38,776
I have way too many patients
who would kill for an easy cure.

266
00:12:38,781 --> 00:12:41,579
I got too many, too many obligations.

267
00:12:41,584 --> 00:12:43,114
All right, you get him to see reason,

268
00:12:43,119 --> 00:12:44,615
I have no doubt that you will,

269
00:12:44,620 --> 00:12:47,122
then I will come back,
I'll put in the pacer.

270
00:12:51,568 --> 00:12:53,631
Okay. Have you, uh...

271
00:12:53,636 --> 00:12:54,933
you seen this problem before?

272
00:12:54,938 --> 00:12:58,236
All the time during the pandemic.

273
00:12:58,241 --> 00:13:01,473
We had a lot of patients who
died claiming COVID was made up.

274
00:13:01,478 --> 00:13:03,208
Well, what do we do next?

275
00:13:03,213 --> 00:13:07,311
He agreed to a brief admission,
so we bring him up to the ICU,

276
00:13:07,316 --> 00:13:09,814
start him on isoproterenol
to raise his heart rate

277
00:13:09,819 --> 00:13:11,117
while I figure out a way to respectfully

278
00:13:11,121 --> 00:13:12,217
get him to see reason.

279
00:13:12,222 --> 00:13:14,290
I will watch and learn.

280
00:13:15,725 --> 00:13:17,489
Hey, Brit, have you had some time

281
00:13:17,494 --> 00:13:19,461
to review your options?

282
00:13:22,499 --> 00:13:25,201
She was here a minute ago.
She should be back soon.

283
00:13:34,110 --> 00:13:38,543
And if you had to change one
thing about emergency medicine,

284
00:13:38,548 --> 00:13:39,611
what would it be?

285
00:13:39,616 --> 00:13:41,313
Well, we're letting money
walk out the door.

286
00:13:41,317 --> 00:13:42,347
That's for sure.

287
00:13:42,352 --> 00:13:45,316
Uh, I personally would deploy
a-a number of strategies

288
00:13:45,321 --> 00:13:47,419
that would be more lucrative
for the hospital.

289
00:13:47,424 --> 00:13:48,553
Uh, I mean, you can't fix

290
00:13:48,558 --> 00:13:50,356
all the inefficiencies at once,
you know?

291
00:13:50,360 --> 00:13:53,858
You got to let this, uh,
this pig work its way through

292
00:13:53,863 --> 00:13:56,094
the-the boa constrictor, so to speak.

293
00:13:56,099 --> 00:13:59,397
So, I created some slides here,
uh, with ideas

294
00:13:59,402 --> 00:14:02,166
for how to capitalize
on low-hanging fruit.

295
00:14:02,171 --> 00:14:03,201
I'll talk you through it.

296
00:14:03,206 --> 00:14:05,508
Uh, shouldn't be more than, uh, an hour.

297
00:14:06,576 --> 00:14:08,010
Or two.

298
00:14:10,580 --> 00:14:12,744
Brit?

299
00:14:12,749 --> 00:14:15,318
I've been looking everywhere for you.

300
00:14:16,553 --> 00:14:18,950
Has your abdominal pain gotten worse?

301
00:14:18,955 --> 00:14:21,653
You shouldn't be out here.
We should get you back inside.

302
00:14:21,658 --> 00:14:23,655
It's not that, Dr. Devi.

303
00:14:23,660 --> 00:14:26,358
I had to get some air so I could think.

304
00:14:26,363 --> 00:14:27,763
Okay.

305
00:14:29,800 --> 00:14:32,097
I can't decide about the surgery.

306
00:14:32,102 --> 00:14:34,466
I tell myself, "Go for it".

307
00:14:34,471 --> 00:14:37,069
Then I think it's too dangerous.

308
00:14:37,074 --> 00:14:40,906
What if I bleed to death
in the OR and my cat dies alone?

309
00:14:40,911 --> 00:14:44,876
Or I go home and die and no one
finds me and Tinkerbell eats me.

310
00:14:44,881 --> 00:14:47,078
- You have to take it easy, Brit.
- Sometimes I wake up

311
00:14:47,083 --> 00:14:49,181
and she's staring at me
like I'm a goldfish.

312
00:14:49,186 --> 00:14:50,849
There's a darkness in her.

313
00:14:50,854 --> 00:14:53,318
I'm indecisive.

314
00:14:53,323 --> 00:14:55,754
Even about things that don't matter.

315
00:14:55,759 --> 00:14:58,894
My cartoons poke fun at people like me.

316
00:15:00,864 --> 00:15:02,264
Brit.

317
00:15:03,800 --> 00:15:06,769
What can I do to help you
make this decision?

318
00:15:08,405 --> 00:15:10,006
Make it for me?

319
00:15:11,108 --> 00:15:12,738
Just be my doctor.

320
00:15:12,743 --> 00:15:14,777
I'll do whatever you say.

321
00:15:22,052 --> 00:15:24,850
How am I doing?

322
00:15:24,855 --> 00:15:27,386
Your heart rate is dangerously slow.

323
00:15:27,391 --> 00:15:29,221
38.

324
00:15:29,226 --> 00:15:32,091
Meds helped transiently,
but they can't fix this,

325
00:15:32,096 --> 00:15:33,292
and it's getting worse.

326
00:15:33,297 --> 00:15:34,460
I feel fine.

327
00:15:34,465 --> 00:15:36,128
That's impossible, okay?

328
00:15:36,133 --> 00:15:37,996
You have to be tired, light-headed...

329
00:15:38,001 --> 00:15:39,068
Not really.

330
00:15:39,937 --> 00:15:41,100
I'm hungry.

331
00:15:41,105 --> 00:15:42,905
This place have ice cream?

332
00:15:44,341 --> 00:15:46,538
Yes...

333
00:15:46,543 --> 00:15:48,874
... but let's finish talking first.

334
00:15:48,879 --> 00:15:50,976
A pacemaker is a simple device.

335
00:15:50,981 --> 00:15:53,378
It is not dangerous to put in,

336
00:15:53,383 --> 00:15:55,247
and it will keep you
from falling off your bike

337
00:15:55,252 --> 00:15:56,415
in the middle of traffic.

338
00:15:56,420 --> 00:15:58,283
Or dying today.

339
00:15:58,288 --> 00:16:01,453
Which could happen.

340
00:16:01,458 --> 00:16:02,955
It's not gonna happen.

341
00:16:02,960 --> 00:16:05,290
What are you afraid of, Wyatt?

342
00:16:05,295 --> 00:16:07,326
I'm not afraid.
I just don't like the idea

343
00:16:07,331 --> 00:16:09,595
of having a foreign object
put into my body.

344
00:16:09,600 --> 00:16:11,730
Do you know anyone with type 1 diabetes?

345
00:16:11,735 --> 00:16:13,498
Yeah. My old boss.

346
00:16:13,503 --> 00:16:15,100
Did your boss use an insulin pump?

347
00:16:15,105 --> 00:16:17,803
She does, but what you're talking about

348
00:16:17,808 --> 00:16:19,671
is putting something in
to control my heart.

349
00:16:19,676 --> 00:16:20,739
That's different.

350
00:16:20,744 --> 00:16:21,774
No. Not really.

351
00:16:21,779 --> 00:16:24,043
Uh, complications
from pacemakers are rare.

352
00:16:24,047 --> 00:16:26,244
I'm sorry, but I do my own research.

353
00:16:26,249 --> 00:16:27,746
I'm part of this Facebook group.

354
00:16:27,751 --> 00:16:29,981
- Oh, here we go.
- And they just published a list

355
00:16:29,986 --> 00:16:31,683
of unsafe products from China.

356
00:16:31,688 --> 00:16:34,720
Know what's on top? Pacemakers.

357
00:16:34,725 --> 00:16:36,521
Now, they're assembled here,

358
00:16:36,526 --> 00:16:38,323
but guess where the parts come from.

359
00:16:38,328 --> 00:16:41,794
Yep. Guy in the group got
poisoned by some bad metals.

360
00:16:41,799 --> 00:16:44,863
Those posts aren't truthful, Wyatt.

361
00:16:44,868 --> 00:16:48,200
They are propaganda
from unqualified people

362
00:16:48,205 --> 00:16:50,368
who have politicized
health and medicine.

363
00:16:50,373 --> 00:16:52,532
They either want to
sow distrust in science

364
00:16:52,537 --> 00:16:53,537
or sell you snake oil.

365
00:16:53,542 --> 00:16:54,641
The real truth, Wyatt?

366
00:16:54,645 --> 00:16:56,275
Bad metal is not a thing.

367
00:16:56,280 --> 00:16:58,743
Dr. Hawkins is who you
want giving you advice.

368
00:16:58,748 --> 00:16:59,778
He's an actual expert.

369
00:16:59,783 --> 00:17:01,613
I form my own opinions, okay?

370
00:17:01,618 --> 00:17:04,583
- You have yours.
- Okay, this isn't an opinion.

371
00:17:04,588 --> 00:17:06,018
It's fact versus fiction.

372
00:17:06,023 --> 00:17:07,823
- Do you understand?
- All right.

373
00:17:08,659 --> 00:17:10,455
We hear you, Wyatt.

374
00:17:10,460 --> 00:17:11,994
Okay?

375
00:17:14,131 --> 00:17:15,795
Be back to check on you in a bit.

376
00:17:15,800 --> 00:17:17,701
Thanks, Doc.

377
00:17:19,770 --> 00:17:21,734
He was getting more and more dug in.

378
00:17:21,739 --> 00:17:23,770
- You have to know how to take a step back.
- Okay, but if Wyatt dies,

379
00:17:23,774 --> 00:17:25,138
it won't be sarcoid that kills him,

380
00:17:25,142 --> 00:17:27,739
it'll be i-irrational fear
and misinformation.

381
00:17:27,744 --> 00:17:30,008
And those are difficult
conditions to cure.

382
00:17:30,013 --> 00:17:31,943
- I...
- Some people only accept information

383
00:17:31,948 --> 00:17:33,378
that confirms their beliefs.

384
00:17:33,383 --> 00:17:35,347
You have to give them the facts,

385
00:17:35,352 --> 00:17:37,215
tell them how important the science is,

386
00:17:37,220 --> 00:17:39,951
- but then if you push too hard...
- I get that, but if...

387
00:17:39,956 --> 00:17:43,355
... we lose what little trust
we may have earned.

388
00:17:43,360 --> 00:17:45,757
Even when you're 1,000% right.

389
00:17:45,762 --> 00:17:48,460
- Uh... He's gonna...
- Gentlemen.

390
00:17:48,465 --> 00:17:51,396
So I don't see your patient
on my cath lab schedule.

391
00:17:51,401 --> 00:17:54,066
- What happened? No pacemaker?
- Uh, not yet.

392
00:17:54,071 --> 00:17:56,167
We were just getting ready
to discuss next steps.

393
00:17:56,172 --> 00:17:58,070
The guy actually believes in luck.

394
00:17:58,075 --> 00:17:59,771
As in, he's too lucky to die.

395
00:17:59,776 --> 00:18:02,707
He did tell us
he's always felt protected

396
00:18:02,712 --> 00:18:04,576
in an "otherworldly" way.

397
00:18:04,581 --> 00:18:07,045
An argument could be made that
he doesn't have the capacity

398
00:18:07,050 --> 00:18:08,681
to make medical decisions for himself.

399
00:18:08,686 --> 00:18:10,483
Well, if he's making
his decision based on

400
00:18:10,488 --> 00:18:12,284
otherworldly information,
you may be right.

401
00:18:12,289 --> 00:18:14,386
I'll call Dr. Malco
in the psych department.

402
00:18:14,391 --> 00:18:17,960
Let's hope this works.
Wyatt's running out of time.

403
00:18:27,300 --> 00:18:29,730
Wyatt, why don't you tell me
in your own words

404
00:18:29,735 --> 00:18:31,595
what's going on
with your health right now?

405
00:18:31,600 --> 00:18:32,930
It's pretty simple.

406
00:18:32,935 --> 00:18:35,299
I've never liked hospitals,

407
00:18:35,304 --> 00:18:38,002
but I came here
because of a bike accident.

408
00:18:38,007 --> 00:18:40,271
They escalated the whole thing
by threatening

409
00:18:40,276 --> 00:18:41,973
to put in a pacemaker.

410
00:18:42,378 --> 00:18:45,042
Do you know how many
people get a pacemaker?

411
00:18:45,047 --> 00:18:47,311
They're slapping them
into everybody these days.

412
00:18:47,316 --> 00:18:49,413
Why don't you trust your doctors?

413
00:18:49,418 --> 00:18:51,549
I make up my own mind.

414
00:18:51,554 --> 00:18:53,317
And, look, I'm not crazy.

415
00:18:53,322 --> 00:18:55,319
You know, agreeing to have
doctors I just met

416
00:18:55,324 --> 00:18:58,822
implant something into my body
is what's crazy.

417
00:18:58,827 --> 00:19:01,726
We just need to make sure that
you understand the consequences

418
00:19:01,731 --> 00:19:03,828
of the decision you're making here.

419
00:19:03,833 --> 00:19:06,497
I've been listening
to those two all day.

420
00:19:06,502 --> 00:19:08,099
Of course I understand.

421
00:19:08,504 --> 00:19:12,569
And there's something you need
to understand about me.

422
00:19:12,574 --> 00:19:14,271
And what is that?

423
00:19:14,276 --> 00:19:16,373
You're not gonna change my mind.

424
00:19:16,378 --> 00:19:19,143
And if I do die, I don't want anyone

425
00:19:19,148 --> 00:19:22,413
going wild and pounding
on my chest, okay?

426
00:19:22,418 --> 00:19:25,849
Write that down in your little notepad.

427
00:19:25,854 --> 00:19:28,056
We all have to die someday.

428
00:19:28,061 --> 00:19:30,396
And I am not going out like that.

429
00:19:36,699 --> 00:19:38,429
- Dr. Bell?
- Yeah.

430
00:19:38,434 --> 00:19:41,332
- Do you have a second?
- Mm-hmm.

431
00:19:44,006 --> 00:19:46,203
Please tell me this gets easier.

432
00:19:46,208 --> 00:19:48,205
Is this about making
a life-or-death decision

433
00:19:48,210 --> 00:19:50,878
- for a person you just met?
- Yes.

434
00:19:50,883 --> 00:19:53,914
It should never be easy.
This is the job.

435
00:19:53,919 --> 00:19:55,647
It's not irrational
for a patient to think

436
00:19:55,651 --> 00:19:57,915
we know more and should decide for them.

437
00:19:57,920 --> 00:19:59,684
What if I can't figure out
what's the best way to go?

438
00:19:59,688 --> 00:20:01,756
You will, because you have to.

439
00:20:02,491 --> 00:20:04,355
That's what your patient needs.

440
00:20:04,360 --> 00:20:06,523
So go with your gut, Dr. Devi,

441
00:20:06,528 --> 00:20:10,094
informed by your experience
and your schooling.

442
00:20:10,099 --> 00:20:13,168
- Okay?
- Okay.

443
00:20:18,207 --> 00:20:19,503
Dr. Voss.

444
00:20:19,508 --> 00:20:21,405
Tell me what you need. I'm here to help.

445
00:20:21,410 --> 00:20:24,775
Well, I'm realizing that all our doctors

446
00:20:24,780 --> 00:20:26,877
are in danger of burnout.

447
00:20:26,882 --> 00:20:29,947
The stress at times can be unrelenting.

448
00:20:29,952 --> 00:20:32,750
Maybe your program can help.

449
00:20:32,755 --> 00:20:34,151
I would love that.

450
00:20:34,156 --> 00:20:36,654
I offer yoga sessions, meditation,

451
00:20:36,659 --> 00:20:39,156
sleep counseling
and positive affirmations.

452
00:20:39,161 --> 00:20:43,594
Plus, fresh-baked resiliency
cookies. Gluten-free.

453
00:20:43,599 --> 00:20:48,532
I think I could make everybody
ten percent happier, at least.

454
00:20:48,537 --> 00:20:51,202
I would invest in ten percent happier.

455
00:20:51,207 --> 00:20:52,736
When can you start?

456
00:20:52,741 --> 00:20:54,371
Shall we start now?

457
00:20:54,376 --> 00:20:57,040
Yes. Sign me up.

458
00:20:57,045 --> 00:20:58,776
- Come sit down.
- Oh.

459
00:20:58,781 --> 00:21:00,816
Just five minutes.

460
00:21:03,919 --> 00:21:06,817
- Lie down, put your feet up.
- Oh, wait, I can't. I'd be...

461
00:21:06,822 --> 00:21:09,386
All right. Okay.

462
00:21:11,427 --> 00:21:12,994
Close your eyes.

463
00:21:14,196 --> 00:21:19,029
And now just take
a deep, cleansing breath.

464
00:21:20,536 --> 00:21:22,036
Ooh, sorry.

465
00:21:23,839 --> 00:21:25,673
- Later. I promise.
- Okay.

466
00:21:38,887 --> 00:21:41,218
- Do you speak Spanish?
- No.

467
00:21:41,223 --> 00:21:43,120
I don't think there's room in my head

468
00:21:43,125 --> 00:21:45,622
for any more words
I'm supposed to understand.

469
00:21:45,627 --> 00:21:49,126
Do you mind turning it down?
I promise to keep this simple.

470
00:21:51,900 --> 00:21:55,165
Based on the size of your
hemangioma and your symptoms,

471
00:21:55,170 --> 00:21:58,001
if it were me, I would
go with the surgery.

472
00:21:59,675 --> 00:22:02,039
Surgery it is. When?

473
00:22:02,044 --> 00:22:03,740
Well, we can operate later today.

474
00:22:03,745 --> 00:22:06,547
But I would like to take you
through the consent.

475
00:22:08,984 --> 00:22:10,747
There are risks.

476
00:22:10,752 --> 00:22:14,618
Bleeding, infection,
damage to your liver.

477
00:22:14,623 --> 00:22:17,221
It's possible but unlikely
that we'll have trouble

478
00:22:17,226 --> 00:22:19,223
getting you off the ventilator.

479
00:22:19,228 --> 00:22:21,492
And as with any surgery,
there is a risk of death.

480
00:22:21,497 --> 00:22:23,727
Have you done this operation often?

481
00:22:23,732 --> 00:22:26,230
Uh, no, I haven't,
but the senior surgeon

482
00:22:26,235 --> 00:22:29,132
I work with has, and he'll be there.

483
00:22:31,440 --> 00:22:32,936
Pen.

484
00:22:32,941 --> 00:22:35,176
All right.

485
00:22:36,411 --> 00:22:38,412
Thank you.

486
00:22:49,992 --> 00:22:51,655
He's clear and consistent.

487
00:22:51,660 --> 00:22:53,490
I don't find him to be influenced

488
00:22:53,495 --> 00:22:55,959
by untreated depression,
and he's not suicidal.

489
00:22:55,964 --> 00:22:57,928
His choice isn't one that
I would make for myself

490
00:22:57,933 --> 00:23:01,164
or someone I love, but it's one
he has a right to make.

491
00:23:01,169 --> 00:23:04,368
What do you make of his belief
that he's cosmically protected?

492
00:23:04,373 --> 00:23:07,004
Hearing celestial voices is one thing,

493
00:23:07,009 --> 00:23:09,406
but it's human nature to search

494
00:23:09,411 --> 00:23:11,575
for explanations for our experiences.

495
00:23:11,580 --> 00:23:14,010
Just describing them
in ways that are fantastical

496
00:23:14,015 --> 00:23:16,046
doesn't signify a lack of capacity.

497
00:23:16,051 --> 00:23:17,915
Um, I'm sorry, it makes no sense.

498
00:23:17,920 --> 00:23:21,085
I mean, look how young he is,
and he even requested a DNR?

499
00:23:21,090 --> 00:23:24,889
Which is a sign that
he's-he's clear and coherent.

500
00:23:24,894 --> 00:23:27,024
Look, lack of capacity is a high bar,

501
00:23:27,029 --> 00:23:28,926
and Wyatt doesn't reach it.

502
00:23:28,931 --> 00:23:30,661
I'm sorry.

503
00:23:30,666 --> 00:23:33,968
- You have to respect his wishes.
- All right, thank you, Leslie.

504
00:23:37,273 --> 00:23:38,669
Uh...

505
00:23:38,674 --> 00:23:40,371
Is that really it?

506
00:23:40,376 --> 00:23:42,106
If he's determined to have capacity,

507
00:23:42,110 --> 00:23:43,408
we can't force him to be treated.

508
00:23:43,412 --> 00:23:44,776
Wait, hold on, I thought
you were the renegade.

509
00:23:44,780 --> 00:23:46,643
I heard you drilled into a guy's head

510
00:23:46,648 --> 00:23:48,111
and you're not even a surgeon.

511
00:23:48,116 --> 00:23:50,080
But you're gonna sit here
and let this man die?

512
00:23:50,085 --> 00:23:51,750
If the guy would've said,
"Whatever you do,

513
00:23:51,754 --> 00:23:56,024
don't drill into my head",
I wouldn't have.

514
00:23:56,029 --> 00:23:58,159
It's pretty simple.

515
00:23:59,194 --> 00:24:02,125
You can't do what the
patient doesn't want.

516
00:24:02,130 --> 00:24:04,761
Okay, this is what we're gonna do.

517
00:24:04,766 --> 00:24:07,064
I did a deep dive into temporary pacers.

518
00:24:07,069 --> 00:24:09,566
Wyatt passes out,
we get the pads on him,

519
00:24:09,571 --> 00:24:11,535
shock him if we need to, slip it in

520
00:24:11,540 --> 00:24:12,936
- at his bedside.
- Hey.

521
00:24:19,381 --> 00:24:20,911
Let's get him some O2.

522
00:24:20,916 --> 00:24:22,946
I'm nauseous. My stomach hurts.

523
00:24:22,951 --> 00:24:24,548
What's going on?

524
00:24:24,553 --> 00:24:27,317
Gut ischemia from poor perfusion.

525
00:24:27,322 --> 00:24:29,219
Your heart rate's too low.

526
00:24:29,224 --> 00:24:30,854
Let's get him some pain meds.

527
00:24:30,859 --> 00:24:31,955
Page Bell.

528
00:24:31,960 --> 00:24:33,561
Okay.

529
00:24:40,599 --> 00:24:42,134
Okay.

530
00:24:47,238 --> 00:24:50,303
Yeah, he's-he's calmer now
with the pain meds on board.

531
00:24:50,308 --> 00:24:52,906
It's highly likely he has dying bowel,

532
00:24:52,911 --> 00:24:55,942
but he's not a viable
candidate for surgery.

533
00:24:55,947 --> 00:24:57,944
Unless we get him to agree to a pacer.

534
00:24:57,949 --> 00:25:01,147
And, yeah, if you do, tell me,
and I'll take him to the OR.

535
00:25:01,152 --> 00:25:03,216
As of now, all the complications

536
00:25:03,221 --> 00:25:05,618
from his untreated
heart condition are fixable,

537
00:25:05,623 --> 00:25:08,325
but I don't know for how long.

538
00:25:10,228 --> 00:25:12,396
He's refusing all intervention.

539
00:25:13,698 --> 00:25:15,662
Is there anything else I can do for you?

540
00:25:15,667 --> 00:25:17,234
I wish there were.

541
00:25:22,574 --> 00:25:24,904
Okay, just... just hear me out.

542
00:25:24,909 --> 00:25:27,740
All right, you know
the Dax Cowart case, right?

543
00:25:27,745 --> 00:25:30,443
He wanted to die after suffering
catastrophic burns.

544
00:25:30,448 --> 00:25:32,946
He was in pain, terribly
disfigured, went blind.

545
00:25:32,951 --> 00:25:34,981
And he was ruled to have capacity, too,

546
00:25:34,986 --> 00:25:39,423
but his doctors disregarded
his wishes and saved his life.

547
00:25:40,258 --> 00:25:41,788
Mm-hmm.

548
00:25:41,793 --> 00:25:44,858
Yeah, he had a career, he had a family,

549
00:25:44,863 --> 00:25:47,660
I mean, he lived until he was 71.

550
00:25:47,665 --> 00:25:49,597
Wyatt can have the same thing.

551
00:25:49,602 --> 00:25:52,732
Dax Cowart became a lawyer
and built a career

552
00:25:52,737 --> 00:25:54,467
on fighting for patients' rights.

553
00:25:54,472 --> 00:25:57,403
He used his own case to show
what the doctors did,

554
00:25:57,408 --> 00:26:00,541
what you want to do to Wyatt,
was a betrayal of those rights.

555
00:26:00,546 --> 00:26:01,811
It's not a betrayal of his rights.

556
00:26:01,815 --> 00:26:03,575
Hey, I'm as frustrated as you are.

557
00:26:04,716 --> 00:26:06,780
As doctors, our purpose is to help.

558
00:26:06,785 --> 00:26:08,514
And you got that part right.

559
00:26:08,519 --> 00:26:10,617
But Wyatt needs to want to be helped.

560
00:26:10,622 --> 00:26:12,456
No, until he's dead, I'm not giving up.

561
00:26:18,429 --> 00:26:20,530
Then neither am I.

562
00:26:23,768 --> 00:26:25,502
Sorry I'm late.

563
00:26:26,504 --> 00:26:29,202
Had a rough consult
with Conrad's patient.

564
00:26:29,207 --> 00:26:31,037
The exact opposite of Brit.

565
00:26:31,042 --> 00:26:33,539
He doesn't trust Conrad,
for all the wrong reasons.

566
00:26:33,544 --> 00:26:35,608
And here I am tied up in knots

567
00:26:35,613 --> 00:26:37,644
over a patient who trusts me too much.

568
00:26:37,649 --> 00:26:39,747
You made the best decision you could

569
00:26:39,751 --> 00:26:41,581
with the information you have.

570
00:26:46,458 --> 00:26:48,655
You have a very unusual career path.

571
00:26:48,660 --> 00:26:51,591
What brought you from oncology
to emergency medicine?

572
00:26:51,596 --> 00:26:53,226
So much suffering and death.

573
00:26:53,231 --> 00:26:55,695
The patients call you
weeping at all hours

574
00:26:55,700 --> 00:26:57,964
of the day and night.

575
00:26:58,469 --> 00:27:01,301
I-I was worn out from the stress.

576
00:27:01,306 --> 00:27:04,170
Those days ruined me. And now?

577
00:27:04,175 --> 00:27:06,873
Just off a shift, look at me...
I'm still fresh.

578
00:27:06,878 --> 00:27:08,908
Well, it must have been
a challenge to go back

579
00:27:08,913 --> 00:27:11,477
to residency and learn
all the ER procedures.

580
00:27:11,482 --> 00:27:13,780
Hmm, I'm not one for new techniques.

581
00:27:13,785 --> 00:27:16,316
I pretty much slept
through that residency.

582
00:27:16,321 --> 00:27:19,252
- It was no big deal.
- I see.

583
00:27:20,959 --> 00:27:22,288
I told you, Doc.

584
00:27:22,293 --> 00:27:26,297
If God wants me to live, I'll live.

585
00:27:27,699 --> 00:27:30,768
He'll reach His hand down to me.

586
00:27:32,437 --> 00:27:34,667
He's always been so good to me.

587
00:27:34,672 --> 00:27:37,003
Is this about luck now, Wyatt?

588
00:27:37,008 --> 00:27:38,208
Or God?

589
00:27:40,044 --> 00:27:44,077
He can't save you right now. We can.

590
00:27:44,082 --> 00:27:46,116
Leave me alone, Doc.

591
00:27:48,319 --> 00:27:51,184
No. Wyatt...

592
00:27:51,189 --> 00:27:53,987
- Trevor.
- You just, you got to listen to what I'm...

593
00:27:53,992 --> 00:27:56,093
Trevor. Trevor, take a walk now.

594
00:28:08,606 --> 00:28:10,006
He's young.

595
00:28:11,442 --> 00:28:14,144
But he cares deeply.

596
00:28:15,981 --> 00:28:18,979
And I respect your faith in God's will.

597
00:28:19,584 --> 00:28:21,948
I'm in His hands now.

598
00:28:21,953 --> 00:28:25,189
And you always have been, right?

599
00:28:26,958 --> 00:28:31,162
How do you know He is not
using us to save you?

600
00:28:33,531 --> 00:28:36,329
You think he wasn't sitting
beside Rune Elmqvist in Sweden

601
00:28:36,334 --> 00:28:39,065
half a century ago when
he invented the pacemaker?

602
00:28:39,070 --> 00:28:42,072
He is sending you one lifeline
after another.

603
00:28:45,810 --> 00:28:47,211
Hey.

604
00:28:50,281 --> 00:28:52,983
I'll ask Him.

605
00:28:54,185 --> 00:28:56,019
Wyatt?

606
00:29:11,136 --> 00:29:13,833
Wyatt.

607
00:29:29,253 --> 00:29:31,284
Yeah, the liver is exposed.

608
00:29:31,289 --> 00:29:32,753
Ready to begin the enucleation.

609
00:29:32,757 --> 00:29:35,088
Remember, the beauty
of this technique is that we,

610
00:29:35,092 --> 00:29:37,857
we work along existing planes
to pop the mass out

611
00:29:37,862 --> 00:29:39,625
and we leave the liver intact.

612
00:29:39,630 --> 00:29:41,160
That's how we avoid massive bleeding.

613
00:29:41,165 --> 00:29:44,564
And note the vessels
extending into the liver.

614
00:29:44,569 --> 00:29:46,833
Divide and ligate.

615
00:29:46,838 --> 00:29:48,906
Be careful.

616
00:29:50,175 --> 00:29:52,038
Ugh, I have a tiny bleeder.

617
00:29:52,043 --> 00:29:53,577
Cautery.

618
00:29:56,047 --> 00:29:57,711
And another one.

619
00:29:57,716 --> 00:29:59,150
Okay, suction.

620
00:30:04,622 --> 00:30:06,356
Okay, that's arterial. Clamp.

621
00:30:08,426 --> 00:30:10,928
Dr. Bell? Here's the clamp.

622
00:30:15,900 --> 00:30:17,234
Are you okay?

623
00:30:18,503 --> 00:30:20,066
Uh, no.

624
00:30:20,071 --> 00:30:21,838
Jessica, I'll take it.

625
00:30:22,506 --> 00:30:24,704
Uh, Dr. Devi, I have to leave.

626
00:30:24,709 --> 00:30:26,239
What?

627
00:30:26,244 --> 00:30:28,308
I-I'll find someone to cover
as soon as possible.

628
00:30:28,312 --> 00:30:29,546
Uh, as soon as possible.

629
00:30:33,618 --> 00:30:35,018
Dr. Bell.

630
00:30:40,925 --> 00:30:42,491
You can do this.

631
00:30:51,130 --> 00:30:53,630
I've got the mass
on the last vascular pedicle.

632
00:30:53,635 --> 00:30:54,865
Any word from Bell?

633
00:30:54,870 --> 00:30:56,999
Nothing yet. You'll probably
get this sucker out of here

634
00:30:57,003 --> 00:30:58,571
before anyone comes.

635
00:31:01,107 --> 00:31:03,605
Pressure's drifting down, Dr. Devi.

636
00:31:03,610 --> 00:31:06,575
She's losing blood. Let's
get some blood products in her.

637
00:31:06,580 --> 00:31:07,943
Tell me what you need.

638
00:31:07,948 --> 00:31:10,277
Lap pads and suction.
I'm operating underwater here.

639
00:31:10,282 --> 00:31:12,381
If I can't find the source for
the bleeding, I can't fix it.

640
00:31:12,385 --> 00:31:13,550
Two units are in, and I activated

641
00:31:13,554 --> 00:31:15,785
massive transfusion protocol.
We're maxed on norepi.

642
00:31:15,790 --> 00:31:17,453
Found it.

643
00:31:17,458 --> 00:31:18,824
You've got to get control.
She won't tolerate

644
00:31:18,828 --> 00:31:20,655
this blood loss much longer.

645
00:31:20,660 --> 00:31:22,526
I need to remove
the portion of the liver

646
00:31:22,530 --> 00:31:24,659
the vessel is feeding.
Prepare for a hepatectomy.

647
00:31:24,664 --> 00:31:26,561
That's a serious change in plans.

648
00:31:26,566 --> 00:31:27,796
We should call Dr. Bell first.

649
00:31:27,801 --> 00:31:29,464
No time. Clamp, now.

650
00:31:29,469 --> 00:31:32,001
Chu, give her 1:1:1
resuscitation to keep up.

651
00:31:32,006 --> 00:31:34,466
- Jessica, do not stop that suction.
- Got it.

652
00:31:40,413 --> 00:31:41,847
Got it.

653
00:31:43,183 --> 00:31:45,080
We've got a stable pressure.

654
00:31:45,085 --> 00:31:47,582
Strong work, Dr. Devi.

655
00:31:49,990 --> 00:31:51,219
You did it.

656
00:31:51,224 --> 00:31:53,755
Let's get her closed up

657
00:31:53,760 --> 00:31:54,961
and off this table.

658
00:32:02,002 --> 00:32:04,332
What do you think the evidence is

659
00:32:04,337 --> 00:32:06,233
behind cookies for stress relief?

660
00:32:06,238 --> 00:32:08,970
- Anecdotal but robust.
- I'm really feeling

661
00:32:08,975 --> 00:32:11,172
- the chocolate chip.
- Dr. Austin?

662
00:32:11,177 --> 00:32:12,507
Of all people.

663
00:32:12,512 --> 00:32:14,309
Do raptors do yoga?

664
00:32:14,314 --> 00:32:17,913
I'm only here because my CEO
told me I had to be here.

665
00:32:17,918 --> 00:32:19,447
But I won't be here for long.

666
00:32:19,452 --> 00:32:20,982
I have to round on the post-ops again

667
00:32:20,987 --> 00:32:22,717
before I fly to Manhattan tonight

668
00:32:22,722 --> 00:32:24,587
- for talk shows tomorrow.
- Well, I'm stiff,

669
00:32:24,591 --> 00:32:25,687
my back is in knots.

670
00:32:25,692 --> 00:32:27,422
I've been in interviews all day,

671
00:32:27,427 --> 00:32:30,458
looking for an actual doctor
who likes actual doctoring.

672
00:32:30,463 --> 00:32:32,397
Welcome, health care heroes.

673
00:32:32,866 --> 00:32:34,896
Uh, listen, I am not a man

674
00:32:34,901 --> 00:32:36,631
that you will find in Child's Pose.

675
00:32:36,636 --> 00:32:38,500
So I'm just gonna be on my way to...

676
00:32:38,505 --> 00:32:40,268
AJ, I happen to know
from personal experience

677
00:32:40,273 --> 00:32:42,971
that you could really benefit
from a little extra flexibility.

678
00:32:42,976 --> 00:32:46,812
All right, come lie down and grab a mat.

679
00:32:48,214 --> 00:32:50,979
Close your eyes.

680
00:32:50,984 --> 00:32:55,517
Let the world fade away and just relax.

681
00:32:55,522 --> 00:32:57,152
It's the ER.

682
00:32:58,162 --> 00:32:59,587
Oh, that's my next interview.

683
00:32:59,592 --> 00:33:01,156
Med-surg floor.

684
00:33:01,161 --> 00:33:03,995
My mother's having another complication.

685
00:33:06,333 --> 00:33:08,163
I mean, I feel

686
00:33:08,168 --> 00:33:09,597
so blissed out right now.

687
00:33:09,602 --> 00:33:11,599
I feel like I'm back to zero.
I feel great.

688
00:33:11,604 --> 00:33:14,202
You know, after this is all done,

689
00:33:14,207 --> 00:33:17,638
I think that you and I should go
to this great little vegan place

690
00:33:17,643 --> 00:33:18,874
that I know about in Inman Park.

691
00:33:18,878 --> 00:33:20,075
It-It's wonderful.

692
00:33:20,080 --> 00:33:22,643
It's the best tempeh à la King
you will ever have.

693
00:33:22,648 --> 00:33:25,684
You're cute. Not a chance.

694
00:33:29,355 --> 00:33:32,057
That's a, that's a no, then?

695
00:33:35,028 --> 00:33:37,392
Okay, Wyatt Barnes'
heart rate is in the 20s.

696
00:33:37,397 --> 00:33:39,660
He has gut ischemia,
his kidneys are failing.

697
00:33:39,665 --> 00:33:40,995
Without a pacer, he's dying.

698
00:33:41,000 --> 00:33:42,464
We're running out of time,
and he's waiting

699
00:33:42,468 --> 00:33:43,632
for the hand of God to reach down

700
00:33:43,636 --> 00:33:45,001
- and-and save him from...
- First of all, back up.

701
00:33:45,005 --> 00:33:46,302
You're in my personal space.

702
00:33:46,307 --> 00:33:49,136
And you have intern coffee
breath, which I do not like.

703
00:33:49,141 --> 00:33:50,806
Okay, look, look, look,
with all due respect,

704
00:33:50,810 --> 00:33:52,773
Dr. Hawkins seems to have lost his edge,

705
00:33:52,778 --> 00:33:54,342
it's gonna cost a young dude his life.

706
00:33:54,347 --> 00:33:55,979
Can you please just
put in a pacer, please?

707
00:33:55,983 --> 00:33:58,013
- I have one right here, come on.
- Put that away.

708
00:33:58,017 --> 00:33:59,480
You are a green recruit

709
00:33:59,485 --> 00:34:01,549
questioning the general on the field.

710
00:34:01,554 --> 00:34:03,318
W-Wait, hold up. If someone
came into this hospital

711
00:34:03,322 --> 00:34:04,987
after slitting their wrists
or-or taking pills,

712
00:34:04,991 --> 00:34:06,021
we'd save them, right?

713
00:34:06,026 --> 00:34:07,523
Wyatt Barnes is doing the same thing.

714
00:34:07,528 --> 00:34:09,124
This is not a suicide.

715
00:34:09,528 --> 00:34:12,493
This is a man with capacity
refusing intervention.

716
00:34:12,498 --> 00:34:14,295
That's a right we cannot abridge.

717
00:34:14,300 --> 00:34:16,296
His recalcitrance is not jeopardizing

718
00:34:16,301 --> 00:34:17,398
anyone else's health.

719
00:34:17,403 --> 00:34:19,536
- He's only hurting himself.
- Okay, but he is hurting himself...

720
00:34:19,540 --> 00:34:20,903
Trevor, stop.

721
00:34:20,908 --> 00:34:24,106
Now you go back to your patient's room.

722
00:34:24,111 --> 00:34:28,642
You watch Dr. Hawkins
and you do what he says.

723
00:34:28,647 --> 00:34:30,878
Stop second-guessing him.

724
00:34:30,883 --> 00:34:32,818
You might learn something.

725
00:34:41,260 --> 00:34:44,262
Please let me save you, Wyatt.

726
00:34:46,766 --> 00:34:49,601
I have everything we need.
You just say the word.

727
00:34:53,005 --> 00:34:54,869
Think of all the beautiful things

728
00:34:54,874 --> 00:34:57,972
you'll never be able
to experience again.

729
00:34:57,977 --> 00:35:01,609
I don't know what happens when you die,

730
00:35:02,014 --> 00:35:04,282
but I bet you don't get
to kiss a woman...

731
00:35:05,618 --> 00:35:09,087
... and know you want to be with
her for the rest of your life.

732
00:35:10,489 --> 00:35:14,088
Don't you want to wake up
on the first day of fall?

733
00:35:14,093 --> 00:35:16,090
Eat a peach?

734
00:35:17,696 --> 00:35:20,161
Laugh your ass off
with your best friends?

735
00:35:20,166 --> 00:35:22,296
You don't have to give up any of that.

736
00:35:22,301 --> 00:35:24,999
Think of how lucky that makes you.

737
00:35:44,924 --> 00:35:47,158
Is he still saying no?

738
00:36:00,239 --> 00:36:01,439
Do it.

739
00:36:02,575 --> 00:36:04,309
Please.

740
00:36:18,257 --> 00:36:21,255
What are we here for, anyway, huh?

741
00:36:21,260 --> 00:36:26,494
To watch people
we could save just... just die?

742
00:36:26,499 --> 00:36:28,734
I was here to save him.

743
00:36:31,503 --> 00:36:35,507
Now we're just here to make sure
he doesn't die alone.

744
00:37:15,414 --> 00:37:17,482
He's your first death.

745
00:37:21,854 --> 00:37:24,184
Yeah.

746
00:37:24,189 --> 00:37:26,487
Not how I imagined it would go down.

747
00:37:26,492 --> 00:37:30,524
You pictured a different
kind of heroism,

748
00:37:30,529 --> 00:37:34,432
blood spattered
all over your white coat.

749
00:37:39,138 --> 00:37:41,572
Do you ever get used to it?

750
00:37:42,474 --> 00:37:45,806
It never gets easier. It just...

751
00:37:45,811 --> 00:37:47,678
It just gets different.

752
00:37:49,381 --> 00:37:55,186
But today was no small
accomplishment. Dr. Daniels.

753
00:38:00,359 --> 00:38:03,424
We allowed him to live and die
according to his principles,

754
00:38:03,429 --> 00:38:06,262
and because of that,
we managed to keep ours.

755
00:38:14,800 --> 00:38:17,880
Look, again, I'm-I'm sorry
about what happened in there.

756
00:38:17,885 --> 00:38:19,749
Well, I'm relieved you're okay.

757
00:38:19,754 --> 00:38:21,518
No, I-I'll be fine, it's just...

758
00:38:21,523 --> 00:38:23,887
It's a pinched nerve and...

759
00:38:24,292 --> 00:38:26,155
little bit of vertigo
that came on suddenly.

760
00:38:26,160 --> 00:38:28,758
I think, you know, I-I overreacted,

761
00:38:28,763 --> 00:38:32,161
but in the moment, I-I thought
if I stayed in the OR,

762
00:38:32,166 --> 00:38:34,797
you'd have two patients
to deal with, so...

763
00:38:34,802 --> 00:38:37,000
Well, then, you did the right thing.

764
00:38:37,005 --> 00:38:39,569
So did you.

765
00:38:39,574 --> 00:38:40,870
This time.

766
00:38:40,875 --> 00:38:43,944
But, to be honest, it could
have gone either way.

767
00:38:51,719 --> 00:38:54,083
- Hi.
- So?

768
00:38:54,088 --> 00:38:56,719
Did you find anything else
horrible inside me?

769
00:38:56,724 --> 00:38:58,888
I'm vaguely optimistic

770
00:38:58,893 --> 00:39:02,325
because I have a familiar sense
of existential dread,

771
00:39:02,330 --> 00:39:05,094
and I'm pretty sure that can't
be removed surgically.

772
00:39:05,099 --> 00:39:06,963
The surgery went great.

773
00:39:06,968 --> 00:39:08,231
You're going to be fine.

774
00:39:08,236 --> 00:39:10,066
Thanks to Dr. Devi.

775
00:39:10,071 --> 00:39:12,502
There was a complication during surgery.

776
00:39:12,507 --> 00:39:14,270
We had to remove
a small piece of your liver.

777
00:39:14,275 --> 00:39:16,339
But it will grow back.

778
00:39:16,344 --> 00:39:18,074
And the hemangioma is gone for good.

779
00:39:18,079 --> 00:39:21,244
Thank you. I mean, really, thank you.

780
00:39:21,249 --> 00:39:24,247
And you made the right
decision for me, too.

781
00:39:24,252 --> 00:39:26,950
Can I call you next time
I'm buying a new car?

782
00:39:26,955 --> 00:39:28,419
Or don't know what to do

783
00:39:28,424 --> 00:39:30,121
when I get in a fight with my mom?

784
00:39:30,126 --> 00:39:32,088
I actually am a triple board-certified

785
00:39:32,093 --> 00:39:33,389
mother vanquisher.

786
00:39:38,866 --> 00:39:40,997
So...

787
00:39:41,002 --> 00:39:43,270
it's a no.

788
00:39:45,006 --> 00:39:46,836
Even the former oncologist?

789
00:39:46,841 --> 00:39:48,337
He's burnt out.

790
00:39:48,342 --> 00:39:50,373
He's not interested
in learning anything new.

791
00:39:50,378 --> 00:39:53,142
H-He doesn't love medicine.

792
00:39:53,147 --> 00:39:54,344
None of them do.

793
00:39:54,349 --> 00:39:56,446
Keep looking. It's just the first round.

794
00:39:56,451 --> 00:39:58,214
No need to be discouraged.

795
00:39:58,219 --> 00:39:59,749
And the thing is, Dr. Voss,

796
00:39:59,754 --> 00:40:02,485
when I was talking to them, I realized

797
00:40:02,490 --> 00:40:04,424
I might not be so different.

798
00:40:05,259 --> 00:40:06,827
Of course you are, Dr. Pravesh.

799
00:40:07,962 --> 00:40:11,360
I am judging people for
not loving medicine enough

800
00:40:11,365 --> 00:40:13,663
while trying to cut down
on clinical time

801
00:40:13,668 --> 00:40:15,264
to go do research.

802
00:40:15,269 --> 00:40:17,100
I think about being in the ER

803
00:40:17,105 --> 00:40:21,738
year after year after year,
with no outlet for research,

804
00:40:21,743 --> 00:40:24,941
and I don't know how we don't
drown in the sickness,

805
00:40:24,946 --> 00:40:28,611
the sadness, the pressure,
the paperwork.

806
00:40:30,084 --> 00:40:33,587
Half of my med school class
isn't doing medicine anymore.

807
00:40:35,857 --> 00:40:38,091
That means something.

808
00:40:38,726 --> 00:40:42,730
Yes, I think it does.

809
00:40:59,414 --> 00:41:00,814
Hey.

810
00:41:05,653 --> 00:41:07,183
Hell of a day.

811
00:41:07,188 --> 00:41:09,819
Yeah, I heard.

812
00:41:09,824 --> 00:41:12,021
So, how tempted were you
to put in the pacer

813
00:41:12,026 --> 00:41:15,525
- against the patient's wishes?
- More than I'd like to admit.

814
00:41:15,530 --> 00:41:18,361
But there are some rules we can't break.

815
00:41:18,366 --> 00:41:21,130
Do I know I made the right choice? Yeah.

816
00:41:21,135 --> 00:41:24,133
Do I wish I'd made the wrong one? Maybe.

817
00:41:24,138 --> 00:41:25,701
I know my intern thinks so.

818
00:41:25,706 --> 00:41:30,106
I heard Dr. Daniels has
a hard time with the rules.

819
00:41:30,111 --> 00:41:32,875
But maybe the example you set
saved his medical career.

820
00:41:32,880 --> 00:41:35,278
To say nothing of your
responsibility to your patient.

821
00:41:35,283 --> 00:41:37,146
Yeah, he's a bright kid, that Trevor,

822
00:41:37,151 --> 00:41:39,448
but too much confidence and passion,

823
00:41:39,453 --> 00:41:41,521
not nearly enough restraint.

824
00:41:46,828 --> 00:41:49,196
He learned something today.

825
00:41:55,369 --> 00:41:56,866
If I'd have saved Wyatt,

826
00:41:56,871 --> 00:41:59,802
would he have come back in ten years

827
00:41:59,807 --> 00:42:01,771
with an armload of kids,

828
00:42:01,776 --> 00:42:04,845
grateful that we didn't listen to him?

829
00:42:12,353 --> 00:42:15,054
And now I realize none of this
is why you are here.

830
00:42:17,892 --> 00:42:19,459
Nope.

831
00:42:20,295 --> 00:42:22,196
I got a favor to ask you.

832
00:42:27,668 --> 00:42:28,831
What?

833
00:42:28,836 --> 00:42:31,667
But, look, before
I even-even spell it out,

834
00:42:31,672 --> 00:42:35,271
can I count on you
for full confidentiality?

835
00:42:35,276 --> 00:42:37,244
Go on.

836
00:42:39,480 --> 00:42:42,749
Something's wrong with me,
a-and I'm not quite sure what.

837
00:42:44,518 --> 00:42:46,620
But I think it may be serious.

838
00:42:47,355 --> 00:42:49,152
You want me to examine you?

839
00:42:49,157 --> 00:42:50,887
Yeah, I'll clear my schedule tomorrow.

840
00:42:50,892 --> 00:42:52,722
Let's come in early.

841
00:42:52,727 --> 00:42:56,292
And the fact that
I'm being tested at all,

842
00:42:56,297 --> 00:42:59,696
the results, all under the radar.

843
00:42:59,701 --> 00:43:02,031
So, is that something you can do?

844
00:43:06,340 --> 00:43:09,772
Okay. Great, thanks.

845
00:43:55,000 --> 00:43:58,500
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