Previously, on The Resident...
We want to make you the director of our program,
but we need to know by next week.
- So, are you gonna take it? - Is there anything left of us?
You're the one who made it clear
that not having kids was a deal-breaker.
Kit Voss offered me a job.
Why would you leave Seattle Children's?
So that I can be closer to you.
You're a good man, Dr. Austin.
I think our child should witness that firsthand.
- Our child? - If you're still willing.
I've gone and fallen for someone.
You're afraid the guy's gonna say no?
Reinforcements are here to cheer you up.
I'm as afraid he'll say yes as I am
- he'll say no. - Go tell the man how you feel.
Hope I'm not too early.
Not at all. Come on in.
- Beautiful evening. - It is.
I've been looking forward to this for a long time.
Thank you so much for offering to babysit.
Are you kidding? I'm so excited.
I can't wait to meet Gigi.
Well, she's asleep now, but, um,
she'll be up in the next couple of hours.
And if we're not back by then...
We're not gonna be back. We're gonna live it up, Nic.
It's our first night out since Gigi was born,
so someone has a little separation anxiety.
You have nothing to worry about.
I took CPR training for infants,
and I have three younger siblings.
Emergency contacts, just in case.
There's pumped breast milk in the fridge.
- We heat it up in the... - The bottle warmer. I've got this.
And I will test it just to make sure it's not too hot.
Great, and don't forget to burp her and change her after.
Of course.
I'm more worried about Nic
than I am Gigi.
- I'm right here. - You're gonna be fine.
Nice new jacket, Dr. Hawkins.
Ah, you like? Thanks.
Have a great time.
Just call if there's anything, okay?
Bye.
Somebody has a little crush.
Don't be ridiculous.
"Nice new jacket, Dr. Hawkins."
Mm.
Daddy.
Daddy, green means go.
Thanks, honey.
CREDITS
Yo, everyone.
The illustrious doctor scientist graces us peons
with his presence for the last time.
Oh, come on. You know, I think I liked it better
when you just ignored me when I showed up for my shift.
Better get into your scrubs.
You're a bit too big for those britches.
Poor guy's gonna hate Baltimore Hospital for Advanced Science.
Do you know how cold Baltimore gets in January?
And he's a fragile flower.
Oh, you don't fool me. I know you're all crying inside.
I'm gonna miss you, a lot.
We're well aware what this exit is about,
and it ain't science, or money,
because Dr. Voss would match any offer.
Talk to Leela.
Fix this.
I wish I could.
Help! We need help over here, please.
Can't... breathe.
All right, this way.
What's going on?
She-she was a little short of breath last night.
We thought it was the baby pressing on her lungs,
but she woke up like this.
How far along is she?
Five months.
Mommy, are you gonna be okay?
Of course, baby.
Hypoxemic. Elevated respiratory rate.
Rales up to the mid chest.
Sounds like pulmonary edema.
Let's get an EKG and get her on O2.
- Mommy? - It's okay.
Can someone... take him?
I'll call Winston in social services.
He'll get someone to look after him.
Come with me, sweetheart.
Fetal heart rate sounds good.
Obvious movement.
The baby looks good.
- Praise God. - Thank you.
Let's get a stat chest X-ray.
Page Dr. Austin.
What's wrong? What's happening?
Devon always kept the keys in a bowl in the hallway.
Thank you so much for reminding me.
I'm sorry.
I just really want to get going.
I can't wait for the ultrasound.
Although I already know I'm pregnant because I can feel it.
My stomach is doing flip-flops.
And guess what, I woke up nauseous this morning.
I told you to not have that pizza last night.
It's not the pizza, Leela. I feel
- different, you know? - Well, actually,
since I've never been pregnant, no, I don't know.
Today's his last day, isn't it?
You guys broke up way too fast.
It's a pattern with you.
You're kind of a relationship wrecking ball.
Oh, come on. Do you remember when you dumped Rick Stamos
right before prom?
He was ripped and a quarterback,
and you had a killer dress.
- I caught him making out with a cheerleader. - Hmm.
He can't wait to go.
He's leaving Atlanta tomorrow.
He's only sticking around for Kit and
Bell's engagement party tonight.
I know he still loves you. Okay?
Everyone knows he still loves you.
And sometimes you can't always see
what's right before your eyes.
There is still time.
Dr. Sullivan, where's your walker?
I know you're feeling better,
but you shouldn't be on your feet alone.
I am discharging myself from the hospital.
- You-you can't do that. - Yes, I can.
I'm a doctor.
You can't be your own doctor.
I know my own body, and I feel fine.
Besides, work is the best medicine.
If you're your own doctor, does that also make you
your own worst patient?
- Ha ha. - You only got shot three times.
Why don't you go run a 10K while you're at it?
You know what? You are just the person I was looking for.
Look what you left in my room on your last visit.
Mr. Giraffe!
He must have been scared in that dark drawer all by himself.
No, not in the least, he was sleeping.
He's a sleepyhead, but he did poke his head out
- to ask for some leaves for dinner. - Silly.
He doesn't eat leaves, he eats chocolate ice cream.
Oh, right.
I'll drop Gigi at preschool and meet you in your dad's room.
His lab results are in.
How are you feeling, Dad?
Fine.
No lingering symptoms?
It's been a day and a half since my little fall.
I'm much better.
Well, it was more than just a fall. You passed out.
Why are you getting dressed?
- I'm discharging myself. - You...
You can't be your own doctor.
The apple fell directly under the tree.
My father and I are both doctors who also happen to be patients.
Other than that, we are nothing alike.
Of course you're not. Your labs.
You're profoundly anemic.
Your stomach pain is getting worse, right?
Combine that with your collapse...
Bleeding ulcer is top of the list.
Ridiculous. No acid reflux. No indigestion.
- Any blood in your stool? - Okay.
Before we discuss my bowel movements in greater detail,
can we clarify
which of you is my actual doctor?
You need more tests.
There may be a simple explanation
for what's going on here,
but until we find it, you aren't going anywhere.
Your vision is fine, Randolph.
You had an MS flare.
Okay. Well, yeah, it was kind of rough.
They're not unexpected, especially near the optic nerve.
With an extra pulse of steroids, you'll be back to normal.
This should be nothing to worry about.
See? It's great news.
You're good to go back in the OR.
I'm clearing you for surgery.
Great.
I know that look. Talk to me.
Every MS flare feels like it's the beginning of the end.
The pain is excruciating, and you're afraid
it's getting worse, but you're catastrophizing.
- You heard the doctor. - It is progressive.
Not necessarily.
You could go into total remission.
I love your optimism.
I'm about to marry Chastain's finest surgeon,
who will hold that title for years to come.
Please, tell me whatever is happening
isn't going to... harm my baby.
Right now, let's focus on you, Mom, all right?
Your echocardiogram is showing
that your heart isn't pumping strong enough
to support you and the baby.
W-What does that mean?
It means that your wife is in heart failure.
No, how-how can this be happening?
Have you had any health issues recently?
Flu... a few weeks ago.
I-It was pretty bad,
but she finally got better.
Help me!
Step aside, please. It's okay.
Acute hypoxemic respiratory failure.
Pulmonary edema is worsening,
which means her heart function is, too.
Pressure's dropping. Hanging a norepi drip.
We're having a baby girl.
We've hoped for one since Miguel was born.
We-we cannot lose this baby.
She's decompensating fast.
We need to intubate now.
Come here.
We are trying to save your wife's life.
Let us work so can save both mom and baby.
Okay.
Nic.
I forgot to tell Marion
to leave the night-light on in Gigi's room.
I left it on.
How about we put all phones away just for the next hour?
Well, your new girlfriend
has to be able to reach me.
Oh, she's on my speed dial.
How convinient!
"Neon Moon."
Same song that was playing right here on our first date.
You don't remember what song was playing on our first date.
I do. It was "Neon Moon."
It's always playing on a jukebox somewhere.
Hmm.
How about we go right to the dancing part of the evening?
This is nice.
- Winston. - Hundley?
Yes.
The mom is critical, but the dad is calmer now.
He wants his son with him.
- Okay. - Come on, sweetie.
Let's go see your daddy.
Winston.
Dr. Hawkins.
Yeah. Do you have a minute?
I have two minutes. Walk with me back to my office.
What's going on?
I have a personal question for you.
- Hope you don't mind me asking. - No, go on.
Well, you know I lost my wife.
Yes. I'm so sorry.
Devon told me you lost someone, too.
A partner who died suddenly.
Yeah, we were together almost 20 years.
He had a heart attack. Was totally unexpected.
So you know about grief.
I do. It was overwhelming.
How did you cope?
For a while, quite badly.
I almost let what I'd lost destroy me.
But eventually I realized I had one life to live,
and I wanted it to mean something.
I have my daughter, and that saved me.
But no matter what I do, for the last four years,
I just can't let Nic go.
I keep remembering this one specific evening.
First date after we had Gigi.
Maybe you shouldn't fight these memories.
Maybe they're trying to tell you something.
The past never goes away.
If you don't deny it,
you can learn from it.
Mr. Alvarez.
How's my wife?
We managed to stabilize her.
Thank God.
And thank you both.
Her heart was damaged,
likely from the flu she had recently.
What she has is post-viral myocarditis.
Her pregnancy makes this even more life-threatening.
Her heart isn't strong enough now to beat for two.
We're so sorry to say this,
but the only safe option for Trini is to
is to end the pregnancy.
What?
N-No.
No, that-that's impossible.
Y-You're talking about killing the baby.
That would be murder.
We can't deliver the baby at five months.
It's not viable.
We understand your pain is enormous.
But we believe your wife will not survive if we don't do this.
Mr. Alvarez, your son will lose his mother.
Honestly, it's not a choice.
We can only save one life.
- Hers. - No.
I-I will not accept this.
There has to be another way.
There is no safe way.
Please, there has to be!
Dr. Voss, we have a problem.
We have a patient who has to terminate her pregnancy
to save her own life.
Her heart is failing.
- God, how awful. - The husband is certain
there's more we can do to save both mom and baby.
And is there?
All we can offer is an incredible long shot,
almost certain to fail.
And what does the patient want to do?
She can't make the decision. She's intubated.
Her husband is her health care proxy.
So the real question is,
do we even suggest this alternative
that we think is far too dangerous?
Oh, this is a tough one.
But if he won't agree to end the pregnancy
to save her life, you have no choice.
Just make the consequences of your plan crystal clear
so he knows the risks he's taking.
Dad, do not move. You know better.
I have an itch.
We're almost done.
I don't want him to be sick,
but please tell me he can go home.
Let's figure out what's wrong with him first,
then plan next steps.
I'm so sorry.
He has pancreatic cancer.
I'm a doctor, a good one.
And I had no clue.
Well, that's not unexpected, Dad.
Pancreatic cancer, it can often be asymptomatic
until it's too late.
Okay, thank you for clarifying.
I must have skipped the part
about pancreatic cancer at medical school.
I'm just trying to help.
Well, you can't help.
Look, I've just been handed a death sentence.
All right, how long?
How long do I have?
Pancreatic cancer is a terrifying diagnosis.
For most,
five-year survival rate is less than ten percent,
but your odds are different.
Look at the scans again.
The tumor appears
localized at the head of the pancreas.
Yes, which means it's operable.
Now, five-year survival rate goes up dramatically to 25%.
A cure is possible?
It is. Yes.
Cade, you hear that?
If the cancer hasn't spread.
- You need a complicated procedure. - The Whipple.
We have a world-renowned surgeon right here at Chastain.
He's performed the Whipple hundreds of times.
Dr. Randolph Bell.
Still a dangerous surgery
that could have serious complications, but...
Okay, can you please stop measuring me for a coffin?
Let's just be positive for one minute.
Is it too much to ask?
Dr. Hawkins just said I can survive this.
Since it's obvious I'm not helping,
I'm going to step out now.
You know, if anyone can survive this, you can.
Well, that went well.
You're under unimaginable stress.
But...
I think you need to recognize
that this is hard for your daughter also.
Can you take the young man out to the waiting room
for a few minutes?
- Thank you. - It's okay.
- No problem. - Thank you.
Mr. Alvarez, we still recommend you end the pregnancy,
today if possible.
It is by far the best chance for Trini.
Although there is another option that we can try.
What is this option?
Well, we could put Trini on a machine called an ECMO.
It would ease the stress of her struggling heart,
and it might perhaps buy us some time
and keep her alive for a few more months
until she can deliver the baby safely.
That sounds perfect.
- Do it. - No, it is far from perfect.
You have to understand that ECMO is very dangerous.
There can be complications like hemorrhage, stroke,
- infection. - Brain damage is possible.
She could wind up paralyzed.
Unable to speak. Blind.
And she could die from any of these complications.
Then the baby would die as well.
But there's a chance
that Trini and the baby could both be fine with this ECMO?
That is a remote possibility, Mr. Alvarez.
So, let's be clear, you are giving up
the absolute best chance that we have
of saving your wife's life.
Listen.
If we end the pregnancy now,
down the road, she can safely have another child.
My heart tells me that you can save them both,
and I believe that Trini would want you to try.
Please.
Why does he lash out at me?
He's scared.
Obviously, things have not been easy between you.
But now is the time for patience and understanding.
Of course.
I love him.
Despite the fact that I can't remember
the last time he said he loved me.
When I was little,
all the other kids thought I had the coolest dad.
Charmed them all.
Bought them all ice cream.
Entertained them at my birthday parties.
It took a while to realize that he lives
for the reflection he sees of himself
in other people's eyes,
and I see him too clearly.
Forgiveness and acceptance is a beautiful thing.
I didn't even talk to my father for years.
I realized our problems were a two-way street.
I wasn't as blameless as I thought.
So...
I gave him a chance, and he was capable of
more than I ever could've imagined.
Now we couldn't be closer.
You only get one father.
You can't change him, and you may lose him.
Now's the time to accept him as he is.
Thank you.
Oh, Nic, it's not what you think.
- What are you doing? - Her name is Anna.
Oh, Anna. Great.
Not exactly the image I want in my head when I'm at home
nursing our daughter and changing her diapers.
Will you just let me explain?
Honestly, I just want to go home.
Let's just go somewhere and talk about it.
Once you know who she is, you'll feel very differently.
Okay.
I diagnosed Anna's husband with stage 4 lymphoma
- two months ago. - Well, if her husband's so sick,
then why is she at a bar alone?
She isn't. She's with her girlfriends.
It's her birthday.
And her husband's in the hospital
after having a bad reaction to chemo.
He's in the ICU.
Her friends decided to get her out and away
from a situation she couldn't control.
She'll go back in a few hours.
Sleeps in his room.
Wow.
I am so sorry.
I didn't know.
You have nothing to be worried about.
You're the only woman I've loved
since the first moment I saw you.
And I can't imagine life without you.
Oh, I love you.
I'm sorry.
I'll talk to Bell and book an OR, okay?
Just tell me. I can't wait any longer.
Is it good news?
Look for yourselves, ladies.
Leela.
It's a miracle.
? Sista, sista! ?
There's only one thing that could make this day happier.
This pregnancy journey, it drove you and Devon apart.
So, please, before it's too late,
talk to him and tell him you love him.
Hey. Came to say goodbye?
We need to talk.
That's a good idea. Let's part as friends.
Actually, I was hoping for something different.
I don't want you to go.
Leela, I start at Baltimore Advanced Sciences on Monday.
I want to try again.
I'm not happy.
You're not happy.
I miss you.
And I think you miss me.
Yeah, I miss you a lot.
But nothing's changed, has it?
Actually, something has changed.
This is my patient on ECMO. She's desatting.
I want to talk to you about this, but I have to go, okay?
Promise me we'll talk later.
I have a big surgery, but if you're still here...
If not, I'll see you at the engagement party.
Her pressure spiked just as her heart rate dropped.
Cushing's reflex. Classic sign of stroke.
It happened faster than we imagined.
I'm going to adjust her arterial support
to get her blood pressure in a tighter range.
It might be too late.
Let's get her to CT, all right?
And page Billie.
Images coming up.
Here's the problem.
Bleed, left side of the brain.
Hemorrhagic stroke?
- Mm-hmm. - Definitely.
Damage may be extensive.
Potentially paralyzed.
I mean, she may have lost the ability to speak forever.
And worse still, this could just be the beginning.
I see more possible bleeds near the dura.
I mean, this could have been avoided.
Did you make her husband understand
this was likely to happen?
Come on, man, don't you think we tried?
We advised against it in the strongest terms,
but he is her health care proxy.
And we had no idea that she would have complications
- this fast. - Look, all we can do now
is double down on trying to save Trini,
no matter what condition she's in,
and hope we can keep her on ECMO long enough
for her heart to recover
or for the baby to mature enough to be viable.
Can you guys give us a minute?
Look, I am perfectly aware of the risks of this surgery,
so I know that I may not get off that OR table.
You got the best of me.
And none of the bad.
I am so proud of you, and I always have been.
You are the child of my heart,
and if I haven't said it enough,
then I need to say it now.
I love you.
All right.
Now go back to being a tough bastard and beat this thing.
You got it.
Hi, baby.
Aw. Hi.
- Update me. - We troubleshot everything,
but as you can see...
Her heart's giving out.
She has a few minutes left, maybe.
Excuse me, excuse me. What's going on?
What's happening to Trini?
Mr. Alvarez, I am terribly sorry,
but your wife is dying.
Just keep her on the machine, right?
You said that it would take over for her heart.
- Let it keep working. - We can't.
Her heart is too badly damaged.
We tried to tell you this was a long shot.
- It didn't work. I'm so sorry. - No. Please.
No.
Mommy?
Do something! Please do something!
Please.
There's nothing more we can do.
We can't bring her back.
She's gone, Matias.
No.
Don't tell me that. Don't tell me that.
And with that,
we dissect the pancreas.
Pancreas is mobilized.
Oh, wait. W...
What's the update?
Well,
looks like the tumor has adhered to the IVC.
Which means they have to resect it.
- If they nick the IVC... - That's not gonna happen.
Bell's done this thousands of times.
Dr. Devi
- all yours. - What is he doing?
He can't pass this off to a resident.
- Leela has never done a Whipple. - Which is why she has to learn.
Bell's there to back her up.
Satinsky clamp, 3.0 Prolene,
sponge stick and forceps.
Dr. Chu, do you have Rh null blood up there?
- I do. - Hang it, please.
We're in for some turbulence. Clamp on.
Dissecting the tumor off now.
Blood pressure's in the toilet.
Going up on pressors.
Okay, Dr. Devi has finished the dissection.
She anticipated this.
I've identified the defect, but I'm having a hard time
getting in position for repair.
Well, remember your anatomy.
This is Cade's father,
so maybe in this case, you should...
The Whipple is the crucible
of a surgical residency, it's the final test.
Just get in there and ace it.
It's your OR, Dr. Devi.
- Proceed. - Right.
Dr. Chu, reverse positioning of the patient, please.
Okay, that's excellent.
You have a clear path to the defect.
3.0 Prolene to you.
Closing and over sewing.
Hemodynamics settling.
That's strong work, Dr. Devi.
She rose to the occasion.
Yes, she did.
He's gonna make it out of the OR, isn't he?
Yeah.
Now we just have to make sure the cancer hasn't spread.
We'll know in a few hours.
Oh, I was so glad you guys could make it.
- Thank you for coming. - Thank you for including me.
- Yeah, so happy to be here. - So, Randolph, what's your secret?
How did you land such an incredible lady like this?
She has very low standards.
Nope. Nothing but the best for this lady.
So, when's the wedding?
- Uh, still working on that. - Mm...
But rest assured, it will be intimate and fabulous.
And you're all invited.
- Hear, hear. - Cheers.
- Cheers.
Hey.
Hey. I got here early so we could talk.
I heard you aced the Whipple.
That's not what I want to talk about.
Do you still feel the same way you did before?
I do.
I can't promise
I'll want a child in the future, but maybe I will.
- I don't know. - Today I watched a man
sacrifice his wife's best chance to live
for a baby that hasn't even been born.
He lost them both.
- That's terrible. - Yes.
But it made me realize something about myself.
That I'm doing the same thing, choosing a hypothetical child
that may never exist over the woman I love.
I was at fault, too.
I was impulsive and rash.
And our life together has to be a decision
that we both make equally.
Do you want to try this again?
- Yes. - Yeah.
A thousand times yes.
I have a lovely feeling that Devon
will not be going to Baltimore.
That is a win all around.
You know I pulled Leela into the Whipple
because she's the one who can follow in my footsteps?
She's going into neuro or cardio, right?
Oh, she just told me she wants to be a general surgeon.
So I get to teach her everything I know
and she can take my patients when the time comes.
If the time comes.
Dr. Bell?
I just want to say thank you
for saving my father's life today.
Well, Dr. Devi was integral.
But we got lucky and your father got even luckier.
The pathology report came back just before I left the hospital
and the tumor was localized.
So, there's every chance he'll be cancer-free.
I am so happy for both of you.
Thank you.
Come here.
I'm pregnant.
Wow. Ah.
So, I'm gonna be a father.
Yes, and I want you to know that I'm open to you
being as involved as you'd like.
I know you're gonna be a loving dad
and a great role model.
Just meet me halfway and... listen?
I can do that.
But what can I do for you now?
Hmm, maybe open up another 529 account?
For college?
Why would we need two accounts?
We're having twins.
Are you serious?
Yes.
Wonder what that's all about.
Well, it's good news, obviously.
I was happy to hear about your dad.
Rumor has it that Kit may offer him
the peds surgery job at Chastain.
I heard. I have mixed feelings about that.
It would be a big adjustment.
Conrad will help you with that.
He already has.
Uh, so the two of you...
Uh, we're friends.
I mean, I was under the impression that you and he...
Are also friends.
So far.
I'll be right back, okay?
Hey.
Mm, wild guess,
you're not taking the job at Advanced Sciences.
And I won't be sleeping on your sofa anymore.
God, I am so done with your furniture.
That's the best news I've heard all day.
Why are you sitting over here alone?
Get out there and party.
Waylon's...
This is where I met Nic.
We had our first date here.
Our first date after Gigi was born.
A lot of memories here.
Well
maybe it's time to make new memories.
Thank you for a lovely night out.
Thank you for being kind about Anna.
Her husband doesn't have much longer.
There's something else I wanted to tell you.
They have a child.
A little boy. He won't even remember his father.
That's awful.
We both know what it's like to lose a parent.
I bought a life insurance policy.
- You did what? - Yep.
A big one.
Well, you're not gonna die, so...
I certainly hope not.
Mm, that wasn't a statement, that was an order.
You know, maybe stop riding your bike to work.
Maybe ease up on the search and rescue missions.
No matter how careful I am, anything could happen.
I could get hit by a bolt of lightning.
- Stop, come on. - We have to talk about this for a reason.
Watching Anna and her husband in the hospital,
it just made me think, what if that was me
in that hospital bed?
You know, I don't want to talk about any of this right now.
- Just drop it. - If something happens to me,
I want you to be secure financially,
and I want you to love someone again.
I mean, don't bring a date to my funeral.
Oh, my God. Seriously?
Come on.
Unless they're nice and Gigi likes them.
- Then that's fine, okay? - Conrad.
After a while, I do want you to move on.
You deserve happiness, and Gigi deserves a father.
Just promise me, whoever it is
you'll find someone who loves you as much as I do.
Hey.
I promise.
Only if you do, too.
I promise.
CREDITS