Strategies for revealing your scars,
- visible and invisible. - Sometimes...
I hurt myself, but we don't have to talk about it.
I'm on a transplant list.
A heart may come tomorrow or never.
You should both know you won't be in limbo
for much longer about the fellowship spot.
I'm deciding by the end of the month.
Every time I think I'Ve built something, that feeling fades
and I... run.
Okay...
Oh, my God! Oh, my God!
Oh! No!
No...
- Did you see that? - Yup.
- Morning. - Thank you.
_
- Synced and corrected by naFraC - - www.addic7ed.com -
- Morning, Dr. Hunter. - Hi, hi.
Um... I was just looking at the schedule.
Nights, weekends are the least popular shifts, I know.
- You're filling gaps for now. - No problem. Totally get it.
Dr. Devi, I just, I...
I appreciate your faith in me and I plan to earn it.
Let Dr. Bergeron know if you have any questions
about shifts or patient assignments.
Sure thing.
Am I only back because Dr. Olsen strong-armed her?
Because in my parole meeting, that was the vibe.
I better...
Good luck with all that.
- June? - What's wrong?
Why does something have to be wrong?
We run a department together. I merely want to discuss it.
Uh-huh. Let me guess, it's about the rotating
surgery residents that are cycling through. Oh!
By the way, this is Ryan. He's first year general surgery.
Hi, Ryan. Why would I be concerned about Ryan
and his inexperienced ilk getting in the way of us
doing our jobs just so that you can feed your benevolent leader?
We are a teaching hospital. And you were CC'd on a least
a dozen emails about justifying the budget by training residents.
Nature abhors a vacuum, Ryan.
Look, if you're not going to engage in the process,
you don't get to be pissy about the results.
Ah, June's been practicing her mantras, Ryan.
Perhaps she'll teach them to you if you ask nicely,
or you could do your actual job and help save our incoming
patient flattened by a forklift, ETA 10.
- You okay? - Yeah, why?
- Let's go get set up. - Alright.
- Hi! - Hi.
Stupid thing's supposed to be waterproof.
Did you want to talk about it?
Because it's been a couple of days.
Oh, Devi said end of the month.
That's technically today, right?
- Devi? - Yeah, about the fellowship.
I thought that's what you were talking about.
No, I was talking about... Since, you know...
How is your brain not fixated on the fellowship job?
I mean, it is, but did you want to talk about it?
- About us? - Yeah.
Well... do you?
Unless you want to wait until today's over.
- No, that's not what I... - Mags.
- I've been texting you. - Dead phone.
Oh, okay. Well, we need help in curtains.
- Okay. - Yeah, we'll just...
This is Dominic. He came in unconscious.
Central line's in. Ryan did the foley cath,
and now he's helping me to debride.
- How long was he crushed for? - EMS says two hours.
Apparently, a forklift knocked a palette of bricks onto him,
so it took a while to get him out.
You have an open femur fracture.
BP's still soft, heart rate's erratic.
- Ryan, right here. - Yup.
And you checked to see that his urine isn't dark, Ryan?
- He did, I already asked. - But he has a voice of his own.
- Doesn't he, Ryan? - Yeah, I checked.
Good, and what's the mainstay of treatment for a crush syndrome, Ryan?
Aggressive fluid recitation to reverse metabolic acidosis.
Track progress over the next few hours,
treat rhabdomyolysis, and prevent renal failure.
He still has a pulse in his lower leg,
so as long as ortho agrees, we will debride and clean for now.
Okay. Sounds like I'm dismissed.
- What do you think, Ryan? - Um...
His BP's dropping.
His urine output is dark. Ryan, did you check that or not?
After the foley catheter, remember I told
you to tell me if his urine was discoloured.
And then I asked you again, you said
you checked it and that it was fine.
- It was. I think that it was. - Was it or wasn't it?
You said renal failure was a risk, Ryan,
but was that just kneejerk memorization because
when proteins get released into the bloodstream
after crush injury, they damage the kidney.
Which you have allowed to happen.
He's in V-tach, set up the cardiovert.
Push 20mg fentanyl, 2 of midazolam.
- What can I do? - Out of the way, Ryan.
Charging.
- Clear. - Shock advised.
How long have you had the headaches, Yuri?
A few weeks. Then I started getting pain here.
And these waves of tired where I can barely keep my eyes open.
- Any loss of appetite? - Yeah.
Has your son gotten sick? We're seeing a
stomach bug going through the daycares.
Alexei's not in daycare.
I'm starting my own contracting business.
Most of the time, he comes along. He loves it.
When the job is too messy, the neighbor watches him.
It's just the two of you?
His mother died when he was a baby.
I think there's something in the water in our building.
Lead maybe.
I told the building manager that the pipes have corroded.
Even offered to fix them, but they're too cheap to pay or even test.
Which is illegal, not that that stops them.
I stopped giving Alexei tap water but bottle is expensive.
So I boil for me. But if it is lead...
Boiling won't help.
The city does have a program aimed at identifying
and responding to environmental hazards in older buildings.
You mean low-rent ones.
Well, you could qualify for extensive testing.
But healthcare is free here, no?
You can just do the tests I need.
Yes, but this program allows us a wider scope.
It moves you to the front of the line, not to mention
it outs the landlords that tend to cut corners.
But I would have to criticize the country that gave my asylum.
No, it's completely anonymous.
Look, all I want to do is help you and
Alexei through this as fast as possible.
He's stable for now, but in trouble with kidney failure.
Amp of bicarb, give mannitol and get his potassium STAT.
No, no. You have to think like a field surgeon, June.
First priority is to flush.
Right, then react with dialysis.
Okay, I'll intubate.
Should I do something?
You've done enough.
Look, Ryan, we'll debrief later about what went wrong, okay?
Why wait? Start it with the abysmal judgment
of whoever matched Ryan to this hospital
bringing us to his astounding incompetence today.
But since we're debriefing, when your tiny brain
can't remember if you've done something or not,
don't lie and say that you have. Unless you want to kill someone.
- Dr. Novak... - I'm sorry, look, I just thought...
Another mistake! Because what you think means nothing in here.
And if you're going to insist on thinking,
then why don't you think long and hard
about whether this is the right profession for you?
Dr. Novak, I think you made your point!
Look, you made a mistake in the heat of the moment.
These things happen, alright?
He's having a panic attack.
Can someone get him one of those kidney basins between...
No, no, no!
Did any get inside? Alright, I'm going to need to irrigate, alright?
Just push as much prophylactic antibiotics as humanly possible.
Hey, hey... Are you okay?
Look, what Novak said, that was about him, alright?
Just don't make it about you.
Alright. Let's keep irrigating, guys.
This is unacceptable.
I'm reporting both of you for creating an unsafe work environment.
Two months ago, after it happened,
Claire said it was a sprain.
And now you can't move it at all.
Are you on anything for the pain?
Well, that's the thing. I'm on something for my blood pressure.
This one. And, um...
Water pills.
And you can't take those with aspirin apparently.
Yeah, with NSAIDs, depending on what your pressure is at...
Oh, I think that's a restaurant receipt.
Um, also, on this.
And also, this for high cholesterol.
But there was some other thing that interacts with those.
Okay, let me just, um...
- You don't have a GP? - Not for years.
Claire's been helping me manage.
I try not to overburden her, but I'm a bit of a handful.
150 over 92.
My wife used to keep track of things, but she...
Anyway.
- Donald, I'm really sorry. - Oh, she's not dead.
She just had enough of me, I guess.
Claire said I could text her if I needed to be looked at.
I tripped over an extension cord at work.
Claire said she'd book an X-ray for me.
But when I didn't hear anything back, I figured,
well, she's not worried, I shouldn't be.
Only it's gotten to the point where I can't work.
I do plaster, you know, so... I need my wrists.
"Technician's committee, I've known Arnold for seven years."
- Actually, it's five years. - Wow, it feels so much longer than that.
Can you please stop reading over my shoulder?
It's very annoying.
"I can confidently say he possesses all the qualities
that are essential for success in a medical field."
- Oh, that's so sweet. - Hey, I just caught one
of Claire's frequent flyers. Is she running late?
- Guys? - We don't know, Mags, okay?
Dr. Leblanc. Can we talk in my office in 20?
Yes! I mean, yes.
Okay, just let me know when she gets in.
Hey, Dr. Devi.
So I started sharing blind data
with Toronto public health regarding certain
- environmental hazards. - In low-income housing
after that patient of yours died from carbon monoxide exposure?
Well, turns out over the last year,
they've been piloting an action designated
to help patients before that kind of thing happens.
Rentsafe. I'm on an email list.
I was wondering if that's something that we could incorporate to ED?
A man came in this morning who qualifies.
A suspected lead poisoning. I'd also like long bone radiography
to check density for chronic exposure.
If we push him forward and they agree, then...
It cuts through a ton of red tape.
You'd need his consent first.
Well, he's with his young son, so moving faster is great incentive.
- The kid's fine, thankfully. - Do I need that?
It's nice to see you engaging in this.
I know you went to Lebanon to do relief work, but...
I wasn't sure if it was personal or professional.
Um...
I think it was both.
Marrying your vocation with your avocation,
good for you, Bashir.
- Let me know how else I can support. - Thank you.
Hi..
Hi, I'm sorry, the door was open.
I'm not sure if you wanted me to...
- Definitely. Sit. - Okay.
Just give me a minute here.
Thanks for bearing with me through this process.
Yeah, for sure.
So you're my first meeting,
Mags, because this is good news. Congratulations.
Congratulations, you mean...
Like, "I got the job" congratulations?
You did. In a few months, when your residency ends,
we'd like you to stay on as our emergency department fellow.
Financial's in here.
All the logistics. I hope you know, Mags,
that you are the essential fit for what
I'm trying to do in this department.
You're patient-focused, you lead with empathy.
You put all of yourself into everything that you do.
And I know your residency hasn't been exactly linear
and you've been dealt with some health challenges,
but getting to know you over this last year,
I have no doubt that you belong... here.
Now, obviously, this is a big commitment
and a major decision, so if you need some time
or you have any doubts or concerns...
No, no. No, no doubts. No.
- Okay. - Yes. Yes, I want it.
- Yes, absolutely. - Good.
Would it be weird if we hugged?
Thank you.
I just ask that you not tell anyone
until I've had a chance to let your colleagues know.
- Should be by the end of the day. - Okay.
Where are we, June?
I'm using negative pressure wound therapy.
- I'm just getting the foam ready. - Is he still hyperkalemic?
And his BP's way too low. Actually, the only good news
is that I debrided twice so the wound looks fantastic.
Free from Ryan's vomit, you mean.
I'm wounding it back with insulation
because the last thing we need is sepsis.
Aside from that, just wait and see how his kidneys recover.
Which the kid is blaming us for.
Olsen requested an audience.
Entitled little troll. I told you, residents were a bad idea.
Just lay it around the film.
But my opinion is irrelevant here.
What is up with you? Don't compress!
I know what I'm doing.
Look, I know things between us have been tricky,
but it seems like there's more bothering you than me having power.
If you can't handle a friendly sparring, June, then that's on you.
The way we work in here, edge of the knife, I need that.
Okay, as weird as that is for me to say.
But not everyone can handle it.
Can you respond at least?
Are you going to play nice with the Ryan thing?
- I'm cutting the hole. - Mark.
Don't put your stability on me, June, I never asked for that.
We're all sucking it up today.
It's a scaphoid fracture.
If you would've done the X-ray two months ago,
we would have put it in a cast to avoid this situation.
Then, it's been broken the whole time?
I'm sorry to say so, yes.
When this happens, the pieces don't properly fuse.
- It's called "non-union". - You seem happy
- that this is happening to me. - No. No, no. I'm just...
No, I'm glad that we're on top of it now.
- So now what? - A surgeon might need
a bone stimulator or maybe even graft...
An operation? And then, how many more weeks off of work?
Donald, I just saw your text.
My wrist has been broken for two months, Claire.
You were supposed to call me about that X-ray.
I did.
I bet somewhere in your bag there, you will find the requisition.
You're right. Odds are it was me.
I didn't mean to accuse you, Claire.
Let's get Doctor Leblanc back to her regular scheduled programming.
And you and I can talk to a surgeon about the next steps?
I'll just get changed and call upstairs.
Yeah, I'll write up a few hydromorphone for his pain.
- He should tolerate them fine. - Okay, thanks.
Chelation therapy should counteract the toxicity.
Over the next days of infusion, it will bind with the lead
in your bloodstream and form a compound that
can be excreted from your body through urine.
Then Alexei will stay, too. He won't be any trouble.
You'll be hooked up to monitors and IVs.
There's no way to run after an energetic toddler.
And as much as we'd love to,
we just don't have the staff to look out for him.
Well, excuse me.
- Hey. - Would you care to fill me in,
- Dr. Hamed? - That's Yuri Zeilinger.
He came in with symptoms of lead poisoning.
And yet you sent a bone scan and an MRI,
that seems like an expensive way to get somewhere
that basic bloods would have taken us.
If you're concerned about resources,
I believe it falls under the public health budget.
So I heard, but I don't remember
approving any patient-sharing initiatives.
Dr. Devi did. I asked her to.
I have experience working in refugee camps in Turkey, Syria, Lebanon.
If we had programs like this available,
we would have saved a lot more lives.
Smart. Not everyone has the personal experience to leverage.
Makes it harder for us to say no to that kind of pitch.
These programs are good in theory, Dr. Hamed.
But I doubt we'll ever see a dime from public health,
which means that we will be eating the extra costs.
Are you asking me to pull Yuri?
Bad optics, too late.
We have a wrinkle.
Did he just accuse me of using my life story to get ahead?
He did. I'm not saying it isn't offensive.
But he's not wrong about public funding being unreliable.
If he okays programs like this one,
he risks losing money we need elsewhere.
And if he doesn't, then he looks like an uncaring racist.
Dr. Devi made it seem like I was on the exact right page,
but Olsen thinks the same idea makes me look
like I have no clue how things work here.
The gulf between those two is above our paygrade.
You said we had a wrinkle?
Yuri won't let me place Alexei with a family while he's in treatment.
I get it, I'm a stranger. But the kid can't stay here.
I don't blame him. I wouldn't trust us either in his shoes.
But you do now, right?
You see yourself in Yuri?
Help him get to where you are.
Liz says exam two's up.
- Are you sure about that, Arnold? - Yep!
Okay.
Hi, I'm Theo Hunter.
Theo Hunter. The Theo Hunter. Okay.
You're Jonathan, right?
Liz's live-in ex. This is Ash.
Hi. You know, if you'd like, I can go get Liz.
She never sees us herself when we come.
"Protocol", she says.
Also, we've already been waiting an hour
and Ash is straining for air.
You're asthmatic, aren't you, Ash?
Yeah. It's been pretty bad today.
Ash texted from school saying they could barely breathe.
Alright, let's get a big breath in and out, okay?
Any triggers? Exercise, allergens?
- What meds are you on? - Big Bad Purple every morning.
- Little Boy Blue for attacks. - Salmeterol and salbutamol.
Oh. And Little Boy Blue hasn't done anything
- to help with the wheezing today? - They lost it.
And are aware that since insurance only covers so many,
the next one's coming out of their allowance.
Okay.
We'll be able to get your breathing sorted,
but I would like to do a chest X-ray just to be sure.
X-ray's not necessary. Nebulizer's normally enough.
Ash, you okay?
John, are you sure this was DEFCON enough to take them out of school?
You could've answered one of my 30 calls and decided yourself.
Your boyfriend thinks it's serious enough
if he wants me getting an X-ray.
Okay, well, I'm going to go run down that nebulizer
and I'll let you guys talk.
Be right back.
Well, first meeting could have gone worse, right?
A week ago, you wouldn't even let me in the car for a pick-up.
Now you're assigning them to me without even a heads-up?
Okay, fine, But I can't treat them,
and you're a person I trust.
And yet you're overruling an X-ray.
Look, Ash does this.
You know, when they came to us a few years ago, they were always sick.
We settled in and it got better.
But now that John and I...
Trust me, all Ash needs is to hear they're fine.
Alright, nebulizer it is, boss.
Thank you.
Over there is where we're going to fix you Dad.
- Dr. Hamed. - Hi.
- Who's this? - This is Alexei.
His father had to make a call to
arrange child care so we are on a tour.
Hi, Alexei. I'm Neeta.
I got your note about Olsen.
Let me worry about him. But when you have a moment,
- I do want to speak in my office. - Okay. Great.
Hey, Donald, has the surgeon not been in?
Not since you left before.
I have been through every paper
and I can't find that X-ray requisition.
And no missed calls or texts from Claire either.
I don't want to make things worse and I know I'm scattered.
But I don't think this was my fault.
And Claire tried to say it was.
Okay, well, um...
Maybe there was a system glitch or some kind of human error.
- Let me just go check... - And maybe give me something
for the pain because I'm still waiting for that, too.
Thanks for meeting.
Anything to assuage hurt feelings.
Poor guy even know where he is?
No, he came in unconscious and we had to intubate.
He's a family member who's driving down,
but still about a day away.
I heard about the resident's complaint.
As this came to me through surgical channels, Dr. Devi, I'm on it.
Maybe so, but the incident happened in my department,
- so my purview. - Incident?
- Seriously? - The young man feels
that a gentler language could have been used.
He lied. About vital information, twice.
You're going to back me up on this, June?
Uh... He did. Yes.
Ryan claims that an environment of fear incited his mistake.
That's crap.
Patient's life was in danger.
He's going to have to face way more intense situations than that.
And if he crumbles, what good is he?
Even so, that justification has fallen out of favour, Mark.
Okay, let's coddle them. Because that'll work out so well
for people who've been crushed by forklifts.
What is that even supposed to mean?
That it is used to be permissible to
berate residents into panic attacks?
It was practically a sport for my attendees.
Radical thought, but it might be nice for new residents
to come up without being repeatedly traumatized.
It's hard to disagree with that.
Then again, Mark makes a fair point about coddling.
Like saying yes to ill-advised public health initiatives
to keep from offending a resident.
That was about encouraging a valid, holistic interest.
Hamed's enthusiasm is not going to pay for unnecessary diagnostics.
Which, as you'll recall, is my purview.
He needs increased pressor doses.
It could be worsening sepsis, but it's hard to tell.
This mess is not a good look for Trauma OR.
So whatever your personal feelings, I need the two of you
to make sure that Ryan feels supported
- and the patient is stabilized. - In that order?
In that case, you can have the future.
June, say whatever you want to Ryan, I am out.
Godspeed, Dr. Curtis.
June, you do not need to hold it back for Novak.
- I know he's great in Trauma OR. - He is Trauma OR.
Someone's got to do it. Anyways, I...
That was spirited.
You should know I have chosen Magalie Leblanc
for the emerg fellowship.
Why don't you walk me through your thinking?
I've already told her.
It was my decision so I made it.
Once I tell the others, we can announce.
Sounds good.
Yuri, it's only for two nights. You said you'd try.
I did. Neighbor who watches him
when I can't take him on jobs has her brother this week.
And he's been in and out of jail. Not an option.
- That's only one person. - There's nobody else.
Yes, there is. Lucy would not put him
- with someone who isn't safe. - If I can't keep him with me,
then there's nothing left to say.
- But you need treatment! - You keep saying that,
but beyond the stomach pain and headaches,
- which I can handle, I'm fine. - No, you're not.
Your blood pressure is through the roof.
You could have a stroke, then what would happen to Alexei, hmm?
When I first got here, I would have said no, too.
I would have taken it all on myself
and it would have been a mistake.
But I've made so many mistakes.
Then take him. If you watch Alexei,
I'll know he's safe and stay here for treatment.
I would, Yuri. I would, but they don't allow that.
I could lose my job, I'm sorry.
Then let us go.
We're survivors him and me, we will manage.
Mags, um...
Did you ask the social worker to help keep Donald organized?
Because I was on that.
Yeah, just 'cause you just started full time again and I...
What? So you can go above and beyond with
every patient, but I'm in over my head?
No, that's not what I...
You didn't order the X-ray.
And there's no record of a requisition or any follow-up.
Donald's in pain.
I can fit him in tonight. He's gonna need ORIF and a bone graft.
How long until he goes back to work?
Eight weeks and it'll be a while tonight,
so stay on top of his pain management. He's in discomfort.
Oh, and Dr. Leblanc,
I understand that congratulations are in order.
The emergency medicine fellowship.
Yeah, I wasn't aware that that was out. Yeah, thank you.
Mags, that's amazing. Way to go.
Now I have to suck up to you more intensely?
- Yeah, you better. - Congrats.
Happy for you, Mags.
That's a nice feeling being at the beginning of something.
Thank you. I do think that you and I have that in common.
The way that we prioritize this place.
And I'm living proof that you can both work here
and manage your health issues. But I'm not doing it alone.
- I'm fine. - Claire, I... Claire!
Okay, I made one mistake. I will apologize to Donald,
but I will not advertise my health problem for sympathy
just because it worked for you.
So you do your job and let me do mine, please.
Hey, first day back, how'd it go?
Awkward. Yours, too, I hear.
- Buy you a drink later? - Sure, only why?
Just, I know how much you wanted that job.
You know, great for Mags, but still, sorry, man.
Ah, wait, you knew already, right?
Yeah, I'll let you know later about that drink, okay?
Ash.
I told Jonathan that you two could go
when the nebulizer ran through.
- Somebody should've came and got you. - Um... John had a work thing.
Liz is driving me home when she finishes.
Is there something you want to say to me, Ash?
Are you the reason she and John split up?
It's more complicated than that.
And something you should probably talk to her about.
Liz is the only mom I have.
So... If you hurt her, you're going to regret it.
Fair enough.
Feel better?
Ash? Hey, Ash, whoa.
Alright, c'mon.
Alright. Okay.
Hey, Ash. Ash!
You're having a reaction to one of the drugs in the nebulizer.
Ash! Hey! Hey! What'd you call it?
"Little Boy Blue?" You had a reaction to Little Boy Blue before?
- I need to know, Ash. - I lied.
I ran out of it because I take extra sometimes.
Did you do that today? Hey, extra meaning what?
More than two or four puffs?
More like 40.
- I like the way it feels. - Combined with the nebulizer,
that is way too much salbutamol.
It's making your heart work way too hard, okay?
Can somebody get me a wheelchair?
Are you hungry, Alexei?
- You want some apples? - Apples.
He's so cute. Who did you say he belongs to?
Just a friend in a bind.
Yeah, you don't have any friends with kids who aren't Theo.
Well, you haven't met all of my friends.
Because this was actually a patient's?
Okay, look, his dad needed treatment,
so I picked Alexei up and now we're babysitting for two nights, hmm?
Bashir, are you even allowed to do that?
Why don't you and Alexei sit on the new couch?
Yeah, right. Then him or probably me spills food
and you freak out because you're not able
to return it if you don't get that job.
I didn't.
I found out today.
- So what does that mean? - Nothing.
There's almost six months left of my residency,
so I'm still employed.
But you can't stay where you are after.
You like it there.
Are you okay?
- Are we okay? - Amira, we're fine.
Starting over is nothing new for us.
Well, I'm staying on the floor just in case.
Just sit on the couch.
- Rhoda prep adenosine. - Veins are flat.
Find me the IO, I'll get access to the left tibia.
No, hold on. I found an entry in the hand, I can make this work.
- Rhoda, we don't have time. - Can you just trust me, please?
- What happened? - SVT from an overdose of salbutamol.
How is that possible? Did you dose the nebulizer wrong?
No. Ash told me, and I've seen this before,
they get a body stone if they hit the inhaler enough times.
- Why would they do that? - Adenosine's prepped.
- You want to stop their heart? - Line's in, ready to push.
Liz, we need to get the heart rate
under control and we have to do it now. Okay?
Okay.
Pushing.
C'mon, c'mon, c'mon.
Ash...
Nice stick.
Try to have faith next time, son.
You okay?
It's been hard since my promotion.
Being everything to everyone at home, too.
Should've trusted your instincts.
- Don't worry about it. - Ash likes you.
Which is kind of a big deal. Very picky kid.
Good to know.
Especially after the talk I got about not hurting you.
You should come to the house.
For dinner with all of us this weekend.
"In addition, Arnold has a natural curiosity
about the human body and its functions,
and his passion for learning is evident."
Does natural curiosity about the human body sound really sexual?
Yeah, try "anatomy" instead.
We're off the clock.
Boss, you told Arnold you would write him
a reference letter for med school weeks ago.
- It's due tomorrow. - It is?
Arnold, why didn't you say anything?
We were just writing a draft and I figured
maybe you could read it and sign off?
You haven't been easy to talk to.
You're right, sorry. Um, yeah, send it.
- I'll get to it before I go. - Thanks.
Bleeding gums after lower-body crush injury.
Really want the poor guy to pull through.
And if he doesn't, you're under scrutiny because of the resident.
All I needed was for Novak to just...
He couldn't just admit that the kid didn't need to be demeaned.
Yeah, did Ryan really lie about checking his urine?
Because no doctor I've ever worked for would take that lightly.
Okay, look, I remember when I was in first year,
we hid a file behind a surgical desk.
Days without humiliation.
The number always hovered around two, now I guess
- I'm back down to zero. - Same.
I think the bar's close enough for us to walk.
- No, you don't have to buy me a drink. - Yeah, I do.
You just beat out a tough crew for that job.
Yeah, including my ex-boyfriend
who's probably now spiralling into a pit
of existential despair about he's eternally unemployable
and will never be able to give his sister
the life that she deserves.
I think we might be on the wrong block.
Yeah, I'm not supposed to be drinking anyway.
Why can't you just let us celebrate?
Because you feel guilty about Bash?
Claire told me I only got the job because
Devi pities me for my health issues.
What? No, Mags, you got the job because you deserve it.
You should've seen her today. Claire.
First, she was late, then she missed a patient's X-ray.
And now he needs surgical intervention.
One minute she's her sweet old self,
and then I offered to help and she just blew off on me.
Yeah, it's like with Bash.
You know the myth about the five stages being linear
when in reality you either experience them
all at the same time or just completely out of order?
- What, I can't evolve? - Okay.
Except I ordered her patient pain meds
and I don't think they ever got to him.
You think Claire took his pain meds?
I guess if she has something to hide,
that would explain her pushing you away.
What are you going to do? Novak.
I need him, so what I always do.
Just suck it up and apologize on his behalf.
Tomorrow's 50 days of no cutting, too.
So that means we're not only celebrating you...
June! Ugh. How you feeling?
- Proud. - Yeah.
I think I'm scared.
Like, what's going to happen without the cutting?
My ability to handle things,
my endless capacity for pain and suffering, my...
Maybe you don't deserve endless pain and suffering.
And I don't think that you won't be able to handle things.
You're right about evolving.
Wait, did you say your patient's gums were bleeding?
- Yeah, why? - Because damaged tissue
after crush injury can pump cellular debris
into the bloodstream and send his clotting system into overdrive.
- DIC. - If it's consuming
clotting factors and platelets faster than they can be replaced...
Go, if you need to take care of it.
Thanks! Congratulations, seriously.
Hello?
Forgive me if I don't apologize for waking you.
I drove out to Branson last night
only to scare the hell out of Yuri's neighbor
who had no idea why I was checking on a child
who wasn't staying with her. And then, I drove all the way
back for Yuri to tell me that you took Alexei.
- Yeah, only for a night or two. - Except it won't be.
Yuri crashed, started seizing from hypocalcaemia.
But we can regulate that.
He might just need slower dosage.
They moved him into ICU.
They're saying he'll need to stay in-patient two weeks now.
Okay, well then, let me keep him.
You said to reach Yuri, this is how I'm doing it.
I told you to get him to trust us.
But all you've done is prove that he can't.
And now I have to place his son with strangers
without the father's buy-in.
You're right, you're right. I'll... I'll come in. I'm sorry.
It's not me you should be apologizing to.
Mr. Cassavetes.
Suffered an industrial accident and crush injury yesterday.
He has fought through kidney failure
and cascading complications.
- How are you feeling, Dom? - Lucky to be alive, Dr. Curtis.
Thank you.
Ryan, can you please
walk us through the clotting disorder
that this patient was treated for?
I hadn't had a chance to review the chart.
Oh.
Let's move on to patient room C.
Ryan, can you walk with me this way?
Yeah.
Look, the way you were treated the other day was unacceptable.
And I apologize.
Shouldn't Dr. Novak be here for this, too?
You had the right to make a complaint
- and this is us addressing it. - Okay.
I thought there was going to be more of a formal meeting.
I'm a little blindsided.
Okay, you feel blindsided because I'm apologizing to you?
Or because I called you out for being unprepared
- for your rounds, Ryan? - I asked my supervising doctor
if I could be excused from that patient because of how it affected me.
That's not exactly how this works, Ryan. You don't get
to pick and choose so that you can hide from your mistakes.
It was your mistake, not mine.
And now you're giving me a fake apology and trying to retraumatize me.
You need to shut up, you entitled little troll.
You know, Ryan, if you knew anything about real trauma,
you would get it together, face your mess and do the damn work.
Claire?
I know doctors aren't supposed to be in here,
but I just wanted to see if Donald had his surgery.
Yeah, he came through fine.
And he told me about
our social worker's plan to get his health care under control.
Yeah, that was the right move, Mags.
How long do you think that'll stick?
Knowing Donald, I have a feeling
he'll still need help from time to time.
Yeah, we all do.
Hydromorphone.
- Mags, what is this? - If you have pain, Claire,
that pain should be managed.
We both know the harm prevention protocols
when it comes to opioid use tend to shut out people
who need them and know how to use them responsibly.
Based on my actions lately,
are you sure that's the word you want to use?
Yeah.
I know you, Claire.
There is physical pain, yeah. But...
Every patient I see I think, "Is this the person who stabbed me?"
I never saw their face and I am so angry!
And I hear myself being terrible to people.
It's just, I can't stop it, I...
How do I know which pain I'm medicating?
We're going to make an accountability plan for the painkillers.
So that they stay under control.
And find you a counselor.
You're not alone with this.
Claire...
Thank you.
Sorry you found out about the job the way you did.
That was... unprofessional.
- I tried to find you, but... - Yeah, I had to...
Rush off with a patient's child and prove Olsen's point
about using your background and public health to work us.
I didn't mean to make things more complicated for you.
Well, you did. And while you're a skilled doctor in so many ways,
this is an example of why you didn't get the fellowship.
This instinct to leap blindly.
You just can't seem to shake it.
What happens now?
You try not to abscond with any more children,
and hopefully, leave here with a glowing recommendation.
They live close.
They promised to bring Alexei by to see me every day I'm here.
I want to believe them, but...
I'm so sorry about all of this, Yuri.
But if Lucy trusts this family then we can, too.
I know you may not be able to see it now, but...
eventually, all of this will be behind you.
You should've seen Ryan's face.
He's just so smug. Feel myself simmering.
And then you just lost it on him.
Yeah, but it did help me get to the end of day 50.
Did you want white or red?
Um, actually, before you open that...
This dinner is going to have her ex-husband and her two kids.
June...
It's hard not to feel like I'm being collected, you know?
- Yeah, sounds complicated. - Hi.
- Hey! - Congrats.
No, you didn't have to do that.
Yeah, he did.
Guys, it's not ornamental. You want to maybe...
No, yeah, I got it.
Is that you?
Nope.
Oh, that's my phone.
My screen's garbled, but...
- Hello? - Hello?
- Magalie, is that you? - Yes.
Mags, this is Connie from your transplant team.
- I've been trying to reach you. - Yeah, I'm sorry.
My phone died. Is everything alright?
There's a heart waiting and it's a perfect match.
If you decide to take it, we need you at the hospital now basically.
Mags? I need you to confirm.
Are you accepting this heart?
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