1 00:00:06,773 --> 00:00:08,800 We should not live together. 2 00:00:10,100 --> 00:00:12,535 That makes no sense. 3 00:00:12,537 --> 00:00:14,370 I rented that apartment, 4 00:00:14,372 --> 00:00:17,373 and neither of us can afford it on our own. 5 00:00:17,375 --> 00:00:19,375 It has a fireplace. 6 00:00:19,377 --> 00:00:21,744 We shouldn't live together. 7 00:00:22,131 --> 00:00:25,347 It has a fireplace. 8 00:00:29,286 --> 00:00:31,587 Do you ever think about us 9 00:00:31,589 --> 00:00:33,434 being together... 10 00:00:34,492 --> 00:00:37,393 as a couple? 11 00:00:37,395 --> 00:00:39,161 Sometimes. 12 00:00:39,163 --> 00:00:40,863 I don't want that. 13 00:00:44,734 --> 00:00:46,869 You don't want us to be a couple? 14 00:00:46,871 --> 00:00:49,672 Or you don't want me thinking about us as a couple? 15 00:00:51,541 --> 00:00:53,375 Neither. 16 00:00:53,377 --> 00:00:55,478 If we get an apartment together, 17 00:00:55,480 --> 00:00:57,580 I feel like that's a signal 18 00:00:57,582 --> 00:01:01,350 that you and I might end up as boyfriend and girlfriend, 19 00:01:01,352 --> 00:01:03,686 and that's not going to happen. 20 00:01:03,688 --> 00:01:06,288 You can't predict the future. 21 00:01:06,290 --> 00:01:08,057 Feelings change. 22 00:01:08,059 --> 00:01:10,459 I used to hate hugs, but now... 23 00:01:10,461 --> 00:01:11,627 sometimes I don't. 24 00:01:11,629 --> 00:01:13,596 But I don't want my feelings to change. 25 00:01:13,598 --> 00:01:15,331 I like being your friend, 26 00:01:15,333 --> 00:01:18,334 and romantic relationships a-are unpredictable. 27 00:01:18,336 --> 00:01:21,237 So much can go wrong, especially when I am involved. 28 00:01:21,239 --> 00:01:24,039 And if we live together, it's gonna be awkward. 29 00:01:24,041 --> 00:01:25,941 You're bound to walk in on me when I'm naked 30 00:01:25,943 --> 00:01:27,810 or hear the weird sex sounds I make 31 00:01:27,812 --> 00:01:29,512 with some out-of-work drummer 32 00:01:29,514 --> 00:01:31,113 or find me crying when that drummer dumps me, 33 00:01:31,115 --> 00:01:33,182 even though I was totally gonna dump him. 34 00:01:40,024 --> 00:01:42,391 I was so unhappy 35 00:01:42,393 --> 00:01:44,379 when we weren't getting along. 36 00:01:44,996 --> 00:01:47,163 You were, too, right? 37 00:01:49,933 --> 00:01:51,267 Yes. 38 00:01:51,269 --> 00:01:53,235 Anything that puts our friendship at risk 39 00:01:53,237 --> 00:01:55,224 isn't worth it to me. 40 00:01:55,673 --> 00:01:56,972 Okay, Shaun? 41 00:02:00,278 --> 00:02:02,077 Yes. 42 00:02:11,721 --> 00:02:13,722 Our gallbladder removal's off. 43 00:02:13,724 --> 00:02:15,057 Patient took an Ambien last night, 44 00:02:15,059 --> 00:02:16,559 woke up eating a roast chicken. 45 00:02:16,561 --> 00:02:17,726 Let's check the consult list 46 00:02:17,728 --> 00:02:19,428 for something a little more interesting. 47 00:02:19,430 --> 00:02:22,164 - See? Gallbladders are boring. - You're a resident. 48 00:02:22,166 --> 00:02:24,200 You don't get to call any surgery boring. 49 00:02:24,202 --> 00:02:25,701 See? 50 00:02:28,906 --> 00:02:30,539 This is interesting. 51 00:02:37,648 --> 00:02:38,981 Fizzy urine. 52 00:02:42,486 --> 00:02:44,286 42-year-old female, syncopal episode 53 00:02:44,288 --> 00:02:45,854 with persistent loss of consciousness. 54 00:02:45,856 --> 00:02:47,690 On the ride, she went into PVT, rate of 180. 55 00:02:47,692 --> 00:02:49,925 We shocked her back to normal sinus rhythm. 56 00:02:49,927 --> 00:02:51,293 I'm starting to feel... 57 00:02:52,496 --> 00:02:53,996 She's going back into PVT. 58 00:02:53,998 --> 00:02:55,273 We need to shock her. Get her into a bay. 59 00:02:55,298 --> 00:02:56,334 - No. No. 60 00:02:59,570 --> 00:03:02,204 That was cool, but you may have just cracked her sternum. 61 00:03:02,206 --> 00:03:04,173 - Get her into bay 2. - What happened? 62 00:03:05,308 --> 00:03:07,109 - You're her husband? - Yes. 63 00:03:07,111 --> 00:03:09,211 Your wife is pretty frail. 64 00:03:09,213 --> 00:03:10,946 Any idea what could have caused that? 65 00:03:10,948 --> 00:03:12,426 She did. 66 00:03:13,184 --> 00:03:14,783 She's anorexic. 67 00:03:16,486 --> 00:03:18,622 ...Captions by VITAC... 68 00:03:18,624 --> 00:03:26,629 Synced & corrected by -robtor- www.addic7ed.com 69 00:03:26,631 --> 00:03:29,498 I'm Dr. Murphy. This is Dr. Park. 70 00:03:29,500 --> 00:03:31,133 We're here about your urine. 71 00:03:31,135 --> 00:03:32,968 How long has it been fizzy? 72 00:03:32,970 --> 00:03:35,237 I hadn't even noticed. Is that a problem? 73 00:03:35,239 --> 00:03:38,173 Ah, it can be a symptom of several conditions, 74 00:03:38,175 --> 00:03:40,309 many of them minor. 75 00:03:40,311 --> 00:03:42,244 You're here for ortho, a scope on your right knee? 76 00:03:42,246 --> 00:03:44,947 It's been sore. I've been training for a race. 77 00:03:44,949 --> 00:03:48,150 Joint pain plus fizzy urine. 78 00:03:48,152 --> 00:03:50,919 You could have emphysematous cystitis, 79 00:03:50,921 --> 00:03:52,855 bladder cancer, kidney problems, 80 00:03:52,857 --> 00:03:55,190 Those sound serious. Should I call my husband? 81 00:03:55,192 --> 00:03:58,227 Emphysematous cystitis is a treatable bladder infection. 82 00:03:58,229 --> 00:04:01,163 Your symptoms could also be from a kidney stone 83 00:04:01,165 --> 00:04:02,531 or dehydration. 84 00:04:02,533 --> 00:04:04,767 Could my issues be caused by... 85 00:04:04,769 --> 00:04:06,635 gastric bypass surgery? 86 00:04:06,637 --> 00:04:08,237 It depends. When was it? 87 00:04:08,239 --> 00:04:09,905 15 years ago. 88 00:04:09,907 --> 00:04:12,241 I used to be 377 pounds. 89 00:04:12,243 --> 00:04:13,442 That's a lot. 90 00:04:13,444 --> 00:04:16,478 Your surgery wouldn't cause those symptoms, 91 00:04:16,480 --> 00:04:20,282 but we need to do a cystoscopy to find out what did. 92 00:04:20,284 --> 00:04:22,751 I'll cancel the ortho and get Lim to sign off. 93 00:04:24,154 --> 00:04:25,454 Hey, wait. What, 94 00:04:25,456 --> 00:04:27,423 So, what is a cystoscopy? 95 00:04:28,558 --> 00:04:30,826 It's like a knee scope, 96 00:04:30,828 --> 00:04:33,423 except the camera goes up your penis. 97 00:04:36,533 --> 00:04:38,667 You administered amiodarone? 98 00:04:38,669 --> 00:04:40,222 Rhythm's normal. 99 00:04:40,838 --> 00:04:42,938 That's good, right? 100 00:04:42,940 --> 00:04:44,810 It's better than when you came in. 101 00:04:45,509 --> 00:04:46,942 Your heart is failing 102 00:04:46,944 --> 00:04:50,312 as a result of a condition called mitral regurgitation. 103 00:04:50,314 --> 00:04:52,548 One of your valves isn't closing all the way. 104 00:04:52,550 --> 00:04:55,150 Blood keeps leaking back into your atrium. 105 00:04:55,152 --> 00:04:56,352 That's why you fainted 106 00:04:56,354 --> 00:04:58,120 and why we need to repair that valve ASAP. 107 00:05:00,690 --> 00:05:02,891 How long have you been anorexic? 108 00:05:05,995 --> 00:05:08,397 I've had issues with food 109 00:05:08,399 --> 00:05:10,099 on and off since I was 14. 110 00:05:10,101 --> 00:05:12,267 Mitral valve issues are a frequent complication 111 00:05:12,269 --> 00:05:13,802 of long-term malnutrition. 112 00:05:13,804 --> 00:05:16,049 This bout started about a year ago... 113 00:05:17,074 --> 00:05:19,141 skipping meals, lying about eating, 114 00:05:19,143 --> 00:05:20,809 exercising excessively. 115 00:05:20,811 --> 00:05:22,311 I don't know what else I can do. 116 00:05:22,313 --> 00:05:24,313 I-I can't monitor her 24 hours a day. 117 00:05:24,315 --> 00:05:25,681 I'm not asking you to. 118 00:05:25,683 --> 00:05:27,282 No, but you are starving yourself. 119 00:05:27,284 --> 00:05:28,784 Mom. 120 00:05:28,786 --> 00:05:30,753 Graham-y, come here. 121 00:05:30,755 --> 00:05:32,441 What's he doing here? 122 00:05:33,257 --> 00:05:35,691 When I got home, I heard about the ambulance. 123 00:05:35,693 --> 00:05:37,860 I made Cindy bring me here. 124 00:05:37,885 --> 00:05:39,785 What's wrong with my mom? 125 00:05:42,599 --> 00:05:45,234 She needs a surgery to repair a valve in her heart. 126 00:05:46,703 --> 00:05:49,371 This heart thing, is, is that why she's so skinny? 127 00:05:50,340 --> 00:05:52,441 Look, what matters, Graham, 128 00:05:52,443 --> 00:05:55,505 is that these doctors are gonna help your mom. 129 00:05:56,547 --> 00:05:57,746 Okay? 130 00:06:04,020 --> 00:06:07,489 You haven't moved your bowels. 131 00:06:07,491 --> 00:06:09,191 Well, thank you, Shaun, for that announcement. 132 00:06:09,193 --> 00:06:10,993 Saves me the trouble of tweeting. 133 00:06:10,995 --> 00:06:13,962 The nurses already knew. They told me. 134 00:06:13,964 --> 00:06:15,764 They also said 135 00:06:15,766 --> 00:06:18,367 you're no longer talking to your dead daughter. 136 00:06:18,369 --> 00:06:21,603 Constipated, but no longer psychotic. A narrow win. 137 00:06:21,605 --> 00:06:23,872 Your first defecation event 138 00:06:23,874 --> 00:06:26,975 is a vital part of the discharge criteria. 139 00:06:26,977 --> 00:06:29,711 Event? What is this, the post-op decathlon, 140 00:06:29,713 --> 00:06:31,780 - pooping, peeing, walking, talking? - Yes. 141 00:06:31,782 --> 00:06:34,216 You have to walk a full lap of the floor. 142 00:06:34,218 --> 00:06:37,186 But you canceled physical therapy this morning. 143 00:06:37,188 --> 00:06:38,587 Those nurses have big mouths. 144 00:06:38,589 --> 00:06:41,657 I canceled because my leg is a little sore. 145 00:06:41,659 --> 00:06:43,859 That could be phlebitis 146 00:06:43,861 --> 00:06:44,993 or a DVT or a, 147 00:06:44,995 --> 00:06:47,329 Could also be an unsurprising complication 148 00:06:47,331 --> 00:06:49,498 from a surgeon poking around in my pons. 149 00:06:49,500 --> 00:06:51,333 Every day in the hospital 150 00:06:51,335 --> 00:06:55,904 increases your risk of infection by 1.37%. 151 00:06:55,906 --> 00:06:58,777 You need to move your bowels, and we should walk right now. 152 00:07:00,643 --> 00:07:02,544 I'll go very slow. 153 00:07:02,546 --> 00:07:03,779 Shaun, is there any chance 154 00:07:03,781 --> 00:07:06,451 that you are needed elsewhere right now? 155 00:07:08,318 --> 00:07:10,052 I-I have 8 minutes 156 00:07:10,054 --> 00:07:12,488 until my patient's cystoscopy. 157 00:07:12,490 --> 00:07:14,292 Good. Be early. 158 00:07:15,525 --> 00:07:17,259 Urethra looks clean. 159 00:07:17,261 --> 00:07:19,394 No lesions, no stones so far. 160 00:07:19,396 --> 00:07:22,231 How do we check for obstructions or stones further up? 161 00:07:22,233 --> 00:07:24,800 Contrast cystogram. 162 00:07:24,802 --> 00:07:26,535 Since you found this patient, 163 00:07:26,537 --> 00:07:28,003 how about you do the honors? 164 00:07:30,173 --> 00:07:32,841 You know this guy used to weigh 370 pounds? 165 00:07:32,843 --> 00:07:36,111 Thread the catheter further into the bladder. 166 00:07:36,113 --> 00:07:38,113 That's a big drop. Good for him. 167 00:07:38,115 --> 00:07:40,449 He did have gastric bypass. 168 00:07:40,451 --> 00:07:42,217 That makes it less impressive? 169 00:07:42,219 --> 00:07:44,219 - Now infuse the contrast. - Well, yeah, 170 00:07:44,221 --> 00:07:47,189 it is the easy way, compared to just diet and exercise. 171 00:07:47,191 --> 00:07:49,925 The contrast dye is dissipating. 172 00:07:49,927 --> 00:07:51,393 It's supposed to. 173 00:07:51,395 --> 00:07:53,662 You said he's training for a race. 174 00:07:53,664 --> 00:07:55,297 Obviously, he turned his life around. 175 00:07:55,299 --> 00:07:56,765 Still dissipating. 176 00:07:56,767 --> 00:07:58,467 Bypass made it physically impossible 177 00:07:58,469 --> 00:07:59,735 for him to eat as much as he wanted. 178 00:07:59,737 --> 00:08:02,590 It's gone. The contrast is gone. 179 00:08:05,074 --> 00:08:07,009 - That makes no sense. - Where did it go? 180 00:08:07,011 --> 00:08:10,946 He probably has a fistula, 181 00:08:10,948 --> 00:08:14,383 a tunnel connecting his bladder to his intestine. 182 00:08:14,385 --> 00:08:16,285 Air and bacteria moving the other direction 183 00:08:16,287 --> 00:08:17,886 caused bubbles in his urine. 184 00:08:21,191 --> 00:08:22,925 Her liver and thyroid are normal, 185 00:08:22,927 --> 00:08:25,561 but her electrolytes are off. 186 00:08:25,563 --> 00:08:27,262 Her albumin is at 2.1. 187 00:08:27,264 --> 00:08:28,630 She's severely malnourished. 188 00:08:28,632 --> 00:08:31,619 She'll be totally vulnerable to post-op infections. 189 00:08:32,102 --> 00:08:33,802 She needs this surgery to survive, 190 00:08:33,804 --> 00:08:35,971 but she may be too sick to survive the surgery. 191 00:08:43,204 --> 00:08:44,626 In order to operate safely, 192 00:08:44,651 --> 00:08:46,337 we need to boost your caloric intake, 193 00:08:46,362 --> 00:08:47,594 optimize protein. 194 00:08:47,596 --> 00:08:49,129 Can't you do that through my IV? 195 00:08:49,131 --> 00:08:51,298 It's more efficient to pump a nutritional supplement 196 00:08:51,300 --> 00:08:52,599 directly into your stomach. 197 00:08:52,601 --> 00:08:54,568 We use a tube running down from your nose. 198 00:08:54,570 --> 00:08:56,536 I had an NG tube once. 199 00:08:57,505 --> 00:08:59,439 It didn't work. 200 00:09:00,075 --> 00:09:01,691 She couldn't tolerate it. 201 00:09:02,277 --> 00:09:05,245 Because it's not really about food. 202 00:09:05,247 --> 00:09:06,613 It's about control. 203 00:09:07,882 --> 00:09:09,950 You've lived for decades 204 00:09:09,952 --> 00:09:12,152 with a condition that has killed more people 205 00:09:12,154 --> 00:09:14,988 than any other psychiatric illness. 206 00:09:14,990 --> 00:09:17,391 You didn't just survive. You had a child. 207 00:09:19,227 --> 00:09:20,861 Can you tell us how? 208 00:09:23,765 --> 00:09:28,702 When I got pregnant, it was like this terrifying miracle. 209 00:09:28,704 --> 00:09:32,773 And the thought of gaining all that weight, but... 210 00:09:32,775 --> 00:09:36,476 I wanted him so much. 211 00:09:36,478 --> 00:09:37,844 We both did. 212 00:09:37,846 --> 00:09:41,882 Every meal, I would sit with pictures of his ultrasound, 213 00:09:41,884 --> 00:09:44,818 I-imagining the food going directly to him. 214 00:09:48,790 --> 00:09:50,657 Can you do that again? 215 00:09:51,160 --> 00:09:52,626 Eat for Graham? 216 00:10:03,806 --> 00:10:05,172 We've determined the fistula 217 00:10:05,174 --> 00:10:06,406 between your bladder and intestine 218 00:10:06,408 --> 00:10:08,241 was caused by Crohn's disease, 219 00:10:08,243 --> 00:10:10,444 an inflammatory intestinal condition. 220 00:10:10,446 --> 00:10:12,746 Once we reverse your gastric bypass, 221 00:10:12,748 --> 00:10:15,482 - you'll need, - Wait. R-Reverse my bypass? 222 00:10:15,484 --> 00:10:16,616 Are you sure? 223 00:10:16,618 --> 00:10:18,985 Bypass surgery shortens the digestive tract. 224 00:10:18,987 --> 00:10:20,587 People with Crohn's disease need 225 00:10:20,589 --> 00:10:21,888 every inch of intestine they have, 226 00:10:21,890 --> 00:10:23,457 or they risk critical, 227 00:10:23,459 --> 00:10:25,092 even fatal malnutrition. 228 00:10:25,094 --> 00:10:27,294 Okay, but I don't want my husband to know, 229 00:10:27,296 --> 00:10:29,162 and he'll be here soon. 230 00:10:29,164 --> 00:10:31,164 Well, we would never reveal anything 231 00:10:31,166 --> 00:10:32,599 without your permission, 232 00:10:32,601 --> 00:10:35,669 but Crohn's disease is going to require 233 00:10:35,671 --> 00:10:37,571 some major adjustments. 234 00:10:37,573 --> 00:10:40,040 Well, I'll tell Spence about the Crohn's, 235 00:10:40,042 --> 00:10:43,126 and I'll tell him I'm having surgery... 236 00:10:43,612 --> 00:10:45,212 on my bladder. 237 00:10:47,315 --> 00:10:49,549 Your husband doesn't know you had gastric bypass? 238 00:10:49,551 --> 00:10:51,785 That would require him knowing I was obese to begin with. 239 00:10:51,787 --> 00:10:52,819 That's not gonna happen. 240 00:10:52,821 --> 00:10:55,422 Your husband must be very shallow. 241 00:10:56,390 --> 00:10:58,892 Even if I don't disclose 242 00:10:58,894 --> 00:11:01,795 that I reversed your bypass, your scars might. 243 00:11:01,797 --> 00:11:03,663 It requires a separate incision. 244 00:11:03,665 --> 00:11:05,313 Well, tell him there was a complication. 245 00:11:05,315 --> 00:11:08,635 Our obligation to protect your privacy doesn't include lying. 246 00:11:08,637 --> 00:11:09,970 And you shouldn't have to go through this without him. 247 00:11:09,972 --> 00:11:14,174 The single abdominal umbilical port. 248 00:11:15,743 --> 00:11:18,712 We can repair Wade's fistula 249 00:11:18,714 --> 00:11:20,781 and reverse his bypass 250 00:11:20,783 --> 00:11:23,083 all through a single incision. 251 00:11:23,085 --> 00:11:26,353 We can help deceive your husband. 252 00:11:26,355 --> 00:11:28,054 - Oh, honey, I'm so sorry. - That's okay, Spence. 253 00:11:28,056 --> 00:11:30,157 - Got here... as soon as I could. - It's all right. 254 00:11:32,293 --> 00:11:35,629 And since my husband is surrounded by surgeons, 255 00:11:35,631 --> 00:11:37,130 what's the issue, what are you gonna do about it, 256 00:11:37,132 --> 00:11:39,499 and how often have you done it successfully? 257 00:11:47,975 --> 00:11:49,442 How are you doing? 258 00:11:50,212 --> 00:11:51,578 I'm fine. 259 00:11:56,150 --> 00:11:58,185 Graham, would you mind filling this? 260 00:12:01,790 --> 00:12:03,857 You've had one spoonful of tuna, 261 00:12:03,859 --> 00:12:06,193 2 ounces of apple sauce. 262 00:12:06,195 --> 00:12:07,627 That's it? 263 00:12:07,629 --> 00:12:10,297 Mom, if that's all I had, you'd never let me up from the table. 264 00:12:10,299 --> 00:12:12,232 This is different. I... 265 00:12:12,234 --> 00:12:13,500 can't eat too quickly. 266 00:12:13,502 --> 00:12:14,701 I don't believe you. 267 00:12:15,803 --> 00:12:16,879 It's true. 268 00:12:16,881 --> 00:12:19,239 Your mother is suffering from severe malnutrition, 269 00:12:19,241 --> 00:12:21,174 and she's trying her best, - I knew it. 270 00:12:21,176 --> 00:12:23,343 You're too skinny. That's why you're here. 271 00:12:23,345 --> 00:12:24,678 That's probably why your heart's messed up, 272 00:12:24,680 --> 00:12:26,880 - and you still won't eat. - Graham, I am trying. 273 00:12:26,882 --> 00:12:29,149 - How hard can it be to eat? - I'm not feeling well. 274 00:12:29,151 --> 00:12:30,750 Me and Dad are really worried about you. 275 00:12:30,752 --> 00:12:32,944 - Don't you care? - Of course I do, Graham. 276 00:12:33,622 --> 00:12:35,530 - So much. - Then do something. 277 00:12:36,458 --> 00:12:37,991 Prove it. 278 00:12:47,001 --> 00:12:48,435 You provoked that argument? 279 00:12:48,437 --> 00:12:51,204 Yep, and I may have just saved our patient. 280 00:12:51,206 --> 00:12:53,673 She requested an NG tube. 281 00:12:53,675 --> 00:12:56,309 Understanding is nice. Calories are better. 282 00:12:59,313 --> 00:13:01,514 He's screwing this up. His husband's scared, 283 00:13:01,516 --> 00:13:03,049 and he just wants to know what's going on. 284 00:13:03,051 --> 00:13:06,019 Nothing like marital advice from the divorced. 285 00:13:06,021 --> 00:13:08,355 - You're divorced, too. - And I'm not advising. 286 00:13:08,357 --> 00:13:10,423 I'm not judging the health of a marriage 287 00:13:10,425 --> 00:13:13,360 based on a single secret, which is neither shocking 288 00:13:13,362 --> 00:13:15,028 nor a sign of its imminent demise. 289 00:13:15,030 --> 00:13:16,863 What, truth in a marriage is overrated? 290 00:13:16,865 --> 00:13:19,332 Well, it was in mine. Not every single insight, 291 00:13:19,334 --> 00:13:21,601 opinion, or impulse needs to be shared. 292 00:13:21,603 --> 00:13:23,203 Marriage sounds confusing. 293 00:13:23,205 --> 00:13:24,971 No wonder you both failed at it. 294 00:13:29,777 --> 00:13:31,878 How's it going in here? 295 00:13:31,880 --> 00:13:33,847 Not as bad as I remember. 296 00:13:35,082 --> 00:13:37,384 Does it hurt, Mom? 297 00:13:37,386 --> 00:13:40,345 No, just a little awkward. 298 00:13:40,822 --> 00:13:42,722 Makes it hard to talk. 299 00:13:42,724 --> 00:13:44,491 But I'm okay. 300 00:13:48,029 --> 00:13:49,562 I am so proud of you. 301 00:14:00,975 --> 00:14:03,042 Dr. Glassman hasn't defecated 302 00:14:03,044 --> 00:14:04,810 or done his physical therapy. 303 00:14:04,812 --> 00:14:07,313 I am aware and yet unalarmed. 304 00:14:07,315 --> 00:14:10,249 - Who are you? - I'm Dr. Shaun Murphy. 305 00:14:10,251 --> 00:14:12,168 Oh, right! 306 00:14:12,920 --> 00:14:16,188 Your Dr. Glassman's... friend. 307 00:14:16,190 --> 00:14:19,091 Please order him to do physical therapy 308 00:14:19,093 --> 00:14:21,994 and give him 15 milligrams of ex-lax. 309 00:14:21,996 --> 00:14:24,063 The ex-lax is a decent idea. 310 00:14:24,065 --> 00:14:27,666 As for the physical therapy, of course, he's stalling. 311 00:14:27,668 --> 00:14:30,569 Glassman's a proud man. He ran this hospital. 312 00:14:30,571 --> 00:14:32,304 He's reluctant to feel weak and vulnerable 313 00:14:32,306 --> 00:14:34,340 in front of people who used to work for him. 314 00:14:34,342 --> 00:14:36,508 That doesn't make sense. 315 00:14:36,510 --> 00:14:38,644 He is weak. He just had brain surgery. 316 00:14:38,646 --> 00:14:40,746 Well, sensical or not, that's my take. 317 00:14:40,748 --> 00:14:42,114 He'll walk eventually. 318 00:14:42,116 --> 00:14:44,883 Every day in the hospital 319 00:14:44,885 --> 00:14:47,820 increases his risk of infection by 1.37, 320 00:14:47,822 --> 00:14:49,722 Well, you tell him that, 321 00:14:49,724 --> 00:14:51,056 and maybe he'll hop right out of bed. 322 00:14:51,058 --> 00:14:52,958 I did. It didn't work. 323 00:14:52,960 --> 00:14:55,227 He didn't respond to the stick. 324 00:14:55,229 --> 00:14:57,429 Try the carrot. Although, really, I would just advise, 325 00:14:59,300 --> 00:15:01,734 Dr. Glassman doesn't like carrots. 326 00:15:03,236 --> 00:15:05,170 What should I do with the stick? 327 00:15:06,439 --> 00:15:08,407 It's a metaphor. 328 00:15:08,409 --> 00:15:11,510 Uh, Glassman, appropriately, is the donkey. 329 00:15:11,512 --> 00:15:14,079 The stick signifies punishment. 330 00:15:14,081 --> 00:15:16,122 The carrot signifies... 331 00:15:16,124 --> 00:15:18,984 reward, but he is, he's recovering nicely, 332 00:15:18,986 --> 00:15:21,387 and your best bet is to just be patient with him. 333 00:15:22,556 --> 00:15:25,357 So, I should use a reward 334 00:15:25,359 --> 00:15:29,294 to motivate Dr. Glassman to do physical therapy. 335 00:15:29,296 --> 00:15:31,330 Actually... what I'm saying 336 00:15:31,332 --> 00:15:34,666 is that you should be patient and supportive... 337 00:15:36,170 --> 00:15:38,437 ...and please, please answer that. 338 00:15:45,712 --> 00:15:47,212 Close the door. 339 00:15:52,585 --> 00:15:55,287 We were headed to pre-op when he started projectile vomiting. 340 00:15:55,289 --> 00:15:57,723 It's... green. 341 00:15:57,725 --> 00:16:00,926 That could mean bile and a partial bowel obstruction. 342 00:16:00,928 --> 00:16:03,262 - We need an NG tube. - An obstruction? 343 00:16:03,264 --> 00:16:05,448 Did the Crohn's cause that? 344 00:16:06,033 --> 00:16:08,367 It's hard to know for sure. NG tube, stat. 345 00:16:16,877 --> 00:16:18,419 You're doing great. 346 00:16:19,613 --> 00:16:22,047 You should try and get some sleep. 347 00:16:22,049 --> 00:16:23,466 I can't. 348 00:16:24,018 --> 00:16:27,252 There's this voice in my head, 349 00:16:27,254 --> 00:16:28,763 and it won't be quiet. 350 00:16:29,457 --> 00:16:31,190 It keeps telling me that 351 00:16:31,192 --> 00:16:36,562 this bag has 60 grams of protein, 352 00:16:36,564 --> 00:16:38,597 40 grams of fat, 353 00:16:38,599 --> 00:16:41,100 1,200 calories in total. 354 00:16:41,102 --> 00:16:43,502 It just won't stop. 355 00:16:45,706 --> 00:16:48,774 Try... to think of Graham and Sam. 356 00:16:50,276 --> 00:16:51,677 I'm trying. 357 00:16:54,114 --> 00:16:55,814 I'll get something to put over that. 358 00:17:01,722 --> 00:17:02,754 Louisa, no! 359 00:17:02,756 --> 00:17:05,657 No! 360 00:17:05,659 --> 00:17:07,226 No! 361 00:17:09,229 --> 00:17:10,796 I'm sorry. 362 00:17:10,798 --> 00:17:12,865 I c... I just, 363 00:17:12,867 --> 00:17:14,809 I can't stand it. 364 00:17:21,859 --> 00:17:23,726 I got your deposit back. 365 00:17:24,434 --> 00:17:25,701 Why? 366 00:17:25,964 --> 00:17:29,866 Shaun, I told you that you and I can't live together. 367 00:17:29,868 --> 00:17:31,401 No. 368 00:17:31,403 --> 00:17:32,802 You told me 369 00:17:32,804 --> 00:17:34,737 we can't be boyfriend 370 00:17:34,739 --> 00:17:36,239 and girlfriend. 371 00:17:36,241 --> 00:17:39,876 We can s-still be friends with benefits. 372 00:17:41,211 --> 00:17:43,713 The benefit is... 373 00:17:43,715 --> 00:17:46,449 we would be living together. 374 00:17:46,451 --> 00:17:47,750 I was clear. 375 00:17:47,752 --> 00:17:49,419 - It's too complicated, - You were. 376 00:17:49,421 --> 00:17:52,655 We can't date or kiss or have sex. 377 00:17:57,162 --> 00:17:59,462 But I thought you wanted to be friends. 378 00:17:59,464 --> 00:18:00,963 Yes. Of course. 379 00:18:00,965 --> 00:18:02,565 - And spend time together. - Right. 380 00:18:02,567 --> 00:18:03,833 Then it's simple. 381 00:18:08,906 --> 00:18:11,140 She begged us to reinsert the NG tube, 382 00:18:11,142 --> 00:18:12,875 then pulled it out again an hour later. 383 00:18:12,877 --> 00:18:15,845 Do we try again with the tube and restraints? 384 00:18:15,847 --> 00:18:18,314 Oh, we'd just be raising her risk of self-injury, 385 00:18:18,316 --> 00:18:19,882 pneumonia, a blood clot. 386 00:18:19,884 --> 00:18:21,717 What about going back to solid food? 387 00:18:21,719 --> 00:18:23,686 Anything less than 1,200 calories a day, 388 00:18:23,688 --> 00:18:26,122 and her malnutrition wouldn't be improving. 389 00:18:26,124 --> 00:18:28,149 In fact, she'll keep losing weight. 390 00:18:28,927 --> 00:18:30,760 We should go ahead with that valve repair now. 391 00:18:35,098 --> 00:18:37,934 I think we can improve her nutrition 392 00:18:37,936 --> 00:18:40,536 without force-feeding or IVs. 393 00:18:41,839 --> 00:18:45,007 I found a small study where deep brain stimulation 394 00:18:45,009 --> 00:18:46,742 was used to treat anorexia. 395 00:18:46,744 --> 00:18:49,712 You want to use brain surgery for a psychiatric disorder? 396 00:18:49,714 --> 00:18:51,747 Surgical procedures have been effective 397 00:18:51,749 --> 00:18:55,017 for, uh, depression, OCD, addiction. 398 00:18:57,488 --> 00:19:00,556 This surgery could reduce her anxiety around eating. 399 00:19:00,558 --> 00:19:02,525 Once she's eating, her malnutrition will improve 400 00:19:02,527 --> 00:19:04,427 and reduce the risk of the valve repair. 401 00:19:04,429 --> 00:19:06,829 It could also cause personality changes. 402 00:19:08,131 --> 00:19:10,900 And this study covers six subjects 403 00:19:10,902 --> 00:19:12,802 with only 50% success. 404 00:19:12,804 --> 00:19:14,704 Well, this could be Louisa's only shot 405 00:19:14,706 --> 00:19:15,972 at getting free of this illness. 406 00:19:15,974 --> 00:19:18,341 And it was done in the UK. 407 00:19:18,343 --> 00:19:20,943 DBS isn't FDA-approved for anorexia treatment here. 408 00:19:20,945 --> 00:19:23,145 So, we call an IRB ethics hearing 409 00:19:23,147 --> 00:19:24,847 and argue emergent-use approval. 410 00:19:24,849 --> 00:19:27,049 Which we shouldn't get off such little data. 411 00:19:28,698 --> 00:19:30,433 Nice work digging this up, 412 00:19:30,458 --> 00:19:32,391 but it's not a real option. 413 00:19:34,191 --> 00:19:36,259 Let's go talk to her about the valve surgery. 414 00:19:42,007 --> 00:19:43,574 Can I help you? 415 00:19:43,576 --> 00:19:46,143 I'm looking for a carrot. 416 00:19:46,145 --> 00:19:48,078 17, 18, 19... 417 00:19:48,080 --> 00:19:50,681 No, uh, sorry, we don't have any carrot muffins. 418 00:19:50,683 --> 00:19:52,683 How about a lemon-poppy, Shaun? 419 00:19:55,821 --> 00:19:57,955 Hello, Debbie Wexler. 420 00:19:57,957 --> 00:20:01,692 It's a metaphor for moving a donkey. 421 00:20:01,694 --> 00:20:03,828 I need a carrot because I don't want 422 00:20:03,830 --> 00:20:06,497 to beat Dr. Glassman with a stick. 423 00:20:06,499 --> 00:20:08,866 He likes blueberry muffins. 424 00:20:08,868 --> 00:20:10,301 How's Aaron, 425 00:20:10,303 --> 00:20:12,203 Dr. Glassman recovering? 426 00:20:12,205 --> 00:20:14,672 He moved his bowels this morning. 427 00:20:14,674 --> 00:20:17,408 But he doesn't want to appear weak, 428 00:20:17,410 --> 00:20:20,878 so he hasn't done physical therapy. 429 00:20:20,880 --> 00:20:23,214 I want that blueberry muffin, please. 430 00:20:23,216 --> 00:20:26,116 It has 23 visible blueberries. 431 00:20:26,118 --> 00:20:29,053 You know, Aaron once told me 432 00:20:29,055 --> 00:20:32,323 that his absolute favorites were the chocolate chip ones. 433 00:20:32,325 --> 00:20:34,091 Do you want one of those instead? 434 00:20:34,093 --> 00:20:37,127 Yes, I want one of those instead. 435 00:20:46,671 --> 00:20:48,672 Oh, hi, Dr. Park. 436 00:20:48,674 --> 00:20:51,008 Um, I have a few questions about Wade's surgery. 437 00:20:51,010 --> 00:20:52,843 Sorry, I'm pretty busy. 438 00:20:52,845 --> 00:20:54,111 Actually, I need to get going. 439 00:20:54,113 --> 00:20:55,379 Uh, I'll walk with you. 440 00:20:55,381 --> 00:20:57,147 I know Wade's surgery is this afternoon, 441 00:20:57,149 --> 00:20:59,683 but I've been researching treatments for Crohn's lesions. 442 00:20:59,685 --> 00:21:01,118 What'd we do before the Internet? 443 00:21:01,120 --> 00:21:03,487 I talked to two experts who felt that Wade should be put 444 00:21:03,489 --> 00:21:05,623 on REMICADE or Azathioprine 445 00:21:05,625 --> 00:21:07,491 before any surgical interventions. 446 00:21:07,493 --> 00:21:08,759 Interesting recommendations, 447 00:21:08,761 --> 00:21:10,561 but considering they haven't seen your husband's chart... 448 00:21:10,563 --> 00:21:12,096 Well, this doctor felt strongly that you should see 449 00:21:12,098 --> 00:21:13,497 how he responds to medication before, 450 00:21:13,499 --> 00:21:15,432 Wade's care is completely appropriate for his condition. 451 00:21:15,434 --> 00:21:17,067 But if his Crohn's lesions could be treated 452 00:21:17,069 --> 00:21:18,836 without cutting him open, - That's not what we're treating. 453 00:21:21,640 --> 00:21:22,907 Excuse me? 454 00:21:24,809 --> 00:21:26,310 Go talk to your husband. 455 00:21:32,284 --> 00:21:36,153 I brought you a chocolate chip muffin. 456 00:21:36,889 --> 00:21:38,455 I love chocolate chip. 457 00:21:38,457 --> 00:21:39,790 Thank you. 458 00:21:42,561 --> 00:21:44,228 Where is it? 459 00:21:44,230 --> 00:21:46,564 At the nurse's station. 460 00:21:46,566 --> 00:21:49,066 - You can walk out to get it. - Shaun, you see, 461 00:21:49,068 --> 00:21:51,201 here I thought you were doing something nice for me. 462 00:21:51,203 --> 00:21:52,636 - I am. - No, you're not. 463 00:21:52,638 --> 00:21:53,871 You're manipulating. 464 00:21:53,873 --> 00:21:55,039 My leg hurts, 465 00:21:55,041 --> 00:21:57,174 and I-I have a sore throat, 466 00:21:57,176 --> 00:21:59,343 and I don't feel like walking. 467 00:21:59,345 --> 00:22:03,080 Dr. Blaize says you don't want to seem weak 468 00:22:03,082 --> 00:22:05,349 in front of people who used to work for you. 469 00:22:05,351 --> 00:22:06,584 Dr. Blaize is wrong. 470 00:22:06,586 --> 00:22:09,053 I don't want to walk because I don't want to walk. 471 00:22:09,055 --> 00:22:11,055 And this is condescending, 472 00:22:11,057 --> 00:22:13,157 and it's insulting, and it's annoying. 473 00:22:16,995 --> 00:22:18,929 Should I get you your muffin? 474 00:22:20,398 --> 00:22:21,765 Well, that would be nice. 475 00:22:27,939 --> 00:22:30,007 An orderly is eating it. 476 00:22:43,355 --> 00:22:45,356 Mr. DeLeon, can I help you? 477 00:22:47,092 --> 00:22:48,392 Uh... 478 00:22:49,495 --> 00:22:52,930 my wife's decided against the valve-repair surgery, 479 00:22:52,932 --> 00:22:54,198 at least until she's tried 480 00:22:54,200 --> 00:22:56,300 the deep brain stimulation for her anorexia. 481 00:23:01,440 --> 00:23:03,073 Did Dr. Browne tell you 482 00:23:03,075 --> 00:23:04,942 that it's an experimental brain surgery, 483 00:23:04,944 --> 00:23:06,944 which could alter your wife's personality forever? 484 00:23:06,946 --> 00:23:09,146 That's if we get the special approval required. 485 00:23:09,148 --> 00:23:11,382 She's explained all the issues. 486 00:23:28,056 --> 00:23:30,624 I got our apartment back. 487 00:23:30,626 --> 00:23:34,161 I had to pay $300 more as a deposit 488 00:23:34,163 --> 00:23:36,563 because someone else wanted it, but that's okay. 489 00:23:36,565 --> 00:23:38,198 No, Shaun! 490 00:23:38,200 --> 00:23:40,033 It has a fireplace. 491 00:23:40,035 --> 00:23:42,035 Why aren't you listening to me?! 492 00:23:42,037 --> 00:23:43,870 You're not listening to me! 493 00:23:54,583 --> 00:23:58,218 I'll be okay running into you naked... 494 00:23:58,220 --> 00:24:01,221 or hearing sex noises 495 00:24:01,223 --> 00:24:04,259 or seeing you cry over breakups with drummers. 496 00:24:05,326 --> 00:24:07,627 I know that you think you can, but how can you be sure? 497 00:24:07,629 --> 00:24:09,996 Because living with you 498 00:24:09,998 --> 00:24:11,731 will be good for me. 499 00:24:13,301 --> 00:24:15,235 It makes me happy. 500 00:24:22,544 --> 00:24:26,279 You remember what you said, Shaun, 501 00:24:26,281 --> 00:24:29,549 that no one can predict the future 502 00:24:29,551 --> 00:24:31,954 and feelings can change? 503 00:24:33,521 --> 00:24:36,250 What if I end up hurting you again? 504 00:24:36,725 --> 00:24:39,993 I don't want to risk our friendship 505 00:24:39,995 --> 00:24:41,797 over an apartment. 506 00:24:42,664 --> 00:24:43,930 Do you? 507 00:24:50,005 --> 00:24:53,559 If we don't live together, 508 00:24:54,376 --> 00:24:57,980 you will have to buy your own batteries. 509 00:24:59,981 --> 00:25:02,315 - We'll still see each other. - That will be hard. 510 00:25:02,317 --> 00:25:05,151 - I work a lot. - We'll find a way. I know we will. 511 00:25:12,928 --> 00:25:15,829 I need to go to work. 512 00:25:24,573 --> 00:25:26,339 I'll stop on the way home 513 00:25:26,341 --> 00:25:28,675 and tell the manager 514 00:25:28,677 --> 00:25:30,977 we don't want the apartment. 515 00:25:33,314 --> 00:25:34,881 No, I'll do it. 516 00:25:53,702 --> 00:25:55,835 The subjects who responded in this study 517 00:25:55,837 --> 00:25:59,906 are all long-term sufferers with a target BMI of 13-16, 518 00:25:59,908 --> 00:26:01,708 who actively pursued this treatment, 519 00:26:01,710 --> 00:26:03,643 much like our patient. 520 00:26:03,645 --> 00:26:07,847 Additionally, DBS surgery requires lighter sedation 521 00:26:07,849 --> 00:26:09,582 and places less strain on her system 522 00:26:09,584 --> 00:26:12,185 than an open-chest procedure. 523 00:26:12,187 --> 00:26:13,553 You're referring to the valve repair 524 00:26:13,555 --> 00:26:15,155 recommended by Dr. Melendez? 525 00:26:16,557 --> 00:26:17,857 Yes. 526 00:26:17,859 --> 00:26:20,560 I propose delaying that surgery by a couple weeks, 527 00:26:20,562 --> 00:26:21,895 which would be well worth it 528 00:26:21,897 --> 00:26:23,296 in terms of reduction of risk 529 00:26:23,298 --> 00:26:25,332 if the DBS is successful. 530 00:26:27,034 --> 00:26:28,935 Excellent presentation, Dr. Browne. 531 00:26:28,937 --> 00:26:30,236 Very thorough. 532 00:26:30,238 --> 00:26:32,539 Agreed, though I do have concerns 533 00:26:32,541 --> 00:26:33,907 about approving this procedure 534 00:26:33,909 --> 00:26:36,343 based on the small subject pool. 535 00:26:36,345 --> 00:26:37,410 But I'll confer with, 536 00:26:37,412 --> 00:26:39,813 There is, uh, one more person 537 00:26:39,815 --> 00:26:42,983 I want you to hear from, the patient. 538 00:26:42,985 --> 00:26:45,652 This is an IRB, not a therapy session. 539 00:26:48,255 --> 00:26:50,790 Actually, patients who had the opportunity 540 00:26:50,792 --> 00:26:54,327 to air their concerns are eight times less likely 541 00:26:54,329 --> 00:26:56,262 to sue their hospital. 542 00:27:01,068 --> 00:27:02,302 You paged me? 543 00:27:02,304 --> 00:27:04,104 You can step out. Dr. Park's got this. 544 00:27:06,907 --> 00:27:08,141 Grab the sheet. 545 00:27:12,848 --> 00:27:15,248 You talked to Wade's husband. 546 00:27:15,250 --> 00:27:16,983 Maybe we should discuss this later. 547 00:27:16,985 --> 00:27:19,419 I can patch him up while tearing you down. 548 00:27:19,421 --> 00:27:21,588 You violated our patient's confidentiality. 549 00:27:21,590 --> 00:27:22,956 I told him what we weren't treating. 550 00:27:22,958 --> 00:27:24,491 That's not a violation. 551 00:27:24,493 --> 00:27:25,925 And their marriage is better off 552 00:27:25,927 --> 00:27:27,794 for having his secrets out in the open. 553 00:27:27,796 --> 00:27:29,562 That'd be meaningful if you were a marriage counselor 554 00:27:29,564 --> 00:27:32,032 instead of a surgical resident. 555 00:27:32,034 --> 00:27:33,600 Whatever lie blew up your marriage 556 00:27:33,602 --> 00:27:35,802 won't be undone if Wade tells the truth. 557 00:27:38,373 --> 00:27:39,906 I was just trying to help our patient. 558 00:27:39,908 --> 00:27:41,708 Our former patient. 559 00:27:41,710 --> 00:27:43,977 Wade's demanding a transfer to another hospital. 560 00:27:48,749 --> 00:27:53,453 I have tried cognitive behavioral therapy, 561 00:27:53,455 --> 00:27:56,366 food psychodynamic therapy, 562 00:27:57,592 --> 00:27:59,995 family therapy, 563 00:28:00,662 --> 00:28:03,797 in-patient treatment, out-patient treatment, 564 00:28:03,799 --> 00:28:06,933 anti-depressants, NG tubes, 565 00:28:06,935 --> 00:28:08,735 TPN. 566 00:28:10,471 --> 00:28:13,907 And yet, here I am, dying. 567 00:28:18,313 --> 00:28:20,280 Killing myself. 568 00:28:21,849 --> 00:28:25,552 And I can't stop on my own. 569 00:28:25,554 --> 00:28:27,272 Please... 570 00:28:28,090 --> 00:28:31,524 help me... to stop. 571 00:28:36,965 --> 00:28:38,665 Are you aware 572 00:28:38,667 --> 00:28:42,702 DBS has been known to cause personality changes? 573 00:28:42,704 --> 00:28:44,337 In your case, the electrode 574 00:28:44,339 --> 00:28:45,972 would be at the nucleus accumbens, 575 00:28:45,974 --> 00:28:49,242 Dr. Browne explained all of the risks. 576 00:28:49,244 --> 00:28:51,111 It's important we know that you understand. 577 00:28:52,446 --> 00:28:56,483 The nucleus accumbens plays a role in maternal attachment, 578 00:28:56,485 --> 00:28:59,805 delivering dopamine when moms interact with their children. 579 00:29:01,555 --> 00:29:06,228 Now, what if in trying to overcome your eating disorder... 580 00:29:06,962 --> 00:29:09,229 you lose the ability to feel love for your son? 581 00:29:18,840 --> 00:29:22,244 My son is everything to me. 582 00:29:23,645 --> 00:29:25,411 For that past year, he has been watching me 583 00:29:25,413 --> 00:29:27,313 starve myself to death. 584 00:29:29,316 --> 00:29:31,918 I'll risk anything 585 00:29:31,920 --> 00:29:34,587 to keep him from seeing me succeed. 586 00:29:42,464 --> 00:29:43,897 Thank you, Ms. DeLeon. 587 00:29:48,503 --> 00:29:50,236 We'll need a few minutes to talk. 588 00:29:56,241 --> 00:29:58,974 You kept it a secret because you think I'm shallow. 589 00:29:59,014 --> 00:30:01,149 I said the same thing. I kept it a secret 590 00:30:01,174 --> 00:30:02,573 because of "friendly fatties." 591 00:30:02,575 --> 00:30:03,941 Any news on my transfer? 592 00:30:03,943 --> 00:30:07,712 San Francisco General should have a bed tomorrow. 593 00:30:07,714 --> 00:30:09,347 Come on. It's a joke. 594 00:30:09,349 --> 00:30:10,881 - A joke?! - I'm here to clamp 595 00:30:10,906 --> 00:30:12,249 your nasogastric tube. 596 00:30:12,251 --> 00:30:13,818 About a couple we've known for years? 597 00:30:13,820 --> 00:30:15,386 We were at their wedding, 598 00:30:15,388 --> 00:30:16,565 and yet you treat them 599 00:30:16,590 --> 00:30:17,822 - like a punch line. - This used to be green. 600 00:30:17,824 --> 00:30:19,423 - Now it's brown. - You're the one who lied. 601 00:30:19,425 --> 00:30:20,791 If I'd known you were offended, 602 00:30:20,793 --> 00:30:23,728 The point is, is that's why I didn't tell you. 603 00:30:25,464 --> 00:30:27,999 Red and green makes brown. 604 00:30:28,001 --> 00:30:30,234 Your bowel is bleeding. 605 00:30:30,236 --> 00:30:33,838 You need surgery now! Page Dr. Park and Dr. Lim! 606 00:30:33,840 --> 00:30:35,506 He has a strangulated bowel. 607 00:30:35,508 --> 00:30:37,041 - Spence. - It's gonna be okay. 608 00:30:37,043 --> 00:30:38,876 We need to open up an O.R. now! 609 00:30:41,414 --> 00:30:43,547 By a margin of 2-to-1, 610 00:30:43,549 --> 00:30:45,783 this Internal Review Board has decided 611 00:30:45,785 --> 00:30:48,452 in favor of allowing this procedure. 612 00:30:48,454 --> 00:30:50,788 - Nicely done. - Thank you. 613 00:30:50,790 --> 00:30:52,356 Hope the surgery goes well. 614 00:31:00,599 --> 00:31:03,134 Use the 45 mm gold stapler. 615 00:31:04,903 --> 00:31:08,873 The truth coming out didn't help Wade's marriage. 616 00:31:10,742 --> 00:31:12,710 Hopefully, with some time. 617 00:31:12,712 --> 00:31:14,078 Secrets are corrosive. 618 00:31:14,080 --> 00:31:15,946 Wade should've been honest from the start. 619 00:31:15,948 --> 00:31:19,083 Maybe Wade thought Spencer would feel 620 00:31:19,085 --> 00:31:21,886 the same way you did about his bypass, 621 00:31:21,888 --> 00:31:24,221 that he lost weight the easy way. 622 00:31:32,764 --> 00:31:34,432 Okay. 623 00:31:34,434 --> 00:31:35,866 It's time. 624 00:31:52,584 --> 00:31:54,185 Graham-y. 625 00:32:01,793 --> 00:32:03,780 You are... 626 00:32:05,131 --> 00:32:07,742 the highlight of my life. 627 00:32:08,901 --> 00:32:10,034 You know that, right? 628 00:32:12,270 --> 00:32:14,772 Yeah. I love you, too. 629 00:32:14,774 --> 00:32:17,875 I love you more than any person on the planet 630 00:32:17,877 --> 00:32:20,711 ever loved any other person on the planet. 631 00:32:22,047 --> 00:32:23,614 I-I know. 632 00:32:25,484 --> 00:32:27,585 Mom, you're gonna be okay, right? 633 00:32:27,587 --> 00:32:29,186 Of course, baby. 634 00:32:30,208 --> 00:32:31,441 Of course. 635 00:32:31,725 --> 00:32:34,492 We'll see you guys in a few hours. 636 00:32:39,198 --> 00:32:40,498 I love you. 637 00:32:50,710 --> 00:32:53,344 The chocolate chip muffin didn't work. 638 00:32:53,346 --> 00:32:55,540 The donkey won't walk. 639 00:32:56,115 --> 00:32:58,782 I told you that Glassman's probably embarrassed. 640 00:32:58,784 --> 00:33:00,251 No. He's not. 641 00:33:00,253 --> 00:33:01,852 I asked him, 642 00:33:01,854 --> 00:33:03,798 and he said you were wrong. 643 00:33:05,423 --> 00:33:07,291 Doesn't mean I'm actually wrong. 644 00:33:10,662 --> 00:33:15,866 He needs help recovering. 645 00:33:15,868 --> 00:33:18,068 I'm trying to help, 646 00:33:18,070 --> 00:33:19,904 but it's not working. 647 00:33:19,906 --> 00:33:22,406 He got angry at me. 648 00:33:22,408 --> 00:33:26,877 Dr. Glassman is your patient. 649 00:33:26,879 --> 00:33:29,513 You need to fix his lack of mobility. 650 00:33:29,515 --> 00:33:31,015 This is your problem. 651 00:33:31,017 --> 00:33:33,117 I don't know what to do. 652 00:33:33,119 --> 00:33:35,052 I don't know how to help him. 653 00:33:35,054 --> 00:33:36,954 Being sick is hard. 654 00:33:36,956 --> 00:33:39,757 Being around sick people is hard. 655 00:33:39,759 --> 00:33:41,725 We want to help. 656 00:33:41,727 --> 00:33:43,327 We all struggle with what to do. 657 00:33:43,329 --> 00:33:45,462 Your obsession, - Okay. 658 00:33:45,464 --> 00:33:48,095 More than a muffin or a bowel movement 659 00:33:48,097 --> 00:33:50,201 or a walk around the ward, 660 00:33:50,203 --> 00:33:53,390 what Glassman needs is someone to be there for him. 661 00:33:54,472 --> 00:33:56,740 A patient, supportive friend. 662 00:34:01,681 --> 00:34:04,181 I know the perfect person. 663 00:34:16,456 --> 00:34:17,722 Mm. 664 00:34:19,091 --> 00:34:20,708 Hey, there. 665 00:34:21,494 --> 00:34:23,561 How are you feeling? 666 00:34:23,563 --> 00:34:25,363 I'm okay. 667 00:34:28,934 --> 00:34:30,593 I feel like... 668 00:34:31,271 --> 00:34:33,104 I want something to eat. 669 00:34:35,375 --> 00:34:37,275 I'm hungry. 670 00:34:40,947 --> 00:34:42,280 All right, buddy. 671 00:34:42,282 --> 00:34:43,981 Let's get you home. 672 00:34:43,983 --> 00:34:46,717 Get you a decent night's sleep. 673 00:34:49,389 --> 00:34:50,821 See you in the morning. 674 00:35:01,134 --> 00:35:02,633 I'll get you some food. 675 00:35:05,604 --> 00:35:07,371 Are you sure you're all right? 676 00:35:08,874 --> 00:35:10,975 Yeah. 677 00:35:10,977 --> 00:35:12,810 I just... 678 00:35:14,346 --> 00:35:17,214 I wonder if that hug felt different for him. 679 00:35:19,185 --> 00:35:20,885 Did it for you? 680 00:35:35,334 --> 00:35:37,435 Your husband's surgery went well. 681 00:35:37,437 --> 00:35:39,036 He's in recovery now. 682 00:35:39,038 --> 00:35:40,604 I think he's awake. 683 00:35:40,606 --> 00:35:41,872 Thank you. 684 00:35:52,884 --> 00:35:54,585 Wade told me where to find these. 685 00:35:56,421 --> 00:35:58,589 This is him before bypass? 686 00:35:58,591 --> 00:35:59,991 He said that seeing these 687 00:35:59,993 --> 00:36:02,560 would help me understand why he never told me. 688 00:36:03,929 --> 00:36:05,563 Which... 689 00:36:05,565 --> 00:36:07,732 I said was ridiculous. 690 00:36:18,177 --> 00:36:19,977 Is he gonna end up like this again? 691 00:36:22,214 --> 00:36:23,514 It's possible. 692 00:36:33,559 --> 00:36:35,026 I wish I didn't know that. 693 00:36:55,247 --> 00:36:56,514 Yeah? 694 00:37:00,218 --> 00:37:01,852 Debbie, hi. 695 00:37:04,289 --> 00:37:06,090 Oh, um... 696 00:37:06,092 --> 00:37:08,192 Shaun thought you could use a visit. 697 00:37:08,194 --> 00:37:10,294 - Huh. - Oh, and, uh, 698 00:37:10,296 --> 00:37:11,662 and another muffin. 699 00:37:11,664 --> 00:37:14,165 Thank you. I wish I'd known you were coming. 700 00:37:14,167 --> 00:37:17,201 I would've slipped into something a little less comfortable. 701 00:37:17,203 --> 00:37:18,769 You look... good. 702 00:37:18,771 --> 00:37:20,938 Uh-huh. - Yeah, well... 703 00:37:20,940 --> 00:37:22,849 Unlikely, but thank you. 704 00:37:23,543 --> 00:37:25,342 I am... 705 00:37:25,344 --> 00:37:27,145 sorry that I've been... 706 00:37:28,081 --> 00:37:29,647 out of touch. 707 00:37:29,649 --> 00:37:32,183 - Well, I had a brain tumor. - Mm. 708 00:37:32,185 --> 00:37:35,019 Understandable. We both dropped the ball. 709 00:37:41,693 --> 00:37:43,161 Okay. 710 00:37:44,263 --> 00:37:45,796 - Here we go. - What's happening? 711 00:37:45,798 --> 00:37:47,898 - We're taking a walk. - Oh, no, no, thank you. 712 00:37:47,900 --> 00:37:49,200 - Oh, yes, we are. Yeah, mm-hmm. - No, my leg hurts a, Ow, ow. 713 00:37:49,202 --> 00:37:52,436 Which is exactly why you need to take a walk. 714 00:37:54,440 --> 00:37:56,474 Wow. You're really good at this. 715 00:37:56,476 --> 00:37:57,975 You sure you haven't done this before? 716 00:37:57,977 --> 00:37:59,677 Well... 717 00:37:59,679 --> 00:38:02,513 I spent a little time as a nurse. 718 00:38:04,951 --> 00:38:06,550 I always liked the night shift. 719 00:38:06,552 --> 00:38:08,719 Everything gets really quiet. 720 00:38:08,721 --> 00:38:10,721 It's almost, It's almost peaceful. 721 00:38:28,807 --> 00:38:31,308 Just came from Louisa's room. 722 00:38:31,310 --> 00:38:32,579 She's eating. 723 00:38:33,002 --> 00:38:34,445 That's great news. 724 00:38:34,447 --> 00:38:35,746 Yeah. 725 00:38:35,748 --> 00:38:37,680 Hopefully we'll be able to do the valve repair 726 00:38:37,682 --> 00:38:39,016 in a couple weeks. 727 00:38:40,185 --> 00:38:41,719 I hope you're right. 728 00:38:43,122 --> 00:38:44,688 But you won't be a part of the surgery. 729 00:38:46,024 --> 00:38:48,267 Or any of my surgeries. 730 00:38:48,694 --> 00:38:51,295 You went around me, directly to the patient. 731 00:38:51,297 --> 00:38:53,063 I had a good idea 732 00:38:53,065 --> 00:38:54,598 that you didn't take seriously. 733 00:38:54,600 --> 00:38:55,833 I considered it, 734 00:38:55,835 --> 00:38:58,068 and then I decided against taking it to the patient. 735 00:38:58,070 --> 00:38:59,770 And yet, I managed to get Aoki and Andrews 736 00:38:59,772 --> 00:39:01,472 to sign off at the IRB. 737 00:39:04,976 --> 00:39:06,477 You didn't get Andrews. 738 00:39:10,582 --> 00:39:12,049 You voted for me? 739 00:39:12,051 --> 00:39:14,318 You made a strong case. 740 00:39:14,320 --> 00:39:16,053 But you're, 741 00:39:16,055 --> 00:39:18,022 you're booting me off your service? 742 00:39:18,024 --> 00:39:20,191 Disagree with me all you want. 743 00:39:20,193 --> 00:39:21,859 I expect my residents to. 744 00:39:21,861 --> 00:39:25,012 I expect them to argue passionately for their position. 745 00:39:26,565 --> 00:39:29,333 And I expect them to then accept my decision. 746 00:39:31,269 --> 00:39:32,970 Even when you're wrong? 747 00:39:35,006 --> 00:39:37,908 I can't run my team any other way. 748 00:39:55,127 --> 00:39:59,830 You know what was insane, was the 1928 Torpedo Roadster. 749 00:39:59,832 --> 00:40:01,232 With the Purpleheart trim? 750 00:40:01,234 --> 00:40:03,500 Ah, and the lizard-skin interior. 751 00:40:03,502 --> 00:40:07,071 My neighbor in Wyoming had a Silver Arrow. 752 00:40:07,073 --> 00:40:09,373 Oh, I'd love to drive one just once. 753 00:40:11,677 --> 00:40:14,228 Good job. You got him walking. 754 00:40:14,847 --> 00:40:17,781 Debbie Wexler did it. 755 00:40:17,783 --> 00:40:20,918 She's a better carrot than I am. 756 00:40:20,920 --> 00:40:22,653 She's a better friend. 757 00:40:29,528 --> 00:40:31,495 Hey, it's me. 758 00:40:32,198 --> 00:40:34,874 Yeah, just making sure the check got there okay. 759 00:40:36,135 --> 00:40:38,085 Great, great. 760 00:40:39,672 --> 00:40:41,605 Hey, I have a question... 761 00:40:41,607 --> 00:40:43,382 about Phil. 762 00:40:43,909 --> 00:40:46,510 I know, I know. He's long gone. 763 00:40:47,113 --> 00:40:49,096 I was actually wondering... 764 00:40:50,149 --> 00:40:51,348 what do you think would've happened 765 00:40:51,350 --> 00:40:53,050 if I hadn't seen you two together? 766 00:41:08,701 --> 00:41:10,934 I found my next apartment. 767 00:41:10,936 --> 00:41:12,836 Okay. 768 00:41:12,838 --> 00:41:16,006 It's has a fireplace... 769 00:41:16,008 --> 00:41:17,441 and natural lighting... 770 00:41:17,443 --> 00:41:19,209 No. N-N-No. 771 00:41:19,211 --> 00:41:21,545 ...and a really great roommate 772 00:41:21,547 --> 00:41:23,781 who's also a friend. 773 00:41:23,783 --> 00:41:27,184 He works a lot, so might be hard to see him otherwise. 774 00:41:30,722 --> 00:41:32,515 I'm talking about you, Shaun. 775 00:41:34,927 --> 00:41:38,228 I don't want to risk anything hurting our friendship. 776 00:41:38,230 --> 00:41:42,099 If you say you can handle living together, 777 00:41:42,101 --> 00:41:43,767 I trust you. 778 00:41:49,975 --> 00:41:53,477 W-We're... going to be roommates? 779 00:41:56,615 --> 00:41:58,282 Oh... 780 00:42:01,921 --> 00:42:03,821 I-It has a fireplace. 781 00:42:03,823 --> 00:42:05,089 Yes, it does. 782 00:42:05,091 --> 00:42:06,790 Oh! 783 00:42:06,792 --> 00:42:08,359 We're going to be roommates! 784 00:42:08,361 --> 00:42:11,061 We're gonna be roommates! 785 00:42:11,063 --> 00:42:12,996 - Okay! - Yes. 786 00:42:12,998 --> 00:42:14,898 - Okay! - Yes! 787 00:42:14,900 --> 00:42:16,100 We're gonna be roommates! 788 00:42:16,102 --> 00:42:17,668 Oh, y... 789 00:42:17,670 --> 00:42:19,269 Yes!