Heartbeat (2016) s01e01 Episode Script
Pilot
1 Welcome to Flight 126 non-stop to Washington, D.
C.
We will be celebrating 75 years in the air by featuring uniforms from past decades.
Ready for some trouble Pretty girls, but she's ruling them all That girl the queen Hi, I think you're in my seat.
No.
This is my seat.
Not according to my ticket.
[sighs.]
I'm trying to be nice here.
I'm giving a speech in a few hours my feet are killing me, and I'd like to sit down.
All that salt will kill you, and get out of my seat.
A little help here? - [passes gas.]
- Facing failure.
- [baby crying.]
- [speaking softly.]
Working tirelessly to make Risk and failure is at the core of who I am as a Are you kidding me? Okay, my friend, we need to talk.
Could you not I'm trying to I have to speak in front of a lot of people.
Okay? The fear of failure holds us back Kid, I'm a doctor.
I have a shot in my purse.
A big one with a really long needle.
What would you do if you knew you could not fail? [ding.]
We need a doctor in the first-class cabin.
Immediately.
[upbeat music.]
Is there a doctor on the plane? [sighs.]
- [coughing.]
- How long have you had a cough? - Two weeks.
- His veins are distended.
- What's going on here? - I'm a cardio-thoracic surgeon.
- Do we need to land? - Hell no! I have a speaking engagement.
You need to get me your medical kit and any other supplies you have.
He has fluid building up around his heart.
I'm gonna have to drain it.
I'm gonna save your ass even though you took my seat, without getting my outfit dirty.
I don't have a change of clothes, you see? Don't worry, I've done this bunches of times, okay? Okay, Glasses, get a trash bag, and tell all the passengers to throw any meds they have in it.
Red, I need a vodka neat to sterilize my hands.
Come on! And, uh Spray Tan, I need something resembling a long needle.
Okay, first class, who has a Black Card? - Chopsticks, thank you.
- Hey.
I need something to cut him open with.
It's titanium.
Wow.
[grunts.]
She was the first woman to train in cardio-thoracic surgery at Loyola University Medical Center, the first woman to complete a heart transplant fellowship.
Okay, napkins.
She recently became the Chief Innovations Officer at St.
Matthew's Research Medical Center in Los Angeles, California.
[cheers and applause.]
And it is my distinguished honor to introduce Dr.
Alexandra Panttiere.
[applause.]
Oh, oh, oh oh oh oh [upbeat music.]
[blow dryer whirring.]
Cartman, once I'd like to go to work drool-free.
Yo! Hey, guys, your dad's here! If you want a ride to school, you got to move! You look like a million bucks [groans.]
Of which I could really use 250 of it.
That '61 Impala's an expensive date.
I have to talk to my hedge fund boyfriends from New York today.
- Part of the new gig? - Corporate enough? Sure, if you're hanging from a stripper pole.
All right, put a jacket on over the dress, wear a belt black leather and, uh, those pearls that your grandmother gave you.
I'm just gonna throw a coat over it.
Alex, hey! Oh, dude.
Do you mind if I attack your ex real quick? Post-surgical manic energy! Okay, don't throw me in the air, Pierce.
- Okay, go.
- 11-hour surgery.
Tumor resection at the head of the pancreas.
14-hour left lobe hepatectomy with involvement of the vena cava.
[groans.]
And guess who came into my OR last night.
Dr.
Shane.
Jesse? When did Jesse start working at the hospital? Last week.
He's the new head of surgery.
I haven't bumped into him yet.
At Harvard, this guy's lectures were, uh, standing room only, and I think my girlfriend used to have a crush on him.
Like every intern.
- Hey, Mom.
- Guys, hey.
Hey, Dad.
Hey, Pierce.
- Deal with it.
- Morning, Mom.
- Yes! - Okay, I'm a memory.
Make your lunches! Have a good day at school, and I love all of you.
I didn't have the heart to tell her it was Saturday.
I never did.
Come on, dudes.
Let's get ready.
[indistinct voice on intercom.]
[upbeat music.]
Good morning, Freida.
You look wonderful today.
Are they still following me? [music winds down.]
Mrs.
Rothberg had end-stage renal disease, one of the worst cases of IgA nephropathy I've ever seen, resulting in a complete shutdown of both her kidneys.
I didn't pee for a year.
And because this is St.
Matthew's, where you low-lifes are lucky to intern, I was able to implant one of the first artificial kidneys into Mrs.
Rothberg.
The technology will blow your mind.
It's kicking the ass out of kidney disease, and I'm kicking yours out of hospital.
- [crying.]
- You're free and clear to go and stand in line to the women's bathroom like the rest of us.
[whispers.]
Thank you.
I'll miss you.
Okay, let's go! If you think you've come to St.
Matthew's to specialize, you are mistaken.
At this hospital, you'll be exposed to a buffet of technology that touches every sub-speciality.
I have patients in neurology, ortho, pediatrics, pulmonary.
So be ready for anything and everything.
- Any word on Mrs.
Agostini? - [many shoes squeaking.]
[sighs.]
Okay, we're gonna need a neurosurg consult on Mr.
Parks.
We'll have to peel the neurogenic tumor clean off his spine.
That's gonna be an epic whack.
And you tell those brain boys they're gonna have to let me use the new duel-headed dissecting microscope.
Have you seen that thing? [indistinct voice on intercom.]
Want some fries with that shake? Get bent, Callahan.
I'm liking what I'm seeing, Panttiere.
[stomps feet.]
- Did I scare you, Doctor? - Yes, one-eyed black man.
Sorry.
Let's pick this up tomorrow.
Oh, you're still there.
I need to talk to my boss Dr.
Pain-In-My-Ass.
Go find someone else to worship.
Not you.
Marty.
You're my new sidekick.
Hang close, but I never want to know you're there.
Show up, shut up, and be beige.
Beni, darling, please don't run off.
Hey, buddy.
Alex.
[clears throat.]
Mrs.
Agostini's family have decided to donate her organs.
Holy wow.
This is good news.
Thank you, Millicent.
How did you convince them? [chuckles.]
I'll arrange the donor papers.
I'll let my patient know.
Dr.
Panttiere, please don't run in the hallways.
Okay? This patient, Deana Monroe, has familial cardiomyopathy and advanced congestive heart failure.
She's 29.
Both her parents died of the same disease before they turned 40.
I have to talk to her in private, so go stand in front of the OR board and learn how to sleep with your eyes open.
["Anaconda" by Nicki Minaj playing.]
Both: My anaconda don't want none Unless you got buns, hon Boy toy named Troy - Used to live in Detroit - [girls laughing.]
- Big, big, big money - [music stops.]
Hey, what's up? Mr.
Agostini was declared brain dead! Shut up.
It's better.
She was suffering.
You're not just saying that to make me feel better? Her family's coming in to sign the donor papers.
Oh, my God! We have a that! And you're be in D.
C.
with your students, Deana.
- Oh, my God.
- I love you! Can we get stoned? - No! - [both laugh.]
[crying.]
It's real this time, right? My sister will get this one? Because she has been waiting a long time.
- [cell phone vibrates.]
- Look, he's texting me again.
And still sending you flowers.
Oh, God, you broke up with him two months ago.
- He cannot let go.
- You never understood Thomas.
Look at that text.
That's that's poetic.
You say poetic.
I say whoo-whoo! That's two votes for We have a heart.
Congratulations.
Home stretch.
[both laughing.]
- I love you so much.
- I love you too.
Jesse, Dr.
Shane, are we still good for two? - Yeah, we're good for two.
- Excellent.
[acoustic guitar music.]
Holy brother, rest the soul Hey, we got a new intern, Millicent Silvano.
- You know her? - No.
Well, you should.
Her father's a friend.
Get her into scrubs and into my OR stat.
Yes, Doctor.
Can you hear your sister sleepwalking - Excuse me, I'm - Are you Millicent? Yes.
Get into Dr.
Shane's OR stat! So, Millicent, your father told me to look out for you.
How is he? Your father.
Uh, good.
Father's good.
Say, you lost your accent already.
Took me two semesters to understand your dad.
Now I speak fluent Cockney.
[chuckles.]
Oh, I go in and out [with bad accent.]
Mate.
[heart beating.]
Oh, my God.
The heart only knows how to beat.
[heart beating.]
Here.
It's hard to explain what you're feeling, right? I'm so sorry I'm late.
Dr.
Shane was looking for me.
I'm Millicent Silvano.
You.
We got to talk.
[sighs.]
Dr.
Shane, I'm so sor Did I spit on you? - What's your real name? - Alex Panttiere.
I attended your lectures on thoracic surgery.
At Harvard? Akron General.
- Listen - I-I-I'm married to him.
- Who? Max Elliot? - Mm-hmm.
- Really? - Yes.
His music is I mean I'm Actually, we're getting divorced.
He wrote this one song Oh, "The Only Present I Want Is You.
" That's my favorite song.
He wrote that for you.
Actually, for the guy he left me for.
Huh.
What you did today was actually something I would've done when I was an intern.
Only I would never have gotten away with it.
Mm-hmm.
Next time I'm in the OR, Alex Panttiere, don't pretend to be someone else.
Just come in.
- [gentle music.]
- [cell phone vibrating.]
So, gents, I really hope you'll be able to join us for our benefit here tomorrow.
It's gonna be a beautiful, star-studded event.
I think you'll really enjoy it.
- Um - [footsteps running.]
And for now, I'm gonna leave you in the capable hands of our new Chief Innovations Officer, Dr.
Alexandra Panttiere.
Keep your shoes on, Alex.
Hello, I'm Dr.
Panttiere.
I've been at St.
Matthew's for five years.
- I'm a cardiothoracic surgeon.
- A heart surgeon? Yes, but this is a research hospital, so I have patients in every department.
What does someone like you love to do in her spare time? I like long walks on the beach, hot bubble baths and the sound of cracking a patient's chest open like a lobster first thing in the morning.
[men chuckling.]
Come.
I recently became St.
Matthew's Chief Innovations Officer, which means I'm responsible for bringing cutting-edge procedures to the hospital.
I have a meeting in Japan this week.
They're taking a patient's own cells and growing a transplantable organ.
Heart, liver, kidney, bone you name it.
They're whupping our asses in bioengineering.
- Did I spit on you? - No, you spit on me.
Yeah, I do that.
Okay, I'm new at all this corporate stuff, but what I do know is this, you bought a basketball team that didn't even make it to the playoffs, your tech company's still no match for Google [laughter.]
And your stunning hotel in Dubai will eventually fill up if the country ever gets out of debt.
But I have something better to sell you gentlemen.
It's lives, an investment in early-stage innovations.
High risk, high reward, and a chance to change the world if you have the balls.
Ping Pang Pong, are those the lab results I ordered? [exaggerated Korean accent.]
Creatinine 2.
5.
[speaking Korean.]
at a range 225.
[speaking Korean.]
Okay, okay, Dr.
Callahan? - Oh, I love you.
- I love doing that to him.
It's the highlight of my life.
The tests you ordered this morning.
And Mrs.
Agostini's family signed the papers, so we're ready to pull her heart.
Finally.
The timing couldn't be better.
My patient's cardiac index is dropping.
Let's get her prepped for OR.
Who's in-house to assist? Well, uh, it is Saturday.
- What? - It's Saturday.
It's Saturday? Mother I know.
It happens to me too.
Okay, fine, you see if Callahan can assist.
He's so gross but flipping brilliant.
You tell him in my OR, he wears deodorant.
Mother Saturday? Okay.
[groans.]
- Yeah.
That's okay.
- Dr.
Panttiere.
Alex.
Mmm, mmm mmm, mmm mmm Mmm mmm mmm mmm - It's been a while.
- Ten years.
Uh, give or take 36 days.
- I want to catch up.
- Me too.
Me too, but right now I have a heart transplant, so Well, actually, you know, that's why I wanted to talk to you.
Your patient isn't getting Mrs.
Agostini's heart.
Like hell she isn't.
You know you did a damn good job with those hedge fund boys this morning.
- They're in for $150 million.
- What does this got One of them's donating a majority of the funds.
His father needs a heart transplant, but your patient has a positive cross match, and his father has a negative.
He's a better recipient.
Alex, most people at this hospital would be popping champagne Yeah, if you remember, I'm not like most people at this hospital.
I didn't go to one of the Ivies.
I remember.
- She did this.
- Millicent? Yeah, for the last six months, she's been all over my ass about procedure.
When Mclntyre ran this place This place was a mess with Mclntyre.
Yeah, but I got away with a hell of a lot more.
And if he was still here, I'd be prepping for surgery.
My patient is dying.
I want that heart.
Then you better figure something out, 'cause I just put it on a plane to New York.
Mmm, mmm mmm, mmm mmm Mmm, mmm mmm mmm Mmm, mmm mmm mmm All right, operation went well, Rick.
You're gonna be just fine.
It was an honor to watch you, Dr.
Harrison operate.
- Is he dead? - Rick dead? This guy had a six-centimeter mass in his pancreas, but I've done a few of those, so I think he's gonna be a-okay.
- Thank you.
- Mm, she's cute.
- What what happened? - Jesse stole my heart.
My patient's been waiting three months to transplant.
I'm gonna go to Oncology.
Maybe somebody died there.
No.
Hold on, hold on.
Hold on.
You'll find a heart.
Your mom called after you left this morning.
- You got to call her back.
- Okay.
She wants to go to the benefit with us.
She's convinced George Clooney's gonna be there.
Yeah, well, I told her he never shows up to those things, so she's not coming, but she, uh she invited me to dinner on Sunday.
Of course she did.
My mother loves you.
Slightly more than your mother likes me.
[groans.]
My mother likes you.
She thinks I come from the wrong side of the tracks.
You do come from the wrong side You desire me in your OR today? Yeah, yeah, yeah, Callahan, the minute I find a heart.
And you better not smell.
Work best when I'm ripe, Pants.
On your left.
If I go this way, can you still see me? I can always see you, Callahan.
You want to get away this weekend? - I have the boys.
- You bring the boys.
Come on.
It'll be like a, uh like a family vacation.
In fact, if I move the rest of my stuff in your place, then we'd already be spending the weekend together.
Aren't I a good thing? All the sex you want, and you don't even have to put a ring on my finger.
I wouldn't mind that either.
[cell phone vibrates.]
[chuckles.]
Look who got saved by a gastric ulcer.
[gentle music.]
[whispers.]
Turn around.
- So predictable.
- Together: Hi, get well soon! - Hi, puppy! - Together: Hope you feel better.
- Mommy can't wait to see you.
- I miss you so much.
Hi.
We're Skyping with the dog.
He's staying with one of Deana's students.
- Together: Hi, Dr.
Panttiere.
- Hey, guys.
I need to steal your teacher for a minute.
- Together: Bye! - We'll check in with you later.
- Okay? - [cell phone vibrates.]
Thomas is texting me again.
- You don't need him, De - Maggie - Listen, there's something - You just didn't get him.
- Guys, I have to tell you - He's bipolar.
- But he was a really good guy.
- Guys Yeah, when he took his meds.
He would do anything for me.
He would, and I do understand.
You don't.
Thomas is a very sweet guy I know what you're going to say.
But he has some serious issues.
The ex, didn't he visit you here once? Thomas? Are you nauseous again? Can you get her something? Yeah, he doesn't get to upset you.
I'll be right back with the meds.
[dramatic music.]
We got a jumper! [sirens wailing in background.]
Thomas, I'm Deana's doctor, Alex Panttiere.
[sirens continue to wail.]
Does Deana know I'm here? I'll take it from here, Panttiere.
This is not gonna happen.
- I'm Dr.
Hackett - Dr.
Hack.
And I'm the hospital psychiatrist.
I only want to talk to her.
All right, just get him away from the ledge as quickly as possible, okay? Say his name as much as possible.
Establish familiarity.
[tense music.]
Thomas.
Deana needs a new heart.
I will find her a donor.
You don't have to.
This gives her permission to use mine.
Think about what you're doing, Thomas.
Thomas, if you jump, the impact will crush your organs, and I will not be able to use your heart for Deana.
You're right.
You're right.
[gunshot.]
[gasps.]
Oh, my God.
[sirens wailing.]
Move it, people.
We got a donor! He authorized me to use his heart.
There are legal considerations - It was a directed donor! - I am obligated to Two hearts in one day? How many more are you gonna take from me? You can't be serious.
I raised $150 million for this hospital, and you know why? Because you have one of the only female heart transplant surgeons in the world, and I am not gonna tell my patient and her sister that they aren't getting that heart! The reason you raised $150 million today is because I promoted you to CIO against the passionate pleas of the committee and just about every other department head here, who said I was out of my mind to entrust you with this position because when it comes to rules and procedure, they only apply to you when they suit your needs, Alex.
And your point? I want you to get this heart and as quickly as possible, but I am not gonna release it until it's been cleared by Legal.
There are some concerns Thomas' family could sue us, claiming we didn't do enough to stop him.
The man was bipolar, standing on the ledge of a building with a gun in his pocket.
I don't think anyone could talk him out of it, but at least I tried! Really? Because you switched gears on a dime.
It felt like the only thing you saw up on that roof was a donor for your patient.
Now, let's hope I'm the only person who saw that, Alex.
[acoustic guitar music.]
[sighs.]
Deana You're not getting Mrs.
Agostini's heart.
[somber music.]
I have some news.
It's about Thomas.
You cut a piece.
You warm it in the oven.
325, five to seven minutes.
There should be enough in here for all you guys for the rest of the week.
Can you take the boys tonight? I have to go back to the hospital.
- Sure.
- This is so good.
Dad, I can't find my phone charger.
- Did you check the bathroom? - "Oh, hi, Mom.
How was your day? Got a patient bleeding out?" Gabe? Why's he so weird? He gets that from me.
Why can't he just be normal? If you go to the land of normal, no one will be there.
Whatever.
I think we should call Dr.
Stanley about Gabriel.
Ah.
I think he's doing fine on the new meds.
Let's just cut him a break.
Keep an eye on him, okay? [sighs.]
Bryan wants to move in with me.
[gasps.]
- I like Bryan.
- I like Bryan too.
And we were talking about maybe renting Pierce's beach house No.
He's okay with it if you're okay with it.
I'm not okay with it.
If you want a bigger house, I'll help you buy one.
Alex I don't know if you've noticed, but Pierce is the guy who's been sleeping on the other side of your bed for the last year.
[scoffs.]
Eight months.
- He's a good guy.
- A great guy.
- Mm-hmm.
- Mm-hmm.
How is it working with Jesse again? I don't want to deal with this right now.
- I know that too.
- So I'm not.
Okay, boys, I'm coming in to hug you! Brace yourselves! You know, it is possible to be in love with two men.
No.
God, I hope not.
All first-year interns to the Educational Conference Center.
[upbeat music.]
I'm waiting [yells.]
For my heart! Hey, you know your nurse, "Gee-Sug"? Ji-Sung.
I was thinking about asking her out.
What does she like? Not you.
You call her Ping Pang Pong to her face.
So you'd put a good word in for me, then? I bet she gives a great massage.
[yells.]
I'm not leaving without my heart! This is nice.
Just hanging out with you.
[siren wailing.]
[indistinct chatter.]
[sighs.]
Why don't they serve alcohol here? 'Cause it's a hospital.
You still looking for that heart? You know what I want right now? Now? No.
No.
- And I want it bad - No, my back is And I want it rough.
I want a safety word.
You get way too into it.
Can I eat first? [both grunting.]
Your life Don't cross them lines What you like What I like Why can't we both be right? You hit me like that again, I'm gonna stop letting you win.
[panting.]
Oh, God, I can't I can't [sighs.]
[both breathing heavily.]
I knew he was gonna kill himself.
Millicent was right.
When I saw him on the roof, all I could see was a perfect match for my patient.
The right height, the right weight.
I would have done the same thing.
No, you wouldn't.
I'm gonna go yell at a nurse.
Uh, hey, come here.
Come here.
Come here.
Talk to me.
I'm fine.
I mean, I'm trying, Alex.
I'm really trying here.
[exhales slowly.]
Isn't it usually the girl that wants to talk about their feelings? Well Look, we can't move forward if you're not gonna open up.
I want to move in.
[exhales deeply.]
Is this about my ex? No, it has nothing to Pierce, it was six months ago.
We were barely dating.
Yeah, we were sleeping together.
But we weren't dating.
I don't need to revisit what happened.
Yeah, I know.
Why not? - It bothers you? - Yeah.
You want me to wake up every morning and say, "Hey, sweetie, you cheated on me with your ex-girlfriend"? Come on.
It was a mistake.
It happened.
I I just [cell phone vibrating.]
Oh, God! She's in full failure.
- Her systolic is 40.
- Give an amp of epi.
And chase it down with an amp of bicarbisa We need to intubate soon.
I need a Mac 3 blade and a 7.
5 tube.
[monitors beeping.]
Oh, oh-oh, oh, oh-oh Oh, oh-oh-oh Oh, oh-oh, oh, oh-oh Oh, oh-oh-oh What's her PTT? Oh, oh-oh, oh, oh-oh She stopped breathing.
Paddles! Charge it to 360.
[electricity whines.]
- 360! - Clear! - Charge to 360.
- 360! [monitor beeping.]
- We got a pulse.
- [exhales.]
What's her PTT? - 36.
- Too low.
Tell me the donor is cleared, and get me that heart.
- Right away, Doctor.
- Callahan, bag her.
[monitor beeping.]
Hey, what are you doing? I want to do a heterotopic transplant.
What? Don't we all.
That's not gonna happen.
Her pulmonary pressures are too high.
If I do an orthotopic transplant, the donor heart will fail.
It won't be able to pump against that kind of pressure.
I can do this.
I assisted on one during my fellowship Alex, there are four doctors in the world who know how to do this operation.
Now there'll be five.
Mmm, mmm mmm mmm Pressure's dropping.
I've got a lot of blood coming back at me through the suction, Doctor.
- Pledgets.
- A lot.
Five O, and get me some, uh some bio-glue.
- Bio-glue, Doctor.
- Okay, walk me through this.
- [inhales deeply.]
- We're losing pressure.
Walk me through this, Doctor.
This is, uh [sniffles.]
This is delicate tissue.
I, uh I'm gonna I want to load everything on the on the Castro to take the tension off the suture line 'cause it's not gonna hold.
Gonna put a side-biter on the vessel to take the tension off so it won't tear more and stop the bleeding.
Bleeding's down.
Pressure's up.
Still here? I almost killed him.
Yeah, so do better.
Would you have let me kill him? No.
Another 30 seconds, I would've kicked you out of the OR.
Oh, so you were testing me.
Hell, yeah.
You want to be a surgeon, you better get a thicker hide, Doctor.
A thicker hide or absolutely no capacity for compassion whatsoever? This isn't personal.
- Isn't it? - No.
You asked me to teach you how to survive.
You choked today.
Why are you always on me? 'Cause you got a shot at making it.
If you don't screw it up.
[whispers.]
Turn around.
Please.
[melancholy music.]
[sighs.]
Doctor, we need to talk.
You need to slow down.
I'm not your protégé, and you're not my mentor.
I'm gonna do this, Jesse.
You're making a decision before the Credentialing Committee has had a chance to approve listen.
We're using single cannulation stitches.
No pledgets.
You got that? My patient doesn't have time to wait for the committee to debate this.
You've been planning to do this from the minute that guy blew his brains out.
I know you, Alex.
You waited until now because you think the committee won't have time to stop you.
I'm Chief of Surgery, Alex.
There's not a chance in hell I'll approve this.
I'm not asking for your approval.
And as Chief Innovations Officer, I no longer need it.
[monitor beeping.]
I suppose that's true now.
I'm ready to do this! Let's move! Marty, I need you to do something for me.
I need you to tell Maggie what's happening to her sister.
You tell her the operation will take eight hours and I'll do my best to send someone out there to let her know how things are going.
[gentle music.]
Tell her I know what it's like to be sitting in this room, waiting to hear if everything's okay.
Explain the procedure is called Heterotopic transplant.
Deana's heart will stay inside her.
We'll take Thomas's heart and connect it on top of Deana's piggyback.
The heart only knows how to beat, but sometimes it forgets.
[monitors beeping.]
Thomas's heart will teach Deana's to remember.
She will have two heartbeats for the rest of her life.
Give it to me, Pants.
No two hearts are alike.
I love it when she does this.
- You're an idiot.
- I want you.
Like snowflakes, every heart is Frozen? How the hell am I supposed to defrost this? [blow dryer whirring.]
It's sterile.
I'm just recycling the air in here.
Let's get his heart where it belongs.
[monitors beeping.]
The left pulmonary vein cuff of the recipient is anastomosed to the donor left atrium behind the interatrial groove.
[sighs.]
I need to somehow I need to [sighs.]
I need to compensate here somehow for the size discrepancy.
[sighs.]
They've got to line up.
Ooh, ooh, ooh, ooh We are coming home, we are coming home Doctor? Pump flows are stable.
Ooh We are coming home You got this, Pants.
We are coming home Okay, walk me through this.
I don't need to.
I I got this, just No, I mean I'd like to know how it's done.
Walk me through this, Doctor.
I'm gonna take a wedge out to add some length to the left atrial suture line so they match perfectly.
[inhales deeply, exhales sharply.]
The donor aorta needs to be shortened at the the origin of the brachiocephalic trunk.
I might need some some graft material to bridge the vessels.
Ooh, ooh, ooh, ooh, ooh We are coming home We are coming home Ooh, ooh They're not beating.
The hearts aren't beating.
The piggyback isn't working.
You've done everything right.
It doesn't always work.
It's not over.
- Take me off pump! - Roger that.
Coming off.
What are you doing, Pants? I need to restart the donor's heart.
The VAD can sustain her for 12 hours.
When you hit two liters of flow, restart the VAD.
Five liters.
Four liters.
Coming down to three liters.
Two liters.
Restart the VAD.
I'm at one liter.
Flowing 500.
[electricity whines.]
- Internal paddles, 50 joules.
- Off pump.
Charge.
- [monitor beeping.]
- [sighs.]
They they just need time.
They have to figure out how to beat together on their own.
She won't survive another transplant.
Come on, Deana.
Beni, I'm gonna take you for breakfast, okay? Just as soon as I'm done talking to Dr.
Panttiere.
You performed a procedure the hospital's Privileging Committee hasn't approved yet.
And don't even attempt to apologize.
I didn't intend to.
Performing that procedure was my call to make.
I have never regretted promoting you until today.
[sighs.]
You've gone too far this time, Alex.
If your patient dies I have six hours to wean her off that VAD.
Well, let's hope it works.
And if it does, you'll have done something remarkable, sans ethical.
And it'll be my job [laughs.]
As usual to make you look good.
I'll get you on Dr.
Oz, "The Today Show," "Ellen," Jimmy Fallon.
We'll do a huge publicity campaign promoting the hospital.
Cool.
If your patient dies, the committee will fire you on the spot.
I did what was right for my patient.
- And I'll do it again.
- [chuckles.]
I know.
This is who you were when we were interns.
Look, Alex you're a brilliant surgeon, but let me be clear about something.
If your patient dies because you performed a procedure the hospital's committee didn't approve, they won't just fire you.
They'll make sure you never work again, and I will not be able to protect you this time.
[mellow music.]
[mellow music.]
[monitors beeping.]
[sighs.]
Any change? All right, they're gonna introduce you in 15 minutes.
George Clooney showed up.
Your mom is gonna kill me.
[chuckles.]
I'm not afraid of a commitment.
[exhales.]
Which is why I'll spend 36 hours straight at this hospital.
I-I'll lose sleep over a patient.
I'll forget what day of the week it is.
But I'm always gonna be there for you and your boys.
I love you.
That's why I stick around.
And I'm willing to put a pin in things that we're not quite sure of.
What do you want from me? I want you to figure out what you want.
As long as it's not a matter of who you want, 'cause otherwise I'm out.
I saw the way he looked at you today.
That doesn't bother me.
It was the way you looked back.
So let's just leave it at that for now.
Let's just leave it at that.
[sighs.]
[monitors beeping.]
You want to see something awesome? [monitors beeping.]
They're beating together on their own.
[whimpers.]
[crying.]
Thank you.
Wean her off the VAD.
These two hearts are connected for life.
I don't know what I would have done without my little sister.
It's good to see you.
Beautiful dress, Millicent.
I'd love to borrow it for Jimmy Fallon.
[chuckles.]
You don't get it.
I mean, not the dress, me.
I'm glad your patient's okay.
Congratulations.
Oh, and, by the way, if we were friends, I'd have given you this dress in a heartbeat.
I don't have a lot of friends.
Well, then you're missing out.
My little sister was my best friend.
I remember when she was in the hospital.
She was lovely.
Excuse me.
Do you know where George Clooney's sitting? Not that I care.
It's for my mom.
He's on table 103.
Not that I care either.
You did a nice job in there today, Panttiere.
I had a good teacher, Shane.
I was worried it might be a little uncomfortable for us to work together.
[chuckles.]
Well, don't Bogart all the good OR nurses, and we'll have no problems.
Why did you come back? It was a good offer.
Ladies and gentlemen, Dr.
Alexandra Panttiere.
- [applause.]
- They're calling you.
[sweeping music.]
C.
We will be celebrating 75 years in the air by featuring uniforms from past decades.
Ready for some trouble Pretty girls, but she's ruling them all That girl the queen Hi, I think you're in my seat.
No.
This is my seat.
Not according to my ticket.
[sighs.]
I'm trying to be nice here.
I'm giving a speech in a few hours my feet are killing me, and I'd like to sit down.
All that salt will kill you, and get out of my seat.
A little help here? - [passes gas.]
- Facing failure.
- [baby crying.]
- [speaking softly.]
Working tirelessly to make Risk and failure is at the core of who I am as a Are you kidding me? Okay, my friend, we need to talk.
Could you not I'm trying to I have to speak in front of a lot of people.
Okay? The fear of failure holds us back Kid, I'm a doctor.
I have a shot in my purse.
A big one with a really long needle.
What would you do if you knew you could not fail? [ding.]
We need a doctor in the first-class cabin.
Immediately.
[upbeat music.]
Is there a doctor on the plane? [sighs.]
- [coughing.]
- How long have you had a cough? - Two weeks.
- His veins are distended.
- What's going on here? - I'm a cardio-thoracic surgeon.
- Do we need to land? - Hell no! I have a speaking engagement.
You need to get me your medical kit and any other supplies you have.
He has fluid building up around his heart.
I'm gonna have to drain it.
I'm gonna save your ass even though you took my seat, without getting my outfit dirty.
I don't have a change of clothes, you see? Don't worry, I've done this bunches of times, okay? Okay, Glasses, get a trash bag, and tell all the passengers to throw any meds they have in it.
Red, I need a vodka neat to sterilize my hands.
Come on! And, uh Spray Tan, I need something resembling a long needle.
Okay, first class, who has a Black Card? - Chopsticks, thank you.
- Hey.
I need something to cut him open with.
It's titanium.
Wow.
[grunts.]
She was the first woman to train in cardio-thoracic surgery at Loyola University Medical Center, the first woman to complete a heart transplant fellowship.
Okay, napkins.
She recently became the Chief Innovations Officer at St.
Matthew's Research Medical Center in Los Angeles, California.
[cheers and applause.]
And it is my distinguished honor to introduce Dr.
Alexandra Panttiere.
[applause.]
Oh, oh, oh oh oh oh [upbeat music.]
[blow dryer whirring.]
Cartman, once I'd like to go to work drool-free.
Yo! Hey, guys, your dad's here! If you want a ride to school, you got to move! You look like a million bucks [groans.]
Of which I could really use 250 of it.
That '61 Impala's an expensive date.
I have to talk to my hedge fund boyfriends from New York today.
- Part of the new gig? - Corporate enough? Sure, if you're hanging from a stripper pole.
All right, put a jacket on over the dress, wear a belt black leather and, uh, those pearls that your grandmother gave you.
I'm just gonna throw a coat over it.
Alex, hey! Oh, dude.
Do you mind if I attack your ex real quick? Post-surgical manic energy! Okay, don't throw me in the air, Pierce.
- Okay, go.
- 11-hour surgery.
Tumor resection at the head of the pancreas.
14-hour left lobe hepatectomy with involvement of the vena cava.
[groans.]
And guess who came into my OR last night.
Dr.
Shane.
Jesse? When did Jesse start working at the hospital? Last week.
He's the new head of surgery.
I haven't bumped into him yet.
At Harvard, this guy's lectures were, uh, standing room only, and I think my girlfriend used to have a crush on him.
Like every intern.
- Hey, Mom.
- Guys, hey.
Hey, Dad.
Hey, Pierce.
- Deal with it.
- Morning, Mom.
- Yes! - Okay, I'm a memory.
Make your lunches! Have a good day at school, and I love all of you.
I didn't have the heart to tell her it was Saturday.
I never did.
Come on, dudes.
Let's get ready.
[indistinct voice on intercom.]
[upbeat music.]
Good morning, Freida.
You look wonderful today.
Are they still following me? [music winds down.]
Mrs.
Rothberg had end-stage renal disease, one of the worst cases of IgA nephropathy I've ever seen, resulting in a complete shutdown of both her kidneys.
I didn't pee for a year.
And because this is St.
Matthew's, where you low-lifes are lucky to intern, I was able to implant one of the first artificial kidneys into Mrs.
Rothberg.
The technology will blow your mind.
It's kicking the ass out of kidney disease, and I'm kicking yours out of hospital.
- [crying.]
- You're free and clear to go and stand in line to the women's bathroom like the rest of us.
[whispers.]
Thank you.
I'll miss you.
Okay, let's go! If you think you've come to St.
Matthew's to specialize, you are mistaken.
At this hospital, you'll be exposed to a buffet of technology that touches every sub-speciality.
I have patients in neurology, ortho, pediatrics, pulmonary.
So be ready for anything and everything.
- Any word on Mrs.
Agostini? - [many shoes squeaking.]
[sighs.]
Okay, we're gonna need a neurosurg consult on Mr.
Parks.
We'll have to peel the neurogenic tumor clean off his spine.
That's gonna be an epic whack.
And you tell those brain boys they're gonna have to let me use the new duel-headed dissecting microscope.
Have you seen that thing? [indistinct voice on intercom.]
Want some fries with that shake? Get bent, Callahan.
I'm liking what I'm seeing, Panttiere.
[stomps feet.]
- Did I scare you, Doctor? - Yes, one-eyed black man.
Sorry.
Let's pick this up tomorrow.
Oh, you're still there.
I need to talk to my boss Dr.
Pain-In-My-Ass.
Go find someone else to worship.
Not you.
Marty.
You're my new sidekick.
Hang close, but I never want to know you're there.
Show up, shut up, and be beige.
Beni, darling, please don't run off.
Hey, buddy.
Alex.
[clears throat.]
Mrs.
Agostini's family have decided to donate her organs.
Holy wow.
This is good news.
Thank you, Millicent.
How did you convince them? [chuckles.]
I'll arrange the donor papers.
I'll let my patient know.
Dr.
Panttiere, please don't run in the hallways.
Okay? This patient, Deana Monroe, has familial cardiomyopathy and advanced congestive heart failure.
She's 29.
Both her parents died of the same disease before they turned 40.
I have to talk to her in private, so go stand in front of the OR board and learn how to sleep with your eyes open.
["Anaconda" by Nicki Minaj playing.]
Both: My anaconda don't want none Unless you got buns, hon Boy toy named Troy - Used to live in Detroit - [girls laughing.]
- Big, big, big money - [music stops.]
Hey, what's up? Mr.
Agostini was declared brain dead! Shut up.
It's better.
She was suffering.
You're not just saying that to make me feel better? Her family's coming in to sign the donor papers.
Oh, my God! We have a that! And you're be in D.
C.
with your students, Deana.
- Oh, my God.
- I love you! Can we get stoned? - No! - [both laugh.]
[crying.]
It's real this time, right? My sister will get this one? Because she has been waiting a long time.
- [cell phone vibrates.]
- Look, he's texting me again.
And still sending you flowers.
Oh, God, you broke up with him two months ago.
- He cannot let go.
- You never understood Thomas.
Look at that text.
That's that's poetic.
You say poetic.
I say whoo-whoo! That's two votes for We have a heart.
Congratulations.
Home stretch.
[both laughing.]
- I love you so much.
- I love you too.
Jesse, Dr.
Shane, are we still good for two? - Yeah, we're good for two.
- Excellent.
[acoustic guitar music.]
Holy brother, rest the soul Hey, we got a new intern, Millicent Silvano.
- You know her? - No.
Well, you should.
Her father's a friend.
Get her into scrubs and into my OR stat.
Yes, Doctor.
Can you hear your sister sleepwalking - Excuse me, I'm - Are you Millicent? Yes.
Get into Dr.
Shane's OR stat! So, Millicent, your father told me to look out for you.
How is he? Your father.
Uh, good.
Father's good.
Say, you lost your accent already.
Took me two semesters to understand your dad.
Now I speak fluent Cockney.
[chuckles.]
Oh, I go in and out [with bad accent.]
Mate.
[heart beating.]
Oh, my God.
The heart only knows how to beat.
[heart beating.]
Here.
It's hard to explain what you're feeling, right? I'm so sorry I'm late.
Dr.
Shane was looking for me.
I'm Millicent Silvano.
You.
We got to talk.
[sighs.]
Dr.
Shane, I'm so sor Did I spit on you? - What's your real name? - Alex Panttiere.
I attended your lectures on thoracic surgery.
At Harvard? Akron General.
- Listen - I-I-I'm married to him.
- Who? Max Elliot? - Mm-hmm.
- Really? - Yes.
His music is I mean I'm Actually, we're getting divorced.
He wrote this one song Oh, "The Only Present I Want Is You.
" That's my favorite song.
He wrote that for you.
Actually, for the guy he left me for.
Huh.
What you did today was actually something I would've done when I was an intern.
Only I would never have gotten away with it.
Mm-hmm.
Next time I'm in the OR, Alex Panttiere, don't pretend to be someone else.
Just come in.
- [gentle music.]
- [cell phone vibrating.]
So, gents, I really hope you'll be able to join us for our benefit here tomorrow.
It's gonna be a beautiful, star-studded event.
I think you'll really enjoy it.
- Um - [footsteps running.]
And for now, I'm gonna leave you in the capable hands of our new Chief Innovations Officer, Dr.
Alexandra Panttiere.
Keep your shoes on, Alex.
Hello, I'm Dr.
Panttiere.
I've been at St.
Matthew's for five years.
- I'm a cardiothoracic surgeon.
- A heart surgeon? Yes, but this is a research hospital, so I have patients in every department.
What does someone like you love to do in her spare time? I like long walks on the beach, hot bubble baths and the sound of cracking a patient's chest open like a lobster first thing in the morning.
[men chuckling.]
Come.
I recently became St.
Matthew's Chief Innovations Officer, which means I'm responsible for bringing cutting-edge procedures to the hospital.
I have a meeting in Japan this week.
They're taking a patient's own cells and growing a transplantable organ.
Heart, liver, kidney, bone you name it.
They're whupping our asses in bioengineering.
- Did I spit on you? - No, you spit on me.
Yeah, I do that.
Okay, I'm new at all this corporate stuff, but what I do know is this, you bought a basketball team that didn't even make it to the playoffs, your tech company's still no match for Google [laughter.]
And your stunning hotel in Dubai will eventually fill up if the country ever gets out of debt.
But I have something better to sell you gentlemen.
It's lives, an investment in early-stage innovations.
High risk, high reward, and a chance to change the world if you have the balls.
Ping Pang Pong, are those the lab results I ordered? [exaggerated Korean accent.]
Creatinine 2.
5.
[speaking Korean.]
at a range 225.
[speaking Korean.]
Okay, okay, Dr.
Callahan? - Oh, I love you.
- I love doing that to him.
It's the highlight of my life.
The tests you ordered this morning.
And Mrs.
Agostini's family signed the papers, so we're ready to pull her heart.
Finally.
The timing couldn't be better.
My patient's cardiac index is dropping.
Let's get her prepped for OR.
Who's in-house to assist? Well, uh, it is Saturday.
- What? - It's Saturday.
It's Saturday? Mother I know.
It happens to me too.
Okay, fine, you see if Callahan can assist.
He's so gross but flipping brilliant.
You tell him in my OR, he wears deodorant.
Mother Saturday? Okay.
[groans.]
- Yeah.
That's okay.
- Dr.
Panttiere.
Alex.
Mmm, mmm mmm, mmm mmm Mmm mmm mmm mmm - It's been a while.
- Ten years.
Uh, give or take 36 days.
- I want to catch up.
- Me too.
Me too, but right now I have a heart transplant, so Well, actually, you know, that's why I wanted to talk to you.
Your patient isn't getting Mrs.
Agostini's heart.
Like hell she isn't.
You know you did a damn good job with those hedge fund boys this morning.
- They're in for $150 million.
- What does this got One of them's donating a majority of the funds.
His father needs a heart transplant, but your patient has a positive cross match, and his father has a negative.
He's a better recipient.
Alex, most people at this hospital would be popping champagne Yeah, if you remember, I'm not like most people at this hospital.
I didn't go to one of the Ivies.
I remember.
- She did this.
- Millicent? Yeah, for the last six months, she's been all over my ass about procedure.
When Mclntyre ran this place This place was a mess with Mclntyre.
Yeah, but I got away with a hell of a lot more.
And if he was still here, I'd be prepping for surgery.
My patient is dying.
I want that heart.
Then you better figure something out, 'cause I just put it on a plane to New York.
Mmm, mmm mmm, mmm mmm Mmm, mmm mmm mmm Mmm, mmm mmm mmm All right, operation went well, Rick.
You're gonna be just fine.
It was an honor to watch you, Dr.
Harrison operate.
- Is he dead? - Rick dead? This guy had a six-centimeter mass in his pancreas, but I've done a few of those, so I think he's gonna be a-okay.
- Thank you.
- Mm, she's cute.
- What what happened? - Jesse stole my heart.
My patient's been waiting three months to transplant.
I'm gonna go to Oncology.
Maybe somebody died there.
No.
Hold on, hold on.
Hold on.
You'll find a heart.
Your mom called after you left this morning.
- You got to call her back.
- Okay.
She wants to go to the benefit with us.
She's convinced George Clooney's gonna be there.
Yeah, well, I told her he never shows up to those things, so she's not coming, but she, uh she invited me to dinner on Sunday.
Of course she did.
My mother loves you.
Slightly more than your mother likes me.
[groans.]
My mother likes you.
She thinks I come from the wrong side of the tracks.
You do come from the wrong side You desire me in your OR today? Yeah, yeah, yeah, Callahan, the minute I find a heart.
And you better not smell.
Work best when I'm ripe, Pants.
On your left.
If I go this way, can you still see me? I can always see you, Callahan.
You want to get away this weekend? - I have the boys.
- You bring the boys.
Come on.
It'll be like a, uh like a family vacation.
In fact, if I move the rest of my stuff in your place, then we'd already be spending the weekend together.
Aren't I a good thing? All the sex you want, and you don't even have to put a ring on my finger.
I wouldn't mind that either.
[cell phone vibrates.]
[chuckles.]
Look who got saved by a gastric ulcer.
[gentle music.]
[whispers.]
Turn around.
- So predictable.
- Together: Hi, get well soon! - Hi, puppy! - Together: Hope you feel better.
- Mommy can't wait to see you.
- I miss you so much.
Hi.
We're Skyping with the dog.
He's staying with one of Deana's students.
- Together: Hi, Dr.
Panttiere.
- Hey, guys.
I need to steal your teacher for a minute.
- Together: Bye! - We'll check in with you later.
- Okay? - [cell phone vibrates.]
Thomas is texting me again.
- You don't need him, De - Maggie - Listen, there's something - You just didn't get him.
- Guys, I have to tell you - He's bipolar.
- But he was a really good guy.
- Guys Yeah, when he took his meds.
He would do anything for me.
He would, and I do understand.
You don't.
Thomas is a very sweet guy I know what you're going to say.
But he has some serious issues.
The ex, didn't he visit you here once? Thomas? Are you nauseous again? Can you get her something? Yeah, he doesn't get to upset you.
I'll be right back with the meds.
[dramatic music.]
We got a jumper! [sirens wailing in background.]
Thomas, I'm Deana's doctor, Alex Panttiere.
[sirens continue to wail.]
Does Deana know I'm here? I'll take it from here, Panttiere.
This is not gonna happen.
- I'm Dr.
Hackett - Dr.
Hack.
And I'm the hospital psychiatrist.
I only want to talk to her.
All right, just get him away from the ledge as quickly as possible, okay? Say his name as much as possible.
Establish familiarity.
[tense music.]
Thomas.
Deana needs a new heart.
I will find her a donor.
You don't have to.
This gives her permission to use mine.
Think about what you're doing, Thomas.
Thomas, if you jump, the impact will crush your organs, and I will not be able to use your heart for Deana.
You're right.
You're right.
[gunshot.]
[gasps.]
Oh, my God.
[sirens wailing.]
Move it, people.
We got a donor! He authorized me to use his heart.
There are legal considerations - It was a directed donor! - I am obligated to Two hearts in one day? How many more are you gonna take from me? You can't be serious.
I raised $150 million for this hospital, and you know why? Because you have one of the only female heart transplant surgeons in the world, and I am not gonna tell my patient and her sister that they aren't getting that heart! The reason you raised $150 million today is because I promoted you to CIO against the passionate pleas of the committee and just about every other department head here, who said I was out of my mind to entrust you with this position because when it comes to rules and procedure, they only apply to you when they suit your needs, Alex.
And your point? I want you to get this heart and as quickly as possible, but I am not gonna release it until it's been cleared by Legal.
There are some concerns Thomas' family could sue us, claiming we didn't do enough to stop him.
The man was bipolar, standing on the ledge of a building with a gun in his pocket.
I don't think anyone could talk him out of it, but at least I tried! Really? Because you switched gears on a dime.
It felt like the only thing you saw up on that roof was a donor for your patient.
Now, let's hope I'm the only person who saw that, Alex.
[acoustic guitar music.]
[sighs.]
Deana You're not getting Mrs.
Agostini's heart.
[somber music.]
I have some news.
It's about Thomas.
You cut a piece.
You warm it in the oven.
325, five to seven minutes.
There should be enough in here for all you guys for the rest of the week.
Can you take the boys tonight? I have to go back to the hospital.
- Sure.
- This is so good.
Dad, I can't find my phone charger.
- Did you check the bathroom? - "Oh, hi, Mom.
How was your day? Got a patient bleeding out?" Gabe? Why's he so weird? He gets that from me.
Why can't he just be normal? If you go to the land of normal, no one will be there.
Whatever.
I think we should call Dr.
Stanley about Gabriel.
Ah.
I think he's doing fine on the new meds.
Let's just cut him a break.
Keep an eye on him, okay? [sighs.]
Bryan wants to move in with me.
[gasps.]
- I like Bryan.
- I like Bryan too.
And we were talking about maybe renting Pierce's beach house No.
He's okay with it if you're okay with it.
I'm not okay with it.
If you want a bigger house, I'll help you buy one.
Alex I don't know if you've noticed, but Pierce is the guy who's been sleeping on the other side of your bed for the last year.
[scoffs.]
Eight months.
- He's a good guy.
- A great guy.
- Mm-hmm.
- Mm-hmm.
How is it working with Jesse again? I don't want to deal with this right now.
- I know that too.
- So I'm not.
Okay, boys, I'm coming in to hug you! Brace yourselves! You know, it is possible to be in love with two men.
No.
God, I hope not.
All first-year interns to the Educational Conference Center.
[upbeat music.]
I'm waiting [yells.]
For my heart! Hey, you know your nurse, "Gee-Sug"? Ji-Sung.
I was thinking about asking her out.
What does she like? Not you.
You call her Ping Pang Pong to her face.
So you'd put a good word in for me, then? I bet she gives a great massage.
[yells.]
I'm not leaving without my heart! This is nice.
Just hanging out with you.
[siren wailing.]
[indistinct chatter.]
[sighs.]
Why don't they serve alcohol here? 'Cause it's a hospital.
You still looking for that heart? You know what I want right now? Now? No.
No.
- And I want it bad - No, my back is And I want it rough.
I want a safety word.
You get way too into it.
Can I eat first? [both grunting.]
Your life Don't cross them lines What you like What I like Why can't we both be right? You hit me like that again, I'm gonna stop letting you win.
[panting.]
Oh, God, I can't I can't [sighs.]
[both breathing heavily.]
I knew he was gonna kill himself.
Millicent was right.
When I saw him on the roof, all I could see was a perfect match for my patient.
The right height, the right weight.
I would have done the same thing.
No, you wouldn't.
I'm gonna go yell at a nurse.
Uh, hey, come here.
Come here.
Come here.
Talk to me.
I'm fine.
I mean, I'm trying, Alex.
I'm really trying here.
[exhales slowly.]
Isn't it usually the girl that wants to talk about their feelings? Well Look, we can't move forward if you're not gonna open up.
I want to move in.
[exhales deeply.]
Is this about my ex? No, it has nothing to Pierce, it was six months ago.
We were barely dating.
Yeah, we were sleeping together.
But we weren't dating.
I don't need to revisit what happened.
Yeah, I know.
Why not? - It bothers you? - Yeah.
You want me to wake up every morning and say, "Hey, sweetie, you cheated on me with your ex-girlfriend"? Come on.
It was a mistake.
It happened.
I I just [cell phone vibrating.]
Oh, God! She's in full failure.
- Her systolic is 40.
- Give an amp of epi.
And chase it down with an amp of bicarbisa We need to intubate soon.
I need a Mac 3 blade and a 7.
5 tube.
[monitors beeping.]
Oh, oh-oh, oh, oh-oh Oh, oh-oh-oh Oh, oh-oh, oh, oh-oh Oh, oh-oh-oh What's her PTT? Oh, oh-oh, oh, oh-oh She stopped breathing.
Paddles! Charge it to 360.
[electricity whines.]
- 360! - Clear! - Charge to 360.
- 360! [monitor beeping.]
- We got a pulse.
- [exhales.]
What's her PTT? - 36.
- Too low.
Tell me the donor is cleared, and get me that heart.
- Right away, Doctor.
- Callahan, bag her.
[monitor beeping.]
Hey, what are you doing? I want to do a heterotopic transplant.
What? Don't we all.
That's not gonna happen.
Her pulmonary pressures are too high.
If I do an orthotopic transplant, the donor heart will fail.
It won't be able to pump against that kind of pressure.
I can do this.
I assisted on one during my fellowship Alex, there are four doctors in the world who know how to do this operation.
Now there'll be five.
Mmm, mmm mmm mmm Pressure's dropping.
I've got a lot of blood coming back at me through the suction, Doctor.
- Pledgets.
- A lot.
Five O, and get me some, uh some bio-glue.
- Bio-glue, Doctor.
- Okay, walk me through this.
- [inhales deeply.]
- We're losing pressure.
Walk me through this, Doctor.
This is, uh [sniffles.]
This is delicate tissue.
I, uh I'm gonna I want to load everything on the on the Castro to take the tension off the suture line 'cause it's not gonna hold.
Gonna put a side-biter on the vessel to take the tension off so it won't tear more and stop the bleeding.
Bleeding's down.
Pressure's up.
Still here? I almost killed him.
Yeah, so do better.
Would you have let me kill him? No.
Another 30 seconds, I would've kicked you out of the OR.
Oh, so you were testing me.
Hell, yeah.
You want to be a surgeon, you better get a thicker hide, Doctor.
A thicker hide or absolutely no capacity for compassion whatsoever? This isn't personal.
- Isn't it? - No.
You asked me to teach you how to survive.
You choked today.
Why are you always on me? 'Cause you got a shot at making it.
If you don't screw it up.
[whispers.]
Turn around.
Please.
[melancholy music.]
[sighs.]
Doctor, we need to talk.
You need to slow down.
I'm not your protégé, and you're not my mentor.
I'm gonna do this, Jesse.
You're making a decision before the Credentialing Committee has had a chance to approve listen.
We're using single cannulation stitches.
No pledgets.
You got that? My patient doesn't have time to wait for the committee to debate this.
You've been planning to do this from the minute that guy blew his brains out.
I know you, Alex.
You waited until now because you think the committee won't have time to stop you.
I'm Chief of Surgery, Alex.
There's not a chance in hell I'll approve this.
I'm not asking for your approval.
And as Chief Innovations Officer, I no longer need it.
[monitor beeping.]
I suppose that's true now.
I'm ready to do this! Let's move! Marty, I need you to do something for me.
I need you to tell Maggie what's happening to her sister.
You tell her the operation will take eight hours and I'll do my best to send someone out there to let her know how things are going.
[gentle music.]
Tell her I know what it's like to be sitting in this room, waiting to hear if everything's okay.
Explain the procedure is called Heterotopic transplant.
Deana's heart will stay inside her.
We'll take Thomas's heart and connect it on top of Deana's piggyback.
The heart only knows how to beat, but sometimes it forgets.
[monitors beeping.]
Thomas's heart will teach Deana's to remember.
She will have two heartbeats for the rest of her life.
Give it to me, Pants.
No two hearts are alike.
I love it when she does this.
- You're an idiot.
- I want you.
Like snowflakes, every heart is Frozen? How the hell am I supposed to defrost this? [blow dryer whirring.]
It's sterile.
I'm just recycling the air in here.
Let's get his heart where it belongs.
[monitors beeping.]
The left pulmonary vein cuff of the recipient is anastomosed to the donor left atrium behind the interatrial groove.
[sighs.]
I need to somehow I need to [sighs.]
I need to compensate here somehow for the size discrepancy.
[sighs.]
They've got to line up.
Ooh, ooh, ooh, ooh We are coming home, we are coming home Doctor? Pump flows are stable.
Ooh We are coming home You got this, Pants.
We are coming home Okay, walk me through this.
I don't need to.
I I got this, just No, I mean I'd like to know how it's done.
Walk me through this, Doctor.
I'm gonna take a wedge out to add some length to the left atrial suture line so they match perfectly.
[inhales deeply, exhales sharply.]
The donor aorta needs to be shortened at the the origin of the brachiocephalic trunk.
I might need some some graft material to bridge the vessels.
Ooh, ooh, ooh, ooh, ooh We are coming home We are coming home Ooh, ooh They're not beating.
The hearts aren't beating.
The piggyback isn't working.
You've done everything right.
It doesn't always work.
It's not over.
- Take me off pump! - Roger that.
Coming off.
What are you doing, Pants? I need to restart the donor's heart.
The VAD can sustain her for 12 hours.
When you hit two liters of flow, restart the VAD.
Five liters.
Four liters.
Coming down to three liters.
Two liters.
Restart the VAD.
I'm at one liter.
Flowing 500.
[electricity whines.]
- Internal paddles, 50 joules.
- Off pump.
Charge.
- [monitor beeping.]
- [sighs.]
They they just need time.
They have to figure out how to beat together on their own.
She won't survive another transplant.
Come on, Deana.
Beni, I'm gonna take you for breakfast, okay? Just as soon as I'm done talking to Dr.
Panttiere.
You performed a procedure the hospital's Privileging Committee hasn't approved yet.
And don't even attempt to apologize.
I didn't intend to.
Performing that procedure was my call to make.
I have never regretted promoting you until today.
[sighs.]
You've gone too far this time, Alex.
If your patient dies I have six hours to wean her off that VAD.
Well, let's hope it works.
And if it does, you'll have done something remarkable, sans ethical.
And it'll be my job [laughs.]
As usual to make you look good.
I'll get you on Dr.
Oz, "The Today Show," "Ellen," Jimmy Fallon.
We'll do a huge publicity campaign promoting the hospital.
Cool.
If your patient dies, the committee will fire you on the spot.
I did what was right for my patient.
- And I'll do it again.
- [chuckles.]
I know.
This is who you were when we were interns.
Look, Alex you're a brilliant surgeon, but let me be clear about something.
If your patient dies because you performed a procedure the hospital's committee didn't approve, they won't just fire you.
They'll make sure you never work again, and I will not be able to protect you this time.
[mellow music.]
[mellow music.]
[monitors beeping.]
[sighs.]
Any change? All right, they're gonna introduce you in 15 minutes.
George Clooney showed up.
Your mom is gonna kill me.
[chuckles.]
I'm not afraid of a commitment.
[exhales.]
Which is why I'll spend 36 hours straight at this hospital.
I-I'll lose sleep over a patient.
I'll forget what day of the week it is.
But I'm always gonna be there for you and your boys.
I love you.
That's why I stick around.
And I'm willing to put a pin in things that we're not quite sure of.
What do you want from me? I want you to figure out what you want.
As long as it's not a matter of who you want, 'cause otherwise I'm out.
I saw the way he looked at you today.
That doesn't bother me.
It was the way you looked back.
So let's just leave it at that for now.
Let's just leave it at that.
[sighs.]
[monitors beeping.]
You want to see something awesome? [monitors beeping.]
They're beating together on their own.
[whimpers.]
[crying.]
Thank you.
Wean her off the VAD.
These two hearts are connected for life.
I don't know what I would have done without my little sister.
It's good to see you.
Beautiful dress, Millicent.
I'd love to borrow it for Jimmy Fallon.
[chuckles.]
You don't get it.
I mean, not the dress, me.
I'm glad your patient's okay.
Congratulations.
Oh, and, by the way, if we were friends, I'd have given you this dress in a heartbeat.
I don't have a lot of friends.
Well, then you're missing out.
My little sister was my best friend.
I remember when she was in the hospital.
She was lovely.
Excuse me.
Do you know where George Clooney's sitting? Not that I care.
It's for my mom.
He's on table 103.
Not that I care either.
You did a nice job in there today, Panttiere.
I had a good teacher, Shane.
I was worried it might be a little uncomfortable for us to work together.
[chuckles.]
Well, don't Bogart all the good OR nurses, and we'll have no problems.
Why did you come back? It was a good offer.
Ladies and gentlemen, Dr.
Alexandra Panttiere.
- [applause.]
- They're calling you.
[sweeping music.]