Lenox Hill (2020) s01e01 Episode Script
Growth Hurts
1
THE PRODUCERS CARE DEEPLY
ABOUT THE SAFETY AND PRIVACY
OF ALL INVOLVED WITH THIS PROGRAM.
ALL PATIENTS APPEARING IN THE PROGRAM
HAVE PROVIDED CONSENT TO PARTICIPATE
AND TO DISCLOSE THEIR HEALTH INFORMATION.
A NETFLIX ORIGINAL DOCUMENTARY SERIES
A YULARI FILMS PROUCTION
EXECUTIVE PRODUCERS RUTHIE SHATZ
ADI BARASH JOSH BRAUN
DIRECTED BY
ADI BARASH, RUTHIE SHATZ
There they are.
Give me a squeeze, Hannah.
Give me a left-hand squeeze.
Squeeze your left hand.
Squeeze your left hand, sweetie?
Hey, Hannah, open your eyes, sweetie.
Open your eyes.
Can you open your eyes?
Hannah.
Can you wiggle your toes?
Can you open your eyes?
She's there.
She's starting to come around.
- She'll be fine.
- Hannah.
We're gonna move you over to another bed.
Just get her upstairs.
I'll tell the family everything's fine.
LENOX HILL
Okay. Yes, of course. Is she fully, or no?
I don't know.
She just walked into the room
- and said she might have to go back.
- Yes, I hope she's fully.
Moisa went into room five or six.
Okay.
Harder, harder, harder.
Harder, harder, harder, harder, harder.
Oh, shoot.
Cough.
Push! Push! Good job! Yay!
- Look down!
- Look down. Open your eyes.
- Open your eyes.
- Look down! Open your eyes.
- Twelve o'clock!
- Oh, my God!
Beautiful. Dad,
do you want to cut the cord?
- Yes.
- Beautiful.
Here you go.
Good job. Good job.
Happy birthday. Congratulations.
Here, Mama, just open your gown with her.
Okay. Hi.
- Hi.
- Hi.
- Do you have a name for her?
- Aria.
She is so sweet.
- I don't think we have tears.
- That was so fast.
Too precious.
Thank you so much.
That was You did everything.
I literally did nothing.
Hi.
When can I try
Oh, now.
- Yeah?
- Yeah, go ahead.
Lenox Hill Hospital, historically,
was a glorified community hospital.
It was an old lady's hospital.
But it was also known
for its outstanding cardiac services,
orthopedics, and obstetrics.
People came to be born here and die here.
It was a sleepy little Upper East Side
hospital with no neurosurgery
competing with some of the greatest
health institutions in the world.
So when Northwell bought
Lenox Hill Hospital in 2010,
the year I was recruited,
I definitely was thinking about
trying to start a department,
and getting a group of people around me
that I knew over the years,
and convinced them to join the team
and build something together.
DAVID LANGER, MD
CHAIR, NEUROSURGERY
I underestimated what that meant.
David Langer.
The equipment was old.
No one knew how to take care
of a neurosurgery patient.
They didn't know
what a neurological deficit looked like.
So we had to start from zero.
I took way more risk than I ever should,
and we still have a ways to go.
Yeah. Did Miss Hannah Deoul
Did Miss Deoul come up yet?
Yes, she did.
On the way up,
there were things that happened here
that would have been avoidable
in a place that was fully running,
and it was incentive.
Hey, Hannah.
How you feeling? You there?
Now we're saving people
that never would have been saved.
It's all done, okay?
The lack of legacy,
the nothingness of this place
Move this left foot.
Is what allowed it
to become everything.
Everything went great.
Luckily for me,
I had the balls to take
the first dive
and make some good decisions.
Okay? I got the whole thing out.
But it's not just me.
It's the whole group.
Our focus and our heart
and our collaborative culture is
what won the day.
That kind of special chemistry is
what allowed us to be able to compete
against the biggest
neurosurgery departments in the city,
and in the world.
We've created something pretty amazing,
and I'm very protective of it.
Do I have anybody else here?
- Langer's patients are okay?
- They're good, yeah.
John's coming here was
This was even crazier Like,
He left Cornell.
Who the fuck leaves Cornell
to come to Lenox Hill to start from zero?
John's a real name.
Why would he do that?
He wanted to try something unique.
He's sort of as romantic as I am, I think.
Breast cancer in 1990.
Liver mass, breast,
and then primary lung also?
Phyllis, this won't take me long.
Show me the bump.
JOHN BOOCKVAR, MD
VC, NEUROSURGERY
There's a bump there,
and it it radiates.
Ah!
- Sorry.
- That's okay.
- You got radiation here?
- I did.
- Yes, you did?
- Yes, that's why my hair fell out.
Well, your hair looks great,
so that's why I was asking.
PHYLLIS, 74
- All right, so
- Yes?
We're doing
scalp exploration,
intersection of mass
I love when it said on the form
that I originally
- That it said "hardware removal."
- Yeah.
Okay, you've signed
a lot of forms this morning.
Welcome to the bureaucracy.
So can I get the screw
and the plate to make
Let's see what we find,
but you can
- call and request it.
- And fight with them?
That's my initials.
Oh, good.
So we're going to go in
and open her scalp.
Um, I did a brain surgery on her
for metastasis to the brain,
which she's doing terrific from.
She had radiation,
and has been disease-free,
for over a year.
Interestingly, about three weeks ago,
she developed,
um, real pain in the scalp area,
And so in a patient
who's had a history of cancer,
we worry about metastasis.
Or in a patient that's had
a history of surgery, we worry about
something in the fixation system
of the skull
back onto the
her natural skull.
And that may be a plate that's come loose
or is irritating the scalp.
So it's my job to figure it out.
- For sure.
- For sure.
- Okay.
- And, either way, it comes out.
Okay?
Keep our fingers crossed
that it's not cancer, and you're home.
- I get nice staples in my head?
- You get staples in your head
- and good drugs when you wake up.
- Great.
- Okay. I'll see you inside.
- Thank you.
Nothing to worry about.
I don't even dare to imagine
what I'm going to encounter
on any given day
when I arrive at work.
In neurosurgery, in research,
there's just so many anomalies.
I mean, constant surprises,
that I must always, you know, keep
Literally, an open mind.
All right.
Time to get focused.
LENOX EMERGENCY ROOM GREENWICH VILLAGE
- Stop
- Take it easy, Bobby.
- Bob?
- Bobecito.
- Bobecito.
- Bob.
Call the medical examiner
on that body.
Oh, boy.
- Can we send it off?
- Sure.
Just she wants to go home.
Mohammed?
All right, I'm Dr. Macri.
So, what brought you
to the emergency room today?
I mean, so, um, Saturday,
I'd been experiencing some pain, right?
And, uh, like, around Saturday night
MOHAMMED
I thought it was
I asked my sister-in-law to check it out.
She said it's an ingrown hair.
It started to grow bigger.
Started to worry me.
I'm going to put on some gloves,
put on a mask, we'll take a look.
Uh, I have to put some lidocaine
on the skin
so that you can tolerate the procedure.
- Okay.
- All right. Very good.
So I'm going to put on a mask.
Hopefully, depending on the look of it,
we won't have to do much.
Well, I actually
took a peek in the bathroom,
- and it's not that quite big.
- Okay, good.
So, what we're going to do is
gonna have you lay on your belly. Okay.
Let me take a look, yes?
Oh, I see.
You're going to feel some burning.
And I'm going to inject
all around the area.
So, it's going to feel tender
and it's gonna be painful.
- Okay?
- I'll bear the pain.
You'll bear okay.
Well, you tell me to stop.
We'll go slow, yes?
- Mm, sure.
- Okay.
One, two, three.
- Okay?
- Oh, mother fucker!
See that? It's okay.
- So I'll tell you
- Stop, stop, stop.
- Okay?
- You need to chill. Oh, my God,
- I'm gonna give you a break.
- I'm trying not to swear.
That's okay. Just be
I'll tell you,
it popped on itself already.
So that's a good sign.
Okay?
- Okay, you ready?
- No.
Tell me when. Take five seconds.
Concentrate on your breathing, okay?
- You're doing great.
- Fuck!
Almost finished.
Okay.
That's it.
- You're welcome.
- Okay. We'll stay like this
for a moment, and I'll check on you
in ten minutes, okay?
- Okay.
- All right.
Uh, if you need anything, just get me.
Hi!
- Hi.
- Mr. Slomowitz?
- Yeah.
- Yeah. Hi.
How are you doing?
- I fell this afternoon.
- I see.
And landed nose-first on the sidewalk.
And, uh, I live with my parents,
and my mother
got concerned that
it might become infected.
- Sure.
- She said
People become doctors,
whatever they become, I think
it comes from a through childhood.
How old are you now?
- Oh, God.
- Sixty-five. How old are your parents?
- Ninety-four and ninety-two
- Oh.
- So you all live together?
- Yeah.
I think your childhood, your upbringing,
what you observe as a young adult,
all goes into molding
what you're going to become.
And from a very early age,
I learned compassion, I learned sympathy.
No blood. That's good.
I grew up feeling,
"Oh, why is this person hurt?"
or "Why is this person feeling this way?"
No pain? Okay, good.
To me, the ER is the front line.
We take whoever
whatever.
If you're uninsured,
if you're insured, if you're a criminal.
Anything you are, we put it to the side,
and we just treat you.
It's a collage
of people that come in.
And that's what I love about this field.
It's overwhelming at times, but, um
I've come to embrace
that empathy and compassion
for people being ill and needing help.
Growing up,
there was a very strong emphasis
on doing what you can to help others
and doing things in a selfless manner.
So it's kind of like,
"What form will that take for my life?"
Both my parents were nurses
in the military,
so there definitely was that bias
toward being in medicine in general.
When you go through medical school,
this is the specialty
they tell you not to do.
The hours are so long,
you're always on call,
because you've nights and weekends.
I'll do that. I'm here today,
I'm working. I'm not going home, so
But I pretty much didn't like any rotation
except OBGYN.
My four years as a resident have been
a very long road.
I mean, you are sacrificing
your 20s and 30s.
Hello. Good morning.
So it's a big commitment.
- Okay.
- I'll be right back.
- Do you want to go in?
- Yeah.
Okay.
- Have you been tired?
- I think I have been tired,
but I've also been working a lot.
Aw, Amanda.
It's going to be all right.
There's the baby.
Nice and strong. Here's the yolk sac.
So you're about seven weeks and one day.
KEVIN
Looks like a
And there the baby is again.
Amazing.
So, at this point,
- everything seems to be okay?
- Yep. Yep.
Wow, that's crazy.
I'm having a kid.
- Here you go.
- Thank you.
You're welcome.
And I'll be right back.
Apparently, we should take
pictures of this with our phone.
We did it, yo. We made this.
- I can see you.
- Just gotta make it all the way.
This is the first grandchild
for my parents.
So everybody's really excited.
- When do we get to know the sex of it?
- Remember, we're not going to know
until we deliver.
I don't know. We have to talk about that.
- It's
- Oh, really? Okay, let's talk.
I would like to know
kind of beforehand, you know?
- I don't like these surprises
- Mmm.
Necessarily.
Um
We'll see.
There's not
that many genuine surprises in life.
And
Well, my cousin, that's what he did.
And it's amazing, I think.
So, well, that's like a contention point.
So we'll work it out.
- Congratulations.
- Thank you.
Mmm.
Yay.
- Thank you.
- Everything looks great.
- How do you feel?
- I feel good. I just feel bloated.
That's it. I haven't had nausea
or vomiting. I just
This looks great.
It measures five days bigger.
- Okay.
- But we wouldn't change the dates.
- Okay.
- Same 3-31 due date.
- Thank you.
- Yay. Best of luck.
- Thank you.
- All right.
I'll probably tell people at 12 weeks.
I'm still trying to keep it hidden.
I won't be back until 8:00 p.m., probably.
Okay.
I'm hoping
that I'll be able to have a full 24 off
and come back Wednesday morning, but
I may have to come back Tuesday morning,
so we'll see.
Okay.
- So, we're pregnant.
- We are pregnant.
And it's good.
- Thank you, Kim, so much.
- Take care.
- Have a good day.
- All right.
My dad was a cardiologist
at UPenn,
and when he walked around the hospital,
he always used to do this.
And I do the same thing.
I didn't even realize it.
My brother said,
"Dave, you do just what dad did."
There's no question I became a doctor
because of him. Yeah, there's no question.
To have a little bit
of him in me is a good thing.
He had a heart attack when he was 42
and died when he was 45.
His stroke was what got me interested
in neuroscience to begin with.
And
I came home on Friday, December 13th,
in 1985.
That's how I remember it.
And he, uh
was too tired to come meet me
at the airport.
And so I went to see him
to say good night, and he was, like, fine.
About an hour later or so,
my mom screamed,
"Your dad's on the floor."
Then I found him on the floor.
You could tell he was having a stroke.
It was totally painful, to be honest.
Really bad. See? I'm doing it again.
To some people,
it's a 9:00 to 5:00 job.
It's a shift. It's a chore.
To me, my job is not a job.
It's my life.
It's about loving to operate,
and loving to do good cases,
and ultimately loving to help people.
All right. Be Daddy.
- I can't.
- You have to. Yes, you have to.
I need you to do this for me.
- Okay?
- Heavenly Father,
please stay with my sister
and make sure you keep her safe
We have a case today.
The patient's a 41-year-old
female police officer from Tennessee.
It's going to be okay.
MITZIE & TONY.
- It's going to be all right.
- I love y'all.
Love you.
Mitzie arrived to us
after living with this tumor
in her skull base and neck
for about ten years.
At the end of the day,
no one near her was
really willing to operate on her.
It was just too difficult.
What she has here is
a big tumor in her neck.
All this white thing is the tumor.
This is the carotid artery
going right through it.
That's the carotid artery right there.
This extends all the way up.
It goes all the way up to the skull base.
It extends into the brain case.
The problem is,
we don't think we can take it out safely
without sacrificing the carotid artery.
And even if we get into it,
it could bleed.
So, we'd rather control the whole thing
ahead of time, before we access the tumor.
In her case, the vast majority
of the blood supply that's coming
It's making up for that carotid,
is actually in the neck also,
the external carotid artery.
And that has to go, too.
So, we're gonna do it in stages.
What we'll do is, we'll we're gonna
close her internal carotid today.
Then we may decide to take
the external carotid down tomorrow.
And then there are all these
other decisions have to be made about
other aspects of the surgery
that are all really important.
That's why having guys like Ortiz here,
and me
And together, um, we're able
to really consider all the options,
and really do all the things necessary
to keep these people safe.
But these are risky operations.
No question about it, you know.
And you live and die for them.
Hi there.
We meet again.
We're going to close the artery
using coils, and a little device.
It's like a little umbrella,
uh, that decreases the blood flow
in the artery.
And, remember, we're doing this
in preparation for the bypass,
because if Dr. Langer does
the bypass tomorrow without this,
uh, the bypass isn't going to work.
We think you'll be fine.
The biggest risk is the other vessel.
You really need two.
And that's gonna give your brain
the blood it needs temporarily.
But by the time we take that one,
the bypass will be out and take over
all the blood flow that you need.
You know, hopefully.
What happens if we get in here
and this isn't working?
You could have a stroke.
You know, that that's the risk.
Tomorrow's a bigger deal.
And look, we're here with you
the whole time. We're not gonna leave you.
And if there's a problem,
we'll attack it and fix it
if it has to be done.
It doesn't mean it's going to be easy.
It could be a little tough,
some tough moments.
You have a great family.
If you trust me,
and you trust us, then we're good.
Because then we can do everything we can.
- Let's see what my wife is up to.
- Hello?
- How's it going? Are you free?
- Nope.
Do you not know
that I go to the dump every morning?
I literally go every morning.
I drop the kids at school,
and then I go to the dump
to drop the compost.
So, that's weird.
It's really fucking stupid.
And I was like,
"Daphne, you're not doing this.
You're too young.
And it looks trashy."
Wait, so what did she get?
She got a second in the right ear
and a third in the left ear?
Yes.
Like me. Like what I have.
But I did it when I was 17.
She goes, "Yeah, but someone put
a pin through your ear."
I'm like, "Yes, that's how I did it."
Wait, did you really do that?
- Yeah.
- I mean, with what? You sterilize it?
And you just pop
Yeah, we lit it on fire, and then
I pierced my ears.
Did you bleed?
Was there any infection risk?
- We didn't bleed back then.
- Exactly. These kids are
- They're wusses.
- We bleed now
when everyone gets a participation award.
Huh. I'm in this paper.
I'm in this journal.
Whatever. And then we're hosting
a jillion people on Sunday.
Oh, shit.
We've got Steph and Jared,
Phyllis and Walter
- Oh.
- Diane and Howard,
Michael and Rachel, my parents, your mom.
We got a shit ton of people coming.
Well, now I know why
you're in an aggravated mood.
And I have my period.
And that too.
Larry.
Hi, it's Dr. Macri.
Hello, darling.
Show me your face today.
What's going on?
Larry.
Wake up.
You cannot choose what comes at you here.
A place where you can't judge people.
Larry, where is your house?
- Where are you living now?
- On the street.
Okay.
And you're not staying in the shelter?
Okay. How long have you been
sleeping on the street now?
- Six months.
- Six months? All right.
You have to have a little flexibility
with what these people are going through.
Up, up, up.
And be a neutral buffer
for them and their problems.
So, it's not just medicine.
And they don't teach this stuff to you
in med school.
You don't read a text book on how to deal
with someone's social situation
or their problems.
You have to just use the best tools
that you have from inside and say,
"I can help you."
I'll just close this
for a moment. All right.
I am going to put on a gown, actually.
Because sometimes these are full of pus,
and they just explode.
- So you ready?
- Yes.
All right.
So do you smoke, Mohammed?
- Cigarettes?
- Mm-hmm.
- Yes.
- And no drugs?
Mmm
Marijuana.
- Marijuana? Okay.
- Yeah.
Always marijuana,
or have you had any other drugs?
Okay, um
You ever heard of, uh freebase?
Uh-huh.
- Sometimes not all the time.
- Okay.
Because since you're my doctor.
Uh, you put a little in the marijuana
and just smoke it.
- Okay.
- It's not crack cocaine. It's, uh
Uh-huh.
It's cocaine, but it's just yeah.
- You put it in the marijuana.
- Yeah.
Okay.
When's the last time you did that?
Mmm
- This weekend.
- So sometimes, yes?
Mm-hmm.
Have you had
any unprotected intercourse recently?
- Mm-hmm.
- Okay.
All right. You ready?
Don't move.
You can scream, but don't move.
- Mother
- Okay.
We're finished. I lanced it already.
Sorry.
So.
Almost finished, okay?
Mm-hmm.
I can't take a picture,
because I have gloves on.
So, listen, if you have to move
your bowels tonight, be very careful,
because you're going to have
a piece of gauze here, okay?
Yeah, but what if that
accidentally comes out?
- It shouldn't.
- Okay, good.
It shouldn't, unless you're
No, trust me, I don't think
I'm going to be back there.
You're gonna go out
dancing tonight, or what?
- No.
- Okay. Then it should.
[Mohammed, Oh, my goodness.
That is incredible.
So you go home and you rest, okay?
- That wasn't too bad, right?
- No, it was like Disney World.
Gentlemen, ladies, you ready to roll?
Yes, sir.
You guys look like a, um,
college version of, like,
Scrubs or something.
Pants are tucked in.
Shirts are tucked in.
Nothing loose.
Check yourself in the mirror and make sure
your hair's covered, ears are covered.
Good morning, everybody. Big D.
- The Donald.
- What's up?
Good job with North Korea this morning.
Hey, you're about to see
what greatness is all about.
Students, come in here,
don't touch anything blue.
Okay, this is Phyllis Landa,
and my left is her right.
We're going in
after this mass on her scalp.
Everyone take a moment,
confirm on the right side, say, "Aye."
- Aye. Right side.
- Say yeah.
- Yeah.
- Janey, she needs an antibiotic.
- Yes.
- No Decadron.
No mannitol, no Keppra.
Let's take a moment to be mindful. Okay.
Let's do a mindful moment.
Everyone relax, close your eyes,
wiggle your toes inside your orange shoes,
if you're wearing orange.
Roll your shoulders back,
close your eyes
take a moment, be here in the present.
Take a deep breath in,
hold it at the top,
exhale.
Deep breath in.
Exhale. Let's roll.
Woo-hoo.
Where's our bump?
What is this?
- Is this the part that's irritating her?
- It looks like a tumor, right?
Question is,
is this mass a cancer or not?
No, it's not.
Can you guys see it on the TV monitor?
There you can see our plate.
Suction to my left.
Thank you.
Shit, man.
Phyllis.
It does not look good.
Let's get a knife.
I hope to God this is just inflammation.
Guys, come here.
You see? This looks like cancer.
You can see this is normal scar tissue.
This is what I was hoping we'd find.
This looks like cancer.
It's purple
and it's bloody.
Hopefully it's just reactive, but
Phyllis, Phyllis, Phyllis.
How big's the tumor?
Yeah.
Let's go to pathology
and look at it frozen. Okay?
I'll be right back.
Fuck.
The pathology team.
Hi.
Hi.
Well, this is a woman who's 70-something.
One with scar tissue, and then,
one looked like cancer.
Take a look.
Dr. Krauss.
Hello, Doctor.
Another cancer specialist
doing frozen specimens.
What are you looking at?
- Big lymph node.
- This is all cancer, right?
It's all cancer.
So what are you going to do?
You stop, or you keep going?
No, we're gonna take it out
Always good to have
the courage of your convictions.
Hey, Rima.
Thanks for everything.
Do you look at the schedule?
- I always look at the schedule.
- Just to see how many rooms
- you're running.
- We're running a lot of rooms.
We're doing what we're supposed to do,
to bring patients and take care of them.
That's what we want to do, we're trained
to do, we're incentivized to do.
However, we continue to push the envelope.
Every time we reach a critical mass,
then we grow again.
- So, we're on the right path?
- I completely agree yes
- You feel we are on the right path?
- Absolutely on the right path.
- Growth hurts.
- They have to understand
that we have to be comparable
to New York hospitals.
I I I will do everything I can.
- I hear you.
- Yeah. Recruits for you.
I get it.
So I can recruit you back?
I am here.
- I am here. You feel my support.
- I know.
- I would never turn away.
- I know.
Really, this is my passion, but
I know. I get it.
So, I'll do
You know I do everything I can.
That's what I needed to say.
I gotcha.
- Okay.
- Okay. Thank you.
Did I show you this something
that was really cute today?
No.
- Dancing.
- Who is that baby?
That's his cousin.
Why do you get a good pregnancy?
You know
- Life
- She was waiting to
- Finishing schooling.
- Fine.
- Can I finish schooling? Is that okay?
- Fine.
- You're going to Cali, right?
- Yeah
You leaving too?
- Why you guys use us like that?
- I know. I'm sorry
You come, you stay here,
make us like you, all kind of thing
- Aw.
- And then you just leave.
Don't speak for all of us.
- No.
- You really leaving?
I'm probably leaving. Because Kevin,
his job is in California, pretty much.
You know, he came here for me
when I matched here.
- So now, it's my turn to give back.
- How sweet.
You leaving when?
- By the end of the year?
- Yeah.
- But, as I said, I'm not long here too.
- Where are you going? You retiring?
Yeah.
Oh, so we can retire
and graduate together.
So,
so, it's a piece
of soft tissue infiltrated
by high-grade neoplastic cells.
This could easily be a
neuroendocrine component.
She had also large cell
and small cell in her tumor.
Right.
Yeah, so this is surprising.
She's gonna be unhappy.
Because she thinks
it's just a plate that's being removed,
and it's a piece of cancer
that sort of popped up, and, uh
has stuck there on the scalp, so
All right, good work.
Thank you.
Oh, it's raining.
The heavens have opened.
It's amazing how, for such a busy city,
how still it looks, right?
- Fuckity fuck, fuck.
- What is the tumor?
It's adenocarcinoma.
I'm surprised. I just thought
it was going to be her plate.
It's her original tumor.
So I've got to call the husband.
Tell him that we found cancer.
Hi, Saul. It's Dr. Boockvar. How are you?
Everything went fine. Phyllis is fine.
No problems with surgery.
We found some evidence
of a previous cancer, though,
in the scalp.
And we're going to have to deal with this.
It wasn't big.
It was about the size of a dime
okay?
But it was right under the scalp.
That was why she was having pain
at that site.
But I'm pleased.
I don't want you to worry,
and I'm gonna tell her the same thing.
It's not the easy part of what we do.
I'm really trying to do
the right thing. I really am.
We're in agreement to do a recruit.
It's just fucking torture.
Anything is radioactive with that guy.
If you don't do exactly what he wants,
he literally goes of the fricking handle.
There's more important things in life
to worry about.
So I just said, "Screw it."
You take this the wrong way,
and you turn this into some sort
of competitive stealing attendings?
Give me a break.
Just want to make the place
the best it can be
and be a voice of reason
in our healthcare system
and do the right thing
so we're all strong.
But I got you.
I have an idea. I'll solve it.
I'm taking full responsibility for it.
No worries.
I'm not going to get pissed off.
It's all going to be okay.
All right, buddy. Take it easy. Bye.
You know what? The hardest part of my job,
by far
As hard as this is
It's just dealing with just.
The behavior of people.
We're doctors.
Phyllis?
Hi.
How are you?
You're in the recovery room.
Everything went beautifully.
So I don't have cancer?
Well, that's what I want to talk to you
a little about.
Oh.
There's a little bit.
I found a little bit under the scalp.
Okay?
I told your husband
that we're going to have to get
a PET scan.
And just to make sure
it's not other places.
When I saw it,
I took the whole bone off.
I lifted up the lining of the brain.
I looked on the brain.
The brain looked perfect.
Okay? So
surgery was successful.
Look, I'm glad we did this.
It was very important.
Okay?
All right.
- I'll see you tomorrow.
- Okay. Thank you.
- Okay?
- Yes.
All right. Get some rest tonight.
"Surgeon booked
for our assistant is Wagner.
INDICATIONS: Patient is an approximately
74-year-old female
with a history
of both breast cancer and lung cancer."
You never know what you're
going to get with brain surgery.
You can't predict
what you'll face with each case.
Neurosurgery's a whole world
yet to be explored,
and you know what?
You can't assume anything.
"Between the scalp and the skull
And was extubated by Doctor Kim."
Thank you. Bye.
There's science here, not assumptions.
And as a surgeon and a researcher,
I have to bring my best every day
and every night.
And anything less than that is
just unacceptable
to me, to my patients,
and to their families.
Hopefully, I won't
see you anymore tonight.
Shawna, how is it going?
I took my daughter to the protest.
I was trying to explain to her it,
but not really say,
"It's about breaking up families."
Yeah.
But this is the trauma
that minority children experience,
because parts of their childhood
are affected by things like this,
things that you constantly
have to deal with.
- So she was like
- Yeah.
Today when I was going to work,
she was like, "Don't go, Mama. Don't go!"
I was like
- We shouldn't be laughing, but
- Am I a horrible mom?
- You're coming back. No.
- Yeah. No, that's what I said.
Then I heard something. People were like,
"This is not America,"
and then I read something else like,
"This is America."
We do have a tradition of separating
the parent. Slavery, obviously.
Very upsetting.
Civil rights was not that long ago.
So true.
Well, nonetheless, had her second protest.
What was her first protest?
Like, around the inauguration.
- Women's Rights?
- Yeah.
- Did she go to that one?
- Yeah.
Good. I told you
I want to raise a city child.
My dream is for my child to run
the streets of New York wild.
- Yeah.
- But, you know, Kevin.
Yeah.
He's like, "No, thanks. No, thanks."
I think it's amazing.
These kids are so bold.
I like how they just interact
with everybody.
- That's true.
- They are not afraid of the world.
- I feel like they're just very aware.
- Yeah.
I have so many notes to write right now.
Yeah, it was nice.
- Aw.
- Maybe you broke your water.
Maybe you did break your water.
Yeah. You broke your water.
- Do you feel
- Just touch, dear.
Relax your leg open. Great.
Going through
medical school, you can become jaded.
And going through residency,
you can become jaded.
I think it's primarily
because you're just so tired.
But I think
there's such a thing as a calling.
That means you're
nine centimeters dilated.
Yeah, so you came in labor
on your own. Yeah.
Almost ready.
We need a table.
She's nine. She broke her own water.
I want to work with populations
who maybe medicine has
traditionally neglected.
And women fall under that, frankly.
We often deliver in isolation.
Many women have not witnessed
births of their sisters,
of their aunts, of cousins.
And it's kind of a loss for women.
There's no easy path to giving birth,
and I feel like I just want
to recognize their discomfort,
normalize it for them,
and help them push through it.
This is the space I'm supposed to be in.
Okay, this baby's coming.
Hi, Mama.
I saw you're going to go swim.
- Yeah.
- I wish I was with you.
But we'll swim before you know it.
We'll be back camping and swimming.
We'll be back in the river
before you know it.
So, we're still hanging out
in the hospital right now,
waiting for her to do her procedure.
They hadn't started yet.
So we've been here all morning.
- 3:15 went to 6:15, to 7:15, to
- It's okay.
Hi.
Good. How are you?
I'm in the middle of two cases. Long day.
I'm going to try to pull chains
and twist arms. It's really not easy.
So you'll wait for me for dinner?
Promise?
Yeah, I know. Okay.
Love you.
- We good to go?
- Yeah.
Okay, I'm going to let you go.
You got all your stuff.
I'm going to print out
your paperwork right now.
- Thank you so much.
- How you feeling?
- Better.
- Better?
Yes, because I can do this
and not feel pain.
- I'm gonna verify your information, okay?
- Sure.
Because I definitely
want to see you tomorrow.
- It's a date, Doc.
- It's a date?
- We're having a date?
- Take me out dancing.
Don't they pay?
Mirna Kean?
They evicted her from her apartment.
Oh, no. Why did she get
kicked out of her apartment?
Her partner died.
Hi, Mrs. Kane.
I'm gonna to find you a room.
As soon as a room opens up,
I'm gonna try to get you
- May I get some more ginger ale?
- Sure.
I need to hydrate.
Sure.
She'll have to go to a shelter.
That's if she wants to go.
She may not want to go to a shelter.
- I feel bad for her.
- Hmm.
That's rough.
I don't think she can go
to the shelter system.
- I mean, she has to be willing.
- I mean, she
- If she was homeless, I don't
- Basically, she's homeless.
I don't know how she would
survive that way, on the street.
I don't think she would do very well.
I feel bad for her.
So why don't we get you
You want to go to the room now or what?
As soon as you can do it,
I'd appreciate it.
Okay. And in the room, then you and I
will have a conversation, okay?
- About what's going on.
- I haven't got much to say, but
- All right.
- Okay.
There's a patient, she takes
It takes some time.
You can only call her Miss Kean.
Okay. She's one of our
We've known her
since we opened this facility.
A lot of these people
don't have a place to go.
Some of these people don't have anybody.
Like, nobody. At all.
And I don't know why,
You know? I don't know how they got here.
I like to ask them,
"Who are your family members?
Who are your significant others?
What happened to you before you got here?"
So you have to come here
with a really open mind.
And you live with your mom?
And an understanding
of how these people are feeling,
what is it they need.
What you can do for them.
Love you. And always.
- I'm ready. Kisses.
- I love you.
I love you too.
I'm going to be right beside you.
See you in a little bit.
- Okay.
- Bye.
ACT, 257.
257, that's good.
Catheterize the aneurysm.
The pressure really is
intense sometimes.
It's a lot of juggling,
being a surgeon and a chair,
but it's the humanity of your own patient
that matters.
It weighs on you.
Everything has to be incredibly precise.
You cannot fuck it up. You just can't.
Advance, advance, advance.
- No, you're not there yet. Now.
- Now.
Nephron's in.
Nephron's in. Thank you.
Everything we all do here, all of us,
it's ultimately for the patient.
It's ultimately for them.
Lift up. All right, let's go, uh
six for
six for ten.
Do we have an ACT?
It gives me great pride.
It gives me great validation.
I really love it.
That looks great.
Happy?
Very happy. Are you?
Yeah.
Mitzie.
Hi.
Can you tell me your name?
Mitzie.
Mitzie, how old are you?
How old?
How old are you, Mitzie?
Forty-two.
Okay. Good. Okay.
You can come on out.
Everything went fine.
- It went good?
- Yeah. So we closed the artery.
She seems good. She's doing
everything she's supposed to do.
Of course.
- Thank you so much, my friend.
- All right. Okay. Hang in there.
- All right.
- Thank you.
- Okay. We'll do a good job for her.
- Step one done.
- All right.
- Two more steps.
Yep.
That's normal.
Tell me more about this
You're feeling scared.
What are you feeling?
Is it about the act of delivery?
Delivery.
And what about delivery specifically?
I'm just scared.
Like, that you'll bleed, or that you'll
If I'm doing it right.
You're doing it right.
You're already following your body.
Everything's fine. You came in in labor,
you went to fully dilated on your own.
You broke your water on your own.
You're going to be awesome. Okay?
Honestly.
- I don't feel awesome.
- But you are awesome.
You are awesome.
A new beginning!
This is great right now.
- Okay. Come on, girl.
- What are you feeling right now?
This is what you were made to do,
and you are doing it so well already.
- I'll take the oxygen, please.
- Yeah.
- I feel like she just had a contraction.
- Mm-hmm.
- You felt it, and you let it pass.
- Yeah.
Okay, we want to use it, next one.
- I'm sorry.
- That's okay.
You can push with that. So you're going
to pull your legs back toward yourself,
nice, deep breath,
and bear down
like you're having a bowel movement.
Totally.
- Okay, let's use it.
- Big pull.
Yes. Okay, same as we just talked about.
Pull those legs back toward you.
Ooh! Ow!
Push. Let it out.
Deep breath in.
Deep breath in, and curl, and push.
- Deep breath in and push down.
- Go.
All the way down. One, two, three,
- four, five, six, seven
- Keep pushing.
Eight, nine, ten. Let the air out.
Okay. Let it go.
Relax. That's excellent.
Good. Everything's fine.
Everything's fine.
Nice deep breaths in between contractions.
Dad, I'm going to make you oxygen man,
so in between you're going to be
responsible for giving her the oxygen.
Okay, good.
The first few pushes,
it takes a while to get in the rhythm.
But your baby's right there, actually.
We can see the hair.
- Good job.
- Push down.
Yes.
Good. Extra! Extra! Extra! Extra!
- Yes, yes, yes!
- Yes!
- Harder. Keep it going. Go.
- Can you give me a push, Mom?
Push.
- Extra! Bring those legs
- Legs up. Legs all the way up.
- Keep going.
- Okay.
- I can't breathe.
- There you go.
It's okay. Push. You got it.
Look down.
Hi. Happy birthday!
Yes! You did great!
Hello.
Hello!
- Hi, Papa.
- Are you okay with 30 seconds?
- What's up, baby?
- He did cry.
Dad, are you going to cut?
- Yeah.
- Okay, you have the scissors?
Right here, in between those two.
- Right here?
- Perfect.
- There you go.
- You can give them to me.
- Just going to take him over quickly.
- The other way.
Yep, thank you.
You did that!
Are you okay?
Michael's here.
- Is that his name?
- Michael.
Happy birthday, Michael.
- Is he okay?
- Yeah, he's fine.
Yeah, he's great.
You don't hear his lungs? He is fine.
- Yeah, he's doing great.
- He is great.
He's great, Mother. He's great.
- Catch him. It's okay.
- Thank you.
Look at him.
Look at him!
Hi.
Look at little feets.
- Yeah.
- Okay.
Look at him.
Hi, babers.
Look at him.
Shaking is normal after delivery.
It's the extra release of hormones, okay?
You did so well.
Hi, Michael.
Happy birthday.
The Upper East Side
s like this iconic place in New York City,
in the world, really, where, you know,
think of this Madison Avenue
and Park Avenue.
All the things that are going on outside,
and the fact you're doing this stuff
right here, in the middle,
in that building when you walk in,
and the stuff that's going on in there,
you just walk outside, and you're
right back in the regular world.
I just left the hospital.
Okay. You going to go home?
Okay. I'm going to go home.
Okay.
Bye.
THE PRODUCERS CARE DEEPLY
ABOUT THE SAFETY AND PRIVACY
OF ALL INVOLVED WITH THIS PROGRAM.
ALL PATIENTS APPEARING IN THE PROGRAM
HAVE PROVIDED CONSENT TO PARTICIPATE
AND TO DISCLOSE THEIR HEALTH INFORMATION.
A NETFLIX ORIGINAL DOCUMENTARY SERIES
A YULARI FILMS PROUCTION
EXECUTIVE PRODUCERS RUTHIE SHATZ
ADI BARASH JOSH BRAUN
DIRECTED BY
ADI BARASH, RUTHIE SHATZ
There they are.
Give me a squeeze, Hannah.
Give me a left-hand squeeze.
Squeeze your left hand.
Squeeze your left hand, sweetie?
Hey, Hannah, open your eyes, sweetie.
Open your eyes.
Can you open your eyes?
Hannah.
Can you wiggle your toes?
Can you open your eyes?
She's there.
She's starting to come around.
- She'll be fine.
- Hannah.
We're gonna move you over to another bed.
Just get her upstairs.
I'll tell the family everything's fine.
LENOX HILL
Okay. Yes, of course. Is she fully, or no?
I don't know.
She just walked into the room
- and said she might have to go back.
- Yes, I hope she's fully.
Moisa went into room five or six.
Okay.
Harder, harder, harder.
Harder, harder, harder, harder, harder.
Oh, shoot.
Cough.
Push! Push! Good job! Yay!
- Look down!
- Look down. Open your eyes.
- Open your eyes.
- Look down! Open your eyes.
- Twelve o'clock!
- Oh, my God!
Beautiful. Dad,
do you want to cut the cord?
- Yes.
- Beautiful.
Here you go.
Good job. Good job.
Happy birthday. Congratulations.
Here, Mama, just open your gown with her.
Okay. Hi.
- Hi.
- Hi.
- Do you have a name for her?
- Aria.
She is so sweet.
- I don't think we have tears.
- That was so fast.
Too precious.
Thank you so much.
That was You did everything.
I literally did nothing.
Hi.
When can I try
Oh, now.
- Yeah?
- Yeah, go ahead.
Lenox Hill Hospital, historically,
was a glorified community hospital.
It was an old lady's hospital.
But it was also known
for its outstanding cardiac services,
orthopedics, and obstetrics.
People came to be born here and die here.
It was a sleepy little Upper East Side
hospital with no neurosurgery
competing with some of the greatest
health institutions in the world.
So when Northwell bought
Lenox Hill Hospital in 2010,
the year I was recruited,
I definitely was thinking about
trying to start a department,
and getting a group of people around me
that I knew over the years,
and convinced them to join the team
and build something together.
DAVID LANGER, MD
CHAIR, NEUROSURGERY
I underestimated what that meant.
David Langer.
The equipment was old.
No one knew how to take care
of a neurosurgery patient.
They didn't know
what a neurological deficit looked like.
So we had to start from zero.
I took way more risk than I ever should,
and we still have a ways to go.
Yeah. Did Miss Hannah Deoul
Did Miss Deoul come up yet?
Yes, she did.
On the way up,
there were things that happened here
that would have been avoidable
in a place that was fully running,
and it was incentive.
Hey, Hannah.
How you feeling? You there?
Now we're saving people
that never would have been saved.
It's all done, okay?
The lack of legacy,
the nothingness of this place
Move this left foot.
Is what allowed it
to become everything.
Everything went great.
Luckily for me,
I had the balls to take
the first dive
and make some good decisions.
Okay? I got the whole thing out.
But it's not just me.
It's the whole group.
Our focus and our heart
and our collaborative culture is
what won the day.
That kind of special chemistry is
what allowed us to be able to compete
against the biggest
neurosurgery departments in the city,
and in the world.
We've created something pretty amazing,
and I'm very protective of it.
Do I have anybody else here?
- Langer's patients are okay?
- They're good, yeah.
John's coming here was
This was even crazier Like,
He left Cornell.
Who the fuck leaves Cornell
to come to Lenox Hill to start from zero?
John's a real name.
Why would he do that?
He wanted to try something unique.
He's sort of as romantic as I am, I think.
Breast cancer in 1990.
Liver mass, breast,
and then primary lung also?
Phyllis, this won't take me long.
Show me the bump.
JOHN BOOCKVAR, MD
VC, NEUROSURGERY
There's a bump there,
and it it radiates.
Ah!
- Sorry.
- That's okay.
- You got radiation here?
- I did.
- Yes, you did?
- Yes, that's why my hair fell out.
Well, your hair looks great,
so that's why I was asking.
PHYLLIS, 74
- All right, so
- Yes?
We're doing
scalp exploration,
intersection of mass
I love when it said on the form
that I originally
- That it said "hardware removal."
- Yeah.
Okay, you've signed
a lot of forms this morning.
Welcome to the bureaucracy.
So can I get the screw
and the plate to make
Let's see what we find,
but you can
- call and request it.
- And fight with them?
That's my initials.
Oh, good.
So we're going to go in
and open her scalp.
Um, I did a brain surgery on her
for metastasis to the brain,
which she's doing terrific from.
She had radiation,
and has been disease-free,
for over a year.
Interestingly, about three weeks ago,
she developed,
um, real pain in the scalp area,
And so in a patient
who's had a history of cancer,
we worry about metastasis.
Or in a patient that's had
a history of surgery, we worry about
something in the fixation system
of the skull
back onto the
her natural skull.
And that may be a plate that's come loose
or is irritating the scalp.
So it's my job to figure it out.
- For sure.
- For sure.
- Okay.
- And, either way, it comes out.
Okay?
Keep our fingers crossed
that it's not cancer, and you're home.
- I get nice staples in my head?
- You get staples in your head
- and good drugs when you wake up.
- Great.
- Okay. I'll see you inside.
- Thank you.
Nothing to worry about.
I don't even dare to imagine
what I'm going to encounter
on any given day
when I arrive at work.
In neurosurgery, in research,
there's just so many anomalies.
I mean, constant surprises,
that I must always, you know, keep
Literally, an open mind.
All right.
Time to get focused.
LENOX EMERGENCY ROOM GREENWICH VILLAGE
- Stop
- Take it easy, Bobby.
- Bob?
- Bobecito.
- Bobecito.
- Bob.
Call the medical examiner
on that body.
Oh, boy.
- Can we send it off?
- Sure.
Just she wants to go home.
Mohammed?
All right, I'm Dr. Macri.
So, what brought you
to the emergency room today?
I mean, so, um, Saturday,
I'd been experiencing some pain, right?
And, uh, like, around Saturday night
MOHAMMED
I thought it was
I asked my sister-in-law to check it out.
She said it's an ingrown hair.
It started to grow bigger.
Started to worry me.
I'm going to put on some gloves,
put on a mask, we'll take a look.
Uh, I have to put some lidocaine
on the skin
so that you can tolerate the procedure.
- Okay.
- All right. Very good.
So I'm going to put on a mask.
Hopefully, depending on the look of it,
we won't have to do much.
Well, I actually
took a peek in the bathroom,
- and it's not that quite big.
- Okay, good.
So, what we're going to do is
gonna have you lay on your belly. Okay.
Let me take a look, yes?
Oh, I see.
You're going to feel some burning.
And I'm going to inject
all around the area.
So, it's going to feel tender
and it's gonna be painful.
- Okay?
- I'll bear the pain.
You'll bear okay.
Well, you tell me to stop.
We'll go slow, yes?
- Mm, sure.
- Okay.
One, two, three.
- Okay?
- Oh, mother fucker!
See that? It's okay.
- So I'll tell you
- Stop, stop, stop.
- Okay?
- You need to chill. Oh, my God,
- I'm gonna give you a break.
- I'm trying not to swear.
That's okay. Just be
I'll tell you,
it popped on itself already.
So that's a good sign.
Okay?
- Okay, you ready?
- No.
Tell me when. Take five seconds.
Concentrate on your breathing, okay?
- You're doing great.
- Fuck!
Almost finished.
Okay.
That's it.
- You're welcome.
- Okay. We'll stay like this
for a moment, and I'll check on you
in ten minutes, okay?
- Okay.
- All right.
Uh, if you need anything, just get me.
Hi!
- Hi.
- Mr. Slomowitz?
- Yeah.
- Yeah. Hi.
How are you doing?
- I fell this afternoon.
- I see.
And landed nose-first on the sidewalk.
And, uh, I live with my parents,
and my mother
got concerned that
it might become infected.
- Sure.
- She said
People become doctors,
whatever they become, I think
it comes from a through childhood.
How old are you now?
- Oh, God.
- Sixty-five. How old are your parents?
- Ninety-four and ninety-two
- Oh.
- So you all live together?
- Yeah.
I think your childhood, your upbringing,
what you observe as a young adult,
all goes into molding
what you're going to become.
And from a very early age,
I learned compassion, I learned sympathy.
No blood. That's good.
I grew up feeling,
"Oh, why is this person hurt?"
or "Why is this person feeling this way?"
No pain? Okay, good.
To me, the ER is the front line.
We take whoever
whatever.
If you're uninsured,
if you're insured, if you're a criminal.
Anything you are, we put it to the side,
and we just treat you.
It's a collage
of people that come in.
And that's what I love about this field.
It's overwhelming at times, but, um
I've come to embrace
that empathy and compassion
for people being ill and needing help.
Growing up,
there was a very strong emphasis
on doing what you can to help others
and doing things in a selfless manner.
So it's kind of like,
"What form will that take for my life?"
Both my parents were nurses
in the military,
so there definitely was that bias
toward being in medicine in general.
When you go through medical school,
this is the specialty
they tell you not to do.
The hours are so long,
you're always on call,
because you've nights and weekends.
I'll do that. I'm here today,
I'm working. I'm not going home, so
But I pretty much didn't like any rotation
except OBGYN.
My four years as a resident have been
a very long road.
I mean, you are sacrificing
your 20s and 30s.
Hello. Good morning.
So it's a big commitment.
- Okay.
- I'll be right back.
- Do you want to go in?
- Yeah.
Okay.
- Have you been tired?
- I think I have been tired,
but I've also been working a lot.
Aw, Amanda.
It's going to be all right.
There's the baby.
Nice and strong. Here's the yolk sac.
So you're about seven weeks and one day.
KEVIN
Looks like a
And there the baby is again.
Amazing.
So, at this point,
- everything seems to be okay?
- Yep. Yep.
Wow, that's crazy.
I'm having a kid.
- Here you go.
- Thank you.
You're welcome.
And I'll be right back.
Apparently, we should take
pictures of this with our phone.
We did it, yo. We made this.
- I can see you.
- Just gotta make it all the way.
This is the first grandchild
for my parents.
So everybody's really excited.
- When do we get to know the sex of it?
- Remember, we're not going to know
until we deliver.
I don't know. We have to talk about that.
- It's
- Oh, really? Okay, let's talk.
I would like to know
kind of beforehand, you know?
- I don't like these surprises
- Mmm.
Necessarily.
Um
We'll see.
There's not
that many genuine surprises in life.
And
Well, my cousin, that's what he did.
And it's amazing, I think.
So, well, that's like a contention point.
So we'll work it out.
- Congratulations.
- Thank you.
Mmm.
Yay.
- Thank you.
- Everything looks great.
- How do you feel?
- I feel good. I just feel bloated.
That's it. I haven't had nausea
or vomiting. I just
This looks great.
It measures five days bigger.
- Okay.
- But we wouldn't change the dates.
- Okay.
- Same 3-31 due date.
- Thank you.
- Yay. Best of luck.
- Thank you.
- All right.
I'll probably tell people at 12 weeks.
I'm still trying to keep it hidden.
I won't be back until 8:00 p.m., probably.
Okay.
I'm hoping
that I'll be able to have a full 24 off
and come back Wednesday morning, but
I may have to come back Tuesday morning,
so we'll see.
Okay.
- So, we're pregnant.
- We are pregnant.
And it's good.
- Thank you, Kim, so much.
- Take care.
- Have a good day.
- All right.
My dad was a cardiologist
at UPenn,
and when he walked around the hospital,
he always used to do this.
And I do the same thing.
I didn't even realize it.
My brother said,
"Dave, you do just what dad did."
There's no question I became a doctor
because of him. Yeah, there's no question.
To have a little bit
of him in me is a good thing.
He had a heart attack when he was 42
and died when he was 45.
His stroke was what got me interested
in neuroscience to begin with.
And
I came home on Friday, December 13th,
in 1985.
That's how I remember it.
And he, uh
was too tired to come meet me
at the airport.
And so I went to see him
to say good night, and he was, like, fine.
About an hour later or so,
my mom screamed,
"Your dad's on the floor."
Then I found him on the floor.
You could tell he was having a stroke.
It was totally painful, to be honest.
Really bad. See? I'm doing it again.
To some people,
it's a 9:00 to 5:00 job.
It's a shift. It's a chore.
To me, my job is not a job.
It's my life.
It's about loving to operate,
and loving to do good cases,
and ultimately loving to help people.
All right. Be Daddy.
- I can't.
- You have to. Yes, you have to.
I need you to do this for me.
- Okay?
- Heavenly Father,
please stay with my sister
and make sure you keep her safe
We have a case today.
The patient's a 41-year-old
female police officer from Tennessee.
It's going to be okay.
MITZIE & TONY.
- It's going to be all right.
- I love y'all.
Love you.
Mitzie arrived to us
after living with this tumor
in her skull base and neck
for about ten years.
At the end of the day,
no one near her was
really willing to operate on her.
It was just too difficult.
What she has here is
a big tumor in her neck.
All this white thing is the tumor.
This is the carotid artery
going right through it.
That's the carotid artery right there.
This extends all the way up.
It goes all the way up to the skull base.
It extends into the brain case.
The problem is,
we don't think we can take it out safely
without sacrificing the carotid artery.
And even if we get into it,
it could bleed.
So, we'd rather control the whole thing
ahead of time, before we access the tumor.
In her case, the vast majority
of the blood supply that's coming
It's making up for that carotid,
is actually in the neck also,
the external carotid artery.
And that has to go, too.
So, we're gonna do it in stages.
What we'll do is, we'll we're gonna
close her internal carotid today.
Then we may decide to take
the external carotid down tomorrow.
And then there are all these
other decisions have to be made about
other aspects of the surgery
that are all really important.
That's why having guys like Ortiz here,
and me
And together, um, we're able
to really consider all the options,
and really do all the things necessary
to keep these people safe.
But these are risky operations.
No question about it, you know.
And you live and die for them.
Hi there.
We meet again.
We're going to close the artery
using coils, and a little device.
It's like a little umbrella,
uh, that decreases the blood flow
in the artery.
And, remember, we're doing this
in preparation for the bypass,
because if Dr. Langer does
the bypass tomorrow without this,
uh, the bypass isn't going to work.
We think you'll be fine.
The biggest risk is the other vessel.
You really need two.
And that's gonna give your brain
the blood it needs temporarily.
But by the time we take that one,
the bypass will be out and take over
all the blood flow that you need.
You know, hopefully.
What happens if we get in here
and this isn't working?
You could have a stroke.
You know, that that's the risk.
Tomorrow's a bigger deal.
And look, we're here with you
the whole time. We're not gonna leave you.
And if there's a problem,
we'll attack it and fix it
if it has to be done.
It doesn't mean it's going to be easy.
It could be a little tough,
some tough moments.
You have a great family.
If you trust me,
and you trust us, then we're good.
Because then we can do everything we can.
- Let's see what my wife is up to.
- Hello?
- How's it going? Are you free?
- Nope.
Do you not know
that I go to the dump every morning?
I literally go every morning.
I drop the kids at school,
and then I go to the dump
to drop the compost.
So, that's weird.
It's really fucking stupid.
And I was like,
"Daphne, you're not doing this.
You're too young.
And it looks trashy."
Wait, so what did she get?
She got a second in the right ear
and a third in the left ear?
Yes.
Like me. Like what I have.
But I did it when I was 17.
She goes, "Yeah, but someone put
a pin through your ear."
I'm like, "Yes, that's how I did it."
Wait, did you really do that?
- Yeah.
- I mean, with what? You sterilize it?
And you just pop
Yeah, we lit it on fire, and then
I pierced my ears.
Did you bleed?
Was there any infection risk?
- We didn't bleed back then.
- Exactly. These kids are
- They're wusses.
- We bleed now
when everyone gets a participation award.
Huh. I'm in this paper.
I'm in this journal.
Whatever. And then we're hosting
a jillion people on Sunday.
Oh, shit.
We've got Steph and Jared,
Phyllis and Walter
- Oh.
- Diane and Howard,
Michael and Rachel, my parents, your mom.
We got a shit ton of people coming.
Well, now I know why
you're in an aggravated mood.
And I have my period.
And that too.
Larry.
Hi, it's Dr. Macri.
Hello, darling.
Show me your face today.
What's going on?
Larry.
Wake up.
You cannot choose what comes at you here.
A place where you can't judge people.
Larry, where is your house?
- Where are you living now?
- On the street.
Okay.
And you're not staying in the shelter?
Okay. How long have you been
sleeping on the street now?
- Six months.
- Six months? All right.
You have to have a little flexibility
with what these people are going through.
Up, up, up.
And be a neutral buffer
for them and their problems.
So, it's not just medicine.
And they don't teach this stuff to you
in med school.
You don't read a text book on how to deal
with someone's social situation
or their problems.
You have to just use the best tools
that you have from inside and say,
"I can help you."
I'll just close this
for a moment. All right.
I am going to put on a gown, actually.
Because sometimes these are full of pus,
and they just explode.
- So you ready?
- Yes.
All right.
So do you smoke, Mohammed?
- Cigarettes?
- Mm-hmm.
- Yes.
- And no drugs?
Mmm
Marijuana.
- Marijuana? Okay.
- Yeah.
Always marijuana,
or have you had any other drugs?
Okay, um
You ever heard of, uh freebase?
Uh-huh.
- Sometimes not all the time.
- Okay.
Because since you're my doctor.
Uh, you put a little in the marijuana
and just smoke it.
- Okay.
- It's not crack cocaine. It's, uh
Uh-huh.
It's cocaine, but it's just yeah.
- You put it in the marijuana.
- Yeah.
Okay.
When's the last time you did that?
Mmm
- This weekend.
- So sometimes, yes?
Mm-hmm.
Have you had
any unprotected intercourse recently?
- Mm-hmm.
- Okay.
All right. You ready?
Don't move.
You can scream, but don't move.
- Mother
- Okay.
We're finished. I lanced it already.
Sorry.
So.
Almost finished, okay?
Mm-hmm.
I can't take a picture,
because I have gloves on.
So, listen, if you have to move
your bowels tonight, be very careful,
because you're going to have
a piece of gauze here, okay?
Yeah, but what if that
accidentally comes out?
- It shouldn't.
- Okay, good.
It shouldn't, unless you're
No, trust me, I don't think
I'm going to be back there.
You're gonna go out
dancing tonight, or what?
- No.
- Okay. Then it should.
[Mohammed, Oh, my goodness.
That is incredible.
So you go home and you rest, okay?
- That wasn't too bad, right?
- No, it was like Disney World.
Gentlemen, ladies, you ready to roll?
Yes, sir.
You guys look like a, um,
college version of, like,
Scrubs or something.
Pants are tucked in.
Shirts are tucked in.
Nothing loose.
Check yourself in the mirror and make sure
your hair's covered, ears are covered.
Good morning, everybody. Big D.
- The Donald.
- What's up?
Good job with North Korea this morning.
Hey, you're about to see
what greatness is all about.
Students, come in here,
don't touch anything blue.
Okay, this is Phyllis Landa,
and my left is her right.
We're going in
after this mass on her scalp.
Everyone take a moment,
confirm on the right side, say, "Aye."
- Aye. Right side.
- Say yeah.
- Yeah.
- Janey, she needs an antibiotic.
- Yes.
- No Decadron.
No mannitol, no Keppra.
Let's take a moment to be mindful. Okay.
Let's do a mindful moment.
Everyone relax, close your eyes,
wiggle your toes inside your orange shoes,
if you're wearing orange.
Roll your shoulders back,
close your eyes
take a moment, be here in the present.
Take a deep breath in,
hold it at the top,
exhale.
Deep breath in.
Exhale. Let's roll.
Woo-hoo.
Where's our bump?
What is this?
- Is this the part that's irritating her?
- It looks like a tumor, right?
Question is,
is this mass a cancer or not?
No, it's not.
Can you guys see it on the TV monitor?
There you can see our plate.
Suction to my left.
Thank you.
Shit, man.
Phyllis.
It does not look good.
Let's get a knife.
I hope to God this is just inflammation.
Guys, come here.
You see? This looks like cancer.
You can see this is normal scar tissue.
This is what I was hoping we'd find.
This looks like cancer.
It's purple
and it's bloody.
Hopefully it's just reactive, but
Phyllis, Phyllis, Phyllis.
How big's the tumor?
Yeah.
Let's go to pathology
and look at it frozen. Okay?
I'll be right back.
Fuck.
The pathology team.
Hi.
Hi.
Well, this is a woman who's 70-something.
One with scar tissue, and then,
one looked like cancer.
Take a look.
Dr. Krauss.
Hello, Doctor.
Another cancer specialist
doing frozen specimens.
What are you looking at?
- Big lymph node.
- This is all cancer, right?
It's all cancer.
So what are you going to do?
You stop, or you keep going?
No, we're gonna take it out
Always good to have
the courage of your convictions.
Hey, Rima.
Thanks for everything.
Do you look at the schedule?
- I always look at the schedule.
- Just to see how many rooms
- you're running.
- We're running a lot of rooms.
We're doing what we're supposed to do,
to bring patients and take care of them.
That's what we want to do, we're trained
to do, we're incentivized to do.
However, we continue to push the envelope.
Every time we reach a critical mass,
then we grow again.
- So, we're on the right path?
- I completely agree yes
- You feel we are on the right path?
- Absolutely on the right path.
- Growth hurts.
- They have to understand
that we have to be comparable
to New York hospitals.
I I I will do everything I can.
- I hear you.
- Yeah. Recruits for you.
I get it.
So I can recruit you back?
I am here.
- I am here. You feel my support.
- I know.
- I would never turn away.
- I know.
Really, this is my passion, but
I know. I get it.
So, I'll do
You know I do everything I can.
That's what I needed to say.
I gotcha.
- Okay.
- Okay. Thank you.
Did I show you this something
that was really cute today?
No.
- Dancing.
- Who is that baby?
That's his cousin.
Why do you get a good pregnancy?
You know
- Life
- She was waiting to
- Finishing schooling.
- Fine.
- Can I finish schooling? Is that okay?
- Fine.
- You're going to Cali, right?
- Yeah
You leaving too?
- Why you guys use us like that?
- I know. I'm sorry
You come, you stay here,
make us like you, all kind of thing
- Aw.
- And then you just leave.
Don't speak for all of us.
- No.
- You really leaving?
I'm probably leaving. Because Kevin,
his job is in California, pretty much.
You know, he came here for me
when I matched here.
- So now, it's my turn to give back.
- How sweet.
You leaving when?
- By the end of the year?
- Yeah.
- But, as I said, I'm not long here too.
- Where are you going? You retiring?
Yeah.
Oh, so we can retire
and graduate together.
So,
so, it's a piece
of soft tissue infiltrated
by high-grade neoplastic cells.
This could easily be a
neuroendocrine component.
She had also large cell
and small cell in her tumor.
Right.
Yeah, so this is surprising.
She's gonna be unhappy.
Because she thinks
it's just a plate that's being removed,
and it's a piece of cancer
that sort of popped up, and, uh
has stuck there on the scalp, so
All right, good work.
Thank you.
Oh, it's raining.
The heavens have opened.
It's amazing how, for such a busy city,
how still it looks, right?
- Fuckity fuck, fuck.
- What is the tumor?
It's adenocarcinoma.
I'm surprised. I just thought
it was going to be her plate.
It's her original tumor.
So I've got to call the husband.
Tell him that we found cancer.
Hi, Saul. It's Dr. Boockvar. How are you?
Everything went fine. Phyllis is fine.
No problems with surgery.
We found some evidence
of a previous cancer, though,
in the scalp.
And we're going to have to deal with this.
It wasn't big.
It was about the size of a dime
okay?
But it was right under the scalp.
That was why she was having pain
at that site.
But I'm pleased.
I don't want you to worry,
and I'm gonna tell her the same thing.
It's not the easy part of what we do.
I'm really trying to do
the right thing. I really am.
We're in agreement to do a recruit.
It's just fucking torture.
Anything is radioactive with that guy.
If you don't do exactly what he wants,
he literally goes of the fricking handle.
There's more important things in life
to worry about.
So I just said, "Screw it."
You take this the wrong way,
and you turn this into some sort
of competitive stealing attendings?
Give me a break.
Just want to make the place
the best it can be
and be a voice of reason
in our healthcare system
and do the right thing
so we're all strong.
But I got you.
I have an idea. I'll solve it.
I'm taking full responsibility for it.
No worries.
I'm not going to get pissed off.
It's all going to be okay.
All right, buddy. Take it easy. Bye.
You know what? The hardest part of my job,
by far
As hard as this is
It's just dealing with just.
The behavior of people.
We're doctors.
Phyllis?
Hi.
How are you?
You're in the recovery room.
Everything went beautifully.
So I don't have cancer?
Well, that's what I want to talk to you
a little about.
Oh.
There's a little bit.
I found a little bit under the scalp.
Okay?
I told your husband
that we're going to have to get
a PET scan.
And just to make sure
it's not other places.
When I saw it,
I took the whole bone off.
I lifted up the lining of the brain.
I looked on the brain.
The brain looked perfect.
Okay? So
surgery was successful.
Look, I'm glad we did this.
It was very important.
Okay?
All right.
- I'll see you tomorrow.
- Okay. Thank you.
- Okay?
- Yes.
All right. Get some rest tonight.
"Surgeon booked
for our assistant is Wagner.
INDICATIONS: Patient is an approximately
74-year-old female
with a history
of both breast cancer and lung cancer."
You never know what you're
going to get with brain surgery.
You can't predict
what you'll face with each case.
Neurosurgery's a whole world
yet to be explored,
and you know what?
You can't assume anything.
"Between the scalp and the skull
And was extubated by Doctor Kim."
Thank you. Bye.
There's science here, not assumptions.
And as a surgeon and a researcher,
I have to bring my best every day
and every night.
And anything less than that is
just unacceptable
to me, to my patients,
and to their families.
Hopefully, I won't
see you anymore tonight.
Shawna, how is it going?
I took my daughter to the protest.
I was trying to explain to her it,
but not really say,
"It's about breaking up families."
Yeah.
But this is the trauma
that minority children experience,
because parts of their childhood
are affected by things like this,
things that you constantly
have to deal with.
- So she was like
- Yeah.
Today when I was going to work,
she was like, "Don't go, Mama. Don't go!"
I was like
- We shouldn't be laughing, but
- Am I a horrible mom?
- You're coming back. No.
- Yeah. No, that's what I said.
Then I heard something. People were like,
"This is not America,"
and then I read something else like,
"This is America."
We do have a tradition of separating
the parent. Slavery, obviously.
Very upsetting.
Civil rights was not that long ago.
So true.
Well, nonetheless, had her second protest.
What was her first protest?
Like, around the inauguration.
- Women's Rights?
- Yeah.
- Did she go to that one?
- Yeah.
Good. I told you
I want to raise a city child.
My dream is for my child to run
the streets of New York wild.
- Yeah.
- But, you know, Kevin.
Yeah.
He's like, "No, thanks. No, thanks."
I think it's amazing.
These kids are so bold.
I like how they just interact
with everybody.
- That's true.
- They are not afraid of the world.
- I feel like they're just very aware.
- Yeah.
I have so many notes to write right now.
Yeah, it was nice.
- Aw.
- Maybe you broke your water.
Maybe you did break your water.
Yeah. You broke your water.
- Do you feel
- Just touch, dear.
Relax your leg open. Great.
Going through
medical school, you can become jaded.
And going through residency,
you can become jaded.
I think it's primarily
because you're just so tired.
But I think
there's such a thing as a calling.
That means you're
nine centimeters dilated.
Yeah, so you came in labor
on your own. Yeah.
Almost ready.
We need a table.
She's nine. She broke her own water.
I want to work with populations
who maybe medicine has
traditionally neglected.
And women fall under that, frankly.
We often deliver in isolation.
Many women have not witnessed
births of their sisters,
of their aunts, of cousins.
And it's kind of a loss for women.
There's no easy path to giving birth,
and I feel like I just want
to recognize their discomfort,
normalize it for them,
and help them push through it.
This is the space I'm supposed to be in.
Okay, this baby's coming.
Hi, Mama.
I saw you're going to go swim.
- Yeah.
- I wish I was with you.
But we'll swim before you know it.
We'll be back camping and swimming.
We'll be back in the river
before you know it.
So, we're still hanging out
in the hospital right now,
waiting for her to do her procedure.
They hadn't started yet.
So we've been here all morning.
- 3:15 went to 6:15, to 7:15, to
- It's okay.
Hi.
Good. How are you?
I'm in the middle of two cases. Long day.
I'm going to try to pull chains
and twist arms. It's really not easy.
So you'll wait for me for dinner?
Promise?
Yeah, I know. Okay.
Love you.
- We good to go?
- Yeah.
Okay, I'm going to let you go.
You got all your stuff.
I'm going to print out
your paperwork right now.
- Thank you so much.
- How you feeling?
- Better.
- Better?
Yes, because I can do this
and not feel pain.
- I'm gonna verify your information, okay?
- Sure.
Because I definitely
want to see you tomorrow.
- It's a date, Doc.
- It's a date?
- We're having a date?
- Take me out dancing.
Don't they pay?
Mirna Kean?
They evicted her from her apartment.
Oh, no. Why did she get
kicked out of her apartment?
Her partner died.
Hi, Mrs. Kane.
I'm gonna to find you a room.
As soon as a room opens up,
I'm gonna try to get you
- May I get some more ginger ale?
- Sure.
I need to hydrate.
Sure.
She'll have to go to a shelter.
That's if she wants to go.
She may not want to go to a shelter.
- I feel bad for her.
- Hmm.
That's rough.
I don't think she can go
to the shelter system.
- I mean, she has to be willing.
- I mean, she
- If she was homeless, I don't
- Basically, she's homeless.
I don't know how she would
survive that way, on the street.
I don't think she would do very well.
I feel bad for her.
So why don't we get you
You want to go to the room now or what?
As soon as you can do it,
I'd appreciate it.
Okay. And in the room, then you and I
will have a conversation, okay?
- About what's going on.
- I haven't got much to say, but
- All right.
- Okay.
There's a patient, she takes
It takes some time.
You can only call her Miss Kean.
Okay. She's one of our
We've known her
since we opened this facility.
A lot of these people
don't have a place to go.
Some of these people don't have anybody.
Like, nobody. At all.
And I don't know why,
You know? I don't know how they got here.
I like to ask them,
"Who are your family members?
Who are your significant others?
What happened to you before you got here?"
So you have to come here
with a really open mind.
And you live with your mom?
And an understanding
of how these people are feeling,
what is it they need.
What you can do for them.
Love you. And always.
- I'm ready. Kisses.
- I love you.
I love you too.
I'm going to be right beside you.
See you in a little bit.
- Okay.
- Bye.
ACT, 257.
257, that's good.
Catheterize the aneurysm.
The pressure really is
intense sometimes.
It's a lot of juggling,
being a surgeon and a chair,
but it's the humanity of your own patient
that matters.
It weighs on you.
Everything has to be incredibly precise.
You cannot fuck it up. You just can't.
Advance, advance, advance.
- No, you're not there yet. Now.
- Now.
Nephron's in.
Nephron's in. Thank you.
Everything we all do here, all of us,
it's ultimately for the patient.
It's ultimately for them.
Lift up. All right, let's go, uh
six for
six for ten.
Do we have an ACT?
It gives me great pride.
It gives me great validation.
I really love it.
That looks great.
Happy?
Very happy. Are you?
Yeah.
Mitzie.
Hi.
Can you tell me your name?
Mitzie.
Mitzie, how old are you?
How old?
How old are you, Mitzie?
Forty-two.
Okay. Good. Okay.
You can come on out.
Everything went fine.
- It went good?
- Yeah. So we closed the artery.
She seems good. She's doing
everything she's supposed to do.
Of course.
- Thank you so much, my friend.
- All right. Okay. Hang in there.
- All right.
- Thank you.
- Okay. We'll do a good job for her.
- Step one done.
- All right.
- Two more steps.
Yep.
That's normal.
Tell me more about this
You're feeling scared.
What are you feeling?
Is it about the act of delivery?
Delivery.
And what about delivery specifically?
I'm just scared.
Like, that you'll bleed, or that you'll
If I'm doing it right.
You're doing it right.
You're already following your body.
Everything's fine. You came in in labor,
you went to fully dilated on your own.
You broke your water on your own.
You're going to be awesome. Okay?
Honestly.
- I don't feel awesome.
- But you are awesome.
You are awesome.
A new beginning!
This is great right now.
- Okay. Come on, girl.
- What are you feeling right now?
This is what you were made to do,
and you are doing it so well already.
- I'll take the oxygen, please.
- Yeah.
- I feel like she just had a contraction.
- Mm-hmm.
- You felt it, and you let it pass.
- Yeah.
Okay, we want to use it, next one.
- I'm sorry.
- That's okay.
You can push with that. So you're going
to pull your legs back toward yourself,
nice, deep breath,
and bear down
like you're having a bowel movement.
Totally.
- Okay, let's use it.
- Big pull.
Yes. Okay, same as we just talked about.
Pull those legs back toward you.
Ooh! Ow!
Push. Let it out.
Deep breath in.
Deep breath in, and curl, and push.
- Deep breath in and push down.
- Go.
All the way down. One, two, three,
- four, five, six, seven
- Keep pushing.
Eight, nine, ten. Let the air out.
Okay. Let it go.
Relax. That's excellent.
Good. Everything's fine.
Everything's fine.
Nice deep breaths in between contractions.
Dad, I'm going to make you oxygen man,
so in between you're going to be
responsible for giving her the oxygen.
Okay, good.
The first few pushes,
it takes a while to get in the rhythm.
But your baby's right there, actually.
We can see the hair.
- Good job.
- Push down.
Yes.
Good. Extra! Extra! Extra! Extra!
- Yes, yes, yes!
- Yes!
- Harder. Keep it going. Go.
- Can you give me a push, Mom?
Push.
- Extra! Bring those legs
- Legs up. Legs all the way up.
- Keep going.
- Okay.
- I can't breathe.
- There you go.
It's okay. Push. You got it.
Look down.
Hi. Happy birthday!
Yes! You did great!
Hello.
Hello!
- Hi, Papa.
- Are you okay with 30 seconds?
- What's up, baby?
- He did cry.
Dad, are you going to cut?
- Yeah.
- Okay, you have the scissors?
Right here, in between those two.
- Right here?
- Perfect.
- There you go.
- You can give them to me.
- Just going to take him over quickly.
- The other way.
Yep, thank you.
You did that!
Are you okay?
Michael's here.
- Is that his name?
- Michael.
Happy birthday, Michael.
- Is he okay?
- Yeah, he's fine.
Yeah, he's great.
You don't hear his lungs? He is fine.
- Yeah, he's doing great.
- He is great.
He's great, Mother. He's great.
- Catch him. It's okay.
- Thank you.
Look at him.
Look at him!
Hi.
Look at little feets.
- Yeah.
- Okay.
Look at him.
Hi, babers.
Look at him.
Shaking is normal after delivery.
It's the extra release of hormones, okay?
You did so well.
Hi, Michael.
Happy birthday.
The Upper East Side
s like this iconic place in New York City,
in the world, really, where, you know,
think of this Madison Avenue
and Park Avenue.
All the things that are going on outside,
and the fact you're doing this stuff
right here, in the middle,
in that building when you walk in,
and the stuff that's going on in there,
you just walk outside, and you're
right back in the regular world.
I just left the hospital.
Okay. You going to go home?
Okay. I'm going to go home.
Okay.
Bye.