Transplant (2020) s01e08 Episode Script
Birth and Rebirth
- I wanna scrub in.
- We don't need you up here.
- You're a trauma surgeon, June.
- Without an effective treatment, he'll die before she gets to know him.
You're solving a problem, Dr.
Leblanc, that he may not want you to solve.
I don't understand.
I caught up with rent last month - I'm sorry, Bashir.
- I have two bedrooms.
It's a lot.
I want to help, I want this to work.
I know he's excited about retiring.
I want to help him get ready for that, I do.
But I'm still working here now, alright? For a few more months, anyways.
So Can you just talk to him for me? Yeah.
Amira? Everything alright? My brother's not back? No.
He's still at work.
Is it okay if I wait for him? Yeah.
Of course.
How was Amira this morning? Tired.
Sorry if she worried you last night.
Grace wakes up like that sometimes after a nightmare.
She's been displaced so many times.
You're there for her, that's all that matters.
I had to leave Lenny on the side of the road.
- Who's Lenny? - That's her car.
You have a car named Lenny? Yes.
And he's got, like, a cracked engine block, and he needs a new transmission That's probably more than the car costs.
I bought that car when I was 17 years old with my own money.
He's got me through university, med school, and an entire leg of Sleater-Kinney's reunion tour Hey.
Excuse me.
- Are you a doctor? - Yeah, how can I help? You should've helped me when you had the chance! - Security! - Back off! - Get off me! - Hey, hey, hey! - We got this.
We got this.
- Get off me! Are you okay? Here.
Take this.
I know I'm late, sir.
Won't happen again.
Actually, you're right on time.
No, it's just Theo this morning, I was Why did you choose emergency medicine, Dr.
Leblanc? I know for a fact you could've had your pick of residencies.
- Why this one? - Uh Because in Emerg, you can't just be good at one thing.
You gotta be the best at everything.
And are you? Well, I I definitely have things to work on.
But Do you know what the minimum expectation of patients treated per shift is? - Twenty.
- And What do you think your average is? - Less.
- Fifteen.
You're saying I need to move faster.
I can do that.
I'm saying there's a reason you don't.
You spend too much time per case.
Your patient histories are more comprehensive than any other resident.
Well, isn't that why I catch as much as I do? You catch too much.
You actively look for problems to solve.
What we do here is present tense.
The drive-through instead of fine dining.
We treat what they came for.
We admit them if they need it, cut them loose if they don't.
You've never raised this before Well, now that you're reaching the end of your second year, it's a good time to correct any bad habits before they become a pattern.
Which is why you're going to be evaluated today, by me.
Who do we have waiting this morning, Claire? Uh, we gotta head lac, we've got an ankle sprain, and a senior with a fever.
I'll start with the fever.
Here you go! Mm.
What I wouldn't give for a large cup of coffee.
Uh, Doctor? Uh, doctor? - Hamed.
- Hamed.
Javier.
Um My wife Maria, she's got this flu.
Javy, mi amor.
I know, I'm just explaining.
Um, and We just wanted to make sure there isn't anything we should be doing.
We're headed up to OB, so no need to bother the doctor.
No, it's not a problem, They'll listen to the baby and probably ask you to take it easy for a couple of days.
- Okay.
Thank you.
- You're welcome.
And ask to check out that rash.
Thank you.
Thanks.
Yeah, it's broken.
Hey, thanks for coming to my rescue.
Did they find out who the guy was? Supposedly he was waiting for a doctor, and I guess he got tired of waiting.
And just needed someone to take it out on? The way you jumped in, uh Guessing you've had to do that kind of thing before? Doesn't mean you get used to it.
Well, I've never been in a fight.
I wouldn't exactly call that a fight.
A stranger came out of nowhere and punched you in the face.
- That's - Twice.
And I didn't do anything to try to stop him.
I just froze.
Hey, I can I can cover your patients if you want to go home.
I don't have to leave.
Well, if you just want to take a break for an hour.
No, I'm good.
Thanks, Bash.
Thanks for the coffee.
Your surgical attending has you transcribing charts? Sutures, cyst drainage, foreign body removal, more sutures.
If he's in a really good mood, I get to suction.
They call it paying your dues.
So I've been told.
I know Singh's work takes precedence over anything you pick up down here, but if you get a second, I have a woman in curtain four with a runny nose.
Don't tell me she needs suction Actually, it's a bit of a mystery.
Been going on three years.
No signs of infection.
Okay, Mrs.
Willis.
Well, based on what I can see here, I think it's just a flu.
So, I'm gonna put you in an IV to rehydrate you, and give you acetaminophen for the fever.
I worried when the dizzy spells got worse.
The dizzy spells, you didn't, you didn't mention that to triage.
Oh, that nurse was so busy, I didn't want to bother.
No, that's no bother.
How long has that been going on? A few weeks.
My doctor says it's a neural thing? Mm And are you diabetic? - Mm-hmm.
- Okay.
Is it possible he called it peripheral neuropathy? Um That sounds right.
I I wrote the name down.
- But I - Well, if it's neuropathy, an inhibitor may not be the best course of action I'm gonna do some tests, okay? Okay, thank you.
Of course.
Excuse me, are you a doctor? - Back off! - We got this! We got this! Are you okay? Mrs.
Rawana? Hi, I'm Dr.
Curtis.
I hear you have quite the runny nose.
I didn't want to come in, but my daughter made me after it started getting worse.
Take a breath.
Sit up.
It's getting worse? I'm used to getting up with a wet pillow.
The last few days it's been more like a pond than a puddle.
Mm.
Okay, and you've spoken to your family doctor about this? She says I have bad allergies, and sent me to an ear, nose and throat doctor who said the same thing.
They put me on this medication.
Diphenhydramine.
It makes me drowsy.
What's the point in feeling that way if it's not even helping? Well, I'm gonna have a look, okay? Can you open your mouth? Is your family from the Caribbean? Jamaica, but my parents met here.
I was born in Trinidad.
My husband, too.
Your parents must be so proud of you.
Beautiful black woman.
Big city doctor.
No pain? Anyway I'm sure you tell them the same thing our daughter tells us.
Be proud, be supportive, but do it from the sidelines.
How long have you had that bump on your collarbone? Is it something I should be concerned about? Not necessarily, but I'll I'll have a closer look.
Can I get a CT and labs on Mrs.
Willis? Mrs.
Willis, that's the elderly lady with the flu? Yeah, she's having dizzy spells.
We need to call her GP for a history.
I won't let it slow me down.
How's doctor Hunter today? He's had better mornings.
Doctor Hamed? Hey, is everything okay? OB is very busy today.
They said they could see us, but not for a while.
Maria's very tired, I just want her to be seen.
We were wondering if you could check her and the baby out? No problem.
Follow me.
Blood pressure's normal.
You must be getting excited.
Over the moon.
- How many weeks? - Thirty-one.
And tell me about your symptoms.
We spent the weekend at a friend's cottage up north.
I started to feel nauseous on the car ride back.
- And this was yesterday? - Uh-huh.
I thought it was car sickness, but this morning I had a fever.
And then we started to worry that the baby wasn't moving as much, but um, we couldn't be sure, so Let's take a look.
Sorry, I know it's a little cold.
That sound's good, right? Yes.
Very good.
Do you know the gender of the baby? - Because I think I can tell.
- No spoilers! Sorry, we've just waited this long, and we want to go the distance.
I completely understand.
Well, everything seems normal, baby seems healthy, blood pressure is good, so you can sit up.
But there is one more thing I should look at.
Um, how long have you had that rash on your arm? I scraped myself on the dock at the cottage, climbing down to the water to go for a swim.
- Any pain? - A bit.
But I bruise easily.
That's all it is, right? Uh, we just need to make sure.
I need to make an incision, prep the Lidocaine.
Are, are you worried about something? If there's an infection, we just need to know how to manage it.
It's okay.
- Hi.
- Hi, love.
- Do you feel anything? - No.
- You may want to look away.
- Oh, he's the squeamish one.
I have other skills.
Ah.
Okay.
Oh.
What is that? Is there a problem? Hey.
Are you okay? I was gonna ask you the same thing.
Bishop's putting me through the wringer today.
What's wrong? I'm a waiting on rush labs.
I have a 31 weeks pregnant woman who seems to have a very serious infection.
31 weeks? Why is she not in OB? They were swamped, so the couple came to me directly.
You know, I'd offer to help, but I'm just I'm trying to stay focused because Don't worry about it.
What kind of infection? - Dr.
Bishop? - Yeah, what is it? I've got a 36-year-old woman, 31 weeks pregnant and presenting with flesh-eating bacteria.
I have never seen necrotizing fasciitis in a pregnant woman.
Neither have I.
Have you treated this infection before? No sir, but I have seen numerous cases of gangrene.
Then you know we have to move fast.
You've started her on antibiotics? 600 milligrams of IV Clinda and 2 grams of IV Ancef.
She's already on fluids.
How'd she contract it? She scraped herself on a dock.
- And the baby? - Fetal heart rate's normal.
Sepsis from infection can cause stillbirth or miscarriage.
Well, it's presenting on her upper arm, just above the elbow, so hopefully we can control it and limit spread.
We'll do an MRI, see if that's the case.
And then what, Dr.
Hamed? Assuming it hasn't spread, what are her options? Uh, radical debridement.
But that means putting her under.
Extremely risky for a pregnant woman.
The only other option is amputation, and she'll need a general anaesthetic either way.
Well, the decision has to be the patient's ultimately.
I'll reach out to infectious diseases, start a dialogue with a surgeon.
I'll talk to Maria.
Are Are you talking about cutting off my arm? If you choose this option, yes.
And this other option, debridement? - It means I get to keep it? - Yes.
But you have to understand, amputation increases the likelihood that we get everything.
Debridement means cutting out only the infected tissue, but the risk of the bacteria spreading are higher.
I should have never gone for that swim.
- Maria, don't say that.
- No, Javier, you can't.
The infection is dangerous and aggressive.
Am I not already exposed? Let's hope not.
And we cannot take that chance.
And these antibiotics, are you sure they won't harm our baby? Your baby is safe for now.
The best predictor of the baby doing well is you doing well.
Which means we need to decide.
How is this happening now? We've tried for so long for this baby! That's all we've thought about for years! A surgeon is coming to talk to you shortly.
But any delay will put your life and your baby's life in danger.
- This is crazy.
We need time - Debridement.
I want the debridement.
No, M-Maria, I want to hold our child in my arms.
Rock my baby to sleep.
Annette Rawana, 55-years-old, persistent runny nose.
If you look really closely, you can actually see the hole in her dura.
There.
Yeah.
Turns out cerebrospinal fluid has been leaking from her brain into her sinuses.
She's seen her GP multiple times about this, even an ENT who thought it was mucus.
But it's not.
It's brain fluid.
Is this a genetic malformation of the dura? Nope.
I found a small deformity on her collarbone.
It's not the cause of the leak, but it is a clue.
So turns out three years ago, she had a minor fall.
Yeah.
She was at the park with her grandson, fractures her clavicle.
The bone didn't heal properly.
Not uncommon in a patient over 50.
But There was a small basal skull fracture that they missed at the time, resulting in a dural defect.
It's been asymptomatic until now.
If you hadn't caught this, she would have had severe seizures, or even meningitis.
Tom, check this out.
Three-year runny nose.
Total mystery.
ENT thought it was mucus.
Wow, you can barely see the hole on the scan.
Nice catch.
I'll put it on the neuro-board, and book an OR.
Oh come on, he said nice catch.
That's a good look for a doctor.
Just so you know, the police are charging the gentleman.
Turns out he has a history of anger problems.
- Is it broken? - I'm fine.
Ah.
We take assault against our staff very seriously.
Even if they are only here temporarily.
I noticed you hadn't submitted or the full-time pediatrics position.
Applications are open for two more weeks.
Wife didn't go for it, huh? Thank you.
Figured it's more of an in-person conversation next time I was home.
Smart man.
These things never work out unless you're both same page.
How do you feel today, Eva? - Okay.
- That's good.
Eva was diagnosed with epilepsy a few months ago.
We've been learning to manage the seizures but this morning she wasn't herself, then started throwing up.
We weren't sure if it was related to the epilepsy.
Is purple your favourite colour, Eva? - Mm-hmm.
- Yeah? My daughter's favourite is pink sparkly rainbow.
Okay.
It's good.
What happened to your nose? To my nose? Uh I told a lie, so it grew like Pinocchio's.
You're worried you might've missed a seizure? Maybe while she was asleep.
She doesn't wear the helmet at night If she hit her head, a concussion would explain the nausea.
I keep a detailed journal of all her seizures, and she's never had one in her sleep before.
Couldn't the vomiting be related to the flu? It's possible, but she isn't running a fever.
Eva, do you remember bumping your head last night? - Mm-mm.
- No? Okay, I'm gonna take a look while you play with that.
There you go.
Okay.
Well, I don't see any evidence of head injury, but we'll run some tests to get a sense of whether or not these symptoms have anything to do with epilepsy.
This is all so new for us.
Well, we have a great social workers here, if you need support while you're adjusting to it all.
Our church family's been amazing.
Sending meals, offering rides.
They've really shown up for us.
Well, a strong community can make a lot of difference.
My Dad's a pastor in Sudbury.
I go every Sunday when I'm home.
You mentioned testing.
What kind, exactly? A CT and an EEG.
But it won't hurt, we're just gonna take a picture of your brain.
What are the chances the pastor's son is our doctor? A nurse will be by to get you when it's time, okay? I'm gonna get that off your hands, okay? Thank you very much.
Why haven't I seen the C results for Mrs.
Willis? - She hasn't been.
- Why not? Because she doesn't need it.
Sir, she has peripheral neuropathy and I just wanted to find the cause I read her chart.
She came in with flu.
That doesn't require a CAT scan.
Her GP has her on an SSRI instead of treating the nerve pain.
Well, maybe there's a very good reason for that.
Maybe they tried antiseizure drugs for her neuropathic pain and they didn't work No, I called for a history.
They haven't.
- I can help her.
- You have helped her.
You treated her dehydration and fever.
Now you send her back to her primary care physician, and you help someone else.
That's the system.
I'm on track for my twenty patients.
Have you caught up on your charts? Have you even take a lunch? The extra time you spend digging in, it has to come from somewhere.
I don't mind sacrificing lunch if it means I can help a patient solve a problem.
This job's about balance, doctor.
See everything, solve what's necessary.
I wouldn't push her if I didn't think she could handle it.
I didn't say anything.
Hey, how was your lunch with your son the other day? Brief.
- Hi.
- Hey.
Where are you? Home.
You mean the old apartment? If you know where I am, why are you asking? The building manager saw you.
Did you Did you go back to see Daneesha? No.
Amira, you can't just go roaming around the city.
I need to know where you are and where you're going.
I didn't mean to! I just got on the bus without thinking.
It's not a big deal, okay? Okay.
Okay.
We only just got used to it here.
It's the first place that felt like home since we left Mama and Baba's.
I know it's hard, Habibti, but we have to keep moving forward.
Mm? Can you get to Theo's on your own? Yes.
I'll be fine.
I'll see you later, okay? Okay.
Are you okay? We tried to conceive for two years.
Three failed rounds of in-vitro.
I took a night job, Maria took extra freelance work, and Every single time a cycle didn't work, and she would get the news, and it destroyed her.
And then, and then it worked.
We're gonna have a baby.
And now all I can think is, is it all worth it? Hey, it will be.
Okay? As soon as she's done, we'll get her into an MRI to make sure the bacteria hasn't spread.
Thank you.
Really? Well, if you're sure that's all I can do, then fine.
- Who died? - Lenny.
My car.
He would need a new engine.
Maybe it's time for an upgrade.
Something awesome, like a Mustang.
I don't want a Mustang, I want Lenny.
I hear Singh and Duncan figured out what was going on - with your patient's runny nose? - Something like that.
Play the long game, Dr.
Curtis.
Suck it up and be excellent.
When the dust settles, you'll be miles beyond them.
What was that about? Some unsolicited career advice from a woman who hasn't exactly cracked the glass ceiling.
That's not fair, she's an attending.
Maybe she's right where she wants to be.
Oh yeah? Stuck as Bishop's second? He's not exactly easy to please.
I'm not interested in pleasing anyone.
- I know, I know.
- And I don't need her advice.
Alright, alright.
Alright? Everything that I have in my life, - I got - on my own, I know.
You know, on my own.
I'm just saying, maybe, you know, she's legitimately trying to help you.
Yeah? Like Bishop's trying to help you? He's saying I over-diagnose.
He's got me doubting my whole approach.
Don't let them get in your head, Mags.
How did you manage this? Stupidity, mostly.
Casualties from my last night of freedom.
Getting married, or going to jail? - Work, actually.
- Mm.
I fly back to the tar sands tonight - for a three-month stint.
- Hmm.
And this is how you celebrate? Let's just say, when you launch yourself off the back of the truck to catch a football, best to watch for the tailgate.
Let me guess, there was a little bit of alcohol involved? Tell me this isn't gonna make me miss my flight.
If I don't go tonight, I'll miss the whole week.
Hold this for me.
Well, you'll need stitches, and a tetanus shot.
Do you have any other pain? Just the hangover.
Any neck pain? No.
So, three months, That's a pretty long stint.
You like working in bursts like that? Easier to focus if it's all in.
Then when I'm off, I can actually relax.
Hmm.
And you can do that? Just shut off and relax? Yeah it's like, as soon as I get off the plane, see my friends, my dog, and it's like a switch flips.
Move your jaw for me.
Alright.
I'll get you started on an IV.
Is that necessary? If you don't want to feel like crap when you're flying, yes.
I'll come back in a few minutes to suture that gash, and then we'll get you out of here.
Thanks, doc.
What happened? She threw up again, then her eyes started rolling back in her head! - Heart rate's 210.
- Another seizure? 2.
5 megs of adenosine.
Prepare to cardiovert.
25 Joules, synchronized.
It isn't working.
Okay, charging.
- Shock advised.
- Everybody clear? Shocking.
Come on baby, wake up.
Why isn't she moving? What else can you do? Okay.
Raising to 50, shocking again.
Charging.
Everybody clear! - Shock advised.
- Shocking.
Oh, thank God.
Hi, Eva.
Do you know where you are? I threw up.
If there's one place you're allowed to throw up, that's the hospital.
- What happened to her? - She's gonna be fine.
We're gonna need to run more tests but it looks like Eva had an episode of supraventricular tachycardia.
It's when the heart suddenly starts beating too fast.
Is that part of her epilepsy? It is a common side effect, and likely explains the symptoms from this morning.
Could this be a one-time thing? Unfortunately, SVT isn't normally isolated.
So you should be prepared for this to happen from time to time.
Does that mean she now has to deal with seizures, and a heart problem? Do we have to bring her back here every time it happens? No.
There are interventions to help with episodes at home.
Hey.
We're gonna get through this.
We're only given as much as we can handle, right? Yeah.
What interventions? Someone needs to teach us what to do.
Mama, I'm thirsty.
You wanted to see me, sir? Yeah.
Our pregnant patient Mm-hmm.
Radiology sent her results directly to me.
The debridement didn't stop the bacteria from spreading.
There's infected tissue deeper in the shoulder.
Which means amputation is no longer an option.
We need to get her back in for another debridement immediately or she'll go into septic shock.
They knew the risks.
All we can do now is deal with what's in front of us.
Sir, the baby might not withstand a second debridement.
And if the infection spreads to the uterus and fetus, then miscarriage and stillbirth are very real possibilities.
We need to move fast, and we're out of conservative options, which leaves us with A C-section.
Get the baby out safely, and then right into another debridement.
- She's 31 weeks? - Yes.
Viable.
Maybe not for the mother.
Delaying debridement for a caesarean poses a major risk.
Her inflammatory response could trigger multiple organ failure.
If we don't deliver, the baby won't make it.
Save the baby or save the mother.
Save both.
But they need to pick who goes first.
- I'll call OB.
- No, we can't send her upstairs.
It's protocol not to let an infection like nec fasc anywhere near that ward.
I'll arrange for an OR.
Sir, I've debrided necrotic tissue before We'll let the surgeons handle it.
- I was a trauma surgeon.
- I'm aware of that Dr.
Hamed, but you are not one now.
You're an emergency resident here.
These parents have sacrificed so much for their baby.
I need to make sure they're around to raise it.
That's what you've been doing all day.
Stay with the husband during the procedure.
He'll need someone to walk him through what's happening.
If they thought they had a tough choice earlier No.
- Javier - No.
He's asking us to choose between your life and the baby's.
We can't do that.
- I can't do that.
- Not choose, Javier.
Just prioritize.
Save the baby.
Maria, but wait Listen Save the baby.
Maria.
Let's talk about this.
Okay? I can't lose this baby, Javier.
I won't.
You know what this means to me.
Okay Maria, but you could die.
I love this baby.
It's already a part of me, and I need to protect it.
I need you to be strong, and there for our baby either way.
And I need to hear you say it.
I need you to promise me.
Of course.
Of course I will.
I promise.
I love you.
Do the C-section, Dr.
Hamed.
We'll get ready.
One more thing before I go? Am I having a girl, or am I having a boy? You'll see for yourself when you wake up.
Has cardiology been by to see you yet? They taught me about vagal maneuvers she can do to slow her heart down, and when to know if she needs to be brought in.
It might not be forever.
Some kids do outgrow their seizures.
If you're asking me to wait for a miracle, that's Luke's department.
He's in the chapel now.
Oh.
I can sit with her if you'd like to go join him.
I pray too, Dr.
Hunter.
But I do it with my eyes wide open.
And I only ask for the courage to be strong enough for Eva, to give my daughter what she needs.
She's lucky to have you.
And I'm lucky to have her.
Promise me you'll keep this clean, and you'll get a doctor to get the clips out.
You're a lifesaver.
- You feeling okay? - Yeah.
Just dry mouth.
I'll grab some water on my way out.
I think we should take your temperature.
I swear doc, I'm fine.
Still probably, you know maybe just a little hungover.
- Okay.
Okay.
- What?! Take this.
Sit down.
Sit back down.
What, uh What's happening? Alright.
Take this off.
Lie down.
It's gonna be cold.
Pleural effusion.
You've got water on your lungs.
What? Why? My guess would be pulmonary embolism.
When you injured your leg, a blood clot formed and travelled to your lungs.
You're gonna need to start anti-coagulants immediately.
I'm I'm gonna be okay? Well, we caught it early, which is good, but you're definitely not gonna make that flight.
I'll be right back.
What? Our obstetrician will deliver the baby with the help of our general surgeon.
There's a team from NICU on standby.
Once they get the baby out, the general surgeon will debride the remaining infected tissue.
Let's get moving.
We're already on borrowed time.
Making the first incision.
And into the fascia.
Scissors.
Thank you.
Suction.
One, two, three, stretch.
Lower end.
Lower end out, retract her out.
I've got the baby's head.
Give me pressure.
Give me pressure! Again! Baby's flat, let's be quick.
Looks like a uterine artery has been clipped.
I'm on it.
Nice work, doctor.
Stay close.
There's not much time.
Come on, let's go.
I'll start bagging.
Get the monitors up.
Chest is moving.
Turn the O2 to 100.
What? Wait, what's wrong? What's happening? The baby's premature.
There are added steps to be taken.
The heart rate's 47.
Prepare to intubate.
What, the baby's not breathing? The heart rate's too low.
They're working to bring it up.
Starting compressions.
Oh, my God.
Pause compressions.
We're good.
Let's get the baby to NICU.
Heart rate's stable.
What the What about the alarms? What's he looking at? What's happening to Maria? She, um She's in respiratory distress and septic shock.
But Javier, I promise you, our surgeons will do whatever they can.
Go to NICU.
Your baby's not out of the woods yet.
There could be choices to be made.
What about Maria? There's nothing you can do for Maria right now.
I know you want to be in two places at once, but you can't.
I'll stay with Maria.
And as soon as there's news of any kind, I'll come get you.
Go see your baby, Javier.
I heard you caught a pulmonary embolism.
- I noti - Nice work.
I noticed him coughing, and I should've investigated it sooner, but All I could hear was your voice in my head.
Telling you what? That I'm That I'm focusing on all the wrong things.
That's your voice, Mags.
Not mine.
This job is all I've ever wanted.
Then find the way to be the doctor I need you to be.
Good night, Dr.
Leblanc.
Maria? She's going to be okay.
It's a beautiful baby.
Dr.
Curtis.
Have you ever wanted to just burn it all down? Instead of sucking it up? All the time.
Have you? Ever? Once or twice.
Was it worth it? The only one who got burned was me.
Well, I I mean, anytime you have a patient for me, I'm interested.
So I'll keep that in mind.
It looks like we stopped the infection.
Your latest MRI was clear.
You are so brave.
You're so strong.
The baby? Baby? I took a video - of our little girl.
- A little girl? She looks just like her papa.
She's four pounds, three ounces, but she's a fighter, like her mom.
I was looking for you.
Listen, I may have been a little short with you today.
Not punching back, Theo, that's nothing to be ashamed of.
I've never punched back.
Not in any part of my life.
Amira went home today.
Our old apartment, without even knowing where she was going.
You know, she's been through so much, and, uh I don't know what I'm doing.
None of us do.
Long road ahead for that family.
And all so that, in 18 years time, the kid can resent them, and they can wonder if everything they went through today was worth it.
Jed.
Is that really how you feel? No.
What happened to getting me something small? I changed my mind.
We both deserve it.
Did you know that you were born with a full head of hair? And you worried just like that when you were little, too.
I'm sorry I lost my temper with you today.
I'm so proud of how you're handling everything that we're going through.
Mama used to get mad at me for playing with my hair.
Said it would all fall out and I would go bald.
She started braiding it so I would stop I could braid for you, too? Mama said braids were way harder than stitches.
I keep dreaming about her.
- Are they good dreams? - Most of them.
Why don't you like it when I talk about Mama and Baba? Is that what you think? No.
No.
Yella.
Time for class.
- You'll wait? - I'm not going anywhere.
- We don't need you up here.
- You're a trauma surgeon, June.
- Without an effective treatment, he'll die before she gets to know him.
You're solving a problem, Dr.
Leblanc, that he may not want you to solve.
I don't understand.
I caught up with rent last month - I'm sorry, Bashir.
- I have two bedrooms.
It's a lot.
I want to help, I want this to work.
I know he's excited about retiring.
I want to help him get ready for that, I do.
But I'm still working here now, alright? For a few more months, anyways.
So Can you just talk to him for me? Yeah.
Amira? Everything alright? My brother's not back? No.
He's still at work.
Is it okay if I wait for him? Yeah.
Of course.
How was Amira this morning? Tired.
Sorry if she worried you last night.
Grace wakes up like that sometimes after a nightmare.
She's been displaced so many times.
You're there for her, that's all that matters.
I had to leave Lenny on the side of the road.
- Who's Lenny? - That's her car.
You have a car named Lenny? Yes.
And he's got, like, a cracked engine block, and he needs a new transmission That's probably more than the car costs.
I bought that car when I was 17 years old with my own money.
He's got me through university, med school, and an entire leg of Sleater-Kinney's reunion tour Hey.
Excuse me.
- Are you a doctor? - Yeah, how can I help? You should've helped me when you had the chance! - Security! - Back off! - Get off me! - Hey, hey, hey! - We got this.
We got this.
- Get off me! Are you okay? Here.
Take this.
I know I'm late, sir.
Won't happen again.
Actually, you're right on time.
No, it's just Theo this morning, I was Why did you choose emergency medicine, Dr.
Leblanc? I know for a fact you could've had your pick of residencies.
- Why this one? - Uh Because in Emerg, you can't just be good at one thing.
You gotta be the best at everything.
And are you? Well, I I definitely have things to work on.
But Do you know what the minimum expectation of patients treated per shift is? - Twenty.
- And What do you think your average is? - Less.
- Fifteen.
You're saying I need to move faster.
I can do that.
I'm saying there's a reason you don't.
You spend too much time per case.
Your patient histories are more comprehensive than any other resident.
Well, isn't that why I catch as much as I do? You catch too much.
You actively look for problems to solve.
What we do here is present tense.
The drive-through instead of fine dining.
We treat what they came for.
We admit them if they need it, cut them loose if they don't.
You've never raised this before Well, now that you're reaching the end of your second year, it's a good time to correct any bad habits before they become a pattern.
Which is why you're going to be evaluated today, by me.
Who do we have waiting this morning, Claire? Uh, we gotta head lac, we've got an ankle sprain, and a senior with a fever.
I'll start with the fever.
Here you go! Mm.
What I wouldn't give for a large cup of coffee.
Uh, Doctor? Uh, doctor? - Hamed.
- Hamed.
Javier.
Um My wife Maria, she's got this flu.
Javy, mi amor.
I know, I'm just explaining.
Um, and We just wanted to make sure there isn't anything we should be doing.
We're headed up to OB, so no need to bother the doctor.
No, it's not a problem, They'll listen to the baby and probably ask you to take it easy for a couple of days.
- Okay.
Thank you.
- You're welcome.
And ask to check out that rash.
Thank you.
Thanks.
Yeah, it's broken.
Hey, thanks for coming to my rescue.
Did they find out who the guy was? Supposedly he was waiting for a doctor, and I guess he got tired of waiting.
And just needed someone to take it out on? The way you jumped in, uh Guessing you've had to do that kind of thing before? Doesn't mean you get used to it.
Well, I've never been in a fight.
I wouldn't exactly call that a fight.
A stranger came out of nowhere and punched you in the face.
- That's - Twice.
And I didn't do anything to try to stop him.
I just froze.
Hey, I can I can cover your patients if you want to go home.
I don't have to leave.
Well, if you just want to take a break for an hour.
No, I'm good.
Thanks, Bash.
Thanks for the coffee.
Your surgical attending has you transcribing charts? Sutures, cyst drainage, foreign body removal, more sutures.
If he's in a really good mood, I get to suction.
They call it paying your dues.
So I've been told.
I know Singh's work takes precedence over anything you pick up down here, but if you get a second, I have a woman in curtain four with a runny nose.
Don't tell me she needs suction Actually, it's a bit of a mystery.
Been going on three years.
No signs of infection.
Okay, Mrs.
Willis.
Well, based on what I can see here, I think it's just a flu.
So, I'm gonna put you in an IV to rehydrate you, and give you acetaminophen for the fever.
I worried when the dizzy spells got worse.
The dizzy spells, you didn't, you didn't mention that to triage.
Oh, that nurse was so busy, I didn't want to bother.
No, that's no bother.
How long has that been going on? A few weeks.
My doctor says it's a neural thing? Mm And are you diabetic? - Mm-hmm.
- Okay.
Is it possible he called it peripheral neuropathy? Um That sounds right.
I I wrote the name down.
- But I - Well, if it's neuropathy, an inhibitor may not be the best course of action I'm gonna do some tests, okay? Okay, thank you.
Of course.
Excuse me, are you a doctor? - Back off! - We got this! We got this! Are you okay? Mrs.
Rawana? Hi, I'm Dr.
Curtis.
I hear you have quite the runny nose.
I didn't want to come in, but my daughter made me after it started getting worse.
Take a breath.
Sit up.
It's getting worse? I'm used to getting up with a wet pillow.
The last few days it's been more like a pond than a puddle.
Mm.
Okay, and you've spoken to your family doctor about this? She says I have bad allergies, and sent me to an ear, nose and throat doctor who said the same thing.
They put me on this medication.
Diphenhydramine.
It makes me drowsy.
What's the point in feeling that way if it's not even helping? Well, I'm gonna have a look, okay? Can you open your mouth? Is your family from the Caribbean? Jamaica, but my parents met here.
I was born in Trinidad.
My husband, too.
Your parents must be so proud of you.
Beautiful black woman.
Big city doctor.
No pain? Anyway I'm sure you tell them the same thing our daughter tells us.
Be proud, be supportive, but do it from the sidelines.
How long have you had that bump on your collarbone? Is it something I should be concerned about? Not necessarily, but I'll I'll have a closer look.
Can I get a CT and labs on Mrs.
Willis? Mrs.
Willis, that's the elderly lady with the flu? Yeah, she's having dizzy spells.
We need to call her GP for a history.
I won't let it slow me down.
How's doctor Hunter today? He's had better mornings.
Doctor Hamed? Hey, is everything okay? OB is very busy today.
They said they could see us, but not for a while.
Maria's very tired, I just want her to be seen.
We were wondering if you could check her and the baby out? No problem.
Follow me.
Blood pressure's normal.
You must be getting excited.
Over the moon.
- How many weeks? - Thirty-one.
And tell me about your symptoms.
We spent the weekend at a friend's cottage up north.
I started to feel nauseous on the car ride back.
- And this was yesterday? - Uh-huh.
I thought it was car sickness, but this morning I had a fever.
And then we started to worry that the baby wasn't moving as much, but um, we couldn't be sure, so Let's take a look.
Sorry, I know it's a little cold.
That sound's good, right? Yes.
Very good.
Do you know the gender of the baby? - Because I think I can tell.
- No spoilers! Sorry, we've just waited this long, and we want to go the distance.
I completely understand.
Well, everything seems normal, baby seems healthy, blood pressure is good, so you can sit up.
But there is one more thing I should look at.
Um, how long have you had that rash on your arm? I scraped myself on the dock at the cottage, climbing down to the water to go for a swim.
- Any pain? - A bit.
But I bruise easily.
That's all it is, right? Uh, we just need to make sure.
I need to make an incision, prep the Lidocaine.
Are, are you worried about something? If there's an infection, we just need to know how to manage it.
It's okay.
- Hi.
- Hi, love.
- Do you feel anything? - No.
- You may want to look away.
- Oh, he's the squeamish one.
I have other skills.
Ah.
Okay.
Oh.
What is that? Is there a problem? Hey.
Are you okay? I was gonna ask you the same thing.
Bishop's putting me through the wringer today.
What's wrong? I'm a waiting on rush labs.
I have a 31 weeks pregnant woman who seems to have a very serious infection.
31 weeks? Why is she not in OB? They were swamped, so the couple came to me directly.
You know, I'd offer to help, but I'm just I'm trying to stay focused because Don't worry about it.
What kind of infection? - Dr.
Bishop? - Yeah, what is it? I've got a 36-year-old woman, 31 weeks pregnant and presenting with flesh-eating bacteria.
I have never seen necrotizing fasciitis in a pregnant woman.
Neither have I.
Have you treated this infection before? No sir, but I have seen numerous cases of gangrene.
Then you know we have to move fast.
You've started her on antibiotics? 600 milligrams of IV Clinda and 2 grams of IV Ancef.
She's already on fluids.
How'd she contract it? She scraped herself on a dock.
- And the baby? - Fetal heart rate's normal.
Sepsis from infection can cause stillbirth or miscarriage.
Well, it's presenting on her upper arm, just above the elbow, so hopefully we can control it and limit spread.
We'll do an MRI, see if that's the case.
And then what, Dr.
Hamed? Assuming it hasn't spread, what are her options? Uh, radical debridement.
But that means putting her under.
Extremely risky for a pregnant woman.
The only other option is amputation, and she'll need a general anaesthetic either way.
Well, the decision has to be the patient's ultimately.
I'll reach out to infectious diseases, start a dialogue with a surgeon.
I'll talk to Maria.
Are Are you talking about cutting off my arm? If you choose this option, yes.
And this other option, debridement? - It means I get to keep it? - Yes.
But you have to understand, amputation increases the likelihood that we get everything.
Debridement means cutting out only the infected tissue, but the risk of the bacteria spreading are higher.
I should have never gone for that swim.
- Maria, don't say that.
- No, Javier, you can't.
The infection is dangerous and aggressive.
Am I not already exposed? Let's hope not.
And we cannot take that chance.
And these antibiotics, are you sure they won't harm our baby? Your baby is safe for now.
The best predictor of the baby doing well is you doing well.
Which means we need to decide.
How is this happening now? We've tried for so long for this baby! That's all we've thought about for years! A surgeon is coming to talk to you shortly.
But any delay will put your life and your baby's life in danger.
- This is crazy.
We need time - Debridement.
I want the debridement.
No, M-Maria, I want to hold our child in my arms.
Rock my baby to sleep.
Annette Rawana, 55-years-old, persistent runny nose.
If you look really closely, you can actually see the hole in her dura.
There.
Yeah.
Turns out cerebrospinal fluid has been leaking from her brain into her sinuses.
She's seen her GP multiple times about this, even an ENT who thought it was mucus.
But it's not.
It's brain fluid.
Is this a genetic malformation of the dura? Nope.
I found a small deformity on her collarbone.
It's not the cause of the leak, but it is a clue.
So turns out three years ago, she had a minor fall.
Yeah.
She was at the park with her grandson, fractures her clavicle.
The bone didn't heal properly.
Not uncommon in a patient over 50.
But There was a small basal skull fracture that they missed at the time, resulting in a dural defect.
It's been asymptomatic until now.
If you hadn't caught this, she would have had severe seizures, or even meningitis.
Tom, check this out.
Three-year runny nose.
Total mystery.
ENT thought it was mucus.
Wow, you can barely see the hole on the scan.
Nice catch.
I'll put it on the neuro-board, and book an OR.
Oh come on, he said nice catch.
That's a good look for a doctor.
Just so you know, the police are charging the gentleman.
Turns out he has a history of anger problems.
- Is it broken? - I'm fine.
Ah.
We take assault against our staff very seriously.
Even if they are only here temporarily.
I noticed you hadn't submitted or the full-time pediatrics position.
Applications are open for two more weeks.
Wife didn't go for it, huh? Thank you.
Figured it's more of an in-person conversation next time I was home.
Smart man.
These things never work out unless you're both same page.
How do you feel today, Eva? - Okay.
- That's good.
Eva was diagnosed with epilepsy a few months ago.
We've been learning to manage the seizures but this morning she wasn't herself, then started throwing up.
We weren't sure if it was related to the epilepsy.
Is purple your favourite colour, Eva? - Mm-hmm.
- Yeah? My daughter's favourite is pink sparkly rainbow.
Okay.
It's good.
What happened to your nose? To my nose? Uh I told a lie, so it grew like Pinocchio's.
You're worried you might've missed a seizure? Maybe while she was asleep.
She doesn't wear the helmet at night If she hit her head, a concussion would explain the nausea.
I keep a detailed journal of all her seizures, and she's never had one in her sleep before.
Couldn't the vomiting be related to the flu? It's possible, but she isn't running a fever.
Eva, do you remember bumping your head last night? - Mm-mm.
- No? Okay, I'm gonna take a look while you play with that.
There you go.
Okay.
Well, I don't see any evidence of head injury, but we'll run some tests to get a sense of whether or not these symptoms have anything to do with epilepsy.
This is all so new for us.
Well, we have a great social workers here, if you need support while you're adjusting to it all.
Our church family's been amazing.
Sending meals, offering rides.
They've really shown up for us.
Well, a strong community can make a lot of difference.
My Dad's a pastor in Sudbury.
I go every Sunday when I'm home.
You mentioned testing.
What kind, exactly? A CT and an EEG.
But it won't hurt, we're just gonna take a picture of your brain.
What are the chances the pastor's son is our doctor? A nurse will be by to get you when it's time, okay? I'm gonna get that off your hands, okay? Thank you very much.
Why haven't I seen the C results for Mrs.
Willis? - She hasn't been.
- Why not? Because she doesn't need it.
Sir, she has peripheral neuropathy and I just wanted to find the cause I read her chart.
She came in with flu.
That doesn't require a CAT scan.
Her GP has her on an SSRI instead of treating the nerve pain.
Well, maybe there's a very good reason for that.
Maybe they tried antiseizure drugs for her neuropathic pain and they didn't work No, I called for a history.
They haven't.
- I can help her.
- You have helped her.
You treated her dehydration and fever.
Now you send her back to her primary care physician, and you help someone else.
That's the system.
I'm on track for my twenty patients.
Have you caught up on your charts? Have you even take a lunch? The extra time you spend digging in, it has to come from somewhere.
I don't mind sacrificing lunch if it means I can help a patient solve a problem.
This job's about balance, doctor.
See everything, solve what's necessary.
I wouldn't push her if I didn't think she could handle it.
I didn't say anything.
Hey, how was your lunch with your son the other day? Brief.
- Hi.
- Hey.
Where are you? Home.
You mean the old apartment? If you know where I am, why are you asking? The building manager saw you.
Did you Did you go back to see Daneesha? No.
Amira, you can't just go roaming around the city.
I need to know where you are and where you're going.
I didn't mean to! I just got on the bus without thinking.
It's not a big deal, okay? Okay.
Okay.
We only just got used to it here.
It's the first place that felt like home since we left Mama and Baba's.
I know it's hard, Habibti, but we have to keep moving forward.
Mm? Can you get to Theo's on your own? Yes.
I'll be fine.
I'll see you later, okay? Okay.
Are you okay? We tried to conceive for two years.
Three failed rounds of in-vitro.
I took a night job, Maria took extra freelance work, and Every single time a cycle didn't work, and she would get the news, and it destroyed her.
And then, and then it worked.
We're gonna have a baby.
And now all I can think is, is it all worth it? Hey, it will be.
Okay? As soon as she's done, we'll get her into an MRI to make sure the bacteria hasn't spread.
Thank you.
Really? Well, if you're sure that's all I can do, then fine.
- Who died? - Lenny.
My car.
He would need a new engine.
Maybe it's time for an upgrade.
Something awesome, like a Mustang.
I don't want a Mustang, I want Lenny.
I hear Singh and Duncan figured out what was going on - with your patient's runny nose? - Something like that.
Play the long game, Dr.
Curtis.
Suck it up and be excellent.
When the dust settles, you'll be miles beyond them.
What was that about? Some unsolicited career advice from a woman who hasn't exactly cracked the glass ceiling.
That's not fair, she's an attending.
Maybe she's right where she wants to be.
Oh yeah? Stuck as Bishop's second? He's not exactly easy to please.
I'm not interested in pleasing anyone.
- I know, I know.
- And I don't need her advice.
Alright, alright.
Alright? Everything that I have in my life, - I got - on my own, I know.
You know, on my own.
I'm just saying, maybe, you know, she's legitimately trying to help you.
Yeah? Like Bishop's trying to help you? He's saying I over-diagnose.
He's got me doubting my whole approach.
Don't let them get in your head, Mags.
How did you manage this? Stupidity, mostly.
Casualties from my last night of freedom.
Getting married, or going to jail? - Work, actually.
- Mm.
I fly back to the tar sands tonight - for a three-month stint.
- Hmm.
And this is how you celebrate? Let's just say, when you launch yourself off the back of the truck to catch a football, best to watch for the tailgate.
Let me guess, there was a little bit of alcohol involved? Tell me this isn't gonna make me miss my flight.
If I don't go tonight, I'll miss the whole week.
Hold this for me.
Well, you'll need stitches, and a tetanus shot.
Do you have any other pain? Just the hangover.
Any neck pain? No.
So, three months, That's a pretty long stint.
You like working in bursts like that? Easier to focus if it's all in.
Then when I'm off, I can actually relax.
Hmm.
And you can do that? Just shut off and relax? Yeah it's like, as soon as I get off the plane, see my friends, my dog, and it's like a switch flips.
Move your jaw for me.
Alright.
I'll get you started on an IV.
Is that necessary? If you don't want to feel like crap when you're flying, yes.
I'll come back in a few minutes to suture that gash, and then we'll get you out of here.
Thanks, doc.
What happened? She threw up again, then her eyes started rolling back in her head! - Heart rate's 210.
- Another seizure? 2.
5 megs of adenosine.
Prepare to cardiovert.
25 Joules, synchronized.
It isn't working.
Okay, charging.
- Shock advised.
- Everybody clear? Shocking.
Come on baby, wake up.
Why isn't she moving? What else can you do? Okay.
Raising to 50, shocking again.
Charging.
Everybody clear! - Shock advised.
- Shocking.
Oh, thank God.
Hi, Eva.
Do you know where you are? I threw up.
If there's one place you're allowed to throw up, that's the hospital.
- What happened to her? - She's gonna be fine.
We're gonna need to run more tests but it looks like Eva had an episode of supraventricular tachycardia.
It's when the heart suddenly starts beating too fast.
Is that part of her epilepsy? It is a common side effect, and likely explains the symptoms from this morning.
Could this be a one-time thing? Unfortunately, SVT isn't normally isolated.
So you should be prepared for this to happen from time to time.
Does that mean she now has to deal with seizures, and a heart problem? Do we have to bring her back here every time it happens? No.
There are interventions to help with episodes at home.
Hey.
We're gonna get through this.
We're only given as much as we can handle, right? Yeah.
What interventions? Someone needs to teach us what to do.
Mama, I'm thirsty.
You wanted to see me, sir? Yeah.
Our pregnant patient Mm-hmm.
Radiology sent her results directly to me.
The debridement didn't stop the bacteria from spreading.
There's infected tissue deeper in the shoulder.
Which means amputation is no longer an option.
We need to get her back in for another debridement immediately or she'll go into septic shock.
They knew the risks.
All we can do now is deal with what's in front of us.
Sir, the baby might not withstand a second debridement.
And if the infection spreads to the uterus and fetus, then miscarriage and stillbirth are very real possibilities.
We need to move fast, and we're out of conservative options, which leaves us with A C-section.
Get the baby out safely, and then right into another debridement.
- She's 31 weeks? - Yes.
Viable.
Maybe not for the mother.
Delaying debridement for a caesarean poses a major risk.
Her inflammatory response could trigger multiple organ failure.
If we don't deliver, the baby won't make it.
Save the baby or save the mother.
Save both.
But they need to pick who goes first.
- I'll call OB.
- No, we can't send her upstairs.
It's protocol not to let an infection like nec fasc anywhere near that ward.
I'll arrange for an OR.
Sir, I've debrided necrotic tissue before We'll let the surgeons handle it.
- I was a trauma surgeon.
- I'm aware of that Dr.
Hamed, but you are not one now.
You're an emergency resident here.
These parents have sacrificed so much for their baby.
I need to make sure they're around to raise it.
That's what you've been doing all day.
Stay with the husband during the procedure.
He'll need someone to walk him through what's happening.
If they thought they had a tough choice earlier No.
- Javier - No.
He's asking us to choose between your life and the baby's.
We can't do that.
- I can't do that.
- Not choose, Javier.
Just prioritize.
Save the baby.
Maria, but wait Listen Save the baby.
Maria.
Let's talk about this.
Okay? I can't lose this baby, Javier.
I won't.
You know what this means to me.
Okay Maria, but you could die.
I love this baby.
It's already a part of me, and I need to protect it.
I need you to be strong, and there for our baby either way.
And I need to hear you say it.
I need you to promise me.
Of course.
Of course I will.
I promise.
I love you.
Do the C-section, Dr.
Hamed.
We'll get ready.
One more thing before I go? Am I having a girl, or am I having a boy? You'll see for yourself when you wake up.
Has cardiology been by to see you yet? They taught me about vagal maneuvers she can do to slow her heart down, and when to know if she needs to be brought in.
It might not be forever.
Some kids do outgrow their seizures.
If you're asking me to wait for a miracle, that's Luke's department.
He's in the chapel now.
Oh.
I can sit with her if you'd like to go join him.
I pray too, Dr.
Hunter.
But I do it with my eyes wide open.
And I only ask for the courage to be strong enough for Eva, to give my daughter what she needs.
She's lucky to have you.
And I'm lucky to have her.
Promise me you'll keep this clean, and you'll get a doctor to get the clips out.
You're a lifesaver.
- You feeling okay? - Yeah.
Just dry mouth.
I'll grab some water on my way out.
I think we should take your temperature.
I swear doc, I'm fine.
Still probably, you know maybe just a little hungover.
- Okay.
Okay.
- What?! Take this.
Sit down.
Sit back down.
What, uh What's happening? Alright.
Take this off.
Lie down.
It's gonna be cold.
Pleural effusion.
You've got water on your lungs.
What? Why? My guess would be pulmonary embolism.
When you injured your leg, a blood clot formed and travelled to your lungs.
You're gonna need to start anti-coagulants immediately.
I'm I'm gonna be okay? Well, we caught it early, which is good, but you're definitely not gonna make that flight.
I'll be right back.
What? Our obstetrician will deliver the baby with the help of our general surgeon.
There's a team from NICU on standby.
Once they get the baby out, the general surgeon will debride the remaining infected tissue.
Let's get moving.
We're already on borrowed time.
Making the first incision.
And into the fascia.
Scissors.
Thank you.
Suction.
One, two, three, stretch.
Lower end.
Lower end out, retract her out.
I've got the baby's head.
Give me pressure.
Give me pressure! Again! Baby's flat, let's be quick.
Looks like a uterine artery has been clipped.
I'm on it.
Nice work, doctor.
Stay close.
There's not much time.
Come on, let's go.
I'll start bagging.
Get the monitors up.
Chest is moving.
Turn the O2 to 100.
What? Wait, what's wrong? What's happening? The baby's premature.
There are added steps to be taken.
The heart rate's 47.
Prepare to intubate.
What, the baby's not breathing? The heart rate's too low.
They're working to bring it up.
Starting compressions.
Oh, my God.
Pause compressions.
We're good.
Let's get the baby to NICU.
Heart rate's stable.
What the What about the alarms? What's he looking at? What's happening to Maria? She, um She's in respiratory distress and septic shock.
But Javier, I promise you, our surgeons will do whatever they can.
Go to NICU.
Your baby's not out of the woods yet.
There could be choices to be made.
What about Maria? There's nothing you can do for Maria right now.
I know you want to be in two places at once, but you can't.
I'll stay with Maria.
And as soon as there's news of any kind, I'll come get you.
Go see your baby, Javier.
I heard you caught a pulmonary embolism.
- I noti - Nice work.
I noticed him coughing, and I should've investigated it sooner, but All I could hear was your voice in my head.
Telling you what? That I'm That I'm focusing on all the wrong things.
That's your voice, Mags.
Not mine.
This job is all I've ever wanted.
Then find the way to be the doctor I need you to be.
Good night, Dr.
Leblanc.
Maria? She's going to be okay.
It's a beautiful baby.
Dr.
Curtis.
Have you ever wanted to just burn it all down? Instead of sucking it up? All the time.
Have you? Ever? Once or twice.
Was it worth it? The only one who got burned was me.
Well, I I mean, anytime you have a patient for me, I'm interested.
So I'll keep that in mind.
It looks like we stopped the infection.
Your latest MRI was clear.
You are so brave.
You're so strong.
The baby? Baby? I took a video - of our little girl.
- A little girl? She looks just like her papa.
She's four pounds, three ounces, but she's a fighter, like her mom.
I was looking for you.
Listen, I may have been a little short with you today.
Not punching back, Theo, that's nothing to be ashamed of.
I've never punched back.
Not in any part of my life.
Amira went home today.
Our old apartment, without even knowing where she was going.
You know, she's been through so much, and, uh I don't know what I'm doing.
None of us do.
Long road ahead for that family.
And all so that, in 18 years time, the kid can resent them, and they can wonder if everything they went through today was worth it.
Jed.
Is that really how you feel? No.
What happened to getting me something small? I changed my mind.
We both deserve it.
Did you know that you were born with a full head of hair? And you worried just like that when you were little, too.
I'm sorry I lost my temper with you today.
I'm so proud of how you're handling everything that we're going through.
Mama used to get mad at me for playing with my hair.
Said it would all fall out and I would go bald.
She started braiding it so I would stop I could braid for you, too? Mama said braids were way harder than stitches.
I keep dreaming about her.
- Are they good dreams? - Most of them.
Why don't you like it when I talk about Mama and Baba? Is that what you think? No.
No.
Yella.
Time for class.
- You'll wait? - I'm not going anywhere.