Good Sam (2022) s01e10 Episode Script
I Thought I Lost You
Previously on Good Sam
That lock is gonna give out eventually.
The accident affected all of you.
I was drunk.
I intercepted the paramedic's field report that said he was impaired.
- How can I make this right? - I'm not sure you can, Mom.
Kevin Dunn, 12 years old.
He was hit by a bus.
- Kevin's parents - Randy and Cathy Dunn.
Governor just declared a state of emergency.
We have a bus crash in the middle of a shift change.
- Will you stay with me? - I may not have been there, but your mother was always there.
Talk to her.
- I'm sorry about the rings.
- No, no, no, I'm sorry about the rings.
Kevin's parents are here.
They didn't come in the front door.
Ambulances are standing by in the hopes - of finding survivors.
- That's Mom's car.
Have they confirmed my mom's license plate or not? - They don't know.
- What do you mean, they don't know? She's still not answering.
Okay, well, Pyne says that she checked in as soon as her flight touched down in Detroit, - so we know she landed.
- Where are we on the plate? Debris is making the site hard to access.
We just have to wait.
What do we got? Patricia Clark.
51.
Increasing shortness of breath and hypoxic.
Lung cancer.
On chemo.
Have you had shortness of breath before? No.
Not like this.
Okay.
Let me have you sit up.
Okay.
This may be a little cold.
Should we intubate? Not unless we have to.
Get RT down here, start a breathing treatment, and get imaging right away.
You're the first patient we've had in a while who wasn't in a car wreck because of the storm.
Car wreck sounds better than this.
Well, we're gonna take good care of you.
Yeah.
Randy Dunn, 40.
Farm truck turned over and dumped its cargo while he was standing outside of his vehicle.
Can I get a hand getting this crate off? Wait, wait.
No, no.
You pull this crate off without pre-treating him, toxins from the damaged cells will flood his bloodstream - and kill him.
- It's crush syndrome.
I'll start aggressive fluid resuscitation with sodium bicarbonate.
Check vitals and get him to imaging.
If a piece of this crate broke off inside of him, we need to know.
Do you know my son? Kevin Dunn.
He's 12.
He had surgery here.
Yeah, I know your son.
Look, he did great.
- Really? He's okay? - Yup.
Your wife just went upstairs to see him.
I want to see him.
We need to get you out from under this crate first, okay? Dr.
Griffith.
That was the state trooper.
They confirmed the plate of the car in the wreck.
It is your mother's, but she's not in it.
- What? - She's not in it? Apparently, she's nowhere in the vicinity.
Well, where the hell is she? Hey, are you going back to the crash site right now? Do not leave without me.
I'm coming with you.
- Sam, Sam, Sam, let me go.
- No.
- Sam.
- Dad, the last thing I said to Mom was that things between us could not be fixed.
- You have to let me do this.
- Okay, hang on.
Whoa, whoa, it was your mom's car.
- Yeah, I got to go.
- Well, l-let me drive.
No.
We're short-staffed as it is, and I don't know when reinforcements are gonna get here.
Oh, they're here.
Sorry I'm late.
Plows took forever.
I hear your mother's out there.
- Do they know anything? - Nothing useful.
Here, take that.
Thank you.
I'm heading back out there now.
If the rescue crews can't find her, I will.
Good luck.
Hey, and she's gonna be okay.
Hey, I need you, I need you to take care of things - while I'm gone, if you're up to it.
- Yeah.
Fine.
Take the service road, - don't take I-75.
- Okay.
And call me the second you get there.
- Dad, I will.
- And be careful 'cause the roads are Dad, I love you.
I love you, too.
You go find your mother.
Yeah, okay.
No! This sucks, this sucks, this sucks, this sucks.
I know, honey.
I'm just gonna take your pulse.
Is this your first pregnancy? - How many weeks? - 36.
Any complications so far? Besides going into labor under a freeway? It's gonna be okay.
It's not gonna be okay.
Nothing about this is okay.
I'm having another contraction.
Yup, yup.
You can do this.
Just breathe through it.
Just keep breathing through it.
Mom? Mom? Sam! Mom?! Sam! Mom?! - Hi.
- Oh.
Are you okay? Are you hurt? - We've been calling - Yes, I lost my phone in the crash, but I-I'm okay.
Okay.
We've got to climb out.
- The rescuers can't get around - We can't.
What? This is Sadie.
Oh, hello.
She's four weeks shy of full-term, and her contractions are less than a minute apart.
Oh, boy.
Girl, actually.
- Okay.
How dilated is she? - I was just about to check when her water broke.
I didn't want to risk infection, but I'm thinking, uh, she's got to be close to ten centimeters and fully effaced.
- I need a doctor.
- You got one.
Yeah.
Two, actually.
Well, it's been a while since I practiced.
All right.
Baby's crowning.
Ah.
Well, Sadie, how far did you get in those birth classes? Not as far as this.
Okay, Sadie, I need you to take a deep breath for me.
Okay.
Sadie.
Push.
Okay, CT shows a fragment of the crate is impaled next to the femoral artery.
And as long as we can visualize the impalement, we can remove it safely.
- Okay.
Local anesthesia? - Already gave it to him.
You ready, Mr.
Dunn? Okay.
One, two, three.
Stop there.
Tilt 45 degrees towards me.
Okay, easy.
Pull up two inches.
- You're clear.
- Okay.
You got it? Ah.
- Okay, I need more four-by-fours.
- On it.
Is that femoral artery still intact? Yes, but it looks like he has a grade two - splenic laceration.
- Okay, that'll heal on its own, but let's get him typed and crossed for blood to be safe, yeah? Already did.
You got a real knack for trauma, don't you? - That's what I've been saying.
- No.
You said, "It's time to stop flirting and get serious.
" Yeah, yeah, about trauma.
I stand by that.
Dr.
Eric Kace, by the way.
Look, I know it's really nice up there amongst the cloud people.
Espresso machines in the lounge and comfy couches.
But this is where the action is.
Everyone needs to get a little action, right, Doctor? I'm gonna go back upstairs.
You.
Hey.
Oh, my God.
Sorry.
I didn't know you were still here.
Yeah, I was just about to head out.
I was thinking about yesterday.
You know, how we were arguing about wedding stuff before you left.
- Mm-hmm.
- Since the engagement, it feels like all we do is argue about the wedding.
Mm.
Yeah, you're right.
- So, let's stop arguing.
- Okay.
And just get married.
What? You were stuck in a blizzard for 14 hours.
What if you hadn't come back? We don't know how much time we have, so let's stop wasting it planning a party and just get married now.
- Right now? - Right now.
Well, I have rounds right now, but today.
Okay.
- Okay.
Yes.
- Yeah, let's do it.
- I'll handle everything.
- Okay.
Hey, sorry I'm late.
Why am I apologizing to you guys? "Hi, Isan.
Good to see you.
So glad you didn't die in the storm.
" - Where's Sam? - Oh, she just texted.
She's at the crash site, but her mom's okay.
Oh.
What does that mean for us? - That's your question? - Yes.
How do we do rounds? - Who's in charge? - Uh - Any word on Dr.
Katz? - She's okay.
Oh, thank God.
Yeah.
So, we have a post-op checkup on our pediatric patient.
Aortic valve replacement, triple CABG, and a possible bronch for persistent hemoptysis.
Shall we? Guess we know who's in charge.
Well, if it isn't Clara Barton.
Hey, Ma.
Look, what are you doing here? Board called an emergency meeting to deal with the impact of the storm, including the blood shortage, which my son successfully mitigated with an in-house blood drive.
I am just doing what I can to help.
You stepped up in a big way, and the board's very impressed.
And speaking of the board, I understand your CMO - is out of commission.
- Temporarily.
- So you're filling in? - Where I can.
Look, what do you need? Um operative reports for the last two weeks? I can pull those up.
What doctor? Rob Griffith.
What? The vote for Chief of Cardiothoracics is in a couple of weeks.
I want to know if the scalpel he dropped was an isolated event.
There aren't any reports.
What? That bypass surgery was two weeks ago.
Surely, the man has been primary in a surgery since? Not according to this.
Then what has he been doing? Ah.
That was - incredible.
- It is, every time.
Bringing a life into the world.
No, I-I mean you.
You didn't skip a beat.
It was like you never stopped practicing.
It was just muscle memory.
It was awesome, Mom.
Sam, these last two weeks have been the longest of my life.
I'm sorry that I've been dodging your calls.
- I just - No, I'm sorry.
- I should have - Mom, after everything that's happened, honestly, all I care about is that you're okay.
Mom! Hey, I need some help over here! Mom? Delayed pupillary light reflex.
- Hmm, but symmetrical.
- Hmm.
What happened? You fainted and hit your head, that's what happened.
Your brain CT was normal But you have a concussion.
I was about to say that.
Let's keep her in overnight for observation.
IV maintenance fluids for hydration.
- Treat the headache.
- Mm-hmm.
I was about to say that, too.
How's Sadie and the baby? I should go and check on them.
- No, no, Mom, Mom.
- Hey, hey, hey.
Take it easy.
You're lucky that a mild TBI is all we have to treat.
I'll follow up with you in a few hours.
Thanks, Steph.
- Thank you.
- Thanks.
Oh, Asher must be worried sick.
Can one of you call him? Tell him I lost my phone.
I spoke to him this morning.
He's in Denver.
He's waiting for the next flight back.
I'll check in with him while you rest.
Thank you, Sam.
You've put up with a lot from me over the years, but this is a hell of a revenge scheme.
Our daughter is speaking to me again.
It's worth the concussion.
That is a crazy thing to say.
You should have your head examined.
Oh.
- Hi.
- Hey.
How's your mom? Uh, she's all right.
Thanks.
Um, mild concussion, not that a head injury ever stopped her.
Hmm.
Yeah, I should probably go by and check on her.
She'd probably like that.
I actually have some work questions for her.
She would love that.
My, uh, mom's looking for your dad's latest surgical reports.
Now, I couldn't find them, so I thought I'd ask to see if you knew where they were, but you know what I realized? What? I am so tired of talking about our parents.
Me, too.
It was better when we just talked about our dads and not also our moms.
Yeah, it was better when we didn't talk about any of 'em.
Yeah, it was.
- Have a good day.
- You, too.
Patricia Clark? Hello.
So, it says here you have stage 4 non-small cell lung cancer.
Post-induction therapy.
It says here that you came in through the ER? I couldn't breathe.
Still can't.
She's on 100% oxygen with intermittent hemoptysis.
Okay.
What are our options, Dr.
Shah? Well, if she continues to decompensate with worsening hypoxia, we should intubate.
- Hmm.
What else? - A bronchoscopy - might temporize the bleeding.
- True, but I'd like to also prepare for the possibility of a pneumonectomy.
Patricia, the lung that is failing you is so diseased that it may actually be simpler to remove it.
You're gonna remove my lung? Don't I need it? Not if the diseased tissue does you more harm than good.
Exactly.
Where is the doctor that took care of me in the ER? Uh, Dr.
, uh, Trulie? Uh She is not here right now, but we have an excellent team of doctors who will take great care of you if we move forward with this procedure.
So, is Lex off the surgery? I don't even know where Lex is.
Trauma.
Crush syndrome.
It was a whole thing with a crate.
- Oh.
- Well, for the record, I would love to be in the pneumonectomy.
So would I.
Okay.
I haven't decided.
A full lung removal is a rare procedure.
It's very technically difficult, so you should be studying.
All of you.
I've never been in a pneumonectomy.
- None of us have.
- Well, I spoke up first.
I offered an actual treatment.
Really? You lost first assist on our last two surgeries.
Why aren't you all over this? I'm prioritizing my relationship.
Plus, I don't need brownie points in CT.
- I excel where it matters.
- Are you talking about plastics? Doesn't Dr.
Glass still call you Jerry? Mom.
- What are you doing in here? - I, um Yeah, I just wanted to make sure her heart rate was coming down.
Okay.
I can take care of her heart.
- You need to rest.
- Yeah.
Okay.
Okay.
Seeing one patient isn't gonna kill me.
You are concussed.
I can't have you putting yourself at any more risk.
I already thought I lost you once today.
You didn't lose me, but I was afraid I lost you when you wouldn't take my calls.
Now I I need you to understand this.
I know it seems like I put - the hospital first - Let's not do this now.
Your father and I We had a plan back then.
This dream.
I mean, we were building something big together.
And when the accident happened, I was just terrified.
I Scandals like that sink hospitals.
They cost in money and donations and endowments and Mom, it's not what you did.
It's what you didn't do.
For years, I have wondered what was wrong with my relationship with Dad.
I have tried so hard to understand the wall that he put up between us.
And all this time, you have had the answer, and you didn't tell me.
Sam I don't want to talk about this right now, and you need to rest.
Please.
Why are you guys studying for a pneumonectomy? Because Sam hasn't assigned first assist yet.
On who, Patricia Clark? Wait, that's my patient.
I did her intake.
Missing rounds reflects a lack of commitment.
Really? Did you sleep great in your bed last night? Because I am committed to my third consecutive shift.
Dr.
Shah is very rested.
Which is why he will be first assist on the pneumonectomy.
Thank you.
I won't let you down.
Whatever.
Lex, you know I can't assign you to a surgery if you weren't there to round on a patient.
I know.
I was treating patients in the ER.
You've already fulfilled all of your elective hours down there.
We need you up here.
Maybe I haven't told you lately how much I depend on you.
I want you in that surgery.
It's the ER.
But that means you have to be here.
Okay.
Hi.
That was quite the decision.
Felt pretty straightforward to me.
I mean, Lex was missing, and Joey was late I was on time.
Caleb, you haven't had more than two consecutive - hours of sleep.
- You didn't even consider me.
Where is this coming from? Here, actually.
Oh.
These bunks are the only place we go.
You signed up for casual.
We were really clear about this.
I said I can't get serious right now I know, I, I know.
It would still be nice to be taken seriously.
And a few more steps.
- Is this a trust exercise? - Make a left.
- Ready? - Yeah.
Behold.
Our wedding chapel.
You hate it.
- No, no - I'm not done decorating.
It'll be more festive when the cake arrives.
Chocolate and lemon which I hate, - a lot.
- So you've said.
But I ordered it because I love you.
I just want to get married and eat cake and stop bickering - over wedding stuff.
- Yeah.
Ooh, did I tell you that Donna's ordained? Sorry, um This is, this this is just a lot.
It's not a lot, that's the point.
It's just an easy, simple way to get married without fighting.
That's not why we've been fighting.
You stopped talking to me for a day over place cards.
I slept with someone else.
What? The week before you proposed.
But it it didn't mean anything, and it was, it was a one-time thing, and I love you.
You love me, but then you cheated on me? I-I-I do.
I do love you, and I want to marry you, but before we do, I I just needed you to know.
Well now I know.
Hey! - Aw.
- There he is.
- Dad.
- Hey, kiddo.
- Oh.
- Oh.
Okay.
Hey, buddy.
Oh! Mmm.
What happened to your leg? Aw, don't ask.
What about you, huh? How many kids in school survive a bus crash and have heart surgery - in the same day, hmm? - We're all in one piece, and we're together.
That's what matters.
So, we can go home? Well, you will be ready to discharge very soon, Kevin.
And I see here that your mom finally let us examine her.
She's okay except for a couple bruises, and she can go at any time.
- And my dad? - Uh, well, his leg is healing.
- Mm-hmm.
- It's gonna be fine.
But your blood levels are still falling.
The laceration that we saw on your scan is still bleeding.
You need a blood transfusion, but our blood bank is depleted, our supply has not arrived yet, and you have a rare blood type.
- Can I donate to him? - Uh, no.
You're B, and Randy is type AB.
I-I got some blood during my surgery.
You sure did.
Last we had.
O neg.
What's O neg? - Uh, well, that's your blood type.
- Uh-huh.
It's very common.
It's, uh, it's known - as the universal donor.
- So, I can give some to my dad? Uh, well, technically, yes.
You could donate to either of your parents, but neither of them can donate to you.
Can I borrow Kevin for an EKG? - Uh-huh.
- Sure.
First take my blood.
- I'm a universal donor.
- Yeah, but you just had heart surgery, and you need it.
Plus, you can't donate till you're 18.
Anyway, uh, we would like to keep you here - until - Wait a minute.
For him to be O, doesn't one of us have to be O? Uh Genetically speaking, it is, um - Is he not my son? - What? What kind of a question is that? If I'm AB and you're B, Kevin can't be O.
It's genetically impossible.
Unless he's not my son.
Of course he's your son.
Then how do you explain the blood? I don't know.
I'm-I'm not a doctor.
Okay.
Doctors, i-is there another explanation? I'm not Kevin's father.
- I took her vitals an hour ago.
- Did you notice her pulse was all over the place? Stop this, both of you.
I am fine.
Her heart rate was normal.
You can't depend on the instruments.
You have to do it manually.
- I did do it manually.
- Well, her blood pressure's rising.
Gee, I wonder why that is.
Some people will do anything for a day off.
You look good.
I'm glad to see it.
Well, back at you.
Your splenic lac patient.
What about him? I need to do an ultrasound of his leg, make sure there isn't any nerve damage that needs my attention.
Be my guest.
- Feel better.
- I will.
I'm not gonna make it that easy for you to take my job.
I don't want it if you have to die for me to get it.
That's more your family's style, isn't it? - Ooh.
- I take issue with that statement.
- Me, too.
- I technically did not die.
I was in a persistent vegetative state.
Okay, thank you all for coming.
- Now get out.
- Okay.
- Vivi? - Mom? - You dizzy? - Yeah, no, I just - I sat up too quickly.
- Okay.
Okay.
Here.
Hey, hey, hey.
Follow my finger.
Delayed tracking.
Yeah.
Let's get a CT angio - of her neck.
- Yeah.
Why are you interested in the blood vessels of my neck? Mom, how's your vision? Yeah, I guess it's a bit blurry.
Okay, it could be a little more than a concussion.
Okay? - I'm gonna go down to Neurology.
- Yeah.
Just stop lying already! Randy, I told you, - it has to be a mistake.
- No, the mistake was me trusting you.
I need two milligrams of IV lorazepam.
We just got our family back together, and now you're blowing it apart.
What's gonna happen when Kevin finds out? There's nothing for Kevin to find out, Randy.
He deserves to know the truth! All right, all right.
He's tachycardic.
Randy, I need you to calm down.
Then tell my wife to not cheat on me.
Okay.
What is that? Hey.
Hey.
So ER again.
Haven't you put out enough fires down there? They need the help.
They have their own residents, and the storm is over.
Do you want me to tell them to back off? Oh, or am I doing that thing where I offer to handle something that you're perfectly capable of handling by yourself? What? - You are learning.
- Mm-hmm.
I know you like trauma, but you committed to CT, and And CT takes total commitment.
I know.
We talked about this.
You're on track to be chief resident of the most prestigious department at this hospital.
Right now, nobody can compete with you.
But if you're not all in, then I don't know how that'll be true.
Fever and a rash with a rising lactate.
Could be infection.
Yeah, but chest X-ray was clear, and blood cultures were negative.
Rhonda was worried about complications from a crush injury.
Any chance they're related? - Lex? - Hmm? Oh, um Mm, it's unlikely.
I mean, there's no signs of rhabdomyolysis, and his urine output is normal, so Sorry.
Okay.
Let's run repeat blood and urine cultures and broaden his antibiotics.
Could it be a stress response? To his wife's affair? I don't have a prescription for that.
Don't date a cheater.
What did you say? That would be my advice for someone who doesn't want to be cheated on.
So it was his fault that he didn't psychically know that his partner was unfaithful? No, not his fault.
But, like, you know, if she cheated, she was probably unhappy.
He has some part in that.
Wow.
Romance advice from someone who's never heard of a second date.
Thanks for the tip.
The wife swears that she did not have an affair.
She's convinced that it's something else.
Well, there's only one I can think of.
Chimerism.
He could have blood cells with distinct and different genotypes.
Part of him is type AB.
The other part is type O.
And that part made Kevin.
I've never seen a genetic chimera.
It can't hurt to test him.
Okay, so I'll send some blood to my geneticist friend - in Boston.
- Okay.
See? I do take you seriously.
Okay.
Thank you.
And I don't.
Okay.
And it's a good thing.
Caleb, I need something in my life that is not so serious.
And you have been that for me for so long, I don't know what I would do without it.
I don't know what I would do without you, Caleb.
And that is seriously how I feel.
I hope it's enough for you.
Mom.
What's happening? Vertebral artery dissection.
Vessel must've sheared in the crash.
- How did we miss this? - Delayed onset.
Contralateral vert is hypoplastic.
Not enough flow to her brain stem.
She could hemorrhage if we don't get her into surgery.
Okay.
You are gonna be okay, Mom.
And I'm here.
Baum's doing your surgery.
You don't get better than him.
I know.
Who do you think recruited him? When you get out, you're gonna have the best neurointensivists I know.
You are going to get through this.
What about us? Are we gonna get through this? Don't think about that right now, Mom.
I thought I was doing the right thing.
I thought I was protecting the right baby.
- Vivi.
- Mom, I Even if Randy has chimerism, doesn't explain any of these other symptoms.
Well, we've ruled out tissue infection.
The wound site was completely clean.
This seems like a respiratory infection.
It does, but when would he have inhaled bacterial particulate? He was trapped under that crate Wait a minute.
Tularemia.
- Isn't that bacterial? - Mm.
It comes from, like, rabbits and - Rodents.
- Right.
If that farm truck was transporting livestock The crate that landed on him could've been contaminated - with rabbit feces.
- All right, I'm gonna order - the labs.
- I'll call the farm and see what livestock they breed.
I'll get the Scooby Snacks and fire up the Mystery Machine.
Don't you have a surgery to prepare for? I do.
Because I was chosen for it and you weren't, which obviously bothers you.
If it's not plastics, I'm not interested.
You're the one who's always saying this is a competition.
And you don't like losing.
Mm, but if the prize for winning is rabbit poop, - I'm fine with it.
- No, you're not.
And you shouldn't be.
It's a big surgery.
And it's not a good look that you keep getting passed over.
If I wanted your surgery, I'd have it.
How's he doing? Strong blood flow to his lower extremities and no nerve damage.
My work here is done.
That's good news.
Uh, though, to be honest, I was looking forward to a fem-pop.
Even if I did need to perform a femoropopliteal procedure, what makes you think you'd be assisting me? I plan to subspecialize in plastics.
I was sure you knew that.
I-I may have been a little distracted lately.
I got engaged.
It's complicated.
But, uh, Dr.
Glass, plastics is my passion, - and I - You know what my passion is? Undeniable surgeons.
When I was a resident, everybody wanted me.
Every specialty, every surgery, every day.
When's the last time you were first assist? Instead of presuming to know what I think or whom I want, you might want to acquaint yourself with the OR.
Doctor.
Kace.
I got your page, but I couldn't get away.
We got an emergent cricothyrotomy on the way.
I figured you wouldn't want to miss it.
I don't.
But I have to ease up on my my trauma rotations.
CT is so demanding.
I already lost a surgery.
I can't be here and there at the same time.
So stay here.
I can't just change my specialty track.
Uh, yeah.
Sure, you can.
People do it all the time.
Right, but I've put years into CT.
If I switch, I'd be starting over from scratch.
If you hadn't been here today, that patient with the crush injury would be dead, and we both know it.
You don't just have talent, Dr.
Trulie.
You have passion, which you're gonna need where-wherever you specialize.
Gavin Larousse, 35.
Respiratory distress with a worsening angioedema.
His tongue is obstructing his airway.
Orotracheal and nasotracheal intubation is impossible.
Okay, let's go.
You sure you want to leave Trauma behind? - Hey.
- I know it's a competition.
This job.
I fight for my spot here every day, which is hard.
I know.
I know.
And whenever I needed to remember why I was doing it, what I was actually fighting for, I looked at you.
And then you did what you did, and now I don't know where to look.
Joey You know what, maybe I've taken too much for granted.
Maybe Maybe I just haven't fought hard enough.
You don't have to fight for me, I am right here.
I'm not talking about you.
Hello, Patricia.
Ready for your surgery? Is anybody ever ready to have their lung taken out? Has somebody walked you through the procedure, what to expect? - Yes.
- Yeah? Dr.
Shah was here.
Oh, good.
He needs a second chance.
What do you mean? Oh, I-I assumed you knew.
I mean, I think it's public record that he lost a patient.
Lost? Oh, it wasn't his fault.
At least, I don't think it was.
But he's struggled - with confidence since then.
- Oh The patient he lost, was it a lung removal? Appendectomy, actually.
A much simpler procedure.
The OR was always her favorite place.
I just never imagined her on the table.
What did she mean, "protecting the right baby"? She used to say she had two babies: you and the hospital.
She was in Orthopedics.
Long hours, a lot of pressure.
She did it all.
She loved being a doctor.
I felt it out there today.
But I also feel like she's been running the hospital for as long as I can remember.
Well, it was a long time ago.
When was it, exactly? Well after the accident, you had a hard time.
Night terrors, panic attacks.
You couldn't be alone.
I couldn't be with you, as we know.
So your mom decided that she would be.
She gave up being a doctor after the accident? She gave it up for me? Admin gave her reliable hours.
Home for dinner every day.
She knew it was what you needed.
How did I never know this? She didn't want you to know.
She would never tell you.
But I was there.
I saw it.
She gave everything to you.
And then, when you didn't need her so much she gave it to them.
We're all in this together, Sam.
- How's the patient? - Uh They repaired her dissection.
We're just waiting for her to wake up.
- I mean, she-she did great.
- How are you doing? I'm okay.
I'm tired.
Is there anything I can do? You could tell your mom to stop looking into my dad.
He has been dealing with something personal, but it is nothing for your mom to be concerned about.
He's okay.
Are you? I am I don't know.
It's okay.
Come here.
I know that your mom is just doing her job.
Hey, don't-don't worry about her.
All right? I will talk to her.
Okay? All right? Come here.
All right? It's gonna be okay.
Okay, Patricia, it is time Where is my patient? In surgery.
They moved it up.
Why wasn't I told? Hey.
Hey.
How's she doing? - She's stable.
- Good.
Trauma still chasing you? Actually, I talked to the program director about changing specialties.
What? I just did an emergent cric.
This patient's tongue was so swollen I had to hyperextend his neck to cut the cricothyroid membrane.
- It was - Electrifying.
- Yeah.
- Yeah, I know the feeling.
But I get it from heart surgery.
Uh, yeah, I mean, I'll still rotate through CT, but the ER will be my home base.
Hmm.
I know you think ER doctors are inferior.
I think some ER doctors are inferior.
You're an excellent surgeon, whatever color scrubs you wear.
- Trauma surgery's no joke.
- Mm-mm.
Dr.
Trulie, they'll be lucky to have you.
I'm lucky to have you.
- Mm-hmm.
- Mm-hmm.
Of course, I think it's a big mistake.
I mean, who trades CT for sore throats and sprained ankles? I can't weigh in on such a big decision for her.
That's all I need, some other woman rearranging her life because of me.
You scared me, Viv.
I thought I lost you.
I started thinking about everything we've been through together.
And, uh you're the love of my life.
So get out of bed, will you? Your husband has pneumatic tularemia, so we've started him on targeted antibiotics, and he should be feeling better soon.
Oh, good.
That's a relief.
And we also spoke to the genetics lab, and Randy does not have chimerism, or any other genetic anomaly that would explain why he has different DNA than Kevin.
It was just a fling.
Over before it began, practically.
And when I realized I was pregnant, Randy assumed the baby was his.
I wanted it to be his.
And I also thought what good would it do to tell him about the affair? Who would it help? That's a long time to carry a secret.
But in my experience, it's better to deal with the truth than to hide from it.
Excuse me.
Mom, you're awake.
How do you feel? Like I just had major surgery.
Mom, I-I remember when you made the switch to Admin.
I didn't know that I was the reason.
Dad told me.
I never wanted you to feel like I gave something up because of you.
But you did.
You gave up something that you love as much as I do.
I cannot imagine giving this up.
I did love it.
But I was also so happy to spend time with you and watch you grow into what you've become.
I'm so proud of you.
I'm so sorry I accused you of putting the hospital first.
And I'm sorry I kept the truth from you for so long.
What do you say we stop apologizing to each other and finally put this accident behind us? Mm.
I would love to.
- Oh - Oh, my girl.
Oh This came for you.
Oh.
How could I forget? Yeah, I know what you did.
Stealing my surgery.
I didn't steal your surgery.
The patient changed her mind after she knew the truth.
Looks like your wedding's off.
I don't know what happened, and I don't really care, but Tim dodged a bullet.
See you on the next one.
Dr.
Trulie.
- Reporting for duty.
- Not in those scrubs.
- They're the wrong color.
- Right.
- Follow me.
- Okay.
Here's your schedule.
All right.
Whoa.
There's a lot of night shifts.
Yep.
Goes by seniority.
Everybody starts at the bottom.
Here you go.
Now, there's a kid in Bay 4 with hand, foot, and mouth disease.
Ugh.
Okay.
- Welcome to the jungle.
- Yeah.
Ooh, the truth hurts.
- But it's better to know.
- Yeah.
She took my advice.
I guess I should, too.
About what? Us.
Um, look, I know I signed up for casual, and I agreed to it, and I'm good with it as long as it's not about Malcolm.
Malcolm? If you can't get serious with me because you still have feelings for him, I just need to know.
It's not about him.
Casual's just where I am right now.
Well, then, it's where I am, too.
Okay.
Do you want to go to my place - and sleep in an actual bed? - Yes, please.
Good.
A personal family matter, huh? Sam's just asking for a little privacy.
Is it really your place to be nosing around in his business? I used to think that Rob Griffith wasn't fit to be department chief, but he shouldn't be a part of this hospital at all.
What are you talking about? This.
There's the truth.
You decide whose place it is to do something about it.
"Driving while intoxicated.
"
The accident affected all of you.
I was drunk.
I intercepted the paramedic's field report that said he was impaired.
- How can I make this right? - I'm not sure you can, Mom.
Kevin Dunn, 12 years old.
He was hit by a bus.
- Kevin's parents - Randy and Cathy Dunn.
Governor just declared a state of emergency.
We have a bus crash in the middle of a shift change.
- Will you stay with me? - I may not have been there, but your mother was always there.
Talk to her.
- I'm sorry about the rings.
- No, no, no, I'm sorry about the rings.
Kevin's parents are here.
They didn't come in the front door.
Ambulances are standing by in the hopes - of finding survivors.
- That's Mom's car.
Have they confirmed my mom's license plate or not? - They don't know.
- What do you mean, they don't know? She's still not answering.
Okay, well, Pyne says that she checked in as soon as her flight touched down in Detroit, - so we know she landed.
- Where are we on the plate? Debris is making the site hard to access.
We just have to wait.
What do we got? Patricia Clark.
51.
Increasing shortness of breath and hypoxic.
Lung cancer.
On chemo.
Have you had shortness of breath before? No.
Not like this.
Okay.
Let me have you sit up.
Okay.
This may be a little cold.
Should we intubate? Not unless we have to.
Get RT down here, start a breathing treatment, and get imaging right away.
You're the first patient we've had in a while who wasn't in a car wreck because of the storm.
Car wreck sounds better than this.
Well, we're gonna take good care of you.
Yeah.
Randy Dunn, 40.
Farm truck turned over and dumped its cargo while he was standing outside of his vehicle.
Can I get a hand getting this crate off? Wait, wait.
No, no.
You pull this crate off without pre-treating him, toxins from the damaged cells will flood his bloodstream - and kill him.
- It's crush syndrome.
I'll start aggressive fluid resuscitation with sodium bicarbonate.
Check vitals and get him to imaging.
If a piece of this crate broke off inside of him, we need to know.
Do you know my son? Kevin Dunn.
He's 12.
He had surgery here.
Yeah, I know your son.
Look, he did great.
- Really? He's okay? - Yup.
Your wife just went upstairs to see him.
I want to see him.
We need to get you out from under this crate first, okay? Dr.
Griffith.
That was the state trooper.
They confirmed the plate of the car in the wreck.
It is your mother's, but she's not in it.
- What? - She's not in it? Apparently, she's nowhere in the vicinity.
Well, where the hell is she? Hey, are you going back to the crash site right now? Do not leave without me.
I'm coming with you.
- Sam, Sam, Sam, let me go.
- No.
- Sam.
- Dad, the last thing I said to Mom was that things between us could not be fixed.
- You have to let me do this.
- Okay, hang on.
Whoa, whoa, it was your mom's car.
- Yeah, I got to go.
- Well, l-let me drive.
No.
We're short-staffed as it is, and I don't know when reinforcements are gonna get here.
Oh, they're here.
Sorry I'm late.
Plows took forever.
I hear your mother's out there.
- Do they know anything? - Nothing useful.
Here, take that.
Thank you.
I'm heading back out there now.
If the rescue crews can't find her, I will.
Good luck.
Hey, and she's gonna be okay.
Hey, I need you, I need you to take care of things - while I'm gone, if you're up to it.
- Yeah.
Fine.
Take the service road, - don't take I-75.
- Okay.
And call me the second you get there.
- Dad, I will.
- And be careful 'cause the roads are Dad, I love you.
I love you, too.
You go find your mother.
Yeah, okay.
No! This sucks, this sucks, this sucks, this sucks.
I know, honey.
I'm just gonna take your pulse.
Is this your first pregnancy? - How many weeks? - 36.
Any complications so far? Besides going into labor under a freeway? It's gonna be okay.
It's not gonna be okay.
Nothing about this is okay.
I'm having another contraction.
Yup, yup.
You can do this.
Just breathe through it.
Just keep breathing through it.
Mom? Mom? Sam! Mom?! Sam! Mom?! - Hi.
- Oh.
Are you okay? Are you hurt? - We've been calling - Yes, I lost my phone in the crash, but I-I'm okay.
Okay.
We've got to climb out.
- The rescuers can't get around - We can't.
What? This is Sadie.
Oh, hello.
She's four weeks shy of full-term, and her contractions are less than a minute apart.
Oh, boy.
Girl, actually.
- Okay.
How dilated is she? - I was just about to check when her water broke.
I didn't want to risk infection, but I'm thinking, uh, she's got to be close to ten centimeters and fully effaced.
- I need a doctor.
- You got one.
Yeah.
Two, actually.
Well, it's been a while since I practiced.
All right.
Baby's crowning.
Ah.
Well, Sadie, how far did you get in those birth classes? Not as far as this.
Okay, Sadie, I need you to take a deep breath for me.
Okay.
Sadie.
Push.
Okay, CT shows a fragment of the crate is impaled next to the femoral artery.
And as long as we can visualize the impalement, we can remove it safely.
- Okay.
Local anesthesia? - Already gave it to him.
You ready, Mr.
Dunn? Okay.
One, two, three.
Stop there.
Tilt 45 degrees towards me.
Okay, easy.
Pull up two inches.
- You're clear.
- Okay.
You got it? Ah.
- Okay, I need more four-by-fours.
- On it.
Is that femoral artery still intact? Yes, but it looks like he has a grade two - splenic laceration.
- Okay, that'll heal on its own, but let's get him typed and crossed for blood to be safe, yeah? Already did.
You got a real knack for trauma, don't you? - That's what I've been saying.
- No.
You said, "It's time to stop flirting and get serious.
" Yeah, yeah, about trauma.
I stand by that.
Dr.
Eric Kace, by the way.
Look, I know it's really nice up there amongst the cloud people.
Espresso machines in the lounge and comfy couches.
But this is where the action is.
Everyone needs to get a little action, right, Doctor? I'm gonna go back upstairs.
You.
Hey.
Oh, my God.
Sorry.
I didn't know you were still here.
Yeah, I was just about to head out.
I was thinking about yesterday.
You know, how we were arguing about wedding stuff before you left.
- Mm-hmm.
- Since the engagement, it feels like all we do is argue about the wedding.
Mm.
Yeah, you're right.
- So, let's stop arguing.
- Okay.
And just get married.
What? You were stuck in a blizzard for 14 hours.
What if you hadn't come back? We don't know how much time we have, so let's stop wasting it planning a party and just get married now.
- Right now? - Right now.
Well, I have rounds right now, but today.
Okay.
- Okay.
Yes.
- Yeah, let's do it.
- I'll handle everything.
- Okay.
Hey, sorry I'm late.
Why am I apologizing to you guys? "Hi, Isan.
Good to see you.
So glad you didn't die in the storm.
" - Where's Sam? - Oh, she just texted.
She's at the crash site, but her mom's okay.
Oh.
What does that mean for us? - That's your question? - Yes.
How do we do rounds? - Who's in charge? - Uh - Any word on Dr.
Katz? - She's okay.
Oh, thank God.
Yeah.
So, we have a post-op checkup on our pediatric patient.
Aortic valve replacement, triple CABG, and a possible bronch for persistent hemoptysis.
Shall we? Guess we know who's in charge.
Well, if it isn't Clara Barton.
Hey, Ma.
Look, what are you doing here? Board called an emergency meeting to deal with the impact of the storm, including the blood shortage, which my son successfully mitigated with an in-house blood drive.
I am just doing what I can to help.
You stepped up in a big way, and the board's very impressed.
And speaking of the board, I understand your CMO - is out of commission.
- Temporarily.
- So you're filling in? - Where I can.
Look, what do you need? Um operative reports for the last two weeks? I can pull those up.
What doctor? Rob Griffith.
What? The vote for Chief of Cardiothoracics is in a couple of weeks.
I want to know if the scalpel he dropped was an isolated event.
There aren't any reports.
What? That bypass surgery was two weeks ago.
Surely, the man has been primary in a surgery since? Not according to this.
Then what has he been doing? Ah.
That was - incredible.
- It is, every time.
Bringing a life into the world.
No, I-I mean you.
You didn't skip a beat.
It was like you never stopped practicing.
It was just muscle memory.
It was awesome, Mom.
Sam, these last two weeks have been the longest of my life.
I'm sorry that I've been dodging your calls.
- I just - No, I'm sorry.
- I should have - Mom, after everything that's happened, honestly, all I care about is that you're okay.
Mom! Hey, I need some help over here! Mom? Delayed pupillary light reflex.
- Hmm, but symmetrical.
- Hmm.
What happened? You fainted and hit your head, that's what happened.
Your brain CT was normal But you have a concussion.
I was about to say that.
Let's keep her in overnight for observation.
IV maintenance fluids for hydration.
- Treat the headache.
- Mm-hmm.
I was about to say that, too.
How's Sadie and the baby? I should go and check on them.
- No, no, Mom, Mom.
- Hey, hey, hey.
Take it easy.
You're lucky that a mild TBI is all we have to treat.
I'll follow up with you in a few hours.
Thanks, Steph.
- Thank you.
- Thanks.
Oh, Asher must be worried sick.
Can one of you call him? Tell him I lost my phone.
I spoke to him this morning.
He's in Denver.
He's waiting for the next flight back.
I'll check in with him while you rest.
Thank you, Sam.
You've put up with a lot from me over the years, but this is a hell of a revenge scheme.
Our daughter is speaking to me again.
It's worth the concussion.
That is a crazy thing to say.
You should have your head examined.
Oh.
- Hi.
- Hey.
How's your mom? Uh, she's all right.
Thanks.
Um, mild concussion, not that a head injury ever stopped her.
Hmm.
Yeah, I should probably go by and check on her.
She'd probably like that.
I actually have some work questions for her.
She would love that.
My, uh, mom's looking for your dad's latest surgical reports.
Now, I couldn't find them, so I thought I'd ask to see if you knew where they were, but you know what I realized? What? I am so tired of talking about our parents.
Me, too.
It was better when we just talked about our dads and not also our moms.
Yeah, it was better when we didn't talk about any of 'em.
Yeah, it was.
- Have a good day.
- You, too.
Patricia Clark? Hello.
So, it says here you have stage 4 non-small cell lung cancer.
Post-induction therapy.
It says here that you came in through the ER? I couldn't breathe.
Still can't.
She's on 100% oxygen with intermittent hemoptysis.
Okay.
What are our options, Dr.
Shah? Well, if she continues to decompensate with worsening hypoxia, we should intubate.
- Hmm.
What else? - A bronchoscopy - might temporize the bleeding.
- True, but I'd like to also prepare for the possibility of a pneumonectomy.
Patricia, the lung that is failing you is so diseased that it may actually be simpler to remove it.
You're gonna remove my lung? Don't I need it? Not if the diseased tissue does you more harm than good.
Exactly.
Where is the doctor that took care of me in the ER? Uh, Dr.
, uh, Trulie? Uh She is not here right now, but we have an excellent team of doctors who will take great care of you if we move forward with this procedure.
So, is Lex off the surgery? I don't even know where Lex is.
Trauma.
Crush syndrome.
It was a whole thing with a crate.
- Oh.
- Well, for the record, I would love to be in the pneumonectomy.
So would I.
Okay.
I haven't decided.
A full lung removal is a rare procedure.
It's very technically difficult, so you should be studying.
All of you.
I've never been in a pneumonectomy.
- None of us have.
- Well, I spoke up first.
I offered an actual treatment.
Really? You lost first assist on our last two surgeries.
Why aren't you all over this? I'm prioritizing my relationship.
Plus, I don't need brownie points in CT.
- I excel where it matters.
- Are you talking about plastics? Doesn't Dr.
Glass still call you Jerry? Mom.
- What are you doing in here? - I, um Yeah, I just wanted to make sure her heart rate was coming down.
Okay.
I can take care of her heart.
- You need to rest.
- Yeah.
Okay.
Okay.
Seeing one patient isn't gonna kill me.
You are concussed.
I can't have you putting yourself at any more risk.
I already thought I lost you once today.
You didn't lose me, but I was afraid I lost you when you wouldn't take my calls.
Now I I need you to understand this.
I know it seems like I put - the hospital first - Let's not do this now.
Your father and I We had a plan back then.
This dream.
I mean, we were building something big together.
And when the accident happened, I was just terrified.
I Scandals like that sink hospitals.
They cost in money and donations and endowments and Mom, it's not what you did.
It's what you didn't do.
For years, I have wondered what was wrong with my relationship with Dad.
I have tried so hard to understand the wall that he put up between us.
And all this time, you have had the answer, and you didn't tell me.
Sam I don't want to talk about this right now, and you need to rest.
Please.
Why are you guys studying for a pneumonectomy? Because Sam hasn't assigned first assist yet.
On who, Patricia Clark? Wait, that's my patient.
I did her intake.
Missing rounds reflects a lack of commitment.
Really? Did you sleep great in your bed last night? Because I am committed to my third consecutive shift.
Dr.
Shah is very rested.
Which is why he will be first assist on the pneumonectomy.
Thank you.
I won't let you down.
Whatever.
Lex, you know I can't assign you to a surgery if you weren't there to round on a patient.
I know.
I was treating patients in the ER.
You've already fulfilled all of your elective hours down there.
We need you up here.
Maybe I haven't told you lately how much I depend on you.
I want you in that surgery.
It's the ER.
But that means you have to be here.
Okay.
Hi.
That was quite the decision.
Felt pretty straightforward to me.
I mean, Lex was missing, and Joey was late I was on time.
Caleb, you haven't had more than two consecutive - hours of sleep.
- You didn't even consider me.
Where is this coming from? Here, actually.
Oh.
These bunks are the only place we go.
You signed up for casual.
We were really clear about this.
I said I can't get serious right now I know, I, I know.
It would still be nice to be taken seriously.
And a few more steps.
- Is this a trust exercise? - Make a left.
- Ready? - Yeah.
Behold.
Our wedding chapel.
You hate it.
- No, no - I'm not done decorating.
It'll be more festive when the cake arrives.
Chocolate and lemon which I hate, - a lot.
- So you've said.
But I ordered it because I love you.
I just want to get married and eat cake and stop bickering - over wedding stuff.
- Yeah.
Ooh, did I tell you that Donna's ordained? Sorry, um This is, this this is just a lot.
It's not a lot, that's the point.
It's just an easy, simple way to get married without fighting.
That's not why we've been fighting.
You stopped talking to me for a day over place cards.
I slept with someone else.
What? The week before you proposed.
But it it didn't mean anything, and it was, it was a one-time thing, and I love you.
You love me, but then you cheated on me? I-I-I do.
I do love you, and I want to marry you, but before we do, I I just needed you to know.
Well now I know.
Hey! - Aw.
- There he is.
- Dad.
- Hey, kiddo.
- Oh.
- Oh.
Okay.
Hey, buddy.
Oh! Mmm.
What happened to your leg? Aw, don't ask.
What about you, huh? How many kids in school survive a bus crash and have heart surgery - in the same day, hmm? - We're all in one piece, and we're together.
That's what matters.
So, we can go home? Well, you will be ready to discharge very soon, Kevin.
And I see here that your mom finally let us examine her.
She's okay except for a couple bruises, and she can go at any time.
- And my dad? - Uh, well, his leg is healing.
- Mm-hmm.
- It's gonna be fine.
But your blood levels are still falling.
The laceration that we saw on your scan is still bleeding.
You need a blood transfusion, but our blood bank is depleted, our supply has not arrived yet, and you have a rare blood type.
- Can I donate to him? - Uh, no.
You're B, and Randy is type AB.
I-I got some blood during my surgery.
You sure did.
Last we had.
O neg.
What's O neg? - Uh, well, that's your blood type.
- Uh-huh.
It's very common.
It's, uh, it's known - as the universal donor.
- So, I can give some to my dad? Uh, well, technically, yes.
You could donate to either of your parents, but neither of them can donate to you.
Can I borrow Kevin for an EKG? - Uh-huh.
- Sure.
First take my blood.
- I'm a universal donor.
- Yeah, but you just had heart surgery, and you need it.
Plus, you can't donate till you're 18.
Anyway, uh, we would like to keep you here - until - Wait a minute.
For him to be O, doesn't one of us have to be O? Uh Genetically speaking, it is, um - Is he not my son? - What? What kind of a question is that? If I'm AB and you're B, Kevin can't be O.
It's genetically impossible.
Unless he's not my son.
Of course he's your son.
Then how do you explain the blood? I don't know.
I'm-I'm not a doctor.
Okay.
Doctors, i-is there another explanation? I'm not Kevin's father.
- I took her vitals an hour ago.
- Did you notice her pulse was all over the place? Stop this, both of you.
I am fine.
Her heart rate was normal.
You can't depend on the instruments.
You have to do it manually.
- I did do it manually.
- Well, her blood pressure's rising.
Gee, I wonder why that is.
Some people will do anything for a day off.
You look good.
I'm glad to see it.
Well, back at you.
Your splenic lac patient.
What about him? I need to do an ultrasound of his leg, make sure there isn't any nerve damage that needs my attention.
Be my guest.
- Feel better.
- I will.
I'm not gonna make it that easy for you to take my job.
I don't want it if you have to die for me to get it.
That's more your family's style, isn't it? - Ooh.
- I take issue with that statement.
- Me, too.
- I technically did not die.
I was in a persistent vegetative state.
Okay, thank you all for coming.
- Now get out.
- Okay.
- Vivi? - Mom? - You dizzy? - Yeah, no, I just - I sat up too quickly.
- Okay.
Okay.
Here.
Hey, hey, hey.
Follow my finger.
Delayed tracking.
Yeah.
Let's get a CT angio - of her neck.
- Yeah.
Why are you interested in the blood vessels of my neck? Mom, how's your vision? Yeah, I guess it's a bit blurry.
Okay, it could be a little more than a concussion.
Okay? - I'm gonna go down to Neurology.
- Yeah.
Just stop lying already! Randy, I told you, - it has to be a mistake.
- No, the mistake was me trusting you.
I need two milligrams of IV lorazepam.
We just got our family back together, and now you're blowing it apart.
What's gonna happen when Kevin finds out? There's nothing for Kevin to find out, Randy.
He deserves to know the truth! All right, all right.
He's tachycardic.
Randy, I need you to calm down.
Then tell my wife to not cheat on me.
Okay.
What is that? Hey.
Hey.
So ER again.
Haven't you put out enough fires down there? They need the help.
They have their own residents, and the storm is over.
Do you want me to tell them to back off? Oh, or am I doing that thing where I offer to handle something that you're perfectly capable of handling by yourself? What? - You are learning.
- Mm-hmm.
I know you like trauma, but you committed to CT, and And CT takes total commitment.
I know.
We talked about this.
You're on track to be chief resident of the most prestigious department at this hospital.
Right now, nobody can compete with you.
But if you're not all in, then I don't know how that'll be true.
Fever and a rash with a rising lactate.
Could be infection.
Yeah, but chest X-ray was clear, and blood cultures were negative.
Rhonda was worried about complications from a crush injury.
Any chance they're related? - Lex? - Hmm? Oh, um Mm, it's unlikely.
I mean, there's no signs of rhabdomyolysis, and his urine output is normal, so Sorry.
Okay.
Let's run repeat blood and urine cultures and broaden his antibiotics.
Could it be a stress response? To his wife's affair? I don't have a prescription for that.
Don't date a cheater.
What did you say? That would be my advice for someone who doesn't want to be cheated on.
So it was his fault that he didn't psychically know that his partner was unfaithful? No, not his fault.
But, like, you know, if she cheated, she was probably unhappy.
He has some part in that.
Wow.
Romance advice from someone who's never heard of a second date.
Thanks for the tip.
The wife swears that she did not have an affair.
She's convinced that it's something else.
Well, there's only one I can think of.
Chimerism.
He could have blood cells with distinct and different genotypes.
Part of him is type AB.
The other part is type O.
And that part made Kevin.
I've never seen a genetic chimera.
It can't hurt to test him.
Okay, so I'll send some blood to my geneticist friend - in Boston.
- Okay.
See? I do take you seriously.
Okay.
Thank you.
And I don't.
Okay.
And it's a good thing.
Caleb, I need something in my life that is not so serious.
And you have been that for me for so long, I don't know what I would do without it.
I don't know what I would do without you, Caleb.
And that is seriously how I feel.
I hope it's enough for you.
Mom.
What's happening? Vertebral artery dissection.
Vessel must've sheared in the crash.
- How did we miss this? - Delayed onset.
Contralateral vert is hypoplastic.
Not enough flow to her brain stem.
She could hemorrhage if we don't get her into surgery.
Okay.
You are gonna be okay, Mom.
And I'm here.
Baum's doing your surgery.
You don't get better than him.
I know.
Who do you think recruited him? When you get out, you're gonna have the best neurointensivists I know.
You are going to get through this.
What about us? Are we gonna get through this? Don't think about that right now, Mom.
I thought I was doing the right thing.
I thought I was protecting the right baby.
- Vivi.
- Mom, I Even if Randy has chimerism, doesn't explain any of these other symptoms.
Well, we've ruled out tissue infection.
The wound site was completely clean.
This seems like a respiratory infection.
It does, but when would he have inhaled bacterial particulate? He was trapped under that crate Wait a minute.
Tularemia.
- Isn't that bacterial? - Mm.
It comes from, like, rabbits and - Rodents.
- Right.
If that farm truck was transporting livestock The crate that landed on him could've been contaminated - with rabbit feces.
- All right, I'm gonna order - the labs.
- I'll call the farm and see what livestock they breed.
I'll get the Scooby Snacks and fire up the Mystery Machine.
Don't you have a surgery to prepare for? I do.
Because I was chosen for it and you weren't, which obviously bothers you.
If it's not plastics, I'm not interested.
You're the one who's always saying this is a competition.
And you don't like losing.
Mm, but if the prize for winning is rabbit poop, - I'm fine with it.
- No, you're not.
And you shouldn't be.
It's a big surgery.
And it's not a good look that you keep getting passed over.
If I wanted your surgery, I'd have it.
How's he doing? Strong blood flow to his lower extremities and no nerve damage.
My work here is done.
That's good news.
Uh, though, to be honest, I was looking forward to a fem-pop.
Even if I did need to perform a femoropopliteal procedure, what makes you think you'd be assisting me? I plan to subspecialize in plastics.
I was sure you knew that.
I-I may have been a little distracted lately.
I got engaged.
It's complicated.
But, uh, Dr.
Glass, plastics is my passion, - and I - You know what my passion is? Undeniable surgeons.
When I was a resident, everybody wanted me.
Every specialty, every surgery, every day.
When's the last time you were first assist? Instead of presuming to know what I think or whom I want, you might want to acquaint yourself with the OR.
Doctor.
Kace.
I got your page, but I couldn't get away.
We got an emergent cricothyrotomy on the way.
I figured you wouldn't want to miss it.
I don't.
But I have to ease up on my my trauma rotations.
CT is so demanding.
I already lost a surgery.
I can't be here and there at the same time.
So stay here.
I can't just change my specialty track.
Uh, yeah.
Sure, you can.
People do it all the time.
Right, but I've put years into CT.
If I switch, I'd be starting over from scratch.
If you hadn't been here today, that patient with the crush injury would be dead, and we both know it.
You don't just have talent, Dr.
Trulie.
You have passion, which you're gonna need where-wherever you specialize.
Gavin Larousse, 35.
Respiratory distress with a worsening angioedema.
His tongue is obstructing his airway.
Orotracheal and nasotracheal intubation is impossible.
Okay, let's go.
You sure you want to leave Trauma behind? - Hey.
- I know it's a competition.
This job.
I fight for my spot here every day, which is hard.
I know.
I know.
And whenever I needed to remember why I was doing it, what I was actually fighting for, I looked at you.
And then you did what you did, and now I don't know where to look.
Joey You know what, maybe I've taken too much for granted.
Maybe Maybe I just haven't fought hard enough.
You don't have to fight for me, I am right here.
I'm not talking about you.
Hello, Patricia.
Ready for your surgery? Is anybody ever ready to have their lung taken out? Has somebody walked you through the procedure, what to expect? - Yes.
- Yeah? Dr.
Shah was here.
Oh, good.
He needs a second chance.
What do you mean? Oh, I-I assumed you knew.
I mean, I think it's public record that he lost a patient.
Lost? Oh, it wasn't his fault.
At least, I don't think it was.
But he's struggled - with confidence since then.
- Oh The patient he lost, was it a lung removal? Appendectomy, actually.
A much simpler procedure.
The OR was always her favorite place.
I just never imagined her on the table.
What did she mean, "protecting the right baby"? She used to say she had two babies: you and the hospital.
She was in Orthopedics.
Long hours, a lot of pressure.
She did it all.
She loved being a doctor.
I felt it out there today.
But I also feel like she's been running the hospital for as long as I can remember.
Well, it was a long time ago.
When was it, exactly? Well after the accident, you had a hard time.
Night terrors, panic attacks.
You couldn't be alone.
I couldn't be with you, as we know.
So your mom decided that she would be.
She gave up being a doctor after the accident? She gave it up for me? Admin gave her reliable hours.
Home for dinner every day.
She knew it was what you needed.
How did I never know this? She didn't want you to know.
She would never tell you.
But I was there.
I saw it.
She gave everything to you.
And then, when you didn't need her so much she gave it to them.
We're all in this together, Sam.
- How's the patient? - Uh They repaired her dissection.
We're just waiting for her to wake up.
- I mean, she-she did great.
- How are you doing? I'm okay.
I'm tired.
Is there anything I can do? You could tell your mom to stop looking into my dad.
He has been dealing with something personal, but it is nothing for your mom to be concerned about.
He's okay.
Are you? I am I don't know.
It's okay.
Come here.
I know that your mom is just doing her job.
Hey, don't-don't worry about her.
All right? I will talk to her.
Okay? All right? Come here.
All right? It's gonna be okay.
Okay, Patricia, it is time Where is my patient? In surgery.
They moved it up.
Why wasn't I told? Hey.
Hey.
How's she doing? - She's stable.
- Good.
Trauma still chasing you? Actually, I talked to the program director about changing specialties.
What? I just did an emergent cric.
This patient's tongue was so swollen I had to hyperextend his neck to cut the cricothyroid membrane.
- It was - Electrifying.
- Yeah.
- Yeah, I know the feeling.
But I get it from heart surgery.
Uh, yeah, I mean, I'll still rotate through CT, but the ER will be my home base.
Hmm.
I know you think ER doctors are inferior.
I think some ER doctors are inferior.
You're an excellent surgeon, whatever color scrubs you wear.
- Trauma surgery's no joke.
- Mm-mm.
Dr.
Trulie, they'll be lucky to have you.
I'm lucky to have you.
- Mm-hmm.
- Mm-hmm.
Of course, I think it's a big mistake.
I mean, who trades CT for sore throats and sprained ankles? I can't weigh in on such a big decision for her.
That's all I need, some other woman rearranging her life because of me.
You scared me, Viv.
I thought I lost you.
I started thinking about everything we've been through together.
And, uh you're the love of my life.
So get out of bed, will you? Your husband has pneumatic tularemia, so we've started him on targeted antibiotics, and he should be feeling better soon.
Oh, good.
That's a relief.
And we also spoke to the genetics lab, and Randy does not have chimerism, or any other genetic anomaly that would explain why he has different DNA than Kevin.
It was just a fling.
Over before it began, practically.
And when I realized I was pregnant, Randy assumed the baby was his.
I wanted it to be his.
And I also thought what good would it do to tell him about the affair? Who would it help? That's a long time to carry a secret.
But in my experience, it's better to deal with the truth than to hide from it.
Excuse me.
Mom, you're awake.
How do you feel? Like I just had major surgery.
Mom, I-I remember when you made the switch to Admin.
I didn't know that I was the reason.
Dad told me.
I never wanted you to feel like I gave something up because of you.
But you did.
You gave up something that you love as much as I do.
I cannot imagine giving this up.
I did love it.
But I was also so happy to spend time with you and watch you grow into what you've become.
I'm so proud of you.
I'm so sorry I accused you of putting the hospital first.
And I'm sorry I kept the truth from you for so long.
What do you say we stop apologizing to each other and finally put this accident behind us? Mm.
I would love to.
- Oh - Oh, my girl.
Oh This came for you.
Oh.
How could I forget? Yeah, I know what you did.
Stealing my surgery.
I didn't steal your surgery.
The patient changed her mind after she knew the truth.
Looks like your wedding's off.
I don't know what happened, and I don't really care, but Tim dodged a bullet.
See you on the next one.
Dr.
Trulie.
- Reporting for duty.
- Not in those scrubs.
- They're the wrong color.
- Right.
- Follow me.
- Okay.
Here's your schedule.
All right.
Whoa.
There's a lot of night shifts.
Yep.
Goes by seniority.
Everybody starts at the bottom.
Here you go.
Now, there's a kid in Bay 4 with hand, foot, and mouth disease.
Ugh.
Okay.
- Welcome to the jungle.
- Yeah.
Ooh, the truth hurts.
- But it's better to know.
- Yeah.
She took my advice.
I guess I should, too.
About what? Us.
Um, look, I know I signed up for casual, and I agreed to it, and I'm good with it as long as it's not about Malcolm.
Malcolm? If you can't get serious with me because you still have feelings for him, I just need to know.
It's not about him.
Casual's just where I am right now.
Well, then, it's where I am, too.
Okay.
Do you want to go to my place - and sleep in an actual bed? - Yes, please.
Good.
A personal family matter, huh? Sam's just asking for a little privacy.
Is it really your place to be nosing around in his business? I used to think that Rob Griffith wasn't fit to be department chief, but he shouldn't be a part of this hospital at all.
What are you talking about? This.
There's the truth.
You decide whose place it is to do something about it.
"Driving while intoxicated.
"