Transplant (2020) s02e11 Episode Script
Locked
1
- Stop!
- Come on!
How is she doing?
Somewhere between didn't happen
and can't stop thinking about it.
My dad died Here, earlier today.
I was alone with him.
You can do your clinical hours here.
Become a nurse practitioner, you'll get a raise, you'll have seniority, I'll make sure.
We're friends, Amira, and she's still in both of our lives.
You're gonna do what? Sue me? Oh, come on Well, in addition to needing a place to stay, apparently, I need a rehab nurse.
Don't forget, I'm leaving right after work today.
It's the trip with Amira? Yeah, I carved out 24 hours for it.
It's the first time I've ever done that.
To go to a dance meet in Peterborough? You know how to live! I think Amira wanted me to let a friend's mom take her.
- Maybe I should have - It's good you go.
I I love that stuff.
You're gonna be okay here on your own? Yeah, I should focus on my own mess.
Mags! - Hey.
- You in emerg all day? Up in cardiology.
Paged for a consult.
Same, or I'm in the middle of one now.
Hey, did the funeral go okay? Fine for me, I didn't go.
Really? I mean, no, that's right.
That's good for you.
Totally healthy and not weird at all.
Yeah, I just didn't want to sit around and listen to everyone say nice things about him.
White blood cell count is up and imaging is showing that Mrs.
Weiland has appendicitis.
Ms.
Weiland, isn't that who you called me down for? Yeah.
May have jumped the gun, Mags, she complained of chest pain, but it's definitely her appendix.
Okay, Nancy.
So, it looks like today, we are going to be evicting an organ.
Any pre-existing conditions we should know about? I have incurable ovarian cancer.
Uh, you didn't mention that earlier.
It's not really something I care to discuss.
Sorry for dragging you down here, however now that you are Did you want me to look at some patients? Yes, okay.
- Thank you.
- Given her hysterectomy, we're not gonna want to do this laparoscopically.
How long's the wait upstairs? A while.
Is it true you've got the approval for the trauma OR? As a pilot program only, but I do have a support team on loan to make sure it gets a fair shake.
Right.
Yeah I don't get to do a lot of open appy's, and I hear that the maiden voyage is supposed to be a pretty big deal, so.
Meet you in there in 20? I'll get everybody prepped.
I'll let the patient know she won't have to wait all day in agony.
Public health flags the contacts of people diagnosed with certain highly contagious diseases.
How long do we have to stay in quarantine? At least until we know what Evi was exposed to.
You also said her G-tube is blocked? Has she taken any new medication? Her GP called in a decongestant and we thought it was water soluble, but I guess not? Last night, she started running a fever.
Okay.
Did you try flushing the tube? Yeah.
And nothing's going in.
Well, we can unblock the tube once we know if she's caught something else.
Evelyn, can I listen to your breathing? Up for yes, down for no.
Have you dealt with many patients with Locked-in-Syndrome? None, actually.
Evie was making dinner five years ago when she had her brain stem stroke.
And she can think and she can hear like anyone else, but she can only move her eyes.
Your shorthand.
It's based on where she looks? Yeah.
We used to need a letter-based board.
But we don't anymore.
She'd say I get it wrong as often as I get it right, but we've always been one of those couples that knows what each other's thinking.
And she wants me to stop rambling.
Is she going to be okay? We're just running a few tests right now, they should be Uh, excuse me a minute.
Hey.
I don't like it here either.
Did you hear back from Public Health? We did.
Unfortunately, you've been exposed to Middle Eastern Respiratory Syndrome.
It's a very serious and contagious respiratory virus.
- Evie has MERS? - We have to assume you both do.
Wow, that was not what I was expecting when I heard about an ear pain.
- Pretty gruesome, eh? - Okay, James, well, I'm Dr.
Leblanc, and I'm sorry to tell you, but I think you have a nail in your ear.
Jamie.
And yeah, I kinda put it there.
Okay.
Why, exactly? I work at a machine shop.
We get bored, and my buddies dared me to pierce my ear with a nail gun.
Guess I was a little too game? - Hm.
- The brain trust tried digging the nail out themselves.
Yeah.
Which just meant more blood.
I hate blood.
Yeah.
Most people don't realize that the ear is so prone to bleeding.
Can you move your neck for me, please? Ah, kind of can't.
Okay.
Sorry.
Here.
Neck pain? - Headache? - Hmm-hmm.
Okay.
We're gonna want to rule out infection.
Open your mouth.
Okay.
I might have to cut through your ear to get this out.
Hm.
There's not a less aggressive way? Hm.
I don't think so.
Oh! Uh, Mags? Hey.
Hey.
Guess you really hate blood, Jamie.
- Can you give me a minute? - Yeah.
Good idea with the water.
It helps, focus on something tactile.
I don't know what happened.
I know he was fainting, but I thought You were assaulted.
This is a completely normal reaction.
That was months ago.
And this guy? He wasn't threatening.
Just because your brain knows that doesn't mean your body does.
He may have an infection from the nail, or from before even, so.
He needs blood cultures and CBC just to be safe.
And we need to page plastics for the ear.
Okay, you need to take a second.
- Make space to process this.
- Yeah.
Retractor? Dividing the fascia, suspending the peritoneum.
Winston, protect the bowel.
She's full of adhesions from when they removed her tumours.
Seems like her appendix is fused to her abdominal wall.
Can you free it up? We have to immobilize the bowel first.
Damn it, we have a bleed.
- Jed.
- It's okay, Wendy.
Bobby? And cauterizing.
Pressure's dropping.
I need suction.
This is a bigger bleed than we thought.
- Arterial? - It's hard to tell.
Maybe an artery was damaged when we removed the appendix from the abdominal wall, it's a little easier to tell with the lap cam.
You can do this here just as well.
You know the positioning, June.
Find it by feel.
June.
Are you saying you need help? Because we can drape her and wait for OR.
Let's just give her a minute, Wendy.
- I can't find the source.
- Okay.
I'm calling upstairs.
I'm sorry, sir, I know you needed this to work down here.
Why don't you try widening the incision? Scalpel? - They can take her in five.
- Got it! No need.
Tie it off now.
Good work, Dr.
Curtis.
Let's crossover later.
I want us to learn everything we can from the procedures that we do here.
Oh There he is! Hey! Dad? What are you doing here? I know, I know we said we were just gonna talk, but the phone is It's too impersonal.
- Hey.
- Hey.
- What'd you do to yourself? - It's not a big deal.
You know, I really wish you'd told me you were coming down.
Well, I figured you were gonna try to talk me out of it.
We've been worried.
You know we almost never see you.
And the last time you asked to borrow money you were still in school.
Yeah, no I'm just, uh, I'm stretched thin with the new house and Mel and She's worried too.
She called us to say so.
Bitter doesn't suit you, son.
Yeah, Dad.
I'm not really interested in a counselling session right now.
Well, how about a tour of this fancy hospital I've heard so much about? And then lunch? I'm at the Radisson and that restaurant's got a great club sandwich.
Yeah.
This city, world class food in every corner.
I can't do lunch, actually.
Well, look, uh, why don't you just point me to the best place to find some Jays merch and then we can meet up for dinner later? - Somewhere world class.
- I'm working late tonight.
Well, can you trade shifts? Look, I'm sorry to be so direct, but if you came all this way just to tell me you can't lend me the money, can you just say so? All I'm asking for is a conversation, Theo.
Best Jays merch, uh By the stadium.
That's down front and take a right.
Okay.
Evelyn had a home care nurse who was exposed overseas.
Public Health has traced his contacts and no one else is sick.
I won't get results to their PCR tests until the morning, but given her unique circumstances, I wouldn't release her.
- And the husband? - Currently asymptomatic, but he's her primary caregiver, so they've been in pretty close contact.
Your trauma OR, that's moving forward.
This is good news? For the hospital, I hope so.
We'll see where it leads.
Of all the things we see in here, locked-in unsettles me the most.
Trapped in your own mind like that? - She is all prepped.
- Thank you, Claire.
My son is in town.
Join us for dinner tonight? Oh, shoot, um, I can't tonight, but will you say hi for me? Sure.
So, um, your bloodwork and cultures came back clear.
We were thorough and you were lucky there was no infection.
Uh, I do still have a headache though.
Because Jamie, there's a second nail in your head.
There is? What are you Seriously? You really didn't know? Uh I mean, there was a misfire, but I didn't feel anything and I guess it went in clean? Well, I'm just surprised you didn't feel anything, but I guess it's possible.
So, what happens now? I need to examine the puncture wound.
Okay.
Okay.
Hey, can I keep the nail when it's out? As a souvenir? You need to stay still, sir, please.
Okay, sorry.
All good in here? Yeah.
There's a second um, nail uh, puncture, and I just can't find the entry point so Would you like me to take a look? Okay.
Yeah.
Let me know if you can find it.
And we need to page neurosurgery.
He'll need the OR.
Did she just say I need brain surgery? Oh, doctor! Doctor? Hi, Mrs.
Welland, nice to see you up so soon.
How did I wind up getting in so fast? Oh, well, we've started doing certain procedures in what we call a Trauma OR and yours qualified, so Oh.
So I'll get out of here soon? I'm supposed to look after my grandson to give my daughter a couple of days of break.
Yeah, I think you'll still need to take it easy.
I'm guessing you've spent enough time in hospitals as it is.
Months of chemo, then a hysterectomy.
They got rid of most of the active cancer, but a couple of cells reached a lymph node and so, therefore, in the future It'll come back.
I may not look much like a ticking time bomb, but ooh, there it is.
Did you want me to call your daughter, ask her to No, absolutely not.
It'll just put her back to seeing me as a sick person and I've decided that's not how I want to live.
Okay.
Oh! Oh! - Ms.
Welland? Are you okay? - They gave me the morphine, - but I definitely felt that.
- I'm on it, ma'am.
Yeah, you know what, I think I'm gonna do an ultrasound to see what's going on.
Evelyn's G-tube is clean, and her chest X-ray looks good.
No pneumonia.
Her symptoms are mild so far, but we want to keep her for observation.
I read that some MERS patients were barely symptomatic? That can be true.
The next 48 hours will be telling, but, uh, Fitz No, I'm not leaving.
I can understand why you want to stay, but you're really safer at home.
I've already been exposed! Except, since you're not symptomatic, our quarantine rules won't allow it.
I'm sorry, but you're under a self-isolation order.
She needs me.
Look, we tried to make it work with other people, computer-assisted devices, it's never enough.
I know her.
She'll be under vitals monitoring all night, okay? Anything that comes up, we will look out.
They're saying I have to go.
I know.
But they're not giving us a choice.
There are five nurses on this floor all night.
She won't be alone.
We're going to take good care of you, you have nothing to worry about, Evelyn.
The best way to communicate is to look her in the eye and ask yes or no questions.
If it's anything more complicated We'll call you, you have my word.
I know, I promise I'll remember to eat.
I'll be fine.
I love you.
Ms.
Weiland is fortunate we were on that so quickly.
This is why you need to be extra vigilant during closing.
We were vigilant, Dr.
Singh.
We had a bleed, yes, but we handled it.
This one started after.
Your dissection technique wasn't on point.
What kind of surgical lighting does Bishop have in there? Lighting's fine, you say this to me every time I do one of these.
Because I'm there to correct you.
It shouldn't be after the fact.
I was opposed to a trauma OR for exactly this reason, us having to clean up another department's mess.
It's not a mess.
Bleeds are a normal complication of abdo surgery.
And Dr.
Bishop's giving me an opportunity to expand my experience.
You're his lab rat, June.
If this goes south, it could affect your reputation.
Is this you calling out landmines again? Because this is an approved initiative and I work for him too.
Let me handle it.
Yeah, I've read their statement of claim, it's Dr.
Bishop I need a word.
Yeah.
Well, truth's our best weapon, so If you think we should push back, good.
Let me now.
Alright.
What's up, Wendy? You specifically told me you weren't hiring another chief, that it was just lip service? Why don't we have this conversation in my office.
Then what I've heard is true? You already have? On an interim basis, to help pilot the trauma OR and share hands-on duties.
Were you ever seriously considering me? Wendy, you are an excellent attending, and of great value to this department.
- In other words, no.
- It's more complicated.
I really think we should continue this in the office.
Wendy, you're acting like this is a demotion.
If anything I am going to be relying on you more in the To prop yourself up, you mean.
All I've done, this last 30 years, is put the interests of this department ahead of my own.
You held me back, Jed.
You kept me where you needed me.
Well, I'm done.
I'm finished.
Good luck! Wendy! Dr.
Hunter, can you supervise non-pediatric patients today? Dr.
Leblanc can you swing a double? - Sure.
- I need residents on the floor that don't require constant supervision.
Dr.
Atwater, hey! I'm sorry you had to see that, Dr.
Curtis.
You're really gonna leave? I've been considering my options for 20 years.
Catering to other people, waiting for my turn.
I'm done sucking it up, June.
- But what are you gonna do now? - Oh! Whatever I want.
I was sorry to hear about your father.
Are you nervous? I know you're going to be great.
It's gonna be you and a bunch of moms sitting there.
I can handle it.
No gross blood and guts talk.
People don't like that.
- Okay.
- Also, we're wearing stage makeup.
- Don't say anything about it.
- Okay.
Or about the fact that this is all getting filmed for YouTube.
Amira.
Okay, okay, not a word.
There's Jameela and Sadie.
Rania? What is she doing here? Uh, I invited her.
As a friend.
- Rania! - Oh, Amira! - I'm glad you're here! - How could I miss this? Hi, Bashir.
I'm sorry.
I should've called earlier than today.
Habibti, Sadie's mom says there's a dressing room in the back.
Will you help with my hair? Yeah.
I'll find us seats.
- Yeah.
- Not at the front! Not at the front.
What brings you guys in here tonight? - Zeke? - I fell off the fourth-floor fire escape outside of my dorm.
The whole truth, bud.
I thought it might be a good idea to make my own zipline.
- Turns out, it was not.
- Okay.
Why don't you toss that in there for me? Have any blurred vision or nausea? Headaches? Headaches a bit.
I told Coach it was no big deal, but he made me come.
And benched me for two weeks! You break the rules, you gotta suffer the consequences.
Are Mom or Dad looped in? I called them, I left a message.
It won't be returned.
Hey, Zeke, why don't you tell Dr.
Hunter why you made the zipline.
Because I'm gonna die anyways.
And uh, what does that mean, exactly? It's like, uh, I know something bad is gonna happen just not what or when.
Were you trying to hurt yourself? No! I definitely don't wanna die, it's just, if it's gonna happen, might as well live big.
Enjoy the rush? He's been talking like this for a month now.
I mean, I thought it was a prank, - but he really believes it.
- Because it's true! Have you had any previous head injuries? That's what I wondered too.
Zeke plays rugby.
He tackles pretty hard, but he assures me after every game that he's feeling okay.
I had the school nurse check him out, but I just wanted to make sure.
It could be a concussion.
Yeah.
It's a good idea to do imaging, and, uh, make sure it's nothing more serious.
Thank you.
Appreciate it.
See? They're gonna look after you, buddy.
Or they'll find something and you'll have to admit that I'm right.
Hey, doc.
Should I keep benching him? I'm not one of those coaches that puts winning ahead of the kids, I just I want what's best for Zeke.
Let's just see what the test results are.
Okay.
His parents, they don't sound too involved? No.
Uh, they both travel a lot.
They're the corporate types.
He's lucky if he sees them around Christmas.
It's a bit of a sore subject.
Do you know if he's spoken to anyone? Just kids can exhibit personality changes during puberty and if the family situation is difficult I mean, he had some trouble adjusting when he first came to us.
I read about kids with brain injuries.
How it changes their whole way of being, you know, - I just want to make sure.
- The CT will be fast.
- Okay.
- It might take a little while for the MRI.
You're good to stay? Yeah.
Impressive woman.
I crumbled with one weak arm.
Should I have talked Wendy out of quitting? I didn't say anything, Jed.
Or would she have resented me for that? I know things have changed since I asked you to stay.
Evie needs saline.
Hello, Evelyn.
Ah yay! Amira, you were so brilliant.
Hey, you're gonna have to teach me that move at the end.
Oh stop! My friends are going for burgers.
- Can I go? - Here.
Okay, keep your phone on, I'll wait for you here, okay? Okay.
Have fun.
That was the most positive feedback I've gotten from her in months.
Thank you for being here.
She needs someone who gets all this.
Yeah.
I heard you got a job at a bookstore? Part-time.
They let me host discussions on my favourite authors.
Mostly just friends come, but it makes me feel like myself.
I knew you'd adapt quickly.
Rania, I still want you in my life.
What life? Tonight, with Amira.
You were present.
And silly.
And fun.
That's how I remember you, don't tell me it's because we were younger.
No, I I try to be present.
I mean, I know I'm busy working, but Looks more like toiling to me.
All you do is survive.
What else is in your life? - I don't say that to upset you.
- What's it supposed to do? Help me? You don't let anyone help you.
Or see you.
Does anyone really see you, Bashir? He's stuck in that cell that they put him in when they took him away from you! And I don't know how to break him free.
I heard you did really well last night, Evelyn.
Your temperature's down and your oxygen saturation's back to normal.
All good signs.
How are you feeling? I know it was upsetting, when I asked Fitz to leave yesterday Dr.
Hamed? Excuse me, Evelyn, I'll be right back.
You gonna have to put a new one on.
He just walked-in.
It came on suddenly last night.
I woke up drenched in sweat.
Now it's hard to breathe.
Is Evie okay? She's doing really well.
What's that mean? It means you're not getting enough oxygen through your system.
Lay back for me please? Fitz, do you have any underlying health concerns? MERS can hit hard if pre-existing conditions weaken your immune system.
- Like what? - Is there any reason your liver could be impaired? Your hands are shaking, and I'm seeing some bruising.
Whatever it is, Fitz, - I need to know.
- I drink, okay? More than I should.
Is that why I'm this sick? I'm seeing evidence of cirrhosis on the ultrasound.
I, uh I understand it can be difficult to manage your own well-being when you're so focused on Evelyn's.
I'm her only connection to the outside world.
She's adapted to so much, I don't want her to think she's a burden.
Does she know how much you drink? I don't talk about it.
She can't know I'm here, Dr.
Hamed.
She'll think it's her fault.
Hey, shouldn't they have taken Jamie to surgery by now? Claire realized the patient was having absence seizures, so we kept him in overnight to monitor.
He was? After you left the room, he zoned out again.
So I asked him if he felt an aura, and he said he thought so.
It's why he was staring off.
We started him on anti-epileptics and he'll need a constant EEG during surgery, since we don't know the cause of the seizures.
It's probably the nail in the head.
This is something you would normally catch.
Was there a reason you didn't assess him yourself? - Jed.
- No, he's right, I should have.
It won't happen again, Dr.
Bishop.
- You didn't have to take that.
- I was supposed to tell my boss that I'm missing things because I can't be alone with patients? No, but that's his job to support you.
I don't want support! I just want to be able to do my job.
Hey, I need a patient on ECMO.
Rhoda tells me you can make that call, now that Atwater isn't? - It's for your MERS patient? - The husband.
He's cirrhotic and desaturating quickly.
I'll get one sent down right away.
Thanks.
- Were you there when she quit? - Yeah, we all were.
Bishop didn't put her up for co-chief.
It was a scene.
You know, this whole trauma OR thing, the way he's so driven by it, did you see how quickly he just moved on from Atwater? - Like she was never even here.
- He was trying to roll with a bad situation the best he could.
One day he's yelling at me, the next day he's promoting me.
Anyone know who he hired? They don't tell me anything.
I'm perfectly capable of supervising an emergency appendectomy.
I didn't call you up to debate your qualifications.
So we're talking about June's? Not her credentials, her bandwidth.
She's stretched thin as it is.
Chief Resident, working both units, - she doesn't have the space.
- She's a confident physician.
If she had a problem handling this, - I expect she'd tell me herself.
- She's my resident, Jed.
Poach a trauma surgeon from somewhere else! Sure.
If you want her to miss this opportunity, so be it.
Hi! I know I said to get you out of here sooner.
Apparently, an organ that turns out I didn't even really need has got us both on the ropes.
Your white blood cell count is still high, but that makes sense given your appendicitis.
That having been said, it also corresponds with your CA-25-antigens, so You checked for tumour markers? We'll have the results in a couple hours - I didn't ask you to do that! - It's okay.
We were already doing bloods, and you're supposed to check them regularly to make sure your cancer is not active again.
I don't care if the cancer is active! I can't change anything that's coming, so why would I even wanna know! So you can plan.
You are not listening to me! I don't want to live that way.
Is that What's wrong with me? Yeah, it's just, low pressure.
I'm on it.
We'll get this figured out, Nancy.
We've been here all night.
I know it's been a long wait, but the senior radiologist reviewed the MRI and agrees, - everything looks fine.
- So no brain injury? That's great news, buddy.
It is.
But I spoke with the psychiatry resident.
They think you might have ADHD.
You think I'm hyperactive? Well, that's one manifestation, but there are others.
Impulsive action, for example.
Like zip-lining off a fire escape.
Exactly.
So, what about the way that Zeke's feeling or his fear? People think ADHD means high energy, but a sense of impending doom, that can be associated with the diagnosis.
It's a common condition in kids your age, even if yours is presenting differently.
So you're saying I'm not dying? - Is there medication? - Yes.
This is great! He's saying that this is a problem we can solve.
- I can help you.
- You shouldn't have to! Zeke! It's Zeke! Zeke! Hey! Open the car! Not until we talk about this.
- I don't want to talk! - Look, Zeke, just come inside.
Zeke, Zeke, what are you doing? I wanna go! My parents said I was the problem when they sent me here! This means they were right all along? Man, screw your parents! Okay? If they can't see what a great kid you are, then they're assholes! Language, Coach.
I'll put a dollar in the jar, but only if you come back inside.
Why don't we get you inside and clean you up a little bit, okay? My blood goes through that machine and then back inside me? ECMO works by temporarily drawing the blood out of your body to oxygenate it.
It does the job of your heart and your lungs.
You got me hooked up to this thing, you must be pretty worried.
Um, we have every reason to stay positive.
Okay? Alright.
To conserve energy, I'm going to sedate and intubate you now.
Fitz, I know you didn't want me to say anything to Evelyn, but if there's a message you want to get across to her, - now's the time.
- Because I might die? No.
She'll be terrified and she won't be able to communicate it.
Just make me better.
I can't leave her alone.
I'll do my best.
You're ready? Yeah.
Thanks for coming.
I wasn't sure you'd call.
You're uh You were right, we need to talk.
I have a bet with your mother.
She says home repairs gone wrong.
And I have pre-mid life crisis motorcycle accident.
I, uh I punched a man.
Why, son? Because Because I'm angry, Dad.
I just I thought I could move on and build something.
But then I'm a failure.
And I don't know what to do.
You have to forgive yourself.
I've tried and I know it was all my choice, - but if I knew it like - No, no, no.
I meant for wanting it.
Theo, it's okay that you wanted this life.
Is this, uh, is this the part where you tell me you and Mom are - You're praying for me? - Yeah, I hate it when people say that.
As though you desperately need it.
But yeah, we are.
But, listen, about the loan.
You don't need money right now.
Oh, I thought, uh we kind of just established how I messed up I am.
And you already have everything you need to clean that up.
His O² stats aren't holding.
Vascular complications can happen on ECMO.
Maybe the cannula isn't functioning properly.
He's cold to the touch.
Something's not right with his blood flow.
And it's pale too.
I'll get the ultrasound.
- Hey.
- Hi.
I wasn't sure if I'd see you again.
Uh, we wanted to talk to you about the cause of the seizures you've been having.
This is Dr.
Curtis, - chief surgical resident.
- Hi.
I'm guessing, if you're here, it's not just about the nail? Well, uh, when the team removed it, we found an un-ruptured aneurysm.
A pretty big one.
Yeah, it's like a bubble on your arterial wall, and the kind of thing you only find if you're looking for it.
If left unchecked, it could burst and have killed you, but fortunately, we had our reason to look so So then shooting myself with a nail was a good idea? More like a stroke of dumb luck.
Hey, did I do something to offend you? Because I can usually tell when someone doesn't like me, and you definitely do not.
It's not you, I'm I'm really glad things worked out for you and I Hey, I heard you wanted to keep this.
Cool.
- Alright.
- Thank you.
Thanks for being in there with me.
Yeah, anytime.
Hi, Evelyn.
I need to talk to you about your husband.
I thought you were upset because you were afraid for yourself, but now I realize that you were worried about him.
Is that right? Okay, hum.
Fitz is here, in the hospital.
He became very sick with the virus.
Much sicker than you last night.
I'm sorry to bring you tough news.
He wanted to protect you, but he can't speak for himself at the moment and we need your help.
Okay.
We're trying to help his body fight the virus, but during the process he developed a complication called an arteriovenous fistula.
It's an abnormal connection between an artery and a vein.
Are you with me so far? Okay.
We need to know if you consent to this.
Okay.
We will try to do it as non-invasively as possible, but if that doesn't work, he may need surgery.
I'm sorry.
I don't know what that means.
Do you have questions about the procedures he might require? Okay.
I'll go through all of the details, and you stop me whenever you have questions.
Okay, Evelyn? - Another bleed? - Actually, one of the clips we used the second time dislodged.
But we reattached and triple checked.
She still won't let us check her tumour markers, but she'll be ready to get on with her life tomorrow.
You called us both up here to tell us that? No, I called you both up because my patient spent time in both of your departments and both times something went wrong.
Which means that nobody's perfect.
But each time we fixed it.
I fixed it, but that's not the point.
Look Dr.
Singh, protecting me does not mean holding me back from opportunities just because you don't like them.
And if you really have my back, I mean, I need to know that when I say I'm overworked, you're gonna hear me.
Even if your initiative takes a hit.
Understood, Dr.
Curtis.
Coming in loud and clear.
Okay.
It's very good.
I taught her well.
I was about to say the same thing.
About myself.
Hey, I hear nail dude was saved by his own stupidity? I'm sorry about snapping earlier.
Mags, you don't have to apologize.
No, to you, I do.
Somehow, I ended up apologizing to nail dude as well, but Well, that sounds about right.
Is this gonna keep happening? These things can take time.
- I'm here if you need me.
- Okay.
You needed an intervention to repair a circulatory problem.
But it's over now, and your vitals are stabilizing.
Hey, uh Evelyn really came through.
She weighed in on every decision.
She's one hell of a mind.
When you beat this virus, and you will, the cirrhosis can be treated.
But Fitz, you'll have to stop drinking.
And for what it's worth, there's nothing wrong with getting outside help.
Clearly, Evelyn can take care of herself.
And you can stand to live for yourself as well.
Okay.
Also You have a visitor.
If any couple deserved some good luck it's those two, huh? My lawyer.
He thinks we should go aggressive against the lawsuit, counterclaim with defamation.
I've asked him to speak to your lawyer.
I can do that.
We're in this together, Bashir.
Let me help you.
Sir, the temperature around here.
I'm guessing you're aware that Yeah, people aren't sure of the recent changes, I know.
When the board approved the pilot program, they decided on a co-chief for me.
Sir? I couldn't tell Wendy in front of everyone.
You're going to be running the department with Dr.
Novak? Things aren't cooling down here quite yet.
Well, why did I bother getting dressed up if we weren't going to wait for the table? It was too loud anyway.
So you're selling the house? Yeah, the pastor knows a thing or two about drywall.
He's gonna help me fix it up.
Put it back on the market.
But I will need to stay with you a little bit longer.
I already told you.
You can stay as long as you want.
Thank you.
My dad left me in charge of his estate.
Is that good? It's more like a sick joke from beyond the grave.
It's a mess.
I wanted to pay someone else - to do it, but - Yeah.
Should I be talking them out of doing that? Uh What's the point? They're gonna wind up in our emerg in about an hour for some other stupid reason.
So you're saying life is gonna bounce itself out here? Wouldn't you like to be one of those stupid happy people? Just once.
Just to see how it feels like to live unburdened.
That's just not who we are.
How was that dance trip? Look.
Hey.
Thanks.
Wow, freedom.
My dad died Here, earlier today.
I was alone with him.
You can do your clinical hours here.
Become a nurse practitioner, you'll get a raise, you'll have seniority, I'll make sure.
We're friends, Amira, and she's still in both of our lives.
You're gonna do what? Sue me? Oh, come on Well, in addition to needing a place to stay, apparently, I need a rehab nurse.
Don't forget, I'm leaving right after work today.
It's the trip with Amira? Yeah, I carved out 24 hours for it.
It's the first time I've ever done that.
To go to a dance meet in Peterborough? You know how to live! I think Amira wanted me to let a friend's mom take her.
- Maybe I should have - It's good you go.
I I love that stuff.
You're gonna be okay here on your own? Yeah, I should focus on my own mess.
Mags! - Hey.
- You in emerg all day? Up in cardiology.
Paged for a consult.
Same, or I'm in the middle of one now.
Hey, did the funeral go okay? Fine for me, I didn't go.
Really? I mean, no, that's right.
That's good for you.
Totally healthy and not weird at all.
Yeah, I just didn't want to sit around and listen to everyone say nice things about him.
White blood cell count is up and imaging is showing that Mrs.
Weiland has appendicitis.
Ms.
Weiland, isn't that who you called me down for? Yeah.
May have jumped the gun, Mags, she complained of chest pain, but it's definitely her appendix.
Okay, Nancy.
So, it looks like today, we are going to be evicting an organ.
Any pre-existing conditions we should know about? I have incurable ovarian cancer.
Uh, you didn't mention that earlier.
It's not really something I care to discuss.
Sorry for dragging you down here, however now that you are Did you want me to look at some patients? Yes, okay.
- Thank you.
- Given her hysterectomy, we're not gonna want to do this laparoscopically.
How long's the wait upstairs? A while.
Is it true you've got the approval for the trauma OR? As a pilot program only, but I do have a support team on loan to make sure it gets a fair shake.
Right.
Yeah I don't get to do a lot of open appy's, and I hear that the maiden voyage is supposed to be a pretty big deal, so.
Meet you in there in 20? I'll get everybody prepped.
I'll let the patient know she won't have to wait all day in agony.
Public health flags the contacts of people diagnosed with certain highly contagious diseases.
How long do we have to stay in quarantine? At least until we know what Evi was exposed to.
You also said her G-tube is blocked? Has she taken any new medication? Her GP called in a decongestant and we thought it was water soluble, but I guess not? Last night, she started running a fever.
Okay.
Did you try flushing the tube? Yeah.
And nothing's going in.
Well, we can unblock the tube once we know if she's caught something else.
Evelyn, can I listen to your breathing? Up for yes, down for no.
Have you dealt with many patients with Locked-in-Syndrome? None, actually.
Evie was making dinner five years ago when she had her brain stem stroke.
And she can think and she can hear like anyone else, but she can only move her eyes.
Your shorthand.
It's based on where she looks? Yeah.
We used to need a letter-based board.
But we don't anymore.
She'd say I get it wrong as often as I get it right, but we've always been one of those couples that knows what each other's thinking.
And she wants me to stop rambling.
Is she going to be okay? We're just running a few tests right now, they should be Uh, excuse me a minute.
Hey.
I don't like it here either.
Did you hear back from Public Health? We did.
Unfortunately, you've been exposed to Middle Eastern Respiratory Syndrome.
It's a very serious and contagious respiratory virus.
- Evie has MERS? - We have to assume you both do.
Wow, that was not what I was expecting when I heard about an ear pain.
- Pretty gruesome, eh? - Okay, James, well, I'm Dr.
Leblanc, and I'm sorry to tell you, but I think you have a nail in your ear.
Jamie.
And yeah, I kinda put it there.
Okay.
Why, exactly? I work at a machine shop.
We get bored, and my buddies dared me to pierce my ear with a nail gun.
Guess I was a little too game? - Hm.
- The brain trust tried digging the nail out themselves.
Yeah.
Which just meant more blood.
I hate blood.
Yeah.
Most people don't realize that the ear is so prone to bleeding.
Can you move your neck for me, please? Ah, kind of can't.
Okay.
Sorry.
Here.
Neck pain? - Headache? - Hmm-hmm.
Okay.
We're gonna want to rule out infection.
Open your mouth.
Okay.
I might have to cut through your ear to get this out.
Hm.
There's not a less aggressive way? Hm.
I don't think so.
Oh! Uh, Mags? Hey.
Hey.
Guess you really hate blood, Jamie.
- Can you give me a minute? - Yeah.
Good idea with the water.
It helps, focus on something tactile.
I don't know what happened.
I know he was fainting, but I thought You were assaulted.
This is a completely normal reaction.
That was months ago.
And this guy? He wasn't threatening.
Just because your brain knows that doesn't mean your body does.
He may have an infection from the nail, or from before even, so.
He needs blood cultures and CBC just to be safe.
And we need to page plastics for the ear.
Okay, you need to take a second.
- Make space to process this.
- Yeah.
Retractor? Dividing the fascia, suspending the peritoneum.
Winston, protect the bowel.
She's full of adhesions from when they removed her tumours.
Seems like her appendix is fused to her abdominal wall.
Can you free it up? We have to immobilize the bowel first.
Damn it, we have a bleed.
- Jed.
- It's okay, Wendy.
Bobby? And cauterizing.
Pressure's dropping.
I need suction.
This is a bigger bleed than we thought.
- Arterial? - It's hard to tell.
Maybe an artery was damaged when we removed the appendix from the abdominal wall, it's a little easier to tell with the lap cam.
You can do this here just as well.
You know the positioning, June.
Find it by feel.
June.
Are you saying you need help? Because we can drape her and wait for OR.
Let's just give her a minute, Wendy.
- I can't find the source.
- Okay.
I'm calling upstairs.
I'm sorry, sir, I know you needed this to work down here.
Why don't you try widening the incision? Scalpel? - They can take her in five.
- Got it! No need.
Tie it off now.
Good work, Dr.
Curtis.
Let's crossover later.
I want us to learn everything we can from the procedures that we do here.
Oh There he is! Hey! Dad? What are you doing here? I know, I know we said we were just gonna talk, but the phone is It's too impersonal.
- Hey.
- Hey.
- What'd you do to yourself? - It's not a big deal.
You know, I really wish you'd told me you were coming down.
Well, I figured you were gonna try to talk me out of it.
We've been worried.
You know we almost never see you.
And the last time you asked to borrow money you were still in school.
Yeah, no I'm just, uh, I'm stretched thin with the new house and Mel and She's worried too.
She called us to say so.
Bitter doesn't suit you, son.
Yeah, Dad.
I'm not really interested in a counselling session right now.
Well, how about a tour of this fancy hospital I've heard so much about? And then lunch? I'm at the Radisson and that restaurant's got a great club sandwich.
Yeah.
This city, world class food in every corner.
I can't do lunch, actually.
Well, look, uh, why don't you just point me to the best place to find some Jays merch and then we can meet up for dinner later? - Somewhere world class.
- I'm working late tonight.
Well, can you trade shifts? Look, I'm sorry to be so direct, but if you came all this way just to tell me you can't lend me the money, can you just say so? All I'm asking for is a conversation, Theo.
Best Jays merch, uh By the stadium.
That's down front and take a right.
Okay.
Evelyn had a home care nurse who was exposed overseas.
Public Health has traced his contacts and no one else is sick.
I won't get results to their PCR tests until the morning, but given her unique circumstances, I wouldn't release her.
- And the husband? - Currently asymptomatic, but he's her primary caregiver, so they've been in pretty close contact.
Your trauma OR, that's moving forward.
This is good news? For the hospital, I hope so.
We'll see where it leads.
Of all the things we see in here, locked-in unsettles me the most.
Trapped in your own mind like that? - She is all prepped.
- Thank you, Claire.
My son is in town.
Join us for dinner tonight? Oh, shoot, um, I can't tonight, but will you say hi for me? Sure.
So, um, your bloodwork and cultures came back clear.
We were thorough and you were lucky there was no infection.
Uh, I do still have a headache though.
Because Jamie, there's a second nail in your head.
There is? What are you Seriously? You really didn't know? Uh I mean, there was a misfire, but I didn't feel anything and I guess it went in clean? Well, I'm just surprised you didn't feel anything, but I guess it's possible.
So, what happens now? I need to examine the puncture wound.
Okay.
Okay.
Hey, can I keep the nail when it's out? As a souvenir? You need to stay still, sir, please.
Okay, sorry.
All good in here? Yeah.
There's a second um, nail uh, puncture, and I just can't find the entry point so Would you like me to take a look? Okay.
Yeah.
Let me know if you can find it.
And we need to page neurosurgery.
He'll need the OR.
Did she just say I need brain surgery? Oh, doctor! Doctor? Hi, Mrs.
Welland, nice to see you up so soon.
How did I wind up getting in so fast? Oh, well, we've started doing certain procedures in what we call a Trauma OR and yours qualified, so Oh.
So I'll get out of here soon? I'm supposed to look after my grandson to give my daughter a couple of days of break.
Yeah, I think you'll still need to take it easy.
I'm guessing you've spent enough time in hospitals as it is.
Months of chemo, then a hysterectomy.
They got rid of most of the active cancer, but a couple of cells reached a lymph node and so, therefore, in the future It'll come back.
I may not look much like a ticking time bomb, but ooh, there it is.
Did you want me to call your daughter, ask her to No, absolutely not.
It'll just put her back to seeing me as a sick person and I've decided that's not how I want to live.
Okay.
Oh! Oh! - Ms.
Welland? Are you okay? - They gave me the morphine, - but I definitely felt that.
- I'm on it, ma'am.
Yeah, you know what, I think I'm gonna do an ultrasound to see what's going on.
Evelyn's G-tube is clean, and her chest X-ray looks good.
No pneumonia.
Her symptoms are mild so far, but we want to keep her for observation.
I read that some MERS patients were barely symptomatic? That can be true.
The next 48 hours will be telling, but, uh, Fitz No, I'm not leaving.
I can understand why you want to stay, but you're really safer at home.
I've already been exposed! Except, since you're not symptomatic, our quarantine rules won't allow it.
I'm sorry, but you're under a self-isolation order.
She needs me.
Look, we tried to make it work with other people, computer-assisted devices, it's never enough.
I know her.
She'll be under vitals monitoring all night, okay? Anything that comes up, we will look out.
They're saying I have to go.
I know.
But they're not giving us a choice.
There are five nurses on this floor all night.
She won't be alone.
We're going to take good care of you, you have nothing to worry about, Evelyn.
The best way to communicate is to look her in the eye and ask yes or no questions.
If it's anything more complicated We'll call you, you have my word.
I know, I promise I'll remember to eat.
I'll be fine.
I love you.
Ms.
Weiland is fortunate we were on that so quickly.
This is why you need to be extra vigilant during closing.
We were vigilant, Dr.
Singh.
We had a bleed, yes, but we handled it.
This one started after.
Your dissection technique wasn't on point.
What kind of surgical lighting does Bishop have in there? Lighting's fine, you say this to me every time I do one of these.
Because I'm there to correct you.
It shouldn't be after the fact.
I was opposed to a trauma OR for exactly this reason, us having to clean up another department's mess.
It's not a mess.
Bleeds are a normal complication of abdo surgery.
And Dr.
Bishop's giving me an opportunity to expand my experience.
You're his lab rat, June.
If this goes south, it could affect your reputation.
Is this you calling out landmines again? Because this is an approved initiative and I work for him too.
Let me handle it.
Yeah, I've read their statement of claim, it's Dr.
Bishop I need a word.
Yeah.
Well, truth's our best weapon, so If you think we should push back, good.
Let me now.
Alright.
What's up, Wendy? You specifically told me you weren't hiring another chief, that it was just lip service? Why don't we have this conversation in my office.
Then what I've heard is true? You already have? On an interim basis, to help pilot the trauma OR and share hands-on duties.
Were you ever seriously considering me? Wendy, you are an excellent attending, and of great value to this department.
- In other words, no.
- It's more complicated.
I really think we should continue this in the office.
Wendy, you're acting like this is a demotion.
If anything I am going to be relying on you more in the To prop yourself up, you mean.
All I've done, this last 30 years, is put the interests of this department ahead of my own.
You held me back, Jed.
You kept me where you needed me.
Well, I'm done.
I'm finished.
Good luck! Wendy! Dr.
Hunter, can you supervise non-pediatric patients today? Dr.
Leblanc can you swing a double? - Sure.
- I need residents on the floor that don't require constant supervision.
Dr.
Atwater, hey! I'm sorry you had to see that, Dr.
Curtis.
You're really gonna leave? I've been considering my options for 20 years.
Catering to other people, waiting for my turn.
I'm done sucking it up, June.
- But what are you gonna do now? - Oh! Whatever I want.
I was sorry to hear about your father.
Are you nervous? I know you're going to be great.
It's gonna be you and a bunch of moms sitting there.
I can handle it.
No gross blood and guts talk.
People don't like that.
- Okay.
- Also, we're wearing stage makeup.
- Don't say anything about it.
- Okay.
Or about the fact that this is all getting filmed for YouTube.
Amira.
Okay, okay, not a word.
There's Jameela and Sadie.
Rania? What is she doing here? Uh, I invited her.
As a friend.
- Rania! - Oh, Amira! - I'm glad you're here! - How could I miss this? Hi, Bashir.
I'm sorry.
I should've called earlier than today.
Habibti, Sadie's mom says there's a dressing room in the back.
Will you help with my hair? Yeah.
I'll find us seats.
- Yeah.
- Not at the front! Not at the front.
What brings you guys in here tonight? - Zeke? - I fell off the fourth-floor fire escape outside of my dorm.
The whole truth, bud.
I thought it might be a good idea to make my own zipline.
- Turns out, it was not.
- Okay.
Why don't you toss that in there for me? Have any blurred vision or nausea? Headaches? Headaches a bit.
I told Coach it was no big deal, but he made me come.
And benched me for two weeks! You break the rules, you gotta suffer the consequences.
Are Mom or Dad looped in? I called them, I left a message.
It won't be returned.
Hey, Zeke, why don't you tell Dr.
Hunter why you made the zipline.
Because I'm gonna die anyways.
And uh, what does that mean, exactly? It's like, uh, I know something bad is gonna happen just not what or when.
Were you trying to hurt yourself? No! I definitely don't wanna die, it's just, if it's gonna happen, might as well live big.
Enjoy the rush? He's been talking like this for a month now.
I mean, I thought it was a prank, - but he really believes it.
- Because it's true! Have you had any previous head injuries? That's what I wondered too.
Zeke plays rugby.
He tackles pretty hard, but he assures me after every game that he's feeling okay.
I had the school nurse check him out, but I just wanted to make sure.
It could be a concussion.
Yeah.
It's a good idea to do imaging, and, uh, make sure it's nothing more serious.
Thank you.
Appreciate it.
See? They're gonna look after you, buddy.
Or they'll find something and you'll have to admit that I'm right.
Hey, doc.
Should I keep benching him? I'm not one of those coaches that puts winning ahead of the kids, I just I want what's best for Zeke.
Let's just see what the test results are.
Okay.
His parents, they don't sound too involved? No.
Uh, they both travel a lot.
They're the corporate types.
He's lucky if he sees them around Christmas.
It's a bit of a sore subject.
Do you know if he's spoken to anyone? Just kids can exhibit personality changes during puberty and if the family situation is difficult I mean, he had some trouble adjusting when he first came to us.
I read about kids with brain injuries.
How it changes their whole way of being, you know, - I just want to make sure.
- The CT will be fast.
- Okay.
- It might take a little while for the MRI.
You're good to stay? Yeah.
Impressive woman.
I crumbled with one weak arm.
Should I have talked Wendy out of quitting? I didn't say anything, Jed.
Or would she have resented me for that? I know things have changed since I asked you to stay.
Evie needs saline.
Hello, Evelyn.
Ah yay! Amira, you were so brilliant.
Hey, you're gonna have to teach me that move at the end.
Oh stop! My friends are going for burgers.
- Can I go? - Here.
Okay, keep your phone on, I'll wait for you here, okay? Okay.
Have fun.
That was the most positive feedback I've gotten from her in months.
Thank you for being here.
She needs someone who gets all this.
Yeah.
I heard you got a job at a bookstore? Part-time.
They let me host discussions on my favourite authors.
Mostly just friends come, but it makes me feel like myself.
I knew you'd adapt quickly.
Rania, I still want you in my life.
What life? Tonight, with Amira.
You were present.
And silly.
And fun.
That's how I remember you, don't tell me it's because we were younger.
No, I I try to be present.
I mean, I know I'm busy working, but Looks more like toiling to me.
All you do is survive.
What else is in your life? - I don't say that to upset you.
- What's it supposed to do? Help me? You don't let anyone help you.
Or see you.
Does anyone really see you, Bashir? He's stuck in that cell that they put him in when they took him away from you! And I don't know how to break him free.
I heard you did really well last night, Evelyn.
Your temperature's down and your oxygen saturation's back to normal.
All good signs.
How are you feeling? I know it was upsetting, when I asked Fitz to leave yesterday Dr.
Hamed? Excuse me, Evelyn, I'll be right back.
You gonna have to put a new one on.
He just walked-in.
It came on suddenly last night.
I woke up drenched in sweat.
Now it's hard to breathe.
Is Evie okay? She's doing really well.
What's that mean? It means you're not getting enough oxygen through your system.
Lay back for me please? Fitz, do you have any underlying health concerns? MERS can hit hard if pre-existing conditions weaken your immune system.
- Like what? - Is there any reason your liver could be impaired? Your hands are shaking, and I'm seeing some bruising.
Whatever it is, Fitz, - I need to know.
- I drink, okay? More than I should.
Is that why I'm this sick? I'm seeing evidence of cirrhosis on the ultrasound.
I, uh I understand it can be difficult to manage your own well-being when you're so focused on Evelyn's.
I'm her only connection to the outside world.
She's adapted to so much, I don't want her to think she's a burden.
Does she know how much you drink? I don't talk about it.
She can't know I'm here, Dr.
Hamed.
She'll think it's her fault.
Hey, shouldn't they have taken Jamie to surgery by now? Claire realized the patient was having absence seizures, so we kept him in overnight to monitor.
He was? After you left the room, he zoned out again.
So I asked him if he felt an aura, and he said he thought so.
It's why he was staring off.
We started him on anti-epileptics and he'll need a constant EEG during surgery, since we don't know the cause of the seizures.
It's probably the nail in the head.
This is something you would normally catch.
Was there a reason you didn't assess him yourself? - Jed.
- No, he's right, I should have.
It won't happen again, Dr.
Bishop.
- You didn't have to take that.
- I was supposed to tell my boss that I'm missing things because I can't be alone with patients? No, but that's his job to support you.
I don't want support! I just want to be able to do my job.
Hey, I need a patient on ECMO.
Rhoda tells me you can make that call, now that Atwater isn't? - It's for your MERS patient? - The husband.
He's cirrhotic and desaturating quickly.
I'll get one sent down right away.
Thanks.
- Were you there when she quit? - Yeah, we all were.
Bishop didn't put her up for co-chief.
It was a scene.
You know, this whole trauma OR thing, the way he's so driven by it, did you see how quickly he just moved on from Atwater? - Like she was never even here.
- He was trying to roll with a bad situation the best he could.
One day he's yelling at me, the next day he's promoting me.
Anyone know who he hired? They don't tell me anything.
I'm perfectly capable of supervising an emergency appendectomy.
I didn't call you up to debate your qualifications.
So we're talking about June's? Not her credentials, her bandwidth.
She's stretched thin as it is.
Chief Resident, working both units, - she doesn't have the space.
- She's a confident physician.
If she had a problem handling this, - I expect she'd tell me herself.
- She's my resident, Jed.
Poach a trauma surgeon from somewhere else! Sure.
If you want her to miss this opportunity, so be it.
Hi! I know I said to get you out of here sooner.
Apparently, an organ that turns out I didn't even really need has got us both on the ropes.
Your white blood cell count is still high, but that makes sense given your appendicitis.
That having been said, it also corresponds with your CA-25-antigens, so You checked for tumour markers? We'll have the results in a couple hours - I didn't ask you to do that! - It's okay.
We were already doing bloods, and you're supposed to check them regularly to make sure your cancer is not active again.
I don't care if the cancer is active! I can't change anything that's coming, so why would I even wanna know! So you can plan.
You are not listening to me! I don't want to live that way.
Is that What's wrong with me? Yeah, it's just, low pressure.
I'm on it.
We'll get this figured out, Nancy.
We've been here all night.
I know it's been a long wait, but the senior radiologist reviewed the MRI and agrees, - everything looks fine.
- So no brain injury? That's great news, buddy.
It is.
But I spoke with the psychiatry resident.
They think you might have ADHD.
You think I'm hyperactive? Well, that's one manifestation, but there are others.
Impulsive action, for example.
Like zip-lining off a fire escape.
Exactly.
So, what about the way that Zeke's feeling or his fear? People think ADHD means high energy, but a sense of impending doom, that can be associated with the diagnosis.
It's a common condition in kids your age, even if yours is presenting differently.
So you're saying I'm not dying? - Is there medication? - Yes.
This is great! He's saying that this is a problem we can solve.
- I can help you.
- You shouldn't have to! Zeke! It's Zeke! Zeke! Hey! Open the car! Not until we talk about this.
- I don't want to talk! - Look, Zeke, just come inside.
Zeke, Zeke, what are you doing? I wanna go! My parents said I was the problem when they sent me here! This means they were right all along? Man, screw your parents! Okay? If they can't see what a great kid you are, then they're assholes! Language, Coach.
I'll put a dollar in the jar, but only if you come back inside.
Why don't we get you inside and clean you up a little bit, okay? My blood goes through that machine and then back inside me? ECMO works by temporarily drawing the blood out of your body to oxygenate it.
It does the job of your heart and your lungs.
You got me hooked up to this thing, you must be pretty worried.
Um, we have every reason to stay positive.
Okay? Alright.
To conserve energy, I'm going to sedate and intubate you now.
Fitz, I know you didn't want me to say anything to Evelyn, but if there's a message you want to get across to her, - now's the time.
- Because I might die? No.
She'll be terrified and she won't be able to communicate it.
Just make me better.
I can't leave her alone.
I'll do my best.
You're ready? Yeah.
Thanks for coming.
I wasn't sure you'd call.
You're uh You were right, we need to talk.
I have a bet with your mother.
She says home repairs gone wrong.
And I have pre-mid life crisis motorcycle accident.
I, uh I punched a man.
Why, son? Because Because I'm angry, Dad.
I just I thought I could move on and build something.
But then I'm a failure.
And I don't know what to do.
You have to forgive yourself.
I've tried and I know it was all my choice, - but if I knew it like - No, no, no.
I meant for wanting it.
Theo, it's okay that you wanted this life.
Is this, uh, is this the part where you tell me you and Mom are - You're praying for me? - Yeah, I hate it when people say that.
As though you desperately need it.
But yeah, we are.
But, listen, about the loan.
You don't need money right now.
Oh, I thought, uh we kind of just established how I messed up I am.
And you already have everything you need to clean that up.
His O² stats aren't holding.
Vascular complications can happen on ECMO.
Maybe the cannula isn't functioning properly.
He's cold to the touch.
Something's not right with his blood flow.
And it's pale too.
I'll get the ultrasound.
- Hey.
- Hi.
I wasn't sure if I'd see you again.
Uh, we wanted to talk to you about the cause of the seizures you've been having.
This is Dr.
Curtis, - chief surgical resident.
- Hi.
I'm guessing, if you're here, it's not just about the nail? Well, uh, when the team removed it, we found an un-ruptured aneurysm.
A pretty big one.
Yeah, it's like a bubble on your arterial wall, and the kind of thing you only find if you're looking for it.
If left unchecked, it could burst and have killed you, but fortunately, we had our reason to look so So then shooting myself with a nail was a good idea? More like a stroke of dumb luck.
Hey, did I do something to offend you? Because I can usually tell when someone doesn't like me, and you definitely do not.
It's not you, I'm I'm really glad things worked out for you and I Hey, I heard you wanted to keep this.
Cool.
- Alright.
- Thank you.
Thanks for being in there with me.
Yeah, anytime.
Hi, Evelyn.
I need to talk to you about your husband.
I thought you were upset because you were afraid for yourself, but now I realize that you were worried about him.
Is that right? Okay, hum.
Fitz is here, in the hospital.
He became very sick with the virus.
Much sicker than you last night.
I'm sorry to bring you tough news.
He wanted to protect you, but he can't speak for himself at the moment and we need your help.
Okay.
We're trying to help his body fight the virus, but during the process he developed a complication called an arteriovenous fistula.
It's an abnormal connection between an artery and a vein.
Are you with me so far? Okay.
We need to know if you consent to this.
Okay.
We will try to do it as non-invasively as possible, but if that doesn't work, he may need surgery.
I'm sorry.
I don't know what that means.
Do you have questions about the procedures he might require? Okay.
I'll go through all of the details, and you stop me whenever you have questions.
Okay, Evelyn? - Another bleed? - Actually, one of the clips we used the second time dislodged.
But we reattached and triple checked.
She still won't let us check her tumour markers, but she'll be ready to get on with her life tomorrow.
You called us both up here to tell us that? No, I called you both up because my patient spent time in both of your departments and both times something went wrong.
Which means that nobody's perfect.
But each time we fixed it.
I fixed it, but that's not the point.
Look Dr.
Singh, protecting me does not mean holding me back from opportunities just because you don't like them.
And if you really have my back, I mean, I need to know that when I say I'm overworked, you're gonna hear me.
Even if your initiative takes a hit.
Understood, Dr.
Curtis.
Coming in loud and clear.
Okay.
It's very good.
I taught her well.
I was about to say the same thing.
About myself.
Hey, I hear nail dude was saved by his own stupidity? I'm sorry about snapping earlier.
Mags, you don't have to apologize.
No, to you, I do.
Somehow, I ended up apologizing to nail dude as well, but Well, that sounds about right.
Is this gonna keep happening? These things can take time.
- I'm here if you need me.
- Okay.
You needed an intervention to repair a circulatory problem.
But it's over now, and your vitals are stabilizing.
Hey, uh Evelyn really came through.
She weighed in on every decision.
She's one hell of a mind.
When you beat this virus, and you will, the cirrhosis can be treated.
But Fitz, you'll have to stop drinking.
And for what it's worth, there's nothing wrong with getting outside help.
Clearly, Evelyn can take care of herself.
And you can stand to live for yourself as well.
Okay.
Also You have a visitor.
If any couple deserved some good luck it's those two, huh? My lawyer.
He thinks we should go aggressive against the lawsuit, counterclaim with defamation.
I've asked him to speak to your lawyer.
I can do that.
We're in this together, Bashir.
Let me help you.
Sir, the temperature around here.
I'm guessing you're aware that Yeah, people aren't sure of the recent changes, I know.
When the board approved the pilot program, they decided on a co-chief for me.
Sir? I couldn't tell Wendy in front of everyone.
You're going to be running the department with Dr.
Novak? Things aren't cooling down here quite yet.
Well, why did I bother getting dressed up if we weren't going to wait for the table? It was too loud anyway.
So you're selling the house? Yeah, the pastor knows a thing or two about drywall.
He's gonna help me fix it up.
Put it back on the market.
But I will need to stay with you a little bit longer.
I already told you.
You can stay as long as you want.
Thank you.
My dad left me in charge of his estate.
Is that good? It's more like a sick joke from beyond the grave.
It's a mess.
I wanted to pay someone else - to do it, but - Yeah.
Should I be talking them out of doing that? Uh What's the point? They're gonna wind up in our emerg in about an hour for some other stupid reason.
So you're saying life is gonna bounce itself out here? Wouldn't you like to be one of those stupid happy people? Just once.
Just to see how it feels like to live unburdened.
That's just not who we are.
How was that dance trip? Look.
Hey.
Thanks.
Wow, freedom.