Saving Hope (2012) s02e17 Episode Script
Twinned Lambs
Huh.
Well, all righty then.
My only advice to you is get some sun.
Alex, hey.
Can I talk to you? I have a consult in emerg.
Oh, uh, okay, later on then, end of day.
Um, I've got some really good news.
I-it's big.
Over wine.
Tonight.
Okay.
Okay.
Hey.
Perfect timing.
Uh, female, mid-50s, brought in by ambulance, suffering from severe abdominal pains.
- Vitals? - Stable.
Anyone come in with her? - Don't think so.
- What did you give her? Couple milligrams of lorazepam.
She was pretty panicky when they brought her in.
Great.
Thanks.
Mrs.
Pernice? Oh, I'm getting old.
That's what the problem is.
I never should have cut out cigarettes.
What's the point? I just need to feel your belly, if that's okay.
Yeah.
Of course.
I-I don't know what happened.
I was taking my morning coffee and Oh, I was watching that ridiculous show "The view.
" And all of the sudden, I just - Pain? - Oh, agony.
Do you think Jenny McCarthy caused this? It's possible.
I'm two cars ahead of you, bro.
No.
No.
We both went down.
The bet is off.
Okay, we need an impartial judge here.
Doctor? Hey! - That is just rude.
- Sorry.
Thank you.
Is there anyone that we can call? Any family members to contact? No.
I lost my husband to cancer in March.
I'm sorry to hear that.
Thank you.
30 years.
He was a good man, though.
He was very strict.
He was very devout.
Right paraumbilical region.
You're impossibly beautiful.
You must be beating them off with a stick.
Not really.
I don't get out much.
Surgeon's hours.
Ah.
"Youth is wasted on the young.
" I'm sorry.
I just really need you to watch this video.
Excuse me, you can't be in here.
Okay, guys, come on.
- Let's go over here.
- Get out.
I have to get out.
- I have to get out.
- Mrs.
Pernice, are you okay? - Why don't you lay back? - No, actually.
Mrs.
Pernice, I-I think that if you just I have to move.
I have to - I got to move.
- Why don't you lay back down? I got to move.
All right, normally I'd have a technician do this, but since you are my favorite couple Hmm.
That's so sweet.
Actually, I just wanted to see your face the first time you see this.
I can't believe it's 12 weeks.
Ah, well, it's time to start telling the masses.
What am I supposed to do? Update my facebook status to "knocked up"? We should probably tell my parents before you do that.
Yeah, Gavin wanted to tell his mother the moment I peed on a stick.
That's just not true.
Well, timing is everything.
You know who I'm not looking forward to telling? It's Dawn.
She's gonna understand, Maggie.
You think? I'm gonna be asking for maternity leave before I've even written my boards.
Take a look.
Look at that.
Wow.
Oh, wow.
That's amazing.
What is that? Is that an arm? Well who cares.
Whatever it is, it's perfect.
You know, Maggie, I'm in pretty much the most forgiving field when it comes to maternity leave.
Have you ever thought about obstetrics? I did a rotation in med school.
Maybe you should do another one today.
- What's your schedule like? - Pretty light.
I mean, I-I was gonna study after, but Skip it.
I've got a fascinating case in active labor.
Why don't you shadow me and see if it fits? Maybe this is all happening for a reason.
Yeah, I mean, timing is everything.
I'm in.
Let's do it.
She having a panic attack? I don't know.
Okay, well, whatever it is, let's put a stop to it.
I'll go talk to her.
Mimi.
Hi.
I'm Dr.
Miller.
I understand that you're scared and you probably feel like you're underwater.
Am I right? Okay.
I'm here to help you and I'm here to give you my hand.
- Get away from me.
- It's okay.
You can take it.
I'm gonna help you.
I'm gonna pull you up.
You can take my hand.
Okay.
Oh! Dude! That was awesome! - Zach, you okay? - Yeah.
- Did I do that? - Yeah.
He's gonna feel that one for days.
Dude, that's awesome.
Wow.
Have you ever had an episode like this before, Mimi? Never.
I have never struck another human being in my life.
Is he gonna be okay? Dr.
Miller is going to be fine.
What's wrong with me? We're trying to figure that out.
We're waiting on your blood work.
In the meantime, I thought maybe you and I could have a little chat.
Who are you? I'm Dr.
Murphy.
He's a psychiatrist.
I should've known by the gingham shirt.
I'll see you in a little bit.
Thank you.
You remind me of my son Danny.
Really? We should call Danny.
Oh, we lost him about 10 years ago in a car accident.
I'm sorry.
Do you have children? No.
Well, yes.
Early days.
My girlfriend's pregnant.
Congratulations.
You're actually the first person that I ever told.
Oh.
Well, don't worry.
I'm very good at keeping secrets.
Think you might have any secrets that might help us figure this out? Memory loss? Ever wake up wearing clothes you don't recognize, or unable to recall the night before? Goodness, no.
I maybe in the gin-and-tonic days, you know, in my 20s, but you know, at this point, I'm just living right to get into heaven.
- Hey.
- Hey.
So, I'm on my way to shadow Dr.
Dimples.
- Jealous much? - Should I be? Come on, he was totally flirting with me this morning.
Really? I kind of think he was flirting with me.
- Seriously? - Yeah.
"I just wanted to see the look on your face" "the first time you saw this.
" Yeah, no, that was totally weird.
Guess the jury's still out on Kalfas.
Maybe.
- So, I've been thinking.
- Always dangerous.
I want to tell my mom tonight.
Can we just wait a couple days before we go public? Why? I kind of like having something that's just ours.
Are you not excited about this? No, I am.
I am.
I just I'm not sure I'm ready to, you know, tell the world.
My mother isn't exactly the world.
She certainly acts like she is.
Love you.
Got to go.
Bye.
Hey.
I have Mimi's blood work.
Still waiting on some results, but what we do have back normal ranges across the board.
What'd you get for me? No markers for dissociative identity disorder.
No history of panic disorders.
No anxiety attacks.
No dramas.
She told me she lost her husband.
And her son.
I think she's very lonely, but I don't think that she's mentally ill.
The only other thing I can think of is that she suffered a mini-stroke.
Could explain the hypertensive and kinetic behavior.
- I'll page Shahir.
- Great.
Excuse me.
- Can I help you? - Yes.
I'm looking for Miriam Pernice.
- Are you family? - No.
No, I'm I'm just a neighbor.
But I saw the ambulance outside my kitchen window.
And I know she recently lost her husband.
I'm just so worried she doesn't have anyone.
What happened? She was she was brought in with abdominal pain.
I can't discuss the particulars of her case.
But how is she doing? She's stable.
Not in pain any longer.
Whatever it was seems to have subsided for the time being.
I would really like to see her.
Tell you what, she's in imaging.
When she gets back, I'll see if she's up for visitors.
The waiting room is just down the hall.
Okay.
Thank you.
Mm-hmm.
- Hey.
- Hey.
Thought you'd given up coffee? Oh, it's changing day, Joel.
Changing day - Where you headed? - E.
R.
Yeah, I got a shoulder dislo Dislocation, possible fracture? - I knew it.
- Yeah.
Sent us the same page.
Yep, Miller must be still reeling from having his cojones granny-slapped.
His bells jingled.
- Merry Christmas.
- Happy new year.
Zach.
How are you doing? - Gentlemen, hey.
- How are you? I don't want to hear it.
You don't want to hear about? Hear about anything that didn't happen in the E.
R.
the last little while.
Oh, well, you sent us the same consult.
Uh, no, they're two different patients.
- With the same injury? - That's right.
What are the odds of that? Spooky.
Meet best bros Marcel and Sandy.
- Gentlemen.
- Hey.
What's up? They both incurred shoulder dislocations while racing over a line of parked cars.
It was a push.
Sucker bet.
- I took it.
- He took it.
So, by racing, you mean you were running and jumping over parked vehicles.
Is that? Turns out it looks way easier in the movies than it is in real life.
- That's true.
- Hmm.
Anyway, right, they're all yours.
Which bro do you want? Uh, it's a pick 'em.
Yes, it is.
I will go with Yep.
So you place your hand on your opposite shoulder for me.
Okay.
I'm just gonna check your sensation here.
Does that hurt? - Yeah, like a mother - Okay.
Okay, I'm just gonna check your axillary nerve function.
Okay.
Can you feel that? Yeah.
And can you shrug for me, please? Okay.
Okay, relax your arm.
Gentlemen, what were we doing this morning? Well, we were on our way to breakfast, and then Sandy bet me that I couldn't beat him - over a line of parked cars.
- Okay.
So you two actually had a wager over this stunt? We bet on everything.
It's a problem.
Well, we're gonna need to get you into imaging and make sure you don't have fractures before we can put your shoulders back in place.
Guy who doesn't have a fracture has to snort wasabi.
- How many lines? - Three.
Okay, no water and you can't blow your nose for at least half an hour after.
On.
Okay, if either of you does have a fracture, you're gonna require surgery.
- Surgery? - Mm-hmm.
But I'm supposed to be starting rehearsals next week.
Yeah, "Winter's tale," Shakespeare.
Bellwood players.
I'm playing the lead.
I guess you should've thought about that before you started playing automobile leapfrog.
Okay, we'll get you into imaging.
In the meantime, gentlemen, why don't you just rehearse some of the more quiet scenes from "Winter's tale"? So? So she aced her neurological exam.
She's sharper than half my junior residents, Alex.
Maybe she didn't like the look of Dr.
Miller.
No, she suffered a hypertensive, hyperkinetic attack.
I was there.
I saw it.
Okay, maybe she didn't like the look of his junk.
You know, he's a big guy, but he could be - I don't know.
- Shahir.
I'm sorry.
You know, I'm trying to be more colloquial.
It's a process.
What do I do about my patient? Right, um, well, I'll send her up for a head C.
T.
, but I don't think the problem is with her brain.
Call me when you get the results.
Yeah.
We just opened up Bloor at Brock.
There's a huge fava bean out front.
Lin, you're up.
Okay.
The fava is the most resilient bean.
Take a deep breath for me, Sara, okay? It's known as the meat of the poor.
Ben and his organic food it's very serious stuff.
Just like Sara and her birth plan.
Sara's been adamant since the beginning of her pregnancy No C-section.
No surgery.
- This is your first baby? - Yes.
Of what we hope will be many.
Sara's one of nine.
Irish catholic, and I'm jewish.
Poor guy gets guilt from both sides.
Dr.
Lin, what do you feel? Cervix is effaced.
Dilating.
How many centimeters? Seven.
Close to eight.
All right.
Well, the fetal heart rate's in the normal range and progressing nicely.
But the placenta is partially abutted against the cervical os, which is called, Dr.
Lin? - Marginal placenta previa.
- Very good.
- Have you ever seen one? - No.
Okay, well, imagine you have a very small garage, but you own a motorcycle and a car.
Now, as long as the motorcycle is parked at the back of the garage, you can get the car out just fine.
The motorcycle is the placenta? Right.
But if the motorcycle's parked at the front of the garage and you try and get the car out - The car is the baby? - Right.
Then you're gonna smash up your bike.
So you're planning on doing a C-section? No, no.
Wait.
You promised we could do this naturally.
I have absolutely no intention of breaking that promise, okay? Dr.
Lin she's a resident.
She's paid to be conservative.
But lucky for you, I'm not.
So you're going to do this naturally.
Absolutely.
Here comes another one.
Breathe, breathe, baby.
Sounds like it'll be very soon.
Back in a bit.
Dr.
Lin? - Ohh.
- Breathe, breathe.
Favaaa! Fava! You don't think I can do it? Jason, I wouldn't pretend to know better.
It's just I've read that disturbing the placenta - during delivery - Very bad news, yeah.
Yeah, the risk of placental ablation, massive bleeding Increases dramatically, correct.
Right.
If there's not two centimeters of clearance, which there isn't in this case, the book says Okay, Lin, first of all, forget about the book.
Tell me what do I have to be worried about.
Post-partum hemorrhage, the mother bleeding out.
Good.
Okay, so, here's what I'm gonna do to prevent that.
I'm gonna sneak in beside this pesky placenta and I'm gonna gently dilate the inner-uterine segment.
Then I'm gonna use the baby's head to tamponade the oozing placenta.
Wait, you're planning on using the baby's head to control the bleeding vessels? That's right.
But don't look too carefully 'cause you're not gonna find it in the book.
Any questions? Good.
I got to grab something from my office.
Scrub up, Maggie.
You having fun yet? Yeah.
Mimi.
The good news is your head C.
T.
and all your other tests have come back clear.
And the bad news is you still don't know what's wrong with me.
We will.
Now, I wanted to let you know that there's a neighbor of yours that's here to see you.
A neighbor? Yeah, I didn't catch her name.
She said she saw an ambulance in front of your house and Yeah, I-I-I know the one.
You know, I'm really not up for visitors.
That's fine.
I'll just tell her that you're not able to see anyone today.
Hi.
I didn't actually get your name.
Oh, it's Claire.
Well, Claire, Mrs.
Pernice isn't up for visitors.
- I need to move.
- Mimi? Are you feeling any pain? No, I feel like I need to walk.
- Dr.
Reid? - Page Dr.
Bell.
She could be throwing an embolus.
Mimi, look at me.
Try to breathe with me, okay? You're gonna be fine.
You've suffered another hypertensive crisis.
- A heart attack? - Not exactly.
Something is causing your heart rate and your blood pressure to skyrocket.
This most recent attack has caused significant damage to the posterior wall of your heart.
That doesn't sound good.
Your heart rhythm has altered.
She's right, so you're gonna need a pacemaker now.
Will you be there for the surgery? Actually, I'm not a cardiac surgeon.
If Dr.
Reid has room in her schedule, she is more than welcome to assist me.
Okay.
Okay then.
I'll be there.
And don't worry.
It's a routine procedure, and Dr.
Bell is the best.
Good.
And then I'll be fine? Your heartbeat will be regular, but we still have to get to the root of what's causing all this.
Okay.
Give me a little push, Sara.
Breathe, breathe.
You breathe! Sorry.
Sorry.
I love you.
You're doing great.
I can feel the vertex of the head.
You can see the head? Is he a ginger? You say that with such disdain.
I just want to be prepared.
All right, guys, it's showtime.
All right, here we go.
Aah! Everything okay? The head's deflexed.
I can't flex it because of the placenta.
What does that mean? Is the baby okay? Should we prep her for a section? Yes.
Do whatever you need to do.
I don't care.
I don't care anymore.
I just want the baby to be safe.
Jason? Not just yet, sweetheart.
I'm gonna call an audible on the play.
We're gonna try and do an internal uterine extraction.
What does that mean? I'm gonna try and flip the baby around in her tummy.
And then I'm gonna grab it by the foot, deliver it as a double footling breech.
Okay? But I think the patient has changed her mind.
Lin, obstetrics is like jazz.
It only gets interesting when you start to improvise.
Okay, here we go.
You're doing great.
You're doing great.
Guidewire in? Guidewire in.
Any complications? B.
P.
is stable, rhythm is okay.
Okay, I'm gonna put the sheath over the wire and I'm gonna thread the pacemaker leads through.
So, how's your heart, Alex? Sorry? You're on the mend, spending time with an old flame.
Joel and I are just friends.
I like Goran.
He's a little rough around the edges, but I think that suits you more.
What's that supposed to mean? Charlie is a racehorse.
Goran's more of a show pony.
I think he's more your speed.
What kind of a horse am I, Dr.
Bell? Leads are in.
Remove the C.
R.
What do you want from me, Dawn? I would like you to hand me the pacemaker.
Victor.
One DDD coming up.
Okay, what could be causing these hypertensive crises? Let's go through the checklist, Reid.
Sleep apnea, obesity, diet, drugs, alcohol, renal disease.
Wait.
Adrenal.
We didn't check her serum catecholamines during the last blood panel.
You think it could be a PHEO.
It could explain the erratic behavior Having a bunch of adrenaline dumping into your bloodstream.
Trouble is, if it's adrenal, it goes away as fast as it comes on.
The markers won't show in her blood until her next attack.
So you're saying you want me to sit around and wait for her to have a potentially fatal crisis? That's right.
High-stakes game of chicken.
My money's on you.
I don't think you're cardiac material, but you have improved leaps and bounds as a surgeon, Alex.
Okay, perfect fit.
Like a 6-4-3 double play.
I didn't know you liked baseball.
Oh, I don't.
Charlie was always trying to get me into it.
Maybe it's time I started.
Okay, close her up.
We're all done here, Reid.
Yeesh.
So, the nurse tells me You're experiencing some numbness in your fingers.
Yeah, dude.
It's starting to really kill.
Okay, I'm gonna check out your radial and your median nerve.
So give me a thumbs up.
Little bit more.
- Like that? - Yep.
Okay, that's good.
Give me an okay sign.
Good.
Okay, that's right.
So where's your better half? Outside making a phone call.
His girlfriend? Yeah, more like which one.
- Really? - It's the drama club.
It's all the hottest girls and most of the dudes are gay.
Suppose.
Okay, let's check out your ulnar.
Spread your fingers for me.
Nice.
And just yeah, try and resist if you can.
Okay.
Yes, that's good.
So you guys are actors, is that right? Yeah.
We both just auditioned for this production of "Winter's tale.
" And he got the lead, and I-I-I didn't get anything.
Well, some good news for you there doesn't appear to be any nerve damage.
Great news.
Ever since he got the part, I just want to beat him at something, you know? Which is why you agreed to somersault over stationary vehicles? I just keep thinking to myself, you know, like, "what does he have that I don't have?" You ever have that with anybody? Yeah.
Medicine can be a competitive field sometimes, yeah.
Hmm.
Can I do my piece for you? Your piece? What do you Yeah, yeah, like my audition monologue.
And then maybe, like, you can tell me where, like, I went wrong.
Yeah, actually, I've kind of got a busy afternoon.
We are, fair queen, but two lads that think not of the behind but of a day such as tomorrow Don't.
Okay, don't - As today.
- I If you don't mind, don't move your arm around like that.
This is my gesticulating arm.
I can see that.
I just don't want you to risk any further damage, so put that just put it down.
So, any feedback on the piece? All right, I've got the foot.
You're doing great.
You're doing great.
You're doing great.
Now, I'm gonna need lots of pressure from above, okay, Lin? Suprapubic please.
- Okay.
- All right, Sara, now, you're gonna feel a little bit of pressure.
Is the baby okay? Heart rate's perfectly fine.
I can see his feet, and they are very cute.
Oh, my god.
Okay, I just need to find his mouth.
What are you gonna do with his mouth? Well, my middle finger is gonna be his first pacifier.
Dr.
Kalfas is gonna flex the head to create a smaller diameter to the birth canal.
Okay.
Lots of pressure.
As much I'm giving you internally, you're gonna give me externally.
Okay? Sara, here we go.
Okay, we're gonna do this all together.
Come on now.
Push, push, push, push, push.
Good, good, good, good, good.
Keep going.
All right, dad, would you like to cut your son free? He looks healthy.
The nurse is just gonna clean him up, and then he's all yours.
You did so well.
I'm sorry I yelled.
That's okay.
Oh, my goodness.
- Hey.
- Hi, baby.
Hey, buddy.
Look at you, little bean.
Look at our tiny little bean.
All right, we'll give you guys a minute and then come back for the placenta, okay? Thank you.
We did it.
Are you a fava bean? Look at you.
That was incredible.
And she said it couldn't be done.
No, seriously.
I've never seen anything like that.
Well, congratulations, Dr.
Lin.
You just helped rewrite the book.
I'm never gonna live that down, am I? No.
Jason.
Uh, sorry.
I guess I just can't resist a pregnant woman.
I don't know what to say.
Um, how about you say we just forget this little indiscretion, okay? Okay.
Maybe you can do me a favor.
Wait a few minutes, then go in there and deliver the placenta.
I got a mountain of paperwork I got to climb.
Of course.
Okay.
Hey, you know what? We made a good team in there today.
You did great work.
You came? Of course.
How are you? I'm better now.
Where's George? George? Yeah.
Mimi, George is dead.
He died.
That's wishful thinking.
Oh, what are we gonna do? I don't know.
You're so beautiful.
Mimi.
Would you kiss me? Excuse me.
I'll just I'll come back later.
Who are you? I'm Dr.
Reid.
Oh, sorry.
Have we met? There's something really wrong with her.
And she's really confused.
She's having another attack.
An "attack"? What? Claire, you're gonna need to leave.
Claire, I need to do my job.
Okay.
Mimi, I'm gonna draw some blood, okay? I can't breathe.
Can you tell me what day it is? It's Wednesday.
And the year? It's 1985.
What are you concerned about? I just went over her chart.
She woke up from her pacemaker surgery in 1985.
Adverse reaction to the anesthetic? Could be.
Before I left the room, she wanted to know who I thought was cuter Tom Selleck or Bobby Ewing.
I've seen this before in Alzheimer's patients.
It's a sort of reversion into the past.
I ran a full blood panel during her last attack.
In the meantime, we should put her on nine south.
Yeah, it's probably the safest place for her.
Okay, I'll send the guys down for the transfer.
When she wakes up, I'll let her know.
Okay.
Hey, Alex.
Mm-hmm? Who is it? Tom Selleck or Bobby Ewing? Harrison Ford all the way.
Dr.
Kalfas asked me to deliver the placenta.
You don't have to do any crazy jujitsu flips like he did with this guy, do you? No, no, no.
So, are we gonna go with Sam? I think.
You? Does he look like a Sam to you? He does, yeah.
He totally looks like an old jewish guy already.
The placenta it's stuck.
What do you mean it's stuck? It must be an accreta.
What does that mean? Your placenta is embedded in the uterine muscle.
It's not separating.
Oh, gosh.
Can you get Dr.
Kalfas? I don't feel great.
Ben, can you take her hand? Sara, take some deep breaths for me.
She gonna be okay? It's just an unexpected complication.
He's not picking up.
I'm sorry.
I think I might faint.
Dr.
Lin, she's losing blood.
What is going on? Ben, I need you to take the baby.
Dr.
Lin? It's okay.
It's okay.
What's happening to me? Dr.
Lin? We need to get her to an O.
R.
now.
Well, whatever wager you made on your C.
T.
results, gentlemen, it is a push.
It's a negative for fractures.
No surgeries for either one of you.
- Oh, yes.
- Thank god.
Well, I wouldn't celebrate just yet.
The shoulder reduction's potentially very uncomfortable.
Gonna be even more uncomfortable for you when I take you down, bro.
In your dreams, Edmonton.
Oh, no.
What did you bet on now? You guys.
Yeah, we put a wager on who got the better surgeon.
That's right.
First guy's surgeon to get the shoulder back in wins.
And what I can't believe I'm even asking this question are the stakes? Winner gets to make the loser do any one thing he wants.
Within reason.
Within reason.
No bodily fluids.
No public nudity.
It's not gonna happen, gentlemen.
We're not here for your entertainment, believe it or not, all right? A resident will be by shortly to give you some freezing, although I'm starting to think we should do this without.
Idiots.
Spectacular idiots.
I mean, if your guy had known that I trained with Ian Hennesey, he never would've taken that bet.
Who? Are you kidding me? Dr.
Ian Hennesey.
Amazing new zealand orthopedic surgeon, basically a god.
Whatever.
Right, all I'm saying is I kind of trained with a pioneer of shoulder reduction.
It wouldn't have been a fair fight.
I'm sorry, Dr.
Goran, are you saying that you actually would've beat me? Charles.
Joels.
Dr.
Ian Hennesey developed an advanced bicipital massage technique.
In a place where they knighted the guy who made "The hobbit.
" Okay, there are other famous new zealanders apart from Peter Jackson.
Name three.
Russell Crowe, Anne Geddes, Keith Urban.
I thought they were australian.
Now you're just trying to piss me off.
Am I-am I sensing a wager here, Dr.
Goran? - Maybe, Dr.
Harris.
- Oh, okay.
Well, why don't you name your stakes, then? All right, same as the knuckleheads.
First guy to put the shoulder back into place Gets the other guy to do whatever he wants.
- Within reason.
- Within reason, for sure.
No bodily fluids.
- Yeah.
- Bingo.
Mm-hmm.
Mimi.
Where's Claire? She's getting something to eat.
And my husband? I don't know.
He hasn't come to visit me yet.
Mimi.
Oh, I know.
It's such a mess.
I met Claire at this party a couple of months ago.
She was wearing these black fingerless gloves and these door-knocker earrings.
The moment I saw her, I was in trouble.
Have you ever been in love, Dr.
Reid? Yes.
So you know.
I'm supposed to be a married woman in the eyes of the church.
But you can't help who you love.
And the heart wants what the heart wants.
You've got the baby man, Dr.
Jason Kalfas.
I'm not in right now, but please leave your Have you seen Dr.
Kalfas? Yeah, he's in the washroom.
Jason? Jason, I can see you.
Maggie, what are you doing here? It's our patient, Sara Collins.
Who? The patient.
Your patient.
- She's placenta accreta.
- Oh.
She's being rushed into the O.
R.
Okay.
Okay.
Right.
Just let me finish my business, okay? Okay.
Hurry.
Okay.
Okay, here's the thing.
She still thinks it's 1985? Mm-hmm.
Shh.
Okay.
What was that about? It's a long story.
35 years long.
Hey.
If you were a Sri Lankan goddess in my zumba class, how would you want me to ask you out? Zumba? Yeah.
"Ahk-ah-guh, ha-low.
" It means "hello, beautiful" in tamil.
"Ahk-ah-guh, ha-low.
" "Ahk-ah-guh, ha-low.
" Wow.
What are you doing? Zumba.
It's a booty roll into a body roll.
Jackson.
Oh, sorry.
Almost forgot.
Blood work on your patient.
I knew it.
Her serum catecholamines.
They're 15 times the normal level.
It's a pheochromocytoma.
An adrenal tumor? Yeah.
Page Dr.
Bell.
Yeah.
You were right about it being a PHEO, and your reward ever handled a live grenade? Well, I've worked with you for awhile now, so, yeah, I guess so.
Touché.
Pheochromocytomas are extremely rare.
I'm guessing you haven't had a lot of practice with them.
One wrong move, the tumor spills adrenaline into the bloodstream, causing massive stroke, organ failure, death.
This your idea of a pep talk, Dawn? I'm just prepping you, Alex.
Mimi is hemodynamically unstable.
She has decreased cardiac reserve.
If I mishandle the tumor, she'll die.
I get it.
So, let's do this.
Bowman, that's your name? You've got to be kidding me.
I've assisted in a dozen of your surgeries.
My apologies.
The patient has a brand-new pacemaker.
I've read the chart.
I'd like you to monitor her arterial pressure and her pulmonary wedges.
I'd like your eyes to be glued to those little waves.
I've got her on a phentolamine drip.
Her pressure should be controlled.
Eyes glued.
Okay, liver is mobilized.
Retractor.
There she is.
Up and away.
Such a small piece of tissue causes so much trouble.
It's not a tumor.
It's that nasty stuff that keeps emptying into her bloodstream.
Bowman, how's my how's our patient's heart? Holding steady at 97.
B.
P.
is 120 over 80.
It's "Baumann.
" Preparing to dissect the adrenal vein.
Reid, what's the difference between the left adrenal vein and the right? I'm not your student, Dawn.
And technically, this is my O.
R.
Okay, well, then let me tell you.
The right adrenal vein is shorter.
Is shorter.
It enters the IVC posteromedially.
It's a tighter anatomy.
No room for mistakes.
Clips.
Scissors.
B.
P.
is 90 and dipping.
What's happening? She's torn the ivc.
I need suction.
You need me to take over? I need you to either shut up or get the hell out of my O.
R.
I can't see anything.
Can you suture blind? There's blind and then there's blind.
Clean the camera! Her b.
P.
Is bottoming out.
Her heart rate's at 128.
She's hypotensive.
She's going into shock.
Okay.
I'm converting to an open procedure.
Okay, listen up.
Dr.
Kalfas has left the building.
Dr.
Lin, she's losing a lot of blood.
- What's her pressure and urine output? - 60 systolic.
No urine in the last 10 minutes.
Are we preparing for an emergency hysterectomy? Well, she wants a big family, so All due respect, but she won't be around to have any family if we don't stop this bleeding.
All due respect, but this is my O.
R.
now.
The gold standard would be an emergency hysterectomy.
That's what the book says, but I want to try an internal iliac artery ligation to save the uterus.
Are you sure that's the right move? Knife.
What are those for? You'll see.
Go! Get on your stomach, please.
Straighten your spine if you can.
I thought tolstoy was heavier than that.
All right, bro, you win.
So what's it gonna be, huh? Spoonful of cinnamon? Snort wasabi? You name it.
No.
Um Your monologue from "Winter's tale.
" Oh.
Do it for these guys.
What? Dude, my shoulder's completely messed up.
I haven't even warmed up.
Don't worry about it.
And besides, a bet is a bet.
We were twinned lambs that did frisk in the sun.
And bleat the one at the other.
What we changed was innocence for innocence.
We knew not the doctrine of ill-doing.
Claire.
How is she? There was a complication during the surgery, but we were able to correct it.
Oh, thank god.
And I was able to remove the tumor en masse with no further complications.
So her prognosis is very good.
That is such good news.
Thank you.
You're welcome.
Thank you.
Um, I wanted to apologize to you for earlier.
Oh, no apology necessary.
Really.
Did she, uh, mention anything to you? A little.
Just that she had met you at a party once and was smitten.
Well, it was very mutual.
It was supposed to be just a one-time thing.
It wasn't.
The affair lasted almost a year until her husband caught us.
That must have been hard.
Oh, you have no idea.
Our circle of friends and our church.
Mimi just chose to bury it and me.
And I stayed single all these years.
I just never stopped loving her.
Claire, I think you should know the adrenal tumor likely caused her to go back in time.
So now that it's gone The fairy tale's over.
Most likely.
Well, that's too bad.
I almost got kissed.
She obviously loved you very much.
Yeah, I guess sometimes that's just not enough.
Dr.
Lin, word has it you saved a young mother's uterus today.
Word travels fast.
You probably also saved her life.
Well done.
What can I do for you? There's no easy way to say this.
Um Dr.
Kalfas? Yes.
What about him? He is abusing narcotics.
This isn't just a rumor? I-I saw it.
I caught him.
It's, uh, it's not a rumor.
It was very brave of you to tell me.
Thank you.
I'll take it from here.
Okay.
Thank you.
Maggie, word to the wise.
Next time you come in here, you might want to change your scrubs first.
The blood's not such a great touch.
I did change.
Oh, my god.
Maggie, are you okay? Oh, my god.
I, uhI thi I think I'm having a miscarriage.
Hi.
Your surgery went well.
I was able to remove your adrenal tumor.
Oh, that's great news.
Can you tell me what year it is? Good.
Why did you ask me that? You experienced a temporary memory lapse.
These adrenal tumors can do some remarkable things.
Oh.
Lucky for me, so can you.
Claire is outside in the hall.
I see.
It's lovely that she stayed, but I-I'm really not up for visitors.
You know, I met this amazing free spirit today.
And she said you can't choose who you love.
I'm not sure what you're talking about.
It isn't too late.
Hello, Claire.
Can I come in? Yeah.
You know, you're gonna have to teach me that crazy kiwi shoulder thing one of these days.
I don't know, man.
You were like seconds behind me with your Dostoyevsky and "Ulysses" or whatever the hell literature you had.
Okay, what's it gonna be? Spoonful of cinnamon or snort wasabi? Double yes.
No, although I am very curious to see that one day, I have to tell you.
Come on, dude, the suspense is killing me here.
Actually, there is something I would like to talk to you about.
- Yeah? - Yeah.
I want you to give Alex some space.
What? You and Alex.
I mean, that's it's over.
It's over, man.
I think you should give her some space, the space she deserves.
And we had the bet.
You asked me what I wanted.
That's what I want.
Have you slept with her, Joel? You mean recently? Charlie!
Well, all righty then.
My only advice to you is get some sun.
Alex, hey.
Can I talk to you? I have a consult in emerg.
Oh, uh, okay, later on then, end of day.
Um, I've got some really good news.
I-it's big.
Over wine.
Tonight.
Okay.
Okay.
Hey.
Perfect timing.
Uh, female, mid-50s, brought in by ambulance, suffering from severe abdominal pains.
- Vitals? - Stable.
Anyone come in with her? - Don't think so.
- What did you give her? Couple milligrams of lorazepam.
She was pretty panicky when they brought her in.
Great.
Thanks.
Mrs.
Pernice? Oh, I'm getting old.
That's what the problem is.
I never should have cut out cigarettes.
What's the point? I just need to feel your belly, if that's okay.
Yeah.
Of course.
I-I don't know what happened.
I was taking my morning coffee and Oh, I was watching that ridiculous show "The view.
" And all of the sudden, I just - Pain? - Oh, agony.
Do you think Jenny McCarthy caused this? It's possible.
I'm two cars ahead of you, bro.
No.
No.
We both went down.
The bet is off.
Okay, we need an impartial judge here.
Doctor? Hey! - That is just rude.
- Sorry.
Thank you.
Is there anyone that we can call? Any family members to contact? No.
I lost my husband to cancer in March.
I'm sorry to hear that.
Thank you.
30 years.
He was a good man, though.
He was very strict.
He was very devout.
Right paraumbilical region.
You're impossibly beautiful.
You must be beating them off with a stick.
Not really.
I don't get out much.
Surgeon's hours.
Ah.
"Youth is wasted on the young.
" I'm sorry.
I just really need you to watch this video.
Excuse me, you can't be in here.
Okay, guys, come on.
- Let's go over here.
- Get out.
I have to get out.
- I have to get out.
- Mrs.
Pernice, are you okay? - Why don't you lay back? - No, actually.
Mrs.
Pernice, I-I think that if you just I have to move.
I have to - I got to move.
- Why don't you lay back down? I got to move.
All right, normally I'd have a technician do this, but since you are my favorite couple Hmm.
That's so sweet.
Actually, I just wanted to see your face the first time you see this.
I can't believe it's 12 weeks.
Ah, well, it's time to start telling the masses.
What am I supposed to do? Update my facebook status to "knocked up"? We should probably tell my parents before you do that.
Yeah, Gavin wanted to tell his mother the moment I peed on a stick.
That's just not true.
Well, timing is everything.
You know who I'm not looking forward to telling? It's Dawn.
She's gonna understand, Maggie.
You think? I'm gonna be asking for maternity leave before I've even written my boards.
Take a look.
Look at that.
Wow.
Oh, wow.
That's amazing.
What is that? Is that an arm? Well who cares.
Whatever it is, it's perfect.
You know, Maggie, I'm in pretty much the most forgiving field when it comes to maternity leave.
Have you ever thought about obstetrics? I did a rotation in med school.
Maybe you should do another one today.
- What's your schedule like? - Pretty light.
I mean, I-I was gonna study after, but Skip it.
I've got a fascinating case in active labor.
Why don't you shadow me and see if it fits? Maybe this is all happening for a reason.
Yeah, I mean, timing is everything.
I'm in.
Let's do it.
She having a panic attack? I don't know.
Okay, well, whatever it is, let's put a stop to it.
I'll go talk to her.
Mimi.
Hi.
I'm Dr.
Miller.
I understand that you're scared and you probably feel like you're underwater.
Am I right? Okay.
I'm here to help you and I'm here to give you my hand.
- Get away from me.
- It's okay.
You can take it.
I'm gonna help you.
I'm gonna pull you up.
You can take my hand.
Okay.
Oh! Dude! That was awesome! - Zach, you okay? - Yeah.
- Did I do that? - Yeah.
He's gonna feel that one for days.
Dude, that's awesome.
Wow.
Have you ever had an episode like this before, Mimi? Never.
I have never struck another human being in my life.
Is he gonna be okay? Dr.
Miller is going to be fine.
What's wrong with me? We're trying to figure that out.
We're waiting on your blood work.
In the meantime, I thought maybe you and I could have a little chat.
Who are you? I'm Dr.
Murphy.
He's a psychiatrist.
I should've known by the gingham shirt.
I'll see you in a little bit.
Thank you.
You remind me of my son Danny.
Really? We should call Danny.
Oh, we lost him about 10 years ago in a car accident.
I'm sorry.
Do you have children? No.
Well, yes.
Early days.
My girlfriend's pregnant.
Congratulations.
You're actually the first person that I ever told.
Oh.
Well, don't worry.
I'm very good at keeping secrets.
Think you might have any secrets that might help us figure this out? Memory loss? Ever wake up wearing clothes you don't recognize, or unable to recall the night before? Goodness, no.
I maybe in the gin-and-tonic days, you know, in my 20s, but you know, at this point, I'm just living right to get into heaven.
- Hey.
- Hey.
So, I'm on my way to shadow Dr.
Dimples.
- Jealous much? - Should I be? Come on, he was totally flirting with me this morning.
Really? I kind of think he was flirting with me.
- Seriously? - Yeah.
"I just wanted to see the look on your face" "the first time you saw this.
" Yeah, no, that was totally weird.
Guess the jury's still out on Kalfas.
Maybe.
- So, I've been thinking.
- Always dangerous.
I want to tell my mom tonight.
Can we just wait a couple days before we go public? Why? I kind of like having something that's just ours.
Are you not excited about this? No, I am.
I am.
I just I'm not sure I'm ready to, you know, tell the world.
My mother isn't exactly the world.
She certainly acts like she is.
Love you.
Got to go.
Bye.
Hey.
I have Mimi's blood work.
Still waiting on some results, but what we do have back normal ranges across the board.
What'd you get for me? No markers for dissociative identity disorder.
No history of panic disorders.
No anxiety attacks.
No dramas.
She told me she lost her husband.
And her son.
I think she's very lonely, but I don't think that she's mentally ill.
The only other thing I can think of is that she suffered a mini-stroke.
Could explain the hypertensive and kinetic behavior.
- I'll page Shahir.
- Great.
Excuse me.
- Can I help you? - Yes.
I'm looking for Miriam Pernice.
- Are you family? - No.
No, I'm I'm just a neighbor.
But I saw the ambulance outside my kitchen window.
And I know she recently lost her husband.
I'm just so worried she doesn't have anyone.
What happened? She was she was brought in with abdominal pain.
I can't discuss the particulars of her case.
But how is she doing? She's stable.
Not in pain any longer.
Whatever it was seems to have subsided for the time being.
I would really like to see her.
Tell you what, she's in imaging.
When she gets back, I'll see if she's up for visitors.
The waiting room is just down the hall.
Okay.
Thank you.
Mm-hmm.
- Hey.
- Hey.
Thought you'd given up coffee? Oh, it's changing day, Joel.
Changing day - Where you headed? - E.
R.
Yeah, I got a shoulder dislo Dislocation, possible fracture? - I knew it.
- Yeah.
Sent us the same page.
Yep, Miller must be still reeling from having his cojones granny-slapped.
His bells jingled.
- Merry Christmas.
- Happy new year.
Zach.
How are you doing? - Gentlemen, hey.
- How are you? I don't want to hear it.
You don't want to hear about? Hear about anything that didn't happen in the E.
R.
the last little while.
Oh, well, you sent us the same consult.
Uh, no, they're two different patients.
- With the same injury? - That's right.
What are the odds of that? Spooky.
Meet best bros Marcel and Sandy.
- Gentlemen.
- Hey.
What's up? They both incurred shoulder dislocations while racing over a line of parked cars.
It was a push.
Sucker bet.
- I took it.
- He took it.
So, by racing, you mean you were running and jumping over parked vehicles.
Is that? Turns out it looks way easier in the movies than it is in real life.
- That's true.
- Hmm.
Anyway, right, they're all yours.
Which bro do you want? Uh, it's a pick 'em.
Yes, it is.
I will go with Yep.
So you place your hand on your opposite shoulder for me.
Okay.
I'm just gonna check your sensation here.
Does that hurt? - Yeah, like a mother - Okay.
Okay, I'm just gonna check your axillary nerve function.
Okay.
Can you feel that? Yeah.
And can you shrug for me, please? Okay.
Okay, relax your arm.
Gentlemen, what were we doing this morning? Well, we were on our way to breakfast, and then Sandy bet me that I couldn't beat him - over a line of parked cars.
- Okay.
So you two actually had a wager over this stunt? We bet on everything.
It's a problem.
Well, we're gonna need to get you into imaging and make sure you don't have fractures before we can put your shoulders back in place.
Guy who doesn't have a fracture has to snort wasabi.
- How many lines? - Three.
Okay, no water and you can't blow your nose for at least half an hour after.
On.
Okay, if either of you does have a fracture, you're gonna require surgery.
- Surgery? - Mm-hmm.
But I'm supposed to be starting rehearsals next week.
Yeah, "Winter's tale," Shakespeare.
Bellwood players.
I'm playing the lead.
I guess you should've thought about that before you started playing automobile leapfrog.
Okay, we'll get you into imaging.
In the meantime, gentlemen, why don't you just rehearse some of the more quiet scenes from "Winter's tale"? So? So she aced her neurological exam.
She's sharper than half my junior residents, Alex.
Maybe she didn't like the look of Dr.
Miller.
No, she suffered a hypertensive, hyperkinetic attack.
I was there.
I saw it.
Okay, maybe she didn't like the look of his junk.
You know, he's a big guy, but he could be - I don't know.
- Shahir.
I'm sorry.
You know, I'm trying to be more colloquial.
It's a process.
What do I do about my patient? Right, um, well, I'll send her up for a head C.
T.
, but I don't think the problem is with her brain.
Call me when you get the results.
Yeah.
We just opened up Bloor at Brock.
There's a huge fava bean out front.
Lin, you're up.
Okay.
The fava is the most resilient bean.
Take a deep breath for me, Sara, okay? It's known as the meat of the poor.
Ben and his organic food it's very serious stuff.
Just like Sara and her birth plan.
Sara's been adamant since the beginning of her pregnancy No C-section.
No surgery.
- This is your first baby? - Yes.
Of what we hope will be many.
Sara's one of nine.
Irish catholic, and I'm jewish.
Poor guy gets guilt from both sides.
Dr.
Lin, what do you feel? Cervix is effaced.
Dilating.
How many centimeters? Seven.
Close to eight.
All right.
Well, the fetal heart rate's in the normal range and progressing nicely.
But the placenta is partially abutted against the cervical os, which is called, Dr.
Lin? - Marginal placenta previa.
- Very good.
- Have you ever seen one? - No.
Okay, well, imagine you have a very small garage, but you own a motorcycle and a car.
Now, as long as the motorcycle is parked at the back of the garage, you can get the car out just fine.
The motorcycle is the placenta? Right.
But if the motorcycle's parked at the front of the garage and you try and get the car out - The car is the baby? - Right.
Then you're gonna smash up your bike.
So you're planning on doing a C-section? No, no.
Wait.
You promised we could do this naturally.
I have absolutely no intention of breaking that promise, okay? Dr.
Lin she's a resident.
She's paid to be conservative.
But lucky for you, I'm not.
So you're going to do this naturally.
Absolutely.
Here comes another one.
Breathe, breathe, baby.
Sounds like it'll be very soon.
Back in a bit.
Dr.
Lin? - Ohh.
- Breathe, breathe.
Favaaa! Fava! You don't think I can do it? Jason, I wouldn't pretend to know better.
It's just I've read that disturbing the placenta - during delivery - Very bad news, yeah.
Yeah, the risk of placental ablation, massive bleeding Increases dramatically, correct.
Right.
If there's not two centimeters of clearance, which there isn't in this case, the book says Okay, Lin, first of all, forget about the book.
Tell me what do I have to be worried about.
Post-partum hemorrhage, the mother bleeding out.
Good.
Okay, so, here's what I'm gonna do to prevent that.
I'm gonna sneak in beside this pesky placenta and I'm gonna gently dilate the inner-uterine segment.
Then I'm gonna use the baby's head to tamponade the oozing placenta.
Wait, you're planning on using the baby's head to control the bleeding vessels? That's right.
But don't look too carefully 'cause you're not gonna find it in the book.
Any questions? Good.
I got to grab something from my office.
Scrub up, Maggie.
You having fun yet? Yeah.
Mimi.
The good news is your head C.
T.
and all your other tests have come back clear.
And the bad news is you still don't know what's wrong with me.
We will.
Now, I wanted to let you know that there's a neighbor of yours that's here to see you.
A neighbor? Yeah, I didn't catch her name.
She said she saw an ambulance in front of your house and Yeah, I-I-I know the one.
You know, I'm really not up for visitors.
That's fine.
I'll just tell her that you're not able to see anyone today.
Hi.
I didn't actually get your name.
Oh, it's Claire.
Well, Claire, Mrs.
Pernice isn't up for visitors.
- I need to move.
- Mimi? Are you feeling any pain? No, I feel like I need to walk.
- Dr.
Reid? - Page Dr.
Bell.
She could be throwing an embolus.
Mimi, look at me.
Try to breathe with me, okay? You're gonna be fine.
You've suffered another hypertensive crisis.
- A heart attack? - Not exactly.
Something is causing your heart rate and your blood pressure to skyrocket.
This most recent attack has caused significant damage to the posterior wall of your heart.
That doesn't sound good.
Your heart rhythm has altered.
She's right, so you're gonna need a pacemaker now.
Will you be there for the surgery? Actually, I'm not a cardiac surgeon.
If Dr.
Reid has room in her schedule, she is more than welcome to assist me.
Okay.
Okay then.
I'll be there.
And don't worry.
It's a routine procedure, and Dr.
Bell is the best.
Good.
And then I'll be fine? Your heartbeat will be regular, but we still have to get to the root of what's causing all this.
Okay.
Give me a little push, Sara.
Breathe, breathe.
You breathe! Sorry.
Sorry.
I love you.
You're doing great.
I can feel the vertex of the head.
You can see the head? Is he a ginger? You say that with such disdain.
I just want to be prepared.
All right, guys, it's showtime.
All right, here we go.
Aah! Everything okay? The head's deflexed.
I can't flex it because of the placenta.
What does that mean? Is the baby okay? Should we prep her for a section? Yes.
Do whatever you need to do.
I don't care.
I don't care anymore.
I just want the baby to be safe.
Jason? Not just yet, sweetheart.
I'm gonna call an audible on the play.
We're gonna try and do an internal uterine extraction.
What does that mean? I'm gonna try and flip the baby around in her tummy.
And then I'm gonna grab it by the foot, deliver it as a double footling breech.
Okay? But I think the patient has changed her mind.
Lin, obstetrics is like jazz.
It only gets interesting when you start to improvise.
Okay, here we go.
You're doing great.
You're doing great.
Guidewire in? Guidewire in.
Any complications? B.
P.
is stable, rhythm is okay.
Okay, I'm gonna put the sheath over the wire and I'm gonna thread the pacemaker leads through.
So, how's your heart, Alex? Sorry? You're on the mend, spending time with an old flame.
Joel and I are just friends.
I like Goran.
He's a little rough around the edges, but I think that suits you more.
What's that supposed to mean? Charlie is a racehorse.
Goran's more of a show pony.
I think he's more your speed.
What kind of a horse am I, Dr.
Bell? Leads are in.
Remove the C.
R.
What do you want from me, Dawn? I would like you to hand me the pacemaker.
Victor.
One DDD coming up.
Okay, what could be causing these hypertensive crises? Let's go through the checklist, Reid.
Sleep apnea, obesity, diet, drugs, alcohol, renal disease.
Wait.
Adrenal.
We didn't check her serum catecholamines during the last blood panel.
You think it could be a PHEO.
It could explain the erratic behavior Having a bunch of adrenaline dumping into your bloodstream.
Trouble is, if it's adrenal, it goes away as fast as it comes on.
The markers won't show in her blood until her next attack.
So you're saying you want me to sit around and wait for her to have a potentially fatal crisis? That's right.
High-stakes game of chicken.
My money's on you.
I don't think you're cardiac material, but you have improved leaps and bounds as a surgeon, Alex.
Okay, perfect fit.
Like a 6-4-3 double play.
I didn't know you liked baseball.
Oh, I don't.
Charlie was always trying to get me into it.
Maybe it's time I started.
Okay, close her up.
We're all done here, Reid.
Yeesh.
So, the nurse tells me You're experiencing some numbness in your fingers.
Yeah, dude.
It's starting to really kill.
Okay, I'm gonna check out your radial and your median nerve.
So give me a thumbs up.
Little bit more.
- Like that? - Yep.
Okay, that's good.
Give me an okay sign.
Good.
Okay, that's right.
So where's your better half? Outside making a phone call.
His girlfriend? Yeah, more like which one.
- Really? - It's the drama club.
It's all the hottest girls and most of the dudes are gay.
Suppose.
Okay, let's check out your ulnar.
Spread your fingers for me.
Nice.
And just yeah, try and resist if you can.
Okay.
Yes, that's good.
So you guys are actors, is that right? Yeah.
We both just auditioned for this production of "Winter's tale.
" And he got the lead, and I-I-I didn't get anything.
Well, some good news for you there doesn't appear to be any nerve damage.
Great news.
Ever since he got the part, I just want to beat him at something, you know? Which is why you agreed to somersault over stationary vehicles? I just keep thinking to myself, you know, like, "what does he have that I don't have?" You ever have that with anybody? Yeah.
Medicine can be a competitive field sometimes, yeah.
Hmm.
Can I do my piece for you? Your piece? What do you Yeah, yeah, like my audition monologue.
And then maybe, like, you can tell me where, like, I went wrong.
Yeah, actually, I've kind of got a busy afternoon.
We are, fair queen, but two lads that think not of the behind but of a day such as tomorrow Don't.
Okay, don't - As today.
- I If you don't mind, don't move your arm around like that.
This is my gesticulating arm.
I can see that.
I just don't want you to risk any further damage, so put that just put it down.
So, any feedback on the piece? All right, I've got the foot.
You're doing great.
You're doing great.
You're doing great.
Now, I'm gonna need lots of pressure from above, okay, Lin? Suprapubic please.
- Okay.
- All right, Sara, now, you're gonna feel a little bit of pressure.
Is the baby okay? Heart rate's perfectly fine.
I can see his feet, and they are very cute.
Oh, my god.
Okay, I just need to find his mouth.
What are you gonna do with his mouth? Well, my middle finger is gonna be his first pacifier.
Dr.
Kalfas is gonna flex the head to create a smaller diameter to the birth canal.
Okay.
Lots of pressure.
As much I'm giving you internally, you're gonna give me externally.
Okay? Sara, here we go.
Okay, we're gonna do this all together.
Come on now.
Push, push, push, push, push.
Good, good, good, good, good.
Keep going.
All right, dad, would you like to cut your son free? He looks healthy.
The nurse is just gonna clean him up, and then he's all yours.
You did so well.
I'm sorry I yelled.
That's okay.
Oh, my goodness.
- Hey.
- Hi, baby.
Hey, buddy.
Look at you, little bean.
Look at our tiny little bean.
All right, we'll give you guys a minute and then come back for the placenta, okay? Thank you.
We did it.
Are you a fava bean? Look at you.
That was incredible.
And she said it couldn't be done.
No, seriously.
I've never seen anything like that.
Well, congratulations, Dr.
Lin.
You just helped rewrite the book.
I'm never gonna live that down, am I? No.
Jason.
Uh, sorry.
I guess I just can't resist a pregnant woman.
I don't know what to say.
Um, how about you say we just forget this little indiscretion, okay? Okay.
Maybe you can do me a favor.
Wait a few minutes, then go in there and deliver the placenta.
I got a mountain of paperwork I got to climb.
Of course.
Okay.
Hey, you know what? We made a good team in there today.
You did great work.
You came? Of course.
How are you? I'm better now.
Where's George? George? Yeah.
Mimi, George is dead.
He died.
That's wishful thinking.
Oh, what are we gonna do? I don't know.
You're so beautiful.
Mimi.
Would you kiss me? Excuse me.
I'll just I'll come back later.
Who are you? I'm Dr.
Reid.
Oh, sorry.
Have we met? There's something really wrong with her.
And she's really confused.
She's having another attack.
An "attack"? What? Claire, you're gonna need to leave.
Claire, I need to do my job.
Okay.
Mimi, I'm gonna draw some blood, okay? I can't breathe.
Can you tell me what day it is? It's Wednesday.
And the year? It's 1985.
What are you concerned about? I just went over her chart.
She woke up from her pacemaker surgery in 1985.
Adverse reaction to the anesthetic? Could be.
Before I left the room, she wanted to know who I thought was cuter Tom Selleck or Bobby Ewing.
I've seen this before in Alzheimer's patients.
It's a sort of reversion into the past.
I ran a full blood panel during her last attack.
In the meantime, we should put her on nine south.
Yeah, it's probably the safest place for her.
Okay, I'll send the guys down for the transfer.
When she wakes up, I'll let her know.
Okay.
Hey, Alex.
Mm-hmm? Who is it? Tom Selleck or Bobby Ewing? Harrison Ford all the way.
Dr.
Kalfas asked me to deliver the placenta.
You don't have to do any crazy jujitsu flips like he did with this guy, do you? No, no, no.
So, are we gonna go with Sam? I think.
You? Does he look like a Sam to you? He does, yeah.
He totally looks like an old jewish guy already.
The placenta it's stuck.
What do you mean it's stuck? It must be an accreta.
What does that mean? Your placenta is embedded in the uterine muscle.
It's not separating.
Oh, gosh.
Can you get Dr.
Kalfas? I don't feel great.
Ben, can you take her hand? Sara, take some deep breaths for me.
She gonna be okay? It's just an unexpected complication.
He's not picking up.
I'm sorry.
I think I might faint.
Dr.
Lin, she's losing blood.
What is going on? Ben, I need you to take the baby.
Dr.
Lin? It's okay.
It's okay.
What's happening to me? Dr.
Lin? We need to get her to an O.
R.
now.
Well, whatever wager you made on your C.
T.
results, gentlemen, it is a push.
It's a negative for fractures.
No surgeries for either one of you.
- Oh, yes.
- Thank god.
Well, I wouldn't celebrate just yet.
The shoulder reduction's potentially very uncomfortable.
Gonna be even more uncomfortable for you when I take you down, bro.
In your dreams, Edmonton.
Oh, no.
What did you bet on now? You guys.
Yeah, we put a wager on who got the better surgeon.
That's right.
First guy's surgeon to get the shoulder back in wins.
And what I can't believe I'm even asking this question are the stakes? Winner gets to make the loser do any one thing he wants.
Within reason.
Within reason.
No bodily fluids.
No public nudity.
It's not gonna happen, gentlemen.
We're not here for your entertainment, believe it or not, all right? A resident will be by shortly to give you some freezing, although I'm starting to think we should do this without.
Idiots.
Spectacular idiots.
I mean, if your guy had known that I trained with Ian Hennesey, he never would've taken that bet.
Who? Are you kidding me? Dr.
Ian Hennesey.
Amazing new zealand orthopedic surgeon, basically a god.
Whatever.
Right, all I'm saying is I kind of trained with a pioneer of shoulder reduction.
It wouldn't have been a fair fight.
I'm sorry, Dr.
Goran, are you saying that you actually would've beat me? Charles.
Joels.
Dr.
Ian Hennesey developed an advanced bicipital massage technique.
In a place where they knighted the guy who made "The hobbit.
" Okay, there are other famous new zealanders apart from Peter Jackson.
Name three.
Russell Crowe, Anne Geddes, Keith Urban.
I thought they were australian.
Now you're just trying to piss me off.
Am I-am I sensing a wager here, Dr.
Goran? - Maybe, Dr.
Harris.
- Oh, okay.
Well, why don't you name your stakes, then? All right, same as the knuckleheads.
First guy to put the shoulder back into place Gets the other guy to do whatever he wants.
- Within reason.
- Within reason, for sure.
No bodily fluids.
- Yeah.
- Bingo.
Mm-hmm.
Mimi.
Where's Claire? She's getting something to eat.
And my husband? I don't know.
He hasn't come to visit me yet.
Mimi.
Oh, I know.
It's such a mess.
I met Claire at this party a couple of months ago.
She was wearing these black fingerless gloves and these door-knocker earrings.
The moment I saw her, I was in trouble.
Have you ever been in love, Dr.
Reid? Yes.
So you know.
I'm supposed to be a married woman in the eyes of the church.
But you can't help who you love.
And the heart wants what the heart wants.
You've got the baby man, Dr.
Jason Kalfas.
I'm not in right now, but please leave your Have you seen Dr.
Kalfas? Yeah, he's in the washroom.
Jason? Jason, I can see you.
Maggie, what are you doing here? It's our patient, Sara Collins.
Who? The patient.
Your patient.
- She's placenta accreta.
- Oh.
She's being rushed into the O.
R.
Okay.
Okay.
Right.
Just let me finish my business, okay? Okay.
Hurry.
Okay.
Okay, here's the thing.
She still thinks it's 1985? Mm-hmm.
Shh.
Okay.
What was that about? It's a long story.
35 years long.
Hey.
If you were a Sri Lankan goddess in my zumba class, how would you want me to ask you out? Zumba? Yeah.
"Ahk-ah-guh, ha-low.
" It means "hello, beautiful" in tamil.
"Ahk-ah-guh, ha-low.
" "Ahk-ah-guh, ha-low.
" Wow.
What are you doing? Zumba.
It's a booty roll into a body roll.
Jackson.
Oh, sorry.
Almost forgot.
Blood work on your patient.
I knew it.
Her serum catecholamines.
They're 15 times the normal level.
It's a pheochromocytoma.
An adrenal tumor? Yeah.
Page Dr.
Bell.
Yeah.
You were right about it being a PHEO, and your reward ever handled a live grenade? Well, I've worked with you for awhile now, so, yeah, I guess so.
Touché.
Pheochromocytomas are extremely rare.
I'm guessing you haven't had a lot of practice with them.
One wrong move, the tumor spills adrenaline into the bloodstream, causing massive stroke, organ failure, death.
This your idea of a pep talk, Dawn? I'm just prepping you, Alex.
Mimi is hemodynamically unstable.
She has decreased cardiac reserve.
If I mishandle the tumor, she'll die.
I get it.
So, let's do this.
Bowman, that's your name? You've got to be kidding me.
I've assisted in a dozen of your surgeries.
My apologies.
The patient has a brand-new pacemaker.
I've read the chart.
I'd like you to monitor her arterial pressure and her pulmonary wedges.
I'd like your eyes to be glued to those little waves.
I've got her on a phentolamine drip.
Her pressure should be controlled.
Eyes glued.
Okay, liver is mobilized.
Retractor.
There she is.
Up and away.
Such a small piece of tissue causes so much trouble.
It's not a tumor.
It's that nasty stuff that keeps emptying into her bloodstream.
Bowman, how's my how's our patient's heart? Holding steady at 97.
B.
P.
is 120 over 80.
It's "Baumann.
" Preparing to dissect the adrenal vein.
Reid, what's the difference between the left adrenal vein and the right? I'm not your student, Dawn.
And technically, this is my O.
R.
Okay, well, then let me tell you.
The right adrenal vein is shorter.
Is shorter.
It enters the IVC posteromedially.
It's a tighter anatomy.
No room for mistakes.
Clips.
Scissors.
B.
P.
is 90 and dipping.
What's happening? She's torn the ivc.
I need suction.
You need me to take over? I need you to either shut up or get the hell out of my O.
R.
I can't see anything.
Can you suture blind? There's blind and then there's blind.
Clean the camera! Her b.
P.
Is bottoming out.
Her heart rate's at 128.
She's hypotensive.
She's going into shock.
Okay.
I'm converting to an open procedure.
Okay, listen up.
Dr.
Kalfas has left the building.
Dr.
Lin, she's losing a lot of blood.
- What's her pressure and urine output? - 60 systolic.
No urine in the last 10 minutes.
Are we preparing for an emergency hysterectomy? Well, she wants a big family, so All due respect, but she won't be around to have any family if we don't stop this bleeding.
All due respect, but this is my O.
R.
now.
The gold standard would be an emergency hysterectomy.
That's what the book says, but I want to try an internal iliac artery ligation to save the uterus.
Are you sure that's the right move? Knife.
What are those for? You'll see.
Go! Get on your stomach, please.
Straighten your spine if you can.
I thought tolstoy was heavier than that.
All right, bro, you win.
So what's it gonna be, huh? Spoonful of cinnamon? Snort wasabi? You name it.
No.
Um Your monologue from "Winter's tale.
" Oh.
Do it for these guys.
What? Dude, my shoulder's completely messed up.
I haven't even warmed up.
Don't worry about it.
And besides, a bet is a bet.
We were twinned lambs that did frisk in the sun.
And bleat the one at the other.
What we changed was innocence for innocence.
We knew not the doctrine of ill-doing.
Claire.
How is she? There was a complication during the surgery, but we were able to correct it.
Oh, thank god.
And I was able to remove the tumor en masse with no further complications.
So her prognosis is very good.
That is such good news.
Thank you.
You're welcome.
Thank you.
Um, I wanted to apologize to you for earlier.
Oh, no apology necessary.
Really.
Did she, uh, mention anything to you? A little.
Just that she had met you at a party once and was smitten.
Well, it was very mutual.
It was supposed to be just a one-time thing.
It wasn't.
The affair lasted almost a year until her husband caught us.
That must have been hard.
Oh, you have no idea.
Our circle of friends and our church.
Mimi just chose to bury it and me.
And I stayed single all these years.
I just never stopped loving her.
Claire, I think you should know the adrenal tumor likely caused her to go back in time.
So now that it's gone The fairy tale's over.
Most likely.
Well, that's too bad.
I almost got kissed.
She obviously loved you very much.
Yeah, I guess sometimes that's just not enough.
Dr.
Lin, word has it you saved a young mother's uterus today.
Word travels fast.
You probably also saved her life.
Well done.
What can I do for you? There's no easy way to say this.
Um Dr.
Kalfas? Yes.
What about him? He is abusing narcotics.
This isn't just a rumor? I-I saw it.
I caught him.
It's, uh, it's not a rumor.
It was very brave of you to tell me.
Thank you.
I'll take it from here.
Okay.
Thank you.
Maggie, word to the wise.
Next time you come in here, you might want to change your scrubs first.
The blood's not such a great touch.
I did change.
Oh, my god.
Maggie, are you okay? Oh, my god.
I, uhI thi I think I'm having a miscarriage.
Hi.
Your surgery went well.
I was able to remove your adrenal tumor.
Oh, that's great news.
Can you tell me what year it is? Good.
Why did you ask me that? You experienced a temporary memory lapse.
These adrenal tumors can do some remarkable things.
Oh.
Lucky for me, so can you.
Claire is outside in the hall.
I see.
It's lovely that she stayed, but I-I'm really not up for visitors.
You know, I met this amazing free spirit today.
And she said you can't choose who you love.
I'm not sure what you're talking about.
It isn't too late.
Hello, Claire.
Can I come in? Yeah.
You know, you're gonna have to teach me that crazy kiwi shoulder thing one of these days.
I don't know, man.
You were like seconds behind me with your Dostoyevsky and "Ulysses" or whatever the hell literature you had.
Okay, what's it gonna be? Spoonful of cinnamon or snort wasabi? Double yes.
No, although I am very curious to see that one day, I have to tell you.
Come on, dude, the suspense is killing me here.
Actually, there is something I would like to talk to you about.
- Yeah? - Yeah.
I want you to give Alex some space.
What? You and Alex.
I mean, that's it's over.
It's over, man.
I think you should give her some space, the space she deserves.
And we had the bet.
You asked me what I wanted.
That's what I want.
Have you slept with her, Joel? You mean recently? Charlie!