The Resident (2018) s03e09 Episode Script
Out for Blood
1 Previously on The Resident What you're talking about is torture.
All I'm talking about is this man, who will die unless Rob Spiro tells us where he's being held.
- I want no part of it.
- It has to be done.
There's a way we can keep an eye on each other's surgical practices.
An Ortho-Spine Surgery Center for comprehensive spine care.
Logan Kim.
Exec VP of Red Rock.
I'll be overseeing the day-to-day operations - of the hospital now.
- DEVON: I took an oath.
I get that you would've made a different choice.
- The right one.
- For you.
But I don't want to be the kind of doctor you are.
Hawkins is a whistle-blower.
He's a threat to the hospital.
I'll handle it.
SURGEON: Last night I took my date to that new five-star place on Peachtree.
SURGICAL ASSISTANT: You went to Manny's? OR NURSE: Oh, I hear it's so good.
Well, it was until my ex and her girlfriends got seated next to us.
- No.
- Those ladies had words for me.
(ASSISTANT AND NURSE LAUGH) - Rongeur.
- (MONITOR BEEPING) - BP is dropping.
- I'm almost done.
Just give her another liter of LR.
She's moving.
I'm gonna bolus the propofol.
No, that'll drop her pressures.
Just hang on, I'm almost finished.
- Damn.
Tube's out.
- Uh, reintubate.
There's no time.
I'll bag her.
Her pressure is falling fast.
ASSISTANT: She's gonna code, what do we do? Uh (LINE RINGING) 911 OPERATOR: 911, what is your emergency? SURGEON: My patient.
We need to get her to a hospital right now.
(SIREN WAILING) What the hell happened? A 53-year-old female.
Lost her airway midway through operation in an outpatient spine surgery center.
- Did they send operative notes? - Yes.
Her name is Lynette Hughes.
She went in for a spinal fracture.
That's minor.
Let's take a peek.
Okay.
One, two, three.
There we go.
Okay, very gently now One, two, three.
KIT: Bloody hell.
Whatever they started to fix, they didn't finish.
All right, start her on IV vanc and cefepime.
Let's get her to CT now.
And my client will stay outside until you can assure they will have absolute privacy and security.
I can't clear half the ER for one patient.
- No matter who they are.
- Everything all right? No.
I need to speak to his supervisor immediately.
- That'd be me.
- And Dr.
Feldman will tell you the same thing that I told you.
What he said.
Phoenix on the move.
But who's the patient? Can you direct me to "Phoenix"? (SIGHS) ER bay four.
I'm on my way, too.
They called you? I am the admitting resident.
Yes.
Any idea who the patient is? No.
Sounds like they're a big deal.
Not to me.
I've been operating on big shots since I was a resident.
Athletes, celebs, heads of state it's all the same.
Gentlemen, allow me to introduce you to Princess Nadine.
Your Highness.
Just Nadine's fine.
My mom's Pakistani but she married a king while abroad.
Pretty sure they sent me to the States when I was a kid so they could have "alone time.
" Nadine fainted while jogging a few hours ago.
No past medical history.
I forgot my water bottle.
Probably just dehydrated.
But Amir's my head of security and he said we had to come in.
Her head has been hurting for weeks.
NADINE: It comes and goes.
- You speak Urdu? - Some.
Yeah, there's overlap with Hindi.
Anything you tell us would help.
Yeah, we'll keep it confidential.
Well, I was running through Piedmont Park, and then I don't know, it was like the ground beneath my feet just disappeared.
DEVON: She's lost sensation in her feet.
And she's had recent headaches, dizziness, fevers.
- More than just dehydration.
- No question.
My money's on a stroke or bleed.
Eh, it could be cardiogenic.
Or vascular.
- Get a noncontrast head CT stat.
- I'll ultrasound her carotids.
We should also do a spinal tap rule out meningitis - and encephalitis.
- (PAGER BEEPING) Page me when the results come in.
Let's get her settled in one of our VIP suites.
Thank you.
And the princess has requested that Dr.
Pravesh stay on her medical team while she's at Chastain.
Thank you.
We good? You tell me.
You've already established a connection with the patient.
I think you should stay on.
MINA: Incredible.
We can see her perfectly.
And she looks just like you.
(LAUGHING) Is she sucking her thumb? - LIN: Yes.
- (ADAKU LAUGHS) LIN: Movement is a very good sign.
Mm.
Your last trimester has begun.
Soon that little blob will be crying in your arms.
(LAUGHS) (BOTH LAUGHING) Have you decided on a name? Not yet.
For now, let's just call her Michelle.
- Obama? - You know it.
(BOTH LAUGHING) (COUGHING) Oh, all right.
- Let's have you sit up.
- (COUGHING) (HEAVY BREATHS) (GASPS) Lost my breath there for a second.
That's common during pregnancies.
Why don't I give a listen to your heart and lungs while you're here? Have you felt like this before? Sometimes when I'm lying down, my chest gets a little tight.
(EXHALES) (INHALES, EXHALES DEEPLY) I did hear some atypical sounds.
It's probably nothing, but I'd like to order some more tests just to be safe.
We'll order a few labs, get a chest X-ray, and an echo to make sure you and your little queen are okay.
She does look like me, doesn't she? - Yeah.
- (LAUGHS) We suggest branding this product by branding you.
That face says strength, confidence, compassion.
Which one's your favorite? It's a tough choice.
I like 'em all.
We think the third one shows more authority.
- In the eyes.
- Exactly.
Am I interrupting? Yes.
I've been looking for a new post-workout shake.
- This one come in mocha? - (CHUCKLES) Uh, we want you and the product to be camera ready for the press ASAP.
Yeah, okay, I'll-I'll get back to you guys later.
That was That was good.
Thanks, that looks great.
Why are you here? For the meeting.
For what meeting? This one.
Dr.
Bell, we have a problem.
A former patient is suing Chastain.
(SCOFFS) Hospitals get sued all the time.
That's why we have lawyers.
KIM: This is different.
The patient has named Dr.
Hawkins in the suit.
And he just walked in our door.
KIM: Rob Spiro was admitted one month ago after he was injured during a failed robbery.
And we saved his life.
That's not what he says.
NIC: I can't believe they let him out.
Once the depositions are over, he goes back to prison to await trial.
- It's just for the day.
- (EXHALES) CAIN: Spiro claims that after his surgery, Hawkins withheld pain medication.
He tortured Spiro to extract the location of a man he abducted.
And you believe that kind of criminal over our top resident? - A judge might.
- Judges almost always side with the doctors in malpractice suits.
And that's if the patient isn't a murderer.
I can assure you, this suit is not gonna cost Chastain a dime.
Any judge would throw it out in a second.
We've worked too hard to improve Chastain's image to let anything threaten it.
KIM: Any association with Spiro is bad for this hospital.
You'll be in the deposition, naturally, and I'll be joining you today.
(SIGHS) Well, be my guest.
Bell has no idea this gives us the perfect way to get rid of Hawkins.
Spiro's out for blood.
And we're gonna give it to him.
Hawkins Don't worry, you'll be fine.
Red Rock's lawyers will be here soon.
You haven't always been on my side.
I am this time.
Gentlemen, we're ready for you now.
- Where's Levin and Sutton? - LAWYER: Levin is sick.
Sutton was unavailable.
We're familiar with the case.
Shoot, I forgot my pen.
TRISH: Dr.
Hawkins, Mr.
Spiro was in a lot of pain when he came out of surgery, is that correct? Yes, that's normal for a major operation.
TRISH: According to his electronic medical record, Mr.
Spiro's morphine was stopped at 8:32 p.
m.
Yeah, it's typical for morphine to be withdrawn if it's depressing a patient's respiratory drive.
- TRISH: That's not the case here.
- (SCOFFS) You stopped the morphine to coerce a confession out of my client.
Gonna perjure yourself, you little bitch? What did you tell them? I said Mr.
Spiro was lying.
That I provided him the standard of care.
Is that true? The less I tell you the better.
He confessed the location of a hostage.
If you hadn't done what you did, another one of Rob's victims would be dead.
But if they find out, you'll never practice at Chastain again.
Or anywhere else.
Does anyone else know? Conrad, who else knows? Just Devon.
Nadine, once the lidocaine takes effect, you shouldn't feel a thing.
Okay? Amir.
Give the man some space.
(DOOR OPENS) How are we doing? Prepping the lumbar puncture.
So, just a few more questions.
There's a chance your symptoms may be caused by an infectious disease.
Any travel outside the U.
S.
recently? - A trip back to the Middle East? - NADINE: No travel.
I haven't been back home since I was six.
I spend most of my time in a campus practice room anyway.
- You're a college student? - At Emory, yeah.
I'm a music major.
Mom and Dad insisted I go to college, even though what I really wanna do is be a professional deejay.
- DEVON: Sweet.
- (NADINE CHUCKLES) - Do you make your own mixes? - Yeah.
I love taking old songs, classics, adding new beats, loops, hooks.
Totally reinventing them.
Making them my own.
DEVON: Okay, Nadine.
All set.
You ready? As I'll ever be.
All right.
Hmm.
You see that? Your heart is enlarged.
It's not pumping as vigorously as we would expect.
You have a condition called dilated cardiomyopathy.
It explains the shortness of breath.
AUSTIN: Most likely brought on by the chemo that treated your breast cancer.
But my baby's okay? Yeah.
But pregnancy is hard on the heart.
The longer you're pregnant, the greater the risk that you develop congestive heart failure.
There is another option.
Induce an early delivery.
My baby's only 28 weeks.
How early are we talking? Ideally, we would want to wait as long as possible to induce.
The sooner we do it, the more risk to the baby.
What kind of risk? AUSTIN: Like underdeveloped lungs with increased risk of respiratory distress and some serious infections.
So what's best for my baby could harm me, and what's best for me could It's not an easy choice.
The health of my baby comes first.
I'm carrying her to term.
(MONITOR BEEPING) CHU: We've got a problem.
I'm not getting a signal from the right L5 nerve root.
CAIN: Must be a screw abutting the nerve.
Retractors? KIT: Whoever started putting in this hardware blew out pedicles and left her with a spinal pseudarthrosis.
CAIN: I see the screw, right there, but it's deep.
KIT: Poor woman should never have been operated on at a spine surgery center.
They thought she only had a spinal fracture, but once they opened her up, they found spinopelvic disassociation.
Got it.
CAIN: Those centers aren't prepared for things to go wrong.
KIT: And when they do, patients can be hours from a hospital and die as a result.
- She's one of the lucky ones.
- (MONITOR CHIMES) - CHU: Nerve signal is back.
- CAIN: Okay.
KIT: Great.
We can start to repair and fix the spine to the pelvis.
It was awful.
(CLEARS THROAT) My own doctor, trying to hurt me.
I swear to God, I I've never felt pain like that.
Thank you, Mr.
Spiro.
That's all.
Don't you have any more questions? We're good.
All right.
I'll begin deposing staff.
What the hell was that? I thought it went well.
Those Red Rock lawyers are barely a day out of law school.
They didn't ask one substantive question.
Conrad deserves an actual defense.
I'm bringing in our old legal team, wherever the hell they are.
No, you're not.
(DRINK POURS) You want Conrad to go down.
Every year, whistle-blowers like Hawkins cost hospitals millions.
He discovered that a drug was killing patients.
And good for him, but what about next time? He won't hesitate to take sides against us.
He is our number one diagnostician.
He's about to become chief resident.
Long-term, I guarantee a whistle-blower is a liability.
Well, then, why not just fire him? Why go through all that? We both know his father's a powerful man.
Former chairman of the board.
I want Hawkins gone, but we can't get rid of him without good cause.
I want it done clean without any blowback from Marshall Winthrop.
So you're using Spiro's lawsuit.
A criminal.
I won't support this.
You clearly still don't understand how things work around here.
You seem confused, so let me help.
Red Rock gave me authority to do whatever's necessary to protect Chastain's bottom line.
So if Hawkins isn't gone by end of business, then today will be your last as CEO.
It's him or you.
This is a new low even for Red Rock.
- You think they'll really do it? - Of course they'll fire me.
Have you met these people? The only way I stay on as CEO is if I let them end Conrad's career.
You can't let them get away with this.
What am I what am I supposed to do? Report Red Rock to the state board.
- Take it to the press.
- Yeah, but then say what? I have no proof.
I'd be out of my office before anybody even returned my calls, and then I'd be the whistle-blower, and then they'd move to destroy me, too.
Then what now? (SIGHS) I don't know.
I-I make Red Rock think I'm on their side.
Show I'm being cooperative.
I, uh I don't know, best-case scenario is I can figure out a way to save both of us.
(SIGHS) How's your pain level, Lynette? If I say zero, can I pack a bag to Vegas? (LAUGHS) Push, push, push.
I have Nelly tickets and a date with the penny slots.
You just went through a grueling spinal repair and fixation.
I think you're stuck hanging with us for a few weeks.
Squeeze my fingers.
W-Weeks? The surgery center people said I could be home by tonight.
Well, they were wrong.
And the surgeons who actually fixed you want you to stay fixed.
Somebody order an angel? Lynette, this is my dad, Kyle.
- He's a volunteer here at Chastain.
- CONRAD: Yeah, we have angels like him to keep patients company - during their stay.
- Anything you need, I'm your man.
(SIGHS) How about a cigarette? No can do.
Smoking constricts your blood vessels, which keeps your surgical wounds from healing.
And means you'd be here even longer.
Well, buckle up, honey.
If I don't get my nicotine, I'm more than a handful.
CONRAD: Still going, huh? Yeah, they're about to depose the staff.
KIM: That is where I'm gonna build the tennis court, and this what I'm thinking of for the interior.
Are you gonna stay in there? Yeah, I cleared my schedule.
Thanks for having my back.
How would you describe Dr.
Hawkins? (SIGHS) Caring.
- Smart.
- Handsome.
We heard he can be a rule breaker.
Is that true? - Never seen it.
- Define "rule breaker.
" Well, I saw him cut in line in the cafeteria once.
At any time, did you see Dr.
Hawkins go into Mr.
Spiro's room alone? - Nope.
- AUSTIN: No.
I was in the OR all day where I should be right now.
NIC: Mr.
Spiro wasn't even one of my patients.
Can I please go? We got nothing.
Conrad is well-liked and respected.
Nobody is liked by everyone, especially doctors like Hawkins.
What do you expect me to do? If I were you, I'd think of something.
(GASPING) - (MONITOR BEEPING) - Hurry, please! Help her! Please, hurry! Hurry! Nadine, try to relax.
We're gonna check your heart and lungs.
BP 210/140.
Sats in the 80s.
DEVON: Okay.
Crackles two-thirds of the way up.
Override a nitro spray bottle.
Then call Radiology for a portable X-ray stat.
What's happening to her? She's got fluid in her lungs.
It's making it hard for her to breathe.
(COUGHING) CONRAD: Give her 40 of furosemide IV.
Okay.
All right, Nadine.
Open wide.
Okay.
This will help you breathe while we figure out what's going on, okay? (BREATHING HEAVILY) I don't get it.
Her head CT was benign.
CSF is clear.
Cultures negative.
No pulmonary or cardiac issues.
Is it renal? Her creatinine was normal.
Besides, that wouldn't explain her syncope.
- So what are we missing? - (PAGER BEEPING) (SIGHS) - I got to go.
- We're not done here.
We still don't know what's wrong with her.
She could decompensate at any point.
You will figure this out.
Keep me updated.
It's not my fault.
- What? - Rob Spiro.
I tried to stop you.
What does that have to do with anything? Because you're taking it out on me, and Nadine will suffer because of it.
I have other patients, including ones in the ICU.
And you were the one who didn't want to work with me.
Because you tortured a man.
(SIGHS) Rob Spiro is a murderer.
And we're doctors.
We're supposed to be the ones who are helping people.
- And I did.
- You break rules, ignore protocol.
That is who you are, and it is wrong.
We have been over and over this.
A man is alive because of what I did.
Oh, you didn't do it for him.
You did it for you.
You're damn right I did.
Had to make a choice I could live with.
(PAGER BEEPING) I got to go.
AUSTIN: So, we'll start you on a cardiac regimen, oral diuretic and a beta-blocker.
And then we'll see you every few days to monitor you and the baby.
Sounds like a plan.
And I have faith that God's watching over us.
Adaku, we want to make sure that you understand what all this means.
LIN: If the strain on your heart becomes too great, we may need to perform an emergency cesarean delivery.
AUSTIN: But even that might not be enough.
I've seen women your age end up with a device implanted to take over the function of their heart.
Tethered to a battery pack.
Waiting for a transplant.
But I feel fine now.
Cardiac issues can escalate quickly for pregnant women.
Worsening heart failure could kill both you and the baby.
We're here to support whatever you choose if you are sure that you want to try carrying this baby to term.
Maybe I should take a minute.
(SIGHS) Add a thyroid panel, ABG and BMP.
You ran those two hours ago.
Two hours ago, she wasn't on oxygen.
- Run it again.
- Yes, Doctor.
You all right? (CHUCKLES SOFTLY) I got to make sure you finish school so you can start deejaying sold-out clubs around the world, right? (CHUCKLES) I like the sound of that.
DEVON: And you can have a disguise, like that guy with the mouse mask.
And hey, you already have a code name.
- Phoenix? - (LAUGHS) Okay, you'll think of a better one.
All I ask for in return are backstage passes for life.
(BOTH LAUGH) All right, I'm gonna go check on those tests.
Wait.
Um before you go, could you pass me the, um the the the the Ras? Juice? Yes.
Sorry.
I couldn't think of the word.
Thank you.
Has that happened before? Forgetting English words for things? A few times.
It's weird, huh? How long has it been going on? A couple weeks.
Why? (WHIRRING) (RAPID, RHYTHMIC BEEPING AND WHOOSHING) Nadine forgets words in her primary language, English, but her secondary language, Urdu, remains intact.
CAIN: Could have a number of causes.
But it happened when she sat up.
So you think she's experiencing positional cerebral hypoperfusion? That's why I ordered an angiogram.
Look.
The blood vessels in her brain have narrowed.
She has Moyamoya.
Which would explain why she lost all sensation in her feet - while she was jogging.
- And why her symptoms only occurred when she exerted herself.
Moyamoya can be unremitting and progressive.
She could die of strokes before she turns 30.
Unless I perform a cerebral bypass.
Time to get our princess to my OR.
The first time my dad busted me, I was 16.
But instead of grounding me, he bought me a pack.
Said fathers and daughters should smoke the same brand.
- He gave you cigarettes? - He'd smoke 'em with me.
- (LAUGHING): Oh.
- Playing slapjack on the front porch like a couple rowdy old drunks.
Till he passed away a couple years ago.
What did he die of? Heart attack.
You know, more people die of heart disease from smoking than cancer.
- And still, you smoke? - I know - it doesn't make any sense.
- (LAUGHING): No.
The right thing to do is to quit, but (SIGHS) I can't.
You know, that's the definition of addiction.
It's in my family, too.
I, uh I was a drinker and, you know, eh, drugs when I was younger.
My daughters they grew up seeing that, and one of 'em became an addict.
(LOUD, RHYTHMIC BEEPS) Oh, that doesn't sound good.
Oh, God.
Can you read that thing? No, but I-I I-I I think I can find someone who can.
Um, I'll be right I'll be right back.
Uh, excuse me? My (INDISTINCT P.
A.
ANNOUNCEMENT) Hey, uh, can I just? (INDISTINCT, OVERLAPPING CHATTER) Hello.
Hey, could you just help? You got to be kidding me.
(SIGHS) Uh, hey, I-I need a doctor.
Hey! Angels will not be ignored.
(SIGHS) It's my patient.
- Y-Your patient? - Yes, yes.
Her mon-monitor thing it-it's beeping.
Could you could you check on her? I think you might be getting a little carried away - with your role here.
- (SIGHS) Okay.
I'm a Nevin.
- All right? - A who? Yeah, th-that's it! I want your name, Scott, and your badge number, right now! - I don't understand.
- I know.
- It is a lot to process, but - No.
I don't understand who comes up with these names.
Mora-maya? - Moyamoya.
- (LAUGHING): Okay.
It means "puff of smoke" in Japanese, because of the way it looks on the angiogram.
- Mm.
- Nadine, if we don't operate (SIGHS) it is fatal.
I've faced a lot of threats in my life.
Kidnapping, poisoning, assassination.
I'm not gonna let a puff of smoke take me out.
Then we'll prep you for surgery.
I want my day in court.
I'm sorry, Dr.
Feldman.
They've decided not to depose you.
But Dr.
Hawkins is one of the best doctors at this hospital.
He A patient came in hypertensive last week.
Hawkins realized it was pheochromocytoma.
Who else makes that call? And not only is Conrad a great doctor, he make great doctors.
Dr.
Pravesh used to train under him.
Total rising star.
Oh, Pravesh isn't Hawkins' intern anymore? No, he requested a new resident.
- (ELEVATOR BELL DINGS) - Why? When did he put in the request? About a month ago.
Wasn't that around the time they were both treating Rob Spiro? Yeah.
Why? (SIGHS) They say a cerebral bypass is like landing on the moon.
Cain only gets one shot.
Oh, I like that music.
The patient requested it.
Yeah? Who's the artist? Her.
Swingin' Don't count me out, 'cause I'll come back Show angiogram.
(TRILLING) This area lacks adequate perfusion.
I'll need to reroute the circulation by performing the anastomosis right here.
Show vitals.
Can't feel my hands, but I got you Pressure's stable.
All looks good.
CAIN: It's exactly what I like to hear.
Stopping the blood flow to the brain.
Nurse.
Pig clips and hemostat.
And I know in my soul that I'm onto something good CAIN: Middle cerebral artery clamped.
Dr.
Chu, the clock, please.
30 minutes starting now.
(BEEPING) Let's dance, Princess.
To you Don't count me out, 'cause I'll come back.
You've been wasting our time, and I'm fresh out of patience.
I need a CEO who will get things done at all costs.
Clearly, that's not you.
I think you should question Dr.
Pravesh.
We were all under the impression that he's one of Hawkins' most loyal allies.
Why talk to him now? Because I've recently discovered that may not be the case.
I think he knows what really happened with Rob Spiro.
Let's put him under oath.
Occlusion time is approaching 30 minutes.
Cain needs to finish soon or risk permanent brain damage.
He's throwing the last stitch.
Let's hope this works.
Prepare to unclamp.
BELL: Dr.
Pravesh? They've decided to depose you.
Now.
(ALARMS SOUND) Pressure's rising.
Elevate the head.
Push the mannitol.
(ALARMS SOUNDING) Her brain is swelling too quickly.
The edges of her skull are lacerating her brain.
We're losing neurological function.
I'm enlarging the craniotomy.
(WHIRRING) (SIGHS) She's my patient.
I'm not going anywhere.
Taking down the anastomosis.
Swelling is coming down.
Time to redo the bypass.
She doesn't have time for him to redo an entire bypass.
But we still need to restore blood flow in her brain.
And complete the surgery quickly.
Are you thinking what I'm thinking? Omental transposition.
Yeah, well, you better lose the suit, buddy.
I save your patient, then we go.
AUSTIN: Step aside.
Two Chastain OGs to the rescue.
- No need.
I've got this.
- Uh, sorry, brother, but the princess does not have time for you to play hero today.
Project abdomen.
(TRILLING) (CHIMING) I see a vascular-rich piece of omentum we can use to place on the brain.
10 blade.
Underneath it all I'll need a piece at least 20 by ten centimeters.
Metz.
Harvesting the omentum.
KIT: Taking that piece of tissue from her abdomen and laying it on her brain can stimulate the growth of new blood vessels, restoring perfusion.
Won't this increase the risk of hematoma? You're right, but we're out of options.
Underneath it all Laying the omentum down.
With the whispers closing in - To lives we all defend - We all defend - And now - And now Show vascularization over the next 90 days.
- It all - No one knows KIT: Devon? No one knows your name Knows your name No one loves you now Loves you now No one feels the same Feels the same Yes, yes, yes.
Let there be blood.
(AUSTIN LAUGHS) - Underneath - (AUSTIN LAUGHS) It all Underneath it all (PAGER BEEPING) I'm sorry.
It's not your fault.
Got to see a patient.
Deep breaths, deep breaths.
Hold on.
- What's going on? - She's in A-fib.
I'm getting her back into sinus rhythm, and you're interrupting.
Hey, hey, man, I really don't like your tone.
How about a little bedside manner? Lynette has been through enough.
Dad, I appreciate the passion, - but take it down a notch.
- This this is what I'm trying to say.
She gets panic attacks, so maybe we can all relax one damn minute.
Panic attacks.
What do they feel like? I don't know, it just feels like my heart is beating out of my chest.
What if they aren't panic attacks but A-fib as well? - Her past EKGs were all normal.
- NIC: An EKG could miss it.
If she's been having A-fib for some time There could be a clot.
Shocking her could dislodge it, 'cause a stroke.
You want to do rate control.
20 milligrams IV Diltiazem.
Try it.
- All right.
- Oh, my God.
(KYLE EXHALES) Breathe.
Come on, breathe.
AUSTIN: So, I hear Adaku decided to continue her pregnancy.
Risk her own health for her baby.
She and I are practically sisters, yet I have never understood her faith.
Have you tried? You believe there's some all-powerful being who can heal us if we just ask nicely? The fact is that faith is good for patients.
Those who believe they'll be okay - generally have better outcomes.
- That's no guarantee.
Surgeons or God everyone needs someone to believe in.
She has a long road ahead.
Even if everything goes right.
All the more reason you should support her on her own terms.
Even if she finds faith in a place you don't understand.
(INDISTINCT P.
A.
ANNOUNCEMENT) Lynette's stable.
It was the right call.
(CONRAD SIGHS) You all right? Devon's about to be deposed.
I'm gonna go talk to him.
- And say what? - (SIGHS) That sometimes telling the truth isn't enough.
Sometimes you have to fight fire with fire.
Devon has to do what he feels is right no matter the consequences.
That's what I tried to teach him.
Now we have to respect his choice.
(SIGHS HEAVILY) TRISH: Dr.
Pravesh, let's cut to the chase.
Did you see Dr.
Hawkins go into Mr.
Spiro's room? I did.
- Alone? - That's correct.
TRISH: I understand you recently asked to be assigned to a new resident.
Why? Dr.
Hawkins and I disagreed.
TRISH: About what? Too many things.
Like the treatment of Mr.
Spiro? Yes.
Because Dr.
Hawkins tortured him? Dr.
Pravesh? Please.
They need an answer.
Do you have any reason to believe Dr.
Hawkins withheld pain medication to elicit a confession? CONRAD: Dr.
Pravesh, just tell them the truth.
I know you're one of the good guys.
(FAINT, ECHOING): Dr.
Pravesh, just tell the truth.
I know you're one I know you're one of the good guys.
Mr.
Spiro was in respiratory distress.
Pain medication needed to be withheld.
This man is alive today because of Dr.
Hawkins.
SPIRO: Why are you lying, huh? Why are you lying!? (CONRAD SIGHS) Why did you lie for me? I didn't do it for you.
These patients need you.
And I had to make a decision I could live with.
Ah, you and I are very different.
I respect that.
Me, too.
And I think this hospital needs doctors like both of us.
(KNOCKING) Your intracranial pressures and post-op labs are trending in the right direction.
Thank you.
Dr.
Pravesh, have you ever saved a princess before? It was a team effort.
The king will want to thank you.
I expect he will be calling shortly.
Well, what do I call him? Your Majesty.
KYLE: Okay, maybe I lost my cool, just a little.
(CHUCKLES) Well, I'm glad you did.
Now I understand why they call you an angel.
- (CHUCKLES): Nah.
- (CHUCKLES) (SIGHS): The truth is I love this job.
Sometimes I feel like it's the only thing I got to hang on to.
- Mm.
- And I know what it's like when things don't go your way.
- Damn! - Yeah.
How did you get that? I gave my kidney to my daughter.
At least I tried.
LYNETTE: The younger one? KYLE: Jessie.
Yeah.
She struggled with addiction.
Opioids.
She, uh she didn't make it.
LYNETTE: Oh, I'm s I'm so sorry.
When we lost Jessie, I I don't think I could've made it through if it hadn't been for Nic.
She's the best thing about Chastain.
(LYNETTE CHUCKLES) You sound so proud of her.
Yeah.
Well (CHOKED UP): She's the best thing about me, too.
I'm scared.
Me, too.
(TAKES DEEP BREATH) Dr.
Hawkins survived the day.
I can't say the same about you.
- Hold it.
- Sorry, I got to make this quick.
Oh, it will be.
(PHONE BUZZES, CHIMES) What is this? My resignation as CEO.
(RAIN PATTERING) Just finish packing and go.
Oh, I won't be leaving Chastain.
I'll be staying on as chief of surgery.
Red Rock won't see it that way.
Well, then you'll need to find yourself some better lawyers, because my surgical contract is bulletproof.
You just try getting rid of me.
(INTRO TO "WRONGWORLD" BY KRYSH PLAYING) Do you really even like me? Are you really even trying? BELL: Today Red Rock asked me to turn against one of my own doctors.
Are you really even trying? And tomorrow they'd just ask me to do something worse.
You are so dead to me Without this hurt, without this curse What would you mean to me? Yeah, yeah, yeah You fled on me Tellin' me to quit so easily You bled on me There's a bloodbath coming.
I don't even want to be up there when it happens.
But down here, I can survive.
What's gonna happen to Conrad? BELL: Red Rock has eyes and ears everywhere.
Conrad still has a target on his back.
You fled on me.
As do we all.
All I'm talking about is this man, who will die unless Rob Spiro tells us where he's being held.
- I want no part of it.
- It has to be done.
There's a way we can keep an eye on each other's surgical practices.
An Ortho-Spine Surgery Center for comprehensive spine care.
Logan Kim.
Exec VP of Red Rock.
I'll be overseeing the day-to-day operations - of the hospital now.
- DEVON: I took an oath.
I get that you would've made a different choice.
- The right one.
- For you.
But I don't want to be the kind of doctor you are.
Hawkins is a whistle-blower.
He's a threat to the hospital.
I'll handle it.
SURGEON: Last night I took my date to that new five-star place on Peachtree.
SURGICAL ASSISTANT: You went to Manny's? OR NURSE: Oh, I hear it's so good.
Well, it was until my ex and her girlfriends got seated next to us.
- No.
- Those ladies had words for me.
(ASSISTANT AND NURSE LAUGH) - Rongeur.
- (MONITOR BEEPING) - BP is dropping.
- I'm almost done.
Just give her another liter of LR.
She's moving.
I'm gonna bolus the propofol.
No, that'll drop her pressures.
Just hang on, I'm almost finished.
- Damn.
Tube's out.
- Uh, reintubate.
There's no time.
I'll bag her.
Her pressure is falling fast.
ASSISTANT: She's gonna code, what do we do? Uh (LINE RINGING) 911 OPERATOR: 911, what is your emergency? SURGEON: My patient.
We need to get her to a hospital right now.
(SIREN WAILING) What the hell happened? A 53-year-old female.
Lost her airway midway through operation in an outpatient spine surgery center.
- Did they send operative notes? - Yes.
Her name is Lynette Hughes.
She went in for a spinal fracture.
That's minor.
Let's take a peek.
Okay.
One, two, three.
There we go.
Okay, very gently now One, two, three.
KIT: Bloody hell.
Whatever they started to fix, they didn't finish.
All right, start her on IV vanc and cefepime.
Let's get her to CT now.
And my client will stay outside until you can assure they will have absolute privacy and security.
I can't clear half the ER for one patient.
- No matter who they are.
- Everything all right? No.
I need to speak to his supervisor immediately.
- That'd be me.
- And Dr.
Feldman will tell you the same thing that I told you.
What he said.
Phoenix on the move.
But who's the patient? Can you direct me to "Phoenix"? (SIGHS) ER bay four.
I'm on my way, too.
They called you? I am the admitting resident.
Yes.
Any idea who the patient is? No.
Sounds like they're a big deal.
Not to me.
I've been operating on big shots since I was a resident.
Athletes, celebs, heads of state it's all the same.
Gentlemen, allow me to introduce you to Princess Nadine.
Your Highness.
Just Nadine's fine.
My mom's Pakistani but she married a king while abroad.
Pretty sure they sent me to the States when I was a kid so they could have "alone time.
" Nadine fainted while jogging a few hours ago.
No past medical history.
I forgot my water bottle.
Probably just dehydrated.
But Amir's my head of security and he said we had to come in.
Her head has been hurting for weeks.
NADINE: It comes and goes.
- You speak Urdu? - Some.
Yeah, there's overlap with Hindi.
Anything you tell us would help.
Yeah, we'll keep it confidential.
Well, I was running through Piedmont Park, and then I don't know, it was like the ground beneath my feet just disappeared.
DEVON: She's lost sensation in her feet.
And she's had recent headaches, dizziness, fevers.
- More than just dehydration.
- No question.
My money's on a stroke or bleed.
Eh, it could be cardiogenic.
Or vascular.
- Get a noncontrast head CT stat.
- I'll ultrasound her carotids.
We should also do a spinal tap rule out meningitis - and encephalitis.
- (PAGER BEEPING) Page me when the results come in.
Let's get her settled in one of our VIP suites.
Thank you.
And the princess has requested that Dr.
Pravesh stay on her medical team while she's at Chastain.
Thank you.
We good? You tell me.
You've already established a connection with the patient.
I think you should stay on.
MINA: Incredible.
We can see her perfectly.
And she looks just like you.
(LAUGHING) Is she sucking her thumb? - LIN: Yes.
- (ADAKU LAUGHS) LIN: Movement is a very good sign.
Mm.
Your last trimester has begun.
Soon that little blob will be crying in your arms.
(LAUGHS) (BOTH LAUGHING) Have you decided on a name? Not yet.
For now, let's just call her Michelle.
- Obama? - You know it.
(BOTH LAUGHING) (COUGHING) Oh, all right.
- Let's have you sit up.
- (COUGHING) (HEAVY BREATHS) (GASPS) Lost my breath there for a second.
That's common during pregnancies.
Why don't I give a listen to your heart and lungs while you're here? Have you felt like this before? Sometimes when I'm lying down, my chest gets a little tight.
(EXHALES) (INHALES, EXHALES DEEPLY) I did hear some atypical sounds.
It's probably nothing, but I'd like to order some more tests just to be safe.
We'll order a few labs, get a chest X-ray, and an echo to make sure you and your little queen are okay.
She does look like me, doesn't she? - Yeah.
- (LAUGHS) We suggest branding this product by branding you.
That face says strength, confidence, compassion.
Which one's your favorite? It's a tough choice.
I like 'em all.
We think the third one shows more authority.
- In the eyes.
- Exactly.
Am I interrupting? Yes.
I've been looking for a new post-workout shake.
- This one come in mocha? - (CHUCKLES) Uh, we want you and the product to be camera ready for the press ASAP.
Yeah, okay, I'll-I'll get back to you guys later.
That was That was good.
Thanks, that looks great.
Why are you here? For the meeting.
For what meeting? This one.
Dr.
Bell, we have a problem.
A former patient is suing Chastain.
(SCOFFS) Hospitals get sued all the time.
That's why we have lawyers.
KIM: This is different.
The patient has named Dr.
Hawkins in the suit.
And he just walked in our door.
KIM: Rob Spiro was admitted one month ago after he was injured during a failed robbery.
And we saved his life.
That's not what he says.
NIC: I can't believe they let him out.
Once the depositions are over, he goes back to prison to await trial.
- It's just for the day.
- (EXHALES) CAIN: Spiro claims that after his surgery, Hawkins withheld pain medication.
He tortured Spiro to extract the location of a man he abducted.
And you believe that kind of criminal over our top resident? - A judge might.
- Judges almost always side with the doctors in malpractice suits.
And that's if the patient isn't a murderer.
I can assure you, this suit is not gonna cost Chastain a dime.
Any judge would throw it out in a second.
We've worked too hard to improve Chastain's image to let anything threaten it.
KIM: Any association with Spiro is bad for this hospital.
You'll be in the deposition, naturally, and I'll be joining you today.
(SIGHS) Well, be my guest.
Bell has no idea this gives us the perfect way to get rid of Hawkins.
Spiro's out for blood.
And we're gonna give it to him.
Hawkins Don't worry, you'll be fine.
Red Rock's lawyers will be here soon.
You haven't always been on my side.
I am this time.
Gentlemen, we're ready for you now.
- Where's Levin and Sutton? - LAWYER: Levin is sick.
Sutton was unavailable.
We're familiar with the case.
Shoot, I forgot my pen.
TRISH: Dr.
Hawkins, Mr.
Spiro was in a lot of pain when he came out of surgery, is that correct? Yes, that's normal for a major operation.
TRISH: According to his electronic medical record, Mr.
Spiro's morphine was stopped at 8:32 p.
m.
Yeah, it's typical for morphine to be withdrawn if it's depressing a patient's respiratory drive.
- TRISH: That's not the case here.
- (SCOFFS) You stopped the morphine to coerce a confession out of my client.
Gonna perjure yourself, you little bitch? What did you tell them? I said Mr.
Spiro was lying.
That I provided him the standard of care.
Is that true? The less I tell you the better.
He confessed the location of a hostage.
If you hadn't done what you did, another one of Rob's victims would be dead.
But if they find out, you'll never practice at Chastain again.
Or anywhere else.
Does anyone else know? Conrad, who else knows? Just Devon.
Nadine, once the lidocaine takes effect, you shouldn't feel a thing.
Okay? Amir.
Give the man some space.
(DOOR OPENS) How are we doing? Prepping the lumbar puncture.
So, just a few more questions.
There's a chance your symptoms may be caused by an infectious disease.
Any travel outside the U.
S.
recently? - A trip back to the Middle East? - NADINE: No travel.
I haven't been back home since I was six.
I spend most of my time in a campus practice room anyway.
- You're a college student? - At Emory, yeah.
I'm a music major.
Mom and Dad insisted I go to college, even though what I really wanna do is be a professional deejay.
- DEVON: Sweet.
- (NADINE CHUCKLES) - Do you make your own mixes? - Yeah.
I love taking old songs, classics, adding new beats, loops, hooks.
Totally reinventing them.
Making them my own.
DEVON: Okay, Nadine.
All set.
You ready? As I'll ever be.
All right.
Hmm.
You see that? Your heart is enlarged.
It's not pumping as vigorously as we would expect.
You have a condition called dilated cardiomyopathy.
It explains the shortness of breath.
AUSTIN: Most likely brought on by the chemo that treated your breast cancer.
But my baby's okay? Yeah.
But pregnancy is hard on the heart.
The longer you're pregnant, the greater the risk that you develop congestive heart failure.
There is another option.
Induce an early delivery.
My baby's only 28 weeks.
How early are we talking? Ideally, we would want to wait as long as possible to induce.
The sooner we do it, the more risk to the baby.
What kind of risk? AUSTIN: Like underdeveloped lungs with increased risk of respiratory distress and some serious infections.
So what's best for my baby could harm me, and what's best for me could It's not an easy choice.
The health of my baby comes first.
I'm carrying her to term.
(MONITOR BEEPING) CHU: We've got a problem.
I'm not getting a signal from the right L5 nerve root.
CAIN: Must be a screw abutting the nerve.
Retractors? KIT: Whoever started putting in this hardware blew out pedicles and left her with a spinal pseudarthrosis.
CAIN: I see the screw, right there, but it's deep.
KIT: Poor woman should never have been operated on at a spine surgery center.
They thought she only had a spinal fracture, but once they opened her up, they found spinopelvic disassociation.
Got it.
CAIN: Those centers aren't prepared for things to go wrong.
KIT: And when they do, patients can be hours from a hospital and die as a result.
- She's one of the lucky ones.
- (MONITOR CHIMES) - CHU: Nerve signal is back.
- CAIN: Okay.
KIT: Great.
We can start to repair and fix the spine to the pelvis.
It was awful.
(CLEARS THROAT) My own doctor, trying to hurt me.
I swear to God, I I've never felt pain like that.
Thank you, Mr.
Spiro.
That's all.
Don't you have any more questions? We're good.
All right.
I'll begin deposing staff.
What the hell was that? I thought it went well.
Those Red Rock lawyers are barely a day out of law school.
They didn't ask one substantive question.
Conrad deserves an actual defense.
I'm bringing in our old legal team, wherever the hell they are.
No, you're not.
(DRINK POURS) You want Conrad to go down.
Every year, whistle-blowers like Hawkins cost hospitals millions.
He discovered that a drug was killing patients.
And good for him, but what about next time? He won't hesitate to take sides against us.
He is our number one diagnostician.
He's about to become chief resident.
Long-term, I guarantee a whistle-blower is a liability.
Well, then, why not just fire him? Why go through all that? We both know his father's a powerful man.
Former chairman of the board.
I want Hawkins gone, but we can't get rid of him without good cause.
I want it done clean without any blowback from Marshall Winthrop.
So you're using Spiro's lawsuit.
A criminal.
I won't support this.
You clearly still don't understand how things work around here.
You seem confused, so let me help.
Red Rock gave me authority to do whatever's necessary to protect Chastain's bottom line.
So if Hawkins isn't gone by end of business, then today will be your last as CEO.
It's him or you.
This is a new low even for Red Rock.
- You think they'll really do it? - Of course they'll fire me.
Have you met these people? The only way I stay on as CEO is if I let them end Conrad's career.
You can't let them get away with this.
What am I what am I supposed to do? Report Red Rock to the state board.
- Take it to the press.
- Yeah, but then say what? I have no proof.
I'd be out of my office before anybody even returned my calls, and then I'd be the whistle-blower, and then they'd move to destroy me, too.
Then what now? (SIGHS) I don't know.
I-I make Red Rock think I'm on their side.
Show I'm being cooperative.
I, uh I don't know, best-case scenario is I can figure out a way to save both of us.
(SIGHS) How's your pain level, Lynette? If I say zero, can I pack a bag to Vegas? (LAUGHS) Push, push, push.
I have Nelly tickets and a date with the penny slots.
You just went through a grueling spinal repair and fixation.
I think you're stuck hanging with us for a few weeks.
Squeeze my fingers.
W-Weeks? The surgery center people said I could be home by tonight.
Well, they were wrong.
And the surgeons who actually fixed you want you to stay fixed.
Somebody order an angel? Lynette, this is my dad, Kyle.
- He's a volunteer here at Chastain.
- CONRAD: Yeah, we have angels like him to keep patients company - during their stay.
- Anything you need, I'm your man.
(SIGHS) How about a cigarette? No can do.
Smoking constricts your blood vessels, which keeps your surgical wounds from healing.
And means you'd be here even longer.
Well, buckle up, honey.
If I don't get my nicotine, I'm more than a handful.
CONRAD: Still going, huh? Yeah, they're about to depose the staff.
KIM: That is where I'm gonna build the tennis court, and this what I'm thinking of for the interior.
Are you gonna stay in there? Yeah, I cleared my schedule.
Thanks for having my back.
How would you describe Dr.
Hawkins? (SIGHS) Caring.
- Smart.
- Handsome.
We heard he can be a rule breaker.
Is that true? - Never seen it.
- Define "rule breaker.
" Well, I saw him cut in line in the cafeteria once.
At any time, did you see Dr.
Hawkins go into Mr.
Spiro's room alone? - Nope.
- AUSTIN: No.
I was in the OR all day where I should be right now.
NIC: Mr.
Spiro wasn't even one of my patients.
Can I please go? We got nothing.
Conrad is well-liked and respected.
Nobody is liked by everyone, especially doctors like Hawkins.
What do you expect me to do? If I were you, I'd think of something.
(GASPING) - (MONITOR BEEPING) - Hurry, please! Help her! Please, hurry! Hurry! Nadine, try to relax.
We're gonna check your heart and lungs.
BP 210/140.
Sats in the 80s.
DEVON: Okay.
Crackles two-thirds of the way up.
Override a nitro spray bottle.
Then call Radiology for a portable X-ray stat.
What's happening to her? She's got fluid in her lungs.
It's making it hard for her to breathe.
(COUGHING) CONRAD: Give her 40 of furosemide IV.
Okay.
All right, Nadine.
Open wide.
Okay.
This will help you breathe while we figure out what's going on, okay? (BREATHING HEAVILY) I don't get it.
Her head CT was benign.
CSF is clear.
Cultures negative.
No pulmonary or cardiac issues.
Is it renal? Her creatinine was normal.
Besides, that wouldn't explain her syncope.
- So what are we missing? - (PAGER BEEPING) (SIGHS) - I got to go.
- We're not done here.
We still don't know what's wrong with her.
She could decompensate at any point.
You will figure this out.
Keep me updated.
It's not my fault.
- What? - Rob Spiro.
I tried to stop you.
What does that have to do with anything? Because you're taking it out on me, and Nadine will suffer because of it.
I have other patients, including ones in the ICU.
And you were the one who didn't want to work with me.
Because you tortured a man.
(SIGHS) Rob Spiro is a murderer.
And we're doctors.
We're supposed to be the ones who are helping people.
- And I did.
- You break rules, ignore protocol.
That is who you are, and it is wrong.
We have been over and over this.
A man is alive because of what I did.
Oh, you didn't do it for him.
You did it for you.
You're damn right I did.
Had to make a choice I could live with.
(PAGER BEEPING) I got to go.
AUSTIN: So, we'll start you on a cardiac regimen, oral diuretic and a beta-blocker.
And then we'll see you every few days to monitor you and the baby.
Sounds like a plan.
And I have faith that God's watching over us.
Adaku, we want to make sure that you understand what all this means.
LIN: If the strain on your heart becomes too great, we may need to perform an emergency cesarean delivery.
AUSTIN: But even that might not be enough.
I've seen women your age end up with a device implanted to take over the function of their heart.
Tethered to a battery pack.
Waiting for a transplant.
But I feel fine now.
Cardiac issues can escalate quickly for pregnant women.
Worsening heart failure could kill both you and the baby.
We're here to support whatever you choose if you are sure that you want to try carrying this baby to term.
Maybe I should take a minute.
(SIGHS) Add a thyroid panel, ABG and BMP.
You ran those two hours ago.
Two hours ago, she wasn't on oxygen.
- Run it again.
- Yes, Doctor.
You all right? (CHUCKLES SOFTLY) I got to make sure you finish school so you can start deejaying sold-out clubs around the world, right? (CHUCKLES) I like the sound of that.
DEVON: And you can have a disguise, like that guy with the mouse mask.
And hey, you already have a code name.
- Phoenix? - (LAUGHS) Okay, you'll think of a better one.
All I ask for in return are backstage passes for life.
(BOTH LAUGH) All right, I'm gonna go check on those tests.
Wait.
Um before you go, could you pass me the, um the the the the Ras? Juice? Yes.
Sorry.
I couldn't think of the word.
Thank you.
Has that happened before? Forgetting English words for things? A few times.
It's weird, huh? How long has it been going on? A couple weeks.
Why? (WHIRRING) (RAPID, RHYTHMIC BEEPING AND WHOOSHING) Nadine forgets words in her primary language, English, but her secondary language, Urdu, remains intact.
CAIN: Could have a number of causes.
But it happened when she sat up.
So you think she's experiencing positional cerebral hypoperfusion? That's why I ordered an angiogram.
Look.
The blood vessels in her brain have narrowed.
She has Moyamoya.
Which would explain why she lost all sensation in her feet - while she was jogging.
- And why her symptoms only occurred when she exerted herself.
Moyamoya can be unremitting and progressive.
She could die of strokes before she turns 30.
Unless I perform a cerebral bypass.
Time to get our princess to my OR.
The first time my dad busted me, I was 16.
But instead of grounding me, he bought me a pack.
Said fathers and daughters should smoke the same brand.
- He gave you cigarettes? - He'd smoke 'em with me.
- (LAUGHING): Oh.
- Playing slapjack on the front porch like a couple rowdy old drunks.
Till he passed away a couple years ago.
What did he die of? Heart attack.
You know, more people die of heart disease from smoking than cancer.
- And still, you smoke? - I know - it doesn't make any sense.
- (LAUGHING): No.
The right thing to do is to quit, but (SIGHS) I can't.
You know, that's the definition of addiction.
It's in my family, too.
I, uh I was a drinker and, you know, eh, drugs when I was younger.
My daughters they grew up seeing that, and one of 'em became an addict.
(LOUD, RHYTHMIC BEEPS) Oh, that doesn't sound good.
Oh, God.
Can you read that thing? No, but I-I I-I I think I can find someone who can.
Um, I'll be right I'll be right back.
Uh, excuse me? My (INDISTINCT P.
A.
ANNOUNCEMENT) Hey, uh, can I just? (INDISTINCT, OVERLAPPING CHATTER) Hello.
Hey, could you just help? You got to be kidding me.
(SIGHS) Uh, hey, I-I need a doctor.
Hey! Angels will not be ignored.
(SIGHS) It's my patient.
- Y-Your patient? - Yes, yes.
Her mon-monitor thing it-it's beeping.
Could you could you check on her? I think you might be getting a little carried away - with your role here.
- (SIGHS) Okay.
I'm a Nevin.
- All right? - A who? Yeah, th-that's it! I want your name, Scott, and your badge number, right now! - I don't understand.
- I know.
- It is a lot to process, but - No.
I don't understand who comes up with these names.
Mora-maya? - Moyamoya.
- (LAUGHING): Okay.
It means "puff of smoke" in Japanese, because of the way it looks on the angiogram.
- Mm.
- Nadine, if we don't operate (SIGHS) it is fatal.
I've faced a lot of threats in my life.
Kidnapping, poisoning, assassination.
I'm not gonna let a puff of smoke take me out.
Then we'll prep you for surgery.
I want my day in court.
I'm sorry, Dr.
Feldman.
They've decided not to depose you.
But Dr.
Hawkins is one of the best doctors at this hospital.
He A patient came in hypertensive last week.
Hawkins realized it was pheochromocytoma.
Who else makes that call? And not only is Conrad a great doctor, he make great doctors.
Dr.
Pravesh used to train under him.
Total rising star.
Oh, Pravesh isn't Hawkins' intern anymore? No, he requested a new resident.
- (ELEVATOR BELL DINGS) - Why? When did he put in the request? About a month ago.
Wasn't that around the time they were both treating Rob Spiro? Yeah.
Why? (SIGHS) They say a cerebral bypass is like landing on the moon.
Cain only gets one shot.
Oh, I like that music.
The patient requested it.
Yeah? Who's the artist? Her.
Swingin' Don't count me out, 'cause I'll come back Show angiogram.
(TRILLING) This area lacks adequate perfusion.
I'll need to reroute the circulation by performing the anastomosis right here.
Show vitals.
Can't feel my hands, but I got you Pressure's stable.
All looks good.
CAIN: It's exactly what I like to hear.
Stopping the blood flow to the brain.
Nurse.
Pig clips and hemostat.
And I know in my soul that I'm onto something good CAIN: Middle cerebral artery clamped.
Dr.
Chu, the clock, please.
30 minutes starting now.
(BEEPING) Let's dance, Princess.
To you Don't count me out, 'cause I'll come back.
You've been wasting our time, and I'm fresh out of patience.
I need a CEO who will get things done at all costs.
Clearly, that's not you.
I think you should question Dr.
Pravesh.
We were all under the impression that he's one of Hawkins' most loyal allies.
Why talk to him now? Because I've recently discovered that may not be the case.
I think he knows what really happened with Rob Spiro.
Let's put him under oath.
Occlusion time is approaching 30 minutes.
Cain needs to finish soon or risk permanent brain damage.
He's throwing the last stitch.
Let's hope this works.
Prepare to unclamp.
BELL: Dr.
Pravesh? They've decided to depose you.
Now.
(ALARMS SOUND) Pressure's rising.
Elevate the head.
Push the mannitol.
(ALARMS SOUNDING) Her brain is swelling too quickly.
The edges of her skull are lacerating her brain.
We're losing neurological function.
I'm enlarging the craniotomy.
(WHIRRING) (SIGHS) She's my patient.
I'm not going anywhere.
Taking down the anastomosis.
Swelling is coming down.
Time to redo the bypass.
She doesn't have time for him to redo an entire bypass.
But we still need to restore blood flow in her brain.
And complete the surgery quickly.
Are you thinking what I'm thinking? Omental transposition.
Yeah, well, you better lose the suit, buddy.
I save your patient, then we go.
AUSTIN: Step aside.
Two Chastain OGs to the rescue.
- No need.
I've got this.
- Uh, sorry, brother, but the princess does not have time for you to play hero today.
Project abdomen.
(TRILLING) (CHIMING) I see a vascular-rich piece of omentum we can use to place on the brain.
10 blade.
Underneath it all I'll need a piece at least 20 by ten centimeters.
Metz.
Harvesting the omentum.
KIT: Taking that piece of tissue from her abdomen and laying it on her brain can stimulate the growth of new blood vessels, restoring perfusion.
Won't this increase the risk of hematoma? You're right, but we're out of options.
Underneath it all Laying the omentum down.
With the whispers closing in - To lives we all defend - We all defend - And now - And now Show vascularization over the next 90 days.
- It all - No one knows KIT: Devon? No one knows your name Knows your name No one loves you now Loves you now No one feels the same Feels the same Yes, yes, yes.
Let there be blood.
(AUSTIN LAUGHS) - Underneath - (AUSTIN LAUGHS) It all Underneath it all (PAGER BEEPING) I'm sorry.
It's not your fault.
Got to see a patient.
Deep breaths, deep breaths.
Hold on.
- What's going on? - She's in A-fib.
I'm getting her back into sinus rhythm, and you're interrupting.
Hey, hey, man, I really don't like your tone.
How about a little bedside manner? Lynette has been through enough.
Dad, I appreciate the passion, - but take it down a notch.
- This this is what I'm trying to say.
She gets panic attacks, so maybe we can all relax one damn minute.
Panic attacks.
What do they feel like? I don't know, it just feels like my heart is beating out of my chest.
What if they aren't panic attacks but A-fib as well? - Her past EKGs were all normal.
- NIC: An EKG could miss it.
If she's been having A-fib for some time There could be a clot.
Shocking her could dislodge it, 'cause a stroke.
You want to do rate control.
20 milligrams IV Diltiazem.
Try it.
- All right.
- Oh, my God.
(KYLE EXHALES) Breathe.
Come on, breathe.
AUSTIN: So, I hear Adaku decided to continue her pregnancy.
Risk her own health for her baby.
She and I are practically sisters, yet I have never understood her faith.
Have you tried? You believe there's some all-powerful being who can heal us if we just ask nicely? The fact is that faith is good for patients.
Those who believe they'll be okay - generally have better outcomes.
- That's no guarantee.
Surgeons or God everyone needs someone to believe in.
She has a long road ahead.
Even if everything goes right.
All the more reason you should support her on her own terms.
Even if she finds faith in a place you don't understand.
(INDISTINCT P.
A.
ANNOUNCEMENT) Lynette's stable.
It was the right call.
(CONRAD SIGHS) You all right? Devon's about to be deposed.
I'm gonna go talk to him.
- And say what? - (SIGHS) That sometimes telling the truth isn't enough.
Sometimes you have to fight fire with fire.
Devon has to do what he feels is right no matter the consequences.
That's what I tried to teach him.
Now we have to respect his choice.
(SIGHS HEAVILY) TRISH: Dr.
Pravesh, let's cut to the chase.
Did you see Dr.
Hawkins go into Mr.
Spiro's room? I did.
- Alone? - That's correct.
TRISH: I understand you recently asked to be assigned to a new resident.
Why? Dr.
Hawkins and I disagreed.
TRISH: About what? Too many things.
Like the treatment of Mr.
Spiro? Yes.
Because Dr.
Hawkins tortured him? Dr.
Pravesh? Please.
They need an answer.
Do you have any reason to believe Dr.
Hawkins withheld pain medication to elicit a confession? CONRAD: Dr.
Pravesh, just tell them the truth.
I know you're one of the good guys.
(FAINT, ECHOING): Dr.
Pravesh, just tell the truth.
I know you're one I know you're one of the good guys.
Mr.
Spiro was in respiratory distress.
Pain medication needed to be withheld.
This man is alive today because of Dr.
Hawkins.
SPIRO: Why are you lying, huh? Why are you lying!? (CONRAD SIGHS) Why did you lie for me? I didn't do it for you.
These patients need you.
And I had to make a decision I could live with.
Ah, you and I are very different.
I respect that.
Me, too.
And I think this hospital needs doctors like both of us.
(KNOCKING) Your intracranial pressures and post-op labs are trending in the right direction.
Thank you.
Dr.
Pravesh, have you ever saved a princess before? It was a team effort.
The king will want to thank you.
I expect he will be calling shortly.
Well, what do I call him? Your Majesty.
KYLE: Okay, maybe I lost my cool, just a little.
(CHUCKLES) Well, I'm glad you did.
Now I understand why they call you an angel.
- (CHUCKLES): Nah.
- (CHUCKLES) (SIGHS): The truth is I love this job.
Sometimes I feel like it's the only thing I got to hang on to.
- Mm.
- And I know what it's like when things don't go your way.
- Damn! - Yeah.
How did you get that? I gave my kidney to my daughter.
At least I tried.
LYNETTE: The younger one? KYLE: Jessie.
Yeah.
She struggled with addiction.
Opioids.
She, uh she didn't make it.
LYNETTE: Oh, I'm s I'm so sorry.
When we lost Jessie, I I don't think I could've made it through if it hadn't been for Nic.
She's the best thing about Chastain.
(LYNETTE CHUCKLES) You sound so proud of her.
Yeah.
Well (CHOKED UP): She's the best thing about me, too.
I'm scared.
Me, too.
(TAKES DEEP BREATH) Dr.
Hawkins survived the day.
I can't say the same about you.
- Hold it.
- Sorry, I got to make this quick.
Oh, it will be.
(PHONE BUZZES, CHIMES) What is this? My resignation as CEO.
(RAIN PATTERING) Just finish packing and go.
Oh, I won't be leaving Chastain.
I'll be staying on as chief of surgery.
Red Rock won't see it that way.
Well, then you'll need to find yourself some better lawyers, because my surgical contract is bulletproof.
You just try getting rid of me.
(INTRO TO "WRONGWORLD" BY KRYSH PLAYING) Do you really even like me? Are you really even trying? BELL: Today Red Rock asked me to turn against one of my own doctors.
Are you really even trying? And tomorrow they'd just ask me to do something worse.
You are so dead to me Without this hurt, without this curse What would you mean to me? Yeah, yeah, yeah You fled on me Tellin' me to quit so easily You bled on me There's a bloodbath coming.
I don't even want to be up there when it happens.
But down here, I can survive.
What's gonna happen to Conrad? BELL: Red Rock has eyes and ears everywhere.
Conrad still has a target on his back.
You fled on me.
As do we all.