The Resident (2018) s04e12 Episode Script
Hope In The Unseen
1
Previously on The Resident
Mom, we need to get you
back to Chastain.
Your mother has lung cancer.
You cannot come to Nigeria with me.
- I do want your job.
- I wouldn't want a resident who didn't.
We're cut from the same cloth.
No hidden agendas.
There have been some developments in gene therapy.
Recent clinical trials with good outcomes.
These are uncharted waters.
A lot of hospitals won't risk hosting our trials.
It's gonna be a long, hard road.
- And nothing is guaranteed, Rose.
- But I have a chance? Well, you have more than just a chance, you have a damn good chance.
("EASIEST THING" BY JEAN DEAUX PLAYING) It's been so long - I think I might - Hey.
- (GIGGLES) - Write you a letter I can't be mad Thought you were making a shopping list.
I am.
I was also just enjoying the view.
Okay.
But your mani-pedi appointment is on the other side of town from your pregnancy message.
We got to plan it out if we want to hit everything today.
You just finished a night shift.
Are you sure you're not too tired? To knock out a pre-baby bucket list with my glowing wife? - Never.
- Mm.
(NIC CHUCKLES) You can say no if you want, because it's your day.
But what if we make a pit stop at home? Someone told me alone time will be hard to come by - once the baby is born.
- Hmm.
I will definitely consider it.
Mm, good.
Then let's get the hell out of here.
Oh, you want to see the new baby picture? Of course.
Aw, another sonogram.
- Let me see.
- (NIC LAUGHS) Aw, it's a fat little potato with fists.
Did you just call my child a fat little potato? A cute, fat little potato.
Thank you.
I don't think that's a compliment.
No, I was thanking her for helping - plan our day.
- A fabulous nail studio, a massage to die for and I got you off the wait list at Marino's Steak House.
You have a table at 8:00.
You are the best.
Why don't you come meet us? No way.
Conrad wants you all to his lonesome.
- Yes, I do.
- (NIC LAUGHS) - And I'm here till midnight.
- Oh, God.
Have fun.
- No, no, no, no, no, no, we're leaving.
- Wait, what's up? My shift is over and you're on maternity leave.
Hang on, what's going on? Mr.
Goldense canceled his appointment, third time this year.
And I've called, but it only goes to machine.
You're the only one he'll talk to.
Nic, don't do it.
(SIGHS) Oh, come on, you know, Pete Goldense.
History of A-fib.
He has cardiac meds that need close monitoring.
We can go check it out.
It's not a problem.
(ELEVATOR DINGS) You're impossible.
It'll take two seconds.
(EXHALES) Okay.
- (SIGHS) - I wonder if it'll be this hard to say no to our daughter.
- Probably.
- Yep.
Here's the problem, Dr.
Voss.
We're still far in the red, north of $25 million.
Well, the numbers are trending in the right direction.
When I took over, we were $35 million in the red.
No one wants to put a price on saving lives.
But as CEO, you must.
I am not like other CEOs.
Which is why you hired me.
And now we're beginning to question the wisdom of putting someone with no business experience at the helm.
You need to find more cuts, Dr.
Voss.
BOARD MEMBER: And we don't mean pennies.
We mean millions.
This isn't coming from me or the board, Kit.
We're getting pressure from the state.
They have given us and by "us", I mean you two weeks to come up with big solutions.
(KNOCKING) (DOOR OPENS) You okay? Come take a look at this.
This was the scan from my mother's diagnosis, when she was stage IV with pleural mets.
BELL: Mm-hmm.
And this is today.
Wow, that much progression? Her lung cancer is highly aggressive.
So sorry.
I, um Has she started chemo? She watched her father die of cancer.
She remembers vomiting and constant nausea.
He was in pain for months until he died.
She is terrified of chemo.
Well, they do much better managing side effects these days.
Surgery's not an option.
There's only one hope left.
Well, targeted therapy.
It could buy my mother years if she's a candidate.
We're waiting for the genetics now.
Well, just, it's Keep me updated.
Yeah.
(DOOR OPENS) Hi.
Hey.
I've got a birthday present for you.
Mm.
My birthday isn't until June.
(DEVON CHUCKLES) Well, this is your new birthday.
500 million genetically modified cells ready to change your life by making healthy red blood cells in your body.
If we're lucky.
I know it's experimental and there are no guarantees, but I can't believe I have this chance.
Is there anyone you want to call or FaceTime for the big moment? Friends? Family? No.
Dr.
Cain? (SCOFFS) He, um hasn't been by for a while.
I'm sure he's busy.
Well, this is a really big deal.
You went through a lot to get to this moment.
I wouldn't be here without you.
(CHUCKLES SOFTLY) Rose (BEEPS) would you like to do the honors? (CHUCKLES, EXHALES) (BEEPS) Please work.
We started her gene therapy an hour ago.
Now we wait.
Is she strong? Is she ready? She's been through a massive chemo blast that devastated her bone marrow.
She's nauseous.
Her counts are dropping.
Her mouth sores are so bad she can barely swallow.
So is she strong? No.
But she is the bravest person I've ever known, and she's ready.
(PHILLIP EXHALES) Look, man, Bio South is running on fumes.
Uh, we need cash, and we won't get a new investor if Rose has a bad outcome, so Everything is riding on this.
Look, if this works, we stand to get FDA approval.
And then sky's the limit.
Thousands of other patients with sickle cell disease would line up for this treatment.
And if it fails? (EXHALES) The company will shutter.
I will be bankrupt.
(EXHALES) And Rose will have risked her life for nothing.
You recommended me to Dr.
Wylie.
Yeah, she was in the market for a promising resident.
But you said that I could work with you, that we were a pair, cut from the same cloth.
You need more practice.
And I'm focusing on my recovery.
You're not gonna get your skills back hiding in this office.
I'm being cautious.
The last time I was in the OR, you had to step in there to save my ass.
Can't ignore that.
So you start with a softball, something simple you used to do in your sleep.
Can't afford another fumble.
Kit's gonna send me packing.
I have to know that, when I come back, my work is gonna be perfect.
Dr.
Wylie is nowhere near the surgeon you are.
I want to learn from the best.
Caution's not a good look on you.
(DOOR OPENS) In case you don't remember, Pete's not the easiest guy.
Took the gold medal in the curmudgeon Olympics.
Well, if it doesn't take too long, we can stay on schedule.
(KNOCKING) Hey, Pete! It's Nic from Chastain.
I'm here with Dr.
Hawkins.
Came to check on you.
We're worried that you missed your appointment.
- (BASEBALL BAT DROPS) - I'll survive.
You know your cardiac medication needs monitoring.
Come on, Pete.
We'll do a quick check and then you won't have to go to the hospital.
Put those masks and gloves on.
Okay.
You know, if you'd get the COVID-19 vaccine, you wouldn't have to be so nervous about guests.
I have no need.
- I have no risk of exposure.
- (BASEBALL BAT DROPS) I see no one.
It's Middle-earth.
Needs a dragon.
(EXHALES) You all right? Yeah.
CONRAD: How long since you've been out of your house? PETE: Over a year.
CONRAD: How you feeling, Pete? (GROANS) I just woke up from a nap, so a little groggy.
The good news is I can take naps whenever I damn well please.
I see the judgment in your faces.
Proves my point.
You've never known real freedom till you lock your door.
Look, no judgment.
- CONRAD: We're just worried about you.
- (PETE GRUNTS) You're a little out of breath.
NIC: Why don't you let us check you out, just make sure nothing serious, okay? (BREATHING HEAVILY) Okay.
- All right.
- But first, let me get something to drink.
- I'm thirsty.
(GROANS) - NIC: No, no, that's okay.
I'll-I'll get you some water.
(PETE PANTING) (SIGHS) Fridge is close to empty.
CONRAD: Pulse is irregular and rapid.
Crackles at the bases.
NIC: Oh Hey.
CONRAD: You having trouble wearing shoes? When you don't go anywhere, you don't need shoes.
Distended neck veins.
CONRAD: Sorry, Pete, but we're gonna have to get you to Chastain after all.
No.
- You can't make me go.
- NIC: Hey, hey, hey, hey, hey.
Whoa, whoa, whoa.
CONRAD: Pete? - NIC: Calling 911.
- Pete? (LINE RINGING) AUSTIN: You'd work much quicker if you had gloves that fit.
What is this, the JNCO jeans of surgical wear? JESSICA: Oh, I'm sorry, Dr.
Devi, did we get you the wrong size gloves? LEELA: It's totally okay.
AUSTIN: It is not totally okay.
Speak up for yourself.
A six and a half would be great next time.
You got it.
I think we're just so used to prepping the OR for Dr.
Austin and Dr.
Okafor AUSTIN: And how would you think that she could even fit in Mina's gloves? Look at this one-handed tie.
Sloppy at best.
Criminal at worst.
And whenever we would do a bypass, Dr.
Okafor and I chose the pedicled approach.
That means there is a bit to clean up, so I would throw a stitch and Mina would cut my suture.
Not there.
Higher.
No, that's too high.
Lower.
LEELA: Like this? Would you steady your hands, Devi? This is not a cadaver.
It's a father of three.
Damn it! You cut the vessel I needed.
LEELA: I'm sorry, Dr.
Austin.
AUSTIN: Is an apology gonna console his children? Small vascular clamp and 8.
0 Prolene.
Not to her.
To me.
I have to learn.
You stay, you watch or you leave.
It's your call.
(PANTING) (MUFFLED SCREAM) Like this.
(SCREAMING GIBBERISH) Nothing more satisfying than teaching the important stuff to young residents.
The day isn't going great.
I messed up in the OR with Raptor, and he yelled at me, again.
Did you kill someone? - No.
- Then don't worry about it.
I don't like to be humiliated.
It wasn't about you, I promise.
He's under a lot of pressure right now, a family thing.
Believe me, he's on a razor's edge for a good reason.
I'm sorry.
So what's the hospital's CEO doing in here, anyway? Bit of a challenging day on my end, as well.
The supply room is a known resource when you're at your wit's end.
It's quiet, private, lots of pillows.
(BOTH CHUCKLE) Come on, come with me.
I'll get you into another OR.
Dr.
Austin isn't the only fine surgeon at Chastain.
Dr.
Voss? I would love to work with you sometime.
Well, if my ass isn't fired shortly, we'll arrange it.
Come on.
Hey, Cindy.
What happened? You paged? She has an elevated temp.
100.
1.
(MONITOR BEEPING STEADILY) - And she's tachy.
- Yeah.
Hey, Rose? Can you tell me how you're feeling? Tired, a little hot.
Let's give her a gram of acetaminophen and bolus her a liter of lactated ringers.
Okay.
It doesn't hurt anywhere.
It's not like a pain I've felt before.
But I don't feel good.
It couldn't be the gene therapy, could it? I don't know yet.
We'll give you some fluid and order a set of blood cultures.
I thought there was nothing left that could scare me.
Whatever happens, we'll manage it.
It's not that.
I know what it is to be sick.
(RAGGED EXHALE) But hope? When I pressed that button, it's what I felt.
And I haven't felt that in so long.
I don't want to lose it.
65-year-old male with syncope and blunt abdominal trauma.
IRVING: All right, let's put him in Bay Two.
BP 90/50, heart rate 130 and irregular.
O2 sat 95%.
PETE: I fell on a chair.
So what? I thought you two were spending a day away from sick people.
Well, best-laid plans - One, two, three.
- Three.
(PETE GRUMBLES) Nothing good can come of this.
- (MONITOR BEEPING RAPIDLY) - Told you.
I'll order an EKG and labs.
Crackles halfway up.
- I need an X-ray stat.
- Yeah.
- And I might have to intubate.
- Okay.
- (PETE GROANS LOUDLY) - CONRAD: Pete, this isn't good, and we have to fix it.
Tenderness and guarding in the right upper quadrant.
(MACHINE BEEPS) Damn it.
Free fluid.
He's on blood thinners that weren't being monitored.
And now he's bleeding into his abdomen.
(SCRUBBING HANDS) Dr.
Wylie already has three residents.
BILLIE: Yep.
And I told you I didn't want the gig.
I need you and only you, for a softball.
Aneurysm clip, OR 7, in 15 minutes.
Dr.
Wylie? I'm gonna have to pass.
Dr.
Cain has requested me.
Hey.
What's going on with Rose? Elevated temps.
She's tachycardic.
Her blood pressure is dropping.
I called in her oncologist to examine her.
- How is she? - Responding to fluids.
Stable for now.
If this is a systemic inflammatory reaction from the cells, we support her through it, and she should improve soon.
Okay.
I'll keep an eye on her.
Okay, I have to see another patient, but tell me if anything changes.
Thank you.
Yee, if you don't sit down Your cancer is getting worse.
When we know the next steps, I'll sit.
- So, until then - Your father has zero chill.
- Tell me about it.
- And at the moment, - mine is in limited supply, too.
- (DOOR OPENS) Hello, Carol.
Yee.
Lovely to see you.
Okay, Dr.
Oliver, we can dispense with the niceties.
- We're dying here.
- Literally.
- Carol.
- OLIVER: This will be short and very sweet.
I am happy to say that Carol's cancer has a mutation that qualifies her for targeted therapy.
Thank you.
AUSTIN: You hear that, Ma? This is incredible.
Conventional chemo is better than it used to be, but it's still a blunt tool.
Targeted therapy is exactly what the name says.
It attacks only the changes in the cancer cells that help it grow and spread while sparing your normal cells.
And what does this mean for me? I mean, I know it's not a cure, but OLIVER: You still have stage IV cancer, but we are buying time.
The cancer will eventually come back, but by then, we could have new and even better treatments.
Mom.
Mom, this is great news.
(CRYING) So, the CT you ordered showed a grade III liver lac.
- What's his most recent hemoglobin? - NIC: 12.
2.
The second one should be back any minute.
Any guesses why he passed out in the first place? - No idea.
It was so abrupt.
- BELL: Doesn't make sense.
So, what accounts for the respiratory failure? It's all a mystery.
His EKG and echo show evidence of severe pulmonary hypertension with right-sided heart strain, and that's all new from a year ago.
We thought it could be a P.
E.
, but he's been on his blood thinners, - so it's unlikely.
- BELL: Severe pulmonary hypertension? So we don't want to put this guy under anesthesia.
Not if we can help it.
Lab just called with a critical value.
Repeat hemoglobin 7.
2.
He's bleeding out.
We don't have a choice.
Okay, yeah.
Pack him up.
Get blood on hold.
- Lots of blood.
And I'll meet him in the OR.
- On it.
Randolph.
- A favor? - Yeah.
Sure, but quickly.
I have to prep a patient for surgery.
I have a first-year surgical intern in need of a new mentor.
He have a falling-out with someone? She.
Yes, and sort of.
AJ let her have it in his OR.
That's understandable.
AJ's under a lot of stress.
He is, which is why I would be eternally grateful if you could have her in your surgeries today.
Yeah.
Is she any good? Judge for yourself.
Solid technique.
Fast.
Clearly determined.
She's whip-smart, too.
Her name's Leela Devi.
Dr.
Devi? I'm Randolph Bell.
How'd you like to throw some of those in my OR? I would love to.
Great.
Let's go.
- (MONITOR BEEPING RAPIDLY) - Rose, Rose, you've got to settle down.
(GASPING): I don't feel good.
- Rose, steady.
- (BREATHING HEAVILY) Deep breaths.
- Deep breaths.
- (BREATHES DEEPLY) - What happened? - Well, she was holding her own, and then her blood pressure plummeted to 70/40.
Okay, give her another liter, wide open.
- Mm-hmm.
- And start her on norepi.
(ROSE GASPS LOUDLY) - I'm so hot! - That's because you have a fever.
I have to examine you again, okay? Ow! (GROANING) - Fever.
- Mm-hmm.
Hypotension, abdominal pain.
I don't think this is from the gene therapy.
Rose, the chemo has suppressed your immune system.
I think you have a bad infection, likely from your gut.
So what happens now? We're gonna get you on the right antibiotics.
All you have to do is get some rest.
You stay hopeful.
Okay? AUSTIN: Aneurysm clip.
Proximal and distal clips in place.
Now I'll ligate the aneurysm.
(SIZZLING) Oh, I trapped the aneurysm.
I'm certain I did that correctly.
I don't I don't understand why this is happening.
Find the feeder vessel I don't need instruction from a resident.
(ALARMS SOUNDING) Cerebral perfusion pressure is falling.
Get back in there, or this'll be the last brain you ever touch.
Suction.
Need to see what we're dealing with.
There's the feeder.
Clip? (BEEPS) Nice work, Dr.
Cain.
Yeah, please.
I almost whiffed a softball.
You close.
I'm finished here.
Maybe he is finished.
If so, no one will miss him.
His hands are back.
But surgeons thrive on hubris.
The problem now is in his head.
I got your page.
Hey, it wasn't the gene therapy.
Rose's blood cultures came back positive.
She's septic.
- And how's she doing? - We started her on the right antibiotics early.
She's stable now.
But her kidneys took a hit.
Take a look.
KIT: Is she making urine? I have flooded her with fluids, but no.
Her potassium is climbing.
Rose needs dialysis if she's gonna make it past this crisis.
(CLASSICAL MUSIC PLAYING) BELL: Lap pad to me.
Have you ever operated on a liver lac? Never as first assist, but I've read a lot about it.
Okay, well, then tell me about the blood supply of the liver.
- Another lap pad.
- Liver has dual blood supply portal vein and the hepatic.
- Mm-hmm.
- (MONITOR BEEPING) All right, Dr.
Devi.
Diffuse bleeding from the liver.
You're on.
- What do you want to do? - Manual compression.
I take the liver in my hand, and squeeze it.
Okay, now do it.
LEELA: It's not working.
He's still bleeding.
So what's your next move? I identify and suture the bleeder? - (ALARMS SOUNDING) - Dr.
Bell, our patient isn't enjoying this teaching moment.
LEELA: I think you should take over.
BELL: No, there's no need to take over.
We're a team.
3.
0 Prolene to Dr.
Devi.
I saw you do this perfectly.
It's muscle memory.
Just do it.
Don't think.
And if you have trouble, I'm right here.
Mm-hmm.
Mm-hmm.
LEELA: Suction.
(WHIRRING) (BEEPS) Well done, Dr.
Devi.
Now, let's hope Nic and Conrad can diagnose Pete's underlying problem.
(SIGHS) It was touch and go in surgery.
He's on two pressors now.
- Water.
- Oh, thank you.
So, Bell fixed his liver lac, but that's still the least of his problems.
Did his rheumatological studies come back? Yep.
All normal.
He'll need a right heart cath to measure his pulmonary pressure.
I'll check with Cardio on that and schedule - a chest angio with CT.
- (SIGHS) If we can't figure out the underlying cause of his pulmonary hypertension There are treatment options, and we'll have to start looking into them, but he could die.
Wait.
When I went to get Pete water, all I saw in his kitchen was rice and beans.
Only rice and beans.
- No vegetables? No fruits? - None.
(LAUGHS): I mean, I know it seems crazy, a one-in-a-million case, but Pete's suffering from a vitamin deficiency.
Think about it.
He's been shut in from COVID this whole time.
That explains the pulmonary hypertension.
Nic, you may have just saved his life.
(SIGHS) Dialysis? My kidneys are failing? I've had family members on dialysis, and they were miserable.
It's devastating news, I know, but I think it's gonna be temporary.
Okay? I-I really I really do, Rose.
We have to give your kidneys time to recover.
And if they don't? Remember, Rose, we're focusing on hope.
Look at me.
I am about out of hope.
I am out of everything.
Just answer the question, please.
If your kidneys don't recover, you will be on dialysis for the rest of your life.
Is dying from renal failure painful? - No, it is not, but that's not where - Look, I appreciate everything that you and Dr.
Voss have done, but I am too tired to go on any further.
Rose, no.
Rose, you're not gonna be alone.
I'm going to be with you the whole time.
(CRYING): I have nothing left.
No dialysis, no anything.
Rose, giving up is not the answer.
You have to fight, you have to fight this and hold on to what your life could be when this is behind you.
I don't have any fight left.
Call in hospice please.
I gave it my best shot.
It's over.
I can't do this anymore.
(ROSE SOBS) I told you I didn't want to come here.
They filleted me like a dead fish, and now I'm farting like a ten-year-old Labrador retriever.
Pete, if Dr.
Bell hadn't operated, you would have died.
So the blame's on me? I didn't eat right.
Food as medicine.
What a crock.
It's not a crock.
Not having enough vitamin C in your diet can be life-threatening.
It can increase the pressure in the vessels leading from your heart to your lungs, causing pulmonary hypertension.
And that explains the strain on your heart.
Which caused shortness of breath, the swelling.
The lack of vitamin C also explains the bruising.
I get the gist.
You want the big dose of, uh, gratitude.
Okay, here it goes.
- Big thanks.
- (CONRAD CHUCKLES) - (NIC GROANS) - Here's the bag, Nic.
- Thank you.
- That's my vitamin C? What about a nice chewable tablet? The kind I gave my kids? If we're right about this, we should see a change in the numbers immediately.
I'm not holding my breath.
(NIC SIGHS HEAVILY) So you have kids? One more disappointment.
You're pregnant.
I have eyes.
You think it's gonna be all, uh, hugs and kisses and "I love you, Mommy, with all my heart".
News flash: they become teenagers, and they turn on you.
Then they spend the rest of their lives griping about that one birthday party that didn't meet expectations.
You seeing what I'm seeing? (BEEPS) NIC: Pulmonary artery pressure is still higher than we'd like to see, but it's coming down.
Feeling better, Pete? Maybe.
A little.
Okay, great.
We'll take that as a rave review.
Nic's on maternity leave.
I'll be back to check on you, though.
Control that impulse as much as possible.
We'll see you later, Pete.
Not the day we hoped for.
Eh, but the kind we live for.
Grumpy patient or not.
Gratitude not required.
(NIC LAUGHS SOFTLY) Carol.
Your new meds have just arrived.
Once a day with a glass of water.
I'm glad I lived to see this day.
And we hope there'll be many more, Mom.
Enough to find the next miracle.
Science wins.
Thank you, Dr.
Oliver.
Here, honey.
(SIGHS) Thank you, son.
Listen, I got to, um, finish up a couple of things, but I'll be back to walk you guys out, all right? - Thank you.
- Of course.
(DOOR OPENS) - Hey.
- Evening.
Hey, I got the good news about your mom.
- I'm happy for you.
- (CHUCKLES) (TAKES DEEP BREATH) Thank you.
The medicine gods were smiling down on us.
- Yeah, I love when that happens.
- Whew.
Me, too.
Hey, by the way, uh, Dr.
Devi assisted me on a liver lac today and did some very good work in a messy situation.
So, you know, if you don't mind, I'd like to keep her in my OR.
Yeah.
Sure, she's all yours.
- That's good news.
- (DOOR OPENS) Thanks, man.
(ELEVATOR DINGS) Rose is refusing dialysis.
Why would she do that? I tried to convince her to keep fighting, but she won't hear me.
I thought maybe she'd listen to you.
Will you talk to her? What's that? Meds to lower your potassium.
Oh, stop, stop.
No more medication.
- Rose - I'm refusing all treatment.
Leave me alone.
(INDISTINCT P.
A.
ANNOUNCEMENT) I know what you're gonna say.
Don't bother.
Devon said you're having a rough time.
Rough time? I know about a rough time.
This is (TAKES DEEP BREATH) There's a limit to what a person can endure, and I found it.
Yeah, I understand.
I get it.
After my accident, I was on a vent.
Hopeless.
Totally alone.
I wanted to die, too.
And I'm glad I didn't.
I don't want you to die, either, Rose.
This dialysis No, I don't want it.
No.
Dialysis may be temporary.
There's no reason not to try.
There's no guarantee.
It probably won't work.
The odds so long.
I can't.
I can't.
Rose, you can.
- You can.
- (CRYING QUIETLY) I believe in you, Rose.
You're the strongest, bravest person I know.
You just got to dig deep, just for that last fight.
- Just dig.
- (SOBBING) I promise you this, Rose.
If nothing works I won't let you suffer.
I think I've seen this film before So I'm leaving out the side door - So step right out - I promise.
There is no amount of crying Can we start dialysis now? I can do for you All this time We always walked a very thin line You didn't even hear me out You didn't even hear me out You never gave a warning sign.
So, how about we celebrate Mom getting targeted therapy - at Dominick's? - Ah, my favorite.
Son, you have no idea how proud we are of you.
Operating on all those patients and still finding time to look after your mother.
Such good care.
So compassionate.
You are a shining example of what a doctor should be.
AJ you're heartbroken over Mina.
You still do your job with grace and dignity.
I'm so proud of you.
Hey, thanks, guys.
You know, I just realized there's one more thing I need to do before I leave.
I'll meet you guys at Dominick's.
- All right? - Okay.
Dr.
Devi.
Dr.
Austin.
Before you yell at me again, I know my dexterity wasn't up to par.
I'm working to change that.
Well, that's a promising start.
Listen Excuse me, but I'm not finished.
I understand your last resident was superhuman.
I'm sorry you find me a poor replacement.
I will work as hard as I can, but there is no doubt I'm mortal.
You will witness mistakes.
Verbal abuse won't help.
I do better with constructive criticism.
And if that doesn't work for you, Dr.
Bell has offered to take your place as my mentor.
Well, he can't have you.
True, your dexterity needs a little bit of love, but your determination and your work ethic are quite admirable.
Now, if I may I came back to apologize.
I can't expect you to do things the way I want them done if I don't take the time to show you, right? So tomorrow morning, I have an aortic valve replacement at 8:00 a.
m.
"Bright" and "early" are the key words.
Will you join me? I will see you bright and early.
Good.
(FOOTSTEPS APPROACHING) Hey.
You're still here this late.
How's Rose doing? She's better.
She was brewing an infection, but, um Her kidneys took a hit, but she's okay.
So it wasn't the therapy cells? - No, it wasn't.
- Ah, that's a relief.
For all of us.
Though we're not thrilled she's on dialysis.
- I think it's temporary.
- PHILLIP: Another good sign.
Thank you, Pravesh, for hanging in.
It's much appreciated.
Yeah.
Rose is my priority, too.
Marshall.
This is Phillip Bondman, the founder of Bio South Labs, the company we partnered with for our sickle cell clinical trial.
Mm.
Kit has great things to say about you.
Please, have a seat.
Marshall is chairman of the board at Chastain.
Dr.
Pravesh told me you're looking for an angel investor in return for a stake in the company.
Kit has proposed that Chastain become that angel investor, and I'm interested.
We could inject cash into Bio South right away, and the hospital would share in your risk as well as the potential returns.
You understand the risk is real with Bio South? We are still speculative.
Chastain needs new sources of revenue badly.
Yes, it's a risky investment, but if we are going to spend our risk currency, it will be on someone who's looking to do good in the world.
That, and your product seems promising.
With enough cash, we believe you can do more.
(LAUGHS): This-this sounds like a godsend.
Could be a perfect partnership.
(PHILLIP EXHALES) ("LIGHTNING" BY MEHRO PLAYING) You don't have to do this, you know.
I do not break promises to my wife.
- (CHUCKLES) - You were promised a spa day and you will get a spa day.
Okay.
I researched.
And apparently, the spas put fruits and vegetables in their water.
That's a very nice touch.
Thank you.
(LAUGHS) (SIGHS): All right.
Okay, we have got Passionate Peach Baby-Oh-Baby Pink and Redder than Red.
I mean, I think Baby-Oh-Baby seems appropriate.
Baby-Oh-Baby it is.
Nothing's gonna wake me up I'm falling asleep with you lying next to me CONRAD: Oh! Nothing's gonna wake me up Not even the thunder Have I told you that I love you? You know what, not often enough.
Well, I love you.
I'm falling asleep With you lying next to me (NIC LAUGHS) Nothing's gonna wake me up You're not supposed to get the skin.
This is why I'm not a surgeon.
(LAUGHS) That's not bad.
Not even the lightning.
(BOTH LAUGH)
Your mother has lung cancer.
You cannot come to Nigeria with me.
- I do want your job.
- I wouldn't want a resident who didn't.
We're cut from the same cloth.
No hidden agendas.
There have been some developments in gene therapy.
Recent clinical trials with good outcomes.
These are uncharted waters.
A lot of hospitals won't risk hosting our trials.
It's gonna be a long, hard road.
- And nothing is guaranteed, Rose.
- But I have a chance? Well, you have more than just a chance, you have a damn good chance.
("EASIEST THING" BY JEAN DEAUX PLAYING) It's been so long - I think I might - Hey.
- (GIGGLES) - Write you a letter I can't be mad Thought you were making a shopping list.
I am.
I was also just enjoying the view.
Okay.
But your mani-pedi appointment is on the other side of town from your pregnancy message.
We got to plan it out if we want to hit everything today.
You just finished a night shift.
Are you sure you're not too tired? To knock out a pre-baby bucket list with my glowing wife? - Never.
- Mm.
(NIC CHUCKLES) You can say no if you want, because it's your day.
But what if we make a pit stop at home? Someone told me alone time will be hard to come by - once the baby is born.
- Hmm.
I will definitely consider it.
Mm, good.
Then let's get the hell out of here.
Oh, you want to see the new baby picture? Of course.
Aw, another sonogram.
- Let me see.
- (NIC LAUGHS) Aw, it's a fat little potato with fists.
Did you just call my child a fat little potato? A cute, fat little potato.
Thank you.
I don't think that's a compliment.
No, I was thanking her for helping - plan our day.
- A fabulous nail studio, a massage to die for and I got you off the wait list at Marino's Steak House.
You have a table at 8:00.
You are the best.
Why don't you come meet us? No way.
Conrad wants you all to his lonesome.
- Yes, I do.
- (NIC LAUGHS) - And I'm here till midnight.
- Oh, God.
Have fun.
- No, no, no, no, no, no, we're leaving.
- Wait, what's up? My shift is over and you're on maternity leave.
Hang on, what's going on? Mr.
Goldense canceled his appointment, third time this year.
And I've called, but it only goes to machine.
You're the only one he'll talk to.
Nic, don't do it.
(SIGHS) Oh, come on, you know, Pete Goldense.
History of A-fib.
He has cardiac meds that need close monitoring.
We can go check it out.
It's not a problem.
(ELEVATOR DINGS) You're impossible.
It'll take two seconds.
(EXHALES) Okay.
- (SIGHS) - I wonder if it'll be this hard to say no to our daughter.
- Probably.
- Yep.
Here's the problem, Dr.
Voss.
We're still far in the red, north of $25 million.
Well, the numbers are trending in the right direction.
When I took over, we were $35 million in the red.
No one wants to put a price on saving lives.
But as CEO, you must.
I am not like other CEOs.
Which is why you hired me.
And now we're beginning to question the wisdom of putting someone with no business experience at the helm.
You need to find more cuts, Dr.
Voss.
BOARD MEMBER: And we don't mean pennies.
We mean millions.
This isn't coming from me or the board, Kit.
We're getting pressure from the state.
They have given us and by "us", I mean you two weeks to come up with big solutions.
(KNOCKING) (DOOR OPENS) You okay? Come take a look at this.
This was the scan from my mother's diagnosis, when she was stage IV with pleural mets.
BELL: Mm-hmm.
And this is today.
Wow, that much progression? Her lung cancer is highly aggressive.
So sorry.
I, um Has she started chemo? She watched her father die of cancer.
She remembers vomiting and constant nausea.
He was in pain for months until he died.
She is terrified of chemo.
Well, they do much better managing side effects these days.
Surgery's not an option.
There's only one hope left.
Well, targeted therapy.
It could buy my mother years if she's a candidate.
We're waiting for the genetics now.
Well, just, it's Keep me updated.
Yeah.
(DOOR OPENS) Hi.
Hey.
I've got a birthday present for you.
Mm.
My birthday isn't until June.
(DEVON CHUCKLES) Well, this is your new birthday.
500 million genetically modified cells ready to change your life by making healthy red blood cells in your body.
If we're lucky.
I know it's experimental and there are no guarantees, but I can't believe I have this chance.
Is there anyone you want to call or FaceTime for the big moment? Friends? Family? No.
Dr.
Cain? (SCOFFS) He, um hasn't been by for a while.
I'm sure he's busy.
Well, this is a really big deal.
You went through a lot to get to this moment.
I wouldn't be here without you.
(CHUCKLES SOFTLY) Rose (BEEPS) would you like to do the honors? (CHUCKLES, EXHALES) (BEEPS) Please work.
We started her gene therapy an hour ago.
Now we wait.
Is she strong? Is she ready? She's been through a massive chemo blast that devastated her bone marrow.
She's nauseous.
Her counts are dropping.
Her mouth sores are so bad she can barely swallow.
So is she strong? No.
But she is the bravest person I've ever known, and she's ready.
(PHILLIP EXHALES) Look, man, Bio South is running on fumes.
Uh, we need cash, and we won't get a new investor if Rose has a bad outcome, so Everything is riding on this.
Look, if this works, we stand to get FDA approval.
And then sky's the limit.
Thousands of other patients with sickle cell disease would line up for this treatment.
And if it fails? (EXHALES) The company will shutter.
I will be bankrupt.
(EXHALES) And Rose will have risked her life for nothing.
You recommended me to Dr.
Wylie.
Yeah, she was in the market for a promising resident.
But you said that I could work with you, that we were a pair, cut from the same cloth.
You need more practice.
And I'm focusing on my recovery.
You're not gonna get your skills back hiding in this office.
I'm being cautious.
The last time I was in the OR, you had to step in there to save my ass.
Can't ignore that.
So you start with a softball, something simple you used to do in your sleep.
Can't afford another fumble.
Kit's gonna send me packing.
I have to know that, when I come back, my work is gonna be perfect.
Dr.
Wylie is nowhere near the surgeon you are.
I want to learn from the best.
Caution's not a good look on you.
(DOOR OPENS) In case you don't remember, Pete's not the easiest guy.
Took the gold medal in the curmudgeon Olympics.
Well, if it doesn't take too long, we can stay on schedule.
(KNOCKING) Hey, Pete! It's Nic from Chastain.
I'm here with Dr.
Hawkins.
Came to check on you.
We're worried that you missed your appointment.
- (BASEBALL BAT DROPS) - I'll survive.
You know your cardiac medication needs monitoring.
Come on, Pete.
We'll do a quick check and then you won't have to go to the hospital.
Put those masks and gloves on.
Okay.
You know, if you'd get the COVID-19 vaccine, you wouldn't have to be so nervous about guests.
I have no need.
- I have no risk of exposure.
- (BASEBALL BAT DROPS) I see no one.
It's Middle-earth.
Needs a dragon.
(EXHALES) You all right? Yeah.
CONRAD: How long since you've been out of your house? PETE: Over a year.
CONRAD: How you feeling, Pete? (GROANS) I just woke up from a nap, so a little groggy.
The good news is I can take naps whenever I damn well please.
I see the judgment in your faces.
Proves my point.
You've never known real freedom till you lock your door.
Look, no judgment.
- CONRAD: We're just worried about you.
- (PETE GRUNTS) You're a little out of breath.
NIC: Why don't you let us check you out, just make sure nothing serious, okay? (BREATHING HEAVILY) Okay.
- All right.
- But first, let me get something to drink.
- I'm thirsty.
(GROANS) - NIC: No, no, that's okay.
I'll-I'll get you some water.
(PETE PANTING) (SIGHS) Fridge is close to empty.
CONRAD: Pulse is irregular and rapid.
Crackles at the bases.
NIC: Oh Hey.
CONRAD: You having trouble wearing shoes? When you don't go anywhere, you don't need shoes.
Distended neck veins.
CONRAD: Sorry, Pete, but we're gonna have to get you to Chastain after all.
No.
- You can't make me go.
- NIC: Hey, hey, hey, hey, hey.
Whoa, whoa, whoa.
CONRAD: Pete? - NIC: Calling 911.
- Pete? (LINE RINGING) AUSTIN: You'd work much quicker if you had gloves that fit.
What is this, the JNCO jeans of surgical wear? JESSICA: Oh, I'm sorry, Dr.
Devi, did we get you the wrong size gloves? LEELA: It's totally okay.
AUSTIN: It is not totally okay.
Speak up for yourself.
A six and a half would be great next time.
You got it.
I think we're just so used to prepping the OR for Dr.
Austin and Dr.
Okafor AUSTIN: And how would you think that she could even fit in Mina's gloves? Look at this one-handed tie.
Sloppy at best.
Criminal at worst.
And whenever we would do a bypass, Dr.
Okafor and I chose the pedicled approach.
That means there is a bit to clean up, so I would throw a stitch and Mina would cut my suture.
Not there.
Higher.
No, that's too high.
Lower.
LEELA: Like this? Would you steady your hands, Devi? This is not a cadaver.
It's a father of three.
Damn it! You cut the vessel I needed.
LEELA: I'm sorry, Dr.
Austin.
AUSTIN: Is an apology gonna console his children? Small vascular clamp and 8.
0 Prolene.
Not to her.
To me.
I have to learn.
You stay, you watch or you leave.
It's your call.
(PANTING) (MUFFLED SCREAM) Like this.
(SCREAMING GIBBERISH) Nothing more satisfying than teaching the important stuff to young residents.
The day isn't going great.
I messed up in the OR with Raptor, and he yelled at me, again.
Did you kill someone? - No.
- Then don't worry about it.
I don't like to be humiliated.
It wasn't about you, I promise.
He's under a lot of pressure right now, a family thing.
Believe me, he's on a razor's edge for a good reason.
I'm sorry.
So what's the hospital's CEO doing in here, anyway? Bit of a challenging day on my end, as well.
The supply room is a known resource when you're at your wit's end.
It's quiet, private, lots of pillows.
(BOTH CHUCKLE) Come on, come with me.
I'll get you into another OR.
Dr.
Austin isn't the only fine surgeon at Chastain.
Dr.
Voss? I would love to work with you sometime.
Well, if my ass isn't fired shortly, we'll arrange it.
Come on.
Hey, Cindy.
What happened? You paged? She has an elevated temp.
100.
1.
(MONITOR BEEPING STEADILY) - And she's tachy.
- Yeah.
Hey, Rose? Can you tell me how you're feeling? Tired, a little hot.
Let's give her a gram of acetaminophen and bolus her a liter of lactated ringers.
Okay.
It doesn't hurt anywhere.
It's not like a pain I've felt before.
But I don't feel good.
It couldn't be the gene therapy, could it? I don't know yet.
We'll give you some fluid and order a set of blood cultures.
I thought there was nothing left that could scare me.
Whatever happens, we'll manage it.
It's not that.
I know what it is to be sick.
(RAGGED EXHALE) But hope? When I pressed that button, it's what I felt.
And I haven't felt that in so long.
I don't want to lose it.
65-year-old male with syncope and blunt abdominal trauma.
IRVING: All right, let's put him in Bay Two.
BP 90/50, heart rate 130 and irregular.
O2 sat 95%.
PETE: I fell on a chair.
So what? I thought you two were spending a day away from sick people.
Well, best-laid plans - One, two, three.
- Three.
(PETE GRUMBLES) Nothing good can come of this.
- (MONITOR BEEPING RAPIDLY) - Told you.
I'll order an EKG and labs.
Crackles halfway up.
- I need an X-ray stat.
- Yeah.
- And I might have to intubate.
- Okay.
- (PETE GROANS LOUDLY) - CONRAD: Pete, this isn't good, and we have to fix it.
Tenderness and guarding in the right upper quadrant.
(MACHINE BEEPS) Damn it.
Free fluid.
He's on blood thinners that weren't being monitored.
And now he's bleeding into his abdomen.
(SCRUBBING HANDS) Dr.
Wylie already has three residents.
BILLIE: Yep.
And I told you I didn't want the gig.
I need you and only you, for a softball.
Aneurysm clip, OR 7, in 15 minutes.
Dr.
Wylie? I'm gonna have to pass.
Dr.
Cain has requested me.
Hey.
What's going on with Rose? Elevated temps.
She's tachycardic.
Her blood pressure is dropping.
I called in her oncologist to examine her.
- How is she? - Responding to fluids.
Stable for now.
If this is a systemic inflammatory reaction from the cells, we support her through it, and she should improve soon.
Okay.
I'll keep an eye on her.
Okay, I have to see another patient, but tell me if anything changes.
Thank you.
Yee, if you don't sit down Your cancer is getting worse.
When we know the next steps, I'll sit.
- So, until then - Your father has zero chill.
- Tell me about it.
- And at the moment, - mine is in limited supply, too.
- (DOOR OPENS) Hello, Carol.
Yee.
Lovely to see you.
Okay, Dr.
Oliver, we can dispense with the niceties.
- We're dying here.
- Literally.
- Carol.
- OLIVER: This will be short and very sweet.
I am happy to say that Carol's cancer has a mutation that qualifies her for targeted therapy.
Thank you.
AUSTIN: You hear that, Ma? This is incredible.
Conventional chemo is better than it used to be, but it's still a blunt tool.
Targeted therapy is exactly what the name says.
It attacks only the changes in the cancer cells that help it grow and spread while sparing your normal cells.
And what does this mean for me? I mean, I know it's not a cure, but OLIVER: You still have stage IV cancer, but we are buying time.
The cancer will eventually come back, but by then, we could have new and even better treatments.
Mom.
Mom, this is great news.
(CRYING) So, the CT you ordered showed a grade III liver lac.
- What's his most recent hemoglobin? - NIC: 12.
2.
The second one should be back any minute.
Any guesses why he passed out in the first place? - No idea.
It was so abrupt.
- BELL: Doesn't make sense.
So, what accounts for the respiratory failure? It's all a mystery.
His EKG and echo show evidence of severe pulmonary hypertension with right-sided heart strain, and that's all new from a year ago.
We thought it could be a P.
E.
, but he's been on his blood thinners, - so it's unlikely.
- BELL: Severe pulmonary hypertension? So we don't want to put this guy under anesthesia.
Not if we can help it.
Lab just called with a critical value.
Repeat hemoglobin 7.
2.
He's bleeding out.
We don't have a choice.
Okay, yeah.
Pack him up.
Get blood on hold.
- Lots of blood.
And I'll meet him in the OR.
- On it.
Randolph.
- A favor? - Yeah.
Sure, but quickly.
I have to prep a patient for surgery.
I have a first-year surgical intern in need of a new mentor.
He have a falling-out with someone? She.
Yes, and sort of.
AJ let her have it in his OR.
That's understandable.
AJ's under a lot of stress.
He is, which is why I would be eternally grateful if you could have her in your surgeries today.
Yeah.
Is she any good? Judge for yourself.
Solid technique.
Fast.
Clearly determined.
She's whip-smart, too.
Her name's Leela Devi.
Dr.
Devi? I'm Randolph Bell.
How'd you like to throw some of those in my OR? I would love to.
Great.
Let's go.
- (MONITOR BEEPING RAPIDLY) - Rose, Rose, you've got to settle down.
(GASPING): I don't feel good.
- Rose, steady.
- (BREATHING HEAVILY) Deep breaths.
- Deep breaths.
- (BREATHES DEEPLY) - What happened? - Well, she was holding her own, and then her blood pressure plummeted to 70/40.
Okay, give her another liter, wide open.
- Mm-hmm.
- And start her on norepi.
(ROSE GASPS LOUDLY) - I'm so hot! - That's because you have a fever.
I have to examine you again, okay? Ow! (GROANING) - Fever.
- Mm-hmm.
Hypotension, abdominal pain.
I don't think this is from the gene therapy.
Rose, the chemo has suppressed your immune system.
I think you have a bad infection, likely from your gut.
So what happens now? We're gonna get you on the right antibiotics.
All you have to do is get some rest.
You stay hopeful.
Okay? AUSTIN: Aneurysm clip.
Proximal and distal clips in place.
Now I'll ligate the aneurysm.
(SIZZLING) Oh, I trapped the aneurysm.
I'm certain I did that correctly.
I don't I don't understand why this is happening.
Find the feeder vessel I don't need instruction from a resident.
(ALARMS SOUNDING) Cerebral perfusion pressure is falling.
Get back in there, or this'll be the last brain you ever touch.
Suction.
Need to see what we're dealing with.
There's the feeder.
Clip? (BEEPS) Nice work, Dr.
Cain.
Yeah, please.
I almost whiffed a softball.
You close.
I'm finished here.
Maybe he is finished.
If so, no one will miss him.
His hands are back.
But surgeons thrive on hubris.
The problem now is in his head.
I got your page.
Hey, it wasn't the gene therapy.
Rose's blood cultures came back positive.
She's septic.
- And how's she doing? - We started her on the right antibiotics early.
She's stable now.
But her kidneys took a hit.
Take a look.
KIT: Is she making urine? I have flooded her with fluids, but no.
Her potassium is climbing.
Rose needs dialysis if she's gonna make it past this crisis.
(CLASSICAL MUSIC PLAYING) BELL: Lap pad to me.
Have you ever operated on a liver lac? Never as first assist, but I've read a lot about it.
Okay, well, then tell me about the blood supply of the liver.
- Another lap pad.
- Liver has dual blood supply portal vein and the hepatic.
- Mm-hmm.
- (MONITOR BEEPING) All right, Dr.
Devi.
Diffuse bleeding from the liver.
You're on.
- What do you want to do? - Manual compression.
I take the liver in my hand, and squeeze it.
Okay, now do it.
LEELA: It's not working.
He's still bleeding.
So what's your next move? I identify and suture the bleeder? - (ALARMS SOUNDING) - Dr.
Bell, our patient isn't enjoying this teaching moment.
LEELA: I think you should take over.
BELL: No, there's no need to take over.
We're a team.
3.
0 Prolene to Dr.
Devi.
I saw you do this perfectly.
It's muscle memory.
Just do it.
Don't think.
And if you have trouble, I'm right here.
Mm-hmm.
Mm-hmm.
LEELA: Suction.
(WHIRRING) (BEEPS) Well done, Dr.
Devi.
Now, let's hope Nic and Conrad can diagnose Pete's underlying problem.
(SIGHS) It was touch and go in surgery.
He's on two pressors now.
- Water.
- Oh, thank you.
So, Bell fixed his liver lac, but that's still the least of his problems.
Did his rheumatological studies come back? Yep.
All normal.
He'll need a right heart cath to measure his pulmonary pressure.
I'll check with Cardio on that and schedule - a chest angio with CT.
- (SIGHS) If we can't figure out the underlying cause of his pulmonary hypertension There are treatment options, and we'll have to start looking into them, but he could die.
Wait.
When I went to get Pete water, all I saw in his kitchen was rice and beans.
Only rice and beans.
- No vegetables? No fruits? - None.
(LAUGHS): I mean, I know it seems crazy, a one-in-a-million case, but Pete's suffering from a vitamin deficiency.
Think about it.
He's been shut in from COVID this whole time.
That explains the pulmonary hypertension.
Nic, you may have just saved his life.
(SIGHS) Dialysis? My kidneys are failing? I've had family members on dialysis, and they were miserable.
It's devastating news, I know, but I think it's gonna be temporary.
Okay? I-I really I really do, Rose.
We have to give your kidneys time to recover.
And if they don't? Remember, Rose, we're focusing on hope.
Look at me.
I am about out of hope.
I am out of everything.
Just answer the question, please.
If your kidneys don't recover, you will be on dialysis for the rest of your life.
Is dying from renal failure painful? - No, it is not, but that's not where - Look, I appreciate everything that you and Dr.
Voss have done, but I am too tired to go on any further.
Rose, no.
Rose, you're not gonna be alone.
I'm going to be with you the whole time.
(CRYING): I have nothing left.
No dialysis, no anything.
Rose, giving up is not the answer.
You have to fight, you have to fight this and hold on to what your life could be when this is behind you.
I don't have any fight left.
Call in hospice please.
I gave it my best shot.
It's over.
I can't do this anymore.
(ROSE SOBS) I told you I didn't want to come here.
They filleted me like a dead fish, and now I'm farting like a ten-year-old Labrador retriever.
Pete, if Dr.
Bell hadn't operated, you would have died.
So the blame's on me? I didn't eat right.
Food as medicine.
What a crock.
It's not a crock.
Not having enough vitamin C in your diet can be life-threatening.
It can increase the pressure in the vessels leading from your heart to your lungs, causing pulmonary hypertension.
And that explains the strain on your heart.
Which caused shortness of breath, the swelling.
The lack of vitamin C also explains the bruising.
I get the gist.
You want the big dose of, uh, gratitude.
Okay, here it goes.
- Big thanks.
- (CONRAD CHUCKLES) - (NIC GROANS) - Here's the bag, Nic.
- Thank you.
- That's my vitamin C? What about a nice chewable tablet? The kind I gave my kids? If we're right about this, we should see a change in the numbers immediately.
I'm not holding my breath.
(NIC SIGHS HEAVILY) So you have kids? One more disappointment.
You're pregnant.
I have eyes.
You think it's gonna be all, uh, hugs and kisses and "I love you, Mommy, with all my heart".
News flash: they become teenagers, and they turn on you.
Then they spend the rest of their lives griping about that one birthday party that didn't meet expectations.
You seeing what I'm seeing? (BEEPS) NIC: Pulmonary artery pressure is still higher than we'd like to see, but it's coming down.
Feeling better, Pete? Maybe.
A little.
Okay, great.
We'll take that as a rave review.
Nic's on maternity leave.
I'll be back to check on you, though.
Control that impulse as much as possible.
We'll see you later, Pete.
Not the day we hoped for.
Eh, but the kind we live for.
Grumpy patient or not.
Gratitude not required.
(NIC LAUGHS SOFTLY) Carol.
Your new meds have just arrived.
Once a day with a glass of water.
I'm glad I lived to see this day.
And we hope there'll be many more, Mom.
Enough to find the next miracle.
Science wins.
Thank you, Dr.
Oliver.
Here, honey.
(SIGHS) Thank you, son.
Listen, I got to, um, finish up a couple of things, but I'll be back to walk you guys out, all right? - Thank you.
- Of course.
(DOOR OPENS) - Hey.
- Evening.
Hey, I got the good news about your mom.
- I'm happy for you.
- (CHUCKLES) (TAKES DEEP BREATH) Thank you.
The medicine gods were smiling down on us.
- Yeah, I love when that happens.
- Whew.
Me, too.
Hey, by the way, uh, Dr.
Devi assisted me on a liver lac today and did some very good work in a messy situation.
So, you know, if you don't mind, I'd like to keep her in my OR.
Yeah.
Sure, she's all yours.
- That's good news.
- (DOOR OPENS) Thanks, man.
(ELEVATOR DINGS) Rose is refusing dialysis.
Why would she do that? I tried to convince her to keep fighting, but she won't hear me.
I thought maybe she'd listen to you.
Will you talk to her? What's that? Meds to lower your potassium.
Oh, stop, stop.
No more medication.
- Rose - I'm refusing all treatment.
Leave me alone.
(INDISTINCT P.
A.
ANNOUNCEMENT) I know what you're gonna say.
Don't bother.
Devon said you're having a rough time.
Rough time? I know about a rough time.
This is (TAKES DEEP BREATH) There's a limit to what a person can endure, and I found it.
Yeah, I understand.
I get it.
After my accident, I was on a vent.
Hopeless.
Totally alone.
I wanted to die, too.
And I'm glad I didn't.
I don't want you to die, either, Rose.
This dialysis No, I don't want it.
No.
Dialysis may be temporary.
There's no reason not to try.
There's no guarantee.
It probably won't work.
The odds so long.
I can't.
I can't.
Rose, you can.
- You can.
- (CRYING QUIETLY) I believe in you, Rose.
You're the strongest, bravest person I know.
You just got to dig deep, just for that last fight.
- Just dig.
- (SOBBING) I promise you this, Rose.
If nothing works I won't let you suffer.
I think I've seen this film before So I'm leaving out the side door - So step right out - I promise.
There is no amount of crying Can we start dialysis now? I can do for you All this time We always walked a very thin line You didn't even hear me out You didn't even hear me out You never gave a warning sign.
So, how about we celebrate Mom getting targeted therapy - at Dominick's? - Ah, my favorite.
Son, you have no idea how proud we are of you.
Operating on all those patients and still finding time to look after your mother.
Such good care.
So compassionate.
You are a shining example of what a doctor should be.
AJ you're heartbroken over Mina.
You still do your job with grace and dignity.
I'm so proud of you.
Hey, thanks, guys.
You know, I just realized there's one more thing I need to do before I leave.
I'll meet you guys at Dominick's.
- All right? - Okay.
Dr.
Devi.
Dr.
Austin.
Before you yell at me again, I know my dexterity wasn't up to par.
I'm working to change that.
Well, that's a promising start.
Listen Excuse me, but I'm not finished.
I understand your last resident was superhuman.
I'm sorry you find me a poor replacement.
I will work as hard as I can, but there is no doubt I'm mortal.
You will witness mistakes.
Verbal abuse won't help.
I do better with constructive criticism.
And if that doesn't work for you, Dr.
Bell has offered to take your place as my mentor.
Well, he can't have you.
True, your dexterity needs a little bit of love, but your determination and your work ethic are quite admirable.
Now, if I may I came back to apologize.
I can't expect you to do things the way I want them done if I don't take the time to show you, right? So tomorrow morning, I have an aortic valve replacement at 8:00 a.
m.
"Bright" and "early" are the key words.
Will you join me? I will see you bright and early.
Good.
(FOOTSTEPS APPROACHING) Hey.
You're still here this late.
How's Rose doing? She's better.
She was brewing an infection, but, um Her kidneys took a hit, but she's okay.
So it wasn't the therapy cells? - No, it wasn't.
- Ah, that's a relief.
For all of us.
Though we're not thrilled she's on dialysis.
- I think it's temporary.
- PHILLIP: Another good sign.
Thank you, Pravesh, for hanging in.
It's much appreciated.
Yeah.
Rose is my priority, too.
Marshall.
This is Phillip Bondman, the founder of Bio South Labs, the company we partnered with for our sickle cell clinical trial.
Mm.
Kit has great things to say about you.
Please, have a seat.
Marshall is chairman of the board at Chastain.
Dr.
Pravesh told me you're looking for an angel investor in return for a stake in the company.
Kit has proposed that Chastain become that angel investor, and I'm interested.
We could inject cash into Bio South right away, and the hospital would share in your risk as well as the potential returns.
You understand the risk is real with Bio South? We are still speculative.
Chastain needs new sources of revenue badly.
Yes, it's a risky investment, but if we are going to spend our risk currency, it will be on someone who's looking to do good in the world.
That, and your product seems promising.
With enough cash, we believe you can do more.
(LAUGHS): This-this sounds like a godsend.
Could be a perfect partnership.
(PHILLIP EXHALES) ("LIGHTNING" BY MEHRO PLAYING) You don't have to do this, you know.
I do not break promises to my wife.
- (CHUCKLES) - You were promised a spa day and you will get a spa day.
Okay.
I researched.
And apparently, the spas put fruits and vegetables in their water.
That's a very nice touch.
Thank you.
(LAUGHS) (SIGHS): All right.
Okay, we have got Passionate Peach Baby-Oh-Baby Pink and Redder than Red.
I mean, I think Baby-Oh-Baby seems appropriate.
Baby-Oh-Baby it is.
Nothing's gonna wake me up I'm falling asleep with you lying next to me CONRAD: Oh! Nothing's gonna wake me up Not even the thunder Have I told you that I love you? You know what, not often enough.
Well, I love you.
I'm falling asleep With you lying next to me (NIC LAUGHS) Nothing's gonna wake me up You're not supposed to get the skin.
This is why I'm not a surgeon.
(LAUGHS) That's not bad.
Not even the lightning.
(BOTH LAUGH)