01x06 - The Inverse

[bunniefuu]

[engine revving]

[tires screech]

[upbeat pop music]

♪ Hey Na-na hey Na-na-uh ♪
♪ Hey Na-na hey Na-na-uh ♪
♪ Hey Na-na hey Na-na-uh ♪
♪ Hey Na-na hey Na-na-uh ♪
♪ Heads turning, no stopping ♪

Great ride, Dr. Panttiere.

Oh, hey. It's a rental.

My, uh, my car's in the shop.

It's the only thing they had.

I swear.

Alex! Alex.

Where, what's the...

Oh, sorry, honey.

I have a bypass at 9:00, and some lunatic on the freeway was honking and...

I'm the lunatic, Al.

You left without me.

Do you remember that we're carpooling?

Because we go to the same place every day?

Oh, right. That's a good idea.

Yeah, isn't it?

I'm sorry, babe, when Max is out of town, I got to stay on top of the boys' schedules.

I got lunches, backpacks, homework, pick up, drop off...

Al, here's a thought, since I'm living with you, I can actually help out with the boys so you don't forget anything.

I appreciate that, but I'm on top of it.

Mm-hmm.

Yeah.

Superhero Day is next Tuesday, Alex.

And Doc Brown is not a superhero.

That man built a time machine.

You just wanted to rent the car.

You wouldn't believe how it hugs the road.

♪ I'm on fire ♪
♪ I am free ♪
♪ I am busting through the doors ♪
♪ Baby, I don't need a key ♪
♪ I'm a fighter ♪

Morning.

New scrubs.

Unisex.

[elevator dings]

♪ Hey, hey ♪
♪ I'm a woman ♪

I could pull off a tool belt.

Really? I think it'd make me look boxy.

I can hear you.

♪ I'm a woman ♪

Thank you.

Jesse.

Alex.

We have a critical patient two minutes out.

Car crash, suspected head trauma.

It's Joy Tanner.

Who's Joy Tanner?

Get every bag of O neg we've got.

Get the neuro attending down here.

Get me plutonium for the flux capacitor, Marty McFly.

Fine, get me scrubs.

Who's Joy Tanner?

[siren wailing]

Run a full trauma panel.

What the hell happened?

Santa Anas, semi versus this lady.

The other driver said the wind pushed him into her lane.

Please not the heart, not the heart.

Sluggish reactions.

Possible subdural hematoma.

Hey, I want eyes on that brain bleed.

She's in v-fib.

Charge panels.

Wait! Wait.

She's situs inversus. Her organs are reversed.

She was a patient of ours ten years ago.

[heart monitor beeps]

Clear!

So this is Joy Tanner, 46, world-renowned archeologist.

Momentarily sidelined from spelunking down dark caves in search of buried treasure.

I imagined my sabbatical would be more catching up on trash television and less dying.

Oh, well, no one's dying, Joy.

Joy has end-stage idiopathic cardiomyopathy.

She needs a heart transplant, the slight complication being she was born situs inversus totalis.

Wow, she has a dextrocardiac heart.

She's literally right-hearted.

Her heart's in the right side of her thorax and not the left.

It's a one-in-ten-thousand heart.

Oh, it's very rare, which is why we held out very little hope of ever finding a dextrocardiac donor heart.

But we have.

It was just confirmed.

We got it?

Your new heart's on its way over and you're on your way into surgery, let's get her prepped.

Oh!

Joy?

[heart monitor convulsing]

Joy?

VAD flows are dropping. This heart's garbage.

Find out where the hell the donor heart is... go!

Move!

Hi, this is Dr. Millicent Silvano.

Yeah, um, we're looking for somebody who might be able to update us on the status...

[sighs]

Of the, um, donor heart you're supposed...

Listen, junior, UNOS gave the green light.

Our patient's circling the drain, we need that heart now.

Dial it down, Doc.

The donor's wife wants to sign the papers, she's just waiting for the father-in-law to arrive.

He wants a chance to say good-bye to his son first.

He can do it here.

We'll have the donor papers for him to sign.

You want to harvest the heart on your end?

Duh.

"Duh?"

[scoffs]

What did they say?

Rookie.

Ballbuster.

Dr. Harrison?

Dr. Panttiere's in trauma and her son's school just called.

Gabriel needs to be picked up.

Is he okay?

Yeah.

They said he's okay, he just doesn't feel well and you're on the list of people authorized to go get him.

I'm on the list?

They tried calling Max first...

Max is out of town.

Then they called me?

Then Bryan.

Bryan's with Max.

Then they called me.

Then Dr. Panttiere's mother.

♪ ♪

I'm on the list.

Congratulations.

I'm...

Need a gram of Solu-Medrol.

Okay, we got a contusion on the left temporal lobe with considerable bleeding.

Leo's on his way.

What, did we pull him away from his golf game?

Please don't die.

She has the heart of a man half her age, it'll fight.

We got to decompress this cranial bleed before she crashes again, she's bradycardic.

Her pulse pressure's widening.

After what we went through to give her a new heart, We can't let her die of a TBI.

You're damn right she's not.

[ambient suspenseful music]

[clears throat]

I'll relieve the pressure myself.

This heart has to live.

[saw whirs]

Elevate the dural flap.

Bipolar cautery or clip?

Clip.

Leo, move. Move the cottonoid. I can't see.

Okay, if anyone else here is a neurosurgeon who played 18 holes and sh*t a 68... 4 under, b*tches... you're welcome to advise me, otherwise, I got this.

Apologies, Leo, she's a former patient of ours.

Oh, my God.

This is her.

And I thought it was an urban legend.

This is the woman who has the dextrocardiac heart you guys stole...

Okay, yeah, you know what...

It was a miscommunication.

It almost cost you both your careers.

Define "stole."

How many surgeons get to participate in a dextrocardiac transplant?

It's surgical p*rn!

And it won't look bad on the résumé.

You still think you're transferring to Cleveland?

They have one of the strongest cardiothoracic programs in the country.

And it's just a coincidence Dr. Shane's transferring there as well.

Is he?

Alex, please.

What does he think about it?

He's giving me a referral that'll get me into the program, as soon as I get the guts to tell him I applied.

I never had you pegged as the trailing-girlfriend type.

Our relationship is professional.

He's my mentor.

Mm-hmm.

Who you happen to be shagging.

I am not shagging him.

[scoffs]

I didn't say I didn't try.

[pagers beeping]

Joy Tanner's coding.

[gasps]

Donor heart's here.

Okay.

[heart monitor beeping]

Hi, I'm Edina Mclntyre, chief operating officer here at St. Matthew's.

Thank you so much for coming.

I know that this is a very difficult time for you, but if you'll follow me, we can go over the donation forms in my office.

♪ ♪

Where's the dextrocardiac heart?

The family just went up to finish the paperwork.

I'll let you know when...

[whispers] Glove up, come on.

Really, now?

Yeah.

They're signing the papers, let's go.

I don't know, Alex, I think maybe we should...

Hey, slouchy, little help here.

We don't have a minute to waste, Millicent. Let's go.

All right, here we go.

All right, if you want to, y-you go ahead.

I'll just... I... I think... I'm gonna go tell Dr. Shane.

Suit yourself.

I'll harvest solo.

[urgent music]

♪ ♪

Oh, Dr. Mclntyre, excuse me, Dr. Mclntyre, sorry.

Do you know if the family's decided to sign the donor papers yet?

Who are you?

Oh, uh, I'm Dr. Silvano, Dr. Shane's waiting for the heart for the transplant...

The family is still talking about what they want to do... why?

Spit it out, freshman.

We've done everything we can. Let's call it.

Push another round of steroids.

Your patient is brain-dead, Dr. Panttiere.

She's not coming out of the coma.

Coward.

[inspiring guitar music slowly builds]

♪ ♪

You want to take her off life support?

She wants you to say "bye-bye."

Look at the contraction of the atria.

The beautiful peak, the perfect sinus rhythm.

There's no next of kin.

I'll take her off life support.

No.

♪ ♪

It's a young heart.

I'm not following.

I am.

We keep her on life support and regift.

Harvest the transplant.

You want to transplant this heart into someone else?

This heart is a one-in-ten-thousand miracle.

We could cath her, make sure the coronaries are clean.

A biopsy would rule out any trace of rejection.

You want to re-transplant this heart?

Oh, God, they're both on board.

[exhales] Okay, okay.

♪ ♪

[exhales] Okay, so am I.

Okay.

We don't have much time to see if there's even another living soul out there who needs a heart like this.

♪ ♪

Then we start looking.

Gabe?

[door latches shut]

Hey, bud.

I just went to your school to pick you up.

I walked home.

You...

Where's Mom?

Uh, I... I think she's prepping for a... a dextrocardiac transplant right about now.

With a bicaval anastamosis?

Yeah, yeah, if that's the right anatomic approach.

So you're not feeling so hot, huh?

All right, well, listen, how about I, uh, I make you some soup, huh?

I have lice.

Okay, well how about we go, we get you some pediculicide and some disinfectant, does that sound fun?

Come on. Hop down.

Hop down, big guy.

[sighs] Lice isn't that bad.

Oh, you look good. Okay, wanna get the door?

Okay, when we get to Lancast make sure we have CBC.

It's not in there.

Chem-12.

IPad, 12-lead EKG, breath strips.

It might be in my bag.

Check the patient's...

Come on, let's go.

Renal function as soon as...

I can't leave without them.

You get there.

Mr. Gonzalez is a perfect match, right?

He's the right height.

Weight.

Negative crossmatch.

I always carry a stash of motion sickness pills, ever since the last time I travelled by helicopter.

When you blew chunks.

When I vomited outside the helicopter.

[laughs]

It was raining puke all over the West Valley.

Still not funny. Never funny.

Ooh! My babies.

Mm.

Okay, Lancaster's two hours by car, which is...

20 minutes by chopper.

Okay, so go.

Get the recipient, bring him back.

Okay, wait.

You're not the only ones who care about this heart.

We all made mistakes that night.

Well, maybe that's why we're all here.

So get your ass on that chopper...

Toss your cookies.

Bring back a home for Joy Tanner's heart.

[helicopter blades whirring]

[woman vocalizing]

Ten years ago, Joy Tanner was our patient.

She was 56 years old.

She was a world-renowned archeologist.

This morning Joy succumbed to head trauma from an MVA.

Joy was born with her internal organs inverted.

If this tissue biopsy confirms that there is no rejection, we'll be able to regift her heart to another recipient.

Pass it around.

♪ ♪

See the tiny, little red part down at the bottom?

♪ Tame the horse and take it for a ride ♪

No, on her license, people.

"Organ donor."

Those two words are her explicit wishes to live on through the most generous gift anyone can give.

So today we're gonna honor Joy Tanner's wishes.

There's a patient in Lancaster dying of congestive heart failure.

His heart's also on the wrong side of his chest.

He needs a miracle, and she has it.

Now, Dr. Silvano's already flown out to evaluate the potential recipient and bring him back.

Now, put your hands in the air if you're a designated organ donor.

If your hand's in the air, scrub in, you're about to participate in a dextrocardiac retransplantation.

The rest of you, please go down to the utility room.

There are bedpans to be washed.

♪ Could have been a hero, I could have been a zero ♪
♪ Could have been all these things ♪

[wind blowing harshly]

Comfortable, Mr. Gonzalez?

Thank you for asking.

Yes, of course.

I appreciate it.

Just relax.

Are you okay?

Mm, yeah, it's just the turbulence, I think.

Winds.

This is Dr. Silvano from St. Matthew's.

This is Luis Gonzalez and his daughter Gloria.

Hi.

Hello. Nice to meet you.

Okay, I'd just like to check your blood pressure.

Oh, it, uh, may be a little high from looking at such a beautiful doctor.

It's the painkillers.

Um, my father's been having trouble breathing for a few days now.

I took notes.

Wow, are those your notes?

Oh, no, that... that's a present from my dad.

[clears throat]

He calls it his "Dead Dad" pack.

Got the deed to the house, pink slip for the car, his funeral plans, the man he decided I'm gonna marry along with the names of my kids, apparently I'm having three?

Yes.

All boys. [laughs]

Um, do you have a right-sided heart for him?

Let me just take a look at his chart.

Everything inside my father is flipped.

Which may account for why you act the way you do...

Don't... don't start.

Including doing things like that, come on, Dad.

Why do you have to control everything in my life?

I should trust that you will do what's best for you?

I'm 18. I'm a legal adult.

I don't need to ask you.

Legal, yes. Adult, not so much, though.

Okay, actually, there may be a problem, um...

We do have a heart like yours, but it's at St. Matthew's so we'd have to transport you.

So I just want to run a few tests, make sure you're up for that, is that okay, Mr. Gonzales?

Luis.

Okay.

Really, Dad? At a time like this?

Tell me what I want to hear.

Millicent says the patient's clear for transplant.

Yes.

But...

No buts.

He's not stable enough to transport.

If the patient can't come to the heart, we'll bring the heart to the patient.

That's exactly what I said to her.

My saw, please.

[saw whirs]

The heart's a bag of blood. Barely b*ating.

She wouldn't have survived another day.

We'll go on bypass, please.

Now, take a good look.

Probably never gonna see one of these again.

Note the inverse...

Dr. Shane!

You have to stop immediately.

What?

The family decided not to donate.

That heart, it's not for you to transplant.

The patient's old heart is in pieces on that tray.

So either you let me do this, or you can sign my patient's death certificate.

Oh, don't worry, I'll make the decision for you.

Suture.

[laughs] Look at this stitching.

Panttiere, you're an artist.

I had a good teacher.

Still, I expected more scar tissue.

This is a heart that does not want to give up.

Marty, the heart box.

[somber guitar music]

♪ ♪

One-of-a-kind heart deserves a one-of-a-kind delivery.

Meet Lazarus.

Lazarus will perfuse Joy's heart, keep it b*ating all the way to Lancaster.

[clicks]

[clicks off]

♪ ♪

Helicopter ready?

There is no helicopter, doctors.

What?

The wind.

Everything's grounded, nothing's coming in or going out.

You can't leave.

You sure you don't want me to request an ambulance for you, Dr. Panttiere?

You ever seen her drive?

This baby can outstrip one of those clunkers any day.

Ever heard of aerodynamics?

Okay, get in.

What if you get a speeding ticket?

You get them at the 99 Cents store.

You sure you don't want this?

Heart. [strains] No.

I think the other hospitals will have everything I need.

Okay.

I got this.

[groans] Yeah, I got it.

Ooh. That is tight.

♪ ♪

[engine revving]

[tires screech]

[car honking]

Stop that DeLorean! Alex!

Where's she going?

I have no idea.

Is she coming back?

All right, you know what? We don't need her.

You trust me, right, amigo?

No.

You know what, you'll see.

I got a lot of clout in this place.

Marty, Lynn! Hey, guys, uh, little help.

I have a case of, uh, juvenile head lice over here.

Oh, we have to, uh...

Do a thing?

[frantic chatter]

Go, just go.

Impressive.

[wind blowing harshly]

Okay, my team from St. Matthew's will be here soon.

Oh, actually they're gonna be arriving really quite soon.

Alex is driving.

You're gonna get your heart, Mr. Gonzales.

I'm gonna have you arranged to be prepped.

Sit tight.

This is great news, Dad.

You're gonna be okay.

Dad?

Dr. Blackhorse said they're really good doctors.

Who's gonna take care of you?

If something happens to me, who'll look after you?

Dad, you're gonna be okay...

No, no, you're gonna go live with your aunt.

In Florida?

Yes, she can take care of you.

No, I can take care of myself.

Hey, I promised your mother I would never let anything happen to you.

I know, Dad.

I was there when she d*ed.

If she were here, she would want you to do as I say.

If Mom was here, she would let me grow up.

[somber music]

Mr. Gonzales will need his catheter changed out...

Dr. Silvano...

Pick up the phone, Jesse.

I can't get either of my colleagues.

When the winds get like this, they usually knock out the phone service.

Okay, we need a full surgical team, FFP and platelets on hand.

We're not really equipped for this kind of procedure out here.

I'm sorry?

The plan was to take the patient back to St. Matthew's.

Yeah, but that plan changed when we discovered the patient wasn't fit for transport.

Look, we could handle gastric bypass, but we don't do cardiac surgery here. We need more time to prepare...

Well, that's not an option so let's figure out what the hell you do have on hand here and how we're gonna manage this.

I...

Well?

I know of a bypass machine that's four counties over.

Wait, are you saying you don't have a heart-lung machine here?

I can get it here by this evening.

Get it here faster.

By this evening, Mr. Gonzales will be dead.

If those people don't retroactively sign the papers donating the heart, your careers are finished.

And if UNOS hears that by all appearances you stole a heart, do you have any idea what kind of trouble that could put the hospital in?

It's on me.

Not entirely.

Millicent wasn't there. She came to find you.

Well, that's not exactly true, Alex.

Actually, I came to tell Dr. Mclntyre what you were doing.

I just wanted... I needed to make sure everything was aboveboard.

But by the time I got to Dr. Mclntyre's office, it was clear that the family had changed their mind.

And the father was having some sort of crisis, he said he couldn't go through with it anymore.

I'm sorry, I knew I couldn't stop you.

I just wanted to wait until the paper was signed...

So instead of confronting your colleague... who made a terrible, stupid decision... you went behind her back?

I never meant for this.

I was just trying to do the right thing.

I think you've said enough, Dr. Silvano.

Yeah.

I didn't teach you to jump the g*n.

No, you taught me to take risks.

They can't really dismiss me, can they?

If you're lucky, all Mclntyre will do is strip you of your surgical privileges for six months.

Six?

If they take my surgical privileges, I won't get into Cleveland!

You applied to Cleveland?

I might have, I...

They have a... a great program.

You won't get in, Alex.

You haven't got a chance after what you did today.

And you belong here, you've got a chance here... well, you had a chance here.

Damn it, Alex.

Don't leave.

I have to.

There's someone in Cleveland.

Huh?

Well, who is she?

Alex, I've been clear to you from the beginning that I was never gonna be the guy you want me to be.

I gave you everything, you know that.

I can't do this, Alex.

I trusted you and you blew it.

You better hope to hell that someone convinces that family to sign those papers or all of this was for nothing.

Still no service?

We wouldn't have blown the tire if you weren't driving like a maniac, topping 95 miles an hour.

Will you check the heart?

You're a bit of a troublemaker, aren't you, mate?

Yeah, so is this bolt.

Great Scott. [sighs]

I lost my chance to go to Cleveland because of that heart.

No, you didn't.

I wouldn't have let you go anyway.

Why?

It would have been too hard to have you there, not be with you.

You said there was someone.

Yeah, my wife.

[exhales]

You never told me.

We were separated before you and I met.

Wow, you were married.

Not for long.

I'd just started my internship, she was a chef.

A chef? Mmm, yum.

Yeah, she got an offer to go to Barcelona.

I couldn't go.

I asked her to wait. She didn't want to.

Wait, she left you?

She took more than her fair share of the bank account with her.

You moved to Cleveland for her?

She got sick.

Rhabdomyosarcoma.

Whoa.

There was a trial in Cleveland so...

You moved to Cleveland to get her into the trial?

[exhales] Who knew you were such a good guy?

After a pretty rough year, she was actually doing all right.

She went back to Spain and I never heard from her again.

After everything you did for her.

Well, I let her down.

Trust me.

In Cleveland, she wanted to try again.

I don't know, I couldn't.

I met you.

[alternative pop music]

♪ ♪

Well, why didn't you come back after she left you?

If I had, would it have made a difference?

The tire's fixed.

Let's get this heart where it belongs.

Right.

♪ ♪

[phone ringing]

Finally, you guys.

Here's his chart. Come on.

This is Mr. Gonzales and his daughter, Gloria.

Hi, Mr. Gonzales, I'm Dr. Panttiere.

This is Dr. Shane, and this is your new heart.

Hello, mate, we're gonna have to get you prepped for surgery.

Cardiac index is hovering around 1.8.

Okay.

Where's that bypass machine?

What?

They're stuck in traffic.

The wind has downed some trees...

We don't have a bypass machine?

What?

Wait, what does that mean, this machine?

We need it to circulate your father's blood and oxygen during the transplant.

Otherwise?

We can't do the procedure.

So what are you gonna do?

Gloria, don't be rude.

This hospital is so outdated.

Wait, I want to know what you're gonna do to save my father's life.

That's what we're trying to figure out.

It's like we're back in time.

What happens if the machine doesn't come soon enough?

Gloria, they will do what they can.

Dad, I'm asking the questions, you're being the patient.

What happens if this machine doesn't come in time?

Nothing.

We don't need it.

The first heart surgeons didn't have bypass machines.

What's your blood type?

O positive.

Same as your father?

Yep.

Same as the heart.

Lillehei procedure.

If we don't have a heart and lung machine, we'll make one...

Out of you.

So, uh, just... just call me back, Alex.

All right.

Okay, you know what, we're doing this.

Just stand right there, uh, don't... don't move.

Don't touch anything or... don't move, all right?

You didn't find Mom?

Uh, you know, she's... she's still at work, she's busy.

I don't want to shave my head.

What?

No, no, we're not gonna do that. Are you kidding?

We got every bug-murdering tool known to man, we're not gonna shave your head.

Although it might look pretty cool.

Maybe like a... a Mohawk or a... a faux-hawk or something?

No?

Okay, look, I promise you whatever we're gonna do to you, we're gonna do to me too.

I wish my mom was here.

Okay, if your mom walks in right now, what's the first thing she's gonna say to you?

"Gabriel, you stink"?

You do.

What's the second thing she would say to you?

"How much homework do you have?"

Do you know that you don't have to do homework when you have lice?

Even if you have a test tomorrow?

What kind of test?

Cursive.

Cursive?

Do you know that I write prescriptions and people can't read them?

Does that stop me from becoming a doctor?

No.

[sniffs] You really do stink.

[laughs]

You stink.

Lice again?

Can I move?

Both: No!

["Old Time Rock and Roll" plays]

♪ Just take those old records off the shelf ♪
♪ I sit and listen to them by myself ♪
♪ Today's music ain't got the same soul ♪
♪ I like that old time rock and roll ♪
♪ Don't try to take me to a disco ♪
♪ You'll never even get me out on the floor ♪
♪ In ten minutes I'll be late for the door ♪
♪ I like that old time rock and roll ♪
♪ Still like that old time rock and roll ♪
♪ That kind of music just soothes my soul ♪
♪ I reminisce about the days of old ♪
♪ With that old time rock and roll ♪
♪ ♪

Mr. Gonzales, we can't perform this transplant without a way to pump and oxygenate your blood.

I said no.

My daughter may not...

Dad.

Please, just listen to the doctors.

Luis, all Dr. Panttiere and I need to do is connect your arteries to Gloria's.

No.

We'll put a tube through her femoral vein, here.

Normally, your blood would travel through a heart and lung machine, but since we don't have one your blood would travel through Gloria's heart and lungs to get the oxygen that it needs.

And since you both have the same blood type, you'll essentially be sharing each other's blood.

Yeah, and I won't feel anything, Dad.

I'll be under anesthesia.

The hospital's used to do it.

What, with little girls?

I'm not a little girl.

[sighs]

What could happen to her?

With any major surgery, the procedure carries risks.

She could lose circulation to her extremities, develop shock.

Die?

There's always a risk.

It's highly unlikely your daughter will die, Mr. Gonzales, but if we don't try this, you will.

This is not what I need, an instruction manual for life without you.

I need you to pick up the phone when I call you from college.

I need you to be there for me when I'm having a bad day!

I need you to live. I am an adult.

I'm 18 years old, I make my own decisions!

I'm 55, I'm an old man.

And I decide what I want to do.

And I want to leave.

Now.

The first time I saw that heart, I made the wrong choice for all the right reasons.

But I gave my patient ten more years.

You never give up on a heart.

[sentimental guitar music]

♪ ♪

You jeopardized our careers.

I could say the same about you.

The first day of our internship, you got me drunk.

We memorized the pediatric drug chart.

[stifled laugh]

I passed out in your bathtub.

[laughs]

You stayed for three months.

You and Max had just broken up.

You didn't want to sleep alone.

I just can't believe you'd do something like this to me.

Alex, I did what I thought was right.

I don't know, maybe someday you'll see that.

We see a lot of horrible things around here.

That's the job.

But the minute there's even the slightest chance to make things better, you jump.

Otherwise, what's the point?

Look, I jumped too soon, I know that, but I also saved Joy Tanner's life, and I'd do it again because it was the right thing to do.

And maybe... [sighs]

I don't know, maybe one day you'll see that.

Knock his ass out, Doctor.

The risk to your daughter is so minimal.

She's prepared to take that risk.

Do you have children, Doctor?

If you were in my place, what would you do?

She's all I've got left.

Couldn't ever forgive myself.

If anything... for...

[indistinct]

♪ ♪

Let's move, people.

[sniffs] Te amo, papi.

I'm sorry.

As soon as we unclamp the cannula Mr. Gonzales' blood with re-route to his daughter, and hers will cross-circulate back to him.

Any imbalance in pressure or flow can pose a serious risk to both of them.

So we got to keep an eye on their BPs.

You ready to unclamp?

[monitor beeping]

[inspirational piano music builds]

♪ The hands we have were made for holding on ♪

Looking good.

♪ Holding on ♪

Holding steady.

♪ ♪

Flow's good. Ready to proceed.

Her heart is b*ating for his.

We are looking at the very foundations of open heart surgery, my friends.

[heart monitor beeping]

♪ Letting go ♪

Her lips are turning blue.

She's malperfusing.

Her father's getting the bulk of the blood.

Okay, let's readjust the flow.

Clamp.

Just enough.

Just enough to restrict Luis' flow.

Gloria's pressure should rise.

Yeah, I've got her tibial pulse, she's pinking up.

Mr. Gonzales is back in range.

Holding steady.

Okay, let's rock!

I'm gonna pass out.

The hell you will.

Whew! Okay, scalpel.

Scalpel.

♪ ♪

I ended up disimpacting gomers and plating sputum for six months because of you.

I almost lost a friend because of you.

But you didn't.

[sighs] Thank you, Joy.

No one ever told me who convinced that family to sign the donation papers, but whoever it was, thank you.

Without you, I wouldn't be here to save this heart and this life.

Amen.

Amen.

Amen.

I know it's been said, but for what it's worth, I am sorry.

I would never have brought him to St. Matthew's if I had known.

I... I don't agree with how things played out, but I...

I think I understand why they did.

[sniffs]

When... when you're in a hospital every day, you see a lot of terrible things, things that should never happen, that no one deserves.

And whenever there's this... this glimmer, this second of hope that you can make the hurt better, you jump at it.

That's what we're trained to do.

Now, somebody jumped too soon, and for that I am very sorry.

Today might be the worst day of your entire life...

But for someone else...

Somebody who didn't think they had a chance, it's the best.

And your husband did that.

And that will be your son's legacy.

[Luisa's "Under the Wild Skies" plays]

♪ ♪
♪ You'll be protected ♪
♪ ♪
♪ But your fate cannot be changed ♪
♪ Under the wild skies ♪
♪ I feel close to you ♪
♪ And share my heartbeat with you ♪
♪ ♪

He looks so much better already.

That's what happens when you have a heart that works.

They'll transfer him back to our cardiac unit, but not till he's awake and stabilized.

I don't know how to thank you guys.

I know he can be really stubborn.

You guys never gave up.

No.

You never gave up.

I'm lucky my daughter has a strong heart and a strong mind and a big mouth just like her mother, who would be so proud to see what a grown woman you've become.

[sniffs]

Thank you, cariño.

And you.

Hmm.

Thank you.

You were badass, Millicent.

I had my moments.

Sans éthique, mademoiselle.

Mr. Gonzales shows no signs of rejection.

Both father and daughter should make a full recovery.

It's not bad for a backward, recycled heart.

And a 60-year-old surgical technique.

They've arranged a car for us.

Oh, great.

Wha... You're not driving with me?

I think I'm just gonna sleep...

Prefer to live, thanks.

Okay, fine.

Yes.

If you'd come back, things would have been different.

[Besides Daniel's "In A Heartbeat" playing]

♪ Can you try to recall a sound ♪
♪ The way my whispers sounded then ♪

27 messages?

♪ Reach for it, you reach, reached for it ♪

Hey, Doc, I... I called Gabe's school.

I guess he's a little under the weather.

My afternoon is light so I'm gonna go pick him up.

♪ Danced in step ♪

Hey, Alex, so Gabriel has lice, um...

I got it covered, but he seems a little uncomfortable without you so whenever you want to come home, we're here.

Checking in. Um, I'm dealing with tiny bugs.

And their eggs. It's gross.

And I...

I don't think Gabriel is very comfortable with me.

So just let us know when you're coming home.

♪ You know I would in a heartbeat ♪
♪ In a heartbeat ♪

Okay, I... I washed anybody who has hair in this house, and now I'm washing the blankets, but I'm throwing out the sheets and pillow cases.

I don't care what you say, and hey, Gabriel is... he's being a big helper, although he still misses you so please still come home.

♪ Were to ask me to ♪
♪ ♪

Hey, Al, there's cold pizza waiting for you whenever you get home.

I'm letting the boys watch "Jackass."

Don't k*ll me, they're having a blast.

Oh, and, uh, Gabe wants to ask if it's okay for me to take him to school this week.

All right, well, take your time.

Love you.

♪ You know I would ♪
♪ In a heartbeat, in a heartbeat ♪