05x09 - He'd Really Like to Put in a Central Line

[bunniefuu]

Previously on The Resident...

Hope it's okay that I'm here.

- HANNAH: How dare you?
- What happened here?

CONRAD: If you stepped out of line,

then it won't just be Pravesh
who comes for you.

Surgery is a dangerous place.

Especially considering your condition.

You mean my dyslexia?

CONRAD: Tell me why
you aren't a scientist yet.

This is obviously your future.
You just got to go for it.

I would like to start shifting
my professional focus

to clinical trials.

Have a proposal on my desk by Monday.

("THE WEIGHT" BY THE BAND PLAYING)

(PHONE CHIMING)

(EXHALES)

♪ I pulled into Nazareth... ♪

No eggs, Daddy, please, no eggs.

I want cereal. And a banana.

Whoa, whoa, excuse me.

Coming right up.

(PAGER BEEPING)

♪ Hey, mister, can you tell me ♪

♪ Where a man might find a bed? ♪

♪ He just grinned and shook my hand... ♪

Daddy, did you forget
to go to the market again?

♪ Take a load off... ♪

I did.

I am a bad daddy.

No, you're not.

♪ Take a load off, Fanny... ♪

Let's grab your backpack.

We'll get something great for you...

takeout on the way to school.

♪ You put the load right on me ♪

♪ Ooh-ooh-ooh-ooh ♪

♪ I picked up my bag ♪

♪ I went looking for a place to hide ♪

- (SIGHS)
- ♪ When I saw Carmen ♪

♪ And the devil
walking side by side... ♪

That's another all-nighter.
This has got to stop.

- I know.
- You're wearing yourself out.

I know.

But I don't know how to stop.

♪ I got to go, but my friend
can stick around ♪

(GRUNTS)

♪ Take a load off, Fanny ♪

♪ Take a load for free ♪

- ♪ Take a load off, Fanny ♪
- _

♪ And, and ♪

♪ And you put the load right on me ♪

♪ You put the load right on me ♪

(PHONE CHIMES)

- ♪ Crazy Chester followed me ♪
- _

♪ And he caught me in the fog ♪

(PHONE CHIMES)

♪ He said, "I will fix your rack ♪

- ♪ If you'll take Jack my dog" ♪
- _

♪ I said, "Wait a minute, Chester ♪

- ♪ You know I'm a peaceful man" ♪
- _

♪ He said, "That's okay, boy ♪

(PHONE CHIMES)

♪ Won't you feed him when you can?" ♪

- ♪ Yeah, take a load off, Fanny ♪
- _

♪ Take a load for free ♪

♪ Take a load off, Fanny ♪

♪ And, and ♪

♪ And you put the load right on me ♪

♪ Put the load right on me... ♪

(BIRDS CHIRPING)

JANICE: Dude, I lanced
this massive abscess,

and the pus exploded
all over Dr. Feldman.

- Ah.
- He was pissed.

- Pus-wise, better him than you.
- Definitely.

Trevor, we know you made
the highlight reel.

TREVOR: Yeah, yeah.

No eruptions of bodily fluids, though.

You had that awesome spinal tap.

- Hello. Beer-gate? Legendary.
- (LAUGHTER)

Okay, Pravesh almost cut me, so...

Sure, but then Hawkins swooped in

and took you under his wing.
Please, golden boy.

- "Golden boy".
- I don't think anyone has any strong feelings

about me either way.

All right, well, I'd really like
to put in a central line.

Hey. Five-car pileup on Peachtree,

multiple injuries headed our way.

All hands on deck. It's game time.

♪ ♪

Dr. Hawkins, Bay .

- On it.
- All right, let's get him to Bay .

- Zach, with me.
- Gemma, Bay .

Pravesh, Bay . We're gonna need

- another set of hands in there.
- Okay,

Janice, Trevor, you come with me.

Pravesh!

- Give me Trevor.
- Go see what he needs.

CONRAD: Grab the ultrasound.

Right.

Assess her for internal injuries,

then we'll deal with the
lower-extremity lacerations.

Got it.

Whoa.

- Ma'am, what's wrong?
- It's not my stomach. I'm okay.

But he's not.

I watched him turn his bike
and drive right into traffic.

He caused all of this.

There's something
definitely wrong with him.

CONRAD: Hey, Zach. I need you
to do a quick FAST exam

and suture up some lacs.
Trevor, come with me.

The X-rays showed a fractured rib

but fortunately no broken ankle.

You're gonna be fine.

- You're in good hands here.
- Thank you.

You're welcome.

I-I really don't know what happened.

One minute I'm riding my bike,
next I'm on the ground

and cars are skidding and crashing.

I feel terrible.

Sounds like you might have passed out?

You got lucky. You could've been k*lled.

Getting lucky is kind of my thing.

Yeah? How's that?

I was on a charter boat once, it sunk.

Everyone drowned except me.

- I won the lottery twice.
- TREVOR: Cool.

Maybe you take a look at
the numbers I've been playing.

Happy to, Doc. (CHUCKLES)

Wow, you got the odds
of the gods on your side.

I have always felt protected
in an otherworldly way.

A-And those are just the highlights.

I also got diagnosed
with this thing, sarcoid?

- Mm-hmm.
- Supposed to be bad,

but it's never been a problem.

TREVOR: Sarcoid?

What medications
are you taking for that?

None. I'm not one to
take meds I don't need.

Too many side effects.

- Whoa, whoa.
- Oh, Wyatt.

Wyatt?

We need to get him on the monitor now.

- Hey.
- Hey.

Sorry you had to come in
on your day off.

It's k*lling me. I've got to get
my grant proposal done.

- How are you?
- Surgery went long. Don't ask.

Man, it's crazy in here today.

I know. Hi, Brit.

- (PAGER BEEPING)
- This is Dr. Devi.

She's the surgical consultant
I told you about.

Uh, I'm so sorry. Hi, Brit.

I probably shouldn't have come.

I've had this pain
on and off for months.

But I realized I'd lost ten pounds.

Without trying, really,
so I'm a little spooked.

I'm probably overreacting, right?

LEELA: Let's just start with an exam.

Ow! Right there.

Can you describe your pain for me?

Throbbing.

Or maybe stabbing.

Are you having any nausea or vomiting?

I thought I was just nervous at first,

you know, existential angst,
which I am prone to,

and it is kind of
my occupational wheelhouse.

I'm a cartoonist.

Life's a Joke.

- That's my strip.
- Hmm.

So, yes to the nausea and vomiting?

Oh, right, yes. Krakatoa,
east of Java, man.

Just keeps on coming up.

We'll start with a CT scan
to take a closer look,

and we can admit you
to get control over your pain

and we'll go from there.

- Okay?
- Cool.

DEVON: All right, we'll be back.

It's a large hepatic hemangioma.

That's a good catch, Dr. Devi.

LEELA: I haven't seen
one of these before.

Well, they're more common
than you'd think.

They're benign tumors
made up of clusters

of blood-filled cavities.

And usually they don't cause symptoms.

Well, I'm relieved it's benign.

My patient will be, too.
She's a little kooky.

Sweet, though.

Should I book an OR for us
this afternoon?

Oh, not so fast.
Surgery's not a slam dunk here.

A benign tumor causing pain?

Well, surgery on the liver
is always high-risk,

even in the best hands,
and pain can be managed.

Okay, so I tell her we're not operating,

and I need a repeat scan in two months.

And that's not the answer, either.

This is not something
we can decide here.

You need to talk to your patient

and get a sense of her risk tolerance

and the seriousness of her symptoms,

and then you tell me what
path you think makes sense.

All right. Can you come with?

Nope. She's your patient, you handle it.

Then meet me in OR ...
an, uh, emergent splenectomy.

Uh, minutes.

LEELA: So, you have two options.

If you go with the surgery
and it goes well,

- your symptoms go away.
- Awesome.

But surgery on the liver
is never an easy call to make.

It's an organ with many
large blood vessels,

which means we could run
into significant bleeding.

Oh. Not awesome.

And that circumstance would require

a much larger abdominal
surgery with complications

and a long recovery.

Are you with me?

Uh, sort of.

Uh, you understand, right?
I'm not a doctor.

I'm a cartoonist.

Right.

Um...

Do you take risks?

If you do, then we go with the surgery.

Are you cautious?
Then we hold off for now,

so long as your pain is tolerable.

(SIGHS)

I don't know, Dr. Devi.

Okay, you know what? Look.

It's okay. Big decision.

Think about it, and I will check in

as soon as I'm back from surgery, okay?

Okay.

Heart block. What is that?

Because of the sarcoid,
your heart's electric circuit

isn't working correctly,
so your heartbeat

slows to a dangerously low rate.

In some cases, it can stop completely.

Which, to state the obvious, is fatal.

This morning,
your heartbeat slowed so much

that you fainted and
you crashed your bike.

AUSTIN: But there is some good news.

Told you guys.

The solution to your problem

is safe and simple.

We put in a pacemaker,

and your heart goes back
to b*ating normally again.

So you're saying I need a surgery?

Yeah, and it's just
an outpatient procedure.

No general anesthesia,
no operating room.

It's super simple.

TREVOR: Another narrow
escape from death.

The Wyatt Barnes legend grows.

- Hey.
- (LAUGHTER)

I'd like to admit you
for observation, and then

we'll schedule the procedure
as soon as possible.

Oh, I don't want the pacemaker.

A-Admit me, fine, but, you know, finish

fixing me up and...
(TONGUE CLICKS) send me home.

No, you don't understand.

If we don't put the pacemaker in,

you will almost certainly die.

Almost?

I'll take those odds.

AUSTIN: We are doctors,

advising you on a procedure
that will save your life.

Sorry, but it's my body, my decision.

No pacemaker.

No, thanks.

- Hey, we need a cart over here!
- Now that you're spending

more time on research
and clinical trials,

we need a new ER doctor.

And I'd like you to do
the interviews today.

I would, of course,
but I'm only filling in

for a few hours today.

And I didn't set aside time for that.

There must be someone else who can help.

There's no one.
And I worked here all night.

I'm sorry. Here are the candidates.

Dr. Voss, I have to get my
grant proposal in by : p.m.

Your proposal will have to wait.

And I don't need to remind you why

we're short-staffed in the ER.

Yeah. I get it.

- (PAGER BEEPING)
- Thank you.

I'm counting on you.

Happy to help.

(PHONE CHIMING AND BUZZING)

♪ ♪

So, our Mr. Lucky has complete AV block

with wide ventricular escape.

He's not gonna live
long enough to cash in

his third lotto ticket
without a pacemaker.

(SIGHS)

I mean, you think he wants to die?

(PHONE RINGING)

Yeah, the guy's super
cheerful. It's bizarre.

Mom, listen, I'm in the middle of...

Well, is-is the cough
getting any better?

Did you call the oncologist?

Mom, just do it now, please.

Yes, I will see you
before I go to the airport.

Tell Carol I'll call her,

talk her through some options
for her respiratory symptoms.

Appreciate it, man.

Look, I-I wish I could engage.

All right? I-If there were
hours in the day,

I would gladly wax poetic
with the patient

about the benefits of a pacemaker,

but I do not have the time.

I have way too many patients
who would k*ll for an easy cure.

I got too many, too many obligations.

All right, you get him to see reason,

I have no doubt that you will,

then I will come back,
I'll put in the pacer.

(EXHALES)

Okay. Have you, uh...

you seen this problem before?

All the time during the pandemic.

We had a lot of patients who
d*ed claiming COVID was made up.

Well, what do we do next?

He agreed to a brief admission,
so we bring him up to the ICU,

start him on isoproterenol
to raise his heart rate

while I figure out a way to respectfully

get him to see reason.

I will watch and learn.

Hey, Brit, have you had some time

to review your options?

She was here a minute ago.
She should be back soon.

And if you had to change one
thing about emergency medicine,

what would it be?

Well, we're letting money
walk out the door.

That's for sure.

Uh, I personally would deploy
a-a number of strategies

that would be more lucrative
for the hospital.

Uh, I mean, you can't fix

all the inefficiencies at once,
you know?

You got to let this, uh,
this pig work its way through

the-the boa constrictor, so to speak.

So, I created some slides here,
uh, with ideas

for how to capitalize
on low-hanging fruit.

I'll talk you through it.

Uh, shouldn't be more than, uh, an hour.

Or two.

Brit?

I've been looking everywhere for you.

Has your abdominal pain gotten worse?

You shouldn't be out here.
We should get you back inside.

It's not that, Dr. Devi.

I had to get some air so I could think.

Okay.

I can't decide about the surgery.

I tell myself, "Go for it".

Then I think it's too dangerous.

What if I bleed to death
in the OR and my cat dies alone?

Or I go home and die and no one
finds me and Tinkerbell eats me.

- You have to take it easy, Brit.
- Sometimes I wake up

and she's staring at me
like I'm a goldfish.

There's a darkness in her.

I'm indecisive.

Even about things that don't matter.

My cartoons poke fun at people like me.

Brit.

What can I do to help you
make this decision?

Make it for me?

Just be my doctor.

I'll do whatever you say.

(MONITOR BEEPING STEADILY)

How am I doing?

CONRAD: Your heart rate
is dangerously slow.

.

Meds helped transiently,
but they can't fix this,

and it's getting worse.

I feel fine.

That's impossible, okay?

You have to be tired, light-headed...

Not really.

I'm hungry.

This place have ice cream?

Yes... (CHUCKLES)

... but let's finish talking first.

A pacemaker is a simple device.

It is not dangerous to put in,

and it will keep you
from falling off your bike

in the middle of traffic.

Or dying today.

Which could happen.

It's not gonna happen.

- What are you afraid of, Wyatt?
- (SCOFFS)

I'm not afraid.
I just don't like the idea

of having a foreign object
put into my body.

Do you know anyone with type diabetes?

Yeah. My old boss.

Did your boss use an insulin pump?

She does, but what you're talking about

is putting something in
to control my heart.

That's different.

No. Not really.

Uh, complications
from pacemakers are rare.

WYATT: I'm sorry, but
I do my own research.

I'm part of this Facebook group.

- Oh, here we go.
- And they just published a list

of unsafe products from China.

Know what's on top? Pacemakers.

Now, they're assembled here,

but guess where the parts come from.

Yep. Guy in the group got
poisoned by some bad metals.

Those posts aren't truthful, Wyatt.

They are propaganda
from unqualified people

who have politicized
health and medicine.

They either want to
sow distrust in science

or sell you snake oil.

TREVOR: The real truth, Wyatt?

Bad metal is not a thing.

Dr. Hawkins is who you
want giving you advice.

He's an actual expert.

I form my own opinions, okay?

- You have yours.
- Okay, this isn't an opinion.

It's fact versus fiction.

- Do you understand?
- CONRAD: All right.

We hear you, Wyatt.

Okay?

Be back to check on you in a bit.

Thanks, Doc.

He was getting more and more dug in.

- You have to know how to take a step back.
- Okay, but if Wyatt dies,

it won't be sarcoid that kills him,

it'll be i-irrational fear
and misinformation.

And those are difficult
conditions to cure.

- I...
- Some people only accept information

that confirms their beliefs.

You have to give them the facts,

tell them how important the science is,

- but then if you push too hard...
- I get that, but if...

... we lose what little trust
we may have earned.

Even when you're , % right.

- Uh... He's gonna...
- Gentlemen.

So I don't see your patient
on my cath lab schedule.

- What happened? No pacemaker?
- Uh, not yet.

We were just getting ready
to discuss next steps.

The guy actually believes in luck.

As in, he's too lucky to die.

He did tell us
he's always felt protected

in an "otherworldly" way.

An argument could be made that
he doesn't have the capacity

to make medical decisions for himself.

Well, if he's making
his decision based on

otherworldly information,
you may be right.

I'll call Dr. Malco
in the psych department.

Let's hope this works.
Wyatt's running out of time.

Wyatt, why don't you tell me
in your own words

what's going on
with your health right now?

It's pretty simple.

I've never liked hospitals,

but I came here
because of a bike accident.

They escalated the whole thing
by threatening

to put in a pacemaker.

Do you know how many
people get a pacemaker?

They're slapping them
into everybody these days.

Why don't you trust your doctors?

I make up my own mind.

And, look, I'm not crazy.

You know, agreeing to have
doctors I just met

implant something into my body
is what's crazy.

We just need to make sure that
you understand the consequences

of the decision you're making here.

I've been listening
to those two all day.

Of course I understand.

And there's something you need
to understand about me.

And what is that?

You're not gonna change my mind.

And if I do die, I don't want anyone

going wild and pounding
on my chest, okay?

Write that down in your little notepad.

We all have to die someday.

And I am not going out like that.

- Dr. Bell?
- Yeah.

- Do you have a second?
- Mm-hmm.

(EXHALES)

Please tell me this gets easier.

Is this about making
a life-or-death decision

- for a person you just met?
- Yes.

It should never be easy.
This is the job.

It's not irrational
for a patient to think

we know more and should decide for them.

What if I can't figure out
what's the best way to go?

You will, because you have to.

That's what your patient needs.

So go with your gut, Dr. Devi,

informed by your experience
and your schooling.

- Okay?
- Okay.

PADMA: Dr. Voss.

Tell me what you need. I'm here to help.

Well, I'm realizing that all our doctors

are in danger of burnout.

The stress at times can be unrelenting.

Maybe your program can help.

I would love that.

I offer yoga sessions, meditation,

sleep counseling
and positive affirmations.

Plus, fresh-baked
resiliency cookies. Gluten-free.

I think I could make everybody
ten percent happier, at least.

I would invest in ten percent happier.

When can you start?

Shall we start now?

(LAUGHS): Yes. Sign me up.

- Come sit down.
- Oh.

Just five minutes.

- Lie down, put your feet up.
- Oh, wait, I can't. I'd be...

(LAUGHING): All right. Okay.

(CLEARS THROAT)

Close your eyes.

And now just take
a deep, cleansing breath.

(PAGER BEEPING)

Ooh, sorry.

- Later. I promise.
- Okay.

(LAUGHS SOFTLY)

♪ ♪

(SPEAKING SPANISH)

- Do you speak Spanish?
- (CHUCKLES) No.

I don't think there's room in my head

for any more words
I'm supposed to understand.

Do you mind turning it down?
I promise to keep this simple.

(TV TURNS OFF)

Based on the size of your
hemangioma and your symptoms,

if it were me, I would
go with the surgery.

(EXHALES)

Surgery it is. When?

Well, we can operate later today.

But I would like to take you
through the consent.

There are risks.

Bleeding, infection,
damage to your liver.

It's possible but unlikely
that we'll have trouble

getting you off the ventilator.

And as with any surgery,
there is a risk of death.

Have you done this operation often?

Uh, no, I haven't,
but the senior surgeon

I work with has, and he'll be there.

(EXHALES)

Pen.

All right.

BRIT: Thank you.

(PEN SCRATCHING)

He's clear and consistent.

I don't find him to be influenced

by untreated depression,
and he's not suicidal.

His choice isn't one that
I would make for myself

or someone I love, but it's one
he has a right to make.

What do you make of his belief
that he's cosmically protected?

Hearing celestial voices is one thing,

but it's human nature to search

for explanations for our experiences.

Just describing them
in ways that are fantastical

doesn't signify a lack of capacity.

Um, I'm sorry, it makes no sense.

I mean, look how young he is,
and he even requested a DNR?

Which is a sign that
he's-he's clear and coherent.

Look, lack of capacity is a high bar,

and Wyatt doesn't reach it.

I'm sorry.

- You have to respect his wishes.
- All right, thank you, Leslie.

Uh...

Is that really it?

If he's determined to have capacity,

we can't force him to be treated.

Wait, hold on, I thought
you were the renegade.

I heard you drilled into a guy's head

and you're not even a surgeon.

But you're gonna sit here
and let this man die?

If the guy would've said,
"Whatever you do,

don't drill into my head",
I wouldn't have.

It's pretty simple.

You can't do what the
patient doesn't want.

Okay, this is what we're gonna do.

I did a deep dive into temporary pacers.

Wyatt passes out,
we get the pads on him,

shock him if we need to, slip it in

- at his bedside.
- Hey.

(WYATT SHOUTING)

CONRAD: Let's get him some O .

I'm nauseous. My stomach hurts.

What's going on?

Gut ischemia from poor perfusion.

Your heart rate's too low.

Let's get him some pain meds.

Page Bell.

- Okay.
- (PANTING)

(CRYING SOFTLY)

BELL: Okay.

Yeah, he's-he's calmer now
with the pain meds on board.

It's highly likely he has dying bowel,

but he's not a viable
candidate for surgery.

Unless we get him to agree to a pacer.

And, yeah, if you do, tell me,
and I'll take him to the OR.

As of now, all the complications

from his untreated
heart condition are fixable,

- but I don't know for how long.
- (PAGER BEEPING)

He's refusing all intervention.

Is there anything else I can do for you?

I wish there were.

Okay, just... just hear me out.

All right, you know
the Dax Cowart case, right?

He wanted to die after suffering
catastrophic burns.

He was in pain,
terribly d*sfigured, went blind.

And he was ruled to have capacity, too,

but his doctors disregarded
his wishes and saved his life.

Mm-hmm.

Yeah, he had a career, he had a family,

I mean, he lived until he was .

Wyatt can have the same thing.

Dax Cowart became a lawyer
and built a career

on fighting for patients' rights.

He used his own case to show
what the doctors did,

what you want to do to Wyatt,
was a betrayal of those rights.

It's not a betrayal of his rights.

Hey, I'm as frustrated as you are.

As doctors, our purpose is to help.

And you got that part right.

But Wyatt needs to want to be helped.

No, until he's dead, I'm not giving up.

Then neither am I.

(WASHING HANDS)

(DOOR OPENS)

BELL: Sorry I'm late.

Had a rough consult
with Conrad's patient.

The exact opposite of Brit.

He doesn't trust Conrad,
for all the wrong reasons.

And here I am tied up in knots

over a patient who trusts me too much.

You made the best decision you could

with the information you have.

(WATER RUNNING)

You have a very unusual career path.

What brought you from oncology
to emergency medicine?

So much suffering and death.

The patients call you
weeping at all hours

of the day and night.

I-I was worn out from the stress.

Those days ruined me. And now?

Just off a shift, look at me...
I'm still fresh.

Well, it must have been
a challenge to go back

to residency and learn
all the ER procedures.

Hmm, I'm not one for new techniques.

I pretty much slept
through that residency.

- It was no big deal.
- I see.

(MONITOR BEEPING STEADILY)

WYATT: I told you, Doc.

If God wants me to live, I'll live.

He'll reach His hand down to me.

He's always been so good to me.

TREVOR: Is this about luck now, Wyatt?

Or God?

He can't save you right now. We can.

Leave me alone, Doc.

No. Wyatt...

- Trevor.
- You just, you got to listen to what I'm...

Trevor. Trevor, take a walk now.

He's young.

But he cares deeply.

And I respect your faith in God's will.

I'm in His hands now.

And you always have been, right?

How do you know He is not
using us to save you?

You think he wasn't sitting
beside Rune Elmqvist in Sweden

half a century ago when
he invented the pacemaker?

He is sending you one lifeline
after another.

Hey.

I'll ask Him.

Wyatt?

Wyatt.

(LAUGHS)

(RAGGED BREATHING)

BELL: Yeah, the liver is exposed.

LEELA: Ready to begin the enucleation.

BELL: Remember, the beauty
of this technique is that we,

we work along existing planes
to pop the mass out

and we leave the liver intact.

That's how we avoid massive bleeding.

And note the vessels
extending into the liver.

Divide and ligate.

Be careful.

LEELA: Ugh, I have a tiny bleeder.

Cautery.

And another one.

Okay, suction.

Okay, that's arterial. Clamp.

JESSICA: Dr. Bell? Here's the clamp.

LEELA: Are you okay?

BELL: Uh, no.

LEELA: Jessica, I'll take it.

BELL: Uh, Dr. Devi, I have to leave.

LEELA: What?

BELL: I-I'll find someone to
cover as soon as possible.

Uh, as soon as possible.

LEELA: Dr. Bell.

JESSICA: You can do this.

LEELA: I've got the mass
on the last vascular pedicle.

Any word from Bell?

JESSICA: Nothing yet. You'll probably
get this sucker out of here

before anyone comes.

(MONITOR BEEPING RAPIDLY)

CHU: Pressure's drifting down, Dr. Devi.

LEELA: She's losing blood. Let's
get some blood products in her.

JESSICA: Tell me what you need.

Lap pads and suction.
I'm operating underwater here.

If I can't find the source for
the bleeding, I can't fix it.

CHU: Two units are in, and I activated

massive transfusion protocol.
We're maxed on norepi.

LEELA: Found it.

CHU: You've got to get
control. She won't tolerate

this blood loss much longer.

LEELA: I need to remove
the portion of the liver

the vessel is feeding.
Prepare for a hepatectomy.

JESSICA: That's a serious
change in plans.

We should call Dr. Bell first.

LEELA: No time. Clamp, now.

Chu, give her : :
resuscitation to keep up.

- Jessica, do not stop that suction.
- JESSICA: Got it.

LEELA: Got it.

CHU: We've got a stable pressure.

- (CHUCKLES)
- CHU: Strong work, Dr. Devi.

(LEELA SIGHS)

JESSICA: You did it.

- (CHUCKLES)
- LEELA: Let's get her closed up

and off this table.

What do you think the evidence is

behind cookies for stress relief?

- NOLAN: Anecdotal but robust.
- I'm really feeling

- the chocolate chip.
- HUNDLEY: Dr. Austin?

Of all people.

Do raptors do yoga?

I'm only here because my CEO
told me I had to be here.

But I won't be here for long.

I have to round on the post-ops again

before I fly to Manhattan tonight

- for talk shows tomorrow.
- DEVON: Well, I'm stiff,

my back is in knots.

I've been in interviews all day,

looking for an actual doctor
who likes actual doctoring.

PADMA: Welcome, health care heroes.

Uh, listen, I am not a man

that you will find in Child's Pose.

So I'm just gonna be on my way to...

AJ, I happen to know
from personal experience

that you could really benefit
from a little extra flexibility.

- (LAUGHTER)
- All right, come lie down and grab a mat.

- Close your eyes.
- (GRUNTING)

Let the world fade away and just relax.

- (PAGER BEEPS)
- It's the ER.

(PAGERS BEEPING)

Oh, that's my next interview.

Med-surg floor.

My mother's having another complication.

- (BEEPING STOPS)
- I mean, I feel

so blissed out right now.

I feel like I'm back to zero.
I feel great.

You know, after this is all done,

I think that you and I should go
to this great little vegan place

that I know about in Inman Park.

It-It's wonderful.

It's the best tempeh à la King
you will ever have.

You're cute. Not a chance.

(SIGHS)

- That's a, that's a no, then?
- (PAGER BEEPS)

Okay, Wyatt Barnes'
heart rate is in the s.

He has gut ischemia,
his kidneys are failing.

Without a pacer, he's dying.

We're running out of time,
and he's waiting

for the hand of God to reach down

- and-and save him from...
- First of all, back up.

You're in my personal space.

And you have intern coffee
breath, which I do not like.

Okay, look, look, look,
with all due respect,

Dr. Hawkins seems to have lost his edge,

it's gonna cost a young dude his life.

Can you please just
put in a pacer, please?

- I have one right here, come on.
- Put that away.

You are a green recruit

questioning the general on the field.

W-Wait, hold up. If someone
came into this hospital

after slitting their wrists
or-or taking pills,

we'd save them, right?

Wyatt Barnes is doing the same thing.

This is not a su1c1de.

This is a man with capacity
refusing intervention.

That's a right we cannot abridge.

His recalcitrance is not jeopardizing

anyone else's health.

- He's only hurting himself.
- Okay, but he is hurting himself...

Trevor, stop.

Now you go back to your patient's room.

You watch Dr. Hawkins
and you do what he says.

Stop second-guessing him.

You might learn something.

(MONITOR BEEPING STEADILY)

Please let me save you, Wyatt.

I have everything we need.
You just say the word.

Think of all the beautiful things

you'll never be able
to experience again.

I don't know what happens when you die,

but I bet you don't get
to kiss a woman...

... and know you want to be with
her for the rest of your life.

Don't you want to wake up
on the first day of fall?

Eat a peach?

(LAUGHS)

Laugh your ass off
with your best friends?

You don't have to give up any of that.

Think of how lucky that makes you.

(LAUGHS SOFTLY)

Is he still saying no?

(EXHALES)

Do it.

Please.

What are we here for, anyway, huh?

To watch people
we could save just... just die?

I was here to save him.

Now we're just here to make sure
he doesn't die alone.

(SNIFFLES)

(FLATLINING)

He's your first death.

Yeah.

Not how I imagined it would go down.

You pictured a different
kind of heroism,

blood spattered
all over your white coat.

(EXHALES)

Do you ever get used to it?

It never gets easier. It just...

It just gets different.

But today was no small
accomplishment. Dr. Daniels.

We allowed him to live and die
according to his principles,

and because of that,
we managed to keep ours.

Look, again, I'm-I'm sorry
about what happened in there.

Well, I'm relieved you're okay.

No, I-I'll be fine, it's just...

It's a pinched nerve and...

little bit of vertigo
that came on suddenly.

I think, you know, I-I overreacted,

but in the moment, I-I thought
if I stayed in the OR,

you'd have two patients
to deal with, so...

Well, then, you did the right thing.

So did you.

This time.

But, to be honest, it could
have gone either way.

- Hi.
- So?

Did you find anything else
horrible inside me?

I'm vaguely optimistic

because I have a familiar sense
of existential dread,

and I'm pretty sure that can't
be removed surgically.

The surgery went great.

You're going to be fine.

Thanks to Dr. Devi.

There was a complication during surgery.

We had to remove
a small piece of your liver.

But it will grow back.

And the hemangioma is gone for good.

Thank you. I mean, really, thank you.

And you made the right
decision for me, too.

Can I call you next time
I'm buying a new car?

- (LAUGHS)
- Or don't know what to do

when I get in a fight with my mom?

I actually am a triple board-certified

mother vanquisher.

(CHUCKLES)

DEVON: So...

it's a no.

Even the former oncologist?

He's burnt out.

He's not interested
in learning anything new.

H-He doesn't love medicine.

None of them do.

Keep looking. It's just the first round.

No need to be discouraged.

And the thing is, Dr. Voss,

when I was talking to them, I realized

I might not be so different.

Of course you are, Dr. Pravesh.

I am judging people for
not loving medicine enough

while trying to cut down
on clinical time

to go do research.

I think about being in the ER

year after year after year,
with no outlet for research,

and I don't know how we don't
drown in the sickness,

the sadness, the pressure,
the paperwork.

(EXHALES)

Half of my med school class
isn't doing medicine anymore.

That means something.

Yes, I think it does.

BELL: Hey.

Hell of a day.

Yeah, I heard.

So, how tempted were you
to put in the pacer

- against the patient's wishes?
- More than I'd like to admit.

But there are some rules we can't break.

Do I know I made the right choice? Yeah.

Do I wish I'd made the wrong one? Maybe.

I know my intern thinks so.

I heard Dr. Daniels has
a hard time with the rules.

But maybe the example you set
saved his medical career.

To say nothing of your
responsibility to your patient.

Yeah, he's a bright kid, that Trevor,

but too much confidence and passion,

not nearly enough restraint.

He learned something today.

If I'd have saved Wyatt,

would he have come back in ten years

with an armload of kids,

grateful that we didn't listen to him?

(EXHALES)

And now I realize none of this
is why you are here.

Nope.

I got a favor to ask you.

What?

But, look, before
I even-even spell it out,

can I count on you
for full confidentiality?

Go on.

Something's wrong with me,
a-and I'm not quite sure what.

But I think it may be serious.

You want me to examine you?

Yeah, I'll clear my schedule tomorrow.

Let's come in early.

And the fact that
I'm being tested at all,

the results, all under the radar.

So, is that something you can do?

(SIGHS)

Okay. Great, thanks.

(DOOR SLIDES OPEN)