01x02 - Natural Order

[bunniefuu]

Previously, on
"Good Sam"...

You're supervising
these doctors.

You're above them in
knowledge, rank and skill.

Act like it.

It's like undermining me
as a sport for him.

I think I'm gonna take
the Cleveland offer, Caleb.

- You don't want to do that.
- Are you saying

I should stay?

- It's not about me.
- Yeah.

Dad!

My father can never be replaced,
but I vow to carry on his legacy

to the best of my ability.

You've earned this.

And I say that
as your chief medical officer,

not your mother.

I'm Sam, by the way. I'm Malcolm.

Kingsley. I'm the new director of finance.

- Sam!
- Mom?

It's your father.

He's waking up.

You were sh*t six months ago.

How long...

till I can work again?

You have to be proctored.

Oh, come on.

It's state law.

I'll do it.
I'll supervise him.

What, do you have company?

I wanted to tell you.

A resident, Griff?
Sam's best friend.

I've decided to continue
proctoring you,

if that's what you want.

I want to be very clear.

I am making this decision
as a doctor.

As your daughter,
I'm calling it.

Good morning, boss.

Getting to work bright
and early.

Bright and early means arriving
before the boss.

Who says I won't?

Edwin Starr's "w*r" playing...

♪ w*r, huh, yeah

♪ What is it good for?

♪ Absolutely

♪ Nothing Listen to me, ah

♪ w*r, I despise

♪ 'Cause it means destruction

♪ Of innocent lives

♪ w*r means tears

♪ To thousands of
mother's eyes ♪

- ♪ Say it
- ♪ w*r ♪

♪ Huh, good God, y'all

♪ What is it good for? ♪

- ♪ Absolutely, just say it again ♪
- ♪ Nothing ♪ -

- ♪ w*r, huh ♪
- ♪ Whoa, oh, Lord

♪ What is it good for? ♪

♪ Absolutely, listen to me ♪ Nothing ♪

♪ w*r, huh♪♪ Whoa, oh, Lord

♪ What is it good for? ♪

♪ Absolutely ♪ Nothing ♪

♪ Listen to me

♪ Huh, oh, w*r

♪ It's an enemy

♪ To all mankind

♪ The thought of w*r

♪ Blows my mind

♪ Induction then destruction

♪ Who wants to die? Oh!

- ♪ w*r, huh ♪
- ♪ Good God, y'all

- ♪ What is it good for? ♪
- After you.

- ♪ You tell me
- Thank you.

♪ Say it, say it, say it,
say it ♪

- ♪ w*r, huh ♪
- ♪ Good God, now

- ♪ Huh
- ♪ What is it good for? ♪

The point of proctorship is
to ensure

a surgeon's skills
have not diminished

during a leave of absence.

The guidelines are rigorous.

But then again,
so is heart surgery.

"A proctorship's
successful conclusion is a win

for the returning surgeon
and the patients in his care."

It's all there. Well, I want to start out

on the right foot,
and I want to make sure

that the terms are clear
and easy to follow.

I just don't know that
clarity is the issue, Sam.

I mean, we're talking about
your father.

We're talking about
my colleague.

I am in as a doctor.
Out as a daughter, remember?

Good. So you've drawn
your boundaries with your...

colleague, but, um...

What about Lex?

Hmm? Have you, uh,
have you talked to her?

Uh... About work, yes.

About having an affair
with my father, no, not so much.

But she's your best friend.

I appreciate your concern.

But right now,
this department head

needs her CMO more than
your daughter needs her mother.

I'm gonna get these guidelines
to Dr. Griffith right away.

Thank you.

Hey, um,
sorry to interrupt.

Uh, year-end projections
just came in.

Thank you, Malcolm.

I'd like to review those
before tomorrow.

Hi.

Hi.

I'll be, uh, in my office.

So, what's tomorrow?

Board meeting.

Does that mean you're preparing

for Mr. Byron Kingsley's
arrival?

He is the chairman of
the board. So, tomorrow

is Take Your Dad to Work day
for both of us?

Uh, yeah.

Yeah, always puts me a little
on edge when he comes in.

Is there anything I can do
to help?

You could go to dinner with me
tonight.

Well...

Dinner for me, uh,
is usually takeout

in the lab,
awaiting test results.

And for me it's takeout
on the couch,

watching Cupcake Wars.

You bake? I watch other people bake.

We should go out to dinner.

Wow.

Nice haircut, Donna.

Thank you.
Morning, doctors.

What do you say, Donna?

Is today the day
we run away together?

Try again next week
when my wife's out of town.

No one else thinks
this is weird?

Griff was our boss,
and now he's, what,

a resident like us? He's being supervised.

It's how proctorship works.

Lex, you agree,
it's weird, right?

It's only weird
if you make it weird.

How do I make it weird?

You try too hard with him, Isan,

and it always backfires.

You end up tripping
over your shoelaces,

dropping your instruments.

Cornering him in the men's room.

I don't corner him
in the men's room, Joey.

No, you just told him
a knock-knock joke at the urinal.

I was making
small talk.

It's not my fault we're forced
to pee next to each other.

Women get their own private stalls.

Oh, right. This is all because
the world is unfair to men.

- Morning, everyone.
- Morning.

Good morning. Thank you. Let's see.

Eval for a mitral
valve replacement.

- Atrial fib.
- Morning.

Right on time.

Consider that
an accomplishment, do you?

Well, given how far away
my new parking spot is,

and then I have to... What do we have?

Patient with a lung mass
needs VATS for biopsy.

And what else?

Ten-month-old with a persistent
cough and a new murmur.

Peds is asking for a consult.

Uh, since when do we take
pediatric cases?

Oh, since I instituted
a cross-departmental policy

to integrate care,

which has significantly
improved patient satisfaction.

What's next,
a tonsillectomy?

We are gonna start
with the peds case.

And Dr. Griffith will join us

after he pages Dr. Chen
in radiology.

And why am I paging Dr. Chen?

Well, I have a feeling
he's looking for his white coat.

Before you offer opinions

on the cases I take,

please make sure
you've dressed yourself properly,

Doctor.

*GOOD SAM*
Season 01 Episode 02

Episode Title: "Natural Order"
Aired on: January 12, 2022.

First, they said
it was a cold,

and then they sent us here.

Nobody can tell us what's wrong.

And his cough keeps
getting worse.

When did it start?

Weeks ago.
What, two, three?

Ellie, for the last time,
put on your shoes.

How Bohemian.

Is there any family history
of heart problems?

Not that I know of.

Let's get a nebulizer

with 2.5 milligrams

of albuterol. You got it.

His heart muscle does appear
to be inflamed,

so I'd like to put him
on an anti-inflammatory

and do a breathing treatment
to calm the cough.

He's just been suffering
so much.

Let's also run
a 12-lead EKG

and do a bacterial culture.

Well, it's most likely viral,
so..,

Well, given the abnormality
in the X-ray,

I would like to be sure.

Let's give it back
to Dr. Hamamura in peds.

Those symptoms are basically...

- Oh!
- Ellie.

Here you go. Ready?
There we go. Sorry.

The findings are nonspecific.

Hence my desire for
more diagnostic testing.

We should have
some answers

for you all very soon.

How long are we gonna do this?

You won't make
eye contact with me,

you barely speak to me. What
do you want me to say, Lex?

Whatever you need to say
for us to get through this.

We have always been straight
with each other.

That was before you slept
with my father.

I trusted you.

I confided in you about him.

And this whole time, you...
No, not this whole time.

I swear, it just started a few
months before the sh**ting.

The fact that it started at all.

What is the drama
with them?

I don't know.
Ask Lex.

I did.

She told me to go back
to my hobbit hole,

which makes no sense.

What makes no sense?

Well, hobbits
are famously short,

and they have hairy feet.

I possess neither of
those traits.

You're more hobbit-y
than I am.

Wow, thank you.

What's the holdup?

What are we talking about?
Oh.

Uh, just... feet.

My feet, uh,

which are not hairy.

Not that there's
anything wr...

I mean,
you could have hairy feet,

and that's a beautiful thing.

Wow.

I can't do this right now.

Is that how it's gonna be
from now on?

This is how it's gonna be today.

I've reviewed your chart,
Mr. Morris.

Ted's fine.
Okay.

How long have you had
the palpitations

and the dizziness? Um...

A couple weeks,
but it's-it's getting worse.

That is a rapid heart rate.

I'd like to revisit
the dosages of your medications.

I don't take them.

I don't like pills.

Besides, I, uh,

I pretty much felt fine
up until now, so...

Says you almost passed out
a couple times.

That doesn't sound fine.

Well, I'm just,
I'm tired, you know.

I'm-I'm not
the greatest sleeper.

Well, given your history
of carotid artery disease,

this could be a critical lesion
that needs intervention.

Exactly.
I'd like to admit you.

And-and stay here?

- Yes.
- Overnight?

Yes.

No way.

Mr. Morris, you may need
to have surgery.

Yeah, you know what?
I-It's fine.

I can always come back tomorrow.

I just, I just
can't sleep here.

Can't sleep at home,
though, either.

Can you?

Given how many times
you're woken up

by your own snoring?

How-how do you know I snore?

Have you lost vision
in an eye recently?

Just for a minute or two?

Yeah, yeah, but I thought
it was a migraine.

Hmm, well,
it wasn't a migraine.

It was a stroke.

Well, a ministroke.

Next time, it'll be
a full cerebrovascular accident.

We're talking, well, paralysis,
speech problems,

- brain damage.
- Wait, I-I didn't...

I didn't tell anybody about
my eye. How do you...

How-how do you know this?

I've been doing this job
a long time, Ted.

Guys like you...
Young, don't smoke,

no diabetes, no hypertension,

none of the typical risk factors
for carotid artery disease...

You all snore,
and you're also stubborn,

which means if you've
experienced warning signs,

you ignored them.

It's why guys like you,

who shouldn't even have
this disease,

usually end up dying from it.

But, you know...

Hey, Hamamura.

We got a triple CABG later,
you want it?

Do I want your coronary artery
bypass surgery?

Yeah, you know, I thought
since we were doing your job.

Keeping that baby alive is,
in fact, all of our jobs.

And I'm happy to consult.

I'll be in touch.

Okay.

Your proctorship requires that
you comply with my directives,

not question them.
It's all in the guidelines I sent to you.

Mm, about those guidelines...

Surgeon's knots?

Sim Lab?
Isn't that a little remedial?

They're standard benchmarks
for evaluation.

And we can't skip
the baby steps?

No, you can't skip
basic skill assessments.

I thought the goal was
to get me back into surgery.

It is, once you've proven
basic competency.

You're questioning
my basic competency?

I am saying that you have to

follow the rules
like everybody else.

Studies show that even
two weeks away from surgery

diminishes performance,
and that's for surgeons

who weren't in a coma
for six months.

Accelerating your time line is

just not in the patients'
best interest.

Which one of us just prevented
a patient from walking out?

You can't skip ahead
without putting in the time.

That's funny.

I know a department head
that did exactly that.

Do you have
an emergency contact,

since you'll be staying
here overnight?

Yeah, my wife.

Well, my ex-wife.

Well, I only see
an email address.

Um, yeah, that's...
I-I don't know her number.

She, uh, she changed it
when she left.

Sounds like she'd maybe
rather not be contacted.

She's just mad, you know.

It's just who she is.

How-how long's it been?

How long were we married?

No, how long since she left?

Um...

About eight-eight years.

Give or take.

He doesn't take his meds
for his heart condition.

Doesn't realize his wife's
not coming back.

That's how denial works.

You see what you want to see.
You ignore what you don't.

Where is she going?

Well,
if I had to guess,

I'd say she's going out.

With him.

What, like a date?

No. No way.

Hey, Caleb.

What's that you were saying
about denial?

I'm not saying

that I wish my dad were

still in a coma.

You're thinking you have had
better conversations

on a first date.

Actually, I am thinking about

how beautiful you look
right now.

Well...

I am, uh...

better at taking vitals
than taking compliments.

Yeah.

Thank you.

You are welcome.

Right this way.

Yeah. Mm.
Uh-huh.

Okay.

I needed this.

To get out of the hospital,
mentally and physically.

And tonight,
all I want to think about is...

My dad.

Sorry?

My dad is here.

And he's having dinner
with my dad.

The chairman of the board.

He's trying to go
over my head.

Skip to the end
of his proctorship.

Hey.

Hi. Ugh.

I'm sorry again
for bailing on you last night.

And I am sorry
for accidentally taking you out

on the worst double date
in history.

It was a long night,

but I am almost done here.

What is all of this?

This is every study I could find
on the value

of empirical assessments
for surgeons

- after an extended leave.
- Hmm.

Before my dad convinces
the board to fast-track him,

I just think they should see
all the data.

- This is a lot of data.
- Yeah.

Which I find to be very, um...

What? Preachy? Pedantic?

Sexy.

Oh.

Data is my love language.

You and me both.

My mom is gonna slip these

to the board
before the meeting.

If they let my dad have his way
and something goes wrong,

they'll have blood
on their hands.

Oh, my God. Okay, you...

You didn't put that in there,
did you?

Not in so many words.

Good.

'Cause I'm guessing that
blood on their hands is not

their love language.

How are his vitals?

Blood pressure 184/124.

Heart rate in the 120s.

Hmm. Let's increase
his nicardipine drip

and order a beta-blocker.

Why haven't you done
the surgery yet?

You have to be medically
optimized for surgery,

and that can take some time,

especially
since you didn't take

your prescribed
anticoagulants.

Can't you just do it?

- Well, I...
- Dr. Griffith can't

perform surgery right now.

- Why not?
- He's undergoing proctorship.

I'll be hands-on.

I'll supervise
the whole time.

In a completely hands-off
kind of way.

Look, I just, I just want
to get this over with.

I understand.

But there is a reason

that we do things this way.

We want to reduce your risk

and increase
your chances of success.

And so, cutting corners

or rushing the process

would not be a good idea.

No matter what the board says.

There's the enlargement we saw
on the X-ray.

The muscle tissue in the left
ventricle is very thick.

The word is "hypertrophic."

His heart
muscle is enlarged,

which can cause

a fluid backup in his lungs.

It might explain the...

Page Respiratory for me now.

Why don't we step
outside, please?

- Why? What's going on?
- Let's go down to the cafe.

What...

- Baby's in V-tach.
- What's wrong with him?

Crash cart! Cart! What's wrong with him?

Get me the pace pads,
I need to shock him out of it.

We need you to step outside.

I'm not going.

Spontaneously converted.

Get him on an ACE inhibitor.

I want an MRI as soon
as anesthesia can do it.

I don't understand.

- He had an arrhythmia.
- What caused that?

That is what
we're gonna find out.

- Hey.
- Hey.

- Thanks for coming.
- Well, you said

that if I met you,
you would stop texting me.

Uh-uh-uh.

Just so we are clear,

whatever we used to do in here,

we're not doing it now.

You have to stop this.

Don't you miss us?

No.

I'm past this.

Okay? And you need to be, too.

I'm trying.

I need time. It's...

It's been six months for you,
not for me.

It's been six months
for everyone, Griff.

You know, but you don't
want to accept it

because in your head,
you're still there...

Before you were sh*t,

before Sam took over,
before we broke up.

It was good back then, though.

Wasn't it?

We cannot go back
to the way it was.

So...

No more texting.
No more calling.

And no more looking at me
the way you do.

I like looking at you.

Well, you need to quit.

Look,
it's in the past,

and that's where it has to stay.

What are you doing?

Uh, nothing.
Really?

Because it looks like
you were in the supply closet

racking up HR violations.
Well, technically,

it's not a violation because
I'm no longer a supervisor.

Oh, my... Where am I supposed to have
a private conversation?

My office is occupied.

It's not your office,
and you are not in charge.

Hey, why were you having dinner
with Byron Kingsley last night?

Because I needed to talk to him,
and, again, no office.

Do you know why Sam was given
this job, Griff?

Because I was in a coma?

Because she was the best.

A lot of people went
up for that position.

She was the best candidate.

I'm sure she was,
compared to them,

but not compared to me.

We both know I should be

back in charge
and back in surgery.

You want to get
back in surgery?

Then get out
of the closet

and focus
on your proctorship.

Oh, I'm very focused. I'm on it.

In fact,
I got a meeting right now.

What meeting?
Proctees don't have meetings.

Can't hear you.

I don't get
it. A ten-month-old

with left ventricular
hypertrophy,

and his cough
is getting worse

despite the meds.

Maybe it's because of the meds?

Side effect of
the ACE inhibitor.

It's possible.
We can switch him

- to irbesartan.
- Put him on irbesartan.

Yeah, that thing.

Sorry. Go ahead.

And we'll put him on a diuretic

to address the fluid
built-up in him lungs.

Whose phone is that?

It's unprofessional.

Oh.

Here, hold that.

It's me.

And I have to take it.
Excuse me.

You tell her I say hi.

Okay. I got to go.

We have an infant undergoing
diagnostic testing.

You cannot take a phone call.

- I understand.
- I don't think you do.

You are under my authority.

I dictate
how this proctorship proceeds,

no matter how many members
of the board you take to dinner.

They concur.

- Who is they?
- The board.

They just called.

They agree with you
on the time line.

No fast-tracking.

This proctorship ends
when you say it ends.

Oh. Well,

good.

They-they did also agree
with me

that when it ends,

I'll be reinstated as chief. What?

I get my job back.

Things go back
to how they were,

and...

how they ought to be.

If I wasn't so angry,
I'd be impressed.

How did he do this?

How could the board have
agreed to it?

- What did he say to them?
- Yeah, I-I don't know.

I wasn't there, but, uh...

The chief medical officer
doesn't get invited

to board meetings,
but he gets a seat at the table.

He should never
have been allowed

in that room.

But he was.

What am I supposed to do now?

You don't have to proctor him.

He'll just find
someone else to do it.

Until you clear him,

he answers to you.

And then what?
He gets his job back?

No, he can't just
get it back.

They have to formally vote
on it.

Without hearing my side?

They can't do that.
I have to get in front of them.

Well, they've already adjourned, but...
Well, then

I'll call an emergency meeting.

If he found a way to get
into that room, so can I.

I am so much happier
working for Sam.

Griff getting his job back
is not good for me.

You're right. He never liked
you. Have you seen Ted's labs?

His blood sugar is
through the roof.

He's afebrile.
Troponins are negative.

Could just be a stress response.

Or he's sneaking food in.

They all do it.

These delivery apps?

Yesterday, I intercepted
a Coney dog with fries.

We need the
evidence, Donna.

I'm on it.

Would you relax?

Sam is still the boss.

Just follow her lead.

I agree.

Because you're trying to get
back together with her.

Oh, that ship has sailed.

Wrong, it hasn't
sailed at all.

I know that ship well.
It's a very reliable vessel.

You do know Sam is not
a boat, right?

The relationship's the boat.
And it's still in the harbor.

It's halfway to Fiji.

Griff can't be our boss again.

I think I'm having
a panic att*ck.

Lex, take my pulse.

You've lost your damn mind.

Look,

we follow Sam.

All right? Don't get caught up
in Griff's game.

Let's go.

Okay, back to
our pediatric case.

MRI shows the muscle
in the left ventricle

is not only thick,
it's filled

with deep
intertrabecular recesses.

The myocardium looks
like a sponge.

It looks, I don't know,
embryonic?

Exactly, undeveloped cells
that contribute

nothing to the overall
heart function.

Dr. Shah,
I'd like to follow up

on this mitral valve
replacement.

Follow up with me?
Yeah.

I need you to get a PFT,

please.

Dr. Shah, stop right there.

No one should be
ordering tests for

or taking cases
from Dr. Griffith.

The board's decision is not

immediately effective.

We are discussing
this infant's treatment plan.

Put him on the transplant list,
prepare for a Berlin Heart.

There, now can we talk about
my thing?

A transplant is not
his only option.

This is a genetic disorder.
For which there is no cure.

A lot of major
academic institutions

are making huge achievements
in gene editing therapy.

Which holds a lot of promise
for the future, but not today.

Not for this patient.

Just because
something is new

and different does not
automatically disqualify it

- as a valid...
- Huntington's. Sickle cell.

Hemophilia.
All caused by an alteration

- to a single nucleotide.
- Mm-hmm.

How do we know which one?

Dr. Costa.

We mapped the genomes
of patients

with those diseases
and found the common mutations.

Which requires what?

Dr. Shah?

A big enough sample size

of affected patients
to draw comparisons.

There are over 50 genes
affecting heart development.

Even if we mapped
the baby's genome,

even if we found the mutations,

we would have no way of knowing
which one caused the disease.

A sample size of one is
simply too small.

What you got there, Ted?

- Huh? Nothing.
- Really?

Because Donna says she saw some
candy wrappers in here earlier.

Gummy bears.

Under the pillow.

You can't eat
before surgery, Ted,

especially not candy.

Why not?

Because high blood sugar causes

something called
oxidative stress,

which will damage
your blood vessels

and increase
your risk of stroke.

And risk of stroke is why
you're here in the first place.

But we can't do your procedure

until you're
medically optimized.

What does that mean?

That means you just
delayed your surgery.

You mean I got to stay here
longer?

Yep.

Well, can I at least have
a new nurse, then?

No, Ted.

We will monitor his heart.

And there are medications
that can help with his symptoms,

but he will likely be
on them

for the rest of his life.

What do you think?

Uh... There are potential
treatment options

that we would like to discuss.

We want what's best
for our kids, don't we?

Sometimes, that means
making difficult decisions

that they just don't understand.

- Thank you, Doctor.
- Wait.

Difficult decisions?
What do you mean?

Gene therapy is one of
the options...

He's gonna need
a Berlin Heart.

That looks like life support.

It is heart support,

but he'll be breathing

on his own.

It's just a stopgap measure

while he awaits
a heart transplant.

A heart transplant?

That was out of line.

It's the next logical step.

I have barely finished
walking those parents

through the diagnosis,
and you are talking about

plugging their child
into a machine.

It's a pediatric
ventricular assist device,

but yes.

It's designed for
end-stage heart failure.

Now is not the time
for that conversation.

Given his rate
of decompensation,

it is precisely the time.

In your opinion.

In my experience,
which we both know

vastly outweighs yours. Yes, it does.

And in this case,
your approach is outdated.

Look, space medicine is not
gonna help that baby.

Gene therapy has helped

a lot of people.

Look, Dad,
I understand

that you want to go back to
a time where you were in charge

and dinosaurs roamed the Earth.

Ouch. But things change.

Meteorites hit,

and a species
that fails to evolve

renders itself extinct.

Speciesevolve

by learning from experience. Okay.

I am not giving up
on that baby.

Those parents would give
anything to help their child,

which I know you can't relate to
as a father.

Wow. I thought we were talking
as doctors.

Are we getting personal now?

Well, you make
it hard not to.

So, what are we talking about?

The job? Lex? Or...

We are talking about
you and your ego

making it impossible
for me to do my job.

I'm trying to help.
I'm trying to help the patient.

Trying to help you.

Trying to help the hospital.
You want to help the patient?

Don't undermine
my treatment strategy.

And since you bought up Lex,

the next time
you want to help me,

don't screw my best friend!

Lex, I'm sorry.

I don't want your apology
any more than you want mine.

It's not gonna change anything.

I didn't mean
to out you like that.

I don't want to make this harder
than it already is.

Too late.

I don't know what it's gonna
take to make this better,

but I know it's bigger
than "sorry."

Dr. Tucker,
I need you to prepare

a surgical consent form

for putting a patient
on a Berlin Heart. Here.

For the pediatric case?

Is there another patient
in imminent need

of an assist device?

Is Dr. Griffith aware that
we're moving forward...

It's a timely request, Doctor.Right.

I'm on it.

What happened to "follow Sam's lead"?

What was I supposed to do?

Dr. Tucker, we have a problem.

- No kidding.
- It's Ted.

Those were not
ordinary gummy bears.

Somebody call 911!

What is going on?

I'm-I'm having a heart
att*ck. He was eating candy,

again, when I checked on him
this morning.

This time,
when I confiscated it,

I took a better look
at the container.

Edible cannabis.
He's stoned?

Ah, rapid heart rate,
disorientation...

I'm dying, and-and...

she's trying to k*ll me. And paranoia.

Yeah, very stoned.

How many of these
did you eat?

Dr. Trulie,
he ate them all.

Let's increase
his maintenance fluids

to help flush out his system.
It'll be a while

before anesthesia touches him.

You just delayed
your surgery again, Ted.

Uh...

I see that you got consent
for the Berlin device.

It was the right call.

I just hope
it doesn't come to that.

Griff had me do it.

Yeah, he can be very persuasive.
Just ask the board.

Have you tried talking to them

- about his reinstatement?
- Yeah.

I've tried, but
only department heads can call

a meeting with the board,
and apparently,

in light of yesterday's
decision, I'm interim head.

So...
Like I said,

he can be very persuasive.

Well, I-I, uh, did some research
into pediatric gene therapy.

So, Boston Children's
has multiple trials

trying to tackle
congenital cardiac disorders.

I sent them an email.

Really?

And if there are
other patients out there

who have his disease,

it could get you
the sample size you need.

I really appreciate that.

Even if it's a long sh*t,
it's...

Better than giving up.

- Thank you, Caleb.
- What can I say?

I'm a sucker for the underdog.

The baby.

And Ted.

Oxygen sats are dropping.

Cardiac output is down.

- We need to get him to the OR now.
- What's happening?

His heart is failing.

We need to place him
on the Berlin device now.

What's going on with Ted?

Started slurring his speech,
said his face felt numb.

Ischemic stroke.

So much for medically
optimizing him.

How long has it been?

Couple minutes.

That's a lot of brain cells.

I'm accessing

the internal carotid artery
right now.

Shunt is in.

Come on, Ted.

Okay.

Thank God.
Let's clean this up.

Make sure they give him
the unfractionated heparin

immediately. I know.

Deterioration of the filling
behavior may indicate

hypovolemia, obstruction
of the inflow cannula.

I know that, too. Well, atrial cannulation

definitely can be a lot harder
than you anticipate.

- You have to get up...
- Stop.

I cannot do this
with you breathing down my neck.

This is as far as you go.

- Suction.
- Suction.

- Good, let's turn it.
- Mm-hmm.

15 blade.

I should be in there.

No, she can handle this.

And you would've kicked
yourself out for far less.

Annular.

All right.

Dammit.

It's not threading.

I need to try again.

Push it.

Decreasing cardiac output.
Perfusion pressures are dropping.

I got to get this thing
in before he codes.

Should we call Dr. Griffith?

Jodie, I am Dr. Griffith.
15 blade.

Start bypass, Dr. Costa.

Starting bypass.

Low flow.

Okay.

There you go.

You did it.

That'll be all, Jodie.

The procedure just started.

Mm-hmm. Clamp.

There you go.
Clamp the aorta.

Start cardioplegia.
What's she waiting for?

You can't keep doing this.

You are sinking
your relationship with her.

I'm doing this
for our relationship.

Things will get better

when the natural order
is restored.

Better for whom?

For both of us.

She's not ready for all this.

She needs me
more than she thinks.

Not right now,
she doesn't.

And if you don't want to
find yourself locked out

of every surgery
from now on,

find a way to get on board
with this proctorship.

Hey.Hi.

- You ready?
- Yeah.

- How'd it go with the baby?
- He made it.

It was...

complicated, and we're still
waiting for a transplant,

but the procedure went well.

And I did it without my dad.

- Where was he?
- I locked him out.

You locked your father
out of surgery?

Yeah.

He made me do it.

Oh.He...

Mm-mm. We're doing it again.Yes.

- Yes, we are.
- Is there no way for you and I

to go on a date
without our dads ruining it?

No, there-there is...

uh, if we start at the end.

You know, I once read that
a ten-second kiss can result

in the transfer
of 80 million microbes.

Did you just tell me...
dirty data?

It gets dirtier.

Come on.

Hi.

Were you guys here all night?

Yeah, we didn't want
to leave him alone

his first night on the machine.

I'm about to take Ellie home

to get some sleep.

Hey, can I help you with that?

Come here.

Where is the one
for this foot?

I need to run some tests on her.

On Ellie?

Peripheral edema.

Due to reduced
systolic function.

Great minds.

I presume you ordered
a diuretic.

And a vasodilator.

But what we really need is... A DNA test.

What is going on? The baby's sister.

The reason she doesn't like
to wear shoes.

It's a symptom.

Wait, of the same disease
her brother has?

Less severe, of course,
but two siblings

with the same genetic disorder? Yes.

That's a sample size
we can work with.

We can map the genomes.

Find the mutations. And fix it.

- Well...
- We need a DNA test right away.

If we're right,

this could change
everything for them.

Yeah.

I was wrong
to dismiss gene therapy

and to undermine you.

This is your department,

and I am happy to respect that.

Thank you.

For the next 87 days.87 days?

Which is when the board will
vote to reinstate me.

Assuming I've proven
my basic competency

to your satisfaction.

Which reminds me,
I got, um...

Surgeon's knots.

Mm...

Single knots.

Double knots, and I even
threw in some granny knots.

So, I think that should
check that off the list,

- don't you?
- Hmm.

Well, despite how dicey
you made things

for the anesthesiologist,

the surgery went well.

I'm gonna be okay?

Yeah. Your arteries look good.

But, um...

before I discharge you,
I want to talk to you about

your other disease.

So,

I took a closer look
at your labs,

and your liver enzymes
are elevated.

So?

Is there any chance that...

you don't take your medications

because you can't drink alcohol
on them?

Okay.

What are you saying?
That-that I'm an alcoholic?

I'm saying someone
who chooses alcohol

over life-saving meds,

or who ingests marijuana

while they're being prepped
for surgery,

or who b*rned so many bridges
with his ex-wife

that she won't even give
him her number,

might have another disease.

But that's one
that can be treated, too.

This is a good rehab,

and they've got
nightly meetings.

Yeah, I'm sure
they're awesome. They are,

actually.

Take it from a fellow alcoholic.

Listen, I know how hard it is
to admit that you got a problem.

And, uh,
no one here even knows this,

but I've been where you are.

And it cost me
someone I care about, too.

But there's a solution.

He's gonna make it.

He has
a long road ahead.

Yeah, well, at least
there's a road.

Five years ago,
his condition would've been

a death sentence.

Hmm.

But he has a chance,

because he has you
for his doctor.

And he only had you

as his doctor
because we have you as a leader.

You think Hamamura would've
brought that baby to Griff?

I appreciate that,

but I'm only
an interim solution.

Oh, so, you're telling me
that we can change

that baby's genetic code,

but you can't change
the board's mind?

I can't even talk to them.

You have to be
a department head.Hmm. Right.

If only you knew one
who owed you a favor.

You fought
for that baby's future.

Now go fight for yours.

I know it's last-minute,

but Dr. Griffith was there
when I needed help.

Calling this meeting was the
least I could do to thank her.

I know that you don't think
the I'm right person

for the position of chief.

To be honest, neither did I.

I thought I was gonna

finish my fellowship
and move on.

I had an offer
from the Cleveland Clinic.

And then I thought,

"I am good at this."

Patients are thriving,

and doctors are, too.

They are happier than they were
under my father,

which means they are
more effective.

They are more efficient.

They're more successful.

There's a baby alive today
to prove it.

You all asked me
to step in as chief.

And now my father is awake, and
you are asking me to step aside,

and I can't do that.

Which is why
I'm not going anywhere.

We are a better department,

and we are better doctors,

because I am a better chief.

You know, the tyrannosaurus rex
was a merciless predator,

unrivaled by any creature
of its age.

I take this as a compliment.

You should take it
as a warning.

Oh?

I spoke with the board.

They share my enthusiasm
for this department's future,

which means yours is
not guaranteed.

They're not just gonna hand you
the reins at the end of this.

They're gonna choose between us.

May the best Dr. Griffith win?

Is that what you want?

You can be the T. Rex, Dad.

I'm the meteorite.

And I'm coming for you.