01x07 - Chronic Insult

Episode transcripts for the TV show "Good Sam". Aired: January 5, 2022 - present.*
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Dr. Sam takes over role as chief of surgery after her renowned boss falls into a deep coma.
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01x07 - Chronic Insult

Post by bunniefuu »

Previously onGood Sam...

I have been trying to
keep up with you in a game

that you've had rigged
the entire time.

I'm going to go
and tell Sam everything.

I think I'm all
caught up.

Ambulance has just landed.
Step back, Dr. Trulie.

You don't need to worry
about your best friend

being with your dad because

you and I are not friends.

It was me. I
called your mother.

Her vote could be the key.

This is not personal.

She is my mother! I told you

I didn't even want
to think about her!

I have to end this w*r.

You ended something, all right.

I want you to know that
you can talk to me.

I think I lost my way.

Morning.

Thank you for letting
me sleep here last night

and letting me
talk your ear off.

Of course.

So, uh, how you feeling,
other than tired?

Uh... Hmm. I feel like...

a bulldozer ran over everyone

and everything
that I care about.

All around me, I
see destruction.

And in the cold light
of day, I realize

that it was not a bulldozer
that destroyed everything.

It was me.Hmm.

I think you're being a
little hard on yourself.

Nah.

You should've seen the
look on Malcolm's face.

And what Lex said to me...
not that I blame her.

And my mother? I accused my own
mother of not being on my side.

Because of what?
This vote for chief?

I am a human bulldozer.

You don't have
to do that. Uh...

No, it's fine. I
want to. I just...

I didn't expect
anyone, so it's a mess.

Compared to my life,
this is nothing.

Hey, you remember the last
thing you said last night?

Uh, was it something
along the lines of,

"I've become a
power-crazed monster

who hurts the people she loves"?

No. It was, "I'm gonna
make this right."

And I said,

"If anyone can do it, it's you."

Did I happen to say how I
was planning on doing that?

No. At that point, you started
snoring like a baby rhino.

I do not snore.
Caleb!

I do not snore!

I'm gonna... I'm
gonna make this right.

I'm gonna try.

Well, uh, guess we
better get to work.

Yeah. Hey.

Oh.

I'm really glad you opened
the door last night.

Yeah, well, glad you knocked.

I'm gonna get
dressed. I love you.

Yeah, get dressed. Me, too.

I'm gonna brush my teeth,
then I'm gonna... Yup.Yeah.

Sounds good.

I never should have
called your mom.

Okay.

You told me that she
was on the board,

and all I could think
about was her vote.

But all I should've been
thinking about was you.

And how reaching out to
her would make you feel.

I'm...

Damn it. It's the ER.

You should go.

What do we have?

Violet Stein. 18.

She fell at her high
school track event.

She was in first place, too.
Okay, just gonna take a listen.

There's a lot of turbulence

between atrioventricular valves.

Is that because
of her broken rib?

They said she has a broken rib.

Looks like this
is the third bone

you've broken at a track meet.

A lot of kids fall
at these things.

Well, three
fractures is unusual.

Are you getting enough
vitamin D, calcium?

We're very good
about supplements.

You have to be, on a vegan diet.

Does this vegan diet include
a lot of soy products?

Yes. Why?

No
air entry left side.

And vital signs are unstable.

Violet, can you breathe?

Tension pneumothorax.

14 gauge needle. Three
and a quarter inch.

Excuse me. Quickly, please!

What's happening?
It's all right.

Just hold on. Her
rib is stabbing

into her lung, and we
need to clear the air

that's trapped in
her chest cavity.

It's all right.

Try to relax.

It's okay.

Straight
into the trauma bay.

Who's the patient? April
Krane, 25, hypothermic.

I'm told her dry suit
ripped while scuba diving.

Scuba diving? In the
middle of winter?

All the lakes are frozen.

They cut a hole in
the ice, I guess.

Water under the surface
is about 39 degrees.

She lost consciousness
on the way over.

Okay, let's get these
wet clothes off of her.

Breathing is shallow,
pulse is weak.

All right.

We need to get her core temp up.

Bring a Bair Hugger
in here, please.

We could warm up her IV fluids.

Good idea. I'll grab a bag.

Hi.Hey.

Still on trauma?

Is that because of me? Not
everything is about you.

I am sorry that I threw
you off that patient.

I was out of line.

If you want to come off trauma,

it will not happen again.

I like trauma.

Oh, if I broke that many
bones running track,

I would take up chess.Mm.

We should also check
her B12 levels.

Oh, it's not B12.
Cadmium is the problem.

Cadmium? Yeah, heavy metal,

chemically similar to
zinc and mercury.Yeah.

Toxic levels linked to
fragile bone syndrome

and often found in...
In soy products.

Doesn't explain the
mid-diastolic murmur you heard,

but does address the
fractures, at least.

Okay, I'll run the labs.
Dad, one more thing.

Hmm?

I'm done fighting you
for the chief job.

The job is yours.

Uh, the vote's not for 42 days.

They don't need to vote.

What are you...? You quitting?

Yeah. I'm out.

Why?

When you put so much into it?

Too much, and that's
the problem. I'm...

I just want to focus
on my patients,

and I want to get you
through your proctorship.

Uh-huh. And speaking of which,

we do have a double bypass on
the schedule for later today.

I'm aware. I am
making you primary.

You've aced every step so far,

and it's time you do
your first solo surgery.

I'll see you in the OR.

How do you

accidentally say "I love
you"? It just slipped out.

I mean, I spent the whole
night listening to her talk

about making up with Malcolm.

And then, right at
the end, I blew it.

Making up? Are
they in a fight?

I heard all about it

right before dropping
the "L" b*mb on her.

I mean, who does that?

And she didn't say anything?

Maybe she didn't hear me.

Maybe she thought I said "I love
the view," or, "I shove you."

I just... I've never
said it before.

Never to Sam? Never to anyone.

You've never said "I
love you" to someone?

You don't tell your mother
you love her? Okay, yeah.

My mom, sure, but...

Why? How many people
have you said it to?

Hundreds. Hundreds?

I'm very comfortable saying it.

It's easier than you think.

I love you, Caleb.

See? Now you say it to me.

You can do it, Dr. Tucker.

I love...

balloon angioplasty.

And, look.

There's one now
in, uh, room 2115.

So...

Everything okay, Dr. Griffith?

Yeah, fine. I just, uh...

I just started thinking
about my office.

Maybe the desk
should go here, huh?

Wait. Your office?

Yeah, well, it's not official
till the vote, obviously,

but, uh, now that I'm running
unopposed, it's not exactly

a nail biter.

What-what do you mean,
you're running unopposed?

What happened to Sam?

Well, she wants
me back in charge.

Back in surgery, back to normal.

S-So she dropped out?

Did she say why?

I think that
ultimately, she realized

I'm the leader this
department needed,

that my world-class

reputation...

Well, I'm not
saying it was easy,

you two fighting all the time,

but is dropping
out the solution?

Yes. And ever since this
whole battle started,

I haven't been myself.

I haven't been there
for you as a friend.

Sure you have. What
about your lawsuit?

The lawsuit settled. And
I wasn't there for you.

Caleb sat up with me all
night, just listening,

and it made all the difference.

It made all the difference?

Labs on your track star.

Thanks, Bernie.

Your dad was right
about the cadmium.

The heavy metals, we can flush,
but look at her troponin levels.

BNP's elevated, too. Her cardiac
enzymes are through the roof.

How does a teenage track
star have the biomarkers

of an 85-year-old in
advanced heart failure?

Hey, there. You
look a little lost.

Yeah, I'm looking for my son.

Apparently, he's
in cardiothoracics.

Oh, well, that's
where I'm headed.

Thank you, Doctor.

Sure. Oh, if you want,

I can look him up for you,
tell you what room he's in.

Oh, no, no. My son's not
a patient. He works here.

Hi.

Hey.

I didn't expect to
see you here, not that

you're here to see me. I
shouldn't make that assumption.

Not everything is about
me. I saw your dad earlier.

He-he was in your office.

Oh. Well, was he
measuring for drapes?

So it is true.

You dropped out of the race.

Mm-hmm.

Hurting you was a wake-up
call for me, Malcolm.

And I know that I
can't undo the past,

but I am not going to repeat it.

For what it's worth, I
think you would've b*at him.

With
or without my mom.

To be honest,

I'm just hoping

we can put the stuff
with your mom behind us.

Oh, it's definitely behind you.

Hello, Malcolm.

What are you doing here, Mom?

Mom?

Malcolm,
please talk to me.

You shouldn't have come.

It wasn't my idea.
Dr. Griffith called.

Yes, and I am very sorry

that you came all this
way, Mrs. Kingsley.

But everything
has been resolved.

My father will take
over again soon.

Your father can't
even perform surgery.

Why do you care?

This isn't your concern.
Of course it is.

I mean, I don't
do the day-to-day.

That's supposed to
be your father's job.

But I do run this foundation.

And should this hospital
fall into disarray,

well, that would make
my job much harder.

Everything is
under control here.

If that were true, you
never would have called me.

Dr. Griffith, you know, bad
leadership leads to chaos.

And chaos is bad for
business... yours and mine.

Order must be restored.

You look like you're
feeling better, April.

I am. Super glad I'm not dead.

Why were you diving down
there in the first place?

Are you kidding? The Great
Lakes are full of shipwrecks.

There's so much to explore.

Why not explore in the summer

when the risk of
hypothermic death

is just a little bit lower?

The risk is why I do it.

The bigger the risk,
the bigger the rush.

Hmm. Adrenaline junkie.

You're like my fiancée.

What happened, exactly?

I was inside one of the wrecks.

So awesome. And...

But then my hand cramped,
and I dropped my flashlight,

snagged my suit going after it.

Wait. Y-Your hand
cramped so badly

that you couldn't hold
on to your flashlight?

Has that ever happened before?

Yeah. All the time, actually.

That can be a, uh, sign

of a neurological condition
called "focal dystonia."

Neurological?

Is there something
wrong with my brain?

It's more like, um,
the way that your brain

and your muscles
talk to each other.

We'll know more after the test.

Violet Stein. That is one of the
ugliest valves I've ever seen.

Mitral deterioration
is very advanced.

There's no family
history of heart disease?

No.

She's a typical teenager with
no preexisting conditions.

What about the cadmium toxicity?

Well, explains the bones, but
not the heart. And she's had

no symptoms of valve disease?

No. None. We only caught
it because she fell.

Although, the falling
could be a symptom.

Cardiovascular syncope.

Blood flow to her brain is
getting cut off during exertion.

Like during a track event.

She's broken multiple ribs.

Because she's fallen
during multiple races.

She's gonna keep falling
unless we replace this valve.

We can do it today...
after Dr. Griffith's

bypass.

Back-to-back surgeries.

I love it. Yeah?

Then why are you
still standing here?

Get to the OR,
man your stations.

Let's go, people.

Byron.

You know, after

all these years, I still
don't like this tie.

What are you doing here, Tina?

I was called, and
now that I'm here,

I have no intention

of rubber-stamping
the reinstatement

of Rob Griffith as chief.

I had reservations about
him the first time around.

You said you'd stay out
of hospital business.

And you said you'd stay
out of our son's business.

Yet, I see he's running
around like your little clone.

It was his decision to
come here. It's not good

for him to live in
your shadow like this.

Don't talk to me about
what's good for him.

You're the one who turned
your back on this family.

Which makes you, what?
The blameless victim?

Is that how you remember it?

It's how it went down.

Clearly, what our
son thinks, too.

You turned him against me.

No.

No, Tina.

You did that all by yourself.

Well, here's hoping
I can undo it.

See you at the
next board meeting.

A
mechanical valve?

Yes.

They're strong, reliable.

It should last you
the rest of your life.

How can she have heart disease?

We're vegans.

Our diets are very healthy.

Your diet may not have
caused your valve disease,

but all of that soy and
cadmium did contribute

to your broken ribs.

Now, a new valve will help
your heart get stronger,

but you'll likely need to
make some dietary changes

to help your bones
get stronger, too.

What kind of changes?

Have you ever considered
eating any fish or meat?

Violet has never had so much
as a glass of milk in her life.

We are diligent
about supplements,

and getting all the nutrients
we need from non-animal sources.

If we need to cut
back on soy, we will,

but meat is not an option.

Why don't we get you
started with a new valve,

and we'll take the
rest from there?

Your EMG results are in.

Your motor unit
recruitment is perfect.

What does that mean? It means
whatever's causing the cramp

is probably not neurological.

Oh. Well, does
that mean I can go?

We still haven't found
the cause of the cramp.

Hey, as long as my brain's okay,

I can live with a few
dropped flashlights

and the occasional
charley horse.

Charley horse.

Peripheral artery disease
would explain the hand

and the claudication in
the lower extremities.

She needs a stress test.

You can't go just yet, April.

So...

Malcolm's mom is here.

Yes.

But you shouldn't feel guilty
or anything. It's not like

you told her to come.

And... Hmm. I need to
get my head in the game.

I blew it.

You didn't blow it. It
was one "I love you."

No. She's never gonna
talk to me again.

She said talking to you
made all the difference.

She said that?

Mm-hmm.

All right, gentlemen,

are you ready to be reminded
how a bypass should be done?

You have an audience.

It's good to be home.

Right this way, Dr. Griffith.

I know where the patient's
head is, Dr. Shah.

Ah.

Let's see if we can
get him to the heart.

Okay.

It's all for you, Dad.

Ten blade to me.

Hit it.

Loupes?

All right.

Remove the clamp.

Aortic clamp is off.

Electrical activity
is restored. Perfect.

Not so fast.
There is excess tissue

over the proximal anastomosis.

Now it's perfect.

: Well done, Dad.

Hey, is everything okay?

Yeah. Just, uh, the light

was angled towards my eyes.

Let's watch that next time.

Close up, Dr. Tucker.

Nice bypass, everyone. We owe
Violet a mechanical valve.

Next, back-to-back
surgeries today.

Back-to-backs.Back-to-backs.

Uh, I hate to miss
out on all the fun,

but I think I should probably go
and dictate an operative report

on that bypass, don't you?

Sooner you can sign
off on this step

the better, right?

Yeah, sure.Okay.

One step closer, Dad.

One step closer.

What is all this?

We think there's a
blockage in your arteries

restricting blood flow
to your extremities.

This is gonna help us find it.

I just start running? Mm-hmm.

This IV has a
radioactive tracer in it.

So we're gonna get
your heart pumping

and let the tracer
lead us to the problem.

Take her to four.

How fast does it go?

Most people get
up to about a six.

Take me to seven. You sure?

Heart rate's at 140.

All right, her hand's
cramping. Are you okay, April?

It hurts. What hurts?

Everything. Take her down.

No! Take me higher.

April... Please, you
have to. Going faster is

the only way to make it
stop. Make what stop?

The pain! All right, all
right. I'm pulling it.

All right, all right.

Mind telling me what
happened in that bypass?

What are you talking about?

Your father dropped
an instrument

in the middle of surgery.

The surgery was over,

and surgeons drop
instruments all the time.

When was the last
time he dropped one?

I'm due in another surgery soon.

He was in a coma for
six months. Now he can't

get through a routine
surgery without incident.

There was no incident.
I know what I saw.

With all due respect, I
am Dr. Griffith's proctor.

I am the only person

who is authorized to
assess his progress,

and I am telling you
that there is no issue

or concern regarding
his performance.

Well, I guess that's
all there is to say.

Stress test shows her
arteries are clear.

We know her nerve and
muscle function are normal.

So, what's with the hand cramp?

It only happens during
extreme activity. My guess:

involuntary response
to stress hormones.

So, she stops the extreme sports

and the hand cramp goes away.

But she's not gonna
stop. Why not?

I see it with Tim, too.
He'll do anything for a rush.

Except with April, it's even

more intense. What
if the hand cramp

is actually a small price
to pay for the upside

of all of those stress hormones?

The adrenaline, the cortisol,
all of those endorphins

that act as natural painkillers?

She's not chasing a high.
She's self-medicating.

The hand cramp isn't
the problem. It's...

it's the solution
to the problem,

Which is... chronic pain.

Okay, let's get an MRI.

Whatever's causing this pain,
jumping out of a airplane

can't be the only
way to treat it.

I'm on it. Thank you.

Hey.Mm. Hey.

You
want some company?

Sure.

I thought you were in
the valve replacement.

Yeah, uh, so, Sam
gave me the, uh,

bypass surgery at
the last minute.

You were primary?

Oh, that's great.
How do you feel?

Yeah, good. I, uh,

just need to, um, come down

a bit from the adrenaline rush.

Mm.

All right. Well,
uh, you do that,

and come find me later.

Mm-hmm. All right.

Hey, do me a favor. Hmm?

Just slip that back
in the charger,

preferably when
Donna's not looking.

What did you do?

Did you drop it?

No. It was like that
when I found it.

Liar.

And what if Donna
thinks I broke it?

You say it was like
that when you found it.

What are you doing with
the quarterly reports?

Reading them.

I would have used your father's
office, but I couldn't find it.

Uh, he doesn't have
one. Doesn't have one?

What, does he do... skulk around
like Phantom of the Opera?

I have work. Whatever
you're doing,

can you do it
somewhere else, please?

We never talked
about my leaving.

What is there to say?

You left. The end.

I left him.

I didn't leave you.

And I didn't leave
because I wanted to.

I left because I had to.

You had to? There's only
one way with your father.

If you can be what
he wants you to be,

if you can stay
within those lines

that he draws for
you, then you're good.

But I couldn't do it, Malcolm.

I knew that if I
chose to be myself,

it would cost me the marriage.

But I never imagined it
would cost me my son.

And I hope

it's not too late
to get him back.

How can I trust you

after all this time? I...

I'm not asking for your trust.

I'm asking you to give me a
chance to earn your trust.

I-I need to get to work.

Yeah. Yeah, me too.

Um, you know,

I know this hospital
better than you think.

I could do some...
some good around here.

With your blessing,
of course. But, um,

if you want me to leave, I...

I can be on the next flight.

Ready for the
valve, Dr. Shah.Mm-hmm.

A new valve in
healthy 18-year-old?

You don't see that every day.

Hold on. Something's
not right here.

I need more light.

Look at this.

Annular calcification.

But that didn't show up in
the echo. No, it did not.

The annulus is supposed to
be firm. This is like Jell-O.


Liquefactive necrosis.
I can't attach

the metal to this
tissue. It's too viscous.

I...

There's literally nothing
for me to sew into.

You need something more pliable.

BP and O2 sats
are trending down.

Call down for a bioprosthetic
valve, stat.Wh...

A pig valve?

Well, it's not a vegan option,

but it'll keep her alive.

Telling a vegan mother
you put a pig valve

in her vegan daughter's heart?
Not the high point of my day.

Well, that valve is
also keeping her alive.

Oh.

Thanks, man. I
appreciate it.Mm-hmm.

And also... I love you.

What?

Nothing. You did it!

Good for you, Dr. Tucker.

What? He accidentally
said "I love you" to Sam.

We're trying to normalize it
so it's not such a big deal.

That advice is why
some of us are engaged

and why others are
going to die alone.

Look, I'm desperate, man, okay?

I cannot let things get
weird with me and Sam.

So, this is the
not-weird solution?

Just go with it.

Fine.

Say it again.

I love you.

You're not my type.

That stung a little.

Operative report... dotted
the I's, crossed the T's.

Does that report mention the
scalpel that you dropped?

Why would it?

Because I've never seen
you drop an instrument.

I told you, it was the lights.

I've also never heard you
complain about the lights.

I'm worried that I
put you in too soon,

and I want to sign off on this,

but I need to understand
what happened in there.

A successful bypass
is what happened.

Who cares about a scalpel?

I'll tell you who cares.

Dad.

Tina Kingsley cares.

She's raising questions
about your competency

after what she saw.

I told you she never liked
me. I covered for you.

I said there was nothing to
worry about. Is that true?

It was the lights.

I heard what happened
with the scalpel.

Scrub nurses like to gossip.

And what, you think I'm
being too hard on him?

Because it was my idea to
put him back in surgery.

I know. This is
just due diligence.

I want to clear him.

I don't think you should.

You don't think
he's ready? I think

he should be ready. I
think he thinks he's ready.

But?

That scalpel's not the
only thing he's dropped.

Her hands are ice-cold
and she won't wake up.

Heart rate's 140.

Why is she so tachycardic?

And hypotensive.

Blood pressure's
90/40 and dropping.

Maybe she's turning septic.

Have we gotten another H and H?

There's no fever, she hasn't
lost any blood volume.

Could she be
rejecting the valve?

No, acute and
chronic rejection

takes weeks to occur.

She's been out of
surgery about an hour.

Could be hyperacute. SAM: No.

Then we would've known
before we closed up.

This is something else.

What's happening?

Her heart is failing.

I need you to increase her
Levophed, get another pressor.

We got to get her pressure
up, and I want a cardiac MRI

as soon as she is stable.

Her body hates this
valve. I want to know why.

Postoperative
ultrasound confirmed

the graft was seamless.

Well, installation's
not the problem.

Maybe it's a defect
in the valve? Well...

I'm gonna check the production
lot for reported problems.

Look at the leaflets
on the mitral valve.

They're so stiff.Uh-huh.

And what are those spots?

They look like goosebumps.

Or hives.

Can we see if there's
inflammation, please?

Ah.

Lit up like a Christmas tree.

That is an allergic reaction.

But to what?

Anesthesia's out of her system.

The only thing she
could be reacting to...

The valve itself.

She's allergic to meat?

To animal protein, yes.

I've never heard of this.
What did you say it's called?

Alpha-gal syndrome.

It's a reaction to the sugar
molecule in most mammals.

It is a severe allergy,

but because Violet's never eaten
meat, she was never diagnosed.

She was fine.

She had a broken rib,
but she was fine.

How did things get
so bad so fast?

I know that she seemed fine,

but something has been
damaging her heart.

But you don't know what it is.

The mechanical
valve didn't work.

The pig valve isn't working.
Her heart is failing.

Which is why we need
to give her a new one.

Your MRI shows that you
have spinal stenosis.

It's the narrowing
of your spinal cavity

that's compressing your nerves
and causing your chronic pain.

Well, can you fix it?

Mm-hmm. It's called
a laminectomy.

We remove part of your vertebra

to ease the pressure
on your nerves.

Sounds complicated.

There are risks, but

the bigger the risk, the
bigger the rush, right?

Look, April,

I know you found a way
to cope with your pain,

but it's just temporary.

Problems like these do
not go away on their own.

In fact, they usually get worse.

Lying down in
the middle of a shift?

This is another first, Dad.

It's low blood sugar.

Or post-exertional
malaise.

Is that why you ducked out of

the valve replacement
surgery? I'll have some

trail mix, I'll be fine.

I want to run a blood panel
on you, a full workup.

Whoa! Why?

Because I know
about the headaches

and the ringing in your ears,

the photosensitivity.

And I hear you dropped a tablet
in addition to that scalpel.

Et tu, Brute?

I'm worried about you.

Ignoring this isn't gonna
make it go away. SAM: I can't

clear you for surgery unless
we address these symptoms.

Symptoms? It's nothing.

It's a little bit of
anemia or something.

Maybe. But the headaches
could be a sentinel bleed,

or a subarachnoid
hemorrhage, or...

Or a tumor.Mm.

I see no
cause for alarm.

Neither did our patient until
her heart started to fail.

You need bloodwork and scans.

I'm not having a scan.

Dad, this is serious.

So am I. Word gets out...

Tina Kingsley finds
out... It's all over.

Forget it.

Okay, fine. Just
bloodwork for now.

I can get around Bernie.

Yeah, I think I prefer it

when you two don't
talk to each other.

Uh... Going down?

Uh, yeah, to the lab.

Thanks.Yeah.

How are things
going with your mom?

Mm. She wants a fresh start.

Not that she has any
right to ask for that.

You're probably right.

But you could
still give her one.

Sometimes people just
need a second chance,

you know, before it's too late.

I've got some bloodwork
for you, Bernie.

Who's the patient?

Um, I didn't put a
name. Say it's me?

Is it you?

How about we say yes
and I'll owe you one.

You and everybody else. It's
death by a thousand cuts.

Hang on. Bernie,
can you run labs

on something that isn't human?

Why did you want to see all
the supplements we take?

So that our lab could test them.

Test them for what? We know

Violet has alpha-gal.

The meat allergy.
Yes, which explains

your reaction to the pig valve.

What it doesn't explain is

the heart condition
you came in with,

because you are
a lifelong vegan.

Whatever's been
damaging Violet's heart,

we assumed it had to be
something other than meat.

But she has no other
conditions, no other factors

that could explain the
damage to her heart.

It had to be the alpha-gal.

Which means you had

to be consuming meat.

Your vitamin B-12

supplements are
encased in a capsule

derived from animal proteins.

Now, the amount in each
capsule is too small

to trigger an outward reaction.

But the chronic insult

to your system damaged
your heart over time.

The label says
they're vegan.Yes.

But supplements are not
regulated by the FDA.

The-the labels,
the ingredients...

They're not verified the way the
prescription medications are.

So, I-I've been
taking meat pills?

The good news is that you are at

the top of the transplant list,

and it is not too
late for a new start.

We're gonna get a nutritionist.
We'll make meal plans.

We're gonna be okay.
Stop saying "we."

What?

We're not the same person.

If it were up to me, maybe
I wouldn't even be vegan.

I might have eaten
a hamburger by now

and found out about this sooner.

None of this would've happened

if you had just let me
make my own decisions.

Violet, I was just trying
to do what I thought...

Well, you were wrong.

Donor match for Violet Stein.

We got a hit? Yeah.
She'll have a new heart

by tomorrow. CALEB: I'll
get her on the schedule.

Okay, great, and I'll
notify the family. Okay.

Oh. Sorry.

You know what? Uh, after you.

You go.I...

Okay, I'll go.

What was that?

That was... awkward.

Mm.

I accidentally
said "I love you."

I've been trying
to undo it, but...

Why, because you don't love her?

Everything okay?

Yeah. Uh... Well,

I can do this if you want

to join Dr. Griffith
and tell the family

about the transplant.

No. I got to, uh, get to
the lab, anyway, so...

Okay.

Dad says once you
break trust, it's gone.

I know he'd say
this is a mistake,

but if you want to stay...

I won't stop you.

Thank you for this chance.

I hope I don't regret it.

All I want is to
make things better

for us and for this hospital.

Starting with

the cardiothoracic department.

Hey.

Hey.

Look, I know you're
out of the race,

but I just want to let you know

that my mom has some
plans for your department.

What do you mean?

Well, she's opening the position

to outside candidates.

Thought your dad
might like to know

that he won't be running
unopposed for too long.

Um... I'll tell him.

Yeah.

So...

she's sticking around, then?

Yeah.

Uh, I'm gonna try this
whole second chance thing.

I'm still so sorry.

No, no, don't. Hey, it's okay.

It's just, I-I got to figure out

this stuff with my
mom right now, and...

I get it. You don't
have to explain.

I will see you around.

I'll see you around.

Okay.

Hey.

How'd it go in there?

Oh, yeah, she's stable.

Um, I just finished the
paperwork for the transplant.

Her mom was just doing what she
thought was best, wasn't she?

She didn't know what
her daughter needed.

This morning, what I said, um,

is probably the
last thing you need.

It was probably the worst
possible time to say it,

but I did, and I don't want
to pretend like I didn't.

What did you say?

I said "I love you."

Which you clearly
didn't hear.

Um, but that's-that's
good, because it just

slipped out. It was an accident,
and it shouldn't have happened.

At least, not like that.

What are you saying?

I... love you.

I love you.

Oh. That's how it
should've happened.

Because that's how I feel.

And now you know.

What are you doing in here?

I always used to come down here

before surgery and after.

Your mother would
say, "He's in church."

Me too.

Hmm.

Tina Kingsley is widening
the search for chief.

She's not gonna make
it easy for me, is she?

You'll be fine.

Your history and relationships.

No one can compete with you.

I know one person who can.

I told you I'm out, Dad.

Well, maybe you
should reconsider.

Better you than an
outsider, right?

What about you?

You got your test results.

Not anemia.

Okay.

That doesn't mean it's
a worst-case scenario.

Doesn't rule it out, either.

This race may be decided for me.

If it is, I would prefer
you to be the one...

Stop. We're not talking about
work. We're going to imaging.

No arguments.

Thanks for telling
me about this.

Thanks for telling me
about his symptoms.

I'm really glad you're here.

Me too.

Just want to remind
you of a little thing called

doctor-patient confidentiality.

A-And Sam?

Don't worry. I'm
not gonna tell Mom.
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