09x07 - Step on a cr*ck and Break Your Mother's Back

[bunniefuu]

[DRAMATIC MUSIC]

I screwed up, okay? I know that.

I'm just trying to look out
for the guy.

I get that, but ideally,

you don't wanna risk your job
in doing so.

I've diagnosed Bert
with dementia.

I have to take care of my ex-husband.

The decisions, the treatments,

that's all gonna fall on me.

This is Dr. Collins.
She started our center.

I think I've seen you
around the hospital.

Just so you know, your son,
he's been a real godsend.

- Yes!
- Oh, man! Yes.

Should have known better than
to invite a bunch of surgeons.

Oh, please.
My talent is innate, all right?

- Okay.
- Oh, yeah!

It's okay. It's not your fault.

- Clearly a recessive gene.
- Heh. Mean.

Okay, let's give this a whirl.

- That was how it's done.
- Bam.

[LAUGHTER AND CHEERS]

A good time for cupcakes, yes?

- Yes.
- Indeed, please.

- Hey.
- Buddy boy!

Happy one year sober.

- Whoo. [CLAPS]
- Yeah!

Yes, congratulations
on this milestone, Sean.

- Speech, speech!
- Nailed it!

- Speech.
- Speech.

- Speech.
- Okay, okay, okay.

I actually have a lot of thank yous.

Um...

I'm grateful for so many things.

My dad's health,

that the kidney transplant was
a success.

And now I have something
to hold over him

every time he's too busy
for a Cubs game.

[LAUGHTER]

Margo, thank you so much
for the opportunity

to work at your center

and help others struggling
with addiction.

I have such an incredible
group of people in my corner.

And I figure if I'm anything
like you, Dad,

I'm moving in the right direction.

Aw.

Love you, kid. [CHUCKLES]

All right.

- All right, show's over.
- Blow it. Blow it out.

Yep.

- Yay.
- [CHUCKLES]

- Thank you.
- Congratulations, Sean.

- Good work.
- Thank you.

- Just keep them over here.
- Do you need a hand here?

Yeah, you better.

You gotta redeem yourself here.

You're apparently
missing out on Cubs games?

- Oh, no.
- Yeah, I know.

Where are all the good men, I ask you?

Yeah, well, apparently, Wrigley field.

[LAUGHS] Well, it's
a good thing opening day is,

you know, right around the corner.

I just need to find something
to do with myself until then.

- Ah, Chicago.
- Yeah.

Plenty of stuff to do.

[SOFT MUSIC]

[CHUCKLING] Okay.

We should stop after work,

pick up something to make for dinner.

Oh, let's order in.

- Oh, you're lazy.
- I am.

- I am indeed.
- [CHUCKLES]

But here's the thing.

- [SPEAKS POLISH]
- [GASPS]

I love you too.

See you later.

Oh, Sharon, good morning.

Oh, Daniel, I was hoping I'd catch you.

Just one second.

I'm telling Bert where
I put his cereal bowls.

Still getting the place re-organized?

Well, I finished labeling
everything in the kitchen.

The bedroom's next.
But so far, he's not taking to it well.

You know what?

Alzheimer's is just a very
tricky diagnosis to accept.

So you gotta be patient with him.

Well, I keep reminding myself of that.

You want me to stop by
on the way home from work,

just to look in on him real quick?

That would be great. Thanks.

Any time.

One, two, three, four, five.

[SIGHS]

My friend, can we pick it up a notch?

Oh, you're messing me up. Just... please.

[GROANS] One, two...

- Hey, marathon man.
- What's up, Asher?

We missed you last night.

Yeah, sorry about that.

Thanks for the invite,
but I had to get up early,

you know, get in my run.

Yeah, I can see that.

So how was it? You make it a burner?

Uh, kind of?

I tweaked my hammy. Only three miles.

I'll ice at lunch and try
to get in another five tonight.

That's hardcore.

Yeah, yeah, I admit
I can be a little, uh,

type A when it comes to my routine.

Trust me. I get it.

I go to meetings, you run.

- We all have our things.
- Mm-hmm.

I'm gonna hit the floor. You coming?

Go ahead. I'm gonna grab
a drip and get showered.

I'll see you out there.

So that's enough. You need to step out.

- Take your time, man.
- Sorry. Can you just...

- We'll all wait.
- Yeah, please.

Can you not do that?
You're just messing me up.

[SOFT TENSE MUSIC]

What's going on?

Guy's been in the door
forever holding everybody up.

You mind if I have a chat?

Be my guest.

Everything okay, pal?

Yeah. Yeah, um... yeah, I'm fine.

I'm fine. I'm fine.

One, two...

You know, there's a lot
of people waiting.

Yeah, I... I know.

It's just... it's just people
keep pushing the door

and they're messing up my count.

- Please stop.
- Your count?

Two... I just need
a few more minutes, okay?

- Three...
- Yeah, I don't think so.

- No, no, no.
- I need you out of there.

Hey, no, no, no, no!

No, please!
Please, please, please don't!

- I'm not gonna take...
- Okay. Whoa, whoa.

Easy, easy, easy. Okay.

You're okay. I need some help over here!

- Just breathe, buddy. I got you.
- [BREATHING HEAVILY]

Okay, okay. Listen to my voice.
Listen to my voice.

I can't breathe.

♪ ♪

Oh, he's moving!

I can feel him! [GROANS]

Dan, a little help, please?

Look at me.

In through the nose. [INHALES DEEPLY]

Out through the mouth. [EXHALES DEEPLY]

- Oh, my God.
- In through the nose.

Oh, my God, oh, my God,
oh, my God, oh, my God,

oh, my God, oh, my God, oh, my God.

Oh, my... Please don't hurt him.

I'm doing the best I can.

Got him, got him.

All right.

Here we go.

Oh, my God.

All right. Okay.

[GROANS AND SIGHS]

Sheesh.

Hey.

[GROANS]

Can you put him in something
so I can take him home?

Are you really sure you wanna do that?

Yeah.

He's Rupert. He's my pet.

- Hey.
- Mm.

Do me a favor.

Let's not let Rupert share
your pillow anymore, okay?

Yeah, that's a solid suggestion.

[KNOCKS ON DOOR] Excuse me, Dr. Charles.

Do you have a minute?

- Well done.
- Thanks.

Name's Jason Davies, 32 years old,

brought his mom in for an
outpatient gallbladder removal,

dropped her off so he could park the car

but got stuck in the
revolving door on his way in.

Stuck?

Refused to exit the door

until he had an even number
of steps per revolution.

Uh, had a panic att*ck the
second we tried to intervene.

He's got an OCD diagnosis.

That includes a need
for even numbers and symmetry.

We had to double everything...
BP cuff, pulse ox.

He made me rearrange the chairs
so there's one on each side.

It's such a misunderstood disorder.

So many people think
it's just this silly thing

about people who
wash their hands too much.

But it can be seriously debilitating.

The longer compulsive behavior
is entrenched,

the harder it can be to bust it loose.

It's... it's tricky.

Well, I'm hoping
you can give him a jostle.

He's pale, sweaty,
and keeps rubbing his sternum.

I'm worried he could have a heart issue.

I need an EKG to rule it out,
and so far, he's refusing

because the leads don't
sit symmetrically on his chest.

Well, um, let's see what we can do.

Mm.

You all right?

Yeah, just a sprain. No biggie.

Snake's out.

Start a discharge. And do me a favor.

Next time there's a reptile in
an orifice, give it to a resident.

Noted.

Hey, you want me to pass a note

to Ripley from you after recess?

Please.

You're one to talk.

I saw you flirting with Margo
last night.

- You're imagining things.
- Okay.

Come on, Dean,
you could do so much worse.

She's smart and funny and sweet.

And Sean's boss.

I don't think he'd appreciate
seeing me around the office.

I think he would be happy if you are.

Well, I'll keep that in mind

if I'm ever actually looking for a date.

Dr. Archer, head lock in T4.

This isn't over.

Hannah, we've got incoming.
We're shorthanded today.

- Can you start the workup?
- Yeah.

- Treatment three.
- Got it.

- Great.
- Going to three.

Marisol Robles, 26.

BP 117/79, heart rate 182,

experienced near syncope
unloading groceries.

This is so embarrassing.

All this fuss because of some dizziness?

There's no fuss, Marisol.
Anything else we need to know?

No, I don't think so.

Seriously?

Okay, fine.

A few days ago, I started getting

what feels like...
like a weird heartbeat,

like a pounding in my chest.

And she's been really sweaty and gross.

Gee, thanks, hon.

You know what I mean.

All right, let's get you transferred.

Oh, no, please, I got it.

Okay.

All right.

Any fever or loss of appetite?

No, but the heartburn.
I've been living off Tums.

Well, your lungs sound clear.

[SUSPENSEFUL MUSIC]

Lymph nodes don't feel swollen.

Any chance these are
early signs of pregnancy?

- We've been trying.
- Well, it's hard to say.

But we can get a full workup,
including pregnancy tests.

- Sound good?
- Yeah, thanks.

Great.

I will put that order in
and check back later.

EKG has too much artifact
with the leads out of place.

Jason, if I could just shift these two

- to the other side...
- No.

I told you.

The only way we do this is
if everything's balanced.

Okay, um...

how about a fresh set of vitals?

- Okay.
- Okay?

Just to get us started.

Hey. Hey! What are you doing?

I'm just grabbing a thermometer.

No, no, no.

Please, I told you, you have
to stay... stay there.

Everything has to stay balanced.
And you have to stay there.

We understand, all right?

Just remember, buddy, we're
trying to help you, all right?

How about we start
with blood pressure, okay?

There we go.

So Jason, you've been diagnosed

with obsessive compulsive
disorder, correct?

What kind of treatment
have you had, if any?

Everything's failed. I...

uh... [SIGHS]

A... a... a strict routine is the
only thing that works.

I'm sorry. I'm sorry.

And what happens if,
for whatever reason,

you're forced to, you know,
deviate from that routine?

Jason, you're still
a little short of breath.

Without the EKG, we're stuck.

If you let me place the leads properly,

they wouldn't be on for very long.

No. No, no, no.

Please, I mean, how many times
do I have to say it?

You know what we could do?
We could, uh...

we could draw some blood, all right?

A little bit from each arm,

keep things nice and...
nice and symmetrical?

Same amount from each arm?

Down to the centiliter, I promise you.

Okay?

- Thank you.
- You hang tight.

And, uh, we will get that set up.

[SOFT SOMBER MUSIC]

♪ ♪

Trini, set up for a blood draw.
I'm gonna need two kits.

- Two?
- I'll explain in a second.

Blood's a good start,
but it's only gonna get us so far

- if he has a heart condition.
- I know.

But you can't really steamroll
a patient like this, right?

This is nuts.
I mean, I'm familiar with OCD,

but needing a routine to the extent

that it's jeopardizing his health?

The routine creates this
crucial illusion of control,

right, which is ironic
because it's compulsion,

which he has no control over.

But the theory is that
they are triggered

by these dark,
intrusive thoughts, right,

this fear that something
really bad is gonna happen,

a fear that something really bad

has already happened
that's his fault, right?

And that's the obsessive part.

The compulsions, in Jason's case,

the whole symmetry thing, they develop

as a kind of a ritualistic
coping mechanism, right?

So how do we help him?

Well, the first step,

try and figure out what
he's so afraid of.

Yeah, well, we got an ED
full of patients

who also need our attention.

Yeah. Is his mom still up in pre-op?

She's rescheduling
her surgery for this afternoon.

So she should be down soon.

Okay, give me a heads-up
when she gets here.

She might be able to,
you know, shed some light.

- Thanks.
- Yeah.

♪ ♪

Okay, so you fell coming
down the stairs, huh?

I know. I'm such an idiot.

I was running late for work again,

missed the last step.

Better than falling
from the top, I guess.

No doubt.

So it doesn't look too bad.

Besides this little goose egg,

any dizziness or lightheadedness?

No, occasional headaches,
but that's probably

just because I've been hitting

dollar margarita
night a little too hard.

I know I shouldn't, but a dollar?

Well, worse ways to spend
a buck, I guess.

- [CHUCKLES]
- There's my girl.

Dr. Dennis!

I got your text. I came right down.

Sorry, I guess I should
call you Dr. Washington.

Oh, no, it's fine.

So what have you gone and done?

Mm, little altercation
with the front stoop.

I'm sorry to barge in
like this, Dr. Marcel.

Hillary and I go way back.

I can see.

Approaching two decades
cancer-free and clear.

Wow. That's fantastic.

I'll check in on you in a bit.

All right, I'll be here.

Okay.

All right, let's put this back on there.

Best I can tell, it's just a sprain,

but I'll get some X-rays to confirm.

I'd also like to do
some additional tests and scans

just to make sure it's the margaritas

causing those headaches.
How does that sound?

- Good.
- Okay, good.

I'll be back in a bit.
Just hang tight for me.

Dr. Washington,
what brings you down here?

Checking on a former patient.

Though I gotta admit,

it's certainly a nice perk
running into you.

- [CHUCKLES]
- Are you free for lunch?

Back-to-back meetings with Everett.

I hope he doesn't drone on too long.

Don't ask him about his golf game.

You never have to.

Would you settle for dinner?

It's a date.

All right.

Okay, your white count's normal.
No sign of infection.

All other labs, you're looking good.

But I am sorry to say that

your pregnancy test came back negative.

[SIGHS]

Well, I've always wanted
to be a medical mystery.

No, no, no.

We still have plenty of stones to turn.

We'll get this chest X-ray out
of the way and go from there.

- Mike, we good?
- All set.

Everybody clear.

[ELECTRONIC BEEP]

[SUSPENSEFUL MUSIC]

Marisol, it appears
you have a foreign object

lodged in your heart.

[GASPS] Oh, my God.

What is it?

I don't know, but it shouldn't be there.

Your CT confirmed a foreign object,

a rod about 4 centimeters long

lodged in your left pulmonary artery.

How did it get there?

That's the million-dollar question.

Have you ever had any surgeries?

Not since I was a baby.

They took out... what's it called?

A bronco...

A bronchogenic cyst? Yeah.

Yeah, that's... that's a big surgery.

I guess I don't remember.

What about any accidents,
traumas, procedures?

No, nothing.

What?

Marisol?

Three months ago,

I had a birth control implant
put in my arm.

What? Birth control?
What are you talking about?

I'm so sorry, honey.

- I can't believe this.
- I know, I know. I'm sorry.

You said you wanted kids.

I do.

I did.

I mean, you're not
freaked out about the world?

What?

w*r, climate change, pandemics.

We're really gonna bring
a baby into all that?

Honey.

You know what I'm saying, right?

To tell you the truth,

I don't think there's ever been
a good time to have kids.

If that implant was placed improperly,

it could have traveled
through a large vein

into your pulmonary artery.

Oh, my God.

She should be fine
once the rod is removed.

It's a minimally invasive procedure

done in interventional radiology.

A catheter is snaked up
through your thigh.

The rod is grabbed.

And then the artery is repaired.

There's no major incisions.

And you might even be able
to get out of here by tonight.

Sound good?

- Yeah.
- All right.

I'll put you on the schedule then.

[SUSPENSEFUL MUSIC]

[SIGHS] Ah, oh.

I know that look. Spit it out.

This kind of surgery
is your bread and butter,

but instead, you punt it to IR.

She had a thoracotomy
when she was a baby,

so I'm guessing she has a mess
of scar tissue in her chest.

We open her up again, all right,

the complication rates skyrocket.

IR is less invasive, sure.

But sneaking a wire through
her pulmonary artery

with limited visibility is no cakewalk.

Yeah.

Have you ever seen a birth control rod
in the heart before?

No? Yeah, that's what I thought.

No one has, all right?

There is no road map for this procedure.

So we pick the safest possible path.

IR, all right?

And if you're so worried about it,
why don't you scrub in and babysit?

Maybe I will.

♪ ♪

Hey, looks like ortho got you fixed up.

You were right. Just a sprain.

That's good. Good, good.

I know this move.

[SIGHS] What is it?

[SIGHS]

So your CT scan
showed a tumor in your neck.

And it's compressing
your carotid artery.

Explains your headaches
and unsteadiness.

So my cancer's back?

It's hard to say conclusively
without a biopsy,

but given your history...

I've been dreading this moment,

more chemo, radiation...

Well, not necessarily.

Far as I can tell,
the tumor's confined to your neck, okay?

Which means there's a surgical option.

Now, we do have an OR available.

And if you give me your consent,

I'd like to operate today.

- Today?
- Yeah.

Wow.

Yeah, look, I know that
this is a lot to digest.

But this tumor,
it's in a precarious location.

What do you mean precarious?

Well, because
it's on the carotid artery,

it could cause visual disturbances,

a loss of consciousness...

possibly stroke.

Okay.

You'll let Dr. Dennis know?

Yeah, of course.

Of course. I'll go page him now.

- You hang in there for me, okay?
- Okay.

We'll get this figured out, all right?

[SOMBER MUSIC]

You said Davies, right?

Yes, Jason. I'm his mother.

- Uh...
- Doris, I can take her back.

- Thanks.
- Miss Davies, I'm Dr. Charles.

I'm one of the physicians
who's treating your son.

Come with me.

Oh, how is he?

You know, right now, he's doing okay.

Oh, thank God. I'm sorry.

I hear he made a scene
entering the hospital.

I wouldn't have had him come,
but he insisted.

Do you mind me asking you
when you noticed

these behaviors showing up in your son,

at what point in his life?

Oh, even as a toddler,
he would have a meltdown

if his apple slices weren't cut evenly.

We didn't really think much of it.

Oh, of course,
because it just seemed like

normal toddler behavior at the time.

Exactly.

It was really when Jason's father
passed away that it got worse.

Yeah, he was only ten years old.

It was extremely hard on him.

He did say he has
had some therapy, though?

Well, he's been in and out of therapy

but never gets too far.

In fact, lately, it only seems
to be getting more intense.

Really?

Any changes going on in his life?
Any big transitions or anything?

No. Well, other than my surgery.

Excuse me, Dr. Charles,
can I talk to you for a second?

Dr. Ripley, this is...
this is Miss Davies.

This is Jason's mom.

Miss Davies, hi.

I just got your son's lab work back.

And?

It seems Jason didn't
just have a panic att*ck.

Jason, your lab showed
elevated levels of troponin

in your bloodstream.

That's a protein that's released

when there's a breakdown
of heart muscle,

most commonly as a result
of a heart att*ck.

- A heart att*ck?
- Unusual in somebody your age.

But, you know, we caught it early,

and so we can address it before
there's any lasting damage.

You'll need an angiogram to find

the source of the blockage
and potentially insert a stent.

It's a simple outpatient procedure.

They're gonna get you
all fixed up, honey.

- Nothing to worry about...
- Mom.

Mom, please.

Can you... can you move back
to the center?

Look, just sit tight, Jason.

Uh, we'll let angio know we're coming.

Wait.

- I only had one heart att*ck?
- Yeah.

I have to have another one.

I'm sorry, what?

Even numbers. Symmetry.

Jason, I just wanna make sure
you understand what you're saying here.

We need to fix this now.
And if we don't, you could die.

Honey, please listen to the doctors.

- You need this treatment.
- No.

It's too important.

I'm not doing anything until
I have another heart att*ck.

♪ ♪

Good to go?

Change of plans.

Based on the location of the tumor,

I believe it's a paraganglioma.

Uh-huh.

Which means I expect it
to respond well to radiation.

Now, radiation's not gonna
do us much good here, Dennis.

This tumor is completely
encasing her artery.

I need to take it out.

And once I shrink it,

you'll be in a far better
position to do that.

Hillary and I discussed all the options,

and it's clear that radiation
is the best place to start.

She's already consented to surgery.

She's rescinded that consent.

- You're kidding me.
- This is now an oncology case.

And I'm taking over Hillary's care.

And we are no longer
in need of a surgeon.

You know I'm gonna
have to take this upstairs?

That's certainly your prerogative.

[TENSE MUSIC]

♪ ♪

Okay, exiting the right ventricle

and advancing over the wire
into the pulmonary artery.

Oh, jackpot. There it is.

Here we go. Opening the grasper.

Got it.

[SUSPENSEFUL MUSIC]

Wow, that's really wedged in there.

Yeah, not budging.

- [ALARMS BLARING]
- BP and sats are falling.

What happened?

Must have perforated
the pulmonary artery.

Damn it. She's bleeding into her chest.

Marty, start the
massive transfusion protocol.

I'll be right back. Dean?

Hey, we need you.

- What?
- She perforated.

We gotta open her up.

[SIGHS]

So much for playing it safe.

If we had a court order,

we could wrap this up,
put in that stent.

Yeah, I just... I don't know.

Mrs. Davies, it is clear your
son is causing himself harm.

Any judge would agree.
- Miss Davies, do you mind?

Can I just grab Dr. Ripley for a second?

- Oh, of course.
- Thank you.

I know what you're gonna say.

I'm not sure you do.

Look, Mitch, in any other circumstance,

I'd probably agree with you.

The problem
with forcing treatment, though,

is that we would violate
Jason's sense of control

over his environment to the extent that

we or anybody else would lose
any chance of helping him

with his OCD for a long, long time.

At this point, doesn't helping him

mean ensuring he doesn't have
a massive coronary?

Yes. The thing is, I'm just starting

to figure out what's behind this,

and I just need a little more
time to reach him.

Okay, well, you better hurry,

'cause time's the one thing
we don't have.

[SIGHS]

Paraganglioma, headaches, syncope.

I mean, Hillary's already symptomatic.

But as I've explained,

in her case, starting
with surgery's not the answer.

If I understand correctly,

your concern is for
the integrity of the artery.

Remove the tumor, and you run the risk

of taking her entire carotid
out with it.

She'll bleed out on the table.

And if you radiate first,
it would scar and distort the anatomy,

making surgery even more difficult.

Actually, radiation would save you

from a difficult operation.

If I shrink the mass, you can
likely avoid a carotid bypass.

Please, Ms. Goodwin,

Dr. Washington and I
can do this all day.

Surgery versus radiation,
I can't even begin to count

the number of times
I've heard this debate.

And there's never a clear-cut answer.

But in this case,

given Dr. Washington's
extensive knowledge

of the patient and her medical history,

he's in a better position
to make this call.

You can move forward with radiation.

Thank you, Sharon.

[TENSE MUSIC]

♪ ♪

This isn't right.

Dr. Marcel, you brought me in
for arbitration,

and that's what I did.

Yeah. Yeah, okay,

and your relationship with him
didn't play a role?

Excuse me?

Miss Goodwin, I...

♪ ♪

You know, one thing I wanna tell you
is that I just really...

I really get how...

incredibly difficult
all this must be for you.

[SCOFFS SOFTLY]

I don't have a choice.

Which must just make it exhausting.

And that's why I wanna...

which is why what I ask you,
like, what if...

what if we could help you?

You can't.

But wouldn't you wanna spend
the rest of your life

feeling, I don't know,
like, a little less...

less like a prisoner of...
of your own mind?

Yeah.

I mean, I'm wondering if you were scared

that if we give you that stent
and disrupt your symmetry

that something really bad
is gonna happen

and that you're gonna think
it's your fault.

I mean, is that your take on...

on what happened with your dad?

And his heart att*ck when
you were a kid?

[SIGHS]

My dad was walking me to school.

I was trying to get
an even number of steps

in between the sidewalk pavement.

But we were late,
so he was hurrying me along.

And he just kept
pulling me and pulling me.

And I just... I couldn't keep up.

And then when I lost count...

he just dropped to the pavement.

It was just... he fell.

[SNIFFLES]

And now today...

in the revolving door...

I couldn't... I couldn't keep count.

And then I had a heart att*ck.

So now you're worried
that something bad's

gonna happen to your mom?

I don't wanna k*ll my mom.

That's why I have
to have another heart att*ck.

Right.

And the second heart att*ck...

[JASON INHALES DEEPLY]

You wanna have a second heart att*ck

because you think that that
is gonna make that not happen?

Yeah. It'll be even.

- It'll be even.
- Even.

It'll make it even.

And your mom'll be safe

if you can have a second heart att*ck?

Yeah, if I... if I have
a second heart att*ck...

Okay, I get it.

- My mom will live.
- Right.

Okay.

- [ALARMS BLARING]
- Pressure's in the t*nk.

She's still bleeding.

This damn lung is completely
fused to the chest wall.

Ugh. More suction.

Good. Can't even see the bleed.

Pressure's still down.

Keep transfusing.

Okay. All right, all right.

Got the lung.

Yeah. I see the tear.

All right, I'm pinching
the pulmonary artery now.

Okay.

[SUSPENSEFUL MUSIC]

I need a Satinsky clamp.

Wait, what are you doing?

What are you doing?

I need to perform a formal lobectomy.

You're gonna remove
a whole lobe of her lung?

It's that or let her bleed to death.

[DRAMATIC MUSIC]

The last clamp on.
And the lobe comes out.

She's not doing well, Dean.

I'm having trouble
keeping her pressure...

Just buy me 40 seconds, Marty, please.

Okay.

Got it. Blowing mass.

[ALARM BEEPING]

♪ ♪

Okay.

All right. Lobe is coming out.

There it is.

Rod's still intact.
- Mm.

All right.
- Numbers are better.

All right, let's finish it up.

[SIGHS]

So Jason thinks that
a disruption in his routine

k*lled his father when
he was a little kid.

So then this morning,

after he messes up his steps
in the revolving door,

he becomes convinced
that his mom is next.

That's why that the second heart att*ck

becomes so important to him,
because he...

he thinks that that's gonna
restore symmetry.

Right? Get him back on track.

And that if that doesn't happen,

then his mom will never
get up off the operating table.

[SIGHS] Wow.

Yeah.

So what's the next step?

Well, I think I figured out a way

to sort of decouple
his compulsion from his fear,

you know, to break the delusion,

but, um, I'm gonna need
your help to do that.

Okay.

Uh, you're not gonna convince me.

That's not why we're here.

So look, your mom knows
that you can get anxious

about her health, right?

She's in pre-op right now,

but she has gotten permission
from Dr. Tanaka-Reed

for us to bring you up there
so you can meet him,

see what great hands she's in,
and also say hi to her

before she goes into the OR
and when she comes out.

We'll each stay on one side
of you just like we are now.

And also, just because we really

wanna think about protecting
your heart at this point,

we're gonna give you a mild
sedative called a pyrazolam.

Have you had that before?

Yeah, I've had that before.

Great.

Good, well, Dr. Charles and I
split the pill in two

just to keep things balanced.

[SUSPENSEFUL MUSIC]

♪ ♪

Taking Hillary upstairs, as directed.

Hey, Hillary.

Richard here is gonna take you upstairs
to radiation oncology.

Where's Dr. Washington?

He'll be up shortly
to get you started, all right?

Come on.

Whoa! Hey, hey, hey.

I got her. I got you, I got you.

It's okay.

Hey, you with me?

You with me? You okay?

Give her a liter of LR.

Hillary, please,
you need this operation.

No.

Dr. Washington's against it.

Dr. Marcel?

♪ ♪

Hang tight for me, all right?

Is this a change in her condition?

Mm-hmm.

And it's because of the tumor?

It's clearly starting to
intrude into her carotid now.

She can't wait any longer.

Jason, this is Dr. Tanaka-Reed.

Hi, Jason.

He is a first-class surgeon

who's gonna take
excellent care of your mom.

We'll be texting Dr. Charles throughout
to keep you up to date.

I'll take good care of her.

Okay.

Okay, so obviously,

the hospital's not gonna
let you observe the procedure.

But we have arranged for

what we think is the next best thing,

which is to monitor it from in here,

in this little area that we've set up.

Your mom will be in OR two.

As you can see,
the light is currently green,

which means her surgery
is just about to get underway.

It'll switch to red
as soon as she's done.

In the meantime,
I think we have things set up

pretty much the way you like them.

And Dr. Ripley and I are

gonna be here with you the whole time.

Thanks.

We've got Hillary on fluids
and she's stable for the moment,

but Dr. Marcel is concerned the tumor

is disrupting the blood flow.

So we wanna revisit surgery?

Yes, Dennis.

This... this new complication
changes the calculus.

It does.

I'm afraid radiation
is no longer viable.

And Hillary is refusing to
consent unless you're on board.

[APPREHENSIVE MUSIC]

In the early years of my practice,

so many kids didn't make it.

I was burning out when
Hillary came along.

Her prognosis wasn't good,
went through more than most.

But she survived.

She gave me hope.

And that hope allowed me to keep going.

And Dr. Marcel is a skilled

and experienced surgeon.

I have all the confidence in
the world that he can do this.

All right.

♪ ♪

Are we ready?

Everything is gonna be okay.

I'll be right here when you wake up.

Tumor-free.

[SIGHS] Okay.

Okay.

- Take good care of her.
- You have my word.

[SOFT DRAMATIC MUSIC]

♪ ♪

[NOTIFICATION CHIMES]

Ah, okay, looks like
they are almost finished.

What... what are you doing?

I just wanna show you something.

No, the light's still green.
The surgery isn't over.

Buddy, it's gonna be okay.

You wanna take a deep breath for me?

Why are you doing this?

Because I wanna prove to you

that you had nothing whatsoever
to do with your father's death.

Move back. Please, she'll die!

No, she's not.
She's gonna be absolutely fine

because the truth is,
is that your behavior,

your routine, I appreciate it
makes you feel better,

but it has nothing whatsoever
to do with outcomes

- out in the real world.
- No.

- It doesn't.
- Yes, it does! It does!

- Hey, Jason.
- Hey, no, no, no, no.

- It does!
- Jason, Jason.

- Please, sit down! Sit down!
- Jason, just relax!

Look, look! It's red.

- Surgery's over.
- She's finished.

She's fine.

What?

It's over.

♪ ♪

Really?

Oh. Matter of fact,
I'm just getting a text.

Surgery on Frances has ended.

She's heading into post-op now.

So she's okay?

She's okay.

- Jason.
- What?

Jason, your mom's fine, okay?

But right now, it's you who's in danger.

So please, before you have
another heart att*ck...

let us place that stent.

[BREATHING SHAKILY]

Okay, okay.

Here it is.

Hmm? You did great.

Thank you.

Okay, you're looking at several weeks

of rest and rehab, and once
you're feeling up to it,

you can decide if you wanna put
one of these back in.

We don't want you to leave
here with the wrong impression.

This is a safe and effective
method of birth control.

What you experienced
was improper placement.

But you have no need
to fear something like this

ever happening again.

Like you said, there's never
a good time to have a child.

I think I'm really just scared
about becoming a parent.

You think I'm not?

Why didn't you just talk to me?

I don't know. I... I should have.

Because I just... I felt ashamed.

There's no shame in that, believe me.

You have kids?

Mm. A son, grown now.

And you were scared?

Oh, petrified.

[CHUCKLES SOFTLY]

Listen, my son and I give each
other a fair amount of grief.

Still, he's the best thing
that ever happened to me.

The trouble is,
it's impossible to understand

unless it happens to you.

It's one of the many
flaws of nature, I guess.

But the point is, there are
plenty of good reasons

not to have kids,
but fear is not one of them.

You might miss out on something great.

I don't know about the implant.

I have a lot to figure out.

We have a lot to figure out.

Together, I hope.

All right. Well, get some rest.

So fear can make you miss out
on something great, huh?

Did I say that?

That's what I heard.

She did great.

Tumor came out intact,
successfully bypassed the carotid.

Thank you.

You bet.

♪ ♪

Listen, Ms. Goodwin...

what I said earlier, I was out of line.

That won't happen again.

You have my word.

My apologies.

You have a good night.

Good night, Dr. Marcel.

What was that about?

Dr. Marcel and I had a little dustup.

Sorry you got put
in a difficult position.

Colleagues dating.

It was bound to happen.

Yeah.

We're still on for dinner?

Yeah, we still are.

[CHUCKLES]

Cardiology placed one stent
into his right coronary artery.

Thankfully, the damage
to his heart was minimal.

Oh, great.

So did you two grifters pull it off?

I had that green light on

for almost ten minutes after we closed.

The whole team kept asking
what the hell we were doing.

You know, just wanted to make
sure Mom was out of the woods

before we shook things up, right, Doc?

Right.

Well, you owe me one.

We sure do. Thanks again.

Yeah.

Hopefully, this is a step
in the right direction.

Yeah, you know, hopefully,

we did cr*ck that door open today.

Well, there's still time
to get in my run.

On that leg?

Maybe I'll give it a rest tonight.

Good call.

- See you tomorrow?
- You bet.

♪ ♪

Oh, hi. Margo, hi.

- Oh, hey, Dean.
- Hi.

Hi.

Uh, what are you doing here?

Oh, one of my residents
had her appendix out,

so I just thought I'd stop in.

- Okay.
- Yeah.

Yeah.

- [CHUCKLING] Okay.
- Mm-hmm.

Well, uh, good night.

- Stay warm.
- Thank you.

- And, Margo?
- Yep?

Uh...

- Okay, so... [CHUCKLES]
- Mm-hmm?

I was wondering if maybe you, uh...

you know, you'd ever wanna
go out sometime?

- Yeah, I would.
- Oh.

So why don't you call me
and we'll make a date?

- All right.
- Okay.

Huh.

♪ ♪

Hey!

- Hey.
- You're not running tonight.

What happened to your type A routine?

I decided to rest my leg
and, uh... and walk instead.

Oh, no. You don't need to do that.

I'll give you a lift.

- Yeah?
- Yeah, jump in.

♪ ♪

- Thanks.
- Sure.

If you wanted to go to my place,

I've got some epic herbal tea.

Wow. Epic?

How can I refuse?

[CHUCKLING] You can't.

♪ ♪