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04x04 - Decisions

Episode transcripts for the TV show, "Transplant". Aired: February 26, 2020 – January 19, 2024.*
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Transplant follows Dr. Bashir "Bash" Hamed, a Syrian Civil w*r refugee and the newest resident at York Memorial Hospital, as he navigates through numerous obstacles to resume a career in the high stakes world of emergency medicine.

04x04 - Decisions

Post by bunniefuu »

Strategies for revealing your scars,

- visible and invisible.

- Sometimes

I hurt myself, but we

don't have to talk about it.

I'm on a transplant list.

A heart may come tomorrow or never.

You should both know

you won't be in limbo

for much longer about

the fellowship spot.

I'm deciding by the end of the month.

Every time I think I'Ve built

something, that feeling fades

and I run.

(GENTLE MUSIC)

Okay

Oh, my God! Oh, my God!

Oh! No!

No

- Did you see that?

- Yup.

- Morning.

- Thank you.

(INDISTINCT)

(OPENING THEME)

- Morning, Dr. Hunter.

- Hi, hi.

Um I was just

looking at the schedule.

Nights, weekends are the

least popular shifts, I know.

- You're filling gaps for now.

- No problem. Totally get it.

Dr. Devi, I just, I

I appreciate your faith in

me and I plan to earn it.

Let Dr. Bergeron know

if you have any questions

about shifts or patient assignments.

Sure thing.

Am I only back because

Dr. Olsen strong-armed her?

Because in my parole

meeting, that was the vibe.

I better

Good luck with all that.

- June?

- What's wrong?

Why does something have to be wrong?

We run a department together.

I merely want to discuss it.

Uh-huh. Let me guess,

it's about the rotating

surgery residents that

are cycling through. Oh!

By the way, this is Ryan. He's

first year general surgery.

Hi, Ryan. Why would I

be concerned about Ryan

and his inexperienced ilk

getting in the way of us

doing our jobs just so that you

can feed your benevolent leader?

We are a teaching hospital.

And you were CC'd on a least

a dozen emails about justifying

the budget by training residents.

Nature abhors a vacuum, Ryan.

Look, if you're not going

to engage in the process,

you don't get to be

pissy about the results.

Ah, June's been practicing

her mantras, Ryan.

Perhaps she'll teach them

to you if you ask nicely,

or you could do your actual

job and help save our incoming

patient flattened by a forklift, ETA 10.

- You okay?

- Yeah, why?

- Let's go get set up.

- Alright.

- Hi!

- Hi.

Stupid thing's supposed

to be waterproof.

Did you want to talk about it?

Because it's been a couple of days.

Oh, Devi said end of the month.

That's technically today, right?

- Devi?

- Yeah, about the fellowship.

I thought that's

what you were talking about.

No, I was talking about

Since, you know

How is your brain not

fixated on the fellowship job?

I mean, it is, but did

you want to talk about it?

- About us?

- Yeah.

Well do you?

Unless you want to

wait until today's over.

- No, that's not what I

- Mags.

- I've been texting you.

- Dead phone.

Oh, okay. Well, we

need help in curtains.

- Okay.

- Yeah, we'll just

This is Dominic. He came in unconscious.

Central line's in.

Ryan did the foley cath,

and now he's helping me to debride.

- How long was he crushed for?

- EMS says two hours.

Apparently, a forklift knocked

a palette of bricks onto him,

so it took a while to get him out.

You have an open femur fracture.

BP's still soft, heart rate's erratic.

- Ryan, right here.

- Yup.

And you checked to see that

his urine isn't dark, Ryan?

- He did, I already asked.

- But he has a voice of his own.

- Doesn't he, Ryan?

- Yeah, I checked.

Good, and what's the mainstay of

treatment for a crush syndrome, Ryan?

Aggressive fluid recitation

to reverse metabolic acidosis.

Track progress over the next few hours,

treat rhabdomyolysis,

and prevent renal failure.

He still has a pulse in his lower leg,

so as long as ortho agrees, we

will debride and clean for now.

Okay. Sounds like I'm dismissed.

- What do you think, Ryan?

- Um

(BEEPING)

His BP's dropping.

His urine output is dark.

Ryan, did you check that or not?

After the foley

catheter, remember I told

you to tell me if his

urine was discoloured.

And then I asked you again, you said

you checked it and that it was fine.

- It was. I think that it was.

- Was it or wasn't it?

You said renal failure was a risk, Ryan,

but was that just kneejerk

memorization because

when proteins get released

into the bloodstream

after crush injury,

they damage the kidney.

Which you have allowed to happen.

He's in V-tach, set up the cardiovert.

Push 20mg fentanyl, 2 of midazolam.

- What can I do?

- Out of the way, Ryan.

- Charging.

- (BEEPING)

- Clear.

- Shock advised.

How long have you had

the headaches, Yuri?

A few weeks. Then I

started getting pain here.

And these waves of tired where

I can barely keep my eyes open.

- Any loss of appetite?

- Yeah.

Has your son gotten sick? We're seeing a

stomach bug going through the daycares.

Alexei's not in daycare.

I'm starting my own

contracting business.

Most of the time, he

comes along. He loves it.

When the job is too messy,

the neighbor watches him.

It's just the two of you?

His mother died when he was a baby.

I think there's something

in the water in our building.

Lead maybe.

I told the building manager

that the pipes have corroded.

Even offered to fix them, but

they're too cheap to pay or even test.

Which is ill*gal, not

that that stops them.

I stopped giving Alexei tap

water but bottle is expensive.

So I boil for me. But if it is lead

Boiling won't help.

The city does have a

program aimed at identifying

and responding to environmental

hazards in older buildings.

You mean low-rent ones.

Well, you could qualify

for extensive testing.

But healthcare is free here, no?

You can just do the tests I need.

Yes, but this program

allows us a wider scope.

It moves you to the front

of the line, not to mention

it outs the landlords

that tend to cut corners.

But I would have to criticize

the country that gave my asylum.

No, it's completely anonymous.

Look, all I want to do is help you and

Alexei through this as fast as possible.

He's stable for now, but in

trouble with kidney failure.

Amp of bicarb, give mannitol

and get his potassium STAT.

No, no. You have to think

like a field surgeon, June.

First priority is to flush.

Right, then react with dialysis.

Okay, I'll intubate.

Should I do something?

You've done enough.

Look, Ryan, we'll debrief later

about what went wrong, okay?

Why wait? Start it with

the abysmal judgment

of whoever matched Ryan to this hospital

bringing us to his

astounding incompetence today.

But since we're debriefing,

when your tiny brain

can't remember if you've

done something or not,

don't lie and say that you haven't.

Unless you want to k*ll someone.

- Dr. Novak

- I'm sorry, look, I just thought

Another mistake! Because what

you think means nothing in here.

And if you're going

to insist on thinking,

then why don't you think long and hard

about whether this is the

right profession for you?

Dr. Novak, I think you made your point!

Look, you made a mistake

in the heat of the moment.

These things happen, alright?

(HEAVY BREATHING)

He's having a panic attack.

Can someone get him one of

those kidney bases between

- (RETCHING)

- No, no, no!

Did any get inside? Alright, I'm

going to need to irrigate, alright?

Just push as much prophylactic

antibiotics as humanly possible.

Hey, hey Are you okay?

Look, what Novak said,

that was about him, alright?

Just don't make it about you.

Alright. Let's keep irrigating, guys.

This is unacceptable.

I'm reporting both of you for

creating an unsafe work environment.

Two months ago, after it happened,

Claire said it was a sprain.

And now you can't move it at all.

Are you on anything for the pain?

Well, that's the thing. I'm on

something for my blood pressure.

This one. And, um

Water pills.

And you can't take those

with aspirin apparently.

Yeah, with NSAIDs, depending

on what your pressure is at

Oh, I think that's a restaurant receipt.

Um, also, on this.

And also, this for high cholesterol.

But there was some other thing

that interacts with those.

Okay, let me just, um

- You don't have a GP?

- Not for years.

Claire's been helping me manage.

I try not to overburden her,

but I'm a bit of a handful.

150 over 92.

My wife used to keep

track of things, but she

Anyway.

- Donald, I'm really sorry.

- Oh, she's not dead.

She just had enough of me, I guess.

Claire said I could text her

if I needed to be looked at.

I tripped over an

extension cord at work.

Claire said she'd book an X-ray for me.

But when I didn't hear

anything back, I figured,

well, she's not worried, I shouldn't be.

Only it's gotten to the

point where I can't work.

I do plaster, you know,

so I need my wrists.

"Technician's committee, I've

known Arnold for seven years."

- Actually, it's five years.

- Wow, it feels so much longer than that.

Can you please stop

reading over my shoulder?

It's very annoying.

"I can confidently say he

possesses all the qualities

that are essential for

success in a medical field."

- Oh, that's so sweet.

- Hey, I just caught one

of Claire's frequent

flyers. Is she running late?

- Guys?

- We don't know, Mags, okay?

Dr. Leblanc. Can we

talk in my office in 20?

Yes! I mean, yes.

Okay, just let me know when she gets in.

Hey, Dr. Devi.

So I started sharing blind data

with Toronto public

health regarding certain

- environmental hazards.

- In low-income housing

after that patient of yours died

from carbon monoxide exposure?

Well, turns out over the last year,

they've been piloting

an action designated

to help patients before

that kind of thing happens.

Rentsafe. I'm on an email list.

I was wondering if that's something

that we could incorporate to ED?

A man came in this

morning who qualifies.

A suspected lead poisoning. I'd

also like long bone radiography

to check density for chronic exposure.

If we push him forward

and they agree, then

It cuts through a ton of red tape.

You'd need his consent first.

Well, he's with his young son,

so moving faster is great incentive.

- The kid's fine, thankfully.

- Do I need that?

It's nice to see you engaging in this.

I know you went to Lebanon

to do relief work, but

I wasn't sure if it was

personal or professional.

Um

I think it was both.

Marrying your vocation

with your avocation,

good for you, Bashir.

- Let me know how else I can support.

- Thank you.

(P.A. ANNOUNCEMENT)

Hi..

Hi, I'm sorry, the door was open.

I'm not sure if you wanted me to

- Definitely. Sit.

- Okay.

Just give me a minute here.

Thanks for bearing with

me through this process.

Yeah, for sure.

So you're my first meeting,

Mags, because this is

good news. Congratulations.

Congratulations, you mean

Like, "I got the job" congratulations?

You did. In a few months,

when your residency ends,

we'd like you to stay on as

our emergency department fellow.

- (LAUGHING)

- Financial's in here.

All the logistics. I

hope you know, Mags,

that you are the essential fit for what

I'm trying to do in this department.

You're patient-focused,

you lead with empathy.

You put all of yourself

into everything that you do.

And I know your residency

hasn't been exactly linear

and you've been dealt with

some health challenges,

but getting to know

you over this last year,

I have no doubt that you belong here.

Now, obviously, this is a big commitment

and a major decision,

so if you need some time

or you have any doubts or concerns

No, no. No, no doubts. No.

- Okay.

- Yes. Yes, I want it.

- Yes, absolutely.

- Good.

Would it be weird if we hugged?

(LAUGHING)

Thank you.

I just ask that you not tell anyone

until I've had a chance to

let your colleagues know.

- Should be by the end of the day.

- Okay.

(CHUCKLING)

Where are we, June?

I'm using negative

pressure wound therapy.

- I'm just getting the foam ready.

- Is he still hyperkalemic?

And his BP's way too low.

Actually, the only good news

is that I debrided twice so

the wound looks fantastic.

Free from Ryan's vomit, you mean.

I'm wounding it back with insulation

because the last thing

we need is sepsis.

Aside from that, just wait and

see how his kidneys recover.

Which the kid is blaming us for.

Olsen requested an audience.

Entitled little troll. I told

you, residents were a bad idea.

Just lay it around the film.

But my opinion is irrelevant here.

What is up with you? Don't compress!

I know what I'm doing.

Look, I know things

between us have been tricky,

but it seems like there's more

bothering you than me having power.

If you can't handle a friendly

sparring, June, then that's on you.

The way we work in here, edge

of the knife, I need that.

Okay, as weird as that is for me to say.

But not everyone can handle it.

Can you respond at least?

Are you going to play

nice with the Ryan thing?

- I'm cutting the hole.

- Mark.

Don't put your stability on me,

June, I never asked for that.

We're all sucking it up today.

It's a scaphoid fracture.

If you would've done

the X-ray two months ago,

we would have put it in a

cast to avoid this situation.

Then, it's been broken the whole time?

I'm sorry to say so, yes.

When this happens, the

pieces don't properly fuse.

- It's called "non-union".

- You seem happy

- that this is happening to me.

- No. No, no. I'm just

No, I'm glad that

we're on top of it now.

- So now what?

- A surgeon might need

a bone stimulator or maybe even graft

An operation? And then, how

many more weeks off of work?

Donald, I just saw your text.

My wrist has been broken

for two months, Claire.

You were supposed to

call me about that X-ray.

I did.

I bet somewhere in your bag there,

you will find the requisition.

You're right. Odds are it was me.

I didn't mean to accuse you, Claire.

Let's get Doctor Leblanc back to

her regular scheduled programming.

And you and I can talk to a

surgeon about the next steps?

I'll just get changed and call upstairs.

Yeah, I'll write up a few

hydromorphone for his pain.

- He should tolerate them fine.

- Okay, thanks.

Chelation therapy should

counteract the toxicity.

Over the next days of infusion,

it will bind with the lead

in your bloodstream

and form a compound that

can be excreted from

your body through urine.

Then Alexei will stay, too.

He won't be any trouble.

You'll be hooked up to monitors and IVs.

There's no way to run

after an energetic toddler.

And as much as we'd love to,

we just don't have the

staff to look out for him.

Well, excuse me.

- Hey.

- Would you care to fill me in,

- Dr. Hamed?

- That's Yuri Zeilinger.

He came in with symptoms

of lead poisoning.

And yet you sent a bone scan and an MRI,

that seems like an expensive

way to get somewhere

that basic bloods would have taken us.

If you're concerned about resources,

I believe it falls under

the public health budget.

So I heard, but I don't remember

approving any

patient-sharing initiatives.

Dr. Devi did. I asked her to.

I have experience working in refugee

camps in Turkey, Syria, Lebanon.

If we had programs like this available,

we would have saved a lot more lives.

Smart. Not everyone has the

personal experience to leverage.

Makes it harder for us to

say no to that kind of pitch.

These programs are good

in theory, Dr. Hamed.

But I doubt we'll ever see

a dime from public health,

which means that we will

be eating the extra costs.

Are you asking me to pull Yuri?

Bad optics, too late.

We have a wrinkle.

Did he just accuse me

of using my life story to get ahead?

He did. I'm not saying

it isn't offensive.

But he's not wrong about

public funding being unreliable.

If he okays programs like this one,

he risks losing money we need elsewhere.

And if he doesn't, then he

looks like an uncaring r*cist.

Dr. Devi made it seem like I

was on the exact right page,

but Olsen thinks the

same idea makes me look

like I have no clue

how things work here.

The gulf between those

two is above our paygrade.

You said we had a wrinkle?

Yuri won't let me place Alexei with

a family while he's in treatment.

I get it, I'm a stranger.

But the kid can't stay here.

I don't blame him. I wouldn't

trust us either in his shoes.

But you do now, right?

You see yourself in Yuri?

Help him get to where you are.

Liz says exam two's up.

- Are you sure about that, Arnold?

- Yep!

Okay.

Hi, I'm Theo Hunter.

Theo Hunter. The Theo Hunter. Okay.

You're Jonathan, right?

Liz's live-in ex. This is Ash.

Hi. You know, if you'd

like, I can go get Liz.

She never sees us herself when we come.

"Protocol", she says.

Also, we've already been waiting an hour

and Ash is straining for air.

You're asthmatic, aren't you, Ash?

Yeah. It's been pretty bad today.

Ash texted from school saying

they could barely breathe.

Alright, let's get a big

breath in and out, okay?

(WHEEZING)

Any triggers? Exercise, allergens?

- What meds are you on?

- Big Bad Purple every morning.

- Little Boy Blue for attacks.

- Salmeterol and salbutamol.

Oh. And Little Boy Blue

hasn't done anything

- to help with the wheezing today?

- They lost it.

And are aware that since

insurance only covers so many,

the next one's coming

out of their allowance.

Okay.

We'll be able to

get your breathing sorted,

but I would like to do a

chest X-ray just to be sure.

X-ray's not necessary.

Nebulizer's normally enough.

Ash, you okay?

John, are you sure this was DEFCON

enough to take them out of school?

You could've answered one of my

30 calls and decided yourself.

Your boyfriend thinks

it's serious enough

if he wants me getting an X-ray.

Okay, well, I'm going to

go run down that nebulizer

and I'll let you guys talk.

Be right back.

Well, first meeting could

have gone worse, right?

A week ago, you wouldn't even

let me in the car for a pick-up.

Now you're assigning them to

me without even a heads-up?

Okay, fine, But I can't treat them,

and you're a person I trust.

And yet you're overruling an X-ray.

Look, Ash does this.

You know, when they came to us a

few years ago, they were always sick.

We settled in and it got better.

But now that John and I

Trust me, all Ash needs

is to hear they're fine.

Alright, nebulizer it is, boss.

Thank you.

Over there is where we're

going to fix you Dad.

- Dr. Hamed.

- Hi.

- Who's this?

- This is Alexei.

His father had to make a call to

arrange child care so we are on a tour.

Hi, Alexei. I'm Neeta.

I got your note about Olsen.

Let me worry about him.

But when you have a moment,

- I do want to speak in my office.

- Okay. Great.

(INDISTINCT CHATTER)

Hey, Donald, has the

surgeon not been in?

Not since you left before.

I have been through every paper

and I can't find that

X-ray requisition.

And no missed calls or

texts from Claire either.

I don't want to make things

worse and I know I'm scattered.

But I don't think this was my fault.

And Claire tried to say it was.

Okay, well, um

Maybe there was a system glitch

or some kind of human error.

- Let me just go check

- And maybe give me something

for the pain because I'm

still waiting for that, too.

Thanks for meeting.

Anything to assuage hurt feelings.

Poor guy even know where he is?

No, he came in unconscious

and we had to intubate.

He's a family member who's driving down,

but still about a day away.

I heard about the resident's complaint.

As this came to me through surgical

channels, Dr. Devi, I'm on it.

Maybe so, but the incident

happened in my department,

- so my purview.

- Incident?

- Seriously?

- The young man feels

that a gentler language

could have been used.

He lied. About

vital information, twice.

You're going to back

me up on this, June?

Uh He did. Yes.

Ryan claims that an environment

of fear incited his mistake.

That's crap. (SCOFFS)

Patient's life was in danger.

He's going to have to face way

more intense situations than that.

And if he crumbles, what good is he?

Even so, that justification

has fallen out of favour, Mark.

Okay, let's coddle them.

Because that'll work out so well

- for people who've been crushed by forklifts.

- (CHUCKLING)

What is that even supposed to mean?

That it is used to be permissible to

berate residents into panic attacks?

It was practically a

sport for my attendees.

Radical thought, but it might

be nice for new residents

to come up without being

repeatedly traumatized.

It's hard to disagree with that.

Then again, Mark makes a

fair point about coddling.

Like saying yes to ill-advised

public health initiatives

to keep from offending a resident.

That was about encouraging

a valid, holistic interest.

Hamed's enthusiasm is not going

to pay for unnecessary diagnostics.

Which, as you'll recall, is my purview.

(BEEPING)

He needs increased pressor doses.

It could be worsening

sepsis, but it's hard to tell.

This mess is not a

good look for Trauma OR.

So whatever your personal

feelings, I need the two of you

to make sure that Ryan feels supported

- and the patient is stabilized.

- In that order?

In that case, you can have the future.

June, say whatever you

want to Ryan, I am out.

Godspeed, Dr. Curtis.

June, you do not need to

hold it back for Novak.

- I know he's great in Trauma OR.

- He is Trauma OR.

Someone's got to do it. Anyways, I

That was spirited.

You should know I have

chosen Magalie Leblanc

for the emerg fellowship.

Why don't you walk me

through your thinking?

I've already told her.

It was my decision so I made it.

Once I tell the others, we can announce.

Sounds good.

Yuri, it's only for two

nights. You said you'd try.

I did. Neighbor who watches him

when I can't take him on jobs

has her brother this week.

And he's been in and out

of jail. Not an option.

- That's only one person.

- There's nobody else.

Yes, there is. Lucy would not put him

- with someone who isn't safe.

- If I can't keep him with me,

then there's nothing left to say.

- But you need treatment!

- You keep saying that,

but beyond the stomach

pain and headaches,

- which I can handle, I'm fine.

- No, you're not.

Your blood pressure is through the roof.

You could have a stroke, then

what would happen to Alexei, hmm?

When I first got here, I

would have said no, too.

I would have taken it all on myself

and it would have been a mistake.

But I've made so many mistakes.

Then take him. If you watch Alexei,

I'll know he's safe and

stay here for treatment.

I would, Yuri. I would,

but they don't allow that.

I could lose my job, I'm sorry.

Then let us go.

We're survivors him

and me, we will manage.

Mags, um

Did you ask the social worker

to help keep Donald organized?

Because I was on that.

Yeah, just 'cause you just

started full time again and I

What? So you can go

above and beyond with

every patient, but I'm in over my head?

No, that's not what I

You didn't order the X-ray.

And there's no record of a

requisition or any follow-up.

Donald's in pain.

I can fit him in tonight. He's

gonna need ORIF and a bone graft.

How long until he goes back to work?

Eight weeks and it'll

be a while tonight,

so stay on top of his pain

management. He's in discomfort.

Oh, and Dr. Leblanc,

I understand that

congratulations are in order.

The emergency medicine fellowship.

Yeah, I wasn't aware that

that was out. Yeah, thank you.

Mags, that's amazing. Way to go.

Now I have to suck up

to you more intensely?

- Yeah, you better.

- Congrats.

Happy for you, Mags.

That's a nice feeling being

at the beginning of something.

Thank you. I do think that

you and I have that in common.

The way that we prioritize this place.

And I'm living proof that

you can both work here

and manage your health issues.

But I'm not doing it alone.

- I'm fine.

- Claire, I Claire!

Okay, I made one mistake.

I will apologize to Donald,

but I will not advertise my

health problem for sympathy

just because it worked for you.

So you do your job and

let me do mine, please.

Hey, first day back, how'd it go?

Awkward. Yours, too, I hear.

- Buy you a drink later?

- Sure, only why?

Just, I know how much

you wanted that job.

You know, great for Mags,

but still, sorry, man.

Ah, wait, you knew already, right?

Yeah, I'll let you know

later about that drink, okay?

(PHONE CHIMING)

(PHONE CHIMING)

Ash.

I told Jonathan that you two could go

when the nebulizer ran through.

- Somebody should've came and got you.

- Um John had a work thing.

Liz is driving me

home when she finishes.

Is there something you

want to say to me, Ash?

Are you the reason

she and John split up?

It's more complicated than that.

And something you should

probably talk to her about.

Liz is the only mom I have.

So If you hurt her,

you're going to regret it.

Fair enough.

Feel better?

Ash? Hey, Ash, whoa.

Alright, c'mon.

Alright. Okay.

Hey, Ash. Ash!

You're having a reaction to one

of the drugs in the nebulizer.

Ash! Hey! Hey! What'd you call it?

"Little Boy Blue?" You had a

reaction to Little Boy Blue before?

- I need to know, Ash.

- I lied.

I ran out of it because

I take extra sometimes.

Did you do that today?

Hey, extra meaning what?

More than two or four puffs?

More like 40.

- I like the way it feels.

- Combined with the nebulizer,

that is way too much salbutamol.

It's making your heart

work way too hard, okay?

Can somebody get me a wheelchair?

Are you hungry, Alexei?

- You want some apples?

- Apples.

He's so cute.

Who did you say he belongs to?

Just a friend in a bind.

Yeah, you don't have any friends

with kids who aren't Theo.

Well, you haven't met all of my friends.

Because this was actually a patient's?

Okay, look, his dad needed treatment,

so I picked Alexei up and now we're

babysitting for two nights, hmm?

Bashir, are you even allowed to do that?

Why don't you and Alexei

sit on the new couch?

Yeah, right. Then him or

probably me spills food

and you freak out

because you're not able

to return it if you don't get that job.

(SIGHING)

I didn't.

I found out today.

- So what does that mean?

- Nothing.

There's almost six months

left of my residency,

so I'm still employed.

But you can't stay where you are after.

You like it there.

Are you okay?

- Are we okay?

- Amira, we're fine.

Starting over is nothing new for us.

Well, I'm staying on

the floor just in case.

Just sit on the couch.

- Rhoda prep adenosine.

- Veins are flat.

Find me the IO, I'll get

access to the left tibia.

No, hold on. I found an entry in

the hand, I can make this work.

- Rhoda, we don't have time.

- Can you just trust me, please?

- What happened?

- SVT from an overdose of salbutamol.

How is that possible? Did

you dose the nebulizer wrong?

No. Ash told me, and

I've seen this before,

they get a body stone if they

hit the inhaler enough times.

- Why would they do that?

- Adenosine's prepped.

- You want to stop their heart?

- Line's in, ready to push.

Liz, we need to get the heart rate

under control and we

have to do it now. Okay?

Okay.

Pushing.

(BEEPING)

C'mon, c'mon, c'mon.

Ash

Nice stick.

Try to have faith next time, son.

You okay?

It's been hard since my promotion.

Being everything to

everyone at home, too.

Should've trusted your instincts.

- Don't worry about it.

- Ash likes you.

Which is kind of a big

deal. Very picky kid.

Good to know.

Especially after the talk

I got about not hurting you.

You should come to the house.

For dinner with all of us this weekend.

"In addition, Arnold

has a natural curiosity

about the human body and its functions,

and his passion for

learning is evident."

Does natural curiosity about the

human body sound really sexual?

Yeah, try "anatomy" instead.

We're off the clock.

Boss, you told Arnold

you would write him

a reference letter for

med school weeks ago.

- It's due tomorrow.

- It is?

Arnold, why didn't you say anything?

We were just writing

a draft and I figured

maybe you could read it and sign off?

You haven't been easy to talk to.

You're right, sorry. Um, yeah, send it.

- I'll get to it before I go.

- Thanks.

(GENTLE MUSIC)

Bleeding gums after

lower-body crush injury.

Really want the poor

guy to pull through.

And if he doesn't, you're under

scrutiny because of the resident.

All I needed was for Novak to just

He couldn't just admit that the

kid didn't need to be demeaned.

Yeah, did Ryan really lie

about checking his urine?

Because no doctor I've ever

worked for would take that lightly.

Okay, look, I remember

when I was in first year,

we hid a file behind a surgical desk.

Days without humiliation.

The number always hovered

around two, now I guess

- I'm back down to zero.

- Same.

I think the bar's close

enough for us to walk.

- No, you don't have to buy me a drink.

- Yeah, I do.

You just beat out a

tough crew for that job.

Yeah, including my ex-boyfriend

who's probably now spiralling into a pit

of existential despair about

he's eternally unemployable

and will never be

able to give his sister

the life that she deserves.

I think we might be on the wrong block.

Yeah, I'm not supposed

to be drinking anyway.

Why can't you just let us celebrate?

Because you feel guilty about Bash?

Claire told me I only

got the job because

Devi pities me for my health issues.

What? No, Mags, you got the

job because you deserve it.

You should've seen her today. Claire.

First, she was late, then

she missed a patient's X-ray.

And now he needs surgical intervention.

One minute she's her sweet old self,

and then I offered to help

and she just blew off on me.

Yeah, it's like with Bash.

You know the myth about

the five stages being linear

when in reality you

either experience them

all at the same time or

just completely out of order?

- What, I can't evolve?

- Okay.

Except I ordered her patient pain meds

and I don't think they ever got to him.

You think Claire took his pain meds?

I guess if she has something to hide,

that would explain her pushing you away.

What are you going to do? Novak.

I need him, so what I always do.

Just suck it up and

apologize on his behalf.

Tomorrow's 50 days of no cutting, too.

So that means we're not

only celebrating you

June! Ugh. How you feeling?

- Proud.

- Yeah.

I think I'm scared.

Like, what's going to

happen without the cutting?

My ability to handle things,

my endless capacity for

pain and suffering, my

Maybe you don't deserve

endless pain and suffering.

And I don't think that you

won't be able to handle things.

You're right about evolving.

Wait, did you say your

patient's gums were bleeding?

- Yeah, why?

- Because damaged tissue

after crush injury can

pump cellular debris

into the bloodstream and send his

clotting system into overdrive.

- DIC.

- If it's consuming

clotting factors and platelets

faster than they can be replaced

Go, if you need to take care of it.

Thanks! Congratulations, seriously.

(PHONE RINGING)

Hello?

Forgive me if I don't

apologize for waking you.

I drove out to Branson last night

only to scare the hell

out of Yuri's neighbor

who had no idea why I

was checking on a child

who wasn't staying with her.

And then, I drove all the way

back for Yuri to tell

me that you took Alexei.

- Yeah, only for a night or two.

- Except it won't be.

Yuri crashed, started

seizing from hypocalcaemia.

But we can regulate that.

He might just need slower dosage.

They moved him into ICU.

They're saying he'll need to

stay in-patient two weeks now.

Okay, well then, let me keep him.

You said to reach Yuri,

this is how I'm doing it.

I told you to get him to trust us.

But all you've done

is prove that he can't.

And now I have to place

his son with strangers

without the father's buy-in.

You're right, you're right.

I'll I'll come in. I'm sorry.

It's not me you should

be apologizing to.

(SIRENS WAILING)

Mr. Cassavetes.

Suffered an industrial accident

and crush injury yesterday.

He has fought through kidney failure

and cascading complications.

- How are you feeling, Dom?

- Lucky to be alive, Dr. Curtis.

Thank you.

Ryan, can you please

walk us through the clotting disorder

that this patient was treated for?

I hadn't had a chance

to review the chart.

Oh.

Let's move on to patient room C.

Ryan, can you walk with me this way?

Yeah.

Look, the way you were treated

the other day was unacceptable.

And I apologize.

Shouldn't Dr. Novak

be here for this, too?

You had the right to make a complaint

- and this is us addressing it.

- Okay.

I thought there was going to

be more of a formal meeting.

I'm a little blindsided.

Okay, you feel blindsided

because I'm apologizing to you?

Or because I called you

out for being unprepared

- for your rounds, Ryan?

- I asked my supervising doctor

if I could be excused from that

patient because of how it affected me.

That's not exactly how this

works, Ryan. You don't get

to pick and choose so that you

can hide from your mistakes.

It was your mistake, not mine.

And now you're giving me a fake

apology and trying to retraumatize me.

You need to shut up, you

entitled little troll.

You know, Ryan, if you knew

anything about real trauma,

you would get it together, face

your mess and do the damn work.

Claire?

I know doctors aren't

supposed to be in here,

but I just wanted to see

if Donald had his surgery.

Yeah, he came through fine.

And he told me about

our social worker's plan to get

his health care under control.

Yeah, that was the right move, Mags.

How long do you think that'll stick?

Knowing Donald, I have a feeling

he'll still need help from time to time.

Yeah, we all do.

Hydromorphone.

- Mags, what is this?

- If you have pain, Claire,

that pain should be managed.

We both know the harm

prevention protocols

when it comes to opioid

use tend to shut out people

who need them and know how

to use them responsibly.

Based on my actions lately,

are you sure that's the

word you want to use?

Yeah.

I know you, Claire.

There is physical pain, yeah. But

Every patient I see I think, "Is

this the person who stabbed me?"

I never saw their

face and I am so angry!

(SNIFFLING)

And I hear myself being

terrible to people.

It's just, I can't stop it, I

How do I know which pain I'm medicating?

We're going to make an accountability

plan for the painkillers.

So that they stay under control.

And find you a counselor.

You're not alone with this.

Claire

Thank you.

(SIGHING)

Sorry you found out about

the job the way you did.

That was unprofessional.

- I tried to find you, but

- Yeah, I had to

Rush off with a patient's

child and prove Olsen's point

about using your background

and public health to work us.

I didn't mean to make things

more complicated for you.

Well, you did. And while you're

a skilled doctor in so many ways,

this is an example of why

you didn't get the fellowship.

This instinct to leap blindly.

You just can't seem to shake it.

What happens now?

You try not to abscond

with any more children,

and hopefully, leave here

with a glowing recommendation.

They live close.

They promised to bring Alexei

by to see me every day I'm here.

I want to believe them, but

I'm so sorry about all of this, Yuri.

But if Lucy trusts this

family then we can, too.

I know you may not be

able to see it now, but

eventually, all of

this will be behind you.

You should've seen Ryan's face.

He's just so smug.

Feel myself simmering.

And then you just lost it on him.

Yeah, but it did help me

get to the end of day 50.

(CHUCKLING)

Did you want white or red?

Um, actually, before you open that

This dinner is going to have

her ex-husband and her two kids.

- June

- (DOOR CLOSING)

It's hard not to feel like

I'm being collected, you know?

- Yeah, sounds complicated.

- Hi.

- Hey!

- Congrats.

No, you didn't have to do that.

Yeah, he did.

Guys, it's not ornamental.

You want to maybe

No, yeah, I got it.

- (PHONE VIBRATING)

- Is that you?

Nope.

Oh, that's my phone.

My screen's garbled, but

- Hello?

- Hello?

- Magalie, is that you?

- Yes.

Mags, this is Connie

from your transplant team.

- I've been trying to reach you.

- Yeah, I'm sorry.

My phone died. Is everything alright?

There's a heart waiting

and it's a perfect match.

If you decide to take it, we need

you at the hospital now basically.

Mags? I need you to confirm.

Are you accepting this heart?

- (BOTTLE POPPING)

- (LAUGHING)

(INDISTINCT CHATTER)