02x11 - En Bloc

[bunniefuu]

You just have to sign this release, and we'll take your brother to the funeral home to prepare him for cremation.

Could you just give us a minute, please?

(door opens)

(door closes)

He looks the same.

Like he's still in there.

Is he?

I don't know.

What do you mean? Can't you see him?

Alex, let's not do this right now.

No. No, seriously.

You said you're a medium. That...

Th-that's what you said, right? You can talk to ghosts?

So... talk.

Why don't I give you some space, and we can talk about it later?

Mm.

(picks up clipboard)

(paper rustles)

I can't sign this right now.

(gasps softly and exhales)

I have to go to work.

♪

So no funeral?

We'll do a memorial next week in St. Catharine's.

I'll scatter his ashes here.

Fun.

Yeah, not so much.

Wake up, honey, wake up.

Is that her? That's her, right?

Definitely.

Excuse me, Dr. Reid?

Yes?

(exhales) My name's Marvin Kapogrecko.

This is my son.

I have a sarcoma.

Nice to meet you.

His name is Lou.

Luke?

Lou. Are you the expert?

Um... not an expert, no.

June 10th, 2011. "Pre-operative radiotherapy"

"on retroperitoneal liposarcoma"...

"results and complications: A review" by Dr. Alex Reid.

It was my third year paper.

Wow. Mine was boils.

You found my paper online?

I found it.

The internet makes my dad say bad words.

(laughs)

(laughs)

Well, that's... that's true, buddy.

We are so glad we found you.

What can I do for you?

Everything, doctor.

Everything in the world.

(exhales)

I'm not really an expert, Mr. Kapogrecko.

But you can still help us, right?

(siren wailing in distance)

So...

(kissing)

See you.

(laughs)

(chuckles)

Oh, well, well, well, well, well. (clears throat)

Celebrating?

You could say that, yeah.

Actually, some news... the board just extended my term as chief here.

Five years.

Wow, th... hey, congratulations.

Mm-hmm.

Yes, I should be, uh, signing the paperwork later this afternoon.

Don't get so excited, Joel, okay?

'Cause you're embarrassing me now.

What-what, uh... They didn't meet your terms?

No, the terms were met.

So? What?

I don't know. It's the job, I guess.

You know, y-you sort of never feel good, you never feel bad, you just kind of feel like you're getting... the job done.

Trapped at the top. Poor Joel.

You know what I'm talking about.

26 specialists in this hospital, every single one of them wants something from you.

What do you want?

That's the point.

Don't matter what I want, Dana.

Of course it matters. (cell phone vibrating)

Guess who this is, by the way.

The nurse?

I'm gonna say someone who wants something.

(phone clicks) And look at that.

I'm correct.

Good-bye.

Her name's Marla.

You named your tumor?

It's after his favorite nurse.

At the Grace in Winnipeg.

She gave me an awesome shark figure. (chuckles)

Like, awesome shark figure. (laughs)

Okay, Lou, I'm gonna check your patellar reflexes.

You ready?

Mm-hmm.

Let's let this dangle. I'm gonna hold the back of your knee.

Relax.

Very good. Now...

Push against my hand with your shin.

Oh...

Wow, you're very strong.

Yeah, I play sports.

That's what it is. You have a good kick.

Yeah.

This imaging... is it recent?

Two weeks.

Let's take a look.

Uh... I know it looks bad, but the growth has actually slowed, and if you look at it, his, uh... his white cell count is normal.

His liver seems to be clear.

You've done your research.

Well, we had to. We, uh...

Well, tumors are kind of our thing.

Yeah, we know a lot about tumors.

The doctors back home...

They don't know what the hell they're talking about.

Why do you say that?

When we first went in... and this was a year ago... he had pain in his abdomen.

It hurt when I breathed.

You know what the doc gave him?

What?

Laxatives.

He said Lou was constipated.

They sent him home to eat prunes.

I'm sorry. This is your oncologist?

No, it's a G.P. in our small town.

We live on a farm.

I saw the doctor on the second day of school.

They didn't find Marla till my friend Andrew's birthday.

Eight months. And he shipped us off to Winnipeg, then they tell us it's too late, there's nothing that can be done.

And we're supposed to accept that?

So you've come here for a second opinion?

Second, third, sixth.

And then we found your paper.

You can cut it out, Dr. Reid.

Can't you?

I'll talk to the chief of surgery.

Stay put. I'll be back.

I'm not changing my mind.

We're their last sh*t, Joel.

This is a hospital, Alex.

It's not a refuge for lost souls.

I think I can help him.

Alex, I understand you just lost your brother.

That's not what this is about.

Alex, this tumor has its hooks in bone and tissue, in organs and veins. It's...

Do you want my advice?

Yeah, that's why I'm here.

Don't do it. I agree with the surgeon in Winnipeg.

I mean, we should let this boy live out his last days with a degree of dignity.

No, we can't give up on him.

Okay, I'll tell you what.

You can convince one doctor in this entire hospital that this tumor's operable, you go nuts.

Joel...

Otherwise, you should just accept what their oncologist has said, and what I am telling you right now.

Which is?

Which is absolutely not.

(sighs)

Catch a tiger by...

Mr. Kapogrecko.

What did he say?

We're a go.

(exhales deeply) Huh?

(chuckles) Okay, buddy.

(indistinct conversations)

Not exactly thrilled to see you, either.

(sighs, lowered voice) What are you still doing here?

If I knew, would I be bothering you?

Good point.

All right, Charlie, this is the part where you tell me how this works, how I get out of here.

(grunts)

Listen, usually when I see a ghost, I help them resolve something, and then they disappear.

So I have some unresolved issue?

I guess so. I don't know.

All right. You gonna help me resolve it?

I... Not right now.

Luke: Charlie, please...

Luke. I can't be talking to you right now.

(sighs)

(equipment beeping, indistinct conversations)

(exhales)

Hmm.

I know.

Hmm.

It's a bear.

We're talking ortho, plastics... you need, what, five surgeons total?

Reycraft...

Look, you know what Charles de Gaulle said.

No, I don't, and neither do you.

"I predict you will sink step by step"

"into a bottomless quagmire."

Mm-hmm.

And you can quote me on that.

Thank you.

Press against my hand, please, Ida.

Yeah, you seem to have lost a little power since you fractured your leg.

Let's lift this up.

I'll check your extension there...

Ohh!

What is it?

I just won 5 bucks. Scratch ticket.

You do know that risk-seeking behavior can be a side effect of the dopamine you take to control your tremors, right?

It's just a scratch ticket.

I'm not running away with a gigolo.

(chuckles)

(door opens)

Ida? Dr. Hamza's ready to start the study.

What study is this?

We're going biking.

(pounding on door) Dr. Murphy! I need your help! Right now! (pounding continues) I need your help. Right now.

(stammers) Walter.

Our appointment's not till 4: 00.

I brought her in like you asked me to, Dr. Murphy, so you could help me say good-bye to Vallenwe'en.

Yes, and we discussed that we'd meet later.

Dr. Murphy, she's gone.

She's gone, and I lost her. Oh...

Walter.

Vallenwe'en! Vallenwe'en!

Walter.

Vallenwe'en!

Walter!

(panting) I thought we were making good progress.

My heart... my chest is, uh...

Walter, you need to calm down. You're feeling anxious because...

Okay. I can't think. I...

Walter...

I... (panting)

Where did you last see her?

She was with me in the lobby.

And she... I retraced my... (gasps loudly)

Somebody kidnapped her.

(chuckles) Or somebody found her, and she's safe.

She can't take this sweater off.

She doesn't have thumbs like us.

Someone took it off her.

Walter...

Mm...

I need you to calm down, okay?

Oh, boy.

Oh, boy, Dr. Murphy, I'm not feeling very well at all.

Walter. Walter-Walter! Oh...

Okay. Walter... (panting and muttering)

Take some deep breaths, okay? Can I get a stretcher, please?

Dr. Murphy, you need a hand here?

Yeah. This is... Walter. He's complaining of chest pains.

Okay, take a nice, deep breath, Walter.

(exhales)

What happened?

He lost his guinea pig.

(breathing heavily)

Mm-hmm.

(Walter sighs)

Bicycle therapy.

I know. It's exciting, right?

Improving gait and postural therapy in Parkinson's patients using bicycles.

So how much?

I'm sorry?

How much am I spending?

Uh, $223,000.

You've got to be kidding me.

I don't kid. But watch this.

Ida...

Okay. Can you get up?

Okay...

Ida, step.

Shahir, she doesn't have this kind of mobility.

Step, Ida.

Step.

Do you see how well she's walking? Hmm?

Step.

We call it kinesia paradoxica. Nurse.

Guided movements can help these patients become more mobile.

So does it last?

Well, the tremors and rigidity, um, start up almost immediately once the exercise is stopped.

Okay. That's great. Easy.

(lowered voice) So... what is the point?

(lowered voice) We don't know the point, which is what is so exciting.

$200,000?

No, $223,000.

Bicycles?

Mm-hmm.

Bicycles.

(indistinct conversations)

Charlie?

Hey.

Wow.

That's the most advanced liposarcoma I've ever seen.

Do you think it's operable?

I mean, that would be a long sh*t, but, uh, it's better than...

(breathes deeply) Well, you're gonna need a lot of skill, a lot of hands, and a lot of luck.

Will you help?

Tumor's too big.

I know. When the digging is done, you'll have a big hole to fill.

No way.

Would you do a pedicle flap?

Nope. Rotation.

And stop trying to close your girlfriend's deals.

Ah, come on, Dana, all you got to do is come in for a patch job.

It's a St. Jude special.

The patron saint of...

Lost causes.

And kids.

This kid, Dana... he's amazing.

He would remind you...

Don't say it.

Molly. (sighs)

You know, that really is below the belt, playing the daughter card.

(club thuds)

Okay, I'll tell you what.

You drain this, and I'm in.

I don't golf.

Oh, that's too bad.

Fine.

New England vs. Miami.

Miami.

Reycraft, can I talk to you?

Yeah, yeah, one second.

Denver/Oakland.

Denver.

I want you to scrub in on my liposarcoma.

Which part of sinking into a bottomless quagmire didn't you understand?

Atlanta vs. New Orleans.

Charlie's in.

Dude is your boyfriend. Doesn't count.

Atlanta vs. New Orleans.

New Orleans.

What are you doing?

Girl has picked every winner two weeks in a row.

I didn't know you were a football fan.

I'm not. He names two cities, I say where I'd rather vacation.

Look...

I need fast hands in there. Name your price.

It's like "indecent proposal."

Cover all my calls for the next three months.

No. Six weeks.

Two months.

You're on.

And you take my niece Jada to see "The wizard of Oz."

We didn't shake on it.

Don't care.

I hate musicals.

Okay. Sure.

Speaking of which, where's my cut from last week?

How much did you win?

Let's just say business is good.

I'm telling you, she has got a horseshoe up her butt.

I've never met anyone that lucky.

Huh.

Maggie, wait.

So we need to deliver this bad boy "en bloc," in one piece.

Reycraft and I will free it from the intestines.

Then I can extend the incision and use the perispinal muscles as my posterior medial margin.

We'll go in the front door and start clearing house.

Then I'll come in and clean up after you.

And what is my job?

You are our good-luck charm and our muscle.

Muscle?

Yeah.

Once we lift up the tumor to start cutting, you can't put it down. Okay?

Okay.

Let's do this. Anything the tumor touches has to go.

His chest C.T. showed metastases, so if we get the primary...

Alex: We can cure him.

But first I'd like you to meet the patient.

(sighs)

How'd she get you to say yes?

Oh... challenged her to sink a putt.

And she drained it?

Nah. Missed it by a mile.

How about you?

I hate musicals.

Fair enough.

(door opens)

Lou, can I introduce you to some folks?

Yeah, sure.

This is Dr. Harris.

Hi.

Hi.

Dr. Reycraft.

Hi.

How you doing, champ?

I'm Maggie, and this is Dr. Kinney.

Call me Dana.

This is your team of surgeons.

We're gonna hunt down the tumor, and when you wake up...

No more Marla?

No more Marla.

Okay, well, text me when you're done.

All right. We'll see you soon.

Okay.

Okay.

(elevator bell dings)

She won't let go.

She'll sign those papers eventually...

That's not soon enough.

I can't be talking to her about you right now.

You saw what happened...

You don't understand what this is like, Charlie.

I am in hell. I see her.

I see life all around me, and I cannot be a part of it.

(elevator bell dings)

(monitor beeping steadily)

Oh, this tumor is heavy.

Hang in there, Maggie.

The intestines are more involved than I thought.

We'll need to resect a foot of the jejunum.

By the way, my niece that you're taking to the show... she isn't entirely toilet trained.

Alex: Could you hold it up a bit higher?

Yeah.

How's that?

Good.

Reycraft, how do you feel about this kidney?

(monitor beeps)

Not good.

Being invaded by the tumor on its lower pole.

Then it's gotta go. Clamps.

(monitor beeps)

(clicking)

Clamp.

(sighs)

(snips)

Okay. The kidney is free posteriorly.

Maggie, you're gonna have to hold that up, too.

Awesome.

I'm feeling some resistance here.

Uh, could be the presacral plexus.

(sighs) I don't know. I just... I can't...

There.

There is a monster vein heading right into the tumor.

I c... I can't visualize it without risking tearing it out.

Reycraft sighs: All right.

(squishing)

You're gonna have to cut it.

Blind?

I don't even know what it is.

You have any other ideas?

(sighs)

Satinsky clamps.

Okay.

The vein...

(clicking)

Metz.

(snips twice)

Got it.

Oh, hell, it's the cava.

You cut off blood supply to the legs.

You need to call cardiac. Get someone down here to do a dacron graft to replace the cava.

No, we don't have time. His SATs could drop.

You cut the damn vein that brings all the blood from his legs to his heart. We have to deal with it.

Can I just put the tumor down while you guys...

No!

No!

Okay. He's young.

He'll grow collateral veins.

Little roads that take over after the highway's gone.

Are you confident with this?

Yes.

SATs and pressure are holding.

(sighs) This is gonna work.

(heartbeat whooshing) Thank god they found her. Where was she?

In an elevator. (sighs)

Okay, Walter, I'm just looking at your heart right now.

Are they feeding her? They shouldn't give her oranges.

They give her mouth sores.

They will not feed her unless you tell them to.

But let's worry about working on you first, and then we'll worry about Vallenwe'en.

Your left ventricle is barely moving.

Put a stent in it, problem solved.

Her mother abandoned her, and that's why she wound up in a pet store.

So that's why I can't give her to another pet store.

And the creeps that had her before, they never would change her hay.

So when I adopted her, all her hair was falling out, and she was, like, scared of everybody, but now she has got, like, this silky coat, and she is, like, so friendly.

Isn't she friendly, Dr. Murphy?

You've definitely given Vallenwe'en a new lease on life.

It's true.

Dr. Murphy is helping me see how dependent I am on her.

Walter's overly attached to Vallenwe'en, so we're working on strengthening the attachments to the people in his life and letting go of his pet.

I just want to give her a good home.

I can't bear the thought of her going to some strangers.

I'll take her.

What? You will?

You will?

Yeah. They want lettuce, right?

Arugula has the most calcium, but yes.

I will take her. I will give her a good home.

Dr. Bell, that is so nice.

Dr. Murphy, isn't that amazing?

Uh...

I'll see you in a bit, Walter.

(exhales)

(door closes)

Everyone, in order for us to get the most out of this little spin class we're doing, we're gonna have to really push ourselves and light up the thalamus.

Who's ready to light that up? (cheering)

Great. Okay. Let's...

(disco music playing)

Feel the pain, and... (with patients) oxygenate the brain.

Great. Joel, you're more than welcome to join the spin class here.

I'll be doing a little guided imagery.

No, thank you. I'm just here to watch Hope Zion's money disappear into the toilet.

Sorry?

Ida!

Sorry. It's the tremors.

(wheels spinning) Okay. Careful now.

I can do this.

Ida, just... careful.

(clicks loudly)

Ohh! Ida! Ida!

(clamoring)

Joel: Hey, hey, hey...

Ida, are you okay?

(stammers)

♪

SATs and pressure again.

Still holding.

(exhales) Okay, so far, so good.

Kidney is free anteriorly.

He's tolerating the resection.

I don't feel any cancer on the liver.

Feeling the vertebral bodies.

(sighs) There is definitely more tumor there.

Near the spine.

Give it a feel. Tell me what you think.

Page Dr. Harris, please.

There's no plane.

Yeah. Damn.

I think the tumor's invading the L3 vertebra.

The C.T. didn't show it.

Tumor has the same consistency as the surrounding tissue and fat, so it wouldn't show on the C.T.

Right.

Did you reach Dr. Harris?

He's not picking up.

Well, he should be answering. He knows that we need him.

I-I'm getting some V-tach. His-his SATs are dropping. (monitor beeping rapidly)

Man: Dr. Reid?

(beeping continues)

Dr. Reid?

Give him his lidocaine drip.

Stabilize him.

What-wh... where are you going? (gloves snap)

Reycraft, make sure we didn't miss any tumor.

I'm going to get Charlie.

Come on, Charlie.

Pick up, pick up, pick up.

Dr. Reid?

Mr. Kapogrecko.

Wh...

Shouldn't you...

(gasps)

No. No. It-it's okay.

There were complications during Lou's surgery.

He's not out of the woods yet, but we managed to stabilize him.

Oh! (exhales and sniffles)

I thought you were gonna tell me that he d*ed.

That's, uh, how it happened with his mother.

I mean, you never expect a doctor to come out and tell you that. (sniffles)

Marvin, he's hanging in there.

You know, he's been so tough about it all.

He's smarter than me.

And he never gives up.

He's a good kid.

No, he's a great kid.

We are gonna get through this.

Okay? (sighs)

Just hang on a little bit longer.

(buttons click)

(sighs, under breath) Come on, Charlie.

Answer the damn phone.

You lied to my patient.

What, about adopting his guinea pig?

Yes. You're not really gonna do that, are you?

No, I'm not.

But it worked, right? He feels better.

I can't lie to my patients, and that means that you can't lie to him with me.

The most important part of my care is trust.

Dr. Murphy, we give patients placebos... sugar pills.

They heal. They feel better. That is good medicine, too.

Okay, this man Walter... everything that he said about that guinea pig is true about him.

He was abandoned by his mother.

He was malnourished, incommunicative.

His adoptive parents gave him one-tenth of the love and encouragement that he needed to be a healthy man with healthy attachments to people.

Guilt trip received.

Okay, now I'm gonna have to give that guinea pig back to him, And everything we worked on is gonna backslide.

He may not ever part with it again.

You gonna waste time backsliding?

That is a choice.

Right now your patient is on his way to being healed.

That is your choice.

(telephone ringing in distance)

(horn honks in distance)

(clears throat)

You canceled the study.

Shahir, won't you come in?

I am in. Joel, I don't understand your decision.

Your patient fell.

She's your patient, too.

She may have sprained her wrist.

Yes, because she's old. She has Parkinson's.

But soon she'll be frozen.

She won't be able to move at all.

Well, a bicycle ride's hardly gonna change anything, is it?

I mean, I... It feels a little pointless.

It's not pointless, Joel.

(sighs)

I believe if a patient seeks treatment early enough, cycling can be just as effective as deep brain stimulation.

You injured your patient.

It was minor.

Okay, if Hope Zion is spending money, I wanna see concrete results and no lawsuits.

So then the outdoor component... that's-that's out of the question.

Is it?

I'm sorry, Shahir. I... Mm. I feel bad.

Nah. You don't feel bad.

You don't feel anything.

Trust me, I'm a bit of an expert on that.

But, see, I-I have Asperger's. What's your excuse?

Three months.

You were stuck like this wandering these halls?

Yep. Alex was here fighting for my life, searching for a way to bring me back.

(sighs) Well, I'm dead, Charlie. There's...

There's no coming back from this.

I know.

I'm worried about her.

She always felt responsible for you.

I think in a way she feels like she let you down.

Maybe that's it. Maybe that's why I'm still here.

Maybe it's my turn to take care of her.

And when I know that she's okay, I'll-I'll move on.

That could take a while, Luke.

Right?

In the meantime, let's, um, let's try this funeral home release.

Couldn't hurt, right?

Baby steps.

Get her to sign it when I see her, and we'll see what happens.

Thanks.

I really appreciate you helping me figure this out.

Hey, man, this is apparently what I do.

Charlie.

Hey! I was, uh...

We've been paging you. We need you in the O.R. now.

Okay.

I'll sign the release.

We need to go.

It's invading the L3?

Yeah, there's no plane.

Well, I can't risk paralyzing the kid, trying to find a clean margin.

Well, we've already cut off his blood supply to the kidney.

The tumor's rotting. I can't close him up.

He'll die of sepsis.

Well, I'll take a look, Alex, but I can't promise you anything.

Charlie, I need this to work.

I know you do, but I don't wanna do more harm than good.

I was wrong getting us into this surgery.

That's what you're thinking.

No, I'm thinking you're trying to save a kid who may have years in front of him.

We can fix him. We can't let him die, Charlie.

He's 7 years old. It'll k*ll his father.

I... (sighs)

Could you go in from the back?

Uh... I can't access the tumor that way, but I...

But what?

SATs and pressure are lousy. He's fluid overloaded.

Alex: Well, we've got a plan. Charlie does.

Charlie: Laminectomy.

Go in from the back.

Expose his spinal cord, which is... (inhales deeply)

Like shaving a balloon, but then someone will have to hold the spine out of the way while I blindly chisel the cancer off the spine from the front.

You better be able to do this.

(monitor beeps)

Page Dana so we can close him up fast.

Right.

Charlie. (scrubbing hands)

Yeah?

Nothing.

Reycraft, you sure this is the right level?

Yes. L3. We landmarked it.

His SATs are dropping, and his B-pressure's way up.

Ballpark timeline?

I can stabilize him for now, but we can't keep him under much longer.

Okay. All right. Reycraft, retract the dura carefully.

It's like tissue paper. Alex?

(Alex clears throat)

(beeps)

I need an osteotome and a mallet, please.

Alex: I'll suction.

(suction gurgling)

(tapping)

Charlie, stop, stop.

I think you might have nicked the spinal cord.

(inhales deeply)

Yeah, I can see the tear.

Put him in trendelenburg.

(beeps)

Loupes.

(beeps)

(sighs)

Yeah, I see a 5-millimeter tear of the dura.

Spinal cord and nerves look intact.

Uh, Victor, 6-0 monofilament.

Coming.

How's it looking, Charlie?

I'll know in a minute.

(monitor beeps)

Scissors.

(snip)

Okay, let's see if that holds. George, lower the table.

Yeah.

(table whirs)

(monitor beeps)

Okay, it's holding. No leak.

Let's get this tumor out.

Dr. Hamza says you're canceling the study.

I am. It was far too expensive for the hospital, and I... Anyway, I would like to take this opportunity to apologize to you again.

Don't.

I had fun.

You put yourself through a lot for a therapy with no long-term benefits.

Long-term?

Mm-hmm.

In the long-term, my brain runs out of dopamine, I don't move again.

I can't... think long-term.

(siren wailing in distance)

So tell me... why do you do it?

I mean, is it the social aspect?

Hope. It gave me so much hope.

When you're trapped, tiny moments of freedom mean a lot.

I'll get a nurse in here.

How much does the study cost, anyway?

Why?

I won 500 bucks on a scratch ticket.

I'd throw it in if that would help.

Walter, you know how we've been discussing your self-esteem and how it's easier for you to stay home with Vallenwe'en and take care of her than to go out and how socially, your experience is feeling withdrawn?

Yeah. And I'm gonna work on that, now that Vallenwe'en has a home.

(exhales) Well, actually, Walter, about that, um...

I've got a good feeling about that doctor.

She's a heart doctor, and she is so beautiful.

Walter, wait. Uh...

I gotta say, I love that guinea pig so much, but I can't believe how nice it feels to give it to the doctor who fixed my heart.

Well...

Walter... (sighs)

Dr. Bell and I discussed the real issues that surround her taking a guinea pig.

Considering her busy schedule, and, um...

And we decided that at my house Vallenwe'en would be left alone for too many hours of the day, and the last time that I checked, my neighborhood doesn't have a guinea pig watcher.

(chuckles)

So Dr. Murphy suggested that I make a home for Vallenwe'en in my office.

That way, I could make sure that she eats every day, and my office has a south-facing window, so she'll get lots of light.

Dr. Bell, how can I ever thank you?

Wow, Dr. Bell.

You can thank me by coming to visit Vallenwe'en, keep her company.

Gavin: Really?

I will.

Not every day, right, Dr. Murphy?

We'll talk about what works for you.

(monitor beeps)

Yes, Joel?

It's a nice, tidy office, man.

Yeah, I don't like to be distracted from my work.

Look...

Essentially, you said something to me earlier... that I don't have any feelings, and, um...

(sighs) You know, I do have feelings, okay?

I-I... I just can't necessarily, um... express them as the chief of surgery.

Are you... coming on to me, Joel?

100% no.

Oh.

I am not coming on to you.

I don't know how you arrived at that.

That's...

Because the...

I...

Way you were...

Yeah, okay...

Not at all.

I'm sorry that... I mean, did you...

No, I don't have those feelings for you at all.

Why would you?

Oh, please, get over yourself.

I just misread social and emotional cues sometimes, like that last one.

Like that last one.

So let's just forget that even happened.

Didn't happen.

Great.

I came here to ask you something.

Then just ask it, please.

You know what? Just come with me.

Are we ready to deliver this bad boy?

Alex: Okay, we're gonna have to do this with kid gloves.

Okay, moment of truth. (exhales)

Okay, the tumor's free on all sides.

Alex, you should do the honors.

Actually, Maggie, you should.

Okay. (sighs)

Okay, here goes.

(squish)

Okay.

Victor: It's a boy!

Alex: Actually, her name's Marla.

It's a girl!

(chuckles)

(Dana) Okay, people, we're gonna have one hell of a hole to fill.

I want a sterile marker and as much 2-0 prolene as this hospital's got.

Jeez, look at that.

Alex grunts: (thud)

Alex!

Hey.

(gloves snap)

You scared me in there.

I'm just tired.

You were phenomenal today.

Thank you.

I'm pregnant.

(whispers) That's great.

(sighs) I, um, I've been keeping it secret.

Just... needed to hear it out loud once, I guess.

Gavin doesn't know?

Can't... seem to find the right moment.

There never really is a right moment.

Speaking of which, I'm sorry.

I'm sorry. I don't know why I'm...

With Luke's death and everything, and...

No, it's okay.

I needed some good news. (chuckles)

Just take some time off. Go somewhere quiet.

Mm.

Let Charlie take care of you.

Tell Gavin.

He loves you.

He can handle anything you throw at him.

I hope so.

Mm-hmm.

Hi.

You okay?

I don't know.

(monitor beeping steadily)

Hey, Lou.

Where's your dad?

(pen clicks)

On the phone with my uncle Casey and before that, my nan, and my aunt Jane.

He's excited.

Duh.

Well, who can blame him, Lou?

Your surgery was a bit of a miracle.

What's a miracle?

Let's just say that somebody will be writing another paper.

Hey.

(chair wheels roll)

What's wrong?

I'm a good listener.

Well, do you think my dad will still like me when I'm better?

Absolutely.

What do you think we'll do together?

(inhales)

Hey... do you think that the... the tumor brought the two of you together?

Yeah. Now that it's gone, you're a bit worried?

After my mom d*ed, we never went to the zoo or anything.

We will now.

(chair wheels roll)

I'm not going anywhere, son.

Make sure he gets some rest, huh?

I'll watch "shark rescue."

He always falls asleep during "shark rescue."

(chuckles) Good idea.

Hey, hey, what do you...

What do you think our new thing should be?

Sharks.

Sharks?

(chuckles)

Hey.

I've been looking for you.

Yeah?

Alex signed the release.

Your body should be on its way to the funeral home soon.

Good.

She's letting go of you and her grief.

I know it's a baby step, but...

It's still a step, right?

Charlie...

I'm saying I don't...

I don't think that you need to watch over her anymore.

She's gonna be okay.

No, she's not.

If you told her the truth... about what you can do, told her everything, didn't hold back, what would she do?

She'd try to fix... she'd try to fix me...

(sighs) No matter what toll it took on her.

You think you're here to protect her from me?

I would never hurt her, Luke.

Not on purpose. I know that.

I know that.

But you and I both know what she'd do if you told her.

(sighs)

What are you gonna do?

Uh...

(sighs)

Well, I guess I need to remove the problem.

En bloc, right?

Think you're free to go.

Yeah. (inhales deeply)

Yeah, I think it's time, you know?

(sighs)

You know, there's actually a really nice place out on mimico creek.

(reuben and the dark's "shoulderblade" playing)

♪ I'm trying not to try ♪
♪ this fire was here before you and I ♪
♪ and I've seen it all before ♪
♪ through a cr*ck in the wall and umbilical cord ♪
♪ hide your love inside my head ♪
♪

Ida? Okay?

Mm-hmm.

Okay. Follow me.

♪ wanna be the only thing on your mind ♪
♪ I'm trying to change ♪
♪ but you cut like a cold ♪ (giggles)

♪ shoulderblade ♪
♪ hide your love inside ♪
♪ my head ♪

Hey, Gavin.

Maggie.

I'm pregnant.

Huh? Whoa! (grunts)

♪ tell me which is which ♪
♪ prepare my heart for this ♪
♪ and call me out ♪
♪ quiet heart ♪
♪ and I'll say ♪
♪ I feel like a wrecking ball ♪
♪ with bottles of alcohol ♪
♪ but when will the dawn break ♪
♪ even again? ♪

I saw you... talking to yourself.

I... I don't know what it is.

If you... really do see things.

I'll fight, Charlie. I'll fight for us.

I'll... I'll fight for you.

I know. I know you will.

That's the problem.

Problem?

(huffs) What are you saying?

God, I love you.

Then talk to me.

I need to fix myself... by myself.

Charlie?

(gasps)

I should go.

(sighs)