20x08 - Blood, Sweat and Tears

[bunniefuu]

[GREY] The human brain contains
roughly 100 billion neurons.

Alone, these neurons would
only allow us to retain

about as much information
as a flash drive.

Fortunately for us, our
neurons connect and combine,

creating a web that exponentially

increases the brain's storage capacity.

It is so peaceful up here.

Oh, yeah.

It's great.

Yeah. According to the map,

- the waterfall is just around the bend.
- Okay.

[GREY] In fact, this
process creates so much space

that we can store the equivalent of

three million hours of video content.

Um... No waterfall.

Did I read this wrong? I mean,
that is a waterfall, right?

Yeah, yeah. But the map also rates
this trail as moderately difficult.

I'm sorry. This was
supposed to be a fun day off.

No, I am having fun.

Mud on the boots, fresh air.

It's the great outdoors,
right? Let's go. Okay.

[GREY] So, why can't we remember

everything we try to commit to memory?

"Following resection of the ileum,

a patient is most likely to require
supplementation of which vitamin?"

B12.

Round starts in five
minutes. Coffee takes longer.

Yesterday, she yelled at me
for going to the bathroom.

Well, everyone is on edge
because the ABSITE's tomorrow.

Or because she's not getting laid.

- I'm not getting any either.
- [PHONE BUZZES]

- [BARISTA] That'll be 4.85, please.
- _

[GASPS] Wow. Oh. Uh, yes.

I swear my wallet is in
here somewhere. [CHUCKLES]

Hey, let me get it.
Do you want breakfast?

I'm in an unhealthy relationship
with these almond croissants.

- Uh. No, you really don't have to.
- I know. I want to.

- Here. Keep the change.
- [BARISTA] Thank you.

What?

She bought me coffee.

Yeah. Maybe she was being nice.

Or weird.

I don't have time for whatever this is.

[SIGHS]

[HOSPITAL ANNOUNCER]
Dr. Wagner to Radiology.

Dr. Wagner to Radiology.

I've been texting.

I'm on your service today.

I think we can downgrade
Mr. Quint from...

Just... [SHUSHES]

I'm practicing my speech
to Altman in my head.

I am quitting general
as soon as she gets here.

- Altman's off today.
- No. What?

I was up all night rehearsing.

You could channel
all that energy into

signing off on Mr. Quint's
step-down room.

Also, Mrs. Valenti still looks

distended, so you
might wanna order a CT.

Also, did you review the
nurse's notes from last night?

Did you forget how this works?

I tell you what to do.

- Now, go do all that.
- Then what are you gonna do?

I'm gonna stew thinking about how long

it took my resident to do what I asked.

Crap rolls downhill, Schmitt. Go.

And they wonder where
I get my tone of voice.

[SIGHS, GROANS]

[HELM] Out of my way.

[KWAN GROANS]

I was here until 11:00
last night doing rectals.

A heads-up would have been
nice before dumping Helm.

I didn't dump anyone.
I just needed space.

Walk faster.

- She's like a pissed off bee.
- I finished my procedure log.

Sorry it took a minute. I
was studying for the ABSITE...

Just hand it to me, Griffith.

You're supposed to submit
that to me or Schmitt,

but why start following the rules now?

Well, congratulations.

In under two months,

you have collectively
done dozens of A-lines,

chest tubes and other
critical procedures.

And I know it is not how you
wanted to spend your time,

but you went back to basics,

worked together, and you're
ready to move forward.

Does that mean we're
allowed back in the OR?

Effective immediately.

Wait, can I please
scrub in on Dorian's...

I was on his case from
the day he got here.

Have I given the impression
that this is a democracy?

Helm.

Griffith and Adams,
you're with Dr. Bailey.

Millin, with Shepherd.

Yasuda, Ndugu. Kwan, Lincoln.

Oh, uh... And study when you can today.

If you don't score
above the 30th percentile

on your exam tomorrow,

Joe's is hiring.

I actually loved that
job, so joke's on her.

Keep up with your notes and pages and

please don't k*ll anyone in the OR.

Yeah.

Go.

How we doing this morning?

My lung is still collapsed,

but I'm having a great hair day, so...

I'll take it. Yasuda.

Emmy Chen, 16, born
with cystic fibrosis.

Admitted for a persisting
left pneumothorax.

Currently on Mucomyst and
two-liters nasal cannula.

I've had way worse.

Tomorrow, she will
undergo a VATS pleurodesis

to irritate the outside lining
of the lung and chest wall.

No way I'm consenting to that.

We've talked about this.

- You and your parents agreed.
- My body, my choice.

For the tenth time, that's
not how you use that phrase.

And your body is leaking air
from your lung into your chest.

So listen to Dr. Ndugu.

- Hi, Caroline.
- Hi.

I'm Dr. Beltran. This is Dr. Millin.

[EMMY] And I'm Emmy.

And unfortunately, peds
is a full house today,

so welcome to Emmy's world.

- We're just living in it.
- Hi.

Hi. You must be
Diane. How was your trip?

Easy. And thank you
again so much for seeing us.

We've heard great things about
you from our support group.

Well, I hope I can live
up to the reputation.

Can I take a look?

You're better than the
first doctor we saw.

- He was super judgy.
- [EMMY] Safe space here.

We can hear you, Emmy.

That doctor judged me for being trans.

[EMMY] Yep. Most doctors suck.

Thank you, Emmy.

Millin, present.

[MILLIN] Uh, Caroline Early, 14,

presents with progressive
discomfort behind the left knee.

Diagnostic ultrasound at an
outside facility showed a lipoma,

scheduled today for an excision.

Your last scans were
a couple months ago,

so I wanna get an MRI
and just repeat ultrasound

just to make sure nothing
was overlooked, okay?

- Okay.
- We'll be back for you soon, okay?

Thanks.

[WEBBER] Dr. Griffith, present.

Dorian Cardenas, hospital
day 55, transferred back...

Fifty-six.

Fifty-six. Transferred back to
the ICU after recurrent sepsis

and high-output enterocutaneous
fistula. Treated with IV antibiotics.

Has since recovered from the infection.

Scheduled today for a laparotomy
and takedown of the EC fistula.

Hey, it's a good day.

You ready for surgery?

Does anyone answer
"yes" to that question?

You okay with an abdominal exam?

- Whatever.
- [CHUCKLES]

It looks like 320 ccs overnight.

[BAILEY] Mm-hmm.

How exactly does this surgery work?

As you know, Dorian's skin
and small bowel are connected.

So today, we are going
to remove that connection

and while we're at it, we're going
to try and reverse his ostomy.

- Wait, really?
- You are young.

Your nutritional markers are where
we want them, so we're gonna try.

One step closer to a cheeseburger.

- I'll believe it when I eat it.
- [DOCTORS LAUGH]

[HUNT] Maybe we should just
give up on the waterfall.

Wait, I... I've seen this tree before.

Are we... Are we going in a circle?

- [HIKER] Rosie!
- [ROSIE SCREAMS]

[ROSIE SCREAMING, CRYING]

- [HIKER] Rosie!
- [ROSIE] Dad, help me, please!

Please help me. My ankle.

What happened?

My daughter fell. Please help.

[ROSIE] Did people
come? Can they help us?

Rosie, my name's Owen.
This is my wife, Teddy.

We're both doctors. We're
gonna figure this out, okay?

All right. No service. I'm
gonna go down and call 911.

- [ROSIE] Ow, ow, ow.
- Rosie,

can you move your arms and your legs?

Yeah, but my ankle really hurts though.

Okay. Try to keep your
weight off it and stay calm.

[ROSIE] Is that a joke?

[SIGHS] Sense of humor's still intact.

Okay. Once we get the
park rangers on the phone,

there'll be help in
less than ten minutes.

- I'm on a ledge!
- Try not to move too much, okay?

- Dad!
- I'm here, honey! I'm here!

Hold on. We're trying to get help.

How am I gonna get out of here?

[HIKER] Hold on! I'm gonna get you out!

- Dad, what are you doing?
- [HIKER] I'm coming, Rosie!

- Sir, wait!
- Dad, no! Dad!

- [HIKER SCREAMS]
- No, no, no!

[ROSIE, HIKER SCREAM]

- Joseph, are you hurt?
- [ROSIE] Oh, my God. Oh, my God.

[JOSEPH GROANS]

I cut my leg. [GROANS]

It's... It's pretty bad!

- Rosie, I need you to take a look.
- Okay.

[SCREAMS]

No, I don't... I don't think I can.
We're on the edge of a huge drop!

- I need you to tell me what you see.
- Oh, my God. Okay.

[BOTH GROANING]

[CRYING] Oh, my God. He's gushing blood.

When you say "gushing," do
you mean it's slow and steady?

I mean gushing!

We're gonna need to try
and stop the bleeding, okay?

- [ROSIE CRIES] Is help on the way?
- Not yet.

Until then, you're gonna need to
try and help him yourself, okay?

Now, there are three steps
to controlling bleeding...

apply pressure, pack the wound,
and applying a tourniquet.

God, I didn't even want to
come on this stupid hike!

Right now you need to listen to me.

Do you have a shirt that you can use?

You need to take that off and use it

to apply pressure in your dad's wound.

Okay. [WHIMPERS]

I'm sorry. I'm sorry.
I'm sorry. Okay. Okay.

Hold on. Hold on. Hold on.

[CRYING] It's not helping!

Pack the wound with some kind of
fabric. You can use the same shirt.

You need to stuff that
completely inside the wound.

Pack it as tightly as possible.

- [ROSIE WHIMPERS]
- [JOSEPH GRUNTING]

This doesn't seem sanitary.

- You don't have any options.
- [ROSIE] Okay.

- [JOSEPH] Rosie.
- Okay.

- Okay, it's in.
- [HUNT] Okay, good.

Now, press down as hard as you can.

We need steady and direct pressure.

Okay.

Okay. Okay.

Are you still there?

I'm still here. I'm not going anywhere.

Come on, Teddy. Come on.

You're almost done.

Could you try not to
move around as much?

How are we not done
yet? This is t*rture.

[BELTRAN] Caroline,
are you a betting woman?

[CAROLINE] I don't know. Maybe.

All right. If this scan isn't done
by the time you count to a hundred,

I will give you $100.

I could buy so much embroidery floss.

Are you into crafting?

I make friendship bracelets.
Usually during my study hall.

I can focus on tying all these tiny

knots and it's like I'm not even there.

Well, your friends are lucky that your

hobby makes them such cool accessories.

- I'm gonna start counting!
- Too late. We're done.

- You can relax now.
- [SIGHS]

Okay. What are we looking at here?

[MILLIN] Well, there's not
enough fat deposits for a lipoma.

There's a nerve running through
it. Is that a neurofibroma?

That I did not bet on.

Which of the
following is an absolute

contraindication to
administration of TPA?

Uncontrolled hypertension,
recent spinal surgery or the...

Yeah. I don't wanna study right now.

Calms me down. Think I'm
nervous to be back in the OR.

Are you?

No.

Kwan, our hip replacement
got pushed a few hours,

so you can go ahead and keep studying.

- [KWAN CLEARS THROAT]
- What are you doing?

I, um, am fixing a sock.

- You're taking the ABSITE tomorrow.
- Yes.

You asked me not to do op notes so

that you could have time to prepare.

And I appreciate the time.

Which you're using to fix a sock.

Yeah, it's... Um...

- It's...
- Lucky?

Would it be weird if I said yes?

- You're Serena Williams.
- I'm not following.

She's got a thing about socks. She

won't change 'em during a tournament.

She won't even wash
'em if she's winning.

You know how many athletes have
lucky socks or shorts or beards?

- You're in good company, Kwan.
- [CHUCKLES]

You just got one problem.

- You need your op notes sooner?
- No.

The gauze.

It'll never hold up.

Let me see that.

So the lesion looks benign, but...

There is always a "but."

- [CLEARS THROAT]
- Hey!

Unfortunately, it's not a lipoma
like your primary doctor thought.

It's most likely a neurofibroma,

which is a spontaneous
growth in the nerve tissue,

and it can damage the nerve itself.

Which is why you're experiencing pain.

- So, can you still remove it?
- Yes.

But we need the help
of the neurosurgeon,

which is why my friend
Dr. Shepherd is here.

Hi, Caroline.

Hi.

Is... Uh...

I'm sorry. With all due respect,

we came here from Texas
to work with Dr. Beltran.

We discussed limiting the number of
physicians for Caroline's comfort.

Yes, I know. But we
need someone extremely

skilled at preserving nerve tissue

to do the actual procedure.

Dr. Shepherd and I have
collaborated on a number of patients,

so I know she's the best. If I needed

a neurosurgeon, she's who I'd choose.

Plus, she's really good at Gem Crush.

I don't know. This wasn't the plan.

[EMMY] You can say no.

Can... can we just have a second?

Please don't take this personally.

- No, of course.
- Yeah. We'll give you some time.

[CAROLINE SIGHS]

[BAILEY] Almost through the fascia.

Okay.

Let's see what we've got. [SIGHS]

Damn it.

Griffith, Adams.

[GRIFFITH] What is that?
Are those adhesions?

- It's like one giant massive scar tissue.
- Which is known as?

[ADAMS] Frozen abdomen. But why
didn't we see this on the scans?

[WEBBER] Sometimes you
don't see a frozen abdomen

until they're staring you in the face.

[BAILEY SIGHS]

Okay. This is going to be a long ride.

If the two of you feel
the need to step out

and study for your exam, no
one in here will question that.

But I need to know now.

Dorian cannot have distraction in here.

I cannot have distraction in here.

Then buckle up.

Right angle.

I'm gonna need traction.

- How's it looking? Any improvement?
- [ROSIE] Oh, God.

It's better, but he's still
bleeding through the packing.

I finally got through.
Help is on its way.

- Where is the dad?
- [JOSEPH GROANS]

You have got to be
kidding me. Is he injured?

Well, I can't see from this angle,
but Rosie says it's a leg wound.

Lot of blood, possible femoral injuries.

There's blood everywhere!
How does he have any left?

Maybe I should just try
to slide down there and...

And gravely injure yourself so the

EMTs have to send another team? Hell no.

He could die. He needs a...

Rosie, do you have a belt?

I'm wearing yoga pants.

Okay. That would be a "no."

- Anything with a strap?
- Yeah, I have a small fanny pack.

Does the strap come off?

- Yeah.
- Okay, that'll work.

You're gonna make a
tourniquet for your dad's leg.

You'll rap it around his
leg right above the wound,

and you're gonna tie it
as tightly as you can.

[ROSIE] It's okay.

Okay.

Okay.

- [JOSEPH GROANS]
- I'm sorry. I'm done.

Okay. Now, can you see any sticks?

[BREATHING SHAKILY] Uh... Uh...

- Yeah. Yeah, there's one right here.
- Okay, now take the stick,

and tie it to the tourniquet
right where the knot is.

You're gonna twist that stick
and it'll tighten the strap.

- Rosie.
- Okay.

- Okay, I'm twisting.
- [JOSEPH GRUNTS]

- [ROSIE] It's getting tighter.
- Great. You're doing great.

Just keep going until
the bleeding stops.

[ROSIE] I think...

I think it stopped. [PANTING]

[HUNT] Great work, Rosie.
Now hold that in place.

Help is on the way.

- Just hang tight, okay?
- [SIRENS APPROACHING]

[BAILEY] Okay. Griffith, get the Metz.

You're gonna take down the adhesions.

I'm not sure I can see where the

adhesions end and the intestine begins.

You want me to change my mind?

[GRIFFITH] Metz, please.

[BAILEY] All right. Nice and easy.

One layer at a time.

Never go any deeper than what
I show you with my right angle.

[GRIFFITH] Okay.

- [BAILEY] Good.
- We've barely made a dent

in this dissection.

Griffith is doing just fine.

Do you think we should continue?

Dorian's had complication
after complication.

We can't even see. If you go further,

you could cause even more damage.

He was dead on the first day here.

Kwan held his heart in his hands.

He's had multiple cases of sepsis.

I've opened him bedside as he
was dying, but he's still here.

He's holding on. So,

I am too.

I see things through. I
am seeing this through.

Okay.

[GRIFFITH] Okay.

[BAILEY] All right, Griffith.

They came a long way to see you.

That must be flattering.

It's enraging.

Caroline shouldn't have to travel

to see a doctor who
treats her with respect.

You didn't wanna stay in Texas,
try to help more kids there?

You know, as much as I hate it,

I think maybe it is safer
for them to come see me here.

I mean, it's just gotten so hostile.

[SIGHS] Forget the awkward
stares and the microaggressions.

One family was talking about putting
a bulletproof vest on their son

just to come see me because he's trans.

That is... [SIGHS]

Yeah, there's no words to describe it.

Hopefully Caroline's
mom will talk to her.

And Emmy won't.

Have you seen Emmy Chen?
She's not in her room.

- Yeah. She's kind of a wanderer.
- Well, thanks for the heads-up.

- You two wanna help me find her?
- We're about to prep a patient.

Oh, you won't be if it's
Caroline. She's also gone.

- You gotta be kidding me.
- Okay.

The elastic bandage is the
most underrated dressing.

It controls swelling, eases pain,
and it's durable and flexible.

Everything you could want in a sock.

How's your continuous suturing skills?

- Even distance. Decent tension.
- Great. What kind of suture?



Yeah, works for me. Let's do it.

They're moving Mr. Quint now.

So once he's settled, make sure
you check his white count again.

And track down Dr. Wilson.

Make sure she sees that we
schedule Mrs. Price's chole.

Can I scrub in on that?

Did you hear anything
I said before "chole"?

Technically I'm on Dr. Ndugu's service.

Crap rolls downhill, Yasuda.

Yasuda, did you see Dr. Ndugu's text?

Gotta go. Sorry.

[STAMMERS, SIGHS]

Emmy and Caroline are missing.

Oh? Maybe they
scrubbed in on a surgery.

All the cool kids are
doing it, except for me.

Well, at least you
have more time to study.

I have a photographic
memory. I don't need to study.

I need to cut. I deserve to cut.

Entitled much?

I finished my procedure log weeks ago

and then I had to wait patiently
for everyone else to finish theirs.

- That was you being patient?
- Yeah.

And now that all the
bottom-feeders are finally done,

I can't scrub in to save my life.

I... I am dying here.

Well, on behalf of all the
bottom-feeders, my sincerest condolences.

Did Ndugu check the attendings' lounge?

What, you think they'd
let themselves in?

I put nothing past Emmy Chen.

She's been my problem
child since day one.

You sound like my mom.

I was not an easy kid.

I thought she was hazing
me my first week here.

She paged me 20 times just
to look at one TikTok video.

And it turns out her parents work,

and they have two other
kids, so she's alone a lot.

I've spent more than a
few dinners in her room.

She's a headache, but
she's my favorite headache.

Reminds me of me at that
age. Stubborn as hell.

We probably would have been friends.

- Hmm. Probably not.
- [SHEPHERD CHUCKLES]

Seriously? You know you're not
supposed to eat before your procedure.

She knows. We're not
idiots. They're for later.

- And you shouldn't be out of your bed.
- It's my fault.

I just wanted to take a snack,
and we didn't have time...

- Emmy! Emmy?
- Emmy! Emmy, Emmy.

- Emmy, are you okay?
- We need oxygen and a gurney.

[BELTRAN] Give me her head. Come on.

Stay with me.

Emmy.

Hunt?

Joseph Scott, 47-year-old
male. Status... post fall into a cave.

Sustained a left leg
puncture wound from a rock.

Arterial bleeding with
significant blood loss.

Controlled with a tourniquet
and packing in the field.

No other injuries or head traumas.

And Altman.

Right. What do we got?

Rosie Scott, 19-year-old female.

Status... post fall into the same cave.

Isolated left ankle injury. Awake
and alert. Vitals are stable.

- How's my dad? Is he okay?
- He's tough. He's hanging on, okay?

Let's do a workup on her ankle.

Gonna get him straight up to the
OR, okay? Rosie, he's in good hands.

We'll update you as soon as we can.

Hell of a way to spend your day off.

All right. Kwan, let's get her inside.

[SIGHS] What if she hates me?
It was my idea to leave the room.

It's gonna be okay. She's getting help.

Take a deep breath for me, okay?

- [BREATHING DEEPLY]
- Good, good. Okay.

Welcome back. Welcome back.

All right. Let's go.

We gotta get your chest tube
hooked back up to suction, okay?

What's wrong? You're scared? It's okay.

No, no, no. Leave it on. I'll
try to name it. What is it?

The pneumothorax?
You're scared it's worse?

Okay. You're scared you won't recover?

You will. I got you.

I'm here. So is Caroline.

We're all here. We just
want you to be safe, okay?

But I swear I'm gonna
put a tracker on you.

[LAUGHS]

[BAILEY SIGHS]

That's all connected to the...

[BAILEY] Stop talking. I'm thinking.

Yeah, it's not gonna work.

We'd have to take too
much of his bowel...

- Wait. But you said that...
- Yeah, I know what I said.

But the amount of bowel he has
is far less than what we thought.

Look, there's friable
bowel around the fistula.

After we resect this area and
get to healthy bowel... [SIGHS]

... he'll be worse off
than when we started.

Could we put him on medication
for short bowel syndrome?

That could help, but he still doesn't

have enough bowel to keep him off TPN.

We did all this, and now Dorian's
gonna have to get all his nutrition

from an IV bag for the rest of his life?

- He's 23.
- Adams.

No, no. He'll end up in liver
failure by the time he's 30.

Do you think I don't know that?

Do you think I'm at all okay with that?

[GRIFFITH] In pediatric
cases of short gut syndrome,

which of the following techniques
increases residual bowel by 20%?

Dr. Griffith, the OR is not a place

to quiz yourself on your ABSITE exam.

[BAILEY] A serial transverse
enteroplasty procedure.

A STEP procedure.

Tell me what it is, Griffith.

[GRIFFITH] You cut the residual
intestine in a zigzag fashion.

[BAILEY] And why do we do that?

To lengthen it and help
increase absorption.

But it is not the standard
of care for an adult.

Because most of the research on
it focuses on pediatric patients.

And nothing this man has gone
through has been standard.

Change of plans.

Adams, switch with Dr. Webber.

We are converting to a STEP procedure.

Follow my lead. Do exactly as I say.

I'm gonna need a GIA
stapler and multiple reloads.

[SIGHS]

Hi. Put a rush on these and text
me their BPs every two hours.

I thought you were meeting me
in the ICU to remove drains.

Yeah, I'm just checking on a few
postpartum moms from yesterday.

But you're in navy scrubs.

Oh, right. I forgot.

When I change my scrubs,

I just forget about all my
patients from the day before.

Also, I checked your notes.

Half the things I told you
to do you gave to the interns.

I supervised them because
I'm a supervisor. Are you?

If you need help removing drains,

we have bigger problems
than you just being annoying.

Bailey and Webber are still in surgery,

so I'm also covering their patients,

and studying for the ABSITE.

Okay. Are you having the
same conversation with them?

[SIGHS] You haven't quit yet.

You made this decision,
like, 48 hours ago,

and you've already checked out.

[SCOFFS]

Hey. Your mom said you wanted to see us?

Yeah. I still haven't decided
on the surgery, though.

Mmm.

Well, that's okay.
Do you have questions?

Emmy's been gone a while.

Oh, yeah. She just needed
to get some tests done.

I'm making her a bracelet.

I didn't know her favorite
colors, so I chose mine.

Green and purple.

Caroline, we do wanna help you.

That thing Emmy did, can I do that?

Where you say what you're scared of?

Oh, sure.

Emmy and I usually take turns
though, so I'll go first.

Um...

I am scared of forgetting
my patients' parents' names.

- So I write them on my hand.
- [CHUCKLES SOFTLY]

I'm scared

I won't recover from surgery
in time for the spring dance.

Mmm.

I'm scared of the hospital basement.

Actually, any basement.

I'm scared of going under anesthesia.

I've never done it.

Yeah.

I am scared of

not living up to my
patients' expectations.

I know that they're counting on me.

I read online that when
you're on the operating table,

you're naked.

I've never been naked
in front of anyone,

let alone an entire
room full of strangers.

I'm scared they won't be able to...

I'm scared they won't
understand. [SIGHS]

I'm scared they won't see me.

[BREATHES SHAKILY]

Caroline.

Hey.

We see you.

You're an amazing girl,

and we are gonna make sure that everyone

in that operating room knows that.

[SIGHS] Okay.

I'll do the surgery.

We will get you prepped.

And I will go tell Diane.

[CHUCKLES SOFTLY]

Okay. This will be more comfortable.

I'll be back to check on you later.

Can we talk?

Usually I'd say yes, but you've
been ignoring me all week.

Yeah, because you screwed with my
ability to become a better surgeon,

which honestly, I rank
as high as cheating.

But I am coming to you as my boss.

I need surgery.

It's our first day back operating,

Ndugu is not in the OR today and I
finished all my work on his service.

Study for the ABSITE
like the rest of us.

[YASUDA] Put yourself in my shoes.

When you worked at Joe's, weren't
you dying to get back into the OR?

- No.
- How are you my boss?

[SIGHS]

Beckman could use an extra
set of hands on a TAVR.

OR 4.

- You better run.
- Thank you.

Oh, I mean it.

And... And we'll talk. Eventually.

Thank you.

[ALTMAN] Punctured the SFA.
We could do a primary repair.

- Mmm.
- We just need to clean the edges.

You know, this is not how I
thought our day was gonna end.

[ALTMAN] You're telling me.

I had a cheese and
charcuterie plate ready

for when we got to the top.

Irrigation.

[HUNT] You know, when I was standing
up there I couldn't see anything,

and I thought for sure that
he'd lost his leg or worse.

Some people are just lucky, I guess.

What's lucky is that we
were hiking the same trail.

[HUNT] Geralds, please.

Hey, thank you for today.

- It was great.
- Speak for yourself. I want a redo.

[CHUCKLES] I don't know. Reminds me of

the old days. Me, you, out in the field.

- Lots of blood, no supplies.
- [ALTMAN] Adrenaline likes us.

I mean, but would a bed-and-breakfast

on Whidbey Island be so terrible?

[HUNT CHUCKLES]

- Any fracture to the lateral malleolus?
- No.

If there was?

Well, it depends if it
was stable or displaced.

Good. Displaced?

Plate and screws.

Exactly.

Why don't you take this?

Is my ankle broken?

It's a bad sprain.

You need to rest it,
use ice and compression,

and keep it elevated.

[STAMMERS] Any word on my dad?

He's still in surgery.

He... he left me and
my mom when I was six.

Got remarried, started a new family.

We just reconnected last year.

And he invited me to go on this
hike, and I didn't wanna go.

And then he... he told
me to stay on the trail,

but I wanted to see inside
the cave, and just...

I needed some space.

So he has to be okay.

We'll let you know as
soon as we hear more.

[CRYING]

Thank you.

[WEBBER] Another reload, please.

[BAILEY] Excellent solve.

I think this is gonna work out nicely.

[WEBBER] Deploying the staple.

- [MONITOR BEEPS RAPIDLY]
- [GRIFFITH] He's coding.

- Wh-Why? What happened?
- [BAILEY] No, no, no.

We're losing him. Okay. Move.

You two, out of the way now.

Okay. Starting compressions.

Push epi. Okay. Come on, Dorian.

You've come way too far
to give up on us now.

Come on.

Come on.

[SHEPHERD] Hey.

- How's Emmy doing?
- Hey. She's good.

Her O2 sats are up. She's
pretty much her old self.

So, on her phone, and
wondering where I am?

[CHUCKLES] Something like that, yeah.

Uh, sounds like
Caroline's surgery went well?

Yeah, thanks to Dr. Shepherd.

All right. Well, I gotta go check on a

patient, but I'll round on Emmy later.

Hey.

- Still waiting for mine.
- [CHUCKLES]

They weaned her off oxygen in
the PACU, and vitals are great.

- Well, how you feeling, Caroline?
- A little tired.

Not bad for someone who
just got a tumor removed.

So how long will it take to recover?

Well, she will need follow-up
care, but I expect a quick recovery.

Yeah, that school
dance is gonna be fire.

[EMMY] No one says that anymore.

You can just say she'll have
fun, like a normal person.

Thank you.

- I'll text you pics.
- You better.

Thank you... both of you... for
taking such good care of my daughter.

- [SHEPHERD] Of course.
- I think we make a pretty good team.

Hey, Rosie.

He should be awake soon.

You know, we...

we fought about that fanny pack
this morning before we left.

He said that hikers need backpacks
so they can bring supplies

and be prepared for anything.

But I was stubborn,

and I brought it anyway
because it went with my outfit.

[CHUCKLES]
Well, I bet he'll feel

differently about that fanny pack now.

- Thank you for saving us.
- [SCOFFS]

Rosie, you did all the saving.
All I did was talk. [CHUCKLES]

I mean, what you taught me wasn't hard.

It's just... I just didn't
know it was what I needed to do.

But if you hadn't been there,
my dad wouldn't be here now.

- [MONITOR BEEPING RAPIDLY]
- [WEBBER] Push more epi, please.

Come on, Dorian.

[GRUNTS] Adams, take over compressions.

Good. Good.

[ADAMS] Come on.

- Come on. Come on. Come on.
- Griffith, what do you see?

Hold.

V-fib. It's a shockable rhythm.

[BAILEY] Okay. Uh...

Paddles, please.

Check his pulse.

- Anything?
- [GRIFFITH] Nothing.

- No pulse.
- [BAILEY GROANS]

All right. Charge to 150. Clear.

Adams, clear!

Adams, clear! Adams!

[GRIFFITH] Lucas! Hey,
hey. It's okay. It's okay.

It's okay.

And clear.

Charge to 170.

Clear.

Charge to 200.

Clear!

- Bailey.
- Again. Clear.

[SIGHS]

[SNIFFLES, SIGHS]

Oh, Millin. So I have
good news and bad news.

The good news is I found a surgery.

The bad news is now Ndugu needs someone

to pull wires on one of his patients.

So, could you just do
me a huge solid and pl...

[SNIFFLES]

Are you okay?

I haven't gotten a single
question right today.

- I'm going to fail.
- No, no. You're not going to fail.

Yeah, and then I'm gonna be unemployed.

I'm gonna have to crash with my
hippie parents or my stupid brother.

You're gonna do fine.

I know all of this.

I know it backwards and forwards,

but every time I look at the
test, my mind just goes blank.

I love my job.

I don't wanna get fired.

Sounds like you need
the Yasuda technique.

What is that?

My patented study method.

It has a 100% success rate.

By 100%, do you mean just you?

Do you want my help or not?

And what about your surgery?

[SIGHS]

I'll get on one tomorrow.

Okay. So...

Here we go.

Okay.

I saw you updated Rosie's chart.

Uh, yeah. I thought I'd try
to get some of your notes done

before I get back to studying.

- Thanks.
- Yeah.

Kwan.

I've watched you work all day.

I know you're gonna ace the
ABSITE, and not because of luck.

It's because you work hard. You're
prepared. You know your stuff.

Remember that when you're in the exam.

Thank you.

But I should still wear
the socks though, right?

Yeah.

And... if you have to clean
them, hand-wash only.

[WHISPERS] Oh, yeah.

[BAILEY SIGHS]

You're still here?

I'm monitoring him myself.

I sent the interns home.

ABSITE's tomorrow.

You've done a good
job with them, Bailey.

Him too.

Yeah, it doesn't feel like
it. And he's hangin' on,

but who knows... if he'll wake up...

what his functional output will be.

And the interns...

And I thought I did a
good job with them too.

I thought the repetition and the focus

would prepare them
for anything. But this?

I mean, shot point-blank
on his way home from work.

And he's just one of the
thousands of g*n v*olence victims

who show up in hospitals every year.

One of thousands who have to undergo

surgery after surgery after surgery.

[STAMMERS] I don't know how
to prepare them for that.

I don't wanna have to
prepare them for that.

I'm still not prepared for that.

No one is, Bailey.

No one is.

[HEAVY RAIN FALLING]

- Hey.
- Hey.

How's Rosie?

She's good. You know,
shaken up, but good.

Listen. If we were just able to teach

a 19-year-old how to stop
her father from bleeding out,

why couldn't we teach that to everyone?

Think of how many traumas
occur every single day

and how many lives are
lost because someone

with medical training just isn't there.

I mean, we could make videos, hold

classes, build websites. I don't know.

But if stopping a bleed
was taught just like CPR,

we would save so many more lives.

I mean, what do you think?

I think it's a great idea.

- You do?
- Mm-hmm.

I mean, would you be able to fund it?

I mean, even just the
research and development?

Um... I...

Well, I just... I'd have
to see how much I have left.

Okay.

This is gonna be great.

Come on.

[SCHMITT SIGHS, MUMBLES]

That's me apologizing.

You could just say, "I'm sorry, Levi."

- Fine. I'll give it to Helm.
- [GRUNTS]

Okay.

I almost lost a pregnant
mom the other day.

And now I can't get her out of my head.

And now I'm literally worrying
whether all of my patients

are still breathing in
the middle of the night.

- Jo...
- Link found me at 2 a.m. last night

logging into the hospital system

just to see everyone's blood pressure.

So, no, I'm not checked out.

I'm just... freaked out.

You are an amazing surgeon.

You're so good both
specialties want you.

[SCOFFS]

Mistakes happen. You've
told me that, like, 20 times.

Why are you still making mistakes
after the first time I told you?

[SCOFFS] You can go to OB now.

I'm good.

Oh, hey. No dinner with Emmy tonight?

Nah, she has a new bestie.
I'm old news. [SIGHS]

Oh, hey. Um, thanks for earlier.

You said nice things
to Caroline and her mom.

Hmm, well, I lied.
You suck at Gem Crush.

I'm never letting you
near my phone again.

- But you would let me operate on you.
- Well, I've seen your hands.

So I, uh, wanna say a thing. Uh...

and I'm a little afraid to say it.

So I'm just gonna blurt it
because that is what I do.

[CHUCKLES] Would you want
to go out with me sometime?

Clearly I misread the situation. Um...

You were just very complimentary

today, and you bought me a coffee, uh...

Please forget that I said anything ever.

[CHUCKLES]

No, it's just, um...

I am going through a
really messy divorce.

And my wife's still in Texas, so...

Hey.

Emmy's parents are in the family room.

I'm happy to talk to them, or...

- No. No. I'll come with you.
- Okay.

Hey, you okay?

I'm fine.

I've been there. It's hard when the

person on the table
is more than a patient.

I couldn't stop.

Bailey was right there telling me,

and I still couldn't.

I guess it's been my
problem all along, right?

I don't know when to let go.

You know how I thought of
the STEP procedure today?

You're an ABSITE genius?

I thought of you.

You're fearless when you
advocate for your patients,

no matter who's in the room.

I've been afraid to take
chances when I might be wrong,

thinking that's putting
my patients at risk,

but it's riskier not to take the chance.

And you taught me that.

I'm a braver doctor because of you.

I'm a better doctor because of you.

[GREY] Our brains are constantly
adapting to the present moment.

Hi.

What time is it?

The test starts in five minutes.

No, that's impossible.

- We literally just fell asleep.
- [GRUNTS]

- The test starts in five minutes!
- I know!

Oh, my...

Just run!

[GREY] Our brains can override
information we no longer use

with newer, more relevant ideas.

So this is a class?

We'll also have video
tutorials, community outreach.

Well, it sounds like the kind of thing

the Fox Foundation can get behind.

We could start this at
Grey-Sloan, and if it goes well,

we could branch it out to all
of the Fox Foundation hospitals.

Have you spoken to
your chief of surgery?

I don't wanna be the cause
of any marital discord.

[CHUCKLES] Yeah. Teddy likes it.

I just... I didn't wanna put her in

an uncomfortable spot asking for money.

- So...
- No, you don't. Church and state.

- Exactly.
- Okay, Dr. Hunt.

I will look into our discretionary
fund and see what I can find.

[GREY] Our brains make these decisions

for us, whether we like it or not.

[LECTURER] You will have
a total of 240 questions

divided into two 150-minute blocks.

You have a 45-minute optional break

and cannot go back to
section one after submitting.

Please enter your
authorization codes and begin.

[GREY] They help us hold
onto the things that matter

and make space for whatever
the future may hold.