07x07 - A Square Peg in a Round Hole

[bunniefuu]

No!

Is there any chance
the Vas-COM caused this?

It's certainly possible.

Then Dr. Cooper may have k*lled her.

Dr. Marcel, I already told you...

Back off, Dr. Blake.

I'm considering applying

for a fellowship in transplant surgery.

Did you get any sleep last night?

Didn't we just have this conversation?

I was mothering you, and I shouldn't.

I won't do it again.

You've essentially been
parenting your mother.

I don't want to be here!

Do you know anyone I can call

to get an illegally-parked van towed?

It's gone! They towed it.

Stay with me tonight, okay?
We'll figure it out.

Oh, you'll know this one.

Outdated surgical procedure misused

to treat mental disorders.
Eight letters.

- Breakfast.
- Too many letters.

Can I see your arm?

Oh, sorry. It was in the bathroom.

- It just looked so...
- No, no, no. No, wear it.

No, it looks good on you.

That's looking better.

I should hope so.

I'm a model patient.

Could use some improvement

in the roommate department, though.

Think maybe you could
clean up a little bit

while I'm at work today?

Wouldn't be an issue
if you loaned me the $

to get my van out of the impound.

I already told you.

Money's tight
until the end of the month.

Some anonymous jerk makes
a phone call, and like that,

I'm out of my home and a pile of cash.

Seem fair to you?

Mom, I promise I'm gonna help you.

But at least right now,
you have a roof over your head.

And a doting daughter.

I gotta run. I'm late for work.

Lobotomy. Eight letters.

Oh, oh, oh.

What I was saying
was like, hey, Trish...

Hey. You two are so cute together.

Anyone ever tell you
that you could be sisters?

Oh, come on, girl.
Say it again. [CHUCKLES]

Come on.

Oh, trust me. That was meant more

as a compliment to me
than an insult to you.

Why would she say we look alike?

Does she know about us?

Trish? No.

Okay, that makes it sound
like there's someone who does.

I'm right. Somebody does know.

- Okay, yes. Sharon does.
- Ms. Goodwin?

Is that how I got this job?

No, I can assure you that.

No, it almost worked against you.

Sharon was very reticent
when she found out.

So she doesn't even want me here?

That's not what I'm trying to say.

Does anyone actually think
that I belong here?

Whoa, whoa, whoa.

- No one else knows. I swear.
- Okay.

- Except for Dr. Charles.
- What?

Oh, my God, everyone's gonna
think that I'm here

- because of nepotism.
- It was in confidence.

I promise, he's not gonna
tell anybody, I swear.

Okay, but she knows, Maggie.

Vanessa, you don't have
to prove yourself to anybody.

We've got a trauma incoming. We're up.

Astrid Meadows, years old,

punched her fist through
a plate glass window.

Looked like arterial bleeding
at the forearm.

Controlled with a tourniquet.

All right. Astrid, I'm Dr. Taylor.

We're going to take care of you.

Oh, my God, they're still here!

- Who's still here?
- The snakes.

They're coming out of the vents.

Why isn't anybody doing anything?

We think she might be tripping.

Okay. On my count. One, two, three.

Thank you, gentlemen.

Let's get her on monitors
and hang a new bag.

Okay, let's set up a CBC, BMP,

and send the blood for a full tox.

Let's open up a minor tray.

- You got it.
- Okay.

Relax for me, relax for me. Thank you.

Okay, Astrid, let's see
what we're dealing with here.

It's definitely the radial artery.

- Ow!
- Let's inflate this cuff.

All right, here you go, sweetie. Yes.

- There you go.
- Two hemostats.

Please! Please, just make them stop.

Hold on, sweetie. Hold on, hold on.

Just hang in there.

Okay, bleeding's under control.

Let's get this tied up.
Get me - silk ties.

I'll get you an extra set of hands.

Okay.

Erika, can you go help
Dr. Taylor, please? Thank you.

[INDISTINCT CHATTER]

Why is everyone standing around?

Excuse me.

Hey, Mags. Long time no see.

Dr. Choi.

[DRAMATIC MUSIC]

All right, everybody
get back to work, yeah.

Hey, listen.

Whenever you find time,
first round's on you.

[CHUCKLES]

Hey. Great to have you back, man.

Thanks, man. You too.

Gotta say, bud, the cane? Nice touch.

Ah, it's just a temporary thing.

So look, us g*nsh*t survivors,

we got to stick together.

You know what I'm saying?
So, I'm around.

I appreciate it.

- Great to have you back.
- Thanks.

Thank you.

Hey.

So, I take it your physical
therapy's gone well?

I'm feeling stronger every day.

Just... just trying my best to
stay out from under the Kn*fe.

Glad to hear it.

And Dr. Archer tells me you're feeling

like you're ready to come back.

- Yes, ma'am.
- We'd be happy to have him.

Hospital policy is you have
to undergo evaluation

before coming back from an injury.

I've been staying up-to-date
with the journals

and the latest COVID protocols.

Good. Well, if you two will excuse me.

It's good to have you back, Dr. Choi.

Thank you, ma'am.

Okay, let's hit the sim lab
and see if we can help you get

your sea legs back again, eh?

Dean, I never got the chance
to thank you in person.

Trying to sweet talk your way
out of this eval?

I'm serious, man.

You pushed for my spinal reconstruction.

Without you, I probably
wouldn't be standing here.

Well, you might not have gotten sh*t

if it weren't for me.

Don't think that hasn't been
keeping me up at night.

[ELEVATOR DINGS]

Hey, uh, you know,
we're already past that.

No need to look back, right?

And can't say I wouldn't
take a b*llet for you.

Okay, liver function's looking good.

Incision's healing nicely.
No sign of infection.

Did a pretty good job,
if I say so myself.

That's good. Would've been
awkward if I had to sue you.

Oh, right?

- Thanks.
- You okay?

So, unless you notice
any changes, we'll see you

in a couple of weeks
for a final checkup.

- A couple weeks?
- Yeah.

I'll have to find an excuse
to see you before that.

How about drinks?

Oh, Avery,

I don't think it's appropriate
for me to date a patient.

I was just saying drinks
but I mean, yeah, a date works.

Well, I should let you
get back to my mother.

Still trying out for the team?

Yeah.

Been shadowing the past few weeks.

Observed a pancreatic
transplant the other day.

Your mother's a very talented surgeon.

And she grants you
the privilege of observing.

I didn't peg you as the type
to sit on the sidelines.

But hey, you decide
you're ready to play,

you know how to reach me.

A full bar the whole day.

They have... if you're hungry
and there's food, whatever,

there's things like lobster
and crab legs.

There's all kind of canapés.

Inconclusive. Neither
Cooper nor the Vas-COM

were deemed responsible
for Eleanor Holt's death.

Now, they're aware that Cooper inserted

that monitor twice, right?

Even after you raised questions
about its safety?

I mean, were his clinical
decisions questionable? Yes.

But no one seemed comfortable
saying he was negligent.

A patient d*ed on our watch,
Dr. Halstead.

Someone needs to be held responsible.

I'm going to that critical
care conference

with Matt today.

Maybe he'll open up
in a more social environment.

Yeah. Maybe.

So, these snakes
that you saw earlier today,

when you punched through the window,

were you trying to... to
get away from them?

Were you trying to escape?

I'm tired.

I don't really feel like talking.

All right, well then, why don't you get

a little rest, and then maybe
we talk some more later?

- Yeah.
- All right.

Nice to meet you, Astrid.

I thought the hallucinations
were drug-induced,

but the tox screen came back negative

for controlled substances.

Okay, so we can cross
those off our list.

You think this might be
some kind of psychotic break?

Maybe.

You know, could be schizophrenia.

I mean, she's the age

when these things start
to present themselves.

She was saying that her hallucinations

were more visual in nature, correct?

- Snakes, yeah.
- Isn't schizophrenia mostly

associated with hallucinations
in the audio modality?

I... I was reading
about this study in

with the Oxford University Press.

They cited a close to
two to one prevalence.

Two to one... for me,
that's still unsettled science.

Dr. Charles, Dr. Taylor,
these are Astrid's parents.

Becky and Tom Meadows.

- My baby?
- Yeah.

I understand you're a psychiatrist?

I wanted to talk to you
about the possibility

of keeping Astrid here on a psych hold.

You know, Mr. Meadows,
I... I haven't been able

to properly evaluate your daughter yet.

This all started about six months ago.

Overnight it seemed, bam,
the hallucinations,

the erratic behavior.

We... we can't protect her anymore.

Did you talk to him
about having her committed?

You know, I would really love
to hear more about

your daughter's history.

Maybe we can find someplace
more private and talk a bit?

- Sure.
- Great. Thank you.

Baghdad!

Nathan Daniels.

-year-old male, high speed MVC.

Significant c-spine deformity. GCS .

Heart rate . BP / .

His son's in the ambo behind us.

Okay, on my count, gently.
One, two, three.

Pupils are reactive.

Feeling a bony step-off on the c-spine.

Diminished breath sounds,
left side. We need an X-ray.

Yep.

Non-reactive to pain
in the lower extremities.

- X-ray.
- Clear.

White out in the left lung. Hemothorax.

Heart rate's , BP's down / .

Give me a chest tube kit.

I'm in.

C-spine's clear.

Where... where's my Dad? Is he okay?

Yeah. My friend Dr. Hammer's

taking care of him right over there.

- I... I need to see him.
- Hey, EJ, EJ.

Look, look, I know you're worried,

but right now let's just
stay focused on you

for a bit longer, okay?
Gotta check out that arm.

[GRUNTS]

Clear.

Mid-shaft radial fracture
with mild angulation.

EJ, you might need surgery,
but, in the meantime,

is there anyone we can call?

Like your mom or maybe a grandparent?

No, he... my dad's all I have left.

Please, you can't let him die.

Please, you... you have to
let me see him. Please.

All right. Look, I'm gonna go
check on him right now.

All right? But Nancy here has
to take you for a CT scan.

We have to see if you have a concussion.

I know. It'll be all right.

- Okay?
- Okay.

How's the dad?

Not good. Not moving his extremities.

Sending him for a panscan
and a neck CTA.

Stat paged neurosurgery.

- Dad?
- Wait!

- Dad?
- Hold on, hold on.

- Dad? Dad...
- Whoa. Hold up. Hold up, EJ.

wait, wait, no. Hold up.

- Is he gonna be okay?
- Come on.

- What's wrong with him?
- Come on, come on.

You don't need to see this. Come on.

Hey, Dr. Blake.

I saw we found a liver
for our patient, Sheldon West.

Take a look.

Oh, yeah. Labs look good.

No abnormalities. Very nice.

Note the measurements.

The donor liver's too large
for Sheldon's abdomen.

So what? You're not going to accept?

Well, as a rule,

I don't like forcing
square pegs into round holes.

Yeah, but Sheldon's got
a MELD score of .

He's running out of time.

He'll tolerate another
round of liver dialysis

while we wait for a better match.

Uh, Dr. Blake.

Sorry, if you'd indulge me,

what about a hepatectomy?
Trim the liver to size?

That adds time to the procedure

that Sheldon won't have.

Well, I've done dozens out of the ED.

If you'll allow me to assist,

I'm confident I can pull it off.

Wait, wait, stop.

Is my Dad gonna walk again?

EJ, right?

It's too early to say.

But he's in good hands with Dr. Abrams.

Are you off to surgery for your arm?

You think it can wait?

I... I don't want anything to
happen to my Dad while I'm out.

How about I make you a deal?

You stick to your surgery,
and I'll keep you looped in

before anything happens.

Sound good?

- Okay.
- Okay.

- Thanks.
- Yeah.

Thank you.

So what's the word?

Mr. Daniels is an ASIA A
at C . Complete injury.

No motor or sensory functions
below the neck.

That's catastrophic. He's tetraplegic.

That would be my assessment.

I assume you ordered a CT scan?

The results just came in.

Bilateral jumped facets at C and .

Well, there's no chance
his cord is getting perfused

when his spine's that maligned.

We need to get him in traction now.

I'll grab the traction cart.

- Okay, sat's at .
- Almost got it.

. You've run out of time, Ethan.

Come on. Come on.

- . He's bradying down.
- [MACHINES BEEPING]

I'm in. I'm in.

Nah, that's it. That's it.
Your patient's coding.

[BEEPING]

I guess I'm a little rustier
than I thought.

Are you gonna stand there
while he arrests or what?

Aye, Chief. [CLEARS THROAT]

Starting compressions.

Dr. Taylor.

Dr. Charles, Uh... I
didn't see you there.

My allergies were acting up.

So, I heard that you sent
Astrid Meadows for an MRI?

I did. Yeah, but not...
but not without cause.

When you were with her parents,

I took the opportunity
to re-examine her,

and I noticed increased tone
in her injured arm,

which is to be expected.

But then I also realized
that it was in her other arm.

- Slow down a little bit.
- Right. Of course. Yes.

So I decided to take note
of the reflexes

that are affected
on both sides of her body.

And then that's when I realized
that something else

might be going on here,
an underlying condition.

Maybe something neurological
or musculoskeletal or...

Well, you know, I did
give her some Haldol.

Which, you know, could explain
the diminished reflexes.

Perhaps. Nonetheless, I felt
it prudent to order an MRI.

And honestly,
the results were interesting.

You want to take a look?

You know, if you look here
and here, you can see

the T white matter changes.

I mean, that could be MS, right?

And that could explain
the rigidity in her arms,

or maybe even the hallucinations.

You know what?

Interpreting MRIs can be
tricky, all right?

For instance, I mean,
these white matter changes,

they could also just be normal aging.

I-I think we want to careful
about getting too far ahead

of ourselves here. You know?

Dr. Taylor? You got an intake in T .

I'll be right there.

I just wanted to be diligent.

That's great.

Will Halstead? We're over here.

Hi, Jessa.

Listen, I heard about what
happened to Eleanor Holt,

and I just wanted
to extend my condolences.

Yeah, thank you.

There was an M&M this morning.

What'd they determine?

That's confidential, Jessa.
I really can't get into it.

Oh, my gosh, of course.

It's just... I'm just
at the beginning of my career,

and I really don't want to be associated

with a potentially defective product.

So I guess what I'm wondering

is do you think it was
the Vas-COM itself,

or was Dr. Cooper possibly at fault?

- Hey guys, how's it going?
- Matt.

Hello, Matt!

Um, I was just telling Will
over here how excited I am

to have you both
at the hospitality suite later.

Room . It's gonna be a blast.

- There's canapés and crab legs.
- It sounds fantastic.

I think I'm gonna walk
the floor though first.

Halstead, let's do this.
Ride shotgun with me.

Yes, sir. See you later, Jessa.

Yeah.

So, Jessa's questioning
my decision-making

in regards to Eleanor's care?

I wouldn't take it personally.

I'm sure she's just
protecting her employer.

That's okay. I, um...

I've been second-guessing
my decisions myself.

Oh, yeah?

If you were a bottle of tequila,

where would you be hiding right now?

Great.

Thank you for responding so quickly.

I promise to be brief.

Over the past few weeks,
we've seen an uptick

in patient complications in regards

to the Vas-COM cardiac monitor,

including a recent tragic death.

So, starting immediately,

the hospital will discontinue
the use of the Vas-COM

until it can be proven
to be totally safe.

About damn time.

Are we sure about the math on this one?

Maybe we're seeing more
problems with the Vas-COM

but that might be

because there's a lot more
being used than ever before.

Exactly.

I have in use right now
in cardiac recovery.

Like, what am I supposed to do?
Swap them out?

Yes. Return to the methods
and devices before Vas-COM.

That'd be going backward.

You can't tie our hands
like that clinically.

I'm confident you'll make do.

Thank you all in advance
for your compliance.

Yep.

- Adding another two pounds.
- Take it slow.

We don't want to damage the ligaments

any more than they already are.

All right. Let's get another image.

Clear.

Okay, alignment looks better.

Should reduce pressure from the cord.

Oh, good, you didn't k*ll him.

The hospital has been unable to find

any next of kin of legal age

to make decisions
on Mr. Daniels' behalf,

so the law says it's now
our call on how to proceed.

So, what are our options?

Well, given the injury's to his c-spine,

our only option is an anterior
cervical discectomy and fusion.

Stabilization is the quickest
road to recovery for Nathan.

Oh, good. I'm glad I have your approval.

I've got an OR opening up
in a few hours.

I'll have my team
transfer him up there then.

Wait, what about the cord swelling?

You could decompress
it posteriorly, improve flow.

No, the injury's complete.

Decompression won't restore
function that isn't there.

But we both know swelling
can mask an incomplete injury.

A more aggressive approach could restore

his motor function.
Nathan could walk again.

Not according to his ASIA results.

The man's got virtually
no function left to restore.

But still, we should get EJ's input

and see if this is what
either of them would want.

Kid's years old.

So, you're welcome to inform
him as to what we're doing,

but we're not conducting
a straw poll here, Dr. Hammer.

The decision's been made.

[SOMBER MUSIC]

- All set for you, Dr. Marcel.
- Okay.

I can't get it to lay posteriorly.

Maybe I can push the stomach
to the left more.

Liver's still too large.

Well, I... I've got more room
to resect tissue.

Not much, from the looks of it.

I can make it work.

Let's hope so.

Dr. Taylor, did I hear that
you gave Astrid a spinal tap?

I just wanted to make sure
we weren't looking at MS.

I thought that we covered that earlier.

Oh, and all the labs are back.

They're negative across the board.

Okay, so it's official. No MS?

It still doesn't rule out
something neurological.

Maggie, I want to order another MRI,

but this time with contrast.

Okay, wait. Look, Vanessa.

This young lady, she's been
through a traumatic event.

Right? She's in a vulnerable place.

And now we've spent the last
couple of hours sliding her

in and out of metal tubes,

sticking big needles in her back.

Her parents are talking
about having her committed.

I just want to make sure
that this diagnosis is correct.

And I applaud your drive

in trying to figure out
what's going on here.

But I also would encourage you
to think of her as,

I don't know, more as a human being

and less maybe as a test
you're gonna get graded on.

I mean, I think
it's... it's just important

to strike a balance there. Okay?

- Yeah.
- Great. Thank you.

Mags, page me once
she becomes lucid. Thank you.

You mean, he's going to be paralyzed?

Like totally paralyzed?

Look, EJ, I know this is difficult.

But the important thing
is that cognitively,

your father should make a full recovery.

He won't be able to... to walk,
or... or ride his bike,

or even eat on his own.

He wouldn't want to live like that.

There's got to be another way.

Actually, there is another option.

If we fuse your father's spine

and then decompress the spinal cord

with a procedure called a laminectomy,

there's a chance
that he could regain some

or all of his motor function.

But it is extremely high risk

with very little chance of success.

It doubles the length of the surgery,

and there's a very good chance

that it could make his injury worse.

Or k*ll him.

I know my dad.

That's a risk he'd be willing to take.

I'll speak with Dr. Abrams.

Dr. Hammer, can I
speak with you outside?

What are you doing?

EJ has a right to know his options.

You made him think he has a choice.

It's his father. His life, his future.

The future you're promising
him, you can't deliver.

But EJ said this is
what his father would want.

Yeah, he's and
recovering from a trauma.

He's just a kid.

Yeah, and I'm gonna do
everything in my power

to help him stay that way.

Damn it. It still doesn't fit. Suction.

I mean, I can't remove any more tissue

- and keep the liver viable.
- How's our patient, Marty?

Temp is down and he's coagulopathic.

Well, if we can't make
our square peg any smaller,

maybe we can make the round hole larger.

What are you suggesting?

That we expand the abdominal cavity?

There's not enough
posterior space, right?

So, can we make the diaphragm larger?

Oh I see, that'll create some
space for us to maneuver

the liver into position, yeah.

Okay. Get Dr. Marcel a scalpel.

- Okay.
- Let's go.

Sharon, hey. Sorry for the intrusion.

You remember Roger Flanagan,
from the Board?

Yes.

I just saw your son-in-law,
Dr. Cooper, at the M&M.

Sad business.

To what do I owe this pleasure?

First of all, I want to salute you

on the stand you took
with the department heads.

What happened with that patient
is a tragedy,

and we need to make sure
it doesn't happen again.

I appreciate that.

That said, we want to make sure

we're in the clear legally.

Peter, you identified a couple

of potential soft spots, didn't you?

You know, Vasik could say
we're in breach of contract.

Or worse, pursue a defamation claim.

And that gets in front
of the wrong judge,

we could be looking
at a pretty hefty payout.

That's why the Board's
decided to hold off

on banning the Vas-COM just yet.

Instead, we'd like to form
a committee to investigate

any claims of malfunction.

And when we get all the data in,

we can make a studied decision.

I see.

Always good to see you, Sharon.

Indeed.

[HEAVY MUSIC]

♪ ♪

I thought you were looking at
breaking into the big leagues.

I don't follow.

Device reps don't like doing
business if the doctors

- don't have a good time.
- Well, well.

Why is that?

Sober doctors aren't as corruptible.

Look, companies like Vasik,
they want to make sure

that when push comes to shove,

you won't suddenly get
a bad case of ethics.

Oh, well...

Excuse me, I just go to...

Oh, I tell you, once you
get used to the taste,

it goes down smooth.

So, do you feel like you've
been morally compromised,

promoting the Vas-COM?

How else are you supposed
to get the crab legs?

[LAUGHS]

I mean, Vas... Vasik's giving you

more than crab legs, right?

How much we talking about?

Look at you, you greedy little bastard.

No wonder Vasik's trying
to get their hooks in you.

Come on, let's just...
what you say we...

what you say we take
this party up a notch?

Just a little?

Mm-hmm!

- Come on, come on.
- Sats down to .

- I'm calling it.
- I'm almost in.

No, come on, your
patient's hypoxic. It's over.

Come on, man.
No one goes down that fast.

Listen, Ethan, we both know

how quickly a situation
like this can go south.

This is why you need to be prepared

if you're going to return to the ED.

You don't think I know that?

Come on, man, let me go again.

Let's go again.

Why exactly are we doing this?

An EEG can determine
Astrid's brain activity

that might be useful in... in realizing

diagnoses such as epilepsy or a tumor.

I thought we determined
she was suffering

from some kind of psychiatric disorder?

Just want to make sure
there's no underlying causes.

Dr. Taylor? Can I get a moment?

I thought we decided to put a pause

on the battery of tests.

I know, but I needed to...
to rule out epilepsy

as an underlying cause.

You know, I gotta be honest with you,

I'm a little concerned.

I think you're pushing
way too hard here.

- No.
- Yeah.

And I think that maybe
you should take a little break.

I think you should go home...

- Go home?
- And get some rest. Yeah.

Dr. Charles, I know that
you think I don't belong here

- but I assure you...
- Whoa, whoa, whoa.

I didn't say that.
Why would I think that?

Maggie told me you that know
about me and her,

that she's my birth mother.

[MACHINES BEEPING]

[ALARM WHISTLE]

BP spiked, over .

Super tachy, heart rate's in the s.

Is she having a seizure?

The EEG says that's
not what's happening.

- Then what is happening?
- Push of labetalol.

And get her on oxygen.

Astrid, can you hear me? Astrid?

- Why is this happening?
- You know, I don't know.

It's usually caused
by traumatic brain injury.

Vitals are stabilizing.

BP's back to normal. Heart rate .

Astrid? You with me?

Why is her arm still doing that?

Can you relax your arm for me, Astrid?

Okay. Let's get another MRI,
this time with contrast.

And I want a full metabolic
genetic panel.

It's okay. We got you.

- Can I get one more?
- Mm-hmm.

Okay, patch is in.

The cut diaphragm should
accommodate the liver now.

Should's not gonna cut it.
This is our last chance.

Okay, liver's in.

Not out of the woods yet.

Still need to attach the vessels.

Let's get started with the hepatic vein.

Okay.

[SNIFFS] You wanna hit
some of this, buddy?

- Nah, I'm okay.
- Good for you, Will.

That's good. That's good.

You... you... you keep
making the good choices.

You leave the bad choices to moi.

[SNORTS]

Matt, do you think putting
another Vas-COM on Eleanor

was a bad choice?

What do you think?

We knew there might
be contraindications.

Why'd you do it?

You still haven't figured that out yet?

- God. That's weird.
- You all right?

Yeah. My arm's... my arm's tight.

- Let me check.
- I'm good, I'm good.

I don't feel so good.

- Let's get you some fresh air.
- Yeah.

No, no, no, let's get you out...

- let's get you out of here.
- Okay.

Just take it easy. Deep breaths.

- There you go, you got it.
- I'm good. I'm good.

All right. Yeah, you're good.

Let's sit you down,
get you a glass of water.

You'll be good as new.

Oh, damn it.

Come on. Talk to me.

- Oh, my God, what's happening?
- Call .

Come on.

Stevie, what's going on?

I'm doing a second ASIA exam.

Abrams already made the call.

That was before Nathan's
spine was in traction.

And you think the stabilized alignment

will improve Nathan's score?

It's the only way to change
Abrams' mind,

get him to go for the
decompressive laminectomy.

- Did you see that?
- Yeah.

Reflexive muscle contraction.
Way beneath the zone of injury.

He's still got motor function.

He might not be completely paralyzed.

Dr. Abrams, I need to
show you something.

Am I missing something?

His pelvis just flinched a second ago.

It was a subtle finding.

Glad to see you two sat
for your neurosurgery boards

- while I was away.
- I know what I saw.

I think that Mr. Daniels has
a Grade B incomplete injury.

He has motor function to salvage

if we decompress the cord.

He could get his legs back.

Well, that would change the calculus.

But you better be certain
you saw what you saw.

Because if you're not,
and this man dies on my table,

you'll be the ones
to explain why to his son.

We're sure.

Okay.

Let's do it.

- Talk to me.
- Cocaine-induced MI.

Shocked three times in the field.

Intermittent ROSC.

Ethan, need an extra set of hands.

- That Matt Cooper?
- Yeah.

All right, on my count.

One, two, three.

Get him up on the monitors.
Milligram of epi.

- You got a pulse?
- Still in V-fib.

Let's run the code. Doris, compressions.

- You got it.
- Where's the defibrillator?

T .

Ethan, intubate while
I grab the paddles.

- Hold compressions.
- Clear.

- Sats are dropping .
- Hang on.

Sats down to .

- Dr. Choi?
- Doris...

I'm in.

How we looking?

Sats are coming back up.

- Still in V-fib.
- Another milligram of epi.

Charge to .

- Okay, clear.
- Clear.

[MACHINES BEEPING]

Got a pulse.

Sinus tach. Just like
riding a bike, right?

-lead EKG, chest x-ray,
and page cardiology.

So, Astrid the good news
is that your hallucinations

are not being caused

by any kind of
underlying mental illness.

So I'm not going crazy?

Well, no.

But a genetic panel has
revealed that you have

a disorder called
metachromatic leukodystrophy

or MLD.

MLD causes the brain and nervous system

to progressively lose its function.

The first symptoms are
often psychotic episodes,

followed by a host of others

such as poor muscle function
like we witnessed.

So this is going to get worse?

Hopefully we can mitigate
its progression with meds.

And the fact that you haven't
shown any symptoms

until recently is a really,
really good sign.

It means we caught it early

and should point to a better
outcome going forward.

At least I know what's going on with me.

Such a huge relief.

Thank you.

Thank you.

Dr. Blake?

Oh. Fundraiser for the program.

hours in the OR, and they
still expect me to wear heels.

- Right. Ha.
- What do you need?

Look, I just wanted to say
that I realize

I might have painted you into a corner,

you know, you and the team,
pushing for that surgery.

And I... I wanted to apologize.

Why?

I've been waiting two weeks
for the Crockett

who threw me off my daughter's
case to show up in my OR.

Nice he could finally make it.

Self-doubt's not a good look on you.

Have a good night, Dr. Marcel.

Nathan, this is Dr. Abrams.

Can you move your left foot for me?

Can you wiggle your toes?

Nathan, can you wiggle your toes for me?

Come on, Dad. Please.

Thank you. Thank you.

Happy we could help.

Excuse me.

Hell of a call today.

Hey, what's wrong?

I'm just so relieved.

I wasn't sure I was making
the right call.

But you did.

It all worked out.

You fought for a -year-old,
and you won.

I don't know.

I feel like maybe

the -year-old I was fighting
for today was me.

I was EJ's age when I had
to start taking care of my mom.

It took so much out of me.

It still does.

Want to talk about it? Grab a beer?

I wish. I can't tonight.

I got to get home to my mom.

- It's all good.
- Yeah. See you tomorrow.

I'll see you tomorrow.

- Thank you for today.
- Yeah.

Dr. Charles? You have a minute?

Yeah. Come on in.

I just wanted to come up and apologize.

What for?

I accused you of thinking
that I didn't belong here

and that wasn't right.

I realize that I was
projecting my own insecurities

- onto you.
- No apology necessary.

Matter of fact, I'm glad you stopped by

because I wanted to commend you

on your stick-to-itiveness
today, really.

Thank you. Thank you. That means a lot.

But you know what really sucks?

What really sucks is when
capable people like yourself

feel like they need,

I don't know, a little, um...

a little extra help to keep up.

What do you mean?

What I mean is, I don't know,
like what, caffeine pills

or too many energy drinks,
or I mean, God forbid,

straight up pharmaceuticals, you know?

If you're talking about
the pill I took this morning,

I... I told you that it
was for my allergies.

I'm not on anything.

Look, Vanessa, all I'm saying
is that I really understand

the kind of pressure you're under...

I should get back to the floor.

But thank you so much,
Dr. Charles. I appreciate it.

Hey.

I heard what happened. How's he doing?

Seems he dodged a b*llet.
But it's too soon to tell.

I was so close
to getting him to confess.

Well, an experience like this
has been known to change a man.

Guess we'll have to wait to see
what effect it has on him.

You cleaned.

The landlord was on my ass about it.

Looks good.

Hey, Mom,

you know I always do my best
to take care of you.

I know, hon.

That avocado toast this morning
was actually pretty good.

Ha ha. Good.

Well, I more meant...
if I push you or overstep,

it's only 'cause I love you.

What's this about?

You were so adamant about
not staying in the hospital.

And I was afraid that you
wouldn't take care of yourself

after you left, so...

I had your van towed.

What?

I thought that if you just
stayed with me for a few weeks,

that I could take care of you

while you took your antibiotics.

My home. You took my home from me.

I know I was wrong. I am sorry.

I did it to protect you.
I didn't know what else to...

My whole life. How could you?

Stop, stop! Mom, please.

Please, let's just talk about this.

- You lied to me!
- Come on. No, Mom, please.

Stop it, Mom.

God...

- I'm... I'm sorry.
- No. I'm okay. I'm okay.

Mom, I'm okay. What are you doing?

Mom, what are you doing?

I gotta go.

No, no. Come on, Mom, please, Mom.

Mom, stop. Mom!

[DOOR SLAMS]

[WOLF HOWLS]