01x01 - Pilot

[bunniefuu]

(Mozart's Die Entführung
aus dem Serail playing)

♪ ♪

Mr. Ferguson!

Mr. Ferguson!

♪ ♪

Mr. Ferguson!

Mr. Ferguson, stop!

♪ ♪

Mr. Ferguson.

Stop!

Mr. Fergu...

son.

Mr. Ferguson, stop!

If you have a heart att*ck
out here,

I am not gonna save you.
Do you hear me?

I'm sorry, Dr. Sam.
(panting)

I just can't go through
with it. (cries, pants)

It's too risky, with my diabetes
and my blood pressure.

We have talked
about this.

The benefits outweigh the risks.

I could die on the table!

You won't die on the table.

How can you be sure?

Because Dr. Griffith
is your surgeon.

♪ ♪

He is one of the best
cardiothoracic surgeons

in the country.

And I say "one of the best"

because I'm quoting
U.S. News & World Report.

But in my opinion,

Dr. Rob Griffith is the best.

He is incredibly...

...detail-oriented.

Meticulous, really.

Sometimes to a degree
that is... hard to believe.

He's a genius.

And I know that you are
scared, okay? I was, too.

You had heart surgery?

Long time ago.

Wow.

But... instead of thinking
about dying on the table

or what could go wrong,

I thought about Crystal Lake.

My dad and I went fishing
there every summer.

It's beautiful.

It's stocked with
trout and coho salmon.

And I just...

I thought about the
next trip we'd take.

Do you have a place
you'd like to go?

Uh...

my wife wants to do a cruise.

Oh, yeah? Where to?

(snorts softly)
Alaska.

Alaska?

That's colder than Michigan!
What happened to going

to the Bahamas?

(laughing)

You know, I don't think you
can promise that I won't die.

Legally speaking.

I'll tell you what.

Have the surgery,

and if you live,
you can sue me.

(laughs)

Deal?

Deal.

Okay.
(chuckles)

Oh.

(hands scrubbing)

Well,

Ferguson
is prepped,

and I got my cardio in.

Ha! Told you
she'd get him back.

20 bucks says this guy
celebrates his new valves

with a yard of beer
and a bloomin' onion.

(chuckles)

Caleb,

does your mechanic care

how you drive your car
after a tune-up?

Oh, I'm so over
blood and guts.

Just give me some fake boobies

and call it a day.

(Caleb chuckles)

You are so superficial.
You know that?

Lex,

you know that frowny face you
make when you're judging people,

you're gonna
need some Botox.

(gasping)

SAM:
Joey.

Don't expect a discount, honey.

Ooh...
Watch out.
Okay, guys,
we're a team.

This is not
a competition.

You all have
strengths.

(chuckles)
I'm afraid

I disagree.

From where I stand,
I see a lot of weaknesses.

Pathologically arrogant.

Profoundly insecure.

Emotionally unpredictable.

And exceptionally vain.

I don't know if any of you
have what it takes.

That's why you're here.

To earn your seat
at the grown-up table

by proving empirically

that you are
more valuable

than the person
next to you.

This is surgical residency,

not a drum circle.

And you, you're supervising
these doctors.

You're above them,
in knowledge,

rank and skill.

Act like it.

♪ I been in the right place ♪

SAM:
Patient suffers
restenosis.

Dr. Griffith
is removing

some of the failed stents

before harvesting the left
saphenous vein for bypass.

Actually,
I've changed my mind.

I'm gonna use

the internal thoracic arteries.

Why would we do that?

Because
some interventional cardiologist

has run a full metal jacket
down this artery,

and now I have nowhere
to put the anastomosis.

But the patient is diabetic.

Yeah. We all read his file,
Doctor.

I just mean that he's
at higher risk for infection,

and harvesting arteries close

to the breastbone only
increases that risk.

Maybe.

That also decreases the risk
of him coming back next year

with an occluded vein graft.
Clamps.

A sternal complication
could k*ll him.

Good thing he's in the hands
of a capable surgeon.

♪ ♪

(elevator dings)

(doors open)

Doctor.

Doctor.

(chuckles softly)

I...

Yeah, just let it out.

I am the cardiac fellow.

I'm second in command here,
and he shows me no respect.

It-It's like undermining me

is a sport for him.

If it...

makes you feel any better,
he doesn't respect anybody.

It doesn't. I...

I think I'm gonna take
the Cleveland offer, Caleb.

You don't want to do that.

Are you... saying
I should stay?

It's not about me.

You need to do what's best
for your career.

Yeah.

(chuckles)

You know, I've
told him before.

If he can't respect me,
I can't work here.

End of story.

♪ ♪

You need to tell the wife
you did a different procedure.

(scoffs)

Okay. I'll tell
her for you.

Tell her I said,
"You're welcome."

There's something else.

I've made a decision.

About my future.

And...

(pager beeping, buzzing)

(sighs)

Ten-car pileup on I-94.

They're running triage.
One cardiac event.

(indistinct chatter)

GRIFF:
That's our code.

Griff.

Doctor. Please,
my wife is in pain.

Oh, no, she's fine.

DOCTOR: Hurry!

GRIFF:
What do we got?

Hang on.

Came in with chest pain.

Nitroglycerin?

Already gave it to her.

All right.

(indistinct walkie transmission)

LEX:
Grab a crash cart.

Uh, AED's closer.

DOCTOR:
One, two,

three.

(exhales)

No pulse.

Start CPR.

Hey!

You can't walk
away from me.

What kind of
doctor are you?

A bad one. You don't want me.

Keep waiting.

(g*nsh*t)

(groans)

(screaming)

(groans)

(gasping)

(wheezes)

Dad!

NEWSMAN:
Breaking news out
of Lakeshore Sentinel Hospital.

There has been a sh**ting.

NEWSWOMAN:
Suspect taken into custody.

He apparently had no connection
to the victim.

NEWSMAN:
The victim is Dr. Rob Griffith,

a renowned surgeon
at the very hospital

where this random att*ck
took place.

♪ ♪

SAM: What happened to my father
was a shock

for our entire community.

As a community, we went on,

as I know he'd want us to.

Morning.

Dr. Griffith.

I was humbled to step in

as interim chief
in my father's absence.

Hi.

Good morning.

And I am humbled again today

and grateful to the board

for making my position
permanent.

My father can never be replaced,
but I vow

to carry on his legacy
to the best of my ability.

I love it.

Huh.

And so would he.

I'm not so sure about that.

No. Do not feel guilty.

(groans softly)

You've earned this.
And I say that

as your chief medical officer,

not your mother.

LEX:
It's perfect.

Really? It's
not boring?

No, it's
definitely boring, but...

How can it be
perfect and boring?

I just mean it's
a very appropriate speech

for a room full
of uptight rich donors.

Mm...

It's a compliment.

Okay, don't do
your overthinking thing.

You're gonna break out
in hives again,

like you did when you spoke
at that wellness retreat.

That was an
allergic reaction.

Okay.

What you call overthinking,

I call evaluating
from all sides

to make the most
informed decision.

Hmm. Is that how
we're spinning it these days?

Got to love therapy.

Good morning, all.

Morning, Dr. Griffith.

Big day.

No kidding.

Atrial fib, hiatal
hernia, ICD candidate?

You know I mean your promotion.

I know.

Shall we?

Mm-hmm.

A-fib. What do we know?

Patient has failed three
anti-arrhythmia meds,

including amiodarone.

ISAN: Yeah, probably needs

an ablation, but I say
we just cardiovert now.

Dr. Shah, run point on that.

Dr. Trulie and Dr. Costa
will take the ICD.

And when Dr. Tucker catches up

from being so very late
for rounds,

he'll take
the hernia.

One last thing.

I couldn't have gotten through
the last six months without you.

Tonight is as much
a celebration of you

as it is of me,

and I hope
to see you there.

That's the fifth hernia
this month.

It's also, like, the fifth
time you've been late.

It's not personal.

I'm pretty sure it is.

She's a professional. You two
didn't work, she moved on.

Uh, we did though.

I just--
I panicked, you know?

I didn't want her to plan
her whole life around me.

It was the Cleveland clinic.
Isan,

what do you think I should do?

Show up on time.

♪ ♪

"My father
can never be replaced,

but I vow to carry on his legacy
to the best of my ability."

That's beautiful.

Oh.

Hi. Oh,
I'm sorry. I...

Thank you.

Just trying to keep it tight
and play to the audience.

Mm. Which is?

Oh, you know,
boring rich donors.

Ah.
(chuckles)

Well, at least
there's an open bar.

(chuckles) I plan on hitting
that hard post-speech.

(chuckles)

I'm Sam, by the way.

Everyone knows who you are,
Dr. Griffith.

Eh.

I'm Malcolm.

Kingsley.

As in the...
Kingsley Family Foundation?

Currently underwriting the
expansion of our surgical wing?

A.K.A. boring rich donor.

(chuckles)

(chuckles softly)

(elevator chimes)

Lovely to meet you.

Pleasure to meet you.

SAM:
Well,

this'll be an awkward
little stroll.

Would you like to
walk ahead of me?

VIVIAN:
Sam!

Mom.

What is it?

It's your father.

He's waking up.

Uh...

Hi, Dad.

Griff.

(grunts)

Oh, I can't believe it.

I mean, your MRIs and EEGs

always showed high
residual function, but...

A-And your brain stem
was intact, which is why

we decided to--

None of this matters right now.

You're awake.

(grunts)

Are you trying
to say something?

Oh, here. Give him some water.

Oh.

Um...

Here.

(grunts)

(hoarse):
How long?

H-How long have you been out?

You were sh*t six months ago.

And how...
till I can work again?

(chuckles) Did you
hear what Sam said?

It's been six months.

Not to me.

It's a long time
to be in a coma.

Long time with no chief.

Actually,
the hospital

named a new chief.

I've been replaced?

I think "succeeded"
is a better word.

Who-who is it?

It's me, Dad.

Tonight was the reception.

I see.

So glad I wore my gown.

(laughs softly)

SAM:
I can't believe it.

I know. I come by here,
every night

wondering if he would
ever open his eyes again.

And he finally does

and all he wants to do
is get back to work.

(chuckles)

Wait, every night?

I-I don't know, I think
I spent more time with him here

than I did when we were married.

He didn't talk, so that helped.

(both laugh)

Oh, baby.

♪ ♪

(piano inaudible)

(knocks on wood)

(gasps)
Hi.

Some pretty impressive playing.

Uh, you couldn't hear anything.

That is true.

But I witnessed some
very powerful body language.

That is mortifying. Uh...

(both chuckle)

When I was a kid,
I-I got it in my head

that I should take the piano

so that I'd make
my fingers more agile.

They'd be faster in surgery.

And now it's my stress release.

I have dragged this thing
everywhere with me.

Med school, residency.

To here.

Mm-hmm.

Speaking of,
what brings you here?

Mm.

I mean, I'm glad
for another opportunity

to apologize for insulting you

in the elevator, but...

I-I work here.

What?

Yeah, I am the new
director of finance.

But your dad is one
of our biggest donors.

(chuckles) Well, he and I
are very different people.

He didn't get me this job,

by the way.

My dad didn't get me my job.

I didn't think that he did.

I didn't think
yours did, either.

So we were both not thinking
the same thing.

(laughs softly)

(both chuckle)

How is he, by the way?

My dad?
Yeah.

He's doing really well.

Remarkably well.

Well, if you ever need to talk,
I'm here.

Thanks.

GRIFF: I've made more
progress in two weeks

than most patients do in months.

VIVIAN:
You almost d*ed.

Don't you think you should
use this time to,

you know,
take stock of your life?

840.

What?

I did one to two procedures
per day,

five days per week,
seven hours of median cut time,

that's 35 hours a week.

140 hours a
month, 840 hours

in six months I've missed.

That's the stock
I've been taking.

I meant more like
"I've never seen Paris."

We saw Paris. Together.

I had a good time.

All right, the Parthenon, then.

What do I have to do
to get back into surgery?

You have to be proctored.

Oh, come on.

It's state law.

After a medical leave
like this,

you are months away
from even picking up a scalpel.

Eh...

Sam.

No.

(grunts):
It has to be Sam.

It is her department now.

Her promotion was...

Premature.

...unexpected.

But it was also well-deserved.

And if you are gonna
ask her to proctor you,

you have to respect
that she's in charge.

I was thinking...
maybe you should ask her.

Oh...

I'll do it.

I'll supervise him.

Sam.

I'm the attending physician.

Have you forgotten how tense
things were between you two?

You had one foot out the door.

Exactly.

Six months ago Sam would not
have been able to handle this.

I'm different. I've changed.

What if he hasn't?

It doesn't
really matter.

I have the authority now and
he will have to respect that.

He also has to undergo
extensive evaluation.

Clinical, technical,
procedural.

Yeah.

You'll have to file assessment
reports for peer review.

And that's only after
he regains his physical stamina.

It's gonna take
a long time, Sam.

I can do this.

And I say that as your head
of cardiothoracic surgery,

not your daughter.

I thought I had the flu.

I don't know why
my doctor sent me here.

Has anyone ever told you
that you have a heart murmur?

No.
That's why.

A new murmur can be
cause for concern,

especially with your
recent dental work.

It could be endocarditis.

It's an infection
that can spread

from the teeth to the heart.

So we are gonna start you
on some antibiotics

and run a couple of tests.

Okay.

How long have you had
the swollen lip?

JULIO:
I don't want to
talk about it.

Okay. We'll get
those tests ordered.

(knocking on door)

(exhales sharply)

Huh?

(door closes)

Huh.

(chuckles)

What are you doing in here?

This isn't your
office anymore.

Uh, looking for my white coat.

I don't remember clearing you.

Your physical isn't
for two more weeks.

Come on, we both know I'm ready.

Hey, feel that muscle.

I am not feeling your muscle.

Come on, just
as a scientist.

It's like a rock.
It's like the statue of David.

Larry David.

Griff, the rules

governing
proctorship are serious,

and if you disregard them,

I have to answer
to the licensing board.

We could put
the whole hospital at risk.

You'll be able to take histories
and talk to families.

You can also be in the OR,

but if you so much
as touch a patient,

malpractice insurance
will drop you

and your bony ass will lose
privileges at this hospital.

Bony? You didn't even touch it.

And for future reference,
coats are in the locker room.

I don't deserve you as a wife.

Probably why I've been married
elsewhere for eight years.

Lucky man.

Tell me something.
And be honest.

Yeah?

When you look at him,

do you ever think

his eyebrows look
like moustaches?

Mr. Vargas's symptoms
are consistent with left-sided,

native valve endocarditis,
status: post-dental implant.

How did you lose the tooth?

It got knocked out.

Trust me, he deserved it.

LEX:
Blood cultures pending,

we empirically started
an antibiotic course.

But the fever persists. Why?

Maybe the infection is
methicillin resistant?

We could change to vanco?

Good. Anything else?

ISAN:
Could be

a deep space abscess
the antibiotics can't reach.

I'd get a soft-tissue CT scan.

I agree.

GRIFF:
I'm afraid I disagree.

Who is that?

Dr. Griffith.

I thought you were Dr. Griffith.

I am. And he is.

We are Dr. Griffith.

That's not confusing at all.

You didn't say he
was starting today.

Your proctorship has not
officially begun, Doctor.

Let's get Mr. Vargas
down to radiology.

It's not endocarditis.

Please don't interrupt me.

Fever hasn't gone down...

...has it?

SAM:
Okay, let's go through
the symptoms again.

Whoa, whoa, whoa.
What happened to my whiteboard?

Oh.

We upgraded.

This can be updated in real time

from any tablet
on the network.

It promotes the sharing of
information across departments.

Well, I like to doodle
on my whiteboard.

Well, sorry for your loss.
What do we have?

The constellation of symptoms
and clinical presentation

really suggest
infective endocarditis.

GRIFF:
Well, I would be
inclined to agree.

Oh, is that what you were doing
when you parachuted

into the room just now?

But not before ruling out
noninfective endocarditis.

A.K.A. Libman-Sacks
endocarditis.

A.K.A....

Lupus.

Two diseases

with almost identical symptoms.

But totally opposite
treatment strategies.

If that's true, we've been
giving him antibiotics

when we should've been treating
him with immunosuppressants.

(stammers)
What are you basing this on?

Because Libman-Sacks is
characterized by lesions

on the aortic valves, and his
transthoracic echo was clear.

Echo imaging
is notoriously insensitive.

We all know that, right?

Fine. In the spirit
of collaboration,

I will order a coags
and a D.I.C. panel.

Already did.

Hey!
Excuse me?

Along with antinuclear
antibodies and ESR.

You cannot order tests
without my authorization.

Should we get him started
on Solu-Medrol? If it is

a lupus flare, we'll need
to deal with the inflammation.

ISAN:
That's a dangerous suggestion.

Suppressing
Mr. Vargas's immune system

if he's actually fighting an
infection would be catastrophic.

Exactly. We wait for test
results before we change course.

Well, looks like I got time
to doodle.

(marker squeaking)

♪ ♪

(door opens)

I thought I'd find you
down here.

I was gonna ask
how you're doing,

but it looks like you're
banging out a concerto, so...

I wanted this to be
a fresh start.

But this all feels
very familiar.

Uh, do not let this affect
your confidence.

These are famously difficult
conditions to differentiate.

I'm sure that's exactly
what he'll say if he's right.

Don't worry about
what he'll say.

That's easy to say
when he's not your father.

No. No, my father gambled
away my college tuition.

So you are not the only
one with daddy issues

around here, sweetheart.

(chuckles)

When you put it that way...

TECH:
Labs are ready.

Thank you.

He was right.

Damn it.

Thanks to Dr.
Griffith's diagnosis,

we have started you
on immunosuppressants

and anticoagulants.

And we will keep
you here to monitor

your overall heart function.

I thought the other thing
affected my heart.

This one can, too,
but in a different way.

Thank you, Dr. Griffith.

You're welcome.

You're welcome.

I think he was talking to me.

And yet, I was the one speaking.

Julio,

I know that your wife

is the one
who knocked your tooth out.

Would you mind telling me why?

It's a long story.

Well, if we only had the time.

I have time.

I got the thing.

(sighs)

I'm listening.

What are you doing in here?

Reading my eulogy.

It's terrible.
You hardly even mention me.

That's because it's not
your eulogy,

it was my acceptance speech.

Dad.

You cannot run out of the room

when patients want to talk
anymore.

It's not how I do things.

So, what, it's your way
or the highway?

It's my way because it works.

If you'd followed protocols
and listened to Mr. Vargas,

you would know that...

That he cheated on his wife
and she decked him.

I don't need
your protocols to solve

that particular mystery.

You do have a lot of experience
to draw from,

given what you did to Mom.

I have work to do,
and this is my office,

so if you could?

(door opens, closes)

Steroids are working.

Inflammatory markers
are down everywhere.

Everywhere
but the sore on his lip.

What could cause that?
Dr. Costa.

He's immune-suppressed
from the treatment.

Could have left him susceptible
to a herpetic outbreak.

But he came in with the sore.

It was less pronounced,
but it preexisted treatment.

So he got it from cheating,
and the immunosuppressants

made it worse.

Agreed.

Give him an ice pack,
some Valtrex.

Let's move on.

I am not ready to move on.

It is the one symptom
that doesn't fit the diagnosis.

Dr. Shah.

Could also be
hereditary angioedema.

Oh, a man has an affair,

turns up with a sore on his lip.

STD or a rare
genetic disorder?

Is this about the patient's lip,

or needing to be right
about something?

CALEB:
All I'm saying is, Rob Griffith
is gonna get his job back.

Sam's just signing her
own pink slip by helping him.

Mm. You should tell her that.

It'll really help your
getting back together cause.

LEX (laughs):
Getting back together?

After he wouldn't commit?
Please.

Separate issue.

Really?
ISAN:
Is it?

Sam was your girlfriend.
You know better than anybody

how hard he was on her.

Yeah, and I also know

that she put up with it
for the same reason we all did.

Griff was tough, okay?

But he's also the best.
He makes us better.

You are really a
black-belt ass-kisser.

You know that?

He made me miserable.

Sam's made
the whole place better.

We are all happier.

We get more sleep,
we're more effective.

Okay, Isan, you have to have

open-heart surgery tomorrow.

Which Dr. Griffith
do you choose?

Anybody who opens my chest
has to be a good person

and a good doctor.

(all groaning)

JOEY:
You know what?

You're in time-out.

(laughter)

(door closes)

Oh, hello.
Hey.

You are officially the first
administrative executive

to ever set foot in this lab.

Look, I was thinking about
asking you to dinner.

But I received

a tip that you rarely leave
the hospital for meals,

and that if I wanted some
alone time with you,

I'd have to get it in the lab
after hours.

My office is next to your mom's.

Ah.

Do you always prep
your own lab work?

Uh, just when the lab
is backed up.

Makes sense. Why wait?

Hate waiting.

Speaking of, when were
you gonna ask me to dinner?

(both laugh)

MAN (over P.A.): Code blue.

Oh, no.

It's your patient?

It's Julio. He's coding.

He was responding to treatment,
so why the cardiogenic shock?

Ooh, ooh, miss.

If you say lesions
on his valves...

Lesions on his valves.

Jinx.

Lactate and blood cultures
were negative.

What are we missing?

Preexisting malignancy, maybe?

Or an undiagnosed
thrombotic disorder?

GRIFF:
For months, I was here
in this hospital,

while you all carried on
without me.

There was no evidence
of me at all.

If you wanted to find me, you
would have had to go looking.

Like with
a transesophageal echo?

No. We just got
him stabilized.

It would answer the question.

And it's relatively low-risk.

It is not low-risk.
His ejection fraction is at 35%.

(scoffs)

Well, why don't we take a vote?

All in favor
of a diagnostic test...

An unnecessary diagnostic test.

...a diagnostic test
to find out

what's actually going on?

Slow down, Sam.

Talk to me.
No.

Since when do we vote on risky,
invasive procedures?

This is not a democracy.

I know, but...

No, I have to do a TEE
on a patient now

because the Almighty Griff
can't fathom

that he could possibly be wrong?

He's not wrong.

Three sets of bacterial cultures
were negative.

We are missing something, Lex.

Sam.

I know it.

I know it.

He was right.

And I know

it's hard to not
make this personal, but...

That's what you think I'm doing?

I think that you are being
very emotional,

and it's possibly
clouding your judgment.

Huh.

Yeah, maybe my judgment is off.

(exhales)

Because I thought my best friend

would have my back.

♪ ♪

(exhales)

We're looking
in the wrong place.

Tricuspid valve appears intact.

CALEB:
Same with the pulmonic.

Valves look fine.

Exactly. There's nothing here.

So I'm here for you to say,
"I told you so, Doctor..."

That is not why I agreed
to this procedure, Doctor.

It's not the valves
we need to see.

It's what's around them.

Like the failing ventricle.

What failing ventricle?

Go transgastric?

The myocardium's dead.

I-It's going after the muscle.

CALEB:
Lupus doesn't
att*ck heart muscle.

Which means
we're missing something.

Exactly. This has nothing
to do with his valves,

but unless we figure out
what this is,

he's gonna need
a whole new heart.

(siren wailing)

Daisy, I relate to living
next to someone

you'd like to punch more
than you can possibly imagine.

But Julio needs your help
right now, and so do I.

Will you tell me the story?

Your version?

There's nothing to tell.

Julio came home from Rio
with that sore on his lip.

Mm-hmm.

He tried to hide it,
but I saw it.

By the time he confessed,
I was so angry, I punched him.

Right in the mouth.

The business trip
where Julio had the affair,

where did you say it was?

Rio de Janeiro saw
a dramatic uptick

in cases of Trypanosoma
cruzi over the last decade.

Cruzi? Sounds like a girl
I dated in college.

It's a parasite.

It's infected over
six million people in Brazil.

Which is where Mr. Vargas
had his affair,

which is where he was
likely bitten by an insect

carrying T. cruzi, which
then likely entered his system

through the insect's feces.

So it bites you
and then it poops on you?

Uh-huh.
JOEY:
You definitely

dated that girl.

The insect targets
mucous membranes

of the face,
like the eyes and the lips.

It's actually nicknamed
the kissing bug.

Yes.

That explains the lip.

Exactly. The STD

is actually an
acute-phase symptom

of Chagas disease.

Ah, so wait, the inflammation
that we diagnosed as lupus w...

Was another symptom.

An immune response to the
tissue-nested parasite.

I'll confirm
with antibody tests.

Start an antiparasitic.

I'm on it.

GRIFF:
It's too late.

The troponin levels
are sky-high.

Massive myocyte necrosis.
Cell death.

So we put him
on the transplant list.

Ventricular-assist
device as a bridge.

He's a young man...

Never gonna happen in time.

The family needs to start
saying goodbye.

SAM:
Give us a minute?

Okay...

(door opens)

(door closes)

Why are you doing this?

The heart is gone.

You have to be able to call it.

Not the case. This.

You don't respect my authority,

or my rules.

So why not work
under someone else?

Somewhere else?

Because you need me.

It's actually
the other way around.

"I can handle him," I said.
"He won't get under my skin."

I can barely hold
my team together.

Well, they're confused.

He was the boss for a long time,
but he is not in charge.

Well, that's not what he thinks.

What do you think?

(stammers)

I think that my entire
management approach was naive.

I think that,
ultimately,

unfortunately, people
respect tyrants and bullies

more than kindness and decency.

That's not respect.

It's fear.

I thought

that the whole almost dying
thing would change him.

Not a lot, but a little.

Something in him is broken, Sam.

Since the accident...

I don't want to talk
about the accident.

Okay? That can't be the excuse
for everything forever.

He was speeding. So what?

What happened to me, my heart,
that wasn't his fault.

And besides, if you feel badly
for hurting someone,

you don't push them away,
you try to make it better.

You do that.

You try to make things better.

Sam. What-what are you
doing here?

I'm sorry that I took my
frustration out on you earlier.

And I brought you
a peace offering.

What, do you have company?

(chuckles)

Look,

I wanted to tell you.

Tell me what?

I-It started
before the sh**ting.

And, look, I know it
shouldn't have, but it did.

But it is over now.

It may not look that way.

It probably looks

really bad.

We should've told you.

"We"?

Yeah.

Uh-- I-I should have told you.

There is no we.

All right, look, if I may...

No. You may not.

At least, not with me.

Find someone else
to proctor you.

(door closes)

What do you mean,
there's nothing you can do?

I have to uphold
the chain of command

the same as I did
when you were attending.

I can't force Sam
to proctor you.

You're insubordinate
and disrespectful.

Please, Vivi.

Don't.

Surgery is the only time
i-it's quiet in my head.

You know that.

Then go somewhere else.

Listen.

I... I can make her stronger.

Better.

Really?

A resident, Griff?
Sam's best friend.

I know, I know.

What do I do?

Just tell me what to do.

Make this right
with your daughter.

Be her father.
Stop hiding behind your work.

This is how I'm her father.
I've always been like this.

No, not always.

Oh, no, not that again.

You need professional help.

You can't see how
the accident affected

your relationship with her.

You have blocked it out.

Stop.

What is this,
a-a memory test?

I remember,

remember leaving the lake house,

I was driving too fast
around the bend,

watching our daughter
getting wheeled into surgery.

Heart surgery, which I think
we both agree was, uh...

Yeah, it was traumatic.

I was gonna say ironic.

Give me your badge.

Come on.

(door opens)

My father and I disagree
about a lot of things.

Including what we see
in each of you.

So here's what I see.

Inspiring confidence.

Wisdom and
compassion.

Commitment, courage

and a complexion
that I truly envy.

A brilliant doctor
who I need on this team.

Right now, this patient
is all there is.

So, if you are with me,
let's get to work.

Lex, do a lit search on
the most up-to-date treatments

for Chagas,
even experimental ones.

Joey, get him into the
transplant network.

Isan and Caleb,
start him on inotropes

and get a Swan-Ganz cath
into him right away.

This is not over.

Julio's in the transplant
registry, status 1A.

And I ordered a CBC.

If we get a hit,
we'll be ready.

Thank you, Caleb.

Second chances.

Excuse me?

Just,

your dad, and this patient.

You don't give up on people.

Which I'm hoping

is also true in my case.

You caught me off guard
back then.

And after everything
that happened,

I never got the chance
to take it back.

Uh, what are you saying?

(pager beeps, buzzes)

Mount Sinai Dearborn
had a failed transplant.

Doesn't say what happened,
but they saw our request.

They're sending it.

There's a heart.

It's en route.

What are we doing here?

(helicopter whirring)

LEX:
Perfusing fluid.
Vessels are cold.

SAM:
Dr. Tucker, we're ready.

No.

That cannot be right.

I thought it was a match.

Blood type is, but the donor's
BMI is, like, 16.

It's too small.

Bet that's why Mount Sinai
didn't want it.

This heart's garbage.

No, it isn't.
We have to make it work.

(phone ringing)

Yeah?

The heart's too small?

SAM:
If I abort and wait
for the right heart,

he dies.

I agree.

And if I transplant that heart,
it'll fail

before I close up.

Agree again.

Neither of these hearts
can keep him alive.

Three in a row.
Why'd you call me?

Because maybe both of them can.

A heterotopic transplant?

That procedure's so rare
it's almost a myth.

He's done it.

Y-You know I can't
perform surgery.

So talk me through it.

The connection
between atria is essential.

If it's not exact, he'll either
embolize or bleed out.

Good thing he's in the hands
of a capable surgeon.

Dad.

Clamp.

Little pericardial flap
on the right side,

above the diaphragm.

11 blade.

11.

Transverse incision
should be at the sternum,

over the diaphragm...

To here.

GRIFF:
Okay.

Ooh, slow... slow down,
slow down.

Okay, watch out for fragments.
There you go.

All right.

Ready for the graft.

GRIFF:
Mm-hmm.

Start the anastomosis
at the posterior portion

of both left atria.

You want to terminate
the sutures...

On the anterior edges.

You want as large a
connection as possible.

Okay. The atrial pathway
should be clear.

Come on.

Come on, come on.

(Sam exhales)

(soft laughter)

(laughs)

(exhales)

♪ ♪

Lucky, lucky man.

Could easily have d*ed.

I think what
you're trying to say

is "well done."

(scoffs)

Look, if...

I have been hard on you,

it's only because you have
tremendous potential.

I want to help you realize it.

I want to teach you
how to realize it.

That's my job as a father.

No, that's your job
as a surgeon.

Maybe I-I
haven't always

been there for you,
the way you would've wanted...

Dad, you have never
been there for me.

At least,
not in a very long time.

But you were there
for this.

Today.

And we saved a man's life.

Yeah.

Oh...

I've decided to continue
proctoring you,

if that's what you want.

Yes. Please.

I want to be very clear.

I am making this decision
as a doctor.

As your daughter?
I'm calling it.

That'll be all, Doctor.