Chicago Med (2015–…): Season 6, Episode 4 - In Search of Forgiveness, Not Permission - full transcript
Dr. Marcel and Dr. Manning lay everything on the line to assist a sick woman. Dr. Halstead faces an uphill battle in getting participants involved in his clinical trial. Dr. Choi clashes ...
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- This is Auggie.
- The foster family felt
he would be too much to handle.
- We'll do it.
We'll foster him.
- I have to make some changes
around here.
The ED has not been running
as effectively as it could be.
A good leader takes
responsibility
for everything that happens
on his watch.
- I'm testing a brand-new
heart failure drug.
With some hard work,
I think we could fill this
trial in a matter of weeks,
not months.
- Why do you do
the one-night stands?
They all end up the same.
With you alone.
- There she is!
Our fearless leader.
- Returning from exile.
- How you doing, Michael?
You look good. You look fit.
- Moving back home.
Solid meals instead of takeout.
The only positive thing
about being furloughed.
- The hospital lifted
restriction
on nonessential personnel
on-site.
- Mm-hmm.
- Device reps are being allowed
into the OR.
- Gotta go, Ma.
Catch you later.
- All righty.
- Doc C.
- I'll see ya.
Oh, Sharon.
- It is so great to see you,
to see you in the flesh.
- Yeah, thanks, Daniel,
and it's about time.
COVID protocols have been
working for months.
Even with my diabetes,
there was no reason
for me to stay at home.
- Watch out, Med.
She's back!
- You, uh,
care to join me
for a nasal swab?
- Would love to.
- After you.
- Ooh.
- Oh.
- Sorry. Good morning.
- Hi.
- Good morning.
- Sorry, I didn't see you
coming up.
- No, I didn't see you
going in.
- Well, no harm, no foul.
- Mm-hmm.
See you around.
- Yeah, catch you later.
- See ya.
- Okay.
- I'm not gonna say anything,
but I saw that.
- You saw what?
We just caught each other
by surprise.
- Right.
Did you want me to pass him
a note in homeroom, too?
- Ha, ha.
- Maggie?
- One second.
- We're friends.
That's it.
- Mm-hmm?
- Mm-hmm.
- Mm...
hypothetically though,
if it were to be
that kind of attraction,
what do you think?
- I don't know, Nat.
Crockett?
Is he really your type?
Oh.
- Sorry,
I just gotta deal with this
before it gets out of hand.
Done.
Last time I pick up the phone.
Promise.
- Trust me,
I know how busy you are.
I really appreciate you making
the time to check in.
- Only way to cross it off
the list is to get it done.
Like dealing
with expense reports,
managing doctor-nurse
staffing levels,
let alone a distribution plan
for a possible COVID vaccine.
- Wow. A lot of stuff.
- Yeah, but I can handle it.
I guess my--my years
on active duty,
the COs I learned under,
chief of the ED
is what I've been trained for.
You know,
this is an opportunity
for everyone to step up.
We need to do the job
better than ever.
- Buddy, I think it's such an
admirable attitude, you know?
It just might be a good idea
to keep it in the back
of your mind, you know,
not everybody is as, um...
combat-tested, if you will,
as you are.
People are just exhausted.
For most of them,
doing better, I mean,
is, like,
getting through the day.
- Yeah.
Listen, my first tour,
I really struggled.
Far from home, no sleep...
Marines dying every day.
I went to my CO,
told him I was exhausted.
You know what he said?
"Now's not the time, Choi.
You can rest when it's over."
- I get it.
- Look, Dr. Charles,
I know I'm not gonna be able
to please everyone,
but that's not the mission.
I was promoted
to right the ship.
- You gonna get that?
- I gotta cut this short.
- Do your thing, man.
Appreciate you stopping by.
- Sure thing.
Dr. Driskell,
what do you got?
- Drew Corbett,
62-year-old male,
eight days-plus presenting
with COVID symptoms.
In and out of respiratory
failure the past three days.
- All right.
- Drew married
his high school sweetheart.
His wife, his two kids,
his three grandkids,
FaceTime him every day.
- Labs?
- Suggestive of
a cytokine storm.
We're trying to get it
under control,
but his vitals
are still unstable.
- What do you want to do?
- Keep him on a high-flow O2,
start him on a COVID cocktail.
- Good.
- V-tach.
No pulse.
- Open his airway.
Bag him.
I'm on compressions.
- No.
Hold compressions.
Charge to 200.
Draw up an amp of epi.
- He's unstable.
Needs to maintain
cardiac profusion.
- No compressions.
Hospital policy.
CPR aerosolizes the virus,
puts you all at risk.
You know that.
- Paddles.
Clear.
- Amp of epi,
recharge the paddles.
Shock him again.
Shock him again!
- Clear.
- Please let me do
compressions.
It'll keep his heart alive.
- No.
Run it again.
- Clear.
We did everything we could.
.
- Ms. Goodwin, welcome back.
- Thank you.
- I haven't had the chance yet
to compile the nightly numbers,
but I'll get them to you ASAP.
- No hurry.
We can go over them later.
I'm just making rounds,
saying hello to everyone.
Mags, who's up?
- Uh, Treatment 5.
Just sent it to your iPad.
- Thanks.
And hey, I'd like to get the
treatment rooms turned over
within ten minutes of a patient
being discharged.
- With UV sanitizing?
- Yeah.
- I can't get it in under 15.
- Try.
And please make sure the
equipment carts are restocked
three times per shift.
- Okay.
- Hey, Mr. Lowry.
- Dr. Lowry.
Plastic surgeon.
- Excuse me.
Dr. Lowry.
What's going on?
- I became lightheaded
during a surgery.
Minor procedure, too.
Lipoma removal.
Fatty tumor. Stain on the body.
Had to go.
Anyway, I felt myself going
limp before I could remove it.
Didn't lose consciousness.
Nevertheless, my surgical
assistant overreacted.
Called 911.
- She did the right thing
for your safety
and your patient's.
- I am the patient.
- I meant who you were
operating on.
- Yeah, that's me.
- You were operating
on yourself?
Of course.
I'm not gonna settle for
anything less than perfection.
- May I?
- Mm.
- Um...
I'm seeing other scars here.
These pectoral implants?
- Indeed.
Very proud of them.
- Oh.
Liposuction?
- Had a six-pack.
Now it's an eight-pack.
Filler, too.
Can't tell, can you?
- Everything you've done here
looks--
- Perfect.
I told you,
I know what I'm doing.
- Even so, your BP's soft.
Likely hypovolemia from blood
loss during the procedure.
- I'm well aware.
I am a doctor.
So hang a liter of LR
and I'll get outta here.
- Actually,
I prefer normal saline.
Also, let's type and cross
two units of blood
to replenish the loss.
As for the lipoma,
we can finish that up.
I'll call Plastics
for a consult.
- No, thanks.
You do it.
- It's best
a surgeon handle this.
- Disagree.
Surgeons don't take advice
very well,
especially from other surgeons.
It's okay.
All you have to do
is follow my instructions.
- Dr. Charles,
I got a patient for you.
Todd Lowry, 43,
plastic surgeon.
He's been operating on himself,
a lot.
Doesn't think twice
about the risks.
- Interesting.
Doctors,
we know best, right?
Keep diagnosing ourselves,
writing our own scripts.
Been guilty of both myself.
- Sure, we take some liberties,
but Todd is way past that.
These aren't just
Botox injections,
they're invasive operations.
- Huh.
Let me, uh, let me have a chat
with him, check back with you.
- Thanks.
- Does that hurt, Isabella?
- Sort of.
Um, it's not pain
as much as just tightness.
- All right, well,
I'm not feeling anything overt,
but you are really clenching
your ab muscles.
Why don't you try to take
a deep breath and relax?
- Relax, yeah.
I wish.
2020 kind of took that
off the table.
- Stomach's been a mess
for a few months now.
I should've come in sooner.
- Well, you're here now.
All right, we're just gonna do
a quick X-ray,
so if you could stay still
for a second.
- So, um, what did you see?
- Well,
your bowel does look distended
and there is a moderate amount
of stool.
When was your last movement?
- A few days ago.
Actually, they've been here
or there for a while.
Could I just be constipated?
- Well, I do want to run
some labs and get a CT,
but yes,
this could just be stress
causing you to clench
the muscles in the back
the way
you're clenching your abs.
It's not the tight ass
I would've wished for,
but then again,
it's still a Zoom world
so I guess no one's really
looking anyway.
- There you go.
All right, a nurse will be by
in a minute, okay?
- Thank you.
- Yeah.
- Ah, so, Doris, I need--
- No.
Mm-mm.
That's your sweet voice.
I know what that means.
What's he want now?
He put together a list.
- You know, I was never a fan
of Dr. Lanik, but Ethan?
- Whatever that means.
- That he sucks.
- Oh.
- I've been learning Italian.
- I noticed.
You're planning a trip?
- I took an ancestry DNA test
a few weeks ago.
I knew my grandparents were
from Chile.
I had no idea though that their
grandparents were from Naples.
- Oh, that's cool.
I've never been to Italy.
It's on the list, though.
Until then, you, Trini,
and Hank take the first three.
I'll take the rest.
- So no running
on the treadmill?
- Nope.
Only bloodwork and an echo,
Mr. Gessner.
- What about the meds?
Hospital's pushing aspirin
for 30 bucks a pop.
Heart disease pill
you're selling?
Bet I'd probably need a second
mortgage to pay for that.
- If you qualify,
the pharmaceutical company
covers all costs.
- I like that.
- So, uh, what do you say?
Can I enroll you?
- No.
Sorry, too risky.
- What? How?
Mr. Gessner.
- You know,
my ticker's not great,
but the pills I'm on
are working.
COVID, though?
That bug is a wildcard. I--
no, no, no hospitals
till I've got the vaccine.
- Please don't hang up.
The COVID ward
is completely contained.
No contact with
where you will be in the ED.
- Yeah, says you.
- Hey, it's the truth.
I'm there all day.
I've never felt safer.
- Okay, I guess I can come in
this afternoon.
- Mr. Gessner, thank you.
I'll see you later.
- Nice job.
He almost got away.
- God, too many of 'em have.
That's why I'm behind
on my quota.
Millions suffer
from heart failure, April.
I had no idea how difficult
it'd be finding them.
- I don't get it.
We get cases in the ED
every day,
not to mention Cardiology.
- And they've thrown me a bunch
of files.
Unfortunately, the study's
exclusionary criteria
weed out a lot of patients.
I am meeting a cardiologist
at Chicago Congress
later this morning,
hoping he'll throw me
a few patients, but--
and I'll, uh, keep pitching
the Med patients that are left.
- I'd like to help.
- Yeah?
- When I was in the COVID ward,
I felt like I was a part
of something
so much bigger than myself.
I'd like to feel that again.
I'll make time.
- Welcome aboard.
- All right.
So why don't you focus
on your meeting?
And I will reach out to
the rest of these Med patients.
- All right.
- Great.
- All right.
- Dr. Manning,
all this, it's...
- Tumor.
Her abdomen is full of cancer.
.
- Cancer?
Um, I don't understand.
I'm--I'm only 21.
I should've come in the moment
that I felt something was off,
but I live at home.
Both my parents are high risk
for COVID.
I just didn't want to bring it
into the house.
- We understand.
You thought you were doing
what was right.
- Am I gonna die?
- No. Hey.
Look,
we'll confer with Oncology,
but I believe that this section
and then this section too
are amenable to resection.
- Resection?
Um, that means surgery, right?
- That's right.
The more tumor I remove now,
the better your position
for cancer treatment later.
- Okay.
- Hey.
I know you're scared,
but you can win this fight.
- Wow, that's impressive.
I mean, not just
the attention to detail,
but I mean, the focus that must
be required to achieve that.
- Flattery.
Really?
You're the head of Psychiatry.
I'd figured you'd use something
a little more clever
to get inside my head.
- Oh, come on.
We're just, uh, we're just
having a little chat.
- Okay, fine.
I'll buy it.
But scrap the pats on the back.
I know I'm good,
you don't need to tell me.
- You mind if I sit?
- This is invasive.
Tumor already has
a blood supply,
has invaded
the surrounding tissues.
- Yes, but there's
two clear areas of focus
around the left lobe
of the liver
and the same with the inferior
poles of the kidneys here.
- I don't think so.
My experience, CTs are rarely
as accurate as they appear.
Tumor already looks like
a nightmare.
What's actually going on inside
is a disaster.
- Okay, look,
all due respect, Dr. Gillen,
I'm not pushing to operate
to boost my résumé.
I want to save Isabella's life.
- So do I.
This CT, though,
worst-case territory.
A biopsy
and appropriate chemo regimen
are the safest first step.
Perhaps surgery down the line.
- Perhaps?
- She's very sick, Dr. Manning.
If we'd been able
to treat her earlier--
- Well, we weren't.
- I understand.
And in that time,
her cancer progressed too far.
- So that's it?
- Dr. Gillen has her opinion,
I have mine.
- So how'd it go?
Did Dr. Lowry, plastic surgeon,
shrink himself?
- Not really his priority.
- Putting him on a five-day,
then?
- A psych hold?
Why?
- Dr. Charles,
he cut himself open.
- Yeah,
because of body dysmorphia.
Which is driven, ironically,
by a desire
to perfect his body,
not to hurt himself.
- Maybe not intentionally,
but that perfectionism clearly
clouds his judgment.
We need to step in.
- Well, the thing is,
BDD isn't something
that we can just fix.
You know, Todd's gotta develop
an entirely new perspective
on his body.
That's gonna take time,
you know?
- You know a guy like Todd
isn't gonna go to therapy
voluntarily.
We intervene now
or this just gets worse.
- I hear you and will, uh,
will take that
under advisement.
- Hey, Mags,
where are we on those changes
to the nursing room team?
- Ethan, we're short-staffed.
I'm doing what I can.
The other nurses, too.
It's Ben.
Give me two minutes?
- Yeah.
Just get the changes done,
okay?
- Yeah.
Hey, babe.
What's up?
- Auggie's not feeling so hot.
Temp's a little high.
He hasn't thrown up,
but feels like he might.
- How's his energy?
- Low.
Doesn't even have enough
strength for "Minecraft."
That's a red flag.
- Can you put him on?
- Sure.
- Hey, little man.
- Sorry for bothering you
at work.
- There's nothing
to apologize for.
Can you do me a favor?
Can you lean in real close
to the phone
and look into the lens
so I can see your eyes?
Okay. Thanks, honey.
You can go back to resting.
- So what do you think?
- Natalie needs to take a look.
- Okay.
I'll bring him in.
- Yeah.
- Are we there?
- I hope not.
- You've been seeing results?
- So far, yes.
Study's still small,
but the data has been
very encouraging.
- It always is
in the early phases.
But I've seen a lot of heart
failure trials come and go.
Is this the real deal?
- I hope so.
Yesterday,
I treated a woman in the ED.
Massive MI.
She's now on a vent in the CCU
and the odds are not
on her side.
But if this oral inotrope
works,
what happened to her may not
have to happen to anyone else.
- Okay.
Sold.
I'm in.
- Wonderful.
Thank you, Dr. Mayfield.
Your patients will really help
the study.
- That's great
for your hospital.
Now let's discuss mine.
How's 30% sound?
- Sorry.
Uh, 30% of what?
- Your patient enrollment fee.
A kickback?
- That's a harsh word.
I prefer we call it
quid pro quo.
- Well,
call it whatever you want.
It's unethical.
I can't do it.
- I'm afraid I can't help you.
- Look, I'm from Canaryville.
I get that one hand washes
the other,
but that's
neighborhood politics.
This is science.
- Yeah, this isn't Chicago Med,
Dr. Halstead.
There's no university backing
or Wall Street investment
or billionaire benefactors.
I cannot afford
to give away patients for free.
I'm sorry.
Good luck with your trial.
- Appreciate your time,
Dr. Mayfield.
- Ms. Goodwin, I've discussed
all the risks with Isabella.
She wants to proceed
with surgery
and I'm confident I can do it.
- This isn't about
your ability, Dr. Marcel,
it's about the state
of Isabella's cancer.
Dr. Gillen is the head
of Oncology.
I will not override
her decision.
- Ms. Goodwin,
without being able to resect
part of the tumor,
the chemo won't work.
Please.
We are where we are because
she was protecting her family.
She deserves our help.
- This virus...
not only is it still
killing people,
but it's forced thousands
of others like Isabella
to delay or even
interrupt treatment.
Not just cancer,
but all chronic illnesses.
Look, I wish I could help
every patient.
But the honest reality is
some won't be able to be saved.
- World kinda sucks right now,
Ms. Goodwin.
- Yes, it does.
Yes, it does.
- Thank you.
- We'll call over to the
Mayo Clinic, Sloan Kettering,
see if they'll do the surgery.
- Yeah, worth a try.
I'm gonna fill in Isabella.
- Oh, I'll come with you.
- Oh, actually if you don't
mind, I'd like to do it alone.
I sold her on this surgery.
It's up to me to tell her
I spoke too soon.
- Okay.
- Thanks.
- Yeah.
.
- Pull slowly and evenly.
- I am.
- No fragments?
- No.
All clear.
Okay.
We can move on.
Easy.
- I'm controlling the bleeders.
- No,
you're frying healthy tissue.
- All right, I'm calling
Plastics, they'll finish up.
- No, look.
We're almost done.
I don't have the energy
to start over with someone new.
- Then please let me do my job.
Rather you'd use
absorbable sutures.
- Can you grab 3-0 absorbable
Vicryl sutures off the cart?
- Actually, Monocryl ones
instead of Vicryl.
- We don't have that in the ED.
I'd have to call OR,
have them sent down.
- I just want it done right.
- Me, too.
But second-guessing
every move I make
isn't gonna get us there.
- Fine.
Vicryl will do.
Yeah.
- All right, let's see.
Okay.
- I'm sorry, Auggie.
I know that we're doing a lot
of poking around.
- It's okay.
I trust you.
- I'm gonna go talk
to Dr. Manning for a minute.
Okay?
- All right.
- Okay.
His liver's failing.
- Yes.
He's stable, though.
Adjusting his meds
will ease his discomfort.
- But?
- It's time to admit him.
Get him on the transplant list.
I knew this day would come.
I've been preparing.
I thought I'd be ready.
I--
- I know.
It feels like you're alone
right now.
But you're not.
I am here for you, okay?
- Last one.
Good.
The nurse will dress the wound.
That guy's impossible.
On me the entire procedure.
- Yeah.
He is challenging,
I'll give you that.
- And he's a doctor.
If he's reckless
with his own health,
he could be reckless
with patients.
He shouldn't be practicing.
- Well, except that people with
BDD tend to be pretty rational.
I mean, except when it comes
to their own bodies, you know?
And that tracks with Dr. Lowry.
I mean, talking with him,
it's clear that he just doesn't
have the same issue
with his patients
as he does with himself.
- Maybe the medical board
should be the one
to decide that.
- Well...
I think I'm pretty qualified.
- I didn't--
He's more unstable
than you think, Dr. Charles.
- Ooh, look on that face,
I'm guessing
the meeting was a bust.
- Huge.
Doctor over there, Mayfield?
He's got a ton of patients
but he won't share any
unless I pad his pockets.
So I walked out.
- Good.
You shouldn't partner
with someone
who's just in it for a payout.
- Of course, turning him down
means I'm back to square one:
short on candidates.
How'd the rest
of the Med files go?
- I called them all.
There was definite interest.
No one committed, but
I told them you'd follow up.
- Fingers crossed.
- Hey, it was a tough morning.
But Ed Gessner's coming in,
right?
Still a win to be had.
- Yeah, you're right.
Keep looking forward.
- Yeah.
- Maggie,
you've got to understand.
Auggie has a rare blood type
and no family to reach out to
for a direct donation.
- Sharon, please don't be
an administrator right now.
You're my friend.
Just level with me.
How long might it be
before Auggie gets a liver?
- I'm not sure.
Gift of Hope oversees
the transplant list.
The hospital has no influence
over that process.
- But you know the system
inside and out.
Experience must be giving you
some kind of a gut feeling.
- Auggie's not critical, so
I imagine at this point,
he's low on the list.
- So we have to wait
for Auggie to get sicker.
And the donor's liver
is gonna be hard to find.
It might not happen...
will it?
- I don't know, Maggie.
I'm sorry.
- No, I understand.
The spread is extensive.
Yes, mm-hmm.
That is the plan our oncologist
recommended as well.
Okay, thank you, Dr. Webber.
- Dr. Manning.
- Just one sec.
- I'm sorry,
but this can't wait.
- Where?
- 6.
- Oh, my God, Crockett.
You've gone rogue?
Have you lost your mind?
- I've overstepped, okay?
But the bigger issue is this.
Dr. Gillen was right.
Deeper I go, more tumor I find.
- Peritoneal studding,
carcinomatosis.
There's cancer everywhere.
- Yeah.
Her kidneys are overrun.
I mean, my first instinct was
to remove them,
but that'll tie Isabella
to dialysis.
- No way she'd be able
to tolerate the chemo then.
If you can't leave
the kidneys in
and you can't take
the kidneys out,
then what's left?
- Ex-vivo.
Remove one kidney, debulk it of
as much cancer as possible,
then re-implant, re-attach,
and repeat with the other one.
- Crockett, ex-vivo surgeries
are still experimental.
There is no guarantee
the kidneys will work
once you put them back in.
- Maybe.
- You didn't call me up here
to debate this, did you?
- Natalie, if we don't do this,
Isabella dies.
- I'll scrub in.
.
- Hey.
How'd the follow-up calls go
to the Med patients I reached
out to?
- Two out of eight.
- It's something.
- Here he is.
Mr. Gessner.
Hey, Mr. Gessner.
Welcome!
What the hell?
Why isn't the ambo using
the COVID entrance?
- I don't know.
Must be backed up.
- What's he doing?
No, no, no, no, no, no, no.
Hey, Mr. Gessner.
Wait, please.
- You said it was safe!
- It is, I swear.
Hey, the ED is nowhere near
the COVID--
- I don't care!
- Please, please don't--
Mr. Gessner!
Hey, I just--just--
Okay.
- You can let Commander Choi
know treatment rooms
are being turned over within
ten minutes, as ordered.
- Okay, great.
- While I've got you,
I have a cousin in Rockford
who needs a hand.
Pregnant,
three kids in homeschool.
I know it's a pain, but
can I get a few days off
next week?
- Yeah, sure.
- Grazie, grazie.
La mia famiglia.
- All right.
All done.
You see?
That only took two seconds.
- What's it for?
- To find you a liver.
All right, sweetie.
- Right kidney's looking good.
- Great.
Seems luck is on our side.
Just gotta finish closing
the capsule.
Then we can reimplant
and move on to the other one.
- Dr. Marcel, you scheduled
a central line insertion.
- We had a complication.
Had to expand.
- Okay.
- You scheduled
a central line insertion
as a cover to book the OR?
- I needed the room with
as few questions as possible.
Figured I'd cross this bridge
when I got to it.
- Well, we're there
and it doesn't seem like she's
gonna be looking the other way.
Only a matter of time
before we're found out.
- Yep.
- What are you doing?
- I don't like your wound,
your eversion.
- No, no, no, I closed out
all the dead space.
It'll heal seamlessly.
- The dimples.
They need to be fixed.
- Don't, don't!
- Get off! Get off of me!
- Please, please!
You're hurting yourself!
Need some help in here!
- This is all your fault.
They're not perfect.
- Hey, hey, hey.
Dr. Lowry, Dr. Lowry.
- Soft restraints!
- No restraints, no restraints.
- Get off of me!
- Five of haldol.
- Not yet.
- He needs to be sedated!
- Ethan!
I'm gonna be the one who makes
that call, okay?
Let me handle this.
Hey, hey, Todd.
Look at me, look at me.
Right here.
What's going on, buddy?
Breathe with me, all right?
In through the nose.
Look at me.
- Okay.
- In through the nose.
Out through the mouth.
- I appreciate it.
- He's a lot calmer--
- Don't you ever interfere
with the treatment
of my patient again.
- Buddy,
you're way out of line.
- Me?
The guy's ripping himself
to shreds.
I told you he need to be
on a hold.
You shot that down
and here we are.
- That's right.
And locking him up
still isn't the answer.
Neither are restraints
or sedatives.
- How can you say that?
He's harming himself!
If you would've just helped me,
we wouldn't be
in this situation!
- How's the left kidney?
Pinking up yet?
- No.
Still purple.
Orientation is good, though.
No rotation.
Inflow artery isn't kinked.
- Doppler it.
- Doppler.
- Sounds monophasic.
There's blood flow,
just not enough.
- Okay. Marty,
get her blood pressure up.
5,000 units of heparin,
let's go.
- Meds are in.
- No change.
- Look, we've been able
to resect a lot of tumor.
Two kidneys would be ideal.
One's enough for her
to tolerate chemo.
Last knot.
Snip.
Moment of truth.
Unclamp the vein.
Nice and easy.
Easy, easy.
Then the artery.
- It's pinking up.
Strong blood flow.
- There it is.
- I am going to have you both
fired.
How is she?
- In great shape.
We're about to close.
- Glad to hear it.
Nevertheless,
she's the last patient either
one of you will ever see
at this hospital.
.
- Dr. Mayfield.
Thanks for seeing me again.
- Course.
Sorry to keep you waiting.
So many patients.
It's always something.
Don't have to tell you that,
though.
I mean, we're all in this
together, right?
- Well, to that end,
I've had some time to reflect
on our earlier conversation.
Realized there's always a way
to find common ground.
I mean, that is,
if you're still interested.
- I am.
Come on in.
We'll talk details.
- Yeah.
- Hey.
Um...
I just wanted to apologize
for my behavior.
I overreacted.
- Apology accepted.
Appreciate you coming down.
What did you, uh,
what'd you do to your hand?
- Rough day.
- Tell me about it, right?
- After I, uh...
left your office this morning,
there was a patient,
Drew Corbett.
He died.
Acute respiratory failure.
When Drew coded,
the resident wanted to do
compressions.
But that's against protocol,
so...
I held them back.
- Okay.
- I stood outside the treatment
room and I watched Drew die.
I wanted to pound on his chest.
But I just stood there
and I did nothing.
Same as yesterday,
same as it'll be tomorrow.
- Man, I'm just, uh...
I'm just so sorry
you gotta go through that.
You know,
maybe the reason that you--
you got so upset at Dr. Lowry
is as simple as this.
I mean, it's very easy
to look at body dysmorphic
disorder as physical.
About the body, right?
But it's actually
a control issue, right?
Not unlike...
feeling responsible
for every patient's outcome.
Or wanting to keep an ED
functioning perfectly
in the middle of a pandemic.
- Lives are at stake,
Dr. Charles.
I have to be effective
at what I do.
- Yeah, but what if that's not
always possible?
- So what?
I'm just supposed to give up?
Accept failure?
- No.
Accept--
accept being mortal.
Remember when we were
dealing with your PTSD?
The, um, the serenity prayer.
How did, uh--
how'd that go again?
- "Grant me the serenity
"to accept the things
that I cannot change,
the courage to change
the things I can..."
- And?
- "And wisdom
to know the difference."
- But even if they put his DNA
into their database,
doesn't it take a really long
time to get the results back?
- I'm expediting the order.
Rush processing.
I mean,
it's gonna cost us triple,
but we'll have an answer
by this week.
- I realize Auggie is low
on the transplant list,
but pinning our hopes
on finding
some long-lost relative?
- Ben, the internet is flooded
with stories of people
who have found family members
through DNA databases.
This is gonna work.
- How can you be so sure?
- Because...it has to.
- You get Goodwin's text?
- "My office, now."
So I guess this is it.
- Yep.
Let's get this over with.
- Okay.
You know, Manning, I put you in
an impossible position today.
When Goodwin lays the hammer,
I take the fall.
- Noble.
But I chose to scrub in
with you,
so whatever happens,
happens to us both.
Okay.
- I don't even know where
to begin.
My dismay at the risk you put
your patient in,
or the headache I have
from Dr. Gillen screaming about
how furious she is.
And by the way,
her anger is justified.
That said--
incredible job.
- We're not fired?
- Trust me...
you came very, very close.
The board was with Dr. Gillen.
They wanted to see you two
gone.
But I helped them see
there's no PR value
in a successful ex-vivo surgery
if you fire the two heroes
of the day.
- Thank you, Ms. Goodwin.
Thank you.
- Hey, Ma. Ready to go home?
- Yeah.
Get outta here.
- Ma'am.
- Good night.
- Oh, so that's where
you've been.
You okay?
- It is what it is.
But 100 patient files here
and more on the way.
- Still, I'm sorry.
I know you had to make a deal
you didn't really want to.
- End of the day,
it's about saving lives
The trial needs a chance
to prove the drug can work.
Mayfield's patients
guarantee that.
- Well, I am done for the day.
I can help you start
sorting through those files.
- Thanks, April.
- Oh, my God, I thought
it was over for us today.
- Yeah, me too.
.
- This is Auggie.
- The foster family felt
he would be too much to handle.
- We'll do it.
We'll foster him.
- I have to make some changes
around here.
The ED has not been running
as effectively as it could be.
A good leader takes
responsibility
for everything that happens
on his watch.
- I'm testing a brand-new
heart failure drug.
With some hard work,
I think we could fill this
trial in a matter of weeks,
not months.
- Why do you do
the one-night stands?
They all end up the same.
With you alone.
- There she is!
Our fearless leader.
- Returning from exile.
- How you doing, Michael?
You look good. You look fit.
- Moving back home.
Solid meals instead of takeout.
The only positive thing
about being furloughed.
- The hospital lifted
restriction
on nonessential personnel
on-site.
- Mm-hmm.
- Device reps are being allowed
into the OR.
- Gotta go, Ma.
Catch you later.
- All righty.
- Doc C.
- I'll see ya.
Oh, Sharon.
- It is so great to see you,
to see you in the flesh.
- Yeah, thanks, Daniel,
and it's about time.
COVID protocols have been
working for months.
Even with my diabetes,
there was no reason
for me to stay at home.
- Watch out, Med.
She's back!
- You, uh,
care to join me
for a nasal swab?
- Would love to.
- After you.
- Ooh.
- Oh.
- Sorry. Good morning.
- Hi.
- Good morning.
- Sorry, I didn't see you
coming up.
- No, I didn't see you
going in.
- Well, no harm, no foul.
- Mm-hmm.
See you around.
- Yeah, catch you later.
- See ya.
- Okay.
- I'm not gonna say anything,
but I saw that.
- You saw what?
We just caught each other
by surprise.
- Right.
Did you want me to pass him
a note in homeroom, too?
- Ha, ha.
- Maggie?
- One second.
- We're friends.
That's it.
- Mm-hmm?
- Mm-hmm.
- Mm...
hypothetically though,
if it were to be
that kind of attraction,
what do you think?
- I don't know, Nat.
Crockett?
Is he really your type?
Oh.
- Sorry,
I just gotta deal with this
before it gets out of hand.
Done.
Last time I pick up the phone.
Promise.
- Trust me,
I know how busy you are.
I really appreciate you making
the time to check in.
- Only way to cross it off
the list is to get it done.
Like dealing
with expense reports,
managing doctor-nurse
staffing levels,
let alone a distribution plan
for a possible COVID vaccine.
- Wow. A lot of stuff.
- Yeah, but I can handle it.
I guess my--my years
on active duty,
the COs I learned under,
chief of the ED
is what I've been trained for.
You know,
this is an opportunity
for everyone to step up.
We need to do the job
better than ever.
- Buddy, I think it's such an
admirable attitude, you know?
It just might be a good idea
to keep it in the back
of your mind, you know,
not everybody is as, um...
combat-tested, if you will,
as you are.
People are just exhausted.
For most of them,
doing better, I mean,
is, like,
getting through the day.
- Yeah.
Listen, my first tour,
I really struggled.
Far from home, no sleep...
Marines dying every day.
I went to my CO,
told him I was exhausted.
You know what he said?
"Now's not the time, Choi.
You can rest when it's over."
- I get it.
- Look, Dr. Charles,
I know I'm not gonna be able
to please everyone,
but that's not the mission.
I was promoted
to right the ship.
- You gonna get that?
- I gotta cut this short.
- Do your thing, man.
Appreciate you stopping by.
- Sure thing.
Dr. Driskell,
what do you got?
- Drew Corbett,
62-year-old male,
eight days-plus presenting
with COVID symptoms.
In and out of respiratory
failure the past three days.
- All right.
- Drew married
his high school sweetheart.
His wife, his two kids,
his three grandkids,
FaceTime him every day.
- Labs?
- Suggestive of
a cytokine storm.
We're trying to get it
under control,
but his vitals
are still unstable.
- What do you want to do?
- Keep him on a high-flow O2,
start him on a COVID cocktail.
- Good.
- V-tach.
No pulse.
- Open his airway.
Bag him.
I'm on compressions.
- No.
Hold compressions.
Charge to 200.
Draw up an amp of epi.
- He's unstable.
Needs to maintain
cardiac profusion.
- No compressions.
Hospital policy.
CPR aerosolizes the virus,
puts you all at risk.
You know that.
- Paddles.
Clear.
- Amp of epi,
recharge the paddles.
Shock him again.
Shock him again!
- Clear.
- Please let me do
compressions.
It'll keep his heart alive.
- No.
Run it again.
- Clear.
We did everything we could.
.
- Ms. Goodwin, welcome back.
- Thank you.
- I haven't had the chance yet
to compile the nightly numbers,
but I'll get them to you ASAP.
- No hurry.
We can go over them later.
I'm just making rounds,
saying hello to everyone.
Mags, who's up?
- Uh, Treatment 5.
Just sent it to your iPad.
- Thanks.
And hey, I'd like to get the
treatment rooms turned over
within ten minutes of a patient
being discharged.
- With UV sanitizing?
- Yeah.
- I can't get it in under 15.
- Try.
And please make sure the
equipment carts are restocked
three times per shift.
- Okay.
- Hey, Mr. Lowry.
- Dr. Lowry.
Plastic surgeon.
- Excuse me.
Dr. Lowry.
What's going on?
- I became lightheaded
during a surgery.
Minor procedure, too.
Lipoma removal.
Fatty tumor. Stain on the body.
Had to go.
Anyway, I felt myself going
limp before I could remove it.
Didn't lose consciousness.
Nevertheless, my surgical
assistant overreacted.
Called 911.
- She did the right thing
for your safety
and your patient's.
- I am the patient.
- I meant who you were
operating on.
- Yeah, that's me.
- You were operating
on yourself?
Of course.
I'm not gonna settle for
anything less than perfection.
- May I?
- Mm.
- Um...
I'm seeing other scars here.
These pectoral implants?
- Indeed.
Very proud of them.
- Oh.
Liposuction?
- Had a six-pack.
Now it's an eight-pack.
Filler, too.
Can't tell, can you?
- Everything you've done here
looks--
- Perfect.
I told you,
I know what I'm doing.
- Even so, your BP's soft.
Likely hypovolemia from blood
loss during the procedure.
- I'm well aware.
I am a doctor.
So hang a liter of LR
and I'll get outta here.
- Actually,
I prefer normal saline.
Also, let's type and cross
two units of blood
to replenish the loss.
As for the lipoma,
we can finish that up.
I'll call Plastics
for a consult.
- No, thanks.
You do it.
- It's best
a surgeon handle this.
- Disagree.
Surgeons don't take advice
very well,
especially from other surgeons.
It's okay.
All you have to do
is follow my instructions.
- Dr. Charles,
I got a patient for you.
Todd Lowry, 43,
plastic surgeon.
He's been operating on himself,
a lot.
Doesn't think twice
about the risks.
- Interesting.
Doctors,
we know best, right?
Keep diagnosing ourselves,
writing our own scripts.
Been guilty of both myself.
- Sure, we take some liberties,
but Todd is way past that.
These aren't just
Botox injections,
they're invasive operations.
- Huh.
Let me, uh, let me have a chat
with him, check back with you.
- Thanks.
- Does that hurt, Isabella?
- Sort of.
Um, it's not pain
as much as just tightness.
- All right, well,
I'm not feeling anything overt,
but you are really clenching
your ab muscles.
Why don't you try to take
a deep breath and relax?
- Relax, yeah.
I wish.
2020 kind of took that
off the table.
- Stomach's been a mess
for a few months now.
I should've come in sooner.
- Well, you're here now.
All right, we're just gonna do
a quick X-ray,
so if you could stay still
for a second.
- So, um, what did you see?
- Well,
your bowel does look distended
and there is a moderate amount
of stool.
When was your last movement?
- A few days ago.
Actually, they've been here
or there for a while.
Could I just be constipated?
- Well, I do want to run
some labs and get a CT,
but yes,
this could just be stress
causing you to clench
the muscles in the back
the way
you're clenching your abs.
It's not the tight ass
I would've wished for,
but then again,
it's still a Zoom world
so I guess no one's really
looking anyway.
- There you go.
All right, a nurse will be by
in a minute, okay?
- Thank you.
- Yeah.
- Ah, so, Doris, I need--
- No.
Mm-mm.
That's your sweet voice.
I know what that means.
What's he want now?
He put together a list.
- You know, I was never a fan
of Dr. Lanik, but Ethan?
- Whatever that means.
- That he sucks.
- Oh.
- I've been learning Italian.
- I noticed.
You're planning a trip?
- I took an ancestry DNA test
a few weeks ago.
I knew my grandparents were
from Chile.
I had no idea though that their
grandparents were from Naples.
- Oh, that's cool.
I've never been to Italy.
It's on the list, though.
Until then, you, Trini,
and Hank take the first three.
I'll take the rest.
- So no running
on the treadmill?
- Nope.
Only bloodwork and an echo,
Mr. Gessner.
- What about the meds?
Hospital's pushing aspirin
for 30 bucks a pop.
Heart disease pill
you're selling?
Bet I'd probably need a second
mortgage to pay for that.
- If you qualify,
the pharmaceutical company
covers all costs.
- I like that.
- So, uh, what do you say?
Can I enroll you?
- No.
Sorry, too risky.
- What? How?
Mr. Gessner.
- You know,
my ticker's not great,
but the pills I'm on
are working.
COVID, though?
That bug is a wildcard. I--
no, no, no hospitals
till I've got the vaccine.
- Please don't hang up.
The COVID ward
is completely contained.
No contact with
where you will be in the ED.
- Yeah, says you.
- Hey, it's the truth.
I'm there all day.
I've never felt safer.
- Okay, I guess I can come in
this afternoon.
- Mr. Gessner, thank you.
I'll see you later.
- Nice job.
He almost got away.
- God, too many of 'em have.
That's why I'm behind
on my quota.
Millions suffer
from heart failure, April.
I had no idea how difficult
it'd be finding them.
- I don't get it.
We get cases in the ED
every day,
not to mention Cardiology.
- And they've thrown me a bunch
of files.
Unfortunately, the study's
exclusionary criteria
weed out a lot of patients.
I am meeting a cardiologist
at Chicago Congress
later this morning,
hoping he'll throw me
a few patients, but--
and I'll, uh, keep pitching
the Med patients that are left.
- I'd like to help.
- Yeah?
- When I was in the COVID ward,
I felt like I was a part
of something
so much bigger than myself.
I'd like to feel that again.
I'll make time.
- Welcome aboard.
- All right.
So why don't you focus
on your meeting?
And I will reach out to
the rest of these Med patients.
- All right.
- Great.
- All right.
- Dr. Manning,
all this, it's...
- Tumor.
Her abdomen is full of cancer.
.
- Cancer?
Um, I don't understand.
I'm--I'm only 21.
I should've come in the moment
that I felt something was off,
but I live at home.
Both my parents are high risk
for COVID.
I just didn't want to bring it
into the house.
- We understand.
You thought you were doing
what was right.
- Am I gonna die?
- No. Hey.
Look,
we'll confer with Oncology,
but I believe that this section
and then this section too
are amenable to resection.
- Resection?
Um, that means surgery, right?
- That's right.
The more tumor I remove now,
the better your position
for cancer treatment later.
- Okay.
- Hey.
I know you're scared,
but you can win this fight.
- Wow, that's impressive.
I mean, not just
the attention to detail,
but I mean, the focus that must
be required to achieve that.
- Flattery.
Really?
You're the head of Psychiatry.
I'd figured you'd use something
a little more clever
to get inside my head.
- Oh, come on.
We're just, uh, we're just
having a little chat.
- Okay, fine.
I'll buy it.
But scrap the pats on the back.
I know I'm good,
you don't need to tell me.
- You mind if I sit?
- This is invasive.
Tumor already has
a blood supply,
has invaded
the surrounding tissues.
- Yes, but there's
two clear areas of focus
around the left lobe
of the liver
and the same with the inferior
poles of the kidneys here.
- I don't think so.
My experience, CTs are rarely
as accurate as they appear.
Tumor already looks like
a nightmare.
What's actually going on inside
is a disaster.
- Okay, look,
all due respect, Dr. Gillen,
I'm not pushing to operate
to boost my résumé.
I want to save Isabella's life.
- So do I.
This CT, though,
worst-case territory.
A biopsy
and appropriate chemo regimen
are the safest first step.
Perhaps surgery down the line.
- Perhaps?
- She's very sick, Dr. Manning.
If we'd been able
to treat her earlier--
- Well, we weren't.
- I understand.
And in that time,
her cancer progressed too far.
- So that's it?
- Dr. Gillen has her opinion,
I have mine.
- So how'd it go?
Did Dr. Lowry, plastic surgeon,
shrink himself?
- Not really his priority.
- Putting him on a five-day,
then?
- A psych hold?
Why?
- Dr. Charles,
he cut himself open.
- Yeah,
because of body dysmorphia.
Which is driven, ironically,
by a desire
to perfect his body,
not to hurt himself.
- Maybe not intentionally,
but that perfectionism clearly
clouds his judgment.
We need to step in.
- Well, the thing is,
BDD isn't something
that we can just fix.
You know, Todd's gotta develop
an entirely new perspective
on his body.
That's gonna take time,
you know?
- You know a guy like Todd
isn't gonna go to therapy
voluntarily.
We intervene now
or this just gets worse.
- I hear you and will, uh,
will take that
under advisement.
- Hey, Mags,
where are we on those changes
to the nursing room team?
- Ethan, we're short-staffed.
I'm doing what I can.
The other nurses, too.
It's Ben.
Give me two minutes?
- Yeah.
Just get the changes done,
okay?
- Yeah.
Hey, babe.
What's up?
- Auggie's not feeling so hot.
Temp's a little high.
He hasn't thrown up,
but feels like he might.
- How's his energy?
- Low.
Doesn't even have enough
strength for "Minecraft."
That's a red flag.
- Can you put him on?
- Sure.
- Hey, little man.
- Sorry for bothering you
at work.
- There's nothing
to apologize for.
Can you do me a favor?
Can you lean in real close
to the phone
and look into the lens
so I can see your eyes?
Okay. Thanks, honey.
You can go back to resting.
- So what do you think?
- Natalie needs to take a look.
- Okay.
I'll bring him in.
- Yeah.
- Are we there?
- I hope not.
- You've been seeing results?
- So far, yes.
Study's still small,
but the data has been
very encouraging.
- It always is
in the early phases.
But I've seen a lot of heart
failure trials come and go.
Is this the real deal?
- I hope so.
Yesterday,
I treated a woman in the ED.
Massive MI.
She's now on a vent in the CCU
and the odds are not
on her side.
But if this oral inotrope
works,
what happened to her may not
have to happen to anyone else.
- Okay.
Sold.
I'm in.
- Wonderful.
Thank you, Dr. Mayfield.
Your patients will really help
the study.
- That's great
for your hospital.
Now let's discuss mine.
How's 30% sound?
- Sorry.
Uh, 30% of what?
- Your patient enrollment fee.
A kickback?
- That's a harsh word.
I prefer we call it
quid pro quo.
- Well,
call it whatever you want.
It's unethical.
I can't do it.
- I'm afraid I can't help you.
- Look, I'm from Canaryville.
I get that one hand washes
the other,
but that's
neighborhood politics.
This is science.
- Yeah, this isn't Chicago Med,
Dr. Halstead.
There's no university backing
or Wall Street investment
or billionaire benefactors.
I cannot afford
to give away patients for free.
I'm sorry.
Good luck with your trial.
- Appreciate your time,
Dr. Mayfield.
- Ms. Goodwin, I've discussed
all the risks with Isabella.
She wants to proceed
with surgery
and I'm confident I can do it.
- This isn't about
your ability, Dr. Marcel,
it's about the state
of Isabella's cancer.
Dr. Gillen is the head
of Oncology.
I will not override
her decision.
- Ms. Goodwin,
without being able to resect
part of the tumor,
the chemo won't work.
Please.
We are where we are because
she was protecting her family.
She deserves our help.
- This virus...
not only is it still
killing people,
but it's forced thousands
of others like Isabella
to delay or even
interrupt treatment.
Not just cancer,
but all chronic illnesses.
Look, I wish I could help
every patient.
But the honest reality is
some won't be able to be saved.
- World kinda sucks right now,
Ms. Goodwin.
- Yes, it does.
Yes, it does.
- Thank you.
- We'll call over to the
Mayo Clinic, Sloan Kettering,
see if they'll do the surgery.
- Yeah, worth a try.
I'm gonna fill in Isabella.
- Oh, I'll come with you.
- Oh, actually if you don't
mind, I'd like to do it alone.
I sold her on this surgery.
It's up to me to tell her
I spoke too soon.
- Okay.
- Thanks.
- Yeah.
.
- Pull slowly and evenly.
- I am.
- No fragments?
- No.
All clear.
Okay.
We can move on.
Easy.
- I'm controlling the bleeders.
- No,
you're frying healthy tissue.
- All right, I'm calling
Plastics, they'll finish up.
- No, look.
We're almost done.
I don't have the energy
to start over with someone new.
- Then please let me do my job.
Rather you'd use
absorbable sutures.
- Can you grab 3-0 absorbable
Vicryl sutures off the cart?
- Actually, Monocryl ones
instead of Vicryl.
- We don't have that in the ED.
I'd have to call OR,
have them sent down.
- I just want it done right.
- Me, too.
But second-guessing
every move I make
isn't gonna get us there.
- Fine.
Vicryl will do.
Yeah.
- All right, let's see.
Okay.
- I'm sorry, Auggie.
I know that we're doing a lot
of poking around.
- It's okay.
I trust you.
- I'm gonna go talk
to Dr. Manning for a minute.
Okay?
- All right.
- Okay.
His liver's failing.
- Yes.
He's stable, though.
Adjusting his meds
will ease his discomfort.
- But?
- It's time to admit him.
Get him on the transplant list.
I knew this day would come.
I've been preparing.
I thought I'd be ready.
I--
- I know.
It feels like you're alone
right now.
But you're not.
I am here for you, okay?
- Last one.
Good.
The nurse will dress the wound.
That guy's impossible.
On me the entire procedure.
- Yeah.
He is challenging,
I'll give you that.
- And he's a doctor.
If he's reckless
with his own health,
he could be reckless
with patients.
He shouldn't be practicing.
- Well, except that people with
BDD tend to be pretty rational.
I mean, except when it comes
to their own bodies, you know?
And that tracks with Dr. Lowry.
I mean, talking with him,
it's clear that he just doesn't
have the same issue
with his patients
as he does with himself.
- Maybe the medical board
should be the one
to decide that.
- Well...
I think I'm pretty qualified.
- I didn't--
He's more unstable
than you think, Dr. Charles.
- Ooh, look on that face,
I'm guessing
the meeting was a bust.
- Huge.
Doctor over there, Mayfield?
He's got a ton of patients
but he won't share any
unless I pad his pockets.
So I walked out.
- Good.
You shouldn't partner
with someone
who's just in it for a payout.
- Of course, turning him down
means I'm back to square one:
short on candidates.
How'd the rest
of the Med files go?
- I called them all.
There was definite interest.
No one committed, but
I told them you'd follow up.
- Fingers crossed.
- Hey, it was a tough morning.
But Ed Gessner's coming in,
right?
Still a win to be had.
- Yeah, you're right.
Keep looking forward.
- Yeah.
- Maggie,
you've got to understand.
Auggie has a rare blood type
and no family to reach out to
for a direct donation.
- Sharon, please don't be
an administrator right now.
You're my friend.
Just level with me.
How long might it be
before Auggie gets a liver?
- I'm not sure.
Gift of Hope oversees
the transplant list.
The hospital has no influence
over that process.
- But you know the system
inside and out.
Experience must be giving you
some kind of a gut feeling.
- Auggie's not critical, so
I imagine at this point,
he's low on the list.
- So we have to wait
for Auggie to get sicker.
And the donor's liver
is gonna be hard to find.
It might not happen...
will it?
- I don't know, Maggie.
I'm sorry.
- No, I understand.
The spread is extensive.
Yes, mm-hmm.
That is the plan our oncologist
recommended as well.
Okay, thank you, Dr. Webber.
- Dr. Manning.
- Just one sec.
- I'm sorry,
but this can't wait.
- Where?
- 6.
- Oh, my God, Crockett.
You've gone rogue?
Have you lost your mind?
- I've overstepped, okay?
But the bigger issue is this.
Dr. Gillen was right.
Deeper I go, more tumor I find.
- Peritoneal studding,
carcinomatosis.
There's cancer everywhere.
- Yeah.
Her kidneys are overrun.
I mean, my first instinct was
to remove them,
but that'll tie Isabella
to dialysis.
- No way she'd be able
to tolerate the chemo then.
If you can't leave
the kidneys in
and you can't take
the kidneys out,
then what's left?
- Ex-vivo.
Remove one kidney, debulk it of
as much cancer as possible,
then re-implant, re-attach,
and repeat with the other one.
- Crockett, ex-vivo surgeries
are still experimental.
There is no guarantee
the kidneys will work
once you put them back in.
- Maybe.
- You didn't call me up here
to debate this, did you?
- Natalie, if we don't do this,
Isabella dies.
- I'll scrub in.
.
- Hey.
How'd the follow-up calls go
to the Med patients I reached
out to?
- Two out of eight.
- It's something.
- Here he is.
Mr. Gessner.
Hey, Mr. Gessner.
Welcome!
What the hell?
Why isn't the ambo using
the COVID entrance?
- I don't know.
Must be backed up.
- What's he doing?
No, no, no, no, no, no, no.
Hey, Mr. Gessner.
Wait, please.
- You said it was safe!
- It is, I swear.
Hey, the ED is nowhere near
the COVID--
- I don't care!
- Please, please don't--
Mr. Gessner!
Hey, I just--just--
Okay.
- You can let Commander Choi
know treatment rooms
are being turned over within
ten minutes, as ordered.
- Okay, great.
- While I've got you,
I have a cousin in Rockford
who needs a hand.
Pregnant,
three kids in homeschool.
I know it's a pain, but
can I get a few days off
next week?
- Yeah, sure.
- Grazie, grazie.
La mia famiglia.
- All right.
All done.
You see?
That only took two seconds.
- What's it for?
- To find you a liver.
All right, sweetie.
- Right kidney's looking good.
- Great.
Seems luck is on our side.
Just gotta finish closing
the capsule.
Then we can reimplant
and move on to the other one.
- Dr. Marcel, you scheduled
a central line insertion.
- We had a complication.
Had to expand.
- Okay.
- You scheduled
a central line insertion
as a cover to book the OR?
- I needed the room with
as few questions as possible.
Figured I'd cross this bridge
when I got to it.
- Well, we're there
and it doesn't seem like she's
gonna be looking the other way.
Only a matter of time
before we're found out.
- Yep.
- What are you doing?
- I don't like your wound,
your eversion.
- No, no, no, I closed out
all the dead space.
It'll heal seamlessly.
- The dimples.
They need to be fixed.
- Don't, don't!
- Get off! Get off of me!
- Please, please!
You're hurting yourself!
Need some help in here!
- This is all your fault.
They're not perfect.
- Hey, hey, hey.
Dr. Lowry, Dr. Lowry.
- Soft restraints!
- No restraints, no restraints.
- Get off of me!
- Five of haldol.
- Not yet.
- He needs to be sedated!
- Ethan!
I'm gonna be the one who makes
that call, okay?
Let me handle this.
Hey, hey, Todd.
Look at me, look at me.
Right here.
What's going on, buddy?
Breathe with me, all right?
In through the nose.
Look at me.
- Okay.
- In through the nose.
Out through the mouth.
- I appreciate it.
- He's a lot calmer--
- Don't you ever interfere
with the treatment
of my patient again.
- Buddy,
you're way out of line.
- Me?
The guy's ripping himself
to shreds.
I told you he need to be
on a hold.
You shot that down
and here we are.
- That's right.
And locking him up
still isn't the answer.
Neither are restraints
or sedatives.
- How can you say that?
He's harming himself!
If you would've just helped me,
we wouldn't be
in this situation!
- How's the left kidney?
Pinking up yet?
- No.
Still purple.
Orientation is good, though.
No rotation.
Inflow artery isn't kinked.
- Doppler it.
- Doppler.
- Sounds monophasic.
There's blood flow,
just not enough.
- Okay. Marty,
get her blood pressure up.
5,000 units of heparin,
let's go.
- Meds are in.
- No change.
- Look, we've been able
to resect a lot of tumor.
Two kidneys would be ideal.
One's enough for her
to tolerate chemo.
Last knot.
Snip.
Moment of truth.
Unclamp the vein.
Nice and easy.
Easy, easy.
Then the artery.
- It's pinking up.
Strong blood flow.
- There it is.
- I am going to have you both
fired.
How is she?
- In great shape.
We're about to close.
- Glad to hear it.
Nevertheless,
she's the last patient either
one of you will ever see
at this hospital.
.
- Dr. Mayfield.
Thanks for seeing me again.
- Course.
Sorry to keep you waiting.
So many patients.
It's always something.
Don't have to tell you that,
though.
I mean, we're all in this
together, right?
- Well, to that end,
I've had some time to reflect
on our earlier conversation.
Realized there's always a way
to find common ground.
I mean, that is,
if you're still interested.
- I am.
Come on in.
We'll talk details.
- Yeah.
- Hey.
Um...
I just wanted to apologize
for my behavior.
I overreacted.
- Apology accepted.
Appreciate you coming down.
What did you, uh,
what'd you do to your hand?
- Rough day.
- Tell me about it, right?
- After I, uh...
left your office this morning,
there was a patient,
Drew Corbett.
He died.
Acute respiratory failure.
When Drew coded,
the resident wanted to do
compressions.
But that's against protocol,
so...
I held them back.
- Okay.
- I stood outside the treatment
room and I watched Drew die.
I wanted to pound on his chest.
But I just stood there
and I did nothing.
Same as yesterday,
same as it'll be tomorrow.
- Man, I'm just, uh...
I'm just so sorry
you gotta go through that.
You know,
maybe the reason that you--
you got so upset at Dr. Lowry
is as simple as this.
I mean, it's very easy
to look at body dysmorphic
disorder as physical.
About the body, right?
But it's actually
a control issue, right?
Not unlike...
feeling responsible
for every patient's outcome.
Or wanting to keep an ED
functioning perfectly
in the middle of a pandemic.
- Lives are at stake,
Dr. Charles.
I have to be effective
at what I do.
- Yeah, but what if that's not
always possible?
- So what?
I'm just supposed to give up?
Accept failure?
- No.
Accept--
accept being mortal.
Remember when we were
dealing with your PTSD?
The, um, the serenity prayer.
How did, uh--
how'd that go again?
- "Grant me the serenity
"to accept the things
that I cannot change,
the courage to change
the things I can..."
- And?
- "And wisdom
to know the difference."
- But even if they put his DNA
into their database,
doesn't it take a really long
time to get the results back?
- I'm expediting the order.
Rush processing.
I mean,
it's gonna cost us triple,
but we'll have an answer
by this week.
- I realize Auggie is low
on the transplant list,
but pinning our hopes
on finding
some long-lost relative?
- Ben, the internet is flooded
with stories of people
who have found family members
through DNA databases.
This is gonna work.
- How can you be so sure?
- Because...it has to.
- You get Goodwin's text?
- "My office, now."
So I guess this is it.
- Yep.
Let's get this over with.
- Okay.
You know, Manning, I put you in
an impossible position today.
When Goodwin lays the hammer,
I take the fall.
- Noble.
But I chose to scrub in
with you,
so whatever happens,
happens to us both.
Okay.
- I don't even know where
to begin.
My dismay at the risk you put
your patient in,
or the headache I have
from Dr. Gillen screaming about
how furious she is.
And by the way,
her anger is justified.
That said--
incredible job.
- We're not fired?
- Trust me...
you came very, very close.
The board was with Dr. Gillen.
They wanted to see you two
gone.
But I helped them see
there's no PR value
in a successful ex-vivo surgery
if you fire the two heroes
of the day.
- Thank you, Ms. Goodwin.
Thank you.
- Hey, Ma. Ready to go home?
- Yeah.
Get outta here.
- Ma'am.
- Good night.
- Oh, so that's where
you've been.
You okay?
- It is what it is.
But 100 patient files here
and more on the way.
- Still, I'm sorry.
I know you had to make a deal
you didn't really want to.
- End of the day,
it's about saving lives
The trial needs a chance
to prove the drug can work.
Mayfield's patients
guarantee that.
- Well, I am done for the day.
I can help you start
sorting through those files.
- Thanks, April.
- Oh, my God, I thought
it was over for us today.
- Yeah, me too.
.