Chicago Med (2015–…): Season 8, Episode 6 - Mama Said There Would Be Days Like This - full transcript
- Dr. Marcel, you
saved Nathaniel's life
in spectacular fashion.
- Got 30 million social
media followers waiting
to hear how this story ends.
- Get ready for what comes next.
- What's that?
- Fame.
- What the hell is going on?
- Will and Vanessa bought
meds off a drug dealer.
- It's a little more
complicated than that.
- You want to risk your
own career, that's fine.
Don't risk Vanessa's.
- April?
Are you back in Chicago?
- Yeah.
You didn't get married
or anything, did you?
- No.
- Well, I'll see you around.
- Did you really ask Jack
to dislocate your shoulder?
- Uh, didn't have much
of a choice, really.
- I couldn't believe it.
Didn't even hesitate.
- Well, my arm was
trapped, uh, at the time.
I felt it was the... the best way
to continue treating Mr. Perry.
- Well, no wonder people
are calling you a hero.
But is that how you would
characterize yourself?
- Did you know that he, um,
jerry-rigged a lung transplant
just days after
the incident? Yes.
Confident, creative, future
of medicine, this guy.
- Uh, it... it
was a team effort.
Look, I'm... I'm sure
you'd rather talk
to Mr. Dayton here.
And my shift is
starting soon, so...
- Dr. Marcel exemplifies the
kind of selfless dedication
we here at Gaffney
pride ourselves on,
and it's what has
attracted a new crop
of generous donations
to this institution.
Dr. Marcel's heroics
that day saved
way more than just one life.
- That's very generous.
- Mm.
- Thank you.
- And we're cut.
- Hey.
- Yeah?
- So I got you lined
up for a few phoners...
- Uh-huh.
- Later in the day.
And then we got "Today
Show" end of the week, okay?
Friday, we're gonna
try to do that.
- Morning, Mags.
How's it going?
- It's going.
I have a twisted
ankle for you in 5.
- Be there in a minute.
- You're still mad at him?
CPD and the hospital
cleared us both.
They're letting it
go. Why can't you?
- Because you brought drugs
into the hospital, Vanessa.
It was irresponsible.
It was dangerous.
- We were out of options,
and it saved our patient.
- I expect that kind of
foolishness from Will,
but he should have
known better than
to drag you down with him.
- No, no.
Will didn't drag
me into anything.
It was my call.
- You don't have to defend him.
I get it... the Halstead School
of Medicine has its appeal,
but it's not who you are.
- What is that supposed to mean?
- It means you're not reckless.
You're smarter than that.
And you don't have to be a
cowboy to be a good doctor.
- Hey, Dean. How you doing?
- Oh, well, I thought a
patient's bowel was nicked
during surgery, but it was
just a flatulent intern,
so I'm excellent.
- Great, but I meant
how are your injuries?
You're looking a little stiff.
- I've had worse.
- Oh, than being brutally
attacked by a patient
on PCP-laced cocaine?
I need to hear your life story.
- Oh, another time.
Uh, I seem to remember
being in considerable pain
when you patched me up.
So if I do need anything,
I'll be looking elsewhere.
- Well, lucky me,
seeing as doctors,
especially surgeons
with God complexes,
make the worst patient.
- Help! Someone, please!
- crying]
Please, I need help!
- Okay, what happened?
- Please, take him!
- T... tell me what's wrong.
- It's me. I'm what's wrong.
I'm gonna hurt him.
- I'll be right back.
Her son, Edison,
is in Treatment 2.
He shows no signs
of abuse or neglect.
He's an entirely
healthy newborn.
- Oh, that's a relief.
- Penelope, however,
is not in great shape.
She's dehydrated, anemic,
and is low in vitamin D.
- It certainly doesn't
look like she's been taking
very good care of herself.
- Well, that's not
unusual for a new mother,
but it could mean she doesn't
have much of a support system.
- Yeah.
- Listen, I don't
want to call DCFS,
but she did say that she
was gonna hurt her baby.
Are you guys comfortable
holding off for now?
- Absolutely... that's a
drastic step for something
that just might be postpartum
depression and treatable.
- Yeah, we're not there
yet, but I... I should have
a little chat with her, though.
- Yeah.
Halstead!
Incoming. Going to Baghdad.
Says she doesn't
want any doc but you.
- Okay.
76-year-old female.
- Tell the whole world, madonna.
- Maria. What happened?
- Crush injury to
the right upper arm.
Lacerations above the elbow.
Denied pain meds on the ride.
- I was just moving the stove.
- What, Anthony
couldn't move it?
- He's useless.
- Okay, in we go. On my count.
- I can do it myself!
- Please lie still, okay?
- Okay. One, two, three.
I need an X-ray!
- All this fussing,
Guglielmo. Basta.
- All right, I'm sorry.
- So you two know each other?
- Maria owns Marguerite's.
Taylor Street institution.
When my folks were
alive, we'd go there
every Sunday for dinner.
- Not so much recently, huh?
You look skinny.
- Uh, diminished
right radial pulse.
Any numbness, tingling?
- Mm-mm.
- Good.
Let's get a CT angio.
- X-ray up.
- Hey, no fractures,
but those lacerations
still need to be repaired.
Let me get you some pain meds.
- Oh, so I go to sleep?
No, I have a dinner
service tonight.
Uh, Maria, I'm sorry,
but I... I doubt
that's gonna be possible.
We'll know more once
we get better imaging,
but I'm gonna call
a surgical consult.
Surgery? No, no, no.
If you think Antonio can
run Marguerite's... oh-ho!
- Let's worry about that
later. You just relax.
- Hey, I'm gonna
take care of you.
- Va bene.
- Hi, Caitlin. I'm Dr. Asher.
- Hi.
- Hey.
This is my husband, Steve.
- How are you?
- Hi, Steve. Okay.
So Caitlin, I saw that
you're nine weeks pregnant
and experiencing spotting?
- Yes.
It just started a day ago, but
it hasn't been super heavy.
- Okay. Any pain or cramping?
- Nope.
- I read it could be
normal this early, right?
It doesn't necessarily mean
that something's wrong?
- That's true, but it is
wise to get checked out.
So let's get a type and screen,
a CBC, and a quantitative HCG.
- It's taken us some time
for us to get pregnant,
so we're probably a
little more neurotic
than most first-time parents.
- Okay, so Caitlin, I'd
like to do an ultrasound.
It'll have to be
transvaginal this early.
- Ah, yes. The joys
of being a woman.
- Yes.
Okay, let's get you set up.
Here we go.
A little bit of pressure.
- Mm-hmm.
- Let's see.
- What? What is it?
- I'm very sorry, but
it's an ectopic pregnancy.
The embryo has implanted
in your fallopian tube.
- What does that mean?
Won't it move to the uterus?
- No.
No, it's not even viable.
- Unfortunately, that's correct.
We need to remove the ectopic
before it can rupture
the fallopian tube,
which would be
fatal for Caitlin.
- Okay, so, uh, what,
uh... What do I have to do?
- Well, we have two
different options.
The first is a chemo
drug called methotrexate.
It stops the cells
from rapidly dividing
and ends the pregnancy.
The embryo ultimately
reabsorbs back in the body,
and it successfully
treats about 90%
of ectopic pregnancies.
- And how do you get that?
- It's an intramuscular shot,
typically in the
buttock or the thigh.
- What are your other options?
- We would operate to remove
the embryo and, if necessary,
the entire fallopian tube.
- The shot.
Please, no surgery.
We're hourly workers
at a bookstore.
We don't get sick days.
- I understand.
We'll just have to do
some additional labs,
and then we'll go
from there, okay?
Try and get some rest.
- Thank you.
- Hey. Hey, hey,
hey, hey, hey, hey.
I'm sorry.
- It'll be okay, all
right? Look at me.
- Penelope?
- How's Edison? Is he okay?
- Oh, he's fine.
He's just next door.
- Does he need breast
milk? I express him.
He's not always great
about waking up to eat,
even if it's been two hours.
- You know what? I'll...
I'll tell the nurses.
I'm Dr. Charles.
- Psychiatry.
Maybe I have
postpartum depression?
- You know, I don't know.
Tell me what's been going on.
How you been feeling?
- Oh, um, I'm not like myself.
- Okay.
- I cry so easily.
My moods are all over
the place, and...
And I have this
ringing in my ears,
but my OB says it's all part
of the recovery process.
- Hmm.
- But Edison was crying
so loudly, and I was...
I was so tired.
And it's not an
excuse, I know, but...
I thought about, uh...
I thought... I...
I thought about throwing
him against the wall?
- Okay.
Well, it was just
a thought, though.
Right?
- Mm-hmm.
- Has... has Edison's dad
been around to help out?
Turns out he
wasn't ready for a kid.
- Well, gosh, I mean,
that's got to be so hard,
facing a life-changing
situation like this
all... all by yourself.
My mom came
out for the first week,
but she had to get back to Ohio.
- How's it been since she left?
Mm, hard.
Uh, my job doesn't have
paid maternity leave,
so I've been working
from home, you know,
juggling phone calls while I
breastfeed every two hours.
And there are no breaks
and there's no time
to, like, turn off.
And his cry, like
a screech, it...
It's just... it's too much.
I... I can't.
I know it's his only
way to communicate,
but it sets my teeth on edge,
and I feel like I'm losing it.
So I just...
I'm sorry.
Can you please just...
Just tell me what...
- You know what?
We're gonna... we're gonna get
to the bottom of this, okay?
I promise you, we will.
Thank you.
- No, no, I will make
that flight, and I'm fine.
My doctor just walked in, okay?
- It's good to see you, Samir.
- You too.
- Mr. Baqri, I'm Dr. Taylor.
- Yeah. So sorry about that.
My work never stops.
And please, call me Samir.
- What seems to be the problem?
- Um, lethargy, myalgia.
It's hard to pin down.
- Ah, you're a physician.
- Oh, no. I... I
work with them.
- Samir runs the Hamsa
Community Health Foundation,
sets up clinics all
around the world.
- Mm-hmm.
- Mm, I get your
fundraising emails.
- Ah, wow. Hopefully,
not too many.
I haven't unsubscribed yet.
Okay, let's check this out.
Open up.
You know, your polio
vaccination program
in Pakistan, incredible.
- Ah.
- I was obsessed with
infectious disease
in med school, but they
would always talk about polio
in the past tense,
and I wanted to shout
at my professors that...
- We were still
fighting it, right.
You know, we almost had it
beat, but then the world
took its foot off the gas,
started reallocating funding,
and now it's back,
and well, you know,
we are struggling to get
buy-in from our partners.
It's just, uh... ugh, I'm sorry.
I will step off
of my soapbox now.
- No, do not apologize.
You're doing something.
I wish I knew how to help.
It's the entire reason
that I got into medicine.
But instead, I just
turn off the news,
and I eat a sleeve of Oreos.
But you know what?
At least now I can
help the helper.
- Right.
- So how long have
you felt this way?
- Um, a couple of weeks.
I've been traveling for
work a lot recently...
Indonesia, Pakistan,
Sierra Leone.
I leave for the
Philippines on Friday.
I'm opening up a new clinic.
- Well, the most exotic place
I've ever been is San Antonio,
and that was for a conference.
- So no interest in travel?
- No, I'd love to.
But between school and
residency, it's just...
- Well, let me tell you,
it's not always so glamorous.
I'm glued to my
phone, and I survive
off of peanut butter
protein bars and coffee.
- Temp's normal.
- Well, you know, I'm not seeing
any obvious signs of infection,
but given your travel history,
uh, I just want to cast
a bit of a wide net
with your bloodwork,
if that's okay.
- Yeah.
Anything that gets me
on a flight, I'm good.
- Uh, CBC, CMP, bacterial
and viral cultures,
O&P, and a sputum.
- On it.
- I don't understand.
You said that most people
can do the drug option.
- Unfortunately, your
liver function tests
were a little too elevated,
so you are not a candidate
for methotrexate.
- Is there something you can
do so that I can get the shot?
I can't do a big surgery.
It'll put me out
of work for weeks.
- If we were to fully
open up your abdomen, yes,
the healing time would
take a lot longer.
Fortunately, this
procedure is laparoscopic,
minimally invasive,
meaning we could likely
send you home tonight
and have you back at work
in a day or two.
- Okay. I guess I
can do a day or two.
- Okay. I'll see you soon.
- Thanks.
- Thank you.
- Hey. How'd it go?
- A couple of red
flags for postpartum,
but I'm not convinced yet.
You know, she was talking
about this ringing
she had in her ears.
- Well, tinnitus could be
caused by multiple things.
It could be idiopathic,
medications,
hypo or hyperthyroidism.
You know, I can work
all of those up,
but what do you want
to do in the meantime?
- Honestly, I want to
see her with her kid.
- Wait, Dr. Charles.
You didn't see her
when she came in.
She was frantic.
And we can't be sure
how she'll react to him,
especially without a
definitive diagnosis.
- Absolutely gonna make
sure the kid is safe, okay?
It's just that I
can learn so much
from watching them
interact, right?
How are they bonding?
Any warning signs of
a lack of connection?
And if it is postpartum,
it sort of helps me
gauge the severity, you know?
- While I understand
your concerns, Dr. Choi,
since Dr. Charles will
be there and Penelope
had the wherewithal
to ask for help
before anything happened,
I think we should proceed.
Also, I'd like to be present.
- All right. Hey, thank you.
- Hey, Archer!
- Yeah?
- Nursing said there's
no fiber optic cables
for the laparoscopic
tower. Where'd they all go?
I've got to do an
urgent ectopic.
- I know we're down two.
Supply chain issue strike again.
Can't you just open?
- No, it's explicitly
against my patient's wishes.
She needs it to be laparoscopic.
- Oh.
- So both options are bad.
Either wait it out,
running the risk
it ruptures and kills her, or
turf it to another hospital.
- Or you can go old
school without video
and just look straight
down into the scope.
- No one's learned how to do it
that way since the Stone Age.
That's like performing surgery
with one hand tied
behind your back.
- Eh, yeah.
I'm ancient enough, all right?
It's how I was trained.
- Well, this doesn't
do me any good.
- Oh, hi. Hey. So, uh,
what's the good news?
- We're not seeing any
signs of infection,
though you are slightly anemic.
- Which would explain
your lethargy.
- Excellent, so I guess
I can just take a couple
of iron supplements,
be on my way?
- I'm actually not comfortable
discharging you quite yet.
- You just said
I'm not infectious.
- That's true, as
far as I can tell.
But without an explanation
for why you're deficient,
I'd just like to run
a couple more tests.
- No, look, if I'm not sick,
I really got to get going.
I've got, like, 1,000
planning calls to make.
And not to mention, I
think there's people
who need this bed more
than I do, so I think...
- Samir... oh!
- Oh!
- You all right?
- Yeah, I'm fine.
I'm not...
- Let's get back on the bed.
- I'm fine.
- Both legs, please.
- Dr. Taylor?
It's both legs.
- Do you know how
long you've had this?
- I don't know. I thought
it was a heat rash.
This is not from
the anemia, is it?
- I don't know.
- Look, don't BS me.
I know what bad news looks like.
What is it?
- These are petechiae, a
breakdown of red blood cells.
It's usually associated
with a bleeding disorder.
But it could be any
number of things.
- So what are we looking at?
I mean, is it an autoimmune
disease or leukemia? What?
- We don't know until
we do further workup.
Um, Maggie, let's get a lupus
panel, an ANA, and an X-ray.
- Hmm.
- On it.
- Thank you.
- Maria.
This is Dr. Marcel.
- Apologies for the
wait, Ms. Piscotta.
- You didn't tell me
the handsome doctor
from the news was coming.
I look a mess.
- No, please.
Uh, apparently, I'm
addressing royalty.
The doctor also tells me
you're the, uh, queen of pasta.
- Only woman in America who
can make the threads of God.
- Oh.
- It's all done by feel.
You have to have the touch.
- Well, I look
forward to stopping by
once we get you patched up.
So your angiogram revealed an
injury to the brachial artery,
a pseudoaneurysm
like, um, a balloon
pushing out from the vessel.
- What does that mean?
- Well, unfortunately, you'll
need a surgical repair.
But it'll remove
the risk of rupture
while preserving healthy
blood flow to your arm.
- Now, Maria, there
are non-surgical
options like stenting.
It's less invasive.
- Let Dr. Handsome finish.
- Uh, my opinion,
surgery would offer
the best long-term results.
I know it seems like a lot,
but it's standard procedure.
And if we did the repair today,
we can send you home tomorrow.
- And you will do the surgery?
- I would.
- If that's what you
think is best, andiamo.
- Okay. I'll make the call.
You have a visitor.
There's my boy.
- Sit.
- Hi.
Ooh.
Shh, shh, shh.
Oh,
no, Eddie, it's okay.
It's okay. Come on. Don't cry.
It's okay.
Hmm.
Please, Eddie, please.
Okay.
You see what I mean
about this cry?
It's like a... it's
like a drill in my head.
Okay.
Stop, baby.
Stop, baby. Please, stop.
Quiet, please.
- Penelope, take a deep
breath. You got this.
You got this. You got this.
- I'm sorry. Can you
please take him out?
I can't stand it.
- I've got it. I've got it.
Shh, shh.
- It's okay. It's okay.
- Penelope?
- What's happening?
- Penelope? Penelope?
- What's happening to me?
- Okay.
- Ah, help me.
- Okay, all right.
Look at me. Look at me.
- We got you.
- Look at me.
Look at me. Look at me.
Okay, can you smile?
Try to smile.
Okay.
Trigger the stroke alert!
Little help in here!
- We got you. We
got you. We got you.
- What the... hey,
where's Maria?
- They just took her to pre-op.
- Look, I've been
thinking about it.
We should hold off on surgery.
I want to pitch her the
stent one more time.
- Come on, Will.
We both know that's not
a long-term solution.
- No, but given her
age and her livelihood,
we shouldn't be so
eager to flay her arm,
risk nerve injury, put her
through extensive rehab.
No, no. Her hands are her life.
We cannot take that from her.
- All the more reason to
stick with a vascular repair.
Deal with the
pseudoaneurysm with a stitch
and keep her off anti-platelets.
And besides, she's
already consented.
That's because
she saw you on TV.
She's starstruck being
treated by the hotshot doctor
from the news.
Hey, you called me, remember?
- You don't think all that
influenced her decision?
- I don't know, but maybe your
connection with the patient
is influencing yours.
Hey, Will?
I'm gonna take good
care of her, okay?
- Thank you.
- You got it.
- Hey, Dr. Asher?
I think something
might be wrong?
- Okay.
Hey, Caitlin.
Are you in pain?
- Uh, it's... it's
not super bad,
but, yeah, it hurts.
- Yeah, heart rate's
in the low hundreds.
- All right, I want to
do a quick ultrasound.
Do you mind?
- Mm-hmm.
Can you lift up, please?
- Sure.
- Here we go. It's
gonna be a little cold.
- Mm-hmm.
- All right.
There we go.
Okay, Caitlin, your
fallopian tube is ruptured,
and there's blood in your belly.
- Oh, my God. Is
she gonna be okay?
- Yes, but we need
to operate now.
And I need to open your abdomen.
- No, no, you said that you
could do it the other way.
I can't be out of work.
- I understand, but we don't
have fiber optic cables.
- But we do have a camera
scope, so we're still able
to operate laparoscopically,
just in a different way,
if you're good with that?
- Um, yeah, okay.
Yes.
- Can you open the
hybrid OR, please?
- What do you
think you're doing?
You jump in like that
without consulting me?
- I'm sorry, but we don't
have time for niceties.
You said yourself
it was emergent,
and this way, we don't
have to open her up.
- Oh, so now it's we?
This is my patient.
- This is her wish.
Your way, she'd be in
for a lot more pain
and a much longer recovery.
Come on, you'll see.
We'll make a good team.
Come on.
- Okay.
Clamps are off.
Check the flow.
Triphasic flow is good.
Nice work.
- You almost finished in there?
- Yeah. Just about to close.
- Good, because the
lieutenant governor
is here with cholecystitis,
and she's requested
you perform the surgery.
- Big time.
- Oh, hush.
Okay, give me 30 minutes.
I'll be right there.
- Come on. It's the
lieutenant governor.
Dr. Tanaka-Reed can close.
- You good?
- Yes, sir. I got it.
- Minimum two layers
plus skin, all right?
- Mm-hmm.
- All right, I'll
be right there.
- Penelope's MRI
and CT are clean.
- Thank goodness,
that wasn't a stroke.
- Yeah. No tumors, either.
Taken all together,
her symptoms add up
to one thing.
- Bell's palsy.
- Tinnitus. Of course.
Edison's cries must
have been excruciating.
- Yeah, it's why she's
having such a hard time
when Eddie was acting up.
- And it's no wonder she
was at the end of her rope.
On top of everything,
she was in pain
and told it was
completely normal.
How'd her OB miss this when she
complained about her symptoms?
- Well, unfortunately,
many women
are failed by postpartum care.
And in American medicine,
the mother is the wrapper;
the baby, the candy.
- At least this case
has a happy ending.
We can treat Penelope's symptoms
and reunite her with her baby.
- You know, I'd say this
is an important first step
in her mental recovery,
but I don't know.
We're not out of the woods yet.
- Samir's labs are in.
No signs of autoimmune
disease or cancer.
Small victories.
- But severe osteopenia?
He has the bones of
a man twice his age.
None of this makes any sense.
What happened?
- I... I don't know.
Oh.
Where'd that
laceration come from?
- Micro stitch?
- Uh, no.
Grab me a heat cautery
and lidocaine 1%.
- You got it.
- Uh, it's okay.
Just slow breaths, okay?
In through your
nose.
Out through your mouth.
- Yes. Good job. Good job.
So what, did you cut yourself?
- No.
- Any injuries that you
forgot to tell me about?
- No, no, nothing. What
is happening to me?
- I don't know yet, but we're
gonna figure this out, okay?
Just, um... just focus on me.
- Maggie, what does
this look like to you?
- An appendectomy scar.
- Yeah.
We're gonna figure this out.
- A bulge on the left fallopian.
- Let me see?
That's the ectopic pregnancy.
- Yeah, that was clear to me.
- Okay, so grasp
the fallopian tubes.
Put them on tension,
and then take your
needlepoint cautery.
- Thank you. Will
you help me, please?
- You all right?
- I'm fine.
- Okay.
Now, make a longitudinal
incision over the bulge.
- What?
- Step in.
- Step in?
What... what are
you talking about?
You're the only person
here who knows how
to perform surgery this way.
- Well, you're about
to learn it now.
- If you knew you were in pain,
you never should
have started this.
- I'm just respecting
your patient's needs.
Now, stop it. Come on
now. Just take it. Go.
- It's not gonna magically
appear on the monitor.
All right, just put your
eye back on the scope.
Come on.
This would go faster
if I could just open.
- You can do this, all right?
Use your assistant,
me. I will guide you.
I will help you.
Come on.
- I can't get the angle.
- All right, so come in
through the other side.
Just tell me where
the tube needs to be,
and I will hold it.
- Okay, hold this.
- I got it.
- I'm going after the tube.
Give me the ligature.
- All right. Got
it? There you go.
- Okay.
- Yeah.
- Okay.
Got it.
- All right. Wrap this up.
- How's Samir?
- His wound looks good, but
he's understandably eager
to find out why
his scar opened up.
- I have a hunch, but I
feel crazy even saying it.
I want to run one more test.
- Okay.
- So fortunately, with
time and steroids,
your Bell's palsy
should fully resolve.
- But what about my
terrible thoughts?
- Well, you know, there's
actually a name for those?
They're called
intrusive thoughts.
They're involuntary, violent,
often self-destructive.
You ever been standing, say,
on a balcony, on
a tall building,
and you look over the
edge, and you go, oh,
what would happen
if I jumped off?
I mean, you don't
do it, but it's,
uh... it's disturbing, right?
- I have friends with
kids, and none of them
ever mentioned having
a thought like I did.
- Well, I mean, it's not exactly
the easiest thing to bring up.
And it's a problem because
that means that people
just don't talk about it.
- Don't you understand
that a good mother,
regardless of Bell's
palsy or anything,
would never think of
harming her own baby?
- No, y... you sought help.
There's proof you're a good mom.
- No!
God, you have to understand.
I could see myself throwing him.
This wasn't some
fleeting, vague idea.
I actually thought about
him hitting the wall.
It felt so horrifically real.
This is not gonna be
my last stressful week,
so I can never trust
myself with him.
- Look, we get it, okay? We do.
We understand, and we're
gonna keep on working on this.
As a matter of
fact, Dr. Choi and I
are just gonna step outside
for a second, all right?
- Hey, we'll be right back.
I get it.
She's scared.
But separating
her from her baby?
They should be together.
- Oh, I completely agree.
I mean, look, we can try
and normalize her fears
until we're blue in the face,
but I think she needs
to hear about it
from a different kind of expert.
- There aren't many reasons
a surgical scar can reopen,
especially an older one
like an appendectomy.
So on a hunch, I ran
one more blood test.
- So have you figured out
what's happening to me?
- Hypovitaminosis C.
- Better known as scurvy.
- You've got to be joking.
Like old timey, sailor
scurvy? People still get that?
- It's rare, but you mentioned
having a limited diet.
Peanut butter, protein
bars, coffee...
They all lack vitamin C.
And without that, your
body can't maintain
the collagen, the
connective tissue,
it needs in order to function.
- Which would explain
your low bone density
and your petechiae.
- But this is all
treatable, right?
I mean, what, eat a
couple slices of oranges,
and I'll be fine?
- Pretty much.
We're gonna set you
up on an infusion.
And then after that,
we'll get you on an oral,
high-dose multivitamin.
- You should start feeling
better in about 48 hours.
You know, I have been in some
hairy situations in my career,
but this scared
the crap out of me.
And you were so calm.
- Like I said, got
to help the helpers.
- Dr. Taylor?
Could I trouble you
for another moment?
- Yeah, sure.
- I'll get the pharmacy to start
working on your infusion.
- Lieutenant governor did great.
- Oh.
- Surgery went perfectly.
- Fantastic.
- Yeah.
- I'll let her
chief of staff know
he can release the statement.
- Okay.
- Hey, nice having Gaffney
and you name-dropped
by the people in
Springfield.
- Oh, well, that's cool.
- Hmm.
- Uh, excuse me.
- Yeah.
- Where you been?
- What happened?
- Arm's cold and dusky.
- Doppler.
- No blood flow
below the repair.
- Must have thrombosed.
- How?
- This soon after surgery?
It's got to be a
technical error.
- No way the repair went down.
It was in good shape
when you scrubbed out.
- You left the OR before
the surgery was finished?
- No. Repair was complete.
- Clearly, it wasn't.
You should have been there.
She should have
been your priority.
- We got to get her
back into the OR.
Kai, let's go. Come on.
- Excuse me.
- Let's go.
Easy, easy!
- Penelope?
May I come in?
- How's Edison? Is he okay?
- Oh, he's wonderful,
has the nurses
all wrapped around
his little fingers.
I could bring him
in, if you'd like.
You're worried
about your thoughts.
- How could I not be?
No one seems to understand
how real it felt.
- May I?
Oh, look at that.
He's so cute.
And he's perfect.
You know that, right?
- Do you have kids?
- I do.
Two boys and a girl, all grown.
Tara was about Edison's age.
She had the worst colic...
I mean, screaming for hours.
Sleeping longer than an
hour felt like a vacation.
One morning about 3:00 a.m.,
I had been pacing the hallway,
trying to soothe her.
My baby was suffering,
and I couldn't fix it.
And I was bone tired.
I felt alone.
I felt like I was the only
person awake in the world.
And I just
was desperate for quiet.
And out of nowhere,
I had this thought
to just toss her out
of the second-floor window.
It really frightened me,
and I questioned whether
I could be a good parent.
And when I finally
worked up the courage
to mention it to a friend
who I thought was
like super mother...
- Mm.
- I was stunned when
she told me she had had
similar thoughts
with her babies.
And when I went to
see the pediatrician,
he reassured me
that it was normal.
- All anyone ever talks about
is the joy and the love
and the happiness, and...
I felt all that too.
- But listen, have you
ever really listened
to the lyrics of a lullaby?
Singing about dropping
cradles from treetops
and feeding crying babies
to crabs and monsters?
But it's proof that
parenthood throughout time
and the world over is hard.
And it is also true
that it takes a village
to raise a child.
And there are mother groups
that have great resources
for making friends,
finding support,
asking questions.
I can connect you with
one, if you'd like.
- I'd love that.
- And here.
You listen to me, Penelope.
You did not have
an easy start...
But I have no
concerns about you.
You hear me?
Edison is a lucky, lucky boy.
- Thanks.
- Uh-huh.
Maybe you'd like to
see him after all?
Yes, please.
- Okay.
Bring him in.
Hi, sweet boy.
Oh.
Thank you.
- Hi. Mama is here.
Mama's here.
- It was something
we call a vasospasm,
random constriction
of the blood vessel,
totally unrelated
to the surgery.
That said, your repair
was in good shape.
- This old bird
still got her wing.
- She sure does.
But, uh, maybe just take
it easy on the pasta roller
while you heal up, okay?
- We need to get your
picture on our famosi wall.
- Getting to eat your
pasta's reward enough.
- Ah, Guglielmo.
Thank you for getting
Dr. Handsome to help me.
You bring him with you,
I'll make you two
squid ink pasta.
- Wow.
She swore she'd only ever
make that for the Pope.
- Oh.
- Grazie.
Grazie mille.
- You got it.
- I'm gonna let
you get some rest.
- Okay.
- Thanks.
- Hey, Will, look, about
the surgery, I, uh...
- It wasn't your fault.
I was out of line.
- No, you had a point.
I got wrapped up in
all the attention.
- Okay, that's true.
You're a good surgeon, Crockett.
Just not sure you deserve
her squid ink pasta.
- Touché.
- So while the bleeding
necessitated our removal
of your fallopian tube,
this will not prevent you
from becoming pregnant
again and carrying
a healthy baby to term.
- Thank you, Dr. Asher.
- Thank you both.
Hannah and Dean...
Good baby names.
We'll have to remember that.
- Actually, I never liked Dean.
I think you can do better.
Oh, yeah?
- Okay, we'll get
you a diet ordered,
and if you do okay, we'll
send you home tonight.
- Thank you.
- Sure.
Hey, I wanted to say thank you.
I'm relieved we could
respect Caitlin's wishes,
and I'm lucky I had your help.
- Well, you did good
for a mere mortal.
Hey, Dean?
- Yeah?
- In the OR, you were in pain.
- Oh, please.
It's a... it's a...
It's a hard angle to hold
when your ribs
are still healing.
- Yeah.
- Yeah.
- Don't kid a kidder.
Look, you don't want
my help, that's fine,
but you have to let
somebody check you out.
- Hey, I'm fine, Dr. Asher.
Yeah.
- Okay.
- All right.
- What's this?
- Recommended
travel vaccinations.
I thought you could give
me a hand scheduling them.
- I didn't know you
were going on vacation.
- Samir offered me
a spot on his team.
He thought I'd be a great fit.
- In the Philippines?
- I said yes.
- Wait, wait. You can't
just up and leave.
What about your residency?
- I'll talk to my program
director and Ms. Goodwin.
I'll defer finishing for
now, but they'll understand.
- But I don't.
Where's this coming from?
- From me, Maggie.
Listen, you... you were
upset, and rightly so,
when I bought those
drugs off the street.
But what I didn't say
to you earlier that
I should have is that I was...
I was actually inspired.
I mean, despite the risk,
I helped my patient.
I was resourceful. I
mean, I was a good doctor.
That's the kind of
person that I want to be.
- And you can't be
that person here?
- Maybe.
But I know that this
opportunity will allow me
to be the kind of doctor
that I want to be,
doing the work that I love.
I... this is my calling.
- Why don't you just take
some time and think about it?
- I don't want to.
- But...
- I just want to close my
eyes and take the leap.
Okay.
saved Nathaniel's life
in spectacular fashion.
- Got 30 million social
media followers waiting
to hear how this story ends.
- Get ready for what comes next.
- What's that?
- Fame.
- What the hell is going on?
- Will and Vanessa bought
meds off a drug dealer.
- It's a little more
complicated than that.
- You want to risk your
own career, that's fine.
Don't risk Vanessa's.
- April?
Are you back in Chicago?
- Yeah.
You didn't get married
or anything, did you?
- No.
- Well, I'll see you around.
- Did you really ask Jack
to dislocate your shoulder?
- Uh, didn't have much
of a choice, really.
- I couldn't believe it.
Didn't even hesitate.
- Well, my arm was
trapped, uh, at the time.
I felt it was the... the best way
to continue treating Mr. Perry.
- Well, no wonder people
are calling you a hero.
But is that how you would
characterize yourself?
- Did you know that he, um,
jerry-rigged a lung transplant
just days after
the incident? Yes.
Confident, creative, future
of medicine, this guy.
- Uh, it... it
was a team effort.
Look, I'm... I'm sure
you'd rather talk
to Mr. Dayton here.
And my shift is
starting soon, so...
- Dr. Marcel exemplifies the
kind of selfless dedication
we here at Gaffney
pride ourselves on,
and it's what has
attracted a new crop
of generous donations
to this institution.
Dr. Marcel's heroics
that day saved
way more than just one life.
- That's very generous.
- Mm.
- Thank you.
- And we're cut.
- Hey.
- Yeah?
- So I got you lined
up for a few phoners...
- Uh-huh.
- Later in the day.
And then we got "Today
Show" end of the week, okay?
Friday, we're gonna
try to do that.
- Morning, Mags.
How's it going?
- It's going.
I have a twisted
ankle for you in 5.
- Be there in a minute.
- You're still mad at him?
CPD and the hospital
cleared us both.
They're letting it
go. Why can't you?
- Because you brought drugs
into the hospital, Vanessa.
It was irresponsible.
It was dangerous.
- We were out of options,
and it saved our patient.
- I expect that kind of
foolishness from Will,
but he should have
known better than
to drag you down with him.
- No, no.
Will didn't drag
me into anything.
It was my call.
- You don't have to defend him.
I get it... the Halstead School
of Medicine has its appeal,
but it's not who you are.
- What is that supposed to mean?
- It means you're not reckless.
You're smarter than that.
And you don't have to be a
cowboy to be a good doctor.
- Hey, Dean. How you doing?
- Oh, well, I thought a
patient's bowel was nicked
during surgery, but it was
just a flatulent intern,
so I'm excellent.
- Great, but I meant
how are your injuries?
You're looking a little stiff.
- I've had worse.
- Oh, than being brutally
attacked by a patient
on PCP-laced cocaine?
I need to hear your life story.
- Oh, another time.
Uh, I seem to remember
being in considerable pain
when you patched me up.
So if I do need anything,
I'll be looking elsewhere.
- Well, lucky me,
seeing as doctors,
especially surgeons
with God complexes,
make the worst patient.
- Help! Someone, please!
- crying]
Please, I need help!
- Okay, what happened?
- Please, take him!
- T... tell me what's wrong.
- It's me. I'm what's wrong.
I'm gonna hurt him.
- I'll be right back.
Her son, Edison,
is in Treatment 2.
He shows no signs
of abuse or neglect.
He's an entirely
healthy newborn.
- Oh, that's a relief.
- Penelope, however,
is not in great shape.
She's dehydrated, anemic,
and is low in vitamin D.
- It certainly doesn't
look like she's been taking
very good care of herself.
- Well, that's not
unusual for a new mother,
but it could mean she doesn't
have much of a support system.
- Yeah.
- Listen, I don't
want to call DCFS,
but she did say that she
was gonna hurt her baby.
Are you guys comfortable
holding off for now?
- Absolutely... that's a
drastic step for something
that just might be postpartum
depression and treatable.
- Yeah, we're not there
yet, but I... I should have
a little chat with her, though.
- Yeah.
Halstead!
Incoming. Going to Baghdad.
Says she doesn't
want any doc but you.
- Okay.
76-year-old female.
- Tell the whole world, madonna.
- Maria. What happened?
- Crush injury to
the right upper arm.
Lacerations above the elbow.
Denied pain meds on the ride.
- I was just moving the stove.
- What, Anthony
couldn't move it?
- He's useless.
- Okay, in we go. On my count.
- I can do it myself!
- Please lie still, okay?
- Okay. One, two, three.
I need an X-ray!
- All this fussing,
Guglielmo. Basta.
- All right, I'm sorry.
- So you two know each other?
- Maria owns Marguerite's.
Taylor Street institution.
When my folks were
alive, we'd go there
every Sunday for dinner.
- Not so much recently, huh?
You look skinny.
- Uh, diminished
right radial pulse.
Any numbness, tingling?
- Mm-mm.
- Good.
Let's get a CT angio.
- X-ray up.
- Hey, no fractures,
but those lacerations
still need to be repaired.
Let me get you some pain meds.
- Oh, so I go to sleep?
No, I have a dinner
service tonight.
Uh, Maria, I'm sorry,
but I... I doubt
that's gonna be possible.
We'll know more once
we get better imaging,
but I'm gonna call
a surgical consult.
Surgery? No, no, no.
If you think Antonio can
run Marguerite's... oh-ho!
- Let's worry about that
later. You just relax.
- Hey, I'm gonna
take care of you.
- Va bene.
- Hi, Caitlin. I'm Dr. Asher.
- Hi.
- Hey.
This is my husband, Steve.
- How are you?
- Hi, Steve. Okay.
So Caitlin, I saw that
you're nine weeks pregnant
and experiencing spotting?
- Yes.
It just started a day ago, but
it hasn't been super heavy.
- Okay. Any pain or cramping?
- Nope.
- I read it could be
normal this early, right?
It doesn't necessarily mean
that something's wrong?
- That's true, but it is
wise to get checked out.
So let's get a type and screen,
a CBC, and a quantitative HCG.
- It's taken us some time
for us to get pregnant,
so we're probably a
little more neurotic
than most first-time parents.
- Okay, so Caitlin, I'd
like to do an ultrasound.
It'll have to be
transvaginal this early.
- Ah, yes. The joys
of being a woman.
- Yes.
Okay, let's get you set up.
Here we go.
A little bit of pressure.
- Mm-hmm.
- Let's see.
- What? What is it?
- I'm very sorry, but
it's an ectopic pregnancy.
The embryo has implanted
in your fallopian tube.
- What does that mean?
Won't it move to the uterus?
- No.
No, it's not even viable.
- Unfortunately, that's correct.
We need to remove the ectopic
before it can rupture
the fallopian tube,
which would be
fatal for Caitlin.
- Okay, so, uh, what,
uh... What do I have to do?
- Well, we have two
different options.
The first is a chemo
drug called methotrexate.
It stops the cells
from rapidly dividing
and ends the pregnancy.
The embryo ultimately
reabsorbs back in the body,
and it successfully
treats about 90%
of ectopic pregnancies.
- And how do you get that?
- It's an intramuscular shot,
typically in the
buttock or the thigh.
- What are your other options?
- We would operate to remove
the embryo and, if necessary,
the entire fallopian tube.
- The shot.
Please, no surgery.
We're hourly workers
at a bookstore.
We don't get sick days.
- I understand.
We'll just have to do
some additional labs,
and then we'll go
from there, okay?
Try and get some rest.
- Thank you.
- Hey. Hey, hey,
hey, hey, hey, hey.
I'm sorry.
- It'll be okay, all
right? Look at me.
- Penelope?
- How's Edison? Is he okay?
- Oh, he's fine.
He's just next door.
- Does he need breast
milk? I express him.
He's not always great
about waking up to eat,
even if it's been two hours.
- You know what? I'll...
I'll tell the nurses.
I'm Dr. Charles.
- Psychiatry.
Maybe I have
postpartum depression?
- You know, I don't know.
Tell me what's been going on.
How you been feeling?
- Oh, um, I'm not like myself.
- Okay.
- I cry so easily.
My moods are all over
the place, and...
And I have this
ringing in my ears,
but my OB says it's all part
of the recovery process.
- Hmm.
- But Edison was crying
so loudly, and I was...
I was so tired.
And it's not an
excuse, I know, but...
I thought about, uh...
I thought... I...
I thought about throwing
him against the wall?
- Okay.
Well, it was just
a thought, though.
Right?
- Mm-hmm.
- Has... has Edison's dad
been around to help out?
Turns out he
wasn't ready for a kid.
- Well, gosh, I mean,
that's got to be so hard,
facing a life-changing
situation like this
all... all by yourself.
My mom came
out for the first week,
but she had to get back to Ohio.
- How's it been since she left?
Mm, hard.
Uh, my job doesn't have
paid maternity leave,
so I've been working
from home, you know,
juggling phone calls while I
breastfeed every two hours.
And there are no breaks
and there's no time
to, like, turn off.
And his cry, like
a screech, it...
It's just... it's too much.
I... I can't.
I know it's his only
way to communicate,
but it sets my teeth on edge,
and I feel like I'm losing it.
So I just...
I'm sorry.
Can you please just...
Just tell me what...
- You know what?
We're gonna... we're gonna get
to the bottom of this, okay?
I promise you, we will.
Thank you.
- No, no, I will make
that flight, and I'm fine.
My doctor just walked in, okay?
- It's good to see you, Samir.
- You too.
- Mr. Baqri, I'm Dr. Taylor.
- Yeah. So sorry about that.
My work never stops.
And please, call me Samir.
- What seems to be the problem?
- Um, lethargy, myalgia.
It's hard to pin down.
- Ah, you're a physician.
- Oh, no. I... I
work with them.
- Samir runs the Hamsa
Community Health Foundation,
sets up clinics all
around the world.
- Mm-hmm.
- Mm, I get your
fundraising emails.
- Ah, wow. Hopefully,
not too many.
I haven't unsubscribed yet.
Okay, let's check this out.
Open up.
You know, your polio
vaccination program
in Pakistan, incredible.
- Ah.
- I was obsessed with
infectious disease
in med school, but they
would always talk about polio
in the past tense,
and I wanted to shout
at my professors that...
- We were still
fighting it, right.
You know, we almost had it
beat, but then the world
took its foot off the gas,
started reallocating funding,
and now it's back,
and well, you know,
we are struggling to get
buy-in from our partners.
It's just, uh... ugh, I'm sorry.
I will step off
of my soapbox now.
- No, do not apologize.
You're doing something.
I wish I knew how to help.
It's the entire reason
that I got into medicine.
But instead, I just
turn off the news,
and I eat a sleeve of Oreos.
But you know what?
At least now I can
help the helper.
- Right.
- So how long have
you felt this way?
- Um, a couple of weeks.
I've been traveling for
work a lot recently...
Indonesia, Pakistan,
Sierra Leone.
I leave for the
Philippines on Friday.
I'm opening up a new clinic.
- Well, the most exotic place
I've ever been is San Antonio,
and that was for a conference.
- So no interest in travel?
- No, I'd love to.
But between school and
residency, it's just...
- Well, let me tell you,
it's not always so glamorous.
I'm glued to my
phone, and I survive
off of peanut butter
protein bars and coffee.
- Temp's normal.
- Well, you know, I'm not seeing
any obvious signs of infection,
but given your travel history,
uh, I just want to cast
a bit of a wide net
with your bloodwork,
if that's okay.
- Yeah.
Anything that gets me
on a flight, I'm good.
- Uh, CBC, CMP, bacterial
and viral cultures,
O&P, and a sputum.
- On it.
- I don't understand.
You said that most people
can do the drug option.
- Unfortunately, your
liver function tests
were a little too elevated,
so you are not a candidate
for methotrexate.
- Is there something you can
do so that I can get the shot?
I can't do a big surgery.
It'll put me out
of work for weeks.
- If we were to fully
open up your abdomen, yes,
the healing time would
take a lot longer.
Fortunately, this
procedure is laparoscopic,
minimally invasive,
meaning we could likely
send you home tonight
and have you back at work
in a day or two.
- Okay. I guess I
can do a day or two.
- Okay. I'll see you soon.
- Thanks.
- Thank you.
- Hey. How'd it go?
- A couple of red
flags for postpartum,
but I'm not convinced yet.
You know, she was talking
about this ringing
she had in her ears.
- Well, tinnitus could be
caused by multiple things.
It could be idiopathic,
medications,
hypo or hyperthyroidism.
You know, I can work
all of those up,
but what do you want
to do in the meantime?
- Honestly, I want to
see her with her kid.
- Wait, Dr. Charles.
You didn't see her
when she came in.
She was frantic.
And we can't be sure
how she'll react to him,
especially without a
definitive diagnosis.
- Absolutely gonna make
sure the kid is safe, okay?
It's just that I
can learn so much
from watching them
interact, right?
How are they bonding?
Any warning signs of
a lack of connection?
And if it is postpartum,
it sort of helps me
gauge the severity, you know?
- While I understand
your concerns, Dr. Choi,
since Dr. Charles will
be there and Penelope
had the wherewithal
to ask for help
before anything happened,
I think we should proceed.
Also, I'd like to be present.
- All right. Hey, thank you.
- Hey, Archer!
- Yeah?
- Nursing said there's
no fiber optic cables
for the laparoscopic
tower. Where'd they all go?
I've got to do an
urgent ectopic.
- I know we're down two.
Supply chain issue strike again.
Can't you just open?
- No, it's explicitly
against my patient's wishes.
She needs it to be laparoscopic.
- Oh.
- So both options are bad.
Either wait it out,
running the risk
it ruptures and kills her, or
turf it to another hospital.
- Or you can go old
school without video
and just look straight
down into the scope.
- No one's learned how to do it
that way since the Stone Age.
That's like performing surgery
with one hand tied
behind your back.
- Eh, yeah.
I'm ancient enough, all right?
It's how I was trained.
- Well, this doesn't
do me any good.
- Oh, hi. Hey. So, uh,
what's the good news?
- We're not seeing any
signs of infection,
though you are slightly anemic.
- Which would explain
your lethargy.
- Excellent, so I guess
I can just take a couple
of iron supplements,
be on my way?
- I'm actually not comfortable
discharging you quite yet.
- You just said
I'm not infectious.
- That's true, as
far as I can tell.
But without an explanation
for why you're deficient,
I'd just like to run
a couple more tests.
- No, look, if I'm not sick,
I really got to get going.
I've got, like, 1,000
planning calls to make.
And not to mention, I
think there's people
who need this bed more
than I do, so I think...
- Samir... oh!
- Oh!
- You all right?
- Yeah, I'm fine.
I'm not...
- Let's get back on the bed.
- I'm fine.
- Both legs, please.
- Dr. Taylor?
It's both legs.
- Do you know how
long you've had this?
- I don't know. I thought
it was a heat rash.
This is not from
the anemia, is it?
- I don't know.
- Look, don't BS me.
I know what bad news looks like.
What is it?
- These are petechiae, a
breakdown of red blood cells.
It's usually associated
with a bleeding disorder.
But it could be any
number of things.
- So what are we looking at?
I mean, is it an autoimmune
disease or leukemia? What?
- We don't know until
we do further workup.
Um, Maggie, let's get a lupus
panel, an ANA, and an X-ray.
- Hmm.
- On it.
- Thank you.
- Maria.
This is Dr. Marcel.
- Apologies for the
wait, Ms. Piscotta.
- You didn't tell me
the handsome doctor
from the news was coming.
I look a mess.
- No, please.
Uh, apparently, I'm
addressing royalty.
The doctor also tells me
you're the, uh, queen of pasta.
- Only woman in America who
can make the threads of God.
- Oh.
- It's all done by feel.
You have to have the touch.
- Well, I look
forward to stopping by
once we get you patched up.
So your angiogram revealed an
injury to the brachial artery,
a pseudoaneurysm
like, um, a balloon
pushing out from the vessel.
- What does that mean?
- Well, unfortunately, you'll
need a surgical repair.
But it'll remove
the risk of rupture
while preserving healthy
blood flow to your arm.
- Now, Maria, there
are non-surgical
options like stenting.
It's less invasive.
- Let Dr. Handsome finish.
- Uh, my opinion,
surgery would offer
the best long-term results.
I know it seems like a lot,
but it's standard procedure.
And if we did the repair today,
we can send you home tomorrow.
- And you will do the surgery?
- I would.
- If that's what you
think is best, andiamo.
- Okay. I'll make the call.
You have a visitor.
There's my boy.
- Sit.
- Hi.
Ooh.
Shh, shh, shh.
Oh,
no, Eddie, it's okay.
It's okay. Come on. Don't cry.
It's okay.
Hmm.
Please, Eddie, please.
Okay.
You see what I mean
about this cry?
It's like a... it's
like a drill in my head.
Okay.
Stop, baby.
Stop, baby. Please, stop.
Quiet, please.
- Penelope, take a deep
breath. You got this.
You got this. You got this.
- I'm sorry. Can you
please take him out?
I can't stand it.
- I've got it. I've got it.
Shh, shh.
- It's okay. It's okay.
- Penelope?
- What's happening?
- Penelope? Penelope?
- What's happening to me?
- Okay.
- Ah, help me.
- Okay, all right.
Look at me. Look at me.
- We got you.
- Look at me.
Look at me. Look at me.
Okay, can you smile?
Try to smile.
Okay.
Trigger the stroke alert!
Little help in here!
- We got you. We
got you. We got you.
- What the... hey,
where's Maria?
- They just took her to pre-op.
- Look, I've been
thinking about it.
We should hold off on surgery.
I want to pitch her the
stent one more time.
- Come on, Will.
We both know that's not
a long-term solution.
- No, but given her
age and her livelihood,
we shouldn't be so
eager to flay her arm,
risk nerve injury, put her
through extensive rehab.
No, no. Her hands are her life.
We cannot take that from her.
- All the more reason to
stick with a vascular repair.
Deal with the
pseudoaneurysm with a stitch
and keep her off anti-platelets.
And besides, she's
already consented.
That's because
she saw you on TV.
She's starstruck being
treated by the hotshot doctor
from the news.
Hey, you called me, remember?
- You don't think all that
influenced her decision?
- I don't know, but maybe your
connection with the patient
is influencing yours.
Hey, Will?
I'm gonna take good
care of her, okay?
- Thank you.
- You got it.
- Hey, Dr. Asher?
I think something
might be wrong?
- Okay.
Hey, Caitlin.
Are you in pain?
- Uh, it's... it's
not super bad,
but, yeah, it hurts.
- Yeah, heart rate's
in the low hundreds.
- All right, I want to
do a quick ultrasound.
Do you mind?
- Mm-hmm.
Can you lift up, please?
- Sure.
- Here we go. It's
gonna be a little cold.
- Mm-hmm.
- All right.
There we go.
Okay, Caitlin, your
fallopian tube is ruptured,
and there's blood in your belly.
- Oh, my God. Is
she gonna be okay?
- Yes, but we need
to operate now.
And I need to open your abdomen.
- No, no, you said that you
could do it the other way.
I can't be out of work.
- I understand, but we don't
have fiber optic cables.
- But we do have a camera
scope, so we're still able
to operate laparoscopically,
just in a different way,
if you're good with that?
- Um, yeah, okay.
Yes.
- Can you open the
hybrid OR, please?
- What do you
think you're doing?
You jump in like that
without consulting me?
- I'm sorry, but we don't
have time for niceties.
You said yourself
it was emergent,
and this way, we don't
have to open her up.
- Oh, so now it's we?
This is my patient.
- This is her wish.
Your way, she'd be in
for a lot more pain
and a much longer recovery.
Come on, you'll see.
We'll make a good team.
Come on.
- Okay.
Clamps are off.
Check the flow.
Triphasic flow is good.
Nice work.
- You almost finished in there?
- Yeah. Just about to close.
- Good, because the
lieutenant governor
is here with cholecystitis,
and she's requested
you perform the surgery.
- Big time.
- Oh, hush.
Okay, give me 30 minutes.
I'll be right there.
- Come on. It's the
lieutenant governor.
Dr. Tanaka-Reed can close.
- You good?
- Yes, sir. I got it.
- Minimum two layers
plus skin, all right?
- Mm-hmm.
- All right, I'll
be right there.
- Penelope's MRI
and CT are clean.
- Thank goodness,
that wasn't a stroke.
- Yeah. No tumors, either.
Taken all together,
her symptoms add up
to one thing.
- Bell's palsy.
- Tinnitus. Of course.
Edison's cries must
have been excruciating.
- Yeah, it's why she's
having such a hard time
when Eddie was acting up.
- And it's no wonder she
was at the end of her rope.
On top of everything,
she was in pain
and told it was
completely normal.
How'd her OB miss this when she
complained about her symptoms?
- Well, unfortunately,
many women
are failed by postpartum care.
And in American medicine,
the mother is the wrapper;
the baby, the candy.
- At least this case
has a happy ending.
We can treat Penelope's symptoms
and reunite her with her baby.
- You know, I'd say this
is an important first step
in her mental recovery,
but I don't know.
We're not out of the woods yet.
- Samir's labs are in.
No signs of autoimmune
disease or cancer.
Small victories.
- But severe osteopenia?
He has the bones of
a man twice his age.
None of this makes any sense.
What happened?
- I... I don't know.
Oh.
Where'd that
laceration come from?
- Micro stitch?
- Uh, no.
Grab me a heat cautery
and lidocaine 1%.
- You got it.
- Uh, it's okay.
Just slow breaths, okay?
In through your
nose.
Out through your mouth.
- Yes. Good job. Good job.
So what, did you cut yourself?
- No.
- Any injuries that you
forgot to tell me about?
- No, no, nothing. What
is happening to me?
- I don't know yet, but we're
gonna figure this out, okay?
Just, um... just focus on me.
- Maggie, what does
this look like to you?
- An appendectomy scar.
- Yeah.
We're gonna figure this out.
- A bulge on the left fallopian.
- Let me see?
That's the ectopic pregnancy.
- Yeah, that was clear to me.
- Okay, so grasp
the fallopian tubes.
Put them on tension,
and then take your
needlepoint cautery.
- Thank you. Will
you help me, please?
- You all right?
- I'm fine.
- Okay.
Now, make a longitudinal
incision over the bulge.
- What?
- Step in.
- Step in?
What... what are
you talking about?
You're the only person
here who knows how
to perform surgery this way.
- Well, you're about
to learn it now.
- If you knew you were in pain,
you never should
have started this.
- I'm just respecting
your patient's needs.
Now, stop it. Come on
now. Just take it. Go.
- It's not gonna magically
appear on the monitor.
All right, just put your
eye back on the scope.
Come on.
This would go faster
if I could just open.
- You can do this, all right?
Use your assistant,
me. I will guide you.
I will help you.
Come on.
- I can't get the angle.
- All right, so come in
through the other side.
Just tell me where
the tube needs to be,
and I will hold it.
- Okay, hold this.
- I got it.
- I'm going after the tube.
Give me the ligature.
- All right. Got
it? There you go.
- Okay.
- Yeah.
- Okay.
Got it.
- All right. Wrap this up.
- How's Samir?
- His wound looks good, but
he's understandably eager
to find out why
his scar opened up.
- I have a hunch, but I
feel crazy even saying it.
I want to run one more test.
- Okay.
- So fortunately, with
time and steroids,
your Bell's palsy
should fully resolve.
- But what about my
terrible thoughts?
- Well, you know, there's
actually a name for those?
They're called
intrusive thoughts.
They're involuntary, violent,
often self-destructive.
You ever been standing, say,
on a balcony, on
a tall building,
and you look over the
edge, and you go, oh,
what would happen
if I jumped off?
I mean, you don't
do it, but it's,
uh... it's disturbing, right?
- I have friends with
kids, and none of them
ever mentioned having
a thought like I did.
- Well, I mean, it's not exactly
the easiest thing to bring up.
And it's a problem because
that means that people
just don't talk about it.
- Don't you understand
that a good mother,
regardless of Bell's
palsy or anything,
would never think of
harming her own baby?
- No, y... you sought help.
There's proof you're a good mom.
- No!
God, you have to understand.
I could see myself throwing him.
This wasn't some
fleeting, vague idea.
I actually thought about
him hitting the wall.
It felt so horrifically real.
This is not gonna be
my last stressful week,
so I can never trust
myself with him.
- Look, we get it, okay? We do.
We understand, and we're
gonna keep on working on this.
As a matter of
fact, Dr. Choi and I
are just gonna step outside
for a second, all right?
- Hey, we'll be right back.
I get it.
She's scared.
But separating
her from her baby?
They should be together.
- Oh, I completely agree.
I mean, look, we can try
and normalize her fears
until we're blue in the face,
but I think she needs
to hear about it
from a different kind of expert.
- There aren't many reasons
a surgical scar can reopen,
especially an older one
like an appendectomy.
So on a hunch, I ran
one more blood test.
- So have you figured out
what's happening to me?
- Hypovitaminosis C.
- Better known as scurvy.
- You've got to be joking.
Like old timey, sailor
scurvy? People still get that?
- It's rare, but you mentioned
having a limited diet.
Peanut butter, protein
bars, coffee...
They all lack vitamin C.
And without that, your
body can't maintain
the collagen, the
connective tissue,
it needs in order to function.
- Which would explain
your low bone density
and your petechiae.
- But this is all
treatable, right?
I mean, what, eat a
couple slices of oranges,
and I'll be fine?
- Pretty much.
We're gonna set you
up on an infusion.
And then after that,
we'll get you on an oral,
high-dose multivitamin.
- You should start feeling
better in about 48 hours.
You know, I have been in some
hairy situations in my career,
but this scared
the crap out of me.
And you were so calm.
- Like I said, got
to help the helpers.
- Dr. Taylor?
Could I trouble you
for another moment?
- Yeah, sure.
- I'll get the pharmacy to start
working on your infusion.
- Lieutenant governor did great.
- Oh.
- Surgery went perfectly.
- Fantastic.
- Yeah.
- I'll let her
chief of staff know
he can release the statement.
- Okay.
- Hey, nice having Gaffney
and you name-dropped
by the people in
Springfield.
- Oh, well, that's cool.
- Hmm.
- Uh, excuse me.
- Yeah.
- Where you been?
- What happened?
- Arm's cold and dusky.
- Doppler.
- No blood flow
below the repair.
- Must have thrombosed.
- How?
- This soon after surgery?
It's got to be a
technical error.
- No way the repair went down.
It was in good shape
when you scrubbed out.
- You left the OR before
the surgery was finished?
- No. Repair was complete.
- Clearly, it wasn't.
You should have been there.
She should have
been your priority.
- We got to get her
back into the OR.
Kai, let's go. Come on.
- Excuse me.
- Let's go.
Easy, easy!
- Penelope?
May I come in?
- How's Edison? Is he okay?
- Oh, he's wonderful,
has the nurses
all wrapped around
his little fingers.
I could bring him
in, if you'd like.
You're worried
about your thoughts.
- How could I not be?
No one seems to understand
how real it felt.
- May I?
Oh, look at that.
He's so cute.
And he's perfect.
You know that, right?
- Do you have kids?
- I do.
Two boys and a girl, all grown.
Tara was about Edison's age.
She had the worst colic...
I mean, screaming for hours.
Sleeping longer than an
hour felt like a vacation.
One morning about 3:00 a.m.,
I had been pacing the hallway,
trying to soothe her.
My baby was suffering,
and I couldn't fix it.
And I was bone tired.
I felt alone.
I felt like I was the only
person awake in the world.
And I just
was desperate for quiet.
And out of nowhere,
I had this thought
to just toss her out
of the second-floor window.
It really frightened me,
and I questioned whether
I could be a good parent.
And when I finally
worked up the courage
to mention it to a friend
who I thought was
like super mother...
- Mm.
- I was stunned when
she told me she had had
similar thoughts
with her babies.
And when I went to
see the pediatrician,
he reassured me
that it was normal.
- All anyone ever talks about
is the joy and the love
and the happiness, and...
I felt all that too.
- But listen, have you
ever really listened
to the lyrics of a lullaby?
Singing about dropping
cradles from treetops
and feeding crying babies
to crabs and monsters?
But it's proof that
parenthood throughout time
and the world over is hard.
And it is also true
that it takes a village
to raise a child.
And there are mother groups
that have great resources
for making friends,
finding support,
asking questions.
I can connect you with
one, if you'd like.
- I'd love that.
- And here.
You listen to me, Penelope.
You did not have
an easy start...
But I have no
concerns about you.
You hear me?
Edison is a lucky, lucky boy.
- Thanks.
- Uh-huh.
Maybe you'd like to
see him after all?
Yes, please.
- Okay.
Bring him in.
Hi, sweet boy.
Oh.
Thank you.
- Hi. Mama is here.
Mama's here.
- It was something
we call a vasospasm,
random constriction
of the blood vessel,
totally unrelated
to the surgery.
That said, your repair
was in good shape.
- This old bird
still got her wing.
- She sure does.
But, uh, maybe just take
it easy on the pasta roller
while you heal up, okay?
- We need to get your
picture on our famosi wall.
- Getting to eat your
pasta's reward enough.
- Ah, Guglielmo.
Thank you for getting
Dr. Handsome to help me.
You bring him with you,
I'll make you two
squid ink pasta.
- Wow.
She swore she'd only ever
make that for the Pope.
- Oh.
- Grazie.
Grazie mille.
- You got it.
- I'm gonna let
you get some rest.
- Okay.
- Thanks.
- Hey, Will, look, about
the surgery, I, uh...
- It wasn't your fault.
I was out of line.
- No, you had a point.
I got wrapped up in
all the attention.
- Okay, that's true.
You're a good surgeon, Crockett.
Just not sure you deserve
her squid ink pasta.
- Touché.
- So while the bleeding
necessitated our removal
of your fallopian tube,
this will not prevent you
from becoming pregnant
again and carrying
a healthy baby to term.
- Thank you, Dr. Asher.
- Thank you both.
Hannah and Dean...
Good baby names.
We'll have to remember that.
- Actually, I never liked Dean.
I think you can do better.
Oh, yeah?
- Okay, we'll get
you a diet ordered,
and if you do okay, we'll
send you home tonight.
- Thank you.
- Sure.
Hey, I wanted to say thank you.
I'm relieved we could
respect Caitlin's wishes,
and I'm lucky I had your help.
- Well, you did good
for a mere mortal.
Hey, Dean?
- Yeah?
- In the OR, you were in pain.
- Oh, please.
It's a... it's a...
It's a hard angle to hold
when your ribs
are still healing.
- Yeah.
- Yeah.
- Don't kid a kidder.
Look, you don't want
my help, that's fine,
but you have to let
somebody check you out.
- Hey, I'm fine, Dr. Asher.
Yeah.
- Okay.
- All right.
- What's this?
- Recommended
travel vaccinations.
I thought you could give
me a hand scheduling them.
- I didn't know you
were going on vacation.
- Samir offered me
a spot on his team.
He thought I'd be a great fit.
- In the Philippines?
- I said yes.
- Wait, wait. You can't
just up and leave.
What about your residency?
- I'll talk to my program
director and Ms. Goodwin.
I'll defer finishing for
now, but they'll understand.
- But I don't.
Where's this coming from?
- From me, Maggie.
Listen, you... you were
upset, and rightly so,
when I bought those
drugs off the street.
But what I didn't say
to you earlier that
I should have is that I was...
I was actually inspired.
I mean, despite the risk,
I helped my patient.
I was resourceful. I
mean, I was a good doctor.
That's the kind of
person that I want to be.
- And you can't be
that person here?
- Maybe.
But I know that this
opportunity will allow me
to be the kind of doctor
that I want to be,
doing the work that I love.
I... this is my calling.
- Why don't you just take
some time and think about it?
- I don't want to.
- But...
- I just want to close my
eyes and take the leap.
Okay.