The Good Doctor (2017–…): Season 2, Episode 11 - Quarantine Part Two - full transcript
Previously on "The Good Doctor"...
I'm covering the E.R. today.
- Gonna be a madhouse.
- Yeah.
This emergency room and everyone
in it is now under quarantine.
A serious respiratory virus
has infected three patients.
Take me to the hospital.
We are going to your appointment
and making sure your think-melon
remains tumor-free.
I no longer have an immune system.
My donor's on his way, right?
Why are you answering our donor's phone?
Because he's here in quarantine.
My wife's in there.
I need to get in there.
If something happens to me,
our son needs someone
to take care of him.
Put your mask back on.
Why?
Because I'm infected.
On the bright side, I think
I'm growing on Morgan.
Dr. Reznick.
Morgan.
He doesn't need to die.
He signed a DNR.
He shouldn't have.
We're gonna get his donor's marrow.
You need surgery now.
There's no operating room.
We will have to improvise.
Use your finger to plug the hole.
Now what?
Dr. Lim?
It's back.
Help my son! Help my son!
311 bus.
$2.35.
Left on Blossom Hill...
Kellan!
Right on Cottle Street...
Dr. Murphy?
Left on Santa Teresa...
I think there's something wrong with him.
- We'll get you a mask.
- Can we get a pregnant woman a mask?
Kellan, can you hear me? Please!
It's empty.
Kellan!
Right on Meridian...
Dr. Reznick needs you.
He's not answering.
Dr. Murphy...
Don't yell. It'll only make it worse.
Okay... what should I do?
Tell him about the surgery.
Give him every detail you can.
Santa Pete... has a torn IMA.
He's hemorrhaging into his belly.
His BP at 87 over 54 and dropping.
A saphenous vein graft.
We can repair the IMA with
a graft from the saphenous vein.
- We just...
- I don't need a diagnosis,
I need an extra set of hands.
Get me a 2-0 silk, vascular
clamps, and an 11 blade.
Clear.
Charge to 200 joules.
Clear!
We just saved his life...
and violated his rights.
We could lose our licenses.
You won't. You were
following instructions
- given by an attending.
- No, I wasn't...
Let's get him stabilized
so I can go to Andrews
and talk to him about
getting him some marrow
so this wasn't a waste of time.
Keep your lips together
and breathe like you're
blowing out a candle.
I c... I can't... I-I can't.
Kel... deep breaths. Deep breaths.
You're a doctor, right?
Any update on the virus...
- Do I have it?
- No... no rash, no fever.
This is your asthma...
When can we go home...
Your lungs are hyper-inflated...
They better send in more doctors,
because that weirdo melted down...
Everybody shut up! Just shut the hell up.
We have multiple people
in serious condition,
including a senior doctor and my son.
Your questions are gonna have to wait.
I need a nebulizer.
It's in isolation...
with the infected patients.
I'll order one in from pharmacy...
No time.
...Captions by VITAC...
Making your own nebulizer?
Something like that.
You broke in?
No.
Dad... I saw the Taser.
I didn't use it. Just threatened to...
That was dumb.
Long, deep breaths.
You got her on maximal oxygen?
Yeah. Her vitals have recovered slightly.
The CDC is sending a PCR test
based off the virus
in the Malaysian outbreak.
So what's their treatment protocol?
Antivirals, steroids,
inhaled nitric oxide
and anti-TNF receptor antibodies.
That's what we did for
the two plane patients.
And Tyler.
We got to Dr. Lim sooner,
that should make a difference.
How's Dr. Murphy?
He's fine.
I saw his breakdown on the security feed.
Better. He's closing on Santa Pete.
Do you have a strategy
for dealing with him?
- Dr. Park and I can...
- Park's in there?
When did that happen?
Just a few minutes ago.
He came in to help his son.
Perfect.
You're still here?
What did they say?
Very kind of you.
No wonder you and Shaun
get along so well.
What did they say?
Did the new tests show anything new?
They need time to process the CT images,
send them off to Dr. Blaize.
So you might have been wrong
about your cancer coming back?
No.
No?
How can you know you're not wrong
if you don't know you're not wrong?
This is how they do it.
First they tell you
there might be something,
and then they order new tests
to test the previous tests...
only to inform you that it was
what they suspected all along.
Very effective way of breaking bad news.
Okay...
And if your tumor really is
back, what does that mean?
It means that I had surgery
and let them pump radiation
into my brain for nothing.
It means that my memory loss
is because my brain is dying.
It means that I probably have
a year, maybe 14 months.
Enough meaning for you?
What are we gonna tell Shaun?
Nothing.
St. Bonaventure's opened up
a room for family and friends.
You want to come?
We expand the quarantine,
we move our marrow donor
and our patient into...
If the donor has the virus,
his marrow will transmit it
to your immunocompromised patient.
He'll be dead in hours.
As he will be without the transplant.
We create a sterile pathway from the E.R.
into this procedure room
using polyethylene sheeting...
No, you won't.
The only people taking any risks here
are my people,
the patient, and the donor...
And this hospital and everyone
in it if you screw anything up.
But my larger objection is...
it won't work.
That procedure room
isn't negative pressure,
which leaves the virus free to
escape to the main vent system.
I'll figure something else...
Janitors' closets.
They're negative pressure
because of the cleansers,
sterilizing agents.
Don't want those odors and toxins
to disperse to patient areas.
Here.
That closet doesn't have
room for two patients.
We can do the extraction there,
but not the transplant.
We could use this linen room,
in the basement,
which is also negative pressure
and connects to the janitors' closet
through this laundry chute.
Once the bone marrow is extracted,
it'd travel through the laundry
chute into the linen room.
Where you could do the transplant.
Dr. Murphy?
Update me on patient status.
Santa Pete's vitals are stable,
no sign of post-op infection.
Toby is in Bay 3 receiving an IV drip;
Ester's ST...
I think you're overloading him.
No. When he's dealing with medicine,
he's not distracted by...
everything else.
It helps. Keep going, Shaun.
Ester's ST depressions have improved.
That should help, too.
Ester's ST depressions have improved,
and Viola's water broke.
What? When?
It appears quite recently.
Aaah! Aah...
Given you're only 36 weeks gestationally,
and there's no sign of infection,
the baby should be able to stay in utero
for at least 24 hours.
If the quarantine is done before...
You're not gonna fall apart
again, are you?
I don't think so, Viola.
The buzzing is gone,
and there is much less yelling.
Except you.
It was the buzzing and the yelling,
not the fact that we're
trapped with three people
who have died from
a highly infectious disease?
That's not something to worry about.
I either have the virus or I don't,
and, based on past national
quarantine mortality rates,
we have a very good statistical
chance of surviving.
But I didn't know that I would
"fall apart" the first time,
so I may be wrong.
Here you go.
You always talk like that?
Like what?
Just say whatever you're thinking
when you're thinking it?
Yes. It's good to be honest.
Wish my dad was like that.
Dr. Park is very honest.
He always shares his opinions.
There's opinions.
And then there's feelings.
Your dad doesn't tell you
that he loves you?
What?
Well, he's just...
not really there for us.
He did just risk his life,
and his career,
to break into a quarantine to help you.
That's true.
But most kids want their dad there
even when it's not life and death.
Sorry for your loss.
Status?
O2 SAT is 92,
respiratory rate is down to 16.
Your lungs sound clearer.
Keep pulmonary edema to a minimum
with conservative fluid management.
Use furosemide so my CVP's under 8.
Absolutely.
I love this place.
I always said I'd be doing this
'til the day I died.
Ta-da.
We started your treatment early.
You'll be back to repairing
late-night, drunken head injuries
in no time.
I forgot to call my mom on her birthday.
I forgot to do a lot of stuff...
Tyler was sweet.
He was a good guy.
Best to put him out of sight.
It's not a healthy reminder...
for either of us.
Tyler's mask had a tear in it.
It's possible the virus is droplet-based,
not airborne.
Blood or saliva could've made
its way through his mask
from the airline passengers.
Unfortunately, until we know for sure,
we're still on lockdown.
But I'll let the CDC know.
Do you have a minute?
Is it urgent?
Not really.
Kel...
What's up?
Why'd you move away?
I'm a resident, you go
where the job takes you.
They don't need doctors in Phoenix?
This was an excellent opportunity for me.
And it's less than
a two-hour flight; I'm not...
You had my baseball schedule for months
and you came for one game
and you were on your computer
the entire time.
I had exams the next day.
So why'd you bother coming?
Mm, good...
Slowly...
Good...
As delicious as these ice chips are,
I think I'm ready for some solid food;
did they send in any cookies?
Dr. Murphy was very clear...
no food until you fart.
Just imagine they're straight
from the North Pole.
- Bob, you ready?
- Of course.
I'm doing a bone marrow extraction,
and I need an extra set of hands
to handle some bloody stuff...
separating bone and fat from stem cells.
Who here isn't freaked out by
what I just said and can help?
Ester's a doctor.
You're a doctor? Why haven't you...
Veterinarian. Retired.
Blood is blood. Follow us.
Fetal heart rate is still
between 130 and 140 BPM.
Contractions 17 minutes apart.
What's happening? Is it my baby?
Viola's BP is 180 over 100.
She may have preeclampsia
and an oncoming seizure.
We need to induce labor.
No. He's not being born in here.
We are waiting for quarantine to end.
Your placenta isn't getting
enough blood flow.
We need to get him out.
This is going to be your first baby.
And mine.
Start bronchodilators.
Dr. Lim... can you hear me?
O2 SATs are still dropping.
Push paralytics.
Starting intubation.
I'm getting resistance bagging.
I gave her hyoscine.
Hello? What's going on?
What's going on?
Lim's O2 SATs are crashing.
Her lungs aren't inflating.
They're filled with fluid and secretions.
- Pick up the phone.
- I've got my hands full.
Villanueva, pick up the phone.
Okay, show me what's going on.
She's in full respiratory failure.
She needs more pulmonary support.
Get her on BiPAP.
That might buy us some time.
Or we take her lungs out of the equation.
We put her on ECMO,
oxygenate her blood outside her body...
her lungs will have time to heal.
We can't do ECMO in the E.R.
We aren't supposed to do
abdominal surgery
in the E.R., either.
Please, walk me through it.
Prep an area over her femoral vein.
That's very loud.
Any crowning, Dr. Murphy?
No, she's dilated at 6 centimeters,
and I don't feel the head.
It's been seven hours
since her water broke.
The baby's stuck. Use Leopold's maneuvers
to identify the location of the baby.
The fetus is transverse.
He's lying roughly thirty
degrees to the left side.
We can't deliver the baby.
What?! Why not?
We need to turn the baby.
We need to do an external
cephalic version.
Or a C-section.
I have assisted on several...
In operating rooms with
an experienced attending.
We are not doing a C-section here.
Tilt her bed. I'll grab the gel.
- Mm.
- Okay.
So when...?
What? When what?
I get not telling him
when he's in quarantine.
He's got enough on his plate, but...
Never.
You told him when you
were first diagnosed.
Yes, and that was a mistake.
He forced you take tests
that saved your life.
Well, no, as it turns out, it didn't.
And he became so obsessed and distracted
that he nearly killed a patient.
He's your friend.
I'm his mentor. It's not
his job to take care of me.
Make sure you turn the needle so
you're getting marrow from all sides.
Aspirate slower.
If you pull fast, it's more painful.
Hang in there, Bob.
I deserve a little pain.
You're his dad. You're saving his life.
I took off before my son
even knew who I was,
traveled in crappy vans
to s-stay at crappy hotels
and play crappy music,
all so I could earn enough to get high.
You're here now.
By the time I got up
the nerve to face them,
my ex was dying.
God willing I did it in time
to save my son.
Dr. Melendez, Chris's
vitals are bottoming out.
His secretions and lung sounds are worse.
I don't know how much longer we can wait.
Administer Levophed,
and prep him for transplant.
Dr. Park, Chris's in hypotensive crisis.
- Go faster!
- Fast as I can.
You ready, Dr. Murphy?
Yes. I can feel the head.
We need to rotate in the same direction.
Deep breaths, Viola.
Okay.
Oh, I can't... I can't do this!
Squeeze my arm hard as you can.
The fetus is moving.
The head is facing the cervix.
One more push.
- We just need...
- Stop!
Placental abruption.
She's hemorrhaging.
Baby's heart rate is decelerating.
I need 2 large-bore I.V. lines
and start 2 units PRBC.
Then please page an OB-GYN to
supervise my first solo surgery.
This is terrible.
This is not how it's supposed to...
This is excellent.
Dr. Garcia will be supervising
me for the C-section.
She's the director of Obstetrics
and Gynecology here.
I'm sure she's much more qualified
than your personal OB-GYN.
Relax. You're gonna be fine.
What's the status?
Nerve block is in, and I gave
her a liter bolus of saline.
Throw some ChloraPrep down
and make a five centimeter
Pfannenstiel incision.
Ten-blade.
Chris's prepped.
Inserting central line now.
How's he doing?
Pressure is 90 over 50, O2 SATs are 85,
heart rate is at 110.
Ready when you are.
One more and we're good to go.
I'm on my way.
I'm scrubbing in. Call me the second
you're ready for the drop.
Abdomen is open. Retraction.
Suction.
Baby's BPM is 110 and dropping.
What's happening?
Dr. Murphy, do you see the uterine wall?
Blood pressure is dropping.
Dr. Murphy, the uterine wall.
Dr. Murphy?
You need to make a gradual
shallow incision
and cut through it.
You do not want to nick the baby.
- What's happening?
- BPM is 95.
Dr. Murphy, please!
Dr. Murphy, should we turn up her oxygen?
Dr. Murphy, you need to make the cut.
Dr. Murphy. Dr. Murphy.
- Dr. Murphy.
- Dr. Murphy.
No!
Quiet! Everyone quiet!
I need to concentrate!
I can see the head.
Is my baby okay?
He's not breathing.
We need to start CPR now.
Get a pediatric Ambu-bag
and start two-finger chest compressions.
There's something wrong with Viola.
She's hypotensive and tachycardic.
She's bleeding out.
You should tell him.
Look at that. Another reason why you two
are so good together.
Neither one of you are willing
to drop a thing.
He deserves to know.
Deserves?
Is that how things work in your world?
People get what they deserve?
Shaun deserves to be toyed with?
- Who's toying with him?
- You.
I'm his friend.
You whisk him away on a road trip,
kiss him and then leave town.
Now you pop back into his life,
move in with him.
Shaun's not some hamster
you get to play with
and then not think twice about
it when you forget to feed him.
You're gonna hurt him again.
You know that.
I know that.
I'm gonna let that slide
because you're dying.
I'm gonna take this outside.
Bubble wrap?
Need to make sure it
doesn't break on the trip.
Or the landing.
Dr. Melendez, we're ready.
Copy. Deposit the marrow now.
The marrow is intact.
We're good to go.
My chest...
It really hurts.
He's going into cardiac arrest.
- What can I do?
- His I.V. is blown.
The tip broke off.
It must be in his heart.
Come on.
Dr. Murphy, the rules
of medical priority are clear.
Focus on saving the mother.
Dr. Murphy, you need to stop now.
Dr. Murphy.
Dr. Murphy?
We can save them both.
Get me a liter of saline, a plastic bag,
some surgical tape
and Kerlix gauze, please.
Who knows CPR?
Who knows CPR?
- Um, in Health, they ma...
- Come with me.
Okay, two fingers right here
in the middle of his chest.
Press down twice per second,
every fifteen seconds,
stop and squeeze the bag.
Twice... Yes, don't press too hard,
or you'll crush his heart.
Okay.
You're making a Bakri tamponade
balloon for Viola's bleed?
- Yes.
- What is that supposed to do?
It will control the bleeding
by applying pressure
- from the inside.
- How's the baby?
I don't know if this is working.
- I just...
- Don't stop.
Are you ready, Dr. Murphy?
Feed the end of the pack
slowly through her cervix.
Once you reach the fundus of
the uterus, start inflation.
Clear.
- That's the fourth one.
- I have to crack his chest.
- Here?
- Get me rib spreaders
and a ten blade from the crash cart.
Marrow's in.
Heart rate's 84, BP's 100 over 60...
vitals look good.
I'm sorry about before.
Are you gonna tell Shaun
you got some good news?
What makes you think it's good news?
Because you apologized.
The cancer's not back.
- That's great.
- It's not great.
It's okay. It's not great.
I have meningitis from
a CSF leak in my head.
I have to have surgery
pretty much immediately.
And, no, I am not telling Shaun.
You're right about one thing.
You're not his friend.
Because friends tell
each other everything.
And you're a lousy mentor.
Friends are there for each
other, and mentors teach.
They don't hide the truth.
I'm just looking out for him.
He's not like you. He's not
like everybody el...
No, he's not,
but he's also not some helpless child
who constantly needs protection.
He's an adult;
a very smart, caring adult.
And you could really use
someone like that right now.
It's not working. She's still bleeding.
Keep injecting saline.
Vitals are 80 over 60. Heart rate's 110.
Stop CPR.
I need to see if he can
breathe on his own.
Is everything okay?
No. His lungs are filled with fluid.
He's drowning.
Get the pediatric laryngoscope stat.
Dr. Andrews, she's still...
It's not Andrews.
Can I see her?
Map is holding steady at 65,
but she was dipping into serious
hypoxia for a short bit.
Can I see her?
Good work, taking care of her.
Thank you.
The baby has meconium aspiration.
Suction catheter.
Is that bad?
Fecal matter has settled in his lungs.
It's blocking his airway.
Did I do something wrong?
You most likely dislodged some of it.
Without that, he would've
suffocated by now.
Clearing his airway.
It's the most important
moment of my life.
And I'm not there with Viola.
This is the way it used to be done.
The men waiting outside.
Now we know better.
Now we know it matters.
Do you think your grandfather
loved your father
- any less just beca...
- Shut up.
Ignore him. He's just a grouch.
Shh.
Is that...?
I think you've got yourself
a new alarm clock.
Congratulations!
Congratulations.
I'm a dad.
He is okay.
A Christmas miracle.
Thank you.
It's Lim.
Could I get some water?
ECMO?
That was a ballsy move.
Ester Blum, Pete Bailey...
your PCR and serology came
back negative for the virus.
You're officially cleared.
We're going home.
Only Ester can go home.
You're going to post-op
recovery for another day.
I'll keep you company.
There's someone I want
to see up there anyway.
On Dasher, on Dancer,
on Prancer and Vixen.
You are stable;
no sign of marrow rejection.
We will be monitoring you
over the next few weeks,
but remission is a very real possibility.
I don't know how to thank you enough.
Guess I should thank my dad too.
Is he here?
There was a complication
during extraction.
Bob's heart stopped.
And we did everything
we could to revive him,
but he died.
What?
We're so sorry for your loss.
Are you Chris Santos?
My name is Ester.
I was with your father when he...
He mentioned that he had lot of regrets.
But it meant a lot to him
that he could help you.
Heard you were a big help
during that delivery.
They needed extra hands.
You asked me why I let
you and your mom go,
why I didn't fight harder.
It's because I wasn't a good person.
I wasn't a good father.
My dad had this mantra...
Be like stone; never cry.
If I got emotional or upset...
he'd repeat it:
be like stone; never cry.
It made me stronger...
which wasn't always a good thing.
Spent my life living behind a wall...
which meant your mom got
to live with that wall
as well, and...
When we split up, I felt like a failure.
Moving away helped me hide from that.
My father's voice is still in my head.
But I'm working on
getting it to be quiet.
I love you, Kellan.
Always will.
Kellan!
Mom!
Are you okay?
I'm fine. I, uh...
I helped deliver a baby.
Oh.
He was amazing.
It's good to see you, Mia.
How was it in there?
The guy I worked on didn't make it.
Merry Christmas.
I don't think I'll forget this one.
Me neither.
The idea of you not being around...
wasn't okay with me.
Who would I drink bourbon with?
I think my bourbon days are
behind me for a little while.
I'll wait.
Shaun!
Hi.
You must be exhausted.
And hungry.
All the sandwiches they gave us
had pickles in them.
Oh, that's no good.
How about we go to that
24-hour breakfast place
and get some pancakes?
I would like that very much.
- Hello, Dr. Glassman.
- Hello.
- I delivered a baby.
- Yes, we heard.
I'm sorry I couldn't drive you
to your appointment.
How did it go?
I have meningitis.
I have to have surgery later today
to fix the CSF leak in my head.
I thought you should know.
That's good.
Meningitis is definitely
not as bad as cancer.
It also explains your memory loss.
Now you can get your license back.
Shaun, would you mind
if Glassy gave you a hug?
I think that would be very nice.
Very proud of you.
I'm covering the E.R. today.
- Gonna be a madhouse.
- Yeah.
This emergency room and everyone
in it is now under quarantine.
A serious respiratory virus
has infected three patients.
Take me to the hospital.
We are going to your appointment
and making sure your think-melon
remains tumor-free.
I no longer have an immune system.
My donor's on his way, right?
Why are you answering our donor's phone?
Because he's here in quarantine.
My wife's in there.
I need to get in there.
If something happens to me,
our son needs someone
to take care of him.
Put your mask back on.
Why?
Because I'm infected.
On the bright side, I think
I'm growing on Morgan.
Dr. Reznick.
Morgan.
He doesn't need to die.
He signed a DNR.
He shouldn't have.
We're gonna get his donor's marrow.
You need surgery now.
There's no operating room.
We will have to improvise.
Use your finger to plug the hole.
Now what?
Dr. Lim?
It's back.
Help my son! Help my son!
311 bus.
$2.35.
Left on Blossom Hill...
Kellan!
Right on Cottle Street...
Dr. Murphy?
Left on Santa Teresa...
I think there's something wrong with him.
- We'll get you a mask.
- Can we get a pregnant woman a mask?
Kellan, can you hear me? Please!
It's empty.
Kellan!
Right on Meridian...
Dr. Reznick needs you.
He's not answering.
Dr. Murphy...
Don't yell. It'll only make it worse.
Okay... what should I do?
Tell him about the surgery.
Give him every detail you can.
Santa Pete... has a torn IMA.
He's hemorrhaging into his belly.
His BP at 87 over 54 and dropping.
A saphenous vein graft.
We can repair the IMA with
a graft from the saphenous vein.
- We just...
- I don't need a diagnosis,
I need an extra set of hands.
Get me a 2-0 silk, vascular
clamps, and an 11 blade.
Clear.
Charge to 200 joules.
Clear!
We just saved his life...
and violated his rights.
We could lose our licenses.
You won't. You were
following instructions
- given by an attending.
- No, I wasn't...
Let's get him stabilized
so I can go to Andrews
and talk to him about
getting him some marrow
so this wasn't a waste of time.
Keep your lips together
and breathe like you're
blowing out a candle.
I c... I can't... I-I can't.
Kel... deep breaths. Deep breaths.
You're a doctor, right?
Any update on the virus...
- Do I have it?
- No... no rash, no fever.
This is your asthma...
When can we go home...
Your lungs are hyper-inflated...
They better send in more doctors,
because that weirdo melted down...
Everybody shut up! Just shut the hell up.
We have multiple people
in serious condition,
including a senior doctor and my son.
Your questions are gonna have to wait.
I need a nebulizer.
It's in isolation...
with the infected patients.
I'll order one in from pharmacy...
No time.
...Captions by VITAC...
Making your own nebulizer?
Something like that.
You broke in?
No.
Dad... I saw the Taser.
I didn't use it. Just threatened to...
That was dumb.
Long, deep breaths.
You got her on maximal oxygen?
Yeah. Her vitals have recovered slightly.
The CDC is sending a PCR test
based off the virus
in the Malaysian outbreak.
So what's their treatment protocol?
Antivirals, steroids,
inhaled nitric oxide
and anti-TNF receptor antibodies.
That's what we did for
the two plane patients.
And Tyler.
We got to Dr. Lim sooner,
that should make a difference.
How's Dr. Murphy?
He's fine.
I saw his breakdown on the security feed.
Better. He's closing on Santa Pete.
Do you have a strategy
for dealing with him?
- Dr. Park and I can...
- Park's in there?
When did that happen?
Just a few minutes ago.
He came in to help his son.
Perfect.
You're still here?
What did they say?
Very kind of you.
No wonder you and Shaun
get along so well.
What did they say?
Did the new tests show anything new?
They need time to process the CT images,
send them off to Dr. Blaize.
So you might have been wrong
about your cancer coming back?
No.
No?
How can you know you're not wrong
if you don't know you're not wrong?
This is how they do it.
First they tell you
there might be something,
and then they order new tests
to test the previous tests...
only to inform you that it was
what they suspected all along.
Very effective way of breaking bad news.
Okay...
And if your tumor really is
back, what does that mean?
It means that I had surgery
and let them pump radiation
into my brain for nothing.
It means that my memory loss
is because my brain is dying.
It means that I probably have
a year, maybe 14 months.
Enough meaning for you?
What are we gonna tell Shaun?
Nothing.
St. Bonaventure's opened up
a room for family and friends.
You want to come?
We expand the quarantine,
we move our marrow donor
and our patient into...
If the donor has the virus,
his marrow will transmit it
to your immunocompromised patient.
He'll be dead in hours.
As he will be without the transplant.
We create a sterile pathway from the E.R.
into this procedure room
using polyethylene sheeting...
No, you won't.
The only people taking any risks here
are my people,
the patient, and the donor...
And this hospital and everyone
in it if you screw anything up.
But my larger objection is...
it won't work.
That procedure room
isn't negative pressure,
which leaves the virus free to
escape to the main vent system.
I'll figure something else...
Janitors' closets.
They're negative pressure
because of the cleansers,
sterilizing agents.
Don't want those odors and toxins
to disperse to patient areas.
Here.
That closet doesn't have
room for two patients.
We can do the extraction there,
but not the transplant.
We could use this linen room,
in the basement,
which is also negative pressure
and connects to the janitors' closet
through this laundry chute.
Once the bone marrow is extracted,
it'd travel through the laundry
chute into the linen room.
Where you could do the transplant.
Dr. Murphy?
Update me on patient status.
Santa Pete's vitals are stable,
no sign of post-op infection.
Toby is in Bay 3 receiving an IV drip;
Ester's ST...
I think you're overloading him.
No. When he's dealing with medicine,
he's not distracted by...
everything else.
It helps. Keep going, Shaun.
Ester's ST depressions have improved.
That should help, too.
Ester's ST depressions have improved,
and Viola's water broke.
What? When?
It appears quite recently.
Aaah! Aah...
Given you're only 36 weeks gestationally,
and there's no sign of infection,
the baby should be able to stay in utero
for at least 24 hours.
If the quarantine is done before...
You're not gonna fall apart
again, are you?
I don't think so, Viola.
The buzzing is gone,
and there is much less yelling.
Except you.
It was the buzzing and the yelling,
not the fact that we're
trapped with three people
who have died from
a highly infectious disease?
That's not something to worry about.
I either have the virus or I don't,
and, based on past national
quarantine mortality rates,
we have a very good statistical
chance of surviving.
But I didn't know that I would
"fall apart" the first time,
so I may be wrong.
Here you go.
You always talk like that?
Like what?
Just say whatever you're thinking
when you're thinking it?
Yes. It's good to be honest.
Wish my dad was like that.
Dr. Park is very honest.
He always shares his opinions.
There's opinions.
And then there's feelings.
Your dad doesn't tell you
that he loves you?
What?
Well, he's just...
not really there for us.
He did just risk his life,
and his career,
to break into a quarantine to help you.
That's true.
But most kids want their dad there
even when it's not life and death.
Sorry for your loss.
Status?
O2 SAT is 92,
respiratory rate is down to 16.
Your lungs sound clearer.
Keep pulmonary edema to a minimum
with conservative fluid management.
Use furosemide so my CVP's under 8.
Absolutely.
I love this place.
I always said I'd be doing this
'til the day I died.
Ta-da.
We started your treatment early.
You'll be back to repairing
late-night, drunken head injuries
in no time.
I forgot to call my mom on her birthday.
I forgot to do a lot of stuff...
Tyler was sweet.
He was a good guy.
Best to put him out of sight.
It's not a healthy reminder...
for either of us.
Tyler's mask had a tear in it.
It's possible the virus is droplet-based,
not airborne.
Blood or saliva could've made
its way through his mask
from the airline passengers.
Unfortunately, until we know for sure,
we're still on lockdown.
But I'll let the CDC know.
Do you have a minute?
Is it urgent?
Not really.
Kel...
What's up?
Why'd you move away?
I'm a resident, you go
where the job takes you.
They don't need doctors in Phoenix?
This was an excellent opportunity for me.
And it's less than
a two-hour flight; I'm not...
You had my baseball schedule for months
and you came for one game
and you were on your computer
the entire time.
I had exams the next day.
So why'd you bother coming?
Mm, good...
Slowly...
Good...
As delicious as these ice chips are,
I think I'm ready for some solid food;
did they send in any cookies?
Dr. Murphy was very clear...
no food until you fart.
Just imagine they're straight
from the North Pole.
- Bob, you ready?
- Of course.
I'm doing a bone marrow extraction,
and I need an extra set of hands
to handle some bloody stuff...
separating bone and fat from stem cells.
Who here isn't freaked out by
what I just said and can help?
Ester's a doctor.
You're a doctor? Why haven't you...
Veterinarian. Retired.
Blood is blood. Follow us.
Fetal heart rate is still
between 130 and 140 BPM.
Contractions 17 minutes apart.
What's happening? Is it my baby?
Viola's BP is 180 over 100.
She may have preeclampsia
and an oncoming seizure.
We need to induce labor.
No. He's not being born in here.
We are waiting for quarantine to end.
Your placenta isn't getting
enough blood flow.
We need to get him out.
This is going to be your first baby.
And mine.
Start bronchodilators.
Dr. Lim... can you hear me?
O2 SATs are still dropping.
Push paralytics.
Starting intubation.
I'm getting resistance bagging.
I gave her hyoscine.
Hello? What's going on?
What's going on?
Lim's O2 SATs are crashing.
Her lungs aren't inflating.
They're filled with fluid and secretions.
- Pick up the phone.
- I've got my hands full.
Villanueva, pick up the phone.
Okay, show me what's going on.
She's in full respiratory failure.
She needs more pulmonary support.
Get her on BiPAP.
That might buy us some time.
Or we take her lungs out of the equation.
We put her on ECMO,
oxygenate her blood outside her body...
her lungs will have time to heal.
We can't do ECMO in the E.R.
We aren't supposed to do
abdominal surgery
in the E.R., either.
Please, walk me through it.
Prep an area over her femoral vein.
That's very loud.
Any crowning, Dr. Murphy?
No, she's dilated at 6 centimeters,
and I don't feel the head.
It's been seven hours
since her water broke.
The baby's stuck. Use Leopold's maneuvers
to identify the location of the baby.
The fetus is transverse.
He's lying roughly thirty
degrees to the left side.
We can't deliver the baby.
What?! Why not?
We need to turn the baby.
We need to do an external
cephalic version.
Or a C-section.
I have assisted on several...
In operating rooms with
an experienced attending.
We are not doing a C-section here.
Tilt her bed. I'll grab the gel.
- Mm.
- Okay.
So when...?
What? When what?
I get not telling him
when he's in quarantine.
He's got enough on his plate, but...
Never.
You told him when you
were first diagnosed.
Yes, and that was a mistake.
He forced you take tests
that saved your life.
Well, no, as it turns out, it didn't.
And he became so obsessed and distracted
that he nearly killed a patient.
He's your friend.
I'm his mentor. It's not
his job to take care of me.
Make sure you turn the needle so
you're getting marrow from all sides.
Aspirate slower.
If you pull fast, it's more painful.
Hang in there, Bob.
I deserve a little pain.
You're his dad. You're saving his life.
I took off before my son
even knew who I was,
traveled in crappy vans
to s-stay at crappy hotels
and play crappy music,
all so I could earn enough to get high.
You're here now.
By the time I got up
the nerve to face them,
my ex was dying.
God willing I did it in time
to save my son.
Dr. Melendez, Chris's
vitals are bottoming out.
His secretions and lung sounds are worse.
I don't know how much longer we can wait.
Administer Levophed,
and prep him for transplant.
Dr. Park, Chris's in hypotensive crisis.
- Go faster!
- Fast as I can.
You ready, Dr. Murphy?
Yes. I can feel the head.
We need to rotate in the same direction.
Deep breaths, Viola.
Okay.
Oh, I can't... I can't do this!
Squeeze my arm hard as you can.
The fetus is moving.
The head is facing the cervix.
One more push.
- We just need...
- Stop!
Placental abruption.
She's hemorrhaging.
Baby's heart rate is decelerating.
I need 2 large-bore I.V. lines
and start 2 units PRBC.
Then please page an OB-GYN to
supervise my first solo surgery.
This is terrible.
This is not how it's supposed to...
This is excellent.
Dr. Garcia will be supervising
me for the C-section.
She's the director of Obstetrics
and Gynecology here.
I'm sure she's much more qualified
than your personal OB-GYN.
Relax. You're gonna be fine.
What's the status?
Nerve block is in, and I gave
her a liter bolus of saline.
Throw some ChloraPrep down
and make a five centimeter
Pfannenstiel incision.
Ten-blade.
Chris's prepped.
Inserting central line now.
How's he doing?
Pressure is 90 over 50, O2 SATs are 85,
heart rate is at 110.
Ready when you are.
One more and we're good to go.
I'm on my way.
I'm scrubbing in. Call me the second
you're ready for the drop.
Abdomen is open. Retraction.
Suction.
Baby's BPM is 110 and dropping.
What's happening?
Dr. Murphy, do you see the uterine wall?
Blood pressure is dropping.
Dr. Murphy, the uterine wall.
Dr. Murphy?
You need to make a gradual
shallow incision
and cut through it.
You do not want to nick the baby.
- What's happening?
- BPM is 95.
Dr. Murphy, please!
Dr. Murphy, should we turn up her oxygen?
Dr. Murphy, you need to make the cut.
Dr. Murphy. Dr. Murphy.
- Dr. Murphy.
- Dr. Murphy.
No!
Quiet! Everyone quiet!
I need to concentrate!
I can see the head.
Is my baby okay?
He's not breathing.
We need to start CPR now.
Get a pediatric Ambu-bag
and start two-finger chest compressions.
There's something wrong with Viola.
She's hypotensive and tachycardic.
She's bleeding out.
You should tell him.
Look at that. Another reason why you two
are so good together.
Neither one of you are willing
to drop a thing.
He deserves to know.
Deserves?
Is that how things work in your world?
People get what they deserve?
Shaun deserves to be toyed with?
- Who's toying with him?
- You.
I'm his friend.
You whisk him away on a road trip,
kiss him and then leave town.
Now you pop back into his life,
move in with him.
Shaun's not some hamster
you get to play with
and then not think twice about
it when you forget to feed him.
You're gonna hurt him again.
You know that.
I know that.
I'm gonna let that slide
because you're dying.
I'm gonna take this outside.
Bubble wrap?
Need to make sure it
doesn't break on the trip.
Or the landing.
Dr. Melendez, we're ready.
Copy. Deposit the marrow now.
The marrow is intact.
We're good to go.
My chest...
It really hurts.
He's going into cardiac arrest.
- What can I do?
- His I.V. is blown.
The tip broke off.
It must be in his heart.
Come on.
Dr. Murphy, the rules
of medical priority are clear.
Focus on saving the mother.
Dr. Murphy, you need to stop now.
Dr. Murphy.
Dr. Murphy?
We can save them both.
Get me a liter of saline, a plastic bag,
some surgical tape
and Kerlix gauze, please.
Who knows CPR?
Who knows CPR?
- Um, in Health, they ma...
- Come with me.
Okay, two fingers right here
in the middle of his chest.
Press down twice per second,
every fifteen seconds,
stop and squeeze the bag.
Twice... Yes, don't press too hard,
or you'll crush his heart.
Okay.
You're making a Bakri tamponade
balloon for Viola's bleed?
- Yes.
- What is that supposed to do?
It will control the bleeding
by applying pressure
- from the inside.
- How's the baby?
I don't know if this is working.
- I just...
- Don't stop.
Are you ready, Dr. Murphy?
Feed the end of the pack
slowly through her cervix.
Once you reach the fundus of
the uterus, start inflation.
Clear.
- That's the fourth one.
- I have to crack his chest.
- Here?
- Get me rib spreaders
and a ten blade from the crash cart.
Marrow's in.
Heart rate's 84, BP's 100 over 60...
vitals look good.
I'm sorry about before.
Are you gonna tell Shaun
you got some good news?
What makes you think it's good news?
Because you apologized.
The cancer's not back.
- That's great.
- It's not great.
It's okay. It's not great.
I have meningitis from
a CSF leak in my head.
I have to have surgery
pretty much immediately.
And, no, I am not telling Shaun.
You're right about one thing.
You're not his friend.
Because friends tell
each other everything.
And you're a lousy mentor.
Friends are there for each
other, and mentors teach.
They don't hide the truth.
I'm just looking out for him.
He's not like you. He's not
like everybody el...
No, he's not,
but he's also not some helpless child
who constantly needs protection.
He's an adult;
a very smart, caring adult.
And you could really use
someone like that right now.
It's not working. She's still bleeding.
Keep injecting saline.
Vitals are 80 over 60. Heart rate's 110.
Stop CPR.
I need to see if he can
breathe on his own.
Is everything okay?
No. His lungs are filled with fluid.
He's drowning.
Get the pediatric laryngoscope stat.
Dr. Andrews, she's still...
It's not Andrews.
Can I see her?
Map is holding steady at 65,
but she was dipping into serious
hypoxia for a short bit.
Can I see her?
Good work, taking care of her.
Thank you.
The baby has meconium aspiration.
Suction catheter.
Is that bad?
Fecal matter has settled in his lungs.
It's blocking his airway.
Did I do something wrong?
You most likely dislodged some of it.
Without that, he would've
suffocated by now.
Clearing his airway.
It's the most important
moment of my life.
And I'm not there with Viola.
This is the way it used to be done.
The men waiting outside.
Now we know better.
Now we know it matters.
Do you think your grandfather
loved your father
- any less just beca...
- Shut up.
Ignore him. He's just a grouch.
Shh.
Is that...?
I think you've got yourself
a new alarm clock.
Congratulations!
Congratulations.
I'm a dad.
He is okay.
A Christmas miracle.
Thank you.
It's Lim.
Could I get some water?
ECMO?
That was a ballsy move.
Ester Blum, Pete Bailey...
your PCR and serology came
back negative for the virus.
You're officially cleared.
We're going home.
Only Ester can go home.
You're going to post-op
recovery for another day.
I'll keep you company.
There's someone I want
to see up there anyway.
On Dasher, on Dancer,
on Prancer and Vixen.
You are stable;
no sign of marrow rejection.
We will be monitoring you
over the next few weeks,
but remission is a very real possibility.
I don't know how to thank you enough.
Guess I should thank my dad too.
Is he here?
There was a complication
during extraction.
Bob's heart stopped.
And we did everything
we could to revive him,
but he died.
What?
We're so sorry for your loss.
Are you Chris Santos?
My name is Ester.
I was with your father when he...
He mentioned that he had lot of regrets.
But it meant a lot to him
that he could help you.
Heard you were a big help
during that delivery.
They needed extra hands.
You asked me why I let
you and your mom go,
why I didn't fight harder.
It's because I wasn't a good person.
I wasn't a good father.
My dad had this mantra...
Be like stone; never cry.
If I got emotional or upset...
he'd repeat it:
be like stone; never cry.
It made me stronger...
which wasn't always a good thing.
Spent my life living behind a wall...
which meant your mom got
to live with that wall
as well, and...
When we split up, I felt like a failure.
Moving away helped me hide from that.
My father's voice is still in my head.
But I'm working on
getting it to be quiet.
I love you, Kellan.
Always will.
Kellan!
Mom!
Are you okay?
I'm fine. I, uh...
I helped deliver a baby.
Oh.
He was amazing.
It's good to see you, Mia.
How was it in there?
The guy I worked on didn't make it.
Merry Christmas.
I don't think I'll forget this one.
Me neither.
The idea of you not being around...
wasn't okay with me.
Who would I drink bourbon with?
I think my bourbon days are
behind me for a little while.
I'll wait.
Shaun!
Hi.
You must be exhausted.
And hungry.
All the sandwiches they gave us
had pickles in them.
Oh, that's no good.
How about we go to that
24-hour breakfast place
and get some pancakes?
I would like that very much.
- Hello, Dr. Glassman.
- Hello.
- I delivered a baby.
- Yes, we heard.
I'm sorry I couldn't drive you
to your appointment.
How did it go?
I have meningitis.
I have to have surgery later today
to fix the CSF leak in my head.
I thought you should know.
That's good.
Meningitis is definitely
not as bad as cancer.
It also explains your memory loss.
Now you can get your license back.
Shaun, would you mind
if Glassy gave you a hug?
I think that would be very nice.
Very proud of you.