The Resident (2018–…): Season 6, Episode 6 - For Better or Worse - full transcript

- Previously on The Resident...
- Just an email Ian forwarded me.

How is everything with him?

Passed his drug test.
Operating up a storm...

Fine, I guess.

Seems crazy.

But we all cover up things
we don't want to see.

The longer we look away,

the harder it gets to see
what's right before our eyes.

I know what
will make me smile.

Showing you photos of
the exquisite venue

where in a few short weeks,



I will marry the
man of my dreams.

Sorry, everyone.

It's the governor's office.
I have to take this.

Okay, let's, uh, just
give her a minute.

Sure, yeah. Let's,
uh, let's all take five.

Daddy, when's Sammie
gonna be here?

She and Jake are on their way.

And they're bringing
your flower girl dresses

for the ceremony tonight,
isn't that exciting?

Yeah!

So, when is he available?

Well, I certainly
hope so. Thank you.

Everything all right?

Our new governor's been
avoiding my calls all week



and now his office won't
even set a meeting.

He's probably too busy
making plans to slash funding

for public hospitals
like Chastain.

And it'll be hard to change his
mind if he keeps dodging me.

I know you're worried,
but we'll figure it out.

Just not today.

I know we will.

And I won't let anything
spoil this evening.

Hi. - Boo!

Hi,
everyone, sorry we're so late.

- Oh...
- Not at all.

Oh, it's lovely to see you.

I'm just sorry Gregg
couldn't make it.

- Yeah.
- Glad you could make it.

Oh, unfortunately,
our luggage did not.

Airline lost our bags.

Oh, no.

Our dresses were in them.

- But I want to be a flower girl.
- That's okay,

Oh, sweetie.

It's Tracy Laybourne.

I believe God created voice
mail for times like this.

Tracy, good morning.

Ms. Laybourne is a tech
mogul from Silicon Valley,

and one of the few
prospective donors

who could keep us afloat
if our funding gets cut.

Randolph, I'm
glad you picked up.

I thought you might
be in surgery.

Actually, uh, I
took the day off.

Is everything okay?

It's my daughter.

She's not feeling well.

Okay, uh, tell me
what's going on.

Well, we were on our
way to the aquarium

and Max started feeling

sluggish and sweaty.

Incredibly tired.

I think she needs to see a
doctor, and you're the only one

- I know in Atlanta.
- Okay, sounds as though

she needs an internist. I can

send our best to meet
you at Chastain ER

and I'll be there
as soon as I can.

Thanks.

Conrad, can you take a
look at Tracy's daughter?

- I-I could, but I...
- Go. I'll watch Gigi.

- I mean, I took the day off.
- Uh, the girls

do need new flower girl dresses

and I need a new suit.

Great. So we'll
divide and conquer.

You go get your suit

and I'll take our
little ladies shopping.

Meet back here.

You don't have to do this.

I can get a sitter.

Are you kidding
me? It'll be fun.

Shouldn't we finish
the rehearsal?

Oh, thank you, Lindsay, but
Randolph and I already have

a few weddings between
us, so I think we're good.

I'll get him back in one piece.

You, not so fast.

What was that for?

That was my last kiss
as a single woman.

And mine as a single man.

Heart sounds are normal.

And lungs are clear.

You're gonna be okay.

We'd be more than
happy to bring in

a sign language interpreter.

Oh, no need. I can translate.

And Max is a great lip reader.

Besides,

most interpreters can barely
keep up with my daughter.

Yeah.

You are too fast.

She's chatty.

Last month, it was
dinosaurs, and then

ancient history, and now...

sea creatures.

And sharks.

Sounds like you've
got it covered.

If you need anything,
let me know.

Oh, thank you.

Were Max's eyes
this yellow when she

- woke up today?
- Hmm.

I don't think so.
Is that serious?

No, there's no
reason to be alarmed.

Could mean a lot of things.

I'll rush some labs,
find out what's going on.

All right,
this is the place.

Oh...

Okay, so we have choices.

I like this one!

Kit said you guys can wear
whatever you like tonight.

So I want each of you to
pick out your favorites

and then we can try them on.

I like this one!

Can I try this one?

- Yay!
- Yeah!

Who is that walking in the door?

Dr. Bell here on
his wedding day?

I can't believe it.

Did Dr. Voss change
her mind already?

Well, thankfully, Kit has
not come to her senses yet,

so I expect to see all of you

- at our ceremony this evening.
- Oh, I would not miss it.

How's Tracy's daughter?

Her liver enzymes just came back

and they're off the charts.

How high are we talking?

So high the lab ran
them three times.

Her INR is 2.0.

She's going into liver failure.

And fast. We need
to move faster.

All right, I'll talk with Tracy

while you get Max
a bed in the ICU.

And I'll bring Ian up to speed.

If we can't figure out the cause
and reverse it fast enough,

- there's only one thing that will keep Max alive.
- Transplant.

Wait...

- my daughter may need a liver transplant?
- I'm...

I'm sorry. I wish
we had better news.

Come on, honey. Let's go.

-Take that thing out. We're getting out of here.
-We need to get her

to the ICU right away to monitor
her labs and mental status.

That's the only way to know how
fast her liver is worsening.

You know what, no offense, but I
brought Max here for a checkup,

not a transplant.

We both know that this hospital
is in financial trouble

and that's why you
reached out to me.

- I'll explain in the car.
- Tracy,

I would strongly advise
against moving her.

This has nothing to do
with you helping Chastain.

Max is critically ill.

Her condition could
change at any moment

and moving her in this state is
a risk I would not recommend.

Okay, right.

Listen.

My daughter was born
with her hearing.

But at six months old
she got an infection

and the hospital I took her
to was wildly underfunded.

They sent her home
with an antibiotic

and completely missed the
fact that she had meningitis.

That's how Max lost her hearing.

Yes.

I donate to hospitals
like Chastain

because they need the help.

But I won't let my
daughter get harmed again.

And I just had my
assistant get the number

of the best pediatric
surgeon in the country.

All right. Let's go, honey.

And we've no idea
what caused this?

Not acetaminophen, I checked.

You started her on
NAC, to be safe?

And a battery of tests.

My daughter deserves the
best and that's exactly

- who she'll be seeing.
- What's the deal?

We've got a problem.

Hello, this is Dr. Sullivan.

Hello?

You're here.

I am.

But I can't talk right now.

I'm about to meet
my next patient.

Hi.

So what happens now?

Well, first,

you have to trust me.

I do.

And I'm sorry.

- I just...
- There's no apology necessary.

Dr. Sullivan will
keep Max stable

while Dr. Hawkins does his
damnedest to try and figure out

why her liver is failing.

We find the cause,

then maybe we can treat Max

and avoid a
transplant altogether.

Give me the real.

You're not here because
the outlook is positive.

Things don't go our way,
we can list Max with UNOS,

get a liver from
a deceased donor.

But that will take time.

There is another option.

Transplant the lobe
of a living donor.

Someone related to Max who can

give a part of
their liver to her.

So, you could make
a list of relatives,

just in case,
people we can call.

There-There's no one else.

No father in the picture
and I have no siblings.

It has always just
been me and Max.

So if she needs a liver,

I will give her part of mine.

Okay. I can take
you to the lab

and get some blood drawn
to see if you're a match

and walk you through

- next steps on the way.
- Okay.

Portal vessels are patent.

Good flow. No sign of clot.

Which would be a good
thing, but, right now...

We still don't have the cause.

- Viral studies back yet?
- Well,

hep B and C are both negative.

Loss of appetite could indicate
worsening liver failure.

Or it could mean...

You don't like Jell-O?

I always get the "E" wrong.

You know how to sign?

A little.

Hey, sweetie.

How are you feeling?

Mm.

So, we can't go home yet.

Right?

The doctors,

they're gonna try to help me

to help you.

By... letting me

give a part of me to you.

You remember when you had

that Mr. and Mrs. Potato Head?

And she could give her ears

or her nose to him?

It's kind of like that.

Of course. I will
be fine, sweetie.

Your mom's liver will grow back.

That's pretty cool, huh?

That was pretty
impressive in there.

When did you learn ASL?

I took a class in college.

I don't remember that much,

but I do remember my
favorite was "microwave."

Oh.

Wait. Hold-hold on.

Do these nails match the dress
I saw in the back of your car?

I got them done for tonight.

I thought you said you weren't
a wedding kind of girl.

I... I believe
your words were...

"weddings are
a special kind of torture."

Yes. But I am looking
forward to this one.

Bell and Kit invited me.

Not just as your plus-one.

Think I'm finally
part of the group.

Means a lot to me.

Me too.

Don't tell me you've been
tweeting at the governor

- all morning.
- You know me too well.

Full disclosure, I also
follow you on social media

and I saw for
myself.

This-this is how you relax?

Says the man treating
patients on his wedding day.

How's the girl?

She may need a liver transplant,

but we just found out
her mom is a match.

That's great news.
Keep me posted.

Of course.

After this echo, you should
be cleared to donate.

Mm.

Nice ink
game, by the way.

Yeah, back in my 20s, I was
big into the music scene.

- And then Max was born.
- Mm.

Now I'm a little... quieter.

She's an amazing kid.

I started my company 'cause I
wanted to give her everything,

and... now I can.

Yeah, well, family is
a powerful motivator.

Mm. Mm.

What is it?

The echo
is showing signs

of critical aortic stenosis.

It's a severe narrowing in
the valve that brings blood

from your heart to your body.

Uh, I have been more
short of breath lately.

Tiring more easily.

Well, an aortic valve
replacement should fix that.

But it is major.

Your heart is going to need
some time to recover before you

can safely donate
part of your liver.

All right, well, how much time?

Weeks.

Maybe months.

But Dr. Bell said that
Max may need a liver soon.

And I'm saying that if we
attempt a transplant now,

you could die on the table.

No, but...

I have to save my daughter.

I can't live without her.

She's my whole world.

So, we will find another way.

What did you find out?

Nothing.

We have no idea why this
kid's liver's failing.

No Kayser-Fleischer
rings in her eyes.

No evidence of Wilson's.

Autoimmune serologies
are... they're pending.

But it's unlikely, and hepatitis
labs came back negative.

Well, we have to hurry,
'cause I just talked to AJ

and Tracy can't donate.

Max's coags are climbing.

She could start
bleeding internally

- at any moment.
- Well, just double down.

Try harder. If you can't figure
out why Max's liver's failing

and we have no donor...

this child could die.

Aunt Billie?

What will you wear
for your wedding?

You know, not
everyone gets married.

If you do, can we
pick your dress?

Is your daddy gonna
get married again?

I don't know.

He has a girlfriend.

Do you like her?

She's okay.

She's not like my mommy.

I mean, I don't
remember my mommy,

but it's different.

I remember your mommy.

She was really nice.

She was a nurse when I was sick.

She took great care of me.

I wish I remembered her.

There she is.

The woman of the hour.

- I'm not married yet.
- No, but you're trending on Twitter.

Yeah. Right behind the
latest banana muffin craze

and a bunny dancing on
a bed to the Beatles.

Hey, that bunny is talented.

Governor Betz has got to
be feeling the pressure

to meet with you now.

So far, no word.

But I did get a call from
a local news station.

They want to interview
me live on-air later.

And I'm actually considering
it, on my wedding day.

You're really
worried about this.

If we lose the millions
the governor plans to cut,

Chastain will become
a third-rate hospital,

and I can't stand that.

I wish I could help.

Gregg and I owe so
much to Chastain.

If it wasn't for you and Bell
and all the doctors there,

we wouldn't have Sammie.

I wouldn't have a family.

Oh!

What do you think?

- Wow.
- I love them.

They're perfect.

- Sammie insisted we try on every dress in Atlanta.
- Mm-hmm.

You know, your daughter
is very persuasive.

Yeah. Who could say
no to that face?

You're right.

Who could say no to that face?

When did this start?

A few minutes ago.

I'm ordering blood and plasma.

I'll reexamine
her belly. Hang on.

Let just see what's going on.

Mm...

So what's the plan?

Well, for now, we try
and keep her stable

while we hope UNOS moves
her up the donor list.

But that's a long
shot, isn't it?

Tell me the truth.

There's a chance a liver
may not come in time.

No.

But I am here.

I don't care about the risks.

Let me donate.

- Your heart can't tolerate...
- What my heart

can't tolerate is
losing my daughter.

I'll write a check.

How much?

- Just tell me.
- Tracy...

You don't get to
tell me that I...

can't risk
my life for her.

I am her mother.

She's in A fib.

I'll page Dr. Austin.

What did you tell her?

I told I'm gonna help her.

Don't make a liar out of me.

All right. Her A
fib has slowed,

but the rapid rate has landed
her in pulmonary edema.

Tracy's in even worse
shape than we thought.

How much time you think we
have before Max's liver fails?

Based on what I've seen so far,

she has days, at best.

Look, I wasn't enthusiastic
about racing Tracy

through a TAVR even when
she was in better shape.

But now you want me to
take her to the cath lab

while she's in heart failure?

Dr. Austin, the sooner
you repair the valve,

the sooner she can recover
and be ready for a transplant.

Organ donation
from living donors

is supposed to be low-risk.

That's how we justify it.

I can't risk the mom's life.

- Randolph, you hear me.
- I do.

As surgeons, we don't risk
a living person's life

to give their organs
to someone else.

Not to mention the guilt

the child will feel if the
mother died saving her.

I'm not gonna make
that child an orphan.

Max doesn't get a liver, she
doesn't have a future at all.

It's your call, AJ.

If you can get Tracy
cleared for surgery,

I'll operate with you.

But whatever you decide,
you have my full support.

I just reached
the damaged valve.

And now I will deploy
the bioprosthetic.

And once it opens,

you should be able
to breathe easier.

Oh...

And after this?

After this, you rest.

The new valve should
make your heart relax

and the fluid in
your lungs go down.

And then I can donate

if Max doesn't get better?

We're all hoping that
Dr. Hawkins can figure out

what's going on with your
daughter so you won't have to.

But, yes,

if she doesn't
improve by tomorrow,

we will proceed
with the transplant.

Thank you.

For giving my daughter a chance.

- Here you are.
- Wheelchair to the cafeteria.

Hey.

I need fresh eyes.
You got a minute?

As long as it doesn't
involve more ear wax removal.

I wish it did.

I got a sick girl.
Ten years old.

Previously healthy with rapidly
progressive liver failure.

Worsening coagulopathy.

- What have you ruled out?
- Ischemia,

toxic ingestions, viral
causes, autoimmune.

Did you send CMV?

Three times.

An anti-smooth muscle antibody?

Negative.

Family history?

Not that we know of.

Uh, any ingestions?
She's a kid,

maybe she was outside.

No poison mushroom in the woods.

So you really have ruled
everything out, haven't you?

I think we both
know what this is.

It's idiopathic. We can't find

the cause of Max's liver failure
and we'll likely never know.

Words I never thought I'd
live to hear you say, Hawkins.

Well, in over 20% of
hepatic failure cases,

we never find the reason.

Well, if we don't
know the cause,

that means it could
recur after transplant.

Yeah. But it's highly unlikely
based on everything I ruled out.

And we all know she'll
die without a new liver.

Of that, we can be sure.

So we turn our attention
to Tracy and hope that

she can recover in time
for us to attempt...

- We'll have less than we ever had.
- transplant.

It's important people understand
Governor Betz's budget cuts

will have an impact
beyond Chastain,

when the population we
serve overcrowds the rest

of Atlanta hospitals.
A burden...

Aren't you marrying
that woman today, Bell?

I certainly hope so.

Dr. Voss, I understand

there's a former patient
with you who would like

to say a word to the governor.

That's right.

You ready?

Hi. I'm Sammie.

And when I was seven,
I got really sick.

Everyone gave up on me.

But the doctors at
Chastain never did.

They saved my life.

Without them, I wouldn't have

a bicycle.

Or get to cook
macaronis with my dads.

And
eat way too much ice cream.

It's Max.

And play with puppies.

- She's in multisystem organ failure.
- And going into DIC.

We don't act now, she may not
make it through transplant.

- Tracy is still tenuous in the PACU.
- We all know

she'd do anything to
save her daughter.

Hawkins, can you
buy us more time?

I can't change the diagnosis.

It is now or never.

Let's get OR 1 and 2 prepped.

Meet you gentlemen there.

Bell, if you
join me in this OR,

you might not make your wedding.

No one would question
you passing this case off

to another surgeon.

Saw you
and Sammie on TV.

You were both great.

Well, we'll see if it works.

That's not why you're calling.

You're headed into
surgery, aren't you?

I just sent someone
to pick up my suit

so I can leave from here.

I should still make
it there on time.

But it'll be close.

Is that okay?

What matters most is you help
that mother and her daughter.

Besides, a surgeon saving
lives on his wedding day...

Sounds like the kind of
man I'd want to marry.

Good luck.

- Hi there.
- Hi.

Seems our online
ordering system is down.

Do you think you could please
fill this for a patient of mine?

Of course, Dr. Sullivan.

We are a little backed up.

Give me 30.

It-It's urgent.

They're all urgent today.

Right.

You know what?

I don't have time to wait.

Thanks though.

My patient said he had a
weird tingle in his toe

- for ten years.
- Pin.

Honestly, I think
he was just lonely

and he needed company.

And you need a drink.

Good thing we're
going to an open bar.

Mm-hmm.

Dr. Devi, I know you
already signed out,

but I have a pediatric
liver transplant

and you have a chance
to scrub in with me.

That sounds amazing.

But you know I'm not applying
for a peds surgery fellowship,

- right?
- You're chief surgical resident.

Let's see if you're as good
as everyone says you are.

OR. Now.

You want me to wait for you?

I'll just meet you there.

Pin.

Thanks.

I'll be there to help keep your
heart stable during the surgery.

While I procure a lobe of
liver from you for Max.

Thanks.

I overheard a nurse said
you're getting married tonight.

Right after this.
That's right.

I can't thank you enough.

Well, you don't have to.
I'm right where I belong.

Okay, I'm ready to
make the incision.

How's her heart looking?

Ejection fraction

is holding steady.

We can proceed.

This is our window. Scalpel.

I've never seen a liver
this inflamed before, Dr. Sullivan.

Does this suggest
anything about the cause?

Clamp to me.

- I'll do the portal vein and the IVC.
- Vascular clamp.

And I've got the hepatic artery.

Can we get some music in here?

Cooley clamp.

Sure, Dr. Sullivan.

Any requests?

I don't care.

Just something with a beat.

And turn it up.

Tracy's new valve is
seated beautifully,

if I do say so myself.

Not as beautiful as
this healthy liver.

Exposing and mobilizing the
right hepatic artery now.

Identifying the portal vein.

Vessel loops to me.

Vascular clamp.

Cooley clamp.

- Miltex clamp.
- Miltex clamp.

All right. Can
someone call OR 2

and ask those gentlemen
what's taking so long?

That's an excellent
graft. Thank you very much.

Vitals are weak.

Well, then we're
gonna have to work faster.

But if we slip the bile and
the... vascular connections,

this'll be all for naught.

- Damn it.
- What's wrong?

This lobe is too large.

Your colleagues are used to
doing transplants for adults.

What if we just try a
retroperitoneal dissection

to make more space?

Uh... yes, of course, Dr. Devi.

Well, we can do that.

But we shouldn't have to.

The sooner we begin,
the sooner we can close.

Hey. Why don't you get
out of here, Randolph?

I can close. I'll see you
when you're a married man.

Thanks, AJ. Appreciate it.

She's hypotensive.

MAP's in the 50s and dropping.

But we tied off all the vessels.

She must have a
bleed someplace else.

I need you back in
here with me, Bell.

I'm nearly maxed on norepi.

All right, give
me an ultrasound.

I don't see a source.

There's oozing but
no frank bleed.

That's because there's
no blood in her abdomen.

It's around her heart.

She's in tamponade.

And she's coding.

- I'll crack her chest.
- No, I don't think

there's time. I can get
there from here. Scissors.

I'm cutting through
the diaphragm.

Oh, the pericardial sac is full.

Drained the fluid.

Starting open heart massage.

An open heart
massage via the abdomen.

Damn, Bell. That's nice work.

Yeah, it's an old trick.

We still need to
find the source.

- I can't keep my arm here forever.
- All right.

Now we crack the chest.

He's still in the OR, isn't he?

I just called.

Tracy had a complication.
They're still at it.

There's no way to know how long
it'll be until Bell gets here.

Or if he makes it all.

Just a few more stitches and...

done.

How we looking?

Pressure has stabilized,

gentlemen. Yeah.

So, how's Max doing?

Early signs are good.

- And Tracy?
- Ah, she made it.

I mean, thanks to the masterful
work of the groom-to-be here.

And if his work is done,

we need to get this
man to the chapel.

- Yeah, I'm beyond late.
- All right, let's go.

I'm gonna stay.

Look out for Tracy and be here
for Max when she wakes up.

I can sign a bit.

I can reassure her till her
mom comes out of sedation.

We can get an interpreter.
You should come.

I know how much you were
looking forward to tonight.

We can't get one this late.

I've connected with this girl.

I have to stay.

All right, then
I'll stay with you.

No, I'm sorry, this is my
ICU and I'm kicking you out.

Oh, so that's how
it is now, huh?

You've known Kit and Bell
a lot longer than I have.

You should be there.

Save me some cake?

Oh, God, you look amazing.

I'm too late.

I am so sorry, Kit.

Don't be.

Everyone's still here.

I told them you
were worth the wait.

Oh, Kit.

Please be seated.

Welcome.

We're here to celebrate the love

between Randolph Bell

and Kit Voss.

They started out as colleagues,

became friends

and had the courage
to open their hearts,

take the leap

and risk it all for love.

Thank God they did.

And now the bride and groom
have prepared their vows

that they would like to share.

Go ahead, Kit.

Randolph,

you know how I like to be right.

Mm-hmm.

When I first met you, I thought

you were a bit of
an arrogant sod.

I never expected

you'd make me feel so happy,

so loved.

And I never, ever thought
you'd be my forever.

But, Randolph, you are.

And I've never been so
glad to have been so wrong.

Kit.

Thank you for
waiting for me to...

become the man I am now.

I've made some mistakes.

Most here could name a few.

And then I met someone who...

believed I could be better.

A better... surgeon.

A better stepfather.

Just a better person.

And all I could do was
just try and become

the man that somehow...

you knew I could be.

Kit, everything
that's good in me

is because of you.

Okay.

And now...

by the power vested in...

Okay.

What a day.

I can't believe
everything worked out.

Well, I think both mother and
daughter are gonna be okay,

and Tracy may want to make
sure Chastain is, too.

And I heard back from
Governor Betz's office.

He's calling a meeting
so I can make my case.

You're incredible.

I'm so proud of you, Mrs. Bell.

And I of you,

Mr. Voss.

Thank you.

Want to dance?

Yeah.

- Oh!
- Oh.

You didn't see that coming, did you?

I'm happy for them.

- Yeah, me, too.
- Mm.

Thank you for taking Gigi.

Of course.

No.

I don't say it enough.

- I'm very grateful.
- Mm.

I know it's a lot, and
you're always there,

for both of us.

It's nothing.

I love you guys.

What a night. Huh?

Yeah.

What a night.

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