Transplant (2020–…): Season 3, Episode 1 - Episode #3.1 - full transcript
I know you were a
trauma surgeon back home.
What do you say to
specializing in that here?
I'm not sure that's
even an option.
You deserve to be here.
All you have to do is accept it.
Plans are underway to build
a permanent Trauma OR.
- Congratulations, Jed.
- I resigned this morning.
Today is my last day.
I'm switching residencies.
I know what Bishop meant to you.
It's actually not about
him, it's about me.
You're telling me that Marcus
had a stepdaughter
that I've never heard of.
How is that possible?
I just told my father's
17-year-old stepdaughter
that she could
come live with me. So...
I know of an organization
that matches specialists
with communities up north,
and flies them up there,
and they're always
looking for doctors.
Tonight, with Amira,
that's how I remember you.
I mean, I know
I'm busy working, but...
All you do is survive.
What else is in your life?
Hi.
Please wait until
your number is called.
Is it true we have
to take a test?
I do.
But only if we qualify,
which we'll find out today.
Are you nervous?
I'm excited.
You should be too, habibti.
If we becoming citizens,
you can vote and get a passport.
You could even run
for office one day.
Is she okay?
Bashir, what's wrong with her?
They're working on power lines
and our network keeps crashing.
Careful, ma'am.
We need to try and
stop the bleeding.
- Stop!
- He's not even breathing.
- Don't touch him.
- I know CPR.
Then you know the first thing
to do is look and listen.
- I called it in.
- That's a live power line.
It could be carrying a current.
His chest is moving. It's
shallow, but he's breathing.
And his heart is still pumping
based on the way his blood
- is pooling, so we have time.
- You're a doctor.
Paramedics are coming.
Best thing we can do
until we have all the facts
is absolutely nothing.
Uh, excuse me, ma'am, I noticed
you're having difficulty breathing.
I was wondering if you
needed any help. I'm a doctor.
I take medication
for high blood pressure.
Okay. Are you having
any pain in your chest?
- Yes.
- Why don't you drink this
and I can check your pulse?
I'm Bashir.
- I'm Rose.
- Hey, Rose.
- How long have you been waiting?
- Hmm! All morning.
I'm supposed to take
my citizenship test.
Uh, my sister and I are
just starting the process.
- We came here from Syria.
- Jamaica.
But I came in 1993.
Why did it take you
so long to apply?
Uh... I'm sorry,
that's none of my business.
I raised a family here,
I'm totally assimilated.
But being in this room...
Reminds you that you aren't.
Mm.
There was nothing you could've
done to save his life.
- Everyone says that.
- I mean it.
I'm a psychiatrist,
but I'm also an MD.
His neck broke on impact.
There was no fixing that.
Uh, my therapist in Sudbury
thinks I'm ready
to see patients again.
Well, you're not running
from what happened.
A good sign.
Coming back is the right call,
- as long as you're vigilant.
- Vigilant?
I mean, I'm...
I'm doing everything I can
to process what happened.
A man died.
And you spent nine days
alone in the woods.
It'll take longer than a
month to work through that.
So if you find yourself
needing help, speak up.
Ah, what a mess.
His blood vessels are a pretty
abstract arrangement.
- You good?
- I can figure it out.
Retracting the mesenteric
portal vein.
- Easy does it.
- Watch the ducts.
Good. Now start dissecting.
With technique like that,
Ajay should be begging you
to stay on as Chief Resident.
Well, I mean one term
is standard.
I guess he just figured
someone else was up.
Lost interest, you mean.
I will too, if you don't apply
for my GI fellowship spot.
Is that even open
to fourth years?
If they deserve it.
Okay, let's close.
Internal cardiac defibrillator.
Test model versus
grapefruit. 80 joules.
Holy!
Mags?
Do we need to get you
a med student
to help organize this...
- What are you doing?
- I'm comparing the ICD device
we're studying to the ones
already on the market.
Ours delivers a more
consistent shock
while leaving a smaller
physical footprint,
but the leads are prone
to shifting...
We're not adding a citrus
column to our study data.
And that would be "no"
to the med student.
I have my own system.
Uh-huh.
- Is she okay?
- Yeah, she'll be fine.
That's it?
You're not even gonna tell
me what's wrong with her?
It wasn't her heart,
she's just afraid.
Of what?
Dr. Curtis?
Did your security
company reach you?
Apparently, your alarm went off.
No, but I think I know
who the intruder is.
- Everything okay?
- Yeah.
Okay. Do you mind?
Um, Mr. Lee here presented
with nausea
and a fever after feeling
ill at work.
Meaning I threw up during
the sales presentation
I flew into town to make.
Some business trip...
Do you still have
your appendix, Mr. Lee?
I thought that too, but there was no
guarding when I pressed on the right.
- Ah!
- Mm.
Don't forget Rovsing's sign.
Sometimes, when you press on the
left and the appendix reveals itself...
Referred pain. So imaging
to confirm and call up to OR?
You know what,
they're wall to wall right now,
so what if you see how long
the wait is and get back to me?
Thank you.
Bash? Action out front.
Some kind of accident
down the street.
Excuse me.
Alexander Gordon, 42 years old,
electrocuted on a power line.
BP 80 over 60,
rate's 130. GCS 10.
His 02 Sats are 80 %. He's
tachy, and his temp's way up.
Hyperthermia is common
with electrical burns.
No evidence of surface burns,
I did a quick neurological
exam, but he'll need CT.
His femur's shattered
and I don't know for sure,
but I think there's
fluid in his belly.
I'll call ortho for the femur
and tell Dr. Novak
we need Trauma OR.
Dr. Devi, are you okay?
People don't fall from
the sky every day.
I'll meet you in there.
- C-arm's in position.
- Everyone, hands off.
We'll need 2 large bore IVs.
Activate MTP and prep
one gram TXA.
Sats are falling!
- 32 French, Claire, hemopneumo.
- Where am I?
You're at York Memorial
Hospital, Alex. Try not to move.
- Pack with fresh gauze.
- Why does it hurt to breathe?
Probably for a lot of reasons. At a minimum,
it's because your lung is collapsed.
We're going to put in something
called a chest tube.
How are you doing, Alex?
- It hurts!
- Why does it hurt so bad?
10mg morphine.
We're going to give you
something for the pain, Alex,
try to remain
as still as possible.
Waiting on film and putting
in a chest tube, boss.
Your call in Trauma OR,
Dr. Novak.
Image is up.
That explains the fluid
in his abdomen.
Looks like his
pancreas is melting.
The current needed
somewhere to land.
It has to come out here. Now.
Any less invasive options to
consider before major surgery?
Not if we want to avoid the
infection due to dead tissue.
- Well, let's get him prepped.
- Dr. Hamed, you're gonna assist.
Claire, see if Ortiz
from General's available,
or if he knows anybody
good who is.
You've resected
a pancreas before?
We'll walk him through it.
Okay, you got your
hands full, Claire.
I will page Ortiz.
Alex, the electrical current
caused severe damage
to your pancreas.
We need to take it out
right now, okay?
- No, no, no!
- I need Callum, where's Callum?
If we don't do this right now,
you're going to die.
- Do you und...
- He's seizing!
Hypocalcaemia from the
pancreatic injury can cause seizures.
I have to intubate.
Dr. Novak, this can't wait.
Okay, let's get Ativan and
calcium to calm the seizure.
Let's go!
Yeah, I apologize,
it was a mistake.
It's just that my...
new roommate
forgot her alarm codes.
So, yeah, you know, it's fine.
Just, uh, send me the bill.
Does Shay know you're
calling her your roommate?
Well, it's that or
father-stepdaughter, so...
What about "sister"?
So that's going well.
You know she's
in university, right?
- Mm-hmm.
- I mean, by then,
I'd been alone for years.
I feel like she should
be fully formed.
Why do I think you were
born fully formed?
- You miss the action down here?
- Yeah, sometimes.
But in cardiology, when
I learn a patient's name,
I actually get to use it again.
- That's right!
- You know, I keep forgetting.
Not everyone prefers their
patients unconscious.
Nope.
Talk about
a life-changing shock.
Hm?
Pancreas guy. You
removed the whole thing?
- Yeah, had to.
- Crazy.
- There he is. Hey!
- No welcome back banner?
Nice to see your face, Habibi.
Theo! Oh my God!
- Oh! Hey, June.
- Hey.
Alright, fire away.
I promise after three
weeks with my parents
and my children
taking care of me,
I can answer all of
your questions.
Okay, so the hair and the
beard, is that really a good idea?
Rhoda? Can I get a word?
Oh, yeah, sure.
Anyone know her story?
No, I'm not an emerg
doc anymore, you know.
She's not even my chief,
why should I know, you know?
Her residency was
in hospital medicine.
But her last job was in Portland,
where she worked for the state,
overhauling patient records...
She has a PhD in public health,
strong policy background.
And most of her publishing
has been on patient-led
approaches to care.
Bishop was here 30 years and
she's never even run an ED?
I think that's the point.
30 years of the same system.
My guess is they're trying
to think more progressive.
All I know is that
I was gone a month
and the world is upside down.
New boss, Mags left the emerg
and Bash, is it true you're
leaving to become a surgeon?
Uh, I'd be doing a dual
residency, half in emerg,
half in Trauma OR
with Dr. Novak.
Yeah, about that, are
they making you start
- in surgery as a first year?
- Well, they better not.
He was a trauma surgeon
before he came here
and he's more than
proved himself.
Hey, Rhoda, do you have
a 20 on Faye Conrad?
She's the patient from our study
whose ICD went off
and triage paged me down.
Oh yeah, waiting in Exam Four.
And Bash? Recovery's
asking for you.
Pancreas guy woke up
and the nurses are saying
that he doesn't "feel"
like himself.
Welcome back, Theo.
Good to be back.
Hey, did it work out
at immigration?
That was today, right?
Yeah, they'll uh, they'll let
us know if we qualify.
And the surgery thing,
I wasn't, you know...
Like, I don't even know
if that's how you feel.
Seems like you usually
have a pretty clear idea.
Well, sometimes. And other times,
you're like a brick wall, and I
never know which version to expect.
Once you figure
it out, let me know.
Mr. Gordon, how are you feeling?
Like a person who can't
get enough air.
Uh, your lung re-collapsed
during surgery.
Oh...
Are you the doctor who operated?
One of them.
Then you should know, you made
it worse by removing our pancreas.
Your lung was injured
during the fall.
It wasn't affected
by the surgery.
We're easing you onto
medication that will supplement
the pancreatic function you lost
when we removed the organ.
Which he didn't want you to do.
Alex, the nurses tell me
you're not feeling
like yourself?
Are you feeling confused?
Uh, you had a seizure, that
could be a common side-effect.
I'm not confused
and I'm not Alex.
- You're not.
- I'm Callum.
Callum, that's who you were
asking for before the surgery.
No, that's who Alex
was asking for.
You should've waited for me
to get here before removing
an organ we both now
have to live without.
Thanks for doing this, Claire.
I'll send you a bill.
As an American, the fact that
you can't is still wild to me.
Hey, if I was a
civilian, not the chief,
how long do you think
I would've waited?
Today?
Uh, five hours maybe.
- That's hard to estimate.
- Claire? Uh, Mr. Lee?
Upstairs is full, and uh,
Novak wants you in Trauma OR.
Alright, thank you.
You manage the nurses,
assist in trauma OR,
and still have time
to see your own patients?
When I qualified
as a nurse practitioner,
I was encouraged to
carve out my own role.
I just wanna make sure we're
not spreading you too thin.
One minute I'm browsing
frying pans,
the next I'm on the floor
looking up at a store manager
who's convinced I'm dead,
poor thing.
Well, poor you too. What
does 80 joules feel like?
Like getting kicked
by a horse from the inside.
Well, according
to your remote monitoring,
the device read
an unstable rhythm
and sent a shock to correct it.
How do you feel now?
Honestly, relieved.
When my doctor first told me
I had this heart condition,
he made it seem like I could
drop dead any second.
Well, left ventricle failure
is a daunting diagnosis, Faye.
One that took ten years to get.
It wasn't until he referred
me to Dr. Fisher's study
that I finally felt
some sense of hope.
And now... this
thing saved my life.
And with that privilege,
you get to answer
a slew of questions for me.
Starting with:
were there any warning signs
- before the device went off?
- Um, maybe a slight headache.
- Okay.
- And this morning,
I felt a bit dizzy and faint,
but no more than usual.
Okay, do you normally
feel dizzy and faint?
On and off
for the last few weeks.
I thought it was my body
getting used to the ICD.
Why didn't you call or come in?
You know how it is, by the
time you actually see someone,
you feel better and you've lost
six hours of your life
and annoyed the doctors.
Faye, you have a direct
line to us now.
The whole point of being
in the study is so we can track
- your reaction to the device.
- Sorry.
After ten years
of being told to go away,
I guess I have a bit
of unlearning to do.
Well, you better start now,
because I'm sending you up
for labs to make sure
everything's okay. Right?
I slept late and you put
the alarm on when you left.
When I opened the door,
it went off
and I couldn't find my code
or my phone!
- So you just decided to bail?
- I panicked!
I thought you could just turn
it off remotely or something.
Shay, I was in surgery. I'm
not just lounging around here
- waiting to fix your mistakes.
- Sorry, okay?
Don't you have friends
at school, phones,
- you're always on your phone!
- I didn't see my friends
'cause I didn't exactly
get to school.
- I'm sorry, what?
- I was studying for this exam
last night, then I realized
what's the point to get a career
coding apps for corporations
destroying the climate
so I can afford a betta fish
and a studio apartment?
- You're dropping out?
- No, no!
I don't know!
I'm just upset today
and I'm trying to explain to you
why I screwed up with the alarm.
Look, if this living
arrangement thing
is gonna work,
you're gonna have to put
all that aside for long
enough to learn an alarm code.
Easy for you to say, your
life's already under control.
Mine's chaos.
What is that?
I als... I also
forgot my keys.
So I tried to get the window
open to get back inside,
- but then, it broke...
- Seriously?!
I know, it was stupid.
Unbelievable.
No, don't do that.
Okay look, it's fine.
It's fine. You're...
Gonna have a nurse
redress that, properly.
Then you can meet me at home.
- We have to go downstairs.
- Mm.
Jackson Tate. 20.
BP is 140 over 110,
saturation is 90% and falling.
Airway obstruction.
We tried to tube him,
but whatever he
ingested got in the way.
What the hell is that?
Jackson, can you squeeze
my hand? It's okay, it's okay.
O2's down to 82. He's
cyanotic and hypoxic.
I'll page RT.
Every second gets us closer
to brain damage, alright?
- We tube him now.
- Unsedated?
- Dr. Hunter!
- Let's get him up.
I need an intubation kit
and three "medas".
Alright, good. Let's get this
down all the way.
Jackson? Jackson.
Look at me.
I'm gonna put a tube
in your throat.
To help you breathe, okay?
It will hurt, but
it will be fast.
Okay.
Theo, we're hurting him.
I'm almost in.
I'm in!
Guess some adrenaline kicked in.
Uh, let's get him
sedated and on a vent.
Try to figure out
what he swallowed.
Your uh, your lung
keeps collapsing.
The pancrectomy was more urgent,
but you need
an intervention called...
VATS pleurodesis. I
heard the nurses. No.
No more surgeries.
Alex, you have to understand...
- Callum.
- Sorry.
Callum, you're
straining to breathe.
If we don't do this now,
it's only going to get worse.
- You see?
- He won't hear me.
Callum, we weren't aware
of you at first,
we were working with the
part of you that goes by Alex.
Now you were both in danger
and Dr. Hamed acted
on the best information
he had at the time.
And now, I want him to stop.
Callum, without surgery,
you won't be able to breathe
on your own, we'll
have to intubate you
- and ventilate you...
- Stop threatening me!
Dissociative identity
disorder is forged by trauma.
Alex had a tough fight
with leukemia as a kid.
Out of the system since 2010.
Now people who heal from DID
work in co-operation with their parts,
like an internal family.
He likely has a number of parts
and what happened today
caused someone else to front.
Meaning, re-fracture?
That must be terrifying.
Will Alex come back?
Maybe. Eh, it's
impossible to know.
But if Callum can't breath,
why won't he let me help him?
Although Alex may have been
building a functional life,
triggers can send patients back
to the bottom of the pyramid.
Maslow's hierarchy.
And Callum's role
is just basic survival.
Protecting the family
from the trauma.
It's all he'll allow
himself to want.
Callum's a bit like...
any loved one advocating
for a patient
who thinks we aren't
hearing him.
The system takes a while
to get used to you.
Speaking of interesting puzzles,
Mark Novak wants you skipping
two years of training,
but the surgeons upstairs
want you at square one.
Where are you with all this?
'Cause I know you've already
started over once.
I'm just grateful for
the opportunity.
Well, Callum Gordon is telling
us exactly what he wants.
- I say we listen.
- No, but refusing the surgery
means risking his life, is he
capable of making that decision?
Dr. Mitchell seems
to think so.
So you want me doing nothing,
even though we know
how to help him.
Callum is here to protect Alex,
and you are the enemy
who re-traumatized him.
I did what I had to do
to save his life.
Callum's... Alex's...
You were there!
Yes! And I've been watching
and you are a "lose-the-limb-to-save-the-life"
kind of doctor.
Our patient is alive
because of that.
But at the cost of
not trusting you.
If he's telling us that,
we're gonna respect it.
Some day trip, the guy didn't
even bring a change of clothes.
Metz.
Okay, I've divided the obliques,
can I get a retractor,
please, Claire?
Entering the peritoneum...
Bowel's clear.
You're having some trouble
with exposure.
Maybe the appendix
is retroperitoneal?
Not a test, Dr. Curtis.
No, I found it, I'm just
trying to bring it out.
- Mm-hmm.
- End tidal's good,
hemodynamics stable.
How much longer?
I think we need about 20.
- Is that good for you, Dr...?
- Svensson.
I need some labs.
My eyes are on the monitor.
Alright, I'm just about
ready to ligate.
Stapler.
Dr. Curtis?
Look.
- Uh, he's awake?
- What?
That's not possible.
Is he feeling everything
I'm doing?
- Everyone, just stay calm.
- June, especially you.
- Svensson?
- On it.
It's okay, Alvin.
- It's gonna be fine.
- No. No, no. We have to stop.
No, the last thing he needs
is for us to start over.
Svensson, get him
under. Deep under.
Claire, we need dedicated eyes
on him until we close.
June?
Will you need me to take over?
No, I'm fine, just...
Let me know when we're
ready to go back in.
Okay.
"Pericarditis" made
my heart stop?
It means inflammation of the
sac that surrounds your heart.
That's never happened
to me before.
- What causes it?
- Sometimes infection,
sometimes an autoimmune
disorder.
And your bloodwork is showing
a positive ANA marker,
- which points to the latter.
- I have a heart condition
- and an autoimmune disorder?
- Well, that's the thing.
It looks like your heart
condition was actually
just a side effect of your
autoimmune disorder.
Why has nobody caught
this before?
Because you had such
a wide array of symptoms.
I mean, these things can take
years to get narrowed down
- and yours still isn't.
- What Dr. Leblanc is saying
is you have the marker,
but you'll need a whole new
testing regimen to isolate
what's actually wrong.
Can we start that now?
What does this mean for me?
Unfortunately, Faye, what we've
learned disqualifies you from our study.
We have to refer you
to a rheumatologist
- to find a diagnosis...
- No! I had a diagnosis!
I know this is so frustrating,
but the parameters of our study
are limited to heart condition.
You'll keep the ICD.
We'll report any
remote monitoring
to your rheumatologist
or your family doctor.
Do you know what he said
when you signed me on?
That he was relieved,
because he didn't know
what else to do with me.
Like I was some piece of paper
he didn't know where to file.
Is there anything
you can do for me?
I'm so sorry, Faye.
Care to explain why you asked me
to schedule a surgery
your patient's refusing?
I just thought if he heard it
coming from you...
Oh.
What, he still won't agree?
Even though he's on
the road to cyanosis.
And not a fan of yours or any
procedure you've recommended.
Then there's the fact that all
of this stems from Trauma OR.
Dr. Curtis is well aware
of my feelings on the topic,
- aren't you, June?
- Oh, yeah.
"Messes downstairs
for surgery to clean up."
Like an appendectomy patient
waking up on the table?
We re-sedated and we closed.
Anyways, this is an "us"
problem, not a "you" problem.
You better put distance
between yourself
and that circus while trying
to land a specialization.
Dr. Singh...
If I ask psych to reconsider
a hold, would you sign off?
You really want to fight that
and force this guy into surgery?
I don't want to fight,
but we have to do something.
And a man looking to re-invent
himself as a surgeon
should be coming to me
with solutions,
not creating more problems.
With me, June!
Oh, June.
It means walk apace.
That was a complete mess before.
It happens 1 in every
600 times in the OR.
In the OR, we have workflow
and consistency! Okay?
Here, it's like every time there's a
new anesthesiologist or radiology tech,
- we have no procedures in place.
- It's early days.
We're working out the kinks.
Every time, there's a "kink",
my reputation with my
surgical bosses takes a hit.
Oh! Yeah, you care about that!
Whatever. Are you
going to tell him?
You know, the patient who woke
up to us slicing through his organs.
No, we both are.
Our new boss wants us
to listen to him
"process the experience,"
whatever that means.
Hence, with me, June.
Dr. Novak,
code blue. Dr. Novak...
Actually, with me later, June!
- Talk to me.
- Faye Conrad!
She was being monitored
for pericarditis.
She was fine,
then she stopped breathing.
Push one mg Epi.
- How long?
- Two minutes!
What's going on here?
Massive pericardial effusion
and no activity on the monitor.
- Pressure's 70 over 30!
- Cardiac tamponade.
There isn't enough time to drain
her. She needs a thoracotomy.
- You wanna crack her?
- You gotta back that up.
Faster access, faster drainage.
She'll bleed out if we don't.
Call RT for intubation and
let's find out whose patient this is.
- O-neg! Four more units, Rhoda!
- On it.
What is this?!
Welcome to the party,
Dr. Leblanc.
Making an incision through
the pericardium from apex to base,
- medial to the phrenic nerve.
- Your patient was in tamponade!
- Pericardial effusion.
- Her ICD kicked in,
but there was too much fluid
for it to do its job properly.
Did you even
try draining first?!
We were too busy trying
to save her life.
She's arresting!
Starting cardiac massage!
Pressure's not coming up!
Can I get a light, Rhoda?
Suction.
You're gonna let us in
on your thinking?
You shifted one of the
leads when you opened her.
It's piercing a ventrical wall.
Can you reach the perforation?
It's a single wound, I think.
Plugging it with my finger.
Don't stop compressions!
- Pressure's coming up.
- Quick thinking, Dr. Leblanc.
- Rhoda.
- We're gonna need
a proper cardiac surgeon to
patch the hole in the ventricle.
- Mags...
- What the hell, Bash!
I acted on instinct!
I was trying to save her life!
Without even thinking
about the risks,
and now, you have her heart
in your hands!
You two, don't move. Let's get
her prepped to go upstairs.
I don't know how long
I was awake,
I just... I couldn't talk,
or move.
That's the paralytic that
we give you to make sure
that you don't accidentally
shift when we're operating.
At first, it felt like pressure,
but then it was searing pain.
Like... Like being on fire.
Unfortunately, sir, you had
a non-standard response
to a standard anesthesia dosage.
Hold on, Mark... We're here
to listen to Mr. Lee.
I tried to... say something.
Tell you to stop,
but I... couldn't.
I had to lay there, trapped...
feeling every cut
until one of you noticed.
Hi, Faye.
How are you feeling?
They told me you saved my life.
The cardiac surgeon said
the repair went well.
But you still don't know
what's really wrong with me?
No, not yet. No.
You know I'm a teacher, right?
Yeah. Yeah, uh,
eight-grade English.
In our unit on mythology,
we do Prometheus.
Sentenced to have his liver
pecked out each day
- by an eagle.
- Faye, don't...
He must've prayed for death.
You don't know what it's like
to be the person
people give up on.
Actually, I do, though.
I've been right where you are,
as a patient, with my own heart.
That's why I turned my
whole career upside down
to do this kind of
work. So I know.
How can you say that when
you're giving up on me?!
You said you'd be there for me.
I guess that was never real.
No more retro challenges, guys.
It was pretty scary,
but I made it.
Jackson, you unhooked
the pulse ox
and took your oxygen off
yourself?!
Just needed a better angle.
Your throat suffered a trauma,
and we're still
monitoring your oxygen.
Guys, say hi to the doctor
who just pulled
a full pack of slime
from my throat.
- Hey!
- This is why this happened?
You were eating slime for
likes? You could've died!
I know! I'm trying not
to think about it! Okay?
By putting yourself at risk
for the validation of strangers?
I took the pulse thing
off for a second.
And they're not strangers! Even
if it is stupid, they care!
Hey. Is everything
okay in here?
Just... keep this on,
so we know you're
circulating oxygen.
And no more filming.
Hospital policy.
I... I was calm during
the conscious intubation.
Just something about seeing
him remove his monitoring
to post some video,
it just sort of set me off.
I get it. Just the
word "influencer"
is enough to enrage me.
Thank you for sitting down
with our psychiatrist.
Most doctors are
piss poor at self-care.
Clearly, I can't afford to be.
Let me know if you need
anything else.
- Yes, yeah.
- Great.
- Salam, Bashir.
- Salam, Saleh.
Okay, so things are still quiet?
Yeah, things are still quiet.
Almost no bombings
or fighting in months.
I mean... no.
I might be able to travel
again soon, so I thought...
Home?
Bashir, I was kidding.
Even with the ceasefire,
they can still arrest you.
I know. I guess I just liked
the idea of letting
my mind wander...
I'll call you later, khouya.
Hey. You wanted to know
about Callum Gordon.
He's still refusing surgery,
but the intensivist says that
they can't wait much longer.
So they're going
to intubate him?
When he loses
consciousness, they will.
Sounds like maybe... 20 minutes?
- Okay, thank you.
- Mm-hmm.
Hey, look...
You were right earlier when
you said I didn't hear you.
Okay, I wasn't listening,
so you came out to protect Alex
and I understand why
you did that, because...
Look, there's a
part of me too that...
There's a part of me too
that all it knows
is how to survive.
Okay, I'm trying to move
pass that, but sometimes...
I can't.
I meant to save Alex,
but I hurt him.
I tried to go around you
to get to him.
And that was wrong.
But if you let me try,
I promise I'll do everything
I can to help you protect him.
Do I have time to check
with everybody else?
Take all the time you need.
We can't disqualify Faye Conrad.
Mags, we talked about this.
The autoimmune disorder
rules her out.
If she came to us now, yes.
But she was undiagnosed before,
and our ethics board approval
says anything that develops
during the course
of our study has to be included.
Meaning side effects
from the device,
not pre-existing conditions.
You're asking me to keep
her on a technicality?
No, I'm asking you to admit
this is a moral grey area
and that this woman needs us.
Fine.
Is this going to be a problem?
This desire you have
to go all in?
I just want what's best
for the patients.
And I don't like being
backed into a corner.
New intakes on your desk, all
need comprehensive histories.
On it.
Hey.
- Hey.
- Tough first day back?
I mean, the new chief
let me off the hook
for losing it on a patient
because I'm a victim.
Theo, you did almost die.
I just walked...
through the woods.
Nine days. That's it.
There was no animals
to fight-off, no...
no rock faces
to climb, I just...
Worst part was
the cold at night.
Walked until my
phone found a signal.
What if I just... I don't...
know how to feel anymore.
I'm modifying a protocol
guide from another Trauma OR.
Oh yeah? Are you being
proactive for Dr. Devi?
Prostrating us like that
was ridiculous.
I mean, I don't envy
our new boss.
She's only here because
the hospital has to pay
lip service to progress.
- What do you want, June?
- What do you mean?
- What's next for you?
- Well, I keep saying
that I'm in a "one
more year" residency,
but really, I'm just ignoring
the fact that I do have
to pick a specialty, so I think
I'm just gonna go with Roche.
Man, they really did
a number on you.
You've forgotten what it's
like to be on the surgical floor?
Walking on eggshells
around egos,
eating it day in day out
until you're one giant callus.
Yeah, pretty much.
You know, if you're looking
for a mentor, that is not me.
But if you want a place
a little less malignant,
why not Trauma OR?
Like as a specialization?
We're one of only a
handful of Trauma ORs
in all of North America. You'll
be getting in on the ground floor.
It's not gonna be a sterile
pristine fellowship or anything,
but I watched you muscle through
a pretty rough situation today.
I don't know,
I thought maybe you'd
be down for some chaos.
Hmm.
Maybe I am.
Wow.
Biting on the hard sell.
Alright. Why don't you
look over these protocols,
while I figure out if I can
actually offer you the job?
Oh, Devi's gonna want
to see them by tomorrow.
- Thought you were off!
- No. The overnight RN manager
- called in sick, so round two.
- Oh!
- What are those?
- Patient satisfaction survey.
Dr. Devi wants us handing
them out at every discharge.
Oh, and you told her that that
would place a time-consuming burden
on nurses beyond our
contractual duties. Right?
Sounds like a job
for the RN manager.
- See you tomorrow, Claire.
- See you.
- Come in, Dr. Hamed. Um...
- Find a place to...
Here, let me.
Oh no, that's okay.
Callum Gordon agreed to surgery.
And I hear that's
because of you.
I don't tend to give up.
I know you and my
predecessor were close.
Dr. Bishop is the reason
I'm a doctor here.
You know, I grew up with
"grateful for the opportunity".
My parents came to California
from the Fiji Islands
where my mother was an engineer
which was very unusual
for women in those days, and
she'd say the exact same thing,
even though it was soul-sucking,
just re-proving the skills
she already had.
I know you want to be
a trauma surgeon again.
I am... a trauma surgeon.
Everything changed
when I came here
and I'm just trying
to reclaim some of it.
Trauma OR's a place
for bold action,
and that is a skill
you clearly have.
But taking time to listen
before you jump in,
that's where you have
things to learn.
- Dr. Devi...
- I want us re-thinking
our entire approach
to patient interaction,
and that means making
some changes, and I'm...
I'm sorry, Bashir,
but for you, that means
not training as a surgeon.
You know you can send these
digitally now, right?
Where's the fun in that?
So?
There are some hoops
to jump through still,
but... we qualify.
Oh my God, that's
amazing, right?
- Yeah.
- So are we like celebrating
on an actual date?
Is that...
I feel like we should see the
world outside of your apartment.
Because I need to be sure...
You know, a person could make
a romantic assumption
about a movie ticket.
trauma surgeon back home.
What do you say to
specializing in that here?
I'm not sure that's
even an option.
You deserve to be here.
All you have to do is accept it.
Plans are underway to build
a permanent Trauma OR.
- Congratulations, Jed.
- I resigned this morning.
Today is my last day.
I'm switching residencies.
I know what Bishop meant to you.
It's actually not about
him, it's about me.
You're telling me that Marcus
had a stepdaughter
that I've never heard of.
How is that possible?
I just told my father's
17-year-old stepdaughter
that she could
come live with me. So...
I know of an organization
that matches specialists
with communities up north,
and flies them up there,
and they're always
looking for doctors.
Tonight, with Amira,
that's how I remember you.
I mean, I know
I'm busy working, but...
All you do is survive.
What else is in your life?
Hi.
Please wait until
your number is called.
Is it true we have
to take a test?
I do.
But only if we qualify,
which we'll find out today.
Are you nervous?
I'm excited.
You should be too, habibti.
If we becoming citizens,
you can vote and get a passport.
You could even run
for office one day.
Is she okay?
Bashir, what's wrong with her?
They're working on power lines
and our network keeps crashing.
Careful, ma'am.
We need to try and
stop the bleeding.
- Stop!
- He's not even breathing.
- Don't touch him.
- I know CPR.
Then you know the first thing
to do is look and listen.
- I called it in.
- That's a live power line.
It could be carrying a current.
His chest is moving. It's
shallow, but he's breathing.
And his heart is still pumping
based on the way his blood
- is pooling, so we have time.
- You're a doctor.
Paramedics are coming.
Best thing we can do
until we have all the facts
is absolutely nothing.
Uh, excuse me, ma'am, I noticed
you're having difficulty breathing.
I was wondering if you
needed any help. I'm a doctor.
I take medication
for high blood pressure.
Okay. Are you having
any pain in your chest?
- Yes.
- Why don't you drink this
and I can check your pulse?
I'm Bashir.
- I'm Rose.
- Hey, Rose.
- How long have you been waiting?
- Hmm! All morning.
I'm supposed to take
my citizenship test.
Uh, my sister and I are
just starting the process.
- We came here from Syria.
- Jamaica.
But I came in 1993.
Why did it take you
so long to apply?
Uh... I'm sorry,
that's none of my business.
I raised a family here,
I'm totally assimilated.
But being in this room...
Reminds you that you aren't.
Mm.
There was nothing you could've
done to save his life.
- Everyone says that.
- I mean it.
I'm a psychiatrist,
but I'm also an MD.
His neck broke on impact.
There was no fixing that.
Uh, my therapist in Sudbury
thinks I'm ready
to see patients again.
Well, you're not running
from what happened.
A good sign.
Coming back is the right call,
- as long as you're vigilant.
- Vigilant?
I mean, I'm...
I'm doing everything I can
to process what happened.
A man died.
And you spent nine days
alone in the woods.
It'll take longer than a
month to work through that.
So if you find yourself
needing help, speak up.
Ah, what a mess.
His blood vessels are a pretty
abstract arrangement.
- You good?
- I can figure it out.
Retracting the mesenteric
portal vein.
- Easy does it.
- Watch the ducts.
Good. Now start dissecting.
With technique like that,
Ajay should be begging you
to stay on as Chief Resident.
Well, I mean one term
is standard.
I guess he just figured
someone else was up.
Lost interest, you mean.
I will too, if you don't apply
for my GI fellowship spot.
Is that even open
to fourth years?
If they deserve it.
Okay, let's close.
Internal cardiac defibrillator.
Test model versus
grapefruit. 80 joules.
Holy!
Mags?
Do we need to get you
a med student
to help organize this...
- What are you doing?
- I'm comparing the ICD device
we're studying to the ones
already on the market.
Ours delivers a more
consistent shock
while leaving a smaller
physical footprint,
but the leads are prone
to shifting...
We're not adding a citrus
column to our study data.
And that would be "no"
to the med student.
I have my own system.
Uh-huh.
- Is she okay?
- Yeah, she'll be fine.
That's it?
You're not even gonna tell
me what's wrong with her?
It wasn't her heart,
she's just afraid.
Of what?
Dr. Curtis?
Did your security
company reach you?
Apparently, your alarm went off.
No, but I think I know
who the intruder is.
- Everything okay?
- Yeah.
Okay. Do you mind?
Um, Mr. Lee here presented
with nausea
and a fever after feeling
ill at work.
Meaning I threw up during
the sales presentation
I flew into town to make.
Some business trip...
Do you still have
your appendix, Mr. Lee?
I thought that too, but there was no
guarding when I pressed on the right.
- Ah!
- Mm.
Don't forget Rovsing's sign.
Sometimes, when you press on the
left and the appendix reveals itself...
Referred pain. So imaging
to confirm and call up to OR?
You know what,
they're wall to wall right now,
so what if you see how long
the wait is and get back to me?
Thank you.
Bash? Action out front.
Some kind of accident
down the street.
Excuse me.
Alexander Gordon, 42 years old,
electrocuted on a power line.
BP 80 over 60,
rate's 130. GCS 10.
His 02 Sats are 80 %. He's
tachy, and his temp's way up.
Hyperthermia is common
with electrical burns.
No evidence of surface burns,
I did a quick neurological
exam, but he'll need CT.
His femur's shattered
and I don't know for sure,
but I think there's
fluid in his belly.
I'll call ortho for the femur
and tell Dr. Novak
we need Trauma OR.
Dr. Devi, are you okay?
People don't fall from
the sky every day.
I'll meet you in there.
- C-arm's in position.
- Everyone, hands off.
We'll need 2 large bore IVs.
Activate MTP and prep
one gram TXA.
Sats are falling!
- 32 French, Claire, hemopneumo.
- Where am I?
You're at York Memorial
Hospital, Alex. Try not to move.
- Pack with fresh gauze.
- Why does it hurt to breathe?
Probably for a lot of reasons. At a minimum,
it's because your lung is collapsed.
We're going to put in something
called a chest tube.
How are you doing, Alex?
- It hurts!
- Why does it hurt so bad?
10mg morphine.
We're going to give you
something for the pain, Alex,
try to remain
as still as possible.
Waiting on film and putting
in a chest tube, boss.
Your call in Trauma OR,
Dr. Novak.
Image is up.
That explains the fluid
in his abdomen.
Looks like his
pancreas is melting.
The current needed
somewhere to land.
It has to come out here. Now.
Any less invasive options to
consider before major surgery?
Not if we want to avoid the
infection due to dead tissue.
- Well, let's get him prepped.
- Dr. Hamed, you're gonna assist.
Claire, see if Ortiz
from General's available,
or if he knows anybody
good who is.
You've resected
a pancreas before?
We'll walk him through it.
Okay, you got your
hands full, Claire.
I will page Ortiz.
Alex, the electrical current
caused severe damage
to your pancreas.
We need to take it out
right now, okay?
- No, no, no!
- I need Callum, where's Callum?
If we don't do this right now,
you're going to die.
- Do you und...
- He's seizing!
Hypocalcaemia from the
pancreatic injury can cause seizures.
I have to intubate.
Dr. Novak, this can't wait.
Okay, let's get Ativan and
calcium to calm the seizure.
Let's go!
Yeah, I apologize,
it was a mistake.
It's just that my...
new roommate
forgot her alarm codes.
So, yeah, you know, it's fine.
Just, uh, send me the bill.
Does Shay know you're
calling her your roommate?
Well, it's that or
father-stepdaughter, so...
What about "sister"?
So that's going well.
You know she's
in university, right?
- Mm-hmm.
- I mean, by then,
I'd been alone for years.
I feel like she should
be fully formed.
Why do I think you were
born fully formed?
- You miss the action down here?
- Yeah, sometimes.
But in cardiology, when
I learn a patient's name,
I actually get to use it again.
- That's right!
- You know, I keep forgetting.
Not everyone prefers their
patients unconscious.
Nope.
Talk about
a life-changing shock.
Hm?
Pancreas guy. You
removed the whole thing?
- Yeah, had to.
- Crazy.
- There he is. Hey!
- No welcome back banner?
Nice to see your face, Habibi.
Theo! Oh my God!
- Oh! Hey, June.
- Hey.
Alright, fire away.
I promise after three
weeks with my parents
and my children
taking care of me,
I can answer all of
your questions.
Okay, so the hair and the
beard, is that really a good idea?
Rhoda? Can I get a word?
Oh, yeah, sure.
Anyone know her story?
No, I'm not an emerg
doc anymore, you know.
She's not even my chief,
why should I know, you know?
Her residency was
in hospital medicine.
But her last job was in Portland,
where she worked for the state,
overhauling patient records...
She has a PhD in public health,
strong policy background.
And most of her publishing
has been on patient-led
approaches to care.
Bishop was here 30 years and
she's never even run an ED?
I think that's the point.
30 years of the same system.
My guess is they're trying
to think more progressive.
All I know is that
I was gone a month
and the world is upside down.
New boss, Mags left the emerg
and Bash, is it true you're
leaving to become a surgeon?
Uh, I'd be doing a dual
residency, half in emerg,
half in Trauma OR
with Dr. Novak.
Yeah, about that, are
they making you start
- in surgery as a first year?
- Well, they better not.
He was a trauma surgeon
before he came here
and he's more than
proved himself.
Hey, Rhoda, do you have
a 20 on Faye Conrad?
She's the patient from our study
whose ICD went off
and triage paged me down.
Oh yeah, waiting in Exam Four.
And Bash? Recovery's
asking for you.
Pancreas guy woke up
and the nurses are saying
that he doesn't "feel"
like himself.
Welcome back, Theo.
Good to be back.
Hey, did it work out
at immigration?
That was today, right?
Yeah, they'll uh, they'll let
us know if we qualify.
And the surgery thing,
I wasn't, you know...
Like, I don't even know
if that's how you feel.
Seems like you usually
have a pretty clear idea.
Well, sometimes. And other times,
you're like a brick wall, and I
never know which version to expect.
Once you figure
it out, let me know.
Mr. Gordon, how are you feeling?
Like a person who can't
get enough air.
Uh, your lung re-collapsed
during surgery.
Oh...
Are you the doctor who operated?
One of them.
Then you should know, you made
it worse by removing our pancreas.
Your lung was injured
during the fall.
It wasn't affected
by the surgery.
We're easing you onto
medication that will supplement
the pancreatic function you lost
when we removed the organ.
Which he didn't want you to do.
Alex, the nurses tell me
you're not feeling
like yourself?
Are you feeling confused?
Uh, you had a seizure, that
could be a common side-effect.
I'm not confused
and I'm not Alex.
- You're not.
- I'm Callum.
Callum, that's who you were
asking for before the surgery.
No, that's who Alex
was asking for.
You should've waited for me
to get here before removing
an organ we both now
have to live without.
Thanks for doing this, Claire.
I'll send you a bill.
As an American, the fact that
you can't is still wild to me.
Hey, if I was a
civilian, not the chief,
how long do you think
I would've waited?
Today?
Uh, five hours maybe.
- That's hard to estimate.
- Claire? Uh, Mr. Lee?
Upstairs is full, and uh,
Novak wants you in Trauma OR.
Alright, thank you.
You manage the nurses,
assist in trauma OR,
and still have time
to see your own patients?
When I qualified
as a nurse practitioner,
I was encouraged to
carve out my own role.
I just wanna make sure we're
not spreading you too thin.
One minute I'm browsing
frying pans,
the next I'm on the floor
looking up at a store manager
who's convinced I'm dead,
poor thing.
Well, poor you too. What
does 80 joules feel like?
Like getting kicked
by a horse from the inside.
Well, according
to your remote monitoring,
the device read
an unstable rhythm
and sent a shock to correct it.
How do you feel now?
Honestly, relieved.
When my doctor first told me
I had this heart condition,
he made it seem like I could
drop dead any second.
Well, left ventricle failure
is a daunting diagnosis, Faye.
One that took ten years to get.
It wasn't until he referred
me to Dr. Fisher's study
that I finally felt
some sense of hope.
And now... this
thing saved my life.
And with that privilege,
you get to answer
a slew of questions for me.
Starting with:
were there any warning signs
- before the device went off?
- Um, maybe a slight headache.
- Okay.
- And this morning,
I felt a bit dizzy and faint,
but no more than usual.
Okay, do you normally
feel dizzy and faint?
On and off
for the last few weeks.
I thought it was my body
getting used to the ICD.
Why didn't you call or come in?
You know how it is, by the
time you actually see someone,
you feel better and you've lost
six hours of your life
and annoyed the doctors.
Faye, you have a direct
line to us now.
The whole point of being
in the study is so we can track
- your reaction to the device.
- Sorry.
After ten years
of being told to go away,
I guess I have a bit
of unlearning to do.
Well, you better start now,
because I'm sending you up
for labs to make sure
everything's okay. Right?
I slept late and you put
the alarm on when you left.
When I opened the door,
it went off
and I couldn't find my code
or my phone!
- So you just decided to bail?
- I panicked!
I thought you could just turn
it off remotely or something.
Shay, I was in surgery. I'm
not just lounging around here
- waiting to fix your mistakes.
- Sorry, okay?
Don't you have friends
at school, phones,
- you're always on your phone!
- I didn't see my friends
'cause I didn't exactly
get to school.
- I'm sorry, what?
- I was studying for this exam
last night, then I realized
what's the point to get a career
coding apps for corporations
destroying the climate
so I can afford a betta fish
and a studio apartment?
- You're dropping out?
- No, no!
I don't know!
I'm just upset today
and I'm trying to explain to you
why I screwed up with the alarm.
Look, if this living
arrangement thing
is gonna work,
you're gonna have to put
all that aside for long
enough to learn an alarm code.
Easy for you to say, your
life's already under control.
Mine's chaos.
What is that?
I als... I also
forgot my keys.
So I tried to get the window
open to get back inside,
- but then, it broke...
- Seriously?!
I know, it was stupid.
Unbelievable.
No, don't do that.
Okay look, it's fine.
It's fine. You're...
Gonna have a nurse
redress that, properly.
Then you can meet me at home.
- We have to go downstairs.
- Mm.
Jackson Tate. 20.
BP is 140 over 110,
saturation is 90% and falling.
Airway obstruction.
We tried to tube him,
but whatever he
ingested got in the way.
What the hell is that?
Jackson, can you squeeze
my hand? It's okay, it's okay.
O2's down to 82. He's
cyanotic and hypoxic.
I'll page RT.
Every second gets us closer
to brain damage, alright?
- We tube him now.
- Unsedated?
- Dr. Hunter!
- Let's get him up.
I need an intubation kit
and three "medas".
Alright, good. Let's get this
down all the way.
Jackson? Jackson.
Look at me.
I'm gonna put a tube
in your throat.
To help you breathe, okay?
It will hurt, but
it will be fast.
Okay.
Theo, we're hurting him.
I'm almost in.
I'm in!
Guess some adrenaline kicked in.
Uh, let's get him
sedated and on a vent.
Try to figure out
what he swallowed.
Your uh, your lung
keeps collapsing.
The pancrectomy was more urgent,
but you need
an intervention called...
VATS pleurodesis. I
heard the nurses. No.
No more surgeries.
Alex, you have to understand...
- Callum.
- Sorry.
Callum, you're
straining to breathe.
If we don't do this now,
it's only going to get worse.
- You see?
- He won't hear me.
Callum, we weren't aware
of you at first,
we were working with the
part of you that goes by Alex.
Now you were both in danger
and Dr. Hamed acted
on the best information
he had at the time.
And now, I want him to stop.
Callum, without surgery,
you won't be able to breathe
on your own, we'll
have to intubate you
- and ventilate you...
- Stop threatening me!
Dissociative identity
disorder is forged by trauma.
Alex had a tough fight
with leukemia as a kid.
Out of the system since 2010.
Now people who heal from DID
work in co-operation with their parts,
like an internal family.
He likely has a number of parts
and what happened today
caused someone else to front.
Meaning, re-fracture?
That must be terrifying.
Will Alex come back?
Maybe. Eh, it's
impossible to know.
But if Callum can't breath,
why won't he let me help him?
Although Alex may have been
building a functional life,
triggers can send patients back
to the bottom of the pyramid.
Maslow's hierarchy.
And Callum's role
is just basic survival.
Protecting the family
from the trauma.
It's all he'll allow
himself to want.
Callum's a bit like...
any loved one advocating
for a patient
who thinks we aren't
hearing him.
The system takes a while
to get used to you.
Speaking of interesting puzzles,
Mark Novak wants you skipping
two years of training,
but the surgeons upstairs
want you at square one.
Where are you with all this?
'Cause I know you've already
started over once.
I'm just grateful for
the opportunity.
Well, Callum Gordon is telling
us exactly what he wants.
- I say we listen.
- No, but refusing the surgery
means risking his life, is he
capable of making that decision?
Dr. Mitchell seems
to think so.
So you want me doing nothing,
even though we know
how to help him.
Callum is here to protect Alex,
and you are the enemy
who re-traumatized him.
I did what I had to do
to save his life.
Callum's... Alex's...
You were there!
Yes! And I've been watching
and you are a "lose-the-limb-to-save-the-life"
kind of doctor.
Our patient is alive
because of that.
But at the cost of
not trusting you.
If he's telling us that,
we're gonna respect it.
Some day trip, the guy didn't
even bring a change of clothes.
Metz.
Okay, I've divided the obliques,
can I get a retractor,
please, Claire?
Entering the peritoneum...
Bowel's clear.
You're having some trouble
with exposure.
Maybe the appendix
is retroperitoneal?
Not a test, Dr. Curtis.
No, I found it, I'm just
trying to bring it out.
- Mm-hmm.
- End tidal's good,
hemodynamics stable.
How much longer?
I think we need about 20.
- Is that good for you, Dr...?
- Svensson.
I need some labs.
My eyes are on the monitor.
Alright, I'm just about
ready to ligate.
Stapler.
Dr. Curtis?
Look.
- Uh, he's awake?
- What?
That's not possible.
Is he feeling everything
I'm doing?
- Everyone, just stay calm.
- June, especially you.
- Svensson?
- On it.
It's okay, Alvin.
- It's gonna be fine.
- No. No, no. We have to stop.
No, the last thing he needs
is for us to start over.
Svensson, get him
under. Deep under.
Claire, we need dedicated eyes
on him until we close.
June?
Will you need me to take over?
No, I'm fine, just...
Let me know when we're
ready to go back in.
Okay.
"Pericarditis" made
my heart stop?
It means inflammation of the
sac that surrounds your heart.
That's never happened
to me before.
- What causes it?
- Sometimes infection,
sometimes an autoimmune
disorder.
And your bloodwork is showing
a positive ANA marker,
- which points to the latter.
- I have a heart condition
- and an autoimmune disorder?
- Well, that's the thing.
It looks like your heart
condition was actually
just a side effect of your
autoimmune disorder.
Why has nobody caught
this before?
Because you had such
a wide array of symptoms.
I mean, these things can take
years to get narrowed down
- and yours still isn't.
- What Dr. Leblanc is saying
is you have the marker,
but you'll need a whole new
testing regimen to isolate
what's actually wrong.
Can we start that now?
What does this mean for me?
Unfortunately, Faye, what we've
learned disqualifies you from our study.
We have to refer you
to a rheumatologist
- to find a diagnosis...
- No! I had a diagnosis!
I know this is so frustrating,
but the parameters of our study
are limited to heart condition.
You'll keep the ICD.
We'll report any
remote monitoring
to your rheumatologist
or your family doctor.
Do you know what he said
when you signed me on?
That he was relieved,
because he didn't know
what else to do with me.
Like I was some piece of paper
he didn't know where to file.
Is there anything
you can do for me?
I'm so sorry, Faye.
Care to explain why you asked me
to schedule a surgery
your patient's refusing?
I just thought if he heard it
coming from you...
Oh.
What, he still won't agree?
Even though he's on
the road to cyanosis.
And not a fan of yours or any
procedure you've recommended.
Then there's the fact that all
of this stems from Trauma OR.
Dr. Curtis is well aware
of my feelings on the topic,
- aren't you, June?
- Oh, yeah.
"Messes downstairs
for surgery to clean up."
Like an appendectomy patient
waking up on the table?
We re-sedated and we closed.
Anyways, this is an "us"
problem, not a "you" problem.
You better put distance
between yourself
and that circus while trying
to land a specialization.
Dr. Singh...
If I ask psych to reconsider
a hold, would you sign off?
You really want to fight that
and force this guy into surgery?
I don't want to fight,
but we have to do something.
And a man looking to re-invent
himself as a surgeon
should be coming to me
with solutions,
not creating more problems.
With me, June!
Oh, June.
It means walk apace.
That was a complete mess before.
It happens 1 in every
600 times in the OR.
In the OR, we have workflow
and consistency! Okay?
Here, it's like every time there's a
new anesthesiologist or radiology tech,
- we have no procedures in place.
- It's early days.
We're working out the kinks.
Every time, there's a "kink",
my reputation with my
surgical bosses takes a hit.
Oh! Yeah, you care about that!
Whatever. Are you
going to tell him?
You know, the patient who woke
up to us slicing through his organs.
No, we both are.
Our new boss wants us
to listen to him
"process the experience,"
whatever that means.
Hence, with me, June.
Dr. Novak,
code blue. Dr. Novak...
Actually, with me later, June!
- Talk to me.
- Faye Conrad!
She was being monitored
for pericarditis.
She was fine,
then she stopped breathing.
Push one mg Epi.
- How long?
- Two minutes!
What's going on here?
Massive pericardial effusion
and no activity on the monitor.
- Pressure's 70 over 30!
- Cardiac tamponade.
There isn't enough time to drain
her. She needs a thoracotomy.
- You wanna crack her?
- You gotta back that up.
Faster access, faster drainage.
She'll bleed out if we don't.
Call RT for intubation and
let's find out whose patient this is.
- O-neg! Four more units, Rhoda!
- On it.
What is this?!
Welcome to the party,
Dr. Leblanc.
Making an incision through
the pericardium from apex to base,
- medial to the phrenic nerve.
- Your patient was in tamponade!
- Pericardial effusion.
- Her ICD kicked in,
but there was too much fluid
for it to do its job properly.
Did you even
try draining first?!
We were too busy trying
to save her life.
She's arresting!
Starting cardiac massage!
Pressure's not coming up!
Can I get a light, Rhoda?
Suction.
You're gonna let us in
on your thinking?
You shifted one of the
leads when you opened her.
It's piercing a ventrical wall.
Can you reach the perforation?
It's a single wound, I think.
Plugging it with my finger.
Don't stop compressions!
- Pressure's coming up.
- Quick thinking, Dr. Leblanc.
- Rhoda.
- We're gonna need
a proper cardiac surgeon to
patch the hole in the ventricle.
- Mags...
- What the hell, Bash!
I acted on instinct!
I was trying to save her life!
Without even thinking
about the risks,
and now, you have her heart
in your hands!
You two, don't move. Let's get
her prepped to go upstairs.
I don't know how long
I was awake,
I just... I couldn't talk,
or move.
That's the paralytic that
we give you to make sure
that you don't accidentally
shift when we're operating.
At first, it felt like pressure,
but then it was searing pain.
Like... Like being on fire.
Unfortunately, sir, you had
a non-standard response
to a standard anesthesia dosage.
Hold on, Mark... We're here
to listen to Mr. Lee.
I tried to... say something.
Tell you to stop,
but I... couldn't.
I had to lay there, trapped...
feeling every cut
until one of you noticed.
Hi, Faye.
How are you feeling?
They told me you saved my life.
The cardiac surgeon said
the repair went well.
But you still don't know
what's really wrong with me?
No, not yet. No.
You know I'm a teacher, right?
Yeah. Yeah, uh,
eight-grade English.
In our unit on mythology,
we do Prometheus.
Sentenced to have his liver
pecked out each day
- by an eagle.
- Faye, don't...
He must've prayed for death.
You don't know what it's like
to be the person
people give up on.
Actually, I do, though.
I've been right where you are,
as a patient, with my own heart.
That's why I turned my
whole career upside down
to do this kind of
work. So I know.
How can you say that when
you're giving up on me?!
You said you'd be there for me.
I guess that was never real.
No more retro challenges, guys.
It was pretty scary,
but I made it.
Jackson, you unhooked
the pulse ox
and took your oxygen off
yourself?!
Just needed a better angle.
Your throat suffered a trauma,
and we're still
monitoring your oxygen.
Guys, say hi to the doctor
who just pulled
a full pack of slime
from my throat.
- Hey!
- This is why this happened?
You were eating slime for
likes? You could've died!
I know! I'm trying not
to think about it! Okay?
By putting yourself at risk
for the validation of strangers?
I took the pulse thing
off for a second.
And they're not strangers! Even
if it is stupid, they care!
Hey. Is everything
okay in here?
Just... keep this on,
so we know you're
circulating oxygen.
And no more filming.
Hospital policy.
I... I was calm during
the conscious intubation.
Just something about seeing
him remove his monitoring
to post some video,
it just sort of set me off.
I get it. Just the
word "influencer"
is enough to enrage me.
Thank you for sitting down
with our psychiatrist.
Most doctors are
piss poor at self-care.
Clearly, I can't afford to be.
Let me know if you need
anything else.
- Yes, yeah.
- Great.
- Salam, Bashir.
- Salam, Saleh.
Okay, so things are still quiet?
Yeah, things are still quiet.
Almost no bombings
or fighting in months.
I mean... no.
I might be able to travel
again soon, so I thought...
Home?
Bashir, I was kidding.
Even with the ceasefire,
they can still arrest you.
I know. I guess I just liked
the idea of letting
my mind wander...
I'll call you later, khouya.
Hey. You wanted to know
about Callum Gordon.
He's still refusing surgery,
but the intensivist says that
they can't wait much longer.
So they're going
to intubate him?
When he loses
consciousness, they will.
Sounds like maybe... 20 minutes?
- Okay, thank you.
- Mm-hmm.
Hey, look...
You were right earlier when
you said I didn't hear you.
Okay, I wasn't listening,
so you came out to protect Alex
and I understand why
you did that, because...
Look, there's a
part of me too that...
There's a part of me too
that all it knows
is how to survive.
Okay, I'm trying to move
pass that, but sometimes...
I can't.
I meant to save Alex,
but I hurt him.
I tried to go around you
to get to him.
And that was wrong.
But if you let me try,
I promise I'll do everything
I can to help you protect him.
Do I have time to check
with everybody else?
Take all the time you need.
We can't disqualify Faye Conrad.
Mags, we talked about this.
The autoimmune disorder
rules her out.
If she came to us now, yes.
But she was undiagnosed before,
and our ethics board approval
says anything that develops
during the course
of our study has to be included.
Meaning side effects
from the device,
not pre-existing conditions.
You're asking me to keep
her on a technicality?
No, I'm asking you to admit
this is a moral grey area
and that this woman needs us.
Fine.
Is this going to be a problem?
This desire you have
to go all in?
I just want what's best
for the patients.
And I don't like being
backed into a corner.
New intakes on your desk, all
need comprehensive histories.
On it.
Hey.
- Hey.
- Tough first day back?
I mean, the new chief
let me off the hook
for losing it on a patient
because I'm a victim.
Theo, you did almost die.
I just walked...
through the woods.
Nine days. That's it.
There was no animals
to fight-off, no...
no rock faces
to climb, I just...
Worst part was
the cold at night.
Walked until my
phone found a signal.
What if I just... I don't...
know how to feel anymore.
I'm modifying a protocol
guide from another Trauma OR.
Oh yeah? Are you being
proactive for Dr. Devi?
Prostrating us like that
was ridiculous.
I mean, I don't envy
our new boss.
She's only here because
the hospital has to pay
lip service to progress.
- What do you want, June?
- What do you mean?
- What's next for you?
- Well, I keep saying
that I'm in a "one
more year" residency,
but really, I'm just ignoring
the fact that I do have
to pick a specialty, so I think
I'm just gonna go with Roche.
Man, they really did
a number on you.
You've forgotten what it's
like to be on the surgical floor?
Walking on eggshells
around egos,
eating it day in day out
until you're one giant callus.
Yeah, pretty much.
You know, if you're looking
for a mentor, that is not me.
But if you want a place
a little less malignant,
why not Trauma OR?
Like as a specialization?
We're one of only a
handful of Trauma ORs
in all of North America. You'll
be getting in on the ground floor.
It's not gonna be a sterile
pristine fellowship or anything,
but I watched you muscle through
a pretty rough situation today.
I don't know,
I thought maybe you'd
be down for some chaos.
Hmm.
Maybe I am.
Wow.
Biting on the hard sell.
Alright. Why don't you
look over these protocols,
while I figure out if I can
actually offer you the job?
Oh, Devi's gonna want
to see them by tomorrow.
- Thought you were off!
- No. The overnight RN manager
- called in sick, so round two.
- Oh!
- What are those?
- Patient satisfaction survey.
Dr. Devi wants us handing
them out at every discharge.
Oh, and you told her that that
would place a time-consuming burden
on nurses beyond our
contractual duties. Right?
Sounds like a job
for the RN manager.
- See you tomorrow, Claire.
- See you.
- Come in, Dr. Hamed. Um...
- Find a place to...
Here, let me.
Oh no, that's okay.
Callum Gordon agreed to surgery.
And I hear that's
because of you.
I don't tend to give up.
I know you and my
predecessor were close.
Dr. Bishop is the reason
I'm a doctor here.
You know, I grew up with
"grateful for the opportunity".
My parents came to California
from the Fiji Islands
where my mother was an engineer
which was very unusual
for women in those days, and
she'd say the exact same thing,
even though it was soul-sucking,
just re-proving the skills
she already had.
I know you want to be
a trauma surgeon again.
I am... a trauma surgeon.
Everything changed
when I came here
and I'm just trying
to reclaim some of it.
Trauma OR's a place
for bold action,
and that is a skill
you clearly have.
But taking time to listen
before you jump in,
that's where you have
things to learn.
- Dr. Devi...
- I want us re-thinking
our entire approach
to patient interaction,
and that means making
some changes, and I'm...
I'm sorry, Bashir,
but for you, that means
not training as a surgeon.
You know you can send these
digitally now, right?
Where's the fun in that?
So?
There are some hoops
to jump through still,
but... we qualify.
Oh my God, that's
amazing, right?
- Yeah.
- So are we like celebrating
on an actual date?
Is that...
I feel like we should see the
world outside of your apartment.
Because I need to be sure...
You know, a person could make
a romantic assumption
about a movie ticket.