Good morning.
Not so much.
- Sorry. I hate when repair guys are late. - He wasn't late.
He realized that my isolated termite presence
is actually more of a complete and total termite infestation.
I have to tent my house.
No. You had to pack up your clothes and food.
Vikane gas doesn't affect clothes,
but you should definitely throw out all your food when you go home.
Already did.
Where are you going to stay?
Stay in our guest room.
I'll stay at a hotel.
But you hate sleeping in hotels.
I hate intruding on my friends,
and I hate intruding on my friend's pregnant wives even more.
It's not an intrusion. Stay with us.
I'm okay. Thank you.
- We want to. - Absolutely. We insist.
Okay.
Thank you.
It's delicious.
- It's disgusting. - And it helps me poop.
I do not need to know that.
As a doctor, you know what prune juice does--
Shut up, I'm trying to eat.
Coffee and a Red Bull.
You prepping for a post-breakfast MMA match there, big guy?
I was up late, need a boost.
I was catching up on some journals, and I've already been to a meeting.
Check my sign-off sheet if you want.
- I didn't say anything. - You don't need to.
Wolke and Perez, you're with me.
We were scheduled with Park.
I just fired one resident, and you two are on probation.
Not exactly my vision for the department.
It's time for me to take a hands-on approach,
see how your surgical educations are progressing.
We round in five, don't be late.
I want to do another embryo transfer ASAP.
Three months is ASAP.
Not if we restart my hormone injections, add methylprednisolone,
and do prophylactic endometrial scratching.
Aggressive uterine prep means more side effects.
I can handle it.
Morgan, I understand your impatience,
but an unsuccessful embryo transfer is--
I wanna do whatever it takes.
Now. Not in three months.
Okay.
We'll start the hormones and the methylprednisolone today.
I have a new idea.
The echo results were that bad?
Your heart muscle's deteriorating way too fast.
We don't have time to wait for a matching donor.
We'll fix the one you have.
We're going to remove the scar tissue,
and use a synthetic patch with healthy tissue
to reshape your ventricle over a balloon.
It's kind of like paper maché.
If that's possible, why didn't we do it sooner?
It's a challenging technique...
Which makes it right in Dr. Lim's wheelhouse.
But I'm confident it's the best option for your situation.
This surgery is amazing. How did you come up with it?
I didn't. It's a modified Dor Procedure,
basically, an endoventricular patch plasty.
There is nothing basic about it. I'm excited.
- Spare me. - What?
Stroking my ego isn't going to get you off of probation.
I am not stroking your ego, I am sincerely--
Start with a DE-MRI to map the scar versus functional tissue,
while I finalize the surgical plan.
Dr. Perez, what do I need from this MRI?
Completely pristine images of right ventricular scarring
without artifact or distortion.
No room for error on this.
There's a small mass.
Her pediatrician said it was a cyst.
He doesn't think she needs surgery, but suggested we get a consult.
She definitely needs surgery.
It's a minor outpatient procedure.
She's only 13, with no previous symptoms. It's most likely benign.
We will need to do a needle biopsy, and CT to confirm.
- What's a needle biopsy? - It's kind of like a shot.
In my belly?
Honey, it's okay. You'll be fine.
Mom, no.
Can you do it while she's asleep?
General anesthesia would add unnecessary risk to a needle biopsy.
Please, I can't do this.
Kelli, We're gonna numb you and you'll close your eyes,
hold your mom's hand and count to ten.
And then it'll all be over.
Do you promise?
Absolutely.
This is not good.
Looks good to me.
Any end systolic volume less than 200 is within parameters.
I mean, Lim's idea for Bob's surgery.
You said it was amazing.
That's before I did research to understand it.
It's way too risky.
You're mad 'cause she called you out for brown-nosing.
I was sincerely psyched.
- After reading one article-- - I read five.
Right-sided failure has resulted in negative outcomes
in every case I've reviewed.
Lim's been treating this guy for years, knows the case way better.
She knows the patient better, which could impact her objectivity.
You want to question the chief surgeon's objectivity?
No, I want to suggest she reconsider her strategy.
I wouldn't.
Why? Because you're scared of her?
Yes. And you should be, too.
My OD and you and Powell going rogue.
I'd rather not add to...
Can you show Mr. Zegras how to apply the eye drops?
Sure, no problem.
I don't know.
I don't know. I will keep this for you.
Watch out.
Okay.
Hey.
I just closed a deal
with one of the biggest CRO's on the West Coast.
They will consolidate all their clinical trials here.
That's awesome.
Are you telling me because you plan to close the clinic
to make room for the CRO?
I have the space.
But what I don't have is a smart, aggressive, ambitious physician
to manage the partnership and serve as PI.
You interested?
- I'm flattered. - It'll be a ton of work,
but a great opportunity for St. Bon's and yourself.
I agree.
It's just a bit unexpected.
Can I think about it?
Of course.
Take some time, but not too much.
I need an answer by Friday.
There's almost no viable cardiac tissue.
And poor contractions in what little there is.
There's still an area of tissue left that could be viable after CABG.
We can't start surgery,
hoping there's enough tissue to reshape the ventricle.
That's a risk to this approach.
If you have another idea...
A BiVAD, with an unmatched donor heart.
Ruled it out.
He'd reject an unmatched heart in less than a year.
Beats dying on the table in less than 24 hours.
I appreciate your opinion, not a huge fan of the tone.
Sorry.
If we put Bob on longer-term anti-rejection meds,
that would buy more time for the unmatched heart.
During which time he'd be completely vulnerable to infection.
I know SVR is high risk,
but given Bob's condition, I'm convinced it's the only solution
to keep him alive long enough to find a matching donor heart.
I plan to spend some time rehearsing every surgical step,
I'd suggest you two do the same.
Why did you say yes?
It was one of those moments
when you say the thing a polite person is supposed to say,
even as you're realizing you don't mean it at all.
Okay. It'll be fine.
You'll be at work all day,
and at night he'll sit in a corner
and read a presidential biography.
That's... oddly specific.
Old dudes love reading about presidents.
They fantasize having done it all better.
What's wrong?
It's not a cyst.
It's an invasive hydatidiform mole.
Interesting.
That type of tumor could only occur from a mutated fertilized egg.
She has had sex.
She's only 13,
which means even if she consented, it's statutory rape.
There's a new problem. Actually two.
This type of tumor is caused by a mutation in a fertilized egg,
meaning, the surgery will be more difficult.
It also means your daughter has had sexual intercourse.
Wait, but...
I'm on birth control, and we use condoms.
- How could I be pregnant? - You're not pregnant.
The implanted egg mutated into a tumor instead of a fetus,
and no birth control is 100% effective.
But you can still remove it, right?
Yes.
You don't seem surprised to learn your daughter's had sex.
I'm not learning it.
She's been going steady with Ryan for over a year.
He's in her grade.
He's sweet.
A 13-year-old child should not be having sex.
I'm not a child, and me and Ryan love each other.
If I want to have sex, it's my decision.
You okay with this?
Teenagers will do it, no matter what their parents say.
So instead of forcing her to sneak around,
I chose to talk to her about safe sex, birth control,
and help her have a positive experience.
Your daughter is--
Scheduled for surgery tomorrow morning.
And as I deflate the balloon...
I'll remove the final clamps.
That was awesome.
Still not sure it's gonna work. But it'll definitely be exciting.
Keep the pessimism to yourself this time.
- I'm not a pessimist. I'm a realist. - Who's on probation.
I know.
Lim's a grown up.
She wants her ideas to be challenged.
It's part of our job to do it.
In recovery, we talk a lot about the value of humility.
Lim's not a higher power.
You're confusing humility with weakness.
It's Lim.
But feel free to ignore it.
Show her what a badass you are.
Hey. I haven't seen you all day.
I took it off.
Lim's covering my residents, and Kellan's in town.
We're going to see Young the Giant. I'd left these in my desk.
That'll be fun.
Fun for me. I think he'd rather be with friends.
Although, he enjoys the free tickets and beer.
Oh, God, he can drink now?
I'm sure he's been drinking for a while, but legally for a month now.
Time flies.
Faster than you'd ever imagine.
Have a good night.
Park.
Andrews closed a partnership deal with a big CRO.
He wants me to manage it and serve as PI.
Congrats.
It is a great opportunity, exactly what I've been looking for.
But it's going to mean a lot more time at work,
and I'm hoping to be a mother soon.
My favorite memories are all school plays,
baseball games, camping trips.
And my biggest regret
is that I missed way too many of those moments.
Sorry.
I wouldn't ask if I don't want to hear your answer.
You have a great job.
Maybe not the opportunity of a lifetime,
but you can have a set schedule with reasonable hours.
Seems you already have the best of both worlds.
Thanks.
- Tell Kellan I said hi. - Will do.
Kelli is prepped for tomorrow morning.
Good. We are going home.
A 13-year-old can't consent to sex, and we're obligated to report it.
You want to call the cops 'cause she had sex with her boyfriend?
No, Child Protective Services.
Just because her mom says it's okay, doesn't negate that it's statutory rape.
If two 13-year-olds have sex,
which one's the rapist, and which one's the victim?
They're both victims.
Only if they're both rapists, which doesn't make sense.
The terminology is not the issue.
She's in 7th grade, sleeps with a teddy bear.
Her mother should be required to talk to a counselor.
You think that would help, or create an even bigger mess?
Not our call.
- We have a duty to-- - No, we don't.
Our patient is post-pubescent, Tanner stage 4.
She can make her own decisions regarding sexual activity
as long as the partner of similar age.
Just 'cause her body has matured doesn't mean--
I am the attending and that is my decision.
That's true,
but maybe you should discuss it a bit more.
The law is clear.
There is nothing more to discuss.
That smells amazing.
I am going to change.
My mother's marinara. Usually, there's roasted garlic in here,
but I was told you have certain food sensitivities.
- Did he say sensitivity or-- - Explosive diarrhea?
- I'm gonna wring his neck. - As you should. Taste.
- Oh, my God. - Right?
That is fantastic.
It's better with the roasted garlic, but, your house, your rules.
Now I see where he learned it.
Shaun cooks just like you, pre-measures everything
and arranges the bowls in the order they go in.
Surgeons, we know how to get it done.
Not to mention your fondness for extra-clean utensils.
No such thing as extra clean.
No, but I cleaned it.
You rinsed it.
I'll sauté some vegetables, should be ready in 11 minutes.
Okay. I'll get changed.
There, the septal leaflet of the tricuspid. Play it again.
He's got severe regurg.
We'll need to add a valve repair
to the CABG and ventricular reconstruction.
- He's not strong enough. - We don't have a choice.
Need to figure how to do it all in one procedure.
We could do the BiVAD with an unmatched donor.
- No. - It's--
The same idea I said no to before.
So, what do you want us to do?
Nothing.
- I need to think this through on my own. - We can help you.
I need to figure out the best surgical plan.
What about implanting an impella first to decrease afterload?
And increase his odds of stroking out?
Sorry. Go home, get rest.
This is my problem. I'll figure it out.
Lim's under a lot of pressure.
I'm fine.
Just tired.
See you tomorrow.
Your call has been forwarded to an automatic voice message system.
Hey, Quinn, it's Danny.
Could you give me a call?
I'm not up for another meeting,
but... I'm feeling like...
I really should talk to someone.
Thanks.
I was about to take a shower.
Unless you would like to go first.
Thanks, but you can go ahead. I'm gonna make some coffee.
Dr. Glassman already made coffee.
He also bought croissants for us before he left for work.
Wow.
With breakfast and coffee already made,
we now have time to take an extra-long shower.
Together.
Yes. We do have time for that.
A new ventricle and a new valve?
Repaired ventricle and replaced valve.
This is really my... only option?
There are mechanical heart devices--
That I've already considered.
With heart failure advanced as yours, it's not a better option.
Okay.
Okay, whatever you think is best.
We're gonna take good care of you.
I know. Thank you.
Get the new valve prepped.
Good morning.
When you start your morning with shower sex and croissants,
it definitely is.
Lucky you.
Would you be okay if your son was having shower sex
and croissants in middle school?
I'm still contemplating nursery colors,
so, not ready to think about all that.
But... maybe her mom has a point.
I spent high school sneaking around my parents' backs.
That's not what I want with my kid.
We're talking about kids. Early teens.
I was 18 when I lost my virginity. Leon Maxwell.
We'd been together for a year, I was sure I was ready.
And... how was it?
Fine.
Fun... after we figured some things out.
But starting from Leon, then to Dwayne in med school,
sex always felt like a distraction.
A distraction?
Sounds like those guys had no idea what they're doing.
Once I was intimate in a relationship,
I felt less like my true self.
And less close to God.
That's why I stopped.
Stopped?
Like, stopped...
Having sex.
I don't intend to do it again until I'm married.
How long has it been?
Years ago, before we met.
You never told me. We joke about sex all the time.
I go along with the joke so I don't become the joke.
I'd never make fun of you for that.
Leah, you told me my Bible study group was "Fantasy Faithball."
I'm sorry.
But then what was your plan with Perez?
The same as any guy I date.
It's not like I don't kiss or some other things.
But if a man is not willing to commit to who I am as a person
or what I believe in, he's not worth my time.
It's just...
seems a bit extreme.
And a little sad.
It can be a really fun part of life,
and you've just cut yourself off from it.
You're not listening.
For me, it wasn't a value add, It was the...
This is why I don't tell people.
It's impossible to know how to shape and size this valve
without knowing the shape of the heart.
We won't know until Lim finishes repairing the ventricle.
He'd be better off with a transplant.
I agree.
The patient's going along because Lim's steamrolled him.
A square peg won't seal a round hole,
and by the time we find that out, it'll be too late.
It is not a perfect solution, but it's the best we have.
You've explained to Bob how imperfect the solution is?
He's aware of the risks, and that he has limited options.
Sometimes they need help making difficult decisions.
I don't think this is a decision you should be making for him.
And I'm not the only one.
I trust you.
We're operating on Bob first thing in the morning.
Her blood pressure skyrocketed.
She could have a stroke. Start IV labetalol.
- This is why children shouldn't have-- - Stop.
You need to focus on the medicine.
She's going into critical bradycardia. We need to push atropine.
My patient's blood pressure has remained stable.
We can operate tomorrow.
That's great.
This smells amazing.
Tastes even better.
The secret is thyme. It has to be fresh.
If you let it dry, it saps all the flavor.
That and a little bit of lemon zest.
Truth bomb. I might have oversold my enthusiasm for you staying here,
but If you keep cooking like Gordon Ramsay,
I won't let you leave.
As much as I love sleeping in a twin bed
in a half remodeled nursery,
I think I may have to decline.
Yeah, Ruben.
That's double the quote.
Okay. Yeah. Approved.
Unbelievable. Now I have to replace the roof rafters.
If it's so much work, why not just get a brand new house?
Why do that? I love the house.
It's ancient, too big for one person, and completely falling apart.
You do complain a lot about all the repairs you have to do.
That is the house where we brought Maddie home as a newborn.
That is the house where we celebrated every birthday of hers.
Every year, we turned it into a haunted house
with a cemetery in the backyard, and a fog machine.
We scared the living daylights out of every kid in the neighborhood.
I come home into that foyer...
and that staircase is where Maddie would descend in her prom dress.
You can never sell that house.
I can never sell that house.
Clinic's low on phlebotomy kits. Could we steal some from surgical?
Sure. Just make us whole when your shipment gets in.
- Andrews offered me-- - I heard. Congrats. You deserve it.
Thanks. I do.
But... you're smart, aggressive and ambitious.
I'm sensing there's another "but."
You decided to never have kids.
Wouldn't really say I decided, it just never happened.
- I'm sorry. - Don't be.
I can't be both the mother I'd want to be,
and the driven perfectionist surgeon I know I am.
My advice...
decide what brings you the most fulfillment
and then commit fully to that.
You can't have it all.
- But plenty of men-- - No, they don't.
They're just less conflicted about the choices they make.
You totally put me on the spot with Lim.
- I never said I was gonna back you up. - You're right. My bad.
Probation means different things for us.
Yours is a slap on the wrist,
a correction for coloring outside the lines.
I'm in a holding pattern,
while everybody watches to see if I'm actually a surgeon or a junkie.
Part of being a surgeon is standing up and fighting for your patients.
Why is your robe hanging on the bathroom door?
I didn't. I lent my extra one to Dr. Glassman.
You both hang your robes outside the bathroom?
I never noticed that before.
I'm glad you find it so amusing.
What'd you expect?
You sneak attacked your husband when you had a house guest.
Who else hangs their robe outside the bathroom
so the steam doesn't make it moist?
And that's not all.
Their cooking techniques, cleaning styles,
how they lay out their toiletries.
- You said he's like Shaun's father. - Yeah.
The apple doesn't fall far.
Somehow, in this case, I think Shaun's the tree.
One thing's clear, Grandpa Glassman needs a new robe,
different from your husband's.
Grandpa Glassy. I love that.
If only I could erase a certain image of Grandpa Glassy.
Hey, I'm really sorry about saying you were extreme and sad.
Thank you.
It's unfair of me to blame you for being surprised at something...
I've intentionally never shared.
Abstinence is important to me,
but I don't always feel comfortable being open about it.
I'm really glad you did.
Do you have a vibrator?
Because in terms of getting closer to God, I find--
No, we're not talking about this right now.
Two croissants, please.
Cut this suture, Dr. Wolke.
The valve is seated... nicely.
I've removed a lot of scar tissue from this ventricle,
but there's still more.
We need enough viable tissue to close this ventricle.
I don't think we have it.
Hold this clamp tight.
This area looked good in the pre-op MIBI scan,
but it's dead now.
Must be delayed apoptosis.
What's the plan?
I need an idea. Any idea.
We could do an additional vessel bypass, it might restore some hibernating tissue.
But we'd never find enough to make up for this deficit.
Can we use a synthetic patch?
It needs muscle tissue, for the ventricle to pump.
A heart can't function without a working right ventricle.
Unless, we do what we do in babies with Ebstein's Anomaly.
Bypass the defective right ventricle
and divert deoxygenated blood back to the lungs.
He'd only have one ventricle pumping blood to his entire body.
In time, the left ventricle will get stronger.
Those babies live to be teenagers.
- That will buy us time to find a donor. - Let's go.
Hey.
They already have four clinical trials with IRB approval.
I am honored that you thought of me.
It's just...
I'm trying to get pregnant, IVF with a donor.
And I've decided...
I can't have it all.
At the risk of overstepping...
I think you're selling yourself short.
My mother was the Senior Director for Human Rights First,
total workaholic.
Growing up, sometimes it seemed
like she was always on the phone or a plane.
- Must have been hard. - It wasn't easy.
But when I really needed her, she was always there.
She was my idol.
And to this day...
I need advice on a tough decision...
she's my first call.
There's more to being a great mom than parent teacher conferences.
- Is her pressure climbing? - No, 120 over 81, holding steady.
Curettage is complete.
The entire tumor's evacuated.
Massage the uterine fundus.
Pressure's dropping. Fast.
She is going into shock.
Could the tumor have caused a bleeding disorder?
There's no bleeding down here.
Push vasopressors and fluids.
What is this?
The tumor thinned her uterine wall.
She's perforated and bleeding internally.
Prep her for a laparotomy.
Rapid infuse two units of O neg.
We need to isolate the vessel and clamp it before she--
We just lost her pulse.
Retraction.
A uni heart? That's new.
Once we removed the scar tissue,
there was even less viable muscle than what we anticipated.
Dr. Wolke came through with the audible.
A sports reference, she's saying it was your idea.
Which Dr. Lim executed brilliantly.
I'd say that even if she weren't here.
You'll still need a donor heart eventually,
but this should buy you five years, maybe more, before that.
Thank you.
The surgery was too dangerous for Bob. You were right.
And about advocating for the patient even when you were pissing me off.
Might've helped if I had the uni-heart idea
before the patient was splayed open on the table.
Sometimes great things come out of pressure,
although I try not to depend on them.
It sounds like the perfect prelude to letting me off probation...
Don't push it.
But... excellent work.
Keep it up.
You, too, Dr. Perez.
Hi, honey.
Is it over?
Your surgery was a lot more complicated than anticipated
and it was successful.
We got all the tumor.
- Everything kind of hurts. - I will increase your medication.
- Ryan. - Hey.
I thought this little guy might make you feel better.
- He's such a cutie. - I got him at the gift shop.
I brought your laptop.
The group-chat's blowing up about this new Apex update.
- Is there Wi-Fi here? - Kelli needs to rest tonight.
And when you go home,
sexual activity will be very risky, given the trauma of your surgery.
- For how long? - Six months at least.
And maybe you should think about waiting even longer.
We'll talk more about this later.
Thank you.
Both.
For saving my girl.
Hey, it's Danny...
Yeah, having a bit of a rough week.
Thanks, man.
You know where St. Bon's is?
There's a coffee shop two blocks West. Meet you there in 20.
Okay.
This is awkward.
What's awkward? Nothing happened.
- What do you mean? - Nothing happened.
- Right. Nothing happened. - Exactly.
That is very impressive.
If I saw your mom totally naked and I was also totally naked,
I would never forget--
- That's not helping. - Thanks, Shaun.
All things considered, I actually had a really nice time.
Yeah, I'll be craving that salmon.
I wrote down the recipe.
The salmon comes out a lot more tender out of my Viking oven,
I'm going to have you both over to dinner as a thank you.
- My neighbor is calling. - The one who stole your lawnmower?
The one who cut back my trees without asking.
Yes, Brent.
Slow down.
What?
Danny.
I was surprised to hear from you. Heard you went to rehab.
Yeah.
All good. Been four times myself.
I'm kind of in a hurry.
It's mostly black tar around right now, but I got little bit of white.
It ain't cheap, but you're a doctor. I'm sure you can afford it.
The less we say about it the better
Make it up as we go along
Feet on the ground
Yo?
Head in the sky
We doing this or not?
I know nothing's wrong... nothing
Hey, yo, I got plenty of time
How'd your case go with the probationers?
They both did good.
Great to hear.
Keep it up, Chief.
And you're standing here beside me
I love of the passing of time
Never for money, always for love
Cover up and say good night
- Say good night - Say good night
Say good night
Home, is where I want to be
But I guess I'm already there
I come home
She lifted up her wings
I guess that this must be the place
Danny.
Are you looking for me?
No, I was just walking by and I heard the choir.
It's comforting.
We practice every Thursday, and I'm late.
Don't mind me. I'll just sit here if that's okay.
Hey, yo, you got light in your eyes
Are you okay?
Yeah.
I love the passing of time
Never for money, always for love
Cover up and say good night
- Say good night - Say good night
Say good night
Home, is where I want to be
But I guess I'm already there
I come home
She lifted up her wings
I guess that this must be the place
I can't tell one from another
Did I find you, or you find me?
- Are you the homeowner? - What happened?
Electrical fire in the kitchen. Old house, old wiring.
Wouldn't have been so bad but the termite guys
disconnected the smoke detectors.
I'm sorry.
- You got plenty of time - Hey, yo
Hey, yo, hey, yo
You got plenty of time