Émission TV: Grey's Anatomy - 21x14
The classic experiment on pain tolerance is to submerge your hand in freezing cold water...
Hi!
...and see how long you can take it.
All right, troops.
Let's get our shoes.
We got five minutes, okay?
Hey.
Welcome home.
Sorry, it's just...
I'm...
I've been up since 4:00 a.m.
I missed you.
Listen, um, while I was away-- No, I'll...
No, I'll go.
You get ready, okay?
You can try to distract yourself by counting slowly or focusing on your breath.
♪ And no one's happy now Can we make it okay?♪ Did you sleep?
Sure.
Are you okay?
Give me ten minutes.
You can have 15 if you shower.
Hey, uh, I wanted to head in early and try to get on a good service before grand rounds.
Molly was discharged last night.
She's already back in California.
So Kwan's broken heart trumps me trying to get back into our class?
No, but how many times has he waited for us?
♪ Like sunburn on my skin ♪ ♪ You never learn ♪ Kwan, you got 13 minutes!
We've got 13 minutes.
But no matter how high you count, or how deeply you breathe, that water is still undeniably cold.
I'm gone two days and everything's trash.
Today is not the day for trash.
Oh, I could help if I was on your service.
A world-renowned surgeon is coming here to see my patient for grand rounds, I'm buried in paperwork, and the attendings' lounge is out of oat creamer.
So I don't have time for whatever this is you're trying to pull.
Well, I-I just don't think I should be on Altman's service.
You know, not-not until I get back in her good graces.
Well, how do you think you're gonna get there if you never work with her?
Bribery?
Oh.
Oh, okay, he's on his way.
Uh, thank you.
Mmm.
Perfect.
Yes, yeah.
Good.
Oh, one second.
Good morning.
Glad you decided to come.
Well, I thought I'd come and see what all the fuss was about.
Here.
Right there.
Late night?
It was for Maxine and Gino.
In their room next to mine.
She really cycles through boyfriends.
What happened to Claude?
Oh, he died.
I am truly sorry.
No, he made it to his 100th birthday.
That was his goal.
You want one?
I'd rather drink gasoline.
Good morning, everyone.
I would like to introduce Gabby Mims.
Hello.
Uh, four months ago, Gabby was diagnosed with pancreatic adenocarcinoma and began neoadjuvant chemotherapy to shrink the tumor.
But because it encases several critical blood vessels, it's considered very high-risk and doesn't meet the guidelines for surgical resection.
That is where today's guest comes in.
He is taking on difficult cases like this to give patients hope of cancer remission.
So please join me in welcoming one of my surgical heroes, Dr.
Joseph Chase.
Oh, my God.
You know him?
He got me kicked out of my first residency program.
No.
No, I'm not okay.
No, I can't calm down.
So save your breath.
Fine.
But maybe you could speed up the freaking out.
Bailey noticed your seat is empty.
Screw Bailey.
She should name the grand rounds guests in the emails.
Yeah, you think you could've gotten away with skipping grand rounds?
I think we can get away with about 45 seconds.
So, go.
He never requested me on his service, he looked past me in rounds, he never remembered my name.
I learned to handle it.
But when he...
...neglected a Black patient with chronic pancreatitis for weeks, I tried to ignore it, but when her symptoms worsened significantly overnight, I told him I was concerned she wasn't being seen.
He informed me, if I was going to make a habit out of telling him things he already knew, I could go be disrespectful at another program.
Which led to...
The scrub room incident.
And during my expulsion review, he called out my "aggressive behavior" and my "subpar" surgical skills.
Well, he clearly didn't know you at all.
Thank you.
Right.
Come on.
We have to go back in.
I can't watch Bailey fawn over him.
She is who you work for now.
You said he never saw you.
Just get through the lecture, lay low, and then you never have to see him again.
Okay?
Okay.
Just give me...
Just give me another minute.
...portion of the IVC.
I'll start by placing a mesocaval shunt, connecting the IVC past the location of the tumor and rerouting the small intestine outflow.
And that's before I begin the periarterial divestment, during which I will resect the cancerous tissue surrounding the vessels, one of which is...
The superior mesenteric artery.
Good.
And it is significant because?
It supplies oxygenated blood to the pancreatic head, small intestines and parts of the colon.
Your residents are quick on the draw, Dr.
Bailey.
Uh, Dr.
Chase, surgical guidelines classify these tumors as inoperable.
How can you ignore the recommendations?
Well, I don't think all patients fall under the same criteria for resection.
We may find that some actually benefit.
By experimenting on them?
Why don't I let our patient answer that one?
I want to live.
Following the guidelines might give me a few months, maybe a year.
Dr.
Chase's surgery could give me much longer.
And his success rate is stellar.
He's planning to publish...
Soon.
And I wanted to include Gabby, and you and your resident.
Who have you chosen to assist?
Uh, Griffith.
Hi, uh, you're scrubbing in.
Uh, and as for everyone else, thank you, you're dismissed.
Okay, you got this.
You're Simone Griffith.
You take your excellence and you shove it down his throat.
Uh, this is Dr.
Griffith, one of our program's shining stars.
Oh, I know Dr.
Griffith.
You do?
Yes, our paths crossed when I worked in Baltimore.
Good to see you thriving here, Dr.
Griffith.
Shall we go show our patient back to her room?
Of course.
Mmm.
Morning.
How was the conference?
Educational.
I'm sure Hunt's glad to have you back.
You know, I barely survived with only one toddler.
I don't know how he managed two-- We have an incoming trauma and a suspected acute diverticulitis in bed two.
I'm here to help.
Uh, want me to start her on broad spectrum antibiotics?
Only if you know something that I don't.
I am waiting on her scans.
Sorry.
Just trying to anticipate what you need.
What I need is for you to get her to CT.
Will do, Chief.
Hey.
Hey.
Hey, so I thought we could go to your favorite Italian place tonight.
Look, I don't want an open marriage.
I almost slept with someone in Oakland, but I couldn't go through with it.
I am so sorry.
But I don't want to be with anybody else.
I only want you.
Me too.
Really?
Yeah.
You know, change was worth a try, but I only want to be with you too.
D...
Did you try?
Rig's outside.
You want me to do the intake or...
We've got it.
Brendon Browning, 25-year-old male, penetrating injury to the chest from an ice pick, 50 mics of fentanyl en route.
GCS 15, hemodynamically stable.
And I'm in love.
Please don't move.
This ice pick is in a very dangerous area.
Is your partner on their way?
Oh, she's not...
Uh, we're not together.
Yet.
I just met her this morning.
Okay, let's get him to trauma 1.
We got you, Brendon.
What the hell is happening?
Uh, former patient of mine gave me two tickets to tonight's game right behind home plate.
You free?
What's the catch?
There's no catch.
Mmm.
I...
I have Baxter as my intern today, you have Kwan.
If I'm gonna make it to this game on time, I need somebody who's efficient and can read their own handwriting.
Uh, an intern for behind home plate?
And an Americano.
Yeah.
Done.
I didn't have to give you the coffee, did I?
You'll never know.
Well, you're late.
Uh, sorry.
Grand rounds ran long.
Do you know about this Chase technique?
It's really interesting.
Well, it's a tragic case, and I hope that works out.
Good job on Ms.
Regalski's central line.
You've been practicing.
Well, I'm upping my game.
Trying to change Dr.
Fox's mind about my remediation.
A central line's not going to do that.
But the practice doesn't hurt.
Oh, I also signed up to help with admin backlog.
And I'm volunteering at the clinic on Saturdays.
I told you that wasn't happening.
Actually, you didn't.
You said-- I am now.
Let's finish rounds.
There's a small left hemothorax.
Let's do a FAST exam to make sure that the heart isn't involved.
Okay, so where do you...
Whoa.
Stabbing?
He was holding an ice pick and he slipped.
So, he stabbed himself?
They say people do stupid things when they're in love, but I didn't get it until today.
He also met the love of his life today.
Ah, neat.
Another one of those.
I was working the bar at a corporate brunch event.
It's not my scene.
But then I looked up, and there she was.
The girl of my dreams.
FAST exam is negative.
Talking with her was the best 17 minutes of my life.
How much ground could you possibly cover in 17 minutes?
Her trip to Japan, her foster kittens, her bug collection.
Enough to know that she's perfect.
Mrs.
Grandy's CT confirms acute diver-- Wow.
Uh, screwdriver?
Ice pick.
He fell in love and slipped onto it.
Warren, focus.
Admit Mrs.
Grandy, get her on antibiotics, and meet us in CT.
All right.
It looks like it only hit the lung.
Yeah, but I don't like how close it is to the heart.
Millin, get us a CT.
I'll let them know we're on our way.
Jack Moss, 36, sustained a tib-fib fracture over a year ago due to a motorbike accident.
It resulted in malunion, here for a corrective osteotomy to realign the bones.
At least I got to see the desert outside Marrakech before skidding into a textile market.
Says you were scheduled for a surgery six months ago.
Did you forget?
My tourist visa came through, and I went to Tanzania instead.
Must be nice.
And how's the pain?
Barely feel it.
All right.
You barely feel any pain?
I mean, I feel it when I walk, like, more than a hundred feet.
Can you fix it?
You know, Jack, just at first glance, we may be looking at an amputation.
What?
Uh, no, no, no, no.
I have another tour next month in Munich.
And then after that, it's Prague.
Uh.
I'll tell you what, we'll get a new round of tests.
CT, MRI, everything.
And we'll take it from there.
Kwan?
You got it.
Okay.
Oh, here he is.
I'm gonna ask him.
I already told you-- Something I can settle for you?
You've done this experimental surgery enough times to know that my baby girl will be okay, right?
You have to stop calling me that.
I'm 38.
And I'm not okay.
I have cancer.
If I don't do this, I may never get to see Chicago.
The musical or the city?
The new library on South Chicago.
That's what our team calls it.
I'm an architect.
It's been my life for four years.
I want to see it finished.
I want to see kids light up at all the books and old people play chess in the community room.
I thought you wanted to spend more time with me.
You'll be one of the people playing chess.
Promise me she'll be okay.
Well, I'd be lying.
Nobody can guarantee that with 100% certainty.
Here's what I can say.
When I walk into that operating room, I'm gonna pour everything I've learned from decades of practice and research into curing your daughter's cancer.
And I won't stop until I've done everything I can for her.
He knows what he's doing, Mom.
I know the odds.
I want this.
Good.
Dr.
Griffith, will you prep Ms.
Mims for surgery?
Of course.
We'll see you soon, Gabby.
Here you go.
Thank you.
Was it the night that I left?
When your mom was watching the kids?
Teddy...
Owen, did you have someone over at our house?
We agreed on rules.
No details.
So that's a yes.
I did not bring anyone into our home.
Anyone?
Were there multiple people?
No.
Why are you accusing me?
We opened our marriage, Teddy.
And you also were with someone else.
How's our young Romeo?
Great.
I know these odds.
He is way more into her than she is into him.
They say every pot has its lid.
Some pots have many lids.
Says the kettle.
You're mixing metaphors.
No, I'm not.
Scans.
Scans are up.
Well, it's hard to see with all of this artifact, but it looks like the ice pick is penetrating the descending aortic arch.
You see that?
There is a contained hematoma that has formed around the entry site.
How is he not bleeding out?
The ice pick is essentially plugging the hole.
So if we move him, and it moves...
He could bleed out and die.
So how do we get him to the OR?
Hmm.
Hi.
How's Chase?
Did he cure metastatic lung cancer too?
Do you two have history?
Never met him until today.
But I do have history with you.
Now, you asked me to do a consult on Gabby Mims two months ago, and clearly, you didn't trust my opinion.
I was looking for options.
Chase had one.
No, he's breaking new ground.
He's resecting a tumor from a place where multiple studies have determined that the risks outweigh the benefit.
I take it you don't approve of his technique.
Yeah.
His so-called technique is the same as resecting any other tumor, just with more arrogance.
And, frankly, I'm surprised you allowed him to use it on Gabby.
I guess she was a good lure.
You think...
...I used Gabby as surgical bait?
People go to great lengths to meet their heroes.
I know you've admired him from afar for years.
Um, Dr.
Chase's methods could be the future of pancreatic surgery.
We can get on board or we can bury our heads in the sand and watch our patients die.
You do what you want.
I prefer to keep my head above ground.
So if we roll over a paper clip, or someone runs into me, I'll die?
It's not that simple.
First, you would start to bleed, then we would get you into surgery as soon as possible.
Oh, God.
We will be very careful.
I don't know.
Well, you rode in an ambulance, and then in an elevator and on a gurney.
Like, those are pretty good odds, and I'm usually a downer.
There's no reason to think that we can't get you to the OR safely.
Yeah, and then you can go be happy with what's her...
What is her name?
I don't know.
Why didn't I ask?
I-I should have asked.
It was 17 minutes!
Hey, Brendon, we need you to calm down, okay?
And we need you to trust us, okay?
Can you do that?
Okay.
Okay.
It's all right.
It's okay.
All right, everybody, move out of the way!
Let's move on my count, okay?
I'll set the pace.
One, two, three.
Okay.
All right.
We got you.
Your pre-op labs are all good.
You're cleared for surgery.
I can't believe it's finally happening.
So, what do you think of Dr.
Chase?
Is he as good as everyone says?
He's excellent.
I've actually watched him operate before.
I once saw him treat a very complicated mesothelioma with HIPEC, combination of surgery and hot chemotherapy in the abdomen.
The patient is okay?
Posted a photo with his new grandson a few weeks ago.
I have to do this, Mom.
It's my only chance.
Last time I was in a hospital bed, I was holding my new baby girl in my arms.
I didn't want to let go of you then, and I don't want to let go now.
What if this the last time...
You've been the best mama I could ever have.
You gave me the courage to think big, dream big, believe big.
Believe big.
That's why I'm not afraid to do this.
I love you.
I love you more, baby girl.
Who's ready for surgery?
Okay.
Now I'm ready.
Let's do this.
All righty.
Hey.
Uh, so I dropped off Ms.
Schiller's labs and I submitted Mr.
Bohigian's discharge paperwork.
Oh.
Good.
When I finish with the scans, you can update the charts.
Uh, Chase's surgery is about to start.
Are you scrubbing in?
No, I-I just assumed we'd watch.
I'm not interested in that.
Well, he could make history today.
And you can learn a lot by watching good surgeons, right?
Come with me.
To the gallery?
Better.
Sorry.
Jack saw a scenic photo in radiology and refused to go back to his room until I could figure out if it was Banff National Park.
Was it?
Oh, he thinks it is.
Okay, what do you see?
Well, a bone that's completely healed but at an angle.
Oh, he's lucky if he gets five feet, let alone a hundred.
Yeah, you can see the vessel is kinked here in the area of the bone deformity.
He only has one vessel running off to the foot, barely keeping it alive.
Damn.
Hope he took lots of pictures in the Serengeti.
He's not going anywhere besides PT.
It's an amputation, right?
Ooh, could I do it?
I always wanted to do one.
Go check on my arthroplasty from last night.
Millin got to do one her first day.
Interns perform them all the time-- Not hyped-up ones.
Put that crap away.
I'm already overloaded with patients.
I don't have time to resuscitate you.
Now go do what I asked.
You're going too fast.
Listen, if you have a problem with my pace, then you lead.
Is everything okay?
You're doing great.
Almost at the elevator.
Whoa, whoa!
Hey!
No running!
Okay.
So, um, tell us more about the woman you met.
What does she do?
She's a graphic designer, I think.
I don't know her name or what she does.
When you get out of here, you'll get a second chance.
But what if I die?
Hey, Millin.
Why don't you get out your phone?
We're gonna find her.
Find her how?
You're the millennial.
You tell me.
This never goes well for me.
Can you think of anything unique?
A...
A blue streak in her hair?
Uh, big glasses?
She has hazel eyes.
I think she has a small dimple when she smiles?
Okay, everyone.
Nice and slow.
Easy.
Okay.
You ready for tonight?
Yeah, last night, Boston was down.
They put in Taft as a designated hitter.
Steps up to the plate with the bases loaded and hits a genius triple to left center.
Unstoppable.
I'm, uh, taking Baxter back.
I've got a sensitive case, and something's up with Kwan.
Um, does tonight's seat go with Baxter?
Nope.
All right.
Take whoever you want.
I do need to see if I can switch the seats to tomorrow.
Oh.
No, no, no.
I got a...
a late CABG tomorrow night.
So...
...put that phone away, please.
My patient's got a severe tib-fib malunion with vascular damage and critical limb ischemia.
I've-I've either gotta amputate or...
bring in a genius designated hitter.
Is he a candidate for a fem-tib bypass?
He's got anatomy distorted below the knee.
No.
No, it won't work.
When I say "severe," I mean I've never seen a leg like this in my entire career.
I can bypass anything.
Even this?
Damn it.
Yeah.
Not everybody's unstoppable.
No, I can do it.
Which means I won't be sitting behind home plate tonight.
What if I never find her?
Seattle's not that big.
But it's that not small, either.
And you're young.
You'll meet somebody else.
Uh, maybe you dodged a bullet.
Every nightmare I ever dated made a great first impression.
Or she's the love of your life.
I-I'm sorry.
Does nobody else find this a little bit creepy?
I'm sure you're great, but stalking is not-- Have you ever been in love?
This feels inappropriate.
When you're in love, you don't give up.
Keep looking.
Okay.
Here we go.
Careful.
Easy.
All right, let's turn.
Doing great.
Brendon, does she have a mole on her neck?
On her right side.
Did you find her?
I think so.
You were right about the bugs. "
Elena Ginsburg, member of the Greater Seattle Entomology Club"?
What's entomology?
Oh, my God.
That's her.
No, no!
Brendon, don't move!
Okay, run.
Let's go!
Let's go!
Hey.
We need to get him on the OR table right now.
We need to get in there.
Gown and glove.
Okay, on my count.
Ready?
One, two, three.
Betadine.
Yeah, I'm on it.
The ice pick in his aorta moved.
We got him here in less than a minute.
We can save him.
Let's go.
Let's go!
All right, we're removing the ice pick.
Scalpel.
How can I help?
You can give us some space.
Come on, Brendon.
You made it this far.
Stay with me.
That's not it.
Yeah, maybe I should get back to rounds.
Uh, Mr.
Vizcaino's wound vac's not gonna check itself.
Uh, we just checked it.
You know, you made a very good point.
I did?
Yeah.
There is a value to watching great surgical cases.
All right.
Ah.
Found it.
What is that?
This, son, is a videotape.
Yeah, I kn-know that.
What's on it?
Surgeries.
Look, I'm talking Whipples and Roux-en-Ys and Puestows.
Procedures that require real skill, not that surgical cowboy nonsense.
You wanna watch and learn, you watch this.
How?
I'm almost finished with the first shunt.
Suction.
But careful, too aggressive a move could spell disaster.
This okay?
It's fine.
Dr.
Griffith recently did a solo surgery.
First in her class.
Wow, congratulations.
Ever seen a mesocaval shunt before?
No, sir.
Congratulations again.
You're about to see one completed.
Oh.
Careful with this margin.
I see it.
Mmm.
And why do we need the shunt?
To bypass the SMV and provide outflow from the intestine while you resect the tumor...
That was meant for Griffith.
Yeah.
But correct.
You must have been one outstanding student.
I like to think I still am.
It helps to have amazing teachers.
Okay.
Shunt is done.
Moving on to the periarterial divestment on the SMA.
Just like we planned before, I'll start with the osteotomy.
Can I help you, Dr.
Kwan?
I'm on Dr.
Ndugu's service now.
Um, fine.
Just stand over there.
I will re-break the bones in your leg, and I will realign them with plates and screws.
That's when I'll go in and attempt the bypass to improve blood flow to the leg.
Okay, great.
Let's do it.
I wanna keep my legs so I can keep traveling.
Jack, we won't perform the surgery unless you agree to stop traveling while you properly heal.
Okay, well, how long will that take?
Months.
If today goes well.
How long does recovery from an amputation take?
Months.
And if I do nothing?
Without urgent intervention, the wound on your leg could become infected, which could lead to sepsis.
Okay.
I want the surgery.
We'll see you in the OR.
Babcock.
Fortunately, the tissue's not friable, so it peels right off the vessel with sharp dissection.
Look at that.
Fundamentally, it's no different than resecting any other tumor.
There's some bleeding.
Where?
Then suction.
Uh, did the tumor invade the SMA?
It's possible.
Yep.
The tumor definitely breached the arterial wall.
Clamp.
We need 4-0 prolene.
And more suction.
Okay, I'll suture the SMA, and then we'll close.
Close?
W-We haven't finished.
If we continue with the procedure, we're putting her in greater danger.
What about blood supply to the small bowel?
Tell your intern that's out of scope for this procedure.
I am officially done here.
You have successfully completed all your other cases.
Why stop now?
Dr.
Chase?
Okay, if you stop, will Gabby be a part of your study?
I'm kind of in the middle of something if you haven't noticed-- Dr.
Chase.
Of course not.
Her procedure was incomplete.
So that's how you do it.
I thought it was unparalleled expertise and steady hands.
But it's cutting and running before there are consequences, at least, for you.
Dr.
Bailey, her small bowel's becoming dusky.
Okay.
Uh, if we stop, she will die.
I told you, I'm done here.
You're damn right you are.
No.
I will finish.
Your patient is no longer a candidate for this procedure-- Then by all means, don't let me keep you.
There's the door.
Use it!
I need a stool, please.
Right away, doctor.
What do we do now?
Uh, I don't know, but we sure as hell aren't closing.
Just have to put in a few more, and if the alignment's in check, it's all you.
When was the original fracture?
Eighteen months ago.
He was treated abroad, but he started weight-bearing way too soon.
Nearly lost his leg today, but, hey, I bet the beer was damn tasty after seeing the Great Migration in the Serengeti.
What?
That's why he risked amputation?
He didn't wanna cancel a trip?
That's what he said.
He lied to you.
Drill.
Jack's brother was an extreme adventurer.
He booked a trip around the world.
Motorcycle tours mostly.
He died unexpectedly two years ago.
Jack quit his job, and he's been spreading his brother's ashes in every country his brother wanted to see before he died.
He could have avoided all this if he let himself heal physically, but spreading his brother's ashes probably healed something, too.
Done.
Ndugu, you're up.
All right.
Let's hope I didn't make you do all that work for nothing, huh?
Potts scissors, please.
Okay, watch this now.
I'm going to...
Oh, come on here.
Come on.
You know, they have places that convert these old tapes.
Oh, to DVDs?
Ah, here we go.
All right.
Now I'm going to dissect the lateral peritoneal attachments.
The Kocher maneuver.
Exactly.
Here's the incision...
Uh, are you using your finger to open up the duodenum?
Yeah.
Simple and effective.
See?
That's how I was taught.
Huh.
It's Bailey.
It's a 9-1-1.
I can't believe I fell for that man's snake oil.
Did you have any idea when you were in Baltimore?
Where's Chase?
Uh, you were right.
Don't gloat.
About what?
Gabby's tumor grew through the wall of the SMA.
Chase transected it while resecting.
Then decided to take a break?
Dr.
Bailey asked him to leave after figuring out he's been selective about the patients in his study.
Well, the artery is shot.
He did a nice job on the shunt, though.
Adams, see how he rerouted the SMV to the IVC?
Hey, look, I know this is a teachable moment, but every minute that goes by increases the chances of Gabby's bowel necrosing.
And as much as I appreciate the genius of Chase's rerouting, we need to...
What are you thinking?
What if we used a saphenous vein graft to reconstruct the SMA?
W-We could restore the blood supply and remove the invaded vessel.
And the whole tumor with it.
You think that's too risky?
Only if you don't have enough hands.
Adams, we're scrubbing in.
Okay.
Okay.
Okay.
We got a plan.
We got a plan.
There's too much bleeding.
Can you see where it's coming from?
How many units has he had?
Four units.
♪ Black and blue, far away ♪ His heart won't restart.
Warren, get over here.
Take over compressions.
Come on, Brendon.
Come on.
All right, stop compressions.
Let me in there.
All right, charge to 40.
Clear.
Charge again.
Clear.
It's been too long.
He didn't give up.
We can't either.
All right.
Charge to 50.
Clear.
Teddy.
Come on.
Damn it.
Let me in there.
Teddy.
Come on.
Teddy.
Teddy!
It's over.
You've done all you can.
Time of death, 19:24.
I spoke to Brendon's parents.
It shouldn't have gone like this.
I, uh...
I have a lot of paperwork to get through.
You should just go.
Teddy.
Teddy, we need to talk about this.
Now is not a good time.
So, you're happy to work on our marriage when it means sleeping with Cass Beckman, but when I wanna have a difficult conversation-- Oh.
I'm sorry, who slept with someone else?
Not me.
What did you think was gonna happen when we opened our marriage?
I'm gonna be late.
Um...
Don't wait up for me.
She's going to be okay, right?
She needs a lot of rest, but she's doing very well.
Thank you.
You hear that, baby girl?
You're gonna be okay.
Thank you so much.
Dr.
Chase go back to DC?
Uh, I don't know.
He was not able to complete the surgery.
But we had other surgeons step in and help, and we resected the tumor.
You got it all?
No more tumor?
We did.
I can't believe it.
Dr.
Chase taught you his technique?
Dr.
Bailey developed her own.
That's what saved Gabby.
I, uh...
I'm so grateful.
Thank you for taking care of my baby girl.
You're gonna keep calling me that, a-aren't you?
Forever and ever.
Oh, my God.
Uh, we'll give you some time.
Griffith.
Hmm?
Uh, he must have been terrible to work for.
I ended up in the right place.
Excellent work today.
♪ I can't see the future ♪ Is it still there?
My leg?
Dr.
Lincoln and Dr.
Ndugu will be in soon, but they were able to realign your bone and reestablish blood flow.
It was pretty amazing.
You probably think I'm an idiot.
I...
think that you were in pain and taking the time to heal.
It sucks, but...
Especially after losing someone.
And now I'm stuck in a bed.
About that.
These are VR goggles.
We keep a few of them in our skills lab.
They help us practice procedures.
But I was able to download a program that allows you to visit spots across the globe.
Uh, virtually, that is.
I thought it would help distract you from being stuck here.
Thank you.
You're welcome.
Dr.
Lincoln?
I am sorry about today.
It's no excuse, but I've been going through something in my personal life.
I'm impressed you even have a personal life.
When I was an intern, there was a 32-day stretch where I didn't see the sunlight.
It's probably for the best.
And I'll get a life when I'm an attending.
Hey.
What is this?
Why are you still in your scrubs?
We can still make it by the third inning if we hurry, but we gotta go.
You didn't take another surgery, did you?
We're still going, right?
Hey, Chief, your post-op notes are done, and I'll check in the ER for any consults before I go.
No need to announce it.
Just get it done.
Okay.
Hey, Chief.
I'm sorry I screwed up during the heat dome, all right?
I wish I could go back in time and do it better, but I can't.
All I can do is play by the rules today.
And I am trying really hard.
But if that's not good enough, just...
just call it.
Good night.
I know it's complicated...
Is that Seattle Grace?
It's Midvale General, Adele's favorite soap.
It appears she taped over my esophagectomy.
Uh, that's disappointing.
I'm sorry.
Not as sorry as Dr.
Lehane's gonna be when he finds out his wife's pregnant with his brother's baby.
When I first read Chase's work, I thought it was too good to be true.
And I still fell for it.
Yeah.
People like Chase prey on our optimism and hope.
The indictment's on him, not you.
But I brought him here.
I misled our residents into believing that these tumors could be resected.
And apparently they can.
You were able to do it.
We were.
Dr.
Chase.
Griffith.
You need something?
Oh.
I can't change Baltimore's decision to terminate you, so don't bother asking.
I'm not.
I'm glad I'm here.
I wasn't at first.
I spent a lot of time wondering what I could've done to make you see what a good surgeon I could be.
But today I realized it wouldn't have mattered.
You don't care about teaching.
You don't care about your patients.
You only care about you.
Maybe that gets you published, wins you awards.
But it does not make you a good doctor.
Well, that's...
...a lot of opinions from an intern who's only done one surgery on their own.
Here's what you could've done to impress me.
You could've been more specific in your post-op notes. "
Better" doesn't really tell me anything useful.
Could've been more assertive with your patients, and there was too much slack in your sliding half-knots.
Still is, from what I saw in there today.
Stands to reason, I suppose, given your mentor who's really no great shakes herself.
Good luck, Dr.
Griffith.
You need it.
When you're in pain, you can grin and bear it all you want.
You can try to pretend it's not there.
Have you seen this map?
We're right behind home plate.
Yeah, yeah.
We get a concession server?
Lincoln was right.
I did need a night out.
Glad he could help you out.
I love baseball.
You love baseball?
Wait, are you for Seattle or Boston?
When we get there, just pretend it's the OR.
Okay?
Hey, don't talk.
Okay?
Don't talk.
♪ See the light, see the light That breaks through ♪ But there's no glory in suffering.
He said my sliding half-knots were sloppy.
His shirt and tie didn't match.
He insulted Bailey.
No!
Karma will get him.
Or a malpractice attorney.
Mmm.
Hey, how was your day?
Actually, uh, pretty great.
Dr.
Webber said he's gonna talk to Dr.
Fox about letting me back into our class-- Nope, keep your good news to yourself.
We're moping.
Yeah, this is Mopetown.
Population, two.
I'm the mayor.
She's the comptroller.
What's a comptroller?
I don't know.
I don't care.
I thought you'd be happy for me.
I am.
It's just been a long day.
Yeah, so get on board or get out.
I'm pretty beat.
I'll see you upstairs?
Okay.
Okay, will you come with me to, like, a bug society meeting, so I can tell this girl that my patient died?
No.
That's not what a comptroller does.
What?
Yeah.
There's no reward.
Sorry.
It doesn't make you wiser.
Or stronger.
It doesn't make you immune.
♪ Here we are, here we are I'm with you ♪ ♪ There's a beautiful dawn In the breakthrough ♪ ♪ There's a beautiful dawn In the breakthrough ♪ Did you even hesitate?
When you slept with someone else?
Of course I did.
Hmm.
I love you.
Teddy, only you.
That night meant nothing.
♪ Here we are, here we are I'm with you ♪ Hey.
Teddy, come here.
It's gonna be okay.
Sometimes it makes the pain even worse.
♪ There's a beautiful dawn In the breakthrough ♪
Hi!
...and see how long you can take it.
All right, troops.
Let's get our shoes.
We got five minutes, okay?
Hey.
Welcome home.
Sorry, it's just...
I'm...
I've been up since 4:00 a.m.
I missed you.
Listen, um, while I was away-- No, I'll...
No, I'll go.
You get ready, okay?
You can try to distract yourself by counting slowly or focusing on your breath.
♪ And no one's happy now Can we make it okay?♪ Did you sleep?
Sure.
Are you okay?
Give me ten minutes.
You can have 15 if you shower.
Hey, uh, I wanted to head in early and try to get on a good service before grand rounds.
Molly was discharged last night.
She's already back in California.
So Kwan's broken heart trumps me trying to get back into our class?
No, but how many times has he waited for us?
♪ Like sunburn on my skin ♪ ♪ You never learn ♪ Kwan, you got 13 minutes!
We've got 13 minutes.
But no matter how high you count, or how deeply you breathe, that water is still undeniably cold.
I'm gone two days and everything's trash.
Today is not the day for trash.
Oh, I could help if I was on your service.
A world-renowned surgeon is coming here to see my patient for grand rounds, I'm buried in paperwork, and the attendings' lounge is out of oat creamer.
So I don't have time for whatever this is you're trying to pull.
Well, I-I just don't think I should be on Altman's service.
You know, not-not until I get back in her good graces.
Well, how do you think you're gonna get there if you never work with her?
Bribery?
Oh.
Oh, okay, he's on his way.
Uh, thank you.
Mmm.
Perfect.
Yes, yeah.
Good.
Oh, one second.
Good morning.
Glad you decided to come.
Well, I thought I'd come and see what all the fuss was about.
Here.
Right there.
Late night?
It was for Maxine and Gino.
In their room next to mine.
She really cycles through boyfriends.
What happened to Claude?
Oh, he died.
I am truly sorry.
No, he made it to his 100th birthday.
That was his goal.
You want one?
I'd rather drink gasoline.
Good morning, everyone.
I would like to introduce Gabby Mims.
Hello.
Uh, four months ago, Gabby was diagnosed with pancreatic adenocarcinoma and began neoadjuvant chemotherapy to shrink the tumor.
But because it encases several critical blood vessels, it's considered very high-risk and doesn't meet the guidelines for surgical resection.
That is where today's guest comes in.
He is taking on difficult cases like this to give patients hope of cancer remission.
So please join me in welcoming one of my surgical heroes, Dr.
Joseph Chase.
Oh, my God.
You know him?
He got me kicked out of my first residency program.
No.
No, I'm not okay.
No, I can't calm down.
So save your breath.
Fine.
But maybe you could speed up the freaking out.
Bailey noticed your seat is empty.
Screw Bailey.
She should name the grand rounds guests in the emails.
Yeah, you think you could've gotten away with skipping grand rounds?
I think we can get away with about 45 seconds.
So, go.
He never requested me on his service, he looked past me in rounds, he never remembered my name.
I learned to handle it.
But when he...
...neglected a Black patient with chronic pancreatitis for weeks, I tried to ignore it, but when her symptoms worsened significantly overnight, I told him I was concerned she wasn't being seen.
He informed me, if I was going to make a habit out of telling him things he already knew, I could go be disrespectful at another program.
Which led to...
The scrub room incident.
And during my expulsion review, he called out my "aggressive behavior" and my "subpar" surgical skills.
Well, he clearly didn't know you at all.
Thank you.
Right.
Come on.
We have to go back in.
I can't watch Bailey fawn over him.
She is who you work for now.
You said he never saw you.
Just get through the lecture, lay low, and then you never have to see him again.
Okay?
Okay.
Just give me...
Just give me another minute.
...portion of the IVC.
I'll start by placing a mesocaval shunt, connecting the IVC past the location of the tumor and rerouting the small intestine outflow.
And that's before I begin the periarterial divestment, during which I will resect the cancerous tissue surrounding the vessels, one of which is...
The superior mesenteric artery.
Good.
And it is significant because?
It supplies oxygenated blood to the pancreatic head, small intestines and parts of the colon.
Your residents are quick on the draw, Dr.
Bailey.
Uh, Dr.
Chase, surgical guidelines classify these tumors as inoperable.
How can you ignore the recommendations?
Well, I don't think all patients fall under the same criteria for resection.
We may find that some actually benefit.
By experimenting on them?
Why don't I let our patient answer that one?
I want to live.
Following the guidelines might give me a few months, maybe a year.
Dr.
Chase's surgery could give me much longer.
And his success rate is stellar.
He's planning to publish...
Soon.
And I wanted to include Gabby, and you and your resident.
Who have you chosen to assist?
Uh, Griffith.
Hi, uh, you're scrubbing in.
Uh, and as for everyone else, thank you, you're dismissed.
Okay, you got this.
You're Simone Griffith.
You take your excellence and you shove it down his throat.
Uh, this is Dr.
Griffith, one of our program's shining stars.
Oh, I know Dr.
Griffith.
You do?
Yes, our paths crossed when I worked in Baltimore.
Good to see you thriving here, Dr.
Griffith.
Shall we go show our patient back to her room?
Of course.
Mmm.
Morning.
How was the conference?
Educational.
I'm sure Hunt's glad to have you back.
You know, I barely survived with only one toddler.
I don't know how he managed two-- We have an incoming trauma and a suspected acute diverticulitis in bed two.
I'm here to help.
Uh, want me to start her on broad spectrum antibiotics?
Only if you know something that I don't.
I am waiting on her scans.
Sorry.
Just trying to anticipate what you need.
What I need is for you to get her to CT.
Will do, Chief.
Hey.
Hey.
Hey, so I thought we could go to your favorite Italian place tonight.
Look, I don't want an open marriage.
I almost slept with someone in Oakland, but I couldn't go through with it.
I am so sorry.
But I don't want to be with anybody else.
I only want you.
Me too.
Really?
Yeah.
You know, change was worth a try, but I only want to be with you too.
D...
Did you try?
Rig's outside.
You want me to do the intake or...
We've got it.
Brendon Browning, 25-year-old male, penetrating injury to the chest from an ice pick, 50 mics of fentanyl en route.
GCS 15, hemodynamically stable.
And I'm in love.
Please don't move.
This ice pick is in a very dangerous area.
Is your partner on their way?
Oh, she's not...
Uh, we're not together.
Yet.
I just met her this morning.
Okay, let's get him to trauma 1.
We got you, Brendon.
What the hell is happening?
Uh, former patient of mine gave me two tickets to tonight's game right behind home plate.
You free?
What's the catch?
There's no catch.
Mmm.
I...
I have Baxter as my intern today, you have Kwan.
If I'm gonna make it to this game on time, I need somebody who's efficient and can read their own handwriting.
Uh, an intern for behind home plate?
And an Americano.
Yeah.
Done.
I didn't have to give you the coffee, did I?
You'll never know.
Well, you're late.
Uh, sorry.
Grand rounds ran long.
Do you know about this Chase technique?
It's really interesting.
Well, it's a tragic case, and I hope that works out.
Good job on Ms.
Regalski's central line.
You've been practicing.
Well, I'm upping my game.
Trying to change Dr.
Fox's mind about my remediation.
A central line's not going to do that.
But the practice doesn't hurt.
Oh, I also signed up to help with admin backlog.
And I'm volunteering at the clinic on Saturdays.
I told you that wasn't happening.
Actually, you didn't.
You said-- I am now.
Let's finish rounds.
There's a small left hemothorax.
Let's do a FAST exam to make sure that the heart isn't involved.
Okay, so where do you...
Whoa.
Stabbing?
He was holding an ice pick and he slipped.
So, he stabbed himself?
They say people do stupid things when they're in love, but I didn't get it until today.
He also met the love of his life today.
Ah, neat.
Another one of those.
I was working the bar at a corporate brunch event.
It's not my scene.
But then I looked up, and there she was.
The girl of my dreams.
FAST exam is negative.
Talking with her was the best 17 minutes of my life.
How much ground could you possibly cover in 17 minutes?
Her trip to Japan, her foster kittens, her bug collection.
Enough to know that she's perfect.
Mrs.
Grandy's CT confirms acute diver-- Wow.
Uh, screwdriver?
Ice pick.
He fell in love and slipped onto it.
Warren, focus.
Admit Mrs.
Grandy, get her on antibiotics, and meet us in CT.
All right.
It looks like it only hit the lung.
Yeah, but I don't like how close it is to the heart.
Millin, get us a CT.
I'll let them know we're on our way.
Jack Moss, 36, sustained a tib-fib fracture over a year ago due to a motorbike accident.
It resulted in malunion, here for a corrective osteotomy to realign the bones.
At least I got to see the desert outside Marrakech before skidding into a textile market.
Says you were scheduled for a surgery six months ago.
Did you forget?
My tourist visa came through, and I went to Tanzania instead.
Must be nice.
And how's the pain?
Barely feel it.
All right.
You barely feel any pain?
I mean, I feel it when I walk, like, more than a hundred feet.
Can you fix it?
You know, Jack, just at first glance, we may be looking at an amputation.
What?
Uh, no, no, no, no.
I have another tour next month in Munich.
And then after that, it's Prague.
Uh.
I'll tell you what, we'll get a new round of tests.
CT, MRI, everything.
And we'll take it from there.
Kwan?
You got it.
Okay.
Oh, here he is.
I'm gonna ask him.
I already told you-- Something I can settle for you?
You've done this experimental surgery enough times to know that my baby girl will be okay, right?
You have to stop calling me that.
I'm 38.
And I'm not okay.
I have cancer.
If I don't do this, I may never get to see Chicago.
The musical or the city?
The new library on South Chicago.
That's what our team calls it.
I'm an architect.
It's been my life for four years.
I want to see it finished.
I want to see kids light up at all the books and old people play chess in the community room.
I thought you wanted to spend more time with me.
You'll be one of the people playing chess.
Promise me she'll be okay.
Well, I'd be lying.
Nobody can guarantee that with 100% certainty.
Here's what I can say.
When I walk into that operating room, I'm gonna pour everything I've learned from decades of practice and research into curing your daughter's cancer.
And I won't stop until I've done everything I can for her.
He knows what he's doing, Mom.
I know the odds.
I want this.
Good.
Dr.
Griffith, will you prep Ms.
Mims for surgery?
Of course.
We'll see you soon, Gabby.
Here you go.
Thank you.
Was it the night that I left?
When your mom was watching the kids?
Teddy...
Owen, did you have someone over at our house?
We agreed on rules.
No details.
So that's a yes.
I did not bring anyone into our home.
Anyone?
Were there multiple people?
No.
Why are you accusing me?
We opened our marriage, Teddy.
And you also were with someone else.
How's our young Romeo?
Great.
I know these odds.
He is way more into her than she is into him.
They say every pot has its lid.
Some pots have many lids.
Says the kettle.
You're mixing metaphors.
No, I'm not.
Scans.
Scans are up.
Well, it's hard to see with all of this artifact, but it looks like the ice pick is penetrating the descending aortic arch.
You see that?
There is a contained hematoma that has formed around the entry site.
How is he not bleeding out?
The ice pick is essentially plugging the hole.
So if we move him, and it moves...
He could bleed out and die.
So how do we get him to the OR?
Hmm.
Hi.
How's Chase?
Did he cure metastatic lung cancer too?
Do you two have history?
Never met him until today.
But I do have history with you.
Now, you asked me to do a consult on Gabby Mims two months ago, and clearly, you didn't trust my opinion.
I was looking for options.
Chase had one.
No, he's breaking new ground.
He's resecting a tumor from a place where multiple studies have determined that the risks outweigh the benefit.
I take it you don't approve of his technique.
Yeah.
His so-called technique is the same as resecting any other tumor, just with more arrogance.
And, frankly, I'm surprised you allowed him to use it on Gabby.
I guess she was a good lure.
You think...
...I used Gabby as surgical bait?
People go to great lengths to meet their heroes.
I know you've admired him from afar for years.
Um, Dr.
Chase's methods could be the future of pancreatic surgery.
We can get on board or we can bury our heads in the sand and watch our patients die.
You do what you want.
I prefer to keep my head above ground.
So if we roll over a paper clip, or someone runs into me, I'll die?
It's not that simple.
First, you would start to bleed, then we would get you into surgery as soon as possible.
Oh, God.
We will be very careful.
I don't know.
Well, you rode in an ambulance, and then in an elevator and on a gurney.
Like, those are pretty good odds, and I'm usually a downer.
There's no reason to think that we can't get you to the OR safely.
Yeah, and then you can go be happy with what's her...
What is her name?
I don't know.
Why didn't I ask?
I-I should have asked.
It was 17 minutes!
Hey, Brendon, we need you to calm down, okay?
And we need you to trust us, okay?
Can you do that?
Okay.
Okay.
It's all right.
It's okay.
All right, everybody, move out of the way!
Let's move on my count, okay?
I'll set the pace.
One, two, three.
Okay.
All right.
We got you.
Your pre-op labs are all good.
You're cleared for surgery.
I can't believe it's finally happening.
So, what do you think of Dr.
Chase?
Is he as good as everyone says?
He's excellent.
I've actually watched him operate before.
I once saw him treat a very complicated mesothelioma with HIPEC, combination of surgery and hot chemotherapy in the abdomen.
The patient is okay?
Posted a photo with his new grandson a few weeks ago.
I have to do this, Mom.
It's my only chance.
Last time I was in a hospital bed, I was holding my new baby girl in my arms.
I didn't want to let go of you then, and I don't want to let go now.
What if this the last time...
You've been the best mama I could ever have.
You gave me the courage to think big, dream big, believe big.
Believe big.
That's why I'm not afraid to do this.
I love you.
I love you more, baby girl.
Who's ready for surgery?
Okay.
Now I'm ready.
Let's do this.
All righty.
Hey.
Uh, so I dropped off Ms.
Schiller's labs and I submitted Mr.
Bohigian's discharge paperwork.
Oh.
Good.
When I finish with the scans, you can update the charts.
Uh, Chase's surgery is about to start.
Are you scrubbing in?
No, I-I just assumed we'd watch.
I'm not interested in that.
Well, he could make history today.
And you can learn a lot by watching good surgeons, right?
Come with me.
To the gallery?
Better.
Sorry.
Jack saw a scenic photo in radiology and refused to go back to his room until I could figure out if it was Banff National Park.
Was it?
Oh, he thinks it is.
Okay, what do you see?
Well, a bone that's completely healed but at an angle.
Oh, he's lucky if he gets five feet, let alone a hundred.
Yeah, you can see the vessel is kinked here in the area of the bone deformity.
He only has one vessel running off to the foot, barely keeping it alive.
Damn.
Hope he took lots of pictures in the Serengeti.
He's not going anywhere besides PT.
It's an amputation, right?
Ooh, could I do it?
I always wanted to do one.
Go check on my arthroplasty from last night.
Millin got to do one her first day.
Interns perform them all the time-- Not hyped-up ones.
Put that crap away.
I'm already overloaded with patients.
I don't have time to resuscitate you.
Now go do what I asked.
You're going too fast.
Listen, if you have a problem with my pace, then you lead.
Is everything okay?
You're doing great.
Almost at the elevator.
Whoa, whoa!
Hey!
No running!
Okay.
So, um, tell us more about the woman you met.
What does she do?
She's a graphic designer, I think.
I don't know her name or what she does.
When you get out of here, you'll get a second chance.
But what if I die?
Hey, Millin.
Why don't you get out your phone?
We're gonna find her.
Find her how?
You're the millennial.
You tell me.
This never goes well for me.
Can you think of anything unique?
A...
A blue streak in her hair?
Uh, big glasses?
She has hazel eyes.
I think she has a small dimple when she smiles?
Okay, everyone.
Nice and slow.
Easy.
Okay.
You ready for tonight?
Yeah, last night, Boston was down.
They put in Taft as a designated hitter.
Steps up to the plate with the bases loaded and hits a genius triple to left center.
Unstoppable.
I'm, uh, taking Baxter back.
I've got a sensitive case, and something's up with Kwan.
Um, does tonight's seat go with Baxter?
Nope.
All right.
Take whoever you want.
I do need to see if I can switch the seats to tomorrow.
Oh.
No, no, no.
I got a...
a late CABG tomorrow night.
So...
...put that phone away, please.
My patient's got a severe tib-fib malunion with vascular damage and critical limb ischemia.
I've-I've either gotta amputate or...
bring in a genius designated hitter.
Is he a candidate for a fem-tib bypass?
He's got anatomy distorted below the knee.
No.
No, it won't work.
When I say "severe," I mean I've never seen a leg like this in my entire career.
I can bypass anything.
Even this?
Damn it.
Yeah.
Not everybody's unstoppable.
No, I can do it.
Which means I won't be sitting behind home plate tonight.
What if I never find her?
Seattle's not that big.
But it's that not small, either.
And you're young.
You'll meet somebody else.
Uh, maybe you dodged a bullet.
Every nightmare I ever dated made a great first impression.
Or she's the love of your life.
I-I'm sorry.
Does nobody else find this a little bit creepy?
I'm sure you're great, but stalking is not-- Have you ever been in love?
This feels inappropriate.
When you're in love, you don't give up.
Keep looking.
Okay.
Here we go.
Careful.
Easy.
All right, let's turn.
Doing great.
Brendon, does she have a mole on her neck?
On her right side.
Did you find her?
I think so.
You were right about the bugs. "
Elena Ginsburg, member of the Greater Seattle Entomology Club"?
What's entomology?
Oh, my God.
That's her.
No, no!
Brendon, don't move!
Okay, run.
Let's go!
Let's go!
Hey.
We need to get him on the OR table right now.
We need to get in there.
Gown and glove.
Okay, on my count.
Ready?
One, two, three.
Betadine.
Yeah, I'm on it.
The ice pick in his aorta moved.
We got him here in less than a minute.
We can save him.
Let's go.
Let's go!
All right, we're removing the ice pick.
Scalpel.
How can I help?
You can give us some space.
Come on, Brendon.
You made it this far.
Stay with me.
That's not it.
Yeah, maybe I should get back to rounds.
Uh, Mr.
Vizcaino's wound vac's not gonna check itself.
Uh, we just checked it.
You know, you made a very good point.
I did?
Yeah.
There is a value to watching great surgical cases.
All right.
Ah.
Found it.
What is that?
This, son, is a videotape.
Yeah, I kn-know that.
What's on it?
Surgeries.
Look, I'm talking Whipples and Roux-en-Ys and Puestows.
Procedures that require real skill, not that surgical cowboy nonsense.
You wanna watch and learn, you watch this.
How?
I'm almost finished with the first shunt.
Suction.
But careful, too aggressive a move could spell disaster.
This okay?
It's fine.
Dr.
Griffith recently did a solo surgery.
First in her class.
Wow, congratulations.
Ever seen a mesocaval shunt before?
No, sir.
Congratulations again.
You're about to see one completed.
Oh.
Careful with this margin.
I see it.
Mmm.
And why do we need the shunt?
To bypass the SMV and provide outflow from the intestine while you resect the tumor...
That was meant for Griffith.
Yeah.
But correct.
You must have been one outstanding student.
I like to think I still am.
It helps to have amazing teachers.
Okay.
Shunt is done.
Moving on to the periarterial divestment on the SMA.
Just like we planned before, I'll start with the osteotomy.
Can I help you, Dr.
Kwan?
I'm on Dr.
Ndugu's service now.
Um, fine.
Just stand over there.
I will re-break the bones in your leg, and I will realign them with plates and screws.
That's when I'll go in and attempt the bypass to improve blood flow to the leg.
Okay, great.
Let's do it.
I wanna keep my legs so I can keep traveling.
Jack, we won't perform the surgery unless you agree to stop traveling while you properly heal.
Okay, well, how long will that take?
Months.
If today goes well.
How long does recovery from an amputation take?
Months.
And if I do nothing?
Without urgent intervention, the wound on your leg could become infected, which could lead to sepsis.
Okay.
I want the surgery.
We'll see you in the OR.
Babcock.
Fortunately, the tissue's not friable, so it peels right off the vessel with sharp dissection.
Look at that.
Fundamentally, it's no different than resecting any other tumor.
There's some bleeding.
Where?
Then suction.
Uh, did the tumor invade the SMA?
It's possible.
Yep.
The tumor definitely breached the arterial wall.
Clamp.
We need 4-0 prolene.
And more suction.
Okay, I'll suture the SMA, and then we'll close.
Close?
W-We haven't finished.
If we continue with the procedure, we're putting her in greater danger.
What about blood supply to the small bowel?
Tell your intern that's out of scope for this procedure.
I am officially done here.
You have successfully completed all your other cases.
Why stop now?
Dr.
Chase?
Okay, if you stop, will Gabby be a part of your study?
I'm kind of in the middle of something if you haven't noticed-- Dr.
Chase.
Of course not.
Her procedure was incomplete.
So that's how you do it.
I thought it was unparalleled expertise and steady hands.
But it's cutting and running before there are consequences, at least, for you.
Dr.
Bailey, her small bowel's becoming dusky.
Okay.
Uh, if we stop, she will die.
I told you, I'm done here.
You're damn right you are.
No.
I will finish.
Your patient is no longer a candidate for this procedure-- Then by all means, don't let me keep you.
There's the door.
Use it!
I need a stool, please.
Right away, doctor.
What do we do now?
Uh, I don't know, but we sure as hell aren't closing.
Just have to put in a few more, and if the alignment's in check, it's all you.
When was the original fracture?
Eighteen months ago.
He was treated abroad, but he started weight-bearing way too soon.
Nearly lost his leg today, but, hey, I bet the beer was damn tasty after seeing the Great Migration in the Serengeti.
What?
That's why he risked amputation?
He didn't wanna cancel a trip?
That's what he said.
He lied to you.
Drill.
Jack's brother was an extreme adventurer.
He booked a trip around the world.
Motorcycle tours mostly.
He died unexpectedly two years ago.
Jack quit his job, and he's been spreading his brother's ashes in every country his brother wanted to see before he died.
He could have avoided all this if he let himself heal physically, but spreading his brother's ashes probably healed something, too.
Done.
Ndugu, you're up.
All right.
Let's hope I didn't make you do all that work for nothing, huh?
Potts scissors, please.
Okay, watch this now.
I'm going to...
Oh, come on here.
Come on.
You know, they have places that convert these old tapes.
Oh, to DVDs?
Ah, here we go.
All right.
Now I'm going to dissect the lateral peritoneal attachments.
The Kocher maneuver.
Exactly.
Here's the incision...
Uh, are you using your finger to open up the duodenum?
Yeah.
Simple and effective.
See?
That's how I was taught.
Huh.
It's Bailey.
It's a 9-1-1.
I can't believe I fell for that man's snake oil.
Did you have any idea when you were in Baltimore?
Where's Chase?
Uh, you were right.
Don't gloat.
About what?
Gabby's tumor grew through the wall of the SMA.
Chase transected it while resecting.
Then decided to take a break?
Dr.
Bailey asked him to leave after figuring out he's been selective about the patients in his study.
Well, the artery is shot.
He did a nice job on the shunt, though.
Adams, see how he rerouted the SMV to the IVC?
Hey, look, I know this is a teachable moment, but every minute that goes by increases the chances of Gabby's bowel necrosing.
And as much as I appreciate the genius of Chase's rerouting, we need to...
What are you thinking?
What if we used a saphenous vein graft to reconstruct the SMA?
W-We could restore the blood supply and remove the invaded vessel.
And the whole tumor with it.
You think that's too risky?
Only if you don't have enough hands.
Adams, we're scrubbing in.
Okay.
Okay.
Okay.
We got a plan.
We got a plan.
There's too much bleeding.
Can you see where it's coming from?
How many units has he had?
Four units.
♪ Black and blue, far away ♪ His heart won't restart.
Warren, get over here.
Take over compressions.
Come on, Brendon.
Come on.
All right, stop compressions.
Let me in there.
All right, charge to 40.
Clear.
Charge again.
Clear.
It's been too long.
He didn't give up.
We can't either.
All right.
Charge to 50.
Clear.
Teddy.
Come on.
Damn it.
Let me in there.
Teddy.
Come on.
Teddy.
Teddy!
It's over.
You've done all you can.
Time of death, 19:24.
I spoke to Brendon's parents.
It shouldn't have gone like this.
I, uh...
I have a lot of paperwork to get through.
You should just go.
Teddy.
Teddy, we need to talk about this.
Now is not a good time.
So, you're happy to work on our marriage when it means sleeping with Cass Beckman, but when I wanna have a difficult conversation-- Oh.
I'm sorry, who slept with someone else?
Not me.
What did you think was gonna happen when we opened our marriage?
I'm gonna be late.
Um...
Don't wait up for me.
She's going to be okay, right?
She needs a lot of rest, but she's doing very well.
Thank you.
You hear that, baby girl?
You're gonna be okay.
Thank you so much.
Dr.
Chase go back to DC?
Uh, I don't know.
He was not able to complete the surgery.
But we had other surgeons step in and help, and we resected the tumor.
You got it all?
No more tumor?
We did.
I can't believe it.
Dr.
Chase taught you his technique?
Dr.
Bailey developed her own.
That's what saved Gabby.
I, uh...
I'm so grateful.
Thank you for taking care of my baby girl.
You're gonna keep calling me that, a-aren't you?
Forever and ever.
Oh, my God.
Uh, we'll give you some time.
Griffith.
Hmm?
Uh, he must have been terrible to work for.
I ended up in the right place.
Excellent work today.
♪ I can't see the future ♪ Is it still there?
My leg?
Dr.
Lincoln and Dr.
Ndugu will be in soon, but they were able to realign your bone and reestablish blood flow.
It was pretty amazing.
You probably think I'm an idiot.
I...
think that you were in pain and taking the time to heal.
It sucks, but...
Especially after losing someone.
And now I'm stuck in a bed.
About that.
These are VR goggles.
We keep a few of them in our skills lab.
They help us practice procedures.
But I was able to download a program that allows you to visit spots across the globe.
Uh, virtually, that is.
I thought it would help distract you from being stuck here.
Thank you.
You're welcome.
Dr.
Lincoln?
I am sorry about today.
It's no excuse, but I've been going through something in my personal life.
I'm impressed you even have a personal life.
When I was an intern, there was a 32-day stretch where I didn't see the sunlight.
It's probably for the best.
And I'll get a life when I'm an attending.
Hey.
What is this?
Why are you still in your scrubs?
We can still make it by the third inning if we hurry, but we gotta go.
You didn't take another surgery, did you?
We're still going, right?
Hey, Chief, your post-op notes are done, and I'll check in the ER for any consults before I go.
No need to announce it.
Just get it done.
Okay.
Hey, Chief.
I'm sorry I screwed up during the heat dome, all right?
I wish I could go back in time and do it better, but I can't.
All I can do is play by the rules today.
And I am trying really hard.
But if that's not good enough, just...
just call it.
Good night.
I know it's complicated...
Is that Seattle Grace?
It's Midvale General, Adele's favorite soap.
It appears she taped over my esophagectomy.
Uh, that's disappointing.
I'm sorry.
Not as sorry as Dr.
Lehane's gonna be when he finds out his wife's pregnant with his brother's baby.
When I first read Chase's work, I thought it was too good to be true.
And I still fell for it.
Yeah.
People like Chase prey on our optimism and hope.
The indictment's on him, not you.
But I brought him here.
I misled our residents into believing that these tumors could be resected.
And apparently they can.
You were able to do it.
We were.
Dr.
Chase.
Griffith.
You need something?
Oh.
I can't change Baltimore's decision to terminate you, so don't bother asking.
I'm not.
I'm glad I'm here.
I wasn't at first.
I spent a lot of time wondering what I could've done to make you see what a good surgeon I could be.
But today I realized it wouldn't have mattered.
You don't care about teaching.
You don't care about your patients.
You only care about you.
Maybe that gets you published, wins you awards.
But it does not make you a good doctor.
Well, that's...
...a lot of opinions from an intern who's only done one surgery on their own.
Here's what you could've done to impress me.
You could've been more specific in your post-op notes. "
Better" doesn't really tell me anything useful.
Could've been more assertive with your patients, and there was too much slack in your sliding half-knots.
Still is, from what I saw in there today.
Stands to reason, I suppose, given your mentor who's really no great shakes herself.
Good luck, Dr.
Griffith.
You need it.
When you're in pain, you can grin and bear it all you want.
You can try to pretend it's not there.
Have you seen this map?
We're right behind home plate.
Yeah, yeah.
We get a concession server?
Lincoln was right.
I did need a night out.
Glad he could help you out.
I love baseball.
You love baseball?
Wait, are you for Seattle or Boston?
When we get there, just pretend it's the OR.
Okay?
Hey, don't talk.
Okay?
Don't talk.
♪ See the light, see the light That breaks through ♪ But there's no glory in suffering.
He said my sliding half-knots were sloppy.
His shirt and tie didn't match.
He insulted Bailey.
No!
Karma will get him.
Or a malpractice attorney.
Mmm.
Hey, how was your day?
Actually, uh, pretty great.
Dr.
Webber said he's gonna talk to Dr.
Fox about letting me back into our class-- Nope, keep your good news to yourself.
We're moping.
Yeah, this is Mopetown.
Population, two.
I'm the mayor.
She's the comptroller.
What's a comptroller?
I don't know.
I don't care.
I thought you'd be happy for me.
I am.
It's just been a long day.
Yeah, so get on board or get out.
I'm pretty beat.
I'll see you upstairs?
Okay.
Okay, will you come with me to, like, a bug society meeting, so I can tell this girl that my patient died?
No.
That's not what a comptroller does.
What?
Yeah.
There's no reward.
Sorry.
It doesn't make you wiser.
Or stronger.
It doesn't make you immune.
♪ Here we are, here we are I'm with you ♪ ♪ There's a beautiful dawn In the breakthrough ♪ ♪ There's a beautiful dawn In the breakthrough ♪ Did you even hesitate?
When you slept with someone else?
Of course I did.
Hmm.
I love you.
Teddy, only you.
That night meant nothing.
♪ Here we are, here we are I'm with you ♪ Hey.
Teddy, come here.
It's gonna be okay.
Sometimes it makes the pain even worse.
♪ There's a beautiful dawn In the breakthrough ♪