Mmm, I love this so much.
The lake, the fir trees, the fresh air…
Good. You have 14 minutes to enjoy it.
We are four hours and ten minutes away from the resort,
and your prenatal massage and aura cleansing begins at 5:45,
given six rest stops at eight minutes apiece.
Wait, you've timed my pee breaks?
Generously.
Shaun, we're supposed to be relaxing.
Schedules are not relaxing.
I find them very soothing.
Okay.
-Fourteen minutes it is. -Thirteen.
[dog barking nearby]
Fourteen is fine.
[tires screeching]
[whining]
Oh, that poor dog.
[whining continues]
47-year-old male, multi-impalement, disoriented, significant blood loss.
Ultrasound and surgical tape.
These spikes… Wood and metal?
We were trimming trees and a shovel got sucked into the wood chipper.
-You work with him? -Sometimes. I'm… I'm his son.
I count 20 pieces. Airway's patent, and he's got good pulses.
Lalo? He's one of my patients.
No significant free fluid in the abdomen.
No bronchospasms or wheezing.
No. Fluid's accumulating in the pericardium.
He could bleed out. We'll have to do it in the OR.
Dad? Dad, can you hear me?
-Ahhh! -No.
-No, no, no, Dad! -Oh!
-[Lalo screams] -Let's get him to the OR!
He couldn't have gotten far.
We don't know that, and that ground is very uneven,
and we know from experience, the woods can be dangerous.
-[shushing] -[dog whimpering]
[gasps]
-Hey, there, buddy. -[whimpering continues]
We're here to help.
It is having trouble breathing.
Leg and multiple rib fractures.
Poor little guy.
I need to reduce the rib fractures. Hold it steady.
Uh, okay.
Hang on, buddy. It'll be okay.
-[rib cracks] -[yelps]
We need to get it to a veterinary hospital.
[whining]
Vince.
[theme music playing]
-I gotta get you to St. Bon's. -I need you to do it here.
I'm a first-year resident.
That's unsupervised surgery.
I can't go to the hospital.
A gang member was at that party. Being there was a parole violation.
Cops get that bullet, I go back to prison.
Just go to your PO. Tell him the truth.
'Cause the criminal justice system is always fair,
especially to guys who look like me.
[grunts softly]
I finally got my life back on track.
I have a good job.
I'm trying to work things out with Viva.
I'm watching my baby twice a week.
I go back inside, I could lose everything.
Danni…
Please.
All right, the bullet's close to the surface.
It's more of a procedure than a surgery.
Thank you.
All right, I gotta get some stuff first.
[Dr. Andrews] What's the strategy?
[Jordan] Start with the most life-threatening spikes.
-Two in the chest, maybe the abdomen. -We can't risk a major hemorrhage so soon.
Do the easier ones, buy time for the transfusions to work.
[Dr. Andrews] Oh. Dr. Reznick's right.
We start with the distal extremities. I'll take his leg.
You get the pieces in his right arm. I'll take his left.
Now that there's an adult in the room…
Always a pleasure.
You leaving, I mean.
[Dr. Lim] Hey.
So, after basketball on Wednesday,
I'm introducing Clay to the wonders of su cai bao.
You in?
Assuming that's food, sure.
Great. It's a date. 8:00 p.m., my place.
Didn't you just finish a night shift?
[sighs] Too much caffeine.
I'm building a trauma simulator to practice removing foreign bodies.
You're weird.
You'll probably be my boss someday.
First grade, I begged my parents for a puppy.
Tessa. Chocolate Lab, sweetest little face.
Next morning, Tessa peed on my dad's briefcase.
He returned her that night.
-That doesn't sound like good parenting. -It wasn't.
The dog's got a damaged spleen, broken ribs, and a fractured radius,
and skin lacerations. He'll need--
An ex-lap and thoracotomy.
I'm a surgeon at San Jose Saint Bonaventure Hospital.
We should go.
When are you planning to do it?
I'm not.
I don't work without up-front payment, and since we don't know the dog's owners--
Well, we'll pay.
That could be expensive.
Quite.
I could slot him in tomorrow morning.
Well, I guess we could stay in a motel?
I mean, we should really be here for Buddy.
I've named him Buddy.
Whatever its real name is,
it is a dog and not our dog.
And we are going to miss your prenatal massage.
Buddy needs us more than I need my aura cleansed.
Okay. It is your babymoon.
Mmm.
Ready?
[inhales deeply]
[breathing heavily]
It's just a fragment. The bullet must have shattered.
-It's still in me? -Yeah.
There's damage deeper in your leg.
I can't locate the rest of the bullet unless I cut further in your muscle.
So cut.
I need a second opinion.
-Hey. -[Danica] Question.
If a bullet's stuck behind the vastus medialis--
-This is for your simulator? -Yeah, it's a scenario I'm practicing.
Um, how do you decide if you leave it in?
It depends on the imaging.
What if you're going in blind?
Well, it depends on the angle of entry, caliber of the bullet exact location.
Okay. I'll figure it out.
Danni?
How about you tell me what's actually going on?
[sighs]
[Dr. Andrews] Removing the left lateral mid-thigh spike.
[Jordan] Irrigating the spike near the sternum.
No signs of pneumothorax.
-[Dr. Park] Starting the shoulder. -[monitor alarm blaring]
-[Jordan] Lost pulse. V-tach. -[Andrews] Get paddles.
Setting up the paddles.
He's coding. Where are those paddles?
Almost ready.
There's no time. Starting cardiac massage.
Push one milligram epi.
[alarm continues blaring]
-[alarm stops] -[Jordan] Got sinus rhythm.
-Blood pressure's normalizing. -Good job, Dr. Park.
I'll do more sharp dissection.
His body can't take any more.
We'll get a pan-scan CT, CTA, transfuse him, and resume in the morning.
Nine spikes down, eleven to go.
[sighs] Definitely landed in the medial compartment.
Blood flow?
Good pulses. Intact nerve function in the leg.
If he was in the OR, we'd leave the bullet in.
Got it. Thank you.
I'll pack the wound and send him home.
Can you take me off video?
Yeah, I'm not a big fan of being lied to.
It won't happen again.
Thanks, Asher.
There's a stain on the floor.
[Lea groans]
Now there's a pillow on the floor.
They should really clean that carpet. Let me call the front desk.
Ugh, it's sticky!
-Okay, maybe… maybe I overreacted. -You did.
I… I thought you loved animals.
I love rabbits and fish.
They don't slobber or jump on you or make messes.
Shaun, someone's about to come into our life
who's going to slobber and jump on us and make messes.
If you are talking about our son--
Yes, of course, I'm talking about our son.
Sorry.
Clearly, we are both stressed.
I don't think I'm stressed.
Fine.
Only I am.
And tired.
And I'm gonna get ready for bed.
[Lea] Ew!
[urgent knocking on door]
[knocking continues]
Something's wrong.
That's infected.
If I don't get the rest of the bullet out, you'll go septic.
So you can do it here, right?
I shouldn't.
[breathing heavily] You got me this far.
Please.
[sighs]
Okay. I'm gonna need some help.
[whimpering]
During the surgery, we discovered sacral and lumbar fractures.
What does that mean?
The dog will have trouble walking and will be incontinent.
So, a second surgery?
Unlikely to be effective.
The dog would still be at risk for infections, UTIs,
and will require constant care.
Euthanasia would be more humane.
We brought this dog here to save him, not have him put down.
I'm gonna find his family,
and if I can't, I will find him a new family.
And you're gonna find a surgery to fix his incontinence.
Dr. Sinclair is the expert in veterinary medicine.
If he cannot think of an effective surgery for incontinence,
there probably isn't one.
In which case, it's very unlikely the dog will be adopted.
Then we'll adopt him.
I will find a surgery.
[knock on door]
Hey. Where are the supplies?
I didn't bring them. You shouldn't be doing this.
-This is straight-up surgery. -Go home.
-Let me help you take him to the hospital. -Not happening.
-Why not? -If you weren't gonna do this, why come?
Because I… I didn't want to desert you.
So don't.
I'll go get the supplies myself. I just need you to talk me through it.
You won't even have to touch him.
If this ever gets out, I'll take the fall.
This is why he went into V-tach.
The spike in his shoulder damaged every critical structure in the area.
We need to do a bypass before we pull it out.
-Risks sending him into V-tach again. -We need to remove the spike.
Unless we remove his arm.
In his current condition, it's a less risky surgery.
Comes down to what Lalo's willing to risk.
And we can't ask him because he's too unstable off the ventilator.
We could ask his son.
He's 16. He's not authorized to make medical decisions.
He'd have a better idea than us what his father would want.
[sighs] Talk to him.
[Buddy whining]
Oh, Buddy.
It's okay.
We're gonna find your humans.
-[barks] -[gasps]
Are you okay?
Yep. All good.
Were you trying to pet the dog?
No.
Mmm-mmm.
You should never touch an injured animal near its wound.
I know.
I'm gonna start putting up "lost dog" fliers.
Making the incision.
[groaning]
Dissecting at the muscle to free up the purulence.
What's her name?
Lila.
What's she like?
The first time she saw snow, she ran outside,
no gloves, no hat.
I had to drag her back in before she…
before she turned blue.
[shuddered breaths] She's like me.
Never listens to anyone.
Mmm. Sounds like Powell, actually.
I know I can be a bit much.
My parents were really tough.
I learned at a young age that if I didn't push back hard
that I'd be pushed around.
So, it helped me, especially after I lost my leg.
My med school advisor told me that I shouldn't be a surgeon,
because I wouldn't be able to stand for hours in the OR
But I can.
And I am.
[knock on door]
[Dr. Lim] Danni, are you okay? It's Audrey.
[whispers] I called out of my shift this morning.
I just told her it was a family emergency.
She's been calling and texting.
This is not good. This is not good.
I know.
Wait! Where are you--
Just, shh. Just…
-Hey. -Hey, is everything okay?
Yeah, yeah, a good friend's having some issues.
-We're still in the middle of it. -Oh.
After what happened with Perez, I was worried.
Just wanted to check on you.
Thanks. I totally get it.
-You'll be in tomorrow? -Yeah.
[Vince groaning]
What was that?
Hey.
If we remove the spike from your dad's shoulder,
it could cause complications that would kill him.
How likely?
Maybe a 5% to 10% chance.
The safer option would be to amputate the arm.
So you're asking me to decide whether to cut off my dad's arm?
No, we're not.
We just wanna figure out what your dad would want if he was awake.
Do you have any other support system?
Family, friends who help out?
Not really.
Mom died, and the rest of the family is in El Salvador.
Has he ever worked with other gardeners?
I mean, me. I help out most mornings before school.
Um, he fell off a roof last winter.
Got a concussion.
I picked up some slack, and it was fine.
I… I know this is different,
but he always says, "We stick together, we'll find a way."
If cutting off his arm means he'll live,
then do it.
That's what he'd want.
Why are you talking to me about operating on a dog?
Lea asked me to.
She is very stressed, and I don't know why.
Well, considering what she's been through, you know?
But she knows her pregnancy is safe now.
Well, you don't get over something like that in… in a week.
Okay, so how much time will she need?
I don't know, Shaun.
Maybe this isn't even the main issue, you know?
Mmm…
Maybe Lea is worried about being a mom?
Well, she wouldn't be the first.
Aren't you a little bit worried about being a dad?
A little.
Crying babies can be very loud,
and bowel movements and spit-up can be very disgusting and smelly.
But I have noise-reducing earplugs, and peppermint oil for under my nose.
And I will keep a supply of surgical smocks at home.
You've certainly gamed that out, huh?
Yes. How do I help Lea be less worried?
[sighs] I don't know, Shaun.
You don't know what the issue is, right?
So I would talk to her
and tell her you've noticed she's been a bit stressed lately,
and ask her what's going on.
-[elevator bell dings] -Send me the doggy imaging.
[whispers] He's stable, for now.
-I'm so sorry. -You should be.
If you're gonna blame anybody, blame me.
Oh, I do. This was unethical, stupid,
and if he dies, possibly criminal.
Vince would've died of sepsis.
-Call an ambulance. -Then what?
EMTs can't force him to go to the hospital.
-They can if he's unconscious. -But he could be dead by then.
The only way to make sure that he lives is to operate here.
You're a trauma surgeon. It would be simple and ethical.
Who is this guy?
I told you. He's a friend of mine from the Navy.
Who's on parole. For what?
-That doesn't matter. -Does to me.
Vince was the first one to the accident. He tourniqueted my leg.
He held my hand, he comforted me.
He was the only person that day that looked me straight in the eyes.
Everybody else was just too scared, too freaked out, too disgusted.
[sighs]
I'm sorry.
Will you give us a second?
If I hadn't warned you off of that surgery four months ago,
you could've ended up worse off or dead on the table.
And whether you knew it or not, you needed me.
Right now, Audrey, I need you.
I will help you with your friend.
And then we'll deal with what you did.
[sighs] I put up tons of fliers,
called around to all the shelters and vet hospitals and…
Did Glassman have ideas at least?
Yes. That I should talk to you.
I've noticed you are stressed, and I don't know exactly why,
but maybe it is because you are worried about motherhood.
I meant about the surgery for the dog.
But I am worried, yeah.
You shouldn't be.
You'll be great.
[chuckles softly] Thanks.
And I know you'll be a great dad to our son,
but what if we're incompatible as parents?
We can't even agree how to wash dishes.
And look at us with this dog.
We're arguing. Buddy hates me.
[whines]
I lied.
He snapped at me after I petted too close to his stitches.
I thought so.
We will work as a team and figure it out.
But what if we don't know how?
We've both had pretty lousy parental role models.
I don't think I'm like my parents at all.
And I don't plan to treat our children like they did me and Steve.
Ugh. I can see my parents in me in ways I really don't like.
I can be stubborn like my dad, and flaky like my mom.
I can't tell you how many times I was the last kid at after-school
because she forgot to pick me up.
What if I mess up like they did?
You probably will mess up sometimes,
in those ways, other ways too.
I probably will as well.
But we will support each other and each…
I know how to help the dog.
[Dr. Lim] Gonna inject more lidocaine.
[Vince winces, groans]
Turn on the ultrasound probe.
How'd you end up in prison?
When I got back from Afghanistan, I couldn't sleep.
I'd lie in bed, staring at the door waiting for someone to come at me and…
I… I was in a bar and I thought some guy looked at me wrong.
Are you getting help?
I'm on meds,
in therapy.
I don't wanna be what I was.
I wanna be a good man for my family.
I don't see the bullet.
It must have migrated.
Three centimeters deep, and medial to the femur in the adductor magnus.
And what does that mean?
It's harder to get to now.
[sighs deeply]
We can do it.
This'll hurt.
[Vince wincing]
Ahhh!
-Let's amputate. Book the OR. -On it.
I think we should save the arm.
Did you not hear what Dylan just said?
I heard a son who'll do anything to make sure his dad lives.
But that's not necessarily what the dad wants.
Lalo's a poor, undocumented manual laborer. No support system.
If he can't work as a gardener, then what?
Dylan told us what. They'll find a way.
Dylan will drop out of school.
He just told us how he works for his dad most mornings.
Took care of him when he had a concussion.
The future Lalo spent building his son would disappear.
You know what else would ruin his future? Having a dead dad.
Lalo would take the risk.
Morgan came away with a different impression.
She's not a parent.
That's very patronizing.
Doesn't mean he's wrong.
-You're confident you can save his arm? -Very.
Then let's do it.
What a dick move!
I am so sick of being told that childless people
can't understand what it means to love someone.
There's love, and then there's being a parent.
In nine months or so, you'll get it.
[exhales deeply]
After drilling the lamina from L4 to S1,
we will use a Kerrison punch to remove fragments two millimeters at a time,
then support the spine with screws and rods.
And that is how we will fix the incontinence and leg weakness.
And by "we," I mean "you."
-A little outside my wheelhouse. -That's why they call it "in the bullpen."
Ah, yes. You're an expert on humans.
-I'm still very unsure. -Why can't you just do the surgery?
Buddy is an innocent little guy who really needs our help.
I've put in a ton of work with Shaun and Dr. Glassman to find a way to save him.
And… And I recognize you have valid questions.
And I know, my hormones are probably playing a role right now,
and my attachment to a dog I met yesterday
probably doesn't make sense to you, but it is real.
And I really need Buddy to be okay.
So I'm asking you to please set aside your concerns
and please help us help Buddy.
Who's paying for this?
Um…
Seriously?
-[screaming] -I need longer forceps.
-God! -We're almost there.
[labored breathing] No.
Vince? Vince!
[softly] It's cold.
Poor pulses. The fragment must've caused a thrombosis.
I'm calling it. Push more fluids.
I need an ambulance at 302 West Holden Drive, Apartment 2A.
We're gonna try to save your dad's arm.
-Did… Did something get better? -No.
But we decided it's worth the risk.
Why did you even ask me then?
So I could screw up, make the wrong decision?
You didn't screw up.
He hasn't taken a weekend off in six years.
He… He wears old clothes so I can have new ones for school.
He's given up his whole life to… to make sure I'm…
I'm happy and healthy and safe.
-I'm just trying to help him and-- -You did.
You gave us the information we needed.
[scoffs] Right.
[monitor beeping steadily]
[Dr. Sinclair] Ten-blade.
Twenty's better.
You worried about a scar? It's a dog.
Dogs like scars, actually. They think it makes them look cool.
A veterinary medical review longitudinal study
showed that post-op recovery outcomes--
Shaun, the man knows how to cut into a dog.
But he may not have read the study--
I've already made the incision,
with a ten-blade.
Preparing to place the three-millimeter pedicle screw.
[softly] A five-millimeter screw's better.
-[monitor beeping steadily] -[Dr. Lim] Removing the bullet.
Slowly release the proximal clamp and let's look for flow.
It's good flow.
Vascular repair's hemostatic.
Let's finish this up and get him off to recovery.
Bag the bullet for forensic evidence.
Hey.
How'd it go?
We won't know until he wakes up.
It meant a lot that you came.
How can you say no to a dog?
Yeah.
You know, when Maddie was a newborn,
[sighs] we were worried that she wasn't
latching on, you know?
But she did.
And then we were worried that she wasn't crawling,
and she did.
And then we were worried she wasn't talking,
and, da, da, da.
You're gonna be a mom.
You're gonna worry, that goes with the gig.
99% of the time, everything works out just fine.
What was Maddie like?
Maddie… [clears throat]
[exhales]
She never walked anywhere, she always ran.
She was angry a lot.
That was her default.
But she loved so deeply.
It was like you were the only one in the world.
I wish I'd known her.
Why'd you ask me about Maddie?
I just can't imagine going through what you went through.
And I am so scared
of that 1%.
After Maddie died, I didn't think that I was gonna make it.
There were times that I hoped that I wouldn't.
But I did.
And then I met Shaun, and then I met you,
and I'm grateful every single day because I love you both so much.
You and Shaun have love,
and you have faith in each other.
If I was a betting man,
I would bet the house on the both of you.
[sniffles]
[monitor beeping steadily]
We're on full flow. Removing the spike.
-[monitor alarm blaring] -Low blood flow to the brain.
-[sighs] How's the NIRS? -61%.
-Graft must've caused an obstruction. -I can fix it. Clamps.
11-blade and 6-0 prolene.
-NIRS? -56%. Dropping fast.
Below 50, he risks brain damage.
We should call this off and ligate the subclavian.
No. We're this close to saving his arm. More sutures.
-52%. -Dr. Park?
-Dr. Park. -Get ready to flush and unclamp.
Go.
-[Dr. Andrews] Starting flush. -Unclamping.
-[alarm stops] -Arm's pink.
NIRS at 70% and climbing.
Ten spikes to go.
If the surgery fails and he is still incontinent,
I found a waterproof dog bed he might like.
For our place?
Buddy is
very calming to pet.
-[whines] -[Lea] Oh.
I think he needs to pee.
We need to get him to the pad.
Hey, Buddy, you gotta hold it in until we get you over there.
-Okay, not yet, Buddy. -[Shaun] Almost there, Buddy.
-No pee pee. -Keep holding it.
Not yet, no pee pee.
-Almost there. -Keep holding it in.
There we go. All right.
Time for urination.
Go pee pee.
-Okay. -Oh, oh!
[Buddy urinating]
He did it.
Oh, we did it.
-We got him to pee. -We did it.
-[chuckles] -Oh! Oh!
Oh, good boy! [chuckles]
I'm thinking letters in their records, remediation plans,
and a two-month probationary direct supervision.
One more misstep, they're out.
That's appropriate.
For Asher.
It's not easy to draw a line between what they did.
Asher never picked up an instrument until you were supervising him.
And Powell has shown a pattern of disobedience
even from her first surgery.
[scoffs]
Wolke's made mistakes of his own.
And he knows that.
Does Powell?
[sighs]
Listen, your department, your call.
You almost lost Shaun as a friend this year,
and I'm worried you're acting out of fear of losing another.
Color looks good.
Strong radial pulse.
Now try to move your fingers, very slow, just a little.
Okay.
Is that good?
It's great.
Muchas gracias, Doctor.
You saved my life.
What's wrong?
Um, they asked me what you would… you know, about your arm.
I told them to amputate.
I made the wrong choice.
Mijo, whatever you did, you were there for me.
I've never been so proud of you.
[speaking Spanish]
[slow indie pop song playing]
[speaking Spanish]
[Dylan, in English] I love you too.
[Lea] So, I started looking for dog walkers.
They're not cheap, but what is, so…
Cooper!
[Buddy barks]
You're Lea? We just saw the flier.
We have been searching for days.
We will, of course, pay you back for any expenses.
Good. It's $22,563.
Yeah, we could work something out.
♪ Maybe it's just a phase but regardless ♪
♪ I'm flipping the pages, pages ♪
You saved the arm.
Guess you were right.
Or I was lucky.
I almost lost him.
Well, you didn't.
I think I pushed too hard on this surgery.
And I definitely said things to you that weren't fair.
Last week Kellan told me he wasn't coming home for the holidays.
Going on a trip with his roommates.
Feels like I'm losing him.
Like I've been a crappy father.
You're not.
Anyway,
I'm sorry.
My implantation failed.
It's been, what, nine days? Blood tests wouldn't be fully accurate.
I could feel I was pregnant,
and
then I wasn't.
I'll be here.
Anytime you need a friend.
[sighs]
I just might.
[sighs]
Probation.
I'm sorry.
We're letting you go from the program.
What about Vince?
-If you have leeway not to report him-- -The bullet was misplaced.
Misplaced?
So I don't see the point in alerting the police.
Thank you.
[sighs]
Danni, this wasn't an easy call.
You gotta learn to compromise sometimes.
If you don't, it's gonna hurt you, not just as a doctor, but in life.
I'm sorry it worked out this way.
I'm not.
If I'd done anything else,
Vince would be dead or headed back to prison.
And either way, his family would be destroyed.
So I did the right thing.
I'll live with the consequences.
Good luck.
[indie pop song resumes]
You too.
I'm gonna miss you, Buddy.
Cooper.
But I'll write you every week.
-He won't get it. -I was kidding.
You're a good boy.
Look, I know everyone says this to you,
but I really mean it. [chuckles]
♪ But I swear I'm the same ♪
-♪ Could you show me some patience ♪ -[whines]
♪ Along the way… ♪
He will be okay.
Yeah, he will.
We still have time to make the 11:00 a.m. nature walk.
[Lea] Mmm.
♪ Trying to fight the seasons ♪
♪ Trying to find my meaning ♪
♪ Maybe there's a reason ♪
♪ Why I'm going through these changes ♪
[closing theme music playing] e changes ♪