[exhales]
[groans]
Stop looking at me.
[sighs]
[door opens]
Mmm, pancakes. The Peanut is thrilled.
You are wearing the maternity jeans I bought you.
Glad you're happy about that.
You're 28 weeks pregnant.
Your weight has increased 21.5 pounds, and our baby is moving lower.
Hmm. At least there's pancakes.
We need to buy a minivan.
No, we don't.
The Striped Tomato has no infant safety features.
Shaun, I just surrendered to maternity jeans.
This is not the right time for broaching the mom-mobile.
When would be the right time?
These are amazing. Did you use buttermilk?
Greek yogurt.
Mmm.
I will e-mail you my spreadsheet of child-safe vehicles.
We can discuss it on your lunch break.
Sonja Baylor?
Wait. Who's the Code Gold?
Is it Taylor Swift's broken heart?
Better. Roland Barnes.
-[engine revs] -[Asher] The green tech guy?
-He was attacked by a tiger. -Sorry. In San Jose?
At his animal rescue in the Santa Cruz Mountains.
Concierge doctor said they're on their way.
San Jose General is much closer. Why would he come here?
[Dr. Andrews] For you.
Deep chest lacerations, rib fractures, hemopneumothorax.
I stabilized him and placed a chest tube, but he needs a CT.
-Dr. Kalu. -Dr. Andrews.
-Good to see you, Dr. Murphy. -Oh, hello, Jared.
A famous billionaire and a cute reunion? This is almost Swift-worthy.
[theme music playing]
[whispers] Is Leo a decent poker player?
Us Weekly has photos of Roland's game last week.
Won my Lambo off him.
No sign of trauma to the liver or spleen.
Ugh. Beyonce did a private show at his birthday?
Ah. It was awesome.
No major intraperitoneal hematoma.
Moving on to the chest.
So, how does one go from St. Bon's resident
to concierge doctor for the fifth richest man in the world?
I was working at Denver Memorial when I met Roland
at a fundraiser hosted by my parents.
His wife collapsed during the silent auction.
Nutmeg allergy.
I gave her an epi and helped outbid John Legend
-for a weekend at an underwater hotel. -Well…
Roland hired me that night.
Why does he need a personal physician?
Does he often get attacked by wild animals?
Uh, chronic sciatica.
And he travels a lot, you know, so there's vaccines,
plus BOTOX injections, cholesterol scripts,
medical advice for friends and family.
Why'd you leave St. Bon's?
He was fired for assaulting an attending who harassed Claire,
and then he sued the hospital.
-You're that guy. -Yeah.
I hear Andrews is, uh, not your biggest fan.
Surprised he let me in the building.
Depressed and dislocated sternum, manubrium, and rib fractures.
They're too fragmented for a standard sternal reconstruction.
-He still does this, huh? -Hmm. Always makes my day.
I have an idea.
This is why I brought Roland here.
It's a girl.
We're naming her Esther.
We hope she'll be brave and selfless like Queen Esther.
Baddest bitch in the Bible.
How are the meds going?
Fine.
Any excessive discharge?
Oh, a couple of days ago, I was on a walk, and it was a little like I'd peed myself.
Could that be from the MilliDox?
No, you're actually on the placebo.
Your amniotic fluid is a bit low. We should admit you for further testing.
He asked for you.
Inoperable leiomyosarcoma with major vascular involvement.
What are you doing here?
I'm dying.
My doctors say that there's nothing they can do for me.
I'm hoping you can.
We should get a CT and a PET scan.
Fine.
[Shaun] We will completely rebuild your sternum and anterior chest wall
with donor bones and titanium plates.
It is a very complicated surgery.
Jared says you're a damn good surgeon.
Yes, I am a damn good surgeon.
[Dr. Andrews chuckles] He is.
And I'll be overseeing your care every step of the way.
Appreciate the personal attention.
I want Jared there too.
Jared is my doctor.
Dr. Kalu will be read in on every major decision.
I want him in the OR.
I will fast-track your surgical privileges.
-[MRI machine whirs] -Something's going on between you two.
I'm very perceptive that way.
It's a long story.
Hmm.
I saw on his chart, he's from Phoenix.
He broke his arm a couple years ago at a tae kwon do match, your sport.
So, I'm gonna go with
he's your Johnny Lawrence who cheated at the All Valley Tournament.
I've been watching a lot of Cobra Kai.
He slept with my wife,
so, yes to the cheating, no to the tournament.
[clears throat]
[mouse clicks]
This is from six months ago.
This is from today.
A leiomyosarcoma should've progressed more than that.
Maybe they had the diagnosis wrong.
[monitor beeping steadily]
[Dr. Andrews] Release the pectoral muscles medially.
[Asher] Should I place the low-profile plate?
[Jared] Don't you need to create a landing zone for the fixation?
He is right.
Get better exposure by elevating the right pectoral muscle from the ribs.
I understand SF General's cardiac unit is named after your boss
and that he sponsored a surgical exchange program with Haiti.
Dr. Kalu, would you like to place the screws?
Very much so.
Thank you, Dr. Andrews.
Drill guide, self-tapping screws.
-[chuckles] Feels good. -[drill whirs]
You have been very polite to Dr. Kalu, despite having fired him.
Is that only because you want a donation from Roland?
-[Jared] It's okay. -[Andrews] It's true.
Dr. Kalu and I did not part on the best of terms,
but I'm happy you found your niche.
-And I believe in the work we do here. -[drill whirs]
And Roland Barnes can help us do even more.
I told Roland this was the best hospital in the state.
When he's healthy, I'll be happy to tell him again.
[alarm blaring]
BP's dropping. Cardiac output is awful.
He's in heart failure. The contusion was too small to spot on CT.
[Shaun] He needs a balloon pump to help circulate more blood.
We need it in five minutes, or he dies.
BP has stabilized.
Cardiac output is improving.
He should make a full recovery,
but should not get close to jungle cats in the future.
[chuckles]
In the… In the OR, I really missed that.
Then why did you stop being a surgeon?
Working for Roland was too interesting an opportunity to pass up.
-Is sciatica interesting to you? -No, it's more, um…
-I came as soon as I heard. -Hey.
Poor Rolly.
-Shaun, this is my girlfriend Dalia. -Hi.
You…
I have seen you on the bus
in a perfume ad.
[chuckles]
Fern test confirms it's a premature rupture of the membranes.
We should terminate before an infection sets in.
What about in-patient expectant management and antibiotics?
PPROM pregnancies can be carried to term.
[Dr. Reznick] Rarely. When they are, babies are likely to have cerebral palsy,
neurologic abnormalities, intellectual disability--
Which we'll tell the parents, but this is a badly wanted pregnancy.
They've been trying for five years,
had two first-trimester miscarriages already.
Saving the baby may be her priority.
But saving her is ours.
Sonja is our patient.
We should explain her options but recommend termination.
Morgan is right.
But be clear about the options.
The seat springs allow the car seat to move more than one inch,
which creates additional injury risk.
There are no over-shoulder seat belts in the back for the car seat,
no crumple zone, and you would have to install a roll cage,
which still would not be as reliable as one built into the vehicle.
Since you hate minivans,
I have looked into hatchbacks and SUVs with sufficient safety features.
It's not just about hating minivans.
-What is it about? -I love this car.
It's my history.
My brother and I restored it, used to drive it to shows at The Fillmore.
You and I took it on our first road trip. I can't sell it.
Then we do not have to.
As long as you never put the Peanut in it. We still need a family car.
-Yeah, we do. -[cell phone chimes]
Roland's awake.
But it's possible that we could save our baby?
You'd have to live here. We'd monitor you every day,
and give you antibiotics and steroids when the baby gets closer to viability.
[Dr. Reznick] To be clear, even with all of that,
you may still develop a serious uterine infection
that could require a hysterectomy or cause fatal complications.
I think we should terminate.
What would you do?
if it was your baby.
Termination is the safest.
I was talking to Dr. Allen.
I would…
pray on it.
And then?
I want to know what you would do.
[exhales softly]
I think I…
would try to save the baby.
[sniffles]
We have to fight for our Esther.
[Daniel] We'd need a biopsy before we can give you any definite answer.
Okay.
So when do we do that?
I'll give you a detailed referral for another doctor.
If I wanted to go to another doctor, I would have.
-I don't have to keep treating you. -But you will.
You're not a quitter.
You worked your ass off to save your marriage.
You never tapped out in a fight.
I always admired your persistence.
I kinda hated it too.
Looking back at my life…
I don't like the view.
I hurt
a lot of people.
[chuckles]
That's the real reason that I came here.
For forgiveness.
The intra-aortic balloon pump worked.
-You won't need a new heart. -Great.
So, when can I get out of here?
Oh, not for a few days.
We will need to monitor you for post-surgical complications.
Your heart rate is elevated. Have you been exerting yourself?
[chuckles]
She did most of the exerting.
-[monitor alarm blaring] -Okay.
I need 1,000 milligrams levetiracetam and 4 milligrams lorazepam, stat!
Is Rolly gonna be okay?
[knocking]
Roland had a seizure.
You should sit down.
[door closes]
Dalia was there.
Naked.
They were having sex.
[scoffs softly]
Dalia and I aren't together.
She's with Roland. It's part of the gig.
I pretend she's with me
so Roland's wife doesn't get suspicious that Dalia's always around.
Oh.
You think sex brought on the seizure?
Oh. Arousal can increase the heart rate by 38%.
And if his brain was deprived of oxygen, it could cause a seizure,
which would mean his heart is still not pumping enough blood.
Does it bother you to have to lie on a regular basis?
It's not my favorite responsibility, but it's a great job, so--
Why is it a great job?
On my last day, Shaun, you told me that one day I'll be very happy.
But I was miserable.
I felt like a failure.
And then I met Roland, and he saw something in me.
This guy that I really admired, that the world admired.
You know, he valued me.
And I certainly don't mind flying private to Amsterdam
to have rijsttafel with the Queen.
I also said you would fulfill your potential.
-And I'm not doing that? -No.
Sciatica.
Thanks for reminding me I'm still a failure.
I'll get the BNP test and echo and check out his heart.
[Dr. Park] Inject saline to get us to submucosal plane.
Why'd you stay on the case?
There's the tumor.
He was right. I take my obligations seriously.
Take four samples.
Not because some part of you wants to forgive him?
Withdraw the scope slowly.
He doesn't deserve it.
-Let's start with a sofa. -[Dr. Glassman] Let's take a look.
[Lea] Finally, somebody recognizes my interior-design genius.
Looks nice. [grunts]
Hey, I love this. I'll take it.
No. This is literally the first thing you've sat on.
Okay, I'll sit in ten other ones, and then I'll take this one.
No. If you know you like something, stick with it.
Like my car.
Shaun wants to buy a minivan.
And what, you wanna put your infant in a '75 Gran Torino?
No. It's not safe for a baby.
But
[sighs] it is…
cool.
Even when I am going to my super grown-up job
in my lady-boss pantsuit,
I get to get out of that car, and I'm cool.
And soon,
I will be just another 30-something mom in a practical car
with a baby seat in the back and spit-up on my shirt.
[chuckles]
Maddie's mom used to warn me to take two shirts
whenever I went out with the baby.
-I had to learn the hard way. -How?
How do I want this baby so badly,
but feel so icked out by being a mom?
Define "icked out."
Like…
[groans]
-[chuckles] -I don't know.
-Okay, that's well said. -I don't know.
Hey, you got mixed emotions. Welcome to the human condition.
I'm gonna take this one.
Her fever's hiked. She's in a lot of pain.
Her heart rate's 117. Fetal heart rate 180.
They're both tachycardic.
500 milligrams acetaminophen, and start ampicillin.
This is the infection we were worried about.
Your baby is very unlikely to survive,
and your life is in danger.
We need to terminate now.
But her heart's still beating.
Esther can only stay alive in utero,
and as long as she's in there, you'll keep getting sicker.
I'm so sorry.
I'm here. We can get through this.
We can try again.
[sniffles]
No.
Your baby needs at least two more weeks to be viable,
and if we wait that long, you will probably die.
"If I perish, I perish."
That's what Queen Esther said before she risked her life to save her family.
Sonja.
"If I perish…
"I perish."
[Dr. Andrews] According to your BNP test and echo,
your seizure was not related to heart trauma.
-The EEG will let us assess your brain. -So, what's your pitch?
Hospital presidents don't supervise EEGs.
[chuckles]
I've been very impressed by your Global Engineers Initiative,
and I think we can do the same thing with medicine,
train doctors from the developing world to take care of their own people.
What makes St. Bon's the place to do it?
We're very hands-on here.
Our residents don't just do appies and lap choles.
With the guidance of our attendings,
they come up with complex treatment solutions,
untangle the thorniest ethical dilemmas,
and learn how to provide top-notch patient care.
If we could sponsor more residents from the developing world,
we'll send them home ready to serve their communities.
But Jared, who I trust with my life,
wasn't good enough to be a resident. You fired him.
-You saw something in him I missed. -Mmm.
But I see it now and I've granted him full access.
A very politic answer.
What do you think, Jared, has he earned my money?
I learned a tremendous amount here,
and as you've experienced, the care is top-notch.
Unfortunately, the food isn't.
Oh, text Dalia and ask her to bring us back some of those, um,
pork buns from Yank Sing.
-Dalia went into the city? -Hmm, to meet up with friends.
And you're okay with that?
Why wouldn't I be?
No reason.
Uh, all right.
Let's start this. Close your eyes and relax.
Labs confirm Sonja has chorioamnionitis.
We should add gentamicin.
-That would damage the baby's kidneys. -It's our only way to keep Sonja alive.
And it buys us time to convince her to terminate.
She's being suicidal.
Risking your life for your child is usually considered admirable.
Not if you're both going to die.
Because of the false hope you gave her.
-I answered a patient's question. -You gave her permission.
We're supposed to at least try to be objective.
Objectivity is a myth, especially on this subject.
I know the pain Sonja's grappling with.
So do I.
I was in med school, on birth control, and I got pregnant anyway.
I wasn't ready for a kid.
I was scared
and sad…
and relieved.
It was medical procedure I had years ago and I'm at peace with it now.
Most women are.
Because it was their choice.
A choice you got to make, and I did too.
Let Sonja make hers.
It's not our job to help patients choose death.
[cell phones chime]
Her lungs are failing.
[sighs]
Her O2 sats are falling. Fever's climbing.
Intubation cart. Administer propofol and rocuronium.
We need to sedate you so we can intubate.
That'll keep you breathing, but the only way to--
No. You can't kill her.
-Esther's life before mine. -Sonja, please.
Promise me.
-I can't. -Promise me.
[Sonja breathing heavily]
Anthony.
I prom…
I promise.
I love you.
Check out the activity in the left frontal lobe from Roland's EEG.
Interictal spikes.
-They are very small, likely incidental. -Hmm.
Roland's selfish and possessive.
He hates it when people have fun without him,
but today he was totally fine with Dalia hanging out with friends
while he's stuck here.
-Being unselfish is a symptom. -Maybe one of his wounds got infected.
Bacterial encephalitis from the claws or teeth.
This could be subtle edema.
-Behavioral changes and interictal spikes. -That sounds like neurocysticercosis.
-A tapeworm cyst. -With larva in the brain.
But it would take a tapeworm weeks
to fully form larva and a cyst in his brain.
The attack was two days ago.
Ooh.
Roland's last local safari was about two months ago,
and he fell into a giant pile of tiger crap.
We can remove the cyst and larva
with stereotactic navigation and hydro dissection.
-Awesome. -Oh!
You're not a failure.
Seriously? Four guesses?
I got it in two.
[sighs]
What's up with you?
You lose a patient?
Actually, I might save one.
Joe.
Mia's Joe?
Waiting on his biopsy results.
He asked me to forgive him.
What did you say?
I refused.
You would have too.
Hmm, well, maybe.
Then again, I'm capable of letting things go.
I can let things go.
I prioritized my career for a day, which you decided was unacceptable,
even after I changed my mind.
And how long did it take you to forgive Mia?
Dr. Park.
Your diagnosis is in.
[objects clattering outside]
[Dr. Glassman, muffled] This way, guys. Be careful. You're carrying history there.
There's a couple of steps. Be careful.
Thanks, guys. First door on the right.
Stadium seats?
Authentic Candlestick Park stadium seats.
-Got them from a broker. -Very cool.
Right? Thank you for the inspiration.
You're welcome.
Your turn next. Get your coat.
You have a stromal tumor in your stomach and a small lesion on your liver.
And we can remove both.
[Daniel] You'll be cancer-free.
Hmm. [chuckles softly]
That's incredible.
Thank you.
You get it, right?
You're not dying.
Yes.
This is amazing.
I'm so grateful.
[sighs deeply]
-But it-- -That's not why you came here.
Sonja will likely be in multi-organ failure
within the next 48 hours.
And when that happens, Esther will not survive.
But if we terminate now,
Sonja still can.
You can save your wife's life.
It's all up to you.
He says…
He says he can't do it.
He needs to keep his promise.
I know what to do.
♪ Yeah, lacing the shoes I'm on the move ♪
-♪ I got so much to prove ♪ -♪ Uh-huh ♪
♪ Ain't no substitute… ♪
-Sorry, man. -Bring it.
♪ I get up even when the fall hurts ♪
♪ Ain't no ceiling for a dream ♪
♪ I hit the ground running I conquered everything ♪
♪ I can conquer anything ♪
-♪ Get up, get up ♪ -♪ We can do anything ♪
[panting]
You okay?
-A worm laid eggs in my skull? -Larva.
[laughs] You were right. Murphy's the best.
What would you say to $100 million?
[mouthing]
I'd say that's remarkably generous, uh…
-But-- -You can't accept it.
You are not medically fit to be making any major decisions
because of the larva.
I closed a huge deal last week with Mr. Worm as my consigliere.
I feel pretty competent.
Well, I'd be happy to accept your money
after the surgery.
-[monitor beeping steadily] -[ventilator hissing]
-[grunting] -Sonja, it's okay.
I turned off your sedation.
I need to talk to you.
I'm gonna let go of your hands, but you can't pull out the tube.
When I was 18,
I had an abortion.
That child would have been 11 now,
just starting middle school.
Every time I see a kid that age,
I think about who they would have become
or what kind of mom I would have been.
I believe God's forgiven me.
That's kinda His thing.
And I believe God picked you for motherhood.
You are so strong,
so brave,
with such a deep capacity for love.
But your Esther
isn't developed enough to survive outside of the womb.
The infection will kill both of you.
I told you if I were you, I would try to save the baby.
I prayed for a miracle.
And I don't know why it didn't come today.
The only way for you to be the mom God wants you to be…
is to let Esther go.
[slow indie song playing]
Please sign this consent form.
♪ Wherever you are, it's okay ♪
♪ I'll never be too far away ♪
♪ Wherever you go I want you to know ♪
♪ You can always call on me ♪
♪ And if you get tired Out there on your own ♪
♪ I will walk you home ♪
♪ I'll walk you home… ♪
Yes.
[sighs]
♪ Nothing you do could change my love… ♪
Speculum.
♪ For you ♪
♪ I'd walk to the ends of the earth ♪
♪ If you asked me to ♪
♪ I'll hold you close ♪
♪ I'll let you go… ♪
[chaplain] If your soul has not yet left your body…
I baptize you, Esther.
♪ But you don't have to be alone ♪
♪ I will walk you home… ♪
Cervix is sufficiently dilated.
♪ Don't worry about a thing ♪
♪ Just close your eyes and sing ♪
♪ I'll walk you home… ♪
[chaplain] In the name of the Father,
and of the Son…
and of the Holy Spirit.
Amen.
-Amen. -[Anthony] Amen.
-Amen. -Amen.
♪ I will walk you ♪
♪ I'll walk you home ♪
♪ I will walk you ♪
♪ I will walk you home ♪
And the margins were clean. We were able to get all the tumors.
No additional metastasis.
Your prognosis is excellent.
Thank you.
I forgive you.
[exhales deeply]
[chuckles softly]
-Thank you. -[exhales sharply]
[Shaun] Extracting the cyst…
and larva.
[Asher] Awesome!
-And I might hurl. -[Dr. Andrews] Let's close.
Can Dr. Kalu do the closing?
Be my guest.
4-0 NUROLON.
You said you missed being a surgeon.
If you complete your residency here, you can do more than closing.
I doubt he wants to go from five-star restaurants
to hospital vending machines.
Actually,
someone, um, helped me realize that I'd love a second chance here.
The Chief of Surgery's responsible for all hiring decisions in her department.
I've, uh… I've learned a lot about myself.
How to better communicate, how to manage challenging personalities.
Hmm. I hear Roland can be a handful.
Prepared me for tough patients and tougher attendings.
And my surgical skills are still sharp.
Andrews actually let me do Roland's closing.
I'm impressed.
Murphy really wants you on his team. That carries weight.
But I don't have any openings for third-year residents.
I understand.
But I do have a slot for a first-year.
[sighs]
I'm so sorry for your loss.
So our Esther will always be with me.
Someday,
maybe we can tell her brothers and sisters all about her.
Oh.
-[Shaun exclaims] -[Lea giggles]
This car is perfect for the Peanut.
And pretty cool too.
[Shaun] Oh…
Oh, let's take this rocket ship for a ride.
[Shaun] Oh, man!
[Shaun exclaims excitedly]
[knock on door]
Dr. Andrews.
Here's your check.
And this is what happens when you poach my employees.
[laughter]
This is so good, especially after a day like today.
[Dr. Lim sighs deeply]
-To our differences. -Mmm.
-[alarm rings] -Mmm.
If you'll excuse me.
Time to exercise my reproductive freedom.
I'm doing my third round of IVF.
You're gonna go jab your belly alone in the hospital bathroom?
[sighs] Give me.
-I am a doctor. -Mmm.
[Dr. Lim chuckles]
Have at it.
To reuniting with old friends.
And a mummy mocktail
with fresh rosemary.
[Lea] Yum!
Love having bougie Kalu back.
To Jared…
[Lea] Mmm.
…fulfilling his potential as my new first-year resident.
[knock on door]
Oh, it's probably Glassy.
You Dr. Shaun Murphy?
Yes.
I am an attending surgeon at San Jose St. Bonaventure Hospital.
You've been served.
You're being sued for malpractice.
It wasn't Dr. Glassman.
[closing theme music playing] ice.