My mother died of prion disease
when she was 45 years old.
My father took his own life three hours later.
Why'd you share this with me?
I knew you wouldn't pity me.
When it comes to surgery,
you have to think three steps ahead.
She is one of the best and brightest I've seen.
And that's a testament to your mentorship.
I've been accepted into Gaffney's
cardiothoracic residency program.
Something I've been working on for the last year or so,
doing IVF.
I wanted to give you this.
25 grand?
It would be a tragedy if you never got to be a mom.
[dramatic music]
[laughs]
Look at her go.
And, of course, the younger one gets the doll.
Sharing is caring.
- Am I right? - Mm-hmm.
I used to hate it when you would take my things.
Oh, I know.
Hey, what is up with you?
You've been smiling like a schoolgirl all morning.
What do you mean?
Did you and Mitch hook up again?
- What? - I mean, I wouldn't blame you.
He's beautiful.
I did not hook up with Mitch again.
Though, I think we do need to have a conversation.
About what?
I Kind of told him I loved him
when he was stuck in the well.
- Oh, my God, Hannah. - I meant it.
I meant it, though.
You know, I got caught up in the moment.
I thought he was gonna die, Lizzy.
It's like a soap opera with you two.
It's... [sighs]
- It's not. - [groans]
You all right?
Yeah. No, it's nothing.
Been having this wicked indigestion lately.
Lately?
Well, how long has that been?
- I don't know, about a week. - OK.
Well, let's get you into Gaffney...
No.
Get a little looksie, just in case.
It's nothing. Please, Hannah, no.
I am not taking no for an answer.
I'm sorry, Dr. Charles.
I know that cardiac workups aren't your normal domain,
but we're a bit shorthanded at the moment.
Yep, yep, yep, yep.
49-year-old male collapsed in a stairwell.
Lenox says she'll be in to do an echo
as soon as she's out of her budget meeting.
Oh, and evidently, the wife is a bit of a character.
Treatment 3.
[laughs]
I'm not actually sure what happened exactly.
I just know that it was getting hard to breathe,
and then my heart started beating fast.
- Like palpitations? - Yeah.
Ever had those before?
I used to get them every now and then,
but it's been quite a while.
So the paramedics said that they found you in a stairwell.
He kind of just collapsed in my arms.
Yeah, thankfully, Cynthia was with me.
Uh-huh.
Cynthia is your... wife?
Ex-wife, actually.
We were attending our class reunion.
That's where we met, Northwestern.
I did a summer session there myself during undergrad.
It's a great school. I'm Dr. Lenox.
I've been looking over your chart, Mr. Parker,
and it seems your enzymes came back negative,
so I think we can rule out a heart attack.
There was a tiny irregularity in your EKG, however,
but that could just be the result of overexertion.
They tell me you were in University Hall
- when it happened? - Mm-hmm.
Were you trying to climb the clock tower?
I'm not sure you can actually reach it from the stairs.
[chuckles]
No, I wasn't taking the stairs.
So why were you in the stairwell?
Uh, Cynthia and I just reconnected
a little over a month ago.
After five years apart.
Actually, more like nine, babe.
Nine? No, that's not right.
I got the canceled alimony checks to prove it.
[chuckling]
Are we still talking about the stairs?
Oh, my God, we were having sex.
[soft dramatic music]
Might that explain the overexertion?
It might.
Let's do an echocardiogram to take a closer look.
You see what you do to me, baby?
You literally make my heart race.
- [laughs] - Get over here.
♪ ♪
You know what?
It is time for my midmorning coffee.
Cynthia, would you like to join me
while Dr. Lenox finishes examining Ron?
♪ ♪
Don't do anything I wouldn't do.
Oh, I know. Oh, God, it is crowded.
OK, you wait here, and I will go check on a room, OK?
- Ooh, ooh. - Oh, oh.
Sorry.
Hi, Mitch.
Lizzy, good to see you.
Likewise.
Uh, I thought you were off today... everything OK?
Yeah, just getting my sister checked out.
You're... you're running again?
- Yeah. - That's great.
Yeah, I guess.
I'm still trying to get my wind up though.
Yeah, it's the last time.
Last time I'm running with this maniac.
Hey, hi. Sorry.
I'd give a proper hello...
cardiac event, I'm pretty sure.
- Sorry. - Mm-hmm.
- [laughs] - [panting]
I've... I've been meaning to talk to you.
Yeah, me, too.
Maybe once you get your sister settled
and I change into some scrubs?
- Yeah. - OK.
Help! Please!
- He's barely breathing. - It's our son.
Anybody, please!
Let me take him inside, OK? OK?
- OK. - I got him.
Right this way. Come on.
Hey, we need a nurse and a tech, and call RT.
- Gotcha, Trauma 1. - OK.
Let's put him on a monitor.
[tense music]
Mommy, I can't see.
- It's all blurry. - It's OK.
- Mommy's right here. - Ma'am? Ma'am? Excuse me.
What happened?
We were at our old farmhouse
we're renovating out in Kankakee,
and Miles was playing in the hayloft.
He was fine until we started driving back,
but he said he felt dizzy and that his stomach hurt,
so we headed straight here.
Sudden lethargy and difficulty breathing.
Toxidrome.
OK, he must have gotten into something.
Organophosphate, maybe?
Do they grow crops there?
Uh, we don't know for sure.
Maybe an anticholinergic?
Could he have gotten into any medications...
antihistamines, antidepressants?
It can't be that either.
I mean, he's drooling.
Look at all the saliva.
- BP 74 over 48. - OK.
We need to intubate.
Give me a 5.0 cuff to ET tube and a Mac 2 scope.
Draw up 5 of etomidate and 17 of rocuronium.
Let's think about it, all right?
Lethargic, hypotensive, drooling, dilated pupils.
And out at a barn.
♪ ♪
OK, I'm not seeing anything over here.
What are you looking for?
No.
Hey.
♪ ♪
[together] Snakebite.
♪ ♪
Good morning.
Hey.
What's... what's with the box?
It's my last day in the ED, remember?
I start up in cardiothoracic next week.
Yeah, that's right.
I'm inviting everyone to Molly's after work
to celebrate.
Oh, yeah. Thanks, no.
Big send-offs aren't really my thing.
However, I do have the perfect parting gift for you,
a patient all to yourself.
Is anyone gonna bring me an extra pillow?
My neck is killing me!
- What's the catch? - There's no catch.
Murph comes in every few months with some mysterious ailment.
You'll love him... maybe not today but eventually.
OK. Good to know.
Thank you.
I'll get changed and get right on it.
OK.
You know, if you would have told me a year ago
that I would all of a sudden find my ex-husband
attractive again, I would have said
you need your head examined.
And yet here I am back again with a schoolgirl crush.
Do you know he's taking me to Norway tomorrow
to see the northern lights for my birthday?
- Lucky you. - [laughs]
Yeah.
[sighs]
PayDay, huh? That is a classic.
It's funny. I loved to use these back...
I love... to use...
I love to use these...
I used to love these back in the day.
They helped me get through my senior thesis.
I don't know why I find myself craving them again.
Maybe that's like a... I don't know...
a theme for you right now, rekindling old loves?
Hmm? What?
The candy bar, your ex-husband.
And since when is nostalgia a crime?
Could you excuse me a quick second?
I'll be right back.
Hey, what do you think?
Well, with Ron, I'm not entirely sure.
His symptoms suggested congestive heart failure,
but his echo looks pretty good.
So I'm gonna talk to Dr. Hayes, see what he thinks.
And maybe you want to debrief the ex-wife.
I'm not sure she approves of my bedside manner.
Yeah. My pleasure.
Thanks.
We're administering what's known
as a polyvalent antivenom. It's called CroFab.
It'd cover the handful of venomous snakes
endemic to the area.
There's four, actually... the copperhead,
cottonmouth, timber rattlesnake,
and eastern massasauga.
Someone from the Home Team sent it to us.
- Home Team? - What we call our followers.
We were live streaming when it all happened,
so we've been getting nonstop messages.
Yeah, I'd stay out of the comment section
when it pertains to medicine.
No, our people haven't steered us wrong yet.
We started doing home improvements
on social media 11 months ago.
Our channel just took off with their help.
That's great. I just...
I would rather focus on your son right now
and not the Home Team.
Are you accusing us of not caring about our child?
Absolutely not.
Honestly, we'll take all the help we can get.
We'll just keep our fingers crossed now
that the antivenom can do its job
and bring Miles' swelling down.
We'll check back soon.
[tense music]
Lizzy, you remember Dean.
- Hi. - Hey.
Hey.
Sorry, finally found a window.
- Oh. - Is, uh... is this a bad time?
It's OK if it is.
- Oh, um... - Oh, no.
I've got...
You two should talk already.
Dean here can get me started, right?
Yeah, I think I can manage it.
Good.
- After you. - Sure.
Mm.
I know I've given you some mixed signals lately,
first breaking up with you and then telling you
- that I love you too... - Hannah,
you don't have to explain yourself.
I'm not gonna hold you to something
you said when I was on the verge of dying.
Oh, Mitch, that's not...
Hey, hey, it's all right.
I've been doing a lot of thinking lately,
and, um,
you were right,
what you said about me when we broke up,
about my anger issues, about me not knowing
how to be in a healthy relationship,
all of it.
I said a lot of that when I was angry.
And you had every right to be.
[sighs]
[soft dramatic music]
♪ ♪
I threw away a winning lottery ticket with you,
and I'm gonna have to live with that the rest of my life.
♪ ♪
I just hope, at the very least,
you'll be able to forgive me.
♪ ♪
Your heart rate sounds normal, Murph.
Well, it was beating like crazy this morning,
- when my arm started hurting. - OK.
So what other symptoms have you been experiencing?
Well, last night, my stomach started hurting so bad,
it was like I couldn't see.
And then this morning, the pain went into my chest.
And now it feels like it's more in my neck.
Well, like I said, sharp pain on and off.
And my hand gets tingly.
You think maybe it's a stroke?
No.
You think I'm crazy, don't you?
Nope, I do not.
Look, we can just slip past all of this,
and you can just slide me some meds,
and I can just get a decent night's sleep.
Dr. Archer is... he is stingy with the good stuff.
I'm sorry, but I can't do that, Murph.
Why do I waste my time?
What I am going to do is try to figure out
what's causing your pain.
So I'll run some tests and see what we can come up with, OK?
You're probably just trying to cover your ass
so I give you a good review.
Hey.
So how did it go?
You didn't take him back, did you?
No, of course not.
Weirdly, it seems like Mitch is actually...
- actually changing. - Oh.
- Hmm. - What?
In my experience, people's changes
tend not to last.
Eventually, everybody goes back to being who they are.
Well, I don't know about that, Dean.
[sighs]
Oh, my God, look at that.
That is your baby girl.
- It's a girl? - You get a girl.
[laughs]
I'm no obstetrician, but I'm pretty sure
- those are her feet. - Yep.
She'll start kicking about now and making facial expressions.
You know, I wonder if she's learned
- how to roll her eyes yet. - OK.
Let's hear that little heartbeat.
[ominous music]
♪ ♪
- Something wrong? - Let me see that.
- Yeah. - [clears throat]
♪ ♪
Why don't I hear a heartbeat?
♪ ♪
Lizzy, I'm so sorry.
There is no heartbeat.
♪ ♪
[cries] What? No.
[sobbing]
Well, you were right, guy's a conundrum.
How'd he get short of breath and syncopize
with a good ejection fraction and normal valves?
My thought, exactly.
Maybe it was an arrhythmia?
Let's keep him on the monitor, slow him down with metoprolol,
- and repeat his EKG. - OK.
Thank you, Dr. Hayes.
You know, usually, you'd want to consult with a cardiologist
for symptoms like these...
not that I'm complaining.
You know I always love these little meetings of our minds.
Speaking of meetings, are you going
to the leadership conference in Myrtle Beach next month?
I don't know, those things aren't really my cup of tea.
Oh, they're not meant to be your cup of tea.
They're meant to be your frozen margarita
with a salted rim and a mezcal float.
Oh, you mean a boondoggle?
Mm, I like to think of it as some well-needed R&R
- to recharge the batteries. - Mm-hmm.
Come on. It's a free weekend in the sun.
Relax by the pool, get a massage,
maybe let your hair down.
You seem to have me confused with someone
- who's able to do that. - Do what?
Uh, let your hair down. That's not me.
I'm not that kind of person.
Oh, I think you're wrong.
You're being very presumptuous.
Oh, um,
I didn't mean any offense.
It's probably best if we keep our interactions
focused solely on work moving forward.
Yeah, message received.
I should know more about your patient within the hour.
I just keep playing it all over and over in my mind.
Should I not have been walking around in the cold today?
- Did that somehow harm the baby? - No.
No, Lizzy, listen to me. Listen to me.
You cannot blame yourself, OK?
[sighs]
Sometimes these things, they just...
they happen.
And based on the measurements, been about a week
since the baby had a heartbeat.
A whole week?
How could I not have felt that?
Hey, I know that this is hard.
OK?
But the fact that you got pregnant the first time
means that you can do it again.
I'm not so sure anymore.
After all I've been through, the IVF rounds, I just...
Stop that, Lizzy. You will be a mother.
I truly believe that.
[soft dramatic music]
[sighs] All right.
So what happens now?
Well, we'll need to perform a D&E to remove the fetus,
which I know it can sound kind of scary,
but it's very safe, very standard.
And you will be doing it, right?
Lizzy, no. I'm sorry.
It's against hospital policy
for doctors to operate on family members.
What? No, no.
Hannah, please.
I need to know someone I trust is there.
[tense music]
♪ ♪
How's your sister?
She asked if I could do her D&E.
Mm, yeah.
It's gonna be hard to get by Legal.
I know.
I already told her.
Let me talk to Kalmick.
Lizzy may have to sign a waiver,
but we'll figure it out.
♪ ♪
Hey, guys, I could use some extra eyes.
- My patient, Murphy Costello... - Oh, Murph.
Oh, what's his problem today?
Trying to score some pain meds off of you?
Well, I initially thought a herniated disk,
but his MRI came back clear.
- You sent him for an MRI? - Yeah. Why?
Well, Accounting's gonna have a conniption,
but, hey, it's not my money.
What about nerve impingement?
- Did you do a Neer's test? - Yes.
And a Hawkins-Kennedy and a Jobe,
and those were negative as well.
OK, well, maybe it's just
all in his head again, like last time.
Um, do you think you maybe
want to, like, hot potato him over
- to Dr. Charles 'cause he's... - No, no, no.
There's got to be something I'm missing.
It's my last day. I want to go out with a win.
Fair enough.
You wanted to know when the fifth vial of CroFab
had been administered?
Yeah.
The antivenom's still not taking.
BP's still softer than we hoped for.
Darla, let's double it up.
Give him another five vials please.
Whoa, that seems like a lot for a little kid.
The dose is actually for the amount of venom
coursing through his body, not his size.
And what if it weren't one of those four snakes that bit him?
Well, in that case,
we'll have a much steeper hill to climb.
I'll go call Animal Control
and see if they've spotted any other venomous species
in that area.
We'll be back with you in a minute, all right?
You heard that, Home Team.
Just to update you, Miles is doing worse than we thought.
We really need everyone's strength and prayers right now.
Excuse me.
What are you doing?
We're just giving our followers
an update on Miles' condition.
Your followers?
Does this seem like an appropriate time
or place to be doing that?
Look, I know what this must look like, but look...
No, what it looks like is you are exploiting
your son's life-threatening condition to get more views.
No, no, that's not our intention at all.
You are aware that you're the reason
he is in this position, OK?
Because you were not watching him
when you were supposed to be watching him.
He's your son, OK?
You're supposed to be there for him to protect him, all right?
So the least you can do right now
is put the phone away and be present with him here.
Dr. Frost.
[tense music]
Perhaps you should go clear your head
for a minute, give these parents
some time alone with their kid.
Yeah.
♪ ♪
But what's it called, WPW?
Wolff-Parkinson-White syndrome, yes.
It's a heart rhythm disorder characterized
by an extra electrical pathway in the heart,
a congenital defect.
You've essentially had it all your life.
That's what's been causing the intermittent tachycardia
over the years.
It just didn't reveal itself until now.
OK, so what happens now?
Well, correcting the arrhythmia
is pretty straightforward.
We'll send a catheter up through your veins
and ablate the extra electrical pathway.
So what's the recovery time on this, usually?
About a week or two.
Well, so if we wanted to travel tomorrow...
I'd recommend against that.
Well, I can just postpone this
until we get back from Norway.
Ron, don't be stupid.
It's your birthday, babe.
It's a big one.
This trip can't be rescheduled.
Look, there's gotta be some kind of Band-Aid
you could put on it, get me through the next few weeks,
- right? - Oh, my God.
You've lost your mind.
We could prescribe an anti-arrhythmia
medication temporarily.
And so has this one. What is wrong with all of you?
I'm surrounded by morons!
What's gotten into you?
God, I need somebody here who knows something.
Dr. Charles, can you get in there?
I... my idiot... my...
my...
he needs a shrink, and so might every single one of them.
OK. OK.
♪ ♪
What are you all looking at?
♪ ♪
Cynthia.
Ron wanted me to find you and tell you that he's decided
to go ahead with the surgery.
And Dr. Hayes is taking him upstairs right now.
OK, well, my little fet...
my... my little effect
had the desired show...
effect, then.
[sighs] You know what I mean.
I hope you don't mind me observing
that that's not the first time that that's happened today.
Well, it's been a stressful few hours,
and I'm turning 50 in a couple of days,
so it's probably just a senior moment.
Maybe.
But, you know, in my line of work,
when those senior moments are accompanied by
fine motor skill issues and sudden flashes
of irritability, disinhibition,
I get concerned.
And something tells me that, I don't know,
maybe you're starting to get a little concerned yourself.
You know the best part
about reconnecting with an old love?
Tell me.
It's the way they look at you,
as if you haven't changed.
I am familiar with that phenomenon.
I mean, Ron was never the most observant partner
to begin with, but it's really sweet.
He's so smitten, he doesn't see.
You know, if you want, we could just run some tests,
you know, while they're working on him.
[soft dramatic music]
[sighs]
OK.
You know,
for a second there,
I was really, really looking forward to this birthday.
Murph, please,
I just need 20 minutes. That's all.
Enough. You're not listening to me.
Fix what's wrong, and let me go...
let me... just let me go home.
Just give me 20 minutes, OK?
20 minutes.
[sighs]
Why hasn't Murph been discharged?
He came in hours ago.
I've been trying to make a diagnosis,
but it's been elusive.
My most recent hypothesis was that
it might be an unusual presentation
for pronator teres syndrome,
but the pain's not localized enough.
I...
I confess, I'm stumped.
I appreciate your thoroughness,
but we need to open up that bed.
So if you can't figure it out and it's not emergent, move on.
Got it. Oh, speaking of moving on...
I know. It's your last day.
I'm sorry, but I'm not available
to come to Molly's tonight.
Um, that's OK.
I know you're busy.
Listen, whatever Murph came in here to complain about,
he's gotten it off his chest,
so don't beat your head against the wall.
Just cut him loose.
He's gotta get something off his chest.
- I just said that. - Thank you, Dr. Lenox.
I need to do an ultrasound.
Hey, Renee?
- Is Trey around? - He... he left.
He was a little worked up and said he didn't want to talk.
About that, uh, we wanted to apologize
for what transpired earlier.
You guys are going through a tough time right now,
and, well, anyway, I think what Dr. Frost
- and I are trying to say is... - I had...
I had no right to lecture you like that,
and I apologize.
No, you were right.
This social media thing was supposed to be something fun
for our family to do together,
but now I'm afraid that I let it become our identity.
Swelling hasn't subsided yet, has it?
No, not like we would want to see right now.
But we are nowhere near giving up hope.
We're actually in consultation with a transfusion specialist,
and we might be able to try an experimental plasma exchange.
I got it!
- Whoa! Hey! - Whoa!
I got it. I got it.
What did you do?
I killed that son of a bitch. That's what I did.
What?
Your words kept ringing in my head, Dr. Frost,
my boy lying there suffering and helpless,
and here I am on my phone,
instead of doing something about it.
Uh-huh.
So I went back to that barn,
and I tore it apart until I found this bastard
up in the hayloft.
I picked up a shovel, gave it a good whack,
knocked him out cold.
You brought a live snake into the ED?
OK, this is good.
Um, you know, we can get Animal Control to ID it now,
- so... - OK.
Yeah, here, look.
- Careful. - I am.
[ominous music]
No, no, no, no, no, no.
Are you sure you brought it in?
Uh, yes. Yes, I am.
OK, I felt it in the bag when I walked in,
and security was giving me a hard time with my ID,
so I put it down, and...
Oh, my God. Trey, tell me you didn't.
Oh, damn.
- Oh, damn. - OK, don't panic.
It's OK. Just...
Hey, at least we know it's in the hospital.
♪ ♪
I checked the waiting room,
the trauma rooms, nothing.
And you didn't tell anyone else, right?
Well, not yet. Why?
Ironically, the protocol for a snake being on the loose
in the hospital is to not tell anyone a snake is on the loose.
What kind of sadist writes these protocol manuals?
We have to project an air of calmness.
Security and maintenance and every other spare body
is searching high and low,
and Animal Control is on the way.
Hey, hey.
So I spoke with the dad.
He said it was red with black and yellow bands.
That sounds like a coral snake,
which is an elapid, not a pit viper,
and that would explain why the polyvalent antivenom
didn't work, because they're not normally found
in this part of the country.
[soft dramatic music]
I'm not even gonna ask why you know that.
I'll call the zoo, see if they can
send over some antivenom.
I'll notify security.
Keep me posted.
Uh, I'll...
OK.
That's just about everything.
Well, you heard the boss.
Let's wrap it up and dial her down.
Hey, thanks for talking Kalmick into letting me
take the lead on this one.
It meant a lot to Lizzy...
and to me.
Don't mention it.
He's actually really understanding
once you've signed all the releases.
Hold on.
What is it?
[vitals monitors beeping]
That's strange.
She's still bleeding.
[tense music]
♪ ♪
Her uterus is boggy.
It's not contracting down at all.
She's starting to hemorrhage.
Give her 250 micrograms Hemabate, IM.
Do you need a balloon catheter?
No, that won't work quickly enough.
We need to open her up.
♪ ♪
- Oh, hey. - [gasps]
Ah.
Hi. Yeah, sorry, yeah.
Sorry, didn't mean to scare you.
No, no, no.
I was actually just about to come find you.
Mr. Parker's ablation went swimmingly.
We can notify the ex-wife.
- Oh, great. - Yeah.
Um, I wanted to get your take on a scan.
Yeah.
There appears to be a pattern of atrophy
on the frontal and temporal lobes.
It's a tad asymmetrical, so I would favor
frontotemporal dementia over Alzheimer's
if I was doing a differential.
Why? Whose image is that?
Cynthia's.
That would explain the disinhibition.
Among other things.
You suspect behavioral-variant FTD?
I do.
And she doesn't want Ron to know.
Well, a terminal diagnosis like that
is hard enough to contextualize for yourself
without dumping it on someone you care about.
Dumping?
That's an interesting choice of words.
The knowledge of a terminal diagnosis
is like its own disease, Daniel.
Once someone knows, they're infected
with all of the pain that comes with it,
and that pain can be worse for those that have
to watch their loved ones suffer than it even is
for the patient themself.
So Cynthia is protecting Ron by not telling him.
She's shielding him from a slow-moving tragedy.
Oh.
It sounds like you've had some experience in this area...
similar cases is what I mean.
Doesn't every doctor?
You know, I'm just saying, Cynthia has a point.
That's all.
OK, what are you looking for again?
The anterior scalene muscle.
If my theory is correct, that's where the bulk
- of the problem lies. - Wait.
You're injecting me with what?
A mix of a numbing agent, Marcaine,
and a steroid that will help reduce any inflammation.
Yeah. Did I mention I hate needles?
Relax, Murph.
This will only pinch a bit.
Just, please, look at the monitor.
[gasps] What the hell?
Thank you.
Oh!
How do you feel?
I feel...
Nothing...
[sighs]
In a good way.
- Yeah. - Wait.
What... what did you say this was again?
Because I couldn't concentrate before.
It's called thoracic outlet syndrome.
It's when the nerve or blood vessel
gets compressed between the space in the first rib
and your collarbone.
In your case, both are being squeezed,
which is why your symptoms were so varied.
But that injection should ease your pain
temporarily, until you can have more definitive treatment.
But I'll refer you to a specialist moving forward.
It's been,
like, forever since I haven't had any pain.
I mean, I've seen so many doctors.
I... I had given up hope.
I'm sorry for being such a jerk.
That's OK.
It's totally understandable.
You are a saint
and a genius,
and I am so grateful to you, Dr. Howard.
Thank you. Thank you.
What's the matter, Murph?
Your pain's not back, is it?
[gasps]
[screaming]
Snake!
Are you OK?
So there's a snake in the ED.
Nice.
Oh, but you're not supposed to say that part out loud.
Can someone get an ETA on Animal Control?
- I can do that, yep. - OK.
[soft dramatic music]
Tissue looks awfully gray.
- Is it necrotic? - Partially.
Well, that explains the bleeding.
What do you want to do now?
Sounds like the uterus should come out.
No.
We do a wedge resection.
We lose the necrotic pieces and salvage the rest,
keep her ability to have a baby.
Get me a Bovie.
Well, is it even salvageable?
In theory, it could work.
The necrosis is localized enough.
BP's moving in the wrong direction.
Then hang another couple of units.
We need to get this bleeding under control.
OK, I'll try a uterine artery ligation...
0 Vicryl suture.
All right.
The bleeding's not slowing. I can't see.
Suction.
The sutures keep tearing through.
The tissue's too soft.
I need to try the other side.
[machine beeps loudly]
Pressure's getting harder to stabilize, guys.
If I were you, I would think about cutting and running.
Yeah, well, you're not her, Marty.
Just do your damn job.
We might need to resect more.
[beeping]
It's your call, Doctor.
What do you want to do?
[beeping]
We keep going.
I can make this work.
[beeping]
What's up, dude?
You had us really worried there, bud.
Yeah. How are you feeling?
Are you hungry?
Do they have any ice cream?
[laughter]
We just might be able to find you something, buddy.
The hospital is gonna want to keep Miles overnight,
but we're confident he'll make a full recovery.
Thank you both for everything.
- Of course. - You're welcome.
Ooh!
I like playing with this bunny.
- Hey, Home Team. - Yeah.
Look who we have here.
- Say, "What's up, Home Team?" - What's up?
Yeah.
See?
People like that don't change.
They're just not capable of it.
[soft dramatic music]
♪ ♪
Wait. Degenerating?
What do you mean?
My cognition, my balance, everything, me.
It's all going away.
What are you trying to say?
You've got dementia?
Sorry.
I was just coming in to do a post-op eval.
I will come back later.
Here are your things.
Do you know anything about this MRI?
Not really my specialty.
No, I told you this is something I was talking
to Dr. Charles about.
I wasn't even gonna say anything to you.
What? Why?
Because I was afraid.
I don't know how long I'm gonna be this version of myself,
and I totally understand if you don't want
to be with me anymore.
I can't believe you.
[sighs]
I just can't believe you think
you can get rid of me that easy.
Babe, these last few weeks have been some
of the happiest of my life.
♪ ♪
I'm not gonna give that up.
♪ ♪
All right.
Listen, I wasn't gonna do this till Norway, but...
I'll give you some privacy.
No, no, no, no.
Stay, Dr. Lenox.
I need a witness.
[crying]
Will you marry me, Cynthia Maude Parker,
again?
Come on. Say yes.
Babe, I'm so scared.
Yeah, me, too.
But look, no matter what,
we're gonna get through this together, OK?
- OK. - Yeah.
Hey, Doris, have you seen...
Your box?
You mean the one you left in the middle
of the nurses' station?
I put it in the doctor's lounge,
where it should have been in the first place.
Thank you.
[exhales]
Wait. Ooh, wait.
Surprise!
So you all didn't forget.
No.
Congratulations, Dr. Howard.
Whoo!
[applause]
Naomi, you brought a high degree
of positivity and intelligence to the ED,
and you will be missed.
Oh.
Aw.
OK, OK.
Can we cut the cake, please?
Thank you.
OK.
Well, I'm gonna go finish my rounds.
Doris, great cake.
Nicholas, one second.
I was giving our earlier conversation some thought,
and...
Myrtle Beach might be a welcome diversion.
Oh.
Though I should warn you I prefer my margaritas
on the rocks, no salt.
Well, that's OK.
I can probably be salty enough for both of us.
I look forward to seeing you poolside.
♪ ♪
I know this residency with Dr. Hayes
is like a dream come true, but I'm actually
really gonna miss the ED.
We see people when they're at their lowest,
and sometimes... well, sometimes...
we're able to turn things around for them.
And we do an awful lot of good down here.
- Yeah, I like to think so. - Yeah.
And, well, the people aren't half bad.
Is it just me, or does this taste like toothpaste?
Well, Doris made it, so who knows?
I think it's actually pretty thoughtful.
It's actually inedible.
Uh-oh.
You all right?
I don't know. You tell me.
Well, what's going on?
I'm sorry.
Dr. Charles, I don't mean to take you away from the party,
all right? I'm fine.
I'm not asking for help right now.
- Thank you. - OK, sure.
What is this?
Did Ripley put you up to this?
What? No.
Put me up to what?
Nothing, all right? Whatever.
I don't need you shrinking me right now, OK?
I'm good.
Well, that's good because I don't shrink colleagues.
I do check in with my friends every now and then
when they're having a bad day.
But if they get all huffy with me,
I tend to leave it alone.
Good night.
[sighs]
Hey.
Oh, hey.
How did everything go?
It went, um...
Well, you see, there were...
There were some unforeseen complications.
And...
Um...
After we performed the D&E,
you started to bleed profusely,
and when we opened you up to locate the source of the bleed,
we found that your uterus was necrotic.
♪ ♪
[gasps]
Necrotic?
There was a lot of dead tissue.
We tried to resect what we could to save it,
but, ultimately, we needed to perform a total hysterectomy.
♪ ♪
You took my uterus without my consent?
We had no choice. You'd have died otherwise.
Becoming a mother was the most important thing
in the world to me, the only thing I ever wanted,
and now that is gone, Dean, because of you.
No, Lizzy, Lizzy, Lizzy.
I made the decision for the hysterectomy.
I made that decision.
What?
[crying]
- I couldn't lose you. - How could you?
I couldn't lose you.
Hey.
I couldn't lose you.
[crying]
I couldn't lose you.
[crying] Oh.
[dramatic music]
♪ ♪
[wolf howls]