Boston Med (2010) s01e02 Episode Script
Episode 2
Boston--home to three of america's greatest hospitals-- Mass general, the brigham and children's.
These are the stories Of the men and women who work in them.
I've never seen a guy piss off more nurses than you on rounds.
oh, really? Are you asking me out in front of this camera? code blue, e.
D.
Code team.
can anyone feel a pulse? I got nothing.
whoa! we're currently en route to your facility With a 74-year-old female Who underwent cardiac arrest at an outside hospital.
We'll be there in about ten minutes.
74-year-old female.
While she's at diasis, she arrested.
According to the staff there, They did about ten minutes of cpr and intubated her.
so this woman was at dialysis at another hospital, And she cardiac arrested.
So they got a heart rate back, got her pulse back.
Now she's here.
Set up for an a-line, and we'll get it-- Okay.
We'll get an artery line going.
You want to try a 22 in there? Mm-hmm.
A lot of people think that nurses just pass out medicines, Put people on bedpans, Wipe their butts and that's it, you know? But it's really so much more.
sounded like we had it-- She's awake and she's fighting the tube.
You guys, she's bradying down to 39.
Does she have a lse? I'm not showing carotid-- So why don't we start cpr? right now she went up to 55.
Does she have a pulse? I was in the room with the family, and they're-- And they're pretty adamant they don't want anything else.
Okay.
You know what? Guys, she's- -she's d.
N.
R.
she's d.
N.
R.
? let's--let me go and-- So the family's outside.
The family's outside.
She was resuscitated When she wasn't supposed to be resuscitated.
All right.
We're done.
yeah, we're done.
This poor woman was do not resuscitate, And for whatever reason, at the other hospital, They resuscitated her-- Like, did cpr, gave her the meds, intubated her-- And the--all the while, she didn't want any of that.
So let's stop what we're doing, let's clean her out, And let's let her family come and spend some time with her.
yeah.
And didn't respect someher last wishes, ball Which is sad, 'cause that's not the way I would want to go.
doctors are supposed to keep Their emotions under control.
Thisan be especially difficult in pediatrics.
He's still pretty crackly, though, and wheezy.
yeah.
? For example, how do you tell an expectant mother Whose baby has a serious heart condition That it'll be okay? at 18 weeks, They sent me for my first ultrasound, And the tech looked at me, and she said, "renee, I have to be honest with you.
"the reason that I'm looking at the heart so long "is because it doesn't look right.
Something's wrong with the baby's heart.
" And I just remember my heart dropping at that point.
And I had my mom and my sister wi me, And I reached over and I grabbed my mom's hand and I just started to fall apart.
I'll put his monkey blanket away.
I just was devastated, and I thought, I need to talk to my husband.
Jacob's in the arm fighting in iraq.
He's been gone my entire pregnancy, But he's working really hard to get home next week For the birth of our son sam.
even though my son has a broken heart, This baby is perfect, And he's gonna make it.
And I can't have any doubt that he's not gonna make it.
? so how you feeling? Really tired yesterday, but I'm doing better now.
All right.
Well, you know the drill.
We've been following renee, um, with a-- Actually a prenatal diagnosis Of what's called hypoplastic left heart syndrome.
This is a severe form of congenital heart disease.
Sam's heart is maybe no bigger than my thumb.
But let's see if we can find his head.
He looks more like my husband.
Many babies don't survive, Even after corrective surgery under the best of conditions.
But we're optimistic that we'll have a great outcome.
M gonna miss it.
just in caset's jake.
Hello.
hi, hon.
Hi, jacob.
How are you? Ess what.
They're giving me two weeks of leave.
I'm coming home.
What? Hopefully I'll be leaving, like, within a day.
I'm just afraid you're not gonna make it home in time.
You know, I'll get there- I'll get back in time.
That's what you think.
This baby might not wait till the 12th, jacob.
They said he doesn't do any drugs, just dnks.
Just drank a gallon of vodka real quick.
Hey, buddy.
And there's the alcohol.
Oh.
Whoo.
Whoa! Apparently, he did not enjoy my singi.
Ugh.
He's gonna get nursed back to health by our angels.
It's gotta be the worst feeling to go out for some drinks Or, like, think you're drinking with your buddies, And then wake up in the emergency room-- No idea how you got there- in a diaper.
? This is, uh, m , Who was drinking vodka th his friends Where am I? Became unresponsive.
So the friends called 9-1-1 and brought him here.
Okay.
Friends rert that this is not his first time Having to be hospitalized for alcohol issues.
Mm-hmm.
Okay.
He came in, vomited all over himself.
Also was incontinent several times.
The family wouldn't come in.
Okay.
Didn't want to see him.
Nothing.
I had to deal with a really tough funeral this week.
I don't know how I ended up here, but I mean, I'm fine.
You've--you've told me your sob story.
I know.
Okay, so-- It okay.
Stop.
You could tell me as many times as you want, But you're not leaving right now, so stop.
I have three hours to get my exam to my teacher.
Honestly-- "honestly" nothing.
You c--you almost died last night.
Okay, but-- So I don't care that you have an exam due.
I know you don't care.
You should've thought of that before you went out I know.
It's-- and you got so drunk And then you almost choked on your own vomit.
Like I said, is not-- I know, it's not-- No.
No.
Honestly, it's really tough.
Show some sympathy.
What the ? As long as I know I'm a good nurse, And I'm doing what's best for him, He can tell me to go "f" myself all he wants.
I liked him much better when he was unconscious.
The kid's got a scholarship That he's just puking away on the mass general floor.
? You hurt in here where this incision was made? No.
No.
I like to think That I'm outstanding in the operating room And that I give a good surgery, But that I also do extremely good patient care.
Oh, wow.
he's a goohealer.
Yeah, or--or he had a great surgeon who-- That--that- that's part of it, too.
But the best part of it is being with the patient Through the whole journey, from the beginning.
How's the weather in the midwest? oh oh, it was ugly.
It was snowing yesterday.
It was snowing.
No, please don't--I'm looking at a job in the midwest.
Ohio is a great-- Cleveland's a fun city.
you make eye contact and you form a bond.
And they decide that they're gonna put Their trust in your hands.
77 year old scheduled for a left, uh, Extrapleural pneumonectomy With intraoperative chemo on Thursday.
you know, in cancer, they're our patients for life.
So if you, uh, remove someone's lung cancer, you will see them On a regular basis for the rest of their lives.
I tell people I married my soul mate and my best friend.
Yeah.
Yeah, we- we've had good 54 years.
And this is probably The toughest thing we've ever faced together.
Hi, mr.
Chew.
Yeah.
Jon daniel.
Pleased to meet you.
I'm dr.
Sugarbaker's chief resident.
Okay.
Okay.
Charlie chew has a cancerous mass Growing around his entire lung.
So here's your normal right lung, And on the left here now, You can see the mesothelioma around the left lung.
Methelioma is a--probably, Uh, one of the most aggressive cancers you can have.
It has been related to asbestos exposure.
And you have known asbestos exposure? I was on a destroyer for three years.
given our age, Everythi was wrapped in asbestos years ago.
Obviously, we can't go back And change the exposure that you had.
No, we cannot.
But we can get this thing out.
I expect a good sewing job.
This is my soul mate you're operating on.
Of course.
Of course.
We understand.
So This is my best friend here.
My husband's coming home from iraq For a few short weeks.
This will be jake's first time seeing me Since I am pregnant.
It's landing.
It's landing.
it's landing right now? Okay.
I've thought it through in my head, Like how am I gonna greet him? But then all the images of, like, in the movies, How they, like, run into each other's arms and, like, You know, he picks her up- like, obviously, that might be A little bit more complicated in this situion.
Oh, he's coming out.
He's coming.
He's coming.
we're currently inbound with a cardiac arrest.
18-year-old male, a known asthmatic, Complaint of shortness of breath before his cardiac arrest.
W18-year-old asthmaticom your in cardiac arrest.
Tions? Everybody here that needs to listen? Yeah.
All right, 18-year-old male, known asthmatic.
Playing basketba outside with friends, Started complaining of shortness of breath And a little bit of dizziness.
How long was he down? Proximately ten minutes prior to our arrival.
We've had him for about 15 minutes.
Okay, dr.
Kabrhel, somebody else, I need a femoral.
Can we please have another epinephrine? only been two minutes since the last epi.
You want another one? It was really intimidating coming here.
And I always felt like, yeah, I had something to prove.
Will someone let me know When it's been another minute, please? I've really had to work on Trying to be someone that can inspire confidence.
I-I have to work on being a little bit more cockier, 'cause people actually respond to that.
Raquel? Yeah.
Needle both sides, please.
All right, let's stop for a rhythm check.
Hold compressions, please.
cease the bag.
And is someone feeling for a pulse? I am.
that looks like v.
F.
Yep, he's back in v.
F.
We need to shock him if he's- all right.
Let's continue.
all right.
Let's go for another shock.
all clear? Clear Raquel, hand clear.
Raquel, off.
find a pulse, please.
all right.
Resume chest compressions, please.
? There's my husband.
(renhe's really coming.
And.
Hey, honey.
Jake! You look beautiful, baby.
I'm nervous.
Oh, gosh.
I am really nervous about seeing him Just because he hasn't seen me pregnant.
I'm so nervous to see you.
It's okay.
Don't be nervous.
You look so hasome.
Mm.
You look beautiful, baby.
So what do you think? That's sammy.
Pretty big, huh? play ball.
is it what you thought it would be like? What'd you do? You want to say hi to your family? Okay.
come here.
Hey.
For any soldier, coming home is always a difficult time.
But he's coming home for a labor and delivery And a baby who's gonna need heart surgery.
You do look beautiful.
I look huge.
No, you don't.
? If he has no cardiac activity.
He's been down for then Okay.
About 40 minutes.
all right.
We're holding compressions.
Anyone feel a pulse? Here, I got nothing.
All right? There's no movement.
Can anybody think of anything else That we're missing? Another ideas? the family may want to come in And be here while we're still doing this.
Ugh.
Oh, no.
Yeah.
all right, guys, just get ready.
The family is coming in.
I love you.
I love you.
I love you.
I love you.
Oman crying and speaking indistinctly) You grow up with him? he was younger than me.
I grew up with his older brother.
That lady, who's his aunt, Has kids I went to camp with every summer.
So That's really difficult.
You know, we know he wasn't gonna come back After a certain point.
And it's just waiting, and then it's--it's hard.
good job.
You were in charge.
Everybody knew who to look to.
You did great.
You did great.
It sucks.
It does suck.
hi.
through that door, to the right.
okay, thanks.
? Now that jake is here, I feel more excited about everything that's going on, And it feels more real.
We've hit him with a lot these last few days, Between all the doctors visits And getting him caught up to speed.
This is where I deliver, though.
And sam might go up to 6 initially For, uh, I.
C.
U.
To be stabilized.
And then he'll come ov to children's hospital.
We go to advanced fetal care center.
Advanced fetal care center.
And, um-- this place is so big.
I think my biggest concern is for jake.
It's gonna be a lot to hit him in a very short period of time.
And this is where sam's doctor is.
Hi, doc.
Good morning.
This is jake.
Oh, hi, jake.
Nice tmeet you.
Nice to meet you, too, finally.
Welcome back.
We're gonna go really spend some time Explaining to jake, uh, and bringing him up to speed About what's going on with their baby--sam.
So what sam has is hypoplastic left heart syndrome.
And for reasons we don't understand, The structures on the left side of the heart didn't form well.
And as a consequence of that, The blood is actually going backwards.
What hpens normally-- This vessel closes after babies are born.
So there's no way for blood to get to his lower body And the rest of his body.
And they die.
And they would die.
Mm-hmm.
We don't have the ability to cure this, But through, uh, a series of three operations Over the first th- two to three years of life, Um, we can get sam to a place where he is, um, Almost running around like other kids.
I don't know, this is probably hard to answer, But whatre chances of Uh Complications in the surgery? The biggest, um, complication that we worry about Is that not all babies, even under the best conditions, Uh, make it through the first surgery.
it's a lot emotionally on me, Um, from everything coming back home to, u Being with renee for the first time in nine months, Seeing her pregnant, To seeing sam's condition.
It--it is tough.
Yeah, that was pretty scary, huh? I know.
Today is surgery day for charlie chew.
He's 77, he's a robust guy, And we want to give him more time.
We are gonna lie you flat.
Are you okay lying flat? Yes.
We're gonna give you some oxygen to breathe.
Sure.
Try not to worry.
This is my soul mate.
Okay.
remember I love you.
I love you, too.
remember, you promised me 60? Yeah, b-- and I want 65.
That's the tumor, and it's just crushing the lung.
oh, wow.
It's coming right around and just crushing it.
dr.
Sugarbaker--he's done than anyone in the world.
N Right.
Right now, we're just, Uh, walking, uh, upstairs to, uh, check in with the family Before surgery on mr.
Chew.
I just want to touch base this morning Before we, y know, get started formally.
It is a devastating problem, but it's not a hopeless problem.
And there's many, many people who survive it and do well.
And that means hope is now in the equation.
That means a great deal.
charlie chew's a very down-to-earth guy.
You know, he's one of these Salt-of-the-earth type individuals who's, uh, you know, Served our country and worked very hard.
And we're gonna do the best we can to attack this disease.
can I have a-another officer, please, To help with a patient? Well, she's just kind of waering the halls.
Thanks.
Bye.
You mean in my bedroom? What, are you crazy? In your bedroom.
There has to be a full moon.
Is there? Elizabeth, who's her doctor? That short girl That I just told needed All right.
I'm on it.
Every year, you get new residents, Fresh out of med school.
And sometimes, getting them to believe you every year, you get new residents, And listen to u and to get that You know what you're talking out is the hardest part.
So we needs meds for her.
She's pushing-- I'm about to--I'm about to write it for her.
'cause security's coming.
She's gonna be put into bed, Probably restrained.
Why don't we start with 1? She's an old lady.
How about 2.
5? 'cause it's 1- -it's 5 per 1 m.
L.
So She's an old lady.
Um Oh, come on.
Okay, let's try with 2.
I think 2.
5, that's good.
Okay.
Thank you.
Yes, I know I don't have That fancy m.
D.
At the end of my name tag Elizabeth, so 2.
5 of haldol.
But it would make people's lives a whole lot easier If they would just listen to us.
do not touch me! No! Okay.
Don't do it! Don't fight.
I am not-- That is-- all right.
All right.
You gotta calm down.
That is my mother in there.
Okay, but you can't fight-- You can't fight in an emergency room.
I--tell him I'm not leaving.
You can't fight in an emergency room, ma'am.
A lot of the time, patients can be nasty, And it's like, " I'm just trying to help you.
" go for it.
The patient was trying to climb out of bed.
The daughter was just making the situation worse.
I asked her to leave.
She refused.
Said, "I'm not leaving my mother!" And I said, "you're making this worse.
"your mom's gonna get hurt.
"she's getting so- you're making her upset And you're compromising her care.
" I--I don't want a shot! I need someone in here with vi in 9, And I need someone with elizabeth in 7.
So can you call backup? What's more important? This o first.
What's wrong with you? ! Calm down, miss.
Tell him to let go of my calf! Miss, calm down.
Call the police! These are the police.
good job.
We're here.
? we're in the, uh, pre-op room ? we're in the, uh, pre-op room Waiting to go, uh, into surgery.
I think the fact that it's cancer, you're always afraid.
He just wanted to be done.
He wanted to get out of the surgery And--and start doing what you need to get him back home.
Today will be a relatively short day for me, Because I'll be out of it.
The long day will be for them, because they have to wait.
The goal of the operation is to remove everything That this tumor comes into contact with.
We remove the lung, The heart sac and the diaphragm.
I need a 45 with 2 refills Need a harken ready.
So the plan here now Is to divide the major vessel to the heart.
What changed my life and my career goals Is when my dad himself had heart surgery.
I'm gonna need pickups in a second.
The surgeon, he ca to me and he told me What he had done with my dad-- He put my dad's chest back together with wires And bypassed these vessels.
Shunt.
That really had a, you know, lasting impression for me.
Clamp it and just check your p.
A.
Real quick.
Is it closed? Yeah, it's closed.
It's closed, yeah.
That's a large piece of the tumor right here You can see--like a rind, something not--not human.
All rit.
Secure.
Suction.
Excellent.
More saline.
We've got the lung out, the tumor out.
We're gonna go ahead and patch- put the patches in.
Have an endo 45 vascular ready.
if you sew the diaphragm in wrong, Or you sew the pericardium in wrong, The patients can die, literally, When you change their position on the operating room table.
I always pray for the s-surgeons, That god guides their hands.
One more stitch, please.
Not a whole lot.
So, uh, you know, everything's going very well.
It's out.
Itas a large tumor.
However, it did not invade things around it.
So far, we're just where we need to be.
We couldn't be in any better shape.
oh, I just thank god.
? You got makeup on.
I always wear makeup, okay, ? Always.
E they taking my pants off? Oh, that's a $20.
Oh, yeah.
Did you ever think that you would have this many Young, beautiful women ripping your clothes off? Never.
Never, huh? It's like a dream come true for you.
Never, never.
You know what's really, really cute? I love cute d men.
I love to flirt with them.
We gotta get you kinda quickly on the monitor.
No, no, no, not off the bed.
Oh, okay, all right.
Undress while you're talking.
I've never been asked by a good-looking woman To undress fast in my life.
To undress fast? Unless her husband was coming in the door.
well, I have never had a man Undress for me this quickly, so Thiss what it's gonna look like walking down the aisle.
Right this way.
Straight.
I wanna go home.
? renee woke me up this morning.
It was about 2:55 in the morning, And she was in the bathroom and she said, "my water broke.
" Then he just looked panicked.
And then we called the doctor, and they said to come on in.
Renee's baby will be delivered next door at the bgham, And shortly after birth, we'll bring him over To the cardiac icu at children's, Where we'll perform the first of hishree operations.
Look at all these people.
It's a birthday party.
Let's have a baby.
Are we ready to go? Here we go.
All right.
Behind your legs.
Yep, big breath in.
Nice big push right now, hard as you can.
Push, push, push, push, push, push, push.
Keep going.
There you go, honey.
Little more, little more Oh, my god.
Little more, little more, little more, little more.
Perfect.
Good for you.
It's coming.
You can see the head.
You seem so terrified.
I can hear you over my shoulder Going, "oh, my god.
" Nice big push.
There you go.
Little more.
Good.
Od job.
Push him down a little further, A little further.
Oh, baby.
good for you.
Good.
There you go.
Oh, my god! Baby! Oh, my god! ta-da! Oh, my god.
there's sammy.
Good for you.
right over to the pediatrician.
Oh, he's okay.
Baby.
Yeah, he looks okay.
oh, baby.
Oh, baby, he's okay.
Is, baby.
he's crying.
He's okay.
we're just gonna dry him off, And you'll have him for about give minutes.
oh, he sounds so cute.
oh, baby.
Look at him.
I can't see him.
hi, mama.
Hi! Hi, sammy.
Hi, mama.
Sammy! Hello.
Hello.
Hello, cameras.
Oh! look at him.
Oh, thank you.
hi, baby.
Oh, hi, baby.
Look at that sweetie.
sam is doing really well.
He's come out in the way that we kind of expected him to, which is almost looking like a normal baby.
But he has hypoplastic left heart syndrome, And there's a real risk there.
If we didn't do anything, he wouldn't make it at all.
Hey, sweetie pie.
I feel like his surgeries are gonna go fine.
oh.
They have to take him.
Yeah.
I'll go with you, sammy.
? ? oh, gracious and loving god, We thank you for this, your precious little boy samuel.
We ask you that this little baby will not be stressed.
He will not be afraid because you're holding him.
Amen.
Amen.
Before we fix sam's heart, Uh, we need to get an exact picture Of how the blood circulates within the heart And the great vessels.
And we need to understand Exactly what kind of abnormality we're dealing with.
What we've done here is inject dye into the baby's heart To see how the blood is flowing.
We hope that this will tell us what kind of surgery We'll need for sam.
This worries me.
This, uh, connection.
We're making this up, right? We're completely-- We have never made this diagnosis before.
yeah.
Even for a baby with hypoplastic left heart syndrome, Sam's, uh, abnormality is much more serious And much more complicated.
And we won know until we get into the operating room What kind of operation, uh, we'll need to do to fix it.
There is a very difficult situation.
We have more data, we have more information, But it has not allowed us to go one way or another.
It's still okay? Still okay, and what we're trying to do Is to make the best decision we can.
So what we're going to do, we're gonna go to the operating room, And we're gonna inspect the heart from the outside.
And unfortunately, we are exactly in this, uh, In this gray zone that I was hoping we wouldn't be in.
clearly not-- but these babies that are in the gray, Like, some of 'em make it, right? Definitely.
None of us are giving up you guys-- but we're more worried, you know.
It's almost hard to bond with him Because I'm afraid that I'm- that I might lose him, And it's, like, hard 'cause I don't want to get too close to him In case he doesn't make it.
But I also don't want to not get close to him.
? It's not that the stakes have changed, But it's just that sam's in a higher risk group.
It's a tough situation, but it's not hopeless.
And if anybody can fix it, we can.
we have to say good-bye, buddy.
love you, buddy.
We'll see you soon.
? We want you to lay still, okay? He's 39 years old, and tonight, he was assaulted.
It sounds like he was seen breaking into someone's car And they caught him.
They came up-- hi, my name's pina patel.
I'm one of the doctors That are gonna be taking care of you, okay? We have to examine you head to toe, okay? Lay back.
Just stay there and let the doctor take care of you.
We'll take care of it, okay? So the first arriving unit Ma'am Found him supine in the street-- no police here.
It's just doctors, okay? there are no police.
"there's no police are there any police?" I mean, it's like, there are no police here.
He doesn't want to be evaluated.
That's nice.
He's just worried that the cops are here.
I am bustin' outta here.
It'll be fun to hang out with my friends.
I just haven't seen 'em in a long time.
I can't wait.
It'll be fun.
Do these look better? I imagine this would be, like, good for hangovers.
This is the sweet life of a resident.
Oh, man.
How are you? How are you? Oh, gosh.
It's so good to see you.
Ready? Yeah.
One, two, three.
My friends, fily, They've tried to set me up here and there, And it's generally been unsuccessful.
I've been on, like, indianmatches.
Com and stuff, And I've just met, le, the weirdest guys.
Guys that are, like, so boring, like, you wanna run outta there.
Guys that have been arrested.
I mean, like, it's just no good.
I think it's awesome.
If I was single, I would be on it in a heartbeat.
There have been a couple of people that I've cared for That things just didn't work out.
And I'm, like, dating kryptonite.
Honestly, I think, like, you're ridiculously hot.
I think that, like, you have an amazing personality.
And, like, I th- -hopefully, you'll meet somebody.
More sake? I know.
Cheers.
Cheers.
I feel sick to my stomach.
that's all emotional stress, Which is something I really not used to.
I mean, I've been through A lot of high-stressful environments.
But emotional stress is- there's nothing unlike it.
It's actually wiped me out.
I've been pretty tired.
this is highly unusual That we have to make the decision during surgery.
May we start? yes.
Incision.
We'll make the--the final decision Once we look at the heart.
It blows my mind when I think about What they're actually gonna do to him today.
I mean, I think that we definitely did the right thing.
I think that sam gonna do big things in his life.
I really do.
Onitor beeping rhythmically) Look at that.
Look that.
See that? yeah.
So he has a large amount of fistulae on the left.
Now that we're looking at sam's heart, It's clear how to proceed.
We'll be putting bands on and restricting The amount of blood flow that goes to the lungs.
What I'm worri about is that the heart muscle Is strong enough to support this operation.
Uh, blood pressure incased.
Nice response to the vent.
yeah.
Now we're going to be tying down the bands.
okay.
Hey.
All goes well, we should be up there within 25 minutes.
Thank you.
Good.
All right.
So he did well with the bands.
All right.
I'monna go talk to the parents.
Hi.
Hey, how you doing, doctor? Good.
All right.
So we have good news.
We've done the bands.
He's very--he's done very well.
We're gonna watch him and stabilize him.
And, you know, this is a-a journey, And there's many, many steps, And we've started off the right way.
Okay.
All right.
Okay.
Thanks, doctor.
Thank you.
Okay.
? ? Is the consult pager still forwarded to me? I'm not me pretty much at all.
just--all I wanted to know is And so I do feel bad that I've neglected my family over the last few years.
If any transplants or perforations Or whatever come in tonight, give me a call.
Wow, honey.
You're all spiffed up.
My wife is a jewel because she knows that, uh, My job brings me a lot of satisfaction, And I couldn't do anything else.
I have a lung transplant in the morning.
Yeah.
What does that mean for you and hannah's dance recital? I don't know.
She's gonna be crushed if you can't come.
We'll see.
A lung transplant has come in, So he's gonna get a couple hours of sleep and go back.
And so hopefully he can make it For hannah's dance recital tomorrow at 1:00.
transplants are tough because they're unpredictable.
They always come in in the middle of t night, And nothing ever goes as scheduled.
? So it's 6:00 a.
M.
Hopefully we could be done by, you know, at least 11:00.
I'm gonna need a vascular clamp.
At this point, we've gone as far as we can.
We're just sitting here waiting for dr.
Camp.
It's a recital dress.
And we have flower dance.
It's kinda beautiful.
today is hannah's ballet recital.
Jon is at the hoital Doing a lung transplant.
And I'm really hoping that he can make it To the dance recital, because it means a lot to hannah.
we're gonna go ahead and, uh, cut it out.
Meanwhile rose and dr.
Camp Are gonna prepare to put the lung back.
So we'll see if we can Get him outta here in time to go to his recital.
Your daddy loves you very, very much.
And he's doing his best job to try to make it here, okay? Where is he? He is at the hospital.
There was someone that was very sick That needed his help.
Ah, I'm in trouble.
I mean, we're gonna be done in ten minutes.
But we still have to wake the patient up And take the patient up to I.
C.
U.
, so Jon.
Hello.
Hello.
We're at the recital.
Where are you? I'm still here.
Think you can come or no? What time do you think she's gonna go? She's gonna go, probably, like, 1:10.
Okay.
I don't think I can make it then.
All right.
Well, do the best you can, sweetie.
Okay? It doesn't look like he's gonna make it.
Hannah had been practicing now For this recital for a whole year, And it was very important to her.
And so I really wanted to be there.
Can you do me a favor and come down And--and, uh, help me take this patient up? My daughter has a recital.
I just want to try to make it.
Yeah.
Thanks, man.
What a nice friend.
go.
Get out.
don't forget the flowers.
Hurry.
Yeah.
Oh, hey, honey.
I just wanted to let you know, You know, she has a finale where she comes out and bows.
Yeah, we're gonna try to come.
But anything you can do to delay.
You're on your way? Daddy! Hey, honey.
I got you some flowers.
You look so pretty.
You did such a good job, honey.
I love you.
Are you wearing makeup? That was pretty neat.
She was happy, and it's nice to see her smile.
? you okay? Getting hungry? Huh? I definitely feel like a mom now.
Before I couldn't even focus.
I was so distracted By everything else that was going on.
Tough guy, huh? hey, sam.
I couldn't imagine doing this without jake.
Having him here has made all the difference in the world.
But, you know, the time is flying by, And he's gonna leave soon.
It's pretty scary- how much you love your son And to be so scared for him.
I think the first step that we've taken now with--with sam Are positive.
You know, it--we're not- -by any means, we're not there yet.
But he's done extremely well, and he's going home.
thank you.
thank you very much.
No problem.
I can't believe we have a child, and we're taking it home.
I know.
Have fun.
take care.
I'm scared, too.
This? Adon't worry.
? You backing that thing up? Yeah.
? ? I'm going back to iraq.
How you doing? hi.
What's your final destination, sir? Uh, iraq.
Any one of these check-in maines can get you I really pray for my husband's health And well-being through this whole time.
really sad to go.
It was really hard saying bye this morning.
But, uh, hopefully, I'll be coming home a little early.
Uh, my chain of command's been really supporte Of sam, his condition.
I got some pictures to take back with me.
He'll probably grow a lot wh I'm gone.
This was us in our sunglasses.
I'm gonna miss him.
Just gotta show him off.
We'll see you, dad.
Okay.
Take care.
? I'm excited.
I feel like I got the perfect job.
I'm gonna be heading off to california.
I'll be an attending.
I'll be working four days a week.
And it feels good.
Just like, I'm 30, I'm a professional, I'm going somewhere warm.
ladies, if I could have you button A couple of buttons for me.
wow.
I know.
Huh? In the back row I was one of the ones that didn't think I was actually gonna make it through.
You're graduating.
Don't be scared.
Come on.
ready? One, two and three.
welcome, everyone, To the graduation ceremony Of the class of 2009.
I'll be the first physician in my family.
My parents are ridiculously proud, To the point where it's almost embarrassing.
But it lasted for five seconds before they were like, "yeah, so when are you getting married?" pina patel.
? "in my most anxious moments, "I gathered my strength from knowing "that I am intrinsically half of my parents.
"my father is my hero.
"the day of my birth, my parents were convinced That I was meant for wonderful things" I came from just a very humble background.
My parents grew up with virtually nothing.
"I never had to worry about peanut.
She would just worry for herself.
" "and for everyone else.
" Congrats.
Thank you.
Thank you.
All the best.
I guess it's good for everyone in their lives To have a little bit of struggle, 'cause then you never know how sweet it is to be at the end.
I finally got it.
The day has finally arrived.
I have survived.
And I'm going to go to the next stage.
Next on Boston Med there's a pediatric trauma coming in.
He has massive internal bleeding.
Spike another bag of saline.
son of a bitch.
Whoa.
I had a seizure.
I'm thinking about my son.
it's brain surgery.
All hell could break loose.
who has dated somebody you've worked with? If it's a cute nurse, the old nurses hone in on you.
it was disastrous.
This is embarrassing.
I'm not comfortable with this case.
No.
It's not that I don't trust you.
These are the stories Of the men and women who work in them.
I've never seen a guy piss off more nurses than you on rounds.
oh, really? Are you asking me out in front of this camera? code blue, e.
D.
Code team.
can anyone feel a pulse? I got nothing.
whoa! we're currently en route to your facility With a 74-year-old female Who underwent cardiac arrest at an outside hospital.
We'll be there in about ten minutes.
74-year-old female.
While she's at diasis, she arrested.
According to the staff there, They did about ten minutes of cpr and intubated her.
so this woman was at dialysis at another hospital, And she cardiac arrested.
So they got a heart rate back, got her pulse back.
Now she's here.
Set up for an a-line, and we'll get it-- Okay.
We'll get an artery line going.
You want to try a 22 in there? Mm-hmm.
A lot of people think that nurses just pass out medicines, Put people on bedpans, Wipe their butts and that's it, you know? But it's really so much more.
sounded like we had it-- She's awake and she's fighting the tube.
You guys, she's bradying down to 39.
Does she have a lse? I'm not showing carotid-- So why don't we start cpr? right now she went up to 55.
Does she have a pulse? I was in the room with the family, and they're-- And they're pretty adamant they don't want anything else.
Okay.
You know what? Guys, she's- -she's d.
N.
R.
she's d.
N.
R.
? let's--let me go and-- So the family's outside.
The family's outside.
She was resuscitated When she wasn't supposed to be resuscitated.
All right.
We're done.
yeah, we're done.
This poor woman was do not resuscitate, And for whatever reason, at the other hospital, They resuscitated her-- Like, did cpr, gave her the meds, intubated her-- And the--all the while, she didn't want any of that.
So let's stop what we're doing, let's clean her out, And let's let her family come and spend some time with her.
yeah.
And didn't respect someher last wishes, ball Which is sad, 'cause that's not the way I would want to go.
doctors are supposed to keep Their emotions under control.
Thisan be especially difficult in pediatrics.
He's still pretty crackly, though, and wheezy.
yeah.
? For example, how do you tell an expectant mother Whose baby has a serious heart condition That it'll be okay? at 18 weeks, They sent me for my first ultrasound, And the tech looked at me, and she said, "renee, I have to be honest with you.
"the reason that I'm looking at the heart so long "is because it doesn't look right.
Something's wrong with the baby's heart.
" And I just remember my heart dropping at that point.
And I had my mom and my sister wi me, And I reached over and I grabbed my mom's hand and I just started to fall apart.
I'll put his monkey blanket away.
I just was devastated, and I thought, I need to talk to my husband.
Jacob's in the arm fighting in iraq.
He's been gone my entire pregnancy, But he's working really hard to get home next week For the birth of our son sam.
even though my son has a broken heart, This baby is perfect, And he's gonna make it.
And I can't have any doubt that he's not gonna make it.
? so how you feeling? Really tired yesterday, but I'm doing better now.
All right.
Well, you know the drill.
We've been following renee, um, with a-- Actually a prenatal diagnosis Of what's called hypoplastic left heart syndrome.
This is a severe form of congenital heart disease.
Sam's heart is maybe no bigger than my thumb.
But let's see if we can find his head.
He looks more like my husband.
Many babies don't survive, Even after corrective surgery under the best of conditions.
But we're optimistic that we'll have a great outcome.
M gonna miss it.
just in caset's jake.
Hello.
hi, hon.
Hi, jacob.
How are you? Ess what.
They're giving me two weeks of leave.
I'm coming home.
What? Hopefully I'll be leaving, like, within a day.
I'm just afraid you're not gonna make it home in time.
You know, I'll get there- I'll get back in time.
That's what you think.
This baby might not wait till the 12th, jacob.
They said he doesn't do any drugs, just dnks.
Just drank a gallon of vodka real quick.
Hey, buddy.
And there's the alcohol.
Oh.
Whoo.
Whoa! Apparently, he did not enjoy my singi.
Ugh.
He's gonna get nursed back to health by our angels.
It's gotta be the worst feeling to go out for some drinks Or, like, think you're drinking with your buddies, And then wake up in the emergency room-- No idea how you got there- in a diaper.
? This is, uh, m , Who was drinking vodka th his friends Where am I? Became unresponsive.
So the friends called 9-1-1 and brought him here.
Okay.
Friends rert that this is not his first time Having to be hospitalized for alcohol issues.
Mm-hmm.
Okay.
He came in, vomited all over himself.
Also was incontinent several times.
The family wouldn't come in.
Okay.
Didn't want to see him.
Nothing.
I had to deal with a really tough funeral this week.
I don't know how I ended up here, but I mean, I'm fine.
You've--you've told me your sob story.
I know.
Okay, so-- It okay.
Stop.
You could tell me as many times as you want, But you're not leaving right now, so stop.
I have three hours to get my exam to my teacher.
Honestly-- "honestly" nothing.
You c--you almost died last night.
Okay, but-- So I don't care that you have an exam due.
I know you don't care.
You should've thought of that before you went out I know.
It's-- and you got so drunk And then you almost choked on your own vomit.
Like I said, is not-- I know, it's not-- No.
No.
Honestly, it's really tough.
Show some sympathy.
What the ? As long as I know I'm a good nurse, And I'm doing what's best for him, He can tell me to go "f" myself all he wants.
I liked him much better when he was unconscious.
The kid's got a scholarship That he's just puking away on the mass general floor.
? You hurt in here where this incision was made? No.
No.
I like to think That I'm outstanding in the operating room And that I give a good surgery, But that I also do extremely good patient care.
Oh, wow.
he's a goohealer.
Yeah, or--or he had a great surgeon who-- That--that- that's part of it, too.
But the best part of it is being with the patient Through the whole journey, from the beginning.
How's the weather in the midwest? oh oh, it was ugly.
It was snowing yesterday.
It was snowing.
No, please don't--I'm looking at a job in the midwest.
Ohio is a great-- Cleveland's a fun city.
you make eye contact and you form a bond.
And they decide that they're gonna put Their trust in your hands.
77 year old scheduled for a left, uh, Extrapleural pneumonectomy With intraoperative chemo on Thursday.
you know, in cancer, they're our patients for life.
So if you, uh, remove someone's lung cancer, you will see them On a regular basis for the rest of their lives.
I tell people I married my soul mate and my best friend.
Yeah.
Yeah, we- we've had good 54 years.
And this is probably The toughest thing we've ever faced together.
Hi, mr.
Chew.
Yeah.
Jon daniel.
Pleased to meet you.
I'm dr.
Sugarbaker's chief resident.
Okay.
Okay.
Charlie chew has a cancerous mass Growing around his entire lung.
So here's your normal right lung, And on the left here now, You can see the mesothelioma around the left lung.
Methelioma is a--probably, Uh, one of the most aggressive cancers you can have.
It has been related to asbestos exposure.
And you have known asbestos exposure? I was on a destroyer for three years.
given our age, Everythi was wrapped in asbestos years ago.
Obviously, we can't go back And change the exposure that you had.
No, we cannot.
But we can get this thing out.
I expect a good sewing job.
This is my soul mate you're operating on.
Of course.
Of course.
We understand.
So This is my best friend here.
My husband's coming home from iraq For a few short weeks.
This will be jake's first time seeing me Since I am pregnant.
It's landing.
It's landing.
it's landing right now? Okay.
I've thought it through in my head, Like how am I gonna greet him? But then all the images of, like, in the movies, How they, like, run into each other's arms and, like, You know, he picks her up- like, obviously, that might be A little bit more complicated in this situion.
Oh, he's coming out.
He's coming.
He's coming.
we're currently inbound with a cardiac arrest.
18-year-old male, a known asthmatic, Complaint of shortness of breath before his cardiac arrest.
W18-year-old asthmaticom your in cardiac arrest.
Tions? Everybody here that needs to listen? Yeah.
All right, 18-year-old male, known asthmatic.
Playing basketba outside with friends, Started complaining of shortness of breath And a little bit of dizziness.
How long was he down? Proximately ten minutes prior to our arrival.
We've had him for about 15 minutes.
Okay, dr.
Kabrhel, somebody else, I need a femoral.
Can we please have another epinephrine? only been two minutes since the last epi.
You want another one? It was really intimidating coming here.
And I always felt like, yeah, I had something to prove.
Will someone let me know When it's been another minute, please? I've really had to work on Trying to be someone that can inspire confidence.
I-I have to work on being a little bit more cockier, 'cause people actually respond to that.
Raquel? Yeah.
Needle both sides, please.
All right, let's stop for a rhythm check.
Hold compressions, please.
cease the bag.
And is someone feeling for a pulse? I am.
that looks like v.
F.
Yep, he's back in v.
F.
We need to shock him if he's- all right.
Let's continue.
all right.
Let's go for another shock.
all clear? Clear Raquel, hand clear.
Raquel, off.
find a pulse, please.
all right.
Resume chest compressions, please.
? There's my husband.
(renhe's really coming.
And.
Hey, honey.
Jake! You look beautiful, baby.
I'm nervous.
Oh, gosh.
I am really nervous about seeing him Just because he hasn't seen me pregnant.
I'm so nervous to see you.
It's okay.
Don't be nervous.
You look so hasome.
Mm.
You look beautiful, baby.
So what do you think? That's sammy.
Pretty big, huh? play ball.
is it what you thought it would be like? What'd you do? You want to say hi to your family? Okay.
come here.
Hey.
For any soldier, coming home is always a difficult time.
But he's coming home for a labor and delivery And a baby who's gonna need heart surgery.
You do look beautiful.
I look huge.
No, you don't.
? If he has no cardiac activity.
He's been down for then Okay.
About 40 minutes.
all right.
We're holding compressions.
Anyone feel a pulse? Here, I got nothing.
All right? There's no movement.
Can anybody think of anything else That we're missing? Another ideas? the family may want to come in And be here while we're still doing this.
Ugh.
Oh, no.
Yeah.
all right, guys, just get ready.
The family is coming in.
I love you.
I love you.
I love you.
I love you.
Oman crying and speaking indistinctly) You grow up with him? he was younger than me.
I grew up with his older brother.
That lady, who's his aunt, Has kids I went to camp with every summer.
So That's really difficult.
You know, we know he wasn't gonna come back After a certain point.
And it's just waiting, and then it's--it's hard.
good job.
You were in charge.
Everybody knew who to look to.
You did great.
You did great.
It sucks.
It does suck.
hi.
through that door, to the right.
okay, thanks.
? Now that jake is here, I feel more excited about everything that's going on, And it feels more real.
We've hit him with a lot these last few days, Between all the doctors visits And getting him caught up to speed.
This is where I deliver, though.
And sam might go up to 6 initially For, uh, I.
C.
U.
To be stabilized.
And then he'll come ov to children's hospital.
We go to advanced fetal care center.
Advanced fetal care center.
And, um-- this place is so big.
I think my biggest concern is for jake.
It's gonna be a lot to hit him in a very short period of time.
And this is where sam's doctor is.
Hi, doc.
Good morning.
This is jake.
Oh, hi, jake.
Nice tmeet you.
Nice to meet you, too, finally.
Welcome back.
We're gonna go really spend some time Explaining to jake, uh, and bringing him up to speed About what's going on with their baby--sam.
So what sam has is hypoplastic left heart syndrome.
And for reasons we don't understand, The structures on the left side of the heart didn't form well.
And as a consequence of that, The blood is actually going backwards.
What hpens normally-- This vessel closes after babies are born.
So there's no way for blood to get to his lower body And the rest of his body.
And they die.
And they would die.
Mm-hmm.
We don't have the ability to cure this, But through, uh, a series of three operations Over the first th- two to three years of life, Um, we can get sam to a place where he is, um, Almost running around like other kids.
I don't know, this is probably hard to answer, But whatre chances of Uh Complications in the surgery? The biggest, um, complication that we worry about Is that not all babies, even under the best conditions, Uh, make it through the first surgery.
it's a lot emotionally on me, Um, from everything coming back home to, u Being with renee for the first time in nine months, Seeing her pregnant, To seeing sam's condition.
It--it is tough.
Yeah, that was pretty scary, huh? I know.
Today is surgery day for charlie chew.
He's 77, he's a robust guy, And we want to give him more time.
We are gonna lie you flat.
Are you okay lying flat? Yes.
We're gonna give you some oxygen to breathe.
Sure.
Try not to worry.
This is my soul mate.
Okay.
remember I love you.
I love you, too.
remember, you promised me 60? Yeah, b-- and I want 65.
That's the tumor, and it's just crushing the lung.
oh, wow.
It's coming right around and just crushing it.
dr.
Sugarbaker--he's done than anyone in the world.
N Right.
Right now, we're just, Uh, walking, uh, upstairs to, uh, check in with the family Before surgery on mr.
Chew.
I just want to touch base this morning Before we, y know, get started formally.
It is a devastating problem, but it's not a hopeless problem.
And there's many, many people who survive it and do well.
And that means hope is now in the equation.
That means a great deal.
charlie chew's a very down-to-earth guy.
You know, he's one of these Salt-of-the-earth type individuals who's, uh, you know, Served our country and worked very hard.
And we're gonna do the best we can to attack this disease.
can I have a-another officer, please, To help with a patient? Well, she's just kind of waering the halls.
Thanks.
Bye.
You mean in my bedroom? What, are you crazy? In your bedroom.
There has to be a full moon.
Is there? Elizabeth, who's her doctor? That short girl That I just told needed All right.
I'm on it.
Every year, you get new residents, Fresh out of med school.
And sometimes, getting them to believe you every year, you get new residents, And listen to u and to get that You know what you're talking out is the hardest part.
So we needs meds for her.
She's pushing-- I'm about to--I'm about to write it for her.
'cause security's coming.
She's gonna be put into bed, Probably restrained.
Why don't we start with 1? She's an old lady.
How about 2.
5? 'cause it's 1- -it's 5 per 1 m.
L.
So She's an old lady.
Um Oh, come on.
Okay, let's try with 2.
I think 2.
5, that's good.
Okay.
Thank you.
Yes, I know I don't have That fancy m.
D.
At the end of my name tag Elizabeth, so 2.
5 of haldol.
But it would make people's lives a whole lot easier If they would just listen to us.
do not touch me! No! Okay.
Don't do it! Don't fight.
I am not-- That is-- all right.
All right.
You gotta calm down.
That is my mother in there.
Okay, but you can't fight-- You can't fight in an emergency room.
I--tell him I'm not leaving.
You can't fight in an emergency room, ma'am.
A lot of the time, patients can be nasty, And it's like, " I'm just trying to help you.
" go for it.
The patient was trying to climb out of bed.
The daughter was just making the situation worse.
I asked her to leave.
She refused.
Said, "I'm not leaving my mother!" And I said, "you're making this worse.
"your mom's gonna get hurt.
"she's getting so- you're making her upset And you're compromising her care.
" I--I don't want a shot! I need someone in here with vi in 9, And I need someone with elizabeth in 7.
So can you call backup? What's more important? This o first.
What's wrong with you? ! Calm down, miss.
Tell him to let go of my calf! Miss, calm down.
Call the police! These are the police.
good job.
We're here.
? we're in the, uh, pre-op room ? we're in the, uh, pre-op room Waiting to go, uh, into surgery.
I think the fact that it's cancer, you're always afraid.
He just wanted to be done.
He wanted to get out of the surgery And--and start doing what you need to get him back home.
Today will be a relatively short day for me, Because I'll be out of it.
The long day will be for them, because they have to wait.
The goal of the operation is to remove everything That this tumor comes into contact with.
We remove the lung, The heart sac and the diaphragm.
I need a 45 with 2 refills Need a harken ready.
So the plan here now Is to divide the major vessel to the heart.
What changed my life and my career goals Is when my dad himself had heart surgery.
I'm gonna need pickups in a second.
The surgeon, he ca to me and he told me What he had done with my dad-- He put my dad's chest back together with wires And bypassed these vessels.
Shunt.
That really had a, you know, lasting impression for me.
Clamp it and just check your p.
A.
Real quick.
Is it closed? Yeah, it's closed.
It's closed, yeah.
That's a large piece of the tumor right here You can see--like a rind, something not--not human.
All rit.
Secure.
Suction.
Excellent.
More saline.
We've got the lung out, the tumor out.
We're gonna go ahead and patch- put the patches in.
Have an endo 45 vascular ready.
if you sew the diaphragm in wrong, Or you sew the pericardium in wrong, The patients can die, literally, When you change their position on the operating room table.
I always pray for the s-surgeons, That god guides their hands.
One more stitch, please.
Not a whole lot.
So, uh, you know, everything's going very well.
It's out.
Itas a large tumor.
However, it did not invade things around it.
So far, we're just where we need to be.
We couldn't be in any better shape.
oh, I just thank god.
? You got makeup on.
I always wear makeup, okay, ? Always.
E they taking my pants off? Oh, that's a $20.
Oh, yeah.
Did you ever think that you would have this many Young, beautiful women ripping your clothes off? Never.
Never, huh? It's like a dream come true for you.
Never, never.
You know what's really, really cute? I love cute d men.
I love to flirt with them.
We gotta get you kinda quickly on the monitor.
No, no, no, not off the bed.
Oh, okay, all right.
Undress while you're talking.
I've never been asked by a good-looking woman To undress fast in my life.
To undress fast? Unless her husband was coming in the door.
well, I have never had a man Undress for me this quickly, so Thiss what it's gonna look like walking down the aisle.
Right this way.
Straight.
I wanna go home.
? renee woke me up this morning.
It was about 2:55 in the morning, And she was in the bathroom and she said, "my water broke.
" Then he just looked panicked.
And then we called the doctor, and they said to come on in.
Renee's baby will be delivered next door at the bgham, And shortly after birth, we'll bring him over To the cardiac icu at children's, Where we'll perform the first of hishree operations.
Look at all these people.
It's a birthday party.
Let's have a baby.
Are we ready to go? Here we go.
All right.
Behind your legs.
Yep, big breath in.
Nice big push right now, hard as you can.
Push, push, push, push, push, push, push.
Keep going.
There you go, honey.
Little more, little more Oh, my god.
Little more, little more, little more, little more.
Perfect.
Good for you.
It's coming.
You can see the head.
You seem so terrified.
I can hear you over my shoulder Going, "oh, my god.
" Nice big push.
There you go.
Little more.
Good.
Od job.
Push him down a little further, A little further.
Oh, baby.
good for you.
Good.
There you go.
Oh, my god! Baby! Oh, my god! ta-da! Oh, my god.
there's sammy.
Good for you.
right over to the pediatrician.
Oh, he's okay.
Baby.
Yeah, he looks okay.
oh, baby.
Oh, baby, he's okay.
Is, baby.
he's crying.
He's okay.
we're just gonna dry him off, And you'll have him for about give minutes.
oh, he sounds so cute.
oh, baby.
Look at him.
I can't see him.
hi, mama.
Hi! Hi, sammy.
Hi, mama.
Sammy! Hello.
Hello.
Hello, cameras.
Oh! look at him.
Oh, thank you.
hi, baby.
Oh, hi, baby.
Look at that sweetie.
sam is doing really well.
He's come out in the way that we kind of expected him to, which is almost looking like a normal baby.
But he has hypoplastic left heart syndrome, And there's a real risk there.
If we didn't do anything, he wouldn't make it at all.
Hey, sweetie pie.
I feel like his surgeries are gonna go fine.
oh.
They have to take him.
Yeah.
I'll go with you, sammy.
? ? oh, gracious and loving god, We thank you for this, your precious little boy samuel.
We ask you that this little baby will not be stressed.
He will not be afraid because you're holding him.
Amen.
Amen.
Before we fix sam's heart, Uh, we need to get an exact picture Of how the blood circulates within the heart And the great vessels.
And we need to understand Exactly what kind of abnormality we're dealing with.
What we've done here is inject dye into the baby's heart To see how the blood is flowing.
We hope that this will tell us what kind of surgery We'll need for sam.
This worries me.
This, uh, connection.
We're making this up, right? We're completely-- We have never made this diagnosis before.
yeah.
Even for a baby with hypoplastic left heart syndrome, Sam's, uh, abnormality is much more serious And much more complicated.
And we won know until we get into the operating room What kind of operation, uh, we'll need to do to fix it.
There is a very difficult situation.
We have more data, we have more information, But it has not allowed us to go one way or another.
It's still okay? Still okay, and what we're trying to do Is to make the best decision we can.
So what we're going to do, we're gonna go to the operating room, And we're gonna inspect the heart from the outside.
And unfortunately, we are exactly in this, uh, In this gray zone that I was hoping we wouldn't be in.
clearly not-- but these babies that are in the gray, Like, some of 'em make it, right? Definitely.
None of us are giving up you guys-- but we're more worried, you know.
It's almost hard to bond with him Because I'm afraid that I'm- that I might lose him, And it's, like, hard 'cause I don't want to get too close to him In case he doesn't make it.
But I also don't want to not get close to him.
? It's not that the stakes have changed, But it's just that sam's in a higher risk group.
It's a tough situation, but it's not hopeless.
And if anybody can fix it, we can.
we have to say good-bye, buddy.
love you, buddy.
We'll see you soon.
? We want you to lay still, okay? He's 39 years old, and tonight, he was assaulted.
It sounds like he was seen breaking into someone's car And they caught him.
They came up-- hi, my name's pina patel.
I'm one of the doctors That are gonna be taking care of you, okay? We have to examine you head to toe, okay? Lay back.
Just stay there and let the doctor take care of you.
We'll take care of it, okay? So the first arriving unit Ma'am Found him supine in the street-- no police here.
It's just doctors, okay? there are no police.
"there's no police are there any police?" I mean, it's like, there are no police here.
He doesn't want to be evaluated.
That's nice.
He's just worried that the cops are here.
I am bustin' outta here.
It'll be fun to hang out with my friends.
I just haven't seen 'em in a long time.
I can't wait.
It'll be fun.
Do these look better? I imagine this would be, like, good for hangovers.
This is the sweet life of a resident.
Oh, man.
How are you? How are you? Oh, gosh.
It's so good to see you.
Ready? Yeah.
One, two, three.
My friends, fily, They've tried to set me up here and there, And it's generally been unsuccessful.
I've been on, like, indianmatches.
Com and stuff, And I've just met, le, the weirdest guys.
Guys that are, like, so boring, like, you wanna run outta there.
Guys that have been arrested.
I mean, like, it's just no good.
I think it's awesome.
If I was single, I would be on it in a heartbeat.
There have been a couple of people that I've cared for That things just didn't work out.
And I'm, like, dating kryptonite.
Honestly, I think, like, you're ridiculously hot.
I think that, like, you have an amazing personality.
And, like, I th- -hopefully, you'll meet somebody.
More sake? I know.
Cheers.
Cheers.
I feel sick to my stomach.
that's all emotional stress, Which is something I really not used to.
I mean, I've been through A lot of high-stressful environments.
But emotional stress is- there's nothing unlike it.
It's actually wiped me out.
I've been pretty tired.
this is highly unusual That we have to make the decision during surgery.
May we start? yes.
Incision.
We'll make the--the final decision Once we look at the heart.
It blows my mind when I think about What they're actually gonna do to him today.
I mean, I think that we definitely did the right thing.
I think that sam gonna do big things in his life.
I really do.
Onitor beeping rhythmically) Look at that.
Look that.
See that? yeah.
So he has a large amount of fistulae on the left.
Now that we're looking at sam's heart, It's clear how to proceed.
We'll be putting bands on and restricting The amount of blood flow that goes to the lungs.
What I'm worri about is that the heart muscle Is strong enough to support this operation.
Uh, blood pressure incased.
Nice response to the vent.
yeah.
Now we're going to be tying down the bands.
okay.
Hey.
All goes well, we should be up there within 25 minutes.
Thank you.
Good.
All right.
So he did well with the bands.
All right.
I'monna go talk to the parents.
Hi.
Hey, how you doing, doctor? Good.
All right.
So we have good news.
We've done the bands.
He's very--he's done very well.
We're gonna watch him and stabilize him.
And, you know, this is a-a journey, And there's many, many steps, And we've started off the right way.
Okay.
All right.
Okay.
Thanks, doctor.
Thank you.
Okay.
? ? Is the consult pager still forwarded to me? I'm not me pretty much at all.
just--all I wanted to know is And so I do feel bad that I've neglected my family over the last few years.
If any transplants or perforations Or whatever come in tonight, give me a call.
Wow, honey.
You're all spiffed up.
My wife is a jewel because she knows that, uh, My job brings me a lot of satisfaction, And I couldn't do anything else.
I have a lung transplant in the morning.
Yeah.
What does that mean for you and hannah's dance recital? I don't know.
She's gonna be crushed if you can't come.
We'll see.
A lung transplant has come in, So he's gonna get a couple hours of sleep and go back.
And so hopefully he can make it For hannah's dance recital tomorrow at 1:00.
transplants are tough because they're unpredictable.
They always come in in the middle of t night, And nothing ever goes as scheduled.
? So it's 6:00 a.
M.
Hopefully we could be done by, you know, at least 11:00.
I'm gonna need a vascular clamp.
At this point, we've gone as far as we can.
We're just sitting here waiting for dr.
Camp.
It's a recital dress.
And we have flower dance.
It's kinda beautiful.
today is hannah's ballet recital.
Jon is at the hoital Doing a lung transplant.
And I'm really hoping that he can make it To the dance recital, because it means a lot to hannah.
we're gonna go ahead and, uh, cut it out.
Meanwhile rose and dr.
Camp Are gonna prepare to put the lung back.
So we'll see if we can Get him outta here in time to go to his recital.
Your daddy loves you very, very much.
And he's doing his best job to try to make it here, okay? Where is he? He is at the hospital.
There was someone that was very sick That needed his help.
Ah, I'm in trouble.
I mean, we're gonna be done in ten minutes.
But we still have to wake the patient up And take the patient up to I.
C.
U.
, so Jon.
Hello.
Hello.
We're at the recital.
Where are you? I'm still here.
Think you can come or no? What time do you think she's gonna go? She's gonna go, probably, like, 1:10.
Okay.
I don't think I can make it then.
All right.
Well, do the best you can, sweetie.
Okay? It doesn't look like he's gonna make it.
Hannah had been practicing now For this recital for a whole year, And it was very important to her.
And so I really wanted to be there.
Can you do me a favor and come down And--and, uh, help me take this patient up? My daughter has a recital.
I just want to try to make it.
Yeah.
Thanks, man.
What a nice friend.
go.
Get out.
don't forget the flowers.
Hurry.
Yeah.
Oh, hey, honey.
I just wanted to let you know, You know, she has a finale where she comes out and bows.
Yeah, we're gonna try to come.
But anything you can do to delay.
You're on your way? Daddy! Hey, honey.
I got you some flowers.
You look so pretty.
You did such a good job, honey.
I love you.
Are you wearing makeup? That was pretty neat.
She was happy, and it's nice to see her smile.
? you okay? Getting hungry? Huh? I definitely feel like a mom now.
Before I couldn't even focus.
I was so distracted By everything else that was going on.
Tough guy, huh? hey, sam.
I couldn't imagine doing this without jake.
Having him here has made all the difference in the world.
But, you know, the time is flying by, And he's gonna leave soon.
It's pretty scary- how much you love your son And to be so scared for him.
I think the first step that we've taken now with--with sam Are positive.
You know, it--we're not- -by any means, we're not there yet.
But he's done extremely well, and he's going home.
thank you.
thank you very much.
No problem.
I can't believe we have a child, and we're taking it home.
I know.
Have fun.
take care.
I'm scared, too.
This? Adon't worry.
? You backing that thing up? Yeah.
? ? I'm going back to iraq.
How you doing? hi.
What's your final destination, sir? Uh, iraq.
Any one of these check-in maines can get you I really pray for my husband's health And well-being through this whole time.
really sad to go.
It was really hard saying bye this morning.
But, uh, hopefully, I'll be coming home a little early.
Uh, my chain of command's been really supporte Of sam, his condition.
I got some pictures to take back with me.
He'll probably grow a lot wh I'm gone.
This was us in our sunglasses.
I'm gonna miss him.
Just gotta show him off.
We'll see you, dad.
Okay.
Take care.
? I'm excited.
I feel like I got the perfect job.
I'm gonna be heading off to california.
I'll be an attending.
I'll be working four days a week.
And it feels good.
Just like, I'm 30, I'm a professional, I'm going somewhere warm.
ladies, if I could have you button A couple of buttons for me.
wow.
I know.
Huh? In the back row I was one of the ones that didn't think I was actually gonna make it through.
You're graduating.
Don't be scared.
Come on.
ready? One, two and three.
welcome, everyone, To the graduation ceremony Of the class of 2009.
I'll be the first physician in my family.
My parents are ridiculously proud, To the point where it's almost embarrassing.
But it lasted for five seconds before they were like, "yeah, so when are you getting married?" pina patel.
? "in my most anxious moments, "I gathered my strength from knowing "that I am intrinsically half of my parents.
"my father is my hero.
"the day of my birth, my parents were convinced That I was meant for wonderful things" I came from just a very humble background.
My parents grew up with virtually nothing.
"I never had to worry about peanut.
She would just worry for herself.
" "and for everyone else.
" Congrats.
Thank you.
Thank you.
All the best.
I guess it's good for everyone in their lives To have a little bit of struggle, 'cause then you never know how sweet it is to be at the end.
I finally got it.
The day has finally arrived.
I have survived.
And I'm going to go to the next stage.
Next on Boston Med there's a pediatric trauma coming in.
He has massive internal bleeding.
Spike another bag of saline.
son of a bitch.
Whoa.
I had a seizure.
I'm thinking about my son.
it's brain surgery.
All hell could break loose.
who has dated somebody you've worked with? If it's a cute nurse, the old nurses hone in on you.
it was disastrous.
This is embarrassing.
I'm not comfortable with this case.
No.
It's not that I don't trust you.