Transplant (2020) s01e12 Episode Script
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So, since it's always
about what you want,
why don't you just tell me
why you're actually here?
- I have stomach cancer.
- Wasn't it three weeks ago, I asked you to go see Doctor Mitchell? Have you gone? Every time I look at my sister, I'm reminded of the one thing I can't give her back.
Our parents.
You never go in.
Why is that? I can't.
You need to face it.
For her.
There's nowhere to wash your hands, to, you know, he didn't have a napkin or a handkerchief.
It was disgusting! And anyway, we would've been here by now if we'd driven.
Well, I like the subway, and I'm not letting myself get sucked into your rarified air.
Why? You might get used to it? Ah! Thank you! Three injured in a car accident.
ETA six minutes.
- Great.
- Bye.
Okay, you too.
Navia Khan.
42.
Uber driver.
Crashed into a vehicle on Spadina.
The light was green.
I didn't realize she hadn't started moving until it was too late.
Pelvic injuries, lacerations and a dislocated shoulder.
BP's 140 over 95, rate's 120.
Are there any traumas - Was speed a factor? - Cops said no.
Is she gonna be okay? We're gonna take good care of her.
Sonja Jessup was rear-ended.
34 years old.
Wounds seem minor.
She cut herself on broken glass helping the other driver and her passenger out of their vehicle.
Doctor, have a look at Ms.
Jessup checked over.
- Use E.
- Manny Kowalski.
34 years old.
Complaining of severe abdo pain, but there's no evidence of trauma.
His BP's 130 over 95, rate's 120, his temp's 38.
3.
Sir, I'm so sorry! I've had worse drivers.
At least you got me to my destination.
You were trying to get the hospital? I had this pain in my gut for a while.
How long have you been having this pain, Mr.
Kowalski? A month, maybe.
But it's been getting worse.
Today it was finally bad enough to get me to come in.
Alright, on a scale of one to ten when I do this? Ah! Fifteen.
Five of morphine for Mr.
Kowalski.
I swear, I'm not usually such a snowflake.
No need to be a hero here.
Possible kidney stone? Positive seatbelt sign.
Claire, I need a plate.
Your shoulder's back in place, but this wound will need to be stitched.
What did you say about a seatbelt sign? We're gonna do an X-ray and an ultrasound of your pelvis.
Seatbelt pressure can sometimes cause it to fracture.
Okay, plate in? 1, 2, 3.
1, 2, 3.
Exposing! Plate out.
1, 2, 3.
1, 2, 3.
X-ray's up! There's free fluid in the pelvis, but no fracture, that's strange.
They usually go hand in hand.
I'll try a blind Foley.
What does that mean? There might be a tear in your bladder from the force of the seat belt.
I'm going to place a catheter.
If it comes back with urine, we'll know your bladder's intact and a tear's unlikely.
- Claire? - On it.
Complex fluid collection in the abdominal cavity.
Dr.
Bishop, I'm seeing debris.
Sir, have you had open surgery recently? - I had a hernia removed.
- Here? Another hospital.
But that was like a year ago.
Why? Is something wrong? We'll X-ray and have a closer look.
Give me the plate.
Thank God I had already dropped my kids off at school.
If they'd been in the car and gotten hurt Ow! Sorry.
Well, uh, nothing seems to be broken, though soft tissue injuries are common after a car collision.
I can give you something for the discomfort.
No, this is, uh, nothing new.
I've had back pain for years.
Okay.
Can I just see your hands? Sure.
It's not too bad.
Still, we should do some imaging.
Is there someone we can call? - My husband's on his way.
- Great.
No urine.
- Probable rupture.
- Can you fix that? Well, we'll confirm with a CT.
Then, you'll need a surgical consult.
I'll page Urology.
We'll take good care of you.
Those have been in there for a year? This only makes sense with the information What's been in where? Sir, whoever performed your hernia operation left two surgical sponges behind.
You're telling me that they forgot something inside of me? It would explain your infection, your fever, your stomach pain.
We're gonna get you to surgery as soon as we can.
Two grams of Ampi, IV-stat.
Deep breath.
And again.
Sonja? Sonja? Sonja! Can you hear me? You lost consciousness, Ms.
Jessup.
Your respiration rate's low.
Do you remember hitting your head? - Any headache? - No.
Um, I'm just dizzy.
Uh, it's probably from all the blood.
I'm fine, I'm sure.
I'm sure it's nothing.
Easy, easy, easy.
Just take a second.
I'm going to order a CT scan to rule out any intercranial injury, also get some blood work done to make sure there's nothing else going on.
- Okay? - Okay.
Alright, I'll be right back.
Really? Complicated differential? No, not exactly.
I got invited to this party, like, old friends from med school.
- I should go, but I - Don't wanna go alone? Sounds like you need a buffer.
Not my thing.
What about, uh Hmm! No, no, no.
No one from Neurology.
No.
He sings when he cuts.
I don't think going with a random is the way to go, Hmm? Hey, what are you doing here? Hey! My surgery is today.
Well, that's on the sixth floor.
That's not down here.
I called your brother.
He didn't want to come up from Chicago.
Elevators are down the hall.
June! Hey.
That looked intense.
- You okay? - Yeah, I'm fine.
Who was that guy? Hmm? That's my father.
Okay.
He's not a patient here, is he? Is everything okay? Apart from being a giant prick? He has stomach cancer and Singh's his surgeon.
Okay, so your father's sick and your boss is his surgeon? Why wouldn't you tell me something like that? I told you that my dad and I don't talk.
Which means you and I don't either? Look, June, I get that your relationship's messed up, and you don't like to talk about it.
But you can't just shut me out of big chunks of your life.
It makes me feel like you don't want me in it at all.
Lou, trust me.
I'm doing you a favor, okay? - That guy - Well, maybe I don't need you to.
Lou! Excuse me, Doctor? I'm, uh, Jason.
Sonja Jessup's husband.
Bashir Hamed.
Uh, she said she was rear-ended.
- Is that true? - Yes.
And she's, um, she's okay? We're running some tests to make sure.
Uh, Dr.
Hamed, did Sonja ask you for painkillers? She's managing fine.
If she does ask for some, please don't give her any.
Sir? My wife's an opioid addict.
She's been clean six months.
It's important you don't even offer her any.
Thank you.
Thank you.
Mags? Does this CT look normal to you? Yeah.
Yeah, I don't think your patient sustained head trauma.
Doesn't seem like it from her scan, but she passed out during the physical exam - and her respiratory rate is low.
- You have a theory? Her husband just told me she's had problems with opioids.
Did you run blood work? Labs aren't back yet, but according to her chart, she was here a couple of times eight months ago requesting narcotics for back pain.
The last doctor she saw here wouldn't prescribe any.
Did she ask for any today? No, even though she's clearly in pain.
She probably knows that she's flagged.
Doesn't wanna draw attention to it.
Decreased resp rate, losing consciousness, no head trauma? Her husband said she's clean now.
Still, it's kind of tough to ignore what those symptoms are saying That she's using again.
I called the surgeons who repaired Mr.
Kowalski's hernia.
Bet they called their lawyer as soon as you hung up.
Wife and kids are downstairs.
She said she tried to get him come over but he kept pulling it off.
Speaking of your father's on the board for his gastrectomy today.
You're welcome to observe.
Obviously, we can't have you scrubbing in, - but - No, thank you.
Understood.
Better stay busy.
You'll have plenty to do once your dad's home anyway.
He said how grateful he was you're willing to look after him.
He told you he was staying with me? Pretty sure my wife and daughter would pay someone to take me off their hands.
Urology should be down as soon as they can.
Okay, any pain here? It was way worse the first time.
You've dislocated it before? - When? - Last year.
I was reaching into the crawlspace.
My husband took one look at it dangling there and almost fainted.
Ex-husband I should say.
I'm still not used to saying that out loud.
Surgery to repair my bladder.
Scale of one-to-ten, how big a deal is it? It's laparoscopic, so recovery shouldn't be too bad.
But having a friend or family member around is always a good idea.
Thing is, I just moved to Toronto, so I don't really know anyone here yet.
When my husband quit our marriage, I quit the office job I always hated.
Gave myself a year to start over and open a food truck.
- That's pretty brave.
- Brave and stupid.
I've been driving Uber to keep things afloat.
Oh.
Sorry.
Your stitches tore through your skin.
Have you been moving around a lot? I'm guessing that's not supposed to happen? Don't worry.
I'll re-suture, and then, uh, we'll figure it out.
Why weren't you moving if the light turned green? You're always the one honking to go before it even changes.
It was green barely a second before she hit me.
Good news, your CT came back negative for any head injury.
Great, but if she didn't actually hit her head, why did you check it? He He's just being thorough.
- I'll give you guys some space.
- No, please.
What aren't you telling me? Nothing.
Sonja? I, um, I passed out earlier.
You passed out? In the accident? No, when I got here and I didn't want to tell you because I didn't want you to worry.
Are you using again? No, Jason! I swear.
Then why didn't you tell me you passed out? Why lie? Because I was afraid you were gonna jump to this exact conclusion.
Or because you were high and that's why you didn't see the light change.
No, I wasn't! I was distracted for, like, a second and then she slammed into me! You drove the kids this morning.
Did you get high and drive the kids? No, Jason! - You have to believe me! - How can I? After everything we've been through? - Because I wouldn't do that - Except you have! When you picked up Tessa from dance! Her carpool got messed up and she was by herself! Excuses! My God! Look, I know things were messed up, Jason! But I swore to you I wouldn't do it again! But you did! And you knew this was your last chance! Gosh, I should have seen it.
You've been distant lately.
Barely present.
Yeah, because I've been in pain! I wasn't using! I wanted to, Jay, but I didn't! I didn't even ask the doctor for painkillers.
That doesn't mean you didn't take something before.
That's what you're waiting for the test results to prove, right? The labs could tell us a number of different things.
You promised we were done with this! You're out of chances.
Jason, don't - Don't do this, just, just - Don't come home tonight.
I don't want you around our kids anymore.
Jason, wait! Oh, I'm gonna be sick.
- I'll get you on fluids.
- I don't need fluids.
We have resources that can help you.
- There's a detox nurse on staff.
- No! I can get you Suboxone for withdrawal.
I said no! I don't want your help.
A doctor like you gave me pain meds in the first place and got me into this mess.
I'm sorry.
I'll be back with your lab results.
Dr.
Hamed.
Your sister's school called and it sounded urgent.
Go.
- We'll cover if we have to.
- Thank you.
I need to add labs for Navia Khan.
- That's the bladder rupture? - Yeah.
Isn't she just waiting for her Urology consult? I know you don't want me overdiagnosing, but her stitches tore right through her skin despite a lack of physical motion.
- She's also bruising easily - Dr.
Leblanc.
No, true, neither of those things point anything concrete, but something in the way her bladder ruptured, even without pelvic fracture was already bothering me I agree! I read her chart.
Didn't she also have a shoulder dislocation from the accident? Yeah, yeah, yeah.
A history of them, actually.
Do you think that's connected? I think you should look into it.
- Keep me in the loop.
- I'll call the lab.
I think you have created a monster in your own image.
One day, we are all gonna be working for Mags.
Thanks so much for coming in.
We were making family trees in class.
Amira didn't want to make hers.
I guess her classmate Candace made a comment about her not doing one and things got heated.
Candace started shoving first - Are they okay? - They're both fine.
We asked the girls to apologize.
Candace did, but Amira said there was no point since she'd be going back to Syria soon anyway.
I don't know why she would say that.
She knows it's not true.
Is anything going on at home that might be affecting her mood? We're moving apartments again, and I know she's not too thrilled about it, but maybe it's affecting her more than I realized.
At this age, it's easier for them to hide when things aren't going well.
Lately, she's been withdrawn, not turning in assignments So she's not doing her homework? I'm concerned Amira's holding a lot in.
Give me the blue one, bud.
Thanks.
Hey! I know they said I should be resting, but this is the best medicine that I could hope for.
Okay, well, I just came to let you guys know that everything went well.
We took out the sponges, and cleared the infected tissue.
I thought it was indigestion.
I can't believe there was something rotting inside me.
He didn't want to have the hernia surgery either, but he had been in pain so long, so I pushed him.
Emily, hon, you couldn't have known this would happen.
Help me out here, doc! Manny's right.
This is what we call a never event.
As in, it never should've happened.
I don't wanna waste any time dwelling on the negative.
Cameron has his soccer tournament next weekend.
You need to take care of yourself.
Cam and I need you healthy.
Look, you just get some rest, okay? Let your body heal.
And take care of your dad, alright? Alright.
I'll check on you guys later.
Thank you.
Your teacher tells me you pushed another student.
She pushed me first! That doesn't mean you push back.
If you're having issues at school, you need to be honest with me.
I know you don't want to move apartments, is that why you've been upset? If we leave Theo's, it's just gonna be us again, and I won't have anyone to talk to.
Amira, that's not true.
You can talk to me! Hmm? Why don't you tell me what happened with the family tree? They called me in the middle of the day, telling me that you've been in a fight, that you're not doing your assignments.
And you know you can't go back to Syria, why are you telling people we are? Because I wish we were! I hate it here! You hate it here? You know you are the only reason we're here! The only reason I came! How could I know that? You say we should be honest, but we're not! We never are! I'm sorry.
Would you do you want to come back to the hospital with me? I have detention.
Sorry they bothered you at work.
Trauma bag has naloxone, epi, atropine, and gear for surgical airway.
Thanks for letting me tag along to log my hours.
Yeah, I guess congratulations are in order.
Have you moved your family here already? We're still, uh, we're just trying to figure out how all that's gonna work.
Well, get ready to test your mettle.
What's Sudbury, like four hours by car? How long do you think you're go to be doing the back and forth thing? Uh, as long as I need to, I guess.
Your wife doesn't wanna move here? I kind of took the offer before really discussing it with her.
Ah, so you're an idiot.
Why did you do that? Because I wanted it.
Yeah, I thought I was taking control of my life, - but I guess I was just - Avoiding the conflict.
Yeah.
I hoped she'd come around, but she hasn't and if I walk it back now Hmm, it won't be the same.
She'll always wonder if you just settled.
Yeah.
Hello, sir.
9-1-1 response? Are you sure you got the right address? 2319 Berkley.
We got a call about a minor with a wrist injury? A minor with a wrist injury.
Um, I didn't know that he called.
Come on in.
Benjamin! Can you come down here, please? Hey, buddy! Did you call 9-1-1? Why didn't you tell me you were doing that? Hi, Benjamin! I'm Joanie.
This is Theo.
- Hi.
- No school today? Our school had a PA day.
Which means since Mom's out of town, Dad gets to work from home today.
You wanna tell us what happened here? I'd managed to coax him away from his video games.
And, um, we went outside, toss the football around, and after about 10 minutes, Ben fell on his wrist.
Ouch.
Well, can we agree that calling in the cavalry was a bit of an overreaction? I'm sure these two have more important calls they should be responding too, hmm? Sorry.
Actually, you guys are in luck.
Theo's a pediatrician, so he can check you out right now and you may not even need to go to the hospital.
Great.
Yeah, why don't you take a seat, bud? Sir, do you have your son's health card? There's some information I need to note down.
Uh, yeah.
You mind if I take a look? Yeah? I want you to tell me where it hurts the most, okay.
My dad was just trying to show me how to take a tackle.
He didn't mean for me to get hurt.
Now, you've been hurt playing sports with him before? Broke a couple fingers once.
There.
It hurts there the most.
Alright, Benjamin Does your dad play a little rough with you? No, it's okay.
Some people just play differently and they don't realize it.
He says I need to toughen up.
Hey, Bash.
Bishop asked me to cover for your patients.
Said you had to step out.
Are you okay? Is everything okay? Everything's fine.
Did Sonja Jessup's blood work come back? Yes, but not before she left.
A nurse tried to stop her, but she wouldn't stay.
I wish she'd change her mind, let us get her some help.
Actually, um, she didn't have any opioids in her system.
You're saying Sonja wasn't using? Blood work was clean.
Yeah.
I tried treating her for withdrawal.
I didn't believe her.
No wonder she didn't stay.
It was a reasonable assumption to make.
Yeah, but that means there's something else wrong with her.
What happened? A massive embolism.
Clot blocked the blood flow to his heart.
He arrested immediately.
Code blue team did everything they could to bring him back, but nothing.
There were no warning signs? We had him on anti-coags, but when it's this big and sudden, there's nothing we can do.
His wife and kid.
I'll talk to them.
- No.
I can handle it.
- I know you can.
But you've got enough going on today with your dad.
He's in recovery.
You can go see him.
Looks like we'll have to take that trip to Memorial after all.
So, it is broken.
We need an X-ray to be sure, but it looks that way.
Ah.
You'll be okay, Ben.
We just need to wait for the police to arrive.
You called the police? They respond to every 9-1-1 call.
We just got here first.
They'll need you to give them a statement.
Okay, about what? His wrist? Yes.
How it happened.
I'm sorry, Dad.
I didn't know the police would come.
It's okay, it's okay.
I'll tell them it was an accident! Ben! That's enough! Look, I don't think there's any need to make a statement to the police.
Well, when a minor's involved, there is.
We were just horsing around.
Kids fall all the time.
Maybe, but the fact is Benjamin broke his wrist when you tackled him.
The police are gonna need to hear what happened.
Okay.
So, if we're gonna go to the hospital, then I'm gonna take him there myself.
Alright? Let's go, Ben.
Sir, let's just wait for the police.
- Get out of my way.
- Dad, don't! Quiet! Move.
I said move! You're scaring your son.
Lower your voice and wait for the police.
Everything okay in here? Is it? This is ridiculous.
Navia Khan has a history of muscle pain and weakness.
At first, I worried it could be MS, but urinalysis and CBC were negative.
And it wouldn't explain the ruptured bladder.
Her bruising is extensive, but her passenger didn't sustain any.
She also has skin atrophy, which explains the stitches tearing.
Did you check for benign growths on pressure areas, - elbows, knees, or even - Heart valve problems? Ehlers-Danlos Syndrome.
Most cases of Ehlers-Danlos take years to diagnose.
If you're right, you saved her a decade of not knowing what was wrong with her.
Sir, this kind of thing Is exactly what I told you not to get sucked into? It's hard to find the line.
Yeah.
I know it is.
I'll get an echo and order a skin biopsy to confirm the diagnosis.
Good work, Dr.
Leblanc.
33-year-old woman collapsed in a coffee shop! She was unconscious when we arrived.
We administered Naloxone at the scene.
Sonja Jessup.
She overdosed? Do we know what she took? BP's dropping.
Heart rate's 145.
- She's in V-Tach.
- She shouldn't be.
I mean, heart rate decreases after an overdose.
Isn't this your car accident victim that walked out AMA this morning? She lost consciousness during the physical exam and her resp rate was low, but she wasn't on opioids then.
Muffled heart sounds.
Scan! Cardiac tamponade.
She needs a pericardiocentesis.
We need to drain the fluid around her heart.
Okay.
Do it.
I need an 18 gauge 7cm needle with a 30CC syringe.
Got it.
I see the trajectory.
Claire, keep the field in view.
Use the subside forward approach.
And aim towards the left shoulder.
SATS are falling.
I don't feel it yet.
Go easy.
You're not quite in.
Got it.
She's stabilizing.
I let her leave.
This is on me.
Sonja left the hospital and OD'd?! She's stable now.
Okay? Here.
This is what I've been dreading.
This is my worst nightmare.
Jason, you should also know that there were no opioids in her system this morning.
You're saying she wasn't high when she drove the kids? Well that means, she only went and used after I accused her? This is my fault! I told her not to come home! She could've died! But she didn't.
She's sedated right now, but you'll be able to see her soon.
Okay? It wasn't the car accident that caused my bladder to rupture? It was this other thing? Well, it was a combination of the two things, but if you hadn't been in the car accident, we may never have found out, because it meant several of your symptoms presented at once.
And this condition.
Ehlers-Danlos? - Is it serious? - It can be.
Your joints dislocate more often.
You bruise easily.
You might experience extreme muscle pain, or be prone to ruptured organs, like your bladder.
But the good news is it's not degenerative, so it's not gonna get worse.
But there's no cure.
So I'll have it forever? I'm sorry, Navia.
I know it's not It's not what you were expecting to hear.
I convinced myself I was strong enough to throw everything out and start this big adventure.
And now, you're telling me I'm broken, fragile, and there's nothing I can do about it? You can be prepared.
Watch for any warning signs.
Be more careful in your day-to-day activities.
I never should have left home.
Now I'm alone with this.
Hey, Ben.
How's your arm? I heard your mom's on her way back.
They said my Dad might not get to come home tonight.
It's all my fault.
Ben, none of this is your fault.
If I was tougher, this wouldn't be happening! When your dad plays rough with you like that, it's not okay.
It has nothing to do with how tough you are.
The father's a real piece of work.
Insists the kid just landed wrong.
Ben landed where his dad tackled him.
And he's pretty upset about it.
Thinks he's got his dad into trouble.
His dad got himself into trouble.
Let's hope he smartens himself up.
Last chance to back out.
Welcome to the team.
Why did you tell Singh you were coming to stay with me? I'm fine.
Thanks for asking.
Yeah, I know.
I checked your chart.
It got your attention, didn't it? You're unbelievable.
I I hoped you might say yes, okay? I know you hate me.
That you haven't forgiven me for my mistakes.
I'm all alone here, June.
Don't put that on me.
You're alone because you've hurt everyone who's ever cared about you.
Yeah.
You're right.
You know, I'm stronger than I used to be.
I'm not just gonna let you do that to me again.
I don't wanna hurt you, June.
I wanna be in your life.
Every time I let you in, I'm the one who ends up paying.
Maybe it was like that before, but now You know, you say you've changed, but you lied to my boss! You lied to my boss to get me to talk to you? Okay, that was, um, that was a mistake.
- I can do better.
- I don't think you can.
And even if you could, I don't think I can give you another chance, so So, uh.
.
You know, Dr.
Singh's a great doctor.
And if you need anything at home, I will find you a nurse.
But that's all.
You know, I've see all kinds, working here.
All kinds of love.
Seen people lose families and find families.
But that's just not who we are.
Hi.
Your husband was just here.
He's making arrangements for the kids.
I I didn't believe you, Sonja.
I'm I'm sorry.
Turns out you were right not to.
You stopped once.
You can stop again.
Yeah, but the pain never goes away.
One bad moment sends me over the edge.
I know my family keeps hoping that this is over, but it's never over.
Now, when I look at my life, all I see is this void.
This giant void.
You have to face it.
What if I can't? What if I'm not strong enough? But you are.
Hey! Hey! - You're back? - Yeah.
I went to this party, but I can't stop thinking about my patient.
I told her she had Ehlers-Danlos today, and she took it pretty hard.
I came back, because Because you're Mags, so what do you do? Yeah.
Hi.
Hi.
I heard your surgery went well.
You should be going home tomorrow.
They said you were gone.
Yeah.
I know what it's like.
Feeling fragile.
And questioning what you're what you're capable of.
I left everything I knew to come here.
Follow my passion.
And now You'll make some adjustments.
The only way to know how is to try.
So tell me about your food truck.
Seriously? I don't know that much about food trucks, other than I like eating at them! A lot.
But I've got nowhere else to be, and I'd love to learn more, if you want the company.
Okay.
- Well, when I was eight - Mm-hmm? My parents used to take me travelling, a lot June, I've been calling you! I thought we had dinner plans! Yeah, I just figured you were still mad.
Yeah, so, we hash it out.
That's how this works, right? I think we should end this.
Okay, whoa, where did that come from? You were right, Lou.
I don't let you in.
Not you or anyone.
I can't.
- If this is about your dad - It's about me.
It's about me, alright? Maybe it's because of him, or maybe it's who I always was, but I'm not good at this.
- And I'm just gonna hurt you.
- You're not him, June.
This kind of stuff takes practice, right? Don't do this.
You deserve better.
June, wait! - Please.
- I'm sorry! You wanted to see me, Dr.
Bishop? Yeah, come in.
Close the door.
About Sonja Jessup, um, it was my fault.
She left before we could We can't keep patients here against their will.
What happened with Amira? Was everything okay? Uh, yeah, there was some drama at school, but, uh, she's fine.
There was an incident with another student.
I tried talking to her, but I guess I'm saying all the wrong things.
She's 12? When my son was 12 It gets harder.
Knowing what to say.
Main thing is, you're there when she needs you.
That's a lesson I learned too late.
Don't make the same mistake I did.
Thank you.
It's ICU.
Sonja Jessup is crashing.
SATS are low, but her heart rate is through the roof again.
Get her on a non-rebreather.
Dr.
Hamed, let's get eyes in her chest.
Have we got her blood work back? Not yet! So we still don't know what we're dealing with.
Massive pleural effusion.
Sonja, you have fluid on your lungs.
We're going to put a chest tube in to help you breathe.
Alright? We'll take good care of you.
Okay.
Scalpel.
Making primary incision.
30 "emo stat".
Performing blood dissection through the muscle in fashion.
Chest tube.
- Inserting chest tube.
- Mm-hmm.
Guide me through placement.
A millimeter left.
Just a millimiter.
I can't feel the pleural space.
Am I close? Sir? Dr.
Bishop? Keep going.
Okay.
- What? - I think I nicked something.
Guys? Placement was wrong.
I think I perforated an organ.
We've got a bleed.
Ease out, nice and slow.
Slowly.
Slowly.
SATS are falling! He's gonna need a new tube, Claire.
Pressure's dropping.
There's free fluid in the abdomen.
Her spleen is ruptured.
Activate massive transfusion protocol! Get me another chest tube! Call for blood! Bash is now on the hook.
A patient's life is at risk.
- You are not taking care of yourself.
- All right Claire, all right.
My fault.
My mistake.
Sir? Jed, what happened? Everyone clear! Dr.
Bishop! THE SHOCKING SEASON FINALE OF CTV'S TRANSPLANT.
GET INTO IT AT A SPECIAL TIME.
- Wasn't it three weeks ago, I asked you to go see Doctor Mitchell? Have you gone? Every time I look at my sister, I'm reminded of the one thing I can't give her back.
Our parents.
You never go in.
Why is that? I can't.
You need to face it.
For her.
There's nowhere to wash your hands, to, you know, he didn't have a napkin or a handkerchief.
It was disgusting! And anyway, we would've been here by now if we'd driven.
Well, I like the subway, and I'm not letting myself get sucked into your rarified air.
Why? You might get used to it? Ah! Thank you! Three injured in a car accident.
ETA six minutes.
- Great.
- Bye.
Okay, you too.
Navia Khan.
42.
Uber driver.
Crashed into a vehicle on Spadina.
The light was green.
I didn't realize she hadn't started moving until it was too late.
Pelvic injuries, lacerations and a dislocated shoulder.
BP's 140 over 95, rate's 120.
Are there any traumas - Was speed a factor? - Cops said no.
Is she gonna be okay? We're gonna take good care of her.
Sonja Jessup was rear-ended.
34 years old.
Wounds seem minor.
She cut herself on broken glass helping the other driver and her passenger out of their vehicle.
Doctor, have a look at Ms.
Jessup checked over.
- Use E.
- Manny Kowalski.
34 years old.
Complaining of severe abdo pain, but there's no evidence of trauma.
His BP's 130 over 95, rate's 120, his temp's 38.
3.
Sir, I'm so sorry! I've had worse drivers.
At least you got me to my destination.
You were trying to get the hospital? I had this pain in my gut for a while.
How long have you been having this pain, Mr.
Kowalski? A month, maybe.
But it's been getting worse.
Today it was finally bad enough to get me to come in.
Alright, on a scale of one to ten when I do this? Ah! Fifteen.
Five of morphine for Mr.
Kowalski.
I swear, I'm not usually such a snowflake.
No need to be a hero here.
Possible kidney stone? Positive seatbelt sign.
Claire, I need a plate.
Your shoulder's back in place, but this wound will need to be stitched.
What did you say about a seatbelt sign? We're gonna do an X-ray and an ultrasound of your pelvis.
Seatbelt pressure can sometimes cause it to fracture.
Okay, plate in? 1, 2, 3.
1, 2, 3.
Exposing! Plate out.
1, 2, 3.
1, 2, 3.
X-ray's up! There's free fluid in the pelvis, but no fracture, that's strange.
They usually go hand in hand.
I'll try a blind Foley.
What does that mean? There might be a tear in your bladder from the force of the seat belt.
I'm going to place a catheter.
If it comes back with urine, we'll know your bladder's intact and a tear's unlikely.
- Claire? - On it.
Complex fluid collection in the abdominal cavity.
Dr.
Bishop, I'm seeing debris.
Sir, have you had open surgery recently? - I had a hernia removed.
- Here? Another hospital.
But that was like a year ago.
Why? Is something wrong? We'll X-ray and have a closer look.
Give me the plate.
Thank God I had already dropped my kids off at school.
If they'd been in the car and gotten hurt Ow! Sorry.
Well, uh, nothing seems to be broken, though soft tissue injuries are common after a car collision.
I can give you something for the discomfort.
No, this is, uh, nothing new.
I've had back pain for years.
Okay.
Can I just see your hands? Sure.
It's not too bad.
Still, we should do some imaging.
Is there someone we can call? - My husband's on his way.
- Great.
No urine.
- Probable rupture.
- Can you fix that? Well, we'll confirm with a CT.
Then, you'll need a surgical consult.
I'll page Urology.
We'll take good care of you.
Those have been in there for a year? This only makes sense with the information What's been in where? Sir, whoever performed your hernia operation left two surgical sponges behind.
You're telling me that they forgot something inside of me? It would explain your infection, your fever, your stomach pain.
We're gonna get you to surgery as soon as we can.
Two grams of Ampi, IV-stat.
Deep breath.
And again.
Sonja? Sonja? Sonja! Can you hear me? You lost consciousness, Ms.
Jessup.
Your respiration rate's low.
Do you remember hitting your head? - Any headache? - No.
Um, I'm just dizzy.
Uh, it's probably from all the blood.
I'm fine, I'm sure.
I'm sure it's nothing.
Easy, easy, easy.
Just take a second.
I'm going to order a CT scan to rule out any intercranial injury, also get some blood work done to make sure there's nothing else going on.
- Okay? - Okay.
Alright, I'll be right back.
Really? Complicated differential? No, not exactly.
I got invited to this party, like, old friends from med school.
- I should go, but I - Don't wanna go alone? Sounds like you need a buffer.
Not my thing.
What about, uh Hmm! No, no, no.
No one from Neurology.
No.
He sings when he cuts.
I don't think going with a random is the way to go, Hmm? Hey, what are you doing here? Hey! My surgery is today.
Well, that's on the sixth floor.
That's not down here.
I called your brother.
He didn't want to come up from Chicago.
Elevators are down the hall.
June! Hey.
That looked intense.
- You okay? - Yeah, I'm fine.
Who was that guy? Hmm? That's my father.
Okay.
He's not a patient here, is he? Is everything okay? Apart from being a giant prick? He has stomach cancer and Singh's his surgeon.
Okay, so your father's sick and your boss is his surgeon? Why wouldn't you tell me something like that? I told you that my dad and I don't talk.
Which means you and I don't either? Look, June, I get that your relationship's messed up, and you don't like to talk about it.
But you can't just shut me out of big chunks of your life.
It makes me feel like you don't want me in it at all.
Lou, trust me.
I'm doing you a favor, okay? - That guy - Well, maybe I don't need you to.
Lou! Excuse me, Doctor? I'm, uh, Jason.
Sonja Jessup's husband.
Bashir Hamed.
Uh, she said she was rear-ended.
- Is that true? - Yes.
And she's, um, she's okay? We're running some tests to make sure.
Uh, Dr.
Hamed, did Sonja ask you for painkillers? She's managing fine.
If she does ask for some, please don't give her any.
Sir? My wife's an opioid addict.
She's been clean six months.
It's important you don't even offer her any.
Thank you.
Thank you.
Mags? Does this CT look normal to you? Yeah.
Yeah, I don't think your patient sustained head trauma.
Doesn't seem like it from her scan, but she passed out during the physical exam - and her respiratory rate is low.
- You have a theory? Her husband just told me she's had problems with opioids.
Did you run blood work? Labs aren't back yet, but according to her chart, she was here a couple of times eight months ago requesting narcotics for back pain.
The last doctor she saw here wouldn't prescribe any.
Did she ask for any today? No, even though she's clearly in pain.
She probably knows that she's flagged.
Doesn't wanna draw attention to it.
Decreased resp rate, losing consciousness, no head trauma? Her husband said she's clean now.
Still, it's kind of tough to ignore what those symptoms are saying That she's using again.
I called the surgeons who repaired Mr.
Kowalski's hernia.
Bet they called their lawyer as soon as you hung up.
Wife and kids are downstairs.
She said she tried to get him come over but he kept pulling it off.
Speaking of your father's on the board for his gastrectomy today.
You're welcome to observe.
Obviously, we can't have you scrubbing in, - but - No, thank you.
Understood.
Better stay busy.
You'll have plenty to do once your dad's home anyway.
He said how grateful he was you're willing to look after him.
He told you he was staying with me? Pretty sure my wife and daughter would pay someone to take me off their hands.
Urology should be down as soon as they can.
Okay, any pain here? It was way worse the first time.
You've dislocated it before? - When? - Last year.
I was reaching into the crawlspace.
My husband took one look at it dangling there and almost fainted.
Ex-husband I should say.
I'm still not used to saying that out loud.
Surgery to repair my bladder.
Scale of one-to-ten, how big a deal is it? It's laparoscopic, so recovery shouldn't be too bad.
But having a friend or family member around is always a good idea.
Thing is, I just moved to Toronto, so I don't really know anyone here yet.
When my husband quit our marriage, I quit the office job I always hated.
Gave myself a year to start over and open a food truck.
- That's pretty brave.
- Brave and stupid.
I've been driving Uber to keep things afloat.
Oh.
Sorry.
Your stitches tore through your skin.
Have you been moving around a lot? I'm guessing that's not supposed to happen? Don't worry.
I'll re-suture, and then, uh, we'll figure it out.
Why weren't you moving if the light turned green? You're always the one honking to go before it even changes.
It was green barely a second before she hit me.
Good news, your CT came back negative for any head injury.
Great, but if she didn't actually hit her head, why did you check it? He He's just being thorough.
- I'll give you guys some space.
- No, please.
What aren't you telling me? Nothing.
Sonja? I, um, I passed out earlier.
You passed out? In the accident? No, when I got here and I didn't want to tell you because I didn't want you to worry.
Are you using again? No, Jason! I swear.
Then why didn't you tell me you passed out? Why lie? Because I was afraid you were gonna jump to this exact conclusion.
Or because you were high and that's why you didn't see the light change.
No, I wasn't! I was distracted for, like, a second and then she slammed into me! You drove the kids this morning.
Did you get high and drive the kids? No, Jason! - You have to believe me! - How can I? After everything we've been through? - Because I wouldn't do that - Except you have! When you picked up Tessa from dance! Her carpool got messed up and she was by herself! Excuses! My God! Look, I know things were messed up, Jason! But I swore to you I wouldn't do it again! But you did! And you knew this was your last chance! Gosh, I should have seen it.
You've been distant lately.
Barely present.
Yeah, because I've been in pain! I wasn't using! I wanted to, Jay, but I didn't! I didn't even ask the doctor for painkillers.
That doesn't mean you didn't take something before.
That's what you're waiting for the test results to prove, right? The labs could tell us a number of different things.
You promised we were done with this! You're out of chances.
Jason, don't - Don't do this, just, just - Don't come home tonight.
I don't want you around our kids anymore.
Jason, wait! Oh, I'm gonna be sick.
- I'll get you on fluids.
- I don't need fluids.
We have resources that can help you.
- There's a detox nurse on staff.
- No! I can get you Suboxone for withdrawal.
I said no! I don't want your help.
A doctor like you gave me pain meds in the first place and got me into this mess.
I'm sorry.
I'll be back with your lab results.
Dr.
Hamed.
Your sister's school called and it sounded urgent.
Go.
- We'll cover if we have to.
- Thank you.
I need to add labs for Navia Khan.
- That's the bladder rupture? - Yeah.
Isn't she just waiting for her Urology consult? I know you don't want me overdiagnosing, but her stitches tore right through her skin despite a lack of physical motion.
- She's also bruising easily - Dr.
Leblanc.
No, true, neither of those things point anything concrete, but something in the way her bladder ruptured, even without pelvic fracture was already bothering me I agree! I read her chart.
Didn't she also have a shoulder dislocation from the accident? Yeah, yeah, yeah.
A history of them, actually.
Do you think that's connected? I think you should look into it.
- Keep me in the loop.
- I'll call the lab.
I think you have created a monster in your own image.
One day, we are all gonna be working for Mags.
Thanks so much for coming in.
We were making family trees in class.
Amira didn't want to make hers.
I guess her classmate Candace made a comment about her not doing one and things got heated.
Candace started shoving first - Are they okay? - They're both fine.
We asked the girls to apologize.
Candace did, but Amira said there was no point since she'd be going back to Syria soon anyway.
I don't know why she would say that.
She knows it's not true.
Is anything going on at home that might be affecting her mood? We're moving apartments again, and I know she's not too thrilled about it, but maybe it's affecting her more than I realized.
At this age, it's easier for them to hide when things aren't going well.
Lately, she's been withdrawn, not turning in assignments So she's not doing her homework? I'm concerned Amira's holding a lot in.
Give me the blue one, bud.
Thanks.
Hey! I know they said I should be resting, but this is the best medicine that I could hope for.
Okay, well, I just came to let you guys know that everything went well.
We took out the sponges, and cleared the infected tissue.
I thought it was indigestion.
I can't believe there was something rotting inside me.
He didn't want to have the hernia surgery either, but he had been in pain so long, so I pushed him.
Emily, hon, you couldn't have known this would happen.
Help me out here, doc! Manny's right.
This is what we call a never event.
As in, it never should've happened.
I don't wanna waste any time dwelling on the negative.
Cameron has his soccer tournament next weekend.
You need to take care of yourself.
Cam and I need you healthy.
Look, you just get some rest, okay? Let your body heal.
And take care of your dad, alright? Alright.
I'll check on you guys later.
Thank you.
Your teacher tells me you pushed another student.
She pushed me first! That doesn't mean you push back.
If you're having issues at school, you need to be honest with me.
I know you don't want to move apartments, is that why you've been upset? If we leave Theo's, it's just gonna be us again, and I won't have anyone to talk to.
Amira, that's not true.
You can talk to me! Hmm? Why don't you tell me what happened with the family tree? They called me in the middle of the day, telling me that you've been in a fight, that you're not doing your assignments.
And you know you can't go back to Syria, why are you telling people we are? Because I wish we were! I hate it here! You hate it here? You know you are the only reason we're here! The only reason I came! How could I know that? You say we should be honest, but we're not! We never are! I'm sorry.
Would you do you want to come back to the hospital with me? I have detention.
Sorry they bothered you at work.
Trauma bag has naloxone, epi, atropine, and gear for surgical airway.
Thanks for letting me tag along to log my hours.
Yeah, I guess congratulations are in order.
Have you moved your family here already? We're still, uh, we're just trying to figure out how all that's gonna work.
Well, get ready to test your mettle.
What's Sudbury, like four hours by car? How long do you think you're go to be doing the back and forth thing? Uh, as long as I need to, I guess.
Your wife doesn't wanna move here? I kind of took the offer before really discussing it with her.
Ah, so you're an idiot.
Why did you do that? Because I wanted it.
Yeah, I thought I was taking control of my life, - but I guess I was just - Avoiding the conflict.
Yeah.
I hoped she'd come around, but she hasn't and if I walk it back now Hmm, it won't be the same.
She'll always wonder if you just settled.
Yeah.
Hello, sir.
9-1-1 response? Are you sure you got the right address? 2319 Berkley.
We got a call about a minor with a wrist injury? A minor with a wrist injury.
Um, I didn't know that he called.
Come on in.
Benjamin! Can you come down here, please? Hey, buddy! Did you call 9-1-1? Why didn't you tell me you were doing that? Hi, Benjamin! I'm Joanie.
This is Theo.
- Hi.
- No school today? Our school had a PA day.
Which means since Mom's out of town, Dad gets to work from home today.
You wanna tell us what happened here? I'd managed to coax him away from his video games.
And, um, we went outside, toss the football around, and after about 10 minutes, Ben fell on his wrist.
Ouch.
Well, can we agree that calling in the cavalry was a bit of an overreaction? I'm sure these two have more important calls they should be responding too, hmm? Sorry.
Actually, you guys are in luck.
Theo's a pediatrician, so he can check you out right now and you may not even need to go to the hospital.
Great.
Yeah, why don't you take a seat, bud? Sir, do you have your son's health card? There's some information I need to note down.
Uh, yeah.
You mind if I take a look? Yeah? I want you to tell me where it hurts the most, okay.
My dad was just trying to show me how to take a tackle.
He didn't mean for me to get hurt.
Now, you've been hurt playing sports with him before? Broke a couple fingers once.
There.
It hurts there the most.
Alright, Benjamin Does your dad play a little rough with you? No, it's okay.
Some people just play differently and they don't realize it.
He says I need to toughen up.
Hey, Bash.
Bishop asked me to cover for your patients.
Said you had to step out.
Are you okay? Is everything okay? Everything's fine.
Did Sonja Jessup's blood work come back? Yes, but not before she left.
A nurse tried to stop her, but she wouldn't stay.
I wish she'd change her mind, let us get her some help.
Actually, um, she didn't have any opioids in her system.
You're saying Sonja wasn't using? Blood work was clean.
Yeah.
I tried treating her for withdrawal.
I didn't believe her.
No wonder she didn't stay.
It was a reasonable assumption to make.
Yeah, but that means there's something else wrong with her.
What happened? A massive embolism.
Clot blocked the blood flow to his heart.
He arrested immediately.
Code blue team did everything they could to bring him back, but nothing.
There were no warning signs? We had him on anti-coags, but when it's this big and sudden, there's nothing we can do.
His wife and kid.
I'll talk to them.
- No.
I can handle it.
- I know you can.
But you've got enough going on today with your dad.
He's in recovery.
You can go see him.
Looks like we'll have to take that trip to Memorial after all.
So, it is broken.
We need an X-ray to be sure, but it looks that way.
Ah.
You'll be okay, Ben.
We just need to wait for the police to arrive.
You called the police? They respond to every 9-1-1 call.
We just got here first.
They'll need you to give them a statement.
Okay, about what? His wrist? Yes.
How it happened.
I'm sorry, Dad.
I didn't know the police would come.
It's okay, it's okay.
I'll tell them it was an accident! Ben! That's enough! Look, I don't think there's any need to make a statement to the police.
Well, when a minor's involved, there is.
We were just horsing around.
Kids fall all the time.
Maybe, but the fact is Benjamin broke his wrist when you tackled him.
The police are gonna need to hear what happened.
Okay.
So, if we're gonna go to the hospital, then I'm gonna take him there myself.
Alright? Let's go, Ben.
Sir, let's just wait for the police.
- Get out of my way.
- Dad, don't! Quiet! Move.
I said move! You're scaring your son.
Lower your voice and wait for the police.
Everything okay in here? Is it? This is ridiculous.
Navia Khan has a history of muscle pain and weakness.
At first, I worried it could be MS, but urinalysis and CBC were negative.
And it wouldn't explain the ruptured bladder.
Her bruising is extensive, but her passenger didn't sustain any.
She also has skin atrophy, which explains the stitches tearing.
Did you check for benign growths on pressure areas, - elbows, knees, or even - Heart valve problems? Ehlers-Danlos Syndrome.
Most cases of Ehlers-Danlos take years to diagnose.
If you're right, you saved her a decade of not knowing what was wrong with her.
Sir, this kind of thing Is exactly what I told you not to get sucked into? It's hard to find the line.
Yeah.
I know it is.
I'll get an echo and order a skin biopsy to confirm the diagnosis.
Good work, Dr.
Leblanc.
33-year-old woman collapsed in a coffee shop! She was unconscious when we arrived.
We administered Naloxone at the scene.
Sonja Jessup.
She overdosed? Do we know what she took? BP's dropping.
Heart rate's 145.
- She's in V-Tach.
- She shouldn't be.
I mean, heart rate decreases after an overdose.
Isn't this your car accident victim that walked out AMA this morning? She lost consciousness during the physical exam and her resp rate was low, but she wasn't on opioids then.
Muffled heart sounds.
Scan! Cardiac tamponade.
She needs a pericardiocentesis.
We need to drain the fluid around her heart.
Okay.
Do it.
I need an 18 gauge 7cm needle with a 30CC syringe.
Got it.
I see the trajectory.
Claire, keep the field in view.
Use the subside forward approach.
And aim towards the left shoulder.
SATS are falling.
I don't feel it yet.
Go easy.
You're not quite in.
Got it.
She's stabilizing.
I let her leave.
This is on me.
Sonja left the hospital and OD'd?! She's stable now.
Okay? Here.
This is what I've been dreading.
This is my worst nightmare.
Jason, you should also know that there were no opioids in her system this morning.
You're saying she wasn't high when she drove the kids? Well that means, she only went and used after I accused her? This is my fault! I told her not to come home! She could've died! But she didn't.
She's sedated right now, but you'll be able to see her soon.
Okay? It wasn't the car accident that caused my bladder to rupture? It was this other thing? Well, it was a combination of the two things, but if you hadn't been in the car accident, we may never have found out, because it meant several of your symptoms presented at once.
And this condition.
Ehlers-Danlos? - Is it serious? - It can be.
Your joints dislocate more often.
You bruise easily.
You might experience extreme muscle pain, or be prone to ruptured organs, like your bladder.
But the good news is it's not degenerative, so it's not gonna get worse.
But there's no cure.
So I'll have it forever? I'm sorry, Navia.
I know it's not It's not what you were expecting to hear.
I convinced myself I was strong enough to throw everything out and start this big adventure.
And now, you're telling me I'm broken, fragile, and there's nothing I can do about it? You can be prepared.
Watch for any warning signs.
Be more careful in your day-to-day activities.
I never should have left home.
Now I'm alone with this.
Hey, Ben.
How's your arm? I heard your mom's on her way back.
They said my Dad might not get to come home tonight.
It's all my fault.
Ben, none of this is your fault.
If I was tougher, this wouldn't be happening! When your dad plays rough with you like that, it's not okay.
It has nothing to do with how tough you are.
The father's a real piece of work.
Insists the kid just landed wrong.
Ben landed where his dad tackled him.
And he's pretty upset about it.
Thinks he's got his dad into trouble.
His dad got himself into trouble.
Let's hope he smartens himself up.
Last chance to back out.
Welcome to the team.
Why did you tell Singh you were coming to stay with me? I'm fine.
Thanks for asking.
Yeah, I know.
I checked your chart.
It got your attention, didn't it? You're unbelievable.
I I hoped you might say yes, okay? I know you hate me.
That you haven't forgiven me for my mistakes.
I'm all alone here, June.
Don't put that on me.
You're alone because you've hurt everyone who's ever cared about you.
Yeah.
You're right.
You know, I'm stronger than I used to be.
I'm not just gonna let you do that to me again.
I don't wanna hurt you, June.
I wanna be in your life.
Every time I let you in, I'm the one who ends up paying.
Maybe it was like that before, but now You know, you say you've changed, but you lied to my boss! You lied to my boss to get me to talk to you? Okay, that was, um, that was a mistake.
- I can do better.
- I don't think you can.
And even if you could, I don't think I can give you another chance, so So, uh.
.
You know, Dr.
Singh's a great doctor.
And if you need anything at home, I will find you a nurse.
But that's all.
You know, I've see all kinds, working here.
All kinds of love.
Seen people lose families and find families.
But that's just not who we are.
Hi.
Your husband was just here.
He's making arrangements for the kids.
I I didn't believe you, Sonja.
I'm I'm sorry.
Turns out you were right not to.
You stopped once.
You can stop again.
Yeah, but the pain never goes away.
One bad moment sends me over the edge.
I know my family keeps hoping that this is over, but it's never over.
Now, when I look at my life, all I see is this void.
This giant void.
You have to face it.
What if I can't? What if I'm not strong enough? But you are.
Hey! Hey! - You're back? - Yeah.
I went to this party, but I can't stop thinking about my patient.
I told her she had Ehlers-Danlos today, and she took it pretty hard.
I came back, because Because you're Mags, so what do you do? Yeah.
Hi.
Hi.
I heard your surgery went well.
You should be going home tomorrow.
They said you were gone.
Yeah.
I know what it's like.
Feeling fragile.
And questioning what you're what you're capable of.
I left everything I knew to come here.
Follow my passion.
And now You'll make some adjustments.
The only way to know how is to try.
So tell me about your food truck.
Seriously? I don't know that much about food trucks, other than I like eating at them! A lot.
But I've got nowhere else to be, and I'd love to learn more, if you want the company.
Okay.
- Well, when I was eight - Mm-hmm? My parents used to take me travelling, a lot June, I've been calling you! I thought we had dinner plans! Yeah, I just figured you were still mad.
Yeah, so, we hash it out.
That's how this works, right? I think we should end this.
Okay, whoa, where did that come from? You were right, Lou.
I don't let you in.
Not you or anyone.
I can't.
- If this is about your dad - It's about me.
It's about me, alright? Maybe it's because of him, or maybe it's who I always was, but I'm not good at this.
- And I'm just gonna hurt you.
- You're not him, June.
This kind of stuff takes practice, right? Don't do this.
You deserve better.
June, wait! - Please.
- I'm sorry! You wanted to see me, Dr.
Bishop? Yeah, come in.
Close the door.
About Sonja Jessup, um, it was my fault.
She left before we could We can't keep patients here against their will.
What happened with Amira? Was everything okay? Uh, yeah, there was some drama at school, but, uh, she's fine.
There was an incident with another student.
I tried talking to her, but I guess I'm saying all the wrong things.
She's 12? When my son was 12 It gets harder.
Knowing what to say.
Main thing is, you're there when she needs you.
That's a lesson I learned too late.
Don't make the same mistake I did.
Thank you.
It's ICU.
Sonja Jessup is crashing.
SATS are low, but her heart rate is through the roof again.
Get her on a non-rebreather.
Dr.
Hamed, let's get eyes in her chest.
Have we got her blood work back? Not yet! So we still don't know what we're dealing with.
Massive pleural effusion.
Sonja, you have fluid on your lungs.
We're going to put a chest tube in to help you breathe.
Alright? We'll take good care of you.
Okay.
Scalpel.
Making primary incision.
30 "emo stat".
Performing blood dissection through the muscle in fashion.
Chest tube.
- Inserting chest tube.
- Mm-hmm.
Guide me through placement.
A millimeter left.
Just a millimiter.
I can't feel the pleural space.
Am I close? Sir? Dr.
Bishop? Keep going.
Okay.
- What? - I think I nicked something.
Guys? Placement was wrong.
I think I perforated an organ.
We've got a bleed.
Ease out, nice and slow.
Slowly.
Slowly.
SATS are falling! He's gonna need a new tube, Claire.
Pressure's dropping.
There's free fluid in the abdomen.
Her spleen is ruptured.
Activate massive transfusion protocol! Get me another chest tube! Call for blood! Bash is now on the hook.
A patient's life is at risk.
- You are not taking care of yourself.
- All right Claire, all right.
My fault.
My mistake.
Sir? Jed, what happened? Everyone clear! Dr.
Bishop! THE SHOCKING SEASON FINALE OF CTV'S TRANSPLANT.
GET INTO IT AT A SPECIAL TIME.