1 00:00:00,835 --> 00:00:02,218 Previously, on "The Resident"... 2 00:00:02,302 --> 00:00:04,085 Good morning. These are the interns I told you about. 3 00:00:04,169 --> 00:00:05,492 I'm Zach, Primary Care. 4 00:00:05,577 --> 00:00:07,039 Let's get started, shall we? 5 00:00:07,124 --> 00:00:08,617 Listen, I'm not a man 6 00:00:08,702 --> 00:00:10,297 that you'll find in Child's Pose, 7 00:00:10,382 --> 00:00:11,938 so I'm just gonna be on my way to... 8 00:00:12,030 --> 00:00:13,930 AJ, I happen to know from personal experience 9 00:00:14,015 --> 00:00:16,485 that you could really benefit from a little extra flexibility. 10 00:00:16,570 --> 00:00:17,867 All right, come lie down 11 00:00:17,951 --> 00:00:18,727 and grab a mat. 12 00:00:18,812 --> 00:00:20,266 I don't know if I want kids. 13 00:00:20,351 --> 00:00:21,547 At least not right now. 14 00:00:21,632 --> 00:00:23,664 What Padma wants can help us both. 15 00:00:23,749 --> 00:00:26,063 I can give her the egg she so desperately wants 16 00:00:26,148 --> 00:00:28,445 so she can have a baby, and at the same time 17 00:00:28,530 --> 00:00:30,968 I can freeze some for us. 18 00:00:32,991 --> 00:00:35,320 - What about him? - This guy? 19 00:00:35,405 --> 00:00:37,578 Yeah. He runs marathons, 20 00:00:37,663 --> 00:00:39,078 plays the cello and, 21 00:00:39,163 --> 00:00:43,710 Oh, Leela, look at that chubby little face. Aww. 22 00:00:44,171 --> 00:00:47,030 Well, I wish we could meet "Tall & Talented" in person. 23 00:00:47,115 --> 00:00:49,530 Or maybe see an adult photo, not just a baby photo. 24 00:00:49,615 --> 00:00:51,050 Well, then these anonymous sperm donors 25 00:00:51,134 --> 00:00:52,654 wouldn't be very anonymous, would they? 26 00:00:52,779 --> 00:00:54,125 I just want the father of your child 27 00:00:54,209 --> 00:00:55,209 to be as amazing as you. 28 00:00:55,294 --> 00:00:57,749 My sister deserves Grade A sperm. 29 00:00:57,834 --> 00:00:59,651 Thank you for doing this for me. 30 00:01:00,066 --> 00:01:01,891 - What, you think I'm doing this for you? - No. 31 00:01:01,975 --> 00:01:04,149 I'm only giving you my egg so I can be an auntie. 32 00:01:04,234 --> 00:01:06,827 Well, you're gonna be the best one. 33 00:01:07,734 --> 00:01:10,210 - We should get to Chastain. - Wait. 34 00:01:11,080 --> 00:01:12,617 What about him? 35 00:01:12,838 --> 00:01:14,351 - "The Right Stuff"? - Yeah. 36 00:01:14,436 --> 00:01:17,616 He loves yoga, travel and Basquiat. 37 00:01:17,701 --> 00:01:20,585 No markers for genetic disease. And he's South Asian. 38 00:01:21,735 --> 00:01:23,143 I think it's a sign. 39 00:01:23,228 --> 00:01:25,796 Okay, well, why don't we email the sperm bank 40 00:01:25,920 --> 00:01:28,843 - and try to get a voice sample? - Leel, he is the one, I can feel it. 41 00:01:28,906 --> 00:01:31,155 No, no, you don't need to decide right now. 42 00:01:31,249 --> 00:01:34,226 - Padma, are you sure? - I am. 43 00:01:35,960 --> 00:01:37,923 "The Right Stuff" it is. 44 00:01:49,921 --> 00:01:51,586 Sorry, I know how busy you are. 45 00:01:51,670 --> 00:01:53,105 Not a problem. Happy to help. 46 00:01:53,189 --> 00:01:55,267 Usually I'm texting you to do something a bit more fun, huh? 47 00:01:55,351 --> 00:01:56,977 Yeah. 48 00:01:57,062 --> 00:01:59,094 It's probably just a stomachache, 49 00:01:59,179 --> 00:02:01,603 - but Gigi insisted that you check. - Oh, did she? 50 00:02:01,688 --> 00:02:03,963 I told Peter you fix hurt tummies. 51 00:02:04,249 --> 00:02:05,320 Hey, Peter, remember me? 52 00:02:05,405 --> 00:02:06,509 Your Gigi's dad. 53 00:02:06,594 --> 00:02:08,327 I am. What's going on, buddy? 54 00:02:08,779 --> 00:02:11,437 We were playing super space, Daddy. 55 00:02:11,522 --> 00:02:13,366 Yeah, these two can go all day. 56 00:02:13,451 --> 00:02:15,999 He is the astronaut, she is the alien. 57 00:02:16,084 --> 00:02:17,781 Peter said he didn't want to play, 58 00:02:17,866 --> 00:02:20,218 but he always wants to play. 59 00:02:20,303 --> 00:02:22,367 I'm gonna place my hands on your stomach 60 00:02:22,452 --> 00:02:24,109 for a second, okay? 61 00:02:24,203 --> 00:02:25,726 All right. 62 00:02:27,346 --> 00:02:29,282 Peter's dad is on the way. 63 00:02:29,937 --> 00:02:32,202 Have him meet me in the ER. 64 00:02:33,006 --> 00:02:34,665 Do you like piggyback rides? 65 00:02:34,818 --> 00:02:37,320 Yeah, I thought so. Hop on. 66 00:02:37,405 --> 00:02:38,883 Can I go with you, Daddy? 67 00:02:38,968 --> 00:02:41,359 You wait here, my little alien. 68 00:02:41,452 --> 00:02:43,822 I'll come back soon and let you know how Peter's doing. 69 00:02:43,999 --> 00:02:46,073 Kids, we're going on a field trip. 70 00:02:46,225 --> 00:02:47,316 A rite of passage. 71 00:02:47,410 --> 00:02:48,735 When I was a first year, like you, 72 00:02:48,819 --> 00:02:51,238 Dr. Hawkins took me, and now it's your turn. 73 00:02:51,322 --> 00:02:52,727 Our turn for what? 74 00:02:52,812 --> 00:02:54,656 Since the start of your intern year, 75 00:02:54,741 --> 00:02:57,281 you've learned to become doctors inside these walls, 76 00:02:57,366 --> 00:02:59,594 and today you are going outside Chastain 77 00:02:59,679 --> 00:03:03,305 to treat one of the most challenging patient populations. 78 00:03:03,390 --> 00:03:06,429 A place you'll tackle complex medical cases 79 00:03:06,554 --> 00:03:07,937 that make great doctors. 80 00:03:08,093 --> 00:03:10,077 Dr. Voss and Dr. Bell will be joining us, 81 00:03:10,265 --> 00:03:11,305 so let's get moving. 82 00:03:11,390 --> 00:03:12,515 Where are we going? 83 00:03:12,600 --> 00:03:14,131 Dr. Pravesh didn't tell you? 84 00:03:14,326 --> 00:03:16,609 Let's not spoil the surprise. 85 00:03:22,101 --> 00:03:24,046 Okay. 86 00:03:35,696 --> 00:03:38,132 All right, here we are. 87 00:03:39,923 --> 00:03:41,448 Shall we? 88 00:03:45,259 --> 00:03:46,350 We got played. 89 00:03:46,435 --> 00:03:48,570 Oh, my God, old folks? 90 00:04:01,265 --> 00:04:02,711 *THE RESIDENT* Season 05 Episode 17 91 00:04:02,796 --> 00:04:03,999 Episode Title: "The Space Between" Aired on: April 05, 2022. 92 00:04:04,341 --> 00:04:06,859 All right, Mr. Astronaut, 93 00:04:07,101 --> 00:04:08,854 can you tell me when it started to hurt? 94 00:04:08,948 --> 00:04:10,948 Does the pain move around at all? 95 00:04:11,100 --> 00:04:12,413 I'm okay now. 96 00:04:12,498 --> 00:04:13,756 Is my dad coming? 97 00:04:13,841 --> 00:04:15,616 Yeah, he's coming. 98 00:04:15,858 --> 00:04:19,040 To take me home? I don't want to go home. 99 00:04:19,125 --> 00:04:21,015 Oh, you're not going home, hon. 100 00:04:21,100 --> 00:04:23,136 You're gonna stay here with us until we can 101 00:04:23,221 --> 00:04:25,327 figure out why you're not feeling so great. 102 00:04:25,412 --> 00:04:27,654 - Hey, bud. - Hey, Daddy. 103 00:04:27,739 --> 00:04:28,806 Are you okay? What's going on? 104 00:04:28,890 --> 00:04:31,109 Hey, Spencer. This is Nurse Hundley. 105 00:04:31,229 --> 00:04:32,859 Spencer works in our IT department. 106 00:04:32,944 --> 00:04:34,293 Nice to meet you. 107 00:04:34,457 --> 00:04:36,140 Peter has a stomachache. 108 00:04:36,385 --> 00:04:39,196 Normally, that's not a reason to be worried. 109 00:04:39,281 --> 00:04:40,664 His temp's a little low. 110 00:04:41,172 --> 00:04:42,514 It could be a sign of infection. 111 00:04:42,599 --> 00:04:44,190 - Oh. - He seemed fine this morning. 112 00:04:44,329 --> 00:04:46,110 Said that he and Gigi were going to space. 113 00:04:46,195 --> 00:04:47,922 Has he been sick at all in the past few weeks? 114 00:04:48,006 --> 00:04:49,712 Had a cold a few days ago, 115 00:04:49,797 --> 00:04:51,399 but nothing out of the ordinary. 116 00:04:51,484 --> 00:04:53,408 Any dietary changes this morning? 117 00:04:54,179 --> 00:04:56,911 I made him a smoothie, um, as a treat. 118 00:04:56,996 --> 00:04:59,496 Bananas, yogurt, protein powder, juice. 119 00:04:59,581 --> 00:05:01,741 I mean, we shared it. I feel all right. 120 00:05:01,826 --> 00:05:03,625 He won't tell us more about his pain. 121 00:05:03,710 --> 00:05:05,077 He keeps saying he's fine. 122 00:05:05,162 --> 00:05:06,939 Well, I think because he doesn't want to go home. 123 00:05:07,023 --> 00:05:09,210 - Right? - I'll go home 124 00:05:09,311 --> 00:05:11,128 if you stay with me, Daddy. 125 00:05:13,775 --> 00:05:16,185 I'll stay right here, no matter what. 126 00:05:16,270 --> 00:05:17,620 Okay, bud? 127 00:05:17,876 --> 00:05:19,133 No matter what. 128 00:05:19,315 --> 00:05:20,982 I'll get us ready to draw labs. 129 00:05:21,067 --> 00:05:22,860 I'm gonna step aside for a second, okay? 130 00:05:22,945 --> 00:05:25,107 - Can I talk to you? - Yeah, sure. 131 00:05:25,191 --> 00:05:26,921 We're good here, right, hon? 132 00:05:29,077 --> 00:05:30,726 Uh... 133 00:05:31,378 --> 00:05:33,647 he's got separation anxiety. 134 00:05:34,859 --> 00:05:37,648 His mom left us both three months ago. 135 00:05:37,880 --> 00:05:40,445 She hasn't been back, or even called. 136 00:05:41,585 --> 00:05:43,359 New boyfriend, drug problem. 137 00:05:43,444 --> 00:05:45,116 It's a long story. 138 00:05:47,287 --> 00:05:50,391 I'm sorry to hear that. 139 00:05:50,475 --> 00:05:53,894 Now Peter's afraid you might disappear, too? 140 00:05:53,978 --> 00:05:55,052 Yes. 141 00:05:55,137 --> 00:05:57,154 He feels safe at Chastain because 142 00:05:57,315 --> 00:05:59,464 he knows that I work in the building. 143 00:05:59,558 --> 00:06:01,793 Well, separation anxiety may be behind this. 144 00:06:01,878 --> 00:06:03,598 It can cause stomach trouble. 145 00:06:03,683 --> 00:06:05,313 Do some blood work, run some tests, 146 00:06:05,397 --> 00:06:06,957 and then we'll go from there, all right? 147 00:06:07,900 --> 00:06:10,911 Dr. Milner to Emergency. 148 00:06:10,995 --> 00:06:13,621 Dr. Milner to Emergency. 149 00:06:21,073 --> 00:06:22,377 There he is. 150 00:06:22,486 --> 00:06:24,269 The Brookhaven resident who happens to be 151 00:06:24,354 --> 00:06:26,314 - one of my health care heroes. - Dr. Kravitz? 152 00:06:26,399 --> 00:06:27,456 Yes. 153 00:06:27,541 --> 00:06:31,557 Just be aware he has early mild cognitive impairment. 154 00:06:31,642 --> 00:06:33,988 He remembers people and events from the past perfectly, 155 00:06:34,073 --> 00:06:35,511 but his short-term memory's going. 156 00:06:35,596 --> 00:06:37,137 Okay, got it. 157 00:06:38,988 --> 00:06:42,292 - Dr. Kravitz. - Kit. Lovely to see you. 158 00:06:42,377 --> 00:06:44,059 I did a gerontology rotation 159 00:06:44,144 --> 00:06:46,112 with Dr. Kravitz when I was a resident. 160 00:06:46,197 --> 00:06:48,030 He was one of my finest teachers. 161 00:06:48,181 --> 00:06:50,308 This is Dr. Randolph Bell. 162 00:06:50,393 --> 00:06:51,347 It's an honor. 163 00:06:51,432 --> 00:06:53,208 You're a legend in the field of geriatrics. 164 00:06:53,293 --> 00:06:54,293 You know, your book, 165 00:06:54,378 --> 00:06:56,034 Compassionate Care of the Elderly, 166 00:06:56,189 --> 00:06:58,027 has been on my shelf for decades. 167 00:06:58,881 --> 00:07:01,058 I-I'm sorry, your name again? 168 00:07:01,153 --> 00:07:02,277 Randolph Bell. 169 00:07:02,362 --> 00:07:03,449 Randolph, Randolph, Randolph... 170 00:07:03,533 --> 00:07:06,373 So do all your friends here wheedle you for free care? 171 00:07:06,458 --> 00:07:09,620 Oh, absolutely not. We won't allow it. 172 00:07:09,705 --> 00:07:11,712 Arthur here is fully retired. 173 00:07:11,797 --> 00:07:13,957 He's earned the right to have others care for him. 174 00:07:14,042 --> 00:07:17,302 Gloria, darling, this is Kit, and this-this is... 175 00:07:17,453 --> 00:07:19,723 Well, there's no introduction necessary, sweetie. 176 00:07:19,808 --> 00:07:22,199 Everybody knows the famous Dr. Randolph Bell. 177 00:07:22,284 --> 00:07:24,409 She not only has my heart, 178 00:07:24,494 --> 00:07:25,683 she is now my head. 179 00:07:25,806 --> 00:07:27,574 In every way, she takes care of me. 180 00:07:27,659 --> 00:07:30,252 Well, it's mutual. 181 00:07:30,458 --> 00:07:31,969 Well, it was nice of you to come today. 182 00:07:32,053 --> 00:07:33,304 You know, it can be kind of hard to get 183 00:07:33,388 --> 00:07:35,630 some of us old coots to get our regular check-ups. 184 00:07:35,715 --> 00:07:37,590 Well, we have an ulterior motive 185 00:07:37,675 --> 00:07:39,613 for bringing some of our interns here today. 186 00:07:39,698 --> 00:07:42,002 We're hoping to inspire them to join your field. 187 00:07:42,086 --> 00:07:44,379 This country needs more gerontologists, 188 00:07:44,464 --> 00:07:45,552 and even some of the best doctors 189 00:07:45,636 --> 00:07:48,222 don't understand the particular needs of senior citizens. 190 00:07:48,378 --> 00:07:51,403 Geriatricians have higher career satisfaction 191 00:07:51,488 --> 00:07:53,706 than other medical specialties. 192 00:07:53,839 --> 00:07:57,355 But the pay... not what you get in surgery. 193 00:07:57,440 --> 00:08:00,019 Would you consider talking to some of our interns 194 00:08:00,104 --> 00:08:01,855 about your career? 195 00:08:01,939 --> 00:08:03,856 Let me at 'em. 196 00:08:07,253 --> 00:08:09,528 Do you think we'll still be that in love 197 00:08:09,613 --> 00:08:10,917 when we're their age? 198 00:08:11,949 --> 00:08:13,519 Why wouldn't we be? 199 00:08:18,605 --> 00:08:20,520 Padma, now that you picked a sperm donor, 200 00:08:20,605 --> 00:08:22,388 we'll start Leela's daily injections of hormones 201 00:08:22,472 --> 00:08:24,418 to encourage her body to produce more eggs 202 00:08:24,503 --> 00:08:27,129 - than it does in a usual cycle. - We're excited. 203 00:08:27,280 --> 00:08:29,683 Me, too. We'll be monitoring you with blood tests 204 00:08:29,768 --> 00:08:31,101 and ultrasounds. 205 00:08:31,186 --> 00:08:33,112 I read about this thing called, uh, 206 00:08:33,404 --> 00:08:36,011 - ovarian hyper-something. - Hyperstim. 207 00:08:36,123 --> 00:08:37,895 Yeah. Do we need to worry about that? 208 00:08:37,980 --> 00:08:40,476 No, not with regular monitoring of my estradiol levels. 209 00:08:40,627 --> 00:08:43,355 If they get too high, we back off, lower the dose. 210 00:08:45,057 --> 00:08:46,556 That question wasn't for me. 211 00:08:46,709 --> 00:08:48,902 But you're right. This is quite a safe process. 212 00:08:48,986 --> 00:08:50,468 Okay, what can I do to help? 213 00:08:50,562 --> 00:08:51,905 For now, nothing. Not until we start you 214 00:08:51,989 --> 00:08:54,649 on meds in a few weeks to prepare for the embryo transfer. 215 00:08:54,733 --> 00:08:56,577 - Okay. - Okay? 216 00:08:56,661 --> 00:08:59,069 Leela, I will walk you through your first injection. 217 00:08:59,221 --> 00:09:00,877 Um, I was thinking... 218 00:09:01,599 --> 00:09:03,509 maybe I can do it. 219 00:09:03,683 --> 00:09:04,693 You want to stick a needle in me? 220 00:09:04,777 --> 00:09:06,752 I just want to be part of this 221 00:09:06,837 --> 00:09:08,663 in every way that I can. 222 00:09:08,947 --> 00:09:11,656 - You know. - Of course. 223 00:09:11,830 --> 00:09:13,259 I would like that, too. 224 00:09:17,720 --> 00:09:20,590 Does our patient have a visitor? 225 00:09:20,743 --> 00:09:22,936 He does indeed. 226 00:09:23,020 --> 00:09:25,262 - Gigi! - Hi, Peter. 227 00:09:25,347 --> 00:09:28,517 Ah, good friends are good medicine. 228 00:09:28,603 --> 00:09:30,018 All right, you two, behave. 229 00:09:30,102 --> 00:09:32,269 I'm gonna chat with your dad real quick. 230 00:09:33,272 --> 00:09:35,939 Thought a fun distraction for Peter could be good. 231 00:09:36,056 --> 00:09:37,650 So his labs came back. 232 00:09:37,735 --> 00:09:40,612 White blood cell count was normal, no sign of infection. 233 00:09:40,697 --> 00:09:43,205 Appendicitis, uh... seems unlikely. 234 00:09:43,356 --> 00:09:45,197 Maybe it's psychological. 235 00:09:45,282 --> 00:09:47,783 You know, he's been through a lot. 236 00:09:48,137 --> 00:09:50,595 My gut's telling me it's more than anxiety, 237 00:09:50,680 --> 00:09:52,486 and I want to run a few more tests. 238 00:09:52,571 --> 00:09:53,681 What's up? 239 00:09:53,766 --> 00:09:55,551 Did you fix his tummy, Daddy? 240 00:09:55,636 --> 00:09:57,877 It's always his tummy. 241 00:09:58,055 --> 00:09:59,759 What do you mean, "always," sweetheart? 242 00:09:59,844 --> 00:10:01,408 It happened before? 243 00:10:02,322 --> 00:10:03,967 How often does your tummy hurt, Pete? 244 00:10:04,061 --> 00:10:06,845 A whole lot of times. 245 00:10:07,415 --> 00:10:09,463 Why didn't you tell me anything, Pete? 246 00:10:09,548 --> 00:10:12,318 - I don't understand. - I didn't want to stay at home. 247 00:10:12,403 --> 00:10:15,521 I wanted to come here, with you. 248 00:10:16,627 --> 00:10:18,890 I'll never leave you, okay? 249 00:10:19,059 --> 00:10:21,285 I'll never leave you. 250 00:10:23,656 --> 00:10:24,822 Do you understand? 251 00:10:25,542 --> 00:10:27,542 Daddy, there's something else. 252 00:10:27,627 --> 00:10:29,911 It's weird, but maybe I should tell you. 253 00:10:29,995 --> 00:10:31,828 This morning, Peter and I were playing 254 00:10:31,922 --> 00:10:33,840 that we were on another planet. 255 00:10:33,924 --> 00:10:36,084 He kept saying that I had two heads. 256 00:10:36,168 --> 00:10:38,168 Yeah, you told me that. Pretending. 257 00:10:38,320 --> 00:10:39,928 No, he meant it. 258 00:10:40,155 --> 00:10:44,141 He said I really was a space alien. 259 00:10:46,911 --> 00:10:49,173 Peter, does anyone else have two heads? 260 00:10:51,483 --> 00:10:54,002 That nurse lady and you, 261 00:10:54,087 --> 00:10:55,592 kind of. 262 00:10:56,694 --> 00:10:59,189 Double vision. How many fingers am I holding up? 263 00:11:01,343 --> 00:11:03,786 - What's going on? - This could be neurological. 264 00:11:03,954 --> 00:11:06,497 We need to get him to CT. 265 00:11:08,367 --> 00:11:12,103 So this woman, who is 83, kept chickens. 266 00:11:12,187 --> 00:11:14,204 And she loved her chickens. 267 00:11:14,356 --> 00:11:15,957 She named each one of them. 268 00:11:16,041 --> 00:11:19,543 The-the first day I spent with her, she gave me eggs. 269 00:11:19,637 --> 00:11:23,121 Anyway, she had a problem with worsening anemia. 270 00:11:23,215 --> 00:11:26,457 Fatigue, muscle weakness, intestinal problems. 271 00:11:26,552 --> 00:11:30,887 She started forgetting things and... falling. 272 00:11:31,040 --> 00:11:33,965 Now, any ideas what was wrong with her? 273 00:11:34,059 --> 00:11:36,560 Likely more than one thing. 274 00:11:36,712 --> 00:11:39,981 Alzheimer's, and possibly cancer? 275 00:11:40,065 --> 00:11:41,639 Or a recent stroke. 276 00:11:41,733 --> 00:11:43,066 I'll give you a hint. 277 00:11:43,218 --> 00:11:45,245 The key was the chickens. 278 00:11:45,329 --> 00:11:48,071 People who name their chickens don't eat them. 279 00:11:48,223 --> 00:11:50,557 Exactly. He's smart. 280 00:11:50,650 --> 00:11:52,000 You-you could be a gerontologist. 281 00:11:52,152 --> 00:11:53,502 I don't get it. 282 00:11:53,653 --> 00:11:56,590 Okay, it's a B12 deficiency, common with age. 283 00:11:56,674 --> 00:11:59,092 Learned that from Dr. Kravitz's book. 284 00:11:59,176 --> 00:12:04,406 So I'm guessing that the patient was a... vegan, 285 00:12:04,585 --> 00:12:06,433 because she gave away the eggs. 286 00:12:06,517 --> 00:12:08,925 Bingo. 287 00:12:09,312 --> 00:12:12,344 The woman's vegan diet was a good choice 288 00:12:12,429 --> 00:12:14,582 because it reduced her risk of heart disease, 289 00:12:14,674 --> 00:12:16,313 Type 2 diabetes, certain cancers. 290 00:12:16,398 --> 00:12:18,890 But she forgot to supplement with B12, 291 00:12:19,054 --> 00:12:21,282 which was the source of all of her symptoms. 292 00:12:21,367 --> 00:12:24,925 This is why gerontology is a great profession. 293 00:12:25,124 --> 00:12:27,287 You spend time with patients. 294 00:12:27,371 --> 00:12:29,789 You talk with them, you get to know the whole person, 295 00:12:29,874 --> 00:12:32,708 all the while keeping your eye on the big picture. 296 00:12:32,935 --> 00:12:35,043 Which is the key to diagnosis. 297 00:12:35,718 --> 00:12:38,187 Oh! My lady awaits. 298 00:12:38,406 --> 00:12:42,031 And I see that they have put out snacks, and I am peckish. 299 00:12:42,190 --> 00:12:44,291 - Excuse me. - Thank you, Dr. Kravitz. 300 00:12:47,625 --> 00:12:49,050 Hi, sweetie. 301 00:12:49,173 --> 00:12:51,735 Hey, maybe gerontology is an aphrodisiac. 302 00:12:51,820 --> 00:12:54,079 This old goat has the prettiest lady in the place, 303 00:12:54,164 --> 00:12:56,078 and I have not had a date ince high school. 304 00:12:56,163 --> 00:12:58,602 - Oh... - No, no, I'm kidding. 305 00:13:00,047 --> 00:13:01,289 Gloria! 306 00:13:01,627 --> 00:13:02,718 Her pulse is thready. 307 00:13:02,803 --> 00:13:04,157 Call 911. Let's get her to Chastain. 308 00:13:04,241 --> 00:13:05,977 Somebody grab these pills. To take with us. 309 00:13:06,062 --> 00:13:07,942 We're gonna need to know what she's been taking. 310 00:13:13,015 --> 00:13:16,297 I don't understand. Are you telling me I fainted? 311 00:13:16,382 --> 00:13:17,365 Yes. 312 00:13:17,450 --> 00:13:19,118 And they're going to figure out why. 313 00:13:19,203 --> 00:13:21,274 I was probably just dehydrated. 314 00:13:21,359 --> 00:13:23,243 I didn't ruin your event, did I? 315 00:13:23,328 --> 00:13:24,834 No, we were winding down anyway. 316 00:13:24,987 --> 00:13:26,411 You added the drama. 317 00:13:26,727 --> 00:13:28,845 The good news is, your wrist isn't broken. 318 00:13:28,930 --> 00:13:29,867 You just need a splint. 319 00:13:29,952 --> 00:13:32,220 And your EKG and your labs look normal. 320 00:13:32,305 --> 00:13:34,407 So how did you feel right before you passed out? 321 00:13:34,492 --> 00:13:36,867 I got dizzy. A little lightheaded. 322 00:13:36,952 --> 00:13:39,696 A-A drop in blood pressure. It's not uncommon 323 00:13:39,781 --> 00:13:41,443 among women on blood pressure meds. 324 00:13:41,528 --> 00:13:42,828 But she's-she's not on any. 325 00:13:42,913 --> 00:13:45,288 Oh, well, yes, I am, dear. 326 00:13:46,293 --> 00:13:48,459 - You are? - Mm-hmm. 327 00:13:49,011 --> 00:13:50,537 Why didn't you tell me? 328 00:13:50,734 --> 00:13:52,862 I did. 329 00:13:53,742 --> 00:13:55,699 Let's start here. 330 00:13:56,344 --> 00:13:58,211 My thought exactly. 331 00:13:58,695 --> 00:14:01,274 Houston to Rocket Nine Niner, 332 00:14:01,359 --> 00:14:02,631 do you read me? 333 00:14:03,414 --> 00:14:05,774 Copy, Rocket Nine Niner. 334 00:14:05,859 --> 00:14:07,899 Please keep your hands and arms 335 00:14:07,984 --> 00:14:09,617 inside the spacecraft. 336 00:14:09,702 --> 00:14:11,509 We are go for liftoff. 337 00:14:11,594 --> 00:14:14,643 Over and out. 338 00:14:16,828 --> 00:14:18,891 Was that for him or for you? 339 00:14:19,039 --> 00:14:21,057 A little bit of both. 340 00:14:21,922 --> 00:14:23,301 I'm worried about him. 341 00:14:25,320 --> 00:14:27,790 If Peter's abdominal issues are caused by 342 00:14:27,875 --> 00:14:30,320 a neurological one, we could be looking at a bleed. 343 00:14:36,151 --> 00:14:37,734 I don't see one. 344 00:14:38,187 --> 00:14:40,687 No evidence of a stroke, either. 345 00:14:41,936 --> 00:14:44,164 But his ventricles are a little... 346 00:14:44,327 --> 00:14:46,422 Too little. 347 00:14:50,630 --> 00:14:52,220 His brain is swelling. 348 00:14:52,305 --> 00:14:54,385 Now, if we don't figure out why and the swelling worsens, 349 00:14:54,469 --> 00:14:56,635 I'll have to perform a craniectomy to relieve the pressure. 350 00:14:56,719 --> 00:14:58,642 Cutting a six-year-old's head open on an "if." 351 00:14:58,727 --> 00:15:00,549 Of course not, but if things move south quickly, 352 00:15:00,633 --> 00:15:02,057 we have to be ready to move to the OR. 353 00:15:02,141 --> 00:15:04,002 Fine, but let's keep in mind the risks aren't just 354 00:15:04,086 --> 00:15:05,392 bleeding and infection. 355 00:15:05,477 --> 00:15:06,830 There could be permanent brain damage. 356 00:15:06,914 --> 00:15:09,857 We need to figure out how to avoid surgery altogether. 357 00:15:10,664 --> 00:15:12,712 Let's start Peter on meds to lower the pressure 358 00:15:12,797 --> 00:15:14,009 on his brain immediately, 359 00:15:14,094 --> 00:15:15,735 hope they work and move him to ICU. 360 00:15:15,820 --> 00:15:17,931 Yes, that sounds like a plan. 361 00:15:19,320 --> 00:15:21,785 Well, why didn't you tell me you were taking all of these? 362 00:15:21,937 --> 00:15:23,587 Oh, I did, dear. 363 00:15:23,672 --> 00:15:25,392 Every time I added a medication. 364 00:15:25,477 --> 00:15:28,032 But you can't be expected to remember all these. 365 00:15:28,648 --> 00:15:30,078 I-I forgot all of them. 366 00:15:30,163 --> 00:15:32,477 Multiple medications, called polypharmacy, 367 00:15:32,562 --> 00:15:35,352 is associated with adverse outcomes, 368 00:15:35,437 --> 00:15:37,665 particularly as we age. They interact, 369 00:15:37,750 --> 00:15:39,774 causing falls, drug reactions, 370 00:15:39,859 --> 00:15:42,109 and can even lead to increased mortality. 371 00:15:42,307 --> 00:15:44,368 It all started with the arthritis. 372 00:15:44,453 --> 00:15:46,595 The ibuprofen wasn't doing anything, 373 00:15:46,690 --> 00:15:49,343 so a doctor put me on prednisone. 374 00:15:49,428 --> 00:15:51,570 Well, that gave me heartburn, 375 00:15:51,655 --> 00:15:53,335 so he gave me omeprazole. 376 00:15:53,420 --> 00:15:55,249 But then that made me nauseous, 377 00:15:55,334 --> 00:15:58,273 so they added ondansetron for my stomach. 378 00:15:58,358 --> 00:16:01,601 That made my heart flutter, so they gave me metoprolol, 379 00:16:01,686 --> 00:16:03,312 and then my legs started to swell, 380 00:16:03,397 --> 00:16:05,116 so they gave me furosemide, and that's when 381 00:16:05,201 --> 00:16:06,773 I stopped walking very much, 382 00:16:06,858 --> 00:16:10,537 and, uh, my blood pressure shot up, so they... 383 00:16:10,655 --> 00:16:11,859 Should I keep going? 384 00:16:11,944 --> 00:16:12,904 ...practitioner to the ER, please. 385 00:16:12,995 --> 00:16:14,959 Nurse practitioner to the ER. 386 00:16:18,827 --> 00:16:20,160 Double shift? 387 00:16:20,733 --> 00:16:23,663 Actually, I'm just starting. 388 00:16:24,053 --> 00:16:25,858 Been having a hard time sleeping. 389 00:16:25,998 --> 00:16:28,537 - Oh, that sucks. - Yeah, tell me about it. 390 00:16:28,944 --> 00:16:33,506 Oh, um, Leela told me about your mother. 391 00:16:33,787 --> 00:16:35,137 How is she? 392 00:16:35,530 --> 00:16:38,124 Sorry, it's... it's none of my business. 393 00:16:38,209 --> 00:16:39,931 No, it isn't. 394 00:16:40,451 --> 00:16:42,124 But it's nice of you to ask. 395 00:16:42,616 --> 00:16:44,662 She just moved in with me on Saturday. 396 00:16:44,795 --> 00:16:46,202 It's been good having her close. 397 00:16:46,355 --> 00:16:48,607 And how are you? 398 00:16:48,748 --> 00:16:51,272 Well, I'm trying to resist the urge 399 00:16:51,357 --> 00:16:53,405 to check my home security camera every five minutes 400 00:16:53,490 --> 00:16:55,733 to see how she's doing. 401 00:16:55,826 --> 00:16:58,326 Okay, well, actually, I'm not resisting. 402 00:16:58,421 --> 00:17:01,810 Would you look at this woman? She's out there gardening. 403 00:17:01,957 --> 00:17:03,507 Are those rhododendrons? 404 00:17:03,592 --> 00:17:07,154 A little pink for my taste, but she loves them. 405 00:17:08,466 --> 00:17:11,294 I'm leading a meditation at 3:00. 406 00:17:11,379 --> 00:17:14,614 - Join us. - Maybe I will. 407 00:17:16,001 --> 00:17:18,537 - So, how are you? - Great. 408 00:17:18,671 --> 00:17:20,422 I just injected my sister with hormones 409 00:17:20,507 --> 00:17:21,608 so she can donate her eggs to me 410 00:17:21,692 --> 00:17:23,525 and I can be a mom. Hmm! 411 00:17:24,638 --> 00:17:26,956 Oh, wear something comfortable. 412 00:17:32,209 --> 00:17:35,715 So they put her on hydrochlorothiazide... 413 00:17:35,866 --> 00:17:37,591 And that made Gloria feel fatigued. 414 00:17:37,676 --> 00:17:39,353 So they gave her methylphenidate. 415 00:17:39,439 --> 00:17:41,139 Which could have had a negative interaction 416 00:17:41,231 --> 00:17:43,530 with the linezolid that she was taking for that cellulitis. 417 00:17:43,614 --> 00:17:46,124 Or the zolpidem or quetiapine, 418 00:17:46,209 --> 00:17:48,060 which Gloria was also on. 419 00:17:52,258 --> 00:17:54,605 What are we even doing, Dr. Pravesh? 420 00:17:54,690 --> 00:17:57,114 We're looking into all contraindications. 421 00:17:57,199 --> 00:18:00,272 But she is a sick older lady who needs these drugs. 422 00:18:00,357 --> 00:18:02,678 Like, which do you even stop? 423 00:18:02,763 --> 00:18:04,243 We move carefully, 424 00:18:04,771 --> 00:18:07,560 removing one by one. 425 00:18:10,031 --> 00:18:11,448 No. 426 00:18:11,771 --> 00:18:14,495 This is over my head and, honestly, kind of boring. 427 00:18:14,647 --> 00:18:17,138 I need to find a surgery to observe. 428 00:18:17,451 --> 00:18:19,584 I thought you were going into primary care. 429 00:18:20,013 --> 00:18:21,591 No. I want to be a surgeon. 430 00:18:21,676 --> 00:18:23,389 It's exciting, and you fix problems 431 00:18:23,474 --> 00:18:26,173 that are actually fixable, not buff up old people 432 00:18:26,325 --> 00:18:27,091 until they die. 433 00:18:27,176 --> 00:18:28,856 You don't think people die on the OR table? 434 00:18:29,549 --> 00:18:30,881 They do all the time. 435 00:18:30,966 --> 00:18:32,496 Not everything is fixable with a knife. 436 00:18:32,589 --> 00:18:33,524 You get that, right? 437 00:18:33,608 --> 00:18:35,332 You can fix things with your brain. 438 00:18:35,425 --> 00:18:37,076 Excuse me, have you met me? 439 00:18:37,341 --> 00:18:38,789 I read that surgeons don't actually have 440 00:18:38,873 --> 00:18:42,351 the highest IQ, and I thought, there, that's my specialty. 441 00:18:42,436 --> 00:18:43,436 Hmm. 442 00:18:43,521 --> 00:18:45,201 This woman needs us, 443 00:18:45,607 --> 00:18:48,195 and Dr. Kravitz needs her. 444 00:18:48,880 --> 00:18:51,717 So if you're not interested, I say go hunt down Dr. Austin 445 00:18:51,802 --> 00:18:53,700 and see if he'll let you into his OR. 446 00:18:53,853 --> 00:18:55,795 But be aware that he will not consider it 447 00:18:55,880 --> 00:18:57,855 for one nanosecond 448 00:18:58,482 --> 00:19:01,175 when I tell him you deserted this patient. 449 00:19:06,641 --> 00:19:09,693 Okay, I will stay. 450 00:19:10,372 --> 00:19:13,287 But don't tell him about that IQ thing, either. 451 00:19:17,851 --> 00:19:19,795 I want to go with him. 452 00:19:19,880 --> 00:19:21,963 You can't, honey. He needs special care 453 00:19:22,048 --> 00:19:23,404 in a special part of the hospital. 454 00:19:23,489 --> 00:19:25,740 You mean he's really sick? 455 00:19:25,915 --> 00:19:27,166 You fix people. 456 00:19:27,251 --> 00:19:31,253 - You'll fix him, can't you, Daddy? - Spencer. 457 00:19:32,084 --> 00:19:33,749 I'll be right there. 458 00:19:36,068 --> 00:19:38,889 What's happening? His daddy is scared. 459 00:19:38,974 --> 00:19:41,107 You have to save Peter. 460 00:19:44,570 --> 00:19:46,123 I got him. 461 00:19:47,050 --> 00:19:48,927 I got him, I promise. 462 00:19:54,718 --> 00:19:56,232 He seems much worse. 463 00:19:56,349 --> 00:19:58,506 Please tell me you have some news. 464 00:19:58,826 --> 00:20:00,194 We gave him another round of meds 465 00:20:00,279 --> 00:20:01,869 to lower the intracranial pressure, 466 00:20:01,954 --> 00:20:05,622 but it'll take time... if it works. 467 00:20:07,963 --> 00:20:10,639 He was hurting, and I totally missed it. 468 00:20:11,947 --> 00:20:14,999 I get guilt, believe me, but it is not earned here. 469 00:20:18,886 --> 00:20:22,074 Help him. Please. 470 00:20:22,660 --> 00:20:24,434 We're doing everything we can. 471 00:20:25,676 --> 00:20:26,719 Uh, just... 472 00:20:27,114 --> 00:20:29,639 I don't want anybody cutting his head open. 473 00:20:29,724 --> 00:20:30,974 Not if we can avoid it. 474 00:20:31,058 --> 00:20:32,725 Understood. 475 00:20:38,118 --> 00:20:39,528 You all right? 476 00:20:40,976 --> 00:20:43,310 Now I feel guilty, about how lucky I am 477 00:20:43,395 --> 00:20:44,837 not to be in Spencer's shoes. 478 00:20:44,936 --> 00:20:46,359 Peter has to make it through this. 479 00:20:46,649 --> 00:20:48,732 - I know. - And Gigi, she lost her mother. 480 00:20:48,817 --> 00:20:49,734 She can't lose her best friend. 481 00:20:49,818 --> 00:20:50,894 We have to make sure they both come 482 00:20:50,978 --> 00:20:52,145 out of this. 483 00:20:52,230 --> 00:20:54,230 Uh, Dr. Hawkins! 484 00:20:57,067 --> 00:21:00,920 Vomiting means his intracranial pressure must be rising. 485 00:21:03,424 --> 00:21:04,656 I'm a little confused. 486 00:21:04,741 --> 00:21:06,466 - I'm sorry. - So the metoprolol 487 00:21:06,551 --> 00:21:07,427 helped your heart, 488 00:21:07,512 --> 00:21:08,929 but it also lowered your blood pressure. 489 00:21:09,013 --> 00:21:10,589 And with all the water pills you were on, 490 00:21:10,673 --> 00:21:12,505 plus the stimulants, your heart rate sped 491 00:21:12,590 --> 00:21:14,989 and BP lowered, which caused you to lose consciousness. 492 00:21:15,129 --> 00:21:16,919 Other doctors have been telling me 493 00:21:17,004 --> 00:21:19,357 that these meds are saving my life, and you're telling me 494 00:21:19,442 --> 00:21:21,778 - the opposite? - No, just listen to them, hon. 495 00:21:21,910 --> 00:21:24,707 They want to take you off medications you may not need, 496 00:21:24,792 --> 00:21:26,688 and-and keep you on ones that are working. 497 00:21:26,773 --> 00:21:28,411 But we'd like to keep you here 498 00:21:28,496 --> 00:21:30,021 to monitor you while we do it. 499 00:21:30,106 --> 00:21:33,028 But it's just for a day, and then, um, you'll go home. 500 00:21:33,410 --> 00:21:35,942 - There's hope for him yet. - Mm. 501 00:21:36,182 --> 00:21:37,708 Thank you both. 502 00:21:38,145 --> 00:21:40,367 We've given Peter the maximum doses, 503 00:21:40,452 --> 00:21:42,877 but he's... he's not improving. 504 00:21:43,038 --> 00:21:44,779 Well, time to book an OR. 505 00:21:44,864 --> 00:21:47,669 No, let's just... 506 00:21:47,754 --> 00:21:49,215 ...start with a drain 507 00:21:49,300 --> 00:21:51,359 before you open his head. 508 00:21:54,017 --> 00:21:55,746 Okay, we can try it. 509 00:21:57,293 --> 00:21:58,887 I'll get an EVD monitor. 510 00:22:02,875 --> 00:22:06,223 - Talk to me. - We're putting in a drain. 511 00:22:06,340 --> 00:22:08,809 It should help relieve the pressure on his brain. 512 00:22:08,894 --> 00:22:10,369 It's a first step. 513 00:22:13,108 --> 00:22:16,676 I don't know how much longer we can put off a craniectomy. 514 00:22:18,132 --> 00:22:19,941 It's my son. 515 00:22:23,896 --> 00:22:26,247 Let's take everything one step at a time. 516 00:22:26,332 --> 00:22:30,185 Right now, we need to sedate and intubate, 517 00:22:30,270 --> 00:22:32,170 and to protect his airway. 518 00:22:32,754 --> 00:22:36,121 I have to talk to him first, before you, before you... 519 00:22:36,442 --> 00:22:38,934 Of course. Of course. 520 00:22:47,078 --> 00:22:49,098 Hey, bud. 521 00:22:51,254 --> 00:22:53,324 I just want you to know... 522 00:22:55,098 --> 00:22:58,622 I want you to know that every second that you're asleep, 523 00:22:59,114 --> 00:23:01,458 I'm gonna be right here beside you. 524 00:23:02,184 --> 00:23:03,959 Deal? 525 00:23:09,050 --> 00:23:10,532 Okay. 526 00:23:28,385 --> 00:23:30,235 Hey, there she is. 527 00:23:30,707 --> 00:23:32,543 So, how'd it go this morning? 528 00:23:32,739 --> 00:23:36,891 The hormone shot was fine, but this is not. Look. 529 00:23:36,984 --> 00:23:38,950 Padma picked a donor, but I did a little bit 530 00:23:39,035 --> 00:23:40,341 of digging into this sperm bank. 531 00:23:40,426 --> 00:23:42,583 It's facing three lawsuits from families who claim 532 00:23:42,668 --> 00:23:44,491 their donors misrepresented themselves. 533 00:23:44,585 --> 00:23:46,458 In one case, the family alleged 534 00:23:46,543 --> 00:23:48,232 that the donor had an undisclosed history 535 00:23:48,317 --> 00:23:50,224 of schizophrenia. In another, 536 00:23:50,309 --> 00:23:51,750 a donor covered up a criminal record. 537 00:23:51,834 --> 00:23:54,586 Some claim college degrees when they're really dropouts. 538 00:23:55,302 --> 00:23:56,645 These families were lied to. 539 00:23:56,754 --> 00:23:59,794 Yes. About the biggest decision they'll ever make. 540 00:23:59,879 --> 00:24:02,177 The genes their kids will share with its father. 541 00:24:02,262 --> 00:24:04,246 Yeah, but, I mean, this is just 542 00:24:04,330 --> 00:24:06,271 a few cases out of how many, right? 543 00:24:06,423 --> 00:24:07,888 I mean, I had a lot of friends 544 00:24:07,973 --> 00:24:09,608 in med school who donated. They were good guys, 545 00:24:09,692 --> 00:24:11,497 they just needed cash; They wanted to help. 546 00:24:11,582 --> 00:24:12,911 Is this your way of saying 547 00:24:12,996 --> 00:24:14,675 there are little Devons out there? 548 00:24:15,778 --> 00:24:18,294 If it helps, every single one of these donors 549 00:24:18,379 --> 00:24:19,927 had to undergo genetic testing. 550 00:24:20,012 --> 00:24:22,654 There is no test to show whether you're a pathological liar, 551 00:24:22,739 --> 00:24:24,669 have a mental illness or a criminal record. 552 00:24:24,754 --> 00:24:26,444 - And you're missing the point. - No, I get it. 553 00:24:26,528 --> 00:24:27,958 Sperm banks are unregulated. 554 00:24:28,043 --> 00:24:30,185 The FDA requires that donors are tested 555 00:24:30,270 --> 00:24:32,590 for infectious diseases, but beyond that, nothing. 556 00:24:32,675 --> 00:24:34,231 Their bios aren't even verified. 557 00:24:34,316 --> 00:24:35,573 That may work for some people. 558 00:24:35,658 --> 00:24:37,569 There are amazing kids out there from anonymous donors, 559 00:24:37,653 --> 00:24:38,848 but that won't work for me. 560 00:24:38,933 --> 00:24:40,248 - This is my egg. - Hey, babe... 561 00:24:40,550 --> 00:24:43,746 You have to accept that this is Padma's choice. 562 00:24:45,451 --> 00:24:47,886 Well, I need to make sure she knows what she's choosing. 563 00:24:52,120 --> 00:24:54,012 We'll talk later, okay? 564 00:24:59,692 --> 00:25:01,458 - Are you hot or cold? - Both. 565 00:25:01,543 --> 00:25:02,756 Okay, don't worry, we're gonna help you. 566 00:25:02,840 --> 00:25:04,356 She's in A-fib and hypotensive. 567 00:25:04,441 --> 00:25:06,435 A-fib could be because we took her off metoprolol. 568 00:25:06,520 --> 00:25:07,513 Let me check if her pressure dropped 569 00:25:07,598 --> 00:25:08,653 before she slipped into arrhythmia. 570 00:25:08,737 --> 00:25:10,397 I-I was here. Her BP started to fall first, 571 00:25:10,481 --> 00:25:11,645 then her heart rate spiked. 572 00:25:11,730 --> 00:25:12,778 Peritonitis? 573 00:25:12,863 --> 00:25:15,299 Gloria, tell me where it hurts. 574 00:25:15,384 --> 00:25:17,777 - Rebound tenderness. - This has nothing to do with the meds. 575 00:25:17,861 --> 00:25:19,974 She has an acute abdomen and she may need surgery. 576 00:25:20,059 --> 00:25:21,418 Let's get her four of morphine. 577 00:25:21,503 --> 00:25:23,012 Hang pressors and page Bell. 578 00:25:23,126 --> 00:25:25,481 Hey, hang in there, okay? 579 00:25:31,545 --> 00:25:33,020 Where to begin? 580 00:25:33,174 --> 00:25:35,600 Gloria has three lumbar compression fractures 581 00:25:35,685 --> 00:25:36,701 from osteoporosis. 582 00:25:36,786 --> 00:25:39,275 And a hiatal hernia. All incidental findings. 583 00:25:39,360 --> 00:25:40,943 Consequence of living for eight decades. 584 00:25:41,028 --> 00:25:43,957 So here's today's problem. Colonic perforation. 585 00:25:44,042 --> 00:25:45,282 No wonder she was in so much pain. 586 00:25:45,366 --> 00:25:46,966 And no idea what caused this? 587 00:25:47,051 --> 00:25:48,387 It couldn't have been the fall. 588 00:25:48,472 --> 00:25:50,170 We thought she passed out from too many meds, 589 00:25:50,254 --> 00:25:51,951 but something else was going on. We just don't know what. 590 00:25:52,035 --> 00:25:54,614 Well, what we do know is that without surgery, 591 00:25:54,708 --> 00:25:55,715 Gloria won't make it. 592 00:25:55,800 --> 00:25:58,744 You're talking about a surgery that's dangerous at any age, 593 00:25:58,829 --> 00:26:00,404 and with Gloria nearly 80... 594 00:26:00,489 --> 00:26:03,193 Well, we'll be sure to be very clear with her 595 00:26:03,278 --> 00:26:04,574 about what we're facing here. 596 00:26:04,659 --> 00:26:07,826 But I agree with you. It's the only option. 597 00:26:08,497 --> 00:26:10,864 Okay. At least she's in the best hands. 598 00:26:10,949 --> 00:26:13,058 Well, I've had success with patients older than her, 599 00:26:13,143 --> 00:26:14,244 much sicker. 600 00:26:14,395 --> 00:26:16,612 I really hope she's one of them. 601 00:26:19,613 --> 00:26:21,535 So you think "The Right Stuff" is secretly 602 00:26:21,620 --> 00:26:23,512 - some sort of axe murderer? - No. 603 00:26:23,597 --> 00:26:24,582 I'm just saying we can't 604 00:26:24,667 --> 00:26:26,731 - really be sure who he is. - Okay, look, 605 00:26:26,816 --> 00:26:29,233 I really appreciate you being protective of me, 606 00:26:29,318 --> 00:26:31,161 but there's no guarantees with kids. 607 00:26:31,292 --> 00:26:32,550 I mean, look at us. 608 00:26:32,635 --> 00:26:33,981 What, there's a one-in-a-million chance 609 00:26:34,065 --> 00:26:35,080 of having twins? 610 00:26:35,232 --> 00:26:36,908 One in 250. 611 00:26:37,098 --> 00:26:40,153 And we are proof that a random genetic accident 612 00:26:40,237 --> 00:26:42,168 can be the best gift ever. 613 00:26:42,402 --> 00:26:44,991 Look, I can't give up on being a mother 614 00:26:45,076 --> 00:26:45,999 just because there's risks. 615 00:26:46,093 --> 00:26:47,067 I don't want you to. 616 00:26:47,152 --> 00:26:50,098 I just want you to be aware of what those risks are. 617 00:26:50,668 --> 00:26:54,451 Which is why I asked Dr. Nolan to join us. 618 00:26:54,536 --> 00:26:55,620 What's up, ladies? 619 00:26:55,775 --> 00:26:57,184 Show her what you showed me. 620 00:26:57,269 --> 00:26:58,360 Oh. 621 00:27:01,364 --> 00:27:02,989 "Dream Doc"? 622 00:27:03,262 --> 00:27:04,716 I don't understand. 623 00:27:04,872 --> 00:27:06,539 - It's him. - It's me. 624 00:27:07,907 --> 00:27:09,342 You're six-foot five? 625 00:27:09,427 --> 00:27:10,832 I do slouch some. 626 00:27:10,917 --> 00:27:12,840 And fluent in French? 627 00:27:13,043 --> 00:27:16,345 - Yeah. - Je suis Rosetta Stone. 628 00:27:17,229 --> 00:27:20,684 - Trombone prodigy? - I got a standing ovation 629 00:27:20,832 --> 00:27:22,193 at my ninth grade recital. 630 00:27:24,039 --> 00:27:25,926 - Just think about it. - Mm. 631 00:27:28,566 --> 00:27:30,142 Think about what? 632 00:27:30,287 --> 00:27:34,074 Surgery? Sounds... dangerous. 633 00:27:34,199 --> 00:27:36,318 Yeah, I'm not gonna lie to you. It is. 634 00:27:36,809 --> 00:27:40,062 But it is the only option. 635 00:27:40,770 --> 00:27:43,692 And without it, you may only have days. 636 00:27:44,691 --> 00:27:46,207 Maybe a week. 637 00:27:46,614 --> 00:27:48,238 I'm sorry. 638 00:27:49,535 --> 00:27:51,449 Y-You always say how 639 00:27:51,675 --> 00:27:54,425 e-easy choices are your favorite. 640 00:27:56,957 --> 00:27:59,423 I wish I could offer you more time 641 00:27:59,634 --> 00:28:01,160 to make this decision. 642 00:28:01,245 --> 00:28:03,071 But the sooner you operate, 643 00:28:03,317 --> 00:28:05,679 the better my chances are? 644 00:28:08,933 --> 00:28:10,567 Well, then, I'm ready. 645 00:28:11,770 --> 00:28:14,921 Arthur, I'm sure everybody over at Brookhaven is worried. 646 00:28:15,015 --> 00:28:16,942 You think maybe you could go call them 647 00:28:17,034 --> 00:28:20,239 - and fill them in? - Oh, of course. 648 00:28:20,395 --> 00:28:21,833 Any-Anything, darling. 649 00:28:21,918 --> 00:28:24,192 Yes, Brookhaven. 650 00:28:24,285 --> 00:28:25,779 Update, update Brookhaven. 651 00:28:25,864 --> 00:28:28,168 Update Brookhaven. 652 00:28:29,920 --> 00:28:31,646 I can't leave him. 653 00:28:31,731 --> 00:28:33,624 - He needs me. - Oh, I... 654 00:28:33,709 --> 00:28:35,393 I get it. 655 00:28:35,879 --> 00:28:39,612 You have got to be better than you have ever been. 656 00:28:40,668 --> 00:28:43,025 Neither one of us have children. 657 00:28:43,118 --> 00:28:45,426 Not even siblings. 658 00:28:45,699 --> 00:28:47,222 It's just the two of us. 659 00:28:47,879 --> 00:28:49,466 He has no one else. 660 00:28:49,738 --> 00:28:51,721 I have no one else. 661 00:28:52,910 --> 00:28:55,606 Do you know what it's like to find the love of your life 662 00:28:55,746 --> 00:28:57,762 this late in the game? 663 00:28:58,639 --> 00:29:00,379 Actually, I do. 664 00:29:01,395 --> 00:29:03,653 And when the day comes, 665 00:29:03,972 --> 00:29:05,934 and he forgets my name, 666 00:29:06,317 --> 00:29:08,582 I won't even care. 667 00:29:09,199 --> 00:29:12,997 I'll fill in that blank, 'cause he'll still love me. 668 00:29:13,922 --> 00:29:15,357 And I'll love him. 669 00:29:15,668 --> 00:29:17,043 To the end. 670 00:29:18,489 --> 00:29:20,809 Just don't let it be today. 671 00:29:22,951 --> 00:29:24,635 Okay. 672 00:29:34,598 --> 00:29:36,928 His intracranial pressure is still rising, 673 00:29:37,023 --> 00:29:38,930 and we're not sure of the cause. 674 00:29:39,083 --> 00:29:41,285 The MRI didn't show any tumors 675 00:29:41,481 --> 00:29:43,861 or blood clots in his brain. 676 00:29:43,957 --> 00:29:45,195 So what does this mean? 677 00:29:45,347 --> 00:29:47,013 That the drain wasn't enough. 678 00:29:47,107 --> 00:29:49,107 Mr. Shafer, we have no choice but to 679 00:29:49,260 --> 00:29:50,360 proceed with the craniectomy 680 00:29:50,444 --> 00:29:52,044 to relieve the pressure in Peter's brain. 681 00:29:52,221 --> 00:29:53,855 My God. 682 00:29:56,116 --> 00:29:57,616 I can't believe this is happening. 683 00:29:57,768 --> 00:29:59,785 There must be something else you can do. 684 00:29:59,937 --> 00:30:03,288 If we wait any longer, he's at risk of brain damage. 685 00:30:03,440 --> 00:30:06,074 Treat him like he's your child. 686 00:30:06,723 --> 00:30:10,345 Would you agree to this if it was Gigi? 687 00:30:14,301 --> 00:30:16,560 Spencer, give us a minute to review. 688 00:30:20,382 --> 00:30:23,393 - Tell me there's another option. - There isn't. 689 00:30:23,477 --> 00:30:25,402 What he just said in there won't help Peter. 690 00:30:25,629 --> 00:30:28,231 Keeping your objectivity will. You have to. 691 00:30:28,315 --> 00:30:29,658 I'm sorry to interrupt, 692 00:30:29,742 --> 00:30:31,742 but the preschool's been trying to get in touch. 693 00:30:31,911 --> 00:30:33,994 Gigi needs you. 694 00:30:36,794 --> 00:30:39,303 Do what you have to do to reduce the swelling. 695 00:30:48,595 --> 00:30:50,771 Hey. She's been like this 696 00:30:50,856 --> 00:30:52,318 since Peter left this morning. 697 00:30:52,403 --> 00:30:54,681 She won't eat or talk. 698 00:30:55,818 --> 00:30:58,202 - Thank you. - Yeah. 699 00:31:05,611 --> 00:31:06,777 What is that? 700 00:31:06,928 --> 00:31:09,354 A space helmet for Peter. 701 00:31:09,506 --> 00:31:13,283 If he goes into space, he can't die. 702 00:31:15,012 --> 00:31:18,288 Is he gonna die, like Mommy? 703 00:31:28,116 --> 00:31:30,426 I'm fighting for Peter. 704 00:31:31,023 --> 00:31:33,775 - I'm scared. - I know. That's okay. 705 00:31:34,054 --> 00:31:35,872 I knew he was sick when 706 00:31:35,957 --> 00:31:38,161 he didn't want to eat my sandwich. 707 00:31:38,246 --> 00:31:41,454 We trade. He always eats my sandwich. 708 00:31:41,538 --> 00:31:44,380 When his mommy left, his daddy started 709 00:31:44,465 --> 00:31:47,569 making his lunch with roast beef. 710 00:31:47,910 --> 00:31:51,895 After he ate it all, his tummy started hurting. 711 00:31:57,646 --> 00:31:59,496 Did he eat your sandwich this morning? 712 00:31:59,723 --> 00:32:01,498 No, Daddy. 713 00:32:09,082 --> 00:32:10,966 Craniotome to me. 714 00:32:15,024 --> 00:32:18,528 I've done this a hundred times, but rarely on a child. 715 00:32:18,934 --> 00:32:21,346 You're more than qualified. 716 00:32:23,580 --> 00:32:26,081 Watch for bleeding, be gentle. 717 00:32:26,824 --> 00:32:29,092 When I pass through bone, I stop. 718 00:32:30,121 --> 00:32:32,596 Now, let's get started. 719 00:32:34,015 --> 00:32:35,106 Wait! 720 00:32:35,259 --> 00:32:37,137 I think Peter has urea cycle disorder. 721 00:32:37,262 --> 00:32:39,560 It's a genetic enzyme deficiency that makes it hard 722 00:32:39,645 --> 00:32:40,858 for people to break down protein. 723 00:32:40,942 --> 00:32:43,747 Whenever Spencer packs his son roast beef, he trades it away 724 00:32:43,832 --> 00:32:45,380 because it makes his stomach hurt. 725 00:32:45,465 --> 00:32:47,445 I think sharing his dad's protein shake this morning 726 00:32:47,529 --> 00:32:48,982 gave him more protein than he could process, 727 00:32:49,066 --> 00:32:51,037 and his body was already under stress from his recent cold. 728 00:32:51,121 --> 00:32:53,482 Talk about a zebra. Urea cycle is extremely rare. 729 00:32:53,567 --> 00:32:54,975 But it would explain all the symptoms. 730 00:32:55,059 --> 00:32:56,466 Let's get him back to the ICU, 731 00:32:56,551 --> 00:32:58,693 start him on dialysis, clear the ammonia. 732 00:32:58,778 --> 00:33:00,209 Yeah, but do we have that kind of time? 733 00:33:00,293 --> 00:33:01,967 The odds you're right are vanishingly small, 734 00:33:02,051 --> 00:33:03,287 and if you're wrong, this boy's brain 735 00:33:03,371 --> 00:33:04,146 continues to swell, 736 00:33:04,230 --> 00:33:06,059 which will cause him permanent damage. 737 00:33:07,382 --> 00:33:08,935 We need to operate now. 738 00:33:09,020 --> 00:33:10,724 A craniectomy is a gamble, too. 739 00:33:10,809 --> 00:33:12,404 At the rate the swelling is worsening, 740 00:33:12,489 --> 00:33:15,083 best-case scenario, what, it buys Peter days? 741 00:33:15,176 --> 00:33:16,823 It doesn't fix the problem. 742 00:33:16,967 --> 00:33:18,408 That is true. 743 00:33:20,942 --> 00:33:22,654 So let's do both. 744 00:33:23,145 --> 00:33:26,293 Dialysis right here. We can watch his ICP. 745 00:33:26,598 --> 00:33:28,088 If it doesn't drop, I'm ready to 746 00:33:28,173 --> 00:33:29,573 start a crani immediately. 747 00:33:40,415 --> 00:33:42,746 I'll be right here when you wake up. 748 00:33:43,530 --> 00:33:46,481 Okay, this is as far as you can go. 749 00:33:55,215 --> 00:33:56,672 I love you. 750 00:33:57,957 --> 00:33:59,950 I love you more. 751 00:34:05,106 --> 00:34:06,581 Okay. 752 00:34:23,813 --> 00:34:25,418 Wire, please. 753 00:34:31,721 --> 00:34:33,688 Dilator. 754 00:34:38,048 --> 00:34:40,657 All right, we're almost there. 755 00:34:41,795 --> 00:34:43,403 All right, catheter in. 756 00:34:43,511 --> 00:34:45,862 If you're right, the pressure should trend down 757 00:34:45,947 --> 00:34:47,412 once the proteins are filtered out. 758 00:34:47,497 --> 00:34:49,564 Yeah, well, it's not gonna happen immediately. 759 00:34:54,067 --> 00:34:56,668 If that number doesn't come down soon, I start. 760 00:34:57,676 --> 00:34:59,977 Whether I want to or not. 761 00:35:02,654 --> 00:35:05,215 We're working through some unexpected adhesions. 762 00:35:05,300 --> 00:35:07,726 Did Gloria mention anything about prior surgeries? 763 00:35:07,973 --> 00:35:10,099 None. Any sign of the perforation? 764 00:35:10,184 --> 00:35:11,427 Running the bowel now. 765 00:35:11,512 --> 00:35:14,137 There's no sign of widespread ischemia. 766 00:35:14,222 --> 00:35:15,317 Oh, there it is. 767 00:35:15,402 --> 00:35:16,341 Can you repair it? 768 00:35:16,426 --> 00:35:17,995 Well, the surrounding bowel is thickened 769 00:35:18,080 --> 00:35:20,559 with extensive lymphadenopathy. 770 00:35:21,777 --> 00:35:23,231 It sounds like whatever's going on 771 00:35:23,316 --> 00:35:24,652 caused significant inflammation. 772 00:35:25,078 --> 00:35:27,130 I should be able to repair the perf, 773 00:35:27,215 --> 00:35:29,067 but, you know, this didn't happen overnight. 774 00:35:29,152 --> 00:35:30,483 It's been going on for years. 775 00:35:30,567 --> 00:35:33,002 Bowel inflammation is extremely painful. 776 00:35:33,086 --> 00:35:35,582 Her daily steroids must have been masking it. 777 00:35:37,369 --> 00:35:39,035 See the big picture. 778 00:35:39,501 --> 00:35:41,442 Dr. Kravitz told me in geriatrics 779 00:35:41,527 --> 00:35:43,854 you always gotta keep your eye on the big picture. 780 00:35:44,081 --> 00:35:46,263 What if the arthritis and the bowel inflammation 781 00:35:46,348 --> 00:35:47,834 are all part of the same disease process? 782 00:35:47,918 --> 00:35:50,152 It's possible. 783 00:35:51,271 --> 00:35:53,104 If the side effects of her medications 784 00:35:53,189 --> 00:35:57,108 were actually symptoms of the underlying issue. 785 00:35:58,203 --> 00:36:00,445 We've been looking at this all wrong. 786 00:36:01,164 --> 00:36:02,852 Let's get back to Gloria's prescriptions 787 00:36:02,937 --> 00:36:04,283 and see if we can't get her some answers 788 00:36:04,367 --> 00:36:06,158 when she wakes up. 789 00:36:09,273 --> 00:36:10,977 It just keeps rising. 790 00:36:11,157 --> 00:36:12,361 Can we dialyze faster? 791 00:36:12,446 --> 00:36:14,711 Any faster and his neurons could shear from diffusion. 792 00:36:14,795 --> 00:36:15,618 Just give it a minute. 793 00:36:15,703 --> 00:36:17,323 Conrad, this is the brain. A minute can be 794 00:36:17,407 --> 00:36:18,541 the difference between life and death. 795 00:36:18,625 --> 00:36:19,784 Just give me one more minute. 796 00:36:19,868 --> 00:36:21,017 We don't have good choices here. 797 00:36:21,101 --> 00:36:24,157 - Billie, we're on the same side. - But this is my OR. 798 00:36:35,908 --> 00:36:37,991 - It dropped. - Wait, Dr. Sutton. 799 00:36:38,979 --> 00:36:40,954 That number's still dangerously high. 800 00:36:56,079 --> 00:36:57,636 It worked. 801 00:37:01,631 --> 00:37:03,266 You ready to close? 802 00:37:04,328 --> 00:37:06,500 Sure am. 803 00:37:12,822 --> 00:37:15,226 Focus on that still space 804 00:37:15,620 --> 00:37:17,742 between our inhale 805 00:37:18,560 --> 00:37:20,180 and our exhale. 806 00:37:22,767 --> 00:37:24,450 Please remember to silence your devices 807 00:37:24,535 --> 00:37:26,070 before we begin the class. 808 00:37:53,210 --> 00:37:55,070 - I seem to have gotten turned around. - Okay. 809 00:37:55,154 --> 00:37:56,586 My wife is in surgery. 810 00:37:56,671 --> 00:37:58,429 Can you direct me to the waiting room? 811 00:37:58,575 --> 00:38:01,042 Uh, here, let me show you. 812 00:38:03,810 --> 00:38:05,175 The cavalry has arrived. 813 00:38:05,260 --> 00:38:07,075 77-year-old woman with a bowel perf. 814 00:38:07,160 --> 00:38:08,083 Pressure started tanking. 815 00:38:08,167 --> 00:38:09,341 At first I thought it was peritonitis, 816 00:38:09,425 --> 00:38:10,707 then I saw her neck. 817 00:38:10,792 --> 00:38:12,519 I need ultrasound now. 818 00:38:12,896 --> 00:38:14,373 Any idea why she might be in tamponade? 819 00:38:14,457 --> 00:38:15,924 No idea what the underlying issue is. 820 00:38:16,008 --> 00:38:18,233 Right now, we just need to get her off the table. 821 00:38:18,325 --> 00:38:20,260 Start another epi and bolus a liter. 822 00:38:20,345 --> 00:38:22,754 There's fluid around her heart. We need to prep her 823 00:38:22,848 --> 00:38:24,088 for pericardiocentesis. 824 00:38:24,183 --> 00:38:25,849 Okay, I'll finish up so I can assist. 825 00:38:26,000 --> 00:38:27,506 All right, but if she doesn't stabilize, Bell, 826 00:38:27,590 --> 00:38:28,661 I'm gonna have to crack her chest open. 827 00:38:28,745 --> 00:38:31,146 Oh, God, let's hope not. 828 00:38:45,153 --> 00:38:46,981 Oh, man, I can't wait to tell 'em. 829 00:38:47,066 --> 00:38:48,520 Hey, we figured it out. 830 00:38:48,605 --> 00:38:50,427 Gloria's medications didn't cause her problems, 831 00:38:50,511 --> 00:38:51,826 but they masked an underlying one: 832 00:38:51,910 --> 00:38:53,128 Whipple's disease. 833 00:38:53,212 --> 00:38:55,371 That's what caused her arthritis, weight loss, fatigue. 834 00:38:55,455 --> 00:38:57,697 And steroids that her doctors first thought was arthritis 835 00:38:57,791 --> 00:38:59,031 only made it worse. 836 00:38:59,125 --> 00:39:00,792 She told us that they increased her dose, 837 00:39:00,877 --> 00:39:01,985 leading to the perf. 838 00:39:02,070 --> 00:39:03,646 Now all Gloria needs is an antibiotic. 839 00:39:03,730 --> 00:39:04,730 We can take her off of 840 00:39:04,872 --> 00:39:06,716 - almost everything else. - She didn't make it. 841 00:39:07,715 --> 00:39:10,097 - I'm sorry. - What? She... 842 00:39:10,269 --> 00:39:12,878 She developed cardiac tamponade, 843 00:39:13,566 --> 00:39:15,290 which was probably the final complication 844 00:39:15,375 --> 00:39:16,809 of her undiagnosed Whipple. 845 00:39:17,300 --> 00:39:19,477 And Austin was working to place a pericardial drain 846 00:39:19,562 --> 00:39:21,395 when she coded. 847 00:39:21,480 --> 00:39:23,906 We did five rounds of CPR. 848 00:39:24,144 --> 00:39:26,552 More than I should have on a woman her age. 849 00:39:26,636 --> 00:39:27,902 It was a tough one. 850 00:39:27,987 --> 00:39:30,145 Now, if she'd been treated properly, 851 00:39:30,230 --> 00:39:31,755 or if she'd gotten to us sooner, 852 00:39:31,840 --> 00:39:34,169 maybe we could have done something 853 00:39:34,254 --> 00:39:35,985 to turn it around. But today... 854 00:39:36,178 --> 00:39:38,321 it was just far too late. 855 00:39:40,022 --> 00:39:42,207 Dr. Kravitz... 856 00:39:44,746 --> 00:39:46,355 Kit is his friend, 857 00:39:46,636 --> 00:39:49,470 so I will call her to tell him. 858 00:40:00,435 --> 00:40:03,114 Even if we had diagnosed her sooner, 859 00:40:03,199 --> 00:40:04,856 Gloria's disease began years ago. 860 00:40:05,008 --> 00:40:06,668 There's nothing we could have done. 861 00:40:07,425 --> 00:40:10,004 Gloria wasn't just another fragile old lady. 862 00:40:10,168 --> 00:40:13,403 She was strong, in love. 863 00:40:13,488 --> 00:40:15,458 She deserved more time. 864 00:40:16,050 --> 00:40:19,652 But every doctor looked at her like just another lost cause. 865 00:40:20,281 --> 00:40:22,441 No one cared enough to see 866 00:40:22,597 --> 00:40:24,144 that by just treating her symptoms, 867 00:40:24,229 --> 00:40:26,505 they were actually making her worse. 868 00:40:31,738 --> 00:40:35,312 No one saw the bigger picture until you did. 869 00:40:37,855 --> 00:40:40,152 Reconsider going into gerontology, Zach. 870 00:40:40,906 --> 00:40:43,040 You may have a gift. 871 00:41:04,843 --> 00:41:07,262 I am so sorry. 872 00:41:07,808 --> 00:41:09,414 I'm so sorry. 873 00:41:29,308 --> 00:41:31,259 Look what I made you. 874 00:41:31,352 --> 00:41:32,675 Wow! 875 00:41:32,902 --> 00:41:34,160 Hey. 876 00:41:34,245 --> 00:41:37,520 So we'll continue dialysis until we lower his ammonia levels, 877 00:41:37,605 --> 00:41:40,268 but with some attention and lifestyle modifications 878 00:41:40,361 --> 00:41:41,378 we can manage this. 879 00:41:41,463 --> 00:41:43,107 You will need to look out for any signs that 880 00:41:43,191 --> 00:41:44,348 his ammonia levels are up. 881 00:41:44,433 --> 00:41:46,419 Sluggishness, nausea, vomiting. 882 00:41:46,504 --> 00:41:47,911 Avoid extreme temps. 883 00:41:47,996 --> 00:41:50,053 Keep him hydrated and on a low-protein diet. 884 00:41:50,138 --> 00:41:52,498 No more roast beef sandwiches. 885 00:41:52,583 --> 00:41:55,002 He'll do great. 886 00:41:55,227 --> 00:41:57,376 I can't thank you enough. 887 00:41:57,706 --> 00:42:00,275 Well, we did have help. 888 00:42:00,399 --> 00:42:01,789 How would you two like a surprise? 889 00:42:02,074 --> 00:42:05,068 What is it, Daddy? What is it? 890 00:42:13,878 --> 00:42:15,419 Wow! 891 00:42:16,190 --> 00:42:19,161 It's beautiful. 892 00:42:32,300 --> 00:42:35,544 Nolan as a sperm donor? Our Nolan? 893 00:42:35,668 --> 00:42:37,090 - Yep. - Ooh. 894 00:42:37,285 --> 00:42:40,114 - That put the fear of God in me. - Yeah, I bet. 895 00:42:40,199 --> 00:42:42,533 But the eggs are gonna be retrieved in about two weeks, 896 00:42:42,618 --> 00:42:45,118 which means I need a volunteer, fast. 897 00:42:45,241 --> 00:42:47,918 Someone I trust, someone I care about. 898 00:42:48,003 --> 00:42:49,411 What are you gonna do? 899 00:42:49,496 --> 00:42:53,164 Actually, um, I had a crazy idea. 900 00:42:53,249 --> 00:42:54,465 You and I are good friends, 901 00:42:54,550 --> 00:42:57,035 now that we aren't lovers, and I wouldn't mind 902 00:42:57,190 --> 00:42:59,504 a kid a lot like you. 903 00:43:00,519 --> 00:43:02,036 You could do worse. 904 00:43:02,293 --> 00:43:04,105 So what if I did... 905 00:43:04,631 --> 00:43:07,730 have a kid just like you? 906 00:43:10,621 --> 00:43:13,682 You want me to be your sperm donor? 907 00:43:22,316 --> 00:43:24,919 Captioning sponsored by 20th CENTURY FOX TELEVISION 908 00:43:25,003 --> 00:43:27,503 and TOYOTA. 909 00:43:27,730 --> 00:43:31,132 Captioned by Media Access Group at WGBH access.wgbh.org