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Previously in Emily Owens, M.D. Welcome to Denver Memorial. Hi, mom. Just tell me the truth. You have pancreatic cancer. I like you. Actually I don't see you that way. I really hope we can still be friends because I really value our friendship. Of course we can be friends. Hi Will! This isn't the first time I told a boy I liked him. Hey Will. Will hey. His name was Alan Zolman. He spit at me. I mean, literally spit. I chose to believe it was accidental, a result of the sialorrhea otherwise known as oversalivation caused by his braces. Hey there, Will. But if I'm being completely honest, the jury's still out. Hey, Will. The point is, this can't possibly be as bad as that. There he is. Act normal. Hey, Willy! Willy? Did you just call him Willy? You go by Willy? Um you know, I-I-I-I No. Never. Oh, no, he's uncomfortable around you. Show him you're fine. What's funny? It's this thing I saw on TV. It was, like, a horse thing. Escape! Escape! Uh, look, oh, we have a couple minutes. I will be right back. What the hell was that? Hmm? - Oh, come on. - Nothing. You're so of Fine. I'll go ask Will. No! I might have told him that I liked him, and he might have shot me down. That might have happened. So the recommendation is mastectomy followed by delayed reconstruction with two-stage implant/expander reconstruction. So, what made you think he would ever be into you? No offense. What kind of message? In med school, after finals, we got kind of drunk, and when I got home, there was this message from him on the answering machine. It said something like, um: "What am I doing with all these crazy girls? "I should be with someone like you. Maybe we should date." - No. - Less shock. - Interesting. But like I said, he was drunk, and he never brought it up, so I didn't mention it. And are the nurses staring at me? Don't be paranoid. I want to hear this message. It was two years ago. I didn't save it. The recommendation is gentamicin and a central line tip culture. Of course, you saved the message. No, I didn't. Oh, no. There are some things you never want to tell a patient. Mr. Mullins Uh, Max. Call call me, Max. - Hi. - Hi. Max, um, presented with a small inferior wall MI and bumped troponins. He has a history of hypertension, hypercholesterolemia and COPD. What's the diagnosis? You had a heart attack, and your heart is failing. So, my grandfather needs surgery? Um, no, unfortunately, he's not a candidate. What do you mean? Well, typically, to treat this condition, we would do one of two procedures a cardiac catheterization with stenting or a full bypass but both are invasive, and due to your grandfather's to your health, we don't recommend that you elect to do either. You saying I'm going to die or something? With medication, oxygen and limited physical exertion, you could have as long as a year. Your face looks very sad. That was really hard. Make it not look like that. Keep some distance. It gets easier. And that's a good thing? I'm not sure, but it does. Dr. Owens, right? Mm-hmm. I'm Kylie. Come this way. You're new, huh? I remember when I was new. You know the best part about being a nurse? We really get to know our patients. In fact, once in a while, we tell the attending if we think a patient would really respond to a particular intern, and for some reason, we thought that the woman in 513 would really like you. - Really? - Yeah. Dr. Bandari already approved it. - Thank you. - Yeah. Hello. - Margo. - Hi. I'm so sorry. Um, could I just trouble you to use some hand sanitizer? - Would would you mind? - Oh. Oh. No. Absolutely. Okay. Uh, my name is Dr. Owens I-I I'm sorry. It's just that you just touched the chart, which actually negates the effects of the sanitizer. Would you mind doing it again? I'm I'm sorry. It's just that I have OCD. Which is in my chart, which I I realize I'm not letting you read. That's okay. Um, why don't we skip the handshake? - That would be great. - Okay. Thank you. I'm sorry. No, it's not a problem. Um, so I see here that you experienced chest pains after a routine colonoscopy. Right? Um, I'm-I'm sorry. Um, would would you mind using an alcohol swab on your stethoscope? It's just that who knows where that's been? - Right? - Right. Okay, I actually have some with me, so You Great. Okay. Um, are you still having chest pains? No. Um, a little heart racing, and I really just want to get out of here. Yeah. Okay. Oh, I'm sorry. Um, you you just tucked your hair behind your ears. Uh, would you mind terribly if I asked you to just sanitize your hands again? My hands again? Sure. Okay. I did some digging, and it turns out the nurses are definitely mad. Apparently, it's because you hit on Jessica, who, by the way, is still staring at me. She's staring at you because she's having an affair with your father. Oh, why did I have to see them together? Okay, for the record, I didn't hit on Jessica. You asked me to find out if she was gay. You're getting hung up on the details. The point is, the nurses are over the whole doctor-hits-on-nurse cliché. Which I get it's totally dehumanizing. Anyway, I smoothed the way for an apology. - And you're welcome. - What? You got me into this in the first place. There you go again with the details. We'll strategize your apology later. Do you bake? I'm thinking lemon bars. So, you're friends with my daughter. Hi, Chief Dupre. Yes. Mm-hmm. - I am. - Excellent. Then you guys can look after one another. Because hospitals can be tricky places. Lots of dynamics to navigate. In fact, sometimes what you think you see, or thought you saw, is not actually what you did see or thought you saw. Okay, he's talking in code. Answer back in code. Yeah, I don't think that I didn't or did see anything sir. Ow! Ow, ow, ow! Sorry. I have to go. Ow! Is everybody okay? Yeah. Ask that one. Sorry. Yes, uh, we were playing bloody knuckles. It's a a card game. I won, I whack. All right. Do you mind if I listen to your lungs? All right, do your thing. I'm going to go grab some food, okay? - Yeah. - You want anything, Pops? No, but be sure you get some ice for that hand. That's very funny. All right. Deep breath, Mr. Mullins. Max. Please Max. Max, deep breath. I guess I should have should have seen this coming, huh? I'm an old man, right? I just always thought I'd I'd feel ready near the end. I don't feel ready. You still have time. Yeah. Like you said, maybe a year. You know what it's like to hear something like that? Nah. What am I saying? You have your whole life ahead of you. You want some advice? Yeah, any and all. None of it's big. That's what I tell my grandson. Stop worrying so much. None of it's big. Feels big, though. Yeah, that's what he says, too. So, you and your grandson, you're really close, huh? He actually lives with me, if you can believe that. While he goes to graduate school. Can you imagine? I got an eighth-grade education, and my grandson's going to be a college professor in three years. Well, see, now, I have to argue with you, 'cause that seems pretty big. You're absolutely right. Well, once in a while, it happens. Yeah so I got to at least try to see that graduation. Huh? So, what the hell? Let's do surgery. What? I-I'm in. No, but, Mist uh, Max you're not a good candidate. I know, but you said there were two procedures. Is one of them less risky? Um, the cardiac catheterization is less invasive, but you'd be at an increased risk for very serious complications. Oh, then at least I'll go out swinging. Which is a hell of a lot better than sitting around on the couch waiting to die. How about I let you think about it? I don't need to. I want at least a chance to see my grandson graduate. Like you said it's big. In medicine, we predict outcomes largely based on precedent because diseases tend to be unoriginal; they chart the same course, invade the same cells, wreak the same havoc. Unless they are disrupted, diseases are completely predictable. Heard you talked your patient into a cardiac cath. Pretty dangerous. Just like people. Didn't know you were such a risk taker, Pits. It's Emily. And where did you hear that? It's all over the hospital. Personally, I find gossip so irritating. Right. Like you weren't the one who spread the Alan Zolman spitting incident around the whole school. Oh, I have to go check on Mr. Rizwell. He keeps telling me that he's in love with me. Don't you just hate it when patients do that? Yes it is so annoying. Dr. Owens, is my test risky? No. No, not at all. It's very low risk. All clean. Um, I'm sorry, it's just that the other doctor was leaning against the handles. Be compassionate. It's a disease. No problem. You have a visitor. You got off work early? Yeah, Bobby covered for me. - I'm sorry. - I'm sorry. No, I messed up. No, it I'm sorry. Uh, Dr. Owens, this is my fiancé, Adam. Nice to meet you. Yeah, thanks. You, too. Okay, let's get you on that treadmill. I'm sorry. Just act normal. Left, go left! Duck! Don't worry, it wasn't as bad as you think. Really? No, I was just saying that to make you feel better. Anyway, update on the Jessica of it all. Uh! I know, she's turned all the nurses against me. Oh, you saw the Facebook page? What? No. What Facebook page? Never mind. I think she's one of those straight-but- curious girls. I mean, she keeps checking me out. Listen, I think you've got forget about Jessica. There are a lot of cute girls here. How about her? She's cute. We're not pieces of meat, you know. No, I'm really sorry. Oh, God. Sorry. I'll be quick. I just need to check his oxygen levels. He's gonna make it through the surgery. My grandpa, he came to this country when he was 15 by himself. He didn't even speak the language. And somehow, he made this great life. He's the kind of guy who beats the odds. Thank you. It isn't necessary. Mom I'll just be sitting there. And I'll just be sitting there with you. It's your first session. I'm not going to let you sit there alone, all right? Maybe this isn't even the right thing. It's not up for debate, okay? I got my schedule cleared. The chemo, I mean. Maybe the chemo isn't the right thing. What? I've done some research. Look, I told you to stay off the Internet. The survival rates for pancreatic cancer You need to get your information from credible sources. Less than ten percent, Micah. Less than ten percent are alive in five years. Which means ten percent are alive in five years. You can beat this. Yeah. I think someone's waiting for you. How's your pancreas patient? She's good. What's up? Max's insurance company is refusing to pay for his cath because they have determined that "his chances of surviving said procedure are minimal". You know what? I am so sick of all these people who think they know what's gonna happen. Nobody knows! If he wants the procedure, just just get it approved. I'm sorry, I just need you to deal with this right now. Okay. Dr. Owens? Hey. Are Margo's results back yet? - No, sorry. - Okay. It's just that she's really bad when things are unknown and she's driving herself crazy in there, just going around and around, and I don't know how to help her. Adam, why is she not on medication? She was for a long time. And then two years ago, a few months after we got engaged, her meds just stopped working, which can happen, I guess. After that, things just started to snowball. - It must be really hard. - Yeah. She's definitely struggling. No, I meant for you. Oh. I haven't She won't let me touch her. Not even hold her hand. It's been five months. How am I supposed to marry someone I can't touch? I'll try and rush the results. Is your patient critical? No, not critical, but Then we don't rush cardiology. Fifth floor Nurses Station. Okay, you need to defuse the awkwardness. Will, wait! Can I talk to you for a second? Yeah. Yeah, you know, sure. So, obviously things are a little awkward between us. And before everything snowballs, I wanted to see if we could just put what happened behind us and move on, because I'm not dwelling. And I'm okay. I'm not upset with you or anything. You sure? That you're not upset with me? No, not at all. Well, that's-that's a huge relief. As long as this relationship can continue on your terms, right? Wait. What? You make some sweeping proclamation that you're in love with me. I would hardly call it a "proclamation." Emily, we were friends and co-workers. And now every single time I ask you to run a CBC, I'm gonna wonder if you're reading something into it. Trust me, I'm not reading any It's very clear that you don't like me. That's the thing, Emily. I do like you. A lot. You kept me sane in med school. You were the person that I could unload to and laugh with. We can still do that. I just Look, I was just freaking out. And I was so nervous about the job, and I think I attached all this significance to you because you were familiar. But the point is you said no, and that's it. Yeah? I mean, did you think I was gonna pine over you forever? I mean, you are a cool guy, but come on. I am moving on. He's buying it. Stop talking. In fact, I already have another crush. What is wrong with you? On who? Micah. I have a crush on Micah. You do? Yes, I do. Please don't tell anyone. You have my word. You are so screwed. No, you denied the procedure. Yes, the case Hello? Do you know where to get good cell reception? Use the nurses' line. Yeah, trying to steer clear of the nurses. Oh, you saw the tweets? What tweets? Well, first, the one that went out about your crush on Micah. Wow. Fast. Cassandra's improved her technique. Well, upside, I guess now they'll believe I wasn't hitting on Jessica. Actually, now they think you're bisexual and a horndog. Which is your hashtag, by the way. Go to the roof if you want cell reception. You gonna listen to that message Will left in med school? There is no message. I'm really, really sorry, but a nurse was in here, and she left me a magazine, and I know that she was just trying to be nice, but who knows where it was before she brought it here, and so my heart started racing and I got really anxious. You haven't heard anything yet have you? About the tests? No. I'm sorry. I'm just going to take your pulse. Okay, but can you just sanitize your hands first? I just did. I know, but then you touched your watch. I didn't touch anything! That had nothing to do with you. I'm sorry. I'm dealing with problems with an insurance company and also some personal stuff, but that's no excuse. And I'm very sorry. That's okay. Um, what's the problem with the insurance company? They're just refusing my patient's procedure. Why? Uh, his age and medical condition, basically. Gotcha. Well, if you reference the Affordable Care Act which established that patients cannot be denied coverage based on a pre-existing condition, they they should probably back down, but if they don't, you can invoke the Age Discrimination in Employment Act which has been interpreted to cover many different policy positions. I'm a lawyer. Well, I was, you know, until my OCD got out of control, okay? Um, do you have a pen? I'll just write it down for you. Yes, yes. Thank you. Oh, um Sorry, I just have to do this. Oh, yes. Of course, of course. Got it? Thank you. Sure. Don't worry about losing your patience. I know I'm pretty awful to be around. No, you're not. No, I am. I'm gonna lose him. I feel myself losing him. I'm sorry. Again, thank you. No, no. Okay, thank you. Case 764256. Yes, well, tell your manager, or whoever, that your company is violating the Affordable Care Act which states that Sorry, it states that patients cannot be denied coverage for a reasonable procedure based on a pre-existing condition. Now I haven't brought this to the hospital's legal team yet, but that is my next step. Hey, good work. Just got the call. The cath was approved. Watch out. That girl's a barracuda, and apparently, she's after you now. The gossip in this place is out of control. Your cardiac stress test results came back. Why are you looking up neurological disruptions? Her OCD gets worse, and now she's demonstrating writing apraxia. I mean, a focal lesion could explain both. You're thinking brain tumor? I'm thinking that she needs an MRI. Normal. Act normal. Um have you seen Dr. Bandari? Uh, she just went in on a CABG. Oh, she's getting discharged. Um, Chief Chief Dupre, you asked earlier if I needed anything. I was just wondering if you wouldn't mind authorizing an MRI? Dr. Bandari's in surgery, and I just need to get my patient in. There is a chain of command. It's just my patient suffers from OCD, and if I don't get her into the imaging room in 15 minutes, not only will I have to tell her that might she have a brain tumor, but she's going to have to wait until tomorrow to confirm this, which will give her heart palpitations, and we'll have to run all the same tests tomorrow that she already passed today. Follow the protocol. But I really think that an MRI would show that something that I thought that I saw, I actually did see. Okay, you just blackmailed the chief of staff. Breathe. Breathe. Breathe. I don't want to hear about what you think you thought you saw again. Thank you. Can you just talk to me, please? Because otherwise I just keep thinking tumor, tumor, tumor. Yeah, sure. Just try to relax, which I realize is the worst thing to say to someone who can't relax, because then you get all worked up about the fact that you can't relax and you start focusing on it, which gets you even more worked up. I totally get that. It's like today, I've just been telling myself all day to just act normal, and that hasn't been too successful. It think it's 'cause the situation isn't normal, and I don't really know when it's ever going to be normal again between us. That's what I've been obsessing about. I just, I keep replaying this stupid thing that I did, over and over and over again, and then replaying all the moments that led up to it. Like the time he stared at me during lab, and the time that we rented a house with our friends during med school up at Greenbrier, and we just talked all night long. 'Cause that's the thing about Will and I. We can really talk. And he makes me laugh. I think it's because he has this way of looking at the world which is so different from the way that I look at the world. Which is probably why, when I'm with him, I feel like everything's gonna be okay. Actually, maybe a little quiet would be good for a while. Right. Sorry. Yeah. I'm going in. Wish me luck. Good luck. I'm married. No. I was just wondering if you could keep an eye out for my MRI results. Already called imaging, told them to push. Thank you. Although, while I'm here, the Jessica thing, that was a misunderstanding, but I totally understand how it rubbed people the wrong way, and I'm very sorry. - Your imaging. - Thank you. Do you like lemon bars? I bake a little. And there's the mass on the right frontoparietal lobe. Chances are it's been growing slowly for the past ten years when your OCD began. The OCD medication helped mask the symptoms, until it grew too big to be controlled. The brain tumor? Yes. Now, the good news is it was caught before it became inoperable. And it's in an ideal location to be resected and removed. And once it's gone, we have every reason to believe your OCD symptoms will subside. Now, it's still brain surgery, and it's a risky procedure, but you know what, if you got to have a tumor, this is where you want it to be. I know it sounds scary No, no, I'm I'm going to get my life back. I mean, we're going to get our life back. All right, thank you. Sure. What happened? We found a mass on the frontoparietal I meant, why would you go over my head for an MRI authorization? Oh, you were in surgery. You could have sent a note. But it wasn't exactly an emergency. Then you wait. I'm sorry. I just We would've had to wait a whole nother day, and I felt really bad for You felt bad? Let me tell you about bad. When you ignore hospital protocol, that's bad. When you go over my head, that's bad. And when you *** me off, twice, in your first week of work? That's very bad. Everything okay? - Tired. - 19 hours into a 24-hour shift? Yeah, tired makes sense. I heard that Max's cath went well. Yup. Just got to hope the stents doesn't reclot. The next 24 hours are critical. So listen, um, I wanted to apologize again for snapping at you before. Oh, please No, no, no, no, no, I should explain. I mean, it will probably get around anyway. This place is a rumor mill. Anyway, um, the woman in 501 is actually my mom. - So - What? She has pancreatic cancer. Which is why I've been a little on edge. Oh. Micah, I'm so sorry. Thanks. Anyway, she's starting chemo at 8:00 a.m. Are you okay? Yeah, I am. I don't know why, but I think she's gonna be okay. I mean, somebody has to beat the odds, right? So why can't why can't it be my mom? Yeah. Oh. Oh, sorry, I didn't know you two were busy. I'll just leave you alone to, um, get to know each other better. Okay. I should explain what that was all about. No, you really don't have to. Here's the thing, um This is embarrassing. I like Will. Well, I I more than like him. I've more-than-liked him all through med school, and I thought that I should tell him because I'm an adult and a doctor and that's what doctor adults do, and, uh, he rejected me. And I was I am embarrassed, and I wanted him to think that I had moved on, so I told him that I liked you. And that's what that was all about. And I'm very sorry that I dragged you into that adolescent nightmare. You know what this means now? I'm gonna have to spread a rumor that I shot you down. I'm used to it. I'm scared. I just want to be able to kiss you again. I love you. Okay. Okay. I'm ready. Thank you. Just let it go. Rise above it. She's not worth your time. You are an adult and a doctor. Oh, screw it. Hey, Cassandra? I don't have a crush on Micah anymore. So, if you could spread that around the hospital, that would be great. Why would I spread it around? Because you spread it around in the first place that I liked him. No, I didn't. Of course you did, just like you made sure that everyone knew about the Alan Zolman incident. The guy who spit on you? It was sialorrhea and that's beside the point. The old Emily would just take it. The new Emily fights back. Is that a threat? Maybe. Do not look away first. She's not gonna be able to do this forever. Stay focused. Think about something else. Like how tired you are. No, don't think about how tired you are! Stay awake! When is this gonna be over?! Why won't she look away?! Oh! What's wrong? But you said he'd never survive open heart surgery. But then the stents reclotted, so now we have no other option. Okay, then why did you talk him into this? He wasn't gonna do it, and then he talked to you, and now And this wasn't supposed to happen. He could have had another year. My patient's stents didn't hold. They're gonna have open him up. Go. No, I'd just be backing up Dr. Bandari. You're his doctor. You're my mother. Yes, and if it was me on that table, wouldn't you want my doctor to be there? He's pretty deep, pressure's good, Dr. Barnes. Internal thoracic artery is dissected and ready to go. Suction, please. The aorta is cross-clamped. Cardioplegia. Infusing cardioplegic solution now. We have asystole. And he's on the bypass machine. What do you know? Old man is a fighter. Someone's gotta beat the odds. You did. Made it through your internship in one piece. Debakey. No thanks to you. Was that a stutter you developed? Core temp? PERFUSIONIST I call it a temporary halting cadence. Graft. LAD is 90% occluded. Retractor. I need loops. Loops now! ACT's 300. All right, hemostat. Oxygen's dropping. PaO2 is 70. We're not perfusing here. What's going on? I think the bypass is clotted. We need to clear this, people. We are losing him. Come on, Max. Stay with us. He's gonna make it. I, honestly, I don't know how. He wasn't doing well on the bypass machine, but he just, he wouldn't give up. It's still gonna be a while, they have to close, but I wanted to let you know that he's out of the woods. Thank you. And I'm I'm sorry about before. No. Ple No. I'm, I'm just really glad that he's okay. First 24-hour shift conquered. Let's get some sleep. It's already 10:00? Yup. Ready to get out of here? Hey, you two. Hi, honey. You were off two hours ago. Why aren't you sleeping? You didn't tell me you were off. Ah, it wasn't important. And I wasn't tired. Four down. Oslo. Oslo, of course. They always use Oslo. On that note, I should be heading home. Absolutely, honey. Thanks for the company. Sure. Anytime. Bye, Micah. See ya. She's cute. I didn't notice. Now look, your session tomorrow is gonna be slightly longer. You didn't notice? Stop changing the subject. You're gonna make me talk about cancer? No, I didn't notice. My patient in 513 Margo? Sorry. The tumor had complicated architecture. When Dr. Morehead tried to remove it, the patient suffered a hemorrhagic stroke. But if I hadn't found it! Her symptoms would have worsened. She would have ended up in the same place. This is why we maintain distance, Dr. Owens. Don't cry. Don't you dare cry. Sorry. Tyra said there was good reception up here, so It's okay. You can make your call. Nah, it's cool. I'll, you know. I'll come back. Okay, fine. I'm not over you yet, okay? But I am trying very hard. But we're also both adults, so until that happens, you have to man up and deal with it. Man up, huh? Yes. Please. Fair enough. Emily what's going on? I lost a patient today. And I know that it's gonna get easier, and I know that it's only hitting me like this 'cause it's the first time, but it doesn't make me feel any better 'cause there's also something so sad about that. I don't think it will. What? Get easier for you. I think you'll get better at hiding it, but I don't think it will get easier for you. Do me a favor and don't tell Dr. Bandari that. You know, Emily, you're a different kind of doctor than she is. But for my money, if I were sick I'd want you. You're supposed to be making me like you less, remember? Right, okay. Yeah, no, so, you know, suck it up then. And grow a pair? - Better. - Yeah, yeah. Oh, that whole love speech thing, by the way? Mm-hmm? Yeah, total proclamation. It was not! It was more of I think an explanation. Not a even close. A declaration? All that heavy breathing you were doing. I was not heavy breathing! A lot of heavy breathing going on, which I think is the very definition of a proclamation, if I'm not mistaken. Okay, fine! It was a stupid proclamation, okay? - Yeah. - You happy? We let go all the time of feelings of people of fear. We let go because we want to because we have to. Because at the end of the day, there is no choice. Hey. I had a great time tonight. I mean, of course I did. We always do, right? I was actually thinking I mean, what am I doing with these crazy girls? I should be with someone like you. Hey, maybe we should date. Man, I probably shouldn't have said that, right, 'cause we're friends? Anyway, I'll see you tomorrow. We let go because if we don't we'll never move on. Hi. Um, is there any way to retrieve a message that you erased because you were trying to get over someone but then you realized that you're not quite there yet, so why rush it? It's got to be in, like, a memory bank or something somewhere. Well, where does it go? It's got to be a hard drive or-or a-a cloud or something. It doesn't just disappear! Can I speak to a supervisor? Or at the very least, we try to.
