[Shaun] After six open houses,
I am sure that "fixer-upper" means "decrepit."
Well, part of the fun is imagining what something could be.
It could be expensive and messy and loud
and even dangerous.
[sighs] Hey, why don't you do your thing with the real estate agent?
I'm gonna go wander.
Hi.
Tori Vargas. Any questions?
Oh, yes, I have many.
About school districts, drought-tolerant landscaping,
-seismic retrofitting-- -[chuckles] Someone came prepared.
Does that include loan pre-approval?
-If not, I can help. -Oh, no.
Going to open houses out of our price range is our new hobby,
and sometimes, there are cookies.
How fun! Uh, excuse me just a sec.
Hi there.
I grew up with a reading nook just like this one.
I'd lay in a pile of pillows, watch the falling snow.
That sounds uncomfortable.
A lot of the work is just cosmetic.
I could do most of it myself.
Make it a perfect family home.
Like, these window frames are just painted shut,
but all you have to do is…
Ow!
-Damn it. -See?
Dangerous.
-Forks and knives? -Hands only.
And don't you drown my shao bing in hot sauce.
-Yes, ma'am. -[chuckles]
A scallion omelet and sesame flatbread.
Mmm! Did I forget an anniversary?
This is a thank-you for planning our first road trip.
Mmm!
I'm planning more road trips.
[chuckles]
I can't wait to head south on PCH.
Last trip was a solo one on my Ducati.
Hold on.
[chuckles] You're a biker chick?
Was. In another life.
You miss it?
The other life?
Motorcycles are too dangerous. You could end up paralyzed.
[chuckles] Nice deflection.
[sighs]
I didn't know you in the other life.
I like this one.
Still feel that way if I go get the hot sauce?
[locker closes]
-We haven't had a chance to talk about-- -You kissing me.
Thereby crossing a line you said we shouldn't cross,
-right as I was headed on a date. -[chuckles softly]
How'd that go?
Great.
I barely heard a word he said,
because the whole time I was thinking about our kiss.
It was… It was amazing.
Yes, it was.
Look, I like you,
but I need some clarity here.
Right.
Let me be clear.
How about I make you dinner tomorrow, my place,
we talk about where we're headed?
Sounds good.
It's a date then.
A date.
Oh. Good morning, Dr. Lim.
Did Clay stay over last night?
-He did. -Excellent.
That means you are likely in a good mood and amenable because of the sex.
Amenable to what?
I think you will like it.
[Dr. Glassman] There was movement, flexion, and lateral rotation,
which means that there was engagement with the psoas and the glutes,
and I saw it twice.
Signals are getting through to your spinal column.
[Shaun] This deformity is not just scar tissue.
It's compressive syrinx. We enter from a midline myelotomy
and drain the fluid after we de-tether your cord.
I could…
You could walk again.
Audrey, this approach is much safer than the one we discussed last time.
I need time to think it over.
Of course.
Okay, today is the first day I will be implementing my new system.
I'm sure you agree it is a major improvement.
I don't know what you're talking about.
My new rating system for first-year residents?
I e-mailed you multiple drafts.
You never responded.
Once all the data is in, I will share the completed version.
Well, can't wait.
[elevator bell dings]
-[Dr. Park chuckles] Whoa! -[laughs]
When I asked to see where you worked, I didn't mean it as a challenge.
I had to see if you exaggerated on your profile.
I'm not really a fan of walks on the beach.
-[grunts] -Whoa! [chuckles]
-Sunsets are overrated. -All right.
Whoa!
Nice.
[grunts] Oh!
[chuckles]
[grunts] What happens on a third date?
Lily?
-Lily? -[moans]
Are you okay?
[theme music playing]
[elevator bell dings]
My new system has over 50 unique metrics that go into your scores.
Everything you do will be assessed.
Everything? Uh, could you be a bit more specific?
-No. -Is this head-to-head competition?
It's designed to make you aware of your individual strengths and weaknesses.
Residents with more strengths
are more likely to get invited back for full residency.
Hi, Teddy. Dr. Powell.
What happened to your head?
I idiotically smacked myself with a 20-pound kettlebell.
Kettlebell injuries are surprisingly common.
My gym has a printout of ten ways you can hurt yourself.
-Did you witness the accident? -Yeah. I'm there for all his workouts.
-Oh, so you're his trainer. -His brother.
My baby brother. He's got a real knack for making me suffer.
All right.
We're gonna run a full concussion protocol
and get a CT as a precaution.
Not until we take care of this gash.
You're also experiencing abdominal pain.
-Did that pain start before… -[winces]
…or after you hit your head?
Um, kind of simultaneous?
Do you mind lifting your shirt?
You recently lost a lot of weight.
Seventy pounds.
In five months. Getting that summer beach bod ready.
Keeping the T-shirt on for now.
Teddy, do you mind if we laid you back just to get a better look?
[grunts]
Oh, got a lump. An inguinal hernia.
It's not reducible.
I think it's also strangulated.
Hmm. Dr. Perez is right.
The blood flow to your herniated intestine has been cut off.
You need immediate surgery.
Okay.
This is Lily, 37, dizziness, epistaxis, purulent nasal discharge.
Let's get full labs including blood cultures.
I guess the upside of dating a doctor is no waiting in the ER.
I dated a guy at the DMV for that very reason.
-Do you have a history of nosebleeds? -Yes.
Part of my perpetual sinus infection.
I've been on and off antibiotics for a year.
I figured it's because I teach kung fu to kids.
Mmm, adorable.
Do you feel any sinus pressure?
Also, how'd you two meet?
Yes, and Bumble.
Thank you, Dr. Reznick. I got this.
He's worried this'll be awkward 'cause I'm his ex.
Don't worry. We're friends now.
Any other recent symptoms?
I've had a few migraines and bad taste in my mouth recently.
Temp's elevated, and she's hypertensive.
Acute-on-chronic bacterial rhinosinusitis?
Probably, but given the headaches,
I want a stat brain and sinus CT with and without contrast.
[monitor beeping steadily]
[Shaun] Hernia is reduced.
Next step in the tension-free hernioplasty?
[Danica and Daniel] Use mesh to cover the fascial defect.
By strengthening the inguinal floor, we hope to prevent further hernias.
No extra credit will be given for statements of the obvious.
It's impressive how much weight Teddy's lost.
I just hope he's doing it for the right reasons.
Hard to see a wrong reason. He was clearly pretty overweight.
[Shaun] I agree.
Obesity increases health risks for diabetes, heart disease, and some cancers.
[Daniel] Fair. But our culture can really go overboard on the fat-shaming,
which can lead to low self-esteem, depression, none of which is healthy.
Trying to change to please someone else rarely works.
Getting someone you love to do what is best for them is a good thing.
[Danica] There's ectopy in the EKG. QT looks prolonged.
Push two grams IV of magnesium.
[monitor alarm blaring]
He's going into torsades.
-Proper response? -Synchronized cardioversion.
Yes. Prepare to shock him.
[defibrillator powers up]
Charging 200 joules. Clear.
-[beeps] -[charge thuds]
[alarm stops]
[steady beeping resumes]
Good catch, Dr. Powell.
I caught the strangulated hernia.
Teddy's arrhythmia is likely a sign of an underlying condition.
It could be quite dangerous. Next you'll be assessed on
how quickly and accurately you can determine what's causing it.
Suture scissors.
[Asher] I'll start with the sinuses.
Hey, I found you a new prospect.
Unless your last date was a love connection for the ages.
-That's a no. -Oh. Hmm.
How terrible for him.
How exciting for me.
Berkeley law grad, former fitness model, just moved back to the Valley from Paris.
Thanks, but I'll pass.
That's severe opacification.
Sinus mucosa's thickened.
There's already bony erosion.
Lily needs endoscopic sinonasal debridement.
He's smart, he's ripped, he's worldly,
and unlike Perez, he's available.
-We kissed. -What?
-You and Perez? -Yeah.
What about his recovery-related boundaries?
I haven't figured that out yet,
but he did invite me to dinner at his place.
I'm exploring.
Just be careful, okay?
Okay.
Her sinus infection's spread through her skull base.
That's a massive 6-by-4 centimeter abscess.
Page Park. If that ruptures, she'll die.
Lily needs sinus and brain surgery.
[monitor beeping steadily]
[Dr. Park] Sinus debridement looks very good, Dr. Allen.
[Jordan] Pulling the scope.
Bacitracin-coated Telfa.
And we use two burr holes to drain the abscess using ultrasound guidance.
[drill whirring]
[Asher] So, how'd you get approval to operate on your new girlfriend?
Two dates does not equal a girlfriend. No approval necessary.
[Asher] Trajectories look good.
Drainage tool.
[Asher] Plus or minus that you got to parade her in front of Morgan?
Definitely not parading,
and Morgan and I are
friends, so neither.
Uh-huh.
Mmm, this is as much as I can get without risking rupture into the ventricle.
Okay, the rest is up to the antibiotics. Leave the drain and close.
Would you say you loved, liked, or hated the last house we saw?
Are those the only options?
I should examine your hand.
Oh, it's fine.
I can't stop thinking about the crown molding and the reading nook,
so as long as you don't hate it,
I'm thinking we should talk to a mortgage broker about making an offer.
You said going to open houses was only for fun.
I've looked at our finances, we can swing it.
Rent is spent.
A mortgage payment is
whatever rhymes with "payment" and means "good investment."
My research shows we should adhere to the 28/36 rule
with regards to monthly pre-tax income.
You have swelling around your second digit's metacarpal
and thumb's proximal phalanx.
I've done worse.
Shaun, we can be homeowners.
Doesn't that excite you even a little?
Hmm.
I am a little excited that you are excited.
Good, because I made an appointment with a mortgage broker.
And you guys can talk 25/36.
Twenty-eight.
[cell phone chimes]
It's silly for us to be competitive.
Said the loser while losing.
Olive branch.
I don't know what's causing the arrhythmia. Do you?
I have ideas.
Okay.
So you can present them and land the knockout blow,
if you're confident that you're right.
-Or? -Or we can bounce ideas off each other,
get the right answer, help this guy.
For all we know, one of Dr. Murphy's metrics is cooperation amongst colleagues.
Fine. But I present.
Do you have any idea how often women get zero credit for their ideas,
even when they come out of their mouths?
Fine.
Blood sample showed critically low potassium and sodium,
which makes no sense
given the power-food diet that his brother's got him on.
There's plenty of nutrients. So maybe celiac.
Mmm. IgA and IgG antibody tests were normal.
I'm thinking primary aldosteronism.
That's interesting.
Please present your ideas on what is causing our patient's arrhythmia.
We think that Teddy has primary aldosteronism.
Explains initial electrolyte levels and…
That doesn't align with urine studies or lack of hypertension.
This was your idea.
Congenital long QT syndrome.
Teddy's QT levels have returned to normal, and he has no family history.
He has critically low levels of potassium, sodium, and magnesium.
I noticed that. Despite a good diet.
It suggests absorption and…
What happened to cooperation amongst colleagues?
I didn't realize you were gonna be wrong.
Slight enamel erosion on the molars and trauma to the oral mucosa.
And these tiny abrasions on his knuckles are from his teeth.
Self-induced vomiting led to malnutrition, which caused the arrhythmia.
Teddy, you are bulimic.
That's quite the cocktail.
Not the kind I was hoping we'd share, but here we are.
Not exactly what I would've worn either.
We're hoping the antibiotics will clear the remaining infected areas
of your sinuses and brain.
I feel like I'm already getting the VIP treatment from you.
Dr. Reznick was right.
She said your flower game was very solid.
She stopped by?
Yes.
Ostensibly to check on me, but mostly to sing your praises.
Not many guys have an ex as a hype man.
Lucky me.
I think it's too soon to discharge Teddy.
He has responded well to electrolyte replacement,
no signs of recurrent arrhythmia,
and the hernioplasty only requires simple wound care.
He's bulimic.
I know. I diagnosed him, thank you, after you and Dr. Powell failed to.
Eating disorders have the highest mortality rate of any mental illness.
I referred him for a psych consult
and provided a list of clinics for eating disorders.
He needs help now, not in a few weeks.
Give me some time. Maybe I can get psych to talk to him.
Points are given for passion and commitment
and taken away for arguing with an attending.
I don't care about the points.
We can't keep him hospitalized without a clear surgical indication.
[sighs]
Stop hounding me.
I'm having a coffee. Can I have a coffee?
You're hovering.
I'm excited about the prospect of getting you back on your feet.
[sighs] This surgery is not an easy decision.
The surgical plan is a very good one.
Yes, it's a solid plan.
But?
But my life is good right now, really good.
Better than it's been in a while.
And the idea of that changing is--
Lea said we would go to open houses as a fun hobby,
but now she wants to buy one.
-I'm in the middle of a-- -No, you're not.
[exhales] A house? Okay, well, congratulations.
Look at you two, grown-upping.
No, it's a fixer-upper.
Dr. Glassman, I don't like it.
Hmm, did you tell Lea that?
No, she is excited when she talks about the house.
It makes her happy.
And I think she has been sad lately.
Why has she been sad?
I told you, we have to wait to get pregnant
because of her Asherman's syndrome.
Well, maybe Lea is looking for a way to move you two forward.
You think if we buy that house, Lea will be less sad?
I don't know, but buying a house can be exciting.
It's a distraction.
-Distractions can be useful. -No. I do not like distractions.
Shaun. [scoffs softly]
You've been rating residents for quite a while now,
now all of a sudden, you revamp your entire system?
When did you decide to do that?
Mmm, after the sextuplets were born.
Wasn't that around the same time you found out about Lea's Asherman's?
Yes.
We were both very sad.
You think my new system was a distraction?
Yeah, and now maybe Lea needs one.
Oh, excellent idea.
[chuckles] Thank you, Dr. Glassman.
Brought your ride out of here, and your discharge papers.
Pulled some strings, got you a psych consult
at an eating-disorder clinic day after tomorrow.
Thanks, but I'm good.
This hospital stay was the wake-up call I needed.
You don't have to go through this alone.
Discharge party. I brought drinks.
Special potassium powerhouse for my big bro.
So, um, Teddy tells me he has some, like, freak electrolyte deficiency?
Do you know what caused it?
Teddy's got the information.
Do I need to make any adjustments to his diet?
Might be a good time to dial back on the weight-loss goals.
Uh, why?
Simon, uh, let's just go.
Is it dangerous for him to diet now?
For how long?
Um…
I… I… I can't really say.
Simon, forget it.
It's on me to make sure you're okay.
No, it's actually not. It's my life.
Why are you mad at me? I'm being supportive.
Otherwise known as micromanaging everything I do.
You were miserable and a mess, okay? I'm the one getting you healthy.
What am I missing?
Tell him.
It wasn't your workouts that took off the weight.
I've been
purging.
Making myself puke.
Is that what caused your heart thing?
Why would you do something so stupid?
'Cause you're obsessed with me not being a fat embarrassment.
-I never said that. -You didn't have to.
You were so excited when I mentioned losing some weight.
-Because I'm worried about you. -You're ashamed of me.
It's been years since we've hung out, and now every day,
you're all over me to meet you at the gym.
You're killing yourself, but this is my fault?
Get your own ride home. I don't wanna micromanage.
Sim…
Teddy, I am so sorry.
It's fine.
I can uber.
-You sent her flowers from me? -You're welcome.
Have you considered I may not wanna keep seeing Lily?
She's clearly a keeper, and you need a girlfriend.
How is that your business?
Because I need you and I not to make the same mistake all over again.
We've been on the edge of falling back into us.
-You're out of your mind. -Haven't thought about it?
-You read too much into my gestures. -Offering your sperm?
For IVF.
Could the symbolism be any more heavy-handed?
We can't go back.
You made it very clear I'm not what you wanted,
and I haven't changed.
So I need you to move on.
[cell phone buzzes]
-How long? -It's just over a minute.
We pushed two milligram IV lorazepam.
Antibiotics clearly aren't working. Push another two lorazepam.
Why you look like you just watched the first two minutes of Up?
I thought Teddy wasn't gonna get the help he needed for his bulimia.
I thought maybe his meddling brother might make sure he did.
Not a bad plan.
The execution was flawed.
So congratulations on your upcoming blowout victory.
[scoffs]
Help! Someone call the RRT.
I got it.
Teddy.
He's ruptured his esophagus. Page Dr. Murphy and prep an OR.
[Daniel] Chest tube placed.
The lung drainage is orange?
What's left of the smoothie.
Advance the endoscope.
He is fortunate that you responded so quickly, Dr. Perez.
I pushed Teddy to admit his bulimia to his brother.
They fought, and then he did this.
Oh. That was
not helpful.
And there is too much damage for a primary esophageal repair.
We can place an endoscopic stent, wait until edema improves.
It will leak.
-What about using omentum as a patch? -Mmm, the tissue is too friable.
It's usually for kids, but what about gastric transposition?
We could resect the damaged esophagus, reconstruct it using stomach tissue.
Good idea, Dr. Perez.
This will improve your score.
We need to open him up.
The abscess is not responding to the antibiotics.
The infection is seeding to the brain.
We could drill a burr hole, get more aggressive with the drainage.
The same approach will get you the same results.
Thanks for the cliche.
[Dr. Reznick] Bifrontal craniotomy with sinus exenteration.
Remove the skull base, then rebuild it to stop bacterial entry.
I'm not taking off Lily's forehead
and consigning her to years of reconstructive surgeries.
Wanna save her life or her face?
You're accusing me of acting unethically 'cause I've been on dates with her,
after your flowers?
-[gasps] What flowers? -Shut up.
You're letting your medical judgment be clouded
because you don't want to agree with me.
It's the right call for the patient. Disagreeing with you is a bonus.
Get Lily and the OR prepped.
[sighs]
[Shaun] Removing the devitalized segment of the esophagus.
We've got a good plane of healthy tissue.
Dr. Perez.
You may perform the two-layered, inverted, hand-sewn anastomosis.
[sighs]
I had a late night on a research project.
My hands aren't stable enough.
Dr. Powell should take this.
Starting to suture.
I am ready to go home.
I am not,
thanks to Andrews dumping reconfiguring the remote interface in my lap.
It's weeks, if not months, of debugging code.
Well, that was fast.
When I asked Dr. Andrews to assign you a new project, he couldn't think of any.
How is your hand?
Annoyed, along with the rest of me. Why would you do that?
Because you have been sad that we have to wait to have a baby.
Work will be a much better distraction than restoring an old house.
[sighs] That's not a judgment for you to make, Shaun.
I'll pick my own distractions.
[sighs] And I have been sad.
And that house is just a chance to make something broken beautiful again.
So is reconfiguring the remote interface.
The house feels like a step forward.
I can really see us being happy in that home, Shaun.
I just wish you would try to see that too.
Okay.
"Okay, we can make an offer"?
No, I meant, "Okay, I will try."
Thanks.
I'll see you at home later.
[door closes]
Sorry I'm late.
I had an impulse.
NBA 2K.
Prepare to get smoked.
Tip-off will have to wait. I'm buried.
Maybe I could help?
Trouble with a case?
Yeah.
My own.
What's happened?
Glassman found movement in my psoas and glutes.
He and Murphy found an endoscopic solution.
They'll de-tether your spinal cord. That's great.
Is there a problem with the surgical plan?
It's quite elegant. [sighs]
Then what's holding you back?
I feel like we've been living in this bubble, this perfect bubble,
and if I step outside of it, it will pop.
This surgery
would change you…
not us.
What we have isn't going to disappear if you walk again.
You need to believe that.
I want to.
Please, I can't be the reason you say no.
We successfully repaired Teddy's distal esophagus
with reconstructed stomach tissue.
Teddy will be able to eat and swallow normally,
but any further purging will cause irreparable damage.
I thought we were finally close again.
He's been hurting, and I…
I had no idea.
[sniffles]
How do I fix this?
Sometimes trying to fix the problem is the problem.
I went through some tough times too,
and plenty of people had ideas about how to fix me.
See, I didn't… I didn't need that.
I just needed them…
[scoffs] to love me.
Broken or not.
Even though I don't like sanding, and paint is sticky and smells terrible,
and power tools are loud and dangerous,
I am positive that we, mostly you,
can make that fixer-upper into a beautiful home
for us and the family we will have.
Are you saying we should buy the house?
If it will make you happy.
I bulldozed you, didn't I?
Yes.
But I do not mind.
But I do.
I'm being selfish.
-Thank you for letting me. -Hmm.
But the only step forward I need right now is one we make together.
Let's find a place we both love.
That is a good approach.
Also, let's get my hand checked out. It does really hurt.
[Dr. Park] Advancing into the abscess.
Couldn't stay away?
[over intercom] Lily is my patient. I admitted her.
Resecting last bits of capsule from the abscess cavity.
Got it.
Pulling the scope.
[monitor alarm blaring]
Heart rate's 32. BP 210/122.
[Asher] Brain is herniating out of the burr holes.
100 grams mannitol, high-dose propofol.
-Won't be enough. Get CO2 below 30. -I'm aware. Place an EVD.
-[Jordan] Pivot to bifrontal craniotomy? -No time.
Connect the burr holes, run a small craniotomy flap?
No, but a hemicraniectomy will reduce the brain pressure.
Then debride the skull-base infection.
-Good. -Good.
[Asher] Mmm, that was hot.
Doing this surgery is a good decision.
-I hope so. -Doubts?
No. I'm a little nervous, but no doubts.
Thank you both for not giving up.
You're welcome.
We'll see you in recovery.
Welcome back.
You've got a visitor.
You're okay?
Getting there.
No gym for a while. You need time to heal.
I'm on it, Doc.
Remember when we were kids,
you made me watch Alien vs. Predator?
[scoffs softly]
I had to let you sleep in my room for three months.
Turns out the combined Alien/Predator canon includes 13 movies.
You and I are gonna watch them together.
If that's cool with you.
Sounds stupid.
But fun.
Looks like both brothers are on the mend.
Take video. Maybe Murphy will give you some points.
[chuckles softly] I'm good.
What happened in the OR when you handed over the anastomosis?
Just didn't feel like my day.
I devised my first-year resident rating system as a distraction.
It was very complicated and encouraged too much competition.
So I have decided to retire it.
You okay?
Easily the worst date I've ever been on.
Well, the next one, I'll put the rest of your skull back on.
We have to wait until the swelling in your brain has gone down.
Am I gonna be okay?
You've got a long road ahead, but yes.
And you won't be alone.
That's a lot of commitment.
Especially when you and Dr. Reznick don't really seem done.
Thanks for everything…
Dr. Park.
[locker closes]
I'm glad you didn't move on.
From the case.
Glad you listened.
I'm working on it.
Lily will be lucky to have you through her recovery,
unless you decided not to see her anymore.
You were right. She's a keeper.
Then I'm happy for you two.
Visiting hours still open?
[chuckles] They don't usually let visitors into pre-op.
Well, nobody says no to a guy in a wheelchair.
I had to see you.
I recognize this is terrible timing, and kind of bonkers,
but I couldn't let you go in before asking.
Audrey…
[clears throat]
will you marry me?
Definitely bonkers.
I don't expect an answer now.
This?
This is me telling you that I am all in.
Thank you.
That's my cue.
I'll be waiting.
Do I look as silly as this feels?
Miss Dilallo?
We're gonna have to postpone your CT.
[slow indie rock song playing]
♪ Talk to me ♪
♪ She wants to know What's stuffed inside that's tearing me ♪
[knocks on door]
♪ I don't have an answer for you now ♪
♪ Stick around I'll find a reason ♪
♪ Tell me what makes Tell me what makes you sad… ♪
I brought ice cream!
Better let me in before it melts.
♪ I said "Well, it's more than you know…" ♪
Danny?
Danny!
♪ I wouldn't break your heart ♪
♪ If I was you I'd fall apart ♪
♪ Next to this beating, bruising art ♪
No. No, no, no, no, no.
No, no. Danny.
Danny.
♪ You leave me hanging and hoping ♪
♪ Oh, tell me what makes you sad… ♪
[panting] Shaun.
What's wrong?
I'm… I'm pregnant.
My OB told us it isn't safe for me or the baby.
And, um…
And I'm really scared.
Okay.
You told me to imagine what could be.
Yeah.
Let's do that.
Together.
♪ You said, "Tell me what makes Tell me what makes you sad ♪
♪ "Oh, tell me what makes Tell me what makes you sad" ♪
[closing theme music playing] ll me what makes you sad" ♪