When was your last tetanus shot . I dont know. Okay, lets give him. 5 ccs i. M. And lets page ortho. Theres no need. Im right here. Seth, just hang in there, okay . panting all right, whos on call tonight . Maggie. Not charlie . Nope. Maggie. All right, seth, why dont you explain to me stepbystep what exactly happened here . Well, i reached my hand inside. I paid, by the way. When i tried to pull it out, it got stuck. I get it. You gotta put in a sng if you want some bling, right . grunts chuckles what . Come on, i got so many more of those. Okay, lets open up this contraption, see whats going on inside. Youre gonna need a screwdriver, please groans covering call again, charlie . Yeah, you, too . Student loans. I remember those days. North american reptile convention is down at metro hall. Tonights the big party and ill be missing it. You a snake man . Snakes and ladies. You surprise me, jackson. Thanks. I think. pen clicks Corporal Fran seymour, i am dr. Harris. Doc. I hear you were skydiving, made a pretty dramatic landing. I cut away and deployed the second, but it was already too close to the ground. But you landed on your feet. Im like a cat. Tried to walk it off, but, uh, no dice. How does it look . Uh, bones in both of your heels are pretty badly shattered. How long am i on the shelf . Well, the bohlers angles okay, so you wont need surgery, but im gonna need to put casts on both feet so youll be out for a while. Whats a while . Eight weeks. Uh, thattoo slow. Six weeks before i redeploy. scissors snipping to . Afghanistan. Wait a minute. I thought everyone was coming home. This is our final. strains mission, and i aint missin it. groans you ever jump out of a plane . Im more into zumba. chuckles now, corporal, anything else bothering you besides your heels . No, all good. Doesnt pay to be a hero around here, trust me. Some, uh, pins and needles in my legs. No big deal. Sure itll go away. chuckles a little. Its a bit numb. Okay. Flex your feet for me, please. Toes to the ceiling. exhales sharply siren wails in distance okay. grunts im gonna have jkson take you up for a c. T. I want to make sure you dont have any spil fractures. pen clicks dont worry, its strictly precautionary. chuckles im not worried. I got nine lives. And you can, uh, you can tell your buddy to come in, if youd like. What buddy . Uh. My mistake. Youre almost there, pal. The good news is youll have more condoms than you know what to do with. chuckles just trying to see the silver lining, but im genuinely embarrassed here. And we got it. All right. clattering ready . You okay, whoa clattering all right. I got em. Okay, lets get those on ice, please. Seth, look at me. Look at me. Try to take deep, slow breaths. grunts and breathes heavily if you have moderate to severe plaque psoriasis. Isnt it time to let the real you shine through . Introducing otezla, apremilast. Otezla is not an injection, or a cream. Its a pill that tats plaque psoriasis differently. Some people who took otezla saw 75 clearer skin after 4 months. And otezlas prescribing information has no requirement for routine lab monitoring. Dont take otezla if you are allergic to any of its ingredients. Tell your doctor if you have a history of depression or suicidal thoughts, or if these feelings develop. Some people taking otezla reported weight loss. Your doctor should monitor your weight and may stop treatment. Side effects may include diarrhea, nausea, upper respiratory tract infection, and headache. Tell your doctor aboutll the medicines you take, and if youre pregnant or planning to be. Ask your dermatologist about otezla today. Mornings. Theyre bad breath, bad hair and a bad case of the mondays. And organized wardrobes that help you pull it together. Theyre showering, shaving, and shuffling. And bathrooms that get big families out the door. Theyre number ones, number twos, and a number of ideas for three. Lifes morning madness. And comfortable, organized bed and bathrooms cell phone rings where are you . Well the squirrels are back in the attic. Mom . Your dad wont call an exterminator. Can i call you back, mom . He says its personal this time. If youre a mom, you call at the worst time. Its what you do. If you want to save fifteen percent or more on car insurance, you switch to geico. Its what you do. Where are you . Its very loud there. Are you taking a zumba class . baseball on tv in background with Heart Failure, danger is always on the rise. Symptoms worsen because your heart isnt pumping well. water filling room about 50 percent of people die dog whimping but theres something you can do. Talk to your doctor about Heart Failure treatment options. Because the more you know, the more likely you are. dog whimpering to keep it pumping. Jane likes to mix things up. Thats why she loves new light fit greek nonfat yogurt mousse. So fluffy and airy its her new 80 calorie obsession. Light fit feel free to enjoy. So i will be doing your finger replant, seth. Fingers, plural. Yeah, look, its a long surgery, too. So we dont want to wait around in case ischemia sets in and then you lose your fingers. Okay. I appreciate your haste. Absolutely. Look, the nurse will be by to prep you soon. And, uh, in the meantime, just. Sit tight. Sit tight, okay . Alex. Yes. Id like to explain dont worry. Joel is an amazing surgeon. indistinct conversations sonja. Hey. Hi. Seth is fine. Were managing his pain, and joel is prepping to do his finger replantation. Wait, so youyou can sew the fingers back on . Yes, we should be able to. Okay. God, i just i feel like this is all my fault. Its not. I know, but still. Andand and i really have to go and relieve my babysitter. Its nobodys fault. And hes got joel. Right. Yeah. And, i mean, joel, he he saved my life once. He that good. Yeah. And. chuckles seth, he really isi mean, hes justhes genuinely a really sweet guy. Im sure he is. Im just. Im not dating right now. Yeah, totally. Okay. No more cupid. Joel and i are just friends. Thanks, alex. Oh, alex. Tell me all. Has word already sead . We live in a viral age. Once a secret gets out, its uncontainable. sighs youre the one who made me come up with the breakup plan. Oh, dont blame the plan. The plan is solid. You said, get out of the house. I did that, and look what happened. Did he really lose Three Fingers in a condom machine . Yes. So you two were gonna get busy . No, we were not going to get busy. He was sprung on me a surprise double date. Just really, really dont want charlie to hear about it. chuckles honey, welcome to the weird and awkward world. cell phone buzzing of postbreakup. Not lovin it. Dr. Reid. So i was doing some figuring, and your board exams are this march. Yeah, and ill be dr. Margaret lin. M. D. F. R. C. S. C, and ill expect a little respect, mister. And the baby will already be born. Yeah. Hows that gonna work . That exam takes a full day. The baby will stay in a sling, and ill breast feed on demand. Not even gonna respond to that. Thats crazy. Well, well figure something out. sighs is that decaf . No, its coffee. slurps you could at least try it. Or at least halfcaf. It tastes the same. No, it doesnt. The baby shouldnt be all hopped up on caffeine. Im not suddenly a different person, gavin. tone sounds sorry. No, i know youre not. Im just pregnant. Yeah, shes pregnant. Okay, i, uh. chuckles i heard that. Well. Were not telling people, though. Its just. Really, were just early on. Okay. Thats good. Well. Big ups, bro. Well. chuckles chuckles thats good. Your boys can swim. whispers yeah. baby crying in distance curtain rings swoosh seth. Yeah, and in my back. Okay. grunts im happy i get a chance to explain. You dont have to, really. I do. The whole condom thing im just gonna palpate your abdomen okay. Okay. machinery beeps grunts ow. I did not assume that i needed a condom. I justi thought you were amazing. You are amazing. strained voice and youre a doctor. And i just thought if we. You know, id feel irresponsible if i wasnt prepared. cause youre a doctor. exhales deeply and the whole safe sex thing. If thats even something that people talk about still. I understand, seth. Just try to relax, if you can, okay . grunts okay. I dont get out there much you know, dating . I think i just got ahead of myself. Mmhmm. You know. Ow okay, the pain is the most intense there, right . sobbing yeah. Or where they used to be. Seth . Im feeling a pulsating mass. Im guessing thats not the good kind. Can i get some help in here . Uhh. Im going to get you a c. T. continues sobbi give him bolus. Fran, you do have a small spinal fracture from your skydiving accident. No. Really . Yeah. I can fix it, but we need to do it right away. Whats the Recovery Time on that . Three months. I got six weeks. So lets get this done. Uh, theres Something Else i need to discuss with you. This showed up on your c. T. What am i looking at . Uh, it would appear to be shrapnel. Shrapnel . Reporting for duty, sir. Um. Id like to have a look at your back, if i could. Yeah. These scars looks like you were in okay. Well, ill have a look at it when io in to repair the fracture. If its impinging on the spine, i will remove it. If its not causing any trouble, generally, we just leave shrapnel where it is. Do what you gotta do. Okay. blinds clattering okay, what do yowant . Reporting for duty, sir. Yeah, i got that. Um, whats your name . I dont know, sir. It says there, mccreary. So it does, sir. sighs your bodys in the morgue . Sir . What are you doing here, private . Just sticking with my unit. Okay. Um, heres what were gonna do. Youre gonna figure out what it is you need from me, yes, sir. Okay. At ease. door opens coughs and sniffles ugh sighs does sleeping in the nude give you a cold . Mm, not that alone, no. Im seeing this guy, and hes really into sleeping all night with nothing on. Enjoy your nudity, fella. Im just gonna freeze over here. I guess i just like him, though. Yeah, thats how it all starts. Yeah. But i do like him. Mmhmm. Of course you do. We all do. Until finally one day were like, you know what . Youre not the boss of me. Maybe youre right. I dont know, though. chuckles instrument clatters i came in a couple weeks ago, and you sent me home and told me to get cold and flu medicine. I saw you a couple weeks ago . Yeah, i thought i had meningitis or something, but you couldnt see anything. I remember you now. Dr. Lin . Yeah . Can i talk to you for a moment . Whats up . Ive got jennys blood work. It came. Back positive for c. M. V. Okay, ill tell her. Okay, but wait. It says on her chart that you saw her a couple weeks ago and she was asymptomatic. Yeah, but shell be fine. Its a flu virus. I mean, unless shes pregnant. Theres a risk that it could cross the placental barrier. Yeah. Yeah. You better get tested. Mmhmm. Hi. Hi. Um, somethings come up did you forget to take your prenatal iron . No, i didnt cause i could write a scrip for you if you need some. That wont be necessary. And just so you know, i, uh, also took my folic acid, so. Dont worry. Maggie. Mmhmm. Seth, the results of the c. T. Angiogram are back. You have a leaking aortic aneurysm. Is that bad . That sounds bad. Its worse than losing Three Fingers. Your aorta is a big, very important blood vessel that carries blood from the heart to your organs. So the fingers are gonna have to wait. No, they cant wait. Life over limb, joel. We have to go in now and together. Both surgeries at the same time . Yes, sir. sighs wheels clacking look, i cant risk those fingers becoming garbage waiting for you to be done. Fine. Stay out of my way. Triple a is a time bomb. wheels clacking i bet this isnt what you had in mind when sonja said, come meet this guy. She didnt say that. Oh. Sorry. Thats the worst. But i think we can turn this around. sighs machinery beeps turns faucet on, both scrubbing hands hey, i apologize, by the way. Honestly, i had no idea that sonja was gonna be bringi a friend. So you and sonja are back together again then . Well, were trying. You know, its complicated. sighs we have a problem. turns faucet off, water gurgles another problem . Ii cant put him under. Hes too highrisk. What more can happen to this guy . His mallampati score is 4. He has a malformed airway. Its like a fusilli in there. And he has a heart murmur. I wont be able to intubate. Okay, well, i have to get at the aneurysm. Its not an option. Can we try a high thoracic spinal . Ive done it before. It means hell be awake and aware of everything were doing during surgery. I try hard to get a great shape. This. I can doasily. Benefiber healthy shape helps curb cravings. Its a clear, tastefree daily supplement. Thats clinically proven to help keep me fuller longer. Benefiber healthy shape. This, i can do. Meet the piadina the newest addition to Olive Gardens lunch duos menu paired with your choice of unlimited soup or salad starting at just 6. 99 think of it as a quesadilla thatspeaks fluent italian olive garden my school reunion. Dunno. Who wants to play in idaho . You think that reno jobs on track . My nana moved to hackensack. Dude, bachelor party, yes or no . Please . Weve got to find some more of these. They just replaced my uncles knees. Gotta get milwaukee up to speed. Well close the deal if we just show. What are you waiting for . Book at choicehotels. Com for your next stay. Its the only way to earninstant rewards and free nights. Book now at choicehotels. Com for savings up to 20 . Why have your glasses fit manually, when theres the Lenscrafters Accufit sysm. Replacing basic handheld measuring tools with a digital system thats five times more precise. Eat up, buddy. Youll get it this time. Ye i got you. Start strong with the Lasting Energy of 100 youre doing it whole grain quaker oats. And off you go. I want my couch back. I love that couch. The other thing. An awake surgery. Its experimenl. Dr. Baumanns done it before. Once. Epidurals on pregnant women dont count. How am i supposed to make an 8inch incision in his abdomen, suck out the aneurysm, and then sew a goretex tube in without anesthetic . I would have said yes when i was chief. Just saying. Joel, i have been interim chief of surgery for exactly two days. Why dont you lob me a pitch that i can hit . Youre chief because you can hit any pitch, dawn. siren wailing in distance you were never here. sighs so . Corporal seymour hi, im dr. Murphy. Hi. Uh, are you taking me to the operating room . Wheres dr. Harris . Dr. Harris has asked me to come and have a quick chat with you before your operation. Can i sit down . Youre a psychiatrist. I am. You got a form there . I do, yes. Do you want me to put it away . It doesnt matter. Youre still gonna fill it out and file it with my commanding officer. Dr. Harris tells me that youre worried about the length of the Recovery Time with your spinal surgery . Im military. I want to go back to my job. Is there something wrong with that . Might be useful to wt a lilett, get well and then go back. Im way more useful there than here. It says in your chart that you have a lot of scars consistent with penetrating wounds shrapnel . Lien. If i tell you about the crap ive seen in combat, on that form you got, and i wont redeploy ever. Do you think you have unresolved issues . You cant trick me into talking. Um. clears throat youve been home for almost a year . Yeah, not my choice. And you find yourself drawn to dangerous activities . Extremeslike skydiving . Gotta stay alert. Stay strong. Gotta stay combat ready. Okay. Well, the key to resolving traumatizing events is remembering them and telling your story over and over. Theyre better out than in. If you knew what my unresolved issue was, you wouldnt ask me to relive it. You can see yourself out now. sighs hey. Hey. Just spoke with your patient fran. And . P. T. S. D. . Eh, i think shes having trouble with one specific event, something she says is too painful to talk about. Yeah, shes a tough cookie. Until she starts to externalize the event that has traumatized her, its gonna remain internal, and shes gonna keep jumping out of planes, nearly killing herself. Okay, well, i can patch her up. But what do we do about her mental state . Hard to say. I mean, theres almost always a key to unlocking a trauma. Just have to keep listening. Thanks. Sorry to bother you so late at night. Oh, im fine. Ill be doing rounds all night. The nursing staff tends to thin out after midnight. Can we get the results tonight . Well, i am the new guy, but ill do my best to sweet talk to the lab into putting a rush on it. Right. Great. You got it . Yeah. instrument clatrs that you contracted a virus from your patient. Whoohoo. But if you do test positive for c. M. V. , theres a chance that your baby will have hearing and vision loss, Heart Failure, seizures, brain damage. Yeah, i know. All right, lets not get ahead of ourselves. But if you do test positive and we see any of the things on the ultrasound, then we can discuss the next steps. Terminating the pregnancy . That would be part of the conversation at that time. But t now, of course. Of course. Cool. Cool monitor beeping steadily alex you feel this . seth dont feel a thing. How about this . Nothing. This . Ooh, a little to the left. I just might rub a little ice on his feet. Hey. Not really into that. Thats not what ive heard, mate. You dont want to know what ive heard out you. Which is nothing, cause youre about to reattach my fingers and i dont want to alienate you. Smart man. Wow. No. But its really tough to find hockey gloves that fit. Have suction ready. Hey. Am i rlly not gonna feel anything . If you do, let me know. Okay . Okay. Awake surgery, here we go. Here we go. sighs deeply just let me know when you start. Oh, here comes nancy. Wow, shes sure making a splash in that designer dress and with a thicker, more fabulous formula, shes not splashing. You can wear anything and ur bleach. And her whiter whites, just dazzling. Clorox splashless bleach. Also try new crystals and packs. Your body was made for Better Things than rheumatoid arthritis. Before you and your rheumatologist move to a biologic, ask if xeljanz is right for you. Xeljanz is a small pill for adults with moderate to severe ra for whom methotrexate did not work well. Xeljanz can reduce joint pain and swelling in as little as two weeks, and help stop further joint damage. Xeljanz can lower your ability to fight infections, including tuberculosis. Serious, sometimes fatal infections, lymphoma, and other cancers have happened. Dont start xeljanz if you have an infection. Tears in the stomach or intestines, low blood cell counts, and higher liver tests and cholesterol levels have happened. Your doctor should perform blood tests and monitor certain liver tests. Tell your doctor if you were in a region where fungal infections are common, and if you have had tb, hepatitis b or c, or are prone to infections. Xeljanz can reduce the mptoms of ra, even without methotrexate. Ask your rheumatologist about xeljanz. Ah, a classic case of who dunnit . Luckily, jay chews trident to help clean and protect his teeth, so he can claim his innocence with a conncing grin. Thats it jay, theyll never know. Triden cherish your teeth. Dad, you can just drop me off right here. Oh no, ill take you up to the front of the school. Thats where your friends are. Seriously, its, its really fine. You dont want to be seen with your dad . No, its. No. Oh, theres tracy. What [ horn honking ] [ forward collision warning ] bye dad it brakes when you dont. The newly redesigned volkswagen passat. Right now you can get a 1,000 president s day bonus on new 25 or 2016 i am getting ready to slice into your aneurysm, seth. Cool. I guess this is what its like to have your hands inside some guys guts, huh . Yep. Suction. suction gurgling sing it again, victor. sighs rink man, rink man all you needs a. falsetto hose laughs hes famous. Stop. Please. Its so embarrassing. Its literally the most embarrassing thing ive ever done, and i just got my fingers caught in a condom machine. What do you mean its embarrassing . drill whirring i love that jingle. I sing it in the car every day. victor who actually buys an ice rink kit . Parents with kids, mostly. Yeah. I played a lot of junior b when i was young. So. You know. Gotta do what you love. Amen, rink man. Yeah, ive had a lot of offers to sell, but i just cant bring myself to do it. Free agencys not for me, just so you know. Im more of a oneteam kind of guy okay, lets bring the carm in here, please. machinery beeps oop. Stick shot. whirs and beeps okay, im done with the kwire. Lets get the carm out of here, and i will start the a. V. N. Can we get the microscope in here . And some 8. 0, please. Thank you. Hey, watch your step. Give me some room. L right, sorry. Victor, p. T. F. E. Graft, 3. 0 prolene. I am going to suture distally first. Okay, i am getting ready to put the graft in. Are you comfortable . Oh, yeah. Is that thing going inside of me . Seth, im suturing with thread thats finer than human hair. I cant have any movement, okay . Sorry. Its just that. Crazy tube thing. I think seth could use a little more sedation. Itsits all just starting to. To hit me. The whole thing, you know . Seth, you are doing great. Ii dont really think i am dng great, guys. joel just stay with us, rink man. inhales deeply okay, ill do my best. You know, alex reid was once a cheerleader. lghs i was not a cheerleader. You still have your costume . Its under my scrubs. Hey. Maggie go home . No, i dont think so. Shes on call in the e. R. Tonight. Is she still up in obstetrics . She was in obstetrics . Yeah, for the blood test. Can you get her to text me when you see her . Okay or better yet, just tell her i need her in the e. R. Stat. Thank you. Wait. What blood test . suction gurgling okay. Before we put the rod in, i wanna get a closer look. At this. Shahir, what does that look like to you . With the rest of the spine. Right, which rules out an osteosarcoma. Give it a feel. machinery beeps squishing well, its not only soft tissue. Its ossified, charlie. It feels a lot like like bone . Yes, very much, but its not part of the spine. So who does it belong to . Well, thats my question exactly. Scalpel, please. Its a real mystery. Reporting for duty, sir. woman dr. Harris . Thank you. Pickups, please. Lets give it a little wash. Charlie. clink, water splashing its definitelnot her bone. How can you tell just by looking at it . Head hurts. I bet your career on it. Sir, i dont want to be discharged, sir. I dont bet. Oh, although i do enjoy a bit of game theory. Uh, loupes, please. instrument clatters thank you. Yeah, it looks like a small wormian fissure. Let me see that. Loupes, please. Thank you. It has four bones, like tectonic plates that have shifted together when the fontanel fuses. Youre right, charlie. This is a piece of someone elses skull. Then its a good thing you dont bet. Oh, please, sir. Let me stay with my unit. Shahir, hows your latin . Excellent. Wanna bet on it . Mm. No. Um. machinery beeps fidus ultra finem. Fyohel bend t end. Why . Oh, nono reason. Just curious. Mm. Latin was an easy a for me in high school. I cant leave her. She needs help. Shahir, i want to put the bone back. Charlie, we just took it out. No, no. Ii wanna do an allograft. Well mulch the bone and use it to stabilize the rod instead of using bone cement. Id much rather graft a piece of her own bone. Wwhy cut her up more than we have to . Her own body didnt reject the skull. So why should we . Its highly unorthodox. It is, but itll work. Just trust me. Start mulching