Saving Hope

The leiomyoma is on the wall of your bowel,

and since it's small, I will remove it laparoscopically.

We take pains to be clear with our patients...

what we're going to do, what might go wrong...

all to explain why we're touching them.

We spend our days touching people.

And we'll also have to remove a small segment of your jejunum,

and then I will staple the ends together,

but that is normal for this procedure.

- Normal? - (Alex) Yes.

Mom, please don't harass Dr. Reid.

I'm not harassing her. I just want to know

everything there is to know about your surgery.

I'm so sorry, Dr. Reid.

Totally fine. Now is the time to ask me anything.

Whoa. (chuckles) Wrong thing to say.

Sandhya keeps saying that she's got a tumor

but that it's not cancer.

Now is this true, or is she just saying that so I won't worry?

Leiomyomas are rarely cancerous, but after we remove the tumor,

we will examine it under a microscope and make 100% sure.

Well, we've planned a pre-wedding celebration

for Sandhya, a puja,

but it's next weekend, and I'm worried that

she won't be healed from the surgery by then.

Well, since we are going in laparoscopically,

she will be able to go home by the end of the day.

Sandhya Ahuja?

Yeah.

This is Victor.

He'll prep you for your surgery,

and then I'll see you in there.

Okay. (sighs)

Come with me. Right through here.

How are you doing today?

As soon as I'm finished, I'll come and talk to you.

- Thank you. - Thanks.

She's gonna be fine, mom. She'll be fine.

Hi. What's up?

Hey, I was looking for you.

I'm booked solid, back-to-back surgeries,

and I need a favor.

- Another favor. - Shoot.

I am bringing in a masseuse today to see Charlie.

Ooh, a masseuse.

Her name's Ashley.

Ooh. Ashley. (chuckles)

I know. Sounds like a blonde.

With a D-cup and braces.

Charlie wishes.

Anyway, the reason I'm bringing her in is

because she works with coma patients.

Don't judge.

No. Every little bit helps.

So do you mind keeping an eye out for her

and buzz me when she gets here?

- Sure. - Great.

Here comes trouble.

Dawn.

Alex, hi.

- Hi. - Hi.

Uh, I'm sorry for just dropping in.

I'm here for a new vascular methodology conference.

Oh. Well, do you want to see Charlie?

Is that okay?

Of course. He'd be happy you were here.

(indistinct conversations, telephone rings in distance)

So how are you feeling?

Feeling like crap is how I'm feeling.

Almost passed out on the way down here.

You been drinking?

It's 10:00 in the morning.

Taking drugs.

No.

I am not taking any drugs.

Oh. All right.

Well, we'll get a nurse down here.

She'll take your temperature and blood pressure.

I'm sure it's just the flu.

It's not the flu.

These are infected!

What are your horns made of?

Silicone implants.

They'll be harder and twice as long when I'm done.

I bet you say that to all the gals.

Do you mind if I touch them?

No.

Look, I know what's wrong,

so could you just give me some antibiotics,

and I'll get out of here?

Actually, I think you may need more than antibiotics.

Just wait here, okay?

Okay.

He's not better.

He's not worse.

No, you're not understanding me. He's not getting better.

Alex, don't react. Just take a deep breath.

What do you want me to say? I come in here every morning,

hoping today's the day he wakes up.

- He had pneumonia? - Yes, and he beat it.

Is this the lost soul?

The man I'm here to work my magic on?

To, uh...

bring back from the brink?

This guy's not touching me. D-don't let that happen.

You're Ashley?

You were expecting a lady.

That's a common mistake.

Ashley.

What's the guitar for?

Well, music is freedom.

Okay, okay. We're just in the middle of something.

Could you just give us a couple of minutes?

Oh. My time is your money.

Thank you.

Coma arousal therapy.

You're the one that suggested it.

Where did you find him, clown school?

Well, he was highly recommended.

You know what? I don't know why I'm explaining myself to you.

You're not the one here every day.

Exactly. I have perspective,

and what I see... and I am not attacking you...

what I see is that Charlie is not waking up.

He will.

I have to get back to my conference.

It was nice seeing you, Alex.

Don't doubt yourself. You know me better than anyone.

I'm right...

here.

We're giving you some medication, Sandhya.

It'll make you very sleepy.

Okay.

And this is just oxygen.

Wow. (chuckles) Wow.

- Hey, Dr. Reid? - Mm-hmm?

Are you married?

I'm engaged, actually.

- Me, too. - I heard. Congratulations.

Yeah. Sanjay.

He looks like Hrithik Roshan.

Bollywood star. Gorgeous.

Sandhya, can you count down from ten for me, please?

Uh... ten... mm...

She's out. Sevoflurane.

Done.

Okay.

Let's take this girl's tumor out,

get her the temple on time.

Bowel looks good.

Tissue's clean.

No sign of any other tumor.

We'll have eyes on this in just a sec here.

Status?

- Blood pressure rising. - Body temp?

Rising as well. 103.

C.O.2 65. Blood pressure 150/100.

We need to hyperventilate. I'm removing the ports.

Turning her off the gas. Giving her 100% oxygen. (beep)

Put her on a propofol drip.

Temp?

Still rising. 104.

- We need to bring it down. - Peak "T" wave on the E.C.G.

Too much potassium. It's malignant hyperthermia.

Get me the M.H. kit.

She needs dantrolene, cooling blankets.

Suture gun now. (beep)

Okay. Patient's convulsing. We've got an emergency.

- Everybody, move now. - Yep.

Got it? She needs the dantrolene.

We've got to get her temp down or she's gonna arrest.

Bolus her with cool saline.

She's on fire. Come on, Sandhya.

What's happening with my M.H. kit?!

- I've gotta mix it, doctor. I'm on it. - Can't you go any faster?!

No. Shut up so we can concentrate. Ohh.

What's going on?

An adverse reaction to the anesthetic.

It wasn't in her file.

We have dantrolene going through her system,

but we need the temperature to go down.

Is it?

Uh... temp falling. 102.9.

It's gotta drop faster.

Come on. Come on. Come on!

Temp 102.8. 102.7.

- Good. C.O.2? - 50 and dropping.

"T" waves are normalizing.

Pupil activity. Come on, come on, come on.

We got it.

That's great news, if you didn't cook her brain.

She only had local anesthetics in her history, no general.

No family history of malignant hyperthermia.

Why'd it take so long to get her on the dantrolene?

We moved as fast as we could.

Yeah, so why isn't she waking up?

Get her up to the I.C.U. Have Shahir take a look.

What do we tell her family?

We tell them what we know, that she had a reaction

to the anesthetic. She's unconscious.