ly. i think you should find out the whole story. 125-- they've encountered some moderate to severe chop, which we do not want to have for this family. so i think we'll climb to about 35 and just cruise from there. awfully far from those hepa-filtered hallways of yours. well, my patients don't usually leave before i'm done. i'm not your patient. that's right, you're a pilot. so let me guess, family vacation? you're in the way of my preflight. oh, by all means. plane looks great, it's the pilot who's not airworthy. screw you. me? wow. you stroke out at 30,000 feet, they're the ones who are screwed. nothing is going to happen. you'd bet their lives on that? i have a copilot, and i'm fine. well, your left hand thinks differently. come with me right now to holt neuro, or i call the faa.

you're not gonna do that. michael. two years ago, i flew my best friend rachel and her family to puerto vallarta. surprise birthday present. hi. safety officer collum, please. we were sitting on the beach, i noticed her foot twitching. she said she would go to the doctor. it was brain cancer. glioblastoma. i'd never even heard of the word before. the doctors kept trying to take it out, but it just kept coming back. until she died eight months later. her husband and two adorable little girls watched her slip away. carol, you don't know if you have cancer and neither do i. your tremor could be something or it could be nothing. but we have to find out.

(sighs softly) how long will this take? michael: about 45 minutes. lie still and don't talk. we don't want to do this twice. i don't want to do it at all. just close your eyes and relax. imagine yourself at 35,000 feet, soaring through a cloudless sky. (machine chugging, humming) your mri shows two lesions in your brain. it's a glioblastoma, isn't it? actually, that's the one thing that it isn't. multiple lesions usually mean that cancer has metastasized from somewhere else in your body. but we scanned your entire body and didn't find anything. then what is it? i'm not exactly sure. you're the best in the business, this place has every possible machine,

every expert, you even bragged to me about it. how could you not know? well, because there are a number of conditions that can cause brain lesions. some of them are infectious. other than my hands, i feel fine. well, then you'll fly right through surgery. you want to cut my head open? it's the only way to determine what those lesions are. this one right here on your primary motor cortex is what's causing the tremor. if i don't remove it, your arm could be permanently paralyzed. (sighs softly) i've had engines die during takeoff, i've landed in storms, 70-mile-an-hour crosswinds, i've even skidded off a runway in beijing. but you've never been as scared as you are right now. 'cause you think you'll never fly again. carol, i'm gonna make sure that you do. (sighs) when do you want to operate? first thing tomorrow morning.

hey, rita, i'm going home. so just forward me carol gordon's images and blood work so i can review them tonight, okay? thanks. thanks, rich. (keys clink) need to go right. i need to go that way. what's going on? you got to go straight. un general assembly's in session. oh, man, i got to get to the bridge. the bridge is all jammed up. you're gonna have to go downtown. (hip-hop music playing, dogs barking)

(cell phone ringing) dr. holt. (over phone): michael, howard eastman. howard, what's up? haven't seen you at the club in a while. ah, i know. hope you're not trying to get me out there. i don't have much time now for golf. it's about that guy with the arrhythmia, rafe douglas. yeah. he never called. ah, damn it. you know... (car horn honks) whoa. (tires screech) howard, i'll call you back. hey, buddy. hey. is this your ball? nope. no. (chuckles): no. no, no, no, no, no, anna. rafe is not my patient, not my patient.

tell you what. i make this shot, i call. i miss, i go home. i'm never making this shot. tavo, michael holt. yeah, i just, i need a number of one of your patients. (cell phone buzzing, tv playing sports) hello. ms. douglas, hi. it's dr. holt. i treated your husband at clinica sanando. (whispers): it's that doctor. (whispers): no. no. i'm sorry, uh, rafe's not home right now. well, has he had any chest pains, weakness, dizziness, passing out? no. rafe is feeling better.

he, uh, went to the store. okay. thank you very much. happy now, anna? it's 4g, so you can do more faster. so, kathryn, post more youtube videos of your baby acting adorable. baby. on it. matt, ignore me and keep updating your fantasy team. huh? jeff, play a game. turbo-boosting now, sir. dennis, check in everywhere you go on foursquare. that's mayor dennis... of the water cooler. you're the best. liz, rock out to pandora. oh, no i'm an only child. and nick, you shouldn't even be here, you can do everything from the golf course. good? good. [ male announcer ] on at&t, blackberry® torch moves at the speed of 4g. ♪

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,,,,,,,,,, carol, hi. i'm dr. lantz. i'll be the anesthesiologist for your surgery. do me a favor, put me way, way under. (chuckles) there is nothing to be nervous about. say that when they're operating on your brain. (chuckles) so, ever have any problems during surgery with anesthesia? i have never had surgery before. any allergies? only allergic to that real housewives show. (chuckles) you're all set. give us a couple of minutes, we'll get started. dr. lantz. can i ask you a question? fine, i'll give you my phone number. it's about michael. is he as good as he says he is? as everyone says he is? honestly? no, he's not. he's better. trust me, if you need your head cut open, you want to be in the hands of michael holt.

i'll excise the cyst on the primary motor cortex first. that's a piece of cake. second one is no picnic though. it's right next to broca's. on top of the frontal operculum. yeah. go even a millimeter too deep, she loses speech. only one way to make sure i don't. brain mapping. she'll have to be awake. tell lantz to wake her up. (monitor beeping rhythmically) bax: carol, i'm gonna show you some images. i want you to identify them. on top of cutting my head open, you're giving me a pop quiz? you'll do fine. so, michael, do i have a nice brain? most beautiful i've ever seen. i bet you say that to all the girls. but i mean it with you. no speech arrests, so let's start dissecting. no speech what? the fact that you're speaking

means i'm in a safe place. that's a relief. bax: all right, carol, tell me what you see. a cat. good. okay, i'm down to the first mass. suction. carol, what do you see now? a helicopter. right again. carol: michael, do i want to know what you found? definitely. doesn't look like cancer. thank god. then what is it? carol, focus on the pictures. now you sound like bax. (bax laughs) what is it? it looks like... neurocysticercosis. what is that? a kind of larva. what?! relax. they're not alive. and besides, you'd rather have this than cancer. eat any bad pork lately? pork? that's how our little worm friend got in.

uh, back in january. i had a layover in ecuador. got really sick. well, you're about to get better... now. bax: hey, your hand stopped shaking. (carol gasps) does that mean i can fly again? first things first... bax, i'm moving on to the other lesion. bax: all right. carol, take a look at the screen. tell me what you see. the heels are my length, but i wouldn't be caught dead in those horr... (slurring words) (machine beeps) michael, you hit her speech center. i'm nowhere near broca's. her speech should be intact. (slurring) then what the hell's going on? she's lost consciousness. pulse is crashing. bp's rising. cushing's reflex! the cyst ruptured spontaneously. fluid's leaking onto her brain; that's why she can't speak. lantz: pressure's 170! she's having an allergic reaction to the cyst fluid. her brain's herniating through the craniotomy. we need to raise the head of the bed and hyperventilate.

heart rate's still dropping. put her on a mannitol drip to lower the swelling, and nitroprusside to get her bp down. lantz: bax, bag her while i do it. come on, let's go! all right. done. irrigation and suction. lantz: she's stabilizing. bp's going down, heart rate's coming up. great work. swelling's going down. did you stop it in time? i hope so. we'll know if she wakes up. (monitor beeping rhythmically) her cyst didn't burst because of you. you had no way of knowing it would. i still should've removed that one first. bax: it could have sprung a leak when she was in the air. you saved lives by getting her here. yeah, i hope hers is one of them. (knocking) michael, i just got a call from clinica sanando. dr. zeke? not now, rita. he said it was important-- about rafe douglas. what about him?

he's on his way to the clinic with neuro symptoms. severely disoriented. that arrhythmia could have thrown a clot and caused a stroke. i gotta run. i'll have your car brought up. there no time. just have someone drop it off at the clinic. where's the big dipper? over there! trevor is a space wiz and he's battling a brain tumor. he came to st. jude children's research hospital where our pioneering research helps save kids, with brain tumors across america. how many stars are there? oh, that's easy... one... two... three... get outta here. give thanks for the healthy kids in your life and give to those who are not. go to st. jude.org or shop wherever you see our magnifying glass. 5,000,001... 5,000,002...

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,,,,,,,,,,,, (panting) what's happening? he came in like this. lungs are clear, heartbeat's faint. give me your stethoscope. looks like his neck veins are dilated, too. he didn't present with that when he came in the other day. pressure's dropping-- 80/40. what the hell is going on? distended neck veins, distant heartbeat, all the hiccupping... he's got a sac full of blood around his heart, it stopped it from beating. cardiac tamponade. pressure's down to 60/30. call for an ambulance. we gotta drain that blood. yeah. i can't crack his chest here. you're the surgeon. not a cardiac surgeon. i'll do a pericardiocentesis. grab me a spinal needle. spinal needle. he must have bruised his heart when he landed from that dunk. cardiologist would've seen it, if rafe decided to show up. we don't have a spinal needle in here. just get me any needle i can put through his sternum. pressure's down to 50. now get me an ultrasound so i can see where i gotta harpoon this guy. we don't have an ultrasound. oh, come on. i gotta go in blind?

what kind of a place is this? the one that we got. here you go. fine, fine, fine. i'll use landmarks. left clavicle... sub-xiphoid... go in at a 45 degree angle... get it right. don't want to drop a lung. (gasping) there we go. easy, easy. damn it, i'm not getting any blood. pressure's 40. yep. there we go. there it is. yep. i got it. there we go. pulse getting stronger. rhythm's regular, pressure's up to 80. dr. michael holt, baby, in the house! way to go! this isn't my house. is my dad okay? he will be if he gets to an or.

of course you're here. no, michael, wait. i should've never let you drag me into this place. i could never drag you anywhere. what is this, anna? what is what? you-you-you come back from the dead. you get me all tangled up with these patients. you make me go after carol, now she's in a coma. well, would you rather have turned her in? i'd have rather gone straight home last night, but instead, you made me take a detour to rafe's basketball court. what was that? then the ball just mysteriously comes out of nowhere, hits my windshield? and then all of a sudden, yeah, i gotta take a shot. just to call him! i didn't do any of that. well, none of that ever would have happened, until you died. you're scared. i am pissed off. no. you're scared. you've built a beautiful wall around your life, and you filled it with people who are at your beck and call, with your hi-tech toys. i didn't have what i needed in there. did you save him? you don't like being out of your comfort zone

any more than i like being dead. or whatever you are. michael! where do you want to send him? manhattan memorial. listen... i'm going to send you to the best cardiac surgeon i know. you need to go to surgery right now. i can't afford it. you can't afford not to. for your wife and your son and all those kids who count on you. all right? even if it means you pay 20 bucks a week. mrs. douglas: rafe, we'll find a way. thanks for talking to me, man. michael! i've been trying to reach you. about what? i talked to kate sykora-- she said you blew her off. yeah, after you forced her on me. forced her? i only want what's best for this place. i thought you did, too. dr. holt. thank you.

yeah, thank you. you're welcome. ah... what? what else? what did he say? who, rafe's son? he thanked me. no, i mean philip. he asked if i found your replacement. why would he ask you that? because i volunteered to do it. stupidly. that's not stupid, that's sweet. maybe you liked philip breathing down your neck, but i can live without it. you're not angry about philip, you're angry about being here. when it comes to complex brain surgery, no one can touch you, but if a patient needs just a little bit more than medical care... it's not my job. i'm not like you, anna. i'm not the one to take care of your patients. did you find someone? no. i offered it to someone, he turned it down. philip had somebody, but she was the wrong type. are you sure?

so now you're gonna second-guess me? philip may be a lot of things... but he has good taste in women. (sighs) (knocking on door) dr. holt. dr. sykora. i'm sorry to bother you at home, but, um... you weren't returning my calls. and i don't blame you. what can i do for you? accept my apology for acting like a jerk the other day. and come and run your clinic because your first choice turned you down? yeah. so i'm offering you the job. okay. great. no, i'll think about it. good night, michael.

(door closes) (elevator bell dings) rita? it's late. what are you doing here? since when do i have a life? handball with bax at 8:00 tomorrow morning. a spina bifida repair at 10:30. then lunch with your investors. usual time and place? yeah. how's carol? no change. she's still unconscious. night, michael. not yet. (sighs)

welcome back. captioning sponsored by cbs captioned by media access group at wgbh access.wgbh.org c'mon, michael! get in the game! [ male announcer ] don't have the hops for hoops with your buddies? lost your appetite for romance? and your mood is on its way down. you might not just be getting older. you might have a treatable condition called low testosterone or low t. millions of men, forty-five or older, may have low t. so talk to your doctor about low t. hey, michael! [ male announcer ] and step out of the shadows. hi! how are you? [ male announcer ] learn more at isitlowt.com. [ laughs ] hey!

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