When you are born special -- when your very existence radicalizes and challenges the grotesque male/female dynamic on which our entire society is and has always been based -- you have two choices: You can roam through your life constantly educating people to ignore that fact, telling them what they're allowed to think and say, or you can accept and take possession of the fact that you are extraordinary.
Eleanor comes out to speak to Harvey, inviting him to her office -- "blocking the hallway," she explains, "Not that it matters" -- but he doesn't want to go anywhere, given that they've had 26 years of close contact so far. She takes him into the trauma room, explaining the patient's respiratory failure, and Harvey finds another nit to pick. (And again, I do totally buy it based on the strength of the performance, but it's still really hard to sit still for all this business.) "My stomach got a little... When you called him patient. How about he's Markus, until he's not?" Take it up with the AMA, sweetheart, puppydog eyes or otherwise. (Harvey looks exactly the same as he did twenty years ago, it's amazing.)
Anyway, Eleanor explains that Markus's heart wants to fail, but his defibrillator won't let it. She wants him to talk to a cardio, a Dr. Hayes, who "may or may not" bring up the idea of deactivating it. Harvey assumes Hayes is a man, which just makes the whole ACT UP thing in this episode even more confusing when both Eleanor and Jackie immediately correct him, because how do you every get anything done when you're fighting about assumptions instead of changing them? Markus isn't in pain, they confirm, and he mourns: "He has more brains asleep than Einstein had awake. For the record."