3 Lbs. (2006) s01e01 Episode Script

Mommy? Here, keep it.
- Dr.
Seger? - Yeah.
I'm Melania Ortiz.
Melania, in person.
Jonathan.
I can't thank you enough for all your help with the move.
Dr.
Hanson asked me to come meet you.
You're late.
Wow.
This is a beautiful hospital.
This is an old hospital with groaning pipes and cracking tiles and ghosts in the attic.
Would have shut down a long time ago, if it weren't for Dr.
Hanson.
The Neuro Wing keeps this place alive.
Working here is all I've thought about since I became a surgeon.
When I had my interview with Dr.
Hanson, I had no idea the position would come up so soon.
Yeah, the turnover here is fairly high.
I know how lucky I am to be here.
This is the most competitive surgical fellowship in the country.
Luck had nothing to do with it, Doctor.
Welcome to Hanson Neuro.
He's expecting you for a patient consult in his office.
They're about to start.
Right now? I haven't even unpacked my things.
Why don't you leave 'em in the box, see how it goes.
The scans show a well-differentiated astrocytoma.
We were playing a concert.
She was fine.
I can't lose my daughter, Dr.
Hanson.
Not Cassie.
Uh, Melania said to come in.
Is that Cassie? No, this row here is your daughter.
The others are other patients.
It's like a week at a glance.
So the question is whether this tumor is infiltrating eloquent cortex.
Uh, that's the part of the brain that controls movement, language, perception.
Stretched out, the eloquent cortex is about the size of a bathroom rug.
It's the only thing that separates us from the crocodiles.
- Your daughter's right-handed? - Yes, she is.
I-I I should break this down.
- What did you just say? Astro? - Astrocytoma.
I need a pen.
Dr.
Hanson's asking you about Cassie's hand because right-handed people will usually have their language areas in their left temporal lobe, where her tumor is.
- Who are you? - This is Dr.
Seger, my new Fellow.
I'll be assisting Dr.
Hanson, here on the Neuro wing.
Hey, Lani, I need you free up a block on the O.
R.
this afternoon for an awake craniotomy, left temporal.
O.
R.
One is booked.
I'll figure it out.
Cassie Mack.
Okay, we'll map the language centers first, and then, um, we'll go back in and take out the tumor, okay? Okay.
Tu? Did he just leave? Your daughter has a very good chance of recovery, Mrs.
Mack.
Dr.
Hanson's the best there is.
Is that your new job? I've been a practicing brain surgeon for several years.
No, is it your new job to tell people how great he is after he takes off? At first, it was just an annoyance.
I'd forget where I parked my car, Doctor.
Tell me when you stop feeling this.
Now.
But it's gotten much worse lately.
Now.
I'll get confused going somewhere new.
Even reading maps is difficult.
You know, this seems kind of old-fashioned to me.
I don't know, I just expected something more high-tech from a brain surgeon.
I'm a neurologist.
We like to try and solve all your problems without actually exposing the brain.
Smell this.
C hristmas.
Peppermint.
Can you tell me what smelling peppermint has to do with me getting lost all the time? Well, lucky for you, nothing.
Follow the light.
If you smelled sewage or turpentine we might have had a problem.
Do you do all your exams barefoot? Eyes closed now.
Tell me what's in your hand.
A rubber ball.
We have as many nerves in our feet as we do in our hands or lips, but we box them up all day.
I think neurologists, of all people, should go barefoot.
All right, no peeking.
Oh, you remind me of my ex.
She hated rules, too.
Is this a pair of eyeglasses? Oh, I don't like random ones.
One more.
This is a cigar.
You have some mild astereognosis.
Together with the disorientation, we should probably get some scans.
Hey, I didn't know if you wanted to take a moment to go over your expectations for me.
This is a tricky little astrocytoma.
Uh, Mrs.
Mack's pretty shaken up.
I reassured her this surgery was just to map her daughter's cortex, but I think she'd like to hear it from you again, before we start.
Yeah, I'll have Lani give her a call.
Right, well, you know, it's my experience that the emotional state of the family can impact the physiological resilience of the patient.
Yeah, I've also found taking the tumor out of the patient's skull is fairly effective, as well.
Doug Hanson! Who's that? You in here? Oh, hi, Penny.
How are you? Meet my new Fellow, Jonathan Seger.
What happened to Zellman? I don't know.
Penny's a stewardess for Air France.
Screw you.
This is the sales uniform.
We have to wear it.
- Who was Zellman? - You have his locker.
Hey, Penny, if you're pushing pills, you're outta luck.
You're gonna have to leave your samples with Melania.
I am not repping pharmaceuticals anymore.
I sell doctor toys for Ulysses.
The Swiss company? Respirators? Next-generation-image processors.
I'm setting up a demo on the floor.
You look great.
Thanks, but we don't need any new toys.
How about surgical robots? We make those, too.
told you I have surgical robots.
They're called "interns.
" But interns make mistakes and they don't have four arms.
Think about the imager, Doug.
The hospital will take it seriously, - if you're interested.
- Yeah, but I'm not.
It's nice to see you, though.
Bye, new guy.
What do you think? Will we all be replaced by surgical robots someday? I don't know.
When a robot can't decide what it wants for lunch or flips off another robot for not letting it merge into traffic, that will be real artificial intelligence.
It'll never happen.
The brain's too mysterious.
Don't you think? It's wires in a box.
How long are you staying here? A week.
Visiting my son.
He's busy with work, so I figured I'd see a doctor about this.
What's his name? Your son? Otis.
My dad fixed elevators.
I helped him out every summer till I went away to school.
Otis's mom never knew where I got the name until we were riding on the elevator down to the maternity ward.
He's a lawyer like me.
They work him like a dog.
Your father must have been very proud.
He was.
And I still miss those summers.
Does this hurt? No, it's loud.
Just scoot down.
Is this gonna be bad? When I opened my eyes this morning, the alarm clock read 9:11.
Bad omen.
I know you're going to find something terrible in there.
That's the beauty of being human.
There's not another species for a billion miles that can make itself scared.
We think too much.
She's back.
You might still feel a little groggy from the general, Cassie, but I'm gonna show you some flash cards now, and I want you to name what you see.
Dr.
Hanson will be using a small electric probe to see where the language areas on your cerebral cortex are.
Uh, don't you, like, have to open my head up first? We're way ahead of you, dear.
All right, let's go.
Um, an umbrella? Next.
A tree.
Good.
A b b A book.
Mark it.
That's language.
Next.
Arterio-Venous Malformation.
That's where Mr.
Wills is getting lost.
What's wrong? Nothing.
Lilacs.
Sometimes the probe can trigger a sense memory.
Did you smell lilacs? We had these bushes outside, by our old house.
Jenna and I used to call it our oasis.
I could smell the flowers, and the wood shingles drying in the sun.
It was morning.
Do you think you could do that again? Doug? Let's keep going.
We have to keep going.
It's It's best if we don't go back.
It's a suitcase.
Who's Jenna? My twin sister.
She was killed in a car accident last year.
She died in surgery.
That's how come my mom is so freaked out.
That's a heart.
- Oh, sorry.
- No Uh, good morning.
- I'm Jonathan Seger.
- Adrianne Holland.
Neurology.
Were you meditating when I came in? Uh, this girl's got a mass right on top of Wernicke's area.
She could lose her language.
I've got a guy who's convinced he was gonna have a bad day because his alarm clock said 9:11 when he woke up.
Turns out he's got an AVM.
Maybe the clock was right.
Is Hanson gonna operate? He'll be supervising Dr.
Coffey.
You'll be there.
You're Hanson's shadow now.
When I look at these I don't know, I feel like I'm looking at an undiscovered country.
There is nothing I love more.
Except, except darkness.
I-I love darkness.
Yeah, the hospital power's being upgraded.
It's a bit flukey.
You were meditating.
Yeah, I-I do it before surgery.
Acknowledge the stress and let it pass through me.
Doug hates all that sort of touchy-feely stuff.
How do you have the time to meditate? Oh, well, if I'm on the run, I'll just be still, put my hand on my heart and breathe for 30 seconds.
That is such a doofus thing to do.
Yeah.
Well, Vicky, Vicky thinks, thinks that, too.
- Vicky's your wife? - Girlfriend.
I-I'm trying to convince her to move out from L.
A.
And just like that, the sexual tension is gone.
Not completely.
I have been waiting for 45 minutes.
No, it can't wait.
This is important.
Sir, everyone who walks through those doors has something important.
Are you are having a medical emergency? What is this place? We're a neurological clinic.
The car rental people gave me this address.
- The car had a GPS.
- Okay, breathe.
- Tell me your name.
- Otis.
Otis Wills.
My dad is Jim Wills.
His car is in your lot, and he's been missing since last night.
- Thanks.
- Sure.
Excuse me, Dr.
Seger? I'm Jerry Cole.
I run Radiation-Oncology here at St.
Abigail.
Of course.
Jonathan.
I'm Hanson's new fellow.
Yes, I know.
The sorcerer's new apprentice.
Cassie Mack is a difficult case.
I did all her scans when they brought her in.
Yeah, they should be prepping her for surgery right now.
I'd mentioned to the mother that Gamma Knife therapy might be an option.
I did some Gamma training with Grady in L.
A.
It can do amazing things.
It's a miracle technology.
Brain surgery with a beam of radio energy.
Bloodless, painless.
Patient's in and out in a few hours.
My practice is the fastest growing on the East Coast.
It might be right for Cassie, and I'd still trust Doug to get in there and eyeball the tissue, but I'm a surgeon.
It's my job to say that.
How's it going with "Dr.
Handsome"? Fine.
He's a tough nut.
Where are you going exactly? I'm still figuring this place out.
Do you think, in this business, you have to have some glaring personality defect to be taken seriously as a genius? His own kids don't talk to him, all right? I heard he literally drove his ex-wife crazy.
Dr.
Seger? Dr.
Flores is looking for you.
Jonathan, the only thing Hanson can teach you is to be exactly like him.
Is it bad? It's a small tangle of arteries and veins in the white matter of his brain.
He's probably had it since birth.
So it has to come out? The risk of hemorrhage is high.
He's scheduled for surgery tomorrow.
He could be anywhere.
He could be depressed, alone, lost.
Without his car, he can't have gone far.
How can you give people news like that and then just send them out the front door, huh? Otis.
Where's my dad? They just woke her up to prep her for surgery.
She was disoriented.
Any headaches, more seizures? She can't talk.
I I I I I I I I I I I I I I I I I I I Sedate her.
Ativan.
One milligram I.
V.
What's going on? What did you do? I wonder what it's like not to be able to speak.
You know when you forget your high school P.
E.
teacher's name and you just can't fall asleep till you remember it? Yeah, except she's got that for every word.
Skulls should come with a warning label: "Removing this bone will change you forever.
" Take it easy.
Dr.
Cole.
I came when I heard about the aphasia.
Is it global? Expressive.
She can't speak or write.
Onset was acute.
Her mother's convinced we did something yesterday, but all we did was probe the surface.
It's probably transient.
Some sort of focal brain seizure.
Yeah, she doesn't want to hear "probably" right now.
She lost the girl's twin on an E.
R.
table last year.
She's waiting to talk to Hanson.
Want me to talk to her? She really wants Doug.
I can reassure her, you know.
Every minute she sits there, she's just imagining the worst.
Okay.
But tell her Hanson's on the way.
I'll use my most reassuring doctor's voice.
Dad! Dad? Dad.
Good guess.
When I left your office, I just started walking up the stairs.
I figured someone who's scared of being lost probably woun't leave the building.
If I close my eyes up here, I'm 15 again.
I know about your surgery.
You're going to be okay.
I don't know.
I got a bad feeling about this.
- If I die - Dad! If I die, Otis, you're going to have a moment in time where everything important in life rises to the top.
You gotta grab that moment.
It's the only chance you'll get.
You may live.
She's very encouraging, isn't she? Fear is the brain's magic trick, and you can choose to believe it or not.
Come on.
Let's get you to surgery.
What's Cole doing in there? He did Cassie's scans.
They're talking.
And that was your idea? I changed my mind.
I'm going to go with the Gamma Knife.
But we already discussed radio surgery and agreed that it might not be the best choice for Cassie.
Yes, I guess that was back when she could discuss things.
No, I understand, but changing therapies this late in the game Actually, the language mapping you performed will be invaluable to us in Gamma therapy.
Looks like she's made up her mind, Dr.
Seger.
My daughter came in here with seizures and now she can't speak or write.
You did something.
And Dr.
Cole explained to you the risks of radio surgery.
Intracranial swelling, radiation injury, and it could be weeks or even months before you even know the outcome.
The tumor is perfectly positioned for me to burn it out.
Aren't you afraid of missing abnormal cells? With all due respect, there's nobody in this city better at reading brain scans.
I don't miss anything.
I think we need to stress the benefits of each treatment here, not the risks.
Yes, and as we discussed earlier, Dr.
Seger agreed that I might have the better solution.
Excuse me, I said both options are viable.
I didn't take a side.
I was just laying out the There he goes, walking away.
Your daughter has lost her language because she has a very aggressive tumor.
Every minute that you hesitate, it invades healthy cells.
You need to let me operate.
You act as if this is some sort of exact science, but you don't know what you did.
You opened up her head with a saw and you poked around.
It's primitive, is what it is.
No more surgeries.
I want the Gamma Knife.
I thought you said you weren't interested.
Why don't you give me your pitch.
Okay.
Medically, the advantages to investing in Ulysses are obvious: foremost, the fact that I could add a deck to my house and eat my sad frozen dinners alone in the sunshine.
Want to take it for a test-drive? You want to scan yourself? Yeah.
Come on.
Quick.
Okay.
Why don't you type in "Anonymous.
" You are one of a kind, Doug.
"I am what I am.
" Was that Descartes? No, Popeye.
See ya.
I didn't realize Cole was going to be so aggressive.
All I said was, Gamma was an option.
Who's "Anonymous"? That's the default when it's loaded from another system.
It's a colleague's patient.
What do you make of these? Presenting symptoms? Visual hallucinations.
Auras? Flashes? Yeah, getting more complex.
Like what? Flying elephants? I thought you were good at this.
My hunch is something's off.
I'd run an angiogram.
FMRI.
I don't run tests without evidence.
Okay, you want the neurological correlates of a hunch? My eyes see something wrong with this scan, ahead of my brain.
- I'm good at it.
- Are you? We do things differently, Doug.
That's the first useful thing you've said since you got here.
Oh come on, mother brings her daughter in.
We pop the top, check the oil and the engine drops out? Coincidence or not, I might change mechanics, too.
Gamma therapy's effective.
I am effective.
The Gamma Knife is a tool.
And Cole is a glorified technician.
Besides, he would do anything to steal a patient.
You think this is personal? Of course it is.
He's been envious of my success for ten years.
Now he thinks his new toy of his puts him in my league.
What if he's right? You got played, Jonathan.
Or maybe I'm the only one who didn't let his ego get in the way.
- What ego? - I'm sorry? What ego? I have yet to see one.
Do you know what "ego" means? Self-- it's what opens our eyes in the morning.
It's the thing that allows us to have an effect on the world.
Our loved ones don't like it, but it saves lives.
Do you even know her name, Doug? Do you know that brain you touched is a brilliant musician? Do you know that her string quartet plays as a trio with an empty chair since her sister was killed? - And those details help you? - Yeah, these details help me.
Then you're as dangerous as you are naive.
Then I should go take polyps off colons, because I can't screw around in somebody's head and not know whose soul I'm bumping up against.
Then go.
Melania? Oh, I'm sorry.
I didn't know anybody was in here.
Dr.
Hanson? Yes.
Oh, my gosh.
I thought you sounded kind of manly.
Lucy Canet.
Do you remember me? Hemangiopericytoma.
Salud.
I'm here for my six month post-op.
This is Ruby.
Makes me sound shallow, but she's the best thing about going blind.
Hello, Ruby.
Lay down.
So, uh, no improvement, huh? Not really.
I had hoped your optic nerve would recover.
Do you mind? I'm forgetting what things look like.
Oh, no, no.
That's perfectly normal.
Your, uh your visual cortex is starting to, uh reorganize to process your other senses-- particularly touch.
I'm sorry about your sight.
That was the cancer.
Thank God you saved the part that can bitch about it.
Ooh, you should smile more often.
I'll try.
Why aren't you assisting with Wills' AVM surgery? AVM's not really my specialty.
How about lying.
Is that your specialty? Hanson's punishing me or testing me.
- What do you think? - I don't know-- what do you call it when a cat bats around a crumpled-up piece of paper? Thanks.
He thinks I screwed up by letting Dr.
Cole talk to Cassie's mother.
Is that some traditional way to eat those? They forgot to put in a fork and I'm too lazy to go and get one.
I'm pretty sure Dr.
Cole is evil.
Who told you that? Hanson, probably.
Look, Doug sees the world as a purely logical place.
The brain is wires in a box, all questions have answers, and he knows if he can save someone's life or he can't.
There's no gray area.
He's like Spock, you know if a girl designed the outside.
Do you and Doug have a history? Not the one you imagine.
Meditate on that.
The thing about our Creator even when He ties the veins in your head into an angry knot, it's beautiful.
Don't mess with the output until all the feeders are done.
Fine.
- But back to God - Oh, no.
Not today, Angus.
Doug, this could easily take another three hours.
Surely we can settle the question.
Intern-- God or no God? I suppose I can't rule Him out.
Then why am I fixing His mistakes? Cancer's alive, too.
How do you know we're not the disease? Touche for the nobody.
Flores, actually.
I think we'll call you nobody.
Mrs.
Mack.
How's Cassie? I wish I had her drugs.
Dr.
Cole's going to start the treatments tomorrow.
I know Dr.
Hanson is brilliant, but the surgery Cassie's sister Jenna had the best, too, and she bled out on the table.
They were so close.
Cassie's not Jenna, Mrs.
Mack.
I still miss her every day.
I know.
And with everything that Hanson's going through, personally Personally? Dr.
Cole explained it all to me.
Thank you, Dr.
Seger.
Hi.
Look, I know you're scared of losing Cassie like you lost Jenna, but if you can believe, for a moment, that it wasn't Hanson's fault that Cassie stopped speaking, then you gotta see it was the tumor.
That's the enemy.
Give us a minute.
I don't know what Dr.
Cole told you about Hanson, but it doesn't matter.
The Gamma Knife is an incredible piece of machinery, but the most advanced equipment in this hospital is Doug's judgment.
He doesn't hold your hand-- he doesn't know how, but there is not another mind on this planet I would want focused on saving my daughter's life.
How's Mr.
Wills? Yeah, good.
The surgery went well.
I heard Jonathan wasn't invited.
Well, it was probably a mistake hiring him.
I think he's gifted.
I think he should be teaching medical ethics at Columbia and confessing his affairs with his graduate students to his wife or his girlfriend or whatever.
He would, too.
It's too bad.
He looked so good on paper.
You know how female praying mantises will often eat male praying mantises when they mate.
That's why I have cable.
Well, most of the time, they do it right before the sex.
Now, you'd think as far as evolution goes, that'd be kind of retarded.
But it would spare you the awkward chitchat afterward.
This is the beautiful thing.
Yes? It turns out the boys perform better without their heads.
- Hey.
- Hey.
Hi.
We were just talking about you.
You were right about Cole.
He's spreading rumors to steal your patients.
Yes, I know.
But I've moved on.
I have acknowledged the stress and let it pass through me.
Walk with me, Doctor.
Is this a school? You know when you told me that you'd rather take polyps off of colons than operate on a patient that you don't know? Yeah? Were you just making that up? I mean, did you just come up with that? Because it's very dramatic.
Listen, Doug, I feel like we've gotten off on the wrong foot.
I'll be back in a minute.
Keep the car moving.
Otherwise, the moms in line get very upset.
Doug? Doug? Excuse me! You can't just leave your car there! Who are you? I'm Jonathan.
Are you Doug's daughter? Tell me he didn't hire a driver.
No, no, no, I'm What's your name? Is my phone up here? Could be worse.
He could be hitting on a teacher.
I don't think that's what he's doing.
My friend Geordie, he says sex is like gravity.
He's more likely to fly than to stop thinking about it.
I don't I don't know.
Uh, Doug! Dad said he cheated on Mom because the love was gone.
I'm pretty sure it's just 'cause he couldn't fly.
Wh-Why are you telling me this? If you're gonna drive me every day, it's gotta come up eventually.
I'm not your dad's driver; I'm a doctor.
Oh Then why are you driving him around? What are you doing? - Dad - Yeah? Joey Cole's mom is married.
Cole? As in Jerry Cole? Yeah, he moved out three months ago.
She caught him with a maternity nurse.
This is how you move on? You hit on his wife? I'm just saying hi to an old friend.
He can take it however he wants to take it.
This is he.
Okay, we're on our way.
Roberta and Cassie Mack want you to operate.
Good.
Hi.
Radio? Music? Oh, yeah-- no, no, no.
Hold on.
No Music's over here, okay? It's safe.
Here.
Take this.
I'll get your words back.
She can't bring that in with her.
Really? Why don't you take it up with the surgeon? See, there's some tricky attachments here by functional cortex.
I think the best way in is the natural cleavage plane here.
I see it.
There's some mass effect, too.
Yeah, but that tissue should recover.
If you're ever resecting tissue in my temporal lobe, do me a favor-- burn out junior high.
Wouldn't that be great? Yeah, you can take most of high school, too.
Just leave the part where Carmen Ramirez got drunk and made out with me by mistake.
You're sucking air.
I'm hearing bubbles in the heart.
It's an air embolus.
Damn it.
All right, put her in the Trendelenberg.
Let's go.
Let's irrigate her.
Internal CO2's plummeting.
Flush the central line.
BP's crashing.
There's still air in the central line.
- Aw, damn! - She's bradying down.
- Calm down.
Calm down.
- She's in the 30s.
She's arresting.
V-fib.
Do it, Seger.
Charge it to 200.
She squeezed my hand about an hour ago and she's been mumbling obscenities.
That's actually a very common way to regain consciousness.
The more obscene the better.
Good.
I'd like to thank Dr.
Hanson.
I'll make sure he knows.
Is it true you almost lost her? She was gone for a moment.
Johnny got her back.
Cassie's a survivor.
Her language areas were being compressed by the glioma.
Once the swelling goes down, she can expect real improvement.
You make it sound so simple.
Wires in a box.
Did you write this? That's Cassie's handwriting.
What's it say? "Jenna says hi.
" How'd it go? Why couldn't you give those to Cole yourself? Because he'd never do me the favor.
He does his best work when he thinks he's stealing one of my patients.
He saw something weird.
Said he wants to see my friend to run more tests.
Is something wrong, Doug? Yes.
It looks like we won't be buying your fancy new scanner.
That was a test? You just can't help messing with people's heads, can you? It's my job.
Want to get a drink? Sure, why not? Life is short.