Medical Investigation (2004) s01e02 Episode Script

Townsend Residence St.
Louis, Missouri Get moving, Marisol.
You're going to be late.
Honey? Marisol, what are you doing up there? Marisol! Baby! Come on.
Female, 14 years old.
Seizure? / Yeah.
How'd you guess? I'll take this one.
Where are we going? Intensive care.
Come on.
Paul? / Sylvia? You know these girls? They're my daughter's best friends.
My landlady, Mrs.
Widmann, lives on the top floor of my building.
Nice enough woman, never raised the rent too high.
Breathe for me.
She's a big gardener.
Spends her days working there, on her hands and knees.
Breathe again.
I've lived in the building nine years now.
Never really noticed it until recently, but there's this stand of roses.
I just saw her on the way over here a few minutes ago and she said that they'll start to bud any day now.
What do you think the chances are, Dr.
Durant, that I'll see them bloom? I think you have a very good chance.
I don't understand you, Barrett.
You've been in this clinical trial, under my care, for almost two years, twice a week, like clockwork and you still won't call me Natalie.
I'll make you a deal.
If you can get me to spring, I'll start to call you by your first name, Dr.
Durant.
It's a deal.
I'll see you in a couple weeks, okay? Thanks, doc.
- You got the page? - Just got it.
How's the Von recklinghausen trial going? I should make T-shirts that say, "taking part in a clinical trial with us can be hazardous to your mental health.
" Yours or theirs? Hey.
Barrett again? Look, Nat, you're making progress on this.
You're doing good work.
Don't tell me I'm doing good work, Stephen.
He's not getting better.
I, I just got a page and all it says is 555.
The fives stand for "S", as in triple "S.
" Syndromic surveillance system.
Oh, yeah.
The what? Just follow us.
A new spike.
St.
Louis, Missouri.
Four teenage girls all went down this morning and were in comas by the time they reached Olson medical center.
There's a lot of smart people at Olson.
Maybe we should wait and see how this develops.
These doctors asked for our help.
How much more do we know? Attempted suicide has been ruled out.
And they're all best friends.
Best friends as a commonality? That's new.
From how it sounds, if we wait, these girls could die.
We go.
Is that ours? Don't get used to it.
Helping people comes with perks.
How did you manage to score? The navy was about to take it out to the Mojave and let it rust for the next 50 years.
Instead, they agree to keep her in operation for various government agencis including the NIH.
We get to use it once in blue moon.
Enjoy it.
It might be our last ride for a while.
Wait till you see the inside.
I've been in touch with Olson med.
All four girls complained of the same mild symptoms last night.
This morning, they all seized, lost consciousness and haven't awoken.
They're all classmates at North adams middle school, apparently joined at the hip.
What's the situation at the school? Still in session.
- Do you want it shut down? - Not yet, but it's an option.
Doctors have told the parents that we're en route and will be taking point upon arrival.
No need to worry about the sled, Miles.
She's solid.
Flew hundreds of sorties during the Vietnam war without a hitch.
All right, cool.
Wait, which war? Olson Medical Center St.
Louis, Missori Dilated.
It's no wonder.
Someone gave them drops.
They've stabilized B.
P.
with a dopamine drip.
It was the right call, but it's just a band-aid.
If we don't find the causative agent, these girls are going to sink deeper into coma.
What's the differential diagnosis? Take your pick.
Brain abscess, subdural hematoma, embolic disease, traumatic hemorrhage, tumor These pictures look clean to me.
Nothing leapt out in the blood work.
Poor oxygenation in the brain? Cardiovascular collapse brought on by anaphylactic shock? Hypoglycemia, encephalitis, meningitis? Maybe.
Could be exposure to carbon tetrachloride from sniffing cleaning fluids, arsenic, cyanide, psychotropic drugs? It could be rooted in the liver or the kidneys.
Or none of the above.
Glad you took this case? Couldn't be happier.
Wow, these girls are rail thin.
Starving themselves until they look like barbie.
I'll check their spinal fluid glucose level and white blood cell count.
To make this diagnosis, we have to learn more about these girls.
I'll talk to the parents.
You want to know about the private life of a 14 year old girl, Parents are the last people you talk to.
Our presence here in no way indicates a lack of confidence in the care at this hospital.
We're here only to consult.
What do you know about our girls? You'll be briefed as soon as possible.
Did your daughter mention feeling at all ill? Nothing unusual.
Uh, she had a headache and cramps.
I thought she was just getting her period.
Has Marisol been out of the country recently? Please, I've answered these questions.
I'll be right back.
What's this? They've already taken all of this information and it's led nowhere.
That's why we're here.
Our answers lie in the margins.
It's as much as what they aren't saying as what they are, okay? I'd like you to meet Dr.
Stephen connor.
Dr.
Connor, these are the Kendalls, the Sipes, the Whitesides, and Sylvia townsend.
This must be extremely difficult for you.
Please know that we're doing everything in our powers to make your girls well.
But right now we need to know everything you can tell us about their lives, including any risky behaviors.
Such as? Sexual activity, drug use Are you serious? They're children, doctor.
I have three daughters myself.
You all are living my worst nightmare.
But we're here to help.
The more information we learn about your daughters, the sooner we can find a way to save them.
What do you need? For starters, please allow Mr.
Powell access to your homes and your daughters' rooms.
Of course.
Thank you.
Dr.
Mccabe? Excuse me.
Head to their school.
I need you to find out where and what these girls eat, drink, smoke, everything.
Okay, um how am I supposed to gain the trust of a 14 year old? Eva, go with Miles.
North Adams Middle School Excuse me.
Can't you just tell me how they are? We're doing everything we can.
What's your name? Ruby, Ruby willens.
Let me guess.
Age 14.
Height five-six.
weight 105.
102, actually.
Are you okay? Yeah.
Yeah, it's just allergies.
What's wrong, sweetheart? You can tell me.
They're my best friends.
I was supposed to go get coffee with them after school, but I didn't because I was mad at Tamra, because she said she lost my jojo cd and I didn't believe her.
And now her, Marisol, Deena and Ariel are in the hospital and I'm not.
I should be there, too.
If you ever want to talk, I'm here for you, okay? It's my job, really.
Can I talk to him? Thanks.
Sure.
What do we do? Sometimes we get taken to high school parties, but mostly we just shop, study, hang out at the mall, look for boys.
The suburbs suck.
Yeah, I grew up in the suburbs outside San francisco.
You ever been? I've been to Disney world.
You guys don't do drugs, do you? The only drug we do is caffeine.
And what about dating? What about it? Are you seeing anyone? Are any of the others? None of us have any boyfriends, if that's what you mean.
The guys here, not cool.
Come on, you must be interested in one of the guys at least.
Maybe.
You seem too cool to be a doctor.
I'll take that as a compliment.
This wasn't an accident.
I know who tried to hurt us.
Who do you think? The pest.
The pest? That's kind of harsh.
It's because her dad's a bug exterminator.
Charlotte raymond is her name.
She totally hates us.
Why? Come on.
I mean, look at her.
Stephen what do you got? You won't believe it.
We believe your daughters have encephalitis.
I'm sorry.
Exactly what is encephalitis? In Layman's terms, it's the inflammation of the brain.
It's heard to be caused by viruses.
It can be brought on by any number of viruses.
In this case, it's herpes encephalitis.
Did you just say herpes? That's not possible.
Why are you wasting your time on this? How the hell did our kids get herpes? Type one herpes causes cold sores and lays dormant in most people.
Type two is sexually transmitted.
When either becomes activated it can travel to the brain.
What type do they have? They have type two.
There must be some mistake.
We just did a test called a western blot which confirmed it was type two herpes.
Herpes plus coma usually equals encephalitis.
How confident are you that that's what it is, encephalitis? The only way to be sure if the virus is in the brain is to do a biopsy.
A brain biopsy? We would need to take a very small sample.
It's a routine procedure, but we're going to need your permission.
Although it's rare, neural and cognitive damage are always possible when you operate on the brain.
Brain damage.
/ The risk of not performing this is much greater.
Now, I understand your concerns, but the more time we wait No.
You doctors are not going to open up our daughter's head on some damn hypothesis.
No.
Let's go.
This is a nightmare being back at school.
I like your jacket.
I have one kind of like that.
Did you get yours on sale? Yeah.
How much? Like $49, I think.
Lucky.
I paid $60.
It pays to read the paper every day for the sales.
I ate lunch by myself every day when I was your age.
You? No way.
The queen bees at my school ruled the place.
Believe me, nobody compares to our spoiled princesses.
I'd spend all day plotting ways of getting back at them.
Me, too.
I've thought of a hundred ways.
What ways? Like ways.
But it's probably too dangerous.
I know they make your life hell, Charlotte.
Why are you asking me these questions, and how did you know my name? Because I understand why you might want to get revenge for how mean they are to you.
I admit it.
I hate their guts.
Who cares? Everybody hates everybody.
But it doesn't mean I'd want to hurt them.
Whiteside Residence St.
Louis, Missouri What do you got? I went to all four of their homes, but I knew I was on to something after the second one.
All right.
/ You see that? Same titles, same order.
Exact same music.
same toiletries.
- Same.
- So what's your point? These girls are living identical lives.
Queen bee does something, the others follow.
That's it? No drugs, no contraceptives, no journal entries that might point us in the right direction? All that you have is that they're like-minded consumers? The answer's in their habits, their hobbies, their tastes.
Frank, I need something concrete and I need it now.
These girls' lives are hanging by a thread.
I know that.
You're the one that sent me to find the commonalties, and I found them.
Check their makeup, their shampoo, their hygiene products.
See if they've introduced anything new into their bloodstreams.
- Look, what's gotten? - Just do your job.
Doing what you do, you must see such cruel suffering.
How can you stand it? It's hard.
Knowing I've done everything I could in some places, it just doesn't mean much.
I lost my husband a lot like this.
In what way? Without any warning.
We went to bed one night, we kissed good night and he didn't wake up.
I can still see his the silhouette of his face in the dark.
I've invested all of myself in Marisol, made my whole world about her.
I've done everything I can to get close to her.
I've listened to the same music, which believe me, wasn't easy.
I bought some of the same clothes.
I even slogged my way through pre-algebra right along with her.
I thought the closer, I got the more I could protect her.
Sylvia I've seen some people who stepped off a curb or rounded a corner, or did nothing at all, and found death waiting for them.
I feel so helpless when someone's taken like that.
But this is different.
We can help them, but we need all the information to do so.
Okay.
I trust you.
I'll consent to the biopsy.
Thank you.
She's in V-fib.
One cc of epinephrine and give me the paddles.
Give me the paddles! Clear? / Clear! Open up the I.
V all the way.
What happened? Let me in there.
Move aside.
We're losing her.
Paddles! Move it out! All right.
Clear?/ Clear! - No rhythm.
- Come on.
Take a look at this.
Ready? Clear! Here we go.
One more time.
Everybody get ready! And clear? / Clear! Come on, Tamra.
Clear! We won't need to perform the biopsy on Marisol.
Tamra's autopsy will tell us what we need to know.
Is this herpes encephalitis? Is it glowing green? No.
Nothing.
Damn it.
What are we missing? These girls have herpes, but the virus isn't in the brain.
If their comas aren't caused by herpes encephalitis, then what is it? Their parents are so in the dark about their sexual activities.
what else are they in the dark about? If you're thinking drugs, tox screen already came back negative.
I expanded it to include gas huffing, nitrous, all the way down the line.
- What about chemicals? - What kind? Poison.
We learned about a girl named Charlotte raymond who has a lifelong grudge against the victims.
It's high school.
I mean, you're nothing unless somebody has a grudge against you.
Actually, it's middle school, and this particular girl's father is the owner and proprietor of Don raymond pest control.
Wait a minute, rat poison and some pesticides could manifest this way.
I'll check for phosphates in the blood.
I spoke to the girl.
she has a healthy amount of bitterness built up, but I doubt she did it.
Are you sure? I can read people better than anyone.
She didn't do it.
Maybe the father got tired of watching his little girl get tormented on a daily basis.
You know what? I'm going to have a little chat with Mr.
Raymond.
I just don't think we can rule her out.
Clear for truma three.
Let's go! Ruby? What happened? She collapsed outside her school.
Well, sir, we need a list of the chemicals that you have on site and your suppliers.
There's a truckers' strike going on.
I take whatever supplies I can get my hands on.
This some kind of new inspection? A few of your daughter's classmates are sick.
We believe they may have been poisoned by a pesticide.
Charlotte's friends are sick? Sorry to hear that.
So, how'd I get dragged into this? What do you want my chemicals for? Well, from what I understand, charlotte was seriously at odds with the girls who are sick.
Those spoiled princesses.
They'll turn out fine.
Their kind always do.
What was that you called them? Spoiled.
Princesses.
And they are.
But if you're suggesting that Charlotte could hurt them, that that thought could ever even form in her mind you know, I'm inclined not to give you any information at all.
Mr.
Raymond, if I were in your shoes, I'd want to protect my daughter as well.
I'd want to speak with her, hear her side of the story, then decide on a course of action.
But we can't wait.
Look, right now, back at that hospital, parents are pleading with god not to take their children.
If the roles were reversed, I'd be asking them to help you, and I wouldn't leave until they did.
Will you help us? Thank you.
Dr.
Mccabe.
What's the matter with us? I'm not sure what's going on with those other girls, but I am certain you don't have it, Ruby.
You sound disappointed.
Your test results in no way fit their pattern.
Tell me about your allergies.
They're just, they're kind of new and just keep getting worse and worse.
What about your weight? You're almost 20 pounds underweight for your age.
Size zero.
Yeah.
Ruby, are you making yourself sick? Bulimia? Laxatives? No.
I eat like a normal person.
Ask anyone.
What are you testing? Phosphates here, anticoagulants there.
I'm measuring the time it takes for the blood to clot.
Compounds like rat poison slow the process, which is one way that they kill.
The last to arrive, Ruby, something different's going on with her.
The only symptoms she's exhibited are acute allergies.
It's not rat poison.
How's Ruby's health otherwise? Lousy.
She's flirting with anorexia, but I checked the blood nutrients, and she eats normally.
Are the allergies new? Yeah, actually they are new.
Her body's producing histamine because it's fighting a foreign presence.
Give her an ultrasound.
This is the list of pesticides Don raymond uses.
If Charlotte used any of those, we have to figure out what it is and start treatment.
Hold up on that.
Charlotte didn't use any of them.
I just got a call.
11 more cases, same symptoms.
In Kirkwood, a few counties over.
Do any fit the pattern? Only three of them are teenagers.
All the others are older and they're all strangers.
We've lost our commonality.
We've got nothing.
Mount Lennox Hospital Kirakwood, Missouri I've got two dead, nine fading fast.
Same symptoms.
All intubated, comatose.
Any links between them? Hardcore medicine, really not my thing.
Anything.
Well, it's probably nothing, but, they all weigh within five pounds of each other.
Around 160.
Their only commonality in both places is their weight.
On your end, they're heavy.
Here they're thin.
What do people with the same weight have in common? Eva, recheck their charts.
See if they have the same measurements.
- Are you serious? - Just do it.
What's in your head? Look, we may have been looking in the wrong direction.
What if this disease wasn't ingested or inhaled? - What if it was in their clothing? - Connor? - Yeah? - These charts are hard to read.
The only measurement I can see is waist size.
And? They all have a 33-inch waist.
Good work, Eva.
Our girls were in their pajamas when they were admitted.
I need you to find the clothing yours were admitted in.
What's that for? This is an ultrasound.
X-ray movie to see inside you.
I don't want the test.
I don't need the test.
Believe it or not, I actually went to med school, and you do need this.
I'm fine, I just, I just fainted or something.
I want to go home now.
Ruby, you want to tell me something? Okay, this is gonna be a little cold.
Ruby look at the monitor.
How recent is this weight loss? I don't know.
Ruby, how did you lose the weight? Did someone sell you some kind of a pill? Maybe.
Did the other girls take it as well? Just me.
I found it on the internet.
Do you know what was inside it? The package said it was a "natural antagonist.
" That's a slick way of saying "parasitic worm.
" All I know is that it worked.
I lost 25 pounds.
Marisol and those girls finally talked to me.
Before then, Charlotte was my best friend.
I can't go back to that.
Ruby, look at the screen.
No way.
Forget it.
- Look at it.
- You're a real jerk, you know that? I'm gonna give you five seconds to look towards me.
Five, four, three, two Get it out.
Get it out of me! Get it out of me! Nurse, I need a dose of praziquantel.
Right away, Doctor.
What is that? It's a pill.
It's going to kill the worm and expel it from your body.
If I take this medicine, I will gain all the weight back.
Yeah.
Here you go.
Ruby, if you don't take it, what's taking over your body will kill you.
You know, for the record, I don't get that whole waif look.
Really? Yeah.
Good.
Okay, let's see how America shops.
I got two skirts, three sweats, one kinky pair of leather pants, and a pair of jeans.
Of the skirts, sweats or slacks, are any of them the same label? Uh, no.
No, they're all different.
Wait a sec.
Two skirts, three sweats, a pair of leather pants, three slacks and a pair of jeans.
That's only ten.
You said there were eleven down.
Oh, got it.
Another pair of jeans.
Let's see.
Same style, same waist size.
Brand is Wattage dungarees.
Excuse me.
Do any of your girls wear Wattage dungarees? Marisol does.
They're her favorite.
My daughter wears those, too.
Where do they get them? A place called Essentials.
Your last shipment of Wattage dungarees, when did they come in? Monday morning.
I was sold out by closing.
Anything unusual about them? Stains, smells, did they look irregular in any way? Not that I could see.
How many size zeroes did you get in? One box.
30 pairs.
I was expecting more product but there's a statewide trucking strike.
Then how did you get your deliveries? We managed to reserve some space with a long-haul company out of Springfield.
It wasn't cheap.
Highest bidder got the space, it didn't matter what the product was.
Where does your delivery come in? Back alley.
Couldn't have happened on the manufacturing end, popular as they are.
There'd be thousands down all over the country.
Must have happened sometime between assembly and retail.
In transit.
What if Don raymond received his pesticide delivery from the same shipment as the jeans? What if the two shared the same cargo bay? Must have been a spill.
With the spill, every product in the truck would be contaminated.
You're right.
The cannisters were tied down.
They were secure.
Nothing tipped over.
Nothing burst.
Must have been a leak.
A very slow leak.
That's it.
The leak only came in contact with the two bottom boxes.
The size zero heading to st.
Louis, the size 14 bound for Kirkwood.
The jeans in the top of the box were never affected in st.
Louis, but by the time they got to Kirkwood which is further down the delivery route, the boxes had more time to absorb the pesticide.
That's why there were more victims in Kirkwood.
If so many pairs of jeans were sold, why did so few get sick? Maybe they never wore them or they washed them before they put them on, which diluted the pesticide.
Hey, look at this.
We found the source.
Start both clusters on atropine.
We're on our way.
Sylvia? can I talk to you? You asked how I could stand the suffering? This is how.
Let's say we make this more interesting.
Put a little something on the line.
I'm in.
What do you got in mind? I don't know.
Let's, uh, - let's try a steak dinner.
- Oh, no can do.
I'm a vegetarian.
Are you serious? Yeah.
/ I always wanted to know a vegetarian, to ask how you do it, not eating meat.
It's easy, when meat is murder.
No, meat is delicious.
Can I have a word? You know, I got to go look at something.
I ever tell you they use guinness beer to treat serious stomach ailments in Malaysia and Thailand? Yep.
Pharmrmacies got guinness on the shelves right next to penicillin.
Beer as medicine.
I could get used to that.
I shouldn't have jumped down your throat earlier.
I should've known better, trusted your judgment.
You're damn straight.
Now forget it.
You all right? Yeah, I'm fine.
Yeah, you sound it.
When's your wedding anniversary? May 6.
11 years.
What's the traditional gift for 11th anniversaries? A convertible.
Hey, talk to me.
What's going on? Today's my anniversary with Lisa.
You two should be ashamed of yourselves.
Miles isn't making much more than minimum wage, and you were about to take advantage of that young man.
How's that your business? Because I'm going to take his money.
Deal me in.
/ Man, it's no fair playing with you.
I know.
Even I can't tell when I'm bluffing.
Natalie, I'm dealing you in.
Any stakes on this baby? I say paid vacation, margaritas and